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Home My WebLink About12-09-1015056051058 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number Po Box 2sosol INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 10 0704 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 207-18-7874 07/05/2010 12/23/1926 Decedent's Last Name Suffix Decedent's First Name MI Williams Dorothy D (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Return 4. Limited Estate 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 2. Supplemental Return 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULCI BE DIRECTED TO: Name Daytime Telephone Numlber Lisa Marie Coyne, Esq. (717) 737-0464 ~ Firm Name (If Applicable) - ~ REC;iSTER Old SE C?N LY~' ~~ ~_'„~ Coyne & Coyne, P.C. ~, ~; ~, ; ~~; First line of address !n'" ~??, ~ ~i„'{ ~',' . 3901 Market Street trams ~.~, ~, ~ d li S f dd - ~ . r : "} econ ne o a ress ~ ~ ~, ~ " - ~ _ ~ ~ t y 7 L..'~ City or Post Office State ZIP Code DAtL tD ~ CSD +~~ Camp Hill PA 17011 Correspondent's a-mail address: 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 hsis any knowledge. SIG U O PERSON R SIBLE FOR FILING RETURN DATE ` ~. ADD S Ralph E. Williams, III 7 Briar Gate Road, Mechanicsburg, PA 17050 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE - - - __ ADDRESS _ - _ __ _ _ _ __ - PLEASE USE ORIGINAL FORM ONLY Side 1 15056051058 15056051058 15056052059 REV-1500 EX Decedent's Social Security Number Dorothy D WilllamS ' 207-18-7874 decedent s Name: RECAPITULATION 1. Real estate (Schedule A) . .......................................... .. 1. 158,078.00 2. Stocks and Bonds (Schedule B) ..................................... .. 2. 0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. 0.00 4. Mort a es & Notes Receivable Schedule D 9 9 ( ) ........................... 4. .. 0.00 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ...... .. 5. 12,277.68 6. Jointly Owned Property (Schedule F) Separate Billing Requested ..... .. 6. 2,638.98 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested...... .. 7. 24,081.95 8. Total Gross Assets (total Lines 1-7) .................... . ............. .. 8. 197,076.61' 9. Funeral Expenses & Administrative Costs (Schedule H) ................... .. 9. 22,504.18 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............. .. 10. 2,767.94 11. Total Deductions (total Lines 9 & 10) ................................. .. 11. 25,272.12 12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. 171 , 804.49 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ...................... .. 13. 0.00 14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... .. 14. 171,804.49 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0! 15. 16. Amount of Line 14 taxable at lineal rate X .045 171,804.49 16, 7,731.20 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. TAX DUE ....................................................... .. 19. 7,731.20 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 15056052059 r REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 10 A704 DECEDENT'S NAME DECEDENT'S SOCIAL SECURITY NUMBER Dorothy D Williams 207-18-7874 STREET ADDRESS 47096 Charles Road __ __ __ CITY __ _ _ ~ STATE _ _ ?IP Mechanicsburg ! PA 17050 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 7,731.20 2. Credits/Payments 0.00 A. Spousal Poverty Credit _ ____ ___ __ B. Prior Payments 0.00 C. Discount 0.00 -_ _ _ __ Total Credits (A + B + C) (2) 0.00 3. InterestlPenalty if applicable 0.00 D. Interest _-- - E. Penalty 0.00 - _ _ Total Interest/Penalty (D + E) (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 7,731.20 A. Enter the interest on the tax due. (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 7,731.20 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? .............................................................................................................. ^ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. ^ [~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ ® ^ 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-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. ~ pennsylvania SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF FILE NUMBER Dorothy D. Williams 21-10-0704 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. If more space is needed, insert additional sheets of the same size. WOOF APPRAISAL GROUP File No. PVT9824 APPRAISAL OF A CONDOMINIUM UNIT LOCATED ATo 47096 CHARLES ROAD MECHANICSBURG, PA 17050 CLIENT: COYNE & COYNE P.C. 3901 MARKET STREET CAMP HILL, PA 17011 AS OF: JULY 15, 2010 APPRAISED VALUE: $130, 000 I BY: REYNOLD R. WOOF, JR. IFAS PA CERTIFIED GENERAL REAL ESTATE APPRAISER su[ SUU I H FKUN 151 REST, WORMLEYSBURG, PA 17043 WOOF APPRAISAL GROUP {ndividual Condominium UnitAgpraisal Report File No. PVT9824 The purpose of this appraisal report is to provide the client with a credible opinion of the defined value of the subject property, given the intended use of the appraisal. Client Name COYNE & COYNE P.C. E-mail LISA COYNEANDCOYNE.COM Client Address 3901 MARKET STREET Cit CAMP HILL State PA Zi 17011 ~ Additional Intended Users THE ESTATE OF DOROTHY D. WILLIAMS Intended Use ESTATE SETTLEMENT Pro ert Address 47096 CHARLES ROAD Cit MECHANICSBURG State PA Zi 170.50 Owner of Public Record THE ESTATE OF DOROTHY D. WILLIAMS Count CUMBERLAND Le al Descri lion BOOK 141, PAGE 305 Assessor's Parcel # 10-21-0279-382-U8 Tax Year 2010 R.E. Taxes S 1,425.87 Nei hborhood Name ST MARKS PLACE Ma Reference 21-0279 Census Tract 3240-0113.04 Pro ert Ri hts A raised X Fee Sim le Leasehold Other describe M research did X did not reveal an rior sales or transfers of the sub ect ro ert For the three ears rior to the effective date of this a raisal, Prior SalelTransfer. Date 06/20!1996 Price $84 900 Sources COUNTY DATA BANK Analysis of prior sale or transfer history of the subject property (and comparable sales, if applicable) THERE HAS BEEN NO TRANSFERS OF THE SUBJECT IN THE LAST THREE YEARS. • Offerings, options and contracts as of the effective date of the appraisal NONE Neighborhood Characteristics CongominiumUnit Housing Trends Condominium Housing Present Lend Use Location Urban X Suburban Rural Pro ert Values Increasin X Stable Declinin PRICE AGE One-Unit 100 Built-U X Over 75% 25-75% Under 25°~ Demand/Su I Shorta e X In Balance Over Su I $ 000 rs 2-4 Unit %`° Growth Ra id X Stable Slow Marketin Time Under 3 mths X 3-6 mths Over 6 mths 115 Low 18 Multi-Famil ~ Neighborhood Boundaries THE NEIGHBORHOOD BOUNDARIES CONSIST OF HOMES IN THE AREA • COMMONLY KNOWN AS THE ST MARKS PLACE AREA OF HAMPDEN TOWNSHIP. 175 Hi h 23 140 Pred. 21 Commercial %6 Other %6 ~ Neighborhood Description THE SUBJECT PROPERTY iS LOCATED IN AN ESTABLISHED RESIDENTIAL NEIGHBORHOOD COMPRISED •' PREDOMINANTLY OF SINGLE FAMILY HOUSES AND CONDOMINIUMS. EASY ACCESS TO EMPLOYMENT CENTERS, SCHOOLS, SHOPPING, AND TRANSPORTATION. Market Conditions (including support For the above conclusions) AREA REAL ESTATE MARKET IS CONSIDERED TO BE MODERATELY ACTIVE. LOAN DISCOUNTS, INTEREST BUYDOWNS, AND OTHER CONCESSIONS ARE NOT TYPICAL IN THIS MARKET.CONVENTIONAL FINANCING I;i READILY AVAILABLE. -- To o ra h LEVEL Size 0.90 ACRES Densit 9 PER ACRE View RESIDENTIAL S ecificZonin Classification RT Zonin Descri lion RESIDENTIALTOWNE ^__ Zonin Com liance X Le al Le al Nonconformin No Zonin Ille al describe Is the highest and best use of the subject property as improved (or as proposed per plans and specifications) the present use? X Yes No If No, describe. _ Utilities Public Other (describe) Publlc Other (describe) Off-si[elm rovemen[s-T e Public Private • Electricit X Water X Street MACADAM X • Gas Sanitar Sewer X Alle NONE Site Comments NO APPARENT ADVERSE EASEMENTS OR ENCROACHMENTS NOTED. Data sources for ro ect information Pro ect Descri lion Detached X Row or Townhouse Garden Mid-Rise Hi h-Rise Other describe General'ilescu [soh GeneralrDescn Uon General pescri lion General Descri lion Pra ec[ Info # of Stories 1 & 2 Effective A e 10 Exterior Walls VINYL Ratio sates/units 1 : 1 # of Units 8 # of Elevators N/A X Existin Pro osed Roof Surface FIBERGLASH. T e GARAGE # of Units Com leted 8 ~ Year Built 1989 Under Construction Total # Parkin 8 Guest Parkin ON STREET # of Units Rented 4_ Describe the condition of the project and quality of construction. AVERAGE CONDITION AND QUALITY. Describe the common elements and recreational facilities. OPEN SPACE ONLY GENERAL DESCRIPTIQN INTERIOR materials AMENITIES APPLIANCES CAR STORAGE Floor # 1 Floors CARPET Fire laces # Refri erator None # of Levels 1 Walls DRYWALLS Woodstove s # X Ran a/Oven X Gara e Coverers 0 en Heatin T eFHA FueIELEC TrimlFinish PINE X DecklPatioPAT10 X Dis X Microwave #ofCars 1 X Central AC Individual AC Bath Wainscot FIBERGLASS X PorchlBalcon PORCH Dishwasher Assi ned X Owned • Other describe Doors HOLLOW CORE Other WasherlDr er Parkin S ace # N/A _ Finished area above rode contains: 5 Rooms 2 Bedrooms 2 Bath s 1,031 Square Feet of Gross Living Area Above Grade Comments on the improvements: THE APPRAISED PROPERTY IS IN AVERAGE CONDITION FOR IT'S AGE AND HAS BEEN FAIRLY WELL MAINTr41NED. THE CARPET NEEDS REPLACED DUE TO STRETCHING AND WEAR. THE SLIDER TO THE PATIO ALSO NEEDS REPLACED DUE TO WOOD ROT. NO FUNCTIONAL OR EXTERNAL INADEQUACIES NOTED. __ ~... ............ .......y .... .,, ... ... .,.,...-_,..,.... .......... ....__.,... ...._._..___~,.., _ __-___.... _. , Pagr 1 of 2 (gPAR"") General Purpose Appraisal Report 05 2006 ~,1.> ,PAR70, OS 08112(108 WOOF APPRAISAL GROUP individual Condominium Unit Appraisal Report File No. PVT9824 FEATURE SUBJECT COMPARABLE SALE N0. 1 COMPARABLE SALE N0.2 COMPARABLE SALE N0.3 Address 47096 CHARLES ROAD and MECHANICSBURG Unit # 8 4714A CHARLES ROAD MECHANICSBURG 24 47138 CHARLES ROAD MECHANICSBURG 12 153 EASTERLY DRIVE MECHANICSBURG 27 Project Name and ST MARKS PLACE Phase 1 ST MARKS PLACE 1 ST MARKS PLACE 1 WESTFIELD 1 Proximit to Sub ect 0.03 MILES WSW 0.04 MILES W 4.04 MILES WSW Sale Price $ S 137,500 $ 149,900 $ 117.000 Sale Pdce/Gross Liv. Area $ 0.00 s ft $ 133.37 s . ft. $ 136.27 s . ft. $ 133.26 s . ft. Data Sources MULTI-LIST SERVICE MULTI-LIST SERVICE MULTI-LIST SERVICE Verification Sources COUNTY DATABANK COUNTY DATABAN K COUNTY DATABANK VALUE ADJUSTMENTS DESCRIPTION DESCRIPTION +(-) S Ad'ustment DESCRIPTION +O $ Ad'usiment DESCRIPTION -(-) S Ad'ustment Sale or Financing Concessions CONY W/HELP -4,200 CONY W/HELP -2,935 FHA Date of SalelTime 02/27/2009 04/16/2010 06/30/2009 Location SUBURBAN SUBURBAN SUBURBAN SUBURBAN Leasehold/Fee Sim le FEE SIMPLE FEE SIMPLE FEE SIMPLE FEE SIMPLE HOA Mo. Assessment $110.00 $85.00 $85.00 $67.00 Common Elements and Rec. Facilities OPEN SPACE OPEN SPACE OPEN SPACE OPEN SPACE Floor Location 1 1 1 1 View RESIDENTIAL RESIDENTIAL RESIDENTIAL RESIDENTIAL Dest n St le RANCH RANCH RANCH RANCH Qualit of Construction. AVERAGE AVERAGE AVERAGE AVERAGE Actual A e 21 19 21 21 Condition AVERAGE ABOVE AVE. -4,000 ABOVE AVE. -4 000 ABOVE AVE. ~~4 000 Above Grade Total Bdrms Baths Total Bdrms Baths Total Bdrms. Baths Total Bdrms Baths • Room Count 5 2 2 5 2 2 5 2 2 3 1 1 +6 000 Gross Livin Area 1, 031 s . ft. 1, 031 s . ft. 0 1,100 s . ft. -2,800 878 s . ft. +6,100 • Basement & Finished Rooms Below Grade SLAB SLAB SLAB SLAB Functional Utilit AVERAGE AVERAGE AVERAGE AVERAGE Heatin /Coolin FHA/CA FHA/CA FHA/CA FHA/CA Ener Efficient Items HEAT PUMP HEAT PUMP HEAT PUMP HEAT PUMP Gana elCar ort 1 CAR GARAGE 1 CAR GARAGE 1 CAR GARAGE OFF STREET +5,000 PorchlPatio/Deck PATIO PORCH PATIO PORCH PORCH +1,000 PATIO +500 EXTRA'S NONE NONE ENC'D PORCH -5,000 NONE Net Ad ustment (Total) + X - $ 8,200 + X - $ 13,735 X + $ _ 13,600 Adjusted Sale Price of Com arables Net Adj. ~.0% GrossAtl. 6.0% $ 129300 Net Adj. -9.2% GrossAd~. 10.5% $ 136165 Net Adj. 11.6% Gross Ad. 18.5% $ 130600 Summary of Sales Comparison Approach MY MARKET RESEARCH AND RESULTS. SALES, LISTING, AND PENDING SALES WERE RESEARCHED FOR SIMILAR AGE, STYLE, SIZE, AND CONDITION CONDOMINIUM SALES FROM THE NEIGHBORHOOD. WITH ONLY TWO RECENT RANCH STYLE UN{T SALES IN THE NEIGHBORHOOD, A DISTANT UNIT HAD TO BE USED. MARKET DATA OF CLOSED SALES WAS STILL CONSIDERED SUFFICIENT TO ARRIVE AT AN OPINION OF VALUE. CONDITION ADJUSTMENTS BASED ON MULTI-LIST DESCRIPTIONS OF UPGRADES ON COMPARABLE SALES. ALL SALES WERE CLOSED AND CONSIDERED EQUALLY WHEN ARRIVING AT MARKET VALUE. Indicated Value b Sales Com arison A roach $ 130 000 INCOME APPROACH TO VALUE Estimated Monthl Market Rent $ NiA X Gross Rent Multi tier NIA = $ N/A Indicated Value b Income A roach _ • Summary of Income Approach (including support for market rent and GRM) THE INCOME APPROACH WAS CONSIDERED NOT APPLICABLE DUE TO LIMITED RENTAL UNIT SALES. Indicated Value b Sales Com arson A roach $130 000 Income A roach (if develo ed) $ N/A ALL THREE APPROACHES TO VALUE WERE CONSIDERED. HOWEVER, ONLY THE SALES COMPARISON APPROACH IS CONSIDERED _ APPLICABLE DUE TO THE NATURE OF THE PROPERTY, A CONDOMINIUM. • • This appraisal is made X "as is," subject to completion per plans and specifications on the basis of a hypothetical condition that the improvements have been completed, ^ subject to the following repairs or alterations on the basis of a hypothetical condition that the repairs or alterations have been completed ^ subject to the following: • APPRAISED "AS-IS". Based on the scope of work, assumptions, limiting conditions and appraiser's certification, my (our) opinion of the defined value of the real property that is the subject of this report is $ 130,000 as of 07/15/2010 , which is the effective date of this appraisal. ~ii.< Pfrl°ULPU U51lIgAt;l$°Irware. aUU.134.tl/L/WWW.aLIWP.°.C°m IUIS IUrm I.UP`~rlynl"[W]-(we nl-i urvi5~°r it isv~nin»nvcr,~. is n rcy i~nc~nvrv. Pagr. 2 of 2 (gPAR'"') General Purpose Appraisal Report 05/200f (,PAR1013 050811200E Woof Appraisal Group File No. pVT9824 Scope of Work, Assumptions and Limiting Conditions Scope of work is defined in the Uniform Standards of Professional Appraisal Practice as "the type and ex[entof research and analyses in an assignment." In short, scope of work is simply what the appraiser did and did not do during the course of the assignment. It includes, but is not limited to: the extentto which the property is identified and inspected, [he type and extent of data researched, the type and extent of analyses applied to arrive at opinions or conclusions. The scope of this appraisal and ensuing discussion in [his report are specific to the needs of the client, other identified intended users and to the intended use of the report. This report was prepared for the sole and exclusive use of the client and other identified intended users for the identified intended use and its use by any other parties is prohibited. The appraiser is not responsible for unauthorized use of the report. The appraisers certification appearing in this appraisal report is subject to the following conditions and to such other specific conditions as are set forth by the appraiser in the report. All extraordinary assumptions and hypothetical conditions are stated in the report and might have affected thE, assignment results. 1. The appraiser assumes no responsibility for matters of a legal nature affecting the property appraised or title thereto, nor does the appraiser render any opinion as to the title, which is assumed to 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 only to assist the reader in visualizing the property. l he appraiser has made no survey of the property. 3. The appraiser is not required to give testimony or appear in court because of having made the appraisal with reference to the property in question, unless arrangements have teen previously made thereto, 4. Neither all, nor any part of the content of this report, copy or other media thereof (including conclusions as to the property value, the identity of the appraiser, professional designations, or the firm with which the appraiser is connected), shall be used for any purposes by anyone but the client and other intended users as identified in this report, nor shall it be conveyed by anyone to the public through advertising, public relations, news, sales, or other media, without the written consent of the appraiser. 5. The appraiser will not disclose the contents of this appraisal report unless required by applicable law or as specified in the Uniform Standards of Professional Appraisal Practice. 6. Information, estimates, and opinions furnished [o the appraiser, and contained in the report, were obtained from sources considered reliable and believed to be true and correct. However, no responsibility for accuracy of such items furnished to the appraiser is assumed by the appraiser. 7 The appraiser assumes that there are no hidden or unapparent conditions of the property, subsoil, or structures, which would render it more or less valuable. The appraiser as~;umes no responsibility for such conditions, or for engineering or testing, which might be required to discover such factors. This appraisal is not an environmental assessment of the property and should not be considered as such. 8 The appraiser specializes in the valuation of real property and is not a home inspector, building contractor, structural engineer, or similar expert, unless otherwise noted. The appraiser did not conduct the intensive type of field observations of the kind intended to seek and discover property defects. The viewing of the property and any improvements is for purposes of developing an opinion of the defined value of the property, given the intended use of this assignment. Statements regarding condition are based on surface observations only. The appraiser claims no special expertise regarding issues including, but not limited to: foundation settlement, basement moisture problems, wood destroying (or other) insects, pest infestation, 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 used to disclose the condition of the property as it relates to the presencelabsence ofdefects. The client is invited and encouraged to employ qualified experts to inspect and address areas of concern. If negative conditions are discovered, the opinion of value may be affected. Unless otherwise noted, the appraiser assumes the components thatconstitute the subject property improvement(s) are fundamentally sound and in working order. Any viewing of the property by the appraiser was limited to readily observable areas. Unless otherwise noted, attics and crawl space areas were not accessed. The appraiser did nol move furniture, floor coverings or other items that may restrict the viewing of the property. 9. Appraisals involving hypothetical conditions related to completion of new construction, repairs or alteration are based on the assumption that such completion, alteration or repairs will be competently performed. 10. Unless the intended use of this appraisal specifically includes issues of property insurance coverage, this appraisal should not be used for such purposes. Reproduction or Replacement cost figures used in [he cost approach are for valuation purposes only, given the intended use of the assignment. The Definition of Value used in this assignment is unlikely to be consistent with the definition of Insurable Value for property insurance coverageluse. 11 The ACI General Purpose Appraisal Report (GPAR'"") is not intended for use in transactions that require a Fannie Mae 1073/Freddie Mac 465 forrri, also known as the Individual Condominium Unit Appraisal Report (Condo}. Additional Comments Related To Scope Of Work, AssumpGOns and Limiting Conditions STATEMENT OF ADDITIONAL LIMITING CONDITIONS AND ASSUMPTIONS THIS APPRAISAL REPORT HAS BEEN PERFORMED FOR THE CLIENT INDICATED IN THE PRECEDING, WITH WHOM PROFESSIONAL. STANDARDS REQUIRES ME TO MAINTAIN A STRICT REQUIREMENT OF CONFIDENTIALITY. I, BY REASON OF THIS REPORT, AM NOT REQUIRED TO GIVE TESTIMONY IN COURT WITH REFERENCE TO THIS APPRAISAL. IF ANYONE WISHES MY APPEARANCE, 1T CAN BE ARRANGED ONLY BY PRIOR ARRANGEMENT BEING MADE WITH ME. SUCH APPEARANCES ;iHALL BE MADE AS AN EXPERT WITNESS AND THE FEE FOR SUCH APPEARANCES SHALL BE AT THE RATE OF $125/HOUR PORTAL TO PORTAL, PLUS ANY REASONABLE COST INCURRED BY ME. PURPOSE: THE PURPOSE OF THIS APPRAISAL IS TO ESTIMATE THE MARKET VALUE OF THE FEE SIMPLE INTEREST IN THE TITLE OF THE PROPERTY THE VALUE IS AS OF THE DATE OF DEATH, WHICH IS NOT THE DATE THE PROPERTY WAS LAST VIEWED IN ITS ENTIRETY AND PHOTOGRAPHED. SIGNATURE: THE ELECTRONIC SIGNATURE USED IN THIS REPORT ARE PROTECTED BY THE APPRAISER AND ONLY THE APPRAISER HAS COMPLETE CONTROL OF THE SIGNATURE. ADDITIONAL CERTIFICATION THE INTENDED USER OF THIS APPRAISAL REPORT IS THE LENDER/CLIENT. THE INTENDED USER IS TO EVALUATE THE PROPERT'>' THAT IS THE SUBJECT OF THIS APPRAISAL FOR AN ESTATE, SUBJECT TO THE STATED SCOPE OF WORK, PURPOSE OF THE APPRAISAL., REPORTING REQUIREMENTS OF THIS APPRAISAL REPORT FORM, AND DEFINITION OF MARKET VALUE. NO ADDITIONAL INTENDED USERS ARE IDENTIFIED BY THE APPRAISER. ~~."* %ntlllfe0 using Al.l sonWale. tlUU.LJ9.tl/L ~ VM'W,acIWCn.cnm i nn ium ~oyy, ym -~ [w~ cuw n~ ~ vn,w u ,~v ~,n m> ~c,v ~~~ „ ~. n rt y ,~ nc~n vc~ Page 1 or 2 (gPARTM') Grneral Purpose Appraisal Report 05/2007 c nRUnnoi otoanzooe File No. PVT9824 Appraiser's Certification The appraiser(s) certifies that, to the best of the appraiser's knowledge and belief: 1. The statements of fact contained in this report are true and correct. 2. The reported analyses, opinions, and conclusions are limited only by the reported assumptions and limiting conditions and are the appraiser's personal, impartial, and unbiased professional analyses, opinions, and conclusions. 3. Unless otherwise stated, the appraiser has no present or prospective interest in the property that is [he subject of this report and has no personal interest with respect to the parties involved. 4 The appraiser has no bias with respect to the property that is the subject of this report or to the parties involved with this assignment. 5 The appraiser's engagement in this assignment was not contingent upon developing or reporting predetermined results. 6. The appraiser's compensation for completing this assignment is not contingent upon the development or reporting of a predetermined value or direction in value that favors the cause of the client, the amount of the value opinion, the attainment of a stipulated result, or the occurrence of a subsequent event directly related to the intended use of this appraisal. 7 The appraiser's analyses, opinions, and conclusions were developed, and this report has been prepared, inconformity with 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 this report. 9. Unless noted below, no one provided significant real property appraisal assistance to the appraiser signing this certification. Significant real property appraisal assistance provided by: Additional Certifications: Definition of Value: QX Market Value ^Other Value: Source of Definition: REAL ESTATE APPRAISAL TERMINOLOGY "THE MOST PROBABLE PRICE WHICH A PROPERTY SHOULD BRING IN A COMPETITIVE AND OPEN MARKET UNDER ALL CONDITIOIVS 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: 47096 CHARLES ROAD MECHANICSBURG, PA 17050 EFFECTIVE DATE OF THE APPRAISAL: 07/15/2010 APPRAISED VALUE OF THE SUBJECT PROPERTY $ 130,000 APPRAISER SUPERVISORY APPRAISER Signature: _y1~~ ~-""""`~,T Signature: Name: REYNOLD R. WOOF, JR. IFAS Name: _ State Certification # GA000002L State Certification # _ or License # or License # or Other (describe): State #: State: _ State: PA Expiration Date of Certification or License. _ Expiration Date of Certification or License: 06/30/2011 Date of Signature: Date of Signature and Report: 07/17/2010 Date of Property Viewing: Date of Property Viewing 07 /1 512 01 0 Degree of property viewing: Degree of property viewing: Q Interior and Exterior ^ Exterior Only ^ Did not personally view Interior and Exterior ^ Exterior Only ^ Did not personally view R PrndUred using ACI software, 800234 8727 wxw.aciweb cexn Thisform Copyright a 2005-2008 ACI Division of ISO Claims Swvices, Inc,. NII Righ[s Reserved Page 2 of 2 (gPAR"") General Purpose Appraisal Report 05/2001 ,PgRUM1071 0108112008 Woof Appraisal Group SUBJECT PROPERTY PHOTO ADDENDUM Cllen[: COYNE & COYNE P.C. Flle No.: PVT9824 ____ Pfoperly AddfeSS: 47096 CHARLES ROAD Case No.: _ _ CI[ MECHANICSBURG Slate: PA ZI :17050 FRONT VIEW OF SUBJECT PROPERTY Appraised Date: ~u~Y 15, 2010 Appraised Value: $ iso,ooo REAR VIEW OF SUBJECT PROPERTY STREET SCENE COMPARABLE PROPERTY PHOTO ADDENDUM Cllent: COYNE & COYNE P.C. Flle NO.: PVT9824 _ PfOpefty AddfeSS: 47096 CHARLES ROAD Case No • _~ CII :MECHANICSBURG State: PA ZI :17050 COMPARABLE SALE #1 4714A CHARLES ROAD, #24 MECHANICSBURG Sale Date: 02/27/2oos Sale Price: $ 137,500 COMPARABLE SALE #2 47136 CHARLES ROAD, #12 MECHANICSBURG Sale Date: 04/16/2010 Sale Price: $ 14x,900 COMPARABLE SALE #3 153 EASTERLY DRIVE, #27 MECHANICSBURG Sale Date: 06/30/2009 Sale PfICe: $ 117,000 FLOORPLAN Cllent: COYNE & COYNE P.C. Flle NO.: PVT9824 FfOpefly AddfeSS' 47098 CHARLES ROAD Case No.: __ CII : MECHANICSBURG State: PA ZI :17050 0 ui M O N r O Sketch by Apex {V WindowsTM' II AREA CALCULATIONS SUMMARY Code Desct;ption Size Totals LIVING AREA BREAKDOW Breakdown N Subtotals GLA1 Firat Floor 1031.00 1031.00 Firat Floor P/P Porch 24.00 13.0 x 47.0 611.00 PATIO 120.00 144.00 12.0 x 35.0 420.00 GAR Garage 216.00 216.00 I 1 TOTAL LIVABLE (rounded) 1031 2 Areas Total (rounded) 1031 4.0' 1 2.0' LOCATION MAP ;Ilent: COYNE & COYNE P.C. Flle NO.: PVT9824 ~fOpef~y Add~eSS: 47098 CHARLES ROAD Case No ,IIy: MECHANICSBURG $Iale' PA Zlp' 17050 - - --~ ~ ;. «. ~, A Io ~* ~ ~; ~. ~. €Taf ~; P~~r~! i,. rr~~q ~ k ~~ ~~ ~ ,y. ~° 4 ~~ ~~ jj jff yyi. ~; 44 r!!r~~ ICI iI .)~.~.}:~~~di. IY~j I~ ~; ~ t~ ~ ~' ~ ~ ~ ~k .. ~ ,, ~ . ~ " ~i ~J ~~~ C. ~ , ~'~' ~~~` ~ ~ '~ F, .... .. .,.. i~ :. ~ . s ,~, E ~~, ~ .,,,tip?; E~ ,. ,..,~. - ".- "~~ rrS «~ ~' -.. c iy e [~..j l .;S ~ ...1 i.: ~'r+ ~ Iii, ; {,i '{~~.~ ~i` ~_ (.~ \py }J' j{ k ~?~fV,R~~~A tA~ ~ Sfl:k a• ~ ~ ~~ \F ~ ~ w1h ~ `"viii ~~~41~ ~ ~' [~~ ~ti ~ '. ~) ~^ td^ Mf Lt:,i :J~ ~ ~ { q '".-''",~~Q „t%, $~~p ~ / ' ~:: t. ~ • ~ k..*i'3 ~ 3 i. ~~'~`~ ~f °i t 3 _~ , 3 j ~ I a ,y,• ~ e f ~" Sher v F 111 aa~ i ~e'i4 tt ~~13 r~a'~s:.~~~~ -,<. .~. ~ ~ i.~ { ~;F ( 1~4~~Z3 F~''F ~ ~~jj gi._ yl~gg $~~NMi~~ ~+~~ ~`~ _E4 jk F"_~j tI 3'n ~ 'k~ ~ .~Y ~f ~ ~ yZ t. ~Z~y yy "3 ~ C' .3 nv' Y' `» .~ ~ ~r~ ,: ~ £ ~ ~" ~ T~i~~~s~ ``y ~4 ~ T ,~f+ ~ ~kPi r. j t ' ~~k4 ~ ~~,~ .. F ~ ~ ~ : . a i 4 ~ . ~ '' .~.,~~. 3 f ~ ) ~~ f kt 3 IJ !~°' 13~~'~ 4s~A~ t ,ri ,. `~ 2 s ~ j ~ l ~~ L f~ Myy~ ~` .~^, ~M ~ 7 X' ~ '~C ~' Y~ s 1'~~-~Eiu:r~~ ~r~`irxct~r~r~ x W ~;, '~ _ ~~ ~`' ..W ~. }^e~ ilk •~ vK ~~ ~ '~'"~F~ .'~.i ~~ }°~II~ ~. ~~fif y ~yN {' Y ~~y''` .~ ~ ~a W~ `~: ~'. €A `~.:, ~~"t: ~ lrl t1~ i~, -:~~ A~~ ~~ c~` t54{~L~ 1 r .,~' ,- . ; 3 1 ~ie~ '. ~~ - `w WOOF APPRAISAL GROUP File No. PVT9824 - --- ********* INVOICE ********* File Number: PvTS824 LISA COYNE COYNE & COYNE P.C. 3901 MARKET STREET II CAMP HILL, PA 17011 1nV01Ce # : PVT9824 Order Date : o7~13r2o1o 47096 CHARLES ROAD MECHANICSBURG, PA 17050 APPRAISAL Invoice Total Deposit Deposit Amount Due TefmS: DUE UPON RECEIPT Please Make Check Payable To: WOOF APPRAISAL GROUP 302 SOUTH FRONT STREET WORMLEYSBURG, PA 17043 Fed. I.D. #: 193-38-0157, SOLE PROPRIETOR/ REYNOLD R. WOOF, JR. 300.00 -------------- 300.00 ($ 7 ($ ) $ 300.00 J 302 SOUTH FRONT STREET, WORMLEYSBURG, PA 17043 ~ ~ ~ a • S ~ ~ s • ~ 1E ~ 's •f ~ f • iyable To: Office Hours: Crawford County, Pennsylvania oanne Homa-Patterson Tuesdays 8~ Thursdays 3:OOPM - S:OOPM BILL # 2347 Iloomfield Twp Tax Coll. - August 27, 28, 30 and 31 1fl:00AM - 4:OOPM 47121n1et Drive October 29, ~ 3010:00 AM - 4:00 PM !non City, PA 1fi438 or by appointment {814) 694 - 3132 * 3 0 1 0 1 3 0 0 2 3 6 7 MAILING DATE: 07!01/2010 Discour~ School ~ 2% Penalty: School ~ 10% . TAXES TAX RATE DISCOUNT AMOUNT Until 08/31/10 FACE AMOUNT Between 09!01110 And 10/31110 PENALTY AMOUNT Starting 11/O1N0 SCHOOL 37.930 ML $375.43 $383.09 $421.40 ~TAL TAB DUE $375.43 $383.09 $421.40 axes are due and payable and -~'' yment is requested from: ILLIAMS, DOROTHY 09 B Charles Rd ~chanicsburg PA 17050 (ate,,.,, ''~ Q ry Tax Collector before 12/3112010 ~ or after 01 J01 /2011, taxes are payable to Tax Claim Bureau, 3 Diamond Square, Meadville, PA. 16335 AXPAYER OR MORTGAGE HOLDER COPY eturn both copies with a self addressed stamped envelope for receipt Control #: 13-0-002367 Map #:1306-026-19-20 Bloomfield Township Union City School District 2 lots 8~ Bldg. Ruggles Park Acreage: 0 Deed Ref: 520/545 ASSESSED LAND - 650 ASSESSED IMPR - 0 ASSESSED TOTAL - 10100 ~ ~ ~'7$' _ ~- ~~ r---~.3 _ ~ ~ ~ c_, ,~~~ _ # ` ~`~_ _ _ ~ li~ 1J Amount Paid Date Tax CoNector U~~ ~ ~~ ~~;~ C ~~~~'I~~ .~ :_ J1JNE 2010 PENNSYLVANIA DEPARTMENT OF REVENUE REALTY TRANSFER TAX COMMON LEVEL RATIO (CLR) REAL ESTATE VALUATION FACTORS FOR CRAWFORD COUNTY The following real estate valuation factors are based on sales data compiled by the Statf; Tax Equalization Board. These factors are the mathematical reciprocals of the actual common level ratios. For Pennsylvania Realty Transfer Tax purposes, these factors are applicable for documents accepted for the periods indicated below. The date of acceptance of a document is rebuttably presumed to be its date of execution, that is, the date specified in the body of the document as the date of the instrument. 61 Pa. Code § 91.102 ACCEPTANCE DATE CLR FACTOR ACCEPTANCE DATE CLR FACTOR FROM TO FROM TO 7-2-1986 6-30-1987 1.40 7-1-2006 6-30-2007 3.02 7-1-1987 6-30-1988 1 34 7-1-2007 6-30-2008 3.04 7-1-1988 6-30-1989 1.41 7-1-2008 6-30-2009 2.98 7-1-1989 6-30-1990 1.47 7-1-2009 6-30-2010 2.85 7-1-1990 6-30-1991 1.62 7-1-2010 6-30-2011 2.78 7-1-1991 6-30-1992 1.70 7-1-1992 6-30-1993 1.79 7-1-1993 6-30-1994 1.84 7-1-1994 6-30-1995 1.97 7-1-1995 6-30-1996 1.93 7-1-1996 6-30-1997 2.06 7-1-1997 6-30-1998 2.17 7-1-1998 6-30-1999 2.2] 7-1-1999 6-30-2000 2.43 7-1-2000 6-30-2001 2.63 7-1-2001 6-30-2002 2.82 7-1-2002 6-30-2003 2.83 7-1-2003 6-30-2004 2.83 7-1-2004 6-30-2005 2.95 7-1-2005 6-30-2006 2.87 REV-1508 EX+ {6-98) r COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Dorothy D. Williams 21-10-0704 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. (If more space is needed, insert additional sheets of the same size) _.. -_ - - --- ~ _ _ BANK 3801 Paxton Street Harrisburg ~ PA ~ 17111 mymetrobank.com 888.937.0004 July 22, 2010 Coyne & Coyne 3901 Market St Camp Hill PA 9:7011 _ : _ - RE: Estate of: Do othy D. Williams ,~ Tax Identifica n Number: 207-18-7 4 Date of Death: Ju 2010 To Whom It May Concern: This letter is in reference to decedent account information you requested' for the individual listed above. We are able to provide the following: Account Type: Checking Account Number: 32061301 Date Opened: 03/20/1996 Primary Owner: Dorothy D. Williams Date of Death Balance: $7223.00 Please feel free to contact me at (717) 412-6127 if I may be of further assistance. Sincerely, Diana Reynolds Metro Bank Research Associate/Deposit Services Calculated Value of Your Paper Savings Bond(s) Page 1 of 1 Calculated Value of Your Paper Savings Bond(s) ` Calculator Results for Redemption Date 07/2010 ~"o~a! ~rl~~ ~`ofa! Vale Toga! Ir~~~rt~~f YTS In~~~-~s~ $300.00 $2,179.68 $1,879.68 $0.00 Bonds: 1-8 of 8 s~~-~~! ~ s~~~~~ ~~no ~~~~e N~~~ ~~~a! ~s~~~ ~~~~~~~ ~~~~~~ ~~~ ~o~~ ~~~~ ~~~~~~ M~~~~~~~- ~r~~~ ~~t~ L.766690489E : E $50 ;10/1969 :10/1999 ; $37.50 ; $232.54 ° $270..04 MA L766859011E : E $50 ;11/1969: ' 11/1999 ° $37.50 $232.54': ~ $270.04 MA L773987329E : E $50 < 11/1969: ' 11/1999 $37.50 i $232.54 ; $270.04 . . _ , MA , ..... ..,...,__,.............. ................~..... L773805792E > ........__._...~......-.. E _.. _..... _,.................._ ,f. .... .....,. ., $50 ;12/1969: ........,_........ .._.....,._..,_... _7... _ ...... .. .12/1999. ..- _......_..... ..... .w $37.50 .,..... _.. _........, ,...4........ ........ ....._. .,,.... $233.94. ._..._...,. ..., . .. . $271~~4 . .. MA L774144797E .. . . .... .... E $50 ;01/19701 :01/2000; $37.50 $2.36.50 $274.00 MA . . . .. . L782806357E 1 E $50 02/1970 3 :02/2000: $37.50 ~ $237.18: $274.6$ MA L780284306E ._ ...._.. .................. E ~ _.. . . . $50 .. 03/1970 ; 03/2000: . . $37.50 ~ $237.22 ; $274.7 MA r. L785006083E_F _ . r E . $50 ~. X04/1970 . _ _ ~ 04/2000: $37.50 $237.22 $274.72 MA To tals for 8 Bonds :.$3.00.00: $1,879.68 ° $ 2 179.68 N~~€~~ NI ;Not Issued NE ;Not eligible for payment _ P5 Iracludes_ 3 month interest penalty ____.__....._._._. MA MMatured and not earnin interest fi1P1lT~•1.CharP~io~2nT~nr.7iment.c\F..~tafe~\(~PFN%,~QF.~TATF,~\WILLIAMS.20101~zIlia~.S%20ESa... 7/3 0/2010 X91 Cadillac Eldorado -Private Party Pricing Report -Kelley Blue Book ~~ ' ~.. ~.,~.,. _ .._ a ._.... ~~~ nd'JertlSe#1"€ent Page 1 of 2 ~"'"" Send to Print ~...... .. n .n~...~.~~. ~k..r ~.,~~~R.~k~ ..~.~,.... .~.. n. . «~.....~~ ,~ ~tiii€ F:~~ ~.-.~.~.,~ :aF. z. ~~~~ ~ ~~~st. ,~~~ ~tr~ c~~il~ o~ ~roc~. r~~~i~~a fM,:;~ , a - ..r~~ ~.... . ~:. ;... u~~.......~ . ~~~~~.~g ~. ~. 1991 Cadillac Eldorado Biarritz Coupe 2D Eceiie Good ~~i~- (Selected) BLUE BoOKO PRIVATE PARTY VALUE Condition ,~ $1,875 Vehicle Highlights Mileage: 60,000 Engine: V8, 4.9 Liter Transmission: Automatic Drivetrain: FWD __ Selected Equipment Standard Air Conditioning Power Doer Locks Cassette Power Steering Cruise Control l.~ual Power Seats Power Windows AM/FM Stereo Stee! Wheels Blue Book Private Party Value Kelley Blue Book. Private Party Value is the amount a buyer can expect to pay when buying a used car from a private party. The Private Party Value assumes the vehicle is sold "As Is" and carries no warranty (other than any remaining factory warranty). The final sale price may vary depending on the vehicle's actual condition and local market conditions. This value may also be used to derive Fair Market Value for insurance and vehicle donation purposes. Vehicle Condition Ratings adver-tiser~nent X99 Close Windo~fv E~s~ellent a ~ $~,~.f ~ Looks newF is ire excellent mechanical condition and needs no reconditioning. + iUeve~- had any paint or body work and is free of rust. (" lean title hi5tnrv arzc3 inriif €~aS~ a smnn anr( satei-v i€-€s€-~ertinn. http ://www.kbb. com/used-cars/cadillac/eldorado/ 1991 /private-party-value/pricing-report?conditio ... 7/3 0/2010 REV-1509 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY OWNED PROPERTY ESTATE OF FILE NUMBER Dorothy D. Williams 21-10-0704 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIC)NSHIP T~J DECEDENT A. Ralph E. Williams, III 7 Briargate Road son Mechanicsburg, PA 17050 B C JOINTLY-OWNED PROPERTY: ITEh4 NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1. A. 03109181 Sovereign Bank Savings Account 5,277.95 ~i0 2,638.98 TOTAL (Also enter on line 6, Recapitulation) $ 2,638.98 (If more space is needed, insert additional sheets of the same size) BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE AND TAXPAYER RESPONSI= FILE N0. 21 10-0704 ACN 10165142 DATE 11-12-2010 RALPH E WILLIAMS III 7 BRIAR GATE RD MECHANICSBURG PA 17050-3178 EST. OF DOROTHY D WILLIAM`.3 SSN 207-18-7874 DATE OF DEATH 07-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. SOVEREIG N B ANK provided the Department with the information below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-named decedent, you were a joint owner/beneficiary of this account. If you feel the information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of Pennsylvania. Please call (717) 787-8327 with Questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0574107934 Date 03-09-1981 To ensure proper credit to the account, two Established copies of this notice must accompany payment to the Register of Wills. Make check Account Balance $ 5, 278 • 02 Payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to Tax $ 2, 639.01 months of the decedent's date of death, Tax Rate X .045 deduct a 5 percent discount on the tax due. Anv Inheritance Tax due will become delinquent Potential Tax Due $ 118.76 nine months after the date of death. PART TAXPAYER RESPONSE FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT A. ^ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain C H E C K a discount or avoid interest, or check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. ONE B L 0 C K B. The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y be filed by the estate representative. C. ~ The above informa ion is incorrect and/or debts and deductions were paid. Complete PART ~2 and/or PART ~ below. PART If indicating a different tax rate, please state OFFiQIAL USE ONLY ~ AAF relationship to decedent: 2^ PA DEPARTMENT OF REVENUE TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. ilate Established 1 1 2. Account Balance 2 $ 2 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 - 5 6. Amount Taxable 6 $ 6 7. Tax Rate 7 X 7 8. Tax Due 8 PART DEBTS AND DEDUCTIONS CLAIMED 3^ DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. HOME C 7l7 ) 6 % ~ ' ~j.3 ~j~j~ /~ O ~~ ~, a' ;' ~~/' ~ ~.~ WORK C ) ~ AYER SIGNATURE TELEPHONE NUMBER DATE TOTAL (Enter on Line 5 of Tax Computation) 5 Sovereign Bank ESTATE OF Dorothy D. Williams SOCIAL SECURITY #: 207-18-7874 DATE OF DEATII: July 5, 2010 Account #: 0574107934 Type: Savings -Open date: 3/9/1981 In the name of: Dorothy D. Williams or Ralph E. Williams, III Date of Death Balance: $5,277.95 Int.(YTD) from 1/1/2010 to 6/30/2010 $3.7~> Accrued interest to date of death: $0.07 Other Info: Closed 7/14/10 Account #: 0358003853 Type: IRA CD Open date: :?/7/1984 In the name of: Dorothy D. Williams Date of Death Balance: $24,081.95 Int.(YTD) from 1/1/2010 to 2/4/2010 $82.66 Accrued interest to date of death: $10.03 Other Info: Beneficiaries: Ralph; Thomas and Carlton Williams (sons) Page 1 of 1 ~ pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER Dorothy D. Williams 21-10-0704 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELAT]oNSHIP TO DECEDENT AND THE BATE OF TRANSFER. ATTACH A COPY of THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'5 INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1~ Sovereign Bank IRA CD 24,081.95 100 24,081.9 Beneficiaries: Ralph Williams III, Thomas Williams, Carlton Williams (sons) TOTAL (Also enter on Line 7, Recapitulation) $ 24,081.95 If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+ (12-99) SCNEDVLE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Dorothy D. Williams 21-10-0704 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1 ~ Myers Funeral Home 3,708.00 2. Reception 500.00 3. Flowers 200.00 4. Honorarium 200.00 5. Headstone and Engraving 1,800.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative"s Commissions Name of Personal Representative(s) Social Security Number(s)IEIN Number of Personal Representative(s) Street Address City .State Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) claimant Carlton Williams Street Address 47096 Charles Road Zip 6,000.00 3,500.00 city Mechanicsburg state PA .zip 17050 Relationship of Claimant to Decedent SOn 4. Probate Fees 323.50 5. Accountant's Fees 800.00 6. Tax Return Preparer's Fees ~. Patriot News -Legal Advertisement 123.38 $. Cumberland Law Journal -Legal Advertisement 75.00 9. Woof Appraisal -- appraisal of Real Estate 300.00 10. Postage 88.00 11. Filing Fee for Inheritance Tax Return 15.00 12. Total from Schedule H, Page 2 4,871.30 TOTAL (Also enter on line 9, Recapitulation) $ 22,504.18 (If more space is needed, insert additional sheets of the same size) A B C D E 1 SCHEDULE H: 2 ~ FUNERAL AND ADMINISTRATIVE COSTS, PAGE 2 --- 3 4 Item No. Description ~ Amount 5 14 ~ Reserves '~ ~i $3,000.00 6 15 ',Sovereign Bank Processing Fee ~ $20.00 7 16 I Extra Death Certificates $20.00 8 17 !Estate Checks $30.00 9 18 'Real Estate Taxes $1 ,801.30 10 I ', . --- 11 TOTAL: ~~ - 1. $4,871.30 ~ pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF FILE NUMBER Dorothy D. Williams 21-10-0704 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. If more space is needed, insert additional sheets of the same size. ~ pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Dorothy D. Williams 21-10-0704 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 outright spousal distributions and transfers under Sec., 9116 (a) (1.2).] 1. Ralph E. Williams, III son 1 /3_of residual 2. Thomas R. Williams son 1~3_of residual 3. Clayton H. Williams son 1f3_of residual ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, A S APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ If more space is needed, insert additional sheets of the same size. . ~ ! LAST WILL AND TESTAMENT OF DOROTHY D. WILLIAMS I, DOROTHY D. WILLIAMS, of 4709B Charles Road, Mechanicsburg, Cumberland County, Pennsylvania, being of sound mind and memory, do make, publish and declare this my Last Will and Testament, hereby revoking and declaring null and void any and all Wills and Codicils by me at any time heretofore made. FIRST: I direct my Executor to pay my just debts, the expense of my last illness, and my funeral expenses, from the property passing under this Will as an expense and cost of administering my estate, as soon after my death as may k~e found convenient. SECOND : I give and bequeath all that I possess iri the world of whatever nature and wherever situate, including both real and personal property, in equal shares to my children, RALPH E. WILLIAMS, III, of 7 Briargate Road, Mechanicsburg, Pennsylvania, provided he survives me; CARLTON H. WILLIAMS, of 4709B Charles Road, Mechanicsburg, Pennsylvania, provided he survives me; and, THOMAS R. WILLIAMS, of 9'07 Thornton Drive, Mechanicsburg, Pennsylvania, provided he survives me. If either CARLTON H. WILLIAMS or THOMAS R. WILLIAMS has predeceased me, PAGE 1 OF A 6 PAGE WILL t then that child' s gift shall lapse and remain part of my estate . However, should RALPH E. WILLIAMS predecease me, then I.give, devise and bequeath his share to his three children, JONATHAN L. WILLIAMS, KRISTEN E. WILLIAMS and RYAN M. WILLIAMS,,in equal shares. THIRD : I direct that no Executor, or other f iduc:iary named, nominated, or appointed in this, my Last Will anal Testament, shall be required to post any bond or give any security of any type for any purpose whatsoever, any law or rule of court of the Commonwealth of Pennsylvania. or any j ur_i.sdiction to the contrary notwithstanding. FOURTH : My Executor shall have the f ollowing powers in addition ,to those vested in him by law and by other provisions of this Will, applicable to all property, real, personal and mixed, and wheresoever situate, whether principal or income, exercisable without court approval, and effective with respect to each item of said property, until actual distribution thereof: A. To retain, as investments, any and all assets of my estate, real, personal, or mixed, without regard to any principal of diversification, and to purchase and acquire real or personal property, and to hold any or all of such real and personal PAGE 2 OF A 6 PAGE WILL property retained or acquired without making the same productive of income; B. To permit occupancy of any real estate retained or acquired upon such terms and conditions,as he shall deem proper; C. To pay all taxes, charges and expenses of maintenance, upkeep, improvements, development, protective, preservaition, and investment of any retained or acquired real or personal property, such payments to be made from either principal or income, as my Executor shall determine; D. To retain or invest any and all funds, whether principal or income, in any real or personal property without resitriction to legal investments; to purchase investments as premiums; to exercise all rights of a security holder or shareholder in any corporation; and to lease, mortgage, pledge, give options upon or sell, at public or private sale and without approval of any court and without any responsibility to the buyer or buyers to see to the application of the purchase price, any real or personal property, or portions thereof, irrespective of the manner or the means by which the same was acquired by my said Executor. E. To make any payment or distribution herein provided for in cash, kind, or partly in cash and partly in kind, at valuations fixed by my Executor at the same time of distribution. PAGE 3 OF A 6 PAGE WILL FIFTH: I name and appoint my son, RALPH E. WILLIAMS, III, Executor of this, my Last Will and Testament. Should may son, RALPH E. WILLIAMS, III, fail to survive me, fail to qualify, or cease to act as Executor, I name and appoint my son, CARLTON H. WILLIAMS to act as substitute Executor. IN WITNESS WHEREOF, I have hereunto set my hand and seal t h i s ~~ `~ ''`day o f ~. ~~~ 2 0 0 0. . ~~ ~~~~.~~ DOROTHY D ILLIAMS PAGE 4 OF A 6 PAGE WILL COMMONWEALTH OF PENNSYLVANIA: SS COUNTY OF DAUPHIN and ~,~-~,: ~.~ ~ ~~\~a~,, c, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we a:re present and saw the Testatrix sign and execute the instrument a;s her Last Will; th~t`'DOROTHY D. WILLIAMS signed willingly and that DOROTHY D. WILLIAMS executed it as her free and voluntary act for the purpose therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that to the best of our knowledge, the Testatrix was at that time eighteen (18) or more years of ,age, of sound mind and under no constraint or undue influence. Sworn o ffirmed to and ,~ , 2000. NOTARY PUBLIC su scrib to before me by Cl.~- ~, and the witnesses, this y--~=- day of In ~.~v~ f ~~,~ • ~uv cw 1 e ~~ °``~ 1 ,NOTARIAL SEAL CABBIE ~. COC)k~ NotQN Public hi~rrisburg, Dauphin Cous 202 ally Commission Expires AuA• PAGE 6 OF A 6 PAGE WILL ,.. Signed, sealed, published and declared by the above-namE~d Testatrix, DOROTHY D. WILLIAMS, as and for her Last Wit.1 and Testament, in the presence of us, who, at her request, .in her presence and in the presence of each other have hereunto subscribed our names as witnesses. ADDRESS ADDRESS s ADDRESS .J""` Sworn and affirmed to and acknowledge before me, DOROTHY D. WILLIAMS, the Testatrix, this day of , 2000. NOTAR{Al 8EA1. -~ CARRtE E. GvOlf. Notary Publla NOTARY PUBLIC Harrisburg, Dauphin county My Commission Expires Aug. 6, 2x02 PAGE 5 OF A 6 PAGE WILL