HomeMy WebLinkAbout12-30-05
REV.1500 EX (6'{)())
REV-1500
FILE NUMBER
21 05
0623
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
INHERITANCE TAX RETURN
RESIDENT DECEDENT
COUNTY CODE YEAR
NUMBER
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DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
Bender, Maria
DATE OF DEATH (MM-DD-YEAR)
06/22/05
SOCIAL SECURITY NUMBER
208-24-1372
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
D 3. Remainder Return (dale of death prior 1012-13-82)
D 5. Federal Estate Tax Return Required
J!..- 8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (Allach Sch 0)
DATE OF BIRTH (MM-DD-YEAR)
06/01/25
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
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IKJ 1. Original Return
D 4. Limited Estate
o 6. Decedent Died Testate (Attach copy of Will)
D 9. Litigation Proceeds Received
D 2. Supplemental Return
D 4a. Future Intenest Compromise (dale of death after 12-12-82)
D 7. Decedent Maintained a Living Trust (Allach copy ofTrusl)
D 10. Spousal Poverty Credit (dale of death between 12-31-91 and 1-1-95)
NAME
Michael A. Scherer, Esquire
FIRM NAME (If Applicable)
O'Brien, Baric & Scherer
TELEPHONE NUMBER
(717) 249-6873
COMPLETE MAILING ADDRESS
19 West South Street
Carlisle, Pennsylvania 17013
75,070.00
0.00
0.00
0.00
44,487.63
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
D 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 & AdminislnBtive 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)
(9)
(10)
9,861.56
, I
(1)
(2)
(3)
(4)
(5)
(6)
(7)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subjectto Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
x.O _ (15)
103,840.26 X.o ~ (16)
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t...;"}
0.00
(8)
11,764.02
13,814.91
(11)
(12)
(13)
129,419.19
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
x .12 (17)
25,578.93
103,840.26
0.00
(14)
103,840.26
18. Amount of Line 14 taxable at collateral rate
.mmm'mm X .15
4,672.81
(18)
(19)
pt.
19. Tax Due
20.~
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Decedent's Complete Address:
STREET ADDRESS
10 Meadowbrook Road
CITYC ,. I
arise
STATE
PA
ZIP
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)
4,672.81
0.00
4,600.00
230.00
3. InteresVPenalty if applicable
D. Interest
E. Penalty
Total Credits (A + B + C ) (2)
4,830.00
TotallnteresVPenalty ( 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)
0.00
157.19
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
(5)
(5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;.......................................................................................... D ~
b. retain the right to designate who shall use the property transferred or its income; ............................................ D ~
c. retain a reversionary interest; or.......................................................................................................................... D ~
d. receive the promise for life of either payments, benefits or care? ...................................................................... D [i]
2. If death occurred after December 12, 1982. did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. D [K]
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?.............. D ~
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ D [K]
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 peljury. 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 representativa is based on all information of which preparer has any knowledge.
,~~2~RN...~_~_.__. ...
1009 East Coover Street, Mechanicsburg, Pennsylvania 17055
......................................______..____m__....._____________.__._ ...............__....m.........................._______..___... m.................___..... ........_._.._....._................. ............................................
SIGNATU PREP ER HER THAN REPRESENTATIVE
DATE
.._.lr2~C?l~(l,r:
DATE
12.1 Z'1/a";-
ADDRESS
19 West South Street, Carlisle, Pennsylvania 17013
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 use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)].
The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum 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 younger at death to or for the use of a natural parent, an adoptive parent,
or a stepparent of the child is 0% [72 P.S. ~9116(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%, except as noted in 72 P.S. ~9116(1.2) [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.
REV-1502 EX+ (6-9.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF
Maria Bender
FILE NUMBER
21-05-0623
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
10 Meadowbrook Road
75,070.00
Carlisle, PA 17013
Decedent's son will retain this real estate
Current total assessed value $75,070.00
TOTAL (Also enter on line 1, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
75,070.00
REV-1508 EX+ (6-98) '*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Maria Bender
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ITEM
NUMBER
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.
2. Supplemental Insurance Rebate
1. Property Tax Rebate-Commonwealth of Pennsylvania
DESCRIPTION
3. Personal Property-Rowe's Auction Proceeds
4. Western-Southern Life Annuity
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
FILE NUMBER
21-05-0623
VALUE AT DATE
OF DEATH
500.00
43.10
1,512.00
42,432.53
44,487.63
REV-1509 EX+ (6-98.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
Maria Bender
FILE NUMBER
21-05-0623
If an asset was made joint within one year of the decedent's date of death, It must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A. Marlin E. Bender, Jr.
1009 East Coover Street
Mechanicsburg, PA 17055
son
B.
C.
JOINTLY-OWNED PROPERTY:
LETTER
ITEM FOR JOINT
NUMBER TENANT
DATE
MADE
JOINT
DESCRIPTION OF PROPERTY
INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR
IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE.
% OF DATE OF DEATH
DATE OF DEATH DECD'S VALUE OF
VALUE OF ASSET INTEREST DECEDENT'S INTEREST
10,671.57 50 5,335.79
9,051.53 50 4,525.77
1.
A.
M & T Bank
r.hAr.kion ;:Irmllot 00 ?671;062462
2
A
M & T Bank
~;lVion~ armllO! no 1!iO04?00976487
TOTAL (Also enter on line 6, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
9,861.56
REV-1511 EX+ (12-99.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Maria Bender
FILE NUMBER
21-05-0623
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
1.
fUNERAL EXPENSES:
Hoffman Roth Funeral Home
8,530.75
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
2,500.00
3. 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
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Register Of Wills 345.00
8. PP & L Electric Utilities 130.24
9. Sprint 2.44
10. Cumberland Law Journal-advertising 180.59
11. The Sentinel-advertising 75.00
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
11,764.02
REV-1512 EX+ (12"()3)
ESTATE OF
Maria Bender
'*'
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
21-05-0623
Report debts Incurred by the decedent prior to death which remained unpaid as of the date of death, Including un reimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
10.
11
2.
PP & L Electric Utilties 60.85
Comcast Cable vision 47.82
North Middleton Authority 3,130.00
Sprint 35.84
Elwood Shughart Excavating 2,140.00
York Waste Disposal 38.52
Middleton Authority 4,900.00
Bankcard Services (VISA) 151.31
Ray Wenger-plumbing 684.00
Robin K. Sollenger 882.82
B & R Masonry-chimney repair 1,743.75
3.
4.
5.
6.
7.
8.
9.
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
13,814.91
REV-1513 EX+ (9-00)
'*
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Maria Bender
NUMBER
I
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
FILE NUMBER
21-05-0623
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
Do Not List Trustee(s) OF ESTATE
Marlin E. Bender, Jr.
son 100.00
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
(If more space is needed, insert additional sheets of the same size)
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THIS IS NOT A TAX BILL
MAZLING DATE: May 10, 2004
Parcel Identifier:
29-19-1653-014.
2004
Market Value
15,300
59,770
75,070
New Assessed Value
(2004 Market x 100%)
15,300
59,770
75,070
District: 29 - NORTH NDlDLBTON TWP
School. .: CARLISLI!: ARZA SD
Location:
10 MEADOWBROOK ROAD
LAND
Old Assessed Value
2000 Marketx 100%)
15,000
55,640
70,640
2004 Clean and Green Valu.
NOT
APPLICABLE
NOT
APPLICABLE
Land
Buildings
TOTAL
TAXABLI!:
Land Size....: .38 acres
Land
Buildings
TOTAL
NOT
APPLICABLE
Property Type: R
Residential Building
Clean and Green values apply to some farm and forest land. Such values
become effective only upon application and approval. All applications must be
received by the Assessment Office by 4:30 p.m. on October 15, 2004. Those
previously approved for Clean and Green do not need to re-apply.
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4.33 .,.,
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GHSbK I-IUMElER
GDC WARRANT 10 ..,
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,~~;J~K/ta.~. . '"" ""j..":':. .,1,?;~::r,.; r';,,>'iJ';~ed~~;~:.:'
'j)rff$,~URG~,PA. U ;i.':.:.; !"n n; ';;'/: '" .., .;q:~~.:1..u';" ~"",q
VER/FICATIONA VAILABLE -"POSITIVE PNf".pR6J'EgED" .'.
PAy~a
ONL~fficTS
07/01/2005
DATE
VOID AFTER180 DAYS
$ ************500.00
~~ ~,Jt.
...- ..---- ._,..-........._-.--_.. .~..
TREASURER OF PENNSYLVANIA
DO NOT ACCEPT WITHOUT HOLDING TO LIGHT TO VERIFY WATERMARKS.
TO THE ORDER OF
MARIA BENDER
DLN 047000286674 REV REBATE
10 MEADOWBROOK RD
CARLISLE PA 17013-8997
I. ..111'1111I1111I.11..11.1..1.1.1..1.1. .1'111...1111111111111
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<I> WESTERN-SOUTHERN LIFE
07-27-05
DEPT.
2500
CONTRACT NUMBERCS) W0020539142
MAIL TO PAYEE
DECEDENT- BENDER MARIA
MARLIN E BENDER JR
1009 E COOVER ST
MECHANICSVILLE PA 17055
THE CLAIM ON THE WESTERN-SOUTHERN LIFE ASSURANCE COMPANY ANNUITY
LISTED ABOVE HAS BEEN APPROVED AND A SETTLEMENT STATEMENT IS PROVIDED
BELOW. PROCEEDS HAVE BEEN PLACED INTO YOUR NEW PREMIER INTEREST-BEARING
ACCOUNT AT' NORTHERNTRUST~ A -PERSONALIZEDWe-LCOME PACKET ,INCeUDING-
YOUR CHECKBOOK, WILL BE DELIVERED TO YOU IN FIVE TO 10 WORKING DAYS.
IF MULTIPLE SETTLEMENTS HAVE BEEN APPROVED, ALL PAYMENTS WILL BE
COMBINED INTO YOUR PREMIER ACCOUNT.
OUR GOAL IS TO SERVE AND ASSIST YOU DURING THIS DIFFICULT TIME. IF
YOU HAVE ANY QUESTIONS ABOUT THE SETTLEMENT AMOUNT LISTED BELOW, CALL
A WESTERN-SOUTHERN LIFE REPRESENTATIVE AT (800) 926-1702 MONDAY
THROUGH THURSDAY, 8:00 A.M. TO 6:00 P.M. EASTERN TIME AND FRIDAY,
8:00 A.M. TO 5:00 P.M. EASTERN TIME.
STATEMENT OF CLAIM SETTLEMENT
THE IRS WILL BE NOTIFIED THAT THE TAXABLE AMOUNT OF THIS
PAYMENT IS $511.28 FOR THE TAX YEAR OF 2005.
AMOUNT OF CONTRACT
$42,188.36
TOTAL PAYABLE THIS CONTRACT
$42,188.36
INTEREST
$244.17
TOTAL DEPOSITED TO PREMIER ACCOUNT
$42,432.53
~
Western-Southern Life
Assurance Company
980
Single Premium Deferred Annuity
. Annual Report .
-. ~ - .. ~
Prepared on 02/14/2005
Owner BENDER MARIA
10 Meadowbrook RD
Carlisle PA 17013-8997
Page 1 of 2
Western-Southern Ute appreciates
your business.
-
..
.
-
-
..
-
-
-
-
Annuitant
Contract Number
Contract Date
Contract Type
BENDER MARIA
W 20539142
02/16/2001
NON-QUALIFIED
* * * INFORMATION ABOUT YOUR CONTRACT * * *
= > Total interest earned during any contract year will be impacted by any withdrawals, including systematic
withdrawals, from the contract dU'ing that year. For example, if you select the systematic withdrawal plan,
the interest you receive wiD be less than the amount indicated by the effective annual interest rate because
interest is being paid out rather than accumulated.
= > Effective December 13, 2004, if a withdrawal or su-render is processed on the day before your Contract
Anniversary, we will deduct the su-render charge that would apply on that Contract Anniversary, if any.
SUMMARY OF ACTIVITY
0211612004 through 0211512005
Beginning Contract Value
plus
Interest Credited*
less
Systematic Withdrawals
Partial Withdrawals
Surrender Charges
Ending Contract Value
SiiTerider Value- .
$ 42,171.29
2,514.34
.00
2,400.00
.00
42,285.63
40;002'.21
PARTIAL WITHDRAWAL ACTIVITY
Transaction Date Description Amount Surrender Charge
03112/2004 Partial Withdrawal $200.00 $.00
04114/2004 Partial Withdrawal $200.00 $.00
0511312004 Partial Withdrawal $200.00 $.00
*. The effective annual interest rate for the contract year indicated above was 6.15% and is 6.30% for the current
year. The Pacesetter guarantees interest rates each year for two 5-year periods. DlI'ing the first 5-year
guarantee period, the interest rate will increase by .15% each year. The initial rate for the second 5-year
guarantee period will be set at the cu-rent market rate at that time and will not be less than 3.00%. The interest
rate will again increase by .15% each year. The minimum guaranteed interest rate in years 11 and later is 3.00%.
** Amomt available after deducting any applicable charges if you cancel your contract.
For further information about your PACESETTER annuity
contract. including interest rates. contact your sales
representative or call Annuity Operations.
ANNUITY OPERATIONS
Western-Southern Life Assurance Company
PO Box 2918
Cincinnati. Ohio 45201-2918
1-800-926-1702
Customer Service Hours:
Mondav - Thursdav. 8 a.m. to 6 p.m.. Eastern Time
~1/27/0p 10:44 .FAX~~~29~5 _H
M AND T BANK RECORDS
141002
499 Mitchell Road
MlIIsboro. DE 19966
Mail code DE.MB-12
Phone: 888-502-4349
Fax: 302-934-2955
I F:! M&TBank I
Fax
To:
Belinda Lawrence
From:
Nancy Clagett
Fax:
717-691-3197
D2t~:
. T"lv?7 ?005
- -~+.1 - , - ..
SuGial nccurity: 208-21 1372
Re:
Estate ot: Mana tienJer
Date of Death: June 22, 2005
Pages: 1
Dear Belinda:
Per your inquiry received June 28, 2005, please be advised that at the time of death, the
above-named decedent had on deposit with this bank the following:
1.
"1'\....-.0. ".(' l\ ~.....n"""+
L.) 1-"'..... ........ .. ~."--'-..'.....' '-~- . -
Cnf'.Cking Account
Ac.count N umbel'
2G760G2462
Ownership (Names at)
Maria Bender, Marlin E Bender Jr *
Opening Date
06/01/68
$10,671.51
L__Q,QQ
Balance on Date of Death
Accnl~d TnterPRt
~..L_1
lULi:l1
$10,671.57
2.
Type 01 ACCOW1L
3d.v.u!!:;~ '/lL..L.UUllL
Account Number
15004200976487
~v~'TIe~h!p {N~~~ 0f)
Maria Bender, Marlin E Bender Jr *
Opening Date
05/06/99
Balance on Date of Death
$9,049.19
Accrued Interest
$
2.34
Toral $9,051.53
* For further account information, regarding ownership, closures and/or reiInbursement of
fund:.;, etc., ple::l0e ~~~-t:"~~'t !h~ B~_!'!,::,~. 0f'Rpor.-n!'n
Tha.'1k Y01.~ f0!' ~'0'-1!" ?....tit"';I'~tpn R~~i~tAnr.e. If you have any questions, please do not hesitate
to call me at 888-502-4349.
Have a great day!
Nancy Clagett (i4 M (y. 1 Daak
North Middleton Authority
240 Clearwater Drive
Carlisle, PA 17013-1100
717-243-8269
email csaoff@pa.net
June 15,2005
Property Owner:
Property Address:
Tax Map Parcel#:
Maria Bender
10 Meadowbrook Road
29-19-1653-014
NOTICE TO CONNECT TO NORTH MIDDLETON AUTHORITY WATER AND SEWER
. SYSTEMS
You are hereby given notice to connect your improved property abutting upon the North Middleton
Authority Water and Sewerage Systems within ninety (90) days of this notice, in accordance with the
Code of Ordinances of North Middleton Township, 2004, Chapter 164, Part I, Article I, Sewer
Connections and in accordance with Chapter 164, Part 2, Article VIII, Water Connections and the Rules
and Regulations of North Middleton Authority.
A connection permit (tapping fee) for water and sewer may be obtained at the North Middleton Authority
Office, 240 Clearwater Drive, Carlisle, PA 17013-1100, Monday through Friday, 8:00 a.m. to 4:00 p.m.;
the phone number is 717-243-8269.
All property owners will be responsible to purchase a water meter package or water meter pit assembly at
the prevailing rate. A typical water meter package is currently $135.00 for a residential property, those
without a basement will need to install a water meter pit assembly in a non-traffic area and the prevailing
rate is $311.00.
For this project the North Middleton Authority is extending an offer to all property owners to finance
these costs over a five-year period, if necessary, due to the fact that both water and sewer were being
extending at the same time.
It is required that you give a twenty-four (24) hour notice prior to the time when connection will be made
so that North Middleton Authority may supervise and inspect the work of connection and oversee any
necessary testing. This notice should be given to the office at the address above during regular working
hours Monday through Friday, excluding Authority holidays.
E. Lee Koch
Authority Manager
North Middleton Authority
NO CONNECTIONS ARE TO BE MADE TO THE WATER OR SEWER SYSTEMS
WITHOUT APPROVAL AND INSPECTION BY NORTH MIDDLETON AUTHORITY
CONNECTION AND TAPPING FEES
FOR
MEADOWBROOK AND NEWVILLE ROAD
AREA 8CID
As approved by Resolution of North Middleton Authority on May 10,2004 Total Connection
Fee for each improved property is $5000.00. The Tapping Fee for each property is based upon
the number of units. The Tapping Fee for a single-family residential property is $2000.00 for
sewer and $1000.00 for water. Multiple use structures such as apartments or mobile home parks
will pay Tapping Fees according to the number of units, apartments or mobile home pads. Each
property connecting to the water system is required to purchase a water meter package sized for
the anticipated use. The cost for a single-family residential meter package is $135.00 for
properties with a full basement, properties built on slab construction will need to purchase a
water meter pit assembly for $311.00. Water meter packages for multiple use structures .will be
priced at the prevailing cost to the Authority.. .
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According to our records the Connection Fee and Tapping Fees for your property at
10 Meadowbrook Road
Carlisle, P A 17013
CONNECTION FEE:
TAPPING FEE SEWER:
TAPPING FEE WATER:
WATERMETERPKG*
TOTAL FEES
$5000.00
$2000.00
$1000.00
$ 135.00
$8135.00
*Subject to confirmation that a standard water meter package is suitable.
8~A ~6UJ~
PROPOSAL
PROPOSAL NO.
SHEET NO.
PROPOSAL SUBMITTED TO:
NAME
CITY, STATE
WORK TO BE PERFORMED AT:
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DATE OF PLANS
ARCHITECT
We hereby propose to furnish the materials and perform the labor necessary for the completion of
'-
Any a.lterati01l 01 deviation from above specifications involving extra costs
will be executed only upon written order, and will become an extra charge
over and abo'fe the estimate All agreements contingent L:por; strikes
accidents. or delays beyond our control
All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and
specifications submitted for above work and completed in a substantial workmanlike manner for the sum of:
Dollars ($ ~ 7~3 4' 75-
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Respectfully submitted .i.#~/ //?V'-r
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Per./I .
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pa,cl II?
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with payments to be as follows
Note - This proposal may be withdrawn by us if not accepted within__days.
ACCEPTANCE OF PROPOSAL
The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the 'Nork as specified. Payments will
be made as outlined above.
SIGNATURE
DATE
SIGNATURE
a" adams 9450
-
MARIA BENDER
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LAST WILL AND TESTAMENT
OF
I, Maria Bender of Cumberland County, Pennsylvania, being of sound
mind, memory and understanding, do hereby make, publish and declare this as and for
my Last Will and Testament, hereby revoking all other wills and codicils heretofore
made by me.
FIRST
I direct the payment of my debts and the expenses of my last illness and
, funeral from my estate as soon after my death as conveniently may be done. If there
ii be no cemetery lot available for my interment, owned by me at the time of my death, I
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I authorize my personal representative to purchase such cemetery lot with a contract for
perpetual care, using therefor funds from my estate, and I authorize my personal
representative to cause title to or ownership of such lot so purchased to be vested in
such person as my personal representative shall designate.
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Further, in this connection, I authorize my personal representative to
expend funds from my estate, in such amount as my personal representative shall
consider necessary and desirable, for the purchase, erection and inscription of a
suitable marker for my grave.
SECOND
I give, devise and bequeath my entire estate of whatever nature and
wherever situate to my son, Marlin E. Bender, Jr., if he shall survive me by thirty (30)
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days. In the event my son, Marlin E. Bender, Jr. predeceases me or fails to survive me
by thirty (30) days, then I give, devise and bequeath my entire estate to my daughter-
in-law, Vicki L. Bender. In the event my daughter-in-law, Vicki L. Bender predeceases
me or fails to survive me by thirty (30) days, then I give, devise and bequeath my entire
estate to my step grandson, Ryan A. Walker.
THIRD
I direct that no trustee, executor, guardian or other fiduciary named,
nominated, or appointed by this my Last Will and Testament shall be required to post
any bond or give any security of any type for any purpose whatsoever, any law or rule
of the court of the Commonwealth of Pennsylvania or any other jurisdiction to the
contrary notwithstanding. I direct that the law of the Commonwealth of Pennsylvania
shall apply to any interpretation or application of the validity of this instrument.
FOURTH
Any and all payment or payments of any sum or sums, whether in cash or
in kind and whether for principal or income, payable to an heir, or any of them, shall be
made upon the sole receipt of the respective individual to whom the payment is made,
and free from anticipation, alienation, assignment, attachment, and pledge, and free
from control by the creditors of any such beneficiary.
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I appoint my son, Marlin E. Bender, Jr., Executor of this my Last Will and
Testament. Should my said Executor fail to survive me or for any reason fail to qualify
as Executor, then I appoint my daughter-in-law, Vicki L. Bender, Executrix of this my
Last Will and Testament.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this,
my Last Will and Testament, consisting of three (3) typewritten pages, the first two (2)
of which bear my signature in the margin for the purpose of identification, this 2nd day
of August, 1999.
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~~f;L. BJZ-u~
Maria Bender
(SEAL)
Signed, sealed, published and declared by the above named testatrix,
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Maria Bender, as and for her Last Will and Testament, in the presence of us, who, at
her request, in her sight and presence, and in the sight and presence of each other,
have hereunto subscribed our names as witnesses.
/~d ADDRESS 2"0 Fc-..f\Ji....,.l JI-. u.rI,J~. 14
Ctm:tJ\dJc ?11 ~v'tt/l
ADDREss517 N t,Ccr./na! '5;{-. flU. tiDily Sfr. PA j 70 u~
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COUNTY OF CUMBERLAND
.
We, Maria Bender, 4{,J,,~ I ,4. ~~ and~ ~
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COMMONWEALTH OF PENNSYLVANIA---:---
: 55.
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II the testatrix and the witnesses, respectively, whose names are signed to the attached
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or foregoing instrument, being first duly sworn, do hereby declare to the undersigned
authority that the testatrix signed and executed the instrument of her Last Will and
Testament, and that she signed willingly and that she executed as her free and
voluntary act for the purposes therein expressed, and that each of the witnesses, in the
presence and hearing of the testatrix, signed the Will as witnesses, and that to the best
of their knowledge, the testatrix was at the time eighteen (18) years of age or older, of
sound mind and under no constraint or undue influence.
Sworn to and subscribed before me this 2nd day of August, 1999.
Notarial Seal P bl'
I n Notary u Ie
Jenn}ter SSO' Ca aC~~bet1and County
CarlISle roo . No 29 199q
My Commission ExpIres " . -
Member. pennsylvania /'I!;sociatiol1 01 NcMP"C
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