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HomeMy WebLinkAbout08-31-101505610140 REV-1500 EX (°'_,°) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO Box 280601 INHERITANCE TAX RETURN Harrisbur PA 17128-0601 RESIDENT DECEDENT 2 1 0 9 0 9 2 2 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 2 1 3 3 2 4 7 8 5 0 9 2 2 2 0 0 9 0 1 2 6 1 9 3 Decedent's Last Name WH I T S ON Suffix Decedent's First Name KENNET H (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW Q 1. Original Return Spouse's First Name THIS RETURN MUST BE FILED IN DUPLiCATc WITH THE REGISTER OF WILLS MI R MI 2. Supplemental Return ~ 3. Remainder Return (date of death 4. Limited Estate ~ 4a. Future Interest Compromise (date of d prior to 12-13-82) ~ 5. Federal Estate Tax Return Required ® 6. Decedent Died Testate (Attach Copy of Will) ~ eath after 12-12-82) 7. Decedent Maintained a Livin Trust g A 8. Total Number of Safe De osit B 9. Litigation Proceeds Received ~ ( ttach Copy of Trust) 10. Spousal Poverty Credit (date of death p oxes ~ 11 Election t t between 12-31-91 and 1-1-95) . o ax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION N ame SHOULD BE DIRECTED T0: MARK A. MA TE YA ESQUI RE Daytime Telephone Number 7 17 241 6500 First line of address 5 5 W. CHURCH Second line of address City or Post Office CARL I S L E A V E N U E State ZIP Code L PA 1 7 0 1 3 REGISTER OF WILLS US~NLY .t 7 c~ .~_ _ .,. ~ _ r..~ ~_ -~ ~, ~~c. ~ Cs,) r ",. I"rl r .) 1 t ~_.. ~ % ~ i ~ ~~ - Correspondent's a-mail address: MAM(p~MATEYALAW COM Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE ~I~~~~N~RESPON~L~FOR FILING RETURN c~~~~~-, c~ VI (~ ~, DATE .,~ ~ I ADDRESS 76 SMIT ROAD SIGNATURE O PREIi1ARFR 55 W. CHURCH AVENUE GARDNERS CARLISLE PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610140 PA 17324 PA 17013 1505610140 J T 1505610240 REV-1500 EX Decedent's Social Security Number Decedents Name: KENNETH R. WHITSON 2 1 3 3 2 4 7 8 5 RECAPITULATION 1. Real Estate (Schedule A) ........................................... 1 2. Stocks and Bonds (Schedule B) ...................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages and Notes Receivable (Schedule D) ......................... . 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ....... 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ....... 7. 8. Total Gross Assets (total Lines 1 through 7) .......................... . 8. 9. Funeral Expenses and Administrative Costs (Schedule H) .................. 9. 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ............. 10. 11. Total Deductions (total Lines 9 and 10) ............................... 11. 12. Net Value of Estate (Line 8 minus Line 11) 13. ......................... Charitable and Governmental Bequests/Sec 9113 Trusts for which ... 12. an election to tax has not been made (Schedule J) ..... ............... .. 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ..... ............... .. 14. TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABL E RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0 _ 0 . 0 0 15 16. Amount of Line 14 taxable . at lineal rate X .045 1 4 3 0 7 7 9 6 17. Amount of Line 14 taxable , 1s. at sibling rate X .12 0 0 0 17 18. Amount of Line 14 taxable . at collateral rate X .15 0 0 0 . 18. 19. TAX DUE ...................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 1505610240 1 3 3 0 0 0,0 0 3 4 2 7,6 7 3 3 3 9 4, 3 9 1 6 9 8 2 2, 0 6 1 4 2 1 0. 7 4 1 2 5 3 3. 3 6 2 6 7 4 4. 1 0 1 4 3 0 7 7, 9 6 1 4 3 0 7 7, 9 6 0. 0 0 6 4 3 8, 5 1 0. 0 0 0. 0 0 6 4 3 8. 5 1 D 1505610240 J REV-1500 EX Page 3 File Number Decedent's Complete Address: 21 09 os22 DECEDENTS NAME KENNETH R. WHITSON STREET ADDRESS 74 SMITH ROAD cITY GARDNERS STATE Zip PA 17324 Tax Payments and Credits: ~ • Tax Due (Page 2, Line 19) 2. Credits/Payments (1) 6 438.51 A. Prior Payments 4,600.00 B. Discount 242 10 Total Credits (A + g) (2) 3. Interest 4 842.10 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (3) Fill in oval on Page 2, Line 20 to request a refund . (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 1 596.41 Make check payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APP R OPRI ATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred; Yes No b. retain the right to designate who shall use the property transferred or its income; .............................. . .. ... c. retain a reversionary interest; or .......................................................................................... . ^ O d. receive the promise for life of either a ments, benefits or care P Y ...................................................... . ^ 0 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" orpayable-upon-death bank account or security at his or her death? ......... ^ 0 4. Did decedent own an individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? .................................................................................................. ^ O IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF ThlE RETURN For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 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 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a stepparent of the child is 0 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 4.5 percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)j. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. LAST WILL AND TESTAMENT OF KENNETH R. WHITSON I, Kenneth R. Whitson, of 74 Smith Road, Gardners, Cumberland County, Pennsylvania, make this my will. I revoke any other wills or codicils to wills made by me. ARTICLE I. DISTRIBUTION OF MY ESTATE A. I give such items of my tangible personal property as are designated below. 1. I give my coin collection to my grandson, Tyler Stevick, presently of 76 Smith Road, Gardners, Pennsylvania. 2. I give all of jewelry which I own at the time of my death to my daughter Kathleen Stevick, presently residing at 76 Smith Road, Gardners, Pennsylvania. 3. I give my real estate which I own at the time of my death both in Pennsylvania and Florida to my daughter Kathleen Stevick, per stirpes. B. I give the residue of my estate to my daughter Kathleen Stevick, per stirpes, provided she survives me by sixty (60) days. C. Whenever property is to be distributed to the descendants of a person (the "ancestor"), such property shall be divided into equal shares, one share for each then living descendant in the first generation below the ancestor in which at least one descendant is living, and one share for each deceased descendant in such generation who has a descendant then living. Each share created for a living descendant shall be distributed to such descendant. Each share created for a deceased descendant shall be divided and distributed according to the directions in the two preceding sentences until no property remains undistributed. D. Any beneficiary or the legal representative of any deceased beneficiaryhall have~e right, within the time prescribed by law, to disclaim any benefit or power under rr,~c~ill and~ie ~~ interest so disclaimed shall be distributed as if such beneficiary had predeceased m~ ~ ° s~ : ~ _ _. , , r `r"t ~'"~ t~'a - .C' -, Page 1 of 4 K.R. W. /~~ ARTICLE II. PAYMENT OF EXPENSES AND OTHER CHARGES I desire to be cremated. I direct my Executrix to pay for my burial expenses (including the cost of a monument or marker) and the cost of cremation. The estate, inheritance and similar taxes assessable on my death (including taxes on assets not passing under this will) shall also be paid as a cost of administering my estate and my Executrix shall not request any beneficiary to pay any part of such tax. ARTICLE III. MISCELLANEOUS PROVISIONS Matters of Interpretation. For simplicity, I have expressed pronouns and other terms in one number and gender, but where appropriate to the context these terms shall be deemed to include the other number and genders. The bold headings are for convenience and shall not affect interpretation. ARTICLE IV. APPOINTMENT OF FIDUCIARIES AND POWERS A. I name Kathleen Stevick to be my Executrix. It is my desire for the Executrix to be remunerated according to local custom. Should she fail or cease to act, I name Thomas Stevick to be my Executor. In the event that Thomas Stevick is unable or unwilling to serve, I name Mateya Law Firm to serve as Executor of my estate. I request that no security be required of any Executrix. References in my will to my "Executrix" are to the one acting at the time, except where otherwise specifically provided. B. Any individual who serves as Executrix or Trustee shall be entitled to receive reasonable compensation for his or her services and, whether or not such individual receives compensation, shall be entitled to be reimbursed for expenses incurred .for such services. C. I grant my Executrix and my Trustee the powers set forth in 20 Pa.C.S. §§ 3311-3332 and 20 Pa.C.S. §§ 7771-7780 respectively. In addition, my Trustee may merge any trust under this will with any trust having the same trustee and substantially the same dispositive provisions. If at any time after my death the size of any trust under this will is so small that, in the opinion of my Trustee, the trust is uneconomical to administer, my Trustee may terminate the trust and distribute the assets to the person or persons authorized to receive the trust income in such shares as my Trustee may deem appropriate. No Trustee who is also an income beneficiary of the trust at issue shall exercise any discretion granted in the preceding sentence. My Executrix and my Trustee may distribute tangible personal property passing to a minor to any adult person with whom the minor resides, and that person's receipt shall be a sufficient voucher in the accounts of my Executrix and my Trustee. D. It is my fervent desire that Mateya Law Firm handle the administration of my estate, they being familiar with my affairs. Page 2 of 4 K.R.W. ~~~ ARTICLE VI. DEFINITIONS The following definitions shall be applicable to all of the provisions of my Will except where otherwise specifically stated: The use of the masculine shall include the feminine or neuter and the use of the singular shall include the plural, and vice versa. 2. The term "estate," where appropriate, shall include any trust hereunder. 3. The term "minor" shall mean an individual who has not attained the age of twenty-one years. Executed this ~ ~"~day of ~ ~ , 2009. /~-~ -~i~ ~1~~ (SEAL) Kenneth R. Whitson Signed, sealed, published, and declared for and as his last will and testament by the testator in our presence, we all being present at the same time; and we, in his presence and at his request and in the presence of each other, have subscribed our names as witnesses whereof, all on the date last above written. l f ~ ~ ~ ~o '~-, -~ Page 3 of 4 K.R.W. X.~/y COMMONWEALTH OF PENNSYLVANIA CUMBERLAND COUNTY : to wit: f, A Before me, the undersigned authority, on this date personally appeared Kenneth R. Whitson, and INS' ~- ~' . ~'~~fi-~ ~ , and ~~2 ~ iY~ ~ . J u ~y t!t/J~ known to me to be the testator and witnesses, respectively, whose names are signed to the foregoing instrument and, all of these persons being by me first duly sworn, Kenneth R. Whitson, the testator, declared to me and to the witnesses in my presence that said instrtument is his last will and testament and that he had willingly signed and executed it in the presence of said witnesses as his free and voluntary act for the purposes therein expressed, that said witnesses stated before me that the foregoing will was executed and acknowledged by the testator as his last will and testament in the presence of said witnesses who in his presence and at his request and in the presence of each other did subscribe their names thereto as attesting witnesses on the day of the date of said will and that the testator, at the time of the execution of said will, was over the age of eighteen years and of sound and disposing mind and memory. Sworn and acknowledged before me by KENNETH R. WHITSON, the testator, a~.,~ • i~` ,witness, and ~P. iKA ~ • ~'u~vKi.-ys ,witness, this ~ ~-~ day o , 2009. ~~~~ ~~~ KENNETH R. WHITSON ~~~ . ~ L Witness Witness Notary Public My commission expires: Page 4 of 4 COMMONWEALTH OF PENNSYLVANIA Notarial Seal Frances A. Aumiiler, Notary Public South Middleton Twp., Cumberiarxl County My Commiysion Expires March 16, 2010 Memh~r o,~nng~,~~~.~,~nt~ gcsOCiatlon of Notaries K.R.W. /~ REV-1502 EX+ (01-10) pennsylvania SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF: FILE NUMBER: KENNETH R. WHITSON 21 09 0922 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property 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. 74 SMITH ROAD 38,000.00 GARDNERS,PA SEE ATTACHED REAL ESTATE APPRAISAL 2. 76 SMITH ROAD 95,000.00 GARDNERS,PA SEE ATTACHED REAL ESTATE APPRAISAL TOTAL (Also enter on Line 1, Recapitulation.) If more space is needed, use additional sheets of paper of the same size. S. W. BARRETT REAL ESTATE AND APPRAISAL SERVICES 04107/2010 Mark Mateya, Esquire P.O. Box 127 Boiling Springs, PA 17007 File Number: 10-0088 In accordance with your request, I have appraised the real property at: 76 Smith Road Gardners, PA 17324-9006 The purpose of this appraisal is to develop an opinion of the defined value of the subject property, as improved. The property rights appraised are the fee simple interest in the site and improvements. In my opinion, the defined value of the property as of September 22, 2009 is: 595,000 Ninety-Five Thousand Dollars The attached report contains the description, analysis and supportive data far the conclusions, final opinion of value, descriptive photographs, assignment conditions and appropriate certifications. Respectfully submitted Stan A. Skowronek PA Certified Residential Real Estate Appraiser Summary Residential ADDraisal Renert .,_ .,, ,,,.~e The purpose of this appraisal report is to provide the client with a credible opinbn of the defined value of the subject property, gNen the intended use of dte appraisal. Client Namellnlended User Mark Mate a ES wire Email NIA cdientAddress P.O. Box 127 ci Boilin S tin s state PA zi 17007 Additional Intended users The Intended User of this a sisal re ort is the Client. No additional intended Users are rmitted without . the rmission of the a raisers . Intended use The Intended Use is to evaluate the ro that is the sub'ect of this a sisal to rovide the Client with an accurate and ad uatel su orted o inion of value. Pro Address 76 Smith Road c' Gardners stare PA zi 17324-9006 OvmerofPUblicRecortlWhitson Kenneth R. coun Cumberland L al Descri lion Deed Book 212 a e 334 " Assessors Parcel # 40-15.0201-009 Tax Year 08/09 R.E. Taxes $ 852.00 Ne hborhood Name South Middleton Townshi Ma Reference 15-0201 CensusTraa 0126.00 Pro R' his raised X Fee Sim le Leasehold Other describe M research did did not reveal an rbr sales or Vansfers of the sub' ro for the three ars riot m me effective date of this sisal. PrforSalelTransfer: Date 12/01/1999 Price 1 Sources Courthouse Anaysis of prbr sale or Vansfer history of the subject property (and rAmparable sales, rfapplkable) COm arable #1 last transferred on Janus 22 2009 for 855 805. Offerings, opdons and convacts as of the effective date of the appraisal NIA Neighborhood Gharacte[istla. One.unrtftanirp TrendE DneiNtitHOUafrp f?remftL:arW USel6-.: ~ Location Urban suburban X Rural Pro a Values Increasin X Stable Declinin PRICE AGE One•Unft 20 % Built-U Growth Over 75% R id X X 25.75% Stable ' Under 25% Sbw Demand/su Markedn Time Strorta e X Under 3 mths X In Balance 3-6 mths Over Su I Over 6 rtahs WO s 80 Low New 2d Unft 0 % Mufti-Fami 0 % Neighborhood Boundaries The sub ect is bounded on the north b the North Mountains on 225 H' h 100 Commercial 0 % the east b route 84 on the south b Smith Rd and on the west b route 233. 150 Pred. 35 on,er Vac 80 % Neighborhood Description The sub'ect is located off of Smith Road alon a shared rivate dirt road Whitson Rd . It is located in a "wooded area. There are several other homes off of the rivate road of va 'n sizes a and uali It is within reasonable drivin distance to ammenities such as schools sho in and em to ant. Market Conditions (including support for the above conclusions) See Attached Addendum Dimensions See le al descri lion Area 20 Acres m/I s Rectan ular view Woods S cificZOnin Gassification WC Zoni Descri lion Woodland Conservation Zonin Com fiance X Le Le al Nonconformi Grandtatheretl Use No Zonin II al describe Is the highest and best use of the subject properly as improved (or as proposed per plans and specificatbns) the present use? X Yes No If No, describe. Utilkies Public Other describe Public Other describe OH-sitelm rovements-T Public Private Elecvici X 100 am water X Weli Street Dirt X Gas X Pro ane Ckn san sewer X Se tic None site comments Private water and sanity s tams are common to the area and have no adverse affect u on marketabiU .The sub'ect site currenU has a vane of abandoned old mobile homes a vane of cars in need of re it and a condemned old two sto home unfit for livin which Kathleen Stevick dau hter claims the Coun ins led and removed from the tax records several ears riot. This o inion of value assumes no environmental issues are resent None area arent GENERALDESCRIPTiDrF '. FtnkdOATRx1 EXTERIORDESCRIPTION ~ rtle0edak INTER1012 Unas X One OnevdACC. unit Concrete Slab X Crawl S e Foundation walls Cone BlklAv Fbors Vin /Av # of Stories 1 Full Basement Partial Basement Eraerbr Walls T-111/Av Walls Panel/Av T X Del Att. S-DetJEnd Uni[ X Existin Pro sad Under ConsL De n s le MobleHome Year Built 1980 Efteunive a Yrs 20-25 Basement Area N/A . ft. Basement Finish N/A % outside En ~ Sum Pum Roof Surface Metal/Av Gufters & Down uts AIUMIrIUmIAV windowT Sin IeHn Av Storm Sashllnsulated Yes/Av Screens YeslAv TrimlFinish Vin Av Bath Fbor Vin IIAy Bath wainscot Vin /Av Car Sror a None X Orivewa # of Cars 4 Attic X None Heavn X FWA HW Ratliant Amenities X WoodSlrnre s #1 Drivewa Sudace Gravel Dro Stair Floor Finished ~ Stairs scuttle Heated Odrer Fuel WOOd Cooii Cenval Air Contltioni Individual Other Fire laces # PatiorDeck Pool Fence Porch Odrer X Gar # of Cars 1 Car rt # of Cars AtL X De4 Built-in A fiances Retr erator X Ran eloven Dishwasher Di oral Microwave WasherlD r Other descdbe ~ Finished area afwve ratle contains: 4 Rooms 2 Bedrooms 2 Bath s 938 S ware Feet of Gross Livin Area Above Grade Adtliaonal FealUfea None Commenrson the Improvements Im rovements are in avers a condition with no h icai or functional inade uaciea noted. - ---'---... ._._...-...._.....-.,,,,.....w..~„"„~~w,,..xmcex irc..wwgra n~smea. Pie 1 M 2 (9PAR`") Gereral PiepoSp AUVrestl Repot 1711-0a GPM10Ud_OS OeI1Xpe ADDENDUM Client: Mark Mateva, Esquire File No 10-0068 Pro Address: 76 Smith Road Case No City: Gardners State: PA Zip: 17324 Neighborhood Market Conditions LisUSale ratio approximately 95°h. I have considered relevant competitive listings andlor contract offerings in the performance of this appraisal and In the trending information reported in this section. If a trend is indicated, I have attached an addendum providing relevant competitive listinglcontrect offering data. Local multi-list data indicates stable market in the past calendar year with no appreciation in the subjects market area, with an average marketing time of 90-180 days. Economic trends and lending rates have remained favorable. Sales concessions are occuring more frequently; however, there is no known prevelance of unusual seller financing concessions or buydowns. There are new homes under construction in surrounding developements, as well as resales available in the neighborhood. Atltlenoum Page 1 of 1 Summary Residential Appraisal Report Fib Nn ,n_nnaa FEATURE SUBJECT COMPARABLE SALEN0.1 COMPARABLE SALEN0.2 COMPARABLE SALEN0.3 76 Smith Road Address Gardners 17324 596 Baltimore Road Gardners 17324 Southside Drive Newville 17241 99 Mountain Lane Newbu 17240 Proxim to sub' 2.02 miles NNW 10.77 miles W 23.95 miles WNW Sale Price $ N/A $ 35 000 ~ $ 100 000 $ 69 000 SakPrice/GrossLN.Area $ 0.00 .>G $ 36.23 .n $ 337.84 .tL $ 111.29 .ft. Data Sources Ins 'on CPMLS 10171914 CPMLS 10176427 CPMLS 10177740 verification source s .Courthouse.' Courthouse Courthouse Courthouse VALUE ADJUSTMENTS DESCRIPTION DESCRIPTION ~ snqumm~a INSCRIPTION - E ~ men DESCRIPTION ..It anent sale or Financing Concessions N/A None, Conv DOM 116 ;15,227 CLCst SA DOM 339 None, Cash DOM 7 Date of Sale/7ime N/A 0511912009 02/15/2010 04124/2009 Location Rural Rural Rural Rural LeasenokllFee Sim le Fee Sim le Fee Sim le Fee Sim le Fee Sim le Sae 20 Ac/Av .59 Ac/Av 58 230 20.87 Ac/Av -2 610 11"56 Ac/Av 25 320 view Woods O en Coun Woods Woods Des n s Moble Home Moble Home Modular Cabin -5 000 Moble Home al' of consaucdon Averse Averse Averse Avers e Actuala a 30 Years 29 Years 11 Years 40 Years Condition Averse Averse Averse Poor 2 000 Above Gratle e rod same edhe rod saps role ea adm raw sins Room Count 4 2 2 5 3 2 2 1 0 4 000 5 2 1 2 000 Gross L' ' Area 10.00 938 . tt 966 . n 0 296 . n. 6 420 620 . n. 3 180 Basement&Finished e RoomsBeknvGrade Crawl Space Full Bsmt Unfinished -2,000 Slab Slab Funuroonal tJdf Averse Averse Averse gvera e - Heabn /COOIin Woodstve/None EBBICA -3 000 Coalstve/None FWAINone Ener Etficientttems T ical T ical T ical T ical tiara efCar n 1 Car tiara a None 5 000 None 5 000 tiara eMlks -1 000 PorchlPatiolDeck None Porch -1 500 SmallPorch -1 000 None None None None Pole Bam -5 000 NetAd'ustment ota X + $ 56 730 X + $ 6 810 X + $ 26 500 AdjusledSalePrice Net Adj. 162.1% Net Adj. 6.8% otCom ambles GrossA,d' 199.2% $ 91 730 GronAd'. 24.0% $ 106 810 summa of sake com rison A roach O inion of value ran a is;92 000 to 5107 000. Su lus acres a ad Net Adj. 38.4% Gross '. 55.8% $ 95 500 ustments are made at 53 000 er acre. No closin cost ad'ustment for com reble #2 since it sold below list rice. The sale date for com rebls #2 is be and the as of date however there has been no measurable than a in the market• therefore it is included as one of the best three sales com rabies located. Coin arable #3 is located in a similar settln to that of the sub'ect even thou hit is at a further distance than normal. The uni ue combination of a of home and the size of the acres ere wired a la er search area than is normal. No value was iven to the condemned two sto and sund old em mobile homes. Neither was a cost to remove included since this o inion of value is "as is". COST APPROACN TOVAWE sttevalue Comments A review of vacant land sales within the sub'ect's market revealed sales ran in from 10.69 acres to 35 acres at a rice r acre ran a of;3 700/acre to;4 OOOlacre. O inion of value for the sub'ect site -;80 000 ESTIMATED REPRODUCTION OR REPLACEMENT COST NEW OPINION OF SITE VALUE ........................................ _ $ 80 000 Source of cost data lhvellin 5 . Ft. $ .. , ......... _ $ Q e uaf roan hom cast service E1feuNive date of cost data . FL $ , = g Comments on Cost A roach roes INin area cakuladons de reciadon, etc. - Cost A roach deemed a oor indicator of value. Estimated Gar eiCar rt O FL $ ,........... _ $ p e Remainin Economic Life - 5-10 ors Total Estimate of Cost•New , g 0 ........... Less Ph 'cal Functional EMernal De reciation = $ 0 De reciated Cost of lm rovemerds ................................ _ $ 0 'AS-is" Value of Site Im rovements ................................ _ $ INDICATED VALUE BY COST APPROACH ...................... _ $ NIA INCOME AP'PROACNTOVALUE EstimatedMOnfh MarketRent$ N/A XGrossRentMul6lier NIA =$ N/A IndicatedValueb Incomes roach Summary of Income Approach (inclutling supportfor market rem and GRM) N/A IndicatedValueb :SalesCOm arisonA roaehS95 000 CostA roach dtlevelo s N/A rncomeA roach itaevelo s N/A The Market Data Anal is su orts m o inion of value for the sub'ect. The Cost A roach was not deemed an a ro riate indicator of value and therefore was not included herein. The Income A roach was also deemed ins ro riate for this anal is. This appraisal is made X 'as is; subject to completion per plans and specficafions on the basis of a frypcthedgl corWition that the improvements have been completed, ^ subject to the following repairs or alterations on the basis of a hypoNetical condition that the repairs or alterations have been completed ^ subjea to the tolbwing: The ro has been a raised in current condition. This is for the clients use onl . Based on the scope of work, assumptions, limiting conditions and appraiser's certification, my (our) opinan of the defined value of the real property that is the subject of this report is $ 95,000 as of 09/22/2009 ,which Is the effecWe date of this appraisal. .~...~...~..-.m ... o, s. w.,w..ai.o,.wn imsiam l,'apynpmGlWSma9 Aa phson x1150 pains Sences.lm.. NlRphls Reeenea Page 2 012 (pPN7"') Generd Puryose appraisal Regan 1920[6 GPARI(W_a5 Oa11afpa S.W. Barrett Real Estate 8 Appraisal Services Scope of Work, Assumptions and Limiting Conditions File No. 10-0068 Scope d work is defined in the Uniform Standards d Professional Appraisal Practlce as " the type and extern d research and anaryses in an assignment" In short, scope of work is simpy whatthe appraiser did and did not do during the course of the assignment h includes, but is not limited to: the exlenttowhich the property is identifred and inspected, the type and extent d data researched, the type and extent d anaryses applied m arrive at opinions or conclusions. The scope d this appraisal and ensuing discussion in this report are specific tothe needs of the client, other identified intended users and to the intended use of Me report This reportwas prepared tar the sde and exclusive use othee cliem and other iderttifired intended users far the identfied intended use and its use by any other parties is prohibited. The appraiser is not responsible for unauthorized use of the report The appraiser's certification appearing in this appraisal report is subject to the fdlowing conditions and to such other specific conditions as aze set forth by the appraiser in the report All extraordinary assumptions and hypothetical conditions are stated in the report and might have affected the assignmem resuhs. 1. The appraiser assumes no responsibility for ma0ers of a legal nature affecting the property appraised or title thereto, nor does tits appraiser render arty opinion as ro the title, which is assumed ro be good and marketable. The property is appraised as though under responsible ownership. 2. Any sketch in this report may show approximate dimensions and is included Dory ro assist the reader in visual¢ing the property. The appraiser has made no survey of the property. 3. The appraiser is not required ro gore testimony or appear in court because of having made the appraisal with reference to the property in question, unless arrangements have been previousy made thereto. 4. Neutrer all, nor any part of the content of this report, copy or other media thereof (including conclusions as ro the property value, the identify of the appraiser, professional desgnations, or the firm with which the appraiser is connected), shall be used for any purposes by arryone but the client antl other intended users as identified in this report, nor shall h be conveyed by anyone ro the public through advertising, public relations, news, sales, or other media, without the wri0en consent of the appraiser. 5. The appraiser will not disclose the convents of this appraisal report unless required by applicable law or as specified in the Unrform Standards of Professional Appraisal Practice. 6. Inrormation, estimates, and opinions furnished ro the appraiser, and contained in the report, were obtained kom sources considered reliable and believed to be Vue and correct. However, nc responsibility for accuracy of such items furnished ro the appraiser is assumed try the appraiser. 7. The appraiser assumes that there are no hidden or unapparen[ contlibons of the property, subsoil, or structures, which would render h more or less valuable. The appraiser assumes no responsibility for such conditions, or for engineering or rosting, which might be required to discover such (actors. This appraisal is not an environmental assessment of Ne property and should not be considered as such. 8. The appraiser special¢es in the valuaton of real property and is not a home inspector, building comractor, structural engineer, or similar expert, unless otherwise noted. The appraiser ditl not conduct the intensNe type of field observations of the Idnd intended ro seek and discover property defects. The viewing of the property and any improvements is for purposes of devebping an opinion of the defined value of the property, given the intended use of tlrb assignment Statements regarding condition are based on surface observafions Dory. The appraiser cbims no special expertise regarding issues including, but not limited ro: foundatbn settlement, basement moisWre problems, wood destroying (or other) insects, pest infestatbn, radon gas, lead based paint, mold or environmental issues. Unless otherwise indicated, mechanical systems were not activated or tested. This appraisal report should not be usetl to distlose the condition of tits property as rt relates ro the presencelabsence of tlefects. me client is invited and encouraged to employ qualified experts ro inspect and address areas of concern. If negative conditans are discovered, the opinion of value may be affected. Unless otherwise noted, the appraiser assumes the components that catstilute the subject property improvement(s) are fundamentally sound and in working order, Any viewing of me property by the appraiser was limited to readily observable areas. Unless otherwise noted, attics and crawl space areas were not accessed. The appraiser did not move furnibrre, ibor coverings or other items that may restrict the viewing of the property. 9. Appraisals involving hypothetical contlitions related ro wmpletion of new construction, repairs or alteration are based on the assumption that such completion, atteratbn or repairs will be competenty performed. 10. Unless the intendetl use of this appraisal specificalry includes issues of property insurance coverage, this appraisal shouts not be used for such purposes. Reproduction or Replacement cost figures used in the cost approach are for valuation purposes Dory, given the intended use of the assignment. The Definition of Vakre used in this assignment is unlikety ro be consistent with the definition of Insurable Value for property insurance coverage/use. 11. The ACI General Purpose Appraisal Report (GPARTM) is not intended far use in transactions that require a Fannie Mae 3004lFreddie Mac 70 form, also known as the Uniform Residential Appraisal Report (URAR). Additional Comments Related To Scope Of Work, Assumptions and Limiting Conditions None ,M1 iy Protlutetl uaiq Aq sailwue P2gE File No. 10-0068 Appraiser's Certification The appraiser(s) certifies that, to the best of the appreiseYS knowledge and belief: 1. The statements of fact contained in this report are Vue and correct 2. The reported anatyses, opinions, and conclusons are limited ony by the reported assumptions and limiting conditions and are the appraiser's personal, impartial, and unbiased professional anayses, opinions, and conclusions. 3. Unless otherwise slated, the appraiser has no present or prospective interest in the property that is the subject of this report and has no personal interest wbh respect to the parties involved. 4. The appraiser has no bias wbh respect to the propery that is the subject of this report or to the parties involved with this assignment 5. The appraiser's engagement in this assgnmentwas not contingent upon developing or repoNng predetermined results. 6. The appraiser's compensation far urompleting this assignment is not contingent upon the devebpment or reportlng of a predetermined value or direcbon in value than favors Ne cause of the client the amount of the value opinion, the attainment of a stipulated result, or tits occurrence of a subsequent event directty related to the intended use of this appraisal. 7. The appraiser's anayses, opinions, antl conclusions were developed, and this report has been prepared, in conformitywfth the Uniform Standards of Professional Appraisal Practice. 8. Unless otherwise noted, the appraiser has made a personal inspection of the property that is the subject of Nis report 9. Unless noted below, no one provided significant real property appraisal assistance to the appraiser signing this certificatan. Sggnficam real propery appraisal assistance provided by: Additional Certifications: None Definition of Value: XQMarketValue ^OtherValue: Source of Definition: USPAP The most probable price in terms of money which a property should bring in competitive and open market under all conditions requisite to a fair sale, the buyer and seller, each acting prudently, knowledgeably and assuming the price is not affected by undue stimulus. ADDRESS OF THE PROPERTY APPRAISED: 76 Smith Road Gardners, PA 17324-9006 EFFECTIVE DATE OF THE APPRAISAL: 09/2212009 APPRAISED VALUE OF THE SUBJECT PROPERTY $ 95,000 5TlS7_~TF~7 Signaure: Name: Sian A. S OWr'One state Certification # RL001572L or License # or Other (describe): State #: state: PA Expiration Date of Certrfication or License: June 30, 2011 Date of Signaure and Report: 04/07/2010 Date of Property viewing: 09/22/2009 Degree of property viewing: QX InteriorantlEzterior ^ExreriorOny ^Ditlnotpersonalyview ProAUCM uanp Ap P,mvrn G„taml Grv,,, 1l S.W. Barrett Real Estate & Appraisal Services GPARUM OS OB11a%IB SUPERVISORY APPRAISER Signature: ~ ~ f /~--- Name: Steven W. BatTett, SRPA, SRA ASA state Certification # GA000298L or License # RB-026921-A stare: PA Expiration Date of Certification or Lcense: June 30, 2011 Date of Signature: 0410712010 Date of Property Viewing: Degree of property viewing: Interior and E#erior ~Exterbr Ony XQ Did not personaly view S. W. Barrett Real Estate 8~ Appraisal Services 505 South Hanover Street, Carlisle, PA 17013 rire rvo 04/09/2010 Mark Mateya, Esquire P.O. Box 127 Boiling Springs, PA 17007 File Number: 10-0069 In accordance with your request, I have appraised the real property at: Smith Road Gardners, PA 17324 The purpose of this appraisal is to develop an opinion of the market value of the subject property, as vacant. The property rights appraised are the fee simple interest in the site. In my opinion, the market value of the property as of September 22, 2009 is: $38,000 Thirty-Eight Thousand Dollars The attached report contains the description, analysis and supportive data for the conclusions, final opinion of value, descriptive photographs, limiting conditions and appropriate certifications. Respectfully submitted, ~s~.~W r Stan A. Skowronek PA Certified Residential Real Estate Appraiser . ~ 'a S. W. Barrett Real Estate & Appraisal Services LAND APPRAISAL RGPnRr -- - - ' - Pro a Address Smith Road Census Tract 0126.00 me n0. -1 V-YVO`J LENDER DISCRETIONARY USE C' Gardners Coun Cumberland State PA Zi Code 17324 Sale Price $ Le al Descri lion Deed Book 273 a e 1171 Tax ID# 40-15-0201-010 Date OwnerlOccu ant Whitson Kenneth R. Ma Reference 15-0201 Mortgage Amount $ „ SalePrice$ NIA Date of Sale NIA Property Rights Appraised Mortgage Type Loan char eslconcessions to be aid b seller $ NIA ^X Fee Simple Discount Points and Other Concessions R.E. Taxes $ 212.00 Tax Year 08/09 HOA $IMo. NIA ^ Leashold Paid by Seller $ LenderlClient Mark Mate a ES ulre ^ Condominium (HUDNA) P.O. Box 127 Boilin S rin s PA 17007 PUD source LOCATION Urban Suburban X Rural NEIGHBORHOOD ANALYSIS coon nw. Fair aoor BUILT UP Over 75% 25-75% X Under 25% Empbyrt>ent Stabil' X ^ GROWTH RATE Rapid X Stable Slow Convenience to Employment ^ X^ PROPERTYVALUES Increasing X Stable Declining Convenience to Shopping X DEMAND/SUPPLY Shortage X In Balance Over Supply Convenience to Schools MARKETING TIME Under 3 Mos. X 3-6 Mos. Over 6 Mos. Adequacy of Public Transportation X ;PRESENT LAND USE % LAND USE CHANGE PREDOMINANT SINGLEFAMLYHDUSNG Recreation Facilities ^ • Single Family 20°~ Not Likey OCCUPANCY PRICE AGE Adequacy of Facilities ^ X ~ ~ 2.4 Family 0% Likely Owner ^X $(tm0) (yrs) Property Compatibility ^ X ^ " Multi-Family 0° In process Tenant ^ 80 low New Protection from Detrimental Cond. ^ X ^ ^ Commercial 0% To: Vacant (D-5%) 225 High 100 Police & Fire Protection X ^ Industrial 0°/ Vacant (over 5%) X Predominant General Appearance of Properties X ^ Vacant 80° 150 - 35 A eal to Market X Nate: Race or the racial composition of the neighborhood are not considered reliable appraisal factors. CO MMENTS~The sub-act is located o ff of Smi th Road alon a shared rivate dirt road Whitson Rd . It is located in a wooded area. There are several other homes off o f the rivate road of va -n sizes a and uali It is within reasonable drivin distance to ammenities such as schoo ls s ho in and em to ant. Dimensions 301.88x65.68x208.95x659.95x408.81x660.30 Topography Basicall Level Site area 5.865 Acres m/l Comer Lot No Sae Larger than normal Zoning Classification Woodland Conservation Zoning Compliance Yes Shape Irre ular HIGHEST & BEST USE: Present Use Present Other Use NIA Drainage A ors Ade uate UTILITIES Publlc Other SITE IMPROVEMENTS Type Public Private V'lew WOOds Electricity X^ Street Gravel X ^ ^ Landscaping N/A Gas ^ CurblGutter None ^ Driveway NIA Water ^ To be well Sidewalk None ^ ^ Apparent Easements None A arent Sanitary Sewer To be Se tic Street Lights None ^ FEMA Fbod Hazard Yes' No X Storm Sewer Alle None FEMA' M (Zone 4203711 Zone X Comments (Apparent adverse easements, encroachments, special assessments, slide areas, etc.): Private water and sanity s tams are common to the area and have no adverse affect u on marketabili The undersignetl has recited three recent sales of properties most similier antl proximate to subject and has considered these in the market analysis. The tlescription includes a dollar adjustment, reflecting mflrkel reaction to those items of significant variation between the subject and comparable properties. If a significant item in the comparable property is superior to, or more favorable than, the subject property, a minus (-) adjustment is made, thus reducing the indicated value of subject; if a significant item in the comparable is inferior to, or less lflvorable than, the subject property, a plus (+) adjustment is metle, thus increasing the indicated value of the subject. ITEM SUBJECT COMPARABLE N0.1 COMPARABLE N0.2 COMPARABLE N0.3 76 Smith Road 231 Old Town Road 60 Southside Drive 201 Doubling Gap Road Address Gardners 17324 GaMners 17324 Newville 17241 Newville 17241 Proximi to Sub'ect 1.21 miles NNE 9.05 miles W 15.36 miles WNW Sales Price $ NIA $ 88 885 $ 84 000 $ 54 sp0 Price/ Acre $ ~ $ 6770 A $ 5949 ~ $ 6770 ~ ' Data Source Ins tion Courthouse Courthouse Courthouse VALUE ADJUSTMENTS DESCRIPTION DESCRIPTION DESCRIPTION DESCRIPTION +-ly • Sales or Financing Unknown Unknown Unknown Concessions Unknown Unknown Unknown Date of Sale/Time NIA 08!28/2009 11130/2009 08/19!2009 . Location Rural Rural Rural Rural SiteNiew 5.87 Ac/Av 13.13 Ac/Av 14.12 Ac/Av 8.05 AGAv Water To be well To be well To be well To be well Sewer To be se tic To be se tic To be se tic To be se tic Access Private Road Private Road Public Rd -2°k -119 Public Rd -2% -135 Net ad'. rota X + ; $ 0 + X - ; $ 119 + X - ~ $ 135 Indicated Value Gross: 0.0 Gross: 2.0 Gross: 2.0 of Sub' ct Net: 0.0 $ 6 770 Net: -2.0 $ 5 830 Net: -2.0 $ 6 635 Comments of Sales Comparison: The com ambles used are of similar a rah and terrain to that of the sub-act. Lack of suitable similar vacant land sales within the sub-ecYs immediate vicini wired an ex anded search area. These are the best sales com ambles known to be available. -2% ad ustment taken for Private Road access versus Publlc Road access. Comments and Conditions of appraisal: Pro has been a raised in "as is" condition. No im rovements were considered in the value re orted. A raiser assumes all necessa rmits for future buildin on site are available. Final Reconciliation: The ad'usted rice r acre ran a is $5 800 to $6 800 r acre -SAY - $6 500/acre. O inion of value for the • sub-act site - 5.87 acres $6 500/acre = $ 38 155 -SAY - $38 000. I(WE)ESTIMATETHEMARKETVALUE,ASDEFINED,OFTHESUBJECTPROPERTYASOFSeptember22,2009 totte3 38000 . I (We) certify: that to the best of my (our) knowledge and belief, the facts and data used herein are true and correct; that I (we) personally inspected the subject property and inspected all comparable sales ci din this report and that I (we) have no undisclosed inter esint or prt~s ectiye the in. ~C„J / ~ ~ Appraiser(s) ~-~13X~1V~. 1i.Jlp,.y Review Appraiser ^Did X^ DidNOt Stan A. Skowronek (rf applicable) Steven W. Barrett SRA SRPA ASA Inspea Property vrnwievan .aria ram u°aa rA t:ernnea Kesiaenual Keal vroaxea vaag nu aor~ware, wo.naaTn wwa..dwb.=m PA Certified General Real Estate Appraiser FctatP Annrairxwr R.W. Rarro4f Raal Fa4a4e R Annrai•nl Snn,irnc REV-1503 EX + (6-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER KENNETH R. WHITSON 21 09 0922 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. US SAVINGS BOND SERIES EE 97 84 $100.00 DENOMINATION C441399279EE ISSUE DATE 09/1993 2. MCDONALDS COMMON STOCK 1,116.20 20 SHARES $55.81 AT CLOSE OF BUSINESS ON 9/22/09 3. A T & T COMMON STOCK 1,567.97 59.168594 SHARES $26.50 AT CLOSE OF BUSINESS ON 9/22/09 4. VERIZON COMMON STOCK 645.66 21.879482 SHARES $29.51 AT CLOSE OF BUSINESS ON 9/22/09 TOTAL (Also enter on line 2, Recapitulation) I E 3 427 67 (If more space is needed, insert additional sheets of the same size) REV-1508 EX + (6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER KENNETH R. WHITSON 21 09 0922 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointty-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. SOVEREIGN BANK 3,042.06 CHECKING ACCOUNT ACCOUNT NO. XXX)OCX3017 2. 2001 CHEVROLET TRUCK 7,500.00 COLORADO SEE ATTACHED KELLEY BLUE BOOK VALUE 3. BENEFICIAL SHARE OF ESTATE OF GRACE WHITSON (DECEDENT'S MOTHER) 22,852.33 BALTIMORE, MD CASE TOTAL (Also enter on line 5, Recapitulation) I $ 33.394. (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (10-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER KENNETH R. WHITSON 21 09 0922 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. HOLLINGER FUNERAL HOME 1,511.00 B. ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City Year(s) Commission Paid: State 2, Attorney Fees: MATEYA LAW FIRM 3. Family Exemption: (If decedents address is not the same as claimants, attach explanation.) Claimant Street Address City State Relationship of Claimant to Decedent ZIP ZIP 4. ~ Probate Fees: CUMBERLAND COUNTY REGISTER OF WILLS 5. I Accountant Fees: 6. ~ Tax Return Preparer Fees: 7. CUMBERLAND LAW JOURNAL -LEGAL ADVERTISEMENT 8. THE SENTINEL -LEGAL ADVERTISEMENT 9. S.W. BARRETT REAL ESTATE APPRAISAL SERVICES 10. CUMBERLAND COUNTY REGISTER OF WILLS -FILING FEE 11. R.T CAREY TRUCKING LLC -TRASH REMOVAL INVOICE NO. 1884 12. R.T. CAREY TRUCKING LLC -TRASH REMOVAL INVOICE NO. 1900 11, 000.00 372.00 75.00 208.78 625.00 30.00 118.56 270.40 TOTAL (Also enter on Line 9, Recapitulation) I $ 14.21 If more space is needed, use additional sheets of paper of the same size. REV-1512 EX+ (12-08) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8~ LIENS ESTATE OF FILE NUMBER KENNETH R. WHITSON 21 09 0922 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 1. AMERICAN GENERAL CONSUMER DISCOUNT COMPANY 4,279.14 LOAN ON AUTOMOBILE ACCOUNT NO. 13498864 2. TROPICAL FINANCIAL CREDIT UNION 7,088.71 ACCOUNT 615660 LOAN NO. 21 REVOLVING LINE OF CREDIT 3. TAX CLAIM BUREAU OF CUMBERLAND COUNTY 253.45 2009 SOUTH MIDDLETON TOWNSHIP TAXES CONTROL NO. 40-002197 4. TAX CLAIM BUREAU OF CUMBERLAND COUNTY 912.06 2009 SOUTH MIDDLETON TOWNSHIP TAXES CONTROL NO. 40-002195 TOTAL (Also enter on Line 10, Recapitulation) I $ If more space is needed, insert additional sheets of the same size. REV-1513 EX+ (01-10) pennsylvania ~ SCHEDULE J DEPARTMENT OF REVENUE I BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: KENNET H R. WHITSON 21 09 0922 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustees) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1. KATHLEEN STEVICK Lineal 143,077.96 76 SMITH ROAD GARDNERS,PA ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: 1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ If more space is needed, use additional sheets of paper of the same size. REV-1500 Discount, Interest and Penalty Worksheet Discount Calculation Total Amount Paid within three calendar months of the decedent's date of death: 4,600.00 Discount: 242.10 Interest Table Year Days Delinquent this time period Balance Due this year Interest this period Before 1981 1982 1983 1984 1985 1986 1987 1988 throw h 1991 1992 1993 throw h 1994 1995 throw h 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 TOTALS Penalty Calculation If the decedent's date of death was on or before March 31, 1993, insert the applicable amount: Total Balance Due on January 17, 1996: Penalty: