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Home My WebLink About03-03-15 (2) � 1505610140 REV-1500 EX (02-11)(FI) PA Department of Revenue OFFICIA�USE ONLY Bureau of Individual Taxes County Code Year File Number Po Box 2soso� INHERITANCE TAX RETURN Harrisbur , PA 1�128-0601 RESIDENT DECEDENT 2 � 1 4 � 5 7 1 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 1 6 0 0 6 0 4 2 0 1 4 0 1 2 9 1 9 5 0 DecedenYs Last Name Suffix DecedenYs First Name GARELL - SHUEY M� L OU I S E q (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 FfLL IN APPROPRIATE OVALS BELOW a 1.Original Return 2. Supplemental Return ❑ � 3. Remainder Return(Date of Death ❑ Prior to 12-13-82) 4. Limited Estate � 4a. Future Interest Compromise(date of � 5. Federal Estate Tax Return Required death after 12-12-82) QX 6. Decedent Died Testate � 7. Decedent Maintained a Living Trust � 8.Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) � 9. Litigation Proceeds Received � 10. Spousal Poverty Credit(Date of Death � 11. Election to Tax under Sec. 9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number DAVI D R . GAL LOWAY , ESQ . 71 7 697 4650 REGISTER OF WILLS USE ONLY First Line ofAddress 4-.� i-:J; c� �-`�' `�;� f� 5 4 E . M A I N S T R E E T �>; � -� f':; <--� -� _s:� .°_ c� Second Line of Address t ;.-�, :� � ,�;;� ,.... � � : • � . � City or Post Office DATE FILFp + State ZIP Code �. . � :•_ � MECHANI CSBURG PA 1 70 55 ' � �� _ ., ►--. . �..� o ' : �.�.� Correspondenrs e-maii address: david(a�waltersgalioway.com � "''' �� Under penalties of peryury,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 compiete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. ATURE PER RE ONSIBL F�R FILING RETURN �� 1 I�E ,, D SS E NIF R G. PENWELL 239 HULLS HWY SOUTHPORT CT 06890 ATU ER OTHER THAN REPRESENTATIVE �A ADDRESS �� DAVID R. G LOWAY, ESQ.54 E. MAIN ST. MECHANICSBURG PA 17055 PLEASE USE ORIGINAL FORM ONLY Side 1 � 1505610140 1505610140 �' � Continuation of REV-1500 Inheritance Tax Return Resident Decedent LOUISE A. GARELL-SHUEY 21 14 0571 DecedenYs Name Page 3 File Number Correspondents Name Daytime Telephone Number First line of address Second line of address City or Post Office State ZIP Code CorrespondenYs e-mail address: Under penalties of perjury,I declare that I have examined this retum,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. SIGNA E O PE�OP�pON��E FOR FILING RETURN DATE L�� ` �� .r�.c /l Z"" I S�-' S pnnRFcc il DAVID J. GARELL 3004 JOSHUA ROAD LAFAYETTE HILL PA 19444 J 1505610240 REV-1500 EX(FI) DecedenYs Social Security Number DecedenPswame: LOUISE A. GARELL-SHUEY RECAPITULATION 1. Real Estate(Schedule A) . . . . . . . .. . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . 1. � 4 2 5 0 0 , 0 0 2. Stocks and Bonds(Schedule B) . . . . . . . . . . . . . . . . . . .. .. . . . . . . . . . . . . . . . . 2. • 3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . . . . . 3. . 4. Mortgages and Notes Receivable(Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . 4. . 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . . . . 5. 9 5 8 6 3 , $ � 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . . . . . . 6. � 2 9 9 5 . 9 2 7. Inter-Vivos Transfers�Miscellaneous Non-Probate Property (Schedule G) � Separate Billing Requested . . . . . . . 7. 6 2 1 8 4 3 � 5 9 8. Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. $ 7 3 2 � 3 , 3 2 9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9. 2 Z 2 $ 2 . 3 2 10. Debts of Decedent,Mortgage Liabilities, and Liens(Schedule I) . . . . . . . . . . . . . 10. 2 5 5 9 $ . 6 2 11, Totai Deductions(total lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 4 7 8 $ � . 9 4 12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . .. . . . . . . . . . . . . . . . . . . . 12. $ 2 5 3 2 2 . 3 $ 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) . . . . . . . . . . . . . . . . . . . . . . 13. 2 � � 0 . Q Q 14. Net Value Subject to Tax(Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . 14. 8 2 3 3 2 2 . 3 $ TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 (a)(1.2)X�0 _ � . � O 15. O . � � 16. Amount of Line 14 taxable at�inea�rate X.045 8 2 3 3 2 2 . 3 8 �s. 3 7 0 4 9 . 5 1 17. Amount of Line 14 taxable at sibling rate X.12 � . 0 � 17. Q . Q � 18. Amount of line 14 taxable at collateral rate X.15 � . � � �g. 0 . Q � 19. TAX DUE .. . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 3 7 0 4 9 . 5 1 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT � Side 2 L 1505610240 1505610240 J REV-1500 EX(FI) Page 3 File Number Decedent's Complete Address: 21 14 0571 OECEDENT'S NAME LOUISE A. GARELL-SHUEY STREETADDRESS 325 WESLEY DRIVE CITY STATE ZIP MECHANICSBURG PA 17055 Tax Payments and Credits: 1• Tax Due(Page 2,Line 19) (1) 37,049.51 2. Credits/Payments A.Prior Payments 30.000.00 B.Discount 1,852.48 Total Credits(A+g) �2) 31,852.48 3. Interest 4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT. �3� Fill in oval on Page 2,Line 20 to request a refund. (4) 0.00 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 5,197.03 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 ...................................................................... � Q b. retain the right to designate who shali use the propeRy transferred or its income ............................... ❑ Q c. retain a reversionary interest ..................................................................................................... ❑ � d. receive the promise for life of either payments,benefits or care? ....................................................... � 0 2. If death occurred after December 12,1982,did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... ❑ Q 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?.................................................................................................. � ❑ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. � � - - „ e � °:� e . For dates of death on or after July 1, 1994,and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is is 3 percent[72 P.S.§9116(a)(1.1)(i)]. For dates of death on or after Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and flling 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 decedenYs lineai beneficiaries is 4.5 percent,except as noted in p2 P.s.§s��s(a)(��. • The tax rate imposed on the net value of transfers to or for the use of the decedenYs siblings is 12 percent[72 P.S.§9116(a)(1.3)].A sibling is defined, under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption. REV-1502 EX+(12-12) pennsylvania SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF: FILE NUMBER: LOUISE A. GARELL-SHUEY 21 14 0571 All real propeity owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts. Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1. RESIDENCE SITUATED AT 486 BRIGHTON PLACE, MECHANICSBURG, PA 17055 142,500.00 VALUE IS ACTUAL SALE PRICE TOTAL(Also enter on Line 1,Recapitulation.) $ 142 500.00 If more space is needed,use additional sheets of paper of the same size. REV-1508 EX+(08-12) pennsylvania SCHEDULE E DEPARTMENTOFREVENUE CASH, BANK DEPOSITS � MISC. INHERITANCE TAX RETURN RESIDENTDECEDENT PERSONAL PROPERTY ESTATE OF: FILE NUMBER: LOUISE A. GARELL-SHUEY 21 14 0571 Include the proceeds of litigation and the date the proceeds were received by the estate. Ail property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. SUSQUEHANNA VALLEY FEDERAL CREDIT UNION 77,946.68 SAVINGS ACCOUNT XXXX8220 2. SUSQUEHANNA VALLEY FEDERAL CREDIT UNION 13,356.30 CHECKING ACCOUNT XXXX8220 3. SOCIAL SECURITY 1,861.00 PAYMENT 4. HARDY'S AUCTION SERVICE 770.80 HOUSEHOLD ITEMS-NET VALUE 5. ADJUSTMENTS FOR ITEMS PAID BY ESTATE IN ADVANCE-REAL ESTATE 1,627.42 REAL ESTATE TAXES, HOA DUES&SEWER-PRO-RATIONS 6. VISA BILL 19.95 REFUND FOR OVERPAYMENT 7. PSER'S 247.88 PAYMENT 8. EZPASS 33.78 REFUND TOTAL(Also enter on Line 5,Recapitulation) $ g5 863.81 If more space is needed, use additional sheets of paper of the same size. REV-1509 EX+(01-10) pennsylvania SCHEDULE F DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: LOUISE A. GARELL-SHUEY 21 14 0571 If an asset was made jointly owned within one year of the decedenYs date of death,it must be reported on Schedule G. SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A.JENNIFER G. PENWELL 239 HULLS HIGHWAY DAUGHTER SOUTHPORT, CT 06890 B. S. PENWELL 239 HULLS HIGHWAY SON-IN-LAW SOUTHPORT, CT 06890 c. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. AB SUSQUEHANNA VALLEY FEDERAL CREDIT UNION 21,863.31 33.33 7,287.04 SAVINGS ACCOUNT XXXX9645 2. AB SUSQUEHANNA VALLEY FEDERAL CREDIT UNION 3,626.99 33.33 1,208.88 CHECKING ACCOUNT XXXX9645 3 A 2006 ACURA TSX 9,000.00 50. 4,500.00 SALE PRICE TOTAL(Also enter on Line 6,Recapitulation) S 12 995.92 If more space is needed,use additional sheets of paper of the same size. REV-1510 EX+(08-09) pennsyivania SCHEDULE G DEPARTMENTOF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCETAXRETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER LOUISE A. GARELL-SHUEY 21 14 0571 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. DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OF THE TRANSFEREE,THEIR RELATIONSH�P TO DECEDENTAND DATE OF DEATH %OF DECD�S EXCLUSION TAXABLE NUMBER THE DATE Of TRANSFER.ATTACH A COPY OF THE DEED FOR REAL ESTATE. VA�UE OF ASSET INTEREST (IFAPPLICABLE) VALUE 1. OPPENHEIMER FUNDS 64,851.30 100.00 64,851.30 2. MASS MUTUAL IRA 556,992.29 100.00 556,992.29 TOTAL (Also enter on Line 7,Recapitulation) $ 621 843.59 If more space is needed,use additional sheets of paper of the same size. REV-1511 EX+(OS-13) pennsylvania SCHEDULE H DEPARTMENTOFREVENUE FUNERAL EXPENSES AND INHERITANCETAXRETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER LOUISE A. GARELL-SHUEY 21 14 0571 DecedenYs debts must be reported on Schedule[. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. FUNERAL-MYERS BUHRIG FUNERAL HOME 12,712.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: �• Name(s)of Personal Representative(s) Street Address ��Y State ZIP Year(s)Commission Paid: 2, Attomey Fees: WALTERS &GALLOWAY, PLLC 8,000.00 3. Family Exemption:(If decedenPs address is not the same as claimanPs,attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4� Probate Fees: REGISTER OF WILLS, CUMBERLAND COUNTY 448.50 5 Accountant Fees: 300.00 FIDUCIARY RETURN -BARBUSH &HOFFMAN, CPA(estimated) 6. Tax Retum Preparer Fees: 550.00 2014 PERSONAL INCOME TAX -BARBUSH &HOFFMAN, CPA 7. ESTATE NOTICE PUBLICATION-CUMBERLAND LAW JOURNAL 75.00 8. ESTATE NOTICE PUBLICATION-THE PATRIOT NEWS 196.82 TOTAL(Also enter on Line 9,Recapitulation) $ 22 282 32 If more space is needed,use additional sheets of paper of the same size. REV-1512 EX+(12-12) pennsylvania SCHEDULE I DEPARTMENTOFREVENUE DEBTS OF DECEDENT� INHERITANCETAXRETURN MORTGAGE LIABILITIES& LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER LOUISE A. GARELL-SHUEY 21 14 0571 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. REDUCTIONS IN AMOUNT DUE ESTATE-REAL ESTATE 12,557.79 REAL ESTATE COMMISSIONS&TRANSFER TAXES 2. PPL ELECTRIC 262 88 486 BRIGHTON PLACE, MECHANICSBURG, PA 17055 3. UNITED WATER 61.23 486 BRIGHTON PLACE, MECHANICSBURG, PA 17055 4. BRIGHTON PLACE 1,506.00 HOMEOWNERS ASSOCIATION &ROOF ASSESSMENT 5. SCHOOL REAL ESTATE TAXES 627 99 FIRST INSTALLMENT 6. UPPER ALLEN TOWNSHIP 112.00 SEWER-BILLING PERIOD FROM 4/1 -6/30 7. REPUBLIC SERVICES 6.51 TRASH BILL 8. TERMINEX 126.14 EXTERIOR PEST CONTROL 9. DAVID GARELL 2�2 89 REIMBURSEMENT FOR TRASH BAGS, DISPOSAL, DUMP FEES 10. REBECCA HECKENDORN 200.00 CLEANING OF PRIMARY RESIDENCE 11. JENNIFER POWELL 42 29 REIMBURSEMENT FOR CELL PHONE CHARGES INCURRED BEFORE DEATH 12. DANBURY MINT 84.39 INVOICE FOR PURCHASE MADE BEFORE DEATH 13. HARLAND CLARKE 17.03 ESTATE CHECKS 14. TRAVELER'S INSURANCE 341.19 PRORATED PREMIUM 15. THE MEDICINNE SHOPPE 199.45 MEDICATION TOTAL(Also enter on Line 10,Recapitulation) $ 25 598.62 If more space is needed, insert additional sheets of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent LOUISE A. GARELL-SHUEY 21 14 0571 DecedenPs Name Page 2 File Number Schedule I - Debts of Decedent, Mortgage Liabilities, & Liens ITEM NUMBER DESCRIPTION AMOUNT 16. BETHANY VILLAGE 8,764.60 EXPENSES 17. BRIDGEPORT RADIOLOGICAL SERVICES 178.34 HOSPITAL SERVICES 18. HERSHEY MEDICAL 34.95 NOVEMBER MEDICAL BILL 19. NEUROLOGICAL SPECIALISTS 29.40 3114/14 HOSPITALIZATION 20. PINNACLE HEALTH 90 �$ TESTS 21. OMNICARE OF CT 39.50 MEDICATION SERVICES 22. NORTHEAST MEDICAL GROUP 43.27 HOSPITAL BILL SUBTOTAL SCHEDULE I 9,180.84 GRAND TOTAL SCHEDULE I $ 25,598.62 REV-1513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: LOUISE A. GAREI.L-SHUEY 21 14 0571 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND AODRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [InGude outright spousal distributions and transfers under Sec.9116(a)(1.2).] 1. LIAM J. MILLER, minor Lineal 1,000.00 602 INDIGO DRIVE DOWNINGTOWN, PA 19335 2. ETHAN B. �IAM, minor Lineal 1,000.00 602 INDIGO DRIVE DOWNINGTOWN, PA 19335 3. ELIZABETH BRIDA, minor Lineal 1,000.00 1159 BROCKTON CIRCLE NEW CUBERLAND, PA 17070 4. ISABELLA BRIDA, minor Lineal 1,000.00 1159 BROCKTON CIRCLE NEW CUMBERLAND, PA 17070 5. JENNIFER G. PENWELL-HALF RESIDUE Lineal 50.00 239 HULLS HIGHWAY SOUTHPORT, CT 06890 6. DAVID J. GARELL- HALF RESIDUE Lineal 50.00 3004 JOSHUA ROAD LAFAYETTE HILL, PA 19444 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 UNOER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. HUMANE SOCIETY OF HARRISBURG 1,000.00 7790 GRAYSON ROAD HARRIABURG, PA 17111 2. ST. PETER LUTHERAN CHURCH 1,000.00 130 NITTANY DRIVE MECHANICSBURG, PA 17055 TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. S 2 000.00 If more space is needed,use additional sheets of paper of the same size. LAST WILL AND TESTAM�NT �� :_,� -'7 r.� OF I give, devise and bequeath all of the rest, residue and remainder of my estate, whatever the nature of such property may be whether real, personal or mi:ced, to my two beloved children. DAVID J. GARELL and JENNIFER GARELL PENWELL. (including Ron's remaining art work.) Each of my children is the get Fifty (50) percent to be divided equally, provided that they survive me. If they cannot agree within 90 days, then I want my Executor(s) to sell the property and, or assets and split the proceeds. If one of my children is not living at my death, then I leave all my assets and personal property to the living child. If neither of my children are living at my death, but either or both of my children have � issue (living or in the womb), I want my estate to be divided equally for each of my grandchildren and the money put in a trust for each child (separately) if the`Tchild/ children is/are under age eighteen (18) to expend and apply so much of the net income (any income not expended or applied to be accumulated and added to the principal). The Trustee should be a bank for continuity. The funds can be used for the child's care. for support and education (including college education, both graduate and undergraduate) , � APPOINTMENT OF FIDUCIARIES .1 Executor. I nominate, constitute and appoint iny both children, David J. Garell and Jennifer Garell Penwell, to jointly serve as my Executors of my Last Will and Testan�ent. In the event of renunciation, death, resignation, or inability to act for and reason whatsoever of one of my children, the other child can serve separately. If it is more convenient for one child to settle the estate, it is my wish that the Executor conduct my Estate with as much transparency as possible. No bond shall be required of any Executrix under this will. Page 2 of 6 `� �� ''� L�, ' .�7 /; —;�'��:'�.,,. :{��.> � (� � % i - -- ir..� � ��'�y'�)�C�u)y � � /I �� ,� r Date C��?-��c 2-�= �J ,,� ` /� V /!_�� J .� 2.2 Executor's Authority. In addition to any powers and elective rights conferred by statue of federal law or by other provisions of this will, I do hereby, give the Executrix hereof full power, discretion and authority at anytime or times to sell, at private or public sale,mortgage, lease,pledge, exchange or otherwise deal with or � dispose of the properiy comprising my estate upon such terms as the Executrix hereof deems best, to settle and compound any and all deeds, mortgages, contr�acts, leases, � bills of sale or other instruments necessary or desirable therefore. I grant my Executrix the authority to administer my estate under any procedure for informal or unsupervised administration, or any other available procedure for avoidance of administration or reduction of its burdens. , On�,�j�,�f;�,c� /`�' , 20 /�T in �'�!�m,,/;� �1�� , Pennsylvania. I J ' � hereby sign this document and declare it to be my will. � � `\'�-��r �.�� dj�,,�./,�.,.,��="��"�,,��/ Date: ��ii�„�;` r" -�"'/� �; � Pa�e 3 of 6 LAST WILL AND TESTAMENT OF Louise Ann Garell Shuev In WITNESS WHEREOF, I have set my hand and seal to this, my Last Will and Testament, this /� da of �%.��c;+�.^� � Y A.D., 20 / . For identification, I have also signed the preceding pages thereof. U � r This instrument, consisting of five typewritten pages, each identified by the signature of the Testator/Testatrix was on the date thereof signed, published and declared by the Testator/Testatrix therein named, as and for her Last Will And Testament in the Presence of Us, who at her request, in her presence, and in the presence of each other have subscribed our names as witness hereto. At her request, in her presence, and in the presence of each other, I hereby sign as witness to the execution of this will, believing that Louise is of sound mind'and under no undue influence. I observed the signing of this will by Louise Ann Garell Shuey, and witness that each signature is the true signature of the person whose name was signed. I am more than eighteen years of age and a competent witness and resides at the address set forth after my name. I declare, under penalty of perjury, that the foregoing is true and correct and acknowledge that this Declaration (Last Will and Testament) was executed for the purposes therein contained on I,.,U:;�,�,��l 1;�;,:','<-!i��, at_ ��4�� '�r�'� , Pennsylvania. �. (Date) (Town) Witness % `�� }�/�.'\.'.�.�� Residing at �� % "�:��' �l ��, �. �? r � �-- � ✓�� , �-,; ��`� l, , � r,� I� �,, ��.� �)► � � , , ��, r, 1,1�� Page 4 of 6 � � � � �.% „ � ,� ��-�.`,, , i� '� %, /i. �•:;,��' j ;,,�7_.�._-,'�� <<�l�l �t� • �� ,� �, ;�,L``C) Uate: (: ,.'�':;-• ,,�: i;"' _��i.� J� -�-_- ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA: ` COUNTY OF C� ��',�� . r SS: XXX - XX - � On this�day of_ f��(,�c,�� ' , 2p�, before me, the undersigned authority, personally appeared Witness ,;-��c��; �(�/�',,� C�'f,.�:�i�'G�,C. 5'f�(��/ � l known to be or adequately proven to be the Declarant and witnes�e pectively whose � ��N �f'�rc names are signed in the forgoing instrument, who, in the presence of each other, did subscribe their names to the a�tached Declaration (Will) on this date, and at the time of the execution of this Declaration, the Declarant was over eighteen (18) years of age and of sound mind. COMMONWEALTH OF PENNSYLVANIA "'� � � --" " ' � � � Notarial Seal � �' „��` _ �� patrida Shaffer,Nota�Y�blic ►.ower Allen Twp,,Cumbertand County Notarv Public My Commisslon Fxplres l�•6�z015 �; MEMBER,PENNSYLVANIA PSSOC�AnON OF NOTARIES Page 5 of c� Date� � r r Paee 6 of 6 �,.-�� OMB Approval No.2502-0265 ��•``'� A. Settiement Statement HUD-1 `�:�I�i�l�; ( ) 1.❑FHA 2.Q RHS 3.Q Conv.Unins. 6.File Number. 7.Loan Number: 8.Mortgage Insurence Case Number. 14387 MBG1407051342 4.�VA 5.❑Conv.Ins. C.Note:This form is furnished to give you 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 closing;they are shown here for informational purposes and are not includetl in the totals. D.Name&Address of Borrower: E.Name&Address of Seller. F.Name&Address of Lender: Robert Neidigh,Dixie Lee Neidigh The Estate of Louise Shuey � Residential Mortgage Services,Inc. 2621 Tamela Avenue,Dover,PA 17315 486 Bnghton Place,Mechanicsburg,PA 17055 24 Christopher Toppi Drive,Soufh Portland,ME 04106 G.Property Location: H.Settlement Agent: I.Settlement Date:10/O6/2014 486 Brighton Place 1stAdvantage Settlemen[Services Inc. Disbursement Date:10/06/2014 Mechanicsburg,PA 17055 6375 Mercury Drive,Suite 102,Mechanicsburg,PA 17050 . Upper Allen Township 717-591-7755 Piace of Settlement: TitleExpress 6375 Mercury Drive,Suite 102,Mechanicsburg,PA 17050 Printed 10/06/2014 at 11:42 am by AM 100. Gross Amount Due from Borrower 400. Gross Amount Due to Seller 101. ConVact sales price 142,500.00 401. Contract sales price 142,500.00 102. Personal property 402. Personal property � 103. Settlement charges to bortower(line 1400) 7,865.63 403. � 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/tovm taxes to 107. Counry taxes 10/06/2014 to 12/31l2014 154.56 407. County taxes 10/0612014 to 12/31/2014 154.56 108. School Taxes 10/06/2014 to 06f30/2015 1,355.77 408. School Tazes t0106/2014 to 06/30I2015 1,355.77 109. Monfhly HOA dues 10/O6/2014[0 10/31I2014 11.18 409. Monthly HOA dues 10/06/2014 to 10/31/2014 11.18 110. 4th Quarter Sewer 10lO6f2014 to 12/31/2014 105.91 410. 4th Quarter Sewer 1 0/0 61201 4 to 12/31/2014 105.91 111. 411. 112. 472. �2�• Gross Amount Due from Borrower 151,993.05 420. Gross Amount Due to Seller �44��2�•42 200. Amounts Paid by or in Behaif of Borrower 500. Reductions In Amount Due to Seller 201. Deposit or eamest money 2,500.00 501. Excess deposit(see insWctions) 202. Principal amount of new loan(s) 114,000.00 502. Settlement charges[o seller(line 1400) 12,557.79 203. Existing loan(s)taken subject ro 503. Existing loan(s)taken subject to 204. Lender Credit 427.00 504. Payoff of frst mortgage loan 205. 505. Payoff of second mortgage loan 206. 506. 207. 10%Tolerance Cure 56.90 507. 208. 508. 209. 509. Adjustments for items unpaid by seller Adjustments for items unpaid by seller 210. City/town taxes to 510. Ciry/town taxes to 211. Counry taxes to 511. County taxes to 212. School Taxes to 512. School Taxes to 213. 513. 214. 514. 215. 515. 216. 576. 217. 517. 218. 518. 219. 519. 22�• Total Paid bylfor Bonower 116,983.90 520. Total Reduction Amount Due Seller 12,557.79 300. Cash at Settlement fromlto Borrower 600. Cash at Settlement tolfrom Seller 301. Gross amount due from borrower(line 120) 151,993.05 gp�, Gross amount due to seller(line 420) 144,127.42 302. Less amounts paid by/for bortower(line 220) 116,983.90 602. Less reduc6ons in amount due seller(line 520) 12,557.79 303. Cash � From ❑ To Borrower 35,009.15 603. Cash QX To ❑ From Seller 131,569.63 ,.:oo�:�o.�ie�u�s,�e.�.w��a.e�,��emos �a.�.. m�:s��y m.y�oi�m«i m�:�o om,.uo�,a�ro�,�.om«a��.�a m�omci<i� Nis lerml�nlezs l d sdays a cummtlwllalid OMB cmbd rrumEers�No cmfEentlaliry Is esSu�eE;Ws Nxtlasure Is man0arory.TTk Iz Oesl9^eE iu VrwlOe Ne paNes lo e RESPA covereE PensaNen wi0i inlmmatlm Ounng Ne Previous editions are obsolete Page 1 of 4 HUD-I 700. Total Reat Estate Broker Fees $8,550.00 Paid From Paid From Division of commission(Iine 700)as follows: Borrower'S Seller's 701. g4,275.00 �o The Homestead Group,Inc. Funds at Funds at 702. g4,275.00 to RelMax7stAdvantage Settlement Settlement 8,550.00 703. Commission paid at settlement 704. Commission to Re1MaxlstAdvantage 395.00 705. Broker Fee to The Homestead Group,Inc. 350.00 800. Items Payable in Connection with Loan 801. Our origination charge (Includes Origination Point 0.000%or$0.00) $974.00 (from GFE#t) 802. Your credit or charge(points)for the specific interest rate chosen $855.00.. '' (from GFE#2) 803. Your adjusted origination charges (from GFE A) 1,829.00 804. Appraisal fee to Forrester&Co.Real Estate Appreisers (from GFE#3) 410.00 805. Credit report to Birchwood Credit Services,Inc. (from GFE#3) 92�9� 806. Taz service to (from 6FE it3) 807. Flood certification to First American Flood (from GFE#3) 15.00 808. to 900. Items Required by Lender to be Paid in Advance 901. Daily interest charges from from 10/06/2074 to 11/0112014 @$132740(day (from 6FE#10) 345.12 902. Mortgage Ins.Premium for monfhs to (from GFE#3) 903. Homeowner's insurance for 1 years[o Erie Insurance Exchange (from GFE#11) �9��4 904. months to (from GFE#11) 1000. Reserves De osited with Lender � 1001. Ini6al deposit for your escrow account (from GFE#9) 924.61 1002. Homeowner's insurance 4 months @$ 16.42/month $65.68 1003. Mortgage Insurance months @$ O.00/month $ 1004. City Property Tax months @$ 0.00/month $ 1005. County Property Tax �0 months @$ 54.04/month $540.40 1006. School Taxes 5 months @$ 153.871month $�69.35 _ 1007. Aggregate Adjustment $-450.82 1100. Title Charges 1101. Title services and lender's Gtle insurance S (from GFE#4) 1,430.00 1102. Settlementorclosingfee to $ 7103. Owner s title insurence-First American Title Insurance Company $ (irom GFE#5) 145.00 1104. Lenders title insurance-First American Title Insurance Company $1,295.00 1105. Lenders title policy limit$114,000.00 Lenders Policy 7106. Owner's tltle poliq limit$142,500.00 Owner's Policy 1107. AgenPs portion of the rotal title insurance premium $��1�75 ro tst Advantage Settlement Services Inc. 1108. Underwriters portion ot the total title insurance premium $32225 ro First Amencan TiOe Insurance Company 1109. 15.00 1110. Tax Certification Fee � to 1 st Advantage Settlement Services Inc. 1200. Government Recording and Tans(er Charges 186.00 1201. Govemmentrecordingcharges $ (fmmGFE#7) 1202. Deed$79_00 Mortgage$107.00 Release$ $ (fram GFE it8) 1,425.00 1203. Transfer Wxes 1204. Ciry/County ta�Jstamps Deed$1,425.00 � Mortgage$ 1,425.00 1205. State Tax/stamps Deed$1,425.00 Mortgage$ 1206. Deed$ Mortgage$ 1207. $ 1300. Additional Settlement Charges (from GFE#6) 7301. Required services thatyou can shop for 380.00 1302. Home Warranry to First American Home Buyers Protection Corp 1303. �0 471.00 75.00 1304. Re-sale CertlCapital expenditure fee to Brighton Place Condominium Association 224.00 1305. 3rd Quarter Sewer&41h Quarter Sewer to Upper Allen Tovmship �gg�.7g 1306. 2014/2015 School Tazes to Dennis Zerbe 157.00 1307. October common monthly expense fo Brighton Place Condominium Association . � 7,865.63 12,557.79 �ii . . � � - . .- . . , - i - . - � 'Paid outside of closing 6y(8)orrower,(S)eller,(L)ender,(I)nvestor,Bro(K)er."Credit by lender shovm on page i."'Credit by seller shown on page 1. HUD-1 Page 2 of 4 Previous edi[ions are obsolete Com arison of Good Faith Estimate GFE and HUD-t Char es Good Faith Estimate HUD-1 Char es That Cannot Increase HUD•1 Line Number Our ongina6on charge # 801 974.00 974.00 Your credit or charge(points)for the specif c in[erest rate chosen # 8�Z 855.00 855.00 Your adjusted origination charges q 803 1,829.00 1,829.00 Transfertaxes # 1203 1,425.00 1,425.00 Char es That in Totai Cannot Increase More Than 10% Good Faith Estimate HUD•1 �201 200.00 186.00 Govemment recording charges � 475.00 410.00 Appraisal fee *804 92 90 Credit report #805 65.00 Flood certificafion q 807 15.00 15.00 Title services and lendefs tiUe insurance q 1101 B65.00 1,430.00 Owner's fitle insurance-First American Title Insurence Company �1103 400.00 145.00 q 1307 0.00 0.00 # 2,020.00 2,278.90 � $258.90 or 12.8168% . Good Faith Estimate HUD-1 Char es That Can Chan e 2 s�z 9Z gp4�61 Ini6al deposit for your escrow account !�1001 Daily interest charges from �901 $132740/da t3.27 345.12 Homeowner's insurance q 903 432.00 197.00 � , # # Loan Tertns Your ini6al loan amount is $114,000.00 Your loan[erm is 30.years ' Your ini6al interes[rale is 4.2500% Your initial monthly amount owed for principal,interest,and any mortgage $560.81 includes insurance is �X Principal QX In[erest �Mortgage Insurance Can your interest rate rise7 ❑X No. ❑Yes,i[can rise to a maximum of %.The first change will be on 1 I and can change again every years after I I .Every change date,your interest rate can increase or decrease by %. Over the life of the loan,your interest rote is guaranteed to never be lower than %or higher than %. Even i(you make payments on 6me,can your loan balance rise? QX No. ❑Yes,it can rise to a maximum of$ � Even if you make paymenls on time,can your monthly amount owed for ❑X No. ❑Yes,the 5rst increase can be on / / and lhe monthly principal,interest,and mortgage insurance rise7 amount owed can rise to$ The mazimum it can ever rise to is$ . Does your loan have a prepayment penalty7 QX No. ❑Yes,your maximum prepayment penalty is$ � Does your loan have a balloon payment? QX No. ❑Yes,you have a balloon payment of$ due in years on / / Total monthly amount owed including escrow accoun[payments ❑You do nol have a monlhly escrow payment for items,such as property taxes and homeowners insurance.You must pay these items directly yourself. �X You have an additional monthly escrow payment of$224-33 Iha[resul(s in a[otal ini[ial monthly amount owed ot$785.14.This includes principal,interest,any mortgage insurance and any items checked below: ❑X Property taxes Q Homeowner's insurance �Floodinsurance ❑ �School Taxes ❑ Note: If you have any questions about the Settlement Charges and Loan Terms listed on this form,please contact your lender. HUD-1 Page 3 of 4 Previous editions are obsole[e HUD CERTIFICATION OF BUYER AND SELLER I have carefully reviewed the HUD-'I Settlement Statement and to the best of my knowletlge and belief,it is a true and accurate statement of all receipts and disbursements made on my account or by me in this t2nsacUon.1 further ceRiy that I have received a copy of the HUD-'I Settlement Statement. c � i� /�� d � �'..� . `fi�1 ��.?+,[��0�'t _ _ � Robert Neidigh � �„j l./� � � � �L ImYN!/� �� / t��-( .�i�Z/�Y��J Dixie Lee N�eidigh ✓ THE ESTAT�OF LOUISE SHU Y %! \ `\� � ' �G�G� �'�'�,�� , �+.�,� � Jennifer G.Pennwell,Co-�cewtor ° � David J.Garell, , ator � � l The HUD-'I 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. .� /C)��/C� SETTLEMENT AGENT DATE WARNING:IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM.PENALTIES UPON CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT.FOR DETAILS SEE TITLE 18:U.S.CODE SECTION 100'I AND SECTION 10'10. HUD-1 Page 4 of 4 Previous edi[ions are obsolete � � �- Name of Borrower: Name of Seller: File Number Robert Neidigh The Estate of Louise Shuey 14387 Dixie Lee Neidigh TitleExpress Prepared 10/02/2014 at 9:58 am Note: This page is furnished to give you an itemization of the amounts shown on Paid From Paid FrOm Lines 110'I, 1103 and 1104 of the Settlement Statement(HUD-1). This page Borrower's Seller's accompanies but is not a part of the settlement statement. If a discrepancy Funds at Funds at exists,the information shown on the Settlement Statem'ent(HUD-1)applies. Settlement Settlement 1100. Title Charges Amounts Included in Line 1101 1101. Title services and lender's title insurance 1,430.00 a. Wire In Fee $ 15.00 b. EmaillDoc Copy Fee 50.00 c. Overnight Delivery Fee-Package 25.00 � d. Notary Fee 45.00 $ 135.00 1102. Settlement or closing fee 1103. Owner's title insurance (policy) $ 145.00 145.U0 1104. Lenders title insurance (policy) 970.00 $ 1,295.00 a. Endorsement 810 Condo 50.00 b. Endorsement 900 EPL-Residential 50.00 c. Endorsement 100(No Violation) 50.00 d. Endorsement 300 Survey 50.00 e. Closing Service Letter 125.00 (Total 1103+1104) 1105. Lender's title policy limit$114,000.00 1106. Owner's title policy limit $142,500.00 1107. AgenYs portion of the total title insurance premium $ 1,117.75 1108. Underwriter's portion of the total title insurance prem. 322.25 (Total 1107+1108) 1109. 1110. 1111. 1112. � - Total Borrower Borrower Seller 1100. Title Char es with Pa ee Char e POC or Credit Line 1101 Paid 1101. Title services and lender's title insurance $ a. Wire In Fee to 1 st Advantage Settlement Services Inc. 15.00 15.00 b. EmaillDoc Copy Fee to 1 st Advantage Settlement Services Inc. 50.00 50.00 c. Overnight Delivery Fee-Package to 1 st Advantage Settlement Services Inc. 25.00 25.00 d. No[ary Fee to Annette Myers 45.00 45.00 1104. Lender's title insurance to 1st Advantage Settlement Services Inc. 1,295.00 1,295.00 $ 1,430.00 1,430.00