HomeMy WebLinkAbout07-29-13 � REV-15QQ°"��"' 1SU561�143
OFFICIAt USE ONCY
PA Department at Revenue psnmy nia camy cm. r«u vir N�
Bureeu Of Individual Texes ��ane��
�o BoXZao�o� INHERITANCE TAX RETURN 2 1 1 2 1 3 0 4
ttar�nbur�,Pa, t�tze-oeot RE$IdENT DECEDENT
EMTER UECfi4ENT INFORliAAT10N BEIQW
Social Security Numbar Data of Death pate of BiAh
1Q 2 ? 2012 09 2 $ 1924
[)ecedeM's Lsst Name SuHbc Decedent's Fint Name MI
LARSEN ELEANOR A
(If AppN�abls}EMer Snrvlring$pouss'a IMartnatton&rlpvr
Spousa's Laat Name Suffnc Spouse's Fint Name MI
Spouae's Sxial Securriy Numbar THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WIILS
Fiu�+apasoPraAr�ov,a�s eE�ow
� t. priginalRetum ❑ 2. SupplpmeMalRetum � 3.pn�ro�1Z�Z�(D����
[] 4. tk�tikd EatMB ❑ �'�oMS Ma�rri afla i�7 ❑ $. FeCerai EstNe Taz R�ri Rec�ked
- � g, oecaasK asi iwete p 7. o�C MeMaYNM a Lirirp Tnut � 8, Totel Number of Safe Depoait Bozea
(Ad9chCWYOfNAN! W �PYMTrusl)
. � 9. t�Prviceed¢RecBived (� 16-bt�ntx-�3�-arct°b�{D�ss�Da�",� ❑ tt.�sa,���e0)sec.si�s�A)
CORRESPl7NDEM•TFNS SECTION MUST BE COAIPLETED.ALL CORRE$PONDENCB AND CONFIpENT1Al.TAX INFORMA7KIN SN01.16p BE DIRECTEO TO:
Name 6aykima T�;�nba �
SOHN M ZIMMERMAN 71c 865 �7.�07� �
n � c-> p
R�R�&F WItl8��81RY
� s,. �:.. t�� r-r;, r�
r- . c� ,
FOstLlneoiAddres� p� �,; : : } ;,,
_ C
4 6 6 .IONESTC7t+tt*I RflAD �� •- � -� �` i
Second Llns W Adtlroas �-' '�' �''�
rv
'� ' u� 't„ O
-rs
� DATE F1E�3
�nY��'��� Strte IIP Code
JONESTOWN PA 17038
corrospand.M�.rmaneaaress: zimmermanlaw�comcast.net
Under ,I Ufa!!hava ar#mk�ad Mis rmWWm.�nc!utl'uq�accamovrvIrp ed�edubs erM sdtart�anb,uW ao the beet ot my knowietlge antl OaNef.
it is USre. d ptapltK Otltat tl�tlu persd�rapree�3mv8 is 6saeQ mi aN iMamaUOn of whidr
m prparerhsnanYk'�cr�e,
SIGtUTURE R80N 8tBLE F FIItNCi RETVRN pp7E
Roy E. larsen �� � � �
nooReas
21 Narth 11th Streat,AI{entow�,PA 18101-1019
IGNATURE pF PREP ER tlTHER THAN REPRESENTATIVE pq7E
� John M Zimmemtian
ER, ER 8 ZIMMERMAN
Jonastown Road,Janestown PA 17038
Side 9
� 1505610143 1505610143 �
� 1505610243
REV-1500 EX
DecedenPs Social Securily Numbar
oecwenreN.�: LARSEN, ELEANOR A.
RECAPRULATION
1. Real Estate(Schedub A).......................................................................................... 1. 1 7 5 . 6 9 8 . 8 2
2. Stadcs and Bonds(Schedule B)............................................................................... 2. �
3. Cloaey HeW Corporetion,PaRnership or Sole-Proprietonhip(Schedule C).......... 3.
4. Mortgagea 8 Notes Recoivabla(Schedule D).......................................................... 4.
5. Cash,Bank Depoaits&Miscellaneous Penonal PropeAy(Schedule E)................ 5. Z 6 , 7 5 5 . 9 $
� 6. Jointy Owned Property(Schedule F) ❑ Separafe Billing Requested............. 6. 1 2 , 7 2 6 . 9 1
7. Inter-Yrvos Transfen&Miscellaneous Non-Probate Pro rty
(scnedu�e c> ❑ separaie�ing Reyuested............. �. 1 7 , 9 1 2 . 2 9
8. Tobl Gross Asseb(total Linas 1 through 7).......................................................... 8. 2 3 2 . 5 9 3 . 9 5
9. Funeral Expanaes and Administretive Coats(Schedule H)..................................... 9. 3 6 , 2 6 0 . 3 9
10. Debta of Decedent,Mortgege Liabililies and Liens(Schedule I)............................. 10. 2 . 6 2 4 . 9 1
11. Tofal Deductlons(total Lines 9 and 10).................................................................. 11. 3 8 . 8 8 9 . 8�0
t2. NK value of Estab(Line a minus Line 11)............................................................. t2. 1 9 3 , 7 0 9 . 1 5
13. C�eritabb and Govemmental Bequeap/Sec 9113 Trusls for which
an election to tax has not been made(Schedule J)................................................. �3. 7 , 4 0 6 . 1 5
14. Nst Value SubJect W Tax(Line 12 minus Line 13)................................................. 14. 1 8 6 , 3 0 3 . 0 0
TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. AmouM of Line 74 taxable
at Me apousal tax rate,or
hanafen under Sec.9116
(a)(1.2)X.00 15.
16. Amount of Line 14 taxable
et lineel rate x o4s 1 8 6 , 3 0 3 . 0 0 �6• 8 , 3 8 3 . 6 9
17. Amount of Line 14 taxable
al sibling rete X ,�y »�
18. Amount oi Lina 14 taxable
at collaterel rate X .15 �8�
�e. rnxoue..................................:................................................................................ is. 8 . 3 8 3 . 6 4
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. �
Side 2
� 1505610243 1505610243 �
REV-1500 EX Page 3 F)k Number 21 • 12 - 1304
Dacedent's Compiete Addreas:
LARSEN, ELEANOR A.
STREETADDRESS
200 West Courtland Avenue
CfTY ----- ---- ---- --- STATE ZIP ---
Shirsmanskown PA 17011
Tax Paymet�and Credits:
1. TaxDue(Paga2,Une19) (1) $�3$3.6A
2. CredilalPayments
A. PriwFayman4s 8,000.00
e. Discount 41$.1$
��- -�-- Totel Credita(A +B) (2) $,419.18
�• ���t {s) 4.80
4, If Line 2 is greaQer ihan Line 1+LNre 3,er$er the difference. This is the OVERPAYMENT. (4) 35.54
GMck box on Page 2.lGw�to rackwst s tNund — -
5. If Line i +Line 3 fs greater lhan Line 2,enter lhe dNterence. This is the TAX DUE. (5)
Make Check Payable to: REGISTER OF WILLS, AGENT.
PLEA3E ANSWER THE FOLLOWING QUESTIONS BY PLACINCa AN "X" IN THE APPROPRIATE BLOCKS
t. Did decedent make s tranafer and: Yea No
a. retain the uae or income oi the propery trensferred:.................................................................................. � �
b. rotain the right to desipnale who shall use the propary trensferred or Ma ineome:.................................... x
c. r+e�in a rovetsronary inMrestt oc......................................................................................_......................... x
d. receive the Promise for 8fe of either paymeMS,benefib or cere?.............................................................. x
2. It death oaurred after Deo. 12, 1982, did decedent transfer property within one ynar of death wRhout
receMing adequate conaideration?..............................................._.........................................................,............ ❑ �
3. Did decetleM am an`i�trust far° a payebte upor�doath bank accoarM or security at h�or her deeth?......... u �
4. Did decedent own an individual retirement accouM,annuiry,or Wher non-probate propetly which
conteins a benoNciary designation7...................................................................................................................... 0 ❑
IF THE ANBWER Tp AMY OF THE A90YE QUEStmNS IS YES,YOU 1�lST CQ(I�LETE SCME��E G AMD FILE IT AS PART Of TkE RETURN.
For daMS W death on or aPoer JuW 1, 1994 end 6ofore Jan. 1, 1995,the tax rete impoaed on tbe net value af trenafen to or for the use of the surviving
Spouse is 3 qercent[72 P.S.§9116(a1(11?f)b
For ds6n aF deaM wE a aMr January 1,19&i�tIm ta�c rate GnPOaed or�the�#vaitw oi iranafen to a far the use of the wrvivi�spouse is 8 Pt«er�t
(72 P.S.§9118 Sa)(7•1)tiijl. The nfafute 6osa not exemDt a franafer to e survivinq spouae fran tex,and Ma statutory requiromanid for disGOSUrc o/
aaaets and flling a tax rvMum are still applicable even ff ffie surviving spouse is the anly beneNdary. �
For datea W death on or afler Juy 1,20W:
�The tax rak'anoosed qn ths net vaWe a€transfers from a deceased child 21ye arn of a{�e ar you�ger at deeth to or for the use ot a natural paren{,an
atloptNe paront,or a stepparent of Ma child is 0 percent[72 P.S.§9118(a)(1.2)].
•Tha tax reta imposed pn the net value of transfets ro or tor the use ot the decedenYs lineal benefidaries ia 4.5 pertent,axeept as noted in
[72 P.S.§9118(a)(1}].
�The te�c rate imposed on the nei value of iranaferc to ar tor the use af the decedeM's aiblings is 12 percenl(72 P.S.6$118(a)(S.3Si. A
aibling la defined under SeGion 91p2,as an indivitlual who has at least one parent in comman with the decedent,wfiether by bba]or adoption.
� pennsylvania
�,�M�RE�� SCHEDUIE A
RES DEM DECEDEM"RN REAL ESTATE
ESTATE OF �p,RSEN, ELEANOR A. PiLE NUMBER
21 - 12- 1304
AFI reai property ownad s�sW or as a Dar�aM in eommon mwt 6e�r�ported at fair mnrket value.Falr marfcet value is defined as the price
at which prs�perty wovld be exchmnged betvreen a wiNrc�g buyer and e ring seiier,neither being campeNed to buy or seii,both having
reasonabie nowlsdge of Me relevant fads.Real property whlch le JoiMlyowned wlth right of aurvivorship must be dladosed on
schedule F.
Attach a capy Mtha s�tement ahest if C�e praperty haa beet�aoM.
In�ule a�ot the d�d shavi�dacedenfs inferoat ii ownad a�tensnt in cammai.
ITEM ' DESCRIPTION VALUE AT DATE OF
NUMBER DEATM
t Reai setate artd residenoe at 200 Caurtland Avenus, Shiremanstown, Cumberiand Caunty, 175,000.00
Pennsylvania-sale price
2 Tax prorations to date of settlement-d5l2912013{s�HUD attac(sed} 698.82
TOTAL(Aiso eMeron Une 1,Rscapituiation) 175,698.82
�y pennsylvania SCHEDULE E
�j� DEGARTMENf OF REVENUE CASH
INHERITANCETAXNETURN , BANK DEPOSITS AND MISC.
RESIDENTDECEDENT PERSONAL PROPERTY
E8TATE OF �,qRSEN, ELEANOR A. FILE NUMBER
21 - 12- 1304
Indude the proceeds of Ikigation and the date the proceeds were received by the estate.All property JoinUyownad with the rlght of
survivorshfp must be disclosed on sehedule F.
ITEM VALUE AT DATE OF
NUMBER DESCRIPTION
DEATH
1 Sovereign Bank-Money Market Savings#1681727226 21,354.52
2 Citizens Bank-Checking Account 6100�15965 861.33
3 Personal Property 500.00
4 1996 Saturn -Blue Book Value 1,675.00
5 The Patriot-News-refund 146.90
6 AAA-refund 70.59
7 Highmark- refunds 242.11
S Quantum Imaging - refund 13.98
9 Comcast-refund 45.51
10 Eshenauer Fuel -refund � 6�8 �z
11 PA American Water-refund �32
12 Westem National Life Insurance Co. -dividend 160.00
TOTAL(Also enter on Line 5, Recapitulation) 26,755.98
REY-1/GlEX�(07.10+
� ���y��/8h�a
OEPARTMEMTOFR6VENUE SCHEDULE F
INMEPITANCETA%RE7URN JqINTLYAWNEQ PROPERTY
a�s,����
ESTATE OF ��SEN, ELEANOft A. FltE NUMBER �
21 - 12- 1304
It an asset was made Jolnt wlthln one year of tt�decedent'a date o!death,tt muat be raported o�acheduia G. �
SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIpNSHiF TQ DEGEDEHT �
Roy E. Larsen 21 North 11th Sireet � Son
q Allentown, PA 18101-1019
JOINTIY OWNED PRdPERTY:
ITEM ��R �TE Indude name ei na u n an n accounf numbe DA'fE OF DEATH %OF i onreoFOe,e�rn
NUMBER FOR JOINT MADE or s�ilar�en' number.Attach deed for'a�t -heid reai VAtUE OF ASSET ��D�$ �"�'��°F
7E�4� JQ�N'( y�y� �� � � INTEREST ��CEDENI"SINTERE6T
_ .�.__"_'__.._��._.._. ._..
1 A Citizens Bank-Money Market Account zs.a5a.e2 5036 12,726.91
#6200258531 �
I
I
I
� �
I
I
(
i
_�� ..,_...� _���_..-1—.—._..�—....�. - ..�
TOTAL{Also enter on Ilne S,Reeapitulation} 12,72B.91
nsw�eto rac,t�!
� pennsyivattia l
OEPARTNENlOFREVENUE SGNEDULE G
INHERITANCETA%RETUFN INTER-VIYOS TRAN3FERS & -
a�s'°E"T°E°EOE"T MISC. NON-PRpBATE PROPERTY
ESTATE OF �.q�SEN, ELEANOR A. FlLE NUMBER
---- - — _.�21 - 12-130A .�__� __
Th3s scheduie must be completed and fiied if the answer to any of questions'I through 4 on page 2 Is yes.
--._�_ — T- r--
��M DESCRIPTIONOFPROPERTV ����T�y %OF EX��Ug�QlF TAXABI.EVALIJE
��e��a��•���m� VALUEpFASBET �C��B (IFPPPLICABLE)
NUNiBER y�ya���s�y q�eCOpybflMOestl/orroelsetels. INTERE6f
— 1� Westem Nationa!life Insurance Co. -Annuity ' �Q���� 100°� t0,006.09
( XV227025-Named BeneBciaries are Eric Larsen and i
Roy Larsen
I
2 E�CA Fountlation-Gift Annuity-Named Beneficiary 7,ao�.t5 1Q0°lo : � T,d�.15
� is EFCA Eastem DisUtict AssociaUon{charity} i
I
i I �
,
I �
, I
i
I
� �'
�
� �
i I
� I
�
� '
� �
, I� �
i
� � I
i I � �
� I � 'I
�_ � _ � �__
i � TOTAL{Also eMer on Ilne 7,RecxPlWlaUon} �412.24
.
REV-06H IX��70-0Y)
� pennsyivania �EH
OEPARTMEHTOFREVENUE L7�d'f�1 N�srrc�w,^
1-M�fYR G/�rGl{7�"w7 fYV
INHERITANCE TA%RENRN _Y—_�_��
RESIDEM OECEDENT /��`�� �
ESTATE OF LARSEN, ELEANOR A. FILE NUMBER
21 - 12 - 1304
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT
A• 1 ' Myers- Buhrig Funeral Home and Crematory 9,975.00
2 Wegmans-funeral luncheon 421.61
B• ADMiNIBTRATIVE CO3T3:
1. Penonal RepreseMative's Commiasions�
Name of Penonal Representative(s)
Street Addresa �
i ��Y
State Zip
Year(a)Commission Paid
z. ' nnomeys Fees Brinser, Wagner&Zimmerman 5,000.00
3. Famiy Exemptlon: (II deadenPs addresa is not the same as daimanfs,attach explanatlon)
Claimant
I StreetAddroea
� ��' State Zip
Relalionahip of Claimant to Deoedent
a. aroea�e Fees Register of Wills-initial probate 382.50
5. Aaountanfa Fees
6. Tax Retum Preparor's Fees
7. Otha�Administrative Cosb
1 Sovereign Bank-fee for date of death information 20.00
TOTAL(Also enter on I�ne 9, Recapitulation)
36,260.39
� Sched��eH I
COMMONWEM1ITrI OF VENMb`YLVANIA ���
INHERITANCE TA%R@TURN ����
RE$IDENT OECEpENT
ESTATE OF (.AR$EN, EIEAMC7R A. FIt,.E NUMBER
�1 - 12- 1304
2 Roy Larsen-reimburse for purchase of new appliances in preparatipn for sale af� &93.35
decedenYs residence{785.90); rentai of steamer to c(ean carpet(62.39); tentai af I
� U-Haui(65.d6)
i
3 I Roy Larsen-reimburse for travei expenses to decedent's residence for repairs and 1,420.40
i cieaning in preparaGon for saie(100.00; 1d0.dd; 270.40;400.d0; 150.00}
d Lawes-suppiies far house repatrs � ��q.gq
I
5 Hnme Depot-supplies for house repairs ! ggg.gg
8 � Heet�s Sutnlus-bathroom vanity and vanity tops, etc. I 911.39
7 I Oilie's-supplies for hause repairs ��.g4
i I
8 I Tuesday Moming -supplies for house repa'rrs 28.��
9 Garpe�AaR-ne+rv carpet far resider�ce In prepara#ion far sale 1,587.17
1 q Faircloth Plumbing, Heating&AIC-repairs to decedenYs residence in preparation for r 1,224.Od
sate
;
11 I Bill Fair-carpentry services 100.00
,
12 RetMsx 1 st Advanfage-reaitor's comrnission on sale of reat estate � 5,250.p0
13 � RelMau f2ealty Associates, inc. -reaitots commission on sale af reai estate + �,�pQ,pp
14 � Vickie Welker-notary fees 10.00
15 I 1 s#Advantage Settlement-tax ceRificatian 5.pp
16 Realty trensfer tax on sale of real estate estate{1%} � �,75p,pq
17 Brinser, Wagner&Zimmerman -deed preparation and aHorney's fees an sale of real I 265.QQ
estate
18 I First American Home Buyers Pratection Corp. -home warranty � 365.p0
' I
i �
, i
I
Page 2 of Scheduie H
. ��
,+� ( Sdtc��eH f
COMMONWEAI,iHOFPENN&VLVANIA � •" ---�
INHERfTANCETAXRETURN ���'�� �
RE81dENT DECEDBNT
ESTATE OF LAR3EN, ELEANOR A. ���N�1�g�R
��21 - 12- 13p4
19 David Gruver-services re: upkeep of real estate pending sale � 200A0
f
20 Roy Larsen-reimburse for rentai of U-Haui to move personal proper#y irom real estate 106.60
�
j �
,
�
i
�
�
�
I
i
�
�
t
�
i
1
�
i I
I
I
a
�
i
I j
Page 3 of Scheduie H
I
� pennsylvania SCHEDULE 1 �
�PARTM£M�REYENUE
�r�rawcer,uca�a DEBTS OF DECEDENT, MORTGAGE
flESIDENY0ECE0ENT LIABILITIES � LIENS
�
' ' _ " ': _' " .._ .
ESTATE OF �,qRSEN, ELEANOR A. Fi�e NuMeeR
-�21 - 12- 1304
Repa�t debts incurrad by the decedent prior to death that remained unpaid at the date of de2th,induding unreimbursed medical expenses.
iTEM '
NUMBER DESCRIPTION AMOUNT
1 Crocket Nlawing and �andscape Maintenance-Iawn care 286.20
2 Discover-payment on credit eard balance � ��
3 Erie Insurance-homepwners insurance premium 563.00
4 PPi.Electric Utilities-electric service{50.$1; 114.3$; 115.A4; 6d.5$; 40.82; 23.44;27.14; d�g.p�
18.43)
5 PA American Water-water sentice(54.68;41.39; 33.28; 35.17; 32.38;26.78;27.72) 247_3$
6 Verizon - phane service 4.69
7 lawer Alie�Tcnvrtship-sewet service{2�65.00) 130.00
8 AT&T-long distance service{Final} 16.34
9 Advance Disposal Service-trash removal service(37.02 8 42.21) �g23
10 Judy C. Proxrell, Tax CaII�#ot-counfy&borough real estate Faxes 808.44
TdTAI(Aiso en�r on line t0,RecapidiFadon) 2,$2;,41
REV-1677 EXt(07-10)
�y pennsylvania SCHEDULE J
r,j� DEPAR7MENT OF REVENUE
INHERITANCE TAX RETIIRN BENEFICIARIES
RESIOENT DECEOENT
ESTATE OF FILE NUMBER
LARSEN, ELEANOR A.
21 - 12 - 1304
NUMBER NAME AND ADDRESS OF PERSON(S) RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
RECEIVING PROPERTY DECEDENT (Words)
-- ��,«�,.�,,,�..,., casa�
I, TAXABLE DISTRIBUTIONS[indude outripht spousal
distributiona anA tror�sfers
under Sec.�176(a)(1.2)]
1 Roy E. Larsen Son 1/2 of residue
21 North 11th Street
Allentown, PA 18101
2 Eric T. Larsen Son 1/2 ot residue
2 S. 513 Ashley Drive
Glen Eltyn, IL 60137 I
I
I
Enter doller amounts iw diatributions shovm above on linas 15 through 18 on Rev 1500 cover aheet,as appropriate.
II. ��'�'T�B�E DISTRIBUTIONS:
A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1 EFCA Foundation -Gift Annuity
7,406.15
TOTAL OF PAR711-ENTER TOTAI NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET �,406.75
LAST WILL AND TESTAMENT
OF
ELEANOR A. T,AIt$EN
I, ELEANOR A. LARSEN, of Shiremanstown, Cumberland
County, Pennsylvania, make, publish and declare this as and for
my Last Will and Testament, hereby revoking all other Wills and
Codicils heretofore made by me.
FIR : I devise and bequeath all the rest, residue and
remainder of my estate of whatever nature and wherever situate,
including any property over which I hald power of appointment and
together with any insurance policies thereon, in equal shares, to
my chilclren, ERIC T. LARSEN ancl ROY E. LARSEN, provided that
should either af my children predecease me, I give and bequeath
such child' s share unto his issue per stirpes by representation
and if there be a failure qf same, then I give and bequeath such
deceased child' s share to my surviving child as provided herein.
SSCdND: Shoulcl any af my granclehildren not have
attained the age of twenty-one (21) years at the time for dis-
tribution to him or her, I give, devise ancl bequeath the share af
d each such grandchild to my hereinafter named Trustee or Trustees,
� IN SEFARATE TRUSTB, ta hold, manage, invest and reinvest the
��I shares so received, and ta use and apply fram time to time such
' b
portian of income anci principal for the said grandchild's
� education tincluding college, trade school or other similar
� training or education} , as my Trustee or Trustees, in their sole
� discretion, deem advisable, The Trustee ar firustees, in
_(� exercising their discretionary authority with respect to the
� payment af income or principal a£ the within Trust to my grand-
children, shall take into consideration any income or other
resources available to my grandchildren from sources outside this
Trust.
Any income or principal not so applied shall be distributed
to each grandchild when he or she attains the age of twenty-one
(21) years. In the event any of my grandchildren die prior to
the termination of this Trust established herein for their
benefit, the interest of my grandchild in said Trust shall cease
with any income and principal being divided evenly between or
among that deceased grandchild' s brother or sisters or the
separate trust established hereunder for their benefit and, in
the absence of any brothers or sisters, to my other grandchildren
in equal shares .
THIRD: In addition to all powers granted to them by
law and by other provisions of this Will, I give the fiduciaries
acting hereunder the following powers, applicable to all proper-
ty, exercisable without court approval and effective until actual
distribution of all property:
(A) To sell at public or private sale, or to lease,
for any period of time, any real or personal property and to give
options for sales, exchanges or leases, for such prices and upon
such terms (including credit, with or without security) or
� conditions as are deemed proper. This includes the power to give
legally sufficient instruments for transfer of the property and
� to receive the proceeds of any disposition of it.
(B) To partition, subdivide, or improve real estate
v� and to enter into a reements concernin the
5 g partition, subdivi-
� sion, improvement, zoning or management of real estate and to
� impose or extinguish restrictions on real estate.
� (C) To compromise any claim or controversy and to
� abandon any property which is of little or no value.
2
(D) To invest in all forms of property, including
stocks, common trust funds and mortgage investment funds, without
restriction to investments authorized for Pennsylvania fiduci-
aries, as are deemed proper, without regard to any principle of
diversification, risk or productivity.
(E) To exercise any option, right or privilege granted
in insurance policies or in other investments .
(F) To exercise any election or privilege given by the
Federal and other tax laws, including, but not necessarily being
limited to, personal income, gift and estate or inheritance tax
laws .
(G) To make distributions to my herein named benefici-
aries in cash or in kind or partly in each.
(H) To borrow money from themselves or others in order
to pay debts, taxes, or estate or trust administration expenses,
to protect or improve any property held under my will, and for
investment purposes .
(I) To select a mode of payment under any qualified
� retirement plan (pension plan, profit sharing plan, employee
� stock ownership plan, or any other type of qualified plan) to the
extent the plan or the law permits them to do so, and to exercise
� any other rights which they may have under the plan, in whatever
� manner they consider advisable.
`� FOIIRTH: I nominate and appoint ERIC T. LARSEN, as
� Trustee of the hereinabove described trusts . In the event of the
� death, resignation or inability to serve for any reason what-
a soever of the said ERIC T. LARSEN, I nominate and appoint ROY E.
� LARSEN, as Trustee of the hereinabove described trusts. I direCt
that my Trustee shall serve without bond and shall receive fair
and reasonable compensation.
3
FIFTH: I direct that all inheritance, estate, trans-
fer, succession and death taxes, of any kind whatsoever, which
may be payable by reason of my death, whether or not with respect
to property passing under this Will, shall be paid out of the
principal of my residuary estate.
SIXTH: All interests hereunder, whether principal or
income, which are undistributed and in the possession of the
fiduciaries acting hereunder, even though vested or distribut-
able, shall not be subject to attachment, execution or seguestra-
tion for any debt, contract, obligation or liability of any
beneficiary, and furthermore, shall not be subject to pledge,
assignment, conveyance or anticipation.
SEVENTH: I nominate and appoint my children, ERIC T.
LARSEN and ROY E. LARSEN, Co-Executors of this, my Last Will and
Testament . I direct that my Co-Executors, Trustee or Trustees,
as the case may be, and their successors, shall not be required
to post security or a bond for the performance of their duties in
any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and �
seal to this, my Last Will and Testament, this ;)�„d day of
•�G.,,u,ar�p�., 2003 .
U
/�ec-N..r,..c... �G- c2f cT�iA.�-"-" (SEAL)
ELEANOR A. LARSEN
4
Signed, sealed, published and declared by the above-
named Testatrix as and for her Last Will and Testament in our
presence, who, at her request, in her presence and in the pres-
ence of each other, have hereunto subscribed our names as attest-
ing witnesses .
<///�!-.L(.([ . �
Address �"
�/1/_�f.t�J� i . \
Address
5
_ . . _
oNre a�o�r».z�ozozes
"�•v A. SettCement Statement (HUD-1�
t❑�FM z❑1�1s a�cam.uN� -�•�eer. .�s.�w�eer. M..ae.c...Mwbe� �
730A0 16171�
4.0'VA S.QCmv.Na
GMa1c71i Y byw7wal�rnt a�stm4 MIlb�Yl�bw��tqsrw�IwilYSnvlee
'�.u)`w�P�aW11e b'lo�bP wahow pwkrY/anrm�pupo��d w net IKidtl Inb Wla
D.NenqB/WbawdBw�oMS: EWr�s8M6esdSder. F.Nsns6MAwsdLwder.
AloCOrr�,taY0.S�dr6 7MFiYbd9en�Alaa� FL7WYoy4�4�7
170PakNsRca4NerQ�6s1�4PA170A �DllfelOnAsidMisue.f�41�.PA770H 50�110ipbyGA4CYid�OH1879
G.P1apeb lar�ai[ H.SaMs�w�tApwt I.SaNsnsit De1s Ofi/19/lM3
200WStCOUb�d/Uienus 1riA6�Iqe8e�wRSeMOM�e OF�6usenaRDe1c06/29�M3
Sfia�r�Yrw�.PA1�017 6i15�►kimyOlie,9ltOQYedMr�gPA770E0
iShYeme�wbNnBaio�� �� �
Tde�ai 717�1�Fs 717d91-7798
��'3M at��1@,Yed�sivhup,PA77�D PAOSdOY�13�t SdHpm
bYVW
1N. 61MA��lO�a�w�f A�. GO�II�ntD�Yrir
�
10�. . �02 Pearl
Nq. Si�ttlrOrbhmewr�e71001 e.�� � . .
f04. IM.
iLS. . . _ .. . � � � . . . . .
�r� r/rYd�e� Ir` MrrY�e
706 Ylw b AOS �� 1� b � .
1W. r � I�tJb1�17 �O IW: .1�� �b1yDiGq13 �p69
106 .8�idT�w . b 1YlR � d00. SdYd'T��..,� b � 19AR � �.
f00. Atl� �daer � OSRYAfJ�b � L1.67 IW. AdC►S1�s... �..iI�pA17b0E�1] 27b7 � � �
110. . .. �� 4 0.
711. 4H.
�{Z 412
1i< . W7tif� : �.Ii 6:Ir�l fil�DAt
�, .: . . ._.. -..: lR��:. . ... ... . _ .., -:YNYr� . .
�OL �._ . .t�urrrr � . . SWiM ... . � arirf4�) �A1
A3.. � b . . b .
70l laiOrtQ�dA1C 1d7ID �01. P�afdi�t Y� . .
�, � � 906. F�'afafieamdwaaelow
108. �
8A. SW.
�g 506
]IN. �
Mri� i �r� �ir
b b
211. Op�Yrt b 511. Ca�ylw� b �
212 Sdd es b 512 SdndTwt b
�y, 511
�Il �
215 61&
21Q 516
Yt7. 517. � .
�q 61&
�g 51&
tfL TMdIW lw�r W.pLN !M. T�YIIYi/o�AM�IONYr � ��N
Ort• i�ilwM� ML O�Yili��l1M��Wr
�01. �nmlAsiewEs�a�rlirYm) 7b7TlZl4 EDI. Q�aww�tArbdrArG0) 775,�682
3pQ, Iar�wiP� � yW 74Z73/.00 E� lsMdar�inaariAe�ir 90j 7 716.OD
aa. ar �n.. ❑rea.�o.r a.ssu �n c.r �r. ❑a..w. u�
.... ._..ra.r.�.......-......�. . ....� ..�,,.,..� �..�. ..
��
eR ege Xu i
100. TWdRedEeMeBrokxFea �a�750. Pai From paid From
Di�iond�, as�: Bo�rower'g Seiler's
. ��,qp � �c s Advantage Funds at Funds at
2 j,55pp,pp �p RerM�t Aasadatea,lnc. SettlBFtte�t 5ettlement
tan pata aa seltlement o� .00
� ffi .�
b6D. ttems In CanneNoe wNh Wan
1. Our alglnetlm d�arge (I .� �� nadon Poktt 0. a .DO) , , from GFE
2. Yau ar nffi ihe 1nSe�eat rate 086. ' rom E
Yau G A}
to Natlans Yelaatlm SerNc�s GFE. .. . 325...
. Ciadit repat � � tp p�p� � GFE. 78.58�
806. T��nk,e � W . E � Z .
. F1rodc�li�eGOn toSOUfl�weatFinandaSOtv(ce�a�Inc. tram� .£ .
. Apqaisal Mgt.Ca Fee to Natla�a VsluaHan Servkxe FE 1
�no. k.m. irea �.a�aKm w v�a e�na.ance
901. t?aNp c�arges ro ib 43.75
2. Mangage Nre.Pramium tor mmtlis tn j
s insurmrca or 1 �{��e InsurgnGg Ezdi � GFE�# 1 .00�
9Qd. mmtl�a b trcm t�FE A"11
1 W1. Initlal Aepodl�far your e9aow aocount - (trom GFE AB 1.793.89
1002 flameawr�r'simurar�ca 3 �� 37.pp�� 5111,00
t0ar.Martge�e M� maahs S U.00tma� S
1Q6d.GtitS'�P�YT� monMe O.Whrim9� i
1005.CaunN�Y Ta�t 6 rtanthe 87:37/man�h t338.85
1006.Schad Tmres 10�a y 179.391maNh 51,T93.9Q
5007. 5417.�
1100. Tkle n
m.nne a�a s an��euranca rmrn cr�� S.au,w
tio2 se�nent«dod�fee � S
t 103.6vnbr's tl9e ireurance. �GFE�6 175.00
1104. t.endePstltleinsuretce E1,325.00 �
1405. Le��letSiWepc6�y&m�¢140:OW.Qp tendefSPC�,y
ti06.4wnet'oidepo�a/NmItS175;t100.00 ar+net'sPaRCp
1t07.AgenPapor6moFqiettit�6tleirquranceprempMn 51,211.25
1108. Urdernllerkpo�tlenntfiiefofaltl9einaura�cepremfum �2BB75
9109.
111D. NdarY toVN�leWelker 10.OD
1111. Taic CeAlAcatlon Fee ���Adv Selllement S 5.00
1286. C,ewrtaaeat ar�Frm�
120i. Gwemment tharges $ (tramGFE;I� 15200
1202. Deed962.00 M ei90.00 ReleaseS
12tYi.Trensler tm�es S {ftnm C�fE NB) t,75Q.00
126a. CRi�S'��Pg OaedEi750.4D M
1205. ShaleTax/stamps peedy1750.00 M E 1,75q.00
��• DeedS M S
12C7. §
1300. AdtlltldnM Satllrnent.
.�5.Requ . .tliatya�cary � �p
� �
1303. Deed & m&Inaer, &2lmmennan
to FlrstArnerkan Flane Bu PmtecUan
1305. {�
023. 13, .
"Paid wtside d do�o9 a/(�kxro�r,(S)dler,(L)ender�(qnv�r�9ro�14er•�Ceemt bY IBrMer shovm m page i."'Credd by aellx ahbwn on pege 1.
�$ood F��e and F�i Good Fdth Estlmeta NUAi
Tp�t Yp�ere NUG1LInetWmbr
. titags (� f � 4� � •W �d,290A6
Yar+xedt a ' Intdesl iate� � 2 �, ��. .4Q
Yda # 863 i,201.� 1, ,86
Transtetim�9 3 1 5Q.OQ 1,7 .
C 71wtbX�i{CU�nakrae�aelkroTlNn407i GoadFatlk�� ,,tflldl.,, i5 .00
Garen»temtec9r6ngtdiapee � t ,�, __...�.
. � 3 "' .fl0 3
. t�t # 805 .25•� . .86
Taoc s #�&� 7 .
# �
;� 1 i .�
eM Neuraioe � 1101 1, .00 1, .
� �etNU�ance 9 303. .ilD i7 .OD
2,
-1 : �8. 56
i�ltlal ��11 �yau�aowa�unr p t � �—�'/�
Pakh Esttmab HU61
� _ .._ ,_�.
��k�t . ftan p 901 i4. � a � ..—� 43.75 .� 75
a surence f '�'�IIII�C. "._...�—.—
�
&
#
i.ou�Te�ms
Ya�r 6tltlal ben amautl Is 5140�fl00.OQ
Your bmr le�m� 30.ymrs
Your initlal Merast rate�is 3,75009:
, YourkAtltl�r�tNYanountnlredfa'principd�in6�eskmldanY�e� i&18.38Midudea
��. inaurar�ceis j�p�
�Nkereffi
Q�m��
CanyWr�tr�e�7 �X Na,. []Ym,�canrisak�am�rnumM 9:. Triefintchange
� wp!be ar I I and.can changb�spaMt evay' S!�u's after �! ! . Every
d�anBgda�0.Y���rel0ceni�adaa�aeby 96, iNertheiKed
� thaloan.YourintereetrNb�guas�adtot�averi.relavvtl�an %a'h�hx
ih8n %.
Even�yautnalWP���canyau�r�ncerise9 �t�. ❑Yes,RCSnAae�am�rtumdi .
E,e�,ayouma��on�,c�,mn�m�r�c,�eafa pno. pves,me��ce�,�aa, t r ��mo�y
prindvei�IM�est�xl mortgaga uuurdnce dse? amouM owed cen Aae fv t
Tham�naxnRCanev��atoi�; .
oo��we,n�sa�er�ta�� Cr,7r+a. ❑Ymar��a�m�ia�r�s .
Does yaur laen I`are a beAaon paymaM'! �No. ❑Yes.lrou have a balWon payment d8 due In
yeers on / i .
T�lmonthiyama�taaredlnd�dngeacrvr+�papments ❑Ya�dandhaaea�wnthiyescrowpaymentfai�ns,srx�aeprapxrt+jtmces
and homeowner'a Inaurance. Yar must pay theae Mams dUecty youreeN.
�You have an add'�IOnel monihry 08cmw payment ot 528376
that result�in a tWal initld mattlYy amwnt uv�l d f�i2.12. Fhla indudes prtnc�al,tr�est,
rratigage insurar�ce and any ilems chedced t�ax:
��I�Y� Q tianeawtte�'s ina�asnUa
�Flad insurence XQ Sdrad Ta�t
❑ ❑
!►Mx if yaa havs any�ons a6ou#ihe SetRimnaz�#Ch�and Lam+Terrns Nated a�this fam�plaase pmfat�y�cxv�r,
HUA CERTIRICATION pF BUYER AND SEL4ER
I have carefully revbxAd the Hu0.1 Sbftlement Statement and M Ihe best oi rcry knowbOga end belief,N a a We and acwreM sketemeM of eq receipb and
dle6wsementa mWe ort my aecemuot by ms In thia tramaatm I tuAhx�fy tt�at i ha�ro�ra�e[vee a cq�y oi»ae MtIPt S�tlazn�mSt�rt�rrt.
(
I tc���.."`����~ a
� a
Nmr Cdtenll � Ld9 D.Sandnes '
THE ESiATE pF � �R A,IARSEN � �� .
1M HU0.1 Stlbbrtisnt ShEqrMSnt whkh I have�PrePBrod�is e Ws�and aCwMe ama��toFtllb tfensedk�n I Mve eauaed w wpl dMwe�tM1a tundaM�be
tliabu�seA In aaaoldanm w1p111tb slatemeiK
���.� /r3
SETTI:�NT AGENT pq�
!
I
i
I
V
t
�
t�al8onv�m: Neata af Se9�: F�Nt�
Alatt C4UgriN Ths Eetete of Eleana'A.Leraen 130�
Loia D.3andna
�
Frapa+Nd O6J38t2013 at�S pn
nae: This page is turnished to give you en Itemization of the amounts shown on.4lnes 1101, Paid From Pald From
1103 and i104 of the Settlement Statement.{HUD-]}.This page accompartfes but fs rtot a SOROWet's S8U@i'3
paR at the settEemeM statement. If a discrepancy exists,the infarmatiort shown on the FUtfd6 et �UndS At
settieme�c scacernenc(HUO•i}aPpites. Settiemer�t Settiement
i�oa s�eaw� a�uMs��eea .
r�uaai»4
. 119i. Tdbaen9aeeaidkndetstltlatneurana 1,4i2.U0
a vVke In Fee E 12(!0
b. E111d1DoC EN9 50.�
c �.�
d: Fea AO.OD
127.00
� t542. 58ltla11entOt te6
1103. Owr�'a tlUe insirance 5 175.00 1T5.00
11Dd. LenQe�'8tltleinwmce 1,iDG:i16 $ 1�325..W
a Endottetnen[906EPL�rodentl8l 50.00
G Enddaeitxnt ifl0 Yfd�an 50.OQ
c. Endaeea�M300 5(3.0�
d � .Sevicelsfler 75.00
(Totd 1103+1104)
� 1fi05. ten9ete��i�e Nmtti�{B.tiB6.9U
� 1106. Owre�'s�le M�It {'17!3,000.00
1107. C6 ' d6�etdoftltla7�eureraa um S 9,Rt1.25
' 110& Unde�i71�'a' d��Eat�eka�ance 2�:75
(Tde(1107*1t09}
11U8. . ._. _ . . ____. � _ ..
tiiff.
1111.
1112
� 7oht � � 8otmwer 8ottow�r� . SeB1r �
tt@R 'FIQl� +�' � PbGisr44od1f � tkn4ibi" - Pald
i10t. '[i9eesvbeeandiender's89el�renm f
a.�Mre In Fee b 1et Se�lemail Servlces lnc. 1200 12.00
b.EmaMDac �eetotsk ' S�Se�elnc. 6t5.� 50.90
c. 4�t m tst AdYg� S�Seti�as k�c. 25.� 25.0�
d. FeetoVEddeWelker 46.OD A0.00
1104. Lendd"s tltle Yreuim�ce to 1et Advantaga Settklment Servkaa kic. 1�325.0� 1�325A0
5 i,aszaa t,ds2ar
I
�
n
�
� o
� o
� o
� o
�
.-
�
0
N
�
N
n
�
7
�
N �
W �
2 � �"
� c t
m c
W W y'
� � LL
^� m c
pPf y J �
� — �
Z � m
U' O �
Q y
3 y
y ` �
� F'
Z �� W
¢ V
m in
�
�
F-
;
�
;;
F
�
:�
E
2
Y
, :i
.1
�
f
3jj
�
ri
�
.... . . . . _ _, ...�.x,r a$ ,75%wa , c�, ,
�.
�
�
�
�
�
�•
a� � � � � �
o° ^ ° w �
u; 3 c° � �,; „ �
`� p S � � .� . � r �
� N O �+ O
D N a C�, - � �'�,,
V N n C
o n � �'
c
w � � � �+ � Y
n � �
° �'�' �
� � _
� �
� , -
� �
�
� � �.
�
� �
�
�.
_ �._
� _.
� �
� �
� �
V �
� �i o;�owreoe�v
� � r N� � �
� �� O�� `.1 9
� Ajj �I�11a��
1[J IJ ■
�W �
f`J �
U� IU C 0 9
m"'N�I
� � ��
����,
ooN
ww o