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Home My WebLink About02-0686 REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA PETITION FOR GRANT OF LETTERS Estate of Kathryn ~tzer No. 2, 1-02 - toSIo also known as , Deceased Social Security No. 192-14-7409 Diana K. Salisbury and Donna K. Orner Petitioner(s), who is/are 18 years of age or older, apply)ies) for (COMPLETE "A" OR "B" BELOW:) GJ A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut rixes Decedent, dated 7/20/1977 and codicil(s) dated named in the Last Will of the State relevant circumstances, e.g., renunciation, death of executor, etc Except as follows, Decedent did not marry, was not divorced and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incapacitated: o B. Grant of Letters of Administration (c.I.a.. d.b.n.c.t.a.: pendente lite, durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse (if any) and heirs: r Name Relationship Residence I (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence at 9 E. Coover St., Mechanicsbur~, PA 17055 (list street. number and municipality) Decedent, then 78 years of age, died July 19 ,2002 ,at Holy Spirit Hospital, Camp Hill, PA (location) Decedent at death owned property with estimated values as follows: (if domiciled in PA All personal property. (if not domiciled in PA Personal property in Pennsylvania (if not domiciled in PA Personal property in County................ Value of real estate in Pennsylvania ............. .................................................................... Total. $ $ $ $ $ 20,000.00 120,000.00 140,000.00 Real Estate situated as foilows: Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: Typed or printed name and residence Diana K. Salisbur 910 S rin Circle, Mechanicsbur , PA 17055 Donna K. Orner 421 Pawnee Drive, Mechanicsbur ,PA 17055 \\-,8- \2... Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to and affirmed and subscribed before me this JULY 26th 2002 day d d2d-4~:;c7: L4d/r ~ ~ (f).~ ~~~ e~~..:..,.. ('In ~ DECR1rOF REGISTER Estate of Kathryn M-n Ment7er Deceased No. 21-02- tbB<a also known as Social Security No: 192-14-7409 Date of Death: AND NOW, .mT.Y ;j~. 7.007. , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters IZl Testamentary 0 of Administration ({c.t.a., d,b.n,c,t.; pendente lite; durante absentia; durante minoriate) are hereby granted to Diana K. Salisbury and Donna K. Orner in the above estate and that the instrument(s), if any, dated 7-20-1977 described in the Petition be admitted to probate and filed of record as the Last Will of Decedent. FEES Extra Pages ( ) ..... $ 235.00 $ 30.00 $ $ 6.00 $ $ $ 5.00 $ $ ~~,~;,^,i1"~"~)~ Y cr. IS Bpisler of ills Letters Short Certificates(s) Renunciation. ~~ Signature ITR.. Inventory...... Other .......... Attorney: R. Mark Thomas I.D. No: 41301 Address: 101 S. Market St. Mechanicsburg JCP Fee ........ PA 17055 TOTAL ................ ....$ 77(; nn Telephone: 717-796-2100 7-31-2002 DATE FILED: mailed to atty 7-31-2002 OATH OF SUBSCRIBING WITNESS All- Estate of KATHRYN ~ MENTZER No. 2. \ - Od.-l.ce\o also known as , Deceased Nancy I. Cassel and Donald Cassel (each) a subscribing witness to the 0 codicil(s) Ill) will(s) presented herewith, (each) duly qualified according to law depose(s) and say(s) that she/he/they was/were present and saw the above Testator(rix) sign the same and that she/he/they signed as a witness at the request of the Testator(rix) in her/his/their presence an~ in the presence of each other 0 in the presence of the other subscribing witne~ ':L~. .,.f/4d,L :::tpl!/~ / 8 E. Coov r st. Mechanicsburg, PA 17055 (Address) Sworn to or affirmed and subscribed before me this dS day of Notarial Seal Anne Carmody, Notary Public Mechanicsburg Boro, Cumberland County My Commission Expires Expires Mar. 11, 2006 Not y Public My Commission Expires:~- /I-(Jt:c, (Signature and seal of Notary or other official qualified 10 administer oaths. Show date of expiration 01 Notary's commission.) NOTE: To be taken by officer authorized to administer oaths. Please have present the original or copy of instrument{s) at time of notarization. RW-2 - - , LAST WILL AND TESTAMENT OF KATHRYN M. MENTZER 21 -02- <08(0 I, KATHRYN M. MENTZER, of the Borough of Mechanicsburg, County of Cumberland and State of Pennsylvania, being of sound and dis- posing mind, memory and understanding, do make, publish and de- clare this my Last Will and Testament. 1. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can conveniently be done. 2. All the rest, residue and remainder of my estate, real, per- sonal and mixed, of whatsoever nature and wreresoever situate, I give, devise and bequeath to my husband, Robert R. Mentzer, absolutely and unconditionally. 3. In the event that my said husband should predecease me, or should he die at about the same time as I do, such as in an accident common to both of us, then in such event, I direct the settlement and.distribution of my estate to be made in the following manner, to wit: A. I give and bequeath all my personal belongings and household furnishings to my children, or so much thereof as they may desire to have as their own, and direct that any items then remaining be disposed of and administered according to the pro- visions hereinafter set forth. B. I give, devise and bequeath all the rest, residue dnd remainder of my estate,of whatsoever nature and wheresoever situate, unto Donna K. Orner and Diana K. Salisbury, in trust, nevertheless, for the following purposes, to wit: -1-_ J o To sell, exchange, partition or otherwise dispose of any property, real or personal of which I may die seized or possessed, or which may at any time form part of my estate or any trust created hereby, at public or private sale, for such purposes and upon such terms, in such manner and at such prices as they may determine; and My Trustees shall hold invest and reinvest the same and shall collect the income therefrom and apply said income, together with the principal of said trust fund, to the comfortable support, main- tenance and education of my son, Brian A. Mentzer, for and during the term of his minority, to wit, until such time as he attains the age of 21 years, at which time said trust shall cease and determine. My said Trustees shall have the absolute right and discretion to make all such expenditures of principal and income in maintaining my said son and providing him with an education, without the necessity or requirement on their part of securing a prior Decree or Order of Court before doing so. In this respect also, I direct that my Trustees be permitted to serve in such capacity without posting bond or other security, and direct that they be excused from filing a formal accounting of their trusteeship whatsoever. C. Upon my son, Brian A. Mentzer, attaining the age of 21 years, or should he be 21 years of age or older at the time of my decease, then in either event, I direct that said trust fund shall cease and determine and that my Executors, hereinafter named, or my Trustees above named, whichever the case may be, shall pay out and distribute the balance of my estate then remaining to my fiVG children, to wit: Donna K. Orner, Diana K. Salisbury, Linda M. Williams, Robert R. Mentzer, Jr. and Brian A. Mentzer, share and share alike, per stirpes. D. Should my husband so predecease me, then in such event, I nominate, constitute and appoint my daughter, Diana K. Salisbury, guardian of the person of my son, Brian A. Mentzer, for and during -2- . - . the term of his minority and direct that she be paid a reasonable compensation from time to time, for the care and maintenance of my said son so long as he remains under her personal care and custody and as a member of her immediate household. LASTLY, I nominate, constitute and appoint my husband, Robert R. Mentzer, Executor of this my Last Will and Testament, and in the event that my said husband should predecease me or for any reason be unwilling or unable to serve in such capacity, then in such event, I nominate, constitute and appoint my daughters, Donna K. Orner and Diana K. Salisbury, Executrices of this my Last Will and Testament in his place and stead. ." , --. () IN WITNESS WHEREOF, dv I have hereunto set my hand and seal this day of July, A. D. 1977. ,-1f:k{':f!ttZ)~~f;:iY/1.~ (SEAL) Signed, sealed, published and declared by the above named Kathryn M. Mentzer, as and for her Last Will and Testament, in the presence of us who have subscribed our names hereto as witnesses, at the request of said testatrix, in her peresence and in the presence of each other. . (:~,' .. tJ ,/1 , 1 / / <-/-1(:'.'('.<-. ~ '.. /f- ,,,--1iL< /L JM~cJ -A-l~~1 -3- , " 0 D I I t-" :t> :s: (J) cD 0: >-3 () ~ "-' :t> "" :ll ;Till p. >-3 ~ . " ill Cjcr :r. H , ::J ~cr~ ~ t-" ~ I :ll f-J.(D 0 0 ~ t-" ~ () cr"jIT Z 0 Ul ::J (]) 'Tj ,"" ~ IT (j) (]) Cj :s: ~ " r '::;..0 ~ ct . t:1 w Cj ,::; I " iJ'1ill(b (j) :s: >-3 0. [ ~ "jcrct t8 t8 m I (b Z en ? >D t-"::; >-3 >-3 .. (]) tdll) H, N :t> " :3 f-'::( H, t8 '? I ::J CL (l) ~ Eil I 1I)iJ'1 >; z , . . >-3 , il D 0 ( J CERTIFICATION OF NOTICE UNDER RULE 5.6(a\ Name of Decedent: Kathryn M. Mentzer Date of Death: 7/19/2002 Estate No. 21-02-0686 SSN: 192-14-7409 File No. 2002-00686 Date Letters Granted: 7/31/2002 Will or Administration No. To the Register: I certify that Notice of Estate Administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on 8/6/2002 Name Address Diana K. Salisbury 910 Spring Circle Mechanicsburg PA 17055 Donna K. Orner 421 Pawnee Drive Mechanicsburg PA 17050 Bnan A. Mentzer 306 E. Elmwood Avenue Mechanicsburg PA 17055 Linda M. Williams 31 Pleasanton Drive East Berlin PA 17316 Robert R. Mentzer, Jr. 2100 Newville Road Carlisle PA 17013 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: 8/6/2002 m~ Signature Capacity: Personal Representative x Counsel for Personal Representative Name (Please type or print) R. Mark Thomas, Esq. , Address , 101 S. Market Street Mechanicsburg PA 17055 Telephone No. 717-796-2100 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT R MARK THOMAS ESQUIRE 101 SOUTH MARKET STREET MECHANICSBURG, PA 17055 nu_u~ fold ESTATE INFORMATION: SSN: 192-14-7409 FILE NUMBER: 2102-0686 DECEDENT NAME: MENTZER KATHRYN M DATE OF PAYMENT: 10/17/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 07/19/2002 NO. CD 001739 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $5,800.00 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: R MARK THOMAS ESQUIRE CHECK# 1678 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS $5,800.00 MARY C. lEWIS REGISTER OF WillS BUREAU OF ZNDZVZDUAL TAXES TNHERZTANCE TAX DZVZSTON DEPT. 280601 HARRTSBURG, PA 17128-0601 R MARK THOMAS ESQ 101S MARKET ST MECHANICSBURG PA 17055 COHNONNEALTH OF PENNSYLVANZA DEPARTMENT OF REVENUE ZNHERZTANCE TAX STATEHENT OF ACCOUNT l:~.~ DATE 05-29-200q Fi/: ESTATE OF HENTZER DATE OF DEATH 07-19-2002 FZLE NUHBER 21 02-0686 '04 APR 20 ~bOb~TY CUMBERLAND ACH 101 Amoun~ Remi~*ed REV-i&D? El( ,~FP [01-95) KATHRYN H HAKE CHECK PAYABLE AND RENZT PAYMENT TO: REGTSTER OF WILLS CUMBERLAND CO COURT HOUSE CARLTSLE, PA 17015 NOTE: To insure proper credi~ ~o your account, submi~ ~he upper portion of ~his fore wi~h your ~ex peyeen~:. CUT ALONG THZS LZNE ~'~ RETA'rN LONER PORT'rON FOR YOUR RECORDS REV-1607 EX AFP (01-03) #~# XNHERZTANCE TAX STATEHENT OF ACCOUNT ESTATE OF HENTZER KATHRYN M FZLE NO. 21 02-0686 ACN 101 DATE 05-29-200q TH'rS STATEHENT TS PROV'rDED TO ADV/SE OF THE CURRENT STATUS OF THE STATED ACN 'rN THE NAILED ESTATE. SHOI./N BELON TS A SUHHARY OF THE PR*rNC/PAL TAX DUE, APPL/CAT/ON OF ALL PAYHENTS, THE CURRENT BALANCE, AND, ZF APPL'rCABLE, A PROJECTED TNTEREST F'rGURE. DATE OF LAST ASSESSHENT OR RECORD ADJUSTMENT: 03-15-Z00~ PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): 6,676.9q PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 305.26 10-17-2002 0q-21-2003 03-15-200q CD001739 CO002q68 REFUND .16- .00 5,800.00 631.06 59.22- ZF PAZD AFTER THZS DATE, SEE REVERSE SZDE FOR CALCULATION OF ADDZTZONAL ZNTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT IS REQUZRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDZT' TOTAL TAX CREDZT 6,676.9q BALANCE OF TAX DUE .00 ZNTEREST AND PEN. .00 TOTAL DUE .00 YOU HAY BE DUE A REFUND. SEE REVERSE STDE OF THTS FORM FOR *rNSTRUCT'rONS. PAYNENT: Detach the top portion of this Notice and submit Hith your payment made payable to the name and address printed on the reverse side. -- if RES[DENT DECEDENT make check or money order payable to: REGTSTEE OF NTLLS, AGENT. -- if NON-RES[DENT DECEDENT make check or money order payable to: CONHON#EALTH OF pENNSYLYANTA. REFUND (CR): A refund of a tax credit, Hhich Has not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-J315). Applications are available at the Office of the Register of NiX[s, any of the 25 Revenue District Offices or from the Department's lq-hour ansHering service for forms ordering: 1-800-$BZ-ZOSO; services for taxpayers Hith special hearing and / or speaking needs: 1-800-~47-50Z0 (TT onlY). REPLY TO: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment ReviaH Unit, Dept. ZB060[, Harrisburg, PA iTl[D-060[, phone (7[7) 787-6505. DISCOUNT: if any tax due is paid Hithin three (5) calendar months after the decadant's death, a five percent (SZ) discount of the tax paid is alloHed. PENALTY: The 15X tax amnest~ non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January [8, 1996, the first day after the end of the tax amnesty period. iNTEREST: [ntarest is charged beginning with first day of delinquency, or nine (9) months and one ([) day from the date of death, to the date of payment. Taxes Hhich beceea delinquent before January [, 198Z bear interest at the rata of six (BZ) percent par annum calculated at a daily rate of .000164. Ail taxes which became delinquent on and after January [, [98Z will bear interest at a rate Hhich Hill vary free calendar year to calendar year Hith that rate announced by the PA Departeent of Revenue. The applicable interest rates for 198Z through ZO0~ ara: [nterest Daily Interest Daily Interest Daily Year Rate Factor Year Rats Factor Year Rata Factor 198Z ZOZ .00054~ 1968-1991 llX .00050! ZOOl 9X .OOOZ~7 1985 X6Z .0004~8 1992 9Z .000247 ZOOZ 6Z .000164 1984 1XZ .000301 1995-1994 72 .000192 2005 5X .000157 1985 15Z .000356 1995-1998 9Z .O00Z~7 2004 ~Z .000110 1986 IOZ .O0027¢ 1999 7Z .O0019Z 1987 9X .0002q7 ZOO0 8Z .000219 --Interest is calculated as folloHs: TNTEREST = BALANCE OF TAX UNPATD X NU}iBER OF DAYS DELTNQUENT X DATEY ;INTEREST FACTOR --Any Notice issued after the tax becomes delinquent Hill reflect an interest calculation to fifteen [15) days beyond the date of the assessment. If payment is made after the interest computation data shown on the Notice, additional interest must be calculated. REV.1500EX'16-(0) . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 11-73- /~ REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT w ~ ,,-CIl va:" w:5g :ta:-, v "-a> "- <( z o ~ ::l l- ii: <C U w a: z o ~ ::l Q. :E o u ~ I- DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) I- Z W C W U w c MENTZER, KATHRYN MARIE DATE OF DEATH (MM-DD-Yearj DATE OF BIRTH (MM-DD-Year) 07/19/2002 05/15/1924 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) [g] 1. Original Return o 4. Limited Estate o 6. Decedent Died Testate (Attach copy of Will) o g, Litigation Proceeds Received o 2, Supplemental Return o 4a, Future Interest Compromise (date of death after 12-12-82) D 7. Decedent Maintained a Living Trust (Attach copy 01 Trust) D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1.95) to- Z W C tj "- CIl w a: a: c v THISS MUST se CO TeD~AU.OO NAME R. Mark Thomas, Es FIRM NAME (If Applicable) '1!'l'Il!l'liiNIlE'" "'N,lllillilijij:f'iL,'-!!F! COMPLETE MAiliNG ADDRESS 1 01 S. Market Street TELEPHONE NUMBER 796-2100 Mechanicsbur 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) (1) (2) (3) (4) (5) 3, Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Noles Receivable (Schedule Dj 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. JoinUy 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) (6) (7) (8) (9) 10. Debts of Decedent Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an eiection to lax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X _(15) 149,356.89 X .045 (16) X .12 (17) X .15 (18) (19) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18, Amount of Line 14 taxable at collateral rate 19. Tax Due (11) (12) (13) (14) OFFICIAL USE ONLY c FILE NUMBER -2 -1l. 4. .12 _aJ;' ~.6... COIJNTYb YEAR $;fuR SOCIAL SECURITY NUMBER 92- 1 4 - 7 4 0 9 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 03. Remainder Return (dale of death prior to 12.13-82) D 5. Federal Estate Tax Return Required _ 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec, 9113(A) (AttachSch 0) PA 17055 130,000.00 OFFICIAL USE ONLY 32,205.63 I 4,483,09 . 166,688.72 17,331.83 17,331.83 149,356.89 149,356.89 6,721.06 6,721.06 20.0 Decedent's Complete Address: STREET ADDRESS E C S 9 . Dover treet CITY . I STATE PA I ZIP Mechanlcsburg 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credils/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 6,721.06 5.800.00 290.00 3. Interest/Penalty it applicable D.lnterest E. Penalty Total Credits (A + B +C) (2) 6,090.00 Total Interest/Penalty (0 + E) (3) 4 If Line 2 is greater than Line 1 + Line 3, enter the difference. This is Ihe OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. if Line 1 + Line 3 is greater than Line 2, enler the difference. This is the TAX DUE. (5) A. Enter the interest on Ihe tax due. (5A) B. Enler the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 631.06 631.06 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. relain the use or Income of the property transferred; ................................. ................. .................... 0 IZJ b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 IZJ c. retain a reversionary interest; or ...................................................................................................... 0 [ZJ d. receive the promise for life of either payments, benefits or care? ............................................................. 0 IZJ 2. If death occurred after December 12, 1982, did decedent Iransfer property within one year of death without receiving adequate consideralion?........................ ..............................................,........................ 0 IZJ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. 0 IZJ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... 0 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 perjury, I declare that I have examined this relurn, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer olher than Ihe personal represenlalive is based on all informalion of which preparer has any knowledge. SIGNAT)-\RE OF PERSON RESPONSIBLE FOR FILING RETURN .I! D TE /iY.hvn.~. LY.-. .e ~ n ADDRESS '1 r?l.- ( y . SIGNATURE OF PREPARER OTHER THAN REP ADDRESS ItJ I J mt:lrlLd- S9. /J1t?c/1al1lcsJ;u/Yj /J4- >-.I", / 71.) ~ ; <<<:<:<" ".,<:t<". For dales of death on or after Juiy 1, 1994 and before January 1, 1995, the tax rate imposed on the net vaiue of Iransfers 10 or for the use of the surviving spouse is 3% [72 PS 99116 (a) (1.1 )(i)). For dates of death on or after January 1, 1995, Ihe 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 statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after Juiy 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 99116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1 I]. The tax rate imposed on the net value of transters to or for Ihe use of Ihe decedent's siblings is 12% [72 P.S 99116(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 RfV_1502EX+II-971~_ .,~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE A REAL ESTATE EST ATE OF FILE NUMBER MENTZER KATHRYN MARIF All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a 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 survillorshin must be disclosed on Schedule F. """. .. . ITEM NUMBER 1. DESCRIPTION 2 Story, 4 bedroom residential house situate at 9 East Coover Street, Mechanlcsburg, PA 17055 Property appraised at $135,400.00 (Copy of appraisal attached) Property has been on the market for six months, listed at $135,000.00. No offers have been made and therefore listing price is being reduced to $130,000.00. VALUE AT DATE OF DEATH 130,000.00 TOTAL (Also enter on line 1, Recapitulation) $ 130,000.00 C'I'~"'.(''''.. COMMONWEALTH OF PENNSYLVANIA INKERIT ~NCE "1" AX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF MENTZER KATHRYN MARIF 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. FILE NUMBER ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Citizen's Bank 30,905.63 Accl. #355-015932 2. Cash 50.00 3. Household Furnishings 500.00 4. 1981 Mustang 750.00 TOTAL (Also enter on line 5. Recapitulation) $ (If more space is needed, Insert additional sheets of the same size) 32,205.63 o,,,,;om,,,.o:,. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTL Y.OWNED PROPERTY ESTATE OF MENT7FR KATHRYN MARIF If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. FILE NUMBER SURVIVING JOINT TENANT(S} NAME ADDRESS RELATIONSHIP TO DECEDENT A. Diana K, Salisbury 910 Spring Circle Mechanicsburg, PA 17055 Daughter B c JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT deed forjoinlly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1 A Citizen's Bank 8,966.18 50. 4,483,09 Accl. #142-110-3324 TOTAL (Also enter on line 6, Recapitulat,on) $ 4,483.09 (If more space IS needed, Insert additional sheets of the same size) """""""'''1. COMMONWEALTH OF PENNSYLVANIA INHERITANCE. TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF MFNTZER KATHRYN MARIE FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A FUNERAL EXPENSES: 1. Ewing Brothers Funeral Home 8,253.00 2. Carlisle Memorial Service, In. 685.00 3. Funeral Dinner 260.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (5) Social Security Nurnber(s) I EIN Number of Personal Representative(s) Street Address City State Z"p Year(s) Commission Paid: 2. Attorney Fees R. Mark Thomas, Esq. 4,000.00 3. Family Exemption: (If decedenfs address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimanllo Decedent 4. Probate Fees 291.00 5. AccounlanfsFees 6. Tax Return Prepare~s Fees 7. Patriot News (Publication of Notice) 119.95 8. Cumberland Law Journal (Publication of Notice) 75.00 9. 2003 Real Estate Taxes - County!Township 384.42 10. "For Sale" sign for real property 15.00 11. Advertising - Sale of real property 350.00 12. 2002 School Taxes 1,296.86 13. Lynn Weldon - Yard work 40.00 14. United Water (Aug. 2002 - Mar. 2003) 64.70 15. Com cast 10.87 16. PP&L (Aug. 2002 - Mar. 2003) 239.54 17. Verizon (Aug. 2002 - Mar. 2003) 115.87 18. Shipley Energy (Aug. 2002 - Mar. 2003) 982.00 TOTAL (Also enler on line 9, Recapllulallon) $ 17,331.83 (If more space is needed, 'lnsert addilional sheels of Ihe same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent MENTZER, KATHRYN MARIE Paqe 1 Schedule H - Funeral Expenses & Administrative Costs - 87 ITEM NUMBER DESCRIPTION AMOUNT 19. Mechanicsburg Borough - SewerjTrash (Aug. 2002 - Mar. 2003) 148.62 SUBTOTAL SCHEDULE H.B7 148.62 REV"1513EX'"". COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER q RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under See" 9116 lal (1"2)) 1" Diana K" Salis burg Daughter 1/5 910 Spring Circle Mechanicsburg, PA 17055 2. Donna K. Orner Daughter 1/5 421 Pawnee Drive Mechanicsburg, PA 17050 3. Brian A. Mentzer Son 1/5 306 E. Elmwood Avenue Mechanicsburg, PA 17055 4. Linda M. Williams Daughter 1/5 31 Pleasanton Drive East Berlin, PA 17316 5. Robert R. Mentzer, Jr. Son 1/5 2100 Newville Road Carlisle, PA 17013 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 1B, 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 t B CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II . ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed. insert additional sheets 01 the same s"lze) Wile No. Mentzerl PaDe #1\ ~ Form GAl - "TOTAL for Windows" appraisa; software by a la mode. inc. - 1.800.ALAMOOE E.J. KOppeMavef true l'l1U. Memzerr t'aae #ll Appraisals by E. J. Koppenhaver 2116 South point Drive Suite B Hummelstown, PA 17036 Phone: 717.683.0306 Mentzer 9 E Coover Street Mechanlcsburg, PA 17066 Re: Property: 9 E Coover Street Mechanlcsburg, PA 17066 Borrower: Not Applicable File No.: Mentzer In accordance with your request, we have appraised the above referenced property. The report of that appraisal Is attached. The purpose of this appraisal Is to estimate the market value of the property described In this appraisal report, as Improved, in unencumbered fee simple title of ownership. This report Is based on a physlca' analysis of the site and Improvements, a locatlonal analysis of the neighborhood and city, and an economic analysis of the market for properties such as the subject. The appraisal was developed and the report was prepared In accordance with the Uniform Standards of Professional Appraisal Practice. The value conclusions reported are as of the effective date stated In the body of the report and contingent upon the certification and limiting conditions attached. It has been a pleasure to assist you. Please do not hesitate to contact any of our staff If we can be of additional service to you. For The Firm, NI~M~W/~ Vicki L. WIckwire Il"'lIe 1'10. MenlZer! t"aoe .;:11 SUMMARY OF SALIENT FEATURES Subject Address 9 E Coover Street Legal Oescnplion Not Available City Mechanlcsburg County Cumbertand State PA Zip Code 17066 Census T racI N/A Map Reference N/A Sale Price $ N/A Date of Sale N/A Borrower I Client Not Applicable Lender Mentzer Size (Square Feet) 1,926 Pnce per Square Foof $ 70.34 Location Average Age 90+/- Years Condition Average T ofaI Rooms 8 Bedrooms 4 Baths 1 Appraiser Vicki L. Wickwire Date of Appraised Vaiue 07/26/02 Final Estimate of Value ~ Form SSO - "TOTAL tor Windows" appraisal software by a la mode. inc. - 1.800.ALAMOOE ~ FannieMae U, Koppenhaver Tax Year 2001 Pro'eelT e Ilesen tion amount of loan c Reference NJA Condo ions to be aid b sel er None Consus Trac\ NIA Property values ~ Increasing Demanl\lsupply ~ Shortage o Stable 0 Declining o In balance 0 O'/er Sl.IJllIy Public Pnvate lZl 0 110 It Yes attach de on, Previous appraisal tiles anuf d 0lJ in No 90.51 rP 98.60 rP 78.35r/J MLS and Count MLS andCoun MLS and Coun DESCRIPTION DESCRIPTION OESCI\IPTION Conv 85 DOM Conv 28 DOM Conv 23 DOM NIA NIA NIA me 07119102 09/13101 11/30101 Avera e Avera e Ayera e 13 068 S . Ft. -1 900 4 366 S .Ft. 6 098 S .Ft. Avera e Ayera e Ayera e 2.6 Sto lAy 2.6 Sto lAy 2.5 Sto IAv 82 +1- Yeara 80+1- Years 90+/- Years Good Good Good olal : Bdnns : B ths Total : Bdnns: otlls 7 : 4 : 2 -1,000 7 : 3 : 2 1 754 S , t +2 600 1430S.Fl. 100% I 0% 100% I 0% Unfinished Unfinished Ca ort -1 000 1 Car Gara e -2 000 OFWAlNone GFWAlNone EnclosedPorch " -1 000 Porch Patio + 12300 + 5600 8000 146 450 135 400 129 900 NIA There Is no known sales This appraisal Is made lZl "os-is", 0 subject to completion per plans and speeilications on the basis ot a hypothetical condition tI1at tile improvements have been eompletBd, or o subject to tile tollowing repairs. alterations or conditions BASED ON AN 0 EXTERIOR INSPECTION FROM ~,lZlINrulIOR AND EXTERIOR INSPi'CT1ON, I ESTIMATE THE MARKET VAUJE, AS DEFIHEO,OFTHE IlW. I'RDPER'lYTllATISTHESUBJECTOFTHlSREPORT BES 135,400 ) ,ASDF 07/26/02 PAGE1Df3 Fannie Mae form 2055 9-96 fFire No. Mentzerl Paoe #51 Mentzer ralsal He ort File No. Mentzer Pro)ecllnlormation lor PUD. (If applicable) - -Is the devaloper/builder In control of the Home Owners' Association (HOA)? 0 Yes 0 No Pro~de the following infonnation for PUDs only if the developer/bullde, is in control 01 the HDA and the subject property is an attached dwelling WIil: T otat number 01 phases T otat number of unlls Total number of unlls sold Totat number of units rented Total number of units lor sate Data Soon:e(s) Was the project created by the conversion of e~sting buildings into a PUD? 0 Yes 0 No If yes, date 01 conversion: Does the project contain any multi-dwelling units? 0 Ves 0 No Data SMce: Are the common e'ements compleled? 0 Ves 0 No II No, describe status 01 completion: Are any common elements 'eased to or by the Home Owners' Association? Describe common elements and Jecreationat laciiities: oVes DNa If yes, attach addendum describing reotaltenns and options. ProJectlnlormation lor CondomInium. (If applicable) - - Is the developer/bullder in control 01 the Home Owners' Association (HOA)? 0 Ves 0 No Provide the following Infonnation for atl Condominium Projects: Total number of phases Totat number 01 units Totat number of units sold Totat number 01 units rented Tolai number of units lor sate Oma SOIlfce(s) Was the project created by the conversion of e~sting buildings Info a condominium? 0 Ves 0 No II yes, date of conversion: Proiect Type: 0 Primary Residence 0 Second Home Of Recreationat 0 Row Of TownhoUse 0 Garden 0 Mldrise 0 Highnse 0 Condition of the project, quality of constnJction, unit mix, etc.: Are fhe common elements completed? o Ves 0 No If No, describe status of completion: Are any common elements leased to or by the Home Owners' Association? Descnbe common elements and recreationat facllmes: o Ves 0 No II yes, attach addendum describing rentat lenns and options. PURPOSE OF APPRAISAL: The purpose of this appraisal Is to estimate the market value of the real property that Is the subject of this report based on a quantitative sales comparison analysis for use in a mortgage finance Iransacllon. DEFINITION OF MARKET VALUE: The most probable price which a property should bring In a competitive and open market under all condmons requlslle to a fair sale, Ihe buyer and seifer, each acllng prudently, knowledgeably and assuming Ihe price Is nol aIIected by undue stimulus. Impflcll in Ihis definllion is Ihe consummation of a sale as of a specllied date and the passing of IIlte from seller 10 buyer under condlllons whereby: (1) buyer and seller are typically motivated; (2) both parties are well Infonmed or well advised, and each acting In what he considers his own best inlerest; (3) a reasonable time is allowed for exposure In the open market; (4) payment is mad\! in tenms 01 cash in U.S. dollars or in tenms 01 financial arrangements comparable thereto; and (5) the price represents the nonmal consideration for the property sold unallected by special or creative financing or sales concessions. granted by arryone associated with the sale. . Adjustments to the com parables must be made for special or creative financing or sales concessions. No adjustments are necessal}' for those costs which are nonmally paid by sellers as a result of tradillon or law in a market area; these Costs are readily IdenOOable since the seller pays these costs in virtually all sales transactions. Special or creative financing adjusbnents can be made to the comparable property by comparisons to financing lenms offered by a third party instllullonal lender thaI is not already lrrvowed In the property or transaction. Arry adjusbnent should not be calculated on a mechanical dollar for dollar cost of the financing or concession but the dollar amount of arry adjusbnent should. approximale lhe markel's reaction to the financing or concessions based on lhe appraiser's Judgment. STATEMENT OF LIMITING CONDITIONS AND APPRAISER'S CERTIFICATION CONTINGENT AND LIMITING CONDITIONS: The appraiser's certllication that appears in the appraisal report is subject to the following condlllons: 1. The appraiser wiil not be responsible for matters of a legal nature that aIIect ellher the property being appraised or the tille to it. The appraiser assumes that the liUe is good and marketable and, therefore, wftl nol render arry opinions aboul the We. The property is appraised on the basis of it being under responsible ownerShip. 2. The appraiser has provided arry required sketch in the appraisal report to show approximate dimensions of the Improvements and the sketch is included only to assist the reader of the report In visualizing the property and understanding the appraiser's detenmlnation of its size. 3. The appraiser will not give testimony or appear in court because he or she made an appraisal of the property in quesllon, unless specllic arrangements to do so have been made beforehand. 4. The appraiser has noted in lhe appraisal report any adverse conditions (such as, but not i1mited to, needed repairs, the presence of hazardous wastes, toxic substances, etc.) obselVed during the inspection of the subject property or that he or she became aware of during the nonmal research irrvotved in perfonming the appraisal. Unless otherwise stated in the appraisal report, the appraiser has no knowledge of arry hidden or unapparent condmons of the property or adverse errvlronmental condlllons (Including the presence of hazardous wastes, toxic substances, etc.) that would make the property more or less valuable, and has assumed that there are no such condllions and makes no guarantees or warranties, expressed or implied, regarding the condllion of the property. The appraiser will not be responsible for any such condllions that do exist or for arry engineering or testing that might be required to discover whether such conditions exist. Because the appraiser Is not an expert in the field of errvironmental hazards, the appraisal report must not be considered as an errvlronmental assessment of the property. 5. The appraiser obtained the infonmatlon, estimates, and opinions that were expressed in the appraisal report from sources that he or she considers to be reliable and believes them to be true and correct. The appraiser does nol assume responsibillly for the accuracy of such IIems that were furnished by other parties. 6. The appraiser will not disclose the contents of the appraisal report except as proVided for in the Unllonm Standards of Professional Appraisal Practice. 7. The appraiser must provide his or her prior wrmen consent before the lender/client specilied in Ihe appraisal report can distribute Ihe appraisal report (including conclusions about the property value, the appraiser's identlly and professional designations, and references to arry professional appraisal organlzations or the flnm wllh which the appraiser is associated) 10 arryone other than the borrower; the mortgagee or lis successors and assigns; the mortgage Insurer; consultants; professional appraisal organlzailons; arry slaite or federally approved financial Institution; or arry department, agency, or instrumentallly of the Uniled Slates or arry slate or the District of Columbia; except that the lender/client may distribute the report to data coileclion or reporting selVice(s) wllhout having to obtain the appraiser's prior written consent. The appraise(s wrmen consent and approval must also be obtained before fhe appraisal can be conveyed by arryone to the public through advertising, public relations, news, sales, or other media. a. The appraiser has based his or her appraisal report and valuation conclusion for an appraisal that is subject to completion per plans and specllications on on the basis of a hypothetical condition that the Improvements have been compleled. 9. The appraIser has based his or her appraisal report and valuation conclusion for an appraisal that is subject to completion, repalrs, or aIleralions on the assumption that completion of the improvements will be perfonmed In a workmanlike manner. PAGE 2 OF 3 Fannie Mae fonn 2055 9-96 Wilt:: 11U. Mt:IlUtlll nlUtl 0/f'01 Id Q Mentzer .Des OP Underwriter uantltatlve Analysis Appraisal Report File No. Mentzer APPRAISER'S CERTIFICATION: The Appralser certifies and agrees that: I. I perfonned this appraisal by (1) personally Inspecting from the street the subject property and nelghborliood and each of the compalable sales (unless I have olhelWise Indicated in Ihis report that I also inspected the interior of the SUbject property); (2) collecting, confinnlng, and analyZing data from reliable public and/or private sources; and (3) reporting the resulls of my Inspection and analysiS In Ihls summary appraisal report. I further certify that I have adequate infonnallon about the phYsical characteristics of the subject property and the comparable sales to develop this appraisal. 2. I have researched and analyzed the comparable sales and offeringslllsllngs In the subject markel area and have reported Ihe comparable sales in Ihls report that are lhe best available lor Ihe SUbject property. I further certify that adequate comparable market data exists in the general market area to develop a reliable sales comparison analysis for the SUbject property. 3. I have taken Inlo consideration the factors that have an Impact on value In my development of the estimate of market value In the appraisal report. I further certify that I have noted alr1 apparent or known adverse condlllons in Ihe subject Improvements, on Ihe subject slle, or on any slle wllhln the immedlale vlclnify of Ihe SUbject property of which I am aware, have considered Ihese adverse conditions in my analysis of the property value to the extent that I had mall<et evidence 10 support them, and have commented about the effect of the adverse condlllons on the mall<etabllify of the subject property. I have not knowingly withheld alr1 slgnllicant Infonnallon from the appraisal report and I believe, to the best of my knowledge, Ihal allstalemenls and Infonnatlon In the appraisal report are true and correct. 4. I stated in the appraisal report only my own personal, unbiased, and professional analysis, opinions, and conclusions, which are subject only 10 the contingent and limiting conditions specllled in this fonn. 5. I have no present or prospective interest in the property that is the sublect of this report, and I have no present or prospective personal Interest or bias wllh respect to the partlclpants in the transaction. I did not base, either partially or completely, my analysis and/or the estimate of market value in the appraisal report on the race, color, religion, sex, age, marllal status, handicap, familial status, or nallonal origin of either the prospective owners or occupants of the sublect property or of the present owners or occupants of the propertles in the vlclnily of the subject property or on alr1 other basis prohibited by law. 6. I have no present or contemplated future interest in Ihe subject property, and nellher my current or future employment nor my compensation for perfonning this appraisal is contingent on the appraised value of Ihe property. 7. I was nol required to report a predetennined value or direction in value that favors the cause of the client or any related party, the amoun! of the value estimate, the attainmenl of a specllic result, or the occurrence of a subsequent event in order 10 receive my compensation and/or employment for performing the appraisal. I did not base the appraisal report on a requesled minimum valuation, a specllia valuation, or Ihe need 10 approve a specWlc mortgage loan. 8. I estimated the market value of the real property that Is the sublact of this report based on the sales comparison approach to value. I further certify that I considered the cost and Income approaches to value, but, through mutual agreement with the client, did not develop them, unless I have noted othelWise in this report. 9. I perfonned this appraisal as a Iimlled appraisal, subiect to the Departure Provision of the Unllonn Standards of Professional Appraisal Practice that were adopted and promulgated by the Appraisal Standards Board of The Appraisal Foundation and that were in place as of the effective date of the appraiSal. (unless I have othelWise indicated in this report that the apPlalsal is a complete applaisal, in which case, the Departure Provision does not apply). 10. I aCknowledge that an estimate of a reasonable time for exposure In the open mall<et Is a condition in the deflnlllon of market value. The exposure time associated wllh Ihe estimate of market value for the subiect property Is consistent wllh the mall<eting time noted in the Neighborhood section of this report. The marketing period concluded for the subject property at the estimated market value is also consistent with the mart<eting time noted In the Neighborhood section. 11. I personally prepared all conclusions and opinions about the real eslate that were set forth In the appraisal report. I further certify that no one provided slgnlllcant professional assistance to me In the development of this appraisal. SUPERVISORY APPRAISER'S CERTIFICATION: " a supervisory appraiser signed the appraisal report, he or she certifies and agrees that: I directly supervise the appraiser who prepared the appraisal report, have examined the appraisal report for compliance with the UnllolTl1 Standards of Professional Appraisal Practice, agree wBh the statements and conclusions of the appraiser, agree 10 be bound by the appraiser'S certlllcatlons numbered 5 through 7 above, and am laking full responsibilify for the appraisal and the appraisal report. APPRAISER: A, SUPERVISORY APPRAISER (ONLY IF REQUIRED): Signature: 11 WI~WJ~ Signalure: Name: Vicki L. Wickwire Name: Company Name: AppraisalS By E. J. Koppenhaver Company Name: Company Address: 2116 Southpolnt Drive Company Address: Hummelstown. PA 17036 Date of Reporl/Slgnature: 07/30/02 Date of Reporl/Slgnature: e- Slate Certification #: RL-003279-L Slate Certification #: or State License #: or State License #: State: PA State: expiration Date of Certnication or License: 06/30/2003 expiration Date of Certnication or License: ADDRESS OF PROPERTY APPRAISED: 9 E Coover Street SUPERVISORY APPRAISER: Mechanlcsbul'll. PA 17066 SUBJECT PROPERTY APPRAISED VALUE OF SUBJECT PROPERTY $ 136.400 o Did not Inspect subject property EFFECTIVE DATE OF APPRAISAL/lNSPECTION 07/26/02 o Did Inspect exterior of subject property from street LENDER/CLIENT: o Old inspect interior and exterior of subject property Name: COMPARABLE SALES Company Name: Mentzer o Did not inspect exterior of comparable sales from street Company Address: 9 E Coover Street. Mechanlcsburg. PA 171 o Did inspect exterior of comparable sales from street PAGE 3 OF 3 Fannie Mae Fonn 2055 9-96 II lie! nu. IfIl:lIlLLC/l r-dU1:I1I"/1 Borrower NotAoollcable Ale Nn. Mentzer PIoDertv AddIess 9 E Coover Street ciiv Mechanlcsbura Counlv Cumberland State PA ZiD Code 17055 Lender Mentzer APPRAISAL AND REPORT IDENTIfiCATION This Appraisal conforms to llI1ll. of the following definitions: [g] Complete Appraisal The act or process of estimating value, or an estimate of value, performed without invoking the Departure Provision. o Limited Appraisal The act or process of estimating value, or an estimation of value, performed under and resulting from invoking the Departure Provision. This Report is llI1ll. of the following types: o Self Contained Report A written report prepared under Standards Rule 2-2(A) of a complete or limited appraisal performed under Standard 1. [g] Summary Report A wrltten report prepared under Standards Rule 2-2(6) of a complete or limited appraisal performed under Standard 1. o Restricted Report A written report prepared under Standards Rule 2-2(C) of a complete or limited appraisal performed under Standard 1. Comments on Appraisal and Report Identification Note any departures from Standards Rules 1-2, 1-3, 1-4, plus any USPAP-related Issues requiring disclosure: E.J. Koppenhaver Form ID1- "TOTAL tor Windows" appraisal software by ala mode, inc. -l-800-ALAMODE IFile No. Menlz,,1 Paoe #81 DEfiNITION Of MARKET VALUE: The mosl probable pnce which a property should Mng in a competitive and open ma/1(el under all condllions requisile to a fair sale, the buyer and seUer, eacll acting prudenUy, knowledge~ and assuming the pnce Is not aflected by undue stimulus. Impilcil In this definition is the conSlJl!lfll3llon of a sale as of a specified date and the pas~ng 01 tiUe from seiler to buyer under condilions whereby: (1) buyer and seUer are typically motlvated; (21 both pms are weil lI11anned or w~1 advised, and each acting in whal he con~ders his own best Interest; (3) a reasonable time is allowed for exposllle In the open ma/1(el; (41 paymenl is made In lenns of cash in U.S. dollars or in tenns of financial arrangements comparable thereto; and (5) the price represents lhe nonnaI conslderntlon for the property sold unaffected by special or creative financing or sales concessions' granted by anyone associated wilh the sale. . Adjusbnenls 10 the comparables musl be made for special or creative financing or sales concessions. No adiustments are necessary for those costs which are nonnally paid by seUers as a result of tladltion or law in a mal1rel area; these cosls are readUy Identifiable since the seUer pays these cosls In virtually all sales lransactions. Special or crsaJWe fmancing adiustments can be made to the comparable property by comparisons to financing tenns ofiered by a Ihlrd party Institutional lender that is not already invoWed In the property or transaction. Any adjustment should not be calculated on a mechanical dOHar lor doHar cost of the financing or concession but the doUar amounl 01 any adjusbnent should appro~mate the ma/1(el's reaction 10 the financing or concessions based on the appraiser's judgement. STATEMENT OF LIMITING CONDITIONS AND APPRAISER'S CERTIFICATION CONTINGENT AND LIMITING CONDITIOIIS: The appraise(s certltication that appears In the appraisal report Is subject 10 the lollowing conditions: 1. The appraiser wlil not be responsible lor matlers of a legal nature lhat affect either the property being appraised or the tnle 10 iI. The appraiser assumes that the tiUe is good and marketable and, therefore, will not render any opinions about the tme. The property is appraised on the basis of iI being under responsible ownership. 2. The appraiser has pro~ded a sketch in the appraisal report 10 show appro~male dimensions of the improvemenls and the sketch Is included only to asslsl the reader of the report In vlsualizinll the property and undelStandlng the appraiser's derenntnalion of ils size. 3. The appraiser has examined the available flood maps that are provided by the Federal Emergency Management Agency (or other data sources) and has noted in the appraisal report whether the subject sHe Is located in an identffied Special Flood Hazard Area. Because the appraiser Is not a Slll'l8'jor, he or she makes no guarantees, express or implied, regarding this delenninalion. 4. The appraiser will not give testimony or appear in court because he or she made an appraisal 01 the property In question, unless specific arrangements to do so have been made beforehand. . 5. The appraiser has estimated the value 01 the land in the cosl approach at ils highest and besi use and the Improvements at their contributory value. These separate valualions of the land and improvarnenls musl not be used in conjunction with any other appraisal and are Invalid if they are so used. 6. The appraiser has noted In the appraisal report any adverse conditions (such as, needed repairs, depreciation, the presence of hazardous wastes, fo~c substances, etc.) abSOlVed during lhe Inspect on of lhe subjec1 property or lhat he or she became aware of llJring the nOnnal research InvoWed in pertorming the appraisal. Unless otherwise staled In the appraisal report, Ihe appraiser has no knowledge 01 any hidden or unapparent conditions of Ihe property or adverse environmental conditions Oncluding the presence of hazardous wastes,. to~c substances, etc.) that would make the plOperty more or less valuable, and has assumed that there are no such condifions and makes no guarantees or warranties, express or Implied, regarding the condition 01 the property. The appraiser win not be responsible tor any such conditions that do exist or for any engineering or testing fhat mlgtrt be required to discover whether such conditions e~st. Because the appraiser is nof an expert In the field of environmental hazards, the appraisal report must not be considered as an environmental assessmard 01 the property. 7. The appraisar obtained the inlannation, estimates, and opinions that were expressed in the appraisal report from sources that he or she considers to be r~iable and believes them 10 be true and correct. The appraiser does nol assume responsibility lor the accuracy of such Items thaI were fumlshed by other pardes. 6. The appraiser will not disclose lhe contents at the appraisal report except as pro~ded for In the Unifonn Standards of Professional Appraisal Practice. 9. The appraiser has based his or her appraisal report and valuation conclusion for an appraisal that is subjecl to satisfactory completion, repallS, or alterations on the assumption that completion ot the Improvements wlil be pertormed In a workmanlike manner. 10. The appraiser musl pr~de his or her phor wriflen consent belore the lenderlcllent specified in the appraisal report can distribute the appraisal report (Including conclusions about the property value, the appraiser's identity and plOfessionaJ designations, and references to any plOtesslonal appraisal organizations or the tinn with which the appraiser is associated) 10 anyone other than the borrower; the mortgagee or ils successolS and assigns; the mortgage insurer; consultants; professional appraisal organizations; any state or federaily approved Ilnancial Instllutlon; or any department, agency, or Instrumentalily of the United States or any state or the District of Columbia; exceptlhat the lender/client may distribute Ihe property description section of the report only 10 dala coilectlon or reporting service(s) without having to obtain the appraiser's pOor WOllen consent. The appraJse(s wrttIen consent and approval must also be obtained before the appraisal can be conveyed by anyone 10 the public through advertising, public relations, news, sales, or other media Freddie Mac Fonn 439 6-93 Pagelol2 Fannie Mae Fonn 10048 6-93 E.J. KOJlilenhaver WUG nu. 1V1r;IlUr;11 rdUr; ~::J' APPRAISER'S CERTIFICATION: The Appraiser certifies and agrees that: 1. i have researched the subject mart<et area and have selected a minimum of three recent sales of properties most ~milar and proximale to the subject property for consideration in the sales comparison analysis and have made a doliar adjusbnent when appropnate to refiect the marirel reaction to those items of significant vartation. It a ~\lI1ilicant item in a comparable property is superior 10, or more favorable than, Ihe Subject property, I have made a negative adjuslment fo reduce fhe adjusted sales pnce of the comparable and, ff a signfficant ffem in a comparable property is infenor 10, or less favorable than Ihe subjecl propeny, I have made a posili'le adjustment 10 increase the adjusted sales pnce of the comparable. 2. I have laken into consideration the factors thai have an impact on vaue In my development of the estimale of market value in the appraisal report. I have not knowingly withheld any significant informalion from the appraisal report and I believe, to fhe best of my knowledge, that all stalemenfS and information in the appraisal report are true and correcl' 3. I stated in the appraisal report only my own personal, unbiased, and professional analysis, opinions, and conclusions, which are subject only to the contingent and limiting conditions specified in this form. 4. I have no presenf or prospeclive interest in the property lhat is lhe subject 10 Ihis report, and I have no present or prospective personallnlelest or bias with respeclto the participants in the transaction. I did not base, either partialiy or completeiy, my analysis aOlVor the estimate of market value in the appraisal report on tile race, color, religion, sex, handicap, familial status, or national angin of eill1er tile prospecllve owners or occupants of the subject property or of the present owners or occupants of the properties in the ~cinity of the subject property. 5. I have no present or contemplated Mure interest in the subject property, and neffher my current or future employment nor my compensalion for pertorming this appraisal is contingent on the awralsed value of the property. 6. I was not required to report a predetermined value or direction in value thai favors the cause of the client or any related party, the amount of the value estimale, the attainment of a specific result, or the occurrence of a subsequent event in order to receive my compensation and/or employment for pertorming the appraisal. I did nof base the appraisal report on a requested minimum valuation, a specITic valuation, or the need to approve a specific mortgage loan. 7. I pertormed this appraisal in conformity with the Unfform Standards of Professional Appraisal Practice that were adopted and promulgaled by the Appraisal Standanls Boanl of The Appraisal Foundation and that were in place as of the effective date of this appraisal, with the exception 01 the departure provision of those Standanls, which does not apply. I acknowledge that an estimate of a reasonable fime for exposure in the open market is a condition In the definlflon of market vaue and the estimale I daveloped is consistent with lhe marketing time noted in the neighborhood section of lhis report, unless I have otherwise slaled in the reconcilialion section. 8. I have personally inspected the intenor and extenor areas of the subject property and the extenor of all properties listed as comparables in the appralsal report. I further certity thai I have noled any apparent or known adverse conditions In the subject improvements, on the subject site, or on any site within the immediate vicinity of the subject property of whiCh I am aware and have made adjusbnents for these adverse conditions in my analysis of the property value to the extent thai I had market ~dence to support them. I have also commented about the effect of the adverse condmons on 1he marketability of the subject property. 9. i personally prepared all conclusions and opinions about the real estate that were set forth in the appraisal report. If I relied on significant professional assistance from any individual or individuals in the pertormance of the appraisal or the preparation of the appraisal report, I have named such indivldual(s) and disclosed the specific fasks pertormed by them in the reconcliiallon section of this appraisal report. I certify that any individual so named is QUalified to pertorm the tasks. I have not authonzed anyone to make a change to any item in the report; therefore, if an unauthoriled change is marle to the awraisal report, \ wlli take no responsibility for it. SUPERVISORY APPRAISER'S CERTIFICATION: If a supervisOlY appraiser signed the appraisal report, he or she certifies and agrees that: i directiy supervise the appraiser who prepared the appraisal report, have ~ewed the appraisal report, agree wffh the statements and conclusions ollhe appraiser, agree to be bound by the appraiser's certifications numbered 4 through 7 above, and am ta~ng full responsibility for the appraisal and the appraisal report. ADDRESS OF PROPERTY APPRAISED: 9 E Coover Street, Mechanlcsburg, PA 17056 APPRAISER: Si9nature: Y; u.... \ '" W I ~W I ~ Name: Vicki L. WIckwire Date Si<jOed: 07130102 Stale Certffication #: RL-003279.L or Slate License #: Slate: PA Expiration {Jate of Certification or License: 0613012003 SUPERVISORY APPRAISER (only If required): Signalore: Name: Date Signed: Stale Certificalion #: or Slale License #; State: Expiration Dale of Certificallon or License; o Did o Did Not inspect Property Freddie Mac Form 439 8-93 Page 2 ot 2 Fannie Mae Form 1004B 6-93 Form ACR - "TOTAL for Windows" awaisai sotIware by a la mode, inc. -1-8Oll.ALAMO{JE Subject Photo Page Count Cumberland Stale PA IFile No. Mentzerl Paoe #101 Zi Code 17066 Subject Front 9 E Coover street Sales Pllce N/A Gross living Area 1,926 Total Rooms .8 Total Bedrooms 4 Total Bathrooms 1 Location Average View Average Sfte 4, 791 Sq. Ft. Quality Age 90+/- Years Subject Rear Subject Street Fa"" PIC3x5.SR - 'TOTAL for Windows" appr~s~ software by a la made, inc. -1-800-ALAMOOE Subject Photo Page frue NO. MentZer! race #111 Borrowor/Clienl Not ADDllcable Prooertv Address 9 E Coover Street Citv Mechanlcsburn Coo"'" Cumberland State PA Zin Code 17055 Lender Mentzer Subject Front 9 E Coover Street Sales Plice N/A Gross Uving Area 1,925 Talal Rooms 8 Total Bedrooms 4 Total Bathrooms 1 Location Average View Average Site 4, 791 Sq. Ft. Quality Age 90+/- Years Subject Rear Subject Street form PIC3x5.SR - ''TOTAL for Windows" awraisal software by a ia mode, illC. -1-600-ALAMOOE Comparable Photo Page IFile No. Mentzer! Paoe #121 Borrower/CUent Not ADDllcable Prooertv Address 9 E Coover Street Cltv Mechanlcsburll COUlltv Cumberland State PA Zio Code 17055 lender Mentzer Comparable 1 24 W Marble Street PreY- to Subject 0.09 miles Sale Price 158,750 Gross UVingArea 1,754 Total Rooms 7 Total Bedrooms 4 Total Bathrooms 2 location Average View Average sne 13, 068 Sq. Ft. Quality Age 82 +/- Years Comparable 2 11 W. Maplewood Avenue Proll. to Subject 0.14 miles Sale Plice 141,000 Gross living Area 1,430 Total Rooms 7 Total Be<llloms 3 Total Bathrooms 2 location Average View Average sne 4,356 Sq.Ft. Quality Age 80+/- Years Comparable 3 120 E Coover Street Prox. to Subject 0.12 miles Sale Plice 137,900 Gross living Area 1,760 Total Rooms 8 Total Bedrooms 4 Total Bathrooms 1.5 location Average View Average sne 6, 098 Sq.Ft. Quality Age 90+/- Years Form PIC3x5.CR - "TOTAL for Windows" appraisal software by a la mode, inc. -l.BOO.ALAMODE IFile No. Mentzerl Paoe #131 Building Sketch (Page - 1) Cou Cumberland State PA Zi Code 17066 12.0' 16.0' .<: l! o a. 1 "0 " W Silting Room Knchen Bath cln Bedroom 17.0' ON 1:> 13.0' Dining 50.0' ON NO 60.0' 4.0' 6.0' Family 12.0' Bedroom Cl 4.0' r 1:> UP 16.0' Living 16.0' Bedroom Bedroom UP 20.0' Covered Porch 20.0' Form SKT.BldSkl- "TOTAl1o! Windows" appraisal software by ala mode. inc. - j.800.ALAMOOE trlle I'4U. Menuerr I"aae ilJl'141 Building Sketch (Page - 2) ,C'e Not A IIcable Address 9 E Coover Street Ci Mechanlcllbur Lllflder Mentzer C Cumberland Stale PA Z1 Code 17055 SKETCH CALCULATIONS I A1 Ai : 12.0x9.0 = 108.0 A2: 20.0 x 13.0 = 260.0 A2 A3: 23.0x6.0= 138.0 t r-;;--.. A4 : 20.0 x 16.0 = 320.0 M5 : 0.5 x 3.0x3.0 = 4.5 AS : 20.0 x 3.0 = 60.0 A7 : 0.5 x 3.0.3.0 = 4.5 A8 : 20.0 x 3.0 = 60.0 A4 First Floor 955.0 c--.---. -- f--. ,c;: A9 : 16.0 x 5.0 = 80.0 A10: 18.0 x 17.0 = 306.0 AlO All: 22.0 x 12.0 = 264.0 A11 A12: 20.0 x 16.0 = 320.0 A12 ~~ond FICOf 970.0 -~--- ..- ------- . Tolal LMng Area 1925.0 Form SKT.BldS~I- "TOTAL tor Windows' appraisal software by . I. mode, inc. -1.BOO.ALAMOOE \.ocat\on t4la' Co '\7066 51' 'PI' C CUmberland \ \:j A} ~,!:;". ..,/~/ \. If. .1)\ ,/' ..~,.../-.., ,---'. ,,' .' /~ ,/ a, /...."~ ~L ./" >'v <.\ 1r\"~'" ~ -,I " . .1'.. , ..,' . ", 'i~ _.~.i \ A \ ~<..=,. .,,'. ""'''.':..~ \ .... .---~ " \"~" Il'\\ ~~/,.. \ .'" "",""';. ,..\....\ ., ~r.>-- ",t'/ ,-' ~" . '. C\' /\ " I '\ /\ v::\ 1 ~J ,/ \ ~ 5\ l\ , /'~~!,~ ( ,. I~'" / l L t: / " -'..,J ."-f_9~~t~lo,. ".l..,,~ -'-~"'-- ../ I ?I ! .: / /:"" ,/Jil ,. "'~ ~JA.._ I~' i -W ......"'- i"'.. I "''T.(l~/ -.,,( \"/\ \ J\ Mal" C1 \. ..,,"-'-"'- - r~~"" i! , ! \ \ /'-", --"'~~ "-'."'"1 , ~",.l ,/ ("'\) { '. ~--,' / '-". l \ " i \.>.~!"'l!'}'~ ! /.."!~~' , _'.. \ -<:J. ./ ~...;;;;;..'L ~f\. . .J'~~ I ",,,,,,"I.oW l)' <>J':/ . ....'<<t ,.,i/'-' "? ( " - t(:"r!lJ!<l~ihr I.. jisr :.' ...:J ~. . i "Cotk:"" ; (''''';'~~Or ! ) ...., ,l "'.' l 0' i -""""-""'"~---~.....,~ -,- Coml1WM\oMlth 01 "~J.ma ~ ofSlalO --- .. ~, Ii ....,... O<.:r"l"'I''Wll Altl&Iol P.o, )OX 2I54t, H.m I ~ l'A 11Il)$.~ "''''''.....,li<lII ~asIO~ AP'IlA~SCR " > .. ~~mlll~ ~Q.o' 1400 25 1998 JU,-OO:J1I7~-L '., ,S~.~t{I~Yi~.......... , " ,-',', '" .' .,", '~~....'.".';:.......'~~........."~ " ......', ,-."-.:'..-,- .:..' ...."..... .. .. "~._;_,..v,,.-.~.,,,.,_ ,"'-.~.;..,_..,,-.._~.., " ;>;;i'-; ~ ~y 2,1 ~OOl .......1'.., ~.~Wt(kWlRA 1'1i Ol-Q .~~lC..1lAMP LBWI$aeItRV PI. 11!" .. . .. .. ,- -. .. ',.. , - . ~ ~ )0 iOQJ lFileNClMeniierl Paoe #161 " 'i. w >- ::w::::$cn ,,0:'" w"-" ,,00 "O:..J "-00 "- " z o i= :3 ::> l- ii: <( u w a: z o i= <( I- ::> Q. ::!: o U ~ I- RFV-1500EX.(6-00) REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG. PA 17128-0601 DECEDENT'S NAME (lAST, FIRST, AND MIDDLE INITIAL) I- Z W o W U w o MENTZER, KATHRYN MARIE DATE OF DEATH {MM-DD-Year} DATE OF BIRTH {MM-DD-Year} 07/19/2002 05/15/1924 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) D 1,OriginalReturn o 4. Limited Estate o 6. Decedent Died Testate (Attach copy of Will) o 9. Litigation Proceeds Received [KI 2. Supplemental Return o 4a. Future Interest Compromise (date of deatl1 after 12.12.82) o 7, Decedent Maintained a Living Trust (Attach copy ofTrust) o 10, Spousal Poverty Credit (date of death between 12.31.91 and '.'-95) >- z w o z o "- VI w 0: 0: o " THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE A NAME R. Mark Thomas, Es FIRM NAME (II Applicable) D OONFIDENTlAL AX INFORMAT. COMPLETE MAILING ADDRESS 101 S. Market Street N SHOULD BE DIReOTED TO: TELEPHONE NUMBER 796-2100 Mechanicsbur 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) (1) (2) (3) (4) (5) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4, Mortgages & Notes Receivable (Schedule 0) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested l.lnter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) (6) (7) 8. Total Gross Assets (total lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) (10) 10. Debts of Decedent, Mortgage Liabilities, & liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 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) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X _(15) 134,664.42 X .045 (16) X .12 (17) X .15 (18) (19) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20.0 > > BE SURETO ANSWER ALL QueSTIONS ON FleWFlSEiS'De AND RECHeCJ<i MATtI < < OFFICIAL USE ONLY FILE NUMBER 2 -02 0686 ""'COUNTY'"Cci5E ----yeA~ - - N"U"MiiER-- SOCIAL SECURITY NUMBER 92-14-7409 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 03, Remainder Retum (date of death prior to 12-1J.B2) o 5. Federal Estate Tax Return Required _ 8. Total Number of Safe Deposit Boxes o 11, Election 10 tax under Sec. 9113(A) (AttachSchO) PA 17055 116,287.91 ! OFFICIAL USE ONLY """',"'" ., ' .0;:: ,.." g -1 1'51 3~,993.09183 Q -- ....., f;ft83.09 !-' :r.> 'D -t)'. ')'.- :1-;' o (8) 152,764.09 18,096.49 3.18 (11) (12) (13) 18,099.67 134,664.42 (14) 134,664.42 6,059.90 6,059.90 (;)ecedoot's Comolete Address: STREET ADDRESS C 5 9 E. Dover treet CITY I STATE PA I liP 1 7055 Mechanicsburg Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2 Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 6,059.90 6.431 .06 290.00 Total Credits (A + B + C) (2) 6,721.06 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E) (3) 4. It Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5 If Line 1 + Line 3 is greater than Line 2, enter the difference This is the TAX DUE. (5) A. Enter the interest on the tax due (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE, (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 661,16 0.00 0.00 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 lZl b. retain the light to designate who shalt use the property transferred or its income; ........................................ 0 lZl c, retain a reversionary interest; or "". ............................. .................................................................. 0 [ZJ d. receive the promise for life of either payments, benefits or care? ............................................................. 0 lZl 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?..................... ......................................................................... 0 ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. 0 lZl 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?", ....................... ....................................................... ................... 0 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 perjury, I declare that I have examined this relurn, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Oeclarallon of preparer other than the personal representative IS based on all information of which preparerhas any knowledge SIGN YRE 9F PERSON R PONSIBLE FOR FILING RETURN DATE .;? IS! {) PA /705 U DATE I. _ / ~/-5/ 0,,/ ADDRESS 101 S. Market 51. Mechanicsburq PA 17055 For dates of death on or alter 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 PS g9116 (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. g9116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or alter July 1, 2000: The tax rate imposed on the net value of transters from a deceased child twenty-one years of age or younger at death to or for the use at a naturai parent, an adoptive parent. or a stepparent of the chiid is 0% [72 PS. g9116(a)(1.2)]. The tax rate imposed on the net value of transters to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. g9116(1.2) [72 P.S. g9116(a)(1)]. The tax rate imposed on Ihe nel value of transters to or for Ihe use of the decedent's siblings is 12% [72 P.S. g9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV_15C2EX'i1.971_~.._ ..~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER MENTZER KATHRYN MARIF 21 0:> ORRR AU 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 survivorshin must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 116,287.91 Proceeds from sale of 2 Story, 4 bedroom residential house situate at 9 East Coover Street, Mechanicsburg, PA 17055 (Copy of HUD-1 attached) TOTAL (Also enter on line 1, Recapitulation) $ 116,287.91 C~"'~""."'~. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF MFNT7FR KATHRYN MARIE FILE NUMBER ::>1 02 OfiRfi 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 VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Citizen's Bank 30,905,63 Accl. #355-015932 2, Cash 50,00 3, Proceeds from sale of household furnishings 204,00 4, 1981 Mustang 750,00 5, Verizon Refund 7,16 6, Interest on Estate Account 22,30 7, Senior Blue Refund 54,00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 31,993,09 "",oem."",,. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTL Y.OWNED PROPERTY ESTATE OF MENTZER KATHRYN MARIE FILE NUMBER 21 02 ORRR 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. Diana K. Salisbury 910 Spring Circle Mechanicsburg, PA 17055 Daughter B c JOINTLY-OWNED PRDPERTY LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEA.TH ITEM FOR JOINT MADE Include name of financial institution and bank accounl number or si rnilaridenlifying number. Attach DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT deedforjointly.held real estate VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1 A. Citizen's Bank 8,966.18 50. 4,483.09 Ace!. #142-110-3324 TOTAL (Also enter on line 6, Recapitulation) $ 4,483.09 (If more space is needed, insert additional sheets of the same Size) """"""".''''* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF MENTZER KATHRYN MARIF FILE NUMBER 21 0;:> 0686 Oebls of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A FUNERAL EXPENSES: 1 Ewing Brothers Funeral Home 8,253.00 2. Carlisle Memorial Service, In. 685.00 3. Funeral Dinner 260.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (5) Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2 Attorney Fees R. Mark Thomas, Esq. 4,000.00 3 Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Stale Zip Relationship of Claimant 10 Decedent 4 Probate Fees 306.00 5. Accountant's Fees 6. Tax Return Prepare~s Fees 7. Patriot News (Publication of Notice) 119.95 8. Cumberland Law Journal (Publication of Notice) 75.00 9. 2003 Real Estate Taxes, CountyfTownship (1/1/03 - 8/28/03) 250.08 10. "For Sale" sign for real property 15.00 11. Advertising' Sale of real property 350.00 12. 2002 School Taxes 1,296.B6 13. Lynn Weldon - Yard work 40.00 14. United Water (Aug. 2002 - Mar. 2003) 64.70 15. Comcast 10.87 16. PP&L (Aug. 2002 - Mar. 2003) 239.54 17. Verizon (Aug. 2002 - Mar. 2003) 115.87 18. Shipley Energy (Aug. 2002 ' Mar. 2003) 982.00 TOTAL (Also enter on line 9, Recapitulation) $ 18,096.49 (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent MENTZER, KATHRYN MARIE 21 02 0686 Paae 1 Schedule H - Funeral Expenses & Administrative Costs - 87 ITEM NUMBER DESCRIPTION AMOUNT 19, 20, 21. 22, 23, 24, 25, Mechanicsburg Borough - Sewerrrrash (Aug, 2002 - Mar, 2003) United Water (Ape. 2003 - Sept. 2003) Shipley Energy (Apr, 2003 - Sept. 2003) Mechanicsburg Borough - Sewerrrrash (Apr, 2003 - Sept. 2003) Allstate Insurance (Homeowners) (Apr, 2003 - Sept. 2003) Glenn Salisbury - Yard Work PPL Utilities (4/03 - 8/03) 148,62 44,02 234,12 202.44 150,50 200,00 52,92 SUBTOTAL SCHEDULE H.B? 1,032,62 . ~"'''m.{'"''. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF MENTZER KATHRYN MARIE FILE NUMBER 21 02 0686 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1. Holy Spirit Hospital 3.18 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, Insert additional sheets of the same size) 3.18 R;V.'S>3EX:19W COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ""hIT7"'" "''' NUMBER I. ,,,n,,, SCHEDULE J BENEFICIARIES FILE NUMBER ?1 O? RELATIONSHIP TO DECEDENT Do Not List Trustee(s) NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 lal (1.2)] 2. Diana K. Salisburg 910 Spring Circle Mechanicsburg, PA 17055 Donna K. Orner 421 Pawnee Drive Mechanicsburg, PA 17050 Brian A. Mentzer 306 E. Elmwood Avenue Mechanicsburg, PA 17055 Linda M. Williams 31 Pleasanton Drive East Berlin, PA 17316 Robert R. Mentzer, Jr. 2100 Newville Road Carlisle, PA 17013 Daughter Daughter Son Daughter Son 1'\"'''' AMOUNT OR SHARE OF ESTATE 1/5 1/5 1/5 1/5 1/5 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 3. 4. 5. 1 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) '-..-.-'- ..---- .~.- ---- u_ -- ^ . u,~:;. LJEPNHMENT OF HOUSING and URBAN OEVELOPMENT SETTLEMENT STATEMENT 1IIIII'IlO IllsPllHirol LIBERTY LAND SETTLEMENT SERVICES, INC. [3 rYI'E OF LOAN 4660 Trindle Road - Suite 101 1.1 I FHA 2 I 1 FMHA 3:K I CONV UNINS Camp Hill, PA 17011 4/ 1 VA 5, r ) CONV, INS. 6, FILE NUMBER T- '7, LOAN NUMBEfl 50428 038395723 8. Morn. INS, CASE: NO -- C NOll: Hws larm is h.nnished \0 give you a stalement 01 actual seHlemenl cosls Amounts paid \0 and by the settlement agent are shown Ilems nwrked '(p,o.c,)' were paid outside the closing: they are shown here lor informational purpose5 ;'InrJ are not included in the totals D N^MF ^NO ADDnESS Of BORROWER: E NAME AND ADDRESS OF SELLER F. NAME AND ADDRESS OF LENDEf~ JEEEMY S. CAR VEIl. KATHEYN M. MENTZER ESTATE COUNTRYWIDE HOME LOANS, SARA c. CAE VEIl. INC. G. PROPERTY LOCATION' H. SETTLEMENT AGENT I SETTLEMENT DAlE 9 COOVER STREET LIBEETY LAND SETTLEMENT SERVICES INC 08/28/03 , MECHANICSBURG BOEOUGH, PLACE OF SETTLEMENT: i CUMBERLAND COUNTY, PA. C-21 WALAK CEDAR AVE. CAMP HILL PA J. SUMMARY OF BORROWER'S iRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION: 100 GROSS AMOUNT DUE FROM BORROWER 400 GROSS AMOUNT DUE TO SELLER 101 Contract sales price 134000.00 401 Contract sales price 134000.00 107. fJersonal property ~o2,Personal properly 10:1 Selllement charaes to borrower (line 1400) 4285.81 403 '01 '0' 10~) 405 Adju5tmen~s lor items paid bv seller in advance Adjustmenls lor items paid bv seller in advance lOG CilyfToWI1 tax 10 ~06City!Town lax 10 107. County lax 08/28/031012/31/03 134.34 ~0'7 Counly tax 08/28/031012/31/03 134.34 1011 A5505t.monts 10 40/1 Assessments 10 109 08/28/031006/30/04 1101.62 409 08/28/031006/30/04 1101.62 110 SEW/TRASH 8/21-,9/30 42.91 <10 SEW/TRASH 8/2. 1-\9 / 3 0 I 42.91 , "' <I' \\7 <I' 170 GROSS AMOUNT DUE FROM BORROWER 139564.68 4?o.GAOSS AMOUNT DUE TO SELLER 135278.87 ?1)1l AMOUNTS PAID BY OR IN BEHALF OF BORROWER :;00 REDUCTIONS IN AMOUNT DUE TO SELLER ?Ol f)epn~it or e,Hnp.st moneY 500.00 ~,olExC8SS deposit (see instructions) ?O? Principal amount of new loan(s) 107200.00 (,07 Setllemenl Ch3rQeS to seller (line 1<100) 10950.96 70:\ FxistinCJ loan(s) taken subject to !,O:I Exislino loan(s) taken subjecf to ?O~ :,04 Payoll 01 First Mortgage Loan 70~, bm,Yayoff 01 Second Mortgage Loan 70G CLOSING COSTS FROM SELLE R 8040.00 !i06 CLOSING COSTS FOE BUYEE 8040.00 c 707 h07 ?(JfI 5011 ?~m !,O!l -- -. Ad)uslnlOnts for ilems unpaid by seller Adjuslments lor itoms unpaid by seller 710 Cily/lown 1.1x '0 ~,10 Cilyrrown I.<IX 10 ?I I COllnly l:;x 10 (;11 COIJnly t.1X 10 ?17 ^<;,;()ssrnonls \0 fil? As:;ossrnonls 10 ?I:l to ~7n \0 f---- m ~14. 71 ~l !lIS ?Hi 516. ?II !i17 ?111 518 ?1!l 519 . - 770 TOTAL PAlO BY/FDA BORROWER 115740.00 b?oTOTAL REDUCTION AMOUNT DUE SELLER 18990.96 :mo CASH AT SETTLEMENT FROM OR TO BORROWER fiOO. CASH AT SETILEMENT TO OR FROM SELLER 30\ Gross amount due Irom borrower (line 120) 139564.68 f,01GroS5 amOllnt due to soller (line 420) 135278.87 :'IO? Less 8moun\ pn\d bvllor borrower (line ?20) 115740.00 (;07,[ ess reduction amount due seller (line 520) 18990.96 30:1 CASH (lXFROM) ([ ] TO) BORROWER 23824.68 003 CASH ([ liTO) ([ ] FRO~) SELLER 116287.91 ~ ;:;.? 7....,,.,....A'L....-e.--' y!Ji44M x;:.. ,J.l;J. ,/ ./.::-x 6 ,. ,,- , ./ (__?i"fe-,- ~ C/C -4 ~ Buyer or Borrowor's Signaturo to-?--7'4-~"<-"" J;' ~.~ Sollor's Sign<lturc L >Z&,(' HtJD- I Rov, 5/86 - -_._--_.~-_._..._.- L. SETTLEMENT CHARGES 50428 100 TOTAL SALES/BROKER'S COMMISSION bued on price $ Division 01 Commission (Iirie 700) as follows: 701 $ 3985.00 10 702 $ 3935.00 10 103 Commission pnid at Settlement 70' TRANS. FEE BOO ITEMS PAYABLE IN CONNECTION WITH LOAN 001 Loan Origination Fee % 802 Loan Discount % 803. Appraisal Fee 10 804 Credit neportto /J05. Lenders Inspection Fee B06 FLOOD CHECK FEE B07 TAX SERVICE FEE BOB UNDERWRITI B09 BID PREMIUM LE BI1 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901, Interest from to 08 902 Mortgage Insurance Premium for mo. to 903 Hazard Insurance Premium for 1 yrs. 10 904. yrs. to 905. 1000. 100\ 1002. 1003. J004. 11005 11006. 1007 10no 1\ 00 TITLE CHARGES ~;IIII Uvlll"' ~;I(\IUv1II"1 132000.006.0 Total: 7,920.00 RE MAX STERLING ASSOC. C-21 WALAK ASSOC. PAID FROM BORROWER'S FUNDS AT SETTLEMENT I';HI!':. PAID FROM SELLER'S FUNDS AT SETTLEMENT WALAK WALTZ STONER APPRAISALS LTD 250.00 LAND SAFE FLOOD COUNTRYWIDE TAX SERVICE COUNTRYWIDE HOME LOANS, 25.00 90.00 525.00 1.125% 1206 POC TO AI-! @$ 18. 72/day 74.88 431 POC RESERVES DEPOSITED WITH LENDER FOR Hazard Insurance 3 mo.@$ 35.92 {mo. 107.76 Morlgage Insurance mo.@$ /mo CityfT own lax mO.@$ /mo. County lax 7 mo. @$ 32.69 /mo. 228.83 Assessrnonls mo. @$ /mo. SCHOOL 3 mo. @$ 109.44 {mo 328.32 mo. @$ /mo. AGG.ADJ. mo @$ {mo. 128.23 1101 Setlfement or closing fee to 1102. Abstract or tille search to 1103 Till(~ examinafion to 1104 Title illsumnce binder to 1105 Document preparation to 1106 Nolary leos to t 107. Attorney's fees 10 (includes rlbove ilelns No.:) r-- 1\108 fille Insurance to (includes above items No :) l1f]9 Lender's coverage $ 1110. Owner's coverage $ 1111 END. III? INS.CLOS II:;~EMML/COUR \ ;)00. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201 flecording fees Deed $ 38 . 50 Mortgage $ 64 . 50 1202. Cily!counly lax/stamps: Deed $ 1340 . 00 Mortgage $ 1203 Slale tax/stamps Deed $ 1340 . 00 Morlgage $ CASH 12.00 4.00 LIBERTY STEWART LIBERTY LAND SETT.SERV. TITLE GUARANTY CO LAND SETT.SERV. 100.00 35.00 40.50 LIBERTY LAND SETT.SERV. 300 8.1 107 200 134 000 Misc. $ 103.00 1340.00 1340.00 1204. 1205. 1300. ADOITIONAL SETTLEMENT CHARGES 1301 PEST/HOME INSP 10 1302 PFST TFlEATMENT 10 1103 ROOF REPAl 1304 '03 SCHOOL 275 POC HOMESPEC GILBERT'S PROF.PEST C.A. HOMAN BARRY HECKERT 174.90 225.00 1287.06 ,1.105 \400. TOTAL SETTLEMENT CHARGES (cnlor on lines 103 and 502, Soctions J and K) 4285.81 10950.96 Pa,lia!: f1l-l'oo 'h"t no liahilily is assumod by Sottlemonl Agonllor tho Ilccurocy of informal ion furnishod by olhors as shown olllhe HULJ-l Sel!lomenl SIalemenL SelllorTIenl Agenl hereby e~p'essly 'H~(!rves the right 10 doposit IIny "mounts coll{!Cled lor disbursmnenl in an Inlorosl bearing accounl in a FodOlaUy insured inslitulion and to credit any inlO/est so earned 10 ils own account as IIddilional cornpellMlion lor ils services in IhistfRnsaction HUD CERTIFICATION OF BUYERS AND SELLERS I havo carolully reviewed the HUD-1 Soltlomont Statement and to the bost or my knowlodge and bolier, it is a true and accurato stalomenl of all receipls and disbursements tll<lda on my <Iccounl by mo in this transaclion. I rurthar cartHy thai I have recoived a copy or tho HUD-1 Sal1lornont Staloman // / /" . '} 7/ c;i1'~p.-'l/..-;'~>~ /).. //~ .:~.-.-_._-~.. ,~d--r-K- ...-""C __ . " - ..--~ X<-./ - /- c c/'- r- t.. (, h~~" " V /c " /./' cC c: ., /) , .',. (. Jllyor or llorrowcr'!l Signature luycr.sAddrp.ss & Phone Sollor'!lSignahHo Sailor's New Address & Phono 111l) I IUlj.l Settlemenl Slalp.rtl()nl which I have fllCparcd is a lruo and aCClJlale acc\lUJ11 ollhis t,.,nsaclion. I have CII Iwd or '(lliIl caur.n Ihe lunds Ie be dishursed irr accordance willllllis slatmnent '-l'/Wf - ,f ,!./ (),~ . r;f'1I1eJlH'Il,I^;wni./. . . _ Dille. .. _ . . !/MlrJrtJ(, II '" a f:1I'TW In knOWI!l(jly nmkn raise sl.,t...menls 10 tlm tJllIl...d Slalcs on this or nny slm,lar lo'm "l!ll;rllll~S ''1;Of! COllV'CIrOtl Cfln 'r'cltJd/~ ., Iln... flnd 'rnpri'lomTlonl lor oclflils s(~') II!I(' In US CodcS"cllonl00l I'lndScclioo 1010 f It JI). 1 Il [~ \I. !, III r; COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128.0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT THOMAS R MARK ESQUIRE 101 S MARKET STREET MECHANICSBURG, PA 17055 nn____ told ESTATE INFORMATION: SSN: 192-14-7409 FILE NUMBER: 2102-0686 DECEDENT NAME: MENTZER KATHRYN M DATE OF PAYMENT: 04/21/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 07/19/2002 NO. CD 002468 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $631.06 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: R MARK THOMAS ESQUIRE CHECK# 1914 SEAL INITIALS: SK RECEIVED BY: REGISTER OF WILLS $631.06 DONNA M. OTTO DEPUTY REGISTER OF WillS STATUS REPORT UNDER RULE 6.12 BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND , PENNSYLVANIA Name of Decedent: KATHRYN MARIE MENTZER Date of Death: 7/19/2002 File No. 2002-0686 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to the completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: YES NO x 2. If the answer is "No", state when the personal representative reasonably believes that the administration will be complete: 8/15/2004 3 If the answer to No.1 is "Yes", state the following: a. Did the personal representative file a final account with the Court? YES NO b. The separate Orphan's Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? YES NO d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date 6/18/2004 ;:O?~ Signature R. MARK THOMAS, ESQ. Name (Please type or print) 101 S. MARKET ST. Address MECHANICSBURG PA 17055 717-796-2100 Tel. No. ... Capacity: )< Personal Representative Counsel for personal representative ..,'. BUREAU OF ZNDZVZDUAL TAXES /NHER/TANCE TAX D~rvzszoN DEPT. 280601 HARRZSBURG, PA 1712B-0601 CONNONNEALTH OF PENNSYLVANZA DEPARTHENT OF REVENUE NOTZCE OF ZNHERZTANCE TAX APPRAZSEMENT, ALLONANCE OR DZSALLONANCE OF DEDUCTZONS AND ASSESSMENT OF TAX REV-lSd7 EX AFP (01-03) R HARK THOHAS ESQ 101S HARKET ST HECHANICSBURG PA 17055 DATE 06-09-200:3 ESTATE OF HENTZER DATE OF DEATH 07-19-2002 F'rLE NUHBER 21 02-0686 COUNTY CUHBERLAND ACN 101 I Aeoun~ Rmni~ad KATHRYN H HAKE CHECK PAYABLE AND REHIT PAYHENT TO: REGISTER OF NILLS CUH~ERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THZS LZNE ~ RETAZN LONER PORTION FOR YOUR RECORDS ~ DZSALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF HENTZER KATHRYN H FZLE NO. 21 02-0686 ACH 101 DATE 06-09-2005 TAX RETURN NAS: { X) ACCEPTED AS F/LED ( ) CHANGED RESERVATZON CONCERNZNG FUTURE ZNTEREST - SEE REVERSE APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Reel Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnersh/p Znterest (Schedule C) (3) q. Mortgages/Notes Receivable (Schedule D) (q). 5. Cash/Dank Deposits/Hisc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTZONS AND EXEHPTZONS: 9. Funeral Expensas/Adm. Costs/Misc. Expanses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule Z) (10) 11. Tote1 Deductions 12. Nat Value of Tax Return 150,000 O0 O0 O0 O0 $2~205.63 ~83.09 O0 (8) 17,331.83 .00 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 13. NOTE: 166,688.72 (11) 17.331 .B3 (12) 1~9,$56.89 Charitable/Governmental Bequests; Non-elected 911:3 Trusts (Schedule J) (13) Nat Value of Estate Sub~ect to Tax (lq) If an assessment ,as issued prev/eusly, 11nes 1~, 15 and/er 16, 17, reflect figures that include the total of ALL returns assessed to date. ASSESSHENT OF TAX: 15. Amount of Line lq at Spousal rata 16. Amount of Line lq taxable at Lineal/Class A rata 17. Amount of Line lq at Sibling rata 18. Amount of Line lq taxable at Collateral/Class B rata 19. Principal Tax Due TAX CREDITS: PAYMENT RECEZPT DISCOUNT DATE NUMBER INTEREST/PEN PAID (-) 10-17-2002 CD001759 0~-21-2005 CD002~68 305.26 .17- .00 lq9,$56.89 IF PAZD AFTER DATE ZNDICATED, SEE REVERSE FOR CALCULATION OF ADDZT/ONAL /NTEREST. 18 and 19 t~ill (1.6) .00 X O0 = .00 (16) lq9,:356.89 x Oq5= 6,721.06 (17) . O0 X 12 = . O0 (18) .00 x 15 = .00 (19)= 6,721.06 AHOUNT PAZD 5,800.00 631.06 TOTAL TAX CREDZT 6,7:56.15 BALANCE OF TAX DUEI 15.09CR ZNTEREST AND PEN. . O0 TOTAL DUE 15.09CR ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS RE~UZRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SZDE OF THZS FORM FOR ZNSTRUCTZONS.) BUREAU OF TMDZVZDUAL TAXES TNHERTTANCE TAX DTVZSTON DEPT. 280601 HARRTSBURG, PA 17128-0601 COHHONNEALTH OF PENNSYLVANZA DEPARTHENT OF REVENUE Z~HER~T~NCE TAX RECORD ADJUSTHENT REV-1595 EX &FP R HARK THOHAS ESQ 101 S HARKET ST HECHANICSBURG PA 1 ,05S DATE 10-07-2004 ESTATE OF HENTZER DATE OF DEATH 07-19-2002 FZLE NUHBER 21 02-0686 COUNTY CUHBERLAND ACN 101 I Amoun~ ReaA~ed KATHRYN H HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF HILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To Ansure proper credA~ ~co your account, subaA~ ~he upper por~cAon of ~hAs fora watch your ~cax payment. CUT ALONG THZS LZNE ~ RETAZN LONER PORTZON FOR YOUR RECORDS ~ REV-1593 EX AFP (01-03) ~ ZNHERZTANCE TAX RECORD ADJUSTHENT ~ ESTATE OF HENTZER KATHRYN H FZLE NO. 21 02-0686 ACN 101 DATE 10-07-2004 ADJUSTNENT BASED ON: BOARD OF APPEALS REFUND VALUE OF ESTATE: 1. Real Es~:a~e (Schedule A) (1) 2. S~ocks end Bonds (Schedule B) (2) $. Closely Held S~ock/Per~:nershAp Tn~eres~c (Schedule C) q. More:gages/No,es ReceAvable (Schedule D) 5. Cash/Bank DaposA~cs/MAsc. Personal Proper~y (Schedule E) (5) 6. JoAn~ly Owned Proper~y (Schedule F) (6) 7. Transfers (Schedule O) (7) 8. To~el Asse~s DEDUCTZONS AND EXEHPTzONS: 9. Funeral Expenses/AdaAnAs:tra~cAve Cos~cs/ NAscellaneous Expenses (Schedule H) (9) 10. Debts/Mortgage LAabAli:tAes/LAens (Schedule z) (10) 11. To~al Deduc~Aons 12. Ne)c Value of Tax Ra~curn 116;475.$5 .00 .00 .00 $2;418.17 .00 (8) 18,521.85 155,$74.61 :5.18 (11) (12) 18~525.01 154~849.60 13. lq. TAX: TAX Chari~able/Governaan~al Bequests; Non-elected 9115 Trusts (Schedule J) Na~ Value of Es~a~a Sub~ec~ ~o Tax (13) .O0 1E. Aaoun~ of LAne lq a~ Spousal ra~e (15) 16. Aaoun* of Line lq ~axable a~ LAneal/Class A ra*e (16) 17. Aaoun~ of LAne lq e~ SAblAng re*e (17} 16. Aaoun~ of LAne lq *axable a~ Collateral/Class B ra~e (18) 19. PrlncApal Tax Due CREDZTS: rAYntfll KCcc~r, DATE NUMBER 10-17-2002 04-21-2005 03-15-2004 CD001759 CD002468 REFUND UI~UUNI t~J INTEREST/PEN PAZD (-) 305.41 .00 .00 .00 x O0 = 134z849.60x 045= .00 x 12 = .00 x 15 = (19) AMOUNT PAZD 5,800.00 631.06 59.22- TOTAL TAX CREDZT BALANCE OF TAX DUE ZNTEREST AND PEN. TOTAL DUE .00 6z068.24 .00 .00 6zO68.Zq 6,675.25 607.01CR .00 607.01CR ZF PAZD AFTER DATE ZNDZCATED, SEE REVERSE FOR CALCULATZON OF ADDZTZONAL ZNTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS RE~UZRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDZT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SZDE OF THZS FORM FOR ZNSTRUCTZONS.) BOARD, OF APP ,F..ALS DEPT. 281021 HARRISBURG, PA 17128-1021 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE R MARK THOMAS ESQ 101 S MARKET ST MECHANICSBURG PA 17055-3851 IN RE ESTATE OF: MENTZER KATHRYN M DOCKET NO.: TAX TYPE: APPEAL TYPE FILE NUMBER: ACN: APPRAISEMENT: PETITION FILED: EXAMINER: MAILING DATE: 0404786 Inheritance Refund 2102-0686 101 6/9/2003 3/17/2004 WILLIAM J ZDRADZINSKI Direct Dial: (717) 787-5761 Fax: (717) 787-7270 Email: wzdradzins@state.pa.us SEPTEMBER 16, 2004 DECISION AND ORDER On June 9, 2003, the Department issued an appraisement and assessment which accepted the original inheritance tax return as filed. That return valued the real estate reported as item 1 on Schedule A at $130,000.00. Petitioner now requests that the taxable value of that real estate be reduced $116,287.91, the net proceeds received from the August 28, 2003 sale of the property. Section 2127(1 ) of the Inheritance and Estate Tax Act of 1991,72 P.S. § 9127(1 ), states "All reasonable expenses of administration of the decedent's estate and of the assets includible in the decedent's taxable estate are deductible." In Peterson Est., 649 A.2d 1007 (Pa.Cmwlth. 1994), the Court stated "It is well settled that expenses necessarily incurred in preserving and distributing the estate may be deducted and that expenditures not essential to the proper settlement of the estate, but incurred for the benefit of the heirs, legatees, or devisees, may not be taken as deductions." In Anderson Est., 1 Fiduc. Rep. 449 (O.C.Phila. 1951), it was held that the cost of one year of public liability insurance is a proper administrative expense. However, it ME'NTZE~, KATHRYN M BOARD DOCKET NO. 0404786 Page 2 of 2 has also been held that expenditures for current repairs, fire and other property insurance, and real estate taxes following the year of death are items which inure to the benefit of the heirs and are not payable out of the general estate. As it was necessary to dispose of the real estate to effect distribution, the estate is entitled to a reduction for costs incurred in the sale of the property. However, no reduction can be permitted for the 2003 school district real estate taxes of $185.44 (net of the reimbursement received at settlement) as they inure to the benefit of the heirs. Accordingly, it is hereby, Ordered that the petition fOr refund is granted-in-part. The Department is directed to reduce the taxable value of the Schedule A Item 1 real estate to $116,473.35. It is further Ordered that a refund be issued for any resulting overpayment, plus appropriate interest. FOR THE BOARD OF APPEALS JOSEPH R. SLEEK, MEMBER ANY APPEAL FROM THIS DECISION MUST BE FILED WITH THE BOARD OF FINANCE AND REVENUE, 1101 SOUTH FRONT ST., SUITE 400, HARRISBURG, PA 17104, WITHIN NINETY (90) DAYS OF THE MAILING DATE OF THIS DECISION. TELEPHONE (717) 787- 2974 A REFUND CHECK WILL BE MAILED TO YOU BY THE BUREAU OF INDIVIDUAL TAXES. IF YOU REQUIRE THIS INFORMATION IN AN ALTERNATE FORMAT UNDER THE PROVISIONS OF AMERICANS WITH DISABILITIES ACT OF 1990, PLEASE CALL (717) 783-3664, OR FOR SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND SPEAKING NEEDS: 1-800-447-3020 (TT ONLY). BUREAU OF /NDIV/DUAL TAXES INHERITANCE TAX DIVISION DEPT. Z806n1 HARRTSBURG, PA 17128-0601 CONHONNEALTH OF PENNSYLVANIA DEPARTNENT OF REVENUE INHERITANCE TAX STATENENT OF ACCOUNT REV-1607 EX AFP ¢01-05) R HARK THOMAS ESQ 101S HARKET ST HECHANICSBURG PA 17055 DATE 10-25-200q ESTATE OF MENTZER DATE OF DEATH 07-19-2002 FILE NUMBER 21 02-0686 COUNTY CUH~_AND ACN 101 :: KATHRYN H HAKE CHECK PAYABLE AND REH~r PAYNENT TO: REGISTER OF NILLS ...... CUHBERLAND CO COURT H,O#..~E · CARLISLE, PA 1701~ ~:' NOTE: To insure proper cred/~ ~o your account, submi~ ~he upper por~/on of ~his form wi~h your ~ax payment, CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~ REV-1607 EX AFP (01-03) ESTATE OF HENTZER ~ INHERITANCE TAX STATEHENT OF ACCOUNT ~ KATHRYN H FILE NO.21 02-0686 ACN 101 DATE lO-25-200q THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAMED ESTATE. SHONN BELON 15 A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSHENT OR RECORD ADJUSTHENT: 10-06-ZOOq PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYHENTS (TAX CREDITS): 6,068.2~ PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 305.ql 10-17-2002 0q-21-2005 05-15-200q lO-07-ZOOq CD001759 CDOOZq68 REFUND REFUND .00 .00 .00 5,800.00 631.06 59.22- 607.01- TOTAL TAX CREDIT 6,068.2q BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ZF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT 15 REQUIRED. IF TOTAL DUE 15 REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF TH/S FORM FOR INSTRUCTIONS. )