HomeMy WebLinkAbout03-0870Register of Wills of Cumberland
PETITION FOR GRANT
OF
County, Pennsylvania
LETTERS
Estate of Mary M. Urich
also known as
Justina A. Fye
Petitioner(s), who is/are 18 years of age or older, apply(les) for:
, Deceased
Social Security No. 234-42-9386
(COMPLETE 'A' or 'B' BELOW:)
A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut rix
the Decedent, dated 07/07/2000 and codicil(s) dated None
named in the last Will of
State relevant circumstances, e.g., renunciation, death of executor, etc.
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents
offered for probate; was not the victim of a killing and was never adjudicated incompetent:
r----j B. Grant of Letters of Administration
(c.t.a.; d.b.n.c.t.a; pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and
heirs:
Name Relationship
Justina A. Fye IDau~hter
(COMPLI: I k IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland
Residence
14 Hummel Avenue, Camp Hill,
County, Pennsylvania with his/her last family
PA
or principal residence at 14 Hummel Avenue, Lower
Decedent, then 75 years of age. died 10/09/2003
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property
(If not domiciled in PA) Personal property in Pennsylvania
(If not domiciled in PA) Personal property in County
Value of real estate in Pennsylvania
Allen Township, Camp Hill, PA
(list street, number, and municipality)
at Chambersbur~, PA
(Location)
17011
8,000.00
40,000.00
situated as follows: 14 Hummel Avenue, Camp Hill
letters in the appropriate form to the undersic~ned:
Si~lnature~
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of
JJustina A. Fye
14 Hummel Avenue, Camp Hill,
Typedorprintednameandresidence
PA 17011
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, Inc. Form RW-1 (1991)
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
Sworn to or affirmed and subscribed
before me this~O-l~'¥~day of
'--'~ 5"Y5/"10 .: ~"~ F(~o 't~the/[[e~sister
.o. 21- o_% -0- o
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true
and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of
the Decedent, Petitioner(s) will well and truly administer the estate according to law.
~Justin. A. Fye /~'
Estate of Mary M. Urich Deceased
Social Security No: 234-42- 9386 Date of Death: 10/09/2003
AND NOW, ~)~~..)\ ~/,~ L-~ ,L~,j~.~_,inconsideration
of the Petition on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters ~ Testamentary [--'-] Of Administration
/c.t.a.; d.b.n.c.ta.; pendente lite; durante absentia; durante minoritate)
are hereby granted to
Justina A. Fye
in the above estate and that the instrument(s) dated 07/07/2000
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters ........... $
Short Certificate(s) ..... $
Renunciation ........ $
Affidavits ( ) .... $
Extra Pages ( ) .... $
Attorney: Michael L. Bangs
I.D. No: 41263
Bangs Law Office
Address: 302 South 18th Street
Codicil ........... $
JCP Fee .......... $ I O · C~ r,.P
Inventory .......... $
Other ........... $
TOTAL ......... $
Prepared by the Pennsylvania Bar Association
Camp Hill, PA 17011
Telephone: 717/730- 7310
Copyright (c) 1996 form software only CPSystems, inc.
Form RW-1 (1991)
I05.805 REX,' 9/86
This is to certify that the information here given is correctly, copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent fiiing.
WARNING: It is illegal to duplicate this copy by photostat or photograph. *
Fee for this certificate, $2.00
P 9690105
Local Registrar
Date
I' !4 Htmmel Avenue
~. Camp Hill, PA 17011
H1~.1~4 ~. t/~l COMMONWEALTH OF PENNSYLVANIA ~ DEPARTMENT OF HEALTH · VITAL RECORDS
~ . CERTIFICATE OF DEATH
m ' (Coroner) '
---- '--- --,- ........ -."~'~-- '---r.u
'" ~" k~ ~' ' l- ~'~Y-~[ ~t~ - ~~~
~X:~'~tT~t-~ ~ ~p~~ ~ J~'-"~w, .... ~c~ I*~ ........... bo. ~te
'' '~U ~ · · ~ ' --
· ' $,~'~ as
~oodlawn ' _M~o~_r'ial Gardens
October '9, 2003
Harrisburg, PA
4: 30 p.m. O .. [] vs. vehicle
October 10
Hetrick, Coroner
1271 S. 28th St., Harrisburg, PA 17111
I, MARY M. ULRICH, of Lower Allen Township, Cumberland County, Pennsylvania,
declare this to be my last will and revoke any will previously made by me.
ITEM I. I direct that all my just debts and funeral expenses, including my gravemarker
and all expenses of my last illness, and any and all taxes and assessments imposed by any
govemmental body as a result of my death, whether on property passing under this will or
otherwise, shall be paid from my residuary estate as soon as practicable after my decease as a
part of the expense of the administration of my estate.
ITEM II. I give and bequeath all of my household goods, automobiles, jewelry, and all
other articles of household and personal use, equipment and ornament, together with all
insurance thereon and relating thereto, to my daughter, JUSTINA A. FYE, of Etters,
Pennsylvania, provided she survives my death by thirty (30) days. Should my said daughter
predecease me or be deceased on the thirty-first day after my death, I give.and bequeath all such
items and insurance thereon to those of my issue, per stirpes, as survive my death by thirty (30)
days.
ITEM III. I give, devise, and bequeath all the rest, residue, and remainder of my
possessions and estate of every nature and wherever situate to my daughter, JUSTINA A. FYE,
of Etters, Pennsylvania, provided she survives my death by thirty (30) days. Should my said
wife predecease me or be deceased on the thirty-first day after my death, I give, devise, and
bequeath all the rest, residue, and remainder of my possessions and estate of every nature and
wherever situate to those of my issue, per stirpes, as survive my death by thirty (30) days.
ITEM IV. All of the interests of the beneficiaries hereunder shall not be subject to
anticipation or to voluntary or involuntary alienation nor shall they be subject to any execution or
attachment.
ITEM V. I appoint my daughter, JUSTINA A. FYE, executrix of this my last will.
ITEM VI. In addition to the other powers and authorities granted to my personal
representatives by Pennsylvania law and by the other terms and provisions of this will, I hereby
give to my personal representatives the following powers and authorities effective without court
approval and until actual distribution of all property: to compromise any claim or controversy;
to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as
my personal representatives may determine and at valuations finally to be fixed by them; to
invest in all forms of property, including any stock or other securities in any corporate fiduciary
or its successor without restriction to investments authorized for Pennsylvania fiduciaries, as my
personal representatives deem proper, without regard to any principle of risk or diversification;
to retain any or all assets of my estate, real or personal, without regard to any principle of risk or
diversification; to sell at public or private sale, to exchange, or to lease for any period of time,
any real or personal property and to give options for sales, exchanges, or leases, for such prices
and upon such terms or conditions as my personal representatives deem proper; and to allocate
receipts and expenses to principal or income or partly to each as my personal representatives
deem proper in their sole discretion.
ITEM VII. I direct that my personal representatives and fiduciaries shall not be required
to give bond for the faithful performance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand this /7/~ day of
,2000.
The preceding instrument, consisting of this and THREE other typewritten pages, each
identified by the signature of the testatrix was on the date thereof signed, published, and declared
by MARY M. URICH, the testatrix therein named, as and for her last will, in the presence of us,
who at her request, in her presence, and in the presence of each other, have subscribed our names
as witnesses hereto.
4
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
)
(SS:
)
The undersigned, being the testatrix whose name is signed to the attached or foregoing
instrument, having been duly qualified according to law, does hereby acknowledge that I signed and
executed the foregoing instrument as my last will, that I signed it willingly; and that I signed it as my free
and voluntary act for the purposes therein expressed.
MA}kY M.
Sworn or affirmed to and acknowledged
befbre me by the tes~trixnamed above
I
CO} MON WEALTH OF PE~SYLVANIA
)
(SS:
)
Sworn or affin ned to and
a~owledg6~ ~VOre me this
' f[~tay of'' ( ,2000
~ ot_ary PublicnL?,~.~ ~
COUNTY OF CUMBERLAND
WE, fi~.,~ ~/qt~65 and ~¢~[~ ~. (j~t.~T/~ , the witnesses whose
names are signed to the a~ached or foregoing ins~ument, being duly qualified according to law, do
depose and say that we were present and saw the testatrix sign and execute the instrument as her last will;
that she signed it willingly and that she executed it as her free and volunta~ act for the pu~oses 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 18 or more years of age, of sound mind, and
under no constraint or undue influence.
MI(]HAEI, L. B~os
ATTORNEY AT
l]O~ SOUTH 18TH STREET
G~P HILL, PE~S~V~ 17011
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
Date of Death:
Will No.: 2003-00870
To the Register:
MARY M. URICH
October 9, 2003
Admin. No:
I certify that notice of beneficial interest (estate administration) required by Rule 5.6(a)
of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the
above-captioned estate on October 28, 2003.
NAME
Justina A. Fye
ADDRESS
14 Hummel Avenue, Camp Hill, PA
17011
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: none.
Date: 10/28/03
Capacity:
Michael ~. Banls, Attorn;Y--
Signature' ]/~<~~at..
302 South 18th Street
Camp Hill, PA 1701
(717) 730-7310
Counsel for Personal Representative
REV- 1500 EX + (6-00)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. Z80601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
HARRISBURG, PA 171Z8-0601
DECEDENT'S NAME ({.AST, FIRST, AND MIDDLE INITIAL)
Urich Mary M.
DATE OF DEATH (MM-OD-YEAR) I DATE OP BIRTH (M M-OD-YEAR)
(IF APPL CABLE SURV V NG SPOUSE'S NAME (LAST, FIRST, AN D MIDDLE I NITrAL)
10/09/2003 03/28/1928
CAPB
HpRL
EDIO
chAC
KOTK
ES
OFFICIAL USE ONLY
FILE NUMBER
21-03-0870
R
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1. Original Return ~ Z47! Supplemental Return
4. Limited Estate . Future Interest Compromise (date of death after lg- 1Z-SZ)
6. Decedent Died Testate Decedent Maintained a Living Trust
(Attach copy of Will) (Attach copy of Trust)
[~]9. LitigaNon Proceeds Received [] 10. Spousal Poverty Credlt
(date of death between 1Z-31-91 and 1 - 1-95)
COUNTYCODE YEAR NUMBER
SOCIAL SECURITY NUMBER
234-42- 9386
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
}. ', · (date of death
.3. Remainder Return priorto 12-13-82)
5. Federal EstateT~x Return Required
8. Total Number of Safe Deposit Boxes
r-~ 11. Election to tax under Sec. 9113(A)
(Attach Sch O)
NAME
Michael L. Ban~s
FIRM NAM E (If Applicable)
TELEPHONE NUMBER
717/730- 7~0
COMPLETE MNLING ADDRESS
429 South 18th Street
Camp Hill, PA 17011
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or (3)
Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (6)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
] Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13.
14.
14,
4, %<¢4
None
6,685.69
None
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
Net Value Subject to Tax (Line 12 minus Line 13)
OFFI.~SE ON LY
(6) 98,628.77
(11) 6,685.69
(lZ) 91,943.08
(13)
(14) 91,943.08
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(aX1.z) X .0 0
16. Amount of Line 14 taxable at Hneal rate 91,943.08 X .0 45
17. Amount of Line 14 taxable at sibling rate X
18. Amount of Line 14 taxable at collateral rate X .15
19. Tax Due
(~5) O. O0
(16) 4,137.44
(17) 0.00
(16) 0. O0
(19) 4,137.44
/Copyright (c) 20~O form software only The Lackner Group, Inc. Form REV-1600 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
14 Hummel Avenue
CIl~(
Camp Hill
STATE
]PA
ZIP
17011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(~)
TotaiCredits (A + B * C ) (Z)
3. Interest/Penalty if applicable D. Interest
E. Penalty
Total Interest/Penalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT,
Check box on Page 1 Line 20 to request a refund (4)
S. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (SB)
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? ................................ [] r~
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
4,137.44
0.00
0.00
0.00
4,137.44
6.37
4,143.81
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.
SIGNATUREOFPERSONRESPONSIBLEFORFILINGRETURN Justina A. Fye DATE
, ~ .~/; 14 Hummel Avenue /
(Z. .........................
~GNATU~EOFPREPAREROTHERT~EPRESENTATIVE Michael L. Bangs DA~E *
I~ ~ ~ ~ 9 ~ / 429 South 18th Street ~/
L ...... .........................
For dates of death on or after July 1, 1994 and before Januau 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is 3% [72 P.S. 9116 (a) (1.1) (i)].
For dates of death on or after Januau 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. 9116(a)(1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutou requiremems for disclosure of assets
and filing a tax return are stilt applicable even if the surviving spouse is the only beneficiau.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twen~-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 0% [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 Jineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116(1
[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 12% [72 P.S. 9116(aX1.3)]. A sibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Copyright (c) z000 form software only T he Lackner Group, Inc. Form REV- 1500 EX (Rev. 6-00)
REV-~S02 EX+It-9?I I SCHEDULE A
COMMONWEALTH OF PENNSYLVANIA I REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Mary M. Urlch SS~/ 234-42-9386 10/09/2003 21-03-0870
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 which is jointly-owned with right of survivorship must be disclosed
ITEM
NUMBER DESCRIPTION
1 14 Hummel Avenue, Camp Hill, PA - (See appraisal attached)
TOTAL (Also enter on line 1, Recapitulation)
on Schedule F.
VALUE AT DATE
OF DEATH
79,000.00
$ 79,000.00
(If more space is needed, insert additional sheets of the same size)
Copyright(c) 1996 form software only CPSystems, Inc. Form REV-1502 EX (Rev. 1-97)
Fi~e No. 03~568
December 10, 2003
L. G. Connor Real Estate Appraisers, LTD
2159 Market Street
Camp Hill, PA 17011
Mr. Michael Bangs, Esquire
302 South 18th Street
Camp Hill, PA 170tl
RE:
Estate of Mary M. Urlch
14 Hummel Avenue
Lower Allen Township, Cumberland County
Camp Hill, PA 17011
Dear Mr. Bangs:
Pursuant to your request, we have prepared a COMPLETE APPRAISAL,
SUMMARY REPORT of the property capitioned in the "Summary of Salient
Features" which follows.
The accompanying report is based on a site inspection of improvements,
investigation of the subject neighborhood area of influence, and review of
sales, cost, and income data for similar properties.
This appraisal has been made with particular attention paid to applicable
value influencing economic conditions and has been processed in
accordance with nationally recognized appraisal guidelines.
The opinion of retrospective value conclusion stated herein is of the date of
death of Mary M. Urich on October 9, 2003; as stated In the body of the
appraisal, and contingent upon the certification and limiting conditions
attached. The purpose of this report is to determine an opinion of the
retrospective market value of the subject property for estate settlement
purposes. The date of inspection was on December 8, 2003.
Please do not hesitate to contact me or any of my staff if we can be of
additional service to you.
Respectfully,
Karan Darr~ey /
PA State Certified General Appraiser
UNIFORM RESIDENTIAL APPIkAISAL REPORT FilaNo. 03-568
Propq~ A_d.d r_e s~s_ 14 Humme~ Avenue . C~ Camp Hill .... ~tate~P_A Zi~ ~od~e 1701
i. eqal Description Deed Book 2t~age 875
Assessor's Parcel No 13-22-0536-034
Naldhborhood or Proient Name Lower Allen Township NA gate of Sale NA
Le_nd?C~nL ~Michjel Bangs, Esquire
Pamela Reitenbach
Built up Over 75% X 25-75% Under 25% ~Ul~nW $(0O0)
Growth rate Rapid X Staple Slow ~ Owner
Propeffy values Increasing ~;~ Stable i Declining '~ Tenant
Demand/supply Shortage ~ In balance Over supply
Neighborhood boundapes and characteris~cs: _T~he neighborhood boundaries are indicated on the enclosed neighborhood map in the adbenpa
Factors ioat affect the marketapllAy of the proposes in the neighborhood (p~o)d miry to employment and amens/es, employment st~"appeaT~o marke~-etc )
I are all within a 10-20 minute commute of the subject prop~_~. Axe r_a~g.e
~ maintenance rams were observed. Employment stability is good due to the ~
New Cumberland, and_thee N~ava~l _Supply Depot in Mechanicsburg~ as well as the expanding west and east shore a--3s __
and MLS statistics indicate a stable demand for the area. (See Addenda)
Market ~ndN~ons in the stablest neiG~orhood (including suppod for the above conclusions related to the trend of properbj values, demand/supply, and ma;k;tetmg ~rne
-. such as data on compe~ve properties for sale in the neighborhood, descripUon of the prevalence of sa~es and financing concessions, otc}:
tax reCOrds and the MLS service show prices stable. The MLS service indicates that the_typical r~pe~jd~ells Ln 3-6
months M~o~a~Qe funds are readily available from a variety of sources with conventional loans bapnR 5.5% to ~5% mortg.~e, u~ to
Sellers are not required to offer sales or finand/ng concessions, however~ salter assistance th occurrinq __
Proje¢~ Information for PUOl (it applicable) - · is the devaloper~ouialer in cobol of the Home Owners' Association (HOA)? Yes NO NA
S~e area 4~165 square feet or 10 Acre Corner Lot I i Yes ~ NO
Zoniog compliance Legal ,~'~ Local nonconforming (Grandfatherap use) ["'j iiiogal ! No zoning
Public Other Off-abe Iml~'Ovemaetl Type Public Private
Gas X ..... Curb/gutter ~ ._ ~
Water ~ Sidewalk ~oncre · j ~
Sanitary sewel X - Street lights ~ ~ j
~x~ ~ Alley TO rear
Topography Generally Level
Size T~L fo_r area
Ora/page Appear s~,~,d~t~
thew _Averaqe~ . _
Landscaping Aver~ _
Odveway Sudace Stone
Aoparent easement~ Standa;d~i'P.t~/~
Stormsewer ~x~ ~ ; MAMaoNo 42101BB
Comments (apparent adverse easements, encroachments, special assessments, alitie areas, illegal or legal nonconforming zoalng use, etc.}: Standard
~-asemeq[s for electric, · ephone, otc There are no known or apparent adverse easements, encroachment or COnditlon~s nqted~ -
Type (Det/Aff) Attached
Design (Style)
Age (Yrs.) 100 +/-
.~TERIOR DESCRIPTION ;OUNDATIOfl BASEMENT
Foundabon Stone )lab NA AreaSqFt 616 JRoof _
Extedor Walls Alum/Bric~ ;rawl Space NA % Finished 0 !Ceiling _
%of Surface Full Bsmt Ca/talC Unfinished Walls ....
3utters & DwnapM Alum/Alum ~ump Pump No Walls Stone Floor
~Vindow Type )ampi?ess None Noted Floor Concrete None
INTERIOR Matefials/Cond~on HEATING QTCHEN EQUIP. ATFIC AMENITIES CAR STORAGE:
Floors Crpt/VinyUAvfl Type __ Rddgerator L~ None ] Fireplace s # .... .I None ~
Walls Fuel Oil :[ange/Oven ~ Stars ~ Patio i Garage # M cz~s
Trim/Falish Wood/Av~ ~isposal [ ] Drop Stair ' Deck
i Attached
Bath Floor Vinyl/Arq -- 000LING None 3ishwasher [i ) Scurde ~ Porch 2 Encl/Froni- ~ Detached _
Bath Wainscot Fiberglass/Av~. __ OerRral -- :aJVHood ~ i Floor Fence Chain Link -- ~ ] Built-in
Doors Other ~ Heated ~ Pool -- - -
Additional features (special energy efficient items, otc,): Shed CX; i CarpoO
[ Driveway 2 Cars
The maiority of the home has newer vinyl clad thermoparle windo~ws~ Home has~o~ted~
Condition of the improvements, depreciahon (physical, functional, and eatemal}, repairs needed, quaJity of cons~uchoth remodeliog/add~ons, Mc: (~ep ~A_dde~d~a[
immediate vtcin~ of the subject property.:
~e Addendum)
Freddie Mac Form 70 6/93 PAGE 1 OF 2
Form UA2 -- '~TOTAL Ior Windows" appraisal software by a la mode, inc. -- 1-800~ALAMOOE Fannie Mae Form 1004 6/93
UNIFORM RESIDENTIAL APPRAISAL REPORT
MARKET DATA ANALYSIS
~ ~ ~U~E~ C~PA~LE NO. 4 COMPILE NO. 5
...... COMP~LE ~ 6
P~O~UbL~ ~ 0.98 mil~ 1.24 miles
VALUEADJ~S~S . DESCRI~ION DESCRI~ON ~ DESCRIP~ON ~A~ - ~sCR~ION
LocaUon Ave~Re Average Su~mor~
AboveGrade T~I ~Bd~s; B~s T~ ~Bd~s~ B~s ~ T~I ~Sd~s~ B~s~ ..... T~Bd~ms~a~
Room Cou~t ~ . ~[.: 1 ~ ~ 5 ~ 1.5 ~ -1,~0 7 ~ 3 ~ 1.~ -1,5~
_Gros~Livin~ ~ea ~ ~ 1,480 ~. ~ 2,070 Sq. R. ~ -5,~0 1,350 ~, R. ~ ~+~300 - ~ - S~;Ft
Rooms Below Grad~ UnRnished Unfln[sh~ Unflnish~
hnc~on~! ~L Ajerage-_ Average ~ In. Hot -~ -- +~
FO~ UA2.(AC) -- "TOTAL for W}ndows" appraisal software by a la m~le, inc. -- 1-800-AL~MODE
Supplemental Addendum Ale No, 03-56~,
~.8ponower/Client NA
rope~ Address 14 Hummel Avenue
County Cumt:~rtand 5'tats PA
NEIGHBORHOOD COMMENTS. Cont'd:
Subject is located in Lower Allen Township. This neighborhood is conveniently Ioceted just south of the Boroughs of
Lemoyne and Camp Hill and northwest of the Borough of New Cumberland. Subject is located along the southern
side of Hummel Avenue; which is one of this areas more heavily traveled roadways, it is anticipated that the
subject's location will have a negative impact on market appeal. Uses along Hummel Avenue include residential,
retail, commercial and light industrial; which are typical of the area and should have no affect on market appeal.
SITE, Cont'd:
The subject site is located in the I-3, Industrial zoning district. It's current use as a residence is not an allowed use
within this zoning district. Therefore, the subject's use Is viewed as legal nonconforming use which predates current
zoning.
IMPROVEMENTS, Cont'd:
Ttie first floor of the home contains a living room, dining mom; kitchen, and unheated enclosed porch. Second floor
contains three bedrooms and an enclosed porch. Due to personal items obstructing access to the third floor your
appraisers;' were only able to view the staircase leading to the this area. According to the occupant of the property
at the time of inspection the third floor is heated and contains two finished rooms. Full unfinished basement. Please
Note: your appraisers' observed an oil teak at the base of the furnace. This appraisal is based on the assumption
that the leak will he repaired and that the heating unit is in good working order requiring no major repairs. In the
event it is determined that major repairs are needed The furnace we reserve the right to review and or revise this
report and conclusion of value stated within.
The home is considered to be in average condition. Some interior painting and new wall paper would enhance
market appeal.
Based on maintenance, condition and comparison neighborhoods, the estimated effective age is below the actual
age. Physical depreciation is present due to the age of the subject, and deferred maintenance. No Economic or
Functional obsolescence noted.
ADVERSE ENVIRONMENTAL CONDITIONS. Cont'd;
The property is of an age where lead based paint may be present. The market does not penalize the property, but
the client should be advised of it's possible existence. It is assumed that it is not present. If the client had a
concern, then a qualified expert should be contacted.
SALES COMPARISON APPROACH, Cont'd
The weighted average was also considered to indioa~d the value of the subject. Estimated indicated value is
determined by using the Gross Adjustment of sale price for each comparable (comp) as a measure of the relative
quality of the comp. A lower adjustment indicates a better comp, and visa versa. The ratio of gross dollar
adjustment to sale price for each of the comps is used to calculate the weight each comp should have in a weighted
average calculation. As with any method, this technique is not perfect. However, it does a good job of giving more
weight to the most similar comps, while at the same time minimizing values near the extremes of the indicated value
range. The indicated weighted average is $79,000; which supports the conclusion of value stated within. Some
adjustments exceeded recommended guidelines but were considered necessary to reflect an accurate value.
FINAL RECONCtLIATION, ¢ont'd:
The retrospective market value opinion stated herein is as of the data of death of Mary M. Urich on October 9, 2003;
as stated within the body of the appraisal, and contingent upon the certification and limiting conditions attached. The
date of inspection was December 8, 2003.
SPECIAL LIMITING CONDITIONS:
This appraisal is not a home inspection and your appraisers' are not acting as a home inspector's when preparing
the report. The client has the right to have the home inspected by a profossional home inspector. When performing
the inspection of this property, your appraisers' visually observed areas that were readily accessible. The appraiser
is not required to disturb or move anything that obstructs access or visibility. The inspection is not technically
exhaustive. The inspection does not offer warranties or guarantees of any kind. No warranty of the appraisal is
given or implied. No liability is assumed f~ the structural or mechanical elements of the property.
If the prope~y is sold, this appraisal is subject to satisfactory inspection reports including, but not limited to: wood
infestation, radon, building inspections, etc. Further, your appraiser is not an environmental expert, and is not
Form TAOD -- 'TOTAL ~ Windows. ~ef)ralsat so~ by a la mode, inc. -- 1-800-A!.~DE
DEFINITION OF MARKET VALUE: The most probable plice which a prope~ should hrel~ in a conlpetJbue and open market under all condelons
[equel~te to a fair sale, the buyer and seller, each acing pmderfiy, knowlndgaably and assuming the pdce is not affected by undue stimulus. ImplJcll in this
detinelon is the consummabon ota sale as of a specified dote and the passing of tllfe from seller to buyer under condilJons whereby: (1} buyer and seller are
for those costs which are normally paid by sellers as a resutt of bboiUon or ~aw in a mad(et area; these costs are readily idenbhable
STATEMENT OF LIMITING CONDITIONS AND APPRAISER'S CERTIFICATION
CONTINDENT AND LIMITIN8 CONDITIONS: The appraiser's ce~icabon that a.opeus in the appraisal rabml is subject to U~e following
3 The aporaser has examined the avaltsble flood ma0s that we provided by the Federal Emergency Management Agency (or other data sources) and bas nntell
4 The abpralsm' will not give loabmony o~ appear in couli because he or she maba an app~-aisai of the properb/in question, unless specgic ~angements to do
The abotalser has eshmated the vetue of the land in the cost approach at its highest ~ best use and the ~provemento at their conbibutoP/ value. Tllese
6 The abpralser has noted in the agp~atoet report any adverse cold.ns (such as, r~eded ragalrs, depreciation, the presence of hazardous wastes, toxto
b The ap~aelar will not disclose the contents of the abpraisal ret)~'t except as provided tot in the Utoforrn Standards of Professional Appraisal Practice
10 The appraiser must provide his or her pdor w~en consent before the lende~/clleof specified in the aboralsal ragort can disbibute the a0prelsal report
(including concalstons aboet the properly value, the agp~etath's identity and professional daslgna~c~s, and references to any professional app~sal
organizapons or the fW~l with which the agpraisef is associated) to mayo~e o~er than Ibc borrower: the moligagee or its successors and assigns; the mortgage
maurer; consultants; p~olosalonal apl3atset ~ganelottoas; any ststs or lede~ty agp,-oved flnalcial Insb~i~o~; ct any dabaitment, agency, or insb'umentsldy
nt the Un,ted States or any state or the District nt Columbia; except ~ Ihe lender/client may disbtb~to the properly de$crippon section of the report otoy to data
cellllnteln or rabor~ng sen"ce(s) wllh~ut having to ootain the appraiser's pdor wdttsn consent. Me appraiser's written consent and abproval must ~Jso
be obtained before the abpraisal can be conveyed by a~one to the pobllc through advmtetng, puMic relations, news, sales, or othel media.
FreddelMacForTn439 6-93
Page 1of 2
Fannie Mae Form 10046 6-93
8ocowel/Client NA
I Prooerb/Address 14 Hummel A'~nue
City Camp Hill
Location Map
mmeteen hundred and SIXTy SIX (1966)
etmeen,
of Georgia,
the
WILLIAM H. SNOOK, III and EVELYN E. SNOOK, his wife, of Athens, State
(hereinafter called the Grantor
and PAUL WALKER URICH and MARy M. URICH, his wife, of the Borough of Camp Hill, County
of Cumberland, State of Pennsylvania,
(hereinafter ca~led the Grantees
~J[lle~e[~, That in consideration of TEN THOUSAND ($10,000.00)
Dollars,
m hand paid, the receipt whereof is hereby acknowledged, the said Grantor s do hereby grant and
convey unto the said Grantee s their heirs and assigns,
ALL THAT CERTAIN lot or piece of land situate in the Township of Lower Allen,
Uumherland County, Pennsylvania, bounded and described in accordance with a survey
10inn thereof ,lade by D. P. Raffensperger, Registered Surveyor, dated April 20, 1966, as
BEGINNING st a point on the No~thern line of Hummel Avenue, said point being
%~o hundred ten (21~) feet West of 1Eth Street (formerly k~o~;n ss ~illtown Road); thence
extending along Hur~el Avenue South fifty-t%vo (52) degrees fifteen (15) minutes West
said premises North thirty-seven (37) degrees forty-five (45) minutes West one hundred
same North flftyt~o (52) d~grees fifteen (15) minutes East thirty-five (35) feet to
tarougn the center of a partition wall South thirty-seven (37) degrees forty-five (45)
n~nuLes East one dundred nineteen (i19) feet to the point and place of BEGINNING.
HAVING thereon erected ~ two and one-half story brick and frame dwelling known
gr~nted and col%veyed unto William H. Snook, III and Evely~ E. Si%ook, his w~fe, by Deed
daL~d dune 29, 19~ a~d recorded in D~ed Book '~N' Vol. 16 page 495, Cumberland County records
S~-SMISSION NO.,.~
Building Sketch (Page - 1)
~orrowel~ClJent NA
12.0' 17.0'
~ Encl. Porch ~ Encl. Porch ;
~;~ ' Bed~
~ Kitchen
~ Pa~y
6.0' Wall Bath
~Dining ~ ? ~; ' E~
. ~- ~ o Third Floor
~ Room '¢, ~ Bedrm ;' ~
~ ~ I ~ ~ ~ Half Sto~
.-- ~ ; ,, 4.0'
Living ~
Porch 14.8' ~. ~4.0' 7.0'
AR~ C~CU~TIONS 8UM~RY LIVING AREA BREAKDOWN
TOTAL LIVABLE (rounded) 1480 17 Cslcul8tions To~I roun J
Form SKT BIdSkl -- 'q'OTAL for Windows" appraisal software by a la made, inc. -- t-800-ALAMODE
Comparable Photo Page
Comparable 1
Comparable 2
Comparable 3
REV- 1508 EX + (1-97)
COMMONWEALTHOFPENNSYLVANIA
INHERITANCETAXRETURN
RESIDENTDECEDENT
ESTATE OF
SCHEDULE E
CASH, BANK DEPOSITS,& MISC.
PERSONAL PROPERTY
FiLE NUMBER
Mary M. Urich SS# 234-42-9386 10/09/2003 21-03-0870
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1
2
3
4
5
6
AARP Life Insurance - Life Insurance
M & T Bank - Certificate of Deposit 31003908145913
M & T Bank - Certificate of Deposit 31003910084266
M & T Bank - Certificate of Deposit #31003910084307
M & T Bank - Certificate of Deposit 31003910392297
M & T Bank - Certificate of Deposit #31003910174174
TOTAL (Also enter on line 5, Recapitulation)
5,125.71
2,719.51
1,247.04
1,247.04
1,227.67
3,260.26
$ 14,827.23
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV- 1508 EX (Rev.
HA~ 22 2804 17:5~ FR NEW YO~K L~FE AARP 813 288 5288 TO 9171~07~,,4~
FAX COVER SHEET
5405 West Cypress Street, Suite 108; Tampa, FL 33607; (800) 695-5165
DATE:
March 22, 2004
TO: Michael L. Bangs
FAX: 717 730-7374
FROM: David Rogers
PHONE; 1 800 69~-5165
Number of pages including cover sheet:
FAX:
1
1 1813t 288-5200
Message: Intured: MirY Ulrich f A14OI30F
Dear Mr. Bangs:
I am writing in reference to the requirements needed to settle a claim on the above-
mentioned Certificate.
We are In receipt of tile certified death certificate for Mary Ulrich and Donald I( Fields along
with a completed claim form by Justina A FVe. However since Mr. Fields predeceased the
Insured, the proceecls are now designated to her estate, Please forward a copy of the
executrix papers for Ms. Fye at your earliest convenience.
If you have any questions or anticipate a flJrther delay, please contact us at 1-800-695-5165
between the hours of 8am to spin Eastern stendarCl Time Monday through Frldav.
Sincerely,
IF YOU DO NOT RECEIVE ALL PAGES, PLEASE CALL THE SENDER
The information and/or documents oontained in this fa~imile transmission contain
information from New York Life, which is privileged and confidential. Only intended
recipients are permitted to view the contents of this facsimile transmission, if you are not
the intended recipient, you am hereby notified that any disclosure, copying, distribution,
or uae of its contents is strintly prohibited. If you received this facsimile transmission in
error, please notify New York Life immediately by telephone at
1-800-695-8165 and destroy the original transmission.
TOTAL PAGE.O1 *~
M&TBank
499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12
Bangs Law Office
Attorneys At Law
302 South 18th Street
Camp Hill, PA 17011
Phone (302) 934-2909
F ax (302) 934-2955
December 9, 2003
Re: Estate of Mary M Urich
Social Security: 234-42-9386
Date of Death: October 9, 2003
Dear Sir or Madam:
Per your inquiry dated October 21, 2003, please be advised that at the time of death, the above-named decedent had on
deposit with this bank the following:
l~pe of Account
Account Number
Ownership (Names oJ)
Opening Date
Balance on Date of Death
Accrued Interest
Total
Certificate of Deposit
31003908145913
Mary M Urich
06/27/01
$2,711.99
$ 7.52
Type of .4ccount
Account Number
Ownership (Names oJ)
Opening Date
Balance on Date of Death
Accrued Interest
Total
Certificate of Deposit
31003910084266
Mary M Urich
01/07/98
$1,235.57
$ 11.47
T) pe of Account
Account Number
Ownership (Names oJ)
Opening Date
Balance on Date of Death
Accrued Interest
Total
Type of Account
Account Number
Ownership (Names oj9
Opening Date
Balance on Date of Death
Accrued Interest
Total
7~pe of Account
Account Number
Ownership (Names o.,9
Opening Date
Balance on Date of Death
Accrued lnterest
Total
Type of Account
Account Number
Ownership (Names oj')
Opening Date
Balance on Date of Death
Accrued lnterest
Total
Certificate of Deposit
31003910084307
Mary M Urich
01/07/98
$1,235.57
$ 11.47
Certificate of Deposit
31003910174174
Mary M Urich, Trustee
K Donald Fields, Beneficiary
08/27/98
$3,260.26
$ 14.89
Certificate of Deposit
31003910392297
Mary M Urich
08/24/99
$1,223.14
$ 4.53
Certificate of Deposit
31003910447901
K D Fields, Organization
Mary M Urich, Signatory
10/05/99
$1,255.06
$ 30.54
~*ype of Account
`4ccount Number
Ownership (Names oJ)
Opening Date
Balance on Date of Death
.4ccrued Interest
Total
Type of Account
Account Number
Ownership (Names 099
Opening Date
Balance on Date of Death
.4ccrued Interest
Total
Checking Account
1082183
Mary M Urich
Justina A Fye
11/23/90
$8,927.58
$ 0.00
$8,927.58
Savings ,4ccount
21000000997926
Mary M Urich
duxtina `4 Fye
11/29/90
$675.50
$ .30
For further account information, closures and/or reimbursemeut of ftmds please call the Itighland Park Office at #717-737-3322.
Please I~ advi~d, there was no safe deposit box found for the above decedent.
Records Management
REV- 1509 EX + (1-97) I
SCHEDULE F
COMMONWEALTH OF PEN N SYLVANIA JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mary M. Urich SS~/ 234-42-9386 10/09/2003
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
FILE NUMBER
21-03-0870
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A.3ustina A. Fye Dau§hter
14 Hummel Avenue
Camp Hill, PA 17011
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
ITEM :OR JOINT MADE Include name of Nnanclal institution and bank
account number or slmilaridentlf-/Ing number. DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT Attachdeedforjolntly-heldmalestate. VALUE OF ASSET INTEREST )ECEDENT'S INTERE.~
1 A 11/23/90 M & T Bank - Checking 8,927.58 50.00% 4,463.79
Account 1082183
2 A 11/29/90 M & T Bank - Savings 675.50 50.00~, 337.75
Account
TOTAL (Also enter on line 6, Recapitulation) $ 4,801.54
(rf more space is needed insert additional sheets of the same size)
Copyrlg ht (c) 1996 form software only CPSystems, Inc. Form REV- 1509 EX (Rev. 1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mary M. Urich SS~ 234-42-9386
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
lO/O9/2oo3
FILENUMBER
21-03-0870
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
1
2
3
FUNERAL EXPENSES:
Woodlawn Memorial Gardens, Inc. - Funeral Bill
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) / EIN Number of Personal Representative(s)
Street Address
City State
Zip
Year(s) Commission Paid:
Attorney's Fees Michael L. Bangs
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
Relationship of Clair~ant to Decedent
Probate Fees Register of Wills
Accountant's Fees
Tax Return Preparer's Fees
Other Administrative Costs
Cumberland Law Journal - Estate Advertising
L. G. Connor Real Estate Appraisers, Ltd.
me Sentinel - Estate Advertising
State Zip
1,340.00
4,500.00
122.00
250.00
75.00
300.00
98.69
TOTAL (Also enter on line 9, Recapitulation) 6,685.69
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV- 1511 EX (Rev. 1-97)
REV- 1513 EX + (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mar: M. Orich SS# 234-42-9386
NUMBER
I.
II.
SCHEDULE J
BENEFICIARIES
10/09/2003
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (include outright spousal distributions, and
transfers under Sec. 9116(aX1 .Z)]
Justina A. Fye
14 Hummel Avenue
Camp Hill, PA 17011
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Daughter
FILENUMBER
21-03-0870
AMOUNT OR SHARE
OF ESTATE
Entire
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET
$ 0.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) Z000 form software only The Lackner Group, Inc. Form REV- 1513 EX {Rev. 9-00)
I, MARY M. URICH, of Lower Allen Township, Cumberland County, Pennsylvania,
declare this to be my last will and revoke any will previously made by me.
ITEM I. I direct that ail my just debts and funeral expenses, including my gravemarker
and all expenses of my last illness, and any and all taxes and assessments imposed by any
governmental body as a result of my death, whether on property passing under this will or
otherwise, shall be paid from my residuary estate as soon as practicable after my decease as a
part of the expense of the administration of my estate.
ITEM II. I give and bequeath all of my household goods, automobiles, jewelry, and ali
other articles of household and personal use, equipment and ornament, together with all
insurance thereon and relating thereto, to my daughter, JUST[NA A. FYE, of Etters,
Pennsylvania, provided she survives my death by thirty (30) days. Should my said daughter
predecease me or be deceased on the thirty-first day after my death, I give and bequeath all such
items and insurance thereon to those of my issue, per stirpes, as survive my death by thirty (30)
days.
ITEM III. I give, devise, and bequeath all the rest, residue, and remainder of my
possessions and estate of every nature and wherever situate to my daughter, JUSTINA A. FYE,
of Etters, Pennsylvania, provided she survives my death by thirty (30) days. Should my said
wife predecease me or be deceased on the thirty-first day after my death, I give, devise, and
bequeath all the rest, residue, and remainde; of my possessions and estate of every nature and
wherever situate to those of my issue, per stirpes, as survive my death by thirty (30) days.
ITEM IV. All of the interests of the beneficiaries hereunder shall not be subject to
anticipation or to voluntary or involuntary alienation nor shall they be subject to any execution or
attaclwnent.
ITEM V. I appoint my daughter, JUSTINA A. FYE, executrix of this my last will.
ITEM VI. In addition to the other powers and authorities granted to my personal
representatives by Pennsylvania law and by the other terms and provisions of this will, I hereby
give to my personal representatives the following powers and authorities effective without court
approval and until actual distribution of all property: to compromise any claim or controversy;
to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as
my personal representatives may determine and at valuations finally to be fixed by them; to
invest in all forms of property, including any stock or other securities in any corporate fiduciary
or its successor without restriction to investments authorized for Pennsylvania fiduciaries, as my
personal representatives deem proper, without regard to any principle of risk or diversification;
to retain any or all assets of my estate, real or personal, without regard to any principle of risk or
diversification; to sell at public or private sale, to exchange, or to lease for any period of time,
any real or personal property and to give options for sales, exchanges, or leases, for such prices
and upon such terms or conditions as my personal representatives deem proper; and to allocate
receipts and expenses to principal or income or partly to each as my personal representatives
deem proper in their sole discretion.
2
ITEM VII. I direct that my personal representatives and fiduciaries shall not be required
to give bond for the faithful performance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand this
day of
3
The preceding instrument, consisting of this and THREE other typewritten pages, each
identified by the signature of the testatrix was on the date thereof signed, published, and declared
by MARY M. URICH, the testatrix therein named, as and for her last will, in the presence of us,
who at her request, in her presence, and in the presence of each other, have subscribed our names
as witnesses hereto.
4
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
)
(SS:
)
The undersigned, being the testatrix whose name is signed to the attached or foregoing
instrument, having been duly qualified according to taw, does hereby acknowledge that I signed and
executed the foregoing instrument as my last will, that I signed it willingly; and that I signed it as my free
and voluntary act for the purposes therein expressed.
ay M. iJRiCH. })'~
Sworn or affirmed to and acknowledged
befores? by t ', t~tri~,named above
this~t]'~ day : ~ · .
°°
Not:ir; Pu~',Z ,
COMMDN WEALTH OF PE~SYLVANIA
)
( SS:
)
Sworn or affir aed to and
a~owledg~ ~efdre me this
.'/'p/gay ofI tV ~, 2000.
~ota~_ Pu61icl
COUNTY OF CUMBERLAND
WE, //~,~u~ C 4talr..65 and ~[l~-~/~, 5. f._.ff~ ,the witnesses whose
names are signed to the attached or foregoing instrument, being duly qualified according to law, do
depose and say that we were present and saw the testatrix sign and execute the instrument as her last will;
that she signed it willingly and that she executed it as her free and voluntary act for the purposes 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 18 or more years of age, of sound mind, and
under no constraint or undue influence.
..... 5.C
REV- 1500 EX + (6-00)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENTOFREVENUE
DEPT. Z80601
HARRISBURG, PA 171ZS-0601
D
E
C
E
D
E
N
T
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEBENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Urich Mary M.
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
10/09/2003 03/28/1928
IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INiTiAL)
OFFICIAL USE ONLY
FILE NUMBER
21-03-0870
COUNTYCODE YEAR hUMBER
SOCIAL SECURITY N UMBER
234-42-9386
THIS RETURN MUST BE FI LED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
1. OrlglnalReturn ~ 247! SupplementaIReturn
C A P B I 4. Limited Estate . Future interest Compromise (date of death after 1Z-1Z-8E)
HpRL I ~-'~t
E P ~ CO I L~] 6. Decedent Died Testate Decedent Maintained a Living Trust
C R T K (Attach copy of Will) (Attach copy of Trust)
K O E S [] 9. Litigation Proceeds Received [] 10. Spousal Poverty Credit
C
O
R
R
E
S
R
E
C
A
P
T
U
L
A
T
I
O
N
C
O
M
T
I
0
N
(date of death
3. Remainder Return prior to 1Z- 13-82)
5. Federal Estate Tax Return Required
8, Total Number of Safe Deposit Boxes
(date of death between 1Z-31-91 and 1 - 1-95)
] Election to tax under Sec, 9113(A)
1
1.
(Attach Sch O)
NAME
Michael L. Banns
FIRM NAME (If Applicable)
TELEPHONE NUMBER
717/730- 7310
COMPLETE MAILING ADDRESS
429 South 18th Street
Camp Hill, PA 17011
1. Real Estate (Schedule A) (1) 79,0 (~.~0
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or (3) ~, ,
Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 14,82~7~,.:~.3
(Schedule E)
6. Jointly Owned Property (Schedule F) (6) 4,
] Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) None
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13.
14.
OFFICIA~SE ONLY
6,685.69
None
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
Net Value Subject to Tax (Line 12 minus Line 13)
(8) 98,628.77
(11)
(12)
(13)
6,685.69
91,943.08
(14) 91,943.08
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(aX1.2) x .0 0
16. Amount of Line 14 taxable at lineal rate 91,943.08 X .0 45
17. Amount of Line 14 taxable at sibling rate X .12
18. Amount of Line 14 taxable at collateral rate X .15
19. Tax Due
(15) 0.00
(16) 4,137,44
(17) 0.00
(18). 0.00
(19) 4,137.44
,/*~ Copyright (c) Z000 form software onh/The Lackner Grond, Inc. Form REV-1500 EX (Rev. 6-00)
Rle No 03-568
December 10, 2003
L. G. Connor Real Estate Appraisers, LTD
2159 Market Street
Camp Hill, PA 17011
Mr. Michael Bangs, Esquire
302 South 18th Street
Camp Hill, PA 17011
RE:
Estate of Mary M. Urich
t4 Hummel Avenue
Lower Allen Township, Cumberland County
Camp Hill, PA 17011
Dear Mt. Bangs:
Pursuant to your request, we have prepared a COMPLETE APPRAISAL,
SUMMARY REPORT of the property capltloned in the "Summary of Salient
Features" which follows.
The accompanying report is based on a site inspection of improvements,
investigation of the subject neighborhood area of influence, and review of
sales, cost, and income data for similar properties.
This appraisal has been made with particular attention paid to applicable
value influencing economic conditions and has been processed in
accordance with nationally recognized appraisal guidelines.
The opinion of retrospective value conclusion stated herein is of the date of
death of Mary M. Urlch on October 9, 2003; as stated in the body of the
appraisal, and contingent upon the certification and limiting conditions
attached. The purpose of this report is to determine an opinion of the
retrospective market value of the subject property for estate settlement
purposes. The date of inspection was on December 8, 2003.
Please do not hesitate to contact me or any of my staff if we can be of
additional service to you.
Respectfully,
Karen Darkey
PA State Certified General Appraiser
SUMMARY OF SALIENT FEATURES
Subject A~dress
Legat Description
c~
County
State
Zip Code
Census Tract
14 Hummel Avenue
Deed Book 21Y, Page 875
Camp
Curnbertand
PA
17011
3240-0110.00
NA
~e Pdce $ NA
Date ct Sae NA
Sorrower / Client
Lender
Michael Bangs, Esquire
NA
Size (Square Feet} 1,480
Price per Square Foot $
Location Average
Age 100 +/- Yrs
Total Rooms 8
B~lrooms 5
Bans 1
Appraiser
Date of Appraised Value
Pamela M. Reitenbach, PA State Certified General Real Estate Appraiser
October 9. 2003; Date of Death of Ma~y M. Urich
Form SSD -- 'TOTAL fo~ Windows" appraisal software by a la mode, I~. -- 1-SO0-ALAMODE
UNIFORM RESIDENTIAL APPRAISAL REPORT
File No. 03-568
Legal Descriphon Deed Book 2~_Y~Page 875
Assessors P~celNo 13-22-0536-034
Lender C/~nt..Mi_c~ael Bangs. Esquire
Pamela ReRenbac~
Location
gu,It up Over 75% X 25-75% Under 25%
G~owth rate Rapid .~ Sta~ie Slow
Prope~ values Increasing ~ StaiRs [ i Oechnmg
Demand/supply Shortage ~ in balance ; Ov~ supply
3-6 mos
Camp Hill __ Sta e~P_A _ Zi~ ~od~e 70_
County Cu_mberlanO~ .
Address 302 South 16th Street, Camp Hill, P~A 17~01~1 _
~ Owner Low 15 2-4 family ~2 . In process
j Tenant MCu-famPy__l_ ~To__ __
~ Vaca~ (0-5% Commercial 5 i
Market conditions in the s~iect neigt~borhood (including support for the above Conclusions related to the t~enP of propeth/values, demand/supply, and mar~mg time
Project Information ~' PUD~ (If apglicable * - is the developer/builder in conb'ol of the Home Owners' Association (HOA)? : Yes -- No NA
ApproxJmate to~ number gl units in the subject project NA Approximate total number of unRs for sale in the subject project NA
Describe common elements and recre~onal facil~ies: NA
Sds area 4~1_65 square feet or .10 Acre Corner Lot ] i Yes ~ No
Zoning compliance Leg~ ~ Legal noncooforming (Gradfathered use) ~ Illegal i No zoning
Electricity ~'~ ..... I Street ~Macadam
Gas ~%~ __. ~ Curb/guOer Concrete -
Water ~ .... J Sidewalk ~
/ Alley To rear
fopograghy Generally Leve~ll
Dranage
View ~Average
Driveway Sudace .Stone
Storm sewer ,~ ,~ i ! FE~4A Map No. 421016 B
No of Stories 25 ~Extedor WalJs ~Brick ;rawlSpace NA
Ty~e (D~t/Att) Attached ~ Roof Sudace ~ ~asemeflt Full Bsmt
Design (Style) ~2 S~ ~ Gutters & Ownspts, Alum/Arum ~ump Pump No
~e~ Sq. Ft.
61~66 Roof
% Finished 0__ .... ~ Ceiling
Floor Concrete
Outside EnHy ...... ~----- Unknow
25 +/- NO None Noted
ROOMS
WTERIOR Materials/CondgJon HEATING KITCHEN EQUIP. ATDC AMENITIES CAR STORAGE:
Fioors CrptJVinyl/Av~ Type __ Refrigerator ~ None i Fireplace(s) ~ .... None
Trim/Finish Wood/Avq 3isposal !'; DropStair ; ~ Deck = At,chad
Doors Other -- ~icrowave ~ Heated ~ Pool Carpo~ ' -
CondlOon Sh,e ID v,w y
Add~ond ioatures (special energy efficient ~ems. ~c.): The maiority of the home has n~er vinyl clad the~opane windo~ Home has ~o ~hted
Freddie Mac Form 70 6/93 PAGE 1 OF 2
Pennis Mae Form 1004 6/93
UNIFORM RESIDENTIAL APPRAISAL REPORT
STIMATED SITS VALUE = $ Comments on Cost A~proach (such as, source of cost eshmate, s~e value
ESTIMATED REPRODUCTION COST-NEW-DF IMPROVEMENTS: square ~oot calculation an~i for HUD, VA and FmHA, ~e estimated remaimn~
Gar~ge/CarpoA 220 Sq. Ft ~$ = ......... best use of the land However, when items of phy~l
Toter Estimated Cost New = $ deterioration and obsoles~n~ must be estimated, andrea
Less Physical ~unc~onal E~emaJ judgement is involved which i~ s~ect to error The Cost
Deprec~abon .... ; ..... L =$ Approach was not utilized aue to the age of the subject Rrope~
'As-is" Value oi Sds ~mprovements = $
029 miles 0.91 mil~ 1.07 miles
~E ADJUSTMENTS _ DESCRIPTION DESCRJP~ON : +{-)$ Adj~ D~SCRIPT~ON
Sales or Finapcing ~ Conventional FHA FHA
Condition AveraDe .... Equal Equal .... Equa~
~ros~)vin~ A e~ 1~480 ~ Ft ._ 1,088 Sq. Ft. ~ +3,900 1,380
difference be~een the ~mparable propedies and the subje~. The adiustmen~ that were made reflea the typi~l actions of buyer~a~/~
ITEM ..... SU~EC~ COMPAR~LE NO 1 _~ COMP~B~ 2 .... ~M~ABL~NO ~'
INDICATED VALUE BY I~E APPROACH (E Applicable) Es~mated Ma~e{ R;m ~
APPRAIS ' SUPERVISORY S L IF ~ ~-- "
PAGE 2 OF 2
Form UA2 -- "TOTAL for Windows" appraisal software by a la mode, inc -- 1-800-ALAMODE
Fannie Mae Form 1004 6-93
UNIFORM RESIDENTIAL APPRAISAL REPORT
MARKET DATA ANALYSIS
.a,v, .o [.a ~b .e ~b~.. ~?.su~b_e~prope~,a n~inu,s ~)a~ju~e~ m~e ~us.reduclng~e ~edv~ue~esub~. Ifasi nific~t ~n P ~ p~rlor ~°r re°re
~M ~ .~U~E~ COMP~ NO. 4 C~P~B~
Addre~s_~ H~PA ~ PA ~
~o~ ~ 098 mil~ ~.24 miles
VALUEA~J~STM~S _ DESCRI~ION OESC~I~ON ~ DESCRI~ION ~A~.- ~CR~ION- ' ~(-~$Adju~
~e of sa~e '~ ~2-03 ~ ~2~03
Gros~ ~ea _ 1~ 2,070 ~, ~ ~ ~,~0 1,350 ~.
Rooms Be~w Grad~ Unfinish~ Unfinish~ Unfinished
~a~A Off ~tr~t.~ Off Strut Gara~e/~ ~
~epce~Po~[ec ~ Shed/Fen~ Fen~ +t00 Fen~
Form UA2.(AC) -- "TOTAL for Windows" appraisal software by a la mode, inc -- 1-800-ALAMODE
Supplemental Addendum File No. 03-56s
_Borrower/Client NA
~ro_pedy Address 14 Hummel ^venue
_City Camp Hill County Cumberland State PA
Lender Michael Bangs, Esquire
NEIGHBORHOOD COMMENTS. Cent'S:
Subject is located in Lower Allen Township. This neighborhood is conveniently located just south of the Boroughs of
Lemoyne and Camp Hill and northwest of the Borough of New Cumberland. Subject is located along the southern
side of Hummel Avenue; which is one of this areas more heavily traveled roadways, It is anticipated that the
subject's location will have a negative impact on market appeal. Uses along Hummel Avenue include residential,
retail, commercial and light industrial; which are typical of the area and should have no affect on market appeal,
SITE, Cont'd:
The subject site is located in the I-3, industrial zoning district. It's current use as a residence is not an allowed use
within this zoning district. Therefore, the subject's use is viewed as legal noncenformlng use which predates current
zoning.
IMPROVEMENTS, Cont'd:
Tfie first floor of the home contains a living room, dining room; kitchen, and unheated enclosed porch. Second floor
contains three bedrooms and an enclosed porch. Due to personal items obstructing access to the third floor your
appraisers;' were only able to view the staircase leading to the this area. According to the occupant of the property
at the time of inspection the third floor is heated and conteina two finished rooms. Full unfinished basement, Please
Note: your appraisers' observed an git leek at the base of the furnace. This appraisal is based on the assumption
that the leak will be repaired and that the heating unit is in good working order reduidng no major repairs. In the
event it is determined that major repairs are needed t~he furnace we reserve the dght to review and or revise this
report and conclusion of value stated within.
The home is considered to pa in average condition. Some intedor painting and new wall paper would enhance
market appeal.
Based on maintenance, condition and comparison neighborhoods, the estimated e~fective age is below the actual
age. Physical depreciation ia present due to the age of the subject, and de[erred maintenance. No Economic or
Functional obsolescence noted.
ADVERSE ENVIRONMENTAL CONDITIONS, Cent'S;
The property is of an age where lead based paint may be present. The market does not penalize the property, but
the client should be advised of it's possible existence. It is assumed that it is not present. If the client had a
concern, then a qualified expert should be contacted.
SALES COMPARISON APPROACH, Confld
The weighted average was also considered to indicated the value of the subject. Estimated indicated value is
determined by using the Gross Adjustment of sale price for each comparebld (comp) as a measure of the relative
quality of the comp. A lower adjustment indicates a better comp, and visa versa. The raUo of gross doflar
adjustment to sale price for each of the comps is used to celcuisfe the weight each comp should have in a weighted
average calculation. As with any method, this technique is not perfect. However, it does a good job of giving more
weight to the most similar comps, while at the same time minimizing values near the extremes of the indicated value
range. The indicated weighted average is $79,000; which supports the conclusion of value stated within, Some
adjustments exceeded recommended guidelines but were considered necessary to reflect an accurate value.
FINAL RECONCILIATION. Cont'd:
The retrospective market value opinion stated herein is as of the date of death of Mary M, Urich on October 9, 2003;
as stated within the body of the appraisal, and contingent upon the certification and limiting conditions attached. The
date of inspection was December 8, 2003.
SPECIAL LIMITING CONDITIQNS:
This appraisal is not a home inspection and your appraisers' are not acting as a home inspector's when preparing
the report. The client has the right to have the home inspected by a professional home inspector. When pertorming
the inspection of this property, your appraisers' visually observed areas that were readily accessible. The appraiser
is not required to disturb or move anything that obstructs access or visibility. The inspection Is not technically
exhaustive. The inspection does not offer warranties or guarantees of any kind. No warranty of the appraisal is
given or implied. No liability is assumed for the structural or mechanical elements of the property.
If the property is sold, this appraisal is subject to satisfactory inspection reports including, but not limited to: wood
infestation, radon, building inspections, etc. Further, your appraiser Is not an environmental expert, and is not
Form TAOD -- '*TOTAL fa' Windows" ~efx'aJsat sofiwai'e by a la mode, ~. -- 1-600-ALAMODE
Supplemental Addendum FileNo. o3-~8
Count'/ Cumberland State PA ~!C)Cod~ 17011 "~t
/
[B0rrower/C~ient NA
p~rTy A~dress 14 Hummel Avenue
C Camp Hi[I
CL~e~if Michael BanjosI Esciuire
qualified to detect environmental defects in and/or on the subject property. Mold may be present in areas the
appraiser can not see. Should the client have a concern regarding any of the above mentioned items it would be
strongly recommended that an expert (ia: home, environmental, structural, etc. ) be contacted.
SUPPLEMENTAL CERTIFICATIONS:
This appraisal was prepared by Karen Darney and Pamela M. Reitanbach for the exclusive use of Michael Bangs,
(client) representing the estate of Mary M. Urich. The purpose of this appreisal report is for estate settlement
purposes. The information and opinions contained in this appraisal set forth the appraiser's best judgement in light
of the information available at the time of the preparation of this report. Any use of this appraisal by any other
person or entity, or any reJianca or decisions based on this appraisal are the sole responsibility and at the sole risk of
the third party. Ms. Darney and Ma. Reitanbach accept no responsibility for damages suffered by any third party, as
a result of reliance on or decisions made or actions taken based on this report.
In our opinion the reasonable exposure time linked to the value opinion is 90 to 180 days.
We further certify that, to the best of our knowledge and belief:
- This appraisal is a COMPLETE APPRAiSAL-SUMMARY APPRAISAL REPORT.
- The statements of tact in this report are true and correct.
- The reported analyses, opinions, and conclusions ara limited only by the reported assumptions and
limiting conditions, and are our personal, Impartial, and unbiased professional analyses, opinions and conclusions.
- We have no present or prospective interest in the property that ia the subject of this report, and no
personal interest with respect to the parties involved.
- We have no bias with respect to the property that is the subject of this report or to the parties involved with
this assignment.
* Our engagement in this assignment was not contingent upon developing or reporting predetermined
results.
- Our compensation for completing this assignment is not cofltingent 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.
- Our analyses, opinions and conclusions were developed, and this report has been prepared in conformity
with the Uniform Standards of Professional Practice.
- No one provided significant professional aestatanca to the persons signing this report.
- This appraisal has been made in conformity with the requirements of the Code of Professional Ethics and
Standards of Professional Appraisal Practice of the Appraisal Institute.
- The use of this report is subject to the requirements of the Appraisal Institute relating to review by its duly
authorized representatives.
- Karen Darney and Pamela M. ReJtenbech personally inspected the interior and exterior of the subject
property. Pamela M. Reitenbach prepared this report. Karan Damey reviewed the report and concurred with the
conclusions contained in this report.
Karen Darney a~is
PA State Certified General App er
Pamela M. Reitanbach
PA State Certified General Appraiser
Form TAOO -- 'TOTAL for Windows" ~praJsaJ software by a I~ mede, Inc, -- 1-800-ALAMOOE
DEFINITION OF MARKET VALUE: The mest probable pflue which a properb/ sM3uld bring in a compefluve aid open market under all condelons
fequisde to a Iair sale, the buyer and seller, each acfl~lg ppJdeofJy, knowledgeably and assuming the p~fue is not affected by undue sifrnulus Implelif in flus
dalin~ofl is the consummapon of a sale as of a apecifiaff date and the passing of flue from seller to buyer under condipons whereby: (1) buyer and seller are
since the seller poys these costs in ~ually all sales ~'ansacaons. Special or creal~e financing adjustments can be made to the
ap~-aiser s judgerne~.
STATEMENT OF LIMITING CONDITIONS AND APPRAISER'S CERTIFICATION
1 The aoprelser will not he responsible f~ rrmtters of a legal nature that affect efluer the pmpen'/being abpralsflu or the flue to ~ The apprmser assumes that
the flue is pood and marketable a~d, therefore, will not render any opinions about the flue. The prope~ is appraised on the basis of d being under responsible
ownership
The appraiser has examined the available flood maps that are provided by the Federal Emergency Management Agency (or other date sources) and has noted
the appraisal rabor~ whether the subject site is located in an idea~faff Special Rued Hazard Area. Bec~se the abpralser )s not a surveyor, he or she makes
4 The ap~-elser will not give tesifmony or appear in court because he or she maffe an apgralsal of the property in quesifon, unless specific arra~fluments to do
so have been made beforehand.
5 The appraiser has es0matsd the value of the ~ in the cost approach of ~ highest and best use a~ the improvements at their c~nt~lbofor'/value. These
se0arate vafualions of the land and improvements must not be used in conjunction with any other apprelsal and ue invalid if they are so used
7 The abprelser ohtsthed the informatmn, estimates, and nginim~s that were exFessflu in the abpraJsal report from sources that he or she considers ID be
reliable and betieves them to be tee and correct. The appraiser does not assume responsibfluy for the accuracy of such items that were furnished by other
The abpra*ser will not disclose the contents of the appraisal repel excabt as provided fur in the Uniform Standards of Professional Appraisal Practice
Freddie MacFo~439 6-93
Page lot 2
Fannie Mae flurm 10048 6-93
APPRAISER'S CERTIFICATION: The Appraiser ce~ifies and ~grees d~tc
2 I have taken into co~aiderafion U~e factors that have an impact on value in my devetopme~t of the esdmofe of marknt value in the appraisal report. I have not
knowingly w~hhaid any significant information from thc appraisal raped and I believe, to the best of my knowledge, that ail statements and inturmahon in the
appraisal report are hue and correct,
on the race, cofof, raiigloth sex, handicap, Iamili~1 status, or na~onal origin ~f ifither the pmspaoflve owners or occupants of the subject propeR u: of the present
owners or occupants of the properties in the vicinify of the subieof properS.
8 I was not required to report a predetermined value or direction In value thof favors the cause of the client or any rifiaed party, the amount of the value esbmcte.
the attainment of a specific result, or the occurrence of a subsequent event in o~der to receive my compensation and/or employment for pedorming the appraisal. I
did not base the appraaiai report on a requested minimum valuation, a specific vaiutatan, or the need to approve a specific mo~age loan.
I further cerUfy that I have noted any apparent or known adverse condidons in the subject ~provements, on the subject site, or on any site w~in the immediate
SUPERVISORY APPRAISER'S CERTIFICATION: It a supervisor'/ appraiser signed the apprifisai repot1, he or she cerUfies and agrees that:
ADDRESS OF PROPERTY APPRAISED: 14 Hummel Avenue, Camp Hill, PA 17011
APPRAISER:
Name: amela M, Reitenbach, PA Certified General Appraiser
Date Signed: December 10~ 2003
STate Cer~ication #: GA001804
or State License ~:
State: PA
Expira*Jon Date ct Certification or L~cense: J~une 30, 2005
SUPERVISORY APPRAISER (only if required):
E~raUon Date of Ce~lcatJon or License: June 30 200~5 ...... '-
Did [ -] Did Notlnspect Prope~
Freddie Mac Form 439 6-93
Page 2 of 2 Fannie Mae Form 10046 $-93
Form ACR -- '~TOTAL fm Windows' appcatsal softwae by a la m~e, inc. -- 1-800-ALAMOOE
REV-1500 EX + (6-00)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
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REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENT'S NAME (LAST, FIRST, AN D MIDDLE INITIAL)
Orich Mary M.
DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM~DD-YEAR)
10/09/2003 03/28/192 a
(IF APPLICABLE SURV V NG SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
1. OrlglnalReturn ~ 247! SupplernentaIReturn
4. Limited Estate . FuturelnterestCompromise(dateofdeathafter 12-12-82)
6. Decedent Died Testate Decedent Maintained a Living Trust
(Attach copy of Will) (Attach copy of Trust)
[~9. Litigation Proceeds Received U 10. SpousaIPovertyCredlt
(date of death between 12-31-91 and 1 - 1-95)
OFFICrAL USE ONLY
FILE NUMBER
21-03-0870
COUNTYCODE YEAR NUMBER
SOCIAL SECURITY NUMBER
234-42-9386
THIS RETURN MUST BE FILED IN DUPUCATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
(date of death
3. Remainder Return 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)
NAME
Michael L. Bangs
FIRM NAM E (If Applicable)
TELEPHONE NUMBER
717/730-7310
3OMPLETE MAILING ADDRESS
429 South 18th Street
Camp Hill, PA 17011
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or
Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
9. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
] Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13.
14.
(1) 79,0(
(Z)
(3)
(4)
(s)
None
6,685.69
None
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
Net Value Subject to Tax (Line 12 minus Line 13)
OFFi~SE ON LY
~,~ 0
(0) 98,628.77
(11) 6,685.69
(12) 91,943.08
(13)
(14) 91,943.08
15.
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(a)(1.2) X .00
16. Amount of Line 14 taxable at lineal rate 91,943.08 X .0 45
17. Amount of Line 14 taxable at sibling rate X .12
18. Amount of Line 14 taxable at collateral rate X .15
19. Tax Due
(15) 0.00
(16) 4,137.44
(17) 0.00
(16) 0.00
(19) 4,137.44
~,~ Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV- 1500 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
14 Hummel Avenue
CITY
Camp Hill
Tax Payments and Credits:
1. Tax Due {Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
STATE I ZIP
PA 17011
(1)
Total Credits ( A + B + C ) (2)
3. Interest/Penalty if applicable
D. interest
E. Penalty
Total Interest/Penalty ( D + E ) (3)
4. if Line 2 is greater than Line 1 + Line 3, enter the d~erence. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to recluest a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SB)
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. retaintheuseorincomeofthepropertytransferred; ......................... ~ ~
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 GUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
4,137.44
0.00
0.00
0.00
4,137.44
6.37
4,143.81
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 ;~nd complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATUREOFPERSONRESPONSIBLEFORFILINGRETURN Justina A. Fye DATE
~ .... -.Y 14 Hummel Avenue
LL. .........................
~GNATUREOFPREPAREROTHERTH~EPRESENTATIVE Michael L. Bangs DA~E
For dates of death on or aEer July 1, 1994 and before Janua~ 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is 3% [72 P.S. 9116 (a) (1.1) (i)].
For dates of death on or after Janua~ 1, 1995, the tax rate imposed on the net va~ue of transfers to or for the use of the surviving spouse is 0%
[72 P.S. 9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statuto~ requirements for disclosure of assets
and filing a tax return are still applicable even if the surviving spouse is the only beneficial.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twen~-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 0% [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%, except as noted in 72 P.S. 9116(1.2)
[72 P.S. 9116(aXl)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(a)(1.3)]. A sibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Copyright (c) Z000 form software only The Lack~r Group, Inc. Form REV- 1 ~0~ ~X (Rev. 6-~)
SCHEDULE A
COMMONWEALTH OF PENNSYLVANIA REAL ESTATE
IN HERITANCE T~ RETURN
RESIDENTDECEDENT
ESTATE OF
Mary M. Urtch SS~ 234-42-9386 10/09/2003
FILENUMBER
21-03-0870
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 which is jointly-owned with ri~lht of survivorship must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION
14 Hummel Avenue, Camp Hill, PA - (See appraisal attached)
TOTAL (Also enter on line 1, Recapitulation)
VALUE AT DATE
OF DEATH
79,000.00
$ 79,000.00
{If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software on;y CPSystems, Inc. Form REV- 1502 EX (Rev.
File No 03-568
December 10, 2003
L. G. Connor Real Estate Appraisers, LTD
2159 Market Street
Camp Hill, PA 17011
Mr. Michael Bangs, Esquire
302 South 18th Street
Camp Hill, PA 17011
RE:
Estate of Mary M. Urich
14 Hummel Avenue
Lower Alien Township, Cumberland County
Camp Hill, PA t701t
Dear Mr. Bangs:
Pursuant to your request, we have prepared a COMPLETE APPRAISAL,
SUMMARY REPORT of the property capifloned in the "Summary of Salient
Features" which follows.
The accompanying report is based on a site inspection of improvements,
investigation of the subject neighborhood area of influence, and review of
sales, cost, and income data for similar properties.
This appraisal has been made with particular attention paid to applicable
value influencing economic conditions and has been processed in
accordance with nationally recognized appraisal guidelines.
The opinion of retrospective value conclusion stated herein is of the date of
death of Mary M. Urlch on October 9, 2003; as stated In the body of the
appraisal, and contingent upon the certification and limiting conditions
attached. The purpose of this report is to determine an opinion of the
retrospective market value of the subject property for estate settlement
purposes. The date of inspection was on December 8, 2003.
Please do not hesitate to contact me or any of my staff if we can be of
additional service to you.
Respectfully,
Karen Darney /
PA State Certified General Appraiser
SUMMARY OF SALIENT FEATURES
Subiect Address
Legal Oescnl~on
County
Map Reference
14 Hummel Avenue
Deed Book 21Y. Page 875
Camp Hilt
Cumberland
PA
17011
3240-0110,00
NA
Sale Pdce $ NA
Oate of Sale NA
Borrower/Client Micaael Bangs, Esquire
Lender NA
Size (Square Feet) 1,480
Pdce per Square Fo~t $
Location Average
Age 100 +/- yrs
Condition Average
Total Rooms 8
Bedrooms 5
Appraiser Pamela M. Reitenbac~, PA State Certified General Real Estate Appraiser
Date of Appraised Value October 9, 2003; Date of Death of Mary M. Uricb
Final Estimate of Value $ 79,000
Form SSD -- "TOTAL for WIn~ows" app~Jsal sMtwm'e by a la mOde, Inc, -- 1-80(NALAMODE
UNIFORM RESIDENTIAL APPRAISAL REPORT P,o,o. 03-5D8
Pro~' Address 14 Hummel Avenue _ ~ity Camp Hill _ __ __ Stata~P_A _ Z~ ~od~ 701_1
C d [J!~y_ ~C t !£n b e~r_a_n.d~
Tax Year 03-04 R,E, Taxes $1,112 16 SDeci~ Assessmer~i ~ 0 ~)~0
Leasehold
Built up Over 75% ~ 25-75% Under 25% ~upancy $(000) (yrs) ~ One tamJly 92 ~ ~ Not Fikely DkeJy
Marke~n~ame ~ Under 3 mos, ~ 3-6 mos ~110 4~0 - ~'
Project Inf~m~on for PUD~ (If applicable) - - Is the developedbuiider in control of the Home Owners' Associabon (HOA)? Yes No NA
App~o~mete total number of units in the subject project NA koprox~mate total number of units for sale in the subieof project NA
Describe common elements; NA
Dimensions 35'x 119'I per enclosed~legat description
Sr[e area 4~_~65square feet or lOAcre ComerLot [ii Yes .~ No
ZonJngcompliance Legal ,~'X,~Legalnonconto?ing(Grancifathereduse) F~]lllega~ [ ]Nozoning
~ Other use (explain)
Electricity X ....... fleet Macadam
~as X .... J Curb/guYot ~ ._
Water .~ . _ ~..~ Sidewalk Concrete
SanKary sewer ~ -"] Street lights Adequat~
Slorm sewer ~ J Alley TO rear
i Tsi~graphy Generally Leve~ .
T~I for ar~ea
Shape Rectangular
Drainage ~a re~Ade~g~Le
View ,Average .....
Landscaping Averaj~e _ _
Driveway Sudace _Stone
Apparent easements Sfe ndard~l~!hty~. -
FEMA Special Flood Hazard Area Yes ~ No
FEMA Zone C Map Date 9-30-1977
~ i EMA Map No, 421016 B
Cornrnems (apparent adverse easements, encroachments, special assessments, slide areas, illega~ or legal nonconforming zoning use, otc): Sta~da r~
easements for electr c, telephone, otc There are no known or apparent adverse easements, encroachment or conditions noted
GENERAL DESCRIPTION ~(TERIOR DESCRIPTION :OUNOATION !BASEMENT ~ NSULATION
NO o~ Un~s One Foundabon Stone ~lab NA
Area Sq. Ft. 616 Root
No of Stodes 2.5 Extedor Wails Ai---~-m/Brick ;rawt Space NA % Finished ~ Ceiling --
Type (Bet/AR) Aitached Roof Sudace ~ ~asement Full Bsmt Ceiling U-~-n~- Wails '-
Design (Style) ~2~S~o~ Gutters & Dwnspts Alum/Alum ~urnp Pump No Wails ~ ' Floor ~ - -
-- ~ rCarpor1
immediate vicinity of the subject property.:
Freddie Mac Form 70 6/93 PAGE 1 OF 2
Form UA2 -- '~TDTAL tot Windows" appraisal software by a la mode, inc. -- 1-800-ALAMODE
Fannie Mae Form 1004 6/93
UNIFORM RESIDENTIAL APPRAISAL REPORT Fl~Ho. o3-~o~
ESTIMATE(~ SITE VALOE = $ ~omments om Cost Approach (such as, source of cost estimate, she va(up,
ESTIMATED REPROOUCTION COST-NEW-OF iMPROVEMENTS: ~quare l~t calculation and lot HUD, VA and FmHA, the eshmated remaining
........... reasonably n~, and the improvements reflec~ the highest ~_
~e/Carpod 220 Sq Ft ~$ = ..... best use of the land. However, when ~tems of physi~l
5ALUE.b~JU~TMENT~ OESCRIPTION O[SCRI~ION : +(-)$Ad~. OESCRIPTION ~(-)$A~just._ DESC.RI~Ip~__
~ro~iying Ares ___ I~4~Q.S~ ..... 1~088 Sq. Ft. +3,900 ' 1,38~ Sq. R~- ~ .... ~26~ Ft _
INDICATED VALUE BY S~ES COMPAR~N APPROACH
SUPERVISORY S ~ ~F Q--~E~ ~
Freddie Mac Form 70 6/93 PAGE 20P 2 Fannie Mae Form 1004 6-93
Form UA2 -- "TOTAL for Windows" appraisal software by a la mode, inc -- 1-800-ALAMODE
UNIFORM RESIDENTIAL APPRAISAL REPORT
MARKET DATA ANALYSIS
~TE~M __.L. _SUBJE~C_T COMPARABLE NO. 4 COMPARABLE NO.
A®re~s_~ HiI~PA ~____ ~
P~ro_~b£ect-- ~ 0.98 miles 1.24 miles ....... _ . .
Sale__s Pdqe .... J; NA~85 900 ~---- 7~90~
Pdc~Gros~A ea$ :/~
· --- ~,~.. 56.22 r/
VALUE ADJ~USTM~E~ITSSaLes or Fiaancing" ~OESCRIPT~0N FHADESCRIPTION ,:~ DESCRIPTION :
Location .... Ave~ _ Averaqe ._ __ ; Superior ~--
QL~al~'.qf Co~._~$~rucfion~ .~veraAe_ ..... i AveraRe --_~-- -~---- ~Avera~/e
............ -- .... Equal
AboveGrade )'otN Bdrrns~ Baflls Tot~ iBd~si Bath~ TotaJ iBdrrn$! Baths. ..... To~-~(~n~s B~aths
RoomCount ~8 . 5_.~1 8 i 5 1.5 ~ -1,500 7 i 3 i 1.5~ -1,500
......... 72~A80(
~orm UA2.(AC) -- "TOTAL for Windows" appraJsaJ software by a la mode, inc. -- 1-800-ALAMODE
Borrower/Cfient NA
~ro~_em/Address -i4 Hummel Avenue
it'/ Camp Hil~l_.
Supplemental Addendum
File No. 03-568
C0um'¥ Cumberland State PA
NEIGHBORHOOD COMMENTS. Cont'd:
Subject is located in Lower Allen Township. This neighborhood is conveniently located just south of the Boroughs of
Lemoyne and Camp Hill and northwest of the Borough of New Cumberland. Subject is located along the southern
side of Hummel Avenue; which is one of this areas more heavily traveled roadways. It is anticipated that the
subject's location will have a negative impact on market appeal. Uses along Hummel Avenue include residential,
retail, commercial and light industrial; which are typical of the area and should have no affect on market appeal.
SITE, (~ont'd:
The subject site is located in the I-3, Industrial zoning district. It's current use as a residence is not an allowed use
within this zoning district. Therefore, the subject's use is viewed as legal nonconforming use which predates current
zoning.
IMPROVEMENTS, Cont'd:
Ttie first floor of the home contains a living room, dining room; kitchen, and unheated enclosed porch. Second floor
contains throe bedrooms and an enclosed porch. Due to personal items obstructing access to the third floor your
appraisers;' were only able to view the staircase leading to the this area. Acoording to the occupant of the property
at the time of inspection the third floor ia heated and contains two finished rooms. Full unfinished basement. Please
Note: your appraisers' observed an oil leak at the ba~e of the fumaoe. This appraisal is based on the assumption
that the leak will be repaired and that the heating unit is in good working order requiring no major repairs, th the
event it is detarmined that major repairs are needed t~he fumaca we reserve the right to review and or revise this
report and conclusion of value stated within.
The home is considered to be in average condition. Some interior painting and new wall paper would enhance
market appeal.
Based on maintenance, condition and comparison neighborhoods, the estimated effective age is below the actual
age. Physical depreciation is present due to the age of the subject, and deforred maintenance. No Economic or
Functional obsolescence noted.
ADVERSE ENVIRONMENTAL CONDITIONS. Cont'~:
The property is of an age where lead based paint may be present. The market does not penalize the property, but
the client should be advised of it's poesible existence, it is assumed that it is not present. If the cJient had a
concern, then a qualified expert should be contacted.
SALES COMPARISON APPROACH, Cont'd
The weighted average was aiso considered to indicated the value of the subject. Estimated indicated value is
determined by using the Gross Adjustment of sale price for each comparable (comp) as a measure of the relative
quality of the comp. A lower adjustment indicates a better comp, and visa versa. The ratio of gross dollar
adjustment to sale price for each of the comps is used to calculata the weight each comp should have in a weighted
average calculafion. As with any method, this technique Is not perfect. However, it does a good job of giving more
weight to the most similar comps, while at the same time minimizing values near the extremes of the indicated value
range. The indicated weighted average ia $79,000; which supports the concicaion of value stated within. Some
adjustments exceeded recommended guidelines but were considered necessary to reflect an accurate value.
FINAL RECONCILIATION, Cont'd;
The retrospective market value opinion stated herein is as of the date of death of Mary M. Urich on October 9, 2003;
as stated within the body oftbe appraisal, and conUngent upon the certification and limiting conditions attached. The
date of inspection was December 8, 2003.
SPECIAL LIMITING CONDITIONS:
This appraisal is not a home inspection and your appraisers' are not acting as a home inspector's when prepenng
the report. The client has the right to have the home inspected by a professional home inspector. When pen~orming
the inspection of this property, your appraisers' visually observed areas that were readily accessible. The appraiser
is not required to disturb or move anything that obstructs access or visibility. The inspection is not technically
exhaustive. The inspection does not offer warranties or guarantees of any kind. No warranty of the appraisal is
given or implied. No liability is assumed for the structural or mechanical elements of the property.
If the property is sold, this appraisal is subject to satisfactory inapection raports including, but not limited to: wood
infestation, radon, building inspections, etc. Further, your appraiser is not an environmental expert, and is not
From TADD -- "TOTAL for WIn~ows' ~ soitwa'e by a ia mode, inc. -- 1-800-ALAMOOE
[B0,0wsr/~lient NA
Pr0~/A~dre$$ 14 Hummel Avenue
(~amp Hill ---
Michael Bangs, Esquire
Supplemental Addendum
File No. 03-568
_~ C0(~ 17011
County Cumberland State PA
qualified to detect environmental defects in and/or on the subject properS/. Mold may be present in areas the
appraiser can not see. Should the client have a concern regarding any of the above mentioned items it woutd be
strongly recommended that an expert (ia: home, environmental, structurat, etc. ) be contacted.
SUPPLEMENTAL CERTIFICATIONS:
This appraisal was prepared by Karen Darney and Pamela M. Reitanbach for the exclusive use of Michael Bangs,
(client) representing the estate of Mary M. Urich. The purpose of this appraisal report is for estate settiement
purposes. The information and opinions contained in this appraisal set forth the appraiser's best judgement in light
of the information available at the time of the preparation of this report. Any use of this appraisai by any other
person or entity, or any reliance or decisions based on this appraisal are the sole responsibility and at the sole risk of
the third party. Ms. gamey and Ms. Reltanbach accept no responstbllity for damages suffered by any third party, as
a result of reliance on or decisions made or actions taken based on this report.
In our opinion the reasonable exposure time linked to the value opinion is 90 to 180 days.
We further certify that, to the best of our know~edge and belief:
- This appraisal is a COMPLETE APPRAISAL-SUMMARY APPRAISAL REPORT.
- The statements of fact in this report are true and correct.
- The reported analyses, opinions, and conclusions are limited only by the reported assumptions and
limiting conditions, and are our personal, Impartial, and unbiased professional analyses, opinions and conclusions.
- We have no present or prospective interest th the property that ia the subject of this report, and no
personal interest with respect to the parties involved.
- We have no bias with respect to the property that is the subject of this report or to the parties involved with
this assignment.
- Our engagement in this assignment was not contingent upon developing or reporting predetermined
results.
- Our compensation for completing this assignment ia 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.
- Our analyses, opinions and conclusions were developed, and this report has bean prepared in conformity
with the Uniform Standards of Professional Practice,
- No one provided significant professional assistance to the persons signing this report.
- This appreisal has been made in conformity with the requirements of the Code of Professional Ethics and
Standards of Professional Appraisal Practice of the Appraisal Institute.
- The use of this report is subject to the requirements of the Appraisal institute relating to review by its duly
authorized representatives.
- Karen Damey and Pamela M. Reitenbach personally inspected the interior and exterior of the subject
property. Pamets M. Reitenbach prepared this report. Karsn Darney reviewed the report and concurred with the
conclusions contained in this report.
Karen Darne~- ~.~
PA State Certified Generel Appraiser
Pamela M. Reitenbach
PA State Certified General Appraiser
Form TADD -- 'TOTAL for Windows spffaiaal software by a ia mode, inc. -- 1 8O0-ALAMODE
STATEMENT OF LIMITING CONDITIONS AND APPRAISER'S CERTIFICATION
3 The apprmser has examined the avadaMa flood maps that are provided by the Federal Emergency Management Agency (or other data sources) and has noted
5 The appraser has esl~mated the vbiue of the land in the cost approach at its highest and best use and the ~provementa at their conbl~utory value. These
7 The appraiser obtsJned the iatorrnaUo~, estimates, and opinions that were ex4xesse~ in the ap~-aisaJ repro1 from sources that he or she considers to be
reliable and believes them to be true and correct. Re appraiser does ~ot assume responsibility fo~ the accuracy bi such items that were furnished by other
The appraiser will not disclose the contents of the apprtssbi report except as provided for in the Uniform Standards of Professional Appraisal Praot]ce
10 The appraiser must prowde his or her prior written consmlt before the lender/client specified in the appraisaJ report can disblbuts the appraisal repml
(including :oncluslons about the propeR vaJue, the appraiser's identity and F'ofesslonal designatidns, ar~ references to a~y professional aporasal
organiZabons or the fiem w~h which the appraiser is asscthMad} to allyone outer than the b~nower; the mortgagee or ~ successors and assigns; the mortgage
Freddie Mac Fom~ 439 6-93
Page 1ct 2
Pamela Rel~bach
F~rm ACR -- "TOTAL for Windows" appr~isat software by a ts mode, inc. -- 1-800-ALAMODE
Yannte Mae Form 10048 6-93
APPRAISER'S CERTIFICATION: The App~aJeer ~rEflee and agrees toof:
6 I was not required to report a pre~ntem~theq vifiue o~ dkeotJon in value that favors toe cause of the client or any related i~arty, the amount of the value eshmate.
the attainment of a specific result, or toe occurrence of a subsequent event ~ onset to receive my compensation and/or employment for peltormicg the appraisal. I
did not base the appraisal report on a requested minimum valuation, a specific vstua~on, or toe need to approve a specific tug,age loan.
8 I have personally inspected the interior and e~erior areas of the spbject property mid the ex~edor of all pmper~es listed as comparables in the appraisal report
furiher ce~y that I have noted any apparent or I~lown adverse condifJons in the subject Imp~ovementh, ga the subject site, of on any sife wifiifn the immediate
vicin~ of the suhient property of which I am aware arid apve mede edjutomeato toe thece adverse condato~s in my analysis of the prope~ value to the extent that
had market evidence to support toem I have also commented about toe effect of toe adverse conditions on the markstabil~ of the subieof property
9 I personally prepareq all concalsions anif opinions about the real estate that were set forifi in the appraJsal report. If ~ ;eheq on algnificaot pro~essional
assistance from any individual or inifividuaJs in the pedormance of lite appraisal or the preparstton of toe appraisal report, ~ have named such inifivi~ual(s) and
disclosed the specific tasks perto~med by them in the reconcil~on seca3n of this aporifisal [epod. I cerifiy that any inifiv~dual so named is qualified to pedorrn
the tasks I have not authorized anyone to make a change to any item In toe report; toe-iris'e, if an um3uthoNzed change Is made to the appraisal cepori, I will take
SUPERVISORY APPRAISER'S CERTIFICATION: if a superviso~ appraiser signed the ap~alsal report, he or she ce~ies and agrees that:
I direcify supervise the appraiser who prepared the appraisal report, have reviewed the eqpralsal report, agree with the statements ~nd concalalons of the appraiser.
agree to be ~Ound by the appraiser's certifications numbered 4 through 7 above, asp ara tstdng full responsibility fo~ toe appraisal and the appraisal report.
ADDRESS OF PROPER'Iqf APPRAISED: 14 Hummel Avenue, Camp HiU, PA 17011
APPRAISER:
Name; Pamela M. Re;tenbach, PA Certified General .Appraiser
Date Signed: December 1 O, 2003
Expirahon Date of Certification or License: J~upe 30, 2005
SUPERVISORY APPRAISER (only If required):
Name: Karen Darney, PA Certified General App?'iser __
FJ~iraifon Oato of CmlJficntton o[ License: June 30, 2005
L~X~ Did {-I Did Not Inspect Properb/
Freddie Mac Form 439 6-93
Peg! 2 of 2 Fannie Mae Form 1004B 6-93
Form ACR -- "TOTAL for Windows' appraisal software by a la mode, inc. -- 1-800-ALAMODE
Location Map
mr~eteen hundred and SIXTY SIX (1966)
~t~'~[, WILLIAM H. SNOOK, III and EVELYN E. SN~K, his wife, of Athens, State
(hereinafter called the Grantor s),
(hereinafter called the Grantees ),
'~J~l'~l~[~, That in consideration of TEN THOUSA~ ($10,000.00) ...................
~llars,
,n bared paid, the receipt whereof is hereby acknowledged, the said Grantor s do hereby gront ~nd
ALL THAT CERTAIN lot or piece of land situate in the Township of Lower Allen,
BEGINNING at a point on the Northern line of Hummel Avenue~ said point being
!wo huildred ten (21~) feet West of 18~h Street (formerly known as Milltown Road); thence
ex%endiag along Huramel Avenue South fifty-two (52) degrees fifteen (15) minutes West
~illr[y-flve (35) feet to a corner of premises know~ ss No, 16 Hummel Avenue; thence along
~ald premises North thirty-seven (37) degrees forty-five (45) minutes West o~le hundred
Iline[een (119) fee~ to a point on the Southern line of a State Highway; thence along the
same North flftytwo (52) degrees fifteen (15) minutes East thirty-five (35) feet to a
turner of premises hnown as NO. i2 H~mrael Avenue; thence along said pre~ises and passing
[llrougi] the center of a partition wail South thirty-seven (37) deErees forty-five (45)
~[autes East one hundred nineteen (119) feet to the point and place of BEGINNING.
HAVING thereon erected a two and one-half story brick and frame dwellin~ known
~lanted sild co~lveyed unto ~llliam B. Snook~ III and Evelyn E. Snook, his wife, by Deed
dated June 29, 1955 and recorded in Deed Book "N" Vol. 16 9age 495, Cumberland County records
described premises, with the hereditaments and appurtenances, unto the said Grantee s their J~eLrs
and assigns, against the said Grantor s and against every other person
lawfully claiming or who shall hereafter claim the same or any part thereof,
~1'~ ~n~ ~[~l~[[O[, the said Grantor s ha vecaused these presents to be duly executed, the
day and year first above written.
In the Presence of:
day of ~-~¢,'~ 1966 , before me, the
William E. Snook~ [Il and Evelyn E. Snook, his wife,
known to me
~r satisfactorily proven) to be the person swhose name s are subscribed to the within instrument,
and acknowledged thett he y executed the same for the purposes therein contained
hereunto set my hend end omci, l seel.
Notary Pub~-~
COUNTY OF ~'
RECORDED on this ~:~'~
in the Recorder's Office of the said County in Deed Book
day of ~/
'A.D. 19G"~
GIVEN under my hand the seal of the said office, the date above written.
Recorder.
SUBMISSION NO...~
.J
TAX MAP
Building Sketch (Page - 1)
8~r~rjCli~ _N_A
Properly Address 14 Hummel Avenue
~. ~.~-u_,!,--. ~_~-~_
ILender Michael Ban~s, Esau ·
12.0' 17.0'
~ Encl. Porch ~;~ EnoL Porch : ~.
,
~: ,
~ Kitchen
· ,¢ Party
6.0'i Wall Bath I
~ Bedrm [ , ~ Third Floor
~ Room ' ~ ~ ! ~ ~ Half Sto~
: ~ ~ 4.0'
Porch 14.0' ~ 14,U' 7.0'
20.0' ' Interior Not To Scale
AR~ C~CU~TIONS SUM~RY LIVING AREA BREAKDOWN
TOTAL LIVABLE (rounded) 1480 17 Calcula~ons To~l (round~ d~480
Form SKT BIcISkl -- 'ffOTAL for Windows" ap~JsaJ software by a la mode, inc, -- 1-80~-ALAMODE
Subject Photo Page
Subject Front
Subject Rear
Subject Street
Comparable Photo Page
Comparable 1
Comparable 2
Comparable 3
Comparable Photo Page
Comparable 4
Comparable 5
137 Herman Avenu~
Comparable 6
REV- 1~O8 EX + (3 -g7)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENTDECEDENT
ESTATE OF
SCHEDULE E
CASH, BANK DEPOSITS,& MISC.
PERSONAL PROPERTY
FILE NUMBER
Mary M. Urich SS~/ 234-42-9386 10/09/2003 21-03-0870
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1
2
3
4
5
6
AARP Life Insurance - Life Insurance
M & T Bank - Certificate of Deposit 31003908145913
M & T Bank - Certificate of Deposit 31003910084266
M & T Bank - Certificate of Deposit #31003910084307
M & T Bank - Certificate of Deposit 31003910392297
M & T Bank - Certificate of Deposit #31003910174174
5,125.71
2,719.51
1,247.04
1,247.04
1,227.67
3,260.26
TOTAL (Also enter on line 5, Recapitulation) 14,827.23
(If more space is needed, insert additional sheets of the same size)
Copyright(c) 1996 form software only CPSystems, Inc. Form REV-1508 EX (Rev. 1-97)
MAR 22 2004 17:5:3 FR HEld YORK LIFE AARP 81:3 288 5200 TO
FAX COVER SHEET
F'. Oi FJi
NEW YORK LIFE
5405 West Cypress Street, Suite 108; Tampa, FL 33607; (800) 695-5165
DATE:
March 22. 2004
TO: Michael L. Bangs
FAX: 717 730-7374
FROM: David Rogers
PHONE: 1 800 69~-5165
Number of pages including cover sheet:
FAX:
1
1 1813t 288-5200
Message; In~ured: ibr,/Ulrich t A1499301
Dear Mr. Bangs:
I am writing In reference to ~e requirements needed to settle a claim on the above-
mentlonec~ Certificate.
We are In receipt of t~e certiflecl death certificate for Mary Ulrich and DOnald K FielCts along
wi~ a completed claim form by JusUna A I=Ve. However since Mr. Fields pfedeceaseq the
InsurecJ, the proceeas are now deflgnated to t~er estate, please forward a copy of the
executrix papers for MS. Fye at vour earliest convenience,
If you I~ave any questions or anticipate a ~urther delav, please con.ct us at 1-800-695-5165
between l:lle hours of 8am to spin Eastern standard Time Monday Ulrough Frldav.
sincerelv,
IF YOU DO NOT RECEIVE ALL PAGES, PLEASE CALL THE SENDER
The information and/or documents contained in this facsimile transmission contain
information from New York Life, which is privileged and confidential. Only intended
recipients are permitted to view the contents of ~ls facsimile transmission, if you are not
the intended recipient, you are hereby notified that any disclosure, copying, distribution,
or use of its contents is strictly prohibited. If you received this facsimile transmission in
error, please notify New York Life immediately by telephone at
1-800-695-5165 and destroy the original transmission.
TOTAL PAGE.01 ~*
Mt TBank
499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12
Bangs Law Office
Attorneys At Law
302 South 18th Street
Camp Hill, PA 17011
Phone (302) 934-2909
Fax (302)934-2955
December 9, 2003
Re: Estate of Mary M Urich
Social Securi.ty: 234-42-9386
Date of Death: October 9, 2003
Dear Sir or Madam:
Per your inquiry dated October 21, 2003, ple~e be advised that at the time of death, the above-named decedent had on
deposit with this bank the following:
7)~pe of Account
Account Number
Ownership (Names oJ)
Opening Date
Balance on Date of Death
Accrued Interest
Total
Certificate of Deposit
31003908145913
Mary M Urich
06/27/01
$2,711.99
$ 7.52
Type of Account
Account Number
Ownership (Names
Opening Date
Balance on Date of Death
Accrued Interest
Total
Certificate of Deposit
31003910084266
Mary M Urich
01/07/98
$1,235.57
$ 11.47
~D~;i
T)pe of Account
Account Number
Ownership (Names
Opening Date
Balance on Date of Death
Accrued Interest
Total
Type of Account
Account Number
Ownership (Names oJ)
Opening Date
Balance on Date of Death
Accrued Interest
Total
Type of Account
Account Number
Ownership (Names oJ)
Opening Date
Balance on Date of Death
Accrued Interest
Total
Type of Account
Account Number
Ownership (Names oj')
Opening Date
Balance on Date of Death
Accrued Interest
Total
Certificate of Deposit
31003910084307
Mary M Urich
01/07/98
$1,235.57
$ 11.47
Certificate of Deposit
31003910174174
Mary M Uric& Trustee
K Donald Fields, Beneficiary
08/27/98
$3,260.26
$ 14.89
Certificate of Deposit
31003910392297
Mary M Urich
08/24/99
$I, 223.14
$ 4.53
Certificate of Deposit
31003910447901
K D Fields, Organization
Mary M Uric& Signatory
10/05/99
$1,255.06
$ 30.54
~*ype of Account
Account Number
Ownership (Names dj)
Opening Date
Balance on Date of Death
Accrued Interest
Total
Type of Account
Account Number
Ownership (Names of)
Opening Date
Balance on Date of Death
Accrued Interest
Total
Checking Account
1082183
Mary M Urich
dustina A Fye
11/23/90
S8,927.58
$ 0.00
$8,927.58
Savings Account
21000000997926
Mary M Urich
Justina A Fye
11/29/90
$675.50
$ .30
For further account information, closures and/or reimbursement of funds please call the ltighland Park Office at #717-737-3322.
Plea~ I~ advis~l, there was no ~afe deposit box found for the above decedent.
Records Management
REV- 1509 EX * (1-97)
SCHEDULE F
COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mary M. Urich SS~/ 234-42-9386 10/09/2003
If an asset was made joint within one year of the decedent's date of death, ]t must be reported on Schedule G.
FILE NUMBER
21-03-0870
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A.Justina A. Fye Daughter
14 Hummel Avenue
Camp Hill, PA 17011
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
ITEM =OR JOINT MADE Include name of financial Institution and bank
account number or similar identlf~ir~j number. DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT Attachdeedforjointly-heldrealestate. VALUE OF ASSET INTEREST )ECEDENT'SINTERE.~
1' A 11/23/90 M & T Bank - Checking 8,927.58 50.007, 4,463.79
Account 1082183
2 A 11/29/90 M & T Bank - Savings 675.50 50.007, 337.75
Account
TOTAL (Also enter on line 6, Recapitulation) $ 4,801; 54
(If more space is needed insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-lS09 EX (Rev. 1-97)
REV- 1511 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mary M. Urich SS~/ 234-42-9386
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
10/09/2003
FILENUMBER
21-03-0870
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
2
3
FUNERAL EXPENSES:
Woodlawn Memorial Gardens, Inc. - Funeral Bill
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) / FIN Number of Personal Representative(s)
Street Address
City State
Zip
Year(s) Commission Paid:
Attorney's Fees Michael L. Bangs
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
city
Relationship of Claimant to Decedent
Probate Fees Register of Wills
Accountant's Fees
Tax Return Preparer's Fees
Other Administrative Costs
Cumberland Law Journal - Estate Advertising
L. G. Connor Real Estate Appraisers, Ltd.
The Sentinel - Estate Advertising
State Zip
TOTAL (Also enter on line 9, Recapitulation) $
1,340.00
4,500.00
122.00
250.00
75.00
300.00
98.69
6,685.69
IIf more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97)
REV-1513 EX + (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Marx M. Urich SS~/ 234-42-9386
NUMBER
I.
1
II.
SCHEDULE J
BENEFICIARIES
10/09/2003
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spo~al distributions, and
transfem under Sec. 9116(a)(1.Z)]
Justina A. Fye
14 Hummel Avenue
Camp Hill, PA 17011
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Daughter
FILE NUMBER
21-03-0870
AMOUNT OR SHARE
OF ESTATE
Entire
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET
$ O. O0
(If more space is needed, insert additional sheets of the same size)
Copyright (c) ZO00 form software only T he Lackner Group, [nc. Form REV- 1513 EX (Rev. 9-00)
I, MARY M. URICH, of Lower Allen Township, Cumberland County, Pennsylvania,
declare this to be my last will and revoke any will previously made by me.
ITEM I. I direct that all my just debts and funeral expenses, including my gravemarker
and all expenses of my last illness, and any and all taxes and assessments imposed by any
governmental body as a result of my death, whether on property passing under this will or
otherwise, shall be paid from my residuary estate as soon as practicable after my decease as a
part of the expense of the administration of my estate.
ITEM II. I give and bequeath all of my household goods, automobiles, jewelry, and all
other articles of household and personal use, equipment and ornament, together with all
insurance thereon and relating thereto, to my daughter, JUSTINA A. FYE, of Etters,
Pennsylvania, provided she survives my death by thirty (30) days. Should my said daughter
predecease me or be deceased on the thirty-first day after my death, I give and bequeath all such
items and insurance thereon to those of my issue, per stirpes, as survive my death by thirty (30)
days.
ITEM III. I give, devise, and bequeath all the rest, residue, and remainder of my
possessions and estate of every nature and wherever situate to my daughter, JUSTINA A. FYE,
of Etters, Pennsylvania, provided she survives my death by thirty (30) days. Should my said
wife predecease me or be deceased on the thirty-first day after my death, I give, devise, and
bequeath all the rest, residue, and remainder of my possessions and estate of every nature and
wherever situate to those of my issue, per stirpes, as survive my death by thirty (30) days.
ITEM IV. All of the interests of the beneficiaries hereunder shall not be subject to
anticipation or to voluntary or involuntary alienation nor shall they be subject to any execution or
attachment.
ITEM V. I appoint my daughter, JUSTINA A. FYE, executrix of this my last will.
ITEM VI. In addition to the other powers and authorities granted to my personal
representatives by Pennsylvania law and by the other terms and provisions of this will, I hereby
give to my personal representatives the following powers and authorities effective without court
approval and until actual distribution of all property: to compromise any claim or controversy;
to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as
my personal representatives may determine and at valuations finally to be fixed by them; to
invest in all forms of property, including any stock or other securities in any corporate fiduciary
or its successor without restriction to investments authorized for Pennsylvania fiduciaries, as my
personal representatives deem proper, without regard to any principle of risk or diversification;
to retain any or all assets of my estate, real or personal, without regard to any principle of risk or
diversification; to sell at public or private sale, to exchange, or to lease for any period of time,
any real or personal property and to give options for sales, exchanges, or leases, for such prices
and upon such terms or conditions as my personal representatives deem proper; and to allocate
receipts and expenses to principal or income or partly to each as my personal representatives
deem proper in their sole discretion.
2
ITEM VII. I direct that my personal representatives and fiduciaries shall not be required
to give bond for the faithful performance of their duties in any jurisdiction.
IN WITNESS WI:IEREOF, I have hereunto set my hand this
9r.~,~ ,2000.
~ q
day of
3
The preceding instrument, consisting of this and THREE other typewritten pages, each
identified by the signature of the testatrix was on the date thereof signed, published, and declared
by MARY M. URICH, the testatrix therein named, as and for her last will, in the presence of us,
who at her request, in her presence, and in the presence of each other, have subscribed our names
as witnesses hereto.
4
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
)
( ss:
)
Sworn or affirmed to and acknowledged
beforve,,~? byti ~ t~trix~named above
this~t~ day ~.,, .
No ~.-y
/ ~c~,~r~.~o, aooa I
CO~MtJN WEALTH OF PENNSYLVANIA
The undersigned, being the testatrix whose name is signed to the attached or foregoing
instrument, having been duly qualified according to law, does hereby acknowledge that I signed and
executed the foregoing instrument as my last will, that I signed it willingly; and that I signed it as my free
and voluntary act for the purposes therein expressed.
COUNTY OF CUMBERLAND
names are signed to the attached or foregoing instrument, being duly qualified according to law, do
depose and say that we were present and saw the testatrix sign and execute the instrument as her last will;
that she signed it willingly and that she executed it as her free and voluntary act for the purposes 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 18 or more years of age, of sound mind, and
under no constraint or undue influence.
Sworn or affir: ned to and
ac-,knowledg~ ~efdre.me this
r ]~/~lay oft F (~!,L(-/ , 2000
No_tary Publi% ~
I
L"~' c.~,r,a..,. ~..,.~, lo, ~ 5
)
( ss:
)
429 SOUTH 18TM STREET
CAMP HILL, PA 17011
E-mail: mikebanes(~verizon nc[
BAN IS LAW OFFIC
PHONE: 717-730-7310
FAX: 717-730-7374
MICHAEL L. BANGS, Attorney-at-Law
WENDY S. CHESBRO, Paralegal
July 21, 2004
WILLIAM E. MILLER, JR.
Of Counsel
Glenda Famer Strasbaugh, Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
RE: Estate of Mary M Urich
File No. 21-03-0870
Dear Mrs. Strasbaugh:
Enclosed for filing as a part of the above-referenced estate you will find the following:
1. Two original inheritance tax returns;
2. The original inventory;
3. A check in the amount of $4,143.81 paying the tax shown to be due; and
4. A check in the amount of $25.00 to pay the filing fee for these documents.
Please file this return accordingly and return a paid receipt to me in the enclosed, stamped, pre-
addressed envelope.
If you have any questions or require anything further, please contact me directly.
Very truly yours,
Michael L Bangs
wsc
Enclosures
cc: Mrs. Justina A. Fye
Estate of:
also known as
EVELYN D. PUNDT
,Deceased
INVENTORY
No.: ~l- t)q- 10(Og
Date of Death: MAY 23, 2004
Social Security No.: 073-10-0818
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of
the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the
valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that
Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the
end of this inventory. I/We verify that the statements made in this Inventory are true and co~c~ I/We understand that false
statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating t~sw~n falsification to authorities.
/ /
I.D. No.: 29101 Dated:
Address: 305 NORTH FRONT STREET
Telephone:
HARRISBURG, PA 17101
(717) 237-7100
Description Value:
1. Alliant Energy Stock: 555 shares (Cusip #: 018802108) $ 13,422.68
2. Carolina $5 Pfd Stock: 200 shares (Cusip #: 144141306) $ 15,300.00
3. Energy East Stock: 2000 shares (Cusip #: 29266M109) $ 44,990.00
4. FPL Group stock: 1000 shares (Cusip #: 302571104) $ 61,825.00
5. Home Properties stock: 1850 shares (Cusip #: 437306103) $ 69,976.25
6. MGE Energy stock: 1125 shares (Cusip #: 55277P104) $ 33,198.75
7. Progress Enerl~y stock: 2492 shares (Cusip #: 763263105) $ t02,894.68
8. Excel Energy stock: 186 shares (Cusip #: 87389B 100) $ 3,000.18
9. A.G. Edwards & Sons, Inc., Centennial Money Market
Account No.: 370-324611. Date Created: $ 9,620.00
10. Miscellaneous Personal Property $ 300.00
Total $ 354~527.54
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal
representative, include the value of each item, but such figures should not be extended into the total of the inventory.
303140.1
429 SOUTH 18TM STREET
CAMP HILL, PA 17011
E-mail: mikebanes(~verizon.net
BAN6S OFFIC
PHONE: 717-730-7310
FAX: 717-730-7374
MICHAEL L. BANGS, Attorney-at-Law
WENDY S. CHESBRO, Paralegal
July 21, 2004
WILLIAM E. MILLER, JR.
Of Counsel
Glenda Famer Strasbaugh, Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
RE: Estate of Mary M. Urich
File No. 21-03-0870
Dear Mrs. Strasbaugh:
Enclosed for filing as a part of the above-referenced estate you will find the following:
1. Two original inheritance tax returns;
2. The original inventory;
3. A check in the mount of $4,143.81 paying the tax shown to be due; and
4. A check in the amount of $25.00 to pay the filing fee for these documents.
Please file this return accordingly and return a paid receipt to me in the enclosed, stamped, pre-
addressed envelope.
If you have any questions or require anything further, please contact me directly.
Very truly yours,
wsc
Enclosures
cc: Mrs. Justina A. Fye
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280S01
HARRISBURG, PA 17128-O601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX(11-96)
NO. CD 004189
BANGS MICHAEL L
302 S. 18TH STREET
CAMP HILL, PA 17011
........ fold
ESTATE INFORMATION: SSN: 234-42-9386
FILE NUMBER: 2103-0870
DECEDENT NAME: URICH MARY M
DATE OF PAYMENT: 07/22/2004
POSTMARK DATE: 07/21/2004
;OUNTY: CUMBERLAND
DATE OF DEATH: 10/09/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $4,143.81
TOTAL AMOUNT PAID:
$4,143.81
REMARKS:
SEAL
CHECK# 95
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
Register of Wills of
CUMBERLAND
INVENTORY
County, Pennsylvania
Estate of Mary M. Urich
also known as
No. 21-03-0870
Date of Death 10/09/2003
, Deceased Social Security No. 234-42- 9386
Justina A. Fye,
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation
placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned
no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this
Inventory. I/We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein
are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Name of
Attorney:
Michael L. Banss
I.D. No.: 41263 Signature:
Address: 429 Soul:h 18th Street Address:
Camp Hill, PA 17011
Telephone: 717/730- 7310
Personal Representative
Signature: ~ j ~-~ ,~, ~,~ ~_,. ~,
~u-s~-na A. Fye
14 Hummel Avenue
Camp Hill, PA 17011
Telephone: 717/761-0306
Dated:
Description
(See continuation page(s) attached)
(Attach additional sheets if necessary)
::~
(33
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the totaJ of the Inventory.
Prepared by the Pennsylvania Bar Association
Copyrlg ht (c) 1996 form software only CPSystems, Inc. Form #RW-? (1992)
Total: 93,827.23
429 SOUTH 18TH STREET
CAMP HILL~ PA 17011
E-mail: mikeban~verizon.net
BAN(iS LAg/OFFICE
PHONE: 717-730-7310
FAX: 717-730-7374
MICHAEL L. BANGS, Attorney-at-Law
WEN-DY S. CHESBRO, Paralegal
July 21, 2004
WILLIAM E. MILLER, JR.
Of Counsel
Glenda Famer Strasbaugh, Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
RE: Estate of Mary M. Urich
File No. 21-03-0870
Dear Mrs. Strasbaugh:
Enclosed for filing as a part of the above-referenced estate you will find the following:
1. Two original inheritance tax returns;
2. The original inventory;
3. A check in the amount of $4,143.81 paying the tax shown to be due; and
4. A check in the amount of $25.00 to pay the filing fee for these documents.
Please file this return accordingly and remm a paid receipt to me in the enclosed, stamped, pre-
addressed envelope.
If you have any questions or require anything further, please contact me directly.
Very truly yours,
wsc
Enclosures
cc: Mrs. Justina A. Fye
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128~0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX(11 96)
NO. CD 004189
BANGS MICHAEL L
302 S. 18TH STREET
CAMP HILL, PA 17011
........ fold
ESTATE INFORMATION: SSN: 234-42-9386
FILE NUMBER: 2103-0870
DECEDENT NAME: URICH MARY M
DATE OF PAYMENT: 07/22/2004
POSTMARK DATE: 07/21/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 10/09/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $4,143.81
TOTAL AMOUNT PAID:
$4,143.81
REMARKS:
SEAL
CHECK# 95
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
Register of Wills of
CUMBERLAND
INVENTORY
County, Pennsylvania
Estateof Mary M. Urich
also known as
No. 21-03-0870
Date of Death 10/09/2003
, Deceased Social Security No. 234-42- 9386
Justina A. Fye,
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation
placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned
no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this
Inventory. I/We verify that the statements made in this Inventory are true and correct. I/VVe understand that false statements herein
are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unswom falsification to authorities.
Name of
Attorney:
Michael L. Ban~s
I.D. No.: 41263
Address: 429 South 18th Street
Camp Hill, PA 17011
Telephone: 717/730-7310
Personal Representative
6~u~st:fna A. Fye
Signature:
Address: 14 Hummel Avenue
Camp Hill, PA 17011
Telephone: 717/761-0306
Dated:
Description
(See continuation page(s) attached)
(Attach additional sheets if necessary)
Total: 93,827.23
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
Prepared by the Pennsylvania Bar Association
Copyrlg ht (c) 1996 form software only CPSystems, Inc. Form #RW-? (1992)
Estate of:
Date of Death:
County:
Mary M. Urich
10/09/2003
Cumberland
INVENTORY
CASH:
AARP Life Insurance - Life
Insurance
M & T Bank - Certificate of
Deposit 31003908145913
M & T Bank - Certificate of
Deposit 31003910084266
M & T Bank - Certificate of
Deposit #31003910084307
M & T Bank - Certificate of
Deposit 31003910392297
M & T Bank - Certificate of
Deposit #31003910174174
5,125.71
2,719.51
1,247.04
1,247.04
1,227.67
3,260.26
REAL ESTATE/PA:
14 Hummel Avenue, Camp Hill,
PA - (See appraisal
attached)
79,000.00
TOTAL RECEIPTS OF PRINCIPAL ...............
14,827.23
79,000.00
93,827.23
-1o
Recorded. Offi::~ of
Regis, t,~r o~ ~t~s
'04 JUL 22 P12:48
U.S. POSTRGE
j~ PflI~
RHOUNT CRHP HILL,PR
170
~v~c~ , 17013
0000
I.,llh,,llh,,,.,Ih,lhl.hl
First Class Mail
I!elN sselo tsJ!d
TO:
BANGS LAW OFFICE
429 South 18th Street
Camp Hill, PA 17011
Glenda Faxner Strasbaugh, Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
429 SOUTH 18TM STREET
CAMP HILL, PA 17011
E-mail: mikebangn~verizon.net
PHONE: 717-730-7310
FAX: 717-730-7374
MICHAEL L. BANGS, Attorney-at-Law
WENDY S. CHESBRO, Paralegai
January 6, 2005
WILLIAM E. MILLER, JR.
Of Counsel
Glenda Famer Strasbaugh, Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
RE: Estate of Mary M. Urich
File No. 21-03-0870
Dear Mrs. Strasbaugh:
Enclosed for filing as a part of the above-referenced estate please find the following:
1. The original and one copy of a Supplemental Inheritance Tax Return;
2. A supplemental Inventory;
3. A check in the amount of $379.32 to pay the tax shown to be due; and
4. A check in the amount of $30 to pay the filing fee for these documents.
Please file the return and inventory accordingly and return a paid receipt to me in the enclosed,
stamped, pre-addressed envelope.
Thank you.
wsc
Enclosures
cc: Mrs. Justina A. Fye
i Very truly yours,
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 0O4819
BANGS MICHAEL L
429 S. 18TH STREET
CAMP HILL, PA 17011
........ fold
ESTATE INFORMATION: SSN: 234-42-9386
FILE NUMBER: 2103-0870
DECEDENT NAME: URICH MARY M
DATE OF PAYMENT: 01/10/2005
POSTMARK DATE: 01/07/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 10/09/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $379.32
REMARKS:
TOTAL AMOUNT PAID:
$379.32
SEAL
CHECK# 1 O0
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
REV- 1500 EX + (6-00)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Urich Mary M.
DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR)
10/09/2003 I 03/28/1928
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
1. OriginaIReturn xL~ 2. SupplementaIReturn
4. Limited Estate F~4a' Future lnterest Compromise (date of death after 12-1Z-87)
6. Decedent Died Testate 7. Decedent Maintained a Living Trust
(Attach copy of Will) (Attach copy of Trust)
~-~9. Litigation Proceeds Received [~ Spousal Poverty Credit
10.
(date of death between 1Z-31-91 and 1-1-95)
cAPB
HpRL
EpIO
CRAC
KOTK
ES
cg
NAME
Michael L. Ban~s
FI RM NAM E (If Applicable)
TELEPHONE NUMBER
717/730-7310
R 5.
E
C
A 6.
P
I
T
U 7.
L
A
T 8.
I
O 9.
N 10.
11.
12.
13.
14.
C
O
M
T
I
O
N
Real Estate (Schedule A) (1)
Stocks and Bonds (Schedule B) (2)
Closely Held Corporation, Partnership or (3)
Sole-Proprietorship
Mortgages & Notes Receivable (Schedule D) (4)
Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
Jointly Owned Property (Schedule F) (6)
[~] Separate Billing Requested
Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
Total Gross Assets (total Lines 1-7)
Funeral Expenses 8, Administrative Costs (Schedule H) (9)
Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
Total Deductions (total Lines 9 & 10)
Net Value of Estate (Line 8 minus Line 11)
OFFICIAL USE ONLY
FILE NUMBER
21-03-0870
COUNTYCODE YEAR NUMBER
SOCIAL SECURITY NUMBER
234-42- 9386
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
(date of death
3. Remainder Return priorto 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)
COMPLETE MAILING ADDRESS
429 South 18th Streete
Camp Hill, PA 17011
None
None
None
None
9,740.02
None
None
None
1,310.59
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
Net Value Subject to Tax (Line 12 minus Line 13)
OFFICI~a~3USE ONLY
(6) 9,740.02
(11)
(12)
(13)
(14)
1,310.59
8,429.43
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(a)(1.2) X .0 0 (15)
16. Amount of Line 14 taxable at lineal rate 8,429.43 X .0 45 (16)
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)
8,429.43
0.00
379.32
0.00
0.00
379.32
Copyright (c) 2000 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
14 Hummel Avenue
CITY STATE ZIP
Camp Hill ;PA 17011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19) (1)
2. Credits/Payments
A. Spousal Poverty Credit
El. Prior Payments
C. Discount
379.32
Total Credits ( A + B + C ) (2)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
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.
Check box on Page 1 Line 20 to request a refund (4) O. 00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 379.32
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (SB)
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
;. retain the use or income of the property transferred; .........................
· 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? ................................ F--']
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.
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 OF PERSON RESPONSIBLE FOR FILING RETURN Justina A. Fye DATE
,/7 -a~, /9'7 / 14 [-lummel Avenue ~//
[f. .........................
ATURE OF PREPARER ~THER TH ESENTATIVE ·
~ ;~ ~ J . ,9 ~
~o; da~es ;f d;at~ ;~ or a~er J a~d befor'e ];nua~ 1, 1995, the tax rate' i~posed on the net' val'ue of ~r;nsfers to ;; ~0[ t~e ~;e 'of' ~; ......
surviving spouse is 3% [72 P.S. 9r1~ (a) (1.1)(0].
For dates of death on or a~er Janua? 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
[72 P.S. 911~ (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the ~tatuto? requirements for disclosure of assets
and filing a tax return are still applicable even if the surviving spouse is the only beneficial.
For dates of death on or a~er July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twen?-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a stepparent of th~ child is 0% [72 P.S. 911; (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent% lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116(1.2)
[72 P.S. 91
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 911;(a)(1.3)]. A sibling is defined, under
Section 910~, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Copyright (c) ~000 form software only The L~ckner ~roup, Inc. Form REV-1500 EX (Rev. 6-00)
REV-1508 EX + (1-97)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Mary M. Urich SS~/ 234-42-9386 10/09/2003 21-03-0870
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on Schedule F,
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 9,740.02
Proceeds from Wrongful Death/Survival Action
Proceeds from Farmland Insurance totaled $223,000.00
less proportionate share of attorney's fee of 25%
($54,972.00), costs to be reimbursed ($3,111.39), and
Medicare Lien ($67,516.37) leaving a balance for
distribution of $97,400.24. Allocated such that
90% shall go to wrongful death action and 10% shall
go to survival action. Approved by The Honorable
John R. Walker, Judge of the Court of Common Pleas of
Franklin County, Pennsylvania, by Order dated
December 28, 2004 (see copy attached).
TOTAL (Also enter on line 5, Recapitulation)
$ 9,740.02
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV- 1508 EX (Rev. 1-97)
MICHAEL L. BANGS, ESQUIRE
I.D. NO. 41263
429 SOUTH 18TM STREET
CAMP HILL, PA 17011
(717) 730-7310
JUSTINA A. FYE, Executrix of
the Estate of Mary M. Urich,
Plaintiff
VS.
RONNIE L. HARTMAN and
MICHAEL WINGERT,
Defendants
ATTORNEY FOR PLAINTIFF
IN THE COURT OF
OF FRANKLIN CO~
PENNSYLVANIA
NO. 2004-1121
CIVIL ACTION - LAW
JUDGE: JOHN R. WALKER
ORDER
AND NOW this ~g' day of r;~f~h ./
,200_~_, after hearing, the
Petition for Compromise or Settlement of Survival Action is GRANTED with disbursements to
be made in accordance with the following:
Total Proceeds:
$223,000.00
Costs to be reimbursed:
Recordex (copies of Hershey Medical Center records)
Franklin County Prothonotary
Franklin County Sheriff
Postmaster
Bunin Associates (economic evaluation)
KLP Investigative
KLP Investigative
($83.74)
($80.50)
($53.48)
($2.67)
($950.00)
($441.00)
($1,500.00)
Counsel fees - 25% to Michael L. Bangs, Esquire
($54,972.00)
Medicare Lien
($67,516.37)
Total available for distribution:
$97,400.24
Atgest: A TRUE COPy
LII~A L. BEARD, PI~OTNONOTARy
Further, the allocation of the settlement proceeds shall be such that ninety (90%) percent shall be
attributable to the wrongful death action and ten (10%) percent shall be attributable to the
survival action.
BY THE COURT,
)C~I-I~ R. W~L~LER, J.
REV- 1512 EX + {1-9'/)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mary M. Urich
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, AND LIENS
FILE NUMBER
SS~ 234-42-9386 10/09/2003 21-03-0870
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION AMOUNT
Lower Allen Township 2004 County and Township Taxes
Lower Allen Township 2004 School Real Estate Tax
TOTAL (Also enter on line 10, Recapitulation)
403.00
907.59
1,310.59
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV- 1512 EX (Rev. 1-97)
REV-1513 EX + (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mary M. Urich SS# 234-42-9386
SCHEDULE J
BENEFICIARIES
10/09/2003
FILENUMBER
21-03-0870
NUMBER
I1.
NAME AND ADDRESS Of PERSON(S) RECEIVING PROPERTY
TAXABLE O ISTRIBUTIONS [include outright spousal distributions, and
transfers under Sec. 9116(a)(1.Z)]
Justina A. Fye
14 Hummel Avenue
Camp Hill, PA 17011
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Daughter
AMOUNT OR SHARE
OF ESTATE
Ent ire
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET
0.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) ZOO0 form software only The Lackner Group, Inc. Form REV-1513 EX (Rev. 9-00)
I, MARY M. URIC ! l, of Lower Allen Township, Cumberland County, Pennsylvania,
declare this to be my last wi I1 and revoke any will previously made by me.
ITEM I. I direct thai all my just debts and funeral expenses, including my gravemarker
and all expenses of my last illness, and any and all taxes and assessments imposed by any
governmental body as a resu It of my death, whether on property passing under this will or
otherwise, shall be paid from my residuary estate as soon as practicable after my decease as a
part of the expense of the administration of my estate.
ITEM II. I give and bequeath all of my household goods, automobiles, jewelry, and all
other articles o f household and personal use, equipment and ornament, together with all
insurance thereon and relati~g thereto, to my daughter, JUSTINA A. FYE, of Etters,
?ennsylwinia, provided she survives my death by thirty (30) days. Should my said daughter
predecease me or be deceased on the thirty-first day after my death, I give and bequeath all such
items and insurance thereon to those of my issue, per stirpes, as survive my death by thirty (30)
days.
ITEM III. I give, devise, and bequeath all the rest, residue, and remainder of my
possessions and estate of every nature and wherever situate to my daughter, JUSTINA A. FYE,
of Etters, Pennsylvania, provided she survives my death by thirty (30) days. Should my said
wife predecease me or be deceased on the thirty-first day after my death, I give, devise, and
bequeath all the rest, residue, and remainder of my possessions and estate of every nature and
wherever situate to those of my issue, per stirpes, as survive my death by thirty (30) days.
ITEM IV. All of the interests of the beneficiaries hereunder shall not be subject to
anticipation or to voluntary or involuntary alienation nor shall they be subject to any execution or
attachment.
ITEM V. I appoint my daughter, JUSTINA A. FYE, executrix of this my last will.
ITEM VI. In addition to the other powers and authorities granted to my personal
representatives by Pennsylvania law and by the other terms and provisions of this will, I hereby
give to my personal representatives the following powers and authorities effective without court
approval and until actual distribution of all property: to compromise any claim or controversy;
to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as
my personal representatives may determine and at valuations finally to be fixed by them; to
invest in all forms of property, including any stock or other securities in any corporate fiduciary
or its successor without restriction to investments authorized for Pennsylvania fiduciaries, as my
personal representatives deem proper, without regard to any principle of risk or diversification;
to retain any or all assets of my estate, real or personal, without regard to any principle of risk or
diversification; to sell at public or private sale, to exchange, or to lease for any period of time,
any real or personal property and to give options for sales, exchanges, or leases, for such prices
and upon such terms or conditions as my personal representatives deem proper; and to allocate
receipts and expenses to principal or income or partly to each as my personal representatives
deem proper in their sole discretion.
ITEM VII. I direct that my personal representatives and fiduciaries shall not be required
to give bond for the faithful performance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand this
,2ooo.
day of
The preceding instrument, consisting of this and THREE other typewritten pages, each
identified by the signature of the testatrix was on the date thereof signed, published, and declared
by MARY M. URICH, the testatrix therein named, as and for her last will, in the presence of us,
who at her request, in her presence, and in the presence of each other, have subscribed our names
as witnesses hereto.
4
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
)
(SS:
)
The undersigned, being the testatrix whose name is signed to the attached or foregoing
instrument, having been duly qualified according to law, does hereby acknowledge that I signed and
executed the foregoing instrument as my last will, that I signed it willingly; and that I signed it as my free
and voluntary act for the purposes therein expressed.
M~A YM. IJRICH' })~
Sworn or affirmed to and acknowledged
before me by the tez~trixnamed above
this(t']~ day o~'~)/13"~.~.1.~-' , 2000.
Notv..~' Pt; ;~. ~" i
COMSZlDN WEALTH OF PENNSYLVANIA
)
(SS:
)
Sworn or affir ned to and
itowledge~ ~ef0re.me this
ay of/ (~ ~/~[/, 2000.
l,qotary Public :l
I . /
COUNTY OF CUMBERLAND
WE, ~.,~/~ ~tOr--65. and ~['l'~, '~. ~x~-"F~ , the witnesses whose
names are signed to the attached or foregoing instrument, being duly qualified according to law, do
depose and say that we were present and saw the testatrix sign and execute the instrument as her last will;
that she signed it willingly and that she executed it as her free and voluntary act for the purposes 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 18 or more years of age, of sound mind, and
under no constraint or undue influence.
Register of Wills of
CUMBERLAND
INVENTORY
County, Pennsylvania
Estate of Mary M.
also known as
Urich No. 21-03-0870
, Deceased
Date of Death 10/09/2003
Social Securib/No. 234-42- 9386
Justina A. Fye,
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation
placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned
no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this
Inventory. I AVe verify that the statements made in this Inventory are true and correct, lAVe understand that false statements herein
are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Personal Representative
Name of _.~
Attorney: Michael L. Banss Signature:
~ustina A. Fye
I.D. No.: 41263 Signature:
Address: 429 South 18th Street
Address: 14 Hummel Avenue
Camp Hill, PA 17011 Camp Hill, PA 17011
Telephone: 717/730- 7310 Telephone: 717/761-0306
Dated:
Description Value
(See continuation page(s) attached)
(Attach additional sheets if necessary) Total: 9,740.02
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, Inc. Form #RW-7 (1992)
Estate of:
Date of Death:
County:
Mary M. Urich
10/09/2003
Cumberland
INVENTORY
CASH:
Proceeds from Wrongful
Death/Survival Action
9,740.02
TOTAL RECEIPTS OF PRINCIPAL ...............
9,740.02
9,740.02
-1-
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BANas LAW OFFICE.
429 SOUTH 18TH STREET
CAMP HILL, PA 17011
E-mail: mikebangslQlverizon.net
PHONE: 717-730-7310
FAX: 717-730-7374
MICHAEL L. BANGS, Attorney-at-Law
WENDY S. CHESBRO, Paralegal
WILLIAM E. MILLER, JR.
Of Counsel
April 27, 2005
Glenda Farner Strasbaugh, Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, P A 17013
C')
!',"
RE: Estate of Mary M Urich
File No, 21-03-0870
Dear Mrs. Strasbaugh:
Enclosed please find a copy of a Notice of Inheritance Tax Appraisement together with a check in
the amount of $59,92 to pay the balance shown to be due, Kindly return a paid receipt to me in the
enclosed, stamped, pre-addressed envelope.
Thank you,
re.1 truly yours,
V \A/~
Michael L. Bangs
wsc
Enclosures
cc: Mrs. Justina A. Fye
BUREA~NDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX ZB0601
HARRISBURG PA 171ZB-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCEO.RDISALLD\ilANCE
OF DEDUCTIONS AND ASSESSi1ENT OF T.AX
'*
REV-1547 EX AFP (03-05)
MICHAEL L BANGS
429 S 18TH ST
CAMP HILL PA 17011
DATE 04-18-2005
"iSTAT~OF :U~iCH
DATE OF DEATH 10-09-2003
FILE NUMBER 21 03- 0870
COUNTY CUMBERLAND
'ACN 501
Anount Renitted
MARY
M
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
~!I)"-~I:,."tf.wj!.m~'ll!,.w"fret.W.!MftA'i"I'~M:"t."'''l.AmAW!~~.'X'J:~W~M:''t.~?r'''.'''....... ...
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF URICH MARY M FILE NO. 21 03-0870 ACN 501 DATE 04-18-2005
TAX RETURN WAS: ) ACCEPTED AS FILED I X) CHANGEO SEE ATTACHED NOTICE
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISE~ VALUE OF RETURN BASED ON: LITIGATION RETURN
1. Reel Estate ISchedule A) II)
2. Stocks end Bonds ISchedule B) (2)
3. Closely Held Stock/Partnership Interest ISchedule C) (3)
4. Hortgeges/Notes Receiveble ISchedule D) (4)
5. Cash/Benk Deposits/Hisc. Personel Property ISchedule E) (5)
6. Jointly Owned Property ISchedule F) (6)
7. Trensfers ISchedule G) (7)
8. Totel Assets
.00
.00
.00
.00
9.740.02
.00
.00
NOTE: To insure proper
credit to your accountz
subnit the upper portion
of this forn with your
tax peynent.
(8)
9,740.02
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adn. Costs/Hisc. Expenses ISchedule H) (9)
10. Debts/Hortgaga Liabilities/Liens ISchedule I) lID)
11. Total Daductions
12. Net Value of Tax Return
13. Charitable/Governnental Baquests; Non-elected 9113 Trusts ISchedule J)
14. Net Value of Estate Subject to Tax
.00
.00
Ill)
112)
113)
114)
00
9,740.02
.00
9,740.02
NOTE: If an assessment was issued previously, lines
reflect figures that include the total of ~
ASSESSMENT OF TAX:
15. Anount of Line 14 at Spousal rete (15)
16. Anount of Line 14 taxable at Lineel/Cless A rete (16)
17. Anount of Line 14 at Sibling rate (17)
18. Anount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tex Oue
14, 15 and~or 16, 17, 18 and 19 will
returns assessed to date.
.00 X 00 =
9,740.02 X 045 =
.00x 12 =
.00 X 15 =
119)=
.00
438.30
.00
.00
438.30
TAX CREDITS:
n.. noO" I .. I~J AHOUNT PAID
DATE NUHBER INTEREST/PEN PAID 1-)
01-07-2005 CD004819 .00 379.32
INTEREST IS CHARGED THROUGH 05-03-2005 TOTAL TAX CREDIT 379.32
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 58.98
REVERSE SIDE OF THIS FORM INTEREST AND PEN. .94
TOTAL DUE 59.92
· IF PAlO AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
I IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL OUE IS REFLECTED AS A "CREOIT" ICR), YOU HAY 8E OUE
A REFUNO. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-961
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
BANGS MICHAEL l
429 S. 18TH STREET
CAMP Hill, PA 17011
_nnn_ fold
ESTATE INFORMATION: SSN: 234-42-9386
FILE NUMBER: 2103-0870
DECEDENT NAME: URICH MARY M
DATE OF PAYMENT: 04/28/2005
POSTMARK DATE: 04/27/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 10/09/2003
NO. CD 005261
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
501 I $59.92
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$59.92
REMARKS:
CHECK# 03
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WillS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
IIOTICE OF INHERITANCE TAll
BUREAU'OF DIIIVlDUAL TAllES""-r,>c ,,_ APPRAISEIIENT, ALLOWANCE OR DISALLOWANCE
INHERITAIICE TAX DIVISII" if: ,r pl".n (jn::!/"" ---IONS AND ASSESSllEllT OF TAll
PO.IOX 280601"-- .-, '.J",j \.J1 ; jt.~ l~1
tW8ItSlLIIG PA 17121-1)601
*'
REV-lS47' EX AFP (03-05)
"Jrt,,-
(.V;,;.
2Q Cit" J? 03
- J I;; if';'" \.J
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
04-18-2005
URICH
10-09-2003
21 03-0870
CUMBERLAND
501
_t _ittlOd
MARY
M
MICHAEL L BAN~~Q",
429 S 18TH ST'.'
CAMP HILL PA 17011
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ...
#I!f!."1!oC"Yf.m.m':.'lI'I'.'lMftl!I.!II!'.!Ml'tIrrlM!r.m.1MlmM!lft'~.'Xt[__.Mt.............. ...
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF URICH MARY M FILE NO, 21 03-0870 ACN 501 DATE 84-18-2005
I
TAll RETURN liAS: I I ACCEPTED AS FILED I XI C_ED SEE ATTACHED NOTICE
i
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: LITIGATION RETURN
1. R_l Est.t. I_I. Al III
2. Stocks _ lands I_I. BI 121
3. Clo..ly Mold Stock/Partnsrship Int.rost ISchodul. CI 131
'I. Nor~s/Not.s _.ivabl. lSc:jwdul.DI I'll
5. Cssh/IIsnk _slts/Nlsc. POIr_l Pr_rty I_I. EI ISI
6. .Jointly _ P~rty I_I. FI 161
7. Trsnsfars I_I. III 171
8. Totel A.sat.
.00
.00
.00
.00
9.740.02
.00
.00
181
NOTE: T~ Insure proper
credit ~o your ~ount,
_It... _r portion
of this !fo,.. with your
Uk .........t.
9,740.02
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funarti ~..s/_. Costs/Nbc. Expan..s IS_I. NI 191
11. Dabts/Nortgaga Liabil1tl.s/Llans I_I. II 1111
11. Tot.l o.dUctlons
12. Mat V.l... of T... R.tum
13. ChSIrltabls/lIovamsant.l "_sto; Non-.lactlld 9113 Trusts I_I. JI
1'1. Mat V.l... of but.5<Djact to T_
.00
.00
1111
1121
113)
II'll
nn
9,740.02
.00
,9,740.02
I. an ........nt was i.sued previou.ly, line. 14, 15 and'or 16, 17, 18 Ind 19 will
r"lllC't .igure. that inclUde the total ~ AlJ. raturns as....ed to chrte, i
ASSESSMENT OF TAX:
15. _t of Une 1'1 .t Spouss1 rot. 115)
16. Aaount of Llna 1'1 t__la .t Llnsal/Cl.ss A r.t. 1161
17. AllDUl'lt of Une 1'1 .t SI1>11ng rot. lln
18. Aaount of Lina 1'1 t__l. .t Co11.t.r.l/C1.ss Brat. (18)
19. Principal Tal< IIua
MOTE:
.00 X
9,740.02 X
.00 X
.00 X
00 =
045 =
12 =
15 =
1191=
.00
438.30
.00
.00
438.30
DATE
01-07-2005
_ER
CD004819
INTEREST/PEN PAID 1-)
.00
AIIOUNT PAID
379.32
'S
INTEREST IS CHARGED THROUGH 05~03-2005
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
379.32
58.98
.94
59.92
. IF PAID AFTER DATE DIIICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
I IF TOTAL IIIIE IS LESS THAN fl, NO PAYMENT IS REflUIRED.
IF TOTAL IlUE IS REFLECTED AS A nCREDlT" ICRI, YOU NAY BE IlUE
A REFlIlD. SEE REVERSE SIDE OF THIS FORM FOR D1STIlIICTIONS. I
,\'
REV-141OEX{&U)
, *' INHERITANCE TAX
EXPLANATION
' COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDMDUAL TAXES
POBox 280601
HAR...sBURG PA 17128-0601
DECEDENrS NAME Mary M UrictJ FILE NUMBER .
2103-0870
REVIEWED BY ACN
Sandra J Eslinger . 101
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES .
I 1-2 Reduced to $0. Real estate taxes are not allowable deductions for tile yearlll after
decedent's date of deatll.
ROW
Page 1
BUREAU OF INDIVIDUAL UlIE$
INtERITANCE TAX DIVISION " ",--'\
PO BOX 280601
HARRISBURG PA 17128-0661
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
I:NHERI:TANCE TAX
STATEMENT OF ACCOUNT
*
REV-16D7 EX AFP (05-05)
i3
Ih
'iO
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
05-31-2005
URICH
10-09-2003
21 03-0870
CUMBERLAND
501
AlIOUIlt R_i ttllCl
MARY
M
MICHAEL L ,,~~':it\S
429 S 18THL:SIt
CAMP HILL PA
17011
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
NOTE: To insu.... proper credit to your account, s,"*,_lt the upper portion of this fora with your tax paYlUnt.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
.......................................~.......................................................................1
REV-1607 EX AFP (03-05) *** INHERITANCE TAX STATEMENT OF ACCOUNT KKK
ESTATE OF URICH MARY M FILE NO.21 03-0870 ACN 501 DATE 05-31-2005
THI$ STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAIlED ESTATE. SHOWN BELOll
IS A SUNKARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT DR RECORD ADJUSTMENT: 04-18-2005
PRINCIPAL TAX DUE: 438.30
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
01-07-2005 CD004819 .00 379.32
04-27-2005 CD005261 .89- 59.92
TOTAL TAX CREDIT 438.35
BALANCE OF TAX DUE .05CR
INTEREST AND PEN. .00
IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .05CR
.
SIDE FOR CALCULATION DF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDI~' (CR),
vnll W.I. v RF nul;' A. REFUND. SEE REVERSE SIDE Of THIS FORM fOR INSTRUCTIONS. )
"",'l.
q..
CUmberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (71 7 ) 240 - 6345
Date: 9/15/2005
BANGS MICHAEL L
429 S 18TH STREET
CAMP HILL, PA 17011
RE: Estate of URICH MARy M
File NUmber: 2003-00870
Dear Sir/Madam,
I
I
It has come to my attention that you have not filed th~ Status
Report by Personal Representative (Rule 6.12) in the above iaptioned
estate. ~
As per the AMENDMENTS TO SuPREME COURT ORPHANS' COURT ULES, NO.
103 SUPREME COURT RULES DOCKET NO.1, for decedents dYing On or after
July 1, 1992, the personal representative or his counsel, wi~hin two
(2) years of the decedent's death, shall file with the Regis~er of
Wills a Status Report of completed or uncompleted administra~ion.
This filing is due by: 10/09/2005
Your prompt attention to this matter will be appreciate~.
,
Thank You.
Sincerely,
~ r ," ,_,
' ...: #,. I
.'. ./ L~l;:;U'U~'.. .
. /
v
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Personal Representative(s)
JUdge
\.-\:r-
U t -
c).
C_L~ ~
t.L..
c.) ,
MARY M. URICH
10/9/2003
Estate
with
Date:
("'.1
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{'~,
21-03-0870
~_,~..>>..~..,",~""....."....-_~~,^",____"",._,.,__""",__^.~..w__~~__
to Rule 6.12 of Orphans' Court
to of the administration of the
est8te:
1
, ,
estate is
[X]
2,
personal representative reasonably
within the next 3-6 months.
3 > If the ans\\tcr to N-o. 1 is
state
a. Did the
o No
aCCO:L"lt w1th
a
b,
the
account is:
L Did
lD
10 the
state an account
c,
of receipts, releases, joinders
accounts may be filed the
attache-d to this
/7
~/VL.'z~ !///j
Si gnature . /1
MICHAEL L. BAf1GS
Name
429 SOUTH 18TH STREET
CAMP HILL, PA 17011
I.
(717) 730-7310
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
~-r",~.r'-v'n 1",'[1',[ r,c, NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAKES_,;,; ,-, I,'; ", i,APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX
PO BOX 280601
HARRISBURG PA 17128-0601
REV-1547 EX AFP (06-05)
10-03-2005
URICH
10-09-2003
21 03-0870
CUMBERLAND
, '502
APPEAL DATE: 12-02-2005
( See reverse side under Objections)
Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
9~!_~~9~9_!~~~_~~~~______~___~~!~!~_~g~~~_~g~!!g~_~g~_ygy~_~~~g~~~__~____________________
REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
MARY M FILE NO. 21 03-0870 ACN 502
_. j
i
D"
I; j
1: ! 9
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
MARY
M
MICHAEL L BANGS
429 S 18TH ST
CAMP HILL
PA 170ll
ESTATE OF
URICH
DATE 10-03-2005
TAX RETURN WAS: (X) ACCEPTED AS FILED
CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: LITIGATION RETURN
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Stock/Partnership Interest (Schedule C) (3)
4. Mortgages/Notes Receivable (Schedule D) (4)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5)
6. Jointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
.00
.00
.00
.00
9.366.10
.00
.00
(8)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
9,366.10
(9)
(10)
415.00
.00
(11)
(12)
(13)
(14)
415 00
8,951.10
.00
8,951.10
NOTE:
If an assessment was issued previously, lines
reflect figures that include the total of ALL
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate
16. Amount of Line 14 taxable at Lineal/Class A rate
17. Amount of Line 14 at Sibling rate
18. Amount of Line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS:
14, 15 and/or 16, 17, 18 and 19 will
returns assessed to date.
.10 X 00 =
8,951.00 X 045=
.00 X 12 =
.00 X 15 =
(19)=
.00
402.80
.00
.00
402.80
(15)
(16)
(17J
(18)
PAYMENT ,,"'.."'.... (+J AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
07-06-2005 CD005533 .00 402.80
TOTAL TAX CREDIT 402.80
BALANCE OF TAX DUE .00
INTEREST AND PEN. .94
TOTAL DUE .94
· IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
Gr
BAN6S LAW OFFICE
429 SOUTH 18TH STREET
CAMP HILL, PA 17011
E-mail: mikebangslO>.verizon.net
PHONE: 717-730-7310
FAX: 717-730-7374
MICHAEL L. BANGS, Attorney-at-Law
WENDY S. CHESBRO, Paralegal
WILLIAM E. MILLER, JR.
Of Counsel
October 31, 2005
Glenda Farner Strasbaugh, Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, P A 17013
RE: Estate of Mary M Urich
File No. 21-03-0870
Dear Mrs. Strasbaugh:
Enclosed please find a Status Report Form for filing as a part of the above-referenced estate.
We anticipate concluding the administration of the estate by the end of November, 2005, but I am
filing this Status Report form at this time for your information.
Please let me know if you require anything further.
V\jC:~S'
Michael L. Bangs
wsc
Enclosure
cc: Mrs. Justina A. Fye
In the Court of Common Pleas of
Franklin
County, Pennsylvania
IN RE:
ORPHANS' COURT DIVISION
Estate of
Mary M. Urich
NO. 21-03-0870
Status Report Under Rule 6.12
Name of Decedent: Mary M. Urich
Date of Death: 10/9/2003
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with
respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes No X
2. If the answer is No, state when the personal representative reasonably believes that the
administration will be complete. 11/30/2005
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes No X
b. The separate Orphans' Court No. (if any) for the personal representative's account is:
c. Did the personal representative state an account informally to the parties in interest:
Yes No X
d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may
be filed with the Clerk of Orphans' Court and may be attached to this report.
~~~_JZ ~
Signature
Name: Michael L. Bangs
Address: 429 South 18th Street
en
L__
C) (/-
bate: / ~2 II c?--
E . ~ ~ ~:_:=.; ;:~~
c:::
1.1"':)
c"::)
=
c-J
Camp Hill, PA 17011
Telephone: 717/730-7310
Capacity:
Personal Representative
X Counsel for Personal Representative
0~
REGISTER OF WILLS OF CUMBERLAND COUNTY
REPORT OF STATUS OF ADMINIST~1Jl<rJN{ 29 Pi1 I?: 54
(For Resident Decedents Dying after July 1, 1984)
ESTATE NO. 21- 03-0870
Name of Decedent:
Social Security No.:
MARYM. URICH
234-42-9386
Date of Death:
October 9, 2003
Name of Personal Representative: Justina A. Fye
Capacity
(check one)
Executors
Administrator
x
Administrator c.t.a.
Administrator d.b.n.
Is the administration of the estate complete? Yes_X_ No
If "Yes", how was the administration ended? (check one)
By court accounting
By account stated to parties in interest X
Did the parties release the
personal representatives? Yes
Other (explain)
Total amount paid to date to creditors and for funeral and $23,932.36
administrative expenses
Total value of distributions to date to beneficiaries $11,580.71
If administration is not complete, estimated value of assets $
still in administration
NOTE: This status report is due no later than the due date for filing of the Pennsylvania
inheritance tax return or, if no inheritance tax return is required, nine (9) months after the
date of death; if the administration of the estate has not been concluded, a summary report
shall be filed annually thereafter until the administration is complete.
I certify under penalty of perjury that the foregoing information is correct to the best of my
knowledge, information and belief.
Date:
II //f/t')~
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INRE:
) IN THE COURT OF COMMON PLEAS OF
) CUMBERLAND COUNTY,
) PENNSYLVANIA
)
) ORPHANS' COURT DIVISION
)
) NO. 21-03-0870
ESTATE OF
MARY M. URICH
Deceased
RECEIPT AND RELEASE
I, JUSTINA A. FYE, the undersigned, being a beneficiary under the Estate of MARY
M. URICH, deceased, do hereby:
1. State and acknowledge that I am an adult individual;
2. Waive the filing of an Account or Schedule of Distribution by the personal
representative of the Estate;
3. Acknowledge that I have received all sums to which I am entitled as a beneficiary of
the Estate of MARY M. URICH;
4. To the extent of said distribution, release Justina A. Fye, Executrix, of the Estate of
MARY M. URICH, and her heirs and personal representatives, from all liabilities, whether due
to her negligence or otherwise, which she may have by reason of her administration of the
Estate;
5. Agree to refund to the Estate and to the said Justina A. Fye, Executrix, any portion of
the distribution to which I am not properly entitled, and, to the extent of said distribution, to
~
~ndemt;lifY her and the Estate for claims made against her and to reimburse her and the Estate all
l.>J r ,"
; experises and costs incurred in connection with any such claim; and
u..;;. ,,',
C-'
N ,:=:6. Declare that this instrument shall be legally binding upon me, my personal
-"- ()
C':)
~preser1k~ives, and assigns.
c.,..J
c::':'1
c--l
IN WITNESS WHEREOF, I have hereunto set my hand and seal this I g day of
ru 0 1/.1
,2005.
()~ [L -i-i'
~TINA A. FYE ~
(SEAL)
COMMONWEALTH OF PENNSYLVANIA )
( SS:
COUNTY OF CUMBERLAND I )
On this, the JM day of k) uWn l1{lr ,2005, before me, the
undersigned officer, personally appeared JUSTINA A. FYE, known to me (or satisfactorily
proven) to be the person whose name is subscribed to the within instrument and acknowledged
that (s )he executed same for the purposes therein contained.
'.-1
IN WITNESS WHEREOF)~ h'1'eunto'set 'f'Y fin? an. 1 o~. lcial seal.
/ / j j, 4 ',~ L!(jytJ7o
/ tary Public ,/
~~-?;~~
NOTARiAL Si7,A1.. -,
I~._ N_DY ....~. CHESBRO.. Nf'. ,'J:PI t;....,Ml<> ~.
IoU"'" A11.,~ 7. ., . >~ r ,"l,;,;""" ~
. ~i .w'?,)., l~U1i1bt{:147'1~"'~ r.~'~f,J.u r\i
Mv"- ..',~ . ." ~ ",...c...'1 r.
,; vt.4"r;mtSs:cn t,'~O'<~t1~<.~ ,~.i1~;.,v 1'1 r'n~~~7 ~
n:~-~~_.~..,,~ .. ~- ~...,~#_~:: ,~;::~,~~:~:..;.;:_'._: '-';::Wf~~~,~~..~:'~~~,~qj