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HomeMy WebLinkAbout07-08-05 OFFICIAL USE ONL Y REV-1500 EX + (6-00) REV-1500 INHERITANCE TAX RETURN FILE NUMBER COMMONWEAL TH OF PENNSYLVANIA 21-05-0374 DEPARTMENT OF REVENUE RESIDENT DECEDENT DEPT. 280601 COUNTY CODE YEAR NUMBER HARRISBURG. PA 17128-0601 DECEDENT'S NAME (LAST. FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 0 SHUE GERALD L. 307-34-5509 E C DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE E 0 04/09/2005 01/16/1922 REGISTER OF WILLS E (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST. AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER N T ~ 1. Original Return 2. Supplemental Return B 3. . (date of death - Remainder Return prior to 12-13-82) CAPB 4. Limited Estate - 4a. Future Interest Compromise (date of death after 12-12-82) 5. Federal Estate Tax Return Required HpRL - EplO ~ 6. Decedent Died Testate - 7. Decedent Maintained a Living Trust a. Total Number of Safe Deposit Boxes - RAC (Attach copy of Will) (Attach copy of Trust) OTK 0 9. 010. 0 11. Election to tax under Sec. 9113(A) ES Litigation Proceeds Received Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) (Attach Sch 0) .. tffIS.SEC'TION'Ml.I$T:~~.'CQMP~ETEl).ALL.CQRFle$P<.>NDENCE$.C:ONfl[)EN'TIAL.:rAX"INfORMATIONSHOUI.08EDIRECTED.TO: P NAME COMPLETE MAILI NG ADDRESS C 0 0 Roger B. Irwin Esa. 60 West Pomfret Street R N FIRM NAME (If Applicable) Professional R 0 West Pomfret Bldg. E E IRWIN & McKNIGHT Carlisle, PA 17013 S N T TELEPHONE NUMBER 717/249-2353 1. Real Estate (Schedule A) (1) 131,000.00 OFFICIAL 'USE ONL Y 2. Stocks and Bonds (Schedule B) (2) None 3. Closely Held Corporation, Partnership or (3) None Sole -Proprietorship 4. Mortgages & Notes Receivable (Schedule D) (4) None R 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 22,383.09 E (Schedule E) C A 6. Jointly Owned Property (Schedule F) (6) None P I 0 Separate Billing Requested T 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) None U L (Schedule G or L) A T a. Total Gross Assets (total Lines 1-7) (a) 153,383.09 I 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 17,045.26 0 N 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 475.81 11. Total Deductions (total Lines 9 & 10) (11) 17 .521.07 12. Net Value of Estate (Line 8 minus Line 11) (12) 135,862.02 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been (13) made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 135,862.02 C 0 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES M T P 15. Amount of Line 14 taxable at the spousal tax U A T rate. or transfers under Sec. 9116(a)(1.2) 0.00 X .0 0 (15) 0.00 X A 135,862.02 45 (16) 6,113.79 T 16. Amount of Line 14 taxable at lineal rate X .0 I 17. Amount of Line 14 taxable at sibling rate 0.00 X .12 (17) 0.00 0 N 18. Amount of Line 14 taxable at collateral rate 0.00 X .15 (18) 0.00 19. Tax Due (19) 6,113.79 20. n U:Qti~~I.<:H~FlE:lfXql.l'~RE:~Eql.lE$t!N~A.:ij~~l.Iij~.offi::M'I:,OVEFleA~~EN"Wl C K .> >. BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE ANI) TO RECHECK MATH. < <: Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS I 710 HILLSIDE DRIVE CITY I STATE I ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 6,113.79 305.69 Total Credits ( A + B + C) (2) 305.69 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 0.00 5,808.10 0.00 5,808.10 H:'::IIII~:t~~~i~::~~~!~~::~A~II~I~~~~~~~~:II~~~~YJB1~~:I~~:~~~21~:~i~~ 1. Did decedent make a transfer and: 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; . c. retain a reversionary interest; or.. ....................... d. receive the promise for life of either payments, benefits or care? . . . . . . . . . 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? . . . . . . . .. ....,......" '....... 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. ":~"J~I:~~:~~~~~~~~:~1~~~tlgj2:k~..m:m: Yes No ~~ [KJ [KJ IT} Under penalties of perjury. I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN LINDA J. BRANDT 3 GUMWOOD DRIVE - - Middle - jfiv~r-,- - Mb- - - 2ii2C'f - - - - - - - - - - - - - - - - - - - -- IRWIN & McKNIGHT 60 West Pornfret Street - - -Carl-is ie- - - PA- - - i i6i3- - - - - - - - - - - - - - - - - - - - - - - - - -- DATE t'7 (; .~ /- l u\ DATE 7~ Y~L/r- For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [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 (l A P \" [72 P.S. 9116 (a) (1.1) Oi)]. The statute does not exempt a transfer to a surviving spouse from tax, and the st; J.,.) 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 twenty-one years of age or younge parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 9116 (a) (1.2)]. ;ets T.-f\~\ The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4. [72 P.S. 9116(a)(1)). The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [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. Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) REV-1502 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF GERALD L. SHUE SS/I 307-34-5509 04/09/2005 FILE NUMBER 21-05-0374 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 knowledqe of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE DESCRIPTION NUMBER OF DEATH 1 710 Hillside Drive, Carlisle, PA - SOLD - Settlement Sheet 131,000.00 Attached TOTAL (Also enter on line 1, Recapitulation) $ 131,000.00 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1502 EX (Rev. 1-97) REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF GERALD L. SHUE SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY SS1I 307-34-5509 04/09/2005 FILE NUMBER 21-05-0374 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 NUMBER 1 DESCRIPTION Members 1st Federal Credit Union - Savings Account 52973-00 VALUE AT DATE OF DEATH 13 ,431. 35 2 Members 1st Federal Credit Union - Checking Account 52973-11 1,122.74 3 Personal - Property 7,829.00 TOTAL (Also enter on line 5, Recapitulation) $ 22,383.09 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form RE V-15G8 EX (Rev. 1-97) REV-1511 EX +(1-97) COMMONWEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF GERALD L. SHUE SS# 307-34-5509 04/09/2005 FILE NUMBER 21-05-0374 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. B. DESCRIPTION AMOUNT 1 FUNERAL EXPENSES: Workinger Semmel - Funeral Home 5,594.30 ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. 3. Attorney's Fees IRWIN & McKNIGHT Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 7,800.00 4. Register of Wills 298.00 Probate Fees 5. Accountant's Fees 6. 250.00 Tax Return Preparer's Fees 7. 1 Other Administrative Costs Closing Costs - Paid at Settlement 2,530.93 2 75.00 Cumberland Law Journal - Estate Notice 3 Register of Wills - Filing Fee 30.00 4 Roy Gottshall - Appraisal on Personal Property 55.00 5 Steve Barrett Real Estate - Appraisal on Real Estate 275.00 6 13 7.03 The Sentinel - Estate Notice TOTAL (Also enter on line 9, Recapitulation) $ 17,045.26 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97) REV-1512 EX +(1-97) COMMONWEALTH OF PENNSYLVANIA INHERIT ANCE TAX RETURN RESIDENT DECEDENT ESTATE OF GERALD L. SHUE SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS SSfl 307 - 34 - 5509 04/09/2005 FILE NUMBER 21-05-0374 Include unreimbursed medical expenses. ITEM NUMBER 1 DESCRIPTION Borough of Carlisle - Trash AMOUNT 32.36 2 Internal Revenue Service - Personal Taxes 205.05 3 PP&L - Electric 65.10 4 Sprint - Telephone 173.30 TOTAL (Also enter on line 10, Recapitulation) $ 475.81 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97) REV-1513 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIAR IES NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] RELATIONSHIP TO DECEDENT Do Not List Trustee(s) FILE NUMBER 21-05-0374 AMOUNT OR SHARE OF ESTATE ESTATE OF GERALD L. SHUE SS1ft 307 - 34 - 5509 04/09/2005 1 Linda J. Brandt 3 Gumwood Drive Middle River, MD 21220 Daughter 1/3 Remainder & Car 2 Joanne I. Shoff 280 S. Pitt Street Carlisle, PA 17013 Daughter 1/3 Remainder 3 Donald E. Shue 7073 Carlisle Pike, Lot 107 Carlisle, PA 17013 Son 1/3 Remainder ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18. AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) Copyright (c) 2000 form software only The Lackner Group, Inc. 0.00 Form REV-1513 EX (Rev. 9-00) LAST WILL AND TESTAMENT OF GERALD LEROY SHUE I, GERALD LEROY SHUE, a legal domiciliary of Cumberland County, Commonwealth of Pennsylvania, being of sound and disposing mind and memory, do hereby make, publish and declare this instru- ment to be my LAST WILL AND TESTAMENT. I hereby revoke any and all wills and codicils by me heretofore made. I IDENTIFICATIONS AND DEFINITIONS A. I am married to HELEN LOUISE SHUE, hereinafter referred to as "my Spouse." I have three children, LINDA JEAN BRANDT, JOANNE IRENE SHOFF, and DONALD EUGENE SHUE, hereinafter referred to as "my Children." B. The following definitions obtain in any use of the terms i nth i s W ill : 1. "Descendants" means the immediate and remote lawful, lineal descendants of the person referred to, and it means those descendants in being at the time they must be ascertained in order to give effect to the reference to them, whether they are born before or after my death or of any other per- son. The persons who take under this Will as Descendants shall take by right of representation, in accordance with the rule of per stirpes distri- bution and not in accordance with the rule of per capita distribution. Persons legally adopted when under the age of fourteen years shall not be dif- ferentiated from blood descendants for any purpose. 2. "Survive me" is to be construed to mean that the person referred to must survive me by thirty days. If the person referred to dies within thirty days of my death, the reference to him shall be construed as if he had failed to survive me. Page 1 of 8 Pages 3. As uS2d in this Will, the words "Executor," "he," "him," "his," a"d the li:<e shall be ta<en as generic and applicable to a natural person of either sex or a corporate person or other legal entity. C. I have served in the Armed Forces of the United States. Therefore, I direct my Executor to consult the legal assistance office at the nearest military installation to ascertain if there are any benefits to which my dependents are entitled by virtue of my military affiliation at the time of my death. Regardless of my military status at the time of my death, I direct my Executor to consult with the nearest Veterans Administration and Social Security Administration office to ascertain if there are any bene- fits to which my dependents may be entitled. I I PAYMENT OF DEBTS AND TAXES I direct my Executor to pay the following as soon after my death as may be practicable: 1. All of my just debts and the expenses of my last illness, funeral and of the administration of my estate; but my Executor need not accelerate and pay those unmatured obligations which, in his opinion it might be proper and more advantageous to retain or renew and pay as they become due and payable 2. All inheritance, transfer, estate and similar taxes (including interest and penalties) assessed or payable by reason of my death, on any property or interest in my estate for the purpose of computing taxes. My Executor shall not require any benefi- ciary under this will to reimburse my estate for taxes paid on property passing under the terms of this Wil1. Page 2 of 8 Pages I I I RESIDUARY ESTiHE A. I define limy Residuary Estate" as all of my property after the payment of debts and taxes under Article II above, including real and personal property, whenever acquired by me, property as to which effective disposition is not otherwise made in this Will, and property as to which I have an option to purchase or a rever- sionary interest. B. I give my Residuary Estate to my Trustee, in trust for the benefit of my Spouse, HELEN LOUISE SHUE. C. If my Spouse does not survive me, I direct my Executor to divide my Residuary Estate into equal shares and to distribute those shares as follows: 1. one share to each of my Children who survive me; 2. if any of my Children fail to survive me, then his or her share shall be distributed among his or her descendants who survive me; 3. if any of my Children fail to survive me and leave no descendants who survive me, then his or her share shall be divided equally among such of my Children who survive me, or their descendants who survive me, as set forth in subparagraph 1 and 2 above. I V ADMINISTRATION OF TRUST A. The primary purpose of this trust is the support, main- tenance, and welfare of HELEN LOUISE SHUE. To that end, the Trustee may accumulate and add to principal the income from prin- cipal to the extent permitted by law and shall payor apply such income as the Trustee elects not to accumulate to or for the use of HELEN LOUISE SHUE until the termination of the trust. Page 3 of 8 Pages B. If the income and other funds avai lable to HELEN LOUISE SHUE are insufficient for the support, maintenance, and welfare of HELEN LOUISE SHUt, the Trustee may payor apply for the benefit of HELEN LOUISE SHUE so much of the principal of the trust as the Trustee considers necessary for the purposes of the trust. C. In carrying out the purpose of this trust, the Trustee may distribute income and principal directly to HELEN LOUISE SHUE, if authorized by law, or to the Guardian or to a person wi th whom HELEN LOUISE SHUE resides, or on behalf of HELEN LOUISE SHUE to any other person. Any and all payment or payments of any sum or sums, whether in cash or in kind and whether from principal or income, payable to or on behalf of HELEN LOUISE SHUE, shall be made upon the sole receipt of the respective individual to whom the payment is made, and free from anticipation, alienation, assignment, and pledge, and free from control by the creditors of HELEN LOUISE SHUE, and shall not be subject to any execution or attachment. D. I do not wish to create, or permit to exist, uneconomical arrangements of more harm than benefit to HELEN LOUISE SHUE. Whenever, in the Trustee's good business judgment, a trust shall no longer make good economical sense (presumably because of its small size) in light of HELEN LOUISE SHUE's best interests, the Trustee is authorized to take such steps, including terminating the trust and turning its assets over to HELEN LOUISE SHUE or her Guardian, as he shall deem in HELEN LOUISE SHUE's best interest. E. The powers the Trustee may exercise in carrying out the purpose of this trust are set forth in Article VII below. F. This trust shall terminate upon the death of HELEN LOUISE SHUE, and the Trustee shall divide the remainder of the principal and accumulated income into equal shares and shall distribute those shares as follows: 1. one share to each of my chi ldren then living; 2. if any of my children are not then living, then his or her share shall be distributed among his or her descendents then living; Page 4 of 8 Pages 3. if any of my children are not then living and leave no descendents then living, then his or her share shall be divided equally among such of my children who are then living, or their descendants then living, as set forth in subparagraph 1 and 2 above. V APPOINTMENT OF TRUSTEE I appoint LINDA J. BRANDT and KARL W. BRANDT, who presently reside at 3 Gumwood Drive, Baltimore, Maryland, as Co-Trustee of any trust established under this Will. I request that the Trustee not be required to furnish bond or sureties. V I APPOINTMENT OF EXECUTOR I nominate and appoint my daughter, LINDA JEAN BRANDT, as Executor of this my LAST WILL AND TESTAMENT. If LINDA JEAN BRANDT is unable or unwil ling to serve in this capacity, I appoint KARL W. BRANDT to serve instead. I request that my Executor be permitted to serve without bond or surety thereon. V I I POWERS OF FIDUCIARIES My Executor and Trustee shall have the following powers, which are to be construed in the broadest manner consistent with the validity of this Will and with their duties as fiduciaries. The powers stated herein are not intended to be exclusive, but shall be in addition to those granted by law and shall also pertain to any administrators or trustees who succeed the fiduciaries I have appointed in Article V and VI above. These powers are: Page 5 of 8 Pages 1. to take possession of property, to keep it safely, and to segregate it from other property owned or held by the fiduciary; 2. to retain and to invest in property, or an undivided interest in property, including residential real estate, for any period, whether or not the property be of the character permissible for investment by fiduciaries; 3. to sell, transfer, exchange, lease, rent, mortgage, pledge, give options upon, partition and otherwise dispose of real or personal property, at private or public sale, for cash or upon whatever terms the fiduciary deems advisable, without notice or order of court; 4. to render liquid my estate, in whole or in part, and to hold cash or readily marketable securities of little or no yield for such period as my fiduciary deems advisable; 5. to borrow in the name of my estate or of the trust, upon whatever terms and conditions and for whatever periods my fiduciary deems advisable for the purpose of preserving, protecting or improving property held by him; 6. to pay, compromise, adjust, settle, compound, renew or abandon claims held by my fiduciary and claims asserted against my fiduciary, on whatever terms he deems advisable, without prior court authority; 7. to distribute in cash or in kind, or partly in cash and partly in kind, in divided or undivided interests, notwithstanding the fact that distributive shares may as a result be composed differently; Page 6 of 8 Pages 8. to insure the property he holds as fiduciary against the risks, and in the amounts he, in his discretion, deems expedient, and to obtain and pay for life, health, liability and other forms of insurance for the beneficiaries of the trust, in his discretion; 9. to employ attorneys, accountants, investment advisors and other professional assistants including deposi- taries, proxies, agents, and appraisers; 10. to enter into transactions with other fiduciaries including executors or trustees of estates and trusts in which my beneficiaries have an interest, and including him as fiduciary for other estates and trusts; 11. to engage in the powers necessary to the effective administration of corporate securities, including, without limiting the generality of this power: a. power to vote in person or by proxy upon all securities held by the fiduciary; b. power to engage in a voting trust or voting agreement with respect to securities; c. power to consent or become a party to, or participate in, mergers, consolidation, sales of assets, recapitalization, reorganizations, dissolutions or other alterations of cor- porate structure, including adjustments in capital structure affecting securities held by the fiduciary, whether or not these adjustments involve payments by or to the fiduciary; and Page 7 of 8 Pages d. power to hold securities in unregistered form or in the name or a nomi~ee. 12. to pay himself reasonable compensation for this services. IN WITNESS WHEREOF, I have at Carlisle, Pennsylvania, this l~ day of ~ARf~ 1985, set my hand and seal to this my LAST WILL AND TESTAMENT consisting of eight (8) typewritten pages. 'J .AqtJ #<-<::!L4~_ (SEAL) GERALD LER~Y SHUE Testator Signed, sealed, published and declared by the Testator, GERALD LEROY SHUE, as and for his LAST WILL AND TESTAMENT, in the presence of us, who at his request, in his presence and in the presence of each other, have hereunto subscribed our names as wit- nesses. ~f ~/) '.., ~/~~hI!~J< . ~ .-: 4: c) ~ \'~ '(1 ii ( ,'":", ........- 1.) ,,-, " ":'00. ,.'"\,........ t V"i _Js:.:...0\ '7-':.~ , '~-" J v\~ Q ~'. y Lv' I II...Li L ,A,ODRESS t: [) i~ [;)( S-7 7 C:~)f.J1- Lt $; if ;0; 12c': SJL 5';' '~.-C.~?J'Ct:..0!< ~L__ Page 8 of 8 Pages Acknowledgment COMMON~EALTH OF PENNSYLVANI~) 55: COU~TY OF CUMBERLAND ) I, GERALD LEROY SHUE, Testator, whose na~e is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and SHUE, the Testator, this 1st (SEAL) acknowledged before me, by GERALD LEROY d a:]o I, M A B.f!i 1,?",85." I ~,;/ 0' f ,/ ~ "~WM~~-; ~f~stator ~,J' /" \ / -(//' __~!.. ./.'j:'2.l._0 L.--{-~~.!_/ "~/.rx..-I__'f---T'-' Not/ary PubTic Affidavit MARY AIINE SMITH, NOTARY PUIILlC CARL!StE BORa. CUMBlRUllQ COUNTY MY CO..MISSIOfl EXPI/US 'OV. 1', 1. Member, P.nnsyhllnil Assoclatioa 01 N"tari,,~ COMMONNEALTH OF PENNSYLVANIA) 55: COUNTY OF CUMBERLAND ) W ,', ,0" :t/.7, I ,- t, ,- d e, ..J.~.:1~?L_.J~,- .....)':t...:...:..~______, ..!..~~5.~~~)~'!:..!.' '71 _2a~ ,/,'-____, an , the witnesses whose names are signed to-rheaTIached-orforegoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testator sign and execute the instrument as his Last Will; that GERALD LEROY SHUE, signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the the Testator signed the will as witnesses; and that to the best of our knowledge the Testator was at that time 13 or more years of age, of sound mind and under no constraint or undue influence. _ .SI'/orn or affi rmed to and su~scri bed to before me by ..hi.:::"!)'2_ L_:l~!-,(I 1:::.'-____, ZJz~.i--f.-,St::-!.,~_~/;.;J-/"'lj, ~_, ______.__________ ___________ , wit n e sse s, t his 1 s ~~a y 0 f !l A R fJi ) 9 8. ,5 . ( I ' ~?;;:; 1-'_~ '.J~~_C~~~---____ WITNESS En L ~ ,ail ' ~ 0 '?ffJ.1 0\!T L'P '\., . <, (".\\...l'T ,~"---"' - ,.s...L.\..l~2l....l.-___ ~L~_ ~_,~~__ WITNESS wTTHESS------------------------ (SEAL) 'Ill, ,/) 1/ l-/ -.-!..J~~f-LL2;c:l.Ud;.,.ll~'=_'ti~___._______ NOT P.. R Y' PUB L I tMAllY AllIIE SMITH. HOTARY PUBliC CAllustE BOliO. CUMBERLAND CO Ulfn --- .~""'~M^" rVDIJ)tll '11IW 1~ .1936 LAW OFFICES IRWIN & McKNIGHT A. Settlement State~~~~----------\ WEST POMFRET PROFESSIONAL BUILDING 60 WEST POMFRET STREET CARLISLE, PENNSYLVANIA 17013-3222 (717) 249-2353 U.S. Department of Housing and Urban Development OMI? No. 2502-026~.xpi~s 9/~Q/20062____ __ S TYPE OF LOAN 1. OFHA 2. DFmHA 3. DConv. Unins. 4. OVA 5. DConv. Ins. -6-:-FILE NUMBER ~-7. LO,AN NUMBER ROBINSONR6.05 _---1868047 B. MORTGAGE INSURANCE CASE NUMBER This TomlTSTurOlsh8010 gIve you a statement of acruar settlement coiI5.Amounts pal 0 an y e se emen agen are sown. Items marked "(p.o.c.)" were paid outside the closing; they are shown here for information purposes and are not included in the totals. WARNING: It is a crime to knowingly make false statements to the United Stales on this or any other similar torm. Penalties upon conviction can include a fine and rmprisonment. For delails see: rble 18 U. S. Code Section 1001 and Section 1010. RONALD M. ROBINSON 1214 GEORGETOWN CIRCLE, CARLISLE, PA 17013 GERALD L. SHUE ESTATE TilleExpress Settlement System Printed 06/16/2005 at 14:Z0 JMR. C. Note: D. NAME OF BORROWER: ADDRESS: E. NAME OF SELLER: _____MJJJRESS: F. NAME OF LENDER: _._ADDRESS: G. PROPERTY ADDRESS: AMERICAN HOME MORTGAGE l 710 HILLSIDE DRIVE, Carlisle, PA 17013 LOT 131 hEAT!:IERLANDS, Carlisle Borough H. SETTLEMENT AGENT: I&M REAL ESTATE SERVICES, LLC, Telephone: 717-249.2353 Fax: 717.249-6354 _-.fLACE OF SETTLEtylENT: West Pomfret ProfessiQ.l!.al B~~O West Pomfret Stree~arlisle. PA 17013 /. SETTLEMENT DATE: 06/16/2005 =__)~~Jt~~AR1QF I!ORROWER'~ TRANSACTION: .JJlL9.BOSS A~OUNI]UE F.ROM_ BORROWER__ _JQL_c:ontr?.f1~aleilli~_ __1.Q.L..E~I~Q..~Il'[QP.~rtY....-..__ _J.9L~lli~ment~harg~s to borrower (line 1400) ._1.Q.L_____________ _.102..________ _ __________Acjil,!stm _JQ.~Q9unty 19~_ I 10B. School Tax I .--~----~--- _JQ~________ 110. ----'---~------_.--~--- 5,736.45 . K. SUMM.ARY OF ~~L~ER~S TRAR~_~ClI0N~--- 400. GROSS AMOUNT DUE TO SELLER 401. Contract sales price 402. Personal Properly 403. ...JQL_. 405. l--=i.3.1JQQQ.OO -~k~-=-~ 131,000.00 ents for items paid bv seller u:! advance 06/16/05 to 12/31/05 -------.. 06/16105 to 06130105 365.72 407. 70.50 40B. 409. 410. 411. 412. 137172.67 420. GROSS AMOUNT DUE TO SELLER I !inn RFnllr.T1nN~N Aurlllt./T n,iCT-" ~I::I I r=o Adjustments for items ~~tU?~_I~in~dva,,!c:~_ Count v taxes 06/16/0510 12/31/05 3~Ul School Tax 06/16/051006/3Ql9~__ _______).0.50 .JJL____ 112. .J..?O. GRpSS AMOU.~T D1J~EROM BOR~OWER _1_QM~Q1I.NTS PAID BY OR ON BEHALF OF BORROWER tl1A~~_,-21 "..~<",."",......;.",.............,.._,",,,,,,.....,_~~I"'-." U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT . L. SETTLEMENT CHARGES ~------------~---------_._-- _l.Q~JOJAL SALES/BROKER'S COMMISSION based onyrice $131,000.00 = __R.i'{i~iQIJ2L~Qf!!lllis;>iofL(line 700) as follows: _JO.1._1____ to 702. $ to )O:L~Q.IllJllj?.$lQ.I1..P.?id at Settlement 8Q~,ITEMS PAYABLE IN CONNECTION WITH LOAN, _JlQJ..,-lQ.~n_QrjglDC3.tion F~e 1.000 %AMERICAN HOME MORTGAGE 8iR..-lQan Di~9JJ!!t % B03. AppraisaLE~ to AMERICAN HOME MORTGAGE 1i0~ Credit Report to AMERICAN HOME MORTGAGE 8Q~~ DU/LP Fee to AMERICAN HOM~f!QBTG~GE _Jl.QPJundinQ ~eview Fee to AMERICAN HOME MORTGAGE ,JLO~.MERS Registration Fee to AMERICAN HOME MORTGAGE ~QLJax Service Fee to AMERICAN HO~~ MORTGA,GE _~Q~ood Hazard Fee to AMERICAN HOME MORT~G;, 810. ----_. _~.1L,_____ gOO. ITEMS REQUIRED ,BY LENDER TO BE PAID IN ADVANCE _(tQLlnterest From 06/16/2005 to 07/01/2005 @$ Iday _9.PL~.Q~Qe Insurance Premium for to JLQ.~c. Hazard Insurance Premium for to ~.Q1, ,.JQ5,_________, ,.1Q.oO.ItESERVES DEPOSITED WITH LENDER FOR JOO1Jjaza ,.JQQ2. Mortg 1QQ:LCity P _1.9.P,'lC ou n y 1 aOi. SchQ -1QQii.o.. Flood ,JQ.Q_9,,_Aggfg .J.tOO. TITL 1~110j, Settle .-JJ..Ol~~ 1103. Title e J.J.Q'Llm~ insurance. birl.der --11.05. Docum~,Il\,PreQaration I 1H\a ,,~,~_.r_h File Number: ROBINSONR6-05 PAGE 2 Titl~l;,xpress !:1Bttlem~t System Prinled 06/16/2005 at 14:~O JMR PAID FROM PAID FROM BORROWER'S SELLER'S FUNDS AT FUNDS AT SETTLEMENT SETTLEMENT - LR 1L048.00 - LR 400.00 ---- LR 8.25 LR 21.70 ,-, LR 430.00. ---- LR 3.95 ~-_. LR 74.00 ~-, ---~- LR 15.00 ._--~. -'---'-- ~--- ~ 256:1f~ 15 Days rd Insurance 5 mo. (Q2 $ 32.67 /mo - LR 163.35 ~ Insurance mo. (Q2 L ------ Imo ,-- IQfl~[jyla~_ mo.~ Imo , , t Property Tax 6 mo...@.L 55.90 Imo LR 335.40 Q[J~- 13 mo.(Q2$ 142.96 Imo , LR 1.858.48 ,J 3 mo. @J... 65.42 /mo LR 196.26 I gQ\e An..9ly-s,is Adiuslment 10 AMERICAN HOME MORTGAGE LR -540.98 0.00 E CHARGES ment or closinQ fee _I act or title search - xamination --, ~. ~ --:;---:.-,-:;-:;-.:_.,;;;:c-:,C;;;Ck:;-":;';;;;'-~:~"''';;;'''-~;.''''~~_'_''__~=_~'' fvlm ME1\ilBERS 1st FEDERAL CREDIT UNION SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Interest Earned from 1/1/05 to Date of Death Name of Joint Owner CHECKING ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Interest Earned from 1/1/05 to Date of Death Name of Joint Owner Estate of: GERALD L. SHUE Date of Death: 04/09/2005 Social Security Number: 307-34-5509 rr;l r;:~ /,-A;;:; j J..;f!;' j \ 1. 1 1...'J \::,":, ,,,. I ~>'-' !J ""''' ;'"\ -;""\ i" ,...,.~<.,~. '"""''''''., 'J - \ \.' I ~/-.~-;). ; ''''. I i \ .,/ I"~ !:J;, .. 'j <,! 11,1 ~> ~e..:.. '" i I .r;H" .'" "'., \.Jj ~i ;'-'/ ; 52973 -00 03/01/1978 $13,416.70 $2.60 $13,419.30 $12.05 None 52973 -11 12/31/1979 $1,122.74 $.00 $1,122.74 $.00 None j~B~RS 1ST>E~~RAL CREDIT UNION L / ;'/t; b' 1 // /,,!~ ;1 /. </L ~ if [Lv fZ- Denise A. Wolfe li Insurance Services Supervisor May 5, 2005 5()()OLouiseDrivl'. PO.Box40. Mech~ll1icsburg,Petlnsylvania17055. 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June. 21, 2005 Pe..Mona1 g PltOneA1J-LOVUU SeJ1.v,(c.eA UJ.J e 06 Fac.J.LLt.LeA ~ Equ.LpmeVLt U.6e. 06 AtLtomatoLve Equ.<.pme.nt $ 1905 00 It em}, 06 /vi eJtc.h. a.rr.W e : Ca.6f2.e.:t VauLt 7425 00 695 00 2120 00 ecu, h Ad.vanc-eA: Flowe.AO g, P A S~ at e. Tax. YoJt~ Ne~papeJt Co. Ch~ge. M.:t. Ro.6e. Ce..me..:te.Jty Ch~ge. Va.uLt .6 e.Jt vic- e.. e.hCUlg e. b y c. em e.t V'u.f Re.v. ThomiUl '0. Bel.w ( 20) C e.Jr.;t.{. n J.. e.d C (/ poL e.6 732 50 91 80 995 00 80 00 150 00 120 00 1569 30 Totaf. 1905 00 2120 00 7569 30 5594 30