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HomeMy WebLinkAbout08-23-13 - � � 15056101�5 RfV-1500°"�"'�"'1�1 PA Oepartment of Revenue P��sYWanla oFFICIAI USE ONLv 9t're"'°f Indwui"atTa"`�s INHERITANCE TAX RETttRN ��� v�r Fue NwM� ���� � ra, �a�r Hamsbum,pA a7u8-o6oy. RESIDENT DECEDENT ENTER DECEDENT INFORMAflON BELOW � Social Secwity NUmber Date W Death MMDDYYYY Dete of 8iAh MMDDYYYY 9'111fi/2012 11/2111$35 DecedenPs Last Name Suffix DecedenPa First Name MI tiake Barbare E (ttAppllceble)EMa$urviviny 8pouse's Infortnallon Balow Spouse's last Nsme SufAx Spouse's Firat Name MI Spouse'e Sodei Securiry Number THIS RETURN MU$T BE FILED IN DUPUCATE WIT'H THE RECISTER OF WI��S FILL iN APPROPRWTE OVALS BELOW � 1.Onginel ReWrn p 2.SupRlemental Retum O 3. Remainder ReWm(Dste of Death Prior to?2•13�82} O 4.timited EBtete y= da.Future Interest Compromise(date ot p 5. Federai Estate Tax ReWrtr Required death atter 72-12-82) m 6.Llecedent Died Tesfete p 7.Deoedent Main4alned a Living Trust 0 g, Totel Number o(Safe Deposit Boxes {A4tach Copp M WHI} (Attech Copy of Trust} O 9.Utigetlw�Prorseds iteceived O 10.SpWSai Foverty Credit{Date af DeaM O N. Ebction fo Tesc under Sec.9113(Aj Belween 12•31•91 and 1•1-Bb) (Attach Schedule O) CORRE8PONDENT- THIS SECTqN MUBT BE CpMPLETED.ALL CORRESPQNpENCE ANO CONflDENTUU.TA7(INFORMA710N SHOULp BE DIRECTED T0: Nar� Oaytir�T Nurnbec-.� � � Cindy Make (717) i5�ir�7 �, �,,+, � m _ c- RE41��4u.t.8 ONC:- r � � W ;' r+ Firet Line of Addrese Z �: �; c� c $5 Bt08dW@11 LD � �' r: � �� = C? G -xi � Second Line ofAddress � � � i����� �� � � �,.. n �,,� tr'� W City a'posf Qiflce Stete ZIP Cod6 6AT€flLEo Mech�nicsburg PA 17055 corrosPonasnes rms��aaaross:c1hake�$verizon.net Under pgnettles of perjury,l dedare th0l I heve exeminetl this reWm,Indudinp�sctpmpenylnp aqMdules and BtatemeMS,entl b the best of my knowMldpe and Delief, � k ia Wa.tnrtacl and oomplete.DedNraUon o/prepprer oNer than Vro pereonel reproeeMetivb in basetl on ell InPoimetbn N which PrePeret has eny krivwle0ge. 5 TURE Of PE RE LE f�i FI�ING FiENRN DATE � E83 E anJ c.� ,. Pfi t v�s SIGNAtURE OF PREPARER O7HER 771AF7 REPRE3ENTATIYE Da7E ADDRESS PLEASE U�E 6R14tffAL FCiRM OkLY Side 1 L 15056101D5 15D561a105 J � � 15Q56��205 �v-t5��c t��i oe�:edern's sac�a�secuaty rturr�r n�aem's niame: Barbare E Hake i2ECAPiTULATlON 7. Real Estate(3chedule A}. . ..... .. . . . . ... .... . ..... .... . .... . . .. .. ... . 1. 152,200.Od 2. Stocks and Bonds{Sdtedule B) ...... ........._..._..._........._. 2. 6B,673.68 3. Qbsely HeW Caporetion,Partnership or Sole-Propnetwship(Schedule C} . . ... 3. 4. Mqrt{3ages and NoEes Receivabie(Schedule D)................... . ....... d. 5. Cash,Bank peposits and Miscellar�wus Peraonal Property iSchedule E)... , .. . 5. 71,567.18 fi. Jokatly Ow�ed Pmperty{Schadule F} O Separete Bi��g fYeque�ed ....... 8. 62.260.32 ?. inter-Viws Transfars R Mis�ilaneous Non-Probate ProyeMy ($cheduie G) O Sapsrete BIIIMg Requested.... .... 7, 1$,�65.04 a. ro��rou�{cot��vres�tnro�,sn�}........_................... a. 374,770.20 9. Funeral Expensea andAdministretive Coats(Schedule H)... ..... ..... . .. ._ 9. 15,247.81 to. Usbts ot Decc+derrc.M«tgage�iaCNtties and E�errs{scheduie i)............... to. 111,041.$0 11. Tpfal Deductions(total Unes 9 and 10)... . .. .. ... . .... . . ... . .... . ... . .. N. 126,289.40 12, ket Yapte ot Eatals ILine 8 mirws Une PI}.............................. 12. 244,488.$Q 13. Charitabie and Govammantei BequeetWSec 8173 Trusts for whicb an eledion to tax has nat been mada(Schedula J) . . .. . . . ... .. . .. . .... .... t3. 14. Ti�t Yaiva Sub�ci Ea Tarz{L'a4e#2 minus li�13} ........................ i4. Z44,480.8� TiUf CALCUTATIQN-SEE IN$TRUCT1dNS FOR APPLICA8L8 RATES 15. Amount of Line 14 taxa6le et the spousel tax rate,or transfers urMer Sac.9118 (a)(12}X.0_.... 1S. 16. Amount of Line 141axable at linea�rate X.0 45 24d,480.$q 16. 11,001.64 � 17. Ama�nt of t.�e 14 taxabie at siDling rata X.12 17. 18. Amount of Line 14 taxable at collatersi rata X.15 18. 1S. TAIC DUE... .... .... . . . ...... _........... 19. 11�001.64 __...... 20. PIIL IN TME OYAI IF YtSt!Atif REGUE8TMIQ A REFUND OF AN OV�kPAYMENT p Slde 2 L 15C15610205 1505610205 J REV•1500 EX(FI) Page 3 Fik Number tiece�rrt's complete Address: DE DEM' NAME Barbare E Hake sTREEraooRess - 2289 MiII Rd CtTV sTah z�, ' "_ Mechanicsburg PA 17055 Ta�c Payments and Gredits: t. ra,c oue(Page 2�line ts) tt} 71,001.64 2. Credits/Payments A Prior Payttrenis _ 8.Dismum _ Tolal Credits(A*B) (2) 3. Interest (3} 4. If i.vie 2 is�reater ihan Line t+U�3,eMer fhe difierence. This is the O�RPAYMENT. Fill in mal on Page 2,41na 20 to request a refund (q) 5. If tlne t+lir�e 3 is greater tha�Lrc�2,�ter it�difier�.TMs Is the 7AX DUE. {5} 1'l,009.64 Make check payable #a: REGIS7ER OF WI�LS,AGENT. . ���.x.���.�,�.�F ��;�� . FLEASE ANSWER THE FO�lBWIPlG QUESTIQNS BY PEACING AN°X"fN THE APFR4PRIATE BtOCKS 1. Did decedent make a transfer and: Yes No a. refain the use or income of the property hansferred........................................ .................................................. � b. r�n ihe rghY ro ' wlw�!�se tt�property tr�sferrad a its Irtco�....,......__............................. ❑ � a. rNein a reversionary imerest.............................................._.............._........................,....................,................ ❑ � d. receive the promiae for life of eRher paymente�benefits or care?...................................................................... ❑ � 2. If death occwred after Dec 12,1992,did decedent Uansfer Propedy within one year of deatlr without teceiv�g adequate cansideration?................................... ❑ ❑ ....................................................................... 3. Did decedem own an"in W st for"or payeble-opon-death bank account or security al his or her death?.............. ❑ � 4. Did dec�dent own an individual retirement account,annuity or Mher non�probate properry,which ' cantainsaDersficierydes�nstian? ,.._................._...........,................................._..............................,........._....... � ❑ I IF THE ANSWER TO ANY Of THE ABpVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND flLE IT AS PART Of THE RETURN. ! � � ��,�z��? . �. �as° Fa dat�of deadt on or aft�Juty 1,1994,and before Jan.1,1995,the tax rate impased an the ne#value of trensfers to or for ths use of tlie surviving spouse is 3 peroent p2 P.S.§9116(a)(1.1)(i11. For dates of death on w afler Jan. t, 1995, ttse t� rate imposed on the net value of Ga�sfers�or for ihe use of ihe surviving spouse is p parcent [72 P.S.§9118{a){1.1}{ii}].Tlte stapate tl�g not e�yt a ita�fer b a survivir�g s�muse fran tax,a�d the statu�ry r�uiremeMS for disdosure of assets and filing a tasc retum are still appiicabie even if�he surviving spouse is Me only beneficiary. For dates of death on a aner July 1,200p: • The�c rate�ed on tk�net vatue o#tra�fers from a deceased dv�f 21 years of age ar yam�r af death ta a for tt�use of a netural psre�t,an adoptive parent or a stepparerd af the child is 0 percent(/2 P.S.§9116(a)(12)]. • The tax rate imposed on the net value of tronsfers W or for the use of Ne decedent's lineal beneficiaries is 4.5 percent,except as noted in(72 P,S.§9116(a)(1)J. . The t�ra�imposred on ttre�t vakte of#ransfers to w fa the use of the decedenYs sib�ngs is i2 percent[72 P.S.§9t1&(a}(1.3)j.A s�Iing is defined, under Section 8102,as an individuai who has at ieast one pareM in common with the der,edent,whether by blood or adoption. REV-1502 EX+(12-12) �pennsylvania SCI�QULE A DEPAPTMENTOFREVENUE INNERITANCETA%RETURN REA� ESTATE RESIDENf DECEDEM ESTATE OP: FILE lqNNER: Barbare E Hake All roal proparty owmd tolNy or as a N�unt in wnr�on mw!M npo�hd at hir mvlM valw.Fair market value is defined as the price at which property would be exchanged between a wiNing Wye�a�a vAlling selier,nqther being compeil�ro buy or sell,both having reasonaWe knowledge of the relevant facts. Ra�l proparty tlwt k�aiMlyown�d wkh ri0ht of wrvWOnhiY m�M be dhclaad on Scheduk F. Attach a copy of Me settlement sheet if Me properry has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIP170N 1 5 South Rd,Mechanicsburg,PA 152,200.00 TOTAL(Also enter on Line 1, Recapitulation.) # 152,200.00 If more space is needed,use additbnal sheets of paper of the same size. a�vaso3 ex.(e-�z> �pennsylvania SCN�I�tULId B ����M��� 5TOCKS � BONDS INH@RITANCE TAX RETUpN RESIDENfDECE�ENT ESTATE OF FtLE NUMBER Barbara E Hake AI!PropeKY 1�tiy ownad with NyM M wrvivorshlp murt be diselosed on Schadule F. � VALUE AT DATE NUMBER pESCRIPI'fON pF DEATH 1. EXJC011 f�ab11C Corporatias,{XOM}264 Shaees,Cammon.COfl4220Q988 22,873.64 Z The PNC Finanaal Services Grap,Inc(PNC)Commpn,760 shares,693475105 41,013.40 3 Tyco intem�nai,36 shares,comman H89128144 7�.�� q TE Cnnnectivity Ltd.37 Shares,common,H84989104 1,261.70 � P�t�rLfd.7st�eres,c�nmar,F�16941QB 319.iS g ADT Corporation, 15 Shares,Camrtwn,p0101J106 619.35 � I tpTAL(Also enter on Line 2, Recapitulation) $ 86,673.6$ ]f more space is needed,insert additional sheetr of the same size HEV-i5o8IX+(tl8-u) �pEl'4C1S}►�Y81118 ���e���y�,,� DEPARTMENTOFREVENUE �'H� �[���eyy�,�a�M'ISC, INHERITANCE TRX q8'lIIRN PERSENlAI.PROP�RTY nesioe�aECeocNr �S7ATf OF: fSIE FNlt�ER: Barbare E. Hake Inciude ihe pmceeds nf ktigation and the dste Ure proceeds wa�e rec�ved by the e�ate. AII propely joMMly�d wRh tipM a! � qM�be dkf�iGMd.at Bd�N F, REM VALUE AT DATE NUMBER DESCRIPTION QP DEATH 1. Valvo�7C1.SUY 9,353.04 2. 24 Month CD,Citizene Bank,xx�c9327 32,852.68 3. Citizens Barrk,Savings Aa�.#62338554� 19,809.34 4. Citlzens Bank,Checking,p6206800982 7,085.16 5. Cash 42.04 g, Clothing,shoes 250.00 7. Fumiture 750.Od g Jewelry,watches 1,200.q0 g Nousefiok!Caoads 425.06 10 TQTAL(AIw enker on Line 5, Recapitulation) Q 71�587.18 If more space Is rreeded,use atldkional shee[s M paper of the same size. — i pEV-L509 EX+(w-io) �(}8C1115�t�Y�1118 �'.H�p�/(� F 6EPANTMENT Of NEVENVE INr�,ur�,�ET�ca�,,,w, 70INTLY-OWNED PROPER7Y itESIDEM DECEpENT �A��: fltE NUMBER: Barbara E Hake N sn anat treicame�Wntly ownad wkhin ona year of the decadent's dah ot�,R mutt ba raported on Schadule 6. SURVIVING 76INT 7ENAHT(S}NAME{5) A6DRESS REtAT26N5HIP TO DEC�EM A�Wendy A. Hake 2289 Mill Rd, Mechanicsburg, PA 17055 Daughter B. C. �OINTLY OWNED PRpPERTY: LET1ER D�t� DESCRIP17pN OF PROPEITfY %oF wTE Or DFA'M [tEM ID0.]OMf MSOE ING.UC7E NM1E Oi FINPNQK Q!$TIIUfION AND A4NK ACCOUN!NWABEF OR SIM[UR CATE OF pERTt4 OE�OEMS VA41E OF NUF�ER TEtiMN[ 707M f�Hii7FitN6NfXA86;.ATTAOi fi]R7t%NRYNH➢NFALESTATE. YKt�Oi IHiFRF57 DECEPRti'SWTEREST � A' O6/20/11 2289 Mili Rd,Mechanicsburg,PA 17055,Morlyage wl$12A79d.91 252,200.00 50 61,202.55 t�are:Mor�age of$129,794.91 wtCitizens Bank 2. A 04I20/11 Jdnt Checkirg,Citizens Bank,q$232868637 2,115.53 50 1,057.77 I 70TAL(Also enter on Line 6, Recapituiation) ; fi2,z80.32 [f more space is needed,use addik�anal sheets oF paper of the ume sire. REV-1510 EX+(OB-09) �pennsylvarria �`'��/ �'f �' DEPAFTMENTOFPEVENOE INTER�ii�.7� F �ND INHERITMICE7AX REfURN MISC. NON'RRQSA7'E PROPERTY RESIDEN(DECEDEM ESTATE OF FILE NUNlER This schedule must be completed and filed if Me answer to any of quesdons 1[hraugh 4 on page three of Me REV-1500 is yes. �M DESLRiP1I0N OF DROPERTY DATE OF DEATH %OF DELD5 EXCLUSION TAXABLE mauoE ne xnrE ainE ni+are�.n�Emre,�nors�roottme+r u�o NUMBER n�wteartru�r�.mr�a�mwornEO�wxw�tem�. VALUEOFASSE? IN7EREST vn»uv� VALUE 1• Wendy A Hake,daughter,$13,000,10/29113 13,000.00 100 3,000.00 10,000.00 2 Wendy A Hake,daughter,IRA g,pG9.04 20 1,613.81 3 Cindy J Hake,daughter,IRA g,p89.04 20 1,613.81 4 Barty R Hake,son,IRA g,p69.04 20 1,613.8� 5 David A Hake,son,IRA g,p89.04 20 1,613.81 6 Timothy S.Hake,son,IRA disburs�nent 8,069.04 20 1,613.81 TOTAL(Alsa enter an Line 7,Recapitulation) ; 18,069.05 If more space is needed,use additional sheMS of paper of the same size. - ���II REV-1511 Ex+(10-09) ��„�,sy��„i�, SCHEDULE H DEPpNTMENTtlFNEVENUE FUNERAL EXPENSES AND INHHtITMIC£TAl(RENRN ApMINISTRATIVE COSTS RESIOENTDECEDEN! fStATE 4F FILE NUM6ER Barbare E Hake Dacadent's�6ts mvot be raported on ScAadala I. REF9 NUMBER DESCRI7TION AMOUNT A. FUNERAL EXPENSES: 1. hlaipez�Fur�erai Nome 18,695.82 Funerel Refreshments 1,15$.49 B. AQMINISTRATiVE COSTS: i. Personai kepreseM2tive Cammi55ions: NBme(s)of PerSOnal RepreSenWtive(s)�. . . Street A�ress-- --- -- - City --- --- --,,.^SWte_2IP Y83r{s}Commis5ion Paid:-- --- -- --- -- 2. Attomey Fees: 3. Family Euemption:(If decedent`5 8ddress is ttOt tha same a5 daimaM's,aitach axplanation.) Claimant� ___ _ , Str2Ct Addr�s City _State�,__ZIP____ _ ' ReWtlanship of Claimant to Decedert-- --- --- a. arobate Fees: 393.50 5. tu,�amnnt r-ees: 6. Tax Retum Preparer fees: 7. M�Iing 3Q.75 TOTAL(Aiw erder on Line 9,Reppitulation) # 15,247.$1 If more space is needed,use addftinnal sheets of paper of the same size. REV-1512 EX+(12-12J �pennsytvartia '�G1��LE 2 OEPARTMENTOFHEVENIIE D@S'J'S QF DECEDEN'f� INXERITANCE TAX RENRN MpRF1�AGE LIA6I1.11'I���LIENS RES[�M 6ECEbEA'T ESTATE OF PILE NIN�ER Barbare E. Hake Report�Ifb inamd by tlw 6sad�nt prbr to�dntlf tlaN nm�iMd�tA at tl�a dNe at d`etA,h�dudMy uarelm�nad m�dfai a�anws. STEM VAtUE AT DATE NUMBER pESCRIPTION OF DEATH 1. li(estar Response of Maryland,inc 212.48 2. Hanger Prosthetics 718.44 3. Mas�nic Viilag� 7.69 a. CiGzens 9ank,Equity une of Credit, 110,105.00 TMAL(Afso enter on Line 10, Recapikulation) ; 111,041.61 If mnre space is needed,insert a0ditlo�al shects of the same size. REV-1513 E%+(O1d0) �pennsytvar»a SCHEDU�E � DEPAHiMENT OF NEVENUE gENEFICIARIES INHEFRRNCE TA%RETURN R�IDENf QECEOENf ES7ATE 8F: FILE NUMBER: Barbara E Hake REtATtONSHlP TO DfCEDENT AMOUNT OR SNARE NUMBER NAME PtlD ADORESS OF PERSQN{S)RECEMN6 PROpER7Y D4 t7�li�T�n(s) OF E57ATE I TAXABIE DSSTRtBUftONS[Indude outdght spousai distHbutions and transfers under Sec.9116(a)(1.2).] i� Wendy A.Hake,2289 Mili Rd,Mech�icsburg,PA D�tght� 23512T.8 2. Cindy J Hake,85 Broadwell Ln,Mechanasburg,PA Daughter 9353 ENTER DOLIAR AMOUNTS FOR DISTRIBUTIONS SNOWN ABQVE ON LINES IS TNROUGH!B Of REV-150�CAVER SHEET,AS APPROPRIATE. n NINi TA3SABtE DSSTR28tlTIONS A, SPOUSAL DISTRiBUTI0N5 UNDER SECTION 9113 Fpk WHICN AN ELECTION Tp TAX IS NOT 7AKEN: 1. ' 8. CHARITA9LE AND GOVERNMENTAL pISTRIBUTtONS: i. TOTAL 4F PART II—ENiER TOTAL NON TAXABLE DISTRIBltTtONS ON l[NE 13 OF REV-1586 CQVER SHEET. S If more apace is needed,use additional sheMS nf paper of the same size. LAST WILL AND TESTA.��I''���,M - _ " ` "_ QF Ei�v�� . _ , .. - - � BARBARA HAKE�-;{� C;� � r;, _ -� C1.ERn G= I, Barbara Hake, of Mechanicsburg, Pennsylvania,revoke my fo��{�f!(;�15'a�Q�"n3icils and declaze this to be my Last Will and Testament. GUMgERLAFI D C w„ °� ARTICLE I IDE�TIFIC�TIO'ti OF FA'.4IILY I am not currenti}�married to any-one. The names of my children are Wendy A. Hake and Cindy 3 Hake. Aif references in this Will to "my children" aze references to the above-narned children. The fai3ure of this Will to provide for any distribution to my child(ren), Bazry Tt Hake, David A Hake and Timothy S Hake,is intentional. Al2TICLE II PAYMENT OF DEBTS AND EXl'ENSES I direct that my just debts, funeral expenses and expenses of last illness be first paid frorn my estate. ARTICLE III DISP4SITiON OF PROPERTX A. S ific uests. I direct ihat the follawing specifia bequests be made from my estate. 1. Jewelry, Clothing&personal effects shall be distributed to Wendy A Hake. If this benefieiary does not survive ma,this bequest shall be distributed to Cindy J Hake. If this beneficiary does not survive me,this bequest shal: be distributed with my residuary estate. 2. Valvo vehicle shall be distributed to Cindy J�Iake. If this beneficiary daes not survive me, this bequest shall be distributed with my residuary estate. 3. My remaining tangible persanal property shall be distributed ta Wendy A. Hake. If this beneficiary does not survive me,this bequest shail be distributed with my residuary estate. ; s � � ° � �. , ,� � � � & �� " � wwww��rr � ' !�` ^ &'� iTt,�a���'�+1� t �: � �� * : � i— � � � r i �i - � 8 .�� ( : . v e V"h � �3... B. Residuarv Estate. I direct that my residuary estate be distributed to Wendy A Hake, Mechanicsburg, Pennsylvania. If such beneficiary does not survive me, ray residuary estate shall be distributed to the following beneficiazies in the percentages as shown: f 40%-Cindy 3 Hake, Mechanicsburg,Pennsyivania.If this persan does not survive me,this share shall be distributed proportianatety ta the othex distributee(s}listod under this provisian. I00-Percent Tatal ARTICLE IV NOMINATION OF EJCECUTOR t nominate Cindy J Hake,of Mechanicsburg, Pennsylvania,as the Executor,without bond or seourity. ARTYCLE V EXECUTC)R PU'WERS My Executor,in addition to other powers and authority granted by law or necessary or appropriate for praper administration, shai2 have the right and gower to lease, sell,martgage,or othenvise encumber any rea1 ar personat property that may be ineluded in my estate, without order of court and without natice to anyone. My Executor shall have the right to admiaister rny estate using"informal", "unsupervised",or "independent" probate or equivalent legislatian designed to operate withaut unnecessary intervention by the probate caurt. ARTICLE VI MISCELLANEOUS P3tOVf3It3N8 A.g�g TiU��Crendsr.Th�tities given to the psrsgraphs of this Will are inserted far refereace purposes onty and are not to be considered as forming a part of this Witl in interpreting its provisions. All words used in this Will in any gender shall extend to and include all genders, and any singular wprds shall inciude the giural expression,and vice versa,s�cificalfy inclading "child"attd"chitdren", when#he context or facts so require,and any pronouns shall be taken to refer to the person or persons intended regardless of gander or number. B. �iabiti of Fiduciaxv.Na fiduciary who is a natural person shalT,in the absence of frauduient canduct or bad faith, be liable individually to any beneficiary of rny estate,and my estate sha11 indemnify such naturai person fram any and�Il elaims ar expenses in connection with ar arising out of th'st$duciary's good faith actians or nonactions of the fiduciary,exeept for swch actions or nonactiona which canstitute frauduleat conduct or bad faith.No successor trustee shall be � � � s� ��,�� ���, �� � ai�v§ t a�*`�6� .a i e, .' : . � . i 'z ,; �„ fi.�'ti-s'�`�N�s? ,�y'��t3"�' ;4 .r° �i�„ .,.(: .. 4Y:S' .S.':" �. ��.,,tt"ffi `C � _ obliged to inquire into or be in any way accountable for the previous administration of the trust ProPertY• C. Beneficiarv Disputes. If any bequest requires that the bequest be distributed between or among two or more beneficiazies, the specific items of property comprising the respective shazes shall be determined by such beneficiaries if they can agree, and if not, by my Executor. IN WITNESS WHEREOF, I have subscribed my name below, this -;�i ''` day of '1c t��:r , . c: a � � ' '�.l -- '�'�.�t �Z� Testator Signature: '-' ��``�" Barbara Hake We,the undersigned, hereby certify that the above instrument, which consists of � pages, including the page(s) which contain the witness signatures,was signed in our sight and presence by Barbara Hake (the "Testator"), who declared this instrument to be his/her Last Will and ' Testament and we,at the Testator's request and in the Testator's sight and presence, and in the sight and presence of each other,do hereby subscribe our names as wimesses on the date shown above. Witness Signatu,re: n Name: 17P� City: �I �G1t1 State: Witness Signature:; � Name: City: State: �,,� � ��� ��: ' . .. � . . : � . . . . ... . . . � . .� � .. `� UPI No. THtS INDENTUi2E, MADE THE 20�' day of June, in the year of our Lord two#housand eieven (2011) betwean BUIU}BLE BEE HOLLOW LIMtT�D, a Pennsyivania limited partnership, GranEor, AND BARBARA E. HAKE, an aduit individual and WENDY A. HAKE, an aduit individual, es Joint Tenants with the Right of Survivorship, Grantees, WITNESSE7H, that Bumble Bee Hollow Limited, for end in consideration of the sum of TWO HUNDRED FlFTY-TWC? THbUSAND EIGHT HUNDRED SIXTY-THREE ($252,863A0} Dotlars Iawfui money of fhe Unfted Sta#es o€America, unto i# weli and truly paid by tfie said Grantee, at and before the sealing and delivery of these presents, the receipt whereof is hereby acknowledged, granted, bargained and sold, aliened, enfenffed, released and confirmed, and by these presents grart#, bargain and sell, alien, errfeaff, relaese and canflrm unto the said Grantee(s), their Heirs and Assigns, ALL THAT CERTAIN singie family Lot Na. 31 (#he "�of"), of Bumble Bee Hollow, a Planned Community, located in Upper Ailen Township, Cumberiand County, Pennsyivania, as designated in the Declaration Covenants, Condition, Restrictions and Easements for Bumble Bee Haiiow, a Pianned Communi#y {hereinafter ttre "Declaration"} dated November 4, 200$ and recorded tdovember 10, 20Q$ in tfie Gffice of the Recarder o# Deeds of Cumberiand County, Pennsylvania to Instrument No. 200836626 and as shown on a Declaratian Plan recorded in the O�ce of the Recorder of Deeds of Cumberland County, Pennsyivania to instrument Na. 200836626; as arrtended by a First Amendment to Declaration dated July 22, 2009 and recorded July 23, 2009 to Instrument Number 200925720 and as shown on a Declaration Plan recorded to Instrument Number 200925720; and further amended by a 8econd Ame�dment to dedaratian dated March 31, 2Q10, and recorded on Aprif 27, 2090 to !ns#rument No. 201010583, the Lot is more particularly bound and described as Pallows: BEGiNNING at the southwest corner of Lat 31 on the eastern Dedicafed Right-of-Way �ine of South Wooley Fiollow Way, thence by the same North 36 degrees 16 minutes 21 seconds East 92.00 feet; thence by Lot 32, South 53 degrees 43 minutes 39 seconds East 170.OQ feet; thence by Lot 37, South 36 degrees 36 minutes 21 secands West 32Qd feet; thenoe by Lot 34, North b3 degrees 43 minutas 39 seconds Wes# 170.00 fee#; To the said eastem Dedicated Right-of- Way Line of South Wooley Holiow Way, to the PC71NT OF BEGINNING. GONTAlNING 15,644 Square feet or Q.3590 acre, mare or Iess. BEING known as 2289 Mill Road, Mechanicsburg, Pennsylvania 17055. I UNDER AND SUBJECT to any and ali reservations, restrictions, rights-of-way, easements and conditions of record. BEING PART C7F THE SANIE Pf2EMISES whieh Bumbie Bee Hallow Golf, inc., a Pennsylvsnia corporation {successor by merger to Klipsen Enterprises, Inc. and Bumble Bee Hollow 8ports, inc.) and West Shore Golf, Inc., a Pennsylvania corporation, by their deed da#ed March 7, 2408 and reco�ded March 11, 2048 in the OHice af the Recorder af Deeds of Cumberland County to Instrument No. 2008p7213, granted and conveyed unto Bumble Bee Hollow Limiked, a Pennsylvania limited partnership, Grantar herein. AND the said Grantor hereby cpvenants and agrees that it will warrant Specially the praperty hereby conveyed. IN WITNESS WHERE4F, the said Bumbie Bee Nollow Limited has caused this Indenture to be signed in its name by its General Partner, the day and year first ebave written. BUMBLE BEE HOLLOW LIMITED, a Pennsylvania limited partnership by its Generai Partner, BUMBLE BEE HOLLOW GENERAL, LLG, a Pennsylvania limited liability campany $��°'���'A��.a ..— Marc DeSouza, Manar�ber COMMpNWEALTH OF PENNSYLVANIA : : SS. COUNTY OF DAUPHIN : �n this the 20th day of June , 2011 , before me, the undersigned officer, persanally appesred MRRC DES4UZA, wha acknowl�dged himself ta be Managing Member of BUMBLE BEE HOLLOW GENERA�., LLC, a Pennsyivania iirnited iiability company, the general partner OF BUMBLE BEE HOLLOW LIMIT�L7, a Pennsylvania limited partnership, and #hat he, being authorized fo do sa, executed the within insttument fo�the purposes therein contained. IN WITNESS WHEftEC}F, I hereunto set my hand and oificia! seai. ��N�TARY PUBLI� {��L} nvnr�u� � P�mY M•81w0Y�ibLry F1+EWe Lower Paxbn T�,�p�yplyh CpntY M CammY�M9n. . . .1. �II018 RAernber, � Citizens Bank ��^'214 1-800-708-6680 EC�UITY LINE OF PO B0170°° � CREDIT STATEMENT P�OWdBr1cB RI 02940 Call enplma/a accaunt iMwmeuon, currant ntaa aM anawen to your pusatlone. Page 1 Closing Date SUMMARY NOVEMBER 10,2012 Account Number 00006017544644 Credit Limit 120,000.00 BARBARA E HAKE Available Credit 10,098.71 WENDY A HAKE Days in Billing Cycle 30 2289 MILL RD Averege Daily Balance 109,904.80 MECHANICSBURG, PA 17055-6069 Daily Periodic Rate , .01158469/o ANNUAL PERCENTAGE RATE a.2a^r> INTEREST CHARGE asi.9� New Principal Balance 109,901.29 Current Payment 381 y� Past Due Amount o.00 Total Late Fees Due 0.00 Minimum Payment 381 97 Payment Due Date �Z�O���z BALANCE SUMMARY Previous - Payments/ + Advances + Interast + Insurance + Total Balance Credits Charge Fees = New Totai 110,301.29 400.00 Balance 0.00 381.97 0.00 0.00 110,283.26 TRANSACTION DETAIL Date Description Check No. 11�01/72 PAYMENT-THANK YOU Amount Principal Balance 400.00 109,901.29 FEES TOTAL FEES FOR THIS PERIOD 0.00 IF YOU HAVE ANY QUESTIONS ABOUT YOUR STATEMENT OR HAV B�EEN REC NTLY CALLED FOR ACTIVE MILITARY DUTY, PLEASE CALL OUR 24HOUR CONTACT CENTER AT 1-800.70&6680. THANK YOU FOR BANKING WITH CITIZENS WHERE GOOD BANKING IS GOOD CITIZENSHIP. ON THE DUE DATE YOUR PAYMENT W ILL BE DEDUCTED FROM ACCOUNT# 6232868637 Please aee rmen¢side br imporlan�f�(ormatlan,tMn detach here arM relurn the botWm poNon with yo�r check payble W Citlzens Bank. BnRBnRA E HAKe EQUITY LINE OF CREDIT WENDY A HAKE Account Number 00006017544644 2289 MILL RD Payment Due Date �yp��12 MECHANICSBURG, PA 77055-6069 Minimum Payment 381.97 Amount Enclosed = —, p c�w w.m,�n n�r,a...o�P«,ww��ro�.uo� --. ''. hn chanpsE uM eampb4 Me 1am on ths nwrsa al0s. ,� Citizens Bank Citizens Bank P.o. eoX a2ooa Providence, R102940-2008 MemberFD�C� Equ�HousingLender 01 060 0000601754y6/.4 000000000038197 Malpezzi Funeral Home �� 8 Market Plaza GVay �' °�,`� Mechan€csburg,PA 27055 (717}C�g��(46 www.Mal ezziFuneralHome.com Jeremy J.Shartzer,FA Miahael J.Malpezzi,dwner,FD Kyle C.Rnipe,FD Becembar 4, 2p 12 Cindy Hake 85 Broadweli Lane Mechanicsburg, PA 17055 The Funeral Service for Bazbaza E. Hake We sincereiy appreciate the confidanca you have plaoed in us and will continue to assist yqu in every way we can. Please feel free to contact us ifyou have any quest'rons in regard to this statement. THE F6LLOW2NCs IS AN ITEMSZED STATEMEN2'OF THE SERVICES.FACILITIES,AI7TOMOTIVE EQtJIPMEN7', AhD MERCHANLltSE THAT YOU SELECTEB WHEN MAKING THE FllNERAL ARRANGEMENTS_ 1. pROFESSIONAL SERVICES: Services of Funenl IIirectortStaff �$¢�$�� FUNERAL HOME 3ERVICE CHARGES $5,475.OQ SELECTED MERCHANDISE: Stainless Steel Casket $3,650.00 I2 ga Gaivanized Steei $1,925.00 Beaches Register Package $195.00 THE Ct?ST OF{}UR SERYtCES,E(7UIpMENT,AND MERCHANDISE THAT YOU HAVE SELECTED 511,245.00 AT THE TIME FUNERAL ARRpNGEMENTS WERE MADE.WE ADVANCED CERTAIN pAYMF,NTS TO OTI3ERS RS AN ACCOMMQDATION. THE FOLLQWING SS AN ACCOt1NTING FQR THOSE CI{ARGES. CASH ADVANCES: Opening Grave $950.00 Ceroetery Equipmant ��90 Qp Certified Death Certificates $I20.00 Newspaper Notices-Patriot $342.64 Newspaper Notices-Sentine! $z�$g$ � ClergylMass Offering $206A0 Flowers $392�0 TOTAL CASH ADVANCES AND SPECIAL CHARGES $2,A34.82 SUB-TOTAL $13,695.82 INITIAL PAYMENT/DISCOUNT/CREDITS $0.00 TOTAL AMOUNT DUE � $13,695,82 —...._. __. I r ^ � , �.. �, {'` ( C� 1/G�/1 �� j �C i.�'C' , , � �,� �=; �.�3� i. �T ( ) 2 �t (� ) 3_ K�G �t � . . �tJ4Vld6DlfFfCA.�B�RPE7�k.I.i�ANDB�O�t'IZ'�'�B�R ( ) Si360�D���,� tl16.04�D�eetic �icj � ����jh�ia�tj�: '�P9em�iuea�bmg bea�ba�od r�rt pritx � - (�3 S'2-��(�1 316.�+��FEE: 510�. . " .. " Roam Ree�i: - �1S4 . . � Food: ��3'f�Q , � �CI�. � t3 �� � �� Ha�ac� � I IO•� (aiaah�ic) �;tt"t� , . H�ea�qs � '�Ys (npn.�ioo�Oi'�c} sqb,��s��a .- 1�oodll�stl�ua a6a�5 �E�+K.T�. ��`i�5 tAal;���5 Ltrd �58� : " . . � • , Brt�ederFe� _ �S� (�10�X„�l�=Z s'° ) 3ub-'litel�l: •> 9�{Q•'� . � � Srdes T�ac(�'X.) '3 7.�° {food c�r} : . ; . , . �r�9oed � d �, O 1$ . � � �c�:�t�-..� ��i e„�-�:� ��� �,icy{1g%j -� lyll•`�y � � �.��.��r�� �_ a � �Toori . � � � t 58. �j ",.: � ��� /''��wd - . ta�tr�rl�R't-s�r�+ :� �M"in�s De�o+�t — �o ���5.2� ^��t��'*.,�s;�•�.�-°� '�a�t';;si '1�'3-6�3� ;��?"�eT£"-&�'� ' I Bf1�CCDUE ' �• �"iC}.5g• '1 i t - �_���►�'L,ae.�^.��� �r x�osc�y�,a�r.��_,.�r� . � � 3 a � � �, `1 � � Q � ` C ` �. y � � � � � � S � � � � � a �, , -� � A � c � w � � n T� ',-: a vJ �i' � W n =: _ � .- r s or C `�' ?a �"'c:.:. � :9 "M . J � :i+ _ [7 . .. a� -c _ a m �y �... .� •Y:7 �. � i . r �i c� r a U` , • .. ,K. , �a z o � . --� - ^�i � n �; ': � _ G C_ F J �.. , � rV '�'� „�� 'D �...a v'+ y N n d - � � �� T � � ' � . .-;'a c p � � r 0 k ,.. . ` — ----- _ — — -- --__— -----— _-�-_ __'�__ 4�_liai� RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Receipt Date : 8/23/2013 Cumberland County - Register Of Wills Receipt Time : 12 : 37 :23 One Courthouse Square Receipt No . : 1075335 Carlisle, PA 17613 HAKE BARBARA E Estate File No. : 2012-01261 Paid By Remarks : CINDY HAKE DB1 --- --------------------- Receipt Distribution --- --------------------- Fee/Tax Description Payment Amount Payee Name INH TAX RETURN 15 . 00 CUMBERLAND COUNTY GENERAL FUN ---------------- Check# 1038 $15 . 00 Total Received. . . . . . . . . $15 . 00