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Home My WebLink About03-20-06 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 MYERS DONALD I 490 CROSSROAD SCHOOL ROAD CARLISLE, PA 17013 _u_____ fold ESTATE INFORMATION: SSN: 162-22-0676 FILE NUMBER: 2105-0664 DECEDENT NAME: MYERS HAZEL E DATE OF PAYMENT: 03/20/2006 POSTMARK DATE: 03/20/2006 COUNTY: CUMBERLAND DATE OF DEATH: 06/23/2005 NO. CD 006448 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $15,964.74 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK# 121 SEAL INITIALS: MG RECEIVED BY: REGISTER OF WILLS $15,964.74 GLENDA FARNER STRASBAUGH REGISTER OF WILLS ~ " .-J 15056051058 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 OFFICIAL USE ONLY County Code Year Ale Number INHERITANCE TAX RETURN RESIDENT DECEDENT 21 05 0664 Date of Birth 162-22-0676 06/23/2005 10/27/1918 Decedent's Last Name Suffix Decedent's First Name MI Myers . Hazel E (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Mt N/A 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 3. Remainder Return (date of death prior to 12-13-82) C...:J 4. Limited Estate '-~^~) 4a. Future Interest Compromise (date of 5. Federal Estate Tax Return Required death after 12-12~82) c:::J 6. Decedent Died Testate C:J 7. Decedent Maintained a Living Trust....Q_... 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) (=~ 9. Litigation Proceeds Received (:::P 10. Spousal Poverty Credit (date of death (.~.) 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: - "1 Name Daytime Telephone Number Robert R. Black Firm Name. (If Applicable) Landis & Black (717) 243-3727 REGISTER OF WILLS USE OMLV First line of address 36 S. Hanover Street "..;,) Second line of address City or Post Office Carlisle State ZIP Code DATE FILED PA 17013 ADDRESS 36 S. Hanover Stret, Carlisle, PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051058 15056051058 ---I ~ -I 15056052059 REV-1500 EX Decedents RECAPlTULAnON Hazel E Myers 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) C:J Separate Billing Requested. . . . . .. 6. 7. Inter-VIVos Transfers & Miscellaneous Non-Probate Property (Schedule G) c::) Separate BiDing Requested.. . . . . .. 7. 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8. ""-..------...--........_...'.r~""....=.>U^..._._,.^....._...,,,...,._...,_""-_................,_"'_~v.....H~.....,...J.-'....~ - .............,...........-....".....,'-"~'"."..-'i....,"'."'_'^""'~^V..'..N...."">"...._""'"_.,'Yo",',."., 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . .. 9. 10. Debts of Decedent, Mortgage Liabilities, & liens (Schedule I) . . . . . . . . . . . . . . . . 10. 11. Total Deductions (totaf 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 INSTRucnONS FOR APPLICABLE RATES 15. Amount of Une 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (aX1.2) X .0_ 16. Amount of Line 14 taxable at lineal rate X.O 45 354,772.00 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 L 15056052059 Side 2 162-22-0676 Decedent's Social Secu~ty Number 370,527.61 11,798.95 11,305.70 393,632.26 38,681.04 179.22 38,860.26 354,772.00 0.00 354,772.00 15056052059 15,964.74 15,964.74 -I Re.-I-1500 EX Page 3 Decedent's Complete Address: File "~",ber 05 0664 ...... P^"" "'en...... ........".. DECEDENTS NAME DECEDENTS SOCIAl SECURITY NUMBER Hazel E Myers 162-22-0676 STREET ADDRESS 381 Kerrsville Road CITY I STATE I ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 2 line 19) (1) 2. CreditslPayments A. Spousal Poverty Credit 8. Prior Payments C. Discount 15,964.74 Total Credits ( A + B + C ) (2) 0.00 3. InterestIPenaJty if applicable D. Interest E. Penalty TotallnterestlPenalty ( 0 + E ) (3) 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. (4) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5) (SA) (58) 15,964.74 5. If Une 1 + Line 3 is greater than Une 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. 15,964.74 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; .......................................................................................... 0 [KJ b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 [K) c. retain a reversionary interest; or........................ .......... ............. ........................ ..... .......................... ........ ............ 0 [it d. receive the promise for life of either payments, benefits or care? ...................................................................... D liJ 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 [i] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .... ...... ........... ......... ......... ........... ............... ................ ........ ................ ...... ......... 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 use of the surviving spouse is three (3) percent [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 zero (0) percent [72 P.S. ~9116 (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. ~9116(a)(1.2)J. 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. ~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 twelve (12) percent [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+ 16-98. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Myers, Hazel E. 21-05-0664 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 wilrmg 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. SCHEDULE A REAL ESTATE ITEM NUMBER 1. DESCRIPTION All that certain tract of farm land with the buildings and improvements thereon erected known VALUE AT DATE OF DEATH 370,527.61 as 381 Kerrrsville Road, Carlisle, PA 17013, and being the remaining land conveyed to Edgar C. Myers and Hazel E. Myers by deed dated March 29,1946, and recorded in Cumberland County Deed Book E, Volume 13, Page 81. The said Edgar C. Myers died on October i4, 1994. See attached HUD 1 for sale of property. Net Proceeds $370,527.61. Assessment- $105,240.00. TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 370.527.61 REV.1508 EX+ (6-98) , . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Myers, Hazel E. FILE NUMBER 21-05-0664 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jolntly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Jones Auction- Public Sale of personal property. See attached Statement 2 Blair Corporation- Overpayment 3. The Sentinel- Refund 11,774.34 7.01 4. Sprint- Refund 5. Met life- Proceeds of life insurance policy # 2050900.- $2,519.32. Non-taxable 17.52 0.08 0.00 TOTAL (Also enter on line 5. Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 11,798.95 . REV.1510 EX. (6-98* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDeNT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF Myers, Hazel E. FILE NUMBER 21-05-0664 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 DATE OF DEATH TAXABLE ITEM INClOOE THE NAME OF 11iE TRANSFEREE. THEIR RB.ATIONSHIP 10 DECEDENT AND % OF DECO'S EXCLUSION NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAl ESTATE. VALUE OF ASSET INTEREST (IF APPUCABI..E) VALUE 1. M& T Bank- Checking Account # 756482. Fully taxable as transferred within 11,305.70 100 0.00 11,305.70 one(1) year of date of death( June 13,2005). See attachments. TOTAL (Also enter on line 7 Recapitulation) $ 11,305.70 <If more space is needed, insert additional sheets of the same size) . REV-1511 EX+ (12-99* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESJDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Myers, Hazel E. FILE NUMBER 21-05-0664 Debts of decedent must be reported on Schedule L DESCRIPTION AMOUNT ITEM NUMBER A. FUNERAL EXPENSES: Hoffman-Roth Funeral Home- Services Eby Granite Works- Lettering tombstone 1. 2 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Donald I Myers I Jesse E. Myers, Jr. Social Security Number(s)/EIN Number of Personal Representatlve(s) 167-40-0056 165-62-6286 Street Address 490 Crossroads School Road I 390 Springview Road City Both--Carlisle, State PA Zip 17013 Year(s) Commission Paid: 2006. $7405,00 for each Personal Representative 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimanfs, attach explanation) Claimant None Street Address City State . Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountanfs Fees 6. Tax Return Preparer's Fees 7. Jesse E. Myers, Jr.-Reimburse for death certificates 8 PPL-invoice 9 PPL-invoice 10 Gilbert's Pest Control- Termite extermination 11 Deborah Piper, Tax Collector-School taxes 12 PPL-invoice 8,614.60 100.00 14,810.00 10,000.00 0.00 644.00 48.00 28.96 30.02 600.00 1,432.59 31.24 $ 36,339.41 TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) . REV-IS11 EX+(12.oo. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Myers, Hazel E. SCHEDULE H (CON'T) Debts of decedent must be reported on Schedule L FILE NUMBER 21-05-0664 ITEM NUMBER A. FUNERAL EXPENSES: 1. DESCRIPTION AMOUNT 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 3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation) Claimant Street Address City State . Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountanfs Fees 6. Tax Return Preparer's Fees 7. 13 PPL-invoice Gilbert's Pest Cntrol- Balance-Termite Extermination PPL- Two(2) invoices Kough's Fuel Oil-Two(2) invoices 37.65 1,500.01 81.72 722.25 14 15 16 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 2,341.63 RfV-1512 EX+ (12-03) *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE UABILmES, & UENS COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Myers, Hazel E. 21-05-0664 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 4 PharMerica- invoice 11.03 84.03 83.33 0.83 1. Sprint- invoice 2 PharMerica- invoice 3 PPL - invoice TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 179.22 R~-1513 EX+ (9-00) .. SCHEDULE J BENEFICIARIES COMMONWEAlTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Myers. Hazel E. FILE NUMBER 21-05-0664 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 pnclude outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)) 1 Stephen Myers, 172 W. Princeton St., Crofton, KY 42217 Grandson 10% 2 David Myers, 204 Stonehouse Road, Carlisle, PA 17013 Grandson 10% 3 Susan Myers. 460 Crossroads School Road. Carlisle, PA 17013 Granddaughter 10% 4 Kimberly Myers, 650 Observatory Drive, Lewisberry. PA 17339 Granddaughter 10% 5 Jesse E. Myers. Jr., 394 Springview Road, Carlisle. PA 17013 Grandson 10% 6 Donald I. Myers. 490 Crossroads School Road. Carlisle, PA 17013' Son 50% 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) LAST WILL AND TESTAMENT OF BABEL B. IIYBRS I, Hazel B. Hyers, of the Township of West Pennsboro, cumberland County, Pennsylvania, make this Will, revoking all my former wills and codicils. :I~ :I: :I direct thai: all my jusi: debts, funera1 expenses and administration expenses, including my grave marker, shall be paid from the assets of my estate as soon as practicable after my decease. Z~ XX: 1: devise and bequeath all of the residue of my estate, of every nature and wherever situate, to my husband, Edgar C. Myers, providing he shall survive me by thirty (30) days. :tHK z:t:t: Should my husband, Edgar C. Hyers, predecease me or die on or before the thirtieth day following my death, I devise and bequeath the residue of my estate, of every nature and wherever situate, in equal shares, with one (1) share to my son, Donald I. Hyers, or his issue, per stirpes, and one (1) share to the issue of my deceased son, Jesse E. Myers, per stirpes. :I""'" :tV: My son, Donald I. Myers, shall have the right and privilege to purchase from my estate the balance of my home farm property, situate in West Pennsboro TownShip, as contained in cumberland County Deed Book "En, Volume 13, page 81. The purchase price for such real estate shall be the value as established on said property for Pennsylvania Inheritance Tax purposes. My said son, Dona1d I. Hyers, sha11 have the period of one hundred twenty (120) days from the date of my death to qive notice of exercise of this option to my Executors. Z~ V: I appoint Farmers Trust Company of Carlisle, Pennsylvania, guardian of any property which passes, either under this Ifi11 or- o~'1erJise, to a m.inor. Said- guardian shall hold, manaqe, invest and reinvest any property received by the guardian, shall collect the income therefrom, and shall apply so much of the net income, and, if the net income is insufficient, so much of the principal of said property held for such beneficiary as the guardian shall deem necessary or advisable for such beneficiary's health, maintenance, support and complete education. The guardian shall accumulate any surplus net income annually and add the SalDe to the principal of the property held for such beneficiary. When such beneficiary attains the age of eighteen (18) years, all property shall be distributed to such ~4J; /3/ lh\. beneficiary, or-to such beneficiary's estate in the event of death prior thereto. Z~ VX: No interest of any beneficiary hereunder in either the principal or income of my estate shall be subject or liable in any manner to anticipation, pledge, assignment, sale, transfer, charge or encumbrance, whether voluntary or involuntary, or for any liabilities or obligations of such beneficiary whether arising fro. his or her death, debts, contracts, torts or engagements of any type. :tTBII ~:r: I direct: that a1.1 taxes which may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. Z'lBII VI:ZJ:: I appoint my husband, Edgar C. Myers, Executor of this, my Last will. S~ould my husband, Edgar C. Myers, fail to qualify or cease to act as Executor, I appoint my son, Donald I. Myers, and my qrandson, Jesse E. Myers, Jr., or the survivor thereof, Executors of this, my Last will. :ITBII :IX: I direct that neither my Executor, guardian, trustee, nor their successors shall be required to give bond for the faithful performance of their duties in any juriSdiction. ;z1)t IN WITNESS ~OF, I have hereunto set my hand this {:.I day of ~I ' 1992. LH cu~1? /3. \n W N 11./ Haz B. Myers (SEAL) The preceding instrument, consisting of this and one other typewritten page, each identified by the signature of the Testatrix, Hazel. B. MYers, was, on the day and date thereof, signed, pub1ished and dec1ared by Hazel B. Myers, the Testatrix therein named, as and for her Last Will, in the presence of us, who, at: her reqq.est, in her presence &'"'ld in the presence of each other, have. subscribed our names as wi tnesses thereto. ~ (L(Y{pYz ~~?~ .. COMMONWEALTH OF PENNSYLVANIA ) . COUNTY OF CUMBERLAND ) We, Hazel B. Myers, Robert R. Black and EPwtti<(J-I-. SCf-jo~Pf , the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, beinq first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will, and that she had signed willinqly (or willingly directed another to sign for her), and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearinq of the Testatrix, signed the will as witness, and that to the best of their knowledge the Testatrix was at the time eighteen years of age or older, of sound mind and under no constraint or undue influence. ~~f3. h1~)(~ Testatri~~ ~;~ers witness Robert . . ack witness sworn to and acknowledged before Ni1TARl~ SEAl SHiRLEY .". NllERS. r<<JTA,4:\Y PUBLIC CAAUSlE 0000.. t~M9ERtA!iD COUNTY. PA MY COGUJiSSiON i:.-xPfRES JULY 14. 1993 A. Settlement Statement U.S. Department of Housing and Urban Development B. Tvne nf Loan nUR Nn . *...- ... .---.. I.OFHA 2. DFmHA 3. Deony. Un ins. I 6. File Number 1 7. Loan Number , 8. Mortgage Insurance Case Number .. OVA :'\ nrftnv In.. JONR<;G03-06 c. Note: This 101m is ILmiIhed to gtwe JOU a ............ of ..... seIII8mIInt cosls. Amounts p8Id to .... br Ihe S8IIIement agent are shown. , TdleExpress SeIUement Systef IIemS mal1ced a(p.o.c.r went paid outside the c:b~ !her are shown '- for infonnaIiclR putpD$IIS and .. nallncludecl in lhelolalL WARNING: Ills a aIme to kr10wIngIr ...... faIsIt sIatemenIa to the United Stales on tis ~ BnI oller similar fonn. Penalties upon D. NAME OF BORROWER: Gerald P. Jones and Marjorie L. Jones AnnUI;"':~' 75 - r Road C..arlisle P A 17013 E. NN,-tE Of SELLER: The Estate of Hazel E. Myers ADDRESS' f. NAME Of LENDER: AG Choice Farm Credit , ~~..~.. '. rlQ I.Arm Credit Drive Ch~mhenburp PA 17201 G. PROI'ERTY ADDRESS: 381 Kerrsville Road, Carlisle, PA 17013 W~t~ H. SETrLEMENT AGENT: P A Real Estate Settlement Services, 'LLC PI.A( ~E OF ~'Trt .1:Ur.IIJT. 354 Alexander Snrin~ Road. Ste. Carlisle P A 17013 I. SE1TIFUFN' lA" .. 03/10/2006 J. SUMMARY OF BORROWER'S TRANSACTION: . K. OF ~r=1 I r=~t~ -- - -.- . II~: 100 ~DI"\CC II .... FROM AM. ~Dnee nllF C!e. I CD. 101 400 000.00 .oIn1 400 000. 01 102. 402 10:\ 14M\ 44 334.19 ..tn."'l 104 AnA 105 An!'> ---M' 00 " . 00 108. AM 107 03/10/06In 12/31/06 222.30 407 03/10/061n 12/31/06 222 .3C 1M 03/10/06 to 06/30 /06 443.51 MHt 03/101061006/30/06 443.5: 109 "-no 110 41n 111 AlIlI 112 41., 170. r:An~~ AUll.INI nllF FROM 445 000.00 A?O I II Ir: Tn !":J:I I r:A- 400 665.8J 200. cnc ~ RFnI Jr.Tln...~ ..... LJUt:: ?O1 5 000.00 ""1 ro. -- 202. 440.000.00 602 30 138.2( 203. ... '>in 2M ~ 20S AA!'> 206. ~nR 207. AA7 208 """ 20Q AAQ . . for items I . . ,,-. . hv _lllu 210. .;tn 211 I ~11 212. fi1., 213 !'>1:\ 214. ~1" 215 fi1S. 71~ !;.11l 217 !'>17 218. 518 219 fi1Q 220. TOTAl ~AII KY/t--UI-( 445.000.00 'i?O TnTAI ---. .--- I AMUUN I . 1111:: !":r:11 r=A 30 138.20 300. CASH A ~t:: I Lt::Mt-N I ROO r.A~H AT SI- .. t-Ml-N 301 - 445.000.00 Anl ---- 400 665.81 302. · .- 445.000.00 M7 30 138.20 303 CA~H FROIA 0.00 "n~ CASH TO SEU .ER 370.527.61 SUBSTITUTE FORM 1099 SELLER STATEMENT: Thelnlormatlon oontalnsd herein is lmportanllax information and Is belng furnished 10 the 1ntBm81 RevwlUe SelVice. If you ...., requited 10 file a return. a nGgligence penally or oCher sancIion wi! be imposed on you if Ihis Item Is required 10 be reported and !he IRS delenrW1es Ihall has not been reported. The Conlracl Sales Price deaatbed on line 40 1 above consftJIes Ita Gross Proceeds or Ihi$ tr8nS8dion. :::=.r;:*.,:'y~~~U;====:=Undefpenaltlellof~~~==:"~~~Is~~~~':-~8lion TlN:_ _ ,_ _ SElLER(S)SIGNATURE(S}: SEllER(S) NEW MAIlING ADDRESS: SEllER(S) PHONE NUMBERS: (H) (W) . . U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT File Number: JONESG03-06 PAGE 2 SETTLEMENT STATEMENT .. DJ:V n..~ ,..-...., I PAID FROM PAlO FROM ~... L~~N 700. TnTAI -400 000.00 = 24.000.00 BORROWER'S SELlER'S FUNOSAT FUNDS AT 701 s. In SETTlEMENT SETTlEMENT 7ft? ~ 24 000.00 In DA-RRT. :Inc. 7n~ . . 24 000.00 7nI.- In BRA-~ Inc. 125.00 125.00 800 ....... Rl\1 ~AG Choice J!'aDl Crecli t 2 150.00 80? ~ 803 IIftA 105 - ' . In AG Choice I'arIIl Credi. t IP.O.C.\ 350.00 Buvar Rl\7 In AS Choice P'axa eredi t 18.00 AnA In AG Choice FarIa Credit 33 433.48 AnA R10 R11 goo. -- LI~~ an1 ...--.. 1=...... 03/10/200610 04/01/2006 ~ If'*t 22 Davs 1.860.83 an? to an", - 10 AIW Gn6 11VV\ ton1 111ft All: Irrtft 1nn., ___Ill: Imn 1 nlL'" ....._!t. Imn 1nnA mn_A~ Imn 1nn1O 1>..-...-. '-_ __ _'It Imn 1nnG .......~ 0.00 0.00 ' f11V\ 11ft1 11ft? In ~ 1 '"""..." RuahaA P.C. 275.00 1103 110.1 11ft'!: 110R Nnl2nI-=- ... Sal.ZIIIADD Huftb.. P.C. 10.00 1107 In Abom & Kutulakis 1. 740.00 \ 11M \ 11na 440 000.00 - 111ft 400 000.00 - 1111 In Salzaann Bwrhes. P.C. 2 302.88 111' 11t~ 1 ?fV\ 1 'Xl 1 42.50 .~c 56.50 .~'It 99.00 170? n.-t~4 000.00 .-......-.. 4 000.00 t~ n-d S" 000.00 . u-...-llt 4 000.00 12M 1205 10 York County Recorder of Deeds 60.00 ..?tv> 1~1 In Deb PinAr Tax Collector 273.20 130' 1400 TOTAL - ....-.., ...... '='__ In 44 334.19 30~8.20_ HUO CERTFICATIOH OF BlNERANO SElI.ER ~":::::=:""-=:''''=':''''ll:::'''''''::::=''-:'':.~-=--=::'''~~~-~''-<<''- ~ ~ . JONES' AUCTION SERVICE . Darryl E. Jones Gardners, Pa 17324 .. Phone 717-486-9923 . Cell phone 226-0776 SETTLEMENT STATEMENT ., SALEFOR Fs~ f)f U(]2t.L Old(!(S ,/ DATE-9l18 l 0, ,-::;(1J5 . -- ,'if(ft.-fa;.. ~~~;~SES ()~ f[C1.no. ~_ ".u. ", THEGUIDS dl~CJ() U~~1 VALLEY TIMES. .2 J A. A t? NEWS CHRONICLE Q7. /X) ;)fU rrv~ , ' OTIIER PAPER ~ ~ ' A'~. " ""k::. ~~}.'ERPRINTS Id. 'ld ~.kfivV'€. ~ r/vvu ~ 'TYPE SIDTINP . c:.: . - 4M- 0 TOTAL ADVERTISING COST ?--P/IJ. '7~ . ("J2J'u-v1' ~ !)}{ ~ . ,~(~~) #d~. tCt~ o ftrr{- ~ TOTAL NUMBER BIDDER NUMBERs Jrt" TOTAL NUMBER SALE SHEETS ~ # # CASH AMOUNT IN 1, qat./,.;s CHECK TOTALS IN q t l ') il A ..50 TOTAL ALL SALE SHEETS -' ~, q 5cl .1 C) + TOTAL ADVERTISING ~OST. 5?ir O. '7 d. AUCTIONEERPERCENTAGE / % =- C} 7((1.[09 - .. OTHER CHARGES-knJ. - riSlj,O" -k.; 1 04- ~ ~\Jie,--I 05,00 - Laooy1.lBJJ.<.:b ~T SALE AFTER EXPENSES---1/, "7'7 cj. ~</ . . , m M&fBank 499 Mitchell Road, MiIlsboro, DE 19966 Mail Code DE-MB-12 Phone (888) 502-4349 Fax (302) 934-2955 October 3, 2005 Law Offices Landis & Black 36 South Hanover Street Carlisle, Pennsylvania 17013 Re: Estate of: Hazel B Mvers Social Securitv: 162-22-0676 Date of Death: June 23. 2005 Dear Sir or Madam: Per your inquiry dated September 26, 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 Checlcing Account Account Number 756482 Ownership (Names oj) Donald I Myers * Hzael B Myers * Opening Date 05/01/69 Closed 09/02/05 Balance on Date afDeath $1 i,305. 70 Accrued interest $ 0.00 Total $11,305.70 Please be advised, there was no safe deposit box found for the above decedent *For further account information, regarding ownership and any changes, closures and/or reimbursement of funds, ete., please caD the High Street earmle OffICe # 717-240-4536. Sincerely, /ft't-r~~ Nancy Clagett Records Management ~~~Jj"li~~~~~~A9rnt.i!C=-===~=:~.~: ===---===:.~- :: ~ p~ill " .,. 06113105 8nach NamIxr 04319 MANUFACTURERS AND 1.'ltADDtS TRtlST COMPANY CONSUMERACCOmrr UPDATED CHANGE REQ1JEST ADDIDELETE CUSTOMER MAJNT&NANCE ACCOUNT Tm& AND ADDUSS onIC& OW ACCOt1NT 4319 HAZEL 8 MYERS DONALD 1 MYERS 381 KERRSVILLE aD CARLISLE PA 170139418 ACCOONrNUMBER OOOOOOOOOOO~ ACCOONrTYPE Prodact 1Wc DDA Subpmdual Code: A2 C'l:ST 1 SSN: 162220676 cusroMER TYPE CODE: n CUST 2 SSN: \614000S6 aJSTOMER nPE CODE: 12 ., ..... .....1 (we) (1)..... .. MaT 8IIIk .. ill.. (WIj - 1M dcpaIk.... ....... .... willa die ...... ........ .... (2) _ ~ ~ IolW- aaIJIt c(, ... .... to . ...... at .. o-.t 0cpaIit ~ --. AwiWliIiIy DiscbaR fbr c..... ne,.it ~ ... SpedIc .... IiIIll Teras ~ ............. ....... ..............,. ........ if_..-.II is....... ~ tJl 0cpaIi1. .. ~ .. T...... ~ .,........... J (we) ~tl!~...... dill if dID IGCOUIt is...... ia... _ oItwo... _.......... ...... __ is. ......,.c-...a.... it will... TeIIIIICJ .., TIle ~ ~ WIlla RiFI oI~ fI_........ 11I____ lI:COUIIli5apcDed........... wit:. -. ia. GdIcr.... aJailtAGcCJlllt WiIIl.....oI~ c.~mIr~ u.Ier......ef~ l(--.r l)~ (I)...... ........................ cerneI T=:'" ...... ...... ~ 1_............... fa.............. (&) ....,- ........ fa ...,.... .-- ~ (a) 1- ~... ~~... ..- .. ..N'''' -... .......,..,.. ___...... (IItS)....._................. fit IS...-II fl...... .. ~ . ......... .. ......... .. (e) .... - .. .... - .. I .. - ..... .... .. .... ..",. - .... ....0) tIIIII.... u.s............. u.s............ ~ ..........- y---.......-W........,......... .~~~..._.....,.. aN aII'NIId.r..... ....... "lit... r~ .. ....~......... . ,...... ...... tAa.-.... -CeltlBeilllla..... _____............ fII'a,) :-___ _ ~_.. 8:1........,..................... _If,!, - I ......... ~ COST 4 DATE IDQ.IIFlCATION: Dl. 010'09 060S5OI' PA ORIGINAL OPENING DATE: OSIOJI69 TITLE CJIAIIIGE ClJIIRENT 11TLE: HAZEL B MYERS lCWTITLE: HAZEL B MYERS DONALD 1 MYEIlS ClJSTOMER ADDID DONALD I MYERS 1674000S6 0Iiai-J - ~ Semces; Capy - a..adt WPMIOI(G7m} 6ft.