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.� 1505610101 REV-1500 Extai-lo> enns lvania OFFICIAL USE ONLY PA Department of Revenue P Y Bureau of Individual Taxes County Code Year File Number OEOANTMEN Oi OEVEMVE PO BOX 28o6oi INHERITANCE TAX RETURN Harrisburg PA 17128-o6oi RESIDENT DECEDENT 3 8 3 7 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 71A1.111.31 / ! / / 19 L5 1,01 Decedent's Last Name Suffix Decedent's First Name MI 1,4141T IA I I I I I I I I FR 14,*191LI I I I I ® E] (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI 14/1hi I I I I I I I I I I I I I I I I I=, 0 Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE TTl REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ® 1.Original Return O 2.Supplemental Return O 3. Remainder Return(date of death prior to 12-13-82) p 4.Limited Estate O 4a. Future Interest Compromise(date of O 5. Federal Estate Tax Return Required death after 12-12-82) 6. Decedent Died Testate O 7.Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 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 Sch.O) CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone,-Number CN ,4QLE C- SN / LDS 1 I /1/ 11 tZW1 7 06 o9 Clgk6i}ST�R OF ikl_S�E&LY rn N First line of address N CS --p -rt Yl 6 CL0451d' 0 b Q ° :::3 Second line of address O N r— rT1 City or Post Office State ZIP Code DATE FILED 1P?j.rjCjff JAW111CIS123144 G ! 0 9 7 3 Correspondent's e-mail address: C ecg�7%e(Cys 3Q t!!O/f�G'C!F vie 9t 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. SIGNATU F PERSO�P FO ILING RETURN DATE Q,EJE. ^2d Zvi ADDRESS A r %Lane, Meekan;es A&I, 9.4 17055' SIGNATURE��R OJkiER T EP �VE DATE ADDRESS CNI¢IZL ES E. S11 EZIbS 1 lO C/0A1S6- (i7d, GC�Ql1/G'SOG19� I'si/70.SS PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610101 1505610101 J 1505610105 REV-1500 EX Decedent's Social Security Number Deoedent's Name: RECAPITULATION �? 1. Real Estate(Schedule A). ......:......... ............ ........:... L 1 + O O D •�O D - •- --._ 2. Stocks and Bonds(Schedule B) ........:............................... 2. IL 26 a' i '•{3 S 3. Closely Held Corporation,Partnership or Sole-Propdetorship(Schedule C) .,... 3. . 0 4. Mortgages and Notes Receivable(Schedule D)....................... .... 4. 11C .)('9 Q 5, Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E).... ... 5, j J p y 6 $' • rQ 7 6. Jointly Owned Property(Schedule F) p Separate Billing Requested ....... 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) p Separate Bitting Requested........ 7. ............ �` • .7 S $ 8. Total Grass Assets(total Lines 1 through 7).... ...... .... 6. 9, Funeral Expenses and Administrative Costs(Schedule H).. ..... .... ........ 9. © Q D ( .a; 7 % Debts of Decedent,Mortgage Liabilities,and Liens(Schedule 1) .............. 10. 3-ryi & �a y ,,tl� 11. Total Deductions(total Lines 9and tO)......... ..... ..... ... ........... i1. J• Y�`---'---'���!��r -f, 12. Net Value of Estate(Line 6 minus Line 11) .. ..... ....................... 12. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which ` an election to tax has not been made(Schedule J) ;.. :. - . .._.... 13. io 14. Net Value Subject to Tax(Line 12 minus Line 13) ........................ 14. TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec,9116 (a)(12)X.OlL .100 15. 1 F. 16. Amount of Line 14 taxable - - "+ •JF----k'f at lineal rate X.043* 2y z_, �QD.>_.s y 16. 17. Amount of Line 14 taxable TIF at sibling rate X.12 Q 17. (� 16. Amount of Line 14 taxable at collateral rate X.15 •�O Q 16. •� 19. TAX DUE ............. .............. ......................::...... 19. 20, FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT p Side 2 1505610105 1505610105 J COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280601 HARRISBURG,PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 017755 ARTZ EARL F JR 1 ARGALI LANE MECHANICSBURG, PA 17055 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- fold ---------- -------- 101 $4,750.00 ESTATE INFORMATION: SSN: FILE NUMBER: 2113-0375 DECEDENT NAME: ARTZ EARL F DATE OF PAYMENT: 06/17/2013 POSTMARK DATE: 06/14/2013 COUNTY: CUMBERLAND DATE OF DEATH: 03/17/2014 TOTAL AMOUNT PAID: $4,750.00 REMARKS: RCPT TO ATTY DB1 CHECK# 123 INITIALS: D131 SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS TAXPAYER REV-1502 EX+(6-98) SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Far] F. tft-Tz ;1`13 -375 All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined`as the price at which property would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. ale a v[2S;den�'�ct Deal Fsf&Ie, loea;t'Gd dtl loq C o e,kle ys Dr ) Copper ,41lew Cum br,r4nd Nu-rely, PennsylilQnI'a �v pall"d w. F�Isbur9 , Sef�lernent on Nor. aa, avi3 3S" 719 d. DO Sf:e S6111eme,1Z Sheef y deel �f Cmr� ahce Q ached) �. vrfe;lure ©r down Money Pe-► +crr»s n� publ-c QjLtJ-;0n he" on Pt�crni scs °h T n e 24, 9D15 CJne n btcy�r d �'a u,I f e,ql �u1cl TOTAL(Also enter on line 1, Recapitulation) $ ( g 700, mo (If more space is needed,insert additional sheets of the same size) Tax Parcel Number: 42-30-2108-139 THIS INDENTURE MADE THE I n day of Nod. , in the year of our Lord two thousand and seven(2013). BETWEEN EARL F. ARTZ,JR., as Executor of the Estate of EARL F. ARTZ a.k.a. EARL F. ARTZ, SR., deceased, late of the Mechanicsburg, Upper Allen Township, Cumberland County, Pennsylvania, Grantor, and DAVID W.FELSBURG rYt , currently of Enola, East Pennsboro Township, Cumberland County, Pennsylvania, Grantees. WHEREAS, the said Earl F. Artz a.k.a. Earl F. Artz, Sr.,was vested in his lifetime with title to the premises hereinafter described, in Mechanicsburg, Township of Upper Allen, County of Cumberland and Commonwealth of Pennsylvania; and WHEREAS, the said Earl F. Artz a.k.a. Earl F. Artz, Sr, departed this earthly life, testate, on the 17`h day of March, 2013, and Letters Testamentary were duly issued to the said Earl F. Artz, Jr.,by the Register of Wills of said Cumberland County, docketed to No. 21-13-0375; and WHEREAS, the lands herein-mentioned were not specifically devised: NOW,THEREFORE,THIS INDENTURE WITNESSETH, that the said Earl F. Artz, Jr.,Executor, as aforesaid, for and in consideration of the sum of ONE HUNDRED THIRTY- EIGHT THOUSAND SEVEN HUNDRED and No/100ths ($138,700.00)DOLLARS, and other good and valuable considerations, to him in hand paid by the said Grantees, at and before the ensealing and delivery hereof, the receipt whereof is hereby acknowledged, has granted, bargained, sold, aliened,released, and confirmed, and by these presents,by virtue of the power and authority in him vested by the Fiduciaries Act of the Commonwealth of Pennsylvania, does grant,bargain, sell, alien, release, and confirm unto the said Grantees, their heirs and assigns: ALL THAT CERTAIN piece or parcel of land situate in the Township of Upper Allen, County of Cumberland, and Commonwealth of Pennsylvania, being bounded and described as follows: BEGINNING at a point on the western line of Cockleys Drive on the hereinafter mentioned Plan of Lots at the southeastern corner of Lot No. 8 on said Plan; thence by the dividing line between Lots No. 8 and 9 on said Plan, South 63 degrees 15 minutes West, a distance of one hundred ninety-one and eighty-five one-hundredths (191.85) feet to a point; thence by other lands now or formerly of Jacob S. Stoner and Alverta B. Stoner, his wife, South 4 degrees 2 minutes West, a distance of ninety-eight and ninety-four one-hundredths (98.94) feet to a point; thence by the dividing line between Lots No. 9 and 10 on said Plan,North 63 degrees 15 minutes East, a distance of two hundred forty-two and forty-nine one-hundredths feet (242.49) feet to a point on the western line of Cockleys Drive; thence by the western line of Cockleys Drive,North 26 degrees 45 minutes West, eighty-five (85) feet to a point, the place of BEGINNING. BEING Lot No. 9 in the Plan of Lots of Jacob S. Stoner, Section I —Tract 2, which Plan is of record in the Cumberland County Recorder's Office in Plan Book 10,Page 53. SUBJECT, NEVERTHELESS, to the restrictions and reservations of record with said Plan, and subject, also, to the set-back lines shown thereon. BEING the same premises which Earl F. Artz and Doris A. Artz, his wife, by their deed dated November 29, 1965, and recorded on December 1, 1965, in the Recorder of Deeds Office in and for Cumberland County, Pennsylvania in Deed Book "U", Volume 21, Page 1143, granted and conveyed to Earl F. Artz and Doris A. Artz,his wife. The said Doris A. Artz departed this earthly life on August 3, 2006,whereupon full and absolute title to the said premises vested in the said Earl F. Artz by the laws of the Commonwealth of Pennsylvania incident to tenancies by the entireties. His said Estate is the Grantor herein. TO HAVE AND TO HOLD the said messuage or tenement and tract of land, hereditaments and premises hereby granted and released, or mentioned and intended so to be, with the appurtenances,unto the said Grantees, their heirs and assigns,to and for the only proper use and behoof of the said Grantees, their heirs and assigns, forever. AND THE SAID GRANTOR,Executor, as aforesaid, his successors and assigns does covenant,promise and agree to and with the said Grantees, their heirs and assigns, by these presents, that the Grantor has not done, committed any act, matter or thing whatsoever whereby the premises hereby granted, or any part thereof, is, are, shall or may be impeached, charged or encumbered in title, or otherwise howsoever. IN WITNESS WHEREOF,the said Executor of the Estate of Earl F. Artz a.k.a. Earl F. Artz, Sr., deceased, Grantor herein,has hereunto set his hand and seal the day and year first above written. Signed, Sealed and Delivered in the Presence of- (SEAL) EARL F. Z . R.,txecutor of the Estate of EARL F. ARTZ a.k.a. EARL F. ARTZ, SR.,Deceased i h OMB Approval No.2502-0265 A. Settlement Statement (HUD-1) FINAL �B.Type of Loan 1.❑FHA 2.❑RHS 3.❑Conv.Unins. 6.File Number: 7.Loan Number: 8.Mortgage Insurance Case Number: 13-1942GC 0421378878 101060654088 4.❑X VA 5.❑Conv.Ins. C.Note:This form is furnished to give you a statement of actual settlement costs.Amounts paid to and by the settlement agents are shown Items marked "(p.o.c)"were paid outside the closing:they are shown here for informational purposes and are not included in the totals. D.Name&Address of Borrower: E.Name&Address of Seller: F.Name&Address of Lender: David W.Feisburg The Estate of Earl F.Artz Wells Fargo Bank N.A. 11 Fortuna Lane,Enota,PA 17025 104 Cockleys Drive.Mechanicsburg,PA 17055 2701 Wells Fargo Way,Minneapolis,MN 5446, G.Property Location H.Settlement Agent: 1.Settlement Date:11122/2013 104 Cockleys Drive Guardian Transfer Corporation Disbursement Date:11122/2013 Mechanicsburg,PA 17055 4075 Market St-,Camp Hill,PA 17011 Upper Allen Township I 717-909-4700 I Place of Settlement: TitleExpress 4075 Market Street,Camp Hill,PA 17011 Printed 1 V22/2013 at 9:25 am by SLC 'J.Summay of Borrowel's Transaction K.Summary of Sellers Transaction 100. Gross Amount Due from Borrower 400. Gross Amount Due to Seller_ 101. Contract sales price 138,700.00 401. Contract sales price 138,700.00 102. Personal property 402. Personal Property 103. Setliement charges to borrower(line 1400) 8,507.21 403. 104. 404. 105. 405. Adjustments for Items paid by seller In advance Adjustments for items paid-by seller in advance 106. City/town taxes to 406. City/town taxes to 107. County taxes 11/22/2013 to 12/312013 76.06 407. County taxes 11/2212013 to 121312013 76.06 108. School taxes 11122/2013 to 06/30/2014 1,193.08 408. School taxes 11/22120131006/302014 1,193.08 109. Sewer O/N/D 11/222013 to 12/312013 48.70 409. Sewer 0/N/D 11/22/2013 to 121312013 48.70 110_ 410. 111, 411. 112. 412. 120• Gross Amount Due from Borrower 148,525.05 420. Gross Amount Due to Seller. 140,017.84 200. Amounts Paid by or in Behalf of Borrower 500. Reductions In Amount Due to Seller 201. Deposit or earnest money 501. Excess deposit(see instructions) 202. Principal amount of new loan(s) 143,200.00 502. Settlement charges to seller(fine 1400) 10,423.46 203. Existing loans)taken subject to 503. Existing loan(s) taken subject to 204. 504. Pa off of first mortgage loan 205, 505. Payoff of second mortgage loan 206. Sellers Assistance 5,586.71 506. Sellers Assistance 5,586.71 207. Sellers Assistance towards appraisal fee 25.00 507. Sellers Assistance towards appraisal fee 25.00 208. Sellers Assilance towards final inspection 100.00 508. Sellers Assitance towards final inspection 100.00 209. 509. Adjustments for hems unpaid by seller Adjustments for items unpaid by seller 210. City/town taxes to 510. City/town taxes to 211. County taxes to 511. County taxes to 212. School taxes to 512. School taxes to 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. Total Paid by/for Borrower 148,911.71 520. Total Reduction Amount Due Seller 16,135.17 300. Cash at Settlement fromho Borrower 600. Cash at Settlement tolfrom Seller 301. Gross amount due from borrower(line 120) 148,525.05 gp1, Gross amount due to seller(line 420) 140,017.81 302. Less amounts paid by/for borrower(line 220) 148,911.71 602. Less reductions in amount due seller(line 520) 16,135.1( 303. Cash ❑ From X❑ To Borrower 386.66 603. Cash [j] To ❑ From Seller 123,882.6 epo np u cn or rs o e ono rn arena ron rs e a mina es per response w e inp,revievnrp,a repo inp e e a. 5 ag-n may no w e ,s m orm ^ou are n mpuv e c _ nis bnn unless X nisplaya•Wnenlly velq OMB wnlml numbers No mnfgenllalfly is essureG:Inis Oi>tlo>uro is maneemry.Tbis�s OOSyneU to pmvge me panics b•RESPA paveroE Innsedron w[ ,MOrmabon dump Inc m senremem p.ocess Previous editions are obsolete Page 1 of 4 HUC 700. Total Real Estate Broker Fees. $8,176.20 Paid From Paid From Divisionofcommission line 700 as follows: 7 Borrower's Seller's 701. $4,238.10 to Coldwell Banker Homestead Group Funds at Funds at 702. $3,938.10 to Coldwell Banker Homestead Group Settlement Settlement 703. Commission paid at settlement 8,176.20 800, Items Payable in Connection with Loan 801. Our origination charge (Includes Origination Point 0.000%or$0.00) $ (from GFE#1) 802. Your credit or charge(points)for the specific interest rate chosen $-1,253.00 (from GFE#2) 803. Your adjusted origination charges (from GFE A) -1,253.00 804. Appraisal fee to RELS Valuation $375.66 P.O.C.B'(from GFE#3) 997 805. Credit report to Corelogic Credco LLC $11.00 P.O.C.B'(from GFE#3) j 806. Tax service to from GFE#3 807. Flood certification to from GFE#3 808. to 900. Items Required by Lender to be Paid in Advance , 901. Daily interest charges from from 11/2212013 to 12101/2013 @$16.67001day (from GFE#10) 150.03 902. Mortgage insurance premium for months to (from GFE#3) 903. Homeowner's insurance for 1 ears to Erie Insurance (from GFE#11) 561.00 904. VA Funding Fee for months to Dept of VA (from GFE#3) 4,577.10 1000. Reserves Deposited with Lender 1001. Initial deposit for your escrow account (from GFE#9) 1,051.74 1002.Homeowner's insurance 3 months $ 46.75/month $140.25 1003.Mortgage insurance 2 months @$ 0.001month $ 1004.Property taxes 2 months @$ 0.00 1month $ 1005.County taxes 10 months $ 57.831month $578.30 1006.School taxes 6 months @$ 164.21/month $985.26 1007.Aggregate Adjustment $-652.07 1100.Title Charges 1101.Title services and lender's title insurance from GFE#4 1,345.00 30.00 1102. Settlement or closing fee to $ 1103.Owner's title insurance-First American Title Insurance Company $ from GFE#5 1104. Lenders title insurance-First American Title Insurance Company $1,120.00 1105. Lenders title policy limit$143,200.00 Lender's Policy 1106. Owners title policy limit$138,700.00 Owner's Policy 1107.Agent's portion of the total title insurance premium $952.00 to Guardian Transfer Corporation 1108. Underwriter's portion of the total title insurance premium $168.00 to First American Title Insurance Company 1109. 100 No Vio11100 to First American Title $50.00 Insurance Company 1110. 300 Survey1300 to First American Title $50.00 Insurance Company 1111. 900 EPL-Res18.1 to First American Title $50.00 Insurance Company 1112.ClosingSvcLtrlCL to First American Title $75.00 Insurance Company 1200.Govemment Recording and Transfer Charge' 1201.Government recording charges $ (from GFE#7) 170.00 1202- Deed$67.00 Mortgage$103.00 Release$ 1203. Transfer taxes $ (from GFE#8) 1,387.00 1204-City/County tax/stamps Deed$1,387.00 Mortgage$ 1205. State Tax/stamps Deed$1,387.00 Mortgage$ 1,387.0( 1206. Deed$ Mortgage$ 1207. $ 1300.Additional Settlement Charges 1301.Required services that you can shop for (from GFE#6) 119.00 1302. Home Inspection Fee to Alpha Home Inspection 300.00 1303. Home Warranty Fee to American Home Shield 520.0( 1304. Sewer Due J/A/S&O/N1D to Upper Allen Township Authority 235.2( 1305. Pest Inspection to Alpha Home Inspection $ 75.0( 1306. Tax Service Fee to Wells Fargo Real Estate Tax $100.00 1307. Flood(Life of Loan) to Wells Faro Flood Services $19.00 r r r . r 8,507.21 10,423.46 'Paid outside of closing by(B)orrower,(S)eller,(L)ender,(I)nvestor,Bro(K)er."Credit by lender shown on page 1.-Credit by seller shown on page 1. Previous editions are obsolete Page 2 of 4 HUD Comparison of Good Faith Estimate.GF and HUD-1 Charges Good Faith Estimate . HUD-1 Cha es'That Cannot Increase •HUD-1 line Number Our origination charge s;;. . # 801 0.00 0.00 Your credit or charge(points)for the specific interest rate chosen # 802 . -895.00 -1,253.00 Your adjusted.origination charges # .803 -895.00 -1,253.00 Transfer taxes 1203 2,774.00 1,387.00 Charges That in Total Cannot Increase More Than 101/6 Good Faith Estimate: HUD-1 Government recording charges' # 1201 . 190.00 170.00 Appraisal fee # 804 375.00 475.00 Credit report # 805 11.66 11.00 VA Funding Fee # 904. 4,577.10 4,577.10 Tax Service Fee # 1306 100.00 100.00 Flood(Life of Loan) # 1307 19.001 19.00 w #. 5,272.761 5,352.10 Increase between GFE and HUD-11 $ 79.34 or 1.5047% ChargeiThat Can Chen e. Good'Faith Estimate HUD-11 Initial deposit for your escrow accodnt # 1001 2,965.00 1,051.74 Daily interest chargesfmm„ If 901 $16.6700/day 150.03 150.03 Homeowner's.insuranoe # 903 960.00 561.00 Title services and lender's title insurance If 1.101 1,907.58 1,345.00 Owner's title insurance-Firs t American Title Insurance Company # 1103 10.00 0.00 Pest Inspection # 1305 0.00 0.00 Loan Terms Your initial loan amount is $143,200.00 Your loan term is 30.years Your initial interest rate is 4.2500% Your initial monthly amount owed for principal,interest,and any mortgage $704.46 includes insurance Is ❑X Principal ❑X Interest ❑Mortgage Insurance Can your interest rate rise? , ❑X No. ❑Yes,it can rise to a maximum of %. The first change Will be on I ! and can change again every years after I 1 Every change date,your interest rate can increase or decrease by °b. Over the life of the loan,your interest rate is guaranteed to never be lower than %or higher than %. Even if you make payments on time,can your loan balance rise? ❑X No. ❑Yes,it can rise to a maximum of$ Even if you make payments on time,cait.your monthly amounnt owed for ❑X No. ❑Yes,the first increase can be on / I and the monthly principal',interest,and mortgage insurance rise?. amount owed can rise to$ The maximum it can ever rise to is$ Does your loan have a prepayment penalty? ❑X No. ❑Yes,your maximum prepayment penalty is$ Does your loan have a balloon payment?, K No. ❑Yes,you have a balloon payment of$ due in S years on I 1 Total monthly`•ainount 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. ❑X You have an additional monthly escrow payment of$268.79 that results in a total initial monthly amount owed of$973.25. This includes principal,interest,any mortgage insurance and any items checked below: X❑Property taxes El Homeowner's insurance ❑Flood insurance E)School Taxes ❑ ❑ Note: If you have any questions about the Settlement Charges and Loan Terms listed on this form,please contact your lender. Previous editions are obsolete Page 3 of 4 HUD- _SIgnature Page HUD CERTIFICATION OF BUYER AND SELLER I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief,it is a true and accurate statement of all receipts and disbursements made on my account or by me in this transaction I further certify that 1 have received a copy of the HUD-1 Settlement Statement. David W.Felsburg The Estate of Ead F.Artz / Agent:Ead F.Adz,Jr.,Ex for Sefflement Agent The HUD-1 Settlement Statement which I have prepared is a true and accurate account of this transaction.I have caused or will cause the funds to be disbursed in accordance with this statement. SETTLEMENT AQX DATE WARNING:IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM.PENALTIES UPOI CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT.FOR DETAILS SEE TITLE 18:U.S.CODE SECTION 1001 AND SECTION 1010. Previous editions are obsolete Page 4 of 4 HUD- Itemization of Line I r Name of Borrower: Name of Seiler: File Number: David W.Felsburg The Estate of Earl F.Artz 13-1942GC Prepared 1112212013 at 9:25 am Note:This page displays an itemization of the charges shown on line 1101 of the HUD-1 Settlement Statement.This page accompanies but is not a part of the HUD-1 Settlement Statement If a discrepancy exists,the information on the HUD-1 Settlement Statement applies. 1100.Title Charges, Total Charge Borrower Seller 1101.Title services and lender's title insurance to Notary Fee-Sellers to Guardian Transfer Corporation $ 15.00 15.0( Tax Cert Reimbursement Fee to Guardian Transfer Corporation $ 15.00 15.0( 1102.Settlement or closing fee to $ 0.00 1104.Lender's title insurance-First American Titto First American Title Insurance G$ 1,120.00 1,120.00 1109.100 No Vio11100 to First American Title Insurance G$ 50.00 50.00 1110.300 Survey1300 to First American Title Insurance G$ 50.00 50.00 1111.900 EPL-ReA.1 to First American Title Insurance Cr$ 50.00 50.00 1112.ClosingSvcLtrlCL to First American Title Insurance Cr$ 75.00 75.00 Totals: $ 1,375.00 0.001 1,345.00 30.0( Seller/Lender credits shown on page 1.: POC=Paid Outside Closing CR=Lender Credit Previous editions are obsolete Page 1 of 1 HUD REV-1503 EX+(6-98) a SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER o,rl F bfz -13 37S All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 5er;e.s EE 13ond5 &,nd Serias F Bonds of V4rld9w c/a es 4*d de/7 m,'17a on 3;,67 A7 see l�Cilil�lfio� Ca/c k/a�'ons 2�a cl,�� 2, dries )VII .13nds 1.see ;Ion;4a aJLom a 1x,:Aa) X17, 00,9- oD 3 A0 shires W CoMmon sfDck o� 1)?dZ;fie, Zno. h 9� 14.2 ,o w 3 7 .9- a = 3 S L 9. 9 ✓ S4 o�e x rSee Yalmohdh Ca/eu/414"Pos Maf eky) TOTAL(Also enter on line 2,Recapitulation) $ a 6, 35/,3$' (If more space is needed,insert additional sheets of the same size) Calculated Value of Your Paper Savings Bond(s) Calculator Results for Redemption Date 03/2013 Total Price Total Value Total Interest YTD Interest $887.50 $5,267.27 $4,379.77 $0.00 Bonds: 1-9 of 9 Serial # Series Denom Issue Next Final Issue Interest Interest Value Note Date Accrual Maturity Price Rate D841286EE: EE 9241982' 02/2012: $250.00 _$ 219.00'! '$1,469.00! MA D841287EE; EE $500;02/1982f 02/2012! $250.00: $1,219.W1 :$1,469.00: MA ----- .. ---------"------------11— 11 R5207955EE, EE $2W08/1981i 108/2011; $100.00: $487.60' ! $587.60; MA ------------------- $256.88: $306.88� MA C6024751EE: EE $100tll/1980, 11/2010: $50.001 -------------------- ----------- C6024750EE: EE J------------- - $100: 11/1980: 11/2010; 11/2010* $50.00-; ---$---2-5---6-.-8-8 : $306.881 M A ^ ' - - -, - , ' ------------------------------------ --------- ----------------C6024749EE---EE $100; 11/1980' 11/2010! $50.00; $256.88 w F $306.88; MA C6024752EE: EE 11/1980 11/2010; $50.00 $256.88: MA T C2184942EE EE $IW,08/1981�, 08/2011' $50.00: $243.80: $293.80 I I I MA ---------- ----------- ----------1-11-1-1------------------- -IK1267040EE: EE $75'08/1981? 08/2011" $37.50: $182.85: $220.35' MA ---------- -------------- ------------------I Totals for 9 Bonds: $887.50 $4,379.77: $5,267.27: Notes NI Not Issued NE Not eligible orpayment Includes 3 month interest p en alty -------------------------------------------------------- MA- Matured and not earning interest i I i _........ ....__._._.I_ .°. __.. 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Search C in2t Ce �Stgnt16,Veb Mail Fri,Dec 20,2013,8:12AM EST-US Markets open in 1 hr and 18 mins ....................__.........._._......._... y6' Fldelt3l®Gash Y, Management imsAccount MettLife,Inc.(MET) -NYSE 1R Follow Add to Portfolio Like 88 52.27 T 0.37(0.71%) Dec 19,4:04PM EST Historical Prices Get Historical Prices for. E03' Set Date Range 15 Daily Start Date "a1 17 2013 Eg.Jan 1,2010 Weekl ...__.:........_ y End Date: 3utar� ' LEI Monthly Dividends Only :Get�Rrices First I Previous I Next I Last Prices Date Open High Low Close Volume Adj Close' Mar 15,2013 40.01 40.28 39.79 40.20 10,700,900 39.48 Close price adjusted for dividends and splits. First I Previous I Next I Last ,�{{ t�'tDownloadtoSpreadsheet �D.o1 - Z ty Currency in USD. yo 28 r' 3?7f 4 ve. = �r7.��y 5!y_ �� 7t: X http:l/finance.yahoo.com/q/hp?s=MET&a=02&b=17&c=2013&d=02&e=17&f=2013&g=d Page 1 of 2 .REV-1508 E)(•(197) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN RESIDENT DECEDENT PERSONAL PROPERTY ESTATE OF FILE NUMBER earl F A-r_"z Include the proceeds of litigation and the date the proceeds were received by the estate.All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE . NUMBER DESCRIPTION OF DEATH 1. 14di14.5 neZ- �,- -�.7tw spa;,V/ ;t] adrarrce tip A-" s a e k l / 4147- equ,) arcs X76.06 L:he SGheo/ /a.res fi/, /93.08 C. C.'nt yo9- Sewer 4i!8ro :�. /P T Bang C ce/t, 1� ,moo{. &'0. //3 SG o *1 7, 0 7.7. oY 3. Zit. a ccr. d D aye Ttur, Ala- 2 (Sec Va�u A- n A AAcAd 0 / me-Anima /s/_ 01-ta%y 4'n1'104 1 '�Icj, kr -Sa.V;nys f ��- 75oG 9--oo 4/13 It SS S. ,Zn f Qccr: fD c%o.c�! ait �'f (Sec ra1a4'4;n a,7%ccl+eo/) 9� otf ta . �QS� iq S,2,4 . Popery ejelpas;ftW :n C,h:Zen_C &.k C- 1,4dAr5a Acl)o47eer5 S6ee-/s gSfu7emen� Qrr� QS a �S bjl2elK -T/ 4Allewl ¢ l9. Pa�7ial nG�in�tar ���G7cn A37.16 f�. �4,194f E7r)e n3ur. 770.00 11• Parh',4 R"" lRepubl,, a4.13 TOTAL(Also enter on line 5,Recapitulation) $ (If more space is needed,insert additional sheets of the same size) _� —�so�../ ter•-// - . Q MBTBank 499 Mitchell Road,Millsboro,DE 19966 Adjustment Services Phone 888-502-4349 F ax (302)934-2955 May 24,2013 Charles E. Shields,III Attorney at Law 6 Clouser Road Corner of Trindle and Clouser Roads Mechanicsburg,PA 17055 Re: Estate of Earl F.Artz Social Security: Date of Death:March 17, 2013 Dear Sir or Madam: Per.your inquiry on May 16,2013,please be advised that at the time of death,the above-named decedent had on deposit with this bank the following: 1. Type ofAccount Checking Account Account Number 11356049 Ownership(Names qn Earl F.Artz Opening Date 0812811964 Balance on Date of Death $ 7,072.04 Accrued Interest $ .01 ----------- - Total $7,072.05 2. Type of Account Individual Retirement Account Account Number 35004202166193 Ownership(Names o) Earl F.Artz Opening Date 091081206 Balance on Date of Death $ 10,522.22 Accrued Interest $ 5.64 Total $10,527.86 A MEMBERS 1St FEDERAL CREDIT UNION REGULAR SAVINGS ACCOUNT: Account Number/Suffix 375069-00 D-ate Account Established 01/06/2010 Principal Balance at Date of Death $484.85 Accrued Interest to Date of Death $.04 Total Principal and Accrued Interest $484.89 Name of Joint Owner None EM ERS 1sT FEDER L CR UNION v C Danielle A. Kline Lending Insurance Support Specialist May 29, 2013 Estate of: EARL F.ARTZ Date of Death: 03117/2013 Social Security Number: 193-24-1726 5000 Louise Drive • P.O. Box 40 • Mechanicsburg,Pennsylvania 17055 (800) 283-2328 wwwmemberslst.org C huck Bricker, Aconeer nary & seit on C+c�nnmissloi - Corr4 � � i� Service 93 Texaco Rd.,:Mechanlosburg, PA 17055 755-5735 of . _ �-� TOW Sala q f L 0 -mss 17SZ c � tasty EXPOMMS . & 27 JU&& Ckkst Propeft Few ` SWO Setup or " bo D 3 � � � 2 -4 )A 7, psi 6re� -rz, SIC ................. —44,10 ------------ Z;o -------------- —-----—--------......... .............. -------------- ----------- ------- ...... ---------- ------------ --------------------- ---------- .......... ------------ 40 ---------- —--------— -------- ----------- ——-------- .............. ------------------------ ---------------— --------------- -----—------ —-- ........... ....... ---------------- ....................... ................... .............................. ------ .......................... ......—------ ................. ...... 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CIJCCT T/1TA1 $ 1 D1 lnlnnnln rnre► $ bu Y tM i ou 1 cn ITEM UQ G L ITEM J x LOT # LOT # 1 i _ $ �, vo ® _ 4 BUYER // BUYER ITEM �� S C (_O ; ITEM LOT # LOT # 1 6 r BUYER BUYER l � ITEM ITEM i+ s b 1 ' 8 BUYER / a i BUYER ITEM / /'� m ✓�Z ITEM n �/4 S `d� 1 LOT # LOT # 1 1 1 io BUYER ; BUYER U nn _ 1 ITEM . l�� lour r t U r i ITEM BO LO - �.D1� 1 BUYER b 1 BUYER t ITEM IJ d 7 i J /4/Lf 7-A ITEM U� • b� r BUYER ; 1 BUYER ITEM .Y. l't ��/Z • F��� ITEM rn 1� 5 LO 4(. D. i BUYER 1BUYER ITEM f V &RD AO7 ITEM IT rT e 40 !�I Ir ITT T/�TA1 1•�I II.IAIIhI/�T/1TA1 BUYER - - ou T Crl n ITEM ,� l� ITEM _ $ �U oy 4 BUYER ._ / w ' r .. BUYER ITEM. /G�u � !7� ( i. ITEM I Cam' LOT # LOT -- ---- - - -- - - BUYER l° ; BUYER'' Il EM l�"c` ITEM �� E r �. - -- - - - - - 8 BUYER:... D BUYER_. ITEM A ITEM i — - - f—``— ----- -- — -- - - - 7 77 i BUYER . ` co �Ql UYER ITEM LQT#: ' COI4 I 12 D•. BUYER .: BUYER ITEM LA� �'C ��1e i ITEM' OT I ' 13; 1'4 �o BUYER; . ; BUYER• l 1 ' ITEM ITEM 4 LOT.# :..,LOT #- 1 I I f5 16. BUYER BUYER p ITEM ITEM SSc�DI() : IJL•D� � LOT # -'LOT # 0 o y. i $ s of mirmKi(r TnTei $ OK5 2/)73 J Z$UYth ovir-n ITEM J ��� ITEM `� "� j A) LOT # LOT # BUYER y 4 BUYER 139 ' ITEM. i ITEM (O 1-4 LOT # LOT # 6 BUYER ' BUYER D ITEM ell S � IT LOT'# BUYER- .-.- BUYER ITEMA s C N� ; ITEM LOT # LOT # • . tj A)S . @ ® _ $ � 10 BUYER• ; BUYER' ITEM C N�4 I SAS ITEM _ $ g',U b _ $ l,U , b o 12 v BUYER BUYER ITEM :/7/. I�1-0 W ITEM yN 1 LOT 3 114 3 b BUYER l S. ; BUYER ITEM. S �. ITEM ' LOT # � LOT BUYER ` 1BUYER ITEM � /T r `v ITEM DU.J Low IM gig _ $ , oy @ _ $ TTw $ `✓ / \/� / � •��••-•• D ITEM 1 ' . /-►"FTS� ki C� ���� ITEM r P LOT # LOT # h i 4 BUYER `� BUYER f ITEM n �S C� S ITEM LOT # 6 BUYER T DL i BUYER R � � 1�( o�s : ITEM ; ITEM Z AI L e LOT # LOT # BUYER . BUYER � R F "S rYi 4-tJ / I ,,7 " S2 P ITEM + U D •. 3n 10 � ( • BUYER 1 BUYER , ITEM �`'l L CS P ITEM CA v i U tp--t 1 12 / BUYER 3 BUYER ITEM S� �Il) dG�JER PART5- ITEM ,Q 3L Jr - "m L19D D &n 1 + 14 3 �/ � . BUYER "t•,5 ; BUYER ITEM ��� sWS � ITEM L:A:P 12,� 0 0 S•aO + 15 UYER ---- - - - --— ----- - - '7 s ; 1 BUYER l] ITEM 2 OL4-6� + ITEM LOT # LOT # .��T �']' r.1•r rr T�Tw1 $ O111.1I.11k1/%_TlITA. `✓ / q -7._ LJC SUYtH ov i cn r ' � n nn ! N TEM �-�`f D L ITEM LOT # LOT # 4 �! 3UYER BUYER TEM /'/ LCf/'✓) ITEM .• LOT #. �. $ 3UYER --- -- --•-- --- _ _��_._.._...I- '6 BUYER ^ .. . TEM (,l'yy�: LJg DErC ITEM • LOT.# B BUYER i BUYER' D`L ITEM G,Sb ; ITEM LOT'# (,-LOT,..# l U d .1 J- �' _ $ _ $ , BUYER /- ' BUYER ITEM 5 ;.�C ; ITEM -.LOT.'7.1 73 .60 BUYER S� BUYER 12 ITEM -:C�D LJ. C N 7q�R W ; ITEM 14 'BUYER ; ,BUYER"" ou p ITEM ITEM :.LOT•#` $ �Q •bD (•!U� BUYER S BUYER IT �T16�-` LAC)106 ITEM B EV C P LOT # LOT # _ $ •°D @ _ $ •�v buytH ✓ uv i un - ITEM ` ITEM LOT # LOT # _ -- ----._..._...-•- --------..__._ _ � .© .....,. 7.. .BUYER i 4 BUYER ' f ITEM ITEM q 1 v 6 BUYER , BUYER 200 776 ITEM 1 r ; ITEM LOT # 8 BUYER ,CO ` BUYER ITEM ITEM 10 BUYER ; BUYER ITEM l� � l� lI'f i r� ' ITEM 77 R�S BUYER 61 Al BUYER s ITEM N S ITEM G Ls S `� BUYER ; BUYER ITEM ��DL� �O!/ .` .� G( ITEM . ! �UL To/o031� M6rn //�� T BUYER -T� ; 1 BUYER o0� C�s� ITEM ITEM LOT # LOT # REV-1510 EX•(1-9T) SCHEDULE G INTER-VIVOS TRANSFERS & COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Earl /rrz 2/- 3 -37S" This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY %OF ITEM INCLUDE THE NAME OF THE TRANSFEREE,THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE ATTACH A COPY OF THE DEED FOR REAL ESTATE. NUMBER VALUE OF ASSET INTEREST IF APPLICABLE) /640X-, zYM .4�. moo. ,3Soo y�o2 /6 6 193 . al4rtce on 41-10-17! 0/10, 52Z"- �5,kq /-Rd/ -5177 86 57a�� i�o90 —o -- %, saT,P6 f.. 4fi Jr. (fee !i4%t�t/�c+ti i" fl`ei" a�',a cAzW) TOTAL(Also enter on line 7,Recapitulation) $ /o, Sa 7. L?g (If more space is needed,insert additional sheets of the same size) REV-'1511 EX+(10-06) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER 37.s- Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: �J tone /,*array �h�cra/ floe e� /l�euJ ��m bola n d �7, 07y. ja �. S)f we lhurra,y ,eNntr4/ �om� of yur G'unrbrr'/�n� �`.3 96,00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) h!zpl fr Street Address /�/Ga li• lam. City ///C Q�n.,c5b U hA State Zip M O 5'9- w Qr Ved Year(s)Commission Paid: 2. Attorney Fees Charlts F. -C1h;C,145 ll �lOj B.Sn•d 3. Family Exemption:(If decedent's address is not the same as claimant's,attach explanation) Claimant /Vp Street Address / City State Zip Relationship of Claimant to Decedent // /• 4. Probate Fees C4y4ct onitiAd IS5(AG B7� 5A6rt Cert'j4G-&k" 0?03,SQ 5. Accountant's Fees 41 IN--hi f-&hj j ejose'-f low), PA 40, E5h4 �p7[1 Ylt *D Sf/ P� �/� fG 6. Tax Return Preparers Fees j[�Q 7. /tG�✓et�75%may i/l j'jtL Cu.>„bt:frl�d Lr.,,.., Toarno1� 75. 00 �dvBrtjSih9 ;h fact (,trlis1 oAn nej jQ I3�,YY `l• %„9 fee !v ,A k,71s / p�Pa;j 4a*ol; /0 ,4 ITQ/ �D/Oba f� �Q� /o Wcjjs t GK A1i115 of � 0,00 TOTAL(Also enter on line 9, Recapitulation) $ 15 00 8 (If more space is needed,insert additional sheets of the same size) i 6, of .Earl F..._Arfz .. _ . ...... _... - _. .. .�-1.3.-3 75- attW' e/lefJse. oil �>%`/<�>C�I`._Sleef1 /e_e�1� _.res ClencG i f l76.Zo err/GGS r3o.00 �: _ Lac IaD.S• �ca/�y �ia�as,�cr' l�-_ . .... .. /3�7.00 Vie.. /�• �:�e L . o wrr ,i�enT d", -l���nu-/#lGw Tom. AS/ -lis an.. o 172-7. e >S�'`ec! Q•%nos - �J o Sfve�-w�to e���cs, _eS�Sin- - . o,7,so rW 6Ur - 3so.6� . H,-r AOL. . 'r/?165 9 /6. j r:G Sri ur. .f3so.(o 7. %r/I wasf Z)apcsa/ .3903 a3. � /Yl4rste/lat' D_r/ /q y 9s ... . ... ..... X566.DD a5urer . P^°r .2�a-ees °6 7, l(pper• Alm. l w�o. ewe•' 4)991,t. IJ/Z.OD ,�& i r��•��ti.�sejnenf � C�s< �: .._.�il�/�s f2 �-�'�.ad'd�f c�r� �erf�� ,ao.o0 r �elinb*rs evc s f f (mss. . _�h,ela�s - >` �Gr�r f e-w $,lo.oo 3v 4�m 5le of _ Cfi oil eel Lo'drA�r5s%oh a4 .,sale P<19&17--es 5SG.85 see fUW oez/ �s fyenZs pla a, a6"W) 31. R¢%�n b urs�,nn en t lO Chas. E -�►�'o!. �� r Rtsea r 501-h'04-5 rc��44 d- i _ ..., .._...__.__..._........ .._.._. _....__ . ......-...__....___........... _.,_..._. _ /yolfSe._/�/2ZisaTS 35. -_-___-____�_�_�• _--_._���..____-------------.._._----_._.___..---_.._.---.___...._..._....._._-.--_----_-----_-_..__..._.___.__.�__.._-. p-3` 31_..___..___ __..__.-----...3_�... ...__u�;tee_�✓afer�_..----__.__...____._.._____...._._.._...____..._---..._ ..._.--.--..__...___....---._..._ ----.__-----_.__...___....._____.__.__�1.1��.�_.__.. __._._._._._..._._3l`_�._.___.yr%�'G✓�is 7>,rSa/_._._...._.......-.----._....._.__....__....._.._..._.....___.__.._..-__.__._.___.____.__..._..----------------- .__......-_--_-___.___..r_� _ _ ._.......___ -.. � _ . . 0- . .._..... /.7 •oa 1 ,0'. Sa/c...... . .. !.0--- b_ •- 5�...._... ....._......._........._..............,_.__.__._._._..----__._..__.__ .-_._...__ #_ f�P_c_. .____.___ . . ... ___._. . _._.---.`f�-_I__L=�o Quo __.!�L�4/k...._ !'_._../_" 21�/al .. ,rs�!_�_._•fIS - -- -_.-._...__ - --f---- ---- ............._........ ...-- _._...-- - -...__ ...__......__..._.--.._j._._.--____._.. _ _.. _. ___ ___.--�-_.____-._......_........ _. _._......._........................ _ . _ ___ -. . _ . ... - . ...... -f---- _ ..-- - --._ _... _ B & R LOCKSMITHING INVOICE # 6317 CHESTERFIELD LANE MECHANICSBURG, PA 17050 4 72 . 717-697-6126 PA017779 NAME j RATE ADDRESS +j PHONE t v 76 Fjr O VISA ❑MASTERCARD DISCOVER LOCATION TERMS r Y DUPLICATE KEYS ORIGINAL KEYS DEADBOLT (TYPE) KNOBSET (TYPE) I. Alt J L , r TOTAL MATERIAL r E R RATE s COUNT �a DESCRIPTION`: i.s,s+,c?,''+x i.r<`'a1• � ,'?I I, LABOR TO INSTALL ABOVE CYLINDER COMBINATION CHANGE EMERGENCY LOCKOUT SERVICE a_ La � / P s J- 6b SERVICE CALL NO REFUND ON SPECIAL ORDERS RETURNED CHECKS $65.00 FEE LATE FEE 1.5% PAST 30 DAYS ❑MAIN ENTRANCE ❑REAR DOOR ❑WTNDOW ❑SAFE ❑C INET ❑TOt GARAGE ❑GARAGE DOOR TOTAL LABOR ❑FRONT DOOR ❑PATIO DOOR ❑SIDE DOOR ❑INSIDE dE> -llct[q S'f'S�` ❑LOWER DOOR C.D OPEN LOCK(S) ❑SECURE PREMISES ❑MASTER KEY ❑REPIN ❑FIT KEYS ❑ADJUST ❑REPAIR SUB-TOTAL ❑CLEAN/LUBE ❑REMOVE&REPLACE ❑CHANGE COMB ❑INSTALL ❑ AUTHORIZATION FOR SECURITYIEMERGENCY SERVICES TAX I hereby certify that I have the authority to order the lock,key or security work designated above. Further,I agree to absolve the locksmith who bears this authorization from any and all claims arising from the performance of such work. Customer guarantees to pay for the TOTAL �• above work and/or parts as stated in this form with no exceptions. Auth. code -� Trans. ID } °Z �; Account# �% ' 1 SIGNATURE - DATE LCT 24250 4 , 1=8007GOT. JUNK!"..t r I ,�, I g Job ID.� THE WORLD'S LARGEST JUNK REMOVAL SERVICE , GS Madison LLC Date: PO Box 4705 Lancaster,PA 17604 Team: hil�rc'�n X14 Tel:877-538-5865 Route#: / C Name: ` 'V' 2 Start Time: Company Name: End Time: Moving: ❑ DM: Pickup Address: TF COPY OFFICE YELL-OYW COPT LUENt City: � Zip/Postal: Home#: Cell#: �'17 't Fax#: Office#: Email: Bill Type Load Size Description Price f, Bill Type:V-Volume,B-Bedload,S-Surcharge,SP-Standard Item Price Other — Subtotal 15 Y'" HQW DID,YOU LEARN ABOUT US? Tax —� Total Job Sign ❑Yes`❑No "Cash is ❑Check# ❑Voice Auth: ISA EIAMEX Approval Code,: ?�(i1.�.h s in`tta C#000 DOD-DODO-LSEI Signature:;��- �a' �' Exp Date: �- []Invoice Contact#: —PO#: Name - Mailing Address:.. City; " State/Pr ow. Zip/Postal: Job Compfetio �IgnatuTe / Date: TERMS:A`li,accginis an'ue:upr receipt un` lredit has been established:ttdue actbuMs areelsubleitto interest not higher than]Re maximum allowable interest rate es determined by law.As owner,agent or tenant of the above location,I hereby agree the work has been satisfactorily completed and understand that I no longer ewn the items that have been removed.If a check is returned for any reason,I agre• pay a$35 returned check fee REV-1512 EX*(12-03) SCHEDULE 1 COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES, & LIENS RESIDENT DECEDENT ESTATE OF rlZ Far/ F FILE NUMBER 7 / pZZ - IS— 3 7Sr Report debts incurred by the decedent prior to death which remained unpaid as of the date of death,including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH -t Acne a dW.e 017 Prsoaal •raAne A -,86 9,00 /,Wely. 144 110M,1 of 13.100 3. Dr. //Z i z k/iah �-71.23 y ypr/l A46 e Z is pOSa/ -39.03 S lalcsf }�°�k /f-�r bra/ar�ct �ertr�e e �/, s�3s.8'0 6. 101-7 L r3V 2/ 7 lmilw wafr /I.2B %. Swer Aagon,t Fig z. 0,0 9. /IYe/urn m C oWpprne�>` orr RS, E`. 61 S. or s8 /o A�w bulTaVeni- t O a / ArtZ, Sr. >0r P4 y112e'„t -1-4 CArd 3 9y 90 ll. Holy . t 1Yo5p fal F3 7.6g sc �± 3s.Y2 1 . /tf. l /,cnAe"W 4r evil/, 6,#, Gtr Wur�ny TOTAL(Also enter on line 10, Recapitulation) $ i3 (If more space is needed,insert additional sheets of the same size) REV-1513 EX+(9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER 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)) t fi-arl F. /,r rz I Jr /�r9���' Gn. , /Ylechul7i�s�itrry, P� loss se rl /o0 90 .504 /►aS /j1G� fie p0 aay Sure-i ra/ ►^�al remevt P/C .5zcr�it9/y !,S .s`id�e /4 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18,AS APPROPRIATE,ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. I I TOTAL OF PART II—ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (It more space is needed,insert additional sheets of the same size) CODICIL I, Earl F. Art2, of Mechanicsburg, Cumberland County, Pennsylvania, wish to add this Codicil to my Last Will, on this 3rd day of September, 1996. I leave nothing to my stepdaughter, Barbara A; Westhafer, for many reasons which I am sure she is well aware of. WITNESSES: L A S T W I L L O F E A R L F. A R T Z I, Earl F. Artz, of Mechanicsburg, Cumberland County, Pennsylvania, do hereby declare this to be my Last Will, and do hereby revoke all prior Wills and Codicils heretofore made by me. 1. My wife, Doris A. Artz (hereinafter referred to as "my wife") , and I presently are the joint owners of a residence located at, and known and numbered as 104 Cockleys Drive, Mechanicsburg, Cumberland County, Pennsylvania, which is our usual home. If my wife survives me and at my death, our home, whether it be the one which we now own described above or one which is hereafter acquired by us, is held in any manner which will not result in the passage to my wife of full title to such home by operation of law, I hereby give and devise my entire interest in such home to my wife. If my wife survives me, I specifically authorize my executor to apply assets of my, estate to the satisfaction and discharge of any mortgages, liens and other encumbrances, together with all interest accrued thereon, which may exist with regard to such home at the time of my death, whether passage to my wife of title to such home is by operation of law or under this paragraph 1. If my wife does not survive me, then our said home shall pass as part of my residuary estate vxz --- _ C-J l Earl F. Artz -1- hereunder. 2 . I hereby give and bequeath to my wife, if she survives me, my entire interest in and to any and all furniture, antiques, clothing, jewelry, pictures, statuary, works of art, silver, plate, ornaments, bric-a-brac, tapestry, household goods, utensils and supplies, books, linen, china, glass, automobiles, horses, boats, plants, implements, and tools that may be in, at or about our home at the time of my death, and all of my other tangible personal property, together with all policies of insurance thereon. If my wife does not survive me, all of the property above described in this paragraph 2, I give, bequeath and devise to my son, Earl F. Artz, Jr. In the event that I am not survived at my death by my wife or by my son, Earl F. Artz, Jr. , then all of the property which they would have taken under this paragraph 2 had they survived me shall pass as part of my residuary estate hereunder. 3. If my wife survives me at my death, I hereby give, be- queath and devise to her all of the rest, residue and remainder of my property and estate, of whatsoever nature and wheresoever situ- -----awe--together wi��i al�po73cies-oirisurance thereon. 4. If my wife does not survive me, then all of the rest, residue and remainder of my property and estate, of whatsoever nature and wheresoever situate, together with all policies of Earl F. Artz -2- insurance thereon, I hereby give, bequeath and devise to my son, Earl F. Artz, Jr. If my said son does not survive me then all of the rest, residue and remainder of my property and estate, of whatsoever nature and wheresoever situate, together with all policies of insurance, I hereby give, bequeath and devise as follws: (a) Two-thirds (2/3rds) of my estate to be divided in equal shares among the issue of my son, Earl F. Artz., Jr. , per stirpes. (b) One-third (1/3rd) of my estate to be divided equally between my step-grandchildren, William K. Westhafer, Jr. and Nicole L. Westhafer, or to their issue, per stirpes. 5. In the event that my wife and I die simultaneously or under such circumstances that it cannot be established which of us died first, then my wife shall be deemed to have predeceased me for all purposes under this Will. 6. Should any legatee or devisee under this Will die within ninety (90) days after the date of my death, he or she shall be deemed to have predeceased me for all purposes under this Will. Provided, that if my wife survives me at my death but dies within ninety (90) days thereafter, she shall have for and during that portion of such ninety (90) day period as she in fact is alive after my death the right to the use and enjoyment as a life tenant of all property in which her interest hereunder will fail by re son of her death within said ninety (90) day period. CL Earl F. Art-z- - -3- i 7 . No statutorily provided interest shall be allowed or paid on the gifts made under this Will. All net income of my estate realized during its administration shall pass and be dis- tributed to my wife under paragraph 3 hereof, or to the residuary beneficiaries under paragraph 4 hereof in proportion to their re- spective shares of my residuary estate passing thereunder, as the case may be, with no requirement that such income be accrued for or apportioned between any successive beneficiaries hereunder. 8 . No interest of any beneficiary hereunder in either the principal or income of my estate shall be subject or liable in any manner while in the possession of my executor to anticipation, pledge, assignment, sale, transfer, charge or encumbrance, whether voluntary or involuntary, or for any liabilities or obligations of such beneficiary whether arising from his or her death, debts, contracts, torts or engagements of any type. 9 . Any amounts, either of income or principal, which are payable to a minor under this Will may at the sole discretion of my executor be paid either to a parent of such minor, to a guardi- an of the person or of the estate of such minor, to the person who has custody of such minor, or directly to such minor, or applied to or for the benefit of such minor. The receipt by such parent, guardian, custodian or minor, or evidence of the application of such amount for the minor's benefit, shall be a full and complete ischarge f my ex cutor to the extent of such payment or applica- Earl F. Artz -4- tion. 10. Except as otherwise restricted, directed or provided in this Will, or required by law, in the administration of my estate hereunder, the fiduciaries serving under this Will shall have the following powers, which may be exercised without leave of court, in addition to those powers as my said fiduciaries may have by law: (a) At any time, to retain any assets, invest- ments or property in the form held by them at the time of my death or thereafter, and to invest and reinvest any funds which they may hold in any stocks, bonds, notes or other securities, or in any other property, real or personal, tangible or intangible, or mixed, or interests therein, wheresoever situate, as and in such proportions as they may deem best, notwithstanding that such investments may not be of a character allowed to fiduciaries by statute or general rules of law. (b) To sell, exchange, grant options upon, or otherwise dispose of any property, real or personal, tangible or intangible, or mixed, or interests therein, wheresoever situate, at any time held by them, at public or private sale, for cash or upon credit, in such manner, to such persons, and at such price, terms and conditions as they may deem best, and no person 04 Earl F. Artz -5- dealing with them shall be bound to see to the application of any funds paid to them. (c) To manage, operate, repair, improve, parti- tion, subdivide, or lease for any term any real estate or personal property at any time held by them, where- soever situate, and to enter into agreements for the same. (d) To borrow money for the payment of taxes or for any other proper purposes in the administration of the .property held by them upon such terms as they may deem advisable, and mortgage, pledge or encumber any real and/or personal property held by them as security therefor. (e) To distribute in cash or in kind, or partly in each, and in shares different in kind from other shares, upon any division or distribution of any pro- perty which they hold. (f) To adjust, settle, compromise and arbitrate claims, to renew or extend the time for payment or otherwise modify the terms of any obligation payable to or by my estate, and to abandon any property held by them which is of little or no value. (g) To retain and pay agents, employees, accoun- tant nd counsel, including but not limited to legal Earl F. Ar z -6- and investment counsel or advisors, brokers, banks, custodians and other agents, for advice and other professional services, and to delegate to them such duties, rights and powers as my fiduciaries may deter- mine for such time periods as they may deem necessary. (h) To allocate, in their discretion, any receipt or item of income, or disbursement or item of expense, to principal or income, or partly to each. (i) To hold assets in bearer form, and to regis- ter securities and other assets in their own name or in the name of a nominee with or without indicating the fiduciary character thereof. (j) with respect to .any securities held by them, to join and participate in any merger, reorganization, voting trust plan or other concerted action of holders of securities for the deposit of securities under agreements and payment of assessments, to subscribe for stocks and bonds, to give proxies, to grant, obtain or exercise options, and generally exercise all rights and powers of holders of securities, and to delegate dis- cretionary duties with respect thereto. (k) With respect to the stock of any close or other corporation, partnership interest or other business held by them hereunder: to disregard any Earl F. Artz -7- principle of investment diversification and retain any part or all of it for so long as they may deem advisable; to participate actively in its management and receive . compensation for such services in addition to any other compensation payable to my fiduciaries; to do anything that they may consider appropriate with regard to its operation, expansion, reduction, liquidation or termination or any change in its purpose, nature, or structure; to delegate authority or duties to any director, stockholder, manager, partner, employee or agent, and to approve its payment of reasonable compensation to any such person; to cause it to borrow money at reasonable terms from the banking department of any corporate fiduciary hereunder notwithstanding any contrary law regarding conflict of interests; and to make additional investments in it if such action appears to be in the best interests of the beneficiaries hereunder. (1) With respect to any policies of insurance forming a part of my estate: to continue such policies in force and to pay the premiums on such policies out of income or principal; to obtain the cash surrender value, if any, of any such policies which insure the lives f others and add the same to principal, or con- / Earl F. Artz -8- vert any such policies insuring the lives of others to permanent paid-up insurance (unless in either case such policies are specifically bequeathed in this Will) ; and to deal with such policies in any way that my fiduci- aries may determine to be in the best interests of the beneficiaries hereunder, including the right to borrow on such insurance policies in order to pay the premiums thereon. (m) To the extent permitted by law, to exercise any election, right or privilege given by federal tax laws, or . the tax laws of Pennsylvania or of any other jurisdiction, including but not limited to the joinder with my wife in filing income tax returns, the joinder with my wife in filing gift tax returns with respect to gifts made by her or by me or by both of us prior to my death, the consent on gift tax returns to have any gift made by her considered as made in part by me for gift tax purposes, the determination of proper taxes, in- terest and penalties and the payment thereof even though not attributable in whole or in part to income or gifts from my property or estate and without re- quiring my wife, her estate or her legal representative to indemnify or reimburse my fiduciaries for taxes (or penalties or interest thereon) attributable to my wife, Earl F. Artz -9- the election of alternate valuation for federal estate tax purposes, the election to have assets or property of my estate or otherwise includable in my gross estate for federal estate tax purposes treated as qualified terminable interest property for the purpose of quali- fying the same for the federal estate tax marital deduction for my estate, and the election to claim deductions for death tax purposes or for income tax purposes, and for their exercise or non-exercise of any such election, right or privilege to make or not make in their discretion equitable or compensatory adjustments as between income and principal of my estate or any part thereof, or as between any beneficiaries thereof or their shares therein, all without the consent of any beneficiary hereunder. (n) To make from time to time partial distribu- tions in varying amounts to the beneficiaries hereunder prior to final settlement and distribution of my estate, and in connection therewith to determine in their discretion the time or times when such partial distributions may require recomputation of said bene- ficiaries, proportionate interests hereunder for the equitable allocation of income or on account of changing asset values pending final distribution. Earl F. Ar z -10- (o) To receive, collect and recover the interest, rents, profits, proceeds, gains, and other earnings and income of and from the property held by them hereunder. (p) In general, to exercise all powers in the management of the assets and property held by them which any individual could exercise in the management of similar property owned in his own right, upon such terms and conditions as to them may seem best, and to execute and deliver all instruments and to do all acts which they may deem necessary or proper to carry out such management and their duties under this Will. 11. I hereby appoint my wife to serve as executrix of my estate hereunder. Should my wife be unwilling or unable, fail to qualify, or cease to act as such executrix, I hereby appoint my son, Earl F. Artz, Jr. , presently of Mechanicsburg, Pennsylvania, to serve as my executor under this Will. 12 . If my wife predeceases me, I hereby name and appoint Dauphin Deposit Trust Company, presently of Harrisburg, Pennsylvania, to act as the guardian of the property and estate of any child who has not attained the age of majority as of the date of my death, it being my intention to make this appointment effective in all cases where permitted under the laws of the Commonwealth of Pennsylvania. Said guardian shall have the ower and authority, exercisable in its sole discretion and Earl F. Artz -11- without seeking or obtaining prior court approval thereof, to apply or expend so much of the net income and if necessary or de- sirable the principal of such minor's property or estate as the guardian may deem advisable to or for the minor's care, mainte- nance, support, health, education, or other proper purposes beneficial to the minor, without regard to such minor's other sources of support or funds. 13 . The fiduciaries named or appointed in this Will, in- cluding any guardian of the estate of any minor child, shall not be required in any jurisdiction to file, enter or post any bond or other security for the faithful performance of their duties hereunder, and shall not be liable for the acts, omissions or defaults of any agent appointed by them with due care. 14 . Subject to the restriction hereinafter set forth, I direct that all estate, inheritance, legacy, transfer, succession and death taxes, of whatsoever nature or kind and by whatsoever jurisdiction imposed, and all interest and penalties thereon, which may be payable or assessed in consequence of my death, whether or not with respect to property passing under this Will, shall be paid out of and charged against the principal of my residuary estate in the same manner as are general administration expenses of my estate so that all property subject to said taxes shall be and pass free and clear thereof, without apportionment of o reimburse ent for such taxes, interest or penalties among any Earl F. Artz -12- beneficiaries, transferees or other persons interested in such property and without any right of my estate or executor to contri- bution, recovery or collection for the same. Taxes on any future or remainder interests hereunder may be prepaid at and in the election and discretion of my executor to the extent permitted by law. In no event, however, shall my executor pay from or charge against my residuary estate or any part thereof, any taxes imposed upon generation-skipping transfers under the Internal Revenue Code of 1986, as amended, or any penalties or interest thereon. 15 . I direct that all expenses of my funeral and last illness be paid from the principal of my residuary estate as soon as is practicable after my death. IN WITNESS WHEREOF, I, the said Earl F. Artz, hereby set my hand to this my Last Will, typewritten on and consisting of these fifteen (15) sheets of paper, at the bottom of each of the preceding pages of which I also have placed my initials, on this 10th day of May, 1991. Earl F. Artz -13- On this 10th day of May, 1991, Earl F. Artz declared to us, the undersigned, that the aforegoing instrument was his Last Will, and he requested us to act as witnesses to the same and to his signature thereon. He thereupon signed said Will in our presence, we being present at the same time. We now, at his request, in his presence, and in the presence of each of us, hereby subscribe our names as witnesses thereto and have placed our initials at the bottom of each of the preceding pages. By so doing, each of us declares that he or she believes this testator to be of sound mind and memory. residing at 1?0 x {fl$, A+A 0 residing at residing at COMMONWEALTH OF PENNSYLVANIA . : SS. COUNTY OF Cv-►1 ber10-v'cl I, Earl F. Artz, testator, whose name is subscribed to the attached foregoing instrument, having been duly qualified accord- ing to law, do hereby acknowledge that I signed and executed such instrument as my Last Will, and that I signed and executed it willingly and as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me, by Earl F. Artz, the testator, this 10th day of May, 1991. Earl F. Artz Notary Public My Commission Expires: ._.... _ SUSAN l 1pR �pub �..__M-COOMMISSMN EXPIRES WW 2 2994 -14- COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF Cvvn'�Oe f` We, To A"n the witnesses whose names are sigiled to the attached foreg ng in- strument, being duly qualified according to law, do depose and say that we were present and saw Earl F. Artz, the testator, sign and execute such instrument as his Last Will; that such testator signed such instrument willingly and executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of such testator signed such Last Will as a subscribing witness thereto; and that to the best of our knowledge, such testator was at that time 18 or more years of age, of sound mind and under no constraints or undue influence. Sworn or affirmed to and subscribed before me by Y1Cxd 0 . r • witnesses, this 10th day of May, 1 91. ITNESSES: - C ... Notary Public My Con4`nission Expires: NOTARIAL SEAL SUSAN L HIRSHMAN,NOTARY PUBLIC CAMP HILL,PA CUMBERLAND COUNTY MY GMMISSION EXPIRES NOV. 2? 190 -15-