HomeMy WebLinkAbout06-17-09 15056051047
REV-1500 EX (06-OS)
PA Depadment of Revenue OFFICIAL U SE ONLY
Bureau of Individual Taxes
PO BOX 280601 County Code
~~ ~
INHERITANCE TAX RETURN
~ Year
'"""
~q 'r File Number
e°
.,
0~
Harrisburg, PA 17128-0601 RESIDENT DECEDENT ;g,„~
,a¢ ~~~...li 9.
. ~
Firm Name
First line
Cit or Post Office State
t1/~~L'zN .4 ~ / ~G SFS= u~R~,r ~ ~ ~ ~/~~
x {.-:..rr + fax..>,wv.xnr. x3~.m.ueamf ~ rn.~r. ..
REGISTER OD~dYILLS USE
r rJO-~rT
e --i
r + ~7
~z~=v.i& D/~ FILED
ZIP C`'o~de ~/ s a
F /i / ~ O ~Y ~ `' Q ~~ / r J S r*
.. y nn~i F. d. .ss .u..3rvx't Yiti a.:
Correspondent'se-mail address: CBSti/e~ds.3Q CO/X.r,~Q$7~. /Jer'
'gip TJ
7;;:'~
ITf t;"')
Z ~. <:')
.: tS
~' i'S=
v "
2' ~7
_ -r.~
_.,
~t
' ..-)
Untler penalties of perjury, I deGare that I have examinetl this re[um, including accompanying schedules and statements, and to the best of my knowletlge antl belie(,
it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowletlge
SIGNA~gyJR~E OF PERSON R~FCp7ONSI~LyE~OR FILING RETURN
-`-~/~ l (7C ~ DATE 6 /'b/o 9
w /~
ADDRESS ~/~./~(~ ~ /L(//~~,~' /ME/'Y ilC /A,n~.G F. .C;.
. ~i..CJ-IiIIPA ~vi~nxrv~vt DATE l / 4
(. /i O
15056051047
'LEASE USE ORIGINAL FORM ONLY
Side 1
15056051047 ~ \~
~'
J 15056052048
REV-1500 EX
Name:
LO/S z,
RECAPITULATION
~ ~.r ~ ~ ~~0
1. Real estate (Schedule A) . ......... ......._ . ............ I (y
9
2. Stocks and Bonds (Schedule B) ..... ....... d
~ pnD~;
rx ~.b7 f'~..,.a ~1 .2 ~
*R~k~S '
~
pt
3.
Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..
. 3
t ~ ~
µ
~
r
~ (/ C.~
4. Mortgages 8 Notes Receivable (Schedule D) ...... ......... q ~ ` ~ c
ti d" ~
#
4~~'~uR2 k4 g
5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) . ... . 5 Q
~ `' ,(, ~ t ~ /"~~ 9 9~
6 Jointl
Owned P
rt
S
h
O P
'
~
~ `
P ~~~
. y
rope
y (
c
edule F)
Separate Billing Requested . .. . 6 1
~
~ "
p ;~(
~ OtO `
7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property az~aa( d1':YEW~»&'y
~
(Schedule G) O Separate Billing Requested..... . 7 # $ ~ [ II J '' ~ ' 0
('F
8. Total Gross Assets (total Lines 1-7) ... ......... ........ ....... :.. 8. 6= ~ ~p 0, Oa9 ~ '-
9. Funeral Expenses 8 Administrative Costs (Schedule H) ......... ......... 9 ~~ ~; *. n ~ ~
re ~ Q
915
10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) .... ......... 10. ~ ~ "Q ~ 7
11. Total Deductions (total Lines 9 8 10) .. .......... ........ ......... 11 ~. ^.~ .j ~ /
. 7~..6 0'5 / ~ ..
12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12 _ ' ~ ~
{ « O d
13 Ch
i . .
. ar
table and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) .......... ........ 13 « u ~ - . ~ t x 0.'
14. Net Value Subject to Tax (Line 12 minus Line 13) ........................ 14.
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES ~-
15. Amount of Line 14 taxable
at the spousal tax rate, or
cransrers unoer sec. anti
(a)(1.2) X .OEL 15.
16. Amount of Line 14 taxable
at lineal rate X
0 ~
. 16
17. Amount of Line 14 taxable
at sibling rate X .12 17
16. Amount of Line 14 taxable
at collateral rate X .15 18
Decedent's Soc-i7al Security Number
.sheet
19. TAX DUE ......................................................... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
15056052048
Side 2
15056052D48
psi or NESS, Lv<S Z.
z~' °9 - oa.~s~
Nor~.s ~, ,~5set; 6~du~/o~s ar.(% C'a/e4./Q/~o.~s,
~eceoPenta S~hedwle E ~issr~"s Tnfa/ X104 S9
Sc1~ H. ~a'm%.~ gr~neaxs ~a~/ % boo. 9s
/9s 9, S/9 c/~~ ,~eeirf ~/4~/~ ~oa.~ d ~-o~ Sc~ E /JSScts
f /plc/ua;d' ik[ `Q/ue nI' i1Cms 3 Sf~ ` f 7)
T:s ,~~~ a 6a/~tn~e due off' X8'9/..36 %/,J q~liek.~t
his d eeh ~,,d Fro.a ~ asuts o~ J~ ,~%~t fefraat
dau~h~--
7Tus laic ~i~t `ll~at of SGFe4~ E,/c~ru Ri~S fQ~i1 tso
i~ S!:/ce~N ~i~z¢ipz1~'.
%~e pigf {'allft aT Sef~tc~ F ~ oa
! % 36 Yz sfa rti was ~o, ~•
!~ • SLia~1`fic// was ~~/.cd ~9A;nst ~e ~G,ooa•~
/h •'s ~a~t~' q /1c~ mad/ ~a/ue o~ I`~ o~;<Z` /ui
BF X79, /off: G 5~ ~ ~
~X C~a/eu/.c~oit is ~tus X79, /06: 6~ X . D~/S = ,3, 5'S3, gq
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
~ BUREA,U OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1]128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ACN
ASSESSMENT
CONTROL
NUMBER
NO. CD 01 1007
LAUCKS DIANE E
103 SOUTH LOCUST STREET
SHIREMANSTOWN, PA 17011
-------- ~oN
ESTATE INFORMATION: ssrv: i~a-2o-1592
FILE NUMBER; 2109-0259
DECEDENT NAME: NESS LOIS V
DATE OF PAYMENT: 03/17/2009
POSTMARK DATE: 03/16/2009
couNTV: CUMBERLAND
DATE OF DEATH: 12/25/2008
REV-1162 EX~11-96)
AMOUNT
101 ~ $3,487.50
TOTAL AMOUNT PAID:
REMARKS: RECEIPT TO ATTORNEY
CHECK# 7374
INITIALS: AJW
sEA~ RECEIVED BY:
$3,487.50
GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
TAXPAYER
REV-1500 EX Page 3
Decedent's Complete Address:
File Number ~, /- Q 9 -~
DECEDENT'S NAME
[.D/S Z. yE'SS
-- - _ _ --
_ _ - __
STREET ADDRESS _ __. _.__ -.. __. __-.. ___. _. _._ __.- _._
/j'12nor Pgre HeaJ~ .~rrcCf_-_. _____
/ 7D0 h/Rr.~ef' ~f:
_. ____
_- __
CITY ___-_ .__ ___- __._-
-- _ ___
~ STATE n~ ~
/" /7~~~
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit _ _ _ _ _ _ _D __ _ _
B. Prior Payments -~ 7 -~~-
- ~y~_. sz? __
C. Discount _ / 7 ~i~. 3 8
3. InterestlPenalty if applicable
D. Interest o
E. Penalty ---.... ---.....- - - ~
Total Credits (A + g + C) (2)
..-___... _
Total InterestlPenalty (D + E )
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Line 20 to request a refund.
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE,
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(3)
(a>
(5)
3, 6 ~ /. ~ ~
O
/ o/, 9'9
r~
(SA) O
(5B) O
Make Check Payable to: REGISTER OF WILLS, AGENT
~~rl~@u ~`A~~'t~a>'~1~~~'?)4 t &„r1~4. ~. ~ 1';~~~~i`&tev~tifi.+f~~1*i1~~f~ ~"<y4~$~t~t rt x1"2~~ , & ,~ „ti, r > v ~y
,. ~~t trs,+~`+']~n~$x~~1~~eh3.~1a~.ty.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred :.................................................................................... ....... ^
b. retain the right to designate who shall use the property transferced or its income :..................................... ....... ^ I~]
c. retain a reversionary interest; or .................................................................................................................... ...... ^
d. receive the promise for life of either payments, benefts or care? ................................................................ ...... ^
2. If death occurred after December 12, 1962, did decedent transfer property within one year of death
without receiving adequate consideration? ...............................................................................
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ........ ...... ^
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .................................................................................................................. ...... ^ 141
IFy}THE yyAyyNSgqW}}ERppssTO„RNY OF THE ABOVE QUESTIONS IS YESy, YOU MUUST COMPLETE (SC~H~JEDULE G ANtD FILE ITSAS PART OF THE RETUc RN.
v~}+'}3~ia~k kKY:~fi+~h'~EdSf Sffi t4 a'{tx.a" SktK,;Ntb'1~N64~$t(`~Fk'o-n~t i`..tY$t~.£.~"n~<F+~1R kauk')<ai~'$ ci3kklYbXks;<';rrb~ikk'3r 1~ik13 k~'.> #av3~.x s~#%~'a~$~E ~~t~t x+s~~@k~+.F +..
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is three (3) percent [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent
[72 P.S. §9116 (a) (1.1) (ii)j. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an
adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in
72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling is def ned, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
~ aEVaSce~x.,US)I
SCHEDULE E
CDMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
INHRESIDENT DECEDEMRN PERSONAL PROPERTY
ESTATE OF IVF+ sS~ ~D/S ~~ FILE NUMBER
eZ/- 6 q_ -~s9
Include the proceeds of liligagon and the dale the proceeds were received by the estate. All property Jointlyowned with the right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. SUStQu.ENMVN/~ Y/FLl.~'Y FED~2/K CRr`~lT UN/OAS
~EiN(~PR ~• 14ZCo
12F6uGAtR ~HA-1ES a+rd SHA~CE DAFT i¢ ~' kNTs
(See p{ficial t/q/ua~ion loh`~r X33] ./8
~m ~us~. ~a/ ~e u
ah'~clcea~)
~• t2EFt~NO of ovt'~2,4~ ON P~'P~4iD ~'>,tN~2.A•L /3u1
SEE ~TA•7~7xt~vr ~~) ~ 37~; ~9
3. p/c/ small TV
¢/p, 06
~'h ex/~ensi ve C us~n~e ,7er.~-.(y ~ ~ S . 60
5, ~erSena~ Znc~r~en~als A~c~: w1' /Ylanor Care 169.27
(`see Goseokt rccei pt a f~a she d
~a. Pt,+-senal Port-alolc ~(1oNG
'J, small CD ~larrr ~/, 00
~" d . xs
TOTAL (Also enter on line 5 Recapitulation) I $ 9 ~ 9 ~ 4
~.
USQUEHANNA
ALLEY
FEDERAL CREDIT U N I O N
February 23, 2009
Charles E. Shields, III
6 Clouser Road
Mechanicsburg, PA 17055
Re: Lois V. Ness a.k.a. Lois Z. Ness
Dear Mr. Shields:
l o~~zs`~~'h
The following is the information you requested for Lois Ness's account at Susquehanna Valley Federal
Credit Union. Ms. Ness did not maintain a safe deposit box with SVFCU.
Account # 14200
DOD Balance: -00 (savings): $57.11
-40 (checking): $280.07
Joint owner (on both savings and checking): Diane E. Ness
Joint owner added when the account was opened on 06/24/2004
Please let me know if you need any additional information.
Kind regards,
~~G%L~~
KathyJO Shoaff
Member Services Supervisor
~, 3850 HARTZDALE DRIVE • CAMP HILL, PA 17011-7809 ~~
~'}' LOCAL: (717) 737-4152 TOLL FREE: (800) 948-1454 FAX: (717) 737-0589 \,._~'
f P ,-tiVY`,R',
~+ .
. ICI I I l'11~f Iii eI ~~Y.
I II I I ~ ~ ~ i"I ~I iA~
-A MCI~~,(•
MYl?.RS-HARNGR FUN L.R.4L HOMF: INC.
IYOJ MARKET STREET
CA MI HILL, PENNSYLVANIA IJ011
]I]-]A-9961
LU(~:1L I YUAA'1'P:U :AVD f1PF,:R,i'P41D
January 7, 2009
National Guardian Life Insurance Company
2 East Gilman Street
P 0 Box 1031
Madison WI 53701-1031
Services for Lois Zirtanerman Ness
December 30, 2008
Charges for Services Selected $ 4,590.00
Professional Services
Use of Facilities
Automotive Equipment
Charges for Merchandise Selected
Casket $ 1,450.00
Vault 1,080.00
Cash Advanced
Opening Grave $ 600.00
Newspaper Notice/Local 156.00
Clergy 150.00
Certified Copies 60.00
Organist 100.00
Limouisine 300.00
Hair Dresser 40.00
ROOF.RT 11. IIA R\Y'.R
SUPERVISOR
RUSTh R. OAA RR
FUNERAL OIR ECTO0.
$ 4,590.00
$ 2,530.00
Total: $ 1,406.00
$ ~5£~
~ ~
T~I~~e r ~'~L~..
• 1~1 Iml Ial 151 12I ~1 ~~+~~I;, ~,
,~ ~ I~1111 ~ k f~l r
.y
MYERS-HARNGR FUNCRAL HOME INC.
I90] MARKET STREET
CAMP HILL, PENNSYLVANIA V011
717-]3 ]-9961
LO(':V LYON'\I!:D :IND OPL:RA'I'ED
January 13, 2009
Mrs. Diane Laucks
103 South Locust Street
Shiremanstown PA 17011
Services for Lois Z. Ness
December 30, 2008
Received check from Insurance Company
Amount of bill
Refund
ROBERT II. RA RNER
SUPERVISOR
DUSTIN R. DAKER
FUNERAL DIRECTOR
$ 8,900.89
- 8,526.00
$ ~T4~5
e,
" ~
~3 ~~ ~
-'~ O v ;Z..g ~ ,
~' ~ m
~" ~~ 3 ~ z
tea z
~ m
2
y
,.*`
ys" ~ 00
- ~ ~
- woro
§':'~~ ' '~. W~ V 69 N V N~ N
... fnm - NNN
,y k. ,at ~ and mZri
i r
°
~ ~~ °
e
. c
> ~m
~. ~ N ~
x
~~
~
m
~
Axat~i `S a
nm
D
~O
2Z
~y~IyV
'~ m
~a
rp
~~0
~~
~N
ti
C
z
0
,~ ~
~ kr ;~ ~L
Y
}}
M1~M d h.
~~?
~
~
t ;
~
(C~,.WCJ ~'
f~+3
ui~
~ v
~~~}~ a
~ ~ i
fi~Y"
f VI
A
~}y ~).
~~ ~~~
Y y 1 /~
* ~~
f ."-
N
ty
T
~Mx
vrA~
~~~ 4~
c
n
~~
$
s
t
~~
i :
,
~ry k y
Sg''4d ~} f}
'??~~ 5 +
n~~ ~'" y
~'i,
~~
i„
i
J
` The Managing T rustees HCR ManorCare
Resident Personal Trust Fund 5th floor
Resident Trust Statement 10/01/2008 Through 12/31/2008
Ol /05/2009 10:24 AM
Page 1
Legal Representative _. _
Resident # 3074
_ - --
58
Ness, Lois Z
Ness, Lois Z 103 S. Locust St.
Shiremantown PA 1 7011
Bank: Wachovia
Acct#: 2020000104913
Admit: 10/27/2004 2:00:00 P
Disch: 3/30/2007
_. 1:24:00 PM
_... _ Beginning Balance I
_ __ $122.22 ~
Date Description Check# Withdrawals Deposits Balance Trans ID
03/2008 Pension $1,088,06 $1,210.28 16297
10/06/2008 SeptSoc Sec $1,]13.00 $2,323.28 16368
10/06/2008 octpp 1774 $2,156.06 $167.22 16397
10/06/2008 septcable 1774 $12.00 $155.22 16398
10/06/2008 septb&b 1774 $]8.00 $137.22 16399
10/31/2008 Interest $0.0] $137.23 16531
10/31/2008 Service Charge $0.00 $137.23 16532
11/03/2008 Nov socsec $1,113.00 $1,250.23 16459
1]/05/2008 Pension Deposit $1,088.06 $2,338.29 16548
11/07/2008 Nov PP 1779 $2,156.06 $182.23 16567
11/07/2008 Oct Cable 1779 $12.00 $170.23 16568
11/07/2008 Oct B&B 1779 $32.00 $138.23 16569
11/30/2008 Interest $0.01 $138.24 16696
11/30/2008 Service Charge $0.00 $138.24 16697
12/01/2008 Pension $1,088.06 $1,226.30 16626
12/04/2008 Social Security $1,113.00 $2,339.30 16710
12/08/2008 Dec pp ]785 $1,820.33 $518.97 16744
12/08/2008 Nov cable 1785 $12.00 $506.97 16745
12/08/2008 Nov b&b 1785 $2.00 $504.97 16746
Ending Balance $504.97
Resident Trust Fund Statement -This is no[ a bill
Wachovia 2020000104913
Substitute K-]'s
Name of Estate of Trust: HCR Manorcare Residents Personal Trust Fund
Trust Employer Identification Number: 34-6935215
Beneficiary's Identification Number: 174-20-1592
Beneficiary's Facility Name MCHS-Camp Hill
Beneficiary's Name, Address, and Zip Code:
Lois Z Ness
103 S. Locust St.
Shiremantown, PA 17011
Fiduciary's Name, Address, And ZIP Code
The Managing Trustees HCR Manorcare
Resident Personal Trust Fund 5th floor
333 North Summit Street
Toledo, OH 43604
Interest Earned: $0.09 2008
.asvnwa ~~ lisn
SCHEDULEF
COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF N F 5 S FILE NUMBER
~ Lp/S z ~I-o9-~~9
If an asset wes made joint wkhin one year of the decedent's date of death, h must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDEM
A. D1~4uE ~. LA-ucKS, l03 S. Locust cSt' dati ti9r~-
~~n~eh/y Kxiwn aS Sl~tireM4 n S'fOwn, Rf} 17D11 9
~/.gvvE E, iVE58
B.
C.
JOINTLY-OWNED PROPERTY:
ITEM
NUMBER LETTER
FOR JOINT
TENANT DATE
MADE
JOINT DESCRIPTION OF PROPERTY
Inclotle name of financial institution aM hank ao:ount number or similar identifying number Attach
deed for pinny-held real estate.
DATE OF DEATH
VALUE OF ASSET %OF
DECD'S
INTEREST DATE OF DEATH
VALUE OF
DECEDENT'S INTEREST
~. A. 3/28/ ff// tfia.1' eertAin /ra~J' of/axd sifitate a+ ~ ~
~+c .3a/'°ag/7 of c~iireiJ7q//S{snM, ~acnL(,er- /~cOJ p00~
/asm' L'ouh y, /~a~sy/rAMer, ~iav:K~ an add
B~ /03 S. Lc cusf Sf, ~Sfi~ir~,ansf~w>,t
P/JL
,
.
noii, and lr:.~ ~.wie ~trrhi:u/ar~ descriif~d
in ffisf Cer/nin decd ~irr Lais ~ ~y~,
Ls'i'c~ord, r D/.4NE F. .UE;S, titr daat~fi/rr,
~i J~i -+rOAv S4id La[s ~ NETS-r, .as -Jrjc1RQ$
dated iYl4rc{t a8, /947 au,d re~rgt~/ i,;r ~
~eeonler of ~s OF{'ce in avld J~'r Curn -
erlwad C'otA,w'ty , Penns~lvan+.ia I.i., 1~eep1
hook I SS ~~ -?3~ AaVi tY ~ Fa.rc..l
# 37-~3- p5ss-- ZuY. (Sec COPY oiC derL/
cedlndLed h~rt,)-
See A~pra~'sa/ ,~' ,Bred Ler,~lflla
l
°F
el', ` g
/ 0
Yj
~
/
_
~
~/J /'Q J .~1 / W/1{ /7 015 ~/~ G~yq~ ~ll'/L°/D> / ~~/ ~ as
TOTAL.(Also enter on line 6, Recapitulation) $ ~Q, ODO • °D
more space is needed, insert additional sheets of the same size)
~~Y~ ~
Tax Parcel No. 3 ~ -=,$',S- "7, yy
THIS DEED
Made the ~S~i day of rngt.c~.J
ninety-seven (1997). m the Year one thousand nine hundred and
Between LOIS Z. NESS, umemartied widow, currently of the Borough of
Shiremanstown, Cumberland County, Pennsylvania, Granror.
and
DIANE E. NESS, single woman, her daughter, and LOIS Z. NESS,
unremarried widow, both currently of the same place, Grattees as joint
tenants with right of survivorship, and not as tenantssn common.
WITNESSETH, that in consideration of the sum of ONE ($1.00) DOLLAR in hand paid,
the receipt whereof is hereby acknowledged, the said Grartroz does hereby grant and convey ro the
said Grantees, their heirs and assigns, as joint tenants with a right of survivorship, and not as
tetutnts in common:
ALL THAT CERTAIN tract of land situate in the Borough of
Shiremansrown, County of Cumberland and State of Pennsylvania,
bounded and described as follows, to win
BEGINNING at a stake eighteen (18) feet from the middle of Locust
Street, and sixty-eight (68) feet from the corner of Locust Street and Green
StrceC thence in a nottiteasteriy direction, one hmidred fifty (150) i'ce; ro a
stake on a twelve (12) foot wide alley, said stake being twenty (20) feet
from the line of Green Street, thence by said alley in a southwesterly
direction, fifty (50) fcet to a stake; thence in a northwesterly direction, one
hundred fifty (150) feet to a stake; thence in a northeasterly dircedon, along
Locust Street, fifty (50) feet to the place of BEGINNING.
HAVING thereon erected a two-story frame dwelling house numbered 103
South Locust Street, and garage.
BEING the same premises which, upon the presentation of a Petition for the
award of real estate by Florence H. Bricker, exceutrix of the Estate of D.
Edgar Ztmmemtart, deceased, the Honorable Judge Sylvia H. Rambo of the
Orphans' Court Division of the Court of Common Pleas of Cumberland
County, Pennsylvania, ordered, decreed and awarded to the said LOIS Z.
NESS, grantor herein Said decree is dated August 23, 1977 and was
recorded the same date in the Recorder's office in and for Cumberland
County in Deed Book "J", volume 29, page 366. Further information
concerning said Estate can be found in the Register of Wills office in docket
file no. 21-76-506
THIS IS A TRANSFER FROM MOTHER TO DAUGHTER AND
HERSELF AN'D IS THEREFORE TRANSFER TAX EXI:MPf.
AND the said Grantor will warrant specially the property hereby conveyed.
IN WI'T'NESS WHEREOF, the said Grantor has hereunto set her
hand and seal the day and year fast above wrinen.
Signed, sealed and delivered
in the presence of:
BDUK 155 ftiGE 12u
CObIINONWEALTH OF PENNSYLVANIA
w
COUNTY OF CUMBBRL
AAID : SS. y . J
rw
,
~~,p
On this
the +
~ u -v
.
-~2 day of ~ A.D. 1997,
before me the utrdetsigned officer
personall
Z 3 0 ~ '_
~^
,
a
. NESS,
known to me, (a sadsfactotiiy proven) ro be tlte~~ LOIS
person whos
i , ~,
~ ~ r„ ~~
;r
e name
s
subscribed ro the within instrument, and acknowledged that she executed
the same for the purposes [heroin contained ,
r.~, .~ c'
w ~ -'
IN WITNESS WFIEREOF, I herounto set my hand and official seal '"'~.
s 1"
4
Notarial Seal Public
Shleltls III, Notary
s
e E
Chatl
~
~~
't
3
1
~~'
~
.
e
~V~r-~Ld
Mecheniabur66 Boro. Gumberlantl Count9 _~ °~ -
-j
~
lrea June 20, 2000 ~5
Ez
l }Si ~~
`
^ rt~,Gt„t
~
y
S p
p
on
My Commlea
Member, Pennsylveni0 Psseclalan M Nobrlea Notary public ~ „~; mi
s '~K _ `
I do hereby certify that the precise rosidence and complete post
office address of the within Grantee is
~D,q 5. Locus! Sz`. /~
~irrcmansrnwn/~.//7aii /~A~,~ G /~~0~-~
Attorrtey for Grantees ~_
~iY. % d .>
:;' Pennsylvania SS
. ^? Cumberland
in the offwe for the recordlnp of Daatas
p !~ - ;,,r Cannberln nd County, P,6
-;~ed r,ndganl of office o{ ~
~~o~.ia:i: / ero o~
rNEBS,LSNEaS.b.bEEDBMPLEa2YWj
BOOK 155 face 1~4
2Dn~ ~ 2°m.'~mn5 D..,3 Do tiro ~~
~D~m
f ON`yao
l m~Z a
ml ~+~I~
~
"~ >>
D
a ydW Np~O F
i D2~o
V
~ Z=
yr
m ~~ ~ ZL
~ o
~m
a
~y O
~
O m n~
c ~
~.
~ ~~
vD~~
~ ~ n° ez
Z
fn r ,_, oy
a W Fym
Z r
~p0;
~ DAN 9 ~~ ~
"' Da
Z~W
V o
m m m °a m vm
3~
V _
~y O Oti
Z ~
-I 3; g
~
O~ ~_
<~ 8
N
W
a
N n ~ ~ O
3~=mm
v ~'m'.~ °
n vgD
$ \
(
p
N ~ C y G \\
~y~~~
B.<wm~
d S~
Q V
. _
O ~ O Q-Z
mw3m~p
a-iy ~° _1
"m3
nm
'~'
~
m
m
~
C
=~
~
c mod~9
O ~ d o ~ ~
~-
~'~
mD~o~m
a
'fi ~
g^~a.
Kdm~'~ „~
~~
~
my nyoD
n f xy`~X -~
~~aca ~~
~+m.a =fr11
~~v°pm
m ~ ~ d
= a
J y ~ ~
~~00
~ c _
y,° ~ m
d < ~ H
n aim
~n~n
m
N N
- n
N
M
rr r P
W'
~Y
N W ~
1pOW
OOC ~~
r
m W
° O
~0
O
Y
r
a O
~W
G „~ o
p Z
i b W
~ O b
M
C ,
0
p~
e~ b
W
o
e m w
„ I
o
0
0
p7
VA
O
r
p~
V
V
D
x
D
m
a
O
K
F+ m p m
a Oq~
-~~+o=
goo ~p-O
c w . , o
•- w
V
O O
N p
O N
W 0
b
APPRAISAL OF REAL PROPERTY
LOCATED AT:
703 S Lommt St
Deed Book 755 Pege 123
Shiremanstown, PA 17071-6733
FOR:
Lois Z. Ness Estate
AS OF:
7225l2006•(Retroapecdve)
BY:
APPreisel SolNiorre
Brett LacMhaler, PA Certified Ganaral Appreiaer
d6 Sen Juan Drive
Metlranksbwg, PA 77055
farm GA6-'TOTAL for Wmdoes' appraisal saMive by a b mode, inc. -1-60D-ALAMODE
S ~
March O6, 2009
Appraisal Solutions
16 San Juan Drive
Mechanicsburg, PA 17055
Phone:717-697-1828
Fax :717-697-0220
Dear Sirs
The accompanying summary appraisal report is based on a site inspection of
improvements, investigation of the subject neighborhood area of influence, and
review of sales, cost, and income data for similar properties.
This appraisal has been made with particular attention paid to applicable
value-influendng economic conditions and has been processed in accordance
with nationally recognized appraisal guidelines.
The value conclusions stated herein are as of the effective date as stated in the
body of the appraisal, and contingent upon the certification and limiting conditions
attached.
Please do not hesitate to contact me if I can be of additional service to you
Respectfulty,
Brett Lechthaler,
PA State Certified Generel Appraiser
Form DCVp -'TDTAL for Wntlows' apOrvsal sMlwam by a la motle, inc. -1-Btl0-gL1MDDE
SUMMARY OF SALIENT FEATURES
Subject Adtlress 103 S Locust St
LtAal DescrpAUn Deeo Bodo 755 Pege 723
City Shiremanstown
Cawdy CumberlarW
Soh PA
Lp Cstle 77077b733
Ceikik Tract 0112.00
MaP AefeNlke ADC: 79/H-5
$ab Ptlu $ Market Value
DakdSak NA
Ba9awa~Caem NA
LaMar Lois Z. Ness Estate
Sim ($piere ke[) 2,095
Prize per Squaw Fuel $
LacetlOn Average
AAe 776 Years
CaMidsn Average
Taal gasnk 6
Betlmarrs 3
Batlk 7.5
Appraisa Brett Lechlhefer, PA Slate Cert Gen Appr
DakdApprdsetl Valk 72/252008`
Flnai Eaankk of Valk $ 760,000
farm SSO - TOTAL iPr wmtlaws' appnlsai sdneare by a b mstle, Inc. -1-6AA~AlAMODE
APPBisal Sdutiare p171fi97-1826
Unfform Residential A sisal Re ore FlisF OB-NESS
The ass a ms smn ralsal r rt is to rodtle Ba leper/hem wllh an eccuBle, all atl ua s , a lion sf the merYat value of 1M s~'ect ra
AdtlBSS 703 S Loa St Ci Shiremanstown 6Ya@ PA D Cotle 17011-6733
Borrowm NA Owner N Pubk flecaro Ness Diane E. 8 Lois Z Co Cumbedend
p Deaai ' n Deed Book 155 P e 123
Assacsor'9 Parod # 37-23-0555244 TaxVeaz 2008Y1009 RE. Tams $ 2455.05
N'hhamaod Name ShwemermrownB h Nta flefemice ADC: 19A1-5 Census TBC(0712.00
Occ am Owrer Temp Varad S cad Assessllwns E None PUD HOA $ NA m r m modh
Pro ' hb 'sea Fees Laesdldtl Okm describe
T e PurehMe Tremectlon fleflmnce TBn38ctian ONm desmibe Market Vslue Retroa ctWa as of Daa of Daeth 72/25f2008
LBMm/CYmd Lek .Ness Esbte Atltlress 103 S. Laamt Shirem nsbwn PA 17011
p the sub c Ahred for sakahes Hheen ofleretl for sab in Ba lweNe monNs 'orto tla ellec%ve tlah of this Bisp? Yas No
R rt tlau a used rice s all date s . Per 1M bcel M tM srO ec[ has nM been offered for sale wahin 1M st twelve morNts.
1 ^ ditl ~ tlid nm analyn Ba comBU1 for sap iorthe subject Dmchase7Bnsackn. FxplNn the resuk of Ore anaysp a me wnaact kr sap or why tlw allelysis was mt
erred. NA
Cailtract Pnce $ Market Velu Date a Coreacl NA Is the ro sekr the owner a bkc record? Vas NO Dffi Source 3 NA
Is Bwe any flrerclp assptaae (pan cherpas, sap cmxessbns, giN ar tlownDeymmt assisBae, etcJ a be geld by arty DaAy on beMtt m Bw bortower? ^ Yes ^ No
BYes, BwNfd dakr emourt am tlexAbe Ba ikna to be 'tl. NA
NrM: RenerplM mdtl can Ntha lral bahaodam not ktlfeebn
LacaBOn Urban suburban RuBI Vahes IncrMSM Slabk DecNli a.,, RUCE AGE Oa-lmB "75 %
Bolt- Uw 75% 2575% UMer 25% DarenWS SMrta pBapae OrmS $ B 2-0lMB 7%
CraMh p SbroN Sbw MaAmti Time Untlm 3 mtla 3-6 mtlm Over 6 mks 55 Law New MWtl-Ferri 1 %
N " bdilootl Bmmdarks the rw tbomad boundaries are the Bom hs of Sheemenstown arxf 300« Hi h 100* Commacial 10 %
Meohanin0u 130-99 Retl. 40-60 OOar 7 %
N ' hbOAlood DeacA Bon SM'ect Ms ewesa to all necessa su rti facilities pclutli srlpok ~Ib arks trans nation s I all
Mrme6 of woreN . Em em atabA k ood ell k wMn a 15-30 m'uxRe drNe.
MarkN ColpNans mcpdm au ortlar tlm above coaldons e e turtle ere reatli avaaebk Hamm a vane of settee wah comrerltlorel loans be'
5.50% to 6.50% bw toad 30 r m u to 3 ones.
Oilrmeiom 50 z 750 x50 x 750 Nm 0.17 sae S R let Mew Ate e
S ific CpssBlpaon RMT 2odn Oescd n MuOi-Farr ReaklenOal TOwne
Zad C el L Nmw Use No ZO' N tlescdk
Is the h" hest all best ~ of sW'ec[ ro as im vetl or as ad r Nns an0 iBCadms Be Baem use? Yes No N Na, describe
INNtlea Prrak OkmldeealM) Punk OBwldamlh) O6-dklm ds-T Public PMaa
Flxm Wsmr Street Meradam
~ San' Sewm Alp Rear
FEMA S Fbod Harertl Ara Yes No FEMA Fpod Zone C FEMA # 42036'90001A FEMA lda Dpe 1/5/7979
Are me uDTpea arp oB-sBe' mvemams 'cal for tlm market areal Yea xo N No, tleacd6e
AB tlwe atlveBe sk wndtions or epmnal hcprs eaeemems, ereroecmmm mnkanmeBd cmpNOns bnd uses ep, ? Yes Na B Yes, tlescdbe
Stallard eaeemems for electrk to rte etc. There sae no other krgwn ore arem adverse easemena encroachments w candhiorm noted. P
iMa search Ms not been tom tad artl re coraidered oumtle the s of this re rt.
Unk One Ore wM Udt Concrete Spb-_.. DBWI S ace klapatl00 W- . , ~. , .. ~ ~ .. . ~, -
a9s Stone BN1cWA Fpas Wrxxl LambenVA
# of Slmia 2.5 S WII Basenmm Pamp Basarem Ettleda Wak Plum' MA Wak Plaster DwaMA
T e Dal AtG S-OethM UnB Baserrem Nee 1 003 S .ft Roa Solace Marel,Sh' le/A TAmTidsh W ood/A
ed UMa Const Basenmq Fnish 0 % Fi1Mks 8 Oowm ub Gelve beNA Batll Floor Vi A
Dad 2.55 llu6xk /Fpt S WxpowT WoodH A Bath Wdmca Fibs IessrA
Y~Bdt 1 Evpmxxa IIIIeskBOn Due to eSprm SasMreupptl tortns/A Car Staa Nore
Eftectlw B 4555 Yeere DBmDlasa SBiBmrem $Cfwns Screerre/A D' #0(Cars
ABIC Noa HmBn FWA HWBB fladiant NreniBes Woodpov s # DAVew SuAace ak
Oro Shtr SceB Otlwr Swam fud Gas Fa ce s # Fence No Value GaB e # a Cars OutbuBd
Fbor SOmN Co Cenhd Nr Condpad PeBWDeck Rear Poch Covered C rt # of Cars
Rdahetl HMDttl Indbitlal Otlw Poal Otlmr Ou1buM Att Det BuiB-in
kmes ReM r R a'Oven Dishwasher Op p Maawaw Washer m ONm descibe
RNShe0 area chow Bde conbira: 6 flooms 3 Bedmolm 1.5 BaN s 095 uare Fee a Crass Liri ABa Above trade
MtlNOmI Ie80aea 181 dfl0art ilmns mc.. TM sW'eG Me been wall maiaabetl nd sled es need . TM oulbukli has rkin for two
cars end oveAwetl bft a e. Thera b a bb near the bem. TM master betlroom has en ad olni s area. The leuntl Ms a owder room.
Desctlbe Bw condiBOn a the a Incgpp ceded re alts ddedoBtlan mnoratlons remodek dc.. TMs b'ect' i avers a to above eve a cortlhion.
The conetructlon uel b kel for e e b wm rkon to mm ib na hboApods. eased on maintenance conditbn aria eom r®on to
" ne' hbnApods Ow estimated e e Is M the a I e . No ecanomb or Nmctb I noted. TM ownx Mc srewtl
Cwlprtw rd ill fowMatbn of the Structure. 1 am not an ex In atruebaal 1 N Ura eIMM Ma a eoneam than I
recommend an ax rt M eomacwtl. I rw tM M to a r tNs re rt N tMre ere etM fourMatlon bawa fourtl.
AB Bee 'cp tlefickamNS Or advmse contlepns tlat ailed Ba' samtlress or strucNtli Mme ro ? Yes No Byes describe
TM streaure b of an a e wfwre lead baaetl al mob and a ma M nt TM raiser k not en art in ill fieb of
detsrmlN heaeh hazards. H ill tlbm Ms a cacem I recommeM an n be ca,mdad. There were no observed nor noted kal
defldanciea or adverse cortleiona t woultl affect the soundness w a I' of the
Dew Bm real cadormathen' almotl ncfloml capBbn, use, corebuctlon etc.7 Ves No BNO dBCnte
TM ro coMorms to the srrroundi ne' hlrortwod.
"'""' """'"'^°'~" ~vvo f ape 1 of 6 Fannie Mae Form 1004 Marcn 2005
Farm 1004-'TOTgL for Wlndaws' appraisal sahware by a b motle, pc -1.800-NAMODE
Uniform Residential Aooraical Rwnnrt
There are s co
There sre 11 a reh
FEATURE
gtltl ro saes c
m sabe in the s
SUBJECT oNaM ror sale In the sub'ea hbpm
' hbarhood wdan tlw em tnehe mom
COMPAR4BLE SALE # 1 ope in In rice from E 134 890
la re in in sap ' e from $ 726 90
COMPAHA&.E SALE # 2 m E 180 000
0 m E 794 900
COMPgHABLE SALE # 3
raSS 103 S Locust St
Shpemanstavm
Prmdm' m Sub'ect
Sap Pace
Sak PdcyGroaz Liv. Arm
O
m S
PA 17011-6733
~
$ Market Value
$ .R 11 W. Factory St
Machenimb PA
3.00 mdse
$ 728 900
E 92.49 8 .iL 36 W. Fecrory St
Medlanksbu PA
3.02 mE
E 135 000
$ 113.92 s .iL ... 200 N Market St
Mechaniceb PA
2.84 miles
- "."mod E 145 000_
S 77.54 s fl ''~,".CV _ .:,:
a
purce a
Vepicapon Scum 6
VPLUE gDIUSTMENTS
Sales qr Fnanldnp
Corceazbm
Dam al SakJfbw
L
d
..
OESCPoPfION
"; ~... MuI1FLisa Serv
C use Rec
OESC6IPIION
Sales A9reemM
None R orted
9/08 21 DOM ice
ords
+ - E Atl' shrem MuaFl.istl Serv
Court use Rec
OESC9IPIION
FHA
Costs
6/08 7 DO ice
ords
+ • $ Admmwm
-0 050 MWt~Lis6 Serv
Courmouse Rec
OESCNIP110N
Conventlonel
None R orted
8/08 197 DO ice
ords
+- $ gdlu'trnem
aca
on
LmeeA0ldIFBS SI
Sm Avers
F hn Ave
F b Avere a
Fee S' b
Avers
F Sim
Ylew
O
' 0.77 erne
A 0.06 saw
E I +3 600 0.14 aae
E ual 0.75 acre
E ual
az
N Consmxtlpn
AChd A e
DOMltlan
Ab 2.55
Avere e
178 Veers
Avere 2.5S
E el
78 Veers
A re 7.55to
E vet
108 Veare
Averse 2.5 St
E ubl
708 Years
Avere e
ove Grade Tavel Bdm¢ Bda TaY Bdrma. 8atlw Tod Btlma. Baps Tod Bame. Lwtla
8opm CAUrt
toms Uvl Arm
Bazamrt8 F0iahetl
Ra01m 8ebw 6retle
Fwcaold lla 8 3 1.5
2 OB5 .h.
1,003 Sq.Ft.
Unfinshed
Avere 6 2/3 1.5
1 372 .h
EWNabM
Unlhislred
A
+7q 480 8 3 2
1 185 b .h.
Equivalent
.5 BA
Avers -7 00
+16 200
-1 000 6 3 1.5
7 870 S .fl.
EquNabnt
Unfinished
Anere e
+q 500
HBea
E Efidapltems
PorcNPaaaDeG
Opar Smem/None
A e
Oulbudd
P rdaes
BBO Sired HTNtrMOne
E ual
1 Car Garde
P s
Nqne
M 000
+1 000 FWNCA
E ual
7 Car Gare a
Porctres
None -2000
+4 000
+7 000 FWNNOne
E ual
Gars 8Ca
Porches
None
+3 000
+7 000
NmAd'ushrlelt oml
A41wmtlS
l
P
i + - S 23060 + - $ 75150 + - $ 8500
a
e
r
ce
m Can ps
I db tlitl net rtsearch
the mm ar hamfa ' NB Adj. 782%
Grins Ao. 18.T % $ 749 860
M tla Sub' ro and co od NdAtlj. 11.2% NdAtlb 5.9%
tams Ad. 23.1 % $ 150 750 Grma Ad. 5.9% E 753 500
e warm. p rot do
M reseach tlb tlitl not revml m dor satin or transfers m pw sub~ect ro ror the three 'a m th eaectlue dam of tlps rWSal.
Dam S s
rmmrch tlitl d'p nm reveal tla sales artrmsmrs m the ca reds roles for the ar 'a m the dine d sam d th coin ble rob.
Oam Souce s
P rt tlw resWm of tlw resmroA and is of the a role m transfer ' m tla rob' ro and co arable sales re rt atld'N'anal 'or saps on a e 3 .
I1EM SUBJECT COMPAMBLE SALE #1 CON~ANABLE SOLE #2 COMPAHABIE SALE #3
Dam m Pdor rensmr Nane None None None
Priced Pda SeklTrsmfa NA NA NA NA
Dam Sane s CH R ros CouNpuee Recoroa CouNmuae Retards CouNreuse Records
E6ectlve OamdDina s 3/05/2008 1/70/2009 7H0l2009 1/10/2009
X Of ' r rob m tr¢mia ' MtrIE b 'act ro and o ambm Saga The aub'eM has not trensferted vvphin 6eee rs. Other ror sales of
the mm ble dies ocwrted more plan one r a o.
Su m $mm COm edSDn inch See comments on addilionel mm ambles e
htlkamtl Vmue Sales Can 'eon ech S 160 000
ArdimbdVsW .9alu Campadeal NE 780000 Cgs1A roedr pldsvwlo S Ilrmme roeM lpda7wb E
ue to tlae IarJC of rental date tlTe Income his note ' re. Greatest ww M re hen m tl>e Sabs Com adson roach as p reflects dw
kal edb~ 01 b rs arW eelims In the manta lace.
This apprWbal W made ®"u h", ~ subject m rompletlan per prom art spedficaaom on pa basis a a Irypomdkal coMlaon that the imaovemem8 have bem
camNmetl, ~ subject m the mlernip repairs or aAwetlaw on tlw bazia sf a hypotleaml contlidon tlat tlw repairs pr apaaaom have bem comppmtl, or ^ subject to the
mmwl Wind ire n based on the emaoN' azeum 'an that the coigPoon or deficl dam rot WfE 8a9aapn Or air. bee $tetemeM Of Clinked
Contl " m and leers Certlaceaon • R aaNe as of Dale of Deem
Baaad an a canpkb viawl Il~~paaap~6on a the Itdedar en0 esmdor man of the auajapt prope~y, defined scope M work, ahdammlt d awumptions erM limkln8
cendlbna, and appmNer'a adiemtlon, mY lour) opbbn d Me merkm value, as deNlletl, of fha red propety thin p tlu auhpq of tNls report ie
E 180 000 n d 12/25/2006' arhkh m the dale of iro ' n eM Me speghe dine of m4 a miael.
mm r u marcn zouq Page 2 of 6 Fannie Mae Form 7004 Mamh 2005
Farm 1004-'TOTAL ror Windows appraisal sohware by a m mode, inc. - i-BOD-ALAMODE
Unifnrtn RRCIe~RFMlaI Onnroical Runnr+
r19p VYIYLJJ
[less; Lion of Ma rebel ProcoesrrSco of work
The a bal s b' Mad m • ascribe the a#ent of the mesas p{ ooYecUn nfmn' arM re rt' tlata' In ortler to re an
a bel rt on Iha aub'ea the foAOwl st were involved:
Plc slb~eLl SAa Bntl n0 IlbOltlOpd MBIe (SCnBI 9a9d Iha B r813ar. The In6 aaipn CMSldaratl the Varb{a Ip(•pl aCpnO1r11C IneCamr3
with res a m tilair tembl kn ea on tiles 'ea stte. The sire fns and weakriesaes of Ma oral a mm were vee' bed as tila efts the
value of the sub ea.
All relevant fact related m the w act were coleaed and verified Ir;dud' but not Irnibtl m mni utAtties bM and bWM' area reatrlaions
erwutnbrarvxs eaeemards emirormemel fadore and other ttems o}a emAar nature deemed icabb~
No butld 8 were avalabb. The huW' were mots was derlvetl from the axle' ease meet records In ON r m determirre s care
cows
A hi hest arM bast use ere was com bled.
The Cwt Sales Com risen and Income roaches m value were considered end the Saba Com rison roach was usetl n the valuatbn of
Mew eM
Data wee cdbaetl du' Mb a aom veMUS sources. Thb mmnnatico b believed m be reliabb antl rification of sales tleta inGWed
relbnce on deed records and/or tlurd a conArmatiorls. Thee bar has no reason m sus a becmaadea in a Intormatbn rovitletl
end dle are 'e end cormkreiau ere based on the relbd' of Mb pdormation.
The a cot an ax rt In Ida moW mAMw bad bane elm rror asbestos. N tht clbnt has a eoncem Men I stro
rseommand tM abm comae an ex in the anvtonmemal entllor home iro bn Mb s .
H an astinatatl value or sales was irxEWetl eiMer on tila a sisal re oast mm. or verbaA from e a invoNed'm the bareadbn the
hoe rro' rrxi on m frW eslenate of pre.
~,, , ..
Provide ode oak illfomwbn for the laleer/ceemto re 'aNtne bebw com res antl cablYetlma
Su tar the o 'nion a efts vaha a e bnd sales m otllm metletls im estirreti sde value NA
ESTBMT® HEPHOOUGTION OH REPIACQABYT COST NEW
Sourcemwet dare
ra~ hmn cost sernce Eileclha eat~acam Bata
C
' OPWION OF 511E VAIUE_.._.._._._.....___ ..............._.
O'NELLNG .........___.___. _$
2 095 .Ft E _ _ _. =g
1003 .Ft 8 _ SS
oltelams on Coco mach mss Gvi area cakuhtions d
ation etc.
The cost wiY ens rewA n an Item estimate of value H
the bold' b new or reasonab new and Me kn rovememe reaect the
eat end beet a of Me of Me bM. However when ttema of icol
d redatian antl obeobscerlco moat be estimated an area of'ud mem
. which b m error. TM Cost eh was rrot
WIWd tlua to the eMom lol and efteedve a se. _ _$
Gat UC $ .Ft E . ,8
Tow Estlmeh a Cost~Yew .8
less Ph sisal Fm¢timw E¢emm
rechtlan eA
lead Cam m I mvemems _...._..___.._......__._..........._ =S
•Aetis' VaYe a She I ..__........._.._ _$
Esdmme0 Hemeni Ecommic Life UD antl VA 15 Vwrs INDMATm YALUE 9Y fABf APPNOAWI ...._..._ ........................... =i
_
ry
Eslnnmee Market Herrt 5 .. NA % Gmss Halt Ner NA
- E
~.. ~ ~ Irmkated Vabe b Imome ~ ...mash
Su mlrmome ash Incgdm su rtmr market rem antl GH
Ia the tlevep er in control a the Nomeowrers' Associetlon OA 7 Yes No Ulit s flebcMd AYachetl
Pmvbe the blba4 ImomaYOn far PIAS ONLY H tla Oevdo rNdba is in cdnbol a tta HOA an0 the s 'em is an abadwe ewelin unP.
L arNamea Mo
Taw Iwmber m bases row lambs a ulfts NA Tobl number a unbs sdtl
Tmal nanba a mM mmM law wn8er a ums im sale NA Dma source s
Was the ro ea crtffitl the comersiona etl bulHl a Illm aMlD7 Ves No Hues eahmcomersion.
Ones Ya o t canwn an mutli-0weN uM6? Yes No Dma Source
Are Ya unBS common elanarts aM rareation faWlYU Ida? Yes No Y No, eescnbe the slaWS a ce ktlon.
Are the common ekmen6 bases to orb the Homeowners' Associarbn7 Ves No NYes eesmihe tla mdm terms one o '
Descebe mnYllon menlenls aM recreaYoml fadYYes. NA
---- -~-- ~ -'°~ • - •^-•-~• ~~~~ rage a m e Fannie Mae Fortn 1004 Mamh 2005
Form 1004-'TOTAL for Vlneows' appraisal software by a b srotle, inc. -100-ANMODE
unuorm
This report form is designetl to report an appraisal of a one-untt property or a one-unit property with an accessory unit;
inclutling a untt in a plannetl unh tlevelopment (PUD). This report form is not tlesignetl to report an appraisal of a
manuhacturetl home or a untt in a condominium or cooperative project.
TDIS appraisal report is subject to the following scope m work, intentletl use, intentletl user, tlefiniUOn of market value,
statement of assumpDons antl limitlng contlhlans, and certttications. Modificabons, adtlifions, or daletlons to the intentletl
use, imantled user, deflnitlon of market value, ur assumptions antl limtting contlMOns are not permitetl. The appraiser may
expand the scope of work m Include any additional researoh or analysis necessary basetl on the completdty of this appraisal
assignment Modrfications or deletlons to the certMCations are also not permitted. However, atltlttional certgications that tlo
not consttbde ma[enal atteretions m this appraisal report, such as those requlred by law or mdse related to the appraiser's
continuing education or membership in an appraisal organization, are pertnittetl.
SCOPE OF WORK: The scope of wont for this appraisal is tletined by me complexity of this appraisal assignmem antl me
repmrting requirements of this appraisal report fore, Inclutling the following tlefinition of market value, staremem of
assumptions and limtting condttions, and cenlfications. The appraiser must, at a minimum: (1) pertorn a complete visual
inspection of me Imedor and etttertor areas of the subject property, (2) inspect me neiphbomaod, (S) Inspect each of me
comparable sales from at least me street, (4) researoh, veMy, and analyze tlata from reliable public antl/or prvale scurces,
antl (6) report his or her analysis, opinions, antl conclusions in this apprsisal report
INTENDED USE: The imentletl use of mis appraisal report is for the lentler/cliem to evaluate me property mat is me
subject a< mis appraisal for a mortgage finance transaction.
INTENDED USER: The intentletl user of mis appraisal report is the lentler/chem.
DEFINRION OF MARKET VALUE: The most probable pnce which a property shoultl brtng in a competitive antl open
manta[ antler all contlttions requisite to a fair sale, me buyer antl seller, each acting prodentry, knowletlgeabty and assuming
me pnce is not affected by untlue stimulus. Implicr in mis tlefinidon is the consummation of a sale as of a specified date antl
me passing of title from seller to buyer under conditlons whereby: (1) buyer and seller are typically mativatetl; (2) both
parties are well imomletl or well atlvised, and each acting in what he or she considers his or her own best iMeree[; (B) a
reasonable time is allowetl for exposure in me open market; (4) paymem is matle in terms m cash in U. S. tldlars or in terms
of financial artangements comparable thereto; and (6) me pnce represems the normal consitleration for the property soltl
unaffemed by special or creatlve financing or sales concessions• greeted by anyone associated wtth the sale.
`Atljustrnents to me comparebles must be matle for special or creative financing or sales concessions. No adjustmems are
necessary for moss costs which are normally paid by sellers as a result of tratlttion or law in a market area; mase costs are
reatlily itlemttiable since me seller pays mase costs in virtually all sales transactions. Special or creative financing
atljustments can be made m the comparable property by comparisons to financing terms offaretl by a thiro party institutlonal
lentler mat is not already involvetl in me property or transaction. Any adjustment should not be calculatetl on a mechanical
dollar for tlollar cost of the financing or concession but the dollar amoum of any atljustmem shoultl approxmate the market's
reaction to me financing or concessions based on the appraiser's judgment.
STATEMENT OF ASSUMPTIONS AND LIMfT1NG CONDRIONS: The appraisers certrfication in mis report is
subject to me fallowing assumptions antl limiting contlttlons:
t. Tne appraiser will not be responsible for matters of a legal nature mat affect either me property being appraisetl or me tfle
to tt, except for imormatlan that he or she became aware of tlunng the research involvetl in pertorning mis appraisal. The
appraiser assumes that the title is goo0 and marketable antl will not antler any opinions about me title.
2. The appraiser has prwitled a sketch in this appraisal report to show the approximate dimensions of me Improvemerits.
The sketch is includetl only to assist me reatler in visualizing me property antl untlerstantling the appraiser's determination
of its size.
3. The appraiser has ezaminetl me available floctl maps mat are pravitletl by the Federal Emergency Management Agency
(or Omer tlata sources) antl has noted In mis appraisal report whether any portion of me subject stte is locatetl in an
itlemtiied Special Flood Hazard Area. Because me appraiser is not a surveyor, he or she makes no guaremees, express or
implied, regarding mis tleternination.
4. The appraiser will not give testimony or appear in court because he or she matle an appraisal of me property in question,
unless specific arrangements to tlo so have been matle beforehand, or as otherwise required by law.
5. The appraiser has noted in mis appraisal report any atlverse conditions (such as needetl repairs, de[enoretion, me
presence of hazaroous wastes, tonic substances, etc.) observetl tluring me inspection m Me subject property ar mat he or
she became aware of tludng the researoh involvetl in pertomring me appraisal. Unless otherwise statatl in mis appraisal
report, the appraiser has no knowletlge of any hitltlen or unapparent physical deflclencies or atlverse contlitlons of me
property (such as, but not limited to, nestled repairs, deterioretion, the presence of hazaroous wastes, toxic substances,
atlverse environmemal condPoons, etc.) that would make me property less valuable, antl has assumed mat there are no such
condhions and makes na puarentees or wararrties, express or implietl. The appraiser will not De responsible for any such
contlttions mat tlo exist or for any engineering or testing Nat migm be required to discover whemer such conditions exist.
Because me appraiser is not an expert in the feltl of environmental hazards, this appraisal report must not be consitleretl as
an environmental assessmem of the properly.
6. The apprelser has basetl his or her appraisal report and valuation conclusion for an appraisal mat is subject to satisfactory
completlon, repairs, or atteretions on me assumption that the completlon, repairs, or atleretions of me subject property will
be pertormetl in a professional manner.
•° --~~ rage a or ti Fannie Mae Forte 7004 March 2005
Form 7004-TOTAL far wntlows' appraisal software by a b nrotle, inc. -1dgo-AtAM00E
unnorm
APPRAISER'S CERTIFICATION: The Appraiser certlfles antl agrees that:
1. I have, at a minimum, developed and reported this appraisal in accordance with me scope of work requirements stated in
Mis appraisal report
2. I pertortnetl a complete visual inspection of the interior antl exterior areas M Me subject property. I reportetl the contlltion
of the improvements in tactual, spec'dic terms. I itlenttlietl and repprtetl the physical deficiencies that could affect the
I'rvablllry, soundness, or structural integrity of the property.
3. I pertortnetl this appraisal in accordance with the requirements of the Unttortn Standards M Professional Appraisal
Prnctlce that were adopted and promulgated by the Appraisal Stantlaros Board of The Appraisal Foundation antl that were in
place at the trme mis appraisal report was preparetl.
4. I tlevelpped my opinion M the market value ai the real property that is the subject of this report Oasetl on the sales
comparison approach tp value. I have atlequate comparable market data M develop a reliable sales comparison approach
far this appraisal asslgnmerR I further certify that I considered me cost and income approaches to value bnt ditl not tlevelop
them, unless amerwise intlicafetl in this report.
5. I researched, vemied, analyzed, antl eportetl on any curteM agreement for sale for the subject property, any offering for
sale of the subject property In me twelve monms prior m the effaMNe tlate of this appraisal, and the prior sales of the subject
property for a minimum of three years prior to Me effective date of Mis appraisal, unless omerwise intlicatetl in this report
6. I researched, vertlie4 analyzed, and eportetl on the prior sales of me Comparnble sales for a minimum of one year prior
to me tlate of sale of the comparable sale, unless otherwise indicated in this report
7. I selected and used comparable sales Mat are locationally, physically, and functionally Me most similar to Me subject property.
8. I have not used comparable sales Mat were Me result of combining a aantl sale with Me comrnct purchase pace of a home Mat
has been Quilt or will be buiR on the land.
9. I have eportetl atljustmenis to Me comparable sales Mat reflect Me market's reaction to Me differences behveen [he subject
property antl the comparble sales.
10. I ver"rfieq tram a disinterestetl source, all information in this report Mat was provided by parries who have a financial interest in
me sale or financing of me subject property.
11. I have knowletlpe antl experience in appraising Mis type of property in Mis market area
12. I am aware of, antl have access to, Me necessary antl appropriate public antl private tlata sources, such as multiple listing
services, tax assessment recoMS, public lantl records antl Omer such data souroes for Me area in which Me property Is localetl.
13. I obtainetl Me intortnation, estimates, and ppinions fumishetl by Omer parties antl axpressetl in Mis appaisal report from
reliable spumes mat I believe M be true antl cortect.
14. I have taken into consitlerntlon me factors mat have an impact on value with respect to me subject neighbomood, subject
property, and Me prwtlmiry of me subject property to atlvarse influences in Me development of my opinion of market value. I
have noted in mis appraisal report any atlvarse conditions (such as, bm nM limited to, neetled repairs, tleteriorntion, Me
presence of hazaroous wastes, toxic substances, adverse environmental contlttlons, etc.) observetl tlurtng the inspection of me
subject property or mat I became aware M tluring me research involvetl in pertprtning this appraisal. I have consitleretl mere
adverse conditions in my analysis M me property value, and have reported on me effect of the conditions on the value antl
marketability of the subject property.
15. I have not knowingly wimheltl any slgntticaM information from mis appraisal report antl, ro Me best of my knowledge, all
sta[emerns antl intortnatlon in mis appraisal report are true and cortact
16. 1 s[a[etl in this appraisal report my own personal, unbiasetl, antl professional analysis, opinions, antl conclusions, which
am subject only to Me assumptions and limiting conditions in this appraisal report
17. I have no presem or prospective interest in me property that is Me subject of mis report, antl I have no present or
prospective personal imerest or bias with respect m Me paNCipants in me transactlon. I did not base, eimer partially or
completely, my analysts and/or opinion pf market value in mis appaisal report on Me race, color, religion, sex, age, marttal
status, hantlicap, familial status, or national origin of ether the prospective owners or occupaMS of Me subject property or M Me
present owners or occupaMS of me properties in me vicinity of Me subject property or on any omer basis prohibi[etl by law.
18. My employment and/or compensation for performing this appraisal or any future or arrecipa[etl apprnisals was not
contlitioned on any agreement or understanding, wrtRen or otherwise, mat I woultl report (or presets analysis supporting) a
pretleterminetl specific value, a predetermined minimum value, a range or tlirectlan in value, a value ma[ favors me cause of
any party, or me atrainment of a specfic result or occurrence of a specific subsequent event (such as approval of a gentling
mortgage loan applicatipn).
19. I personally preparetl all conclusions and opinions about me real estate that were se[ forth in mis appaisal report. m I
relied on signmcaM real property appraisal assistance from any indivitlual or individuals in the performance of mis appraisal
or the preparation of mis appraisal report, I have named such indivitlual(s) and tlisclosed Me specific tasks performed in mis
appraisal report I certify mat any indivitlual so named is qualRieO to pertortn me tasks. I have rip[ aUMpnZBtl anyone to make
a change to any Rem in mis appraisal report; merefore, any change made to mis appraisal is unaumorizetl and I will take no
responsibility for R.
20. I itlenTrfied the lentler/client In this appraisal report who is [he Indivitlual, organizagon, or agent for Me organ¢aaon mat
oroered and will receive this appraisal report
•--~ rage o or ti Fannie Mae Form 7004 MarcA 2005
Form 1009 -'TOTAL for winrJOws' appraisal ssfiware aY e tr motle, inc. - tAOpN,gM00E
unnorm rcesjaenuaj
21. The lentler/client may disclose or tlisMbu[e this appraisal report to: the borrower, another lentler at me request of the
borrower, the mortgagee or its successors and assigns; mortgage insurers; gwemmem sponsored enterprises; other
secondary market pamcipants; tlara collection or reporting services; professional appraisal organlzatlons; any department,
agency, or insbLmemalfly of the Unaetl States; and any state, the District of Columbia, or Omer juristlictions; wahoW having to
obtain me appraiser's or supervisory appraiser's (g applicable) consem. Such consem must be oMainetl before mis appraisal
report may be tlisclosed or dismbuted ro any omer party (including, but not limited to, the public mrough advertising, public
relations, news, sales, or other media).
22. I am aware ma[ any tlisclosure or distribution of mis appraisal report by me or the lentler/client may be subject ro certain
laws and regulatlans. Further, I am also subject ro ma provisions of me Uniform Stantlaros of Professional Appraisal Practice
mat pertain ro tli3Closure or tlistriDWOn by me.
23. The borrower, anoher lender at me request of me borrower, me mor~agee or hs successors antl assigns, mortgage
insurers, government sponsored enterprises, antl Omer secondary market parBCipants may rely on mis appraisal report as part
of any mortgage finance transaction mat involves any one ar more of mesa parties.
24. If this appraisal report was transmitted as an "electronic record" comalning my "electronic signature," as moss terms are
tlefinetl in applicable federal andor state laws (excluding audio and video recordings), or a facsimile transmission of mis
appreisal report containing a copy or representation of my signature, the appraisal report shall be as effective, ardoroeable antl
valid as 'rf a paper version of mis appraisal report were delivered containing my original hantl written signature.
25. Any imantional or negligem misrepresemation(s) corrtainetl in mis appraisal report may result in civil liability anNar
criminal penalties including, but not limited ro, fine or imprisonmem or born antler me Drovisions of Title TB, Unhetl States
Code, Section 1001, et seq., or similar state laws.
SUPERVISORY APPRAISER'S CERTIFlCATION: The Supervisory Appraiser certifies antl agrees mat
1. I directly supervised me appraiser for mis appraisal assignment, have reatl me appraisal report, and agree with me appraiser's
analysis, opinions, statemems, conclusions, and me appraiser's certiFlCafion.
2. I accept full responsibility for the contemn of mis appraisal report including, bW not limitetl ro, me appreiseYS analysis, opinions,
statements, conclusions, and me appraiser's certification.
3. The appraiser itlentifled In mis appraisal report Is either a sub-comreurtor or an employee of me supervisory appraiser (or me
appraisal finny, is qualified to perform mis appraisal, and is acceptable to pertonn this appraisal antler the applicable state law.
4. This apprelsal report complies whh me Uniform Shentlaros of Professional Appraisal Practice mat wee atlop[etl antl
promulgated by me Appmisal Stantlards Boats of The Appraisal Fountlation and that were in place a[ me time mis appraisal
report was preparetl.
5. fi mis appraisal report was transmitted as an "electronic record" conaininp my "electronic signature:' as mdse terms are
tlefinetl in applicable fatlerel and/or state laws (excluding autlio and video recordings), or a facsimile transmission of mis
appraisal report comaininp a copy or represemation of my signaure, me appraisal report shall be as effective, eMoroeable antl
valitl as 'rf a paper version of mis appraisal report wen: tleliveretl containing my original hantl wriDen signaure.
APPRAISER
Signature
Name Brett Ledltlabr. PA State Cert Gen Aoor
Company Name APPrakal Solutions
Company Address 16 San Juen Drive
Matllenicebvo. PA 17055
Telephone Number 717-697-7626
Email Atltlress blechtrleler®comcastrret
Date of Signature ono Report 3/08/2oos
Effective Dale of Appraisal 12Y25l2006•(Retrosoedivel
Stale CertmCation # GA-003594
orSmte License #
orOmer (tlescribe) State #
State PA
Expiratlon Date of Certif cation or License 6/30/2009
ADDRESS OF PROPERTY APPRAISED
103 S Lowst St
Shiremanstown. PA 17077.6733
APPRAISED VALUE OF SUBJECT PROPERTY$ 160.000
LENDER/CLIENT
Name
Comparry Name Lois Z. Naas Fatale
Company Address 703 S. Lonrst St. Shkemanslown PA 17011
Email Atltlress
SUPERVISORY APPRAISER (ONLY If REQUIRED)
Signature
Name
Comparry Name
Company Adtlress
Telephone Number
Email Address
Dale of Signature
State Cerlfication #
or State License #
State
Expiration Date of Certlfication or License
SUBJECT PROPERTY
^ Did not Inspect subject property
^ Did inspect exterior of subject property from street
Date at Inspection
^ Dltl Inspect interior antl exterior of subject property
Date of Inspection _
COMPARABLE SALES
^ Dltl not inspectexteriorof comparable salesfrom street
^ Ditl inspect exterior of comparable sales from street
Date of Inspection
rlcuulc rvlµ ~VIIII / V MCIVII LV VJ
rape ti m 5
Fannie Mae Form 1004 March 2005
Fenn 10D4-ROYAL im wmeawY apprdsal sohware M a D maae, mc. - tADhAL4M00E
a
Un'rfOrm Residential Annnalcal Rwnnai
FEATURE
Atldras 103 S Locus[ St
Shremansown
Pnum' h Suh'ect SUBJECT
PA 77011.8733
- ~. COMPARABLE SALE #4
78 E. Portlantl St
Mechenkxbu PA
2.78 maes COMPARABLE SALE #5
300 S. York St
Mechanicsb PA
3.72 m ~~ COMPARABLE SALE #6
472 E Main St
Shiremanstown PA
0.28 miles
Stk Price
Sale PrieeJGross Liv. Alga $ Martcet Value
$ s .tt : '- > -_ $ 754 900
$ 84 74 5 .tt '~ -f-' -, , .. $ 194 900
$ 7 .27 s h. ~' ' ' : E 174 900
$ 127.46 5 .tt ~ '-
Dale Saaa 5
VeNBCatlon Sources
VALUE AOJUS7AtENfS
Saks ar Rarsh9
Conasskns
Dah of Same
L ~''
..'.
DESCPoP110N
„ ; -.
?:
`' ~ `..'?
. a MukFListr Servke
CourMrousa Recortls
OFSGRIPIION +-EAtl'usbned
FHA
Costs 1000
12/08 103 DO I raised
ouMrouse ReWros
OFSCRIP110N +-$Ad'
CarveMbnel
Re ales/700.00
6/08 0 DOM Multi-Lis' Servke
Courthouse RBeatls
OESCRIPf10N +-$Adusmmd
Conwntbnel
Coats 1500
7/07 28 DO
aatlon
Leasellok/Fee S' k
bit Awre
Fee Sim E uel
Fee Skn k E ual
Fee Sim k E al
Fee Sim k
e
Mau
D
' 0.77 aae
Awre 0.08 aae
E I +3 600 O.t0 aae
ud +2 600 0.78 acre
E ual
re
Dual W ColahuctlOn
A
hd 2.5 S
Awre 2.5 St
E ual 2.5 Sto
E ud 7.5 Sto
E ual
C
a
CoMiBan
AhoreGratle
Room Count
CY065 LNi Area
Basaren[B Rrishetl
Hams Blow Crade
Fvnctlonal Utl' 718 Veers
Aw
Takl Btlma. BARS
8 3 1.5
2095 .tt.
7,003 SO.Ft.
Unfmiahed
Awre 708 Veers
Awre
lad Bdmu. Betla
7 3 1.5
7847 s .tt.
EquNekM
Unfnkhe0
Awre a
5 080 708 Years
S ' r
Takl Btlma. BaIR
6 3 1.5
7 834 s .R
E9uiwkM
UMinished
Awre
-30 000
+5 220 87 Veers
S nor
Tohl Berms. Bala
6 3 7,5
1440 3 .tt
EouivaleM
Rec Room
A re
-70 000
+13 100
-2 000
E Effidad Mans
Ge NCa
'a'Oeok
OMa SteemMOne
Awre
Ourbustli Loft
Porches
BBO Shed FWNNOne
E I
OR Street
Porches
2 Fire laces
+6 000
-7 000 FWA/CA
E uel
2* Car Gare e
ParcMs
None -2000
1,000 H1W4Mone
E ual
7 Car Gate a
Pordree
Flee ace
+d 000
NetAd'usMaa x181 + - E 8680 + - E 22 960 + - $ 600
Atljuehtl Sak Pnce NM 6.2 % Nat 719 % NN 0.3 %
of Cam ks 'Y ..- -., ^, ; Groan 12.7 % $ 784 580 Gras 21.0 % $ 777 920 Grae 19.2 % $ 175 500
fl Ve realtlh of the research and sis Nthe 'a sale or transler Msd of the suh'st and a k sake re rt addlBOlul 'or sales an a 3.
OEM SUBILLi COMPARABLE SALE#4 COMPARABLE SALE#5 COMPARABLE SALE#6
Oat of Prior SekRransia None Nona Nara None
Paced Prior $ale/frensfa NA NA NA NA
08d Sauces CH ReooMS Coureroae Records Courtrouse Records Courmouse Records
Eflxsve Ooh d Ooh Source 5 09 1/70/2008 3/05/2009 3/05/2009
k of " r sale artraMa Ms altla sub act M aM co sable sales mesa addhoraal cam rebles haw not trarmfened more man once
wMk me st r.
is/Oammenh A7[er a search of awikbk market data the su tloaetl sales d tl are considered to be era beat indicators of wore, mere
was rw k10n8hetl sales m the s 'ecYa boo h wphin are st r which ware mrreklere mm bk. S k #8 k a sale mat occumetl owr one
r ' r b me efkctlve date of mk re ort arM was treed sole as a sale whhn trre 'e s boron h. The flue Darer webs are kicaktl in me
ub'ecca school district n the na' Mon boro h of MBChaMa Ad'ustmeMS ware made W icel adbns of b rein mm 'son to
the 'act. Sales mat ezceetled a sbc monm trarreMr from sub ecCs a reisel were rot ad usktl for time due to minimal market d,a e. Acres
tllfference a 'atrn Ms reflect rho teat wlue k Mmesite wM on mlMmal wl k reek) I d No a ed ustrneMS a had as ell mes
are considere0 sanikr m efkM6.e a s. Sales #5 and #6 a ' r mndlBon tlue to renowaorre/u redes. S uere feo diRererree ed'uaMeMs
reflect ecoramks or seek. All com bks wme we' Mad antl consideretl. The edrretetl re e of com table wlues is $169 960 to $775 500.
FmAA. Men Cam....
- __ . _..... _ ..._. _.. ___,. Fannie Mae Form 1004 March 2005
Farm 7004.(AC) -'TOTAL for HfMaxs• appraisal software hY a k motle, mc. -1-B00-ALAMpOE
Supplemental Addendum Fle NO 0&NESS
B NA
Ad msa 103 S Lowst St
C' Shtemarislown Cumberland SqR PA L Code 17011-6733
Centel Lois Z. Nees Estate
SPECIAL LIMITING CONDITIONS:
This appraisal is not a home inspection and the appraiser is not acting as a home inspector when
preparing the report. When pertortning the inspection of this property, the appraiser visually observed
areas that were readily accessible. The appraiser is not required to disturb or move anything that
obstructs access or visibility. The inspection is not technically exhaustive. The inspection does not offer
wartanties or guarantees of any kind.
SUPPLEMENTAL CERTIFICATIONS:
I certify that:
- This appraisal was prepared by Brett Lechthaler for the exclusive use of the Lois Z. Ness
Estate, Giant, to estimate market value in terms of cash or financing similar to cash for estate valuation
purposes. The information and opinions contained in this appraisal set forth the appraisers best
judgement in light of the information available at the time of the preparation of this report. Any use of
this appraisal by any other person or entity, or any reliance or decisions based on this appraisal are the
sole responsibility and at the sole risk of the third party. Mr. Lechthaler accepts no responsibility for
damages suffered by any third party, as a result of reliance on or decisions made or actions taken based
on this report.
- In my opinon the reasonable exposure time linked to the value opinion is up to 100 days.
- In my opinion the reasonable market time linked to the value opinion is up to 150 days.
I further certify that, to the best of my knowledge and belief:
- The statements of fact contained in this report are true and correct
- The reported analyses, opinion, and conclusons are limited only by the reported assumptions
and limiting cendRions, and are my personal, impartial, and unbiased professional analyses, opinions,
and conclusions.
- I have no present or prospective interest in the property that is the sul>jeG of this report, and no
personal interest with respect to the parties involved.
- 1 have no bias with respect to the property that is the subjeG of this report or to the parties
involved with this assignment.
- My engagement in this assignment was not contingent upon developing or reporting
predetermined results.
- My compensation for completing this assignment is not contingent upon the development or
reporting of a predetermined value or direction in value that favors the cause of the Giant, the amount of
the value opinion, the attainment of a stipulated result, or the occurrence of a subsequent event directly
related to the intended use of this appraisal.
- My analyses, opinions, and contusions were developed, and this report has been prepared, in
conformity with the Uniform Standards of Professional Appraisal Predice.
- No one provided significant professional assistance to the persons signing this report.
- Brett Lechthaler inspected the property and prepared this report.
Respectfulty,
Brett Lechthaler,
PA State Cert~ed General Appreiser
Poem TROD -TOTAL for M7ndows° apDmisal saNwam by a tr mode, inc.-1-BOPALAMODE
Location Map
Form MAP.LOC -'TOTAL tar Windows' aCD~aisal software by a W mode, Inc. -1-800-ALAMODE
_ _. _ _..
FED/: `iDF'3'T.Gi J;:OD F'7
DG?
Tax Paorl Na 37-d3- osss-7, yy
THIS DH®
nrnaeme~&1$aayof ~14~J mrbeyesroaerboa.aaamarnaodroa.as
niteety.ser.W (1997)_
S ~LOI~ c~~, t~mamnued widow. ~xe~Iy~ of the Hotaugh o€ `
Ooomey, PmoaylVaNa, (ipn4ar.
and
DIAL fi. N&SS. single vnaoazr, her daaghar, azttl I.OIS Z. NHSS,
~cmaatly of the name Pte; Otantees as joint
~erffiip, and as es tenanpm oommoa
Wt17.1ESSH1ii, that in ooneitiaation of the s~ otONE (53.0 DOLLAR m hmapaiq
O they hales ~ e~gtsl~as j~aa'at tams v~OV¢h~ gpt ~~ebY Saaat sad coway m the
sravtvorahip, and not as
AId.1'AATC6RTAIN nactofhaad sitmtt in the HOmag6 of
homded andsad~dos<a16ed as follow dad Sram of peaoeyiyaafa,
HEGIIdNINO az a snake eigharn (18) feet firm the ttdddle otLocust
Suee6 sod sixty-eight (6S) feet fiom the cmuc of Loegst Steed add Oran
9ueeK draceinamathastedY dhauon, ens hmdmd fifty (230)feet toa
stela on a twelve (22) too[ wide alley. said atety haiog twenty ~ fat
fro®thc Hoe ofOreen Soar{ rheas by askl alley in a
dmxdon. 8flY (SO) tat to a amkr thence in a ttmhwos~y
hmrhed ~9 <~ ttle[ to a stake; thence in a m'13' ~don'~B
Locoat Sna4 HflY (50) foot m the phta ofBEO~ ~~'
~S ~ t"'Gatagy fiamc dwelli¢g houu mtmhaed 103
AND da said Caaator wlQ Wanaot spaialiy the Property hawy conveyed
hand and sSSeIIaR'I~RHOF, the said Cuaatorhas heesuoto set her
Y Yeer£a5t argue waded
Signed, sealed e~ deHvtmd
in the pressed of:
8001( iS$ PALE i~~
Form SCA-'TOTAL Ion Wnmws' aDP~aiaa aollware by a h motle, inc.-1~8110.ALAFaIOE
~s~~arro~ISTTI~I~o ~TODAUGHTBRAND
TRANSPHR TAX fiXF.MPI'.
11.00•
5 BA °o
Laundry m
0
Kitchen v'
0
0
ui
0
h
eo Dining Room Living Room °o,
a
Foyer
°o
a Parlour 6.00'
12.00'
AREA C~
ced. o..oiprm
CGl Yiitt Flooz
m.9z s.Lme Weer
TOTAL LIVABLE
S. SUMMARY
9W NNTar61a
1091.<]SO 1091.6]30
1003.6]60 1003.6]60
2095
Secontl Floor
18.75'
o c
b N
tO Betlroom gath °
6.25'
0
0
u
b Bedroom
~ °o
Betlroom
Sitting Area 5.00'
0
v 6.00'
12.00'
LIVING. ARFA BREAKDOWN
t &ubbf6U:
rizzL Fleoz
0.66 z 10.00 6.6000
3.00 z <.00 12.0000
0.5 z 3.00 z 3.00 6.5000
0.5 z 3.00 z 3.OD 1.5000
5.00 18.00 90.0000
9. D0 z 32.00 308.0000
18.]6 s 36.00 63].5000
e.DO : 11.00 ea. oooo
fi.zs z 39.60 121.e]s0
3. DO z le. sD le. so9o
a6eeztl ROer
0.66 z 10.00 6.6000
3.00 z <, 00 12.0000
0.5 z 9.00 z 3.00 6.5000
0.6 z 3.00 z 3.00 <.9000
6.00 : 18.00 90.0000
9.00 z 32.00 106.0000
38.]5 z 96.OD 63].6000
6.$6 z 19.60 123.8]60
1.00 z 18.30 18.5000
19 Calculations Total(reuntled) 2095
Form $I(f.Bld$Id-TOTAL for Windows' 6ppRl6al soltwue Oy a omode, ix.-1-800-AUMOOE
Building Sketch (Page - 1)
Subject Photo Page
Sub)ect Front
103 S Locust Sl
Saks Pace Market Value
Grass Llvinp Arp 2,098
Tafelflooms 6
Topl Betlrooms 3
TNaI BathrpCms 1.5
Loratlon Average
New Average
$Ih 0.11 aae
Opelpy Average
Ape 118 Years
Subject Hear
Outbuilding
Form RCbB.Bfl-?OTAL for WiMOwY Spp2is91 software by a V motle, inc. - i-B00-ALAh}~OE
Subject Photo Page
Outbuilding and Shed
103 S Locust St
Bales Pdae Market Value
Groa Liulnp Ara 2,095
Total flomRS 6
Taal Betlmorts 3
Talal BaNrooms 1.5
Lacadan Average
Yew Avarege
Site 0.17 aoe
Quality Average
Ape 716 Veers
Street
cloy
Form P103a5.SIi -°TOTAL for Wintlowa' apgalsal eoftware by a m mod& inc.-1-S00-ALAMOOE
Comparable 1
17 W. Factory St
Pmx to Subject 3.00 mres
Sob Price 126,900
Gass Living Afm 1.372
Totalflooms 6
Tolal58tlmoms 2/3
Total BetMOOms 7.5
Cocoon Average
View Epuel
lice G.Ga a«e
Graliry Equal
Ape 76 YeaB
Cemparabio 2
36 W. Facory St
Pmc. to Subject 3.02 maes
Sak Pace 735,000
Gow LNirp Ares 1,155
Total flaoirs 6
Total Betlmoms 3
Total Baarooms 2
tampon Average
Yaw Equal
sie G.7aa«e
Galgy Equal
Aga 105 Vears
Comparable S
200 N Market St
PmX to Subject 2.84 miles
Sale Price 145,000
Gross thing Arm 7,870
Togl Haoim 6
Total Betlrooim 3
Total BaCaaams 7.5
Lacatgn Avaraga
Yew Equal
Sloe 0.75 acre
Ouegry Equal
Are 108 Years
Form PIC3s5.Cfl - TOTAL kr Wnaows' appreiml sotMare M a ce maoe, inc. -1A00.ALAMOOE
Comparable Photo Page
r
Comparable Photo Page
Comparable 4
18 E. PoNantl St
Pmx tg Subjxt 2.79 urges
Sab Price 754,900
Gross Livirg Area 7,941
Tatel Roorm 7
Talal Bedrooms 3
Tale) Batluorms 7.5
Lacatlan Equal
Hari Equal
Site 0.09 acre
Ouegry Equal
Age 106 Vears
Fib PMto
Comparable 5
300 S. Vork St
Prox to Subject 3.72 mees
Sak Pace 794,900
Gross Living Am 1,934
ToW Harms 6
Tmal Bedrooms 3
Total Balhraam6 1.5
t.ocagan Equal
New Equal
sip atoaare
aailry Equal
Ape to9veara
File Ptwio
Comparable 6
412 E Main St
Prot to Subject 0.26 mees
Sale %ice 174,900
Gross LNirp Area 7,640
TNeI Ragm 6
Tatai Bedroam4 3
Total Batlraoms 1.5
Locatlon Equal
Mew Equal
Sge 0.78 aae
Oueliry Equat
Aqe 67 Ye9rs
Farm %C3x5.Cfl-'fOTALior Windows' appraisal srltware by a W mode, mc. -1-B00-gLgMppE
[ ,
Cemmoew[[Itp Yf P[[wvlnnu pry[epepl or5ote
aYR[Y O(P(o(pypnl [ad GIXYp[fMnN Aatiri
CaNned Ganural Appmbx.
Cenifieah'Nhmber Expintba Dah
GA0a3a94 a6I301a0a9
C[rufinte Stamx
Anrva
BRETT WESLEY LECfITHAIER
't6'RMIJUANDRIV[ .
MEGHANICSBURG PA 1]055
Registration Code
BRETT WESLEY LECHTHALER
t8 SAN JUAN DRIVE
MECHANICSBURG PA 17055
93
~~~~~
~~T
xsnnrxs WubWwp x¢mYnnen cm[xv~r caucarwxoraua ~casc:
R. GETM TIIE ~L IMWp.nn9eCEAlIPY. p1E 4i PEalaaAn~gl~.
Vour teglstrafian sotle L5 found on the attached wallet
pM.
Uss tDis rcghrtration cotle online to: renew your license,
change your pareprud or li~nae adtlress, or order
duplicate ficpnaea.
Visit our waDSile et h-~~~~
F1rsl time u9ers will be repaired to uw Nia registn8on
cotle b create a user ID end password,
CDmtoouwealtk~of Pettnsylvania ~`
Department of State '- Z ~~~ ~ 2 g ~
- Bureau of Professional and Occupafional Affairs ~-'
PO Box~2649 Harrisburg PA 17105-2649
Certificate Type ':.
- Certi{icate States
Certified General:Appraiser
.:Active
`Initial Ceitifiradon Datc
BRETi WESLEYLECHiHALER Certificate 06/27l20D7.:
16 SAN JOAN DRIVE Number
MECHANICSeORG PA 17055
GA063594 . Eacpiratidn Date
C.vNn ry$gYa Yf Pmfasima and (ldipuiaM ARY5S S~rwurc ,V ^
Farm SCA-ROTAL fm Wilpawr appnisa software by a a Ilwae, mc. -16110-ALAMppE
REV-1511 EX+ (12-99)
• '
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
scNE~u`E x
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
NE-aS, ~o~s z. ~<-o9-as9
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
/-~'l~'S- plA-R~VV~' FuNE7t~t How' o~ CA-n+P a~t~ (/'/~EPR~iD) - ~ -
.~. St. Tcbns ~kf/~tn Chkrc,ti {vr Funeral Mea~ ~187,~fS
(sec pi»oFS a//xr-~e~)
3. Gin9rkli /YleniorialS~ ~r en~rtiivlnc~ 130.00
(Sce ~prooFS d/fi~c~ltq~> U
e. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
f
Name of Personal Representative(s) ~rQY1e L,4x.r~5 NLSS ~1
~rl"~~~~
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees Charles k. .5hteld5 ~ (esfim.) So
f / y62
,
3. 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
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
Filin~ Fee f !'u~;sOcr of !v,'l/s ~l
sao
~. /Qei/n/>arse/~enf ~ Clrar,/es E. Sl,a/ass mil'
~.' p~ns~aye ,
.
,
/r7~ZO~°CD/GiCSi ~. 1dG
o0
,
TOTAL (Also enter on line 9, Recapitulation) $ ~, 8Q p • 9s
flf more soace is needed. insen additional sheets of the same size,
_ _ _.
D C^^ 1 ~' ~ V I~ V
1"~~ I~ ~i VI 1 'C I
L
I~ ~~~,ae ~~ k Icy i'~ C ~~~ f ~
~~'.~ `
~~G' J ~~~ ~d -~rtt~
a n
3{
:.
CI
8 ~~~\
0
p~
oK
o
i~yg
nJ ( a m O=
~+' \\r
'~~
~~ ~ ~r5m
~
!p
I1J
l1'I
9 A
E gr' g
C
3
~~
N~
r
v "i y >
0'~
Y
~
~
Cb
•• ~
~ ~~,~ o~ 7
C
N
O
O O~
O ~
O
ru
r
r
O
O
d
-
a
w r` ,
r
ru
.0
9
~ ~
~
!
IV^Y ~ ~ W
N
r;aa Y ~
www.GlantFoodStores.cae
4
~uulify,ed~cNon, tovinys, Mary Da t
Vtstt us on the Internet ,
My soel le to ensure dour setisfactD
everw tine wou shop with ua. If the
le snwthlns eor^ I can do to lepro
sour experience please call or writ
Terrw Glseous, Store Manessr
Giant Food Store 8331
5301 Stepson Ferrw Road
Mechsnicsbure, PA 17050
Store Telephone; (717) 766-6550
Pharescw Telephone; (717) 591-9565
12/30/06 10:29AM
THRNK YOU 48001111895
MRRTINS CHIPS BC 4,59 F
SC BONUSBUY SAVINGS 1.09-F
Price aou paw 3.50
,MRRTINS CHIPS BC 4.59 F
SC BONUSBUY SAVINGS 1.09-F
Price aou pew 3.50
MRRTINS I;HIPS BC 4.59 F
SC BONUSBUY SRVINGS 1.09-F
Prlc• wou psw 3.50
PRRTY TRRY 69.99 F
PRRTY TRRY 39.99 F
BP 200 GRS PTS 200
PRRTY TRRY 19.99 F
FRUIT TR11Y MED 29.99 F
RELISH TIiRY,SM 16.99. F
TOTAL BEFORE SRVINGS 190.Rz~
YOUR TOTRL SRVINGS 3.'27
TOTAL RFTER SRVINGS 187,45
TRX PRIG 00 /
eeeeTOTAL 187.46
ACCT RECEIVABLE 187.45
CHAWGE .00
TOTRL NUMBER OF ITEMS SOLD 8
12/30/OB 10:30 RM 0331 11 0021 150
INSCRIPTION ORDER FORM
No. 12-20529
ingric
MEMORIALS Since 1921
5243 Simpson Ferry Road, Mechanicsburg, PA 17050
(717) 766-5622 • Fax (717) 766-8007 • www.gingrichmemorials.com
CEMETERY -s~~. Jd~g ~-eaGQ VC LOCATION_ Skl'fYMO~»$\owh
NAME OF DECEASED C~b1S IV~2S$
LETTERING REQUIRED:
~~Og
FAMILY NAME MEMORIAL N CSS IND. NAMES ON MEMORIAL C r 4! ~06 S
TYPE OF MONUMENT ~aA?1QI~t COLOR OF GRANITE _ QNay
LOCATION: DRAW A PRECISE MAP OF LOCATION OF MEMORIAL ON CEMETERY (Use back of work order if necessary)
BILL TO: ~)l aK~ L.Q ~ ~:.,5 DATE OF ORDER D - 0 q - O ~I
e~3 `~' l~~~~ ~~ ORDERED BY _ SCt,Wtc
5~freynendfbW~ ~fl (ZO ( PHONE#() 7Gil -~'7G-j
UPON EXAMINING THE ABOVE INSCRIPTIONS, I/WE THE UNDERSIGNED, FIND THE SPELLING AND DATES TO BE
CORRECT. THE WORK WILL BE COMPLETED AS IT IS ACCUMULATED. NO SPECIFIC COMPLETION DATE IS
GUARANTEED.
~~y
I ~~.,!, SIGNED
WHITE-Office YELLOW-Production
SIGNED
PRICE
DEPOSIT
BALANCE DUE
PINK-Customer GOLDENROD-Branch
$ 03 0, -
$ 630. -
$ b-
,~ RE~1512 E%t (12-03)
COPAMDNWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF
NESS LO/S 2 FILE NUMBER
Report debts incurred by the decadent prior to death which rerlLalned unpaid as of the date of death, including unrelmhursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
M~NA6lNr: 7XKST~"~5- HGP flt.4r/a.P GJIh2f , ~/1D~vT
PER,So,U~9L ~RilSF• Fit~v.0 -STN FLOOR "O
~. Comm. o~ AENNIi~. DET''T flF Pu~3uc UJE'GFA~LE
~~ E~pl,~JSES incurru/ wt~ih lost ,'LX Mnn'1'RS (Jrior fe
dea.f~ us class 3 (ariori?y claim ~!~{, SSV, 7.Z
~•) ~3t u~svc~e ~f' elct,im- uriSe.~.wrul ~d.i~r .slaws
a5 class (Q priority ~[l,im X13! ,?53,7
(~ s~nfcmenf a~i'ucl~ed~
TOTAL (Also enter on line 10 Recapitulation) $ I ~SIS 8•pIj/ S~9
,. ,
<,
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF PUBLIC WELFARE
BUREAU OF FINANCIAL OPERATIONS
DIVISION OF THIRD PARTY LIABILITY
ESTATE RECOVERY PROGRAM
PO BOX 8186
HARRISBURG, PA 17105-8486
January 6, 2009
CHARLES E SHIELDS III ESQUIRE
CHARLES E SHIELDS III ESQUIRE
6 CLOUSER ROAD
MECHANICSBURG PA 17055
Re: LOIS NESS
CIS #: 840162799
SSN: 174-20-1592
Date of Death: 12/25/2008
Dear Attorney Shields
Please be advised that the Department of Public Welfare maintains a
claim in the amount of $145,604.49 against the above-mentioned estate. This
claim is for restitution of medical assistance granted on behalf of the
decedent for which the Probate Estate is now responsible to reimburse the
Department according to Act 49, 62 P.S. 1412, effective August 15, 1994, as
amended by Act 20-95, effective June 30, 1995. Enclosed is the Department's
itemized statement of claim.
A portion of this medical expense, namely $14,550.72, was incurred
during the last six months of the decedent's life; therefore, it is a Class 3
claim pursuant to Section 3392 of the Decedents, Estates, and Fiduciaries
Code, 20 Pa. C.S.A. 3392(3). The balance of the claim, namely $131,253.77,
is to be entered as a priority Class 6 claim against the estate.
Please acknowledge receipt of this letter and advise whether the
Commonwealth's claim is admitted and when payment may be expected. If the
estate accounting is complete, please provide a copy. If the estate contains
real estate, please provide copies of the deed, the latest tax assessment,
and a current appraisal, if available.
Sincerely,
~~~~~ ~ ~. ~~2
Angela D. Carter
Claims Investigation Agent
717-772-6612
717-772-6553 FAX
Enclosure
REV~1513 EX+ (9-00) ,
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
~llF's S, GolS z.
~/-v 9 - 2 5 9
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY REL DoI Not List TOrust e(s)ENT AMOOF ESTATEARE
I TAXABLE DISTRIBUTIONS [include outfight spousal disMbutions
antl transfers under
,
Sec. 9716 (a) (12)]
7 ~I.4.vF LfFKCKS /~~~' 17~-N?n'/T~P
/ O O po
4fCa .a/.4~'E' E', L~KULS
shi remn~~,ivwn, ~ l ~o l l
EMER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 75 THR OUGH 78, AS APPROPRIATE, ON REV-7500 COVER SHEET
11 NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9173 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
7.
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 73 OF REV•7500 COVER SHEET $
1~~ inure space Is needed, Insert atltlilional sheets of the same size)
I, LOIS Z. NESS, currently of Shiremanstown, County of Cumberland, Commonwealth of
Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and
declaro [his my Last Will and Testament, hereby~revoking and making void any and all prior Wills by
me at any time heretofore made.
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, personal and mixed, whatsoever and
wheresoever situate, is to be distributed to my daughter DIANE E. NESS.
In the event that my daughter predeceases mq then all the rest, residue and remainder
shall go to my brother DAVID S. ZIMhICRMAN, ~ rg~6rn~
3.
I nominate, constitute and appoint my daughter DIANE E. NESS, to be the Executrix of
this my Last Will and Testament. In the event that she is unable or unwilling to act as Executrix,
I appoint my brother, DAVID S. ZIlIIMERMAN to be the Executor in her place and stead. In
the event that he is unable or unwilling to act as Executor, I appoint my niece, CLAUDIA
ZTT'IIWERMAN, to so serve as the Executrix in his place and stead. I further direct that thcy shall
not be required to file bond or other security in the Office of the Register of Wills for the purpose
of administering my Estate.
~5~-~7~~
~`~I\N WIT''NE'~StnS WHEREOF, I have hereunto set my hand and seal this ~-= day of
"' '~y~, A.D. 2003.
LOI~NESg ~y ~ 'e""`e'I')
Signed, sealed, published and declared by the above-named LOIS Z. NESS, as and for her
Last Will and Testament, in the presence of us, who at her request and in her presence, and in the
presence of each other, have hereunto subscribed our names as witnesses.
C`n,..,p.~~a~..,~-,.... li3a G.-~2aP.:, I' m,.-6,.~'fl ~IoSS ~`)Il-~~~-6a~a
;,69vN (l%////G~ i irk/ /9~/~~ /J /7~.~6`
' ~ goo ~"D ~,~ f~
CHARLES E. SHIELDS, III
ATTORNEY-AT-LAW
6 CLOUSER ROAD
Comer of Trindle and Clouser Roads
MECHANICSBURG, PA 17055
GEORGE M.HOUCK
(1912-1991)
June 16, 2009
Register of Wills
Cumberland County Court House
1 Courthouse Squaze
Cazlisle, PA 17013
Re: Estate of Lois Z. Ness
No. 21-09-0259
TELEPHONE (717) 766-0209
FAX (717) 795-7473
' Dear Register of Wills:
Please find enclosed for filing 2 copies of the Inheritance Tax Return for the Lois Z. Ness
Estate as well as Check No. 1322 in the amount of $15.00 for the filing fee.
Thank you for your kind attention to this matter
Verry//t/,rul~~yyo~Qur®,s, ~ ,, ~,~~
Chazles E. Shields, III
Attorney-At-Law
CES/mjj ~ a
.o '°
Enclosures W L ~~
try ~ r-r^r ,-
L~ >
t~ 4-it•~
rte- 7
~~ V _a7 r
y ~`~ ,7i
Y7
0 ._7