HomeMy WebLinkAbout08-31-15 J �'��`� pennsylvania 15 0 5 618 4 0 3
OEPARTMENTOFREVEN�X(03-14)
REV-1500 OFFICIAL USE ONLY
County Code Year File Number
Bureau of Individual Taxes �NHERITANCE TAX RETURN
Po Box 2soso� 21 14 0 8 9 2
Harrisburq,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
09 01 2014 01 02 1920
Decedent's Last Name Su�x Decedent's First Name MI
HORNER RAYMOND H
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name M�
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
� 1. Original Return � 2. Supplemental Return � 3. Remainder Return(date of death
priorto 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)
� 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.)
� 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 T0:
Name Daytime Telephone Number
LINDA J OLSEN 717 540 4332
First Line of Address
2000 LINGLESTOWN ROAD
Second Line of Address
SUITE 202
City or Post Office State ZIP Code
7
HARRISBURG PA 17110 ��=� �
c� �;, � rn
G �Ti r,7
CorrespondenYs email address: �olsen(aahazenlawgroup.com �' � � ''� <'�
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REGIS7E QF�-LS U��NLY `. ;:�
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REGISTER OF WILLS USE ONLY - .•-�
DATE FIIED MMDDYYW —.� ; `rl
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DATE FILED STAMP��
Side 1
(II�III IIIII�IIII��III IIIII�II�I II'II I'lll�IIII��III IIII I��I
� 1505618403 1505618403 � r ��
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� 15056b84Z1
REV-1500 EX
DecedenYs Social Security Number
oec�aem�$N$me: Horner, Raymond H
RECAPITULATION
1. Real Estat+e(Scheduie A>....................................................................................... 1. 13 0,0 0 0•0 0
2. Stocks and Bonds(Schedute B)............................................................................. 2.
3. Closely Held Corporation,PaRnership or Sole-Proprietorship(Schedule C)......... 3.
4. Mortgages and Notes Receivable(Schedute D).................................................... 4.
5. Cash,Bank Deposits and Misceflaneous Persona{Properly(Schedule E).......... 5. 9,9 6 6.�4
6. JoiMly Owned Property(Schedu�� ❑ Separate eilling Requested..._........ 6. 3 3 9,4 4 2•5 0
7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property
(Schedule G) ❑ Separate Billing Requested............ 7.
8. Totai Gross Assets ttotal�ines 1 through 7)........................................................ 8. 4?9,4 0 8-5 4
9. Funerai Expenses and Administrative Costs(Schedule H).................................... 9. 2 8,5?5•14
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1}............................ 10. 5,3 6 7•5 0
1 t. Total Deductions(tatal Lines 9 and 10)................................................................ 11. 3 3,9 4 2•6 4
t 2. Net Vaiue ot Estate(Line 8 minus Line 11).......................................................... 12. 4 4 5,4 6 5•9 0
13. Charitable and Govemrrientai Bequests/Sec 9113 Trusts for which
an ekcuon to tax has not beeo made(Schedule J)............................................... 13.
14. Net Value Subject to Tax(Line 12 minus Line 13}............................................... 1q. 4 4 5,4 6 5•9 0
TAX CALCULATION-SEH INSTRUCTIONS FOR APPUCABLE RATES
15. Arrtount of Line 14 ta�cable
at the spousai tax rate,or
transfers unde�Sec.9116
(a)(1.2)X.QO 15. 0•0 0
16. Amount of Line 14 taxable
atlinealrate X .045 445,465-90 16. 20,045•97
17. Amourrt of Line 14 ta�cable
at sibling rate X.12 0•Q� 17• 0•�0
18. Amount of Ltne 14 taxable
at coi�ateral rate X.15 0•Q 0 �8. 0•0 0
19. Tn�cDUE................................................................................................................ 19. 20,045•97
20. FILL IN THE OVA�IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT �
Under penalties of perjury.I dedate 1 have examined ihis retum.indudiny aaoompanying 9diedules arW statemenQs.and to the best of my kno�Medge artd belief,
it is We.oorrect and oompete.Dedaradon d preparer other than the person responsibie iw fiG�g the retum is baaed on aU intormation ot which preparer has
any kROwiedge.
SIGNATURE OF PERSON RHSPONSIBLE FOR FILING RETURN ���g g Horner � ` °ATE � ✓
C �(ii ..Z , �` � ��
ADDRESS -�
1223 Chelsen Cross Mechanicsbu ,PA 17050
SIGNATUR PREPARER O R PRESENTATIVE �inda J.tJlsen Esq. � 8, ���
A
2000 Linglestown R d,Harrisburg�PA 17110
� �('lll����'�'���'�'���5�'I�N�8�4����I)��I')���'������'�) Side 2 b 5056 b 8 411 �
REV-1500 EX Page 3 File Number 21-14-0892
Decedent's Complete Address:
DECEDENT'S NAME
Horner, Raymond H
STREET ADDRESS
1223 Chelsen Cross
CITY STATE ZIP
Mechanicsburg PA 17050
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 20,045.97
2. Credits/Payments
A. Prior Payments 19,500.00
B. Discount 1,002.30
Total Credits(A +B) (2) 20,502.30
3. Interest (3)
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. �4� 456.33
Check box on Page 2,Line 20 to request a refund
5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5)
Make Check Pa able to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred:............................................................................... ❑ ❑x
b. retain the right to designate who shall use the property transferred or its income:.................................. ❑ Ox
c. retain a reversionary interest;or............................................................................................................... ❑ ❑x
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?.................................................................................................................... ❑ ❑x
3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?....... ❑ ❑x
4. Did decedent own an individual retirement account,annuity,or other non-probate property which ❑ ❑
contains a beneficiary designation?..................................................................................................................
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 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 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 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
Horner, Raymond H 21-14-0892
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 jointlyowned 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 342 Andersontown Road, Mechanicsburg, PA-Property was sold to a 130,000.00
disinterested third party.
TOTAL(Also enter on Line 1, Recapitulation) 130.000.00
(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)
Rev-1508 EX+�08-12)
SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENT OF REVENUE pE RSO NAL PRO PE RTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Horner, Raymond H 21-14-0892
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 Rolling Green Cemetery plots-2 plots 5,590.00
2 Vehicle 2000 Buick Regal LS-94,000 miles 2,248.00
3 Refund-AAA dues 20.25
4 Refund-Bankers Life and Casualty Company-Long-Term Care insurance premium refund 1,454.59
5 Refund-County/Local real estate taxes-Refunded at real estate settlement as noted on HU 412.19
-1
6 Refund-Erie Insurance premium 33.00
7 Refund-School real estate taxes-Refunded at real estate settlement as noted on HUD-1 208.01
TOTAL(Also enter on Line 5, Recapitulation) 9,966.04
(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-1509 EX+(01-10)
pennsylvania SCHEDULE F
DEPARTMENTOFREVENUE JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Horner, Raymond H 21-14-0892
H an asset was made joint within one year of the decedenYs date of death,it must be repoRed on schedule G.
SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT
A. Craig B Horner 1223 Chelsen Cross Son
Mechanicsburg, PA 17050
B.
C.
JOINTLY OWNED PROPERTY:
DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM LETTER DATE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DECD�S VALUE OF
NUMBER FOR JOINT MADE NUMBER OR SIMILAR IDENTIFYING NUMBER.ATTACH DEED FOR VALUE OF ASSE INTEREST DECEDENT'S INTEREST
TENANT JOINT JOINTLY-HELD REAL ESTATE.
1 A 01/21/2009 Heritage Investment cd 1014855-Joint with 71,778.76 50.000% 35.889.38
Craig B. Horner
2 A 01/21/2009 NCFCU Checking 74111-S4-Jointwith Craig 7,831.65 50.000% 3,915.83
B. Horner
3 A 07/08/1997 NCFCU Money Market 74111-S3-Joint with 9,829.21 50.000% 4,914.61
Craig B. Horner
4 A 07/08/1997 NCFCU Savings 74111-S1 -Joint with Craig 4,657.02 50.000% 2,328.51
B. Horner
5 A 07/21/2009 VanguardBrokerage67098788-Jointwith 522,309.40 50.000% 261,154.70
Craig B. Horner
6 A 07/08/1997 Vanguard Money Market 88031997324-Joint 62,478.94 50.000°/a 31,239.47
with Craig B. Horner
TOTAL(Also enter on Line 6, Recapitulation) 339,442.50
(If more space is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group,Inc. Forrn PA-1500 Schedule F(Rev.01-10)
REV-1511 EX+(08-73)
pennsylvania SCHEDULE H
DEPARTMENTOFREVENUE FUNERAL EXPENSES AND
RESIDENNDECEDENTTURN ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Horner, Raymond H 21-14-0892
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
M
q, FUNERAL EXPENSES:
See continuation schedule(s)attached 7,255.89
B. ADMINISTRATIVE C�STS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zio
Year(s)Commission Paid
2. Attorney's Fees Hazen Law Group 11,500.00
3. Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation) 3,500.00
Claimant Craig B. Horner
Street Address 1223 Chelsen Cross
citv Mechanicsburg state PA z�o 17050
Relationshi�of Claimant to Decedent SOII
4. Probate Fees 355.50
5. AccountanYs Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 5,963.75
See continuation schedule(s)attached
TOTAL(Also enter on line 9, Recapitulation) 28,575.14
Copyright(c)2013 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.08-13)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Horner, Raymond H 21-14-0892
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Ex et� nses
1 Giant-Funeral luncheon �22,g2
2 Parthemore-funeral 6,038.07
3 Rolling Green Cemetery-grave opening 1,045.00
4 Rolling Green Cemetery-marker plate 50.00
H-A 7,255.89
4ther Administrative Costs
5 AAA-vehicle transfer 136.37
6 Closing Costs 5.010.00
7 Cumberland County Law Journal -Estate advertising 75.00
8 Harbor Freight-parts for repairs-Repairs were made to real estate in preparation for sale. 31.79
9 Home Depot-bathroom repair-Repairs were made to real estate in preparation for sale. 26.21
10 Journal Multimedia-Estate advertising 167.00
11 Keystone Oil -furnace repair-Repairs were made to real estate in preparation for sale. 350.92
12 Lowes-home repairs-Repairs were made to real estate in preparation for sale. 78.63
13 Tractor Supply-repair parts-Repairs were made to real estate in preparation for sale. 87.83
H-B7 5,963.75
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98)
Rev-1512 EX+��2-72)
SCHEDULE 1
pennsylvania DEBTS OF DECEDENT,
DEPARTMENTOFREVENUE MORTGAGE LIABILITIES AND LIENS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Horner, Raymond H 21-14-0892
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 Alert Pharmacy Service 274.64
2 Apria Healthcare 10.33
3 Charles Hoffman-Property taxes 2,569.73
4 Hershey Kidney Specialists 14.37
5 Messiah Lifeways 1,620.00
6 Pennsylvania Department of Revenue-2014 taxes 347.00
7 Pinnacle Health 23.43
8 United States Treasury-2014 taxes 508.00
TOTAL(Also enter on Line 10, Recapitulation) 5,367.50
(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+�01-70)
pennsylvania $CHEDULE J
DEPARTMENT OFREVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Horner, Ra mond H 21-14-0892
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT �Words) ($$$)
I� TAXABLE DISTRIBUTIONS [include outright spousal
distributions,and transfers
under Sec.9116 a 1.2
Craig B Horner Son All the rest,
1223 Chelsen Cross residue and
Mechanicsburg, PA 17050 remainder of the
estate
Total
Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 cover sheet as a ro riate.
NON-TAXABLE DISTRIBUTIONS:
II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -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 J(Rev.01-10)
HERITAGE INVESTMENT
SERVICES FUND
September 30, 2014
Tiffany J. Mutzabaugh
Hazen Elder Law
2000 Linglestown Road
Suite 202
Harrisburg, PA 17110
R2: �Siaic Gi ipEiyf7i0�'id H. i�crr�er
Dear Ms. Mutzabaugh,
We are in receipt of your letter dated September 22, 2014 regarding the Estate of
Raymond H. Horner.
Please find below the information requested on the account held by the decedent.
1. Note number: 1014855
2. Ownership: Raymond H. Horner, Primary and Craig B. Horner, joint tenant
with right of survivorship
3. September 1, 2014 Value: $71,778.76 (see enclosed statement)
4. Account Type: Unsecured Promissory Term Note
5. One note
There have been no changes to the account since January 14, 2014 inception.
Please don't hesitate to contact me if you have any questions.
Sincerely,
17e�u�e �a�
Administrative Assistant
Enclosure
`��1� ��,_� �`"� � �'Li 5 y�`: �' � iy,
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3 KACEY COURT,STE 101 MECHANICSBURG,PA 17055 • 'Toll Frce: 86(-21�)-0820 . P:717-7)6-97�4 . F:717-795-9568
New Cumberland Federal Credit Union
Your Community Credit Union
P.O. Box 658,New Cumberland,PA 17070-0658
Phone: (717)774-7706• 1-800-716-2328 •Fax: (717)774-7996•Web: www.ncfcuonline.or�
October 17, 2014
Hazen Elder Law
2000 Linglestown Road
Suite 202
Harrisburg, PA 17110
RE: Estate of Raymond H. Horner .
Dear Ms. Mutzabaugh,
Pursuant to your letter dated September 22, 2014, pertaining to the above
referenced member the information is as follows:
Account Number: 74111
Owner(s) on Account: Raymond H. Horner
Craig B. Horner
Date acct opened: 7/8/1997
Date of Death Balances: S 1 (Savings) $4,657.02
S3 (Money Market) $9,829.21
S4 (Checking) $7,831.65
Dividends as of August: $ 29.45
If you need anything additional pertaining to this matter, please do not hesitate to
contact me directly.
SiilCCfi;iy',
�
Barbra J. Wright
Branch Manager
Enclosures
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PO. Box 2600
November 18, 2014 vaiiey Fo�ge, Pa �y4e1-zsoo
www.vanguard.com
TIFF�ANY J MUTZABAUGH
HAZEN ELDER LAW
2000 LINGLESTOWN RD STE 202
HARRISBURG PA 17110
Re: Estate of Raymond H. Horner
De�r Ms. Mutzabaugh:
I am responding to the letter we received requesting a valuation of Raymond H.
Horner's Vanguard accounts as of September 1, 2014. The information
requested is included on the enclosed account value reports.
If you have any questions, please call me at 800-643-3398 on business days
from 8:30 a.m. to 5 p.m., Eastern time. If I'm unavailable, you can leave me a
voice rnail and I'll call you back or you can speak with another representative.
Sincerely,
'�a, , ,.�r,�`.
Evan Smrek
Registered Representative
Enclosure(s): **Raymond H. & Craig B. Horner Joint Account Value Report
**Raymond H. & Craig B. Horner Joint Brokerage Account
Report
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52813848 �r,( ��
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`�'�-�-.'��r ��� ���,���
Raymond H Horner& Report for 09/01/2014
Craig B Horner Flagship Services:800-345-1344
JT TEN WROS Evan Smrek extension 17450
1223 Chelsen Cross
Mechanicsburg, PA 17050-6609 Total report value: $62,478.94
(Total report value includes any accrued dividends.)
Raymond H Horner,Craig B.Horner-Joint Account
Account value summary
Narne Fund&Account Date 'Price Per Accrued
Number Opened Shares Share" Value' Dividends
Prime Money Mkt Fund 0030-88031997324 01/21/2009 62,478.920' $1.00 $62,478.92 $0.02
Totals $62,478.92 $0.02
'Doesn't include accrued dividends.
"As of the prior business date,08/29/2014,since the report date is a nonbusiness day.
0534096438 11/18/2014 09:03:34
Vanguard Brokerage Services0
A Division of Vanguard Marketing Corporation
Flagship Rep Evan Smrek
Raymond H Horner&
Craig B Horner
JT TEN WROS
1223 Chelsen Cross
Mechanicsburg, PA 17050-6609
Brokerage Account: 67098788
Below is your Date of Death Account Valuation for the above referenced account.
Holdings Summary Values on: 911/2014
Stocks Total $206,105.83
FundAccess Total $316,203.58
Bonds Total $0.00
Accrued Income Total $346.4000
Total Account Value: $522,309.40
Holdings
Siocks Symbol Quantity Price per Share Current Value Accrued Dividends
Exelon Corp EXC 1000.0000 $33.1138 $33,113.8000 $310.0000
JPMorgan Chase&Company JPM 264.0000 $59.4350 $15,690.8400
Monsanto Company MON 34.0000 $115.6275 $3,931.3350
Pfzer Inc PFE 140.0000 $29.3375 $4,107.2500 536.4000
PPL Corp PPL 4040.0000 $34.4525 $139,188.1000
Sturm Ruger&Co Inc RGR 200.0000 $50.3725 $10,074.5000
Total stocks $206,105.8250 $346.4000
FundAccess Symbol Quantity Price per Share Current Value Accrued Dividends
AllianceBernstein Global Bond CI ANAGX 2341.7030 $8.5700 $20,068.3947
A
Deutsche High Income CI A KHYAX 4527.5430 $5.0400 $22,818.8'167
Dre;�fus?a CI A P?PAX 2465.1320 $1fi.3100 i40,2G6.3G29
Eaton Vance Pennsyivania Mun ETPAX 5147.1730 $9.0100 $46,376.0287
Income CI A
Eaton Vance Tax Managed ETTGX 139.0680 $37.9300 $5,274.8492
Growth 1.1 CI A
Franklin Small Mid Cap Growth FRSIX 520.1270 $36.6000 $19,036.6482
CI C
Franklin Mutual Financial TMFSX 2755.9550 $18.0700 $49,800.1069
Services CI C
Invesco High Yield Mun CI A ACTHX 2163.8680 $9.8400 $21,292.4611
Invesco Senior Loan CI Ib XPRTX 7065.7710 $7.0200 $49,601.7124
Oppenheimer Main Street CI A MSIGX 791.3570 $52.7300 $41,728.2546
Total FundAccess �316,203.5755 $0.0000
Page 1 of 2
Vanguard Brokerage Services0
A Division of Vanguard Marketing Corporation
Fixed Income Cusip Quantity Price per Share Current Value Accrued Interest
No fxed income securities held in the account.
Totai Fixed Income $0.0000 $0.0000
Disclosure:
The fair market value of individual stocks and bonds is generally calculated using the mean between the highesl and lowest selling prices quoted on the valuation date.If selling prices are not
available on the valuation date,such as a weekend or holiday,a weighted average of the means between the highest and lowest prices on the nearest trading days be(ore and after the
valuation tlate is used Thc fair market value o(open end mutual funds is calculated using the latest public redemption price avaiiable on the valua!ion date.For bonds,if a high and low pnce
are not available,the mean between lhe quoted dosing selling price on the valuation date and on the frading day before the valuation date is used to determine the fair market value.If the
valuation date is on a weekend or holiday,a weighted average of the means between the highesl and lowest prices on the nearest trading days before and after the valuation date is used.If
high and low prices are not available on these dates,the mean between the quoted dosing selling price on the nearest business days before and after the valuation date is used. 'Fair market
value provided includes an adjuslment for a dividend because the stock was tradiny ex-dividend as required under Treas.Reg.202031-2(i).
Page 2 of 2
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OMB Approval No.2502-0265
ptMEHr�,o. ..
a} `�.
� `��"`� A. Settlement Statement (HUD-1)
i� x
Gqa1N oa�E��
B.Type of Loan
1.Q FHA 2.Q RHS 3.❑X Conv.Unins. B. File Number: 7. loan Number: 8. Mortgage Insurance Case Number:
4.Q VA 5.�Conv.Ins. 2015E017-SMITH-8772 3804032791
C. Note: This/orm fs furnished fo giw you a statement of adual settlement costs. Amounts pakl to and by the sett�ment agent are shown.
Items marked"(p.o.c.)"were paid oufside the dasing;they are shown here ior ir�formafbnal purposes and are rrot induded in the rotals.
D. Name and Address of Borrower:
E. Name and Address of Seller: F. Name and Address of Lender:
Estate of Raymond H.Horner Home Pant Finandal
Ryan L Smith Corporatbn
1332 North 2nd St.,3rd Fbar Apt. 1223 ChBISen GfOSS
Harrisburg.PA 17102 Mechanicsburg,PA 17050 3419 Market Streat,First Floor
Camp HAI,PA'17011
G. Property LOCation: H. Settlement ABent: 25-1833632 I. Settlement Date:
342 Mdersontown Road Robert G.Radebach,Esquire
Mechanicsburg,PA 17055 3419 Market Street May 21,2015
York County,Pennaylvania Camp HI�,PA 17011 Ph. (717)8962666
Place of Settlement:
3419 Market Street
Camp HiN,PA 17011
J. Summary of Bortower'a transaction K. Summary of Sellers transaction
100. GrossAmount Due ftom Borrower: 400. GrossAmouM Due to Seiler:
130,000.00 407. Co�tradsales rfce �30,000.00
101. ConVad seles rice qp2, persqnal ro
102. Persanal ro
103. Settlement Char to Borrower Line 7400 9,928.73 403.
�� 404.
105. 405.
Ad ustments for itams aid b Seller in advance Ad ustments for Ilems aid b Seller fn advance
106. C /Tw .Taxes 05/22115 to 01l01/16 412.19 408.C ffw .Taxes 05/22/15 to Ot/01/16 412.19
107. SchoolTa�s 05l22/15 to 07101/15 208.07 407.SchoolTaxes 05l22/15 fo� 07/01/15 208.01
108. Assessments to 408.Assessments
109. 409.
110. 410.
411.
111. 412.
112.
120. Gross Nnount Due from Borrower
140,548.93 420.Gross Amount Due to Seller 130,620.20
200. Amounts Paid b or in Bahalf of Bortower 500. Reduetions In Amount Due Selier:
201. �e sit or earnest mone 1,000.00 501. Excess d sit sae in�utlans
132,653.00 502. Settlement char es to Seller Line 1400 1,981.65
202. Prl "al amount of new ban s i
203. E�astin loan s taken sub' to 503. Exigtin loan s taken sub ed to
2�. 504. Payoff Fhst Mortgage
205. 505.Pa ff Second Mort e
506.D sit retained b selier 1,000.00
206.
207. �7.
3,700.00 508.Seiler Credk 3,700.00
20$. Seller Cred'R 509.
209.
Ad ustments for items un aid b Seller Ad ustments for kems un afd b Selier
210. C !Tw .Ta�ces to 510.C /Tw .Taxes to
211. SchoolTaxes to 511. SchoolTaxes to
212, qssessrnents to 5'12.Assessrnents to
213. 513.
214. 514.
515.
215. 516.
216, 517.
217. 518.
218.
219. 519.
220. Total Paid b Hor Borrower
137,353.00 52(1. Total Redudion Amount Due Seller 6,681.65
300. Cash at Settlament fromko Bortower 600. Cash at settlement toltrom Seiler
140,548.93 601. Gross amount due to Se�er line 420 130,620.20
301. Gross amount due from Borrower line 120 6,681.65
302. Less amount paid Hor Borrower line 220 '( 137,353.00 602. Less re.duGtions due Seller Nne 520 �
303. Cash a From � To Borrower 3.195.93 603. Cash ❑X To � From Seller 123,938.55
.P�a,,,a;a�a�,osu,B�i,�„��e�,�ia�s�,i�+mtU,«��acgMr> this statement&an F�ttachments referred to herein
7he undersigned here viowledge recep4e4^s�oompleted coPY y
Borrower 7 S�� Estate o ym d H.Home
L Smi BY: ��
Tha Pdlc Repatlnp Burda�fa t�ue cdlecCm cf irdormaEm is ectlmaletl et 35 mindas pe retpase fa WlectlnB.reria�Anp.anJ repvtlrpthe deaa TNs agericy mry r�edlectlYis irAumakm,and yw ae M requretl b canqeEe
ais ram.wess it aspa�s a cvrerar�mia ob�e cmva nmea.No caf�aanialiry�s essved�a dsda�re is madelav.THs is tlesfgien ro pralae a�e Pa9es roa RESA4caxad ae�eacnmHim iAorm elim ar�n9me aamem ac
process. HUD-1
Page 1 of 3
(2015E017-SMITH-8772.PFD/2015E017-SMITH-8772/41)
L.Settiemen�Cha es
700.Total Real Estate Broker Feea P�d FfOf" P�F�
Di�ison of commission(line 700)as iolbws: Borrowers S4iets
Funtls at Puntls at
701.$ � SettlemeM Satdement
7pp,$ t0
703.Commission id at settlement
704.
800.Nems Payabie in Connection wkh Loart
801.Our or'inatfon cfiar e $ 995.00 from GFE#1
802.Your credR or char e Ints for the interest rate chosen 1 022.75 from GFE#2
803.Your ad'usted or' ination char es from GFE#A 2 017.75
804.A raisal fee to SettlementOne Valuation from GFE#3 P.O.C. 525.00 B`
805.Credit R rt to Credit Plus from GFE#3 62.00
806.Tax service ro from GFE#3
807.Flood certification to CoreL ic Flood Services from GFE#3 9.00
808.Guarantee Fee to Hane Point Finandal C ration from GFE#3 2 653.08
809 from GFE#3
from GFE#3
810. (from GFE#3)
S'It
900.ttems Requlred by Lender to Be Paid in Advance
901.Dai interest char esfrom 05/21/15 to O6/Ot/15 11 $13.630000/da from GFE 1i70 749.93
902.M age insurance premium for months to (from GFE#3)
903.Homeowner's insurance for 1.0 years ro Erie insurence (from GFE#11) 336.00
904. (from GFE#11)
�5 {from GFE#17)
1000.Reasrves De osked wRh Lander
1001.Initiai depo�t far}rour escxow account (from GFE#9) 1,766J4
1002.Homeowner'sinsurance 3.000 months @ $ 28.00 per month $ 84•00
1003.Mort a e insurance months $ er month $
1004.Property W�s $
1005.
1006.County Property Taxes 4.000 months @ $ 54.88 per month $ 219.44
1007.SdrooiTaxes 11.000 months @ $ 158.15 per month $ 1,739.98
1008.USDAAnnuai Fee 2.000 months @ $ 54.81 per month $ 109.62
1009.AggregateAdjustment $ -386.30
1100.Tit�e Charges
1101. Title services and lender's title insurence (from GFE#4) 1,465.25 10.00
1102. Settlement or dosin fee $
1103. Ownar's tiGe insurence to Old Republic National Tdle Insurance Canpany (from GFE#5)
1104. Lender's title insurance to Old Republic Nationai Title Ins�rance Compe�y $ 59325
1105. Lender's title policy limtt $ 132,653.00
1106. OwnePs tiUe policy limk $ ��•��•�
1107. AgenYs portion of the total tftle insurance premium $
1108. Underwriter's portio�of the total title insurance premium to Old Republic Nadonal Title Insurance Company $ 593.25
1109. $
1110. $
1111. $
1112. �
1113. $
1200.Govornmant Recordin and Trensfer Ch ' ea
1201.Govemment remrdin char es to Recorder's Offce from GFE#7 169.00
1202.Deed$ 75.50 Mort a e$ 93.50 Releases$ ��$ 1,300.00
1203.Transfer taxes to Recorder's Office l�°m GFE#8)
1204.C /Cou taxlstam s $ 1,300.00 $
1205.State taxlstam s $ 1,300.00 $ 1,300.00
1206.
1207. :. .. . .
1300.Addklonal Settlement Charg6s `
1301.Required services that you can shop for (from GFE#6)
1302.2015 County-Twp.Real Estate Taxes to Charles Hoffrnan,Tax Coliector $ 671.65
1303. $
1304, $
1305. $
1400.Totat Sattlement Charpes(enter o01inas 103,Sectlon and 502.SectiodJ(y. 8,928,�3 1,981:65
•Paid aAsitle d Gainp by borroaal6).seller(S).lentler(L),a dYrbportylT)
BY sig.rp paga 1 of ttYs statemeM.Mie sipnatories aGow�A90ge reeapt cf a cmipele�l cWY dp�2 8 3 dll�is tlree Pege atalemaR.
Robert G.Radebach,Esquire.SettlementAgent
Page 2 of 3 HUD-1
(2015E017-SMITH-8772.PFD/2015E017-SMITH-8772/41)
Comparisort of Good Faith Estimate(GPE)and HUD-1 Charges Good Faith Estimate HUD-1
Char ea That Cannot Increase HUD-1 Line Number
Our originatbn charge #801 995.00 995.00
Your aed'R or charge(points)for the spedfic rate chosen #802 1,022.75 1,022.75
Youradjusted orginatlon charges # 803 2,017.75 2,017.75
Transfertaues #1203 1,300.00 1.300.00
Charges That in Total Cannot increase More than 10% Good Faith Estimate HUD-1
Governmentrecording charges #120t 225.00 169.00
ApPraisaifee #804 525.00 525.00
Credit repart #805 62.00 62.00
Fbod certifiption #807 9.00 9.�
Guarantee Fee #808 2,653.06 2,653.06
Tftle services and lender's title insurance #1101 1,450.25 1,465.25
Totaf 4,924.31 4.883.31
Inaease between GFE and HUD-1 Charges $ -41.00 or -0.83°/
Charges That Can Change Good Fakh Estimate HUD-1
Initial deposit for your escrow acoount #1001 1,657.12 1,766.74
Daiyinterestcharges #901 $ 13.630000/day 122.87 149.93
Homeowner's insurance #903 336.00 336.00
Loan Terms
Your initial loan amount is $132,653.00
Your loan tern+is 30.00 years
Your initial interest rate ts 3.7500%
Your initiai monthly amount owed for p►incipai,interest and $614.34 includes
any mortgage insurance is Q Prindpal
� Interest
� Mortgagelnsurance
Can your interest rate rise� �X No � Yes,it can rise to a mapmum of %. The first
cha�ge wiA be on and can change again every_months after
Every change date,your interest rate can inaease or deaease
by %. Over the iffe of tha loan,your interest rate is guaranteed
to never be lower than %or higher than %�
Even if you make payments on time,can your loan balance rise? QX No � Yes,it can rise to a mapmum of$
Eve�if you make payments on time,can your monthty �X No � Yes,the frcst inaease can be on and the monthy
amount owed for principal,interest,and mortgage insuronce rise? amount owed can rise to$
The maxenum R can ever rise to is$
Ooes your loan have a prepayment penafty4 �X No � Yes,your mabmum prepayment penatty is$
Does your loan have a balloon payment? QX No � Y�.You have a balloon payment of$
due in_years on
Total monthly amount owed inciuding escrow account payments ❑ You do not hare a monthly escrow payment for items,such as property
taxes and homeowner's insurance. You must pay these items directly
yourself.
�X You have an addifronai monthy escrow payment of$295.85 that resufts
in a total in'dial monthly amount owed of$910.19. This indudes
principal,interest,any mortgage insurance and any kems checked beiow:
QX Property tattes QX Homeowner'S i�surance
� Flood insurance ❑X USDAMnual Fee
QX SchoolTaxes ❑
Note: If you have any questions about the SeHlement Charges and Loan Terms listed on this form,please contact your lender.
Page 3 of 3 HUD-1
(2015E017-SMITH-8772.PFD12015E017-SMITH-8772/41)
HUD-1 Attachment
Borrower(s):Ryan L.Smith Selle�(s): Estate of Raymond H.Horner
1332 North 2nd St.,3rd Fioor Apt. 1223 Chelsen Cross
Harrisburg,PA 17102 Mechanicsburg,PA 17050
Lender:Nome Point Financial Corporation
Settlement Ayent:Robert G.Radebach,Esquire
(717)896-2666
Place of Settiement:3419 Market Street
Camp Hili,PA 17011
SettlemeM Date:May 21,2015
Property Locatlon:342 Andersontown Road
Mechanicsburg,PA 17055
York County,Pennsylvania
Adjusted Origination Charge Details
Origination Charge
Loan Origination Fee 995.00
to Home Point Financial Corporation
Total $ 995.00
O�gination CreditlCharge(points)for the speci�c interest rate chosen
Loan Discount Points 1,022.75
to Home Point Financial Corporation
Totai $ 1,022.75
Adjusted Origination Charges $ 2,01T.75
Reserves Deposited with Lender
Homeowner's Insurance 84.00
3.000 at 28.00 per month
County Property Taxes 219.44
4.00�at 54.86 per month
School Taxes 1,739.98
11.000 at 158.18 per month
USDAAnnual Fee 109.62
2.000 at 54.81 per month
Aggregate Adjustment -386.30
Total $ 1,766.74
Title Services and Lender's Title Insurance Details BORROWER SELLER
Ciosing Service Letter 125.00
to Old Republic National Title Insurance Company
Notary Fees 15.00 10.00
to Robert G.Radebach,Esquire
Download Document Fee 50.00
to Robert G.Radebach,Esquire
Wire In Fee 17.00
to Robert G.Radebach,Esquire
Express Delivery Fee 25.00
to Robert G.Radebach,Esquire
Document Preparation 25.00
to Robert G.Radebach,Esquire
Settlement Fee 100.00
to Robert G.Radebach,Esquire
Title Examination and CeRification 500.00
to Robert G.Radebach,Esquire
WARNING: N Is a wlme to knowingly make talse atatements to the United Statea on this or any slmilar form. Penalties upon conviction can
include a fine and imprisonment. For details see:Titie 18 U.S.Code Section 1001 and Section 1010.
(2015E017-SMITH-8772.PFD/20'I5E017-SMITH-8772/41)
HUD-1 Attachment- Corkinued
Tax Certification Fee 15.00
to Robert G.Radebach,Esquire
Lender's title insurance 593.25
to Old Repubiic Nationai Title Insurance Company
Totai $ 1,465.25 $ 10.00
Lender's Title Insurance BORROWER SELLER
*feea aiso shown above in Titie Services and lender's Title Insurance Details
Lender's Policy Premium 443.25
to Old Republic National Title Insurance Company
Lender's Endorsement Charges 150.00
Endorsement Endorsement Charge
Total $ 593.25 $ 0.00
WARNING: k is a crime to knowingly make false statements to the United States on thls or any similar form. Penalties upon convldion can
include a fine and imprisonment. For details see:Title 18 U.S.Code Section 1001 a�d Sectfon 1010.
(2015E017-SMITH-8772.PFDf2015E017-SMITH-8772141)
Loan#:3804032791
ADDENDUM TO HUD SETTLEMENT STATEMENT
This Addendum is fumished to give you a statement of actual settlement costs.Items marked"(p.o.c.)"were paid
outside the closing;items marked"(p.t.c.)"were paid through closing;they are shown here for informational purposes.If
you have any questions about the Settlement Charges listed on this for lease contact your lender.
\
R N SMITH / DATE ��
..� vi., S'. S_..-
A � F Y .HORNER DATE
enie nnae,inc. GHUDI3AS Oa10
G2HU015S
5... OSl21l2015 12:07 PM P5T
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HUU—�5—�b15 dy�b� kULL1N� ukt�N LtMtItKY 'r1'f'rb14��b N.b�
Rolling Green Cemetery
August 24,2015
Linda 1.Olsen, Esq.
Hazen Law Group
2000 Linglestown Road,Suite 202
Harrisburg. PA 1711Q
Re: Raymond H.and Treva l. Harner
Dear Ms.Olsen:
I am In receipt of your letter dated August 19,2015 concerning the lots owned by Raymond H.and Treva
L. Horner. There are two(2}burial lots that remain on the property. They are described as Block F,
Section 1026,Spaces 3 and 4. If Craig B. Horner is the only child and there are no other heirs to the
property than he,Craig B. Horner,would be the sole heir.
The current prite of each space is$2795.00 in Block F. E hope this information has heen helpful and
please let me know if you need any additional information.
Sincerely,
� _ ._.
Sherry Blu nst ck
Manager
Dignity�
\II.\N%I!V
1811 Garlisle Road•Camp fiill,PA 17Ol.l • i 17-761-4055• Fa7c 717-761-4826
tvww.rollin�;reenec[ne[ery.conf•w'ww.Di�niryl�lemorial.com
TOTAL P.02
REGISTER OF WILLS CERTIFICATE OF
CUMBERLAND COUNTY GRANT OF LETTERS
PENNSYLVANIA
y oF �V�ye � `<R�
�` No. 2014- 00892 PA No. 21- �4- 0892
J�'� ��`� ��
�1 Es ta te Of: RA YMOND H HORNER
O � �Z (Fiist,Midd/e,LasU
V �
��� G� Late Of: HAMPDEN TOWNSHIP
— - � CUMBERLAND COUNTY
� w��� �� �
�--��� Deceased
Social Securi ty No: 204-01-41 13
1750
WHEREAS, on the 18th day of September 2014 an instrument dated
August 13th 1971 was admitted to probate as the last will of
RA YMOND H HORNER
lFirst,Middle,Lastl
late of HAMPDEN TOWNSH/P, CUMBERLAND County,
who died on the lst day of September 2014 and
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, L/SA M. GRAYSON, ESQ. , Register of Wills in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereh_y
certify that I have this day granted Letters TESTAMENTARY to:
CRAIG B HORNER
who has duly qualified as EXECUTOR(R/X)
and has agreed to administer the estate according to law, all of which
fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE,
CARLISLE, PENNSYL VANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my office on the 18th day of September 2094.
,.
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**NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST)
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�'�; I'i x�;":�P��E�D, that I, �,aymond ii. Horner, of 222 Orchard
Road, Reas�r`s Sunmit, A3e�a C�.mberland, Pennsylvar�i�, heing o�' �o�nci
�ind, r�emo�y and un_derst�ndin;, do make, pubiish and declare ti:is as
ar�d for my Last ':'l�ll and Testali;erlt, riereby revr�kin� und ��kin.� null
�nd void any and all ';'7ilJ.s and Testanents and �vriti:gs :�a the nature
thereof b�� r�e Qt any timo neretofore mede.
IT'�"sd i: I direct that aIl my just debts snd funoral expens�s
be paid as scon aitor r�y demise ss m.s�y be contTz�ient.
IT'�iV; 2: All the rEst, residue and re�.ainder ef my estate, oi
w'r�atsoever r.ature a�d Yti..eresoever s_tu�tsd, ;ahetiler it be real, perso�a�
or :nixed, includin� �rO�JEP'tP cver tivhi�h I hava a po�r;er of ap�oint�us:.t,
I �ia�, devise and boqu�ath unte my wife, mrE�ra L. H�rnar, abscZutel;�,
p=oviding shs su:rvivas �e for a period of thir�y (30j days.
IIi�.Ivi 3: In the event that mp �vife, ireva I:. riorner, preds-
ceasea me or dies on or before the thirtie�h day f�lZowir� my ceath,
I devisa �r�d bequeath all of a�y ss�flte of e aery nuturs and �;herevsr
situ:=.te to ny son, �raig B. Horner, ner stirpes oz tse thi�^ty-�'irs�
da� follo�vin� my death.
I�ui�? 4: I agpoint Tne Curabe�lend County Tvat?�nal Bank, o,
ii��� Gumberland, Pennsylvania, gu�rdian o`_' ai�y pro�arty a�hich passss
either ur.der this �n�ill o_ �ttisrvaise to a minoT and ��:�ith res�ect to
wnicn I a�n �ut:�ari:.Ed to appeint a �uaraisn and h;ve r.o� othervvise
specifi�ally done so, p.�ov�c�ed th�t t�is appoir.tme�t �i a �u�rdi�n
s:.uil not supersa3e tl:e r�g;::t oi' ar�y fiducisry in its discretion to
distribute a share whsre possible ta the �3ner or to anot,her Fc= the �
minor's ber.efit. Suc�� gu�:dian sr�al� have the �o�ver t� usE pr�ncip�l �
'iII�,SS:
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as well as income from tins to tiine �or the minor's sup�ort and
education (including college education, both Qraduate and undergradu�te)
without regard to his or har parent's abilzty to provlde for such
support ar.d education, or to make payment for these purposes, v�ithout
further responsibilitp, to the minor or to the minor's pa.rer�t or to
any person ta�ing ca�e o� the minor.
IT�.IaI 5: I appoint �y �t�ife, Treva L. Horner, executria of this
mp Last 71i11 and Testament. Should �y wif'e, Treva L. riorner, feil to
qu3liPy or cease to act as execuLrix, I appoint my son, Craig B. Horner
exeoutor oP this �y Last i�Vill and Test��ent. Should r�y son, Craig B.
Horner, fail to cualif',v or cease to act as executor, I appoint 1he
Cumberland County i�?ational Bank egecutor of tnis tny Last ��'ill and
Testument.
ITEN: 6: I direct that my executrix, guardian or their
�uccessors shall not be required to give bond Por the Pa ithiul perPor-
�n�nce of tneir dutryes in any jurisdiction.
IT�1 ',+ITNuSS �'dHEi�OF, I have hereunto set ��� h�nd and seal this
I�t day of August, 1971.
!�-. .�'��/�-u'�c. (5�`t�L)
�A ,'.0?JD H. HO�TE:?
The precedin� instrunent, consisting of this and one (1) other
typeT.vritts� page, ��aas on tne day and dat� thereoY signed, sealed,
published and declared by �SY.P�iO�TD ?3. H02�;;3, the testator herein na��aed,
as and for his Last ;^lill and Testament, in the presence oP us, tvho, at
his request, in his p_esencs and in the presance of ezch other, have
subseribed our names as witnesses nereto.
�
OF
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�`r I
r,'l-, ;f .��%^�t�� o F y'��„�'z....�,���:s`�=' —
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COMMONWEALTH OF PENNSYLVANIA .
: SS
COUNTY OF YORR .
I, RAYMOND H. HORNER, the Testator, whose name is
signed to the attached or foregoing instrument, bearing
a date of August 13, 1971, being first duly sworn, does
hereby declare to the undersigned authority that I signed
and executed the instrument as my Last Will and
Testament.
;�, � _
RAYMOND H. HORNER
Sworn to and subscribed
befc•re m� this f/��� daj� of
t
_ ! ; , 1997.
_ �' �•-
NOTARY PUBLIC
MY COMMISSION EXPIRES:
�
�LL�����r� �otaral Sea�
� S.Dawn Gladfelter,Notary Public
i Dillsb�rg Baro,Yo�k Gcunty
My Gommiss�on Expires MaY 17,2001
Member, ennsylvania Associatlon of ot2nBs
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