HomeMy WebLinkAbout12-10-13 (2) Wool
REV-1500 Ex(0110) 1505610143
OFFICIAL USE ONLY
PA Department of Revenue Pennsylvania County Cede Year File Number
Bureau of Individual Taxes DEPARi ENT OF REVENUE
Po 80x.280601 INHERITANCE TAX RETURN 2 1 13 00306
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
02 21 2013 10 04 1929
Decedent's Last Name Suffix Decedent's First Name MI
GALLAGHER DORIS J
(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 ❑ 2. Supplemental Return ❑ 3.Remainder Return(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)
5 Decedent Died Testate 7 Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
® (Attach Copy of Will) ❑ (Attach Copy of Trust)
❑ 9. Litigation Proceeds Received ❑ 10F Speusal Poverty Credit(date of death ❑ 11.Election to tax under Sec.9113(A)
between 12-31-91 and 4-95) (Attach Sch.O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
ROBERT P KLINE 717 770 2540
qq
REGIST?S OF WILLS=E ONE n
Co r� O
First line of address rrt = n n Cn =o
M F-
714 BRIDGE STREET n z M f- a
0
z
r'
x
Second line of address D C) -TI
PO BOX 461 o r 1
�RATE FILE
City or Post Office State ZIP Code
NEW CUMBERLAND PA 17070 cn
Correspondent's e-mail address:
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 Ill my9ct and complete.Declaratio f preparer other than the personal representative Is based on all information of which preparer has any knowledge.
SIG ATU F PERSON SPONSIB FILI G ETURN DA
Brenda Pfautsch La� 6
ADDR SS
76 Ridgeshore Lane, Millville, DE 19967
SIGNA RE OF ER CTHER THAN REPRESENTATIVE DATE
Robert P Kline r{ DAL Z10 13
ADDRESS
714 Bridge Street, New Cumberland, PA 17070
Side 1
L 1505610143 1505610143 J M,
r 1505610243
REV-1500 EX
RECAPITULATION
1. Real Estate(Schedule A).......................................................................................... 1. 119 000 . 0 0
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. 28 , 171 . 21
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............. 6.
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) ❑ Separate Billing Requested............. 7.
6. Total Gross Assets(total Lines 1-7)..................... ............... ..................... ........... 8. 147 , 171 . 21
9. Funeral Expenses&Administrative Costs(Schedule H)......................................... 9. 37 , 187 . 97
10. Debts of Decedent,Mortgage Liabilities,&Liens(Schedule 1)................................ 10. 4 , 537 . 86
11. Total Deductions(total Lines 9& 10).__................ ........ ............... .............. .....11. 41 , 7 2 5 . 83
12. Net Value of Estate(Line 8 minus Line 11).............................................................12. 105 , 445 . 38
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. 105 , 445 . 38
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.
16. Amount of Line 14 taxable 16. 4 , 520 . 04
at lineal rate X .045 100 445 . 38
17. Amount of Line 14 taxable
at sibling rate X .12 77.
18. Amount of Line 14 taxable
at collateral rate X .15 5 , 000 00 18. 750 00
19 Tax Due...................................................................................................................19. 5 , 270 04
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. FRI
Side 2
L 1505610243 1505610243
{ i
REV-1500 EX Page 3 File Number 21 - 13 - 00306
Decedent's Complete Address:
DECEDENTS NAME
Gallagher, Doris J
STREET ADDRESS
5 Creek Road
CITY . . .. .- - ---- - —` STATE ZIP T --
Camp Hill PA
Tax Payments and Credits:
1. Tax Due(Page 2, Line 19) (1) _ 5,270.04
2, Credits/Payments
A. Prior Payments 6,0M00 .
B. Discount 263.50
Total Credits(A +B) (2) 62263.50
3. Interest (3) 0.00
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) 993.46
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)
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;........ ............ .............. .................... ........ 'xi
b. retain the right to designate who shall use the property transferred or its income:...............1-1-1 �rx I
c. retain a reversionary interest;or................_... .................. .............. .................. ........................... 4^�
d. receive the promise for life of either payments,benefits or care?.........._...........
._...................._......._....t xj
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?..._............._...................................__....,....__................._....................._...', - rXI
3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?......... _x;
4. Did decedent own an Individual Retirement Account,annuity,or other non-probate property which _
containsa beneficiary designation?............... ..........................................,.......................... _...................... xi
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETUR
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 172 P.S. §9116(a)(1.1)(i)].
For dates of death on or after Janus ry 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 ears of age or younger at death to or for the use of a natural parent,an
adoptive parent,or a stepparent of the child is 0 percent[72 P.S.§9116(a)J.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 1.2)[72 P.S. §9116(a)(1)].
•The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P,&§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 blooj or adoption.
1
SCHEDULE A
COMMONW LT40FPENNSYLVANIA REAL ESTATE
INHER[TANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Gallaher Doris J FILE NUMBER
� , ____ 21 - 13-00306_ ____
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 wi reported seller, neither being compelled to buy or sell, troth having
reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on
schedule F.
Attach a copy of the settlement sheet if the property has been sold.
Include a copy of the deed showing decedent's interest if owned as tenant in common.
ITEM DESCRIPTION VALUE AT DATE OF
NUMBER DEATH
1 5 Creek Road, Lower Allen Twp, Cumberland Co. Parcel#12-23-0547-433 (sale price per 119,000.00
attached HUD-1)
TOTAL(Also enter on Line 1,Recapitulation) 119,000.00
t t
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
COMMONWEALTH OF PENNSYLVANIA PERSONAL PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF Gallagher, Doris J 21 - 13 -00306
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 DESCRIPTION VALUE AT DATE OF
NUMBER DEATH
1 Metro Bank Savings#7760481511 &Checking#0538301573 26,171.21
2 1999 Hyundai Sedan 2,000.00
TOTAL(Also enter on Line 5, Recapitulation) 28,171.21
SCHEDULE H
FUNERALEXPENSES&
CWMNVCEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN AWNSTRAlMICAOSTS
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF Gallagher, Doris J i
21 -13-00306
Debts of decedent must be reported on Schedule I.
DESCRIPTION--—— AMOUNT
NT
NUMBER FUNERAL EXPENSES:
A. 1 Auer Cremation Services of PA 2,331.57
2 Funeral Stipends(St.Theresa, Lee&Lisa Smith, Barry Grandon) 622,00
3 Misc Funeral Expenses (Michaels/Halimark/Royeers/Co stco) i 157.21
4 Cheltenham Veterans Cemetary 400.00
51 Reception (Ninos/Glen Millers/PA Bakery) 1,808.11
B. ADMINISTRATIVE COSTS:
1, Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zip
Year(s)Commission paid
2. Attorney's Fees Kline Law Office 5,000.00
3, Family Exemption: (if decedent's address is not the same as claimants,attach explanation)
claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees Register of Wills 368,50
5. Accountant's Fees
6. Tax Return Preparer's Fees
7, Other Administrative Costs
1 Settlement Expenses adjusted for pro-rated taxes and seller assist(per attached 15,997.91
HUD-11)
TOTAL(Also enter on line 9, Recapitulation) 37,187.97
,
Schedule H
Funeral E>Vert m&
COMMONWEALTH INHERITANCE DTAXRETURN LANIA Admmstral5w Costs continued
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF Gallagher, Doris J 21 - 13 -00306
2 Comcast 289.70
3 PPL 417.65
4 UGI 693.96
5 Verizon 344.54
6 PA American Water 312.58
7 Penn National Insurance 455.30
8 Lower Allen Twp Authority 224.86
9 Lawn Doctor 129.75
10 Eric Morrow (Lawn mowing) 805.00
11 Home Depot 26.00
12 Bonnie K. Miller, treasurer(property taxes) 694.65
13 AAA 51.00
14 UGI HVAC Services 124.00
15 PNC Bank 18.15
16 Layton Keiser Painting 1,686.50
17 Wadlinger Windows 1,204.03
18 American Radon Solutions 800.00
19 Susan Miller(house cleaning) 1,500.00
20 Brenda Pfautsch (misc Executrix expenses) 500.00
Page 2 of Schedule H
Schedule H
Funeral EVffK es&
COMMONWEALTH OF TAX PENNSYLVANIA Aylnisba;.„.Cost�med
INHERITANCE DECEDENT fWl�� IJ1l G11YC lAAL7
RESIDENT DECEDENT --- -.�
FILE NUMBER
ESTATE OF Gallagher, Doris J 21 - 13 - 00306
21 College Hunks 225.00
Page 3 of Schedule H
SCHEDULEI
DEBTS OF DECEDENT, MORTGAGE
COMMONWEALTH OF PENNSYLVANIA LIABILITIES, & LIENS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
t
FILE NUMBER
ESTATE OF Gallagher, Doris J 21 - 13 -00306
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ITEM DESCRIPTION AMOUNT
NUMBER
1 Chase 26.00
2 Boscovs 156.32
3 West Shore EMS 138.67
4 Spirit Physician's Services, Inc. 338.35
5 VCA Animal Hospital 1,253.52
6 Hospice House 2,625.00
TOTAL(Also enter on Line 10, Recapitulation) 4,537.86
REV-1513 EX.(11()8)
SCHEDULEJ
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Gallagher, Doris J 21 - 13 - 00306
R T7 --T-
ELATIONSHIP ARE OF ESTNT OF ESTATE
NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$)
RECEIVING PROPERTY Do Not List TrusteelsTAXABLE DISTRIBUTIONS[include outright spousal
distributions, and transfers
under Sec.9116(a)(1.2)]
1 Brenda Pfautsch Daughter one-third residu
36376 Ridgeshore Lane
Millville, DE 19967
2 Susan L. Miller Daughter one-third residual
t
PO Box 671848
Chigiak, AK 95567
3 David H. Miller Son one-third residual &
1924 Rudy Road car
Harrisburg, PA 17104
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate.
II. NON-TAXABLE DISTRIBUTIONS:
A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
0.00
TOTAL OF PART 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEpT
REV 4513 EX.(9-U0)
SCHEDULE )
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES continued
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Gallagher, Doris J 21 - 13 -00306 _
RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) Sss)
RECEIVING PROPERTY Do Not List Tmstee(s)
I TAXABLE DISTRIBUTIONS(include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2)]
4 Ryan Rivera Grandson 500.00
1037 Spa Road, Apt. L
Annapolis, MD 21403
5 Matthew Miller Grandson 500.00
421 Geary Avenue
New Cumberland, PA 17070
6 Cody Boyles Grandson 500.00
PO Box 671848
Chigiak, AK 95567
7 Jason Meadows Step-grandchild 500.00
1747 Eastlake Drive
Oconomowoc, WI 53066
8 Amy Ives Sroka Step-grandchild 500.00
2414 Powderhorn Court
Gambrills, MD 21054
9 Michael Duvall, Jr. Step-grandchild 500.00
412 Dewey Drive
Annapolis, MD 21401
10 Nicole Duvall Burden Step-grandchild 500.00
2419 Bolton Lane
Crofton, MD 21114
11 Erica Gallagher Step-grandchild 500.00
802 Winstead Place
Manassas, VA 20109
12 William Gallagher III Step-grandchild 500.00
3505 Malec Lane
Bowie, MD 20715
13 Drew Gallagher Step-grandchild 500.00
3505 Malec Lane
Bowie, MD 20715
Page 2 of Schedule J
aEVnsu EX-(940)
SCHEDULEJ
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES continued
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF (FILE NUMBER
Gallagher, Doris J 21 - 13 -00306_ _
RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) (SSS)
RECEIVING PROPERTY Do Not List TmsteO(S)
I TAXABLE DISTRIBUTIONS[include outright sFousal
distributions and transfers
under Sec.6116(a)(1.2))
14 Timothy Gallagher Step-grandchild 500.00
3505 Malec Lane
Bowie, MD 20715
15 Brian Gallagher Step-grandchild 500.00
1133 Turkey Point Road
Edgewater, MD 21037
16 Elizabeth Gallagher Phelan Step-grandchild 500.00
8110 Brink Road
Gaithersburg, MD 20882
Page 3 of Schedule J
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LAST WILL AND TESTAMENYU cCD
OF
DORIS J. GALLAGHER
I, DORIS J. GALLAGHER,of Lower Allen Township, Cumberland County,
Pennsylvania,being of sound and disposing mind,memory and understanding, do make,publish
and declare this to be my Last Will and Testament,hereby revoking and making void all previous
Wills and Codicils heretofore made by me.
FIRST
I order and direct my personal representative hereinafter named to pay all of my just debts,
funeral expenses and expenses involved or connected with the administration of my estate as soon
after my death as is reasonably possible. However,my personal representative need not accelerate
and pay those unmatured obligations which, in his, her or its opinion, it might be proper and more
advantageous to retain or renew and pay as they become due and payable. If I do not own a burial
plot or a grave marker at the time of my death, I authorize my personal representative,in his,her, or
its sole discretion,to purchase a burial plot and to erect a suitable marker at my grave, and to
expend sums from my estate for this purpose.
Page 1 of 7 Pages
SECOND
I give, devise, and bequeath any automobile that I may own at the time of my death, if I
should own one,to my son, DAVID H.MILLER,providing that he survive me by sixty(60) days.
THIRD
I give, devise, and bequeath any specific personal items that had belonged to my late
husband,to include certain momentos and war memorabilia, as determined by my personal
representative,to my grandson, JASON MEADOWS,providing that he survive me by sixty(60)
days.
FOURTH
I give, devise, and bequeath,the real property which I own located on Creek Road in Lower
Allen Township, Cumberland County, Pennsylvania, together with all furnishings contained
therein,to my children, BRENDA L. PFAUTSCH,DAVID H. MILLER, and SUSAN L.
BOYLES,providing that they survive me by sixty(60) days,per stirpes.
FIFTH
I give, devise, and bequeath,the sum of Five Hundred and 00/100 ($500.00)Dollars to each
of my grandchildren and step-grandchildren, JASON MEADOWS,AMY IVES,MICHAEL
DUVALL,JR.,NICOLE DUVALL,ERICA GALLAGHER,WILLLAM GALLAGHER,HI,
DREW GALLAGHER,TIMOTHY GALLAGHER,BRIAN GALLAGHER,ELIZABETH
GALLAGHER,MATTHEW MILLER,RYAN RIVERA, and CODY BOYLES,who survive
me by sixty(60) days,per stirpes.
Page 2 of 7 Pages
SIXTH
I give, devise, and bequeath the rest and remainder of my entire estate, together with all
insurance proceeds thereon, of whatever nature and wheresoever situate, to my children,BRENDA
L.PFAUTSCH,DAVID H. MILLER, and SUSAN L.BOYLES,providing that they survive me
by sixty(60) days,per stirpes.
SEVENTH
If, at the time of my death, any beneficiary of this my Last Will and Testament is under the
age of twenty(20)years or is, in the judgment of my personal representative, mentally disabled,I
give, devise and bequeath said beneficiary's share to my Trustee,my daughter, SUSAN L.
BOYLES, in Trust for said beneficiary, in accordance with the paragraphs below.
EIGHTH
During the terms of any trust created pursuant to this Will the Trustee is authorized to
expend and apply so much of the net income and principal of each such trust as the Trustee shall
consider advisable for the health,maintenance, support, and education(including college education,
undergraduate and graduate) of each such beneficiary until he or she attains twenty(20)years of
age, or until all such amounts are paid out of the Trust. When the beneficiary attains the age of
twenty(20)years or is in the judgment of my Trustee mentally sound whichever event occurs later,
the Trust shall terninate and the remainder thereof shall be paid to said beneficiary. If said
beneficiary shall die before the termination of said Trust,the Trust shall terminate and the
remainder thereof shall be paid in accordance with the paragraph above. I direct that no Trustee
shall be required to give or post bond for the faithful performance of the Trustee's duties in this or
any other jurisdiction.
Page 3 of 7 Pages
NINTH
My Executor and Trustee are authorized and empowered to exercise from time to time in
his,her or its sole discretion and without prior authority from any Court,in respect of any property
forming part of any trust hereby created or otherwise in its possession hereunder all powers
conferred by law upon trustees or executors and I intend that such powers be construed in the
broadest possible manner.
TENTH
I nominate,constitute and appoint,my daughter, SUSAN L. BOYLES, Executrix of this
my Last Will and Testament. In the event SUSAN L.BOYLES is deceased,unable or unwilling to
serve or shall cease to serve for any reason whatsoever,then I nominate, constitute and appoint my
daughter,BRENDA L.PFAUTSCH,to serve instead. In the event BRENDA L. PFAUTSCH is
deceased,unable or unwilling to serve or shall cease to serve for any reason whatsoever,then I
nominate,constitute and appoint my son,DAVID H.AMLER,as personal representative of this
my Last Will and Testament. I direct that my personal representative shall not be required to give
or post bond for the faithful performance of his,her or its duties in this or any other jurisdiction.
ELEVENTH
I hereby declare it to be my expressed desire that my personal representative employ
Kline Law Office of New Cumberland,Pennsylvania, for legal advice and assistance regarding this
my Last Will and Testament, said attorneys having considerable knowledge of my affairs,views
and wishes respecting any matters that may arise at the probate of this instrument,the
administration of my estate, and the execution of the powers herein mentioned.
Page 4 of 7 Pages
IN WITNESS WHEREOF, I have hereunto set my hand to this my Last Will and
Testament this t/ C4 day of 2011.
Witness DORIS J. GAItAGIIER
W' es
Page 5 of 7 Pages
ACKNOWLEDGEMENT
COMMONWEALTH OF PENNSYLVANIA
: SS
COUNTY OF CUMBERLAND
I,DORIS J. GALLAGHER,the Testatrix whose name is signed to the attached or
foregoing instrument, having been duly qualified according to the 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.
DORIS J. GXLLAGHER
Sworn or affirmed and acknowledged before me by DORIS J. GALLAGHER,the
Testatrix,this—�-2 day of 2011.
,,-NOTARY PUBLIC
COMMONWEALTH CAF PENNSYLVANIA
NOTARIAL SEAL
SHARON R. FEISTIER, Notary Public
NewCumbedandBoro.,Cumberland Cc.
My Commission Expires April 15,2011
Page 6 of 7 Pages
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF CUMBERLAND
We, ' 6g� xt� and the
witnesses whose names are attached to the foregoing document, being duly qualified according to
the law, do depose and say that we were present and saw Testatrix sign and execute the instrument
as her Last Will and Testament; that she signed willingly and that she executed it as her free and
voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and
sight of the testator signed the Last Will and Testament as witnesses and that to the best of our
knowledge the Testatrix was at the time 18 or more years of age, of sound mind and under no
constraint or undue influence.
Sworn or affirmed and subscribed before me by ,i,� /T 7�z yE and
70 iuL this day of 2011.
NOTARY PUBLIC
COMMONWEALTH OF PENNSYLVANIA
=Cumbedand SEAL
, Notary Public
Cumberland Co.
s Apri115,2011
Page 7 of 7 Pages
11/24/2D13 01:07 7172580862
TRI COUNTY ABSTRACT PAGE 05
ao .,, e,
ROBERT P. ZIEGLER
RECORDGPi OF DEEDS
CUMBERLMIDCOUNTY-PA,
101 JUL 16 PA 1 11
TAX PARCEL NO. 13-23-0547-433
,MADE THE day of in the year two thousand one(2001)
BSTV=N DANIEL E. CALE and GRETCHEN L. CALE, his wife, of Camp Hill,
Pennsylvania, Grantors,
AND
DORIS J. GALLAGHER, single woman, of New Cumberland, Pennsylvania,
Grantee,
WITNESSETA, that in consideration of ONE HUNDRED EIGHT THOUSAND-----------------------
-----------------------------------------------($108,000.00)....-------------- ------------ ----------Dollars,
in hand paid,the receipt whereof is hereby acknowledged, the said grantors do hereby grant
and convey to the said grantee, her heirs and assigns,
ALL THAT CERTAIN piece or parcel of land, together with the improvements thereon erected
situate in the Township of Lower Allen, County of Cumberland and State of Pennsylvania,
more particularly bounded and described as follows, to wit:
BEGINNING at a point on the eastern side of Creek Road at the dividing line between Lot Nos.
44 and 45, as shown on the hereinafter mentioned Plan of Lots; thence eastwardly along said
dividing line, 115 feet to Lot No. 20 on said Plan; thence southwardly along Lot Nos. 20 and
21, 70 feet to Lot No. 46 on said Plan; thence westwardly along said Lot No. 46, 115 feet to the
easterly line of Creek Road; thence northwardly along the easterly line of Creek Road, 70 feet
to Lot No. 44, the place of BEGINNING.
BEING Lot No. 45 in the Plan of Highland Village, as recorded in the Cumberland County
Recorder's Office in Plan Book 3, Page 48. l;. 2z37 t;,cc206
11/24/2013 01:07 7172580862 TRI COUNTY ABSTRACT PAGE 06
I
HAVING THEREON ERECTED a single family brick and frame dwelling known and numbered
as 5 Creek Road, Camp Hill, Pennsylvania.
BEING THE SAME PREMISES which Shirley L. Kennedy, Executrix of the Last Wil l and
Testament of Vaughn W. Leidigh, by Deed dated March 11, 1987 and recorded March 12, 1987
in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in Deed
Book N, Volume 32, Page 645, granted and conveyed unto Daniel E. Cale and Gretchen L.
Cale, his wife, Grantors herein.
�pp
f
I
f
80M 247 PAGEW7
.5 F a
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V
11(2412013 01;07 7172580862
TRI COUNTY ABSTRACT PAGE 07
AND the said grantors do hereby Warrant Specially the property hereby
conveyed,
IN WIC AWS WMMO.F, said grantors have hereunto set their hands and Scala the day
and year first above written.
Signadi Sealed and Delivered
D NIB CALF,
In the Presence of /7
GRETC HEN L. CALF
STATE OF �At
COUNTYOF
On this, the 1� clay of 2001, before me,
the undersigned officer, personally appoared DAN EL E, CALF and GRETCHEN L. CALE, his
wife, known to me (or satisfactorily proven) to be the persons whose names are subscribed to
the within instrument, and acknowledged that they executed same for the purposes therein
contained.
IN WITNWS WHERROP,I hereunto set my h d and official seal,
(SEAL)
24 MEWS
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"""''•>`w*. _ NOTARIAL SEAL
-r. CONNIE L.HOFFMAN.NoU1y Public
• "�` Camp HIII 80M,Cumbw"d Cuunty
MY Oomlnipiilor E iree A Yil @ 20112
11/24/2013 01:07 7172580862 TRI COUNTY ABSTRACT PAGE 08
CER241FICATE OF RE8IDRNCX
grantees is:
f hereby certify that the precise residence and complete post Office address of the within e
!
A for
i
I
COMMON'9=TII OF PENNSYLVAHIA
County of SS
RECORDED on this�y day of
A. D. 200],
in the Recorder's office of the said County, in Deed Book
Vol.
-----z., Page..
Given under my hand and
written, the seat of the said office, the date above
I Certify this to be recorded
Recorder.
%0'4Re0order0of DeediBOOK r 4'7 `T2179
r
_eMBPnpwtlM 1502 @65
A. SETTLEMENT STATEMENT(HUD-1) B. TYPE Of LOAN
FHA 2 0 IRIS 3. CONV.Users.
Abstract Land Associates,Inc. 4. OVA S.❑CONV.INS.
1,101 ,"s 3912 Market Street e.ESCROW FILE NUMBER: 7.LOAN NUMBER:
01316173-001 MAW 504011473
•^.xm° Camp Hill,PA 17011 _
(717)763-1450 e.MORTGAGE INSURANCE CASE NUMBER
FINAL 446-1931913-703
C.NOTE: This form is furnished to giveyou a statemento/aclual settlement costs Amountspald 0 and by the settlementagent are shown.
Items marked"(P.O.C.)"rRn;paid outsisic the closing,fheyare shown here forinfpRrrattonaf purposes and are nodincluded in the totals.
D.NAME OF BORROWER Cody J.Sulzer
ADDRESS OF BORROWER: 218 Rosemont Avenue
New Cumberland PA 17070
E.NAMEOFSELLER: Estate of Doris J.Gallagher
ADDRESS OF SELLER: 5 Creek Road
_ Camp Hill PA 17011
F. NAME OF LENDER: Register Bank FSB
ADDRESS OF LENDER: 5151 Corporate Drive
Troy,Mf 48098
G.PROPERTY LOCAROM 5 Creek Road
Camp Hill,PA 17011
Cumberland County 13-23-0547-433
_ Parcel#13-23-0547-033
H.SETTLEMENT AGENT: Abstract Land Associates,Inc. (717)763-1450
PLACE OF SETTLEMENT: 3912 Market Street,Camp Hill,PA 17011
L SETTLEMENTDATE:1 0/1 812 01 3 PRORATION DATE: 1 0/1 812 01 3 DISBURSEMENT DATE 10/1812013
J. SUMMARY OF BORROWERS TRANSACTI0N R. SUMMARY OF SELLER'S TRANSACTION
1011"GROSSAIttol1NT DUE FROM 'f''*'"'4001 GROSS AMOUNT'DUE TO SELLER:
101, Contract Sales Price 119,000.00 401. Contract Sales Price 119,000.00
102, Personal Property 402. Personal Property
101 Settlement charges to Borrower(line 1400) 7,36100 403. i^
104. 404.
105, 405.
ADJUSTMENTS FOR ITEMS PAID BY SELLER IN ADVANCE: ADJUSTMENTS FOR HEMS PAID BY SELLER IN ADVANCE:
106. Crylrown Taxes 406, C' Frown Taxes
707, Count Taxes 70/78/13 to 12/31/13 142,60 407, County Taxes 10118113 to 12131113 142.60
108. Assessments 409._Assessments
109. School Tax 10118713 to 06130114 884.65 409. School Tax 10/18/13 to 06/30/14 884,66
110. Sewer 10118113 to 12/31/13 52.71 410, Saaar 10118113 to 12131113 52.71
111. Trash 10/18/13 to 12131/13 38.46 411. Trash 10/18/13 to 12!31/73 38.46
112 412.
113. 413.
114. 414.
115. ~� 415.
120. GROSSAMOUNTDUE FROM BORROWER: 127,461A3 420, GROSS AMOUNT DUE TO SELLER: 120,118.43
'1Y00.AMOl1NTS PAID'BY ORIN BEHALF OF BORROWER.+- 500.REDL1CTIDNS INAMOUNT DLESO SELLER.(
201. Deposit orearmin money 1,500.00 1 501. Excess deposit(see Instructions
202. Principal amount of now ban(s) 116,844.00 502. Settlement charges to Seller(line 1400) 10,64391
_203. Existing loan(s)taken subject to 503. Existing IoaMs taken sub act to
204. 504. Payoff of first mortgage loan
205. 505. Payoff of second mor ga a loan
206, Seller Assist 6,472,43 506. Seiler Assist 6,47243
207. 507.
208, 538.
209. 509,
ADJUSTMENTS FOR ITEMS UNPAID BY SELLER: ADJUSTMENTS FOR HEMS UNPAID BY SELLER:
210, CityRown Taxes 510 Cityrrown Taxes
211. County Taxes 511, County Taxes
212, Assessments 512. Assessments
213. 513,
214. 514.
215. 515,
216. 516,
217, 517,
2% 518.
219. 519, �-
220. TOTAL PAID SY/FOR BORROWER: 124,81643 52D TOTAL REDUCTIONS IN AMOUNT DUE SELLER; 17,116.34
300.CASHAT,SETTLEMENTFROMITO.BORROVII ;J{ 600.CASH AT SEfTLEMENYTOIFROM,SELLER,
301. Gross arromtdue from Burrower(line 120) 127,481.43 601, Groasavroumdueto SeRcrYiine4207 120,118.43
302. Less amount paid by/for Burrower(line 220) 124,81043 602. Less reduction in amount due Sewer(Grre 5201 17,116.34
303, CASH I X FROM) 1 0 TO)BORROWER: 2,666.00 603. CASH(❑ FROM) I T TO)SELLER; 103,002.09
The Public Reporting Burden for this collection of information is estimated at 35 minutes par response for collecting,reviewing,and reporting the data This
agency may Trot collect this infoml anon,and you are not required to complete this form,Unless it displays a currently Valid OMB control n=bar,No
confidentiality,Is assured;this disclosure is mandatory.Th is is designed to provide the parties to a RESPA covzred transaction with information during the
settlement process,
Previous editions are obsolete Pane t of 4 �^ HUD-1
1 e
L SETTLEMENT CHARGES ESCROW FILE NUMBER 0 iJ16Y7100t MAW
700.TOTAL REAL ESTATE BROKER PEES: - - -�- _ .p, , , ,
DIVISION OF COMMISSION(LINE 700)AS FOLLOWS: PAID FROM PAID FROM
701, S4,140.10to HowaNRanra Cemoon, BORROWER'SFUNOS SELLER'S
AT SETTLEMENT FUNDSAT
702. 63,915.10 to Keller W9kmmsaf Cennai PA SETTLEMENT
703. Commissim paid at setlkmem
704. Ttansac4on Fee to%eiler Williams '
8,055.20
705. 350.00
.800.ITEMS PAYABLE IN CONNECTION WITH LOAN:
801. Ovrmppnai[an charge 5544870 (hc»GFE.D
802. MesPecon interest rate Ch- (54,673.76)hnr GFEx2)
803. Youradjualedodginationcharges prom cFEq M774.94 804. Appraisal he to Sireetlinks(POC Borrower) nnm GFEa31 (550.0018
805. Cmatrepw ;tGFEaa)
606. T-loWiceto FastAammmdn Tax RE (hn GFe,*)807008.900.ITEMSREOUREDBYLENDERTOBEPAIDINADVANCE:901. Da4yinteenAcharges (mom GFE»10)
hem 10116/2013 to 1111/2013 @$13.6051/day %(14 days)
902. Mortgage Insurance premium br0 nwaih{ajMHUO (tam GFEY3j
903. Homeowna15 asprmce foil 2,009.61
years)io Sata Farm ttrom GFE a11}
_ 628.¢0
904.
905. --
100a RESERVES CEPOSRE44MTH LENDER:.'.'t -
1007, tnitlai tlepaNl 1,w Yacescrow acmulrt tman GFE 49) .
649.4$
1002 Homeavner's insumnca 3m0llihs@$ 52.93 per month $156.99
1003 126.20 per month
1004. Citypeopetly taxes mantis®$ per month
1005. County properly taxes s models @$ 58.61 wona h $527.49
1006. Amuai assessments months a IS perrtwnin
1007. Solmollaxas 5monlhs 0E 105.52 permolM 352760
1008.
months @$ Pernnamn
1009. Aggregate ACCt.Adj. months @$ per month 4562.80
1190.TITLEC ARGE :
1101. Title servkes and tender`58ikinsuranre gmm GFEMi 1,335.00
1102. Setllementordosingfee
11030 Owner's UUe insumna to Abslmtl Land ASaddales Inc (m.m GFE 05) 70.00
1104. Lender's tills insvmncein Abstract Lantl ASSOOiates.mc $085.00 '-
1105. L@geY9 11774 pofiry Amd 3116,644.60
1106. Owners m.pelicyho it $119,000.00
1107. A9ent'apodlon of the total Lille insumnce pmmium $845.75 10 Abstract Land Associates,Inc.
1108. Undelwnhes Pentad,ofthe Intel Utle Insurance premium $149.25 to Old Republic National Title ins.CO.
1109, Ends.400,days,8.1•toAanmd Land Assooakz,in $$150.00
1110. insured Cbsmg Letter-to Bid Republic Natbnai F�cins.CO. 575.00
1111, Notary Fees•sesswement Otpcer 545.011 10.00
_1112 Ua
. °Seeachedforbreakdam sso.00 10.00
9200: GOVERNMENT RECORDING AND TRANSFERCHARGE S: PA.C.
1201. GavecMmt recenNng Belies @,m 9FEm
1202- Deeds67A0 Mangagesal,90 Rates"39.00 148.00
.1203. Transfer taxes (scan GFEae) 7,190.00
1204. Clry/Cwmty WVSlamps 0.00 10,190.00 Mortgage E0.o0 1,190.00
1205. Steatevlslamps Deed$1,190.00 Mortgage
1206.
-1300. ADDITIONALSETTLEMENT CHARGES:- .. 2.0.0. . . ....�- -. ..
1301. Remsmad.ervlceath.aWUCan9hopfor prom GFEX6)
1302. 2013114Schad Taxesto8d sa KMiler 126628
1303. Sewer iQ+i-12f3iti3 io laver Aitm Twp SawerAUmodty 65.00
1304. Trashl0/i-12131/13WLwror Allen Twp Sewer AUthodry 4
1305. 7.43
1306.
1400. TOTAL SETTLEMENT CHARGES(Enter an Me IOSSecdan 1,and the 502,Samoan ip 7,363.0¢ 1¢,64391
1 how amfuly ravkwed me HU0.t SeNament Statement and 0 the bast of my klleMedge and belief,it is W eand accurala ldso meat0 at repeipts aM alone maments made on my
ac[punt or try me In th15 transaction. I tuMer mty IhOt I have mmived a apl of the HUdl SeW ment SlalamenL
Cody J,Stiizet Estate of Dons SGailagher
eeconams Severs
/TIncMD-15e(./tAp-mRMSiaterlrent jw/hichi Isar/e/p,"rej�Qarea)isn/a true a�Maccurate awpmtIX 9estranaNm Ihase reusedmwi3Cm:sa Gle lunds�N Cfa�sbursad+n arcordana with Una
J J,.yy7}'� -bo-s` �/ I<y Y*/ O SetllessamAgent 10/I{�j, Data
Abstr cA t Land Associates,Inc.
WARNING: it isaererero bmxi ymak.(mse siatemenisaNe Uniad Sates on Nkor anysiniariorm. PemiSes uponcrnwk6oncan NCiudea fire and lnpftsoranent For deals anc
Title 18 U.S.Coda Section 1001 and section 1010.
Penn...edition,ate obsolete Pao.2 of 4 Hl1D-1
Esrnow N.W. 01316173-001 MAW
.Comparison of Mood Faith Estimate(GFE)and HUD-1 Charges „ .:Good Faith Estimate` HUD-1
Charges That Cannot Increase HUD-1 Line Number
Our origination charge #801 6,667.43 5,448,70
Your cretin or charge(points)for the specific interest rate chosen #802 4,673,76 4,67176
Your adjusted origination charges #803 993,67 774.94
Transfer taxes 41203 1,190.00 1,190,00
Charges That In Total Cannot Increase Mora Than 10% - Good Faith Estimate HUD-1
Government recording fees #120t 176.00 148.00 1
Appraisal fee #804 560.00 550.00
Tax service #606 69.00 69.00
Flood cedi8cation #807 8.50 8,50
Mortgage insurance Y #902 2,009.61 2,009.61
Title services and lenders site insurance #1101 1,530.00 1,335.00
Owners title insurance #1103 100.00 10,00
__ Total 4,452.11 �_ _ 4,130.ti
�— Increase between GFE and HU0.f Charges $ -322,00 or -7 2325°(0
Charges That Can Change' - - Good Faith Estimate; .i HUD-11, -
Initial deposit for your escrow account #1001 2,159.04 649.48
Daily interest charges #401 $116054 f day 136.05 190.47
Homeowner's insurance u 0903 600.00 628,00
If —
Loan Terms
Your initial town amount is $116,844.04
Your loan term is W years
Your initial interest rate is 4.2500%
Your initial monthly amount owed for principal,interest,and any $703.00 includes
mortgage insurance is ❑% Principal
0 Interest
Mortgage insurance
Can your interest rate rise? N.-❑ Yes,it can rise to a maximum of 0,0000%.The first change will be
on and can change again every after.Every change date,your interest rate
can Increase or decrease by 0.0000%.Over the fife of the Loan,your interest rate
is guaranteed to never be lower than 0.0000%or higher than 0.0000 916.
Even if you make your payments on time,Can your roan balance rise? 0 No ❑ Yes,a can rise to a maximum of$0,00.
Even if you make your payments on time,son your monthly MMM El No.❑ Yes,the first increase=1 be on and the monthly amount owed can
owed for principal,interest,and mortgage insurance rise? rise to$0.00.
The maximum it can ever rise to Is$0.00,
Does your loan have a prepayment penalty? No.❑ Yes,your maximum prepayment penalty is$0.00,
Does your toan have a balloon payment? No.❑ Yes,you have a balloon payment of$UO due in 0 years on.
Total monthly amount owed including escrow account payments ❑You do not have a monthly escrow payment for items.such as property taxes
and homeowner's insurance.You must pay these items directly yourself,
Q You have an additional monthly escrow,payment of S 216.46 that reaults in a
total Initai monthly amount owed of$919.46.This includes principal,interest,
any mortgage Insurance and any items checked below.
d Property taxes Q Homeowners insurance
❑Flood insurance fl School taxes
❑ ❑
Note:if you have any questions about the Settlement Charges and Loan Terms listed on th is form,please contact your lender,
perAce,edWidis are obse ete N.3 of 4 HUD-1
Escrow Number 01316173-001 MAW
HUD 1112 DETAILED BREAKDOWN OF ADDITIONAL TITLE CHARGES
Description Detail Seller
Amount
1113. Doc Trans/Wire Fees•to Abstract Land Associates,Inc. $50.00 Amount
1114.Overnight Fees•to Abstract Land Associates, Inc. $30.00
1115.Tax Cert Fee Reimbursement to Abstract Land Associates, Inc.
10.00
Total as shown on HUD page 2 Line#1112 10.00
HUD 1200 DETAILED BREAKDOWN OF GOVERNMENT RECORDING AND TRANSFER FEES
Buyer Seller
City&County Tax/Stamps mount Amount
City Tax/Stamps: Deed $1,190.00
Total as shown on HUD page 2 Line#1204
1,190.00
Buyer Seller
State Tax/Stamps Amount Amount
State Tax/Stamps: Deed $1,190.00
Total as shown on HUD page 2 Line#1205
1,190.00
Previous etlitions are obsolete Pace 4 of4
_ HUD-1