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HomeMy WebLinkAbout10-12-07 ~~ 1, , *' REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFF1Cl:~-L USE ON".V REV .1500 EX + (f.O!', COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT,280601 HARRISBURG, PA 17128-0601 FILE NUMBER 21 2006 COUNTY CODE YEAR SOCIAL SECURITY NUMBER 00268 NUMBER DECEDENT'S NAME (LAST. FIRST. AND MIDDLE INITIAL) MILLER, JEAN LOUISE 186-14-1912 I- Z W o w <.> w o DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE 02/28/2006 02/26/1923 REGISTER OF WILLS SOCIAL SECURITY NUMBER 1, Original Return o 2. Supplemental Return o o o 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach copy of Trust) 10. Spousal Poverty Credit (date of death between 1 -3 I o 3. Remainder Return (date of death prior to 12-13-82) o 1 5, Federal Estate Tax Return Required (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) W I- \l:$Ul <.>1I:\l: wo..<.> ::cOO <.>II:...l 0..10 0.. <( 4. Limited Estate 6. Decedent Died Testate (Attach copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes o 11 . Election to tax under Sec. 9113(A) (Attach Sch 0) AME .;, !z Lisa Marie Coyne ~ ~ IRM NAME (If applicable) 8~ I Coyne & Coyne, P.c. ELEPHONE NUMBER 717/737-0464 z o ;:: :5 => l- ii: <( <.> w II: 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 3901 Market Street Camp Hill, PA 17011-4227 (1 ) 139,000.00 (2) 29,054.02 (3) None' (4) None (5) 254,146.13 (6) 3,940.71 (7) 62,926.19 (9) 37,091.17 (10) 4,033.32 OFFICIAL USE 9N~ y 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) (--} 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) r '.:' r.-:C:r C-) '. (8) 489,067.05 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) (11 ) 12. Net Value of Estate (Line 8 minus Line 11) (12) 41,124.49 447,942.56 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (13) (14) 447,942.56 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) z 447,942.56 .045 (16) 0 16.Amount of Line 14 taxable at lineal rate x ;:: :!: => 0.. 17.Amount of Line 14 taxable at sibling rate x .12 (17) :;; 0 <.> g 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) 20,157.42 20,157.42 20. ~ CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) CtJ /. Decedent's Complete Address: STREET ADDRESS 140 Wesley Drive CITY Mechanicsburg STATE PA ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 20,157.42 22,000.00 1,007.87 Total Credits (A + B + C) (2) 23,007.87 3. Interest/Penalty if applicable D. Interest E. Penalty 0.00 2,850.45 Total Interest/Penalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is thEDVERPAYMENT. (4) Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is theBAlANCE DUE. (58) 0.00 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X"IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;............................................................................. 0 ~ b. retain the right to designate who shall use the property transferred or its income;................................ 0 ~ c. retain a reversionary interest; or............................................................................................................ 0 ~ d. receive the promise for life of either payments, benefits or care?........................................................... 0 ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.................... ........ ............................... n............................ n..................... 0 ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... 0 ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?.............................__............................--.................................................. ~ 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FilE IT AS PART OF THE RETURN. Under penalties of pe~ury, I declare that I have examined this retum, including accompanying scheduies and statements. and to the best of my knowledge and belief, it is true, correct and complete. Declaration preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS ae e L. Miller 140 Wesley Drive Mechanicsburg, P A 17055 DATE 8NlOb ADDRESS DATE 495 East Elmwood Avenue Mechanicsbur , PA 17055 ,"- '6 ADDRESS 3901 Market Street Camp Hill, PA 17011-4227 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. 99116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (Ii)]. The statutedoes not exemDta transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural L'earent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 99116 (a) (1.2)]. ~e rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 99116 1 P.S. 99116 (a) (1)]. ~ ~a:<Jrate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 99116 (a) (1.3)]. A sibling is defined, y'S:) nd~ection 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. ~ ~v......^' ~4~~ ....SCHEDULE A REAL ESTATE -" ~_._._-------~-~_.~---~--~--~----~-~- COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATEO-F~-MILLE~~;;~N LOUISE I FILE NUMBER ----------- ____________ ___ I 21 - 2006 - 00268 ____ Ail real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. -_.~ ITEM NUMBER 1 DESCRIPTION VALUE AT DATE OF DEATH 139,000.00 140 Wesley Drive, Mechanicsburg, Cumberland County, Pennsylvania (See Attached Appraisal) TOTAL (Also enter on Line 1, Recapitulation) 139,000.00 WOOF APPRAISAL GROUP .... File No. PVTS'::-51 APPRAISAL OF A SINGLE FAMILY RESIDENTIAL HOME LOCATED AT: 140 WESLEY DRIVE MECHANICSBURG, PA 17055 FOR: COYNE & COYNE P.C. 3901 MARKET STREET CAMP HILL, PA 17011 BORROWER: ASOF: APRIL 7, 2006 BY: REYNOLD R WOOF, JR. IFAS PA CERTIFIED GENERAL REAL ESTATEAPPRAlSER .... WOOF APPRAISAL GROUP File No PVTB061 i ; : : APRIL 7, 2006 , ! LISA COYNE COYNE & COYNE P.C. 3901 MARKET STREET CAMP HILL, PA 17011 File Number: PVTB061 , DEAR MS. COYNE, In accordance with your request, I have personally inspected and appraised the real property at: 140 WESLEY DRIVE MECHANICSBURG, PA 17055 The purpose of this appraisal is to estimate the market value of the subject property, as improved. The property rights appraised are the fee simple interest in the site and improvements. In my opinion, the estimated market value of the property as of APRIL 7,2006 is: : $139,000 ONE HUNDRED THIRTY-NINE THOUSAND DOLLARS The attached report contains the description, analysis and supportive data for the conclusions, final estimate of value, descriptive photographs, limiting conditions and appropriate certifications. , i SINCERELY; : ~~~ REYNOLD R. WOOF, JR. IFAS PA CERTIFIED GENERAL REAL ESTATE APPRAISER WOOF APPRAISAL GROUP The purpose of this summary appraisal report is to provide the lender/client with an accurate. and adequately supponed, opinion of the market value of the subject property Pro"""" Address 140 WESLEY DRIVE City MECHANICSBURG State PA Zio Code 17055 Borrower Owner of Public Record MILLER JEAN L. County CUMBERLAND Leoal Descrintion DEED BOOK 22Y, PAGE 563 Assessors Parcel' 13-24-0793-100 Tax Year 2005/2006 R.E. Taxes $ 1 854.66 Neiohborhood Name WINDSOR PARK Mao Reference N/A Census Tract 3240-111 Oo::ulanl f lOwner ilTenant f lvacant Soecial Assessments $ NONE I \PUD HOA $ N/A I 1 oer year I l 0" men" Prooertv Riohts Aooraised xl Fee Simole I l Leasehold I 1 Other (descnbe) Assionment Tvee I lPurchase Transaction IlRefinance Transaction IX10ther fdescnbel MARKET VALUE Lender/Client COYNE & COYNE P.C. Address 3901 MARKET STREET, CAMP HILL PA 17011 Is the subiect DfOP~ currentlv offered for sale 0( has it beef1 offered for sale in the twelve months rior to the effective date of this aporaisal? I I Yes I X I No Repon data source(s) used, offering price(s). and daters). MULTI-LIST VERIFIED. I Udid U 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 nol performed. N/A Contract Price S Date of Contract Is the nropertv seller the owner of nlblic record' I Yes I INo 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? UYes UNo If Yes. report the total dollar amount and describe the items to be paid. $ Note: Race and the racial comoosition of the neiohborhood are not aooraisal factors. Location I I Urban X Suburban Rural I Pronenv Values T X llncreasinn I I Stable Declinino PRICE AGE One-Unit 100 % . Built.Un IXIOver75% 25.75% Under 25% I Demand/SuoplY -r lShortaoe I X Iln Balance Over SunnlY $fooo) (vrs) 2-4 Unit % . Growth I I Rapid X Stable Sklw I Marketinn Time [X I Under 3 mths [ 13.6 mths Over 6 mths 115 Low Multi.F amilv % . Neighborhood Boundaries THE NEIGHBORHOOD BOUNDARIES CONSIST OF HOMES IN THE AREA 195 Hiah Commercial % . COMMONLY KNOWN AS WINDSOR PARK. LOCATED IN LOWER ALLEN TOWNSHIP. 140 Pre<!. Other % Neighborhood Descnption THE SUBJECT PROPERTY IS LOCATED IN AN ESTABLISHED RESIDENTIAL NEIGHBORHOOD COMPRISED PREDOMINANTLY OF SINGLE FAMILY HOUSES. COMMERCIAL USES LOCATED AROUND THE SUBJECTS' NEIGHBORHOOD, DO NOT HAVE AN ADVERSE EFFECT ON MARKETABILITY. EASY ACCESS TO EMPLOYMENT CENTERS SCHOOLS SHOPPING, AND TRANSPORTATION. Market Conditions (including support for the aboye conclusions) AREA REAL ESTATE MARKET IS CONSIDERED TO BE MODERA TEL Y ACTIVE. LOAN DISCOUNTS, INTEREST BUYDOWNS, AND OTHER CONCESSIONS ARE NOT TYPICAL IN THIS MARKET.CONVENTIONAL FINANCING IS READILY AVAILABLE. Dimensions 94.02 X 121.87 X 92.96 X 120.78 Area 0.26 ACRES Shaoe IRREGULAR View BUSY STREET Soeclfic Zonina Class1f1catlon R-1 Zonino Desenotion RESIDENTIAL Zonino Comoliance I X I Leoal I I Leoal Nonconformino (Grandfathered Use) r l No Zonina f lllleaal fdescribe) Is the highest and best use of the subject property as improved (or as proposed per plans and specifications) the present use? lXJYes DNo If No. descnbe. Utilities Public Other (describe) Public Other (describe) Off-site lmDrovements-T~ Public Private Eiectric1lv IXI I I Water Ixl l Street MACADAM Txl n Gas I I I I Sanitarv Sewer Ixl l AIIev NONE il rl FEMA Soeclal Flood Hazard Area I I Yes 1 xl No FEMA Flood Zone C FEMA Mao # 421016B H&I-01 FEMA Mao Date 09/30/1977 Are lhe utilities and off-site imnrovements tvnical for rhe market area? fXlyes I INO If No, describe. Are there any adverse sire conditions or external factors (easements. encroachments. environmental conditions. land uses. etc.)? lXJves UNO If Yes, describe. THE SITE IS LOCATED ON A BUSY STREET WITH HI-TENSION POWER LINES EASEMENT IN THE FRONT YARD. THE MARKET INDICATES THAT THESE ADVERSE CONDITIONS HAVE A MINIMAL IMPACT ON VALUE AND MARKETABILITY. i"J'';:!'. OOERIOR1'lESCRII'TION.. n;~i~riatS/l:Oiidition:' '11'I'IEIli6tl! inaieii.lskOOditioi1 Units IXlone I lOne with AccessM! Unl I Concrete Slab I Icrawl Space Foundation Walls CONC. BLK/AVE Floors HDWD&CPT/AVE # of Stories 1 I Full Basemem r xl Partial Basement Exterior Walls BRK & VINYUAB AVE Walls DRYWALUAB. AVE. Tvoe IXloet. I IAn. I IS.DetJEnd Unlf Basement Area 1176 sO.tt. Roof Surface FIBERGL.SH.lGOOD Trim/Finish PINE/AVERAGE Xl Exlsti"" I 1 Proposed I 1 Under Const. Basement Finish 0% Gutters & Downsoouts ALUMINUM/AVE Bath Floor VINYL TILE/AVE DeslOn (Stvle) RANCH 1 Outside En'N/Exrt I I Sumo Pumo Window Tvoe VINYL D.H.lGOOD Bath Wainscot CERAMI CIA VE. Year Builf 1959 Evidence of IT llnlestation Storm Sash/Insulated INSULATED Car Storaae I l None Effective Ace (Yrs) 15 Y 1 Damoness I Y l Settlement Screens YES X IDnvewav , of Cars 2 Attic None Heatirol IFWA IfXlHWBB II IRadiant Amenities WoodStov;r~\ , Drivewav Suface MACADAM l Droo SlaW Stairs lOther I Fuel OIL l Fireolacels} , Fence I Garaoe # of Cars 1 Floor X Scuttle Coolino I I Central Air CondiliOnino l Palio/Deck Porch ICaroort , of Cars l Finished Heated llnolVidual JrXlOther1 WALL lPool Other IAn. I IDet TTSuilt.in Aooliances f 1 Refnaerator I X I Ra~oeI0ven XlDishwasher f lDisoosal IXIMicrowave il-washerlDrver I I Other Idesenbe) Finished area above made contains: 7 Rooms 3 Bedrooms 1.5 Bath(sl 1 581 SQUare Feet 01 Gross Livina Area Above Grade Additional feattxes (special energy efficient Items, etc.). REPLACEMENT THERMOPANE WINDOWS AND UPDATED FURNACE. Describe the condition of the property Orduding needed repairs. deterioration. renovations. remodeling. etc.). REMODELED KITCHEN CIRCA 1990. A FAMILY ROOM ADDITION WAS ADDED IN 1991. THE APPRAISED PROPERTY IS IN ABOVE AVERAGE CONDITION FOR ITS AGE AND HAS BEEN WELL MAINTAINED. NO FUNCTIONAL INADEQUACIES NOTED. EXTERNAL OBSOLESCENCE DUE TO THE BUSY STREET LOCATION. Ale there any physical defidencles or adverse conditions that affect the livability, soundness, or struet",,1 integnty of the propeny? 0 Yes lXJ No If Yes, desaibe. HOW EVER, THE BASEMENT WALLS WERE TREATED FOR INFESTATION. THE SOUTHERN BASEMENT WALL HAS SETTLEMENT CRACKS THAT REQUIRED THE BRICK TO BE REPAIRED ON THE SOUTHEAST CORNER OF THE HOME. POOR ROOF WATER DRAINAGE IS CAUSING A DAMP BASEMENT. Does the property generally conform to the neighbor11ood (functional utility, style, condition. use, construction, etc.)? lXJ Yes U No If No, describe. HOWEVER, THE 405 SQUARE FOOT FAMILY ROOM ADDITION IS AN ITEM NOT TYP I CALL Y FOUND IN THIS DEVELOPMENT. . Uniform Residential Appraisal Report File No. PVT8061 " FredcIiIe M8c Form 10 Martn zoos Pmauald\lSll'l9/1l:J~. ilIO.2J4.8721_,-=~-COIII Page 1 ct6 F... MIMI FiW11004 March 2005 ,,*_osonoos WOOF APPRAISAL GROUP There ar:: 4 comoarable prooerties currently o~ered for saie:n me suo"eet neiGhborhood ranaina in orice from S 139,900 to I 189,900 There are 6 comparable sales in the subiect neiohborhood wtt.,in the Dast twelve months ranaino in sale mice from S 115,000 to I 154.000 F=...:"TUR.E I SUBJECT I CC\4?ARABLE SALE NO.1 I COMPARABLE SALE NO.2 COM?ARA8L:: SA:"':: NO.3 140 WeSLEY DRIVE 128 WESLEY DRIVE 15209 ROYAL DRIVE 5210 ROYAL DRIVE Address MeCHANICSBURG MECHANICSBURG MECHANICSBURG MECHANICSBURG Proximirv ::J Subiect 0.09 MILES 10.11 MILES 0.11 MILES Sale PC"" I ',';<:-1 I 130,000 s 137000 11 125,000 Sai!Pr=""..r= Liv.l'le:iJ =- I 110.54 SQ. ftl<':;->>,hi';/;,b s 128.52 sn. ft S 108.89 so. ftl'., ,-,,,V;';;-; './ Data S=ce(s) R.E.D.S. MULTI-LIST SERVICE MULTI-LIST SERVICE Veriflcatoo Sou'ce(s) COUNTY DATABANK COUNTY DATABANK COUNTY DATABANK VALUE AIlJUSTMENTS DESCRIPTION DESC~IPTION +(.)SAcfustme11t DESCRIPTION +(-)SAdiu$Ul'letl DESCRIPTION I ...(-] SAdiusunent Sale or Fr.ancing COtNENTIONAL CONVENTIONAL CONV W/I-lELP 1 -3,410 Concess.ens UNK DOM 1 DOM 82 DOM Date 01 SaielTime 06/2412005 10/27/2005 07/29/2005 I Location SUBURBAN SUBURBAN SUBURBAN SUBURBAN I Leaseroo'Fee Simple FEE SIMPLE FEE SIMPLE FEE SIMPLE FEE SIMPLE I Site 0.26 ACRES 0.20 ACRES 0.19 ACRES 0.19 ACRES I V",W BUSY STREET BUSY S I REET TYPICAL -2000 TYPICAL I -2,000 Desion (S."Vie) RANCH RANCH RANCH RANCH I Quality eX Construction AVERAGE AVERAGE AVERAGE AVERAGE ! Actual Me 47 45 45 45 i Condition ABOVE AVE. ABOVE AVE. ABOVE AVE. AVERAGE I +6 000 Above Glade T....I""""I Bot'" 1r....1-J tlalhs T"'" ItldnMJ tlalhs T....I...",J tlalhs I Room C:xJnt 7 I 3 I 1.5 6 I 3 I 1.5 6 I 3 I 1 +1 000 6 I 3 I 1.5 I Gross L;.....,Area20.00 1 581 so. ft 1.176 so.h. +8,100 1,066 sn. ft +10,300 1 148 so. ftl +8 660 Baseme'l" & Flnished PART BASEMENT fULL BASEMENT FULL BASEMENT FULL BAS"MENT 1 Rooms Set:lw Grade UNFINISHED UNFINISHED REC RM & DEN -4 000 UNFINISHED Functional Utilitv AVERAGE AVERAGE AVERAGE AVERAGE I Heat;ncI"'.....ooiinQ HWBB/1 WALL HWBBINONE +500 HWBB/CA -1,500 HWBB/CA I -1500 . Enernv ~oent Items THERMOPANES I NONE +3 000 THERMOPANES NONE ! +3 000 GaraoetCaroort 2 CAR OFF ST I CARPORT -2,000 CARPORT -2.000 CARPOR I I -2,000 PorcrJPaJo/DO!c, STOOP I STOOP & SHED -500 I STOOP STOOP & SHED i -500 . FIRE?'...ACE NO FIREPLACE I NO FIREPLACE NO FIREPLACE NO FIREPLACE i I T I I . Net Adicstment (Total) I IXI- I I. II 9,100 Ixl+ I I- Is 1,800 Ixl+ I I. Is 8.250 Adjustec Sa.. Price NetAdj. 7.0~ls I Net Adj 1.30/: I ' NetAdj 6.6%1 of CO!'1'1:iiaraoies Gross A<i 10.8% s 139.100 Gross"'. 15.2% s 138.800 Gross Mi. 21.7% s 133 250 I l!0::id U did not research the sale or transfer hlstory ri t1e S".Jbject property and comparable sales. If not explain MY rese2l'd1 II did r X I did not reveal anu orior saleS or rrans:ers of the sub;ect nronenu for the three vears onor to the effective date 01 this aooralSal. Data scuce{S) COUNTY DATA BASE. Mv reseam r 1 did fx 1 did not reveal. anv onor saies Of Inns;ers of the comoarable sales for the vear Of:Of to the date of sale of the comoarable sale. Data scuce{s) COUNTY DATA BASE. Reoort ~ results of the research and analvsis of the Dnor sa:e ~ transfer historv of the subject Ofooertv and camoarable sales (reoort additional Drior sales on oaae 31- ITEM SUBJECT COMPARABLE SALE NO.1 I COMPARABLE SALE NO.2 COMPARABLE SALE NO, 3 Date at Pr'a Sale/Transfer N/A N/A N/A N/A Price ct ?nor SaleJTransfer Data 500Jre(sl COUNTY DATA BANK COUNTY DATA BANK COUNTY DATA BANK COUNTY DATA BANK EffectM! Date 01 Data Sourcefs) NO DATE INDICATED NO DATE INDICATED NO DATE INDICATED NO DATE INDICATED Anal)'S6 :>f poor sale or transfer history of the subject property and comparable sales THERE HAS BEEN NO TRANSFERS OF THE SUBJECT IN THE LAST THRE YEARS. s~ ri Sales Comparison Approach. MARKET DATA OF CLOSED SALES WAS SUFFICIENT TO ARRIVE AT AN OPINION OF VALUE. CONDITION ADJUSTMENTS BASED ON MUL Tl-L1ST DESCRIPTIONS OF UPGRADES ON COMPARABLE SALES. ALL SALES WERE CLOSED AND CONSIDERED EQUALLY WHEN ARRIVING AT MARKET VALUE. Indic3lI!d VUle bv Sales Comoarison Aoomach S 139,000 Indicaled Value by, Sales Comoarison Aooroach S 139 000 Cost Anoroach nf _'''''''''' S 139 400 Income APproach Of devetnnorll S NI A ALL THREE APPROACHES TO VALUE WERE CONSIDERED. HOWEVER MARKET AREA LACKS AN ADEQUATE NUMBER OF RENTAL.. SALES TO USE THE INCOME APPROACH. MOST WEIGHT WAS PLACED ON THE MARKET DATA APPROACH DUE TO THE AGE OF THE SUBJECT. This 3p!DisaI is made [xJ"as is," U subject to compleliPn per plans and specifrcations on the basis of a hypothetical condition that the improvements have been canpIeIed. o Slqect to the following repais or a.erations on the basis of a hypothetical condition that the repais pr alterations haY<! been completed. Of 0 sul1iect to the foIowing required . inspeclia1 based on the extraordinary assumption that the condilion a deficiency does not requn alteration or repair: APPRAISED "AS-IS". Based on a complete visual inspection of the interior and exterior areas of the subject property. defined scope of work. statement of assumptions and limiting conditions. and appraiser's certification. my (our) opinion of the market value. as defined. of the real property that is the subject of this report is S 139,000 as at 04/07/2006 . whid"l is the dale of insnection and the effective date of this aODraisal. - Urnform Residential Appraisal Report File No. PVT8061 FftOjie!Me,...1O MImI 2005 F'roduaIll usng ACl $Ill'IWIft. 800.2)4.1nl _.KlWI!lb.anl P1lgeZat6 Woof Appraisal Group F...e"" ~orm lOCM MarCh 200S lOOUIS033Oll!i WOOF APPRAISAL GROUP . '- . . ~ ''',. , > . . .,\'i Provide adeQ;ate information for the lender/client to reo!icate tne oetow ~st f:oores and calculations. Support for the ooinion of site value (summary of comparable land sales or orner methods for estimating site value) LOT SALES FROM COMPETING AREAS WEqE RESEAqCHED TO ARRIVE AT A SITE VALUE. ESTIMATED i X I REPRODUCTION OR I , REPLACEMENT COST NEW OPINION OF SITE VALUE. . $ ~O.OOO . Scw:e 01 <= data MARSHALL & SWIFT Dwellinq 1.581 So. Ft @$ 74.00. . - $ ',16.994 : QuaUtv ""'.no from cost se<Vice AVE Effectve dale of cost data 03/2006 BSMT: 1176 sa.FT. So. Ft@$ 14.00.. . s , 6,464 Comments 00 Cost AOlYoach (nmss livinn area calcuiations. detteciation. ere.) SEE SKETCH ADDENDUM FOR BUILDING DIMENSIONS. Garaoe1Caroon So. Ft@$ - $ . COST DATA OBTAINED FROM MARSHALL VALUATION 133,458 Total Estimate of Cost.New - $ SERVICE AND VERIFIED WITH LOCAL BUILDERS. less 50 PhVSiCal I Functional I External Deoreciation $40,037 I I -$2 000 . $ ( 38,037 Deoreciated Cost of ImorovementS .... .' $ 95.421 "As-is. Value of Site IlTID"ovements. . . . $ 4000 Estimated Remainino Economic Ufe lHUD and V A orivl 35 Years INDICATED VALUE BV COST APPROACH. . $ 139,400 ,-':' " . ):>,:,<p.-\ . Estimated t.Ao1ltIv Market Rent $ N/ A X Gross Rent _Ialier N/A .$ N/A Indicated Value bv Income Aooroach SlI11lIB)' '" ncome Approach Oncluding suppon fa market rent and GRM) ~'I'jf-~ // w, c"iiC.G;: Is the ae.eIooerIlx.ild... in control ri the Homeowners' Associalion (HOAI? flve, r lNO Unit tvoe(sl fl Detached I I Attached _ the _no ,nfonnation fa PUDs ONL V W the deYelooerIbUIder ~ in control of the HOA and the subieet orooertv ~ an attached dwellino unit. Loaal name d- Total nunber d o/lases TOl3i runbel'" of units Total number of units sold . Total nunber ri units renled Total rllI1i>er ri units fa sale Data SOU'celsl Was the mliecI created bv the conv...sion of an existioo buiJdjnatsl inlo a PUD? I lves I lNO W Yes, date of~. . Does the oroiect contain anY multi-dwellino units? Ilves I lNO Dala sOlXCe(sl . Ne the ..-.s. tDlTI"OOn elements, and reaealion fadities complete? UVes UNO If No, desaibe the stalUS ri completion. Ne the CDIMlllII elements leased to or by the Horreowners' AssociatJon? UVes UNO If Yes. desaibe the rertat terms and options. Desaibe caTUl'On elementS and recreational facilities. Uniform Residential Appraisal Report File No. PVT8061 ..... FreQ;1ie ME.,.... XI w.rtrl2005 PwlGuI;ed usangAO ~8002J4_8n7 __IaWm.com P8ge3d6 fIn'leWael'"1nllQ)4Marc:h?005 lCIN_~033005 WOOF APPRAISAL GROUP .... Uniform Residential Appraisal Report File No P'1T8051 This report form is designed to report an appraisal of a one-unit property or a one-unit property with an accessory u~i:; i~,ci~ding a unit in a planned unit development (PUJ). This report form is not designed to report an appraisal of a manufactured horne or a unit in a condominium or cooperative project. This appraisal report is subject to the following scope of work, intended use, inte~ded 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 iimiting conditions are not permitted. The appraiser may expand the =pe of work to include any additional research or analysis necessary based on the complexity of this appraisal assignment. Mocifications or deletions to the certifications are also not permitted. However, additional certifications :''1at do not constitute material alterations to this appraisal report, such as those requiree 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 r:1arket 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 proper.)', (2) inspect the neighborhood, (3) inspect each of the comparable sales from at least the street, (4) research, verify, and analyze data from reliabie public and/or private sources, and (5) report his or he! 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 represer.:s the normal consideration for the property sold unaffected by speciai or creative financing or sales concessions. granted by anyone associated with the sale. . Acjustments to the comparables must be mace for special or creative financing or sa!es 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 ccsts 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 no: already involved in the property or transaction. Any acjustment should not be calculated on a mechanical dollar for dollar cost of t~e financing or concession but the doliar amount of any adjustment should approximate t.',e market's reaction to the financing or concessions based on the appraiser's judgment STATEMENT OF ASSUMPTIONS AND L1MmNG CONDITIONS: The appraiser's cerUfication 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 t'1e 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. Tne 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 idenlified 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 this appraisal. Unless otherwise stated in tlnis appraisal report, the appraiser has no knowledge of any hidden or unapparent physical deficiencies or adverse conditions of tine 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 tlnat might be required to discover whether such conditions exist. Because'tlne appraiser is not an expert in the field of environmental hazards, this appraisal report must not be considered as an environmental a,ssessment of the property. 6. The appraiser has based his or her appraisal report and valuation conclusion for an appniisal 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. r-recoe MK. ~~ 10 Marcn 200:i PrQducecl..--,g ACl sottww., 500.234_8777 _.~c:t* Page 4 016 rant.... Ftnn 10001 Matl'm zoos 1(lOot _ os 0330Q5 WOOF APPRAISAL GROUP '" .. Uniform Residential Appraisal Report File No P\fj8C-5-: APPRAISER'S CERTIFICATION: The Appraiser certifies and agrees that: 1. I have, at a minimum, developed and reported this appraisal in accordance with the sccpe of work requirements stated ir this appraisal report. 2. I performed a ccmplete visual inspection of the interior and exterior areas of the subject property. I reported the condi;K,(1 of the improvements in factual, specific terms. I identified and reported the physical deficiencies that could affect the livabiiity. 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 Ihis 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 c:herwise indicated in this report. 5. I researched, verified, analyzed, and reported on any current agreement for sale for the subject property, any offering fer sale of the subject property in the twelve months prior to the effective date of this appraisal, and the prior sales of the subject prcoerty 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 L~e 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 croper.y. 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 su~ject 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 irterest in the sale or financing of the subject propeny. 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 ;isting services, tax assessment records, public land records and other such data sources for the area in which the property is iocated. 13. I obtained the information, estimates, and opinions furnished by other parties and expressed in this appraisal report ~m 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, sLbject property, and the proximity of the subject property to adverse influences in the development of my opinion of market vaiue. 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 subjec: proper.y or that I became aware of during the research involved in performing this appraisal. I have considered these adverse con;jitions 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 pr~etermined 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 approviliof 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 perfonmance 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 perfonm 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 responstbility 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. Frf!dOM'" fam 10 Matd\. 200S Proouced U5II'lg AClllOftwW., 800.234.8727 __~.c:om PageSd6 fawe'" Rnll004 IoWal zoos 1001_05 oJ3005 ." WOOF APPRAISAL GROUP Uniform Residential Appraisal Report File No. PVTa051 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:he appraisal finm), 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. APPRAISER SUPERVISORY APPRAISER (ONLY IF REQUIRED) Signature ~ ~~ Name REYNOLD R. ~ Company Name WOOF APPRAISAL GROUP Company Address 302 S. FRONT STREET WORMLEYSBURG, PA 17043-1338 Telephone Number (717) 975-9411 Email AddressREYWOOF(CilAOL.COM Date of Signature and Report 04/07/2006 Effective Date of Appraisal 04/07/2006 State Certification # GA-000002-L or State License # or Other (describe) State # State PA Expiration Date of Certification or License 06/30/2007 PA CERTIFIED GENERAL REAL ESTATE APPRAISER ADDRESS OF PROPERTY APPRAISED 140 WESLEY DRIVE MECHANICSBURG, PA 17055 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 APPRAISED VALUE OF SUBJECT PROPERTY $139,000 SUBJECT PROPERTY 8 Did not inspect subject property. . Did inspect exterior of subject property from street Date of Inspection o Did inspect interior and exterior of subject property Date of Inspection LENDER/CLIENT Name LISA COYNE Company Name COYNE & COYNE P.C. Company Address 3901 MARKET STREET CAMP HILL, PA 17011 Email Address COMPARABLE SALES BDid not inspect exterior of comparable sales from street Did inspect exterior of comparable sales from street Date of Inspection FredCie Mac Form 70 Mardl 2005 ProdUcecl ~ ACI ~e. BOO.234.8721_.aoweb.CCftI P&ge6of6 F;n1ieM8eFc:lml004/ola1:r.200S lOO1_OSQJ30C:5 Woof Appraisal Group ADDENDUM File No.: PVT8061 Case No.: State: PA Zip: 17051; Borrower: Property Address: 140 WESLEY DRIVE City: MECHANICS BURG Lender: COYNE & COYNE P.C. ST A TEMENT OF ADDITIONAL LIMITING COl\'DITIONS AND ASSUMPTI01\'S THIS APPRAISAL REPORT HAS BEEN PERFOR1v1ED FOR THE CLIENT INDICATED IN THE PRECEDING, WITH WHOM PROFESSIONAL ST A1\TDARDS REQUIRES ME TO MAINTAIN A STRICT REQUIREMENT OF CO},TFIDENTIALITY. THE APPRAISER IS NOT A HOME INSPECTOR, THE APPRAISER ONLY PERFORMED A VISUAL INSPECTION OF THE ACCESSIBLE AREAS AND THE APPRAISAL CANNOT BE RELIED UPON TO DISCLOSE CONDITIONS AND/OR DEFECTS IN THE PROPERTY. I, BY REASON OF THIS REPORT, A..'v1 NOT REQUIRED TO GIVE TESTIMONY IN COURT WITH REFERENCE TO THIS APPRAISAL. IF ANYONE WISHES MY APPEARANCE, IT CAN BE ARRANGED ONLY BY PRIOR ARRANGEMENT BEING MADE WITH ME. SUCH APPEARANCES SHALL BE MADE AS AN EXPERT WITNESS AND THE FEE FOR SUCH APPEARANCES SHALL BE AT THE RATE OF $125/HOUR PORTAL TO PORTAL, PLUS A..'\i-V REASONABLE COST INCURRED BY ME. PURPOSE: THE PURPOSE OF THIS APPRAISAL IS TO ESTIMATE THE MARKET VALUE OF THE FEE SIMPLE INTEREST IN THE TITLE OF THE PROPERTY. THE VALUE IS AS OF THE DATE OF THE APPRAISAL, WHICH IS THE DAY THE PROPERTY WAS LAST VIEWED IK ITS ENTIRETY AND PHOTOGRAPHED. SIGNATURE: THE ELECTRONIC SIGKATURE USED IN THIS REPORT ARE PROTECTED BY THE APPRAISER AND ONLY THE APPRAISER HAS COMPLETE CONTROL OF THE SIGNATURE. ADDITIONAL CERTIFICATION: THE INTENDED USER OF THIS APPRAISAL REPORT IS THE CLIENT. THE Il\TENDED USER IS TO EVALUATE THE PROPERTY THAT IS THE SUBJECT OF THIS APPRAISAL FOR AN ESTATE. SUBJECT TO THE STATED SCOPE OF WORK, PURPOSE OF THE ,\PPRAISAL, REPORTING REQUIRE~NTS OF THIS APPR..<\ISAL REPORT FOR..\1, AND DEFINITION OF MARKET VALUE. NO ADDITIONAL INTENDED USERS ARE IDENTIFIED BY THE APPRAISER. Addendum Page 1 of 1 Borrower: Propert:.i\ddress: 140 WESLEY DRIVE Cit'!: MECHANICSBURG Lender: COYNE & COYNE P.C. SUBJECT PROPERTY PHOTO ADDENDUM File No.: pvra06', Case No.: State: PA ZiD: 17055 FRONT VIEW OF SUBJECT PROPERTY Appraised Date:APRIL 7,2006 Appraised Value: S 139,000 REAR VIEW OF SUBJECT PROPERTY STREET SCENE COMPARABLE PROPERTY PHOTO ADDENDUM Borrower: File No.: PVT8061 Property Address: 140 WESLEY DRIVE Case No.: ZIP: 17055 City: MECHANICSBURG State: PA Lender: COYNE & COYNE P.C. COMPARABLE SALE #~ 128 WESLEY DRIVE MECHANICSBURG Sale Date: 06/24/2005 Sale Price: $ 130,000 COMPARABLE SALE #2 5209 ROYAL DRIVE MECHANICSBURG Sale Date: 10/27/2005 Sale Price: $ 137,000 COMPARABLE SALE #3 5210 ROYAL DRIVE MECHANICSBURG Sale Date: 07/29/2005 Sale Price: $ 125,000 -" FLOORPLAN Borrower: File No_: PVT8061 Property Address: 140 WESLEY DRIVE Case No.: City: MECr'ANICSBURG State: PA Zip: 17055 Lender: COYNE & COYNE P.C. , I I I , I 15.0' ; ! ! Family Room b ,; , 2€.C. 1.0' Bedroom K:tChen Dining Room Sa'" b ~ N b Parki:lg Pad ~ Bedroom B~room Living Room I 42.0' '2..0" I Stoop I Sketch by Apex IV Windows'" I I I AREA .CALCULA TIONS SUMMARY LIVING AREA BREAKDOWN i I Code Description: Size Totals Breakdown Subtotal's "'-A1 l"ir.t !'loor ~581. 00 1581.00 Firlllt 1"'100:- '" BSl<T B.._ent 1176.00 1176.00 :'S.O x 27.0 40S .00 l PIP Parking Pod HO.oO 240.00 ~8. C x 42.0 1175.00 I- I- f; r I I- ; ~~ I lJ : , , , i i J ~ I TOTAL LIVABLE (rounded) 1581 2 Areas Total (rounded) 1581 ~ , ~~ _'~__''''>>'''''',~ ..,.v_".,,--,,,~_ ~~......~ "'~'P."~.~.,,.-~~~ LOCATION MAP Borrower: Property Address: 140 WESLEY DRIVE City: MECHANICSBURG Lender: COYNE & COYNE P.C. File No.: PVTB061 Case No.: State: PA Zip: 17055 7l$ 5S: "'. "';t.. ..,-"" ~'Jr :'-c..#~ ,~- .w ~. .\'-<. .,.<0-..., .'.- '.,:,-.-..------. ":'~I;>> -.-",' ".' . ~ '. ..o.,;'~ .~>:\.'" '. ... 1.. .~u . \: \~\.' ~\: ~ '~'. 0.:> O<J,\ .,s<3-", ~'> , ':",,~ ;.~ t ~ ~.. ~ 7C~ i't: t7 ,i- .c. E .... SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT L I I FILE NUMBER 21 - 2006 - 00268 ESTATE OF MILLER, JEAN LOUISE All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 DESCRIPTION UNIT VALUE 77.04 VALUE AT DATE OF DEATH 2,696.40 35 shares of Prudential 2 US Savings Bonds-- See Attached Inventory 26357.62 26,357.62 TOTAL (Also enter on line 2, Recapitulation) 29,054.02 PRU: Historical Prices for PRUDENTIAL FINCL INC - Yahoo! Finance Page 1 of2 Yahoo I M'\IewtUser? li1:~hUf;J1<Stgn In Help ". YA:E:OO!" FINANCE Dow ... 0.600/0 Nasdaq 't 0.02% Wednesday, October 10, 2007, 12:01PM ET - U.S. Markets close in 3 hours and 59 minutes. ( GET QUOTES ) Symbol Lookup Finance Search Prudential Financial Inc. (PRU) Scottrade' . M\m!or I1NRAf$JPC up tu $1(J(J DA~ . ._.J!!IJI!I1l!!t~~ 100 FREE TRADES CTrade Smarter fj\Fideli~ i At 11 :41AM ET: 100.00 't 0.42 (0.42%) [!l AMERITRADE $9.99 trades. No surprises. [*TUN: S<lc..;~..., . Historical Prices Get Historical Prices for: I GOI SET DATE RANGE ADVERTISEMENT Start Date: I Feb ..:::.1 128 End Date: I Feb ..:::.f 128 12006 12006 Eg. 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H H H H H ." \C) "-< o \0 <l.) on ~ H ." \C) o o M -- (V) M -- If) '- 0 C 0 -;; a.. Q,) 1:: :::l III .... :::l 0 >, '- O'l ltl C t:: U. '- ..... ..... '- E ..0 :::l III ~ 't:l .e 0 c 0 Q,) C) ..0 Q,) O'l rei Q.. ~ ..... c ..... Cl) Cl) a; L :::. rei u III X .... W ~ "0 t:: '- rei 0 ..... ..... t:: ltl ',= ~ Q.. u <l.) Q,) ltl 0 III () ...... l-< rei p.., Cl) 't:l U - c ..... ~ 0 (:Q u:l <l.) !Xl CZl '- -- <l.) Q,) lJl U ...... Cl :::: .~ c (:Q ....... c: .:; -- bJ) ;> :::: Cl) ltl 0 ...... en en bJ) E Q) u:l ro C';l .2 <I) l-< f.Ll 0 ~ '- ..... ...... ...- ....; C';l 0 - Z Q) ..0 ;::l en <l.) 0 '"d '"d ca @ en .~ U ..t: - '"d '"d ..... .g :::: <l.) Q) ~ '- ..... 0 ;::l ca u:l (:Q ..... ~ C';l L. u:l ~ Q) ~ bJ) fI) ~ ..... ..... ~ ca -- .~ (l) -:-: p. CZl a. - - ..c \ ,I t ~ JI l~ \ II I .1 ,.~' . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY i I I FILE NUMBER I 21 - 2006 - 00268 ..... COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MILLER, JEAN LOUISE Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER 1 VALUE AT DATE OF DEATH 10,030.92 DESCRIPTION PNC Bank Certificate of Deposit #21 00 1 031853 2 PNC Bank Certificate of Deposit #21001031854 10,030.92 3 PNC Bank Certificate of Deposit #21001031855 10,030.92 4 PNC Bank Certificate of Deposit #21001031856 10,030.92 5 PNC Bank Certicate of Deposit #21001031857 10,030.92 6 PNC Bank Certificate of Deposit #31800236354 20,037.46 7 PNC Bank Certificate of Deposit #31100214978 31,035.16 8 PNC Bank Checking Account No. 5080166889 5,599.93 9 M&T Bank Checking Account No. 64090268 34,158.67 10 Sovereign Bank (Harry Miller Predeceased Jean L. Miller) Certificate of Deposit NO. 0575131297 40,219.84 11 Sovereign Bank Certificate of Deposit No. 0575138318 20,114.44 12 Sovereign Bank Certificate of Deposit No. 0575286687 20,167.79 13 Sovereign Bank Certificate of Deposit No. 0575131362 30,179.24 TOTAL (Also enter on Line 5, Recapitulation) 254,146.13 SCHEDULE E CASH, BANK DEPOSitS, & MISC. -PERSONAL PROPERTY continue~1 I FILE NUMBER 21 - 2006 - 00268 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MILLER, JEAN LOUISE Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. . 1 ITEM I NUMBER i 14 I Personal Property Per Attached Inventory DESCRIPTION VALUE AT DATE OF DEATH 2,479.00 i i I I i I I Page 2 of Schedule E ~1S-'22:::': ~=: 27 Ff-~/~B:':!>}: 412 7SS ].<:-,] F'. ['~ ~ '.... o PNCBAN< April 17, 2006 Lisa Marie Coyne 3901 Market Street , Camp Hill, P A 17011 RE: Estate of Jean 1. Miller, deceased SSN: 136-14-1912 DOD: 2/28/2006 Dear Ms. Coyne: In response to your rcqL.>est for Date of Death balances for the customer ooted above, our records show the following: Certificates ofDep()sit Account #21001031853 Established 04/06/1994 JEAN MILLER DOD balance: $10,000.00 + $30.92 accrued interest Account #21001031854 Established 04/06/1994 JEAN MILLER DOD balance: S10,OOO.OO + $30_92 accrued interest Account #21001031.855 Established 04/0611994 JEAN MILLER DOD balance: $10,000.00 + $30.92 accrued interest Account#2100103185G Established 04/06/1994 JEAN MILLER DOD balance: $10,000.00 + $30.92 accrued interest Account #21001031857 Established 04/06/1994 JEAN MILLER DaD balance: $10,000,00 + $30.92 accrued interest Account #31800236354 Established 10/30/2003 JEA.'l' MILLER DaD balance: $20,000.00 + $37.46 accrued interest i\ccount#31 100214978 Established 07/16/2001 JEAN MILLER DOD balance: $31,000.00 + $35.16 accrued interest Page 1 of2 lC--~~0C~G 1'3: IJ7 Fl~Cc:n~~l< ,~:? 7S2 345: 0.['2 .... Checking Account Account #5080166889 Established 04/06/1994 JEA.N MILLER DOD balance; $5,599.66 + $.27 accru~d interest The decedent maintained Investment Account (INV #58966263). For further information, you may contact the Brokerage Department at 1-800-762-6111. Please note that this office only provides date of death balances for deposit accounts (IRAs, CDs, Checking and Savings accounts). We do not process an)' financial tranSllctions or provide statements. lfyou need assistance with any of these items, please call1-888-PNC-BANK (1-888-762-2265) or stop by your local me Bank branch office. Sincerely, tJ)DPJlJlft ~ Rachelle Wells 1-800-762-1775 P7-PFSC-04-F 500 first ^ ve. Pittsburgh PA 1521 <) Page 2 of2 Member FDIC TOTAL P.02 .~ IV1&T'Bfu-ll{ .... 499 Mitchell Road, :-'Iillsboro, DE 19966 Mail Code DE-~1B-12 Phone (883) 502-4349 Fa, (302) 934-2955 April 4, 2006 Re: Estate or Jean L lvfiller Social Securitv: 186-14-1912 Date of Death: Februarv 28. 2006 II~/ ;i~J~ Q:~7 [~:,! r il Ii 1\ \ i f',n\ - 6 [006 Ii! Ii! IU~I . . . J~ I h.u- t-\\ ~\ ~ t I' - Coyne & Coyne PC Attorneys At Law 3901 Market Street Camp Hill, Pennsylvania 17011-4227 Dear Sir or Madam: Per your inquiry dated March 28, 2006, please be advised that at the time of death, the above-named decedent had on deposit wiLl-) this bank the following: 1. Type of Account Checking Account AccozmlNumber 64090268 o.mership (Names oj) Jean L Miller * Raegene L Miller, POA * Opening Date 08/28/64 Balance on Date of Death $34,158.02 Accmed Interest $ 0.65 T olal $34,158.67 2. T,\pe of Account IRA Account Number 035004201743926 o.mership (Names oj) Jean L Miller * Raegene L Miller, Beneficiary * Opening Date 05/15/82 Balance on Date of Death $4,715.68 Accrued Interest $ 4.47 Total $4,720.15 3. T."Ype of Account IRA .",- Account Number 035004201743934 o,mership (Names oj) Jean L lv/iller * Raegene L Miller, Beneficiary * Opening Date 07/21/82 Balance on Date of Death 51,467.54 Accrued Interest $ 4.26 Total -------------------------------~----~--- $1,471.80 4. Type of Account ----------------------------~----------------------- IRA Account Number 035004201743942 o,vnership (Names oj) Jean L lv/iller * Raegene L Miller, Beneficiary * Opening Date 04/10/85 Balance on Date of Death $26,321.04 Accrued Interest $ 127.94 Total --------------------------------------------------- 526,448.98 -------------------------------------------------------- 5. Type of Account Safe Deposit Box Box ;Vumber/Location 0000343/ Mechanicsburg Ownership (Names oj) Harry R Miller * Jean L Miller * Opening Date 12/01/50 * For further account information, regarding ownership and any changes, closures and/or reimbursement of funds, please contact our Mechanicsburg Branch at 5219 Simpson Ferry Road, Mechanicsburg, PA 17050, or #717-255-2031. Sincerely, /J:f?W'uy- ~~ Nancy Clagett Records Management .0 1::) - - ~ove~~@l bank Suc~ is conjkilpue. ~ cali bf4p )Ol! ~"'tliArr:~ /, ~;~?<Z~~~:,~,-,: ,.~~ , If/! / I~ AP;y 2 / ,,-' ..~~{~! / 1J~ ,,1006 // .'..c. " ',' , 11/' -.......:.::: ' ,. ). . ~ /[; ~ L-r ~J Court Ordered Processing / MAl MB3 02-10 P.O. Box 841005 Boston, MA 02284 April 17, 2006 Coyne & Coyne, P.c. Attorneys at Law 3901 Market St. Camp Hill, PA 17011-4227 RE: Estate of: Jean Louise Miller Date of Death: February 28,2006 Dear Ms. Coyne: Per your request, enclosed please find the account information as of date of death for the above-named decedent Please note the balances do not include accrued interest If you should have any further questions, please do not hesitate to call. Very truly yours, ~~- Linda Spavento OAG Team Leader (617) 533-1789 (617) 533-1931-fax ; :...-:. /~:.....-..-.~ , ....... ::_-- ,-~.: ':~-::~:~:::-I~ :> '",,~ ''"'- Sovereign Bank ESTATE OF SOCIAL SECURITY #: DATE OF DEATH: Jean Louise Miller 186-14-1912 February 28,2006 Account #: 0571141358 Type: Money Market Open date: 2/13/2001 In the name of: Jean L Miller or Barbara A Miller or Raegene L Miller Date of Death Balance: $11,823.30 Int.(YTD) from 1/1/2006 to 2/28/2006 $8.60 Accrued interest to date of death: $0.00 Other Info: Account #: 0575131297 Type: In the name of: Jean L Miller or Harry Miller Date of Death Balance: Int.(YTD) from 1/1/2006 to Accrued interest to date of death: Other Info: CD Open date: 12/7/1998 $40,000.00 2/28/2006 $0.00 $219.84 Account #: 0575138318 Type: In the name of: Jean L Miller or Harry Miller Date of Death Balance: Int.(YTD) from 1/1/2006 to Accrued interest to date of death: Other Info: CD Open date: 9/14/1991 $20,000.00 2/28/2006 $0.00 $114.44 Account #: 0575286687 Type: In the name of: Jean L Miller or Harry Miller Date of Death Balance: , Int.(YTD) from 1/1/2006 to Accrued interest to date of death: Other Info: CD Open date: 6/4/2001 $20,000.00 2/28/2006 $0.00 $167.79 Account#: 0575131362 Type: In the name of: Jean L Miller or Harry Miller Date of Death Balance: Int.(YTD) from 1/1/2006 to Accrued interest to date of death: Other Info: CD Open date: 1/13/1999 $30,016.71 2/28/2006 $0.00 $162.53 Page 1 of 1 . . ~ J~ SCHEDULE F ~ COM~N~~~:=tLJ~EoJ~E:E~tY~~ANIA JOINTL V-OWNED PROPERTY RESIDENT DECEDENT . . -- - ESTATE OF I FILE NUMBER MILLER, JEAN LOUISE i 21 - 2006 - 00268 .... If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Barbaa A. Miller Daughter B. Raegene L. Miller Daughter JOINTLY OWNED PROPERTY: I I DESCRIPTION OF PROPERTY 0 ITEM II F6~TJgl~T ~~b~ ,Incl~d~ n~me <;>f ~nancial institution and bank .a?count number DATE OF DEATH D~CO&S DA~~~~ED~TH NUMBER I TENANT ',' JOINT lor similar Identifying number. Attach deed for JOintly-held real VALUE OF ASSET INTEREST DECEDENT'S INTEREST ,estate. ' A, B : 02/13/20011 Sovereign Bank 11,823.30 33.33% 3,940.71 I Money Market Acct. 571141358 I TOTAL (Also enter on line 6, Recapitulation) 3,940.71 . I SCHEDULE G J COMMONWEALTH OF PENNSYLVANIA \ '" INTER-VIVOS TRANSFERS & INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY ___RESIDENT D~~E[)ENT __ ____---'--- - - ------~----------~ --~._._--- ESTATE OF I FILE NUMBER MILLER, JEAN LOUISE I 21 - 2006 - 00268 This schedule must be completed and filed if the answer to any of -----. I T I DESCRIPTION OF PROPERTY DATE OF DEATH I EM I Include the name of the transferee, their relationship to decedent and the date of transfer, VALUE OF SSET NUMBER I Attach a copy of the deed for real estate. A i uestions 1 throu h ~age 2 is yes. %OF DECD'S EXCLUSION, TAXABLE VALUE INTEREST (IF APPLICABLE) M&T Bank IRA Account No. 035004201743926 4,720.15 4,720.15 2 M&T Bank IRA Account No. 035004201743934 1,471.80\ 1,471.80 3 M&T Bank IRA Account No. 035004201743942 26,448.98 26,448.98 4 TransAmerica Annuity No. 02pB0002568 I 30,285.26\ I I i i I i 30,285.26 TOTAL (Also enter on line 7, Recapitulation) 62,926.19 t1tvi~~R~N~~ '1 ~[\ 1;:5' 0 f5 0 '\\i! !2i::', jlliL:::l'0LS D 1.5[1\\ I Jlr-- 1111,! / /1 I .' Illi\MAY - B 2006 Ii i I! i!i\\ I!L/) t iJ 1;/ ..... Transamerica Life Insurance Company 4333 Edgewood Road NE PO Box 3183 Cedar Rapids, Iowa 52406-3183 May 4, 2006 The Estate of Jean L c/o Coyne & Coyne PC Attn Executor 3901 Market St Camp Hill PA 17011 Miller RE: Annuity Number 02PB0002568 Dear Executor: We have received notification, Harry R Miller, annuitant of the above listed non-qualified tax deferred annuity is deceased. Our office wishes to extend sincere condolences for your loss. The following lS the current information on this annuity: Primary Beneficiary: Annuity Policy Date: Full Value as of 5/03/2006: Taxable Portion: Full Value as of 03/25/2004: Harry R Iv1iller Harry R Iv1iller Jean L Iv1iller Jean L Iv1iller 100% April 11, 2002 $30,285.26 $ 5,285.26 $27,630.84 Annuitant: Owners: It is our understanding the beneficiary, Jean L Iv1iller, passed away while entitled to receive the policy proceeds. If this is correct, the policy provisions state the death benefit options are available to the Estace of Jean L Miller. The attached document reflects the options available to the Estate of Jean L Iv1iller. The full value as of the date of death lS for tax purposes only and is not a guaranteed death benefit amount. Operations performed on an automatic basis when applicable have been terminated, such as; Systematic Payouts or Automatic Billing. Member of the ~EGOrl. Group " -... The attached document co~tains general tax information based on Transamerica Life Insura~ce Company's interpretation and should not be relied upon for your personal tax planning. If you have questions concerning the direct tax consequences when selecting an option, you may wish to consult a tax advisor. Any additional questions regarding this annuity can be directed to the Annuity Service Center at 1-800-553-5957. A Transamerica Life Insurance Company representative will gladly assist you with any questions you may have regarding this annuity and help you meet your financial goals. Sincer.elY.", .7 _ ~ ~~~---~ Nicholas Hayes Transamerica Life Insur~Lce Company Claims Enclosure(s) Annuity C~aimants Statement Death Option Packet postage ?aid Return Envelope "" Death Option Packet 02PB0002568 please submit the following documents upon selection of an option, defined below: . Certified copy of the death certificate indicating the manner of death for Harry R Miller . Certified copy of the death certificate indicating the manner of death for Jean L Miller . Original annuity policy (excluding the Continue Option) . Annuity Claimant's Statement . Letters of Testament The Claimant Information section on the Annuity Claimant's Statement needs to be completed in the name of the estate. Please include the estate's tax identification number and signature(s) of the executor (s) . The following options are available to the Estate of Jean ~ Miller: Lump Sum Payment The death proceeds value, per the terms of the contract, will be disbursed to you in a lump sum paYment. Delay the Lump Sum Payment up to 5 years from date of death You will be responsible for notifying the company to remove any remaini~g funds prior to the fifth arilliversary of the date of death. Include designation of beneficiary(ies) on the Annuity Claimant's Statement " please note, regardless of WDlCD option is chosen, the taxable amount will be reported on a Form l099-R the January following the distribution. In the event the claim has multiple beneficiaries, we require only one certified copy of the death certificate indicating the manner of death. A separate Annuity Claimant's statement is to be completed by each beneficiary. Each beneficiary may choose from the options applicable, and need not elect the same option as any other beneficiary. Upon receipt of the required documents from all of the designated beneficiaries, our company will begin processing your request. Please contact our office for information concerning products available to you at this time. . SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE cosrs l ~ I FILE NUMBER I 21 - 2006 - 00268 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ___~~~~ENT DECEDENT ~ .._-~._---------_._._-~..---- ESTATE OF MILLER, JEAN LOUISE Debts of decedent must be reported on Schedule I. ITEM I NUMBER I DESCRIPTION ~rNERAL EXPENSES: i Musselman Funeral Home ! I 2 I Rolling Green Cemetary AMOUNT 9,099.00 1,100.00 300.00 3 Flowers 500.00 4 Reception 100.00 5 Honorarium B. I ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City Year(s) Commission paid Attorney's Fees Coyne & Coyne, P.e. State _ Zip 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Reajean Miller Street Address 140 Wesley Drive City Mechanicsburg Relationship of Claimant to Decedent 14,900.00 3,500.00 2. State P A Daughter Zip 17055 4. Probate Fees Cumberland County Register of Wills 295.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 Postage 78.00 2 Legal Advertisement--Patriot News 116.67 Total of Continuation Schedule(s) 7,102.50 TOTAL (Also enter on line 9, Recapitulation) 37,091.17 *' COMMONWEALTH OF PENNSV'tvANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ScheduIeH Funeral Expenses & Mninistrative Cos1s continued 3 Legal Advertisement--Cumberland Law Journal I FILE NUMBER 21 - 2006 - 00268 T 1 75.00 ESTATE OF MILLER, JEAN LOUISE 4 Recorder of Deeds 5 Reserves 6 Filing Fee-- Inheritance Tax Return 7 Estate Checks 8 H&R Block 9 Woof Appraisals 10 Bonnie K. Miller, Tax Collector 11 Mileage for Executors 12 Dusty Chapman-- Appraisal of Personalty 13 Real Estate Taxes 14 Holy Spirit Hospital 15 Dr. Connor 16 Missed work for Executrixes @ $35/hr 75.00 3,000.00 15.00 25.00 300.00 300.00 10.00 67.50 250.00 1,100.00 65.00 70.00 1,750.00 Page 2 of Schedule H *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE- LIABILITIES, & LIENS ~ I FILE NUMBER i 21 - 2006 - 00268 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MILLER, JEAN LOUISE Include unreimbursed medical expenses. ITEM NUMBER 1 DESCRIPTION AMOUNT Department of Revenue-- Estate of Harry Miller, Deceased 329.35 2 Raegene Miller-- Reimbursement for Christmas and Birthday Gift purchases 3,000.00 3 Pa. SERS 64.97 4 Uncleared Checks from Checking accounts 639.00 TOTAL (Also enter on Line 10, Recapitulation) 4,033.32 REV.1513 EX'; (9-00) *' SCHEDULE J BENEFICIARIES COMMONWEAL -rttOF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ~. I FILE NUMBER I ! 21 - 2006 - 00268 _.___~_._ . I. I RELATIONSHIP TO I AMOUNT OR SHARE NUMBER . . NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY . . DECEDENT L---- OF ESTATE --i~-TAXABLE DISTRIBUTIONS(i~clude outri-ght spousal distributions) 1,.-DO.fullllsLTniSteeoo-_\ - .~-- 1 RaeJean Miller Daughter I 1/2 Residual I I Dough'" 11/2 R,,;duol I ESTATE OF MILLER, JEAN LOUISE 2 Barbara Miller i i . Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet ! II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11_ ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEE /,~ REV-485 EX (05-04) *' SAFE DEPOSIT ~~~ BOX INVENTORY co,; Department of Revenue 48500041046 .~ Social Security or D?-3th Certificate Number r7I ES~t- Date of Death l~lIf~~1e:JeIfJ ' Suffix PLEASE USE ORIGINAL FORM ONLY County Code Year File Number .':'g:4'":::<~"~_:;":';;:;~- t3tCj Iv1I ~~L''''~ ~ [~ ~~~~ LLvLLL1-nL~ .1/ / CITY: / /V1. !.. C-Ji<-ClMt' C 'i';)l/,-' STATE: /A .ui e-5Q g ;t((-r/~ i)r. T TE: ZIP CODE: /70 / ( V~LA~IONS P: CITY: e~c'(J bG/' RELATIONSHIP: STREET ADD?:::SS: CITY: STATE: ZIP CODE: 'c. NAME: RELATIONSHIP: STREET ADD;:(:::SS: CITY: S:AE: ZIP CODE: NAME AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED ,NAME: )Y)jE: Zip CODE: 7f7SJ NAME Aim ADDRESS OF PERSON{S) HAVING ACCESS TO BOX a. NAME: '- - - (L' -~ ~\~ ~:/_ /' 1\ f"'f D Jij P5 <.., y,r- - CITY' . j J 7. ST^TE' ZIP CODE: '/VL L \..C.l,.1'L{ 1:5 b..rv' P/~ /'7iJ S-r - NAME AND. TlTLE OF EMPLOYEE TAKING THE INVEN10RY 'b. NAME: ~~ L {)uc'r;e flit!-tv- STREET ADD,RESS: _ /, _ /, ,/-r 0 If/.-e s. -f1, lk- . CITY: I _ I vfl.e~1. i CJ-@d WAS A WILL IN TliE BOX? 0 YES NO If yes, a, Date of will: b. Name and address of ,personal rep esentative, if na~ed in the will 'NAME: STREET ADDRESS: CITY: STATE: ZIP CODE: c. Name and address of attorney, if any NAME: STREET ADDRESS: CITY: STATE: ZIP CODE: L 45500041046 48500041046 .-I SAFE DEPOSIT BOX INVENTORY INSTRUCTIONS ~ Pags__of ~ ..... REV-485 EX (1) Cash: Report total only. (2) Stock" Li,t '0 ,,,,,, MCY eommO' oc p"""'" "rt"oat" wac"ot oc othe, 'ght> fooo' '0 bo<. Stock, '" to" ,,,i,oo',d by Mme of wmp'oY, "rtlfioate "mb", det' of ""',,," , Mme io wh'eh ,tock i> "gi,te,ed, eod "m'" of ,t,,," ,eo cl,,, of ,took (3) Oblig,tlo", of U.S. Go"comeot Nom'" of It,m" d,te ofi,,"', "'" ~'\"', "me> io whioh",',te"d eod ~" ,f ow,,,,hl?, i.e., jointly held, payable on death, etc. (4) BondS: Designate by name, amount, serial number, or other designation. (Bearer Bonds) (5) Beok '0' S"io" eod Loeo p,,,boo'" S\,\e Mme of d'PDOitOC, "mbel of book, ,,,t "te 'PP"'o, io bOO' "m, of beok and branch, and balance. . . (6) Jewelry, Coins, Stamps, Manuscripts, etc: list and describe as fully as possible. (7) Dee", Mortg,ge', Co"ent fo,""no' Moie> 0' othel e~idenee> of indebtedne>" Li~ ,nd 'e>o'"'' fully" po"lbl< (8) All other contents. 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'~-__T~____. _,._._.,__~~_.._..__.._.__ -- ~----~_._, -.. ,,--.-..-. -- ,-----~-------_.- .-.-- --..-----.. ..~- -'- -.--. -..-------.- , -"".---..-.-".-- - -. --~ ,-.-- ---~---_.__.--_.. ~----- --- ,-' .----'.-. .-..------,--..---.. ~_,_.~~.___._._. n.___ ____.____...__._~_.._._._____._______ ---_.---~~--~-- ---- - ~. --==== r~ . --- -----,-~--~------------~-------..- - REGISTER"-OF WILLS CUMBERLAND County, Pennsylvania CERTIFICATE OF GRANT OF LETTERS No. 2006-00268 FA No. 21-06-0268 Es ta te Of: JEAN LOUISE MILLER (First, Middle, Last! Late Of: LOWER ALLEN TOWNSHIP CUMBERLAND COUNTY Deceased Social Security No: 186-14-1912 i '- WHEREAS, JEAN LOUISE MILLER (First, Middle, Last) la te of LO'0iER ALLEN TOWNSHIP CUMBERLAND COUNTY died on the 28th day of February 2006 and, WHEREAS, the grant of Letters of Administration is required for the administration of the estate. THEREFORE, I, GLENDA FARNER STRASBAUGH , Register of wills ~n and for CUMBERLAND County, in the Commonwealth of Pennsylvania, have this day granted Letters of Administration to: RAEGENE L MILLER and BARBARA A MILLER who have duly qualified as p~MINISTRATOR(RIX) of the estate of the above named decedent and have agreed to administer the estate according to law, all of ,vhich fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYL VANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 28th day of March 2006. . /9;/ft/~ '-iulA./Lbi x1i1aA!1O-L0L Register of Wills . 0 '--'V7l&e-'~ ~~/!)L Deputy **NOTE** ALL NA.1\iES ABOVE APPEAR (FIRST, MIDDLE, LAST) COYNE & COYNE A PROFESSIONAL CORPORATION ATTORNEYS AT LAW Henry F. Coyne Lisa Marie Coyne 3901 Market Street Camp Hill, Pennsylvania 17011-4227 717-737-0464 Fax: 717-737-5161 ( -~) October 10,2007 Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, P A 17013 '~---~, C-, ....' Re: Estate of Jean Louise Miller, Deceased No. 2006-00268 Dear Madam: We represent the Estate of the Late Jean Louise Miller. Enclosed please find an original and two copies of the Inheritance Tax Return for the estate of the Late Jean Louise Miller. Kindly docket the original and return to this office a "clocked-in" copy with the enclosed, stamped envelope. Also enclosed is a check for the $15.00 filing fee for this Return. Kindly issue a receipt for payment of filing fee. Thank you for your assistance. If you have any questions, please feel welcome to contact me. Very truly yours, COYNE & COYNE, P .C. . ----v? /71/0''-'" ~---- (J,jsa Marie Coyne LMC/jms Enclosure cc: Ms. Raegene L. Miller, Administrator Ms. Barbara A. 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