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03-30-10 (2)
i i ~ 1505607121 "'-' REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of {ndividual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN 2 1 1 0 0 0 5 2 Harrisburg PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATfON BELOW Social Security Number Date of Death Date of Birth 1 7 7 2 4 6 9 3 9 0 1 0 1 2 0 1 0 0 6 D 6 1 9 2 8 Decedent's Last Name Suffix Decedent's First Name MI H U B L E Y J O H N E (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name H U B L E Y Spouse's Social Security Number FILL INAPPROPRIATE OVALS BELOW Suffix Spouse's First Name J A N E THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS M{ G Q 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate Q 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) Q 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 1 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 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 J O E L R Z U L L I N G E R 7 1 7 2 6 4 6 [~2 9 ~ ~ Firm Name (If Applicable) r- REGISTER O.S USE O~ _ , Z U L L I N G E R D A V I S P C i ~~ x~ ~ f I ~, -~ -' First line of address C"~, ~ ~~~, r, ~, 1 4 N O R T H M A I N S T R E E T ~ ~ ..~., <~ ', ~ ~ ~ Second line of address ~, ~» `T {. 7 ~ , ~ S U I T E 2 0 0 b ~ ` '> ~~~ ZIP Code t St rE FILED DA City or Post Office a e C H A M B E R S B U R G P A 1 7 2 0 1 Correspondent's, a-mail address: Under penalties of perjury, I dedare that I have examined this return, induding accompanying schedules and statements, and to the best of my knowledge and belief, it is true, co nd complete. eclaration of pre re r th the personal rep enta a ~s based on all information of which pn;parer has any knowledge. SIGNATll E OF ERS SPONS OR FI IN TURN i , ATE w ` O~Vt •- "" !~/ ADDRESS 2827 FAIRVIEW DRIVE CAMP HILL PA 17011 U OF PRE R T RES E .~ DATE .. O/d ADD 14 ORTH MAIN ST T, SUITE 2 CHAMBERSBURG PA 17201 PLEASE USE ORIGINAL FORM ONLY Side 1 1505607121 1505607121 ~ ~~ e s~ 15D5607221 REV-1500 EX Decedent's Social Security Number Decedent's Name: JOHN E• H U B L E Y 1 7 7 2 4 6 9 3 9 RECAPITULATION 1. Real estate (Schedule A) 1. 1 5 8 5 0 0. 0 0 ..................................... 2. Stocks and Bonds (Schedule B) .................................. 2. 1 2 7 1 1 5 4. 0 8 3. Closely Held Corporation, Partnership orSole-Proprietorship (Schedule C) ..... 3. 4. Mortgages & Notes Receivable (Schedule D) ........................ 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . ..... . 5. 1 D 6 0 1 . 9 8 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested . ..... . 6. 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested . ..... . 7. 4 9 4 8 6. 2 7 8. Total Gross Assets (total Lines 1-7) ..................... ..... . 8. 1 4 8 9 7 4 2. 3 3 9. Funeral E enses & Administrative Costs Schedule H xp ( ) .......... .... 9. .. 3 5 9 5 9. 4 2 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ...... ..... . 10. 3 1 7 1 . 8 4 11. Total Deductions (total Lines 9 A 10) ..................... .... .. 11. 3 9 1 3 1. 2 6 12. Net Value of Estate (Line 8 minus Line 11) ................... .... .. 12. 1 4 5 D 6 1 1 • 0 7 13. Charitable and Governmental Bequests/Sec 9113 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. 1 4 5 0 6 1 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.o _ 8 6 4 7 4. 5 3 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate x .oa5 1 3 6 4 1 3 6. 5 4 16. 6 1 3 8 6. 1 4 17. Amount of Line 14 taxable D D D D D D . at sibling rate X .12 17. . 18. Amount of Line 14 taxable 0 D ll 0 D 0 0 at co ateral rate X .15 18 • 19. Tax Due .......................................... .... ..19. 6 1 3 8 6. 1 4 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505607221 1505607221 REV~1500 EX Page 3 Decedent's Complete Address: File Number 21 10 0052 DECEDENTS NAME JOHN E. HURLEY STREET ADDRESS 621 Charles Street CITY Shi ensbur STATE PA ZIP 17257 Tax Payments and Credits: 1 • Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3,069.30 3. Interest/Penalty if applicable D. Interest E. Penalty (1) 61,386.14 Total Credits (A + B +C) (2) 3, 069.30 Total Interest/Penalty (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. (3) 0.00 (4) 0.00 (5) 58,316.84 (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) 58, 316.84 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, benefits or care? ....................................................... ^ 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... ^ ^X 3. Did decedent own an "intrust for" or payable~upon death bank arx:ount or security at his or her death? ......... ^ ~]C 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .................................................................................................. X^ ^ 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)]. 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-0ne 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)j. 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}]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV~1562 EX + (g-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE FILE NUMBER JOHN E. HUBLEY 21 10 0052 All real property owned soley or as a tenarrt in common must be reported at fair market value. Fair market value is defined as fhe price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real orooerty which is lointhr-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Tract of real estate situate in the Borough of Shippensburg, Cumberland County, 158,500.00 Pennsylvania, being known and numbered as 621 Charles Street, Shippensburg, Pennsylvania, appraised by Tim L. Ausherman, with copy attached TOTAL (Also enter on line 1 /If mnro en~nn ie nm~lnrl ineeh ~rliliFinnfll e6nnle of s6., ~.,.......t-..~ a REV~1503 EX + (8-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER JOHN E. HUBLEY 21 10 0052 All property jointly-owned with fight of survMorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 39.0787 shares common stock Spectra Energy Corp. @20.67 per share 807.75 2. 76.123 shares common stock BP p.l.c. @58.74 per share 4,471.46 3. 438.125 shares common stock The. Procter & Gamble Co. @61.00 per 26,725.62 share 4. 81.4309 shares common stock Duke Energy Corp. @17.22 per 1,402.24 5. Vanguard Account #0040/09936093797, consisting of Vanguard 500 Index 7,799.84 Fund 75.970 shares @102.67 per share 6. Merrill Lynch Account#697-11284, including accrued interest and dividends 929,004.26 to date of death 7. Ross Sinclaire & Associates (formerly Commonwealth Securities & Investments, Inc.) 300,942.91 Account #3kw-401479, including interest/dividends to date of death, valuation attached . I• TOTAL (Also enter on line 2, Recapitulation) (S 1 271 154.08 - /IF ..+w.n enenn ie nndleil inenA ~~I~iiHnnel el~mM of fMn es.r.e ~i-n~ RE~ 1508 EX + (6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. IN RESIDENT DECEDENT N PERSONAL PROPERTY ESTATE OF FILE NUMBER JOHN E. HUBLEY 21 10 0052 Include the proceeds of litigation and the date the proceeds were received by the estate. All properly jolnUyowned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Personal property of John E. Hubley, appraised by Carl E. Ocker, with 2,637.00 copy attached 2. Checking Account #97316067, M&T Bank 274.03 3. Dividend from Commonwealth Securities & Investments, Inc. by check 1,464.97 dated 12/16/2009, deposited to estate after death 4. Dividend from Canda Life on Whole Life Policy #953184 by check 38.90 dated 12/4/2009, deposited to estate after death 5. Refunds from Highmark Blue Shield 2,643.08 6. U.S. Treasury, 2009 income tax refund 3,544.00 TOTAL (Also enter on line 5, Recapitulation) + $ 10 601 98 of ~ cnece is needed. insert additional sheets of the same size) REV 1510 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER JOHN E. HUBLEY 21 10 0052 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIDNSHIP TO DECEDENT AND THE DATE OF TRANSFERATTACHACDPYDFTHEDEEDFDRREALESTATE DATE OF DEATH VALUE OF ASSET °~o OF DECD'S INTEREST EXCLUSION pFAPPUCAeLE~ TAXABLE VALUE 1. Account #00000011432892864002, Ameriprise Financial, 49,486.27 100. 49,486.27 consisting of 13267.096 shares @3.730, named beneficiaries in equal shares to John Michael Hubley and Joseph Daniel Hubley, sons of decedent TOTAL (Also enter on line 7 Recapitulation) ~ 3 49 486.27 -- -- - - - - - -. ns __... ~........ :-. ..mdeel ineeA sridifinn~l ehmla of 41w eflmn ehnl REV-1511 EX+(10-08) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER JOHN E. HUBLEY 21 10 0052 Debts of decederH must be reported on Schedule L ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Fogelsanger Bricker Funeral Home, funeral expenses 11,597.49 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Street Address City State Zip Year(s) Commission Paid: 2, Attorney Fees Joel R. Zullinger 3, Family Exemption: (If decedents address is not the same as claimant's, attach explanation) Claimant 4. 5. 6. 7. 8 9 Street Address City State Zip Relationship of Claimant to Decedent Prolate Fees Letters - 810.00; will -15.00; short certificates - 28.00; JCS fee 23.50; automation - 5.00; additional probate fee - 100.00; filing return 15.00 Accountant's Fees Tax Return Preparers Fees Ausherman Bros. Real Estate, appraisal of real estate Timmons Oil, fuel oil for residence Carl E. Ocker, appraisal of personal property 22,500.00 981.50 300.00 430.43 150.00 TOTAL (Also enter on line 9, Recapitulation) I S ~~ ece ~~ (If more space is needed, insert additional sheets of the same size) REV-1512 EX + (12-03) SCHEDULE 1 COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT f ESTATE OF FILE NUMBER JOHN E. HUBLEY 21 10 0052 Report debts incurred by the decedent prior to death which remained unpaid as of tl1e date of death, Including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Comcast, cable service due at death 63.67 2. Century Link, telephone service due at death 25.16 3. Verizon, cell phone service due at death 4. Borough of Shippensburg, water and refuse service due at death 5. Penelec, utilities due at death 6. Timmons Oil, fuel oil due at death 7. Zullinger-Brenize, lawn maintenance and snow removal due at death 8. Erie Insurance Group, homeowner's insurance due at death 9. PA Department of Revenue, PA 40 income tax due for 2009 10. Chambersburg Imaging, medical services due at death 11. Family Home Medical, medical services due at death 12. Grace Keiter, Tax Collector, borough and county real estate taxes due at death 84.56 194.26 77.75 505.96 150.00 426.00 689.00 8.84 14.76 931.88 TOTAL (Also enter on line 10, Recapitulation) I $ (If more space is needed, insert addfional sheets of the same size) REV-1513 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT SCHEDULE) BENEFICIARIES ESTATE OF FILE NUMBER JOHN E_ HUt31 FY ~~ ~n nnc~ RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include out ~ spousal distributions, and transfers under Sec. 9116 a 1.2 1. Jane G. Hubley, 621 Charles Street, Shippensburg, PA 17257 Spousal 86,474.53 life estate in real estate 28,474.53 life interest in trust under will 58,000.00 2. John M. Hubley, 2827 Fairview Road, Camp Hill, PA 17011 Lineal 682,068.27 1/2 remainder interest in real estate 65,012.73 1/2 remainder interest in trust underwill 71,000.00 1/2 residue of estate 546,055.54 Lineal 3. Joseph D. Hubley, 9999 McCreary Rd.,Shippensburg, PA Lineal 682,068.27 1/2 remainder interest in real estate 65,012.74 1/2 remainder interest in trust under will 71,000.00 1/2 residue of estate 546,055.53 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: L A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET S fir more space Is neeaea, insert atloitlonal sheets of the same size) 12EV-1514 EX + (12-03) COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT SCHEDULE K LIFE ESTATE, ANNUITY & TERM CERTAIN ESTATE OF FILE NUMBER JOHN E. HUBLEY 21 10 0052 This schedule is to be used for all single life, joint or successive life estate and term certain calculations. For dates of death prior to 5-1-89, actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit. Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death from 5-1-89 to 4-30-99, and in Aleph Volume for dates of death from 5-1-99 and thereafter. Indicate the type of instrument which created the future interest below and attach a copy to the tax return. ® Will ^ Intervivos Deed of Trust ^ Other NAME(S) OF LIFE TENANT(S) DATE OF BIRTH • DATE OF DEATHT LIF TERM OF YEARS E STATE IS PAYABLE Jane G. Ruble 1/12/1927 83 ®Life or ^Term of Years ^ Life or ^Term of Years ^ Life or ^Term of Years ^ Life or ^Term of Years ^ Life or ^Term of Years 1. Value of fund from which life estate is payable,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,$ 158,500.00 2. Actuarial factor per appropriate table ................................................ 0.17965 Interest table rate - ^3 1/2% ^ 6% ^ 10% X^Variable Rate 3.00 % 3. Value of life estate(Line1multipliedbyLine2) ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,$ 28,474.53 NAME(S) OF LIFE ANNURANT(S) DATE OF BIRTH . ~ DATE~OF DEA HT ANNUITY IS.PAY~S ABLE ^ Life or ^Term of Years ^ Life or ^Term of Years ^ Life or ^Term of Years ^ Life or ^Term of Years 1. Value of fund from which annuity is payable ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,$ 2. Check appropriate block below and enter corresponding (number) , , , , , , , , , , , , , , , , , , , , , , , , , , , Frequency of payout - ^ Weekly (52) ^ Bi-weekly (26) ^ Monthly (12) ^ Quarterly (4) ^Sgimi-annually (2) ^ Annually (1) ^ Other ( ) 3. Amount of payout per period ...................................................... $ 4, Aggregate annual payment,Line2muftipliedbyLine3 ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 5. Annuity Factor (see instructions) Interest table rate - ^ 3 1 /2°k ^ 6% ^ 10% ^ Variable Rate 6. AdjustmentFactor(seeinstructions),,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 7. Value of annuity - If using 3 112%, 6%, 10%, or if variable rate and period payout is at end of period, calculation is: Line 4 x Llne 5 x Line 6 ...........................$ If using variable rate and period payout is at beginning of period, calculation is: (Line4xLine5xLine6)+Linea,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,$ NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through G of this tax return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on Lines 13 and 15 through 18. (If more space is needed, Insert additional sheets of the same size) Annuity, Life Estate, and Remainder Factors 3/24/2010 Transfer Date: 1/2010 §7520 Rate: 3.00% Calculation Type: Life Principal: $158,500 Lives: 1 Ages: 83 Life Estate Remainder Factor: 0.17965 0.82035 Value: $28,474.53 $130,025.47 REV-1514 EX + {12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT esrwre vF FILE NUMBER JOHN E. HUBLEY 21 10 0052 This schedule is to be used for all single life, joint or successive life estate and term certain calculations. For dates of death prior to 5-1-89, actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit. Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death from 5-1-89 to 4-30-99, and in Aleph Volume for dates of death from 5-1-99 and thereafter. Indicate the type of instrument which created the future interest below and attach a copy to the tax return. ® Will ^ Intervivos Deed of Trust ^ Other NAME(S) OF LIFETENANT(S) DATE OF BIRTH DATE OF DEA HT LIFETfi:RM OF YEARS ESTATE IS PAYABLE Jane G. Ruble 1/12/1927 83 ®Lrfe or ^Term of Years ^ Life or ^ Term of Years ^ Life or ^ Term of Years ^ Life or ^Term of Years ^ Life or ^Term of Years 1. Value of fund from which life estate is payable ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,$ 200,000.00 2. Actuarial factor per appropriate table,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 0.17965 Interest table rate- ^3 1/2% ^ 6% ^ 10% X^Variable Rate 3.00 % 3. Value of life estate(Line1multipliedbyLine2) ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,$ 35,930.00 NAME(S) OF LIFE ANNUITANT(S) DATE OF BIRTH . ~ DA E OF DEATHT AN UITY~S PYA RS YABLE ^ Life or ^ Term of Years ^ Life or ^ Term of Years ^ Life or ^ Term of Years ^ Life or ^ Term of Years 1. Value of fund from which annuity is payable ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,$ 2. Check appropriate block below and enter corresponding (number) , , , , , , , , , , , , , , , , , , , , , , , , , , , Frequency of payout - ^ Weekly (52) ^ Bi-weekly (26) ^ Monthly (12) ^ Quarterly (4) ^Serni-annually (2) ^ Annually (1) ^ Other ( ) 3. Amount of payout per period ......................................................$ 4, Aggregate annual payment,Line2muftipliedbyLine3 ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 5. Annuity Factor (see instructions) Interest table rate - ^ 3 1/2% ^ 6% ^ 10% ^ Variable Rate 6. AdjustmentFactor(seeinstructions),,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 7. Value of annuity - If using 3 1 /2%, 6%, 10%, or if variable rate and period payout is at end of period, calculation is: Line 4 x Line 5 x Line 6 ......................... . .$ If using variable rate and period payout is at beginning of period, calculation is: (Line4xLine5xLine6)+Linea,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,$ SCHEDULE K LIFE ESTATE, ANNUITY & TERM CERTAIN heck Box 4 on Rev-1500 Cover Sh NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through G of this tax return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on Lines 13 and 15 through 18. (If more space is needed, insert additional sheets of the same size) Annuity, Life Estate, and Remainder Factors 3/24/2010 Transfer Date: 1/2010 §7520 Rate: 3.00% Calculation Type: Life Principal: $200,000 Lives: 1 Ages: 83 Life Estate Remainder Factor: 0.17965 0.82035 Value: $35,930.00 $164,070.00 REV-1647 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT OF SCHEDULE M FUTURE INTEREST COMPROMISE Cover FILE NUMBER JOHN E. HUBLEY 21 10 0052 This Schedule is appropriate only for estates of decedents dying after December 12,1982. This schedule is to be used for all future interests where the rate of tax which will be applicable when the future interest vests in possession and enjoyment cannot be established with certainty. Indicate below the type of instrument which created the future interest and attach a copy to the tax return. ^X Will ^ Trust ^ Other I. I Beneficiaries NAME OF BENEFICIARY I RELATIONSHIP I DATE OF BIRTH I ~~~~~ ACE TO u^AV ~• Jane G. Huble souse 1/12/1927 83 2. 3. 4. 5. II. For decedents dying on or after July 1,1994, if a surviving spouse exercised or intends to exercise a right of withdrawal within 9 months of the decedent's death, check the appropriate block and attach a copy of the document in which the surviving spouse exercises such withdrawal right. ^ Unlimited right of withdrawal ^ Limited right of withdrawal III. Explanation of Compromise Offer: In paragraph II of his will, the decedent gives a life estate to his surviving spouse, Jane G. Hubley, to reside in the real estate located at 621 Charles Street, Shippensburg, Pennsylvania. In paragraph III of his will, the decedent gives the sum of $200,000.00 cash to his sons, John M. Hubley and Joseph D. Hubley, to be held in trust for the maintenance of the real estate at 621 Charles Street, Shippensburg, Pennsylvania, as well as payment for the cost of homeowners' insurance, real estate taxes and heating of the home during the term of the life interest of his wife, Jane G. Hubley. The life expectancy of Jane G. Hubley is 7 years. The value of her life estate is $37,910.00, which is taxable for inheritance tax purposes at the spousal rate of -0-%. The value of the remainder interest is $162,090.00, which is taxable for inheritance tax purposes at the lineal rate of 4.5%. The dwelling at 621 Charles Street, Shippensburg, Pennsylvania was built in 1958. The age of the furnace and roof is 20 years. The dwelling needs painted. The dwelling is heated with fuel oil. The following expenses will be Continued on a Separate Page IV. Summary of Compromise Offer: 1. Amount of Future Interest .................................................. $ 200,000.00 2. Value of Line 1 exempt from tax as amount passing to charities, etc. (also include as part of total shown on Line 13 of Cover Sheet) ...... $ 3. Value of Line 1 passing to spouse at appropriate tax rate Check One ^ 6°k, ^ 3~, ©0% ................ $ 58,000.00 (also include as part of total shown on Line 15 of Cover Sheet) 4. Value of Line 1 taxable at lineal rate Check One ^ 6%, ®4.5% ...................... $ 142,000.00 (also include as part of total shown on Line 16 of Cover Sheet) 5. Value of Line 1 taxable at sibling rate (12°~) {also include as part of total shown on Line 17 of Cover Sheet) ...... $ 6. Value of Line 1 taxable at collateral rate (15°~) (also include as part of total shown on Line 18 of Cover Sheet) ...... $ 7. Total value of Future Interest (sum of Lines 2 thru 6 must equal Line 1) ..................... $ 200,000.00 (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent JOHN E. HUBLEY 21 10 0052 Decedent's Name Page 1 File Number Schedule M -Future Interest Compromise - Ilt. Explanation of Compromise Offer incurred by the trust during the 9 year life expectancy of the surviving spouse: New roof and furnace Paint dwelling, twice during life expectancy Fuel oil costs $1,705.38(current for 2009/10) x 7 Homeowners' Insurance 426.00(current 2010) x 7 Real estate taxes 2,786.88(currentfnr 2009/10) x 7 Total 15, 000.00 10,000.00 11, 937.66 2, 982.00 19.508.16 58,427.82 The trust assets cannot be invested in stock as the assets need to be protected to insure that monies are available to maintain the home for the benefit of the surviving spouse. Current interest rates are at best 1-1/2%. Taking into account all of the above, the estate is proposing that the life estate of the surviving spouse be valued at $58,000.00 and the remainder interest be valued at $142,000.00. Life Expectancy 3/24/2010 Age of Person 1 (to nearest birthday): 83 Individual Statistics Your Additional Life Expectancy (Yrs.) Should Be: 7.0 Your Age at Life Expectancy Should Be: 90.0 The Probability of Living to Life Expectancy is: 44.856% The Median Age of Death for Your Current Age is: 89.3 Probability You Will Live to Median Age of Death: 52.070% Your Median Age of Death Minus Your Life Expectancy: -0.7 e JRZ - S.l hubley.l September 18, 2608 L•A.$T WILL AND TESTP.~IENT ~, heretofore made . ``~~ ~ - _ c._. ~, " --; ~ _ - .. --i ~ i - ~~ -cCL L'L~aL =__~ ~'i1V ~i:.S'- -.=utS end =1~T1~~-~ ~ ~ p~n,~s i 17r11~d1_!Q ?- I i ==-~j`1"!~=_.~ ~~ 71 _L% 1,~Sr _l i n,:ec ,~rlall __.- 'Ja=C! --C'i1 -~1": I, John E. Hubley, of 621 Charles Street, Shippensburg, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby declare this to be my will, hereby -revoking any and all former wi 1ls and codicils thereto by me " _ .Stag= ~= .-~iGll ~~~ ~raCt=cable eft.-= -rl'.; ucC~c1-.S° =~5 =. ^a~t ~r -~G ~~ - =' e_ tense of the actmi r_istrution of m~.% =stet= . II. ~~ In the event m - wife Jane G. Huble ~ y y, is living at the time of ~.! \~~my death and we are residing together as husband and wife at the time of my death, she shall have the right to reside in my -real estate located at 621 Charles Street, Shippensburg, Cumberland County, Pennsylvania, for and during the term of her natural life, subject, however, to immediate termination of this life interest upon her remarriage or cohabitation with a member of the opposite sex. While my wife resides in my property, she shall be responsible for the payment of the cost of snow removal, lawn maintenance, and all utilities. Upon the death of my wife or if she permanently discontinues residence in my property, her life interest shall be terminated. My wife shall not be permitted to sublet the property. At any time upon the termination of my wife's life interest for any reason, my property shall be sold and the proceeds divided in accordance with the provisions of this will concerning the residue of my estate. IIT. ~\ gi-.%.~ the sum ~~f 5200 ; 000 . ~~~ cash to my sons, John M. Hub1eV - - and J ose~~i-~ D . Hub1e-_% =i~ -~ RUST r.~~~~.fBR1'HELESS . =or th.e roll oC,,,; nc, ASKS =iiU parr"~SCS ~_~r_en.~ so ~zuc:~ ~f ~h= pri n~:, pal ~_z,-~ -~,conie w_ -,~-- ~''! , _ i t~ S - -nei " =~~! ~.i srret~ O_ ~eeiil w~.,i~rOiJ_.at f' ' t~ repairs and maintenance of rely real estate at 21 Charles 3 Street, Shippensburg, Pennsylvania, as well as she pay-[Went of the cost of homeowners' insurance, real estate J taxes and heating the home during the term of the life interest in said real estate for my ;wife, Jane G. Hubley, as defined herein. B. At the termination of the life interest, this trust shall terminate and the remaining principal and income shall be distributed under the terms of paragraph IV hereunder. Page 2 IV. I give, devise and bequeath the residue of my estate of every nature and wherever situate to my children, John M. Hub ley and Joseph D. Hubley, in equal shares, provided that the share of any child who predeceases me or dies on or before the thirtieth day following my death shall be distributed to my other child. V. ~n~- f i duci ar_y under this iai11 shall have the ~ ollovai ng ~ovaers in addition to those vested in them by law and i~v other provls~OnS ~~ .~i;:- -,fi 1 1 a~J?J1i ~,=_i~l e tv^ ~ i ~ _~rOpert_ 'i7.rletne?_ -Oi~ir1C_L~%a l ~~~ _i7~~~Y~; y_~i~! 1„i ;~-=^!"~ J ~^'.J"..'`.= l,_ 1 ~1`~ _~' f~ ,tiinor,~ -___r~l=a1~1-7 nil Ls (~!1N% ~y~r'~l1Tr ~~~-'i-G~'~1~ ~~Q ~--~~~?-..i= ~.~i_t'i .-i i~tilal ~"1l jl.,r lJi.~. ~~~!~J 1~ t~1 ~.I .l.. ~''.t ~ Cdr''. _-. To -etaz_~ an_~ and all of the assets of m~% estat~, meal 'ter personal, without regard to any principle of diversification of risk. B. To invest in all forms of property including stock, common trust funds and mortgage investment fur_ds without restriction to investments authorized for Pennsylvania fiduciaries as they deem proper, without regard to any principle of diversification of risk. C. To sell at public or private sale, to exchange or to lease for any period of time any real or personal property and to give options for sales, exchanges or Page 3 r leases, for such prices and upon such terms or conditions as they deem proper. D. To allocate receipts and expenses to principal or income or partly to each as they from time to time think proper. E. To compromise any claim or controversy. F. To distribute in cash or in kind or partly in each. G. To hold property in their names without designation of any fiduciary capacity- or in the name of a nominee or unregistered. VIo 1 ~1tcCt =r!a+~ ~1l ~a=-=S '-1_~~t -tta-r 1J~ wS5~SS2C~ ii: ~OZ1S~~'1~'1=C~ O~ -lt-,' ~'=di.i1 ~~?~ ~ici__--~Y '~"t?.LU.I^~ 7i7C7 iJ;,' .r1i'lc_tc',-=- ~11=~1 Cf7i r'i-;-C?,_ -~t1~OS=~ , nal 1 '~~c U,~1~,:i =rOrt !~_' -,-C._1~:!1_i~.r_- ~St~t~ ~.~ ~ '~=~i_'`, ~- -~'= _--!.-:"?t= .._ ~r~E ?dminlSt'r~t1O?-1 OL ;Tl'v .5~~=~_~. VII. I appoint my sons, John ~. Hub ley and Joseph D. Hubley, as co-executors of this my will. VIII. No bond shall be required of any fiduciary hereunder in any jurisdiction. Page 4 IN WI'I'PIESS s~JF3ERE0~', I hereunto set my hand and seal to this my last will and testament, consisting of six typewritten pages, the first four of which bear my signature in. the margin for the purpcse of identification this ~_~ay of ~~~~~~,~~~ 2 ®o (SEAL) Signed, sealed, published and declared by the above-named testator as and for his last will and testament in our presence, who in his presence, at his request and in the presence of each other have hereunto set our hands as attesting witnesses. ./~~i 1 ~ r i ' r ~- ~ r n / / p 7..~ ~i / ~ ~ 'L_~ ~,: 1_,`.'`~ ~~ l ~ ~ ( .1~.' I, j._ !~/ ? (./ ~f ~f ; f P~;l'~~~ ~~. ~%C `f ~~ / 1, ~_ L. , i, r _ i ~~ L~r, _. ~ ;~~, e;~'!`x~: ®. ~~.",a~,1 yr'r I -_ ~ (fl :nom _~--_ - ~~~l~; ~iCti r-- ~,i- ' /~L tl the ~_eStatOr anC~ she -tii tnesSc~. _ec,~,~eCt~ 'Te j _-, whose names a-re signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument as his last will and testament and that he executed it as his free and voluntary act for the purposes therein expressed and that each of the witnesses, in the presence and hearing of the said testator signed the will as witnesses and to the best of their knowledge said signer was at that time eighteen years of age or older, of Page 5 sound mind and under no constraint or undue influence. Subscribed, sworn to and acknowledged before me by the above-named signer and subscribed and sworn to beforei~y the above-na ~ witnesses this }~ d~.-y of !~~. ~, ~~ `"~ Notary aubli c 4 ~'otari~J S~~! i n,.r_ 9 ...~IC`yia~i~~'.:'G LOCO ~i~e~\.i!.~} rG~~.?`lf 9 Page 6 SUMMARY OF SALIENT FEATURES Subject Address 621Charles Street Legal Descdptlon Dead Book Vol. 18Z page OD315 City Shippensburg County Cumberland Stare Pa Dp Code 17257 Census Tract 0132.D0 Map Reference 25420 Sale Pdce S n/a Date of Sale N/A Borrower Estate of John E. Hubley Lender/Client Joel R Zullinger Attorney Size (Square Feet) 1,566 Pdce per Square Foot $ , Location Good Age 51 Conditlon Average Total Rooms 6 Bedrooms 3 Baths 1.5 Appraiser Tim L Ausherman GAA Date M Appraised Value 1/1/2010 OpinionMValue S 156,500 Form SSD2 -'WInTOTAI' appraisal software by a la mode, inc. -1-BOO-ALAMODE Ausherman Bros. Real Estate Inc. APPRAISAL AND REPORT IDENTIFICATION this Appraisal Report is 9D@ of the following types: ^ Self Contained (A wdtten report prepared under Standards Rule 2-2(a) , persuant to the Scope of Work, as disclosed elsewhere in this report.) ®Summary (A wrffien report prepared under Standards Rule 2-2(b) , persuant to the Scope of Work, as disclosed elsewhere in this report.) ^ Restricted Use (A written report prepared under Standards Rule 2-2(c) , persuant to the Scope of Work, as disclosed elsewhere in this report, restricted to the stated Intended use by the specified client or intended user.) Comments on Standards Rule 2-3 I certify that, to the best of my knowledge and helief: -the statements of fact contained in this report are true and coned. -the reported analyses, opinions, and conclusions are IlmiNd only by the reported assumptions and limitlng condiAons and are my personal, impartial, and unbiased professional analyses, opinions, and conclusions. - I have no (or the specified) preserd or prospectlva interest in the properly that is the suh~ect of this report and no (or the specified) personal irderest with respect to Na ponies involved. - I have no bias with respectto the property that is the subject of Nis report or to the paNes invelved wdh this assignmerd. - my engagement in Nis assignment was not contingent upon developing or repartlng pradetennined results. - my compensation tar completing Nis assignment is not contngent upon the development or reporting of a predetermined value or direction in value that favors the cause of the client, the amount of Ne value opinion, Ne attainment of a stipulated result, or the occunence of a subsequerd event directly related to the intended use of this appraisal. - my analyses, opinions, and conclusions were developed, and Nis report has been prepared, inconformity with Ne Unflorm Standards of Professional Appraisal Practice. - I have (or have not) made a personal inspection ci the property Nat Is the subject of Nis report. (g mom than one person signs this certification, Ne certigcation must cleady specify which individuals did and which Individuals tlItl not make a personal Inspection al Ne appraised property.) - nc one provided significant real property appraisal assistance to the person signing this certdication. (If there are exceptions, Ne name of each individual providing sign'rficant real property appraisal assistance must he stated.) Comments on Appraisal and Report Identification Note any USPAP related issues requiring disclosure and any state mandated requirements: APPRAISER: n~ Signature: Name: Tim L ~ Date Signed: J a OB 2010 State CertiBcatflin #: GA000149L or State License #: State: PA Expiratbn Date of CeNfication or License: 6/30/2011 Eflectrve Date of Appraisal: 1/1/2010 SUPERVISORY APPRAISER (only U required): Signature: Name: Date Signed: State Certlfication #: - or State License #: State: Expiratlan Date of CertiHcatlon or Lcense: SupeMsory Appraiser inspection of Subject Property: ^ Did Nat ^ Exterior-ordy from street ^ Inteda and Extedor Form IDO6 -'WInTOTAL• appraisal soitware by a la mode, inc, -1-800-ALAMODE RESIDENTIAL APPRAI~ Ausherman Bros. Real Estate Inc. SUMMARY REPORT Census Intended Use: Fee Location: Urban Suburban ^ Rural Predominant One-Unit Housing Present Land Use Change in Lantl Use Built up: ®Over 75% ^ 25-75% ^ Under 25% ~u~n~ PRICE AGE One-Unh 90 % ®Not Likely Growth rate: ^ Rapid ®Stable ^ Slow ®Owner 95 $(000) (yrs) 2-0 UnR % ^ likely • ^ In Process Property values: ^ Increasing ®Stable ^ Declining ®Tenant 5 75 Low 10 MuIG-Unit % ' To: Demand/suppty: ^ Shortage ®In Balance ^ Over Supply ®Vacant (O-5%) 350 Hi h 160 Comm'I % Marketing time: ^ Under 3 Mos. ®3-6lvlos. ^ Over 6 Mos. Vacant > 5% 150 Pred 75 vacant 10 % Market Area Boundaries, Description, and Market Conditlons (Including support torthe above characteristics and trends): Bounded by Earl St to the west Walnut f Zoning Classdlcation: Residential uescnpoon: rtesrgenuat use Zonin Com liance: Le al ^ Le al noncontormin randtathered ^ Ills al No zonin ' Are CCBRs a licable? ^ Yes No Unknown Have the documents been reviewed? ^ Yes No Ground Rent 'rf a licable $ I ,, i Highest & Best Use as improved: ®Preserd use, or ^ Other usa (explain) Actual Use as of Effective Date: Residential use Use as appraised in this report: Residential Use Z Summary of Highest & Best Use: Highest and best use presently is a single family home O F a U Utllttks Public Other Provider/Description ON-alts Improvements Type Public Private Topography Level W Electricity ® ^ Street Asphalt _ ® ^ Size typical 4_?I; Gas ® ^ Curb(Gutter concrete ® ^ Shape rectangular Water ® ^ Sidewalk concrete _ ® ^ Drainage adequate rn Sanitary Sewer ® ^ Street Lights street ® ^ Vlew Average Storm Sewer Alle none Other stte elemerds: Inside Lot Comer Lat Cul de Sac Unde round Utilities Other describe FEMA S 'I Road HazaN Area Yes No R:MA Flood Zone X Fl:MA M # 4204tC0342E FEMA M Date 3/16/2009 "' Stte Commends: Site is rectangular in shape ;~ General Description Exterior Daaeriptlon Foundation Basement Nane Heating Hot water # of Units 1 ^ Acc.Untt Foundation Block/av Slab none Area Sq. Ft. 1 566 Type Hot water a'3 # of Stories 1 Exterior Walls Brk & Fr/av Crawl Space none % Flnished 50 Fuel oil Type ®Det ^ Att. ^ Roo1 Sudace as haltlav Basement full Ceiling tits Design (Style) ranch Gutters & Dwnspts. alum/av Sump Pump ^ Walls anel Cooling ac ®Exlsting ^ Proposed ^ Und.Cons. Window Type Double Hun av Dampness ^ floor c t Central yes Actual Age (Yrs.) 51 StomVScreens insul wind/av Battlement noneobs Outside Entry es Other EBective A rs. 20 Irtlestatron None obs ~ Im~lorDascriptlon Appliances Atlic ^None Amenttk+s Car Storage ^ None Floors C t viNa Refrigerator ~ Stairs ^ Flreplace(s) # _ t Woodstove(s) # Garage # of cars ( 2 Tot.) Walls loafer/ Dori Range/Oven ® Drpp Stair ® Patio none Attach. .°~, TdMRnish wood/a Disposal ® Scuttle ^ Deck None Detach. ~ Bath Floor Vn Ua Dishwasher ® Doonvay ^ Parch screen porch Bit: In },. Bath Wainscot fibs lash Fan/Hood ^ Floor ® Fence none Carport 2 ~ Dcors wood/a Microwave ^ Heated ^ Pool None Driveway WasheryD r Flnished Surtace as haft ~ Rrtished area above a coMalns: 6 Roans 3 Be drooms 1.5 Baths t 566 S uare feet of Gross Livin Area Above Grade p h. Additlonal features: Brick exterior fireplace in living room screened rear porch 50% of basement is finished. _ C. V w Describe the condition of the property (including physical, functional and external obsolescence): Overall conditipn is average no adverse factors were ~~ ~ m R ESI D E NTIAL CapyrlphlO 2007 by a to mode, Inc. This farm maybe repraducw umgdl0ed wltlau[ wrltlan pemxssloa however, a la mode, h¢. must 6e aeknawbdped and aredlred. Form GPRES2 -'WInTOTAL' appraisal software by a la mode, inc. -1-800-ALAMODE 3/20f17 C?~CIEI~IUTie1 eDDRAICeI SI IMMeRY RFPART 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 : Cumberland Coun Courthouse o' 1st Prior Sub ect Sale/Trensfer Anatysis of sale/bansferhistory and/or any currerd agreemerd of saleAlsting: The subied orooerN has not transferred Date: N/A wtthin the oast three veers Comparables sales have not sold 12 months prior to current sale. ~ ut Pdce: N/A Sources :Courthouse w 2nd Pdor Sub ect Sale/Transfer Date: ~ Pdce: Sources : I SALES COMPARISON APPROACH TO VALUE K d evelo The Sales Cam adson A roach was nol develc ed for this sisal. FEATURE SUBJECT COMPARABLE SALE # 1 COMPARABLE SALE # 2 COMPARABLE SALE # 3 '" Address 621 Charles Street Shi ensbu Pa 17257 623 Brenton St Shi nsbu Pa 17257 626 Glenn St Shi ensbu 140 Park Place East Shi nsbur Pa 17257 ~' Proxl to Sub'ect 0.17 miles S 0.08 miles SE 1.92 miles VV Sale Price $ n1a `. ; $ 155,000 ~ ^ $ 170 000 ~~~. ~ $ 175 000 Sale Pdce/GLA $ /s .tt. $ 106.2415 .tt. - ! ~ 3 73.3a /5 .ft .t ` $ 1 D7.10 /s .tt, DataSouroe s Ins coon MLS MLS MLS ' / Verhicatlon Sources Courthouse Courthouse Courthouse Courthouse VALUE ADJUSTMENTS DESCRIPTION DESCRIPTION + - $ Ad'ust DESCRIPTION + - $ Ad' st. DESCRIPTION + - $ Ad'ust. Sales or Flnancing Concessions NIA N/A Conv 32 DOm No wncess Conv 83 DOm Concess 6500 -6 500 Conv 214 DOM Concess 10000 -10 000 Date of Sale/time N!A 12128/2009 4/30/2009 7/1/2009 Ri Ms A raised Fee Sim le Fee Sim le Fee Sim le Fee Sim le Location Good Good Good Good Sfte ..52 acre .43 acre +1 000 .34 Acre +2 000 ..23 Acre +3 000 'Jfew Avere a Avera a Avere a Avera e Oesi n S le ranch ranch Ranchlav ranch Oual of Consbuctlon Bricklav Brick/av Rand Rock/av Brlck/av ?~? A e 51 47 48 33 Condition Avera a Avera a Avera a Avera e Above Grade Total Bdnns Baths Total Bdrms Baths Total Bdnns Baths Total Bdrms Baths Room Ccunt 6 3 1.5 6 3 2 -2 500 6 2 1.5 7 3 2 -2 500 Gross Llvln Area 1 566 s .tt. 1 459 s .ft. +2 140 2 318 s .tt. -15 040 1 634 s .ft. -1 360 - Basement & Rnished Rooms Below Grade Basement Fam rec nn Basement Unfinished +6 000 Basement Unfinished +6 000 Basement Unfinished +6 000 ~:, Functional Utl Avera a Avera a Avera a Avera e ' Headn Coolln Hw/ac I rod/ac Hw/ac Base/ac _ Ener Etticierd hems Thermo wind Thermo wind Thermo wind Thermo wind s Gera e/Ca orl 2 ca ort 2 car -5 000 1 car 2 car -5 000 ~ Porch/PatlofDeck Screen orch Porch +2 000 Porch +2 000 Porch olio 4 Khchen Std r Kitchen Std r Kitchen Std Kitchen Std Kitchen Rre laces 1 1 1 1 1 1 1 f l p: Other None None None None at tY ~: Net Ad ustment otal + - $ 3 640 + - $ -11 540 + - $ -9 860 y ai' Adjusted Sale Pdce of Com ambles .> ~ Net ,~ 2 3 ;, % GoSs. ': 12 0`'% $ 158 640 Net '`~ 6.8 . % Gross 1~8{ % S 158 460 Nark 5 r~. ~ Gros : 15,9 `6 $ 165 140 ~+ Summary of Sales Comparison Approach Comparable sales # 1 and # 2 are located within the same neighborhood as the subied orop market condhions continue to be slow within the marketplace. ertv. Overall z'% r? `~`" Indicated Value Sales Com riaon A oath; 158 soO mRESIDENTIAL ~~„~<w,~..,,.~.,,,~.,,..,u,.,,,.rw,.„~...v.,~,...~w,..,~,,,_.,~,,.,,~.,..- , _,.~...,......_....__... ---~--__. Form GPRES2 -'VJInTOTAL' appraisal software by a la mode, inc. -1-800•ALAMDDE 3/2007 SUMMARY REPORT Support for the opinion of site value (summary of comparable land sales or other methods for estlmagng site value): The cost approach is not applicable for this property due to the age end condition of the improvements i Source of cost data: DWELLING 5 .Ft S ..... =s i 0u ' ratio from cost seMce: Effective date of cost data: Sq.Ft @ $ ....... _$ Commerds on Cost Approach (gross living area calculatlons, depreclatlon, etc.): Sq.Ft. @; _ _; Functlonal Summary of Income Approach (including support for market rent and GRM): eI Descrihe common elements and recreational facilltles: 7 a Indicated Value by: Selee Comparison Approach S 158 500 Coet Approach (if developed); N/A Income Approach (n deveopec) s N/A Rnal Reconciliation Emphasis was placed on the sales comparison approach to value which is best reflective of market value Cost approach This appraisal is made ®"as Is", ^ subject to completlon per plans and specifications on the basis of a Hypothetical Condition that the Improvements have been completed, ^ suhject to the following repairs or atteratlons on the basis of a Hypothetlcal Cond'Nan that the repairs ar aherations have been completed, ^ subject to the following required Inspection based on the ExbaoNinary Assumption that the conditlon or deficiency does not require atleration or repair. This re ort is also sub act to other H etlcal Conditions and/or Fxbaordina Assum ons as s ec'rfied in the attached addenda. Based on the degree of Inepectlon of the subJect property, as indicated below, defined Scope of Work, StaEemeM of Awumptlona end Llmftlng Condltlons, and Appraiser's Certlflcatlona, my (our) Opinion of the Market Value (or other specified value type), ea defined herNn, of the real property that la the subject 01 this report la: S 158,500 es of: 1/12010 ,which Is the eilective date of this appraisal. It indicakd above, this Opinion of Value le subject to Ftypothetlcal Condkiona and/or Extraordinary Assumptions included In this report. See attached addenda. » A true and complete copy of this report contains _ pages, Including exhibits which are considered an Integral part of the report This appraisal report may not be L properly understood withcut rsierence to the Infomratlon comained in the complete report g Attached Exhibits: ^ Scope of Wark ^ Llmi0ng Cond.lCerffiicadons ^ Narrative Addendum ^ Photograph Addenda ^ Sketch Addendum t ^ Map Addenda ^ Additlonal Sales ^ Cost Addendum ^ Rcod Addendum ^ Manui. House Addendum t H othetlcal Condltlons Exhaordin Assum dons ~CIIeMContact: CllentName: JceIRZullingerAttomev E-Mall: Address: 14 North Main Street 310 Chambersbu Trust Co Buildi Chamberst APPRAISER or)CO-APPRA SER (M alppiicable)Quired) ]! ~ ~ SupeMsory or a Appraiser Name: Tim L Ausherman G Co-Appraiser Name: Comparry: Aushertnan Bros. Real E 1 Company: Phone: (717) 264715 x202 717 264.4973 Phone: _ Fax: t' E-Mall: timaour~pa.net E-Mail: Date of Report (Signature): February 15.2010 Date of Report (Signature): s License or CeNflcaikm e : GA000149L State: PA License or Cerligcagan #: State: Designation: Designatlon: 3~ Expkation Data of Lcense or Certiticatlon: 6/302011 Expiratlan Date of License or Certgicatlon: ~ Inspection of Subpct ®Inteda & Exredor ^ Extedor Onty ^ None Inspectlon of Subject ^ Intedor & Extedor ^ Exterior Only ^ None Date of Inspection: 2!112009 Date M Ins ctlon: Capydaht0 2007 by a m made, Ina. ThIs tam may be mP~uced unmod0ed vdtlwul vMaen pennlsslon, however, a le mode, Inc. must be aclmowledpad and crodited. ~ RESI DENTIAL Form GPRES2 -'WInTOTAL' appraisal software by a la mode, inc. -1-800-ALAMODE 312007 Subjcect Photo Page Subject Front 621 Charles Street Sales Pdce n/a Gross Building Area Age 51 Subject Rear Subject Street Fonn PIC3x5.SC - "WinTOTAL' appraisal software by a la mode, inc. -1.800-ALAMODE Comparable Photo Page Borrower Estate of John E. Huble Address 621 Charles Street C' Shi ensbu Cou Cumberland State Pa T Code 17257 Lender Joel R Zulli er Attome Comparable 1 623 Brenton St Sales Price 155,000 Grass Building Area Age 47 Comparable 2 626 Glenn St Sales Price 170,000 Grass Building Area Age 48 Y Comparable 3 140 Park Place East Sales Price 175,000 Gross Building Area Age 33 Form PIC3x5.CC - "UVInTOTAL' appraisal software by a la mode, inc. -1.800-ALAMODE Butldinq Sketch Borrower Estate of John E. Huble Pro a Address 621 Charles Street C' Shi ensbu Cou Cumberland State Pa Zi Code 17257 Lender Joel R Zulli er Attorne Screened Porch 24' 1/2 Bath Kitchen Bedroom Bedroom Laundry N I Carport I I N Dining Room Living Room Bedroom Bath 24' 54' ~a~~_ Form SKT.BIdSkI -'ydnTOTAL' appraisal software by a la mode, inc. -1-800-ALAMODE Building Sketch Borrower Estate of John E. Hubl Pro a Address 621 Chades Street Ci Shi ensbu Coun Cumberland State Pa Zi Code 17257 Lender Joel R Zulli er Attome AREA CALCULATIONS SUMMARY LIVING AREA BREAKDOWN Code Dmcripnon Net Sipe Nat Totals Breakdown Su6AOteb G[,Al Firet Ploor 1566.0 1566.0 Firet Floor GAR Garage 696.0 696.0 29.0 x 54.0 1566.0 P/P Porch 300.0 300.0 Net LIVABLE Area (rounded) ~ 1566 1 Item (rounded) ~ 1566 First Floor GLA1 Garage GAR 29.0 x 59.0 1566.0 29.0 x 24.0 696.0 Area total (rounded) = 1566 Porch P1P zs.o : la.o - 300.0 Area total (rounded) = 300 Area total (rounded) = 696 Pone SKT.BIdSkI -'tNhITOTAL' app2bal software by a la mode, inc. -1-800,ALAMODE y 1 n~atinn M91e 8onower Estate of John E. Hubie Pr Address 621 CharVes Street. Ci Shi ensbu Coun Cumberland State Pa L' Code 17257 Lender Joel R Zullin er Attome a la mode, inc: p GephnM1 R4 M~c~ ... '}qtr _ hOta~. Mkldla ~o Spring d• - ~o~a ~ Pa ~ e9ei ~+9d~9e. Rc d4~ G"PhBrt Rtl ~~,6' r ~ a ti ;' `~~, ~.~ ~, . •.~~ _ . r~ ~ ~~, 'Pi. ,! 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Our last pick exploded 1547% -Join our free newsletter today! www.PennyStockAdvice.com J Find a broker ~-~ JOHN E 'HU$LE'( 621 CHARLES ;iT SHIPPENSBUIZG PA 17257-2119 TRAI~ISACTIDI'd DETAIL. 800-662-2739 - Client services www.vanguard.com -` ~ (800) 662-6273 - Tele-Account TRANSACTIOrI ACTIVITY VanguaM 500 IMrx Fund IrnestorShares Trade date Transaction description - ---- - - ---Btdanceon-'12/31-/2~8 -- 3/26 In~me dividend .528 6/12 A~:count service fee 6/23 In,:ome dividend .435 9/28 Irw:ome dividend .482 12/28 In:ome dividend .659 &dance on 12/31 /2004 Dollar amount Share price Shares transacted Total shares owned - - -$ 6,185.34 - - $ 83:09 - -- - - _ -_ 74.442_. 39.31 76.64 .513 74.955 -20.00 87.58 -228 74.727 32.51 82.46 .394 75.121 3621 97.98 .370 75.491 49.75 103.81 .479 75.970 $ 7,799.84 $102.67 75.970 Year-to-date Short term gars / Purchases / Total cost basis / hcome divid+~ds Long-term gars Redempt'bns Average cost per share $ 1 ~'?.7~3 $ 0.00 $ 0.00 $ 9,433.41 0.00 20.00 ; 124.17 _-. I Reid / Account no. 0040 !09936093797 Jan 19 2819 12:19:19 17177734436 -> 717 264 1884 Merrill Lynch Page 986 Jan 19 2810 12:19:53 17177734436 -> 717 264 1884 Merrill Lynch Page 807 Pase 688 717 264 1884 Merrill Lynch -> lg 2616 12:26:34 17177734436 Jan 19 2810 12:21:88 17177734436 -> 717 264 1884 Merrill Lynch Page 009 Jan 19 2818 12:22:91 17177734436 -> 717 264 1884 Merrill Lynch .. ~ ~ ~~ Page 81B ~.~.~ Cy Y fg ~' d r '00 .~ ~~ rl- ,J .~ S ^ •Jan 19 2818 12:17:56 17177734436 -> 717 264 1884 Merrill Lynch Page B81 a ^ ^ Merrill Iaynch FACSIMILE COVER SHEET TO Carol AT FAX 17172641884 FROM Merrill Lynch SENDER ROSIN KAIVIINSKI DATE Tue Jan 1912:16:59 EST 2010 If the transmission is incomplete or illegible, please contact the sender. CONFIDENTWLtTY NOTE: THE INFORMATION CONTAINED IN THIS FACSIMILE TRANSMISSION IS CONFIDENTIAL AND IS INTENDED ONLY FOR THE USE OF THE ADDRESSEE NAMED ABOVE. ADDITIONAL RESTRICTIONS ANDfOR LIMITATIONS MAY APPLY TO THE USE AND/OR CONTENT OF THIS FASCIMILE. SUCH RESTRICTIONS AND/OR LIMITATIONS, IF APPLICABLE, ARE DESCRIBED IN THE ATTACHED DOCUMENT. IF THE RECIPIENT OF THIS FASCIMILE IS NOT THE INTENDED REGIPIENT, YOU ARE HEREBY NOTIFIED THAT ANY RETENTION, DISSEMINATION, DISTRIBUTION OR COPYING OF THIS FASCIMILE IS STRICTLY PROHIBITED. IF YOU HAVE RECEIVED THIS FACSIMILE IN ERROR, PLEASE IMMEDIATELY NOTIFY US BY TELEPHONE AND DESTROY THE ORIGINAL TRANSMISSION. No of Page(s) (including this page) 10 Subjoct FW: Hubloy Estate Carol: Please find attached the date of deathvalues for Mr. Hubley. I have also faxed you a profile information form which must have all the executors information- (and if they are married- their spouses 'information) in order to open an estate account. , If you have any questions please give me a call. Robin Kaminski Merrill Lynch. 1108 Kennebec Drive Chambersburg, Pa, 17201 Phone: 717-262-4219 Fax:717-773-4436 Too much paper in your mailbox? You can now get any or all of the following e-delivery: * Shazeholder Notices * Service Notices * Trade Confurnations '" Prospectuses * Statements e Jan 19 2818 12:18:89 17177734436 -> 71? 264 1884 Merrill Lynch Page 882 * Tax Reports Getting Started is easy- sign up can be completed in under 2 minutes ----Original Message----- From: Kaminski, Robin (CHAMBERSBURG, PA) Sent: Tuesday, January 19, 2010 12:13 PM To: Kaminski, Robin (CHAMBERSBURG, PA) Subject: Scan from a Xerox WorkCentre Please open the attached document. It was scanned and sent to you using a Xerox WorkCentre. Sent by: [robin kaminski(i~nl.com] Number of Images: 8 Attachment File Type: PDF Device Name: W01021P201 Device Location: Chambersburg, PA Device Serial Number: FKA641024 Device IP Address: 10.136.96.213 For more information on Xerox products and solutions, please visit http : //www.xerox.coml Jan 19 2010 12:18:18 17177734436 -> 717 264 1884 Merrill Lynch Page ae3 PROFILE INFORMATION: ~•` ~ ..............................................................................:~ ~ ............................................ Account Holder ~ ~ .........................Joint Account Holder/ ....................... ' , , .. : Spouse Information ~ . . Name. : ~ f Name • ... DOB DOB ; . Address `• Address . ~ , . ... ....Home Phone: ` ~ ` .....Home Phone: ~ • .: .............. Namber of dependent childteu: : ,• Number of dependent childre~n:..~ Marital .. ... .. : • • Single .: ..: Divorced - .. ~ Widowed : . : Email Address: ,- . . Email Address... .• F Employment Status: ~ Employment Status: ~ . •, _Employedlnot owner ` ~ Employedlnot owner . • ~ Not employed .Not employed - • ' , Student .. ~ Student • • ~ ~ HoYnemgker :. Homemaker Business Owner ~' ~ Business Owner •- ~ .. . .... • -Retired Retired ' .. ~ . ; ~ : • Employers Name: ` • `` Employers Name: ~ - ; . . • . ~ . ~ ~ Employers Address: ` „ ;Employers Address: ~' • Employers Phone: :Employers Phone: .,• ` . ~ ~ ,• . ~ Position/Title " , • J .Position/Title : .~ .. ~ . Employed since .. • Employed since .. .. •• ~ .Annual Salary 'Annual Salary ~ ' • • ..•• . . • ,:~ Household annual income: ...~ ~ Household annual income: ~ .• ••~ ~ .Household Net Worth: .. •• ; .Household Net Worth:• ,. ~ : . Jan 19 ZB18 12:18:41 17177734436 -> 717 264 1884 Merrill Lynch Page 884 Investable Assets: ~ .. Investable Assets: . ............. Liabilities: .... :. Liabilities: . ............. Financial t'lan:`yes no -- : ' .Financial Plan_yes _no ~ . ....... . `~ ..............Other Merrill Lynch Accounts: ~ Other Merrill Lynch Accounts" • + trading information: ` trading information: ,...-mutual funds ;`+mutuat funds ~ ...~ ................ -bonds „-,-bonds ..: .. ,-equities .....,...,,,.., ~ •_„_,equities ,... ........ .. options .:. +~ ,_,~options ~~` ' cash ' ~ ....~ , .. , cash ,. none .. ... ~ -none ~ ~ ` . Ltd partnerships ____Ltd partnerships . futures .. : .~ -futures .. . " ` .trading experience: ~ ~ ' ,` trading experience: ~ ` , . ,cash _casb margin _margin ~. none ~ ~ »oae . trading frequency . ~ trading frequency ~ . seldom ~ seldom moderate moderate active ~ . active : ,: 'years at residence ~ ~ ...:. ~ :. ,:~ :. ~ ' years at residence .. ~ ~ . ~ ~ . . ~ ~ ~ - own own .. rent .. ~ -rent ~ . ~ . . : ~ .acct malting address:: ~ . accE mailing address: . , : residence ~ . ~ residence ~ ~ ~ •~ ~ . business ~ . .:. , . business .. ~ ~ .. ~ .. `vacation ~ .: ~ varaNon .. :..: school .:.... . , . schoal .. . ~~ ~ ~ other ~ ~ other ~ ~ ~ ~ ~ ~ ~ ~ ~~ ...... _ . .. ` ~~~ Year began investing ~ ~ ~ ~ : ~ .: ~ ~ ~ ~ ` ... ~ . ' Jan 19 2010 12:19:01 17177734436 -> 717 264 1884 Merrill Lynch Page ~5 . If opening fR~- please fill in bencticiary information below: . ~ f Benencairy Type primary contingent . Name SS# ~ ~~ relstidaship - ~ „spouse ^n4n~s~o -se ........................................... , ~ ~ ~ trust estate .Percentage of assets ~ ~ "~% Date of Airt6 Beneficiary type primary :. contingent ,~ Name SS# ~spouse ~~non spouae trust estate Percentage of assets~% Date of Birth ` Beneficiary Type ^primary contingent ... ,: . , Name SS# spouse non`spouse ` trust estate ~Percentage~of assets % `Date of Birth Beneficia T g . rY ype primary -~ ~ ~ contin ent ~ . Name • SS# _ spouae ~ ~ ~ rion spouse ~ ~ : .. .~ ~ . ~ trust trust ~ . :Percentage of assets f'` % Date of Birth .. ~ ' ... ., :: .. ... ,, . .. CARL E. OCKER AUCTIONEER 4401 Philadelphia Avenue Chambersburg, PA 17201 (717) 264-6578 Personal Property Appraisal for John E. Hubley Estate 621 Charles Street Shippensburg, PA 17257 HALL MAYTAG WASHER & DRYER .................................................................................. 300.00 KITCHEN FRIGIDAIRE REFRIGERATOR ..:...............................................................................150.00 PINE TRESTLE TABLE W/4 CHAIRS .......................................................................... 75.00 FAMILY ROOM BLUE SOFA ..................................................................................................................... 20.00 TAN LIFT CHAIR ......................................................................................................... 125.00 OAK GLIDER ROCKER ................................................................................................. 50.00 SONY TV ......................................................................................................................... 35.00 MAHOGANY DRUM TABLE ........................................................................................ 30.00 MAPLE NIGHT STAND .................................................................................................20.00 MAPLE ARM CHAIR ................................................................................................... .... 5.00 BEDROOM TWO 2 MAPLE DRESSERS ................................................................................................... 150.00 MODERN OAK ROLL TOP DESK .............................................................................. 200.00 OAK ROCKER .............................................................................................................. .. 35.00 OAK CHAIlZ .................................................................................................................. ..10.00 2 PARTICLE BOARD BOOK CASES ......................................................................... .... 5.00 CORNER CABINET PAINTED.....' .............................................................................. .. 15.00 BASEMENT BACK ROOM BLANKET CHEST ........................................................................................................ .. 40.00 RADIO CABINET ......................................................................................................... .. 40.00 OAK DESK .................................................................................................................... .. 50.00 UPRIGHT FREEZER ..................................................................................................... .. 75.00 BASEMENT LIVING ROOM PINE SOFA .............................................................................................................................................10.00 RECLINER, NAUGAHIDE ................................................................................................................. .....5.00 MAPLE DESK .............:....................................................................................................................... ...15.00 2 UPHOLSTERED CHAIRS ................................................................................................................ .....5.00 2 SCHOOL BENCHES ........................................................................:............................................... ...75.00 PINE BOOK SHELF ........................................................................................................................... ....20.00 MAPLE END STAND ......................................................................................................................... .....15.00 TAN SOFA ........................................................................................................................................... ...75.00 HALL WALNUT MARBLE TOP WASH STAND .........................................................................................150.00 BEDROOM THREE OAK WASHSTAND W/TOWEL BAR ................................................................................................ 125.00 IRONSTONE BOWL &PITCHER ....................................................................................................... ..35.00 KEROSENE LAMP .................................................................................................................................20.00 CHILDS ROCKER ..................................................................................................................................75.00 WOODEN SEED BOX ......................................................................................................................... ..15.00 LIVING ROOM 2 ETHAN ALLEN BOOKSHELVES .................................................................................................... 125.00 SMALL BOOKSHELF .......................................................................................................................... ..50.00 OLD WATERBURY MANTEL CLOCK ...............................................................................................50.00 J. RAYMOND SMITH FOOT STOOL ................................................................................................. 125.00 QUIMPER COMPOTE ............................................................................................................................40.00 QUIlVIPER BOWL .......................................................................................................................:......... ..25.00 BRONZE BABY SHOES ...................................................................................................................... ....2.00 DINING ROOM MODERN PINE DRY SINK ...................................................................................................................50.00 PAIR ROSE CARVED SIDE CHAIRS ...................................................................................................25.00 PATIO PICNIC TABLE .......................................................................................................................................25.00 REDWOOD FURNITURE ...................................................................................................................... .25.00 TOTAL ............................................................................................................................................. $2,637.00 I, DO HEREBY CERTIFY that I have examined the tangible personal property of John E. Hubley Estate, 621 Charles Street, Shippensburg, PA 17257 And do value and appraise the same at $2,637.00 as being fair market Value of said property on this date of March 3, 2010 Date •~.~ 3 ~ D Carl E. Ocker ~ +% Appraiser a~~ 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 Phone (888)502-4349 Fax (302)934-2955 January 20, 2010 Zullinger -Davis 14 North Main Street Suite 200 Chambersburg, PA 17201 Re: Estate of: John E Hubley Social Security: 177-24-6939 Date of Death: January 1, 2010 Dear Sir or Madam: Per your inquiry, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Account Account Number 97316067 Ownership (Names o~ John E Hubley Opening Date 0128/80 Balance on Date of Death $ 274.03 Accrued Interest $ 0.00 Total $ 274.03 Please be advised, there was a safe deposit box found for the above decedent, Box # 131 at the Walnut Bottom. * If upon reviewing the information above, you believe there are additional accounts not referenced, please provide us with an account number and/or name of any possible joint account holder. For any additional information on the above accounts, including ownership and any changes, closures and/or reimbursement of funds, etc., please contact our Walnut Bottom branch, 28 Walnut Bottom, Shippensburg, PA 17257. Office # 717-532-2414. Sincerely, N rissa Sears A justment Services • DR JOHN E HURLEY (individual) 3KW401479 Holdings -Positions Account Summary Values -- Lon4 Market Yalue: _ _ - _ Net Balance: 0.00 Totai Equity: _ _ ; Short Market Value: 0.00 Gash Available:. 0.00 Monet Fund Balance: 0_00 Tech Short: 0.00 Today Fed Colt: 0.00 Pro3ected Cali;h Flow: ~-6~ Real Time Positions PiZ1c:C !~~ ' 1 0 17357US1 0 1 N C~4 G 10,000 /O~~.S~ ,~2 `~ BAAl/A s/SB~P Moody 5 BjEDlD 000% 2J SER A RFDG /w~ 0 5/18/05 N/C 2 075313GE0 BEAVER PA AREA SCH DIST RFDG FGIC-NAIL 40,000 NR/A Moody's/S&P RE 3.750% 03/15/13 B/EDTD 12/15/02 ~04. ~~ y ~"'1 ~~ CLB CLB 02/22/10 ~ 100.000 FGIC r +3 ~ 092833]FO BLAIR CNTY PA SER AA 3.800% 01/15/14 B/EDTD 06/01/07 CLB CLB 07/15/12 10,000 / Q [~~ ~ ~'3 /~y 1 BAA1/N R Moody's/S8~P ~ 100.000 AMBAC ~ 153300PY8 CENTRAL DAUPHIN PA SCH DIST RFDG-NTS 10,000 AA3/AA Moody's/S&P 4.000% 02/01/21 BJEDTD 10/01/06 CLB CLB 100•~ia~ ~ 11D,~ A 08/01/16 ~ 100.000 0100707571 ;5 246343DW4 DELAWARE RIV JTTOLLBRDG COMMN PA BRDG 10,000 A2/A- Moody's/S8P REV RFDG 5.000% 07/01/24 B/EDTD rr ~0~ L1~ ~~~,f Q r 01/21/03 CLB CtB 07/01/13 ~ 100.000 ' O 0 353268CT0 FRANKLIN CNTY PA INDL DEV AUTH HOSP REV 25,000 NR/NR Moody's/58.P ~ l RFDG-THE CHAMBERSBURG HOSP 5.000% 07/01/22 B/EDTD 02/15/98 CLB CL8 02/22/10 q ~ ~, ~' ~ i ~ 1`~ ~ 100.000 AMBAC ~' 519804FC7 LAWRENCE CNTY PA RFDG-SERA 4.000% 10,000 BAAi/A MOOdy's/5&P 02/01/14 REGDTD 03/15/03 CLB CLB 08/01/13 ~QS ~~~ 1?~. b~ I ~ 100.000 0100703684 `' S5072RAJ6 LUZERNE CNTY PA INDLDEV AUTH LEASE REV 30,000 j~ ~ AA3/AA Moody's/SAP j { GTD 3.700% 12/15/15 B/EDTD 06/15/08 ~ ~~~ ~ A N ~ i j55072RAT4 i LUZERNE CNTY PA INDLDEV AUTH LEASE REV GTp 4.550% 12/15/23 B/EDTD 06/15/08 40,000 ~O l ~ ti` (y r' fOl~~3~ AA3/AA A Moody's/S8~P CLB CLB 06/15/18 ~ 100.000 0100707571 ~'_- J 643425MA6 - NEW CASTLE PA RFDG-SERA 4.000% 20,000 NR/NR Moody's/SAP ~ 11/01/16 REGDTD 10/15/05 CLB CLB liJOl/10 ~ ~C~ ~ 53•,3 ~ 100.000 0100700019 t z 664551CA4 NORTHEASTERN PA HOSPED AUTH COLLEGE 10,000 BAA1/A Moody's/SB~P ~ REV LUZERNE CNTY CMNTY COLLEGE 5.150% 08/15/16 REGDTD 08/15/97 CLB CLB ~tf~, 3Y 4~'Y ' o~/z2/1o ~ 100.000 0l0o7o36s4 i ~ 7091413Q6 PENNSYLVANIA ST SECOND SER 5.000% 30,000 " AA2/AA Moody's/SB~P 01/01/22 B/EDTD 12J15j05 CLB CLB 01/01/16 ~ 04. eta 3 ~ ~ { ~ 100.000 i i 3 70915RAZ0 PENNSYLVANIA ST FIN AUTH LEASE REV RFDG 10,000 AA3/AA MoodY's/S&P 1 -GTD-CNTY BEAVERPJ-SERA 3.650% 1 1 ~ e~ ~ A 09/01/14 REGDTD 10(15/06 CLB CLB 09!01/il 0~~ a1 ~ O ~ ~ •7 ~- 100.000 0100707571 14 70917NXF6 PENNSYLVANIA ST HIGHER EDL FACS 10,000 NR/NR Moody's/S&P X AU7HREV CLARION UNN FNDTN INC-SERA t ~ ~ ZOO t (a a 5.000°x6 07/01/28 B/EDTD 09/01/03 CLB CLB ~, 07/01/13 ~ 100.000 0100700771 "-~ 174514LND5 PUERTO RICO COMWLTH RFDG-PUB IMPT-SER 15,000 ~~ ~g'r ~Q 6 3 BAA1/A Moody'sJ58~P i A 5.500% 07/01/19 B/EDTD 10/16/07 N/C ~: 755553UH5 READING PA RFDG-NT5 3.750% 11/15/14 5,000 AA3/AA Moody's/SB~P B/EDTD 09/15/05 CLB CLB 11/15/10 ~ i ~~ '~ 6b yL~,3] A 100.000 0100707571 ~ ~ t tc~, X79' oa 3~,7~~~~ ~C~,15~.3~ ~3, p~y.7C~ /p~ ~o~.~l`~' 7,73~,~p Thin roport is a service from your Inveshnent Professional. not a subatlarte for your aocourrt stptemenfs and oonflrrnatlons. Thb ropoit is proparad as of trade date rather than settlement date and may be propared on a dif{nront date tlrarl your statement This report uses iMamalbn flan sources that Pershing betleves tD be refiabb, but Pershbtg gnnot guarantee fhe acwracy of this IMonrretlon or the reliat>bity of these sources. ff you find discrspanaes in this repoR, Abase contact your Imeafinent Professional. Prepared by P3ICWPHER a102122@010 01:12:51 Page 1 DR~10HN E HURLEY (Individual) 3KW401479 Ho{dings -Positions As of -~ r-~-1-I~?_ ~ ~ j'D --- _ --- - ~~1ztr ~N! • a>srr sec. , .. - laid size::.' ... .: ~; 1 % 810759MX5 SCRANTON PA RFDG-SERB 4.35096 10,000 09/01/20 B/EDTD 08/01/03 CLB CLB 09/01/13 ~ ~ ~5~ c~ NR/BB Moody's/58eP I ~ @ 100.000 AMBAC -~-~. 4 ~o ~ qNa- ~ ~ This report k a service from your Imrashnent Professional, not a sutratfbuts for your aocourk statements and oorttkrnatlons. Thk report k preparod at of trade daEe rather than settismerd date and may be prepared on a diRsrsrK data than your statement. Thls report uses irrMrnution from souroae ttua Perahinp t~efieves to be reRahle, twt Perehinp cannot puerantes the accuracy of thk iMonnation or the reMabiNfy of the sources. K you find dkcrepanGes in this report, please contact your Invee6nsnt Prolafbnai. Prepared by P3KWPHER ~ 02/22/2010 01:12:51 p~ 2 s -26-2010 14:21 FROM: JEFF HARRISON 717-267-2549 OST AdvisorCarnp~ss® Online Service and Transactions TAX-EX BOND FD - A 70:2641884 P.1 Page 1 of 1 Ameri rise ®,~ plinancial HAIR C ae Wi~dQr.~ Own®rship Information 1 Value As of 12/30/2009 Shares NAV Principal Value 'i 3267.096 3.730 $49,486.27 Vew Corporate Entitieg~~n JAI npartant DsGosute~, Web Site Rules air ~Regulatio,~~, Private Statement and About ~~m~il fraud. Copyright ®2008.2009 Ameriprise Fnancial. All Rights Reserved. Users of this site agree to be bound by the terms of the Ameriprise Web Site Rules and Regulations. ti JAN-26-2010 14:21 FROM: JEFF HARRISDN OST 717-267-2549 TD:2641884 P.2 Page 1 of 3 ~dvisorCompelss~ Onll~e Service and Transactions Account Proflie -TAX-FJ( BOND FD - A Account Profile ~ Activ~t ` Cinec~Cs_is$ugd Ameri rise ~w pF~»aacial Held Close. Window ~ s~8~r~e~ These clients and/or accounts have incomplete suitability information. Suitability rules may • not allow you to begin, or to complete a transaction until the suitability information is updated. Please click on the exclamation-point icon to update the required data. Tfansaction Wizards ..~_.. Move Money Move Money New Money In Out of Account Wiithtn Account Ownership Information Account #: 0000 0011 4328 9286 4 002 Account Status: ACTIVE Opened Date: 10/22/1979 Ownership: JOHN E HURLEY TOD Plan Type:. NON-QUALIFIED Associated. T1N: 177-24-6939 Taxpayer's Current Age: B1.5 Associated Group IDs - Select Group Account List Group ID Group Type 028 9286 1 Q01 HOUSEHOLD Associated Client IDs - Select Client Profits Client ID Client Name Role 1042 6610 1 001. MR JOHN E HURLEY OWNER TAXPAYER eneficia Information PRIMARY BENEFICIARY LIVING, LAWFUL CHILDREN IN EQUAL SHARES 0% JOHN IEHAEL HURLEY SON J-26-2010 14:21 FROM: JEFF HARRISON osT JOSEPH DANIEL HURLEY SON 717-267-2549 70:2641884 P.3 _ Page 2 of 3 Value as of 01/25/2010 Account Opened Date 10/22/1979 Good Funds Amount $49,951.00 A# Risk Amount $0.00 Amount available for redemption: $49,951.00 Approximate amount available without CDSC: $,49,980.60 Co{laterally Assigned: No Lhquidation Information as of 01/25/2010 Shares: 13320.267 NAV: 3.750 Principal Value: $49,951.00 . Plus Accrued Dividends: $29.60 Gross Value: $49,980.60 . Less cosc Amount: $o.oo Liquidation Value: $49,980.60 Investment Information Ticker Symbol: tNTAX CUStP Number: 76931 P504 Asset Value: NO ` Cost Basis: $52,595.20 Combined ROA Value: $49,951.00 Lstter Of Intent Commitment Amount: Not Available Purchases within 90 days: Not Available Repurchase Credits: $0.00 LC3t Escrow Shares: 0.000 New Money Shares: 0.000 fund Progress Report Fund Progress Report ~ Fund As-Of Values