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Home My WebLink About03-07-06 -.J 15[]5b[]51047 REV-1500 EX (06-05) PA Department of Revenue *' Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY County Code Year 1 J ~ ~ File Number ~~'b Date of Birth 3/ /2.:2 705"G tJb J /);).() () ~ O?;03l'lZL1 Decedent's Last Name Suffix Decedent's First Name MI ~~HReJN~R 8~R8Af<A~ (s- (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW _ 1. Original Return c::> 2. Supplemental Return c::> 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required c::> c::> 4a. Future Interest Compromise (date of death after 12-12-82) c::> 7. Decedent Maintained a Living Trust (Attach Copy of Trust) c::> 10. Spousal Poverty Credit (date of death c::> 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received JL 8. Total Number of Safe Deposit Boxes 4. Limited Estate c::> - c::> ~l<tJNK J' ~CftRE-JWER. 7J1q3~e3e9 Firm Name (If Applicable) REGISTER OF WILLS USE 9-~,L Y C:'-', First line of address ~e ~ 816- ~Pr<llt/tr RolJP " j .-.J Second line of address (..'; ... :....,.~ NE~tJ C l) roB E-~ ~ IfN f) PA 1()7D DATE;FILED t, .:') c.) I....[) City or Post Office State ZIP Code Correspondent's e-mail address: Under penalties of perjury, I declare that I have examined this retum, induding accompanying schedules and statements, and to the best of my knowledge and belief, it is true. correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE F..,f>>, SON PO F. R FILING RETURN ~ /Yt'N ?bh~~~~/V~ r ADDRESS Wt 8/ ~/,J(I/V'fr T?1J, SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051047 15056051047 --I --.J 15[]56[]52[]48 REV-1500 EX Decedent's Name: 81l~8fi;(,4 {r, 7t./rIl<.clN 8/<. RECAPITULATION 1. Real estate (Schedule A). ............................................ 1. 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . .. 3. 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5. 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested.. . . . . .. 7. 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8. 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . .. 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . . . . . 10. 11. Total Deductions (total Lines 9 & 10).. . . .. . ..... .. ... .. .... ..... ... ... . 11. 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . . . 14. TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0_ . 16. Amount of Line 14.t~ble ~ '!1 11) ~ ". '1 J at lineal rate X.O '-'- ;J:J ~:J I- .;I 17. Amount of Line 14 taxable at sibling rate X .12 . 18. Amount of Line 14 taxable at collateral rate X. 15 . 15. 16. 17. 18. 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15[]56052048 Decedent's Social Security Number 3 / J 22 1 f) 66' t '3 h 8 15'.0 0 3781.tf~ 0.0 0 o.()O J 8 q q ;; e '. 5 7 D . ~ () q1J~9.fr 3 1 1/ 7 3 Lj'. b '8 I 6 b 6 3. 't :J. ~ ~ '2 g. ~ ? ~ ~ e e ~. 3 ,. 3 3 7 B ~ z. 3 } t . 0 f) 3 3 1 e G' 7.. 3 J . 1~2.e~.5?; . . I ~ '2. () ~. ~3 1505b052048 ---' ~~ .. REV-1500 EX Page 3 Decedent's Complete Address: File Number 2/ ~ ~ 5~ t) ~~~ DECEDENT'S NAME f3 f1 j( ~A 1<1/ G, f;e II /( c / f\/ &1<. STREET ADDRESS (3').1 OAJ< t'VAL- CITY f}1t.CN/lN/~S StJ Rt,. I STATE 'PA I ZIP 17{)G~ Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits ( A + B + C ) (2) -- (3) --- (4) (5) 15; ZD3, ~:3 (5A) - (5B) 16; ').03, ~3 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. )~ 20 3j 53 A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. 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 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? ...................................................................... 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. D 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? ........................................................................................................................ ~ No ~ 3 ~ ~ r& D IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the u~e of the surviving spouse is three (3) percent [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 use of the surviving spouse is zero (0) percent [72 P.S. 99116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child 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 zero (0) percent [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 four and one-half (4.5) percent, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. 99116( 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 bv blood or adoption. ,1 LAST WILL AIm TESTAMENT OF BARBARA G. SCHREIBER. (~ ':::,..-:;0 .~. ~~ .-J""; , ~~:: c~ -;-.....~ t~._. Ii ....-- BE IT REMEMBERED, THAT I, BARBARA G. SCHREINER, :r~siding in the:'B~~~ugh=) of Harveys Lake, County of Luzerne, and State of Pennsylvania, being ofsoiin.d.: and disposing mind, memory and understanding, do make, publish and declare the C} following as my Last Will and Testament, hereby revoking and making null and void any and all Wills and Testaments or writing in the nature thereof by me at any time heretofore made. FIRST: I direct that all my just debts and funeral expenses be paid as promptly as possible. SECOND: (a) I give and bequeath the sum of Five Thousand ($5,000.00) Dollars to each of my children, CARL J. SCHREINER, III, and FRANK J. SCHREIBER. (b) I give and bequeath the sum of One Thousand ($1,000.00) Dollars to each of my grandchildren, MELANIE SCHREINER, WILLIAH SCHREINER, BRIAN SCHREINER, and CBRISTIBA SCHREINER. THIRD: I give, devise and bequeath all the rest, residue and remainder of my property and estate, both real and personal, of whatsoever kind and whereso- ever situated, of which I shall die seized or possessed, or of which I shall be entitled to dispose of at the time of my death to my husband, CARL J. SCBBEIHKR. FOURTH: In the event of the simultaneous death of my husband and myself~ or in the event of the prior death of my husband, I give, devise and bequeath all the rest, residue and remainder of my property and estate, of whatsoever kind and wheresoever situated, of which I shall die seized or possessed, or which I shall be entitled to dispose of at the time of my death to my two (2) sons, CARL J. SCHREINER, III, and FRANK J. SCHREINER, in equal shares, per stirpes. FIFTH: I do herebY ~rplp.oint my husband, CARL J. SCHREINER, as the E f If ~,y ~ll~~and shall fail to qualify, or ceases to act xecutor 0 my estate. ~ as Executor, or fails to sorv~~~:me, I do hereby appoint my son, FRANK J. SCHREINER, as the Executor of lIllY" .estate. SIXTH: I hereby dirre.c:l that: no Executor or Administrator shall be required to give any'bond, ~nm t~at if, notwithstanding this direction, any bond is required by any law., st3tute: o-t: rule of Court, no sureties shall be required thereon. IN WITNESS WHEREOF, I, ~6ARRA1M G. SCHREINER, the Testatrix, have to this my Will, written on t~O ((:2:) ;sbeets of paper, set my hand and seal this 7l- ""'0/ day of October, 1999- ,'J -' d~ ;(...,.:j ,') ,~:,," , / ...~ ./ /I b/.f'#~~~ .. ".j "L~~/~ (SEAL) BARBARA G. SCHREIBER Signed, Sealed, publl.is:lited and Declared by BARBARA G. SCBREnmR., the above. named Testatrix, as and fO'1 ber Last Will and Testament, in the presence of us, who at her request are here lPtr'esent, all being present at the same time, have hereto subscribed our names as writnesses. '/'/:'/""',' c.'' ~" ~~ U n_~. ". ~:L--, residing a~a.I.-L1:~ L ,a I /7) /,r. /) /c Ii ( 'Y~! / , /LY~Fl J" A. C BEN residing at ~ ' _. /~ h ,?i;C&Ui-k<-_- '. V 0- f. I ACKNOWLEDGMENT OF TESTATRIX COMMONWEALTH OF PENNSYLVANIA S8: COUNTY OF LUZERNE I, BARBARA G. SCHREINER, the Testatrix whose name is signed to the foregoing instrument, having been duly qualified and sworn according to law, do hereby acknowledge that I signed and executed such instrument as my Last Will and Testament; that I signed it willingly and that I singed it as my free and voluntary act for the purposes therein expressed. / / /:>' Ii. ~</ ;c , ",1-t,'~L' _4;,,6//~ , v BARBARA G. SCHREINER Sworn or affirmed to and acknowledged before me by BARBARA G. SCHREINER, the Testatrix, this /4EL day of October, 1999. ,-------- .(; ..c/L: ,~ ,,-.-J ! I . .f D 0... "Yt.jei;"~ NOTARIAL SEAL TERESA DAt~KO, NOTARY PUBLIC WilKES-BARRE, LUZERNE COUNTY. PA. My CommIision Expires January 27.2001 AFFIDAVIT OF WITNESSES ()F PENNSYLVANIA ss: O:r.' TI.JUlZERNE JEROME L. CODER and CLAIRE A. COHEN 1], Te . whose names are signed to the foregoing instrument, being duly I sworn according to law, do depose and say that we were present and J;'B~ C. SCHREIBER, the Testatrix, sign and, execute such instrument as and for hei ~t ~ill and Testament; that BARBARA G. SCHREINER signed willingly and that ~ tG. S{]lRK[NIR executed it as her free and voluntary act for the purposes there!P ~~cessed; and each of us in t~e hearing and sight of BARBARA G. SCHREINER, the Te5t,Ci.tIrilx., signed the Will as witnesses, and that to the best of our knowledg e:I cae restatrix was at the time eighteen (18) or more years of age, of sound mi~~ a~d under no constraint or undue influence. ~~k~ L. OllEN ? (; /l/J .afet~ /{, C4~ , CLAIRE A. COHEN Sworn Qr mff~rmed "to and ackri.o~l~e"d before me, by JERO~ I... COlIER and ~ ~ ,L..' C>>lIER , this ~ tdair ()f October, 1999. ~_/---- / 1'/ l' ~.~ -- 1:1 /..JI1~11_.A:-<;- .NOTARIAl SEAL lJllfE$fl 011"0., NOTARY PUBUC ~1l.JflS-lAIIRE, lUZERNE COUNTY, PA. tfly c.....onExpires January 27, 2001 -- . . REGISTER OF WILLS CUMBERLAND County, Pennsylvania CERTIFICATE OF GRANT OF LETTERS No. 2005-00556 FA No. 21-05-0556 Estate Of: BARBARA G SCHREINER (First, Middle. Last) Late Of: UPPER ALLEN TOWNSHIP CUMBERLAND COUNTY Deceased Social Securi ty No: 311-22-7055 WHEREAS, on the 20th day of June 2005 an instrument dated October 14th 1999 was admitted to probate as the last will of BARBARA G SCHREINER (First. Middle, Last) late of UPPER ALLEN TOWNSHIP, CUMBERLAND County, who died on the lOth day of June 2005 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, GLENDA FARNER STRASBAUGH , Register of wills in and for CUMBERLAND County, in the Commonwealth of pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to: FRANK J SCHREINER who has duly qualified as EXECUTOR(RIX) and has agreed to administer the estate according to law, all of which fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYL VANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 20th day of June 2005. ~M-O\"-~OJv~ ~ Register of Wills ( ~b% (~~ Deputy REV.1502 EX+ (6-98* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ~RT ESTATE OF Barbara G. Schreiner FilE NUMBER 21-05-0556 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 1 Hillside Ave., Harvey's Lake, PA Luzeme County Harvey's Lake Borough VALUE AT DATE OF DEATH 96,625.00 Located at the comer of Hillside Ave. and Ridge Ave. Lot size .39 acres Closed on July 8, 2005 2. 2 Hillside Ave., Harvey's Lake, PA Luzeme County Harvey's Lake Borough 40,250.00 Located adjacent to 1 Hillside Ave. Lot size .19 acres Closed on June 30, 2005 TOTAL (Also enter on line 1, Recapitulation) $ 136,875.00 , 1 (:/)f1 t<t c(J!/J IJI1' ; ~celslor . Inc.. PublIsher N.Y 10013 www.blumberg.com I ~ T88 HUD-I. Setllemenl. substitute 1099 Seller Slalement. 9-88 ~ Page 2 on Back. OMS NO. 2502'()265 HUD-1 RESPA. HB 4305.2 I. Settlement Statement U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT .. Type of loan 6. File number 7. Loan number 8. Mortgage........ce case number . 0 FHA 2. 0 FmHA 3. 0 Cony. Unins. .0 VA 5.0 Cony. Ins. ~. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(p.o.c.)"were paid outside the closing; they are shown here for informational purposes and are not included in totals. - . I. Name and address of borrower: JOSEPH M. RYAN AND ELSIE H. RYAN, HUSBAND & WIFE . Name and address of seller: ESTATE OF BARBARA G. SCHREINER, DECEASED . Name and address of lender: N/A i. Property location: 1 HILLSIDE AVENUE, HARVEY'S LAKE, PA.18618 I. Settlement agent: Place of settlement Settlement date: CONTINENTAL ABSTRACT 480 PIERCE STREET, KINGSTON,PA. 18704 JULY 8,2005 J. SUMMARY OF BORROWER~ TRANSACflON 100. GROSS AMOUNT DUE FROM BORROWER: 01. Contract sales rice 02. Persortal ro art 03. Settlement char as to borrower line 1400 04. 05. K. SUMMARY OF SELLER'S TRANSACfION 400. GROSS AMOUNT DUE TO SELLER: 401. Contract sales rice 100 , 000 . 00 402. Personal 403. 404. 405. Adjustments/or items paid by seller in advance 181.66 20. GROSS AMOUNT DUE FROM BORROWER ,102,349.68 420. GROSS AMOUNT DUE TO SELLER 100,250.93 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER- 01. Oeoosit or earnest money =>,uuu.uu 501. Excess deoosit (see instructions) 02. Princioal amount of new loan(s) 502. Settlement ct1araes to seller (line 1400 J 9,625.0 03. Existina loan is) taken subiect to 503_ Existina loanls) taken subiect to 04. 504. Payoff of first mortaaae loan 05. 505. Payoff of second mortaaae loan 06. 506. DeDosit or earnest monev 07. 507. 08. 508. 09. 509. Adjustmentsfor items unpaid by seller: Adjustments for items unpaid by seller: 10. Cv/Tn Tx to 510. CylTn Tx to ~1. Co Tx to 511.. Co Tx - to .---......... 12. Assess. to 512. Assess. to 13. 513. -.(1 04. 504. Payoff of frs: mortqaQe 'can is. , I 505. Payoff of second mortaaae loan 06. 506. Deoosit or earnest money 07. 507. 08. 508. 09. 509. Adjustments for items unpaid by seller: Adjustments for items unpaid by seller: 10. CvlTn Tx to 510. CvlTn Tx to 11. CoTx - to ._--~._,,-_. 511. Co Tx ----. to ,-..-- .. _.no . ...._-_.. - .._. - 12. Assess. to 512. Assess. to 13. 513. 14. 514. f 20. TOTAL PAID BY/FOR BORROWER 5,000.00 515. 516. 517. 518. 519. 520. TOTAL REDUCTION AMOUNT DUE SELLER I 9. 625 · 00 15. 16. 17. 18. 19. 300. CASH AT SETTLEMENT FROMITO BORROWER . . )3. CASH ~ FROM) (0 TO) BORROWER 97,349.68 603. CASH ctJ TO) (0 FROM) SELLER, 90,625.93 lBSTlTUTE FORM 1099 SELLER STATEMENT: The information contained in Blocks E, G. H. aud I and on line 401 (~r. if line 401 is asterisked, lines 403 and 404) is important tax information ad is beirag 'Dished to the Iotemal Revenue Service. U you are required to file a return, 8 negligence penalty or other sanction will be imposed on you if this item is required to be reported and the IRS deIermiDes thai a has t been reported. lLER INSTRUCTIONS: U this real estate was your principal residence. file Form 2119. Sale or Exchange of Principal Residence, (or any gain, with your income tax return; (or other transactions, complete the plicable parts of F0I1Il4797. Form 6252 and/or Sc:heduIe D (form UMO). IU are required by law 10 provide the Seulement Agent (named in Block H) with your coned taxpayer identification number. If you do not provide the SettIemeat Agent with your coned taxpayer ~diIi. -lion mhPr. vnu mAY he mbiect to civil or crimitud oenaIties imoosed bv law. Under oenabies of oeriurv. I certify that the number shown on lbia IlatemeDl is my corred lamaver iden1ili~tinn numJ-. .- .a Page 2 T88, p. 2, Julius Blumberg. Inc.. NYC 10013 L. SEITLEMENT CHARGES 700. TOTAL SALESIBROKER'S COMMISSION based on Division of conuni$sion PAIl FBOII PAID fROM price $ . @ %= (line 7(0) as follows: ......-s SELLER'S 701. $ to FUIOS AT FUNDS AT SffilEMBlT SETTlEMENT 702. $ to 703. Commission oaid at Settlement GARRITY REALTY 2,500.1)0 704. 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan oriaination fee % 802. Loan discount % 803. Aooraisal fee . . to 804. Credit reoort to 805. Lender's insoection fee 806. Mortaaae insurance aoolication fee to 807. Assumotion fee , 808. 809. 810. -, 811. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest from to (ii)$ Idav 902. Mortaaae insurance oremium for months to 903. Hazard insurance oremium for vears to i 904. \ vears to 905. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard insurance months (ii) $ per month 1002. Mortaaae insurance months CO> $ oer month 1003. Citv. orODertv taxes months (ii) $ per month 1004. Countv orooertv taxes months (ii) $ oar month 1005. Annual assessments months (Q) $ per month 1006. months (ii) $ oar month 1007. months (ii) $ per month 1008. months (i:i) $ oer month 1100. TITLE CHARGES 1101. Settlement or closina fee to 1102. Abstract or title search to 1103. Title examination to 1104. Title insurance binder to 1105. Document oreoaration to ATTV ,1":"'( 1M": T. _ I -IIH..:N 125.00 1106. Nolarv fees to 1107. Attomev's fees to (includes above items numbers; ) 1108. Title insurance to -~ ~I\I.I' . .T. -- ,,..... RI;'l "7~ (includes above items numbers; J 1109. Lender's coveraae $ 1110. Owner's coveraoe $ lnn nnn nn . 1111. 1112. ENDORSEMENTS: 100, 300, 8.1 l.~U.UU 1113. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recordina fees: Deed S 50.00 . Mortaaae $ . Releases $ 50.00 1202. Citv/countv tax/stamos: Deed $ 1,000.00 : Mortaaae $ T,OOO.OO 1,000.00 1,OOO.OU. 1203. State tax/stamos: DeedS . Mortoaae $ 1204. CERTIFIED TAXSEARCH 15.00 1205. PIN CERTIFICATION 10.00 1300. ADDITIONAL SETTLEMENT CHARGES 130'. Survev to - 1 ~n? P~c:t inc:n~,.tinn tn includes above items numbers; 08. Title insurance to incl~des above ilems numbers; 09. Lender's covera e 10. Owner's covera e 11. 12. ENOORSEMENTS: 13. 15. 10.00 : '01. Survey to - '02. Pest inspection to '03. ESTATE ESCROW 6,000.00- 104. 105. '06. ~OO. TOTAL SETTLEMENT CHARGES (enter on lines 103, Seclion J and 502. Section K) 2,098.75 9.625.00 I have carefully reviewed the HUD-I Settlement Statement and to the.best of my knowledge and belief, it is a true and accurate ltement of all receipt nd disb e my account or by me in this transaction. I further certify that I have received a copy of eHUD-ISettlement t ~.~. _ J~ Borrower: Seller: ~ ' ~~_ . The HUD-I use the funds to be Settlement Age which 1 have prepared is a true and accurate account of this transaction. I have caused or will n t tement. ) . J Date O'7/oT/OS- / , nited States on this or any other similar form. Penalties upon conviction can include a fine and ection 10 I O. ~ . . ~ SEP.21..2~85 2:1SPf'1 1"0.916 P.2/3 u..a.~OF~.ANO~~ A. MUD-1 UNIFORM SETTLEMEJrr STATEMENT of l.oIIn 1.[] FHA 2.( ) FmHA 3.[ ] Conv. Unins. It File Number: 7. t..oa, Number: a. t.1wtgaae If's&lranctJ C.a~ NumD8l': 4.( ] VA 5.[ 1 Co"",. In$. 121.74S C. NOTE: Tt1is fann fuml&tis& ~ statement of setttement C::tstS. Amounta iJaic to and by the s8tt8lT'em I\,:ent 1fto shaWl'l. ~tems ."artcBd ''1p 0 0 )- were patd outside ~ doling; ti'l~ ere ShoWn ~r ln1a~al purpoSRS &nd ere r.ot inoludfld If' the tot.ls. . . D: Name & AcdrllSs of Bonower. E. Name. Aadress & TIN of astler. F. Name & Address of Lender: John G. Frzsnk end Helen M. Ff1U'\1<. Barbara G. SCI'1rein8r, W1cJow, ~ N/A RO #1, Box 337~ her AgWtt, Fran'< J. SChrtlner H~ 1..3~, PA 1Ba13 . G. P!'oMI"l'J Loccr.iol1: TI N cf Seller. I H. Settlement Agerrr. 2 HIllside Ave P:ace of Settlement H.rveY3 LAke, PA 18618 23 Wast Walnut strBet FllInk J, ~ ~qulrB KirlQston. PA 18704 I. Settlement D~ta .ll1n SO. 2D05 J. SummM'Y of BorMWer"S Transaction 100 Gross Amount DlIO frCm Sorroww' K. Summary of Seller's T...~ 400. Grc~c Amount Due to Setler: 101. Contract sales PriCII 43.000. :0 401. Conl:rIc:t s.lC!S orlce 43,000.00 101 Personal oroperty 402. PSl'lanal tJrooettY 103. aorrcwer's settlfiWT1ent cI1urQe5 (line 1400) 1,041.75 403. 104. 404. 'OS. 405. Adiustment& for Item.. Daid bY leller In advance Adtutme" for items paid bv seller in .Q~nce , 08. cttvllown taxes to 408. ntMown taxes to 101. County taxa !l30105 to 12JS1/05 1 ~5. 72 407. Co:mlv tzw= SI3QI06 to 12131105 136 72- 108. a.rtiIQli 7/1106 to 12mll05 5'.2. SO 408. Gel'ba.:it 711105 to 12131106 92.50 109. to 409. to 110. 410. 111. 411. '12. 41'2. ~ 13. 413. 120. Gr088 Amou nt Due fr4M Borrower "~.245.97 420. Brass Amount Due to Seller ~, 191t22 %00. Amounb Paid by Olin Bebalf of 8Q1'rower: !iOO. Reductio.. in .4.mount Due to Sellar: 2~1. C8Eloslts Qr earnest money 1,500.00 50,. &cess deDosit (see Instructionli) 1.500.00 202. Princloal *mOl4nt of tltlW loan(.) 5C2. SatrlSI'JIQnt ch3raes to sellar (lins 1400\ '.433.50 203. Existing loan(sll8ken aUbjac; to IS03. edstlnG taanfs' taken sublect to 204. 304. PevaIY of firit mormBae 205. l50d Payoff of aec;:onc mortgegG 208. D. 201. 507. 2D8. 508. 209. 509. Adlunmcnb for ltemll ..,Deid by "Uer Adlustmentl for iwm- ltllt'~ tw eel", 210. c1tvJtawn 1aes ~o S10, CItVItOWn teMS to 2' f. County t~ to 5"11. COlJlltv tlllXee to 2,~. .c\AaM!merr.a to 612. AsG...rr<<Jts to ~13. to 513 to 214, 514. 215. I 51&. :e16. S1S 217. !17. EKrcw Inlleritlnca Tet g.SCCl~O 2~a. 518. 2~S. 51i. 220. Tota' Paid Bvlfor aorrower ,1.500.00 520. TaUIi ReductIon Amount !)ue Seller 8.04aa.50 300. c..... Ii: Settlement Fromlttt Borrower GOO. C..-h III settlement ToIrrom SeQer :30,. Groll. .~0u11t due from bQr,"O\AIer lltn. 1:20' I" .44. 245. Q] 80'! . GrtJ" Q.,.,cunt due to seils'lllns 420) 43 19B.2Z 302. Lea amounts oald bvJfor borrower (I'''' 220) I , 500.00 602. LM& reductions in lmourt Que seI16f (line 520l l!433.50 303. ClMh . from Oto BomMer I 42, 145.97 803. cash .to DftDrn Seller 36.7e472 SlIbatItutB Ferm 10Q9 Sc:tler 9tatemeRt :'he information in BIo.:ka e, G, H, I & line 401 (Of, if line 4C1 is a6terI6~,lInB4J3 iind4G4) Is impcrtanl t1uC ~nf:rmation and Is betr1Q fumishea ~o the Intarnal Revenue Service. If yo~ are required to 1I1~ a return. a unCIa" will be impasee O~ you If this item is required to be "'PO~ Ql1d t.'~e tRS (fetetmlnes tn. It :ulS not eeen repor:8d. If tnil filiI estate Ii 10Llr principlll rMlderu:a, 1118 Form 211 a, acto or E~ of Prinoq./ ~lts/dttnctJ. for any gaIn, with your Income tax mum; far othw transaetlans. complete the applICable pans of FolTJ'I 4787, For~ 82fS2 andler Schedllle 0 (Fonn 100\0). You ~re fBqtJlred to prcvide the 6ettIementAgent (namec! aboVe) with yo~~ currect ta~ayer IdGnlJflcatlDn numb." If you do not ~rfMd8 thll Settlement Agent with your taxpayer ldl!fttltClltion numb.. you may be subject ~ dvll ar crimina! pentttfeS Imposed by 'aw. UnlMt penetl' perjUry, l certify tl1et the numb. ~l'lQwr. on tttls stammefTt II my caITec:r taxpaYilf ldentlftcatlon r: 'Jmber. (Seller} (Seltef) o~~ TIlQtplflll'nl'-' ~ ... . ,.. ~ SEP.2~.2005 3:15~~ 1'.0. '316 P. :;"'3 . 700. TotiI SaIBlBro..... CDrnmIs"on: (baRd an 43.000.00 @ 5.00 'MI 'P-ald from Paic From Olvlslon at Commlesion I!ine 7001 fiB follows; 3orroWs ~118~ 701. S2 150.00 Funds at FUl'lds at - ... Settlement 702. 703. Commission caid at s.ttIement - G...rItv R_t Estateleo S1...:s;:.r ~ '~~lt 660.00 704 . 800. hltm. Pavable In ConnectJon with lJ:)An tW1 Loan Opaiution Fee 802. Leen OIsccunt 803. Aooralcal Fee 604. Credit Reaort 806. Lender'slnSD9ction Fse aoe. Mcrtcttt.ze lnauran~ Acoll~~n ~ee B07. aoa. ace. i10. B11 812- 813 814. goo. Items Reauired -bv lender m Be Paid In Adv.nee 90 1. I ntlW!tst from to es ~.r da'll 902. Utllttlane Insurance -Premium ~or . 803. Haz3/'d inl!lUti'!ln I. 904. SOS. 1000. ReHrws DeDOIited With LAnder 1001. Hazard i~urance months S !W' ".onlh 1 002. Mcrtaaoe Insurance mOMM !b 0" mont!'! 'loin. taxes months S t1I!I montl'l 1004 County otOoertv t8Xt!!!l!! montt'1e S Mf mcntll I 1005. Annual aSS8IIsmenb months S Mt month 1flM. ......... ......., C D<< month 1007. 100B. 1000. A. .---" a...._, ....., r- ,a,.;ilu:stment 1100. 11tIe Charaas 11 Q1. Settlernentlcloslno fI!e 50.00 1 ~ 02. Ab:rtnlctftitltt ..rell t1 03. T'atie t!Xaft"lil1ation 1104. nu.lnlur.ance bincf8r {1n.. en 1106. 11 01. Attom8Y'8 f881i: Jarome L... CohBn ESQIJlre 325.00 IlM1udes numbers 1108. TItle In&Uf3Roe: FranK'; ~ Esouire ~14.~ (lnciudes .bow Itwr. numbllni - 11 OS. Lander'll lSOVenHle 1110. OM1n CO\Ier.tge 11 '! 1. -1112 11 't~. 4~ ~""Ina 3nd Transfer Ch=raes I 1201. Rec::ordlrd l1iIN.IId t41. 60 Mortaa09 ~elfiil~e , ~.50 120? Ci' I ~ ~nttn"ae 430 nn 120~. Sb!te tn/stamlls: 0eeC i\4ortasae 430,00 1204. ?ower cf AttcmllV 2 !1. !:O 1205. PIN Cartificatian 10.00 1~ I 1300. Additional Settlel1Mnt Ch81'aM 1301.SuNe\' 1302.' p:1Mt InsMd.~n 1303. '304. 1305. 1301!.. 1307. 13011. 1<U)Q. Total SeftlameM C"8I'CIMl'l"hi. Number Tr.Hfere to LiMe 1. a 102 AbCM:\ 1.047.76 14U.60 CERTIFICATION i ""\Hi ~r.NUy f"WitwliPd the HUD-1 ~.~.m S'latllfl"lerW and to ttt. ~ of my at all recefpts nd dll;bLlrsernent'B rI'lSde an tft'l__CiIOunt or by mA In mIl; n ~~o . I 1 SAttla Selier 9Q1TOMr aorroower Helen Y. FNtllC atemem lo""i:::h '1 have orecared :s true and aCCUf2!8 accour! of the funds which were a uf\derslQf\ed as part t:f tI'\~ ~ilent at thl~ ~re...s.adlor. . StItt,..",rt Agent Jtme 30.2005 Date sq'Jire ... e.... ~ lIS 1M l.:nUll Sla1lB on l1li.. or Arw altI8r 1Ii1Jlll1IT fbrm. p.;.Il.- upon COIl\I!ct1clll CIII'I IN:lqu .. nn. -.a ~~. P.lr 100, and $edlon 10'0. C:mnalll nJIIPCr.'CI'lN.a:m 10(13 ... REV-1503 EX+ (6-98* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS F~TATF OF ~RT Barbara G. Schreiner FILE NUMBER 21-05-0556 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION US Savings Bonds - Series E cashed in on June 28,2005 VALUE AT DATE OF DEATH 3152.16 2. PNC Investments Federated equity Acet. #16297795 Tricia Tompkins -consult. 717-691-4014 629.26 TOTAL (Also enter on line 2, Recapitulation) $ 3,781.42 ~~ .~. -- ,r:;:. - ,ft - VI . · ~i z~ ... 0 0 ~ ~! r2~ ... _ 5 t:' ~~ ~~ l~O ,-s. .. ft ~, ~a ~ ;~ ~ ~: (\ . ;;,..... \l\i g"h;;'i-o ~ -3""g ~ ~ a~~~~ ~~t~i ~:;l:.cI'd~ ~~~~i S~~;, ~o..~~-;' ';l~;,;;i fl~1.~' :) .... 0 .....n~ ... II' .. .. ;. :- -:- ':= :to .... ~ "l~ -~ 1t- -"t;: C) ::i ~ ,ti' ~ ~ ) , \ - ...------ .,.-- ~---- .':,liIt,., ... S .c 1ft .. -l o " ... Z 11Ift o ,. S " -l ... o z Z .$> 01 11 'S rl1~~~ ~ ;Z 0) 'Jl' Z i 0-=-\1' cG>01,- ~ ;.~O(J) ~ %~;~ 3 ~~~~ ~ 6:1JOJZ ~ -00-;01 ')> ')>:0 ~ G>~ ~ ~~ o :t:c ~ ~d o -:J) (,) *' :JJ o -' - ,..' G> ... o~'ii:.fi ~ CD CD ::;' Q) . cO ~ ~::::-:-< · 0)33'c>>o; sP Q) 0) 5'~ .. a.;%~g.c: t1' - 11 . ::::: " CD sP _' - 0. 0. ~~~~I>> . =' 0 6 ~ cO. .. ?- ":$ 0)' - ~ ~-o:;- -o().....~ -<0:;:..... 0'='(1)~ c:. ~ ~. ~ 3~c,c' Q) - - 0) ~~~~ ~h\~o c:. '=' ... '=' .... - <0 _io~: 3.:o~:r :::;: ~ -QcO ~oZr-t- (f) c:. 0 ~ ~o.. ~ I>>~ to (j)Q) -::r 0' 0 0-0 So -~ ~ r"'d ~ '0 ...... ~ ~ tP n "-' 0 % ;::::;i( n o v>-; '" N G, ?; ~ d '1'0'-~ .......0.,., .so- ~ S ~ v> N 0'" ~ ~o~""'"'-< () ... -' ~ ~%.5~% 0 0 ')> sP n ~ s ; (f) CIt (f) (f) ~ () : 00 --n c.- O - ~ % ~-;$')>-' -' .. 0 ~~ -;6~ s: -g (f) ~ "'" ::s 1ft '=' -::r c: ~ " t9 ~ -' C') S- O) c:: Ol (J) 0;' (') n ... 0 '0. ~. ... ... ~ t9 ~ -0 -' ~ ,1\ ::so.. C -::r ~ ~ ~ '2. .$> l' !. -4 . ~ .,~~ s a CD ~ -' ~ -0 c:... ~. '0. ~ n Zo - s: ~~= ... -0 i r) )It. .c::. ~ ~ (I) .c 0 t9 (Jl ::s S -\?'::. s: , c- <::) ;. !!. P ~ o " 11Ift ~ ~ --0 : ~ )(J)~ s- a 5 ~ ... 0 0 'o::i ,: 0) ~ tJ 1:r.~ c:. CD c: :s -a. " ~ ~ ~ :: r) ~'.33 ~ 1ft i C C) 1m 11 ~ 3 U" C 1Z c:. CD a. ~ CD a. - ... t: ~~ ~ c:.- c... 3 \ ~ -' CP c: (I) ~ )~ <0 i CD ~ ... U) ~ 0 ,... .,m m (I) )0 -:!! ~ .;, Z '" :S 0 () 9 a ~o ~ t'" ;'.33 -::r ~ ~ ~ , ~ 0 t9 t ) (II ~ c:. '3 ~~1~ ~ '2.' -0 i!.. ~ ~-..aOn 0 cB CD Tn ::t.~-t9 c: ~ ~;2(1) ~ t9 Cii n ..Jt. 0 0 ~rn. z 9- ~ '3 (}(')(1)2 s: ~- '3 -;!! w,:JJ;g. (J .....::so.. 0 ~~ C {11 {11 ::s i :JJ (f) Z fD. ... :1~ G> 0 ~ ..(. $~ ~ ~(JlO -o~ S ~ :! ~ .f:It ')>fT\ l? Ol R' ~ ..... ~ 1'> ~ ~ .f:It .f:It ...J ~ 0 Ol '" 0 g ~ '6 ~ $ (J'\ -l <D (J'1 a (J'1 ..,.'11\ REV-1508 EX+ (6-98) .. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21-05-0556 ESTATE OF ~RT Barbara G. Schreiner 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. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. PNC Bank- Acct. # 92-0072-9710 Checking 1065.97 2. Susquehanna Valley Fed. Credit Union #14388 Regular Shares 50.00 3. Susquehanna Valley FCU #14388 Money Market 40,379.90 4. PG and W Employees FCU Acct. # 858-018 Regular Shares 95.18 5. Plymouth Voyager Mini-van 1998 Expresso 93)000 approx. miles 1350.00 6. Furniture, Household and personal items 3325.00 7. Messiah Village amortization refund on apartment 93,672.50 TOTAL (Also enter on line 5, Recapitulation) $ 139,938.55 Premiiun Plan Account Statement )NC Bank For the period 05/1412005 to 06/14/2005 y BARBARA G SCHREINER OR CARL SCHREINER 821 OAK OVAL MECHANICSBURG PA 17055-8409 o PNCBAN< Primary account number: 92-0072-9710 Page 1 of 2 Number of enclosures: 0 g For 24-hour banking, customer service arid ~ transaction or interest rate information, tt sign-on to Account link ~ by Web on pncbank.com or call1-888-PNC-BANK Para servicio en espaflol, 1-866-HOLA-PNC Moving? Please contact us at 1-888-PNC-BANK I2!SJ Write to: Customer Service PO Box 609 Pittsburgh PA 15230-9738 8 Visit us at pncbank.com I] TDD terminal: 1~8oo-531-1648 For hearing impaired clients only f>>r...i..... Plan Interest Checking Account Summary ~ccount number: 92-0072-9710 Barbara G Schreiner Or Carl Schreiner lalance Summary Please see the Activity Detail section for additional information. Beginning balance Deposits and other additions 2,117.62 Checks and other deductions 1,45 L 73 2,503.38 Average monthly balance ] ,296.94 Ending balance 1,065.97 Charges and fees .00 rransaction Summary Checks paid/ withdrawal s Check Card POS signed transactions Check Card/Bankcard POS PIN transactions 15 o Total ATM transactions PNC Bank ATM transactions Other Bank ATM transactions o o As of 06114, a total of $2.38 in interest was earned this year. nterest Summary Annual Percentage Yield Earned (APYE) Number of days in interest period Average collected balance for APYE 0.00% 32 1,266.66 llctivlty Detail Jeposits and Other Additions )ate /mount Oescri ption )5/27 V 184.34 Direct Deposit - Instll-ance / Allstate Life In Ga18299850 )6/01 V 435.00 Direct Deposit - Af Ann Pay / DFAS-Cleveland XXXXX7055 )6/03 V1,075.00 Direct Deposit - Soe See / us Treasury 310 XXXXX7055A )6/03 V 423.28 Deposit Referen('e No. 027044445 o () Interest Earned this period .00 There were 4 Deposits and Other Additions totaling $2.117.62. SUSQUEHANNA ~ALLEY FEDERAL CREDIT UNION 25 DEARDORFF DRIVE ETTERS, PA 17319 LOCAL: (717) 737-4152 TOLL FREE: (800) 948-1454 FAX: (717) 737-0589 1111111'11111'1.111.1111111111111111111111111.1111.11...111111 ESTATE OF BARBARA G SCHREINER 480 BIG SPRING RD NEW CUMBERLAND, PA 17070 TRAN POST TRANSACTIOtl~ DATE DATE JlESCRIPTION l1ell1berl: Social Securi~y I: statement Date: Page.: Mail Code: Web Code: 14388 X-XXXX 06/30/2005 1 YTD TAXABLE DIV: $327.92 YTD TAXABLE INT: $.00 YTD FINANCE CHG: $.00 TRAN FEE FINANCE- - LOAN AMOUNT AMOUNT. _ _CtlARGE__PRINC-IPAL ----- ------~-------------------~--- -~--------- -------- -~-~----~ -~-------- ---~-----~- . BALANCE 06/01 Type: 00 - REGULAR SHARES - 00 PREVIOUS BALANCE 06/13 06/13 Share Wi~hdrawal 45.00- Share W/D (Xfer to Mb 114388 - Acct '40') 06/30 NEW BALANCE 06/01 Type: 3S - MONEY MARKET ACCOUNT - 3S PREVIOUS BALANCE 06/06 06/06 Ite.'- 1010 233.82- 06/13 06/13 Share Withdrawal 32288.38- Share W/D (Xfer to Hb 114388 - Acct '40') 06/14 06/14 Ite.l- 1011 210.00- 06/17 06/17 Ite.'- 1012 7881.52- 06/30 06/30 Dividend Pos~ing 24.67 ** ANNUAL PERCENTAGE YIELD EARNED: 1.75 X FOR A PERIOD OF 30 DAYS ** 06/30 NEW BALANCE Cleared Items This Period NOTE: An .- indicates a skip in sequence. Amount IteMI Amount Ite" Amount I'te" Ite" 50.00 5.00 5.00 40613.72 40379.90 8091.52 7881.52 .00 24.67 24.67 1010 210.00 -------- ----------- -----~-- ------~---- ----~~-- ---------~~ ~~~----- ---------~- Allount 233.82 1011 Description Su.aary Count Share Draf~ Iteas ATM Transactions EFT Transactions Electronic Checks Voice Transactions Other Wi~hdrawals Other Deposi1:s Balance Forward: Ne1: Change: New Balance: 3 o o o o 1 1 06/01 Type: 40 - SHARE DRAFT - 40 06/13 06/13 New Share Account Vlt5.00 06/13 06/13 Deposi1: Deposi~ (Xfer fro. Hb .14388 - ~t '00') 06/13 06/13 Deposit 32288.38 Deposit (Xfer fro. Kb 114388 - Acct.' 35 ' ) 06/17 06/17 Share Withdrawal \/275.00- Share W/D (Xfer to Kb 11551 - Acc1: '40') 06/20 06/20 ACH Debi1: VB. 51- LIBERTY CHECK CHK ORDER \1470.00- 06/20 06/20 Share Withdrawal 06/20 06/20 Ite.l- 1001 ?818.S4- 06/22 06/22 Deposi~ 1069.81 Deposit (Checks In (GUI)) 1012 7881.52 Debits Credits 8325.34 .00 .00 .00 ._~OU.-. 32288.38 .00 .00 .00 .00 . -~ 0-0- 24.67 40,613.72 40,589.05- 24.67 PREVIOUS BALANCE .00 .00 45.00 32333.38 32058.38 32049.87 31579.87 22761.33 23831 . 14 TO REPORT ERRORS OR MAKE INQUIRIES .. ABOUT LOANS MARKED WITH AN · WRITE TO: STATEMENT OF ACCOUNT TO REPORT ElUlORS 011 MAKE INQUIRIES ABOUT HaECTIIONlC R.N)S TIlANSfEIIS" WRITE TO THE ADOIESS AT LEFT 011 CAll.: 888/749-3328 525801BP 205. ~jf~t~~~~tA~~m_QM...ftlifM~ii 858-018 ::!!!!!!!: S.S.N. SECURED .. ~ ::8:1:1:88:::::::::: PG & W EMPLS FCU 1!!I~rll ~~~K~~U~~R::IN p:T~:~~1 j1~i~~i~iI~i~!~ii~1iii~~ -= === - - - !!!!!!!!!!!!! iiiiiiii - - BARBARA G SCHREINER FRANK ~ SCHREINER 821 OAK OVAL MECHANICSBURG PA 17055-8409 . . . . . . . .. . .. . ~ . . . . .. . . .. . . . . . . . . . . . . .. . ... ................. ...................... ...................... ................. ~:rrtJ.AtflW irmf~tgClrJ Je.$~\:~~ 1030 i!!.'ll1i:I::i:;~'.Il.II.I_i:...t_lt.lllr(~1 - - 018 SHAR E -- ACCOUNT 06~~5 NO~TRANSACTIONS THIS PERIOD PREVIOUS BALANC1E j NEW BALANcr --S-S!t3 - 95!13 ------..-----------------------yEAR TO DATE TOTALS------------------------------- $ .00 REGULAR DIVIDENDS THE POSSIBILITIES ARE ENDLESS. .1. HOME IMPROVEMENTS, A VACATION, ~ONSO~IDATING ypUR DEBTS... WHATEVER YOU HAVE IN MIND, A PG&W EMPl FCU HOME EQUITY LOAN CAN MAKE IT HAPPEN. ~RATES AREl AS LOW AS 4.5%APR. BUT DON'T WAIT ~ROUN~, THESE LpW - - ---- - - - === - - - ---- - - - - - - ---- - ~ - - - - - iiiiiiiiiiiii - - - - - iiiiiiiiiiiii - !!!!!!!!!!!!!!! - - REV-1510 EX+ (6-98* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF ~RT Barbara G. Schreiner FILE NUMBER 21-05-0556 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY ITEM INQ.UDE THE NAME OF THE lRANSFEREE, THEIR RElATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPliCABlE) VALUE 1. Allstate Advantage Annuity - IRA 50,394.38 100% 50,394. Acct. # GA05957 4 7 Allstate Life Insurance Co. PO Box 94260 Palatine, IL 60094-4260 2. Allstate Advantage Plus Annuity 43,745.46 100% 43,745.4 Acct. # GA 18299850 Address same as above The above were arrange through PNC Investments - Tricia Tompkins, consult. 717 -691-4014 Beneficiaries for the above are: Carl J. Schreiner, 111- son and Frank J. Schreiner - son TOTAL (Also enter on line 7 Recapitulation) $ 94,139.8 38 6 4 '~ Allstate Life Insurance Company PO Box 94260 Palatine IL 60094-4260 Telephone: 1-800-755-5275 Fax: 1-866-628-1006 Allstate. BARBARA G SCHREINER 821 OAK OVAL MECHANICSBURG PA 17055-8409 June 21. 2005 . . __ _ __.'.' .__ ," _,_ " _, .... n" '. .. '" . . Your Repre~{'tative .... TRICIA J TOMPKINS PNC INSURANCE SERVICES, INC 127 KIM ACRES DRIVE MECHANICSBURG PA 17055-5534 (717)000-0000 Allstate. Advantage Plus Annuity Statement # GA 18299850 ACTIVITY THIS .PERIOD: Beginning Account Balance 03/20/05 ................................................. $ 44,005.14 Withdrawals . ...... ...... ............. ........ ... ..... .... ...... .... .... .... .......... $ 614.46 Interest Earned 03/20/05 thru 06/20/05 .................................................. $ 486.87 Ending Account Balance 06/20/05 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. $ 43,877.55 Net Cash Surrender Value 06/20/05 Net Cash Surrender Value 03/20/05 .. ...... ... ... ................ ........ ...... ........ $ 42,926.00 $ 43,540.55 . .................. ......... ........ ... ......... .......... .ACC()UNTV~~PEJ)ET All- AS OF.. 06120105: < Current Rate Fund Value 4.500/0 4.500/0 $ 30,291.19 $ 13,586.36 New effective annual rates for each fund will be determined when the current guarantee expires. If you have any questions concerning your annuity please contact your representative at your financial institution. &~~~~ 814S7DDR.N01 -~ Allstate Ufe Insurance Company PO Box 94260 Palatine IL 60094-4260 Telephone: 1-800-755-5275 Fax: 1-866-628-1006 Allstate. BARBARA G. SCHREINER 821 OAK OVAL MECHANICSBURG PA 17055-8409 May 31,2005 Your. Representath'~ ARTHUR E. BAIRD PNC INSURANCE SERVICES, INC 325 MEMORIAL HIGHWAY DALLAS PA 18612-1152 \...- (570)675-8940 ~ tuft! ~II*,WJ <# ....",t/~~t/~ ItIIP/" l+f1ef . Allstate. Advantage Plus Annuity Statement # GA0595747 . ACTIVITY THIS PERIOD: . Beginning Account Balance 02128/05 ................................................. $ 50,020.32 Interest Earned 02128/05 thru 05/31/05 .................................................. $ 374.00 Ending Account Balance 05/31/05 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. $ 50,394.38 Net Cash Surrender Value 05/31/05 ... ..................... ...... ..... ..... .... ..... ........ $ 46,765.98 Net Cash Surrender Value 02128/05 .... ................. ....... ..... ................. ..... ....... $ 46,418.85 ACCOU.NT. VALUE.. DETAIl;.. ASQF.... 05131/05:. . Current Rate Fund Value 3.00% 3.000/0 --$' 39;606:90 $ 10,787.48 New effective annual rates for each fund will be determined when the current guarantee expires. If you have any questions concerning your annuity please contact your representative at your financial institution. .~~~~ B14RVXRF.NOl " REV-1511 EX+ (12-99) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATM COSTS ~RT ESTATE OF Barbara G. Schreiner FILE NUMBER 21-05-0556 Debts of decedent must be reported on Schedule I. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Frank J. Schreiner Social Security Number(s)/EIN Number of Personal Representative(s) Street Address 480 Big Spring Road ITEM NUMBER A. 2. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: Parthemore Funeral Home, New Cumberland, PA Flowers Pasto~s Fee Pianist Fee for Funeral Services 7881.52 265.00 200.00 75.00 4000.00 City New Cumberland Year(s) Commission Paid: 2006 State pA . Zip 17070 Attorney Fees 325.00 3. Family Exemption: (If decedent's address is not the same as daimant's, attach explanation) Claimant 4. Street Address City . State _Zip Relationship of Claimant to Decedent 5. Accountant's Fees Probate Fees 470.00 6. 7. Tax Return Preparer's Fees 75.00 Estate Posting - Cumberland Law Journal and Carlisle Sentinel Postage, Check Printing, Photocopies Probate and Estate Instructional Books Cleanout and Preparation for dosing of 1 and 2 Hillside Ave., Harvey's Lake, PA U Haul Rental and moving expenses from Messiah Village and Harvey's Lake 164.84 75.68 49.76 200.00 572.87 TOTAL (Also enter on line 9, Recapitulation) $ 16653.95 .. Schedule H (page 2) Estate of Barbara G. Schreiner File # 21-05-0556 Past due inheritance tax on the estate of Beatrice F. Schreiner (mother-in-law of Barbara) Inheritance tax was taken out of the sale of2 Hillside Ave., Harvey's Lake, PA. Due to Life Estate. Arty Jerome Cohen, Wilkes-Barre, PA Paid to Register of Wills , Luzeme County 1226.95 Additional Tax due on Estate of Beatrice Schreiner after state review 264.41 Mileage - trips to Wilkes-Barre for 2 property settlements 224 miles x 2 x 40.5 cents 201.60 Mileage- 5 trips to Harvey's Lake to prepare, clean out and paint 1 Hillside Avenue, Harvey's Lake, P A 256 miles x 5 x 40.5 cents 518.40 Mileage - to Carlisle, Courthouse, Post Office 180 x 40.5 cents 72.90 Estate Tax Filing Fee 15.00 REV-1512 EX+ (12-03) '* COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE UABIUTIES, & UENS F~TATF OF ~RT Barbara G. Schreiner FII F NIIMRFR 21-05-0556 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 15. 16. 17. 18. 1. Discover Card payoff 863.82 2. MBNA America Credit Card Payoff 5441.79 3. Signature Loan Payoff - PNC Bank 8818.54 4. Messiah Village Aparbnent maintainance fees (rent) - June and July 2005 1485.53 5. Silkies - item ordered by decendent 17.91 6. PG Energy - gas bill for 2 Hillside Ave, Harvey's Lake 53.19 7. PPL - elec. bill for Messiah Village Aparbnent 18.11 8. UGI - elec. bill for 2 Hillside Ave., Harvey's Lake 9.40 9. Bank One Card member Services Credit Card Payoff 2006.30 10. Encompass Insurance bill on houses at Harvey's Lake 180.92 11. Bill Davis Plumbing - Water Heater replacement - 1 Hillside Ave. Harvey's Lake 547.27 12. United Water - 2 Hillside Ave., Harvey's Lake 1.36 13. UGI Elec. Bill - 1 and 2 Hillside Ave. Harvey's Lake 24.21 14. PG Energy - gas bill - 1 and 2 Hillside Ave, Harvey's Lake 44.41 Encompass Insurance 73.57 Auto Camp -van repair bill 231.04 Joe Holowich - lawn and grounds maintainance for 1 and 2 Hillside Ave, Harvey's Lake 210.00 Chase Credit Card Services - payoff 201.00 TOTAL (Also enter on line 10, Recapitulation) $ 20,228.37 REV-1513 EX+ (9-00) .. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF ~RT Barbara G. Schreiner ~ FILE NUMBER 21-05-0556 RELATIONSHIP TO DECEDENT- AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON{S) RECEIVING PROPERTY Do Not List Trustee{s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. Cart J. Schreiner III 727 Hand Avenue, Sarasota, FL 34232 son 5,000.00 plus 1/2 of rpm;::linrlpr 2. Frank J. Schreiner 480 Big Spring Rd., New Cumbertand, PA 17070 son same as above 3. Melanie A. Schreiner 5975 Wysteria Ct., Brownsburg, IN 46112 grand daughter 1,000.00 4. Brian S. Schreiner 3507 Countryside Lane, Camp Hill, PA 17011 grand son 1,000.00 5. William Z. Schreiner 4711 Hoxie Lane, Sarasota, FL 34233 grand son 1,000.00 6. Christina M. (Schreiner) Derr 5609 Stradford Dr. Harrisburg, PA 17112 grand daughter 1,000.00 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 NONE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS NONE TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT SCHREINER FRANK J 480 BIG SPRINGS ROAD NEW CUMBERLAND, PA 17070 u___u_ fold EST A TE INFORMATION: SSN: 311-22-7055 FILE NUMBER: 2105-0556 DECEDENT NAME: SCHREINER BARBARA G DATE OF PAYMENT: 03/06/2006 POSTMARK DATE: 03/06/2006 COUNTY: CUMBERLAND DATE OF DEATH: 06/10/2005 NO. CD 006398 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $15,203.53 I I I I I I I I TOTAL AMOUNT PAID: $15,203.53 REMARKS: F J SCHREINER CHECK#1043 SEAL INITIALS: VZ RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS