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Home My WebLink About12-26-06 ...J 15056041114 REV-1500 EX (06-05) OFFICIAL USE ONLY County Code Year File Number 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 J.. \ olP {)~Ltl Date of Birth 209-28-8611 05162006 02121936 Decedent's Last Name Suffix Decedent's First Name MI WERT MR. (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix DALE E 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 m 1. Original Retum D 2. Supplemental Return D 4. Limited Estate D 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) D D o D 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required m 6. Decedent Died Testate (Attach Copy of Will) D 9. Litigation Proceeds Received D D 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number STEPHEN D. TILEY Firm Name (If Applicable) 717-243-5838 , REGISTEROf WILLS USE;G!JL Y L.,-.... FREY AND TILEY First line of address r') ,"'"') 5 SOUTH HANOVER STREET 1") ,j"\ Second line of address CARLISLE City or Post Office ..C _..._, ".0 State ZIP Code DATEl'n..ED / co PA 17013 STILEY@FREYTILEY.COM ADDRE MER E E. WERT, 641 HAMILTON ST., CARLISLE, PA 17013 SIGNATURE OF PR}PARER OTHER THAN ~EPRESENTATIVE ADDR~6-/f"'--t A . "7 .....L ( STEPHEN D. TILEY, 5 SOUTH HANOVER ST. CARLISLE, PA 17013 PLEASE USE ORIGINAL FORM ONLY DATE 12/21/06 Side 1 L 15056041114 15056041114 ...J ~ -.J 15056042115 REV-1500 EX Decedent's Name: DALE EWERT MR. RECAPITULATION 1. Real estate (Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. Stocks and Bonds (Schedule B) . . . . . . . . . . __ . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . . . 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . . . 6. Jointly Owned Property (Schedule F) DSeparate Billing Requested. . . . . . . . 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) DSeparate Billing Requested. . . . . . . . 8. Total Gross Assets (total Lines 1-7) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209-28-8611 Decedent's Social Security Number 1. 2. NONE 3. NONE 4. NONE 5. 6. NONE 7. NONE 8. 9. 30000.00 65953.66 95953.66 11923.03 9. Funeral Expenses & Administrative Costs (Schedule H) . . . . . . . . . . . . . . . . . . . 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 Subjectto 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.O L 16. Amount of Line 14 taxable at lineal rate X .0 ~ 17. Amount of Line 14 taxable at sibling rate X . 12 18. Amount of Line 14 taxable at collateral rate X . 15 $74,453.95 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15056042115 15. 16. 17. 18. 15056042115 9576.68 21499.71 74453.95 0.00 74453.95 0.00 0.00 8934.00 0.00 8934.00 IT] -.J REV-1500 EX Page 3 209-28-8611 Decedent's Complete Address: DECEDENT'S NAME WERT, DALE E., ESTATE STREET ADDRESS 26 EAST WINDING HILL ROAD 21-06-0447 File Number CITY MECHANICSBURG STATE PA ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 8934.00 $10,000.00 $526.30 Total Credits ( A + B + C) (2) 10526.30 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. Fill in oval on Page 2, Line 20 to request a refund. (4) 0.00 1592.30 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 A. Enter the interest on the tax due. (SA) 0.00 B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58) 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; . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 0 b. retain the right to designate who shall use the property transferred or its income; . . . . . . . . . . . . . . .. 0 c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 0 o o 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .. 0 o d. receive the promise for life of either payments, benefits or care? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . No o o o o o o o 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. 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. 39116 (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. ~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. 217 REV-1502 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Wert, Dale E. 21-06-0447 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 Gross proceeds from sale of real estate at 26 East Winding Hill Road, Mechanicsburg, PA 17055 VALUE AT DATE OF DEATH $30,000.00 TOTAL (Also enter on line 1, Recapitulation) (If more space is needed, insert additional sheets of the same size) $ 30,000 217 REV-1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Wert, Dale E. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21-0600447 Include the proceeds of litigation and the date the proceeds were received by the estate. All prooertv iointlv-owned with riaht of survivorshio must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. PNC Bank checking Accl. No. 500064058 Accrued interest to date of death $7,003.07 1 2. PNC Ban savings Accl. No. 5030021673 Accrued interest to date of death $11,354.86 16 3. Net proceeds of sale of real estate at North Middlesex Road, Cumbo Cty., PA, which sale took place prior to death. Net proceeds received after death from Attorney Paul Bradford Orr. $41,578.73 4. Sale of 1952 Harey Davidson motorcycle $5,000.00 5. Sale of miscellaneous personal property located in self storage unit $250.00 6. Sale of juke box $300.00 7. Sale of 1986 Chevy Truck $450.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 65,954 217 REV-1511 EX + (12-99) COMMONWEALTH OF PEiNNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Wert. Dale E. FILE NUMBER 21-0600447 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Hoffman-Roth Funeral Home $7,242.00 Refund from Hoffman-Roth Funeral Home ($433.80) B. ADMINISTRATIVE COSTS: 1. 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: 2. Attomey Fees $4,796.83. 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees $298.00 6. Tax Retum Preparer's Fees 7. Five short certificates $20.00 TOTAL (Also enter on line 9 RecapitUlatiOn)' $ 11 923 Debts of decedent must be reported on Schedule I. (If more space is needed, insert additional sheets of the same size) REV.1512 EX+ (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER Wert, Dale E. 21-06-0447 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. See attached list $9,576.68 TOTAL (Also enter on line 10, Recapitulation) $ (If more space IS needed, Insert additional sheets of the same size) 9,577 ESTATE OF: WERT, DALE E. FILE NO.: 21-06-0447 ATTACHMENT TO SCHEDULE "I" Date 2006 3-Jun Paul Bradford Orr Law Office - Invoice No. 7408 for services rendered in connection with sale of Middlesex Road property to Strickland Brothers 75.00 3-Jun Lancaster HMA Phys Mgmt. Central P A 21.89 3-Jun Merle E. Wert - Reimburse for Stardust Self Storage Rentals 79.50 3-Jun Andorra Radiology Assoc., P.c. 7.79 3-Jun PP&L 31.88 3-Jun Masland Associates, Inc. 92.69 3-Jun Masland Associates, Inc. 9.98 3-Jun West Shore EMS 73.05 3-Jun Masland Associates, Inc. 9.98 6-Jun Andorra Radiology Assoc., P'c. 10 .44 6-Jun United Water of Pennylvania 6.76 12-Jun Carlisle Regional Medical Center 952.00 12-Jun Carlisle Regional Medical Center 189.68 12-Jun Carlisle Regional Medical Center 48.72 12-Jun Carlisle Regional Medical Center 712.00 14-Jun Lancaster HMA Phys. Mgmt. Central P A 37.70 23-Jun Masland Associates, Inc. 112.96 23-Jun PP&L 25.33 27-Jun Diversified Appraisal Services 300.00 Attachment to Schedule "I" Page 1 of 2 ESTATE OF: WERT, DALE E. FILE NO.: 21-06-0447 27-Jun United Water of Pennsylvania 6.76 24-Jul PP&L - Refund for disconnect of East Winding Hill Road (15.80) 24-Jul Carlisle Regional Medical Center 952.00 24-J ul Marlin A. Yohn, Sr. '" Treas. 2006 Cty. & Twp. Tax East Winding Hill Road Property 404.91 24-Jul Lower Allen Township (Sewer for E. Winding Hill Road) 100.00 24-Jul Masland Associates, Inc. 10.81 28- Aug Claremont Nursing Home 3,266.04 28-Aug Claremont Nursing Home 2,460.00 28-Aug The Sentinel 137.03 28-Aug Marlin A. Y ohn, Sr. - Treas. - 2006/07 School Real Estate Tax for East Winding Hill Road property 1,248.16 31-Aug Refund - Carlisle Regional Medical Center (952.00) 31-Aug Transfer Tax - Sale of East Winding Hill Road property 300.00 31-Aug Tax Certification by Tax Collector - Sale of East Winding Hill Road property 5.00 31-Aug Final Water and Sewer Bil - Sale of East Winding Hill Road 100.00 31-Aug County and Township Tax Pro-Ration - Sale of East Winding Hill Road property (136.44) 31-Aug School Tax Pro-Ration - Sale of East Winding Hill Road property (1,039.56) 31-Aug Sewer Bill Pro-ration - Sale of Ease Winding Hill Road property (67.58) TOTAL SCHEDULE "I" DEBTS OF DECEDENT: 9,576.68 Attachment to Schedule "I" Page 2 of 2 217 REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Wert Dale E SCHEDULE J BENEFICIARIES FILE NUMBER 21 060447 ,. - - 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)J Merle E. Wert, 641 Hamilton St., Carlisle, PA 17013 Brother 100% 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 $ (If more space is needed, insert additional sheets of the same size) LAST WILL AND TESTAMENT OF DALE E. WERT I, DALE E. WERT, unmarried, of Upper Allen Township (mailing address; 26 East Winding HilI Road, Mechanicsburg, PA 17055), Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament hereby revoking and making void any and all Wills by m.e at any time heretofore made. 1. I direct my hereinafter named Executor to pay all of my just debts and funeral expenses as soon after my death as may be found convenient to do so. I direct that my funeral services be conducted by Hoffman-Roth Funeral Home, 219 North Hanover Street, Carlisle, Pennsylvania, in accordance with arrangements which I intend to make there, and that my body be interred on a burial lot which I intend to acquire either in Westminster Cemetery, or in Cumberland Valley Memorial Gardens, each of which is located near the Borough of Carlisle, Pennsylvania. 2. I direct that all inheritance, transfer, succession, estate and death taxes, including interest and penalties thereon, which may be payable on account of my death shall be payable from the residue of my estate regardless of whether the assets upon which such taxes are based are included in my probate estate. 3 All of the rest, residue and remainder of my estate, real, personal and mixed, and wheresoever the same may be situate, I give, devise and bequeath to my brother, MERLE E. WERT, his heirs and assigns. 4. I hereby nominate, constitute and appoint my brother, MERLE E. WERT as Executor of this my Last Will and Testament, and further direct that he shall not be required to post any bond to secure the faithful performance of his duties in the Commonwealth of Pennsylvania or in any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament written on one (1) page, this .:l:J~ay of September, 2005. ,4b (;: Z#Jl/27. DALE E. WERT (SEAL) l -~ + ~. - ) ~ ."J ~. .., Signed, sealed, published, and declared by DALE E. WERT, the Testatorabove t;-~) named as and for his Last Will and Testament, in our presence, who, in his presence, at co his re~uest, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. ~-:fj ~ / .~ ~dL Pagel of I r'...,) (::::'1 c.;', C',", ::-0 rri <J C.:J ...:r""J c') I; t '~J ---; ~~-;;~ :.-:; ~'..;~ no ,...-~I (~~ j'.) c.) .u.,,' nvu"' \.,)IOtl} UtI nanaoQoll. 4,)UO.:':: A. Settlement Statement ~ U.S. Department of Housing and Urban Development ,.' I n~n OMBA r .. ... 7~n7.n2n~ I..xnin.. ~J:ln/20n61 I. DFHA 2. DFmHA 3. DConv. Unins. I 6. File Number I 7. Loan Number I 8. Mortgage Insurance Case Number 4. OVA .~ O~nnv Ins. S100-504 C. Note: This form Is furmshed to give you a stltemenl of &dUlY selUement costs. Amounls paid to and by the setuement agent are shown. I TiUeExpress SeWement System Items marked "(p.o.c.t were pllid outside the dosing; they are shown here for Info""ellon purposes and are not induded.in the lolals. WARNING: Ills a crime to knowingly make fel.. staleme.nls to ,!h~I~n1~~1 S~.t.s on this ~ eny other similar fonn. Penallles upon ..... ....,. D. NAME OF BORROWER: Richard P. Hart, Jr. and Nancie J. Hart .nnR"~~' 5154 Kvlock Road Mechanicsburl> PA 17055 E. NAME OF SELLER: The Estate of Dale E. Wert . nnD.... F. NAME OF LENDER: Orrstown Bank ,nnR"~.' P. O. Box 250 Shinnensburl!. PA 17257 G. PROPERTY ADDRESS: 26 East Winding Hill Road, Mechanicsburg, PA 17055 UDDer Allen Townshin H. SETTLEMENT AGENT: P A Real Estate Settlement Services, LLC 1>1 '''''''ur. 354 Alexander SDrine: Road Ste Carlisle P A 17015 I.SETTL 08/3112006 J. SUMMARY OF BORR , TRAN~Ar.TION: K. SUMMARY OF SELLER'S TRANSACTION' 100. M 400 GROSS """ "'T nl '" T() !':I=I I I=R 101 30 000.00 401 30 000.00 1n? .n? 103. 4 491. 75 An, 1n. .n. 105. '05. ". . . bv ...n..,' "r" 106. .06 1n7 OB/31/0610 12/31/06 136.44 An7 08/31/06'n 12/31/06 136.44 lOB. 08/31/06'n 06/30/07 1 039.56 .08 08/31/061006/30/07 1 039.56 1n~ 409. 11n 67.58 .,n 67.58 111. .,1 117 412 120. 35 735.33 47n "'""c,,, '''''' 31 243.58 200. 500 T '''''' ?n1 1 000.00 501 ". 1 000.00 202 ,ntn' 502 405.00 203. <n, on. 5n. 'Mn 205. 35 735.33 <no Orrstown Bank 206. <OR ?n7 507 208 <no ,ng 509 for items noaid bv .ell 210. "n 711 511 212 "_h II.... 512 213 513. 214 <14 ?1< '" 716 51B 217. "7 718 518 219. 519 220. TOTAl 36 735.33 ~7n T()T A' AM()IINT 0111= !':I=I I=R 1 405.00 300. IORTO 600 ~. ~ TO OR 301. . nine 120\ 35 735.33 601 31 243.58 ,no 36 735.33 An? 1 405.00 303 1 000.00 603 CASH TO SE'llE'R 29 838.58 SUBSTITUTE FORM 1099 SELLER STATEMENT: The information contained herein is lmportanllaxlnformatlon and Is being furnished to the Internal Revenue Sarvfee. If you are required 10 file II return, s negligence penalty or other sanction will be Imposed on you If this Item is required to be reported and the IRS detennlnes that it has not been reported. The Contract Sales Price described on line 401 above consUMe. the Gross Proceeds of thlslransactloo. You are rsqulred by law 10 provide the setdemenl agent (Fed. Tax 10 No: ) wilh your corred taxpayer identification number. If you do not provide your correct taxpayer identification number, you may be Subject 10 civil or a1minal penalties impoSed by law. Under penalties of perjury, I certify that the number shown on this .tatementls my ~ct taxpayer ldenlllicalion number. TIN:_9_"_'_-_-_ SElLER(S)SIGNATURE(S): SELLER(S) New MAILING AOORESS: SELLER(S) PHONE NUMBERS: (H) (WJ JEPARTMENT OF HOUSING AND URBAN DEVELOPMENT T MENT File Number: S 100-504 PAGE 2 ,rTLEMENT STA E 'TTL PAID FROM PAID FROM VITA' "AI C"'DD"K I based on oriee 530 000.00 = BORROWER'S SELLER'S , , . . FUNDS AT FUNDS AT ., . 'n :lETTLEMENT SETTLEMENT 702 S 'n 70~ ROO ITEMS PAYABLE IN CONNECTION WITH LOAN B01 IMn 1.000 '/_Orrstown Bank 1 800.00 R07 I n.n n.....,,,n. 'k on~ 10 Orrstown Bank 500.00 RnA RO. "nn" "prt F.. 10 Orrs town Bank 30.00 RO. 10 Orrstown Bank 250.00 on7 ROR B09 B10 ." 000 ITFMS RFOl II NDER TO BE PAID IN ADVANCE 001 'nlpr..1 From 10 i!l)S '".u 007 Mortn.n. lo.","or.o Pr.mi"m fnr In ao~ .....r" fn ao~ 90B 1 Don. RFSFRVFS nFpnSITFn WITH I FNnFR FOR 1001 ....70r" In..".n"" mo i!l)S I~n 1002 Mortn.a. 'os"rao"" ~n "". I~n 100~ ~n "". 1mn 100~ mn i!l)S '~n 100B ~n "". I~n 1nna 0.00 0.00 1100. TIT! 1101 1107 110' 110~ 1105 110R Nnt.~ Fpp. In Salzmann Ruches P.C. 10.00 1107 110R In Stewart Title Guarantv/PA RE SS 1 300.75 ,lIp~, Nn' 11 00 I .n".'. Pn"", 180 000.00 - 838.75 1110 30 000.00 - 462.00 1111 Fn"' nn Fn".nn Fn" ann In Stewart Title Guarantv/PA RE 5S 150.00 1117 "" In Stewart Title Guarantv/PA RE SS 35.00 1200.G RECORDING AND TRA",c::cCD 1701 38.50 . Un"n~p' 48.50 . I>p'P"P . 87.00 1?07 npprt. 300.00 ' ...."" .. 300.00 "0' n..... 300.00 . U,,"" , . 300.00 1204. "M 'n Cumberland County Recorder of Deeds 29.00 1"00 Ann'TI""'AI NT ..01 In Salzmann Huahes P.C, 5.00 "o~ 'Rill In UDDer Allen TownshiD 100.00 1400. TOTAL SETTLEMENT CHARGES I .O? "....'nn 1(\ 4 491. 75 405.00 HUO CERTIFICATION OF BUYER AND BELLER enl of all recelpls and disbursements made on my accounl or by me " WARNING: IT IS A CRIME TO KNOW'NGL Y 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. ,.J......,' .&oJ l::;.~~U c;.J. -;;:>0 t"'NI...l:SHNK 412 76B 345B P.01/01 o PNCBAN< June 20, 2006 Frey & Tiley Attn: Stephen D Tiley 5 South Hanover St. Carlisle, P A 17013 scp RE: Estate of Dille E Wert (Deceased) SSN: 209-28-8611 DOD: 05-16-2006 Dear Mr. Tiley: In response to your request for Date of Death balances for the customer noted above, our records show the following: Checking ACCOIlDt Account #5000646058 Established 01-03-1997 DALE E WERT DOD balance: $7,003.07 + $0.94 accrued interest Savings Account Account #5030021673 Established 02-05-1990 DALE EWERT DOD balance: $11,354.86 + S 15.51 accrued interest Please note that this office only provides date of death balances for deposit accounts (IRAs, CDs, Checking and Savings accounts). We do not process any financial transactions or provide statements. If you need assistance with any of these items, please call 1-88S-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch office. Sincerely, " ./ '" _./ ~e,- ~. ~ Erica L Schlegel 1-800-762-1775 P7-PFSC~-F SOO First Ave. Pittsburgh PA 15219 Member FDIC TOTAL P.01 . <fAn!' . J!) 11 .-1 -!J /l ~ _ . ..~..~ C!4Y~ yJ~___.. 7 bV~f~ .~~ -# __________q__-__________>iq .... .. t:~ 1ft:!.H. .....ll.~ C. . .Z;; .... . . .. .....1~~ C.. ... ....10..... ' .~~~=.~~=.~:.....~.=~..:..........._.=-...~ . . __ .. ._.'.'_ _ .__._._~----.-:. __ .__._ _:.._.______ _ .._ _.._.._ ...__ _ __ _.________ _.__ ----;;;22-r:2:...--.----- .__ i .............. _~..cL: .~..=.~=..=.='{r . ~~- ;f~ .~ .~.--f- -.J~__...;J~,_ _ -..--78': - I( j~_~_JJ'&.~L6__.~ --....----..------ '. -----ii---,-.~C~--tJ~V--U~ - - -----~--~_..._..,.;.-- I!> 9::> o ..-\ \ ~ \1 \ 0 ill <8 (<) ...- C') .n ~ 6 <l) ,- i~ '-J) \;) (Y) ) S) '- U1 '4 o IX. ':\ 1 0. I"- 0. ...- 4~ f . 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