HomeMy WebLinkAbout02-05-07
REV-1500 EX (6-00)
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV -1500
INHERITANCE TAX RETURN
.
RESIDENT DECEDENT
~L
COUN1Y CODE
~L 0408 ___
YEAR NUMBER
OFFICIAL USE ONLY
FILE NUMBER
I-
Z
.11
is
W
(.)
W
C
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
BENION ELLEN
N
SOCIAL SECURI1Y NUMBER
097-38-8143
'!'H!S RETYR!oI MUST BE FILED IN DUPLICATE WITH THE
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REGISTER OF WILLS
SOCIAL SECURITY NUMBER
5/3/2006 6/24/1913
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Original Retum
Limited Estate
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11.
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001
04.
006
o 2. Supplemental Retum 0 3. Remainder Retum (dale of death prior to 12.13-82)
o 4a. Future Interest Compromise (date of deeth after 12-12-82) 0 5. Federal Estate Tax Retum Required
o 7. Decedent Maintained a Living Trust (Attach copy oITrust) L 8. Total Number of Safe Deposit Boxes
o 10. Spousal Poverty Cred~ (data of death between 12-31.91 and 1-1-95) 0 11. Election to tax under See. 9113{A) (AUachSch 0)
Decedent Died Testate (Attach copy of 'Mil)
o 9. Litigation Proceeds Reeeived
THIS SECTION MUST BE COMPLETED. All CORRESPONDENCEANOCONFIOENTIAI..TAXINFORMATIONSHQ1JlDBEDIRECTED TO;
NAME COMPLETE MAJLlNG ADDRESS
....
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o
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DC
DC
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Gates, Halbruner &
Lowell R. Gates, Es .
FIRM NAME (If Applicable)
Gates, Halbruner & Hatch, PC
TELEPHONE NUMBER
1013 Mumma Road, Suite 100
Lemo e, PA 170143
717-731-9600
1. Real Estate (Schedule A)
(1)
160.000
402.251
o
o
61,989
2,851
2. Stocks and Bonds (Schedule B)
(2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
Z 6. Jointly Owned Property (Schedule F)
0 o Separate Billing Requested
~
:3 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
::;:) (Schedule G or L)
l-
ii: 8. Total Gross Assets (total Lines 1-7)
<(
(.)
W 9. Funeral Expenses & Administrative Costs (Schedule H)
0:::
(4)
(5)
(6)
(7)
284,648
11. Total Deductions (total Lines 9 & 10)
(8)
19,853
194
(11)
(12)
(13)
(14)
L(15)
45 (16)
(17)
(18)
(19)
(9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for v.tlich an election to tax has not been
made (Schedule J)
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911,739
20,047
891,692
o
891,692
14. Net Value Subjectto Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal lax
z rate, or transfers under Sec. 9116 (a)(1.2)
o
~ 16. Amount of Line 14 taxable at lineal rate
....
~
~ 17. Amount of Line 14 taxable at sibling rate
o
o 18. Amount of Line 14 taxable at collateral rate
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~ 19. Tax Due
20.0
o
891,692
o
o
x.O
x.O
o
40,126
o
x.15
o
x.12
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
40,126
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH <<
3W4645 1.000
Estate of
Executors
Name
Address
Tax ID
.
.
097-38-8143
(Page 1)
Harry G. Benion
315 Monroe Street
Mechanicsburg, PA 17055-
097-38-0257
Decedent's Com lete Address:
STREET ADDRESS
1714 Brid e Street
Cumberland
CllY
New Cumberland
STAlE
PA
ZIP
17070-
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. SpOl)sal Poverty Credit
B. Prior Payments
C. Discount
(1 )
40,126
o
37,000
1,850
Total Credits (A + B + C) (2)
38,850
3. Interest/Penalty if applicable
D. Interest
E. Penalty
o
o
Total Interest/Penalty (D + E) (3)
o
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)
o
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(5)
1,276
A. Enter the interest on the tax due.
(5A)
o
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check to:
(58)
1,276
AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred;. . . . . . . . . . . . . . .
b. retain the right to designate who shall use the property transferred or its income; .
c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . .
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? . . . . . . . . . . . . . . . . . . . . . . . . . . .. D
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? 12[]
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..!XJ 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 penalties of perjury. I declare that I have e..mined this return, including accompanying schedules and statements. and to the best of my knowledge end belief, tt is true, correct and complete.
Declaration of preparer other tha the personal representative is based on information of which preparer has knC7Nledge.
Ves
No
D
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D
D
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D
AOORESS
Mechanicsburg, PA 17055
DAlE
Lemoyne, PA 17043
For dates of ath 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.s 99 6 (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. 99116 (a) (1.1) (ii)l
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 retum are still applicable even W
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 0% [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 4.5%, except as noted in 72 P.S. 9 9116(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 12% (72 P.S. 9 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.
3W4646 1.000
REV-1502 EX + (5-98)
.
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
ELLEN N. BENION
21 06 0408
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 v.tlich property would be
exchanged between a willing buyer and a willing seller. neither being compelled to buy or se!!, both having reasonable knC'.a..~edge cfthe relevant facts.
Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
Real Property located at 1714
Bridge Street, New Cumberland,
PA 17070 - Situated in
Cumberland County - Map
Reference #26-22-0820-076
160,000
3W4695 1.000
TOTAL (Also enter on line 1, Recapitulation)
(If more space is needed. insert additional sheets of the same size)
$
160,000
REV-1503 EX + (6-98)
.
SCHEDULE 8
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
ELLEN N. BENION
21 06 0408
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION
1.1,941.624 Shares Hennessy FOS Inc.
Total Return Fund @ $11.30/share
2 2,488.142 Shares Dreyfus Growth
Opportunity Fund Inc. @
$8. 97/share
3 3,476.336 Shares DFA Five-year
Global Fixed Income Portfolio @
$9.88/share
4 3,500 Shares Tenguy World
International Corporation @
. 51/share
5 3,919.688 Shares USAA Tax Exempt
Intermediate-Term Fund Account
#44900922172 @ 12.97 - includes
accrued dividends of $17.42
6 30 Shares AMREIT Class B Common @
$1,031.06/share
7 4,479.199 Shares DFA INVT
Dimensions Group Inc. Two-year
Global Fixed Income Portfolio @
$10. 23/share
8 5 Units I-PA 107 PA Ins. Mun
Income Trust Ser 107 Account
#02507616 @ $190.13.share
9 526 Shares Exxon-Mobil Corporation
@ $63.77/share
10 678 Shares Texas Utilities
Corporation @ $57.05/share
11 7,712.701 Shares Dimensional Invt
Group Inc. Global E01 Portfolio
Instl. Cl @ $14,08.share
Total from continuation schedules
VALUE AT DATE
OF DEATH
21,940
22,319
34,346
1,785
50,856
30,932
45,822
951
33,543
38,680
108,609
12,468
402,251
3W4696 1.000
TOTAL (Also enter on line 2. Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
.
.
Estate of: ELLEN N. BENION
097-38-8143
Schedule B (Page 2)
Item
No.
Description
Value at Date
of Death
12 Cronos 15 (Limited Partnership) -
1,000 Units @ $6.94/unit - based
on two secondary market valuations
from Advantage Partnership Board
and Alliance Trading
6,940
13 WNC Housing Tax Credit VI Series V
(Limited Partnership) - 30 Units @
$184.25/Unit - based on two
secondary market valuations
~-- ---
.1. L:U.w.
Advantage Partnership Board and
Alliance Trading
5,528
Total (Carry forward to main schedule)
12,468
REV-1507 EX + (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
ELLEN N. BENION
SCHEDULE D
MORTGAGES & NOTES
RECEIVABLE
FILE NUMBER
21 06 0408
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM I
NUMBEK
DESCRIPTION
VALUE AT DATE
OF DEATH
None
TOTAL (Also enter on line 4, Recapitulation) $
o
3W46AC 1.000
(If more space is needed, insert additional sheets of 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
ELLEN N. BENION
FILE NUMBER
21 06 0408
...I~~~J
I'IUIVIOC""
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.
DESCRIPTION
VALUE AT DATE
OF DEATH
1
Household Furnishings, Personal
Property and ~scellaneous Items
(Appraised)
2,785
2
Sovereign Bank Money Market
Account #2331031304 (Includes
accrued interest of $10.82)
40,000
3
Sovereign Bank - Checking Account
#2331032319
2,692
4
Sovereign Bank Money Market
Account #2331030855
16,512
3W46AD 1.000
TOTALlAlso enter on line 5 Recaoitulationl $
(If more space is needed, insert additional sheets of the same size)
61,989
REV-1509 EX + (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
ELLEN N. BENION
SCHEDULE F
JOINTLY-OWNED PROPERTY
FILE NUMBER
21 060408
If an asset 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
ADDRESS
RELATIONSHIP TO DECEDENT
A.
Benion, Harry G
315 Monroe Street, Mechanicsburg,
PA 17055
Son
B.
c.
JOINTLY-OWNED PROPERTY:
lET1ER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINAl\CIAI.. INSTITUTIONNS:J BAN<. ACCOLM DATE OF DEATH DECD'S VALUE OF
N..MBEROR SIMIlAR IDENTIFYING f\lJMBER. ATTACH DEED FOR
NUMBER TENANT JOINT JOlNTl Y->B.D REAL ESTATE. VALUE OF ASSET INTEREST DECEDENrS INTEREST
1. A.
1 A 1/15/1991 278.422 Shares
Tri-Continental Corporation
Account #8693961804 5,702 50.0000 2,851
TOTAL {Also enter on line 6 Recaoitulationl $ 2.851
3W46AE 1.000
(If more space is needed, insert addnional sheets 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
ELLEN N. BENION
.
FILE NUMBER
21 06 0408
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
NUMBER
1.
3W48AF 1.000
IN:ll.OO T>€ NAME OF TIt TRANSfEREE. T>€IR RELATIONSHIP TO DECEDENT I'>IJ
nE DATE OF TRANSfER ATT.ACH A COPY OF TI-E DEED FOR REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET
% OF DECO'S
INTEREST
Jackson National Life Insurance
Company - Individual Deferred
Variable and Fixed Annuity
Contract #009042444A
87,462 100.0000
2 Jackson National Life Insurance
Company - Individual Deferred
Variable and Fixed Annuity
Contract #009071757A
69,473 100.0000
3 Peoples Benefit Life Insurance
Company - Annuity #ADV200196
127,665 100.0000
4 Sovereign Bank Savings Account
#2334017429 (In Trust For
Angela Christine Benion -
Granddaughter)
48 100.0000
TOTAL (Also enter on line 7, Recapitulation) $
(If more space is needed, insert add~ional sheets of the same size)
EXCLUSION
!IF APPLlCABLE\
TAXABLE
VALUE
o
87,462
o
69,473
o
127,665
o
48
284,648
REV-1511 EX + (12-99)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
ELLEN N. BENION
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21 06 0408
ITEM
NUMBER
DESCRIPTION
A
FUNERAL EXPENSES:
1.
Parthermore Funeral Home &
Cremation Services Inc.
B.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
1.
Name of Personal Representative(s) Harry G. Benion . Jr.
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address 315 Monroe Street
City Mechanicsburg
State PA
Zip 17055
Year(s) Commission Paid: Waived
2.
Attorney Fees
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
6. Tax Return Preparer's Fees
7.
1
Certified and Registered mail and
Delivery Charges
2
Chuck Bricker - appraisal of
household contents
Total from continuation schedules
3W46AG 1.000
TOTAL (Also enter on line 9, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
AMOUNT
$
10,651
7,500
600
74
100
928
19.853
.
Estate of: ELLEN N. BENION
Schedule H Part 7 (Page 2)
3
Cumberland County Recorder of
Deeds - recording of new deed
4
Cumberland Law Journal -
Advertising of Estate
Administration
5
PA Auto License Brokers -
Messenger Service
e:
...
n___~__ ~____~__,~ ~---- yy~~'
&~C~~~~ ~~~.Q~~Q~~I ~4W~ n~~~,
- appraisal of real property in
New Cumberland.
PA
7
Ri te Aid Pharmacy
8
Staples Office Supplies
9
The Patriot News - Publication of
Estate Notice
10
U-Haul packing supplies
Total (Carry forward to main schedule)
.
097-38-8143
43
75
5
275
7
120
265
138
928
REV-1512 EX. (12-03)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
ELLEN N. BENION
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
21 06 0408
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM I
NUMBER
1.
DESCRIPTION
BankCard Services
2 Borough of New Cumberland - sewer
charges
3 Comcast Cable
4 HCR Manor Care
5 Health Drive Eye Care
6 PA American Water
7 PPL Electric
8 Verizon Telephone
\f.A.LUE AT DATE
OF DEATH
17
66
3
10
38
17
16
27
3W46AH 2.000
TOTAL (Also enter on line 10. Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
194
REV-1513 EX+ (9-00)
.
SCHEDULE J
BENEFICIARIES
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RElURN
RESIDENT DECEDENT
ESTATE OF
ELLEN N BENION
FILE NUMBER
21 06 0408
1
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers
under Sec. 9116 (a) (1.2)]
Angela C. Benion
315 Monroe Street
Mechanicsburg, PA 17055
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
AMOUNT OR SHARE
OF ESTATE
NUMBER
I
Granddaughter
48
2
Harry G. Benion
315 Monroe Street
Mechanicsburg, PA 17055
Son
891,644
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
3W46All.000
TOTAL OF PART II. 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)
$
o
.
.
Estate of Ellen N. Benion
Pennsylvania Inheritance Tax Return
Form REV-1500
EXHIBIT A
Copy of the Certified Death Certificate of the Decedent
Local Registrar.
that t~e information hWiven. is con:ectly copied from an origi~a~ificat~ of ,death dul~. filed with me as
The ongll1al certIfIcate be forwaraed to the State VItal RecOldW:1ce fOl permanent fllll1g.
'rhi;~ is to
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
~;-?~
Local Registrar .
Fee for this certificate. $6.00
p
12411438
1"\A~ 0 4 2006
Date
RI\I.01.u6
lllNTIN
~NENT
:KINK
1 Name 01 Oec~ (F.st. mddll. last)
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH STATE FILE NUMBER
92
llb. County 01 Dealh
Cumberland
6-24-13
e. 8irt e C aOOsta.or
Ellen Noel Benion
Vrs.
7. Date~Birth nth,da ear
DE
on.
ClIner:
lien! 0 DOA ~i Homo
9. Was Oecedenl 01 HispInic 0rigil1
:M. No 0 Yes (II yes. spetify Cuban.
Mexican, Puer10 Rican. etc.)
o Aesid8I'ICI 0 Other.
10. RIce: Ameran Indiafl. BlBck. While,lIe.
(Spoci{y) white
5. Age (Lesl birthday)
Carlisle
Manor Care Carlisle
1'. Oecldtnl'sU5l8IOcc lion lOndofworkdoneduril rroslof IhrdonolSlaleretir
~ofWoo ~of~
homemaker domest1cs
16. Decedent's Maino AddrISS ISlr"1. dynown. Slall, zip cod.)
12. Wu Dec:edenlever In lhl us
AImed Forces?
o Ves 1S No
Decedenl's
ktual Residence 171. Slate
13. Oecedtnrs Educaliofl
f!'nlarylSec:ondoJy(O-l21
o h" I c leIed
4 ColIogo('''.'S.)
1., MlrblSlalus:Merried,NeverrNlried, 15. SurvimgSpouse(lfwile.g;...nidtnnanw)
w~~~(SpeciI)\
VA
OidDecedtnl
lWetnB
T~1
17c. 0 Vas, Decedent LNtd in Twp.
17d:Jb No.O"-UvodwilhinNew Cumberland
Actual LiniIs 01
ClyiBolo
1714 Bridge St.
New Cumberland, PA 17070
1711. COimly
ClImherl find
18. Fathefs Name (Firsl,IriddIe, lasl)
19. MoU'Ie(s NIIN (First. micIdIe, maiden suman)
Joseph Noel
Margaret Reilly
Harry G. Benion, Jr.
201>. Inlonronfs MoIilg _... (su.... dlylloWn. s1a... q. codo)
315 Monroe St. Mechanicsburg, PA 17055
201. Inbnrerrl's Name (T~rill)
21b. Dale 01 Disposlion (Monlh. day. year)
21c. PIlei of Disposlion (Name 01 cemetery, crernaklfy Oi oIher piece) 21d. Localion (Ckyllown. s18Se. ~ code)
ndiantown Gap NationalCemetery Hanover Twp., PA
22c. Name and h;ldress at Facilly
FS 012849-L
ParthemoreF.H~&C.S.,Inc.NewCumberland,PA 17070
2311. license Nu_ 23<. Dale SIgnod (Monl/I. d.p..')
bJ Sb!90::" L If?
Con1*lIa IIttrI-. 23a-c: on
physician is noIavailable I .
certiIy cause of dulh.
IIems 24-261T1JS1 be ~Ied b't person
who pronounces dealtl.
'1: 3/ M. rrz
CAUSE Of DEATH (Soli InolNCtlons and..........'
..", 'Zl. Part!: Enl8f lhe ~ - dis'ases, ~,or CQn'C)Icalions -hi directly caused.... d_lh. DO NOT tnlll' letminal eveNs such as C8ldillc arrest,
fapnk)fy afTesL Of ventricular lbrilllion wiIhotl1 showi'Io the 1tioIog';'. 00 NOT abbfeviala. &I" orIt on. Cluse on. h.
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Medical ellmlnerkoroner
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.
.
Estate of Ellen N. Benion
Pennsylvania Inheritance Tax Return
~n..."", D~'T _ 1 COO
....v.a .a.a.a ...~,. -....Jvv
EXHIBIT B
Copy of the Last Will and Testament of Ellen N. Benion
Da ted December 19, 1990
.
.
LAST WILL AND TESTAMENT
OF
ELLEN N. BENION
I, ELLEN N. BENION, now of 1714 Bridge street, New
Cumberland, Cumberland County, Pennsylvania, do publish and
declare this to be my Last Will and Testament, hereby revoking
all other prior wills and codicils mad~ by me.
FIRST: Family Background and Appointment of Executor.
(Aj Family and Background Information. I am married to
HARRY G. BENION. The child of our marriage is HARRY G. BENION,
JR., (and any children born or adopted hereafter). Throughout
this Will, HARRY G. BENION, will be referred to as "my husband"
or "my spouse" and HARRY G. BENION, JR., (and any children born
or adopted hereafter) as "my child." The word "issue" will
include my child as well as my other descendants.
(B) Appointment of Executor. I appoint as my Executor and
successor Executor (all hereinafter referred to as Executor or
Executor(s)) under this will, the following named persons or
corporations to serve without bond and without being required to
account to any Court:
Executor: My spouse, HARRY G. BENION
Successor Executor: My son, HARRY G. BENION, JR.
SECOND: Funeral and Last Illness Expenses: Taxes.
(A) Expenses of Funeral and Last Illness. Notwithstanding
that my spouse survives me, I direct my Executor to pay my
funeral expenses (regardless of amount) and the expenses of my
last illness from my estate.
(B) Taxes. I direct my Executor to pay any and all estate,
inheritance, succession, legacy, transfer and other death taxes
or duties, by whatever name called, including any and all
interest and penalties thereon, imposed under the laws of any
cOpy
.
.
LAST WILL AND TESTAMENT
OF
ELLEN N. BEN ION
PAGE 2
jurisdiction by reason of my death, upon or with respect to any
and all property included in my gross estate for the purpose of
such taxes, whether such property passes under or outside of this
will, out of my residuary estate, without being prorated or
apportioned among or charged against the respective devises,
legatees, beneficiaries, transferees, or other recipients of any
such property or charged against any property passing or which
may have passed to any of them.
My Executor shall not be entitled to reimbursement for any
portion of any such taxes from any such person. The foregoing
provisions of this Article SECOND shall not apply to the
following:
(1) The amount, if any, by which taxes, interest
and penalties thereon shall be increased as a result of
the inclusion in my gross estate of property (a) in
which I may have a qualifying income interest for life,
under section 2044 of the Internal Revenue Code of 1986
(hereinafter, "IRC") (or the corresponding provisions
of any subsequent federal tax laws) or corresponding
provisions of state law, or (b) over which I may have a
general power of appointment under IRC section 2041 (or
the corresponding provisions of any subsequent federal
tax laws) or corresponding provisions of state law, or
(c) over which I may have retained an interest as
defined in IRC section 2036 (or the corresponding
provisions of any subsequent federal tax laws) or
corresponding provisions of state law, and any taxes,
interest and penalties on said incremental amount shall
either be paid from said property directly or shall be
recovered by my Executor from the person holding or
receiving said property as provided in IRC sections
2207, 2207A, or 2207B (or the corresponding provisions
of any subsequent federal tax laws); and
(2) A generation skipping tax imposed by IRC
Chapter 13 or the additional estate tax imposed by IRC
section 2032A(c) (or corresponding provisions of
federal or state law applicable to my estate and
.
.
LAST WILL AND TESTAMENT
OF
ELLEN N. BENION
PAGE 3
imposing said taxes), and any and all interest and
penalties on said Chapter 13 and IRC section 2032A(c)
and comparable state taxes; and
(C) Flower Bonds to be used to pay Federal Estate Tax. If
at the time of my death I own any United states bonds redeemable
to pay the united states Estate Tax at par plus accrued interest,
I direct my Executor to redeem said Bonds to the fullest extent
possible and to use said bonds ahead of any other assets held in
my probate estate to pay said tax, as well as any interest and
penalties thereon. To the extent that the Trustee of the Trusts
described below does not distribute to my Executor any such bonds
for my Executor to use in paying said tax, my Executor shall pay
said tax only after first ascertaining from the Trustee the
amount of tax and any interest and penalties thereon which the
Trustee can pay by redemption of the bonds held in the Trusts;
and thereafter, when my Executor has received the information, my
Executor shall redeem all said bonds held in my probate estate up
to the full amount of any remaining portion of said tax, interest
and penalties thereon not payable by redemption of said bonds
held by the Trustee. If the Trustee holds no such bonds or has
distributed all such bonds to my Executor, my Executor shall
redeem these bonds as directed hereinabove in this Article
SECOND.
THIRD: Tangible Personal property. Except for those items
excluded below and those items enumerated in the Letter of
Instruction, I bequeath to my spouse, HARRY G. BENION, all
tangible personal property, including but not limited to
clothing, jewelry, heirlooms, furniture, household, garden and
lawn furnishings, equipment and supplies, bedding, rugs, carpets,
household goods, linen, silver, silverware, plate, china, glass,
glassware, pictures, paintings, antiques, works of art, clocks,
books, ornaments, personal effects, motor vehicles, and all other
similar articles, which I own, and the insurance thereon, if my
spouse survives me by sixty (60) days. Tangible personal
property shall not include: (1) any and all property used by me
in any business, (2) cash on hand or on deposit in banks, (3)
stock or securities, (4) any type of evidence of indebtedness,
and (5) any life, health or accident insurance policies.
~
.
.
LAST WILL AND TESTAMENT
OF
ELLEN N. BENION
PAGE 4
If my spouse is not living on the sixty-first (61st) day
after my death, I bequeath such tangible personal property to my
son, HARRY G. BENION, JR.. If my spouse and my son do not
survive me, I leave such tangible personal property to the issue
of my son, per stirpes. If there is any disagreement as to
distribution, I direct my Executor to make such distribution.
The decision of my Executor shall be final and binding. Any
items not selected or any items which my Executor considers
unsuitable for my son may be distributed or sold in the sole
discretion of my Executor and, if sold, the net proceeds
therefrom shall be added to the residue of my estate. Any such
article allocated to a minor may, as my Executor deems advisable,
either be delivered to the minor or to any person to safeguard on
behalf of the minor.
Notwithstanding any other provisions in this Article THIRD,
I may leave a separate, dated and unsigned Letter of Instruction,
which I shall place with my Will, containing directions as to the
ultimate disposition of certain of the property bequeathed under
this Article THIRD, and such Letter of Instruction shall
determine the distribution of such items.
FOURTH:
Residuary Gifts.
(A) If my spouse, HARRY G. BENION, survives me, I give,
devise and bequeath all the rest, residue and remainder of my
estate, of every kind and character, real, personal and mixed,
tangible and intangible, and wherever situated, including any
lapsed or renounced legacies, devises or residuary bequests (and
including any property over which I may have a Power of
Appointment), to my spouse, HARRY G. BENION.
(B) If my spouse, HARRY G. BENION, does not survive me, I
give, devise and bequeath all the rest, residue and remainder of
my estate, of every kind and character, real, personal and mixed,
tangible and intangible, and wherever situated, including any
lapsed or renounced legacies or devises (arid including any
property over which I may have a Power of Appointment), to my
son, HARRY G. BENION, JR., per stirpes.
/1
~lC
,,/J /lz-
......--:-: ><----,' .
.
,
.
LAST WILL AND TESTAMENT
OF
ELLEN N. BENION
PAGE 5
(C) Distributions duri~ Administration. Prior to final
distribution of my estate, the Executor, in his discretion, may
make partial distributions to one or more beneficiaries or
Trusts. As a consequence, the Executorship and any Trusts
created under this will may exist contemporaneously. A
distribution may be made subject to any indebtedness or liability
of my estate.
FIFTH: Spendthrift provision. No beneficiary shall have
the power to anticipate, encumber or transfer his or her interest
in the estate in any manner other than by the valid exercise of a
power of appointment. No part of the estate shall be liable for
or charged with any debts, contracts, liabilities or torts of a
beneficiary or subject to seizure or other process by any
creditor of a beneficiary.
SIXTH: powers of Executor. In addition to the powers and
duties as may have been granted elsewhere in this Will, but
subject to any limitations stated elsewhere in this Will, the
Executor shall have and exercise exclusive management and control
of the Estate and shall be vested with the following specific
powers and discretion, in addition to the powers as may be
generally conferred from time to time upon him by law:
(A) In the management, care and disposition of the Estate,
the Executor shall have the power to do all things and to execute
such instruments as may be deemed necessary or proper, including
the following powers, all of which may be exercised without order
of or report to any Court:
(1) To sell, exchange or otherwise dispose of any
property at any time held or acquired hereunder, at
public or private sale, for cash or on terms, without
advertisement, including the right to lease for any
term notwithstanding the period of the Estate, and to
grant options, including any option for a period beyond
the duration of the Estate; except that, in lieu of any
binding shareholder agreement or buy/sell agreement to
the contrary, the Executor shall not be permitted to
sell the stock or any other ownership interest in any
.
.
LAST WILL AND TESTAMENT
OF
ELLEN N. BENION
PAGE 6
business owned by me, or my spouse, or held in trust,
at my death, without first offering the same for sale
to my children, or without next offering the same to
the corporation or business represented by such
ownership interest for redemption.
(2) To invest all monies in such stocks, bonds,
securities, mortgages, notes, choses in action, real
estate or improvements thereon, and any other property
as the Executor may deem best, without regard to any
law now or hereafter enforced limiting investments of
fiduciaries, except that the Executor may not invest in
any securities issued by the corporate Executor, or
issued by a parent or affiliate company of such
Executor.
(3) To retain for investment any property
deposited with the Executor hereunder; except that the
Executor may not retain for investment any stock in the
corporate Executor, or in a parent or affiliate company
of such Executor.
(4) To vote in person or by proxy any corporate
stock or other security and to agree to or take any
other action in regard to any reorganization, merger,
consolidation, liquidation, bankruptcy or other
procedure or proceedings affecting any stock, bond,
note or other security.
(5) To use attorneys, real estate brokers,
accountants and other agents, if such employment is
deemed necessary or desirable, and to pay reasonable
compensation for their services.
(6) To compromise, settle or adjust any claim or
demand by or against the Estate and to agree to any
rescission or modification of any contract or agreement
affecting the Estate.
/I
,e
.
.
LAST WILL AND TESTAMENT
OF
ELLEN N. BENION
PAGE 7
(7) To renew any indebtedness, as well as to
borrow money, and to secure the same by mortgaging,
pledging or conveying any property of the Estate,
including the power to borrow at a reasonable rate of
interest.
(8) To retain and carryon any business in which
the Estate may acquire an interest, to acquire
additional interest in any such business, to agree to
the liquidation in kind of any corporation in which the
Estate may have an interest and to carryon the
business thereof, to join with other owners in adopting
any form of management for any business or property in
which the Estate may have an interest, to become or
remain a partner, general or limited, in regard to any
such business or property and to hold the stock or
other securities as an investment, and to employ agents
and confer on them authority to manage and operate the
business, property or corporation, without liability
for the acts of such agent or for any loss, liability
or indebtedness of such business if the management is
selected or retained with reasonable care.
(9) To register any stock, bond or other security
in the name of a nominee, without the addition of words
indicating that such security is held in a fiduciary
capacity, but accurate records shall be maintained
showing that such security is an Estate asset and the
Executor shall be responsible for the acts of such
nominee.
(B) Whenever the Executor is directed to distribute any
Estate assets in fee simple to a person who is then under
twenty-one (21) years of age, the Executor shall be authorized to
hold such property in Trust for such person until he/she becomes
twenty-one (21) years of age, and in the meantime shall use such
part of the income and the principal of the Estate as the
Executor may deem necessary to provide for the proper support and
education of such person. If such person should die before
.
.
LAST WILL AND TESTAMENT
OF
ELLEN N. BENION
PAGE 8
becoming twenty-one (21) years of age, the property then
remaining in trust shall be distributed to the personal
representative of such person's estate.
(C) In making distributions from the Estate to or for the
benefit of any minor or other person under a legal disability,
the Executor need not require the appointment of a guardian, but
shall be authorized to payor deliver the same to the custodian
of such person, to payor deliver the same to such person without
the intervention of a guardian, to payor deliver the same to a
legal guardian of such person if one has already been appointed,
or to use the same for the benefit of such person.
(D) In the disbursement of the Estate and any division into
separate trusts or shares, the Executor shall be authorized to
make the distribution and division in money or in kind, or both,
regardless of the basis for income tax purposes of any property
distributed or divided in kind, and the distribution and division
made and the values established by the Executor shall be binding
and conclusive on all persons taking hereunder. The Executor may
in making such distribution or division allot undivided interests
in the same property to several trusts or shares.
(E) The Executor shall be authorized to lend or borrow,
including the right to lend to or borrow from the estate of my
spouse or any trusts which I or my spouse may have established
during life or by will at an adequate rate of interest and with
adequate security, and upon such terms and conditions as the
Executor shall deem fair and equitable.
(F) The Executor shall be authorized to sell or purchase at
the fair market value as determined by the Executor, any property
to or from the estate of my spouse, or any trust created by me or
my spouse during life or by Will, even though the same person or
corporation may be acting as Executor of my estate or the estate
of my spouse or as Trustee of any of my other trusts.
(G) The Executor shall have discretion to determine whether
items should be charged or credited to income or principal or
allocated between income and principal as the Executor may deem
~
.
.
LAST WILL AND TESTAMENT
OF
ELLEN N. BENION
PAGE 9
equitable and fair under all the circumstances, including the
power to amortize or fail to amortize any part or all of any
premium or discount, to treat any part or all of the profit
resulting from the maturity or sale of any asset, whether
purchased at a premium or at a discount, as income or principal
or apportion the same between income and principal, to apportion
the sales price of any asset between income and principal, to
treat any dividend or other distribution of any investment as
income or principal or apportion the same between income and
principal, to charge any expense against income or principal or
apportion the same, and to provide or fail to provide a
reasonable reserve against depreciation or obsolescence on any
assets subject to depreciation or obsolescence, all as the
Executor may reasonably deem equitable and just under all the
circumstances.
(H) If at any time the total fair market value of the
assets of any trust established or to be established hereunder is
so small that the corporate Trustee's annual fee for
administering the trust would be the minimum annual fee set forth
in the Trustee's regularly published fee schedule then, in
effect, the Trustee in its discretion shall be authorized to
terminate such trust or to decide not to establish such trust,
and in such event the property then held in or to be distributed
to such trust shall be distributed to the persons who are then or
would be entitled to the income of such trust. If the amount of
income to be received by such persons is to be determined in the
discretion of the Trustee, then the Trustee shall distribute the
property among such of the persons to whom the Trustee is
authorized to distribute income, and in such proportions, as the
Trustee in its discretion shall determine.
(I) When the authority and power under this will is vested
in two (2) or more Executors, the authority and powers are to be
held jointly by the Executors. A majority of the Executors may
exercise any authority or power granted under this will or
granted by law, and may act under this will. Any attempt by one
such Executor to act under this will on other than ministerial
.
.
LAST WILL AND TESTAMENT
OF
ELLEN N. BENION
PAGE 10
acts shall be void. The action of one such Executor under this
will may be validated by a subsequent ratification of the act by
a majority of the Executors.
SEVENTH: Rights and Liabilities of Executor.
(A) No bond or other security shall be required of any
Executor.
(B) This instrument always shall be construed in favor of
the validity of any act or omission by any Executor, and any
Executor shall not be liable for any act or omission except in
the case of gross negligence, bad faith or fraud. specifically,
in assessing the propriety of any investment of the estate, the
overall performance of the entire estate shall be taken into
account.
(C) Each Executor shall be entitled to receive reasonable
compensation for services actually rendered to my estate, in an
amount the Executor normally and customarily charges for
performing similar services during the time which he/she performs
the services.
EIGHTH: Tax Elections. In determining the estate,
inheritance and income tax liability relating to my Estate, the
Executor's decision as to all available tax elections shall be
conclusive on all concerned. If the Executor joins with my
spouse in filing income tax returns, or consenting for gift tax
purposes to having gifts made by either of us during my life
considered as having been made one-half by each of us, any
resulting liability shall be borne by my Estate and my spouse in
such proportions as they may agree. In accordance with IRC
Section 2632(a) and without regard to whether a Federal estate
tax return is actually filed, my Executor shall allocate so much
of the Federal Generation Skipping Transfer (GST) exemption
amount as will fully exempt any generation skipping transfer
which may occur under this will.
Ie
.
.
LAST WILL AND TESTAMENT
OF
ELLEN N. BENION
PAGE 11
NINTH: Definitions and General provisions.
(A) survival. Any beneficiary, including my spouse, who
dies within sixty (60) days after my death shall be considered
not to have survived me.
(B) Trust Estate. "Trust Estate" means all assets, however
and wherever acquired, including income, which may belong to a
Trust at any given time.
(C) children. Except for discretionary distributions which
may be made unequally among a group of persons and distributions
pursuant to a valid exercise of a Power of Appointment, in making
a distribution to the children of any person, the property to be
distributed shall be divided into as many shares as there are
living children of the person and deceased children of the person
who left children who are then-living. Each living child shall
take one share and the share of each deceased child shall be
divided among his then-living descendants in the same manner. A
posthumous child shall be considered as living at the death of
his parent.
(D) Code. Unless otherwise stated, all references in my
Will to section and chapter numbers are to those of the Internal
Revenue Code of 1986, as amended, or the corresponding provisions
of any subsequent federal tax laws applicable to my estate.
(E) Other terms. The use of any gender includes the other
genders, and the use of either the singular or the plural
includes the other.
(F) captions. The captions set forth in this will at the
beginning of the various divisions hereof are for convenience of
reference only and shall not be deemed to define or limit the
provisions hereof or to affect in any way their construction and
application.
(G) Powers of Appointment are not Exercised. By this will
I exercise any Power of Appointment which I may possess at my
death.
,,{,/
Y:L4i>--....._
.
.
LAST WILL AND TESTAMENT
OF
ELLEN N. BENION
PAGE 12
IN WITNESS WHEREOF, I, ELLEN N. BENION, the Testatrix, have
to this my Last Will and Testament, typewritten on thirteen (13)
pages, including the ACknOW~dgment and Affidavit, set my hand
and seal this / 1 ~. day of 1 U/1?U).j/t--- , 1990.
7:1 D \
1r fJ).i'-'lJ l1' I:: J01/f./}-'?<-'
ELL N N. B NION
Signed, sealed, published and declared by the above-named
Testatrix, as and for her Last will and Testament, in the
presence of us, who have hereunto subscribed our names at her
request, as witnesses hereto, in the presence of the said
Testatrix, and in the presence of each other. Each of us further
declares that he or she believes the Testatrix to be of sound
mind and memory. The preceding instrument consists of this and
twelv (12) other consecutively numbered typewritten pages
incl ing the Acknowledgment and Affidavit.
residing at J'lAed1~ CS~?--, fA- ~
Cl-f- R., c,/1-7'[;3
(print name)
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"- ;(o.S/
name)
residing at ;J;~~iI,cf11JrJdiV'e6
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fees
~int
AOCLj-;/-/}{ c/i2 /r
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c:'51 {! I'[~ I- . 'AI f't
(prlnt na e)
residing at '-;/Jhfl/t/?/?;'/Fl ,~
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.
.
ACKNOWLEDGMENT AND AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF tVJYI~X lC\J'J---
S5:
The Testatrix and the witnesses whose names are subscribed
to the foregoing instrument, being first duly sworn and qualified
according to law, do hereby acknowledge and declare to the
undersigned authority that the Testatrix signed and executed the
instrument as her last will in the presence of the witnesses,
that she signed willingly or willingly directed another to sign
for her, that she executed it as her free and voluntary act for
the purposes therein expressed, that each of the witnesses, in
the presence and hearing of the Testatrix, signed the will as
witnesses, and that to the best of their knowledge the Testatrix
was at that time eighteen years of age or older, of sound mind
and under no constraint or undue influence.
,~ ')2 .~ J
//, /d.L~"
Testatrix
. "
A'/vtdl-Ljfc/JaO
~ ~ ;1 witness
v
Sworn to, subscribed and acknowledged befo~e
above-named Testatrix and witnesses this \9-1
DQ.~Q..r'(\~l,^--- , 1990.
me by the
day of
l~J, f< v--0-
I N tary Public
or
Attorney-at-Law
( SEAL)
NOT.ARii\i :~r=/\! 1
\ . _' ,.."....". .l~r~ -," "-.' ;~ I " I
I "l}lN!:'{ ,! f.;l \f,Y, !".lcv,'.! PUOMr. I
c~~;":; ;~i!i, F;:-;. ~ .,. - J COU~!y
L~:L_....,..,.____~~E:"."S._.._.~ ~~1.J
.
.
Estate of Ellen N. Benion
Pennsylvania Inheritance Tax Return
~~-- RE'T ... ~I\I\
.A" Ullll " - .1.J\1\1
EXHIBIT C
Copy of the Short Certificate Letters Testamentary
issued on May 10, 2006
e
STATE OF PENNSYLVANIA
COUNTY OF CUMBERLAND
estate of ELLEN N BEN/ON
.
SHORT CERTIFICATE
I,
GLENDA FARNER STRASBAUGH
Register for the Probate of wills and Granting
Letters of Administration in and for
CUMBERLAND County, do hereby certify that on
the lOth day of May, Two Thousand and Six,
Letters TESTAMENTARY
in common form were granted by the Register of
said County, on the
, la te of NEW CUMBERLAND BOROUGH
(Fir..t, Mirlrll", I astl
a/k/a
ELLEN NOEL BEN/ON
in said county, deceased, to HARRY G BEN/ON JR
(First, Middle, Last!
and that same has not since been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the
seal of said office at CARLISLE, PENNSYLVANIA, this lOth day of May
Two Thousand and six.
File No. 2006-00408
PA File No. 21-06-0408
Da te of Dea th 5/03/2006
s. s. # 097-38-8143
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NOT Vll,LID WITHOUT ORIGINAL SIGNATURE _AND IMPRESSED SKilL
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Estate of Ellen N. Benion
Pennsylvania Inheritance Tax Return
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.I.' Villi .I.'-b ,. - .l.JUV
EXHIBIT D
Copy of Pennsylvania Inheritance And Estate
Tax Official Receipt No. CD 007025
<
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
.
.
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
BEN ION HARRY G JR
315 MONROE ST
MECHANICSBURG, PA 17055
n~nn_ fold
ESTATE INFORMATION: SSN: 097-38-8143
FILE NUMBER: 2106-0408
DECEDENT NAME: BEN ION ELLEN N
DA TE OF PAYMENT: 07/28/2006
POSTMA RK DATE: 07/28/2006
COUNTY: CUMBERLAND
DA TE OF DEATH: 05/03/2006
NO. CD 007025
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
~.=,=--
101 I $37,000.00
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$37,000.00
REMARKS: HARRY BENION JR
CHECK#1002
INITIALS: AJW
RECEIVED BY:
SEAL
TAXPAYER
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
.
.
Estate of Ellen N. Benion
Pennsylvania Inheritance Tax Return
Form REV-1500
EXHIBIT E
Documentation of Assets
\.
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APPRAISAL REPORT
OF
1714 Bridge Street
New Cumberland. PA 17070
PREPARED FOR
Gates, Halbruner & Hatch, P.C.
1013 Mumma Road, Suite 100
lemoyne, PA 17043
AS OF
0S-03-06
PREPARED BY
Premier Appraisals
3015 Harvard Ave.
Camp Hill, PA 17011
~-~
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Premier Appraisals
rile No. 605041
Case No.
Table of Contents
Page T tIe
uRAR age'
URAr 'age 2
URA' Page 3
Extr' ~omps 4-5-6
SkI n
Page #
L6c ltion Map
Phc . to Subject
Photc ' Comparables 1 -2-3
3
4
5
6
Umiting .Cl 'Jnditions
8
9
10
'1
Photo Comparables 4-5-6
Apprais, ~r License Certificate
Avlifdi:i~"'s i. '::i:r"tificaliot,
~2
Mui\i Purpose Add. Page 1
MUI~'Ptirpose"" dd. Page 2
13
14
ClickFORMS Appraisal Software 800-622-8727
eemier Appraisals
File No.
Case No.
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Unl orm eSI en la ppralsa eoo
rhe purpose ollhis summary appraisal report is 10 crovide the lender/client wilh an accurate and adeauatelv suaaorted oainion of the market value of the subiect nronertv.
Propertv Address 1714 Bridee Str"et City New Cumberland State PA Zin Code 17070
BorrowEr Benion Estate Owner of Public Record Benion Ellen Countv Cumberland
Legal [}~scrip!ion Deed Book 23-0 Paqe 43
Assessor's Parce! # 26-22-0620-076 Tax Year 2005-06 R.E. Taxes $ 1 670.00
Neiohborhood Name New Cumberland Borouoh MaD Reference 26-22-0620-076 Census Tract 42-041-0107.00
Occupant r I Owner I I T enanl I X I Vacant Snecial Assessments $ N/A I I PUD HOAS N/A Il Der vear r. I oer month
Propert\, Riahts Aaaraised I X I Fee Simole I 1 Leasehold I I Othe;(describel
AssiQnmen! T ype I I Purchase T ransaclion I i Relinance l ransactlon IX lOther 'describei Market value as at U!J-U::J-Ub
Lender/Client Gates. Halbruner & Halch. P:C. Address 1013 Mumma Road Suite 100, Lemovne PA 17043
Is the subject property currently offered lor sale or has it been offered for sale in the twelve months orior to the effeclive date of this aooraisal? I 1 Yes r X 1 No
Report data source(s) used, offerings price(s), and dalels\. To the annraiser's knowledoe and the multi list svstem the sub'ect has not been offered for sale in the twelve
months orior to Ihe effective dale of Ihi~isal.
1D1id U did not analyze the contract for sale for the subject purchase transaction. Explain the results of Ihe analysis of the contract for sale or why the analysis was nol
'p'ertorm ~d N/A
Conlracl Price $ N/A Date of Contract N/A Is Ihe nrODertv seller the owner of public record? 11 Yes I 1 No Data Sourcels) N/A
Is there any financial assistance (loan charges. sale concessions. gift or downpaymenl assistance, etc.) to be paid by any party on behalf 01 the borrower? DYes DNa
It Yes, report Ihe lotal dollar amount and describe Ihe items to be oaid. N/A
Note: Race and the racial comoosition of lhe neinhborhood are not annraisal factors.
'''I",j...~h^..a..-",^,4'''h:':''~''''.';o...jiio.;'';'';' . ".'.;":i. : ::,~!;;.;\:: ..:; .,,:\.-\,,".',~i.'-\::~~"'~"'~1i:':i;~'it"~~';'i~in;",r.:~dlffi~~~ 1r@~lrr~~~~J..rrrgp~~ te~ibf~~t($~r~j~':,:";'
Localkm n~';~;~ "wr~i'~~~~~~~~nRural "pr~oert~Val~~sr~rr~~;:~;~i~~"-'F-Ys;~=""'nO:;;;;-; PRICE AGE One-Unit 85 %
BUill-Up I X I Over 75% I 125-75% I I Unde' 25% Demand/SunDlv I 1 Shortaae r X lln Balance r -Io.e-Sllnlw $ 1000\ Ivrs\ 2-4 Unit 1 %
Growth r l Rapid r xl Slable 11 Slow Markelina Time T T UOOer3mihs I X 13-6mlhs I 10ver6mlhs 100 Low 10 Mulli-F amilv 1 %
Neighborhood Boundaries The subiect's neiahborhood is rounhlv bounded bv Roule 83 to lhe wesl Lowther Street 10 350+ Hiah 100+ Commercial 3 %
the north the Susauehanna River to the easl and Third Streelto the south. 130-200 Pred. 40-60 Other 10 %
Neighborhood Description The subiect's surroundino area is mainlv residential in nalure with a short commute to schools shODDino and desired amenities. Maior
employment cenlers include The Comrnonweallh of PA B!ue Cross / Biue Shield and The Armv and Navv Deoats. The surroundino various slvle dwellinos anoear of
averaae. condition and construction. Appeal to market is rated averane. No adverse markelabilitv faclors noled at insneclion.
Market ':ondilions (includinq support for the aboye conclusions Genera! market condlllons are considered stable as mortoaoe interest rates have been available in the
5-8% ranae for several monlhs. FHA and VA financinn is available and seller concessions are sometimes paid in contribulion towards Durchaser's c1osino costs.
MarketinQ time Ivpicallv ranaes from 30 to 120 davs. Demand and Sunnlv annear in line with similar neiohborhoods in Ihis market area.
Dimensions As Per Public Records Area .17 Acre Shaoe Mostlv Rectanaular View Residenlial/Ava
SpeCific Zoning Classification R-' Zonina Descriotion Residence
Zoning Comoliance I X Leaall I Lea.al Nonconformina (Grandfathered Use! I 1 No Zonina I IlIIeoal (describel
Is the h'1hest and best use of subject property as imoroved lor as DroDosed Der olans and soecificalionslthe present use? X lYes f No If No. describe.
Utilities Pubfic Other Idescribe! Public Other Idescribel 1 Off-site ImDrovements--TvDe Public Private
Elec!rici:v I X I 1 I Circuli Breakers Water Ix 1 11 I Street Asohall r xl IT
Gas I 1 11 Sanilarv Sewer IX 1 r 1 I Allev Rear fxl 11
FEMA Soecial Flood Hazard Area I IYes Ix 1No FEMA Flood Zone Zone C FEMA MaD # 420366B FEMA Man Dale 02-16-77
Are the .Jtililies and/or off-site improvements typical for the market area? T X TYes r No If No, describe.
Are there any adverse sile conditions or externaltactors leasements, encroachments environmental condilions land uses etc.n I 1 Yes I X I No If Yes, describe.
General Oescriation ..' .."..,..\Fou'ndiltjiln;;~ii~i."Jjii!i' EXfeliilr._giDI) -. .. i~fojfdimlliltm'ti~f,ih:i'i:'~lii;ihial~B~I$'L~o611iti(jo '
Units r X lOne I lOne wilh Accessorv Unit I Concrete Slab I lCrawl Snace Foundation Walls Concrete/Avo Floors HW/Ava
# of Stories Two xl Full Basement lloartial Basement Exterior Walls Brick Frame/Avo Walls Ptaster Drvwall/Avn
~xl Deff lAIl. lS-Oel./EndUnit Basement Area 804 so. ft. Roof Surtace Shinales/Ava Trim/Finish Wood/Avo
X Exi,;tino r l Prooosed r l Under Canst. Basement Finish 0% Finished % Gullers & Downsoauts Metal/Avn Bath Floor Tile/Avo
Desiqn (St le\ 2 StOrY/Ava X I Outside Ent v/Exitr 15umn Pumn Window Tvoe Wood Obi HunoJAvo Bath Wainscot Tile/Avn
Year Built 1934 Evidence of r Infestation Storm Sashllnsulated Storm Windows/Avo Car Storaoe I I None
Effeclive, Aoe (Yrs) 24-26 Vears 1 Damoness I Selllemenl Screens Yes/Avo IX 1 Drivewav # of Cars 2
Allie None Heatinn r lFWA lHW8~ r lRadiant Amenities Woodsfoyefsl # 0 Drivewav Surtace Asohalt
r l Drao Slair X Stairs X 1 Other Slm Ralfuel Oil X IFire loceI5\# 1 X Fence Rear 1 Garane # of Cars 0
I X I FlcoOr ScuWe Coolinn r 1 Cenlral Air Conditionino II X IPatio/Oed< Rear X Porch Cov. Frnl R I Carnnrt #ofCars 0
I I Finished Heated Ilndividuadr xl Other W.Units tp II IPool X Other Stooa JAil. r lDet. r 1 Buill-in
~ces f P 1 Refrioeralor IX 1 Ranae/Oven r loishwasher I X IDisoasal r I Microwavel I Washer/Dryer I IOther Idescribel Fan/Hood' P;Personaltv
Finished area above grade contains: 6 Rooms 3 Bedrooms 1.50 Bath{s) 1612 SQuare Feet of Gross Livino Area Above Grade
Additiona! features (soecial eneravefficient items, etc.\ Newer Steam Boiler Unrlated Circuit Breakers Crown and Chair Rail Moldino. Built-Ins in Dininn Room Cedar
Closet, Interior Shullers. Brick Palio Covered Front and Rear Porches Front Stoon Stone Walkwav. Window Unit Air Conditioners (PI Storm Doors Slorm Windows
Descrite the condition of the prooerty (indudino needed renairs deterioration renovalions remodelina. etc.\. The subiect imorovements were in averaoe overall condition
althe time of the annraisal insneclion. There were no items of ahvsical functional or external obsolescence olher than tvnical nhvsical denreciation due 10 ane noted at
the limE~ of this appraisal.
Are there any physical deficiencies or adverse conditions that affect the livabilllv. soundness. or structural inteQritv of the orooertv? I Yesfx1No If Yes describe
I The appraiser is not a home inspector or en(lineer and does nol warrant anv oart or whole of the subiect prooertv.
I
I Does the property qeneraliy conform 10 lhe neiqhborhood (functional utili!v. stvie, condition, use, construction, elc.l? I X I Yes I I No If No describe
e
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ClickFORMS Appraisal Software 800-622-8727
Fannie Mae Form 1004 March 2005
Page 1 of 14
ldie Mac Form 70 March 2005
Uniform Residentla \ppralsa epo
There are 3 comparable properties cunentlv offered for sale in the subiect nelohborhood ranoino in price from $ 136 900 10$ 169900.
There ,Ire 10 comparable sales in the sub'ect neiohborhood within the nast twelve months ranoino in sale orice from $ 125500 10 $ 164 900
FEATURE I SUBJECT COMPARABLE SALE # 1 COMPARABLE SALE # 2 COMPARABLE SALE # 3
Address 1714 Bridge Street 1701 Elm Street 610 Harding Street 525 Harding Street
New Cumberland PA 17070 New Cumberland PA 17070 New Cumberland PA 17070 New Cumberland PA 17070
Proximity to Sub'ect ',. .,.,.,.,".- ':'.:?~;r,:;tt: 0.19 miles 0.34 miles 0.27 miles
<', '
Sale Pri:e $ ':~,~~Tf}~ $ 159 000 " -.,-:,. 164 900 ~~V1$ =-
N/A
~e/Gross LivArea "M' 109.35 so. fl.;" " :'f'-- 109.64 so. ft. 114.63 so. ft
I Data SC!JfCE'/S\ I '"..,".:j: . Public Records/Ex!. Insa Public Records/Ex!. Inso Public Records/Ex!. Inso
Verification Source/sl ;"':'~ESCRIPTION Multi LisURealtar Multi LisURealtor Mulli LisURealtor
VALUUDJUSTMENTS DESCRIPTION -+I.l $ Adiustment DESCRIPTION -+1-' $ Adiustment DESCRIPTION 1-+1-\ $ Adiuslment
Sale or =inancinn . .... Conventional Conventional Conv. $1,000
Conces:lions ~r 2 Davs Mkt 16 Davs Mkt 5 Davs Mkt
Date of SalelTime ):.' 04-19-06 02-07 -06 03-17-06
Locatio" Suburban/Avo Suburban/Avn Suburban/Avo Suburban/Avn
Leasehold/Fee Simole Fee Simale Fee Simole Fee Simole Fee Simole
Site .17 AclAvn .23 AclAvn .22 AclAva .15 Ac/Ava
View Residential/Avo Residential/Avo Residential/Avo Residential/Avo
Desion tStvlet 2 Slorv/Avn 1.5 StorY/Ava 1.5 Starv/Ava 1.5 Storv/Avn
Qualitv of Construction Brick Frame/Avo Aluminum BricklAv +150 Brick AI Vn/Avn Aluminum/Avo +200C
Actual Aqe 72 Yrs Est 66 Yrs Est 53 Yrs Est 66 Yrs Est
Condilion Averaae Averaoe Averaae AveraQe
Above Grade TotalTBdrmsl Baths Total IBdnnsJ Baths Total IBdnnsJ Baths Total IBdnns.! Baths
Room Count 6 i 3 i 1.50 6 i 3 i 1.50 6 i 3 i 1.50 7 i 4 i 2.00 -100
Gross L vino Area 1,612 so. ft 1454 <n.fl. +237C 1504 sn. ft. +162r 1,360 so fl. +378
Basemenl & Finished Full Basement Full Basement Partial Basement Full Basement
Rooms 3elow Grade Unfinished Unfinished Unfinished Unfinished
Functional Utililv Averaae Averaoe Averaoe Averaae
Heatino.'Coolinn Oil Stm Rad/No CA 011 HWBB/No CA Oil FWNCA -200r Elect BB/No CA
Enerov Efficienlllems Storm Windows Insulated Windows Storm Windows Insulated Windows
GaraoelCaraort None None 1 Car Gar Det -200r 2 Car Gar Det -4 000
Porch/F atiolDeck 2 Porches Patio Scm Prch Porch Sun Room Porch -100e Porch +100r
Fireolaces , Firenlace 1 Firenlace 1 Firenlace 1 Fireolace
Net AdiL stment IT alall . ..... I X I + I I. $ 3870 I I + I X I. Is -3380 xl..j 1- $ 1760
Adjusted Sale Price . ""',.: ~lNet Adj: 2% Net Adj: -2% Net Adj: 1%
of Com(,arables "', Gross Adi : 2% $ 162 670 Gros~Adi: 4%. . .Is 161 520 GrossIAdi:8% Is 157660
I r X l did r l did not research the sale or transfer historY 01 the subiect orooertv and comoarable sales. If not exolain Three vear sate/transfer histories were
researclled for all properties.
Mv research n did !xl did not reveal any prior sales or lransfers of lhe subiect orooertv for the three vears orior to the effective date of this aooraisal.
Data sOJrce(s) Public Records
My research IX 1 did r l did not reveal anv prior sales or transfers of the comoarable sales for the vear crior to Ihe dale of sale of the comnarable sale
Dala soJrce(s) Pubhc Records
Report Ihe resulls of the research and analvsis ollhe prior sale or Iransfer hislorv of lhe subiect property and comoarable sales (renort additional Drier sales on oaoe 31.
ITEM SUBJECT COMPARABLE SALE # 1 COMPARABLE SALE # 2 COMPARABLE SALE # 3
Date of Prior SalelT ransfer No Known Sales In The No Known Sales In The 12-06-04 01-13-04
Price of Prior Sale/T ransfer Past Three Years Past Three Years $147000 $128900
Data Source(sl Source: Public Records Source: Public Records Source: Public Records Source: Public Records
Elfeclivl! Dale of Data Source(sl 06-01-06 06-01-06 06-01-06 06-01-06
Analvsis of prior sale or transfer hislory of Ihe subiect prooertv and comoarable sales The prior sale of comoarable three had no aooarentaffect on it's recent sale orice.
Summary of Sales Comparison Approach All sales are detached dwellinas located in the sub'ect's market area and are considered the best available for comaarison as
value injicalors. The selected comoarables are closed transactions unless otherwise nOled. The snecified dates of sale for the utilized comoarables are the aclual
setlleml!nt dates or dates of deed transfer. Vf:(i~cation is with the Cumberland Count Courthouse. See the attached comment section for an exolanation of the
adjustments.
Indicaled Value bv Sales Comnarison Aooroach $ 160 000
Indicatr!d Value by: Sales Comparison Approach $ 160 000 Cost ADoroachTil develooed\ $ N/A Income ADoroach {if develooedl $ NIA
Three approaches to value were considered in develooina the oninion of value. Due to the reliabilitv of the data emnhasis was nlaced on the sales comnarison
aaaroach. The cost and income approaches were considered as not aaDlicable due to the aae of the home and the lack of reliable rental data resoectivelv.
Jacoueline Paae sinnificanllv assisted the certified annraiser in all steos of the aooraisal process.
This appraisal is made W "as is," L--.J subj"ct to completion per plans and specifICations on the basis of a hypothetical condition that Ihe improvements have been
compleled, 0 subject to the following repairs O' alterations on Ihe basis of a hypolheticat condition that the repairs or alterations have been completed. or 0 subject to !he
followinq required inspection based on the extraordinarv assumotion that the condition or deficiency does not reouire alteration or reoair:
Based "n a complete visual inspection of the interior and exterior areas of the subject property, defined scope of work, statement of assumptlons.and limiting
conditi"ns, and appraiser's certification, my (our) opinion of the market value, as defined, of the real property that is the subject of this report is
$ 160,000 , as of 05-03-06 which is the date of insoection and the effective date of this appraisal.
.ier Appraisals
. IA
IR
rt
ddie Mac Form 70 March 2005
ClickFORMS Appraisal Software 800-622-8727
File No.
Case No.
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Fannie Mae Form 1004 March 2005
PaQe 2 of 14
.mier Appraisals
Uniform Residential Aooralsal Report
An aoc-raisallnspection was recently performed and the subiect oroDertv was aDoraised for this summarv reDort of a comolete annralsa!. The use of the term
insoeclion in this appraisal only refers to the orocess of oatherino data oertinent to the comoletion of an aDoraisal for an ooinion of market value. This nrocess is
onlv a 'lisual observation of readily visible and accessible areas of the sublect orooertv. The aooraiser is not a home insoector and does not warrant any nart or
whole of the subject property.
File No. .
Case No.
The Inlended User of Ihis appraisal reporl is the Lender/Client. The Intended Use is to evaluate the orooertv that is the sub'ect of this aooraisal for a mortoaoe
finance Iransaclion, subiectlo ttle stated SClloe of Work ournose of the anoraisal reportino renuirements of this aooraisal renort form and Definition of Market
Value. No additional Intended Users are identified bY the aonraiser.
Campa rabies one, two and three differ somewhat in desion however are similar in location utilitv. and/or amenitv. and were selected as reliable value indicators
A ouality of construction adjustment was applied to sales one and three due to the absence or extent of masonrv on their exterior walls.
Gross livino area adiuslments were calculated at $15 oer souare foot.
The adiustments were calculaled for the market's reaction to the differina amenities and conditions.
.' " .:;;i ::""j:"j:i;:fC0S:#4:eeR(!)Wcl;\:tt€lV~i!I!l~i~Wi"
ProvidE' adequate informalion for the lender/client to reolicate vour cost fioures and calculations,
~t for the opinion of site value (summary (,f comoarable land sales or other methods for estimatino site value\
"W'
ESTIMATED n REPRODUCTION OR II REPLACEMENT COST NEW
Source of cost data
Qualitv ralinQ from cost service Effea:ive date of cost data
Commmts on Cost Approach (Qross livinQ area calculations deoreciation etc.)
Due 10 Ihe aoe of the subiect, the cost apprcach was considered as not
aoolicable and was not completed,
OPINION OF SITE VALUE
Dwellino 1 612
Bsmt. 804
So. Fl.@$
So. Ft:tID $
=$
=$
=$
Garaoe/Canoort So. Ft"7a)$
Total Estimate of Cost-new
Less Phvsical 36 I Functional
Deoreciation 0 I
Deoreciated Cost of Imorovements
. As-is' Value of Site Imorovements
=$
=$
I External
I
=$ I
=$
=$
o
o
Estimated Remainino Economic Ufe tHUD and VA onlv)
. D~~~4i'
Estima:ed Monthly Market Rent $ N/A X Gross Multiolier N/A =$ N/A Indicated Value bv Income AOProach
Summary of Income Approach (includinQ support for market rent and GRM\ Due 10 the lack of reliable rental data the income aODroach was considered as not
aoolicable and was nol completed.
<. .... ., '..f /i;.;i'5;~'''~?jj!.fiip.R'Q~E'0.T~rNEQR_f.EfRlp. ;',
Is the developerfuuilder i~ contr~ of Ihe ~~m~~:ner'~ A~sociati~ tHo'A\? r lves I i No Unit tvoels\ I I Detached I IAttached
Providflthe foltowinQ information for PUDs ONLY if the develoner/builder is in control of the HOA and the subiect oronertv is an attached dwellino unit.
Leoal Name at Project
T alai number of phases Total number of unils Total number of units sold
Total number of units rented Total nllmber of units for sale Dala source's\
Was lh~ project crealed by lhe conversion of existino buildinots) into a PUD?T lyes I INo If Yes date of conversion.
Does the proiect contain any multi-dwellinQ units? r 1 Yes 11 No Data source.
Are the units, common elements, and recreation facilities comolete? I I Yes r 1 No If No describe the status of comoletion.
40-50
Year
Indicated Value Bv Cost Aooroach
,Il
=$
o
Are the common elements leased to or by the Homeowner's Association? r 1yes 1 '1 No If Yes describe the rental terms and ootions.
,
.
Describe common elements and recreational facilities.
,....1:...1,1:'1""\1":). Ie:- ^ ..._.......:........1 C"...&h............. ann C!.,") Q7')7
Fannie Mae Form 1004 March 2005
0......... ...1
!ddie Mal; Form 70 March 2005
.
Premier Appraisals
EXTRA COMPARABLES 4-5-6
.
File No. 605041
Case No.
Borrower Benion Estate
Property Address 1714 Bridge Street
City New Cumberland County
Lender/Client Gates. Halbruner & Hatch. P.C.
Cumberland State PA Zip Code
Address 1013 Mumma Road. Suite 100. Lemoyne. PA 17043
17070
II:EATURE
Addres:; 1714 Bridge Street 1549 Bridge Street
New Cumberland. PA 17070 New Cumberland PA 17070
Proximitv 10 Subiect ,....j,;~.;:,:,:....;~\':i(~~if:i 0.18 miles
Sale Price $ N/A "~~$ 165 000 .. J$
'--: '"'
Sale Pr.:e/Gross Liv. Area $ 0.00 so. II. S 115.95 so. ft. ;~l~\'i~i. $ so.ftJ so. " ':,...:.:, .....
Dala Source/s) ", .' .:..':;)\ Public Records/Ex!. Insn
Verification Source/sl Multi LisVReallor
VALUE ADJUSTMENTS DESCRIPTION DESCRIPTION -ti. \ $ Adiustment DESCRIPTION ->1-) $ Adiustment DESCRIPTION +/- \ $ Adiustment
Sale or Financing ;Ill None Known
Conce!.sions 9 Davs Mkt
Date of Sale/Time ,__;".,/1.-, Under Contract
Location Suburban/Avo Suburban/Avn
Leasehold/Fee Simole Fee Simote Fee Simole
Site .17 Ac/Avn .17 AclAva
View Residential/Avo Resident Comm/Avn
Desion 1St leI 2 Storv/Avo 2 Storv/Avo
Qualitv 01 Conslruction Brick Frame/Avo Brick VinvVAvo
Actual lIoe 72 Yrs Est 76 Yrs Est
Condition Averaoe Averaoe+ -500C
Above Grade Total BdrmsJ Baths Total IBdrmsJ Baths Total IBdrmsJ Baths Total IBdrms.l Baths
Room Count 6 3 I 1.50 6 I 3 1 2.00 -1 oar 1 1 I 1
Gross Livino Area 1612 SQ. II. 1423 sn. II. +283 so. ft. so. ft.
BaSelTllml & Finished Full Basement Partial Basement
Rooms Below Grade Unfinished Unfinished
Funclional Utilitv Averaae Averaae
Heatinc/Coolino Oil,Stm Rad/No CA Gas FHNNo CA
EnerQY Efficient Items Storm Windows Storm Windows
GaraQe/Caroort None 1 Car Caroort .100C
Porchlf'atiolDeck 2 Porches. Patio Sun Room Balconv -100r
Firepla.:es 1 Fireplace 1 Fireolace
Net AdiustmentlT otal) 11 + 1 X 1- -5165 1 1 +1 I- S 0 r +11- 0
Adjustej Sale Price Net ~j: -3% Net .A:~hO% , Net.Adj;O%
01 Com Jarables GrossAdi : 7% S 159835 GrosscJ1.rJi:O% . S 0 Gross Adi:0% 0
Reoort the results of the research and analvsis 01 the oricr sale or transfer historY of the subiect orooertv and comoarable sales
ITEM SUBJECT COMPARABLE SALE # 4 COMPARABLE SALE # 5 COMPARABLE SALE # 6
Dale 01 Prior SalelT ransler No Known Sales In The No Known Sales In The
Price 01 Prior SalelTransfer Past Three Years Past Three Years
Data Source(s) Source: Public Records Source: Public Records
Effective Date of Data Source!s' oti-O 1-06 06-01-06
Analysis of prior sale or transfer history of the subiect orooerty and comoarable sales N/A
Summary 01 Sales Comparison Approach Comparable four was orovided as sunnortinn data onlv. It is not a dosed transaction and is currenUv under contract for
sale. The price utilized in the sales comparison nrid is the contract nrice as verified with the listinn anent involved_ As ner the Iistinn aoent the contract orice is
$165000 or $100 over the list price of $164,900. The cpntract is continnent on the seller findino a new house and as such no settlement date has been se!.
SUBJECT
COMPARABLE SALE #
4
COMPARABLE SALE #
5
COMPARABLE SALE #
6
CtickFORMS Appraisal Software 800-622-8727
Page 4 of 14
Borrower Benion Estate
~,r1Y Address 1714 Bridge Street
Q!L New Cumberland County
Lender/Client Gates, Halbruner & Hatch, P.C.
.emler Appraisals
SKETCH ADDENDUM
File No. 605041
C::lse No.
.
Cumberland Slate PA ZiDCode 17070
Address 1013 Mumma Road, Suite 100, Lemoyne, PA 17043
r'O
II
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Brick
Covered Patio
Porch 37.0'
Kitche n Living Fp 13.5'
Room
28.0' Pwdr
Room 16.0'
Dining Covered Porch
Room Stairs
I Foyer 114.5'
21.0'
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!
I 37.0'
I Bath
Bedroom Room Bedroom 13.0'
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I 3.0'
Bedroom 4.0'
Stairs 15.0'
21.0'
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SKETC H CALCULA TIONS Perim eler Area
E? A 1 : 37.0 x 13.5 = 499.5
~ A2 : 21.0 x 14.5 = 304.5
Rrst Floor 804.0
i
I EF A3:21.0x 15.0= 315.0
A4 : 37.0 x 13.0 = 481.0
A5:4.0x 3.0= 12.0
Second Floor 808.0
Total Living Area 1612.0
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ClickFORMS Appraisal Software 800-622-8727
Page 5 of 14
LOCAllJrM~~ADDENDUM
File No.
Case No.
6050.
Borftlwer Benion Estate
f1QQer1Y Address 1714 Brid~e Street
QrL New Cumberland
LencerlClienl Gates, Halbruner & Hatch.
County
P.C.
Cumberland State PA Zip Code
Address 1013 Mumma Road, Suite 100, Lemoyne, PA 17043
17070
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SUBJ.PHOTO ADDENDUM
BorrOW1!1 Benion Estate
Propert/ Address 1714 BridQI! Stmet
~ew Cumberland County
Lender/Client Gates, Halbruner & Hatch, P.C.
File No.
Case No.
605041.
Cumberland
Address
State PA Zip Code
1013 Mumma Road, Su~e 100, Lemovne. PA 17043
17070
r
FRONT OF
SUBJECT PROPERTY
1714 Bridge Street
New Cumberland, PA 17070
REAR OF
SUBJECT PROPERTY
STREET SCENE
Page 7 of 14
~'er J<ppralsals
.ARABLES 1-2-3
BorrOWtlf Benion Estate
Prope"" Address 1714 BridQ" Street
~ew Cumberland County
Lender/Client Gates, Halbruner & Hatch, P,C,
File No,
Case No.
605041.
Cumberland Slate PA Zip Code 17070
Address 1013 Mumma Road, Su~e 100, Lemoyne, PA 17043
COMPARABLE SALE #
1701 Elm Street
New Cumberland, PA 17070
COMPARABLE SALE # 2
610 Harding Street
New Cumberland, PA 17070
COMPARABLE SALE # 3
525 Harding Street
New Cumberland, PA 17070
Page 8 of 14
.,'r'".....,;,-
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':'Ier AppraisalS
.ARABLES 4-5-6
BorrOWllf Benion Estate
Property Amess 1714 Brid!3" Streel
~lew Cumberland County
Lender/Client Gates, Halbruner & Hatch, P.C.
File No.
Case No.
605041.
Cumberland State PA Zip Code 17070
Address 1013 Mumma Road, Sutte 100. Lemoyne, PA 17043
. .
... ^".. .... ....., .... . .
ClickFORMS Appraisal Software 800-622-8727
COMPARABLE SALE # 4
1549 Bridge Street
New Cumberland, PA 17070
COMPARABLE SALE # 5
COMPARABLE SALE # 6
Page 9 of 14
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APprai.License Certificate
Cummon~veaUl.t ofl"eIl:IL'Yl,,!#flio
l.lepRrlm~1ll of Sh'l~li;".
Hllre.a.u of Pl"Ofe.~~ioillll~aud OeeoplI:dOlilfll A1Iais-s
PO ll.n 2(,4" 1Il1rrhb!\Jr~ I'A ri,hIS.2M9
CenltJed Fle$l(tcllU~.lAppralscr
....'ILL.W,I M DAVIS
,015 HA~'1ARD AVENUE
CAMP' HilL I'A 11011
C<:rllfi<f. c~
Nltmbcr
RtO0341Ill..
File NO.6.
Case No.
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.ernier Appraisals
File No.
Case No.
60504.
DEFINITION OF MARKET VALUE: 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: (1) buyer and seller are typically
motivated; (2) both parties are well informed or well advised, and each acting in what he considers his own best interest;
(3) a reasonable time is allowe,j for exposure in the open market; (4) payment is made in terms of cash in U. S. dollars
or in terms of financial arrangements comparable thereto; and (5) 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.
. Adjustments to the comparables must be made for special or creative financing or sales concessions. No adjustments
are necessary for those costs which are normally paid by sellers as a result of tradition or law in a market; these costs
are readily identifiable since th,g seller pays these costs in virtually all sales transactions. Special or creative financing
adjustments can be made to the comparable property by comparisons to financing terms offered by a third party
institutional lender that is not already involved in the property or transaction. Any adjustment should not be calculated
on a mechanical dollar for dollar cost of the financing or concession but the dollar amount of any adjustment should
approximate the market's reaction to the financing or concessions based on the appraiser's judgment.
STATEMENT OF LIMITING CONDITIONS AND APPRAISER'S CERTIFICATION
CONTINGENT AND LIMITING CONDITIONS: The appraiser's certification that appears in the appraisal report is
subject to the following conditions:
1. The appraiser will not be responsible for mailers of a legal nature that affect either the property being appraised or
the title to it. The appraiser aS1:umes that the title is good and marketable and, therefore, will not render any opinions
about the title. The property is appraised on the basis of it being under responsible ownership.
2. The appraiser has provided a sketch in the appraisal report to show approximate dimensions of the improvements
and the sketch is included only to assist the reader of the report in visualizing the property and understanding the
appraise~s determination of its size.
3. The appraiser has examined the available flood maps that are provided by the Federal Emergency Management Agency
(or other data sources) and has noted in the appraisat report whether the subject site is located in an identified Special
Flood Hazard Area. Because the appraiser is not a surveyor, he or she makes no guarantees, express or implied, regarding
this determination.
4. The appraiser will not give testimony or appear in court because he or she' made an appraisal ofthe property in question,
unless specific arrangements to do so have been made beforehand.
5. The appraiser has estimated the value of the land in the cost approach at its highest and best use and the improvements
at their contributory value. These separate valuations of the land and improvements must not be used in conjunction with
any other appraisal and are invalid if they are so used.
6. The appraiser has noted in the appraisal report any adverse conditions (such as, needed repairs, depreciation, the presence
of hazard wastes, toxic substances, etc.) observed during the inspection of the subject property or that he or she became
aware of during the normal research involved in perlorming the appraisal. Unless otherwise stated in the appraisal report,
the appraiser has no knowledge of any hidden or unapparent conditions of the property or ;ldverse environmental conditions
(including the presence of hazardous wastes, toxic substances, etc.) that would make the property more or less valuable,
and has assumed that there are no such conditions and makes no guarantees or warranties, express or implied, regarding
the condition of the property. The appraiser will not be responsible for any such conditions that do exist or for any
engineering or testing that might be required to discover whether such conditions exist. Because the appraiser is not an expert
in the field of environmental hazards, the appraisal report must not be considered as an environmental assessment of
the property.
7. The appraiser obtained the information, estimates, and opinions that were expressed in the appraisal report from sources
that he or she considers to be reliable and believes them to be true and correct. The appraiser does not assume responsibility
for the accuracy of such items that were furnished by other parties.
8. The appraiser will not disclose the contents of the appraisal report except as provided for in the Uniform Standards of
Professional Appraisal Practice.
g. The appraiser has based his or her appraisal report and valuation conclusion for an appraisal that is subject to satisfactory
completion, repairs, or alterations on the assumption that completion of the improvements will be performed in a
workmanlike manner.
10. The appraiser must provide: his or her prior written consent before the lender/client specified in the appraisat report
can distribute the appraisal report (including conclusions about the property value, the appraise~s identity and professional
designations, and references to any professional appraisal organizations or the firm with which the appraiser is associated)
to anyone other than the borrowe:r; the mortgagee or its successors and assigns; the mortgage insurer; consultants;
professional appraisal organizations; any state or federally approved financial institution; or any department, agency,
or instrumentality of the United States or any state or the District of Columbia; except that the lender/client may distribute
the property description section of the report only to data collection or reporting service(s) without having to obtain the
appraiser's prior written consent. The appraiser's written consent and approval mllst also be obtained beforettje appraisal
can be conveyed by anyone to the public through advertising, public relations, news, sales, or other media.
Freddie Mac Form 439 (6-93)
ClickFORMS Appraisal Software 800-622-8727
Fannie Mae Form 10048 (6-93)
PaQe 11 of 14
ernieI' Appraisals
File No.
Case No.
605041.
APPRAISER'S CERTIFICATION: The Appraiser certifies and agrees that:
1. I have researched the subjeGl market area and have selected a minimum of three recent sales of properties most similar
and proximate 10 the subject property for consideration in the sales comparison analysis and have made a dollar adjustment
when appropriate to reflect the market reaction to those items of significant variation. If a significant item in a comparable
property is superior to, or more favorable than, the subject property, I have made a negative adjustment to reduce the
adjusted sales pdce of the comparable and, if a significant item 111 8 comp::H'8b!e. property is inferior to, or less favorable
Ihan the subject property, I have made a positive adjustment to increase the adjusted sales price of the comparable.
2. I have taken into consideration the factors that have an impact on value in my development of the estimate of market
value in the appraisal report. I have not knowingly withheld any significant information from the appraisal report and I
believe, to the best of my knowle,dge, that all statements and information in the appraisal report are true and correct.
3. I stated in the appraisal report only my own personal, unbiased, and professional analysis, opinions, and conclusions,
which are subject only to the contingent and limiting conditions specified in this form.
4. I have no present or prospective interest in the property that is the subject to this report, and I have no present or
prospective personal interest or bias with respect to the participants in the transaction. I did not base, either partially or
completely, my analysis and/or the estimate of market value in the appraisal report on the race, color, religion, sex,
handicap, familiar status, or national origin of either the prospective owners or occupants of the subject property or of the
present owners or occupants of the properties in the vicinity of the subject property.
5. I have no present or contemplated future interest in the subject property, and neither my current or future employment
nor my compensation for performing this appraisal is contingent on the appraised value of the property.
6. I was not required to report a predetermined value or direction in value that favors the cause of the client or any
related party, the amount of the value estimate, the attainment of a specific result, or the occurrence of a subsequent event
in order to receive my co,npensation and/or employment for performing the appraisal. I did not base the appraisal report
on a requested minimum valuation, a specific valuation, or the need to approve a specific mortgage loan.
7. I performed this appraisal in conformity with the Uniform Standards of Professional Appraisal Practice that were
adopted and promulgated by the Appraisal Standards Board of The Appraisal Foundation and that were in place as of the
effective date of this appraisal, with the exception of the departure provision of those Standards, which does not apply.
I acknowledge that an estimate of a reasonable time for exposure in the open market is a condition in the definition of
market value and the estimate I developed is consistent with the marketing time noted in the neighborhood section of this
report, unless I have otherwise stated in the reconciliation section.
8. I have personally inspecte,j the interior and exterior areas of the subject property and the exterior of all properties
listed as comparables in the appraisal report. I further certify that I have noted any apparent or known adverse conditions
in the subject improvements, on the subject site, or on any site within the immediate vicinity of the subject property of
which I am aware and have made adjustments for these adverse conditions in my analysis of the property value to the
extent that I had market eviden,;e to support them. I have also commented about the effect of the adverse conditions on
the marketability of the subject property.
g. I personally prepared all conclusions and opinions about the real estate that were set forth in the appraisal report. If I
relied on significant professional assistance from any individual or individuals in the performance of the appraisal or the
preparation of the appraisal report, I have named such individual(s) and disclosed the specific tasks performed by them
in the reconciliation section of this appraisal report. I certify that any individual so named is qualified to perform the tasks.
I have not authorized anyone to make a change to any item in the report; therefore, if an unauthorized change is made to the
appraisal report, I will take no responsibility for it.
SUPERVISORY APPRAISER'S CERTIFICATION: If a supervisory appraiser signed the appraiser report, he or she
certifies and agrees that: I directly supervise the appraiser who prepared the appraisal report, have reviewed the appraisal
report, agree with the statements and conclusions of the appraiser, agree to be bound by the appraiser's certifications
numbered 4 through 7 above, and am taking full responSibility for the appraisal and the appraisal report.
ADDRESS OF PROPERTY APPRAISED:
1714 Bridge Street. New Cumberland, PA 17070
APPRAISER:
SUPERVISORY APPRAISER (only if required)
(J./~~ /11. Ll~..4
06/30/07
Signature:
Name:
Date Signed:
State Certification #:
or State License #:
State:
Expiration Date of Certification or License:
o Did 0 Did Not Inspect Property
Signature:
Name: William M. Davis - PA Certified Residential R.E. Appraiser
Date Signed: 06-12-06
State Certification #: RL003418L
or State License #:
State: PA
Expiration Date of Certification Cot License:
Freddie Mac Form 439 6-93
ClickFORMS Appraisal Software 800-622-8727
Fannie Mae Form 10048 6--93
Page 12 of 14
MULTIPURPOS~UPPLEMENTALADDEND~
FOR FEDERALLY RELATED TRANSACTIONS
File No. 605041
Case No.
Borrower/Client Benion Estate
Property Address 1714 Bri,jge Street
~ New Cumberland
Lender Gates, Hatbruner & Hatch. P.C.
County
Cumberland State PA Zip Code
Address 1013 Mumma Road, Suite 100, Lemoyne, PA 17043
17070
This Mulli-Purpose Supplemental Addendum for Federally Related Transactions was designed to provide the appraiser with a con-
veniE.nt way to comply with the current appraisal standards and requirements of the Federal Deposit Insurance Corporation (FDIC\.
the Office of the Controller of Currency (OCe), The Office of Thrift Supervision (OTS), the Resolution Trust Corporation (RTC) .
and 1I1e Federal Reserve.
[
This Multi-Purp'ose Supplement Addendum is for use witb any appraisal. Only tbose
statemenls whkh h"ve been checked by the appraiser apply to the property being appraised.
x liL!Iii:.l'}'~=I~';IJNt1H~B
RA1SAL I : ! I I
The purpose of the appraisal is to e~;timate the market value of the subject property as defined herein. The function of the appraisal is to
assist the above-named Lender in ,!Valuating the subject property for lending purposes. This is a Federally related transaction.
IIIIJ;XTENT OF APPRAI AL PROCESS I i I I :
o The appraisal is based on the information gathered by the appraiser from public records, other identified sources, inspection of the
subject property and neighborhood, and selection of comparable sales within the subject market area. The original source of the com-
parables is shown in the Data Source section of the market grid along with the source of confinnation. if available. The original source
is present first. The sources and data are considered reliable. When conflicting information was provided, the source deemed most
reliable has been used. Data believed to be unreliable was not included in the report nor used as a basis for the value conclusion.
o The Reproduction Cost is based on Local Builders and the Appraiser's Data Bank
supplemented by the appraiser'S, knowledge of the local market.
o Physical depreciation is based on the estimated effective age of the subject property. Functional and/or external depreciation, if
present, is specifically addresse,j in the appraisal report or other addenda. In estimating the site value, the appraiser has relied on
personal knowledge of the local market. The knowledge is based on prior/or current analysis of site sales and/or abstractions of site
values from sales of improved properties.
o The subject property is located in an area of primarily owner-occupied single family residences and the Income Approach is not consi-
dered to be meaningful. For this reason, the Income Approach was not used.
o The Estimated Market Rent and Gross Rent Multiplier utilized in the Income Approach are based on the appraiser's knowtedge of the
subject market area. The rental knowledge is based on prior and/or current rate surveys of residential properties. The Gross Rent
Multiplier. is based on prior and/c.r current analysis of prices and market rates for residential properties.
o For income producing properties, actual rents, vacancies and expenses have been reported and analyzed. They have been used to pro-
ject future rents, vacancies and "xpenses.
1111 UBJECT PROPERTY OFFERING INFORMATION
According to the Central Penn MLS the subject property:
~ has not been offered for sale in the past 30 days,
is currently offered for sale for $ .
was offered for sale within the past 30 days for $ .
Offering information was considered in the final reconciliation of value.
Offering information was not considered in the final reconciliation of value.
Offering information was not available. The reasons for unavailability and the steps taken by the appraiser are explained later in
this addendum.
x
ALE HISTORY OF S BJECT ROPERTY
Acc-ording to Count Public Records the SUbject property:
~ has not transferred in the past twelve months. X has not transferred in the past 36 months.
has transferred in the past twelve months. has transferred in the past 36 months.
All prior sales which have occurred in the past months are listed below and reconciled to the appraised value, either in the body
of the report or in the addenda.
Date Sales Price Document # Seller Buyer
1111 EMA FLOOD HAZARD DATA I
o Subject property is not located in a FEMA Special Flood Hazard Area.
o Subject property is located in a FEMA S ecial Flood Hazard Area,
I Zone . FEMA Map/Panel# Ma Date
Zone C 420366B 02-16-77
Name of Commun'
New Cumberland Borou h
x
ram.
FW-70M November 1991
M IIhj'Plllnuse SuDolementnl Addclldum P;lI(C I of2
ClickFORMS Appraisal Software 800-622-8727
Page 13 of 14
emier Appraisals
File No.
ase No.
60.
X eoill:~:l:::t~"A-.~.'.~"'e{.m~
CD The subject property is currently not under contract.
o The contracl and/or escrow instructions were not available for review. The unavailability of the contract is explained later in the
addenda section.
o The contract and/or escrow instructions were reviewed. The following summarizes the contract:
Contract Date
Amendment Date Contract Price
Seller
U The contract indicated lhat personal property
U The contract indicated that personal property
was not included in the sale.
was included. It consisted of
Estimated contributory value is $
~ Personal property was not included in the final value estimate.
Personal property was included in the final value estimate.
The contract indicated no financing concessions or other incentives.
The contract indicated the following concessions or incentives:
o If concessions or incentives exist, the com parables were checked for similar concessions and appropriate adjustments were made, if
applicable, so that the final value conclusion is in compliance with the Market Value defined herein.
x l'J'.':~~~:tIIII.l'l:t:~'ll:t'iljl
nclude a explanation of current market conditions an trends.
_~ month(s) is considered a reasonable marketing period for the subject property based on the Central Penn MLS. Exposure
time is 3oproximateiy the same.
X I..
The Appraiser certifies and agrells that:
(1) Their analyses, opinions and conclusions were developed, and this report was prepared, in conformity with the Uniform Standards of
Profressional Appraisal Practice ("USPAP"), and in accordance with the regulations developed by the lender's Federal Regulatory
Agency as required by FIRREA, ,~xcept that the Department Provisions of the USPAP do not apply.
(2) Their compensation is not contingent upon the reporting of predetermined value or direction in value that favors the cause of, the
client, the amount of the value estimate, the attainment of a stipulated result, or the occurence of a subsequent event.
(3) This appraisal assignment was not based on a requested minimum valuation, a specific valuation, or the approval of a loan.
x
DDITIONAL (ENVIRONMENTA ) LIMITING CONDITIONS I I I
The value estimated is based on the assumption that the property is not negatively affected by the existence of hazardous substances or
detrimental environmental conditions unless otherwise stated in this report. The appraiser is not an expert in the identification of
hazardous substances or detrimental environmental conditions. The appraiser's routine inspection of and inquires about the subject
property did not develop any information that indicated any apparent significant hazardous substances or detrimental environmental
conditions which would affect the property negatively unless otherwise stated in this report. It is possible that tests. and inspections made
by a qualified hazardous substance and enviornmental expert would reveal the existence of hazardous substances or detrimental
environmental conditions on or around the property that would negatively affect its value.
I x Ir.,. .
This is a summary appraisal report of a complete appraisal intended for use by the above named client for mortgage finance purposes and is not intended
for any other use. It was prepared with elf,ctronic technoloqy including digital signatures. unaltered digital photographS and digital maps. All attached
addf.nda are a siqnificant and necessary part of this appraisal report.
x
PPRAISER'S SIGNATU E & LICENSE/CERTIFICATION '
Appraiser's Signature wdt-- tVl Ll~
Appraiser's Name (print) _William M.
State PA 0 License
Effective Date
Davis - PA Certified Residential R.E. A
X Certification # RL-003418-L
raiser
05-03-06 Date Prepared
Phone # (-1SL... ) 730-9586
Tax 10 #
06-12-06
O-SIGNING APPRAI ER'S CE~TIFICATION
o The co-signing appraiser has personally inspected the subject propertY, both inside and out, and has made an exterior inspection of
all comparable sales listed in the report. The report was prepared by the appraiser under direct supervision of the co-signing appraiser.
The co-signing appraiser accepts responsibility for the contents of the report including the value conclusion ,and the limiting condi-
tions, and confirms that the certifications apply fully to the co-signing appraiser.
~ the co-signing appraiser has not personally inspected the interior of the subject property and:
has not inspected the exterior of the subject property and all comparable sales listed in the report.
has inspectedthe exterior of the subject property and all comparable sales listed in the report
The report was prepared by the appraiser under direct supervision of the co-signing appraiser. The co-signing appraiser accepts
responsibility for the contents of the report, including the value conclusions and the limiting conditions, and confirms that the
certifications apply fully to the co-signing appraiser with the exception of the certification regarding physical inspections. The above
describes the level of inspection performed by the co-sigining appraiser.
o The co-signing appraiser's level of inspection, involvement in the appraisal process and certification are covered elsewhere in the
addenda section of this appraisal.
..leO.SIGNING APPRAISER'S SI NATURE & LICENSE/CERTIFICATION
Co-Signing
Appraiser's Signature
Co-Signing Appraiser's Name (print)
State License Certification #
FW-70M November 199\
Mulli-PuJl)OsC Supplememal Addendum P:lge 2 0(2
Effective Date 05-03-06 Dat~ pnepared
Phone#(_ )
Trainee' Tax ID #
ClickFORMS Appraisal Software 800-622-8727 Page
14
of
14
IW..J.J.I.J.I...JOJ....J''''''t.:'........
r.II:::J.L/~.L
.
",. D. wa-kr houJ-e.
.
Date of death values May 3. 2006
508-51413-YWT 1-4
ELLEN N BEN ION
TOO
1714 BRIOGEST
NEW CUMBERLAND PA 17070.-1124
DFGFX - 9.88 clp = 34,346.199
DFGBX - 1023 c1p = 45,822.205
DGEIX -14.08 C/p!lS 108.608.910
DREOX - 8.97 c1p = 22,318.633
HDOGX - 11.30 clp = 21 ,940.351
XOM - 63.77 clp = 33,543.020
TXU . 57.05 clp = 38.679.900 '
(clp is cl06ing price)
'1'f119 JAuiI
~ !M.ttIIitIF
~Sm1i&e tUtam
qtD~m;I~tDiMsitmtfqtD~OE, I*
fM.... N.MD/SIt1!C
a:l62019
** TOTAL ProE. 01 **
~
USAA~
.
9800 flederichburg Road
San Antonio, Texas 78288
.
EST OF ELLEN BENION
C/O HARRY G. BENION JR.
MECHANICSBURG, PA 17055
May 17, 2006
USAA # 789 94 03
Tax Exempt Intermediate.,.Tem Fund
CUSIP 1903289'-20-5
Account #44900922172
Dear Mr. Benion:
USAA is cOl\l1li tted to providing excenent service to its members. As you requested, I am
providing the following information for the account of the late Enen Benionregistered as
foll ows :
ELLEN BENION
The account value oriMay 3, .2006 was:
Shares
Share
Price
Accrued
Dividends
Acc()Unt
Value
3,919.688
$12.97
$17.42
$50,855.77/
If you have questions, please call a USAA member service representative at (800) 531-8448 (in
San Antonio, 456-7200).
Sincerely,
/S/ CAROL HENRY
Carol. Henry
Investor Account Services .Representative
USAA ..INVESTMENT MANAGEMENT. COMPANY
USAA Shareholder Account Services (USAA).
789 94 03-51126-52136-SAS.SAS45
.
.
Subj:
Date:
From:
To:
Stock Certificates
6/14/20064:33:02 PM Eastern Daylight Time
C h ristine@isifinancialgroup.com
jsamom3@aol.com
Hi Harry,
I wanted to touch base on the copies of the stock certificates that you left
for us to have T.D. Ameritrade research. They gave me the following
information. The 2000 shares of Heartsoft, Inc has no value. As of 6f7/06
this closed at $.0001. The 5000 shares of Americon International
Corporation also have no value as of 8/04/04. Lastly, the 3500 shares of
the Brown Disc Products Company has had a name change to T enguy World
International- symbol TGWI and it is trading at $.51/share.
Please let me know if you have any questions.
Have a great evening,
Christine Weit
Director of Client Services
ISI Financial Group
Wednesday, June 14, 2006 Americ~ pn1ine: JSAMom3
t/
.
.
'/he BAN K
of NEW YORK..
, ,/ II '" I'\^^'''' H \ \ , ,
May 31,2006
Harry G. Bemon, Jr.
315 Monroe Street
Mechanicsburg P A 17055
RE: PENNSYLVANIA INSURED MUNICIPALS INCOME TRUST SERIES 107
AlC: 02507616
N/O: ELLEN N BENION
Correspondence #: 05300@Q603
Dear Mr. Benion:
To complete your redemption request, stock transfer regulations require that we have additional
information. For your convenience, we have filed your documents regarding this request. We
are holding them for the following reasons:
We require a completed Form W -9 with a revision date of November 20050r later.
Please complete and return the form certifying the taxpayer identification number for the
Estate. Please check the "Other" box and on the line next to it write, "Estate".
We require and have not received the Certificate of Beneficial Ownership. If the
certificate cannot be located, please contact your broker as the certificate may be held in
local safekeeping. If this is not the case, please contact our Customer Service
Department at the number listed below so that the appropriate Affidavit of Loss may be
mailed to you.
We reserve the right to request additional documents based on Securities Transfer Association
guidelines if we determine unusual circumstances exist.
The per unit value of the referenced fund was as follows:
Fund & Series
Trade Date
Units
Bid Price
Accrued Interest
I-PAl 07
05/03/2006
5.00
$190.13
$5.94
P.O. BOX 463, EAST SYRACUSE, NEW YORK 13057 - 0463
.
.
According to our records, there are one or more outstanding checks on the account. Please
include a request to reissue these checks including a payee name and address. A form is
enclosed for your convenience.
Units will be redeemed at the bid price determined at the close of the New York Stock Exchange
on the date the request is received, in proper order, by The Bank of New York. Proceeds will be
mailed three (3) business days later.
Should you have questions, please call our Customer Service Department at (800) 856-8487. If
we do not receive your response within thirty (30) days, we will return your documents to you.
To ensure the timely processing of your request, please use the enclosed envelope to forward the
additional documents.
We look forward to being of service.
Enc!.
Very truly yours, ~.
t;YYLU ~. rfl !
(jJ Jamie Moriarty
Unit Investment Trust
Legal Transfer
.
.
Subj: Secondary Market Values
Date: 6/21/20063:06:09 PM Eastern Daylight Time
From: Cbristine@isifin.aDcialgroup.com
To: j?ClmQm~@a.QLcQm
Hi Harry,
As promised, here are the quotes I received for secondary market values for
Ellen's Limited Partnerships.
WNC Housing Tax Credit VI Series V 30 units
Total
Quote
Advantage P'ship Board $161.50/unit
$4848
Alliance Trading $207/unit
$6110 ($100 transfer fee subtracted)
A,JC1.', \ '6lJ ,2. 5/ SrI )( ~ 0
Cronos 15
1000 units
Advantage P'ship Board $7.14/unit
$7140
Alliance Trading $6.75/unit
$6725
A \\q: b'~ 4 (s'P. y. \ (yCO
Amreit - you could sell this directly through Wells Fargo who is the
transfer agent for Anireit. I was told by Amreit that the current value of
the account is $30,932.t/
Please let me know if you need anything additional.
Have a great day,
Christine Weit
ISI Financial Group
Wednesday, June 21, 2006 America Online: JSAMom3
. APPRAISALe
Personal Property of E LLEV }/()e-~ !fFJJ/o;J
Appraised by Chuck E. Bricker AU094-L
ITEM
~
Date 7-/, -
ITEM
VALUE
VALUE
~a>
Lj{)40i)
51),60
~ t1D
M, ~I)
'ftJ, ()f)
D
3tJ,oo
~o 6D
c
, ~
/6, oj)
f d rOD
OD
r/1T,4/ (?h,,~A C; M/L\"Pu, /11 ,~'iitJ'i\.oJ)
.
.
Sovereign Bank
ESTATE OF
SOCIAL SECURITY #:
DATE OF DEATH:
Ellen N Henion
097 -38-8143
May 3, 2006
Account #: 2331030855 Type:
In the name of: Ellen N Henion
Date of Death Balance:
Int.(YTD) from 1/1/2006 to
Accrued interest to date of death:
Other Info: closed 5/11/06
Money Market
Open date: 8/8/1997
$16,512.05 ./
4/28/2006
$0.00
$30.36
Account #: 2331031304 Type:
In the name of: Ellen N Henion
Date of Death Balance:
Int.(YTD) from 1/1/2006 to
Accrued interest to date of death:
Other Info:
Money Market
Open date: 12/15/1982
$39,999.92 /
4/12/2006
$10.82
$75.89
Account #: 2331032319 Type:
In the name of: Ellen N Henion
Date of Death Balance:
Int.(YTD) from 1/1/2006 to
Accrued interest to date of death:
Other Info:
Checking
Open date: 12/5/1980
$2,691.51 j
4/24/2006
$0.02
$0.21
Account #: 2334017429 Type: Savings
In the name of: Ellen N Henion ITF Angela Christine Benion
Date of Death Balance: $47.63 v'
Int.(YTD) from 1/1/2006 to 3/31/2006
Accrued interest to date of death: $0.00
Other Info:
Open date: 6/29/1988
c~ L~..-__ c\
.. :
$1.55
i ."
Page 1 of 1
.SELIGMAN DATA c!RP.
SERVICE AGENT FOR THE SELIGMAN GROUP OF FUNDS
AND TRI-CONTINENTAL CORPORATION
STOCKHOLDER SERVICES
800-TRI-1092
24-HOUR AUTOMATED
RESPONSE LINE
800-622-4597
June 2, 2006
Harry G. Benion Jr.
315 Monroe Street
Mechanicsburg, PA 17055
RE: Reference #6363623676
Tri-Continental Corporation - Common
AlC #8693961804
Ellen N. Benion and Harry G. Benion Jr., Joint Tenants
Dear Mr. Benion:
I am writing concerning your recent telephone conversation with Valerie Rust of our
office. I understand you would like to transfer all shares in the above referenced account
to an individual account and obtain a date-of-death value, due to the death of Ellen N.
Benion. Please accept my condolences for your loss.
We will promptly honor your request to transfer the shares when we receive the
additional documentation discussed with Ms. Rust.
As requested, the total value of this account on May 3,2006, was $5,702.08. This is
based on a balance of 278.422 shares and a closing market price of $20.48 per share.
I hope this information is helpful. If you have any questions, please contact your
financial advisor or call Ms. Rust at 1-800-221-2450, extension 846, any business day
from 9:00 AM to 5:00 PM Eastern Time. Ms. Rust will be happy to assist you.
&incerely,
~::it~9'~
Stockholder Services
100 Park Avenue, New York, NY 10017
RightFax
5/26/2006 10:44
PAGE 2/2
RightFax
--------.
lJ,. PEOPLES BENEFIT
11:)", LIFE INSURANCE COMPANY
.
.
Peoples Benefit Life Insurance Company
4333 Ed~ood Road NE
PO Box 3183
Cedar Rapids, Iowa 52406-3183
May 26, 2006
/
ISI Financial Group
Attn: Christine
Via Facsimile
1-717-581-5425
RE: Annuity Number ADV200196
Dear Christine:
Thank you for the recent inquiry on the above listed non-qualified
annuity for Ellen Benion (deceased).
As of May 3, 2006, the date of death, the full-accumulated value was
$127,665.32.
Peoples Benefit Life Insurance Company is a member of the Insurance
Marketplace Standards Association (IMSA), an organization committed
to high ethical marketplace standards in the sale and service of
individual life insurance and annuities.
If you have any questions or concerns, you may call our customer
service line. Our toll free customer service line, 1-800-866-6007,
is available Central Time from 7:00 AM to 5:30 PM Monday-Thursday
and Friday 7:00 AM to 4:30 PM. We appreciate your business and look
forward to serving you in the future.
Sincerely,
Customer Care Group/ka
Peoples Benefit Life Insurance Company
Member of the !lEGON. Group
Form 712
(Rev. May 2000)
Department of the Treasury
Intemal Revenue Service
Decedent -Insured (To be filed by the executor with Fonn 706, United States Estate (and Generation-Skipping Transfer) Tax Retum. or
Form 706 - NA, United States Estate (and Generation-Skipping Transfer) Tax Retum, Estate of nonresident not a citizen of the United States.)
Decedent's first name and middle initial 2 Decedent's last name T 3 Decedent's social security number 4 Date of death
N BENION ELLEN I (if known) 097-38-8143 5/3/2006
.
Life Insurance Statement .
OMB No. 1545-0022
1
5 Name and address of insurance company
JACKSON NATIONAL LIFE INSURANCE COMPANY ONE CORPORATE WAY LANSING, MI 48951
6 Type of policy 7 Policy number
VARIABLE
009071757A
8 Owner's name. If decendent is not owner, attach copy of
application.
9 Date issued
10 Assignor's name. Attach copy of
assignment.
11 Date assigned
ELLEN N BENION 1/3/2000
12 Value of the policy at the 13 Amount of premium (see instructions 14 Name of beneficiaries
time of assignment $102,816.66 00 HARRY G BENION JR
15 Face amount of policy.
16 Indemnity benefit
17 Additional insuranc
18 Other benefit
19 Principle of any indebtedness to the company that is deductible in determining net proceeds Loan Principle.
20 Interest on indebtedness (line 19) accrued to date of death. LOiJn Interest
21 Amount of accumulated dividends
22 Amount of post-mortem dividends
23 Amount of returned premium
24 Amount of proceeds if payable in one sum
25 Value of proceeds as of date of death (if not payable in one sum)
26 Policy provisions concerning deferred payments or installments.
Note: If other than lump-sum settlement is authorized for a surviving spouse, please attach a copy of the
insurance policy.
15 $
16 $
17 $
18 $
19 $
20 $
21 $
22 $
23 $
24 $
25 $
0.00
69 472.70
0.00
0.00
0.00
69,472.70
29 Amount applied by the insurance company as a single premium representing the purchase of
instal:ment benefits
27 Amount of installment
28 Date of birth, sex, and name of any person the duration of whose life may measure the number of payments.
30 Basis (mortality table and rate of interest) used by insurer in valuing installment benefits.
31 Were there any transfers of the policy within the three years prior to the death of the decedent?
32 Date of assignment or transfer: /
Month Day Year
33 Was the insured the annuitant or beneficiary of any annuity contract issued by the company?
34 Did the decedent have any incidents of ownership on any policies on his/her life, but not owned by
him/her at the date of death?
DYes i!1 No
[iJ Yes 0 No
DYes [i] No
35 Names of companies with which decendent carried other policies and amount of such policies if this information is disclosed by your records.
The undersigned officer of the above-named insurance company (or appropriate Federal agency or retirement system official) hereby certifies that this statement sets forth
true and correct information.
4~
fj~~
Assistant Vice President
Title ~
July 10, 2006
Date of Certification ~
Signature ~
Cat. No. 10170V
Form 712 (Rev. 5-2000)
.
Jackson National Life Insurance Company
.
@
A Stock Company
Policy Number: 009071757 A
Annuitant: ELLEN N BENION
JACKSON NATIONAL LIFE INSURANCE COMPANY ("the Company" or
Jackson National) agrees to provide benefits to the Contract Owner subject to
the provisions set forth in this Contract and in consideration of the application
and Premiums We receive.
The value of amounts allocated to the Separate Account during' the
accumulation and annuity periods is not guaranteed and may increase or
decrease based upon the investment experience of the Fund underlying the
Separate Account. Infonnation on variable benefits may be found on pages
8-13.
Tbe Guaranteed. Account Options are subject to an Interest Rate Adjustment
which may increase or decrease amounts payable or withdrawn, but the
Guaranteed Account Contract Value will never decrease to less than the
Guaranteed Account Minimum Value.
NOTICE OF TWENTY DAY RIGHT TO EXAMINE POLICY
You may return this Contract to the selling agent or Jackson National within
20 days after You receive it. The Company will refund the Contract Value for
the Valuation Period in which the Contract is received. Upon such refund, the
Contract shall be void.
TIllS IS A LEGAL CONTRACT BETWEEN YOU AND THE COMPANY.
READ YOUR CONTRACT CAREFULLY.
EXECUTED FOR THE COMPANY ON THE ISSUE DATE
INDIVIDUAL DEFERRED VARIABLE AND FIXED
ANNUITY CONTRACT (FLEXIBLE PREMIUM).
MONTHLY INCOME AT MATURITY.
DEATH BENEFIT PRIOR TO MATURITY.
NON-P ARTICIP A TING.
This contract is signed at the
Home Office of Jack~on National Life,
Lansing, Michigan
4r/~
President
~""'~
r\ ..
Secretary ....., ,.-J
tt CONTRACT DATA PAGEtt
Contract Number:
009071757A
Annuitant:
ELLEN N BENION
NO JOINT ANNUITANT
ELLEN N BENION
NO JOINT OWNER
Owner:
Issue Date:
Issue Age: 86
Issue State: PENNSYLVANIA
January 3, 2000
Annuity Date:
January 3, 2004
First Premium:
$102,816.66
Annual Contract Maintenance Charge: $35.00
Subsequent Guaranteed Rate:
3%
Separate Account:
Expense Risk Charge:
Jackson National Separate Account - I
On an annual basis, this charge equals 0.23 % of the daily net asset value
of the Portfolios or .000630137% on a daily basis.
On an annual basis, this charge equals 0.15% of the daily net asset value
of the Portfolios or .000410959% on a daily basis.
On an annual basis, this charge equals 0.9% of the daily net asset value
of the Portfolios or .00246575% on a daily basis.
On an annual basis, this charge equals 0.12 % of the daily net asset value
of the Portfolios or .000328767 % on a daily basis.
Administration Charge:
Mortality Risk Charge:
Enhanced Death Benefit Charge:
Contingent Deferred Sales Charge:
Contribution Year
o
1
2
3
4
5
6
7
Percent
7
6
5
4
3
2
1
o
Home Office:
Jackson National Life Insurance Company
5901 Executive Drive
Lansing, Michigan 48911
517/394-3400
Annuity Service Center:
P.O. Box 378002
Denver, CO 80237-8002
800/766-4683
L\ll payments and values in the Guaranteed Account are subject to an Interest Rate Adjustment, the calcula-
:ion of which may result in an increase or decrease in amounts payable. In no event will the values be less than
:he Guaranteed Account Minimum Value.
CD002 PA 4i95
Page 2
,:~
,
i
;~'"
.,
II
;11
H
'i
'i:
.1';
Form 712
(Rev. May 2000)'
Department of the Treasury
Internal Revenue Service
Decedent -Insured (To be filed by the executor with Fonn 706, United States Estate (and Generation-Skipping Transfer) Tax Return, or
Form 706 . NA, United States Estate (and Generation-Skipping Transfer) Tax Return, Estate of nonresident not a citizen of the United States.)
Decedent's first name and middle initial 2 Decedent's last name 3 Decedent's social security number 14 Date of death
N BENION ELLEN (if known) 097-38-8143 5/3/2006
.
Life Insurance Statement .
OMS No. 1545-0022
5 Name and address of insurance company
JACKSON NATIONAL UFE INSURANCE COMPANY ONE CORPORATE WAY LANSING, MI 48951
6 Type of policy 7 Policy number
VARIABLE 009042444A
8 Owner's name. If decendent is not owner, attach copy of
application.
9 Date issued
10 Assignor's name. Attach copy of
assignment.
11 Date assigned
ELLEN N BENION 10/19/1998
12 Value of the policy at the 13 Amount of premium (see instructions 14 Name of beneficiaries
time of assignment $65,064.88 00 HARRY G BEN ION JR
15 Face amount of policy.
16 Indemnity benefit
17 Additional insuranc
18 Other benefit
19 Principle of any indebtedness to the company that is deductible in detenmining net proceeds Loan Principle.
20 Interest on indebtedness (line 19) accrued to date of death. Lo~n Interest
21 Amount of accumulated dividends
22 Amount of post-mortem dividends
23 Amount of returned premium
24 Amount of proceeds if payable in one sum
25 Value of proceeds as of date of death (if not payable in one sum)
26 Policy provisions concerning deferred payments or installments.
Note: If other than lump-sum settlement is authorized for a surviving spouse, please attach a copy of the
insurance policy.
15 $
16 $
17 $
18 $
19 $
20 $
21 $
22 $
23 $
24 $
25 $
0.00
87.462.12
0.00
0.00
0.00
87,462.12
29 Amount applied by the insurance company as a single premium representing the purchase of
installment benefits
27 Amount of installment
28 Date of birth, sex, and name of any person the duration of whose life may measure the number of payments.
30 Basis (mortality table and rate of interest) used by insurer in valuing installment benefits.
32 Date of assignment or transfer:
/
H - - - - ~ . . . - - - - - ..--...----
DYes ~ No
IXI Yes 0 No
DYes IXI No
31 Were there any transfers of the policy within the three years prior to the death of the decedent?
Month Day Year
33 Was the insured the annuitant or beneficiary of any annuity contract issued by the company?
34 Did the decedent have any incidents of ownership on any policies on his/her life, but not owned by
himlher at the date of death?
35 Names of companies with which decendent carried other policies and amount of such policies if this information is disclosed by your records.
The undersigned officer of the above-named insurance company (or appropriate Federal agency or retirement system official) hereby certifies that this statement sets forth
true and correct information.
4~
J:j~'
Assistant Vice President
Title ~
July 10, 2006
Date of Certification ~
Signature ~
Cat. No. 10170V
Form 712 (Rev. 5-2000)
Jackson National Life Insura. Company
.
@
1
\
1
A Stock Company
Policy Number: 009042444A
Annuitant: ELLEN N HENION
JACKSON NATIONAL LIFE INSURANCE COMPANY ("the Company" or
Jackson National) agrees to provide benefits to ~he Contract Owner subject to
the provisions set forth in this Contract and in consideration of the application
and Premiums We receive.
The value of amounts allocated to the Separate Account during the
accumulation and annuity periods is not guaranteed and may increase or
decrease based upon the investment experience of the Fund underlying the
Separate Account. Information on variable benefits may be found on pages
8-13.
The Guaranteed Account Options are subject to an Interest Rate Adjustment
which may increase or decrease amounts payable or withdrawn, but the
Guaranteed Account Contract Value will never decrease to less than the
Guaranteed Account Minimum Value. .
NOTICE OF TWENTY DAY RIGHT TO EXAMINE POLICY
You may return this Contract to the selling agent or Jackson National within
20 days after You receive it. The Company will refund the Contract Value for
the Valuation Period in which the Contract is received. Upon such refund, the
Contract shall be void.
THIS IS A LEGAL CONTRACT BETWEEN YOU AND THE COMPANY.
READ YOUR CONTRACT CAREFULLY.
EXECUTED FOR THE COMPANY ON THE ISSUE DATE
INDIVIDUAL DEFERRED VARIABLE AND FIXED
ANNUITY CONTRACT (FLEXIBLE PREMIUM).
MONTHLY INCOME AT MATURITY.
DEATH BENEFIT PlUOR TO MATUR1TY,
NON-PARTICIPATING.
This contract is signed at the
Home Office of Jackson National Life,
Lansing, Michigan
/ /J....--?
~/~
President
~~.,.~
Secretary C,...')' (j
VA?OO 4/95
20
.. . -CONTRACT DATA"Ali~
.,
Contract Number:
oo9042444A
Annuitant:
ELLEN N BENION
NO JOINT ANNUITANT
ELLEN N BENION
NO JOINT OWNER
Owner:
Issue Date:
October 19, 1998
Issue Age: 85
Issue State: PENNSYLVANIA
Annuity Date:
October 19, 2003
First Premium:
$65,064.88
Annual Contract Maintenance Charge: $35.00
Subsequent Guaranteed Rate:
3%
Separate Account:
Expense Risk Charge:
Jackson National Separate Account - I
On an annual basis, this charge equals 0.23 % of the daily net asset value
of the Portfolios or .000630137% on a daily basis.
On an annual basis, this charge equals 0.15% of the daily net asset value
of the Portfolios or .000410959% on a daily basis.
On an annual basis, this charge equals 0.9% of the daily net asset value
of the Portfolios or .00246575% on a daily basis.
On an annual basis, this charge equals 0.12 % of the daily net asset value
of the Portfolios or .000328767% on a daily basis.
.
~.
Administration Charge:
Mortality Risk Charge:
Contingent Deferred Sales Charge:
Contribution Year
o
1
2
3
4
5
6
7
Percent
7
6
5
4
3
2
1
o
~
~
r~
~
1:
,
~
Enhanced Death Benefit Charge:
t
~
~
"
"
~
.j
'k
.
)
~
;y
;1
j
Home Office:
Jackson National Life Insurance Company
590 I Executive Drive
Lansing, Michigan 48911
517/394-3400
Annuity Service Center:
P.O. Box 378002
Denver, CO 80237-8002
800/766-4683
i
~
i
~. .
~
1.11 payments and values in the Guaranteed Account are subject to an Interest Rate Adjustment, the calcula-
on of which may result in an increase or decrease in amounts payable. In no event will the values be less than
Ie Guaranteed Account Minimum Value.
CD002 PA 4/95
Page 2
.
..
Estate of Ellen N. Benion
Pennsylvania Inheritance Tax Return
Form REV-1500
EXHIBIT F
Documentation of Expenses
.
A Family Tradition Of Caring
PARTHEMORE Funeral Home & Cremation Services, Inc.
Mr. Harry G. Benion, Jr.
315 Monroe Street
Mechanicsburg, P A 17055
5/5/2006
For the services of Ellen Noel Benion
1303 Bridge Street
P.O. Box 431
New Cumberland, PA 17070
(717) 774-7721
(Fax) 774-5546
www.pMtftCl.lt6fe":C6ftt - - -
We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way
we can. Please feel free to contact us if you have any questions in regard to this statement. The following
is an itemized statement of the services, facilities, automotive equipment and merchandise that you selected
when making the funeral arrangements.
Terms Due Date Account #
._.____ ._"_"____ _.---i-_.___u
_ Ne~_.__~ 614/2006 _ i 2006032.0
Description
----
SERVICES & MERCHANDISE
Traditional Funeral Service
Stainless Steel "Lindsay" Casket
10 Gauge Galvanized Steel Vault
r----
I .. .
Amount
Gilbert W. Parthemore,
Founder
Total Services and Merchandise
5,405.00
2,675.00
1,563.00
9,643.00
Gilbert J. Parthemore,
Supervisor
. CASH ADVANCE ITEMS
Death Notice, Harrisburg Patriot
Death Notice, Mt. Carmel
20 Certified Copies of Dea.thCertificates
Hairdresser /.,. ........
Clergy Honorarium
Organist Honorarium
Soloist Honorarium
Altar Servers
Flowers, Casket Spray
Flowers, Matching Mache Vase
109.20
75.00
120.00
40.00
250.00
100.00
50.00
15.00
185.50
63.50
Stephen K. Parthemore,
CFSP
Bruce R. Parthemore.
Pre-Need Coordinator, CPC
Total Cash Advances
1,008.20
Professional Memberships:
NFDA · PFDA
DCFDA . CCFDA
~
The Rule YOII Know.
The Penple Ynu Tru.\'I
L__.___
_ '."}___ ..' _.. 1_____. _-.J
Total $10,651.20
- PaymenbiCreditS;~I~ ~~\ .$-1-,008.20
1-' .-o------:-;:-J1.~ L ...i.' .-
Balance Due 1 $9,643.00
l___ .___0._______.
.
-------------------
-------------------
RECEIPT FOR PAYMENT
.
GLENDA FARNER STRASBAUGH
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17G13
BENION ELLEN N
Estate File No. :
Paid By Remarks:
2006-00408
BENION HARRY G JR
MG
Receipt Date:
Recetpt Time:
Recelpt No. :
5/10/2006
14:02:05
1044322
------------------------ Receipt Distribution ------------------------
Fee/Tax Description
PETITION LTRS TEST
WILL
SHORT CERTIFICATE
JCP FEE
AUTOMATION FEE
Check# 2936
Total Received.........
PaYment Amount
510.00
15.00
60.00
10.00
5.00
----------------
$600.00
$600.00
Payee Name
CUMBERLAND COUNTY GENERAL
CUMBERLAND COUNTY GENERAL
CUMBERLAND COUNTY GENERAL
BUREAU OF RECEIPTS & CNTR
CUMBERLAND COUNTY GENERAL
FUN
FUN
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STATEMENT OF ACCOUNTS
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HARRY~.ENION. .JIl
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2331110139
page 5 of5
.
.
WAL*MARY.
ALWAYS LOW PRICES.
~.
WE SELL FOR LESS
MANAGER RANDALL MUMHERT
( 111 ) 691 - 3150
STI 1886 OPI 00006367 TEl 72 TRa 038~O
SB~O CHAMP H 087QQ4301926
..!r_ HINI BONE VP 06156S09S01~
LATCH TOTE 00731~~94044
;.
~' LATCH TOTE 00731~59~044
LATCh TOTE 00731199~041
LATCH TUTE 0073149940~1
LATCH TOTE 00131499~044
:"'A7CH TOlE 00f311~9404",
CARD 066152659178
CARD 066152659005
CARD 066152658935
CARD 066152658937
PILLOWCASE 007665785261
PILLOWCASE 007665770601
TOOTHBRUSH 003500068650
OLROY CKN GR 068113188890
DOG TREAT 001780029955
SUPERMAN TEE 068150971207
SUBTOTAL
TAX 1 6.000 I
TOTAL
MCARD TEND
ACCOUNT 1260'1
APPROVAL 1016093
TRANS ID -
VALIDATION -
PAYMENT SERVICE - A
CHANGE DUE
3.00 0
5.88 X
6.4'1 X
6.44 X
6.44 X
6.41 X
6 .~~ :'
6.14 X
0.48 X
2.23 X
3.73 X
3.13 X
5.'16 X
5.'16 X
1.94 N
2.91 )I
'1.62 X
9.4'1 N
81.58
'1.'10
91.98
91.98
0.00
I ITEMS SOLD 18
TCI 2136 8405 72'1'1 0019 550
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06/16/06 19: 14: 08 .
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CUMBERLAND LAW JOURNAL
32 SOUTH BEDFORD STREET
CARLISLE, P A 17013
June 23. 2006
Cumberland Law Journal is published every Friday by the Cumberland County Bar
Association and is designated by the Court of Common Pleas as the official legal publication for
Cumberland County and the legal newspaper for publication of legal notices.
TO:
Lowell R. Gates, ESQUIRE
Ellen N. Benion - a.k.a. Ellen Noel Benion, ESTATE
RE:
Legal advertisements must be received by Friday Noon. All legal advertising must be
paid in advance. Make all checks payable to: Cumberland Law Journal.
---------------------------------------------------------------------
---------------------------------------------------------------------
Advertisement inserted on following dates:
June 9, June 16, and June 23, 2006
Advertising Cost
Second Proof Request
75.00
$ 0.00
$ 0.00
$ 75 .00
-------------
Proof of Publication
Payment received
Total Amount Due
$ 00.00
---------
--------
Payment received 6/2/06
Becky H. Morgenthal, Executive Director
I ([be patriot-Jews
Now you know
.
Order Confirmation
Customer
GATES, HALBRUNER & HATCH, P.C.
Orderer Account Number
41052
Ad Order Number 0001516065
Payer
Payer Account Number
41052
Sales Rep.
Order Taker
kkline
kkline
Phone
Order Source
Special Pricinq None
GATES, HALBRUNER & HATCH, P.C.
ATTN: TRACI L. SEPKOVIC, 1013 MUMMA
ROAD,SUITE 100
Lemoyne PA 17043 USA
PO Number
Ordered By
Customer Fax
Benion Estate
Lowell Gates
Customer EMail
Customer Phone 717-731-9600
Payer Phone 717-731-9600
Tear Sheets
o
Proofs
o
Affidavits
1
Blind Box
Promo Type
Invoice Text
Materials
\' ~. C'f.-
". U- /'L.....'
'-z ...
'.~l ....>-...
'\;"
Total Ad Cost
$264.60
Payment Amount
$0.00
Payment Method
Amount Due
$264.60
Ad Number Ad Type
0001516065-0' Legal Liners
Ad Size
:1.0X20Li
Color
<NONE>
Production Method Production Notes
Ad Booker
Product Information
Classification
# Inserts
Run Dates
PNCO: :Full Run
806-Estate Notices
3
6/3/2006, 6/10/2006, 6/17/2006
Run Schedule Invoice Text .
ESTATE NOTICE LETTERS TESTAMENTARY for the Estate of ELLEN N. BEll/ON
6/19/20068:44:41AM
1
-
.
USPS HARRISBURG PA
HARRISBURG, Pennsylvania
171069714
4134870106-0096
;/28/2006 (800)275-8777 04:4~:10 PM
Sales Receipt
Sale Unit
Qty Price
USPS HARRISBURG PA
HARRISBURG. Pennsylvania
171069714
4134870106-0096
07/03/2006 (800)275-8777 01:28:02 PM
Final
Price
~oduct
ascription
AN ANTONIO TX 78265
irst-Class
0.60 oz.
Return Rept (Green Card)
Certified
label #:
....1"'\ ",...
~U.J::1
Product
Description
Sales Receipt
Sale Unit
Qty Price
Final
Price
~"
EAST SYRACUSE NY 13057
First-Class
0.40 oz.
Return Rcpt (Green Card)
Certified
Label #:
$0.39
$L.40
70060810000263:~~~~~::
Issue PVI: $4.64
$1.85
$2.40
70060810000263320046
--------
--------
Issue PVI: $4.64
'otal;
$4.64
'aid by:
:ash
:hange Due:
$10.00
-$5.36
Total:
Paid by:
Cash
Change Due:
$4.64
$5.00
-$0.36
Bill#: 1000401940951
Clerk: 20
__ All sales final on stamps an~ postage.
Refunds i~r guaranteed serv~ces only.
Thank you for your busIness.
Customer Copy
BII1#: 1000401943906
Clerk: 11
-- All sales final on stamps and postage. --
Refunds for guaranteed services only.
Thank you for your business.
Customer Copy
--~
M' . I --............ . '.
Act1a" J cs~." . ."._ _ ~..~ _.'l'!'1
- .:' .' ""il p"s! orflce
MECHANi """" _ 'f' ,
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USPS HARRISBURG PA
HARRISBURG, Pennsylvania
171069714
4134870106-0092
07/10/2006 (800)275-8777 04:46:14 PM
07'29/2006
1:. . ~-, . ~..,~ ~t'j
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01~,
Sales Receipt
Product Sale Unit
Description Qty Price
LANCASTER PA 17601
First-Class
0.60 oz.
Return Rcpt (Green Card)
Certified
Label #:
Final
Price
P,'oduct
Description
$0.39
~EOAR RAPIDS IA 524C~
Flrst-Class
3.00 Ol.
Ret, ,"q, R..pt I;';,een r:dle;)
(;e,.t it i eel
Labi fI:
87
$1. 85
$2.40
70060810000263325652
icilY,'
'!i1 3'"
'J, ;; '; .<::: ' f ;:;~ 'Ei
--------
--------
Issue PVI:
$4.64
b,;ue PVJ.
==.:=.:;:;::::
$5.12
$4.64
Total:
~;;:'::;;..:.~- ----
Total:
Paid by:
Cash
Change Due:
$5.1:.2
$10.00
-$5.36
Paid bv:
Cash -
Change DUe:
$6.00
-$;0 8S
8ill#: 1000800468042
Clerk: 16
B111#: lOOfJ:?02<J14<l9t:
Clerk: 03
-- All sales final on stamps and postage.
Refunds for guaranteed services only.
Thank you for your business.
Customer Copy
- AI) soles f)"dl.'
R'fun1~';' t~~t:~L" C~::b~'; ,~~i:';,~C
. .
Messenger Service Receipt
Pa Auto License Brokers
6483 Carlisle Pike Suite 104
Mechanicsburg, Pa 17050
717-691-6720
Invoice #: 15139
For: HARRY G BENION JR
Date: OS/27/06
Time: 10: 45 AM
717-697-2618
Clerks Initials: RAM
File Name: REBECCA
State Fees
Title # or Date of Birth:
VIN or Driver's Number
Tag Number or Eye Color
-Year-Make or Soc. Sec.#
Transaction NOTARY
Odometer 0
Comments:
Title Fee..... . . . . . . . .
Encumbrance Fee.......
Tag Transfer..........
Registration.. _ _......
Dup. Fee..............
Increase Fee....... ...
Replacement Fee... ....
Tax-On $0.00....
This item will be Mailed to you.
WARNING: Bureau regulation require that any
item left in our office for 60 days be
returned to the Bureau of Motor Vehicles as
unclaimed.
Total State Fee.......
Check #. . . . . . . . . . . . . . .
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Service Fees
I/We swear that I/we have applied for the
above item(s) .
Messenger Fee.........
Temp Tag Fee....... ...
Notary Fee. . . . . . . . . . . .
Copy/Fax Fee..........
Document Fee..........
Check or M.a. Fee.....
Total Service Fee.....
Service Fee Check #...
0.00
0.00
5.00
0.00
0.00
0.00
0.00
0.00
5.00
Cash
Sworn & subscribed to before me on OS/27/06.
Grand Total...........
Total Due.............
Amount Paid...........
Change Given..........
Notary
Seal
5.00
5.00
10.00
5.00
No Refunds on Service or
Notary fees. We are not
responsible for work the
State fails to process.
EIN 25-1641815 If this is a bill you MUST return a copy w/ payment to get
credit. All accounts must be paid by the 15th of the month or no further credit
will be granted. Partial payments are not acceptable. We are not responsible
for work that is not processed by PennDOT. HAVE A NICE DAY!!
Contract Receipt
.
.
page 1 ot 1
IU-Hoaul Sales Item Invoice
Contract Number: 00281792
Friday 6/23/2006 8:39 AM
II
(717)763-7677
U-HAUL MECHANICSBRG
(811055)
4725 OLD GETlYSBURG
MECHANICSBURG, PA. 17055
Part Code
DS
GP
DescrlDtion
KIT, DISH SAVER,(8 SETTINGS)
KIT,GLASS PACK,(18 POUCHES)
Item Cost
$10.20
$10.20
Quantity
2.00 ea.
3.00 ea.
~......._&......
~ULl"''''''''DI.
Taxes:
Total Charges Including Tax:
Support Sales Item:
Total Charges:
Previous Paid:
Network:
Visa
Account: Expire:
XXXXXXXXXXXX17092 0207
Credit Card Payment:
Net Paid Today:
Auth:
08607A
x
x
Sales Items
Line Cost
$20.40
$30.60
....1:'.. nn
"'.J~.vv
$3.06
$54.06
$54.06
$54.06
$0.00
$54.06
$54.06
U-Haul Signature - (Scott Greenfield)
Customer Signature
https:/ /uhauldealer .comlContractPrinting/contractPrint.aspx?guid=FEF6D 178-55B5-4D08-... 6/2312006
.
.
IU-Haul Sales Item Invoice
Contract Number: 00280142
Saturday OS/27/06 1l:50AM
Part Code
ME
CF1240
Description
BOX,MIRROR,2.3CF 37X4X27in
CUSHION,FOAM,12X40
uS
KIT,uISH SAVER, (8 SETTING5j
GP
SubTotal:
KIT,GLASS PACK, (18 POUCHES)
Network:
Visa
Expire:
0808
Account:
XXXXXXXXXXX47397
x
Customer Signature
II
Sales Items
U-HAUL MECHANICSBRG
(811055)
4725 OLD GETTYSBURG (717)763-
MECHANICSBURG PA, 7677
17055
Item Cost
$4.25
$4.60
....." ^^
.yJ.u...:::.u
$10.20
Auth:
04066A
$4.74
$83.64
$83.64
$83.64
$0.00
$83.64
$83.64
https://uhauldealer .comlContractPrintinglContractPrint.asp?Function=00079&CC 1 =True&... 5/27/2006
Quantity Line Cost
2.00 ea $8.50
2.00 ea $9.20
.;l.UV ea
........n rr.
>;'.Jv.vv
3.00 ea
$30.60
$78.90
Taxes:
Total Charges Including Tax:
Support Sales Item:
. Total Charges:
Previous Paid:
Credit Card Payment:
Net Paid Today:
Scott Greenfield
.
SlAPlES
that was easy.
LOW pricus. Every item [very day.
110% Price-Match. GUilra1teed.
i iR :~"jutt1 32nd 5t I'eet
[.MP HILL, PA 17011
(717) 731-'1761
:RlF 421983 4 00135701
1644 06/17/06 11:43
U>' " OUR PRICE
:~) [IIi'; C, hl::,HHJt., i'f<
~7~J~1111:84 19.49
,! ri\f'l j:S ~\UP,i\1 I'!t;,<'.!.
u75353112~33 19.99
'LJBTOTA! 39.48
t?tj:t h's C:Oi.lIiOI\ Nt}! H~J 18\ 4 /(n 4 2(!~ ,) 3 . 00
.)1 dildo I II 1,1.... I, ell;:, 2, 1 S
Ji;\L $38.67
;' 1:,:1
, cd'; IKI.: ~,\X)(XXX.KXX1,X5430 (S,.
.'.i1 t il No : 002226
3B.67
IUTAL. ITEMS
Compare and Save
with stap les-brand products.
THANK YOU fOR SHOPPING AT STAPLES
Shop on 11 ne at www.staples.com
II \\11111' \ 1111\ ""III {'''I II I I! 11111\ Illlll II 11111111111111
1 6 4 4 0 6 1 7 0 63 5 7 0 1 0 1
.
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With us, it's personal.
Store #00418
105 OLD YORK RO
NEW CUMBERLAND. PA 17070
(717) 774-0261
Resister #5 Transdction #22012u
Cashier #4182109 6/17/06 3:38PM
1 EZSTRI SEAlNG IP 1.88X30Y 3.19 T
1 5CTCH 55 M^L TPE TN 2X800 3,49 T
2 Items Subtotal 6.68
Tax .40
Total 7.08
CASH PAVI,IENT 10.08
Tendered 10.08
Cash Change 3.00
**w~*w****~*h~********~*****wk*******~*~***
; Tell us about our service
and you will be entered
to win
$10,000
Ca'11 TOLL FREE
Oisponlble en Espanol, llame
1-800-962-1914
Enter Code:
0617 1504 1805 127
Entry code expires 14 days frolD the
date of this receipt
for Official Rules Call 1-800-RITE-AID
. ******<<***********w~**w******w*********~**~
**.*******~*~~*~****.*~.~.._~**~***~**w*****
We'rs l.1edi caT"S ~"'.oeT-ts
Ask your pharmaci st for a, fl\L~
1.led i care PresC ri pt i on ~l~~...~~~~~...;~~~~"'h
~~******.***************
Internet-; \ls :t RiteAid.colD
powerel by drugstore.colD .
1_800-R11EAIO far customer serVIce
.
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:; T I~PLES UU8,P,:~ ',I
O/,5~3::311.::~~'~'~':
~jl ;;PLFS 1~'; :r..;,f"-i
,J!53531,', :::{;,
12Xt2\1! ;;,l)i"-']rb
791 133Y;;,lr,';
SUBH1T n
S::ap les C'Ji:r;;'"jj"1 tMi
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C'->q'iiJ(t; i1Fpl .li':'
hilth'3L'", le::>-L(,~)I'~I!lll ).
Thll.Nt': YOU FOI~ SHOP?l ;;L; <.: ',: T.il.. ,i:S
ShOfj ~.i; i j r ;i~ (! t vJ:,\lt..;, ~'.' i, .jr l r-;3 . ~ 0(,:
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STAPlES
"
that was easv.
Low prices. Every item. Every day.
110% Price-Match. Guaranteed.
128 South 32nd Street
CAMP HILL, PA 17011
('117) 731-1761
SALE 184682 9 001 37632
164406/23/0601:39
*****t**~ftl~t'******************'**t~t*+*
$5,UUu . ,:!.. :,:, SPREE AT STAPLES!
it,' ..n m WIN!
We C(:I -= llll.,I;; \~hat YLJU think!
Tak,". d short surve'l (\iid he entered
into a IFflnthly rl, awinu ,Just log on to
WI'!w.staples-;)Ii('\'L. :11
or call 1-800'B~I:, 1.;(',
'y,iur ~;urvey code: 0101 kill! ~)2r9 j 184
H.f.TOnle nuestra encuesta en espanol en
la pagina del Internet 0 POI' telefono.
Consiga las reglas en la tienda.***
See store for rules.
Survey code expires 06/30/2006.
******************************************
aTY SKU
OUR PRICE
14X14X14 SHIPPING
797133492801 8.59
iS~: ,1, SHIPPING
797133500230 8. 250ea 16.50
SCTCH PKGTPE TAN S
051131642n~B 3.29
SCTGH PKGTPE TAN S
051131642058 3.29
PROF MASKING TP .9
075353056004 5.59
SUBTOTAL 37.26
Stap les Coupon NO. 1899181429134281 -3.00
St~ndard Tax 6.00% 2.06
TOT AL '., $36.32
Vlsa 36.32
Card No.: xXXXXXXXXXXX5887 <5>
Auth No.: 03598A
TOTAL ITEMS 6
.
.
-
USPS HARRISBURG PA
HARRISBURG, Pennsy1van18
171069714
4134870106-0094 04:47:45 PM
'06/22/2006 (800)275-8777
Pro: t
Description
Sales Receipt
Sale Unit
Qty Price
Final
Price
~~":''Ii'~.....~~~'----'-'...;
NC;,I CUMBLRL.J\ND PO
NUl Cl!t1BEPL.l\ND. Pt,n(I~,/ i;a!' 1 d
170'702163
41:3Li870070 -00%
Ob/17/2UClb {'OOCii27'5-dln 1l:('.J.:t5 Mol
LANCASTER PA 17601
First-Class
1.90 oz, ,
Return Rcpt (Green Carel;
Certified
Label #:
$0.63
~..~_t..c-;_;r;C:'''l..1!l-I"~~~~..~''f1.''t'E'~
- Sd 1 es Pec.e !.p1
Sa 1 e Ur, i t
Ow Pr i c8
Pr'oduct
Oeser i pt) 0,.'
Fif',al
Pr'j ce
------ -
--------..---
Issue PVI:
$.:1 88
LANCAS1f]( Pi'.
Fi r'st ,r1 dSS
3.60 02
Return Ht:p [
Cer-t it' 8(j
Label it
17bOl
$1.11
~
'1>. ..;1)
7006(IOlU0002li:';l.:;' n
(Ui"c~!' ,>" ,,: $1 85
$2 clO
7[)O~i! ~.;tUCJC;('j) /G' ~(Jl E;~~'
Total:
Paid by:
Cash
Change Due:
:1>4. 2~'
Issut: ,':'V1:
1/'),3f.
$5,00
-$0.12
U~~T SYRr.Df;E t~\' ljijj7
Firsl"Cl ~.;ss
3,30 oz
netllr'I':: .t (n!'-':.'::;:;~i
Reaist,!l ~.,
Irl::i!.JI"t. i value
Ar t k ~ val Lit;
Lab",! h.
$1.11
Bill#: 1000602065731
Clerk: 18
_ All sales final on stamps an~ post~ge.
Refunds for guaranteed serv~ ces 0111 y.
Thank you for your busll~ess.
Customer Copy
$18~)
$10 . 25
'I; 1 . UG.j {)i)
:1-1. DOC:, C;(.i
HR 9>~~~~~~~3 28:?jUS
.:' d'
IsSue: PVI
$13.21
PAWl UCKE-' RI 02hl!: $0.87
First-Class
3.UO 02
Return '<cpt i Green Co: ',j) $1,35
Reyi ~~tcn:d $12,95
lnSUi.'~'O \fd: Lit:: -1;.,) i)~)i}. ..Jl)
Artie'", VH1Lle : :j;,: euu 00
Label #: RH95B;:';2;'" \J~~
Issue f'VJ:
$l:5,El
39c Stamp
$0 39
$0,39
Total:
$:J'I.63
Paid b'/:
Cash .
Change Due'
$40,00
-$5,37
Order- st:irnl> 'j~ iISP'),com/sho[.' .:w COli!
1-800-$t 11ror,,'..:J, ')<) to
USPS. com'c I i cknshi p to p, i nt $:';: 'I' i ng
labels w'1h pustage, Fe,r otf'le,
informat'cn call l':~"J'!l.SK-USP:>
Bi 11 II: :.0004012'::1911:
Clerk: 02
ft.1; Sill as f jl;d! en ~,t ami:'~' ",lid [idS tiii,Je, --
P~funds for" Qliararltt;eC; St:l'y i i..:t:S (Jnl v.
Thank YOli for ,-'our bus i ne5S. -
Custom8r Lop'",
,r-"4:.....
".:.;"'J.,>
.
.
Mechanicsburg Main Post Office
MECHANICSBURG. Pennsylvanla
170553459
41~4R70055-0094
05/12/2006 '(800)275-8777 11:25:46 AM
Sales Receipt
Product Sale Unit
Description Qty Price
Mechanicsburg Main Post Office
MECHANICSBURG. Pennsy1vani3
170553459
4134870055-0098
OS/27/2006 (800)275-8777 11:32:56 AM
. -------------- Sales Receipt
Product Sale Unit
Description Qty Price
Final
Price
HARRISBURG PA 17101
First-Class
0.70 oz.
Return Rcpt (Green Card)
Certified
Label #:
Final
Price
$0.39
, EAST SYRACUSE NY 13057
First-Class
1.30 oz.
Return Rcpt (Green Card)
Certified
Label #:
$0.63
$1.85
$2.40
70060100000093315304
--------
--------
$4.64
$0.39
Issue PVI:
LYNCHBURG VA 24506
First-Class
0.50 oz.
Return Rcpt (Green Card)
Certified
Label #;
$1.85
$2.40
70060100000093278746
--------
--------
Issue PVI: $4.88
$0.39
PROVIDENCE RI 02940
First-Class
I 0.50 oz.
Return Rcpt (Green Card)
Certified
Label #;
$1.85
$2.40
70060100000093315298
--------
--------
$4.64
$0.39
Issue PYI;
_ONDON KY 40742
~irst-Class
0.50 oz.
Return Rcpt (Green Card)
Certified
Label #;
$1.85
$2.40
70060100000093278753
Issue PVI;
--------
--------
$4.64
Total:
Paid by;
Cash
Change DUe:
$9.52
$1.85
$2.40
70060100000093315281
========
$4.64
Issue PYI:
otal;
aid by:
ash
hange Due:
$20.00
-$10.48
; Bill#: 1000202346796
I Clerk: 16
-- All sales final on stamps and postage.
Refunds for guaranteed services only.
Thank you for your business.
Customer Copy
$13.92
$20.00
-$6.08
ill#: 1000602238262
lerk: 03
- ,'II sales final on stamps and postage.
Refunds for guaranteed services only.
Thank you for your business.
Customer Copy
.
USPS HARRISBURG PA .
HARRISBURG, Pennsylvanla
171069714
4134870106-0092 01:27:48 PM
08/03/2006 (800)275-8777
Sales Receipt
Product Sale Unit
Description Oty Price
Final
Price
SAINT PAUL MN 55164
First-Class
1.20 oz. )
Return Rcpt (Green Card
Certified
Label #:
$0.63
$1.85
$2.40
70060100000453256995
========
$4.88
Issue PVI:
Total:
Paid by:
Cash
Change Due:
$4.88
$10.00
-$5.12
Bill#: 1000800485665
Clerk: 14
-- All sales final on stamps an~ postage.
Refunds for guaranteed servIces only.
Thank you for your business.
Customer Copy
-
MHchanicsburg Main Post Office
MECHANICSBURG, Pennsylvania
170553459
4134870055 -0096
08/26/2006 (800)275-8777 01:44:00 PM
~ I oduct
Description
Sales Receipt
Sale Unit
Oty Price
Fiola!
.)r ;'b
Other
PITTSBURGH PA 15264 $4.05
Pri ori ty Mai 1
0.90 oz.
Delivery Confirmation $0.50
Label #: 03060320000549204411
--------
--------
Issue PVI: $4.55
Total: $4.55
Paid by: $10.00
Cash
Change Due: -$5.45
Bi 11#: 1000401289102
Clerk: 18
All sales final on stamps and postage.
Refunds for guaranteed services only.
Thank you for your business.
Customer Copy
.
U S Postal Service",
C'ERTIFIED MAIL.. RECEIPT . d
Domestic Mail Only; No Insurance Coverage ProvIde )
<0
:~ I11III
!..Jl ~."""""~;J:11~"'~r:'..q >J
! <0 I L~STC ra"l )6~_ I A I ~'t, ~S----., -' ,;~.
,n.l - m II II - II ~ ,_ j%-L '-,..-,\
. rn $.O.~,9..Io '\ '~6
' LJ'l Postage $ ..
! 06
g; Certified Fee AUGPo~nijk 2005
o Return Receipt Fee Frere
o (Endorsement ReqUired),,- . __ .--/j'
i 0 Restricted Delivery. Fee
,0 (Endorsement ReqUired)
1...-'10 $ 08/15/20SP 1)65
Total Postage & Fees U
~ C~-.l~l ~.'I(!'!f..J.~!.~rr.:_I.~Lf(!Y!.!~~.tf:!.f.::.~. oop~t~
~ ~~-AiiCNO' 1\ < 0 nr < V ( L L.c. &o/"(J
orpo'BcxNo:' ~G Elf;; \ ~~c?f:...m..m.._oo .m.moo
citY.'Stai9;ziP+rm'~--~C'A~Z~ . P A 11@o [
USPS HARRISBURG PA
HARRISBURG, Pennsylvania
171069714
4134870106 -0092
09/07/2006 (800)275-8777
- Sales Receipt
Product Sale Unit
Description Oty Price
SAINT PAUL MN 55164
First-Class
0.30 oz.
Return Rcpt (Green Card)
Certified
Label II:
01:30:09 PM
Final
Price
$0.39
$1.85
$2.40
70060100000452283299
--------
--------
Issue PVI: $4.64
7.80 Lv 1 $7.80 $7.80
TruBlu PSBk
Total: $12.44
Paid by;
Cash $20.00
Change Due: -$7.56
Order stamps at USPS.com/shop or call
1-800-Stamp24. Go to
USPS.com/clicknship to print shipping
labels with postage. For other
information call 1-800-ASK-USPS.
8111#: 1000800506130
Clerk: 14
All sales final on stamps and postage.
Refunds for guaranteed services only.
Thank YOU for your business.
CustOlller Copy
J n0€- 5\0.0\) --
--Pd 5Io.6l)
0-A p \)