HomeMy WebLinkAbout01-13-14 REV-1500 EX(02-ss 15056117105
)(FI) � Y
lvania
Bu OFFICIAL USE ONLY
Department of Revenue P ends Y
Bureau of Individual Taxes County Code Year File Number
–" —
PO BOX 1
Harrisburrg,g,P PA INHERITANCE TAX RETURN
A 19128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
07/07/2012 12/29/1935
Decedent's Last Name Suffix Decedent's First Name _ _ _ _ MI
Shirey j Christa
(If Applicable)Enter Surviving Spouse's Information Below -
Spouse's Last Name Suffix Spouse's First Name MI
i
i
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
CID 1.Original Return O 2.Supplemental Return O 3. Remainder Return(Date of Death
Prior to 12-13-82)
O 4. Limited Estate O 4a. Future Interest Compromise(date of O 5. Federal Estate Tax Return Required
death after 12-12-82)
ONO 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.)
O 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 Schedule O)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
Thomas N Shirey 1(404) 2g-5405
REdIST OF WILLS.USE OfyyY
Gj
Cp
n — L7
First Line of Address _ _ �n r- F`' 1-ri rr1
11937 Misty Woods Drive x r,�
CU
Second Line of Address
L ............ ....._ ..p H DATE FI E f
City or Post Office - State_ ZIP Code y _
Duluth PA 30097 u
Correspondent's e-mail address:tOm @shlreyfamlly.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 ERSON RESP BLE FILING RETURN DAT
Fr9 /3
ADDRESS �4
1937 Misty Woods Drive, Duluth GA 30097
SIGNAT P REr2 OT R TH FARE N�TATIy DAT
/ZZ6//3
ADDRESS`
108 COLONY PARK DRIVE ITE 500 CUMMING, GA 30040
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610105 1505610105
J _
1505610205
REV-1500 EX(Fl)
Decedent's Social Security Number
Decedent's Name: Christa Shirey
RECAPITULATION
1. Real Estate(Schedule A). .... . .. ... . .... . . ... ....... . ... .... . .. . .. .. t r......- 182,000.00
2. Stocks and Bonds(Schedule B) . . . ... . .... . .... . ... ... . .. . ... . ... . .. .. 2. 79,808.00
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) . .. .. 3. 0.00
4. Mortgages and Notes Receivable(Schedule D) ... ... . .......... ......... . 4. 0.00
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E).. .... . 5. 140,710.00
6. Jointly Owned Property(Schedule F) CZ) Separate Billing Requested .... . .. 6. 0.00 I
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested.. . ... . . 7.
8. Total Gross Assets(total Lines 1 through 7)... ....... . ... . .. ... . .... . .. . 8. 402,518.00
9. Funeral Expenses and Administrative Costs(Schedule H). .... .... ... .... ... 9. 14,505.00
I
i
10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule 1)......... ...... 10. 24,906.00
11, Total Deductions(total Lines 9 and 10).. . ... ..... ... . .......... . ... .... 11. �- 39,411.00
12. Net Value of Estate(Line 8 minus Line 11) . ..... .. . ....... . .. . ... . ... ... 12. 363,107.00
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J) .... . ... ... ... . ..... .. . . 13. 0.00
14, Net Value Subject to Tax(Line 12 minus Line 13) ..... .... ... ... . .... ... . 14. 363,107.00
TAX CALCULATION-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_ 0.00 1 15. 0.001
16. Amount of Line 14 taxable
at lineal rate X.0 45 334,821.00 16,! 15,067.00
17. Amount of Line 14 taxablem
at sibling rate X.12 - 0.00 f 17, '., 0.00
18. Amount of Line 14 taxable i� 26,266.00 I 4,243.00
at collateral rate X.15 18.
19. TAX DUE ... ... . ..... .... ... .. . . .... . .. .... . 19.
- .. 19,310.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT C=)
Side 2
1505610205 1505610205
r 5
REV-1500 EX(FI) Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
Christa Shirey
STREETADDRESS
103 Elm Drive
CITY ' STATE li ZIP
Carlisle PA 17013
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 19,310.00
2. Credits/Payments
A.Prior Payments 0.00
B.Discount
Total Credits(A+B) (2) 0.00
3. Interest
(3) 397.00
4. If Line 2 is greater than Line 1+Line 3,enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2,Line 20 to request a refund. (4) 0.00
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 19,707.00
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 .............................................................................................................................. ❑ 0
d. receive the promise for life of either payments,benefits or care?..................................................................... ❑ 0
2. If death occurred after Dec.12, 1982,did decedent transfer property within one year of death
without receiving adequate consideration?.............................................................................................................. ❑ ❑
3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?.............. ❑
4. Did decedent own an individual retirement account,annuity or other non-probate properly,which
contains a beneficiary designation? ........................................................................................................................ ❑
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994,and before Jan. 1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is 3 percent[72 P.S.§9116(a)(1.1)(i)].
For dates of death on or after Jan. 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 lax rate imposed on the net value of transfers from a deceased child 21 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 0 percent[72 P.S.§9116(a)(1.2)].
• The lax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[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.
V
REGISTER OF WILLS CERTIFICATE OF
CUMBERLAND COUNTY GRANT OF LETTERS
PENNSYLVANIA
No. 2012- 00752 PA No. 21- 12- 0752
Estate Of: CHRISTA SHIREY
/First,Middle.Last/
Late Of: NORTH MIDDLETON TOWNSHIP
CUMBERLAND COUNTY
0 Deceased
Social Security No:
WHEREAS, on the 10th day of July 2012 an instrument dated
March 29th 2000 was admitted to probate as the last will of
CHRISTA SHIREY
(First Middle,laid
late of NORTH MIDDLETON TOWNSHIP, CUMBERLAND County,
who died on the 7th day of July 2012 and,
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, GLENDA FARNER STRASBAUGH , Register of Wills in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby
certify that I have this day granted Letters TESTAMENTARYto:
THOMAS N SHIREY
who has duly qualified as EXECUTOR/RIX)
and has agreed to administer the estate according to law, all of which
fully appears of record in my office at CUMBERLAND COUNTY COURTHOUSE,
CARLISLE, PENNSYLVANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my office on the 10th day of July 2012.
Te isler,o
A 01
enur
**NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST)
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LAST WILL AND TESTAMENT �� C- r,-,t--,
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OF
CHRISTA SHIREY o 1 1-' c s
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W �
I,CHRISTA SHIREY, Social Security Number 577-62-9888, of the Commonwealth of
Pennsylvania,declare that this is my LAST WILL AND TESTAMENT and I revoke all other
wills and codicils previously made by me.
I. I appoint my son, THOMAS N. SHIREY of Georgia as my Personal Representative
concerning this Will. If my son,THOMAS N. SHIREY,is unable or fails to serve, I then
appoint my daughter,NANETTE ROSS of New Jersey,to serve as my Personal Representative.
A. I request that my Personal Representative be permitted to serve without bond or
surety thereon and without the intervention of any court, except as required by law. I direct that
my Personal Representative act in unsupervised administration so as to administer my estate with
a minimum of court supervision. If it becomes necessary to have ancillary administration of my
estate in any jurisdiction where my Personal Representative is unable or does not desire to
qualify as ancillary legal representative, I appoint as such ancillary legal representative such
individual or corporation as my Personal Representative shall designate, in writing.
B. I direct my Personal Representative to pay the expenses of my last illness,the
expenses of a funeral appropriate to my station in life and custom of living(including a suitable
monument or marker for my grave), and written charitable pledges which I have made. I grant
my Personal Representative the power to extend or renew any debt for such time as my Personal
Representative shall deem appropriate.
C. All estate, inheritance, succession and other death taxes with respect to all property
passing under this my Will shall be paid from and borne by the principal of my residuary estate,
without regard to reimbursement, as if such taxes were administration expenses. My Personal
Representative may pay such taxes at any time deemed advisable,whether or not then due and
payable.
D. My Personal Representative is requested to settle my estate as soon after my death as
may be practicable, and to pay or deliver every legacy or bequest to my beneficiaries without
waiting any time that may be believed to be customary in probate matters.
Last Will and Testament of CHRISTA SHIREY
Q� 4i"
L�tFL Cf c
Page 1 of 4
d ^
E. I may leave a letter of intent with the executed copy of this Will for the purpose of
giving guidance to my Personal Representative concerning the distribution or sale of certain
items of my property. I request, but do not require, that my Personal Representative honor my
wishes therein expressed.
II. I hereby make the following specific bequests:
A. I give to my fiance,STEPHEN D. KASARDA,a life estate in my real property at 103
Elm Drive, Carlisle,Pennsylvania 17013 until he dies or decides to vacate the property
whereupon the property should be sold and the proceeds divided equally between STEPHEN D.
KASARDA fifty percent(50%)and my still living children fifty percent(50%) or their heirs.
B. I give all of my jewelry, to my daughter,NANETTE ROSS of New Jersey.
C. I give the crystal that was given to me by my mother,DOROTHEA HECHT, to my
son, THOMAS N. SHIREY, JR. of Georgia.
D. I give a total of$10,000(ten thousand dollars)each to the following individuals and
to any other grandchild that survives me: RACHEL L. SHIREY, CALVIN SHIREY,MAREN
E. ROSS, STEPHEN DUNST and RENEE DUNST.
III. I give, devise and bequeath, absolutely and forever, all of the rest,residue and
remainder of my estate and property o1"which I may be seized or possessed,or to which I may be
entitled,at the time of my death,wherever situated or of whatever nature,be it real,personal, or
mixed, to my son,THOMAS N. SHIREY,JR.of Georgia and my daughter,NANETTE ROSS
of New Jersey, in shares of substantially equal value to be divided as they may agree, It is my
hope but not my direction,that these bequests be shared with MICHELLE KASARDA and
YVONNE DUNST in whatever amount or fashion as my son,THOMAS N. SHIREY of
Georgia, and my daughter, DANETTE ROSS of New Jersey,may choose.
A. If any of my children shall not survive me,then the share of that deceased child shall
go to the descendants of that child, who are to take per stirpes and not per capita. If any of my
children shall not survive me and shall not be survived by any descendants, then the share of that
deceased child shall be distributed to my surviving children and the descendants of any of my
other children who fail to survive me, in the manner set forth above.
B. If they are unable to agree,the division among my children and the descendants of
any of my children who fail to survive me shall be made by my Personal Representative,in that
person's sole and absolute discretion. I empower my Personal Representative to sell any or all of
such property,if such property is not distributed in kind hereunder,and to distribute the proceeds
among my said children in substantially equal shares. Any determination of my Personal
Representative as to what should pass or be sold under this paragraph and to whom it should pass
or be delivered or at what price it should be sold shall be conclusive.
Last Will and Testament of CIIRISTA SHIREY
LC,GI 1 i�1 t� P—k— -
1 Page 2 oC4
IV. Except as otherwise provided in this Will, I have intentionally failed to provide for any
other relatives or other persons, whether claiming to be an heir of mine or not. Insofar as I have
failed to provide in this Will for any of my issue now living or later born or adopted, such failure
is intentional and not occasioned by accident or mistake.
V. Any beneficiary who fails to survive until One Hundred and Twenty(120)hours after
my death shall be deemed to have predeceased me, and the gift to that beneficiary shall be
disposed of accordingly.
VI. Definitions:
A. The term "children" as used in this Will does not include adopted and afterborn
persons. The term "children" as used in this Will shall not include step-children, the natural born
or adopted children of a person's spouse who are not the natural born children of the person. A
relationship by or through legal adoption shall be treated the same as a relationship by or through
blood for purpose of succession to property under this Will.
B. The term "per stirpes" as used in this Will means that whenever a distribution is to be
made to the descendants of any person, the property to be distributed shall be divided into as
many shares as there are (1) living children of the person, and (2) deceased children,who left
descendants who are then living, of the person. Each living child (if any) shall take one share
and the share of each deceased child shall be divided among his then living descendants in the
same manner.
C. The term "Personal Representative" as used in this Will shall have the same meaning
as Executor, Executrix, Independent Executor, or any other title of like import which is used to
describe such a fiduciary.
VII. In addition to any powers granted by the laws of the jurisdiction in which this Willis
probated, I hereby authorize and empower the fiduciaries named in this Will, to the extent of the
discretion herein granted, to sell, exchange, convey, transfer, assign, mortgage,pledge, lease or
rent the whole or any part of my real or personal estate, to invest,reinvest, or retain investments
of my estate, to perform all acts and to execute all documents which my fiduciaries may deem
necessary or proper in regard to my property. If any of my fiduciaries elect to receive
compensation for services, such compensation will be that allowed by law.
VIII. If any part of this Will shall be invalid, illegal, or inoperative for any reason, it is my
intention that the remaining parts, so far as possible and reasonable,shall be effective and fully
operative. My Personal Representative may seek and obtain court instructions for the purpose of
carrying out as nearly as may be possible the intention of this Will as shown by the terms hereof,
including any terms held invalid, illegal, or inoperative.
Last Will and Testament of CHRISTA SHIREY
n
Page 3 of 4 `
This document
unplementin was prepared under the
S ao Judge Advocate Legal Sets
tons vice, instructions by�ONATH S' Code section 1044
te
Of Georgia, UnitedStates ANIiOWq j>ero
Army, is licensed to �, a member of
IN WIT practice law in The
NESS WI'EREOp
set my hand and seal to this m ' I have at Carlisle
Pages, each y LAST WILL ' Pennsylvania, on /
Page bearing my haindwritten Signature.TESTAMENT,
consistin typewritten
g of 4
CHRISTA SgrR-EV, (SEAL)
The foregoing instrument SWILL'Seal d'Published and declared b lisle Pennsylvania, on �Zr,
her request and n her ENT in the presence of all A SHIREY, the testatrix
names as attestin Presence and in the °f us at one ti to be her LAST
dis g witnesses Presence of each me, and at the same ti
posing mind and memo ' and we do so verily believe that have hereunto ib d r
r1 at the date said testatrixtns subs our
hereof.
sound and
n
of l
Last will and Testament of CHRIS,A SHIREY
\ .
Page 4 of 4 1___l
I,CIIRISTA SHIREY,the testatrix,sign my name to this instrument on
�� n ��hcli 'PaaC
and being first sworn,declare to the undersigned authority that I sign and execute this instrument as my last will,
that I sign it willingly or willingly direct another to sign for me,that I execute it as my free and voluntary act for the
purposes therein expressed,and that I am eighteen years of age or older,of sound mind,and under no constraint or
undue influcnec.
a"4'e
CHRISTA SHIREY
ACKNOWLEDGMENT
I, CHRISTA SHIREY, testatrix,whose name is signed to the attached or foregoing instrument,
having been duly qualified according to law,do hereby acknowledge that I signed and executed
the instrument as my Last Will; that I signed it willingly; and that I signed it as in free and
voluntary act for the purposes therein expressed.
A �� �e r k[ _(SEAL)
CHRISTA SHIREY
AFFIDAV
We, �Qd�y���� S and the
witnesses, sign our names to this instrument,being duly qualified according to law,do depose
and say that we were present and saw the testatrix sign and execute the instrument as her Last
Will;that the testatrix signed willingly and executed it as her free and voluntary act for the
purposes therein expressed; that each subscribing witness in the hearing and sight of the testatrix
signed the will as a witness; and that to the best of our knowledge the testatrix was at that time 18
or more years of age, of sound mind and under n onstrain`or undue influence.
of
0
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
Subscribed,sworn to and acknowledged before me by CHRISTA SHIREY,the testatrix,and subscribed and
swore to before me by
i1A9 ti i Ri
,
Notary Public
Cumtierlar,county
w i;�rntaission Er-cite°r,.quy 14,20113;
Last Will and Testament of CHRISTA SHIREY r' yssnciatip of Not`a�
Witnesses Attestation and Self-Proving Clauses
r
REV-1502 EX+(12-12)
1?' pennsylvania SCHEDULE A
' • DEPARTMENT OF REVENUE REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
CHRISTA SHIREY 577-62-988
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 that 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.
ITEM Include a copy of the deed showing decedent's Interest If owned as tenant in common. VALUE AT DATE
NUMBER OF DEATH
DESCRIPTION
1 RESIDENCE LOCATED AT 103 ELM DRIVE
CARLISLE,PA 17013(SEE ATTACHED ZILLOW REPORT ATTACHED) 182,000.00
NOTE THAT PER THE WILL THIS PROPERTY WAS LEFT TO THE DECEDENTS FIANCE
WITH WHOM SHE HAD BEEN RESIDING FOR OVER 25 YEARS FOR LIFE AS A LIFE
EETTATE. THEREFORE,BASED UPON THE ACTURIAL TABLES MR KASARDA HAS A
LIFE EXPECTANCY OF 14 YRS. THUS HIS INTEREST IN THIS PROPERTY FOR
INHERITANCE VALUE IS$28,286.40 AND THE DECEDENTS CHILDREN RESIDUAL
PRESENT VALUE IS$153,713.60. SEE ATTACHED CALCULATION.
TOTAL(Also enter on Line 1, Recapitulation.) $ 182,000.00
If more space is needed,use additional sheets of paper of the same size.
y
12/12/2013 Page 1
LIFE ESTATE FOR STEPHEN KASARDA - 14 YRS
Compound Period .......: Monthly
Nominal Annual Rate ... : 1.200 %
Effective Annual Rate .. : 1.207 %
Periodic Rate .............. : 0.1000 %
Daily Rate ...................: 0.00329 %
CASH FLOW DATA
Event Start Date Amount Number Period End Date
1 Loan 07/06/2012 153,713.60 1
2 Payment 08/06/2026 182,000.00 1
AMORTIZATION SCHEDULE - Normal Amortization
Date Payment Interest Principal Balance
Loan 07/06/2012 153,713.60
2012 Totals 0.00 0.00 0.00
1 08/06/2026 182,000.00 28,286.40 153,713.60 0.00
2026 Totals 182,000.00 28,286.40 153,713.60
Grand Totals 182,000.00 28,286.40 153,713.60
Homes Rentals Mortgage Rates Advice Find a Pro Local Info Digs- More - For Pros - Sign In
Location: City,State,or DP O
Pennsyhonia Schlusser 17013 103 Elm Or Views:27
103 Elm Dr, Carlisle, PA 17013 Get a professional estimate
Christian Boegel
Not for Sale Map Biro's Eye Street View f+l� (1 ranee.)
Zestimate:$174,952 1 e $ cell:(717)6094342
.W�nerp NR
Rent Zestimate:$1,312/mo Steve Johansen
Est.Re(Payment5676/mc
Call:(717)30 41174
See current rates on Ztbw j
Julie Hallisey
,g ( 19 mNevn)
Call:(71716094027
Bedrooms. 3 beds G Your Name
Bathrooms: 1.5 baths
rl , 1. . _
Single Family: 1,639 sq fl a Phone( � _
Lot: 0.42 acres r-. Y \\, Qn Ema':Address
Year Built: 1975
Heating Type: Contact for details ' y RO 1yQC I own this home and would like a professional
estimate at 103 Elm Dr,Carlisle,PA 17013.
Lean how to appear as the agent above
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Description
This 1639 square foot single family home has 3 bedrooms and 1.5 bathrooms.it Is located at 103 Elm Dr
Carlisle, Pennsylvania.
1
Cooling Parking Basement Type
Unknown Unknown Unknown
Fireplace Floor Covering Attic
Unknown Unknown Unknown
-Mm County website See data sources
Zestimates Similar Homes for Sale
' Value Range 30-day change $/sgft Last updated 40 101 Faith Cir.Carlisle. ...
Zestimate $174,952 $166K-$164K -$855 $106 11/17/2013 ':k For Sale:$130,000
Rent Zestimate $1,312/mo S1.2K-S1.5K/mo -$17 $0.80 11/11/2013 Bats:3 Lot: 1272
1 Baths:2.0 Lot:0.36 ac
1 Owner tools Post your own estimate 1
...
Market guide Zillow predicts 17013 home values will increase 1.1%next year,compared to a 1.2% 180 Faith Cir.Carlisle.
increase for Schlusser as a whole.Among 17013... For Sale:$129.900
i more Beds:3 Still: 1232
Baths:2.0 Lot:0.48 ac
I �
11 Lonustreet Dr. Canis...
slimete I Rent Zestimate�mo 1 year�5 years;10 years
$200k For Sale:$189,900
— TNS home $1 ( Beds:3 Sqft: 1560
-- 77013 $143k $190k Baths:2.0 Lot:0.48 ac
schwase s142k Value of home Jul s190
Jul 2012 y I See listings near 103 Elm Or
, pp
% �• 3140c
$121k 7... j:11 11 t ai 7.
r - 1.11 t�.
• -- - $11ok ~� jj -
:2303 Doc 2O05 Doc 2007 We 2009 Dac 2011 iA •.
Price History • ` �
l
Date Description Price Charge $1sg8 Source t 4
H istodcal transaction data is not"liable for this home.
Tax History Nearby Similar Sales
Find assessor information on the county wabsite 2570 Sodna Rd.Carlisle.PA 17013
Year Property taxes Change Tax assessment Charge Sold on 612612013:$169,900
2013 $2,966 21.1% $193,400 _ Beds:3 Stilt:1600
Baths:1.5 Lot:0.34 ac
2011 $2,450 6.3% 5193,400 49.4% -- -- -- —.
2010 52,304 3.1% $129.470 _ 15 Riche Ave.Cadide.PA 17013
-More sold on 1211012012:6184,900
Beds:3 Sgit:1624
Baths:2.0 Lot:0.38 ac
Monthly Payment 4
Mortgage payment breakdown or rite home price of$174,952 31 Hove Ter,Carlisle.PA 17013
Sold on 612612013:$170,000
Percent down: Beds:3 Sall: 1200
❑(534,490)
209E Estimated Payment $886 Baths:20 La:0.6 ac
O Principal&Interest $676 —�-
Program: - See sales similar to 103 Elm Dr
O Taxes $153
30yr 6xotl 4.097%
O Homeowners Insurance $57 Featured Partners
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Walk Score® 31100 (Car-Dependent) List of nearby homes
Nearby Schools inSchiusser Worst Best
Data by GreatSchools.org
Grades Distance
Middlesex Elementary KS 2.0 mi
Crestview Elementary KS 2.1 mi
Hamilton Elementary KS 2.5 mi
Northwestern Human Services Autism Scho... K-12 3.1 mi
Bellaire Elementary KS 3.1 mi
Wilson Middle 6.8 3.2 mi
Carlisle Area High 9-12 3.3 mi
More schools in Schlusser
Get a professional estimate
Christian Boegel
�J' (i review)
Call:(717)609-0342 Year Namc
Steve Johansen - -- --�_
[� (2,.viewa) Phono
Call:(717)3033174 _
Julie Hallisey Errol!Addr.as
Call:(717)60M627
I own this home and amid like a professional
estimate at 103 Elm IX,Cadisle,PA 17011
Contact Agent
Leam how to appear as the agent above
Bmaae more 17013 listing agents
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Aereo_
' P-201-AS—Wc—W me Sho[ Boom. Ad of 1900--AmneM feo Pho ,doA,n
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MADE THE 28" day of in the year
of our Lord one thousand nine hundred seventy-six (1976)
BETWEEN LEBO, BURKHOLDER & CLELAND, a partnership composed of
GEORGE 0. LEBO, RAY T. BURKHOLDER and JOHN N. CLELAND, of Carlisle,
Cumberland County, Pennsylvania, hereinafter called
Grantor
and THOMAS N. SHIREY and CHRISTA SHIREY, his wife, of North
Middleton Township, Cumberland County, Pennsylvania, hereinafter
called
Grantee s:
WITNESSETH, that in consideration of Fifty-One Thousand Nine hundred and
no/loo------------------------(551 900.00)-------------------Dollars,
in hand paid, the receipt whereof is hereby acknowledged, the said grantor does hereby grant
and convey to the said grantee g their heirs and assigns, as tenants by the
entireties
ALL that certain tract of land with the improvements thereon erected
situate in North Middleton Township, Cumberland County, Pennsylvania,
bounded and described as follows:
BEING Lot No. 166 on the Plan of Kingsbrock, Section "2", as recorded
e in the Office of the Recorder of Deeds for Cumberland County in Plan Book
24, Page 126; containing 195.65 feet along the West along lands now or
formerly of Hooke, Lebo & Hooke; also containing 88.55 feet along the West-
along Hope Terrace; containing 130 feet along the North along land now or
5
formerly of Hooke, Lebo & Hooke; containing 238.87 feet along the East
along Lots No. 167 and Lot No. 168 on said Plan, and containing 79.76 feet
along the South along Elm Drive as shown on said Plan and containing
31,606.13 square feet.
BEING improved with a seven room split-level dwelling and two car garage
I03 �(w. D•-.,.t
known as BL4r Taf-e< e, Carlisle.
AND BEING the same property which Hooke, Lebo & Hooke, a partnership,
granted and conveyed to Lebo, Burkholder & Cleland, a partnership, Grantor
herein, by deed dated April 6th, 1976 and recorded in the Office aforesaid
in Deed Book "N", Vol. 26, Page 189.
BEING SUBJECT to the Building and Use Restrictions as recorded in the
Office aforesaid in Miscellaneous Book No. 184 at Page 763.
eoaxW26 PAGE 276
"OkAMONWEALTH OP FRNNSYLVANIA
S-APZIMENT OF REVENUE
AND the said grantor hereby covenants and;agree,, .,tl
e
generally -6y df��
TAX
will warrant the property he?"' "Zt 1 2=1 7=6
P.BmI62 [5 19. 0 0�
Cumb. Co., Pa. School 010 P.
I 7—Ra.1 W.I. T, -U:Z,T.. —A�.Real ELiaia lrann hr Tax
'D A.f.
C.1W Ca. Eud,CA!4VAV`1
zip
'
IN WITNESS WHEREOF', said grantor has hereunto set its hand and seal
the day and your first above written- LEBO, BURKHOLDER & CLELAND, A Partnership osoi
—.1 — ....16 --------------------
fyiontb,zscal,b nb ptfiftatb E-M EB
in the 13ramue of
---------- ----
.............. --------- ----- ----------------------- ... ..... SEAL
0 N LE ND.....
...........-------................ ---------------------------- -------------------------------------------------- .....................
State of PENNSYLVANIA
County of CUMBERLAND
On this, the a: day of 6-ct'F-4t ig 76 , before me,
the undersigned officer, personally appeared George 0. Lebo, Ray T. Burkholder and
John N. Cleland, ttq al—k'.16— fi
7mown to me (or satisfactorily proven) to be the person S whose name s are subscribed to the
within instrument,and acknowledged that they exconted same for the purposes therein
T to in d.
44 :1 S WHRRFOF, I hereunto se nd and official seal.
Go
--------------------------
7..... ------- -------------
ROGER B. I RITARY PUPLIC
-------------------------------------........
Y Ca"RUSSION CXPRc`S OCF 3,IMO Title of Officer.
7Y
I do hereby certify that the precise residence and complete post office address
of the within named grantee s is
(012,9 19 76 [ 01 L
f9A 00t3
---------------- ----------------------------------------------------
Attorney for ..........Grantees- - - - ------------....................
BODXW26 PAG- 277
�v DATE
MOT l* I SH
du of De.WS
EJIE,
Account No. 126-62778°ij•• OF OEEOS ,Thir instrument was b
_T COUNT-i',1 PavPArrd y.
'9'l Jul. lU 0m 1 03 E.Peso Financial Service
5070 Rlttei�'Qond. Suite 115
' NcehallicaharR Ps. 17055
Pdan,p
MORTGAGE
i THIS MORTGAGE Is nude this 17th day of July 1994 ,between the Mong.gor,
Chrisea Shlrav __________________________ (heein 'Norrower•7. whole Add— I.
107 Elm Drfvc. Carlisle. Punnavlvnnla 1701] ------------- and the Mongagm,
Flr»Utioa Nome Egviry Cael"An"I ,A eotpontmo erg-Iced and ealsting ender the 1-w-of North CArollva.wbose
addm s is CONS-14. Charlotte, March cpr,lAn, 28288 1 (hcrcla'U dc,').
WHEREAS.Borrower is indebted To I.Andcr In the pdneipal rum of U.S.S 21,200.00 ,which indebted...is
evidenced by Borrower's note stand July 12th, 1994 and a kend.m.renewaU and rmdiOuNon-
Werced(herelo'NOte'),provldiag for mavWly iesWlnsnU of peindpal and inremt.with We balance o(Indebledaen,
Vast sooner Paid,due and psyableen August lot, 2004
TO SECURE In Under the rcpynmnt of the indebtedness evideoeW by Ill,Note.with Interco theme.:the p.ymcm
Of all other manse,with Ivmmn thenoe,ad-sa.ed in.ee.nienee herewith.protect We ao,urity of We Mon'.";and _
the perfornwme of the covenants and agreemants of Bonswer herein contained. Dmrover does bemby r6odgage.
grant And convey to •Lender The following drecribeal property .tonnes In Na, County of
Cumberland, North Middleton Taunaltin.Stateofpcvarylv.dc
BEING LOT NO. 166 on the Pl.n of Ringabrook. Scotian "2", to recorded
In the Office of the Recorder of Deeds for Cumberland County In Plan
Book 24 Page 126-containing 195.65 feet Along the Want along land.
no. or formerly of Ilooke,Lcbo h Hooke; also eoucnlnlng 80.55 feet
Along the Went along (lope Terrace- containing 170 taco along the Nortlt
l .long and F. 00r formorly of Bouu�a 1,ebo 55 Naoke• a tnlain 3Z38 87
feat a Ongg tile F. nt alon LOTS DO. (4l tst WT NO. Y8tl oa Ati ld 1'1 an,
and cents nine 79,76 feet Along the South Along File Delve no all..,,
on Anid PIA. And eont"Aing 71,606.17 Ill, fast.
t
which has the add.,of 103 Blm Urdu., Cnrlialc, P-lluoylvanln 17015
f Par) as" la.„) trio cap
(berm-Property Address');
TGOE lEN with all the bnpmvemems new of bmeane, caned on T(.e Pmpeny, and all rewnunts. rights,
aPPuneoanas and seats all of which shall be deemed to be and mein a pan of the pmpony co,con,by this
Mortgage; and all of she (oregeing. toilette,wRh said pfapeny(a,the I_dald...e If M. Monpge b ov A
Irvebeld)am bcmio-Rer inferred m-(he'Pmpeny.•
Any Rider(Rider")-trashed hereto and a-mused of even dine U Incorporated heroin and the eavawt and
agremnenU tar the Elder shall amend and rripplarnead the corer..0 and sgraanenU of this Mertg.gq As if the
Rider were At part hereof.
Borrower eove.eat,that Bormwcr is nwr-IIY-tired of the erum bemby conveyed and has We right 1e omng.ge.
` grim and eonvey'he Property.and Wn The Property Is uneraumbe'ed.a-cept for encumbr-ncn of stools. gerrower
If [..,amen rho'Bovowef warrant,and will defend generally be(111..We Pmpeny.g5im'all el.ims and demand.,
subject m cneuvbsenees of record,
UNIFORM COVENANTS. Borrow.,and Under e.vcn.nt and agne a follows:
1. Payment of principal and Internet. Benawer shall promptly pry when due the principal And Interest
s Indebmdnnr evlEnaW by The Nom. This Mongag--cum payeaw of Wd Note.eeording m Its to..which.n
IuetyomW herein by'arena..
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REV-r503 a(.(e-u)
pennsylvania SCHEDULE B
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN STOCKS & BONDS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
CHRISTA SHIREY 577629888
All property jointly owned with right of survivorship must be disclosed on Schedule F.
REM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
I' PER BROKER STATEMENT ATTACHED:
862.063 SHARES AMERICAN HIGH INC TRUST CLASS C 9,430.97
tF . 111 10,000 FACE GEN ELEC CAP CORP INTERNOTES 10,006.00
486.844 LORD ABBETT BOND-DEB FUND CLASS C 3,836.33
7,105.55 SHARES PUTNAM HIGH YLD TRUST FUND CLASS A 54,357.46
CASH MONEY FUNDS IN BROKERAGE ACCT 355.73
2 METLIFE UNITS 60 PER STMT TIMES$30.37 I 1,822.00
r
i
I
1L'—
TOTAL(Also enter on Line 2, Recapitulation) $ 79,808 49
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SeMcing Broker Dealer
Delia Corporation 579 Mn Street,got en V A 01740 9787]9.5361 Brokerage
Clearing through Pershing,LLC
Account S!alemen!
• 00153000 01 AV 0.350 01 M 00611 X102 M12 000000 Account Number:39K-220307
Statement Period: 07(0112012-07131/2012
Valuation at a Glance Rm triad
Beginning Account Value $77,6.sa.0 5
CIIRISTA SHIREY Cash Wilhdtaeas -35533
103 ELM DRIVE Dmderdylnl Neu 357.74
CARLISLE PA 17013-8876 Nftge in AaWnl Value 6 66A7
uihlu1b11hrIDu119t111 do^lhrh111'ltld,ILrLI'11 Estimated Anna)Income •55,041.0
Your Investment RepresmtaMC
FUCK40 PLMELL
(866)443-0619
Asset Allocation IMP 11;5 Periad KARaa6m
Cash Money Funds,and FOICOeposiU 355.73 357.74 1% C dauooleoe�xld�eM
Fixed lnmme 10006,00 10,010.90 13% .y pcnariage.
milwal Funds 67,29632 68,157.89 8695 �r- 'O Pe Dart abcalarescadn al
to a Whitt,asset c4sses a19rh w Acco9nt Total(Pie Chan) $77,658.05 $78,521.53 10095 ? ''
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CHRISTA SHIREV
Investor ID 80e5 8701 8289
"arket Value Dlvldeed summary
k Price as w Total Market Toml Trust Dividend per• Current
11 09 z0t2 Value Record Date Imaresta Trust interest Distribution
$1,921.20
11/09/x012 60.0000 $0.74 $44.40
TI B e b c ( pdLgt o Payable Date Tex held Net DlatrlbutlGn Pdor Year
a Distribution
12/14/2012 $0.00 $44.40 $44.40
For account Inquiries, you may visit www.cpushareownerservices.com or call 1-000.649-3593.
When contacting us please have your Investor ID available, located in the upper right hand corner of this document.
Important Note: To avoid being subject to abandoned property rules, .p.lea&
keep your account
Y.
Trust Bertaaday Infonnedan
You may purohase or sell your aharea of MetLMe, Inc- common stock An annual shareholders' mooting to elect rnembero of the Board of
(represented by 'Trust IMaresta'T held In the Motule Pdbyholder Trust Director; of Meti Ina. and for the transaction of other business is
0he 'Trust'), hea of any oommI'long or other fees, undez the MetLits ee�xppeeotdtetl to be hold on or about April 23, 20t3. The deadline for
Pt 0 Tbu and Bela Program, 8; amended. A copy of the brochure submidMg shareholder proposals for consideration at this meeting is
deaorIti the pprogram Is available on the Internet at November 26, 2012. A copy of MetLife, Ina's annual report and pr
http /Investol.motlife.com by selecting the Shareholder Services statement will be available free of charge on or about March 31, 20�
Information page,or byy calkng the number fated above.You are psrmitted along with other MetL6e, Inc. and.Trust filings under federal securities
to dansfel your Trust IMereste only in the ciroumetences described In the laws,(1)on the Internet at www.unstlifacom by aelectirg About MetLife,
brochure. You may also Instruct that all Out not less than all) of your Corporate Governance,(il)by writing to Me Ufe,Inc.,c/o Computershare
shares d Metl6e.Inc.common stock held by the Truat be withdrawn hom Sharehwner SeMcefi LLC,PO Box 366447,Pldaburgl PA 16252.8447,or
the Trust Information regarding yolu w8hdrawal dghts may ba found In (ia)b�telling the number listed above.These and other SEC filing;by
die Purchase and Sale Program rochure or by calling the number listed MatLi e, k1o. and the Trust are also available on the Internet at
above.MetLBe,In.amended the Plaeheee anti Sale Program Procedures wwwaec•gov.
In October 2012. As a result
111tratla99 atlditlonal aheras 011MINIUMI&V rte-cemmen sleek through the
Purchase and Sale rroaram,
0052966 as
Please Note: Important 2012 Tax Information Metuire
FORM 1099-DIV. U.S. TAX INFORMATION FOR 2012 OMB NO.1545-0110
DIVIDENDS/DISTRIBUTIONS
COPY B FOR
RECIPIENT
RECIPIENT'S TOTAL ORDINARY
IDENTIFICATION NUMBER DIVIDENDS QUALIFIED DIVIDENDS FEDERAL INCOME TAX WITHHELD
%1a BON to BOX 4
XXXXX9888 .40 .40 .00
PAYER'S NAME PAYER'S FEDERAL IDENTIFICATION NUMBER
COMPUTERSHARE SHAREOWNER SERVICES LLC 51-65113987
AS CUSTODIAN OF THE METUFE POLICYHOLDER TRUST
SECURITY DESCRIPTION TO WHOM PAID
TRUST INTERESTS 03 EL M DR A SHIREY
1 REPORTED BY
103 EL
CARLISLE PA 17013.8878 COMPUTERSHARE
P.O. BOX 43010
PROVIDENCE, RI 02940-3010
IMPORTANT 2012 TAX INFORMATION FOR INFORMATION REGARDING THE ABOVE, CALL 1-800e4 9-3593
Th a'Is Important tax Information and le•being sundered to the Internal Revenue Service. Box 4-Shows.backup withholding..A payer must backup withhold on oedain payments if you
II you we required to Ilia a return,a trariggence penalty or other sanction may be did not give your taxpayer ldenf llcallon number to the payer,See Form W-9,Request IerTex-
Imposed on you it this Income Is taxable and the WS deleandrans that It has not been payer Identification Number and Cedtlamon,Its Informallon on backup withholding. Include
reported. this amount on your Income tax return as tax widlheld.
Box to-Shows total onllnary dWarda that are taxable.Include his amount on fine M of Forth Nominees.If this form Includes amounts belonging to another friction,you are considered a
1040 w 1040A.Also,report It on Schedule B(1040A on 1040),If required,The amount shown ermines reclplent.You must the Form 10i(with a Form 1098)with the IRS far each of
may be dividends a corporation paid directly b you as a participant(or beneficiary of a particl- the other owners to show may,share of the Income,and you most lumish a Farm 1099-13IV b
pant)in an employee stock owrreMip plan(ESOP).Regan it as a dvkfl nd an your Form each.A husband or wife is not required to file a nominee ratum to shmv amounts owned by
M011040A,bon beat It as s plan distribution,not as Investment Income,far any other purpose, the other.Sea the 2012 General Instructions for Cedaln INannailon Returns.
Sax ib-Shows he portion of the amoum In box 1e,that may be eligible for the 167,or zero
capital gains tutee. Sea Form 1040,1040A Instructions for how to determine his amount.
Round are eligible amount on line 9b,Form 1040 or I%0A. - -
Please Deposit.thiB Enclosed Dividend Checklmmediately
REV-r5o8 EX+(oe-u) ,
pennsylvania SCHEDULE E
DEPARTMEMOFREVENUE CASH, BANK DEPOSITS & MISC.
INHERRANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: - FILE NUMBER:
CHRISTA SHIREY 577629888
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM - VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 1, ,MET LIFE ANNUITY ACCT#M3164054 63,329.21
1 —
I�-2� PERSHING IRA#39K-634440 I 3' MI CHECKING ACCT 53038 4' M1 S AVINGS ACCT �
5 (jM1 MONEY MGT ACCT _ 13,843.59
g' CASH ON HAND �- ,` 21.00
7 AUTOMOBILE AND OTHER PERSONAL ASSETS j 20,500.00
' 3
i
4
TOTAL(Also enter On Line 5, Recapitulation) $ 140,710.00
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. Q{' $WO LouiseDri' 3Tatertent 67AcCOunts
r7v 50010 Loulso Bdva
PO Sox 40
Mechanicsburg,PA 17055
wtvw.memberstst.arg Jun 25, 2012 thru Jul 24, 2012
Main Switchboard: (800)283.2328 -
EZ Call: 1717)697.4372 or(800)2133,1372 Account Number: 53038
TOO: (717)697-5312 or(600)283-2328 ext.5312
ToieBranch: (900}237-72$8
MEMBERS 1st Balances at a Glance: _
FEDERAL CREDIT UNION Checking: 92.00
16140 1 BB 0.404 55741-163.48 Savings: 5.00
»— ir,Ii,H trllt I,L.L..iLrJLLrtfir„r Ilr liJrrdl J,i Certificates: 0.00
CHRISTA SHIREY Loans: 0.00 _
C/O THOMAS SHIREY Money Management: 0.00
1937 MISTY WOODS DRIVE
'= DULUTH GA 30097-7961 Swipe 5 YTD Reward: 0.95
w�
�_- Page: 1 of 3
Your current Member Loyalty Rewards level is Platinum.
Your aggregate balance as of July 1st is $60,022.43.
An aggregate balance of$75,000 and having 3 products
will move you to the Titanium level.
You can now deposit your checks using a mobile device!
See the enclosed insert for more details.
CHECKING ACCOUNTS
0011 -CHECKING
Date Transaction Description Additions Subtractions Balance
dun 25 Balance Forward 12,497.04
Joint Owner: THOMAS N SHIREY JR
Jun 26 Check 001082 Tracer 0028831795 49.65- 12,447.39
Processed Check - TruGreen TYPE: CHECK PYMT 0: 0480000472
DATA: 0000000001 041204975
Jun 28 Check 001083 Tracer 0001111692 65.00- 12,382,39
Jun 29 Deposit Transfer From Share 0000 1,361.00 13,743.39
Jun 30 Deposit 225.00 13,968.39
Jun 30 Deposit Dividend 0.100% 1.06 13,969.44
Annual Percentage Yield Earned 0. 100 hom 0610112012 through 0613012012
Based on Average Da#y Balance of 12,797.22 *P
Jul 02 Deposit Transfer From Share 0000 238.00 14,207.44
Jul 02 Deposit 300 00 14,507.44
Jul 02 Check 001087 Tracer 0498590140 k t 75.00- 14,432.44
Processed Check - FIA CardServices ,
TYPE: CHECK PYMT 10: 2200000005 DATA: 18004212110
Jul 02 Check 01089 Tracer 049858702 80.00- 14,352.44
Processed Check - FIA CardServices '
TYPE: CHECK PYMT 10: 2200005 DATA: 18004212110
Jul 02 Check 01090 Tracer 001272028 825.00- 13,527.44
Jul 03 Check 01088 Tracer 015323893 ”-. 70.65- 13.456.79
Processed Check - Centurylink ,
TYPE: BILL PYMT 10: ,420297M
Jul 03 Check 010&5 Tracer 5513371977 , , ' ' 200.0- 13,256.79
Processed Check - CAPITAL ONE ARC, '
TYPE: CHECK PYMT 10: 9541719756
Jul 03 Check 01071 Tracer 001122966 100.00- 13,156.79
Jul 04 Withdrawal Transfer To Loan 005 724.98- 12,431.81
TRANSACTION DATE - 07/03/2012
Jul 05 Check 01086 Tracer 0001731889 149.27- 12,282.54
Jul 06 Withdrawal ACH PHP 800-533-5954 19.90- 12,262.64
TYPE: HEALTH DIS ID: 00023944
DATA: 80-533-5964 CO: PHP 80-533-5964
--- Continued on following page ---
Send Inquires lo:
St Main Swltcbbowd: (800)283-2328
5000 Louise 40 Drivc EZ Call: (717)6974372 or(800)2834372 Jun 25, 2012 Ihru Jul 24, 2012
Me Box 40 TOD: (717)0975312 or(800)2832328 ex1.5312 snuaaw
Mechanicsburg,PA 17055 Account Number: 53038
MEMBERS i" www,membarslsLOrg TCIeBron[h: (800)237-7288
Page: 2 of 3
ate Transaction Description Additions Subtractions Balance
Jul O6 Check 001084 Tracer 0022474623 49.73- 12,212.91
Processed Check - Allied Waste Svc _
TYPE: CHECK PYMT ID: 0480001142 DATA: 0000100000 041204975 _
Jul 09 Deposit by Check 647.54 12,860.45
Jul 10 Withdrawal 39.99- 12,820.46
Jul 10 Withdrawal 12,520.46- 300.00
Jul 10 Check 001091 Tracer 0001120871 198.00- 102.00
Jul 18 Check 001092 Tracer 0001278409 10.00- 92.00
Jul 24 Ending Balance 92.00
w° CHECK SUMMARY
o-
Check # Amount Date Check # Amount Date
001071 100.00 Jul 03 001067 75.00 Jul 02
001082' 49.65 Jun 26 001088 70.65 Jul 03
001083 65.00 Jun 28 001089 .80.00 Jul 02
001084 49.73 Jul 06 001090 825.00 Jul 02
001085 200.00 Jul 03 001091 198.00 Jul 10
001066 149.27 Jul 05 001092 10.00 Jul 18
Asterisk next to number indicates skip in number sequence
12 Checks Cleared for 1,872.30
!SAVINGS ACCOUNTS
0 - REGULAR SAVINGS
Date Transaction Description Additions Subtractions Balance
Jun 25 Balance Forward 16,969.06
Joint Owner: THOMAS N SHIREY JR
Jun 29 Deposit ACH XXVA BENEF 1,361.00 18,330.06
ID: 3111036002 CO: XXVA BENEF
Jun 29 Withdrawal Transfer To Share 0011 1,361.00- 16,969.06
Jun 30 Deposit Dividend 0.250°/a 3.40 16,972.46
Annual Percentage Yield Earned 0.250,16 from 0610112012 through 0613012012
Jul 02 Deposit ACH XXCIV SERV 238.00 17,210.46
ID: 3121736156 CO: XXCIV SERV
Jul 02 Withdrawal Transfer To Share 0011 238.00- 16,972.46
Jul 03 Deposit ACH PERSHING 355.73 17.32R 1
TYPE: BROKERAGE ID: 1132741729 CO: PERSHING
Jul 0 Withdrawal 50.00- 19
ul 10 Withdrawal 1 14,604.05- 2,674.14
Jul 10 Deposit i• 13,844.61 16,518.75
Jul 10 Deposit ) �, 12,520.46 29,039.21
Jul 10 Withdrawal Transfer 29,034.21- 5.00
To THE ESTATE OF C XXXXXXXXXX Share 0000
Jul 2&trding-Balance-__ \! 5.00
005-MONEY MANAGEMENT r
Date Tiansat5t�` escesc' t" //// Additions Subtractions Balance
Jun 25 Balance Forward _ 13.840.26
Joint Owner: THOMAS N SHIRE RJR `L
n 30 Deposit Dividend Tiered Raterr.+-.r �sr+�.� n ,,, r 3.33 13,843.59
Annual P ntage Yield Earned 0.30016%rpm 0610 f1.2012'It ough 0030/2012
Jul 110 Deposit Dividend .EVJLl�,..,rY�=.1=�1�,�:>.`IttJ A. 1.02 13,844.61
Annual Poroentage Yield Earned 0.300%#&rf 0710112012,'throbgh 0710972012
Jul 10 Withdrawal 13,844.61- 0.00
MONEY MANAGEMENT Closed
"'This is the final statement presenting information on this product"'
"' Please retake this final statement for tax reporting purposes
--- Continued on reverse side ---
&EV-1511 EX+y(08-13)
% pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
CHRISTA SHIREY 577629888
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:,
1' tHOFFMAN ROTH FUNERAL HOME ! 7,859.48
_ -- — --
L 2' (FUNERAL CATERING FOOD _ V _ 737.06
B. ADMINISTRATIVE COSTS: -���■++�
I. Personal Representative Commissions:
Name(s)of Personal Representative(s)
Street Address
City State—zip
Year(s)Commission Paid:
Z. Attorney Fees: y
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation.)
Claimant .
Street Address
qty State_ZIP
Relationship of Claimant to Decedent
1 4
4. Probate Fees: 27.50
5. Accountant Fees: 890.00
6. Tax Return Preparer Fees: 900.00
7• 'REAL ESTATE TAXES ON REAL ESTATE 2,217.55
- --^-
L e
:OTHER ADMIN COSTS �~ 691.00
C 9 INSURANCE COSTS - � 776.00
❑ F- - -�-- -- - �..._..�
TOTAL(Also enter on Line 9, Recapitulation) $ 14,504.59
If more space is needed,use additional sheets of paper of the same size.
Y
219 North Hanover Street
Carlisle,Pennsylvania 17013
717.243.4511
toll free 1.866.451.4511
rF'rx�dF /'" 7f'df fax 717.243.3723
wv hoffmanrotncom
FUNERAL HOME & CREMATORY, INC. Info@hoffrnanroth.com
July 24, 2012
Thomas N. Shirey, Jr.
1937 Misty Woods Drive
Duluth, GA 30097
Statement of Funeral Expenses for: Christa Shirey
Date of Death: July 7, 2012 Account Id: 16596-159
PACKAGE:
Traditional Funeral Service
TRADITIONAL FUNERAL SERVICE PACKAGE $ 4,850.00
Sub Total: $ 4,850.00
MERCHANDISE:
Casket: Highland Cabernet $ 2,550.00
Sub Total: $ 2,550.00
TOTAL FUNERAL HOME CHARGES: $ 7,400.00
CASH ADVANCES:
10 Certified Death Certificates at$6.00 each $ 60.00
Newspaper Notice- Sentinel $ 100.48
Clergy $ 100.00
Flowers $ 159.00
Hairdresser $ 40.00
Sub Total: $ 459.48
Total Funeral Expense: $ 7,859.48
Balance: $ 7.859.48
Please return this portion with your Remittance. 1 I In
� I3(
$ Amount Enclosed
Christa Shirey CV — -0 to
Service ID#: 16596-159
SERVING OUR COMMUNITY SINCE 1907
♦ r �
REV-1512 EX+(12-12)
INpennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
CHRISTA SHIREY 577629888
Report debts Incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. CAPITAL ONE CREDIT CARD 6,324.25
2 M1 AUTO LOAN 14,604.00
3 M1 VISA 39.99
4 BANK OF AMERICA VISA#4313070120952905 2,340.13
5 BANK OF AMERICA CARD 95466320151791918 1,597.81
TOTAL(Also enter on Line 10, Recapitulation) $ 24,906.18
If more space is needed,Insert additional sheets of the same size.
C Y
Capital.0 e-
Account No. in g Balance ference No. For the Estate of:
************6742 /16324.25 0045474 CHRISTA N
--------- SHIREY
August 01,2012
Dear THOMAS N SHIREY:
Toll-Free:877-326-5680
Please accept out sincere condolences on the passing of CHRISTA N SHIREY.We Fax:877-326-5689
understand that you may be going through a very difficult time.
We wish to talk to the person handling the estate of CHRISTA N SHIREY. If you are
not that person,we'd appreciate it if you'd please call us with the contact information for
that individual. Please know the estate is responsible for this debt,not you personally.
You can reach us toll-free at 1-877-326-5680. Our office hours are indicated to the right.
Once again,we are very sorry for your loss. If you have any questions,we're here to help.
For helpful information for survivors and personal representatives of an estate,please
visit www.mywayforward.com.* 7:00 am-9:00 pm CT(M-Th)
7:00 am-5:00 pm Cl'(F)
Cordially, 8:00 am-12:00 pm CT(Sa)
Capital One Estates Can Team
*This site is for informational purposes only and is not affiliated with Capital One.
Please aaept this letter as a notice of claim.
NOTICE: PLEASE SEE REVERSE SIDE FOR IMPORTANT INFORMATION
7601 Penn Ave South,
Suite A650
***Detach Lo Porion and Retmn with Peymmtt** Minneapolis,MN 55423-5007
f o
Send Inquires to:
��St 5000 Loulso Drive Main Switchboard: (800)283-2328
PO Box a0 TD Call: (717)897-0372 or(800)283-4312 Jun 25, 2012 lhru Jul 24, 2012
i Mechanicsburg,PA 17055 TDD: (717)8BA5312 or(gOD)283-2328 ext.5312 ssu-rmo Account Number: 53038
MEMBERS[- www.rn=bcrslst.org TelcBranch: (800)2377288 Page: 3 of 3
LOAN ACCOU
0005 - INDIR C—T--NEW' U� TOS
Date Tra on Amount Interest Fees Principal .Balance
Jun 25 Balance Forward 15,196.95
Jul 04 Payments Transfer From Share 0011 724.98- 107.92 0.00 617.06- 14,579.89
TRANSACTION DATE - 07/0312012
Jul 10 Payments 14,604.05- .16 0.00 14,579.89- 0.00
INDIRECT NEW AUTOS Closed
777& is the final statement presenting informalbn on 1 rs pro UC1"'
"' Please retain this final statement for tax reporting purposes
2011 Interest Paid 1,943.95
YTD SUMMARIES
TOTAL DIVIDENDS PAID TOTAL LOAN INTEREST PAID
0000 REGULAR SAVINGS 17.61 0005 INDIRECT NEW AUTOS 881.99
0005 MONEY MANAGEMENT 18.65
0011 CHECKING 7.27
Total Year To Date Dividends Paid 43.53
NOTE: Total includes closed shares
Don't forget about our new Member Loyalty Rewards Program.
The more products you have with us, the more benefits you'll receive.
Ask an associate for details or visit our website at www.memberslst.org for details.
c:
F n U
PENNSYLVANIA 04/14/2007 Ut 17 2 ' y
MOTOR VEHICLE INSTALLMENT SALE CONTRACT, Dated Qf� ;i APR 18 2007
ANNUAL FINANCE Amount Financed Total of Pa t Total Sale Price
PERCENTAGE RATE CHARGE The amount of credit provided Theamounlypuwillhav ' sfte?,you The total cost of your purchase on
The cost of your credit ac The dollar amount the to you or on your behalf. have made all scheduled payme 'Ur credit,including your downpaymenl
a yearly rate. r credit will cost you. - of$ 2457.47
8. 7 % E $ 45275. 19 $ 60898.32 3 63355. 79
Your Pa menl Schedule will be: Security; You are giving a security interest in the motor vehicle being
No.of Payments Amount of Payments When Payments Are Due purchased.
84 $ 724.98 Monthly,beginning 05/2912007 . Prepayment: If you pay off early,you will not have to pay a penalty.
$ N/A —�
. Filing Fees:$ N/A
Late Charge:ll a payment is late,you will he charged 2%of the portion of the payment which is late for each month,or part of a month greater than 10 days,that it remams.unpaid,
See below and any other Contract documents for any additional information about nonpayment,default,any required repayment in lull before the scheduled date•and-prepayment
refunds and Densities. a means estimate
IF YOU DO NOT MEET YOUR CONTRACT
In this Contract OBLIGATIONS,YOU MAY LOSE THE MOTOR
we are 6305 CARLISLE PIKE VEHICLE AND PROPERTY THAT YOU
the SELLER. BOBBY RAHAL LEXUS MECHANICSBURG PA 17050 BOUGHT WITH THIS CONTRACT,AND/OR
Name Address Zip Code MONEY ON DEPOSIT WITH THE ASSIGNEE.
County_(71 IMBERL9ND This Contract is IaEbveen Seller and Buyer.All
disclosures have been made by Seller Seller
You are CHRISTA SHIREY 103 ELM DR. CARLISLE PA 17013 intends to assign this Contract to the Assignee.
the BUYER(S). STEPHEN KASARDA 103 ELM DR. CARLISLE PA 17013 mization of Amount Financed
CUMBERLAND Cesh Ite
Narri Addressies) Zip Cadets)
Pice [including optional service
County,_ritHPICRI AND contract and/or warranties Jn the
amount of $ N/A
If there Is more than one Buyer,each promises,separately and together,to pay all sums due us and to perform all agreements in this Contract. paid to •N/A
TRADE-IN: & intaxaf$ 1'400. 16 I:
You have traded In Cash Price `
the following vehicle: eyYIQ scSizm
Year and Make Description $
Cash Downpayment
If a balance is still awing on the vehicle you have traded in,the Seller will pay off this amount on your behalf.You warrant and represent to us that $
any trade-in is free from lien,claim,encumbrance or security interest,except as shown in the`Itemization of Amount financed'as the*Lion Payoff.'
PROPERTY INSURANCE:You may choose the person through whom insurance is-obtained against loss,or damage to the Vehicle and against Trade-in
liability arisingout of use of ownership o1 the Vehicle.In this Contract,you are promisingto insure the Vehicle and keep it insured. Value of Trade-In
DEBT CANCELLATION(GUARANTEED AUTO PROTECTION)AGREEMENT IS VOLUNTARY AND NOT REQUIRED AS A CONDITION OF THE $ 22879.00.
CREDIT.This agreement will not be provided unless you sigh below,agree to,pay the aildilional charge,and sign the separate disclosure and Lien Payoff lo: MEMBERS 1ST
agreement page,which is pad of this Contract This agreement Will,appty during the ehtire term of the Contract.This agreement may not cover $ "
your entire indebtedness;see the MAXIMUM PROTECTION amoubtstbfed In the separate disclosure and agreement. Unpaid Cash Price Balance
Typeof Debt Cancellation Agreement Charge T Signature .$ ..E.
Guaranteed auto protection(GAP) $ NSA, By signing,you select guaranteed auto protection Optional Debt Cancellation IGAP)
Signature of Buyer Document Preparation Fee
SERVICE CONTRACT,OR WARRANTY AGREEMENT IS VOLUNTARY AND NOT REQUIRED AS A CONDITION OF THE CREDIT.The service Contract $ nVam
or warranty agreement will not be provided unless you sign the separate-agreement with the third,party provider,who is not the Seller named Paid to Others on Your Behalf
above,and agree to pay the additional charge.This section does not apply to any warranty that you may receive for which there is not separate To Public Oflldels for.
charge.
License,Tags and Registration
CREDIT INSURANCE IS NOT REQUIRED:Credit Life Insurance and Credit Accident&Health (Disability)Insurance are not required to obtain $ 28.50
credit,and will not be provided unless you sign below and agree to pay the additional cost(s). Please read the NOTICE OF PROPOSED CREDIT
INSURANCE on the reverse side.Your insurance certificate or policy will tell you'the MAXIMUM amount of insurance available.All insurance Lien Fee
purchased will be for the term of the credit. We may receive a financial benefit from your purchase of credit insurance. § C; VIA
By signing,you select Single Credit Lire Insurance, What Is your By signing,you select Single Credit Accident& What is your Taxes Not Included in Cash Price
which costs$ NIA age?_Years Health Insurance;which costs N/A age? Years $ N/A
;IA; To NIA
Signature of Buyer to be insured for Single Credit Tilelnsumnce Signature of Buyer to be insured for Single Credit Accident&Health Insurance $ N/q
• I Far Messenger Service
By signing,you both select Joint What am 'By signor&-you both select Joint Credit yVhatam Percentage To NIo
Credit Life Insurance,which costs$�__N/A your ages?Accident&Health Insurance,which costs$__N/N�ur ages? to be
Insured $' N/q
1, % For NIB
rTa Cmdd Insurance Company
1 ' ► At —•
VISAAJGNATURE
CHRISTA N SHIREY
Account Number;4313 0701 2095 2905
July 15-August 14, 2012
A000unt lnfonnatlon:
www,bankofamorim.00m Payment Information Account Summary
Mall billing Inquiries to: New Balance Total.....................................................................$2,340.13 Previous Balance.................... ...$2,340.13
I`.Bank of America Current Payment Due......................................................................$23.00 Payments and Other Credits........ -1-0.00
P.O.Box 982286 Past Due Amount............................................................................$48.00 Purchases and Adjustments....................0.00
El Paso,TX 7MS-2235
Fees Charged....................................................0.00
Melt payments to: Total Minimum Payment Due.........................................................:..$71.00 Interest Charged...............................................0.00
Bank of America Payment Due Date...........-...... ......... ..:9/11/12 -
P.O.Box 16019 Now Balance Total........................$2,340.13
Wilmington,DE 18888.5019 Total Minimum Payment Warning:If you make only the Total Minimum
Customer Servloe: Payment each period,you will pay more in Interest and It Wit take you longer Total Credit Line..........................$20,000.00
L80OA21.2110 to pay off your balance. For example: Cash Credit Line............................$6,000.00
Statement Closing Data...................8/14/12
(1,800-346.3178 T-M If you make no You will payoll And you will end Days In Billing Cycle..................................31
additional charges the balance up paying an estimated
using this card shown on this total of
and each month you stalenu;nt m about
pay
Only the Total 12 years $2.340.13
Minimum Payment
If you would like information about credit counseling services,call
1.866.300.5238.
Transactions —
nenseadon Posthip HelOmncO Account
Date Cars Oaeer0obn Numbs, Number Amount rote/
Interest Charged
08/14 08/14 Interest Charged on Purchases 0.00
08/14 08/14 Interest Charged on Balance Transfers 0.00
08/14 08/14 Interest Charged on Dlr Dep&Chk CBshAdy 0.00
08/14 08/14 Interest Charged on Bank Cash Advances 0.00
TOTAL INTEREST FOR THIS PERIOD $0.00
2012 Total* Year-to-Date
Total fees charged in 2012 $0.00
Total Interest charged in 2012 $191.57
12 0023401300007100000075000004313070120952905
BANK OF AMERICA Account Number: 4313 0701 2095 2906
P.O.BOX 15019
WILMINGTON,DE 19886-5019 New Balance Total ..........................................................$2,340.13
Total Minimum Payment Due............. .....................................71.00
Payment Due Date ...................................................09/11/12
CHRISTA N SHIREY Enter payment amount $
103 ELM DR
CARLISLE PA 17013-8876
Ej Gwocre hem tore chenge cr-111 g eddmss orph.numhars.
Neass Pmost,all conecilons on the mrems Olds.
Mail this coupon along with your ctuok payable to:Bank of Amenoa
I: S 240 2 2 2 SOI: 09400 1 209 S 290 Sllr
I . • R G Mali
BankofAmedca�
CHRISTA SHIREY
Account Number:5466 3201 5179 1918
July 3-August 2,2012
Account Information: - - -
www.bnnkofamerica.com Payment Information Account Summar
Mali tilling inquiries to: New Balance Total. .... ................................. .. ....... ......$1,697.81 Previous Balance .. .. ..... .... .$1,597.81
)`.Bank of America Current Payment Due....................................:.................................$15.00 Payments and Other Credits............
FP.O.Box 982235 Past Due Amount............................................................................$30.00 Purchases and Adjustments....................0.00
El Palo,TX 78998.2235 Fees Charged................................... ;.....0.00
Mail payments to:
Total Minimum Payment Due............................................................$45.00 Interact Charged...............................................0.00
Bank of Amcdca Payment Due Dato...............„.,. ............,...........,.......9/1/12_- _ ._. ...._- _
P.O.Box 15018 New Balance Total........................$1,597.81
Wilmington,DE 19886:6018 Total Minimum Payment Warning:If
g you make only the Total Minimum
Customer So"I”: Payment each period,you will pay more In interest and It will take you longer Total Credit Line..........................$25,000.00
1800.421,2110 to pay o8 your balance.For example: Cash Credit Line...........................$7,500.00
Statement Closing Date.....................8/2/12
(1.800.3465178 TTY) If you make no You will payoff And you will end Days In Billing Cycle..................................31
additional charges the balance up paying an estlnuited
using this card shown on this total of
and each month you statement if,about
pay
Only the Total 9years $1,597.81
Minimum Payment
If you would like information about credit counseling services,call
1.866900.5238.
Transaotlons _. ... _ ... - . . .
Pansectlan A>shng Rmfomnce Account
Date Dare ovs tRWn Number Number Amount total
Interest Charged
08/02 08/02 Interest Charged on Purchased 0.00
08/02 08/02 Interest Charged on Balance Transfers 0.00
08/02 08/02 Interest Charged on Dir Dep&Chk CashAdv 0.00
08/02 08/02 Interest Charged on Bank Cash Advances 0.00
TOTAL INTEREST FOR THIS PERIOD $0.00
2012 Totals Year-to-Date
Total fees charged In 2012 $25.00
Total Interest charged In 2012 $112.14
------- ---- ---- --- - ----------- ---- --- ---- .---- -`- - - ---- -
03 001597810000450000008000000.5466320151791918
BANK OF AMERICA Account Number: 5466 3201 5179 1818
P.O.BOX 15019
WILMINGTON,DE 18886-5019 New Balance Total..........................................................$1,597.81
Total Minimum Payment Due...................................................45.00
Payment Due Date ...................................................09/01/12
CHRISTASHIREY Enter payment amount $
103 ELM DR
CARLISLE PA 17013.6876
Check hale fore change ormellingaddmaa orphmre mlmbors.
P/BBBB poNOB Bl/00/IBONOOB N!Me m1erBB a/dB.
Mall this coupon along with your check payable to:Bank of America
1: 5 240 2 2 2501: 15540 L5179L9LBIIe
as
I
REV-1513 EX+(01-10)
jpennsylvania SCHEDULE J
DEPARTMENT UP REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT '
ESTATE OF: FILE NUMBER:
CHRISTA CHIREY 577629888
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS(Include outright spousal distributions and transfers under
Sec.9116(a)(1.2).)
I. `MARE N E ROSS (GRANDCHILD — 10000
C `GRIFFEN ROSS GRANDCHILD _ 10000
[73$ JACKSON ROSS GRANDCHILD 10000
8 `RACHEL SHIREY - iGRANDCHILD Yom ' 10000
} 5, )CALVIN SHIREY GRANDCHILD �� 10000
C `STEPHEN DUNST BOTHER -' ^J 10000
' 7' RENEDUNST 'OTHER
8 ITOMSHIREY - 'SOr N- - ii 132411
! 9 NANEr TTE ROSS �i- }DAUGHTER ^ ,', 132411
_,_J �.
r7 STEPHEN KASARDA T r-- _ _ (FIANCE'-COMMON LAW 28286
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS -
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT TAKEN:
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:..._
❑I _
TOTAL OF PART H–ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $,
r
If more space is needed,use additional sheets of paper of the same size.