HomeMy WebLinkAbout10-28-08 (2)__.
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J 15056051047
REV-1500 EX (06-05) OFFICIAL USE ONLY
PA Department of Revenue County Code Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURN
PO Box 280601
RESIDENT DECEDENT 2 1 0 8 0 2 8 8
Harrisburg, PA 17128-0601
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
0 2 0 1 2 0 0 8 0 3 3 1 1 9 3 1
Decedent's Last Name Suffix Decedent's First Name MI
L I P P E R T J R W I L L I A M D
(If Applicable) Enter Spouse's Information Below
Spouses Last Name Suffix Spouse's First Name MI
~ a
Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
~ I~ I I I I REGISTER OF WILLS
FILL INAPPROPRIATE OVALS BELOW
® 1. Original Return O 2. Supplemental Return ~ 3. Remainder Retum (date of death
prior to 12-13-82)
O 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required
death after 12-12-82)
® 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust r~ 8. Total Number of SDB's
(Attach Copy of Will) (Attach a Copy of Trust)
O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPOADENCE AND CONFIDENTIAL TAX INFORMATION SHALL BE DIRECTED TO:
Name Daytime Telephone Number
T A Y L O R P A N D R E W S E S Q 7 1 7 2 4 3 0 1 2 3
Firm Name (If A pplicable)
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First line of address
line of address
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Correspondent's a-mail address: tpandreWSt~pa.net
n er pena res o peryury, ec are a ave examme is re um, inc u mg accompanying s e u es an a eme s, an o e e my now ge an a ie , i is rue, come
and complete. Declaration of preparer other than the personal representative is based on all the iMonnation of which the preparer has any knowledge.
SIG TURF OF PE O ESPONSIBLE FO LING ETURN ~~ DATE
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ADDRE S 1439 Cranberry Rd., York S
1
15056051047 15056051047
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Decedent's
REV-1500 EX
12 minus Line 1
15056052048
C.
1. Real estate (Schedule A) 1. ~ $159 960.00
2. Stocks and Bonds (Schedule B) 2. $35,806.94
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) 3. ~ $0.00
4. Mortgages & Notes Receivable (Schedule D) a. ~ - $0.00
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 5. ~ - $9 151.50
6. Jointly Owned Property (Schedule F) Q Separate Billing Requested 6. $2 135 45
7
Inter-Vivos Transfer
& Mi
ll
.
s
sce
aneous Non-Probate Property
(Schedule G) Q Separate Billing Requested
7.
$0.00
8. Total Gross Assets (total Lines 1-7) 8 ~- 5207 n5~ R9
9. Funeral Expenses & Administrative Costs (Schedule H) 9. $36 045.17
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 10. $6,364.14
11. Total Deductions (total Lines 9 & 10) 11. ~ $42 409.31
12. Net Value of Estate (Line 8 minus Line 11) 12. $164,644.58
13
Charitable and Govern
t
l B
.
men
a
equests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) 13. $0.00
14. Net Value Subject to Tax
TAX COMPUTATION -SEE it
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 .045
17. Amount of Line 14 taxable
at sibling rate x .12
18 Amount of Line 14 taxable
at collateral rate x .15
19. TAX DUE
Social Security Number
$7.409.01
$0.00 I
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
15056052048
Side 2
19 ~ $7 409.01
15056052048
REV-1500 EX Page 3
F[le Number
~ t _nu_muQ
Decedent's Complete Address: ~- ~~ ~""'
Decedent's Name
William C. Lippert, Jr.
STREET ADDRESS
100 South Market St.
CITY STATE
ZIP
Shiremanstown PA 17011
Tax Payments and Credits:
1. Tax Due
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discounts
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A+B+C)
Total InteresUPentaRy (D+E)
4• If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
F[II in oval on Page 2, Line 20 to request a refund
(]) $7,409.01
(Z) $0.00
(3) $0.00
(4) $0
5• If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) $7,409.01
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) $7 409.01
Make Check Payable to REGISTER OF WILLS, AGENT
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PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS ~ _. }' ~~
1. Did decedent make a transfer and: yeS n0
a. retain the use or income of the property transferred:
b. retain the right to designate who shall use the property trenserred or ds income:
c. retain a reversionary interest: or X
d. retain the promise for life of either payments or care? ~ Q
2. ff death occurred after December 12, 1962, did decedent transfer property within one year of death
wkhout receiving adequate consideration?
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary disignation?
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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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°h [72P.S. Sec. 9116(a)(1.1)(1)].
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 cf the surviving spouse is 0 % [72 P.S. Sec. 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 detes of death on a aver July 1, 2000:
The tax refs imposed on the net value of transfers from a deseased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent,
or a stepparent of the child is 0% [72 P.S. Sec. 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 4.5%, except as noted in 72 P.S. Sec. 9116(1.2) [72 P.S. Sec.9116(a)(1).
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. Sec.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.
SCHEDULE A
REAL ESTATE
ESTATE OF FILE NUMBER
William C. Lippert, Jr. 21-28-0288
All real estate owned solely or as a tenant in common should be reported at fair market value with is defined as the price at which property would be
exchanged between a willing buyer and a willing seller, neither being compelled to sell, both having reasonable knowledge of the relevant facts.
Pro erty jointly-owned with Right of Survivorship must be disclosed on Schedule F.
ITEM DESCRIPTION VALUE AT DATE
NUMBER OF DEATH
1 House and lot at 100 S. Mazket St., Shiremanstown, Cumberland County, PA $145,000.00
See attached appraisal
House listed for sale but no offers
2 .17 acre lot with mobile home,
Churchtown Rd., Southwest Madison Township, Perry County, PA
pazcel 142,140.00-058.001
tax appraisal: $11,000.00 $14,960.00
common level ratio 1.36
Total (also enter on Line 1, Recap) $159,960.00
S. W. Barrett Real Estate & Appraisal Services
File No. 08-0145
APPRAISAL OF
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LOCATED AT:
100 S. Market Street
Shiremanstown, PA 17011
FOR:
Ma. Cynthia Becker
1439 Cranberry Road
York Springs, PA 17372
AS OF:
April 22, 2008
BY:
Cassandra J. Crockett
Certified Residential Appraiser
S. W. Barrett Real Estate 8 Appraisal Services
04/30!2008
Ms. Cynthia Becker
1439 Cranberry Road
York Springs, PA 17372
File Number: 08-0145
In accordance with your request, I have appraised the real property at:
100 S. Market Street
Shiremanstown, PA 17011
The purpose of this appraisal is to develop an opinion of the defined 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 defined value of the property as of April 22, 2008 is:
5145,000
One Hundred Forty-Five Thousand Dollars
The attached report contains the description, analysis and supportive data for the conclusions,
final opinion of value, descriptive photographs, assignment conditions and appropriate certifications.
Respectfully submitted,
~,Qddtlr+t..e's~t~~/7~ . l'~~7twcY.-!./ _
Cassandra J. Crockett (/
Certified Residential Appraiser
Residential enn~niee~l Rn•..,.r~
FNe No OS-0145
The purpose of this appraisal repoA b to provide the dient wNh a credible opinbn of me~defned value of the aubled property, gken ms intended use of me appraisal.
Ctant NameMlended llaer Ms. thin Becker E-may
• CNentAddreaa 1439 Cronbe Road c' York S Mn s state PA 17372
'
Addawnal intended u s The intended user of this re rt is the Client. No additional Intended Users are rmitted without the
tmission of the a raise s .
. mended Uea The Intended Use Is to evaluate the ro that is the sub act of this a roisal to rovide the Client with an
accurate and a uatel su orted o inion of value.
Address 100 S. Market Street c Shiremanstown state PA Z 17011
owner of pudic Reoord Li William C Jr. ~ Joann W, coon Cumberland
L al Dead Book 27-K• Pa 846
' Asaeoear's Parcel t 37-23-0555-0SOA Tax Yea 07108 RE. Taxes S 2 029.00
hb«twod Name Borou h M R~ererwe 23-0555 Census Trail 0112.00
ha elaed X Fee Leasehold Other describe
research did X did not reveal sales «tranafere of the sub br the cores sere b the ertecwe date of tlde sisal.
Prbr Sele/rranafer: Date 8!2211977 Price 12 000 So« a Courthouse Records
Analyab of prior sale «tranafer history d me aubled property (and comparable sales,'d applirabb) No recent recorded transfers were found.
olreringa, options and contrails as of the ertecave date of me appreisal None known
NNlalawrlwod ChreWriefics OnNMR Fi•ueliq Trends -. tMe..UrYt H•udna PrewnF Lend lies %
Locatbn Urban X Suburban Rural P' Vehles X Increaei Stablo Dedinin PRICE AGE Ono-UnR 70 %
Bua- X Ova 76% 25-75% Under 25% DemandlSu e X N Belarlce Over Su 000 s 2.q ~y 8 %
Growm Ra X Slabb Sbw Make Time Under 3 rdha 36 mRla X Ova 8 mlha 80 Low 20 MdlfFaml 2 ~%
Neighbortwod Bounderiea Sub act la bounded on the north b Rt647 • on the east and south 200+ h 100 Commerdal 10 x
• b Rt.15• and on the west b Sheele LanelWesle Drive. 150 Fred. 70 omer Indstri 10 %
Neighborhood Descriptbn Sub act ro is located in an established nei hborhood of homes troth detached and attached within
" the Borou h of Shiremanstown. Sho in and other amenities are within welkin or short drivin distance. Schools tam Is
Mechanicsbu District and local elements school is within .5 mile. SMSA 42-3240
MadcetCondilions(Indudkp wppartior me above conckubns) Pro a values are currenU stable with an avero a marketin time of 90-180
der .Economic trends and lendln rates have remained favorable. Salsa concessions occur occasional! .There are new
homes under construction in surroundin develo manta as well as resales available in the nei hborhood.
Dimenaisna Sea le al descri tionltax ma Mea 0.10 Acre MIL Sh a Rattan ular view Residential
Zonin Claeeficalbn RMT Zon Descri Multi-Famil Residential Towne
Zuni a X L L Nwncorlr«min trend6mered flee No Zonin N N describe
b Me highest and best use of the aubled properly es hnproved (« ere proposed per plane and spedNcetlona) the present use? X Yes No R No, describe.
lkllaMe Public Otter deealbs Public Orlav dnnibe Oa-sae lm owmanle-T Public AIvW '
X 200 am water X street As halt X
Gas ~"~ sewer X Aue To side Parish X
site Commenu There are no a arent advese easements encroachments or other adverse conditions.
.GENERAL DESCRIPTION .FOUNDATION t:XTERIORDESCRIPTION metadala INTERIOR materials
Unite X One One wNh Unit
/ of stories Two
T X DaL Att. SDethnd Unil
X Eldstln Pro undo Conat
n s 2 Sto
Yea Buie 1937
ERedive a vra 15-20 Concrete Slab Gewl ace
X FuN Basement Partlal Baeenlent
Basement Mee 740 . R.
easement Fmish 0 %
Outside En rEdt Su Pu Foundatbn Walls Block/Av
Exterbr walls Vin AV -Gil
Roof Slrfaa Shin IB1Feir-AV •
Guaere a Down to AluminumlAv
Window T a DbIHn lA-G
St«m SesNlnsuteted InsuletedlA-G
Screens Yes/A-G Flo«c HMwdMn lAV
warn P18ster/AV
TrkNFlnieh WOONIIAV
Bem Floor Vin UCer Av
Berm wainscot PlstrlFb Is1Av
Ca Star a None
X ANeer if of Cars 2
Altlc
Dr Stet
X Nano
Stars Fleatin FWA FIYVBB Radiant
X OmerHW Roc Feel Oil Am enitba
Ftr s !~ WoodStov s I
Fence Dd
X v Buries Aa halt
Ga tdcan 2
X Fkxr Battle
Finished Nbetad
antes R abr X Ra elOven
• F'Inlehed sea above ode contains:
' Carlin Central A'r Conditbnin PetblDedc X Porch 2 / of cos
IndMdual Other Pod Omer X Att. Det. eaa-in
X Dishwasher D' sal X Microwave Washer a Omer describe
5 Rooms 3 Bedrooms 1.5 Ba a 1 370 oars Feet d Gras LMn Mee Abovs Grade
Additlonal Feahrea Re Iseement windows vin sldin added• breakfast bar some built-ins on final woodwork hardwood floore•
no recent interior u -datin • front and side orches• staire to loft storo a over tiro e. '
Comments on me lmpraementa Im rovements are in avero a condition with no functional inade uacies a rent • Roof ca son
both the home and tiro a showin evidence of wear and tearldeterioroted no interior evidence of leaks e.
nmrr my•a rot... ep ssrarn .ewe
Py1tl2 wn. .mm iAY icon COyryee]0061WrACl txwimtlieogrw awiar, k, Neyrf flrrvw. '
(GPM+')Grrey Prpaw Anxtlrtl lt.Pm 1]flroa '
ynnur:AprruwnePDreuulreyort GPNt100/_er01n]000 -.
Residential Annraic~l Ger....e
FEATURE SUBJECT
100 S. Market Street
kltresa Shiremanstown
'
COMPARABLE SALE NO.t
417 East Green Street
Shiremanstown ------- ---
COMPARABLE SALE N0.2
13 Railroad Avenue
Shiremanstown .~, vlw
COMPARABLE SALE N0.3
412 E.Mafn Street
Shiremanstown
ro Sun
a
~° Prix
Selo Aicet:9oee LH. area
oabsar s
z
E 0.00 . n
- 0.35 MI ENE
i 149 900
S 97.78 . rt. -
MuIU-list 0.16 MI NNW
S 144 900
S 107.33 . rt.
Multidist 0.35 MI ENE
S 174 900
S 121.46 . rt.
Multi-list
verirtcatbn Sow s ~ Courthouse Rec ords Courthouse Rec ords Courthouse Rec ords
VALUE ADJUSTMENTS
l DESCRIPTION DESCRIPTION . S mown DESCR~iION -)S DESCRIPTION - s
Sa
e a fnandng
Conceasbne CIsg.Csta.
DOM 1 -3,000 CIsg.Csts.
DOM T3 -4,400 CIsg.Csts/Conv
DOM 28 -4,500
Date of Saklrkrle 7107 5/07 8107
Location Suburban Suburban Suburban Suburban
LeasehoWFee
Site Fee Sim le
LoUAv .10 Fee Sim le
LoUAv .14 Fee Sim le
LoUAv .11 Fee Sim le
LoUAv .18
view
n
' Residential
2 Sto Residential
1.5 Sto Residlindust.
2 Sto 7 500 ResidlComm.
1.5 Sto
Dunk ofConatrud
an
Adual a
~ Averse
71 Yre Avere a
53 Yre Averse
100 Yre+l- Avere e
67 Yre
_ Cormlitbn
A Averse Su rior -5 000 Su rior -5 000 Su rior -15 000
bowGlade Talm amhs TaW amin. saw Tmm Brar TaW edn• aWa
Room Count 5 3 1.5 6 3 1.5 B 3 1 1 000 6 3 1.5
aoeB aTea30.00
B 1 370 . rt. 1 533 . R. -4 890 1 350 . ft. 0 1440 . rt. -2 100
asement a Fmiehed
Roane Bebw Grade
Funabnal aril' Full BamU
Unfinished
Averse Full BamU
Famil Room
Avere a
-3 500 Full BsmU
Unfinished
Avere a Full BsmU
Rec Room
Avere e
-3 500
- Hex OHW/None OFHAICA -2 000 GHWlNone OHW/None
En EAident Iterro T ical T ical T ical T ical
Gar elCar 2 Car Gare a Ca rt 8 000 2 Car Gan e 1 Car Gare e 5 000
PaduPaMorDedc Porches Deck 0 Porohesl -1000 Porch/Patio/FP -1000
Fenced rd
Net Ad' sbment Tobl + X - i 10 390 + X - = 1 900 + X - S 21 100
Adjusted Sat Price
d tdea Net Adj. -6.996
Grose 17.6X
139 510 Net Adj. -1.3%
Grose ad' 13.0%
S 143 000 Net Adj. -12.1 %
Gmae 17.896
153 800
of sales ad1 All tom reties are imilar in uUli and location to the sub act ro are verified closed
sales are within the Borou h of Shiremanstown and Mechanicsbu School disW and are the best currenU available.
Condition ad'ustment taken for deteriorated roofln in the sub'ect ro • sale #3 had been remodeled/u -dated. A 5%
ad'ustment was taken for sale #2 with industriallreilrosd roximi
Ad usted ran a of value is 139 000 to 154 000.
COST APPROACH TO VALUE
sire value Caananb Site value from current assessment data and recent local land sales.
ESTIMATED REPRODUCTpN OR REPLACEMENT COST NEW
S
f OPINION OF SRE VALUE ................ -
........................ - S 25 000
awoe o
coat data
~ Oua tom cost service ErtedWe date of coat data
Camlenb on Cost oath ose Iivi sea calculetlona d datbn, ate Dwetin . Ft. S -
............ - S
Ft >: _ _
Cost A roach from MarehalllSwift Valuation Service
• handbook and local cost anal is was considered but
deemed not credible due to fhe a e of the im rovements.
Site value from Market Data. De reciation based on a ellife
observed condition and Market Data Anal is. Estimated
remainin Economic Life is 35-40 ears. Gar . Ft. S ............ _ _
Total Estimate aCoat-New „, , s
Lela Ph I functlonal Exlemal
edetton , _
Da edated Cost or I ovemenb ................................ = s
•As-is•Valwafskekn ovemenb ................................=s
I
O INDICATED VALUE BY COST APPROACH ...................... _ : NJA
NC
ME APPROACH TO VALUE - -
Eatlmeted Monts Market Rent S NIA X Gross Rent Mu ' er WA = _ NIA Indicated Value b klmme wch
Surmlary of ku»me Approadl (Indudin0 suPDat for market rent and GRM) N/A
IlWloabd Valw Sa4s C icon oath S 145 006 Coat Dash If d•wl f NIA Ircoma oath II dawl S NIA
Market Anal is consistent) su orts m o anion of market value. GRM and Cost Anal Is were found ins ro caste for this
anal Is. Su ortin file information substantiates these estimates.
TAb appraisal is made X "ae is," aubjea to completion per plans and apedrtcalbns on the basis of a hypoMetkal taMitbn that Mae improvement have been completed,
a ^aubjed to the A7rovdrp repais a alteratbns on the basis a a hypodteticel tondilion Mat Me repairs a alleradons have been completed ^subjea b the forowirq:
Based on the swps of work, asaumplions, IlmRing conditions and appraiser's esniReation, my (our) opinion of the dsened value of the real property
that Is the subject of this report Is f 14b.000 as or 412 212 0 0 8 ,which Is the efleetive date of this appralpl.
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S.W. Barrett Real Estate 8 Appraisal Services
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File M• 08-0145
Scope of Work, Assumptions and Limiting Conditions
Scope of work Is delinsd in the Unform Standards of Professional Appralpl Profits as'tM type and extent of rueareh and analyses in an
assignment." In shat, scope or work Is simply what the appraiser did and did not do during the course of tM assignment. It Includes, but is not
limited to: the extent to which the property is IdeMigsd and inspected, the type and extent of data researched, the type and extent or analyses applied
to arrive at opinions a eoneluslons.
The scope of this appraisal and ensuing diseussbn In this repoA are speclRe to tM needs of tM client, other IMMHIed Intended veers and to tM
Intended we o(the report. This report was p-epared Tor the sole and exclusive use or the client and other Identified Intended users fa the Idsntiaed
Intended use and Hs use by any other parties b prohibited. The appraser is not responsible (or unauthorized use or tM report.
TM appraiser's carti0eatlon appearing in this appraisal report is subjsd to the following wndklom and to such other spscRle condRbns as are
set forth by tM appraiser in the repoA. All extraordinary assumptions and hypothstieal eonditlons are slated In the report and might haw aReeted the
assignment rssuks.
t. The apprelaer assumes no responaiMlity far matters of a legal nature aRecBrp the properly apprdsed a Btle thereto, nor dose Me appraiser render any opinon as b Me tltb, wllirh b
aewrrled b be good ant mekebble. The property Is eppraMd as Magh under responsible owneahp.
2. Any sketch in tlrb report may show approximate dknensbns and b Induded only to assist Me reader in visuafizbg the property. The apprenar has made no survey d the property.
3. The apprase b not requtred to ghro batlmony a appear h cart because d hating made Me appreisal wiM reference to the properly b questbn, unless amargemenb have been
prevbusty made thereto.
4. NeiMe ar, nor any part of the content of Mb report, Dopy a other media Meroof (bofudirp oorrduebns as b the property value, Me idantlty of the apprelaer, profeadonal dealgnatbna,
e the tYrn wiM which the apprelaer b conneded), shall be used br enY PurD~s by anyone but the diem end oMe Intended users as ken8fied in this report, nor shat d be corneyed by
anyone to the public tlrough adver8sing, pubtlc rela8ona, news, sales, a oMe media, wlMout the written consent of Me appraiser.
8. The appraiser will not disclose the contents of this appaieal report unties requred by applMaide law or as spedlbd N the Uniform Standeds of Proleseional Appraisal Radice.
8. Inkrme8on, eatlm&es, and opinions Punished to Me appraiser, erM oonleined in the repot, were obtained tom sources considered reliable and 6efieved to be true and Domed.
Fbwave, rq responaibifily for acaraq of wch dams furnished to Me appretaer b assumed by the appraiser.
7. The appraiser essrunea Mat Mxe are rw hidden a unappeent conditbns of Me properly, subsoil, a strudues, whidr wouN render F mare a less valuable. The appreiae assumes
~~ ~ canaidead~aud ns, a for engineeirg a tes8ng, which might be requFed to discover such (adore. This appraisal b not an enviraunentd assessment d the popery and - -
da not acondud Me blensive b Me vabatlon of real properly end b not a home inapedar, buildkp oontradar, strucbral engineer, a sinfler expert, udees oMarwiae rated. The appraiser '
type d field obaervatbns d Me kind intended M seek and discover property defeda. The vlewirq of Me properly and any improvements b for puposes of
dwebping an opinion of the defined value of the propey, given Me ntanded use of Wa aedgnmenl. Statements regarding oordition are based on aufaco obaervatbne Doty. The
appraise deirrrs no epetlal ezperlise regarding bsues bduding, but not goofed b: bundatbn settlement. basement mdshre probbro, wood destroying (a oMe) inaeds, pest infesta8on,
radon gas. bed based paint, mold a envFonmental issues. Unless oMerwise indicated, mechanical systems were not activated a tested.
Thb appraisal report should not M used M disdae Me condition of the property as tt relates b Me presencelebsence of dafeda. The client b invited and encaraged b employ qualdbd
experts b bsped and address seas d Donato. y negative condilbns are discovered, Me opinbn of value may be ensiled.
Unlasa otherwise noted, the appraiser assumes the components that constltuts the subject property Improvement(s) ors fundamentally sound and in
working order.
Arty viewing of the property by the appraiser was dmked b reality observable seas. Unless oMerwise noted, attics and crawl apace teas were rat accessed. The apprelser did not move
undue. Moor caverbgs a oMe items Mal may restrbt Me viewing of the property.
9. Appreieab bvoNing hypoMetical condi8ona related to compb8on of new construction, repa'rs a dtxetbn are based on Me esaumplion Met such oompbtlal, atteatlon a repa'rs wg
be competently perbrmed.
f 0. lMbas Me intended use of Mb appraisal spedficetly Includes issues of properly bsuance coveage, Mb appabal should rat be used tar such purposes. Repraduc8on a
Raplaoemenl cost Ilgues used in Me cost approach e6 fir valuatbn purposes ony, given Me blended use of the assignment. The Definition d Vdue used b Mia assignment is unlikery
b be consiebrrt wiM Me definition of Insurable Vdue far property osuance covxegeNse.
11. The ACI General Purpose Appraisal Report (GPAR'r') la not intended for use in tnnsaelions that require a Fannie Mae 1004IFrsddie Mac 70 form,
also known as the Uniform Rssidantial Appraisal Report (URAR).
Addalonal Comments Related To Scope a Work, Assumptions and Lunging Conditions
P~oa,MwY,p vci avl..., xoo.za~.mn.,w.mtaw.~a rw ram cwrgreaxxam~a dN+mraOCWnbwor, ~,NPoyx, wm...x.~
tcvutm)cewrArPa.~rprrar~R~er 1mas..
germralPurVaaeaPPralealrePat aP marlrt0rl
FtlaNo. nR.n~as
Appraiser's Certification
The appnisar(s) earlMss that, to the best of the aptxalser's knowledge and belie(:
t. The atatemenb of fad mnfaWed b Mia roport are true and coned.
2. The reported anaysea, opkrbna, and mra:Wsbna ae Wilted only by the reported asaurrptions and Nmitirg condilbns and are Me personal, knpartid, and unblaeed poleseiond
anatyeea, opinions, and condusiona
n~Uvn~ otherwise dated, the apprds« has no present «proapedlve Wterest in the property Mat fs Me subied of this report and has no p«amal Ntereat with reaped b fhs pxtlee
4. The appraiser has no bias with rasped to Me properly Mat is Me arbject of Mis (spar! «fo Ma partlea involved wiM Mis assigmnenL
5. The appraiser's engagement b tlde assignment was not mntlngent upon devebpinp «rep«gng predetermined resutls.
6. The appraiser's mmpensatbn far mrrpletlrg Mie assignment k not contingent upon Ma devebpment «reparling of a predetermined valve «dFecdm h value Mat favors Me cause of
Me dbnt, Me amount of the vaWe opinbn, Me attainment of a stlpulded result, «Ma acaxrenco of a eubeequent avant dtrectly related b Me blended use of Mia attprefed.
7. The appraser's anaysea, opinions, and mnduslone were devebped, and Mb report has been prepared, in cont«mity wgh Me lMif«m Standards of Proteeabnal Appraisal Practlco.
S. lMbsa oherwise rated. Me appraiser has made a peroond inapsdbn of the property Mat is Me aubjed of Mb report.
9. Unbse rated baba, no one provided egnNcant red property appraisal assistance b Me apprda« signing Mis cerUtcadon. Signitcant real property appraisal aoeistence provided by:
Addkfonal Certincatfons:
DMlnition or Value: X^ Market Value ^ Other Value:
so«ceofDeRnition: USPAP
The most probable price in terms of money 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.
ADDRESS OF THE PROPERTY APPRAISED:
100 S. Market Street
Shiremanstown, PA 17011
EFFECTNE DATE aF THE APPRAISAL: April 22, 2008
APPRAISED VALUE OF TFIE SUBJECT PROPERTY S 145,000
APPRAISER SUPERVISORY APPRAISER
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Signature: ~--
Hama: Cassandra J. Crockett ~ Name: Steven W. Barrett, SRPA SRA ASA
state CereWatbn t RL001348L state Certaratbn tl GA000298L
«Licorue/ «Licensei R8026921A
«gher (dea«ibeg stater: stile: PA
State: PA Expiatbn Date of Certiacadorr «Lbense: 06130!2009
Exptratbn oats d Certltlcaron «Lbense: 06/3012009 Date of Signature: 04/3012008
Data of Signature and Report: 04/30/2008 Deta of Roperty Viewing:
Date of Properly Viewing: 04/2212008
Degree of property viewing:
Degree of properly viewing:
^X Interior and Exterior ^ Exterior Onty ^ Did not peroonatly view ^ Interior and Exterior ^ Exterior Onty X^pW rat permnely vbw
n. Amoauts,~ci,w..., eoo.aann.w..e,.e.,,,, Mimnranw+Oa1p61Wlld owluitla~DCWnMNOy, y.., Napwwww.~..
~~.~_.__:__~.____. w_-__... _ _ _ _ _ _ (GPAR^q save.! NVOUApprrWNalV el an)]tlN
_._•• ••-.. o....o.., ..a.a.w es nppraraeu services
FLOORPLAN
Client: Ms. Cmthia Becker File No ~ OS-0145
Prouertv Address 100 3. Market Street Case No
CI .Shiremanstown State: PA Zi :17011
Bam BaOroom
R
Bedroom Betlroom
2ntl Fkwr 24.a
28.a
21.a
s.a ~ cross
KBd1en b
O~~ it
Parch
b
5 B. 24.a
Nook
b
~ Clat.
living Room S.a
b
21.a
Porch a
2o.a
Sketch by Apex IV WlfldoW8TM
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CoG AREA CALCULATIONS SUMMARY
DescrlpBOn Sirq
Totab
OL711 Hr~t Ploor 740.00
tlacond door 630.00 1370.00
F~F F°r°n 160.00
pOLC1i 60.00 220.00
~+ o+rew 4eo.oo wo.oo
TOTAL LIVABLE (rounded) 1370
LIVING AREA BREAKDOWN
Breakdown SBMMNf
Piret door
21.0 x 30.0 630.00
5.0 x 22.0 110.00
8~cond door
21.0 x 30.0 630.00
3 Areas Total (rounded) 1370
SUBJECT PROPERTY PHOTO ADDENDUM
Client: Ms. Cvnthla Becker File No • OB-0145
Property Address.100 S. Market Street Case No
CdY: Shiremanstown State• PA ZiD 17011
FRONT VIEW OF
SUBJECT PROPERTY
Appraised Date: Apr1122, 2008
Appraised Value: $145,000
REAR VIEW OF
SUBJECT PROPERTY
STREET SCENE
Attached garage
Street -north
Side alley
COMPARABLE PROPERTY PHOTO aOOEN~uiu
COMPARABLE SALE #1
417 East Green Street
Shiremanstown
Sale Date: 7/07
Sale Price: $ 149,900
COMPARABLE SALE #2
13 Railroad Avenue
Shiremanstown
Sale Date: 5107
Sale Price: $ 144,900
COMPARABLE SALE #3
412 E.Main Street
Shiremanstown
Sale Date: 8/07
Sale Price: $ 174,900
LOCATION MAP
Client: Lippert, William C, Jr. 8 Joann W. File No.: 08-0145
Property Address: 100 S. Market Street Case No.:
Ci :Shiremanstown State: PA Zi :17011
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Prepared by: Steven W.BarrettRE. Apps Svc. (717}243-6648
ID" r4ss Dafe Prks B o
S 100 S Maxkat St 5 3 1.5 1370 0.00 F1I
Y 917 E Oxeea St 7/07 149900 6 3 Y.S 1533 0.33 MI ENE
2 13 RaSlxoad Avg 5/07 144900 6 3 1 1350 0.16 MI NNN
3 412 E Main St 8/07 174900 6 3 1.5 1440 0.35 M1 ENE
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"***'***" QUALIFICATIONS *********
The following checked items are SPECIFIC SPECIAL CONDITIONS that were identlfled by this appraiser during the
inspection of the subject property, the comparebles sales, and their neighborhoods and locatlons. Unless otherwise
noted, the conditions that apply to the subject property or the comparable sales used DO NOT AFFECT THE MARKET
VALUE OR THE FUTURE MARKETABILITY OF THE SUBJECT PROPERTY BEING APPRAISED. This is not a home
inspection service. This is an appraisal to estlmate market value.
_,1. The subject Is located in a rural area and is less than 25°~ built-up.
_x_2. Commerclalllndustrial uses are located within the subject's neighborhood. These uses are typical of similar
neighborhoods.
_3. Vacant and undeveloped land uses are located within the subject's neighborhood. These uses are typical for
the area.
_4. The predominant value in the neighborhood Is less than that of the market value of the subject property. This
is due to the very wide range of value of properties in the area and superior quality of the subject property.
_5. The subject property Is located in a F.E.M.A. Identified Flood Zone. Flood Insurence coverage is required and
suggested.
_6. Dampness is noted in the basement of the subject Standing or running water was not present on basement
floor. This condition is considered typical in dwellings of this style.
_7. The subject property Is serviced by pNvate well andlor septic systems which is common for the area.
_x_8. The subject is older than flve(5) years. All mechanical systems including the heating, electrical and plumbing
systems appear upon a visual exterior inspecton to be In working order. No warranties are implied in this statement
_9. Repair items were noted in the comments sectlon of the report. These comments on repair Items are for
descriptlve purposes only and are not required repalre. The items listed are cosmetic In nature.
_10. The basement floor Is a dirt floor. This condition is common and typical for the area. and does not pose a
health or safety hazard.
_11. The subject properly does contain functlonal obsolescence as noted in the report. This condition is
considered typical and common for the area and this style dwelling.
_72. The land value exceeds 30Y. of total value due to the high demand for vacant land In this neighborhood. This
conditlon is considered common and typical for the neighborhood.
_13. The land value exceeds 30°b of total value. This is due to the large size of the site. This conditlon is
considered to be typical and common.
_14. Individual adjustments were required that exceed 15%. These adjustments were required due to lack of more
similar comparebles on that individual retlng. All comparebles used are the best available.
_15. Total adjustments exceed 25%. This is due to the lack of comparable sales that were more similar in the
subject's market area. All comparebles used are the best available.
_x_16. One or more comparable sales are older than six(8) months. Although there are comparable propertles in the
subject's area, none have sold recently; therefore, sales in excess of siz(8) months have to be used. All comparebles
used are the best available.
_17. One or more comparebles used were in excess of one (1) mile from the subject property. Although there are
comparable properties in the immediate area, none have sold recently. Therefore, it was necessary to use comparable
sales outside of the immediate area. All comparebles used are located in similar neighborhoods and within the same
marketing area. All comparebles used are the best available.
_18. The electrical system was not connected during Inspection.
_19. The water service was not connected during inspection.
_20. The heating system was shut down during inspection.
_21. Roofing_Plumbing_Electrical_Heatlng_certificatlon(s) Is/are suggested.
_22. Inground swimming pool-, out buildings are Included .not included according to lenders
guidelines. -
_23. According to lenders guidelines a maximum of acres were considered for this valuation. Remaining
acreage was given no value.
********* QUALIFICATIONS *********
_24. The subject properly Is located on a private road.
_25. Wood infestation inspection is suggested.
_x_26. Last recorded deed transfer: Date_9I22H977 ,Consideration: 512,000
_27. Proposed constructionlrenovation in accordance to plans and specifications to be completed in a workman-like
manner.
_28. Seller is paying part or all of closing costs.
x_29. All comparable sales are verified closed sales.
_x_30. There are no special conditions or other requirements that would affect market value or future marketability In
the Appreisal Report.
********* QUALIFICATIONS *********
Confidentiality and Security Policy
We consider privacy to t-e fundamental to our relationship with clients. We are committed to maintaining the
confldenUality, integrity and security of clients' personal information. Internal policies have been developed to protect
this eonfldentiality, while allowing client needs to be served.
We restrict access to personal information to authorized individuals who need to know this information to comply with
federal standards to protect your nonpublic personal information. We do not disclose this information about you or
any former consumere or customers to anyone, except as permitted by law. The law permits us to share this
information with our affiliates. The law also permits us to share this Information with companies that pertorn
marketing.
When we share nonpublic information referred to above, the Information Is made available for limited purposes and
under controlled circumstanees. We require third parties to comply with our standards for security and conflentiality.
We do not permit use of consumerlcustomer information for any other purpose nor do we permit third parties to rent,
sell, trade or otherwise release or disclose information to any other party.
Education
As of the date of this report, I andlor Steven W. Barrett, SRPA, SRA, ASA have completed the requirements under the
continuing education program of the Appraisal Institute.
SCHEDULE B
STOCKS AND BONDS
ESTATE OF FILE NUMBER
William C. Lippert, Jr. 21-28-0288
'1'U"1'AL (also on line 2, Recapitulation) $35,806.94
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANIOUS PERSONAL PROPERTY
ESTATE OF FILE NUMBER
William C. Lippert, Jr. 21-28-0288
Include the proceeds of litigation and the date the proceeds were received by the estate
All property jointly-owned with Right of Survivorship must be disclosed on Schedule F
ITEM DESCRIPTION VALUE AT DATE
NUMBER OF DEATH
1 Household furnishings and Misc personal property $494.50
sold at public sale
2 2005 Dodge Caravan Minivan -sales price -arms length sale $8,000.00
3 Car insurance refund $57.00
4 Stimulus check $300.00
5 property tax rebate $300.00
TOTAL (also on line 5, Recapitulation) $9,151.50
ROWE'S AUCTION SERVICE (RH 79L)
2505 Ratner Highway` '• Carlisle, PA 17015
Bill Rowe (AU 1538L) 249-1978 697-4794 249-2677 Dave Rowe (AU 2295L)
Auction Is Action Call "Rowe" For Satisfaction
,f"TA~~ aF W/[cry=1n~ C. LIPPK`"~GT J2~
SELLERS NAME L' ~o TNy~ ~r2 -.~ ~~~~'~/ S DATE `~"~ 7 'v (3
ADDRESS
PHONE S z S '- ~+' S' ° ~
OTHER AUCTIONEER %
L~.~,~, e.. , ~...
AUCTION DATE/LOCATION ~ `~~'- ~ *-''-~ `~ CL .-9~0
DESCRIPTION OF MERCHANDISE
~S-
S~
~~ -T -~ ~ s s 2 ~- Wis.
~ C~,~
n,>s a .r').,~ ~ ~ l ~~ - 1 ~, S-
I Commission the Auctioneers to sell the merchandise to the highest bidder by Public Auction. Merchandise
to be sold as is & grouped as necessary to obtain bids. I certify that I am the owner or authorized represen-
tative of the merchandise, goods and or property and have good title and the right to sell and that they are free
from all incumbrances. I agree to accept all responsibility for providing merchantable title and for delivery of
title to the purchaser. I agree to hold harmless the Auctioneers against any claims of the nature referred to in
this agreement. /r
AUCTION SIGNATURE SELLERS SIGNATURE
Total Sales (Clerking Tickets Attached) $ ~ ~ 4 ~ a
Less Sale Expense:
L'_ ~ „~
"3 s ~ % Commission,Auctioneer $ ! -1. "~
/yts¢cc C..r ..c :,~. 7 3
OTHER:
TOTAL SALE EXPENSE DEDUCTED $ l ~ ~ ~°~
~"1 f. [l
SELLERS NET $ --1 `'~ ~r ?-!~
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF FILE NUMBER
William C. Linnert. Jr. 21-28-0288
if an asset was made joint within one year of the decedent's death, it must be reported on Schedule G
Surviving Joint Tenant (s):
NAME ADDRESS RELATIONSHIP TO
DECEDENT
A Cynthia A Becker 1439 Cranberry Rd., York Springs, PA 17372
B
C
daughter
Jointly-owned nronertv:
ITEM NUMBER LETTER FOR
JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF
INSTITUTION AND BANK ACCOUNT NUMBER OR
SIMILAR IDENTIFYING NUMBER. ATTACH DEED
FOR JOINTLY•HELD REAL ESTATE TOTAL VALUE OF
ASSET DECD'S % INT. DOLLAR VALUE OF DECEDENT'S
INTEREST
1 A 06-Jun-66 Citizens Bank cking acct: $2,625.10 50% $1,312.55
6100714020
2 A 14-Mar-91 Citizens Bank savings acct: $1,645.79 50% $822.90
6140171938
TOTAL (also online 6, Recapitulation) $2,135.45
Citizens Bank~M
Account Number 6100714020
Account Title WILLIAM LIKPPERT JR OR CYNTHIA BECKER
Date O ened 6/6/1966
Account T e Checkin
Princi al Balance as of DOD $2625.10
Interest from Last Postin to DOD $ .00
Account Balance as of DOD $2625.10
YTD Interest to DOD $ .00
Citizens Bank
Account Number 6140171938
Account Title WILLIAM LIKPPERT JR OR CYNTHIA BECKER
Date O ened 3/14/1991
Account T e Savin s
Princi al Balance as of DOD $1645.79
Interest from Last Postin to DOD $ .03
Account Balance as of DOD $1645.82
YTD Interest to DOD $ .36
CHEDULE H
FUNERAL EXPENSES, ADMINISTRATIVE
COSTS AND MISCELLANEOUS EXPENSES
ESTATE OF FILE NUMBER
William C. Lippert, Jr. 21-28-0288
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
DESCRIPTION
AMOUNT
A.
1
2
B
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
Funeral Expenses:
Neil Funeral Home
,Rolling Green Cemetary -interment, recording, marker
Wake -service
Administrative Costs:
Personal Representive Commissions
Name of Personal Representative: Cynthia A. Hennessey Becker
Social Security Number of Personal Representative:
Street Address: 1439 Cranberry Rd.
City: York Springs State: PA Zip: 17372
Year(s) commissions paid: 2009
Attorney fees to Andrews & Johnson
Family Exemption
Claimant
Street:
City: State & Zip
Relationship of Claimant to Decedent:
Probate Fees to Register of Wills
Accountant Fees to Patricia Rosendale, CPA
Tax Return Preparer's Fees
Expenses for house and Perry County Lot:
PP&L Electric
Heating oil
Trash service
Insurance
Water/sewer
Property tax
Barrett Realty -Real estate appraisal
Michael Klunk -Tax preparation -decedents last individual return
Postage
Estimated realtor's fee for selling Shiremanstown property
Estimated transfer tax for selling Shiremanstown property
Public sale expenses
TOTAL (also on line 9, Recapitulation)
$7,041.82
$3,947.00
$562.73
$4,500.00
$4,500.00
$0.00
$345.00
$250.00
$372.67
$936.96
$79.76
$455.00
$195.83
$2,070.68
$325.00
$85.00
$29.92
$8,700.00
$1,450.00
$197.80
36,045.17
SCHEDULE I
DEBTS OF DECEDENT
MORTGAGE LIABILITIES AND LIENS
ESTATE OF FILE NUMBER
William C. Lippert, Jr. 21 08 0288
Report debts incurred by the decedent poor to death which remained unpaid as of the date of death, mcludmg unretmbursed medical expenses.
~ v tz r.a. ~atso on une t u, xecapttulatlon) $6,364.14
SCHEDULE J
BENEFICIARIES
ESTATE OF
William C. Linnert, Jr.
ITEM NAME AND ADDRESS OF BENEFICIARY
NUMBER
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transtus under Sec. 9116(eJ
1 William C. Lippert
34 S. St. Johns Road, Camp Hill, PA 17011
2 Debra Lippert Premici
313 E. Main St., Shiremanstown, PA 17011
3 Michael A. Lippert
RR 1, Box 118, Meiser Rd, Thompsontown, PA 17094
4 Cynthia A. Hennessey Becker
1439 Cranberry Rd., York Springs, PA 17372
FILE NUMBER
21-28-0288
RELATIONSHIP AMOUNT OR SHAKI~;
Do Not List Trustee(s) OF ESTATE
Son 1/4 of estate
Daughter 1/4 of estate
Son 1/4 of estate
Daughter 1/4 of estate
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
Charitable and Governmental Bequests:
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (also enter on line 13, Recapitulation) $0
Uttst dill tttxd (~estarrrcertt
of
WILL~iAM C. LIPPERT JR.
BE IT RII'~I~BERID, that I, WILLIAM C. LIPPERT JR.,.of 100 South Market
Street, Cumberland County, Shiremanstown, Pennsylvania, being of sound
mind, memory and understanding, do make, publish and declare this as and
for my Last Will and Testament, hereby revoking and malting null and void
any and all Wills and Testaments and writings in the nature thereof by
me at any tune heretofore made.
ITEM 1: I direct that all my dust debts and funeral expenses be
paid as soon after my demise as may be convenient.
ITEM 2: All the rest, residue and remairxier of my estate, of
whatsoever nature and wheresoever situate, whether it be real, personal
or mixed, including property over which 2 have a power of appointment, I
give, devise and bequeath unto my wife, Joann W. Lippert, absolutely,
provided she survives me for a period of thirty (30) days.
ITEM 3~ Should my wife, Joann W. Lippert, predecease me, fail to
survive me for a period of thirty (30) days, or should we die simultaneously,
I then give, devise and bequeath my entire residuary estate unto my
issues in equal shares per stirpes.
ITEM 4: I appoint Comrranwealth National Bank: as guardian over any
property which passes either under this Will or otherwise to a minor and
with respect to which I am authorized to appoint a guardian and have not
otherwise specifically done so, provided that this appointment of a
guardian shall not supersede the right of any fiduciary in its discretion
to distribute a share where possible to the minor or to another for the
minor's benefit. Such guardian shall have the power to use principal as
well as income, from time to time for the minor's Support and education,
(including college education, both graduate and undergraduate), without
regard to his or her parent's ability to provide for such support and
education, or to make payment for these purposes, without further
ESS:
Z~1-~~~j~ C' ~~~ ~' (SEAL)
WILLIAM C. LIPPERT
responsibility to the minor's parent or to any person taking care of
the minor.
ITEM 5: I direct that my hereinafter Warned Executrix pay all
inheritance, estate, succession and legacy taxes of whatsoever nature
and kind, to .which my Estate or the transfer of-any property passing
hereunder or otherwise passing by reason of r4Y demise, and may be
subject and to charge such taxes against my residuary estate, it being
my intention that none of the aforesaid taxes, either federal or state,
or any property required to be included in my gross estate, under the
provisions of any state or federal law now in Porce or hereafter enacted,
shall be prorated among the persons interested in my Estate to whom such
property is or may be transfermed or to whom any benefit accrues.
I'I~I 6: I appoint Joann W. Lippert, as Executrix of this my Last
Will and Testament. Should Joann W. Lippert predecease me, fail to
qualify, cease to act or renounce probate, I then appoint Cynthia A.
Hennessey, William C. Lippert III, Debra S. Lippert, and Michael A.
Lippert, as alternate Co-executors of this n1y Last Will and Testament.
ITEM 7: I direct that my Executrix, guardian or their successors
shall not be required to give bond for the faithful performance of their
duties in any Jurisdiction.
IN WITNESS WHEREOF, I have hereunto set Rly hand and seal this / A''4'
day of LC (.c._~ t-CU. ~ , 1982.
wzTNESS:
WILLIAM C. UPPER'
C
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF ~<' i ` <<-
t/. ~ L~. ~` ~ 2C'/I'J cf~ ti/• -~'tL1 / lax
and ~fl rtl ~y~ •, ~'Z~ ~t-~r ~-~ 2. ,the Testator and the witnes es
7
res ively, 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 willingly directed
another to sign for him), and that he executed it, is 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. witness and that to the best of their Imowledge the Testator was at
that time eighteen years of age or older, of sound mind and under no
constraint or undue influence.
my ~omtrussion rxpires:
GLEP:UA M. WEiHIPlfTUN, Plotary PabNc
UILLSBUR6 UOROIJGN, YOi2R COUNTY
MY COMMISSION EXPIRES UEf,. `e7, I382
Memher, Pennsylvania Association of Motarizs