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Home My WebLink About08-01-05 JAN L. BROWN, ESQUIRE' JACQUELINE A. KELLY, ESQUIRE 'ADMITTED IN PA AND DISTRICT OF COlUMBIA ]AN 1. BROWN & ASSOCIATES ATTORNEYS AND COUNSELORS AT LAW OLOE ENGLISH GAP 845 SIR THOMAS COURT SUITE 12 HARRISBURG, PA 17109 EMAIL: jlbassoc@verizon.net TELEPHONE (717) 541-5550 FACSIMILE (717) 541-9223 BRENDA F. KEPHART, LEGAL ASSISTANT PAULA K. WHITE, LEGAl ASSISTANT JUDITH A. EBERSOLE, ADMINISTRATIVE ASSISTANT July 28, 2005 Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, P A 17013 r~ f~ C~ en .' :,~ r'.- G,") Re: !-0 Estate of Clarence H. Watson File No. 2005-00312 C~.) a Gentlemen or Ladies: Enclosed please find the following items for filing with the Register of Wills: 1. Inventory. 2. An original and one copy of the Inheritance Tax Return. 3. Estate Check 118 payable to the Register afWills in the amount of$30 to cover the filing fee for the Inventory and Inheritance Tax Return. Please time stamp and return our file copies of the Inheritance Tax Return and Inventory. If you have any questions, feel free to contact this office. Sincerely, I '----f / \f}UIld:L tt-/{phcUL Brenda F. Kephart Legal Assistant bfk Enclosure . -n i'h ,I f_'") ';'1 .~I {.'-:) :-;) C-) j r-~ :"1 " 1 ~.-:--~J f '. 4 BEFORE THE REGISTER OF WILLS, CUMBERLAND COUNTY, PENNSYLVANIA INVENTORY Estate of Watson Clarence H , Deceased No. 2005 00312 Date of Death 3/28/2005 Social Security No. 210267285 also known as Clarence H Watson Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We verify that the statements made in this inventory are true and correct. I/We understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Personal Representative: Name of Attomey: Jan L Brown Diane L Kyle I.D. No.: 67993 Address: 845 Sir Thomas Court Suite 12 HarrisburQ Telephone: 717-541-5550 Dated 7/25/05 PA 17109 Description Prudential Financiallnc (PRU); 36 shares @ $56.92/sh Value C) o :j"~ _..'~~ ~-'" .'02,049.12J W"l'T: i- Orrstown Bank 412732 G:::i I '. ) {..--\ 30f;6a~; :.~: ','.' '-, "J; ::2 1997 Buick LeSabre Limited Sedan 4D , .1 ~ ,00oM~:; c.) C:) Central PA Teamsters Pension Fund; final payment 281.00 MetLife; Clarence Watson, benef of Jean Watson (spouse) policy 5,000.00 Claremont Nursing and Rehabilitation Center Benef of Jean Watson (spouse) Guest Fund Account 337.64 Total (Attach Additional Sheets if necessary) 140,082.72 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. RW-4 v-- 1 " Continuation of Inventory Watson Clarence H 2005 00312 PaQe 1 Description of Inventory Description Prudential Financial; premium refund Value 20.24 Sprint; customer refund 4.86 Comcast; customer refund 32.79 Union Fidelity Life Insurance Co; premium refund 30.76 United States Treasury; 2004 Form 1040 refund 300.00 County/School Tax reimbursements 172.63 Homeowners' Association reimbursement 2.00 10 Mel-Ron Court, Middlesex Township, Cumberland County 121,900.00 Veterans of Foreign Wars; death benefit; Estate beneficiary 300.00 Prudential Financial; life insurance; Estate beneficiary 5,000.00 Fraternal Order of Eagles; death benefit; Estate beneficiary 500.00 Union Fidelity Life Insurance Co; death benefit; Estate beneficiary 2,500.00 South Mountain American Legion Post 674; death benefit; Estate benef 350.00 Subtotal $ 131,113.28 140,082.72 Grand Total $ REV-1500 EX... (6-00) . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 21 -05 03 1 2 COUNTY"'OOO'E"" --vEA~ - - N'U"MBER- - I- Z W o W o w o DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Watson Clarence H DATE DF DEATH (MM-DD-Year) SOCIAL SECURITY NUMBER DATE OF BIRTH (MM-DD-Year) 2 1 0 - 2 6 - 7 2 8 5 THIS RETURN MUST BE FILED IN DUPLlCA.TE WITH THE REGISTER OF WILLS 03/28/2005 03/28/2005 (IF AFPLlCABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER ~ 1<:-<11 (,)0::1<: Ul Q.(,) zOO os:a; Q. 4: 00 1. Original Return o 4. Limited Estate 00 6. Dece<lenlDied Testate IAllachcopyofWiU) o 9. Litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (date of death aller 12-12-82) o 7. Decedent Maintained a Living Trust (Attach oopy ofTrusQ o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) o 3. Remainder Return (date ofd<ath plior 10 12-1:l-82) o 5. Federal Estate Tax Return Required _ 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach SCl\O) .... z Ul Q Z o Q. <II Ul Ill: 0:: o (,) THISSECTIONt.1UST BECOt.1Pl..ETEO.ALl..CORRESPONDI:NCE AJIIDCONFIOENTIAL TAX lNFORt.1A TION SHOUL08EDlRECTED TO: NAME COMPLETE MAILING ADDRESS Jan L Brown FIRM NAME (If Applicable) Jan L Brown & Associates 845 Sir Thomas Court Suite 12 TELEPHONE NUMBER 717-541-5550 Harrisbur (1) (2) (3j (4) (5) 1. Real Estate (Schedule Al 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule Dj 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointiy Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election 10 lax has not been made (Schedule J) z o i= :5 ::J I- 0: < o UJ ~ ,- , ": ~IJ ....,.., ,-"-, ?,{i :'0 7,483.60 CII,) = (6) (7) (8) 131,432.72 (9) 23,283.30 55,328.81 (10) (11) (12) (13) 78,612.11 52,820.61 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (14) 52,820.61 z o i= ~ ::J Q" :E o () >< ~ 15. Amount of line 14 taxable at the spousal tax rale, orlranslers under See. 9116 (a)(1.2) 16. Amount of Line 14 taxable allineal rate 17. Amount ofLine 14 taxable at sibling rate lB. Amount of Line 14 taxable at collateral rale 19. Tax Due 0.00 X _(15) 52,820.61 X _045 (16) 0.00 X .12 (17) 0.00 X .15 (18) (19) 0.00 2,376.93 0.00 0.00 2,376.93 20. [gI CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < o I C ecedents omplete Address: STREET ADDRESS 10 Mel-Ron Court Middlesex Township 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 8. Prior Payments C. Discount (1) 2,376.93 2.400.00 118.85 Total Credits (A + B + C) (2) 2,518.85 3. InteresVPenalty if applicable D. Interest E. Penalty T otallnteresVPenalty ( 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. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 141.92 0.00 0.00 PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ........................................................................... 0 00 b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 00 c. retain a reversionary interest; or ...................................................................................................... 0 00 d. receive the promise for life of either payments, benefits or care? ............................................................. 0 00 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?............................................................................................... 0 IZl 3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ................. 0 IZl 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... 0 IZl IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this retum, including accompanying schedules and statements, and to the besl of my knowledge and belief, it is true, correct and complete. Declaration of prepare< other than the pemona! representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ~y:)/~-~ ADDRESS 806 Fairview ad Carli SIGNATURE OF PREP '-t / DATE tlQ7Y/-OG' ADDRESS PA 84 Sl(~Thomas Court Suite 12 HarrisburQ PA 17109 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. 99116 (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 USf t\ '\ ("\ t[) " The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclos \ '-J \4 \ V 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-<>ne years of age or younger at or a stepparent of the child is 0% [72 P.S. 99116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, '.5. 99116(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. 99 I '''1''11 ...)JJ. f'\ o.".,,'~ ,. Uw,," 'wU, u, 'u~, vw..on 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. 16 (a) (1.1) (ii)]. pplicable even if 3.~ I adoptive parent, REV-1502 EX + (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Watson Clarence H 21 05 0312 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 wilUng buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real orooertv which is jolntly-owned with right of survivorshio must be disclosed on Schedule F. SCHEDULE A REAL ESTATE ITEM NUMBER 1. DESCRIPTION 10 Mel-Ron Court, Middlesex Township, Cumberland County Settlement Statement dated 6/30/2005 is attached. VALUE AT DATE OF DEATH 121,900.00 TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 121 900.00 REV-1503 EX + (6-98) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Watson Clarence H FILE NUMBER 21 05 All property jointly-owned with right of survivorship must be disclosed on Schedule F. 0312 ITEM NUMBER 1. DESCRIPTION Prudential Financiallnc (PRU); 36 shares @ $56.92/sh VALUE AT DATE OF DEATH 2,049.12 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 2049.12 ------ REV-150B EX + (6-9B) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Watson Clarence H SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21 05 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. 0312 ITEM NUMBER 1. 2 3 4 5 6 7 8 9 10 11 12 DESCRIPTION VALUE AT DATE OF DEATH 301.68 Orrstown Bank 412732 1997 Buick LeSabre Limited Sedan 4D Vehicle is in poor running condition and has cosmetic defects. 1,000.00 Central PA Teamsters Pension Fund; final payment 281.00 MetLife; Clarence Watson, benef of Jean Watson (spouse) policy 5,000.00 Claremont Nursing and Rehabilitation Center Benef of Jean Watson (spouse) Guest Fund Account 337.64 Prudential Financial; premium refund 20.24 Sprint; customer refund 4.86 Com cast; customer refund 32.79 Union Fidelity Life Insurance Co; premium refund 30.76 United States Treasury; 2004 Form 1040 refund 300.00 County/School Tax reimbursements 172.63 Homeowners' Association reimbursement 2.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 7 483.60 ------ REV-1511 EX + (12-99) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Watson Clarence H SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Debts of decedent must be reported on Schedule I. FILE NUMBER 21 05 0312 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Hoffman-Roth Funeral Home 6,192.85 B. 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. Attorney Fees Jan L Brown & Associates 6,572.00 3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Register of Wills, Cumberland County 373.00 5. Accountanfs Fees Parks & Company 250.00 6. Tax Return Prepare(s Fees Charles Goodyear 50.00 7. The Sentinel; legal advertising 144.29 8 Cumberland Law Journal; legal advertising 75.00 9 Recorder of Deeds; photocopy deed 2.00 10 Executrix out-of-pocket costs (postage, travel, etc) 111.07 11 Harmon Hall Court Condominium; monthly maint fee; 3 @ $60 180.00 12 PPL Electric Utilities 80.05 13 Real estate settlement charges 9,253.04 TOTAL (Also enter on line 9, Recapitulation) $ 23283.30 (If more space is needed, Insert additional sheets of the same size) REV-1512 EX + (6-98) '* SCHEDULE' DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATEOF Watson Clarence H FILE NUMBER 21 05 0312 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1. Constitutional Life; supp health insurance premium VALUE AT DATE OF DEATH 191.00 2 MTMA; water & sewer 86.62 3 PPL Electric Utilities 105.20 4 Sprint 13.01 5 West Shore EMS - BLS 144.03 6 Orrstown Bank Mortgage Loan 160030740; payments April-May 2005 609.38 7 Orrstown Bank Mortgage Loan 160030740;morlgage paYOff; see settlement statement 54,179.57 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 55328.81 ~'",m"* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER ... :Iarence H 21 O'i 0312 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE 1. TAXABLE DISTRIBUTIONS Unclude outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)J 1. Denise Meyer (formerly Denise She/lhouse), stepdaughter Lineal 15,605.15 23201 Richfield Rd, Corning, CA 96021 Specific bequest of $9,600 and 25% residue 2 Doreen R Peiper, stepdaughter Lineal 15,605.15 161 Clemson Dr, Carlisle, PA 17013 Specific bequest of $9,600 and 25% residue 3 Diane L Kyle, stepdaughter Lineal 15,605.16 806 Fairview Rd, Carlisle, PA 17013 Specific bequest of $9,600 and 25% residue 4 Darwin Bowers, stepson Lineal 6,005.15 4 Barry Circle, Shippensburg, PA 17257 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTiONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B, CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART n - 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) A Settlement Statement U.S. Department of Housing and Urban DeyeJopmenl " Tuno n" n"" OMB No 2502-0265 REV. HUO-l (3/B61 I. DFHA 2 OFmllA J Deuov Umns I 6 File Number J 7 Loan Number I 8. Mortgage Insurance Case Number luJyA 5 DConv 1n.. S I 00-280 ThiS lonn IS lurrll!;hed to 9'Y'9 you II statement 01 actual setllemenl co~l$ AmOUflls paid 10 and by lt1e !oelUemenl agent II", shown C. Note; trems marh.d .,(POC.l" were paid oulsioe the closing: they are sh~ here for ,nformatlon fXJ~~~es lln.d are nOllllcluded, In the IOlals I TiUe8,press Selllemenl SYS\l:lm WARNING It '5 it \;film! \0 \r,~f'>9\'JI make f~~ statemenls \O'~T~t~nli~?J ~kal~~~ ill'S or 8fl oIher $Imllar f~r~-T~enallles upon P,in,pn I "R" K,r. D. NAME OF BORROWER: Ann Elizabeth Basnight ADDRE<S: E. NAME OF SELLER: The Clarence Watson Estate f-. AlJlJRESS: - F. NAME. OF LFNDER: Sovereign Bank ^DDRESS: 1130 Berksf1ire Blvd. Wvomissing PA 19610 G. rROf'ERIY ADDRESS: 10 Mel.Ron Court, Carlisle, PA 17013 Middlesex TownshlD .- H. SETTLEMENT AGENT: PA Real Estate Settlement Services, LLC ~E OF SETTLEMENT: 95 Alexander Soring Road Sle. Carlisle PA 17013 .- I 'ETfLEMENT DATE. 06/30/2005 J SUMMARY OF BORROWER'S TRANSACTION. K . OF <:I=III=Q'<:; TRANSACTION. -- ...100. GROSS AMOIINT DUE FROM .00 r,RO~~ AMOUNT DUF TO SE'LLFR. m, price ~2~ 900.00 401 Contrl'lr.1 sl'Ill'!": orice 121 900._Q.Q. 1n:1 P"rsonal Prooertv '0' In, ' uoo, 5 225.63 .01 10. - .0. - ,n, ,0' Arljuslments for item!'> oaid bv selL~r .A.. Adiustment!'> for itp.ms oaid by seller in adv;mce ,~ City/lown laxes .- .n" r;o,,"n ,n, c, "",,, 06/30/05'012131/05 ~69.86 ,n7 06/30/05," 12/31/05 169.86 ,nn Schoollaxes 06/30/05'006/30/05 2.77 '"'8. 06/30/05'n 06/30/05 2.77. ,nn .00 "n D. ,..~ of Homp.ownp.r<; Assnr. .. 2.00 ..0 ,A,,~ 2.00 f-w.- - .., '" d1, - 1?0 GROSS AMOIJNT DIIE FROM 6 127 300.26 .,0 r,RO~~ A III' TO~I'III'R. 122,074 .63 "00 A''''''NTS PA'D RY OR ON RFHAI I' SOO IN AMOUNT DUE TO <:1'1 , FR ?n1 fl..no..;t nr earnP.'l.! mnnf'V 1 000.00 '0' '0'. D. 9? 520.00 "", ler (line 14001 9 25~~ ".In".! c,; "n M1 F""'nn In.n, "la" , ",hipc' 'n '0' "'n4 P::IvnH nf First Mortmloe I n:ln 54 179.57 f---. Orrstown Bank 'no M' ~ . """ "", . . ,ru< ,nn ~. "". .A' ?1n qlvJlown I:1XP-!:. 510. "" 51' ~St;hOOlt::lllP.S 512 RC'..horu lal'.e!1. ?I, '" 0,. <1, ~5. '" -- >1R "" ~. <17 71> <1. ?,q <1" no TOTAl PAin Rt/FOR BORROWER 98 520.00 <70 TOTO' " ''''T n,,~ ~~, , ~I> 6~ 432 61 10n r.A<:H A I <:FTTI 'OR "on rA<:'" AT ~~TTI lOR '0 ~l- Gross amnunldtlP. from bOHn,_.Ilin.. 1?n\ ~27 300.26 on1 ", 122 07.L.g .'VI? I...... ..rnn,,'1'" paid bvlfnr borrower tUne :220l 98 520.00 .n, ,5>01 63 432.61 '"' rA<:H I'ROM RORROWER 28 780.26 ""' rA<:'i TO <:0" ~I> 58 642,02 S\.lBSJlTUTE FOR'" 1099 SELLER STATEMENT: The ;nfor-mlll;Qn (;Ol11~jned ~erejn IS impol"lanllilll inlormallOn ane! i.s beinglurnished 10 Ihlllnlemal RlWenue Service. If you are required 10 "'I!! it relUIn, ~n~'~Y~~v~r:~~I:;:I~~hl~e5G~~~'~Pr~~m~~lr~~li~hlli Ilem IS reQUired 10 be repOfled ilnd the IRS determines Ihalll h;;JS '101 been reported. The ConIrBd Sales Price des(".tiDe(l or1 ~~:::. r;:~e:y ~el:~:~r~~~II: ~~~::.e~i.:~ (i~e:~~lI ~~l~~: umJ.r penallles of pt!~~~ ~~1I~IJ,"e"~~~~~~~'=t:n~~~~~~~~~~4~:er ~:;J~~r~~~~~~fjCllhDn T'N _"_,_-__"_ SEllI:R(SISIGNATURE/S)" SE.LLER(SI NEW MAILING ADDRf-SS: ~ SEllER(S) PHONE NUMBERS (HI__ (W) U.S. VEPARTMEN r OF /lOUSING AND URBAN DEVELOPMENT Fik Number: SIOo-280 PAGE 2 SI=TTII=MI=NT .~TATI=MI=NT REV. H!lP~($.L_ I L. S"TT' """"'T i'HAR"'E~ m" F'TAL ~A' ~/6BQ~O:R'SCQMM1S.SJmL~d on o,ice $121. 900.00 @ 6,000 -_'7_J1LQQ 701 <I'. 3 682.00 In Wolfe Iii Shearer Real tors 7Q2- <t 3 632.00 In Re/Max Sterlincr ,,, rnmmi " ~o'''omo., A"" IT"M< PAYABL" IN CONNEr.TION WITH' OAN '0' '.L___ B07 '0 ,,- Fln:l Annlais,alEetL Rnd c."..", Re~rt ~OfkC.ommilm"nl Fpp An" "n"nMe A,n'MID"', Fee . . am P,n,o..,~ Fee RO' ROO R.h.,o '10 A" q"O. 'T IRFD BY L"Nn"R TO RF PA,n '''' AnVA"'''F 0'" ,.,"'", Fmm Q.U..30/20Q5..Jo 071..01L2.QQ..' "1$ OO? "n"n.no r 1m '0' Hm.rt 'n<o".n,. p..m..,m In, 'OA '", ~lLR~_,~RV~S DEf'QSITFD WITH' FNnFR "OR ,"01 ""..rt In."..n,o m. '" < 10", "n"n.ne 'o.",.n,e mn '" < -. '00' .T.. 'O"A rn"n'''' '"0' <.hM' ,,... 1 nflQ ....nn.<>""'<> ....0"1' i 11QQ.I!I~rH'R"'E~ "nl e'''1 .o. I.....' 11 O? Ahd"cloI"Ue~.aroL 1,0. I UQ-L_TIUv.'n . hj ,rl.. 1105. n" '''',,' Or"'''''''''''i' n 1100 "'.,,,,, Fee. 110' _ ".m. Nn ' 110Cl I <>nr-l"r'.sPolicy _ 97 520.00 - 11'0 nwne,'.Pnll,v 121 900.00 - 96B.15 111' ~nrI"'" C_'~(l(l Cn'" 0111 Ownpln Stewart Title Guarant~,IPA RE 55 111? 111. r:ln..inn.<;'VI'llr Stewart T;t-l-~-G~~~ant",/PA RE SS '""" """"ONM"NT RE"ORnJN(; ANn TRANSFFR I "01 Reemn'.. Fee. neert< 38.50 10.50 Re'e...' 1?0? r.."lrn"n'v,..ld.mno neert<l 219.00.".-.< 1?0, n..rt<l 2J9,0()_.,Mortgan.' I>OA "", ---.. 1 ,on. .nnITlo",., <FTT' ""FNT CHAR"'F~ --.13.llt _2Q05:.Co "T-o. Pennv Davis Tax Collector 1~'~" 'hh'U~il Salzmann Hunhes P.C. ~ke:.f....w Salzmann Hu"'hes P. C. 1.1JJ4 Middlesex Townshi.... Muni~al Aut~.ori.ty ~. finaLW In Middlesex Townshin Municinal Authoritv _(im;MI~~abQYe.,ite:rru;.NQ~ 110R 1dnn TOTA' <qTI "MFNT , ." no,on.ooo. ., ...< vOr PAID FROM BORROWER'S FUNDS AT SETTLEMENT PAID FROM SELLER'S FUNDS AT SFTTLEMENT -~ 7 314.00 Ir American Horne Bank ,... American Home Bank 10 Sovereinn Bank .~ American Home Bank In American Home Bank NA NA 275.00 20.00 500.00 1 462.80 345.00 LR NA NA In Aarrow Mortaaae GrOUD Sl 340.90 poe bv Lender ------- 15.5761 Idav 1 Davs __1--___ 1S '-~.~.l-- In --~----~-~.. I Imn ,. mQ.~@ S _~_~ mn '" < mn "" {mo Imn 'mn -- 0.00 0.00 In Salzlll.~n.J}._Ii'Y:gtt_~~ P. C. In Jan L. Brown & Associates __m_l<L..O~ ________ 260.00 , In Stewart Title Guarantu/PA RE S8 968.75 _u_~___ 200.00 35.00 109.00 1 219.00 -- -- 1 219.00 20.50 20.00 25.00 368.66 20.50 10.88 , 0.."..' ." OM O. .. v, 5 225.63 9 253.04 I have careful''t reviewed the HUO-1 Selllement Slalemenl and 10 the best of my knowledge and belief. it is a true and accurate r.lalemenl of 0111 fB!;;uipl5 i1nd disbursements miide on my account or by me ,n Ih15 lranslIcilon. 1 lurlher cen.ly lhall have recetved II cop)' of Ihe HUO-l Settlement Stalement HUO CERTIFICATION OF BUYER AND SELLER /// l.'.~j:~?_, ~: '.l, (. ~.:~' /OC~_~~.-,,--r Ann EhzalH!lh Basnighl ?~ ~,~-;te - 5~~K WARNING.IT1S A CRIME TO KNO INGLY MAKE FALSE STATEMENTS TOTHE UNITED STATES ON TIllS OR ANY SIMILAR fORM PENAl liES UPON CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT, FOR DETAILS SEE TITLE 18 U,S. CODE SECTION 1001 AND SECTION 1010 The HUD- t Seltlement Statement which I have prepaled is a true and accurate account 01 this transaction IMvecauseaorwlllcausetnefunostobedlsbtJrsedinaccordanceWlththi:;;stdtel1ltlnt By VATE LAST WILL AND TEST AMENT OF CLARENCE H. WATSON I, CLARENCE H. WATSON, now domiciled in Cumberland County, Pennsylvania, declare this to be my Last Will. I revoke all other Wills and Codicils that I may have previously made. Article I My just debts and expenses of my last illness, funeral, and administration of my estate shall be paid by my Executor from the principal of my residuary estate as soon as practicable after my death. Article II All inheritance, estate, and succession taxes (including interest and penalties thereon, but not including any generation skipping tax) payable by reason of my death shall be paid out of and be charged generally against the principal of my residuary estate without reimbursement from any person. This provision is not a waiver of any right which my Executor has to claim reimbursement for any such taxes which become payable as the result of any property over which I have the power of appointment. Article III I give, devise and bequeath in accordance with any memorandum which I have either handwritten or signed, located with my Will or with my valuable papers and found within 30 days of the probate of my Will. Gifts may only be to persons who survive me or to organizations which exist at my death, and ifthere is a conflict, the memorandum having the latest date shall govern. Article IV I give and bequeath NINE THOUSAND SIX HUNDRED DOLLARS ($9,600) to each of my stepdaughters, DENISE SHELLHODSE, of Vinemont, Alabama, DOREEN PEIPER, of Cumberland County, Pennsylvania and DIANE KYLE, of Cumberland County, Pennsylvania. Article V All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, I give, devise and bequeath IN EQUAL SHARES to: DENISE SHELLHOUSE, of Vine mont, Alabama DOREEN PEIPER, of Cumberland County, Pennsylvania DIANE KYLE, of Cumberland County, Pennsylvania DARWIN BOWERS, of Cumberland County, Pennsylvania If any of my beneficiaries predeceases me or fail to survive me by thirty (30) days, I give, devise and bequeath his or her share to his or her issue who survive me, per stirpes, or ifhe or she have no issue, the share(s) are to be added equally to the other shares. Article VI Except as otherwise provided in this will, I have intentionally failed to provide for any other persons or relatives, whether claiming to be an heir and/or relative of mine or not. Insofar as I have failed to provide in this will for any of my relatives, and/or issue now living or later born or adopted, 2 such failure is intentional and not occasioned by accident or mistake. Specifically CLARENCE W. WATSON is not to inherit under this will. Article VII If a beneficiary under this Will has not attained the age of twenty-five (25) years, the share of the beneficiary shall be placed in a separate trust, for the benefit of that beneficiary according to the terms in Article VITI. Article VIII In the event that a Trust is created by or as a result of any part of this Will, the terms and conditions of the Trust shall be as follows: A. To expend and apply so much of the net income and so much of the principal of the Trust as the Trustee shall consider advisable for the support, health, care and education of the child until the child attains the age of twenty-two (22) years. B. Upon attaining the age of twenty-five (25), the remaining principal and accumulated income of the child's share shall be distributed outright to the child. C. No beneficiary or remainderman of this Trust shall have any right to alienate, encumber, or hypothecate his or her interest in the principal or income of the Trust in any manner, nor shall any interest be subject to claims of his or her creditors or liable to attachment, execution, or other processes of law. 3 Article IX In order to carry out the purposes of the Trust established by this Will, the Trustee, in addition to all other powers granted by this Will or by law, shall have the following powers over the Trust estate, subject to any limitations specified elsewhere in this Will: (a) to retain in the form received and to sell either at public or private sale, any real estate or personal property except that which I specifically bequeath herein, (b) to manage real estate, (c) to invest and reinvest in all forms of property without being confmed to legal investments, and without regard to the principal of diversification, (d) to exercise any option or right arising from the ownership of investments, (e) to compromise claims without court approval and without consent of any beneficiary, (f) to file any federal income tax return for any year for which I have not filed such return prior to my death, (g) to make distributions in cash or in kind, or in both, and to determine the value of any such property, (h) to employ any attorney, investment advisor, or other agent deemed necessary by my Executor; to pay from my estate reasonable compensation for all their services, (i) to conduct along with or with others, any business in which I am engaged in or have an interest in at the time of my death, and (j) to receive reasonable compensation in accordance with their standard schedule offees in effect while their services are performed. 4 Article X I hereby appoint my stepdaughter, DIANE KYLE as Trustee of any Trust(s) created in this Will. In the event of the renunciation, death, or inability to act, for any reason whatsoever of . DIANE KYLE, I nominate, constitute and appoint my stepdaughter, DOREEN PEIPER, successor Trustee of any Trust(s) created in this Will. Article XI I nominate, constitute, and appoint my stepdaughters, DOREEN PEIPER and DIANE KYLE, as Co-Executrices of my Last Will and Testament. I direct that my Co-Executrices be permitted to serve without bond and in addition to those powers granted by law, I grant them power to distribute in cash or in kind in like or in unlike shares and to file any qualified disclaimer I could have filed ifliving. My Co-Executrices shall receive reasonable compensation for services rendered to my estate. Article XII In addition to the powers conferred by law, I authorize my Co-Executrices, in their absolute discretion: (a) to retain in the form received and to sell either at public or private sale, any real estate or personal property except that which I specifically bequeath herein, (b) to manage real estate, (c) to invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principal of diversification, (d) to exercise any option or right arising from the ownership of investments, 5 (e) to compromise claims without court approval and without consent of any beneficiary, (f) to file any federal income tax return for any year for which I have not filed such return prior to my death, (g) to make distributions in cash or in kind, or in both, and to determine the value of any such property, (h) to employ any attorney, investment advisor, or other agent deemed necessary by my Executor; and to pay from my estate reasonable compensation for all their services, (i) to conduct alone or with others, any business in which I am engaged in, or have an interest in at time of my death, and (j) to receive reasonable compensation in accordance with their standard schedule of fees in effect while their services are performed. IN WITNESS WHEREOF, I, CLARENCE H. WATSON, hereby set my hand to this my Last Will and Testament, on this 19 day Ofrr cf!~tI. W~vJ CLARENCE H. WATSON , 1999, at Harrisburg, Pennsylvania. In our presence, the above-named CLARENCE H. WATSON signed this and declared this to be his Last Will and now at his request, in his presence, and in the presence of each other, we sign as witnesses. o Name ~/// ~)(/4~~_ 2?u.1i:u) U} &uAf? 11/L0 ) I / ?(f/ / ..' ,J ~) /?"-c Address _I 1/ i /l{)~0 / j c;u~~ .CivVth:1i'J /;( /7/(:) / (~77I./I:/ 7fJ,A(~rLj: , fJ;7 ;7/t]'7 I / ~J {. 1h ,:!/l /,I}I 0711/)'-2. 6 I, CLARENCE H. WATSON, Testator, who signed the foregoing instrument, having been duly qualified according to law, acknowledge that I signed and executed this instrument as my Will, and that I signed it willingly as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged before me by CLARENCE H. WATSON, the Testator, this 19 d day of dtL'M,u'(J , 199 '1. ~~ N \~Ublic ~ j-f, Wc.-krvJ CLARENCE H. WATSON Notarial Saal Jan L. Brown. Notary Public Lower Paxton Twp., Dauphin County My Commission Expires Mar. 20, 2000 We, the undersigned witnesses who signed the foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the Testator sign and execute this instrument as his Will; that he signed and executed it willingly as his free and voluntary act for the purposes therein expressed; that each of us in his sight and hearing signed the Will as witnesses, and that to the best of our knowledge, that he was at that time eighteen (18) years or more of age, of sound mind, and under no constraint or undue influence. Sworn to or affirmed and subscribed to before me . ~. ;/) !~/ ~ tf~~ Witness by KtcflA12{) Il AAII/45k'(;; and iP/57/1// /Ai /111{'-I:(411/4/11 witnesses, this /9 ./. day of , (VJ1{A4<<- , 199-1. ~J~/-i1{ ) Witness U J. &MJ[CU1fl.JU I Notarial Seal Jan L. Brown. Notary Pubiic Lower Paxton Twp., Dauphin County My Commission Expires Mar. 20, 2000 7