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Home My WebLink About02-18-14 (3) � 1505611185 REV-1500 Ex�°2-„>�F', OFFICIAL LSE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN Po sox zsoso, 21 13 10 2 3 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 09162013 02131940 DecedenYs Last Name Suffix DecedenYs First Name M I BRENNEMAN KAY I (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name M I Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE - - REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW � 1. Original Return � 2. Suppiemental Return � 3. Remainder Return(Date of Death Prior to 12-13-82) ❑ 4. Limited Estate ❑ 4a. Future Interest Compromise(date of ❑ 5. Federal Estate Tax Return Required death after 12-12-82) � 6. Decedent Died Testate � 7. Decedent Maintained a Living Trust � 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) ❑ 9. Litigation Proceeds Received ❑ 10. Spousal Poverty Credit(Date of Death ❑ 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 KEITH 0 • BRENNEMAN, ESQ • 717-697-�$528 ':;= , _ __. REGISTE�f ,`TNILLS USE ONLY ' � :T�'-1 �" • ; r '� t .�� -, J' CJ � �.! ,._,_ _�_ _� j> ^-- First Line of Address ��- C� ' ' _ � 44 WEST MAIN STREET '�'�- �' _,� __. Second Line of Address �=`; .. = ."ry P • 0 • BOX 318 �" `��' 4 City or Post Office State ZIP Code DATE PILED� � � MECHANICSBURG PA 17055 CorrespondenYs e-mail address: Under penalties of perjury,I declare that I have examined this return,inciuding accompanying schedules and statements,and to the best of my knowledge and belief, it is true,correct and complete. Deciaration of preparer other than the personal representative is based on all infortnation of which preparer has any knowledge. SIGNA LErO`�SO�RESPON��`O��LING RETURN y / /DATEr� x� �Q.I.U� �' `� ` �`7 ADDRESS DAWN D • FENTRESS, EXECUTRIX 1135 REDWOOD DRIVE, CARLISLE, PA 17013 SIG' RE OF PREPARER OTHER THAN REPRESENTATIVE ',l p'�� CX�� ADDRESS KEITH 0• BRENNEMAN, ESQ • 44 WEST MAIN STREET, MECHANICSBURG PLEASE USE ORIGINAL FORM ONLY PA, Side 1 � 1505611185 OM46473.000 15�5611185 �� .� � 15�5611285 REV-1500 EX(FI) �ecedenes Name: B R E N N E M A N K A Y I RECAPITULATION 1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . � ],O O,8 91• 4 2 2. Stocks and Bonds(Schedule B). . . . . . . . . . . . . . . . . . . . . . . . . p. 7 7 2 • 0 4 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C), , , , , g. � • �� 4. Mortgages and Notes Receivable(Schedule D) , , , , , , , , , , , , , , , , , q. � • 0� 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E) , , , , , 5, 9,2 4 0 - 8� 6. Jointly Owned Property(Schedule F) � Separate Billing Requested , , , , g. 6$ • 0 7 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) � Separate Billing Requested . . . . 7. 2 2,2 4 8 • 8 3 8. Total Gross Assets(total Lines 1 through 7) , , , , , , , , , , , , , , , , , , $ ],33,221-16 9. Funeral Expenses and Administrative Costs(Schedule H). . . . . . . . . . . . . g. 52,311• 2 2 10. Debts of Decedent, Mortgage Liabilities,and Liens(Schedule I) , , , , , , , , , �0. 53,655- 59 11. Total Deductions(total Lines 9 and 10), , , , , , , , , , , , , , , , , , , , , ��. ],�5,9 6 6 • 81 12. Net Value of Estate(Line 8 minus Line 11) , , , , , , , , , , , , , , , , , , , �2 2 7,2 5 4 • 3 5 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J), , , , , , , , , , , , , , , , �3. �•0� 14. Net Value Subject to Tax(Line 12 minus Line 13) . . . . . . . . . . . . . . . 1 q 2 7,2 5 4 • 3 5 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers unSter Sec.9116 (a)(1.2)X.O�� 0-�� 15. 0 • 0� 16. Amount of Line 14 t xable at�inea�ratex.o4� 27,254 •35 �s. 1,226 • 45 17. Amount of Line 14 taxable at sibling rate X.12 0 • 0 0 ��. 0 •0 0 18. Amount of Line 14 taxable at coliateral rate X.15 � •�� 18. 0 • �� 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 1,2 2 6 • 4 5 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT � Side 2 � 15�5611285 1505611285 � OM4648 3.000 REV-1500 EX(FI) Page 3 File Number DecedenYs Complete Address: 21 13 10 2 3 DECEDENTS NAME BRENNEMAN KAY I STREET ADDRESS MIDDLETON TOWNSHIP CUMBERLAND CIN STATE ZIP CARLISLE PA 17013- Tax Payments and Credits: 1. Tax Due(Page 2,�ine�s) (�) 1�2 2 6 . 4 5 2. Credits/Payments A. Prior Payments � • �0 B. Discount Q • �� Total Credits(A+g) (2) � • 0� 3. Interest (3) � • 0� 4. If Line 2 is greater than Line 1+Line 3,enter the difference.This is the OVERPAYMEN7. Fill in box on Page 2,Line 20 to request a refund. (4) � •�� 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 1�2 2 6 • 4 5 Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred . . . . . . . . . . . . . . . . . . . . . . . . ❑ ❑X b. retain the right to designate who shall use the property transferred or its income . . . . . . . . . . ❑ ❑X c. retain a reversionary interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ❑ � d. receive the promise for life of either payments,benefits or care? . . . . . . . . . . . . . . . . . . ❑ � 2. If death occurred after�ec. 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 property,which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . � ❑ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 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 applicabie even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a naturai parent, an adoptive parent or a stepparent of the child is 0 percent(72 P.S.§9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedenYs 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. OM4671 2.000 � REV-1502EX+�,z_,2, SCHEDULE A pennsylvania DEPARTMENT OF REVENUE � INHERITANCE TAX RETURN REAL ESTATE � RESIDEM DECEDENT ESTATE OF: FILE NUMBER: Kav 2. Brenneman 21 13 1023 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 propeAy 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 fads. Real property that is jointlyowned 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 decedenYs interest if owned as tenant in common. VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Property known and numbered 100,891.42 30 Cave Hill Drive, North Middleton Township, Cumberland County, Carlisle, PA 17013, sale value (see attached settlement sheet) TOTAL (Also enter on Line 1,Recapitulation.) S 100,891.42 zwasss 2.00o If more space is needed,use additional sheets of paper of the same size. REV-1503 EX+(&12) pennsylvania SCHEDULE B DEPARTMENT OF REVENUE INHERITANCETAXRETURN STOCKS 8o BONDS RESIDENT DECEDENT ESTATE OF FILE NUMBER Kay I. Brenneman 21 13 1023 All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTiON OF DEATH 1. U.S. Savings Bonds 772.04 17 EE bonds (16 with face value of $50.00 & 1 with face value of #100.00 -- See attached listing) TOTAL (Also enter on Line 2,Recapitulation) $ 772 04 zwasss z.000 If more space is needed,insert additional sheets of the same size REV-1508 EX+(pg12) pennsylvania SCHEDULE E DEPARTMENTOF REVENUE CASH, BANK DEPOSITS 8�MISC. RESIDENTDEC ENTTURN PERSONAL PROPERTY ESTATE OF: FILE NUMBER: Kav I Brenneman 21 13 1023 Include the proceeds of litigation and the dffie the proceeds were received by the estate. All property jointl owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. AT&T �'68 refund due the decedent 2 Carlisle Petroleum, Inc. 157.53 refund due the decedent 3 CenturyLink 3.38 refund due the decedent 4 Cornerstone Federal Credit Union, account #963 138.00 savings account 5 Cornerstone Federal Credit Union, account #963 100.10 checking account 6 Cornerstone Federal Credit Union, account #963 1,387.00 Christmas Club account 7 Direct TV 7.54 refund due the decedent 8 DS Waters 24.00 refund due the decedent 9 Highmark 305.07 insurance premium refund due the decedent 10 Household items 4,784.00 retained by family (see`attached appraisal) il Household items 779.50 gross proceeds from sale of household goods by Haar's Auction 12 Social Security Administration 1,547.00 social security payment due the decedent TOTAL(Also enter on line 5,Recapitulation) S 9,240.80 2wasao 2.00o If more space is needed,use additional sheets of paper of the same size. REV-1509 IX+�p�-10) pennsylvania SCHEDULE F DEPAF2TMENT OF REVENUE INHERITANCE TAX RETURN JOINTLY-OW NED PROPERTY � RESIDENT DECEDENT ESTATE OF: FILE NUM BER: Kav I. Brenneman 21 13 1023 If an asset became jointly owned wRhin one year of the decedent's date of death,it must be reported on Schedule G. SURVNING JOINT TBJANT(S)NAAT�S) ADDRESS R�,4TIONSHIP TO DECEDB�fi A Fentress, Dawn D 1135 Redwood Drive, Carlisle, PA 17013 Daughter JOINTLY OWNED PROPERTY: �� LETTER �ATE pESCRff'T10N OF PF20PB�TY %OF DA7E OF DEATH fORJpNT MADE INCLU�ENAhEOFFINANCIALINSTITUTIONANDBANKACCWNTNUhEEROR5IMLAR �ATE�FDEATH DECEDINI'S VALUEOF NU�VSER TENPNT JQ�nfJ� IDENTIFVINGNUIrHER.RTTACMDEEDFORJdNTLVHELDREALESTATE. VALUEOFASSET ��T DEC�B�IT'SINTEREST 1 A 7/6/2009 Sovereign Bank 136.14 50.0000 68.07 checking account #0511085605 TOTAL (Also enter on Line 6, Recapitulation) S 68.07 swaenE z.000 If more space is needed, use additional sheets of paper of the same size. _ _ REV-1570EX+(08-09) SCHEDULE G pennsylvania DEPAR7MEMOFREVENUE INTER-VIVOS TRANSFERS AND INHERITANCETAXRETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Kay I. Brenneman 21 13 1023 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. DESCRIPTION OF PROPERN ITEM INCLLpETI{tyW7EOFTFETRANSFEREE,TFEIRRELATIONSHIPTODECEDENTA(�ID DATEOFDEATH %OFDECD'S EXCLUSION TAXABLE NUMBE TFEDATEOFiRNSFEF2AITP�HACqPVOFTHEDEEDFORREALESTATE VALUEOFASSET INTEREST IFPPPLJCABLE VALUE �• John F. Wain Financial Services 22,248.83 100.0000 0.00 22,248.83 IRA Annuity, account #SA0697800. Beneficiaries are decedent's children in equal shares. TOTAL(Also enter on line 7,Recapitulation)$ 22 248.63 If more space is needed,use additional sheets of paper of the same size. 9W46AF 2.000 REV-1511 EX+(�0.09) pennsylvania SCHEDULE H DEPARTMEPfTOF REVENUE FUNERAL EXPENS�ES AND INHERIT,�wCETnxRETURN ADMINISTRATIVE COSTS RESIDENT pECEDENT ESTATE OF FILE NUMBER Kav I. Brenneman 21 13 1023 DecedenYs debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: �, Hoffman Roth Funeral Home funeral services 3,540.49 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City State ZIP Year(s)Commission Paid: 2. AttorneyFees: Snelbaker & Brenneman, P.C. (Estimated) 2,000.00 3. Family Exemption:(If decedent's address is not the same as claimanYs,attach e�lanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: 313.50 5. Accountant Fees: 6. Tax Return Preparer Fees: 7. 1 Cumberland Law Journal advertising Executrix Notice 75.00 Total from continuation schedules . . . . . . . . . 46,382.23 TOTAL(Also enter on Line 9,Recapitulation) $ 52 311.22 swasnc z o0o If more space is needed, use additional sheets of paper of the same size. Estate of: Kay I. Brenneman 21 13 1023 Schedule H Part 7 (Page 2) 2 Haar's Auction, Inc commission and fees associated with the sale of household goods at auction 321.80 3 Jason M. Smith appraisal fee 50.00 4 Settlement chages associated with the sale of.real estate a. Seller Assist $5,000.00 b. County Taxes $9.03 c. Purchase price agreement paid to Troy Brenneman $19,000.00 d. Purchase price agreement paid to Dawn Fentress $19,000.00 43,009.03 5 Snelbaker & Brenneman, P.C. attorney services from 9/23/13 to 1/27/14 2,260.00 6 Sovereign Bank fee to obtain date of death balances 20.00 7 The Sentinel advertise Executrix Notice 221.40 8 Reserve for filing fees, accountant fees and other miscellaneous costs associated with the administration of the decedent's estate 500.00 Total (Carry forward to main schedule) 46,382.23 REV-1512EX+�72-�y) SCHEDULE I pennsylvania DEPPRTMENTOF REVENUE DEBTS OF DECEDENT, INHERITANCETAXRETURN MORTGAGE LIABILITIES & LIENS RESIDEM DECEDENT ESTATE OF FILE NUMBER Kay I. Brenneman 21 13 1023 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 �• Ascension Point Recovery Services, LLC credit card debt with GE Capital Retail Bank Walmart, account #1498558 2,413.60 2 AT&T phone service 308.85 3 Bank of America claim against the estate for credit card debt, account #5466322216703185 7,310.48 4 Bank of America claim against the estate for credit card debt, account #374322086113202 3,573.15 5 Bank of America claim against the estate for credit card debt, account #53290060473754718 3,016.22 6 Bureau of Account Management medical expenses for Penn State Hershey Medical Center 120.00 7 Carlisle Regional Medical Center medical expenses 466.38 8 CenturyLink utility service 175.89 9 Crystal Springs bottled water service 9.81 10 DCM Services credit card� debt with GE Capital Retail Bank Lowe's, account #9517318 1,335.15 11 Estate In£ormation Services, LLC credit card debt with Citibank N.A.Sears, account #3586795 1,096.16 12 Home Solutions medical expenses 323.58 13 Horizon Healthcare Services medical expenses 393.25 Total from continuation schedules . . . . . . . . . 33,113.07 TOTAL(Also enter on Line 10,Recapitulation) $ 53 655.59 zwasnH z.000 If more space is needed, insert additional sheets of the same size. Estate of: Kay I. Brenneman 21 13 1023 Schedule I (Page 2) Item No. Description Amount 14 Milton S. Hershey Medical Center medical expenses 50.00 15 National Rehab Equipment, Inc. medical expenses 64.04 16 NCO Financial medical expenses for Health Management Associates 255.22 17 PP&L electric service 165.29 18 Sovereign Bank Line of Credit payoff, account #4539462350 32,558.52 Total (Carry forward to main schedule) 33,113.07 REV-1513 EX+(01-10) SCHEDULE J pennsylvania DEPAR1Tv1ENTOF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDEPfT ESTATE OF: FILE NUMBER: Ka I. Brenneman 21 131023 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[InGude outrighi spousai distributions and transfers under Sec.9116(a)(1.2).] �. Dawn D. Fentress 1135 Redwood Drive Carlisle, PA 17013 One Third of Residue: 7,418.12 Daughter 7,418.12 2 Troy O. Brenneman 104 Eakin Avenue Pittsburgh, PA 15214 One Third of Residue: 7,418.12 Son 7,418.12 3 James S. Brenneman 5 Earl Street Boiling Springs, PA 17007 One Third of Residue: 7,418.12 Son 7,418.12 EMER DOLLAR AMOUNTS FOR DISTRIBU110NS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. �� NON-TAXABLE DISTRIBUTIONS A.SPOUSAL DISTRIBU110NS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: t. TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ O.00 9W46AI 2.000 If more space is needed,use additional sheets of paper of the same size. Estate of: Kay I. Brenneman 21 13 1023 Schedule J Part 1 (Page 2) Item No. Description Relation Amount 4 Kaylin A. Trimble 30 Cave Hill Drive Carlisle, PA 17013 Bequest per Item #4 of Will 5,000.00 Granddaughter 5,000.00 __ _ . OMB Approval No.2502-0265 ,'iiliili4,' A• Settlemenfi Statement (HUD-1) FiNAL .- . .. �.Q FHA 2.Q RHS 3.Q Conv.Unins. 6.File Number: 7.Loan Nurnber: 8.Mprtgage Insurance Case Number: CS13609 17509905 4.Q VA 5.Q Conv.Ins. C.Note:This form is furnished to give you a statement of actual settlement costs.Amounts paid to and by the sBttlement agents are shown.Items marked "(p.o.c)"were paid outside the closing;they are sliown here for informational purposes and are not included in the totals. D.Name 8 Address of Borrower: E.Name&Address of Seller: F.Name&Address of Lender: James Scoit Brenneman Estafe of Kay Brenneman Morigage Services,III,LLC 30 Cave Hill Drive,Cadisie,PA 17013 502 N.Hershey Road,Bloominglon,IL 61704 G.Property Location: H.Settlement Agent: I.Settlement Date:0'V08/2014 30 Cave Hiil Drive Charfet Settlement Services,LLC Disbursement Date:01/08/2014 Carlisle,PA 17013 4705 E Trindle Road,Mechanicsburg,PA 17050 North Middleton Township 717-730-9664 Place of Settlement: TitleExpress 101 S.Front St.,Boiling Springs,Pa.17007 Printed 0'V08l2014 at 11:54 am by VS 100. Gross Amount Due From Borrower 400. Gross Amount Due to Seller 101. Contract sales price 100,000.00 401. Contract sales price 100,000.00 102. Personal ro ert 402. Personal ro ert 103. Setllement charges to borrower(line 1400) 4,503A7 403. 104. 404. 105. 405. Ad'ustments for items aid b seller in advance Ad ustments fo�items aid b seller in advance 106. Cityltown laxes fo 406. City/town taxes to 107. Couniy taxes l0 407. County taxes to 108. Assessments to 408. Assessments to 109. School Taxes 01I08/2014 to 06130/2014 891.42 409. 0110812014 to 0613012014 891.42 110. 410. 111. 411. 112. 412. 120. Gross Amount Due from Borrower 105,394.89 420. Gross Amount Due to Seller 100,891.42 200. Amounts Paid b or in Behaif of Borrower 500. Reductions In Amount Due to Selier 201. Deposil or earnest money 501. Excess deposit(see instructions) 202. Principal amounl of new loan(s) 80,000.00 502. Seltlement charges lo seiler(line 1400) 43,334.00 203. Existin loa s taken sub'ect to 503. Existin loa s taken sub'ect to 204. 504. payoff of first morlgage loan#4538462350 l0 32,50A.06 Santander 205. 505. Payoff ofsecond morfgageloan 206. Gift of Equity 20,000.00 506. Gift of Equily 20,000.00 207. SellerAssist 5,000.00 507. SellerAssist 5,000.00 208. 508. 209. 509. Ad'ustments for items unpaid b seller Ad'ustments for items unpaid b seller 210. Cityltown taxes fo 510. Cilyltown taxes to 21 L Counry taxes 0110112014 to 01108I2014 9.03 511. County laxes 0110112014 to 0110812014 9.03 212. Assessments to 512. Assessments lo 213. School Taxes to 513. to 2�q 514. 215. 515. 216. 516. 217. 517. 218, 518. 219. 519. 2Z�• Total Paid b Ifor Borrower 105,009.03 520. Total Reduction Amouqt Due Seller 100,651.09 300. Cash at Settlement fromlto Borrower 600. Cash at Settlement tolfrom Seller 301. Gross amount due irom borrower(line 120) 105,394.89 601. Gross amounf due to seller(line 420) 100,891.42 302. Less amounts paid bylfor borrower(line 220) 105,009.03 602. Less reduclions in amount due seller(line 520) 100,851.09 303. Cash QX From ❑ To Borrower 385.86 603. Cash QX To ❑ From Seller 40.33 e��or iny es�e�resn��.se n� inB,reviev�iny.eni ie��nr ii�p �e a n is ayAi�cy inay no co nc iix��niinT i��,nn�ynu nre�o re��iire n c�m��v.s I�'is lnrm,iinlnss II t1is�IpySPP G�rrenlly velid OMB conlmi numbae5 No�co��fltlanllellly fs essiirxR,IhLS discl siirefis menAalory.Tlils Is designad lo�rovlAa Ihe�atlles lo a RESPA oovaretl lrnnsncllon wIIM1 lnlormnlinn tli��inp lM1e r :Pm.me��o�o�es:. 700. Total Real Estate Broker Fees Pald From Paid From Divisionoicommission Iine700 asfollows: BorroWel''S Seller's 701. $0.00 to Funds at Funds at 7�z, $0.00 to Settlement Settlement 703. Commission paid at settlement 800. Items Pa able in Connection with Loan 801. Our origination charge (Inciudes Origination Point 0.000%or$0.00) $2,775.00 {from GFE#1) 802. Your credif or charge(poinls)for the specific interest rate chosen $-1,576.80 (from GFE#2) 803. Your adjusted origination charges (from GFE A) 1,198.20 804. Appraisai fee to Act A raisal $425.00 P.O.C.8'(from GFE#3) 805. Credit report to Cod Financial Morl a e Services,Inc.for Credit P(from GFE#3) 108.00 806. Tax service to trom GFE#3 SW. Flood certification to irom GFE#3 808. lo 900. Items Re uired 6 Lender to 6e Paid in Advance 901. Daily interest charges from irom 01/0812014 to 02/01/2014 @$10.68001day (from GFE#10) 256.32 902. Morlgage Ins.Premium for monfhs to (from GFE#3) 903. Homeowner's insurance for 1 ears to Goodvilie Mutual Casualt Co. $891.00 P.O.C.B'(from GFE#11) 904. Flood Insurance for monlhs to ASI Flood Insurance $1,523.00 P.O.C.B'(from GFE#11) 1000. Reserves De osited with Lender 1001. Initial deposit for your escrow account (from GFE#9) 1,584.95 1002.Homeowner's insurance 4 mon(hs $ 74.251month $297.00 1003.Mortgage Insurance monihs $ O.DO/monlh $ 1004.Flood Insurance 4 monihs $ 126.92/month $507.68 1005.Coun(y Property Tax 12 months $ 39.251month $471.00 1006.School Property Tax 8 months $ 155.831month $1,246.64 1007.Aggregafe Adjuslment $-937.37 1100.Title Char es 1101. Title services and lender's title insurance from GFE#4 1,090.00 1102. 5etllemenl or closing fee to $ 1103. Owner s tille insurance-Old Republic National Tille Insurance Co. from GFE#5 110.00 1104. Lender's tifie insurance-Old Republic National Title Insurance Co. $1,015.00 1105. Lender's tilie policy limil$80,000.00 Lender's Policy 1106. Owner's litle policy limit$100,000.00 Owner's Policy 1107.Agenfs portion of the tolal title insurance premium $892.50 1108. Undenvriter's portion of the total title insurance premium $232.50 1109. E-doc Delivery Fee to Charter SetUement Svcs.ac$35.00 1110. CounerlWire Fee to Charter Settiement Svcs.ac$�5.00 1111. Nofary Fee to Charier Setllement Svcs.ac$25.00 1112. Reimburse for Tax Certification to Charter Settlement Svcs.ac$ 1200. Govemment Recordin and TransferChar es 1201. Govemment recording charges $ (from GFE#7) 156.00 �2o2, Deed$67.00 Mori a e$89.00 Release$ 1203. Transier taxes $ (irom GFE#8) 1204. Deed$ Morl a e$ 1205. Slate Taxlslamps Deed$ Morl a e$ 1206. Deed$ Morl a e$ 1207. $ 1300. Additional Settlement Char es 1301.Required services thal you can shop for ((rom GFE#6) 1302. Survey to $ 1303. io 1304. Purchase Price Agreement to Tro 0.Brenneman 19,000.00 1305. Purchase Price Agreement to Dawn D.Fentress 19,000.00 1306. Escrow Inhentance Tax to Held b Charter Setflement Services,LLC 5,334.00 ,�i , i , � 4,503.47 43,334.00 "Paid outside of closing by(B)orrower,(S)eller,(L)ender,(I)nveslor,Bro(K)er."Credil by lender shown on page 1.'""Credif by seller shown on page 1. Com arison of Good Faith Estimate GFE and HUD-1 Char es Good Faith Estimate HUD•1 Char es That Cannot Increase HUD-1 Line Number Our originafion charge # 8�� 2,775.OD 2,775.00 Your credit or charge(points)for the specific interest rate chosen # 802 -1,576.80 -1,576.80 Your adjusted originalion charges # 803 1,19Q.20 1,198.20 Transferlaxes # 1203 0.00 0.00 Char es That in Total Cannot Increase More Than 10% Good Faith Estimate HUD-1 Government recording charges # 1201 190.00 156.00 Appraisal(ee # 8�4 425.00 425.00 Credi!report q 805 50.00 108.00 TiUe services and lender's title insurance # 1101 1,150.00 1,090.D0 Owner's title insurance-Old Republic Nationai TiUe Insurance Co. # 1103 110.00 110.00 # # # 1,925.00 1,889.00 � $ -36:00 p� -1.8701% Char es That Can Chan e Good Faith Estimate HUD•1 Ini�ial deposit for your escrow account # 1001 515.17 1,584.95 Daily interesl charges trom # 901 $10.68001day 320.40 256.32 Homeowner's insurance # g�3 594.00 891.00 Flood Insurance # 9�4 3,442.08 1,523.00 # # # Loan Terms Your inilial loan amount is $B0,000.00 Your loan term is 30.years Your initial interest rate is 4.8750% Your inifial monthly amounl owed(or principal,interest,and any morigage $423.37 includes insurance is XQ Principal QX Interest ❑Mortgage Insurance Can your interest rate rise? X❑No. ❑Yes,it can rise to a maximum of °/. The first change will be on I I and can change again every years after 1 I . Every change dale,your interest rale can increase or decrease by °/. Over the life of the loan,your interest rate is guaranteed to never be lower than %or higher lhan %. Even if you make payments on lime,can your loan balance rise? ❑X No. ❑Yes,il can rise lo a maximum ol$ Even if you make payments on time,can your monthly amount owed for QX No. ❑Yes,the first increase can be on ! 1 and the monfhly principal,inlerest,and morigage insurance rise7 amount owed can rise fo$ The maximum it can ever rise to is� Does your loan have a prepaymen�penaity? QX No. ❑Yes,your maximum prepayment penally is$ . Does your loan have a bailoon payment? ❑X No. ❑Yes,you have a balloon payment of$ due in years on I I Total monthty amount owed induding escrow account payments ❑You do not have a monthly escrow payment for items,such as property taxes and homeowner's insurance. You musl pay lhese items direcUy yourself. QX You have an additional monthly escrow payment of$396.25 that results in a total initial monlhly amount owed oi$819.62. This includes principal,interest,any morlgage insurance and any items checked below: QX Properiy taxes Q Homeowner's insurance ❑X Flood insurance QX School Tax ❑ � Note: If you have any questions about the Settlement Charges and Loan Terms listed on this form,please contact your lender. . HUD CERTIFICATION OF BUYER AND SELLER I have carefully reviewad the HUD-1 Settlement Statement and to the best o(my knowledge and belief,it is a true and accurale statement of all receipts and � disbursements made on my account or by me in this transaction.I further certify that I have received a copy of lhe HUD-1 Seltlemenl Statement. ; p , � jL� ��,�. i�('r't/ �'� '�....:u _.�. .:.---_.. Jant'es Scotl Brenneman i i i �._/� /�' �1�['LL�' �1�c��1'��a-� l /(.l'aa,cttt.,[..� Estate of Kay Brenneman The HUD-1 SetNement Statement which I have prepared is a true and accurate account of this transaction I have caused or will cause lhe funds lo be disbursed in accordance with this statement. �v�C'��+�t,�I/J J'r��c:�,a� �,�/��' SETTLEMENTAGENT DATE WARNING:IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM.PENALTIES UPON . Name of Borrower. Name oi Seller: File Number. James Scott Brenneman Estate of Kay Brenneman CS13609 Prepared 01108/2014 al 11:54 am Note:This page displays an itemization of the adjusted origination charges shown in section 800 of the HUD-1 Settlement Statemen 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. Your Loan Origination Charges Borrower Seller 801. Our origination charge (Includes Origina(ion Point 0.000%or$0.00) Origination Fee to Cod Financial Morl a e ServicE$ 2,100.00 Adminisirafion Fee to Mort a e Services,III,LLC $ 675.00 802. Your credit or charge(poinis)for the specific interesl rate chosen Lender Credit to Borrower $ -1,576.80 803. Your adjusled origination charges 1,198.20 0.00 . i Name of Borrower: Name of Seller. File Number: James Scott Brenneman Estate of Kay Brenneman CS13609 Prepared 01108/2014 at 11:54 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 Borrower Seller 1101.Title services and lender's title insurance �0 1,090.00 0.00 Subtotal $ 0.00 1102.Seitiement or closing fee to $ 0.00 Borrower 1104.Lender's tille insurance-Oid Republic Natiqo Charter Setilement Svcs.a ent f�$ 1,015.00 Borrower 1109.E-doc Delivery Fee to Charter Settlemenl Svcs.a ent f$ 35.00 Borrower 1110.Courier/Wire Fee to Charter Settlement Svcs.a ent 6$ 15.00 Manual 1111.Notary Fee to Charter Settlement Svcs.a enl f$ 25.00 Manual 1112.Reimburse for Tax Certificafion to Charter Settlement Svcs.a ent f�$ 0.00 Seller SellerlLender credits shown on pa e 1 POC=Paid Outside C�osin CHARTER SETTLEMENT SERVICES, LLC CENTRIC ESCROW ACCOUNT 'BANK � N�rti�bury.PAlill? NUMBER 4705 E.TRINDLE ROAD MECHANICSBURG,PA 17050 5576 60-1526/313 O1/08/14 ***$19,000.00*** DATE AMOUNT The Sum NINETEEN THOU�iDR3 DOLLARS and 00/100 PAY TO THE VOID AFTER 90 DAYS ORDER Troy O. Brenneman OF `�;��U�U1_,�.li''� ��1,c.�.�—' � _ ,� �., � ��°0055 ?~6��' �:03b315269�: LLL27B8��' CHARTER SETTLEMENT SERVICES,LLC /ESCROW ACCOUNT ^J 'rj 7 6 Date: O1/08/14 Amount: 19,000.00 File Number: CS13609 Check #: 5576 Pay To: Troy 0. Brenneman Buyer: James Scott Brenneman Seller: Estate of Kay I. Brenneman Property: 30 Cave Hill Drive, Carlisle, PA 17013 19,000.00 Purchase Price Agreement SF4001-i REORDER FROM YOUR LOCAL SAFEGUARD DISTRIBUTOR.IF UNKNOYYN.CALL800-523-2922 - HXW%YN0010000 8705F076261 `lL*SAtfGUARD. .r-,,.._� _:;__. -... , CHARTER SETTLEMENT SERVICES, LLC CENTRIC ESCROW ACCOUNT �B�,�,K NUMBER 4705 E.TRINDtEt10AD MECHANICSBURG,PA 77050 5573 60-1526/313 O1/OS/14 ***$19,000.00*** DATE AMOUNT The Sum NINETEEN THOIISAND DOLLARS and 00/l0D PAY TO THE VOID AFTER 90 DAYS ORDER Dawn D. Fentress OF ` ��' � � � /� �_ � r i�'00 5 5 7 3��■ �:0 3 1 3 15 269i; L b � 2 788��' CHARTER SETTLEMENT SERVICES,LLC /ESCROW ACCOUNT 5 5 7 3 Date: O1/08/14 Amount: 19,000.00 File Number: CS13609 Check #: 5573 Pay To: Dawn D. Fentress Buyer: James Scott Brenneman Seller: Estate of Kay 2. Breuneman Property: 30 Cave Hill Drive, Carlisle, PA 17013 19,000.00 Purchase Price Agreement SF�Q�� REOADER FROM VOUR LOCAI SAfEGUARD DISTRIBUTOR,IF UNKNOWN,CALL 800-523•2422 HXWXVN00100�� 6105F016267 "�'SAffGUARD _ . ._ ,__ .- .., .. � CHARTER SETTLEMENT SERV{CES, ��c CENTRIC � ESCROW ACCOUNT �BANK 4705 E.TRINDLE ROAD "'""'"'Fr^""= NUMBER MECHANICSBURG,PA 17050 5565 60-1526/313 O1/10/14 ***$32,558.52*** DATE AMOUNT The Sum THIRTY TWO THOUSAND FIVE HUNDRED FIFTY EIGAT DOLLARS and 52/100 PAY TO THE ORDER Santander Bank, N.A. VOIDAFiER90DAYS OF ��,�V/-' • G•'`nf�f /� E ��/ ytt L fCG � k�yt _ _' _... . _. ..�.�_.� ..,.. ..�.�.:. _,��.�/i.'-�� ` a ,a s a-. .u��s+ � et i i �a er-� 'i�I c, a a l� � - ii'00 5 58 5�i° se0 3 � 3 b 5 269�: b b b 2 788ii' CHARTER SETTLEMENT SERVICES,LLC /ESCROW ACCOUNT �J 8 5 Date: Ol/10/14 Amount: 32,558.52 File Number: CS13609 Check #: 5585 Pay To: Santander Bank, N.A. Buyer: James Scott Brenneman Seller: Estate of Kay I. Brenneman Property: 30 Cave Hill Drive, Carlisle, PA 17013 32,558.52 Loan #4539462350 0.00 Estae of Ray I. Brenneman 0.00 30 Cave Hill Drive 0.00 Carlisle, Pa. 17013 SF4001-7 REORDER FROM VOUR LOCAL SAFEGUARD OISTRIBUTOR,IF UNKNOWN,CALL B00•523-742Y HXWXYNOD70000 B7DSF076267 �Sflf-[GUhilD.. un,ous�. s�s�z cn�sos»z� � aTu�ated Value of Your Paper Savings Bond(s) ��'��}�-� ��/�1-�� -�-�• Page 1 of 1 ��,rin P!�'��j Calculated Value of Your Paper Savings Bond(s) Calculator Results for Redemption Date 09/2013 Total Price Total Value Total Interest YTD Interest $450.00 $772,04` $322.04 $20.68 Bonds: 1-17 of 17 Serial # Series Denom Issue Next Final Issue ' Interest Interest Value Note Date Accrual Maturity Price Rate L622262fl20EE! EE $50'04/2002 10/2013 04/2032 $25.00: $9.26 0.63% $34.26 __ _ .. - L586224156EE� EE $50 02/2000 10/2013, 02/2030 $25.00 $13.08 0.68% $38.08 L589331248EE EE $50 10/2000 10/2013 10/2030 $25.00 $12.08; 0.63%_ $37.08 L579557180EE EE . $50, 10/1999 10/2013 10/2029 $25.00 $13.86 0.63%a_$38.86 L575562575EE EE $50, 04/1999 10/2013' 04/2029 $25.00 $14.72' 0.63% $39J2 __ . _ . __ C655168604EE EE $100' 10/1998 10/2013 10/2028 $50.00 $31.56 0.63% $81.56 __ L559206066EE EE $50 07/1997 10/2013 07/2027_ $25.00 $18.18 0.68% $43.18 L557107461EE EE $50 04/1997 10/2013 04/2027 $25.00 $17.02 0.59% $42.02 L561087486EE EE ' $50 10/1997 10/2013' 10/2027 $25.00 $18.12 0.63%: $43.12 L516653593EE EE $50 04/1996 10/2013 04/2026 $25.00 $25.00 0.59% $50.00 L548698483EE EE ' $50. Q7/1996 01/2014 07/2026 $25.00 $25.00, 0.65% $50.00; L538859717EE EE $50, 07/1995 01/2014 7 07/2025, $25.00 _$25 34 0.65%: $50 34 L534670795EE: EE $50 Ol/1995 10/2013 O1/2025 $25.00 $27.38 4.00% $52.38 L536721954EE EE $50', Q4/1995 10/2013 04/2025 $25.00 $26.86 4.00%. $51.86 __ _ _ L527924524EE EE $SO, 10/1994 10/2013 10/2024 $25.00 $27.90 ' 4.00% $52.90 _. _. L597807512EE EE $50 01/2003 10/2013 01/2033 $25.00 $8.02 0.68% $33.02, _ __ L624128865EE EE $50 07/2002 10/2013 07/2032 $25.00 $8.66 0.68% $33.66 Totals for 17 Bonds $450.00I 322.04. ' 772.04'. Notes NI Not Issued _ __ ___ _ . . _ _ NE Not eligible for payment __ __ _ _ __ PS Includes 3 month interestpenalty _ .. _ ______.._ MA 'Matured and not earnin interest �� 1 � G- ��G�e l'�n C./�c�1�.� , f��.� jL ��r'� �,r�,i- ,.{ � �'�. (`?�4f�.K J' G`�t P C'P/-�,J t._��e� ��`�C�_S,r,�� _.�_.ii.........�..............a:_,.,.� ��_.mrionnn..:..,, n/�n/�n�� APPRAISAL REPORT OF PERSONAL PROPERTY OF The Estate of Kay I. Brenneman 30 Cavehil) Drive Carlisie PA 17013 FOR Scott Brenneman 30 Cavehiil Drive Carlisie PA 17013 AS O F November 11, 2013 BY: JASON M. SMITH Appraiser of Personal Property 545 Mumper Lane Dillsburg, PA 17019 717-421-9750 APPRAISAL CERTIFICATE I hereby certify that upon request for valuation of the personal property of the Kay i. Brenneman Estate, located at 30 Cavehill Drive Carlisle PA 17013, by Scott Brenneman, 30 Cavehill Drive, Carlisle PA 17013, I have personally inspected the following personal property for the purpose of appraising and reporting the Fair Market Value as of this 11th day of November 2013. The information and values contained in this report are based upon my experience as an appraiser and other reliable sources. The personal property was found to be in good condition unless otherwise noted. Values are reported piece by piece and as a whole. APPRAISAL SUMMARY It is my opinion that, as of thlS 11th day of November, 2013, the Fair Market Value of the personal property of the Kay I. Brenneman Estate is: FOUR THOUSAND SEVEN HUNDRED EITHYTY FOUf� DOLLARS ($4,784.00) Signed, f� ^ '�r-- � � +'� l. .i` SON M. SMfTH APPRAISER __ FURNITURE Sectional Sofa Set 60.00 Recliner 45.00 Coffee Table as is 5.00 Single Bed 20.00 Kitchen Table w/4 chairs 4�.00 Cupboard 35.00 Butcher Block 30.00 Chest of Drawers 15.00 Full size mattress and box spring w/bed frame 80.00 Dresser w/mirror 45.00 GUNS Marlin 80/22 rifle w/scope 125.00 Harrington and Richardson Plainsman 22 rif{e 60.00 Marlin 30/30 model 336 lever action 225.00 Mossburg 16 ga. bolt action 50.00 LAWN AND GARDEN Yard Machines push mower 45.00 Huskee 46" cutting riding mower 125.00 Small Trailer 75.00 BOATS AND VEHICLE Paddle Boat 125.00 Sweetwater Challenger pontoon boat 800.00 2002 Ford Taurus (106,000 miles) 2,779.00 4,784.OQ LAST WILL AND TESTAMENT OF KAY I.BRENNEMAN � I,KAY L BR�NNENIAN,widower,of 30 Cave Hili Drive, Carlisle,Cumberland County,Pem�syivania,being of sound and disposing mind,inemory and understanding,do � hereby make,publish and declare this as and for my Last Will and Testament,llereby revoking � and making void any and ail wills by me at any time heretofore made. �� ? l. I direct my hereinafter named Executrix,Co-Executors or Executor,as the case may t � be,to pay all of my just debts and funeral expenses as soon after my death as may be found ��.. _ � convenient to do sa I furtl�er direct that all inheritance,transfer,succession,estate and death �� ^�� taxes,includin�i�lterest and penalties thereon,whidi may be payable oiz account of my death, \� � � H_____, shall be payable from the residue of my estate regardless of whether the assets upon which such taxes are based are iilcluded in my probate estate. 2. I declare that I am a widower,and that I have three children,DAWN D.FENTR�SS of Carlisle,Pennsylvania,TROY 0.BRENN�MAN,of Pittsbuigl�,Pennsylvania and JAMES S. BRENNEMAN of Boiling Springs,Pennsylvania. 3. I give and bequeath to my two sons,TROY O. BRENNEMAN and JAMES S. BRENN�MAN,all of the guns owned by me at the time of my death and my knif'e collection to be divided eyually betweeu the two of thein. Should either of my sons predecease me or fail to survive me by a period of uinety(90)days,then tl�eir share shall lapse and be added to the reinaining sl�are,and if neither of them should survive me by a period of uinety(90)days,then this bequest shall lapse aud be added to tlle residue of my estate. � 4. I give and devise Five Thousand Dollars($5,000.00)to my granddaughter,KAYLIN `A"'°FF'�ES p,TRINtBLE of Carlisle,Pennsylvania,provided she shall survive me by a period of ninety(90) SNELBAKER EC BRENNEMAN,P.C. days. Should my�randdaugl�ter,KAYLIN A.TR1MaLE predecease me or fail to survive me by a period of ninety(90)days,this bequest si�all lapse and be added to the resi�lue of iny estate. 5. All the rest,residue and remainder of my estate, real,personal aud nlixed,and i �I I �I � i �; wheresoever the same may be siCuaCe,I give,devise and bequeath in equal sl�ares to sucl�of my � childreu as shall survive me by a period of ninety(90)days. The share any deceased cl�ild��ould � have received shall pass to his or her issue per stii-��es,and if there be no such issue,said share shall lapse and be added to the rei�iaining sllare or shares. At the present tiine I have three children as alorementioned. 6. I hereby nomiilate,constitute and appoint my dau�l�ter,DAWN D. FEN"1'RESS,as Executrix of this n�y Last Will and Testament,but sl�ould she predecease me or fail to qualify as such,thetl in siicl�event,I nominate constihite and appoint my two sons,TROY 0. BRENNEMAN and Jt1MES S.BRLNNEMAN, to serve together as Co-Executors,or the survivor of them to serve as�xecutor if one should predecease,and i furti�er direct that none of thenl shall be required to post any boud to secur•e the faithfiil performance of her or his duties in the Commonwealth oFPennsylvania or in any other jurisdictioil. 1N WITNESS WHEREOF,1 have hereunto set my hand and seal to this my Last Will and Testament written on Two(2)pages this 19`�day of Atiigust,2013. � �� '�c �„i,�,�^%r (SEAL) Kay I.Br neinail Signed,sealed,published and declared by KAY I. BRENNEM.AN,the Testator above named,as aild for his Last Will and Testament,iu our presence,who,in his presence,at his rec�uest,and in the presence of each other,have hereuilto subscribed our names as attestin� witnesses. bd� (S�AL) ;�1;?,.l',�.,�.`;.�._ _ --(SLAL) LAW OFFICES SNELBAKER E� BRENNEMAN, P.C. . _2' I r � � COMMONWEALTH OF PENNSYLVAMA) : SS. COUNTY OF CUMBERLAND ) We,KAY I. BRENNGMAN,KEITH O. BRENNEMAN,ESQUIRE and RICHAIZD C. SNELBAK�R,ESQUIRE,the Testator and the witnesses,respectively,whose uames are signed to the attached or foregoing instrument,being tirst duly s�vorn,do hereby declare to the undersigned atiitllority that the Testator signed and executed the inshui�ient as his Last Will and Testament and that he l�ad signed willin�ly,a�Id that he executed it as l�is fi�ee and voluntary act � for the purposes tl�erein expressed,and that each of the witnesses,in tl�e presence a�1d hearing of � the Testator,signed the Will as witness and that to tlle best of'lvs or her knowledge the Test�ator was at that time eighteen years of age or older,of sound mind and under�no constrainC or undue influence. �� Y-� �'»'"ti'1 --�—d � �r��n. Testator C�"�------ witness ,'"�^� .,� � /) �r ��'4"G'e>!%:�' /�"'J.--[/�.�i<..J_� '� wltrieSS SubscriUeci,swo�n to and acknowledged before me by KAY I.BRENNEMAN,Testator,and subscribed and sworu to bePore me by KEITH O.BRENNEMAN,ESQUIRE andRICHARD C. SNELBAKER,ESQUIRE,witilesses,this 19`�'day of Auglist,2013. � l i ,�. � _�, ,� � � , Nofary Public � LAW OFFICES I/ SNELBAKER 8c V BRENNeMnN,P.C. COMMONWEALTH 0�PENNSYLVANIA Notadal Seal � Susan L Matrazi,Notary Publit Mechanicsburg Boro,Cumberland Counry My Commission Expiras Nov.24,2015 MEMBER,PENNSYLVA(P/J�FS<OQAT70N OF NOTARIES