The URL can be used to link to this page

Home My WebLink About08-18-15 J pennsy�vania b505618148 DEPARTMENT OF REVENUE EX(03-14) REV-1500 OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number Po sox 2aoso� INHERITANCE TAX RETURN .�f > .� Harrisburg,PA 17128-0601 RESIDENT DECEDENT v�(� '/ ��—/�6� ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 10282014 03301933 DecedenYs Last Name Suffix DecedenYs First Name MI TAYLOR MARY J (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 BOXES BELOW XQ 1. Original Return Q 2. Supplemental Return Q 3 Remainder Return(date of death priorto 12-13-82) Q 4. Agriculture Exemption(date of Q 5. Future Interest Compromise(date of Q 6. Federal Estate Tax Return Required death on or after 7-1-2012) death after 12-12-82) 0 7. Decedent Died Testate � 8. Decedent Maintained a Living Trust 1 9. Total Number of Safe Deposit Boxes (Attach copy of will) (Attach copy of trust.) Q 10. Litigation Proceeds Received Q 11. Non-Probate Transferee Return Q 12. Deferral/Election of Spousal Trusts (Schedule F and G Assets Only) Q 13. Business Assets Q 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 STEPHEN D . TILEY 717-243-5838 First Line ofAddress 5 SOUTH HANOVER STREET Second Line ofAddress r'J G� � n U-� �'�'- rT'� City or Post Office State ZIP Code C � � � -� `� o CARLSILE PA 17013 �� c -.� � r;7 _._ 4-� � c� -�� r._ ►—., j r�i Correspondent's email address: , - �-� pp .� r.� , _ __,. , - -' , .- REGISTER OF,WILLS USE OgLY ''�1 -7 � ..,,. � REGISTER OF WILLS USE ONLY � � ' �_...= C DATE FILED MMDDYYYY � �� r r-- U1 � -s _ -�7 DATE FILED STAMP PLEASE USE ORIGINAL FORM ONLY Side 1 ��I��I��I��I�I��I��I��I��I�I��I�I��I��II I�� L 1505618148 1505618148 J � 1505618155 REV-1500 EX Decedent's Social Security Number Decedent�SNarr�e: MARY J TAYLOR RECAPITULATION 1. Real Estate(Schedule A). . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . 1. � . 0 0 2. Stocks and Bonds(Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . 2. 73522. 43 3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C). . . . . . . 3. � . �� 4. Mortgages and Notes Receivable(Schedule D). . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. 0 . �0 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . . . . . 5. 273 418. 59 6. Jointly Owned Property(Schedule F) OSeparate Billing Requested. . . . . . . . 6. 8O LO . 9 4 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) �Separate Billing Requested . . . . . . . . 7. 18 7 O S 3. 3 2 8. Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. 5 4 2 O O 5 . 2 8 9. Funeral Expenses and Administrative Costs(Schedule H) . . . . .. . . . . . . . . . . . . . . g, 2],4 6 4 . 4[, 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I). . . .. . . . . . . . . . . . �0. 4 72 . 8], 11. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11. 21937 . 27 12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . 12. 520068 . �1 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J). . . . . . . :. . . . . . . . . . . . . . . . . .13. � . �� 14. Net Value Subject to Tax(Line 12 minus Line 13). . . . . . . . . . . .. . . . . . . . . . . . . 14. 5 2 O O 6 8. �1 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 (a)(1.2)X.0 � 16.Amount of Line 14 taxable 15. 0. �� at�inea�ratex.o 45 520068 . 01 �s. 23403. 06 17. Amount of Line 14 taxable at sibling rate X . L 2 17. � .0 0 18. Amount of Line 14 taxable at collateral rate X • 15 1 g. �. �� 19. TAXDUE. . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 23403 . 06 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0 Under penalties of perjury,I clare I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true,correct and co�n e.Declaration of preparer other than the person responsible for filing the return is sed on all information of which preparer has a knowle e. IG TU E RESPONSIBLE FOR FILING RETURN DATE -- e l y l5 ADDRESS 433 WOODLAND DR. DILLSBURG PA 17019 - ODD ROAD CARLISLE PA 1701 SIGNATUR ERSON RE�+�ONSIBLE FOR FILING THE RETURN DATE � �-�' -1 �' %� <.�``>•.�� ADDRESS STEPHEN D . TILEY, 5 S0 . HANOVER STREET, CARLISLE, PA 17013 �� Side 2 L 1505618155 1505618155 � REV-1500 EX Page s Fi1e Number 166-26-1133 Decedent's Complete Address: 21-14-1065 DECEDENT'S NAME MARY J TAYLOR STREET ADDRESS 22 TUNBRIDGE �ANE CITY STATE ZIP CARLISLE PA 17015 Tax Payments and Credits: 1. Tax Due(Page 2, Line 19) (1) 23403.06 2. Credits/Payments A. Prior Payments 22500.00 B. Discount 1170.15 (See instructions.) Total Credits(A+B) (2) 23670.15 3. Interest (3) 4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT. Fill in box on Page 2,Line 20 to request a refund. (4) 267.09 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 0.00 Make check payable to: REGISTER OF WILLS, AGENT. � .. v ,_, � �� . ..,. 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............................................................................... � � b. retain the right to designate who shall use the property transferred or its income................................. � Q c. retain a reversionary interest.................................................................................................................. ❑ � d. receive the promise for life of either payments,benefits or care?.......................................................... � Q 2. If death occurred after Dec. 12, 1982,did decedent transfer property within one year of death without receiving adequate consideration?.................................................................................................. ❑ Q 3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?................................ � Q 4. Did decedent own an individual retirement account,annuity or other non-probate property,which contains a beneficiary designation?............................................................................................................. ❑X ❑ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994,and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent[72 P.S.§9116(a)(1.1)(i)]. For dates of death on or after Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an adoptive parent or a step-parent of the child is 0 percent[72 P.S.§9116(a)(1.2)]. � The tax rate imposed on the net value of transfers to or for the use of the decedenYs lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedenYs siblings is 12 percent[72 P.S.§9116(a)(1.3)].A sibling is defined, under Section 9102,as an individuai who has at least one parent in common with the decedent,whether by blood or adoption. REV-1503 EX+(02-15) pennsylvania SCHEDULE B DEPARTMENTOFREVENUE INHERITANCETAXRETURN STOCKS & BONDS RESIDENT DECEDENT ESTATE OF FILE NUMBER Mary J Taylor 21-14-1065 All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 1,507 Shares ACNB Corp. common stock @ 19.41 per share 29,250.87 See Exhibit"A" 2. American Century Investments 1,754.761 shares Ginnie Mae Fund @$10.84 per share 19,021.61 See Exhibit"B" 3. American Century Investments 652.285 shares Income and Growth Fund @$38.71 per share 25,249.95 See Exhibit"C" TOTAL(Also enter on Line 2, Recapitulation) $ 73,522.43 If more space is needed,insert additional sheets of the same size REV-1508EX+(02-15) SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. NHERITANCET�AXRR TURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Mary J Taylor 21-14-1065 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. M&T Bank-See Exhibit"D"-Checking Account No.: 586056 47,706.98 For Safe Deposit Box Inventory See Exhibit"K" 2. Susquehanna Bank individually owned accounts-See Exhibit"E" Checking No. 10010375102 125.10 Certificate of Deposit No. 70175658 49,335.65 3. Members 1st Accounts to No. 21951 -See Exhibit"F" Regular Savings-00 9,069.85 Life Savins Account-04 4,000.30 Certificate of Deposit-40 10,271.58 Certificate of Deposit-41 11,585.75 Certificate of Deposit-49 62,156.30 Certificate of Deposit-50 61,794.67 4. Susquehanna Valley Federal Credit Union Personal Accounts to No. 1933-See Exhbit"G" Savings-00 12.69 Checking-40 6,246.72 5. Sale of 2005 Buick Automobile to William M. Miller,Jr. -See Exhibit"H" 6,000.00 6. AllstateAutomobile Insurance Refund 273.00 7. Public School Employees' Retirement System death benefit 810.00 8. Refund of Year 2014 Federal Personal Incomet Tax 2,294.00 9. Cash on person at death 56.00 10. Household personal property-See Exhibit"L" 1,680.00 TOTAL(Also enter on Line 5, Recapitulation) $ 273,418.59 If more space is needed, use additional sheets of paper of the same size. REV-1509 EX+(02-15) pennsylvania SCHEDULE F DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Mary J Taylor 21-14-1065 If an asset became jointly owned within one year of the decedenYs date of death,it must be reported on Schedule G. SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A. Suzanne Keck 2 Todd Road, Carlisle, PA 17013 Daughter B. C. JOINTLY OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOIN7 MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENTS VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER.ATTACH DEED FOR JOINTLY HELD REAL ESTATE. vA�UE oF,4SSET INTEREST DECEDENTS INTEREST 1. A. 8/29/03 Susquehanna Bank-Joint Checking Account No. 110221 -See 16,021.88 50.00°/o 8,010.94 Exhibit"E" TOTAL(Also enter on Line 6, Recapitulation) $ g,010.94 If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+(02-15) pennsylvania SCHEDULE H DEPARTMENTOF REVENUE FUNERAL EXPENSES AND RESIDENNDEC DENTURN ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Mary J Taylor 21-14-1065 DecedenYs debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Hollinger Funeral Home 1,300.00 First Church of God for Funeral Luncheon 300.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City State ZIP Year(s)Commission Paid: 2. Attorney Fees: 3,2��.�� 3. Family Exemption:(If decedenYs address is not the same as claimanYs,attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: 2�5.5� 5. Accountant Fees: InCI. Wlth Atty Fee 6. Tax Return Preparer Fees: 7. Advertising-The Sentinel 201.16 8. Advertising-Cumberland Law Journal 75.00 9. MiscellaneousAdministrative Expenses from Schedule H-1 15,862.80 10. Additional Probate Fee due with Inheritance Tax Return 320.00 TOTAL(Also enter on Line 9, Recapitulation) $ 21,464.46 If more space is needed, use additional sheets of paper of the same size. ESTATE OF: FILE NO.: MARY J.TAYLOR 21-14-1065 SCHEDULE H-1 ADMINISTRATIVE EXPENSES 2014 15-Nov PP&L 33.69 20-Nov Refund-Comcast -18.50 20-Nov UGI 18•� 1-Dec PP&L 31.07 1-Dec UGI 59.74 1-Dec Reimburse Benjamin Keck for 11/24 payment to to Herman Plumbing 60.00 2-Dec Check Prin6ng Charge 9•� 22-Dec PP&L 29.89 2015 5-Jan UGI 66.42 13-Jan South Middleton Municipal Authority 13522 15-Feb PP&L 30.68 15-Feb Allstate Insurance Company-Homeowner's Insurance 1,007.87 15-Feb UGI 82�� 15-Feb Tom Gusler-Mowing �� 16-Feb Refund of overpaid UGI bill -18•`� Schedule H-1 Page 1 ESTATE OF: FILE NO.: MARY J•TAYLOR 21-14-1065 SCHEDULE H-1 ADMINISTRATIVE EXPENSES 20-Feb PP&L 27•� 12-Mar UGI 67.67 20-Mar Overpayment Refund-Allstate Insurance Company Homeowner's Inswance �17.37 25-Mar PP&L 27•� 30-Mar Selling Expenses-22 Tunbridge Lane See Schedule "G"Item 2 See Exhibits "I"& "J" Realtor's Commission 10,795.00 Attorney's Fees 1,800.00 Realty Transfer Tax 1,750.00 Tax Certification Fee 10.00 2015 County&Municipal Real Estate Taxes 440.03 Final Water&Sewer Bill to So.Middleton Twp.Mun.Auth. 147.32 County&Municipal tax pro-ration -333.94 School tax pro-ration 396.61 8-Apr Unused Premium Refund on sale of house Allstate Insurance Company Homeowner's Insurance 1F93.84 10-Apr UGI 54.95 10-Apr UGI 68.57 10-Apr PP&L 9•78 4-Jun Refund-UGI -54.95 Total Schedule H-1 Administrative Expenses: 15,862.80 Schedule H-1 Page 2 REV-1512 EX+(02-15) pennsylvania SCHEDULE I DEPARTMENT OF REVENUE INHERITANCE TAX RETURN DEBTS OF DECEDENT� RESIDENT DECEDENT MORTGAGE LIABILITIES 8 LIENS ESTATE OF FILE NUMBER Mary J Taylor 21-14-1065 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. Miscelianeous Debts of Decedent from Schedule I-1 472.81 TOTAL(Also enter on Line 10, Recapitulation) $ 472.81 If more space is needed, insert additional sheets of the same size. ESTATE OF: FILE NO.: MARY J.TAYLOR 21-14-1065 SCHEDULE I-1 DEBTS OF DECEDENT 2014 28-Oct Checks Cleared After Death M&T Bank Checking Account No. 586056 11/3/14-Comcast Central PA 45.69 11/3/14-So. Middleton Municipal Authority 13522 20-Nov Century Link 17.12 20-Nov Verizon 24.71 22-Dec Morganstein Defalcias Rehab 10.00 22-Dec MS Hershey Medical Center 25.00 2015 22-Jan Refund-CenturyLink -0.93 6-Apr MSHMC Physicians Group 10.00 14-Apr PA Dept. of Revenue-Form PA-41 Fiduciary Income Tax Year 2014 6.00 14-Apr PA Dept. of Revenue-Form PA-40 Personal Income Tax Year 2014 180.00 27-Apr Pinnacle Health Medical Group 10.00 30-Apr MSHMC Physicians Group 10.00 Total Schedule I-1 Debts of Decedent: 472.81 Schedule I-1 Page 1 REV-1513 EX+(02-15) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Ma J Ta lor 21-14-1065 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE � TAXABLE DISTRIBUTIONS[Include outright spousal distributions and transfers under Sec.9116(a)(1.2).] � Ms. Connie L. Marks, 433 Keller Street, Mechanicsburg, PA 17055 Step-daughter 1/4ACNB Stock 2 Ms. Barbara J. Lynch, 201 Horseshoe Road, Carlisle, PA 17013 Step-daughter 1/4ACN6 Stock 3 Ms. Roxann K. Killinger, 7 Stallion Road, Carlisle, PA 17013 Step-daughter 1/4ACNB Stock 4 Ms. Tina L. Magill, 203 Beaver Drive, Mechanicsburg, PA 17055 Step-daughter 1/4 ACNB Stock 5 Mr. David C. Gibb,433 Woodland Drive, Dillsburg, PA 17019 Son 1/2 Residuary 6 Ms. Suzanne G. Keck, 2 Todd Road, Carlisle, PA 17013 Daughter 1/2 Residuary ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART 11—ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ �.�� If more space is needed,use additional sheets of paper of the same size. �� ; , �� ' LAST WILL AND TESTAMENT � � � ' OF �, MARY J. TAYLOR �`�� '.� • � I, MARY J. TAYLOR, of Monroe Township, (1179 Boiling Springs Road, M � ,� ', Mechanicsburg,PA 17055),Cumberland County, Pennsylvania,being of sound and disposing � " ' mind,memory and understanding,do hereby make,pubiish and declare this as and for my Last , Will and Testament,hereby revoking and making void any and all Wills and Codicils heretofore �' �' !� made. i i � FIRST _ i ,�; I d'uect the paymen[of my just debts and funeral expenses as soon after my death as may be convenient. I I direct that all federal and Pennsylvania estate taxes,Pennsylvania inheritance taxes,and ' generation-skipping transfer tax payable as a result of my death,not lunited to taxes attributable to `; I property passing under this Will,shall be apportioned equitably to the beneficiary or transferee of ! the property in proportion to the value of the interest of each beneficiary or transferee. � F .. ' SECOND ' I declare that I am now the widow of Robert W. Taylor, who died September 26, 1997. ' My husband, Robert W. Taylor, and I had no children,however he had four children from a prior marriage,to wit: Connie L. Marks of 921 C West Trindle Road, Mechanicsburg,Pennsylvania , 17055;Barbara J. Lynch of 201 Horseshoe Road, Carlisle,Pennsylvania 17013; Roxanne K. �� Killinger of 7 Stallion Road, Carlisle, Pennsylvania 17013;and Tina L. Magill of 203 Beaver j Drive, Mechanicsburg,Pennsylvania 17055. I have two children from a prior marriage to � ' Charles D. Gibb, who died on Mazch 20, 1974. My two children are David C. Gibb of 39 .��: `�� LimekilnRoad, Carlisle,Pennsylvania 17013 and Suzanne G. Keck of 2 Todd Road, Carlisle, ` � ��\, Pennsylvania 17013. `� � \� �.b i � � j�-�' �� , THIRD � -- I give and bequeath whatever stock which I may own at the time of my death in ACNB t ,� �', Corporation to my husband,Robert W.Taylor's,four children,as above named. `� �� `� �; ;,�' ��- FOURTH [ � ,� All the rest, residue and remainder of my estate, real, personal and mixed, and � �` wheresoever the same may be situate,I give, devise and bequeath in equal shares,per stirpes and �� r n: I not per capita,unto such of my two children,David C. Gibb and Suzanne G. Keck, as shall �� survive me by a period of ninety(90)days,but should either of them fail to so survive me then the "�� share such deceased child of mine would have received shall pass to such of his or her issue as shall survive me by a period of ninety(90)days, per stirpes, and if there be no such issue the ` f�`' same shall lapse and be added to the remaining share or shares. r �.,° : �. ~" FIFTH , I hereby nominate, constitute and appoint my said two chiidren,David C. Gibb and �� : Suzanne G. Keck, as Co-Executors of this my LasC tiVill and Testament,or the successor or �`:' survivor of them as Executor or Executrix,as the case may be. I further direct that no bond or other security shall be required of any Executor or Executrix appointed in this Will for the performance of his,her or its duties in any jurisdiction in which he,she or it may be called upon to ., ; act. The terms Executor or Executrix may be used interchangeably in this Will and shall refer to '�`' any Executor or Executrix appointed in this wiil,or any other Administrator appointed by a court of competent jurisdiction. � "i ��;.;� ;;.� ,�.,. ;�;�. �°t Last Will and Testament of Mary J.Taylor Page 1 of 3 =�� '. �� k ��:, � „�, , I ' heazing and sight of the Testatrix signed the Last Will and Testament as a witness and yeazs of agee of ound mindland under no constraint or undue influence.(18�or more '; �, i i� % .Z1.C- � `�c+..�, ' Mary J.Tay.br ` ' �/ I "V � �.,, ..� =�i�? � 1 �ii Subscribed,swo to and acknpw/;edged before me by the Testa[rix and the witnesses above-named,tkus �/'''� day of C?c'� ,1997. � ii � Public ` - - —p�-- —__�c� INota.k�ai�Ea� i RECORDER OF OEeDS.NOiARY?116UC I CARLISLE.CUMBERLAND COUNTY COURT HQUSE I � MY CO�h!11SSION EXPIRES IANUARY l,1998 I ''� { � `� {i -I :� � ; I I , I i I Last Will and Testament of Mary J.Taylor Page 3 of 3 IWSJ REALTOR.i.Cttill 6�1PrTOtd'S ( 141E116ERSHiA MORE 3x@�3�1E';i''i,�0l.l:(tc°�� * 1_a�Iu:"'.�:�i� _ _ _ __ __ .__ ACNB Corp. ACNB <U.S.:Nasdaq) virw ai i !'(1MPANIGC r.' _ ��a�+Rea _+ °J,.a:"4 �i 3.F'�'v � ._._._,'�J1 l:v+�� . _ �r_��_ � _� � ✓,:�;,f: �; % � � i��ss 5�O,p __ ., _. ,._A 19 S ....-_, �_ �:"�"a, :o !v1ar�. Mar_8 :"via;�., --- - - DOWNLOAD A ;10/27/2014 " t0 '10/28/2014 ! GO SPREADSHEET Date Open High Low Close Volume 10/28/14 19.60 19.60 19.21 19.52 3,724 __. __ __ ._ _ __ _ NOTES&DATA PROVIDERS � Back to Top � Customer Service ' Policy Ads Tools&Features More Customer Center Privacy Policy Advertise Rpps Reprints Nevr!Live Nelp Cookie Policy Place a Ciassified Ad Emaiis&Alerts Content Partnerships ContacY Us Data Policy Seil Your Home Graphics&Photos Conferences WSJ Weekend Copyright Policy Seii Your Business Columns Make Time Contact Directory Subscriber AgreQment Commercia!Reai Estate Ads ` Topics SafeHause &Terms af Use Corrections Retruitment&Career Ads Guides Mobile Site Your Ad Choices Franchising , Portfolio Price&Velume Rdvertise Locally Oid Portfoiio Keyword&Symbol ' News Rrchive Jobs at WSJ Co;;Yri�ht G�015 Dow Jones&Company,!ro.All Rights Reseraed. ��"��:. .;: l��i��<��Y��n�� °�� , �I2C��i�2�F1i.S`, � �21�uc�(�� C, G�I�• - �pC2C�l�JE�` u'�, ��f�.f Page 3 oT 4 .,,,�� :t� ,� .�� t� ��.<� %of Total Assets � _ ��a Account Number 970-009019810 Account Owners Cost Basis MeYhad Average Cost - Fund Number 970 Mary J Taylor Covered Average Cost Per Share $10.98 = Ticker Symbol BGNMX Covered Cost Basis Share Count 142.881 < Share C{ass Investor Class Covered Cost Basis Amount $1,568.34 Non-Covered Average Cost Per Share $10.62 Non-Covered Cost Basis Share Count 1,622.414 Non-Covered Cost Basis Amount $17,227.43 Account Sumrnary I�co�e Sumr�ary This Quarter Year•TaDats Beginning Value $18,916.32 $18,280.78 Dividends year-to-date $474.27 + Investments 0.00 0.00 - Withdrawals 0.00 0.00 +l-Market Change/Adjustments +254,78 +gg0.32 Ending Value $19,171.10 $19,171.1Q Activity This Year Trade Shares This Total _ Date Transac�ons Dollar Amount Share Price Transaction Shares = 01/01/2014 Balance forward 1,721.354 = 41/31/2014 Div Reinvest $43.26 10.17 4.017 1,725.371 - 02/28/2014 Div Reinvest 42.17 10.78 3.912 1,729.283 = 03/31/2014 Div Reinvest 38.58 10.70 3.606 1,732.889 = 04/30/2014 Div Reinvest 40.87 10.76 3.798 1,736.687 = 05/30/2014 Div Reinvest 41.28 10.81 3.819 1,740.506 = 06/30/2014 Div Reinvest 3$.18 10.82 3.529 1,744.035 = 07/31/2014 Div Reinvest 38.58 10.74 3.592 1,747.627 08/29/2014 Div Reinvest 39.65 10.80 3.671 �,751.298 09/30/2014 Div Reinvest 37.33 10.78 3:463 ,754.761 10/31/2014 Div Reinvest 40.08 10,84 3.697 1,758.458 11/28/2014 Qiv Reinvest 35.69 1b.87 3.283 1,761.741 12/31/2014 Div Reinvest 38.60 10.86 3,554 1,765.295 12131/2014 Total Account Value $19,171.10 10.86 1,765.295 Keep on track Review your fund's performance, investment strategy and risk fevel by searching Ginnie Mae at americancentury.com. Please call us if you have questions about how to ensure you stay aligned with your go�ls. We're here to help. Informati�n abaut cost basis "Non-covered"are shares acquired prior to 1/1/2012 and"covered"are acquired after 1/1/2012.Average cost�er share is calculated to multiple decimals, but rounded to two decimal places above. For more about cost basis, search cost basis reporting at americancentury.com. � ��, �71613 2/2 . DJIA Nasdaq U.S.10 Yr Gude Oil Euro Subscribe Now Home World U.S. Politics Economy Business Tech Markets Opinion Arts Life Real Estate BGNMX (U.S.:Mutual Funds) '�� a� s � Auy Sep Oc[ lJov Dec Jan Feb Mar Apr May Iun 10/27/2074 to 10/29/2074 GO Date Open High Low Clo� 10/29/14 10.83 10.83 10.83 10/28/14 10.84 10.84 10.84 NOTES&C U.S.Edition Subs Subscribe Customer Service Tools&Features Ads More Why Subscribe? Customer Center Emails&Alerts Advertise Content Partnership WSJ+ Live Help Guides Advertise Locally Corredions Corporete Subscriptions Redesign Guided Tour My News Commercial Real Estate Ads lobs at WSJ Apps Portfolio Place a Classified Ad Make Time Professor Journal RSS Feeds Sell Your Business News Archive Student Journal Topics Sell Your Home Register for Free Video Center Recruitment&Career Ads Reprints Watchlist f y' $+ in '� s Dow Jones Products Barron's BigCharts DJX Dow Jones Newswires factiva Financial News Mansion Global MarketWatch Private Markets realtor.com Risk&Compliance WSJ Conference WSJ Video WSJ Wine Privaty Policy Cookie Policy Copyright Policy Data Policy Subscriber Agreement&Terms of Use Vour Ad Choices Copyright�02015 Dow lones&Company,Inc All Rights Reserved. ��C6��". <<.:) � �� , , , ��i�: I..:.:��"f L.EI�_4 �,t�;� ��iz�c��I��T�� r��C:I`�� f, �.�i`E�e e L��f1��E'�' ��, ��t F� Fage 4 oT k � '' �E"E��`�� c`� t¢��'�� %of Totad Assets ��s��`� � Account Number 981-009132226 Account Owners Cost BaSis Method Average Cost - Fund Number 981 Mary J Taylor Covered Average Cost Per Share $34.74 = Ticker Symbol BIGRX Covered Cost Basis Sha�e Count 76.750 < Share Glass Investor Class Covered Cost 8asis Amount $2,666.26 Non-Covered Average Cc,st Ps�Share $28.37 Non-Covered Cost Basis Share Count 615.952 Non-Covered Cost Basis Amount $17,473.08 �4ccour�t Summary lncom�Sum�ary This Quart�r Yaar-TaDate Beginning Value $25,015.13 $23,302.61 Dividends year-to-date $517.29 + lnvestments Q.00 0.00 Short-term capitaf gains year-to-date $266.72 — Withdrawals 0.00 0.00 Long-term capital gains year-to-dafe $1,068.18 +/—Market Change/Adjustments +1,203.64 +2,916.16 Income year-to-date $1,852.19 Ending Value $26,218.77 $26,218.77 Activity This Year Trade Shar�s This Total Date Transactions Dollar Amount Share Price Transaction Share�s 01I01/2014 Balance forward 643.008 03/11/2014 Div fteinvest 0.1434 $92.21 36.29 2.541 645.549 06/10/2014 Div Reinvest 0.1952 126.01 38.28 3.292 648.841 09I09/2014 Div Reinvest 0.2064 133.92 38.88 3.444 � 652.285 12/12/2014 St Cap Gain Rein 0.4089 266.72 36,9'1 7,214 659.499 12l12/2014 LT Cap Gain Rein 1.6376 1,068.18 36.97 28.893 688.392 12/2312014 Div Reinvest 0.2399 165.15 38.32 4.310 692.702 12131/2014 Total Account Value $26,218.77 37.85 692T02 � KQep on track F � Revi�w your fund's performance,investment strategy and risk level by searching Income&Growth af americancentury.com. Please call us if you have questions about how to ensure you stay aligned with your goals. We're here to help. Informa4ion about cost basis "Non-covered"are shares acquired prior to 1/1/2012 and°covered"are acquired after 1/1/2012.Average cost per share is calculated to multiple decimals, but rounded to two decimal places above. For more about cost basis, search cost basis reparting at americancentury.com. � � �� DJIA Nasdaq U.S.10 Yr Crude OII Euro Subscribe Now Home World U.S. Politics Economy Business Tech Markets Opinion Arts Life Real Estate ��Fund;lnvestor�� BIGRX (U.S.:Mutual Funds) =„k ..� .,. .,. ..� ._ `r Aug Sep (�ct Nov Dec Jan F�b Mar Apr Niay Juri 70/27/2014 to 10/30/2014 GO Date Open High Low Clos 10/30/14 38.88 38.88 38.88 10/29/14 38.68 38.68 38.68 10/28/14 38.71 38.71 38.71 NOTES&C U.S.Edition Subs Subscribe Customer Service Tools&Features Ads More Why Subscribe? Customer Center Emails&Alerts Advertise Content Partnership WSJ+ Live Help Guides Advertise Locally Corrections Corporate Subscriptions Redesign Guided Tour My News Commercial Real Estate Ads Jobs at w51 Apps Portfolio Place a Classified Ad Make Time Professor Journal R55 Feeds Sell Your Business News Archive Student Joumal Topics Sell Your Home Register for Free Video Center Recruitment&Career Ads Reprints Watchlist f �r S+ �n "� i Dow Jones Products Barron's BigCharts D1X Dow Jones Newswires Factiva Financial News Mansion Global MarketWatch Private Markets realtor.com Risk&Compliance W5J Conference WSJ Video WSl Wine Privacy Policy Cookie Policy Copyiight Policy Data Policy Subscribei Agreement&Terms of Use Your Ad Choices Copyright OO 2015 Dow Jones&Company,Inc All Rights Reserved. ��f.�'��R��3ff� ��y � ��E� 499 Mitchell Road,Millsboro_DE 19966 Records Management Phone 888-502-4349 F ax (302)934-2955 November 19,2014 Frey & Tiley Attorneys at Law 5 South Hanover Street Carlisle, PA 17013 Re: Estate of Mary J.Ta.� Social Securitv: 184-38-0807 Date of Death: October 28,2014 Dear Sir or Madam: Per your inquiry on November 14,2014,please be advised that at the time of death,the above-named decedent had on deposit with this bank the following: 1. Type ofAccount CheckingAccount Account Number 586056 Ownership(Names o,� MaryJ. Taylor Opening Date 10/24/1980 Balance on Date ofDeath $ 47,706.65 Accrued Interest $ .33 _._._.... _...... _. _ ___.............. Total $47,7076.98 . 2. Type of Account Safe Deposit Box Box Number/Location 2543/High Street Carlisle Ownership(Names o� Mary J.Taylor Opening Date 02/07/1992 ��esr,-,as ��ii� �� o��arno�ad�o4io€�al i¢�for�usatioe�om 4he abo�e�ccoarsts,incEQiding ow�ne€•sh'sp a�sd ar��'chsan�es,eEosa�ees ar�ci/or re€¢��ba�rsemec�t of Ei�nd�, p6ease e�6t the b�igh�treet C�rtisie Bt 717-240-453fi. Ti�fis fet�er da^s not inelude any aceourots in whicB the deceased ma��have been fistecE as�ower oE.44torney,Castodiaa of'Uniform T o•ansfe�•s, Representative I'ayee,or�rustee under a Vl�ritYen.4,greement Sincerely, Valarie Mercer Records Management .r 9. �Sa.°$�°66�>"> �71i p 5u�t�ra�eh��t� November 24, 2014 Susquehanna Bancshares, Inc. 26 North Cedar Street P.O. Box1000 Lititz, PA 17543-7000 FREY&TILEY Tel 1.800.311.3182 5 SOUTH HANOVER STREET Fax 717.625.4478 CARLISLE PA 17013 RE: Mary J Taylor Estate DOD: October 28, 2014 SS#: XXX-XX-1133 Tracking# 393985 To Whom It May Concern: In response to your letter of November 14, 2014, here is the above customer account information as of October 28, 2014. Account#1 Account#2 Account#3 • Account Title: Mary J Taylor Mary J Taylor Mary J Taylor ITF Suzanne Keck • Account Type/# Checking/110221 Checking/10010375102 CD/70175658 • Date Opened/Maturity 8/29/03 3/1/12 12/1/09 3/U15 • Interest Rate: .100% .050% 1.340% • Account Balance*: $16,021.88 $125.10 $49,335.65 • Accrued Interest: $.35 $.00 $50.71 • YTD Interest: $13.51 $.OS $492.97 *Account balance does not include accrued interest. � There is no safe deposit box in the name of the decedent. ❑ There is a safe deposit box# 0 in the name of the decedent located at the branch name. If I can be of further assistance, please feel free to call. ` �.Jc�t,,.�'�'Y5 Dawn M Berrier Susquehanna Bank Deposit Research Department Lead 1-717-625-6546 DMB/jran ��A� �� MEMBERS lst FEDERAL CREDTT UPIION REGULAR SAVINGS ACCOUNT: Account Number/Suffix 21951-00 Date Account Estabiished 04/30/1979 Principai Balance at Date of Death $9,069.59 Accrued Interest to Date of Death $0.26 Total Principal and Accrued Interest $9,069.85 Name of Joint Owner None LIFE SAVINGS ACCOUNT: Account Number/Suffix 21951-04* Date Account Established 04/30/1979 Principal Baiance at Date of Death $4,000.00 Accrued Interest to Date of Death $0.30 Total Principal and Accrued Interest $4,000.30 Name of Joint Owner None *Rollover from 21951-00 on 02/01/2001. CERTIFICATE OF DEPOSIT: Account Number/Suffix 21951-40* 21951-41** Date Account Established 04/22/2013 09/14/2013 Principal Balance at Date of Death $10,264.75 $11,574.28 Accrued Interest to Date of Death $6.83 $11.47 Total Principal and Accrued Interest $10,271.58 $11,585.75 Name of Joint Owner None None *Rollover from CD 21951-44 opened 01/19/2012. "*Rollover from CD 21951-48 opened 06/14/2012. CERTIFICATE OF DEPOSIT: Account Number/Suffix 21951-49* 21951-50** Date Account Established 12/03/2013 12/24/2013 Principal Balance at Date of Death $62,094.75 $61,733.48 Accrued Interest to Date of Death $61.55 $61.19 Total Principal and Accrued Interest $62,156.30 $61,794.67 Name of Joint Owner None None MEMBERS 1ST FEDERAL CREDIT UNION �� Tessa L Klugh Lending Insurance Support Specialist December 4, 2014 Estate of: MARY J TAYLOR Date of Death: 10/28/2014 Social Security Number: 166-26-1133 6��t3�:f 5000 Louise I3rive ' P.fl. Bo�40 � t�/Iechanicsburg,Pennsylvania 17055 � (800) 283-2328 � tivw�vmembers"lst.org 3850 Hartzdale Dr. Camp Hill,PA 17011-7809 USQ�.JEI-�ANI�TA 339 East Park Dr. Harrisburg, PA 17ll1-2730 ALLEY Local: 717-737-4152 Toll Free: 800-948-1454 FEDERAL CREDIT UN ION Fax: 717-737-OS89 November 24, 2014 Stephen D.Tiley Frey&Tiley 5 S Hanover Street Carlisle, PA 17013 Re: Estate of Mary J.Taylor Dear Mr.Tiley: The following is the information that you requested regarding the account of Mary J.Taylor at Susquehanna Valley FCU. This account was only in Mary's name. Account: Date of Death Balance 1933-00 Savings $12.69 1933-40 Checking $6,246.72 1933-11 IRA $12,053.32 Please let me know if you need any additional information. Kind regards, _�!� G G-�� Kathy Jo McCabe Member Services Supervisor , �";'� a�" �� a � � � The Estate of Mary J. Taylor, Deceased, hereby selis to C��' (+s �e � ��ec�'o� C�'.S� the 2005 Buick Lacrosse (title # �z o� �5619 do 1 ) "AS IS" for a price of $6,000. c `x , — /`—/ DAVID C. G(BB - v'� �� j� S�JZAN G. KECK � �� PURCHASER _ -_� -T.��s-�-�r a.s�e�� ._ WILLIAM M MILLER,JR. 1046 CARLISLE COLLECTOR CARS 63-751/631 1000 BRYN MAWfi ROAD _,� BRANCM00238 CARIISLE,PA 17013 — ' Date order f �t� � `f' � � �a r ' . � $ � b£:} d• �u � LL �J � 5 �� Dollats � F:�:Y � ��k" � wA,cxovrA ///�� Wadro�Aa Benk,a dWisbn o1 Wells Fergo Bank NA. � , ` � 1 For �.� _�l.�l�. +,�� %\J nm e:063 L075 L3�: �0 LO 2 68 480 50 3��' L046 :� �� .,� ; � � � t . � i �� -�� = �� ; s� 1 :, - �i�� ri��u�u��,�� C�R T 1!� C A'�'E O F '�`�T L�_.F Q�f� A ,��E t-��I��L�E ,, �� ;° h � lill �Ili�4w�l� i . kl � J WGm � ;:�- -- ��'�--"�r—..�..'.�;"' �\��' � ��\\��\ �Y `\\\ � �'� ��pll I� il�i il�l'��V�Vi�l�l��' �I��,��j� � lii '�..i�, ��-�� .\ � ��-�� c��. �� '�`�\�\\ \\�d�\�`\ \\\\� \� - y�l i, �� i�lli�l� �Il��.i ii Ifl��ry��li li �� .�� ,\,�y\\t ��,\�\�, ��,\\ ;\ \�� '.�`� . i��,. ` I�II�'��jI��, ��I II� ,„�p� ��Il,�i�, �I��I�Vy� �� \ \ � �� \ �`\t�\\� \�`\� �� ,��,`\�F ��\�� \;\�� \� � � � � � �i i � � �� ,�� A��,� ��A\��.� \1�A� ,�� _ ��IIIIII6h,ill ��illl�l�i�li� I��I��II'. 4��III��I�I�� Illlll�li iI�I�Ili�ii �\�� \ � ..i<, ;"'�`';� e��;��a;E;i e<;;�:i�°s;¢�ii�e�::i;e.��':;ai;;iioEii;�oo',�ii�vi°;;�a',i;1is?r°':F;�='"seai��'a;��;ieo'i�iavi��ii'°s;:^iee;i4ii�°;;�io°i�:so;E;ii;a°ii ee!4;i oa°�iiooca;�:;a;��o<a�`ioe�i:;e^��.:oo!;:� �,,...., ,,,,,,,,,,,,,, ,,., ; ,..e....................a,,,..,o,.�...<,,,...,,,,..,,,.,..,,,,,,,,....,.,. �'��:�:s��°k��'�'°��i;�.,.,.� ,� , �y�� o;'i�?�i?ev;°�? g��:a�o��iA��€��,. ;;�ea�;:°a'�ai;o::;;sep��o;¢e�"e'¢°ao i;;ie� ��?:E7l.�� :EE;��`;�o ,•��: ;;�i b i°�°�."�°�i� ........................ ... .. :c:a;�.,:::e;�a;;;:r:;:°�:;s;..�ee;;,:.:;r.r:e:;:;:::;¢.:�a;t:::e:,:::.r.r�:a,.r:c::v.,;:t.¢.tc:o¢,: ,.,.�..,.,.,..e..............a,.,..,,,,,,,.,.,......,,,....,,,...,,,,....,,,,...,.,....,,,...,,.�....,.�..,,,�..a., �"��i��a: '�s� °,�.•,��;�� ,..., ;��„.� � , , .«<'t a,�.,,,.,,.�� ,�. «„„ >«. ,.^,� .,, a': � �:«„�:, �'�,. „M. ��,..,. � , ��;�N��. ��jnn��.ee��.��;iiu1111�1��nl�la��l�u� �i��u��°��1�'��Il�i� �� . � , �i,� �. .e�., ..�.., .eh _ :,;; :. ..............::......e,.,...�.�.:::.,:.:,:..,.,...::;.,.:....,........,.,:.,,,.. .aa �..::�...a.,,..;:.....e..�:.:::,:::o,:;.e..,o,...,,,...,�.;a.;.,.�..,,,.�..,a.,,..,,.�..,., :: ,...,....�,.,,....a.................�...,......,.�...,...,...a,.�..o,.......,,,..o,.�,.a,,.,..e. .�..o.,.,..,, a.,. � ...,,.....o ., .. , ;;..::� ��;;. �;; �� ,.�° �°�,�'.:�, :;;.�, e�' �° ,.;;o,„��. ;�� :.;��. �. , � ;,,�e, — �;��:��: °� � S ILE �io:i �r:A�;: (� p -� � S1 B ;:��<,°° .P P •��. '.� .\ � ��T1t�� S�.�AP ��. Ct�ITL�o I,�I il� I' � � I\�\\�� `�� .� �s � ��Il,�,,.�,�ii,�, �i��ll�;��`I� ,'',� �i �� Jlu�� ;,� ,�`� ,� �� ,.... .�............. - '•.:e-:.;;,.,.,.;o ,a,:.a..�:...::..:.....a,.,..,a..._,.,...,.�..e,,.....a„�. � ,,,.. ,a,,,,,,,,,,,,,,,,,,e,.,,..e,,,,,,a,„, ..,e, , .,...,..,,.�..................�....,....,.,�...,,....,,,,._. .�...so::,.::a,:�.:o•:..:;o.,�:;e�:��;;�:..a;:�.:;o:..:;;, .. �, ,,....,,..,.a,..�..,,.�...e,...,o,,.,..,,,.,.o....,,....a,., ��.�;��`�;�.,... ,��.��,.„�.�, , . , . .a ,,,. .,:.;..�...e..,..ee..................o.�..,e..,..,e.,....e... � .�,�......�......,,�..,�,.«.,,.�..ee.�,,,�,.,..,..,..,a, .-;� ...............e,..o...,..,,.,...,....a.,�.......,,,... ,,,,�. .,>.�..�. , ,.,,�,,,�, •o..,e.,.e�,.,..,,,�..e..�.................�.....,...,��....., �. 3 OATE PA TITLED DATE OF ISSUE UNLADEN WEIGHT GVWFi GCWR TITLE BRANDS �� S ��I�IIiIIIVI!Ilro �� \ �� p �I $ i��o� �'i�. � � � �� i�� 1a r`' � I i 'III�I��Ili�ql�� t a .MI . CH� L � ' ' �: � \ � '. � � l, � � � � � -O �� '��I� LI � i i� �M �� , �, - � �I � ��, \ �� 3 �� q �� . . . �� „ . . .��.. /� a�o\��` ,I�il�I� TAM . I 81FlE iI� .��I��i II �� ' ' �,y�',R 4�EXEMPT�fiOM OOOMETER DISGIOSURE ��`y � �. ro��'.Nfri STE��'DOW �� rF g = �\�1� �1��' IC A �� - �� \\� �\\�g , BRAN �� \�\\�1\\\ � ' � ��r�� V� �1 \��b �� I I�.�; r� � � . (�� A��V��F ' AF� � �V� � � �� Y. ��` 6 � \ �� I�i I �� :�"'Aa �� . �� . . "1�, � �� v��c� \ �\,�\\��\1;�` �. C i S A 7 � -- � � . . � � � p m IS/WA&A POLICE VEHICIE II. � �� ... UCTE�� A �� c ° I � �I� �� I � �� rri i`�� -• � ��a� `� a � i � � � '� I � c�� i �� ,� � � �_ � � v '�x`, �, i�� ' � . � a ��, i��i�� , $� " �� FIPi�n��AV 1�� N�II � . � a �d � �� .EC IE 1� �I� � ��s�� .�� . E : �` a � � � � R� � ��;-� � � �� I��°•� �� l �� ,�� '�"� � �' �. e ��d ld ted �� . � y� s °� � a,• .Till h �Fe o��hi �h' � �;- ...,, ,., . > �. , ... ,. � � �.. FlF��AE � . �!,�. ; �..� ��II � . �IIIII��I�u��,dlll"� ��.��li' .��III�II��IIIII��III• . . ..:;:.. .._::._..:., ._. ...�. . .. . .. . . BY� � . . SECOND LIEN RELEASED �'� - � �AUTHORI2ED REPRESENTATIVE � � � . � DATE � � �� MAILIN�ADDRESS. . , . � � BY � - � . . AUTMOR�ZED REPRESENTATNE � - � � .� • � � � � � � � � � MARY J TAYlOR ,. ,�. 22 `TUNBRIOGE i.N ' CARLIStE PA 3�?[1�3 _� . _.:� �. . . � ... . . . f� � ��,es of ihe date of fssue,ihe ollidel recoMs ot ihe Pannayivania DeparlmeM +, 'AL L E M � -B I E HI.E R � • � , �:d�TransportaUon rellect fhat the person(s)w�comPe�Y namea hereu(�.Is the iawlur-ow�er �� . . "._ ��.. �• .ot the saM vehicie. � , . . . <� . . SecretaTY o[Trausportation � � � -..� '-, � � ' � 1 1 ' ' � � � � � �.4 M a co-purchaser other than your spouse Is Ifsted end you want ihe title to ' SUBSCRIBED AND SWORN be Ngted aS mt Teaants dh R� t of S „ orship` O dea :, ;one r FO e � � �, p � �� o�tltl� ��survrvi' �, ; ❑. rwf N �! ' � wil��ss��?�aMs' m w� � . ��' 8 �%. � ;I � � d r' ��to h' h or e)s �q � � � �� .i , �i � � �.TM � �� _ .. _ '� � ;.� , . � „ ' �� !'��,�� ., `� ,sr u�rio�o�i`� � `�,.�� , ,�d,� ;7� �.` .: ��I��u ,I��pQ� ST �� \ .r, ,�;', a =..� �iYv . R.,,�: ' �� ... \N� .' �� . i �.a � � �� p A� K HER INA � • "� �� NO .N. INS �. - . N , . � � �` 2NQ EN DAT • � F NO LIE CFiEC �� ..._ � /�/� ga fw TMe ! i w �� .� �� a .F{.. \ i � � �i � �� _ �\\� \@.' ..II III I�� ' el��ll I''. .�; =; ? =�. �� ^. N � .. �eoF�icar�:� •A¢eos��H�� .�^ , .. C�Ti� ��"'��. ��,�I N� � S7n Illd��.� r ��il I ..�i `1J � IF THIS IS AN ELT.CHECK HERE❑ PINANGAL � //1 � SIGNATURE OF C4APPLICANTRRLE OF AIITHORIZED SIGNER . NOTE:FIN REQUIRED 1 INSTRUTION NO. e""4 dS 1� ti./ noiiim i �i ii �� ' ��, �� . � • •• • � „ ......� .x. x. ,�... - (TYPE OR PRINT)Certiiicate of Title must be submitted within 20 days, unless the purchaser is a registerad deaier holding the vehicie for resaie. WARNING - FEDERAL AND STATE LAWS REQUIRE THAT YOU STATE THE MILEAGE (ODOMETER READING) IN CONNECTION WITH THE TRANSFER OF OWNERSHIP. FAILURE TO COMPLETE OR PROVIDING A FALSE STATEMENT MAY RESULT IN FINES AND/OR IMPRISONMENT. IMPORTANT NOTICE Piease be advised that in lieu of notarization on this form, verification of a person's signature by an issuing agent who is licensed as a vehicie dealer by the Pennsylvania State Board of Vehicle Manufacturers, Dealers and Salespersons, or its employee is acceptable.The signature and printed name of the issuing agent or the issuing agent's employee, date of verification,the issuing agent/licensed dealership's dealer identifi- cation number(DIN) and business name, must be listed in the space provided for notarization.Vehicle seiler and purchaser must sign oniy in the presence of an officer empowered to administer oaths or an authorized agent as identified above. _ - . . . - A. • � .'. � � � � � IAST FIRST M.L� IIWe ceN1y,to the best of my/our lawwledge tliat the odometer reading is . � . � w;::::St:;: "..�'INrHs � PURGin&Bi OR FUII � . ` , UI I^ "�` "w.�::�e:�."� endu aC1uN rt7�9�B of}I�gVehicla NE E � t . t1on76 e � �I � � � `' � ? �,�:� �� C` " ` a�.;" �� .�� .,�z ��a�,- � . ��+ �,\�� i � or me_` al a�a�ge�� es� ° � �r pNING �4 u � .. -�d\.. �'� 'i i i ,.. � �' . ��°e. �.�W. .�!� �V' � ��1u.'-. VYY . CBhBY.tl1 �e is ��anY B 2nd ihet Ovu�BENP IS hef6EY`, �=• ,. � � E P Vansie to the person �r the dealet ed. . . �STA7E . � � ZIP� ��p�I �`OR DIN . . EFa.�� .��A�� .�DA '� i � � _� E �` , .,. e �a. � _ � ._ ' ' �� : nr � * � ^.� \q \2 l�i,'� .�'�� ,. , ' . .� ,� , ' .`�� i� � YUR � °PER , RING OA � . �, . .. C EP 51 . � .�:' ,.�. �� . . � . . �` ..� . . . . , . �CQ PU CHASER MUST�� . - � .�� HA P � - �� II I'! �� ` �� 3� �,� 3 , ��\ � I .� �` �'3 '� �..� �; *. �� I � 4 �. \� ..�� 'E� ..�p s�' . .� � . . ... ... . . ` CO-S R M ST � . . . . .. . . . . `� HAND.RlNT �HEHE� .. . . ;.�,. ... .. . - : . � � . � � . B. � : ' � � IryVa-ceNfy to the baet of my/our Imowledge that the adometer readng is . LAST � , FtRBT� M.I. »;i � . , ��,�,� �q�� `��A , �a�� 1�� a� wal�of�eh� E��a �,:N� �,C��, �d�� ti �� + µ ��. ,. � � \ 1 v x ' 1 � , � �� o°� •�� ,� or me� i��s �u�a �Fp�� v�7� „ � :.� � a � ,_ Nuva�kti��Y er n u��4 w; �� µ� �;: ��, � ;��' � rtify is t l and thel�Q4z�'ship is� �� RE . �\ r . a ��q n a thePe etle (ed. �,. � � . �C�iY . . ,..... � . .�.. , ,� b� wP . .. Sk.�BSCRI�D AND&�(!/ORN �� ,. ��EF `.ME pp� I A � �A7E� � ZIP �' � t E y �� ::� _ ., . �� i I �d � . ��u�.��.�� A,. .�c::ER ERWG�� ',I � 1 � � � II �9f�. � � �� '�y�\\� ` .. 'r' ��r.I , ��:�' . : . � . - • R NASER N TUR� a,�, yA�� .� RCH AN ^ � � �((: �� " �; PU E :w I� � i � ; � ��F � � � �.� ��° D :.� \ �I �� .3 '� �l ��. � .�i � I� ��` �� ,�,�`� �' ,.�� OF� �� Y i� �� \� �' � � I, I �,�>� ,,. . . . � ANDP ...� xr . .. ..�.. ... ,., .. � � . � � � �WVe certtty to the�best M�my/our knowledge that the odometer reading is '. ,. LAST - . FlRST. M.L � _iur� r� '�� N��a\N ,� (�w� A \'��.; ° �9 . al rt�R�e of��hu� N .E�x �\�N�� °xoAh`r n� pp�� a H)��, � U�'�ll I �I� � ��on� .e � �n9� s� , - � ' . � P�� x� �: � ��v, �� A �0�'� �1 ��t. s Tthe�� .�9a � �a V„}�\ � ��, �� t . $ � I r I�, i NING�' -. isc ET d� h ' d� � �;. � A.. �� rv� , v' iFy is1 � .en� arMthatS�sxN�rsNp1 � qE�.� '��N �'� .� �� ,� ,A. �d'' Uan the Pe e dea ed. .� �� , .. ��.. �, . " .„�:. C�7Y S SCRI¢�D AND�SKYORN � � I��1 I �� EP j�EF4� ME au�a H; �> DA�I I�� i i� ' � �� ' �Ii�I��h�� z�P�� '� � � � ��i ' �' � � '1' � i � �_� �` `� � _ � � � ` �� il �� '� � � '�� I �� .� ��'� � � � ..�fA'141R � .EFB A �.� 1�QERING Q� III I � ��I�� I� �Iliv nl I L� ��SIG � fi � ��- � ' ;S � i �i I� � l� ��' i'i p I I��i� ��\ �.�`�'.�. �� N �i r �u��III) I��'�illllu I�i� ��II�III� ��..��I�I�� y. �� ,�� ;:�� C4PURCHASER SIGNATURE ��\'PURCH�J.4ERANDf� I��Ijqi III�I Irl IIII I� I II II �'I. .. �� ;.� a�� CSOPUR ZSSER &i`� � ��iII I IIP!�I ii II �I�I r� �II Ii. II o ' . :\, � ��; �p\��e;..�HAYJOPRI �..NAA4� If i i III�� h I�h I �ih i I i , °' � � �� `�� a \�� \�� \� �7�h�i iil��l� ��Igi ��I�ul��I� I��I� �� I I I' � I �' o ,y\ �� A �� s�ti\ �qA: ��r� I °��l I,'� III�� I� I�j�� I JI �I�i� � I��, IM1a � �� si6e�� .ffoFs � I�;��III Va��!�� q _ � d. �� a ��,�,., i�i�iili 4i��' �li ��iIV' �i� I� �i I ui � ��, �..:�`�ueR�r�sr ��I�I��N � Ih��IIIi6!�� '��Ilill u ,�I,,. f 3rYrt�t�'�'�[�`'' ,:. ;`.' ' . H o aE �/� �� AN PRIN NAML'W� � ..�4.t1 b� '��' v• 1 � i 11 � . n ��.��1161 1�.�1 4iif�1 '��1� 110 n� i"�l I;AI '.I,11110i�I '�� 1 �. ,�.IIIIIII��'Tlllu 1111 IIPIAI.III�II I�Ilfe 1 1','Mi�.l�ll ��lii„ 1�� II��mlll �111111�1 �s3 �� (3��nn em�� , ; ; �, ; Od3DC6 Tax Parcel�o.40-2d-0748-149 TI-iIS DI?l:U MADE this a0"� day oC /h�2c tt , 2012 by and bctween: 1�-fARY J. TAYLOR, �vido«�, of Soutll A+1idd(eton T��vnship, Cumberland County, Pennsylvania, p�uty oF tl3c first pari, hcrcinaftcr "Grantor" A�i D SULANNE G. KECK and nAVID C, GIBB, parties of the second part, hereinalter "GraT�tees" �VITt�'I;SSET]-I: TEI�T in consideratiot� of'thc sum of One and Nai]00 Dallar($].00) in hand paid hy the Grantees to tl�e Grantor, thc; reccipt ��hercof being llereby� acknowledbed, thc said Grantor docs hereby grant and convey unto ti�e said Graiitees, their heirs and assigns as joint tenants with right of survivorship and not as tenants in commo�t: ALL THA`I'CER"I'A1N lol or parccl of ground situate in South Middleton`I'o�vnship, Cumbcrland County, CortinZon�r�ultEt of Pcitnsylwactia, morc particul�rt�� bouncicd Fulc1 dcscrihcd in accordanee�vith Final 5ubdi��ision Plan far Greenfield Yhase IV-B recorciccl in Cwnberland County Plan Boak 72, Pagc 97, as follows, to �vit: 13t�GiNNIh'G at 1 point on the northcrn right-of-way line of Tunbrid};e Lane{50 feet wife), said poini being on the dividing linc het��een I.ot Na. 120 and I_ot T`o. 12l as shown on the Plan; thenee eontinuin�alon� the said cli�riding line\arth 00 degrees�7 minuees 54 szconds East a distancc c�f'110.29 fcct t�a point on linc of lands known as Forest Mcadows (Plfln Book 46, �'age 64); ihcncc alon�;sanie South �9 dc�rees 12 minutcs 06 scconds �ast a distance of 36.00 feet to a poi►tt on tf�e dividing linc behtieen l.ot No. 1 l9 and Lot No. 1?0 as sho��m on tlie Plan; thenee continuing alon�the said dividing line South 00 degrees 47 minutes S4 seconds tiVest a dista�tce of]10.?9 feet to a poini on the northern ri�t�t-of-tivay line of Tunbridge Lanc Exhibit "I" aforementivncd;thencc continuing along T'unbridge Lane North 89 degrecs l2 minutes 06 scconds West a distance of 36.00 feet t� a point on the dividing linc between Lot No. l20 and Lot No. t 21 as sha�vn �n the Pltm, said poinl being the paint and place �i'I3EGINVING. I3rIti'G LOT NO. 120. UNDE2 AND SUBJ�CT to a 20 feet �vide utility easemcnt located on the nonhern portion of tlte above dcscribed lot, as more particularly sha��m on the Plan. BEING the samc premiscs which Greenfield C�urt Limited Partncrship and Mar Ij. Marbain by their Deed datcd January 21, 1998 and recordcd January 30, 1998 in the Office nf the Recordcr of Dceds in a�id far Cumberla�id County, Pennsylvania in Uccd i3ook 171, PAbe 4�9,granted and conveyed unto ivtary J. Taylor, Grantor hLrcin. UNDER AND SUI3JECT to a Master Deciaration of Covenants, Conditions and Restrictions Applicable to Building L.ots in G;eenfield Residential Development dated I�4arch�, 1993, and recordeci in Cumberland County Miscellaneous Book 439, Pagc l 85. FUR'I'HER UND�R AND SUIIJECI-to all eas�ments, restrictions, encumbranecs and other matters of record or which a physical i��spection of the premises would reveal. '1'HIS CONVEYAl�{CE is cxempt froat th� imposition of rculty transf'er tar as bein�a transfer betwecn parent and hc:r cl�ildren pursuant ta 72 P.S. § 8102-C.3(6). AND the said Grantor liereb��varrants Spccially the prcmises hereby convcyecl. T� 1VITNCSS WHER�OF, the said Grantor has sct her hand an�! seal the;it�y and year first above�vritten. SIGNED, SEALED �1ND DELIVLRI;D IN TI-iE PRLSENCE OP: !�c�—�.�, -'� .. � EAL� Mary J. 1 ayl -�- Exhibit "I" COMMONWEALTI-1 OF I'ENNSYLVANiA) . SS. COL'NTY UF CU:�9BERLANll ) On ttiis lhe o?�r`' day of March,2012 beforc mc, the undersigned officer, personally appcarcd Mary J. Taylc�r, ��ido�v, kno�tim to mc{c�r satisfactorily pro�•enj to be the person whos� nanie is subscribed to the within instrument and acknowled�ed that she executcd the s�une for the purpos�s therein contained. IN �VI'I'NESS WHERLOF, I hereunto set my hand and official seal. ooht�urH oF r�r�uv,mvuru r�sw � Sttsin L Msba�i�HotarY R�ic — Hea,r,resa�o e«o,c,�r�«++�+a c�,+,cy I`Totary ul�l ic carur�on r�rs rwv.x�,Zois Kuee�,rr�5Ytvuna�tsoa,tna+oF narueus I hereby ceriify th�t the precise residrnce and complete post oflice address of the within namcd Grantees is: 2 �I'unbridgc Lane, Carlisle, PA 17015. (�--- Attorney/Agent for Grantccs (1�i.T.S.)^ -3- Exhibit "I" ROBERT P. ZI�GLER RECORDER OF DEEDS CUMBERLA�ID COUNTY , 1 COURTHOUSE SQUAR�C - � ' -� - CARLISLE, PA 17Q13 " �� 717-240-G370 � � .. _ :� ' � ---a....,�.�w.f+�:. Instrument Numbcr-Z012083b5 Recorded On 3/22/2d12 At 1:26:43 PNI '�Total Pagcs-4 *Instrument Type-llEEll Invoice Number- 104485 User ID-KW �'Grantor-TAYLOR,I�tARY,l *Grnntee-KECK,SUZr1NNE G '�Customcr-BRENNEMAN �FEES ST'ATE WRIT TAX $Q.50 Certification Page STATE JCS/ACCESS TO $23.50 JUSTICE DO NOT DCTACH RECORDING FEES - $11.50 RECORDER OF DEEDS T�1IS il C IS pb1Y art PARCEL CERTIFICATION $10.00 P g P FEES of this legal document. AFFORDI►BLE HOUSING $11.50 COUNTY ARCHIVES FEE $2.00 ROD ARCHIVES FEE $3.00 SOUTH MIDDLETON SCHOOL $0.00 DISTRICT SOUTH MIDDLETON TOWNSHIP $0.00 TOTAL PAID $62.00 I Certify this to be recarded in Cumberland County PA t aLy� , s4 •� / � REC�KDER O� �rso "-Information denotrd by an asterisk may thange durine the verification proces�and may not be reflected an this pnge. 003006 III Iflll{IIIllili11111111 III Exhibit "I" F:r+icus ec.'.:tns are o�5ye!o k•*++I�llO-t(?�efi)rc1 Manc��o�d7�_5 2 A. Jett1e111eI�lt Statell��Ilt U.S.DeparlmentofHousingandUrbanDevelopment 2FS . 1. ❑FHA 2. ❑FmHA 3. ❑Con.•.Unitu. 6.Filc Number 9.Loan\umbcr �S.\tongagc Insursncc C:�sc humbcr '��. 4 ❑v,� � ❑C nv �m �n15-063 � i 7�s fom�s f sMa io y y D sLtidmMl d a'1 al settllme'ft C»st5 M Ns p3A tn an�Ey Ne sr i ent aqYr.t Yr snau��n. � C.Not2: Ite s a-ke0 1p o.<) �t a D�a a+s��e u dos:rsy n�ay are sno+'n nc21w��ortnx.m�.uDas s arW x in,iCaC � t��!s. TiL'eEiG�ess SetLemer.t System�, LYAR IN .It 5 a Wne to kn0 n y ma�.E 1813!SIMC MIS lo Ne U^.�:CO SUI<S on I!.S U uY olher Si.��ar(am.Pena CCS Y./� � — �cc•c_�.,i ..T•,.• •.ti f�.n r i�ot ne c . i io Pi r��i a/v0�2 15 at m�9;Kc ' D.NA�fEOF 60RROWER:rtr�\Villiam^E.Hoovcr and Emilv L.Eloover . E.�.��tE oF SELLHR: Suz��nne G.Kcck and Benjamin L.Keck and Dnvid C.Gibb and f3renda A.Gibb � � F.NASIE OF LENDER: N/A i i G.PROPGRTY nDnREss: 22 7'unbridgc Lane,Carlislc,P:\ 17015 � S i 1 0 'ow s i i ti.sEr-r�Etie�:-r:��ENr: PA Iteal Estate Settlemcnt Services,LLC,Telcphonc:717-249-6333 rax: 717-249-7334 � 5 's 5 1 � i MMARY B WE 'S RAN ACTI N: K.S M A Y E L ' TRAN A TION: I � I i�s 000.00 i�s aoo.00 z �In 6pffnK�o�p 3 A16.50 � I � I Adj�!stmenle lor f��pgj�Y3.' 'ustmrn�s fOLiICfIls oaid hv�CLIE i dYaIlpe '. I �' Ily��ovin 1arAS � 03 30 15 12 31 15 333.94� e 03 30 15 12 31 15 333.9C! � t a 03 30 15 06 30 15 396.61 03 30 IS 06 30 15 396.62i � a I � � i � � � i j 179 147.05 E(,�, 175 730.55 _200 AMOUNTS PAID BY OR ON BE �j9�E ! ��n <torramP<tmqpPy 5 000.00 - •) �—� I I 'I s loseiler(line tAp01 —�� 14 942.35 �o� F=�srinp�ani-)�aken,si4^ec an(sLlaKe1.�'ect i i ➢ll98ffCLG i � IIqdqC(p J 1 � i � ustments tor item i c n . ltaxe_c � 7 - � ' i I I �,� I �„ i � I I � � � 5 000.00� 14 942.35 I$EHT TO OR F � 179 147.05 ) 175 730.55� 1 llar eorrmv�L(Lne 22Q 5 000.00 p3t�(�.�5 14 94` 2.35� 174 147.05 ER 160,78B.20I SU85TINTE FORtd 1049 S£LLER STA7EIdEN7:Thp inlorma6on conWinetl ne�e�n is unCawnl taz in/crmetion BnE Is Oe:ng lumisnetl lo Inp Iniemai Revenue Senrco.II�ou are reQuuetl to fde a remm, a ne9��ylr.co Qenat.y or o:ner SantUM wiU Oe�mposeC on yvu II�tis dCm is reQuitM lo Oe rcportetl nn�Iha IRS tlelerminez tnal il has nol becn re0�o7 Tha Conbact Sales Pn.e Cesv�beo on une d0�ab�ve wnsmmes tne Grma Proceeas ol Ih�s Vansaclion. Vpu are re�u�retl Dy law to proHOe!he 5et'.lemenl agent(Fed.Taa ID No: 1 with)c:s cerced Wrpaye�iCentilca:ion num0er.11 you ao not prmre your carr.;ta�payer idenf�L:abcn num0er,yca may De sa5jett to dvil or enmuwl pC�i��iCS�Do:vO by�m. n e�De�aiues a De�ury,i ttr,;!y{nat NB num0e�Show�n cn Ni,ata:emenl is my carce:t Lupayer iCCnjRwuo��umber. TIN: _ f _ SELLER(S�SIGNATURE(S): SELLER(S)NE�V 6NILtNG AODRESS: SEILER;S�PHONE NU�.�BERS: _�H) (�Y� Exhibit "J" wenovs eo-.vc�s am ctzaete !�+*n NUO-5(J/B6)rei Ha.�eaoca.3C5 2 U.S.DEP;RTM�TOF HOUSIT.'G AND URISAN DGVELOP4IL-'NT Fitc Numbcr.2015-OG3 PAGE 2 SET7CEMENTSTATEMENT r�_Er,oresssewementsvsl: ��> 53.Ksqc' PAID FROM PAID FROA7 j - r 175 000.00 = 10 795.00 BORROVJER'S SELLER'S I +��,y�;�n ri�a�ooi,,1��.--� FUNDS AT FUyDS AT ,' . m� SETTLch.tENT SETTLE�lE�lT i �� c 10,795.00 io Be=kshire Hathaway �� I 70a G��rm't��.n oa��at aninPm< � 10 795.00 i i �n• s c..a �o Harkshire Hathawav 295.00� i ( IT � 5 � S / 0 m fn � 4 ' � F r1 I � 10n2 htrnnape InSr��arr.� T��5 /m0 � � � �.n r3D S � • � - r i q d.00 0.00� 1 � � arall Kamela Cornman 15.00 �f Stowart Title Guarant PA RE SS 1 275.00 � ' ludec a6ove ta�jY� �17 � i�s 000.00 - i 275.00 � .].4.�nets evlc � Fra 6 Tile 1 800.00'�� ,�,7at,_ rzE;,�y n�„a Fees Deetl 5 Bl.50 �e orc,�=�$ Rey � 81.50 I i 1 9 .-rri.�,nN!=rFvamo� D� eC1.750.00 �l,1��y;3�Pi I 1 750.00 � �763 StateTaxr,��mes DsdS1.750.00 r� � 1 750.00, � 1ffi: Dne r - � _ I�'i0Q ADDITIONAL SETTLEMENT G � ! Salzmann Hu hos P.C. 10.00 Jonni£ar Varner Tax Collector 440.03 SMTMA 147.32 3 d16.50 14 942.35 NUD CERTIFICATION OP OUYER AVO SELLER I na��a carMuity re�e»M Ine HUD•1 Se;Uamonl 5ialemo�t and lo Ina bast ol myknow,etlgo ane Ce6ef,it Is a uve anA aauraie slatemon�cl an roce�pLS antl tl:5tunemenfs made on my atcounf or by me in L�is Cens on.I IUMM tertily thet i�,a�vo�recewC a copy M No HUD�1 SeHlem,e�J��L9tam/ml. ,�� '��f6 c=D'tu--' �a J� t+`�� 1YilliBm .HOovEr Em�oOvcr i� ,�.�w�IG�-L � � nne . xk &m7am�n�.1 C. iCD mCa A.G::b WARNINC R IS A CRIlAE TO KNOYlINGLY MAKE FALSE STFTEIdENTS TO TNE ihe HU�-1 Se!Cemutt Sia�emeo:xTicn i naw preparea is a uuo an�aca:ra:a eccounl ol N�s t:3nsacic�� UNITE�STATES ON THtS OR ANY 5tlJIUR FORid.PENALTIES VPON LONVICTICN I!'d�s�f2U5C0 C�`ni!�TUSC IhC funtl5 t0 CP GSG�:lh1 M e:;ArC3R:C H1:h�'��S 3'3tCmCn:. CA1!Iti"IUDE F FIhE Ft1D UdFR15CR6SENT.FOR DETAILS SEE TIiLE 78� U.S.CQD'c SEC7ICN SfAt AND SECTION t010. � /� � C,�� 3/�`/' ' i.TE -' i. Exhibit "J" REV-1510EX+(02-15) SCHEDULE G pennsylvania lNTER-VIVOS TRANSFERS AND DEPARTMENT OF REVENUE INHERITANCETAXRETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Mary J Taylor 21-14-1065 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. DESCRIPTION OF PROPERTY ITEM INCLUDETHENAMEOFTHETRANSFEREE,THEIRRELATIONSHIPTODECEDENTAND DATE OF DEATH %OF DECD�S EXCLUSION TAXABLE NUMBER THEDATEOFTRANSFER.ATTACHACOPYOFTHEDEEDFORREALESTATE. VALUEOFASSET INTEREST (�FAvvucne�e� VALUE 1. IRA No. 1933-11 -See Exhibit"G" Susquehanna Valley Federal Credit Union 12,053.32 100.00% 12,053.32 Beneficiaries: David C. Gibb, son&Suzanne G. Keck, daughter 2. Real Estate at 22 Tunbridge Lane, Carlisle, PA 17015 For March 20, 2012 Deed No. 2012-08365 See Exhibit"I" Decedent continued to reside at the property until her death. Decedent continued to pay all household expenses until her death. Tax Parcel No.: 40-24-0748-149 Assessment$173,500/CLR 101.1%_$171,612.27 Property Sold March 30, 2015 for$175,000.00 175,000.00 100.00% 175,000.00 For copy of settlement sheet see Exhibit"J" TOTAL Also enter on Line 7, Reca itulation $ 187,053.32 If more space is needed, use additional sheets of paper of the same size. _ - -- - L .^.` _.,,� �-.. ._ _ " i n _ � _.r!'„- (�� /� � _ .. i ,. r :E I�J � �l`��I.—��,�� . ��- �� . ';i,i,__'! .`.I�C� , .,..'\�I�.;'JI�' ' �E�i 2E06U1 I �r�fiRF.ISBUr�_G ?F.17'�28-OG01 �� '�E��E E'C[I'fL G[' ly'��C- i Iv1UST BE CGIv1PL�i�^EY P,�PP.ESEI�TATIVE OF FIIJANCINL INSTITUTI01�WHEP.E SAFc DE?OSIT BO::IS LOCATED AND RETURNED TO ABGVE ADDP.ES:. «c; ! COUI'.�Tl'�GDc FILE fvUMS�'r, : SOCI�iL SECUP.ITI'OP,DEATH CERTIFIC�,TE I�UMpER � �:-� j.0_ /��" /�� —��--- i/� � � � DECEDEI�i'S N�'ME(LAST,FIRST MIDDLE) � DATE OP DEATH I ,y";',''/,�2�% ;� �-�/ /�'/� f�� :.�� "'�� /� �DDRESS OF DECE`�Ef�!T � (STREET) � (CITY)� (STATE) (ZIP CODE) e � ? J G �7''.n/=,./ i'�, � / �G'�'_S'� �"<',�,C 1� �A✓��.E'/i�c' �v. /�� .� /v � •/ � NAME AND ADDRESS OF PEP.SOPI REQ STING THE OPENING OF THE SAFE DEPOS{T BOX (NANiE) ,._--. _-s`��.; ��;�r �- � , /�c,� (S?REET NAME) � (CITY) (STATE) (ZIP CODE) �;' �`'��-.u � �'-�,y�t��'`''f�Ry2� �J `� �''',��j� ��/-�- / i�-��s` : NAME,ADDRESS C.ND RELATIOtdSHIP(IF AfJY)TO DECEDEMT,O PERSON(S)PRESENT AT THE BOX OPENING a. (NAME) / / � � (RE�IONSHIP) ✓.�'L�; �l- �. C""'j'�"J-�.� �..i �/I� (STREcT NAME) p � -(CITY} / (STATE) (ZIP CODE) '��l�'�7 �.��/l t+C //T/��% �� , "+C„/�%�/�.%�LJ_/.��"i c-� �/T� � �� ,i Y / b. (NAME) l (RELATIONSHIP) ' �� ,�;,ri.,�� -�� -� (STREET NAME� / (CITY) (STATE) (ZIP CODE) �� j �� E%s�-.�-C ��S�'l� :?�� .I %'G�I�`� a (NAME) / � (RE TIONSH�P) �` � ��' -�1/ '�� (STREET fd�ME) ' / � (CITI') (STATE) (ZIP CODE) � F�.�..-.'�� /� ,/?1�41'^✓�'!�^.� �� • � y �/!C_... /c6 /T'-� l /�� l ' NAME AND ADDRESS OF FINANCIAL INSTfTUTION WHERE THE SAFE DE�SIT BOX IS LOCATED (NAMEj � �-y7 ,�.,=— — �,4-�,,% (STREET NAME) � j �,� �f ��/ (CITY) �` (STATE) (ZIP COD� �' �'i�i�'�„/"y / /,%�'�`,�':% �✓�,/�'.i`'%�" �i' ' r' � . ��i�' . ;.;r�. �i'��,! � DATE AND TItdE 0 LAST ENTRY ! NAME OF PERSOh MAKING LA T ENTgY � y� � -� ,/� � � s �t�/'�� .o� �7/�/�-1� :�'s�f� �G;�� s'� n ��Jtl',n �� DATE OF CONT CT TO �NT BOX NUMBER OF BOX � TITLE UPIDER WHICH BOX IS REQUESTED �.` .�! �Y 9 i � �1'~ 7"'� .�/ /'�.�/'��,� / =�' ,-_S�•r,r� ! r , NA(Vf�ANG ADDRESS OF PERSON(S)HAVING ACCESS TO BOX ' C '� rn b. (NAME) �} � G9 a. (NAME) �� /� � ,.ti � � � ��!./�'/�'"' ,� : /"%�.��r� C7'1 f,'a (STREET ADDRE�) � (STREE i ADDRESS) • A � T"r! m J � � � -� � C3 �.--� %��,.��:��✓��- ��-_ tn (CITY) (ST1�TE) (ZIP CODE) (CITY) � f,��ATE)� (ZIP�[y0E1�) /,'��t,�t,.��, ✓,��-- / �Ci"'/� �,.� p ,.,� '� ^� 'Ti �i ' ^ , NAME�ND TlTLE OF EMPLO'YEE TAKING THE INVENTORY : � �.._► �"" !"�i ' "t3 � � � O ,y ' � 3;,i � `T1 d v`��,�"' ;:}-- �' ✓' . � WAS A VUILL IN THE BO)C? ❑ YES ��NO If yes, a.Date of will; b. Name and address of personal representative,ii named in the will (NAME) (STREET hIAME) (C�TY) 15TATE) (ZIP CODE) c, Name and address of aYtorney,if any I' � j I�1FIv1 E) � !c,T�F_FT Nfi.ME! EXrllblt ��K� fCIT") iSTA.TcI l'IP CODEI I I _ II _ ; _ --- _ _ - - � _- - _ — �," -- -- - - ;�. --- — _ _ ;:. � ,,.s' =�::-�i�, _., �_�r�l',- �� ` ` , , ,_ �._ I ;C•GI . LISi tc!I �V61';� GGI„iii"i0ii vl' � �i�ii�G =.C-I-I il' otc, ��! ii�ll'i UI"G'.�I::i I iil'i�iOUI�� Il�i u0):. :t0':�(S cic `t,i );; I _ , �Esiyn�ied �� lnlllv Oi COIll�211)/, C2I"iliiC2ic II,.IIII�C-', GJlE G"i G21ililCatE I"i211"�C- �Il VJiIICh SiOC�; IS i0gl£i2r2J allG ��umber of shGr�s anG class o�stocl:. (�) C�(�+PEg.at6ec�� a�E�.�. �c�verre�-�ecs�: I�!umber of it2rns, date of iss�!e, face value, names in which registereci and type of ownership, i.e.,jointly held, pay�bie on death, etc. (4) Boroc�s: Designate by name, amount, serial number, or other designation. (Eearer Bonds) (5) Banl: anc� S�a��i�ar�s and Lcsan Passbooks: State name of depositor, number of boolc, last date appearing in book, name of bank and branch, and balance. (6} Jewelry, Coins,Stamps, f��anuscriprs,e�c: List and describe as fully as possible. (7) Deeds, fJdortgages, Currert i�§ur�nce Policies or�ther evidences of iradebYedness: List and describe as fully as possible. (8) l�ll other corrten�s. ITEM ITEM DESCRIPTION N0. . � �-�-�/� l�,� ,�G,.3'7 �1 � -�� d�' J .:�' y i S""�� ` ,�'e.�7��-G . ,�' �- �"/� ��, _ �'"� �/�� .�-� l �� ...r/>�te�5 ,� �� _ ��n� . .5�' . �'"��-�' G�.�� /�? �9� .�? � .y�% 'f.-�' y�:.,- . .J�l.g-.� � G^'C r_'�� cn✓`�� /fl`Y.( f� ,��✓� /�.'i/'�j✓l/T�K �/7��-�� . ,.� :� �/j��'"� `�' � .��`�r'`"' __---� ��;.� �r� .0 ��-� :�/ , / �' .�.-� i+'-'�'. 'c"_:::E.r��'-_.0 ��'1'�4>'l'f'' ✓� '��t� /�J'/� ,`./�?Gc�=,J'7�J"9°� /� �� ;D ,.�`7' �, � ��,^..��-C'� � � :� ��7�/�' —f� I CERTIFY UIJDER PEIVALTY OF PERJURY THAT THE ABOVc RECORD IS PERSON RECE�� G COPY OF /! CORRECT AND CO�PLETE TO 7HE BEST OF MY KNOWLEDGE AND EELIEF. SP�FE DEPOSfY1 k INVEiVTORY: SIGNAT �tE f � ,� . , ,'�,,= SIGNATU�--r._�"„� ,--. �-- � __ , ....�„�r„�..� / ., r` . , .�./ y �} f �r' �-,,. - , J- , _ _ I " i __ `� 9 E .r` • � -� Jj'r�-' ;"1, ., - ;': N . t. ,� PRIIJT NAME� PF�INT'NAME AND CHECK APPROPRIATE B0�BELO\N: .>r i _- � . .�. ....- _ , . : . .. , . .; � . _ _ . . :' . �.- , �� : ....� -� -� . . �, _.._ _. ... J '.. FRRJT TITLE DATE r CHECK APPROPRIATE BOX I � ' �Execurorllrix) �Administrator(trix) � . _ , _. I � � �Esiaie Representative � Joint owner cf safz deposit box �i ' �, ,r .;,:(" y s, `t� b•i�eC��Sc[it .�[ .�:� s:�i�,G"�oCc�� rJT'��3f� ,,!`ic"�01E C}C 7C5��1 EXhlblt "K�� .srar� €�,�er,r�^,� =��E�E��ai �'!_ n , � c.; �}� � Estate of Mary J.Taylor Personal Property Received by Suzanne G. Keck bedroom set 100 entertainment center 35 recliners (2) 50 sofa/chair 75 drop leaf table 45 desk 75 pine chest 50 cedar chest 75 oak chair 15 vacuum 45 sewing ma,chine 25 wedding ring set 500 misc costume jewelry 50 misc kitchen utensils 40 1,180 Personal Property Received by David C. Gibb dining room set 100 chestfreezer 45 snowblower 65 misc kitchen items 25 chair 10 tv 25 tv 35 lamp set 10 lamp set 20 dry sink 45 shelves 25 garage cabinets 50 mirror 45 500 Exhibit "L"