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HomeMy WebLinkAbout05-16-14 (2) 1505610105 REV-1500 ax-""F1' i►3' PA Department of Revenue Pennsylvania OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year Fie Number PO BOX 280601 INHERITANCE TAX RETURN) Harrisburg,PA 17128-O60i RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMODYYYY 04/22/2013 12/22/1918 Decedent's Last Name Suffix Decedent's First Name MI Teitrick Frances 13 ; (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name M! Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW OD 1.Original Return C.7 2.Supplemental Return p 3. Remainder Return(Date of Death Prior to 12-13.82) CC 4.Limited Estate tC 4a.Future Interest Compromise(date of C:) 5. Federal Estate Tax Return Required death after 12-12-82) OD 6.Decedent Died Testate C) 7. Decedent Maintained a Living Trust 1 8.Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) C3 9.Litigation Proceeds Received O 10.Spousal Few"Credit(Date of Death G3 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 John C. Oszustowicz (717) 243-7407 0 ...� .M REGISTEfEMf LLS USE cdsjJ Y C'� CID da m =C c� c �G First Line of Address � 7. M f-T Q 104 S Hanover St, n cn z z . � d> o Second Line of Address n C> O M ...� N City or Post Office State ZIP Cade UATE FILED p Carlisle PA 17013 Correspondent's e-mail address:john @cadislepalaw.com 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 We,corect and correlate.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF M RESPOOMBLE FOR HONG RETURN CATE uGC SIG !y ADDRESS SIGNATURE OF PREPARER OTHER THAN REPRESENTATtvE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610105 1505610105 1505610205 REV-1500 EX(Fl) Decedent's Social Security Number Decedent's Name: i RECAPITULATION 1. Real Estate(Schedule A). ............................................ 1. '. 179,000.00 2. Stocks and Bonds(Schedule B) ...... ................................. 2. , 3,392.40 3. Closely Held Corporation,Partnership or Sole-Proprietorshlp(Schedule C) ... .. 3. 4. Mortgages and Notes Receivable(Schedule D)........................... 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. , 216,379.49 6. Jointly Owned Property(Schedule F) C= Separate Billing Requested . ...... 6. 1,201.89 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested........ 7. . 38,086.97 8. Total Gross Assets(total Lines 1 through 7)............................. B. 400,012.6411 9. Funeral Expenses and Administrative Costs(Schedule H)................... 9. 26,939.03 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)........ ....... 10. 1,539.39 11. Total Deductions(total Lines 9 and 10)................................. 11. ._-- 28,478.42 12. Net Value of Estate(Line 8 minus Line 11) ........... ................... 12. I 371,534.22 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) ...................... .. 13. 2,000.00 14. Net Value Subject to Tax(Line 12 minus Line 13) ........................ 14. • 369,534.22 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 -- (9)(1.2)X.0- 15. 16. Amount of Line 14 taxable at lineal rate X.0 45 1 369,534.22 16.I 16,629.04 17. Amount of Line 14 taxable at sibling rate X.12 17. 18. Amount of Line 14 taxable - -1-- v- - ---- 11'"--' at collateral rate X.15 18. 19. TAX DUE.............. ........................................... 19.1 16.629.04 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT p Side 2 L 1505610205 1505610205 J REV-1500 EX(FI) Page 3 File Number Decedent's Complete Address: DECEDENTS NAME Frances B Teitrick STREET ADDRESS 177 Glendale Street CRY STATE ZIP Carlisle PA 17013 Tax Payments and Credits: I. Tax Due(Page 2,line 19) (1) 16,629,04 2. Credits/Payments A.Prior Payments 13,000.00 j 8.Discount 664.00 3. Interest Total Credits(A+8) (2) 13,684.00 j 4. U line 2 is greater than Line i+Line 3,enter the difference. this is the OVERPAYMENT. (3) 27.53 Fill In oval 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) 2,972.57 Make check payable to: REGISTER OF WILLS,AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X' IN THE APPROPRIATE BLOCKS I. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred.......................................................................................... Q N It. retain the right to designate who shall use the property transferred or its income................_.......................... ❑ c. retain a reversionary interest.................................................................---...................................................... ❑ ■ d. receive the promise for life of either payments,benefits or care?.............--..................................................... ❑ 0 1 If death occurred after Dec.12,1962,did decedent transfer property within one year of death w thou,receiving adequate consideration?.......--................--...............--........................................-................ ❑ 3. Did decedent own an 9n 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? ....................,............---........................,..................._............. ........._._..... © j 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 172 P.S.§9116(a)(1.1)(1)]. 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 disdosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an adoptive parent or a stepparent of the child is 0 percent(72 P.S.§9116(a)(1,2)). • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in(72 P.S.§9116(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 172 P.S.§9116(a)(1.3)].A sibling is defined, under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption. REV-1502 Ek+(12-12) pennsytvania SCHEDULE A DEPARTMENT OF REVENUE REAL ESTATE INNERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Frances Teitrick 2013-0546 All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value Is defined as the price at which property would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts. Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F, Attach a copy of the settlement sheet if the property has been sold, ITEM include a copy of the deed showing decedent's Interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1. 177 Glendale Street,Cadisle,PA 17013-MUD attached 179,000.00 l I TOTAL(Also enter on Line 1,Recapitulation.) $ 178.000.00 If more space is needed,use additional sheets of paper of the same size. REV-1503 EXa(a-rz) i pennsylvania SCHEDULE B DEPARTMENTOFREVENUE INHERITANCE TAX TURN STOCKS & BONDS RESIDENT DECEDENT ESTATE OF FILE NUMBER Frances Teitrick 2013-0546 All property jointly owned with right of survivorship must he disclosed on Schedule F. ITEM NUMBER VALUE AT DATE DESCRIPTION OF DEATH t' 116 Shares AT&T stock @$38.55 4,471.80 i. TOTAL(Also enter on Line 2, Recapitulation) $ 3,392.40 If more space is needed,insert additional sheets of the same size REV•rso8 Ex+08-W pennsytuania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERn"CE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Frances Teitrick 2013-0546 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. M&T Bank Checking Account#441627 25,134.85 2 M&T Bank CD#31003916165036 12,802.28 3 M&T Bank CD#31003917740572 9,002.07 4 M&T Bank CD#31003920367438 10,000.28 5 M&T Bank CD#31003920367165 7,002.54 6 Accrued interest on items 1-5 443.41 7 Susquehanna Bank CD#290004707 with accrued interest 12,061.58 8 Susquehanna Bank CD If 290002936 with accrued interest 37,921.06 9 Metro Bank CD#7700175537 with accrued interest 35,286.51 10 Santander Bank Checking Account 128.60 11 Santander Bank CD#231372691 1675547895 10,009.04 12 Santander Bank CD#231372691 1675548950 37,00000 13 Santander Bank CD#231372691 1675551632 1,021.45 14 Fidelity&Guaranty Life Asset Account#50008374 payable to Estate 12,889.79 15 Fidelity&Guaranty Life policy#00112628 payable to Estate with settlement interest 2,075.84 16 Dividends on AT&T stock 52.20 17 Interest on M&T Bank CD's 8.56 18 Comcast Cable refund 4.58 19 Interest on Santander Bank CD's 34.85 20 Personal Property 3,500.00 TOTAL(Also enter on Line 5, Recapitulation) $ 216,378.49 If more space Is needed,use additional sheets of paper of the same size. REV-1509 EX+(01-10) Pennsylvania SCHEDULE F DEPARTMENT OF REVENUE INHERITANCE TAX RETURN JOINTLY-OWNED PROPERTY 0.ESIOERT DECEDENT ESTATE OF: Frances Teitdck FILE NUMBER: SURVIVIN If an asset became jointly owned within one year of the decedent's date of death,it must be report 2013-0546 05 dole G. A,Nancy Bachman G JOINT TENANT(-)NAME(-) AODRESs d on 619 Hilltop Drive RELATIONSHIP TO DECEDENT New Cumberland, PA 17070 Daughter B.Ron Bachman 619 Hilltop Drive New Cumberland, PA 17070 Son-in-law C. JOINTLY OWNED PROPERTY: LETTER DATE ITEM FOR JOINT DESCRIPTION OF PROPERTY NUMBER TENANT MADE INCLUDE NAME OF FINANCIAL IN JOINT IDEn1 NG NUMBER.ATipCH DEEDD FOD0.JplNRYCHElO REAL ESTATE.SIMILAR %OF DATE OF DEATH DATE OF DEATH DECEDENTS VALUE OF 1 A 08/12/11 Sovereign Bank CD#1675450249 vuuE of ASSET INTEREST DEOEOEHTS INTEREST 1 6. 08112111 See Above CD 1,201.89 33. 400.63 TOTAL(Also enter on Line 61 Recapitulation) $ 400.63 If more space is needed,use additional sheets of paper of the same size. REV-1510 EX,(08-09) j[ 7pennsylvania SCHEDULE G �-� DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INNERITANE:ETAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF Frances Teitrick FILE NUMBER This schedule must be completed and filed If the answer to any of questions 1 through 4 on page three of the REV 2013-0546 ITEM DESCRIPTION OF PROPERTY NUMBER 1NQ1JpE"¢HWE Or TK TMAxWME.ME14 REUnOWp To DEaoExr AND DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE ME DAIS V TRARM ATTAO A 00"a n DEED FOR REAL EsiA1E. I• Westem Nauonal FLE Annuity Contract 11 W224054 VALUE OF ASSET INTEREST nAE c." VALUE Transferrees: 38,086.97 100 0.00, 38,086.97 Sue Coffee, Step-Daughter Transferred 9/13 Nancy Bachman,Daughter Transferred 8/13 Carolyn Eshelman,Daughter Transferred 8/13 Larry Eshelman,Son Transferred 8/13 I i N } TOTAL(Also enter on Line 7, Recapitulation) $ 38,086.97 If mare space is needed,use additional sheets of paper of the same size. REV-1511 EX+ (08-13) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE RN RESIDENT NTDECEDENT ADMINISTRATIVE COSTS ESTATE OF Frances Teitrick FILE NUMBER ITEM 2013-0546 Decedent's debts must be reported on Schedule I. NUMBER DESCRIPTION A. FUNERAL EXPENSES: AMOUNT 1' Food&supplies for memorial service , 2 Auer Crematorium ' - 408.54�� ` 3' IOsieds Holding-graveston engraving F'�-=_-�—.-- 55.00 I < 210.00 ' Music for memorial service r -_ .250.00 5 Pastor fee for funeral —�- �....�: - 400.00 B. ADMINISTRATIVE COSTS: - 1. Personal Representative Commissions: Name(s)of Personal Representative(s) I Street Address city State_ZIP Year(s)Commission Paid: Z• Attorney Fees: L__113,600.00 • 12,600.00 4 3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation.) Claimant - • Street Address City State_ZIP Relationship of Claimant to Decedent 4• Probate Fees: 568.50 S• Accountant Fees: 6. Tax Return Preparer Fees: ,; --+++�...�.r- 7. +CUmberiand County Law Journal-legal advertising 75.00 LThe Sentinel-legal advertising 1 15.20 9 Borough of Cadisle-water&sewer -� -: - _ ___ _ _ _ _J 1 _ 291.60 _1 D. Calaman's Lawn Service-mowing - - 11 843.75 11' Carlisle Borough Tax Collector-2013 School Taxes — _ 2,371.15", ) 12 From Schedule H Continued -- 8,750.291 TOTAL(Also enter on Line 9, Recapitulation) ; 26,939.03 If more space is needed, use additional sheets of paper of the same size. SCHEDULE H CONTINUED Estate of: Frances Teitrick File d 2013-0546 Item Description Amount 13 Carlisle Petroleum -oil 2090.82 14 Carlisle Propane-propane 230.18 15 Centurylink- phone bill 17.78 16 Charles Holtry,Tax Collector-2014 Real Estate Taxes 1112.80 17 Ibis Appraisal Services, LLC 375.00 18 The Sentinel- House for sale ad 140.20 19 PA Dept of Revenue- 2013 Estate Tax due 3.00 20 Penn National Insurance-homeowners insurance 830.00 21 PPL Electric Utilities 439.36 22 Precision Cleaning-house cleaning to put up for sale 160.00 23 Shane Bouder-trash removal 350.00 24 House settlement fees due from seller 1892.90 25 Deluxe Check-fee for estate checks 33.25 26 Charles McKenrick-to reimburse for home inspection repairs 1075.00 Total to include on Schedule H line 12 8750.29 REV-1512 Ex+(12-12) i pennsylvania SCHEDULE I 1 DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INNERrE ED ENT RETURN RESIDENT W DE�D MORTGAGE LIABILITIES & LIENS ESTATE OF FILE NUMBER Frances Teitrick 2013-0546 Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE DATE OF DEATH 1. Sarah A Todd Memorial Home 567.50 2 M&T Bank-credit card payment(Prescriptions) 845.04 3 Cumberland Goodwill EMS 51.85 4 John C.Oszustowicz-2012 tax prep 75.00 TOTAL(Also enter on Une 10, Recapitulation) $ 1,539.39 If more space is needed,insert additional sheets of the same size. REV-1513 EX+(01-10) Ji pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAI(RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Frances Teitrick 2013-0546 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS[Include Outright spousal distributions and transfers under Sec.9116(a)(1.2).] I. Nancy Bachman 619 Hilltop Dr.,New Cumberland,PA 17070 Daughter 102999.70 2 Carolyn Eshelman 1944 Leonard St.,York,PA 17404.5233 Daughter 102318.51 3 Larry Eshelman 2128 E Acres Rd,Ottawa,Ontario,Canada Son 10209&80, 4 Susan Coffey 10940 DelCano Ave,Baton Rouge,LA 70816 Step-Daughter 56117.27 5 Elizabeth Stith Bachman 8102 Hams Ave.,Parkville,MD 21234 Granddaughter 1000.00, 6 Michael Bachman 607 CeeJay Dr.,Etters,PA 17319 Grandson 1000.00 7 Alexandra Eshelman 740 Avenue Rd.North Upper,Toronto,Ontario Granddaughter 1000.00 8 Marc Eshelman 2128 E Acres Rd,Ottawa,Ontario,Canada Grandson 1000.00 9 J Douglas Coffey 1476 Highland Heights Trail,Dacula,GA 30019 Step-Grandson 1000.00 10 Lee Ann Coffey 2255 Cedarcrest Ave.,Baton Rouge,LA 70816 Step-Granddaughter 1000.00 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE, II NON-TAXABLE DISTRIBUTIONS A, SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NUT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1 Second Presbyterian Church 528 Garland Ave.,Cadisle,PA 17013 1000 2 Samaritan Fellowship PO Box 495,Carlisle,PA 17013 1000 TOTAL OF PART 13-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. 2000 If more space is needed,use additional sheets Of paper of the same size. A. Settlement Statement (HUD-1) OMB Appreyal Ne.zs FINAL 1.❑FHA 2.❑RHS 3.❑Conv.Unins, B.File Number: 7.Loan Number: 8.Mortgage Insurance Case Number: CL14928 76080 0191686 4.[]VA S.®Conv.Ins. 80 Thb form b bmhhed to give you a statement of actual settlement costs.Amounts paid to and by the walement agents are shown Items marked '(p.o.e)'were paid outside the dosing:they are shown here for Informational purposes and are not Included in the totals. D.Name d Address of Borrower: E.Name 8 Address of Seller: F.Name 8 Address of Lender: Charles R McKmrlck,Noreen G.Md4endck Estate of Frances B.Teilride,aWa Fran B.Teitrick,aVa Cole Taylor Bank 3 W*CMK MechaniaMttg,PA 17055 Frances Baler Te rick 2350 Green Road,Suite 100,Ann Arbor,MI 177 Glendale Street CaBsle,PA 17013 48105 G.Property Location H.Settlement Agent: 1.Settlement Date:0&012014 177 Glendale Street Corrections Land Transfer,Inc. Disbursement Date:0 510 92 01 4 Carlisle,PA 17013 4705 E.Tdadle Road,Mechanicsburg,PA 17050 Carlisle Borough 717-7309664 Place of Settlement: TItleEzpress 3805 Market Street,Camp Hie,PA 17011 Printed 0 413 0 2 01 4 al 1¢49 am by VS PIP 1.11,1141.10 100. Gross Amount Due from Borrower 400. Gross Amount Dire to Seller fill. Contract sales Pace 1 1, Contract as 102. Persa,al 402. personal property 103. Sealamtldhages to bornmer([ne 1400) 7,167.12 403. 1D4. 404. 105. 405. AdIusboisdits far Items paid by seller In advance Adjustments for hems paid b seller in advance 105. GryMm lazes to 406. Cityrfm taxes to 107. County rates 05h0112014 to 121312014 762.19 407. County bass 05018014 to 12!3112014 762.19 106. Assessments to 408. Assessments to 109. School Tams 05012014 to OV30014 404.36 409. 05010014 t0 08G0/2014 404.36 110. 410. 111. 411. 112. 412. 120. Gross Amount Due from Bonowar 187,3$3.67 420. Gross Amount Daa to Seller 180,166.55 200. Arounb Paid or In Behahof Burrows 500. Reductions In Amount Due to Seller W%eamesl erlOney cess ep=-I Ism Instructions) 500.00 202. Principal amount of raw loan(s) 170,050,00 502. Sedismitnl charges to sense(One 1400) 1,892.90 203. Existim ws)taker,subject to 503. Fiistl s tak subled to 2D4. 504. Payoff or first ban 2D5. 505. Pay08 Of sucand mortgage ban 206. 506. 207, 5D7. 200. 508, 209. 509. A usbmenb la Items unpaid setter Adjustments for Items unpaid "Her races to TO. CItYAM tam to 211. Ceuntytaces to 511. County tares to 212 Assessment; l0 512. Assessments to 213. School Taxes to 513. to 214. 514, 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. Total Paid byffor Borrower 170,550.00 520. Tobl Reduction Amount Due Seller 2,39290 380. Cub at Settlement fromho Borrower 600. Cash at Settlement toHrom Seller 301, Gros,amrnldue bonoser(line r ) 187, .67 601. Gross amount due to 420) 180,16655 302. emote bOerOwa phe ) 170,550.00 602. Less ctlms s,ae8a due$ala(Ihe5 ) 2,39210 303. CaM ❑X From ❑ To Bomo var 16,783.67 603. cash ❑1( To ❑ From Seller 177,773.65 ��,.Y(♦r •sYw\,Y(��YW,�b.rY aM.lt/.,YY,KYt\O n\.YM,iY.M\Y4MYY.ML MMW Y.1f➢MmwMYw.Ow.tl M.,YMYh1Y Yrrs Previous editions are obsolete Page 1 of HUD-1 700. Total R'al Eshh Broker Feea Pal=atFunds rom DMsbnofcvanbN°"(In,7M as follows: Borr's �� to Fu at 702. �'� to Setent Caron 703. at 800• ►ems In Cnnedbn with loan gtna nt O.OW a rap GFE 91) 1 Ou a pants a s rc inleresi role rap Oa AUsted orrittriaton chE,,m rom W4. Appral"IN TO Catl 1-Mandal end Dan IT= Credit report 110 Cody Fill a der @o Cred6%3 ran GFE Q) 68.831 806. Tat service to from GFE$3 807. Flood ani0a0m to Core ic Flood SerAcas (from GFE 43) 9.00 80e. m �0. ftemitegulned Lender to he Paid In Adwence Wily hfOst clungis fmin Ip �, trorn M"71 m W months to a lnslr n a Io AIA lnsurante $555.00 PAC48-itfrorn Urt:OFT 1) months to from GFE 011 1000. Resann Deposbd with Lender 1001.IMS deposit for your escrow account (from GFE s9) 2,419.54 1002 Horneowna insu s rerce 3 rteonths 3 46.25/monN $178.75 1003.Magage Inituanea monUu a$ 87.86 n onth $ 1001.Gry Property Tax martins S O.OMnmtIT $ 10D5.County Properly Tax 3m 'S 94.63hnonih $283.89 1006.Sdael Property Tax 11 months S 2O1.631nnmth $2,217.93 1007.Aggmgate Adjustment $421.03 1100. -1101. m from GFE$a Ttl 1102 Setaerrwnt a doskgfn to $ 1103.Owners use inwmrce-FkIeAry NaBaWl Title lnsdrance Canpaeey S from GFE 95 40.00 1101.Lerdera NO Insurance-Fidelity National Title Insumce Canpany $1,480.00 1105.Landers We policy Unit$170,050.00 Lender's Policy 1106.Owner's tide policy Brit 5179,000,00 Dwrwrs Percy 1107.Agenda portion of To idol Utle hlsurance premium $1,228.25 1108.UndwoWs pWm d the tZ UUe insurance premium $291.75 1109. E.Dm D*my Fee to Cornerstone Land Transfer, 535-00 Agent for FNTIC 1110.Carier;Wm Fee to Coniersdre land Transfer $15.00 Agent for FNTIC 1111.Notary Fee to Valerie Priest $25.00 20.00 1112 RaOrWrae fa Tax CeN0a0m to Camerabne land Transfer 10.00 Agent for FNTIC 1200.GMMUSN t Recording and Transer Chuga 1201.Goverment retorting charges $ (ham GFE i7) 16200 121Y1.Geed$67.00 Mortgage,$95.00 Release$ 1101 TranWerhxes e 5 (tram GFE 98) 1,790.00 1204.Ciryramty,larJaaelps Dead$1.79D.00 Man $ 1205.Stain TwAstarnps Deed$1,790.00 Mortgage$ 1,790.00 1�• Deed$ Man $ 1207. $ i 1700.AddWonal Settlemam Ch es aerwcas you an shop Ter (from GFE 96) MUM N 1303. Io 1304, Final Wahrlliewer to Carlisle B&ough 72. 1305. to •e e e e 7, 6- 1,892.90 'Pall adalde of doskg by(8)ormwa,(S)ella,(Loder,(I)nMlor,WK)er.^Credd by lender sham on page 1.-Credit by setter shown on page 1. Pre ous edidons ere obsolete Page 2 of 4 MUD-1 COPY LAST WILL AND TESTAMENT OF FRANCES B.TEITRICK 1, FRANCES B. TEITRICK, a resident of the Borough of Carlisle, Cumberland Country, Pennsylvania, being of sound and disposing mind, memory, and understanding, do hereby make, publish and declare the following to be my Last Will and Testament, hereby revoking and making void any and all Wills that t have made prior to this date. FIRST: I appoint Ronald Bachman Executor of my estate. Ronald shall have the right, power, and authority to distribute my estate, either in cash or in kind, and, for any purpose of administration or distribution. I appoint John Oszustowicz to be my alternate executor. SECOND: I direct that all my just debts and funeral expenses be paid and discharged by the Executor of this my Will first out of any Social Security death benefits and then from the proceeds of my estate. THIRD: I direct that $7,000 to be divided as follows: $1,000 to Elizabeth Stith, $1,000 to Michael Bachman, $1.000 to Alexandra Eshelman, $1,000 to Mark Eshelman, $1,000 to J. Douglas Coffey, $1,000 to Lee Ann Coffey, and $1,000 to Susan Coffey. If any grandchild is deceased then the surviving grandchildren shall divide the $7,000 equally. I direct that $1,000 be distributed to Second Presbyterian Church of Carlisle and $1,000 to Samaritan Fellowship. The items on the attached list shall be distributed according to the list. All other household property and furniture that was in the house when Susan Coffey lived in the house shall be distributed to her. My house on Glendale St., Carlisle, PA shall be sold and the net proceeds of the sale shall be distributed equally to Larry L. Eshelman, Carolyn J. Eshelman, Nancy C. Bachman and Susan Coffey. My remaining estate is to be distributed equally among Larry L. Eshelman, Carolyn J. Eshelman, and Nancy C. Bachman. Should any of these individuals be deceased at the time of my death then their heirs shall take their share per stirpes. FOURTH: I direct that no personal representative, guardian, trustee, or other fiduciary appointed under this instrument be required to give bond for the faithful performance of his duties. IN WITNESS WHEREOF, I, FRANCES B. TEITRICK, have set my hand and seal to this my Last Will and Testament this +" _ day of 2012, �& am��4 � FRANCES B. TEITRICK Signed, sealed, and declared by the above-named Testatrix as and for her Last Will and Testament in the presence of us, who have hereunto subscribed our names at her request as witnesses, in the presence of the Testatrix and of each other. ADDRESS* ��/ l ADDRESS ACKNOWLEDGEMENT We, FRANCES B. TEITRICK, ()` Q, AND �LVVI� .k,hrt :SffnylGL the Testatrix and the witnesses, respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and that she signed willingly, and that she executed it as her free and voluntary act for the purpose therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as a witness and to the best of their knowledge the Testatrix was at that time eighteen years of age or older, of sound mind, and under no undue influence. Frances B. Teltrlck itness Witness STATE OF PENNSYLVANIA: SS: COUNTY OF CUMBERLAND: Subscribed, sworn to, and acknowledged before FRANCES B. TEITRICK, the Testatrix, and subscribed and sworn to before me b t y i�I eZI-) C' 0t7.`3♦•nigh J and ,kinn C.(�_S�ILd'ni/�,CZ. witnesses this_� day of— C)C�Dhrr , zolz. 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