HomeMy WebLinkAbout07-23-13 (2) J 1505610140
REV-1500 EX �°,_,°,
PA Department of Revenue OFFICIAL USE ONLY
Bureau of Individual Taxes County Cade Year File Number
Po aox zsoso� INHERITANCE TAX RETURN 2 1 1 3 0 0 0 6
Harcisbum PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MmtDOYYVV Date of Birth MMOOVriY
1 0 1 3 2 0 1 2 1 2 0 5 1 9 4 4
DecedenYs Last Name � Sufix DecedenPs First Name MI
S H E R I F F B E T T Y �
(If Applicable)Enter Surviving Spouse's Informatlon Below
Spouse's Last Name Suffuc SQouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED iN DUPIICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
Q 1.Original Return � 2.Supplemental Retum � 3.Remaindes Return(date of death
priorto 12-13-82)
� 4. Limited Estate � 4a.Future Interest Compromise(date of � 5.Federal Estate Tax Retum Required
death after 12-12-62)
� 6.Decedent Died Testate � 7.Decedent Maintained a Livi�g Trust _ 8.Total Number of Safe DeposR Boxes
(Attach Copy of Will) (Attach Copy of Trust)
� 9.Litigation Proceeds Received � 10.Spousal PuveRy GreAit(date of death � 11.Election to tax under Sec.9113(A)
6etween 12-31-91 and 1-1-95) . (Attach Sch.O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name , Daytime Telephone Number �
R 0 G E R B • 2 R W I N 7 1 7 2 4 9 2 3 5 3
REGISTER OF WILLS USE ONLY
� ^ :�
C r-.J �^-' ' .-r
First line of address � —_ �__ '`- n
�' � c _: G
I R W I N 8 M c N I G H T , P • C . a 5� � ' � ~'
Second line of address � � '- N �-. �J
A� U; � GJ : m
6 0 W E S T P 0 M F R E T S T R E E T ° � � �' '-'
�' ,.-� -�' ; �
City or Post Office State ZIP Code �A�Ft�E� � - 'n
: _ _ n
C A R L I S L E P A 1 7 0 1 3 � —'' � r "'
�- �� co c�
cn -n
CorrespondeM's e-mail address:
UiMer penallies of perjury,1 Aacfare that I have ezamined this return,inGUtling accompanying schedules and statements.and to the best of my knowledge and belief,
it is true,cortect antl complete.DeGaration of preparer oMer than Ne personal representative is based on all information of which preparer has any knowletlge.
SIG TURE OF PER O RE NSIBLE FO FI G RETUR ATE
7 2.L i;
AD SS
31 S • RIDGE ROAD BOILING SPRINGS PA 170�7
SIGNATURE REPARER OTHER T AN REP SENTATIVE DATE �
� : �, L �3
ADDR S
6� WE3T POM ET STREET CARLISLE PA 17�13
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 1505610140 15�561fl140 �
����
J 1505610240
REV-1500 EX
DecedenPs Social Security Number
oecedem�sName: BETTY L • SHERIFF
RECAPITULATION
1. Real Estate(SChedule A) .. . . . . . . . . . . . . .. . . . . . . . . .. . . .. . ... . . . . . . . . . �. 4 1 0 0 0 , 0 0
2. Stocksand Bonds(Schedule B) . . . . . . . . . .. . . .. . .. . . . . . . . . . . . . . . . . . .. . 2. •
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Scheduie C) . . . . , 3. �
4. Mortgages and Notes Receivable(Schedule D) . . . . . . . .. . . . . . . . . . . . .. . . . . 4. .
5. Cash, Bank Deposits and Miscellaneous Personal Property(SChedule E). . . . . . . 5. 1 2 8 3 6 . 9 4
6. Jointty Owned Property(Schedule F) ❑ Separete Bilting Requested . . . . . . . 6. � •
7. IntervVivos Trensfers 8 Miscellaneous N n-Probate Property
(Schedule G) � Separate Billing Requested .. .. .. . 7. 5 8 5 3 3 . 9 2
8. Total Grass Assets(totel Lines 1 through 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. 1 1 2 3 7 0 . 8 6
9. Funeral Expenses and Administrative Costs(Schedule H) .. . . . . . . . . . . . . . . . . 9� 3 0 7 4 0 . $ 3
10. Debts of Decedent,MoRgage Liabilities, and Liens(Schedule I) .. . . . . . . . . . . . 10. 3 1 7 9 . 4 5
it, Total Deductions(total Lines 9 and 10) .. . . . . . . . . . . . . . . . . . . . . .. . . . . . . . 11. 3 3 9 1 9 . 9 8
12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 7 8 4 5 0 . 8 8
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an eledion to tax has not been made(Schedule J) . . . . . . . .. . . . . . . .. . . . . . 13. ,
1a. Net value Subject to Tax(Line t2 minus Line 73) . . . . . . . . . . . .. .. . . . . . . . 1a. 7 8 4 5 0 . 8 8
TAX CALCULATfON-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
atthe spousaltex rete,or
transfers under Sea 9116
(a)(12)X.0 _ 0 . 0 0 �5. 0 . 0 0
16. Amount of Line 14 taxable
at lineal rate X.0_ d . 0 0 �6. 0 . 0 0
. 17. Amount of Line 14 taxable
at sibling rete X.12 3 9 9 3 . 4 � ��. 4 7 8 . 0 1
18. Amount of Line 14 taxable
ac co��atere�rate x.t s 7 4 4 6 7 . 4 8 �e. 1 1 1 7 0 . 1 2
19. TAX DUE . . . . . . . . . . . . . . . . . . .. . . . . . .. . .. . . . . . . . . . . . . . . . . .. . . . . . . 19. 1 1 6 4 8 • 1 3
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OV�RPAYMENT �
Side 2
L 1505610240 150561024D J
REV-1500 EX Page 3 File Number
DecedenYs Complete Address: 2� �3 000s
DECEDENTSNAME
BETTY L. SHERIFF
STREETADDRESS
222 McALLISTER CHURCH ROAD
cin srare ziP
CARLISLE PA 17015
Tax Payments and Credits:
� Tax Due(Page 2,Line 19) (1) 11,648.13
2. Credits/Payments
A.Pnor Payments
B.Discrount
Total Credits(A+g) (2� 0.00
3. Inferest
4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT. (3�
Fill in oval on Page 2,Line 20 to request a refund. (4) 0.00
5. If Line 1 +�ne 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 11.648.13
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 ihe property transferred: ...................................................................... ❑ ❑X
b. retain the right to designate who shall use ihe property transferred or i�s income; ❑ ❑X
c. retain a reversionary interest;or ................................................................................................ ❑ ❑X
d. receive the promise for life of either payments,benefits or care? ....................................................... ❑ Q
2. If death occurced after December 12,1982,did decedent iransfer propeAy within one year of death
without receiving adequate consideration? ....................................................................................... ❑ ❑X
3. Did decedent own an"in trust for"or payable-upon�eath bank account or security at his or her death? ......... ❑ ❑X
4. Did decedent own an individual retirement account,annuity or other non-probate propeRy,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 July 1, 1994,and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is
3 percent[72 P.S.§9116(a)(1.1)(i)].
For dates of death on or after Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an
adoptive parent or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)].
• The tax rate imposed on the net value of Uansfers to or for the use of the decedenPs lineal benefciaries is 4.5 percent,except as noted in
72 P.S.§9116(1.2)[72 P.S.§9116(a)(1)]•
• The tax rate imposed on the net value of transfers to or for the use of the decedenYs siblings is 12 percent[72 P.S.§9116(a)(1.3)j.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-1502 EX+(12-72) '
pennsylvania SCHEDULE A
DEPARTMENT OF REVENUE
INHERITANCETAI(RETURN REAL ESTATE
RESIDEN�DBCEDENT �
ESTATE OF: FILE NUMBER:
BETTY L. SHERIFF 21 13 0006
All real property owned solety or as a tenant in common must be repoAed at fair market value.Fair market value is defined as ihe price at which property
would be exchanged behveen a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts.
Real property that is jointlyowned with right of survivorship must be disclosed on Schedule F.
Attach a copy of the setllement sheet if the property has been sold.
ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE
NUMBER OFDEATH
DESCRIPTION
1. 222 McALLISTER CHURCH ROAD, CARLISLE, PENNSYLVANIA 41,000.00
SOLD-SETTLEMENT SHEET ATTACHED
TOTAL(Also enter on Line 1,Rerapitulation.) $ 41 000.00
If more space is needed,use additlonal sheets ot paper otthe same size.
REV-1508 EX+(0&12)
pennsylvania SCHEDULE E
DEPAfiTMENTOFREVENUE CASH, BANK DEPOSITS 8� MISC.
INHERITANCE TAX RETURN
aESioeNroeceoeNT PERSONAL PROPERTY
ESTATE OF: FILE NUMBER:
BETTY L. SHERIFF 21 13 0006
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly owned with right of survivorship must be disclosed on Schedule P.
ITEM
NUMBER DESCRIPTION VALUE AT DATE
OF DEATH
1. M&T BANK- CHECKING ACCOUNT#77788486 7,996.44
2. PERSONAL PROPERTY-SETTLEMENT SHEET ATTACHED 840.50
3. 1966 CHEVY-SOLD 1,000.00
4. 2004 CHEVY CAVALIER -SOLD 3,000.00
TOTAL(Also enter on Line 5,Recapitulation) $ 12 836.94
If more space is needed, use additional sheets of paper of the same size.
REV-1510 EX+(OB-09)
pennsylvania SCHEDULE G
OEPARTMENTOF REVENUE INTER-VIVOS TRANSFERS AND
INHERITANCETAXRETURN MISC. NON•PROBATE PROPERTY
RESIDEN7 DECEDENT
ESTATE OF FILE NUMBER
BETTY L. SHERIFF 21 13 0006
This schedule must be completed and fled it the answer to any of questions 1 through 4 on page miee of the REV-1500 is yes.
DESCRIPTION OF PROPERTY
ITEM INCLUUETHENAMEOFTHETRANSFEREE,THEIRFEfATONSHIPTO�ECEOEMAND �ATEOFDEATH %OFDECD�S EXCLUSION TAXABLE
NUMBER iHEDATEOFTRANSFFR.ATSACHACOPYOFTHEDEEOFOflRFA�ESTATE. VALUEOFASSET IN7ERESi �rnrwua.q VALUE
1. M&T SECURITIES ACCOUNT#AZR-373228 42,646.03 100.00 42,646.03
FRANKLIN INCOME FUND CLASS A
BENEFICIARIES: AMANDA 8 LORI
2. M&T SECURITIES ACCOUNT#AZR-373228 15,887.89 100.00 15,887.89
WESTERN NATIONAL ANNUITY
BENEFICIARIES: AMANDA& LORI
TOTAL (Also enter on Line 7,Reca itulation) $ 58 533.92
If more space is needed,use addifional shee4s ot paper of the same size.
REV-1511 EX+(�0-09)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCETAXRETURN ApMINISTRATIVE COSTS
RESIDENT�ECEDENT
ESTATE OF FILE NU�BER
BETTY L. SHERIFF 21 13 0006
DecedenPs debts must be reported on Schedule 1.
ITEM
NUMBER DESGRIPiION AMOUNT
A. FUNERALEXPENSES:
1. HOFFMAfd-ROTH FUNERAL HOME 5,254.60
2. BAUGHMAN MEMORIAL WORKS, INC. 3,026.40
B. ADMINISTR4TIVE COSTS:
i. Personal Representative Commissions:
Name(s)oFPersonalRepresentative(s) JEAN R. RAUDABAUGH 2,700.00
SireetAdd2ss 310 S. RIDGE ROAD
City BOILING SPRINGS State PA Z�P 17007
Year(s)CommRSion Paid:
y, nnomeyFees: IRWIN &McKNIGHT, P.C. 3,800.00
3, Family Ezemption:(If decedenPs address is not the same as claimanPs,attach ezplanation.)
Claimant
SfreetAddress
City Shate ZIP
Relatianship of Claimant to Oecedant
4. probateFees. REGISTER OF WILLS 203.50
5 AccountantFees:
6. TaxRetumPreparerFees: PATRICIAA. ROSENDALE, CPA 375.00
FINAL FIDUCIARY TAX RETURN
7. CLOSING COSTS FROM SAIE OF REAL ESTATE � 13,588.92
8. ROWE'S AUC710N SERVICE- REAL ESTATE ADVERTISING 818.40
9. ROWE'S AUCTION SERVICE-PUBLIC SALE COMMISSION 359.17
10. CUMBERLAND LAW JOURNAL-ESTATE NOTICE 75.00
11. THE SENTINEL-ESTATE NOTICE 189�`�
12. BASSETT APPRAISAL SERVICES-APPRAISAL ON REAL ESTATE 350.00
iOTAL(Also enter on Line 9,Recapitulation) $ 30 740.53
If more space Is needetl,ose additional sheets of paper oi the same size.
.
REV-1512 EX+(72-72)
pennsylvania SCHEDULE (
DEPAR7MENT OF REVENUE DEBTS OF DECEDENT�
INHERITANCETAXRETURN MORTGAGE LIABILITIES&LIENS
RESIDEM DECEDENT
ESTATE OF FILE NUMBER
BETTY L. SHERIFF 21 13 0006
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed mediwl expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. M8T BANK-CRED{T CARD 216.02
2. CENTURYLINK-TELEPHONE 124.50
3. SHIPLEY ENERGY- FUEL 1,081.54
4. PP&L- ELECTRIC 114.65
5. CUMBERLAfJD GOODWILL F1RE RESCUE -AMBULANCE 150.00
6. PINNACLE HEALTH HOSPITALS -MEDICAL 450.00
7. BRETHREN MUTUAL INSURANCE- HOMEOWNERS INSURANCE 396.00
8. CARLISLE REGIONAL MEDICAL CENTER - MEDICAL 600.00
9. SOUTHAMPTON TOWPISHIP -WATER/SEWER 46.74
TOTAL(Also enter on Line 10,Recapitulation) $ 3 179.45
If more space is needed,insert additional sheets of the same size.
REV-0513 EX+(0140)
pennsylvania SCHEDULE J
OEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN '
- RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
BETTY L. SHERIFF 21 13 0006
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [Include outrightspousal disGibutions and transfers under
Sec.9N6(a)(1.2).�
1. JEAN R. RAUDABAUGH Sibling 3,983.40
310 S. RIDGE ROAD 1/5TH REMAINDER
BOILING SPRINGS, PA 17007
Collateral 3,983.39
CHILDREN OF CONNIE MILLER 1/5TH REMAINDER
(SISTER OF DECEDENT
2. LAURIE A. MYERS Collateral 29,266.96
313 N. BALTIMORE AVENUE 1/5TH REMAINDER
MOUNT HOLLY SPRINGS, PA 17065 AND 1/2 ANNUITIES
Collateral 3,983.39
CHILDREN OF MAYARD MYERS 1I5TH REMAINDER
(BROTHER OF DECEDENT)
3. ANGIE MYERS Collateral
621 N. PITT STREET, 2ND FLOOR •
CARLISLE, PA 17013
4. DAVID MYERS Coilateral
3159 RITNER HWY
NEWVILLE, PA 17241
Collateral 3,983.39
CHILDREN OF JOHN MYERS 1/5TH REMAINDER
(BROTHER OF DECEDENT)
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
II. NON-TAXABLE DISTRIBUTIONS:
A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAK�N:
1.
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1. ,
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $
If more space is needed,use additional sheets of paper of the same size.
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
BET'f1'L. SHERIFF 21 13 0006
DecedenPs Name Page 1 File Number
Schedule J -Beneficiaries-1
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [Include ouVight spousal distributlons and trensfers under .
Sec.9716(a)(1.2).]
5. DEBRA KULP Collateral
211,SPRINGFIELD ROAD
NEWVILLE, PA 17241
6. VICKIE GOSS Collateral
825 W. SIDDONSBHRG ROAD
DILLSBURG, PA 17019
Collateral 3,983.39
CHILDREN OF JENNIE VIRGINIA 1/5TH REMAINDER
(SISTER OF DECEDENT)
7. DAVID MYERS Collateral
PO BOX 49
NEW CUMBERLAND, PA 17070
8. RANDY MYERS Collateral
118 COLLEGE HILL RD., PO BOX 386
ENOLA, PA 17025
9. RHONDA CARBAUGH Cotlateral
116 W. SPRINGVILIE ROAD
BOILING SPRINGS, PA 17007
10. TINA CANTU Collateral
5549 ROLO CT.
MECHANICSBURG, PA 17055
11. AMANDA MYERS Collateral 29,266.96
313 N. BALTIMORE AVENUE 1/2 ANNUITIES
MT. HOLLY SPRINGS, PA 17065
�.rr. .. ��:. ;. .ti,?r. s : . ., -.:... .__.
� �
REGISTER OF WILLS Certificate of Grant of Letters
CUMBERLAND COUNTY, PENNSYLVANIA
No.21-13-0006 PANot21-13-0006
ESTATE OF Betty L. Sheriff
a/k/a:
� Late Of: West Pennsboro Townshiu, Cumberland County,Deceased
� Social Security No.
WFIEREAS, Betty L. Sheriff, late of West Pennsboro Township, Cumberland County, died
on the 13th day of October, 2012,and
WHEREAS,the grant of Letters of Administration is required for the adminish�ation of the
estate.
THEREFORE, I, Glenda Farner Strasbaugh, Register of Wills in and for the County of
Cumberland, in the Commonwealth of Pennsylvania,have this day granted Letters of of
Administration to Jean R.Raudabaugh AKA Jeanne R. Raudabaugh,who has duly qualified as
Administratix of the estate of the above named decedent and has agreed to administer the estate
according to law, all of which fully appears of record in my Office at Cumberland County
Courthouse, Cazlisle, Pennsylvania.
IN TESTIMONl'WHEREOF, I have hereunto set my hand and affixed the seal of my office
the 4th day of January, 2013. � "
�
� ti ' � �J
eg te o ' e
�I
Deputy
**NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST)
A.Se'lemenl5b[emant US.Oaparbnent of Nousing OMB Appraval No.2502-0Y65
antl Ilrban Dwelopment
B.Type�f Lmn
t.� ]FHA 2.I 1 RHS 3.� J Conv.Unins. 8.File Number 7.Loen Number. B.Mohgape Insunnce Cese NumEer.
i.� �VA 5.� �Conv.Ins. 401301859-CL
C. NOTE:This torm is Nmishatl b gire yo�e statement a(acNal soNemant cosis.Amounla peid W anE Ey tlie setllement agent are shown.Ilams
markeE"(p.o.c.)'wtte paM outsitle of Ne Gosi�g:Ney are ahown here for i'rtormational purposes a�W are not induEetl in Ihe ta�eis.
D.NameantlAtlUressolBOnower E.NameantlAtltlresaof5eller F.NameandAdCressolLenOer
DALESCHLUSSERPNDGAILLL JEANR.RAUDABAUGHAM/AJEANNE
SCHLUSSER R.RAUDABAUGH,FOMINISTRHTRIX OF
THE ESTATE OF BETTY L.SHERIFF
3B30URGNER5130AD P1K/ABETTYJ.SHERIFF
CARLISLE,PA i]015 222 MCALLISTER CHURCH ROAD
CARLISLE,PA 11015
G.Propeily Lacatlon H.9ottlemant Agant
222 MCALLISTER CHURCX ROF�. SECURED IAND TRANSFERS,LLC
CNRLISLE,PF/�015
Of$ELU0IHIC ASetllemefRDafe U6M912013
COUMI':CUMBERLAN� 1..,...
PARCEL 10:fS08-0.599-033 1���"""�6� DlsEUO<mant Dab O6H9201J
TONMSHIP:WEST PENNSBORO TONMSHIP �CLLSI2� PA
J.SUMMARVOFBORROWER'STRANSACTIONS K.SIIMMARYOFSELLER'STNANSACTIONS
100.Oross Amounl0ue From Bortowor �00.Gmss Amounl Uue To Selle�
101.Cantracl Sales P�Ice E41.000.00 I07.ConVep Sales Prica Sd7,000.00
102.Personal PnpeM a02.Personel Pmparty
103.Setllemen�Cherges lo Borrower 51,948.00 CO3.
FAjuatmenia For ttems Paitl By Sallar In Ativanca AEjusbnants For kems Paitl By Sellar in Mvance
113.CityROwn Taaes t13.City/�own Taxes
119.COUnIyTaxa5305.9P/yr61192013ta1/VY014 5164.01 {tl.COUnIyTazPS30.5.4P/yrN1B2013b1A2014 5166.01
115.SrhoolTaaesi,P2fi.91NtH�19201310]/120'13 510.30tl5.5C�oolTares1,228.91/yr8118R019inIH/2073 500.34
118.Auessmenis tl8.AasessmeMe
118. a19.
1Y0.Gross Amount�ue irom Borrowar 562,550.35 IM.Gross Amemrt Oue To Seller 547.204.35
P00.AmounR Poitl By Or In Behal/Of Bortowar 600.ReducUons In Amounl�ue To Seller
201.Depasit or eamesl maney E1.000.00 601.Fxcess DeDOSps
202.PrInGOaI 50P.SettlemeiM1 C�argn b Seller 513,SBB.B2
203.Fxisting Loen�s)Taken Subied m 503.Fxisiing Laan(s)Takan Subjea lo
204. 500.Payoft Flrst Martgage to MdT Bank 52].00
. Atl�ustmenb Farltamn Unpeftl 0y Sellor AtlJustmenfs ForMems UnpalC By 9eiler
214. 510.
211. 511.
212. 512.
213.CiyROwn Tvtes 513.Clly/�own Taxes
21a.Counry Texes 514.Couny Tazes
2t8.Assessmenls 518.Assessmen�s
219.HOF 518.
320.BuyersTOtalCretllts; ' - � • � f1.000.00I520.5eIleYSTOtalCharges � � 513,615.B2
300.Cas�At Se4lertrent FmmRO Bartower 800.Caah At Settlama�R To1From Solle��
301.Grosa lvnount Oue From Bortower(Iine 120) i42,55U.35 601.Gross Amount�ue Ta Seller(Ilne 420) 541,204.35
302.Less Amaunis PaiO By/FO�Batrower(line 220) 51,000.00 fi02.Less Detludions In Ami.Due To Seller(line 52�) 513.615.92
SO].Cash[X�Frvm[ �To Bortower I 511,550.35I809.Cach[X7 To[ �From SeYer I' S21.588.43
001301858-CL
L Setllemeirt Sbdment P: e Y
]00.Total Sale Commisslon/1000.00�,ID].OtOp9!M1-¢BBOAO -
Olvlalon a/COmmissiDn(Ane l00)Ne Follmvs: Paitl Fmm Bortowe�s PeW Fmm Sellev��
701.51655.00 to Prutlentlal HomeSale SeMces(E1230.00�f225.00) FunES A1 SatUemenl, Funds At SeNerj�ant
]02.E1/P3.00 fo ERA-NRT.LLC(E1230.00 i{185.00) �:
103.Commission paq at setllement 5795.00 51,685.00
BOO.Ilams Peyeble In Connee4on With Laan
801.Loan Origination fce
802.Laan oiswunt
809.PpP�'+�sal Fee
BQI.Cmtlil Repotl
805.Lentler Inspection Fee
9�U.Itemc RequlreG By LanEer To Be Paitl In Ativance
801.Interest
902.Mortgaga Insuranca PremNm
903.Hezerd Ins.Premlum
f 000.Rea�rvae Depo5ltatl WXIi Lentler
1D01.HazaN Ins.Reserve
1002.Mor(qa8e��s.Reserve
1003.Ciry Propetly Tass
1004.County PropeM Texes
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B YJ/ �5 �� SELLERS
rl�K� ha EsWia a�Bely L SlheMf alk/a 8 i y J, heMl
D�ale Stli(lu�as(�er�y.n o , .O (
/--�n-i[l/ (A. ���1..A 1�J y:Jean R.R aug�elkle Jeanne R.RaWaUeu ,Atlmi sbatrlx
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06/192013
� M�TBank
499 Mitchell Road,Millsboro,DE 19966 Adjushnent Services
Phone 888-502-0349
F ex (302)934-2955
lanuary 11,2013
Law Offices ���a�����
Irwin & McKnichg,P.C.
West Pomfret Professional Building
60 West Pomfret Street �JAN 14 2013
Carlisle,PA 1'7013-3222 IRWIN�I�cKNIGHI
IAW OFFICES
Re: Estate of Beriy L. Sheriff
Social Secwity:
Date of Death: October 13, 2012
Deaz Sir or Madam:
Per your inquiry on January 7,2013,please be advised that at the time of death,the above-named decedent had
on deposit with this bank the following:
I. Type ofAccount CheckingAccount
AccawuNumber 77788486
Ownership(Names oJJ Betty L.SherrfJ
Harold J.Sherifj'
Opening Date Ol/28/1974
Balance on Date ofDeath $7,996.40
Accrued Interest $ .04
---------------------------------------------
Total $7,996.44
ROWE'S AUCTIQN SER�ICE �ftH 79L)
2605 Ritner Highway • Carlisle,PA 17015
Bill Rowe (Ar�T 1538L) 249-1975 215-1044 574-1008 Dave Rowe (AU 2295L)
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Auction Is Action C¢Zl "Rowe" For Satisf¢ction
SELLERS NAME r��"t"O� �-- 5 G�a+-'�K.� �za 'r�4-rr DATE .1na-n-e--+c �� �03
ADDRESS ��a �.r�6�s+- � . ��h-�++-crtl PHONE °Ll�"�-c.�+.tt �-sS-3cz"i
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O'1'HER � �+.� - G��'�r.�-�z sZ AUCTIONEER % �5�
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AUCTION DATE/LOCATION � ��A- CLERK % ���'`���`�
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DESCR.IPTION OF MEftCHANDISE
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I Commission the Auctianeers to sell the merchandise to the highest bidder by Public Auction. Merchendise
to be sold as is & grouped as necessary to obtain bids. I certify that I am the owner or authorized represen-
tative of the merchandise,_goods and or property and have good title and the right to sell and that they are free
from all incumbrances. I agree to accept ell responsibility for providing merchantable title and for delivery of
title to the purchaser. I agree o hold hazmless the Auctioneers again any claims of the nature referred to in
tlus agreement.
.
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AUCTION SIGNAfURE SELLERS SIGNATURE
S�_
Total Sales (Clerking Tickets Attached) � �4 CJ .
Less Sale Eapense: i �
`3`+ % Commission Auctioneer � �'q y"
% Commission Clerks $
O'PHER: RLlJ+.c•G,aiii� 4 S •J-J—
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S�n.�-�t t�h;� 2� —
TOTAL $ALE EXPENSE DEDUC'I'ED $
3 ,, `i �---Z
3b
SELLERS NET $ y 8�
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�
279 North Hanover5heet
� Cadisle,PennryNania 17013
717243.4511
� � toll free 1.866.451.4511
�
fax 717.243.3723
wNnv.hoffmanmth.cam
FUNERAL HOME 62 CREMATORY, INC. inro@nottmanrom.com
March 7, 2013
Charles A. Lark
315 North Baltimore Avenue
Mount Holly Springs, PA 17065
Statement of Funeral Expenses for: Betty Lou Sheriff
Date of Death: October 13, 2012 Account Id: 16680-241
PACKAGE:
Traditional Funeral Service at Another Facility
-including Transportation, Embalming, Other Prep of Body, Public �
Viewing and Cremation.
OPTION 1 -Cremation $ 4,850.00
Sub Totai: $ 4,850.00
TOTAL FUNERAL HOME CHARGES: $ 4,850.00
CASH ADVANCES:
10 Certified Death Certificates at$6.00 each $ 60.00
Newspaper Notice-Sentinel $ g2,gp
6 Add'I DC From New Castle $ 54.00
Flowers $ 42.40
Sub Total: a 239.20
Total Funerel Expense: $ 5,089.20
Payments Made:
Accrued Late Fees: $ 765.40
Balance: $�
��������
MAR o � zat�
4ftWiN&�4cKNiGHi
LAW OFFICES
SERVING OUR COMMUNITY SINCE 1907
•• • • � • � •�. • ••
� Rowe's Auction Service
2505 Ritner Highway
Carlisle, PA 17015
717-249-1978 215-1044 574-1008
May 14, 2013
To: Roger B. Irwin
60 W. Pomfret St.
Cazlisle,PA
From: Rowe's Auction Service
2505 Ritner Highway
Carlisie,PA 1'7015
Re: Real Estate Advertising
Betty L. Sheriff Estate
Guide $360.00
Sentinel 248.40
Newville/Sluppensburg 210.00
Totat Due Rowe's Auction Service $818.40
� . � C�
William G. Rowe
.....� ; ....-1 �, � . . ..
Price �-K :;� S �,`t.
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� 23-25 th Main Street � 10 First Avenue `- ��'rt�% �%t;�'��y '�Y(�' " ��;
Dov , PA 17315 Red Lion, PA 17356
Telephone (71� 292-2621 Telephone (71�244-1828
Fax (717) 292-7936 Fax (717)417-5263 r�
E-mail info(�baughmanmemorials.com E-mail lori@baughmanmemorials.com Total Price �` Q�lO•• ��"�.�
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Balance Due � _�� 1� `
Style of Letters _._.__�..�....._.T......�.�..�,,�,... ,�._„�,..�4�_..,�_�..�_....�,..�..._..M�,..._.,�,�
Foundation to be furnished by
Material to be best selected monumental grade and to be free from imperfections and first class in every way.Work to be finished in a workmanlike
mannec . � �
This memorial to be erected in l sti�'���r���d�f��� � u"{`.�},!t��t..� Cemetery in or near
during the month of ��� �f � unless unavoidably delayed by labor
troubles and other contingencies beyond our control and then as soon as possible.Ad�itional lettenng and other work on this memonal in the future is
not included in the Contract Price.
Title and right of possession and removal of said stone,monument or appurtenances shall remain for all purposes in Baughman Memorial Works,
Inc.until work and materials ordered are fully paid by purchaser or purchasere. In consideration of the acceptance by Baughman Memorial Works,Inc.
of this order,the undersigned(hereinaker known as the purchaser)agrees to pay Baughman Memorial Wo�ks,Inc.
�`'i...% -,' ��"� ^-��'� Dollars on or before the 15th day following
the billing of the work or job upon completion thereof by Baughman Memorial Wo�ks,Inc.Thirty(30)days from date of invoice a 1-1/2%finance charge
will be added to the unpaid balance. Said billing to be notice of completion thereof, this order shall become a contract between the purchaser and
Baughman Memorial Works,Inc.upon acceptance thereof in the space below by a duly authorized representative of said Baughman Memorial Works,
Inc.It being understood that this instrument upon such acceptance covers all of the agreement between the purchaser and Baughman Memorial Works,
Inc. a�d that no agent or representative of Baughman Memorial Works, Inc. has made any statements or agreements,verbal or written, modified or
adding to the tertns and conditions herein set forth. .
It is further understood that upon the acceptance of this order the contract so made cannot be cancelled,altered,or modif ed by the purchaser or
by any agent of Baughman Memorial Works,Inc.in any manner except by ag�eement in writing between the purchaser and Baughman Memorial Works,
Inc.and it is hereby understood and agreed by all parties involved that in case of default by purohaser or purchasers,twenty-five per cent of the total
original cost of the work or work and materials ordered,as the case may be,shall be a specified correct sum as liquidated damages which purchaser
shall owe Baughman Memorial Works, Inc.less any payment on account made prior to such default,this specification of damages to be due regardless
of removal and taking possession of stone,monument or materials from purchaser�or,purchasers by Baughman Memoria�Works, Inc.upon following
i � ;�
such default. � 1 „ �'
�'�": ^i;.�/(SEAL)
� ,' .,... � .,y ,-- " 1
t�� � 20�.` � (SEAL)
Baughman Memorial Works, �nc.Approval By �-�"i-V:`r ±��'..��+ ' �-'..�:��^M.. (SEAL)
Whire�OHice Coov:Canarv:Customer Coov:Pink:Salesman Copy;Gold:Deposit Copy
_
: Page 1 of 4-
` e M�T Visa
�4��
� AccouM Number Ending:2801 � �
B�L SHEd21FF
Account Summary cus�omer service t-soo-�2a-2dao
`5�`ilml7ia�eT�AC_�i,�,fiuM-JYtsttRiCfi"; .�. .�Y '-P$� @YRII�ftiinlAtR7 � .�;; '<�.„°��ti=, ,.��;�-.r�.�..y
tt,
Previous Balance� $216.02 New Balarrce - 5246 02µ •
Payrrients $0.00 Past Due Amount � � $45 00 � � ��
Credits - $O:DO Total Minimum Payment Due _ f60.00 �� I
Purohases � �+ $0.00 PaymeM Due Date �� - Ot/23/2015 �:: ' , ;"
Detids + $0.00 Headmg south for,the
Cash Advances + -- $0.00 late PaymeM Waming:If we do not receive your minimum °�'�i�t?r't RgrtteJilbe�to�ro4ide �
Fees Charged + � � �530:00 paymenf by the date listed above,you may have to pay e late fee Sus With yOUt tempotarj!melling�'
Intere3t Char ed + - $0.00 of up to$35.00 and your APRS may be fncreased up to the ' adtltess,s0�+our State[�tent5 �:
NewBalance- - . , . $246.02 PenaItyAPRof24.99%�. � . � � - 'j amvebnitrtn@ SiMplyca0 -
Total Credit Line SS,000.00. � Min�mum Pa 1-80Q 724�440 4
yme�rt Waming:If you make oniy the � �
Available Credit � 50.753.98 � minimum paymeM eaoh period,you will pay more In interest and d � � �
Cash Limit $1,500.00- will take yoq longer to pay off your balance. - � . ' `t --c� r
Available Cash $15.00 For example:� � � - � -'� '
,_�
Days In Billing Cycle � °'=J#syou t1�5fce[�o- `�oit;�llAaYa fr �i,`` "`-� '��i� , :
ClosingDate , 12I26/2072 �addRwllqlcha7ge5 $�th�fia�ns�x .. A1�dyo�4�n1Y �
s'�s�R91h�5ca��„`; sfi'oV�tclhLs� ��e�pr�'i'are�te�i�,�
� � �`
- . s�,��,�id��lh d� ,y*.z . ��i 'w 'tQ�A�fbf� -��3�
. im.° ecf ...� .«. &' k`-n.8�7011G .t.v R Y+ .t s,,;;i -w.'n`�a„ i ,
� � � Onlytheminimum f��Qmonths. $252 Y
�payriient �
If you would like information about credit counseling services
please call i-800-388-2227. � � - - � .
Effective this cycle, the Index Rate on your account is 3.25°/u.
Due to the serious delinquency on your account, your Credit Line has been su5pended. Please pay the
overdue 8mount immediately.
�Please detach end retum poAion below with your payment:Keep portion above for yo�r records.�
^4�PI�ds R!�em��er�.TOS�¢��.£S.�,r,h ��`i x��4�{� *3�ilyj� � �' �
�t 1�4��5� Y�����fi� ��R �TFS�����Tl`��»j!�i'4�f`�'N� , , ' '• ' � -
;� � � �,t x fu.�,�`• �is4 F��,�. . '€ 4 �i ��,� ° '� C-'
� ,�Cumberland Gootlwill Fire;Rescue,EMS >"�, .
ts Billing Office'�' `� ' 12-197547 10/22/2012 $150.00
PO Box 726
New Cu erland, PA 17070-0726
QUESTIONS ABOUT THIS BILL7 Phone: 677-214-6018 EspaFol: 866-724-4114 Fax: 717-214-6020 Emall: Into�ambulancebil�ingo�ce.com
Date of Service: 9/19/2012 09:43 � Please visit our website to provide tnsurence or make payment, and
Patient Name: SHERIFF, BETTY - for addltional payment options and frequently asked questlons:
From: CaAisle Regional Medical Center Wyyyy,ambulantebillingo�ce:com
To: Harrisburg Hospital(Pinnade)
•
E <<We'frlet7�"a c7aem wuh your:nsurdnce campmiyEand received a�7cu�hal paym�ritx The remaim'��`g 8alan`�c�isr oirr res ohsrbilt � � �'
�^'nrPlea`se�ie'mt��"�amery1�^7r{t��C OU,�h�i'yi ` �q"7- �ae�ti'F�1t ��y�'t�k� f o,� i 'i+�'.a4 �kvrY �Lah�F`f�`�'�i�^' ��tei^�x::,�.�d�f���fv��V.,C.,��`u;=r
6r t�r�xTV �S� itpffi�.' � 'S r ,, y i' a 1 ) sU k $�r� A- �` . ? �l�s', �, _} Y,. �1
dNC'.tiv ( ��'1:n £2' ux' k..l ��fy� l�Y�fl < � .��44�Y �. ..��rb ii� ,+�k+� i4i,rH ya. j�r".w�ii �.i. �Fi 'C'+A'j l'[S1��i'�¢1'�r4�•i'L�i�}'"�y ,�i$�`�i 4��s4�. 'p
t �\�`.�t,�..'�''Nlt{ F'rk' iS' }. yy K F3e.�4-' �
l�iY4��N <. �n ?- fl +t y yY. l,y,,, f r Rj.� � 4�af `3.�.�1� � fy-t; ,57���Y ,}�a'�'4�'Xt°��4A�'r�Slk �''T,. SeK`td, i`y'���,'f�V � t'".
E..1sn��u..�..�..s..r�--.� 5.�:.,:ins�+::.�..v'��iH.rs'.i'_ t�tl,�..e�`,.a.�T?yf.y'f��.,�...Y,�`:C`.:.e.'.Jn:n�.a.. a,iP:�.?:re!51ti�?f�s..,�'.;;,..>`1.;��1+.r�^uv_n�a.,:_��i�i.:..,^... .�3�z:��`;
0" p" m p
9/19/12 BLS Emergency Transport A0429 1.0 630.00 630.00
9/19/12 Mileage A0425 20.2 12.08 244.02
9/19/12 Adjustment-Insurance -398.70
10/22/12 Adjustment- Insurance �.g�
10/22/12 Payment -320.71
Total s . -. . . . 874.02 -403.31 -320.71
I
j
�
�
____Y.4^DETACH AND RETURN BOTTOM PORTION WITH YOUR PAVMENT.
-�' �-
. . _ • -
PINNACl.EHEALTH
, HOSPITALS �
Financial assistance is available for the uninsured
or underinsured who appty artd qualify. For more
ioformation, please cali or see our website at
www.pinnaclehealth.o�g/billpay.
BETfY SHERIFF For AccouM Information,
222 MCALLISTER CHURCH RD Please Call (71�230-3717 or
CARLISLE PA 17015-9504 1-800-603-6084 for Out of Area Calls.
See details on the 6ack of this statement.
tf payment has been seM, please disregard.
Pay ontine at:
https:/lbil lpay.pin naclehealth.org
� � . - . -
Patier�t Name: Sheriff,Betty Total Charges: 5741,743.25
Statement Date: 72/31/12 Payments/Adjustments: 5141,293.25-
Service Date(s): 09i19/12-10/09/12 Account Batance: 5450.00
AccouM Num6er. 130094315 Patient Balance: S450,00
Primary Diagnosis Code: 038.9 Please Pay This Amt: 5460.00
. . , •
Ins. 1:ADVANTRA .00 For questions, call our Billing Help line at:
Ins.2: MEDICARE A .00 717-230-3717 for local cails or
��g 3. 1-800-603-6064 for Out of Area.
Ins.4: Customer Service Hours:
Mon-Wed-Fri 7:00 AM to 4:00 PM
TueaThurs 7:00 AM to 6:00 PM
Please Note: Your physi�cian wiAbill separetely for professional services.
Make Checks Paqa6le Ta: P+nnaGeHeaith Haspitals AanuN NumEer: Plaaee Vry TNS Nmemrt
300943 5 ,��450•00 _
�th�rt Nam¢ � Y=
unnum�niiimumnn�am�a�ai�mi� Sheriff,B Upon ReCeipt
J PinnacleHealth Hospitals � � ❑ ❑ � ❑
a, PO Box 2353 CarC Num6er. �r+o:^ �a.o.�:
Hatcisburg PA 17105
Sipimwre: . Amoum Peid:
❑ LMixk 4ox if your Wdnes o�in6urenro infarmmien -
Me MengeG. Pla�co rtuke elunBK an Oack •Tpe L1NY Numbet is the last 9 digNS on tlro Wct af yaur eredit uM,Ey Your 6igMtur
onna1725 001 0.53
BETTY SNERIFF � ��� ( ���� � � �� �
222 MCALtISTER CHURCH RD "' "' "' "" ' " "
CARLiSLE PA 17015-95Q4 PINNACLE HEALTH HOSPITALS
P.O. BOX 2353
HARRISBURG, PA 17705-2353
OQDOOb3D09431500000045U�00U0U00U�D
__ _ �
��REGtONSA�L ,
NEDICqL CENTEp
�
� � � � � � � � ' �
Patient Name Betty L Sheriff e pnline at www.car(istermacom
Account Number 9534692 (available 24/7)
Date of Service September 15, 2012 �
Service Type Inpatient Services BY phone-717-960-1680
Insurence Name Advantre Ha Medi Replc
Name of Insured Betty L Sheriff �By credit ca�d-complete section bebw and retum
Policy Number 80214817001
Amount Due From You $600.00 �By cheCk-return section below with check
� • • � • •
Amount due from you is$600.00 as of 9 7/26/2012 for The cherges listed below do not reflect the discount that
Inpatient SerVices pefformed on September 15, 2012. you and your insurance company reoeiyed.
ICU 5,740.80
Tofal Charges $58,941:58 Pha�macy 74,556.15
Discounts/Adjustments Given -$48;968:65 IV Solutions 9,075.31
Insurance Payments Rebeived -$9,372.93 Supplies 4,595.39
Amount You Paid $0.00 Radiology 1,113.24
' Cab 5,781.70
, Ca'rdiovascular Study � 688.13
• � . . Respirafory 12,955.80
Emergency Room 2,490.02
Amount Due From`You $600.00 ' Gardioiogy i,945.04
TOTAL CHARGES $58,941.58
� , •• �• O ��'����lu 3269-HMASTMT-1525914-133561712&P;682244&7-028;32822960.1; 1
As of today,we have not received payment irrfull on your account. immediate
payment is required, please contact our business office today.
r - FOR CREDIT CAR�PAYMENT,PLEASE FILL OUT BELOW...
aTERCARD �� DLJISCOVER Y�SA V❑ISA � �EX
��'� 369 Alexander Spring Rd. cn�Humeea exv.
RECIONAL Cadisle, PA 17015 �
SIGWITURE SECURITYCOOE
PATIENT NAME SiATEMENT DATE DATE DUE
Betty L Sheriff 11/26/2012 UPON RECEIPT
� P8t1811�FII18f1C12I SBNICeS: ACCOUNT NUMBER AMOUNT DUB AMOUNT PAYING
717-960-1880 g534692 $600.00
� �Check6oxi/etltlressbelowisincnrteclorchargedantlindicatachenge(s)onback. 654D69A(PC2)
REMIT TH/S PAYMENT STUB TO:
teo oiot gETTY L SHERIFF CARLISLE REGIONAL MEDIGAL CENTER
222 MCALLISTER CHURCH RD PO BOX 281442
CARLISLE, PA 17015-9504 ATLANTA, GA 30384-1442
h�r�Pili��i���n�����n�hi�������dhi�Il��Pdr�lp���hrl dlll�ll��i�l�ul��quuiuiu�hlu�ui4��lll�nidd�hll����
�0000953469200000060000BETTYL3HERIFF 0
_
INVENTORY
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA 1 SS
COLINTY OF CUMBERLAND f FileNumber z�-�3'0006
Personal Representative(s) of the Estate of BETTY L.SHERIFF
deceased,depose(s)and say(s)that the items appearing in the following inventory include all of[he personal assets wherever situate
and al]of the real estate in the Commo�wealth of Pennsylvania of said Decedent,that the valuation placed opposite each item of said
inventory represents its fair va(ue as of the date of the decedenYs death, a�d that Decedent owned no real estate outside of the
Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory.
I verify that the statements made in this Inven-
tory are true and correc[. 1 understand [hat false state-
ments herein are made subject to the penalties of
18 Pa.C.S. § 4904 relaring to unswom falsification to
authorities.
Attorney-- (Ncrme) ROGBR B. IRWIN,ESQUIRE (Supreme Court LD. No.) 6282
(Address) 60 WEST POMFRET STREET, CARLISLE,PA 17013
(Telephone) �717)249-2353
�ATE OF OEATH LAST RESIDENCE DECEDENTS SOC.SEG N0.
10/13/2012 222 McALLISTER CHURCH RD,CARLISLE,PENNSYLVANIA
FIGURES MUST BE TOTALED
222 McALLISTER CHURCH ROAD,CARLISLE,PENNSYLVANIA 41,000.00
M&T BANK-CHECHING ACCOUNT 7,996.44
PERSONAL PROPERTY 840.50
1966 CHEVY 1,000.00
2004 CHEVY AVALIER 3,000.00
L �
O V7 !(�
u= '' f-- �—
U '-� `� tY '
� .. _ � G
L'_ ta. � ' J �i
c'. ;� ::1. �"- U C_l
� .. '., �� �
k:i LV � l'J �
� .-- N -_.i MJ, `l
GY 4�) C? :.t W
V � '7 t: �
� � `.-.`—,� � �
v
(Attach additional sheets as needed)
TOTAL: 53,836.94
NOTE: The Memorandum of real esta[e ou[side Ihe Commonwealth of Pennsylvania may, at[he election of lhe personal represen[a[ive indude ihe value of each
irem,bu[such figures should not be ex[ended in[o the to[al of[he Inventory. (See 20 Pa_C.S§33Q!(6)J
Form RW-09 rev. 10.13.06 ��