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Home My WebLink About03-0783REV-1500 EX (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 2 I -- 0__3__ 0__0__7___8__3___ ~,O UNTY CODE YEAR NUMBER DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) l.- z uJ z O uJ n, ,w O O z Z DECHENE, ROGER W. DATE OF DEATH (MM-DD-YEAR) 08-09-2003 SOCIAL SECURITY NUMBER 167-40-0099 DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE 04 -05-1961 REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER ~ 1. Odginal Return I J 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) ~-~4. Limited Estate ~--~6. Decedent Died Testate (Attach copy of Will) [-----~ 9. Litigation Proceeds Received ~-~ 48. Future Interest Compromise (data of death after 12-12-82) J~ 5. Federal Estate Tax Return Required ~'--] 7. Decedent Maintained a Living Trust (Attach copy of Trust) .__q_0 8. Total Number of Safe Deposit Boxes [~ 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) [--'---] 1 1. Election to tax under Sec. 9113(A) (Attach Sch O) NAME COMPLETE MAILING ADDRESS CRAIG A. DIEHL, ESQUIRE, C.P.A. FIRM NAME (If Applicable) LAW OFFICES OF CRAIG A. DIEHL TELEPHONE NUMBER (717) 763-7613 3464 TRINDLE ROAD CAMP HILL, PA 17011-4436 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Prepdetorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) ~-'] Separete Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 0. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 1. Total Deductions (total Lines 9 & 10) 12. Net Value of Estata (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) 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) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate O O 1 8. Amount of Line 14 taxable at collateral rate ~-- 19, Tax Due 190,000.0~Qc' .02 10,333.65 .00 .00 OFFICIAL I~ ONLY (8) 200,333.65 20,182.46 81,713.47 (11) 101,895.93 (12) 98,437.72 (13) 3W4645 1.000 (14) 98,437.72 98,437.72 x.0 __. (15) x,0 45 (16) 4,429.70 x .12 (17) x .15 (18) (19) 4,429.70 > > SE SU~ TO ANSWER ~E QUES¥iQNS ON REVERSE SIDE mD RECHECK Decedent's Complete Address: STREETADDRESS 5 TIMBER LANE NEWVILLE ISTATE IZIP 17241 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Interest/Penalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) Total Interest/Penalty (D + E) (3) (1) 4,429.70 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) . O0 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 4,429.70 A. Enter the interest on the tax due. (5A) .00 B. Enter the total of Line 5 + 5A This is the BALANCE DUE. (5B) 4,429.70 Make Check Pa able to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ....................... ~ r~ b. retain the right to designate who shall use the property transferred or its income; ......... ~ r~ c. retain a reversionary interest; or ................................ ~ r~ d. receive the promise for life of either payments, benefits or care? ................. ~1 ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ............................ ~ ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? [~ r~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation'~ 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 refum, incJuding accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. c.~RE OF PERSON-RESFC, i~S~I~E FOR FILING RETURN DATE 5 TIMBER LANE, NEWVILLE, PA 17241 SIGNATURE OF PREPAP~ER OTHEiq TITAN D E REPRESENTATIVE ADDRESS .~ ~' - - ' , 3464 TRINDLE ROAD, CAMP HILL, PA 17011-4436 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. § 9916 (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. § 9116 (a) (1.1) (ii)] The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. § 9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. § 9116(1.2) [72 P.S. § 9116(a)(1 )]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% (72 P.S. § 9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. 3w4646 1.000 REV-1502 EX + (6-98) COMMONVVEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE A REAL ESTATE ROGER W. DECHENE FILENUMBER 21-03-00783 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 survivorship must be disclosed on $chedul F. ITEM NUMBER 1. DESCRIPTION 5 TIMBER LANE NEWVILLE, PA 17241 UPPER MIFFLIN TOWNSHIP, (SEE ATTACHED APPRAISAL) CUMBERLAND COUNTY TOTAL (Also enter on line 1, Recapitulation) 3w4695 1.000 (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH 190,000.00 190,000.00 · ~ IFile No. 0333951 Paqe DYNAMIC APPRAISALS, INC. 629 WYNDAMERE ROAD ETTERS, PA 17319 NOVEMBER 19, 2003 PRIVATE APPRAISAL (DECHENE) Re: Property: 5 TIMBER LN NEWVILLE, PA 17241-8607 Borrower: N/A File No.: 033395 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 physical analysis of the site and improvements, a Iocational 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 me or any of my staff if we can be of additional service to you. Sincerely, DANIEL a HOFFMAN RL-OO1638-L PA STATE CERTIFIED RESIDENTIAL , Dynamic Appraisals (717) 932-5802 IFile No. 0333951 Paqe #31 Summary Appraisal Report ProDertvDeecriDtlgn uRIrUfllVI RESIDENTIAL APPRAISAL REPORT FileNo. 033395 · ProDe~ Address 5 TIMBER LN · LeQai Bescdption ATTACHED E 194-60 IAssessor's ParcelNo. 44-06-0037-03,5D ~__ Borrower N/A ~ Propert7 dqhts appraised [~ Fee Simple r~l Neighborhood or Proiect Name N/A · Sale Price $ N/A o Lender/Client ATTACHED DEED 194-601 Leasehold Date of Sale N/A PRIVATE APPRAISAL (DECHENE) i Appraiser DANIEL A HOFFMAN Location [] Urban [] Suburban [] Rural Built up [] Over 75% [] 25-75% [] Under 25% Growth rate [] Rapid [] Stable [] Slow Property values [] Increasing [] Stable [] Declining Demand/supply [] Shortage [] In balance [] Over supply Marketndtme ~ Under3mos. [~ 3-Gmos. I--~ 0verGmos. City NEWVILLE State PA Zip Code 17241-8607 County CUMBERLAND Tax Year 2003 R.E. Taxes $1,721 APP Soecial Asse~ii~,,i~ $ N/A Current Owner DECHENE, ROGER Occupant: r-~ Owner ~ Tenant [~ Vacant Proiect Type ~ PUD ~ Condominium (HUBBA only) H0A $ N/A /Mo. Map Reference SEE APN Census Tract 0130.00 DescdDtion and $ amount of loan charQe~concessions to be paid by ~e~er N/A Address Address DYNAMIC APPRAISALS~ INC. 629 ~NDAMERE ROAD, E~ERS PA 1731~ I Pr~omtnant I~f"m"~h°~=~pI Preeentland use% j ~nd u. Change ~cc.pancy $(000~ ~r~ I One family 95 I ~ Not likely ~ Likely ~ Owner 80 Low NEW ~ 2-4 family J ~ D process ~ Tenant 250 H~qh 100+ JMulti-fam~ly~To:N/A ~ Vacant (o-5~ I Predominant I ~ Commercial ~ ~ W~.~o.rS~ ~00-200"Ew'"° ~ / Note: Race and the racial composition of the neighborhood are not appraisal factors. Neighborhood boundaries and characleristics: THE SUBJECT NEIGHBORHOOD INCLUDES A NINE MILE RADIUS OF THE SUBJECT. COMMERCIAL USE IN THE AREA IS LIMITED TO THE TYPE TYPICALLY FOUND AND DESIRED ALONG MAIN ROADS IN SUCH AREAS Factors that allect the marketability ct the properties in the neighborhood (proximity to employment and amenities, employment stability, appeal to market, etc.): THE SUBJECT IS LOCATED IN A PREDOMINANTLY RESIDENTIAL AREA AMONG PROPERTIES OF SIMILAR STYLE AND MARKET APPEAL. THIS AREA IS CONVENIENTLY LOCATED IN RESPECT TO SCHOOLS, SHOPPING, EMPLOYMENT, AND TRANSPORTATIOA ACCESS. HOMES IN THE NEIGHBORHOOD ARE OCCUPIED AND APPEAR TO BE WELL MAINTAINED. THIS AREA PROVIDES REASONABLE SAFETY AND SECURITY COVERAGE. ***PLEASE NOTE THAT THE PRESENT LAND USE PERCENTAGES LISTER ABOVE ARE THAT OF THE DEVELOPED UTILIZED LAND. Market conditions in the subject neighborhood (including support for the above conclusions related to the trend of property values, demand/supply, and marketing time -- such as data on competitive properties for sale in the neighborhood, description of the prevalence of sales and financing concessions, etc.): UPPER MIFFLIN TOWNSHIP PROVIDES AN AVERAGE ENVIRONMENT FOR THE HOUSE BEING APPRAISED. THERE ARE NO KNOWN FACTORS THAT WILL NEGATIVELY AFFECT THE MARKETABILITY OF THE HOUSE. ALL OF THE ITEMS IN THE NEIGHBORHOOD RATING GRID ARE RATED GOOD OR AVERAGE. THE PUBLIC SCHOOLS, PARKS, VIEWS, AND NOISE LEVEL TYPICAL FOR THIS TYPE OF NEIGHBORHOOD. THIS IS A FAIRLY ACTIVE MARKET WITH NO SPECIAL FINANCING, LOAN DISCOUNTS OR OTHER CONCESSIONS PREVALENT, Project Information for PUDe (If applicable)-- Is the developer/builder in control of he Home Owners' Association (HOA)? [] Yes [] No Approximate total number of units in the subject project N/A Approximate total number of units for sate in the subject project N/A Describe common elements and recreational lacilities: N/A Dimensions SEE ATTACHED DEED Site area 1.73 AC Comer Lot [] Yes [] No Specilic zoning classification and description RESIDENTIAL Zoning compliance [] Legal [] Legal nonconforming (Grandfathered use) [] Illegal [] No zoning Present use r-~ Other use (explain) Utilities Public Other Off-site improvements Type Public Private Electricity [] 200 AMP Street ASPHALT [] [] Gas [] Curb/gutter NONE [] [] Water [] WELL Sidewalk NONE [] [] Sanitary sewer [] SEPTIC Streetlights NONE [] [] Aey NONE Topography ROLLING Size AVERAGE Shape IRREGULAR Drainage APPEARS ADEQUATE View AVERAGE Landscaping AVERAGE Driveway Sudace STONE Apparent easements NONE APPARENT FEMA Special Rood Hazard Area [] Yes [] No FEMA Zone C Map Date 11/26/1982 [--] ~ FEMA Map No. 4215890010B Comments (apparent adverse easements, encroachments, special assessments, slide areas, illegal or legal nonconforming zoning use, etc.): THE SIZE, SHAPI AND LANDSCAPING OF THiS SITE IS TYPICAL OF SITES IN THIS NEIGHBORHOOD. NO APPARENT ADVERSE EASEMENTS, ENCROACHMENTS, SPECIAL ASSESSMENTS, SLIDE AREAS, ETC. NEGATIVELY AFFECT THE VALUE. GENERAL DESCRIPTION I EXTERIOR DESCRIPTION I FOUNDATiON J BASEMENT l INSULATION No. of Units 1 IFoundation CONC BLK ISlab NO Area Sq. Ft. 1 503 PRoof [] ?o. o!...Stories 2 IExtedor Walls LOG ICrawl Space NO I% Finished 0 JOe ng ~ [] /ype (uet./Att.) DET JRoof Surface COMP SHING JSasement FULL ICeiflng J~S lWalls [] Design (Style) LOG IGutters & Dwnspts. ALUMINUM ISump Pump NO JWa s 'CONE BLK /Floor ~ [] Existing/Proposed EXISTING /Window Type DBL-HUNG dDampness NO EVIDENCE IFIoor ~None Age (Yrs.) 16 dStorm/Screens ~ .~Settlement NO EVIDENCE /0utside Entry YES ~Unknowr~ Effective Aqe {Yrs. 3-5 pManufactured House N"-~-~-~ /Intestation NO EV DENCE / ~ ' Levet t I / I I 1 I 1 I 1 15 I 1 1,503 Finished area above qrade contains: 7 Rooms; 3 Bedroom(s): 2.5 Bat i(s); 2,700 Sq Jare Feet of Gross Livinq Area INTERIOR Materials/Condition Floors CARPET/AVG Walls WOOD/AVG Trim/Finish WOOD/AVG Bath Floor VINYL/AVG Bath Wainscot FIBERGLASS/AVG Doors WOOD/AVG HEATING EBB Type FWA Fuel OIL Condition AVG COOLING Central YES Other NONE Condition AVG Additional leatures (special energy efficient items, etc,): KITCHEN EQUrP. Refdgerator Range/Oven Disposal Dishwasher Fan/Hood Microwave Washer~Dryer ATI'IC None Stairs Drop Stair Scuttle Floor Heated Finished SEE COMMENT ADDENDUM AMENITIES CAR STORAGE: Fireplace(s)# 2 [] Patio CVDWOOD [] Deck [] Porch CVDWOOD [] Fence [] Pool [] None [] Garage #of cars Attached Deached 2CAR Built. In Carport Ddvewa~ STONE Condition of the improvements, depreciation (physical, functional, and external), repairs needed, quality of construction, remodeling/additions, etc.: NO FORMS OF FUNCTIONAL OR EXTERNAL OBSOLESCENCE WAS NOTED DURING THE INSPECTION. NO PHYSICAL DEPRECIATION WAS OBSERVED AT THE TIME OF THE INSPECTION. Adverse environmental conditions (such as, but not limited to, hazardous wastes, toxic substances, etc,) present in the improvements, on the site, or in the immediate vicinity of the subject properly.: NO KNOWN OR OBSERVED ADVERSE ENVIRONMENTAL CONDITIONS WERE NOTED AT THE TIME OF THE INSPECTION FOR THIS APPRAISAL. Freddie Mac Form 70 6/93 PAGE 1 OF 2 Fannie Mae Form 1004 6/93 Form UA2 -- "TOTAL lor Windows" appraisal software by a la mode, inc. -- 1-800-ALAMODE UNIFORM RESIDENTIAL APPRAISAL REPORT FtieNo. 033395 ESTIMATED SITE VALUE ......................................... .-- $ 35,000 Comments on Cost Approach (such as, source of cost estimate, site value, ESTIMATED REPRODUCTION COST.NEW-OF IMPROVEMENTS: Dwelling 2,700 Sq. Ft. @$ 51.95 = $ 1,503 Sq. Ft. @$ 11.14 = BUILTINS/2FP/EXTERNAL FEATURES = Garage/Carpod 960 Sq. Ft. @$ 20.36 = Total Estimated Cost New ................ ~= $ Less Physical Functional External Depreciation 9,426J I 140,265 16,743 11,958 19,546 188~512 =$ 9,426 ,File No. 0333951 Paqe #41 square foot calculation and for HUD, VA and FmHA, the estimated remaining economic life of the properly): THE MARSHALL AND SWIFT RESIDENTIAL COST HANDBOOK WAS USED AS AN AID IN Depreciated Value of Improvements ................................ =$ "As-is' Value of Site Improvements ................................. =$ INDICATED VALUE BY C0ST APPROACH ......................... $ ITEM ] SUBJECT COMPARABLE NO. 1 5 TIMBER LN 299 SPRINGFIELD RD Address NEWVILLE SHIPPENSBURG 5.93 miles Sales Price N/A J$ ct: $ 118.69 ~] Data and/or INSPECTION MLS # 10079295 92 DOM DESCRIPTION DESCRIPTION FHA NO EFFECT 11/27/02 AVERAGE AVERAGE FEE SIMPLE FEE SIMPLE VALUEADJUSTMENTS Sales or Financing Concessions 179,086 15,000 229,086 189,900 ! +(-)$ Adjust COMPUTING THE RI::PLACEMENT COST APPROACH UTILIZING AVERAGE QUALITY. ESTIMATED REMAINING ECON. LIFE 40-50 YEARS COMPARABLE NO. 2 COMPARABLE NO. 3 168 KERRS RD 2832 RITNER HWY CARLISLE CARLISLE 6.66 miles 8.95 miles 19 169,000 15 200 000 102.83 al 9~.58 ~ MLS #10084462/0UMB T MLS#10084815 16 DOM 155 DOM DESCRIPTION CONVENTIONAL NO EFFECT DESCRIPTION : +(-)$Adjust. CASH NO EFFECT 02/14/03 : 6/20/03 I AVERAGE :AVERAGE I FEE SIMPLE +(-)$ Adjust. View Condition Above Grade Room Count Basement & Finished Porch, Patio, Deck, Adjusted Sales Price 1.73 AC AVERAGE 2STORY LOG 16N3-5E AVERAGE 2.78 AC FEE SIMPLE -4,000 1.17 AC Total i Bdrmsi Baths 7i 3i2.5 2,700 Sq. Ft. FULL UNFINISHED -2,000 3.99 AC AVERAGE AVERAGE AVERAGE CAPE COD CAPE COD 2 STORY VINYL VINYL 11N2--4E -2,500 AVERAGE TotaliBdrmsi Baths i 6 i 3 i 2 : +1,000 1,600 Sq. Ft. i +11,000 FULL FAM RM NO HEATING AVERAGE OFWA/CA GEOTH/CA STORM UNITS SIMILAR 3C DET GAR -2,500 -5,00( -2,000 +1,000 +1,500 -500 189~90C 3N1-3E r AVERAGE -4,000 Total iBdrms! Baths ' 7 : 3 i 2 ; +1,000 1,838 Sq. Ft. ! +8,620 FULL UNFINISHED AVERAGE -5,000 OFWNCA SIMILAR 2C ATr GAR PORCH,DECK -1,000 1 FIREPLACE i +1,500 NONE [--] + {~ - i$ 2,880 Net 1.5 % Gross 13.3% $ 186,120 BRICK,VINYL , NEW AVERAGE +2,000 -2,500 -6,00C Total !Bdrms ! Baths ' 8 ; 4 j 2.5 i -2,000 2,184 Sq. Ft. i +5,160 FULL UNFINISHED AVERAGE EHP/CA SIMILAR 2C ATT GAR -5,000 PORCH,DECK NONE 2C DET GAR PORCH,C-PAT 2 FIREPLACES NONE PATIO,PORCH 1 FIREPLACE GAZEBO -50O +3,500 NONE ~ + [~ - iS 5,340 Net 2.7 % Gross 13,3% ~; 194,66o Net ,~ $ Gross 15.3 Comments on Sales Comparison (includin~ the subject property's compatibility to the neighborhood, etc.): ALL SALES ARI CLOSED TRANSACTIONS AND DATES UTILIZED ARE SETTLEMENT DATES NOT CONTRACT DATES. ALL COMPARABLE SALES ARE CONSIDERED EQUAL INDICATORS OF VALUE AND WEIGHED EQUALLY IN THE FINAL RECONCILIATION. A WIDER TIME FRAME AND DISTANCE WERE REQUIRED TO BE UTILIZED TO LOCATE SUITABLE COMPARABLE SALES. THE BEST AVAILABLE COMPARABLE SALES WERE SELECTED AND USED FOR THIS APPRAISAL ITEM SUBJECT COMPARABLE NO. 1 J COMPARABLE NO. 2 COMPARABLE NO. 3 Date, Price and Data NO TRANSFERS NO TRANSFERS 1 4/30/2003 NO TRANSFERS Source, tot prior sales WITHIN WITH. IN $1 WITHIN THREE YEARS ONE YEAR COUNTY RECORDS ONE YEAR Analysis of any current agreement of sale, option, or listing of subject property and analysis of any prior sales of subject and comparabies within one year of the date gl appraisal: SEEATTACHEDFIRREAADDENDUM INDICATED VALUE BY SALES C0MPARISON APPROACH ............................................................................................ $ 190,000 INDICATED VALUE BY INCOME APPROACH df Applicablel Estimated Market Rent $ N/A /Mo. x Gross Rent Multiplier = $ N/A This appraisal is made ~] "as is" L.J subject to the repairs, alterations, inspections or conditions listed below [] subject to completion per plans & speciticatJons. Conditions of Appraisal: SUBJECT IS APPRAISED IN ITS PRESENT CONDITION AS OF THE TIME OF INSPECTION. Final Reconciliation: THE SALES COMPARISON APPROACH IS THE BEST APPROACH FOR THIS TYPE OF PROPERTY AND THE ONE FOF; WHICH THE MOST RELIABLE DATA IS AVAILABLE. THE COST APPROACH SUPPORTS SALES APPROACH. THE INCOME APPROACH IS N/A SINCE BUYERS ARE MORE INTERESTED IN AMENITIES THAN INCOME POTENTIAL. The purpose of this appraisal is to estimate the market value of the real property that is the subject of this report, based on the above conditions and the certification, contingent and limiting conditions, and market value definition that are stated in the attached Freddie Mac Form 439/FNMA form 10048 (Revised 6-93 ). I (WE) ESTIMATE THE MARKET VALUE, AS DERNED, OF THE REAL PROPERTY THAT IS THE SUBJECT OF THIS REPORT, AS OF AUG UST 9, 2003 (WHICH IS THE D A,~O F INSPECTION AND THE EFFECTIVE BATE OF THIS REPORT) TO BE $ 190,000 APPRAISE ~/.l~'~ SUPERVlS0RY APPRAISER (ONLY IF REQUIRED): Siqnature k~./r,~ Siqnature [] Did [] Did Not Name DANIEL A HOFFMAN Name Inspect Property Date Report Siqned NOVEMBER 19, 2003 Dale Report Siqned State Certification # RL-001638-L State PA State Certification # State Or State License # PA STATE CERTIFIED RESIDENTIAL State Or State License # State Freddie Mac Form 70 6/93 PAGE 2 OF 2 Fannie Mae Form 1004 6-93 Form UA2 -- "TOTAL for Windows" appraisal software by a la mode, inc. -- 1-800-ALAMODE REV-1508 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER ROGER W. DECHENE 21~_03_00783 Include the proceeds of litigation and the date the proceeds were received by the estate. Ail property jointly-owned with the right of survivomhip must be disclosed on Schedule F. ITEM NUMBER 4. 5. 6. DESCRIPTION MEMBERS 1ST FEDERAL CREDIT UNION SAVINGS ACCOUNT NO. 180525-00 PRINCIPAL BALANCE = $206.65 ACCRUED INTEREST = $0.06 MEMBERS 1ST FEDERAL CREDIT UNION CHECKING ACCOUNT NO. 180525-11 PRINCIPAL BALANCE = $4,450.19 ACCRUED INTEREST = $0.50 SHIPPENSBURG LEASING - PAYROLL CHECKS 1995 CHEVY LUMINA VAN HOUSEHOLD FURNISHINGS GROSS PROCEEDS FROM PUBLIC AUCTION (KENNY'S AUCTION) TOTAL (Also enter on line VALUE AT DATE OF DEATH 206.71 4,450.69 2,127.25 800.00 1,000.00 1,749.00 10~333.65 3W46AD 1.000 (If more space is n~ded, inse~ additional sh~ts of the same size) REV-1511 EX + (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (PAGE I OF 2) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER ROGER W. DECHENE 21-03-00783 Debts of decedent must be reported on Schedule I. ITEM NUMBER 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. DESCRIPTION FUNERAL EXPENSES: HOFFMAN-ROTH FUNERAL CUMBE~ VALLEY MEMORIAL THE COUNTRY BUTCHER SHOP - CUMBERLAND VALLEY MEMORIAL HOME - FUNERAL EXPENSE GARDENS - TOMBSTONE FUNERAL LUNCHEON GARDENS - GRAVE OPENING ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State__ Zip Year(s) Commission Paid: Attorney Fees - LAW OFFICES OF CRAIG A. DIEHL Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State ~ Zip Relationship of Claimant to Decedent Probate Fees REGISTER OF WILLS, CUMBERLAND COUNTY Accountant's Fees T~ Retum PreparefsFees LAW OFFICES OF CRAIG A. DIEHL THE SENTINEL - ESTATE ADVERTISEMENT CUMBERLAND LAW JOURNAL - ESTATE ADVERTISEMENT ORPHANS' COURT, CUMBERLAND COUNTY - FILING FEE FOR MISCELLANEOUS PETITION RECORDER OF DEEDS, CUMBERLAND COUNTY - RECORDING FEE FOR DEED REGISTER OF WILLS, CUMBERLAND COUNTY - FILING FEE FOR PENNSYLVANIA INHERITANCE TAX RETURN -- CONTINUED -- SUBTOTAL FROM PAGE 2 TOTAL (Also enter on line 9, Recapitulation) $ AMOUNT 6,961.10 1,574.00 400.00 945.00 7,500.00 308.00 160.00 112.37 75.00 18.00 39.00 15.00 2~074.99 20f182.46 3W46AG 1.000 (if more space is needed, insert additional sheets of the same size) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS (PAGE 2 OF 2) ESTATE OF ROGER W. DECHENE FILE NO. 21-03-00783 ITEM NO. DESCRIPTION AMOUNT 12. WESTFIELD INSURANCE - HOMEOWNERS INSURANCE $ 129.25 (OCTOBER - DECEMBER 2003) 13. ROGER L. MYERS BODY SHOP - TOWING FEE TO $ 100.00 REMOVE VEHICLE FROM ACCIDENT SCENE 14. KENNY'S AUCTION - AUCTIONEER FEE $ 612.15 15. KENNY'S AUCTION - DISPOSAL FEE $ 10.00 16. FRANCES E. OILER, TAX COLLECTOR - 2003 SCHOOL $ 810.33 REAL ESTATE TAXES (TOTAL BILL = $1620.65; PRO- RATED AMOUNT IS FOR JULY - DECEMBER 2003) 17. ADAMS ELECTRIC COOPERATIVE, INC. - ELECTRIC $ 163.26 BILLS (OCTOBER - DECEMBER 2003) 18. DYNAMIC APPRAISALS INC. - APPRAISAL OF REAL $ 250.00 ESTATE SUBTOTAL OF PAGE 2 I $ 2,074.99 REV-1512 EX+ (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ROGER W. DECHENE FILE NUMBER 21-03-00783 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unmimbumed medical expenses. ITEM NUMBER 4. 5. 6. DESCRIPTION PHH MORTGAGE SERVICES - MORTGAGE BALANCE; LOAN NO. 0002049005 MEMBERS 1ST FEDERAL CREDIT UNION - VISA CREDIT CARD NO. 4287-5900-0180-5254 ADAMS ELECTRIC COOPERATIVE, INC. - ELECTRIC BILL AT&T WIRELESS - TELEPHONE BILL UNITED STATES TREASURY - TAX DUE ON 2003 FORM 1040 FRANCES E. OILER, TAX COLLECTOR - 2003 COUNTY/TOWNSHIP REAL ESTATE TAXES TOTAL (Also enter on line 10, Recapitulation VALUE AT DATE OF DEATH 75,366.50 361.92 217.83 98.20 5,330.00 339.02 81,713.47 3W46AH2.000 (Ifmorespaceisneeded, insedadditionalsh~tsofthesamesize) REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES ROGER W. DECHENE NUMBER I 1. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfer: under Sec. 9116 (a) (1.2)] OLIVIA R. DECHENE (minor child) 5 TIMBER LANE NEWVILLE, PA 17241 OWEN R. DECHENE (minor child) 5 TIMBER LANE NEWVILLE, PA 17241 FILE NUMBER 21-03~00783 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) DAUGHTER SON AMOUNT OR SHARE OFESIATE 1/2 OF ESTATE 1/2 OF ESTATE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 3W46AI 1.000 (If more space is needed, insert additional sheets of the same size) I, I~ ~ ~, of C~lar~ Cour~, Per~lvania, declar~ this as a~ for my ~t Will and Tmstam~m, hereby ~ all other wills ~ codicils her~tofor~ ma~e by m~. I Cl~ th~ pay~arfc of my d~ ar~ the ex~ of ~ 1~ ~ ~. If ~ ~ ~ ~~ 1~ a~le for ~ ~~, ~ ~ ~ at ~ t~ of ~ ~, I a~ze~~ ~~ti~ ~ ~~ ~ ~ 1~ wi~ a ~~ for ~ ~, ~ ~for ~ ~ ~ ~, ~ I a~ize ~ ~ ~ti~ ~ ~ ti~e ~ ~ ~p of ~ 1~ ~~~ ~ ~ ~ ~ ~n ~ ~ ~ ~tive ~1 ~i~. Further, in this omx~ction, I authorize my personal r~gr~e~ative to ex~ fun~s f~ my estate, in such amount as my ~-rsonal r~,~ativ~ shall ~i~er nscessary and ~es/rable, for t_he purchase, er~ctic~ ar~ lnscrip~.ion of a ~uitable marker for my grave. I give, devise and bequeath my entir~ e~tate of whatever nature a~d w~ situate to my wife, EARLA JEAN ~9C~, if she shall survive m~ by thirty (30) day~. I~ t-he event ~y Wife pr~ me or fails to survive ~ by th/try (3o) ~ay~, then I give, ~vis~ ~n~ bequeath my entir~ estata t~ m~uildz~n, ir~ludinganydLildbca-n~the~i~ningofthi~Wil~, per [~C~%IE, an~ a portic{% of my e~tate passes to an heir urder the age of twenty- five (25), then that port/on of my e~tate ~ir~ to r/%e heir shall be placed · with ~FARMERS NATIONAL B~NK OF N~WV/LLE, Cumberlmrd Oounty, ~-nnsylvan/a, as TRUSTEES, urder the foll~ir~ conditions: 1. My Trustee shall pay principal and inom~ to or for the benefit of the he/r durir~ his or her life as my Trustee, frum time to tim~, shall deem advisable for the health, mairfcer~, support and c~plete -m'~v~-tion of ~ h~ir ar~ the m~TdDer~ of his or her i~nediate family. In a~d/ti~, my Trustee in their sole d~c~ may advanc~ principal to said beneficiary aga/nst the frmctional ~hares to be advanced ~er for the ~ of marriage, or tim par~msi~ of a h~m Or co~t~ of entarin~ a busine~ or profe~sic~ if my said Trustee shall deem such ~ r~2~onably prudent. 2. Notwi~ardir~ the foregoin~ pr~v/si~, after attairm~nt of twenty-one (21) years, each heir may withdraw o~e-half (1/2) of the principal of kis or her trust val, _~_ as of said birthday or the date of division into shar~s, if later; ar~ after attaining age t~-five (25) years, each heir may wi~ the remainder of ~aid principal an~ urdistr~ imcume. 3. Ln t. he everrt of the o~ath of a ~ beneficiary prior to age ~tY-five (25) t_hmn my Trus~=_ shall distrj]m/te any remainir~ principal in~ am such beneficiary shall appo/nt by Epecific r~f~ to this power PrinCil~xl shall be O/_~r~_~_ to b{~ or ~ is.~ue, ~ st~, or i~ default of ~xmh issue, to my iss~e, per stirpes; provided, hom~m~_r, any portion of such prir~:ipal, which %~lld be distri~_~d to a~y beneficiary for whc~n a trust 4. Should the principal of any trust herein provided for be or ~ too small in my Trustses' dis~0~ to make es~_~blishmmnts or ccnt~ of the trust advisable, my Trus~ my distribute the r~maining Drincipal ar~ any ac~at_~_~ or undistri~ ~. outright to the k~neficiaries in the pi~o~ions to which they ar~ t~ entitled to. r~-e~ipts and releases of r. he distr/but_~ will terminate absolutely the rights of all ~ who ~Light ot_harwime have futur~ ir~_er~ in the trust, whether v~stsd or c~ntingent, without notic~ to thrum am~ without the necessity of I ~ that no trustee, executr/x, 9uard/an or other fiduciary namm~, n~mtnated, or appoint~ by this my T~t Will and TesTament shall be r~ to pc~t any bc~d or give any security of any type for any purpose whatsoever, a~y law or rule of the court of the C~,~m~alth of P~nnsyl~ia law of the C~ATth of Pennsylvania shall ap~ly to any interpretation or application of the validity of th4~ My ex~nutr.ix and trustee shall have the following ~ in add/ti~ to those vested in them by law ar~ by other provisions of this Will, ir~.luding pr~ h~ld for minor~, Whether principal or ~, ~xarcis~abl~ without c~mart ap~, ar~ effective, w/th respect to each item of said ~z~rty until aco~/ distr~i~ thereof. A) To ~in, as inve~~ of my estata or trust, any or all of diversification, ar~ to ~uruhase ar~ acquire ~ or pe~ property and to hold any or all of such ~ and personal property reta/nsd or acqu/red s) To p~rmit the children, or any of th~m, tn oomxpy any real estate r~cained or acqu]red upc~ su=h tezms and c=~diti~ as my executrix or C) To pay all taxes, chaz~es and ~ of maintenance, upk~e_p, img~w~men~, d~-lqz~nt, prot~cti~, pr~ar~tion and ~t of any r~tair~d or aoqu~ed real or ~ property, ~ payments to be made either pr/ncipal or inccm~ as my executrix or trustees shall determine. D) To r~taln or invest any ar~ all fla~ds, whether princiDal or znc~n~, in any real or personal pr~ w/thout rmstriction to leqal ~~t~; to purchas~ /nve~tments at pr~niums; to ex~r=ise all rights, of a seouri~y holder or ~hare holder in any corporatic~; and to lease, mortujage, ple~, give outi~ upon or sell at ~ublic or privat~ sale an~ without aP~zroval of any ~ourt, any rmal or per.mgm/ ~, or portion or portions ~, ~ive of th~ =ann.r or th. ~ by which the ~m~ was ~-) To ~ Paymerfc or d~//a/tic~ herein provided for in cash, ~r ~ at the tim~ of d/str~ion. SIXTH Any and all payment or pa~ of any sum or sums, whethar in cash or in ~ an~ whether for principal or ir~mmma, payable t~ an heir, or any of th~, ~hall be ~_ag_ upon the sole r~oeipt of the respectiv~ ind/vidual to whc~ the payment is maS, ar~ fr~ frc~ anticipation, alienation, assignment, attar, ar~ pl~k~e, and fr~ f~ control by th~ creditors of any Euc~ ~r~ficiary. Ln the event I amnot survived by my wife, KARIA~ ~, I appo~ ~ B. AND ~ K. WISER, guardia~ of any of my children who may be minors at the time of my death. I appoint my wife, KARIA JEAN ~, Executrix of this my Will ar~ Tes~. Should my said Exect~cr/x fail to ~11rvive me or for any rma~on fail to qualify as Ex~o~rix, th~n ! ax:~oint ~ NkTIONAL ~ OF N~, Cumberland County, Pennsylvania, E~mcutor of ~ my ?~_~t Will and IN WI~ WHER~DF, I hav~ her~ set my harm] and seal tn this, my Last Will ar~ T~, consisting of five (5) t~itten pages, the f/i~h fc~r (4) of which bear my signat%~r~ in the ~_wgin for the purpos~ of id~tificati~, ~ /O~ day of ~r~<~ , 1994. terra, r, ~ WILLIAM ~, a~ aI~ for hi~ ~t Will ar~ Te~t~ ~ C~ OF PENN~YL~ : : SS. r~v~ly, whose names are signsd to the attached or for~o/n~ instrument, ~ f~t ~Y ~, ~ ~ ~1~ ~ ~ ~i~ a~ori~ ~t ~ ~~ si~ ~ ~ ~ ~ of ~'~ Will ~ ~~, ~ ~t ~ si~ will~ly ~ ~t ~ ~ ~ ~ f~ ~ ~1~ a~ for ~ ~ ~~ ~, ~ ~t ~ of ~e ~~' ~ ~ ~ ~ ~~ of ~ ~~, si~ ~ Will ~ wi~, ~ ~t ~ ~ ~ of ~ ~1~, ~ ~~r ~ at ~e ~ e~ (lB) y~ of ~e or olaf, of ~ ~ ~ ~ ~ ~ ~ ~ ~~ ~f~ ~ ~ /W~{~y of ~~/ , ~94. * IN THE COURT OF COMMON PLEAS I.:.* OF CUMBERLAND $.TATE OF.,~...:~~,...~. <. COUNTY PENNA. ....................................... Plain.tif. f ........................ il Versus " ....................................... Defendant ........................ DECREE iN DIVORCE AND NOW ........ April. ~2 .............. 1~..%q0..~, it is ordered and decreed that ............... .r~..R.x.,.~..~.....D.~.C.H.~..~.~ ................ plaintiff, and ......................... Fo..cF.R..~.-..D. EC..HF~F .............. defendant, are divorced from the bonds of matrimony, Tt is further ordered that the terms of the Marital Settlement Agreement of the parties dated Janua~hye 26, 1999, shall he incorporat¢~, herein,, but nQt m~rqed. court retains jurisdiction of the fOllOWing claims wnlcnnave been raised of record in this action for which a final order has not yet been entered; None ~), ,) CERTIFIED COPY ISSUED APRIL 17, By The Court: L _s. L...K..ey.i..n.., A,._. _H_e_$_S. ....................................................... ............ ~ ............. ~ > (7 ............ i~;ti~;;;i~'~; .... 2001 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. ';'80601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 0O3919 DECHENE KARLA JEAN 50 WEST MAIN STREET NEWVILLE, PA 17241 ......... fold ESTATE INFORMATION: SSN: 167-40-0099 :ILE NUMBER: 2103-0783 DECEDENT NAME: DECHENE ROGER WILLIAM DATE OF PAYMENT: 05/1 O/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 08/09/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 t~4,429.70 TOTAL AMOUNT PAID: $4,429.70 REMARKS: KJ DECHENE SEAL CHECK# 1768 INITIALS: VZ RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 28060! HARRISBURG, PA 17128-06ol COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX CRAIG A DIEHL ESQ C A DIEHL LAW OFFICES 3464 TRINDLE RD CAMP HILL PA 17011 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 06-28-2004 DECHENE 08-09-2005 21 05-0785 CUMBERLAND 101 Amount Remitted ROGER W MAKE CHECK PAYABLE AND REMIT PAYMENT TO.' REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA I7015 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS -~ REV-1547 EX AFP C01-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF DECHENE ROGER W FILE NO. 21 05-0785 ACM 101 DATE 06-28-2004 TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON= ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds CSchedule B) S. Closely Held Stock/Partnership Interest (Schedule C) ~. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule 6. Jointly Owned Property CSchedule F) 7. Transfers CSchedule G) 8. TotaZ Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expanses (Schedule H) C9) lO. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 11. Total Deductions 12. Net Value of Tax Return 190~,000. O0 .00 .go .00 10~353.65 .00 .00 (8) 20,182.46 NOTE: To insure proper credit to your account, submit the upper port/on of this form w/th your tax payment. 15. 1~. NOTE= 200,555.65 81~715.47 Cll) 101.89R.9~ ([2) 98,457.72 Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) Net Value of Estate Subject to Tax If an assessment was Issued Previously, lines 14, 15 end/or 16, 17, reflect figures that Include the total of ALL DISCOUNT C+) INTEREST/PEN PAID .00 ASSESSMENT OF TAX: 15. Amount of L/ne 1~ at Spousal rate 16. Amount of L/ne I~ taxable at Lineal/Class A rate 17. Amount of L/ne 1~ at Sibling rate 18. Amount of L/ne 1~ taxable'at Collateral/Class B rate 19. Principal Tax Due FAX CREDITS: PAYMENT / RECEIPT DATE NUMBER 05-10-2004 CD005919 .00 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 98,457.72 18 and 19 will returns assessed to date. (Is) .00 x O0 = .00 cz6) 98,457.72 x 045= 4,429.70 tiT) ~00 x 1~! = .00 czs) i~O0 x l~:=' = .00 (:~)= 4,429.70 AMOUNT PAID 4,429.70 4,429.70 TOTAL TAX CREDIT BALANCE OF TAX DUEI .00 INTEREST AND PEN. TOTAL DUE I .49 c IF TOTAL DUE IS LESS THAN ~Z, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU NAY BE DUE'~.~-( A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION= PURPOSE OF NOT[CE= PAYMENT= REFUND OBJECTIONS= ADHIN- ISTRATIVE CORRECTIONS= DISCOUNT= PENALTY= INTEREST= Estates of decedents dying on or before December 12, 1982 -- if ar~ future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class 8 Ccollateral) rate on any such future interest. To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of 2000. (72 P.S. SectAon 91~0). Detach the top portion of this Notice and submit with your payment to the Register of N1118 printed on the reverse side. --Make check or money order payable to= REO[S~ OF NZLLS, AGENT A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-iSIS). Applications are available at the Office of the Register of Wills, an~ of the 25 Revenue District Offices, or by calling the special 24-hour answering service for forms ordering= 1-800-$62-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-$020 CTT only). AnY party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as sho~n on this Notice must object within sixty C&O} days of receipt of this Notice by= --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to= PA Department of Revenue, Bureau of Individual Taxes, ATTN= Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" CREV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three CS) calendar months after the decedent's death, a five percent CSX) discount of the tax paid is allowed. The 15X tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before JanuarY 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable An the same manner and in the the same tame period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquenc~J, or nine C9) months and one C1) day from the date of death, to the date of payment. Taxes which became delinquent before JanuarY 1, 1982 bear interest at the rate of six (~X) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after JanuarY l, 1982 will bear interest at a rate which will varY from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2004 are: Interest Daily Interest Da/iv Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor ~'~ 20~ .000548 ~'~-1991 11~ .000501 ~'~ 9X .0002~7 1985 16X .000458 1992 9~ .000247 2002 &~ .000164 1984 11X .000301 199~-1994 7X .000192 2003 5X .000157 1985 15~ .00055& 1995-1998 9~ .000247 2004 4~ .000110 1986 lOX .000274 1999 7X .000192 1987 lOX .000274 2000 7X .000192 --Interest is calculated as follows: I'NTEREST = BALANCE OF TAX UNPAZD X NUHBER OF DAYS DELZNI~UF.,NT X DAXLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment Ks made after the interest computation date shown on the Notice, additional interest must be calculated. I.J_. (~ U_.,l-. C) u=: - L C~, (~~i . I.'.i '. (::-, ~~~ C) LU 0:.: STATUS REPORT UNDER RULE 6.12 Name of Decedent: Roger W. Dechene Date of Death: August 9, 2003 Will No,: Admin. No.; 21-03-00783 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes B No 0 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete; 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 [R] b. The separate Orphans' Court No. (if any) for the personal representative's account is: N/A c. Did the personal representative state an account informally to the parties in interest? Yes 0 No IKl c. Copies ofreceipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date; 1/24/05 ~OfLl1 Signature Craig A. Diehl, Esquire Name In M 0.1 3464 Trindle Road Camp Hill, FA 17011 Address ,.- c::~ "- w.. ~~~ E~';. b~ ~2 ~: L!.J ~'c:'~ _J.<: ' o:c; 8:( 0' o ; = N (717) 763-7613 Telephone No. ::;; U'O = = '" Capacity: 0 Personal Representative !Kl Counsel for personal representative