HomeMy WebLinkAbout01-25-07
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15056041125
. R.EV -1500 EX (O6-(5)
PADepartmentof RevenueW
6ureauoflndMdualTaxes . INHERITANCE TAX RETURN
PO BOX 280601 '
Harrisburg, PA 17128-0601 . RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
OFFICIAl USE ONt y
County Code Year
2 1 0 6
File Number
o 966
Date of Birth
16824 4 397
1026200 6
11211930
Decedenfs Last Name
SMITH
Suffix
Decedents First Name
CHARLENE
MI
P
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's First Name
MJ
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WilLS
FILL IN APPROPRIATE OVALS BELOW
00 1. Original Return
o 4. Limited Estate
006. Decedent Died Testate
(Attach Copy of Will)
o 9. Litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (date of
death after 12-12-82) .
o 7. Decedent Maintained a Uving Trust
(Attach Copy of Trust) ,
o 10. Spousal Poverty Credit (date of death 0 11. Elect/on to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95} (Attach Sch. 0)
CORRESPONDENT - THIS SECTION MUSrBE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD B~RECTED TO.:
Name . Daytime Telep~e Number 5 ." Cl r~
J A NEE A DAM S E S Q 7 1 7 i~~ 5 8~ 0 ~~8
IXO -- c. .. r~J
REGISTE;~~I~ USE~Y i.1t18
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"()C) -" 1:, ',1
..O-'h 3 L=: :D
5~-:.; N~. ~~
Cl ::~ .. L-:-:) C:::.l
'J:> c...> I --n
i
I
o
o
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
Firm Name (If Applicable)
First line of address
6 4 SOU T H P IT T S T R E E T
Second line of address
City or Post Office
State
ZIP Code
DATE FILED
CAR LIS L E
P A
17 0 1 3
Correspondent's e-mail address: ESQAdams(CUaol.com
Under penalties of pesjury, I declare that I have examined this return, Including accompanying schedules and statements, and to the best of my knowledge and belief.
it is true, correct and complete. Declaration of preparer other than the personal representative is based on all Information of which preparer has any knowledge.
SIGNA OF P RSON RESPONSIBL R FIUN RETURN
DATE
T ST CARLISLE PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
L
15056041125
15056041125
-.J
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15056042126
REV-1500 EX
Dececlenfs Name: CHARLENE P. SMITH
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) 0 Separate Billing Requested . . . . . .. 6.
7. Inter-Vivos Transfers & Miscellaneous N.QD;Probate Property
(Schedule G) U 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 Govemmental Bequests/Sec 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.
TAXCOMPUTA TION - 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 .00L
16. Amount of Line 14 taxable
at lineal rate X.O
17. Amount of Line 14 taxable
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate X .15
9 4 750
7 7
15.
o
o 0
16.
o
o 0
17.
3 0 5 9 8
2 8
18.
19. Tax Due
. . . . . . . . . . . . . . . . . . . . . . . . . .. . . .. . .. . . . . . . . . . . . . . . 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
L
15056042126
Decedent's Social Security Number
16824 439 7
9200000
4 6 5 4 2 1
o 0 0
1000000
3689370
o 0 0
o 0 0
14354791
1782233
3 7 6 5 3
1819886
12534905
o 0 0
12534905
4 2 6 3 7 8
o 0 0
o 0 0
4 5 8 9 7 4
8 8 5 3 5 2
D
15056042126
--I
REV-1500 EX Page 3
Decedent's Complete Address:
File Number
0966
DiCEDENrs NAME
CHARLENE P. SMITH
STREET ADDRESS
140 PORTER AVE
CITY I STATE I ZIP
CARLISLE PA 17013
Tax Payments and Credits:
1. Tax Due (Page 2 Une 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1 )
8,853.52
442.68
Total Credits (A + 8 + C) (2)
442.68
3. Interest/Penalty if applicable
D. Interest
E. Penalty
TotallnterestJPenalty ( 0 + E) (3)
4. If Une 2 is greater than Une 1 + Une 3, enter the difference. This is the OVERPAYMENT.
Fill In oval on Page 2, Line 20 to request a refund. (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (SA)
0.00
0.00
8,410.84
8. Enter the total of Line 5 + SA. This is the BALANCE DUE.
(58)
8,410.84
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 00
b. retain the right to designate who shall use the property transferred or its income; ............................... 0 00
c. retain a reversionary interest; or ................................................................................................ 0 00
d. receive the promise for life of either payments, benefits or care? ....................................................... 0 00
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ........................ ................................ .n............... ............. 0 00
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ......... 0 I&J
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .............................. ........ ............................................................ 0 00
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 exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax retum are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an
adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. ~9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 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 + (6-98)
iW
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
CHARLENE P. SMITH 0966
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 wining buyer and a willing seller, neither being compelled to buy or sen. both having reasonable knowledge of the relevant facts.
Real DroDlrtv which Islolntlv-owned with r1aht of survlvorshlD must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
HOUSE AND LOT AT 140 PORTER AVENUE, CARLISLE, PA 17013
Life Estate to Friend, Remainder Interest to Children (See Calculation at Exhibit "B")
Value based on appraisal attached as Exhibit "Bn
VALUE AT DATE
OF DEATH
92,000.00
TOTAL (Also enter on line 1, Recapitulation) $
(If more space is needed, Insert additional sheels of the same size)
92000.00
REV-1503 EX + (6-98)
~.
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
CHARLENE P. SMITH
FILE NUMBER
0966
All property jolntly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
4,654.21
79 SHARES METLlFE, INC.
Value based on 1099 attached as Exhibit "C"
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
4.654.21
REV-1504 EX + (6-98)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE C
CLOSELY-HELD CORPORATION,
PARTNERSHIP OR
SOLE-PROPRIETORSHIP
ESTATE OF
CHARLENE P. SMITH
FILE NUMBER
0966
Schedule C-1 or C-2 (including all supporting information) must be attached for each cIosely-he1d corporation/partnership interest of the decedent other than a
sole-proprietorship. See instructions for the supporting information to be submitted for SOle-proprietorships.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
NONE
0.00
TOTAL (Also enter on line 3, Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
0.00
REV-1507 EX + (6-98)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE D
MORTGAGES & NOTES
RECEIVABLE
ESTATE OF
CHARLENE P. SMITH
FILE NUMBER
0966
All property jolntly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
10,000.00
DEBT OWED BY BRAD T. SMITH
TOTAL (Also enter on line 4, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
10.000.00
REV-1508 EX + (6-98)
'W
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
CHARLENE P. SMITH
FILE NUMBER
0966
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jOlntIy-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
MISC. PERSONAL FURNITURE AND PERSONAL PROPERTY
VALUE AT DATE
OF DEATH
1,500.00
2.
WACHOVIA BANK NA
CD No. 247412044008831
Value based on bank statement attached aqs Exhibit "0"
WACHOVIA BANK NA
CD No. 247412064102975
Value based on bank statement attached as Exhibit "E"
WACHOVIA BANK NA
Deposit Account No. 1010080462152
Value based on bank statement attached as Exhibit "F"
1970'S GRANDFATHER CLOCK
Inexpensive, Not Antique Quality and Not Working
20,163.91
3.
3,506.62
4.
11,623.17
5.
100.00
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
36 893.70
REV-1509 EX + (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
CHARLENE P. SMITH
FILE NUMBER
0966
If an asset was made joint within one year of the decedents date of death, It must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A.
NONE
B
c
JOINTL Y-owNED PROPERTY:
LEffiR DATE DESCRIPTION OF PROPERTY "'OF DATE OF DEATH
ITEM FOR JOINT MADE. INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER ATTACH DEED FORJOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENrSINTEREST
1. A. NONE 0.00 0.00
TOTAL (Also enter on line 6, Recapitulation) $ 0.00
(If more space IS needed, Insert additional sheels of the same size)
REV-1510 EX + (6-98)
..
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
CHARLENE P. SMITH
FILE NUMBER
0966
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 INClUDE THE NAME OF THE TRANSFEREE, THEIR R8.ATlONSHIP 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. NONE 0.00 0.00
TOTAL (Also enter on line 7 Recapitulation) $ 0.00
(If more space IS needed, insert additional sheets of the same size)
REV-1511 EX + (12-99)
.
tF.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
CHARLENE P. SMITH
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
0966
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. HOFFMAN - ROTH FUNERAL HOMES, INC. - Funeral 8,306.79
2. WESTMINSTER CEMETERY - Grave Opening and Closing 1,150.00
3. GEORGE'S FLOWERS - Funeral Flowers 159.00
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 JAN E E ADAMS ESO 7,177.40
3. Family Exemption: (If decedents address is not the same as claimants. attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent .
4. Probate Fees REGISTER OF WILLS 310.00
5. Accountants Fees
6. Tax Return Prepare(s Fees
7. STATE FARM INSURANCE - Homeowner's Insurance 324.00
8. DEBORAH FEGLEY - Reimburse Executrix's Travel Expenses 41.00
9. POSTMASTER - Postage 24.14
10. REGISTER OF WILLS - File Inventory and Appraisement 30.00
11. DIVERSIFIED APPRAISAL SERVICES - Real Estate Appraisal 300.00
TOTAL (Also enter on line 9, Recapitulation) $ 17.822.33
(If more space Is needed. Insert additional sheets of the same size)
REV-1512 EX + (12-03)
'*,
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
CHARLENE P. SMITH
FILE NUMBER
0966
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, Including un reimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. KOHL'S 55.21
Credit Account
2. UGI 245.31
Utility Account
3. EMBARQ 25.34
Utility Account
4. COMCAST 50.67
TV Cable Bill
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
376.53
REV_1513EX<,.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
CHARLENE P SMITH
SCHEDULE J
BENEFICIARIES
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 o~ht spousal distributions. and transfers under
Sec. 9116 (a (1.2)]
1. DEBORAH FEGLEY Lineal
4523 Cameron Road One-Third Residue
Caledonia NY 14423
2. SUZANNE CRULL Lineal
148 Opossom Lake ROad One-Third Residue
Carlisle P A 17013
3. BRAD T. SMITH Lineal
15 Partridge Circle One-Third Residue
Carlisle PA 17013
4. JOSHUA FEGKEY Lineal
Office of Residential Life I SUNY Brockport Grandfather Clock
Brockport NY 14420
5. LAMONT BLACK Collateral
140 Porter Avenue Life Estate in Home
Carlisle PA 17013
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 TAXIS NOT BEING MADE
1. NONE 0.00
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1. NONE 0.00
TOTAL OF PART IT - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00
..
FILE NUMBER
0966
(If more space Is needed, Insert additional sheets of the same size)
&)(",.,,. .. A"
Last Will and Testament of
Charlene Smith
I, CHARLENE SMITH of 140 Porter Avenue, Carlisle, Cumberland County, ~~ .:J
Pennsylvania, being of sound and disposing mind, memory, and understanding, hereby d~V,!;
this instrument to be my Last Will and Testament, revoking any and all Wills by me heretof9Q;;
mad " ~', '71
e. " ,. c'~ ;:.:::
- ~~j '-:,~~
ITEM ONE: I direct that all my just debts and ftmeral expenses, including the i-~~~-6
reasonable cost of a grave marker, shall be paid from my estate, as soon as practicable ~,;Tihy
decease, as part of the expense of the administration of my estate.
ITEM TWO: I hereby appoint my daughter, DEBORAH FEGLEY, of Caldonia, New
York, Executrix of this, my last will. If she should for any reason fail to qualify, be unable to act,
or cease to act, then I appoint LAMONT BLACK of Carlisle, Pennsylvania as Executor with the
same rights, powers, and duties.
ITEM THREE: I direct that my Executor or Executrix, shall not be required to give bond
for the faithful performance of his ,or her duty in this or any other jurisdiction.
ITEM FOUR: I direct that all taxes may be assessed in consequence of my death, of
whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as
part of the expense of the ailm;nistration of my estate.
ITEM FIVE: I authorize my Executor to exercise the following powers in addition to
those given by law, to be exercised in his or her sole discretion: '
A. To retain any real or personal property 'which may at any time fonn a part of
my estate so long as he or she deems advisable.
B. To invest, in any real or personal property without restriction to legal
investments.
C. To repair, alter, improve, or lease for any period of time any real or personal
property and to give options for leases.
D. To sell, at public or private sale, for cash or credit, with or without security, to
exchange or to partition real or personal property and to give options for sales and
or exchanges.
E. To make distribution in kind.
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F. To compromise claims.
G. To exercise all pow~r, authority, and discretion given by this will after the
termination of any trust created herein until the same is fully distributed.
ITEM SIX: I hereby give my House, to my Executor upon the following trust:
a. LAMONT BLACK shall have personal use and occupation of my house as a
place of residence, and the use thereof during his lifetime;
b. The monthly rent payable by LAMONT BLACK during his lifetime shall not
exceed the prorated cost of taxes and insurance on the house. LAMONT BLACK
shall be responsible for the costs of utilities.
c. LAMONT BLACK shall be responsible for necessary and reasonable upkeep
and maintenahce of the house. .
d. My ~xecutor shall be responsible to ensure that the grounds of the property are
maintained as nearly as possible as they were at my death.
e. I authorize my Executor, during the lifetime and with the consent of,
LAMONT BLACK, to lease the premises on such reasonable terms as my
Executor may determine such that the rents received are paid to LAMONT
BLACK.
f. Upon the death of LAMONT BLACK, the house shall pass to my children,
suZANNE CRULL, of Carlisle, Pennsylvania, and DEBORAH FEGLEY, of
Caldonia, New York, and BRAD TIMOTHY, of Carlisle, Pennsylvania, or their
issue per stirpes, for their use absolutely.
ITEM SEVEN: I hereby give my oldest grandson, JOSHUA FEGLEY, ofCaldonia, New
York, my grandfather clock.
ITEMEIGHT: All the rest, residue and remainder of my Estate, real, personal, or mixed,
of whatsoever nature and wheresoever situate, I give in equal shares, unto my children,
SUZANNE CRULL, of Carlisle, Pennsylvania, and DEBORAH FEGLEY, of Caldonia, New
York, and BRAD TIMOTHY, of Carlisle, Pennsylvania, or their issue per stirpes.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my last Will and
Testament, consisting of two (3) typewritten pages, this / d. it day of
C;; !7r'~~ , in the year of our Lord two-thousand and three.
SIGNED: (~.~. ~
CHARLENE SMITH, Testatrix
.
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
BOROUGH OF CARLISLE
I, CHARLENE SMITH, the Testatrix, whose name is signed to the attached or foregoing
instrument, having been duly qualified according to law, do hereby acknowledge that I signed
and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I
signed it as my free and voluntary act for the purposes therein expressed.
SIGNED: -C/!J'~ ~
CHARLENE SMITH, Testatrix
tx . .
On this, the l~daY of ~-n~ ,2003, before me, a Notary Public, the
undersigned officer, personally appeared CHARLENE SMITH, TESTATRIX, known or proven
to me to be the person whose name is subscribed to the within Last Will and Testament, and
acknowledged that she executed the same for the purposes therein contained.
IN WTINESS WHEREOF, I hereunto set my hand and official seal.
(SEAL)
EXHIBIT "B"
APPRAISAL REPORT
140 PORTER AVENUE
CARLISLE, PENNSYLVANIA .
PREPARED FOR
THE ESTATE OF CHARLENE P. SMITH
BY
LARRY E. FOOTE
DIVERSIFIED APPRAISAL SERVICES
35 EAST mGH STREET, SUITE 101
CARLISLE, PENNSYL VANIA
17013-3052
(717) 249-2758
cCOpy
SUMMARY OF IMPORTANT FACTS AND CONCLUSIONS
LOCATION: 140 Porter Avenue
Carlisle~ Pennsylvania
TAX PARCEL NUMBER: 02-21-0318-178
IMPROVEMENTS: One-story detac~ed single-family dwelling.
PROPERTY RIGHTS: Fee simple interest.
OWNERSHIP mSTORY: The subject property is owned by Charlene E. Smith. The
property was purchased on November 18~ 1953 for a
reported consideration of $1.00 and ownership transferred
on deed reference 15-U-551.
SCOPE OF THE ASSIGNMENT: The scope of the assignment included an analysis of the
subject's area, an inspection of the subject property, an
estimation of the property's highest and best use~
consideration of all three approaches to value, and the
application of those relevant to the valuation of the
subject.
OBJECTIVE: To estimate the market value of the subject property as
unencumbered.
EFFECTIVE DATE: October 26,2006.
IDGHEST AND BEST USE: Continued use as a single-family residence.
COST APPROACH: N.A
SALES APPROACH: $92~000
INCOME APPROACH: N.A. .
FINAL VALUE CONCLUSION: $92,000
2
APPRAISAL CERTIFICATION
I hereby certify that upon application for valuation by:
THE ESTATE OF CHARLENE P. SMITH
the undersigned personally inspected the following described property:
All that certain piece or parcel of land, with the improvements thereon erected, situate
in Carlisle, Cumberland County, Pennsylvania, bounded and described as follows:
Beginning at a point on the west side of Porter Avenue, at lands now or late of Walter F.
Nickel, Jr., and wife, said point being 44 feet South of the intersection of the west side of said
Porter Avenue with the south side ofa 16-foot wide alley; thence at right angles to Porter
Avenue westward along lands of said Nickel and wife, 99.6 feet to the east bank of the Letort
spring; thence along the east bank of the Letort Spring in a southwesterly direction 61 feet,
more or less, to lands now or late of Leo Davis; thence by a line at right angles to Porter
Avenue eastward along line of lands of said Davis, 120 feet, more or less, to the west side of
Porter Avenue; thence along the west side of Porter Avenue northward 58 feet to a point, the
place of beginning.
To the best of my knowledge and belief the statements contained in this report are true
and correct, and that neither the employment to make this appraisal nor the compensation is
contingent upon the value reported, and that in my opinion the Market Value as of October 26,
2006 is:
NINETY-TWO THOUSAND DOLLARS
$92,000,000
The property was appraised as a whole, subject to the contingent and limiting conditions
outlined herein.
Af?~
. LanyE. Foote
Certified General Appraiser
GA-OOOOI4-L
3
INTENDED USE OF THE APPRAISAL
The intended use of this appraisal is to estimate the Market Value of the subject
property as of October 26,2006.
Market Value is defined as the most probable price which a property should bring in a
competitive and open market under all conditions requisite to a fair sale, the buyer and seller,
each acting prudently, knowledgeably and assuming the price is not affected by undue
stimulus. Implicit in this definition is the consummation of a sale as of a specified date and the
passing of title from seller to buyer under conditions whereby:
a. Buyer and seller are typically motivated.
b. Both parties are well informed or well advised, and each acting in what
he considers his own best interest.
c. A reasonable time is allowed for exposure in the open market.
d. Payment is made in terms of cash in U.S. dollars or in terms offinancial
arrangements comparable thereto.
e. The price represents the normal consideration for the property sold
unaffected by special or creative financing or sales concessions granted
by anyone associated with the sale.
Source: Office of the Comptroller of the Currency, 12 CFI ~34.42(f).
meHEST AND. BEST USE
Highest and Best Use is defined by the Appraisal Terminology and Handbook,
published by the Appraisal Institute, as "the most profitable likely use to which a property can
be put". The opinion of such use may be based on the highest and most profitable continuous
use to which the property is adapted and needed, or likely to be in demand, in the reasonable
near future.
However, elements affecting value that depend upon events or a combination of
occurrences which, while within the realm of possibility, are not fairly shown to be reasonably
probable, should be excluded from consideration. Also, if the intended use is dependent on an
uncertain act of another person, the intention cannot be considered.
Based on the above defInition and after seeing the site, neighborhood, and area, it is my
opinion that the present use of the subject is its Highest and Best Use.
4
SITE DATA
ADDRESS: 140 Porter Avenue
BOROUGH: Carlisle
COUNTY: Cumberland
STATE: Pennsylvania
LOT SIZE: 58' x 120'
SEWERS: Public utility.
WATER: Public utility.
ELECTRICITY: PP&L
LANDSCAPING: Typical for the ar~ with a sodded lawn, trees and shrubs.
DETRIMENTAL INFLUENCES
None. Pride of ownership is evident.throughout the neighborhood.
DESCRIPTION OF IMPROVEMENTS
GENERAL DESCRIPTION: One-story detached single-family dwelling containing approxi-
mately 984 square feet of gross living area above grade with an attached one-car carport. .
CONDmON:
Exterior: Average
Interior: Average
Basement:
Living room, dining room, kitchen, two bedrooms and a
full bathroom.
Full, with two finished rooms.
ROOMS:
First Floor:
EXTERIOR:
Foundation:
WaIls:
Sash:
Gutters:
Roof:
Concrete block.
Permastone
Vinyl-clad thermopane replacement windows.
Aluminum, painted.
Hip, ~th shingles.
5
INTERIOR, PRINCIPAL ROOMS: Flooring:
Walls:
Ceilings:
Trim:
Carpet and vinyl.
Drywall, papered.
Drywall and acoustical tile blocks.
Wood, painted.
KITCHEN:
Cabinets:
Counters:
Walls:
Flooring:
Sink:
Oak, natural finish.
Formica
Drywall, papered.
Vinyl
Double-bowl, porcelain.
Flooring: Hardwood
Walls: Drywall, papered.
Bathtub: Built-in, with shower.
Lavatory: Vanity
Water closet: Two-piece.
Medicine cabinet: Wall-mounted.
BATHROOM:
CONSTRUCTION: Joists:
Beams:
Columns:
Plumbing:
Wood
Wood
Steel
Copper and iron.
HEATING:
Gas-fired forced hot air.
COOLING:
Central air conditioning.
HOT WATER:
Gas-fired, 30-gallon.
ELECTRIC:
Circuit breaker system, 200-ampere.
OTHER: There is a covered porch attached to the front of the dwelling and there is
a detached wooden storage building located in the rear yard.
GENERAL CONDITION: All improvements are considered to be in average condition on the
interior and on the exterior, with mechanical systems appearing to be adequate and functioning
properly. Although no water damage was observed, the dwelling occupant stated that water
enters the basement dwing extended periods of wet weather.
6
THE APPRAISAL PROCESS
Three approaches to value are generally included in an appraisal report. These
techniques include the cost approach, sales comparison approach, and income approach to
value.
The cost approach to value is based on the assumption that the reproduction cost of a
building plus land value, tends to set the upper limit to value. A key assumption is that a newly
constructed building would have advantages over the existing building, therefore an evaluation
focuses upon disadvantages or deficiencies (depreciation) of the existing building compared to
a new facility. Due to the age of the subject improvements, the cost approach is considered to
be inappropriate and has, therefore, not been included in the development of this appraisal
report.
The sales comparison approach to value assumes that under normal conditions, a given
number of parties acting intelligently and voluntarily, tend to set a pattern from which value
can be estimated Application of this approach relies on a comparison of the subject with a
sufficient number of recent transactions of comparable properties in the market, based on a
common unit, such as price per square foot of building area.
The income approach concerns itself with present worth of the future potential benefits
of a property. The initial estimate involves the net income, which a fully informed person is
justified in assuming the property will produce during its remaining useful life. This estimated
net income is then capitalized into a value estimate, based upon the level of risk as compared
with that of a similar type and class. Since homes similar to the subject are not typically
utilized as income-producing investment properties, the income approach to value is considered
to be inappropriate and has, therefore, not been included in the development of this appraisal
report.
7
SALES COMPARISON APPROACH
In arriving at this conclusion of the value of the subject property, the appraiser made a
survey of properties that have sold in the area of the -subject property.
Consideration was given and adjustments were made on each comparable sale as to
time of sale, size, location, as well as all other factors that might affect value. A resume of
some of the sales considered by the appraiser is as follows:
SALE NO.1:
Location:
Date of Sale:
Sale Price:
Size:
Unit Price:
SALE NO.2:
Location:
Date of Sale:
Sale Price:
Size:
Unit Price:
SALE NO.3:
Location:
Date of Sale:
Sale Price:
Size:
Unit Price:
259 E. Louther Street, Carlisle.
June 2, 2004.
$105,000
1,258 square feet.
$83.47 per square foo~.
659 Hamilton Street, Carlisle.
May 31, 2006.
$90,900
840 square feet.
S108.21 per square foot.
1219 N. West Street, Carlisle.
August 22, 2006.
$83,500
624 square feet.
$133.81 per square foot.
The appraiser, in addition to the sales listed, also considered several additional sales in
arriving at his final opinion of value. On the Sales Comparison Analysis form that follows this
page are dollar adjustments reflecting market reaction to those items of significant variation
between the subject and comparable properties. If a significant item in the comparable
property is superior to, or more favorable than, the subject property, a minus (..) adjustment is
made, thus reducing the indicated value of the subject; if a significant item in the comparable is
inferior to, or less favorable than, the subject property, a plus (+) adjustment is made, thus
increasing the indicated value of the subject.
After making all of the necessary adjustments, it is the appraiser's considered opinion
that the indicated value of the subject property by the Sales Comparison Approach is $92,000.
8
..
SALES COMPARISON ANALYSIS
ITEM SUBJECT COMPARABLE #1 COMPARABLE #2 COMPARABLE #3
140 Porter Avenue 259 E. Louther Street 659 Hamilton Street 1219 N. West Street
Address Carlisle Carlisle Carlisle Carlisle
Proximi1y to Subject
Sale Price N.A. S105,OOO S9O,900 583,500
Price I Sq. Fl GLA N.A. $83.47 S108.21 133.81
Data Source Inspection Courthouse records Courthouse & Central Pam MLS Courthouse & Central Penn MLS
ADJUSTMENTS DESCRIPTION DESCRIPTION S Adjust. DESCRIPTION $ A4just. DESCRIPTION S Adjust
Sales or Financing
Coocessions Nooe None None
Date of Sale I Time As of 10-2~ 6-2-04 +10,500 5-31-06 8-22-06
Locdi.on Average Similar Similar Similar
Site I View 58' x 120' 42' x 120' 59' x 125' SO' x 190'
Design and Appeal One-stoty dctacbed 1 ~ cktached One-story detached One-story detached
Construction Permastone Aluminum siding Aluminum siding Vinyl siding
Age 64 years 10S years 54 years S6years
Condition Average Similar Superior -4,500 Superior -4,200
Above Grade Tot Bed. Bath Tot. Bed. Bath Tot. I Bed. Bath Tot Bed. Bath
Room Count
5 2 1 6 2 1 -2,000 4 I 2 1 +2,000 4 2 1 +2,000
Gross Living Area 984 square feet 1,258 square feet -8,200 840 square feet +4,300 624 square feet +10,800
Ba~t &Finished Full basement,
Rooms Below Grade partially finished. Full basemmt. + 1,000 Full basement. +1,000 Full basement + 1,000
Fuoctional Utility Avcnac Similar Similar Similar
Heatina I CooJina Gas FHA w/cen. air Similar Similar Similar
Gantae I Carport Qno.Qar carport 1-car Uf., 1-car CDOrt -5,000 . Similar None +2,000
Pcnbes, Patios Porch, storage Porch, enclosed Two porches, storage Patio. storage
Pools, etc. buildina. oorch. star. build.iwl. -1,000 bui1ciimL -500 buildiJuz.
Special Energy Typical for the
Efficient Items resrion. Similar Similar Similar
FiJcp1ace(s) None Fireplace -1.000 FireDlace -1.000 None
Other (o.g. kitchen simi18r
equip., remodeling) Built-ins. Similar Similar
Net Adj. (total) -5,700 +1,300 + 11,600
Indicated Value
ofSubieot 99,300 92.200 94,]00
FINAL INDICATED VALUE OF SUBJECT PROPERTY: $92,000
9
"
CORRELATION
Correlation may be dermed as "the bringing together of parts in a proper relationship."
The parts of this appraisal report are the following approaches to value your appraiser used:
Value Indicated by Cost Approach
Value Indicated by Sales Comparison Approach
Value Indicated by Income Approach
N.A.
$92,000
N.A.
These approaches are representative.ofthe market value of the subject property. I have
carefully reexamined each step in each method, and I believe the conclusions accurately reflect
the attitude of typical purchasers of this type property in this neighborhood. It is my belief that
this reexamination has confirmed the original conclusions.
The Cost Approach will result in an excellent estimate if all elements are figured
accurately, because no prudent person will pay more for a property than the cost to produce a
substitute property with equal desirability and utility. Purchasers of the type of dwelling
typical of the subject property are more concerned with amenities than with hypothetical
replacement of the property. Due to the age of the subject improvements, the Cost Approach is
considered to be inappropriate and has not been included in this appraisal report.
The Sales Comparison Approach was based on several recent sales of properties similar
to that of the subject, all of which are located in the same general area. The adjusted sales
prices are most consistent under comparison. This approach is the most reliable because it
reflects the reactions of typical buyers and sellers in the market.
The Income Approach is most applicable to income producing properties or properties
that are primarily utilized for income producing purposes. Purchasers of income producing
properties are willing to pay no more for ~ particular property than the net operating income
will support. Since the majority of properties similar to the subject are not utilized for income
producing purposes, this approach to value has not been included in this appraisal report.
Therefore, as a result of this appraisal and analysis, it is this appraiser's considered
judgment and opinion that the Market Value of the subject property, as of October 26,2006, is:
NINETY-TWO THOUSAND DOLLARS
$92,000
10
UNDERLYING ASSUMPTIONS AND LIMITING
CONDmONS SUBJECT TO THIS APPRAISAL
1. I assume no responsibility for matters legal in nature, nor do I render any opinion as to
the title, which is assumed to be marketable. The property is appraised as though under
responsible ownership.
2. The legal description used herein is correct.
3. I have made no survey of the property, and the boundaries are taken from records
believed to be reliable.
4. I assume that there are no hidden or unapparent conditions of the property, subsoil or
structures which would render it more or less valuable. I assume no responsibility for
such conditions or for engineering which might be required to discover such factors.
5. The information, estimates, and opinions furnished to me and contained in this report
were obtained from sources considered reliable and believed to be true and correct
However, no responsibility for accuracy can be assumed by me.
6. This report is to be used in its entirety and only for the purpose for which it was
rendered.
7. Neither all nor any part of the contents of this report (especially any conclusions as to
value, the identity of the appraiser or the firm with which he is connected) shall be
reproduced, published, or disseminated to the public through advertising media, public
relations media, news media, sales media, or any other public means of communication,
without the prior written consent and approval of the appraiser.
8. This appraisal was prepared for the exclusive use of the client identified in this appraisal
report. The information and opinions contained in this appraisal set forth the
appraiser's best judgment in light of the information available at the time of the
preParation of this report. Any use of this appraisal by any other person or entity, or
any reliance or decisions based on this appraisal are the sole responsibility and at the
sole risk of the third party. The appraiser accepts no responsibili~ for damages
suffered by any third party as a result of reliance on or decisions made or actions taken
based on this report.
11
CERTIFICATE OF APPRAISAL
Your appraiser hereby certifies that:
1. The statements of fact contained in this report are true and correct.
2. The reported analyses, opinions, and conclusions are limited only by the' reported
assumptions and limiting conditio~, and are my personal, impartial, and unbiased
professional analyses, opinions, and conclusions.
3. I have no present of prospective interest in the property that is the subject of this report,
and no personal interest with respect to the parties involved
4. I have no bias with respect to the property that is the subject of this report or to the
parties involved with this assignment
5. My engagement in this assignment was not contingent upon developing or reporting
predetermined results.
6. My compensation for completing this assignment is not contingent upon the
development or reporting of a predetermined value or direction in value that favors the
cause of the client, the amount of the value opinion, the attainment of a stipulated result,
or the occurrence of a subsequent event directly related to the intended use of this
appraisal.
7. To the best of my knowledge and belief, the statements of fact contained in this
appraisal report, upon which the analyses, opinions, and conclusions expressed herein
are based, are true and correct. .
8. This appraisal report sets forth all of the limiting conditions (imposed by the terms of
my assignment or by the undersigned) affecting the analyses, opinions, and conclusions
contained in this report.
9. This appraisal report has been made in conformity with the Uniform Standards of
Professional Appraisal Practice adopted by the Appraisal Standards Board of the
Appraisal Foundation, and is. subject to the requirements of the' Code of Professional
Ethics and Standards of Professional Conduct of the National Association of Realtors
Appraisal Section.
12
10. No one other than the undersigned prepared the analyses, conclusions, and
opinions concerning real estate that are set forth in this appraisal report.
~?M.-
Larry E. Foote
Certified General Appraiser
GA-000014-L
13
PRIVACY NOTICE
Pursuant to the Gramm..Leach-Billey Act of 1999, effective July 1,2001, appraisers,
along with all providers of personal financial services are now required by federal law to
inform their clients of the policies of the firm with regard to the privacy of client nonpublic
personal information. As professionals, we Understand that your privacy is very important to
you and are pleased to provide you with this information.
In the course of performing appraisals, we may collect what is known as ~~nonpublic
personal infonnation" about you. This information is used to facilitate the services that we
provide to you and may include the information provided to us by you directly or received by
us from others with your authorization.
We do not disclose any nonpublic personal information obtained m the course of our
engagement with our clients to nonaffiliated third parties, except as necessary or as required by
law. By way of example, a necessary disclosure would be to our independent contractors, and
in certain situations, to unrelated third party consultants who need to know that information to
assist us in providing appraisal services to you. All of our independent contractors and any
third party consultants we engage are informed that any information they see as part of an
appraisal assignment is to be maintained in strict confidence within the firm. A disclosure
required by law would be a disclosure by us that is ordered by a court of competent jurisdiction
with regard to a legal action to which you are a party.
We will retain records relating to professional services that we have provided to you for
a reasonable time so that we are better able to assist you with your needs. In order to protect
your nonpublic personal information from unauthorized access by third parties, we maintain
physical, electronic and procedural safeguards that comply with our professional standards to
insure the security and integrity of your information.
14
LARRY E. FOOTE
REAL ESTATE APPRAISER
EXPERIENCE:
1979-Present: Chief Appraiser, Diversified Appraisal Services, Carlisle, Pa.
Principal Broker, LaRue Development Company, Carlisle, Pa.
1976-1979: Associate Broker, Colonial Realty, Carlisle, Pa.
1972-1976: Realtor Associate, Jack Gaughen Realtor, Carlisle, Pa.
Appraisal experience included undeveloped land, farms, building lots, single-family dwellings, mobile
home parks, medical centers, nursing homes, motels, apartment buildings and complexes, office
buildings, service stations, veterinary clinics, rehabilitation centers, retail buildings, daycare centers,
warehouses, and manufacturing facilities.
EDUCATION:
Bachelor of Business Administration, Pennsylvania State University, 1976.
Associate Bachelor of Business Administration, Harrisburg Area Community
College, 1974.
Diploma, Carlisle Senior High School, 1965.
CertifiCate, Pennsylvania Realtors Institute, GRI 1, GRI II, GR! ill.
Certificate, Realtors National Marketing Institute, CI 101, CI 102, CI 103, CI 104,
CII05.
Standards of Professional Practice, American Institute of Real Estate Appraisers.
Real Estate Appraisal Principles, American Institute of Real Estate Appraisers.
Residential Valuation, American Institute of Real Estate Appraisers.
Appraisal Procedures, Appraisal Institute.
Principles of Income Property Appraising, Appraisal Institute.
Case Studies in Real Estate Valuation, Appraisal Institute.
Report Writing and Valuation Analysis, Appraisal Institute.
PROFESSIONAL LICENSES:
General Appraiser #GA-OOOO 14-L, Commonwealth of Pennsylvania.
Real Estate Broker #RB-029729-A, Commonwealth of Pennsylvania.
PROFESSIONAL DESIGNATIONS:
ORI: Graduate of the Pennsylvania Realtors Institute, awarded by the Pennsyl-
vania Association of Realtors. .
CRS: Certified Residential Specialist, awarded by the Realtors National Market-
ing Institute of the National Association ofRea1tors.
CCIM: Certified Commercial Investment Member, awarded by the Realtors
National Marketing Institute of the National Association of Realtors.
PROFESSIONAL ORGANIZATION AFFILIATIONS:
National Association of Realtors Appraisal Section.
Greater Harrisburg Association of Realtors.
Pennsylvania Association of Realtors.
National Association of Realtors.
Realtors National Marketing Institute.
15
PAST CLIENTS:
Borough of Carlisle
Keystone Financial Mortgage
Cornerstone F~ Credit Union
Pennsylvania State Bank
Commerce Bank
Cumberland-Perry Association for Retarded Citizens
Carlisle Suburban Authority
Members 1 st Federal Credit Union
Pennsylvania National Bank
Evans Financial Corporation
Greenawalt & Company, CPA
Smith's Transfer Corporation
Carlisle Department of Parks and Recreation
Executive Relocation Services
Carlisle Area School District
Messiah Homes, Incorporated
ERA Eastern Regional Services
Pennsylvania Turnpike Commission
Chase Home Mortgage Corporation
Defense Activities Federal Credit Union
Pennsylvania State Employees Credit Union
PNC Mortgage Corporation
F&M Trust Company
National City Mortgage Corporation
Washington Mutual Home Loans, Inc.
Prudential Relocation Services
Lender's Choice
Market Intelligence, Incorporated
United Telephone Employees Federal Credit Union
Cumberland County Commissioners
Allstate Enterprises Mortgage Corporation
Dickinson College
PPO Industries, Incorporated
Gettysburg College
Redevelopment Authority of Cumberland County
Record Data Appraisal Services, Incorporated
First United Federal Savings Association
Fulton Bank
United States Marshall Service
GMAC Mortgage Corporation
Orrstown Bank
Letterkenny Federal Credit Union
BancPlus Mortgage Corporation
Coldwell Banker Relocation Services, Incorporated
Central Pennsylvania Savings Bank .
Mellon Bank.
Provident Home Mortgage Corporation'
Drovers Bank
16
American Home Bank .
Trans Union
M&T Mortgage Corporation
Cody Financial Mortgage Services
Waypoint Bank
Northwest Savings Bank
Blue Ball National Bank
Adams County National Bank
Countrywide Home Loans
Aarrow Mortgage
Various law firms and individuals
PHOTOGRAPHS OF THE SUBJECT IMPROVEMENTS
17
COMPARABLE SALE NO.1
COMPARABLE SALE NO.2
, .:~:::4.'::'~';}{ ",' ~ r1,. I
COMPARABLE SALE NO.3
18
, '.
~1-18-/~7 11:42 FROM-ZULLINGER-DAVIS PROF 717-53~-5222
Annuity, life Eatllle, and Remainder F.ctors
T-1~8 P~2/~2 U-029
1/1812007
Transfer Date:
t7520 Rate:
Calculation Type:
Principal:
Lives:
Agel:
Factor:
Value:
Life Estate
0.33259
530.598.28
1012005
5.80%
Life
$92,000
1
81
Remainder
0.86741
$61,401.72
, \
EXHIBIT "C"
,
.t~: Your Sale Proceeds Check is Attached
OMS NO. 1545-0715
tor
gto
NJ
me, Address, ZIP Code, 2006 Proceeds From Broker and Barter Exchange Transactions
cation Number and Form 1099-8 Instructions for Recipient
ber: Brokers and barter exchanges must report proceeds from transactions to
Substitute COpy B FOR RECIPIENT you and to the Internal Revenue Service. This form Is used to report
Services -JMPORTANT TAX INFORMATION- these proceeds.
n Blvd. This is important tax information and is being
07310 furnished to the Internal Revenue Service. If 1.. Ollte of Sale 1 b. CUSIP Number
you are required to file a return, a negligence 11/21/2006 59156R10
penalty or other sanction may be I~posed on 2. Sl:ocka, Bonds, etc. 4. FEDERAL INCOME TAX WITHHELD
yoU if this Income is taxable and the IRS
9-3593 determines that it has not been reported. $4,654.21 $0.00
- QJ
REPORTED Gross Proceeds
TO IRS 0 Gross Proeeeds less commission and
options premiums
lEY EX UW 7. Description
TH METlIFE, INC.
N ROAD Investor 10 Recipient's Identification Number on File
14423-9764 125183666250 207133522
Na
Itlfl
~um
1-800-64
;10
EG
SMI
~O
;NY
ws the trade date of the transaction. For aggregate reporting, no entry will
Box 4. - Shows backup withholding. Generally, a payer must backup withhold at
a 28% rate If you did not fuml8h your taxpayer Identification number to the payer.
See Form W-9, Request for Taxpayer Identification Number and Certification, for
information on backup withholding. Include this amount on your Income tax
return as tax withheld.
Box 7. - Shows a brief description of the item or service for which the proceeds or
bartering Income Is being reported. For reguleteCI futures contracts and forward
contracts, "RFC. or other appropriate description may be shown.
broker transactions, may show the CUSIP(Committee on Uniform Security .
Procedures) number ofthe Item reported.
'S the proceeds from transactions involving stocks, bonds. other debt
ammoditles, or forward contract8~ losses on forward contracts are shown
s. This box does not include proceeda from regulated futures contracts.
.~lOunl on Schedule 0 (Form 1040), Capital Gains and LotI88S.
lm~rMf~L~'lli.!t~ :. __ . :~li~t.'~Jl~ .J. .I~~~ 1 J1Jllm ".:~ _IT Jjj;L,:.~~ ,~ ~Jll~llll ,,: l.~1ii m#$i
For inquiries about your account, contact Mellon Investor. Services, MetLife's Transfer Agent:
Telephone: 1-800-649-3593 U.S. Mail:
E.Mail: metlife@melloninvestor.com MetUfe
Internet: www.melloninvestor.com/isd c/o Mellon Investor Services
PO Box 4447
South Hackensack, NJ 07606-2047
ACCOUNT HAS BEEN CLOSED. THE ATTACHED CHECK REPRESENTS THE FULL VALUE OF YOUR ACCOUNT.
III
.
III
-
ill
~
-
-
II!III!iI
6
~
m
N
.
~
^ IMPORTANT TAX RETURN DOCUMENT ATTACHED ^
._--_._----------------_._---------~--------~_._------.--------------~----~---------------~-----------_.~------------------~--~.~
METUFE. INC.
INVESTOR ID ACCOUNT KEY
,59156R10 125183666250 SMITH--CHA1..QFOO
1ST INTEREST BALANCE SHARES SOLD
79.0000 79.0000
TRANSACTION DATE
11/21/2006
CHEC~ NUMBER
278952
PRICE PER SHARE ($)
58.9141000
CLOSING TRUST INTEREST BALANCE
o
NET PROCEEDS
$0.00
$4,654.21
00.0000
......'.,f-
PLEASE DETACH BELOW
CHECK NUMBER: 278952
e~"'8''1' "0"
WACHOVIA
...
I '
TIME DEPOSIT WITHDRAWAL CONFIRMATION
Office Name
NE CNTRL PAl CARLISLE
PA
Customer Name(s), Address and Taxpayer JD Number
CHARLENE P SMITH
140 PORTER AVE
Date
11/01/2006
CARLISLE PA 17013
5168244397
CURRENT BALANCE: $20,000.00
+ ACCRUED INTEREST: $163.91
Availlnt WD/PenFree: $163.91
- PENAL TV AMOUNT: $0.00
- FEDERAL WIHD DUE: $0.00
- WITHDRAWAL FEE: $0.00
- OUTSTANDING PYMT: $0.00
FULL REDEMPTION
CD ACCOUNT NUMBER:
247412044008831
PAID TO CUSTOMER: $20,163.91
5811594
.
~ACHOVIA
TIME DEPOSIT NOT TRANSFERABLE
Opening Date
Account Number Taxpayer 10 Number
This Receipt Acknowledges That The Depositor Named ****************VO I 0 *-**
Below Has DeposIted With This Bank The
Sum Of
Depositor
Name And
Address
Tenn
Maturtty Date
Interest Rate Per Annum Annual Percentage Yield Interest Payment FrequencylPertod
Interest Payment DIsposition
Account to Credit
PROD-TYPE:
PROMO CD:
Issued by WACHOVIA BANK, N.A.
X
Authorized Signature
X
Date
5e65lI4
.,
.. ... ..
.
WACI-IOVIA
. ,
TIME DEPOSIT WITHDRAWAL CONFIRMATION
Office Name
Customer Name(s), Address and Taxpayer 10 Number
CHARLENE P SMITH
NE CNTRL PA 1 CARLISLE
PA
140 PORTER AVE
Date
11/01/2006
CARLISLE PA 17013
S168244397
CURRENT BALANCE: $3.500.00
+ ACCRUED INTEREST: $6.62'
Availlnt WD/PenFree: $6.62
- PENAL TV AMOUNT: $0.00
- FEDERAL WIHD DUE: $0.00
- WITHDRAWAL FEE: $0.00
- OUTSTANDING PYMT: $0.00
FULL REDEMPTION
CD ACCOUNT NUMBER:
247412064102975
PAID TO CUSTOMER: $3,506.62
5685114
"'\\TACHOVIA
TIME DEPOSIT
NOT TRANSFERABLE
Opening Date
Account NUmber
Taxpayer 10 Number
This ReceIpt AcknowtedoeI That The Depositor Named
Below Has Deposited With This Bank The
Sum Of
...............*\1010*****
Depositor
Name And
Address
Term
Maturity Dale
Interest Rate Per Annum Annual Percentage Yield Interest Payment FrequencylPeriod
Interest Payment DIsposition
Account 10 Credit
PROD-TYPE:
PROMO CD:
Issued by WACHOVIA BANK. N.A.
X
Authorized Slgnalure
X
Date
586594
6)("'.'" "f.
"\VACHOVIA
. . .
Deposit Account Close Confirmation (Debit)
WACHOVIA BANK, N.A.
Date
Customer Name( s) and Address
Taxpayer 10 Number
11/01/2006
CHARLENE P SMITH
5168244397
140 PORTER AVE
CARLISLE PA 17013
ACCOUNT NUMBER: 1010080462152
Available
Balance
$11,611.38
+ Accrued Int : $11.79
- Fed W/Hd Due: $0.00
- Admin Fee: $0.00
- Outstanding Db : $0.00
- Closing Fee: $0.00
Paid To Customer: $11,623.17
i6596
CUSTOMER COpy