HomeMy WebLinkAbout10-26-09J 15056051047
REV-1500 EX (06-05)
PA Department of Revenue OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
Po sox 2aosol INHERITANCE TAX RETURN
Hanisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 0 9 0 0 1 3 1
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
201 18 8505_; 0102 2009 05151927
Decedent's last Name Suffix Decedent's First Name
MI
_APPEL JR WILLIAM L_
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name
MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
F~ILyL IN APPROPRIATE OVALS BELOW
t~ 1. Original Retum O 2. Supplemental Retum O 3. Remainder Retum (date of death
prior to 12-13-82)
O 4. Limited Estate (~ 4a. Future Interest Compromise (date of (~ 5. Federal Estate Tax Return Required
death after 12-12-82)
(7C7t 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
Ct 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name
Daytime Telephone Number
K E I'T H 0. BRENNEMAN 7 1` 7 6 9 7' 85 2 8
Firm Name (IfApplicabie)
S N E L B A K E R & BRENNEMAN P C REGISTER OF WILLS USE ONLY
First line of address
C`7
44 WEST MAIN STREET ? -z-
;?~
Second line of address ,
~
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a
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Cit
P ~ ....I
y or
ost Office State ZIP Code DATE FiLfaD~; i
C r
MECHANICSBURG PA 1 7055
`~ -- -'~ ~
=~i
J . i ~ ~ ~T l
Correspondent's a-mail address: ~ ~' 1
_
.C"
Under penalties of perjury, I deGare that 1 have examined this return, inGuding ac~mpanying schedules and statements, and to the best of my knowledge and belief,
it is true, correct and complete. Declr3ratlon of preparer other than the personal representative is based on all i
f
ti 5a
n
orm
SIGNATURE OF P SON RESPONSI E FOR LING R RN a
on of which preparer has any knowledge.
ADDRESS Executrix DATE
/o .zG~°~/
6213 Charing ross, Mechanicsburg, PA 17050
SIGNA~ EPARER OTHER THAN REPRESENTATIVE
DATE
/o~ZG~oS
ADDRESS
44 West Main Street, Mechanicsburg, PA 17055
PLEASE U8E OR161NAL FORM ONLY
Side 1
L 15056051047 1505605104?
~~
J 15056052048
REV-1500 EX
Decedent's Name: William L. Appel, Jr.
Decedent's Social Security Number
2 0 1 1 8 8 5 0 5
RECAPITULATION
1. Real estate (Schedule A) ............................................ . L 1 4 1 , 8 3 4. 0 0
2. Stocks and Bonds (Schedule B) ...................................... . 2. 8 6 1 • 5 6
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. •
4. Mortgages 8 Notes Receivable (Schedule D) ............................. 4. •
5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ........ 5. $ , $ 2 8 • 2 0
6. Jointly Owned Property (Schedule F) O Separate Billing Requested ....... 6. 3 6 , 1 3 1 . 5 1
7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested........ 7. 4 0 , 8 5 0' S 7
8. Total Gross Assets (total Lines 1-7) .................................... 8. 2 2 8 , 5 0 5• 8 4
9. Funeral Expenses & Administrative Costs (Schedule H) ..................... 9. 2 0 , 1 3 3 • 0 0
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................ 10. 3 , 1 5 5 ~ 7 7
11. Total Deductions (total Lines 9 8 10) ................................... 11. 2 3 , 2 8 8. 7 7
12. Net Value of Estate (Line 8 minus Line 17) .............................. 12.: 2 0 5 , 2 1 7 ~ 0 7
13. Charitable and Governmental Bequests/Sec 9713 Trusts for which
an election to tax has not been made (Schedule J) ........................ 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) ........................ 14. 2 0 5 2 1' ~ . 0 7
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X .0_ . 15.
16. Amount of Line 14 taxable
at lineal rate x .o ~ 2 0 5, 2 1 7. 0 7 16. 9 2 3 4. 7 7
17. Amount of Line 14 taxable
at sibling rate X .12 . 17 •
18. Amount of Line 14 taxable
at collateral rate X .15 • 18 •
19. TAX DUE ......................................................... 19. 9 ,_ 2 3 4• 7 7
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~X
Side 2
15056052048 15056052048
REV-1500 EX Page 3 Flle Numbsr
Decedent's Complete Address: 21-09-00131
DECEDENTS NAME
William L. Appel, Jr.
STREET ADDRESS
24 E. Portland Street
clrr
Mechanicsburg srATE
PA zIP
17055
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments 9 , 000.00
C. Discount 450.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A + B + C )
(1) 9 , 234.77
(2) 9 , 450.00
Total Interest/Penalty (D + E) (3)
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. (4) 215.23
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
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 transferred or its income :.............................
c. retain a reversionary interest; or .......................................................................................................................... ^
d. receive the promise for life of either payments, benefds or care? ..................................................
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 acxount 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? ........................................................................................................................ ® ^
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN
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)J.
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)]. 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 isdefined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1502 EX+ (11-08)
-: ~ Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
esrart: of FILE NUMBER
William L. Appel, Jr. 21-09-00131
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 ar sell, both having reasonable knowledge of the relevant facts.
Real property that Is jointly-owned with right of survivorship must be disclosed on Schedule F.
Attach a copy of the settlement sheet if the property has been sold.
ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE
NUMBER OF DEATH
DESCRIPTION
1. All that certain parcel of land improved with a
residential dwelling located in the Borough of
Mechanicsburg, Cumberland County, Pennsylvania,
commonly known as 24 E. Portland Street, Mechanicsburg,
Pennsylvania. Value (settlement sheet attached): $102,500.00
2. All that certain parcel of land improved with 1/2 of a
2 1/2 story residential dwelling located in the
Borough of Chambersburg, Franklin County, Pennsylvania,
commonly known as 141 South Coldbrook Avenue,
Chambersburg, Pennsylvania. Decedent owned an
undivided one-third share as a tenant in common.
Appraised value (appraisal attached) on one-third
interest: 39,334.00
TOTAL (Also enter on Line 1, Recaoitulation.l ~ t 141.834.00
If more space is needed, insert additional sheets of the same size.
REV-1503 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
William L. Appel, Jr. 21-09-00131
All property JoIntIY-Owned With right of survivenhin must M d~ar~need ..., e..~..w..~_
~•• •••~••• ~r~ ~~ noovoa, mami awmonai sneers or [ne same size)
REV-1508 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCNEDVLE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
William L._Appel, Jr. 21-09 00131
Indude the proceeds of Irtigahon and the date the proceeds were received by the estate.
All property jointly-owned with right of aurvivarship must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION VALUE AT DATE
OF DEATH
1. Furniture, furnishings and miscellaneous household goods
and personalty $ 500.00
2. Commonwealth of Pennsylvania State Employees' Retirement
System account settlement payment 126.51
3. 1992 Buick Roadmaster 1,850.00
4. M&T Bank Certificate of Deposit, account No. 31003911189081 5,031.94
5. Veterans Administration Benefit 100.00
6. 2008 Federal Income Tax refund 266.00
7. Thrivent Financial premium refund 936.74
8. Central Penn Auto Club membership refund 17.01
TOTAL (Also enter on line 5, Recapitulation) ~ 18 , 828.20
(If more space is needed, insert addiftonal sheets of the same size)
REV-1509 EX+ (8-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCMEDI~LE F
JOINTLY-OWNED PROPERTY
ESTATE OF FILE NUMBER
William L. Appel, Jr. 21-09-00131
ff an asset wss made Joint within one year of the decedent's date of death, It must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A. Nancy A. Scott 6213 Charing Cross Daughter
Mechanicsburg, PA 17050
8.
C.
JOINTLY-OWNED PROPERTY:
ITEM
NUMBER LETTER
FOR JOINT
TENANT DATE
MADE
JOINT DESCRIPTION OF PROPERTY
INCLUDE NAME OF FINANCIAL INSTRUiION AND BANK ACCOUNT NUMBER OR SIMILAR
IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLKHELD REAL ESTATE
DATE OF DEATH % OF
DECD'S DATE OF DEATH
VALUE OF
~•
A.
5/2/95 .
PSECU Accounts: VALUE OF ASSET INTEREST DECEDENTS INTEREST
a. No. 0201-SO1: $1
016.00
,
b. No. 0201-504: 27 $ 1,016.27 50~ $ 508.1
2. A. 0/18/91 M&T Bank checking account No.
11086831 9,719.94 50~ 4,859.9;
3. A. 1/01/79 PNC Bank checking account No.
5070020798 28,646.40 50~ 14,323.2(
4. A. /01/87 Sovereign Bank Certificate of Deposit:
a. No. 1685210443 26,787.85 50~ 13
393
9°
b. No. 1685210419 6,092.54 50~ ,
.
3,046.27
_ TOTAL (Also enter on line 6 Recapitulation) 15 qh 1 '~ 1 s i
(If more space Is needed, Insert addldonal sheets of the same size)
REY-1510 EX+ (8-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCI~IEDt~LE 6
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF FILE NUMBER
William L. Appel, Jr. 21-09-00131
This schedule must be completed and filed ff the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is ves
ITEM
NUMBE DESCRIPTION OF PROPERTY
INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENTAND
THE DATE OF TRANSFER.ATTACHACOPYOFTHEDEEDFORREALESTATE.
DATE OF DEATH
VALUE OF ASSET
°k OF DECD'S
INTEREST
EXCLUSION
(IF APPLICABLE)
TAXABLE
VALUE
~. Thrivent Financial For Lutherans, Annuity
Contract C2878983. Beneficiary: Nancy A.
Scott, daughter of Decedent, Date of
transfer: January 2, 2009 (date of death) $18,710.62 100% -~ $18,710.62
2. MetLife Annuity contract 077907506 AB.
Beneficiary: Nancy A. Scott, daughter of
Decedent. Date of transfer: January 2, 2009 22,139.95 100 ~ 22,139.95
3. Department of Veterans Affairs, Government
Life Insurance Policy V3187698. Beneficiary:
Nancy A. Scott, daughter of Decedent.
Date of transfer: January 2, 2009 11,938.92 100% $11,938.92 -0-
4. American Income Life Insurance Company,
Policy No. 2120309. Beneficiary: Nancy A.
Scott, daughter of Decedent. Date of
transfer: January 2, 2009 6,898.00 100 6,898.00 -0-
5. Prudential Insurance Company, Policy No.
24707907. Beneficiary: Nancy A. Scott,
daughter of Decedent. Date of transfer;
January 2, 2009 5,583.45 100% 5,583.45 ~
TOTAL (Also enter on line 7 Recapitulation) : I LIQ~g~ 57
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+ (10-08)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCNEDIJLE N
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF FfLE NUMBER
GFi l l i am L. Appel, Jr. 21-0}-00131
Debts of decedent must be reported on Schedule L
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1' Thomas L. Geisel Funeral Home, Inc.
$9,695.60
2. Lincoln Cemetery 700.00
3. Funeral Luncheon 600.00
4. Gordon's Memorial 600.00
B.
1
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
waived
City
Year(s) Commission Paid:
State Zip
2• AttomeyFees to Snelbaker & Brenneman 5,500.00
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 io Decedent
4_ Probate Fees to Register of Wills: Initial probate fee ($268.00)
and additional probate fee ($100.00) 368.00
$ Accountant's Fee ~ miscellaneous probate expenses, reserve 1, 000.00
6• ufmatzea~l~-~ass~x~c Appraisal fee for real estate (Schedule A,
Item 2) to John D. Ausherman, SRA 350.00
~• Advertise grant of letters testamentary:
a. Cumberland Law Journal: $ 75.00
b. The Sentinel: 219.40
294.40
8. Transfer tax paid on sale of real estate 1,025.00
TOTAL (Also enter on line 9, Recapitulation) $ 20 ,133.00
(If more space is needed, insert additional sheets of the same size)
REV-7.512 EX+ ~1?-OS)
Pennsylvania
DEPARTMENT OF REVENUE
INHERRANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
ESTATE OF FILE NUMBER
William L. Appel, Jr. 21-09-00130
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
i. Cumberland Goodwill Fire Rescue, payment on account $ 277.50
2. Chapel Pointe at Carlisle, payment on account of nursing
services ($271, $16.23, $1,695.70)
1,982.93
3. Millenium Pharmacy System East, payments on account
($347.37, $72.20) 419.57
4. Comcast Cable, payment on account 63.33
5. PP&L Electric, payment on account 35.99
6. Borough of Mechanicsburg, payment on account sewer/trash 108.32
7. J. J. Skelton Oil; payment on account 178.00
8. United Water, payment on account 8.93
9. UGI Utilities, payment on account 12.83
10. Verizon, payment on account 68.37
TOTAL (Also enter on Line 10, Recapitulation) I # 3 ,155 77
If more space is needed, insert additional sheets of the same size.
REV-157.3 EX+ (11-08)
Pennsylvania SCHEDULE ~
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
William L. Ansel. Jr_ .,, „
NUMBER
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY ~.i
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s) V~-VV1J1
AMOUNT OR SHARE
OF ESTATE
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec. 9116 (a) (1.2).]
1~ Nancy A. Scott
6213 Charing Cross Dau hter
g
100 of residue
Mechanicsburg, PA 17050
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 16 OF REV-1500 COVER SHEET, A S APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II -ENTER TOTAL NON TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $
,~ inuic space is neeaea, mserc aaaaionai sneers or the same size.
--- .
,,,
306 CH,4M$EFSDUKG'TRUSTCBUI~DING
CF'3`A~M~BE~P_.'S~~iJRG;PFl. "'"~~.`, ~ .
I~.. ,.
I.,AST WII.I. ANI~ TESTAMENT
.. ,e .. K
I, WILLIAM L. APPEL, a resident of the Borough of Mechanicsburg, Cumberland
County, Pennsylvania, being of sound mind and memory, do make, publish and declare this my Iast
will and testament, hereby revoking any and all wills by me heretofore made.
ITEM I. I direct my personal representative, hereinafter named, to pay my funeral expenses
as soon after my decease~as may be found convenient, and also to pay ail estate, inheritance, succes-
sion and other death transfer taxes, of whatever nature and by whatever aurisdiction imposed and in-
terest and penalties in respect thereto, assessed against my estate or payable by reason of my death,
with respect to any and all property, Life insurance and other interests comprising my estate for
death tax purposes, whether or. not such property or interests pass under this will. or any codicil
thereto, without reimbursement as if such taxes were administration expenses.
ITEM. II. I give, devise and bequeath alI my estate, real, personal and mixed, of whatever
nature and wheresoever situate, which I may own. or have the right to dispose of at: the time of my
decease, to my daughter, NANCY ~', SCOTT, or her issue, per stizpes.
ITEM III. I nominate and appoint THE i st BAND ~ TRtJS'F CJMpp,Iv~~T, of Mechar-
icsbur, Pennsylvania, guardian of the estate of any erson under the awe of 1~
p ~, years and. with
respect to which I am authorized to appoint a guardian and have not otherwise done so, to serve ur:-
tiI such persons attain the age of 1.8 years, and no bond shall. be required of said guardian;, said
.. ,. ,
t;tlarftIdl2 :tiRli tln.vr,'''- ~ ~ - ~- -
~: rig. ~.:t.ii.~ .: ~:"I? ~ :: ;rs r~ma rr~M Ytrrtµ YC1 tl„
maintenance, education and medical care of siu;h henenciarie„ unde, ~ ; ~ ~-
tII~- a~~ of I r7 years.
GLEN 6z GLEN
~nambersburg Trusr Bldc.
~umbersbuzc. P¢. 172Q1
1 ! '' ~,
+~f
ITEM IV. I hereby nominate and appoint my daughter, NANCY J. SCOTT, executrix of
this my Last will and testament, but,irl the event the said Nancy 7. Scott is not Iivin,~g at the time of
my decease, or fails to qualify, I nominate and appoint THE 1st BANK & TRUST COMPANY, of
Mechanicsburg, Pennsylvania, executor of this my Iast will and testament, and direct that no bond
shall be required of said executrix or executor.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this last will and testa-
ment, this ~" day of February, A. D. 1992.
,~~ , • `
SIGNED, SEALED, PUBLISHED AND DECLARED by the said William L. Appel to be
his last will and testament in our presence, who at. his request and in his presence and in the;
presence of each. other, we believing him to be of sound. and disposing mind and memory, have
hereunto subscribed our names as witnesses.
~, s;;
!~
~,
-~ ~ , ~'`
,,,
Law Offices
GLEN 6z GLEl~
~nambetabure Trusr Bldc.
,nambersburc• ?w, Ii201
2.
A• OMB NO. 2502-0265 n
B. TYPE OF LOAN:
U.S. DEPARTMENT OF HOUSING 8 URBAN DEVELOPMENT 1. FHA 2. FmHA 3. XQCONV. UNINS. 4. QVA 5. QCONV. INS.
6. FILE NUMBER: 7. LOAN NUMBER:
SETTLEMENT STATEMENT - -
8. MORTGAGE INS CASE NUMBER:
C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown.
Items marked '~POCJ' were paid outside the closing; they are shown here for informafional purposes and are not inGuded in the totals.
D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: (~EMOYNe-za- F RNAME AND ADDRESS OF LENDER:
Lemoyne Land Corp., Inc. Nancy A. Scott, Executrix of the
319 South Third Street, P.O. Box 31 Centric Bank
Estate of William L. Appel, Jr. 4320 Linglestown Road
Lemoyne, PA 17043
Harrisburg, PA 17112
G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 23-2083639
24 E. Portland Street I. SETTLEMENT DATE:
Mechanicsburg, PA 17055 Kerwin & Kervvin
Cumberland County, Pennsylvania PLACE OF SETTLEMENT August 31, 2009
Tax Parcel No. 18-22-0519-067
Centric Bank - 4320 Linglestown Road
Harrisburg, PA 17112
iACTION K !
102,500.00 401. Contract Sales
to
105.
106. Sewer/Garbai
107. Count Taxes
108. School Taxes
109.
110.
111.
cu ~. veposit or earnest money
202. Principal Amount of New Loans
203. Existin loans taken sub'ect to
204.
205.
206.
207.
208.
'209.
rustments or terns np
_210. Sewer/Garbage
211. County Taxes
212. School Taxes
213.
214.
215.
216.
217.
~ i a.
220. TOTAL PAID BY/FOR BORROWER 84,500.00
300. CASH AT SETTLEMENT FROM/TO BORROWER:
301. Gross Amount Due From Borrower Line 120 106,047.78
302. Less Amount Paid By/For Borrower (Line 220) ( 84,500.00)
303. CASH (X FROM) ( TO) BORROWER 21 547.78
The undersigned hereby acknowledge receipt of a completed copy of pages 1&2
Borrower Lem
., n
BY:
M~~t?oattsTPr€si ent
402. Personal Pro
ie 1400 2,344.25 403.
404.
405.
r
to 10/01/09 36.95 406. Sewer/Garbac
to 01/01/10 174.34 407. Count Taxes
to 07/01/10 992.24 408. School Taxes
409.
----_ 410.
411.
412.
ROWER 106,047.78 420. GR05S AMO
= OF BORROWER: 500. REDUCTIONS
500.00 501. Excess De osit See Instructi
000.00 502. Settlement Char es to Seller
503. Existin loans taken sub'ect
504. Payoff of first Mortgage
505. Pa off of second Mort a e _
506. De osit retained by seller
to
to
to
03
510. Sewer/Garba e ^ ~ to v
511. County Taxes to
512 School Taxes to
513.
514.
515.
516.
517.
518.
519.
520. TOTAL REDUCTION AMOUNT DUE SELLER
600.
CASH AT SETTLEMENT TO/FROM 5E LER: 4,730.:
501. Gross Amount Due To Seller Line 420)
302.
Less Reductions Due Seller (Line 520) 103,703.;
(
603.
CASH(' X TO) ( FROM) SELLER 4,730.;
98 973
~f this statement & any attachments referred to herein. .
Seller The Estate of William L. A
ppel, Jr.
/'~ ,, "X-+°`'c-t-t" r
Nanc A. Sc t, Executrix
102,500
09/01!09 to 10/01/09 36.95
09/01 /09 to 01 /01/10 174.34
09/01/09 to 07/01/10 992 24
HUD-1 (3-86) RESPA, H64305.2
LEMOYNE-24-PORTLAND / LEMOYNE-24-PORTLAND! 12 )
s~' d~''Z..--~'
Certified to be a true copy, Kerwin ~ K ~~
n
Settlement ent
RESIDENTIAL APPRAISAL SuMMaRV RFpnRT
Pro a Address: 141 S Coldbrook Ave ~ ~ ~ ~ ~ ~ e Fib No.:
Coun :Franklin C • Chambersbu State: Pa Zi Code: 17201-2713
Le al Desch lion: Franklin Coun Deed Book 894 a 408
w
m Assessor's Parcel #: 03-1 E12-061
Tax Year: 2009 R.E. Taxes: $ 890 S ecial Assessments: $ N1A Borrower a licable : Estate of Wllllam L
A el Jr
.
Current Owner of Record: Estate of William L.A el Jr. Occu ant: Owner Tenard Vacard Manufactured Housi
~ Pro act T e: PUD Condominium Coo eratlve Other descdbe HOA: $ er ar er rtwrdh
Market Area Name
$ : Borou h of Chambersbur
Ma Reference: 03-1E12-061_ Census Tract: 0109.00
The ur sa of this sisal is to develo an o inlon of: Market Value as defin
d
th
e
or o
u a of value describe
This re ort reflects the foilowi value tl not Current, see comments : Current the Ins action Date Is the Effective Date Retros ectlve Pros ctlve
A
h
roac
es develo ed for this a sisal: Sales Com adson A roach Cost roach Income roach See Reconciliation Comments and Sco a of Work
Pro a Ri hts A raised: Fee Sim le Leasehold Leased Fee Other descdbe
~ ; Imended Use: Appraisal For Valuation
in .
Intended Users b name or t e : A sisal for Valuation William L. A el Jr. Estate
' ' Client: Snelbaker & Brenneman Attn Address: 44 W. Main Street P.O. Box 318 Mechanicsbur PA 17055
A raiser. John D. Ausherman SRA Address: 229 North Second Street Chambersbu Pa 17201
r Locagon: Urban Suburban Rural Predominant One-Unit Housing Present Land Use Change In Lend Use
Buitt up: ®Over 75% ^ 25-75% ^ Undet 25% Occupancy
o pRiCE AGE One-Unit 60 % ®Not Likely
• Growth rate: ^ Rapid ®Stable ^ Sbw ®Dwner g0 $(000) (yrs) 2-0 Untt 20 % ^ Likely * ^ in Process
F : Property values: ^ Increasing ®Stable ^ Declining ®Tenant 10 105 Low 30 Multl-lJrdt 20 % ' To:
Oemand)supply: ^ Shortage ®In Balance ^ Over Supply ®Vacant (0.5%) 165 HI h 100 Comm'I %
~ ' Marked tlme: ^ Under 3 Mos. 3.6 Mos. ^ Over 6 Mos. Vacard >5% 135 Pred 75 %
o Market Area Boundaries, Descdptlan, and Market Conditions (including support for the above characteristlcs and trends); Property values in the area appear to
'
c be stable and supply and demand are in relative balance Market absomtion has remained constant and financlna funds are available at
~ competitive rates. All sales consessions writ be analyzed and env Impact on value will be noted. Ft{ture trends in the area are anticipated to
follow oast trends
.
w
~
.
ifY
~ .
s-
~:
4, Dimensions; 35'X118' StteArea: 4,1305 .Ft.
Zoning Classification: low density resid. Descrfption: Residential
Zonin Com Ilance: Le al ^ Le al noncordormin randfathered ^ Ille al ^ No zonin
Are CC&Rs a ppcable? Yes ®No Unknown Have the documents been rev(ewed? ^ Yes No Ground Rent a licable $ /
Highest & Best Use as Improved: ®Present use, or ^ Other use (explain)
4 ~ Actual Use as of Effective Date; single family residential Use as appraised in this report: single famil
z Summary of Highest & Best Use: Single family
0
1=
a
Utilities Public Other Provider/Descdption Off-sitelmprovements Type Puhlic Private Topography flat
Electrictty ® ^ Street asphalt ® ^ 9ize average
® ^ Curb/Gutter concrete
Gas ® ^ Shape rectan ular
Water ® ^ Sidewalk concrete ~ ^ Drainage avers e
Sanitary Sewer ® ^
.~; Street Lights yes ~ ^ View Avers e
Storm Sewer ® Ape none j
Other she elements: ®Inside Lot Corner Lot Cul de Sac Unde round llplltles Other descdbe
' FEMA S ec'I Flood Hazard Area Yes No FEMA Flood Zone C FEMA Ma # 42046900056 FEMA M Date 7!17/1978
J Stte Comments: No adverse conditions or easements observed.
i, General Description Exterior Description Foundation Basement None Heating
+.~ # of Units 1 ^ Acc.Unit Foundation Concrete Slab None Area Sq. ft. 5 Type hair
~; # of Stories 2 Exterior Walls alum. Crawl Space no % Finished 0 Fuel as
'~ Type ^ Det. ~ Att. ^ Rooi Surface as shin Ilav Basement ey s fu11 Ceiling fl
'oist
' Design (Style) Semi-del Gutters $ Dwnspts. alum/av Sump Pump ^ .
Walls stone Cooling
~, ®Existing ^ Proposed ^ Und.Cons. Window Type d.hun Dampness ^ Floor cons Central
in
z Actual Age (Yrs.) 84 StorMScreens x/av Settlement No Evid. Outside Entry no Other wail unit
'
w. Effective A e rs. 25 Irtfestatlon no avid
~; Interior Description Appliances Aritc None Amenftles Car Storage ^ None
o Floors h/wAinlw/way
W
ll Refrigerator ® Stairs ^ Fireplace(s) # _ Woodstove(s) # Garage # of cars ( 1 Tat.)
,a a
s !aster/av Range/Oven ® Drop Stair ^ Patio Attach.
Trim/Finish wood! d
Disposal ^
Scuttle ^ _
Deck _
Detach. 1
w Bath Floor vin I/av Dishwasher ^ Doorway ^ _
Porch x Blt: In '
Bath Wainscot lastedav FaKlHood ^ Floor ^ _
Fence Carport
o Doors woodlav Microwave ^ Heated ^ _
Poal _ Ddveway
z Washer/D er Finished ^ Sudace
a Finished area above rode contains: 6 Rooms 3 Bedrooms 1 Baths 1 044 S uare Feet of Gross LJvin Area Above Grade
'
x Additional textures: Full unfinished basement detached garage front porch
~:
w Describe the condltlon of the property (Including physical, functional and external obsolescence): Physical incurable depreciation only due to normal wear and
tear associated with age.
s,
® ~ Capyright® 2007 by a la made, inc. This farm may be reproduced unmodfied witlmut wriaen pwmisaian, however, a la mode, Inc. must be acknoxiedged and cradled.
RESIDENTIAL ~,rm r;ppG~~ _ nul~rnTer ~ ~,,.,..,.......,«,...._ G.
~~ a ~a ~~iwc, 1114. -- 1-OW-IILHIYI4UC V1GVVi
RESIDENTIAL APPRO~GO~ S~ ~nnnneQV pctonnr
~*~
~
~ - - - ------- - ..... Flk Na.:
My research did did not reveal any prior sales or transfers of the subject property for the three years prior to the effective date of this appraisal.
' Data Sources : MLS/C.House
'.
'O
y
'a 1st Prior Sub act Sale/Transfer
! Date: N/A
Price: N/A Analysis of sale/transfer history and/or any current agreement of saleflisgng: There have bee no previous transfers of
the subject property or the comparable sales utilized within this appraisal report
~ ~ Sources :Courthouse
~+; 2nd Pdor Sub act Sak/Transfer
~;
~M1
}-; Date:
Price:
Sources
-,
,
" SALES COMPARISON A
FEATURE
Address 141 S Coidb
Chambersbu
Proxim to Sub act
Sale Price PPROACH TO VALUE i
SUBJECT
rook Ave
rg_ pa 17201-2713
' ___ ~ i° ,
$ f develo d The Saks Cam oris
COMPARABLE SALE # t
305 East McKinley Street
Chambersbu Pa 17201
0.66 miles W
~-' ' $ 130.000 on A roach was not develo ed for this
COMPARABLE SALE # 2
1347 Alexander Avenue
Chambersbu Pa 17 01
1.29 miles N
~ `
3 134 900 'soh
COMPARABLE SALE # 3
439 East King Sheet
Chambersbu Pa 17201
0.58 miles NW
' -
~
•. Sale Price/GLA
. Data Sources
Verhicalion Sources
VALUE ADJUSTMENTS
: ~ Sales or Financing
~
Concessions
Date of 5ale/Time
. ' Ri his A raised
t~' Location
~' Site
View
_ Desi n St le
Ouali of ConstrucBon
r ' A e
• Condition
- Above Grade
R
$ /a .it
Ins action
Courthouse
DESCRIPTION
N/A
N/A
N/A
Fee Sim le
Resid/av
4 130 S .Ft.
Avera a
Semi-det
Alum/av
84
Avera a
Total Bdrms Baths
$ 95.03 /s .ft
Ins action
Courthouse
DESCRIPTION
Conv.Sale
Concessions
02/12/2009
Fee Sim le
Residlav
3485 S.F
Avera a
Semi-det
~n I/av
75+
Avera a
Total Bdrms Baths
~"
+ - $ Ad'ust
4 000
_---- _--
$ 97.75 Is .ft
Ins action
Courthouse
DESCRIPTION
Conv.Sale
Concessions
01/30/2009
Fee Sim le
Resid/avq
3920 S.F
Avera a
Semi-det
Brick/su
75+
Avera a
Toth Bdnns Baths
~
+ - $ Ad ust.
4 047
000 _
3
$ 91.1615 .2 -
Ins action
Courthouse
DESCRIPTION
Conv.Sale
Concessions
061D1/2009
Fee Sim le
Resid/av
3485 S.F
Avera e
Seml-det
Vin I/av
75+
Aver e
Total Bdrms Baths 130 000
, s, ,..
+ - $ Ad ust,
5 000
oom Count
Gross Li
i
A 6 3 1 6 3 1 6 3 1 6 3 2 -3 000
v
n
rea
= Basement & Flnished
K Rooms Below Grade
Functional Utlli
<a', Neatin Coolln
S Ener Efticientftems
~~, Gara e/C od
~: PorcfUPatio/Deck
a Kitchen 1 044 s .ft.
Full
N/A
Good
ha no air
Insul.Wind
1 car
Porch
Std.Kit 1 368 s .ft.
Full
NIA
Good
oho no air
Insui.Wind
None
Porch
Std.Kit -6 000
2 000 1 380 s .ft.
Full
N/A
Good
ha no air
Insul.Wind
None
Porch
Std.Kit -6 300
2 000 1 426 s .it.
Full
N/A
Good
oho no air
Insui.Wind
None
Porch
Std.Kit -7 q5p
2 000
z
o.
v3,
rr
a
~ Net pd'ustment Total
Adjusted SalePdce
w of Com arables
a Summary of Sales Comparison Approach All th
~? general neighbofiood as the subject prope
+ - $ -8 000 + - $ _13347 + - $ -13 450
fJet 6.2% Net 9.9~ Ne( 111;3,%
Gross 9.2 ~% $ 122 000 ' Gross ;~-12:9 ~ $ 121 553 Groff .'13 4 % $ 116 550
ree sales would appeal to the same market as the subject property and are located in the same
rty These sales as well as other sales and current market offerinos were considered by the
T appraiser.
i
fE~
~.g,
~'.
~'
1'
Indicated Value Sales Com orison A roach S 118,000
R F~ ~ n F NT~ ~ ~ Copyd¢itd> 2007 by a la mode, inc. Tltis form may be reproduced umnad0ied wi0wul wdaen pelmisSlon, however, a la mode Inc. must be acWwvdedped and credited.
- - - -- -- ~ ~,~~ arnwc - rrm ~ u INL' appraisal sortware by a la motle, Inc. - t-800•ALAMODE 3/2007
RESIDFNTIaI ~Pt~Re1Ce~ c~~nnnnwnva~a-_nr.r.T
~~ COST APPROACH TO VALUE it develo ed The Cost A roach was not develo ed for this a raisal.
P
rovide adequate Imotmatlon for replication of the following cost figures and calculations
' ~ Support for the opimon of site value (summary of comparable land sales ar other methods for estimating stte value):
f
~~
ESTIMATED REPRODUCTION OR REPLACEMENT COST NEW OPINION OF SITE VALUE.._._............_.._._ ......
_$
Source of cost data: ...................._........
DWELLING S .Ft. $
_$
o Qual ratio from cost service: Effective date of cost data:
a C
C _.
S .Ft @ $ _ _ _$
omments an
ost Approach (gross living area cakulatlans, depreclatlon, etc.):
n;, S .Ft. $ _ __ _$
a' S .Ft. $ _ _ _$
o _ Sq.Ft @ $ a$
V . _$
G e/Ca r. S .Ft $ .. _$
Total Estimate of Cost-New __ .g
Less Ph sical Funedonal External
+
~ De reciation =$
De reclatetj Cost of Im rovemems
Y ° "As•Is" Value of Stte Im rovements -......._ ......................... -$
_$
4
ti _$
r
Estimated Remains Economic Life fl re aired : 40 Years INDICATED VALUE BY COST APPROACH -____
s
____________________________
INCOME APPROACH TO VALUE if devel ed The Income roach was not develo ed for this ralsal.
a ' Estlmakd Monthl Market Rent $ X Gross Rem Mufti Iler = $ Indicated value b Income roach
a Summary of Income Approach (ncluding support far market rent and GRM):
a
Q
it l
~
b '
U
'. . PROJECT INFORMATION FOR PUDs H a liable The Sub' ct is art of a Planned Unit Developmem.
:< , Le al Name of Pro ct
o Describe common elements and recreational facilities:
a
k.
~
' Indicated Value by: Sales Comparison A proach $ 118 000 Cost Approach (if developed) $ Income Approach (it developedf $
Flnal Re
ili
ti
k; conc
a
on Principal weight is given to the sales approach which indicates what buyers and sellers are doing in the marketplace after
:x negoiating for similar tugs properties
z
O
F-
Th)s appraisal is made "as Is", subject td completion per plans and specifications on the basis of a Hypothetical Condition that the improvements have been
completed, ^ subject to the following repairs or alterations on the basis of a Hypothetical Condition that the repairs or alteratkns have been completed
^ subject to
Gz' ,
the following required inspection based on the Extraordinary Assumption that the condition or deficiency does not require alteration ar repair
U'
W .
~~
~ ]This re ort is also subect to other H othetical Conditions and/or Extradrdina Assumptions as s ecttied In the attached addenda
~~ `
' .
Based on the degree of inspection of the subject property, as indicated below, defined Scope of Work, Statement of Assumptions end Limiting Conditions
'
~ ,
and Apprelser
e Certifications, my (our) Opinion of the Market Value (or other specified value type), as defined herein, of the real property that is Ura subject
n
~; ` of this report Is: $ 118,000 as oY. June 22, 2009 ,which is the eikctive date of this appraisal
If indicated above
this Opinion of Value Is subject to Hy
othetical C
diti
d
E
,
p
on
ons en
/or
xtraordinary Assumptions included in this report See attached addenda.
F A ime and complete copy of this report contains 10 pages, including exhibits which are considered an Integral part of the report. This appraisal report may not be
w propedy understood without reference to the information comained in the complete report.
_ Attached Exhibits:
®Scope of Work ^ Limiting CondlCertitications ^ Narrative Addendum ~ PhotographAddenda ®Sketch Addendum
® Map Addenda ^ Additional Sales ^ Cost Addendum ^ Flood Addendum ^ Manuf
House Addendum
a .
H otheUcal Conditions ^ Extraordina Assam lions ^ ^
( Cliem Contact: Snelbaker & Brenneman Attny Client Name: Snelbaker & Brenneman, Attnv
E-Mail: NIA Address: 44 W. Main Street P.O. Box 316 Mechanicsbur PA 17055
APPRAISER SUPERVISORY APPRAISER Qf required)
or CO-APPRAISER (if applicable)
~. ,
w
~i
Appraiser Name: John D. Ausherman SRA Su ry
Co Appraiser Name:
Company: Ausherman Bros. Real Estate Inc. Company:
rn
Phone: 717 2646715 Fax: 717-264-4973 _
Phone: Fax:
E-Mail: TausherCa pa.net E-Mail:
Oak of Report (Signature): June 23 2009
License or Cartlficatl
# Date of Report (Signature):
on
: GA000148L Stak: pa License or Certrfication #: $~;
Designation: SRA OesignaUcn:
E>~iration Date of License or Certittcation: 6/30/2011 _
Expiration Date of License a Cemiica0on:
I nspection of Subject: ®Imertor& Exterior ^ Exterior Only ^ None Inspection of Subject: ^ Imedor A Fxterbr ^ Exterior Onty ^ None
_ Date of Inspection: June 22 2009 Date of Ins action:
!7'J R ~ C 1 f 1 G n~T~ e i CWYdAht® 2007 ay a la mode, Inc. This lorm may x reproduced unmaditied without wdaen permission, however, a la made, inc. must ice aclowxledaed and credited.
- --- -- -- - - -• -- ~~~~.. arnroc - -rrm ~ u i R~- appraisal sonware oy a la mode, Ina, --1-800-ALAMODE 312007
Subiect Photo Paae
Borrower/CNerd Estate of William L. A el Jr
Pro a Address 141 S Coldbrook Ave
CI Chambersbu Coun Franklin State Pa Z Code 17201-2713
Lender Snelbaker 8 Brenneman Attn
Subject Front
141 S Coldbrook Ave
Sales PdCe
Gross LMng Area 1,044
Total Rooms e
Total Bedroans 3
Total Ballrooms 1
Locatlon Resid/avg
View Average
Si[e 4,130Sq.Fi
Ouallty Alum/avg
Age 84
Subject Rear
Subject Street
Comparable 1
305 East McKinley Street
Rox. to Subject 0.68 miles W
Sales Rice 130,000
Gross lhdng Area 1,368
Total Rooms 6
Total Bedrooms 3
Total Bathrooms 1
Location Resid/evg
uew Average
9tte 3485 S.F
Quality Vinyllavg
Ape 75+
Comparable 2
1347 Alexander Avenue
Prox. to Subject 1.29 miles N
Sales Price 134,900
Gross Lihrg Area 1,380
Total Rooms 6
Toth Bedroans 3
Total Bathrooms 1
Location Resid/avg
View Average
Site 3920 S.F
oualtty Brick/sup
Ape 75+
Comparable 3
439 East King Street
Prox to Subject 0.58 miles NW
Sales Price 130,000
Gross Living Area 1,426
Total Rooms 6
Total Bedrooms 3
Total Bathrooms 2
Location Resid/avg
View Average
Site 3485 S.F
OualBy Vinyl/avg
Age 75+
e,...., o~ro„c ro n~n..rnTU .........~...i ..,«..M.., ~., . ~., «,,.~. i..,, ~ onn ni ~unno
Comparable Photo Pang
9.0'
9.0' o
6.0' `-
Porch 6.0'
00
vv
~~
6.0' b o
co ~
2nd floor
o
~ N
1 st floor ~
2.
0
N
2.
O
13.0'
13.0'
o 13.0' o
~ Porch ~
13.0'
eFW,bYOq"N*'
frorm SKT.BIdSW - "WInTDTAL" appraisal software by a la mode, inc. -1-800-ALAMODE
Buildinf5 SkniFrf6
Buildinn Sketch
AREA CALCULATIONS SUMMARY
Code Deaeription :.:.. NetSiza- NetTotala"
GL7~1 First: Floor 522.0 522
0
DI.A2 9ecottd Flooz 922.0 .
522.0
P/P Porch 84.0
Porch 91.0 175.0
Net LIVABLE Area (Rounded) 1044
LIVING AREA BREAKDOWN
~~ - Subtotsls.•
FiraG Fiooz
9.0 x 42.0 379.0
6.0 x 16.0 96.0
4.o x la.o as.o
Sacond Floor
19.0 x 16.0 240.0
9.0 x 14.0 126.0
12.0 x 13.0 156.0
6ltems (Rounded) 1044
First Floor GLA1 Second Floor GLA2
9.0 x 42.0
6.0 x 16.0 = 376.0
96
0 15.0 x 16.0 ~ 240.0
4.0 x 12.0 = .
18.0 9.0 x 14.0
12.0 x 13.0 126.0
156.0
Area total (Rounded) = 522 Area total (Rounded) = 522
Porch P/P Porch p/p
6.0 x 14.0 84.0 7.0 x 13.0 = 91.0
Area total (Rounded) = 84 Area total (Rounded) = 91
Form SKT.BIdSki -'WInTOTAL" appraisal software by a la mode, Inc. -1-800-ALAMODE
Neighborhood Map
Borrower IieM Estate of William L. Appel Jr
P Address 141 S Coldbrook Ave
Ci Chambersbu Cou Franklin State Pa ZI Code 17201-2713
Lender Snelbaker 8 Brenneman Attn
a to mode, tnc: ~,
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