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HomeMy WebLinkAbout06-05-07 (2) .....I 15056051058 REV-1500 EX (06-05) PA Department of Revenue *' Bureau of Individual Taxes PO BOX 280601 ~arrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY County Code Year File Number J-I O(P 1135 Date of Birth 195-16-3809 12/08/2006 06/21/1920 Decedent's Last Name Suffix Decedent's First Name MI Shoap Leslie R (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW '. 1. Original Return 2. Supplemental Return 4. Limited Estate .' 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Retum Required 4a. Future Interest Compromise (date of death aftar 12-12-82) 7. Decedent Maintained a living Trust (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENnAL TAX INFORMAnON SHOULD BE DIRECTED TO: Name Daytime Telephone Number '.~ 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes Patricia A. Shoap Firm Name (If Applicable) Shoap Law Offices First line of eddress (717) 261-1345 {"'. '1 - --~- , REGISTER ~ \'lm;LS USE O9l.v '---- (:,. 139 E. Washington Street I Ul Second line of address :--~.. P.O. Box 532 City or Post Office Chambersburg State ZIP Code 17201 DATE FILED r :- c PA Correspondent's e-mail address:shoaplaw@innernet.net RESS 047 Roxbury Road, Shippensburg, PA 17257 ~~EPARER OTH~REPRESENTATIVE ,"",-,(7 ~ ADDRESS 139 E. Washington Street, Chambersburg, PA 17201 PLEASE USE ORIGINAL FORM ONLY DATE t:. .J 6/'07 , L 15056051058 Side 1 15056051058 ...J , ~ -.J 15056052059 REV-1500 EX Decedent's Name: Leslie R. Shoap 195-16-3809 RECAPITULATION 1. Real estate (Schedule A). ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1. 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . .. 3. 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5. 6. Jointly Owned Property (Schedule F) c:) Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) C:) Separate Billing Requested. . . . . . .. 7. 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8. Decedent's Social Security Number 123,000.00 7,882,387.00 0.00 0.00 74,340.00 0.00 0.00 8,079,727.00 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . .. 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). . . . . . . . . . . . . . . . 10. 11. Total Deductions (total Lines 9 & 10). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . . . 14. TAX COMPUTATION. SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0_ 16. Amount of Line 14 taxable at lineal rate X.O_ 17. Amount of Line 14 taxable at sibling rate X .12 7,847,368.0 18. Amount of Line 14 taxable at collateral rate X .15 200,000.00 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L 15056052059 Side 2 32,359.00 8,047,368.00 0.00 8,047,368.00 15. 16. 17. 941,684.00 30,000.00 971,684.00 18. C:) 15056052059 .....J REV-1500 EX Page 3 File Number Decedent's Complete Address: r If I i DECEDENT'S NAME DECEDENT'S SOCIAL SECURITY NUMBER Leslie R. Shoap 195-16-3809 STREET ADDRESS 11 South Penn Street CITY I STATE I ZIP Shippensburg PA 17257 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) 971,684.00 922,000.00 48,525.00 Total Credits ( A + 8 + C ) (2) 970,525.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5A) (58) 1,159.00 0.00 1,159.00 A. Enter the interest on the tax due. Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;.......................................................................................... D iii b. retain the right to designate who shall use the property transferred or its income; ............................................ D iii c. retain a reversionary interest; or.......................................................................................................................... D [i] d. receive the promise for life of either payments, benefits or care? ...................................................................... D Ii] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. D Ii] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. D iii 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ D iii IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. ~9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. ~9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX+ (6-9_ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Leslie Richard Shoap 2006-01135 AR real property owned solely or as a t8nant In common must be report8d at fair mart. value. Fair rnarl<et value is defined as the price at which property would be exchanged between a willing buyer and a wiHing seRer, neither being compeled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which Is jolntly-owned with right of survivorship must be dlacloaed on Schedule F. ITEM NUMBER 1. DESCRIPTION 11 South Penn Street, Shippensburg, PA 17257 Legal description: DR: 134/628; DR: 35N1271 Cumberland County Census Tract: 132 VALUE AT DATE OF DEATH 123,000.00 (See attached appraisal) TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 123,000.00 REV-1503 EX+ (6-98* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Leslie Richard Shoap FILE NUMBER 2006-01135 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION See attached inventory and brokerage quotations. VALUE AT DATE OF DEATH 7,882,387.00 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 7,882,387.00 Item Stocks/Bonds Description Value at Date Number of Death: 12/08/2006 1 Ameriprise Finllnc; AMP; 40 shares; mean px. $55.165 $ 2,207.00 2 AT&T Inc; T; 1,007shares; mean px $34.696 $ 34,938.00 3 Amer Express Co.; AXP; 200 shares; mean px $ 59.445 $ 11,889.00 4 Amer Inti Group Inc.; AIG; 159 shares; mean px $70.40 $ 11,194.00 5 Anheusr Busch Cas Inc; BUD; 440.6447shares; mean px $47.735 $ 21,035.00 6 Archer Daniels Midld; ADM; 6,722 shares; mean px $33.910 $ 227,943.00 7 Avon Prod Inc; AVP; 48 shares; mean px $33.825 $ 1,624.00 8 BP PLC; BP; 534 shares; mean px $68.58 $ 36,622.00 9 Bank of America Corp; BAC; 254.7734 shares; mean px $51.85 $ 13,210.00 10 BASF AG Sponsored; BF; 100 shares; mean px $94.345 $ 9,435.00 11 Bellsouth Corp.; BLS; 540 shares; mean px $45.515 $ 24,578.00 12 Briggs & Stratton WI; BGG; 214 shares; mean px $27.19 $ 5,819.00 13 CVB Fincl Corp; CVBF; 400 shares; mean px $12.936 $ 5,174.00 14 Comcast Corp New CI; CMCSA; 277.1283 shares; mean px $41.95 $ 11,626.00 15 Corn Products Intllnc; cpa; 200 shares; mean px $37.05 $ 7,410.00 16 Orrstown Bank; 3,273 shares @36.75 per share $ 120,283.00 17 Campbell Soup Co.; CPB; 224.8212 shares; mean px $38.735 $ 8,708.00 18 CVS Corp. Delaware; CVS; 126.8638 shares; mean px $30.105 $ 3,819.00 19 Citigroup Inc; C; 419.4065 shares; mean px $52.525 $ 22,029.00 20 Chevron Corp; CVX; 224.5146 shares; mean px $73.385 $ 16,476.00 21 Conocophillips; COP; 560 shares; mean px $70.755 $ 39,623.00 22 Clorox Co Del Com; CLX; 433.1721 shares; mean px $64.195 $ 27,807.00 23 Coca Cola Com; KO; 2,072.4300 shares; mean px $48.815 $ 101,166.00 24 Colgate Palmolive; CL; 1,148 shares; mean px $65.375 $ 75,051.00 25 Conagra Foods Inc; CAG; 530.7782 shares; mean px $25.905 $ 13,750.00 26 Corning Inc; GLW; 360 shares; mean px $20.765 $ 7,475.00 27 Diageo Pic spsd Adr; DEO; 305.8808 share; mean px $77.56 $ 23,724.00 28 Del Monte Foods Co.; DLM; 80.1258 shares ; mean px $11.165 $ 895.00 29 Disney (Walt) Co Com; DIS; 300 shares; mean px $34.25 $ 10,275.00 30 Dollar Gent Corp; DG; 1373.9005 shares; mean px $15.35 $ 21,089.00 31 Dow Chemical Co; DOW; 300 shares; mean px $39.885 $ 11,966.00 32 Du Pont E I De Nemou; DD; 300 shares; mean px $47.010 $ 14,103.00 33 Eastman Chemical Co; EMN; 58 shares; mean px $59.53 $ 3,453.00 34 Eastman Kodak; EK; 234 shares; mean px $25.765 $ 6,029.00 35 Energizer Hldgs Inc; ENR; 83 shares; mean px $69.06 $ 5,732.00 36 Exxon Mobil Corp; XOM; 662.1351 shares; mean px $75.93 $ 50,276.00 37 Fortune Brands Inc; FO; 2,292.1275 shares; mean px $81.98 $ 187,909.00 38 Beistle Co. Common Stock; 3,097 shares @ 319.92 per share $ 990,792.00 39 Flowers Foods Inc; FLO; 1,783.1052 shares ; mean px $26.92 $ 48,001.00 40 Van Kmpn PA Mun Inc; VPV; 7,018 shares; mean px $14.225 $ 99,831.00 41 Putnam Inv Grad Mun; PGM; 1,000 shares; mean px $10.065 $ 10,065.00 42 Nuveen Muni Mkt Opp; NMO, 6,000 shares; mean px $15.22 $ 91,320.00 43 Nuveen PA Inv Qual M; NQP; 400 shares; mean px $13.825 $ 5,530.00 44 Nuveen Sel Qual Muni; NQS; 2,000 shares; mean px $16.322 $ 32,664.00 45 Nuveen Quallnc Muni; NQU; 3,000 shares; mean px $15.09 $ 45,270.00 46 Nuveen MI Quallnc M; NUM; 1,000 shares; mean px $14.86 $ 14,860.00 47 Nuveen Tx Quallnc M; NTX; 1,000 shares; mean px $14.795 $ 14,795.00 48 Van Kmpn Merr Mun Tr; VKQ; 1,000 shares; mean px $15.405 $ 15,405.00 49 Nuveen Prem Muni Inc; NPF; 2,000 shares; mean px $14.06 $ 28,120.00 50 Van Kam Tr Invt Gm S; VGM; 2,255 shares; mean px $15.28 $ 34,456.00 51 Nuveen Prem Inc Muni; NPM; 1,500 shares; mean px $14.245 $ 21,368.00 52 Putnam Muni Oppty Tr; PMO; 1,500 shares; mean px $12.035 $ 18,053.00 53 Blackrock Muniyld PA; MPA; 5,000 shares; mean px $14.73 $ 73,650.00 54 Western Asset Mun; MHF; 1,500 shares; mean px $7.885 $ 11,828.00 55 Gallaher Grp Pic spd; GLH; 2,027 shares; mean px $91.70 $ 185,876.00 56 General Electric; GE; 3,101.3352 shares; mean px $35.18 $ 109,105.00 57 General Mills; GIS; 234.5680 shares; mean px $57.095 $ 13,393.00 58 Honeywelllntllnc 0; HON; 208.9284 shares; mean px $42.26 $ 8,829.00 59 Hospira Inc; HSP; 10 shares; mean px $34.43 $ 344.00 60 Hanesbrands Inc; 42.0437 shares; mean px $23.795 $ 1,000.00 61 Heinz H J Co Pv 25CT; 181.2817 shares; mean px $45.465 $ 8,242.00 62 Hershey Co; HSY; 449.1436 shares; mean px$49.555 $ 22,257.00 63 Idacorp Inc; IDA; 800 shares; mean px $38.745 $ 30,996.00 64 Intel Corp; INTC; 400 shares; mean px $20.695 $ 8,278.00 65 Inti Business Mach; IBM; 160 shares; mean px $93.93 $ 15,029.00 66 Idearc Inc; IAR; 21 shares; mean px $27.185 $ 571.00 67 Johnson and Johnson; JNJ; 215.1971 shares; mean px $65.965 $ 14,195.00 68 Kellogg Co Pv 25CT; K; 232.4838 shares; mean px $49.68 $ 11,550.00 69 Monsanto Co New Del; MON; 34 shares; mean px $48.075 $ 1,635.00 70 Medco Health Solution; MHS; 43 shares; mean px $51.745 $ 2,225.00 71 McDonalds Corp; MCD; 200 shares; mean px $43.57 $ 8,714.00 72 Merck&Co Inc; MRK; 360 shares; mean px $43.52 $ 15,667.00 73 Merrill Lynch and Co.; MER; 102.3190 shares; mean px $89.965 $ 9,205.00 74 Nestle S A Rep Rg Sh; NSRGY; 429.5796 shares; mean px $88.275 $ 37,921.00 75 PPG Industries Inc; PPG; 106 shares; mean px $65.730 $ 6,967.00 76 Puget Energy Inc; PSD; 500 shares; mean px $25.205 $ 12,603.00 77 Pepsico Inc; PEP; 650.8134 shares; mean px $63.385 $ 41,252.00 78 Pfizer Inc Del PV$O; PFE; 2460.5907 shares ; mean px $24.995 $ 61,502.00 79 Proctor & Gamble Co; PG; 1,782 shares; mean px $63.875 $ 113,825.00 80 Sara Lee Corp; SLE; 337.3500 shares; mean px $16.975 $ 5,727.00 81 Schwab Charles Corp; SCHW; 450 share; mean px $19.19 $ 8,636.00 82 J M Smucker Co; SJM; 3 shares; mean px $48.06 $ 144.00 83 3M Company; MMM; 128 shares; mean px .$78.035 $ 9,988.00 84 Tootsie Rolllndust; TR; 1,925.8450 shares; mean px $33.005 $ 63,563.00 85 Unilever NV Ny Reg; UN; 272.7730 shares; mean px $26.20 $ 7,147.00 86 Verizon Communications; VZ; 424 shares; mean px $53.07 $ 14,870.00 87 Zimmer Holdings Inc; ZMH; 10 shares; mean px $75.16 $ 752.00 88 Wal-Mart Stores Inc; WMT; 400 shares; mean px $46.435 $ 18,574.00 89 Walgreen Co; WAG; 1,200 shares; mean px $43.455 $ 52,146.00 90 Wrigley William Jr C; WWYWB; 288 shares; mean px $52.35 $ 15,077.00 91 WM Wrigley Jr Co; WWY; 1,152 shares; mean px $52.28 $ 60,227.00 92 Yum Brands Inc; YUM; 122.1040 shares; mean px $59.575 $ 7,274.00 93 Wachovia Corp. New; WB; 117.3340 shares; mean px $55.58 $ 6,521.00 94 Wyeth; WYE; 10,040 shares; mean px $50.125 $ 503,255.00 95 F & M Trust; 501 shares @ 27.30 per share $ 13,677.00 96 Dreyfus Prem State M; PTPAX; 646 shares; mean px $16.28 $ 10,517.00 97 Pennsylvania St Hefa; J4NU3; 5,000; 9.38% due 7/1/2010; mean px $111.248 $ 5,564.00 98 Allegheny Co Pa Arpt; MHG77; 10,000; 5.75% due 1/1/2011; mean px$107.510 $ 10,751.00 99 Allegheny Co Pa ARPT; MHG81; 10,000; 5.25% due 1/1/2016; mean px $102.298 $ 10,230.00 100 Philadelphia Pa At I; MLF08; 10,000; 5.13% due 7/1/2028; mean px $102.288 $ 10,229.00 101 Kiski Vy Wtr Pollutn; M2645; 5,000; 6.13% due 7/1/2013 $ 5,691.00 102 Moon Schs Unsd At PA; N6269; 5,000; 6.5% due 11/15/2007; mean px $102.708 $ 5,135.00 103 Montgomery Co PA Heh; PCPY7; 5,000; 4.88% due 6/1/2018 $ 5,113.00 104 Geisinger At PA Hlth; PD4GO; 5,000; 5.00 % due 8/15/2028; mean px $102.133 $ 5,107.00 105 Pennsylvania St Hghr; PKM16; 15,000; 5.00% due 8/1/2029 $ 15,496.00 106 Dauphin Cnty PA Gen; RA8B6; 10,000; 5.50% due 7/1/2008; mean px $100.664 $ 10,066.00 107 Bucks Co PA Hsg Auth; REYL2; 5,000; 6.15% due 10/1/2014; mean px $100.649 $ 5,032.00 108 Franklin Co PA Indl; RGAA2; 10,000; 5.00% due 7/1/2022; mean px $101.559 $ 10,156.00 109 Franklin Co PA Indl; RGDH7; 5,000; 5.00% due 7/1/2018; mean px $101.651 $ 5,083.00 110 Lehigh Cnty PA Gp At; RGM33; 10,000; 5.00% due 7/1/2018; mean px $102.531 $ 10,253.00 111 Gettysburg PA Mun Au; RH6W3; 5,000; 5.00% due 8/15/2023; mean px $102.776 $ 5,138.00 112 Gettysburg PA Mun Au; RH6W3; 5,000; 5.00% due 8/15/2023;mean px $102.776 $ 5,138.00 113 South Fork Mun At PA; RJ1T3; 10,000; 5.00% due 7/1/2028; mean px $102.393 $ 10,239.00 114 Pennsylvania St Hghr; RJ711; 10,000; 5.00% due 8/1/2029; mean px $102.834 $ 10,283.00 115 Pittsburgh PA Sch Di; RN175; 10,000; 5.00% due 9/1/2018; mean px $111.669 $ 11,167.00 116 Abbott Labs; ABT; 100 shares; mean px $48.05 $ 4,805.00 117 Altria Group Inc; MO; 15,177.6718 shares; mean px $84.93 $ 1,289,040.00 118 Acco Brands Corp; ABD; 538.0299 ; mean px $25.53 $ 13,736.00 119 Ringgold PA Sch Dist; R2639; 5,000; 6.75% due 1/15/2013; mean px $110.386 $ 5,519.00 120 Pittsburgh PA Wtr-SW; T18X4; 30,000; 7.25% due 9/1/2014; mean px $114.331 $ 34,299.00 121 Altria Group Inc; MO; 323 shares; mean px $84.93 $ 27,432.00 122 BB& T Corp; BPT; 200 shares; mean px $43.75 $ 8,750.00 123 BP Prudhoe Bay Rty Trust Units Ben Int; BPT; 400 shares; mean px $75.89 $ 30,356.00 124 Bank of America Corp; BAC; 1300 shares; mean px $51.85 $ 67,405.00 125 Blackrock Insured Muni Income; BYM; 5005 shares; mean px $15.01 $ 75,125.00 126 Blackrock Muni Income Tr; BFK; 6,000 shares; mean px $17.29 $ 103,740.00 127 Blackrock PA Strategic Muni Trust; BPS; 2,000 shares; mean px $18.00 $ 36,000.00 128 Blackrock CA Insured Muni Income Trust; BCK; 1,000 shares; mean px $14.92 $ 14,920.00 129 Blackrock Muni Bond Trust; BBK; 1,005 shares; mean px $18.49 $ 18,582.00 130 Blackrock CA Muni Income Trust \I; BCl; 3,000 shares; mean px $15.66 $ 46,980.00 131 Blackrock MuniYield Fd Inc; MYD; 8,000 shares; mean px $15.32 $ 122,560.00 132 Blackrock Munienhanced Fd Inc; MEN; 3,000 shares; mean px $11.03 $ 33,090.00 133 Blackrock Muniholdings Insd Fd; MUS; 6,000 shares; mean px $13.00 $ 78,000.00 134 Blackrock Muniholdings Inds Fd \llnc; MUE; 3,000 shares; mean px $12.97 $ 38,910.00 135 Blackrock Muniyield Insd Fd Inc; MYI; 2,000 shares; mean px $14.30 $ 28,600.00 136 Blackrock Muniyield NJ Fd Inc; MY J; 1,500 shares; mean px $15.24 $ 22,860.00 137 Citigroup Inc; C; 100 shares; mean px $51.53 $ 5,153.00 138 Consolidated Edison Inc; ED; 100 shares; mean px $47.99 $ 4,799.00 139 DWS Strategic Mun Income Tr; KSM; 1,000 shares; mean px $12.41 $ 12,410.00 140 Dow Chemical Co; DOW; 300 shares; mean px $39.89 $ 11,967.00 141 Dreyfus Strategic Muns Inc; LEO; 10,026 shares; mean px $9.45 $ 94,746.00 142 Eaton Vance PA Muni Inc Tr SBI; EVP; 1,000 shares; mean px $14.60 $ 14,600.00 143 Eaton Vance Insd Muni Bond Fund; ElM; 3,000 shares; mean px $15.87 $ 47,610.00 144 Eaton Vance Insd PA Munibond Fund; EIP; 2,000 shares; mean px $15.06 $ 30,120.00 145 First Horizon Natl Corp; FHN; 200 shares; mean px $40.18 $ 8,036.00 146 HSBC Holdings Pic 6.20%; HBCPRA; 200 shares; mean px $25.33 $ 5,066.00 147 Harvest Energy Trust-CAD; HTE; 200 shares; mean px $23.25 $ 4,650.00 148 JPMorgan Chase & Co; JPM; 300 shares; means px $46.75 $ 14,025.00 149 Kraft Foods Inc Class A; KFT; 300 shares; mean px $34.79 $ 10,437.00 150 Lehman Brothers Hldgs Inc.; lEHPRF; 100 shares; mean px $25.65 $ 2,565.00 151 MFS Muni Income Tr SBI; MFM; 5,500 shares; mean px $8.60 $ 47,300.00 152 Metlife Inc 6.50% PFD; METPRB; 500 shares; mean px $26.01 $ 13,005.00 153 Nestle S A Sponsored ADR; NSRGY; 100 shares; mean px $88.61 $ 8,861.00 154 New York Community Baneorp; NYB; 500 shares; mean px $16.38 $ 8,190.00 155 Nuveen Premium Ine Mun Fd 4; NPT; 2,000 shares; mean px $12.94 $ 25,880.00 156 Nuveen PA Prem Ine Mun FD 2; NPY; 5,000 shares; mean px $13.64 $ 68,200.00 157 Nuveen Prem Inem Mun Fd 2 Ine; NPM; 3,000 shares; mean px $14.25 $ 42,750.00 158 Nuveen Dividend Adv Muni Fd; NAD; 1,000 shares; mean px $15.51 $ 15,510.00 159 Nuveen PA Dividend Adv Muni Fd; NXM; 500 shares; mean px $16.12 $ 8,060.00 160 Nuveen Dividend Adv Muni Fd 2; NXZ; 1,000 shares; mean px $16.78 $ 16,780.00 161 Nuveen PA Dividend Adv Muni Fd 2; NVY; 2,000 shares; mean px $15.35 $ 30,700.00 162 Nuveen Muni Value Fd Inc; NUV; 2,000 share; mean px $10.45 $ 20,900.00 163 Nuveen Premier Muni Ine Fd Inc; NPF; 2,000 shares; mean px $14.06 $ 28,120.00 164 Pengrowth Energy Tr-CAD New; PGH; 200 shares; mean px $16.89 $ 3,378.00 165 Penn West Energy Tr-CAD; PWE; 400 shares; mean px $32.45 $ 12,980.00 166 PIMCO Mun Ine Fd; PMF; 3,000 shares; mean px $17.37 $ 52,110.00 167 PIMCO Mun Ine Fd II; PML; 5,006 shares; mean px $15.94 @ 15.82 per share $ 79,796.00 168 PIMCO Muni Ine Fd 3; PMX; 3,000 shares; mean px $16.05 $ 48,150.00 169 Precision Drilling Tr CAD; PDS; 300 shares; mean px $25.26 $ 7,578.00 170 Prime West Energy Tr-CAD New; PWI; 200 shares; mean px $21.57 $ 4,314.00 171 Putnam Muni Oppty Tr; PMO; 3,500 shares; mean px $12.04 $ 42,140.00 172 Royal Dutch Shell Pie Adr CI A; ROSA; 100 shares; mean px $71.27 $ 7,127.00 173 Trusteo Bank Corp - N Y; TRST; 1,000 shares; mean $11.07 $ 11,070.00 174 Van Kampen Amer Cap Muni Opp; VMO; 8,408 shares; mean px $15.09 $ 126,877.00 175 Van Kamp Adv Muni Inc Tr II; VKI; 4,177 shares; mean px $13.31 $ 55,596.00 176 Van Kamp Select Sector Muni Tr; VKL; 5,006 shares; mean px $13.03 $ 65,228.00 177 Van Kamp Amer Cap PA Val Mun; VPV; 9,017 shares; mean px $14.23 $ 128,312.00 178 Wachovia Corp 2nd New; WB; 200 shares; mean px $55.58 $ 11,116.00 179 Wells Fargo & Co New; WFC; 200 shares; mean px $35.40 $ 7,080.00 180 Western Asset Mun; MHF; 1,517 shares; mean px $7.89 $ 11,969.00 181 Blackrock Muniyield PA Insd Fd Inc; MPA; 4,000 shares; mean px $14.73 $ 58.920.00 SUB- TOTAL STOCKS! BOND $ 7,882,387.00 __, _........., ..........v j,-.n.A 1.L I "'U'tV"tO'" ;)m.lTli .l:SAKNI:IY I4J002 cltlgroutit' SMllHBARNEY 446 $tllufrct Avenue Chambmburg, AL 17201 Tel 717-2.64-S90 I Fax 717-264-6463 Toll Frue 800.842-7076 Date of Death Valuation L. Richard Shoap Dat.e of Death December 8, 2006 Quantity Description High Low Close 40,382 Money Market 1.00 LOa 1.00 323 Alma Group me 85.33 54.53 84.83 200 BB&T Corp 43.99 43.51 43.87 400 BP Prudhoe Bay Rty 'frust 76.25 75.50 75.50 1300 Bank of America Corp 52.38 51.32 51. 66 5005 Blackrock InsuredMuni IncolDe 15.07 14.95 14.96 6000 Blackrock Municipal Income Trust 17.33 17.25 17.29 2000 Blaclcrock Pennsylvania Strategic Municipal 18.12 17.88 18.12 1000 Blackrock California Utsured 14.95 14.88 14.95 1005 Blackrock Municipal Bond 18.53 18.44 18.45 3000 Blackrock California Muni Income 15.73 15.59 15.61 8000 Blackrock Muniyield Fund 15.35 15.29 15.30 3000 Blackrock Muni Enhanced Fund 11.05 11.00 11.01 6000 Blackrock Muniboldings Insd Fund 13.04 12.97 13.00 3000 Blackrock Muniholdings Insd Fund IT 12.99 12.95 12.97 2000 'B lackrock Muniyield Insd Fund 14.36 14.24 14.25 1500 Blackrock Muniyield NJ Fund 15.29 15.18 15.26 4000 Blackrock Muniyield PA Insd fund 14.76 14,70 14.73 100 Citigroup 52.70 50.35 51.85 100 Conso1id!1Led EdisOll 48.23 47.75 47.83 1000 DWS Strategic Mun Income Tr 12.47 12.35 12.35 300 Dow Chemi.cal 40.08 39.69 39.91 10,026 Dreyfus Strategic MlJ1lS Ine 9.45 9.45 9A5 1000 Eaton Vance Pennsylvania Muni Income 14.61 14.58 14.61 3000 Eaton Vance Insd Muni BOnd Fd 15.91 15.83 15.85 2000 Eaton Vance InsdPA Mum Bnd Fund 15.09 15.02 15.09 200 First Horizon National Corp 40.44 39.92 40.41 200 HSBC Holdings PLC 6.2% 25.40 25.25. 25.31 200 Harvest Energy Trost 23.50 22.99 22.99 300 JP Morgan Chase 47.14 46.35 46.76 300 Kraft Foods 35.10 34.48 35.00 100 Lt:lllnan Brothers Holdings 25.77 25.53 25,54 5,500 MFS Municipallncome Trust 8.64 8.57 8.571 500 Mctlite Inc 6.5% 26.10 25.933 25.96 100 Nestle SA Sponsored ADR. 88.605 88.605 88.605 500 New York Community BancoTp 16.45 16.30 16.34 2000 Nuveen Premium Income Mutt Fund 4 13.03 12.85 12.88 5000 Nuveen P A Prem Income Mun Fund 2 13.66 13.62 13.62 3000 N uveell Prem Income.: Mun Fd 2 !ne 14.30 14.19 14.23 1000 Nuvct.."I1 Dividend Advantage Muni Fl.md 15.56 15.46 15.52 500 Nuveen Pennsylvania Div Advantage Muoi Fd 16.14 16.00 16.14 Ciugroup Global Mark.u Inc. ~~ .. ..... --..-- THe lIWVKII4/-','IQN Sl1."r FORTH WAS OBTAINBD PROM S<.W~I:IZ.~ '>lf1oiICH W1! RF.I.lIM'. RF.UAIlLE lilT Wli DO NOT C;UAlIAI"1'1ll! IU ~(.:lr"",I,;' ll~ C<J""I.I('I'I'NF~'\.~. Nr,rTHU THE INFOltMAT1r~~1 "')'1 ."v ....NNION F.XPRF.!;-'EO c:mll,"TJTU"I'ES A sO~ICm\TION ~y us OF '!'HI; N.rnCHAS~ CIR SAl..E OF ANY seC;UKITIIlS. ...L._v'Sv":t.v.... >:IllU lotI. J)fU{I~J:H: 141003 ... cltlgroUpJ SMITHBARNEY 446 Stouffer Avcn uc Cha.."b,r~b(org, AI. 17201 Td 7]7.264.5901 F,lx 717 -264-6411~ Toll Free 800-842-7076 Quantitv Description Hi~h ~ ~ 1000 Nuveen Dividend Advantage Muni Fd 2 16.84 16.72 16.82 2000 Nuveen Pennsylvania Div Advantage Muni Fd 2 15.35 15.35 15.35 2000 NuveeD Municipal Valllt Fd lnc 14.49 1..40 10.41 2000 Nuveen Premier Muni Income Fund 14.06 14.06 14.06 200 Pengrowth Energy Tr 16.98 16.79 16.88 400 Penn West Energy 32.72 32.18 32.45 3000 Pimco Mun Income Fd 17.43 17.30 17.42 5006 Pimco Mun Income Fd IT 16.05 15.82 15.82 3000 Pimco Muni Income Fd ill 16.05 16.05 16.05 300 Precision DrilJing Tr 25.479 25.04 25.07 200 Prime West Energy Trust 21.571 21.571 21.571 3500 Putnam Muni Opportunities 12.08 11.99 11.99 100 Royal Dutch Shell PLC 71.66 70.87 70.87 1000 Trustco Bank COTp NY 11.14 11.00 11.10 8408 Van Kampen ADler Cap Muni Opp 15.11 15.06 15.10 4177 Van Kampen Advantage Muni Income Tr n 13.36 13.25 13.30 5006 Van Kampen Select Sector MUlli Tr 13.09 12.96 12.98 9017 YanKampenAmer C'.ap PA Val MWl 14.25 14.20 14.21 200 Wachovia COIp 2ad Ne:w 55.89 55.27 55,85 200 Wells Fargo & Co 35.58 35.2] 35.43 1517 Western Asset Mun High Income Fund 7.93 7.84 7.88 Sincerely, (S~~C~. Lisa Morris Registered Sales Assistant 1-800-842-7076 or 717-264.5901 The above prices hllYC been obtained from sourc~. bcli~vt:d 1.0 be reliable bUlllre not necessarily complet\': an<l cannot be guara.n~ed. This infonnl.tian is being provided at )'OUI' reque~t and docs not replace or supersede the Smith 6amc:y customer stalt:menl. i / Citigroup Global Marko;cs In~. THU 1I"l'OkMATlON S1!\T POII'Mi WAS OllTA1NEO FROM !IOUllCES WHICH WE BEL1EYl! REI.IAIlI." BI7T wr. 00 NOT C;:I7ARANTU lT~ Ac:(:I7R.ACY OR COMrLETENF_~S. NEITHER THG IN'Ol<J,lJI:flOl'l I'O~ ^~V ON1ol10N PXl'JI,R>:,f.n COIol~TITllTIlS .. SOI.ICITA'l'lON llY US op Tl-lil r'UJl,CH..S~ OJl, SAI.~ OP "lo:Y SnCllJl,ITlilS. (0 o o ~ ~ ..... o.~ ClloE o c: .s::. 0 CJ):;:; "E ~ ~(ij 0> i:i::5 .Cll ....I Q) cO - Q) 0 Cil Q) Ciica wo o '<t o ..... ..... I ,.... 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'ti:::J ~g, CI) Q) ~ 5-~ ~ .u) CI) ~ Cl:l (,) C::..c:: .Q (,) CtiS-, ~ -.I . --CI) 0:;::: c:: o.,;;;c:: t:: 0 '- Q) :0::: ~~ ~ o . ~ .o~~ Cl:l.o~ Q).~ .... :5]):::3 O)I.;..~ c::Q).... '-.0 c ~01:) :s....., e ~ c Q..:S(,) n. .Q) ~ ""..:::; I.;..Q)- Cl:l .0 ,~ ~~~ REV-1508 EX+ (6-98) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Leslie Richard Shoap FILE NUMBER 2006-01135 Include the proceeds of litigation and the dale the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH See attached inventory 74,340.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert addttional sheets of the same size) 74,340.00 Cash, Bank Deposits and Personal Property Smith Barney bank deposit program Merrill Lynch bank deposit program Cash on hand Household furnishings: Living room furniture Bedroom set wi double bed Bedroom furniture wi single bed Dining room fumiture Microwave oven Portable T.V. Console T.V. Yamaha electric organ Hammond electric organ Rocking chairs (3) Cedar chest Kelvinator chest freezer Washerldryer WetJdry vacuum Tabletop sewing machine Misc. tools Misc. pots/pans Misc. dishes Video player Misc. clothing Refrigerator Misc. lawn chairs French Fra ncs (40) Silver certificates (2) $5.00 each Silver Certificates (13) $1.00 each 1997 Toyota Corolla 1988 Chevrolet Sprint Hatchback $40,382.00 $27,947.02 $15 $200 $150 $125 $200 $25 $20 $75 $250 $300 $50 $50 $75 $100 $35 $50 $50 $50 $40 $20 $250 $200 $50 $8 $10.00 $13 $3,025 $575 SUB-TOTAL Cash, Bank Deposits and Personal Property $74,340.02 REV.1511 EX+ (12-99>* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Leslie Richard Shoap FILE NUMBER 2006-01135 Debts of decedent must be reported on Schedule L ITEM NUMBER A. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: Fogelsanger-Bricker Funeral Home 7,881.00 B. ADMINISTRATIVE COSTS: 1 . Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees 20,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City . Stale . Zip RaIationship of Claimant to Decedent 4. Probate Fees 3,630.00 5. Accountanfs Fees 6. Tax Return Preparer's Fees 8. Advertisement of Letters (The Public Opinion; Cumberland Law Journal) Probate/Estate Administration Treatise Real estate appraisal fee 267.00 280.90 300.00 7. 9. TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 32,358.90 REV-1513 EX+ (9-00) '* COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE .. BENEFICIARIES ESTATE OF Leslie Richard Shoap FILE NUMBER 2006-01135 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Ust Trustee(.) OF ESTATE I TAXABLE DISTRIBUTIONS pnclude outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)) 1. Kenneth E. Shoap, 9579 Roxbury Rd., Lurgan, PA 17232 Nephew $50,000 2. Richard L. Shoap, 3361 Camoustie Dr., Chambersburg, PA 17201 Nephew $50,000 3. Lindsey E. Shoap, 3361 Camoustie Dr., Chambersburg, PA 17201 Great-niece $50,000 4. Matthew B. Shoap, 3361 Camoustie Dr., Chambersburg, PA 17201 Great-nephew $50,000 5. John Kenneth Shoap, 1047 Roxbury Rd., Shippensburg, PA 17257 Brother 50% of remainder 6. Donald R. Shoap, 4560 Schooner Ave., Lakeland, FL 33805 Brother 50% of remainder ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET D NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) Form 706 United States Estate (and Generation-Skipping Transfer) Tax Return OMS No. 1545-0015 (Rev. October 2006) Department of the Treasury Estate of a citizen or resident of the United States (see separate instructions). IntemaI Revenue Service To be filed for decedents dying after December 31,2005, and before January 1,2007. 1a Decedent's first name and middle initial (and maiden name, if any) 1b Decedent's last name 2 Decedent's Social Security No. Leslie R. ... o 3a County, state, and ZIP code, or foreign country, of legal ~ residence (domicile) at time of death Gl ~ 'tl C I'll 6a i 'tl Gl U Gl ~ ... 7a Shoa 3b Year domicile established 4 Date of birth 195 16 5 Date of death 3809 Cumberland, Pennsylvania 17257 1920 06/21/1920 12/08/2006 6b Executor's address (number and street inclUding apartment or suite no. or rural route; city, town, or post office; state; and ZIP code) and phone no. 1047 Roxbury Road Shippensburg, PA 17201 Name of executor (see page 4 of the instructions) John Kenneth Shoa 6c Executor's social security number (see page 4 of the instructions) 179 12 3272 Phone no. ( 717 ) 532-6159 7b Case number 1:: I'll a. Name and location of court where will was probated or estate administered Cumberland Coun Court, Carlisle, PA 2006-01135 8 If decedent died testate, check here ~ III and attach a certified copy of the will. 9 If you extended the time to file this Form 706, check here ~ 0 10 If Schedule R-1 is attached, check here ~ 0 1 Total gross estate less exclusion (from Part 5-Recapitulation, page 3, item 12) 2 Tentative total allowable deductions (from Part 5-Recapitulation, page 3, item 22) 3a Tentative taxable estate (before state death tax deduction) (subtract line 2 from line 1) b State death tax deduction c Taxable estate (subtract line 3b from line 3a) . 4 Adjusted taxable gifts (total taxable gifts (within the meaning of section 2503) made by the decedent after December 31, 1976, other than gifts that are includible in decedent's gross estate (section 2001 (b))) 5 Add lines 3c and 4 6 Tentative tax on the amount on line 5 from Table A on page 4 of the instructions . c o 7 Total gift tax paid or payable with respect to gifts made by the decedent after December 31, 1976. i 'S Include gift taxes by the decedent's spouse for such spouse's share of split gifts (section 2513) only if Q. the decedent was the donor of these gifts and they are includible in the decedent's gross estate (see ~ instructions) ~ 8 Gross estate tax (subtract line 7 from line 6) . I'll 7 9 Maximum unified credit (applicable credit amount) against estate tax. ('II 10 Adjustment to unified credit (applicable credit amount). (This adjustment -; may not exceed $6,000. See page 6 of the instructions.) 10 a. 11 Allowable unified credit (applicable credit amount) (subtract line 10 from line 9) 12 Subtract line 11 from line 8 (but do not enter less than zero) . 13 Credit for foreign death taxes (from Schedule(s) Pl. (Attach Form(s) 706-CE.) 13 0 00 14 Credit for tax on prior transfers (from Schedule Q) 14 0 00 15 Total credits (add lines 13 and 14) . 15 0 00 16 Net estate tax (subtract line 15 from line 12) . 16 2,359,941 00 17 Generation-skipping transfer (GSl) taxes payable (from Schedule R, Part 2, line 10) 17 0 00 18 Total transfer taxes (add lines 16 and 17) . 18 0 00. 19 Prior payments. Explain in an attached statement 19 0 00 20 Balance due or ove a ment (subtract line 19 from line 18 20 2,359,941 00 Under penalties of perjury, I declare that I have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, err, and complete Decl ion f preparer other than the executor is based on all information of which preparer has any knowledge. 1 8,107,390 00 2 53,925 00 38 8,053,465 00 3b 923,159 00 3c 7,130,306 00 4 0 00 5 7,130,306 00 6 3,140,741 00 7 8 o 3,140,741 00 00 9 . . . 780,800 00 00 - 00 o 00 780,800 2,359,941 ~~7 Date 139 E. Washington Street Chambersburg, PA 17201 Address (and ZIP code) ~/S-/o7 Date ' For Privacy Act and Paperwork Reduction Act Notice, see page 28 of the separate instructions for this form. Cat. No. 20548R Form 706 (Rev. 10-2006) Form 706 (Rev. 10-2006) Estate of: Part 3-Elections by the Executor Please check the "Yes" or "No" box for each question (see instructions beginning on page 6). Note. Some of these elections require the posting of bonds or liens. Yes No 1 Do you elect alternate valuation? 2 Do you elect special-use valuation? . . If "Yes," you must complete and attach Schedule A-1. 3 Do you elect to pay the taxes in installments as described in section 6166? If "Yes," you must attach the additional infonmation described on pages 9 and 10 of the instructions. Note. By electing section 6166, you agree to provide security for estate tax deferred under section 6166 and interest in the form of a surety bond or a section 6324A special lien. 4 Do you elect to postpone the part of the taxes attributable to a reversionary or remainder interest as described in section 6163? 1 ./ ./ 2 3 4 Part 4--General Information (Note. Please attach the necessary supplemental documents. You must attach the death certificate.) (see instructions on page 11) Authorization to receive confidential tax information under Regs. sec. 601.504(b)(2)(i); to act as the estate's representative before the IRS; and to make written or oral presentations on behalf of the estate if return prepared by an attorney, accountant, or enrolled agent for the executor. Name of representative (print or type) Patricia A. Shoa I declare that I am the attomeyl certified public accountant! this return for the executor. I am not un er suspension or disbarment t te hown above. Signature Address (number, street, and room or suite no., city, slate, and ZIP code) 139 E. Washin ton St., Chambersbu ,PA 17201 enrolled agent (you must check the applicable box) for the executor and prepared rom practice before the Internal Revenue Service and am qualified to practice in the Date Telephone number (717) 261-1345 1 Death certificate number and issuing authority (attach a copy of the death certificate to this return). P 12996475 Commonwealth of Pennsylvania Department of Health 2 Decedent's business or occupation. If retired, check here ~ IiZI and state decedent's former business or occupation. U.S. Postal Service rural mail carrier 3 Marital status of the decedent at time of death: D Married D Widow or widower-Name, SSN, and date of death of deceased spouse ~._____._____..........._.....__________...__________________._ III Single D Legally separated D Divorced-Date divorce decree became final ~ 4a Surviving spouse's name 4b Social security number 4c Amount received (see page 11 of the instructions) 5 Individuals (other than the surviving spouse), trusts, or other estates who receive benefits from the estate (do not include charitable beneficiaries shown in Schedule 0) (see instructions). Name of individual, trust, or estate receiving $5,000 or more Identifying number Relationship to decedent Brother Brother Nephew Nephew Great-niece Great-ne hew Amount (see instructions) $2,284,370 $2,284,370 $50,000 $50,000 $50,000 $50,000 Donald R. Shoap 193-24-1588 John Kenneth Shoap 179-12-3272 Kenneth E. Shoap 180-38-7782 Richard L. Shoap 180-38-7783 Lindsey E. Shoap 203-70-5140 Matthew B. Shoa 211-70-1730 All unascertainable beneficiaries and those who receive less than $5,000 ~ Total Please check the "Yes" or "No" box for each question. 6 Does the gross estate contain any section 2044 property (qualified tenminable interest property (QTIP) from a prior gift or estate) (see page 11 of the instructions)? 7a Have federal gift tax returns ever been filed? . . If "Yes," lease attach copies of the returns, if available, and furnish the followin infonmation: 7b Period(s) covered 7c Internal Revenue office(s) where filed $4,768,740 Yes No (continued on next page) Page 2 Form 706 (Rev. 10-2006) Part 4-General Information (continued) If you answer "Ves" to any of questions 8-16, you must attach additional information as described in the instructions. Sa Was there any insurance on the decedent's life that is not included on the return as part of the gross estate? b Did the decedent own any insurance on the life of another that is not included in the gross estate? Yes No ./ ./ 9 Did the decedent at the time of death own any property as a joint tenant with right of survivorship in which (a) one or more of the other joint tenants was someone other than the decedent's spouse, and (b) less than the full value of the property is included on the return as part of the gross estate? If "Ves," you must complete and attach Schedule E . ./ 10 Did the decedent, at the time of death, own any interest in a partnership or unincorporated business or any stock in an inactive or closely held corporation? . ./ 11 Did the decedent make any transfer described in section 2035, 2036, 2037, or 2038 (see the instructions for Schedule G beginning on pa e 13 of the se arate instructions)? If "Ves," you must com lete and attach Schedule G . ./ 128 Were there in existence at the time of the decedent's death an trusts created b the decedent durin his or her lifetime? . ./ b Were there in existence at the time of the decedent's death any trusts not created by the decedent under which the decedent possessed any power, beneficial interest, or trusteeship? ./ c Was the decedent receiving income from a trust created after October 22, 1986 by a parent or grandparent? ./ If "Ves," was there a GST taxable termination (under section 2612) upon the death of the decedent? . d If there was a GST taxable termination (under section 2612), attach a statement to explain. Provide a copy of the trust or will creatin the trust, and ive the name, address, and hone number of the current trustee s . e Did decedent at any time during his or her lifetime transfer or sell an interest in a partnership, limited liability company, or closely held corporation to a trust described in question 12a or 12b? . If "Ves," provide the EIN number to this transferred/sold item. ~ 13 Did the decedent ever ossess, exercise, or release an 14 Was the marital deduction computed under the transitional rule of Public Law 97-34, section 403(e)(3) (Economic Recovery Tax Act of 1981)? If "Ves," attach a separate computation of the marital deduction, enter the amount on item 20 of the Recapitulation, and note on item 20 "com utation attached." 15 Was the decedent, immediately before death, receiving an annuity described in the "General" paragraph of the instructions for Schedule I or a rivate annui ? If "Ves," ou must com lete and attach Schedule I ./ 16 Was the decedent ever the beneficiary of a trust for which a deduction was claimed by the estate of a pre-deceased spouse under section 2056 and which is not re orted on this return? If "Ves," attach an ex lanation ./ Part 5-Recapitulation Item Gross estate Alternate value Val ue at date of death number 1 Schedule A-Real Estate 1 123,000 00 2 Schedule B-Stocks and Bonds 2 7.882,387 00 3 Schedule G-Mortgages, Notes, and Cash 3 74,340 00 4 Schedule D-Insurance on the Decedent's Ufe (attach Form(s) 712) 4 27.663 00 5 Schedule E~ointly Owned Property (attach Form(s) 712 for life insurance) 5 0 00 6 Schedule F-other Miscellaneous Property (attach Form(s) 712 for life insurance) 6 0 00 7 Schedule G-Transfers During Decedent's Ufe (att. Forrn(s) 712 for life insurance) .7 0 00 8 Schedule H-Powers of Appointment 8 0 00 9 Schedule I-Annuities 9 0 00 10 Total gross estate (add items 1 through 9) 10 8,107.390 00 11 Schedule U-Qualified Conservation Easement Exclusion 11 0 00 12 Total gross estate less exclusion (subtract item 11 from item 10). Enter here and on line 1 of Part 2-Tax Computation 12 8,107,390 00 Item Deductions Amount number 13 Schedule J-Funeral Expenses and Expenses Incurred in Administering Property Subject to Claims 13 32,359 00 14 Schedule K-Debts of the Decedent 14 21,566 00 15 Schedule K-Mortgages and Liens 15 0 00 16 Total of items 13 through 15 16 53,925 00 17 Allowable amount of deductions from item 16 (see the instructions for item 17 of the Recapitulation) 17 53.925 00 18 Schedule L-Net Losses During Administration. 18 0 00 19 Schedule L-Expenses Incurred in Administering Property Not Subject to Claims 19 0 00 20 Schedule M-Bequests, etc., to Surviving Spouse . 20 0 00 21 Schedule O-Charitable, Public, and Similar Gifts and Beauests 21 0 00 22 Tentative total allowable deductions (add items 17 throuah 21\. Enter here and on line 2 of the Tax ComDutation 22 53.925 00 Page 3 Form 706 (Rev. 10-2006) Estate of: Leslie R. Shoapl SSN 195-16-3809 SCHEDULE A-Real Estate . For jointly owned property that must be disclosed on Schedule E, see the instructions on the reverse side of Schedule E. . Real estate that is part of a sole proprietorship should be shown on Schedule F. . Real estate that is included in the gross estate under section 2035, 2036, 2037, or 2038 should be shown on Schedule G. . Real estate that is included in the gross estate under section 2041 should be shown on Schedule H. . If you elect section 2032A valuation, you must complete Schedule A and Schedule A-1. Item Description Alternate Alternate value Value at date of death number valuation date 1 House, lot and separate garage located at 11 South Penn Street, Shippensburg, Cumberland County, Pennsylvania. Value based on appraisal, $123,000 a copy of which is attached. Total from continuation schedules or additional sheets attached to this schedule . TOTAL. (Also enter on Part 5-Recapitulation, paae 3, at item 1.) . $123.000 (If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.) (See the instructions on the reverse side.) Schedule A-Page 4 Form 706 (Rev. 10-2006) Estate of: Leslie R. Shoapf SSN 195-16-3809 SCHEDULE B-Stocks and Bonds (For jointly owned property that must be disclosed on Schedule E, see the instructions for Schedule E.) Item Description, including face amount of bonds or number of shares and par Alternate number value for "identification. Give CUSIP number. If trust, partnership, or closely Unit value valuation date Alternate value Value at date of death held entitv, oive EIN CUSIP number or EIN, where applicable 1 See attached inventory and brokerage quotations. Total from continuation schedules (or additional sheets) attached to this schedule TOTAL (Also enter on Part 5-Recapitulation, page 3, at item 2.) $7,882,387 (If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.) (The instructions to Schedule B are in the separate instructions.) Schedule B--Page 12 Form 706 (Rev. 10-2006) Estate of: leslie R. Shoapl SSN 195-16-3809 SCHEDULE C-Mortgages, Notes, and Cash (For jointly owned property that must be disclosed on Schedule E, see the instructions for Schedule E.) Item Description Alternate Alternate value Value at date of death number valuation date 1 ISee attached inventory $74,340 Total from continuation schedules (or additional sheets) attached to this schedule . TOTAL. (Also enter on Part 5-Recapitulation, page 3, at item 3.) 74,340 (If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.) (See the instructions on the reverse side.) Schedule C-Page 13 Form 706 (Rev. 10-2006) Estate of: Leslie R. Shoapl SSN 195-16-3809 SCHEDULE D-Insurance on the Decedent's Life You must list all policies on the life of the decedent and attach a Form 712 for each policy. Item Description Alternate Alternate value Value at date of death number valuation date 1 Prudential Insurance CO.! Policy No. P0304832 $27,012 2 United States Postal Service (Group Life Insurance) $651 Total from continuation schedules (or additional sheets) attached to this schedule . TOTAL. (Also enter on Part 5-Recapitulation, page 3, at item 4.) 27,663 (If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.) (See the instructions on the reverse side.) Schedule D-Page 15 Form 706 (Rev. 10-2006) Estate of: Leslie R. Shoapl SSN 195-16-3809 SCHEDULE J-Funeral Expenses and Expenses Incurred in Administering Property Subject to Claims Note. Do not list on this schedule expenses of administering property not subject to claims. For those expenses, see the instructions for Schedule L. If executors' commissions, attorney fees, etc., are claimed and allowed as a deduction for estate tax purposes, they are not allowable as a deduction in computing the taxable income of the estate for federal income tax purposes. They are allowable as an income tax deduction on Form 1041 if a waiver is filed to waive the deduction on Form 706 (see the Form 1041 instructions). Item Description Expense amount Total amount number A. Funeral expenses: 1 Fogelsanger-Bricker Funeral Home 7,881.00 112 West King Street Shippensburg, PA 17257 Total funeral expenses .~ __m__m?~~!!:Q~_ B. Administration expenses: 1 Executors' commissions-amount estimated/agreed upon/paid. (Strike out the words that do not apply.) 0.00 ...........--... ..--..------........ 2 Attorney fees-amount estimated/agreed upon/paid. (Strike out the words that do not apply.) m______~9~~_~Q:Q~_ 3 Accountant fees-amount estimated/agreed upon/paid. (Strike out the words that do not apply.) 0.00 --- -- --... ---...... -..__.._- Expense amount 4 Miscellaneous expenses: Probate Fees (Cumberland County Court of Common Pleas, Carlisle, PA 17013) 3,630.00 Advertisement of Letters (The Public Opinion; Cumberland Law Journal) 267.00 Probate/Estate Administration Treatise (Thomson/West publications) 280.90 Real estate appraisal fee (Ziobrowski Appraisals. 1 N. Second St., Chambersburg, PA 17201) 300.00 Total miscellaneous expenses from continuation schedules (or additional sheets) attached to this schedule Total miscellaneous expenses ~~ 4.477 .90 TOTAL. (Also enter on Part 5-Recapitulation, page 3, at item 13.) .~ 32,358.90 (If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.) (See the instructions on the reverse side.) Schedule J-Page 23 Form 706 (Rev. 10-2006) Estate of: Leslie R. Shoapl SSN 195-16-3809 SCHEDULE K-Debts of the Decedent, and Mortgages and Liens Item Debts of the Decedent-Creditor and nature of claim, and Amount unpaid to date Amount in contest Amount claimed as number allowable death taxes a deduction 1 2006 U.S. Individual Income Tax (11112 of year accrued as of date $21,566.00 death: $23,526 x 11112 = $21,566) Total from continuation schedules (or additional sheets) attached to this schedule TOTAL. (Also enter on Part 5-Recapitulation, page 3, at item 14.) $21,566.00 Item Mortgages and Uens-Description Amount number 1 Total from continuation schedules (or additional sheets) attached to this schedule TOTAL. (Also enter on Part 5-Recapitulation, paoe 3, at item 15.) (If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.) (The instructions to Schedule K are in the separate instructions.) Schedule K-Page 25 FORM TO BE USED '/'JHEN INVENTORY TP.KEN BY 8J:.,NK EMPLOYEE peA !lANK SAfE DEPOSIT BOX INVENTORY DATE OF DE;'J.Tr! 5l)CIA.L :' ;:.C::r:. I ~ ~.:. ..~ .....1.....-...... .' ..... _-.J ........... N~~E, ADDRESS ~~~ RELATIONSHIP (IF ~~~) TO DECEDENT OF PERSO~ REQUESTING THE OPE~I~G OF THE SAFE DEPOSIT BOX Name C' 17~ \ 7 . PRESENT AT THE BOX (b) Address (c) Name Relationship NAYili ~~ ADDRESS OF Branch Name PBA BANK BRANCR WHERE THE SAFE DEPOSIT BOX IS I I LOCATED I Address Address OF PBA BANK EMPLOYEE TAKING THE INVENTORY Title lILE UNDER WHICH BOX IS 'REGISTERED NUMBER OF BOX DATE OF CONTRACT TO RENT BOX AME AND ADDRESS OF PERSON(S) HAVING ACCESS TO BOX ' (a) Name Address (b) Name Address AMI OF PERSON MAKING LAST ENTRY DATE AND TIME OF LAST ENTRY AS THERE A WILL IN THE BOX? f yes, (a) Date of Will: (b) Name and Address (if given) and relationship (if any) to decedent of personal representative(s) named in the will NO (c) Name and address of attorney shown on the will, if any FEE PAID TO PBA B~~ FOR SERVICES REh~ERED IN TAKING nrvENTORY OF THE CONTE1'1'S OF THE BOX: $ 14 Page 1 of Pages .~~~ ...:..... -~'_,...'-.~...~...,..,.-'_...~_...,.......;.;;."""'..i;.~:;~.:,'"..;;;;:.....d.t.;.i;,~~~~~~;~ SAFE DEPOSIT BOX DNENTORY I~STRUCTIONS FOR LISTING ~\~ DESCRIBING CONTENTS OF SAFE DEPOSIT BOX (1) Cash: Report total only. (2) st;Cks: List in detail every common or preferred certificate, warrant or other rights found in box. Stocks are to be designated by name of company, certifi- cate number, date of certificate, name in which stock is registered, and number of shares and class of stock (See attached Stocks/Bonds Inventory form). (3) Obligations of U.S. Government: Number of items, date of issue, face value, names in which registered (See attached Stocks/Bonds Inventory form), (4) Bonds: Designate by name, amount, serial number, or-other designation (See form). (5) Bank and Savings and Loan Passbooks: State name of depositor, number of book, last date appearing in book, name of bank and branch~ and balance. (6) Jewelry, Coins, Stamps, Manuscripts, etc: List and describe as fully as possible. (7) Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness: List and describe as fully as possible. (8) All other contents. ) / IT EH NO. Page 2 of. 4c. ---1 I -I ?ages ITe1 DESCRIPTION ) Page 3 of Pages 49 '~~~-,;:"'?"'~~~~~"Z~~.";:""~"::-':"D!,:-...~..;.~~~.....r.~r .. ITE~ DESCRIPTION F~ n () VWaC1 S-Ioct -I Page 3 of Pages 49 "":':~~.,.~.~;';;fo~.zr-:!'::,:":,"'-_~':~:':"":'-:":,~~,,;,,.~,-,r.-~;:"~"_.-..-.,.. I certify under penalty of perjury that the above record is correct and complete to the best of my knowledge and belier. Name and Title of Bank Employee Entering Safe Deposit Box .\fifj(( L. r13ehnetl PrJ.nt ame 9:!IMkA '?1 ~~A1jJj SJ.gnature B m /Ii C 1 f.>{ ~MJl ~ ()(// fer Title -L /Ie! /0 7 Date The undersigned acknowledges that he/she requested the opening of the safe deposit box referred to on page 1 of this~afe deposit box inventory, that the foregoing inventory, consisting of ~ pages (including this acknowledgement page) is a complete and accurate record of the contents of such box, that he/she has ~eceived a copy of such inventory, that such box has been closed and that he/she has removed all of such contents from the box and either (check one) taken such contents from the Bank's premises }JI'~/07 Date /" or ~deposited such contents into safe deposit box - number ;{~q at the branch of PBA Bank in~ed on page 1 of this inventory. tft?:/(~k ignature _ The undersigned acknowledge that they were present at the opening of the safe deposit box referred to on page 1 of this safe deposit box inventor;, and that the foregoing inventory is a complete and accurate record of the contencs or such safe deposit box. jllt/o7. Date ~)/~:zZ~ ~~ . Date Signature Date Signature Page of Pages 52 RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Receipt Date: Receipt Time: Receipt No.: 12/21/2006 11:35:11 1046754 SHOAP LESLIE RICHARD Estate File No. : Paid By Remarks: 2006-01135 JOHN KENNETH SHOAP CJ ------------------------ Receipt Distribution ------------------------ Fee/Tax Description Payment Amount Payee Name PETITION LTRS TEST WILL SHORT CERTIFICATE JCP FEE AUTOMATION FEE Check# 1528 Total Received......... 3,560.00 15.00 40.00 10.00 5.00 ---------------- $3,630.00 $3,630.00 CUMBERLAND COUNTY GENERAL FUN CUMBERLAND COUNTY GENERAL FUN CUMBERLAND COUNTY GENERAL FUN BUREAU OF RECEIPTS & CNTR M.D CUMBERLAND COUNTY GENERAL FUN -' APPRAISAL OF REAL PROPERTY LOCATED AT: 11 South Penn Street DR: 134/628; DR: 35N/271 Shippensburg, PA 17257 FOR: Client: Shoap Law Offices P.O. Box 532 Chambersburg, PA 17201 AS OF: 12/8/06 BY: Robert G. Ziobrowski Ziobrowski Appraisals 1 North Second Street Chambersburg, PA 17201 Form GA3 - "TOTAL for Windows" appraisal software by a la mode, inc. - 1-800-ALAMODE . . SUMMARY OF SALIENT FEATURES Subject Address 11 South Penn Street Legal Descrtption DR: 134/628; DR: 35N/271 City Shippensburg County Cumberland state PA Zip Code 17257 Census Tract 132 Map Reference 33-34-2415-099 & 102 Sale prtce Date of Sale $ Borrower I Client Lender Client: Shoap Law Offices Client: Shoap Law Offices Size (Square Feet) 1,009 prtce per Square Foot $ Location Suburban Age 75+/- Condition Average T ota! Rooms 5 Bedrooms 2 Baths Appraiser Date of Appraised Value Robert G. Ziobrowski 12/8/06 Rnal Estimate of Value $ 123,000 Form SSD - "TOTAL for Windows" appraisal software by a la mode, inc. - 1-800-ALAMODE Ziobrowski Appraisals m arm eSI enla Lppralsa epo File # 27003 The purpose of this summary appraisal report is to provide the lender/client with an accurate, and adequately supported, opinion of the market value of the subiect orooertv. Properly Address 11 South Penn Street C~ Shippensbura State PA Zip Code 17257 Borrower Client: Shoap Law Offices Owner of Public Record L Richard Shoap Estate Counly Cumberland Legal Description DR: 134/628' DR: 35N/271 Assessor's Parcel # 33-34-2415-099' 33-34-2415-102 Tax Year 2007 R.E. Taxes $ 1 445.00 Neighborhood Name N/A Map Reference 33-34-2415-099& 102 Census Tract 132 Occupant DOwner D Tenant ~ Vacant Special Assessments $ None D PUD HOA$ D per year D per month II Properly Rights Appraised ~ Fee Simple D Leasehold D Other (describe) Assignment Type D Purchase Transaction D Refinance Transaction ~ Other (describe) Estate Lender/Client Client: Shoao Law Offices Address P.O. Box 532, Chambersbura. PA 17201 Is the subject property curren1ly offered for sale or has it been offered for sale in the twelve months prior to the effective date of this appraisal? DYes ~ No Report data source(s) used, offering price(s), and date(s). MLS I D did ~ did not analyze the contract for sale for the subject purchase transaction. Explain the results of the analysis of the contract for sale or why the analysis was not performed. N/A I Contract Price $ Date of Contract Is the properly seller the owner of public record? DYes D No Data Source(s) Is there any financial assistance (loan charges, sale concessions, gift or downpayment assistance, etc.) to be paid by any party on behalf of the borrower? DYes D No · If Yes, report the total dollar amount and describe the items to be paid. N/A Nole: Race and !he racial composition of the neighborhood are not appraisal factors. ....... ,i. .' ,..... ."',' .Ii'...........k...,.. ,'..~.~I'~'t....".... Location D Urban 12<J Suburban D Rural Properly Values D Increasing 12<J Stable r l Declining PRICE AGE One-Unit 70% . Built-Up DOver 75% 12<J 25-75% D Under 25% DemandlSuoolv D Shortage ~ In Balance D Over Supply $ (000) (yrs) 2-4 Unit 2% . Growth D Rapid ~ Stable D Slow Marketing lime D Under 3 mths [Xl 3-6 mths DOver 6 mths 50 Low 0 Multi-Family 2% I Neighborhood Boundaries Shiooensbura Area School District comprised of Shippensbura Borouah and 750 High 200 Commercial 6% I the adiacent townshios. 170 Pred. 30 Other 20% Neighborhood Description Shipoensbura Area School District is located in the southwest portion of Cumberland County and the northeast portion of Franklin County. Neiahborhood employment opportunities, schools shopping, and recreational areas are amole and convenient. Shiooensbura University provides a stable economic base for the neiahborhood. Manv nelahborhood residents commute to urban areas via Interstate 81. This Market Conditions (InCluding suooort for the above conclusions) Market conditions in the subiect neiahborhood are typical of the reaion. Mortaaae funds are available at comoetitive rates from many sources. Dimensions See Additional Comments Area 0.07+0.04=0.11 Acres Shape Nearly rectangular View Averaae Specific Zoning Classification NC Zoning Descriotion Neiahborhood Commercial Zoning Compliance [XJ Legal D Legal Nonconforming (Grandfathered Use) D No Zoning D Illegal (describe) Is the hiahest and best use of subject orooertv as improved (or as oroposed oer olans and soecifications) the present use? ~Yes D No If No, describe Utilities Public Other (describe) Public Other (describe) Off-site Improvements - Type Public Private Electricity ~ D Water ~ D Street Asphalt 12<J D Gas ~ D Sanitary Sewer ~ D Allev Asohalt ~ D FEMA Special Flood Hazard Area DYes ~ No FEMA Rood Zone C FEMA Mao # 420368 0001 A FEMA Mao Date 3/15/1979 Are the utilities and off-site imorovements tvoical for the market area? ~Yes D No If No, describe Are there any adverse site conditions or external factors (easements, encroachments, environmental conditions, land uses, etc.)? DYes ~ No If Yes, describe The site is subiect to all typical utility and drainaae easements of record. There are no apparent adverse conditions affectina the subject I property. '.,. .... ,~ ........... ' ~ Units ~ One D One with Accessory Unit D Concrete Slab D Crawl Soace Foundation Walls Concrete 1 Ava Floors HW Cot Vin 1 Ava # of Stories 1 ~ Full Basement D Partial Basement Exterior Walls Wood Sidina 1 Ava Walls Plaster 1 Ava Type ~ Del D Att. [l S-Det./End Unit Basement Area 1 009 SQ.ft. Roof Surface Comp Shinale 1 Ava Trim/Rnish Wood I Ava 12<J Existing D Proposed D Under Const. Basement Rnish 0 % Gutters & Downspouts Aluminum I Ava Bath Floor Carpet 1 Ava Design (Style) 1 StOry ~ Outside Entry/Exit D Sump Pump Window Type Double Hung I Avg . Bath Wainscot Ceramic 1 Ava Year Built 1930 +1- Evidence of D Infestation Storm Sash/Insulated No I Yes 1 Ava Car Storage l J None Effective Age (Yrs) 20 D Darnoness D Settlement Screens Yes 1 Ava l Driveway # of Cars Attic I J None Heating l)<J FWA IL J HWBB IL I Radiant Amenities Woodstove(s) # Drivewav Surface D Drop Stair D Stairs D Other I Fuel Gas ~ Fireplace(s) # 1 Fence ~ Garage # of Cars 2* ~ Roor D Scuttle Cooling ~ Central Air Conditioning D Patio/Deck [g Porch D Carport # of Cars I [XJ Rnished D Heated D Individual I D Other D Pool Other ] Att. ~ Det. D Built-in I Appliances [Xl Refrigerator [Xl Range/Oven D Dishwasher D Disposal r l Microwave D Washer/Dryer D Other (describe) Finished area above grade contains: 5 Rooms 2 Bedrooms 1 Bath(s) 1009 Square Feet of Gross Living Area Above Grade . Additional features (special energy efficient items, etc.). I , Describe the condition of the orooertv (including needed reoairs, deterioration, renovations, remodeling, etc.). Accrued depreciation is typical for dwellinas of this effective aae. There are no aooarent reoairs needed. No functional or extemal deoreciation was observed. Are there any ohvsical deficiencies or adverse conditions that affect the Iivabilitv, soundness, or structural integrity of the orooertv? l Yes 12<J No If Yes, describe Does the orooertv generally conform to the neiahborhood (functional utility, style, condition, use, construction, etc.)? 12<J Yes [l No If No, describe U 'f R 'd t' I A IR rt Freddie Mac Form 70 March 2005 Page 1 of 6 Fannie Mae Form 1004 March 2005 Form 1004 - "TOTAL for Windows" appraisal software by a la mode, inc. -1-800-ALAMODE m arm eSI entia ~ppralsa epa File # 27003 There are 5 comparable properties currentlv offered for sale in the subject neiahborhood ranaina in once from $ 100 000 to $ 150,000 There are 4 comparable sales in the subiect neiahborhood within the past twelve months ranaina in sale once from $ 100 000 to $ 150 000 FEATURE SUBJECT COMPARABLE SALE # 1 COMPARABLE SALE # 2 COMPARABLE SALE # 3 Address 11 South Penn Street 131 Roxbury Road 108 Orange street 21 Wyrick Avenue Shiooensbura. PA 17257 Shiooensbura. PA 17257 Shiooensbura. PA 17257 Shiooensbura. PA 17257 Proximity to Subiect >i 0.45 miles 0.69 miles 0.78 miles Sale Price $ $ 133 000 ....ii.. 1$ 125 000 $ 109 900 Sale Price/Gross Liv. Area $ sa.ft. $ 138.25 sa.ft.! i' $ 117.48 sa.ft. $ 82.26 SQ.ft. ............ Data Source(s) Data Bank ML CB6133292 Data Bank ML CB6036835 Data Bank ML CB6118157 Verification Source(s) CH Records.Exterior Insoection CH Records Exterior Insoection CH Records Exterior Inspection VALUE ADJUSTMENTS DESCRIPTION DESCRIPTION +(-) $ Adiustment DESCRIPTION + (-) $ Adiustment DESCRIPTION + (-) $ Adjustment Sales or Financing Seller Subsidy -3,671 None None Concessions Date of Sale/Time '. 8/06 7/06 8/06 Location Suburban Suburban Suburban Suburban Leasehold/Fee Simole Fee Simole Fee Fee Fee Site 0.11 Acres 0.25 Acres -5 000 0.16 Acres -3 000 0.34 Acres -5 000 View Averaae Averaae Averaae Averaae Desian (Stv!e) 1 Storv 1 StorY 1 StorY 1.5 stOry Qualitv of Construction Averaae Averaae Averaae Averaae Actual Age 75+/- 55 -4 000 46 -6.000 58 -3 500 Condition Averaae Averaae Averaae Averaae Above Grade Total I Bdnns.lBaths TotallBdrms.1 Baths Total I Bdrms. Baths Total I Bdrrns.1 Baths Room Count 5 I 2 1 1 5 I 2 I 1 5 I 3 1.5 -2 000 6 I 3 I 1 Gross Livina Area 1 009 sa.ft. 962 sa.ft. +1,000 1 064 sa.ft. -1 000 1.336 sQ.ft. -6,500 Basement & Finished Full Full None +8,000 Full Rooms Below Grade Unfinished Part Finished -3 000 N/A Unfinished Functional Utilitv Averaae Averaae Averaae Averaae . HeatinaiCoolina FHA/CAC FHA I No CAC +2 000 BB I No CAC +2 000 FHA / No CAC +2 000 ~ Enerav Efficient Items None None None None : Garaae/Carpart 2 Car off site 2 Car Det Gar -2,000 None +8 000 None +8.000 . Porch/Patio/Deck Porch FP Deck FP +5,000 COy Deck +6 000 Porch Patio +5 500 . Finished Attic . . . . Net Adjustment IT otal) 0+ [gJ- $ 9671 [gJ+ 0- $ 12000 [gJ+ 0- $ 500 Adjusted Sale Price -. Net Adj. 7.3% Net Adj. 9.6% Net Adj. 0.5% of Comparables Gross Adi. 19.3 % $ 123 329 Gross Adj. 28.8 % $ 137000 Gross Adi. 27.8 % $ 110400 . I [gJ did lJ did not research the sale or transfer history of the subiect oroperty and comparable sales. If not, eXDlain My research 0 did [)<J did not reveal any prior sales or transfers of the subject property for the three years prior to the effective date of this aoDraiSal. Data Source(s) CH Records MLS My research 0 did I:XI did not reveal anv orior sales or transfers of the comparable sales for the year prior to the date of sale of the comoarable sale. Data Source (s) MLS Report the results of the research and analysis of the prior sale or transfer history of the subject orooertv and com arable sales (report additional orior sales on page 3). ITEM SUBJECT COMPARABLE SALE #1 COMPARABLE SALE #2 COMPARABLE SALE #3 Date of Prior SalelTransfer None in 3 years None in 12 Months None in 12 Months None in 12 Months Price of Prior SalelTransfer Data Source(s) CH Records MLS MLS MLS MLS Effective Date of Data Source(s) 1/07 1/07 1/07 1/07 Analysis of prior sale or transfer history of the subject orooertv and comparable sales None within the above referenced time frames. Summary of Sales Comparison Approach The subiect orooertv is comoatible to the neiahborhood. The comoarable sales are the closed sales most similar to the subiect prooertv. Indicated Value bY Sales Comoarison Aooroach $ 123 000 Indicated Value by: Sales Comparison Approach $ 123.000 Cost Approach (If develoPed) $ N/A Income ADDr08Ch Of developed) $ N/A The Sales Comoarison Aooroach is the most reliable indicator of value in this marketolace. . . This appraisal is made ~ "as is", D SUbject to completion per plans and specifications on the basis of a hypothetical condition that the improvements have been completed, D subject to the following repairs or alterations on the basis of a hypothetical condition that the repairs or alterations have been completed, or 0 subject to the . following required inspection based on the extraordinary assumQtion that the condition or deficiencv does not reauire alteration or reoair: The subiect orooertv owner died 12/8/06. I insoected the orooertv 1/11/07. I assume no chances in the condition of the orooertv occurred in the interim. · Baaed on a complete visual =tlon of the Interior and exterior areas of the 8U~t pro':1 defined SCOf'8 of work, statement of aaaumptlons and limiting conditions, and appraiser's cation, my (our) opinion of the market valua, as ned, of e real property that Is the subject of this report is $ 123 000 . as of 12/8/06 . which is the date of insoection and the effective date of this aDDI'lIiaal. U Of R "d o I A IR rt Freddie Mac Form 70 March 2005 Page 2 of 6 Fannie Mae Form 1 004 March 2005 Form 1004 - "TOTAL for Windows" appraisal software by a la mode, inc. -1-800-ALAMODE m orm eSI en la lppralsa epo File # 27003 Dimensions: Parcel 99 79' 21/4" x 40' 6 3/4" x 79' 31/2" x 41' 1/8" Parcel 102 32x50x32x50 The subiect is over 40 vears old but has been modernized as necessary and is marketable in its oresent condition. Its effective aae as noted is sianificantlv less than its actual aae. The subiect aaraae is located off site on a seoerate 0.04 acre Darcel. It is a 24 x 24 foot concrete block buildina located about 400 feet from the subiect. The lack of off-street oarkina ootential on the subiect site is somewhat offset bv the off-site aaraae. All comparable sales are settled transactions recorded in the countv deed records. Further verification sources include when available: multi-list services, court house records Realtors. sellers and buvers. Adiustments or lack of adiustments for site are based uoon estimated site contribution to value which are not necessarilv directlv related to site size. . . . . . .' i> ,..... . .,' - .'..' ........). . '. i Provide adequate information for the lender/client to reolicate the below cost f1aures and calculations. Support for the opinion of site value (summarv of comoarable land sales or other methods for estimatina site value) Lot sales in the subiect neiahborhood were researched and com oared to the subiect orooertv. ESTIMATED il REPRODUCTION OR il REPLACEMENT COST NEW OPINION OF SITE VALUE .......mm......m'm'mmm.." .. . -,-_...-..--.. ...m =$ . Source of cost data DWELLING Sll.Ft. @ $ =$ --<--------_. I Quality ratino from cost service Effective date of cost data Sa.Ft. @ $ =$ . _.uuu___._ . Comments on Cost Aooroach (aross Iivino area calculations, deoreciation, etc.) ------------- =$ The subiect imorovements are over 25 vears old. Due to changes in Garaoe/Caroort So.Ft. @ $ no____.__.__ =$ builders techniaues as well as a reliable basis for market extracted Total Estimate of Cost-New ..mmm" =$ depreciation the cost approach is not meaninaful as an indeoendent Less Phvsical I Functional I External approach to value' therefore a cost aooroach is not aoolicable. Depreciation I T =$( \ Depreciated Cost of Improvements _.._'n____________ m....mm...mm........ =$ "As-is" Value of Site Irnorovements hun "",,".........mmmu.. =$ Estimated Remainina Economic Life (HUD and VA onlv) Years INDICATED VALUE BY COST APPROACH ......m.................................. =$ , . ' .... ....~...:._(nOt . .,. '...... .... . Estimated Monthlv Market Rent $ N/A X Gross Rent Multiplier N/A =$ N/A Indicated Value by Income Aooroach Summary of Income Aporoach (includina suooort for market rent and GRM) Homes in this price ranae and neiahborhood are tvoicallv ourchased for use not income. Therefore the income aooroach lacks rationale, and is not aoolicable in this reoort. . '-;:- .............. , Is the developerlbuilder in control of the Homeowners' Association (HOA)? r l Yes il No Unit tvoe(s) r l Detached r l Attached Provide the followino information for PUDs ONLY if the develooerlbuilder is in control of the HOA and the subiect property is an attached dwellina unit. Leaal Name of Project T ota! number of phases T ota! number of units Total number of units sold Total number of units rented Total number of units for sale Data source(s) Was the oroiect created bv the conversion of existina buildina(s) into a PUD? il Yes l No If Yes, date of conversion. ~ Does the proiect contain any multi-dwellino units? r l Yes r l No Data Source Are the units, common elements, and recreation facilities complete? r l Yes r l No If No, describe the status of comoletion. . . Are the common elements leased to or bv the Homeowners' Association? r l Yes il No If Yes, describe the rental terms and options. Describe common elements and recreational facilities. U "f R "d f I A IR rt Freddie Mac Form 70 March 2005 Page 3 of 6 Fannie Mae Form 1 004 March 2005 Form 1004 - "TOTAL for Windows" appraisal software by a la mode, inc. - 1-800-ALAMODE Uniform Residential Appraisal Report File # 27003 This report form is designed to report an appraisal of a one-unit property or a one-unit property with an accessory unit; including a unit in a planned unit development (PUD). This report form is not designed to report an appraisal of a manufactured home or a unit in a condominium or cooperative project. This appraisal report is subject to the following scope of work, intended use, intended user, definition of market value, statement of assumptions and limiting conditions, and certifications. Modifications, additions, or deletions to the intended use, intended user, definition of market value, or assumptions and limiting conditions are not permitted. The appraiser may expand the scope of work to include any additional research or analysis necessary based on the complexity of this appraisal assignment. Modifications or deletions to the certifications are also not permitted. However, additional certifications that do not constitute material alterations to this appraisal report, such as those required by law or those related to the appraiser's continuing education or membership in an appraisal organization, are permitted. SCOPE OF WORK: The scope of work for this appraisal is defined by the complexity of this appraisal assignment and the reporting requirements of this appraisal report form, including the following definition of market value, statement of assumptions and limiting conditions, and certifications. The appraiser must, at a minimum: (1) perform a complete visual inspection of the interior and exterior areas of the subject property, (2) inspect the neighborhood, (3) inspect each of the comparable sales from at least the street, (4) research, verify, and analyze data from reliable public and/or private sources, and (5) report his or her analysis, opinions, and conclusions in this appraisal report. INTENDED USE: The intended use of this appraisal report is for the lender/client to evaluate the property that is the subject of this appraisal for a mortgage finance transaction. INTENDED USER: The intended user of this appraisal report is the lender/client. 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 or she considers his or her own best interest; (3) a reasonable time is allowed 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 com parables 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 area; these costs are readily identifiable since the 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 ASSUMPTIONS AND LIMITING CONDITIONS: The appraiser's certification in this report is subject to the following assumptions and limiting conditions: 1. The appraiser will not be responsible for matters of a legal nature that affect either the property being appraised or the title to it, except for information that he or she became aware of during the research involved in performing this appraisal. The appraiser assumes that the title is good and marketable and will not render any opinions about the title. 2. The appraiser has provided a sketch in this appraisal report to show the approximate dimensions of the improvements. The sketch is included only to assist the reader in visualizing the property and understanding the appraiser'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 this appraisal report whether any portion of 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 of the property in question, unless specific arrangements to do so have been made beforehand, or as otherwise required by law. 5. The appraiser has noted in this appraisal report any adverse conditions (such as needed repairs, deterioration, the presence of hazardous wastes, toxic substances, etc.) observed during the inspection of the subject property or that he or she became aware of during the research involved in performing the appraisal. Unless otherwise stated in this appraisal report, the appraiser has no knowledge of any hidden or unapparent physical deficiencies or adverse conditions of the property (such as, but not limited to, needed repairs, deterioration, the presence of hazardous wastes, toxic substances, adverse environmental conditions, etc.) that would make the property less valuable, and has assumed that there are no such conditions and makes no guarantees or warranties, express or implied. 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, this appraisal report must not be considered as an environmental assessment of the property. 6. 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 the completion, repairs, or alterations of the subject property will be performed in a professional manner. Freddie Mac Form 70 March 2005 Page 4 of 6 Fannie Mae Form 1004 March 2005 Form 1004 - "TOTAL for Windows" appraisal software by a la mode, inc. - 1-800-ALAMODE Uniform Residential Appraisal Report Rle # 27003 APPRAISER'S CERTIFICATION: The Appraiser certifies and agrees that: 1. I have, at a minimum, developed and reported this appraisal in accordance with the scope of work requirements stated in this appraisal report. 2. I performed a complete visual inspection of the interior and exterior areas of the subject property. I reported the condition of the improvements in factual, specific terms. I identified and reported the physical deficiencies that could affect the livability, soundness, or structural integrity of the property. 3. I performed this appraisal in accordance with the requirements of 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 at the time this appraisal report was prepared. 4. I developed my opinion of the market value of the real property that is the subject of this report based on the sales comparison approach to value. I have adequate comparable market data to develop a reliable sales comparison approach for this appraisal assignment. I further certify that I considered the cost and income approaches to value but did not develop them, unless otherwise indicated in this report. 5. I researched, verified, analyzed, and reported on any current agreement for sale for the subject property, any offering for sale of the subject property in the twelve months prior to the effective date of this appraisal, and the prior sales of the subject property for a minimum of three years prior to the effective date of this appraisal, unless otherwise indicated In this report. 6. I researched, verified, analyzed, and reported on the prior sales of the comparable sales for a minimum of one year prior to the date of sale of the comparable sale, unless otherwise indicated in this report. 7. I selected and used comparable sales that are locationally, physically, and functionally the most similar to the subject property. 8. I have not used comparable sales that were the result of combining a land sale with the contract purchase price of a home that has been built or will be built on the land. 9. I have reported adjustments to the comparable sales that reflect the market's reaction to the differences between the subject property and the comparable sales. 10. I verified, from a disinterested source, all information in this report that was provided by parties who have a financial interest in the sale or financing of the subject property. 11. I have knowledge and experience in appraising this type of property in this market area. 12. I am aware of, and have access to, the necessary and appropriate public and private data sources, such as multiple listing services, tax assessment records, public land records and other such data sources for the area in which the property is located. 13. I obtained the information, estimates, and opinions furnished by other parties and expressed in this appraisal report from reliable sources that I believe to be true and correct. 14. I have taken into consideration the factors that have an impact on value with respect to the subject neighborhood, subject property, and the proximity of the subject property to adverse influences in the development of my opinion of market value. I have noted in this appraisal report any adverse conditions (such as, but not limited to, needed repairs, deterioration, the presence of hazardous wastes, toxic substances, adverse environmental conditions, etc.) observed during the inspection of the subject property or that I became aware of during the research involved in performing this appraisal. I have considered these adverse conditions in my analysis of the property value, and have reported on the effect of the conditions on the value and marketability of the subject property. 15. I have not knowingly withheld any significant information from this appraisal report and, to the best of my knowledge, all statements and information in this appraisal report are true and correct. 16. I stated in this appraisal report my own personal, unbiased, and professional analysis, opinions, and conclusions, which are subject only to the assumptions and limiting conditions in this appraisal report. 17. I have no present or prospective interest in the property that is the subject of 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 opinion of market value in this appraisal report on the race, color, religion, sex, age, marital status, handicap, familial 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 or on any other basis prohibited by law. 18. My employment and/or compensation for performing this appraisal or any future or anticipated appraisals was not conditioned on any agreement or understanding, written or otherwise, that I would report (or present analysis supporting) a predetermined specific value, a predetermined minimum value, a range or direction in value, a value that favors the cause of any party, or the attainment of a specific result or occurrence of a specific subsequent event (such as approval of a pending mortgage loan application). 19. I personally prepared all conclusions and opinions about the real estate that were set forth in this appraisal report. If I relied on significant real property appraisal assistance from any individual or individuals in the performance of this appraisal or the preparation of this appraisal report, I have named such individual(s) and disclosed the specific tasks performed in 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 this appraisal report; therefore, any change made to this appraisal is unauthorized and I will take no responsibility for it. 20. I identified the lender/client in this appraisal report who is the individual, organization, or agent for the organization that ordered and will receive this appraisal report. Freddie Mac Form 70 March 2005 Page 5 of 6 Fannie Mae Form 1004 March 2005 Form 1004 - "TOTAL for Windows" appraisal software by a la mode, inc. - 1-800-ALAMODE Uniform Residential A raisal Re art File # 27003 21. The lender/client may disclose or distribute this appraisal report to: the borrower; another lender at the request of the borrower; the mortgagee or its successors and assigns; mortgage insurers; government sponsored enterprises; other secondary market participants; data collection or reporting services; professional appraisal organizations; any department, agency, or instrumentality of the United States; and any state, the District of Columbia, or other jurisdictions; without having to obtain the appraiser's or supervisory appraiser's (if applicable) consent. Such consent must be obtained before this appraisal report may be disclosed or distributed to any other party (including, but not limited to, the public through advertising, public relations, news, sales, or other media). 22. I am aware that any disclosure or distribution of this appraisal report by me or the lender/client may be subject to certain laws and regulations. Further, I am also subject to the provisions of the Uniform Standards of Professional Appraisal Practice that pertain to disclosure or distribution by me. 23. The borrower, another lender at the request of the borrower, the mortgagee or its successors and assigns, mortgage insurers, government sponsored enterprises, and other secondary market participants may rely on this appraisal report as part of any mortgage finance transaction that involves anyone or more of these parties. 24. If this appraisal report was transmitted as an "electronic record" containing my "electronic signature," as those terms are defined in applicable federal and/or state laws (excluding audio and video recordings), or a facsimile transmission of this appraisal report containing a copy or representation of my signature, the appraisal report shall be as effective, enforceable and valid as if a paper version of this appraisal report were delivered containing my original hand written signature. 25. Any intentional or negligent misrepresentation(s) contained in this appraisal report may result in civil liability and/or criminal penalties including, but not limited to, fine or imprisonment or both under the provisions of Title 18, United States Code, Section 1001, et seq., or similar state laws. SUPERVISORY APPRAISER'S CERTIFICATION: The Supervisory Appraiser certifies and agrees that: 1. I directly supervised the appraiser for this appraisal assignment, have read the appraisal report, and agree with the appraiser's analysis, opinions, statements, conclusions, and the appraiser's certification. 2. I accept full responsibility for the contents of this appraisal report including, but not limited to, the appraiser's analysis, opinions, statements, conclusions, and the appraiser's certification. 3. The appraiser identified in this appraisal report is either a sub-contractor or an employee of the supervisory appraiser (or the appraisal firm), is qualified to perform this appraisal, and is acceptable to perform this appraisal under the applicable state law. 4. This appraisal report complies 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 at the time this appraisal report was prepared. 5. If this appraisal report was transmitted as an "electronic record" containing my "electronic signature," as those terms are defined in applicable federal and/or state laws (excluding audio and video recordings), or a facsimile transmission of this appraisal report containing a copy or representation of my signature, the appraisal report shall be as effective, enforceable and valid as if a paper version of this appraisal report were delivered containing my original hand written signature. Signature Name Robert G. Ziobrows Company Name Ziobro ki Appraisals Company Address 1 North Second Street Chambersburg, PA 17201 Telephone Number 717-263-4620 Email Addresszio@mris.com Date of Signature and Report 2/14/07 Effective Date of Appraisal 12/8/06 State Certification # GA-000569-L or State License # or Other (describe) state # State PA Expiration Date of Certification or License 6/30/07 SUPERVISORY APPRAISER (ONLY IF REQUIRED) APPRAISER Signature Name Company Name Company Address Telephone Number Email Address Date of Signature State Certification # or State License # State Expiration Date of Certification or License SUBJECT PROPERTY ADDRESS OF PROPERTY APPRAISED 11 South Penn street Shippensburg, PA 17257 APPRAISED VALUE OF SUBJECT PROPERTY $ 123,000 LENDER/CLIENT Name Company Name Client: Shoap Law Offices Company Address P.O. Box 532, Chambersburg, PA 17201 D Did not inspect subject property D Did inspect exterior of subject property from street Date of Inspection D Did inspect interior and exterior of subject property Date of Inspection COMPARABLE SALES Email Address D Did not inspect exterior of comparable sales from street D Did inspect exterior of comparable sales from street Date of Inspection Freddie Mac Form 70 March 2005 Page 6 of 6 Fannie Mae Form 1004 March 2005 Form 1004 - "TOTAL lor Windows" appraisal software by a la mode, inc. - 1-800-ALAMODE SubJect Photos Cou Cumberland State P A Zi Code 17257 Subject Front 11 South Penn Street Subject Rear Subject Street Form PICPIX. TR - "TOTAL for Windows" appraisal software by a la mode, inc. -1-800-ALAMODE SubJect Photos Cou Cumberland State P A Zi Code 17257 Garage Front 11 South Penn Street Garage Rear / I ,I I Garage Street Fonn PICPIX. TR - "TOTAL for Windows" appraisal software by a la mode, inc. - 1-800-ALAMODE Comparable Photo Page Cou Cumberland State P A , - .. ....."".,--.. -tt_ Zi Code 17257 Comparable 1 131 Roxbury Road Comparable 2 108 Orange street Comparable 3 21 Wyrick Avenue Form PICPIX.BR - "TOTAL for Windows" appraisal software by a la mode, inc. -1-800-ALAMODE Comparable Sales Map Cou Cumberland State PA Zi Code 17257 ~#: ---- ..~ '. l.~ /i 'J II 'I Ii MapPOTnr \1\' n II II , , \ 'I . , ". -.~ ,- \ ~ ~~ of PIl1roVyMllll ...,,". ';/ >;:', .t#f<1' .... "\ ,>. ,<~t, ) ,\',,",},I 11 I! Shlpptnsbur.. To'M'\JNp II "-ok. ...,' I .'" , .. :>., ShiD '"- ,/ ',\1W~~" ~, " \' crt <:f .(/ ~;V. , '''':~ i'/ ,,-.:: ...~:,\ ,#v ., f,lb cP" \ ~. " ; ,i,'. ,(j.)1 (~\ :" , ./" /::> ~_:~;, J,f--$i> '4-: "'::~:/::. ~:>--~~, Ii \, I ,-- ~ " - --- .~ 4. -., ... " ", "'c:~ _ J\~~\ .~. r'-'" . ".' ',', : I,i,,', ....'., ", '- i, if_:.': \1; ,'. .r ,~ " ,l,., r' \':~\ , .:jll~i:~~::Ra-=' 'JJ' .....,.......... ---" . ..... . . ~' ~. ::t ;' (@i ..".., " . ,:<4.+ ,:\ '.~ ,. :"\.. ~ : .,)~~ :"~ <,?'". \'J;~~~; /X". '10 . .. ....;\',;;~;~. . , \ ViJ:ra- ' ". ~.\ yf' ~. ". '" 4- .,..... 'i}I' ~,~'." ,.~..j~~.I- .'~,~.~,~""""..........t" ~'ji . 'Yf; #' , '" " ~'~~ ~~\ ~:\ ,,:~"""\';~ ',...:,'!I<~ ,,,>>,," 'e, <11::, / ,.:.'~~''''''''':';~ ;.." '" ,( ',,\ ~~ . ) , " '. " oJl'::',:\. \:\ flS"C:~ /.. .......If ':~ .t ' /,op_ f : Spring.' if' !i \\ -;' (6.jji \ . ,..':,\\ .~. ,/., ::,~. ~9~ it'l! ". ~'.... 1/:: i::.":'lrc:~", "::~\,\::"'....," ...., IJ~~C\'\...... (t i i '\. '. :it,.f.'." ..../! \'>, ............ .... ~J;.. i. '. ,;Wi,' I "", ii' /1,// ,; ( . 1 ~1111'.H .11 d, ~.:-1 1 ,\ 1 ~.',) Ii I ~t II \; Pl.,t.! d'.V'IIIII''';l "', ". ,:'.'......."".~....I.i.,'.' "... . , :i ...... ~......i...it'+ ~, 'i 4 , i i lIprirlo .. .::.1::.::..... ,: c.net.ry i~'$j> .e} .,'1 .~. ',. .. t#"4. X . ...<'- "'~" . ~"'" " . .... " :. .~ '.'> ."'....'* ~~---,/ '.. hrl<" ~, ~ ~ J' \ " II 'I ',ts.'~ I''''''.,., ( ~ -1111 1.11 ,,111.- loa \" ,1IH!t. '11'....1 , II J. 'I 1I111 t' ~. ~ ''\ , ~ r 1Il:"/ "."t:'" 0,1 0.2 f;2007 MicttSOIC., Crloo6 MAVIEQ,WtdjOr'felt Ahs.lrIc. i'" .~.~ mil .,:,i . Scale Fonn MAP.Comp - "TOTAL for Windows" appraisal software by a la mode, inc. -1-800-ALAMODE s \L.- Building Sketch Coun Cumberland Y2.. 3'"'2... F\R~T 5')1. I 5 :::. 32)( 2.,-; s~ I Lt ': TOT f' L.:;~ State PA Zi Code 17257 LEVEL 7S gb~ 70 1)009 SF Form SKIBldSkl- "TOTAL for Windows" appraisal software by a la mode, inc. -1-00D-ALAMOOE IY. 5 13 Flood Map Cou Cumberland state P A e InterFIOod~._ www.lnterflood.com . 1-800-252-6633 Prepared for: Robert G. Ziobrowski 11 South Penn Street Shippensburg, PA 17257 ~/f \ , --lI; \_. . \. \. \ O~\ \ \~A\\ . \:s. \ \ \. \~ \, .\ \(\ '..:p ". \.1Il.,l .~'... .._\ \, \, \ ./ I , \':'0 \ \~ .\'S- \. '. \~ .,. \~ . RM2\ .. // )(. . , ZONE C t -:1.' ..' :-.:.I ---" \'" 01.-....... < i'r,-. . .' . . / . ,.- , " ~ / .l ,,- . ~ ~/ .{ ,J ." Y " ,/ 'I /0 /4t' i~ /~~ /+.ft; .-oJ. Zi Code 17257 Vl~ RM3 FLOODSCAPE M.p Number 4203680001 A Effedhle o.te MllIl'ch 15, 1979 For more infonn.ion about flood zones and flood ins\lnlnce. cont.at: PolHl'ed by Flood Souroe 877.77 .FLOOD __ .floodsource.com lillGllD-2007 Source Prose and/or FloodSource Corpor.Itions." rights ltierved. .......s 8.831.328 .nd 8.878.815. OtherP3hntS pending. For Info: info@ftoodsource.com. Form MAP. FLOOD - "TOTAL for Windows" appraisal software by a la mode, inc. -1-800-ALAMODE Legal Description Coo Cumberland State P A Zi Code 17257 BEOn..t"Ilt.t'ING I... -'- .. (.' .... . ".--~ .....::.:._~.....:\:r~.::-:j';~~m U'If J"I at an II 0.. ':"~'. ~.'" . _,'" ._,. ......... _ _ . ~ " _' . ~ '. ._ ,.; _....'\.,..." ..... . . .. ~,' .... .... ......... .,j' .... .r.; ~. s.~~'~ ....~nn ~treer: 8t. th . CC:7:::e~;j:' .!. "~l,;:-.;ee:-, (,4) foot wide alley; thence with said curb un: North nineteen (19) degrees West seventy-nine (79) feet, two <:::~ 0:>>- r.ourth (2..1/4) 'nc"'es "'0 .. I!"''l:'' po ~... "t......-o.--. "'."'-"'-''''9'''''ft' ~."'f' A......_ "':'-'f .~.. ...". II ,., ... ..- c;. ~~."...{w "., 101"'-"0-'" ................... .,.,y ...... ..--.,.J.,....f:oI.y.o.... .....1J;}e :<., A;;;i-:::::~t4::3;;, ::ow :;)c. Foose. NOl1h sbay-nine (69) degrees, forty (40) minutes, East fony (<10) feet, six and three-fourths (6...3/4) f~c.~.es ~~::' t!t..t.e 0" !;M,r<a !:'!.....f. t:". '-,0.'/' ....I":'r · ~.., .6'-' ...... . )._".._......., ............, t-I.. ! .Ji.a.l\ .. .......... 0..",:. .,0.. ....-. .'[... ..... .. ,-Jv'Ss.:.:,., ,J";W ,Hl;;,.,,,.-.-. ..,. ':>\,;o..6.1'1a..\., .. :::~~;~6e '.Ii:;, :,'.e iot of said Burkhart. South twenty (20) degrees, fony (40) minutes. east seventy-nine (79) feet, three and Ol'.e-~~:f (3- :/2) inches ~o r: ~::-:.:e ~ :::~~:;':~.: eo: ':::e :-o::.-:=:: ,: I;) ::"o~ wide aliey &i'o:esaic;; thence with tbe said alley South sixty-niM (69) dl::grees, forty (40) minutes, West forty..one (41) feet~ one-etg~~~ (!/8} ~.~ .;.~ :'~-::~ :~c .. , . . ... . .. .. ". , i 1/2 .....;~e ,-,,,,- .""'''IW "'''':'':) ....,. ':',^~ .,-'""'t". ~,..6"~'II""^'."'(~' 'tP"""J'~ ""'Ie..oeo"" erecte..... a ..... ...... J..,,~ ......... J.\<,.,.....-,,;;...;. -..I.,...~., .,....J..... .-.:....v.".:J. ~\\... \ U . _ ~ . '-' ~ ..." story frarne bungalow~ known as number J J Sou~h Penn Street. Fonn MAP. Legal- "TOTAL for Windows" appraisal software by a la mode, inc. - 1-800-ALAMODE ! Legal Description Cou Cumberland State P A Zi Code 17257 .ade and entered into tbi. an4 b.t",.n; tftU. DIID \!"- clQ of y- ~'-~-~ 1m ~ , ... ...... ......... filii......, ..._..".... IIKlY B. L. LUHRS, 01 Shippen.bU~~r eumb.~lan4 CoUftt7, pennstlvanla. he%einafter r.f.~r.4 to as "Craqto~~~ I Ind L.. RICII1UU) SROAP. of 11 South 'enn str..t. Shippen,burg, Cull'b.rland County, P.Dn.fl~.ft1. r herll'in..ft.er r.t.I'~.d to .. "Ol'antee": wrr19B1JSftH tbat the sud OrantoX', fen" and ill eou:ld.ration of the .u. of TWo ~bous.ftd t$2,OOO.OOJ Dollars to him in band ~.ld b~ C~ant.'t the reeeipt whereof h,'<<oe. b.~.bX ackh~1.<<9., by ~... ~'..ntl!l does gr.llt and eon..1' Uftt-o the ..:1.4 Grant.., in f.. 81111'1., ALL !BAt RlAt B~TB lyinv and being .1tuate in the Borough of Sb1ppentJburg, C'l.b.~18~4 County, remu;ylvll\ia 1I0ra p<<:rt!oularl,. boun4e4 and d..ar1~ed a. folio..: , L. . 8SGtIOf%NG .t an iron ~1D on the ...tern BeIOw.o! South Gettle Ayenue, upon whicb. it front,: thence bl' t.he Welllt_m e4ira of ..outh caettl. Avenue South ten (10) degra., no (\)) ainut.. no (OJ ..coneS. ...t l:ld.rty-two (32) f..t to 8ft i:ron pitH t1henee South ..ventrnln. (79) d.,~... ten (10) minute. DO (0) .econds W.at fifty (50) teet to an iZ'on >>in by th. Wortham edge of :hilu 1.1i.y: thane. North ten (101 degrees no CO) .1nut.. no (0) se~onds w..t tb!rty-~wa feet to aD lrOD piD at lend of '.a~l 8. Luhrs: thence .orth ..ventY-DSn.'(79~ deor... " . "~35 ~ 211 ...... Form MAP.Legal- "TOTAL for Windows" appraisal software by a la mode, inc. -1-800-ALAMODE . .. Legal Description Cou Cumberland State P A Ii Code 17257 ten (10) .inut.. 80 (OJ aeconds .Iaat fift, ($0) feat to .n iron pin, tbe plac. at BBGIHNlRG. Co~t.ining 1,600 sq~.r. f..t, p.r 8urv.y of Carl nt '&kt. R.$.. 4at.4 3anuary 14. 1992. llUJfC AND I'IftIDlDD 'ro .. " portion. of that r..l a.tate conveyed by two 11..46 of LAn.CI I.. W3LKR and SANDal L. KELK!R., hi. vif., the fir.t at _hiGh i. 48~e4 S.pt..b.~ a~, 1'67 and is rsC!oZ"d.d i4 CUU...lan.c:1 County De.cl look B2~ . t page 122 _n4 ~he ..aanrJ of .hiab i. dated Aagust 1i I 1975 and 1s r-eeorc1.4 at cuaberlaftd Count7 Deed'Book '26 at paGe 198 to RBNaT B. L. LUHRS, GU~ berein. rf BUMG ftB 8.UIB RIAL 1ft.... .bown. Oft .n IWI"O...d Sl1bdiV'1s102\ tl.n prepared by Ca~l D. Bert, R.S., dated aanuary 1., 1992.n4 reOorded in Cumberlan4 CO~ftt1 tlaD look 63 at page 138y '1'U AVOlaSA!1) alAL aTA"'" is aonv.yed \mcser a.n4 .ub:S.c~ too all ~..t~ictton.. cov.n.nts. an4 eas.ments of ~~oor~ .~d to .11 e.....At. apparent on ~b. ~eal estate and to ~h. fo11owiog restriatty. coyen.at Mhtch .~p11.. onl~ to tb. land bereby con~y.4 .nd to no other 1.nd. of Or.ntor: .0 .tructure ~r b. ereeCe4 OQ th. land hereby conveyed -blob shall be used for e~.rclal bu.inea. otber than the .'01:'80. of p.""onal p~op.rty.. . If any" .tt'ucture is . er-acte401l the 1.Dd herebr eoDV.Y.cI, .tor. draiui1IIcre shall be d1~.Qt.e4 otf the laniS h.X".~y I:Onvey.d OAto what 1s now knoWb .. So~th GWttle ~ve~~.. ~he.. r..triat1ofts shall e.pil:. cho\114 thie tx-act. COIl. unct.r aqUOb owaer.h:lp with aQ edjacent t~.Qt. . '. '-"r ~()35 rAGE 2'12 Form MAP.legal- "TOTAL for Windows" appraisal software by a la mode, inc. -1-800-ALAMODE r' s~mo"wtllUhor Pennsylvll!1\a Dtp..r~meD~9(St8'e ,. ....... 'S\Jreap ofPr&(ts!liona' ..Ii '6i:e~"ti6!lIlA.itat,." '. .." " . .,./.<t~rtifl"d Gen~,~"rii:<{ .<! Certificate Number . "Expiration Date GA000669L 08130/2007 '::':', .'.:"....-:., IssuedTof ". "'ee~fi~~'S~~s ~ctlye . . f,"" '';~:;>t~ "it'.. ,'~ >" :')~:11i ." ;,f<~t . .fitbelittTGEOROS,ZJ6BROWsKi 1NORTHSECONDST~ET !::I-lAMeI;RSBt.I~9 p~:tt~O'l.. c. . '. , ... - .... . - .. -. .. , . ROBERT GEORGE ZIOBROWSKI 1 NORTH SECOND STREET CHAMBERSBURG PA 17201 OFFICIAL DOCUMENT READ THE FOLLOWING INFORMATION CAREFULLY CONCERNING YOUR LICENSE: 1. SIGN THE WALLET CARD AND CERTIFICATE WHERE INDICATED. 2. DETACH THE WALlET CARD AND CERTIFICATE AT PERFORATION. . . I . 780 , C~~~~\~tia'~>";,:;>V~~'~8i~'1 Burea;~::=~~~:i::~~~~~;~;A;mHrs"i:"':"" J ".. -'- .. ,...... ",. .", --,-. ," ......,....,...'.. ,,','. ....,. ..c.... ...__.'.;'_......,. .. ...,.........:.. c..... pCerlifi~t~T~e.: " . '... ", '.", ,'. ,\;-,.' .::q~.d9.p_rat)Apprais.t . ....c......".... -..-.......: -......;.. ..:....... ROBERT GEORGE ZlOBROWSKI 1 NORTH SECOND STREET .~BER$!iJ~R(,; PA17~1 .,'....:-.... -'..'. ", ;-, 'Certifleate Number ~Ai9~~~;. {~j;'7)Jf/JiJL CommIssioner or-Professional and Occupational Affairs ,..\ _::'~;.:. Sl.ttfs :i~lthd .lz~rti~t,yn/Date ~2130/199~~ · .....i'~~i~!~~;t.l!!~i ......:-...,...-..........-':.. ','",,-,""',,: .....',.,...-.....-.:.:..,. "",-,' .::-:,:'-,-":"":'-"'," -':........ o$i3o/2oo1< ~a~; Fonn SeA - "TOTAL for Windows" appraisal software by a la mode, inc. - 1-800-ALAMODE } \, IJitS'I ~rlIIIL Al\iU T'ESTJ\I'-1El'JT OF LESLIE RICEliPD SI-~C"AP \i'! IL L I, LESLIE RICHARD SHOAP, of 11 South Penn street, Borough of Shippensburg, CQ~berland County, Pennsylvania, being of sound mind, memor'y and understanding do make and publish this my Last Will and Testament, hereby revoking and making void any ana all former wills by me at any time heretofore made. FIRST. I direct my hereinafter named Executor to pay all my just debts and funeral expenses, as soon as may be convenient after my decease. SEC01\1D. I give and bequeath to EACH. of the follo'VIring named beloved, the amount of FIFTY THOUSAND DOLLARS ($.50,000.00). Provided, however, that in the event that any of them should predecease me, then in that event, the amount given to THAT person shall remain as part of the estate to be distributed as described later. Ivjy nephew, KENNETH EmIDND SHOAP, my nephew RICHARD LEE SHOAP, my great niece, LINDSEY ELIZABETH SHOAP, and my great nephew MATTH~~ BRIAN SHOAP. THIRD. I give, devise and bequeath all my remaining property, real, personal and mixed, whatsoever and wheresoever situate, to my beloved brothers, JOHN KENNETH SHOAP and DONALD RAY SHOAP, share and share alike absolutely. Provided, however, that in the event that either of my brothers should predecease me, then in that event, I give said share to the survivor of them. FOURTH. I noninate, constitute and appoint my said brother, JOHN KENNETH SHOAP, as the Executor of this my Last Will and Testament; provided, however, that in the event my said brother, JOHN KENNETH SHOAP, should predecease me thenin that event I appoint my said brother, DONALD RAY SHOAP, as the Executor of this my Last Will and Testament. IN WITNESS WHEREOF, ~ve to this my Last Will ~€t my pand and seal this ~ ~~~:~~ "--- '-- .,; I, LESLIE RICHARD SHOAP, the a~Testament'{1onsisting of day of fJ7?I5t?R Testator, two /tage s, 19 '/-7- . ~:.; s.-'-) / -;;z::. /?!;:4~j .[l~ (SEAL) C'J ;:;:! ::2::__ (-) u:c ,';... . ti:;-; ,~,i=S~gned, sealed, publlshed and declared by the above-named ~aest~y, as and for his Last hTill and Testament in our presence, ~ho in(~is presence, at his request and in the presence of each other have hereunto set our hands as attesting witnesses. trJ)H 1tfull ~J 1 :: It{ >~/n1/11( ~ residing at 1?t ,,~dL// 5'4r' J:r . ;., / I residing at Page O:-ie .. ." ""'-'/7 /7 / I!fJ 1:Je, LESLIE,RICH.I\-RD S:-IOAP, (/1111/)(/tLt:f' } and ~ra ~/nln(,fL~ ' the testator and :he witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn do hereby declare to the undersigned authority that the testator signed and executed the instrument as his Last Will and that he had signed willingly (or directed another to sign for him), and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testator signed the will as ",ritnesses and to the best of' their knowledge, the testator was at that time eighteen years of age or older, of' sound mind and under no constraint or undue in- fluence. ,f K~ ~(cro-r Testator iJJk,~~1/ Irli tne s s ~ ~~/J7(m(~ Witness Subscribed, sworn to and acknowledged before me by the above-named testator and subscribed and sworn to before me by the 8bove~med witnesses this <f~ day of .':hhW , 19~ ~9~~ Notary blic Notarial Saet OIMa J. Zinn, Notary pubnc Shlppensburg Bore, Cumberland Countv My Commission Expires May 22, 1 egg .. IIiIIta; PIilmsyIIIanle.As8c:d!JIlon of NcBIIII A TRUE COpy FROM RECORD In Testimony wherof, I hereunto set my hand and the seal of said Court at Carlisle, PA ..-tf\ 7 ThisEday 0 20~ Page Two Clerk of the hens Court Cumberland County TJ10S")~0S" R~V '/0~ This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. No. ~~q4. - Fee for this certificate. $6.00 p 12996481 ~-.~ 7$b. Date H105.1.3 Rev. 0111)6 TYPEmIIIIT IN PERMANENT BLACK INK 1. NlfT1lII 01 Decedtrd (Fist. middle. Ies') COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH STATEFILENUMBER L. RICHARD 5. Ago(~"_1l 86 VI<. ;. ~. County 01 Dealh 7. Do1eo/llirlh ..... 1920 Cumberland West Pennsbaro 11. Dtaden1', U..I liMl Kind 01 work doI'lt mDIl of I,. do not .. rUed KildolWotk Kindo/lIuIlneuIlnd...... Rural mail carrier u.s. Post Offi e 1.. ~nr,MaInO__ ISl'....clyOOML ..~. '" codal 12. o 00... 10. Race:.American 1ndiIn. Black, Whh, .le. 1- White ". "'rIolSlalus:Marriod.__, 15. SlMtilgSpouH(K""',..............1 _.0Mln:0d(_ 171.5aIt, Pennsylvania Oil Docoda" lWei:l1 TOWl'IIhJp? 1?c.D Vu,OIl:edIttUvtdin . _ Twp. 17d. m: :"~olum'fi Shippensburg QyIIlo<o St. PA 17257 17b. CaunIy Cumberland 19. Mo/Iltl'sNlrneIFnt._._on_1 Leslie D. Shoa 200. 1nIonnI".'.... (Type.\lrinl) Hazel Diller 201>. -.....-......9_ (Slr....~...~."'coda) o w en ~ ~ :" ~ 1047 Roxbur Rd. sb 21c. AlctofDapadion (NImIofc:tmI&Iry,crtmlIoryClfaUlll pIacI) PA ... CAUSE OF DEAT1tc'" _......_) 118m 27. Perl I: ENIIht~ -....u.lnPies. or COft1JIicaIionI-lbll dHcIy CIUIfd!hl duIh, 00 NOT anIIr ""'*-' IVtfds a&d1 IS cardiIc anal. ,ospilaIoIy....... _'''ilalion _"""""''''' Ili%gy. DO NOT Ibb,_. _,.-..._. "'..... =~~=.~'. ~.J;;-~ ~....~ C4 OUt to (OIlS I conllqUlllC8 ot): DulIoIOl"I~ol): '1.Jv c. -0 P t:J Gp. L ~ 2B. DidTobIc::co U..CoIVbult 10 OeIlh? g~:,~ 29, K_: o NoI,II'OI'''' _ pu1 jII' o PregnaAl., lima oldealh o Notpregnlnt, bulpr-c,NnI wIhil.2 days 01_ o NoIp1_.bu1p_'3dayo101yu. ......dealh o UnkncMn ~ prtgRInI wlhil1he put yell 32c. PIIcIolll1urY:Home.flrm,Street,FICtOIy,Office BuIdilg.....I_ Appronr.lfI inlemil: Part U: EnItf oIher lianilcanl candiIIJn& coNrbdinu to dulh, onseItodMth bulnotl'JllllilOil1hloodlrtti'laca...""", in Part 1. Sequonlidy iII_. B .ny, Inding 10 lhe ClUH IIIId on LiM: .. EnIe,1he UHDERL Y1NG CAUSE . ~orinjMy"llnIiIIIdlht evenIIllIlJIilgindeldl)LAST. b. Dtllto(orUllXInIIqUInCIOI): 301. W.. an Autopsy _mod? d. 3llb. WIf. _. Fildings _Prio!k>~ 0/ CeuH 0/ Doolh7 DYesONo 31. MannIl: IUIII D_ O_ 321. Do~ "1niUrY _. day. ,"'1 ' 321>. D""'''' bow """ 00:_: o V.. D_ O Ptndiog-"" o CoUd Nol Be DIIonrinod 32d. TiN at Injury 329. LocI,.,. (51..... cBy_, ..~) ... !z w o w U w o u. o w ::0 .. z 331. ClH1lfier_onlJOflI) CerIffIlnIIphyIlclon~CIIIIying"....'''''h__,phyIitIon,,",__''''_IlIIm23) To lilt bell of Iff{ knewledge,..... oc:cwnd dUe to U. caUN(.).......r II Slated _.... -*Y1no phyIlclon (P1lyoan boIh__ ....OIlIIylngk>"...ol....hl To tM" 01 my knDwtIdga, deIlh occunw:I at lht Ume,.... and pIac:a.. dUe to the ~.).nd manner II ItItId _,_ On the... of exaanuon andIor InvedpUon. tn my opinion, 35. Regiatrar" SV-U8 and DiA'k* Hwm. (See Instructions and examples on reverse)