Loading...
HomeMy WebLinkAbout06-28-06 (2) REV-1500 eX (6-00) OFFICIAL USE ONLY COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 2 1 o 5 00964 COUNTY CODE YEAR NUMBER I- Z W C W () W C DECEDENrs NAME (LAST, FIRST, AND MIDDLE INITIAL) Webst:er, Jean I DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 10/12/2005 03/08/1925 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 191-18-3655 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER w Q91 o 2. Supplemental Return 03 I- Original Return Remainder Return (date of death prior to 12-13-82) ~~en 04 o 4a. Future Interest Compromise (date of death after 12-12-82) 0 U ,,~ Limited Estate 5. Federal Estate Tax Return Required wc..U J:OO Q96 Decedent Died Testate (Attach copy of Will) o 7. Decedent Maintained a Living Trust (Attach copy of Trust) 0 8. Total N umber of Safe Deposit Boxes U "...J c..lXl c.. 09 Litigation Proceeds Received o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) 0 < 11. Election to tax under Sec. 9113(A) (Attach Sch 01 I- Z W Cl Z o c.. en w " " o u THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS Susan E Stott FIRM NAME (If Applicable) Stott: & Stott TELEPHONE NUMBER 157 S Hanover St Carlisle, PA 17013 (71 7) 243-8077 2. Stocks and Bonds (Schedule B) (2) 150,491.00 2,912.75 OFFICIAL USlO ONLY 1. Reall::state (Schedule A) (1) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortllages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property 13 , 992 . 62 (Schedule E) (5) Z 3,638.58 0 6. Jointly Owned Property (Schedule F) (6) i= CJ Separate Billing Requested :3 7. Inter..Vivos Transfers & Miscellaneous Non-Probate Property (7) 78,756.79 ::::> (Schedule G or L) l- n: 8. Total Gross Assets (total Lines 1-7) (8) <( () Funeral Expenses & Administrative Costs (Schedule H) (9) 12,442.76 W 9. 0::: 1,547.61 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) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES '",....." 249,791.74 13,990.37 235,801.37 1,000.00 234,801.37 z o i= <( I- ::::> c.. :! o () >< <( I- 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x .0 _(15) 16. Amount of Line 14 taxable at lineal rate 234,801. 37 x .0 ~(16) 17. Amount of Line 14 taxable at sibling rate x .12 (17) 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) 10,566.06 10,566.06 20. [] CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 5W4632 1.000 D d t' C I t Add cce en s ample e ress: STREET ADDRESS Church of God Home 801 N Hanover St CITY I STATE I ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 10,566.06 Total Credits (A + B + C) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (0 + 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) .00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 10,566.06 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check to: REGISTER OF WILLS, AGENT (5B) 10,566.06 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? . . . . . . . . . D 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? ~ 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. Under penaltl"s of pe~ury, I declare that I have examined this retum, 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 representative is based on all information of which preparer has any knowledge. No ~ ~ ~ ~ ~ D SIGNATU OF PERSON RfSPONSIBLE FOR FILING RETURN " "2:'- It) 0tuZljv~'L/' A E S 804 E Louther St. Carlisle, PA 17013 SIGNA~~~r;:;c~.~~P~RESENTATIVE ADDRESS 157 S Hanover St Carlisle, PA 17013 DATE b/~/0//{) t DATE 06/20/2006 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.g 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. 9 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 survivin9 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 steppan~nt of the child is 0% [72 P.S. 13 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. 13 9116(1.2) [72 P.S. 13 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. 13 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. 5W4633 1.000 REV-1502 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Webster, Jean I 21-05-00964 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. Residential Real Estate 166 & 168 E North St SeE~ Attached Settlement Sheet Carlisle, PA 17013 VALUE AT DATE OF DEATH 150,491.00 DESCRIPTION TOTAL (Also enter on line 1, Recapitulation) $ 150,491.00 5W4695 1.000 (If more space is needed, insert additional sheets of the same size) REV-1503 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER Webster, Jean I 21-05-00964 All property jointly-owned with right ofsurvivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 2,912.75 1. 61 Shrs Metlife Inc. (includes accrued dividends 31.72) TOTAL (Also enter on line 2. Recapitulation) $ 2,912.75 5W4696 1.000 (If more space is needed, insert additional sheets of the same size) REV-1508 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Webster, Jean I FILE NUMBER 21-05-00964 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 4. 5. 6. DESCRIPTION Checking Account, Wachovia Bank Acct# 1000293614875 Money Market Account, Wachovia Bank Acct# 1010083586938 (Includes accrued interest $ 12.16) 1988 Plymouth Sedan VIN# 1P313BJ46K2JC228569 (See Attached title) Miscellaneous Personal Property Federal Income Tax Refund Citizens Bank IRA Distribution Receivable VALUE AT DATE OF DEATH 1. 2. 1,120.93 10,745.25 3. 500.00 825.00 715.00 86.44 5W46AD 1 000 TOTAL (Also enter on line 5. Recaoitulation) $ (If more space is needed. insert additional sheets of the same size) 13,992.62 REV-1509 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Webster, Jean I SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER 21-05-00964 If an aliset 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 A. Kristin A Darhower ADDRESS RELATIONSHIP TO DECEDENT 804 E Louther St Carlisle, PA 17013 Daughter B. Kathy M Shork 335 Glenwyn Dr Littlestown, PA 17340 Daughter C. HeathE:r R Baker - McGee 483 Centerville Rd. Newville, PA 17241 D. Gwendolyn Y. Baker - Whistler RD 2 Box 183A Newville, PA 17241 Grand Daughter Grand Daughter JOINTLY -OWNED PROPERTY: lETTER DATE DESCRIPTION OF PROPERTY '10 OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DECO'S VALUE OF NJMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR NUMBER TENANT JOINT JOINTLY-I-ELDREAL ESTATE VALUE OF ASSET INTEREST DECEDENTS INTEREST 1. J\. 11/27/1981 Series EE US Savings Bond 454.24 50. 227.12 (accrued interest 354.24) 2. A. 12/24/1981 Series EE US Savings Bond 454.24 50. 227.12 (accrued interest 354.24) 3. B. 05/14/1981 Series EE US Savings Bond 463.28 50. 231.64 (accrued interest 363.28) 4. B. 06/11/1981 Series EE US Savings Bond 463.28 50 231. 64 (accrued interest 363.28) 5. B. 07/09/1981 Series EE US Savings Bond 463.28 50 231. 64 (accrued interst 363.28) 6. B 08/06/1981 Series EE US Savings Bond 463.28 50 231.64 (accrued Interest 363.28) 7. B. 09/03/1981 Series EE US Savings Bond 463.28 50 231.64 (accrued imterest 363.28) 8. B. 03/19/1981 Series EE US Savings Bond 493.60 50 246.80 (accrued interest 393.60) 9. B. 04/16/1981 Series EE US Savings Bond 493.60 50 246.80 (accrued interest 393.60) 10. C. 08/12/1988 Series EE US Savings Bond 123.92 50 61.96 (accrued interest 73.92) 11. C. 07/15/1988 Series EE US Savings Bond 123.92 50. 61.96 (accrued interest 73.92) 12. C. 06/17/1988 Series EE US Savings Bond 123.92 50 61.96 (accrued Interest 73.92) 13. C. OS/20/1988 Series EE US Savings Bond 123.92 50 61.96 (accrued interest 73.92) 14. C. 04/22/1988 Series EE US Savings Bond 126.40 50 63.20 (accrued interest 76.40) See Attached 2,442.93 50 1,221.50 TOTAL (Also enter on line 6, Recapitulation) $ 3,638.58 5W46AE 1.000 (If more space is needed, insert additional sheets of the same size) Schedule F: Jointly-Owned Property, Continued Estate of Webster, Jean I File # 21-05-00964 Item Letter for Date Made Description of Property Date of Death % of Decedent's Date of Death Value Number LI JQln.t ~ Interest of Decedent's Interest 15 C. 3/25/1988 Series EE US Savings Bond 126.40 50 63.20 (accrued interest 76.40) 16 C. 2/26/1988 Series EE US Savings Bond 126.40 50 63.20 (accrued Interest 76.40) 17 D 1/15/1988 Series EE US Savings Bond 94.80 50 47.40 (accrued interest 57.30 18 D 12/18/1987 Series EE US Savings Bond 94.80 50 47.40 (accrued interest 57.30) 19 D. 11/20/1987 Series EE US Savings Bond 94.80 50 47.40 (accrued interest 57.30) 20 D. 10/23/1987 Series EE US Savings Bond 96.69 50 48.35 (accrued interest 59.19) 21 D. 9/23/1987 Series EE US Savings Bond 96.69 50 48.35 (accrued interest 59.19) 22 D. 8/28/1987 Series EE US Savings Bond 96.69 50 48.35 (accrued interest 59.19) 23 D. 7/31/1987 Series EE US Savings Bond 96.69 50 48.35 (accrued interest 59.19) 24 D. 6/30/1987 Series EE US Savings Bond 96.69 50 48.35 (accrued interest 59.19) 25 D. 6/5/1987 Series EE US Savings Bond 96.69 50 48.35 (accrued interest 59.19) 26 D. 5/8/1987 Series EE US Savings Bond 96.69 50 48.35 (accrued interest 59.19) 27 D. 4/10/1987 Series EE US Savings Bond 98.64 50 49.32 (accrued interest 61.14) 28 D. 3/13/1987 Series EE US Savings Bond 98.64 50 49.32 (accrued interest 61.14) 29 D. 2/13/1987 Series EE US Savings Bond 98.64 50 49.32 (accrued interest 61 .14) 30 D. 1/16/1987 Series EE US Savings Bond 98.64 50 49.32 (accrued interest 61.14) 31 D. 12/19/1986 Series EE US Savings Bond 98.64 50 49.32 (accrued interest 61.14) 32 D. 11/21/1986 Series EE US Savings Bond 98.64 50 49.32 (accrued interest 61.14) 33 D. 9/12/1986 Series EE US Savings Bond 74.60 50 37.30 (accrued interest 49.60) 34 D. 10/24/1986 Series EE US Savings Bond 111.90 50 55.95 (accrued interest 74.40) 35 D. 8/15/1986 Series EE US Savings Bond 74.60 50 37.30 (accrued interest 49.60) 36 D. 7/18/1986 Series EE US Savings Bond 74.60 50 37.30 (accrued interest 49.60) 37 D. 6/20/1986 Series EE US Savings Bond 74.60 50 37.30 (accrued interest 49.60) 38 D. 5/23/1986 Series EE US Savings Bond 74.60 50 37.30 (accrued interest 49.60) 39 D. 4/25/1986 Series EE US Savings Bond 76.08 50 38.04 (accrued interest 51.08) 40 D. 3/28/1986 Series EE US Savings Bond 76.08 50 38.04 (accrued interest 51.08) 2,442.93 1,221.50 REV-1510 EX + (6-9B) COMMONWEALTH OF PENNSYLVANIA INHEFilTANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Webster, Jean I SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 21-05-00964 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 If\CLLOE Tt-E t\V\ME OF TI-E TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE NUMBER Tt-E DATE OF TRANSFER. ATTACHACOPY OF THE DEED FOR REAL ESTATE VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE 1. Har1:ford Non-Qualified Annuity 32,448.28 100 32,448.23 Con1:ract # 710312110 2. Wachovia Individual Retirement 27,192.23 100 27,192.23 Account # 750191183655-7 3. Ci t:Lzens Bank IRA CD 19,116.33 100 19,116.33 Acc1: # 0191183655 TOTAL (Also enter on line 7, Recapitulation) $ 78,756.79 (If more space is needed, insert additional sheets of the same size) 5W46AF 1.000 REV-1511 EX + (12-99) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHEHITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Webster, Jean I FILE NUMBER 21-05-00964 ITEM NUMBER A 2. 3. 4. 5. B. 1. 1 2. Debts of decedent must be reported on Schedule I. DESCRIPTION FUNERAL EXPENSES: Hoffman Roth Funeral Home Carlisle Memorial - Headstone Flowers Funeral Reception Miscellaneous Funeral Expenses ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 4. Claimant Street Address City State Zip Relationship of Claimant to Decedent Probate Fees 5. Accountant's Fees 8. 9. 5W46AG 1.000 6. 7. Tax Return Preparer's Fees Stott & Stott Administrative Expense Advertising - The Sentinal Advertising - Cumberland Law Journal TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) $ AMOUNT 7,930.60 570.00 204.58 483.65 670.00 o 1,000.00 506.00 750.00 6.00 246.93 75.00 12,442.76 REV-1512 EX + (12-D3) COMMONWEALTH OF PENNSYLVANIA INHEHITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Webster, Jean I SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21-05-00964 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NUMBER 1. 2. 3. 4. 5. DESCRIPTION Church of God Homes - Final Billing for Nursing Care Continuing Care - Prescriptions Bon Ton - Credit Card Ci i:ibank Visa Stott & Stott - Decedent's final Income Tax Preparation VALUE AT DATE OF DEATH 900.00 273.61 120.11 58.89 195.00 5W46AH 1.000 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1,547.61 REV-1513 EX+ (9-CO) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Webster, Jean I NUMBER I 1. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Kathy M Schork 335 Glenwyn Dr Littlestown, PA 17340 Deborah J. Baker 35 Summerfield Dr Carlisle, PA 17013 Kristin W. Darhower 804 E Louther St. Carlisle, PA 17013 Matthew Darhower 804 E Louther St Carlisle, PA 17013 Heather R Baker - McGee 483 Centerville Rd. Carlisle, PA 17241 Gwendolyn Y. Baker - Whistler Newville, PA 17241 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) FILE NUMBER 21-05-00964 AMOUNT OR SHARE OF ESTATE Daughter Daughter Daughter Grandson Grand Daughter Grand Daughter 1/3 remainder and 1,6541.80 1/3 remainder 1/3 remainder and 454.24 2,500.00 437.44 from US Savings BDS 1095.10 from US Savings BDS 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 2. 3. 4. 5. 6. 1. 2. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS First United Methodist Church Letort United Methodist Church 500.00 500.00 5W46AI 1000 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET (If more space IS needed, insert additional sheets of the same size) $ 1,000.00 II II I' ,[ II I! i I ! I II ,I II I LAST WILL AND TESTAMENT OF JEAN I. WEBS'IER I, JEAN I. WEBSTER of 168 East North Street, Carlisle, Cumberland II II County, Pennsylvania, being of sound and disposing mind, rnerrory and understanding, do hereby make, publish and declare this as and for my Last ~Qll and Testament, hereby revoking all other wills and codicils heretofore , i I i I; 'I \1 'I !I Ii I i II II I, i' II II I' ,i II II II Ii Ii Ii ,i made by me. FIRST I direct the payment of my debts and the expenses of my last illness and funeral fram my estate as soon after my death as conveniently may be done. Further, in this connection, I authorize my personal representati veto expend funds from my estate, in such arrount 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 specifically the following items: 1. Cherry antique bedroom suit, box spring, mattress, double wedding ring and quilt to Deborah. 2. Diarrond earrings, opal earrings, two china chests and matching desk, blue dishes, goblets and quilt to Kathy. 3. Grandrrother I s clock, large oven, large grandmother I s mixer to Kristen. j A ~ O\J 4. Llado porcelain, Hummels figurines to my granddaughters, Jenny, Becky, Gwen and Heather in equal shares. 5. Sewing rna.chine in cabinet and quilting books to Gwen. 6. Cutting table and sewing shelves to Heather. 7. Portable machine to Becky. 8. Great grandfather's pipe (Ilgenfirz) to Hans. 9. Grandfather's ring, desk & painting tilt table to Tbmmy. 10. Four poster bedroom suit to Matty. 11. $500.00 to First United Methodist Church, Carlisle, Pennsylvania. 12. $500.00 to Letort United Methodist Church, Drytown, Pennsylvania. I give, devise and bequeath to my grandchildren all old silver dollars ,~d other old coins as well as the paintings which are rna.rked on the back, in equal shares. THIRD I give, devise and bequeath the sum of $2,500.00 to each of grandchildren should they attending or will attend college. I direct that my Executrices set aside this sum to the extent I have not already provided some or all of that aIIDunt to a grandchild directly or through savings bonds purchased in my name and the grandchild I s and owned by me at the time of my death. FOURTH All the rest, residue and remainder of my estate, real, personal 'or mixed wherever situate, I give, devise and bequeath unto my daughters, Kathy M. Schork, Deborah J. Baker and Kristen A. Darhower, in equal shares, per stirpes. -------_._--,~~---~._._~-_. -_.__._.,._---~---~_._~---:---:-------. ----~--- . . . FIFTH I nominate, constitute and appoint my daughters, Kathy M. Schork, Deborah J. Baker and Kirsten A. Webster, Executrices of this my Last Will and ~Cestament . I relieve my personal representatives fran the necessity of posting security in connection with his duties as such in any jurisdiction in which he may be called upon to act insofar as I am able by law to do so. :1 , SIXTH In addition to the powers conferred by law, I authorize my JP-::xecutrices in their absolute discretion: !i Ii A. To retain in the fom received, and to sell either at public il 'lor private sale any real or personal property. Ii B. To manage real estate. il \i c. To invest and reinvest in all fonus of property without being ,I confined to legal investments, and without regard to the principal of 'I I, \i diversification. 1\ D. To exercise any option or rights arising from ownership of ,I " i I invesbnents. \1 'i E. To canprornise claims without court approval, and without the ! i i consent of any beneficiary. 'I I IN WI'INESS WHEREOF, I, have hereunto set my hand and seal to this, I my Last Will and Testament, consisting of four (4) typewritten pages, the first two (2) pages which bears my signature in the margin for the purpose of ~ . identification, this the \q - day of ~~, 1996. 9.-aw 5-7.ehtA- JEAN I. WEBSTER (SEAL) -y------- -- I ,;, .~: \~_:;~~ :'.'I~:.:1~~X.;:~,~';t;l~~~~~~.~: ~'~; - "": ' '_L""". Signed, sealed, published and declared by the above named :1 testatrix, JEAN 1. WEBSTER, 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. '~~ ~/!. Yd ADDRESsfl E:".tQ~~ ~ ?A- I{O\~ ADDRESS 2-;0' Flit 1't'V"~ S1-:) C'^ f" 1151<. 1-4 I ~ 13 ~TH OF PENNSYLVANIA: COUNTY OF CUMBERLAND We, JEAN I. WEBSTER, ;t//~~t<e I A. 5c--h~/t:-r- f2- ~ +- L. t) '!P, ~ and , the testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instnnnent, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instnnnent of her Last Will, 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 testator, 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 /9oM day of ~ 1996. Notarial Seal Jennifer S. Calaman, Notary Public Carlisle Bora, Cumberland County My Commission Expires Nov 29, 1999 Member, Pennsylvania Association of ~Jotaries u - 5 ~'fr B. J YPE OF LOAN: - A. 1.DFHA 2.DFmHA 3. [2I]CGrN. Uf'IINS. 4.DVA - 5.DCONV, INS. U:S. UI:i-'A!UMENT OF HOUSING & URBAN DEVELOPMENT ~----_.. . 6. FILE NUMBER: I 7. LOAN NUMBER: SETTLEMENT STATEMENT MOWERS 8. MORTGAGE INS CASE NUMBER: C. NOTE: This form is furnished,,to give YI;JU a st?Jtement of ,!ctual settlement costs. Amoynts pa!d to and by the settlement C!gent are shown. Items marked "{POC] were paid outside the closing; they are shown here for informational purposes and are not Included in the totals. . 1.0 3198 (MOWERS.PFDIMOWERS/11 ) D. NAME AND il,DDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER: ~> Tosha Mowers adult woman Estate of Jean Webster First Guaranty Mortgage 166 & 168 E. North Street 166 & 168 E. North Street 8180 Greensboro Dr., Suite 500 Carlisle, PA 17013 Carlisle, PA 17013 McLean, Va 22102 G. PROPERTY LOCATION: H. SETTLEMENT AGENT: I. SETTLEMENT DATE: 166 & 168 E. North Street Lindsay Dare Baird, Esq. Carlisle, PA 17013 February 27,2006 Cumberland County, Pennsylvania PLACE OF SETTLEMENT " 37 South Hanover Carlisle, PA 17013 J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION linn. ~Dnc>c> AAU UNT nilE I=RnM H()I-lI-I( WER: 400 r.Rn!'lS AMOIINT nllF Tn SEU ER: 101. Contract Sales Price . 150,491.00 401. ContradSales Price I 150,491.00 102. Personal Property I 402. Personal Property I 103. Settlement Charqes to Borrower (Line 1400) 5,278.51 403. I 104. 404. I 105. 405. I Adill~tments For Ilems Paid 8;; Seller in advance AdiuslmAnl" For Items Paid 811 Seller in advance 106. Cityrrown Taxes 02/28106 to 01/01/07 . 396.85 406. Cityrrown Taxes 02/28/06 to 01/01/07 I 396.85 107. County Taxes to 407. County Taxes to I 108. School 02/28/06 to 07/01/06 381.91 408. School 02/28/06 to 07/01/06 I 381.91 109. 409. I 110. 410. I 111. 411. I 112. 412. I 120. GROSS AMOUNT DUE FROM BORROWER 156,548.27 420. GROSS AMOUNTDUE TO SELLER I 151,269.76 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. Deposit or earnest rnonev 1,000.00 501. Excess Deposit (See Instructions) I 202. Principal Amount of New Loan(s) 120,000.00 502. Settlement Charqes to Seller (Line 1400) I 3,578.27 203. Existing loanls) taken subject to 503. Existing loan(s) taken subject to I 204. 2d Mortqaqe 504. Payoff of first Mortgage I 205. I 505. Payoff of second Mortqaqe I . 206. . 506. I 207. 507. (Deposit disb. as proceeds) I 208. 508. I 209. Seller assistance 4,500.00 509. Seller assistance I 4,500.00 Ad'us/ments For Items UnDaid Bv Seller Adjustments For Items Uno aid BV Seller 210. Citvrrown Taxes to 510. Cityrrown Taxes to I 211. County Taxes to 511. County Taxes to I 212. School to 512. School to I 213. 513. I 214. 514. I 215. 515. I 216. 516. I 217. 517. I 218. 518. I 219. 519. I 220. TOTAL PAID BY/FOR BORROWER 125,500.00 520. TOTAL REDUCTION AMOUNT DUE SELLER I 8,078.27 300. CASH AT SETTLEMENT FROMrrO BORROWER: 600. CASH AT SETTLEMENT TO/FROM SELLER: 301. Gross Amount Due From Borrower (Line 120) 156,548.27 601. Gross Amount Due To Seller (Line 420) i 151,269.76 302. Less Amount Paid By/For Borrower (Line 220) ( 125,500.00) 602. Less Reductions Due Seller (Line 520) [( 8Jm~,f7, 303. CASH ( X FROM) ( TO) BORROWER I 31,048.27 603. CASH ( X TO) ( FROM) SELLER 1/ 143,191.49 _-----.-0-.-- -- o~m NO 2502 026 HUD-1 (3-86) RESPA, HB4305.2 ACKNOWLEDGMENT OF RECEIPT OF SETTLEMENT STATEMEi',n Se!ttlement Date: Property Location: Tosha Mowers adult woman Estate of Jean Webster First Guaranty Mortgage Lindsay Dare Baird, Esq. 37 South Hanover Carlisle, PA 17013 February 27,2006 166 & 168 E. North Street Carlisle, PA 17013 Cumberland County, Pennsylvania Borrower: Seller: Lender: Settlement Agent: Place of Settlement: I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief, it is a true and accurate statement of all receipts and disbursements made on my account or by me in this transaction. I further certify that I have received a copy of the HUD-1 Settlement Statement. '- 1{Ya)l!J (10 f If II I ) Tosha Mowers E~a~~~..n. W. e.bst~,... "'J... ../f ~ C -) /'~\// /J BY: ~-=~-:~.J--i_~_.A,/ ~/--. President Ex t: 71/::;;;.' ,%;0' ATTEST: I Secreta ry/Treasu rer To the best of my knowledge, the HUD-1 Settlement Statement which I have prepared is a true and accurate account of the fund.s which were received and have been or will be disbursed b'1t.f1 he'Cf~e{sig.ned .as P?rtlJ. tt~e s,ynTeyent of this transaction. \.~,/l~AcL; .at 7.....) /0't?c.cC:S- LFldyY D~re Baird, Es,q. /' Settlement Agent \~j WARNING: It is a crime to knowingly make false statements to the United States on this or any similar form. Penalties upon conviction can inClude a fine and imprisonment. For details see: Title 18 U.S. Code Section 1001 and Section 1010, HUD-1 (3-86) RESPA, HB4305.2 II-! II.: L: II h'l 'j 'j =f:. , .. i : . II :t :.J :h'I~'\-. iI'~ .. 'I:. h'l r.:. , .' DEPARTMENT OF TRANSPORTATION CERTIFICATE OF TITLE FOR A VEHICLE 2,48 ----------------------------------------------------.--------------- issued in accordance with Section 1/05 of the Vehicle C;ode, Title 75, Pennsylvania Como/idated Stallltes 039036 JEAN I 168 E NORTH CARLISLE PA WEBSTER ST 17013 CODE LEGEND A ~ ANTIOUE VEHICLE C ~ CLASSIC VEHICLE F ."' OUT OF STATE VEHICLE H ~ AGRICULTURAL VEHICLE L ...~ LOGGING VEHIC;LE; 'P'''' FORMERLY A POLICE VEHICLE R ~ RECO~ISTRUCTED VEHICLE X ~ FORMERLY A TAXI WE 0 DUPL 88 YEAR PLYMOUTH MAKE OF VEHICLE MAX GROSS VEHICLE WEIGHT 8111/89 8/11/89 5167 WEIGHT DATE ISSUED DATE PA TITLED ODOMETER AT PURCHASE vehicle described hereon is subject to the following liens: CODES . .LIEN RELEASED BY AUTHORIZED REPRESENTATIVE SECOND LIEN FAVOR OF: LIEN RELEASED DATE LIEN HOLDER BY AUTHORIZED REPRESENTATIVE / certify that reasonable diligence has been used in examining the statements presented in the application for Certificate ot' Title to the vehicle described hereon. and that the proof of ownership of said vehicle presented wit/I said application warrants the issuance of chis certificate naming the applicant as lawful owner of said vehicle. Wherefore. J certify that as of the date inscribed hereon. the official records of the Pennsylvania Department of Tran~'portation reflect that said applicant is the lawful owner of said vehicle. 7.hu'~,,jJ fCr2-(.<~'-"~ l-IO'NAI10VERUSAUM. '" en J: f- <! o cr: LU f- en 2 2 o <! o f- o LU cr: LU ~ o a.. ::;: LU cr: LU U u... u... o 2 <! u... o LU U 2 LU en LU cr: a.. LU J: f- 2 >- ...J 2 o 2 (:l Vi c:i LU N cr: <! f- a 2 LU <Xl f- Vl :J 2 Vl LU a:: :J f- <! 2 (:l Vl ...J -l <! <0 "? ~ > ::; FIRST NAME MIDDLE INITIAL TYPE OR PRINT A io~ ~~~~~~,~e~t~:m~~ME O~ eR CO"PURCHASER LAST NAME i/< \ Q \-\ ((j) 1--.. FIRST NAME MIDDLE INITIAL f- Z LU 2 2 (:l Vl Vl <! f- Vl a:: u... STREET ADDRESS \ I Y- '7 (J Q Kl?/2... '0 CITY STATEp S 1-\ i P Je ,u ~ 6 [).1<G- . A SUBSCRIBED AND SWORN TO: MONTH BEFORE ME ~ (p ~ SI:NS~~~A~~S~~T~ ~ NI ZIP CODE '(~ S7 DAY YEAR d ''-0 i.? COMM I s: Borough of Carlisle, Cumberland County 8 PURCHAS (or Full Business Name) _9 INITIAL CO"PURCHASER LAST NAME FIRST NAME MIODLE INITIAL f- 2 LU :E 2 (:l Vi Vl <! o 2 o U LU Vl STREET ADDRESS CITY ST ATE ZIP CODE SUBSCRIBED AND SWORN TO: MONTH DAY BEFORE ME SIGNATURE OF PERSON ADMINISTERING OATH ...J <! UJ Vl MUNICIPALITY COUNTY COMMISSION EXPIRES: C liEN DATE 2 0 FIRST liENHOLDER f- 2<! :!:2 STREET ADDRESS -la:: 0 u... CITY 2 D 2 aLU --l f-f- <!- Uf- ...J -a:: <! <to LU a..u... Vl <! ~IF NO LIEN, CHECK STATE ZIP CODE ;p. YEAR Purchaser's DIN (If applicable) l/WE warrant this Certificate of Title and transfer ownership of this vehicle to purchas€r(s) listed in this section and certify that except as listed ir; Section C, this vehicle is not subject to liens or other legal claims IlWE certify to the best of my-lour knowledge that the odometer reading IS Lt LL D D D and reflects the actual mileageot the vehicle - _l,_ _ _ described herein (check below If applicable). Not to include tenths o ~~:~~ss f~~h~ra~~~~ld~llil~~;T~~/~rerror D Mileage is over 99,999 and actual mileage is unknown WARNING: An inaccurate odometer statement may make you liable for damages to your Transferee pursuant to 9 409 (Al of .the Motor Vehicle Information and Cost Savings Act of 1972. . "d,~Q '\/'i <;. l~ft::' DA R ulc__ L- .~ Purchaser's DIN (If applicable) I/WE warrant this Certificate of Title and transfer owner.shlP of this vehicle to purchaser{sl listed in this section, and certify that except as lIsted in Section C, thiS vehicle is not subject 10 liens or other legal claims. I/WE certify to the best of my/our knowledge that the odometer reading is and reflects the actual mileage of the vehicle - - -,_ _ _ described herein (check below if applicable) Not to include tenths O Differs from actual mileage for reasons other than cal ibration error and actual mileage is unknown. WARNING: An inaccurate odometer statement may make you liable for damages to your Transferee pursuant to 9 409 (A} of the Motor Vehicle Information and Cost Savings Act of 1972. o Mileage is over 99,999. SIGNATURE OF SELLER X SIGNATURE OF CO"SELLER X DO NOT SIGN UNLESS PURCHASER'S NAME AND ADDRESS APPEAR TO THE LEFTI liEN DATE ~IF NO liEN, CHECK SECOND liENHOLDER STREET ADDRESS CITY STATE ZIP CODE X When applying for title with a co.owner, other than your spouse, check one of these blocks. If no block is checked, titlewdl be issued as "Tenants in Common." A 0 Joint Tenants with Right of Survivorship (on death of one owner, title goes to the surviving owner). B 0 Tenants in Cornman (on death of one owner, interest of deceased owner oes to his Of' her heirs or estate).