HomeMy WebLinkAbout11-22-13 1505610143
REV-1500 EX(02-11)
OFFICIAL USE ONLY
Department of Revenue Pennsylvania cawtycma- veer File Number
Bu
Bureau of Individual Taxes 0O•"*"°"*�"nEauE
PO BOX.260601 INHERITANCE TAX RETURN 21 10 1010
Harrisburg,PA 17126-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
09 30 2010 03 26 1923
Decedent's Last Name Suffix Decedent's First Name MI
BAIR ANN E
(if Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
❑ 1. Original Return FX] 2. Supplemental Return ❑ 3. Remainder Retum(Date of Death
Prior to 12-13-82)
❑ 4, Limited Estate ❑ 4a.Future Interest Compromise ❑ 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
® B, Decedent Moor Testate Decedenr�t Maintm'nad a Living Trust D B. Total Number of Safe Deposit(Attach Copy of will) ❑ (Attach bopyof rust) posit Boxes
9. Litigation Proceeds Received ❑ 10. ousel P ven Freditl(Ds;%of Death ❑
Mroen tyl 3v end 1- ) 71 (AttachnSchedule under Sec.9113(A)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
CRAIG S SHARNETZKA 717 848 4900
REGISTER OF WILLS USE ONLY
First Line of Address
CGA LAW FIRM 135 NORTH o �
Second Line of Address FW+7 n c CA
y7. rrI
rn N
m rn
t V
City or Post Office FILED
State ZIP Code =
YORK PA c� c�� o 2�
TTt
Correspondent's e-mail address: :y fV rn O
Under penalties of perjury,I declare that 1 have examined this return,Including accompanying schedules and statements,and to the best of my knowledge and belle(,
it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGN�AA�>TU�R°oE OF PERSON RESPONSIBLE�F9aJFILINCt RETURN DATE
ADORES vl l..'cv� Sheldon E,Bair 00V,
ADDRESS
60 ast Broadway, Bel Air. MD 21014
SIG T PREPMYEROTt1 MpREPRESENTATIVE 1'DATE
\`/� Craig S. Sharnetzka J�/OU,A0,adl3
AD
alf
CG Law Firm, 135 North George Street,York, PA
1505610143 Side 1 1505610143
' -D
1505610243
REV-1500 EX
Decedent's Social Security Number
Dewdam's Name: Bair, Ann E.
RECAPITULATION
1. Real Estate(Schedule A)....................................................................................... 1. 30 , 000 . 00
2. Stocks and Bonds(Schedule B)............................................................................. 2.
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C)......... 3.
4. Mortgages&Notes Receivable(Schedule D)........................................................ 4.
5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)............... 5.
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers&Miscellaneous tyoq-Probate Property
(Schedule G) u Separate Billing Requested............ 7,
8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 30 , 000 . 00
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 5, 716 . 00
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10.
11. Total Deductions(total Lines 9 and 10)................................................................ 11. 5 , 716. 00
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 24 , 284 . 00
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J)............................................... 13.
14. Net Value Subject to Tax(Line 12 minus Line 13)............................................... 14. 24 ,284 . 00
TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116
(a)(1.2)X.00 15. 0 . 00
16. Amount of Line 14 taxable 24 284 . 00 16. 1 , 092 . 78
at lineal rate X .045
17. Amount of Line 14 taxable
at sibling rate X.12 0 . 00 17. 0 . 00
18. Amount of Line 14 taxable
at collateral rate X.15 0 . 00 18. 0 . 00-
19. TAX DUE................................................................................................................ 19. 1 , 092 . 78
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. El
Side 2
1505610243 1505610243
REV-1500 EX Page 3 File Number 21-10-1010
Decedent's Complete Address:
DECEDENT'S NAME
Bair,Ann E.
STREET ADDRESS
5225 Wilson Lane
- — ---- --- --- -- --- -
CITY STATE ZIP
Mechanicsburg PA 17055
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 1,092.78
2, Credits/Payments
A. Prior Payments
B. Discount
Total Credits(A +B) (2)
3. Interest (3) 78.94
4, If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4)
Check box on Page 2,Line 20 to request a refund
5, If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 1,171.72
Make Check Payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a, retain the use or income of the property transferred;........ .................._....... ......... ......
b. retain the right to designate who shall use the property transferred or its income;............___ _....I x
c. retain a reversionary interest;or............................................................-................................................. x
d. receive the promise for life of either payments,benefits or care?............................................................ 0
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?......-........._...................._..................._.........................................-........... ❑
3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?....... ❑ Q
4. Did decedent own an individual retirement account, annuity,or other non-probate property which ❑ ❑
contains a beneficiary designation?_............_................_._._...._.._._..........................................._...............
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
- . .n. . :_ . — -
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 January 1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S.§9116(a)(1.1)(ii)]. The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 yyears 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 172 P.S.§9116(a)(i.2)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent 172 P.S.§9116(a)(1.3)]. A sibling is defined,
under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
Rev-1502 E%.(01.10)
SCHEDULE A
pennsylvania REAL ESTATE
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Bair,Ann E. 21-10-1010
All real property owned solely or an a tenant In common must be reportad at felt market value.Fair market value is darned as the price at which progeny would be
exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,Win having reasonable knowledge of me relevant lasts,
Real property that Is Joln itr,owned with right of survlvonmIp must be disclosed an schedule F.
Ahach a copy of the settlement shoat If the property has been sold
Include a copy of the deed showing decedent's Interest If owned as tenant In common.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Real estate located at 50 Center Road and 140 Center Road, Buffalo Township, Perry County, 30,000.00
Pennsylvania -Actual Deed consideration
TOTAL(Also enter on Line 1, Recapitulation) 30,000.00
(If more space Is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule A(Rev.01-10)
T
REV-1511 EX.(1049)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX
RESIDENT DECEDENT RETURN ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Bair, Ann E. 21-10-1010
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER A. FUNERAL EXPENSES:
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representatives)
Street Address
City State Zio
Year(s)Commission Paid
2. Attorney's Fees CGA Law Firm 1,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation)
Claimant
Street Address
City State ZiD
Relalionshio of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 4,716.00
See continuation schedule(s) attached
TOTAL(Also enter on line 9, Recapitulation) 5,716.00
Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev. 10.09)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Bair,Ann E. 21-10-1010
ITEM
NUMBER DESCRIPTION AMOUNT
Other Administrative Costs
1 CGA Law Firm -Long distance phone calls and photocopies 18.00
2 CGA Law Firm -Legal fees with respect to negotiations necessary to complete real estate 2,961.29
transaction
3 CGA Law Firm -On line research regarding issues with real estate transaction 42.21
4 CGA Law Firm -Long distance phone calls and photocopies 15.00
5 Charles E. Petrie, Esquire -Attorneys'fees with regard to real estate transaction 1,000.00
6 Cumberland County Register of Wills - Filing fee for supplemental REV 1500 15.00
7 Perry County Recorder of Deeds -Fee to transfer decedent's interest in property,see 659.50
attached recording receipt
8 Tina M. Gingerich -Notary fee 5.00
H-B7 4,716.00
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev. 6-98)
f
REV-1513 E%•(01.10(
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Bair, Ann E. 21-10-1010
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT (Words) ($5S)
Do NQt List Trusteefs)I• TAXABLE DISTRIBUTIONS [include outright spousal
distributions,and transfers
under Sec.9116 a 1.2
Sheldon E. Bair Son Entire estate
602 East Broadway
Bel Air, MD 21014
Total
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet as a Do riate.
NON-TAXABLE DISTRIBUTIONS:
II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule J(Rev.01-10)
Sep 1913 02:39p Charles E Petrie 7175614121 p.3
LAST WILL AND TESTAMENT
I, ANN E. BAIR, of 302 Fishburn Street, Harrisburg, County of Dauphin,
Pennsylvania, do hereby make, publish, and declare this to be my LAST WILL
AND TESTAMENT, revoking any and all prior wills and codicils, in manner
following, that is to say,
FIRST, that I direct that my Personal Representative shall pay all of my
just debts and funeral expenses as soon as this shall be practicable.
SECOND, that I give, devise, and bequeath all of my property, real,
personal, and mixed, to my husband, LOWELL S. BAIR.
THIRD, that if my husband has predeceased me, or has failed to survive
me for a period of at least ninety (90) days, or if our deaths should occur in
such a manner that it cannot be determined which of us has predeceased the
other, then I give, devise, and bequeath all of my property, real, personal, and
mixed, to my son, SHELDON E. BAIR.
FOURTH, that if my son has predeceased me or has failed tocsurvive 'e
c� o
for a period of at least ninety (90) days, then I give, devise and be ij allsf
MY property, real, personal and mixed to be divided as follows:
a. I give, devise, and bequeath one-half (1/2) of my nevi
o
distributable estate to my husband's daughter, TAMARA BAIR.
b. I give, devise, and bequeath the remaining one-half(1/2) of my
net distributable estate to be divided equally between my grandson, ZACHARY
BAIR, and my granddaughter, MORGAN BAIR.
Sep 19 13 02:40p Charles E Petrie 7175614121 p.4
FIFTH, that I hereby appoint my husband, LOW-ELL S. BAIR, as the
Executor of my Estate. If he is unable or unwilling to perform in this capacity,
then I appoint my son, SHELDON E. BAIR, as the Executor of my estate. If my
son is unable or unwilling to perform in this capacity, then 1 appoint TAMARA
BAIR as the Executrix. I direct that my Personal Representative shall not be
required to past bond in this or in any other jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this 27th
day of August, 2003.
4
•
ANN E. BAIR
2 /lam t!/��s`
WII EEESS
WITNESS
Sep 18 13 02:40p Charles E Petrie 7175614121 p.5
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF DAUPHIN
I, ANN E. BAIR, testatrix, whose name is signed to the attached or
foregoing instrument, having been duly qualified according to law, do hereby
acknowledge that I signed and executed the instrument as my Last Will and
Testament; that I signed it willingly; and that I signed it as my free and
voluntary act for the purposes therein expressed.
Sworn or affirmed to and acknowledged before me by ANN E. BAIR, the
testatrix, this 27'h day of August, 2003.
ANN E../BAIR
...,NOTARY BLIC
"riotermi seam-
Kalty P.goberts,No$wy Public
Paxtanp Born.Daophtn
!dy CarmMas Expires Jan.27.X005
Member.PannsyNanla Assoolation of Notaries
Sep 18 13 02:40p Charles E Petrie 7175614121 p.6
AFFIDAVIT
WE, CHARLES E. PETRIE and LOWELL S. BAIR, the witnesses whose
names are signed to the attached or foregoing instrument, being duly qualified
according to law, do depose and say that we were present and saw testatrix
sign and execute the instrument as her Last Will and Testament; that ANN E.
BAIR signed willingly and that she executed it as her free and voluntary act for
the purposes therein expressed; that each of us in the hearing and sight of the
testatrix signed the will as witnesses; and that to the best of our knowledge the
testatrix was at that time 18 or more years of age, of sound mind and under no
constraint or undue influence.
Sworn or affirmed to and subscribed before me by CHARLES E. PETRIE
and LOWELL S. BAIR, witnesses, this 2VI day of August, 2003.
Gfi
iT ESS
WITNESS
7
f! �` 1
i`,.NOTAR UBLIC
Notarial Sealry
PetQanB 1Dwpl* 200
my Commiww lxplres Jan.27, 5
Membar,PeMsy"nia Assxi91Nn 01 NOW"
Prepared By:
Craig S. Sharneuka,Esquire
CGA Law Firm
135 North George Street
York, PA 17401
Return To:
John W. Albright
1179 Dowhower Road
Harrisburg, PA 17111
Parcel lDH030,040.00-053.000 50 Center Road
Parcel IDtt030,040.00-018.000 140 Center Road
THIS EE
MADE the f , day of .r,0r-1n1'"' in the year of our Lord Two
Thousand Thirteen (2013)
BETWEEN
SHELDON E. BAIR, Executor of the Estate of ANN E. BAI.R, transferring her one-
half(l./Z) interest, late of Dauphin County, .Pennsylvania, deceased,
GRANTOR
AND
JOHN W. ALBRIGHT, SR., JOHN W. ALBRIGHT, JR., AMY A. GORDON,
DAVID T. ALBRIGHT, of Dauphin County, Pennsylvania, in equal shares as Joint
Tenants with Right of Survivorship,
GRANTEES
WHEREAS, Ann E. Bair died testate on the 30th day of September, 2010, and her Last-
Will and Testament dated August 27, 2003, was duly entered for probate in the Office of
the Register of Wills in and for Cumberland County, Pennsylvania on October 6, 2010,
where it remains of record to Pile No. 2010-01010, and
WHEREAS, said Testatrix in Item Fifth of her Last Will and Testament, provided, inter
alia, as follows:
"I appoint my husband, Lowell S. Bair, as the Executor of my estate. If he is
unable or unwilling to perform in this capacity, then I appoint my son., Sheldon E. Bair,
Executor of my Estate. . ."; and
WHEREAS Letters Testamentary were granted by the Register of Wills of Dauphin
County, Pennsylvania on October 6, 2010, to Sheldon E. Bair, the Executor named in the
Last Will and Testament of the Decedent; and
WHEREAS the said Testatrix, at the time of her death, was the owner in the real estate
hereinafter described; and
WHEREAS, the said Sheldon E. Bair, Executor of the aforesaid Will, acting under and
pursuant to the authority given to him, tinder the terms of the Last Will and Testament of
the Decedent, and Section 3532 of the PEP Code, has agreed to distribute the real estate
herein described, to the Grantee named herein.
NOW, THEREFORE, Witnesseth, that the said Sheldon E. Bair,Executor, as aforesaid,
for and in consideration of the sum of Thirty Thousand ($30,000.00) Dollars lawful
money of the United States, to him in hand paid by the Grantees, at and before the sealing
and delivery hereof, the receipt whereof is hereby acknowledged, has remised, released
and quit-claimed, and by these presents, does remise, release and forever quit-claim unto
the said Grantees, their heirs and assigns,
ALL those certain two tracts of land situated in Buffalo Township, Perry County,
Pennsylvania, bounded and described as follows:
Tract 1 —
BEGINNING at an iron pin in Township Road 467, North seven (07) degrees fifty (50)
minutes fourteen (14) seconds East along the land of Haven Showers (deed book 145,
Page 536) on the west for one thousand three hundred sixty-six and sixty-eight
hundredths (1,366.68) feet to an iron pin; thence South eighty-two(82) degrees nine (09)
minutes forty-six (46) seconds East, a distance of four hundred forty-one and zero
hundredths (441.00) feet along the same Maven Showers property to a stone; thence
South six (06) degrees thirty-seven (37) minutes zero (00) seconds West for a distance of
one thousand two hundred eighty-six and zero hundredths (1,286.00) feet to an iron pin;
thence along Township Road South eighty-eight (88) degrees one (01) minute forty-five
(45) seconds West to the point of BEGINNING. Tract No. 1 consisting of 13.856 acres
as shown on a survey 1/28/81 by Thomas L. Palm Loysville, Pennsylvania, for The
Josiah Bair Fleirs and Maven Showers.
i
Tract 2 —
BEGINNING at a bolt in the road of L.R. 50002, South fifty (50) degrees twenty-seven
(27) minutes thirty-eight (38) seconds East a distance of eight hundred eight and fifty
hundredths (808.50) feet along the lands of Haven Showers as shown in deed book 150,
page 447 to a bolt in the same road; thence South five (05) degrees five (05) minutes five
(05) seconds East for a distance of one thousand five hundred sixty and fourteen
hundredths (1;560.14) feet to a stone along the lands of Haven Showers; thence South
seventy-three(73) degrees thirty-three (33) minutes four(04) seconds West for a distance
of eight hundred eighty-three and sixteen hundredths (883.16) feet to a stone along the
land of Raymond Shutt (deed book 257, page 29); thence North eighty-three (83) degrees
seventeen (17) minutes fifty-nine (59) seconds West for a distance of two hundred thirty-
five and eighty-eight hundredths (235.88) feet along the land of Thomas Weidenhof
(deed book 271, page 378) to an iron pin; thence North four(04) degrees forty-five (45)
minutes twenty-two (22) seconds East for a distance of two hundred thirty-two and
eighty-six hundredths (232.86) feet along the Weidenhof property to a bolt set in
Township Road T-467; thence North eight (08) degrees thirty-six (36) minutes eleven
(11) seconds Fast for a distance of one thousand four hundred twelve and thirty-five
hundredths (1,412.35) feet along the lands of Haven Showers (deed book 145, page 536),
to an iron pin; thence North eighty-two (82) degrees thirty-six (36) minutes forty-one
(41) seconds West for thirty-three and eighty-five hundredths (33.85) feet to an iron pin;
thence North ten (10) degrees thirty-two (32) minutes twenty-two (22) seconds East for a
distance of six hundred sixty-nine and sixty-nine hundredths (669.69) feet along the lands
of Fred. Santiago (deed book 223, page 27) to the point of BEGINNING. Tract No. 2
consisting of 39.288 acres as shown on a survey by Thomas Palm, Loysville,
Pennsylvania, for The Josiah Bair Heirs and Haven Showers.
IT BEING the same premises which The Josiah Bair Heirs by Lowell Bair and John W.
Albright by deed dated April 8, 1990, and recorded in the Office of the Recorder of
Deeds in and for Perry County, Pennsylvania, in Deed Book 579, Page 330, granted and
conveyed unto Lowell Bair, Ann E. Bair, John W. Albright and Jane P. Albright. The
said Lowell Bair having predeceased, by operation of law the property is vested in Ann
E. Bair. Ann E. Bair died on September 30, 2010, and tier one-hair(1/2) of the property
is being transferred by her Executor, Sheldon E. Bair, Grantor herein.
TOGETHER with all and singular the premises, ways, waters, water-courses, rights,
liberties, privileges, hereditaments and appurtenances, whatsoever thereunto belonging,
or in anywise appertaining, and the reversions and remainders, rents, issues and profits
thereof; and also, all the estate, right, title and interest, use, trust,property, possession,
claim and demand whatsoever, in law, equity, or otherwise howsoever, of, in, to or out of
the same.
TO HAVE AND TO MOLD, the said tract of land, the hereditaments, and premises
hereby remised, released, and quit-claimed or mentioned and intended so to be, with the
appurtenances, unto the said Grantees, their heirs and assigns, by these presents, that
Sheldon E. Bair, Executor, as aforesaid, has not done, committed or knowingly or
willingly suffered to be done or committed, any act, matter or thing whatsoever whereby
the premises hereby remised, released and quit-claimed, or any part thereof, is, are, shall
or may be impeached, charged or encumbered; in title, charge, estate or otherwise
howsoever.
WITNESS the due execution hereof the day, month and year first above written,
Witness: J THE ESTATE OF ANN E. BAIR
Al
" Sheldon 9. Bair, Executor of the
Estate of Ann E. Bair, deceased
COMMONWEALTH OF PENNSYLVANIA:
ss
COUNTY OF YORK
On this, the_ _ _ day of = 2)i"J i.— , 2013, before
me, a Notary Public, the undersigned officer, personally appeared Sheldon E. Bair,.
Execrator of the Estate of Ann E. Bair, deceased, known to me (or satisfactorily
proven) to be the person whose name is subscribed to the within instrument, and
acknowledged that he executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I have hereunto set my hand and notarial seal.
Notary Public
P
Notarial Soul
Chrlstbq py Gingerich,Notary Po41k.
Cky d York,York County
My Car miu M'Enplros Nay]8,2017
Member,RparytrMb nstocbe of MWaNN
J
• •
CERTIFICATION OF RESIDENCE
I do hereby certify that the precise residence and complete post office address of the
within names Grantees is;
�C.�r•.i �J+<r.F
%A 1 71x1
Agorxt/� Attorney for Grantees
iJ
WENDY NI. WELFLEY
Nt
PERRY COUNTY RECORDER OF DEEDS
2 East Main Street
New Bloomfield, Pennsylvania 17068
(717) 582-2131 w`
3 $
Recorded On 10/18/2013 At 2:08:21 PM
• Instrument Type - DEED
Invoice Number- 119608
• Grantor-BAIR, SHELDON E Recorded b SItl1nilflle
•Grantee - ALBRIGHT, JOHN W SR Y p
• Customer- SINIPLIFILE LC &RECORDING
• FEES 'Total Pages - 6
STATE TRANSFER TAX $300.00
STATE WRIT TAX $0 .50
JCS/ACCESS TO JUSTICE $23.50
RECORDING FEES — . $16.00 This is a certification page
RECORDER OF DEEDS
AFFORDABLE HOUSING $10.00
COUNTY ARCHIVES FEE $2 .00 DO NOT DETACH
RECORDER' S ARCHIVES FEE $0 .50
- TO COUNTY This page is now part
RECORDER IMPROVEMENT $2 .50 of this legal document.
FUND — TO OFFICE
NEWPORT SCHOOL $150 .00
DISTRICT REALTY TAX
BUFFALO TOWNSHIP $150.00
TOTAL PAID $655 . 00 •RETURN DOCUMENT TO:
CGA LAW F1RNI
135 NORTH GEORGE STREET
PORK,PA 17401
I hereby CERTIFY that this document is
recorded in the Recorder of Deeds Off&e;
f9Jf Perry Cpountyl, Penn�s, Ivania.
P.O. Box 223
New Bloomfield, PA 17068
•-Information denoted by an asterisk tnay change during
the verification process and may not he reflected on this page.
Instrmneut Number: 201308122