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Home My WebLink About08-11-14 . � 15�561�105 REV-1500�`�°�-31,�,�� PA Department of Revenue pennsylvania OFFICIAL USE ONLY Bureau of Individua(Taxes •°'""�`OFYe"" Cou ode Year Flle Nu (NHERITANCE TAX RETURN � � � � � � PO BOX 280601 E - __ E , f � Harrisbur ,PA i iz8-o6oi RESIDENT DECEDENT � � � � +; ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY �---------------------- - , ,—.______._—.,._.__------; Suffix DecedenYs Firat Name M� �-------•---------- --------------------; ;---..__... ._.-------__– -- i Hoffman I ; William . - -----T� rj F � � � __—. �...._..._...-----.._..._..,___.._ , ..___---- — . _� �! --...._,__..._..------------------------- (If Applicable)Enter Surviv(ng Spouse's informatlon Below . Spouse's Last Name Suifix Spouse's First Name M� ,.____��_ ---- i � _. _......._........._.............. .._..............._.......-- ---- ._. _. , . i I ' ; i . . - �-'------- ' . . ..__._ . ......._.. _............ . . ......_ ... -'------------— —.....__.. .._...__..._.__.... ...._.._......__...... .............._...! i _-� Spouse s Soclal Security Number '- "� � ' ""� THIS RETURN MUST BE FILED IN DUPLICATE WITH THE � REGISTER OF WILLS , � :_ __ _.._ _ _ _ _ - : FILL IN APPROPRIATE OVALS BELOW ClR� 1.Original Reh�rn p 2,Suoplemontai Return C� 3. Remainder Return{t�ate of Death Prlorto 12-13-82) C7 4.Limited Estate O 4a.Future Interest Compromise(date of O 5. Federal Estate Tax Return Requtred death after 12-12-82) � 6.Decedent Died Testate O 7.Decedent Maintained a Llving Trust _ 8.Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy oi Trust.) O 9.Litigatlon Proceeds Received O 10.Spousal Poverty Credit(Date of Death O 11. Elecdon to Tax under Sec.9113(A) Between 12-31-91 and 1-1-95) (Atlach Schedule O) r--:> -- -�� CORRE3PONDENT THIS SECTION MUST BE COMPLE7ED.ALL CORRESPONDENCH ANQ CONFIDENTIAL TAX fNFORMATWN SH01IL�8E DIRECTED� ��" Name .___ _..................._._.. .-------- Daytime Telepho ber � ��" i ---- - - -----�------- --, , �..... __... . . _. _ � ;Michael Cherewka, Esquire � I(717)232-474�i�,. �' � �� _._ ...__.._ ._. __. ... � -- _ - --. ___.. -- - �-,. k . : _ __ ----- ,.. __ . .. �. ,... RECi18TER O�,�L,C8 USE ONLY : ��; "p -. , r`� ._.. _� .�. FirstLfneofAddress :7�� ''" -_ �rr, _._ .. __._ . . . .. ___------- ------------------------ --------___._ .. _. ��: , _' : �_� r`? `�� ;624 North Front Street ,,,o -� � � �..__ ---- y' �, Second Line of Address ----..._.._..__,..: �--------------•--------------------------------..-----------------.._.._. f �---------•------._...�._._._..___. ... .._ . .. . _............._.. _... � City or Post Office State ZIP Code OATE FILED ____.�_ ----._...._._...__.._._..._.----------..__.� .--._......_._..... ;.........._........_.._.. _..._.._...._.__......_...------ i Wormleysburg 4 ; PA i I 17043 � ------------- -----._..__...,_.._--- t - � '• correspondent's�e-mail addresa:mcherewka�cherewk�law.com Und?t Tenekles�f pPrlsry,l dea�are thet I havn a�camined this retum,Includina acoompanWng schedules end atatements,end to the best of my knowledge and bellei, tt Is true,carcect and corr�plete.Decleralion of preparer other than tlie personel representetive is based on all Infortnatbn of which prepruer hes any knuwfedge. � AT O P RESPONS OR FILING RETURN D E c��l� � D SS , 1 estnut Street, Gamp Hiil, PA 17011 SIG F REP R AN REPRESENTATNE TE ADD SS � ! 624 North Front Street,Wormleysburg, PA 17043 PLEASE USE ORIGINAL FORM ONI,Y Side 1 � 150561�1�5 150561�105 � � J 1505610205 REV-1500 EX(FI) DecedenYs Social Security Number DecedenYs rvame: William F. Hoffman ! ' RECAPITULATION _ _ 1. Real Estate(Schedule A). ............................................ L I 125,000.00 ': 2. Stocks and Bonds(Schedule B) ....................................... 2. I 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ..... 3. j ; 4. Mortgages and Notes Receivable(Schedule D)........................... 4. ' '�I 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. ', 28,965.98 i 6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6. ' ' 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property " " (Schedule G) O Separate Billing Requested........ 7. ', 38,251.40 ' 8. Total Gross Assets(total Lines 1 through 7)............................. 8. j 192,217.38 ' 9. Funeral Expenses and Administrative Costs(Schedule H)................... 9. 17,022.73 ' 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............... 10. j 15,134.00 ; 11. Total Deductions(tota�Lines 9 and 10)................................. 11. 32,156.73 12. Net Value of Estate(Line S minus Line 11) .............................. 12. I 160,060.65 i 13. Charitable and Govemmental 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. ', 160,060.65 '' TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousai tax rate,or transfersunderSec.9116 _ _ _ __ __ �a)�1.2)X.0- '. 15. ' 16. Amount of Line 14 taxable " . ° at lineal rate x.0 45 160,060.65 : �g, ' 7,202.73 17. Amount of Line 14 taxable . at sibling rate X.12 ' ��. j __ .��_...... _ �. _ � 18. Amount of Line 14 taxable , at collateral rate X.15 ' ', �g. ', ' 19. TAX DUE ......................................................... 19. ', 7,202.73 ' 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT � Side 2 L 1505610205 15�5610205 J REV-1500 EX(FI) Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME William F. Hoffman STREETADDRESS 26 Gale Road CITY STATE ZIp Camp Hill j PA 17011 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 7,202.73 2. Credits/Payments A.Prior Payments 9,000.00 B.Discount 382.30 Total Credits(A+B) (2) 9,382.30 3. Interest 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (3) Fill in ova)on Page 2,Line 20 to request a refund. (4) 2,179.57 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 ............................................ ❑ � c. retain a reversionary interest.............................................................................................................................. ❑ � d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ � 2. If death occurred after Dec.12, 1982,did decedent transfer property within one year of death without receiving adequate consideration?.............................................................................................................. ❑ � 3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?.............. ❑ � 4. Did decedent own an individual retirement account,annuity or other non-probate property,which containsa beneficiary designation? ........................................................................................................................ ❑ � IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1,1994,and before Jan. 1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent[72 P.S.§9116(a)(1.1)(i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax retum 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 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)].A sibling is definetl, under Section 9102,as an indivitlual 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 REfURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: William F. Hoffman 21-14-0333 All real p�operty owned solely or as a tenant in common must be reported at fair market value.Pair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seiler,neither being compelled to buy or seil,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 decedenYs interest if owned as tenant in common, VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1• 26 Gayle Road,East Pennsboro Township,Cumberland County,#09-20-1850-079, 125,000.00 TOTAL(Also enter on Line 1, Recapitulation.) $ 125,000.00 If more space is needed,use additional sheets of paper of the same size. REV-15o8 EX+(08-12) � pennsylvania SCNEDULE E DEPARTMENTOFREVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: William F. Hoffman 21-14-0333 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. Welis Fargo Crown Classic Banking,Checking Account#1000070545138 14,596.78 2.I Wells Fargo Preferred Rate Savings Account#1010041725773 14,368.88' TOTAL(Also enter on Line 5, Recapitulation) $ 28,965.66''' If more space is needed, use additional sheets of paper of the same size. . .. . _...e .� . :a� ,ARtiy.. . . . . � � ' � O 0 O � y � � � y. �$ p��J � W� V � � � f° n m' � y' � y' ° k � f"e � � w °7 �D � � � � � � � � z � � eo C�D ' � � � � � � � � � � '" a � o � `� o 0 0 0 0 o A e�o � � � r�+� � � M � ; � � � � � � " '�� .��. dti �^ � � � � � � cfl b y �T rf y �nfy � rF �y [7. O ri. QV k � � � o � y ►—� a o 0 0 0 0 0 0 0 � cn ' m � c�o � m fD � � -, O -, -, O pi w � o � o � o � o Gl ri � �'y � �-�t � y � �.�. . � � � � � ti �' � � ° � � � � � � � p�� V f! � q C/] � � ;� x" � s r-r � � � � a W � � � �. � �• � � � � � � o cD � �' vo �: �i.> � p y �' Vi � � � � o�m a o ^' � C � O a �: � � o � tra � A (� � � � � � � G � � # � � o �' d 5' �' � � � $ � � � � o N � � � � w u, u, N d � p. C W w u'�oo � � ,� y ro � K v} rs� vs o !q � � o b � � � � �''� � � � °�� ' rsa o o ��! � � � � � � � O �� .�. . '� Ci� b A 7` � O p�� p O' ' � N ryj Gl 00 `h � pt Cn v> vr v} ,��','� N �D 'E�, V o !d � O O O ,.r � O O p N � � p "��' A N y ci ttl b p �....fD,`..`'.�'.�. R, k °` � R O� N ti ? .P � .��..�.. N � � '! W Cn � : ��A... N � o°�o � ° R °, o�+ o �o�o � � ° a � � _ __ _ _ _ . REV-1510 EX+{OS-04) � pennsylvania SCHEDULE G DEPARTMENTOFREVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OP FILE NUMBER William F. Hoffman 21-14-0333 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE,THEIR RELATIONSHIP TO DECEDENT AN� DATE OF DEATH %OF DECD�S EXCLUSION TAXABLE NUMBER THE DATE OF TAANSFER. ATfACH ACOM Of TNE DEED FOR REAI ESTATE, VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE �. Aegon/Pfl Endeavor,Wells Fargo Annuity#7263 38,251.40 100 0.00 38,251.40 ' TOTAL(Also enter on Line 7, Recapitulation) $ 38,251.40 If more space is needed,use additional sheets of paper of the same size. REV-1511 EX+{08-13) � pennsylvania SCHEDULE H DEPARTMENTOFREVENUE FUNERAL EXPENSES AND INHERITANCETAXRETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER William F. Hoffman 21-14-0333 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' Rolling Greem Cemetery Company, 1/3 of Niche. Invoice 006533 3,167.33 ' 2. Rolling Green Cemetery Company, Marker 820.00 s.' Daily Funeral Home , 1,945.00 a.' VFW Post 6704, Luncheon 1,393.39 , s. Rolling Green Cemetery Company,Opening of Niche&Um 635.00 s. Flowers 270.58 �. CVS, Photos for Service 15.25 ' B, ADMINISTRATIVE COSTS: 1. Personal Representative Commissions 0.00 Name(s)of Personal Representative(s) Street Address ___ _ City _ ___ _.._ State _ZIP_ Year(s)Commission Paid: 7,729.00 2. Attorney Feer. 0.00 ' 3. Family Exemption: (If decedent's address is not the same as claimanYs,attach explanation,) Claimant Street Address City State 2IP Relationship of Claimant to Decedent 4. Probate Fees: 413.50 5. Accountant Fees: 0.00 ' b. Tax Return Preparer Fees , 0.00'' �. Patriot News Obituary 400.00 s. Legal Advertising-Cumberland Law Joumal 75.00 s. Legal Advertising-Sentinel 158.68 ' TOTAL(Also enter on Line 9, Recapitulation) $ 17,022.73 If more space is needed,use additional sheets of paper of the same size. L�JT�BCK}IOU�@XPEIISE3:.. ❑TAX-DEDUCTIBLE ITEM 099 � ❑Clothing ❑Food ❑Transportation ❑Credit Card ❑Utilities ❑Mortgage ❑Entertainment ❑Insurance ❑Other: �/ / / / � (� % O WARD . ��G� �� . .�� -� � THISITEM � //, ,y� / �/� � BALANCE / ( .N,'� I� 'L�V l�` �� ` �V. �� .. . . . .. DEPOSIT l OTHER BALANCE FORWARD � ' /dGll —Z/G� 3C�;6��(�� , J ' . « � Fot added securiry,your name and account number do not appear on this copy. NOT NEGOT,IABLE - --- :.- � -��—�°--- • ' I r...,.....�..�,-�--�- ,, , . , h _ _ . . .. .. .. . �. !` } Li�Track your expenses... ❑rnx-oeoucne�e i1EM '�Q Q 4 ❑Clothing ❑Food ❑Transportation I- � ❑Credit Card ❑UHlities ❑Mortgage _ / Entertainment ❑Insurance ❑Other. </3 �// `.J / - ❑ � - � �IANCE . , . � - � �FORWARD . . ��`r V.. 4"'�.s� t.J C �/ � y� � �� THIS REM I �.� � /� } �( . ,/�� . �l� � .../ _ BALANCE V.� Z:_l.��f'/f'�� ` :C C. " ��pEpp51T � . . . - � � - � OTHER - . � � � � � . . �..�� ' �BAU�CE`. . � . � -�'�'F R .RD _: � r / � � `��l'j�:S ��-J/1i1"� ,�� I.: '� � ,� - ;Fpr added secUnty.you�name antl account.number do not appear on this copy. • { NOT:NEGOTIABLE " � '�t I„ - 4.,i - ' ''> ��; �: �'. WILLIAM FREDERICK HOFFMAN ESTATE � �003 J MICHAEL HOFFMAN EXfC s-soi3�o soss �' � � / 6919893690 3811 CHESTNUT ST CAMP HILL,PA 17011-4317 ` ''' _ � t_�,i:`�'f'1 C_i�1Cc2�I.I.Y C:{JiiV::....'...� . • a . � _, � � - �� Paytothe �. :,� ��tr ��d:k'lT='.:�,.�.W �w`-V; Order of �:i^ - . ... • ^ . � _ . . . "" . a��h �l f �, , . s Cl�L� Dollars�:, �<�dw � ., , �.. .. . . � ,� . ��r;_. a:-� .. . . ...�. ��+�. . --�. .L �v � . ._ . �� - R ! WeNsFargoBankNJ4 � b�• �t< � ''.i'.conl �n�}, � _ fi�� f1�' �, 4 �z ', 4 t t..:` ! k.�- � t � rg.., 7 � ��`� �� ;1 � � t '.x� � i'. =#_ . �,a � �'''p_`1M�„e 'i .s r ::n 3t� :kTr'.;,h`f �'�r',�.`-�'�a 'tH. a� . '� .. ., .,.._ .. . .. -- .... .. , �y�� . . ., . .. .�.. . . . . .. .� b. _ ' � .:�. . ,� , .., ... . l'� . ... . � � .. �:0 3 �0:00 50 3�:. 69 i989.3690n' " OQ 3 �._— - - -�---- _ - — - --- - - - ;[�TFBCK yOU�EXpC1,�SBS... ❑TAX-DEDUCTIBLE ITEM � - �/�/��+ �"p Clothfng ❑Food ❑Transportation O Credit Card ❑Utilities p Mortgage ❑Entertainment �Ffnsurance ❑Other. 3��' �uwcE _ � - 4 FORWABD . C_L � .. � � N C��4�""� �.1�. ' .- ��,.. THIS ITEM , I J l [_ .... . .� �tx \� .. �U �;. �� , BALANCE. : rG,��--� �V VSht� �� V �, U 1�.� � DEPOSIT . . . _ . � _ � �� . � � .. � ' � � OTHER� \j � � - � BALANCE �� " . - � .FO RD'' � ' J ��_V�v1'� .��. . . . ' , . . � . . . . ... ..�.i_"__.' . . . \ -�IAT1.ICf�I1T1I1C1 C .. . . ........ . ............... . . RECEIPT FOR PAYMENT LISA M. GRAYSON, ESQ. Receipt Date : 4/10/2014 Cumberland County - Register Of Wills Receipt Time : 11 : 04 : 00 One Courthouse Square Receipt No. : 1077590 Carlisle, PA 17613 HOFFMAN WILLIAM FREDERICK Estate File No. : 2014-00333 Paid By Remarks : JOHN HOFFMAN HMW ------------------------ � Receipt Distribution ------------------------ Fee/Tax Description Payment Amount Payee Name PETITION LTRS TEST 310 . 00 CUMBERLAND COUNTY GENERAL FUN WILL 15 . 00 CUMBERLAND COUNTY GENERAL FUN SHORT CERTIFICATE 30 . 00 CUMBERLAND COUNTY GENERAL FUN JCS FEE 23 . 50 BUREAU OF RECEIPTS & CNTR M.D AUTOMATION FEE 5 . 00 CUMBERLAND COUNTY GENERAL FUN INVENTORY 15 . 00 CUMBERLAND COUNTY GENERAL FUN INH TAX RETURN 15 . 00 CUMBERLAND COUNTY GENERAL FUN ---------------- Check# 1136 $413 . 50 Total Received. . . . . . . . . $413 . 50 ;:: � LgTrack your expenses, }.-Q TAX-DEDUCTIBLE ITEA.1 - JSLJ ❑Clothing ' EtFood. ❑Transportatlon O bredit Gard ❑Utilitles �Mortgage , /' p Entertalnment ❑Insurance p Other: � �/ � []j � , f VM - . . -� . o�ORWARD. . - . . �� „`�.,.r� THIS ITEM v// ��.� f� � � �U��. �'vV��..� �-{!,.� �� DEFsOSiT . _-' . , , - - . � . � .. � - � . � .. . . . . . . � �OTHER � � � - - . . � . . . .� . . . . . . .. .. �. � BACANCE. - . . � . , � . . . . � . . . � . � - � . FORWARD �.� -- ' '-° �. . . . . .� . - . _.•i� . �� . , .. For addeii security,your name and aocount number do not appear on this copy.. . NOT NEGOTIABLE. , t . � � ��v� . � - ,__, ; � � ��-�- �-� �� , �� . . . . . ,. . ,...;:. , �- �� _ , _ , ' � , , ,R�'�!I.�.I�1G CC�F�L�N C�1��'�,R'Y._C�'AWt�'I�N"V' �0 . _ ��,1��R�� .:��,,��;��na1 .��7�,.� �.� a��s�� , CEMETERY INTERMENT RIGHTS;�MERGHANDISE AND:SERVICES T'YTRCHASE/SECURITY AGREEIYIENT T�IIS AGR��IVIENT�I�,(�`�yFQI�t END!UWIYIENT;C�ARE � , � ,; .R�ETIAIL`��TST'�� I�i.T�CONTR�ICT �. �;,°� -'�- r..�• , ��.,<�, �.-,:�� , _, , : - _ 8334 `- �{i�, This Agreement i§made this a� •, day of ` f1s ,20 \� ; ,byand lietween the undersigned"Seller" C� �'., and � �`'�,':�[�C.� '�- `C�c c �� ' 1.'4,�i��, ri ; hereinafter called the "Purchaser" -�1t a� T.�. Address �5��_{��..c'�; �a `5\ �' .c'r:;��,�. �i � ,� I�ICJ�� treet ��Ci State �P ResidenceTelephoneNo.(��) "'l� ��1��"�, �ayTelephprieNo �_) -; WI'�NESSETH THAT.; The Seller`�agrees to sell and�Pyrahaser;agree5"to b�q tHe following described Interment;Rights,;Merchandise and Sericices. ❑ DeYeloped :0 Predev�lope�",❑ Lot ❑ Lawi�CYy�t 0 Mausoleum �'Niche CI Oth�r F�y!x � Desc,rxpt�n q#` In 4 y�'�;i ` ��_; ' , ..,� ;�� '�,).:}t ' �,�, .a '�� ; n `';:F. �� ''J�z� � `+ � r,��r��'t��1' ;,t,. ,_ � ' � :' ' : ,. :� �Io � ;�. ,,: .. :w , , T�R�I�1"I'.�LiGH'�'$'1v1,ERC�-IANDISEr�,NjJSEI�VIGES, ;.. , , :. . ..... ._ ,:: . . , a , ., a t„rf ��, ti: �� . . 'r � � r,. � �t} : ; ,:. • *. � , ;:.;, Int�FmefitRights(mc $ ��1�� ECF) $ : �.ess r " :. Memq�altzation Type ' ' ; �y��''�� .F, 'DownPaymentC�sh; . :�$�.�v) ? Size :..�; , ` ; Design ^' , . . _ „ _.. : , � -., ' Memorial Base. - Type . .�`� �Credit�For � ) � Size , Color ... (b) Total Down Payment .......:....... ....... .. ....,„ {$q'...x./�.�� ) -- Memorial Installation/Ins ectioh Fee �' :(c) Unpaid Balance of Cash Price.(Amount Financed) C.a Memorial Mdintenanee.��:�.,..... ..:..... ..... . ��.� (d) Service Chazge(Fihance Charge)..........:........ ..:...... Ca ,: Casket Descriprion • � r � _ (e) Time Balance(Total of Payments)'.. Material Wood/Metal .: Gauge- � � � Time Sale Piice Tota1 Sale Price::;.... ...... . $ � Outer Burial Contamer-Type — �fl � � , ` � ° • Inteiment and Recordibg Fee :......:. ......:c. ............ qQ�dC? �..� ___. ' `:I', -�: . . ,i; Proa s��t�gFee.:. .:. ,,: �'�.: .�:. �, � C�� ;; � 4 ;.�� - q1--�-`- Re[�farks: ' . c. Other: �Q�F�.t� C�.y�t��-re �'�t�1l��f. � � ,Away Fiom Home:ProfectiAn""Plan(see below)..........:... ° � ` ,;. Sales Tax :........ ....:,.. :..::. . ........ �^. ,,. ' .(a)Total Cash Price(Including.Sales Tax):..:..:.:.......:....... $ ��(p�•5� 'The Ativay From Home Proteclion Plan b� ' " --�-''"'"'��"'h"''�^a*�-not by the cemetery identified in this Agreement. The third party provider is�ot ownedby or affiliafed with' ce ofthe services associatedwith the AwayFrom HomeProtection P1an:ThePurchaserwillberequicedtoenl � ��5 �AwayFromHomeProtectionPlan Thatplanhasbeenrefer.enced.. • �n this.Agreetnent and�ncluded in the,pu: making payments , , . r. , .. . . . �V��/-�.5� � ,, .., ;:. ' ITEIVIIZATION OF:>AMOUNT F i shall be credited to:your aecounti with Seller. Arr�ount paid�o others on'your be] �Assist America Prearrangement Setvices,Inc. (we may be,retaining a portion'o: t � _ ANNi1AL. FIN �� /3 hotal of Payments: Total SalePrice PERCENTAGE =CH t'he amount you will have , The total cost of your pur- RATE The �� --7 _ 3 � yaid;after you have m2de a11 chase on credit;including The cost of your credit `crec �j � � bayments•as scheduled. your down paymenf of as a yearly rate., , � � . $ �`�j C7� .."`'� �) - o�a �dj. Ce)$ {a+d)$::q��>�c� Your payment:schedule`will be: � Number of Payments 'Ai ,,,.,:,w.When Payriients Are Due $ Beguuun$.:::. -- Prepayment:'.`If.you:pay�offearly,j i arge:;` :' , . Security.'You are giving:a security ' - Late Charges` If full'payment i's nu�u�n��,........,_ __,_ i.00 oi'S%of such paymenC,whichever is less. Other Provisions: See tHis Agreement for any additional information about nonpaymeni,qe�au��;any required repayment in full.(exclusive of unearned finance charges)before the saheduled date,and prepayment rebates and penalfie.s.. If accepted by Seller,the parfies hereto agree to the.fallowing ternis and conditions:. 1.klgreementto Pay.Having:first been quoted both a Total Cash Price and a Total Sale Price for the items described aboue;and for value ieceived,the undersigned Purchaser;jointly and severally;if more than one;promises to pay to the order of Se1ler,at its addres's shown below,the amount identified above as the Total of Payments m accordance.vyith the payment schedule dates set out above. - " .,. ... �_.� -,.,r. : .::,. , , : �lthe . ... Seller�;, ,, .. 2 Title SeTler wil�,te�n tttle;to said Interment Rights and Merchandise un �'ptal,SalePnce has':be,�q Aaid by{Pur�hasa,z tb, � �3. �e�fiete 'Rule�°'"�idRe .'ahons:"Purchaser a Yees that:211 n hts conve ed nrider fhis'A r�ement�re sub ect to,and Purchaseragrees to atall times comply �')� �, � g g Y g J.. with,the present,(�n +�C►ap be pereafter adopted;amended or.altered)Rules,Regulatipns and Bylaws of Seller,wfiich are av.ailable for ezamination in Seller's office. 4:P'.repaymept . "prepayment in full,whetlier voluntanly or.upon acceleration.by reasop:qf Purchase�5$efaylt and;payment in full orjudgme�it:being entered aga'inst Purch'aset f :- �npaid lialance;Purchaser,shall receiVe a rebate of any unearned Fin.anc�Charge:c��iuted in,accordance vvith the Actuarial•method: If(i) the rieed for intermenf arises with'in 120 days of the date of this Agreement and the Agre@menf'is paid in full or(ii)this Agreement.provides only for the purchase of inemorialization and its installatiomand is paid in full within:120 days of the date of this Agreement;�urchaser rvill be enNtled to a full rebate of all Finance ��..._;......._...........�..�..:a , � !� �� '� 't �� t��:��a_ ��t c�M�x�gv rc��tp��r �� t��14� , � '•�v .�, .,,.Yra��our�a�tp�u.,p�a_iro�f��trl�.m-�osa r;. Contract �� ,' �� - File Folder Name/Number � CEMETERY INTERMENT R3G�IT5,MERCHANDISE,AND SERVICES PURCHASE/SECURITY AGREEMENT THI5 AGREEIVIENT'.PRUVIDES FOR=PERPETUAL/ENDOWMENT CARE. The undersigned,referred to es`Purcfiaser',hereby-agrees ta pucchase the InEerment Rights,Merchandise and Services described herein,subject to acceptance and approval of the above named cemetery,hereaFter referced to as`Seller'. Purchaser:Last Name: V:J R�� ' � �..-�� ( .�'.. � � ' � ';�. � �, � �,, Firsr-0 �"R� �� : � � � � � _� I Middle; I � � � � � � Telephone: ` SSN: _ _ DOB: / . / . . EmaiL• (�.)�$�-�- Address: ., �,�, � '�' �_� . �L�- � � Cityr,.�..,�C.�n�� G� � � State: A m� Z�p. � T�'7'� t Co-Purchaser:Last Namei � � � � � � � � � � � � ��' � � � � � First: :� � .� � �' � .� � �. � � � I I Middle: I . I I ` I � � � Telephone:�_� _ SSN> _ _ DOB: � � Email: Address: � � I I i I I I I I I I I I 'i I I I I I I I I I .I I C�ty' I I I I I I I I I I I I I SEate; � Zip: Deceased:Last Name:;, .L�.�O.�'��'')�-�� ' � �._� �' I'. � �' First ';��`�II�'1'T'II" W I ULII A I�I 'I .'� Middlei I � � � � �. � { � � DOB ' �. � DOD: � � Burial D'ate: � � Veteran: ❑ s'—, Description of Interment Rights to be used: MemorIalization Rights: �?'�' _ ;!°. Issue Certificate of IntermentRighfs tor - Address: �.. City: State: Zip: INTERMENT MERCHANDISE&SERVICES .. • Interment Righfs $ • Urn r� c�Anr�l `'�.[�-Q�1Q�t° J�g�7,Q� (Includes Perpetual/Endowment Care of$ ) Supplier 1�v�P�=r�a��1.��err� sc.�,r7o��_ • Interment and Recording Fees ` Type/Coloc •SAb.cQ � • Outer Burial Confainer ""'" Design/Size Supplier • Admin/Processing Fee ��U , � Model/Design . • Other r� G�Cc}(��nw �1h_CC��'�^,cn„ �� Material/Color • Other ^ • Outer.Burial Container Installation —' • Other — f MEMORIALIZATIO�Y • Other ` • Memorial � � • Other .<-J3=�: — Supplier . ; • Other ` Type/Color, ,. ` . , �. �. . TOTALS,�ALLUWANCES&TAXES�; , _ � _...-.._.�--.• - ' �- s�- - -. n -:. _ it: c:°�.. ;-_ _ __ ._.._ . .— _ _,^:.:. ,. _ . .... --- Design/Siie � • IntermenfRights....... ...:..:... ..... ... ......... ......:.. ( ) • Memorial Base '— Reason __ ._ _.. .- - - — ._ _ ,__ :. ..-._._ . ._,.. ._.:.._ Supplier _ , : - -.Merchandise/Ser�ice a ........ ..............:. :........... ( — ) TyPe/Color Reason Design/Size Apply to • Memorial Perpetual/Endowment Care � • Merchandise/Service ...:..... ..:....:.......................... ( — ) • MemoriaiInstallation Fee ' Reason • Memorial Inspection Fee "` ,r..��1 Apply to p • Nameplate/Scroll '+r �, - Sub Total 6nZ� . � • Lettering ; — . ' Total Taxable — • Flower Vase .. _ < , :.. Sales Tax(if applicable) �t......................:...................... ^ Supplier TOTAL CASH PRICE $c��.� ,� Type/Color Less: Down,Payment � ,�� Design/Size Other `_ • Vase Base — Total Down Pa ent (�c�) Size/Mate�ial � Unpaid Balance of Total Cas Price $� Notes&Payment Terms(where applicable): � , TERMS The Total Cash Price is due and payable.as of the date of[his Agreement. A delinquency charge of - percenf will be assessed monthiy on any balance not paid within 30 days of the.date of this AgreQment: If less,.than full paymenC is recerved Seller shall deduct the accrue�delmquency charge from the amount recewed_�nd�redit the �remamderiof`fk�5i�i3WiPn'�'fTi'th`r.T-}nnxr��'R�1'ar�`r-�!.,..'=.. : < ., . , - • . , t.' , , . , _ _ _ . Leslie From: Christina Corica <cwolfe@cumberlink.com> on behalf of SEN Classified <SClassified@cumberlink.com> Sent: Friday,June 13, 2014 9:48 AM To: Leslie Leach Subject: RE: Estate Advertisement Hi Lesiie, Below is the receipt for the Hoffm�n Notice: THE SENTINEL 457 E NORTH ST CARLISLE, PA - 17013 7 T7-240-71 G7 Merchant Number: G2040 _=Tr�nsaction Approved =_ Receipt#: 1427013793.64A4 C�rd Number: ********G893 Date:June 13, 2014 C�rd Type: MASTERCARD Input Type: i<EYED Tr�ns Type: Purch�se Auth #: 04578Z Tot�l: $158.G8 I agree to p�y above total amount�ccording to c�rd issuer agreement. Thank You, Chrissy Corica Advertising Sales Executive The Sentinel Cumberl�nd Valley's Only D�ily Newspaper Phone: 717-240-7171 Fax: 717-243-3754 New oniine business directory at cumberlink.com/get-it � � . �� +�'�" 1�'.__� � 1 � �/�f pharmacyV 3201 MRRKET STREET, CAMP HILL, PA PHRRMACY: 303-3022 STORE 303-3019 REG#09 TRN#3865 CSHkttOG39839 STR�2882 Helped by; JOHN ' � ExtraCa�e Card �: **+�**+�**3402 5X7 OR 6X8 SECONDS 6X8 4 @ 1.99 7.96 - KDK PRNT SECONDS 9X6 2 @ .32 .6 T �� , ' 1 TRES SUPR HLD SPRY 10Z 5.7 T C ' - ' 7 ITEMS SUBTOTAL 19.39 PA 6.07. TAX .86 TOTAI. 15.25 CASH 2O.00 � CHRNGE 9.75 � uJ\ , (IIIIIIII�IIIIIIIIIIIIIII IIIII II II III 2502 8824 1213 8650 92 RETURNS WITN RECEIPT THRU 06/30/2014 MAY 1 , 2019 9;39 AM THRNK YOU. SHOP 29 HOURS AT CUS.COM ExtraCare Cerd balances as of 04/28 �' Year to Date Savinss 122.56 SPring 2014 SPendin�: 250.79 Fill 10 prescriPtions, earn 35 Pharmacy and Health ExtraBucks Quantity Toward this Reward 3 Quantity Needed to Earn Reward 7 Pharriacy ExtraBtxics Rewar�ds Errollment Stat� � of Patients Rctive t REV-1512 EX+(12-12) � pennsylvania SCHEDULE I DEPARTMENTOFREVENUE DEBTS OF DECEDENT, INHERITANCE TAX REfURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OP FILE NUMBER William F. Hoffman 21-14-0333 Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1• East Pennsboro Township,Sewer&Trash 138.00 ' 2. Verizon Telephone 1/16/14 120.41 3.' PPL Electric 1127114 157.26 4.' Keith B.Stone Concrete,Chimney Repair 875.00 5. Home Depot,Home Repairs 33.46 '' ' 6.', Verizon Telephone 218114 120.41 7. Walmart,Supplies to Repair Basement �87•87 8., Pennsylvania American Water 33.30 ' 9. 'Drain&Pump Services 95.00 ` , 10.' Christine Gray,Reimbursement for Supplies for Home Repair 52.14 ' 11. Outstanding checks that had not cleared on dod 5,025.81 ' 12.' Closing Costs 6,227.13 ' 13. Darina Hoffman-Fuel Oil 493.71 14 Pennsylvania American Water 1127114 50.94 15. PPL Electric 2128114 147.96 16. PPL Electric 3116114 142.53 ` 17. Verizon 3111114 120.41 18.' Pennsylvania American Water 3111114 65.32 ' 19.' Darina Hoffman-Fuel Oil 3/11/14 588.61 20. Pennsylvania American Water 511114 98.31 ' 21.' PPL Electric 511114 101.91 '' 22.' East Pennsboro Township 511114(trashlsewer) 138.10 '' 23. Verizon 5111114 120.41 TOTAL(Also enter on Line 10, Recapitulation) $ 15,134.00 , If more space is needed,insert additional sheets of the same size. �.�-----------------------__ _ ; ; [�Track youc expenses:.. ❑rnx-oe�ucne�e ireM . 9475 _; ❑Cbthing ❑Food ❑Transportation ❑Credit Card ❑Utilities ❑Mortgage ❑Entertainment �Insurance ❑Other: +�6 /� � � j LANCE � r � FOHWARD - � }.� � � �...-�/L.J 'J �v • W�� :�NISITEM� .�� . L%!`t ��lJ.l�� C.�� u t�2�� Q �-�S�-T�NF `a�'�oE�T' . � . �. � . . . OTHER . ✓� � . . . BALANCE. � � . FOR ARD j,�.v�F1'� �" 61�7-' . . . 4` For added security,your name and account number do not appear on this copy. , NOT NEGOTIABLE . �T�BCK)IOU�@XFIBO$@5... � ❑TAX-DEDUCTIBLE ITEM . J�"1'/V ' ❑Clothing ❑Food ❑Transportation , - , ❑Credit Card ❑Utilities ❑Mortgage ' ❑Entertainment ❑Insurance ❑Other: 1/t 6 I t � ��6�� B LANCE FORWARD � ��`� V Z:V�.-1 v��.� ITEM t�ZO l T ��NCE � �� J6 � �(V j�.�.. � DEPOSIT � ... _ v OTHER BALANCE FORWARD k . For added security,your name and accounfnumber do not appear on this copy. NOT NEGOTIABLE __---_—_--�--Y.�� --------------^��__,..w_-� „_. ..__ -•----------^---------- }. � �. � . ... .. � . .� . � TAX-DEDUCTIBLE ITEM � . . v�H� . [gTrack your expenses... ❑ � ❑Ciothing ❑Food �Transportation r � p Credit Card ❑Utilities ❑Mortgage � /��,� ❑Entertainment ❑Insurance ❑Other. /n� I /r-� � �BA�CE C � . . . . � FORWARD ... o . 3 � ��_�� .U��-�.-�,v �'.��Nc ��z. �� c�f �c `�,e�� - �`'z°� � OTHER � . "' . . . BALANCE�� . . . . � . .__.. . .� � � � .pORWARD . �v� L ar� �rr`�- C� ,, ' NOT NEGOTIABLE For atlded security,your name and accountnumber do not appear on this copy. , . ..�-.. , : _ - , - . - _ ___ � �T�BCK)/OUf CXF7CI13B8... ❑TAX-DEDUCTIBIE ITEM - v�v� - ❑Clothing Ofood ❑Transportation ❑Credit Card ❑Utilities ❑Mortgage ❑Entertainment ❑Insurance ❑Other: , /Z � / l Cf � � ORWa.RD� ` �T �'/ �I/L�+/t �C ?—'�,�•l/t/"' �`P"'�- .�CJ ^ �'!t7 . r�r� �— ��w aA�N�E �� . DEPO5IT � OTHER LANCE -�� RWARD �: � a For added security,your name and account number do not appear on this copy. NOT NEGOTIABLE . . �..:_.. .�.'__..�._'.... � . .�f .. . . �. �T�BCK YOUY @XPBIIS@5... ❑TAX-DEDUCTIBIE ITEM . V�FV�/ ❑Clothing ❑Food ❑Transportation . ❑Credit Card ❑Utilities ❑Mortgage / ❑Entertainment ❑Insurance ❑Other: [J � � . , �2� ` � BALANCE ... .. FORWARD Pl � �i��C..-1�t...i� ��`�� ` J .�..r-------��s�TEM i�7 ��, � �... ,�J ��BALANCE ��C�� ,tjfC- ��/�2� �l�� r/�N'�" / `��T �/ OTHER BALANCE ��+ PORWARD�� 1� �< . For added security,your name and account number do not appear on this copy. NOT N�GOTIABLE .� ... �1 :�i._.,,,,,�;;e;, .._.:._,t... ..,,.__,_ ,�. :, ...,::,.. _.... . ... �- . ^^-�- -------' ---' ----- ------ ---- -- � ---°,- '- °--- —'--- -- --_y�'^-�� -- . - --. - - ` 9496 . . �(�TI'BCK�}IOUf BX`I@I13@5....�. . - � � ❑TAX-DEDUCTIBLE ITEM � � � ❑Clothing f]Food ❑Transportation ❑Credit Cartl ❑Utilities ❑Mortgage Entertainment �lnsurance ❑Otfier. � ❑ . . � � � '-B�NCE. � . - � . � �� /FORWARD�.. . . . . . n . , ...�C� ll"_- C�..�L�.,� . . . � ITEM. I ZO ��_^�.�{ � L" BALANCE . . � �/IJ�, �J.U'� �U ti..��2�L-( �(1..� ^Z Jv �' �" '��POSiT � � � . OTHER � � . � . . � � � � �� .: �BALANCE �. .. . . . � . . � . � PQRWAR�. . . � . . . �! �� . For addetl security,your name and account number de;not appa�r onrthis co . NOT NEGOTIABLE ------- ---------°--- -- - �r�_��— ---- -- -- - -�:- .. - - --- _..__., �-.:_ �TI'8CK yOU�BXp@OSCS... ❑TAX-DEbUCTIBLE ITEM 9510 ❑Clothing ❑Food ❑Transportation ❑Credit Card p Utilities ❑Mortgage ❑Entertainment ❑Insurance ❑Other: Z /� �� I . .... BA CE 5 FORWARD �/ ` /`�/` � .� �-.-t..�_.�t 1"- C- V ��'��.:J THIS ITEM .� .� 7 .��j�_ l( �..��.-C C.�� l.._ ��.l/ G_!��! ��i' 'pAEPB6IT �v � �� OTHER BALANCE FORWARD �'S/�° - ��Ov 7 , .. ► �TI'8CK yOU�@XpQflSES...� ❑�TAX-bEDUCTIBLE ITEM� �. v�v • �.� ❑Clothing ❑Food ❑Trensportation ❑Credit Card ❑Utilities ❑Mortgage p Entertainment ❑Insurance ❑Other: � / (p � ... � ��B�NCE .. �y / FORWARD � I / �� t��G `✓ / `� LC / �.--�,j � . THIS ITEM ., l � I"'( �. , / � g0i e.i� t— �,Ul� t�v�.c�l.�'c::� �drL"� �1 cU`�-- �C.1ZJ' �� / � DEPOSIT L j( OTHER S . �. .. y � BAUINCE }� F RWARD ! ^ . , f For added security,your name and accouni number do not appear on this copy. NOT NEGOTIABLE � � Lp TI'8CK�/OUI'@Xp80SB8... �TAX-DEDUCTIBLE ITEM � � JJG� ❑Clothing ❑Food ❑Transportation ❑Credit Card ❑.Utiiities ❑Mortgage , ❑Entertainment p Insurance ❑Other. ��` � �r , � ' BALANCE � � � FORWARD . �� +! . � THISITEM �O. � / �� DN.� ��t V �I "'�C,�j [_� �W C...-N � .�..,�� BALANCE Vc.s I DEPOSIT OTHER BAtANCE � � FORWARD � � �� . For added securiry,your name and account number do not appearon this copy. NOT NEGOTIABLE _.V_---�-° --__��_ --------------- ----.— -------------------- � _ i ' 19 T�BCK yOUf @Xp0flS0S... � ❑TAX-DEDUCTIBLE ITEM 95 1 9 ❑Clothing p Food ❑Transportation . �Credit Card p Utilities ❑Mortgage yyy ❑Entertainment �Insurance ❑Other: � /�� l// I BALANCE FORWARD ��N�� . 1 (f� 'V�x[`. �V�llf/�.-.��m`✓�J+�- HIS TEM s. �..l . � �� '�� BALANCE I�� S( fC/ J'_" ( �t..-~f` ��j C/ �T OTHER BAIANCE PORWARD.. ._. .___.. J �� . For added security,your name and account number do not appearon this copy. NOT NEGOTIA � -- J — -- (�Track your experiSes... 95�8 p Clothing ❑Food ❑Transportation �TAX-DEDUCTIBLE ITEM � ❑Credit Cerd 0 tltilities ❑Mortgage ) ❑Entertainment ❑Insurance ❑Other: ��( 1 /t � �f ALANCE 1 FORWARD �J v� �^- � �/V�T-� L� f C/�� ( ""��_'_A I. .. THIS ITEM �� I V U /�-� '� '\J �^ [ � f/ � � l ' v�. l� "�V�V LE � �.V�� .�G�.I i �:.�� 6EPOSIT .. � OTHER � . .BAUINCE - . ... .... .... FORWARD � � . �.,J��,�..Q �c L „�, - For added securiry,your name and account number d not appear on�ttii�, py. NOT NEGOTIABLE ��., _ _ _ _ _ . _ (�"Track your expenses:.. ❑rnx-oeoucTisie iTern ' 099 ❑Clothing ❑Food ❑Transportation ❑Credit Card ❑Utilities ❑Mortgage ❑Entertainment ❑lnsurance ❑Other: ( �/ i . . .� �// / BALANCE . f /�.... FORWARD •� j ,` �!{/L/ �'-�'_G.�-. �(J�M1�.�.�: l�° _Y��, , . � THiS ITEM � �1 BALANCE I �<� �I G Gr �� .� �r � �� DEPOSIT i � OTHER �� ' � BAUINCE � FORWARD � �dL�� -z��36.�y�� r�t � - . . . . ! • ' . . , � Poradded securityyy�ur�ame�nd a�cou�tnumberdo�not appear on th�s copy. NOT NEGOTIABLE ---� ---� --- `�- .�...t�.;"F-� . . . -.�,..:.:;..»i'-.,�-,-�......y..-,w�._,.9: __....,�.. �.� �_".' -. . . . . . . . . . .. ,. . .. . . . : i r ��TfBCK�/OU�E'XPBIISE8... � ❑TAX-DEDUCTIBLE I7EM .' . O�Q � ❑Clothing ❑Food ❑Transportation V . 0 Credit Card ❑Utilities ❑Mortgage / ❑Entertainment ❑Insurance p Other. � �7/ � � � � � � lBALANCE � � FORWARD � C� �� . / ! .L. . �' t�� 1 �_. �� b �. �.,/ .�"��-THIS ITEM /� j BALANCE t ��.� �V N��C..� �O'v � ��v (�/ . DEPOSIT OTHER . � . BALANCE � PORWARD ��-�d�, -�73ao�� , f For added security,your name and account number do not appear on ihis copy NOT NEGOTIABLE L _. _. __�_�.�-,-- _�__ _-----. . .._ ,__ _. �_. - -- - ----------- ---------------_ ,..�� t�:-�, -,. .:.r- .m... .....�... ,_ ,.., . _ , - .�- �.., ,_.,,__� ; [�Track your expenses... ❑uvc-oeoucns�e iTern r 096 � ❑Clothing ❑Food ❑Transportation ❑Credit Card ❑Utilities ❑Mortgage �� / i ❑Entertainment ❑Insurance ❑Other. � ,�11 t � BALANCE �-� S��`� FORWARD Z�A s T: �i^^'�r� � �-U /w-�� ' niis iTeM � (/� ; / � //'� BALANCE I . �� /,U..Q, t'"1��Ci /""( YC.., �,.� �� POSIT � � ��-��_. � J 1� OTHER .�-"�� BAUINCE FORWARD �tv ��N1 � . DO Z-- For added securiry,your name and account number do not appear on this copy. NOT NEGOTIABLE ��. .. , _.=��'�-. - -===" -<-6�...�..Q,.e.._�-��-c��w>„z��-�-�_ . ,r . .� -��. . . � ; . . . . . �_'_�"_' �'� .:.� �.....:.. ..,_.�:...__�._..��...__. . . . .. ..__:. �..y._.._.:..... . . . . <. . � . .. .'. .. . ' {:_. z'�._ . . ,:. . . .. _. �. .�\�� [�TYBCI(�/OUI'6XpB11388... � . �.�❑TAX-0EDUCTIBLE ITEM � . _ 095 ' � ❑Clothing ❑Food ❑Transportation ' ❑Credit Card ❑Utilities ❑Mortgage ` � ❑Entertainment ❑Insurance ❑Other: � / ` . . . . .�. /BALANCE � FORWARD i f 1 t , THISITEM _O . ;�/��tz �'� � i � BqLANCE Y f`�j�(j/ / �{ � / !J `/ //�J'� ��. �/Y��.. .1' ' ��T..,�..-� �!'"'"�• �� / / CI 4�� SIT � . . . � �� . . OTHER � � � � . � � � - � . BALANCE � �. - � � � � . � � � .FORWARD F � � �, ?�' 96�£�rjf-��.-3 c� -o I . t ` ; . , --•--___._�.,,.,,,,,,,„, NOTNEGOTIABLE � PROOF OF PUBLICATION State of Pennsylvania, County of Cumberland Patrick Doane,Production Director of The Sentinel, of the County and State aforesaid, being duly sworn, deposes and says that THE SENTINEL, a newspaper of general circulation in the Borough of Carlisle,County and State aforesaid,was established December 13th, 1881, since which date THE SENTINEL has been regularly issued in said County, and that the printed notice or publication attached hereto is exactly the same as was printed and published in the regular editions and issues of June 14,2014 and iune 21, 2014 and Tune 28 2014. COPY OF NOTICE OF PUBLICATION �€ Affiant further deposes that he/she is not I Notice is hereby giv�n thafLetters Testamentary have been grenfed in the fotloWin�'estete.A p6rsons intfebted to the said estate are required,to 1rit2PeSt2(�1Tl tlle SUb�eCt TTLdtt2T Of tll2 naake paymsnts and thoae he�g ctalms or demands are to present the seme W�u,o�t aeiay�tne EXecuto��amoa neioW. aforesaid notice or advertisement, and that ESTATE 1�F WILl1AM F:HO�FMAN,late of Cumberland County, all allegations in the foregoing statement as Pennsylvania(died June 29;2013).J.Miehesl Hoffman,Executor. • to time, place and character of publication Attomey: e Michae6Cherewka,Esquire are�Y'Ue. 6241�Orth Front$treet VHormleysburg,PA 170¢3 ' ' ' �, � C. Sworn to and subscribed before me this �� -�-� cl. �1 t�C�..� �f1 L� � - _ � �-� _ '��- Notary blic My commission expires: �6�Y�i��+s��1��+�.`r��F,6?ENNSYL`JAI�IA t�ivtariai Seai Bethany h�.F9oltry,Notary Pubiic Carlisie Boro,Cumberland County My Commission Expi,;.s Sept.26,2015 MEMBER,PENNS'4L+i"+�F�=�:'��5:�I��ION OF NOTARIES The Sentinel MICHAEL CHEREWKA AD NUMBER PAGE NO. www.cumberiink.com 624NORTHFRONTSTREET 431588 10f1 / �� ,.}- � WORMLEYSBURG, PA 17043 BILL DATE SALESPERSON L�� '�"�� 717-232-4701 --�`""""'��' 06/29/14 wolfc �'(,S[E SillF LI�tSH�kG t'z@�':i;�itii'e START DATE STOP DATE 06/14/14 06/28/14 AD NUMBER AD DESCRIPTION CLASS LINES 431588 NOTICE NOTICE IS HEREBY GIVEN THAT 10 PUBLIC NOTICES 28 * 2 cols Publication Insertions Rate Net Amount Gross Amount 3 THE SENTINEL-LEGAL 3 LGL $148.68 TOTAL AD CHARGE $148.68 3 MOBILE SITE M062 $3.00 3 PROOF OF PUBLICATION 01PRF $7.00 PREVIOUSLY PAID ($158.68) Purchase Order Est.W.F.Hoffman $0.00 $0.00 Lee Enterprises no longer accepts credit card payments sent via e-mail. Emails containing credit card numbers will be blocked. Please use the coupon below to send credit card payment to our lockbox. THE SENTINEL You may also send the coupon to a secure fax at 319-291-4014. c/o LEE NEWSPAPERS Thank you for advertising with The Sentinel! Deadline for PO BOX 540 in-column legal ads is 4:00 p.m. two business days prior to �NATERLOO IA 50704-0540 date of insertion. For questions, call (717)240-7130. Return this portion with your payment Legal � Check# �Credit Card Ad Number 431588 THE SENTINEL c/o LEE NEWSPAPERS ❑ � ❑ v ❑ � ❑ � Billing Date 06/29/14 PO BOX 540 WATERLOO IA 50704-0540 Acct#: Amount Due $ .00 Exp.Date:� m A1110U11t Name on credit card ERC�dSea $ Signature Please make checks payable to: THE SENTINEL 000163 THE SENTINEL � MICHAEL CHEREWKA c/o LEE NEWSPAPERS 624 NORTH FRONT STREET PO BOX 742548 WORMLEYSBURG, PA 17043 CINCINNATI OH 45274-2548 ��n��n��n��i�n��n��n�� 215402000000043158800000�0000000000000000000000001 ..... ,,..�t � � Law Offices of Michael Cherewka 624 North Front Street Wormleysburg, Pennsylvania 17043 (717) 232-4701 Fax (717) 232-4774 June 17, 2014 Cumberland County Register of Wills lst Floor, Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 Re: Estate of William F. Hoffinan DOD: 3/19/2014 21-14-0333 Our File No. 4387.00 Enclosed please find a check in the amount of$9,000.00 representing a payment of Pennsylvania lnheritance TaY for the above-referenced Estate. Very truly yours, Mic ael Cherew a MC/11 Enclosure - • ,..,. .w. "�r '� ._ >,�,��.M�.,..w, T � � Od (�WL� .. ° �p ��,'y�� O � o ��nr w �'m =m2D .�. � �� a� � � - �Q 1 �z^�-n � d<" �. D�r 70 p 3&m � o�ov O � 1U�.:.:�. p � A 9 A � (�.\ y �A W " Z 7C .. � m0 � n� � r ��•, � Z � �<� .� ��_: � R4 - €��;a m Q� �f � .a ��;��' ,�- � � � � '.'�� -� m � �� O '�� , ' ( � r 1�'� O � n� � c� ❑ � � � � � � ! � � � o " � � � N \\ � J l� �4a � ('�".1� . mp �� . � .�= � �.7/ ' m j � � ;, wo N I' @::° �� O . .. .. �'=F /� oN i� ;_= f \ _ _._ _ _ __ _. Q��S$�R� ro s East Pennsboro Township ' '' '' ' ' ' • � • � 98 S. Enola Drive 1-01-2014 PREVIOUS BALANCE 138.00 � ' � Enola, PA 17025-2796 1-22-2014 PAYMENT -138.00 �sss�2 � - �1��32 0�11 6-30-2014 SEWER SERVICE 91.50 n� a+c 4 Office hours:8:00 am -4:00 pm M-F 6-30-2014 TRASH SERVICE 46.50 ��o� SEUUER/SAN ITATI O N ACCT.NO. � �' • • � HOFFMW.002 5-09-2014 138.00 �'�II"I�I�II1�11��1��1��1�1��1�'��'��'ll'I�I��'�'�'I� ---- T2 P1 000638""•'AUTO"5-DIGIT 17001 1 51 .80 . WILLIAM HOFFMAN � � � � ' ' 26 GALE RD SERVICE CAMP HILL PA 17011-2619 � ADDRESS 26 GALE.ROAD CAMP HILL PA 17011 IIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIIIIII � please detach a return bottom portion with payment� �` L�Trackyourexpenses... '❑Tnx-oeoucne�eiTeM r'o7CJ O Clothing ❑Pood Q 7ransportation ❑Credit Card ❑Utilities p`Mottgage ❑Entertainrrient �.Insurance .❑Other.. � / L . . . . _ .�-/BALANCE . . . . . . . . . . FORWARD V � /� /�_O./v � . . - � � � � - � � . THIS ITEM� � O 1�1 �,�i�::r`tC/ �C.�c� �` :_,�- `� ' ��r�� "—`cE . . . . /L t �� /V�l,/-� . �DEPOSIT . OTHER . � . . - � � . _ . - . - .�BAIANCE� � . . . .� . . . - " . . . . . � FOflWARD. . Z� �6da�'/1-�/v/�-3C� 'v� _ '' For added security,your name and,account number do not appear on this copy. NOT NEGOTIABLE --^ _... ,. - ._ , x...,,, - . . ... � ' " __?sY.�..�.�- .. . .. . . ._ - ' � ' ' LgTrack your ekpenses... ` ❑Tnx-oeoucns�E iTErn :096 ❑Clothing p Food ❑Transportation ❑Credit Card ❑Utilities ❑Mortgage r� /' p Entertainment ❑Insurance ❑Other: - /! V y BAUINCE � FORWARD Z'�A s T • I/1NV� � u `'V //�/ --�' THIS REM ! ((/(/ � / / `„ �.. BALANCE O 'C_.- l'7 V�d�cf I"`-c c2. �.�. �`�i— �/`�EP�S�T r� � � ° OTHER �� BALANCE FORWAFiD � !7 0 ��/vL W r OQ � r For added securiry,your name and account number do not appear on this copy. NOT NEGOTIABLE -----------------��___,.._�--,- ' --- - -------- -- — ---- -� [}�Track your expenses... ❑rnx-�eoucne�e mern 098 ❑Clothing ❑Food ❑Transportation ❑Credif Card O Utilities` ❑Mortgage ❑Entertainment ❑lnsurance ❑Other. / .' . ��/" ./� �ALANCE�. � � FORWARD_ ��L � (�G-f-_ c/f� L r-� �.1 TM�s��M I� � BAUNCE 0�� •u N��2 E d= o ti � ��rrU o�osR . � � � � OTHER � - t . . � ' . . . � � � . � ..BALANCE . � � � . - � � � �FORWARD � �f�d� —73<ao�� ' For added securiry,your name and account number do not appear on this copy. - - NOT NEGOTIABLE T.. p z :t'ti.€�y�; r n. t� "w,.��s'�-� .. 1-r<� �".� �- `�;�F �' ers�s x ,� �x 'n'y "F�� t� �' e X'' n. r r�-<e ''``� , Keith B:S�oneJConcrefe ' _` �` ° 4 � ,. � � Reasonable,Reliable Service INVOICE 1� da'�� DATE� 258 Montebello Farm Road Duncannon, PA 17020 Phone 717-418-2973 kbstoneC�aoLcom TO �/<�n c_� ,�o��arr.�t� o�C� '6��e R°t? L� w,p ��If .�•�. Y .Fra_� -hr� - 3 �°9��.*'"r` i.. 1✓ 5 ys 1t'k �'��k+xxr� �"-'� � v '' `i�"�'x�a5� -`st.V�"��NK+J*'�.n�a!_ M1-s N� � �}�+ty ro: - ~'i -SAL�SPEIt50N' � ` `�`�� JOB` `' �'� �` � � �' pUE DA�'E ; - ;: , � �� t" u- ' t;�PJ�Y1k1EN7 TERMSe �x�� '^� ,Y' . - ,,,e , ,�,a. ,, <<.��.,. ... : �t. �-,<h.�, ��., , .._ _ , . � � .. . _..._ - s .� .,_ �� , � . �. � , ,._ ,-. :, � . . rt ` " ' ` QTY. '�' DESCRI�7'fON y, �^ �`" � '"� t ��'� z'.��lNIT}PRICE? � `�LINE TOTAL' ' � , ; -, ` , . . ; , ,: �.. ;'� .: c�:y .,. .< < � 14<�q�� avrs� G�...��s�'�J �C�Cs�� / 7��r�pN4 �rau� �? ��+N� I �o�� ,+,,.,� 1 A��y f . �� (�� " � � r v SUBTOTAL � � � SALES TAX v TOTAL .i" � ,; ,, ,_: ..,,. ,:� ..,..: , �� ,.�. _ _ _ _ _ _ _ More saving. More doing:" 600�-CARLZSL-E-PTIfE,-M��H-- PA-17055 � STORE MANAGER TEDD B TERRY(717)795-9602 � � ' 4120 00059 13512 05/26/14 09:31 AM CASHIER SELF CHECK OUT - SCOT59 075378205708 FLRTILE GLUE <A> 6.47 2057 PREMIl1M VCT ADHESIVE 1�T 081725208940 208R 1 GAL. <A> 19.47 . 208R RUBBER WET PATCH 0.9GAL ' 010306100335 V SPREADER �A> 2.98 ' , V NOTCH COVE BAS� SPREADER 049727880632 3PK2"4"6" <A� 2.64 WB TAPING KNIVES 2"4"6" 3PK PLASTIC SUBTOTAL 31.56 SALES TAX 1.90 TOTAL $33.46 XXXXXXXXXXXX7006 QISCOVER 33.46 AUTH CODE 02623�/3590837 TA II IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII 4120 59 13512 05/26/2014 0612 RETURN POLICY DEFINITIONS POLICY ID DAVS POLICY EXPIRES ON A 1 90 08/24/2014 THE HOME DEPOT RESERVES THE RIGHT TO LIMIT / DENY RETURNS. PLEASE SEE THE RETURN POLICY SIGN IN STORES FOR DETAILS. BUY ONLINE PICK-UP IN STORE AVAILABLE NOW ON HOM�DEPOT.COM. CONUENIENT. EASY AN� Mosr nRnFa� V�� . � �J (� � ��,,, oney: ' 4 / MANA R 5TEVE M 6620 CRRLISLE PIKE STE §� � MECHANICSBURG PA 1;t0 T� 1886 OP# 00000101 T 22 09859 � DBL GRD 8X12 00q7034q2 04 6.27 X UBL GRD 8X12 009703 b2604 6.27 X D8L GRD 8X12 00970 402604 6.27 X DBL GRD 8X12 00970 26 4 6.27 X . DRYLOCK 00799412 ��;-9�7'X % � DUST MASK 0076670856 0 0.97 �i . � � DUST MASK 0076670866�0 0.97 X � DUST MASK 0076670866 0 0,97 X J ROLLER CDVER 0701661069 1 1 ,77 X � 2PK ROLLER 00223899628 6,37 X . 2PK ROLLER 00223849628 6:37 X ' COLOR TAPE 00763530331 3.00 X DUGK TAPE 00763630336 3.00 X DUCK TAPE 00763530302� 3.00 X AI.EX FST DRY 00707981842 2,67 X '� CLKRITE CAUL 004107206B6 3.47 X TRRY LINER 00982620168 1 .9T X TRRY LYNER 00982620168 1 .97 X TRAY LINER 009626201689, 1.97 X 7RRY LINER 009826201689' 1.9� X TRRY OOT708940012 2.77 X PRINT TRRY 009826201465 0.97 X SUBTOTAL 17T,23 TAX 1 6,000 X 10,69 TOTAL 187.87 � ECA CHECK TEND 187,87 . �--� CHANGE OUE 0,00 u pa� ba check, you authorize o lts lnfbrmetton to pro s lc Funds Tranaf�.r- T) nr n draft ra n on count, or to pr•or.ess he paament as a check. If Pay�nent s returned unPald, you authuriz ollectlon of aour Payment and the turn Fee below ba EFT(s) or drnft(s drawn on aour account. Call . 888-906 3388 wlth ana queationa - • RETURN FEE AMOUNT 30,00 � irEMS so�n z2 ' � TC# 2662 8261 8260 9378 8027 8 I III�)III IIII I)III IIII IIIIIIII IIII IIIII III)IIIII)IIII IIIIII III IIIIIII IIII(III II�I ur Guaranteed Low Prlces � � Unbeateble wlth Ad Matchl � . 05/16/14 12:21 :49 BILLING PERIOD AND METER READINGS BILLING SUMMARY • Billing date:May 15,2014 For Service To: 26 GALE RD • Due Date:lune 6,2014 For Account 1024-210036648444 • Billing period:Apr 15 to May 14(30 Days) Prior Balance • Next reading on or about:Jun 13,2014 • ealance from last bill 98.31 • Customer Type: Residential • Payments as of MayS:Thank you! -98.31 • Meter Reading Measurement: Balance Forward 0.00 1 unit=100 gallons of water • Billing Measurement: 100 gallons(CGL) Current Water Service Water Service Charge 15.00 Meter No. N090978102 • Water Usage Charge($1.02140000 x 17.00) 17.36 Size of inete� 5/8" • Total Water Service Related Charges �\`\\ 32.36 Current Read 981(Actual) other Charges �� Previous Read 964(Actual) • Water Late Payment Charge v 0.94 Total water used this 17 units • 7otal Other Charges o.94 billing period (1,700 gallons) TOTAL CURRENT CHARGES 33.30 Total Water Use Comparison(in 100 gallons) • Current billing period 2014: 17.00 CGL TOTAL AMOUNT DUE � $33.30 • Same billing period 2013: 34.00 CGL Pay your bill online:www.water.paymy6ill.com Billed Use Graph(100 gallons) m Pay by phone:24-hours a day,every day at 1-866-271-5522 55 + Pay in person:Residential customers may obtain a listing of aa payment locations by visiting www.amwater.com/myh2o � Pay by mail:Remit your payment to the address shown above 33 __ _ 22 11 2 M J J A S 0 N D J F M A M 2 � a u u u e c o e a e a p a 0 3 y n I g p t v c n b r r y 4 Important messages from Pennsylvania American Water • Approximately 4.44 percent,or.$ 1.48,of state taxes are included in your current bill. • Any portion of the water charges which is not paid as of 06/06/2014 will be subject to a 1.50%penalty. � Questions about this bill?Call our 24-Hour Customer Service Center:l-800-565-7292 www.pennsylvaniaamwater.com 617500413130 013597/013760ACRMNNETM1C0021 4 (ACRMNN 0135970101900) . .. ... . ..._.._ ..._._ .._ . .... . . . .. . .. . Account Number Amount Due 79 9000 8154013530 01 5240.84 � ------� • veri�n _ = vi};.ti�f'. - `��f�:-�:4i:_ - - - - a io _ - n:�;��=. unt Inform t n - Acco ' '::`2y!: - —�yy /yy��iri�':.i'j'r' ' ' .4'�.i:�. " '_- ,�'',�..�'7'�vlfi:'i:.;:��.r'.!..{:n _ ;;.�,: �;:y;:�: <..0 �.��...:�....�zt�,.'c"� .�.. :.ti. statemeneoate: a�25�1a .'ti�.'i - nyl:: _ ._1-;:;f;i�:.}'' `:',�,jii� -'tial:i � ��:5?��R..%jj�F� _`-:�^'"';:•• WILLIAM HOFFMAN `=�r�:;y.�.::,=;:;; ��'i��.�..#�iit�jpa�;r;=;,,'r?:s�:.,,.,:;�:',: l;y�;- .:7,.. �i'i.p:h's �'T!1`f�!�I�.�a.�....� ?:..1r . . ,:;::;sr::r,.�r:�� _ .:,d�s';;��:;��,:,.:,:bwr'a:r;',•...r Phone: 717-761-1754 i ... i :._.�,.�. �,r.• r ;i:.��;.E';Pl%1.:;�1,dtitiN!t�';�y;�S�?l$4V;�1�i1/,$..;;:�;:?�.��;=�ir :. :. . . .,. rF..:`..: :::r;: ;:S;�ip€�Fyid11fA1�Yjrt-.�i.�D.�..;��11'RpE;`�{�Eq;''::�:�u:;3;:;:'� ::��.:� :;_:,: :,s� :.;,:;�:k:��,<- :.;K�.: AccountSumma - - ry ��.i. __ L`}'}`tir� i�.f;�, ..:i�ih - __._—'__—.__. :::�,^�:,'. ;:5:`ji':i r:i:='� '____'_--"—____"__'_—'—_'—__'_ _ !'i�r'r::�rJ.: _ .;'c_;�ll:ti. _t +�:t . —___ -- :_'Fi'' i:�:ti>a- �:n:: �.'ti5t � . _;':�:, ,;.:y;_;:•a.��~ :!r� �s�14: 120.41 - . ,. , , , , Previous Balance $ ..........:..�.....,.._...,.,....:.:r:..,..�.:s�3��:;: .....,.:.,...�,_.,...:':�,�.. ----------------- --------------- - • , � � � � $ No Paymenl Received ---- ---_----- --- - $.00 . � :� � ;YQ�Q�,� f��:£`g'�r ��"� Overdue Balance-Please Pay Now � 5720.41 Get The Speed You Need Make sure all your devices have the speed ihey need. New Charges �� Upgrade to FiOS OuaMum 50/25 Mbps Internet for just Current Activity $129•97 $10 per month more.Visii FiOS N channel 500 or call --__— -_- -- - --- ----.--.--..--- 1-877-896-1157 ioday.Limited-time ofter.Speeds. Specials and Promotions -$20.00 not available in all areas.Taxes apply. Taxes,Governmental Surcharges and Fees $2.70 01'del'MLB EXTRA INNINGS Verizon Surcharges and Other Charges&Credits � See 80 oul-ot-market baseball games a week with Total Naw Charges Due by May 19,2014 5120.43 the MLB IXfRA INNINGS SM package.Order now and MLB.N�is included so you can watch irom any Total Am UB $240.84 device.Limited-time offer.Order on channels 1475-1488 or visit , verizon.comlpremiumentertainment.Avail.varies and restrictions apply. Get A FREE Month Of Movies With Redbox Instant by Verizon you get 4 DVD credits �- lo use at Redbox Kiosks every monih,plus movies you can stream instanlly tor just$8/mo.(plus taxes).Visit redboxinstant.com/trynow and get your 1st monih iree with subscription.Cancel anytime.New subscribers � only.Add'1lerms8pply. - - - - - - - - `- puestions about your bfll or servfce? Want Automatic Payment? View your bills in deiail aT verizon.com or call 1-800-VERIZON(1-800-837-4966). Enroll below or at Verizon.com to authodze your tinancial When asked for your account number,please enter 8154013530.Customers with inslitulion to deduct ihe amount of your monthly biil irom disabilities cali 1-800-974-6006 TTY. ihe account associated with your enclosed check and send payment directly to Verizon.To discontinue Automatic Payment,call Verizon.Piease keep a copy of lhis authorization. � Please return remit slip with payment. � ' � � � °� � \ , o, ---- ---- ---- ---= ---- �---- --- ---- --- - � o � � --- --- --------- a } W � W j � Q 0 M C \ W W W Z � � . ��J/�� Q' W ` O` tV` W S Z � WU` p .; � ! 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W ww 'v v � t— W t� a � � � ZQ u' � i=- ¢ = cnw �- J zZ ¢ w WaZ > Z N ¢ > Zg � Z Q � � Q ¢ WQ � v cai ? cwn � = a � � � o � � � � � a � a � : v cWn � ¢ � � cWn � ? � w � � . . . . . . . . . . . . . . _ _ - � ----- - ------------ --- ------- _ .. . _ __. __ .. � �'�P�T� ��; � C(��- � o � z`( �. - 1 Zs: _ a t a S E�,rt c tTi�c, GR,4 - D.S8 =-�° t o �1 ��S-n,.s� Ga� - s-� . t� � . � __ _ _ _ _ �enrq, �E±`,,�� OMB Approval No.2502-0265 � � n.Settlement Statement(HUD-1) •,,,��,s B. Type of Loan 8.File Number. 7.Loan Number. 8.Mortgage Insurance Case Number. t.Q FHA 2.Q RHS 3.❑COnv.Unin3. 806-168935-STG N/A N/A 4.�VA 5.�Conv.Ins. C.Note: This fortn is fumished to give you a statement of adual settlement costs. Amounts paid to and by the settlement agent are shown.Items marked "(p.o.c)"were paid outside the closing;they are shown here for Informationai purposes and are not Included in the totals. D.Name 8 Address of Banoxer. E.Name 8 Address of Seller. F.Name 8 ACdress of Lender: Mlchael R. ShreRier EstaM ofWllflam F.HoHman,John M. WA 118 Lewlsberry Road Hoffman,Executor ,P/� New CumbeAand,PA 17070 26 Gale Road Camp Hill,PA 17011 � G.Property Location: H.Settlement Agent: I.Settlement Date: 26 Ga/e Road DETHLEFS•PYKOSH LAW GROUP,LLC, 07N9/2014 Camp Hifl,PA 17011 Darrel!C.Dethlefs,Esqul�e - Phone Num6er.(71�975-9448 Cum6eAand Couny „ 2132 Market Street Camp H711,PA 17011 Place of Settlement: 2132 Market S6eet,Camp Hlll,PA 17011 Dlsbursement Date:07/09/Y074 J. Summary of Borrower'a Trensaetion K.Summary of Sellers Transaction 100.Gross Amount Due From Borrower 400. Gross Amount Due To Seller 101.ConVact sales price $i25,000.o0 401.Contract sales price gi25,ooa.o0 102.Personal properly 402.Personal property 103.Settlement charges to borrower(line 1400) 52,357.o0 403. 104. 404. 105. 405. Adjustrnents for items paid by seller In advance Adjustrnents tor items paid by seller in advance 106.Cityttawn taxes to 406.Cirykown taxes � w 107.Countyt2%es 07/09/2011 to 12/32/2011 5290.10 407.Countytaxes 07/09/2011 to 12/31/201I $290.10 108.Assessments 07/09/201/ to 06/30/2025 $1,832.30 408.ASSesSrtIC�tS 07/09/2014 �0 06/30/2015 $1,H31.10 1pg,Municipal: 07/09/2029 - 09/30/20I9 5126.00 409.Miuiicipal: 07/09/2014 - 09/30/201 5126.00 110. " 410. tt 111. = 411. ��- 112.� - 412. �- 120.Gross Amount Due From Borrower $129�601.20 420.Gross Amount Due To Seller 522�,2�7.20 200.Amounts Paid By Or In Behalf , Borrower 500.ReducGons In Amount Due To Seller �- 201.peposit ar eamest money 515,000.o0 501.Excess deposit(see instrudions) 515,000.o0 202.Principal amount of new laan(s " 502.Settlement charges to seller(line 1400) S6,227.13 203.Existing loan(s)taken subject to -, 503.Existing loan(s)taken subjed to 204. 504.Payoff of first mortgage loan 205. 505.Payoff of second mortgage loan 206. 506. 207. . 507. . ... 208. 508. 209. .. 509. AdJustments for items unpaid by seller Adjustrnents for items unpaid by seller 210.City/town taxes ro 510.Ciry/town texes ro 211.Countytaxea �ro 517.Countytaxes � 212.Assessments 'ro 512.Assessments ro 213. ' S13. 214. - 514. � 215. 515. 216. - 516. �� 217. 517. 218. 518. 219. 519. 220.Total Paid By/For Borrower $15,000.00 520.Tofal Reduetion Amount Due Seller 521,227.13 300.Cash At SeClement FromlTo Bo wer 600.Cash At Settlement To/From Selier 301.Gross amount due from borrower(Iine 120) 9129,60a.20 601.Grou amount due to seller(line 420) 5127,2�7.20 302.Less amounts paid by/for bortower(Ifne 220) ( Si5,000.00 602.Less reducdons in amt.due selter(line 520) 521,227.13 303.Cash � From ❑To Borrower 5�14,60�.20 603.Cash �To ❑From Seller S1o6,020.07 The public Reporting Burden for this collection of information is estimated at 35 minutes per response for collecting,reviewing,and reporting the data.This agency may not collect this information,and you are not required to complete this form,unless,it displays a currently valid OMB wnVol numbei.No Confidentiality is assured;this disdosure is mandatory.This is designed to provide the parties to a RESPA covered transaction with informatio�during the settlement process. Prev(ous editions are obsolete Page 1 of 3 HUO-1 - . _ _ L. Setttement Charges 700.ToGI Real Estate Broker Fees SZ,500.00 Paitl From Paitl From Divfsion of Commissian(line 700j as follows: eormwers seners 701.$ 2.500.00 tp Scott Beiu�:kp i C�paay (AuctioneerJ Fundsat FunCSat Seltlement SetGement 702.5 to 703.Commission paid at Sattlement 52,500.00 704. ( P.O.C.by ) 800.Items Payable In Connecdon With Loan 801.Our orfgination charge N�A $ (from GFE#1) 802.Your credit or cha�ge(points)for the specific interest rete chosan $ (from GFE#2) 803.Your adjusted origination charges (from GFE A) So.o0 804.Appraisal fee to N/A � v.o.c.cy �(from GFE#3) 805.Credit report to x/a � r.o.c.ey �(ftom GFE#3) 806.Tax service to ( P.O.C.by �(hom GFE#3) 807.Flood certification ' � a.o.c.ny �(from GFE#3) 808. 809. - 810. - 811. - 812. . 900.Items Required By Lender To 6�Paid In Advance 907.Daiy interest charges from o�/09/201� �0 09/01/201� �E /day(from GFE#10) 902.Mortgage Insurance Premium for,;. months. (from GFE#3) to - 903.Homeowners insurance for - years. (from GFE#11) to - 904. � years. to 905. 7000.Reserves Deposited Wfth Lander 1001.Initial deposit for your escrow account (from GFE#9) 1002.Homeowners insurence " months(c�S per month $ 1003.Mortgage insurenca months�S per mo�th S 1004.Property taxes months�S par month $ ' 1005. months�S per month $ 1006. - months(�S per month $ 1007.Aggregate Adjustment �y o.o0 1100.Title Charges 1101.Title senrices and lenders titla irtsurence (from GFE#d) 1102.Settlament or closing fee - S � 1103.Ownets title insurance � (from GFE#5) Si,ozs.o0 1104.Lenders Utle insurance � S 1105.Lendef S titla poliCy limit$125,000.00 1106.Owner's title policy limit$ - 1107.Agents portion of the total title insurence premium Dethl.efa-Pykonh Lar Group y 87a.25 1108.Underwriters portion of the total Utle insurance premium security ritle y z53.�5 1109. (Sale Rate -No End. - Qimer Po2icy On1p1 ��p, Darre2l C. Dethlefa (NOr��Fee) SS.00 $5.00 ��, Debbie EupoSd (Tax Cert=Fee) SZ0.00 1112. ' 1113. ' 1114. 1115. 7200.Government Recording and Transier Charges 1201. ��lanC CovaGy Racordar Govemment recording charges: (from GFE#7) 56�.o0 1202.Deed$67.00 ;Mortgage S ;Releases$ 1203.Transfertaxes C�mbarinnd covnty Recorder (from GFE#8) 51,250.00 51,250.00 1204.City/COUnty tax/stamps: ' Deed$1,250.00 ; Mortgage S 1205.State tax/stamps: Deed$1,250.00 ; Mortga9e S - 1206. ' S �zo�. a �zoa. -� s 1 z09. S 1300.Additlonai Settlement Charges� 1301.Required services that you can shop for (from GFE p6) 1302. S 1303. ' S 1304. 1305. - 1306. ��ie Lupold, Treaaurerj (2011-15 School Tax) $1,872.13 � �3q7, Scott Bendiaeky i Ca�pany (Advertiaing FeeaJ $152.00. 1308. L^ant Penaaboro Tornehip.`7luthority (MUnicipal: 3rd Qts-July-Sep[ 201C) $138.00 1309. East Penn.7boso Rbraehip'AVthority (Tranafer Fee) $30.00 1400.Total SeNlement Charges(enteJ on Iines 103,Section J and 502,Section K) 52,357.00 $6,227.13 -i Previous editions are absolete •- Page 2 of 3 HUD•1 e PAGE 3 OF HUD NOT APPLICABLE ON CASH TRANSACTIONS _ . Certification (continued from HUD-1) I have carefully reviewed the NUD-1 Settiement Statement and to the best of my knowledge and belief, it is a true and accurate statement of all receipts and disbursements made on my account or by me in this transaction. I further certifythat I have received a copy of the HUD-1 Settlement Statement. Seller or 1 Borrower: � Date: � Ln��. Agent: � c !j Date: J7�_ i e R. Shr.�ffl r ohn M.Ho n,Executor Estate of W am F.Hoffman 418 Lewisberry Road 26 Gale Road New Cumberland,PA 17070 Camp Hill,PA 17011 x it The HUD-1 Settlement which I have prepared is a true and accurate account of this tr saction. I have caused or will cause the funds to be disbursed in accordance with this statement. Date: Settlement Agent: Date: �'9�� Darr .Dethlefs,Esquire WARNING: It is a crime to knowingly make faise statements to the United States on this or any other similar form. Penalties upon conviction can include a fine and imprisonment For details see:Title 18 U.S.Code Section 1001 and Section 1010. Rev-lsis ex+�oi-io) \.,x' � 'pennsylvania SCHEDULE � - DEPARTMENT OFREVENUE INHERITANCE TAX RETURN B E N E FICIARI ES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS[Include outright spousal distributions and transfers under Sec.9116(a)(1,2).] 1• Joan Michele Bradley ' ,Daughter 40,015.16 2. John Michael Hoffman,3811 Chestnut Street,Camp Hiil, PA 17011 Son 40,015.16 3. Deborah Jean Cooney ' Daughter 40,015.16 4. Christine Elizabeth Jones Daughter 40,015.16 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: L ' B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: L TOTAL OF PART II—ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ 160060.65'' If more space is needed,use additional sheets of paper of the same size. � . [ ' ' ��".t i . . . I� ' � � . � ' . . This is an original will. _ Any alterations or erasures � ,$�, �5 _�� _ may make it void. DO NOT . _ � � ` attempt to change it without - 'I consulting your Legal Assistance Off icer or your • Lawyer. i LAST WII,L AND TESTAMLNT ' OF ___ I i WILLIAM FREDERICK HOFFM�N i' � ( I, WILLIAM FREDERiCK HOFFMAN, Social Security Number 578-05-5428, of the Common�aealth-of Pennsylvania, ,declare that this�°-�is >my LAST WILL � • •:. AND TESTAMENT �and�'�`'revoke�`a11, otlier}�wi�lls�and��codicils� -previously�hmacTe , by me. . , FIRST: I appoint my Wife, BERTHA ELIZABETH HOFFMAN, as mg Personal Representative concerning this Will. If my Spouse is unable • or fails to ser�re, I then appoint my son JOHN MICHAEL HOFFMAN to serve as my Personal Representative. a. I request that my Personal Representative be permitted to serve without bond or surety thereon and without the intervention of any court,� except as required by law. I direct "that my Personal Representative act in unsupervised administration so as to administer my estate with a mini.mum of court supervision. If it becomes necessary to have ancillary administration of my �state :in; any juris�diction where my Personal Representative is unable or �does n�t; des,ire to qualify as �- ancillary legal 'regzesentative, I;appoint as s�eh ancillary legal representative such individual or corporation `as my `Personal Representative shall designate, in writing. b. I direct my Personal Representative to pay the expenses of my last illness, the expenses= of a- funeral apprppriate to my station in life and custom of living� (in� lu �in"`'�su3stabTe ;inonument� ar= marker �.-:��: ° ��" ,��-,r�� . for my grave)�, and written�, c a� d e w � .ch R a ma e, ,��I�� grant my Personagl�=Repres�en �tt. 1� we, ex en o e e an�,�debt,-=. -°� for such time as my "Persona�l -l�ep�esen��a} i�e s ].1 �de appropri�"ate`; , .. ..y J.._'�v,�rl�"��r;�`-� t'h�..b ws iz-y�#.�� ..':q tya`f � : ��. � . (�• .� . , {�' J c. All estate; inheritanc'e, successiqn and:other� death taxes with respect to a1T property passing under tliis� my Will sha;1T be paid from and borne by the principal; of my residu�ry;.:estate, without regard to xeimbursement; as if such taxes were admini�tration ,expenses. My Personal Representative �may ,pay �such' taxes at�°�ariy time deemed advisable, whether or not then due and payable:!''�- : d. My Personal Representative is requested to settle my estate as soon after my death as may be practicable, and to pay or deliver every legacy or bequest to my beneficiaries without waiting any time that may be believed to be �customary in prpbate matters . -- ; : , ` ; PAGE 1 , �� ,OF 5 PAGES _ v ,��. : _ �.� �. � _.:: , .�.:. , � . .. �.. _ .,.�,. p� .... f,. ...,. _,_ � .:.T_ , ...... ��.;_. �:�_ ,... �f�ttil,��,t��'�:f�Y JSS n�; �t �w�s,`` �.a y µy� is m'^�,� ,�.;,as�r ,�3" -�wX�� ynd- .� k,$` _ . � . ,tti °n',:t 'v 2�: �.. r � � � ' - � e. I have served �in the Armed Forces of the United States . � Therefore, I direct my Personal Representative to consult with a Legal . Assistance Attorney at the nearest military installation and with the--� Department of Veterans Affairs and the Social Security Administration to ascertain if there are any benefits to which my family members are entitled by virtue of my military service. SECOND: I give, devise and bequeath, absolutely and forever, all of my estate and property of which .I-..may be seized or possessed, or to which I may bewentitled, at, the .��ev of�my death� wherever situated or of whatever nature,' be �=it real, .p�rsona�; or;:mi�ed, �to my;�Wife, BERTHA ELIZABETH HOFFNlAN=; ' as�her sole and abso:lute p"roperty if she shall survive me. THIRD: In the event that my Wife, BERTHA ELIZABETH HOFFMAN shall not survive me, I give, devise and bequeath, ab.solutely and forever, all of my estate and property of which I may be �seized .or possessed, or � to which I may be entitled, at the time of my death, wherever situated or of whatever nature, be it real, personal, or� mixed, to JOAN MIChiELE ' BRADLEY, JOHN MICHAEL HOFFMAN, DEBORAH JEAN COONEY, CHRISTINE ELIZABETH JONES and to any child or children that have been or may be born to or adopted by me; in shares of substantially equal value to .be divided as they may agree. a. If any of my children shaTl not survive me, then I _- give the share of that deceased child to my surviving children in shares of substantially equal value to be divided as they may agree. b. If none of my children survive me, then I give, devise, and bequea�h, absolutely and forever, all of my. estate and property of which I may be seized or possessed, or to which I may be, entitled, at the time of my death, wherever� situated�or�of whate�er nature, be it real, persflnal, or mixed,��to tli�` ci�'�e��"`-` f�my clu�ld�,ors�children � •��. 3�., � �_; � � who are to:=take�per:�st��' es e ca � - �'n s�s�o� substantially equa].�`va to�, ed as he may�agree:��,In ord"er:<to �� '� �� a F .r � � :� � , * � ;- r e c e i v e a s h a r e o f my`�e s tat�e� un der��t h is rparagrapk�', °.a descen dan t o f any child of mine must su�vive �me: , � �� . - � c. If they are unable to agree, the division among my children and the descendants of any of my children who fail to survive me shail be made by my Personal Representative, in that person's sole and absolute discretion. I empower my Persona];� Representative to sell any or all of such property, if sueh property is not distributed in kind hereunder, and to distribute the proceeds among my said children in substantially equal shares. Any determination of my Personal Representative as to what should pass or be sold under this paragraph and to whom it should pass or be delivered or at what price it should_._ . � be sold shall be conclusive. PAGE 2 �j�„ /� p '� � OF 5 PAGES `-�,;°"� � '�� ) � , � , .d::�- . -._.. �'�� - _ . _ .. _ - ,:: F2�i Y ":� Q1�3M,. 4} .f t�,.,�� J : - ' , , � . ,. .. .._.. . .: . . . :.._ � ..... .„ . . ..�., E.3�.- . ..._. .. � . ' I � FOURTH: Except as otherwise provided in this Wi11, ,I have ! intentionally failed to provide for any other relatives or other , . persons, whether claiming to be an heir of mine or not. Insofar as I_.-_- have failed to provide in this Will for any of my issue now living or later born or adopted, such failure is intentiona'1 and not occasioned by accident or mistake. FIFTH: Any beneficiary who fails to survive until one hundred 'i twenty (120) hours after my death shall be deemed to have predeceased !. me, and the gift to that beneficiary shall be disposed of accordingly. � SIXTH: Definitions: . � � a. The term "children" as used in this Will includes adopted i and afterborn persons . The term "children" as adodted childrenlofhall not include step-children, the natural born or p person' s spouse who are not the natural born or adopted children of the person. A relationship by or through legal adoption shall be treated the same as a relationship by or through blood for purpose of succession to property under this Will. b. The term "descendants" as used in this Will means the immediate and remote lawful, lineal descendants by blood or adoption of the person referred to who are in being at the time they must be- - ascertained in order to give effect to the reference to them. c. The term "Personal Representative" as used in this Will means Executor, Executrix, Independent Executor, or any other title of like import which is used to describe such a fiduciary. d. The te�m "per stirpes" as used in this Will means that whenever a distribution is to be made to the descendants of any person, the property to be distributed sha1LL be�rdivided into as many shares as there are (1) living_ children�of t�ie '.person,., and (2) deceased children, who left descendants w�io'-are_ tlien 3living; of "the person. Each living child (if any) shall talce orie share and the share of each deceased child sha1T be divided among his then living descendants in the same manner. PAGE 3 �,� � OF 5 PAGES -{�� . . �.: ..;. ,,,.,,, . ,-;� „ . �,:, , -�..,-�� _�� _x��x��'��a�`�� _ � . _ _ � F � ,.. .�., ..> _ _. . ,; . „... _. - � � z SEVENTH: In addition to any powers granted by the laws of the ____ state in which this Will is• probated, I hereby authorize and empower the fiduciaries named in this Will, to the extent of the discretion herein granted, to sell, exchange, convey, transfer, assign, mortgag�, pledge, lease or rent the whole or any part of my real or personal estate, to invest, reinvest, or retain investments of my estate, to perform all acts and to execute all documents which my fiduciaries may deem necessary or proper in regard to my property. If any of my fiduciaries elect to receive compensation for services, such compensation will be that allowed by law. EIGHTH: If any part of this Wi:ll shall be invalid, illegal, or inoperative for any reason, it is my intention that the remaining parts, so far as possible and reasonable, shall be effective and fully operative. My Personal Representative may seek and obtain court instructions for the purpose of carrying out as nearly as may be possible the intention of this Will as shown by �the terms hereof, including any terms held invalid, illegal, or inoperative. � ', IN WITNESS WHEREOF, I have at Carlisle:, Pennsylvania, on April 2, 1993, set my hand and seal to this my LAST WILL AND TESTAi�EN�'� consisting of 5 typewritten paqes, each page b�aring my handwritten _ • initials . ' This document was prepared under the authority of 10 U.S.C, section 1044, and implementing military regulations and instructions, by � 0�t� .�• �'"`��- , who is licensed� to� practice law in �(.�.�isy�il�'",;� , (S�) WILLI E ERTCK F , ; � � � I�� PAGE 4 { � � �J� OF 5 PAGES ��,.�'s,,� ,.�,�, � �. ; _ � ;_n .� �,,�pyy . � , .+^.:.,r € L '.,'Y.;"t" ,..� ;� ;; . :. �. .. r.yz g �sY'f��.�Y."�}�F'J�',lr��~ 5; - ... _: . _.� ...�.:a . :r,.3.- .: . ��. .' I � s $ . k 1 3'r. . ' 7'° /.� N F �. , ;. ;�, A y ,�d i� 3 y# F r7-("s ia+��, .�`.'`_ ... . . <..� .,;: . *��.:"n �. s.. ;,r L .�r,,, s, � .r., w'c� � - .,.w, . �� . - x. . s '_ ,� ;., .. . . . 4.?e. g �. The foregoing instrument was, at Carlisle, Pennsylvania, . on April 2, 1993, signed, sealed, published and declared by WILLIAM FREDERICK HOFFMAN, the testator, to be his LAST �nTILL AND TESTAMENT in the presence of all of us. at one time, and at the same time we, at his request and in his presence and in the presence of each other, have hereunto subscribed our names as attesting witnesses, and we do so verily believe that the said testator is pf sound and disposing mind and memory at the date hereof. . z.. �., *,� cr�+ §"� �.� s.� w�.�^G.�`�e.'� .�i.z s �� A -�_ � \\\J�, ^ � � _ - //\/ �� "_�..Y9 _`ii: e `°rn�.—_d..NC('��'1 <�.V Py.§W''� -� z s r Y ` ... � �\. �iX Z�V.I�1'�".� j'�� <Y.. Soc.Sec.No. S��-/9-�S"3/ Soc.Sec.No.rj�g-"�C�-�y�QS .Sec.No. d1S"`fY'��11G, OF _ ��1/SC? D� OF � C G�'{��'c'�-�.1, /C�'¢ OF /70/3 - � �106� i�Uf� -t ��., , PAGE 5 - OF 5 PAGES �� _�� . _ .. ...: f ,1 �vF.:? , . :.��. .. � - -=i.�, . , ..� _ ..- ... . - --. �.,.._ . ..i�_ Y... :. . .��., � if�. �•: . r'"' �. ` ". COMMONWEALTH OF PENNSYLVANIA CUMBERLAND COUNTY --- ' ACKNOWLEDGMENT I, WILLIAM FREDERICK HOFFMAN, testator, 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 the 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 expressed. (sE�) LLIAM FREDERICK H AFFIDAVIT _�-� � �� , We, /G'�� !l• ��A✓L�� , ,.,� �l� � 1 � , and J �'�� .4. �``f� , the witnesses, sign our names to this instrument, being duly qualified according to law, do depose and say that we were present and saw the testator sign and execute the instrument as his Last Will; that the testator signed willingly and ____ 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 will as a witness; and that to the best of our knowledge the testator was at that time 18 or more years of age, of sound mind and under no onstraint or undue influence. • G� �1� � Witn " s Witness ' ness Subscribed, sworn to and acknowledged before me by WILLIAM FREDERICK HOFFMAN, the testator,. and subscribed and sworn to before me by -�U L. �'�.��c �� ,—� .� �ti'�.kt 1�► I lR.--S . and , T��" �• �"T� , the witnes�es, on April 2, Y993 . ; - - ;� - NOTAR PUBLIC "� ` My Ca:nmiss 'on Exp�s� _ ' Wanda K Hurtter,A�u61 a �.. �y - = G2rlisle�oro,Cumbodand Courity . _ - - l�4�r Ca�nmission Exp�s Oct 1 a�1�93 _ ��' " M2tnber,Panr�yivaniaAss;ra:i�n os t�^A, � COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE REV-1162 EX(11-96) BUREAU OF INDIVIDUAL TAXES DEPT.280601 HAiiflISBURG,PA 1 71 28-060 7 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 019314 J MICHAEL HOFFMAN 3811 CHESTNUT STREET CAMP HILL, PA 17011 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- fold """"'_ """" 101 � 59,000.00 ESTATE INFORMATION: ssN: I FILE NUMBER: 2114-0333 I �ECE�E►vT ►v,4ME: HOFFMAN WILLIAM FREDERIC � DATE OF PAYMENT: 06/18/2014 I POSTMARK DATE: 06/18/2014 i COUNTY: CUMBERLAND I DATE OF DEATH: 03/1 9/2014 I � TOTAL AMOUNT PAID: 59,000.00 REMARKS: J MICHAEL HOFFMAN CHECK# 1020 INITIALS: WZ SEAL RECEIVED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS TAXPAYER Law Offices of Michael Cherewka 624 North Front Street Wormleysburg, Pennsylvania 17043 (717) 232-4701 Fax (717) 232-4774 August 6, 2014 Cumberland County Register of Wills 1 St Floor, Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 Re: Estate of William F Hoffman, File#21-14-0333 Our File No. 4387.00 Enclosed please find one original and one copy of the inheritance tax return for the above referenced estate. Also enclosed is a copy of the first page of the return along with a self- addressed stamped envelope. Please time stamp this page and return it to our office. Should you have any questions or require anything further,please do not hesitate to contact our office. Thank you. Very Tr�ly Yours � ':' ri� :. / _ -_ � 2:� � �, , �1�� - ��„„ �, ,�4, _ :;� � . �rs� , . ' [�, /� l�'� G'��r � �� „�'`� � "` a Dominic Montagnes�,�� " ociate � � �.� ��"�,�"� f .�'� � /� �� -''� ,-,�� _ ;,� ��.� �� - � �-, ��. �, : x �`t'� C�-; a� ,'� � �; -+��.� ,«' ,� � �—�CJ C , �� :: � � ��. � � � m�, � �� =�� s' ��:��hrk � � _._. � 4 �,�;,:9.e`��"'� a��`a. �" � �� t-�� . — wi- . . � �' . ''�� .� 'k�` ,�b ¢k"< $ c .G ��.. . � . ... �:��k6 � �p y� a��s'..� ��x, � �C' y� —T�. $ � ,� n� '�� `F` '`w,,�z2 + "�rx '�'' - �tal �j =- r•r'j �_" .� a � _� �— � � o �'°o x�� t�� . ' � ��,� �,�� - �;r° �;�, ..�� : r x ,,u� t ` : ,p €-�� ;� ,� � x� r s q �" 't t ,.�. .F . „° .a,,,,.'��..� q'�s'.�.�-� .3��rr'� 4`+`'e, e � �� '� h ; �M�d �a � � - 1 �i. `�, ?��Y� a 'by � l .... � : � ��. t�4'#,s��w± z.E t�e � ' �': � y _ > wy.+a:{..'��"�i,s' � t,4�; � q� � . _ i "� F�z x ��'�`�� . �' ,�'4�s� r ��r� �` �� ,. � "� �,;�-�� ,.� � x,; � `� <. , _ ��` : 3„= -. , _ _-- _ �._:.__I u� � �� ¢ �� a= a P � (n�- �P J--.. I_ � CIOJ-. .Z N Q_...-Iot0:7 t ^V" ¢2f�op v.l /o viaa"c�¢ {E}o _� ¢ � o U ¢ �-� �� -��'� M � -�� o �� n --�� _' -�—�_ � f �� in a' � o �N O ti Q j� C � � V+ � O �_ � O � � � � M V' �-' � � U � � � ° .� � � ti � �.� .� , � � � � � � a UNQ � � N ��- �, � +r -p � � C�V� p F_._� 'i; � � � Q u. ' C`.+ S ' � � � � (� � � �--} _ �- �� N � V � � � ts._ � — __ ' _ `i�� p � � O •L =' — � ' � � � � UU � =� � �� ; -�� t° U .�, , � � �� '� j� � L ,�. .-'- - � � �-� - c.� ,� L . �� ' 0 � �"L �' � � U � B981fi00-9t-069L � !� ELOZ'ueP 0091e9e'I �� N�� .�,-�.,�. � e�- ELOZ�I�f`dLOI IeQe� �(u � �� I O as�oi�sawod ao� ��■ �„� �3�1/12I3S7r/1SOd � Y�� S31f/15031/N/1� W U � �� d � - o0 1 . �W ~ N � 11b� W � W� a� r � • , .J1112i012id Zo =°_ � �Q � •� � �� ;,, �. . �, _,.�.�.,�� -�.� �e.�, �.�,�a��. .. �..�,.,,,�,�,,� ., _,.p .� . . _ _ Law Offices of Michael Cherewka 624 North Front Street Wormleysburg, Pennsylvania 17043 (717)232-4701 Fax(717)232-4774 August 7, 2014 Cumberland County Recorder of Wills 1 Courthouse Square Suite 102 Carlisle, PA 17013 Re: William Hoffinan Estate Mike Fioffinan, Executor Docket No. 21-14-0333 Our File No. 4387.00 To whom this may concern, Enclosed please fmd corrected first page of the Inheritance Tax Return for the above referenced Estate. Please disregard original first page. Please send us a time stamped copy of the corr cted first page enclosed. Very ly yours, �� Dominic Montagnes � '_51µ.. _)_ T �Z.'? �� r^` r -e ( �'I"1�_. G�7 . `: �<<' � �`_, . � _ ' C?C' � : _`.-' ��°�.) � ' _ F-.r..f -�-� �:�� C3., DM/BS Enclosure � _ � � :1L��r _ � - � ;,�t,;� � F' T .'t :� j �� F P� 2� p�- Y � . � .� �t�,�, ,�. �#, it t ' '' �' / � � � �i,�,�fBE� G�'` D �� .,., �, �� :;� � � s� � � � � 3;�' S�� w � �� o ;� � 'a � � � :� ,� � � � � � � � a. � _ V � n '� � � � � �c o �., a � � o � tr} i7 '° � a� � ;�� V � v �j �r� � 3 ij� �r3 ! .;..� !��3 ��~' .t..t � � O � � O � � � � += � y � � V � C y O � � � 3 s � � � t L d' Z � � � �r � V N � � � N � O �