HomeMy WebLinkAbout12-02-13 (2) -J REV-1 1505607122
500 EX(06-05) OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year File Number
PO BOX 280601
Harrisburg,PA 17128-0601 RESIDENT DECEDENT 2 1 1 3 [0[0
3 2 4
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death _ Date of Birth
203 20 1911139 03072013 100511932
Decedent's Last Name Suffix Decedent's First Name MI
IRIEININIIINIGIE M = 7 FLI
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
TTTJ �I a___
Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
m � REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
• 1.Original Return o 2.Supplemental Return o 3.Remainder Return(date of death
prior to 12-13-82)
0 4.Limited Estate o 4a.Future Interest Compromise(date o 5.Federal Estate Tax Return Required !
of death after 12-12-82)
• 6.Decedent Died Testate o 7.Decedent Maintained a Living Trust 0 8.Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
0 9.Litigation Proceeds Received o 10.Spousal Poverty Credit(date of death o 11.Election to tax under Sec.9113(A)
between 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 TO:
Name _ _ Daytime Telephone Number ��������
IWIIILILIIIAIMI-TR�KAUFMANI ��T1 �7�117 1716I6_N717O21
Firm Name If A licable _ C C--> %�a
REM O'WILL HOSE O
First line of address —II—IL
rn N r n rt
1914101 CENTURY DRIVE I I I c Cn C�l
Second line of address 1 _ _ _ _ _ p � �
S Fui T E I E I TTJ 11 �� T������ 'a DATE FIMP P
i
City or Post Office State ZIP Code ;,. C1't Cn G:O
M ESC H A N IJCTS B '1U, RI ( MPA 1JjI 7
Correspondent's e-mail address: wrkaufman.wrkaw @comcast.net
Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,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.
SIGNATUR' R,C �1 NSIBL�FlOR FI NG RETURN EXECUTOR DATE
ADDR SS y,�—
6111 LOCUST LANE, MECHANICSBURG, PA 17050
SIGN R REP O HER TOAN REPRESENTATIVE ��
. 1 1110 ESQUIRE /
ADDRESS
940 CENTURY DRIVE, ITE B, MECHANICSBURG, PA 17055-4376
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505607122 1505607122 _J \
C �
1505607222
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: PHYLLIS RENNINGER
RECAPITULATION
1. Real estate(Schedule A) 1. 1 2 51010 0 . 0 0
2. Stocks and Bonds(Schedule B) 2. 0 0 0
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) 3. 0 0 0
4. Mortgages&Notes Receivable(Schedule D) 4. 0 0 0
5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E) 5. 2 611 9 91 115
6. Jointly Owned Property(Schedule F) o Separate Billing Requested 6. 0 • 0 0
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
4 3 0 5 0 . 0 O
(Schedule G) o Separate Billing Requested 7
8. Total Gross Assets(total Lines 1-7) 8. 1 9 4 2 4 9 . 1 5
9. Funeral Expenses&Administrative Costs(Schedule H) 9. 3 8 0 4 4 .15181
10. Debts of Decedent,Mortgage Liabilities,&Liens(Schedule 1) 10. 1 3 8 9 8 3
11. Total Deductions(total Lines 9&10) 11. 3 8 4 3 4 . 4 1
12. Net Value of Estate(Line 8 minus Line 11) 12. 1 5 5 8 1 4 . 7 4
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J) 13. 0 0 1 0
14. Net Value Subject to Tax(Line 12 minus Line 13) 14. 1 5 5 8 1 4 7 4
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 0. 15. 0 0 i 0
16. Amount of Line 14 taxable
at lineal rate X 0. 16. 0 . 0 0
17. Amount of Line 14 taxable
at sibling rate X .12 2 3 4 0 0 . 0 0 17. 2 , 8 _0 8 .1010
18. Amount of Line 14 taxable
at collateral rate X.15 1 3 2 4 1 4 7 4 18. 1 9 8 6 2 . 2 1 ,
19. TAX DUE 19. 2 2 6 7 0 . 2- 1-1
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT •
Side 2
1505607222 1505607222
ti
REVA500 EX Page 3 Fife Number
Decedent's Complete Address: 211300324
DECEDENT'S NAME DECEDENTS SOCIAL SECURITY NUMBER
PHYLLIS RENNINGER
STREET ADDRESS
38 WILLIAM PENN DRIVE
CITY STATE ZIP
CAMP HILL PA 17011
Tax Payments and Credits:
1. Tax Due(Page 2 Line 19) (1) $22,670.21
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments $26,000.00
C. Discount 1,133.51
Total Credits(A+B+C) (2) $27,133.51
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty(D+E) (3) $ 0.00 !
4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT. t
Fill in oval on Page 2,Line 20 to request a refund. (4) $4,463.30 ;
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) $ 0.00
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5+5A.This is the BALANCE DUE. (513) $ 0.00
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1• Did decedent make a transfer and: Yes No
a.retain the use or income of the property transferred; ❑ 0
b.retain the right to designate who shall use the property transferred or its income; ❑ 0
c.retain a reversionary interest;or ❑
d.receive the promise for life of either payments,benefits or care? ❑ D
2• If death occurred after December 12, 1982,did decedent transfer property within one year of death
without receiving adequate consideration? 0 ❑
3• Did decedent own an"in trust for"or payable upon death bank account or security at his or her death? ❑ 0
4. Did decedent own an Individual Retirement Account,annuity,or other non-probate property which
contains a beneficiary designation? ❑ 0
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 January 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving
spouse is three(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 zero(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 twenty-one 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 zero(0)percent[72 P.S.§9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half(4.5)percent,except as noted
in
72 P.S.§9116(1.2)[72 P.S.§9116(a)(1)1.
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve(12)percent[72 P.S.§9116(a)(1.3)].A sibling is
defined,under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
REV-1502EX+(6-98)
COMMONWEALTH OF PENNSYLVANIA
SCHEDULE A
INHERITANCE TAX RETURN
RESIDENT DECEDENT REAL ESTATE
ESTATE OF PHYLLIS RENNINGER FILE NUMBER 211300324
All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts.
Real property which Is jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. DECEDENT'S PRINCIPAL RESIDENCE,LOCATED AT 38 WILLIAM PENN DRIVE,CAMP HILL, $125,000.00
CUMBERLAND COUNTY,PA;TAX PARCEL ID NO: 13-24-0797-012.VALUE IS EQUAL TO GROSS SALES
PRICE AS REPORTED ON ATTACHED HUD-1,FROM SALE OF SAID PROPERTY ON MAY 28,2013
TOTAL(Also enter on line 1,Recapitulation) $125,000.00
(If more space is needed,insert additional sheets of the same size)
OMB Approval No.2502-0265
�O� A. Settlement Statement (HUD-1)
. . ..
1.❑X FHA 2.❑RHS 3.❑Conv.Unins. 6.File Number: 7.Loan Number: 8.Mortgage Insurance Case Number:
13.80 5701647790 446.1770547-703
4.❑VA 5.❑Conv.Ins.
C.Note:This form is furnished to give you a statement of actual settlement costs.Amounts paid to and by the settlement agents are shown.Items marked
"(p.o.c)"were paid outside the closing;they are shown here for informational purposes and are not included in the totals.
D.Name&Address of Borrower: E.Name&Address of Seller: F.Name&Address of Lender:
Amanda J.Aliland,Jean L Keller-Thau Estate of Phyllis L Renninger Fulton Bank,N.A.
317 Eutaw Avenue Rear,New Cumberland,Pa 17070 940 Century Drive,Suite B.,Mechanicsburg,PA 17055 One Penn Square,Lancaster,PA 17602
G.Property Location: H.Settlement Agent: 1.Settlement Date:05/2812013
38 William Penn Drive The Law Office of Andrew H.Shaw,PC Disbursement Date:05/2812013
Camp Hill,PA 17011 200 S.Spring Garden Street,Suite 11,Carlisle,PA 17013
Lower Allen Township
Telephone:717-243-7135
Place of Settlement: l itleExpress
200 S.Spring Garden Street,Suite 11,Carlisle,PA 17013 Printed 05!28/2013 at 12:40 pm
by SDC
J.Summary of Borrower's
100. Gross Amount Due from Borrower 400. Gross Amount Due to Seller
101. Contract sales price 125,000.00 401. Contract sales price 125,000.00
102. Personal property 402. Personal property
103. Settlement charges to borrower(line 1400) 6,101.23 403.
104. 404.
105. 405.
Adjustments for items paid by seller in advance Adjustments for items paid by seller In advance
106. Cityftown taxes to 406. Cityhown taxes to
107. County taxes 05/28/2013 to 1213112013 392.64 407. County taxes 05/28/2013 to 121312013 392.64
108. School Taxes 05282013 to 061302013 108.43 408. School Taxes 05282013 to 06/302013 108.43
109. 2nd Quarter SewerlTr 05282013 to 061302013 43.98 409. 2nd Quarter Sewer/Tr 05282013 to 06/302013 43.98 i
110. 410.
111. 411.
112. 412.
120. Gross Amount Due from Borrower 131,646.28 420. Gross Amount Due to Seller 125,545.05
200..Amounts Paid by or In Behalf of Borrower 500. Reductions In Amount Due to Seller
201. Deposit or earnest money 1,000.00 501. Excess deposit(see instructions)
202. Principal amount of new loan(s) 122,735.00 502. Settlement charges to seller(line 1400) 9,760.00
203. Existing Ices taken subject to 503. Existing loa s taken subject to
204. 504. Payoff of first in a e loan
205. 505. Payoff of second mortgage loan
206. Sellers Assist 3,750.00 506. Sellers Assist 3,750.00
207. Lender Paid Fee 1,000.00 507.
206. 508.
209. 509.
Adjustments for items unpaid by seller Adjustments for items unpaid by seller
210. City/town taxes to 510. Cityltown taxes to
211. County taxes to 511. County taxes to
212. School Taxes to 512. School Taxes to
213. 513.
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. 519.
220. Total Paid b 1for Borrower 128,485.00 520. Total Reduction Amount Due Seller 13,510.00
300. Cash at Settlement fromlto Borrower 600. Cash at Settlement to/from Seller
301. Gross amount due from borrower(line 120) 131,646.28 601. Gross amount due to seller(line 420) 125,545.05
302, Less amounts paid by/for borrower(line 220) 128,485.00 602. Less reductions in amount due seller(line 520) 13,510.00
303. Cash ❑X From ❑To Borrower 3,161.28 603. Cash ❑X To ❑ From Seller 112,035.05
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Previous editions are obsolete Page 1 of 4 HUD-1
L.Settlement Charges
v.
1700. Total Real Estate Broker Fees $7,470.00 Paid From Paid From
Division of commission line 700 as follows: Borrower's Seller's
701• $3,637.50 to Jack Gaughan ERA Funds at Funds at
702. $3,637,50 to Prudential Homesale Services Group Settlement Settlement
$195.00 to Jaa Gaughan ERA
703. Commission paid at settlement 7,470.00
7D4. Broker Fee to Prudential Homesale Services Group 1 295.00
800. items Payable in Connection with Loan
801.'Our origination charge (Includes Origination Point 0.000%or$0.00) $695.00 (from GFE#1)
802. Your credit or charge(points)for the specific interest rate chosen $-1,841.03 (from GFE#2)
803. Your adjusted origination charges (from GFE A) -1,146.03
804. Appraisal fee to Central Penn Appraisals (from GFE#3) 400.00
805. Credit report to Credstar (from GFE#3) 23.36
806. Tax service to (from GFE#3)
807. Flood certification to Corelogice Flood Services (from GFE#3) 11.50
808. to
900. Items Required by Lender to be Paid in Advance
901. Daily interest charges from from 05128/2013 to 06101/2013 @$10.92841day (from GFE#10) 43.71
902. Mortgage insurance premium for months to Dept.of HUD (from GFE#3) 2,110.94
903. Homeowner's insurance fort years to State Farm Insurance (from GFE#11) 360.00
904. months to from GFE#11
1000.Reserves Deposited with Lender
1001.initial deposit for your escrow account (from GFE#9) 1,187.75
1002.Homeowner's insurance 3 months @$ 30.001month $90.00
1003.Mortgage insurance months $ 134.46/month $
1004.Property taxes 2 months @$ 0.001month $
1005.County/iwp.Taxes 4 months @$ 55.86 1month $223.44
1006.School Taxes 12 months @$ 98.981month $1,187.76
1007.Aggregate Adjustment $,313.45
1100.Title Charges
1101.Titre services and lenders We insurance to The Law Office of Andrew F from GFE#4 1,385.00 40.00
1102.Settlement or dosing fee to $
1103.Owners title insurance-Security Title Gurantee Co.of Baltimore from GFE#5 10.00
1104.Lenders title insurance-Security Title Gurantee Co.of Baltimore $1,015.00
1105.Lenders title policy limit$122,735.00 Lenders Policy
1106.Owners fitle policy limit$125,000.00 Owners Policy
1107.Agent's portion of the total title insurance premium $820.00
to The Law Office of Andrew H.Shaw,PC
1108.Underwriters portion of the total title insurance premium $205.00
to Security Title Gurantee Co.of Baltimore
1109• to $
1200.Government Recording and Transfer Charges
1201.Government recording charges $ (from GFE#7) 160.00
1202, Deed$62.00 Mortgage$98.00 Release$
1203.Transfertaxes $ (from GFE#8) 1,250.00
1204.City/County tax/stamps Deed$1,250.00 Mortgage$
1205.State Tax/stamps Deed$1,250.00 Mortgage$ 1,250.00
1206.UPI Fee Deed$ Mortgage$
1207. $
1300.Additional Settlement Charges
1301.Required services that you can shopfor from GFE#6)
1302.Survey to $
1303. to
1304.Deed Preparation to William Kaufman 150.00
1305.Attorneys Fees to wilfiam Kaufman 850.
i i r r r M 6,101.23 9,760.00
'Paid outside of dosing by(B)orrower,(S)eller,(L)ender,(I)nvestor,Bro(K)er."Credit by lender shown on page 1.-Credit by seller shown on page 1.
Previous editions are obsolete Page 2 of 4 HUD-1
Comparison of Good Faith Estimate(GIF and HUM Charges Good Faith Estimate HUM
7Cha es?hat Cannot Increase HUD-1 Line Number.
Our origination charge # 801 695.00 695.00
Your Creditor charge(points)for the specific interest rate chosen # 802 -1,841.03 -1,841.03
Youradjusted origination charges # 803 -1,146.03 -1,146.03
Transfer taxes # 1203 1,250.00 1,250.00
Charges That in Total Cannot Increase More Than 10% Good Faith Estimate HUD-1
Government recording charges. # 1201 220.00 160.00
Appraisal fee #804 450.00 400.00
Credit report #805 40.00 23.36
Tax service #806 0.00 0.00
Flood certification #807 11.50 11.50
Mortgage insurance premium #902 2,110.94 2,110,94
#
2,832.44 2,705.80
Increase between GFE and HUD-1 Charaes $ -126.64 or -4.4711%
Charges That Can Change Good Faith Estimate HUD-1
Initial deposit for your escrow account # 1001 1,911.00 1,187.75
Daily interest charges from #901 j$fl10.928W4/day 1 0.93 43.71
Homeowners insurance #903 600.00 360.00
Title services and lenders title insurance # 1101 1,450.50 1,395.00
Owners title insurance-Security Title Gurantee Co.of Baltimore # 1103 10.00 10.00
#
Loan Terms
Your initial loan amount is $122,735.00
Your loan term is. 30.years
Your initial interest rate is 3.2500%
Your initial monthly amount owed for principal,.interest,and any mortgage $668.61 includes
insurance is X❑Principal
❑X Interest
Q Mortgage Insurance
Can your interest rate rise? Q No. ❑Yes,it can rise to a maximum of %. The first change
will be on I I and can change again every years after I i . Every
change date,your interest rate can increase or decrease by %. Over the life of
the loan,your interest rate is guaranteed to never be lower than %or higher
than %.
Even if you make payments on time,can your ban balance rise? ❑X No. ❑Yes,8 can rise to a maximum of$
Even if you make payments on time,can your monthly amount owed for Q No. ❑Yes,the first increase can be on I I and the monthly
principal,interest,and mortgage insurance rise? amount owed can rise to$
The maximum it can ever rise to is$
Does your loan have a prepayment penalty? ❑No. ❑Yes,your maximum prepayment penalty is$
Does your loan have a balloon payment? ❑X No. ❑Yes,you have a balloon payment of$ due in
years on I I
Total monthly amount owed including escrow account payments ❑You do not have a monthly escrow payment for items,such as property taxes
and homeowners insurance. You must pay these items directly yourself.
X❑You have an additional monthly escrow payment of$184.84
that results in a total initial monthly amount owed of$653.45. This includes principal,interest,any
mortgage insurance and any items checked below.
X❑Property taxes X❑Homeowners insurance
❑Flood insurance X❑School Taxes
❑ ❑
Note: If you have any questions about the Settlement Charges and Loan Terms listed on this form,please contact your lender.
Previous editions are obsolete Page 3 of 4 HUD-1
N 4
Signature
HUD CERTIFICATION OF BUYER AND SELLER
1 have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief,it is a true and accurate statement of all receipts and
disbursements made on my account or by me in this transaction I further certify that I have received a copy of the HUD-1 Settlement Statement
!! aC1
_Zzdda
Amanda J.Altland ll can L.Keller-Than
ESTATE OF PHYLLIS L.RENNINGER
Settlement Agent
The HUD-1 Settlement Statement which I have prepared is a true and accurate account of this transaction I have caused or will cause the funds to be
disbursed in accordance with this statement.
SETTLEMENTAGENT DATE
WARNING:IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM.PENALTIES UPON
CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT.FOR DETAILS SEE TITLE 18:U.S.CODE SECTION 1001 AND SECTION 1010.
Previous editions are obsolete Page 4 of 4 HUD-1
Itemization of Line 1101
Name of Eorrower. Name of Seller: File Number:
Amanda J.Altland Estate of Phyllis L Renninger 13.80
Jean L Keller-Than
Prepared 0528/2013 at 12:07 pm
Note:This page displays an itemization of the charges shown on line 1101 of the HUD-1 Settlement Statement This page
accompanies but is not a part of the HUD-1 Settlement Statement If a discrepancy exists,the information on the HUD-1 Settlement
Statement applies.
1100.Title Charges Total Charge Borrower Seller
1101.Title services and lenders title insurance to The Law Office of Andrew H.Shaw,PC
Notary Fee to Sarah D.Dieckman $ 25.00 25.00
Overnight Fee to The Law Office of Andrew H.Shi$ 30.00 30.00
Document Prep.Fee to The Law Office of Andrew H.Sht$ 100.00 100.00
Tax Cert.Fee to Law Office of Andrew H.Shaw T$ 10.00 10.00
Notary Fee to Sarah D.Dieckman $ 10.00 10.00
Courier to Sarah D.Dieckman $ 20.00 20.00
100 No VjoA100 to Law Oifice of A.H.Shaw/STGC($ 50.00 50.00
300 Survey= to Law Office of A.H.Shaw/STGC($ 50.00 50.00
900 EPL-Res18.1 to Law Office of A.H.Shaw/STGC($ 50.00 50,00
ClosingSvcLtrlCL to Law Office of A.H.Shaw/STGC($ 75.00 75.00
1102.Settlement or dosing fee to $ OLD
1104.Lender's title insurance-Security Title Gunto Law Office of A.H.Shaw/STGC($ 1,015.00 1,015.00
1109. to $ 0.00
Totals: 1,435.00 0.00 1,395.00 40.00
SellerfLender credits shown on page 1 POC=Paid Outside Closing CR=Lender Credit
Previous editions are obsolete Page 1 of 1 HUD-1
REVA SWEX+(6-98)
SCHEDULE E
COMMNHERITANCETAXRETURNANIA CASH, BANK DEPOSITS, & MISC.
RESIDENT DECEDENT
PERSONAL PROPERTY
ESTATE OF PHYLLIS RENNINGER FILE NUMBER 211300324
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. CHECKING ACCOUNT—PNC BANK,A/C#51-4005-2219—SEE ATTACHED STATEMENT $23,920.52
2. CLOTHING, FURNISHINGS,AND PERSONAL EFFECTS—SEE ATTACHED INVENTORY DATED 1,394.00
MARCH 10,2013.AMOUNTS ARE PER ATTACHED SALVATION ARMY VALUATION GUIDE
3. CASH ON HAND 105.00
4. REFUND FROM SENIOR HELPER'S FOR UNEARNED CAREGIVER SERVICES 38.50
5. REFUND FROM VERIZON FOR OVERPAYMENT ON ACCOUNT 69.73
6. REFUND FROM COMCAST FOR OVERPAYMENT ON ACCOUNT 2.89
7. REIMBURSEMENT AT SETTLEMENT FOR SCHOOL TAXES PAID BY ESTATE IN ADVANCE- 108.43
SEE LINE 408 OF ATTATCHED HUD-1
8. REIMBURSEMENT AT SETTLEMENT FOR 2ND QTR SEWERrrRASH PAID IN ADVANCE- 43.98
SEE LINE 409 OF ATTATCHED HUD-1
9. 2012 PROPERTY TAX REBATE RECEIVABLE—RECEIVED BY ESTATE ON 7/1/13 500.00
10. REFUND FROM PPL FOR OVERPAYMENT ON ACCOUNT 16.10
TOTAL(Also enter on line 5, Recapitulation $26,199.15
(If more space is needed,insert additional sheets of the same size)
Total Banldng Statement (DPNCBANI(
PNC Bank
Primary account number:51-4005-2219
Page 1 of 7
For the period 02107/2013 to 03/06/20113 Number of enclosures:0-
001055 M For 24-hour banking,and transaction or
PHYLLIS L RENNINGER interest rate information,sign onto
38 WILLIAM PENN DR PNC Bank Online Banking at pnc.com.
CAMP HILL PA 17011-6669 For customer service call 1-888-PNC-BANK
Monday-Friday: 7 AM-10 PM ET
Saturday&Sunday: 8 AM-5 PM ET
Para servicio an espaffol,1-866-HOLA-PNC
Moving? Please contact us at 1-888-PNC-BANK
C0 Write to:Customer Service
PO Box 609
Pittsburgh FA 15230-9738
F13 Visit us at pric.corn
TDD terminal:1-800-531-1648
For hearing impaired clients only
Relationship Overview
Bank Deposit Accounts
Description Account Number Deposit Balance
Interest Checking 51-4005-2219 23,920.52
Performance Money Market 50-0350-3386 .00
Total Deposits 23;920.52
IMPORTANT ACCOUNT INFORMATION FOR PERFORMANCE CHECKING CUSTOMERS
We have recently expanded the investment assets which are included with the combined average balances to avoid monthly service charges.
Any PNC Investment(PNCI)asset*where PNCI is the broker-dealer of record will be included with your combined average balance to avoid
service charges on your checking account.
For more information,contact your PNC Financial Advisor,stop by your local PNC branch office or call us at the Customer Service phone
number listed above.
Assets managed under a fiduciary relationship with PNC Wealth Management are not included.Some accounts may not be eligible to be included in the
combined average monthly balance requirement based on titling structure,product type or other constraints. You must request your accounts be linked to your
checking account to receive relationship beneilts.
Performance Cheediling Phyllis L Renninger
Interest Checiiing Account Summary
Account number.,51-4005-2219
Overdraft Protection has not been established for this account.
Please contact us if you would like to set up this service.
Overdraft Coverage-Your account is currently Opted-Out.
You or your joint owner may revoke your opt-in or opt-out choice at any time.
To loam more about PNC Overdraft Solutions visit us online at pne.comloverdrafteolutions.
Call 1-1977-588-3605,visit any branch,or Sign on to PNC Online Banking,and select the"Overdraft
Solutions"link under the Account Services section to manage both your Overdraft Coverage and Overdraft
Protection settings.
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VALUATION GUIDE FOR THE ITEMS DONATED TO THE SALVATION ARMS
The following is a list of the average price charged in our stores if the items are in good condition. New
expensive items would be higher and damaged materials less.The list is for your guidance only,It is recommended
that you have an appraisal for valuables over $200.The following paragraph is a copy of the IRS Rules.
From publication 526, Internal Revenue Service Charitable Contributions: Requires that the contributor
attach to his/her income tax return, the following information: 1) Name and address of the organization to
which the contribution was made. 2) Date of contribution. 3) Description of property, including its condition.
4) Cost of property.5) Fair market value showing method utilized in determining fair value.6)Amount claimed as
deduction.Additional information is required for any single item contribution for which a deduction in excess of
$200.00 is claimed. Check with your local IRS Office in such instances.
LADIES'CLOTHES LOW HIGH FURNITURE LOW HIGH DRY GOODS LOW HIGH
Blouse $2.00 $7.50 Air Conditioner $20,00 $45.00 Blankets $2.50 $6.00
Bathrobes 2.50 8.50 Barbecue 10.00 15.00 Bedspreads 3.00 12.00
Boots 2.00 4.50 Bed Complete(double) 60.00 145.00 Chair Covers 5.00 35.00
Bras 1.00 3.00 Bed Complete(single) 35.00 85.00 Curtains 1.50 4.00
Bathing Suits 4.00 7.50 Bicycles 15.00 45.00 Drapes 8.50 15.00
Coats 10.00 65.00 Carriage 5.00 100.00 Pillows 2.00 6.00
Dresses 4.00 16,00 Chest 25.00 45.00, Sheets 2.00 6.00
Evening Dresses 10.00 35.00 China Cabinet 85.00 150.00 Throw Rugs 1.50 4.00
Fur Coats 25.00 70.00 Clothes Closet 15.00 30.00 Towels .50 2.00
Fur Hats 7.00 12.00 Coffee Table 15.00 45.00
Foundation Garments 3.00 8.00 Convertible Sofa
Handbags 2.00 10,00 (with mattress) 85.00 150.00
Hats 1.00 5.00 Crib(with mattress) 25.00 75.00
Jackets 4.00 8.00 Desk 25.00 125.00
Nightgowns 4.00 8,00 Dresser(with mirror) 20.00 85.00
Pant Suits 6.50 10.00 Dryer 46.00 85.00
Socks - .40 1.25 End Tables 10.00 25.00
Suits 6.00 30,00 Floor Lamps 7.50 22.00
Shoes 2.00 5.00 Folding Beds 20.00 45.00
Shorts 3.00 7.00 Heaters 7.50 22.00
Sweaters 3.50 12.50 High Chairs 10.00 35.00
Slips 1.00 4.50 Hi Riser 35.00 60.00
Slacks 3.50 7.50 Kitchen Cabinets 25.00 75.00
Kitchen Chair 2.50 7.00
MENSI CLOTHING LOW HIGH Mattress(double) 20.00 50.00
Jackets $7.50 $15.00 Mattress(single) 15.00 35.00
Overcoats 15.00 40.00 Play Pen 7.50 20.00
Pajamas 2.00 3.50 Radio 7.50 50.00
Pants/Shorts 3.50 8.50 Refrigerator(working) 75.00 250.00
Raincoats 6.00 12.00 Rugs 20.00 75.00
Suits 15.00 45.00 Secretary 50.00 125.00
Slacks 5.00 10.50 Sewing Machine 15.00 75.00
Shirts 2.50 10.50 Sofa 35.00 85.00
Sweaters 2.50 8.50 Studio Couch 35.00 85.00
Shoes 3.50 10.50 TV(B/W working) 25.00 86.00
Swim Trunks 2.50 5.50 TV(Color working) 75.00 225.00
Tuxedo 10.00 35.00 Trunk 5.00 22.50
Under Shirt 1.00 2.50 Typewriter 7.50 22.50
Under Shorts 1.00 3.50 Upholstered Chair 25.00 55.00
Vacuum Cleaner
CHILDREN'S CLOTHING LOW HIGH (working) 10.00 35.00
Blouses $2.00 $6.00 Washing Machine
Boots 1.00 10.50 (working) 35.00 125.00
Coats 4.50 12.50 Wardrobe 20.00 60.00
Dresses 3.50 10.50
Jackets 3.00 18.00 COMPLETE
Jeans 3.50 8.50 FURNITURE SETS LOW HIGH
Pants 3.50 8.50 Bedroom Set $350.00 $800.00
Snowsuits 1.00 8.50 Dining Room Set 150.00 $50.00
Shoes 2.50 8.00 Kitchen Set 35.00 125.00
Skirts 1.50 4.50
Sweaters 2.50 6.00
Slacks 3,00 6.00
Shirts 2.00 4.50
Socks .60 1.50
Underwear 1.00 1.50.
a.
REV-1510 EX+(6-98)
SCHEDULE G
INTER-VIVOS TRANSFERS &
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF PHYLLIS RENNINGER FILE NUMBER 211300324
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REVA 500 COVER SHEET is yes.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE
INCLUDE THE NAME OF THE TRANSFEREE,THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER.
NUMBER ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1. $13,000 CASH GIFT TO STEVEN R MABEN,NEPHEW OF DECEDENT, $13,000.00 100% $3,000.00 $10,000.00
MADE ON FEBRUARY 11,2013
2. $13,000 CASH GIFT TO MICHELLE Y MABEN,NIECE OF DECEDENT, 13,000.00 100% 3,000.00 10,000.00
MADE ON FEBRUARY 11,2013
3. $13,000 CASH GIFT TO STEPHANIE S MABEN,NIECE OF DECEDENT, 13,000.00 100% 3,000.00 10,000.00
MADE ON FEBRUARY 11,2013
4. CASH GIFTS TOTALING$12,650 TO KELLY J PETERSHEIM,NIECE OF 12,650.00 100% 3,000.00 9,650.00
DECEDENT,MADE AT VARIOUS TIMES WITHIN 1 YEAR OF DEATH
5. CASH GIFTS TOTALING$6,400 TO JOSEPH R SILKS,BROTHER OF 6,400.00 100% 3,000.00 3,400.00
DECEDENT,MADE AT VARIOUS TIMES WITHIN 1 YEAR OF DEATH
TOTAL(Also enter on line 7,Recapitulation) $43,050.00
(If more space is needed,insert additional sheets of the same size)
REV-1511 EX+(10-06) SCHEDULE H
FUNERAL EXPENSES &
COMMONWEALTH OF PENNSYLVANIA ADMINISTRATIVE COSTS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF PHYLLIS RENNINGER FILE NUMBER 211300324
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. HOENSTINE FUNERAL HOME,LEWISTOWN,PA—SEE ATTACHED INVOICE $3,483.52
2. JUNIATA MEMORIAL PARK,LEWISTOWN,PA—SEE ATTACHED INVOICES 2,969.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zip
Year(s)Commission Paid:
2. Attorney Fees 15,683.75
3. Family Exemption:(If decedent's address is not the same as claimant's,attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees CUMBERLAND OF COUNTY REGISTER OF WILLS 383.50
5. Accountant's Fees
6. Tax Return Preparer's Fees 200.00
7. ESTATE ADVERTISEMENT-CUMBERLAND LAW JOURNAL 75.00
8. ESTATE ADVERTISEMENT—HARRISBURG PATRIOT-NEWS 116.44
9. REPAIR TO DECEDENT'S RESIDENCE—GLASSMASTERS—SEE ATTACHED INVOICE 221.20
10. OTHER MISCELLANEOUS CLEANING&REPAIRS TO DECEDENT'S RESIDENCE INCURRED IN MAKING 173.88
RESIDENCE READY FOR RESALE
11. SCHOOL TAXES ON DECEDENT'S RESIDENCE—PAID TO LOWER ALLEN TWP ON 4/4/13 657.40
12. CLOSING COSTS ON SALE OF DECEDENT'S RESIDENCE—SEE LINES 702,1101,&1205 OF HUD-1 8,760.00
13. SELLER ASSISTANCE WITH BUYER'S CLOSING COSTS ON SALE OF DECEDENT'S RESIDENCE—SEE 3,750.00
LINE 506 OF HUD-1
14. AMOUNT PER SCHEDULE H CONTINUATION SCHEDULE 1,570.89
TOTAL(Also enter on line 9,Recapitulation) $38,044.58
(If more space is needed,insert additional sheets of the same size)
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EJPT No. 161598
DATE
FROM /�l�fl 1 Y V J 1%li �U I s
DOLLARS
0FOR RENT
Q FOR
ACCT. CASH � -
OCHECK FR T
PAID
i O MONEY ORDER'Y A•2501
DUE /� '`� OCREDITCARD By T-46820
Juniata Memorial Park Burial No. CONTRACT NO.
9010 U.S.Highway 522 South • Lewistown,PA 17044
717-242-2555
Property Deed No. Today's Date:
INTERMENT/ENTOMBMENT AUTHORIZATION AND INDEMNIFICATION
DATA ON DECEASED-
NAME: D.O.B. D.O.D. TIME OF DEATH SEX AGE MARITAL STATUS
ADDRESS: VETERAN: YES / NO
WAR RECORD
PLACE OF DEATH:
-DATA ON NEXT OF KIN AND SECOND NEXT OF KIN OR REPRESENTATIVE-
1.NAME: - _ RF-LATIONSHIP: PHONE:
f ,,({ lam`.
ADDRESS:
f,E/r ! r'�',/CJ / l v' C d •� r+�jfJ�JJ /i l ff' `� �l
L
2.NAME: .. REUMON'§HTP: PHONE:
ADDRESS:
-DATA ON PROPERTY OWNER-
NAME: RELATIONSHIP: PHONE:
ADDRESS:
-INTERMENT/ENTOMEMENT/INURNMENT DATA-
CALL RECEIVED DATE: + Tam., ,:y BY r
�,'t,i i:�is f i i� .•.,.� /.•'��ry1� L f;i�. -
FUNERAL HOME: ADDRESS:
PHONE: % - ;, FUNERAL HOME CONTACT; ( f r; FUNERAL DIRECTOR r f
D,9Xr
DA OF B;URiAL:T FUNERAL FUNERAL HOME CHURCH _CEMETERY: EST ARRIVAL AT CEMETERY
11 :i j 4. �? k%y)`<y i -'� SERVICE AT: TIME: /
-MAUSOLEUM-
TEMP:_ MAUSOLEUM NAME: SECTION NO. LEVEL NO. CRYPT/NICHE NO. LETTERING:CRYPT PLATE
PERM:_ - YES/NO
INCISING/SCROLL DEATH DATE NEEDED: YES/NO RELIGIOUS AFFELIATION/OTHER ..
BURIAL-
GARDEN NAME/ LOT NO. GRAVE(S) SINGLE/REO I TYPE OF OUTER BURIAL CONTAINER: OUTER BURIAL CONTAINER CO.:
SECTION NO. 4-, DID -
TRIPLE
_CHAPEL SERVICE ti GRAVESIDE _OTHER OTHER SPECIAL INSTRUCTIONS/SPECIAL EQUIPMENT: ..
PN MEMORIAL INSTALLED:YES/NO
SCROLL DEATH DATE/ENGRAVING NEEDED: YES/NO
-CURRENT CHARGES AND PREPAID INFORMATION-
PRENEED CONTRACT: DATE NUMBER SELLING PRICE AMOUNT DUE
OPENING/CLOSING ;j r<, _ Lj-i i!: � N
y
VAULT/VAULT INSTALL. c�
d<
CASKET
MARKER/BASE ,e`?a° „z,>'t "n?4:.:cg...:i�
.,.ace,....
��P:o�-�z�t?;���a�;?'s. _
PROPERTY
OTHER
AMOUNT DUE TO BE RECEIVED FROM: FAMILY _FUNERAL DIRECTOR TOTAL DUE: ;- f L� fit•'
CONDOLENCE CALL Date:
The undersigned hereby certifies they have the full legal authority to direct the Interment,Entombment,or Inumment of the remains of the deceased,and hereby author-
ize the cemetery to make disposition of the remains of the deceased as indicated.The undersigned hereby further certify and represent that they are owner(s)or author-
ized representative(s)of the owner(s)of the above described Interment Rights and hereby authorize use of said Internment Rights of the Interment,Entombment,or
inurement of the remains of the herein named deceased. The cemetery is hereby directed to supervise installation or install any outer burial container,to the extent
required by law,purchased in connection with this Interment and the Interment Rights described herein.
The undersigned hereby agree to indemnify and hold harmless the cemetery,its agents and employees from any and all LIABILITY,including reasonable attomey's
fees,and against any loss it or they may sustain in connection with the Internment,Entombment,or Inurnment authorized hereunder. The cemetery takes great care to
avoid errors,but in the event an inadvertent error does occur,the cemetery shall have the right to correct any error in the Internment,Entombment or Inumment,at its
own expense,without any liability for such error.
NOTES: Flowers will be removed 2 days from burial.
Signature of Family Service Counselor Signature of Lot Owner/Authorized Representative
OFFICE USE ONLY SPACE VERIFICATION -AUDIT AND RECORDKEEPING-
Intemtent ,— (Initial after each step is completed)
Check Family Verified:- (��/P INTERMENT ORDER CHECKED
INTERMENT CARD COMPLETED AND FILED
Surveyed By: MASTER CARD UPDATED
PLAT BOOK AND LOT MAPS UPDATED
Checked By: BURIAL.PERMIT RECEIVED AND FILED
OTHER
White-Administration Canary-Administration Pink-Maintenance Rev 3/07
Juniata Memorial Park,Inc.
Retail Installment Contract and Security Agreement : 0117
13 Juniata Memorial Park IA.0 1"I.LC') Contract e
StoncMnr 11cnnsvivania Subsidiary I.L.0('Company")
Juniata Memorial Park I-Cbme(cry'")
9010 1)S.Highway 522 S..Lcw•rsmwn.1.1 17044 fhls contract is subject to a security interest in
717.242-2555 favor�f Bank of America,N.A.,as collateral agent
LLC and Company(somee}w���yfieJrrcd to collectiv y Ihis A reemmnt as"Seller")are OwnersN�ypd operators Of the('• �fcry.TWS AGREEMENT is made by and between Seller and
n '� , 'I(f��! �f7�1171./!l� hereinafter called the"Purchaser'.
WITNESSE'll f TVATT Pu cliaser agrees to htry and LLC wit Company'agrees to sell to Purchaser,or h1 dcsignand benchaary,in accnrdim wish the Icmu hereof,the following items to he provided or used at the above checked location.
1.DFSCIUMON OF BURIAL RIGHTS.The Burial Rights covered by the Agreement are shown by the map of such garden/building on file in the once of the CEMETERY,and am more particularly described below.
Burial Rights in:_Grave Spaces) _+Mausoleum:O Chapel 0 Garden 0 Tandem O Side-by-Side O Single O Developed 0 Preconstroclion
Lawn Crypt:0 Double Depth 0 Side-by-Side _Niche: 0 Chapel 0 Gorden 0 Single 0 Companion 0 Developed 0 Preconstruclion
0 Single 0 Developed 0 Preconstruction Man..—Le dime n—,are:legph 85".,wdih 29",height 26"
lst Choice 2nd Choice Isl Choice 2nd Choice
Garden Garden Building _ Building
Section Section Section —__ Section
Lot Lot No.(s) —__ No.(s) _
Spacels) Space(s) Level Level
2. MERCHANDISE: 3. ITEMIZATION OF CHARGES LLC' Company-
(A)Burial Rights Indecribedia Pan.tabove) S
0 Check here if merchandise is being purchased for use at another cemetery. (B)Perpetual Care _— S
Cemetery's Name: _ (C)Less Certificate Discount S
(D)Second Right of Interment S _
A.VAULT(S) fit.Description -- — -- (F,)Vault(s) ,S
42.Description (F)Urals) -_ S
B.URN(S): kl.Description I'�' (G)Mausoleum Lcttering/Crypt Plate $ '
(H)M mcnl
l2.Description (I) Granite Bassist S
_� S
(J)Installation Charge
C.MEMORIAL INFORMATION: (K)Caskets S _
Memorial Design: Vase: Y!� (L)Initial Fee for Interment S
(M)Final Imcmucnt/FntombmenUfnumment Fee $
Bronze Size X Granite Silt X J (N)Ycmiancnt Records&Processing Fee $
Location(Section,etc.) (0)Other $
(P)Sales Tax S S
D.MONUMENT INFORMATION: - 4. TOTAL CASH PURCHASE PRICE.(A THRU P) S �l ,V0
Type: Color:
Size: x x p ITEMIZATION THE AMOUNT FINANCED :�-(i I Gf e-t)
(I)Total Cash Pricem ..................................S� . —
Die: x x P (2)A.Down Payment 0 Cash 0 Check O Credit Card .....S
Base: x x P B.Trade In: ..........S
Old Agreement No.
E.CASKET(S): C.Total Down Payment(2A+2B)....................S
(3)Unpaid Balance of Cash Price(1-2C) ................S
1.Model: - Gauge: (4)Finance Charge
2.Model: Gauge: (5)Total Unpaid Balance(3+4)........................S
•The LLC and the Company shall each remain secondarily liable to the other for the sales of items and services provided by one another pursuant to this Agreement;however,Purchaser shall not be required to exhaust
any remedies against the LLC or the Company before proceeding against the other.
5.PAYMENT.The Purchaser shalt pay J; AMOUNT FINANCED TOTAL OF PAYMENTS TOTAL SALE PRICE
the SELLER for such rights in accordance The cost of your credo a a yeady rate. The dollar amount the credd will cost you. The amount Of eras it provided m you The arroua you will have paid after you The total cast of purchase on credit incld
with the following disclosure statement: on your own behalf. have made all psymanu as scheduled. era dram payment m S
% S S S $
YOUR PAYMENT Number of Payments Amount of Payments First Payment Due Date Thereafter,Payments Are Due
SCHEDULE WILL BE: S 0 Monthly on the
S
SECURITY:You arc giving a security imemst in the goods or property being purchased or in part of the Ponds paid under this Agreement held in a Merchandise'rrust Fund.
PREPAYMENT.if you pay off arty,you will not have to pay a penalty and you may be entitled to a refund of part of the Finance Charge.
NOTICE:See the remainder of this Agreement(including Geneml Provisions on the mvenc side herwn far additional infMmatton abnut nonpayment,default,dclinqucney charge•security interests,any required payment in full before the
scheduled dale,and prepayment refunds and penalties.
THIS AGREEMENT ARISES OUT OF A CONSUMER CREDIT SALE AND IS SUBJECT TO THE ADDITIONAL GENERAL PROVISIONS CONTAINED ON THE REVERSE SIDE
OF THIS AGREEMENT,WINCH ARE A PART OF THIS AGREEMENT.
This Agreement shall be binding upon the heirs,executors,administrators,successors and assigns of the parties hereto.
THIS AGREEMENT AND THE FAMILY PROTECTION CERTIFICATE,IF APPLICABLE,CONTAIN ALL THE COVENANTS AND PROMISES BETWEEN THE PARTIES,AND
NO AGENT,SALESPERSON,OR OTHER REPRESENTATIVE OF EITHER PARTY HAS AUTHORITY TO MODIFY,ADD TO OR CHANGE ANY OF THE TERMS AND
CONDITIONS CONTAINED IN THIS AGREEMENT AND/OR THE FAMILY PROTECTION CERTIFICATE.
NOTICE TO ASSIGNEES OF SELLER
Any holder of this consumer credit contract is subject to all claims and defenses which the debtor(Purchaser)could assert against the Seller of goods or services obtained pursuant hereto
or with the proceeds hereof. Recovery hereunder by the debtor(Purchaser)shall not exceed the amount paid by the debtor(Purchaser)hereunder.
NOTICE TO THE PURCHASER
(1) Do not sign this Agreement before you read it or if it contains any blank spaces.
(2) You are entitled to a completely filled in copy of this Agreement at the time you sign it.
(3) Under the law,you have the right to payoff in advance the full amount due and under certain conditions to obtain a partial refund of the finance charge;to redeem the property if repossessed for
a default;to require,under certain conditions,a resale of the property if repossessed.
PURCHASER'S RIGHT TO CANCEL
If this Agreement was solicited at your residence and you do not want the goods or services,you,the Purchaser,may cancel this Agreement at any time prior to midnight of the third
business day after the date of this Agreement.(For an explanation of this right,see the attached Notice of Cancellation form.)
Recovery Fund:A Real Estate Recovery Fund exists to reimburse persons who have suffered monetary loss and have obtained an uncollectible judgement due to fraud,misrepresentation,or deceit in a
real estate transaction by a Pennsylvania licensee. For complete details call(717)783-3658 or 1-800-822-2113.
SEE REVERSE SIDE FOR'ADDITIONAL TERMS AND CONDITIONS
IN WIT WHEREOF,Purchaser has executed this Agreement this�day ofl�Q[,�_.By executing IMs Agreement,Purchaser acknowledges receipt of a copy of this Agreement.
'lr` 1 a� 11 I.1'urchastr l� � '".4,
Connsclor. w--� ------ SrNUmrc
signanne Email__—_—_._.__ __Dale or Birth
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Seller by: 2.Purchaser __-----
Authonzad Reptesenrerwe srgnamrc
F-mail-_______— Date of Birth
NOTICE:AuU�orfu Representative is signing on behalf of bath LLC arid Company. / r
This Agreement it not valid unfit signed by an Authorized Representative of the SeUer. Jdres � LO CAST�1 (��. ,e Lr Td ur1 �/J rill,!O
��ff —City v'Scare Ap
If Burial Rights Certifcte to be printed in Nari other Nan Purchasers,then provide Nam Ys)here
-"-- -- '------ I. Emplo)cr`--'---------------Phone ----'--'----
State License No.—_______ —_—_—_—__... 2. fnspluycr:.__.__—_.—_—_______Phone______.--._—
E COPY-The Campvrv'srCelten C.,, YEIA ON'COPY-Iles d,Can,,are PINK 01M-IYnchascr'+(bpv (A1I.000P1'-P'arha,er',Cnpy
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GLASSMASTERS, INC. LJ �� ��/ � 11 cm l!
www.theglassmasters.com L1
5253 E. Simpson Road
MECHANICSBURG, PA 17050
(717) 766-2561 Fax (717) 766-2563 4094
DATE ORDER NO.
13
TO SHIP TO
'eve m?Q e4
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.SALESPERSON DATE SHIPPED - I SHIPPED VIA I P.O.B.POINT TERMS
_ QUANTITY � .. � .DESCRIPTION ,, UNIT PRICE TOTAL
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17 S.2nd Street,Floor 6
LLC Harrisburg,
PA 17101-2039
SkarlatosZonarich Telephone(717)233-1000
Fax(717)233-6740
Sound Advice.Smarter Decisions. www.skarlatoszonarich.com
PRIVILEGED AND CONFIDENTIAL
INVOICE SUMMARY
Steven Maben November 12,2013
Estate of Phyllis L.Renninger File#: RENNPH1302
6111 Locust Lane Inv #: 61036
Mechanicsburg,PA.1705Q
RE: Estate of Phyllis L.Renninger- Claims against Kelly Elder Petersheim
TOTAL PROFESSIONAL FEES $9,705.00
TOTAL EXPENSES MADE TO YOUR ACCOUNT $1,000.00
$0.00
TAXES
PAYMENTS AND CREDITS $0.00
TOTAL BILL AMOUNT FOR INVOICE# 61036 $10,705.00
PREVIOUS BALANCE $0.00
INTEREST ON OVERDUE BALANCE $0.00
PLEASE PAY THIS AMOUNT(Please also see attached invoice detail) _ $10,705.00
A 1 1/12%PER MONTH REBILLING CHARGE WHICH IS AN ANNUAL RATE OF 18%WILL BE APPLIED AFTER 30 DAYS.
Please send remittance to: SkarlatosZonarich LLC
17 S.2nd Street,Floor 6
Harrisburg,PA 17101-2039
PLEASE INDICATE YOUR INVOICE NUMBER ON YOUR REMITTANCE
Law Firm Tax Identification No:25-1839294
a '
William R. Kaufman
✓d ttorner at o nn aw
940 Century Drive
Mechanicsburg,PA 17055
717-766-7702
Fax: 717-790-9031
Email: wrkaufman.wrklaw @comcast.net
April 25, 2013
Steven R. Maben, Executor
Phyllis L. Renninger Estate
6111 Locust Lane
Mechanicsburg, PA 17050-7335
FEE FOR PROFESSIONAL SERVICES RENDERED:
2/28-3/5/13 1.25 Consultation with Mrs. Renninger concerning gifts
3/18/2013 0.75 Preparation of Grant of Letters
4/6/2013 0.25 Meeting with Executor
4/16-18/13 1.00 Preparation of Estate Recovery Notice to PA Department
of Public Welfare, preparation and placement of estate
advertisements, preparation of beneficiary estate notices
and Certificate of Notice
4/22/2013 0.50 Conversation with Attorney Scherer, representing
Kelly Elder
Total Hours 3.75 Total Fee $ 918.75
Expenses Advanced: Cumberland Law Journal 75.00
Balance Due 3 5
William R. Kaufman
JEfttorney at o Caw
940 Century Drive
Mechanicsburg,PA 17055
717-766-7702
Fax: 717-790-9031
Email: wrkaufman.wrklaw @comcast.net
May 28, 2013
Steven R. Maben, Executor
Phyllis L. Renninger Estate
6111 Locust Lane
Mechanicsburg, PA 17050
Fee for preparation of deed $ 150
Fee for preparation of Petition for Authority
to Convey Real Estate and related consultation
with client and Attorneys Scherer and Shaw
(3.0 hours) 735
Fee for correspondence and conversations
with Attorney Zonarich
(0.50 hours) 115
1 000
William R. Kaufman
-AtorneW at o n/aw
940 Century Drive
Mechanicsburg,PA 17055
717-766-7702
Fax: 717-790-9031
Email: wrkaufman.wrklaw @comcast.net
July 12, 2013
Steven R. Maben, Executor
Phyllis L. Renninger Estate
6111 Locust Lane
Mechanicsburg, PA 17050
FOR PROFESSIONAL SERVICES RENDERED
5/30/2013 0.50 Meeting with executor concerning estate matters
5/31/2013. 0.50 Review file and forward requested and pertinent information
to Attorney Zonavich concerning contest matter
5/31/2013 1.00 Calculation of inheritance tax prepaymentand related
6/3/2013 0.75 coordination as to amoutn and timing of payment with
Attorneys Scherer and Shaw
and Certificate of Notice
6/19/2013 0.25 Review and forward to Attorneys Scherer and Zonavich
copy of inheritance tax payment receipt
Total Hours 3.00 Total Fee 765
William R. Kaufman
..lttorneW at o//l1 aw
940 Century Drive
Mechanicsburg,PA 17055
717-766-7702
Fax: 717-790-9031
Email: wrkaufman.wrklaw @comcast.net
August 30, 2013
Steven R. Maben, Executor
Phyllis L. Renninger Estate
6111 Locust Lane
Mechanicsburg, PA 17050
Fee for services related to compliance with
August 14, 2013 Petersheim subpoena:
1.0 hours SZ55
William R. Kaufman
_Atorne y at o//l1 aw
940 Century Drive
Mechanicsburg,PA 17055
717-766-7702
Fax: 717-790-9031
Email: wrkaufman.wrklaw @comcast.net
November 27, 2013
Steven R. Maben, Executor
Phyllis L. Renninger Estate
6111 Locust Lane
Mechanicsburg, PA 17050
Fee for preparation of inheritance tax return $2,040
Less: amount paid from escrowed funds (2,040)
Balance Due S 0
REV-1512 EX+(12-03)
SCHEDULE 1
COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT,
INHERITANCE TAX RETURN
RESIDENT DECEDENT MORTGAGE LIABILITIES, & LIENS
ESTATE OF PHYLLIS RENNINGER FILE NUMBER 211300324
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death,include unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. PENNSYLVANIA RETINA SPECIALISTS,CAMP HILL,PA 17011—MEDICAL SERVICES—SEE ATTACHED $389.83
TOTAL(Also enter on line 10,Recapitulation) $389.83
(If more space is needed,insert additional sheets of the same size)
REV-1513 EX+(9-00)
SCHEDULE,!
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF PHYLLIS RENNINGER FILE NUMBER 211300324—
RELATIONSHIP TO DECEDENT AmouwoRs"E
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) CFESrATE
TAXABLE DISTRIBUTIONS[include outright spousal distributions,and
transfers under Sec.9116(a)(1.2)]
1. JOSEPH R SILKS BROTHER $20,000.00
133 W MARKET STREET,APARTMENT 1
LEWISTOWN,PA 17044
2. STEVEN R MABEN NEPHEW 100%OF
6111 LOCUST LANE RESIDUARY
MECHANICSBURG,PA 17050 ESTATE
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18,AS APPROPRIATE,ON REV 1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART H-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00
a
CONTINUATION PAGE
SCHEDULE _H___
ESTATE OF PHYLLIS RENNINGER FILE NUMBER 211300324
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. ELECTRICITY SERVICE FOR DECEDENT'S RESIDENCE-PPL;PAID 3/15/13 $48.00
2. ELECTRICITY SERVICE FOR DECEDENT'S RESIDENCE-PPL;PAID 4/12/13 48.00
3. ELECTRICITY SERVICE FOR DECEDENT'S RESIDENCE-PPL;PAID 5/14/13 48.00
4. MONTHLY GAS BILL FOR DECEDENT'S RESIDENCE-UGI UTILITIES;PAID 3/27/13 67.00
5. MONTHLY GAS BILL FOR DECEDENT'S RESIDENCE-UGI UTILITIES;PAID 4125/13 67.00
6. MONTHLY GAS BILL FOR DECEDENT'S RESIDENCE-UGI UTILITIES;PAID 5/23/13 67.00
7. TELEPHONE SERVICE FOR DECEDENT'S RESIDENCE-VERIZON; PAID 3/18/13 73.75
8. WATER BILL FOR DECEDENT'S RESIDENCE-PA WATER CO;PAID 4/2/13 28.17
9. WATER BILL FOR DECEDENT'S RESIDENCE-PA WATER CO;PAID 5/2/13 20.72
10. 2ND QTR SEWER&TRASH SERVICE FOR DECEDENT'S RESIDENCE-LOWER ALLEN TWP;PAID 5/2/13 117.70
11. WATER BILL FOR DECEDENT'S RESIDENCE-PA WATER CO;PAID 6/4/13 21.67
12. FINAL WATER BILL FOR DECEDENT'S RESIDENCE-PA WATER CO;PAID 6/21/13 3.38
13. FINAL MONTHLY GAS BILL FOR DECEDENT'S RESIDENCE-UGI UTILITIES;PAID 6/25/13 93.04
14. LAWN SERVICES FOR DECEDENT'S RESIDENCE-WILSON HARDSCAPE WORKS;PAID 6/4/13 74.20
15. STEVEN MABEN-AUTOMOBILE EXPENSE INCURRED ON ESTATE BUSINESS-SEE ATTACHED LOG
1,404 TOTAL MILES x$0.565 IRS STANDARD MILEAGE RATE IN EFFECT DURING PERIOD 793.26
TOTAL $1,570.89
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N N M M cj l0 I r-I Ln 0) e-1 N
LAST WILL AND TESTAMENT
OF
PHYLLIS L. RENNINGER
I,PHYLLIS L. RENNINGER,of Lower Allen Township, Cumberland
County, Pennsylvania, being of sound mind and body declare this to be my Last Will and
Testament and revoke any and all Wills and Codicils previously made by me.
ITEM I: 1 hereby direct that my funeral and my burial be carried out
in accordance with my arrangements already on file with Barr's Funeral Home in
Lewistown, Pennsylvania.
ITEM II: I hereby direct that all just debts,funeral expenses,all
administration expenses, including inheritance tax shall be paid from the assets of my
estate as soon as practicable after my decease.
ITEM III: I hereby give, devise and bequeath$20,000 to my brother,
JOSEPH R. SILKS, of Lewistown,Pennsylvania, if he survives me by thirty(30)days. If
he does not survive me by thirty(3 0)days, I give such distribution to the following
beneficiaries:
(a) $10,000 to JOHN R. SILKS, if he survives me by thirty(30)days,if
not,then to those of his issue who survive me by thirty(30)days, per stirpes; and
(b) $10,000 to MARK HOCKENBERRY,if he survives me by thirty
(30)days, if not,then to those of his issue who survive me by thirty(30)days,per stirpes.
Page 1 of 5
ITEM IV: I hereby give, devise and bequeath all of the rest and residue
of my estate,real and personal,wheresoever situate and in whatsoever name,to my
nephew, STEVEN R. MABEN,of Mechanicsburg,Pennsylvania, if he survives me by
thirty(30)days.
ITEM V: In the event that my said nephew does not survive me by
thirty (30)days, I hereby give,devise, and bequeath such property in equal shares to those
of his daughters, MICHELLE Y. MABEN and STEPHANIE S. MABEN,who survive me
by thirty(30)days. In the case of my personal property,such gift shall be as equal as is
practicable.
ITEM VI: No person, to whom any gift or interest shall have been
given by the terms of this Will, shall be deemed to have survived me who shall have died
at the same time as I, or in a common disaster with me,or under such circumstances that it
is difficult or impossible to determine which of us survived the other.
ITEM VII: No interest in income or principal of my estate or any trust
created hereunder shall be subject to attachment, levy or seizure by any creditor, spouse,
assignee or trustee or receiver in bankruptcy of any beneficiary of my estate or of any trust
created hereunder prior to the beneficiary's actual receipt thereof. My executor and trustee
shall pay over the net income and the principal to the beneficiaries herein designated,as
! their interests may appear,without regard to any attempted anticipation(except as may be
specifically provided herein),pledging or assignment by any beneficiary of my estate or of
any trust created hereunder and without regard to any claim thereto or attempted levy,
attachment, seizure or other process against said beneficiary.
Page 2 of 5
i FA
ITEM VIII: If any beneficiary under the age of twenty-one(2 1)years
shall become entitled to any share hereunder, then such share shall immediately vest in
such beneficiary, but notwithstanding the provisions herein,my executor may distribute
such beneficiary's share to any adult person standing in loco parentis,or to a legal guardian
of such beneficiary, or to a custodian(to be selected by my executor)under the
Pennsylvania Uniform Transfers to Minors Act, without requiring bond of such adult
person, guardian or custodian. The receipt of such adult person, guardian or custodian
hall constitute a full release of my executor for any property so distributed.
ITEM IX: I confer on my executor to sell or otherwise convert any real
or personal property at public or private sale, at such time or times, in such manner, and for
'J
%ch price or prices, and on such terms and conditions as my executor shall determine,and
to execute and deliver good and sufficient conveyances,assignments,and transfers of the
property,without liability of any purchaser for the application of any consideration;to
borrow money and to secure its payment by mortgage of real or personal property,pledge
of investments,or otherwise,without liability on the part of the lenders to see to the
application thereof;to remain any investments at discretion;to invest and reinvest at
discretion,without restriction to so-called"legal investments"; to make distribution in cash
or in kind;to allocate and distribute kinds or disproportionate shares of property.or
undivided interests in property among beneficiaries, in cash or in kind, or partly in each;
and to do all other acts and things necessary or appropriate in the management,
administration and distribution of my estate.
ITEM X: I hereby appoint my aforementioned nephew, STEVEN R.
MABEN,of Mechanicsburg,Pennsylvania, as Executor of my estate. If for any reason he
Page 3 of 5
should fail or cease to act, I appoint my attorney WILLIAM R. KAUFMAN, of
Mechanicsburg, Pennsylvania, as Executor.
ITEM XI: The Executor, or any successor Executor, shall qualify and
serve without the duty or obligation of filing any bond or other security.
IN WITNESS WHEREOF, I have set my hand and seal to this,my Last
Will and Testament, consisting of this and the preceding three(3)pages,this ( day
of �-z-�^ry c , 2013. ,
PHYLLIS L. RENNINGER (SEAL)
We, the undersigned, hereby certify that the foregoing Will was signed,
sealed,published and declared by the above-named Testatrix as and for her Last Will and
Testament, in the presence of us,who, at her request and in her presence and in the
lkesence of a -h of ,have hereunto set our hands and seals the day and year above
writ ri, an ,we rtify that a he time of the execution thereof,the said Testatrix was of
soun an ing nd Y.
/
(SEAL) Residing at: /.2-9 ✓��TSI�/$ �-
(SEAL) Residing at:
Page 4 of 5
y t ,ki
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND ss.
We,PHYLLIS L. RENNINGER, d �r1�la rZ.z" ,and
d,\ CU —'the Testatrix and the Witnesses,respectively,whose
names are signed to the attached or foregoing instrument,being first duly sworn, do hereby
declare to the undersigned authority that the Testatrix signed and executed the instrument
as her Last Will,that she signed it willingly, and that she executed it as her free and
-1 voluntary act for the purposes therein expressed, and that each of the Witnesses in the
presence and hearing of the Testatrix signed the Will as a Witness and that to the best of
their knowledge,the Testatrix was at that time eighteen(18)years of age or older,of sound
mind and under no constraint or undue influence,
atr*
Wi ness
Witness
Sworn to, acknowledge and subscribed before me by PHYLLIS L. RENNINGER,
the Testatrix, and sworn to and subscribed before me by ,.d 4 A A V rl+ and
AL o 2-Of-3 ,the Witnesses,this 1S day of Q
A.D.,2013.
Notary Pu lic
COMMON 'Fi O� F PgNNSYLVANIA
NOTARIAL SEAL
PATRICIA A.BENDER,Not:ry Public
Lower Allen Twp.,Cumberland Coun --
k4y Commission Expires Se tember 22,115
r:
..Page 5 of15
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