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Home My WebLink About07-10-15 (2) A �A Pennsylvania 1505618403 DEPARTMENT OF RE EN `gX(03-14) REV-1500 OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN Harrisburg PA 17128-0601 RESIDENT DECEDENT 21 14 1203 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 11 23 2014 09 27 1934 Decedent's Last Name Suffix Decedent's First Name MI MELL BETTY R (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 M1. Original Return 1:12. Supplemental Return 3. Remainder Return(date of death prior to 12-13-82) 4. Agricultural Exemption(date of 5. Future Interest Compromise(date of 6. Federal Estate Tax Return Required death on or after 7-1-2012) death after 12-12-82) ❑X 7. Decedent Died Testate ❑ 8. Decedent Maintained a Living Trust 9. Total Number of Safe Deposit Boxes (Attach copy of will) (Attach copy of trust.) 0 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 ROGER B IRWIN ESQ 717 249 6333 First Line of Address 354 ALEXANDER SPRING RO Second Line of Address City or Post Office State ZIP Code CARLISLE PA 17015 Correspondent's email address: rogerbirwin(a)_salzmannhughes.com o cn ::0 REGISTEFEOF, LLS USE=LY O O, CX7 REGISTER OF WILLS USE ONLY r-t DATE FILED MMDDYYYY ]> r F—+ r�r1 rn CCn � ;X G7 O DATE FILED STAMFCO r" M Side 1 I IIIIII IIII IIII ��II IIIII I III III II I I III II II I I IIII 1505618403 1505618403 1505616411 REV-1500 EX Decedent's Social Security Number Decedent's Name: Mell, Betty R. RECAPITULATION 1. Real Estate(Schedule A)....................................................................................... 1. 122 -,000 . 00 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. 290 ,776 - 49 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) ❑ Separate Billing Requested............ 7. 42 ,676 - 71 8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 455 -,453 - 20 9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 56 ,143 - 16 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10. 8 ,052 - 66 11. Total Deductions(total Lines 9 and 10)................................................................ 11. 64 1195 - 82 12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 391 1257 - 38 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. 391 ,257 - 38 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.00 15. 0 . 110 16. Amount of Line 14 taxable at lineal rate X .045 391,257 - 38 16. 17 ,606 - 58 17. Amount of Line 14 taxable at sibling rate X.12 0 . 00 17. 0 . 00 18. Amount of Line 14 taxable at collateral rate X.15 0 . 00 18. 0 . 00 19. TAX DUE................................................................................................................ 19. 17 ,606 . 58 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. SIGNATUR�NSP IB17 ALE' FOV FI �JG RETURN athy J. KiDAT 7// ADDRESS 38N Orange St., Carlisle, PA 17013 SIGNATUR P EPARER OTHER THA&REPRESENTAINE Roger B. Irwin Esq. ATE ADDRESS 354 Alexande pring Road, Suite 1, Carlisle, PA I 111111111111111111111111111111111111111111111111111111111111 Side 2 1505618411 1505618411 REV-1500 EX Page 3 File Number 21-14-1203 Decedent's Complete Address: DECEDENT'S NAME Mell, Betty R. STREET ADDRESS 525 D.Street CITY STATE ZIP I Carlisle PA 17015 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) 17,606.58 2. Credits/Payments A. Prior Payments 17,046.76 B. Discount 897.20 Total Credits(A +B) (2) 17,943.96 3. Interest (3) 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) 337.38 Check box on Page 2,Line 20 to request a refund 5. If Line I +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) Make Check Payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;...................__............_........ ..............__ 0 FAI b. retain the right to designate who shall use the property transferred or its income;.......... ....................... c. retain a reversionary interest;or.............................................. ........ ................................................... H d. receive the promise for life of either payments,benefits or care?........... ............................................... 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.......................................................__............................._...........__ 1:1 nX 3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?....... 4+ Did decedent own an individual retirement account,annuity,or other non-probate property which contains a beneficiary designation?......................................................................................... ....................... bx] El IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. _7 For dates of death on or after July 1,1994 and before Jan.1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent[72 P.S.,§9116(a)(1.1)(i)). For dates of death on or after January 1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(ii)). The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an adoptive parent,or a 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 172 P.S.§9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S.§9116(a)(1.3)]. A sibling is defined, under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption. Rev-1502 EX+(12-12) SCHEDULE A pennsylvania REAL ESTATE DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Mell, Betty R. 21-14-1203 All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts. Real property that is jointly-owned with right of survivorship must be disclosed on schedule F. Attach a copy of the settlement sheet if the property has been sold Include a copy of the deed showing decedent's interest if owned as tenant in common. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Real Estate located at 525 D Street,Carlisle, PA-sold as shown on attached Settlement 122,000.00 Sheet(HUD-1 i TOTAL(Also enter on Line 1, Recapitulation) 122,000.00 (If more space is needed,additional pages of the same size) Copyright(c)2012 form software only The Lackner Group, Inc. Form PA-1500 Schedule A(Rev. 12-12) OMB Approval No.2502-0265 A. Settlement Statement (HUD-1) 6.File Number: 7.Loan Number: S.Mortgage Insurance Case Number: 1. FHA 2.1-]RHS 3.0 Gonv.Unins' NEWHARDJ6-15 000009724 4.Q VA 5.❑Conv.Ins. C.Note:This form is furnished to give you a statement of actual settlement costs.Amounts paid to and by the settlement agents are shown.Items marked "(p.o.c)"were paid outside the closing,they are shown here for informational purposes and are not included in the totals. D.Name&Address of Borrower: E.Name&Address of Seller: F.Name&Address of Lender: JAY L.NEWHARD,ASHLEY F.NEWHARD BETTY R.MELL ESTATE ORRSTOWN BANK 47 S PITT STREET,CARLISLE,PA 17013 525 D STREET,CARLISLE,PA 17013 2695 PHILADELPHIA AVENUE, CHAMBERSBURG,PA 17201 G.Property Location: H.Settlement Agent: f,Settlement Date:07/06/2015 525 D STREET I&M Real Estate Services,LLC Disbursement Date:07/06/2015 Carlisle,PA 17013 West Pomfret Professional Bldg,60 West Pomfret Street, Carlisle Borough Carlisle,PA 17013 Place of Settlement: TitleExpress West Pomfret Professional Bldg,60 West Pomfret Street, Printed 07/06/2015 at 12:00 pm Cadisle,PA 17013 by JMR 100. Gross Amount Due from Borrower 400. Gross Amount Due to Seller 101. Contract sales price 122,000.00 401. Contract sales price 122,000.00 102. Personal property 402. Persona(property 103. Settlement charges to borrower(line 1400) 6,574.22 403, 104. 404. 105. 405. Adjustments for items paid by seller in advance Adjustments for items paid by seller in advance 106. Cityltown taxes to 406. City/town taxes to 107. County taxes 07106/2015 to 12131/2015 342.87 407. County taxes 07/06/2015 to 12/3112015 342.87 108. School Taxes to 408. School Taxes to 109. 409. 110. 410. 111. 411. 112. 412. 120. Gross Amount Due from Borrower 128,917.09 420. Gross Amount Due to Seller 122,342.87 200, Amounts Paid by or in Behalf of Borrower 500. Reductions In Amount Due to Seller 201, Deposit or earnest money 1,000.00 501. Excess deposit(see instructions) 202. Principal amount of new loan(s) 92,600.00 502. Settlement charges to seller(line 1400EVE 203. Existing loans taken subject to 503. Existing loa s taken subject to 204. 504. Payoff of first mortgage loan 205 505. Pa off of second mortace loan 206. 506. 207. Seller Assist 3,437.50 507. Seller Assist 3,437.50 208, Appraisal Fee Refund 50.00 508. 209. 509. Adjustments for items unpaid by seller Adjustments for items unpaid by seller 210. City/town taxes to 510. City/town taxes to 211. County taxes to 511. County taxes to 212. School Taxes 07/01/2015 to 07/06/2015 20.23 512. School Taxes 07/01/2015 to 07106/2015 20.23 213. 513, 214. 514. 215 515. 216, 516. 217. 517. 216. 518. 219. 519. 220, Total Paid by/for Borrower 97,107.73 520. Total Reduction Amount Due Seller M20,9�54.11 300R� Weffl Cash at Settlement from tto Borrower 800. Gash at Settlement tolfrom Seller unt due trom borrower(lin128,917.09601. Gross amount due to seller(line 420)unts paid bylfor borrower( 97,107.73 602. Less reductions in amount due seller(line 520) 20,954.11 From ❑ To Sor31,80936603, Cash ❑X To ❑ From Seller 101.388.76 pla........cunenlly valitl OM9 Gonir¢I numb¢r$No¢onhtl¢nl ably is assured;this disclosure i5 mandatory.This is designed to provide the panics l0 a RESPR wavered Iransatlion with inforinalibn tludng the aeUlement pracoss. See attached addendum for additional information HUD-1 Previous editions are obsolete Page 1 700. Total Real Estate Broker Fees $7,835.00 Paid From Paid From Division of commission line 700 as follows: Borrower's Seller's 701. $3,570,00 to HOOKE,HOOKE&ECKMAN,LLC Funds at Funds at 702. $4,265.00 to BHHSHOMESALE REALTY Settlement Settlement 703. Commission paid at settlement 7,835.00 704. Broker Fee to HOOKE,HOOKE&ECKMAN,LLC 245.00 800. items Payable in Connection vaith Loan 801. Our origination charge (Includes Origination Point 0.000%or$0.00) $870,00 (from GFE#1) 802. Your credit or charge(points)for the specific interest rate chosen $ (from GFE#2) 803. Your adjusted origination charges (from GFE A) 870.00 804. Appraisal fee to D.A.POTTS APPRAISAL,' $375.00 P.O.C.B (from GFE#3) 805. Credit report to CBINNOVIS,INC (from GFE#3) 52.80 806. Tax service to from GFE#3 807. Flood certification to CBCINNOVIS (from GFE#3) 10.00 808. to 900. Items Required by Lender to be Paid in Advance 901. Daily interest charges from from 07/06/2015 to 0810112015 @$10.78001day (from GFE#10) 280.28 902. Mortgage insurance premium months to from GFE#3 903. Homeowner's insurance for 1 years to ERIE INSURANCE (from GFE#11) 357.00 904. months to from GFE#11 1000. Reserves Deposited with Lender 1001, initial deposit for your escrow account (from GFE#9) 430.24 1002.Homeowner's insurance 3 months @$ 29.751month $89.25 1003. Mortgage insurance months @$ Imonth 1004. Property taxes months @$ /month 1005.County taxes 6 months @$ 59.451month $356.70 1006.School Taxes 2 months @$ 125.Mmonth $251.84 1007.Aggregate Adjustment $-267.55 1100.Title Charges 1101. Title services and lender's title insurance $ (from GFE#4) 1,264.00 1102. Settlement or closing fee to $ 1103. Owner's title insurance-STEWART TITLE GUARANTY COMPANY $ (from GFE 45) 121.00 1104. Lenders title insurance-STEWART TITLE GUARANTY COMPANY $889.00 1105. Lenders title policy limit$92,600.00 Lender's Policy 1106. Owner's title policy limit$122,000.00 Owner's Policy 1107.Agent's portion of the total title insurance premium $858.50 to i&M REAL ESTATE SERVICES,LLC 1108. Undewriter's portion of the total title insurance premium $151,50 to STEWART TITLE GUARANTY COMPANY 1109. End 1001100 to STGCII&MREAL ESTATE $50.00 1110. End 300\300 to STGCII&MREAL ESTATE $50.00 1111.End 90018.1 to STGCII&MREAL ESTATE $50.00 1112. ClosingSvcLtACSL to STGCII&MREAL ESTATE $125.00 1200.Government Recording and Transfer Charges 1201. Government recording charges $ (from GFE#7) 206.00 1202. Deed$81.00 Mortgage$125.00 Release$ 1203. Transfer taxes $ (from GFE#8) 1,220.00 1204. City/County taxfstamps Deed$1,220.00 Mortgage$ 1205. State Tax/stamps Deed$1,220.00 mortgage$ 1,220.00 1206. Deed$ Mortgage$ 1300.Additional Settlement Charges 1301.Required services that you can shop for (from GFE#6) 1302.Final WirlSwr#005490 to CARLISLE BOROUGH 116.38 1303. to 1304.2015-16 School taxes to CHARLES HOLTRY,TAX COLLECTOR 1,517.90 1305.Repairs to home to NEIDLINGER FINE HOMES 90.00 1306.Escrow for Inheritance Taxes to I&M REAL ESTATE SERVICES,LLC 8,235.00 r r r 6,574.22 17,496.38 *Paid outside of closing by(B)onower,(S)eller,(L)ender,(I)nvestor,Bro(K)er.**Credit by lender shown on page 1."'Credit by seller shown on page 1. See attached addendum for additional information Previous editions are obsolete Page 2 HUD-1 Comparison of Good Faith Estimate(GFE)and HUDA Charges Good Faith Estimate HUD-1 Char I ges That Cannot increase HUD-1 Line Number Our origination charge # 801 870.00 870.00 Your credit or charge(points)for the specific interest rate chosen # 802 0.00 0.00 Your adjusted origination charges # 803 870.00 870.00 Transfer tares # 1203 1,220.00 1,220.00 Charges That in Total Cannot Increase More Than 10% Good Faith Esfimate HUD-1 Government recording charges # 1201 240.00 206.00 Appraisal fee #804 425.00 375.00 Credit report # 805 62.70 52.80 Flood centication If 807 10.00 10.00 # 737.70 643.80 $ -93.90 or -12.7288% Char es.That Can Chane Good Faith Esfimate HUD-1 Initial deposit for your escrow account # 1001 645.36 430.24 Daily interest charges from # 901 $10.7800/day 280.28 280.28 Homeowner's insurance # 903. 357.00 357.00 Title services and lender's title insurance # 1101 1,426.50 1,264.00 Owner's title insurance-STEWART TITLE GUARANTY COMPANY # 1103 - - 155.E 121.00 # # Loan Terms Your initial loan amount is $92,600.00 Your loan term is 30.years Your initial interest rate is 4.2500% Your initial monthly amount owed for principal,interest,and any mortgage $455.54 includes insurance is Q Principal ❑X-, Interest ❑Mortgage Insurance Can your interest rate rise? X❑No. ❑Yes,it can rise to a maximum of %. The first change will be on I I and can change again every years after / I . Every change date,your interest rate can increase or decrease by %.Over the life of the loan,your interest rate is guaranteed to never be lower than %or higher than %. Even if you make payments on time,can your loan balance rise? X❑No. ❑Yes,it can rise to a maximum of$ Even if you make payments on time,can your monthly amount owed for ❑X No. ❑Yes,the first increase can be on I / and the monthly principal,interest,and mortgage insurance rise? amount owed can rise to$ The maximum it can ever rise to is$ Does your loan have a prepayment penalty? ❑X No. ❑Yes,your maximum prepayment penalty is$ Does your loan have a balloon payment? FX]No. ❑Yes,you have a balloon payment of$ due in years on / / Total monthly amount owed including escrow account payments ❑You do not have a monthly escrow payment for items,such as property taxes and homeowner's insurance. You must pay these items directly yourself. 0 You have an additional monthly escrow payment of$215,12 the',results in a total initial monthly amount owed of$670.66. This includes principal,interest,any mortgage insurance and any items checked below: XC)Property taxes ❑Homeowner's insurance ❑Flood insurance ❑ ❑ ❑ Note: If you have any questions about the Settlement Charges and Loan Terms listed on this form,please contact your lender. See attached addendum for additional information Previous editions are obsolete Page 3 HUD-1 HUD CERTIFICATION OF BUYER AND SELLER 1 have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief,it is a true and accurate statement of all receipts and disbursements made on my account or by me in this transaction.I further certify that I have received a copy of the HUD-1 Settlement Statement, JAY LAEWHAJRb ASHLEY F.NEWFL Rt f BETTY R.MELL ESTATE rr"6( L' k C" L-" CATHY J.K[NelfXECUTRIX The HUD-1 Settlement Statement which I have prepared is a true and accurate account of this transaction.I have caused or will cause the funds to be disbursed in accordance with this statement. SETTLE NTAG Tv DATE WARNING:IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM.PENALTIES UPON CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT.FOR DETAILS SEE TITLE 18:U.S.CODE SECTION 1001 AND SECTION 1010. See attached addendum for additional Information Previous editions are obsolete Page 4 HUD-1 " r r �.ram �;,, ��n.- ''� �� •-� �x� �� r� Name of Borrower: Name of Seller: File Number: Prepared 0710612015 712:00pm Note:This page displays an itemization of the credits shown in section 200 of the HUD-1 Settlement Statement.This page accompanies but is not a part of the HUD-1 Settlement Statement.If a discrepancy exists,the information on the HUD-1 Settlement Statement applies. Credits Credit Name of Borrower: Name of Seller: File Number: JAY L.NEWHARD BETTY R.MELL ESTATE NEWHARDJ6-15 ASHLEY F.NEWHARD Prepared 0710612015 at 12:00 pm Note:This page displays an itemization of the adjusted origination charges shown in section 800 of the.HUD-1 Settlement Statemen This page accompanies but is not a part of the HUD-1 Settlement Statement.If a discrepancy exists,the information on the HUD-1 Settlement Statement applies. i Your Loan Origination Charges Borrower Seller 801. Our origination charge (Includes Origination Point 0.000%or$0.00) Underwriting Fee to ORRSTOWN BANK $ 265.00 Doc Prep Fee to ORRSTOWN BANK $ 265.00 i Application Fee to ORRSTOWN BANK $ 265.00 Tax Service Fee to ORRSTOWN BANK $ 75.00 802. Your credit or charge(points)for the specific interest rate chosen to $ 0.00 803. Your adjusted origination charges 870.00 0.00 Name of Borrower: Name of Seller: File Number: JAY L.NEWHARD BETTY R.MELL ESTATE NEWHARDJ6-15 ASHLEY F.NEWHARD Prepared 07106/2015 at 12:00 pm Note:This page displays an itemization of the charges shown on line 1101 of the HUD-1 Settlement Statement.This page accompanies but is not a part of the HUD-1 Settlement Statement.If a discrepancy exists,the information on the HUD-1 Settlement Statement applies. 1100.Title Charges Total Charge Borrower Seller 1101.Title services and lender's title insurance to WIRE FEE to M&T BANK g 20.00 20.00 OVERNIGHT AND EMAIL to I&M REAL ESTATE SERVICES$ 50.00 50.00 NOTARY to I&M REAL ESTATE SERVICES$ 30.00 30.00 1102.Settlement or closing fee to $ 0.00 1104.Lenders title insurance-STEWART TITLEto STGCII&MREAL ESTATE $ 889.00 889.00 1109.End 1001100 to STGC/I&MREAL ESTATE $ 50.00 50.00 1110.End 3001300 to STGCII&MREAL ESTATE $ 50.00 50.00 1111.End 90018.1 to STGC/I&MREAL ESTATE $ 50.00 50.00 1112.ClosingSvcLtrICSL to STGC/I&MREAL ESTATE $ 125.00 125.00 Totals: $ 1,264.00 0.00 1,264.00 0.00 SellerlLender credits shown on page 1 POC=Paid Outside Closing CR=Lender Credit See attached addendum for additional information Previous editions are obsolete Page 1 HUD-1 Rev-1508 EX+,(08-12) SCHEDULE E w17pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OFPERSONAL PROPERTY INHERITANCE TAXAXRETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Mell, Betty R. 21-14-1203 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Members 1st Federal Credit Union Investment Savings Account#43672-05-unknown 2,066.50 deposit after date of death 2 Pro-rated Real Estate Taxes-as shown on Settlement Sheet(HUD-1) 342.87 3 SAC, Inc. - Refund 15.00 4 Members 1st Federal Credit Union Certificate of Deposit Account#43672-40-date of death 59,233.00 .value Accrued income on Item 4 through date of death 14.28 5 Members 1st Federal Credit Union Investment Savings Account#43672-05-date of death 132,255.56 value Accrued income on Item 5 through date of death 19.93 6 Members 1st Federal Credit Union Savings Account#43672-00-date of death value 114.05 Accrued interest on Item 6 through date of death 0.01 7 MetLife-account#4049620333 payable to decedent's estate 8,873.30 8 Santander Bank Checking Account#2891026632-date of death balance 65,724.77 9 Personal Property/Household Goods -appraised value 820.00 10 Vehicle-sold for 12,200.00 11 Escrow for Inheritance Taxes-as shown on Settlement Sheet(HUD-1); refund expected after 8,235.00 acceptance of REV1500 Total of Continuation Schedule See attached page TOTAL(Also enter on Line 5, Recapitulation) 290,776.49 (If more space is needed,additional pages of the same size) Copyright(c)2012 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev.08-12) Rev-1508 EX.(08-12) SCHEDULE E Pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OF REVENUE INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT continued ESTATE OF FILE NUMBER Mel[, Betty R. 21-14-1203 ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 12 Nationwide Mutual Insurance-refund from cancelation of car insurance 77.22 13 United States Treasury-2014 federal tax refund 785.00 TOTAL(Also enter on Line 5, Recapitulation) 290,776.49 Copyright(c)2012 form software only The Lackner Group, Inc. Form PA-1500 Schedule E(Rev.08-12) A MEMBERS 1st FEDERAL CREDIT UNION REGULAR SAVINGS ACCOUNT: A000untNumber/Suffix 43672-00 Date Account Established 03/15/1985 Principal Balance otDate ofDeath $114�16 Accrued Interest to Date of Death $0.01 Total Principal and Accrued |nbaneut 8114.18 Interest from 01/01/2014 to 11/23/2014 $0.11 Name ufJoint Owner Nona INVESTMENT SAVINGS ACCOUNT: AonountNunnber/Suf5x 43672-05 Date Account Established 05/16/2005 Principal Balance atDate ufDeath $132.255.50 Accrued Interest to Date of Death $18.93 Total Principal and Accrued Interest $132.275.49 Interest from 01/O1/2O14to 11/23/2014 $300.81 Name ofJoint Owner Nona IRA CERTIFICATE OF DEPOSIT: AncountNumber/Sufhx 43672-18 Date Account Established 01/16/2013 ' Principal Balance at Date of Death $42.666.42 Accrued Interest to Date ofDeath $1029 Total Principal and Accrued Interest $42.676.71 Interest from 01/01/2014 to 11/23/2014 $310.47 Name ofBeneficiary None CERTIFICATE OF DEPOSIT: AoonuntNumbar/GuMix 43672~40 Date Account Established 07108/2013 Principal Balance at Date of Death $59.233.00 Accrued Interest to Date ofDeath $1428 Total Principal and Accrued Interest $59.247.28 Interest from O1/O1/2014bz11/23/2O14 $404.04 Name ofJoint Owner None VISA CREDIT CARD ACCOUNT Account Number 4672090000123323 Date Account Established 05/18/2005 Balance atDate of Death $0.00 Joint Cardholder None MEMBERS 1 ITFEDERAL CREDIT UNION TZessa L Klugh Lending Insurance Support Specialist February 10. 20i5 Estate of: BETTY RK8ELL Date of Death: 11/23/2014 Social Security Number, 184'26'291S ,50007.00iscDrive " T!(l Box 40 , "\{ecbunics6ocg, 9enosyl,xuix l78S") " (80[) 283-2328 ° n`x`�cucco6crs|yror� 7 �j r � � z, F� y l 4 4143 , _ r .......... F 41 r .,� I r GrtJ.��i r r Z7- 01m: i� let • --- ------- - ----------- ---------- ----------- if i ........... .......... ------------- rJ f; Your good equity. Our great rate. Name Equity Lime of Credit A Santander"Home Equity line of credit can give you the freedom and flexibility to plan ahead for life's major purchases, or prepare for unexpected expenses from out of the blue.it's a smart way to handle life's plans and surprises. Ask about our highly competitive Home Equity rates. L:2 santanderbank.com/lines O Cali 1.877.476.8562 `visit your local branch. Q Equal Housing Lender.Santander,Santander Bank,and the name Logo are registered trademarks of Banco Santander,S.A.or its affiliates or subsidiaries in Lire United States or other countries Subject to approval.Account use is subject to the terms of the Santander Home Equity Line of Credit Agreement,including Cerins that permit lines to be suspended,reduced or terminated in certain circumstances. +411HEL0 Aow3ig 11/14 BETTY R MELL Account#2891026632 CATHY 1 KIME ATTY!FF Balances Deposits/Credits +$1,366.02 Average Daily Balance $66,020.96 1t flldravvals/Debits 15 1 TM ; Interest I Nd Earned Earned this Period $1.63 Paid Last Year $41.60 f'ar:d dearQ Iat -55 ?5(3 *The interest earned and the interest paid may differ depending on when interest is credited to your account. Checks Posted Check# Date Paid Amount Reference 1 Check{s}Posted=$50.43 Account Activity Date Description Additions Subtractions Balance 11-08 Beginning Balance $65,816.79 11-12,1'3"l £l3 Etl C SVC 71 c16t7666D8t! S $419 , 565,?75ti,°. 11-14 CHECK 000000002156 $50.43 $65,724.77—date of i:1.. 5,. triurytankSPl 1p P $ 7747 death 12-01 XXUS TREASURY 312 XXCIV SERV120114 F 2964733 W CSF $1,366.02 $67,043.49 value fit, [c XST C> TttAL iv N7 €;P7k1 017;?I 01 7 9 "$ fj .7 5M 12-07 Ending Balance $66,967.70 zw 0 et CC Hm q, 60-1503-313 LU x °o a'2f Y~ U TOTAL p ITEMS V 0 PLEASE BE SURE ALL ITEMS IT t: ARE PROPERLY ENDORSED, 0 x o EPOS TSMAYNOr BE AVAILABLE V) z z Ed LU — ILI) 1 FOR 1AMEDIA rE WMDRA WAL. cr _1w Llj 0 $ 0 D_0 0 w cr SALZMANN HUGHES PC PA INT ON LAWYER TRUST ACCOUNT o IOLTA ACCOUNT 354 ALEXANDER SPRING ROAD,STE. I CL CARLISLE,PA 17015 1: S001- 1320i: 108 1103200 CHECAS-0 OTHER ITEMS ARE RECEIVED FOR DEPOSIT SUBJECT TO THE PROVISIO-vS OF THE UNIFOR&t CO—IERCIAt CODE OR ANY APPLICABLE COLLECTICIFI'GREE.1,E.17 a 60-8755—'*" %LORNERSTONE 2313 F e d e.ta' I Credq Union No.. 9326 P.O.BOX 1181 IERS.CHEOK CARLISLE,PA 17015 CASH t 2313' 'Memberfpunded Semicebased. -Adanlic C diporals Pa;aplo through Mid Federal-Credit'Unp -00 Harrisburg.PA 171110 N L Y ****12' 800. DOLLARS AND 00 CENTS *129200. 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IFc•Nk r,-.(,- `!'•� .'y-x�'IfX r"R'+ 3r' A kD,�,)u i a i torah he e 7 s *,-„g '.w•,,'�'c tK..c'et' "rs rl'x f'�.'f, { 1.YN. EQU)iED.YES t .x - �'q-•� ` °~ T:'k'a`ki Fa 4.fefi'J^.P"�.frR ?I +'Pr'•)Hf.'kV�;n3tYO .ts'�5' }}F� e�,yT , . ✓! o ;.:r ,: +. S rmr rre •�i ;n,k 'it HOLDERFtNAP1C +� itu r 'Sv P E'AC•: a ,t z�.i, fr,>1 .fi�'�ri. 'V�a`^s-}'s'`'�t�•'""S�" ,'�,x' °,�•'+.ri+ m t%- �F r, �t'�.i�R-Z.'}'tczL.:...�u'Kriryt:r�STiUyiION'NUtABER� �,3/�'5��}T`��.t• ;�fJ .� I_ .._.':.-,?e r.n.3 m;<.-F f�`r; ''�i"�L �� _,,!^N r�y t�N�iR:�,:i w�.• � �,a,*r 's ,s' s� � �- '�r,++`f'".E P.��' �•y't!�'/��e��.l'r�rd •ai"4� ��h4 .. s y. Y'�•{s r Sri x b _ - �srcrrnrene oFlnr�uckNr oFr nurHomiEo sreraEn- !rte �� y rssy, (2ND11ENHpLDEA NA-iYtE�y ty+g;tr{!{'r$' ifi,�t�.<Z''"4+ ,1�'�'f•x• -�,'�,i'gi:'� r, ; Ja _ M - - .r'I a a STREET '�'' '? S'i„a �»w•:td t4 i a r.di 4 � 1 Rev-1510 EX*(08-09) SCHEDULE G Tf,f pennsytvania INTER-VIVOS TRANSFERS AND > DEPARTMENT OF REVENUE INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Mell, Betty R. 21-14-1203 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. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE NUMBER THE DATE OF TDE NAMERANSFERSATTAC)i A COPEIR Y OF RELATIONSHIP DEED FOR REAL ESTATE. VALUE OF ASSET ND INTEREST (IF APPLICABLE) VALUE 1 Members 1st Federal Credit Union IRA Certificate of 42,666.42 42,666.42 Deposit#43672-18-named beneficiaries are decedent's children: Larry Mell, Brian Mell and Cathy Kime-date of death value 2 Members 1st Federal Credit Union IRA Certificate of 10.29 10.29 Deposit#43672-18-accrued interest to date of death TOTAL(Also enter on Line 7, Recapitulation) 42,676.71 (If more space is needed,additional pages of the same size) Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule G(Rev.08-09) nsv^511m+w8-13) SCHEDULEH ti-,'J7 pennsylvania DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN RESIDENT DECEDENT ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Mell, Betty R. 21-14-1203 Decedent's debts must bereported onSchedule i ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s)attached 10,832.93 B. ADMINISTRATIVE COSTS: I Personal Representative's Commissions Name of Personal Representative(s) Cathy J. Kime Street Address 38 N. Orange Street city Carlisle State PA zio 17013 Year(s)Commission Paid Waived 2, Attorney's Fees Salzmann Hughes, P.C. 17,413.29 3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation) Claimant Street Address City State ZiD Relationshio of Claimant to Decedent 4, Probate Fees 515.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 27,381.44 See continuation schedule(s)attached TOTAL(Also enter on line 9, Recapitulation) 56,143.16 Copyright(c)ou13form software only The Lackner Group,Inc, Form PA-1000Schedule H(Reuo8'13) ' ' SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Mell, Betty R. 21-14-1203 ITEM NUMBER DESCRIPTION AMOUNT �FuneralExpenses 1 Ewing Brothers Funeral Home, Inc. -funeral service 8.153.93 2 Westminster Cemetery LLC'interment fee/tombstone and engraving fee 2.679.00 H-& 10.832.83 Other Administrative Cost % Cathy J.Kime-reimbursement for purchase of for sale signs in order to sell decedencs 7.22 vehicle 4 Cathy J. Kime-reimburse for duplicate key costs and supplies to fix leaking pipes at 525 ID 54.05 Street, Cedia|e, PA 5 Cathy J.Kime-reimburse for materials for real estate repairs at 525 D Street,Carlisle, PA 254.96 6 Cathy J.Kime-reimburse for materials for real estate repairs at 525 D Street,Carlisle, PA 25.82 7 Cathy J.Kime'reimburse for materials for real estate repairs at 525 DStreet,Carlisle, PA 12.36 O CanturyLink-phoneaen/ioa 25.00 g CenturyUnk-phoneaervice 38.97 10 Charles Holtry,Tax Collector'real estate taxes for 525 D Street property 889.15 11 Cumberland Law Journal-legal advertising 75.00 12 DaveYugoviuh 'labor and materials for real estate repairs ot635DStreet, Cur|io|m. PA 620.37 13 Ed Warner Handyman Services-January and February snow removal services at 525 D 290.00 Street property Copyright(c)uOuuform software only The Lackner Group,Inc. Form pA.150VSchedule H(Ray.&Sn) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Mell, Betty R. 21-14-1203 ITEM NUMBER DESCRIPTION AMOUNT 14 Ed Warner Handyman Services-March and April snow removal/lawn services and materials 315.00 ut525DStreet property 15 EdWarner Handyman Services 'lawn services 165.00 16 EdWarner Handyman Services 'lawn services for June 2U15 140.00 17 Nationwide Mutual Fire Insurance Company'homeowner's insurance premium 535.00 ' 18 Nationwide Mutual Fire Insurance Company'additional premium owed onhomeowner's 11.00 insurance toincrease limits ofliability due bodumpob*ronproperty iS Nationwide Mutual Insurance'monthly car insurance premium 99.82 28 PPL 'electric service 85.52 21 PPL 'electric service 37.31 22 PPL -e|ectricsen/iue 38.82 33 PPL 'e|eotrio service 46.58 24 PPL 'electric service 53.86 25 Roy D. Gottshall 'personal property appraisal fee 55.00 26 RT Carey Trucking, LLC-reimburse to Larry Mell for clumpster fee at 525 D Street,Carlisle, 390.00 PA 27 S.W. Barrett Real Estate&Appraisal Services-weo|estaheopproioa|foe 875.00 28 SAC, Inc. - heating oil for 525DStreet 373.50 Copyright(c)2UO2form software only The Lackner Group,Inc. Form PA'1s8VSchedule*(Fev.8-9V , SCHEDULEH FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Mell, Betty R. 21-14-1203 ITEM NUMBER DESCRIPTION AMOUNT 29 SAC,Inc.-heating oil for 525DStreet 426.80 30 Salzmann Hughes,P.C.-closing costs and final fees for income tax preparation, postage , 1.000.00 and miscellaneous contingencies inorder toadminister the estate 31 Settlement Expenses'asshown onSettlement Sheet(HU84) 20,95411 32 The Sentinel-legal advertising 179.92 i ' R-B7 27,381.44 Copyright(c)2002 form software only The Lackner Group,Inc. Form PAn500Schedule H(R�.6-98) ` Rev-1512 EX+(12-12) SCHEDULE I pennsylvania DEBTS OF DECEDENT, DEPARTMENT OF REVENUE INHERITANCE TAX RETURN MORTGAGE LIABILITIES AND LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Mell, Betty R. 21-14-1203 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 Borough of Carlisle-water and sewer service for 525 D Street-08/20/14-11119114 74.82 2 Borough of Carlisle-water and sewer service for 525 D Street-11/19/14-02119115 74.82 3 Borough of Carlisle-water and sewer service for 525 D Street-02/19115-05/21/15 79.35 4 Century Link-telephone service 47.30 5 Comcast -cable service 75.79 6 Millenium Pharmacy Systems Inc.-'pharmacy services rendered prior to death 10.61 7 Patricia A.Rosendale,CPA-preparation of 2014 final life tax returns 125.00 8 PPL -electric service 45.60 9 RUI Credit Services-payment for Comcast service 62.39 10 Santander Bank-repayment of reclaimed social security check not due to decedent 1,366.02 11 Thornwald Home-nursing home services rendered prior to death 4,874.96 12 Thornwald Home-nursing home services rendered prior to death 1,216.00 TOTAL(Also enter on Line 10, Recapitulation) 8,052.66 (If more space is needed,additional pages of the same size) Copyright(c)2012 form software only The Lackner Group,Inc. Form PA-1500 Schedule I(Rev. 12-12) REV-1513 EX+(01-10) pennsylvania SCHEDULE DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Mell, Betty R. 21-14-1203 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT (Words) ($$$) Do Not List Trusteels) TAXABLE DISTRIBUTIONS [include outright spousal distributions,and transfers under Sec.9116(a)(1.2)] Cathy J. Kirne Daughter 1/3rd Residue 38 N. Orange St. Carlisle,PA 17013 Brian J.Mell Son 1/3rd Residue 29 Cardinal Drive Stevens, PA 17578 Larry L. Mell Son 1/3rd Residue 330 Laurel Dr. Lake Ariel, PA 18436 Total Enter dollar amounts for distributions shown above on lines 15 throw to on Rev 1500 cover sheet,as appropriate. NON-TAXABLE DISTRIBUTIONS: A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11 -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET_ Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule i(Rev,01-10) C=� 3-- C> rn n LAST WILL AND TESTAMENT r".) CO .-,Z) w Ci (D C1 -T, I, BETTY R. MELL, of the Borough of Carlisle, Cumberland Couhty:-TennsyWaniF, m being of sound mind, disposing memory and full legal age, do hereby make, publish and Qclare this to be my Last Will and Testament, hereby revoking all Wills and Codicils heretofore made by me. 1. 1 direct my Executrix or Substitute Executor to pay all of my debts, funeral and administrative expenses as soon as convenient after my decease. Furthermore, I direct that all state, inheritance, succession and other death taxes imposed or payable by reason of my death and interest and penalties thereon with respect to all property composing of my gross estate for death tax purposes, whether or not such property passes Linder this Will, shall be paid by the Executrix or Substitute Executor from my estate, and that none of the aforesaid taxes shall be prorated among those persons named herein or otherwise beneficiaries hereunder. 2. My Executrix or Substitute Executor may, at her or his discretion, compromise claims, borrow money, retain property for such length of time as she or he may deem proper; lease and sell property for such prices, on such terms, at public or private sales, as she or he may deem proper; and invest estate property and income without restriction to legal investments unless otherwise provided hereunder. 3. 1 authorize and empower my Executrix or Substitute Executor to sell any realty and/or personalty owned by me at my death and not specifically devised or bequeathed herein, at public or private sale or sales and to give good and sufficient deeds and/or bills of sale therefore, in fee simple, as I could do if living. My Executrix or Substitute Executor is authorized and empowered to engage in any business in which I may be engaged at my death, for such period of time after my death as seerns expedient to said Executrix or Substitute Executor, 4. 1 give,, devise and bequeath all of my estate of every nature and wherever situate to my three (3) children, CATHY J. KIME, LARRY L. MELL and BRIAN J. MELL, share and share alike, per capita, which provides that if one or more of my children is deemed to have predeceased me, then the share of that child shall be distributed equally among the remaining children then living at the time of my death. 5. 1 nominate and appoint CATHY J. KIME to be the Executrix of this my Last Will and Testament. In the event she has predeceased me, failed to qualify or is not able or does not serve for whatever reason, I then appoint BRIAN J. MELL to be the Substitute Executor of this my Last Will and Testament, whereby the said Substitute Executor shall have the same powers as are given to the original Executrix hereunder. 6. No person(s) shall benefit hereunder unless such beneficiary shall survive me by sixty (60) days. 7. No Executrix or Substitute Executor acting hereunder shall be required to post bond or enter security in this or any other jurisdiction. 8. No beneficiary may assign, anticipate or pledge her or his interest in any income or principal held or distributable hereunder, and no beneficiary's creditors may levy, attach or otherwise reach any such interest. 9. If any person entitled to share in any distribution under the terms of this my Last Will and Testament becomes an adverse party in any proceeding to contest the probate of this Last Will and Testament, such person shall forfeit her or his entire interest inherited hereunder and all provisions in favor Of Such person shall be declared void and of no effect. The share of such person so forfeited shall be distributed as part of the residue pursuant to Paragraph 4 or Paragraph 5 hereof, as the case may be, except that if such person is entitled to share in the said residue, that interest shall be distributed proportionately to the other residuary beneficiaries. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 4`h day of November 2013. _(SEAL) BETTV MELL Signed, sealed, published and declared by the above-named Testatrix, as and for her Last Will and Testament, in our presence, who, at her request, in her presence and in the presence of each other have hereunto set our names as subscribing witnesses. f ACKNOWLEDGMENT AND AFFIDAVIT WE, BETTY J. MELL, MARTHA L. NOEL and TRACI D. SMITH, the Testatrix and witnesses respectively, whose names are signed to the foregoing instrument, being C� In first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and that she had signed willingly, and that she executed it as her free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as a witness and that to the best of their knowledge the Testatrix was, at that time, eighteen years of age or older, of sound mind and Linder no constraint or undue influence. -"7 ,,BE. MELL 1 MAR* HA L. OEL TRACI D. SMITH COMMONWEALTH OF PENNSYLVANIA : : SS: COUNTY OF CUMBERLAND Subscribed, sworn to and acknowledged before me by BETTY J. MELL, the Testatrix herein, and subscribed and sworn to before me by MARTHA L. NOEL and TRACI D. SMITH, witnesses, this 4"' day of November 2013. -3 C cl *tary Public (20"'IMONWEALTLI GILP'ENNSYLVANIA Notaijal Seal Roger S.irwin,Notary Public Carlisile Scj,o,Cumberland County L My Cornm!qsion Expires Oct.3,2016 OF,14C)TARIES 4