HomeMy WebLinkAbout04-0725Estate qf C_hloe E
a~o knowtl as
PETITION FOR PROBATE and GRANT OF LETTERS
Deceased.
SocialSecurio'No. 174 05 0739
The petitio~ of the andersigned respectfully represents that:
Yuur petitioner(s), who~are 18 years of age or older an the execul
in the last will of the above decedent, dated March 27
and codicil(s) dated
Register of Wills for the
County of C,jmbcw!cnd m the
Commonwealth of Pennsylvania
named
1998 _
{state rd~vam clrcnmstanc¢$, e.g renunclanon, death o{ ~xecutor, etc.
Decendem was domiciled at death in Cumber!an d County. Pennsylvania, with
last family or principal residence ar 227
Car lic]~, PA 17013
Decendent. then 90 ;,ears of age, died July 12 lxgx 2004,
at~orliclo Rc§iona~-Medical Ccntg~, C, ar}~,sleo PA ....
Except as follows, decedent d~d not marrs, was not m;orceo ano mO not nave a cnuu born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
Decendent at death owned property with estimated values as follows:
(Ii domiciled in Pa.) All personal property
(Il' no~ domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
$_ 205,000.0n
$
WHEREFORE. petitioner(s} respectfull5 request(s) thc probate of the la~' Will and codicil(s}:
presented herewith and the~rant of letters ~-~ ~ 4-~ ~ ,,,~,, .... +.~ry~ ~
theron.
- Linda A~t:Rohm ~
C~lialu FA 17013
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA '
COUNTer OF C_,L,Lr~q~SL~q.L/~I'--iLb jF ss
The petitionerisl 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 represen-
tative{s) nf the above dece6em {etmoner(s) will well and truly aOm~nister the estate according to lau.
Sworn [o o a'firmed and subscribed ,~;,~(,~ /',¢,? ~7'~ ~
No. )ill0 4- 7k5
Estate Of Chloe E Keller , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
_0oq
AND NOW A (.~F_.*~, Zl fi0 , in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated March 27. q~gtB
described therein be admitted to probate and filed of record as the last will of r'_h ] n ~ F k: ,= 11 ,= ~-
and Letters T~st@mentarv
are hereby granted to K~o-r~cn g Mc'/erh-'2*=ff~=v and Lqqdo A R~., LIIOO~ 0N~
FEES
Probate, Letters, Etc ..........
Short Certificates(k>) ..........
....
TOTAL
Filed ...................................
ATTORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
LAST WILL AND TESTAMENT
OF
CHLOE E. KELLER
I, Chloe E. Keller, a legal resident of the Borough of Carlisle, Cumberland County,
Pennsylvania, being of sound and disposing mind, memory, and understanding, do hereby make,
publish, and declare this as and for my Last Will and Testament, hereby revoking all other wills
and codicils heretofore made by me.
FIRST: I direct that all my just debts and funeral expenses, including my grave
marker, shall be paid from the assets of my estate as soon as practicable after my decease.
SECOND: I direct that all taxes that may be assessed in consequence of my death, of
whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as
a part of the expense of the administration of my estate.
THIRD: ! give, devise, and bequeath unto each of my grandchildren who shall have
survived me the sum of Five Thousand and no/100 ($5,000.00) Dollars.
FOURTH: I give, devise, and bequeath the residue of my estate, of every nature and
wherever situate, to my two daughters, Karen Sue Souders and Linda Ann Rohm, equally,
provided that the share of either daughter who shall predecease me shall be distributed to her
issue, per stirpes, and in default of any such then living issue, such share shall be added to the
share for my other daughter.
FIFTH: Should either of my daughters be indebted to me at the time of my death, i
direct that the amount of such indebtedness be added to the total value of the residue of my
estate, and after determination of each daughter's share, such indebtedness shall be deducted
from such indebted daughter's share.
SIXTH: Any distribution of the monetary bequest identified in paragraph THIRD
of this Will, which is distributable to a minor, shall be held in a savings account, certificate of
deposit or similar security, in a federally insured banking or savings institution in the name of the
minor and marked not to be withdrawn until the minor attains the age of 21 years.
SEVENTH: I direct that any share of resith~e of any beneficiary under the age of
Twenty-one (21) years shall be held, IN TRUST, however, by my surviving daughter, as Trustee,
to hold said share for the benefit of each said beneficiary under the age of Twenty-one (21), upon
the following terms and cond~ti¢.~
initials
To pay the income and so much of the principal as may, in the sole discretion of
my Trustee, be necessary for the maintenance, support, medical expenses, and
education of each beneficiary.
The amount to be paid for the benefit of any of said beneficiaries shall be
determined from time to time by the need of each of said beneficiaries, and the
amounts and times of said payments shall be determined by such need. The said
payments may be made by my Trustee directly to each of the said beneficiaries, or
to such of them as may be, in the sole opinion of my Trustee, of such age and
ability to handle properly the funds so paid to such beneficiary, or may he made
by my said Trustee directly to the person having the custody and care of any of
the said beneficiaries, or may be made by my said Trustee directly to any
institution entitled to such payment by reason of services rendered or to be
rendered to any of the said beneficiaries.
To pay the accumulated income and principal then remaining in her hands to the
said beneficiaries, upon each beneficiary's attaining the age of Twenty-one (21 )
years.
Any and all payment or payments of any sum or sums, whether in cash or in kind,
and whether for principal or income, payable to said beneficiaries, shall be made
upon the sole receipt of the respective beneficiary to whom the payment is made,
and free from anticipation, alienation, assignment, attachment and pledge, and
free from control by the creditors of any such beneficiary. All shares of principal
and income herein given shall be free from anticipation, assignment, pledge or
obligation of any beneficiary, and shall not be subject to any execution or
attachment.
EIGHTH: I nominate, constitute, and appoint my two daughters, Karen Sue Souders
and Linda Ann Rohm, Executrix, or the survivor as Executrix, of this, my Last Will and
Testament. In the event of the renunciation, death, resignation, or inability to act for any reason
whatsoever of the said Karen Sue Souders and Linda Ann Rohm, I nominate, constitute, and
appoint Financial Trust Services Company of Carlisle, Pennsylvania, Executor, of this, my Last
Will and Testament. I hereby relieve my Executrix from the necessity of posting security in
connection with their duties as such in any jurisdiction in which they may be called upon to act,
insofar as I am able by law so to do.
IN WITNESS WltEI~EOF, I have hereunto set my hand and seal to this, my
Last Will and Testament, con~istj,~ o, f½h?~j t,~pewritten pages, each of which bears my initials,
this t~'~'~ dayof "~ ~'~-~C,e-}r I , t998.
Signed, sealed, published, and declared by the above-named Testatrix, Chloe E. Keller, as
and for her Last Will and Testament, in the presence of us, who, at her request, in her sight and
presence, and in the sight and presence of each other, have hereunto subscribed our names as
witnesses.
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS.
I, Chloe E. Keller, Testatrix, whose name is signed to the attached or foregoing
instrument, having been duly qualified according to law, do hereby acknowledge that I signed
and executed the 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.
Sworn or. affirmed to and acknowledged before me by Chloe E. Keller, the
Testatrix, this 1~ 'qT'~ day of ~ , 1998.
Chloe E. Keller, Testatrix
Nota-ry Public
AFF~tDAVIT
COMMONWEALTH OF PENNSYLVANIA
SS.
COUNTY OF CUMBERLAND
We, Edward L. Schorpp and ~.. ~ Aa~ ~. ~ , 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 Testatrix sign and execute the
instrument as her Last Will; that Chloe E. Keller signed willingly and that she executed it as her
free and voluntary act for the purpose therein expressed; that each of us in the hearing and sight
of the Testatrix signed the Will as witnesses; and that to the best of our knowledge the Testatrix
was at that time eighteen or more years of age, of sound mind, and under no constraint or undue
influence.
Sworn or affirmed and subscri~ed to before ~ne by Edward L. Schorpp and
,/
'~~ ,~. ~-~ --- , witnesses, this ,o~ ~'-:'"'~" day
~SEAL)
Witness, Edward L. Schorpp
Witntess
(SEAL)
(SEAL)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENTOFREVENUE
BUREAU OFINDIVIDUAL TAXES
DEPT 280601
HARRISBURG, PA 17128 0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX(11 96)
NO. CD 004233
ROHM LINDA ANN
227 WEBSTER STREET
CARLISLE, PA 17013
fold
ESTATE INFORMATION: SSN: 174 05 0739
FILE NUMBER: 2104-0725
DECEDENT NAME: KELLER CHLOE E
DATE OF PAYMENT: 08/04/2004-
POSTMARK DATE: 08/04/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 07/12/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $7,500.00
TOTAL AMOUNT PAID:
$7,500.00
REMARKS: LA ROHM
SEAL
CHECK#421
INITIALS: VZ
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717)240-6345
Date: 11/01/2004
MEYERHOEFFER KAREN S
48 EASTOVER BLVD
MT SIDNEY, VA 24467
RE: Estate of KELLER CHLOE E
File Number: 2004-00725
Dear Sir/Madam:
It has come to my attention that you have not filed the
Certification of Notice Under Rule 5.7 (a) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES,
NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on
or after July 1, 1992, the personal representative or his
counsel, within ten (10) days after giving proper notice to the
beneficiaries and intestate heirs as required by subdivision
(a) of Rule 5.7, shall file with the Register of Wills or Clerk
of the Orphans' Court his/her Certification of Notice.
This filing will become delinquent on 11/14/2004
Your prompt attention to this matter will be appreciated.
Thank You.
cc:
File
Counsel
Judge
GLENDA FARNER STR_ASBAUGH
Clerk of the Orphans' Court
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717)240-6345
Date: 11/01/2004
ROHM LINDA~2FN
227 WEBSTER STREET
CARLISLE, PA 17013
RE: Estate of KELLER CHLOE E
File Number: 2004-00725
Dear Sir/Madam:
It has come to my attention that you have not filed the
Certification of Notice Under Rule 5.7 (a) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES,
NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on
or after July 1, 1992, the personal representative or his
counsel, within ten (10) days after giving proper notice to the
beneficiaries and intestate heirs as required by subdivision
(a) of Rule 5.7, shall file with the Register of Wills or Clerk
of the Orphans' Court his/her Certification of Notice.
This filing will become delinquent on 11/14/2004
Your prompt attention to this matter will be appreciated.
Thank You.
cc:
File
Counsel
Judge
GLENDA FARNER STP~ASBAUGH
Clerk of the Orphans' Court
Name of Decedent:
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Chloe E. Keller
Date of Death: July 12, 2004
Will No. 2004-00725 Admin. No.
To the Register:
I certify that notice of (beneficial interest) t dmi 'str ti 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 November 6 t 2004 :
Name Address
Tammera Fl'iht 33 Sprin9 Court, WaYnesboro, VA 22980
JoE] T. Soud~rs 6] Harper Street, Weyers Cavet VA 24486
Rri~n W_ "ohm
Daniel L. Roh~
997 W~¼Stor S~ro~t. C~rlisle, PA 17013
2977 Enola Road, Carlisle, PA 17013
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:
Signature
Name Linda A. Rohm
Address 227 Webster Street
Carlisle, PA 17013
%lephone( ) (717 243-5641
Capacity: X Personal Representauve
__Counsel for personal representative
NOV-08-2004 ~ON I0:56 R~ LIB DEV SUBSDIES&6RRNTS ?R× NO, ?177872117 P, 02
Name of Decedent:
CEIlTWICATION OF NOTICE UNDER RIiLE
Da~eofl~ath: July 12, 2004
Will No, 200~.-00725 Admin. No.
To ~e Register:
I certify that no,lc~ of (b~ndidsl inmr~s0 sl~ required by Rule 5.6(a) of the O~hans' Court Rules
served on or mailed to the following beneficiaries of the above-captioned estate on November 6, 2004
Name
__] ~ammer~ Fl'iht
,7o~1
Daniel L. Re, bm
Addmss
3~ Spring Court, Wavnesboro~ VA .22980
61 HarPer .gtr~t, Wey~rs Cave, VA 24486~
2977 Enola Road, Carlisle. PA 17013
Noti~ has now been given to all persons entitled thereto under Rule 5,6(a) exc, ep.
Date: ~' A,/O ty O tv'
Signature
Capacity: X Personal Representative
.... Counsel for ~rsonal rcpresen~fiv,
COMMONWEALTH OF PENNSYLVANIA
DEI'ARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ROHM LINDA ANN
227 WEBSTER STREET
CARLISLE, PA 17013
n______ fold
ESTATE INFORMATION: SSN: 174-05-0739
FILE NUMBER: 2104-0725
DECEDENT NAME: KELLER CHLOE E
DA TE OF PAYMENT: 04/01/2005
POSTMARK DATE: 04/01/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 07/12/2004
NO. CD 005148
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $766.79
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$766.79
REMARKS:
CHECK#103
SEAL
INITIALS: CCP
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
-
REV. t 50<: EX {6-00)
'* COMMONWEALTH OF
, PENNSYLVANIA
. . DEPARTMENT OF REVENUE
. DEPT. 280601
HARRISBURG, PA 17128-0601
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DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
KELLER, CHLOE E.
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
21 04
0725
NUMBER
DATE OF BIRTH (MM-DD.YEAR)
10/29/1913
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
, REGISTER OF WILLS
-i SOCIAL SECU-RITY NUMBER--
o 2. Supplemental Return
o 4a. Future Interest Compromise (date of death after 12-12-82)
o 7, Decedent Maintained a Living Trust (Attach copyofTrustl
o 10. Spousal Poverty Credit (dale of death between 12-31-91 and 1-1-95)
o 3, Remainder Return (dale 01 death phor 10 12-13-82)
o 5. Federal Estate Tax Return Required
8, Total Number of Safe Deposit Boxes
o 11, Election to tax under Sec_ 9113(A) (Altach Sell 01
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THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
Lind_a_!\~n~oJ1rT1n 227 Webster 8t
FIRM NAME (If Applicable) Carlisle PA 17013
COUNTY CODE YEAR
SOCIAL SECURITY NUMBER
174-05-0739
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
(1)
(2)
(3)
(4)
(5)
4. Mortgages & Notes Receivable (Schedule D)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
1,085.00
5 Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
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8 Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
DATE OF DEATH (MM-DD-YEAR)
07/12/2004
\Xl 1 , Original Return
o 4. Limited Estate
IX] 6. Decedent Died Testate (Attach copy of V\jll)
o 9. Litigation Proceeds Received
TELEPHONE NUMBER
(717) 243-5641
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
56,683.66
(6)
32,276.65
(7)
125,000.00
(9)
(10)
(8)
22,461.72
105.26
c:>
f'.....l
215,045.31
22,566.98
192,478_33
192,478.33
8,661.52
8,661.52
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12 Net Value of Estate (Line 8 minus Line 11)
(11)
(12)
(13)
13 Charitable and Govemmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
(14)
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X
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15. Amount of Line 14 taxable at the spousal lax
rale, or transfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19 Tax Due
x .0 (15)
192,478.33 x.O 45 (16)
x .12 (17)
x .15 (18)
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
(19)
20.0
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
LAST WILL AND TESTAMENT
OF
CHLOE E. KELLER
I, Chloe E. Keller, a legal resident of the Borough of Carlisle, Cumberland County,
Pennsylvania, being of sound and disposing mind, memory, and understanding, do hereby make,
publish, and declare this as and for my Last Will and Testament, hereby revoking all other wills
and codicils heretofore made by me.
FIRST: I direct that all my just debts and funeral expenses, including my grave
marker, shall be paid from the assets of my estate as soon as practicable after my decease.
SECOND: I direct that all taxes that may be assessed in consequence of my death, of
whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as
a part of the expense of the administration of my estate.
THIRD: I give, devise, and bequeath unto each of my grandchildren who shall have
survived me the sum of Five Thousand and nol1oo ($5,000.00) Dollars.
FOURTH: I give, devise, and bequeath the residue of my estate, of every nature and
wherever situate, to my two daughters, Karen Sue Souders and Linda Ann Rohm, equally,
provided that the share of either daughter who shall predecease me shall be distributed to her
issue, per stirpes, and in default of any such then living issue, such share shall be added to the
share for my other daughter.
FIFTH: Should either of my daughters be indebted to me at the time of my death, I
direct that the amount of such indebtedness be added to the total value of the residue of my
estate, and after determination of each daughter's share, such indebtedness shall be deducted
from such indebted daughter's share.
SIXTH: Any distribution of the monetary bequest identified in paragraph THIRD
of this Will, which is distributable to a minor, shall be held in a savings account, certificate of
deposit or similar security, in a federally insured banking or savings institution in the name of the
minor and marked not to be withdrawn until the minor attains the age of 21 years.
SEVENTH: I direct that -any'sharexjt"~ittlle of any beneficiary under the age of
Twenty-one (21) years shall be-held, IN!fRUS'lit'h'6wever, by my surviving daughter, as Trustee,
to hold said share for the benefit of each said beneficiary under the age of Twenty-one (21), upon
the following terms and condi~1'Sltt 17- 9nV 170.
"'.'/:' '(' 1:~"'';'"_tP.:''';.t j
~"!!!:.f\ ~'" ,,>,)!,)c.'t:!
~.c., 2 :r!j~+()..p;:; l:uc:atj
_ell(
initials
A. To pay the income and so much of the principal as may, in the sole discretion of
my Trustee, be necessary for the maintenance, support, medical expenses, and
education of each beneficiary.
B. The amount to be paid for the benefit of any of said beneficiaries shall be
determined from time to time by the need of each of said beneficiaries, and the
amounts and times of said payments shall be determined by such need. The said
payments may be made by my Trustee directly to each of the said beneficiaries, or
to such of them as may be, in the sole opinion of my Trustee, of such age and
ability to handle properly the funds so paid to such beneficiary, or may be made
by my said Trustee directly to the person having the custody and care of any of
the said beneficiaries, or may be made by my said Trustee directly to any
institution entitled to such payment by reason of services rendered or to be
rendered to any of the said beneficiaries.
C. To pay the accumulated income and principal then remaining in her hands to the
said beneficiaries, upon each beneficiary's attaining the age of Twenty-one (21)
years.
D. Any and all payment or payments of any sum or sums, whether in cash or in kind,
and whether for principal or income, payable to said beneficiaries, shall be made
upon the sole receipt of the respective beneficiary to whom the payment is made,
and free from anticipation, alienation, assignment, attachment and pledge, and
free from control by the creditors of any such beneficiary. All shares of principal
and income herein given shall be free from anticipation, assignment, pledge or
obligation of any beneficiary, and shall not be subject to any execution or
attachment.
EIGHTH: I nominate, constitute, and appoint my two daughters, Karen Sue Souders
and Linda Ann Rohm, Executrix, or the survivor as Executrix, of this, my Last Will and
Testament. In the event of the renunciation, death, resignation, or inability to act for any reason
whatsoever of the said Karen Sue Souders and Linda Ann Rohm, I nominate, constitute, and
appoint Financial Trust Services Company of Carlisle, Pennsylvania, Executor, of this, my Last
Will and Testament. I hereby relieve my Executrix from the necessity of posting security in
connection with their duties as such in any jurisdiction in which they may be called upon to act,
insofar as I am able by law so to do.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my
Last Will an~ament, con~ewritten pages, each of which bears my initials,
this OJ../t day of , 1998.
~?;, .k~ (SEAL)
AFFIDA VIT
COMMONWEALTH OF PENNSYLVANIA )
SS.
COUNTYOFCUMrnERLAND )
We, Edward L. Schorpp and -K G::t:ii JuJu. ~'. ~ , 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 Testatrix sign and execute the
instrument as her Last Will; that Chloe E. Keller signed willingly and that she executed it as her
free and voluntary act for the purpose therein expressed; that each of us in the hearing and sight
of the Testatrix signed the Will as witnesses; and that to the best of our knowledge the Testatrix
was at that time eighteen or more years of age, of sound mind, and under no constraint or undue
influence.
t! Sworn ~r affirme~. and su~sc~d to before me by Edward L. Schorpp and ~
~~. ~ ,witnesses, this ~ 1~ day
of _ ,1998.
~.##-<sEAL)
Witness, Edward L. Schorpp
~./~~
Witness -
(SEAL)
~~rro
(SEAL)
Notarial Seal
Susan K. Guyer, Notary Public
Carllsle Boro, Cumberland County
My Commission Expires Sept. 4, 1999
Mfimbpr, Penney Vlltlll 'SOC atitltl 0 otarles
Signed, sealed, published, and declared by the above-named Testatrix, Chloe E. Keller, as
and for her Last Will and Testament, in the presence of us, who, at her request, in her sight and
presence, and in the sight and presence of each other, have hereunto subscribed our names as
witnesses.
~~~
~ J ~~--~
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA )
SS.
COUNTY OF CUMBERLAND
)
I, Chloe E. Keller, Testatrix, whose name is signed to the attached or foregoing
instrument, having been duly qualified according to law, do hereby acknowledge that I signed
and executed the 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.
Sworn ~rrmed to ~~ ~knowled~ed before me by Chloe E. Keller, the
Testatrix, this a. '1 day of -r "-6-I"tt.P\ , 1998.
_Lhl1r! t l~
Chloe E. Keller, Testatrix
Notarial Seal
Susan K. Guyer, Notary Public
Carllsls Bora, Cumberland County
I My Commission El:pirlilS Sept. 4, 1999
"M'amber, Pel1t1t:y!VI111U'J t;${Jclation ~ olar es
.
REV-15D3 EX+ (6-98)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
KELLER, CHLOE E.
FILE NUMBER
21-04-0725
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
The MONY Group, 35 shares common stock. Final day of trading 7/7/05, merged with AXA
VALUE AT DATE
OF DEATH
Financial. Reported at cash consideration value of $31.00 per share
1,085.00
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
1,085.00
ImmiI
~~
An AXA Financial Company
The MONY Group
1740 Broadway
New York, NY 10019
www.mony.com
THE MERGER WITH AXA FINANCIAL HAS BEEN COMPLETED
YOUR FINAL DIVIDEND CHECK IS ENCLOSED
MONY GROUP POLICIES REMAIN SECURE
July 2004
Dear Fellow Stockholder:
As all of you know, the merger with AXA Financial was approved by a majority of our stock-
holders at our special meeting on May 18th. This marked a great day for our two companies
and I want to again extend my sincerest appreciation for your support and patience throughout
the process.
Not only does this merger deliver the best value creating opportunity for our stockholders, but
those stockholders who are also policyholders will now also enjoy the advantages that come
from being part of one of the world's premier financial services organizations. With approxi-
mately $522.6 billion in assets under management as of March 31,2004 and superior financial
strength ratings, AXA Financial has the size, scope and resources to provide MONY policy-
holders with an additional array of products and services.
Under the terms of the merger, MONY stockholders will receive $31.00 per share in cash from
AXA Financial, plus $0.34755 per share in combined dividends from MONY, each without
interest and less any required withholding tax. Accordingly, we are enclosing a check for the
full amount of dividends owed to you based on the number of shares of MONY common stock
you owned immediately prior to the effective time of the merger, which occurred on July 8,
2004. For those enrolled in the company's Dividend Reinvestment Plan, please be aware that
given the merger consideration your final dividend could not be reinvested and therefore is
included in the enclosed check.
Most stockholders will be receiving an additional check from AXA Financial in the coming
weeks, which accounts for the $31.00 per share owed to you based on the number of shares of
MONY common stock you owned as of July 8, 2004. Those shareholders who are seeking
appraisal rights or are in the process of certifying their Taxpayer Identification Numbers (TIN)
or returning a Letter of Transmittal related to their stock certificates, will have to wait until
those procedures are completed before any payment from AXA Financial will be made.
A full account statement and 1099 statement retlecting the shareholder distributions will be
mailed directly to you in January 2005. If you have any questions, please don't hesitate to call
EquiServe Trust Company toll-free at 1-800-926-6669, or email usatMONY@Equiserve.com.
Again, thank you for your support and best wishes.
On behalf of the Board of Directors,
Ff/K
3
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REV-15G8 EX'" (6-98)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
KELLER, CHLOE E.
FILE NUMBER
21-04-0725
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1. H/HH Bonds, US Treasury Department
D5242363HH - face value 500, issue date 4/2000
V1472586HH - face value 5,000, issue date 4/2000
X1020500HH - face value 10,000, issue date 4/2000
X1020501 HH - face value 10,000, issue date 4/2000
X1020502HH - face value 10,000, issue date 4/2000
X1020503HH - face value 10,000, issue date 4/2000
X1020504HH - face value 10,000, issue date 4/2000
55,500.00
17.00
2. American Red Cross, refund
3. Hurst Corporation, subscription refund
3.66
4. Sale of personal property
466.00
5. US Department of Revenue, income tax refund
697.00
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
56,683.66
~_._-_.---~~-------.
SERIES HH
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OEF ERRED INTEREST
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WILL .....T AT ANV TIME SIX MONTHS ...rTER OATE or ISSUE
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174-05-0739
04
.2000
CHLdli' EKliLLliR
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CARLISliE, PA i7013
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Will PA,Y AT A,NY TIME 151X MONTHS ...fTER C...TE or PSSUE
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INTEREST CEASES 20 YEARS
FROM ISSUE DATE OF
174-05-0739
04 2000
7;,
CHLOE: ,E KELLER.
227 .WEBSTER lAVE
CARLISLE, ~A. 17013
01020504
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INTEREST CEASES 20 YEARS
FROM ISSUE DATE OF
174-05-0739
04 2000
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CHLO~! E KEILL~R.
227 WEBSTER.A\!e
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INTEREST CEASES 20 YEARS
FROM ISSUE DATE OF
174-05-0739
04 2000
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CHLOE E KELL~8
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DEFERRED INrEREST $---8-,.246.36
\~ 00414100118077 *?
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WILL PAY AT ANY 'flME: 51:< MONTI-lS AFT"R o,o,TE: OF tSSUE:
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INTEREST CEASES 20 YEARS
FROM ISSUE DATE OF
174-05-0739
04 2000
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CHLOE E KEL.LER:
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DEFERRED INTEREST $
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W1U.. PA'I ^-r }ioN" TIME Sl~ MONTHS ..."YEP DATE OF 155UE
174-05-0739
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CHLOE (,KELLER.
221 . W,EBSTER.AVE
CA~LISL~) ~A 170~3
8,246.40
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INTEREST CEASES 20 YEARS
FROM ISSUE DATE OF
04 2000
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REGULAR SAVINGS ACCOUNT:
Account Number/ Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
Date Joint Ownership Establised
CHECKING ACCOUNT:
Account Number/Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
Date Joint Ownership Established
INVESTMENT SAVINGS ACCOUNT:
Account Number/Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
Date Joint Ownership Established
CERTIFICATES OF DEPOSIT:
Account Number/Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
Date Joint Ownership Established
Estate of: CHLOE E. KELLER
Date of Death: July 12, 2004
Social Security Number: 174-05-0739
~1~
MEMBERS 1st
FEDERAL CREDIT UNION
197805 -00
10/16/2000
$327.91
$.10
$328.01
Linda A. Rohm, Karen S. Meyerhoeffer
10/16/2000
197805 -11
10/16/2000
$1,823.91
$.00
$1,823.91
Linda A. Rohm, Karen S. Meyerhoeffer
10/16/2000
197805 -05
08/18/2001
$63,994.00
$25.74
$64,019.74
Linda A. Rohm, Karen S. Meyerhoeffer
08/18/2001
197805 -41
02/21/2003
$23,137.33
$20.92
$23,158.25
Linda A. Rohm, Karen S. Meyerhoeffer
02/21/2003
lJ. ~RS [STJ1DERAL CREDIT UNION
:1t~U~~
D mseA. Wolfe /-
Insurance Supervisor
July 30, 2004
5000 Louise Drive · P.O. Box 40 · Mechanicsburg, Pennsylvania 17055 . (717) 697-1161 · wwwmemberslst.org
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OR KAREN MEYERHOEFFER
DEFERRED INTEREST $ 0 . 60
~~~.~
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iNTEREST CEASES .20 YEARS
FA OM iSSUE DATE OF
174-05...0739
08
2002
CHUJEIEKELLER i
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CARLiSLE, PA~ 170
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INTEREST CEASES 20 YEARS
FROM. ISSUE DATE OF
174-05"'0739
08
2002
CH LdE:lEI( EllLE R:
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WILL fOAl' A.T. ANl' TIME .S.lII. MONTHS "'I"T!;l'I D"'TE Of ISSUE
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FROM ISSUE bATE OF
174-05-0739
08 2002
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CHLOE. EKELLER ;
227WEBSTER.ST
CARL ISLE; PA' 17'013
OR KAREN MEYERHOEFFER
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WlLL PAY AT ANY TIM!!: SIX .MONTH5 AI'TER DATE Of IS.5UIE
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CHLOE E KELLER
227 WEB$'TER.st' ......>.
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OR
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FAOM ISSUE DATE OF
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2002
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INTEREST CEASES 20 YEARS
FROM ISSUE DATE Of
'08
2002
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174-05-0739
CHLOE! E. KEllER
227 WEBSTER ,. sf
CARLISLE, PA 170
OR LINDA ROHM
DEFERRED INTEREST $ 0 . 80
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INTEREst -cEAsES 20 YEARS
FROM ISSUE DATE OF
08
2002
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174~05~0739
06
I
!2003
DEFERRED INTEREST
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CH L O~~;E: KEl. LER
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DEFERRED INTEREST
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SE Itll':S lIll
DEFERRED INTEREST
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WILL PA" AT ANY riME SlX MONTHS AfTER OATl! Of ISSUE
m.~~@jl!~llj)I!~~ !~l~~I~~Y:fSj
INTE~E:STe,::EASES 20 YEARS
FJ:?OM iSSUE DATE OF
174-05-0739
:tJ6
2003
CH LO.~E'~REl.I..E~ .....
227i'WE:B~lER SJii
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OR LINDA ROHM
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WilL PAY JIlT ANY TI"'1O SIX J'.ONTI'IS AfTER O"'TE. OF IS$UE
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INTEREST CEASES 20 YEARS
FROM ISSUE DATE OF
174-05-0739
06
i2003
---
OR LINDA ROHM
0.00
06326037
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REV-1510 EX+ (6-9B)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISe. NON-PROBATE PROPERTY
ESTATE OF
FILE NUMBER
KELLER, CHLOE E. 21-04-0725
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
ITEM
NUMBER
1.
DESCRIPTION OF PROPERTY
INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND
THE DATE OF TRANSFER. ATTACH A COpy OF THE DEED FOR REAL ESTATE.
DATE OF DEATH % OF DECO'S EXCLUSION
VALUE OF ASSET INTEREST (IF APPLICABLE)
TAXABLE
VALUE
All that certain improved tract of land
situate in the Borough of Carlisle,
Cumberland County, Pennsylvania, known as
and numbered 227 Webster Street, Carlisle,
PA to Linda A. Rohm, March 10, 2004. See
Cumberland County Deed Book 262, Page 1188.
Valued as per attached appraisal. $125,000
0%
o
125,000.00
TOTAL (Also enter on line 7 Recapitulation) $ 125,000.00
(If more space is needed, insert additional sheets of the same size)
.' . JCY7WI ~.
HOBERT P. ZIEGLER ufO
'1...."r)nr)l='n f';V.c- Dr.r:OS
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Tax Parcel No. 02-20-1800-119
1Ll riAR 29
A~ 9 3THIS
DEED,
MADE THE 10th day of March in the year of our Lord Two Thousand and Four (2004),
BETWEEN CHLOE E. KELLER, widow, of Carlisle, Cumberland County, Pennsylvania
Grantor
and
LINDA A. ROHM, of Carlisle, Cumberland County, Pennsylvania,
Grantee
WITNESSETH, that in consideration of One and 00/100 Dollars, - $1.00
in hand paid, the receipt whereof is hereby acknowledged, the said grantor does hereby grant and
convey to the said grantee, her Heirs and Assigns,
ALL those two certain lots of ground situate in the Borough of Carlisle, County of
Cumberland and State of Pennsylvania, bounded and described as follows, to wit:
BEIN G Lots Nos. 18 and 19 as shown on a plot of lots laid out and known as "Henderson
Addition", and recorded in the office of the Recorder of Deeds in and for the said Cumberland
County in Plan Book 2, Page 27, and being known and numbered as 227 Webster Street, Carlisle,
Pennsylvania.
BEING the same lots of ground which Ray S. Cornman, Executor of the Last Will and
Testament of Mrs. Gertrude M. Cornman, conveyed by deed to Clyde E. Keller and Chloe E.
Keller, his wife, dated January 3, 1939, and recorded in Cumberland County Deed Book "X",
Vol. 11, Page 504. Clyde E. Keller died on the 25'h day of November, 1985, thus vesting sole title
to the property in Chloe E. Keller, his widow.
TOGETHER with all and singular ways, waters, water-courses, rights, liberties, privileges,
hereditament" and appurtenances whatsoever thereunto belonging or in anywise appertaining, and
the reversions, and remainders, rents, issues, and profits thereof; and all the estate, right title,
interest, trust, property, possession, claim and demand whatsoever, of it in law, equity, or otherwise
howsoever, of, in and to the same and every part thereof.
AND the said grantor hereby covenants and agrees that she will warrant specially the
property hereby conveyed.
THIS conveyance is a transfer from mother to daughter and is, therefore, exempt from
Pennsylvania realty transfer tax.
-
f.crl~
.-~.~.~'
~~:t~..-
~';~11IqfJ
"-"'__"~''''"Vl
IN WITNESS WHEREOF, said grantor has hereunto set her hand and seal the day and
year first above written.
Signed, Sealed and Delivered
in the Presence of
C~jJcZ~ [Kd/~)
Chloe E. Keller
,7~kJt,,,~ \
~
Commonwealth of Pennsylvania
ss.
County of Cumberland
On this, the lOth day of March, 2004, before me, Lindsay D. Baird, the undersigned
officer, personally appeared Chloe E. Keller, known to me (or satisfactorily proven) to be the
person whose name is subscribed to the within instrument, and acknowledged that she executed
same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
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I Hereby Certify, that the precise residence and complete post office address of the wifum rr~ed
Grantee is: ;J.;r:; ll/cDSK;/ Y/U( (-
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!File No. 0408731 Pace #1
APPRAISAL OF REAL PROPERTY
LOCATED AT:
227 WEBSTER ST
CARLISLE, PA 17013-2027
FOR:
MEMBERS 1ST FEDERAL C.U.
5000 LOUISE DRIVE
MECHANICSBURG, PA 17055
AS OF:
APRIL 8, 2004
BY:
DANIEL A. HOFFMAN, RL-001638-L
PA STATE CERTIFIED RESIDENTIAL APPRAISER
THE DYNAMIC TEAM, INC.
629 WYNDAMERE ROAD, ETTERS, PA 17319
PHONE (717) 932-8028 FAX (717) 932-4745
Form GA6 - 'TOTAL lor Windows' appraisal software by a la mode, Inc. - 1-800.l\lI\MOOE
IFile No. 0408731 Paoe #31
THE DYNAMIC TEAM, INC.
629 WYNDAMERE ROAD
ETTERS, PA 17319
APRIL 15, 2004
MEMBERS 1ST FEDERAL C.U.
5000 LOUISE DRIVE
MECHANICSBURG, PA 17055
Borrower:
FileNo.:
227 WEBSTER ST
CARLISLE, PA 17013-2027
ROHM,L1NDA
040873
Re: Property:
In accordance with your request, we have appraised the above referenced property. The report of that appraisal is
attached.
The purpose of this appraisal is to estimate the market value of the property described in this appraisal report, as
improved, in unencumbered fee simple title of ownership.
This report is based on a physical analysis of the site and improvements, a locational analysis of the neighborhood and
city, and an economic analysis of 1he market for properties such as the subject. The appraisal was developed and the
report was prepared in accordance with the Uniform Standards of Professional Appraisal Practice.
The value conclusions reported are as of the effective date stated in the body of the report and contingent upon the
certification and limiting conditions attached.
It has been a pleasure to assist you. Please do not hesitate to contact me or any of my staff if we can be of additional
service to you.
Sincerely,
C0Jg~
DANIEL A. HOFFMAN
RL-001638-L
PA STATE CERTIFIED RESIDENTIAL
The Dynamic Team, Inc (717) 932-8028
IFile No. 0408731 Paae #41
Summary AppraIsal Report UNIFORM RESIDENTIAL APPRAISAL REPORT FileNo. 040873
Proper\v Address 227 WEBSTER ST Cltv CARLISLE State P A Zip Code 17013-2027
leoal Descrintion ATTACHED DEED 262-1188 Countv CUMBERLAND
Assessor's Parcel No. 02-20-1800-119 Tax Year 2003 R.E. Taxes S 1 972 APP Sneclal Assessments t NIA
Borrower ROHM LINDA Current Owner ROHM LINDA Occuoant fX1 Owner f l Tenant f l Vacant
ProoeJtv riohts annralsed M Fee Simnle I Ileasehold ProieclT Vt\l\ I I PUD r \ Condominium (HUON A onlvl HOA $ NIA 11.10.
Nelnhborhood or Proiect Name NONE Man Reference SEE APN Census Tract 0121.00
Sale Price $ RE-FI Date of Sale N/ A Oescriotlon and S amount 01 loan char"eo/concesslons to be nald bv seller N/A
Lender/Client MEMBERS 1ST FEDERAL C.U. Address 5000 LOUISE DRIVE MECHANICSBURG PA 17055
Aooraiser DANIEL A HOFFMAN Address THE DYNAMIC TEAM INC. 629 WYNDAMERE ROAD ETTERS PA 17319
Location o Urban ~ Suburban W Rural Predominant _~ntframIlYhouslE9 Preaenlland use % Land use change
Built up DOver 75% o 25-75% 0 Under 25% occupancy PRI AG One family ~ [8J Not likely o Likely
$(000) (yrs)
Growth rate o Rapid [8J Stable o Slow o Owner ~Low~ 2-41amily _ o In process
Property values [8J Increasing o Slable o Declining o Tenant 250 Hinh 150+ Multi-family _ To: NIA
Demand/supply 0 Shortage [8J In balance 0 Over supply ~ Vacant (0-5%) .Itll Predominant ~, Commercial 10
Marketina time n \Jnder 3 mos. ~ 3-6 mos n Over 6 mos. ' VacJover 5%\ 75-175 50+
Hote: Rece end lhe recla' composlllon 01 lhe neighborhood are nol appraise' 'aclors.
Neighborhood boundaries and characteristics: THE SUBJECT NEIGHBORHOOD INCLUDES A ONE MILE RADIUS OF THE SUBJECT.
COMMERCIAL USE IN THE AREA IS LIMITED TO THE TYPE TYPICALLY FOUND AND DESIRED ALONG MAIN ROADS IN SUCH AREAS
Factors that altect the marketability of the properties In the neighborhood (proximity to employment and amenities, employment stabmty, appeal to market, etc.):
THE SUBJECT IS LOCATED IN A PREDOMINANTLY RESIDENTIAL AREA AMONG PROPERTIES OF SIMILAR S1YLE AND MARKEl
APPEAL THIS AREA IS CONVENIENTLY LOCATED IN RESPECT TO SCHOOLS, SHOPPING, EMPLOYMENT, AND TRANSPORTATIOr-.
ACCESS. HOMES IN THE NEIGHBORHOOD ARE OCCUPIED AND APPEAR TO BE WELL MAINTAINED. THIS AREA PROVIDES
REASONABLE SAFETY AND SECURtTY COVERAGE. '''PLEASE NOTE THAT THE PRESENT LAND USE PERCENTAGES LISTEr
ABOVE ARE THAT OF THE DEVELOPED UTILIZED LANQ.
Markel conditions In the subject neighborhood (including support for the above conclusions related to the trend of property values, demand/supply, and marketing time
__ such as data on competitive properties for sale In the neighborhood, description of the prevalence of sales and financing concessions, etc.):
CARLISLE BOROUGH PROVIDES AN AVERAGE ENVIRONMENT FOR THE HOUSE BEING APPRAISED. THERE ARE NO KNOWN
FACTORS THAT WILL NEGATIVELY AFFECT THE MARKETABILITY OF THE HOUSE. ALL OF THE ITEMS IN THE NEIGHBORHOOD
RATING GRID ARE RATED GOOD OR AVERAGE. THE PUBLIC SCHOOLS PARKS VIEWS AND NOISE LEVEL
ARE TYPICAL FOR THIS TYPE OF NEIGHBORHOOD THIS IS A FAIRLY ACTIVE MARKET WITH NO SPECIAL FINANCING LOAN
DISCOUNTS OR OTHER CONCESSIONS PREVALENT.
Project lnlormallon lor PUOs (II applicable) - - Is the developer/builder in control 01 the Home Owners' Association (HDA)? U Yes U No
Approximate total number of units In the subject project NJA Approximate total number of units lor sale In the subject project NJA
Descrtbe common elements and recreational facllilles: NIA
Dimensions SEE ATTACHED DEED Topography LEVEL
Site area .19AC Comer Lot 0 Yes [8J No Size AVERAGE
Specific zoning classification and description RESIDENTIAL Shape IRREGULAR
Zoning compliance ~ legal o legal nonconforming (Grandfathered use) 0 Illegal o No zoning Drainage APPEARS ADEQUATE
Hlqhest & best use as imoroved: [XJ Present use n Other use (evnlainl View AVERAGE
UlIIRlee Public Other Off-elte Improvements Type Public Private Landscaping AVERAGE
Efecbicity [8J Street ASPHALT [8J 0 Driveway Surface CONCRETE
Gas [8J Curb/gutter CONCRETE ~ 0 Apparent easements NONE APPARENT
Water [8J Sldewaik CONCRETE [8J 0 FEMA Special Flood Hazard Area DYes [8J No
Sanitary sewer ~ Street lights MERCURY VAPOR ~ R FEMA Zone C Map Date 21311982
Storm sewer Allev ASPHALT FFMA Man No. 4253620oo4B
Comments (apparent adverse easements, encroachments, special assessments, slide ilfeas, lUegal or legal nonconforming zonll1lJ.use, etc.): THE SIZE, SHAPE
AND LANDSCAPING OF THIS SITE IS TYPICAL OF SITES IN THIS NEIGHBORHOOD NO APPARENT ADVERSE' EASEMENTS
ENCROACHMENTS SPECIAL ASSESSMENTS SLIDE AREAS ETC. NEGATIVELY AFFECT THE VALUE
GENERAL DESCRIPTION EXTERIOR OESCRIPTION FOUNDA nON BASEMENT INSULATION
No. 01 Units 1 Foundation BLOCK STONE Siab NO Area Sq. Ft. 760 Roof _0
No. of Stories 1.5 Exterior Walls ALUMINUM Crawl Space NO % Finished 25 Ceiling _ 0
Type (Del/Att.) DET Roof Surface COMP SHING Basement FULL Ceiling WOP2-- Walls_D
Design (Stylel CAPE COD Gutters & Dwnspts. ALUMINUM Sump Pump DRAIN Walls WOOD FloO! _ 0
ExlstinglProposed EXISTING Window Type DBL-HUNG Dampness NO EVIDENCE Floor WOOD None _ 0
Age (Vrs,) 65 Storm/Screens YES Settlement NO EVIDENCE Outside Entry NO Unknow~ [8J
Effective Ane IVrs. I 5-7 Manulactured House NO Intestation NO EVIDENCE
ROOMS Fover Livinn Dininn Kitchen Den Familv Rm. Rec. Rm. Bedrooms # Baths Laundrv Other Area Sn. F\.
- Basement 1 760
Levell 1 1 1 1 1.0 1 851
level 2 3 1.0 858
Finished area above nrade contains: 6 Rooms' 3 Bedroomlsl: 2.0 Bathlsl: 1709 S uare Feet of Gross lIv1nn Area
INTERIOR Materials/Condillon HEATING KITCHEN EQUiP. ATIiC AMENITIES CAR STORAGE:
- Floors CARPET VINYUAVG Type FWA Refrigerator [8J None 0 Fireplace(s) # ~ [8J None 0
Walls DRYWALLlAVG Fuel OIL Range/Oven [8J Stairs 0 Patio 0 Garage # of cars
Trim/Finish WOODIAVG Condition A VG Disposal ~ Drop Stair 0 Deck 0 Attached 1 CAR
Bath Floor VINYLlAVG COOLING Dishwasher 0 Scuttle [8J Porch FRONT [8J Detached
Bath Wainscot FIBERGLASSIAVG Central YES FarVHood 0 Floor 0 Fence 0 Built-In
Doors WOOD/AVG Other NONE Microwave 0 Heated R Pool R Carport
Condition A VG Washer/DNer Fi Finished Drivewav CONC
Additional lealures (special energy ellicient items, etc.): SEE COMMENT ADDENDUM
Condition of the Improvements, depreciation (physical, lunctional, and extemal), repairs needed, quality of construction, remodeling/addilions, etc.: NO FORMS
OF FUNCTIONAL OR EXTERNAL OBSOLESCENCE WAS NOTED DURING THE INSPECTION. NO PHYSICAL DEPRECIATION WAS
OBSERVED AT THE TIME OF THE INSPECTION.
Adverse environmental condmons (such as, but not IImlled to, hazardous wastes, toxic substances, etc.) present in the improvements, on the site, or in the
Immediate vicinity 01 the subject property.: NO KNOWN OR OBSERVED ADVERSE ENVIRONMENTAL CONDITIONS WERE NOTED AT THE
TIME OF THE INSPECTION FOR THIS APPRAISAL
Freddie Mac Form 70 6(93
PAGE 1 OF 2
Form UA2 - "TOTAL for Windows" appraisal software by a fa mode, inc. -1-800.ALAMODE
Fannie Mae Form 1004 6(93
_11.._ "'__11__
IFile No. 0408731 Paoe #51
UNIFORM RESIDENTIAL APPRAISAL REPORT FileNo. 040873
... = $ 20.000 Comments on Cost Approach (such as, source 01 cost estimate, site value,
square foot calculation and for HUO, VA and FmHA, the estimated remaining
economic life of the property): ON HOMES OF THIS AGE THE
COST APPROACH IS UNRELIABLE AND IS NOT UTILIZED
DUE TO THE DIFFICUl TV OR IMPOSSIBLE TASK OF
ASSESSING DEPRECIATION AND OBSOLESCENCE.
ESTIMATED SITE VALUE
ESTIMATED REPRODUCTION COST.NEW-OF IMPROVEMENTS:
Dwelling 1,709 SQ. Ft. @$ = $
760 SQ. Ft. @$ =
. Garage/Carport __ SQ. Ft. @$
Total Estimated Cost New
Less Physical
Depreciation I
Depreciated Value of Improvemenls
"As-Is" Value of Site Improvements . .
INDICA TED VALUE BY COST APPROACH
ITEM 1 . SUBJECT
227 WEBSTER ST
Address CARLISLE
Proxlmitv to Subiect
Sales Price
Price/Gross LivinQ Area
Data and/or
Vermcallon Source
VALUE ADJUSTMENTS
Sales or Financing
Concessions
Date of SalelTlme
Location
Leasehol&fee Simnle
Site
View
Desinn and Anneal
, nualllv' of ~onstruction
Ane
Condition
Above Grade
Room Count
Gross Livinn Area
Basement & Finished
Rooms Below Grade
. Functional Utility
Heati;;-niCoolino
- EnerQv Efficient Items
Garane/Carnort
Porch, Patio, Deck,
Firenlace1s\ etc.
Fence Pool etc.
=$
........ =$
.. =$
....... ~$'
COMPARABLE NO.1
69 E ST
CARLISLE
~'l'!;''/I,~!<,~;!!I!i~ 0.44 miles
~ RE-FI .li'lh . '
$ rP $ 75.50 rfJ:
INSPECTION MLS # 10096035
17DOM
DESCRIPTION : +( -1$ Adiust.
, CONVENTIONAL :
NO EFFECT '
12/23/03 :
AVERAGE :
FEE SIMPLE :
.17 AC
AVERAGE
CAPE COD
BRICK
56A
AVERAGE
Total : Bdrms: Baths :
6 : 3 " 1.5 :
1616 So. Ft. :
FUll
UNFINISHED
AVERAGE
OHWBB/NONE :
SIMILAR
NONE
CVRD PORCH
1 FIREPLACE
NONE
Functional
DESCRIPTION
AVERAGE
FEE SIMPLE
.19AC
AVERAGE
CAPE COD
ALUMINUM
65A
AVERAGE
Total: Bdrms: Baths
6 : 3 : 2.0
1 709 So. Ft.
FUll
REC ROOM{-}
AVERAGE
OFWA/CA
STORM UNITS
1C ATT GAR
PORCH
1 FIREPLACE
NONE
= $
External
N/A ESTIMATED REMAINING ECON. LIFE 40-50 YEARS
COMPARABLE NO.3
230 W SOUTH ST
CARLISLE
0.92 miles
COMPARABLE NO.2
633 N HANOVER ST
CARLISLE
~
122000J~
65.14 rfJ
MLS # 10093928
300M
DESCRIPTION : + (-\$ Adlust.
CONVENTIONAL:
NO EFFECT '
09/30/03 :
AVERAGE :
FEE SIMPLE :
.13AC :
AVERAGE ;
2 STORY
-2500 VINYL
69A
AVERAGE
Total: Bdrms: Baths :
+1,000 8', 4 : 2.0 :
o 1 942 Sn. Ft. :
FULL
+1 000 UNFINISHED
AVERAGE
+2 500 GFWAlCA
SIMILAR
+2 500 2C DET GAR
-1,000 PORCH,PATIO
1 FIREPLACE
NONE
122 500
+ (- \$ Adlust.
-2330
+2410
+1000
+2 500
+2 500
-2,500
+1 500
:
Net Adl. (total) + - :$ 3500iIiI'i' - -~ ?30Jlijt- :s
Adjusted Sales Price
ot Comnarable 1$ 125500 123170 129910
Comments on Sales Comparison (including the subject property's compatibility to the neighborhood, etc ) ALL SALES ARE CLOSED TRANSACTIONS AND
DATES UTILIZED ARE SETTLEMENT DATES NOT CONTRACT DATES. ALL COMPARABLE SALES ARE CONSIDERED EQUAL
INDICA TORS OF VALUE AND WEIGHED EQUALLY IN THE FINAL RECONCILIATION. THE BEST AVAILABLE COMPARABLE SALES
WERE SELECTED AND USED FOR THIS APPRAISAl.
7410
ITEM SUBJECT COMPARABLE NO.1 COMPARABLE NO.2 COMPARABLE NO.3
Date, Price and Dala 03/10/2004 NO TRANSFERS NO TRANSFERS NO TRANSFERS
Source, for prior sales $1.00 WITHIN WITHIN WITHIN
within vear of annraisal DEED ONE YEAR ONE YEAR ONE YEAR
Analysis of any current agreement 01 sale, option, or listing of subject property and analysis of any prior sales of subject and comparables within one year of the date of appraisal:
SEE ATTACHED FIRREA ADDENDUM.
INOICATEO VALUE BY SALES COMPARISON APPROACH .... $ 125000
INDICATED VALUE BY INCOME APPROACH (if Applicablel dE~ti~;t~d M;rk~t Reni d n~ H N/A H u/M~.u~ Gr~ssRerrt Multi~li~; = S N/A
Ihis appraisal Is made [:><J 'as is" U subject to the repairs, aiterations, inspections or conditions listed below D subject 10 completion per plans & specifications.
Conditions of Appraisal: SUBJECT IS APPRAISED IN ITS PRESENT CONDITION AS OF THE TIME OF INSPECTION.
Final Reconcilialion: THE SALES COMPARISON APPROACH IS THE BEST APPROACH FOR THIS TYPE OF PROPERTY AND THE ONE FOR
WHICH THE MOST RELIABLE DATA IS AVAILABLE. THE COST APPROACH WAS NOT APPLICABLE AS NOTED ABOVE. THE INCOME
APPROACH IS N/A SINCE BUYERS ARE MORE INTERESTED IN AMENITtES THAN INCOME POTENTIAL.
The purpos~ 01 this appraisal Is 10 eslimale the market yalue of the real property that Is the subject 01 this report, based on the above conditions and the certlficatfon, contingenl
and limiting conditions, and market value definition that are stated In the attached Freddie Mac Form 439/FNMA form 1004B (Revised 6-93 )-
I (WE) ESTIMATE THE MARKET VALUE, AS DEFINED, OF THE REAL PROPERTY THAT IS THE SUBJECT OF THIS REPORT, AS OF APRIL 8 2004
- (WHICH IS THE DA~F INSPECTION AND THEEFFECTIVE OATE OF THIS REPORT) TO BE $ 126,000
APPRAISE , h t\.L SUPERVISORY APPRAISER (ONLY IF REQUIRED):
SionalUre t>J. V . q--- SIQnature 0 Old 0 Old Not
Name DANIEL A. HOFFMAN Name Inspecl Property
Date Report SIQned APRIL 15, 2004 Date Renort Sinned
State Certitlcation (/ RL-001638-L State PA Stale Certilication (/ State
Or State License (/ PA STATE CERTIFIED RESIDENTIAL State Or State License /I State
Freddie Mac Form 70 6/93
PAGE 2 OF 2
Form UA2 - 'lOT AL for Windows" appraisal sollware by a la mode, inc. -1-800-ALAMODE
Fannie Mae Form 1004 6-93
Borrower/Client ROHM LINDA
Pronertv Address 227 WEBSTER ST
City CARLISLE Countv CUMBERLAND State PA Zln Code 17013-2027
lender MEMBERS 1ST FEDERAL C.U.
Supplemental Addendum
IFile No. 0408731 Paue #61
File No 040873
PURPOSE, FUNCTION AND INTENDED USE OF THE APPRAISAL
THIS REPORT HAS BEEN PREPARED FOR USE IN A MORTGAGE FINANCE TRANSACTION BY THE LENDER/CLlENT. AS
LISTED IN THE SUBJECT SECTION OF THIS REPORT. THIS REPORT MAY ALSO BE UTILIZED BY HUD FOR ANY FHA
FINANCING FOR WHICH IT IS APPROPRIATE. THE USE BY ANY OTHER PARTY WITHOUT WRITTEN CONSENT OF THE
APPRAISER AND/OR APPRAISAL FIRM IS PROHIBITED AND VOIDS THE APPRAISAL REPORT. ANY DISCUSSION
ICONSUL T A TION WITH OTHERS REGARDING THIS APPRAISAL REPORT WilL BE DONE SO A FOR A FEE. WRITTEN
AUTHORIZATION TO DISCUSS THIS APPRAISAL REPORT MUST BE OBTAINED FROM THE LENDER/CLlENT NOTED
HEREIN PRIOR TO ANY SAID CONVERSATION.
SCOPE OF REPORT
THE APPRAISAL IS BASED ON THE INFORMATION GATHERED BY THE APPRAISER FROM PUBLIC RECORDS, OTHER
IDENTIFIED SOURCES, INSPECTION OF THE SUBJECT PROPERTY AND NEIGHBORHOOD, AND SELECTION OF
COMPARABLE SALES, LISTINGS, AND/OR RENTALS WITHIN THE SUBJECT MARKET AREA. THE ORIGINAL SOURCE
OF THE COMPARABLES IS SHOWN IN THE DATA SOURCE SECTION OF THE MARKET GRID ALONG WITH THE
SOURCE OF CONFIRMATION, IF AVAILABLE. THE ORIGINAL SOURCE IS PRESENTED FIRST. THE SOURCES AND
DATA ARE CONSIDERED RELIABLE. WHEN CONFLICTING INFORMATION WAS PROVIDED, THE SOURCE DEEMED
MOST RELIABLE HAS BEEN USED. DATA BELIEVED TO BE UNRELIABLE WAS NOT INCLUDED IN THE REPORT NOR
USED AS A BASIS FOR VALUE CONCLUSION. THE EXTENT OF ANALYSIS APPLIED TO THIS ASSIGNMENT MAY BE
FURTHER IMPARTED WITHIN THE REPORT AND/OR ANY STATEMENT OF LIMITING CONDITIONS AND APPRAISER'S
CERTIFICATION WITHIN THIS APPRAISAL REPORT.
THIS REPORT HAS UTILIZED MODERN AND ACCEPTED TECHNOLOGIES IN ORDER TO ENSURE THE EFFICIENT
PRODUCTION OF A QUALITY APPRAISAL IN A TIMELY MANNER. THESE TECHNOLOGIES MAY HAVE INCLUDED THE
USE OF DIGITAL MAPPING, AND/OR DIGITAL SIGNATURES. PLEASE BE ADVISED, THAT IF DIGITAL PHOTOGRAPHS
HAVE BEEN UTILIZED, AS PER APPRAISAL GUIDELINES, WE CERTIFY THAT NO TOUCH-UPS OR MODIFICATIONS
HAVE BEEN PERFORMED TO THE PICTURES WITH THE EXCEPTION OF ACCEPTED DARKENING OR LIGHTENING AS
MAY HAVE BEEN REQUIRED FOR CLARITY. ALL DIGITAUELECTRONIC SIGNATURES IN THIS REPORT HAVE A
SECURITY FEATURE MAINTAINED BY INDIVIDUAL PASSWORDS FOR EACH SIGNING APPRAISER. NO PERSON CAN
ALTER THE APPRAISAL REPORT WITH THE EXCEPTION OF THE SIGNING APPRAISER.
ADDITIONAL FEATURES
THE SUBJECT IS A WELL MAINTAINED CAPE COD STYLE HOME WITH A NORMAL AND ACCEPTED FLOOR PLAN FOR
THIS TYPE OF HOUSE. MAIN ENTRY IS FROM THE FRONT PORCH WHICH OPENS INTO THE FOYER. THERE IS A
DINING ROOM TO THE LEFT, WITH A LIVING ROOM TO THE RIGHT. BOTH HAVE CARPETED FLOORS WHILE THE
LIVING ROOM HAS A FIREPLACE. THE KITCHEN IS TO THE REAR AND HAS A VINYL FLOOR, "L" SHAPED DESIGN, AND
WOOD CABINETS. THERE IS A FULL BATH AND LAUNDRY ROOM TO THE REAR. THE RIGHT SIDE OF THE HOUSE
HAS AN ATTACHED 1 CAR GARAGE. THE UPPER LEVEL CONSISTS OF 3 BEDROOMS AND THE MAIN BATH. THE 2
FRONT BEDROOMS EACH HAVE A DORMER WINDOW, AND ALL ARE CARPETED. THE HOME IS BUILT ON A FULL
BASEMENT WHICH IS PARTIALLY FINISHED INTO A REC ROOM. DUE TO THE CONDITION, MINIMAL VALUE WAS
ASSIGNED. THE PRECEDING MENTIONED AS ADDITIONAL FEATURES MAY OR MAY NOT WARRANT INDIVIDUAL
ADJUSTMENTS IN THE COST OF SALES ANALYSIS. THEY WERE WORTHY OF MENTION BECAUSE THEY DO INDEED
AFFECT THE COST OF CONSTRUCTION, QUALITY OF CONSTRUCTION, APPEAL, UTILITY AND MARKETABIliTY OF
THE PROPERTY. IF ANY ADJUSTMENTS ARE REQUIRED THEY WILL BE TAKEN IN THESE CATEGORIES.
JOHN ADAMS HAS PROVIDED SIGNIFICANT PROFESSIONAL ASSISTANCE IN ONE OR MORE OF THE FOLLOWING
AREAS, SUBJECT/COMPARABLE DATA RESEARCH, VISUAL INSPECTIONS, REPORT PREPARATION, AND OR
OVERALL APPRAISAL REVIEW IN THE PREPARATION, AND/OR OVERALL APPRAISAL REVIEW.
Form TADO - "TOTAL for Windows' appraisal software by a la mode, Inc. -1-800-ALAMODE
Subject Photo Page
/Fiie No. 0408731 Page #7
liD Code 17013-2027
~rro~jlrLC11~nU~QfiM,!oI~J~_A___ _
rL~rtv Address 227 WEBSTER ST
J;i!Y CARLJSLE___ Gounlv CUMBERLAND
Lender MEMBERS 1ST FEDERAL C.U.
State PA
I.
Form PIG4x6.SR - "TOTAL for Windows" appraisal soffware by a la mode, Inc. -1-BOO-AlAMODE
Subject Front
227 WEBSTER ST
Sales Price RE-FI
GLA 1,709
Total Rooms 6
Total Bedrms 3
Total Bathrms 2.0
Location AVERAGE
View AVERAGE
S~e .19 AC
Quality ALUMINUM
Age 65A
Subject Rear
Subject Street
IFlle No. 0408731 Pane #81
Building Sketch (Page - 1)
Borrower/Client ROHM LINDA
ProDertv Address 227 WEBSTER ST
Citv CARLISLE County CUMBERLAND Slate PA lin Code 17013-2027
Lender MEMBERS 1ST FEDERAL C.U.
17.0'
15.0'
8.0' I Ldry Bath I 9.0' 26.0'
1 C Garage
Kitchen
25.0' Living Rm
17.0'
Dining Rm Foyer
I~~~~ J 20.0'
8.0' 6.0'
'.
~.
l.'
SKETCH CALCULATIONS
Living Area
First Floor 851.0
Second Floor 858.0
Total Living Area 1709.0
Garage Area
Attached Garage : 442.0
Total Garago Aroa 442.0
Porch Area
Porch 24.0
Form SKT.BldSkl- "TOTAL for Windows" appraisal softWare by a la mode, inc. - l-BOO-ALAMODE
Comparable Photo Page
!File No. 0408731 Paae #10
!!Qrrower/~1lI ROHMJINDA
!'r9P~!\!!i!rJl!~_227 WEBSTER ~T_~_____
~Itv CARLI~L. Countv CUMBERLAND
Lender MEMBERS 1ST FEDERAL C.U.
Stare PA
liD Gode 17013-2027
Form PIG4x6.CA - 'TOTAL for Windows' appraisal software by a la mode, Inc. -l-SOO-ALAMOOE
Comparable 1
69 E ST
Proximity 0.44 miles
Sale Price 122,000
GLA 1,616
Total Rooms 6
Total Bedrms 3
Tolal Bathrms 1.5
Location AVERAGE
View AVERAGE
SlIe 17 AC
Quality BRICK
Age 56A
Comparable 2
633 N HANOVER ST
Proximity 0.12 miles
Sale Price 126,500
GLA 1,942
T ola\ Rooms 8
Total Bedrms 4
Total Bathrrns 2.0
Location AVERAGE
View AVERAGE
SlIe .13 AC
Quality VINYL
Age 69A
Comparable 3
230 W SOUTH 5T
Proximity 0.92 miles
Sale Price 122,500
GLA 1,46B
Total Rooms 6
Total Bedrrns 3
Total Bathrms 1.2
Location AVERAGE
View AVERAGE
SlIe 13 AC
Quality VI NYL
Age 99A
IFile No. 040873\ Paoe #91
Building Sketch (Page - 2)
Borrowe,.lClient ROHM LINDA
Pronertv Mdress 227 WEBSTER ST
Citv CARLISLE Countv CUMBERLAND Slale P A Zin Code 17013-2027
lender MEMBERS 1ST FEDERAL C.U.
21.0'
12.0' Bedroom 14.0'
22.0'
6.0' Bath 17.0'
Bedroom 17.0'
13.0' Bedroom
32.0'
'.
-~, --
" -
;
Form SKT.BldSkl- "TOTAL for Windows" appraisal software by a la mode, inc. -1-800-ALAMODE
!File No. 0408731 Paae #11
Location Map
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e!J!P!r!Y!Q!lress 227 WEBSTER ST
~RlISLE
lender MEMBERS 1ST FEDERAL C.U.
Slate PA
ZIo Code 17013-2027
Countv CUMBERLAND
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Fonn MAP.lOC - 'TOTAL lor Windows' appraisal software by a la mode, Inc. -l-BOD-ALAMODE
IFile No. 0408731 Paoe #121
DEFINITION OF MARKET VALUE: The most probable price which a property should bring in a competitive and open market under all conditions
requisite to a tair sale, the buyer and seller, each acting prudently, knowledgeably and assuming the pnce is not affected by undue stimulus. Implicit in this
definition is the consummation of a sale as of a specified date and the passing of title trom seller to buyer under conditions whereby: (1) buyer and seller are
typically motivated; (2) both parties are well informed or well advised, and each acting in what he considers his own best inlerest; (3) a reasonable time is allowed
for exposure in the open market; (4) payment is made in terms of cash In U.S. dollars or In terms of financial arrangements comparable thereto; and (5) the price
represents the normal consideration for the property sold unaffected by special or creative financing or sales concessions. granted by anyone associated with
the sale.
. Adjustments to the comparables must be made for special or creative financing or sales concessions. No adjustments are necessary
lor those costs which are normally paid by sellers as a result of tradition or law in a market area; these costs are readily identifiable
since Ihe seller pays these costs in virtually all sales transactions. Special or creative 1inancing adjustments can be made to the
comparable property by comparisons to 1inancing terms offered by a third party institutional lender that is not already involved in the
property or transaction. Any adjustment should not be calculated on a mechanical dollar for dollar cost of the 1inancing or concession
but the dollar amount of any adjustment should approximate the market's reaction to the financing or concessions based on the
appraiser's judgement.
STATEMENT OF LIMITING CONDITIONS AND APPRAISER'S CERTIFICATION
CONTINGENT AND LIMITING CONDITIONS: The appraiser's certification that appears In the appraisal report Is subject to the following
conditions;
1. The appraiser will not be responsible for matlers of a legal nature that affect either the property being appraised or the title to it. The appraiser assumes that
the title is good and marketable and. therefore, will not render any opinions about tha title. The property is appraised on the basis ot It belng under responsible
ownership
2. The appraiser has provided a sketch in the appraisal report to show approximate dimensions of the improvements and Ihe sketch is included only to assist
the reader of the report in visualizing the property and understanding the appraiser's detennination of its size.
3. The appraiser has examined the available flood maps that are provided by the Federal Emergency Management Agency (or other data sources) and has noted
In the appraisal report whether the subject site is tocated in an klentified Special Flood Hazard Area. Because the appraiser Is not a surveyor, he or she makes
no guarantees, express or implied, regarding this detenminatlon.
4. The appraiser will not give testimony or appear in court because he or she made an appraisal of the property in question, unless specific arrangements to do
so have been made beforehand.
5. The appraiser has estimated Ihe value of the land in the cost approach at its highest and best use and the improvements at their contributory value. These
separate valuations ot the land and improvements must not be used In conjunction with any other appraisal and are Invalid If they are so used.
6. The appraiser has noted in the appraisal report any adverse conditions (such as, needed repairs, depreciation:'lhe. presence of hazardous wastes, toxic
substances, etc.) observed during Ihe inspection 01 the subject property or that he or she became aware of during the normal research involved' in perfonning
the appraisal. Unless otherwise stated in the appraisal report, the appraiser has no knowledge of any hidden or unapparent conditions of the property or
adverse environmental conditions (including the presence of hazardous wastes, toxic substances, etc.) that would make the property more or less valuable, and
has assumed that there are no such conditions and makes no guarantees or warranties, express or Implied, regarding the condition of the property. The
appraiser will not be responsible for any such conditions that do exist or for any engineering or testing that might be required to discover whether such
conditions exist. Because the appraiser is not an expert In the field of environmental hazards, the appraisal report must not be considered as an
environmental assessment of the property.
7. The appraiser obtained the information, estimates, and opinions that were expressed in the appraisal report from sources that he or she considers to be
reliable and believes them to be true and correct. The appraiser does not assume responsibility for the accuracy of such items that were furnished by other
parties.
8. The appraiser will not disclose the contents of the appraisal report except as provided for in the Uniform Standards of Professional Appraisal Practice.
9. The appraiser has based his or her appraisal report and valuation conclusion for an appraisal that is subject to satisfactory completion, repairs, or
alterations on the assumption that completion of the improvements will be performed in a workmanlike manner.
10. The appraiser must provide his or her prior writlen consent before the lender/client specified in the appraisal report can distribute the apprals~1 report
(including conclusions about the property value, the appraiser's identity and professional designations, and re1erences to any protesslonal appraisal
organizations or the firm with which the appraiser is associated) to anyone other than the borrower; the mortgagee or Its successors and assigns; the mortgage
insurer; consultants; professional appraisal organizations; any state or federally approved financial institution; or any department, agency, or instrumentality
of the United States or any state or the District of; Columbia; except that the lender/Client may distribute the property description section of the report only to data
colieclion or reporting service(s) without having to obtain the appraiser's prior writlen consent. The appraiser's writlen consent and approval must also
be obtained belore the appraisal can be conveyed by anyone to the public through advertising, public relations, news, sales, or other media.
Freddie Mac form 439 6-93
Page t of 2
Fannie Mae Fann 1004B 6-93
The Dynamic Team, Inc (717) 932-8028
Form ACR - "TOTAL for Windows' appraisal software by a la mode, Inc. -1-800-ALAMOOE
/File No. 0408731 Paoe #131
APPRAISER'S CERTIFICATION: The Appraiser certilies and agrees that
1. I have researched the subject market area and have selected a minimum of three recent sales of properties most similar and proximate to the subject property
for consideration in the sales comparison analysis and have made a dollar adjustment when appropriate to reflect the market reaction to those lIems of significant
variation. If a significant item in a comparable property is superior to, or more favorable than, the subject property, I have made a negative adjustment to reduce
the adjusted sales price of Ihe comparable and, If a significant Item In a comparable property Is inferior to, or less favorable than the subject property, I have made
a positive adjustment to Increase the adjusted sales plice of the comparable.
2. I have taken inlo consideration the factors that have an impact on value In my development of the estimate of market value In the appraisal report. I have not
knowingly withheld any significant Information from the appralsat report and I believe, to the besl of my knowtedge, that all statements and information In the
appraisal report are true and correct.
3. I stated In the appraisal report only my own personal, unbiased, and professional analysis, opinions, and conclusions, which are subject only to the contingent
and limiting conditions specified In this form.
4. I have no present or prospective Interest In the property that is the subject to this report, and I have no present or prospective personal Interest or bias with
respect to the participants in tl1e transaction. I did not base, either partially or completely, my analysis and/or the estimate of market value In the appraisal report
on the race, color, religion, sex, handicap, familial status, or national origin 01 either the prospective owners or occupants of the subject property or of the present
owners or occupants of the properties In the vicinity of the subject property.
5. I have no present or contemplated future interest In the subject property, and neither my current or future employment nor my compensation for performing this
appraisal Is conllngent on the appraised value of the property.
6. I was not required to report a predetermined value or direction in value that favors the cause of the client or any related party, the amount of the value estimale,
the attainment of a specific result, or the occurrence of a subsequent event In order to receive my compensation and/or employment for performing the appraisal. I
did not base the appraisal report on a requested minimum valuation, a specific valuation, or the need to approve a specific mortgage loan.
7. I pertormed this appraisal In conformity with the Uniform Standards of Professional Appraisal Practice that were adopted and promulgated by the Appraisal
Standards Board of The Appraisal Foundation and that were In place as of the eflective date 01 this appraisal, with the exception of the departure provision of those
Standards, which does not apply. I acknowledge that an estimate 01 a reasonable time for exposure In the open market Is a condition In the definition of market value
and the estimate I developed Is consistent with the marketing time noled In Ihe neighborhood section of this report, unless I have otherwise stated In the
reconciliation section.
8. I have personally inspected the Interior and exterior areas 01 the subject property and the exterior of all properties listed as comparables In the appraisal report.
I further certify that I have noted any apparent or known adverse conditions In the subject Improvements, on the subject slle, or on any site within the immediate
vicinity of the subject property of which I am aware and have made adjustments for these adverse conditions In my analysis of the property value to the extent thai
I had market evidence to support them. I have also commented aboul the effect of the adverse conditions on the marketability of the subject property.
9. I personally prepared alt conclusions and opinions about the real estate that were set forth In the appraisal report. If I relied on significant professional
assistance from any Individual or individuals In the performance of the appraisal or the preparation 01 Ihe appraisal report, I have named such indlvlduat(s) and
disclosed the specific tasks performed by them in the reconciliation section of this appraisal report. I certify that any individual so named Is qualified to perform
the tasks. I have not authorized anyone 10 make a change 10 any lIem in the report: therelore, If an unauthorized change..ls made to the appraisal report, I will take
no responsibility for It. --'-
SUPERVISORY APPRAISER'S CERTIFICATION: If a supervisory appraiser signed the appraisal report, he or she certifies and agrees that:
I directly supervise the appraiser who prepared the appraisal report, have reviewed the appraisal report, agree with the statements and conclusions of the appraiser,
agree 10 be bound by the appraiser's certifications numbered 4 through 7 above, and am taking full responsibility for the appraisal and the appraisal report.
ADDRESS OF PROPERTY APPRAISED: :m WEBSTER ST, CARLISLE, PA 17013-2027
APPRAISER:
CiJ~ (J~
SUPERVISORY APPRAISER (onl, If required):
Signature: _
Name: ___
Date Signed: APRIL 1~004
State Certification #: R L -00 1638-L
or State license #: PA STATE CERTIFIED RESIDENTIAL
State: PA
Expiration Date of Certification or License: 6/30/2005
DANIEL A. HOFFMAN
Signature:
Name:
Date Signed:
State Certification #:
or Stale license #:
State:
Expiration Date 01 Certification or license:
o Did
o Old Nollnspect Property
Freddie Mac form 439 6-93
Page 2 of 2
Fannie Mae Form loo4B 6-93
Form ACR - "TOTAL for Windows' appraisal soflware by a /a mode, inc, -1-800-ALAMODE
SUMMARY OF SALIENT FEATURES
Subjecll\ddress 227 WEBSTER ST
Legal Description ATTACHED DEED 262-1188
City CARLISLE
County CUMBERLAND
Slate PA
Zip Code 17013-2027
Census Tract 0121.00
Map Reference SEE APN
Sale Price $ RE-FI
Date of Sale N/A
Borrower I Client ROHM,UNDA
Lender MEMBERS 1ST FEDERAL C.U.
Size (Square Feet) 1,709
Price per Square Foot $
Location AVERAGE
Age 65A -,.
Condttion AVERAGE
Total Rooms 6
Bedrooms 3
Baths 2.0
Appraiser DANIEL A. HOFFMAN
Date of Appraised Value APRIL 8, 2004
Final Estimate of Value
$ 125,000
Form SSD - 'TOTAL lor Windows' appraisal software by a la mode, inc. -1-BOO-ALAMODE
Ifile No. 0408731 Paoe #21
REV-1511 EX+ (12-99)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
KELLER, CHLOE E.
FILE NUMBER
21-04-0725
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
Hoffman-Roth Funeral Home, funeral
Cumberland Valley Memorial Gardens, grave opening
5,864.50
995.00
2.
B. ADMINISTRATIVE COSTS:
1. 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:
2. Attorney Fees
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
State
Zip
Relationship of Claimant to Decedent
4.
Probate Fees
307.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
9.
US Department of Revenue, tax on deferred Series E/EE bond interest. See attachment to Schedule E
95.27
75.00
15,124.95
8.
The Sentinel, Executrix notice
Cumberland Law Journal, Executrix notice
7.
TOTAL (Also enter on line 9, Recapitulation) $
22,461.72
(If more space is needed, insert additional sheets of the same size)
.. 1 r, ..
REV-1512 EX+ (12-03)
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
KELLER, CHLOE E.
FILE NUMBER
21-04-0725
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
Belvedere Medical Corporation, unreimbursed medical expense
47.53
2.
CV Nephrologh Associates, unreimbursed medical expense
15.31
3.
Spring Road Family Practice, unreimbursed medical expense
18.36
4.
Belvedere Medical Corporation, unreimbursed medical expense
24.06
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
105.26
...' . I, "
REV-1513 EX+ (9-00) f.
~iJ~~~_
~
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
KELLER, CHLOE E
Daughter !z Remainder
Daughter !z Remainder
Grand-daughter $5,000.00
Grandson $5,000.00
Grandson $5,000.00
Grandson $5,000.00
NUMBER
I
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
FILE NUMBER
21-04-0725
AMOUNT OR SHARE
OF ESTATE
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS:
A SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
Karen S. Meyerhoeffer
48 Eastover Blvd, Mt Sidney VA 24467
Linda A. Rohm
227 Webster St, Carlisle PA 17013
Tammera Z. Flint
33 Spring Ct, Waynesboro VA 22980
Joel T. Souders
61 Harper St, Weyers Cave VA 24486
Brian W. Rohm
227 Webster st, Carlisle PA 17013
Daniel L. Rohm
2977 Enola Rd, Carlisle PA 17013
2.
3.
4.
5.
6.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
EAU OF INDIVIDUAL TAXES
RITANCE TAX DIVISION
OX 280601
ISBURG PA 17126-0601
LINDA A ROHM
227 WEBSTER ST
CARLISLE
ALONG THIS LINE
PA 17013
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
,.
REV-1547 EX AFP
06-27-2005
KELLER
07-12-2004
21 04-0725
CUMBERLAND
101
APPEAL DATE: 08-26-2005
( See reverse side under Ohjections)
Amount Remittedl' (P89- II I
MAKE CHECK PAYABLE AND REMIT PAYMENT 1
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
CHLOE
--+ RETAIN LOWER PORTION FOR YOUR RECORn~ .
-
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAl- TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11.9Bl
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ROHM LINDA ANN &
MEYERHOEFFER KAREN S
227 WEBSTER STREET
CARLISLE, PA 17013
----^---I<)ld
ESTATE INFORMATION: SSN: 174-05-0739
FILE NUMBER: 2104-0725
DECEDENT NAME: KELLER CHLOE E
DATE OF PAYMENT: 06/27/2005
POSTMARK DATE: 06/27/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 07/12/2004
NO. CD 005484
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $689.11
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: LINDA A ROHN AND
KAREN MEYERHOEFFER
CHECK#104
SEAL
INITIALS: SK
RECEIVED BY:
REGISTER OF WILLS
$689.11
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
IIUIlEAlI OF INDIVIDUAL rDIJIB)D!:D orFICE or
_ITAIlCE TAlI DIVISIlII nwun '- r ' I
PO lOX 211601 DE~I""'''''r'rD 0F \1,/!ll ('
....ISIURS PA 17121-0601 I! v:~ 1 t: I ;.....1 ',I,/'. ~._.)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
'*
REV-1607 EX AFP C05-05)
2005 JUL 22 PI"l 2: 12
DATE
ESTATE OF
DATE OF DEATH
. FILE NUMBER
COUNTY
ACN
07-18-2005
KELLER
07-12-2004
21 04-0725
CUMBERLAND
101
~t ...ittlld
CHLOE
E
CLERK OF
~gPH/,.r\!'S COl JRT
~~~D:E:S~~~lC~l' /' r:-
CARLISLE PA 17013
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To in..... p~r crlldit to )lour _t, lIUblIlt tM _r portion of th18 fora with )lour t... ...~t.
CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS ...
---------------------------~-----------------------------------------------
REV-1607 EX AFP (03-05) ... I"HERITANCE TAX STATEMENT OF ACCOUNT ...
UTATE OF KELLER CHLOE E FlU NO.21 04-0725 ACN 101 DATE 07-18-2005
THD STATEIlEIIT IS PROVIDED TO ADVISE OF THE CUUENT STATUS OF THE STATED ACN IN TIlE ~ ESTATE. SIlOlIN BELOII
IS A SUlllARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND,IF APPLICABLE,
A PIlO.IECTED INTEREST FIIUIlE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 06-27-2005
PRINCIPAL TAX DUE: 9,342.15
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
08-04-2004 CD004233 394.74 7,500.00
04-01-2005 CD005148 .00 766.79
06-27-2005 CD005484 7.09- 689 . 11
TOTAL TAX CREDIT 9.343.55
BALANCE OF TAX DUE 1.40CR
INTEREST AND PEN. .00
. IF PAID AFTER THIS DATE. SEE REVERSE TOTAL DUE 1.40CR
SIDE FOR CALCULATION OF ADDITIOMl\L INTEREST.
( IF TOTAL DUE IS LESS THAH .1,
NO PAYMENT IS REllUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (eRl.
YOU MY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOIlll FOR INSTRUCTIONS. l
"'5K
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NDTICE DF INHERITANCE TAX
APPRAISEMENT, ALLDWANCE DR DISALLOWANCE
DF DEDUCTIONS AND ASSESSMENT DF TAX
06-27-2005
KELLER
07-12-2004
21 04-0725
CUMBERLAND
101
APPEAL DATE: 08-26-2005
( See reverse side under Objections)
Amount ReBittedl I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE _ RETAIN LOWER PORn ON FOR YOUR RECORDS _
REy:is4;-Ex-AFP-lo3:osi-NOTICE-OF-INHERITANCE-TAX-APPRAIsEMENT:-ALLowANCE-OR---------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
CHLOE E FILE NO. 21 04-0725 ACN 101
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
BUREAU DF INDIVIDOAlTAKES
INI-ERITANCE TAX DIVISION ., .
PO BOX 280601
HARRISBURG PA 17128-0601
,,' ; j: 33
r,.'
LINDA A ROHM
227 WEBSTER ST
CARLISLE
PA 17013
ESTATE OF
KELLER
TAX RETURN WAS: (
I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..l Estate (Schedula AI
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. C.shJB.nk Deposits/Hisc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. T~sf.rs (Schedule Gl
8. Total Assets
( X I CHANGED
SEE
III
(21
(31
('II
(51
(61
(71
.00
1. 085 . 00
.00
.00
56.683.66
32.276.65
125,000.00
(81
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral ExPens.s/A~. Costs/Hisc. Expenses (Schedule H)
10. Debts/Ho~tgego Liabilities/Lions (Schedule II
11. Totel Deductions
12. Net Value of Tax Return
13. CharltablalGov.r~nt.l Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estat. Subject to Tax
I~ an asses~ent was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
re~lect ~1gures that include the total o~ ALL returns assessed to date.
ASSESSMENT OF TAX:
IS. A~unt of Line 14 at Spousal rat. lIS)
16. A.ount of Line 14 taxable at Lineal/Class A rat. (16)
17. Amount of Line 1'1 .t Sibling ~te 1171
18. ~ount of Line 14 taxable at Collateral/Class Brat. (18)
19. Principal Tax Due
NOTE:
+
INTEREST/PEN PAID (-I
394.74
.00
DATE
08-04-2004
04-01-2005
lU1BER
CD004233
CD005148
~
INTEREST IS CHARGED THROUGH 07-12-2005
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
(91
1101
7,336.77
00 =
045 =
12 =
15 =
1191=
*'
REV-1547 EX AFP (06-05)
CHLOE
E
105.26
1111
1121
1131
11'11
.00 X
207,603.28 X
.00 X
.00 X
AMOUNT PAID
7,500.00
766.79
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
DATE 06-27-2005
ATTACHED NOTICE
NOTE: To insure proper
credit to your account,
su~it the upper portion
of this for. with your
tax pay_nt.
215,045.31
7.44? 03
207,603.28
.00
207,603.28
.00
9,342.15
.00
.00
9,342.15
8,661. 53
680.62
8.49
689 . 11
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FDR CALCULATIDN DF ADDITIONAL INTEREST.
IF TDTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TDTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE DF THIS FDHN FDR INSTRUCTIONS.I
REV-'470 EX (8-88)
'*
INHERITANCE TAX
EXPLANATION
OF CHANGES
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG PA 17128-0001
DECEDENT'S NAME
.
FILE NUMBER
Chloe E Keller
REVIEWED BY
Deborah Washington
ACN
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
H B-9 Reduced to zero. Fiduciary income taxes are not allowable deductions for
Pennsylvania inheritance tax purposes.
H
ROW
2104-0725
101
Page 1
INRE:
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYL VANIA
ESTATE OF CHLOE E. KELLER,
Deceased
ORPHANS' COURT DIVISION
NO. 21-04-0725
FIRST AND FINAL ACCOUNT OF KAREN S. MEYERHOEFFER
AND LINDA A. ROHM, EXECUTRIX
OF THE ESTATE OF CHLOE E. KELLER
LATE OF BOROUGH OF CARUSLE
CUMBERLAND COUNTY, PENNSYLVANIA
Date of Death: July 12, 2004
Letters Testamentary Granted: August 4, 2004
Letters Advertised: Sentinel - October 14, 21, 28, 2004
Cumberland Law Joumal- September 10, 17,24,2004
Account Stated as Final
SUMMARY & INDEX
PRINCIP AL PAGE
Receipts 2 147,081.57
Conversions (Gain) or (Loss) 2 -13,167.07
Less Disbursements 2 1,704.96
Balance Before Distributions 132,209.54
Advancements to Beneficiaries 3 21,085.00
Principal Balance Remaining 111,124.54
INCOME
Receipts 3 2,165.02
Less Disbursements 3 ~
Income Balance Remaining lli5.02
COMBINED BALANCE REMAINING 113,289.56
..1
-It 'I L ,., r',"\l"'
8S :(;, 'iCJ - J .::uuir
q -.''-
jiJ j:JIJJ:;J t]j(]UC)JJu
RECEIPTS OF PRINCIPAL
2004
7/12 Member's I sl Federal Credit Union - checking account # 197805-11 1,823.91
7/12 Member's 1st Federal Credit Union - savings account #197805-00 328.01
7/12 Member's 1st Federal Credit Union - investment savings account #197805-05 64,019.74
7/12 Member's 1st Federal Credit Union - certificate of deposit #197805-41 23,158.25
7/12 US Treasury Department - H/HH bonds 55,500.00
7/12 The MONY Group - 35 shares, cash consideration value 1,085.00
2005
1/20 The Hearst Corporation - subscription refund 3.66
3/24 Sale of personal property 466.00
4/28 US Department of Revenue - income tax refund 697.00
TOTALRECEWTSOF PRINCWAL 147,081.57
PRINCIP AL CONVERSIONS
2004 GAIN LOSS
7/15 Member's I st Federal Credit Union - checking -.-
account #197805-1 I Proceeds 453.14
I Account Value 1823.91 1,370.77
8/4 The MONY Group - 35 shares
I Proceeds 1,085.00
I Account Value 1,085.00 0.00 0.00
11/24 Member's I st Federal Credit Union- savings
account # 197805-00 Proceeds 329.23
I Account Value 328.01 1.22
11/24 Member's I st Federal Credit Union-
investment savings account # 197805-05
Proceeds 51,794.37
I Account Value 64,019.74 12,225.37
2005
2/22 Member's I st Federal Credit Union - certificate
of deposit # 197805-41 Proceeds 23,586.10
I Account Value 23,158.25 427.85
3/10 US Treasury Department - H/HH bonds
I Proceeds 55,500.00
I Account Value 55,500.00 0.00 0.00
NET LOSS ON CONVERSIONS 13,167.07
DISBURSEMENTS OF PRINCIPAL
2004
12/22 Belvedere Medical Corporation - unpaid account 24.06
2005
4/1 Register of Wills - Pennsylvania inheritance tax 766.79
6/27 Register of Wills - balance, Pennsylvania inheritance tax 689.11
10/4 Patricia Rosendale - fiduciary tax returns 225.00
TOTAL DISBURSEMENTS OF PRINCIPAL 1,704.96 I
RECEIPTS OF INCOME
Member's I st Federal Credit Union - interest, account #254871-05
lIm
2
12/31 Member's I sl Federal Credit Union- interest, account #254871-05 47.20
12/31 Member's 1st Federal Credit Union- interest, account #254871-11 1.51
2005
1/31 Member's 15t Federal Credit Union - interest, account #254871-05 38.47
2/28 Member's 15t Federal Credit Union - interest, account #254871-05 42.87
3/24 US Treasury Department - interest, series H/HH bonds 1,110.00
3/31 Member's 1st Federal Credit Union- interest, account #254871-05 121.03
4/30 Member's 15t Federal Credit Union - interest, account #254871-05 146.30
5/31 Member's 1 st Federal Credit Union - interest, account #254871-05 152.22
6/30 Member's 1 sl Federal Credit Union - interest, account #254871-05 147.51
7/31 Member's 1 sf Federal Credit Union - interest, account #254871-05 171.82
8/31 Member's 15t Federal Credit Union - interest, account #254871-05 172.08
TOTAL RECEIPTS OF INCOME 2,165.02
2004-05 I None
I TOTAL DISBURSEMENTS OF INCOME
DrSBURSEMENTS OF INCOME
I
1
~
=00
ADV ANCEMENTS TO BENEFICIARIES
2004
8/4 Linda A. Rohm - cash 542.50
8/4 Karen S. Meyerhoeffer - cash 542.50
12/24 Tammera Z. Flint - cash 5,000.00
12/24 Joel T. Souders - cash 5,000.00
12/24 Brian W. Rohm - cash 5,000.00
12/24 Daniel L. Rohm - cash i,Q00.00
TOTAL ADVANCEMENTS TO BENEFICIARIES 21,085.00
JL,dO>-' ,.1. Zdn'"L _
Linda A. Rohm, Executrix
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
Karen S. Meyerhoeffer and Linda A. Rohm, being duly sworn according to law, deposes and says
that the Account as stated is true and correct, and that the Grant of Letters Testamentary and the first
complete advertisement thereof occurred more than four (4) months before the filing of the Account.
~~r~.1 "'/;/-
t}f,., d~ !Iv ~~.r~/Y!._
Linda A. Rohm
Sworn and subscribed to before
;:0his. ~ day of
\(' 2005
,
""OMMONWEALTH Of PENNSYLVANIA\
- ~EAL
NOTAR!AL ;) Public :
DAWN M. SHUGHART. Notary C unty ,
Boro of Cart Isle, Cumberland 02006
Mv ~~,:,,~~~i<:l.~.~X.P~~~~.~:Y.',t~--
4
IN RE
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ESTATE OF CHLOE E. KELLER,
Deceased
ORPHANS' COURT DIVISION
NO. 2]-04-0725
Combined Balance for
Distribution Remaining as per
First and Final Account LU,2~~=i6
TO: Karen S. Meyerhoeffer - cash 56,644.78
Linda A. Rohm - cash 56,644.78
TOTAL BALANCE FOR
DISTRIBUTION H3,282.56
SCHEDULE OF PROPOSED DISTRIBUTION
STATEMENT OF THE REASONS FOR THE PROPOSED DISTRIBUTION
The above distribution is proposed in accordance with the Last Will and Testament of Chloe
E. Keller.
aren S. Meyerhoe . er, Exec
~d-~. A ~4/Y7 _
Linda A. Rohm, Executrix '-
.-----
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
Karen S. Meyerhoeffer and Linda A. Rohm, being duly sworn according to law, deposes and says
that the facts set forth in the Statement of the Reasons for the Proposed Distribution are true and correct.
. "fH Of PENNSYLVANIA
'OMMONWEAL _ \
:-:::. NOTARIAL SEAL Public I
DAWN M. SHUG~~~b~n~~J County ,
Boro of Carlisle....... " c Nov. 28, 2006
Mv Comn.:!sslon tYDI,e, ~
-,~.~.,,,;..~..,..~,-,,. .,,,,"
~~~-
Karen S. Meyerho fer
~d:L ,I/, %::s;(~
Linda A. Rohm
Sworn and ~scribed to before
,Vltttt1is ~ day of
I~~ - ,2005
r
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