HomeMy WebLinkAbout10-15-14 (2) J 1505610143 , ,
REV-1500 Ex(02-11)
OFFICIAL USE ONLY
PA Department of Revenue pennsylvania County Code Year File Number
Bureau of Individual Taxes DEPARTMENT OF REVENUE
PO 60x.280601 INHERITANCE TAX RETURN 21 _Z;Ar 0104
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
12 18 2012 09 07 1915
Decedent's Last Name Suffix Decedent's First Name MI
STUCKEY JUSTIN M
(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
FK 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 T Decedent Maintained a Living Trust 0
(Attach Copy of will) ❑ (Attach Copy of Trust) 8. Total Number of Safe Deposit Boxes
❑ 9. Litigation Proceeds Received ❑ 10,Spousal PovertyCredit(Dateof Death ❑ 11.Election to tax under Sec.9113(A)
between 12-31--91 and -1- 95) (Attach Schedule O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
EDMUND G MYERS (717) 2-61 4 5 4i :
C:=1
C)
REGISTER Off iVILk-,$USE-dNLY� �
c
� t--+ I-ry
First Line of Address "'; �s "� Lrl
Ca
301 MARKET STREET _0 -n
Second Line of Address
►—' F C2
PO BOX 109 C3 €
DATE FILED G3J
City or Post Office State ZIP Code
. I
LEMOYNE PA 17043
Correspondent's e-mail address: egmAjdsw.com
Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGN TURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
Ralph E Stuckey (�
ADDRESEf
217 Towpath Road, Duncannon, PA 17020
SIGNAW OF PREPARER OTR THAN REPRESENTATIVE DATE
Edmund G. Myers (� ��
ADDRESS
301 MARKET STREET, Lemoyne, PA
Side 1
1505610143 1505610143 J
1505610243
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: Stuckey, Justin M
RECAPITULATION
1. Real Estate(Schedule A)....................................................................................... 1. 132r500 . 00
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. 123, 466. 29
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers&Miscellaneous fon Probate Property
(Schedule G) Lf Separate Billing Requested............ 7.
8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 255, 966. 29
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 45, 148 . 97
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10. 23, 585 . 87
11. Total Deductions(total Lines 9 and 10).........................:...................................... 11. 68, 734 . 84
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 187 ,231 . 45
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. 187 ,231 . 45
TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 15. 0 . 00
(a)(1.2)X.00
16. Amount of Line 14 taxable 187 231 . 45 16. 8, 425 . 42
at lineal rate X .045
17. Amount of Line 14 taxable
at sibling rate X.12 0 . 00 17. 0 . 00
18. Amount of Line 14 taxable
at collateral rate X.15 0 . 00 18. 0 . 00
19. TAX DUE................................................................................................................ 19. 8,425 . 42
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑X
Side 2
1505610243 1505610243 J
REV-1500 EX Page 3 File Number 21-12-0104
Decedent's Complete Address:
DECEDENT'S NAME
Stuckey,Justin M
STREETADDRESS
204 High Street
CITY SuSTATE ZIP
mmerdale PA 17093
Tax Payments and Credits:
1. Tax Due(Page 2, Line 19) (1) 8,425.42
2. Credits/Payments
A. Prior Payments 10,000.00
B. Discount 0.00
Total Credits(A +B) (2) 10,000.00
3. Interest (3)
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) 1,574.58
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 "V IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;............................................................................... ❑ ❑x
b. retain the right to designate who shall use the property transferred or its income;.................................. ❑ x
c. retain a reversionary interest;or............................................................................................................... x
d. receive the promise for life of either payments,benefits or care?............................................................ x
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?.................................................................................................................... ❑ ❑x
3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?....... ❑ ❑x
4. Did decedent own an individual retirement account,annuity,or other non-probate property which
contains a beneficiary designation?.................................................................................................................. ❑ ❑x
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1,1994 and before Jan.1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is 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)(ii)]. The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an
adoptive parent,or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S.§9116(a)(1.3)]. A sibling is defined,
under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
Rev-1502 EX+(01-10)
SCHEDULE A
pennsylvania REAL ESTATE
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Stuckey,Justin M 21-12-0104
All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts.
Real property that is jointly-owned with right of survivorship must be disclosed on schedule F.
Attach a copy of the settlement sheet if the property has been sold
Include a copy of the deed showing decedent's interest if owned as tenant in common.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Real Estate located at 204 High Street,Summerdale, East Pennsboro Twp.Cumberland 132,500.00
County, PA-Contracted Sales Price. Real Estate sold on September 19,2014. A copy of the
HUD-1 Settlement Sheet is Attached
TOTAL(Also enter on Line 1, Recapitulation) 132,500.00
(If more space is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule A(Rev.01-10)
Rev-7508 EX+(111-10)
SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Stuckey,Justin M 21-12-0104
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 VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 First National Bank of Marysville Certificate of Deposit Account-Date of Death Letter for 2,957.02
Accounts is Attached
2 First National Bank of Marysville Checking Account No. 104752 13,794.34
3 Bricker's Auction—Auction of Personal Property on November 23, 2013 27,647.50
4 Bricker's Auction -Auction of Personal Property on October 12,2013 22,508.00
5 Bricker's Auction-Auction of Personal Property on September 28, 2013 24,591.00
6 Bricker's Auction-Auction of Personal Property on September 7,2013 29,581.00
7 Guns, Rifles and Firearms 1,000.00
8 Real Estate located at 204 High Street,Summerdale, East Pennsboro Twp. Cumberland 1,387.43
County, PA-Reim bursement/Refund County/School Taxes and Sewer Payments
TOTAL(Also enter on Line 5, Recapitulation) 123,466.29
(If more space is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule E(Rev. 11-10)
REV-1511 EX+(10-09)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX
RESIDENTDECEDENTTURN ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Stuckey,Justin M 21-12-0104
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s)attached 3,960.43
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Ralph E Stuckey
Street Address 217 Towpath Road
City Duncannon State PA zio 17020
Year(s)Commission Paid 5,000.00
2. Attorney's Fees JOHNSON DUFFIE 8,500.00
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation)
Claimant
Street Address
City State ZiD
RelationshiD of Claimant to Decedent
4. Probate Fees 354.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 27,334.54
See continuation schedule(s) attached
TOTAL(Also enter on line 9, Recapitulation) 45,148.97
Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev. 10-09)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Stuckey,Justin M 21-12-0104
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Expenses
1 Enola Sportsman's Club 560.00
2 Frank Snyder Monuments-Head Stone Graving 1,000.00
3 Funeral Expenses 1,500.00
4 Minister 100.00
5 Pamela's Flowers-Flowers for Funeral Service 320.43
6 The Patriot News 480.00
H-A 3,960.43
Other Administrative Costs
7 Advantage Disposal-Dumpster at Residence 478.13
8 Bricker's Auction-Auction of Personal Property on November 23,2013 -Expenses of 5,420.00
Auction
9 Bricker's Auction-Auction of Personal Property on October 12,2013-Expenses of Auction 3,900.00
10 Bricker's Auction-Auction of Personal Property on September 28,2013-Expenses of 4,580.00
Auction
11 Bricker's Auction-Auction of Personal Property on September 7,2013-Expenses of 6,150.00
Auction
12 Chester W.Yeager-Lawn Care Services 665.00
13 D&D Septic Services 86.00
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Stuckey,Justin M 21-12-0104
ITEM
NUMBER DESCRIPTION AMOUNT
14 Dumpster Service/Yard Clean Up 539.13
15 Ed Stuckey-Reimbursement to Mr.Stuckey for sale of Craftsman Lathe sold at Auction on 450.00
9/8/2013
16 Ed Stuckey -Reimbursement for time spent preparing real estate for sale,Tree and Yard 320.00
Work
17 R.T. Dunn Insurance 498.00
18 Reserves: Additional Miscellaneous Costs and Expenses 350.00
19 Riverview Bank Estate Checking Account No.226419610 28.60
20 RMI-Home Insurance 516.00
21 Sadler Oil 2,712.51
22 Stago Construction&Remodeling-Repairs to Residential Real Estate 100.00
23 The Cumberland Law Journal-Notice of Estate Administration 75.00
24 The Patriot News Co.-Notice of Estate Administration 148.17
25 Wonder's LTD-Tents for Auction 318.00
H-137 27,334.54
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98)
Rev-1512 EX+(12-08)
SCHEDULE 1
pennsylvania DEBTS OF DECEDENT,
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MORTGAGE LIABILITIES AND LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Stuckey,Justin M 21-12-0104
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 2012 East Pennsboro Twp School District Real Estate Taxes 1,545.21
2 2012 Personal Income Taxes Due 1,241.00
3 Caregiver Services(Sherri) 120.00
4 Caregiver Services(Sherri) 200.00
5 Checks clearing after date of death 2,201.95
6 CMS Medicare Payment 167.80
7 Comcast Cable 864.83
8 Cumberland County Real Estate Taxes 488.26
9 East Pennsboro Sewer 840.50
10 Home Aid 400.00
11 Lifeline Systems 40.87
12 PA American Water 494.18
13 PP&L 1,573.27
14 Real Estate located at 204 High Street,Summerdale, East Pennsboro Twp.Cumberland 12,942.00
County, PA-Settlement Charges/Real Estate Closing September 19, 2014.A copy of the HU
-1 Settlement Sheet is attached
15 The Patriot News 65.00
16 Verizon 401.00
TOTAL(Also enter on Line 10, Recapitulation) 23,585.87
(If more space is needed,additional pages of the same size)
Copyright(c)2008 form software only The Lackner Group,Inc. Form PA-1500 Schedule I(Rev. 12-08)
REV-1513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Stuckey,Justin M 21-12-0104
NAME AND ADDRESS OF RELATIONSHIP TOSHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT (Words) ($$$)
Do of ist rustee s
ITAXABLE DISTRIBUTIONS [include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2)]
See attached schedule
Total
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate.
NON-TAXABLE DISTRIBUTIONS:
II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule J(Rev.01-10)
SCHEDULE J
BENEFICIARIES
(Part I, Taxable Distributions)
ESTATE OF:
Justin M Stuckey 12/18/2012 172-01-5006
Item Name and Address of Person(s) Share of Estate Amount of Estate
Number Receiving Property Relationship (Words) ($$$)
1 Jane E Biddle Daughter 1/3rd of Remaining
12 Woburn Abbey Avenue Tangible Personal
Camp Hill, PA 17011 Property; 1/3rd of
Residue
2 Jean E Raisner Daughter 1/3rd of Remaining
203 Kings Highway Tangible Personal
Marysville, PA 17053 Property; 1/3rd of
Residue
3 Ralph E Stuckey Son Specific Bequest of
217 Towpath Road Guns, Rifles and
Duncannon, PA 17020 Firearms; 1/3rd of
Remaining Tangible
Personal Property;
1/3rd of Residue
1
ESTATE OF JUSTIN M. STUCKEY A/K/A JUSTIN M. STUCKEY, JR.
SCHEDULE OF EXHIBITS
EXHIBIT Last Will and Testament of Justin M. Stuckey signed and dated
March 12, 2012.
EXHIBIT Settlement Sheet (HUD-1) for Real Estate located at 204 High
Street, Summerdale, PA 17093, Property sold on September 19,
2014.
EXHIBIT C Date of Death Letter for Checking Account and CD Account from
First National Bank of Marysville
EXHIBIT Bricker's Auction —Receipt of Sale for Auction held on November
23, 2013
EXHIBIT Bricker's Auction — Receipt of Sale for Auction held on October
12, 2013
EXHIBIT F Bricker's Auction —Receipt of Sale for Auction held on September
28, 2013
EXHIBIT G Bricker's Auction —Receipt of Sale for Auction held on September
7, 2013
EXHIBIT H Receipt of Payment of Tax in the amount of$]0,000.00 on
December 18, 2012
:657639
Last Will and Testament
OF
JUSTIN M. STUCKEY
I, JUSTIN M. STUCKEY, of East Pennsboro Township, Cumberland County,
Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make,
publish and declare this as and for my Last Will and Testament, hereby revoking and making void
any and all Wills or Codicils at any time heretofore made by me.
ARTICLE I
DEBTS
I direct the payment of all my legal debts and the expenses of my last illness and funeral
from my estate as soon after my death as conveniently may be done.
ARTICLE II
SPECIFIC BEQUESTS
I give and bequeath all of my guns, rifles and firearms unto my son, RALPH E.
STUCKEY,provided he survives me.
ARTICLE III
TANGIBLE PERSONAL PROPERTY
I give and bequeath the remainder of my household goods and personal effects and other
tangible personalty of like nature (not including cash or securities), together with any existing
insurance thereon, unto those of the following of my children, JANE E. BIDDLE, JEAN E.
RAISNER and RALPH E. STUCKEY, who survive me, to be divided among them with due
EXHIBIT A
regard for their personal preferences in as nearly equal shares as is practical. If there is a
disagreement as to the disposition of any item described in the Article, I direct that it shall be sold
and distributed in accordance with Article IV hereafter.
ARTICLE N
REST,RESIDUE AND REMAINDER
I give, devise and bequeath all the rest, residue and remainder of my Estate, of whatever
nature and wherever situate in equal shares unto those of the following of my children, JANE E.
BIDDLE, JEAN E. RAISNER and RALPH E. STUCKEY. If either of my daug_b_ters, JANE E.
BIDDLE or JEAN E. RAISNER, predeceases me, I give, devise and bequeath such deseaced
daughter's share unto her then living issue, per stirpes. If my son, RALPH E. STUCKEY,
predeceases me, I direct that his share shall be divided equally between my daughters, or the then-
living issue of either who may then be deceased.
ARTICLE V
TRUST FOR BENEFICIARY(IES)UNDER THE
AGE OF 25/INCAPACITATED BENEFICIARIES
Whenever my Personal Representative is directed to distribute property to or for the
benefit of any beneficiary who is under (a) twenty-five years of age, or (b) a legal disability or
otherwise suffers from an illness or mental or physical disability that would make distribution
directly to such beneficiary inappropriate (as determined in my Personal Representative's sole
discretion exercised in good faith), my Personal Representative may distribute such property to the
person who has custody of such beneficiary, may apply such property for the benefit of such
beneficiary, may distribute such property to a custodian for such beneficiary, whether then serving
or selected and appointed by my Personal Representative (including my Personal Representative),
under any applicable Uniform Transfers to Minors Act— or Uniform Gifts to Minors Act, or may
2
distribute such properly directly to such beneficiary without liability on the part of my Personal
Representative to see to the application of such property. ' This provision shall not in any way
operate to suspend such beneficiary's absolute ownership of such property or to prevent the
absolute vesting thereof in such beneficiary.
ARTICLE VI
POWERS OF FIDUCIARIES
My fiduciaries shall have the following powers in addition to those vested by law and by
other provisions of my Will applicable to all property, whether principal or income, including
property held for minors, exercisable without court approval and effective until actual distribution
of all property:
A. To make distribution in cash or in kind, or partly in cash and partly in kind,
and in such manner as my fiduciaries deem appropriate.
B. To retain any.or all of the assets of my estate, real or personal, without
restriction to investments authorized for Pennsylvania fiduciaries, as they
deem proper,without regard to any principle of diversification or risk.
C. To invest in all forms of property without restriction to investments
authorized for Pennsylvania fiduciaries;as they deem proper,without regard
to any principle of diversification or risk.
D. To sell at public or private sale, to exchange, or to lease for any period of
time any real or personal property and to give options for sales, exchanges or
leases, for such prices and upon such terms or conditions as they deem
proper.
3
a
E. To allocate receipts and expenses to principal or income or partly to each as
they from time to time think proper.
F. To compromise any claim or controversy.
G. To. make such elections, decisions, concessions and settlements in
connection with all income, estate, inheritance, gift, generation skipping or
other tax refunds and the payment of such taxes as my Personal
Representative and/or Trustee shall deem appropriate, without obligation to
adjust the distributive share of any person thereby affected.
ARTICLE VII
PERSONAL REPRESENTATIVE
I name, constitute and appoint my son, RALPH E. STUCKEY,Executor of this my Last
Will and Testament. Should he fail to qualify or cease to so act, I name, constitute and appoint
my daughter, JEAN E. RAISNER, alternate Executrix to complete the administration of my
Estate. I direct that no fiduciary acting under this Will, whether or not named herein, shall be
required to give bond for the faithful performance of the duties in any jurisdiction.
IN WITNESS WHEREOF,I have hereunto set my hand and seal to this,my Last Will and
Testament,this qday of C 2012. ----
(SEAL)
?IN�M. STdIeJOEY
4
Signed, sealed, published and declared by the above-named Testator, as and for his Last
Will and Testament, in the presence of us, who at his request, in his presence and in the presence of
each other,have hereunto subscribed our names as witnesses.
/2"
5
0
AFFIDAVIT AND ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF CUMBERLAND
We, JUSTIN M. STUCKEY, YY1 a tJ G e C and
j I LI SSS E 5 tom-, the Testator and the witnesses, respectively,
whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby
declare to t1h&-mid-,ersigned authority that the Testator signed and executed the instrument as his Last
Will and that he had signed willingly and that he executed it as his free and voluntary act for the
purposes therein expressed, and that each of the witnesses, in the presence and hearing of the
Testator, signed the Will as witness and that to t e best of his/her knowledge the Testator was at
that time eighteen years of age or older, of sound mi d and un er no constrai o undue i uence.
JU M. STUCKE ,
Witness /f
Witness
Subscribed, sworn to and acknowledged before me by JUSTIN M. STUCKEY, Testator,
and subscribed and sworn to before me by E
A M u d 6 , M V e-P`S and
5(Iv\ ,witnesses,this « day of `j Ct d' ,2012.
Notary Public
:484671
COMMONWEALTH OF PENNSYLVANIA
NOTARIAL SEAL
Gail J.Mahoney,Not:ry Paablie
Lemoyne Borough,Cumbland County
My commission expires Februuy 19,2014
6
OMB Approval No.2502-0265
A. Settlement Statement (HUD-1)
Type of Loan
Ltn FHA 2.E]RHS 3.F1 Conv.Unins. 6,File Number, 7.Loan Number: 8.Mortgage Insurance Case Number:
t� :f
C.Note:This form is n�h d to give Y. a statement of actual settlement costs.Amounts paid to and by the settlement agents are shown.Items marked
"(p.o.c)"were paid outside the, osing;they are shown here for informational purposes and are not included in the totals.
D.Name&Address of Borrower. E.Name&Address of Seller: F'Name&Address of Lender.,
CHARLES D.SMITH,JENNIFER L SMITH THE ESTATE OF JUSTIN 9 STUCKEY,JR ALSO 13 Lending,Inc.
139 Landisburg Rd.,Shermans Dale,PA 17090 KNOWN AS JUSTIN M.STUCKEY 379 W Uwchian Avenue,Ste.201,
204 High Street,Summardale,PA 17093 Downingtown,PA 19343
G.Property Location: H.Settlement Agent., 1.Settlement Date.,09/19/2014
2G4 HIGH STREET,EAST PENNSBORO Homesale Settlement Services Disbursement Date:09/19/2D14
TOWNSHIP 4000 Crums Mill Road,Suite 101,Harrisburg,PA 17112
SUMMERDALE,PA 17093
East Permsboro Township 717-671-9876
Place of Settlement: TitleExpress
BHHS HomeSale Services,3435 Market Street,Camp.1-1111, Printed 09/19/2014 at 11:36 am
by SH
PA 17011
10D. Gross Amount Due from Borrower 400. Gross Amount Due to Seller
101. Contract sales p(ice 132,500.00 401. Contract sales price 132,500.OD
102. Personal pmperty 402, Personal pro
103, Settlement charges to borrower(line 1400) 5,959A9 403.
104. 404.
105. 405.
Adjustments for items paid by seller in advance Adjustments for items paid by seller in advance
106. City/town taxes to 406. City/town taxes to
107. County taxes 09119/2014 to jwwou 145.88 407. County taxes 09/19/2014 to 12131/2014 145.88
108. School taxes 09119/2014 to 06/30/2015 1,229.62 408. School taxes 09/19/2014 to 06/30/2016 1,229.62
109. sewer 09/lWO14 to 0913012014 11,93 409. Sewer 09/19/2014 to 09/3012014 11.93
110. 410.
ill. 411.
112 412.
120. Gross Amount Due from Borrower 139,846.92 420. Gross Amount Due to Seller 133,887.43
20D. Amounts Paid by or in Behalf of Borrower 500. Reductions In Amount Due to Seller
201. Deposit or earnest money 1,000.00 601. Excess deposit(see instructions)
2OZ pfincipal amount of new loan(s) 125,875.00 502. Settlement charges to seller(line 1400) 11,442.00
203. Existing loan(s)taken subject to. 503. Existing loan(s)taken subject to
204. 5X Payoff of first mortgage loan
205. 505. Payoff of second mortgage loan
206. 506.
207 507.
208, Seller Assist 2,500.00 508. Seller Assist 2,500.00
209. 509.
A*stments for llama unpaid by seller Adjustments for items unpaid by seller
210. Cityltown taxes to 510. City/town taxes to
211. County taxes to 511. County taxes to
212- School taxes to 512. School taxes to
213. 513.
214. 514,
215. 515.
216. 516.
1217. 517.
218. 618.
219. 519.
220. Total Paid by1for Borrower 129,375.00 520. Total Reduction Amount Due Seller 13,942.00
300. Cash at Settlement from/to Eorrower 600. Cash at Settlement tolfrom Seller
301. Gross amount due from borrower(line 120) 139,846-92 601. Gross amount due to seller(line 420) 133,887.43
302. Less amounts paid by/for borrower(fine 220) 129,375.00 602. Less reductions in amount due seller(line 520) 13,942.OD.
303. Cash FXJ From n To Borrower 10,471.92 603. Cash nX To n From Seller 119,945.43
ExHiBIT B
Irevious editions are obsolete Page I of 4
__
700. Total Real Estate Broker Fees .$7,950.00 Paid From Paid From
Division of commission(fine 700)as follows: Borrower's Seller's
L7O4.
$3,975.00 to REMAXREALTYASSOCIATES Funds at Funds at
. $3,975.00 to Berkshire HathawayHomeServices Settlement Settlement
. Commission paid at sedlement7 950 00
Broker Fee to Berkshire Hathaway HomeServices 300.00
705. Broker Fee to ReMax Really Assoc. 295,Op
=credit
Pa able in Connection with Loan
rigination charge (Includes Origination Point 0.000%or$0.00) $900.00 (from GFE#1)
redit or charge(points)for the specfic interest rate chosen $ (from GFE#2)
djusted origination charges (from GFE A) 900.00
isal fee to Nationwide A raisal, $420.00 P.O.C.B (from GFE#3)
report to UCS (from GFE#3) 85.00
806. Tax service to from GFE#3
807. Flood certification to from GFE#3
BOB. to
900. Items Required by Lender to be Paid in Advance
901. Daily interest charges from - from 09/1912014 to 10101/2014 @$15.0878/day (from GFE#10) 181.05
902. Mortgage insurance premium for months to (from GFE#3)
903. Homeowner's insurance for 1 years to Liberty Mutual (from GFE#11) 706.00
904. months to from GFE#11)
1000.Reserves De osited with Lender
1001. Initial deposit for your escrow account (from GFE#9) 698.19
1002.Homeowner's insurance 3 months @$ 58.83/month $176.49
1003.Mortgage insurance months @$ 56.641month $
1004.Property taxes months @$ lmonth
1005.County taxes 8 months @$ 42.67/month $341.36
1006.School Taxes 4 months @$ 131.23/month $524.92
1007.Aggregate Adjustment $-344.58
1100.Idle Charges
1101.Title services and lender's title insurance from GFE#4 1,423.00
1102. Settlement or closing fee to $
1103.Owners fide insurance-Old Republic Title Insurance Company from GFE 141.50
1104. Lenders Ude insurance-Old Republic 710e Insurance Company $1,305.00
1105.Lenders fide policy limit$125,875.00 Lenders Policy
1106.Owners We policy limit$132,500.00 Owners Policy
1107.Agent's portion of the total Ode insurance premium $1,176.13
to Homesale Settlement Services
1108. Underwriters portion of the total Ode insurance premium $270.37
to Old Republic Title Insurance Company
1109.
1200.Government Recording and Transfer Charges
1201. Government recording charges $ (from GFE#7) 192.00
1202 Deed$79,00 Mortgage$113.00 Release$
1203.Transfer taxes $ (from GFE#8) 1,325.00
1204.City/County tax/stamps Deed$1,325.00 Mortgage$
1205.State Tax/stamps Deed$1,325.00 Mortgage$ 1,325.00
1206. Deed$ Mortgage$
1300.Additional Settlement Charges
1301.Required services that you can shop for (from GFE#6)
1302 to $
1303.Inheritance Tax Escrow to CPSS Escrow Account 1,000.00
1304.Tax Certification to Homesale Settlement Services 10.00
1305. Notary Fee to Notary Public 1200
1305.Trash 9119114 to 9130/14 to East Pennsboro Township 7.75
1307,Radon Mitigation to American Radon Solutions 850.E
_, "WIMMM.MOTOWN5,959.49 11,442.00
`Paid outside of closing by(B)orrower,(S)eller,(L)ender,(I)nvestor,Bro(K)er,-Credit by lender shown on page 1.-Credit by seller shower on page i.
r
>revious editions are obsolete Page 2 of 4 HUD-1
N
mof Good Fab Estimate GF and HUD•1 Ghar es Good Faffh Es6mafe HUD-1
atCannotlncrease HUD•1LineNumber oncharge. 801" 900.00 900.00
r:charge,{pofnfsj`for the specific interest rate chosen #. 802 p"pp 0.00
d origination charges+ # 803 90000 900 00
es .• # 1203 1,325.00 1,325.00
',Char es That.fn..Total:Cannbt increase More Than lO% Good Faithsstimate HUD 1
:,Government iecording:chargas,....•." , " #..1201. ,• 151.00 192.00
.A ralsaf fee. ;
804'.. 450.00 420.00
.Credit report: 50.00 85.00
Tqe services and.lendefs title insurance #.1101_.;;.: 1,354.00 1,423.00
Owne s,Gtle-insurance-Old Republfc Tftle lnsurance Company„ -# 1103: 180.00 141.50
# 1302 : 0.00 O.DO
2,185.00 2,261.50
$ 76.50 or 3.5011
.-Charges That Can Chah e:: Good.Faith'Estimate �HUD-1
Initial deposit for.your•escrow acx Dunt # 1001 --2,759.00 698.19
Baily intemst.charges from. .. # 901 $15.0878/da 241.40 — 181.05
..HomeawnV.s insurance #903 660.00 --"— 706.00
Loan Terms
Your init alloan amount is $125,875.00
Your loan t'errn is' 3O,years
Your initial ihferest,rate:is 4.3750%
Your•in'�fial monthly amount owed:far`principal,.interest;and anyinorlgage $685.12 includes
insuiance"is"..: . ❑X Principal
❑X Interest
X❑Mortgage Insurance
Can ytiui interest rate iise?' X❑No. ❑Yes,ii can dse to a masdmum of %.The first change
will be on ! / and can change again every years after ! ! . Every
change date,your interest rate can increase or decrease by %. Overthe I'rfe of
the loan,your interest rate is guaranteed to never be tower than %or higher
than %.
Everi if.you;inakepayments�on time„Can pour.idan.balance ase? X❑Nc. ❑Yes,it can rise to a maximum of$
Evan ifyou mafce,paymentg on-time,can your monthly ainguot Dived`#or'; [X]No. ❑Yes,the first increase can be on 1 t and the monthly
principal;interest and mortgage insurance rise?.'' amount owed can rise to$
The maximum it can ever rise to is$
Does you�daari;have'a:prepayment penaltyt. :. Q No. El Yes,your maximum prepayment penalty is$
Does your loan.have a balloon payment? X❑No. ❑Yes,you have a balloon payment of$ due in
years on t !
Totat"mohthly aino>znf Dived including escrow account payments: F1You do not have a monthly escrow payment for items,such as property taxes
and homeowner's insurance.You must pay these items directly yourself.
0 You have an additional monthly escrow payment of$232.73
that results in a total initial monthly amount owed of$917.85.This includes principal,interest,any
mortgage insurance and any items checked below:
[X "Property taxes Q Homeowner's insurance
Flood insurance
FX]School taxes
❑ ❑
Vote: If you have any questions about the Settlement Charges and Loan Terms listed on this form,please contact your lender.
r
'revious editions are obsolete Page 3 of 4 HUD-1
t
HUD CERTIFICATION OF BUYER AND SELLER
I have carefully reviewed the HUD-1 Settlement 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 certify that I have received a copy of the HUD-1 Settlement Statement
CHARLES D.SMITH JENNIF�RL,SMI
THE'ESTATE CIP JUSTIN M.STUCKEY,JR ALSO OWN AS JUSTIN M.
r
The HUD-1 Settlement Statement which I have prepared is a true and accurate account of this transaction I have caused or will cause the funds to be
disbursed in accordance with this statement
SETTLEMENT AGEk' DATE
r
r
NARNING IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORK PENALTIES UPON
;ONVICTION CAN INCLUDE A FINE AND IMPRISONMENT.FOR DETAILS SEE TITLE 18:U.S.CODE SECTION 1001 AND SECTION 1010.
'revious editions are obsolete Page 4 of 4 HUD-1
December 18,2012
Johnson Duffie
301 Market Street
PO Box 109
Lemoyne PA 17043-0109
Account Numbers(s) 104752 3065734
Type of Account Checking CD
Date Opened July 3, 1984 March 29,2008
Principal Balance $13,794.34 $2,957.02
Maturity Date March 29,2014
Name of Primary Owner Justin M Stuckey Justin M Stuckey
Name of Joint Owner,if any
Account Number(s)
Type of Account
Date Opened
Principal Balance
Maturity Date
Nance of Primary Owner
Name of Joint Owner,if any
REC IVSD
MAR 9 2013
--.-----._._.1_C1-H_NI:�.tl.tiLric --- --
6PUft ! 10/vs ExHieIr --
C
3�1��a3
Buy & Sell on Commission - Complete Sale Service .
93 Texaco Rd.,.Mechanicsburg, PA 17055 766-5785
Personal Property of
Ad ss
Sold At Public Sale N d e ;f,? 20 1?
Outstanaliwig Total Sale � � �a7l b
Total-Checks
Total Cash
Cash After layout
Expenses
Auctioneer& Clerks
Aew. Cast
Property Fee - /g� d, do
Sale Seton or Help ���c 49b
Total Expenses
SO F
EXHIBIT D
BRICKERS AUCTION
Butt & Sell on Commission - Complete Sale Service .
93 Texaco lid., Mechanicsburg, PA 17055 766-6785
r
Personal Propefty of
Adfress
'told At lilac Sale } 6 .� 20 ti D
Outstanding Total Sale
Total-Checks
Total Cash
Cash After Payout
Expenses
Auctioneer & Clerks `
Adv. Cost l�
Sale Setup or Reba �/Y
Total menses �3 q
. wq�
CPAZ*_
EXHIBIT E
a
BRICKERS AUCTION
Buy & Sell on commission - Complete Sale Service .
93 Texaco Bd.,•Mechanicsburg,, PA 17055 766-6785 '
Personal Property of ovv i I A) S Tv FILE
Adss
old
At palflec sale . C 20
Outstanding Total sale
Total-Checks
Total lash 2-t, �t?
Cash After Payoff
Expenses
Auctioneer& Clerks 36 0, b�
Acle. Cost
Sale setup or Help
Total menses
24 5-91 Fuld
s Wqcvj-s p ojp .
lEXHIBIT F
BRICKERS AUCTION
Buy & Sell on Colrnliilssicn - Complete Sale Service .
93 Texaco loci., Mechanicsburg, PA 17055 766-6785
Personal Property of
Address
.Saki At Public Sale ` s1 -? 20
Outstanding Total Sale
Total.Checks2 7,
Total cash
Cash After Payout
Expenses
Auctioneer & clerks A/
Adv. Cost
Property Fee
Sale Setup or Help
Total Expenses _
EXHIBIT G
COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT.280601
HARRISBURG,PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 018975
STUCKEY RALPH E
217 TOWPATH ROAD
DUNCANNON, PA 17020
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
-------- fold
__________ --------
101 $10,000.00
ESTATE INFORMATION: SSN:
FILE NUMBER: 2113-0104
DECEDENT NAME: STUCKEY JUSTIN M
DATE OF PAYMENT: 04/03/2014
POSTMARK DATE: 04/02/2014
COUNTY: CUMBERLAND
DATE OF DEATH: 12/18/2012
TOTAL AMOUNT PAID: $10,000.00
REMARKS: RECEIPT TO ATTY
CHECK# 1023
INITIALS: DMB
SEAL RECEIVED BY: LISA M. GRAYSON, ESQ.
REGISTER OF WILLS
TAXPAYER
EXHIBIT H
tnf4
V