HomeMy WebLinkAbout04-25-15 , � 1505610105
REV-1500 F"�°�,°""
OFFIQNL USE ONLY
vnoepanmen�orAevenue Panosylvama counrycmevaa2r riiarvumbar
eureeumi�em�e�eira,« INHERITANCETAXRETURN �I IJ I�31
ao eox aeosm Q
Hamse�,a.PA+�+�e-osm RESIDENTDECEDENT I
ENTER DECEDENT INFORMATION BELOW
Social Sea�ity Number Date of Death MMDDYVYV Da�e oBitlM1 MMODVVW
09102013 10�21921
DecetlenPs Last Name Suffix DeceaenPs First Name MI
Ll1DT BETTY J
(It Applicable)En[er Surviving Spouse's Intormation Below
Spouse's Last Name SuKx Spouse's Fire�Name MI
Spouse's Social Security Numbe�
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE BO%ES BELOW
� 1 OriginalReWrn Q 2. Supplemen�alPeNm Q 0. Remain4e�PeWm��eteotOeetM1
Pnor�012-1]-62)
0 a. rmnm e:�zm 0 aa Fwure m�eresi coma�om�.e laaie m � s. Feaa,ai es�a�era.aewm reeamrea
aeein ener�x-�s-az�
� s. oe=�eemo��are.r� 0 �. oeceeemMamumma��.meTrys� _ e Toieirvumee�oisareo�posneo.e�
�avacncooroiwnp (nnecncopyorirus�.�
O 9. LitiBationProceaUSReceiveE Q f0. SpousalPoveM1yCreEit(Dateol�ee�h Q H. ElectionbTaxuntler5ec.91ll(H)
Be[ween 12-01-91 antl 1-0-95) (Attac�ScM1Mule 0)
GORRESPONDENi-iNI55ECilON MUST 9E COMPLEiED.ALL CORRESFON�ENCEAN�CONFI�ENTIALTAX IHfOHMAiION SHOULU BE DIRECTE�i0:
Name Daytime Telephone Number
ROBERT 6 . FREY 71724358� o �
z
REGIST Im'ILLSVSEON�Y T � �
m � ti 6' 0
m �, n �J y .TJ
FirslLineofAddress �� _� ��� N n T
T' N =.� � :av �
5 S. HANOVER ST. =
- ^ � o
�' � o ro `., �
Secontl Line otAtldress n O -n 3 �. '1
G � -
. yA J� i"' m ,
�pTEFlLEo r O
City or Post ORice Stale ZIP Code .* '
v
CARLISLE PA 17013
correspondenCse-maiiaaarass: RFREYoIFREYTILEY. COM
unaer penei�es or pe�iu�y,i a«ia,�mau na�e e.am�nea m�s rewra�inuum�g auompa����a��aa�ies a�a�ia�ema�re,ana ro me easi ar my knowiee0e a�e e�rei,
in:w� �,reaamromie�e.cedere-onoi r ane�ma�� �aire mu�e�i easeaonaumm�me�io�orwmm� r «na�a� k�owime
SI ORE FPE NR F earNGRETO ATE
�- � / `f,��, /�
����� �
,
SIGNFIDREOFPREPAREROTHERTHANREPRE NTATNE �NTE ' / , /
nooaess
E �. �T ' �7
5 SOUTH HANOVER STREET, CARLISLE, PA 17013
PLEASE USE ORIGINA�FORM ONLV
Side 1
L 15�561�1�5 15�56101�5 J
��\`
J 15�5610205
aevasao ex�Fp
DecetlenCs Social Security Num�er
oecee��r,Name� BETTY J LUDT
RECAPITULATION
1. RealEs[ale(SchetluleA). . . . . . . . . . . . . . . .. . . . . . ... . . . .. . . . . . . ... . . . 1. 160�. �0
2 SbGs and Bontls(Schetlule B)... . .. . .. . .. . . .. . .... . ... . . .. . ..... . . 2. 0 . ��
3. Closely Meltl Corporation,Partnership or Sole-Pmprierorship(Schedule C). .. 3. � . 00
4. Mohgages antl Notes Receivable(Schetlule 0). . . . . . . . . . . .. . . .. . . . . . . .. Y. � .��
5. Cas�,Bank Deposits and Miscellaneous Personal Property(Schedule E).. . . . 5. 1�911. 0�
6. Jointly Ownetl Pmpetly(ScM1etlule F) OSeparo�e Bllllnq Requested . . . . . . . 6. 0 . �0
l. Inter-Vws Trensfers 8 Miscellaneous Non-Pmbate Pmpetly
(Schetlule G) �Separete Bllling Requestetl. . . . . .. �, � . ��
e. rowi c�oss as:e��miai�me:i m�o�en��. _ . .... . . . . . a. 19511. �0
& Funeral Expenses antl AtlminisVa�ive Costs(Schetlule H). . ..... . ... . . . . . . 9. 11756.�0
10. �ebtsof�ecetlent, MortgageLiabilitiesandliens(ScheGulel). . . ._ . ... . . .10. 3�922. 00
n. To�inea��eo�s(miai�mesea�aio). . ._ . . _ . . .. . . _. . ._ . _. __ n. 42678 . 00
12. NeNalueo/Estala(LineBminusLinell).. . ... . . .. . . ... . . ... . ... . . .. 12. -23167.��
13. CharitableandGovernmentalBequestsl5ec9113Tmstsfarwhich
an election ro lax has not been matle(Schetlule J). . .. . . ... . . .. . . . . . . ... 13. �.��
14. NetValueSubiecttoTax(Linel2minusLinel3). . . . ... . . . . 14. -23167. 0�
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Gne 14 taxable at
[he spousal tax rate,or
Vansfers untler Sec.9116
(a)(12)X.0 0 15. 0.00
16. Amount of Line 14�axable
atiineairetexA 45 i5. 0. 00
1I. Amoun�ot Line 14
taxable at siEling rate X • 12 �z 0. 00
18. Amount of Line id taxable
atwllaleralraleX • 1$ 18. � .��
19. TAX�UE . . .. ... . . . . . . . . . . . . . . . . . . . .. . . . . . . ... 19. 0 . 00
20. FILLINTHEBO%IFVOUAREREQUESTINGAREFUNDOFANOVERPAVMENT 0
Side 2
L 1505610205 1505610205 J
, reev-�sooex�cp vaae� F��aHumne. 17&�6-SOfi4
DecedenPs Complete Address: 2i-i3-�a�s
DECEDENT'SNAME
BETTV J LU�T
STREETADDRESS
2123 RITNER HIGHWAV
CITV STATE ZIP
CARLISLE PA 17015
Tax Payments and Credits:
1. Tax Due(Page 2.Line 19) (D �-Q�
2 Cretlits/Payments
A PriorPayments
B.Discounl
TotalCredi�s(AtB) (2) 0.00
3. Interest
(3)
4. If Line 2 is greater than Line 1 t line 3,en�erthe diRerence.This is ihe OVERPAYMENT.
Fill in boz on Page 2,Line]0[o reques[a retuntl. (4) 0.00
5. If Line i +Line 3 is grea�er�han Line 2,enter the diRerence.This is(he TA%DUE. (5) 0.00
Make check payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
i. Ditltlecetlentmakeatransferand'. Ves No
a. re�ainUeuseorinwmeoflhepropetlytranskrre0 ......._ .......... _.___ __._.. ❑ ❑
b. retain(he rigM to designate who shall usethe properrylransferretl orits income...._.___._._........................ ❑ ❑
c. retainareversionaryinlerest .............._ _.___ ..._.__ _._.... ........._.. ❑ ❑
d. receivethepromisekrlifeo(eitherpaymen�s,beneFltsorcare� ..__... ._....._ __..._ ❑ ❑
2 If tleaU ocwrretl afler pec.12 1982,tlitl decetlent hansfer property withm one year of deaN
withoNreceivingatlequateronsitlera�ion?..._. ............ ...___ ..._...... .____ ❑ ❑
3. �i0 tlecetlent own an"in Irus��or'or payable-upon-0eath bank accounl or secu�i�y a�his or her tleath?........._.. ❑ ❑
4. Did decetlent own an individual re�vement account annmty or o�her non pmbate pmperty which
wnlainsabene(cia7designation'+ ....__. .......... _._._. . ............... .._._.. ❑ ❑
IF THE ANSWER TO ANY OF THE ABOVE QUESTION515 YES,YOU MUST LOMPLETE SCHEOULE G AND FILE IT AS PART OF THE RETURN.
For tla[es ottlea[M1 on or afler July 1, 1994,and before Jan. 1, 1995.the tax rate imposetl on the nel value of Vansfers to o�for the use of ihe surviving
spouse is 3 percent�]2 PB.§9116(a)(1.p(I)].
For tla[es of Oeath on ar afler Jan. 1, 1995,the tax rate imposed on the net value ot transfers to or for the use of�he surviving spouse is �percenl
[92 PS.§9116(a)(1.1)(ii)�.The staWta tloes not exempt a Uansfar[o a surviving spouse from tax,end�he staNrory raqulremenls for dlsclosure of
assets and filing a tax reNrn are still applicable even if ihe surviving spouse is Ihe ony beneficiary.
Por dates of death on or aRer July 1,2000'.
� The tax rate imposetl on Ihe net value of irensfers fmm a deceasetl chiltl 21 years of age or younger at tleath to or for Ihe use of a naNral parent an
atloptive pa�en�or a s[epparent of the chiltl is 0 percen��l2 P5.§9116(a)(12)].
• The�ax rale imposed on ihe net value oilransfers to orfor Ihe usa afihe tlecedenfs Ilneal bene�iciaries Is 4_5 percen�,except as noted in�72 P_S,§9116(a)�i��.
• The�ax rate imposed on ihe net value of transfers to or br Ihe use ot the tlecetlent's siblings is 12 percent[]2 P.S.§9176(a)(1.3)].Asibling is
tlefined, untler Seciion 9102,as an intlividual who has at leas[one parenl in common wilh Ihe decetlent whelher by blood or adop�ion.
FEV-1502 E%�(12-02)
pennsylvania SCHEDULE A
oEaaArniErvr or aEVEHUE
,H�Eq,rqN�Er�„qE,�R„ REALESTATE
acsioEHroccEOErvr
ESTATE OF: FILE NUMBER:
Betty J Ludt 21-13-t319
nnreaprop•M�•avobyore..uvnuncommonmurteanoonearttmrmarx•�vaw•. Fehmarkeevawelsaerineaas�neo��ua�wnicny,oyeny
woulE be exc�enBed�eMeen a wlllinB�uyer enU e wllllnp xller,nelNer Eelnp mmpelleE lo Euy or sell.Eot��eNnp reasoneEle knowleOge ot Ne relevent lacts.
Rul property[M1al le Io���lyawroE wIN rig�t of eurvivorvMp mual Ee E6cIweE on SCM1atlula F.
Atlach a copy of lhe se�tlement sheet i(�he property has been soltl.
ITEM Inclutle a copy of the deetl showing decedenfs interest if owned as tenant in common. VALUE AT DATE
NUMBER DESCRIPTION OF�EATH
i. land locked property.West Pennsboro 7ownship, Cumberland County 1 6�0.00
TOTAL(Also enter on Line 1, RecapiWla�ionJ 5 1 600.��
If more space is needeQ use atldilional sheets of paper of ihe same size.
RE�„°aE""°a"" SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, & MISC.
oePAa.mEx.oFa�HUE pERSONAL PROPERTY
INHEFRANCETKKRETORN
RESIOENTOECE�ENT
ESTATE OF: � FILE NUMBER:
Be�ty J Wtlt 21-�3-13�9
Include the proceeds of li[igation antl IM1e tlate�he proceeds were received by the estale.
All property join[ly owned with right o(survivorship musl be tlisclosetl on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Citizens Bank checking account 32D0
2. Citizens Bank savings account 3.00
3. Personal pmperty sold at sale 17,876.00
TOTAL(Also en�er on line 5, Recapitulation) E 17,91�DO
If more space is needed,use addi�ional sheels of paper of the same sixe.
REV-i5fl EX��061]�
pennsylvania SCHEDULE H
oePu<nnen.orRevexue FUNERALEXPENSESAND
'""`a'�"NOETAXRE�1RN qDMINISTRATNECOSTS
aEsioeHroeceoeur
ESTATE OF FILE NUMBER
BettyJ Lutlt 21-13-1319
Decedent's tlebls must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERALEXPENSES�.
t Ewing Bro�hers Funerel Home 8,470.00
B. ADMINISTRATIVECOSTS'.
1. PersonalRepreSen�aliveCommission5:
Name(s)olPersonalRepresan�allve(s)
SVeetAOtlmss
Cily Ste�e ZIP
rear�n�comm�ssmn vam�.
2. nno,�eyree.: 2,SOOAO
3. FamilyExemp�ion:Qlaeceaentsaaaressisno��M1esameastlaimanl's,allacM1explanationJ
Claiman�
SVeetAUtlress
Ciry State Zlv
e�iaw��n�p o�Cia�ma��m oe�e�m
a. aroeaeFea:: 354D0
5. AccoumantFees�.
6. 1ax eewrn vrepamr Fees:
z Fiduciary bond 135A0
B. Advertising in Sentinel antl Cumberlantl Law Journal 282 00
9. Bontl filing fee 15.00
TOTAL(Also enter on Line 9, Rewpitulation) E 11,756D0
If more space is neetletl,use atltlitional sheeW of paper of ihe same size.
REV-1612 EXr I12-02)
pennsylvania SCHEDULE I
pEPARTMENiOFREVENVE
iNnEAirnNCErnxreEr�RH DEBTSOFDECEDENT,
reesioeHroEceoEHr MORTGAGE LIABILITIES & LIENS
ESTATE OF FILE NUMBER
Betty J Ludt 21-13-1319
ftepo�debb Incurtetl by Ihe deadent prior to Ceath that rtmalnetl unpaltl at Me Eate of tleath,Intlutling unrelmbu�sed metlical expenses.
IiEM VALUE AT DNTE
NOM9Eft DESGRiPTION OFDENTH
1.
Citizens Bank Loan 30,922.00
TOTAL(Also en[er on Line 10,RecapiWlation) $ 30,922.00
0 more space Is neeaed Insen atlaitionel sheet o1 ine aame alze.
aev-isa ex.�oi-io7
pennsylvania SCHEDULE J
oevna.merv.ornevervue
BENEFICIARIES
INMEPRPNLE TA%RETORN
RESI�ENT�ECE�ENT
ESTATE OF: FILE NUM9ER:
Bett J Wtlt 21-13-1319
FEUTIONSHIPTODECEDENi AMOUNTORSHARE
NUMBER NAMEANONpORE550FPEF50N(5)RECEIVINGPROPERTY DONOLLbtTru�b��a) OFESTATE
� TA%ABLEOISTFI6UTIONS�1nGUEeoNrIOM1�spousalEiaVibWlonaantlVansle�suntle�
Sec.9�i6(a��t3).�
� John F. Lutlt, IV
� 82 Sleepy Hollow Road, Staunton,VA 24401 Son 1/3 of ihe remainder
2 William Ludt
' 3 School Streel, , New Hampshire 03031 Son 1/3 0(the remainder
3 MaryJane Lutll
2230 Mitltlle Range RoaQ Newport, PA 17074 Daughter 1/3 of�he remaintler
ENTER OOLLARAMOl1NT5 FOR DISTRIBUTIONS SHONMABOVE ON LINE515 THROUGH 10 OF REV4500 COVER SHEELASAPPROPRIATE.
II NON-TAXABLE�ISTRIBCTIONS
H. SPOUSALDISTRIBUTIONSUN�ERSECTION9110FORWHICHANELECTIONTOTAXISNOTTAKEN'.
�.
B. CMNRITq9LEPNpGOVERNMENTALDISTRIBUT10N5�.
�.
TOTRLOFPRNTII-ENTERTOTALNON-TpRABLE015TRIBUT10N50NLINEI�OFREV-t50�COVERSNEET. S
�.�Q
u mo�e rpa=e���eeeea,�se aaanm�ai�neeu oi paper onne seme eize.
a\ � 1 �
'�, o �
�`� ,a�, ` \ `;
� ��_
� g.�'� �' � A\\�3 F9L�Li!/
,t". \ i �v D �y �\
�� � ,����� , �i � �\
\ � , �
� v ; a �
�
� ��� �p�-..y n' �
� �.
\ � � � m
�,
\ Y/o�* j � � i"
\ r�$ �� '� � r m q�� � �'\
�`� , %��' � • � �.'�� 'y w 2 � � �
a\ �^ "•,
� � \ � . n `\ `•, \
�� �±�a
� \
\ 8 �1 F3\ � �� � �
i - i �
` g 8 0�,� �n� �
�, w.:c: ', w�m •
�_ z. ...� .. 3�2 W
i.5C
///
5 F�""// �; ,
�,r'J� '� �':n'�r�!�F
Y
fna /���,E, a �ry °�� '%
X
� i �; ¢
� � x
�s� r ''� � ��d�.�
�.-'� ;� ,,�y��
������{.
,, f ��„
;� �, ;;x,�''� <
o � s,
:�� � y�
�_
��.�
����� ^W'`9:S � _
C.�
�\\. 2rcqa
�J� __
Q��
�. \
\`��
\\``\
�tA
. �
��.
N ���
A
��Q
/ \�
� \\\ .
�/p ��? ��\� i�i
p � .�
/ ���\
� 10�V v A��� ��•% ���
. i � 1 . Iry � 7 .
�� f I ! .
� � ' iY i{ I� J, � .
j � °. ,I
1 i
'
<'e..` �
_ ..... r.:. ...... .. . . ., -..:�
,�. = `\\`��. i'
�� �,�.. 6� � �� s z � �f� � �m
Account Numbcr 630>"'6R�95
----- .. ._ . _ _ �
Accotmt TitIE _ B�th J Ludt
Dam pal R lan��a}_of,DUU — . ._.�_ 1 $�4�,U�� I�II
A��ounl T � Chcckin�
Intcrest from L�s� l ostin to UOD $ 00
.�Account Ralance as of DOD $34231 � �
'I YTD In[crest to DOD $ 00
�� �: �� # ��r� s �� � �
Account Numbcr 6244692883
Accoun["Citic Be[ty L Ludt
Datc Opened 8/6/2004
AccountTv c Savings
" __
Principai Balance as of DOD . . . _ $2.84 _
Interes[ from Last Posting to DOD $ .Ol
nccoun[I3alance as of DOU $2.85
—_ _..__ _ . _— �
YTD [n[eres[ to l1011 � $ .1�
ROWE'S AUCTION SERVICE �RH �9L,
2505 Ritner Highway • Cadisle,PA 17015
Bill Rowe (AU 1538L) 249-1978 215-1044 574-100H Dave Rowe (AU 2295L)
Auction Is Action Call "Rowe" For S¢tisf¢ctioa
SELLERS NAME ��� rt( `� �- �✓-�____R ��DATE LLyP1L. �-; � ��
ADDRESS c7. 1 '}..'3 Ri—N�_. Hwi-1 PHONES4�'�'t'� S' �-`Y��
r
OTHER �-�'�-�ti�i �� I'� o S AUCTIONE;Ek{ y _� O
AUCTIONDATElLOCATION A'����- t�y Zo"� p� =�� .4"< CLERK %�3 �-5
DESCRIPTION OF MEACHANDISE
�L�-_ o7dw.S ��S�4.D
C ......____ --- _—
__. . J ���f � � �� 7. ��
,q t� __..___._.—'---
—.____�� (uv;l�� �fa�bi ' �� -- -
GU�c�e-- - �2 / l0 � 00 _
. - �, ---
—\ �,s.rz L..t,c,^c �k.,.4,.,,�,'�---I Cd� y,ti� —.
(�YL.vT'� ��-oV Wir_;,p i ,F � �F-J+F�A '____
a`f�'T - "-- �,o�n� S.�L L.q� — — 5 � v ----..___.
A-�Dv �.r T� si i�cr �sTS - 5a��,f.�+
I Commission the Auctioneers to sell the merchandise to the highest bidder by Public Auction. Merchandise
to be sold as is & grouped as necessary to obtain bids. I certify that 1 em the owner or euthorized represen�
tative of the merchandixe,goods and ot property and have good title and the right to sell and that they are free
from all incumbrances. I agree to accept all responsibility for providing merchantable citle and for deGvery of
title to the purchaser. agree to hold harmless the Auctioneers agains6 any claims of the nature referred t�'m
thia agreement. /
� � ��
AUCTION SIGNATURE /) � SELLF,RS SIGNATU/jj.tE(� � I^
Tota] Sales (Clerking'ISckets Attachedl $ .�SL ���"- /.�1 M I V `
Less Sale Expense:
____._——%CammissionAuctioneer $ .�O /�' �� — �
%CommissionClerks $/�+�7 'Ud 7� 1
OTHER: . *�� GI7 ' .�C�U Sii = S� Jc�
TOTAL SALE EXPENSE UEDUCTED $ _-�n-3.��� � ` � "
SELLERSNET $ �/ 0 / 5 ' 7d 1 �(
_ . ��� S-C'� � -� � ��q. r � \
1
Ewing Brothers Funeral Home, Inc.
630 9outM1 Hanove�S��eet Latlbl¢,PA 1]Oi91]1i�]3}Iyy1
SNvanq�EwingF�,SupervrsoqQvnei EmeII�. PA�i�n�5trce18iJ.wm xemEiiwlB5lcom Pox �]P)2o3-�5fi3
�ATE 9/H/201b ___ 9tHVNENO. Lutll,BetlyJane_ _ _
DECEPSE�NAMEB �NJ Ldt
0 EOFDEATH 9110/R011 RACCO fl ��L f�
PY�'r;m�,��91Y d6Peoov��YF '�448a,aRae�e� eurc ,� `XoW Fea�L�a"Y nao�dm�mn9:eAe.�a. . . row�'c
m�, , m� ,
_._ _ . .. _ _ —.
STATEMENT OF FUNERAL GOODS AND SERVICES SELEGTED,AGREEMENT 8 PROMISSORV NOTE I
.___ _. _ .. . . _ .—
P. SERVICES.STAFF,FACILITIES, Sp¢Cidl CM1a�ges
WUIPMENT�INDMOiOREpNPMENT PoiwaNintioBumalnsio
9eslc5ervlcesotPALFD. t29500 S -0.
Bai�inaan4Embalmmg f _83pq RBceMngolRemen6Pom
O�I�eiPrepaiet�onof�emese0 4 �Y5114 � -0.
easmoseo�Facmb k s5000 5__�0�
oowme.�ie�roo v�eplaewraing F 3�s.oa y _o-
FD/$�NSupenisonUiewMsrllServlce b '�' S � -0-
PealllylEqmpNewMsiWPrviCe £ k
F�AYaR9uparvimanVazwMsib9ervlca b k -p-
r,an�yrea��omeau�:�oseN�« o- -o_ � o.
fo5�enmrimeimamservi« E _�aooa g a
CMen4edFp5[aNUsage �-
ExtenaeeFaciluyusage § -0- p. ITEM5INVOLVINGCASH
r��,r�o����emF��e,�inoma ¢ aasaa ca�eooa�aci�e s �sss.00
Hearse Ilsage f� 39500 RocN OrcaFNg a�arg¢��??? 5 0-
Sa�ery/LeeOVeMcle 5 1d000 T�eSen�InelO0l�uary(Esl) S 25000
wi�n�vamme -o_ mevamomov�ary s o
Fa�lyVeM1mle } J ClcgyHonoraium (FemAy� 3 h
-o- orea��s�a�cn�Rn�v,may� s o
-o- soio�svca�mr s -o-
AltarServsis 5 -0.
-0- �eatM1GetliY��az 5 JO-00
-6 Flo'xen 5 �5��
-0. OPe�NewspapeiObtluary $ -0-
-A PmlemonalHauSryling 5 8
-o- sawmayrnargerorcra�eao:i�e a �oo_oo
-o- v.,�is�wmoru�a�sd 8 �aao
s n s a �
o. s o-
B. CXl�RGESFOR � 5 39B1C0 � �-
8 0-
G9kpt � Bi50� � �
20GNGEe�MoneCaske: � � �
$ -0-
ONercon�alner 13950o �
N1Yguar4lanOBG 3 225�0
Vault 5 L P�eGa'9nyou�arourserviceslnobiainirg�.(speory�sM1aWanmtlems�.
Reg¢trvv9ook $ -0
MamocelFolders 5 9i00
T�ankvouNotes S 1000 I 'uI�G�UMMARTOFCHAFGES:
S O � " �(h CrvPNGE5FON5F.RNCES S 0,9BOD0
. S 8 Rr �. GHPRGESFORMERGHAN�ISE �.aE`L�4
s o �y�jy�•c. orxEa cxnacrs s a-
g -o- (� o. cnsnnovaNces 8 a'asoo
$ �p� l V E 9PLE9TM,IFPPpLICPBLE � -4-
g� _0- @�I��y TOTA�FUNERALHOMECHARGES S tla/040
E .p. d+ � SS CftE01T AN�PREPAVMENTg: p
5 o C� � p
b � �
g o. s o-
a o- s
a . _ a_ rora�caeoir s �o� .
s 2ae5ao �a�oEoue s eno.00
r . '� o - - rv v� .e � 7e°e'a °' .ema� °' o n m
- - �000�e.-'_a n rea. oecer � � n � . . . _____
. _ oec oy -� �y
enimqronury�a�ewoo aaaso�ro,emmm,��qaea�anaeior�ewmg �
svormaamrzmaeaa_uw,porc.rnvma aeq���eamr.,ewmg
N¢wpotl PA 90A
�m eeye�' e�nN M1av easssaiseQa���a�elo 9 � ee o �i�a ayio
rs�aBsute°e�i�i tneYi�naoe'�receee�°e`ue��i° �`itipn"eii°°anenave°°Ce°enonerea°�°o�r°e`:ie�`.�'in�e'°°�e`di�'cei�ne°roia'�oiue`o�u°ii��'oma�ne°se�
1
n
°`�4m°m�smamw�.a�v=eani`�"r,aP��a�o�m�ma�a�omare8°ieo�=neeaw„me a�re au��ae�aeT,mwoi e�w�,ma��e wn or m�ag�amama,a�n,��EnP��.�mm
� ���::e 1 �A� �
l�iMl✓�
�aee �`�' oa,� ,�,o n
.
—..__ . . _._- ----
Cao9neiv pale� . . ..
�le._JI(S.�.r�. . e�weo
NemeoM1unerz.�omeipo¢renlanw — /lm�rzb /
�v/
�� Fax Server 3/5/201� 8 : 18 : 20 AM PAGE 1/001 Fax Sercer
■�
:f
.�
�� Citizens Bank
Loan AccountNo: 6057033978
Da[e: 3/5/2014
Requeslor Name:
Attention To: ROBERT G FREY
Fax: (71� 243-6441
Customer Name: BETTY JANE LUDT
Collateral Description: 2123 RITNER HIGHWAY CARLISLE PA
You are receiving this notifica[ion as a resWt of your recent request for a fax payoff confirmation. To pay your
account in full. you need to remit[he balance owed of S3Q921 B5.
The amoun[reflected above is your outsCantling loan balance of S30.921.85 inclusive of a recortling fee of
555.50 and/or an eady termination fee of 50.00. This amowt also includes the Fax Fee of 90.00 which was
disdosed[o you at thetime of the fax confirmation reques[.
The payoff is valid through: 9/10/2013.The Per-diem is S2.53 per tlay if paymen[is received atterthe valitl-
[hrough date.
Paymant can be made atany Citizens Bank branch or mailed to:
Consumer Finance
Attn:Payoff-RJW230
443 Jefferson Blvd.
Warwick, RI02886
Please check one of Ihe following selections and sign where indicated below:
❑ By signing below. INVe request[hat this account be permanently closed to further advances and a
discharge of mortgage be issued.
❑ By signing below. INJe acknowledge thatthis account is to remain open and available forfuNre
advances and that the payoff amount is requested only forthe purpose of paying down the account
6alance.
BETTY JANE LUDT
PLEASE READ THE DISCLAIMER BELOW
My oufstanEing cM1eckz or cM1arges IM1rt ara not Inclutletl In [M1e above payoX amount are IM1a nsponslbllity of IM1a customa�.
The wslomer is also responslCle for the entire balance on the aaount ragardless ol the quotetl payaR amount. It t�is accounl
Is sewmtl by a mortgaga, Ihe motlgage wlll not be released until Ihe above condllions are met.
The customar Inlortnation conlalnatl In IMs far Is anty lor ihe use as requestetl or aalhorizatl by Ihe customer whose name Is
Ilstetl above. This informatlon may nol be reusetl for any purpase or reEiscbsetl to any afllllated or nenaNllateC lhird parly
uniess authorizatl by tM1e cuslomer or by Cttlzens Bank ot PennsNvanla. R ihls fax has been recelvetl In enor, please tlestmy
mis aocumem immetliatey.