The URL can be used to link to this page

Home My WebLink About09-23-05 . rt( -.~.r' REV-1500 EX + (6-00) . W I- ",~Ul 01>:'" w"'o ",00 ol>:...J ...m ... c( OFFICIAL USE ONLY REV.1500 INHERITANCE TAX RETURN RESIDENT DECEDENT I- Z W C W () W C COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 I DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) , Holtry, Dorothy R. , DATE OF DEATH (MM-DD-YEAR)I ' DATE OF BIRTH (MM-DD-YEAR) 04-17-2005 09-25-1921 (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) FILE NUMBER II 0396 05 COUNTY CODE YEAR I SOCIAL SECURITY NUMBER I 174-20-0533 -_r:HIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS ---- SOCIAL SECURITY NUMBER , NUMBER 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach copy of Trust) o 10. (date of death between D 3. Remainder Return (date of death prior to 12-13-82) [~ 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit 1Il0xes I- Z W C Z o ... Ul w I>: I>: o o . NAME _ Jerry A. Weigle, Esquire FIRM NAME (If applicable) Weigle & Associates, P.C. TELEPHONE NUMBER (717)5}2-7388 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship Ii] 1. Original Return 4. Limited Estate l-:!J 6. Decedent Died Testate (Attach copy of Will) IJ 9. Litigation Proceeds Received D 2. Supplemental Return D 11. Election to tax under Sec. 911 ~(A) (Attach Sch 0) COMPLETE MAILING ADDRESS z o i= <( ...J ~ l- ii: <( () w a::: 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) [J Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) Separate Billing Requested 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 1126 East King Street . Shippensburg, PA 17257 (1 ) 65,000.00 OFFICIAL USE ONLY (2) None .) ')1 ., n (3) None '1 -.----..- i I (4) None u _._-~----- ".1 (5) 4,613.30 ,) (6) None ) (7) , i None ,.1 (8) ("'.:/ 9,613.30 (9) 14,985.50 -----+---..- -~-_..,'-_..._- (10) 30,487.19 (11 ) 45,472.69 24,140.61 0.00 24,140.61 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) (12) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, 0.00 x .00 (15) 0.00 or transfers under Sec. 9116(a)(1.2) -------+---~..__._- z 0 .045 (16) 0.00 i= 16.Amount of Line 14 taxable at lineal rate 0.00 x ~ ._-~-----+----~ ~ Q. 17.Amount of Line 14 taxable at sibling rate 0.00 x .12 (17) 0.00 ::E I 0 () 18. Amount of Line 14 taxable at collateral rate 24,140.61 x .15 (18) 3,621.09 x ~ : 19. Tax Due (19) 3,621.09 ~_._----t 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. >> BE SURE TO ANSWER ALL QUESTlONS'ON REVERSE SIDE AND RECHECK MATH << ; I Copyright 2002 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00; r- ~p iJ Decedent's Complete Address: STREET ADDRESS 313 1/2 East King Street, Borough of Shippensburg CITY Shippensburg STATE P A Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount 0.00 Total Credits (A + 8 + C) 3. InteresUPenalty if applicable D. Interest E. Penalty TotallnteresUPenalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPA YMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE A. Enter the interest on the tax due. 8. Enter the total of Line 5 + 5A. This is theBALANCE DUE Make Check Payable to: REGISTER OF WILLS, AGENT ---T---' ..---- i ZIP 17257 (1 ) 3,621.09 (2) 0.00 (3) (4) (5) (5A) (58) , 3,621.09 -----_.,------I-------.,_._~.~ ~,621.09 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;............................................................................. 1!J b. retain the right to designate who shall use the property transferred or its income;............................__.. f:!J c. retain a reversionary interest; or..............................__............................__.............................................. l!J d. receive the promise for life of either payments, benefits or care?........................................................... I-X] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?............................. ............................... __................................................... 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?................................................................................................................ iJ IlC.J IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE REjrURN. 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, icorrect and comp~. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. ._ ___._ _ _ ' SIGNATU E OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS Ger d H. Hershey n before January 1, 1995, the tax rate imposed on the net value of transfers to or for 1 1) (i)]. For dates of death on or after January 1, 1 5, the tax rate imposed on the net v [72 P.S. ~9116 (a) (1.1) (ii)]. The statutedoes not exempt a transfer to a survivin! of assets and filing a tax return are still applicable even if the surviving spouse is 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. natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. ~9 The tax rate imposed on the net value of transfers to or for the use of the decedl ~9116 1.2) [72 P.S. ~9116 (a) (1)]. 126 Neil Road Shippensburg, PA 17257 ADDRESS ADDRESS 126 East King Street Shippensburg, PA 17257 .~C-~ (':>c \ J:.~ e D .- "~--' \ 35 ( ~)"'- Cfe, (-)-~, ~~5 ~ . ~~\..S.~ '-J l__ [J x Ii] DATE ? /2-/ #S- DATE --------'---OATE -- t:Js- or for the ~se of a i as noted inl72 P.S. The tax rate imposed on the net value of transfers to or for the use of the decedl 1.3)]. A si~ling is defined under Section 9102, as an individual who has at least one parent in COIT"..v.. mu. ...v VV~VV"" n"V"M V7 v.vvd or adoption. f", " \ t Rev-1502 EX+ (6-98) *' SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEOENT ESTATE OF Holtry, Dorothy R. FILE NUMBER 21-05-0396 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 wo~ld 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 which is jointly-owned with right of survivorship must be disclosed on schedule F. ITEM VAL UE AT DATE NUMBER DESCRIPTION ( F DEATH 1 Residence - 313 - 3131/2 East King Street, Borough of Shippensburg, Cumberland 65.000.00 County, PA - gross proceeds of sale 8-24-05 , I TOTAL (Also enter on Line 1, Recapitulation) 65.000.00 I .. I (If more space IS needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. I Form PA-1500 Schedule A (Rev. 6-98) ! I f' ,t Rev-1508 EX+ (6-98) *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Holtry, Dorothy R. FILE NUMBER 21-05-0396 ESTATE OF Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right 01 survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION 1 County Tax proration at real estate settlement VALUE AT DATE qF DEATH 124.04 2 M & T Bank Checking Account #950963290 133.40 3 Com cast Cable - refund 63.50 4 Commonwealth of Pennsylvania. rebate 500.00 5 Personal Property - gross proceeds of public sale 07/16/05 3.588.00 6 Sprint. refund 31.93 7 Timmons Oil, Inc. - refund 172.43 TOTAL (Also enter on Line 5, Recapitulation) 4.613.30 (If more space IS needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 ScheduleE (Rev. 6-98) ,- 1) REV-1151 EX+ (12-99) *' SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Holtry, Dorothy R. FILE NUMBER 21-05-0396 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. FUNERAL EXPENSES: DESCRIPTION AMO~NT See continuation schedule(s) attached 6,860.00 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Gerald H. Hershey Social Security Number(s) I EIN Number of Personal Representative(s): Street Address 126 Neil Road City Shippensburg Year(s) Commission paid 2005 State PA Zip 17257 3,481.00 2. Attorney's Fees Weigle & Associates, P.C. 4,231.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent State Zip 4. Probate Fees Register of Wills, Cumberland County 128.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs See continuation schedule(s) attached 285.50 TOTAL (Also enter on line 9, Recapitulation) 14,985.50 , Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) ! r ,- ~ Rev-1502 EX+ (6-98) . SCHEDULE H-A FUNERAL EXPENSES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Holtry, Dorothy R. FILE NUMBER 21-05-0396 ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1 Eby Granite Works 250.00 2 Fogelsanger-Bricker Funeral Home 6.610.00 Subtotal 6.860.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 6-98) " Rev-1502 EX+ (6-98) . SCHEDULE H-87 OTHER ADMINISTRATIVE COSTS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Holtry, Dorothy R. FILE NUMBER 21-05-0396 ITEM NUMBER DESCRIPTION AMOUNT 1 Cumberland Law Journal - advertising Letters Testamentary 75.00 2 Linda K. Klein - notary fee 9.00 3 News Chronicle - advertising Letters Testamentary 92.75 4 Register of Wills, Cumberland County - filing PA Inheritance Tax Return 15.00 5 Register of Wills, Cumberland County - filing Family Settlement Agreement 75.00 6 Weigle & Associates, P.C. - reimbursement for postage, xerox copies, and long distance telephone calls 18.75 Subtotal 285.50 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) I It I' Rev-1512 EX+ (6-98) SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Holtry, Dorothy R. FILE NUMBER 21-05-0396 Include un reimbursed medical expenses. ITEM NUMBER DESCRIPTION 1 Borough of Shippensburg - water, sewer, refuse billing VAUUE AT DATE C>F DEATH 95.59 2 Borough of Shippensburg - dumpster fee 208.00 3 Borough of Shippensburg - final water, sewer, refuse billing 260.43 4 Everett Cash Mutual Insurance - homeowner's premium 112.50 5 Expenses of public sale 4.436.80 6 Gerald H. Hershey - balance owed at date of death for debts paid for Wesley H. Holtry estate so that Dorothy R. Holtry could acquire real estate; and debts paid for Dorothy R. Holtry from 07/03/02 through date of death 19,417.00 7 Gerald H. Hershey - reimbursement for expenses paid on behalf of decedent from date of death through 07/16/05, including Borough of Shippensburg - 133.00; Comcast Cable - 48.00; Penelec -78.00; PPL Utilities - 316.00; and Sprint - 49.00 624.00 8 M & T Bank Checking Account #950963290 - checks clearing after date of death 128.58 9 M & T Bank - Home Equity Line of Credit - paid off at real estate settlement 08/25/05 3.787.11 10 Penelec 26.35 11 Penelec 14.21 12 Real Estate Settlement Charges - notary fees -15.00; attorney's fees - 150.00; realty transfer tax - 650.00; 2005 county taxes - 383.12; overnight mailing -17.50 1.215.62 13 School Tax proration at real estate settlement 113.60 14 Tim Chamberlin Heating Service - repair prior to real estate settlement 47.40 Total of Continuation Schedule(s) See attached page TOTAL (Also enter on Line 10, Recapitulation) 30,487.19 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) 11 ,II I' REV-1513 EX+ (9-00) *' , SCHEDULE .J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Holtry, Dorothy R. 21-05-0396 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$) Do Not List Trustee(s) I. TAXABLE DISTRIBUTIONS [include outright sp,ousal aistributions, and ransfers under Sec. 9116(a)(1.2)] 1 Edgar J. Hershey Nephew 1/2 1\2,070.31 P. O. Box 282 Shippensburg, PA 17257 2 Gerald H. Hershey Nephew 1/2 1:2,070.30 126 Neil Road Shippensburg, PA 17257 Total 24,140.61 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 ScheduleJ (Rev. 6-98) ~ . " LAST WILL AND TESTAMENT I, DOROTHY R. HOLTRY, presently residing at 313-313~ East King Street, Shippensburg, Cumberland County, Pennsylvania 17257, being of sound mind, memory and disposition, do hereby make, publish and declare this my Last Will and Testament, hereby revoking and making void all wills by me at any time heretofore made. FIRST. I order and direct the payment of all my legally enforceable debts and funeral expenses as soon as may be convenient after my decease. SECOND. Since the passing of my brother, Wesley L. Holtry, who passed away on July 3, 2002, my nephew Gerald H. Hershey has advanced,funds toward my maintenahce and for the settlement-of the said Wesley L. Holtry's estate from yYhich I solely benefited. It is my express intent and desire, after payment of my funeral expenses, to reimburse the said' Gerald H. Hershey for any and all funds advanced on my behalf either directly or indirectly through funds advanced to the estate of Wesley L. Holtry that he can document in writing. S~ch expenses advanced as of the date of this my Last Will and Testament total approximately Eight Thousand Dollars ($8,000.00). ,,'" THIRD. I give, devise and bequeath all of the rest, residue and remainder of my estate, real, personal and mixed, whatsoever and wheresoever situate, to my nephews, GERALD H. HERSHEY and EDGAR J. HERSHEY, or the survivor thereof, provided t1hat they survive me by a period of sixty (60) days. FOURTH. I nominate, constitute and appoint GERALD H. HERSHEY, presently residing at 126 Neil Road, Shippensburg, Pennsylvania 17257, to be the Executor of this my Last Will and Testament; if he be unable to fulfill the duties of Executor, I then nominate, constitute and appoint BETSY A. GRAHAM, presently residing at 1122 Greenspring Road, Newville, Pennsylvania 17241, to be the Executrix of this my Last Will and Testament. FIFTH. I direct that my personal representative(s) shall not be required to g~ve bond for the faithful performance of their duties in any jurisdiction. SIXTH. I hereby direct that all federal, state and other death taxes payable because of my death, with respect to the property forming my gross estate for tax purposes, whether or not passing under this Will, including any interest or penalty imposed in connection with such taxes, shall be considered a part of the expense of administration of my estate and that such:'be paid out of the rest and residue of my estate. .Jl:.~ar:;t )f, j{:,elr;1 (SEAL) WEIGLE & ASSOCIATES, RC. - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397 .""'.. SEVENTH. I direct my Executor to retain the services of JERRY A. WEIGLE, ESQUIRE, with offices located at 126 East King Street, Shippensburg, Pennsylvania 17257, with respect to the settlement of my estate due to his familiarity with my affairs. IN WITNESS WHEREOF, I, Dorothy R. Holtry, have hereunto set my hand and se'l-l to this my Last V{~Jl Testament, "1' en on two (2) pages, the first page signed for identifica~. ion only, this ,~rlll day of '- Lt1/19-- ,2003. . ~I i1n7 J? - Ji.:;JSE4Ll .;. WEIGLE & ASSOCIATES, P.c. - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG. PA 17257-1397 .' This instrument was by the Testatrix, on the date hereof, signed, published and declared by her to be her Last Will and Testament, in our presence, who at her request and in the presence of each other, we believing her to be of sound and disposing mind and memory, have hereunto subscribed our names as witnesses. "- {J~tu. ,c~ ol I Qv~~6Y ~/Kj/{d7 ((;mIll , COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND .j'>> I, Dorothy R. Holtry, the person whose name is signed to the foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed ~e 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. ;S~1'7lr/~,".', ., /; . .;Y ; Sworn or affirmed to and acknowledged before me by I?~9THY R. H~~TRY, the Testatrix, this ~~ day of rj~ ,2 03. q I cJ ' ',{'I,.; NOTARIAL SEAL Je A. Weigle, Notary Public Shippensburg, PA Cumberland County My Commission Expires October 7, 2006 , . .,\.., "'-.,j'. ...'..-i....-<. .~.~ .. .;- -~" ~::~. WEIGLE & ASSOCIATES, RC. - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397 COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND ~CUJ-)n In, Srl()DP , the witnesses whose names are signed ,to and the foregoing instrument, being du y qualified according to law, do depose and say that we were present and saw Dorothy R. Holtry, the Testatrix, sign and execute the instrument as her Last Will; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix, signed the will as witnesses; and that. to the best of our knowledge the Testatrix was at the time eighteen (18) or more years of age and of sound mind and under no constraint or undue influence. ~_jJd;:; ~.{~ t Sworn or affirmed to and subscribed before me by ~lk-bu-C~ft._ ~, I~ Jnwn rY\. S~ and Reb~ 1-. Jj;;1r; witnesses, this !Ji11day Of~ ,2003. ~. " NOTARIAL SEAL rry A. Weigle, Notary Public . Shippensburg, PA ~umber\and County My Commission Expires October 7. 2006 WEIGLE & ASSOCIATES, P.C - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG. PA 17257-1397 II ..j, ,j fleES lA Settlemc';~ ~~" ,. " WEST POMFRET PROFESSIONAL BUILDING 60 If/FST POMFRET STREET [iVf\JSYLVANIA 17013-3222 (717) 249-2353 U,3, Department of Heuslng and Urban Oelletopmen\ OMS No. 2502-0265 (expires 9/30/2006) B. TYPE OF LOAN 1. OFHA 2. OFmHA 3. OConv. Unins. _LOVA 5. OCony. Ins. ;ILE NUMBER HAFlNERST8.05 8. MORTGAGE INSURANCE CASE NUMBER! i!:~ ~';::p . ,,',\.....'1._1' IRWIN & McKNIGHT onn . um a 0 g you a a emen ac a ae men cos. un pa 0 aye.. emen agen are a own. Itema marked "(p.o.c.)" w.re paid oulsld. the closing; they are ahown her. for Infonnatlon purpos.a and are not Included In the totala. WARNING: It Is a crime to knowingly make fala. statemenlslo lhe United States on this or any other similar fonn. Penalties upon conviction can Include a fine and 11 rlsonrnent For details l8e: Title 18 U. S. Code S.ctlon 1001 and Section 1010. D. NAME OF BORROWER: STEVEN J. HARNER and PATRICIA M. HARNER 8. Note: Titleaxpress Settlement System PrLf!!.~<t 08/24/200.53L1Q~00j.Mfl ____ APDR._~SS ._... .._.____,.,.._..~~_. ._,~ .n. .--..-..... . ._-- ".'.. .___._A.____.___ E. NAME OF SELLU<. DOROTHY R. HOLTRY ESTATE ADDRESS: F. NAME OF LENDER: ADDRESS: , G. PROPERTY ADDRESS: 313 AND 3131/2 E KING STREET, Shippensburg, PA 17257 Shiooensbura Borouah H. SETTLEMENT AGENT: I&M REAL ESTATE SERVICES, LLC, Telephone: 717.249-2353 Fax: 717.249.6354 i PLACE OF SETTLEMENT: West Pomfret Professional Bldg, 60 West Pomfret Street. Carlisle. PA 17013 I. SETTLEMENT DATE: 08/24/2005 J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TR~P aSACTION: i 100. GROSS AMOUNT DUE FROM BORROWER 400. GROSS AMOUNT DUE TO SEllER 101. Contract sales orice 65 000.00 401. Contract sales price 65.000.00 102. Personal Prooerty 402. Personal Prooertv 103. Settlement charoes to borrower IIine 140m 1.996.41 403. I 104. 404. 105. 405. I Adiustments for items paid by seller in advance Adiustments for Items paid bv seller. n advance 107. County taxes 08124/05 to 12/31/05 124.04 407. County taxes 08/24/05 to 12/31/05 ' 124.04 109. 409. 110. 410. 111. 411. 112. 412. -- 120. GROSS AMOUNT DUE FROM BORROWER 67.120.45 420. GROSS AMOUNT DUE TO SELLER 65124.04 200. AMOUNTS PAID BY OR ON BEHALF OF BORROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER 201. Deoosit or earnest money 6,500.00 501. Excess Deposit (see instructions) 6 500.00 202. Princinal amount of new loans 502. Settlement charaes to seller (line 140m 1 215.62 203. Existina loanls\ taken subiect to 503. Existina loan(s) taken subiect to 204. 504. Payoff of First Mortaaoe Loan 5 000.00 M & T MORTGAGE CORPORATION 205. 505. ?n~ i rr'~ ",">~"",,'~"'''--'''<'''''''''''''''''''''''~ " ,~. ...i I' U,S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT File Number: HARNERSTS.05 SSP' 08/4/20 PAGE 2 OOJ R TitleExoress ettlement ivstem nnted 2 o 5 at 10: M t. SETTlEMENT CHARGES PAID FROM PAID FROM 700. TOTAL SALES/BROKER'S COMMISSION based on price $65.000.00 = BORROWER'S SELl,ER'S Division of commission /line 700) as follows: FUNDS AT FUNDS AT 701. $ to SETTLEMENT SETTLEMENT 702. $ to 703, Commission oaid at Settlement SOO.ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Orioination Fee % 802. loan Discount % 803. Aooraisal Fee 804, Credit Reoort 805, Lender's Insoection Fee 806. Mortoaoe Aoolication Fee 807. Assumotion Fee 808. 809, 810. 811. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From to (ii)$ Idav 902. Mortoaoe Insurance Premium for to 903. Hazard Insurance Premium for to 904. 905. , 1000. RESERVES DEPOSITED WITH LENDER FOR , 1001. Hazard Insurance mo. (iil $ Imo 1002. Mortoaoe Insurance mo. @. $ Imo 1003, City Prooertv Tax mo. @. $ Imo 1004, County Prooerty Tax mo. (iil$ 29.02 Imo 1005. School Tax mO,t1i) $ 63.99 Imo 1009. AQareaale Analvsis Adjustmenl 0.00 0.00 1100. TITLE CHARGES 1101, Settlement or closina fee 1102, Abstract or title search 1103, Title examination 1104. Tille insurance binder ~ 1105. Document Preoaration 1106, Notary Fees 15.00 15.00 1107. Attornev's fees 10 IRWIN & MCKNIGHT/J. WEIGLE 525.00 150.00 !includes above items No: ) 1108. Title Insurance !includes above items No: ) 1109, lender's Coveraoe $ 1110. Owner's Coveraoe $ 65 000.00 . 1111, _...".,',..,......,~___._..."',.~_,."'""'.M.,~..,...'";.....'''''F~ ,._~,~'....._,""""""_'"".."'.._".........,,"',.,"',.,.._"""'"',."".j..-.'".."',;..>i~...=.,. I' " I. LAW OFFICES IRWIN & McKNIGHT ROGER B. IRWIN MARCUS A. McKNIGHT. 11l DOUGLAS G. MILLER MATTHEW A. McKNIGHT WEST POMFRET PROFESSIONAL BUILDING 60 WEST POMFRET STREET CARLISLE, PENNSYLVANIA 17013-3222 (717) 249-2353 FAX (717) 249-6354 WWW./MHLAW.COM HAROLD S. IRWIN (1925-1977) HAROLD S. IRWIN. JR. (/954-1986) IRWIN. IRWIN & IRWIN (1956-1986) IRWIN, IRWIN & McKNIGHT (1986-1994) IRWIN. McKNIGHT & HUGHES (1994-2003) IR WIN & McKNIGHT (2003- ) August 25, 2005 Linda Klein South Central Home Settlements, Inc. 126 East King Street Shippensburg,PA 17257 RE: Proceeds of settlement SETLEMENT DATE 08/25/05 Dear Linda: Enclosed herewith please find a check in the amount of One Thousand Two Hundred Twelve and 89/100 ($1,212.89) Dollars which represents the remaining funds held from the settlement in anticipation of receiving the payoff from M & T Bank. If you have any questions, please do not hesitate to call. Very truly yours, IRWIN & McKNIGHT '~~, '-rrl ~'/~u ,LL1\,~ Jean M. Rice, CLAS Certified Legal Assistant Real Estate Specialist Jmr Enclosures III I&M REAL ESTATE SERVICES, llC ESCROW ACCOUNT 006282 Date: 08/25/05 Amount: 1,212.89 File Number: HARNERST8-05 Check *: 6283 Pay To: ESTATE OF DOROTHY HOLTRY Buyer: STEVEN J. HARNER and PATRICIA M. HARNER Seller: DOROTHY R. HOLTRY ESTATE Property: 313 AND 313 1/2 E KING STREET, Shippensburg, PA 17257 1,212.89 PROCEEDS 11100 (; 28 2111 1:0:l.:l. SO:l (;1: .08 ..0 2 Ii 2111 I' " rlIM&fBank MAY 1 4 2005 Phone (888) 502-4349 Fax (302) 934-2955 May 11,2005 499 Mitchell Road, MiIlsboro, DE 19966 Mail Code DE-MB-12 Weigle & Associates P C Attorneys At Law 126 East King Street Shippensburg, Pennsylvania 17257-1397 Re: Estate of Dorothv R Holtrv Social Security: 174-20-0533 Date of Death: April 17, 2005 Dear Sir or Madam: Per your inquiry dated May 03, 2005, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Account Account Number 950963290 Ownership (Names oj) Dorothy R Holtry * Gerald H Hershey, POA Opening Date 07/22/02 Balance on Date of Death $133.40 Accrued Interest $ 0.00 Total $133.40 Please be advised, there was no safe deposit box found for the above decedent. * For further account information, regarding ownership, closures and/or reimbursement of funds, etc., plea$e call the Walnut Bottom Office # 7l7~532-2414. Sincerely, /j. i~.~,' /,"/ / . /....., /./>) <.1'< c. /,'L ~7' (/{/(y<< ''''G''''' ~ ~. .~ . i Nancy Clagett Records Management EFFECTIVE IMMEDIATELY . Please Send All (Datf. of Death Balance , Requests) Attorney Letters to: M&T BANK Records Management DE-MB-12 PO Box 900 MiUsboro, DE 19966 Phone: (888) 502-4349 option 2, option. 3 Fax: (302) 934-2955 I' ,. f~ s;(~ ~ 7- /G,.-oS- ! ~~ ~~ -1 s~ c1 ~~~ /?~:S ItJ~6 I~ '$ f-- ^->-J ~ '(DN 9v-.. l:'f~r;:, i s~ : ~l, 1CM ~-\ ~ ~ ~~ ,f) h ~- 5+,(/ ~+o 79roo.oo :< J08,&'0 .. ~ 1 s(,r(, '2. 0 'j. .'Ij ;, " .~ ~ i III 35~cf( pO (; SOO. CPo I IOf 0 8- 8-,106 - LfLj3ro, Scp S- G S I. 2 :0 0- C e \'\ ~C$S ---- /'. C~,.JJ' \,./ t- ,- "Z. 2( U 10~~ 1~"O( .~ 0- C a7 - 00 1./+ 1~-OOv'+ 418-00 v + 9;3-00:..- + 6,sop-00 - + 10j?-OOvof 406-00 v+ 7~-OO....... + CJ - 00 + 7dJ.OO ""'-'+ 25.00 v + 21.00 v + 6;3.00 v+ 27!.OO ....... + 25.00 v' + 70:.00 v" + 58i- OOV' + 7, 735~OO * " Shetron Auction & Equipment, LLC 1505 Walnut Bottom Road Newville, PA 17241 (717) 776-6962 (717) 226-1918 Fax (717) 776-4485 Name i>" c\ \ ;\ \ \" \ \ '1_ 2s--IJe. Date 'I !~) . 0 S, \.) 0 Address Quantity ( - I ~ - Phone Unit Price -.J r/ Y J Amount ICJC:;O.CO /C?5 .00 GO.OO Sub Total Tax liotal t. I U:;l' c., -f 1 JJ...t;. $CJ (r,() 1-1/2% Per Month Added After 30 Days DOROTHY R. HOLTRY ESTATE Dorothy R. Holtry was sole beneficiary of the Estate of Wesley L. Holtry who died on July 3,2002, Estate File No. 21-02-0742. In order for Dorothy R. Holtry to take the real estate In Kind, Gerald H. Hershey (nephew of Wesley L. Holtry and Dorothy R. Holtry) paid debts, administration costs, fees, and taxes for the Estate of Wesley L. Holtry. After July 3, 2002, until the date of death of Dorothy R. Holtry, he paid additional debts and expenses for Dorothy R. Holtry. (Cancelled checks can be provided for all debts paid) Total Expenses paid by Gerald Hershev Dorothy's Income used for expenses Net paid by Gerald Hershey 2002 3,823 2,284 2003 13,367 5,069 Debts of Decedent Paid for Wesley Holtry Estate (2003) 490 Executor Commission Paid for Wesley Holtry Estate (2003) 1,912 2004 12,543 5,069 2005 (Jan. to date of death) 1,988 2,284 Total 34,123 14,706 19,417 Additional Expenses paid after 4/17/05: Borough of Shippensburg Comcast Cable Penelec PPL Gas Utilities Sprint 133 48 78 316 -----1.2 624 Total owed to Gerald H. Hershey 20.041 - " 2--002- ~cV<t ~ t;:I~ ?- pun 11., ~ .' (~~ J..>.-' ,_:>_0 '-) 2-_IY_07... \'.,...... -'\ ~ {-- ~ I~~ ..,~ " <?-~ .. ...'~ .,' "t 1" ~ ~~,~ u 00 '1 jk; rfJ.~ fo",J 5~ C~~ ~~l ~ (VI, {Y\lJ,.-N L:tv 9..v. (~ 2'i'^~ f~ I~ OJ.J. 1~'4~ ~~~ ~o>-i 0 ~ t>&t'- ~~~ 6o~,1'1--t ),/\) ~ o~ 5'~ ~ , d 2-~, 00 1, Ot) '2-- ~ 7-2-'i,31 ~ '2- /1' 2-C /S5',fjg I q {,I & I P\,g'7 ~ /~ fOOOrOO L 7 S. ~ S' :> J 1,00 ~ ~'1. R -:> ~Sl '5.r, 0(1 lOgo,,, r I sz,>.oo I SD, 00 ''"l..- (", 00 ~ ~ ~ 3[?7-J,Z9 I · '/Q ewd$ I' CJ 0' ~) ~, " fi- r}! ~) ") t'~ '~7 ,_./ ~ ') 'f' - . , '\ ';, C t'l '\ S! 5 . ') \), l()? U '\ jl i) '<J i'J n r} '<. '7 t) 5 ;) '\ ~) )ij n() l'! 1, S: D ~\ 'r:; {) , '2 ~;' 'j' 1", r 1-2-'dV ~ ~jS'-lO) - !A) / L (~vJ) ,,'''I ~~S,.J'f~ - I)Ve5 e.tQ' / U U --..:.;J(j __ (- ~ AO{)9--, ",. 3 3-' 'J-.q ~ IDI , cleM I &. (p I p)'4 1(5V ~ ;s: rJ/r Q.tU/~rd I 1, ' 'f 7 eJ-~ ;/.';1., !J-l/ ~ .>0 ~'di. J f). ~ >>. oD " 2. 5;?-, ~ I~ I \\ ;r;, '7 I (iJ.;'b 1;9-!J- i\ /{,.~S- ~/YJ \1 !J. '/. 30 (J.ui"- J'/ D ,\\~ \\ II poJ · \(J~ r; '7 , fAD ~~\I(~, of;; '" W /~q ,~~S'.5'~ _~d \ \\, ~ t.~?, ~. \\ ~,""B \ \ 3/),ft5: ~ ,\ (ri / s:S: 3:3 - " f:X:JL q 3 ~-J/;. 1/5 t!Y-/p-,5 ~ /.1,4// at- #- I '-I '-f (l f: ~5~IO . "H rzS'.84 u 3 1,52) 3" I jIf:b- ~ I q5* / <t eJ:,..JL. I I 1)- f!);.=f1. I J-I (]t- -w- 130 (lbh flPL ~05 ~-- J-O. 9~ i ~ .~-q I~' (pl.f 13 ' ~ tJ 13-.4-5 /3.tp5" /.;:; . !R I.t 13-. (pc, L/:Cf'i 34 /7-./;'1- J I '7:5" I ' '1,' f!.L j:J;. i () ?:1 r!f..- -* I () tJ (!J:.-:i:J:. / ( D (!)t d:J- / I ( f!.J-. :J:! II '1 ~* I z-D oJ:./# I ')..'7 ~ I :J-? ~-J:}. / ;;s- ~JF. 13~ ry::./#- II '7 (!i.;J:J- ) I /f lot! ()V<' .. At,-' , -fc;' '::JI-c',""t"V"2/ -; ~ r;z0' '), '1 4ii. _ (j 'I/) 9.53- ...) u/IJl.. J I '" tJ ' Jfy,5iRS', 'DZ ~( "". '7 35. ~ CJ fi.J &.v ~J - t:~~.fh-2e~oJ Fd.J,Ia2if.~ " .:) v.-.t ... ~ c!:}U-:. cf~~' ?P' / tl . g7 .r._ ,f I It f!lc,n ~/y14;r1 kL_ C'-?k /4, 17~ /2. :<~ /~. ~~ rfI. tf, t/ Y ~~-~ Ie~ .,<>. 11 ]7~, ~.it:- q t; I!L~ I () f' U:#- //2-f (!t. #=- 11/ A~&1Jjt ;/onu- ~h :::.--" II ...);J'I n f) ~60" II ~ .;<(... R lo~t'O li },: il "" I /~S- '/()t) P It) II &d 1;Z It I (Jt) 4' ~I II /tv. '}{S' ' lOOn Ii <pu-., M 11 100/1.' ____ il ~ ~~ ~.}. . ::Y-rYl ~f L :tAL. ~ II * ;\5--- tJl'-dL /6 if ,'~J'; ii' ~ II if) C' I ;l A ( / I I ': il LVpm~-<f/a/tctf~J:. ~ I I~'" ~h fI'" Ii ~nJ SAtJ- fJO-,b"J /fdw- 8t" rnhdSu.'o/f'O -!o .A<~.~ I~,~)~mh, '~'J ./-k)p ~oj'\ 1/ /~- et: /7'~ --- '7)~.L. /'i :lAJ ef file- ~, '/57) .#'J! t? I {),S ' , Vi1c-~ Lumber II;IYI. ftj --- ~,~ --- 6sh- ~y HKA r! " . . i ;Jt&jiIL' kfUi ~- tJttS /co:> If'rt t -'3'7/ &\ h. 4,-0' I-J-.. ~/lPI5 . IE ~- ,11 ~ n:.;, a rD'f- Ih,rYI....WWFliZ.K5 . ," , ; , ..3 3! . 6D (!J!.. $: I tJ to .4 c9-b -r;:; &/I~r --- 'II("'I1.8?;' U /..;;8 II /C)s- !. L------;;I/~ I \ ,___.Hf1Cf!....-:: .... /;<10};:2- ~:1- t (J ~ ii t.Ash a-li-/01 M-- .iJ. / I {p bt-* /;J, ~ et_dJ; 13 ~ &- 7J- /tj5 . = H l.c,{)tJ '017-5, h 5- (!t -d:{ / Y:J.. /i~ iU.~ " "/(I~" rzn/ ' " ,~ ~ ,..y ....' ,I, ,I -;~~;1~~~~~;:~~:~/~ - -- . -i3.~ti~ _-.- - - Tl~y !i1-J~_ .. - - -_.__~____-L' -11L ~2i.- ~.2Q >--- It --- .~ .----fi~. .-="---...----~------...-.- ------- - -----.s-~~~-_d.; ,-S b._________~_ - . -~. ~~--.a..!Li~--~ SZJ d-: ~_r~ tzp _~ ~~ k.~ $~q : H~----~-- ~ - -.-- :i!z'!1- fLj,SZU 2.-;'-'9:;; 5!1-- Zt, "'!L 62J .~:: , 9 ~'o _ . i 6-oD6 .. t ~6D ^:2.. ;; 'q t!OIY~ ---'- --t-l~P-n:/Y1~U-~ ~3. t)~ ----- 'i ~____ Ii . . .' . ~ir fdic~/ f~Jo~rJAf --:- .! ~ , -es/~~:z.~o:l. --------4~~-'!ds::~ ~ . - ~ b ,4lVvlJe- --I1-4(/7<1.5!6~]iRo~~__ ~~~-W;/ ~- ijtj~~~~~rq~~____ - - - - - .. - -.- 1:-':' -&-.f!J:.4J. ~ :< 'i .- -- --- -__ ---__ - -_____-i~_-,---"- 1~~V --------~_u----~--(07Jer1-- ( I' " \ I. ----m-~-9.----.....~.--.:-.~..-u ..-._ .' ...-......-",.)ll~ /J/~--'J-- .....~~~~=~~l/~~=__~ ~~~~-~~/fl[!Ji~ .-/;?tb ~d ~('~, ~. . ( (ltit ,57~ S?;p.cf fl ';<.:5: S1~ j~7J; 57~S :.i-ZJi .. ,"57 tjtj' ~-k:- . <-5/'1/bS c5j '1/ CC d~/~ W :5;4 c;-" . 6-/.:<~~r / &, /tJ Y'/ ro- , I' '7/~/o~ , , --~X;~~+ "Lt: ~ QJ" .31. 13 .~. ;Ad- ~ "Y?S9 &no .,f~~.M '/~. /,/ 1i~/t'J GJ; "J/.~_' jJ PL k ~ !.31(,.;LL) , ~rTn~ .1 ?7< /1 ~ MiL3~- /5' dl.' /);z ~ r::.e4'\c leD....... ~--~ - G Z-Lf,OO ~-,-~.~~---~-~~---~--_._---.-~-""-~~~-'- , . ---;-+----~-- ~---- --:---~~---~--~ ~ Ut-5e- . ~ ~e- -!z,.5e.e.. 9-f ~ a-i'-<-. en ~/!,e-,r- 1M ~ ';Z:~t!':<-. :r-f' ~ <Lr-G. /ld-; pkdSe 11--- " Social Security Administration Chambersburg P A District Office ~~va Date: Claim Number: June 17,2005 174-20-0533AI Name: DOROTHY RUTH HOLTRY GERALD HENRY HERSHEY, FOR DOROTHYRUTH HOLTRY 126 NEILL RD SHIPPENSBURG, PA 17257-9416 You asked us for information from your record. The information that you requested is shown beloW. If you want anyone else to have this information, you may send them this letter. Other Important Information For the period 01/01/02 to 12/01/02 you received a total o~n Supplemental Security Income benefits. ~2 'fr:::. '2..2...9'1. If You Have Any Questions If you have any questions, you may call us at 1-800-772-1213, or call your local Social Security office at 717-263-4138. We can answer most questions over the phone. You can also write or visit any Soc.al Security office. Your closest office is located at: SOCIAL SECURITY ADMINISTRATION 50 N THIRD STREET CHAMBERSBURG, PA 17201 If you do call or visit an office, please have this letter with you. " Food II I I ~: i GorD : ~ JA& # ~{)g ~M'riJ ~ ..313 Cb~j "# 57/ () 11 II t P L 12 II (b~ I( 1~-r 13 II I' Acl-;:-rtST - m tiT ~t:. 1~) ! I II ~/~IF~ /-10 il ,I 1YLL f) 2~/uf:$ !:j 1 i .--;---'- /i", i I {f / I/-~ f];~J~(-- - / ~~0-= <<2- '1 II Posl ~cz_ - ~ dt7f:l.. - ~ 8' ;1 .~< III, ,t I PavJiL AcYI3 (/!:e-cC:5r;ds (Jf If 07 I _ I 1 /J. /."I {) J IJ' ~.- /1 UJ:j:J[Jy 1'0 ~-<-f, f DrtJ1 I-.J ZJ htNA--d Jlofru.. II ~()~, Sf) $ 87? \.:::::: '~____",".~-;-Je{' ~occ~~~'~> ?oo3 o " 'I' &f> [ 711 C; - tem5C11L I ~t-- ~ oif -~Jyo6 T ~f c:2 '1,1 f' ..:-'ILS. '/ i;_ ,:~ '7 i,) iJ ~~) ':, 'J I )c;., - --~\ . , '_" c-:' , -~_ i :; 3,] (~i () i 'I 'I ' . . / V 04fck- ~A.-z5(f'-L _15/ .. ~"r;uj~ 5-cfJlc- .c;ik - II"1J3 i SS~ IS -r.;,lfJ ~ -r 2 0 H -r /30 -r 2~~ ~r:- ..,. t<' dtw,. 9f'/'. (If z. F /' Se~ jtJ4rY"C'.i1f(1 Iv" ZJk /-bkv -- 9J 73 " , - I' " 126 NEILL RD SHIPPENSBURG, PA 17257-9416 You asked us for infonnation from your record. The information that you requested is shown below, If you want anyone else to have this information, you may send them this letter. Other Important Information For the period 01/01/03 to 12/01103 you received a total o"""n Supplemental Security Income benefits. T SOD ' ~!C\t; 6v,.~ SO~19 If You Have Any Questions -' If you have any questions, you may call us at 1-800-772- 1213, or call your local Social Security office at 717-263-4138, We can answer most questions over the phone. You can also write or visit any SOQial Security office. Your closest office is located at: SOCIAL SECURITY ADMINISTRATION 50 N THIRD STREET CHAMBERSBURG, PA 17201 If you do call or visit an office, please have this letter with you. It will help us answer your questions. ,-"'\ . <, .' ,. / \ ,~.( / t t ~ '. ".' ."'. \ I 1';0,." 1/:2., .-) 'r: es/B1f~gr\~""'u:... '<0-" , .1 l, Ojfice Manager ., , .. WEIGLE & ASSOCIATES, P.C. Attorneys-at-Law 126 EAST KING STREET SHIPPENSBURG, PENNSYL VANIA 17257-1397 JERRY A. WEIGLE Associates JOSEPH P. RUANE RICHARD L. WEBBER, JR. Of Counsel THOMAS L. BRIGHT TELEPHONE (717) 532-7388 or (717) 776-4295 FAX (717) 532-5289 March 27,2003 Mr. Gerald H. Hershey 126 Neil Road Shippensburg, P A 17257 FOR PROFESSIONAL SERVICES RENDERED: Estate of Wesley L. Holtry To File Pennsylvania Inheritance Tax Return - need two checks as follows: Register of Wills, Cumberland County - filing fee 15.00 (rA --- Register of Wills, Cumberland County - P A Inheritance Tax 2,464.00 pvf .........- Attorney Fee 2,544.68 Reimbursement for postage, xerox copies, and long distance telephone calls 22.75 Notary Fees 8.00 Reserve for filing Family Settlement Agreement with Register of Wills, Cumberland County 75.00 Total 2,650.43 Less: Balance held in Clients' Account 100.65 2.549.78 f J , - '- 0 -zS. ~~ PLEASE MAKE CHECKS PAYABLE TO "WEIGLE & ASSOCIATES, P.c." A billing fee often dollars per monthly statement will be charged after 30 days TOTAL DUE AND PAYABLE "r .t TO: Gerald Hershey 126 Neil Road Shippensburg, P A 17257 DATE: March 11, 2003 FROM: Fee for appraising personal property of the Estate of Wesley Holtry, 313 & 313 ~ East King Street, Shippensburg, P A on March 10, 2003: ~30.~ Dennis L. Gotshall, AuctIo rop. Dan Hershey Auctioneering Service 3 Brown Road Shippensburg, P A 17257 RE: \~ ,~l ~ r]~ ~J Cf " ,I ' . *** INVOICE *** Lim" ed BK REAL ESTATE APPRAISALS, INC 14 N. Main street, Suite 410 Chambersburg, PA 17201 Invoice #: 030283 Date Invoice 3110103 Terms: 30 days Date Due: 4110103 ~ To: Borrower: Wesley Holtry Estate For Property located at "~.... i .,.;.;~~-.-...-...._,_~",.:,.:.:,....,....:,~ ... (1-97) "I . · SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS AONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT (ATE OF tlesley L. Holtry Include unreimbursed medical expenses. ITEM NO. FILE NUMBER 21-2002-0742 DESCRIPTION AMOUNT 1 Orrstown Bank Checking Account 103000640, checks clearing after date of death 210.48 2 Allfirst Bank- home equity loan 23-26316 ;6,320.41 3 H & R Block - 2002 income tax preparation 4 Chambersburg AIS/West Shore EMS - 02/05/03 staterrent 7 CPA12 NTF 10912 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 7,020.46 Copyright Forms Software Only, 1997 Nelco, Inc. II (1-97) I' I ,. SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ,AONWEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ~TATE OF lesley L. Holtry FILE NUMBER 21-2002-0742 Debts of decedent must be reported on Schedule I. ITEM NO, DESCRIPTION A. FUNERAL EXPENSES: AMOUNT 1 Fogelsanger-Bricker Funeral Home 5,300.00 2 Opening grave 390.00 8, 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Gerald H. Hershey Social Security Number(s)/EIN No. of Personal Representative(s) Street Address 126 Neil Road City Shippensburg State 168-36-7505 012.9 PA Zip 17257 Year(s) Commission Paid: 2. 3. Attorney Fees Narre : Weigle & Associates, P. C. 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 2,544.68 0.00 4, Probate Fees 155.00 5, Accou ntant's Fees 0.00 6. Tax Return Preparer's Fees 0.00 See Schedule attached Total from continuation page(s) 389.01 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 10,690.93 7 CPA11 NTF 10911 Copyright Forms Software Only. 1997 Nelco. Inc. ~. ar ,j' . ~()/y-/ r,?uPfi, ' j~ff.:~;,20.':iv'" . , 1\ ~ ,,-, q<9 vv II ~/no~ &rL :I~' /(L;v5e~L' ;:.L ff8L - ijr;71. g~ )a;J ~ J'lf /S';;"D. is 0 ?~ ;l!J.fJr - f 2513. 9q~cP~ P L Ii v f ~ 31., , IR~ .--/ i)e.n A/~$ - '* :yt rJ · i/ r; .Joj1'Ltfl vJJyf;5:: I; J!oiP · SD r1 d) " - vJ e51~ LMf' P I'>"J. - 11 p,IJ, ~ ~ y;.k, If',m J /1 ~~b"1 V';!Jr - "..3b U:!'- :;/I!J 01" J . - _ ~ 11/'11. '7:) M-~ .:3.1/1 ~ ~ C-()~ - &i/~1,/3 ~(rJ-''.. "3rJQ , ~ ~r I.) \ \ ~ f~~~ ~ \7\r~ 1'-/ /)/0'1 bvr.A>$o(:,'}-pr~::::; s 2-'1. 71i \, ' 3,;2. '7 'I. Y 0 A .k,.s \: jkflf~ p,1tJ>>--- JILL. iJ-3j D "3, j)t) - f!e,1tW- 1M ~, '1 ,,'\ (5Lo 9tO\le- ~//..?tUi~J . r;ljr-- _ i Icj. g1 {!.u.h - frqJ4re-- -.94d.e... uJtf.j~ /, J ,\' C I Y12 I ("'//h.(J Ii' A ~-rou-fif~f - L.a:W/1 rfl.ot1Xr - $; I. J.S f!ftsh :.\ ." \ \ r->>,,-Jyd -=:l~-t.y ~~ef~" S5fb.u&J k. ~ LAkD~ - '115-<1 - " {'3 l >, Vi S-SI .... i 'z !~ ,,' ',,,' " i ? '\ ;^'\ " :.) \1, t\ "[ ), g rJ ;'\ '. :;.2-::; (:,?, '~i ,.-, ",0': ,/ ! "\ ;:S .~' ~,.....,;.) 1 1 U ,\ ,. ~.. " I, _ . '-' ';' i\" ? '1 ., C; IJ '," ,-' \ -/ -, ' ~, sob Cl. ijti0 /j-rl' /!; {J?dL !fV.rtfff'L1- 1t1? 9 ~ s~, 6e f!}~ t(! ~ (Jldi ~ ~ a1(uj .J/df. - ", I' Social Security Administration Chambersburg P A District Office Date: Claim Number: ~~ June 17,2005 174-20~0533AI Name: DOROTHY RUTH HOLTRY GERALD HENRY HERSHEY, FOR DOROTHYRUTH HOLTRY 126 NEILL RD SHIPPENSBURG, PA 17257-9416 You asked us for information from your record. The information that you requested is shown below. If you want anyone else to have this information, you may send them this letter. Other Important Information For the period 01/01/04 to 12/01/04 you received a total ofW ~ mw Supplemental Security Income benefits. -r- SOu ~ (;n~ 5""'0 Co 9 r If You Have Any Questions .--- - If you have any questions, you may call us at 1-800-772-1213, or call your local Social Security office at 717-263-4138. We can answer most questions over the phone. You can also write or visit any Social Security office. Your closest office is located at: . SOCIAL SECURITY ADMINISTRA nON 50 N THIRD STREET CHAMBERSBURG, PA 17201 If you do call or visit an office, please have this letter with you. It will help us answer your questions. ~! - , J es reen r , flee Manager ,., I I , . A.E.S. Hearthplace, Inc. 1743 Pine Rd. Newville, PA 17241 Quotation A.E.S ,,~l\R l"HP l...t C'~ Quote Number: EG40 B-Vent STOVE SHOP Telephone: Fax Number: Web Site: 717-486-7690 717-486-7310 Quote Date: Sep 28, 2004 www.aeshearthplace.com Page: 1 Quoted to: Gerald Hershey 126 Neil Road Shippensburg, PA 17257 Customer ill Good Thru Payment Terms Sales Rep Hershey, Gerald 10/28/04 50/50 Rick Quantity 1.00 G40 B-VENT STOVE PAINTED DOOR oneywell MVolt T-Stat Control " B-VENT PIPE THRU 2 FLOORS AND INTO EXISTING CHIMNEY , LINE CHIMNEY SECTION FR(,H ATTIC Description ENETRATION UP TO TOP OF CHIMNEY lum. liner kit 4"x 25' " ROUND WALL STRAP B-VENT 5' LENGTH B-VENT 45/60 DEG. ADJ. ELBOW B-VE 90 DEG. ADJ. ELBOW B-VENT 12" ADJ LENGTH B-VENT 12" LENGTH B-VENT " SQUARE FIRESTOP SUP. B-VENT ELLET/B-VENT4"PIPE COLLAR NSTALL B-VENT STOVE THROUGH 2 FLOORS AND INTO CHIMNEY WITH FIRESTOPS AT EACH FLOOR (APPROX- ETERMINED AT SURVEY -$500) TIE INTO EXISTING-(DETEffi~NED AT SURVEY, TYPICALLY $200-$350-NOT INC ,IN ( QJ ~\ j,r \ . . %:- SG,~~ qJ9~ 0'1 cP I{.. $1 (0 oCJ c/t. S(p Y S" 11/2 -r../O y #'; (p 7l/, yo Subtotal Sales Tax Total 2,870.75 172 .25 3,043.00 - ,. /" <'zpo'J J ~^' ~~\ 1, -;,_;"( 0' 'J '; t: .j ./ ': ,"',\ /' .- 1 ",' , u ' r"., <.'.') ;0'1 '- ),1 r;. ') 1 ';; , DOl- s S l ~ Z '2g4 , ~ z.q<o.'t" - ,~ 11'1 ,J It. cA /)()5 ~?~pls 0mU[SJj- . 'I J a/1 .3 P-b <I A-pr; 7 /1ii~r. r; -<I~. gLj ~-I-. J-t/ ~,59 L/ If. j 9' 1 !Je;u}ct:. i ~ <j r:cb s- !Yl4r-6' Apr; 7 ~.tl!,o ..:54 # <II .3~, tJ3 -3,/. ?I ~~/7'r' ;' --deln ~/p 1:11 Ab. /.7 I, /J14 Y: .j/7 -3 / , a..~ -..3(" 9( ..3/. '11 An) " i' J~~ ~ ~n ~~. "r..' ,. :1 , ~ aId: - ~4f\~? -: rw btJ? /Yltt~ ~~ 4pr. / t,. ~ : , I tJ.3. t./ If (/ Jl, 1/:2., 3tZ (jf /J";<...3y /,-/.33- t,/-z-li . - ~/<<J N.9B ' - fjotJ ~ /~d, iRt: PPL '- " m J'T-. {Jonu, ~,. ,5~,. /I /<~ 71. (( ~ '/:k. .3.3-/P ~.bJi. 4 </:.5'-- ae~ ~5-3 &sh &. <iL ..32/7 (jJ:4J. ..3l.f c; {!L.JL ..3 t! ~ f!Ldi. ~ (!}!#- ;;;i f/ I ~* ~ t/~ (le.:il: ...5 '11 U~43t!:L ee""- .,3. C; 3 !!pdt; ..3 '17 (]LdI ~5Z:> f!L~~S0 ~ (}/UUV1 oerhn - i!'-fa5V Plurnb<J?} <iJ /93, 85 ~ /f). I f> rVl IY1 0 (l-S UL 'f'L J/1- ~ ---_.~.._. -- ~ ~ ~;<&7, tJo ;'-h/YLL 5J tA..)M/:S 7ro' . . -JC{l'1 cj _"--~--'-'-----'--"--'-'" .4pr; /4- IY Cbu9cb-lI1#dZ51/lL ~ ~a^ V " / 1'1,. v4s ~ / /,-/, ~s- cf (~, L){) fP lS~ · II :'.11 1/;' 13~.. q / ~q5-:/D 16,5r;) . 13 -.. ~ /Yl(L.reA ~i' 'UJ 3::;7 {!# ~-3 fi t!L~ ~~8 ~~.5'/ (!L~ ~ tj () ]I 1lI'11 .. ~__.~1 Social Security Administration Chambersburg P A District Office \jJ~~ Date: Claim Number: June 17, 2005 174-20-0533AI Name: DOROTHY RUTH HOLTRY GERALD HENRY HERSHEY, FOR DOROTHY RUTH HOLTRY 126 NEILL RD SHIPPENSBURG, PA 17257-9416 You asked us for information from your record. The information that you requested is shown below. If you want anyone else to have this information, you may send them this letter. Other Important Information For the period 01/01/05 to 12/01/05 you received il total o~nSupplemental Security Income benefits. If You Have Any Questions If you have any questions, you maycaU us at 1-800-772-1213, or call your local Social Security office at 717-263-4138. We can answer most questions over the phone. You can also write or visit any Social Security office. Your closest office is located at: SOCIAL SECURITY ADMINISTRATION 50 N THIRD STREET CHAMBERSBURG. P A 17201 If you do call or visit an office, please have this letter with you will help us answer your questions. B' . L . .7U.o 't:.)ULL4L~) es Breen -71 ~ flee Manager COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 l' REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERIT ANCE AND ESTATE TAX OFFICIAL RECEIPT WEIGLE JERRY A 126 E KING STREET SHIPPENSBURG, PA 17257 ____u__ fold ESTATE INFORMATION: SSN: 174-20-0533 FILE NUMBER: 2105-0396 DECEDENT NAME: HOl TRY DOROTHY R DATE OF PAYMENT: 09/23/2005 POSTMARK DATE: 09/23/2005 COUNTY: CUMBERLAND DATE OF DEATH: 04/17/2005 NO. CD 005832 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $3,621.09 I I I I I I I I TOTAL AMOUNT PAID: $3,621,09 REMARKS: CHECK# 4221 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WillS