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HomeMy WebLinkAbout06-05-13 1505610143 REV-'1500 OFFICIAL USE ONLY Department of Revenue Pennsylvania Gc my Ccac n:er rae r+unx, Bureau of Individual Taxes PO BOX,280601 INHERITANCE TAX RETURN 21 Harrisburg, PA 17128-0601 RESIDENT DECEDENT c.y ENTER DECEDENT INFORMATION BELOW 03 05 2013 OB 26 2017 Decedent's Lost Name Suffix Decedent's First Name MI BARKDOLL LUCILLE E (if Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name ?Al Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW X 1, Original Return 7 Supplemental Return 3, Remi mder Rclum(Date of Death ' Prior to 1213.82) A. Limited Estate I i mledest C.1111M.sc I da �ti 0'"' 5 Federal Estate Tax Return Required 8 DeCMenl Dlctl7esle!r: f)rcntlenl hta++lanc�a t.rvn+q Lmf - Q B Total Number of SdfC upp5i(Bakes `I WlWl Cnpy of Will) __ (Arm¢M1 CnPY na nmq TotaDeposit 9 Litigation Proceeds ReteivNl to nvu�mnP`-]t 3.n nl v'Da4 d OoatM1 I i I.E-leclion to tax under See 9113fA) (Attach Schedule O) CORRESPONDENT.THIS SECTION MUST BE COMPLETED,ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number LINDA J OLSEN ESQ 717 540 4332 c+ � REGKZ POF WILDS USES IDO c First Line of Address M D z rn 2000 LINGLESTOWN ROAD S = N K cn 0 4 Second Line of Address O n n =D -n -1f1 nT SUITE 202 c T F - C_;t` EBATE FILED' n'1 City or Post Office Slatn _ ZIP rode - - rJT � HARRISBURG PA 17110 D w _q Correspondent's e-mail address'. lolSen @haienelderlaw.Com Under penalties of perjury.I declare that I have examined this return,including accompanying schedules and statements.and to the best of my knoviledge and belret. it is t,ue.coi!;fct and template Oedaralion of propaor other than the personal represenlabve is based on all information of which prep aver has any knaMedge s,GNa1t OFPERSOaRE5 +SI Po I 0mil a DATE �e.m.�1_ Gregory L Cutler �0-,3 13 ADpness 391 N. 19th Street,Street, Camp Hill, PA 17011 BI A EOF Poll ER OhHER THAN REPRESENTATNE DATE , Linda J.Olsen Esq. (0/3�/3 C . s y r 2000 Linglestown Road,Ste 202, Harrisburg, PA Side 1 1505610143 1505610143 V '� 1505610243 REV-1500 EX RECAPITULATION 1. Real Estate(Schedule A)....................................................................................... 1. 2. Stocks and Bonds(Schedule,B).....:.._._.............:......:.......................................... . 2. . . 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C)......... 3. 4. Mortgages&Notes Receivable(Schedule D)....................'.. .',..:.................'....... 4. 5. Cash, Bank Deposits&Miscellaneous Personal Property(Schedule E)............... 5. 1 , 516 . 02 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 9 , 020 . 42 7. Inter-Vivos Transfers&Miscellaneous Probate Property (Schedule G) "'_ ' ' Separate Billing Requested............ 7. 2 , 529 . 23 8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 13 , 065 . 67 9. Funeral Expenses and Administrative Costs(Schedule H)........................._........ 9. 2 , 180 . 27 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10. 11 , 850 . 99 11. Total Deductions(total Lines 9 and 10)....... ..... ...... .................................. 11. 14 , 031 . 26 12. Net Value of Estate(Line 8 minus Line 1 1).......................................................... 12. -965 . 59 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J)............................................... 13. 14. Net Value Subject to Tax(Line 12 minus Line 13)............................................... 14. -965 . 59 TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 15 0 . 00 (a)(1.2)X.00 16. Amount of Line 14 taxable 0 . 00 16. 0 . 00 at lineal rate X .045 - - 17. Amount of Line 14 taxable at sibling rate X.12 0 . 00 .. 17. 0 . 00 18. Amount of Line 14 taxable at collateral rate X.15 0 . 00 18. 0 . 00 19. TAX DUE................................................................................................................ 19. 0 . 00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 1505610243 1505610243 J REV-1500 EX Page 3 File Number 21 Decedent's Complete Address: DECEDENT'S NAME Barkdoll, Lucille E STREETADDRESS 25 Erford Road CITY STATE ZIP Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Due(Page 2, Line 19) (1) 0.00 2. Credits/Payments - - A. Prior Payments B. Discount 0.00 Total Credits(A +B) (2) 0.00 3. Interest (3) 4, If Line 2 is greater than Line 1.+Line 3,enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2,Line 20 to request a refund 5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 0.00 Make Check Payable to REGISTER OF WILLS, AGENT. _ PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and Yes No a. retain the use or income of the property transferred;............ .......... ....... ...... ................................... f❑f11 f❑f11 b. retain the right to designate who shall use the property transferred or its income:.................................. LJ u c. retain a reversionary in or........ ........................................... ................ ......... ...........__.... x d. receive the promise for life of either payments,benefits or care?......................................................__. ❑x ❑ 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.................................................................................................................... ❑ 0 3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?....... ❑ ❑x 4. Did decedent own an individual retirement account,annuity,or other non-probate property which contains a beneficiary designation?........................................................:..........:.....:........................................ ❑ ❑x 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 July1,1954 and before Jan. 1, 1995,the tax rate imposed on the�net value of transfers to or for the use of the surviving spouse is 3 percent[72 P.S.§9116(a)(1.1)(i)]. For dates of death on or after January 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(ii)]. The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax return are still applicable-even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent,or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in [72 P.S.§9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S.§9116(a)(1.3)]. 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-0509 EX.(11-10) SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OF REVENUE INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Barkdoll, Lucille E 21 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 M&T Bank cking acct.#9856525671 1,516.02 TOTAL(Also enter on Line 5, Recapitulation) 1,516.02 (If more space is needed,additional pages of the same size) Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule E(Rev. 11-10) Rev-1609 EX+(01-10) pennsylvania SCHEDULE F DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Barkdoll, Lucille E 21 If an asset was made joint within one year of the decedent's date of death,it must be reported on schedule G. SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT A. Gregory L. Cutler 391 N. 19th St. Son Camp Hill, PA 17011 B. C. JOINTLY OWNED PROPERTY: DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM LETTER DATE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DECD'S VALUE OF NUMBER FOR JOINT MADE NUMBER OR SIMILAR IDENTIFYING NUMBER.ATTACH DEED FOR VALUE OF ASSE DECEDENT'S INTEREST TENANT JOINT JOINTLY-HELD REAL ESTATE. INTEREST 7 A 08/01/2008 Auto-2008 Toyota van (KBE Sienna) -Jt. 13,844.00 50.000% 6.922.00 2 A 01/06/2012 M&T Bank cking acct.#9856525689-Jt. 4,196.84 50.000% 2,098.42 TOTAL(Also enter on Line 6, Recapitulation) 9,020.42 (If more space is needed,additional pages of the same size) Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule F(Rev.01-10) Rev-1510 EX+(09-09) SCHEDULE G Pennsylvania INTER-VIVOS TRANSFERS AND DEPARTMENT OF REVENUE INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Barkdoil, Lucille E 21 This schedule must Ite completed and filed if the answer to any of questions t through 4 on page lnree of the REV-1500 is yes ITEM DESCRIPTION OF PROPERTY DATE OF DEATH r OF DECOS EXCLUSION TAXABLE NUMBER THE DATE NAME TANSFERsATTACH A COPYEOF THHE DEED FOR REAL ESTATE, VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE 1 Life Estate in the real property located at 391 North 2,529.23 2,529.23 19th St., Camp Hill, PA-See Schedule K,attached. i TOTAL(Also enter on Line 7. Recapitulation) 2,529.23 (If more space is needed,additional pages of the same size) Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule G(Rev.08.09) REV-1511 EX.(10-9) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE - FUNERAL EXPENSES AND RESIDENT DEC ENTTURN ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Barkdoll, Lucille E 21 Decedent's debts must be reported on Schedule 1. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached 365.27 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions . Name of Personal Representative(s) Street Address City State ZiD Year(s)Commission Paid 2. Attornev's Fees Hazen Elder Law 1,800.00 3, Family Exemption: (If decedent's address is not the same as claimant's,attach explanation) Claimant Street Address City State ZiD RelalionshiD of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 15.00 See continuation schedule(s)attached TOTAL(Also enter on line 9, Recapitulation) 2,180.27 Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev. 10-09) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Barkdoll, Lucille E 21 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Minnich Funeral Home 365.27 H-A 365.27 Other Administrative Costs 2 Register of Wills-filing fee for Inheritance tax return 15.00 H-B7 15.00 Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98) Rev-1612 EX+(12-08) SCHEDULE 1 pennsylvania DEBTS OF DECEDENT, DEPARTMENT OF REVENUE INHERITANCE TAX RETURN MORTGAGE LIABILITIES AND LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Barkdoli, Lucille E 21 Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unmimbumed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Dept. of Public Welfare-Class 3 claim 11,490.10 2 Golden Living -NH 360.69 TOTAL(Also enter on Line 10, Recapitulation) 11,850.99 (If more space is needed,additional pages of the same size) Copyright(c)2008 form software only The Lackner Group, Inc. Form PA-1500 Schedule I(Rev. 12-08) REV-1513 EX-(01.10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Barkdoll Lucille E 21 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSONS)RECEIVING PROPERTY DECEDENT N st {Words} ($$$) 5 s I• TAXABLE DISTRIBUTIONS [include outright spousal distributions,and transfers under Sec.9116(a)(1.2)] 1 Gregory L Cutler Son All of residue 391 N- 19th Street Camp Hill, PA 17011 Total Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate, NON-TAXABLE DISTRIBUTIONS: LI. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule J(Rev.01-10) REV-0914 EX-Id-091 .. SCHEDULE K LIFE ESTATE, ANNUITY COMMONWEALTH OF PENNSYLVANIA & TERM CERTAIN INHERITANCE TAX RETURN RESIDENT DECEDENT (Check Box 4 on Rev-1500 Cover Sheet) ESTATE OF FILE NUMBER Barkdoll, Lucille E 21 This schedule should be used for all single life,joint or successive life estate and term-certain calculations.For dates of death prior to 5-1-89, actuarial factors for single life calculations can be obtained from the Department of Revenue. Actuarial factors can be found in IRS Publication 1457,Actuarial Values,Alpha Volume for dates of death from 5-1-89 to 4-30-99. and in Aleph Volume for dates of death from 5-1-99 and thereafter. Indicate the type of instrument which created the future interest below and attach a copy to the tax return. ❑Will ❑Intervivos Deed of Trust ® Other LIFE ESTATE INTEREST CALCULATION T NEAREST AGE AT TERM OF YEARS NAME OF LIFE TENANT DATE OF BIRTH DATE OF DEATH LIFE ESTATE IS PAYABLE Lucille E. Barkdoll 0812611917 96 ID Life or ❑Term of Years ❑ Life or ❑Term of Years ❑ Life or ❑Term of Years ❑-Life or ❑Term of Years 1, Value of fund from which life estate is payable $ 63,215.04 2. Actuarial factor per appropriate table .04001 Interest table rate- ❑ 3 1/2% ❑ 6% ❑ 10%d ®Variable Rate 1.4% 3. Value of life estate(Line 1 multiplied by Line 2) $ 2,529.23 ANNUITY INTEREST CALCULATION NEAREST AGE AT TERM OF YEARS NAME OF ANNUITANT DATE OF BIRTH DATE OF DEATH ANNUITY IS PAYABLE ❑ Life or ❑Term of Years ❑ Life or ❑Term of Years ❑ Life or ❑Term of Years ❑ Life or ❑Term of Years 1. Value of fund from which annuity is payable - $ 2. Check appropriate block below and enter corresponding number Frequency of payout-0 Weekly(52) ❑Bi-weekly(26) ❑Monthly(12) ❑Quarterly(4) ❑ Semi-annually (2) ❑Annually(1) ❑Other 3. Amount of payout per period $ 4. Aggregate annual payment. Line 2 multiplied by Line 3 5. Annuity Factor(see instructions) Interest table rate- E131/2% ❑ 6% ❑ 10% ❑ Variable Rate 6. Adjustment Factor(see instructions) $ 7. Value of annuity- If using 3 1/2%,6%, 10%or if variable rate and period payout is at end of period, calculation is: Line 4 x Line 5 x Line 6 $ If using variable rate and period payout is at beginning of period, calculation is: (Line 4 x Line 5 x Line 6)+Line 3 NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through G of the tax return.The resulting life or annuity interest(s)should be reported at the appropriate tax rate on Lines 13 and 15 through 18 of the return. Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule K(Rev.4-09) Q ' z © MBank APR 12 2013 i 499 Mitchell Road,Millsboro,DE 19966 Adjustment Services p�-J� Phone 888-5024349 Fax (302)934-2955 April 10,2013 Hazen Elder Law 2000 Linglestown Road Suite 200 Harrisburg, PA 17110 Re: Estate of Lucille E. Barkdoll Social Security: 214-09-8729 Date of Death: March 5,2013 Dear Sir or Madam: Per your inquiry on April 5,2013,please be advised that at the time of death,the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Account Account Number 9856525689 Ownership(Names of) Lucille E.Barkdoll Gregory L. Cutler Opening Date 0110612012 Balance on Date of Death $4,196.81 Accruedlnterest $ .03 __---------------- Total $4,196.84 2. Type of Account Checking Account Account Number 9856525671 Ownership(Names of) Lucille E.Barkdoll(Principal) Gregory L. Cutler(Rep Payee) Opening Date 0110612012 Balance on Date of Death $1,51602 Accrued Interest $ .00 Total $1516.02 imm T ! • i , - , CER-rIF`ICATEdOF TITLE FOR A VEHICLE % �. y L 131 069999 0117 09-G'[17r ` t . a 5TDZK23C48S21663$ 2008 TOYOTA 662623 013 01 CU . NLNfaE`�� 1'�AP .M4KE OF`NEHICCE rf`: nTC6 NUMIjP.R'n '.�"�sr�� ' ,r�•.I 1Li, a.W 1i.rAK D sit 4 }. SW q ! 1 8/❑1/❑8! 1313❑❑36) ❑ V�� AtJ•� ew�YCAP t PMOAU STATE .I OWI&PWI)11MM, rr 16DW, si Ill•I • ODw.72 TAT3t4W�?° ;i :3 8101/06 8/❑L/QB, I yr DATE PA MUD DD)ATE OFISSUE- UNLADEN W�EIaGyHOT GWM GCWR TITLE BRANDS ��s y'• 'fir is e" 'aF',�{ �� *t "'� 4aa�ens Arvs ."`^' �, w L N.i }+pt�'� ] �•�r .. � •� h�+ � �. uN1i5-, f A��n � Mi L `Y.:' r !' AN,f �'�? CR -•a,t` ,4 y��ft ^t .,"F.3 .tiicnm�NUµ.Nilk�o�atgwtsp '1 �.I ^a ♦'r• ♦ w.yr' a"!'� ',y�A rrF>r. .. ...U4t+Prmura uA%¢TEH9tSir.DSUAF _ i' i y�tRS�tEp�A eRtgl.r�Jr,.^!•r1� ,�ii ,Y,T. _ . 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Barkdoll, of 391 North 19 Street, Camp H Ell, Pennsylvania 17011 (hereafter "Mother") and Gregory L. Cutler and Colleen D. Moyer-Cutler of 391 North 19' Street, Camp Hill, Pennsylvania 17011, (hereafter collectively "Children"). WITNESSETH WHEREAS, Children (son and daughter-in-law of Mother) own as tenants by the entireties a certain tract of approved real estate known and numbered as 391 North 190' Street, Camp Hill, Pennsylvania 17011, which is utilized as Children's primary residence ("the Property"); and, WHEREAS, Mother requires assistance with all of her activities of daily living which assistance Children have agreed to provide in the Property pursuant to the terms of a separate care agreement; and WHEREAS, Mother and Children desire to enter into an arrangement whereby Mother moves to the Property and purchases from Children a life estate interest in the Property; and WHEREAS, the parties are desirous of entering into an agreement providing for the purchase by Mother of the life estate interest in the Property and for the conditions of Mother's occupancy of the Property thereafter. NOW THEREFORE, the parties hereto, each of the parties intending to be legally bound, do hereby covenant and agree as follows: I. TRANSFER OF PROPERTY: Upon the signing of this Agreement, Children shall transfer and convey a life estate interest in the Property to Mother. 2. CONSIDERATION: The appraised value of the Property is Two Hundred Twenty Four Thousand ($224,000.00) Dollars. Mother is currently ninety (90) years of age and the life estate factor for her age is .28221. The purchase price of Mother's life estate interest in the Property will be Sixty Three Thousand Two Hundred Fifteen and 04/100 ($63,215.04) Dollars. The purchase price will be paid upon the sale of Mother's real Property located in Maryland. 3. EXCLUSIVE OCCUPANCY: On and after the transfer of title to the Property aforesaid, Children and Mother shall each be entitled to use of the Property. Mother's right to occupy the Property shall terminate without further notice upon the earlier occurrence of the following triggering events: 1 4;JgJ1 29 Unremedied Default: Mother's default in the terms of this Agreement which remains unremedied for a period of sixty (60) days after Mother's receipt of written notice of such default from Children; B. Death: Mother's death. 4. ADDITIONAL CONDITIONS OF OCCUPANCY: The Mother's life estate interest in the Property shall be under and subject to the following terms and conditions: A. Real Estate Taxes: Mother shall pay her proportionate share of all real estate taxes as said taxes become due and payable, which payment shall be made within the face period and not within the penalty period. If Children have made the tax payment then Mother shall reimburse Children therefore; B. Insurance: Mother shall pay her proportionate share of all costs for insuring the Property at its full replacement cost, with an insurance company selected by Children as such costs come due, which payment shall be made within the face period set forth on said billing statements and without penalty. If Children have made the insurance payment then Mother shall reimburse Children therefore; C. Utilities and Other Expenses: Mother shall pay her proportionate share of the costs and expenses for all utilities and all other costs and expenses associated with or relating to the Property and her use thereof; D. Maintenance and Repair: Mother shall keep the Property clean and free from dirt or other refuse, and otherwise keep the Property in good maintenance and repair, in the same condition it was as of the date of this Agreement, ordinary wear and tear and damage by accidental fire or other casualty not occurring through Mother's negligence, excepted; E. No Assignment by Mother: Mother shall not assign, mortgage or pledge any interest she may have in this Agreement, nor lease or sublease the Property, or any part thereof, F. Fire Insurance Requirements: Mother shall not do or allow to be done, any act, matter or thing objectionable to the fire insurance company whereby the fire insurance or any other insurance shall become void or suspended, or the rate increased. 5. RIGHTS AND REMEDIES OF CHILDREN: Children shall have the following nghts and remedies: A. Declaration of Default: To declare Mother to be in default of this Agreement upon Mother's failure to comply with any of Mother's obligations under this Agreement set forth in Paragraph 4 herein, which default remains unremedidied within sixty (60) days following Mother's receipt of written notice of such default from Children. 6. CHILDREN'S REMEDIES: Upon the occurrence of Mother's default specified herein, Children shall have the following remedies: 2 A. Termination of Life Estate Interest: To terminate the life estate interest and to enter upon and repossess the Property without being considered a trespasser; B. Collection of All Sams Due: To collect all sums due Children under this Agreement in any manner provided for by law. 7. NOTICES: Any notice required or permitted by this Agreement or any other law, rule or regulation governing this Agreement, shall be deemed to have been given to a party if sent by Certified United States Mail to that party to her address listed herein, or to such other address as such other party may provide written notice thereof. Notice shall be deemed to have been given as of the date of mailing and not as of the date of receipt. Failure or refusal to claim such notice shall not negate the giving of notice. 8. MEMORANDUM: A Memorandum of this Agreement shall, at the request of either party, be recorded in the Office of Recorder of Deeds in and for Cumberland County, Pennsylvania, concurrently with or any time after the recording of the deed transferring an interest in the Property to Mother. 9. BINDING EFFECT: This Agreement shall be binding and shall inure to the benefit of the parties hereto and their respective heirs, executors, administrators, successors and assigns. 10. ADDITIONAL DOCUMENTS: The parties shall forthwith, and within five (5) days after demand therefore, execute any and all instruments, assignments, satisfactions, deeds, notes or other such document may be necessary or desirable for the proper effectuation of this Agreement. 11, BREACMATTORNEYS FEES: If any party fails to perform his or her obligation owed to or for the benefit of the other party or otherwise breaches the terms of the Agreement, then the other parties shall be entitled to all rights and remedies allowed in Iaw or equity together with any all reasonable attorneys fees and costs incurred as a result of said breach and bringing action for enforcement of the terms of this Agreement. 12. SEVERABILITY: If any terms, condition, cause or provision of this Agreement shall be determined or declares to be void or invalid in law or otherwise and only that term, condition, or cause, shall be stricken from this Agreement and all other respects, this Agreement shall remain valid and continue in full force, effect and operation. Likewise, the failure of any parties to meet her obligations under this Agreement, under any one or more of the paragraphs hereunder, with the exception of the satisfaction of other conditions present, shall no way avoid or alter the remaining terms of the Agreement. 13. ENTIRE AGREEMENT: This Agreement constitutes the entire understanding of the parties and supersedes any and all prior agreements and negotiations between them. 14. COUN'T'ERPARTS: This Agreement shall be executed in various original counterparts. Upon the execution of any counterpart by all parties, this Agreement shall become valid. 3 IN WITNESS WHEREOF, the parties have set their hands and seals the day and year below written. Witness Lucille E. Barkdoll Date: '7 Qk Date: -Qk � {SEAL} Witness Gre y . Cutler Date: Date: 0& {SEAL} ttne Colle4Doyer- utl er Date: -l(i-iJ � Date: COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF DAUPHIN On this the Ae�'day of -yy 2008, before me the undersigned officer, Personally appeared, Lucille E. Barkdoll, Gregory L. Cutler and Colleen D. Moyer-Cutler, known to me (or satisfactorily proven) to be the persons whose names are subscribed to the within Agreement, and acknowledged that they executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and notarial seal. NOTARY PUBLIC COMMONWEALTH OF PENNSYLVANIA Notarial Seal Melissa M.Kain,Notary Public Susquehanna Twp.,Dauphin County My Commission E�ires Aug.11,2010 4 I LABELFORMS 610262-3216 1210-010 106535 i l O � ` L!7 .:.� na. c yt) E ✓cam. . n ('r. A. Wl Ln I i �T Y wa wi A m F=- �— i Y.aa 1 nZ �t y�"1 is o "� 5s, t' ar✓"TY J s aAa; Ink ez CO ;✓Jp'" a>.. 'S, �✓ � l%n - ei a<t �e�.)'(>�<'.� f"� dam.. 7 m 3J3Y4 Copy e (DEED Made the day of , in the year Two Thousand Eight (2008) BETWEEN GREGORY L. CUTLER and COLLEEN D. MOYER-CUTLER, his wife, of the Borough of Camp Hill, County of Cumberland, Commonwealth of Pennsylvania, GRANTORS, A N D LUCILLE E. BARKDOLL, of the Borough of Camp Hill, County of Cumberland, Commonwealth of Pennsylvania, a life estate interest, and GREGORY L. CUTLER and COLLEEN D. MOVER-CUTLER, his wife, of the Borough of Camp Hill, County of Cumberland, as to vested remainder, GRANTEES. WITNESSETH, that in consideration of the sum of One Dollar($1.00), in hand paid, the receipt whereof is hereby acknowledged,the said Grantors do hereby grant and convey a remainder interest to the said Grantees, ALL THAT CERTAIN lot or piece of ground,with the buildings and improvements thereon erected,situate in the Borough of Camp Hill, Cumberland County,Pennsylvania,more fully bounded and described as follows, to wit: BEGINNING at a point on the eastern side of Nineteenth Street, 67.66 feet south of the southeast corner of Nineteenth and Dighton Streets;thence south along the eastern line of Nineteenth Street, 67.66 feet to line of Lot,No. 12 on the hereinafter mentioned Plan of Lots;thence along line of said Lot No. 12, north 82 degrees 08 minutes east, a distance of 98.07 feet to line of Lot No. 9 on hereinafter mentioned Plan of Lots;thence along line of said Lot No. 9,north 08 degrees 00 minutes west, a distance of67.66 feet to line of Lot No. 10 on said Plan of Lots;thence along the line of said Lot No. 10 south 82 degrees 08 minutes west, a distance of 97.91 feet to a point, the place of BEGINNING. BEING all of Lot No. I 1 as shown on Plan of Lots laid out for Cignetto, as recorded in Cumberland County, and also Lot No. 316 and parts of Lots 315 and 317, as shown on Plan of Harrisburg Gardens, as recorded in Plan Book l; Page 86, Cumberland County records. HAVING THEREON ERECTED a dwelling house known and numbered as 391 North Nineteenth Street, Camp Hill, Pennsylvania. BEING THE SAME PREMISES which John T. O'Leary and Joanne D. O'Leary,husband and wife, by Deed dated February 15, 2008, and recorded in the Office of the Recorder of Deeds in and for Cumberland County,Pennsylvania,on February 25,2008 as Instrument Number 200805270, granted and conveyed unto Gregory L. Cutler and Colleen D. Moyer-Cutler, husband and wife, Grantors herein. TOGETHER with all and singular the buildings, improvements, ways, woods, waters, watercourses,rights,liberties,privileges,hereditaments and appurtenances to the same belonging or in anywise appertaining; and the reversion and reversions, remainder and remainders, rents, issues and profits thereof, and of every part and parcel thereof; and also all the estate, right, title, interest, use, possession, property, claim and demand whatsoever of the Grantors both in law and in equity, of,in and to the premises herein described and every part and parcel thereof with the appurtenances. To have and to hold all and singular the premises herein described together with the hereditaments and appurtenances unto the Grantees and to Grantees' proper use and benefit forever. AND the said Grantors do hereby covenant to and with the said Grantees that they shall and will warrant and forever defend the herein above described premises, with the hereditaments and appurtenances,unto the said Grantees and assigns,against the said Grantors and against every other person lawfully claiming or who shall hereafter claim the same or any part thereof,by,from or under or any of them. THIS CONVEYANCE IS A TRANSFER FROM CHILD TO PARENT OF A LIFE ESTATE INTEREST IN THE PROPERTY WITH THE REMAINDER INTEREST RETAINED FOR GRANTORS AND IS THEREFORE EXEMPT FROM PENNSYLVANIA AND LOCAL REALTY TRANSFER TAXES. IN WITNESS WHEREOF, the said Grantors have caused these presents to be duly executed the day and year first above written. Signed and delivered in the presence of GREGfflV L. CUTLER a&-OXA- Adff:�4 U& COLLEEN D. MO AR-CUTLER COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF DAUPHIN On this, the day of �J /,1 2008, before me, a Notary Public, in and for the Commonwealth of Pennsylvania,cam—bove named Gregory L. Cutler and Colleen D. Moyer-Cutler,known to me(or satisfactorily proven)to be the person whose names are subscribed to the above Indenture,and acknowledged the foregoing deed to be their act and deed and desired the same to be recorded as such. WITNESSETH my hand and notarial seal the day and year aforesaid. C-Al NOTARY PUBLIC COMMONWEALTH OF PENNSYLVANIA z?` Notarial Seal z, Melissa M.Kain,Notary Public Susquehanna Twp.,Dauphin County My Commission Expires Aug.11,2010 _ 01 I hereby certify that the precise address of the Grantors/Grantees is: y" k- 391 North 19a' Street Camp Hill, PA 17011 Attorne for Grantees COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF CUMBERLAND Recorded in the Office for Recording of Deeds in and for Cumberland County,Pennsylvania, in Record Book , Page Witness my hand and seal of Office this day of 2008. Recorder of Deeds ROBERT P. ZIEGLER RECORDER OF DEEDS CUMBERLAND COUNTY 1 COURTHOUSE SQUARE +' t CARLISLE, PA 17013 = 717-240-6370 ' Instrument Number-200832342 Recorded On 9/24/2008 At 10:57:14 AM *Total Pages - 4 *Instrument Type-DEED Invoice Number-29520 User ED-KW *Grantor- CUTLER, GREGORY L *Grantee-BARKDOLL, LUCILLE E *Customer-LUCILLE BARKDOLL *FEES STATE WRIT TAX $0.50 Certification Page STATE JCS/ACCESS TO $10.00 JUSTICE DO NOT DETACH RECORDING FEES — $13.00 RECORDER OF DEEDS AFFORDABLE HOUSING $11.50 This page is now part COUNTY ARCHIVES FEE $2.00 of this legal document. ROD ARCHIVES FEE $3.00 CAMP HILL SCHOOL $0. 00 DISTRICT CAMP HILL BORO $0.00 TOTAL PAID $40.00 I Certify this to be recorded in Cumberland County PA F cvy„ RECORDER O D DS *-Information denoted by an asterisk may change during the verification process and may not be reflected on this page. 2 c � , ƒ . u c « coca c \ c @t « Q 2 99 yC \ \ % ® 3 30 7 CC 0 % \ ƒ M rn ƒ� 2 ® T-7 \ � /� / o rn \ g -0 q ` m \ � � co � ) \\ e|� . \\� | � \\��% HAzENEwFR LAW Estate Planning • Elder Lain • Special Needs Planning 2000 Linglestown Road EL:(717)5404332 Suite 202 enx: (717)5404313 Harrisburg,PA 17110 www.HazenElderLaw.com June 3, 2013 Register of Wills M ;a ro z Cumberland County Courthouse a r m One Courthouse Square a N : "' Carlisle, PA 17013 0 C-, ° ° Re: Estate of Lucille E. Barkdoll ~ m File No.: 21 y% a' C Social Security No.: 214-09-8729 Date of Death: 3/5/2013 Inheritance Tax Return To: The Register of Wills: Enclosed for filing please find the original and one copy of the above-referenced Inheritance Tax Return, along with a copy of the first page of the Inheritance Tax Return. Please date stamp the first page of the return and return it to my office in the enclosed self-addressed envelope. Also enclosed is a check in the amount of $15.00 for payment of the filing fees associated with the return. If you have any questions or require any additional information, please do not hesitate to contact me. Sincerely, �Q Sacr5 k)ct ur` Y� Corinne Eggers Woodhouse Paralegal Enclosures cc: Gregory Cutler