HomeMy WebLinkAbout06-11-14 � 150561014�
REV-1500 EX (02-11)(FI)
OFFICIAL USE ONLY
PA Department of Revenue Counry Code Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURN
PO BOX 280601 2 1 1 4 0 2 6 5
Harrisbur PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
0 3 1 6 2 � 1 4 1 1 2 5 1 9 2 0
DecedenYs Last Name Suffix DecedenYs First Name M�
K A T C H E R M A R Y M
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Su�x 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
a 1. Original Return � 2.Supplemental 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_-DecedentDied-Tesiate--- Q---Z.DecedentAAaintained-�liuiag-Trus�-----�—&-Tatal-Alumbe�e�Saf��epssi��oxes- _
(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 T0:
Name Daytime Telephone Number
G E R A L D J S H E K L E T S K I E S Q 7 1 �7 7 7 � 8 4 � 5
� � rn
R��IS R OF Wllck�.USE4Q L a
�
1.�1 � C� � u� ��-�
First Line of Address � �� ,r� ~ �`"
��r �
. ..... , M—' _:"t C:.J
4 1 4 B R I D G E S T � `�� = �
� � �
? u.., � _ , -,-.
Second Line of Address �`
., :::� :~;
�:� �- .._� r>
P . p . B 0 X E _ �~a �" _._ rrr
City or Post Office State ZIP Code I— y M� DATE FI � o
Cn �f�
N E W C U M B E R L A N D P A 1 7 � 7 0
CorrespondenYs e-mail address: g S h e k 1 e t S k i a�S t o n e 1 a W • n e t
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 betief,
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.
SIGN TU E OF PERSON SPONSIBLE F R FILING RETURN DATpE ,
! �
ADDRESS
GLORIA J • SAMPL S 480 ROSSTOWN ROAD LEWISBERRY PA 17339
SIGNATU EPA R R T PRE 7Y�TIVE ATE �
DDRESS
GERALD J • SHEKLETSKI ESQ • 414 BRIDGE ST • NEW CUMBERLAND PA 17070
PLEASE USE ORIGINAL FORM ONLY
Side 1
� 15�561�140 1505610140 �
� 150561�240
REV-1500 EX(FI) Decedent's Social Security Number
oecedent's Name: M A R Y M • K A T C H E R
RECAPITUTATION
1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ��
115000 . 00
2. Stocks and Bonds(Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2� '
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . . . . . 3. •
4. Mortgages and Notes Receivable(Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . 4. •
5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . . . . 5. 1 7 5 1 . 2 �
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . . . . . . 6. 1 6 7 7 1 . 1 4
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) ❑ Separate Billing Requested . . . . . . . 7. •
8. Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. 1 3 3 5 2 2 , 3 4
9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9 3 2 2 9 6 . 4 6
10. Debts of Decedent, Mortgage Liabilities, and Liens(Schedule I) . . . . . . . . . . . . . 10. •
11. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 3 2 2 9 6 . 4 6
12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12• 1 � 1 2 2 5 . 8 8
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J) . . . . . . . . . . . . . . . . . . . . 13. •
14. Net Value Subject to Tax(Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . 14. 1 � 1 2 2 5 . 8 8
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec. 9116
(a)(1.2)X.0 _ 0 . 0 � 15. 0 . 0 0
16. Amount of Line 14 taxabie
at�inea�rate x .oa5 1 0 1 2 2 5 . 8 8 �s. 4 5 5 5 . 1 6
17. Amount of Line 14 taxable
at sibling rate X.12 � . � 0 17. � . � �
18. Amount of Line 14 taxable
at collateral rate X.15 0 . 0 D 1 g. 0 . 0 0
19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 4 5 5 5 . 1 6
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑
Side 2
� 1505610240 150561�240 J
REV-1500 EX(FI) Page 3 File Number
Decedent's Complete Address: 21 14 �265
DECEDENT'S NAME
MARY M • KATCHER
STREETADDRESS
31 SAMPLE BRIDE ROAD
CITY STATE ZIP
MECHANICSBURG PA 17050
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 4,5 5 5 • 16
2. Credits/Payments
A.Prior Payments
B.Discount 2 2 7 •7 6
Total Credits(A+B) (2) 2 2 7 • 7 6
3. I nterest
(3)
4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT.
Fill in oval on Page 2,Line 20 to request a refund. (4) 0 • 0�
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 4,3 2 7 • 4 0
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 ....................................•.•••••••••••••••••••••••••••••... ❑ O
b, retain the right to designate who shall use the property transferred or its income ...............................
c. retain a reversionary interest ..................................................................................................... ❑ ❑X
d, receive the promise for life of either payments,benefits or care? ....................................................... ❑ 0
2. If death occurred after December 12, 1982,did tlecedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... ❑ X❑
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?.................................................................................................. ❑ ❑X
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
is 3 percent[72 P.S.§9116(a)(1.1)(i)],
For dates of death on or after Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
(72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000:
• The tax rate imposed on the net value of transfers from a deceasetl chiid 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 p2 P.s.§s��s(a)(���.
• 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.
REV-1502 EX+(12-12)
pennsylvania SCHEDULE A
DEPARTMENT OF REVENUE
REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
MARY M • KATCHER 21 14 0265
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 • ALL THAT CERTAIN TRACT OF LAND WITH THE IMPROVEMENTS 115,000 • �0
THEREON ERECTED SITUATE IN SILVER SPRING TOWNSHIP,
CUMBERLAND COUNTY, PENNSYLVANIA KNOWN AS 31 SAMPLE
BRIDGE ROAD, MECHANICSBURG, PENNSYLVANIA 17050 • BEING
THE SAME PREMISES WHICH ROBERT P • EICHELBERGER AND
BEVERLY J • EICHELBERGER, HIS WIFE, BY DEED DATED
SEPTEMBER 19, 1952, AND RECORDED SEPTEMBER 20, 1952,
IN THE OFFICE OF THE RECORDER OF DEEDS OF CUMBERLAND
COUNTY IN DEED BOOK 8, VOL • 15, PAGE 584, GRANTED AND
CONVEYED UNTO JOHN 8• KATCHER AND MARY M • KATCHER,
WIFE • JOHN B • KATCHER DIED ON AUGUST 5, 1998, THUS BY
- Q�E R l�'�Z Wu-0�-L�A l�l-u E�'��[U�-'�I-'���- I Al--q A��-�l----K-A-��ki��---__ _- _-
DECEASED • THE PROPERTY WAS SOLD TO DEJAN JAGESIC ON
JUNE 6, 2014 • COPIES OF THE DEED OF CONVEYANCE AND
SETTLEMENT SHEET ARE ATTACHED •
TOTAL(Also enter on Line 1,Recapitulation.) $ ],],5,0 0 0 • 0 0
If more space is needed,use additional sheets of paper of the same size.
- - ._ _ _ __ _ _
REV-1508 EX+(08-12)
pennsylvania SCHEDULE E
DEPARTMENTOFREVENUE CASH, BANK DEPOSITS 8� MISC.
INHERITANCETAXRETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
MARY M • KATCHER 21 14 0265
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
�, MISCELLANEOUS PERSONAL PROPERTY SOLD AT AU�TION BY 1,751 • 20
RSR AUCTION COMPANY - $ 2,258 • 0� LESS $506 • 80 (ITEMS
SOLD THAT WERE NOT THE DECEDENT ' S PROPERTY) _
$1,751 • 20
TOTAL(Also enter on Line 5,Recapitulation) $ 1,7 51 • 2 0
If more space is needed, use additional sheets of paper of the same size.
REV-1509 EX+(01-10)
pennsylvania SCHEDULE F
DEPARTMENTOFREVENUE JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
MARY M • KATCHER 21 14 0265
If an asset was made jointly owned within one year of the decedenYs date of death,it must be reported on Schedule G.
SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
A. GLORIA J • SAMPLES 480 ROSSTOWN ROAD DAUGHTER
LEWISBERRY, PA 17339
a.
c.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. 08-08 CENTRIC BANK ACCOUNT NO • 1930723 28,975 • 68 50 • 14,487 • 84
2 • A • 06-84 PNC BANK CHECKING ACCOUNT 3,905 • 83 50 • 1,952 • 92
#57,40263606
3 • A • 06-84 PNC BANK SAVINGS ACCOUNT 660 • 75 50 • 330 • 38
#5130182239
TOTAL(Also enter on Line 6,Recapitulation) $ 16,7 71 - 14
If more space is needed,use additional sheets of paper of the same size.
REV-1511 EX+(OS-13)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCETAXRETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
MARY M • KATCHER 21 14 0265
Decedent's debts must be reported on Schedule 1.
ITEM
NUMBER DESCRIPTION AMOUNT
q. FUNERAL EXPENSES: 10 ,719 • 3 6
�, MALPEZZI FUNERAL HOME
8 MARKET PLAZA WAY, MECHANICSBURG, PA 17055
g. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s)
Street Address
Ciry State ZIP
Year(s)Commission Paid:
2, AttorneyFees: STONE, LAFAVER & SHEKLETSKI 5,750 • 00
3, Family Exemption:(If decedenYs address is not the same as claimanYs,attach explanation.)
Claimant
Street Address
�iry State ZIP
Relationship of Claimant to Decedent
4. ProbateFees: LETTERS TESTAMENTARY 348 • 50
AccountantFees: SHAWNA SIMPSON, TAX PREPARER 90 • 00
5' 201,3 INCOME TAX RETURN PREPARATION
6. Tax Return PreparerFees:
�, THE SENTINEL — LEGAL ADVERTISING 190 • 54
8 • CUMBERLAND LAW JOURNAL 75 • �0
9 • CLOSING CHARGES ON SALE OF 31 SAMPLE BRIDGE ROAD, 8 ,494 • 61
MECHANICSBURG, PA • SETTLEMENT SHEET LINE 5�2
($13,056 • 31) LESS PA INHERITANCE TAX LINE 1304
($4 ,200 • DO) LESS SEWER/TRASH PRORATION LINE 408
($1� • 06) LESS REAL ESTATE TAX PRORATIONS LINES 406
AND 407 ($351 • 64 ) _ $ 8 ,494 • 61,
10 • SILVER SPRING TOWNSHIP AUTHORITY (SEWER) 109 • 14
11 • KNOW SWEAT — TERMITE TREATMENT 1,060 • 00
12 • PLUMBING REPAIR 197 • 31
13 • PAINT AND SUPPLIES 336 • 15
TOTAL(Also enter on Line 9,Recapitulation) 8 3 2,2 9 6 • 4 6
If more space is needed,use additional sheets of paper of the same size.
� Continuation of REV-1500 Inheritance Tax Return Resident Decedent
MARY M. KATCHER 21 14 0265
DecedenYs Name Page 1 File Number
Schedule H - Funeral Expenses 8�Administrative Costs - B7.
ITEM
NUMBER DESCRIPTION AMOUNT
14 • LANDSCAPING 243 • 79
15• ELECTRICAL SUPPLIES 33 • 17
16 • CARPET BARN - CARPET REPAIR 648 • 00
17 • W. S • �AREY ELECTRICAL 1,435 • 00
18 • DOLL ' S OIL COMPANY (HEATING OIL) 621 • 22
19 • ANDERSON PAINTING 1,350 • 00
20 . OMNICARE PHARMACY 69 - 47
21 • PPL 45 • 82
22 • TRACTOR SUPPLY LAWN REPAIR 84 • 78
23 • TAMMY HILBOKY - HOUSE CLEANING 60 • 00
24 • PPL 28 • 96
25• PPL 23 • 15
26 • OMNICARE PHARMACY 32 • 49
__— 2.2,_ ___ RESE�V-�EQ�--C1.-QSI�t�_€?���NS��- — _---- __— — _— -----25E}� Q0-_
SUBTOTAL SCHEDULE H-B7 4 ,9 2 5 • 8 5
REV-1513 EX+(01-10) .
pennsyivania SCHEDULE J
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
MARY M • KATCHER 21 14 �265
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
TAXABLE DISTRIBUTIONS (Include outright spousal distributions and transfers under
I• Sec.9t 16(a)(1.2).] SCh2Clule F, ItemS ', �
�. GLORIA J . SAMPLES Lineal 2 and 3 .+ 1/2
480 ROSSTOWN ROAD of residue
LEWISBERRY, PA 17339
2 • JERRY KATCHER Lineal �/2 of residue
4474B CROUSE DRIVE
FREDERICK, MD 21701
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 NOT TAKEN:
1.
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $
If more space is needed,use additional sheets of paper of the same size.
W f
�'�� a ,
Z:\EP\WILLS\KATCHER.Mary 3-2011.wpd *� �� ,
( ���1
3��� I�
. � �
LAST WILL AND TESTAMENT
OF
MARY M. F(ATCHER
I, MARY M. KATCHER, of Mechancisburg, Cumberland County,
Pennsylvania, declare this to be my last will and revoke any will
previously made by me.
ITEM I : I devise and bequeath all of my estate, of every nature
and wheresoever situate, in equal shares to such of my children, JERRY
KATCHER and GLORIA J. SAMPLES, as survive me. Should my son, JERRY
_ _---- __--- --- --
———_----- ----- -----------
KP,TCHER, predecease me, I devise and bequeath his share of my estate to
my daughter, GLORIA J. SAMPLES. Should my daughter, GLORIA J. SAMPLES,
predecease me, I devise and bequeath her share of my estate to my son-
in-law, MICHAEL SAMPLES, or his issue, per stirpes .
ITEM II : I appoint my Executrix and her successors guardian of any
property which passes, either under this will or otherwise, to a minnr
and with respect to which I am authorized to appoint a guardian and have
not otherwise specifically done so, provided that this appointment of a
guardian shall not supersede the right of any fiduciary in its discre-
tion to distribute a share where possible to the minor or to another for
the minor' s benefit . Such guardian shall have the power to use
principal as well as income from time to time for the minor ' s support
and education (including college education, both graduate and undergrad-
uate) without regard to his or her parent ' s ability to provide for such
support and education, or to make payment for these purposes, without
Page 1 of 4
I
�
further responsibility, to the minor or to the minor' s parent or to any
person taking care of the minor.
ITEM III : I appoint my daughter, GLORIA J. SAMPLES, Executrix of
this my last will . Should my daughter, GLORIA J. SAMPLES, fail to
qualify or cease to act as Executrix, I appoint my son, JERRY KATCHER,
Executor of this my last will.
ITEM IV: No fiduciary acting hereunder shall be required to post
bond or enter security for the faithful performance of his or her duties
in any jurisdiction.
IN WITNESS WHEREOF, I, MARY M. KATCHER, have hereunto set my hand
__— — ------_—_-----
-- --
_ -__ --
--- - __ --_
and seal this ��day of ��wLt , 2011 .
i r
M Y . KATC R
SIGNED, SEALED, PUBLISHED and DECLARED by MARY M. KATCHER, the
Testatrix above named, as and for her Last Will and Testament, and in
the presence of us, who at her request, in her presence and in the
presence of each other, have subscribed our names as witnesses .
�ct� �r� S�. D��v� c�bcx�o•�d, ��
Witnes Address
5�/ '� � �
Witnes Address
Page 2 of 4
J
COMMONWEALTH OF PENNSYLVANIA:
. SS:
COUNTY OF CUMBERLAND .
I, MARY M. KATCHER, the Testatrix whose name is signed to the
attached or foregoing instrument, having been duly qualified according
to law do hereby acknowledge that I signed and executed this instrument
as my last will; that I signed it willingly and that I signed it as my
free and voluntary act for the purposes therein contained.
MA _ . �fA��R—--_ ----_ —. ___
Sworn to or affirmed to and acknowledged before me by MARY M.
KATCHER, the Testatrix, this � day of ��C. , 2011 .
� f/�/' ,,
__--_� . �.-�-'
�� �.
. � Notary Public
COMMONWEALTH OF PENNSYLVANIA
I�OTARlAL SEAL
JENNIFER A. MEARKLE, Notary Publ;c
New Cumberland Boro. Cumberfand Co.
My Commission Expires July 7, 2p12
Page 3 of 4
COMMONWEALTH OF PENNSYLVANIA :
. SS:
COUNTY OF CUMBERLAND .
,
We, ��e�lG�✓ � U��`���`( and �t\\i,� �� �,'C(�50.�� ,
the witnesses whose names are signed to the attached or foregoing
instrument, being duly qualified according to law, depose and say that
we were present and saw Testatrix sign and execute the instrument as her
last will; that Testatrix signed willingly and that she executed it as
her free and voluntary act for the purposes therein expressed; that each
of us in the hearing and sight of the Testatrix signed the will as
-----_--_ -��-�esse�T ��a�tcr ��e-bes�-o-€-0��--1�r�Q�a-�eelge;-�i�e-'P�s����-'rx--was-a�-that- __
time eighteen or more years of age, of sound mind and under no
constraint or undue influence.
Witnes
-�� Q�,Q��Wc1�
Witness
Sworn to or affirmed to and acknowledged before me by
L�� ,� �!�-�it-��% and ���,1��U,�, �-� '�1,'C(�54��� ,
witnesses, this �� day of �G�(C11 , 2011 .
, i>
_ _.� -' ` .=�;/%
-- �.' . ,i,%/'.
Nota y Public
COMMONWEALTH OF PENNSYLVANIA
NOTARlAL SEAL
JENNIFER A. �+1EAAKLE, Notary Public
New Cumberland Boro.Cumberiand Co.
My Commission Expires July 7, 2012
Page 4 of 4
Z:\RE\DED\Katcher.Mary—31 Sampie Bridge Road
Tax Parcel#:38-18-1328-056
Address:31 Sample Bridge Road
Mechanicsburg,PA 17055
DEED
THIS INDENTURE made the C�c tt► day of �✓Lr i7 Q , in the year 2014,
between GLORIA J. SAMPLES, Executrix of the Last Will and Testament of MARY M.
KATCHER, late of Silver Spring Township, County of Cumberland, and Commonwealth of
Pennsylvania, of the first part, hereinafter called the Grantor,
- AND -
DEJAN JAGESIC, of the second part, hereinafter called the Grantee;
WHEREAS, the said MARY M. KATCHER became in her lifetime seised, as of fee,
of and in a certain tract of land, together with the improvements thereon erected, situate in
Sil�er Spring Township, County of Cumberland, and Commonwealth of Pennsylvania, and I
more particularly described hereinafter; and being so thereof seised, died on March 16, 2014,
_ ___ hauin�_first�nade-he� �,a�-�i�-an�-�'�s�a�n�-��-�i���g�a�e-�-�a�EYr 1€r-�&��d�ly�-pra�atec�-_ �_
and registered in the Office of the Register of Wills of Cumberland County on March 25, 2014,
wherein and whereby she appointed as Executrix, the said Gloria J. Samples, to whom Letters �
Testamentary were duly issued by said Register of Wills on March 25, 2014, wherein and �
whereby said premises hereinafter described were not specifically devised, all as in and by said ;
Will and the records of said Register of Wills, recourse thereunto being had, appears:
NOW THIS INDENTURE WITNESSETH, that the said Grantor, for and in '
consideration of the sum of ONE HtTNDRED FIFTEEN THOUSAND and NO/100-------- I
($115,000.00)------------Dollars, which has been paid to they by the said Grantee at or before '
the sealing and delivery hereof, receipt whereof is hereby acknowledged, has granted, �
bargained, sold, aliened, released and confirmed, and by these presents does grant, bargain, sell, �
alien, release and confirm unto the said Grantee, �
i
ALL THAT CERTAIN tract of land with the improvements thereon erected situate in �
Silver Spring Township, Cumberland County, Pennsylvania, bounded and described as follows: j
�
�
BEGINNING at a point in the center of the Sample Bridge Road, said point being at ;
, the dividing line between Lots Nos. 6 and 7 on the hereinafter mentioned Plan of Lots; thence ;
along said dividing line in a westerly direction 272.25 feet; thence parallel to the Sample j
Bridge Road in a Northerly direction 75.5 feet to the dividing line between Lots Nos. 7 and 8; �
I thence along said dividing line in an Easterly direction 272.25 feet to the center of the Sample �
jBridge Road; thence along the center of the said road in a Southerly direction 75.5 feet to the i
� place of BEGINNING. ,
�
�I BEING the easterly one-half of Lot No. ? on a Plan of Lots known as "Mellwood i
Farm", said plan being recorded in the Recorder's Office at Carlisle, PA, in Plan Book 4, Page i
j18, and being improved with a frame dwelling house. ,
I
�
�
� vlv
i�
I
,i
ii
BEING the same premises which Robert P. Eichelberger and Beverly J. Eichelberger,
his wife, by Deed dated September 19, 1952, and recorded September 20, 1952, in the Office of
the Recorder of Deeds of Cumberland County in Deed Book "B", Vol. 15, Page 584, granted
and conveyed unto John B. Katcher and Mary M. Katcher, his wife. John B. Katcher died on
August 5, 1998, thus by operation of law vesting title in Mary M. Katcher, deceased.
The above described parcel of land is sold subject to the following reservations and
restrictions:
There shall be no selling or manufacturing of any commodity whatsoever upon the
premises or any part thereof.
No dwelling shall be erected upon the said premises which shall cost less than
$4,000.00 above foundation.
No hog pen, or other building or buildings used for obnoxious purposes, shall be erected
upon the premises.
No building shall be erected within ten (I 0) feet of any common property line.
TOGETHER with all and singular the buildings, improvement�ways, streets,_alleys,_ __
_ —--
—___-----
_ _—_ - --_— ____
__------ — — --
passages, waters, water-courses, rights, liberties, privileges, hereditaments and appurtenances
whatsoever, thereunto belonging or in any wise appertaining and the reversions and remainders, �
rents, issues and profits thereof, and all the estate, right, title, interest, property, claim and
demand whatsoever of her, the said Mary M. Katcher, at and immediately before the time of �
her decease, in law, equity, or otherwise howsoever, of, in,�to or out of the same.
TO HAVE AND TO HOLD the said lot or piece of ground above described, with the '
buildings and improvements thereon erected, hereditaments and premises hereby granted or f
mentioned, and intended so to be, with the appurtenances unto the said Grantee, to and for the i
only proper use and behoof of the said Grantee, forever. �
f
AND the said Grantor, for herself and her respective heirs, executors and
administrators, does covenant, promise and agree to and with the said Grantee, his heirs and
assigns, that they, the said Grantor, has not heretofore done or 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, charge, estate or otherwise howsoever. �
�
i '
I
l
�
,
i �
�
�
� �
�
�
�
�2., ;
� i
i; !
IN WITNESS WHEREOF, the said Grantor has hereunto set her hand and seal the
day and year first above written.
Signed, Sealed, and Delivered :
in the Presence of .
,
�'����. (��-G���� • ��a (SEAL)
Witness� : GLORIA J. AMPLES, Executrix of the Last
: Will and Testament of MARY M. KATCHER
COMMONWEALTH OF PENNSYLVANIA :
: SS:
COUNTY OF :
On this, the day of , 2014, before me a Notary Public,
the undersigned officer, personally appeared GLORIA J. SAMPLES, Executrix of the Last
Will and Testament of MARY M. KATCHER, known to me or satisfactorily proven to be the
person whose name is subscribed to the within instrumentiand acknowled�_that_he/she___ �____
__— ---- _-- - ------_____—_-----
___ —
— executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I have hereto set my hand and notarial seal. �
I
i
Notary Public j
�
�
�
i
,
;
�
i
I
�
i
�
;�
i
II hereby certify that the precise address of the Grantee is �
;
�I
I DATE: '
Attorney for '
i�
� �
� I
! ,
iI "3" !.
` i
�� �
�pP�M,/��•�y I�I OMB Approval No.2502-0265
cL I�� P?
�'� � *W= A. Settlement Statement (HUD-1) II
��N oeJEyO .
B. Type of Loan
1.�FHA 2.�RHS 3.❑Conv.Unins. 6. File Number: 7. Loan Nurtjber: 8. Mortgage Insurance Case Number:
4.�VA 5.Q Conv.lns. 2014050012AS 30035250 ' 446-2103776-703
C. Nata: This form is furnished to give you a slatement of actual settlement costs. Amounfs paid to and by the settlement agenf are shown.
Items markad"(p.o.c.)"we�e paid outside lhe closing:thay are shown here for informa'onal purposes and are not included in the totals.
D. Name and Address of Borrower. E. Name and Address of Seller: F. Name and Address of Lender:
Glona J.Samples,Executrix � Merrimack Mortgage Company,
Dejan Jagesic Inc.
1820 Chatham Orive 480 Rosstown Road ���� 1045 Elm Street,Suite 601
Camp Hill,PA 17011 Lewisberry,PA 17339 ', Manchester,NH 03101
G. Property Location: H. Settlement Agent: , I. Settlement Date:
31 Sample Bndge Road Academy Settiements,LLC j
Mechanicsburg,PA 17050 1104 Fernwood Avenue,Suite 302 i June 6,2014
Cumberland County,Pennsylvania Camp Hill,PA 17011 Ph. (717)695-9521
Place of Settlement: I
875 Market Street
Lemo ne,PA 17043 �
J. Summary of Borrower's transaction K. Summary bf Seller's transaction
100. Gross Amount Due from Borrower: 400. Gross Am unt Due to Seller:
101. Contract sales rice 115,000.00 401. Contract sales rice 115,000.00
102. Personal ro e 402. Personal ro e
103. Settlement Char es So Borrower Line 1400 24,941.8� 403.
104. 404.
105. 405.
Ad ustments for itema aid b Seiler in advance Ad ustments fo�items afd b Selle�in advance
106. Coun /Tw Taxes O6/06/14 to 01l01/15 269.21 406.Coun /Tw Taxes 06J06/14 to Ot/01/15 269.21
107. School Taxes 06/06/14 to 07/01/14 82.43 407.School Taxes 06/O6/14 to 07/01/14 82.43
108. Tresh 4/1-6/30 O6/O6/14 to 07/01/14 10.06 408.Trash 4/1-6/30 O6/O6/14 to 07l01/14 10.06
109. 409. ''
110. 410.
111. 41L
112. 412.
120. Gross Amount Dua from Borrower 140,303.57 420.Grosa AmOunt Dua to Seller 115,361.70
200. Amounts Paid b or in Behalf of Borrower 500. Reductlons in Amount Due Seller:
201. De osit or earnest mone 1,000.00 501. Excess de osit see instructions
202. Pnnci al amount of new loan s 112,917.00 502. Settlement char es to Seller Line 1400 13,056.31
203. Existin loan s taken sub'ect to 503. Existin lo n s taken sub'ect to
204. A lication Fee Credit 460.00 504. Payoff Firs Mortgage
205. 505.Pa off Sec nd Mort a e
206. 506.
207. 507. De osit disb.as roceeds
208. 508. '
209. 509. '
Ad uatments for items un aid b Seller Ad ustmente fo�items un aid b Seller
210. Coun /Tw Taxes to 510.Count/Tw Taxes to
211. School Taxes to 511.School Taxes to
212. Trash 4/1-6l30 to 512.Trash 4/1-6/30 to
213. 513.
214. 514.
215. 515. ��
216. 516.
217. 517.
218. 518.
219. ; 519.
220. Total Paid b Hor Borrower 114,377.00 520. Total Reduction Amount Due Seller 13,056.31
300. Cash at Settlement fromfto Borrower 600. Cash at settlement to/hom Seller
301. Gross amount due from Bortower line 120 140,303.57 601. Gross amount due to Selier line 420 115,361.70
302. Less amount paid b/for Borrower line 220) ( 114,377.00 602. Less reductions due Seller.(line 520) ( 13,056.31
303. Cash �From � To Borrower 25,926.57 603. Cash �To � From Seller 102,305.39
'PaiO outsi0e of closing Oy borrowBr(B),seller�S),IanGer(L),or thirtl-Darty(T) �
The undersigned hereby ackno dvd e receipt completed copy of this statement&any attachments referred to herein
Borrower i_ � Selleri 1���/`"��l ,�') Q�!:�y� ��
il
ejan agesic , Gloria J.Sampi�e',Executrix �
TO THE BEST OF MY KNOWLEDGE,THE HU0.1 SETTLEMENT STATEMENT W HICH I HAVE PREPARED IS A TRUE AND ACCURATE ACCOUNT OF THE FUNDS
W HICH W ERE RECEIVED AND HAVE BEEN OR W IlL BE DISBURSED BY THE UNDERSIGNED AS PART OF THE SETTLEMENT OF THIS TRANSACTION.
._;.
.__ ... .__,
. . ...� ....-�--._._�....;,w,-
'�� Academy Settlements,[:LC,Settlement Aqent
WARNING: IT IS A CRIME TO KNOWiNGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM. PENALTIES UPON CONVICTION
CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE: TITLE 18 U.S.CODE SECTION 1001'$SECTION 1010.
The Public RaporUng Burtlen for Nis colleqion of infortnation is estlmatetl at 35 minutas per response for collectlng,reviewing,anU repor�ing Ihe tla1a.This agency may not collect this information,an0 you are nol requlretl lo
complele Nis form,unless it Cisplays a curtently vafd OMB conVol numCer.No confdenliality is assured;ihis tlisclosure is mantlatory.This is tlesigne0 to Drovitle the parties lo a RESPA covaretl iransaction with information
during the settlemenl process. �
Page 1 of 3 HUD-1
(2014050012AS.PFD/2014050012AS/15)
L.Settlement Char es
700.Total Real Estate Broker Feea $7,150.00 '
Paid From Paid Pmm
Division of commission(line 700)as(ollows: Borrower's Seller's
Funds at Funds at
702. 3 450.00 to ERA-NRT Settlement Settlement
703.Commission aid at settlement � 7 150.00
704. '
705.
800.Items Pa ble in Connectlon with Loan I
801.Our ori ination char e $ 2,540.63 frotn GFE#1
802.Your credit or charge(points)for the specific interest rete chosen $ 3,482.36 (fro GFE#2)
803.Your ad'usted ori ination char es fro�n GFE#A -941.73
804.A raisa�fee to Lender X fro GFE#3 455.00
805.Credit Re ort to Credco fro GFE#3 126.92
806.Tax service to fro GFE#3
807.Ffood certification to Corelo ic fro GFE#3 19.95
808.Final Ins ection Fee to Lender X from GFE#3 100.00
809. fro GFE#3
810.Loan Credit 1 Mone line�endin ,lLC fro(n GFE#3 $2540.63 PBL � �� �
811. (fro' GFE#3)
900.Items Re uired b Lender tqBe Paid in Advance
901.Dail interest char es from O6/O6/14 to 07l01/14 25 $13.147900/da fro GFE#10 328.70
902.Mort a e insurance remium for months to HUD from GFE#3 1,942.06
903.Homeowner s insurance for 1.0 ears to Erie Insurance fro GFE#11 893.00
904. fro GFE#11
905. fro GFE#11)
1000.Reserves De osited with Lender
1001.Initial deposit for your escrow account (fro�n GFE#9) 1,471.87
1002.Homeowner's insurence 2.000 months @ $ 74.42 per month $i 148.84
1003.Mort a e insurance months 123.89 er month
1004.Pro e taxes $ 1,332.38
Count/Tw Taxes 2.000 months 39.37 er month
School Taxes 12.000 months 104.47 er month
Tresh 4/1-6/30 months er month
1005.
1006. months $ er month $
1007. months $ er month $ �
1008. $'
1009.A r ate Ad'ustment $ -9.35
1100.Title Charges
1101.Title services and lender's title insurance from GFE#4 1,400.00 30.00
1102.Settlement or closin fee to Academ Settlements LLC 150.00
1103.Owner's title insurance to Fideli National Title Insurance Com an fr m GFE#5 10.00
1104.Lender's title insurance to Fideli National Title Insurance Com an 1 115.00
1105.Lender's title olic limit 112 917.00
1106.Owner's title otic limit $ 115,000.00 100/300/8.1
1107. A enYs ortion of the total title insurance remium to Academ Settlements �LC 956.25
1108. Undenvriter's ortion of the total Gtle insurance remium to Fidelit National Title Insuranc@ Com an� $ 168.75
1109.C�osin Protection Letter to Fidelit National Title Ins.Co. $ 75.00
1110. $
1111. $'
1112. $'
1113. $'
1200.Government Recording and Trensfer Charges
1201.Government recordin char es to Recorder's Office from GFE#7 166.00
1202.Deed 67.00 Mort a e 99.00 Releases Other
1203.Transfer taxes to Recorder's Office from GFE#8 1 115.00
1204.Ci /Coun tax/stam s 1 115.00 �
1205.State ta�stam s $ 1,115.00 $ 1,115.00
1206.
1207.
1300.Additional SettlemeM Charges ��
1301.Re uired services that ou can sho for from GFE#6
1302.2013 Count/Tw Taxes to Debra B.Weist $, 482.06
1303.Final Sewer to Silver S rin Townshi Authorit $ ��� #1536-1543 7925
1304.PA Inheritance Tax to Register of W ills,Agent $i 4,200.00
1305.Pay on Account to Nissan $ #102474631670001 17,855.10
1400.Total Settlement Chargea(enter on lines 103,Section J and 502,Section K) � 24,941.87 13,056.31
•aam ou�siae or c�osinq oy eorrowerte�,seueqs),ienaeqy,or m�m-�eny�r�
By signinq paga 1 of Ni5 Slelemen�,the Signalories acknovAeCge recaipl o/a complete7 Copy of page 2 8 3 of Nis�hree page slalemenf.
..;, .., ._......:-._..
_ � } _s
Academy Settlements,LLC,Se@lement Agent
Page 2 of 3 HUD-1
(2014050012AS.PFD/2014050012AS/15)
Comparison of Good Faith Estimate(GFE)and HUD-1 Charges ' Good Faith Estimata HUD-1
Charges That Cannot Increase HUD-1 Line Number �!
Our origination charge #801 �� 2,540.63 2,540.63
Your credit or charge(points)for the specific rate chosen # 802 I 3,482.36 -3,482.36
Your adjusted origination charges # 803 -941.73 -941.73
Transfer taxes #1203 1,115.00 1,115.00
Charges That in Totai Cannot Increase More than 10% I Good Faith Estimate HUD-1
Government recording charges #1201 188.50 166.00
Appraisal fee # 804 460.00 455.00
Credit report # 805 70.00 126.92
Flood certification # 807 19.00 19.95
Final Inspection Fee # 808 ' 100.00 100.00
Mortgage Insurance Premium # 902 1,942.06 1,942.06
Title services and lender's title insurance #1101 1,395.00 1,400.00
Owner's title insurance to Fidelity Nationai Title Insurance Compa #1103 100.00 10.00
�� Total 4,274.56 4,219.93
Increase between GFE and HUD-1 Charges $ -54.63 or -128%
Charges That Can Change Good Faith Estimate HUD-1
Initial deposit for your escrow account #1001 � 3,042.00 1,471.87
Daily interest charges # 901 $ 13.147900lday 333.26 328.70
Homeowner's insurance # 903 ' 696.00 593.00
Loan Terms
Your initial loan amount is $112,917.00
Your loan term is 30.00 years �
Your initial interest rete is 4.2500% I
Your iniNal moothly amount owed for principal,interest and $679.37 includesi
any mortgage insurance is �
�X Principal
� Interest '��.
QX Mortgage Insurance
Can.your interest rate riseT QX No � Yes,it can rise ro a maximum of %. The first
change will be or� and can change again every_months after
Every change date,your interest rate can increase or decrease
by %. Over the life of the loan,your interest rate is guaranteed
to never be lower4han %or higher than %.
Eve�if you make payments on time,can your loan balance rise? �X No � Y�s,it can rise to a maximum of$
Even if you make payme�ts on time,can your monthly �X No � Yes,the first increase can be on and the monthly
amount owed for principal,interest,and mortgage insuranca rise7 amount owed can rise to$
The maximum it oan ever rise to is$
Does your loan have a prepayment penalty9 �X No � Yes,your maximum prepayment penalty is$
Does your loan have a balloon payment? �X No � Yes,you have a balloon payment of$
due in_years on
Total mo�thly amount owed including escrow account payments ❑ You do not have a monthly escrow payment for items,such as property
taxes and homeowner's insurance. You must pay these items directly
yourself.
❑X You have an additional monthly escrow payment of$218.26 that results
in a rotal initial monthty amount owed of$897.63. This includes
principal,interest,.any mortgage insurance and any items checked below:
�X Property taxes Q Homeowner's insurance
� Flood insurance QX School Taxes
❑ ❑
Note: If you have any questions about the Settlement Charges and Loan Terms listed on this form,please contact your lender.
Page 3 of 3 HUD-1
(2014050012AS.PFD/2014050012AS/15)
HU�-1 Attachment
Borrower(s):Dejan Jagesic Selle�(s): Gloria J.Samples,Executrix
31 Sample Bridge Road '
Mechanicsburg,PA 17050
�ender:Merrimack Mortgage Company, Inc. ''
Settlement ngent:Academy Settlements,LLC
(717)695-9521
Place of Settlement:$75 Market Street
Lemoyne,PA 17043
Settlement Date:,June 6,2014
Property Location:31 Sample Bridge Road
Mechanicsburg,PA 17050
Cumberland County,Pennsylvania '
Adjusted Origination Charge Detaiis ,
Origination Charge
Broker Compensation 2,540.63
to MoneyLine Lending �
i Total $ 2,540.63
Origination CrediUCharge(points)for the specific interest rate choserj
Lender Credit -3,482.36
to Merrimack Mortgage Company,inc. '
Total $ -3,482.36
Adjusted Origination Charges $ -941.73
Reserves Deposited with Lender
Homeowner's insurance 148.84
2.000 at 74.42 per month
County/Twp Taxes 78.74
2.000 at 39.37 per month
School Taxes 1,253.64
12.000 at 104.47 per month
Aggregate Adjustment -9.35
Total $ 1,471.87
Title Services and Lender's Title Insurance Detaiis BORROWER SELLER
Notary Fee 20.00 10.00
to Academy Settlements,LLC
Overnight Courier/Wire Fee 40.00
to Academy Settlements,LLC
Tax Certification 20.00
to Academy Settlements,LLC
Closing Fee 150.00
to Academy Settlements,LLC
Lender's title insurance 1,115.00
to Fidelity National Title Insurance Company
Closing Protection Letter 75.00
to Fidelity National Titie Ins.Co. '
Total , $ 1,400.00 $ 30.00
WARNING: It is a crime to knowingly make false statements to the United States on this or any similar form. Penalties upon conviction can
include a fine and imprisonment. For details see: Title 18 U.S.Code Section 1001 and Sdction 1010.
(2014050012AS.PFD/2014050012AS/15)
I
HUD-1 Attachment- Continued
Owner's Title(nsurance BORROWER SELLER
Owner's Policy Premium I 10.00
to Fidelity National Title Insurance Company I
Total � $ 10.00 $ 0.00
i
Lender's Title Insurance BORROWER SELLER
"fees alao shown above in Titie Services and Lender's Title Insurance Details
Lender's Policy Premium ! 965.00
to Fidelity Nationai Title Insurance Company
Lender's Endorsement Charges 150.00
Endorsement Endorsement',Charge
ALTA Endorsement Form 8.1 (Environmental Protection 50.(�0
Lien) I
PA Endorsement 100-No apparent violation of 50.00
restrictions-existing constructi
PA Endorsement 300-Survey Endorsement 50.00
Total ' $ 1,115.00 $ 0.00
WARNING: k is a crime to knowingly make false atatements to tha United States on this or any similar form. Penalties upon conviction can
include a fine and imprisonment. For details see: Title 18 U.S.Code Section 1001 and S�ctton 1010.
' (2014050012AS.PFD/2014050012AS/15)
RSR AUCTION COMPANY/ESCROW ACCOUNT �O9Q
Mary Katcher Or Gloria samples 4/25/2014
3Q' - ��►T.r.T.TxRY AUCTION 4/12/14 (4/12/2014) 2,258.00
VUII� /� LVI '� L � JV� '�� vLltllilv Vrii1�� ��v� J/LJ � � L
CENTRIC
BANK
� weR�wlveAroundYw•
�
June 9,2014
Stone LaFaver&Shekletski
Attorneys at Law
414 Bridge Street
Post Office Box E
New Cumberland,PA 17070
Re: Estate of Mary M Katcher
Dear Attorney Shekletski:
For yoar clarification,Ms. Mary M.Katcher opened checking account#1934723 on August
18tk�,2008 as a joint account with Gloria J. Samples. The date of death balance on March 16�',2014,for
the aforementioned account was$28,975.6$.
If yau have any further questions or concerns,please do not hesitate to contaot me at(717)591-
1360.
Cordially,
, ,
, (
,
w / .
,r..
Mary Ann�$ er,AVP
Branch�n ger Silver Spring Branch
Centric ank
6480 Carlisle Pike
Mechanicsburg,PA 17050
(71'7}591-1364 T
(717)591-1363 F
4320 Ling�estown Road
Hacsiaburg,PA 17112
T 717.657.7727
� 717.657.77�8
www.Centricbulk.com
Jun. 10. 2014 2 ; 52PM PNC Ba�k No, 4954 P, 1/2
; ........ ... . .
T�._ ���
June 1 Q, 20l 4
Gezry Shekletslr�
Attome�,A.t Lavc�
414 Bridge St
I�Tew Cumberland, l�A 17070
RE: Mar�I�.atcher
SSN: 208-20-7�68
DOD: 03-16-2014
�7ear Mr. She�Cletski:
Zn response to �aur request for Date of Death(bOb)balances for the custozner noted abo`ve, oux
records sk�ow t�ae�'o�aowing:
Checking Acco�nr
Aecot�nt#� 5140263606 Established: OS-29-19$4
MAR.Y I�ATC�IER
GLOR�A SA�'LES
Y70Y7 baiance: �3,905.$3 + O.QO accrued interes�
Savings A,ccou�t
Account# SX30X822�9 �stablished: 06-22�1984
MARY I�ATCHER
G�,O1�A SAMpLES
DOD balance: $ 660_75 +p_00 acerued interest
Please�aote#t,at thzs o�fce provxdes d�te o�deat}�ba7at�ces �or c�eposxt accou�zts(J�tA.s, CDs,Ch.ecking and
Savings). ''VVe do not�rocess any�inancial transactions or provide statements. Yf you�eed assxstaz�ce�itla
an� of these items,please call 1-$$$-PNC-BANK(1-88$-762-2265)or s�op b��our local pNC Bank branch
o�ce.
Sincerel�,
National Financial Services Center
PI�]�C�ank,N_A.
Member FDYC
Page 1 of 2
Jun. 10. 7014 2: 52PM PNC Ba�k No, 4954 P, 2/2
This message is ir�terrded for the use of the rndrvzdual or entiiy to which ft is addressed a�d r�ncry
contain infarmatian t�iat is prrviZeged, confdential a�d exempt,fr-om disclosure urza'er applicabre raw_
If the reader of this message is nat a�ie intended recipient or the employee or agent responsible for
delivering this message to the intended recipient, ynu are hereby notifred ahat any dissemination,
distr-ibution or copying of this communicatians is strictly prohibited. If you have received this
co�rcmurxicatzors f� e�r-or-,plea.se not��ne zmmediately by reply or by telephnne at 800-762-r77.5 arid
immedia�ely destroy thrs faxed dacurrzent.
page 2 of Z