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HomeMy WebLinkAbout06-30-11J 1505610101 REV-1500 Ex `°1.1°' ' enns lvania OFFICIAL USE ONLX _ PA Department of Revenue p y County Code Year s File Number Bureau of Individual Taxes DEPARTMENT OF REVENUE PO Box Z8o6oi INHERITANCE TAX RETURN .~ Harrisburg, PA 1128-0601 RESIDENT DECEDENT _ ~ 1 1 1 0 4 6 4 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 1 8 6 3 0 5 7" 7 3 0 4 0 4 2 0 'l 1 0 3 1 8 1 9 3 5 Decedent's Last Name Suffix Decedent's First Name MI B l e m l e r S r. F r a n k E" (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ® 1. Original Return p 2. Supplemental Return Q 3. Remainder F;eturn (date of death prior to 12-13-8:?) p 4. Limited Estate p 4a. Future Interest Compromise (date of Q 5. Federal Estate Tax Return Required death after 12-12-82) ~ 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) Q 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED ~,,0~ Name Daytime Telephone(-V~mber ~=- ' ~~ ~ ___. ~~ n t h o n y ,L. D e L u c a E s q. 7 1 7 2 ~~-' 6 4 ;~-~ REGISTER OE~NJf~#S?USE OAI15,Y ~~,~ ;..~~ First line of address :_ J ~.7 `f 2 ~ TM ~ r~z ~~~~~ n ,_, , _ _. _ _.-- -.f_.~ c .T -,~ ~ ~ 1 1' 3 F r v n t S t r e q, e t -~ ., .~ ~"~' Second line of address ~-~ "~ ~ ~~ ~.:: 'P`O B o x 3 5 8 City or Post Office State ZIP Code DATE FILEC) B o i l i n g S p r i n g s P A 1 7 0 0 7 Correspondent's a-mail address: Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal re sentative is based on all information of which prep;arer has any knowledge. ATURE OF ERSO RE ONSIBLE F FI TURN ~/ ~/''y C- ` ADDRESS SIGNA RE O RER OT RAN R N IVE ~ ~~ C-ATE f ~~ L -T-~ PLEASE USE ORIGI AL FORM ONLY Side 1 1505610101 150561010:L _.~ °~ J REV-1500 EX Decedent's Name: RECAPITULATION ~~ 1. Real Estate (Schedule A) ............................................. 1. 1 1 0 6 i 4 1 0 0 2. Stocks and Bonds (Schedule B) ....................................... 2. 7 4 , 2 0 4 9 ' 6 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3.. 0 + ~ 0 4. Mortgages and Notes Fteceivabte (Schedule D) ........................... 4. 0 , 0 0 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. 1 9 8 , ~ 9 8 ' 1 4 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ....... 6. 0 •. 0 0 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) Q Separate Billing Requested........ 7. 2 '7 7~ 4 7 2 ~ 5 9 8. Total Gross Assets (total Lines 1 through 7) ............................. 8. 6 6 1 , 0 1 6 • 6 9 9. Funeral Expenses and Administrative Costs (Schedule H) ................... 9. 2 '] ~~ r- 4 7 ~ 4 4 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) .............. 10. 2 , f~ 3 3 3 8 11. Total Deductions (total Lines 9 and 10) ................................. 11. 3 0 ~~ ~~ $ 0 • 3 2 12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. 6 3 0 , 4 3 5 • 8 7 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ........................ 13. 0 ,• 0 0 14. Net Value Subject to Tax (Line 12 minus Line 13) ........................ 14. 6 ~ 0 ~ ~ 3 5 • $ 7 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x .0~ 6 3 0, 4 3 5. 8 7 15. 2 8, 3 6 9 6 1 16. Amount of Line 14 taxable at lineal rate X .0 _ + 16. 0 0 ' 0 17. Amount of Line 14 taxable at sibling rate X .12 . 17. ~ 0 . 0 0 18. Amount of Line 14 taxable , .: ;: at collateral rate X .15 • 1 g. ~ ~ 0 0 ,, 19. TAX DUE ......................................................... 19. 2 8 r •3 ~ 9 ,n 6 1 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~ 1505610105 Decedent's Social Security Number 1 8 6 3 0 5 7 1 `8 Side 2 1505610105 1505610105 J REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME t~'rank Edw~.~rd ~3lemler, STREET ADDRESS 4')9 Walnut Stre:~t CITY foiling Springs Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments _ B. Discount 3. Interest -0- Sr. $_1,418.48 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. File Number 21 -1 1 - 0 4 E~ ~4 STATE ~ ZIP PA 17007 (1) $ 28, 369.61 1',418.48 Total Credits (A + B) (2) (3) -- 0 - (4) -- - - 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) $ 2 E• , 9 51.1 3 a e c eck payable to: REGISTER OF y Y, ~~~~~~ ~, ~ s ~ ~~~. ;. ,.<~ ~~ WILLS, AGENT ...t~C ... S~~-~'~.q~',_~"~ . a`t.. ~ a.*d".k ~ `#, ~R".. „'' ^t `'~~F t :~~x~i ~ 'i~ r ~ ~.+'4 '~j~. 'a r~ h~ s» n 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 Dec. 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? .................................................................................................................. ...... ® n IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)). The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 K~en;ent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. ~ / REV-150" EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Frank Edward Blemler, Sr. 21 -'I 1-0464 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 on Schedule F. (If more space is needed, insert additional sheets of the same size) r REV-1503 EX+ (6-98) ~. -~ ~ SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Frank Edward Blemler, Sr. 21-11-0464 All property jointly-owned with right of survivorship must be disclosed on Schedule F ~~r more space is needed, insert additional sheets of the same size) REV-1504 EX+ (1-97) _ I SCHEDULE C ~`~" °~ _'~` CLOSELY-HELD CORPORATION COMMONWEALTH OF PENNSYLVANIA ~ INHERITANCE TAX RETURN PARTNERSHIP orSOLE-PROPRIETORSHIP RESIDENT DECEDENT ESTATE OF FILE NUMBER Frank Edward Blemler, Sr. 21-11-0464 Schedule C-1 or C-2 (Including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than asole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. NONE _0_ TOTAL (Also enter on line 3, Recapitulation) 1 $ _ 0 _ (If more space is needed, insert additional sheets of the same size) REV-1507 EX+ (1-97) ~~~i~~, SCHEDULE D ~.<<, COMMONWEALTH OF PENNSYLVANIA MORTGAGES & NOTES INHERITANCE TAX RETURN RECEIVABLE RESIDENT DECEDENT ESTATE OF FILE NUMBER Frank Edward Bleml r, Sr 21-11-0464 All property jointly-owned with right of survivorship must be disclosed on Schedule F. (Ir more space is needed, insert additional sheets of the same size) REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY Frank Edward Blemler, Sr. FILE NUMBER 21-11-0464 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 ~~ Miscellaneous items of personal property. $28,958,00 See attached appraisal. 2. Checking account, #1323679, at M&T Bank, NA 18,601.34 3. MonF~y Market Account, #15004200055752, at 129,971.65 M&T Bank, NA 4, Certificate of Dep~>it, #31 00391 771 4973, at 21 , 1 67.1 5 M&T Bank, NA TOTAL (Also enter on line 5, Recapitulation)1:61 9 8 , 6 9 8. 1 4 (If more space is needed, insert additional sheets of the same size) i REV-1509 EX + (1-97; COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER Frank Edward Blemler, Sr. 21-111-0464 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. NONE 8 C JOINTLY-OWNED PROPERTY; ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY nclude name of f nancial institution and bank account number or similar identifying number. Attach ~jeed for jointly-held real estate. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1. A. NONE i I i a r I i ~ I I j j I ~ ~ ~ I -0- -0- TOTAL (Also enter on line 6, Recapitulation) 3, (` nor.; .. ,- ~ ,.~a~e~~ ~nse!~' additien~ shee?s of twe ~:~t~E~ :size REV-1510 EX + (1-97) SCHEDULE G ~I+NTER-VIVOS TRANSFERS & COMNCHERITANCECTAXERETURNANIA MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT _ ESTATE OF Frank Edward Blemler Sr . FILE NUMBER 21--11-0464 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE . DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST L-XC'LUSION iSF aPPUCAaLE TAXABLE VALUE ~. 3, 537.1 74 shares of DWS Strategic $31 , 091.76 1 00$ ~-0~- $31 , 1 62.5( Government S~C Fund-A, IRA rollover of Frank E. Blemler, @ $8.81 per share. 2. 1 , 388. 469 shares of DWS Balanced 1 3, 051.61 1 00~ -0-- 1 3, 051. 6 Fund-A, IRA rollover of Frank E. Blemler, @$9.40 per share. 3. New York Life Choice Fixed Annuity 34,212.71 100$ -C)- 34,212.7' #51308790, noz-qualifie:~ 4, Equitrust Annuity, #EQ00011179~3aF, 37,465.41 100$ -0- 37,465.4' noz-qualifiP:~ 5. Equitrust Annuity, #EQ0001117994F, 46,283.48 100$ --0- 46,283.4E I R-A 6. Western National Life Insurance ~=~. ~•^ixP•d Annuity, #AN205090. 1 1 5, 296.88 1 00$ -~J~- 1 1 5, 296.88 TOTAL (Also enter on line 7, Recapitulation) $ :? 7 7 , 4 7 2 . 5 9 (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (10-06) ~~ ~: COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCNEDt~LE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Frank Edward Blemler, Sr. 21 -1 1 --0464 Debts of decedent must be reported on Schedule I. ITEM _ - NUMBER DESCRIPTION AMOUNT _ A. FUNERAL EXPENSES: 1. Hollinger Funeral Home & Crematory, Inc. $12,306.16 501 North Baltimore Avenue Mount Holly Springs, PA 17065 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions -0- Name of Personal Representative(s) Street Address City _____ State _ Zip Year(sl Commission Paid: 2~ Attorney Fees Anthony L, DeLu~,a, E.~-~uire 1 4, 000.00 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. Pr obate Fees 3 7 7. 5 0 5• Accountant's Fees 500.00 6. Tax Return Preparer's Fees ~. Legal Advertising - Cumberland Law Journal 75 00 8. Legal Advertisin3 - The Sentinel . 208 78 9. Filing Fees for Inheritance Tax/Inventory . 30 00 10. Diversified Appraisal Services- Appraisal of Residence . 350 00 11. Roy D. Gottshall, Auctioneer . 100 00 Appraisal of Personal Property . TOTAL (Also enter on line 9, Recapitulation) $ 2 7 , 9 4 7 . 4 4 (If more space is needed, insert additional sheets of the same size) REV-1512 EX+ (12-03) Y COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FIILE NUMBER Frank Edgard Blemler, Sr. 21 -1 1 -t)464 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. (If more space is needed, insert additional sheets of the same size) REV-1513 EX+ (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Frank Edward Blemler, Sr. 21-11-0464 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AIMOUNT OR SHARE OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions and transfers under , Sec. 9116 (a) (1.2)) 1. Frank Edw,~rd Blemler, Jr. 4181 Carlisle Road Son One-Third Gardners, PA 17324 2, Kurt Preston Blemler Son One-Third 42 Meadowview Drive Dillsburg, PA 17019 3. Mark C. Blemler Soa One-Third 1113 Ray Avenue #4 Louisville, Kentucky 40204 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. NONE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I $ - 0 - (If more space is needed, insert additional sheets of the same size) - - LAST WIf,L AND TESTAMENT .-- Fr k Ed _ .Lc ~ ...ia ~_ an ward Blemler, Sr. - J ~--~ - -~ r-~ ::,:.,~ SSN: 186-30-5778 ~ 4" ~' ~~`~~ - ` 409 Walnut '' _ ~ ~, ~-, ,--- _ ~ : ~. Street ::~ ~~ `~ ', Boiling Springs, PA 17007 `''`- - ~ -_--~ -- 1 eclaration L' • ~ `•~ c_~ ~. I hereby declare that this is my last will and annul all wills and codicils previousland testament and that I hereby revoke, canc declare that I am of legal age to make th' y made by me either jointly or severall ,• el and testament expresses m Is will and of sound mind and that this lest I y wishes without undue influence or duress. will 2• Family Details I have the following children: Name: Frank Edward Blemler, Jr. Name: Kurt Preston Blemler Name: Mark Charles Blemler 3• Appointment of Executors Date of Birth: October 21, 1956 Date of Birth: February 16, 1961 Date of Birth: Apri13, 1970 3.1 I hereby nominate, constitute and a ppoint Frank Edward Blemler, Jr. as Executor or if this Executor is unable or unwillin to serv as alternate Executor. g e then I appoint Kurt Preston Blemler 3.2 I hereby give and grant the Executor all ow allowed in law, and especially that of assum tioand authority as are required or P 3.3 I hereby direct that my Executors shall not be r serve without any bond, equired to furnish security and shall 3.4 Pending the distribution of my estate m Execut any business, venture or partnership in which I mas shall have authority to carry on my death. y have any interest at the times of 3.5 My Executors shall have full and absolute ower Improve or to sell all or any assets of my estate whehis discretion to insure, repaiir, sale and shall be entitled to let any property in m estate by public auction or private conditions as will be in the best interest of my beneficiaries, such terms and 3.6 My Executors shall have authority to borrow money for any purpose connected with the liquidation and administration of my estate and to that end may encumber any of the assets of my estate. 3.7 My Executors shall have authority to engage the services of attorneys, accountants and other advisors as he may deem necessary to assist with the execution of this last will and testament and to pay reasonable compensation for their services from my estate. 4. Bequests 4.1 I bequeath unto the persons named below, if he survives me by 30 (thirty) days, the following property: Name: Frank Edward Blemler, III Relationship: Grandson Property: My share of the Haussman Hunting Camp in Tioga County, PA, 4.2 If at the time of my death any of the property described in 4.1. above is no longer in my possession or part of my estate, then the bequest of such property shall be defamed null and void and shall no longer form part of this will and testament. 4.3 If any of the persons named in 4.1. above do not survive me by 30 (thirty) days, the property bequeathed to such a person shall become part of the remainder of my estate. 5. Remaining Property and Residual Estate 5.1 I bequeath the remainder of my estate, property and effects, whether movable or immovable, wheresoever situated and of whatsoever nature in equal shares to my children named in 2. above. 5.2 I direct that the inheritance devolving upon any of my children under my last will and testament as well as the proceeds, the reinvestment of such proceeds and the income thereon shall be free from the legal effects of any present or future marriage of any of my children, whether in or out of community or property including any accrual system and with or without the presence of any pre-marital agreement. 5.3 If any of my children are proved to be indebted to me by means of a legal inst~:tiunent, then his share of my estate shall be reduced by the amount of such debt. 5.4 Should any of my children not survive me by 30 (thirty) days I direct that the remainder of my estate, property and effects, whether movable of immovable, wheresoever situated and of whatsoever nature be divided in equal shares between my remaining surviving children. 6• Special Requests 6.1 I direct that on my death my remains shall be buried at Mt. ' my wife, Nancy Blemler, and all funeral expenses shall be anon Cemetery, beside p d out of my elate. 6.2 I request the song, "The Great Speckled Bird," be la ed at m P Y y funeral. 7• General Should any provision of this will be judged by an appro riate co it shall not affect any of the remainin p ~ of law as invalid g provisions whatsoever. IN WITNESS WHEREOF I hereby set my hand on this ~ ~~ day of 20~ at - ~ ~ /y in the presence of the undersigned witness es. SIGNED: '^- ~,~ ~~ ~5~~~ 72 WITNESSES As witnesses we declare that we are of sound mind and of le al a e and that to the best of our knowledge Frank Edward Blemle g Sr. ~ to witness a will make a will, appears to be of sound mind and si of legal age to undue influence or duress. We declare that he sine this will willingly and free of signed as witnesses in the presence of each othergall bthis will m our presence as we Under penalty of perjm`y ~,e declare these statements tolbe true n at the same tune. day of 20~ at ~, ya ~, / d correct on this Witness 1. Name: ~- /tr~~ l... 6 ~ Address: r Q ~~ ~ c~-~ ~9z~ Signature:. Witness 2. Name: ~~''`tr I ~~ C~~Y'-r~~ Address: ~ ~"C'' l~~~fr,S~c~ l~ f~•z~<1~'~ Signature: ,. ,~~ ~ ~ ~ ~ APPRAISAL REPORT 409 WALNUT STREET BOILING SPRINGS, PENNA. PREPARED FOR THE ESTATE OF F. EDWARD BLEMLER BY LARRY E. FOOTE DIVERSIFIED APPRAISAL SERVICES 35 EAST HIGH STREET, SUITE 101 CARLISLE, PENNSYLVANIA 17013-3052 (717) 249-2758 ~, '- SUMMARY OF IMPORTANT FACTS AND CONCLUSIONS LOCATION: 409 Walnut Street Boiling Springs, Pennsylvania TAX PARCEL NUMBER: 40-30-2659-005 IMPROVEMENTS: Two-story detached single-family dwelling. PROPERTY RIGHTS: Fee simple interest. OWNERSHIP HISTORY: The subject property is owned by F. Edw<~rd Blemler. The property last transferred on August 12,, 1.961 for a reported consideration of $9,000 and ownership transferred on deed reference 20-H-54. SCOPE OF THE ASSIGNMENT: The scope of the assignment included an analysis of the subject's area, an inspection of the subject property, an estimation of the property's highest and best use, consideration of all three approaches to value, and the application of those relevant to the valuation of the subject. OBJECTIVE: To estimate the market value of the subject property as unencumbered. EFFECTIVE DATE: Apri14, 2011. HIGHEST AND BEST USE: Continued use as asingle-family residence. COST APPROACH: N.A. SALES APPROACH:. $106,000 INCOME APPROACH: N.A. FINAL VALUE CONCLUSION: $106,000 2 ~ ~ ~ c~OW ~ e o N o N ~ W N p ~ _ NQQt- ~ ~!-Oo ~ ~_ ~ cfl ~ Z W ~ m c° ~ c°D `nOOo r ~ :GWN ~ O M 4. m ~ ~ Lt.. ~ O N -~, O N N r CC ch Z ~ e- M ~ V~ ~ MOO O O ~ N oC~LLN a ~ Mam° ~ Fes- L1. 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