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HomeMy WebLinkAbout03-18-15 1505614134 EX(03-14)(FI) REV-1500 OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN 2 1 1 4 0 8 1 9 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYW Date of Birth MMDDYYYY 0 8 0 6 2 0 1 4 0 8 1 4 1 9 2 6 Decedent's Last Name Suffix Decedent's First Name MI GEEDY BETTY L (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 0 1.Original Return ❑ 2.Supplemental Return ❑ 3.Remainder Return(date of death Prior to 12-13-82) ❑ 4.Agriculture Exemption ❑ 5.Future Interest Compromise(date of ❑ 6. Federal Estate Tax Return Required (date of death on or after 7-1-2012) death after 12-12-82) ❑X 7.Decedent Died Testate ❑ 8.Decedent Maintained a Living Trust 0 9.Total Number of Safe Deposit Boxes (Attach copy of will.) (Attach copy of trust.) ❑ 10.Litigation Proceeds Received ❑ 11. Non-Probate Transferee Return ❑ 12.Deferral/Election of Spousal Trusts (Schedule F and G Assets only) ❑ 13.Business Assets ❑ 14.Spouse is Sole Beneficiary (No trust involved) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number J OE R . Z U L L I N G E R 71 7 264 6029 First Line of Address 1 4 NORTH MAIN STREET Second Line of Address S U I T E 2 0 0 City or Post Office State ZIP Code CHAMBE R S B U R G PA 1 7 2 0 1 ry o � rTi, Correspondent's e-mail address: G p rri CD -rte �7 REGISTER-OF ILLS'USE ONLY ._..( REGISTER OF WILLS USE ONLY r— 00 DATE FILED MMDDYYYY `\ 7'D �7 71 DATE FILED STAMP PLEASE USE ORIGINAL FORM ONLY Side 1 I IIIIII VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII IIII 1505614134 1505614134 J 1505614234 REV-1500 EX(FI) Decedent's Social Security Number Decedent's Name: BETTY L. G E E DY RECAPITULATION 1. Real Estate(Schedule A) .... ........ .. . . . ...... ... .. .. . . .. . . . .. .... 1. 1 1 1 6 1 8 . 3 7 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. 7 3 5 3. 1 9 7 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested .... . . . 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property 2 4 1 4 4 • 2 2 (Schedule G) [:] Separate Billing Requested ...... . 7. 8. Total Gross Assets(total Lines 1 through 7) ............... . . . ......... 8. 2 0 9 2 9 4 • 5 6 9. Funeral Expenses and Administrative Costs(Schedule H) ...... .. . . . ....... 9. 2 2 7 9 9 . 6 7 10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule 1) ... . . ....... . 10. 3 2 5 0 . 0 8 11. Total Deductions(total Lines 9 and 10) .................... . . ........ . 11. 2 6 0 4 9 . 7 5 12. Net Value of Estate(Line 8 minus Line 11) ................ .. . .. ...... . 12. 1 8 3 2 4 4 . 8 1 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) ............ . . . ...... . 13. 14. Net Value Subject to Tax(Line 12 minus Line 13) ........... . . ........ . 14. 1 8 3 2 4 4 . 8 1 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 (a)(1.2)X.0 _ 0 . 0 0 15. 0 . 0 0 16. Amount of Line 14 taxable at lineal rate x.045 1 8 3 2 4 4 . 8 1 16. 8 2 4 6 . 0 2 17. Amount of Line 14 taxable at sibling rate X.12 0 . 0 0 17. 0 . 0 0 18. Amount of Line 14 taxable at collateral rate X.15 0 . 0 0 18. 0 . 0 0 19. TAX DUE ......... ....... .. ............. .... .. . . ......... ...... 19. 8 2 4 6 . 0 2 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑ Under penalties of perjury,I declare 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 person responsible for filing the return is based on all information of which preparer has any knowledge. S TURE OF PERSO ES SIBLE FOR FILING RETURN DTE 3 1� ADDRUSS 104D,Ridqe Road Shippensburg PA 17257 SI NAT E O PREPA HER N RESPONSIBLE FOR FILING THE RETURN /ATE IS- AID S- t, 717 AD AR SS 1 orth Main Stree auite 200 Chambersburg A 1 201 111111111111111111111111111111111111111 Side 2 1505614234 1505614234 J REV-1500 EX (FI) Page 3 File Number Decedent's Complete Address: 21 14 0819 DECEDENTS NAME BETTY L. GEEDY STREET ADDRESS 50 Airport Road CITY STATE ZIP Shippensburg PA 17257 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 8,246.02 2. Credits/Payments A.Prior Payments 6,840.00 B.Discount 360.00 (See instructions.) Total Credits(A+B) (2) 7,200.00 3. Interest (3) 4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT. Fill in oval on Page 2,Line 20 to request a refund. (4) 0.00 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 1,046.02 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 ...................................................................... ❑ ❑X b. retain the right to designate who shall use the property transferred or its income ............................... ❑ 0 c. retain a reversionary interest ........................................................... ❑ Q d. receive the promise for life of either payments,benefits or care? ....................................................... ❑ Q 2. If death occurred after Dec.12,1982,did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... ❑ 0 3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death? ......... ❑ ❑Q 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 Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an adoptive parent or a step-parent 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-1500 EX (FI) Page 3 File Number Decedent's Complete Address: 21 14 0819 DECEDENTS NAME BETTY L. GEEDY STREET ADDRESS 50 Airport Road CITY STATE ZIP Shippensburg PA 17257 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 8,303.39 2. Credits/Payments A.Prior Payments 6,840.00 B.Discount 360.00 (See instructions.) Total Credits(A+B) (2) 7,200.00 3. Interest (3) 4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT. Fill in oval on Page 2,Line 20 to request a refund. (4) 0.00 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 1,103.39 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 ...................................................................... ❑ ❑X b. retain the right to designate who shall use the property transferred or its income ............................... ❑ ❑ c. retain a reversionary interest ..................................................... .. ❑ 0 d. receive the promise for life of either payments,benefits or care? ....................................................... ❑ 0 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 Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an adoptive parent or a step-parent 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 decedents 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) pennsytvania . SCHEDULE A DEPARTMENT OF REVENUE REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: BETTY L. GEEDY 21 14 0819 All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts. Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1. Gross proceeds from sale of real estate, together with improvements thereon, situate at 111,000.00 50 Airport Road, Shippensburg, PA, to John M. & Rebecca A. Clouse, copy of HUD attached 2. Received on proration of real estate taxes at sale of the above property 618.37 TOTAL(Also enter on Line 1,Recapitulation) $ 111 618.37 If more space is needed,use additional sheets of paper of the same size. REV-1508 EX+(08-12) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN RESIDENT DECEDENT PERSONAL PROPERTY ESTATE OF: FILE NUMBER: BETTY L. GEEDY 21 14 0819 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. Checking Account#97254002, M&T Bank, including interest accrued to date of death 31,067.79 (Note-account is titled in the names of Betty L. Geedy and George A. Geedy, Jr. George A. Geedy predeceased on 7/30/2014) 2. Certificate of Deposit#31003914544125, including interest accrued to date of death 1,568.49 (Note-account is titled in the names of Betty L. Geedy and George A. Geedy, Jr. George A. Geedy predeceased on 7/30/2014) 3. Certificate of Deposit#31003914583628, M&T Bank, including interest accrued to date 8,311.29 of death (Note-account is titled in the names of Betty L. Geedy and George A. Geedy, Jr. George A. Geedy predeceased on 7/30/2014). 4. Net proceeds from sale of personal property 12,268.50 5. Refund, Erie Insurance 195.00 6. Refund, Hlghmark Blue Shield 361.32 7. Refund, AAA membership 0.98 8. Refund, Highmark Blue Shield 503.48 9. Refund, Green Ridge Village 456.89 10. Social security payment received by estate after death 775.00 11. Annuity Contract#FA09012334, Pacific Life, Owner of Contract-George A. Geedy, Jr. 17,634.23 and Betty L. Geedy; George A. Geedy, Jr. predeceased on 7/30/2014; death benefit paid to"Estate of Betty L. Geedy" making it a probate asset 12. Refund from Realtor on overpayment of sale commission 389.00 TOTAL(Also enter on Line 5,Recapitulation) $ 73 531.97 If more space is needed,use additional sheets of paper of the same size. REV-1510 EX+(08-09) pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER BETTY L. GEEDY 21 14 0819 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 INCLUDETHE NAME OF THETRANSFEREE,THEIR RELKnONSHIPTO DECEDENT AND DATE OF DEATH %OFDECD'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER.ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IFAPPUCABW VALUE 1. Annuity Contract held with Western Southern; 24,144.22 100.00 24,144.22 named beneficiary Judith A. Daihl, daughter TOTAL (Also enter on Line 7,Recapitulation) $ 24 144.22 If more space is needed,use additional sheets of paper of the same size. REV-1511 EX+(08-13) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER BETTY L. GEEDY 21 14 0819 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Wagoner's Memorials, gravemarker 1,275.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City State ZIP Years)Commission Paid: 2. Attorney Fees: Joel R. Zullinger 5,500.00 3• Family Exemption:(If decedent's address is not the same as claimant's,attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: Letters-260.00; will- 15.00; codicil - 15.00; JCS fee-35.50; automation- 385.50 5.00; short certificates-25.00; inventory 15.00; return 15.00 5 Accountant Fees: 6. Tax Return Preparer Fees: 7. Transfer of vehicle title after public sale 102.67 8. Food for workers at public sale 96.37 9. Penelec, utilities at residence 12.10 10. Lawn care prior to death and replacement of dehumidifer 249.00 11. Borough of Shippensburg, water service 38.20 12. Cumberland Franklin Joint Municipal Authority, sewer service 116.55 13. Fee for estate checks 27.50 14. Tim Gruver Plumbing & Heating, repair work prior to sale 84.55 15. Penelec, utilities 30.25 16. Timmons Oil, fuel oil for residence 122.50 17. Penelec, utilities at residence 72.19 18. Erie Insurance, homeowner's insurance 57.00 TOTAL(Also enter on Line 9,Recapitulation) $ 22 799.67 If more space is needed,use additional sheets of paper of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent BETTY L. GEEDY 21 14 0819 Decedent's Name Page 1 File Number Schedule H -Funeral Expenses&Administrative Costs -B7. ITEM NUMBER DESCRIPTION AMOUNT 19. Penelec, utilities at residence 53.81 20. Realtor's commission at sale of real estate 6,660.00 21. 1% Realty Transfer Tax at sale of real estate 1,110.00 22. Seller assist at sale of real estate 6,660.00 23. Borough of Shippensburg, final water bill 58.20 24. Cumberland Franklin Joint Municipal Authority, final sewer bill 88.28 SUBTOTAL SCHEDULE H-137 14,630.29 REV-1512 EX+(12-12) pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES&LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER BETTY L. GEEDY 21 14 0819 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. Penelec, utilities due at death 49.60 2. Fayetteville Volunteer Fire Company, ambulance transport 274.00 3. Green Ridge Village, balance due on care services 955.00 4. Millennium Pharmacy, balance due for prescriptions 241.12 5. Cumberland Goodwill Fire& Rescue, ambulance transport 430.31 6. Vivian Coy, Tax Collector, 2014/15 school real estate taxes due at death 1,230.05 7. Baxter, Drew, Wellmon, II, DO, medical services due at death 70.00 TOTAL(Also enter on Line 10,Recapitulation) $ 3,250.08 If more space is needed,insert additional sheets of the same size. REV-1513 EX+(01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: BETTY L. GEEDY 21 14 0819 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. Judith A. Daihl, 1040 Ridge Road, Shippensburg, PA 17257 Lineal 183,244.81 Items 1 on Schedule G-24,144.22 Residue of estate- 159,100.59 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. II, NON-TAXABLE DISTRIBUTIONS: A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ If more space is needed,use additional sheets of paper of the same size. e 4 t I 4 4 LAST WILL AND TESTAMENT I, Betty L. Geedy, of Southampton Township, Cumberland Coun- ty, Pennsylvania, being of sound and disposing mind, memory, and understanding, do hereby make, publish and declare this instru- ment as and for my last will and testament, hereby revoking any and all wills by me at any time heretofore made. 1. I direct the payment of my just debts and funeral expenses. 2. i I authorize my personal representative, hereinafter named, to purchase a burial plot for my interment and to provide per- petual care therefor, using such funds of my estate as my per- sonal representative considers necessary or desirable for these purposes. - - - 3. I If my husband, George A. Geedy, is living at my death and ifp f I jhe survives me for a period of thirty (30) days, I give devise and bequeath all the rest, residue and remainder of my property, real, personal and mixed, wheresoever situate, to him, my said husband, but if he does not survive me for a period of thirty devise and bequeath m entire residuary and {30) days, I give, dev q y y remaining estate to my daughter, Judith Ann Daihl. Should my husband, George A. Geedy, and my daughter, Judith Ann Daihl, both predecease me, I give, devise and bequeath my entire residuary and remaining estate as follows: I y t i (a) One (1) share to my son-in-law, Richard L. Daihl. (b) One (1) share to my granddaughter, Kim- berly Ann Daihl. (c) One (1) share to my grandson, Scott R. Daihl. In the event that any of the residuary legatees hereunder predecease me, the share of said deceased legatee shall pass to j� the surviving legatees in equal shares. 'f ' 4. I In the event that any of my property shall pass, either un- der this will or otherwise, to a minor, I appoint Richard L. Daihl as guardian of his or her estate. I direct that the guard- ian of the estates of the aforementioned minor beneficiaries L above nominated, constituted, and appointed, shall have the pow- er, in his sole discretion, to make expenditures from principal for the maintenance, support, and welfare of said beneficiaries, and to invest and reinvest the funds entrusted to him under the provisions of this, my last will and testament, at such times and in such manner as he shall deem fit, without regard to any prin- ciple of diversification or lists of investments authorized by law, any law or rule of court of the Commonwealth of Pennsylvania or of any other jurisdiction to the contrary notwithstanding. 5. i Finally, I nominate, constitute and appoint my husband, ( George A. Geedy, executor of this, my last will and testament. In the event that my husband, George A. Geedy, shall predecease I -2- I me, I nominate, constitute and appoint my daughter, Judith Ann Daihl, as executrix of this, my last will and testament. 6. I I direct that my executor and the guardian designated here- under, or their successors, shall not be required to post any bond for the faithful performance of their duties in this or any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and affixed my seal thisday of 1989. J �r2c?�;>' (SEAL) Betty L.1 Geedy ! Signed, sealed, published and declared as and for her last will and testament by Betty L. Geedy, the above-named testatrix, in the sight and presence of us, who at her request and in the sight and presence of her and of each other, have hereunto sub- scribed our names as witnesses on the day and year last above written. {I 'f j -3- �i COMMONWEALTH OF PENNSYLVANIA: SS COUNTY OF FRANKLIN I, Betty L. Geedy, the testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified ac- cording to law, do hereby acknowledge that I signed and executed the instrument as my last will; that I signed it willingly and as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged before me by Betty L. �/t Geedy, the testatrix, this day of � Ia� , 1989 . Tdstatr Vx otary Notarial SaM Lynsnn M.Funic,Notary Public Clembersburg Bora,Franklin Courtly Aly Coln-mimlon Expires Feb.29,1462 ktentbor,IPennsy, 011W FA&wolatlo;t of Notorles COMMONWEALTH OF PENNSYLVANIA: SS COUNTY OF FRANKLIN We, —i"'_ i'.'F I d_S and �t,�: �I-k t-c,rt the witnesses whose names are signed to the. attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the testa- trix sign and execute the instrument as her last will; that the I -4- I A testatrix signed willingly and executed it as her free and volun- tary act for the purposes therein expressed; that each subscrib- ing witness in the hearing and sight of the testatrix signed the will as witness; and that to the best of our knowledge the testa- trix was at that time eighteen or more years of age, of sound i mind and under no constraint or undue influence. Sworn to or affirmed and subscribed to before me by S as and witnesses, this r,14 day of 6 , 1989 . 16-4 �J Wit ess ' W'tne s Nota y Notarial seal Lynann M.Fumy Notary Public Chambersburg&oro,FrarMin County Icy Comm ISA-on Expirw Feb.29,14@2 Mernber,Pennsy+rsnia Notaries i -5- i JRZ - 5 . 1 geedy2 . cod May 16, 2008 CODICIL I, BETTY L. GEEDY, of Southampton Township, Cumberland County, being of sound and disposing mind, memory and understanding, do hereby declare this to be a codicil to my will dated July 24, 1989 . I. I hereby revoke paragraph 5 . of my said will which reads as follows : "Finally, I nominate, constitute and appoint my husband, George A. Geedy, executor of this, my last will and testament . In the event that my husband, George A. Geedy, shall predecease me, I nominate, ` constitute and appoint my daughter, Judith Ann Daihl, as executrix of this, my last will and testament . " IN LIEU THEREOF, I direct that the following be substituted: "Finally, I nominate, constitute and appoint my husband, George A. Geedy, executor of this, my last will and testament . In the event that my husband, George A. Geedy, shall predecease me, I nominate, constitute and appoint my daughter, Judith Ann Daihl, as executrix of this, my last will and testament . In the event my husband, George A. Geedy and my daughter, Judith Ann Daihl, shall predecease me, I nominate, constitute and appoint Kimberly Burke as executrix of this, my last will and testament . " II. In all other respects I hereby ratify, confirm and republish my will dated July 24, 1989, together with this codicil as and for my will . IN WITNESS WHEREOF, I have hereunto set my hand and seal this day of .J,eticP _ 2 pp� (SEAL) Signed, sealed, published and declared by the above-named testatrix as and for her codicil to last will and testament in our presence, who in her presence, at her request and in the presence of each other have hereunto set our hands as attesting witnesses . ,ZIP P LCUIL, We, BETTY L. GEEDY, ��d-ti ✓ 1 and the testatrix and the witnesses respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the Page 2 undersigned authority that the testatrix signed and executed the instrument as her codicil to her last will and testament and that she executed it as her free and voluntary act for the purposes therein expressed and that each of the witnesses, in the presence and hearing of the said testatrix, signed the codicil as witnesses and to the best of their knowledge, said signer was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. A� atrix 6r' Wi iess Witn�s6 Subscribed, sworn to and acknowledged before me by the above-named signer and subscribed and sworn to before by the above-named witnesses this y of 72 Z; Notgry'Public cari Notarial sea, n L.Walter Chambersburg 8 ' Not"'Y Public Y CO i'ssio oro, Franklin County Expires y 3,2009 Page 3 OMB Approval No.2502-0265 k A Settlement Statement (HUD-1) B.Type of Loan FHA 2. RHS 1 F Conv.Unins. 6.File Number 7.Loan Number •8.mortgage Insurance Case Number". 3417-S 1140917019 446-2262877-7036 4, a VA 5. Corm.Ins. C.Note: This Penn Is furnished to give you a statement of actual Seteesnant costs.Amounts paid to and by UM settlement agent am shv ftents a*,ed '(p.o.c.y were paid outside the closing;they are shown here for informational purposes and are net Included in the totals. D.Name and Address of Borrower E.Name&Address of Seller. ^F.Name and Address of Lender. John M.Clouse& Estate of Betty L.Geedy CityWorth Mortgage LLC Rebecca A.Clouse '11781 Lee Jackson Memorial Highway 515 Wenksville Road !Sufte 100 Biglerville,PA 17307 Fairfax,VA 22033 G.Property Location: H.Settlement Agent Name: (717)532-57113 1.Settlement Date: 50 Airport Road,Shippensburg,PA 17257 Zullinger-Davis,Professional Corporation 1212912014 Southampton Township,Cumberland County Tax Parcel#39-34-2409-004 Place of Settlement Hamilton C.Davis,Esq.,Shippensburg,PA 1K.sluim-ma-ry of Sellees Transaction 100. Gross Amount Due From Borrower 1400. Gross Amount Due To Seller -2 . ..... 101. Contract sales price 111,000.00 401. Contract sales price 111,000,00 102. Personal Property 402. Personal Property 103. Settlement charges to borrower(line 1400) 7,443.3 403. 104. 404. 105. 1405. Adjustments for items paid by seller in advanceAdjustments for items paid by seller in advance 106. City/town taxes to (es to 107. County taxes 12/29114 to 12131/14 1.66 !407 County taxes 12/29/14 to 12/31/14 1.66 108. Assessments to 1408. Assessments to 109. School Tax 12/29/14 to 06130/15 616.71 1 1409. School Tax 12/29/14 to 06130/15 616.71 110. Garbage Fee 1410. Garbage Fe 112. 120. Gross Amount Due From Borrower 11119,061134h 420. Gross Amount Due To Seller 111,618.37 200. Amounts Paid By Or in Behalf Of Borrower j 1500. Reductions in Amount Due To Seller - 201. Deposits or earnest money 500.001 1501. Excess deposit(see instructions) 202. Principal amount of new loan(s) I I 1502. Settlement charges to seller(line 1400) 7,913.51 1203. Existing loan(s)taken subject to I : 1503. Existing loan(s)taken subject to 204. 1 i504. Payoff of first mortgage loan I 1205. 505. Payoff of second mortgage loan 206. 506. 207. 507. 208. Seller Assistance 6,660.0101 508. SelFer Assistance 6.660.00 209. 509. Adjustments for items unpaid by seller Adjustments for items unpaid seller 210. City/town taxes to 151 0. City/town taxes to 211. County taxes to J511. Countytaxes to 212. Assessments to 512._Assessments 213. School Tax to j513. School Tax to 214. 514. 215. I 515. 216. 1 1516. 217. 1 517. 218- I 518. 219. 519. 220. Total Paid By/For Borrower 116.149.00 520. Total Reduction Amount-Due Seller 14,573.51 300. Cash At Settlement Fronri Borrower i 600. Cash At Settlement TolFrorn Seller-- POI. Gross Amount due from borrower(line 120) 602� Less reductions in amt.due seller(tine 119,061.74 601. Gross Amount due to setter(line 420) 111,618.37 1302. Less amounts paid by/for borrower(line 220) 116,149.00}; -- - 520) _- 14,57151) V 303. Cash From LiTo Borrower $2,91214:1 1603. Cash X To From Seller $97,044.86 1 [K I ','I L .. ) -_ The Public Reporting Burden for this collection of information is estimated at35minutes per response for collecting,reviewing and a arcing the am?� valid&� control data. This agency may not collect this information,and you are not required to complete this form,unless it displap a out number. No confidentiality is assured;this disclosure in mandatory. designed to provide the parties to a R SPA covered transaction with information during the settlement cess. ; r* orr John M.Clou S�ell , Judith Exec of the Estate of Betty L. BdrroNker Rebecca A.Clouse Seller The HUD!)Settlement Stalement is a true and accurate account of this transaction. I have caused the funds to be disbursed in accordance with this statement. At Zullinger-Davis,Professional Corporption j Settlement Agent Date6a _ Z� providus ceitions era Obsolete C/ Page I of 3 _ w HUD-1 700'i�Total Reat'Estate Broker,Fees ;Paid From,,.xPaid From Division of commission(line 700)as follows: Borrower's Sellefs 701. $ 3,330.00 to Re/Max Realty Agency Funds at Funds at 702. $ 3,330.40 to Jalex Real Estate Services - - - Settlement, Settlement 703. Commission paid at settlement �- J- 6,660.00 704. 800),JtemsPayaWe in Connection With 801. Our origination charge $ 1,225.58 (from GFE#1) 802. Your credit or charge(points)for the specific interest chosen $ 0.00 (from GFE#2) 803. Your adjusted origination charges (from GFE#A) -- 1,225.58 804. Appraisal fee to Rogers Appraisal Service Inc.($460 POC) (tram GFE#3) 805. Cre it report to Credit Plus (from GFE#3) _ 23.00 BOB, Tax service to (from GFE#3) 807. Flood certification Core Logic (from GFE#3) 12.00 BOB. _ 809. 810. 900..:Items Requrre'd by Lenderto Bs Paid'iri Advance,, 901. Daily interest charges from 12129/14 to 01/01/15 @$ 12.69 /day (from GFE#10) - 38.07 902. Mortgage insurance premium for mo nt s to HUD (from GFE#3) 11874.51 903. Homeowner's insurance for 1 years to (from GFE#11) 904. 945. k1000 ,Reserve`s_OepositedjwithiLender ,,_ t i z, ,> ;, _ „ 1001. Initial deposit for your escrow account (from GFE#9) 623,71 1002. Homeowner's insurance 3 months @$ 61.67 per month $ 185.01T 1003. Mortgage insurance 2 months @$ 119.58 per month $ 239.16 1004. Property taxes months @$ per month $ 1005. County/Township RE Tax 12 months @$ 25.20 per month $ 3_02.40 1006- School RE Tax 8 months @$ 102.50 per month $ 820.00 1007. months @$ per month $ 1008. Aggregate Adjustment $ 922,86 1100aSitie.CNu es-L - 1101. Title services and lender's title insurance (from GFE#4) C 1,305.00 1102. Settlement or closing fee $ 1103. Owner's title insurance 10.00 (from GFE#5) 1104. Lender's title insurance $ 945.04 1105. Lender's title policy limit $ 108,989.00 -- 1106. Owner's title policy limit $ 111,000.00 _ 1107• Agent's portion of the total title insurance premium $ 1108, underwriter's portion of the total title insurance premium $ _ 1109- Endorsements 100/300/900 150.00 1110. Insured Closing Protection Letter 125.00 �- 1111. Package Download Fee/Ovemight Mail Package 75.00 9200:$Goverriharges 1201. Government recording chargeERecorder of Deeds (from GFE#7) r 191.50 0.00 1202. Deed$ 83.50 Mortgage$ 99.00 Releases$ -� 1203. Transfer taxes Recorder of Deeds (from GFE#8) 1,110.00 : 1,110.00 1204. City/County tax/stamps Deed$ 1,110.00 Mortgage$ 1205. State lax/stamps Deed$ 1,110.00 Mortgage$ _ ! 1206, (Electronic Recording Fee$4.50 per document=$9.00 included in line 1201 1207. 1300:^Additional Settlemont Chaiges v °• _ 1301, Required services that you can shop for (from GFE#6) C 1302. Final Water Bill to: Borough of Shippensburg 55.23 1303. Final Sewer Bill to: CFJMA ; 88-28 1304. Home Inspection to: Analytical Hygienist Service reimbursed to Marva Purvis - 300.00. 1305. 1306. 307. 308. 309. Total Settlement Charges(enter on i lines 103,Section J and 602, 7,443.37 7,913.51 Paid outside m dosing by bonrner ••P1d outside or ddsrng by self Pnx>'=edibansareobsolete Page 2.13 HUD-1 rGompariso o"fG ori Faith Estima#e(CFE}and'liUD"1 ChargesNOW r ;nate Ht3o Charges That Cannot Increase HOD-1 Line Number Our origination charge # 801 1,225.58; 1,225.58 Your credit or charge(points)for the specific interest chosen #, 802 Your adjusted origination charges # 803 _ 1,225.58' 1,225.58 Transfer taxes # 1203 1,110.021 1,110.00 Charges That in Total Cannot Increase More Than 10% jGcWFaihfsirr4#e , ftHOD=1 Lt Government recording charges # 1201 245,101 191.50 Appraisal Fee #. 804 460.00 I 460.00 Credit Report # 805 50.00; 23.00 Flood Certification # 807 -- 12.00 i -- 12.00 Mortgage Insurance Premium # 902 1,874.51, 1,874.51 Title Services&Lender's Title Insurance # 1101 1,543.10 1 1,305.00 Owner's Title Insurance �# 1103 126.75� 10.00 4,311.46! 3,876.01 - s $ 335.45 or -10.10% Charges That Can Change C>addFalhairiafe HoDD 1 Initial deposit for your escrow account # 1001 619.52 623.71 Daly interest charges # 901 $ 12.69 /day — 190.36 38.07 Homeowner's insurance # 903 740.04 740.00 # Loan Terms Your initial loan amount is $ 108,989.00 Your loan term is 30 years Your initial interest rate is 4.250 Your initial monthly amount owed for principal,interest $ 655.74 includes and any mortgage insurance is Principal Interest Mortgage Insurance Can your interest rate rise? No❑ Yes,it can rise to a maximum of %. The first change will be on and can change again every after . Every change date,your interest rate can increase or decrease by %, Over the life of the loan,your interest rate is guaranteed to never ne lower than %or higher than %. Even if you make payments on time,can your loan balance rise? Z No Yes,it can rise to a maximum of $ Even if you make payments on time,can your monthly 0 No Yes,the first increase will be an amount owed for principal,interest and mortgage insurance rise and the monthly amounts owed can rise to$ The maximum it can ever rise to is$ Does your loan have a prepayment penalty? © No❑ Yes,your maximum prepayment penalty is$ Does your loan have a balloon payment? 91,i No❑ Yes,you have a balloon payment of$ due in years on You do not have a monthly escrow payment for items such as property taxes Total monthly amount owed including escrow account payments and homeowner's insurance.You must pay these items directly yourself. You have an additional monthly escrow payment of$ 189.37 that results in a total initial monthly amount owed of$ 845.11 This includes principal,interest,mortgage insurance and any items checked below. I Property taxes Homeowner's insurance ❑ Flood insurance Note: If you have questions about the Settlement Charges and Loan Terms listed on this form,please contact your lender. Previous editions ate obsolete Page 3 of 3 --m — HUD-1 M M&T"Bank 499 Mitchell Road,Millsboro,DE 19966 Records Management Phone 888-542-4349 F ax (302)934-2955 September 15,2014 Law Offices of SEP Zullinger-Davis 2014 20 East Burd Street P.O. Box 40 Shippensburg,PA 17257 Re: Estate of Betty 1,. Geedy Social Security: Date of Death: August 06, 2014 Dear Sir or Madam: Per your inquiry on August 19,2014,please be advised that at the time of death,the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Account Account Number 97254002 Ownership{Names of) Judith A.Daihl(POA) Betty L. Geedy George A. Geedy,Jr. Opening Date 0112811980 Balance on Date of Death $ 31,067.77 Accrued Interest $ .02 Total $31,067.79 2. Type ofAccount Certificate of Deposit Account Number 31003914544125 Ownership(Names o) Judith A.Daihl(POA) Betty L. Geedy George A.Geedy,Jr. Opening Date 1111511996 Balance on Date of Death $ 1,568.23 Accrued Interest $ .26 Total $1,568.49 3. Type of Account Certificate of Deposit Account Number 31003914583628 Ownership(Names of) Judith A.Daihl(POA) Betty L.Geedy. George A. Geedy,Jr. Opening Date 1011711997 Balance on Date of Death $ 8,310.47 Accrued Interest $ .82 ..............................................................................__.........._...... -........__.._.. Total $8,311.29 For any additional information on the above accounts,including ownership and any changes,closures and/or reimbursement of funds, please call the Walnut Bottom at 717-532-2414. We were unable to locate any safe deposit box for the above-mentioned decedent. This letter does not include any accounts in which the deceased may have been listed as Power of Attorney,Custodian of Uniform Transfers, Representative Payee,or Trustee under a Written Agreement Sincerely, Valarie Mercer Records Management PACIFICLIFE October 24, 2014 Ms.Judith A Daihl 1040 Ridge Rd Shippensburg, PA 17257-9716 Re: Accumulated Cash Value Contract: FA09012334 Annuitant: George A Geedy Jr Owner: George A Geedy Jr and Betty L Geedy Dear Ms. Daihl: We are writing in response to information requested on the above-referenced contract. The Accumulated Cash Value as of 08/06/2014 is$17,634.23. If you have any questions, you may contact an Annuity Information Specialist at (800) 722-4448, Monday through Friday from 6 a.m.to 5 p.m., Pacific Time. You may also contact your registered representative with questions. Neither Pacific Life nor its representatives give tax or legal advice. Sincerely, Gid '/'9 . '�5 � Lorene C Gordon Vice President, Operations Retirement Solutions Division Pacific Life Insurance Company Retirement Solutions Division P.O. Box 2378,Omaha, NE 68103-2378 www.PacificLife.com Securities Distributed by Pacific Select Distributors,Inc., Member, FINRA&SIPC Feb. 9. 2015 1 :54PM HC DAVIS No. 2945 P. 2 Annuity Operations Western & Southern Life PO Box 2918 Cincinnati,ON 45201-291$ A member o1 Western&Southern Financia!GfoUtoll free 800.926.1702A fax 513.362.2353 February 2, 2015 JUDITH DAIHL 1040 RIDGE RD SHIPPENSBURG, PA 17257-9716 Dear Judith Daihl: Thank you for your request for information on the annuity contract. I hope the following contract information is helpful to you. Annuitant: GEORGE GEEDY Owner: GEORGE GEEDY Westem-Southern Life Assurance Company Contract Number: W0021448246 Contract Value on 8/6/2014: $24,144.22 The quoted value information is as of 211/2015. If you have any questions, please contact Client Services at 1-800-926-1702. We can be reached Monday-Thursday 8 a.m. to 6 p.m. and Friday 9 a.m. to 5 p-m_ EST. Sincerely, Annuity Operations Department Western & Southern Life DC0331-1407 Western-Southern Life Assurance Company Annuity Operations Western & Southern Life PO Box 2918 Cincinnati,OH 45201-2918 A member of Western&Southern Financial Group toll free 800.926.1702 fax 513.362.2353 February 2, 2015 JUDITH DAIHL 1040 RIDGE RD SHIPPENSBURG, PA 17257-9716 Dear Judith Daihl: - Thank you for your request for information on the annuity contract. I hope the following contract information is helpful to you. Annuitant: GEORGE GEEDY Owner: GEORGE GEEDY Western-Southern Life Assurance Company Contract Number: W0021448246 Contract Value on 8/6/2014: $24,144.22 The quoted value information is as of 2/1/2015. If you have any questions, please contact Client Services at 1-800-926-1702. We can be reached Monday - Thursday 8 a.m. to 6 p.m. and Friday 9 a.m. to 5 p.m. EST. Sincerely, Annuity Operations Department Western & Southern Life DC0331-1407 Western-Southern Life Assurance Company