HomeMy WebLinkAbout01-0232
PETITION FOR PROBATE and GRANT OF LETTERS
Es if Joseph F. Arnold
tate 0
also known as Joseph F. Arnold, Sr.
No.
To:
Register of Wills for the
, Deceased. County of in the
Social Security No. Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of ag~ol oldfi an the execut ors
in the last will of the above decedent, dated u y
and codicil(s) dated N . A.
C-7~/ijd(,)u::_7 H AYkcl,j- c/~'&-?:l /J~f ~ / 9~t
21-01-232
n~wed
, 19_
(state relevant circnmstances, e.g. renunciation, death of executor, etc.)
p~cendent was domiciled at death in Cumberland County~ PennsY.1vania, with
h last family or principal residence at Ij.J C Street, tlorough 01.: Carlls1e
(list street, number and muncipality)
Decendent then 81 years of age died February 5
at Cariisle Hospital, Carlisle, PA
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in f'.eonSYlv..ania .
situated as follows: j) C ~treet, Carllsle
,~ 2001 ,
SeGu.OD
$
$
$
$
{D, t~O{), DO
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters testamentary
(testamentary; administration c.La.; administration d.b.n.c.La.)
theron.
Joseph F. Arnold, Jr.
68 Leho Road
Carlisle, PA 17013
Jack L. Arnold
250 Mountain View Road
Shippensburg. PA 17257
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA l ..,..
r s~
COUNTY OF' Cumberland J
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the kilOwledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed 'l-wd ~
before me this 28th day of ~.
~;~;~Y~;L<<'~~~;:;P/ j~~, ~
/ / Register ~
/ /,- (] I~-/
~o. 21-232-2001
Estate of
Joseph F. Arnold
, Deceased
DECREE OF PROBATE A~D GRA~T OF LETTERS
AND NOW FEBRUARY 28 ~ 200~ in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated July 11, 1996
described therein be admitted to probate and filed of record as the last will of
Joseph F. Arnold, a.k.a. Joseph F. Arnold, Sr.
and Letters Testamentary
Joseph F. Arnold, Jr. and Jack L. Arnold
are hereby granted to
, ()'1.'. ~
7J)/)Ui/ . ,:;' ///L<'~t7t/(N'-),,~y
. R . lster of Wil s (;
FEES
Probate, Letters, Etc. ......... $
Short Certificates( ).......... $
x-pag~s.
RenuncIatIOn ................ $
$ 5.00
TOTAL _ $ 141.00
Filed... .~~~:. .~~!. .~q~~................
115.00
12.00
~.uO
Stephen B. Lipson 19453
ATTORNEY (Sup. Ct. J.D. No.)
5 Hilltop Drive, Mount Holly Springs,
ADDRESS PA 17065
(717) 486-8981
JCP
PHONE
21-01-232
REGISTER OF WILLS OF C C),,,/gj;;U/1J/j) COUNTY
OATH OF SUBSCRIBING WITNESS
,S-f 2~,j;7jel/ B, L/';?f"c~ fl
- ;- - - ~ I~'-
(......., a subscribing witness to the will presented herewith, ~ being duly qualified according to
law, depose(s) and say(s) that A p present and saw
~" ( 0:/,
the testat 0 j~ , 'sign the same and that A e
request of testati2L- in h fj" presence and (in d~o p"^M ~
other subscribing witness(es)).
signed as a witness at the
II ! lh H) (in the presence of the
~~-g~,
,S- -fe--T/C',6~ (Name) LJ.- /_y"JrC /7
,S 1// / /-7-:-: ~ J.J/'A~
A f -f ~ J Ie:' /1/ (~ddress )l/~F~,d~,f ~ /;1 ) 7 C /-~;-
Sworn to or affirmed and subscribed before
me this day of
19_
Register
(Name)
(Address)
REGISTER OF WILLS OF C'G,i/!5fi-:/!-,LAi-j) COUNTY
OA'IH OF NON-SUBSCRIBING WITNESS
,~7;;__<;-'L~' ;:~i F A /7t C h/~ ~
~ a subscriber hereto, ( {) being duly qualified according to law, depose(s) and say(s} tha~
) e /~ familiar with the signature of :JO S ';1'/ ~ A /-h (' / '"
~ .ft1j 'I
testat c y of (OR If' fro R'l~..;h;ng "'itIU!lJ l!l 181 the will presented herewith and
~
that /\ ~. believes the signature on the will is in the handwriting of
J;; -> <2-/,/
to the best 0; <A /7;-
I~' A //
, ' /I r /1 c t cf/" ~
knowledge and belief.
) /Jt?(7
/i/!/L4~---Ci/ ~
Of~/''< (Name) F A r '" Ie{
{- P' c<. e t!' c ;(7 < ~-ct
, (Address) .--7" , "
Cc< //It'vA=) j7,'/1 ) /C/J
(Name)
~.A//
Sworn to or affirmed and subscribed before
me this day of
19_
Register
(Address)
h 1~ IS to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
,)(;;] Registrar. The original certificate will be forwarded to the State Vital Records OffIce for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
&-~.~~~~
Local Registrar
Fee for this certificate, S2.00
P
I
6948235
FEB
7 2001
Date
21-01-232
105. ;43 Rev 2/87
COMMONWEALTH OF PENNSYLVANIA. OEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
81
UNDER 1 D~
-.os ! Minut..
SEX
STR E FILE NUMBER
SOCIAL SECURITY NU"BER
NAME Of DECEDENT I~"" "oddle. l""
\==.
I.
..:JO"::>.e
h
Ar(\old
5R.
2. M
3. 162 - 12
.. 2/5/2001
Vrs
BIRTHPLACE !Co/'; arod PlACE ~ DEATH IC_' Of'Iy 0I'e - __ ,,,,"ueloOOO on _ _I
Stale Of Fcrewgn Coontrv) HOSPITAL..;
Mt. Union, PA Inpa,;....lZl ERIOuIpo...nt 0
7. ...
FACILITY NAME (II nrn ,n"'M""'. gIve st'eelan<l nomee"
="",0
AGE (la.. Bw1noay)
5.
COUNTY ~ OE)JH
'"
FATHER'S NAME (F.... M_.. La..)
". Frank W. Arnold
INFOAMAHT'S NAME (T ypelPrinl)
200. Jose h F. Arnold, Jr.
METHOO Of DISPOSITION
O IIuri8l tzl C,_ion 0
~ OI'-~\
. 21"
SIGI'UlTURE Of FU
17b. Cou
Did
--
Mina
Cumberland .......,,;p? 17d.~ ::;;"'~~OI
MOTHER'S NAME IF..t MoO<lIe. MalClen Sufnamel
". Lila Ber
INFORMANT'S MAIlING ADDRESS t$IJeeI. CtyITown, SWte, rill Codel
2Gb. 68 Lebo Rd., Carlisle, PA
PLACE Of DISPOSITION. N..... 01 Cemet.ry. C,emaoory
0< Ol/Ie< Place
MARITAL STATUS. M_
N~ "'.(fied. Widowed.
~ced (Speclly)
1.:Widowed
17C.0 _.__in
RACE . A~ Indian. 8teck.. Whit.. MC
(Speclyl
10. White
SURVIVING SPOuSE
(" 'MI.. grve maiden namel
;\.
. .... Cumber land
DECEDENT'S USUAL OCCUPIJION
I~_~ ~.';.,"=':::':l,:'i'
llL Diesel Electrician lib. ilr
DECEDENT'S MAllING ADORESS (51,.... C...,/1Own. SlaM. Zop Code\
135 "e" Street
Carlisle, PA 17013
Ie,
118. Slate
PA
lWp.
Carlisle
c:ily/bon).
Carlisle, PA 17013
Hane, PA 17013
0/
No~
c...o P"D
DUE 10 (OA AS /l, CONSEOUENCE Of):
21.
I Approximate
: interval bet'wMn
I...-anddealll
! ~'" kr...
PART II: 0I1ler .ignillcant _ conItt>ullng to de.th. but
noI .....ftineJ in .... underlying 08_ given in PmT I.
2., M. 25.
21. PART I: Enter rhe diuaus, inlur," ot comohCafions which caused the death. 00 netent., the mode 01 dying, such as cardillC Of respiratory anes'- st1c)a or neart lailure
List 0ftIy one cause on each tine
l :
c.~TN..'- ~, ,,<:'\l'\\~(,.
~~ ~""'~
DUE 10 (OR "S /l, CONSEQUENCE OF):
DUE 10 (OA AS A CONSEOUENCE OF)'
WERE AUlOI'SV FINDINGS
""""lABlE PRIOR 10
COLlPLETlON OF CAUSE
OF DEnH7
MANNER QF DEATH
DATE OF INJURV
IMonlt\. Day. Year)
TIME Of INJURV
INJURV J(f WORK? OIESCRIBE HOW INJURV OCCURRED.
Aceldent
Pending Invesligation
o
o
o ~~CE OF INJURV - .\1 hom.. ...~~;..... factory, ollie.
bu;tdino. .tc. IS_Ov\
30..
_ 0 NoD
Suiclde
~
o
o
HomOClCM
Natural
REGISTRAR'S SIGNATURE AND N B
~. ~tu.-~U-t>J
~l,~\ {J!
""''U
e ..~~~ ()1..
No 1}(-
VIIS 0
NoD
Could not be determIned
210. 2.b.
aRT IFIEA IC~eck ani., one)
.CEJIITlfYING PHYSICIA" (PT'I'fSlClroln cP.r,1fytng cause ~ ~aln 'Nr"" anOll'er OhVSK:lan has pronovnc::ed death ano completed lIem ZJ)
To"'- best of my knowle<fge, death oeeurred due 10 the c.u.e(s~ and manner a. stated. . . . .
.PftONOUNCIHG AND CERTIFYING PHYStClAN (PhySIC~n tJQft: iJlOnOUf'IC11"lg tleath and C~"Ylnq 10 cause 01 deatt'\l
To the best of my knowl.d';)l"I, dell I'" occurred at the Um., date, ~nd place. .nd due to the clluse(s) IInd manner n slaled
.MEDICAL EXAMINER/CORONER
On the b..il of examination andlor Investigation, in my opinion, death occurred 1'1 the time, dale, and place, and due to the cause(l) and
m.nne, a. .t.tl'd.. , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . .
31._
d-,\S1) \
~
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~
LAST WILL AND TESTAMENT
OF
JOSEPH F. ARNOLD
I, JOSEPH F. ARNOLD, of 135 C street, Carlisle, Cumberland
county, Pennsylvania, being of sound and disposing mind, memory
and understanding, do hereby make and declare this as my Last
will and Testament and revoke all wills and codicils heretofore
made by me.
FIRST
I direct the payment of my debts and expenses of my last
illness and funeral from my estate as soon after my death as
conveniently may be done. If there is no cemetery lot available
for my interment, owned by me at the time of my death, I
authorize my personal representative to purchase such cemetery
lot with a contract for perpetual care, using therefor funds from
my estate in such amount as my personal representative shall
"'-
~consider necessary and desirable.
r Further, in this connection, I authorize my personal
representative to expend reasonable funds from my estate, in such
/
amount as my personal representative shall consider necessary and
desirable, for the purchase, erection and inscription of a
suitable marker for my grave.
SECOND
I give, devise and bequeath all of my property, both real,
personal and otherwise, wherever located, to my beloved Wife,
GERALDINE H. ARNOLD, should she survive me by thirty (30) days.
THIRD
Should my Wife, GERALDINE H. ARNOLD, predecease me or fail
to survive me by thirty (30) days, then I give, devise and
bequeath my entire estate in four equal shares, per stirpes, one
share to each of my beloved children, JOLENE N. BARRICK of
Carlisle, Pennsylvania; JOSEPH F. ARNOLD, JR. of Carlisle,
Pennsylvania; JACK L. ARNOLD of Shippensburg, Pennsylvania; and
LINDA L. STONE of North Middleton Township, Pennsylvania. Any
share which passes to my grandchildren under this Paragraph shall
be subject to the provisions of Paragraph Fourth, infra.
FOURTH
~
~
~
~
.
~
Any share of my estate passing to a beneficiary under the
age of twenty-one years shall be in trust, with the trustee to be
designated by my Co-executors. The income and/or principal of
said trust may be accumulated or expended for the maintenance,
education and support, including college education, of such
~ beneficiary as my trustee in its sole discretion may determine;
~and my trustee, in the expenditure of income and/or principal for
~ such purposes, may, at its discretion, apply the same directly
~ithout the intervention of a guardian or pay the same to any
~,~
person having the care or control of said beneficiary or with
whom the beneficiary resides, without duty on the part of the
trustee to supervise or inquire into the application of the funds
by any person to whom any payment is so made. The balance of
such income and/or principal shall be paid to such beneficiary
upon reaching the age of twenty-one years, or to such
beneficiary's estate in the event of death prior thereto.
FIFTH
I nominate and appoint my Wife, GERALDINE H. ARNOLD, as
Executrix of this my Last will and Testament. Should my Wife
fail to survive me or be unable to serve in this capacity, then I
nominate, constitute and appoint JOSEPH F. ARNOLD, JR. AND JACK
L. ARNOLD as Substitute Co-executors of this my Last will and
Testament. I hereby relieve my Executrix or Substitute Co-
executors from the necessity of posting security in connection
with their duties as such in any jurisdiction in which they may
be called upon to act insofar as I am able by law to do so.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to
this, my Last will and Testament, consisting of three (3)
typewritten pages, the first two (2) of which bear my signature
in the margin for the purpose of identification, this
/ I/!-;'
/"i/ ~,. ~
day of
~J' I
, ~/ L / i../
, 1996.
/
/
~~#?'~lf2t~~d >
(SEAL)
Signed, sealed, published and declared by the above-named
Testator, JOSEPH F. ARNOLD, as and for his Last will and
Testament, in the presence of us, who, at his request, in his
sight and presence, and in the sight and presence of each other,
have hereunto subscribed our names as witnesses.
/ b rz (1/ ~ Jtfd, (" J..d-
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///;; ( ,.)p--~-~-:i':
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...... .
"
4
~
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: JOSEPH F. ARNOLD, a.k.a., JOSEPH F. ARNOLD, SR.
Date of Death: February 5, 2001
Will No:
Admin. No. 21-01-0232
To the Register:
I certify that notice of estate administration required by Rule 5.6(a) of the Orphans' Court
Rules was served on or mailed to the following beneficiaries of the above-captioned estate on
;u'0YC/t/ 15- ,20fL:
Name
Address
Joseph F. Arnold. Jr.. 68 Lebo Road. Carlisle. PA 17013
Jack L. Arnold. 250 Mountain View Rd.. Shippensburg. P A 17257
Jolene N. Barrick. Box 970. RR # 2. Landisburg. P A 17040
Linda L. Stone. 18 Heather Dr.. Carlisle. PA 17013
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: No
exceptions.
Date: (:3)/5)6/
~/ b-->--
Stephen B. Lipson, Esq.
5 Hilltop Drive
Mt. Holly Springs, P A 17065
Phone: 717-486-8981
/'
Capacity: Counsel for personal representatives
E:
.--
\
.-" ,
IMPORTANT NOTICE
NOTICE OF ESTATE ADMINISTRATION
THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE
ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE.
Whether you will receive any money or property will be determined
wholly or partly by the decedent's will. If the decedent died
without a will, whether you will receive any money or property
will be determined by the intestacy laws of Pennsylvania.
BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, CARLISLE, PA
IN RE: Estate of JOSEPH F. ARNOLD, a.k.a. JOSEPH F. ARNOLD, SR., deceased, Estate
No.21-01-0232
TO: Joseph F. Arnold, Jr.
68 Lebo Rd.
Carlisle, PAl 7013
Jack L. Arnold
250 Mountain View Rd.
Shippensburg, PA 17257
Jolene N. Barrick
Box 970, RR # 2
Landisburg, PA 17040
Linda L. Stone
18 Heather Dr.
Carlisle, P A 17013
Please take notice of the death of decedent and the grant of letters to the personal
representative( s) named below.
Joseph F. Arnold, Jr. and Jack L. Arnold
The Decedent Joseph F. Arnold, Sr., died on the 5th day of February, 2001, at Cumberland
County, Pennsylvania
The Decedent died testate (with a Will);
The personal representatives of the decedent are (name and address):
Joseph F. Arnold. Jr.. 68 Lebo Road. Carlisle. PA 17013
Jack L. Arnold. 250 Mountain View Rd.. Shippensburg. PA 17257
The Decedent died testate, and thus the will has been filed with the Office of the Register
of Wills of Cumberland County, 1 Courthouse Square, Carlisle, Pennsylvania 17013. Phone No.
717-240-6345.
. ..
A copy of the Will or petition may be obtained by contacting the Register of Wills and
paying the charges for duplication.
Date: 3//5)6}
. /---!!? ~
SIgnature: ..-?C::>t::-/ c.~--'
~
Name
Stephen B. Lipson. Esq.
Address
5 Hilltop Drive
Mt. Holly Springs. P A 17065
Telephone
(717)486-8981
Capacity:
Personal Representative
Counsel for personal representative
/ b -~/-'-/- I
*
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280E-1l1
HARRISBURG, PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT 1 ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
ReCC.i
Re!j
REV-1547 EX AFP (12-00>
11-12-2001
ARNOLD
02-05-2001
21 01-0232
CUMBERLAND
101
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
All =s 1 COUNTY
ACN
F
JOSEPH
.01 NOV 16
STEPHEN B LIPSON
61 W LOUTHER ST
CARLISLE
PA 17g~~berii~;.;..
Amount Remitted
PA
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLEI PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REY=is4-i-i;f-AFP--ci"2':ocir-NCffici--OF-.rtiHiifiTAifcE-TAi-APPRAisii'-ENT~--ALi-oWAifcE-oi-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF ARNOLD JOSEPH F FILE NO. 21 01-0232 ACN 101 DATE 11-12-2001
TAX RETURN WAS: (X) ACCEPTED AS FILED
CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
S. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
68.000.00
.00
.00
.00
2.395.15
.00
10.500.00
(8)
NOTE: To insure proper
credit to your accountl
submit the upper portion
of this form with your
tax payment.
(1)
(2)
(3)
(4)
(S)
(6)
(7)
801895.15
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
151429.24
337.00
(1U
(12)
(13)
(14)
(9)
(10)
15.766 24
651128.91
.00
651128.91
NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ ALL returns assessed to date.
ASSESSMENT OF TAX:
IS. Amount of Line 14 at Spousal rate (IS)
16. Amount of Line 14 taxable at Lineal/Class A rate (16)
17. Amount of Line 14 at Sibling rate (17)
18. Amount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CREDITS:
.00 X 00 = .00
651128.91 X 045 = 21930.80
.00 X 12 = .00
.00 X 15 = .00
(19)= 21930.80
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
10-04-2001 CDOO0350 .00 21930.80
TOTAL TAX CREDIT 21930.80
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
( IF TOTAL DUE IS LESS THAN $11 NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR)1 YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
. IF PAID AFTER DATE INDICATED 1 SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
\.. I h -02/~- /
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS, AND ASSESSMENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
REV-1548 EX AFP (12-DD>
JOSEPH F ARNOLD JR
68 LEBO RD
CARLISLE PA 17013
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
08-20-2001
ARNOLD
02-05-2001
21 01-0232
CUMBERLAND
162-12-0850
01118021
JOSEPH
F
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REfv:is~8-E3f-AFP--(i1f:ool------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 08-20-2001
ESTATE OF ARNOLD
JOSEPH
F DATE OF DEATH 02-05-2001
COUNTY
CUMBERLAND
"-
'I
FILE NO. 21 01-0232
TAX RETURN WAS:
S.S/D.C. NO. 162-12-0850
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
01118021
FINANCIAL INSTITUTION: MEMBERS 1ST FCU
ACCOUNT NO.
49761-11
TYPE OF ACCOUNT:
DATE ESTABLISHED
( ) SAVINGS (X> CHECKING ( ) TRUST ( ) TIME CERTIFICATE
04-06-1999
X
1,895.00
0.500
947.50
.00
947.50
.45
42.64
NOTE: TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
X
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
05-03-2001 AA496548 2.13 42.64
TOTAL TAX CREDIT 44.77
BALANCE OF TAX DUE 2.13CR
INTEREST AND PEN. .00
TOTAL DUE 2 . 13CR
* IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. *
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
'\. /6-e:l/"t"- I
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENTL ALLOMANCE OR DISALLOMANCE
OF DEDUCTION~, AND ASSESSMENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
REV-1548 EX AFP (12-00)
JOSEPH F ARNOLD JR
68 LEBO RD
CARLISLE PA 17013
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
08-20-2001
ARNOLD
02-05-2001
21 01-0232
CUMBERLAND
162-12-0850
01118022
JOSEPH
F
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
RE-v:is~i-E)f-AFP--(i2-:oo1------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 08-20-2001
ESTATE OF ARNOLD
JOSEPH
F DATE OF DEATH 02-05-2001
COUNTY
CUMBERLAND
FILE NO. 21 01-0232
TAX RETURN WAS:
S.S/D.C. NO. 162-12-0850
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
01118022
FINANCIAL INSTITUTION: MEMBERS 1ST FCU
ACCOUNT NO.
49761-00
TYPE OF ACCOUNT: (Xl SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 05-07-1986
x
542.00
0.500
271.00
.00
271.00
.45
12.20
NOTE: TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
x
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
05-03-2001 AA496547 .61 12.20
TOTAL TAX CREDIT 12.81
BALANCE OF TAX DUE .61CR
INTEREST AND PEN. .00
TOTAL DUE .61CR
* IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. *
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
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HARRISBURG, PA 17128-0601
I
I
I
~VQP
TAXPAYER RESPONSE
DATE
~1 01-0232
Dll18022
04-11-2001
REV-1543 EX AFP (09-00)
EST. OF JOSEPH F ARNOLD
S.S. NO. 162-12-0850
DATE OF DEATH 02-05-2001
COUNTY CUMBERLAND
TYPE OF ACCOUNT
[i] SAVINGS
D CHECKING
D TRUST
D CERTIF.
JOSEPH F ARNOLD JR
68 LEBO RD
CARLISLE PA 1701'3
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
MEMBERS 1ST FCU has provided the Depart.ent with the infor.ation listed below which has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of
this account. If you feel this infor.ation is incorrect, please obtain written correction fro. the financial institution7 attach a copy
to this for. and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Co..onwealth
of P6nnsylvania. Questions .sy be answered by calling (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 49761-00 Date 05-07-1986
Established
Account Balance
Percent Taxable
Amount Subject to
Tax Rate
Potential Tax Due
x
542.00
50.000
271.00
.045
12.20
TAXPAYER RESPONSE
To insure proper credit to your account, two
(2) copies of this notice .ust acco.pany your
pay.ent to the Register of Wills. Make check
payable to: "Register of Wills7 Agent".
x
NOTE: If tax pay.ents are .ade within three
(3) .onths of the decedent"s date of death,
you .ay deduct a 5% discount of the tax due.
Any inheritance tax due will beco.e delinquent
nine (9) .onths after the date of death.
Tax
PART
[!]
1~11i111r"""'i"""':"''''''''''''''''''''''
-...................-.......-.................-
....-...................-...............-.....................
...........-...-...-.-.-.-.-.-.-.-...-.......-.-.-.-.-.-.-.-."
[CHECK ]
ONE
BLOCK
ONLY
A. ~he above infor.ation and tax due is correct.
1. You .ay choose to re.it pay.ent to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or you .ay check box "A" and return this notice to the Register of
Wills and an official assess.ent will be issued by the PA Depart.ent of Revenue.
B. c=J The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
to be filed by the decedent"s representative.
C. c=J The above infor.ation is incorrect and/or debts and deductions were paid by you.
You .ust co.plete PART ~ and/or PART ~ below.
PART
~
TAX RETURN - COMPUTATION
LINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
TAX ON JOINT/TRUST ACCOUNTS
If you indicate a different tax rate, please state your
relationship to decedent:
OF
1
2
3
4
5
6
7
8
x
x
PART
[!]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
$
I
TOTAL (Enter on Line 5 of Tax Computation)
perjury, I declare that the facts I
ledge and belief.
have reported above are true, correct
HOME (7/7) 2.S'f- 5'73'>
WORK ( )
TELEPHONE NUMBER
and
-5-- 3/- 0)
DATE
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
'*
It' --~/y- - (
'-)' JL c/
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21 01-0232
ACN 01118021
DATE 04-11-2001
REY-l&45 EX AFP (09-00)
EST. OF JOSEPH F ARNOLD
S.S. NO. 162-12-0850
DATE OF DEATH 02-05-2001
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
IX] CHECKING
o TRUST
o CERTIF.
JOSEPH F ARNOLD JR
68 lEBO RD
CARLISLE PA 17013
REMIT PAYMENT AND FORMS TO:
REGISTER OF WIllS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
MEMBERS 1ST FCU has provided the Deparbent with the infor.ation listed below which has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of
this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy
to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Co.monwealth
of Pennsyl~ania. Que$tions may be answered by calling (717) 767-.8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 49761 - 11 Date 04- 06 -1999
Established
Account Balance
Percent Taxable
Amount Subject to
Tax Rate
Potential Tax Due
x
1,895.00
50.000
947.50
.045
42.64
TAXPAYER RESPONSE
To insure proper credit to your account, two
(2) copies of this notice must accompany your
payment to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
x
NOTE: If tax payments are made within three
(3) months of the decedent"s date of death,
you may deduct a 5Z discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) months after the date of death.
Tax
PART
[!]
A.
[ CHECK ]
ONE
BLOCK B.
ONLY
c.
~he above information and tax due is correct.
- 1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or you may check box "A" and return this notice to the Register of
Wills and an official assessment will be issued by the PA Depart.ent of Revenue.
c=J The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
to be filed by the decedent"s representative.
c=J The above information is incorrect and/or debts and deductions were paid by you.
You must complete PART ~ and/or PART ~ below.
PART
~
TAX RETURN - COMPUTATION
LINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
TAX ON JOINT/TRUST ACCOUNTS
If you indicate a different tax rate, please state your
relationship to decedent:
OF
1
2
3
4
5
6
7
8
x
x
PART
~
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Line 5 of Tax Computation)
I
$
Under penalties of perjury, I declare that the facts I
e to the best of my knowled and belief.
+~~
SIGNATURE
have reported above are true, correct
HOME (717 ) 2J'f~ 5--75..5--
WORK ( )
TELEPHONE NUMBER
and
.};:.. 5/-0 I
DATE
,.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
LIPSON STEPHEN B
501 S HANOVER ST
CARLISLE, PA 17013
______n fold
ESTATE INFORMATION: SSN: 162-12-0850
FILE NUMBER: 21-2001- 0232
DECEDENT NAME: ARNOLD JOSEPH F
DA TE OF PAYMENT: 10/04/2001
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 02/05/2001
NO. CD 000350
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $2,930.80
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$2,930.80
REMARKS: JOSEPH F ARNOLD JR
C/O STEPHEN B LIPSON
CHECK# 098
SEAL
INITIALS: PB
RECEIVED BY:
MARY C. LEWIS
REGISTER OF WILLS
REGISTER OF WILLS
~.
OKI
C/
STATUS REPORT UNDER RULE 6.12
Date of Death:
JC) -;- E' fii
I'
Fe -6 y v ar <.",
/
F ArA-I~jld~ (~/I)
--~ I ;}-()O!
./
Admin. No. ;;Lj-oj- OJ-32-
Name of Decedent:
Will No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1 .
State w~ther administration of the estate is complete:
Yes~ No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete: -----
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes No ~.
b. The separate Orphans' Court No. (if any) for
the personal representati ve' s account is: --_.
c. Did the personal representative sta~an
account informally to the parties in interest? Yes ~ No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
Date: ///~~/O]
,
....~~. /?0~-
/' ~,. ........-.'.
Signat re -
~ / /) / ~
,5. .--{1AC:?/7 I::> ." c-.- / A1Jc-'k..-
Nam . (Please type 9f print)
S If /~r A--,/4/-(, Jh:1c '7"'7
Address F4 17~~J
(7/7) /.2 C; 9- 3 r ~9
Tel. No.
Capacity:
Personal Representative
~
L.../"" Counsel for personal
representative
(MAH:rmf/AM3)
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
(' ..- - Phone: (71 7) 240 - 6345
Date: 1/06/2003
JOSEPH F ARNOLD JR
68 LEBO ROAD
CARLISLE, PA 17013
RE: Estate of ARNOLD JOSEPH F
File Number: 2001-00232
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after
July I, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing will become delinquent on: 2/05/2003
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
cc: v File
Counsel
Judge
~V-1!1OOEXIa4l1
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG. PA 17128-0601
1(" -;;)./4 - I
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OFFICIAL USE ONLY
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INHERITANCE TAX RETURN FILE NUMBER
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RESIDENT DECEDENT COUNTYCoDE YEAR-
SOCIAL SECURITY NUMBER
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THIS RETURN MUST BE FILED IN DUPUCATE WITH THE
REGISTER OF WILLS
SOC~SECUffiTYNUMBER
03. Remainder Retum {dale ofdlllllh priOr 10 lZ-l3-8Zj
o 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
o 11. Section to tax under Sec. 9113{A) \P.~SchO)
DECEDENTS NAME (LAST. FIRST, AND MIDDLE INITIAL)
Ano/J~.r ~ F:
DATE OF DEATH (M DO-YEAR)
{);L-vS-u/ {)J'-~ft--)'J
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
FIRM NAME (II ""
COMPLETE MAILING ADDRESS
6 / Wes r Lo u77( er- S7'-:
Ca--r/;U/e.- ,tPA 17c/3
::J
OFFICIAL USE ONLY
(8)
St)(?Y s. / S
DATE OF BIRTH (MM-DD-YEAR)
~ 1. Original Return
o 4. limited Estate
~ 6. DeceOOn\ Died Testate \kttadl ropy of Will)
o 9. li~ga~on Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (dale 01 dealh after 1Z-12-821
o 1. Decedent Maintained a living Trust (Anach copy of Trust)
o 10. Spousal Poverty Credit (dale of death betWeen 1Z-31-91 and 1-1-95)
(11)
(12)
(13)
15 76b~ ;Lt;-
65 I;;L? '11
NAME
:A <2fJ
13-
(14)
bS /;L'j: 1'/
5-1
TELEPHONE NUMBER (7/7) :;:L iff - 3 9' ~ '1
d-.-<T30, fo
:;:L '73 D. f"LJ
1, Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4, Mortgages & Notes Receivable (Schedule D)
(I)
(2)
(3)
(4)
(5)
{?; voe:. OC
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IX:
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6, Join~y Owned Property (Schedule F)
o Separate Billing Requested
7. Inter.Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G Of L)
8, Total Gross Assets (total Lines 1-7)
g, Funellll Expenses & Admlnistra~ve Costs (Schedule H)
10. Debts of Decedent, Mortgage liabilities. & liens (Schedule J)
It Total Deductions (total Lines g & 10)
12. Net Value of Estate (Une 8 minus Une 11)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
mede (Schedule J)
(6)
(7)
/0500, CD
(9)
/5r;;t.~ ;2-9-
337. GO
(10)
14. Net Value Subject to Tax {Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APl'L1CABLE RAttS
z
o
!;;:
I-'
:J
Q.
::::lil
o
(.)
~
0.00
t.5 /..2.-!? 7'1
CJ.OO
0_00
15. Amount of line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a){1.2)
,,0_ (15)
"Og(18)
16. Amount of Line 14 taxable at lineal rate
17. Amount of line 14 taxable at sibling rate
, ,12 (H)
, ,15 (18)
(19)
18. Amount of line 14 taxable at collateral rate
19. Tax Due
20,0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Decedent's Complete Address:
STREET ADDRESS
/35 C S -/-;,-e L-7
CITY Ca.r l's/e- I STATE I' A I ZIP/7c:13
Tax Payments and Credits:
1. Tax Due (Page 1 Une 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
C,(){)
Total Credits (A + B + C) (2)
u~ {) ()
(3) C~OO
(4)
(5) ,;;2-930. ?o
(SA)
(5B) C?--93C. ?'L?
3. InteresUPenalty ~ applicable
D. Interest
E. Penalty
TotallnteresUPenalty (D + E)
4. If Line 2 is greater than Line 1 + Une 3, enter the difference. This Is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund
~ "130. ,f"J
5. If Line 1 t Line 3 is greater than Line 2, enter the difference. This is the TAX DUE,
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + SA. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
" i . f, ~~" . ~ ~ -' ' . ' , "'" -.,' - "~~.- . -, '"
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Old decedent make a transfer and: Yes
a. retain the use or income of the property transferred;.......................................................................................... 0
b. retain the right to designate who shall use the property transferred or its income; ............................................ 0
c. retain a reversionary interest; or......................."................................................................................................. 0
d. receive the promise for life of either payments, benefits or care? .........."......................................."..."............ 0
2. If death occurred afte' December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .....,...............................................................................,........................ I8r
3. Did decedent own an 'in trust for" or payable upon death bank account or security at his or her death? .............. 0
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ 0
No
~
~
(;g-
Ia
o
~
~
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES. YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury. I declare thai I have examined this return. including accompanying schedules and statemenlS, and to the bast of my knowledge and belief. it is tNe, correct
and oomplete.
Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
f-/~j /a...d ''eo - ~'<~13/
'-1(DDRESS ~stJ H'Wh :t>..; 1/, 'UN .
SI.,I}t?,"'l'/fOJ<,/, ;1. I ]glJ7
SIGNA~4ZR~~R O~ THAN 4~TA~E ,
ADDRESS ~ / '""
e;: / Lv. /""'" :;?-C_ '.<; 7, ,
~
DATE
t:j/U/O}
9~ :;.~~ "CO. cx-a~"i.;-
("g Le60 fc!
{'t1R./iJU (J tI nOtJ
A-/j'~y~ /~.v f2~ :J,~~
/
~:C1/ly(~ , jj,f /7;:;3
/
For dates of death on or .fte, July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transters to or for the use of the surviving spouse is 3%
[72 P.S. ~9116 (a) (1.1) (i)J.
DATE
r/2fk/
For dates of death on or after January I, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)].
The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax relum are still applicable even if
the surviving spouse is ttle 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 twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent,
or a stepparent of the chiid is 0% [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%, exow as noted in 72 P.S. ~911fi(I.2) [72 P.S. ~9~16(a)(I)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [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.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REALESTATE
ESTATE OF
Arnold, Joseph F.
FILE NUMBER
21-01-00232
ITEM
NUMBER
DESCRIPTION VALUE AT DATE OF DEATH
1.
All that certain tract of land, together with the $68000.00
dwelling located therein, known and numbered as
135 "c" Street, Borough of Carlisle, Cumberland
County, PA. This realty was sold by the
decedent's Estate on 5/31/01, and a settlement
sheet is attached hereto.
TOTAL $68,000.00
COMMONWEALTH OF I'ENNSYLV ANIA
INHERITANCE TAX RIITlJRN
RESIDENT DECEDENT
ESTATE OF
Arnold, Joseph F.
ITEM
NUMBER
1.
2.
3.
4.
5.
6.
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS PERSONAL
PROPERTY
DESCRIPTION
Household goods & furnishings (see attached
appraisal).
Pro-rated real estate taxes for 135 "C" Street,
Carlisle.
1976 Scout (inoperable).
1988 Ford Bronco - sold "as is" with engine
problems.
One Beacon Insurance - refund
Internal Revenue Service - 2001 tax credit
FILE NUMBER
21-01-00232
VALUE AT DATE OF DEATH
$799.00
$349.70
$100.00
$700.00
$295.00
$151.45
TOTAL $2395.15
COMMONWEALTIl OF PENNSYLVANIA SCHEDULE F
INHERITANCE TAX RETURN JOINTLY-OWNED
RESIDENT DECEDENT
PROPERTY
ESTATE OF FILE NUMBER
Arnold, Joseph F. 21-01-00232
JOINT TENANT(S):
NAME ADDRESS RELATIONSHIP TO DECEDENT
A.Joseph F. Arnold, Jr. 68 Lebo Road, Carlisle, P A Son
17013
B.
C.
JOINTLY-OWNED PROPERTY:
ITEM LETTER DATE DESCRIPTION OF PROPERTY TOTAL VALUE OF DECO'S DOLLAR VALUE OF
NO. FOR MADE ASSET % INT. DECEDENT'S INTEREST
JOINT JOINT
TENANT
1. A 5/7/86 Members 1'1 Savings Tax already
acct.#49761-00 paid by A
2. A 4/6/99 Members 1'1 Checking acct. Tax already
#49761-11 paid by A
TOTAL $
COMMONWEALTH OF I'ENNSYL V ANIA SCHEDULE G
INHERITANCE TAX RETIJRN TRANSFERS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Arnold, Joseph F. 21-01-00232
ITEM DESCRIPTION EXCLUSION TOTAL DECD.Of. DOLLAR VLAUE
NUMBER VALUE OF INT. OF DECEDENT'S
ASSET INTEREST
A. Bank account at Members l't $3000.00 $27000.00 50% $13500.00
No. 49761-05 that had been
jointly owned by decedent and
his son, Joseph F. Arnold, Jr.
Decedent and co-owner
transferred $27,000.00 from
this account to Joseph F.
Arnold, Jr., alone on January 8,
2001.
$10500.00
TOTAL (AFTER EXCLUSION)
COMMONWEALTH OF I'ENNSYL VANIA
INHERITANCE TAX RETIJRN
RESIDENT DECEDENT
ESTATE OF
Arnold, Joseph F.
ITEM
NUMBER
A.
1.
B.
4.
C.
1.
2.
3.
4.
5.
6.
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATION COSTS
AND MISCELLANEOUS
EXPENSES
FILE NUMBER
21-01-00232
DESCRIPTION
Funeral Expenses:
Ewing Brothers Funeral Home, 630 South Hanover
Street, Carlisle, PA 17013
Administration Costs:
Personal Representative Commissions
1. Social Security Number of Personal Representative:
Year Commissions paid:
Attorney's Fees - Stephen B. Lipson, 61 W. Louther St., Carlisle, PA
2. 17013. (717) 249-3929
3. Family Exemption N.A.
Claimant
Relationship
Address of Claimant at decedent's death
Street Address
City
State _ Zip Code
AMOUNT
$2553.80
$2337.50
Probate Fees - Register of Wills - opening of estate ($141.00) filing of $278.00
inher. tax return ($15.00), filing ofacct. ($122.00)
Miscellaneous Expenses:
Patriot - News Co. - Adv. of estate
Cumberland Law Journel - Adv. of estate
Wayne Myers Auction Service - appraisal of household goods
Wolfe & Shearer Realtors - appraisal of realty
Group's Taxes and Payroll Service - 2000 income taxes
Darlene Moyer, Tax Collector - personal taxes due
(continued next page)
TOTAL
$82.95
$75.00
$50.00
$200.00
$50.00
$9.90
$
7.
8.
9.
10.
11.
12.
13.
14.
IS.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
SCHEDULE H - CONTINUED
John Mohler - furnace repair to realty
Richard Mowery - trash removal from realty
Penna. Power & Light - electric service to realty from Feb. '01 to June '01
Borough of Carlisle - water/sewer to realty from Feb. '01 to June '01
Sprint - phone service to realty for Feb./Mar. '01
Shipley Oil- fuel oil to realty delivered in Mar. '01
CGU - homeowner insurance for realty
Comcast Cable - final bill for service to realty
I % Realty Transfer Tax for 135 "C" Street, Carlisle
Darlene Moyer, Tax Collector - 2001 Municipal taxes for 135 "C" St., Carlisle
Borough of Carlisle - final water/sewer bill for realty
AHS - home warranty for 135 "C" Street, Carlisle
Home Paramount - termite treatment fee for 135 "C" Street, Carlisle
Lutria & Rahman Cehajic - credit to buyers at settlement on realty
Wolfe & Shearer Realtors - commission for sale of realty
Staples - supplies for estate's record keeping
US Postal Service - postage
Gasoline for lawnmower
Comcast Cable - adv. to attempt to sell hospital bed
Cindy Arnold - reimbursement for long distance calls
Total
$20.00
$70.00
$124.09
$68.06
$55.98
$166.84 $162.75
$5.30
$680.00
$464.70
$23.49
$182.50
$842.00
$2700.00
$4080.00
$33.84
$21.50
$7.46
$5.00
$78.58
$15429.24
~~.,..
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX REI1JRN
RESIDENT DECEDENT
ESTATE OF
Arnold, Joseph F.
ITEM
NUMBER
1.
2.
3.
4.
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE
LIABILITIES AND LIENS
DESCRIPTION
West Shore Emergency Services
United Church of Christ Home (Sarah Todd)
United Church of Christ Home (Sarah Todd)
Penn Rehab Associates (deductible
FILE NUMBER
21-01-00232
$32.00
$7.00
$198.00
$100.00
TOTAL $337.00
AMOUNT
COMMONWEALTH OF I'ENNSYLV ANlA SCHEDULE J
INHERITANCE TAX RIITURN BENEFICIARIES
RESIDENT DECEDENT
EST ATE OF FILE NUMBER
Arnold, Joseph F. 21-01-00232
ITEM NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR
NUMBER SHARE OF
ESTATE
1. Joseph F. Arnold, Jr., 68 Lebo Road, Carlisle, PA SOD One-fourth
17013
2. Jack L. Arnold, 250 Mountain View Road, Son One-fourth
Shippensburg, PA 17257
3. Jolene N. Barrick, Box 970, RR2, Landisburg PA Daughter One-fourth
17040
4. Linda L. Stone, 18 Heather Drive, Carlisle, PA Daughter One-fourth
17013
ITEM NAME AND ADDRESS OF BENFICIARY AMOUNT OR
NUMBER SHARE OF
ESTATE
N.A.
TOTAL $
~
,)
~\
~
~
~-~----
,
LAST WILL AND TESTAMENT
QE
JOSEPH F. ARNOLD
(GCQ)[P))f
I, JOSEPH F. ARNOLD, of 135 C street, carlisle, Cumberland
County, Pennsylvania, being of sound and disposing mind, memory
and understanding, do hereby make and declare this as my Last
Will and Testament and revoke all wills and codicils heretofore
made by me.
FIRST
I direct the payment of my debts and expenses of my last
illness and funeral from my estate as soon after my death as
conveniently may be done.
If there is no cemetery lot available
for my interment, qwned by me at the time of my death, I
authorize my personal representative to purchase such cemetery
lot with a contract for perpetual care, using therefor funds from
my estate in such amount as my personal representative shall
,-. .-
~ consider necessary and desirable.
r~ Further, in this connection, I authorize my personal
representative to expend reasonable funds from my estate, in such
,
amount as my personal representative shall consider necessary and
desirable, for the purchase, erection and inscription of a
suitable marker for my grave.
SECOND
I give, devise and bequeath all' of my property, both real,'
'.'
personal and otherwise, wherever located, to my beloved Wife,
GERALDINE H. ARNOLD, should she survive me by thirty (30) days.
J..
THIRD
Should my Wife, GERALDINE H. ARNOLD, predecease me or fail
to survive me by thirty (30) days, then I give, devise and
bequeath my entire estate in four equal shares, per stirpes, one
share to each of my beloved children, JOLENE N. BARRICK of
Carlisle, Pennsylvania; JOSEPH F. ARNOLD, JR. of Carlisle,
Pennsylvania; JACK L. ARNOLD of Shippensburg, Pennsylvania; and
LINDA L. STONE of North Middleton TownShip, Pennsylvania. Any
share which passes to my grandchildren under this Paragraph shall
be subject to the provisions of Paragraph Fourth, infra.
FOURTH
c:::::,.,.
'i
,J
~
\j
\}
Any share of my estate passing to a beneficiary under the
age of twenty-one years shall be in trust, with the trustee to be
designated by my Co-executors. The income and/or principal of
said trust may be accumulated or expended for the maintenance,
education and support, including college education, of such
,,,J beneficiary as my trustee in its sole discretion may determine;
~and my trustee, in the expenditure of income and/or principal for
'~
~ such purposes, may, at its discretion, apply the same directly
~ithout the intervention of a guardian or pay the same to any
{ -'
person having the care or control of said beneficiary or with
whom the beneficiary resides, without duty on the part of the
trustee to supervise or inquire into the application of the funds
by any person to whom any payment is so made. The balance of'"
such income and/or principal shall be paid to such beneficiary
,.~
upon reaching the age of twenty-one years, or to such
beneficiary'S estate in the event of death prior thereto.
FIFTH
I nominate and appoint my Wife, GERALDINE H. ARNOLD, as
Executrix of this my Last will and Testament. Should my Wife
fail to survive me or be unable to serve in this capacity, then I
nominate, constitute and appoint JOSEPH F. ARNOLD, JR. AND JACK
L. ARNOLD as Substitute Co-executors of this my Last will and
Testament. I hereby relieve my Executrix or Substitute Co-
executors from the necessity of posting security in connection
with their duties as such in any juriSdiction in which they may
be called upon to act insofar as I am able by law to do so.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to
this, my Last will and Testament, consisting of three (3)
typewritten pages, the first two (2) of which bear my signature
in the margin for the purpose of identification, this //
day of
"J '
',. , / '/
, 1996.
/
~1~)g '-~ Q"t~( ~cJ
ose F. Arnold
(SEAL)
..:.~
J,_L
WAYNE
MYERS
,
SERVICE
Office/Residence:
R.D. #1, Box 680
Landlsburg, PA 17040-9742
Phone: 789-4264
· AUCTIONEER : · APPRAISER
Appraisal Report
~(Q)[pJw
Of
Personal Property
..
Prepared For:
Executors:
Joseph Arnold Jr.
68 Lebo Road
Carlisle, Pa. 17013
Jack L. Arnold
250 Mt. View Road
Shippensburg, Pa. 17257
Estate Of:
Joseph Arnold Sr.
135 C Street
Carlisle, Pa. 17013
As Of:
March 3, 2001
" Purpose:
Estate Settlement
~
Wayne Myers, Auctioneer/Appraiser #2408
Attorney:
Stephen B. Lispson, Attorney
Mt. Holly Springs, Pa. 17065
~ ~ ,,,,\, ~
If'' ~'S ~ '," ,)>~
("".: ,;.cO '.
\'~
....:~... :.;.
",~Dir"
,
,
ppraijer j
Certi icate
I, the undersigned, do hereby certify that I have personally
inspected the property appraised, that I have no present or
contemplated future interest therein, that the fee received for
this assignment is in no manner contingent upon the value
reported, and that no important factors affecting the value of
this property were knowlingly overlooked or withheld.
The information contained in this report is not guaranteed;
however, it has been gathered from sources we believe to be
reliable. The appraiser certifies that to the best of his knowl-
edge and belief, the statement, information, and materials
contained in the appraisal are correct as set forth.
I certify that this report has been completed in conformity with
recognized industry standards. The appraisal assignment was
not based on a requested minimum valuation or specific valu-
ation for approval of a loan.
Signed
d~
Firm Wayn~ Mypr~ Allf"'t-i nn .c:::~r'1:T; ,...~
Date March 3 r 200]
KAS-660@ 1996 Kiefer Supply Co. Fergus Falls, MN (800) 435-2726
Livinq Room:
3 Pc. upholstered, Matching, Sofa, Chair, Love Seat,
Fair Condition $ 75.00
Four (4) Wood End Stands With Matching Coffee
Table, Fair Condition
Curtis Matis 19" Color TV, Doesn't Work
25.00
8.00
5.00
20.00
No Value
8.00
3.00
Two (2) Wood Stand Lights, Fair Condition
upholstered Recliner, Poor Condition
RCA 13" Color Portable TV, Fair Condition
Wood TV Stand, Fair Condition
Electric White Box Fan, Good Condition
Total
$ 144.00
Dininq Room:
Solid Wood Dining Room Table With 2 Captains
Chairs And 4 Regular Chairs, Good Condition
$ 225.00
Assorted Pots, Pans, Dishes, Silverware,
Roasters, Etc. Located On Table
25.00
Kirby Floor Vacuum, Fair Condition
20.00
Total
$ 270.00
,
Kitchen:
Refrigerater Will Be Sold With House
Drop-leaf Wood Table With 2 Wood Chairs,
Good Condition
$
35.00
Tappan Microwave, Fair Condition, Older Model
20.00
Total
$
55.00
Bedroom #1 - Front Of House
4 Pc. Bedroom Set Consists Of Dresser, Needs
Repairs, Chest Of Drawers, Fair Condition,
Night Stand, Fair Condition, Bed With Box Spring
And Mattress, Fair Condition $
50.00
Two (2) Room Air Conditioners-110 V And 220 V,
Do Not Work - Need Repairs
No Value
Wood TV Stand, Fair Condition
3.00
Total
$
53.00
Bedroom #2 - Rear Of Home
Wood Bedroom Set Consists Of Night Stand,
Double Bed With Box Spring And Mattress,
Fancy Dresser With Mirror, Chest Of Drawers,
Good Condition
Humidifier, Fair Condition
$ 270.00
5.00
Bath Tub Seat
2.00
Total
$ 277.00
,
Summary
Contents:
Living Room $ 144.00
Dining Room 270.00
Kitchen 55.00
Bedroom #1 53.00
Bedroom #2 277.00
Total
$ 799.00
~
~pprai~al
TO: Executors
Jn~pph Arnnl~ .TT
Jack L. Arnolci
Estate Of:
RE: Joseph Arnold Sr.
135 C Street
Carlisle, Pa. 17013
135 C Street,
DATE: March 3, 2001
Pursuant to your request. I have inspected certain personal property located at
Carlisle. Pa. 17013
for the purpose of appraising its fair market value as of the
3 rd
day of
March
1'19 2001
Based upon the information contained in this report in the attachments and schedules attached hereto and hereby made a part hereof and upon
my general experience as an appraiser and auctioneer, it is my opinion that said personal property had a estimated fair market value on the
above date of
Seven Hundred-Ninty Nin~ Doll~r~($
7qq 00
,
The term "Fair Market Value" as used in this report is defined as follows: the highest price estimated in terms of money which the property
will bring if exposed for sale in the open market by a seller who is willing but not obligated to sell. allowing a reasonable time to find a buyer
who is willing but not obligated to buy, both panies having fuli knowledge of all the uses to which it is adapted and for which it is capable of
being used.
This appraisal is based upon the following assumptions. limitations and conditions:
I. That title to the property appraised is good and merchantable or that is will be prior to the time of sale.
2. That all liens and encumbrances. if any, have been satisfied and the property has been appraised as though free and
clear under responsible ownership and competent management.
J. That matters of a legal nature have not been considered in this appraisal.
4. That Ihis appraisal report is made for the use of the named recipient oniy and that no part of it maybe used or relied
upon by any other person without the previous written consent of client and/or the appraiser.
5. That the fee for this appraisal does not provide for or include compensation for conference or testimony and/or
attendance at any court proceeding.
This undersigned appraiser hereby cenifies:
I. That he has no interest now. heretofore or contemplated in the future in the personal propeny covered by this appraisal.
2. That he has personally inspected the personal property to the extent that it was reasonably necessary and possible to do so.
J. That, to the best of his knowledge and belief. all statements and information included in this appraisal are true and are
based upon his objective findings and that no peninent information has been knowingly withheld or deleted in this report.
4. That neither his employme~t to make this appraisal nor his compensation for so doing is contingent upon the value of (he
property.
Even though it is the firm belief of the appraiser that the information furnished in t . appraisal report and the conclusions drawn from this
information are true and correct they are not guaranteed.
A
R.D.
Street Address
680
Landisbura.
City
17040
KAS.654
K"'erAUCIklnSuppty
(800) 43502128
).
~ ' . ...
STATEMENT OF QUALIFICATIONS
Wayne L. Myers - Auctioneer
.~. Licensed and Bonded Auctioneer - State of Pennsylvania
2. Graduate of HACC Auction School, Harrisburg, Pennsylvania
3. Auctions a weely consignment auction facility. Have been
Licensed since 1986. Appraisals are done on a regular basis.
4. College Credits From HACC For Appraising
,A,~ttlement Statement
< .
5/31101
B. Type of Loan
1. FHA 2. FmHa 3.
Summit Abstract Services, Inc.
3904 Trindle Road
Camp Hill, PA 17011
Conv. Unins.
Fife Number . Loan Number
8. Mortgage Insurance Case Number
4. VA 5. XXConv. Ins B-1067 2150981 Not Supplied
o e: s orm S Uf",!! e 0 9 ve you a 5 a emen 0 ae ua!le emen cos s. moun s pa 0 an y e se ernen agen are
shown. Items markerl "(p,o.c.)" were paid outside the closing; they are shown here for Informational purposes and are not
Included In the totals
-- -.. --
O. Name and Address of Borrower E Name and Address of Seller F. Name and Address of Lender
Lutvija Cehajlc I\rnold Estate Countrywide Home Loans, Inc.
Rahman Cehajic C/O Stephen B. Lipson, Esq. 500 Park Grenada
537 N. Hanover St Apt 9 501 South Hanover Street Calabasas, CA 91302-1613
Carlisle, PA 17013 Carlisle, PA 17013
G, Property Location CC'@&0jy H. Settlement Agent
135 "C" Street Summit Abstract Services, Inc.
Carlisle, PA 17013 lace of Settlement I Settlement Date
3904 Trindle Road
Camp Hill, PA 17011 5/31/01
J. Summary of Borrower's Transact!?"
100 Gross Amount Due From Borrower
K. Summary of Seller's Transaction
400 Gross Amount Due to Seller
101. Contract sales price 68,000.00 01. Contract sales price 68,000.00
102. Personal property 02. Personal property
103. Settlement charges to borrower (line 1400) 3,885.86 03.
104. 04.
105 05.
Adjustments for Items paid by sener 1" advance Adjustments for Items paid by seller In advance
--'-~'- 06. Citvltown taxes
106. City/town taxes to to
107, County taxes 5/31101 to 12/31101 272.45 07. County taxes 5/31/01 to 12/31/01 272.45
108. School taxes 5/31/01 to 6/30/01 77.25 08. School taxes 5/31/0110 6130101 77.25
109. Assessments to 09. Assessments to
110. Sewer to 10. Sewer to
111. Trash to 11. Trash to
112. 12.
120. Gross Amount Due From Borrower 72,235.56 20. Gmss Amount Due to Sener 68,349 70
200 Amounts Paid By Or In Behalf of Borrower
500 Reductions In Amount Cue To Seller
-
201, Deposit or earnest money 1,000.00 50l. Excess deposit (see instructions)
202. Principal amount of new loan(s) 61,200.00 502. Settlement charges to seller (line 1400) 6,272.69
203. Existing loan(s) taken subject to 503. Existing loan(s) taken subject to
'-'-~--
204. 504. Payoff first mortoage None
205. 505, Payoff second mortgage
206. 506.
207. Credit from Seller for Closing Costs 2,700.00 507. Credtt to Borrower for Closing Costs 2,700.00
208. 508.
209. 509.
Adjustments for Items unpaid by selle.r Adjustments for Items unpaid by seller
210 Cityltown texes to 510. Cilvitown taxes to
--'--_.---~ --'--'-~-- -_.~_.
.211, C~~nty tax~~__~.~~___~_..~__ 511 , County taxes 10
..----
212. School taxes to 512. School taxes to
213. Assessments 10 513. Assessments to
214. Sewer to 514. Sewer to
215. Trash 10 515. Trash to
216. .-- 516.
217. 517.
218. 51B.
219. 519.
220. Total Paid By/For Borrower 64,900.00 520. Total Reduction Amount Due Seller 8,972.69
300. Cash At Settlement From/To Borrower
600. Cash At Settlement To/From Seller
301. Gross amount due from borrower (line120) 72.235.56 R01, Gross amount due to seller (line 420) 68,349.70
302. Less amounts paid by/for borrower (line 220) 64,900.00 602. Less reductions in amI. due seller (line 520) 8,972.69
303. Cash From Borrower 7,335.56 603. Cash To Seller 59,377.01
HUD~l (3-86l
RESPA, HB 4305.2
:::.h1-ent Charges
" ' ;tal~ales/Broker's Comm~sslon based on price $ 66000.00@ 6.00%04080.00 Paid From Paid from
..Jiv~;on of Commission (line 700) as follows: Borrower's Seller's
$ 2065.00 10 Wolfe & Shearer Realtors Funds at Funds at
- Settlement Settlement
J2 $ 2015.00 to Prudential Thompson Wood
103. Commission paid at Settlement 4,080.00
704. Transaction manaaement fee to Prudential Thomoson Wood 125.00
,
800 Items Payable In Connection With loan
801. Loan Origination Fee to
802. loan Discount to
603. Appra\sal Fee 10 Real Estate Valuation Advisors 300.00
804. Credit Report to CHL 25.00
805. lender's Inspection Fee to
806. Mortgage Insurance Application Fee to
-~.,-_.._---
807. Assumption fee to ..~--~-- -
808. Tax Service Fee to CHL 90.00
.._~--~-
809. Courier/Overnight Mail to
810. Document Preparation 10 CHL 350.00
811. Flood Certification to CHL 25.00
812
813.
814.
900 'tema Required By l..ender To Be Paid In Advance
901. Interest From 5/31/01 to 6/1/01 (fjJ 11.95 /dav 11.95
902 Mortgage Insurance Premium for month(s) to
903. Hazard Insurance Premium for year(s) to
904.
1000. Reserves Deposited Wt~h Lender -
1001. Hazard Insurance 3 months @ 10.42 per month 31.26
1002 Mortgage Insurance 1 months @ 27.03 per month 27.03
1003. City property taxes monl~s @ per month
1004. County property taxes 5 months @ 37,95 per month 189.75
1005. Annual assessments months @ per month
1006 School taxes 13 months.@ 78.33 per month 1,018.29
1007. Flood insurance ._.~~~~~-- per month
1008. ._.___~'!i~~@ per month
1009. Mareaale adlustment 1172.67)
1100 Tille Charges
1101. Settlement or cloSing fee ta
1102. Abstract or title search 10
1103. Title examination to
1104 Title insurance binder to
1105. Document preparation to
1106. Notary fees la Diane Jenkins 4.00
1107. Attorney's fees to
(Including above items numberS. )
1108. Title insurance 10 Summlt Abstract Services, Inc. 786.75
(including above items numbers: 1101,1102,1103,1104 )
1109. lender's coverage $
1110. Owner's coverage $
1111 ICS Letter Fee to Security Title Guarantee Corp of Baltimore 35.00
1112
1113. Overniaht mail 10
1200 Government Recording and Transfer Charges
1201. Recording fees: Deed $ 25.50 Mortgage $ 51.50 Rel.lAssign. $ noo
1202. City/county tax/stamps: Deed $680.00 Mortnage $ 680.00
1203. State tax/stamps: Deed $ 680.00 Mortgage $ 680.00
1204. 2001 municipal taxes to Darlene J. Moyer, Tax Collector 464.70
1205. Final sewer bill to Borouah of Carlisle 23.49
1300 Addlllona' Settlement Charges
1301. Survey to
1302. Pest lnsflection to
1303. Radon test to BIS Home Inspection 100.00
1304. PremIum fer home warranty toAHS 182.50 182.50
1305. Termite Treatment Fee to Home Paramount 842.00
1400. Total Settlement Charges (enter on lines 103, Section J and 502, Section K) 3,885.86 6,272.69
Certlflcatlon
I have carefully reviewed the HUD.1 Settlement Statement and to the best of my knowledge and belief, it is a true and accurate s@temen
of all receipts and disbursements made on my account or by me In this transaction. I further ce fy u: receive. d a/
copy of the HI/D.l Settlement. State")en!. ._;> _
y ?Mo.t/{....-., c/~j-j?,/t'<:..' _ CC~ -"C-.
,L 'irt~'{f.L t~,kDj(:" ~' Lej
Borrowers or( gents I. or A ents
The 0.1 Set lem nt Statement which I have prepared is a true and aecurat ceou of this transaction. I shall cause the funds to be disbursed
in or~ w his statement. ~ / )
C/0''eJ. 0QIt!1
ent Date
Warnfng: ff is a crime .to knowingly make false statements fa the United States on U1is or any of her similar form. Penalties upon conviction can
Include a fine Bnd imprisonment. For details see: firle 18 U.S. Code Section 1001 and Section 1010. 5/31/01