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Home My WebLink About06-11-14 ` �` 1505610143 REV-1500 EX�°2_„> ; i� OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year File Number Bureau of Individual Taxes �EPARTMENTOFREVENl1E Po Box.28oso� INHERITANCE TAX RETURN 21 12 012 7 2 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 11 24 2012 08 20 1962 DecedenYs Last Name Suffix DecedenYs First Name MI BARGE ROBERT A (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW � 1. Original Return ❑ 2. Supplemental Return � 3.Remainder Return(Date of Death Prior to 12-13-82) � 4. Limited Estate � 4a.Future Interest Compromise � 5. Federal Estate Tax Return Required (date of death after 12-12-82) g Decedent Died Testate � Decedent Maintained a Living Trust 8. Totai Number of Safe Deposit Boxes � (Attach Copy of Will) � (Attach Copy of Trust) � 9. Litigation Proceeds Received � 10.Spousal Poverty Credit(Date of Death � ��,Election to tax under Sec.9113(A) between 12-31-91 and 1-1-95) (Attach Schedula�0) � CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATIOt�6FtDULD BE[3'Iitr CTE� . r� � +�� Name Daytime Telepho�Nf�ynber � �,;a � ROBERT P KLINE 717 770 ==�,�'41`�' �'' r�7 =� • r.�_� F---► "-, E:'7 �'..^'� f�� ;` C�� REGISTER OP HNI�S`USE ONLY ,� �� '�7 C;j �.."..> � ...,� _,�Z First Line of Address � C�_ � '-� _ ~r� • :.,, f-.., ' = C7 714 BRIDGE STREET � � � �- rn �V p Second Line of Address � � PO BOX 461 DATE FILED City or Post Office State ZIP Code NEW CUMBERLAND PA 17070 Correspondent's e-mail address: Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true,correct and complete.Declaration of preparer other than the personal representatrve is based on all information of which preparer has any knowledge. SIGN RE OF PERSON RESPONSIBLE FOR FILING RETURN DATE� Bruce J. Barge ADDRESS 600 Steinhour Road,York Haven, PA 17370 SIGNATUR PR ARE ER T N REPRESENTATIVE DATE � �� Robert P Kline � ��,e �� ADDRESS Kiine Law Office 714 Bridge Street, New Cumberland, PA 17070 Side 1 � 1505610143 1505610143 J � , ' � 1505610243 �J REV-1500 EX DecedenYs Social Security Number oe�denesName: BARGE� ROBERT A. 202 46 6716 RECAPITULATION 1. Real Estate(Schedule A).......................................................................................... 1. 2 0 , 0 0 0 . 0 0 2. Stocks and Bonds(Schedule B)............................................................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C).......... 3. 4. Mortgages&Notes Receivable(Schedule D).......................................................... 4. 5. Cash, Bank Deposits&Miscellaneous Personal Property(Schedule E)................ 5. 1 6 , 1 8 3 . 8 2 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............. 6. 7. inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) ❑ Separate Billing Requested............. 7. g. Total Gross Assets(total Lines 1 through 7).......................................................... g. 3 6 , 18 3 . 8 2 9. Funeral Expenses and Administrative Costs(Schedule H).............. ........ 9. 2 0 , 2 7 8 . 3 3 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................. 10. 1 6 , 0 2 8 . 7 9 11. Total Deductions(total Lines 9 and 10)..................................................................11. 3 6 , 3 0 7 . 1 2 12• Net Value of Estate(Line 8 minus Line 11).............................................................12. -1 2 3 . 3 0 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 2 3 . 3 0 TAX COMPUTATION-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.00 15. 16. Amount of Line 14 taxable at lineal rate X .045 16. 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18� 19. TAX DUE.................................................................................................................19. 0 . 0 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑ Side 2 L 1505610243 1505610243 � . REV-1500 EX Page 3 File Number 21 - 1 2 - 01 272 Decedent's Complete Address: DE EDENT' NAME Barge, Robert A. STREET ADDRESS 823 South Humer Street CITY STATE ZIP Enola PA 17025 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 0.00 2. Credits/Payments A. Prior Payments _.._ ___ B. Discount Total Credits(A +B) (2) 0.00 3. Interest (3) 0.0 0 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2,Line 20 to request a refund 5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (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:.................................................................................� � b. retain the right to designate who shall use the property transferred or its income:....................................[I [� c. retain a reversionary interest;or...............................................................................................................[_ [x] d. receive the promise for life of either payments,benefits or care?..............................................................',� i z 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.....................................................................................................................�•—� �X I 3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?......... ;j [x� 4. Did decedent own an individual retirement account,annuity,or other non-probate property which �, contains a beneficiary designation?...................................................................................................................� i� IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETUR 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 January 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)(n)]. 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 surviwng 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 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 decedenYs siblings is 12 percent[72 P.S.§9116(a)(1.3)1. A sibling is defined under Section 9102,as an individual who has at least one parent in common with the decedent,whether by bloocf or adoption. �• pennsylvania �:�\� DEPARTMENTOFREVENUE SCHEDULE A �� INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT � FILE NUMBER ESTATE OF Barge, Robert A. 2� - �2 -0�2�2 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 excl�anged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survrvorsh�p must be disclosed on schedule F. Attach a copy of the settlement sheet if the property has been sold. Include a copy of the deed showing decedent's interest if owned as tenant in common. ITEM DESCRIPTION VALUE AT DATE OF NUMBER DEATH 1 823 South Humer Street, East Pennsboro Twp, Cumberland Co. Parcel#09-16-1052-020 20,000.00 (HUD-1 Settlement Statement Attached) TOTAL(Also enter on Line 1, Recapitulation) 20,000.00 �� pennsylvania SCHEDULE E ' � DEPARTMENTOFREVENUE CASH, BANK DEPOSITS AND MISC. INHERITANCE TAX RETURN RESIDENT DECEDENT PERSONAL PROPERTY FILE NUMBER ESTATE OF Barge, Robert A. 2� - �2 -0�2�2 Include the proceeds of litigation and the date the proceeds were received by the estate.All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM DESCRIPTION VALUE AT DATE OF NUMBER DEATH 1 Unum Insurance(short-term disability) 4,404.87 2 Lord &Taylor credit 1,354.62 3 Unum Insurance refund 707.65 4 1996 Chrysler Sedan 300.00 5 Integrity Bank Checking Accounts 3,017.59 6 Washer& Dryer 100.00 7 Auction Proceeds (personal property) 5,639.73 8 IRS refund 560.34 9 Progressive Insurance refund 99�02 — - - ------ - ---- -_ —-- TOTAL(Also enter on Line 5, Recapitulation) 16,183.82 - - REV-1511 EX+(i0-09) '�i-', pennsylvania SCHEDULEH � �� DEPARTMENT OF REVENUE FUNERAL p�EE1VSESAND � INHERITANCE TAX RETURN /�ry�Alwp�+Tp/�TT/C�+l1CT@ RESIDENT DECEDENT f1LAr1 IYh71 fv'111YG VW 1 A FILE NUMBER ESTATE OF Barge, Robert A. 21 - 12 -01272 Decedent's debts must be reported on Schedule I. -- __ - - ITEM AMOUNT NUMBER FUNERAL EXPENSES: DESCRIPTION A. 1 Stone & Murray Funeral Home, New Cumberland, PA 8,561.00 2 Flre Mountain (funeral luncheon) 226.05 3 Rominger Memorials, Penbrook, PA 1,265.00 B. ADMINISTRATIVE COSTS: �, Personal Representative's Commissions Name of Personal Representative(s) , Street Address City State Zip Year(s)Commission Paid 2. Attorney's Fees Kiine Law Office 6,000.00 3, Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation) Claimant Street Address I� City State Zip Relationship of Claimant to Decedent 4. Probate Fees Register of Wills (to date) 638.50 Cumberland Law Journal/Patriot News 170.66 5. AccountanYs Fees � 6. Tax Return Preparer's Fees 7. Other Administrative Costs � P. Scott Archibald Appraisais 225.00 See attached 3,192.12 TOTAL(Also enter on line 9, Recapitulation) 20,278.33 _ � � Schedule H ' Fw�er�l E�erues& COMMONWEALTH OF PENNSYLVANIA �M�M��n� INHERITANCE TAX RETURN 1 WYAYVG RESIDENT DECEDENT _ -- — - -- — --- --- -- __ - ESTATE OF Barge, Robert A. 'FILE NUMBER �21 - 12 -01272 — - _ __ ___ _ 2 East Pennsboro Township (sewer&trash) � 414.00 3 PPL 128.87 4 Tiger Trash (dumpster) 425.00 5 Tri County Abstract 135.00 6 Tax Claim Bureau (2012 real estate taxes) I 1,580.58 � Debbie Lupold, Treasurer(2013 Co/Twp tax) � 330.57 8 Settiement Costs related to sale of real estate, adjusted for pro-rations (per HUD-1 178.10 attached) i � Page 2 of Schedule H -�� ; pennsylvania SCHEDULE I � DEPARTMENTOFREVENUE DEBTS OF DECEDENT, MORTGAGE INHERITANCE TAX RETURN RESIDENTDECEDENT LIABILITIES & LIENS .. .. - - -- - �I- __ .._. -- �-- —�FILE NUMBER ESTATE OF Barge, Robert A. 2� - �2 -0�2�2 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM DESCRIPTION AMOUNT NUMBER 1 M&T Bank 1,146.00 2 Comcast 78.50 3 Verizon 95.70 4 Pinnacle Health 10.00 5 PPL 365.04 6 United States Treasury 569.84 7 MS Hershey Medical Center 828.34 8 Bruce J. Barge- Promissory Note 4,500.00 9 Jeremy Helm -tool account 365.73 10 Holy Spirit Hospital 337.50 11 MSHMS Physicians Group 555.12 12 Camp Hill Emergency Physicians 1,246.00 13 Oakwood Center 35.00 14 FIA Card Services (MBNA/Bank of America) 2,772.43 15 Comcast Harrisburg 108.59 16 Verizon PA 438.00 TOTAL(Also enter on Line 10, Recapitulation) 16,028.79 � SCHEDULEI DEBTS OF DECEDENT, MORTGAGE COMMONWEALTHOFPENNSVLVANIA LIABILITIES & LIENS INHERITANCE TAX RETURN y J RESIDENT DECEDENT C O I7 lI Il U P.U . __ __ - ._ _-_. _.._ _ .._- __.-_. — FILE NUMBER ESTATE OF Barge, Robert A. �2� - �2-0�2�2 _ Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. NUMBER DESCRIPTION AMOUNT 17 Camp Hill Emergency Physicians 2,328.00 18 Holy Spirit Hospital 249.00 i � � Page 2 of Schedule I REV-1513 EX+(01-10) � �� pennsylvania SCHEDULE J � DEPARTMENT OFREVENUE INHERITANCETAXRETURN � BENEFICIARIES RESIDENT DECEDENT — --_ — - -- — ___ _ _ —_ - _ _ _ — --- ESTATE OF FILE NUMBER Barge, Robert A. 21 - 12 -01272 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) ( DECEDENT (Words) ($$$) RECEIVING PROPERTY Do Not List Trustee(s) I. TAXABLE DISTRIBUTIONS[include outright spousal � distributions,and transfers under Sec.9116(a)(1.2)] 1 Ryan R. Barge Son 2 Danielle R. Barge , Daughter 3 April C. Frock Stepchild I ; 'I, ' , i Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 covelr sheet,as appropriate. � II. NON-TAXABLE DISTRIBUTIONS: ��, A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN i i B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS � �i TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 —�--- - - - r.� n � � ,�-' �3 `sl � � C� c�'�j �-n, W � C� C.� -�J � z r�- -+ �' n �,-� m D � � a-� � c� � U-' � o � o �, o � -;y -:� c� a -r; _;,_..2 -rr o � ca . � c�� ;_ rr� LAST WILL AND TESTAMENT � � �-j �' ° � � OF ROBERT A. BARGE I,ROBERT A.BARGE, of East Pennsboro Township, Cumberland County, Pennsylvania,being of sound and disposing mind,memory and understanding,do make,publish and declare this to be my Last Will and Testament,hereby revoking and making void all previous Wills and Codicils heretofore made by me. �-> FIRST � I order and direct my personal representative hereinafter named to pay all of my just debts, funeral expenses, expenses involved or connected with the administration of my estate,and all federal, state, or other death taxes payable because of my death with respect to the property �� forming my gross estate whether or not passing under this Will as soon after my death as is reasonably possible. However,my personal representative need not accelerate and pay those unmatured obligations which,in his,her or its opinion, it might be proper and more advantageous to retain or renew and pay as they become due and payable. If I do not own a burial plot or a grave marker at the time of my death,I authorize my personal representative, in his,her, or its sole Page 1 of 6 Pages _ _ discretion,to purchase a burial plot and to erect a�suitable marker at my grave, and to expend sums from my estate for this purpose. SECOND At the tixne that I make this Last Will and Testament,I am legally married to BETHANY BARGE. However, as we have been separated for many years, I have not made any provision for her in this,my Last Will and Testament. '1'HIRD I give,devise,and bequeath my entire estate together with all insurance proceeds thereon of �vhatever nature and wheresoever situa.te to the following beneficiaries,providing that they survive me by sixty(60)days,per stirpes, as follows: thirty-five(35%)percent to my son,RYAN R BARGE;thirty-five(35%)percent to my daughter,DAN�LLE R.BARGE; and thirty(30%) percent to my stepdaughter,APRIL C. FROCK. FOURTH � If,at the time of my death, any beneficiary of this my Last Will and Testament is under the age of thirty-five(35)years or is,in the judgment of my personal representative,mentally disabled, I give, devise and bequeath said beneficiary's share to my Trustee,my father, BRUCE J. BARGE, in Trust for said beneficiary,in accordance with the paragraphs below. If BRUCE J.BARGE is unwilling or unable to serve for any reason,I appoint my sister, SHELLEY DILLON,to serve instead. FIFTH During the terms of any trust created pursuant to this Will the Trustee is authorized to expend and apply so much of the net income and principal of each such trust as the Trustee shall consider advisable for the health,maintenance, support, and education(including college Page 2 of 6 Pages education,undergraduate and graduate)of each such beneficiary until he or she attains thirty-five (35)ye�of age,or until all such amounts are paid out of the Trust. When the beneficiary attains the age of thirty-five (35)years or is in the judgment of my Trustee mentally sound whichever event occurs later,the Trust shall terminate and the remainder thereof shall be paid to said beneficiary. If said beneficiary shall die before the termination of said Trust,the Trust shall terminate and the remainder thereof shall be paid in accordance with the paragraphs above. I direct that no Trustee sha11 be required to give or post bond for the faithful performance of the Trustee's duties in this or any other jurisdiction. SIXTH lviy Executor and Trustee are authorized and empowered to exercise from time to time in his,her or its sole discretion and without prior authority from any Court, in respect of any properry forming part of any trust hereby created or otherwise in its possession hereunder,all powers CT conferred by law upon trustees or executors and I intend that such powers be construed in the broadest possible manner. SEVENTH No interest of any beneficiary of my estate, either in income or in principal, shall be subject to anticipation or pledge, assignment, sale or transfer in any manner,nor shall any beneficiary have the power in any manner to charge or encumber his or her interest either in income or principal, nor shall the interest of any beneficiary be liable or subject in any manner while in the possession of my personal representative for the liability of such beneficiary. Page 3 of 6 Pages _ . EIGHTH I nominate, constitute and appoint my father,BRUCE J. BARGE,Executor of this my Last Will and Testament. In the event BRUCE J. BARGE is deceased, unable or unwilling to serve or shall cease to serve for any reason whatsoever,then I nominate, constitute and appoint my sister,SHELLEY DILLON,to serve instead. I direct that my personal representative shall not be required to give or post bond for the faithful performance of his,her or its duties in this or any other jurisdiction. NINTH I hereby declare it to be my expressed desire that my personal representative employ Kline Law Office of New Cumberland,Pennsylvania,for legal advice and assistance regarding this my Last Will and Testament, said attomeys having considerable knowledge of my affairs,views and wishes respecting any matters that may arise at the probate of this instrument,the administration of my estate,and the execution of the powers herein mentioned. IN WITNESS WHEREOF, I have hereunto set my hand to this my Last Will and � � �� ,2012. Testament this s day of � 1� . �� ) � Witness ROSERT A.BARGE .� � �� W ess Page 4 of 6 Pages ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA . : SS COUNTY OF CUMBERLAND • I,ROBERT A.BARGE,the Testator whose name is signed to the attached or foregoing instrument,havi.ng been duly qualified according to the law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament;that I signed it willingly,and that I signed it as my free and voluntary act for the purposes therein expressed. ; BERT A.BARGE Sworn or affirmed and acknowledged before me by ROBERT A.SARGE,the Testa.tor, this 'Q'�day of 71�0 v��rn�i�2.� , 2012. ,.; r ��J%��2�,G. � i1� 'NOTARY PUBLIC � ` COMMONWEALTH OF PENNSYLVANfA NOTARIAL SEAL SHARON R.FEISTER,Notary Public New Cumberland Boro.,Cumberland Co. My Commission Expires April 15,2015 Page 5 of 6 Pages AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA . : SS COUNTY OF CUMBERLAND . A , ,r-- _ y� � ,� ,ZA � f� � We, o��lL� '�, �i) , �-r c and �L�I(� ' ,the witnesses whose names are attached to the foregoing document, being duly qualified according to the law,do depose and say that we were present and saw Testator sign and execute the instrument as his Last Will and Testament;that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed;that each subscribing witness in the hearing and sight of the Testator signed the Last Will and Testament as witnesses and that to the best of our laiowledge the Testator was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. ) �.�2.��-,� 1�-- �ae-sz—r� � '�i� /v/�� , �� Sworn or affirmed and subscribed before me by �o G �� and ��A/t,�,U� ,� . CA i,�� this /�� day of Ov�-�nb�� ,2012. /, � -! , / �CsC� � .�/�./�L. OTARY PUBLIC . � COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL _ SHARON R.FEISTER, Notary Pubiic ' New Cumbe�land 8oro.,Cumberland Co. My Commission Expires Aprii 15,2015 Page 6 of 6 Pages _ _ _ _ _ _ 12/10?2�12 13:16 i177702553 KLINE LAI�I OFFICE PAuE Et�lE�4 ��- � � ��..��:.� � �� ' � �I� r1� 042TT5 Ta�Parc�l No. 09-1.C�-10�2-020 T:�II� D�E�l' N�ATJE this .71 s�d�y ut'Nov�zz�bet-, ii� the year two t��ous�u�d twel�1e (2012 j; BETWrEN BrTFil1T�1Y B�R�E, hereznai�ter ct�l.lcd Granto�-, AND ROF3�R7'�°�.. BARCTF,Izerei�n�.fte.r, c�iled Gxax�te�, WI�"�1ESSEI"IZ, t11at in cvr�sideration of t�xe sum ofi pNL; ($J.AD} DULLAR, i.n. hand ��id, the reccipt wliercof. i.s her�by �►clu�owl�dged, thc said Grantor does l�ereby qu�t-c,i.aiia� to thc sa.id �'rrantce, j� ,A,�,L T�-1f1.T CEPti'x'1a.JN �iec:c or ��u�cel oi'land situatc in tk�.e Townsl.Zip c�f La.st Pennsb�ro,� Couyrtty of C;u.zx�k�erlax�.d 1n.d State o:F PeniYSylvania., �y�ore ��articui.a��ly bounded az�.d d�scribcd as iollows,to wit: S�GINNING a.t �t paiiat on tl�e west side; of��iurY�er S1;reci:; tkzer�ce i.n � v��estcrly directi.�n. ane hundi�ed ni�lcteen {119) �eet, �nore or lcss, �:o t1.�e e�stcz'n I.i.ne vf�t�relve 12) foot wide alley; ihence northwardly alon.g the c�stern. �i.ne of said alley, sE�r�cnl;y (7U) �eet to a pc7i.ac; tlencc in a.! castcrly d��'e.ction, o��e l�iuldred z�.iu��teen (1.1.9) fcet, ��.oi'c or less, to tl» wesCci�n sid,c of IIuax�er Stre�t; thenec by tlie westexx�. si.de oI'HuiZ�er Street, Sc)�iL'11 BCVCXIt�r {74) rcc;t �o a pQint, tJac pl.ace of BLG�INNT�iG. H�V1NG thereon erected a sulglc family d.wellin��lsnow�.3.a.s No. $23 Humer Strect, �z�al�, Pennsylvania.. BEINCT THE �1lMi� PRFMISES wlucl� Bz�lce J. Sar�e �nd Jut�e F. Barge, by tllcir dced datcc) (�ctoUer 29, 1998, �►��d recorci.ed.Novezx�,hea� 19, 199$, i�� t1�e 0��1�i.ce of tllc Rccordcr of Deeds i.►,a and ior CU.it?.herl.�.riCl COU[�ty, Per��zsylv�u�ia, in r�ced Bc�c�lt 1£9 at pa�e 520, ga•�ntec� ��d coisvcycd untt� Robcrt A. ]3�irge a,i1d Bcth.a.ily Barge,h�rsba�acl.A,n.d wi:fe. It is specircally ua�det�5tooci Uy the L�ildcrsign.ed Grat7tor that, by tlae�:?�ecu.ii,o��c��f tl�is Decc�, shc canxt�t claim z.�1y .ri.�lyis in and to said. prol�erty as "i�naiita.� l�.r�perty" ui,der- an� aciic�ns for "equit�tl�ie distribu.ti�n" uizdcr p�cse?zt 1.aw��.�d that slie is aff nm.�tively ��vai�vin�ai�� nd. all rights to cla�m any.i.�ateresl in saici real esllce. '�iTtS iS l-� C4NVFYANCE L�T�VELN 'VVJrJ: AND HUSB�ND �1.ND T� T�IS;�tLrClS�. EXEMPT FROM PFNNSYLVl1.NXl�T�331�..T�,T�.'Ti'v1NSI�ER 1�l1.�. _ 1'�/1�/�012 13:1E �1777�255� KLINE L�W �FFICE P�GE 63,'�� IN WTTNLSS Vd�IE1�E0�', tlle Gran.tor l�.as l�er�.u�ito s�t I��r hand az�.d s�al thc:d.�y at�d ycaz• Iirst above�written. Seal.cd a.�d delivcred in ihc��rESencc of: � _ : /� �--- ��'�TAN AR � — ACIt�'O«'.LED G�M�N'�' COMMONWE1I.LTH O�PFNNSY'LVANI�1 : : S� �OCJNTY OF G�� -�� : Un. this Z 1 �� clay of�„_n��N-�-ra F�� , 201?, be.f�r� tr,.c, a Notaxy P��blic, �11c u.n.d.crsi.gn.ed off�cer, person��ll�r �ppe�.xed BETHII.NY ]3l�.RCT�, la�.ornm �o mc, (o�- satisfactor.ily p.rovan)to be the persal�s whose �aan�e is suhscribed to thc �'or�going instxx�.i?�ent 1nd acicr�.orvledged thc iarcgoi.a�g decd.to b�l�cr act and dccd ar�d desireci to be record,ed as sucl�. WTTN.F.,SS my}�11�d and o.f.fcial sea1,the da.y an.ci yca.r a.f:oa,�sai.d. ��.�. �� nTt11�Y PtTF3LIC COMPM1aNW�LTH OF PENNSYLVAh��.� . " � Ncrtarlal5ea4 � Katrieec�M.MAq�ra,Nota�Y Publlc eas4 PennsUorn�T'wp.,�umncri�nd CountY My Commi�4an�x�i�es A��?��20i� _ ..�.:}� ., �ylv�riC/�;.;nr��t:i0r�nS P1oC�riE= I H��i3Y CERTIT'Y tliat 1�he precisc a.cl.dxess o'Cthc Grantee hezeiai is: $23 S. Humer Sirc�t, Lno).�, PA 170�� "� t�ttor�.cy:FQr C'Jra��tec � RQI3ERT P. �t`L,IN�,�SQUIR� AtCor��cy a�d Counseliar aL Law IVew Cambc�rlflrtd,Pcxlnsytv�nia 1�f1�/2012 1�: 16 71?77�255a K�LINE L�W OFFIGE FAGE �41�� O$ER'�'' �. ZIEG��R �ECORA��t OF �].�+EDS '�� , CUri�BERL,A,�TD C�UNTY � -�., �� ':', -,.�:��; ,� 1 C�'C.TRT�OUSE S UfiT�E , ,,.,. � - '. ,._.; C,ARLXSLE, PA. 17013 :�`��`:��r 4 R: 7� I��0��!� I � �I a�. 1�. Y;.� ' ;ti �.' , i. ' �i e� .��, r!1 u ...--:�!�N'�r�,,.', ' �nstrumcnt Nu�mb�r-2Qx236G7'� �eco�rded Qn 11/2$/201.2 At$:�7:z6 AM *Tata��a�es w 3 *�nstrument T�rpe-,DE�D Tnvoiee Nuz�tber�12302$ Use�'� �MS�V *G�rant�r-BAYZGE,��+TILA,NX *Gr��tee-B.A,RG�,TtOBFRT A *Caslo�nter-I�Y,INE *FEES $�'AT� WRZT TAX $0.5� Certif�cati4� P��e S'��,,'J.'� JCS/ACCESS T� $23.5p ,7vs�� ]O N�T DETACH �co��c�t� FE�s - ��1.50 RECORDER Uk' DEEDa P,ARCEL c��zc�TZON ��.o. oo '�'his page is naw Part FEES of this l�gal document. AFFQRDASZE HOUSSNG $�.1.50 COiJN�Z'Y �1RCHI'VES FEE $2, 00 ROA P�RCHZVES FEE $3.00 EAST P��INSBORO SCHOOL $0. 00 DISTRTCT E.'AST PENNS�dk20 TOLCNSH�� $0.00 TOTAL PAID $62.Q0 I Ce�'t��y t�iis to bc recor•ded in Cu�x�.bexland County PA ca,y� , a� � �� a a ZtFCORDFR Q D EDS ._ yrao "-Informntion tlenotcd by un nstcrislt may d�nnge during tl�e verit�cAi9on process nad mrty nat be ret�ecCecl on tl�is pago. 002TT5 II I ll l ll i l ll l lll lll l l ill l�l a Settlement Statement U.S.Department of Housing � and Urban Development � � � �r OMB Approval No. 2502-0265 B.T e of Loan 7. ❑ FHA 2. ❑ FmHA 3.�Conv.Unins. 6.F°e N""'e�r 7.Loan Number e.Mortgage Insurence Case Number 4. ❑ VA 5. ❑ Conv.Ins. C. Note: This form is fumished to give you a statement of actual settlement costs. Amounts paid to and by the setdement agent are shown. Items marked"(p.o.c.)" were paid outside closing; they are shown here for infortnational purposes and not included in the totals. D.Neme end Mtlress ol Bartower E.Neme and Adtlreae of Seller F.Name end Address of Lender Ryan Rodgers Robert A.Barge Estate Andy Pequignot G.Property Lacetlon H.Senlement Agenl 823 South Humer Street Rob A.Kru Es uire East Pennsboro Township �acaotSetuement �.setuememoate 53 East Canal Street 8/20/2013 Dover PA 17315 asbunement Data �a: eiock: 8/20/2013 J.Summary of Borrower's Transactlon K.Summary of Sellefs Transaction 100.Groas Amount Due From Borrower 400.Gross Amount Due To Seller 70t.Convaa sales rice 20 000.00 4ot. Conuact sales rice 20 000.00 102. Personal ro e 402. Personal ro e 103.Settlement cha es to borrower llne 1400 66�.�0 403. 104. 404. 105. 405. Ad ustments for items ald b seller In advanca Ad usVnents for kems paid 6 seller in advance tos.Clt nown taxes 8/20/20130 12/31/2013 35.41 4os. Ci /town taxes 8/20/2013012/31/2013 35.41 �o�. co�n taxe5 8l20/201�0 12/31/2013 84.14 ao�.caun �axes 8/20/2013�12/31/2013 84.14 tos.Assessments 8/20/2013u 6/30/2014 953.17 aoe.Assessments 8/20/20130 6I30/2014 953.17 ios. ro aos. � iio.Sewer 8/20/20130 9/30/2013 62.17 aio.Sewer 8/20/20130 9/30/2013 62.17 111. to at 7. � 112. l0 412. to 713. to 473. to N4. to 414. ro 115. to 415. �p 120.Grou Amount Due From Borrower 2�,801.89 420.Gross Amount Due 7o Seller 2�,134.89 200.Amounts Pafd B Or In Behalf OT Borroxrer 500. ReducUons In Amount Due To Seller 201. De os�t or eamest mone 2 000.00 501. �ccess de sit see inswcuons 2 000.00 202.Princf al amount of new loan s 502.Settlement char es to seller Ilne 1400 �,312.99 203. Existin loan s Wken sub ec[ro 503. Existin loan s taken sub'ect to 204. 504. Pa ff of first mo a e loan 205. 505. Pa ff of second mort a e loan 206. 506. 207. 507. 208• 508. 209. 509. Ad ustments for Items un aid 6 saller Ad ustments for Items un aid b seller 210.q ftowntaues �O StO.CI /towntaxes � 211.Coun taxes � 511.Coun taxes �a 212.Assessments �O 512.Assessments �a 213. 1O 513. to 214. t� 514. lo 215. � 515. lo 216. �� 516. lo 217, to 517. to 218. �� 51 B. to 219. �� 519. to 220.Total Paid BylFor Borrower ?,OOO.00 520.Total Reduction Amount Due Seller 3,312.99 300.Cash At Settlement FrortJTo Borrower 600. Cash At Settlement TofFrom Seller 307.Gross Amount due 6om borrower Ilne 720 21 801.89 601.Gross amount due to seller Iine 420 21 134.89 302.Less amount aid b Ifor borrower Iina 220 2��.0� 602.Less reduc0ons in aml.due seller Iine 520 3 312.99� 303.Cash �From ❑To Borrower �g 801,89 bp3.Cash ❑X To ❑ From Seller 17,82�.9� SUBSTITUTE FORM 1099 SELLER STATEMENT The InfwmaUon wnWined In Blocks E,G,H,and I end on Ilne 401(or,Iine 403 and 404)Is important tax Infortnation and is being tumished to the Intemal Revenue Senice.H you are requlred to file e retum,a negiigenca penalty or other sanctlon will be Imposed on you if this item is requlred to be reported and the IRS determines that it has rrot been reported.If this real estale Is your princlpal resldence,file Form 2119,Sale or Exchange of Principal Residence,for any gain,with your Income tax retum;for other Vansactions,complete the applicable parts of Form 4797,Fortn 6232 and/or Schedule D,Form 1040).You are requlred to provide the Settlement Agent (named above)with your conect taxpayer ldentlflcaUon number.If you do rat provlde the Settlement Agent wlth your cortect taxpayer identification number,you may be subject to cNil or cdminal penaltlas Imposed by law.Under penaltles of perJury,I certiry Nat tha number shrnm on this statement is my correct taxpayer ldentlflcatlon number. (Selle Signature) . �L.SeNlemenl Char es 700.Total Sales/Broker's Commlaslon 6ased on rlce S Z��0�.�� X= �.0� paid Prom Pald From Dlvision of Commission line 700 as follows: Borrowefs Selleh 701.$ �o Funds At Funds At 702.$ � Settlement Settlement 703.Commission ald at Sattlement 704. B00.Items Pa ble In Connection With Loan 801.Loan Ori inatlon Fee � 802.Loan Discount � 803,A raisal Fee �p 804. Credit Re ort tp 805.Lendefs Ins ectlon Fee 806.Mo a e Insurance A Ilcation Fee to 807.Assum tlon Fee 808. 809. 810. 81L 812. 813. 900.Items Re uired B Lender To Be Pald In Advance Exclude last da In calcs-lina 901 901. Inlerestfrom to $ /da 902.Mort a e Insurance Premlum for months to � 903. Hazard Insurence Premium for ars to 904. ars to 905. 1000.Reserves De osited With Lender 1001.Hazard insurance '� months $ er month � 1002.Mort a e insurance 1 monihs $ er month 1003.CI ro taxes � months 5 ar month 1004. Coun ro e taxas � manths S er month 1005.Annual assessments � months $ ar month 1006. '� months $ er month �� monihs $ er month 1008.A ate Accountln Ad usUnent 1700.Tltle Char es 1101.Settlement or closin fee to 1102.AbsVact or GGe search tp 1103.Tit1e examina0on � to 1104.Title Insurance binder �p 1705. Document re retlon to 1108.Nola fees to CBSh 7107.Attome s fees to Rob A.Kru - 5.00 400.00 �ncludes above items numbers: 1101 1102 1107 1108.TIUe insurence �o Indudes above Items numbers: 1109.Lendefs covera e $ 1110.Owner's wvere e y 1111. 1112. 1113. 1200.Government Recordin and Transfer Char es 1201.Recwdin fees: Deed S 67.�� ; Mort a e 3 ;Releases y 67.QD 1202.CI /wun �ax�stam s: oeea E 200.00 ;Mort a e S 200.00 1203.State tax/stam s: Deed $ 200.00 ;Mort a e 200.00 1204. 1205. 1300.Additlonal Settlement Char es 1301.Surve �o 1302. Pest Ins ection .to 1303. isoa.2013/14 School taxes 1 107.99 1305. 1306. 1307. 1308. 7400.TotalSettlement Charges(ente�on Iines 103,Section J and 502,Section K) � BB�.00 1 312.99 CERTIFICATION I have caretully revlewed the HUD-1 Settlement Statement and to the best of my knowledge and bellef,It is a We and accurate statement of all receipts and disbursemenis �on my ount a by me in ihts tran/fsactlon.I turthar ceNry that I hava recelved a copy of tha HU0.1 Setilem tatement. �L� =-;�� Seller Bonower Robe�A.B�arge Es t� /Ryan Rod ers Seller " orr y P ignot � To st o y knowledge the D-1 Settlement Stetement whlch I have prepared Is a We and accurate account of the funds which were recelved and have been or will b isburs y� u�sign s part of the settlemant of ihls Uansacllon. Settlement Agent 8/20/2013 Date Rob .Krug,Esqu'e WARNING: Il is a crime W n ngly make falsa statements to the Uniled States on lh(s ar any othar simllar form.PenalUes upon convicUon can Include a fine and Imprisonment For details s • Itle 1B U.S.Code Sectlon 1001 and Section 1010. U.E.GOYENWIENf pPotlIING OFflCE:19W}yµ}u ROBERT P. KLINE, ESQ. ,�Q�� '� �"�� rv June 9, 2014 r, � � � � c� ��I c� �7 � �— tRa Q � �.� �c� �.., � _,;� :�� :�ra ._; M-� ,._ ��, F� ,�� f�i Lisa Grayson, Register of Wills - '�' � � �' Cumberland County Courthouse ; L_.; '' ` � '';; `-; One Courthouse Square, Room 102 ', t�-' �; -� �� =•' .::a � �., �-=- �� Carlisle, PA 17013 : _� �.. i:� rn -� v, o .� W -�n Re: Estate of Robert A. Barge No. 21-12-1272 Dear Lisa: Enclosed is an original and two copies of an Inheritance Tax Return. As it is an insolvent estate, no check is enclosed. Please file the original and one copy of the Inheritance Tax Return and return a time-stamped copy to my office in the enclosed postage paid envelope. If you have any questions concerning this request, please do not hesitate to contact me at my office. ery tru ours, � Robert P. Kline, Esquire RPK/srf Enclosures cc: Bruce J. Barge 714 Bridge Street P.O. Box 461 New Cumberland,PA 17070 (717)770-2540 (717)243-5940 Fax (717)770-2553 l �' O � � � � � � :� �- � � Q � � � � � � � �.. o 0 u � n � i �l � C '�1 � � � � . W ,� �r� �. � � � O, � � � � O �' � d ` c - � �.; �. � � � � O N N E�. _ �G v '� � y ;a ca � �� 0 N'�~ # OOOOU08803 � H � � � W � a •�.y -v W �'O � � Q+ s s�'- 7� �+� _ :,. � . .. .�.�, �� , � RoBExT P. KLINE, ESQ. � ��,��,�� c7 C � � � � {.:;,, �� f.o� � p..,.t -r, C � �� t:�r c'� _ •r,�� I:.._ � �� _ �; �� -. ...w ,,, �.. ., : .,. C:� ' y.,,, r t=:7 � r;� .':i ,-� " . • . t�'.r . __ r-�. .. ._.:.a c') June 10, 2014 :� � ��7 _.'�,�-,3 �; -,, � � :� �� a -� � ti �. �� '1.� �-�' r'� Cumberland County Register of Wills � � � Attn: Heidi Cumberland County Courthouse One Courthouse Square, Room 102 Carlisle, PA 17013 Re: Estate of Robert A. Barge No. 21-12-1272 Dear Heidi: As per your telephone conversation with my office this afternoon, enclosed you will find a check payable to the Register of Wills in the amount of$15.00 for the Inheritance Tax Return filing fee in regard to the above-referenced estate. Very truly yours, � Robert t. i�iine, Esquire RPK/srf Enclosure 7l4 Bridge Street P.O. Box 461 New Cumberland,PA 17070 t�»>��o-2sao (717)243-5940 Fax (7l7)770-2553 � � . a � . � �. � � w CD � 7 ro � ,.+. �' �„J �-- � `� — i ^ 7' i-rr% r T ✓, _ � � ^ ✓ �� J {..t. L� �~t �• �� n v �:� c � '� -:J � �i -r t-r7 (� � Ci n (� r� � . � `;y� C'� � ,� � � �� Y+�. 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