HomeMy WebLinkAbout03-0364PETITION FOR PROBATE and GRANT OF LETTERS
also known as To:
, Deceased.
Social Secarity No. _ 0 ~ ~l - q ,q - ~ j[ ~ x[
The petition of the undersigned respectfully represents that:
Yotn petitioner(s), xxho is/are 18 years of age or older an the execut o~-
in the last wilt ot the above decedent, dated 7J-"tt {~, / O ~ ~
and codicil(s) dated
Register of Wills for th?a ,t
County of ~ tx ~]0 e,-~ d
Commonwealth of Pennsylvania
in the
namcd
,19 q?
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent ,,'as domiciled at death in t? t~ ~._ ~ .~,.,- /a_ ~td .County,pennsylvania,
with
h ~ last.family or principal residence at q3 · 7 ~. ~ ~ ~/~ ~d.
(list street, number and muncipality)
Decendem, then Y~ ~ars%agg, died ~ ~,..a.7 23 , ~ ~008
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property $ 3
(If not domiciled in Pa.) Personal property in Pennsylvania $
(If not domiciled in Pa.) Personal property in County $
Value of real estate in Pennsylvania $ 2.~ OOO
situated as follows: C,,~.'{,t<e O t/aJ['e
WHEREFORE, petitioner(s) respectfully re__quest(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters --] -g..sT-'~ tn ~'~0'T,~y'
theron.~z~. L /~0. (~gk2_'O."..-(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA -I
COUNTY OF O._~t-~q~et~ar, e{ y ss
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s)~nd that as personal represen-
tative(s) of the above decedent petitioner(s)will well an~l~ini~state according to law.
/ff ~ ll l U
Sworn to or affirmed and subscribed c X ~~y% ~.~ ~
before me this _~ T/ff. day of [ / / - ' ~ ~'
Estate Of
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated
described therein be admitted to probate and filed of record as the last will of
~d Letters ~~~ ~
~e hereby granted to ~g~ ~M ~
~o~dX2~, in consideration of the petition on
FEES
r_obate, Letters, Etc .......... ~~-~
Sho~t'~ertificates( ) ..........
iation ................ $
TOTAL ~ ~.~ o ~ ~
Filed .~:)./..o~...~'..~...~. ...........
ATTORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent fiiing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
P 9161420 'EB2003
Local Registrar
No. Date
H105.143 Rev.
NAME OF DECEDENT (F,rsl. M~dale.
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
FEB. 23,2003
JSEX ISOCAL SECURIT~ NUMBER OATE OF .OEATH ~Mor~l. Oa~. '~l
LILLI~ F. BULLOCK CAZER ,. F 3' 064 -- 44 -- 9284 4.~ , ~ ~0~
, FEB. 17,19 WA~RT,PA.
DECEDEm'SUSUAL~U~ I m~BUSINES~IN~Ry I~SDff~NX~mN I OE~ENT'gEDUCmION I 1,. ,0. ~ITE
,,~~m~nm. T~AeW~R ,,~. EDUCATION
~m's ~u~*~ss m,~. c,~. ~. z~ c~ ' ' ,~. NONE ACTU~
'~ MEC~ICSBURG,PA. 17055 ~'~') ,~.~.~ CUNBE~ ~' ' ~.~
~'s ~ (~,~. ,~.. L,~ ,
· . CLarENCE BULLOCK :,o.,,ER.S--,,, ........... ~--i~L ~uP~CK
~a~ST~ .~ J~. ~l/ 1 WA~RT,PA. 18472
U:'= ~"'{ ~-'~ I,-- 011056L ' ~ BRE~AN & BRENNAN FH'~NC CARBONDALE,PA. 18607
~iv
.................................... . (~ []
LAST WILL AHD ~TAMBgVT
OG
LILLIAH G.
I, Lillian F. Cazer, of Harrisburg, Dauphin County, Pennsylvania, declare this to be my
Last Will and Testament, hereby revoking all prior Wills and Codicils.
ITEM I. I direct that the expenses of my last illness and funeral shall be paid from the
funds of my estate.
ITEM II. I give, devise, and bequeath all of my property, both real and personal, of every
nature and wherever situate, as follows:
A. First, I give, devise and bequeath twenty-five percent (25%) of my estate to each
of my two sons, Frederick D. Cazer of Earlville, New York, and Paul G. Cazer of Greene, New
York.
B. Second, I give, devise and bequeath fifty percent (50%) of my estate to my
grandchildren, share and share alike, provided that grandchild survives me. For purposes of
identification, my current grandchildren are: Elizabeth D. Cazer of Earlville, New York, Patricia I.
Cazer, Wilson D. Cazer, and Constance Marie Cazer of Greene, New York;
C. Third, I give, devise and bequeath the rest, residue, and remainder of my estate in
equal shares to my two sons, or the survivor. Should neither of my sons survive me, then I give,
devise and bequeath the rest, residue, and remainder of my estate in equal shares to those of my
grandchildren who survive me.
ITEM III. I nominate, constitute and appoint my son, Frederick D. Cazer, Guardian of
the Estate of any grandchildren under the age of twenty-three (23), handling that child's share of
my estate upon the following terms and conditions:
A. To pay the income and so mUch of the principal as may be necessary for the
maintenance, support, medical expenses, and education, including college education, both
graduate and undergraduate, of the said child.
B. The amount to be paid for the benefit of any said child shall be determined by that
child's need. The said payments may be made by the Guardian directly to any child if in the sole
opinion of my Guardian the said child is of such age and ability to handle properly the funds so
paid to any child, or may be made by the Guardian directly to the person having the custody and
care of any of that child, or may be made by the Guardian directly to any institution entitled to
such payment by reason of services rendered or to be rendered to the said children.
C. To pay the accumulated income and principal then remaining in the Guardian's hands
to the said children, share and share alike, on the child's twenty-third (23rd) birthday.
In the event my son, Frederick Cazer, does not serve or continue to serve for any reason,
then I nominate, constitute and appoint my son, Paul G. Cazer, Guardian of the Estate of any
grandchildren in place of Frederick D. Cazer.
ITEM IV. No interest of any beneficiary under this Will or any Codicil hereto shall be
subject to anticipation or voluntary or involuntary alienation.
ITEM V. No provision in this Will is intended to exercise any power of appointment.
ITEM VI. In addition to powers vested in them by law, my Executor and his successors
shall have the following powers, applicable to all property held by them, including all property
held for minors, effective without the order of any Court and until actual distribution of all such
property:
A. To retain any property received by them including the stock of any corporate fiduciary
acting hereunder.
B. To sell real estate for any purpose, publicly or privately, for such prices and on such
terms as they deem proper, without liability on the purchasers to see to application of the
purchase monies.
C. To compromise controversies.
D. To distribute in cash or kind or partly in each at valuations fixed by them.
E. To hold investments in the name of nominee.
ITEM VII. All taxes and interest and any penalties thereon payable by reason of my death
with respect to property comprising my gross taxable estate, whether or not passing under this
Will, shall be paid from the principal of my residuary estate.
ITEM VIII. I hereby nominate, constitute and appoint' my son, Frederick D. Cazer,
Executor of this my Last Will and Testament. If my son, Frederick D. Cazer, predeceases me or
if for any reason does not act or continue to act as such, I appoint my son, Paul G. Cazer,
Executor in his place. No fiduciary acting hereunder shall be required to post bond or enter
security in any jurisdiction.
IN WITNESS WHEREOF, I have set my hand and seal this /~ day of July, 1997, to
this my Last Will and Testament, which consists of three (3) typewritten pages to each of which I
have affixed my signature.
Lillian F. Cazer
COMMONWEALTH OF PENNSYLVANIA )
'SS:
COUNTY OF )
We, Lillian F. Cazer Testatrix, .~?6'd,:'z ~ '? -'~: / ~- ~'- -- ,
(,..:;n/ /: '
' , :., ~ ~- ~d the witnesses,
respectively, whose names ~e signed to the attached or foregoing instrument, being first duly
sworn, do hereby declare to the undersigned authority that the Testator signed and executed the
instrument as his Last Will and Testament and that he had signed willingly, and that he executed it
as his free voluntary act for the purposes therein expressed, and that each of the witnesses, in the
presence and hearing of the Testator signed the Last Will and Testament as witness and that to
the best of their knowledge the Testator was at that time eighteen (18) years of age or older, of
sound mind and under no constraint or undue influence.
Lillian F. Cazer .
SubScribed, swo~to and ac~owledged he're 'me by ~~er, Testator, ~d
~ /~--,/~i ~ -z /
.... '~' /'~ .:~-:'>/ , and
Notary Pt~c
My Commission Expires:
~..-~:~, :.,,;z -/p~_' , the witnesses, this
NotadaJ Seal
Robert J. Kreidler, Notary Public
Susquehanna Twp., Dauphin County
My Commission Expires Aug. 24, 1998
Member, Pennsyb,~n~a A..~c~Jation of Notaries
4
Name of Decedent:
Date of Death:
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
~. 2, 3~ A o'-o3
Will No. ~-,.
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of~e Orphans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on ~//~/'~ / ?6/9 )-~ t9 0.~ :
Name Address
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:
Signature
Name
Address. 2,
315-
Telephone ( )
Capacity: ~ Personal Representative
~Counsel for personal representative
November 18,2003
Register of Wills
Cumberland County
1 Courthouse Square
Carlisle, PA 17013
To Whom It May Concern:
Enclosed please fred two complete copies of the completed Pennsylvania Inheritance Tax
Remm for Resident Decedent Lillian F. Cazer, file # 21-03-0364. Included are the
following appendices:
The Last Will & Testament of Lillian F. Cazer
Appraisal of property located at Lake Alden, PA
Enclosed also please find a check in the amount of $15.00 filing fee, and a check in the
amount of $18001.31 Inheritance Tax due.
If you have questions or additional information is needed, please contact me by phone at
(607)335-2154 days or O 15)691-3239 evenings.
Frederick D. Cazer, Executor
Estate of Lillian F. Cazer
220 Reese Road
Earlville, NY 13332
Enc.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD OO3264
CAZER FREDERICK D
220 REESE ROAD
EARLVILLE, NY 13332
........ fold
ESTATE INFORMATION: SSN: 064-44-9284
FILE NUMBER: 2103-0364
DECEDENT NAME: CAZER LILLIAN F
DATE OF PAYMENT: 11/20/2003
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 02/23/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $18,001.31
TOTAL AMOUNT PAID:
$18,001.31
REMARKS: FREDERICKDCAZER
OVERNITE EXPRESS 11-19-2003
SEAL
CHECK# 1001
INITIALS: SK
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
REV- 1 500
I
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601 INHERITANCE TAX RETURN
HARRISBURG, PA 17128-060t RESIDENT DECEDENT
DECEDENT'S NAME (LASTi'FIRST, AND MIDDLE IN'I'rlAL) ' ' "' '
FILE NUMBER
__21___ __03__ 0364
COUNTY COOE YEAR NUMBER
Z
u.I
u.I
W
Cazer, Lillian F.
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DO-YEAR)
02/23/2003 02/17/1915
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
N/A
THIS RETURN MUST BE FILED IN DUPUCATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
O64-44-9284
r~ 1. Original Return [] 2. Supplemental Retem r--] 3. Remainder Return (dae of death p~or to 12-13-S2)
r-"] 4. Limited Estate [] 4a. Futura Interest Compromise (de~ ~f death ~ t2-12-82) [] 5. Federal Estate Tax Return Required
r~6. Decedent Died Testate (N~ch copy of w~t) r~ 7. Decedent Maintained a Living Trust (Atta~ copy of Trust) 8. Total Number of Safe Deposit Boxes
O 9. Utigation Proceeds Received [] 10. Spousal Poverty Credit (dele of death betwe~ 12-31-91 and 1-1-95) [] 11. Election to tax under Sec. 9113(A)(A~ch Sch O)
~ SECTION .UST,,BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION, ,SHOULD BE ~D ?0:
NAME
Frederick D. Cazer
FIRM NAME (~App~a~)
TELEPHONE NUMBER
(315) 691-3239
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule 8) (2)
3. Closely Held Coq~oration, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
[~] S~parate Billing Requestad
71 Inter-V'n/os Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administralive Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Mens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
COMPLETE MAILING ADDRESS
220 Reese Road
Earlville, NY 13332
13. Charitable and Governmental 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)
40,000.00
268,867.91
11,839.01
103,266.12
(8) :~' 423,973,04
22,793.82
1,150.12
(11) 23,943.94
(12) 400,029.10
(13)
(14) 400,029,10
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPUCABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or Iransfers under Sec. 9116 (a)(112)
16. Amount of Une 14 taxable at lineal rate
17. Amount of Erie 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19, Tax Due
20.
.o .... (15)
.o 45 (16)
.12 (17)
.15 (18)
(19)
> > BE SURE TO ANSWER ALL QUESTION8 ON REVERSE 81DE AND RECHECK MATH < <
400,029.10
18,001,31
sOCiAL SECUR,TY NUMBE ....
Decedent's Complete Address:
STREET ADDRESS
4833 East Tdndle Road
CITY
Mechanicsburg
I STATEpA
Tax Payments and Credits:
1. Tax Due (Page I Line 19)
2. Credits/Payments
A. Spousal Poverty Credit 0.OO
B. Prior Payments 0.00
C, Discount 0.00
Interest/Penalty if applicable
D. Interest
E. Penalty
(1)
Total Credits ( A + B + C ) (2)
0.00
0.00
Total Interest/Penalty ( D + E ) (3)
If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT,
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
7055
(5)
18,001.31
0.00
0.00
18,001.31
0.00
18,001.31
(5A)
(58)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; .......................................................................................... [] []
b. retain the right to designate who shall use the property transferred or its income; ............................................ [] []
c. retain a reversionary interest; or .......................................................................................................................... [] []
d. receive the promise for life of either payments, benefits or cam? ...................................................................... [] []
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. [] []
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. [] []
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ [] []
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
SIGNATU RE OF PE~ES/~DNSIBLE F~R F ~.I~G I~TU (~1
220 Reese Road, Eaflville, NY 13332
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfem to or for the use of the surviving spouse is 3%
[72 P.S. {9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rote imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 RS. {9116 (a) (1.1) (ii)].
The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if
the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent,
or a stepparent of the child is 0% [72 P.S. {9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decadent's lineal beneficiaries is 4.5%, except as noted in 72 RS. {9116(1.2) [72 RS. {9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. {9116(a)(1.3)]. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1502 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Cazer, Lillian F.
SCHEDULE A
REAL ESTATE
F'ILE NUMBER
21-03-0364
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 pdce 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 JolnUy~vmed with Hght of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. $40,000.00
Property located at 9-1-35 Lake Alden. See attached appraisal. Though
dated 9/21/2003, all comparable sales used for the appraisalwere from 2002
TOTAL (Also enter on line 1. Recapitulation) $
40,000.00
(ff mom space is needed, inset additional sheets of the same size)
REV-1503 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Cazer, Lillian F.
SCHEDULE B
STOCKS & BONDS
FIL-E NUMBER
21-03-0364
ITEM
NUMBER
1.
2.
3.
4.
5.
6.
7.
8.
10.
NI property Jointly.owned Mth right of suwlvorshlp must be dl~clOeKI on Schedule F.
DESCRIPTION
Tenn Valley PARS 6500 29MY01
Duff & Phelps Utility
Partner RE LTD Prf Sera
Morgan Stanley Dean W
Satums-BAC 7250
TCW/DW Term Trust 2003
American Electdc Power Company
Money Market
Morgan Stanley Mutual Funds
Divided Growth Securities B.
Total Return Trust B
Money Market
350 Shares @ $24.45
1600 Shams @ 13.66
900 Shams @ 25.32
1000 Shams@ 26.34
1300 Shares @ 26.48
2200 Shams @ 10.79
1021 Shams @ 21.47
1396 Shams @ 34.28
4264 Shams @ 11.04
TOTAL (Also enter on line 2, Recapitulation)
(If mom space is needed, inser~ additional sheets of the same size)
VALUE AT DATE
OF DEATH
8557.50
21856.00
22788.00
26340.00
34424,00
23738.00
21920.87
14254.68
47854.88
47074.56
59.42
$ 268,867.91
REV-1508 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
_ _ESTATEOF ' '
Cazer, Lillian F.
JSCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPER'W
' FILE NUMBER
21-03-0364
Include the proceeds of litigation and the date the proceeds were received by the estate.
All prope~ Jointly.owned wlt~ right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
2.
3.
4.
5,
6.
DESCRIPTION
Fulton Bank Checking Account
GHS Federal Credit Union Savings Account
Country Meadows Retirement Home Refund
Federal Income Tax Refund, 2002
Seabury & Smith Health Insurance Refund
Associate Cardiologist, P.C. Refund
TOTAL (Nso enter on line 5, Recapitulation) $
(If mom space is needed, insert additional sheets of the same size)
VALUE AT DATE
OF DEATH
$5,571.35
1,137.91
1,679.81
3,170.00
256.99
22.95
11,839.01
REV-1510 EX+ (6-98)
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FiLE NUMBER
Cazer, Lillian F. 21-03-0364
This schedule must be completed and fled if the answer to any of questlees 1 through 4 on the mversa side of the REV-1500 COVER SHEET is, ,es.
DESCRIPTION OF PROPERTY
ITEM II~J.JDE THE NM, IEOFTHETRANSFERE~.THE~RRELA]IONSHtPTODECI:DENTANO DATE OF DEATI' % OF DECD'S EXCLUSION TAXABLE
NUMBER , THED/~OFTRAN,~-R,. ATTACHACOPYOFTHEDEEDFORREALESTATE. VALUE OFASSET INTEREST {~A~Puc~ VALUE
1. Morgan Stanley Vadable Annuity II
Allstate Life Insurance Company 103266.12 103266/
TOTAL (Nso enter on line 7 Recapitulation) $ 103,266.t:
(If more space is needed, imed addilioaal sheets of the same size)
EV-1511 EX+ (12-99)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
E~TATE OF"
Cazer, Lillian F.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21-03-0364
ITEM
NUMBER
5.
6.
7.
8.
9.
Debts of decedent must be reported on Schedule )[.
DESCRIPTION
FUNERAL EXPENSES:
Brennan & Brennan Funeral Home
Minister
Funeral Dinner
ADMINISTRATIVE COSTS:
Personal Repreeenta~e's Commissions
Name of Personal Representative(s) Frederick D. Cazer
Social Secudty Number(s)/EIN Number of Personal Representative(s) 209-34-4605
Street Address 220 Reese Road
city Earlville state NY
Year(s) Commission Paid:
Attorney Fees
Family Exemption: (If decedent's address is not the same as daiment's, attach explanation)
Claimant
Zip
13332
Street Address
city
Relationship of Claimant to Decedent
Probate Fees
Accountant's Fees
Tax Return Prepamr's Fees
Executor Expenses(Travel, Lodging, Meals)
Appraisal of Cottage(Lake Nden)
Property Tax (Lake Alden)
State , Zip
TOTAL (Also enter on line 9, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
AMOUNT
5109.00
100.00
250.00
15,619.10
326.00
302.82
300.00
776.90
$ 22,793.82
REV-1512 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Cazer, Lillian F.
JSCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
21-03-O364
n'EM
NUMBER
2.
3.
4.
5.
6.
7.
8.
Indude umetmbursed medical expenses.
DESCRIPTION
PA State Income Tax 2002
Mechanicsburg Rehabilitation
Home Instead Care
West Shore EMS
R. George Azizkhan Jr. DO/CMAL
EKG Associates
Vedzon
Comcast
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert addl0onal sheets of the same size)
VALUE AT DATE
OF DEATH
450.00
125.17
50.85
373.25
65.51
35.00
14.65
35.69
1,150.12
REV-1513 EX+ (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Cazer, Lillian F.
SCHEDULE J
BENEFICIARIES
FILE NUMBER
21-03-0364
NUMBER
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS ['include outright spousal disbibutions, and transfers under
Sec. 9116 (a) (1.2)]
Frederick D. Cazer
220 Reese Rd.
Earlville, NY 13332
Paul G. Cazer
1937 County Road 32
Greene, NY 13778
Elizabeth D. Cazer
13A Walnut Street
Norwich, NY 13815
Patricia I. Cazer
1937 County Road 32
Greene, NY 13778
Wilson D Cazer
1937 County Road 32
Greene, NY 13778
Constance M. Cazer
1937 County Road 32
Greene, NY 13778
RELATIONSHIP TO DECEDENT
Do Net List Trustee(s)
Son
Son
Granddaughter
Granddaughter
Grandson
Granddaughter
AMOUNT OR SHARE
OF ESTATE
1/4 of Residue as
stipulated in the will
1/4 of residue as
stipulated in the will
1/8 of residue as
stipulated in the will
1/8 of residue as
stipulated in the will
1/8 of residue as
stipulated in the will
1/8 of residue as
stipulated in the will
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX iS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of lhe same size)
WHEREAS, on the 25th
dated July 10th 1997
Register of Wills of CUMBERLAhrD County, Pennsylvania
Certificate of Grant of Letters
No. 2003-00364 PA No. 21-03-0364
ESTATE OF CAZER LILLIAN F
(L~--~'I', ~'1~'1', ~1~)
Late of HAMPDEN TOWNSHIP
CU~L~N~ ~OU~'~,
Deceased
Social Security No. 064-44-9284
day of April
2003 an instrument
was admitted to probate as the last will of CAZER LILLIAN F
late of HAMPDEN TOWNSHIP , CUMBERLAND County, who died on the
23rd day of February 2003 and,
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, DONNA M. OTTO , Register of Wills in and for
the County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify
that I have this day granted Letters TESTAMENTARY
to CAZER FREDERICK D
who has duly qualified as Executor(rix)
and has agreed to administer the estate according to law, all of which fully
appears of record in my Office at CUMBERLAND COUNTY COURT HOUSE,
CARLISLE, PENNSYLVANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my Office the 25th day of April 2003.
**NOTE** ALL AIAMES ABOVE APPEAR (LAST, FIRST, MIDDI.W.)
O~
£If.f. Ij~W' ~'. C~Zff,~
I, Li/lian F. Cazer, of Harrisbu~g,'DauPhin County' pennsylvania, declare this to be my
Last V~rfl/and Testament, hereby revoking a~ priOr Wills and Codicils. ~'
ITEM I. I direct, that the expenses of my last illness and funeral shall be paid from the'
funds of my estate.
ITEM II. I give, devise, and bequeath all 0fray property, both real and personal, of every
nature, and wherever situate, as follows: ,
A. First, I give, devise and bequeath twenty-five percent (25°/,0) of my estate to each
of my two sons, Frederick D.' Cazer of Earlville, New York, and Paul G. Cazer of Greene, New
York.
B. Second, I givi, devise and bequeath ~ percent (50%) of my estate to my.
grandchildren, share and share alike, provided 'that' grandchild survives me. For purposes of
identification, my current grandchildren are: Elizabeth D. Cazer of Earlville, New York, Patricia I.
Cazer, VtrflSOn D.' Cazer, and Constance Marie Cazer of Greene, New York;
C. Third, I give, devise and bequeath the rest, residue, and remainder.of my estate in
equal shares to my two sons, or the survivor. Should neither of my sons surviveme, then I give,
devise and bequeath the rest, residue, and remainder of my estate in equal shares to those of my
grandchildren who' survive me.
ITEM Ill. I nominate, constitute and appoint my son, Frederick D. Cazer, Guardian of
the Estate of any grandchildren under the age of twenty-three. (23), handling that child's share of
my estate upon the following terms and conditions:
.1
· ~ '~.~To~ pa~ ~th, e income and so much
maintenance, support, medical expenses, and
graduate and undergraduate, of the said child.
..... , · ~::. :......-:
of the principal as may be necessary for the
education, including college education, both
B. The amount to be paid for the benefit 'of any said child shall be determined by that,
· child's need. The said payments may be made by the Guardian. ,direCtly to any child if in the sole-
Opinion of my Guardian the said child is o£ such age and ability to handle properly the funds so
paid to any child, or may be made by the Guardian directly to the person having the custody and
care of any of that child, or may be made by'the Guardian directly to any institution 'entitled to
such Payment by reas°n of services rendered or to be rendered to the said children.
C. To pay the accumulated income and P._rincipal then .remaining in the Guardian's hands
to the said chi/dren, share and share alike, on the child,S twenty'third (23rd) birthday.
In the event my son, Frederick Cazer, does not serve or continue to serve for any reasOn,
then ! nominate, constitute and appoint my son, Paul G. Cazer, Guardian of the Estate of any
grandchildren in place of Frederick D. Cazer.
/TEM IV. No interest Of' any beneficiary under this W'dl or
subject to anticipation or voluntary or involuntary alienation, any Codicil hereto shall be
/TEM V. No provision in this W~RI is intended to exercise any power of appointment.
ITEM VI. In addition to powers vested in them by law, my Executor and his successors .
shall have the following powers, applicable to al/property held by them, including all property
held for minors, effective w/thout the order of any Court and unfi/actua/distribution of' all such
property:
A. To retain any property received by them ine/uding the stock of any corporate fiduciary
acting hereunder.
B. To sell real estate for any purpose, Pubffely or Privately, for such prices and on such
terms as they deem proper,
without liability on the purchasers to see to application of the
purchase monies.
C. To compromise controversies.
E. To hold investments in the name of nominee.
ITEM VII. All' taxes and interest and any penalties thereon payable by reason of my death
'with respect to property comprising my gross taxable estate, whether or not passing under this
W'fll, shall be pa/d from the principal' of my residuary estate.
ITEM VIII. I hereby nominate, constitute and appoint' my son, Frederick D. Cazer,
Executor of this my Last W'fll and Testament. If my son, Frederick D. Cazer, predeceases me or
if for any reason does not act or continue to act as such, I appoint my son, Paul G. Cazer,
Executor in his place. No fiduciary acting hereunder shall be required to post bond or enter
security in any jurisdiction.
IN W/TNE$$ WHEREOF, I have set my hand and sea/this__~..~__day of Ju/y, 1997, to
this my Last W'dl and Testament, which consists of three 0) typewritten pages to each of which I
have affixed my signature. '
Lillian F. Cazer
'respectively, whose names are signed to the attached or foregoing instrument, being first duly
sworn, do hereby declare to the undersigned authority that the Testator signed and executed the .
instrument as his Last Will and Testament and that he had signed willingly, and that he executed it
as his bee voluntary act for the purposes therein expressed, and that each of the witnesses, in the
presence and hearing of the Testator signed the Last Will and Testament as witness and that to
the best of their knowledge the Testator was at that time eighteen 08) years of age or older, of
sound mind and under no constraint or undue influence.
Lnnan F C~az,,~ ,n ,
Witness~/~/~...~~ ,~f.~L~ residing at _~/,/~ /~ /Tp~/ ,
· ~uvs~noea, sworn to and acknowledged he're 'me b-~ .... ~--_. '. .
subs~,',b .ed a~d_ sworn to before me ,~y~" .~'~.'~-'¢ .smm~r'an`
,~day//of~ly, J99..~.~- , ana ...c,<~//-f/ .A~W,~i_. , the witne,,e,, t~s
My Commission Expires:
Notaria~ ,Seal
Robert J. Kreidler, Notary Public
Susquehanna Twp., Dauphin County
My Commission Expires Aug. 24, 1998
File No. cazar
SUMMARY APPRAISAL OF
THE PROPERTY LOCATED AT
9-1-35 Lake Alden
Honesdale, PA 18431
as of
September 21, 2003
for
Estate of Lillian F. Cazer
220 Reese Rd
Earlville, NY
13332
by
The Roegner Appraisal Group
RR4, Box 4944
Honesdale, PA 18431
Complete Appraisal Analysis - Summary Appraisal Report
UNIFORM RESIDENTIAL APPRAISAL REPORT File No. cazar
?ropertyAddress 9-1-35 Lake Alden City Honesdale Stata PA Zip Code 18431
!~ .Lean, Deschption Wayne County Deed Book 310 at Page 693, Book 236 at Page 887 County Wayne
Assessor's Parcel No. 9-1-35 and 9-1-70 Tax Year 2003 R.E. Taxes * 776.90 Special Assessments $ N/A
Borrower N/A Current owner N/A Occupant: [~ Owner [~ Tenant ~] Vacant
Property rights appraised ]XI FeeSimple [ [Leasehold Project Type [ [ PUD I IC°nd°minium(HuD/VA°nly) HOA$ N/A ~o.
Neighborhood or Project Name Dyberry Township Map Reference 422165 Census Tract 9604
sate Price $ N/A Date of saleN/A Deschption and $ amount of loan charges/concessions to be paid by seller N/A
Lender/C,ent Estate ofLillian F. Cazer Address 220 Reese Rd, Earlville, NY , 13332
Appraiser Georee A. Motsko Address RR 41 Box 4944, Honesdale, PA. 18431
Location I I Urban LX~ Suburban [~ Rural ] Predominant Single family housing Presentland use % Land uss change
'~ occupancy PRICE AGE
Builtup ~ Over75% [-X~ 25-75% [] Under25% $(000) (yrs) OneFamily 50 [~ NotLikely [] Likely
Growth rate ~ Rapid ~X~ Stable ~ Slow [] Owner 950//o 60 Low 1 2-4 fam 0 [] In process
Property values [] Increasing ~ Stable ~ Declining []Tenant 0-5%350 High 100 Multi-family 0 To: Single FalTli]y
Demand/supply ~ Shortage [] Inbalance [] Oversupply [X~vacant(0-5%) _Predominant Commercial 51[~esidentia]
Marketingtime ~ Under3mos. ~X~ a-6rnos. [~ overemos. ~lva~nt(overs%)120 60 Vacant 45
Nota: Race and the racial composition of the neighborhood ars not appraisal factora.
Neighborhood boundades and characteristics: North to S.R. 371, East to S.R. 191, South to U.S. Route 6 and West to S.R. 296. Low to
moderate density suburban neighborhood..
Factors that affect the marketability of the properties in the neighborhood (proximity to employment and amenities, employment stability appeal to market etc.):
There are no apparent adverse factors which would negatively affect the subject's marketability. The subject is located within 6
miles of shopping, services and employment in Honesdale Borough, which is the county seat and within conunuting distance of _
employment centers in the Greater Scranton Area. School busing provides access to the Wayne Highlands School District. Most
L.properties are well maintained and no inharmonious uses were noted. *** See Additional Cornrnents ***
Market 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.):
The neighborhood is in the stability stage. Supply is short and demand is increasing with less than 5% of the improved properties
offered for sale. Marketing times are within 6 month's for properties offered at reasonable listing prices. Conventional lending is
..._a_~a_ilable from a variety of lenders with FHA and VA accounting for approximately 3% of transactions. Seller's do not typicall7__~
_offer financing concessions.
Project Information for PUDs (If applicable) - Is the developertbuilder in control of the Home Owners' Association (HCA)? ~J Yes [] No
prox,mate to , number of units ,n the subject project N/A Approx,mata tota, number of un,ts for sa,e ,n the subject project N/A
Describe common elements and recreational facilities: N/A
Dimensions See Deed Topography Sloping
sitearea Two earcels---0.222+/-Acres & 0.437+/- Acres ComerLot [~Yes [~Uo S,ze _Typical/Adequate
Specific zoning c,assific~tion and description None Shape Regular
zoningcomp,iance [] Lega~ ~] tega, noncanforming(Orandfathereduse) [] ,,,ega~ [] No zonm Drainage Appears adequate
Highest & best use as improved: [] Present use ~ Other use (explain) View Good lakefront
Utilities Public Other Off-site Improvsmants Type Public Pdvate Landscaping Typical/Natural
Electricity [~ Street Shale [~ [] Ddveway Sur*ace Shale/Crushed Stone
Gas ~ LP only curb/gu,er Shale [] [] Apparent easements None Observed
Water ~ Lake _Only Sidewa,k None [] [] FEMA Specia, Flood Hazard Area [] Yes [] No
Sanita, sewer [] None St~eetlights None [] [~] FEMAZo,e X Map Date 09/30/87
SJ0m~ sewer [] None A,ey None [~ [] FEMA Map No. 422165
Comments (apparent adverse easements, encroachments, special assessments, slide areas, illegal or legal nonconforming zoning use, etc.): Rustic lakefront
_lot and rear lot with mature trees and a good lakefront view. On-site water and sewer systems are typical for the area. No
adverse easements, encroachments or other adverse conditions were noted.
GENERAL DESCRIPIION EXTERIOR DESCRIPTION FOUNDATION BASEMENI INSULATION
!'No.of Units 1 Foundation Piers S~ab NO ~rea sq. Ft. N/A Roof U []
No. of Stories 1.00 ExteriorWa,s Wood Lap craw~ space NO % F,n~shed N/A Ce,,ng U []
Type(Det./Att.) Detached Roof Sur~aca Comp Shingle Basement NO cci,ina N/A Wa,s U []
Design(Style) Ranch/Ava Gutters&Dwnspta. _None Sumppump N/A Wa,s N/A Floor None []
Existing/Proposed Existing Window lype WoodfDh Dampness N/A Floor N/A None []
Age (Yrs.) 47 Sto~/Scraens No/yes settlement N/A Outside En~ N/A unknown -- ~
. ct,ve^ge( rs.I 35 Manu.acturedHouse NO ,n.estat,on N/A
ROOM_S_ Foyer Living Dining Kitchen Den Family Rm. Rec. Rm. Bedrooms # Baths Laundry Other Area Sq. Ft.
Lave" 624
Finished area above grade contains: Rooms; Bedroom(s); Bath(s); 624 Square Feet of Gross Living Area
INTERIOR Materials/ConditionHEATING KITCHEN EQUIP. Al-I-lC AMENITIES CAR STORAGE:
F,oors Unknown Type Unknown Refrigerator []None [] F rep,acelsl# [] .one []
Wa,s Unknown Fue, Unknown Range/oven [] Stairs [] Patio --[~ Garage #of cars
T,m/Finish Unknown Condition Unknown Disposa, ~ DropStair ~ Dec~ 240 Sq Ft [] Attached
Bath F,oor Unknown COOL,NC D,shwasber Scott,e [] Porch [] De ched
Bath Unknown centra, Unknown Fan..ood F,oor [55] Fenc [] Su,,t-,n
Doors unknown Other Unknown Microwave ~ Heated [~ Poo~ [] Carvort
Condition Unknovv'I1 Washer/Dryer · Finished ~ ~ Ddveway
Additional features (special energy efficient items, etc.): A non winterized cottage is located on the subject property. An exterior inspection
only was completed. The subject prope~/has no well or on site sewage system.
Condition of the improvements, depreciation (physical, functional, and external), repairs needed, quality of construction, remodeling/additions, etc.: The subject
_property exhibits signs of average care. Some general repairs and maintenance arc required at this time. Normal physical
depreciation due to age and use. The subject propc~y has no well or on site sewage system. No external deficiencies were noted.
Adverse environmental conditions (such as, but not limited to, hazardous wastes, toxic substances, etc.) present in the improvements, on the site, or in the
immediate vicinity of the subject property.: The subject was built prior to 1978 and may contain ]cad paint. No other adverse
environmental conditions were noted in the construction of the subject, on the subiect site or in thc immediate neighborhood.
Freddie Mac Form 70 e-93 12 CH.
PAGE I OF 2
The Roegner Appraisal Group
Fannie Mae Form 1OO4 6-93
Valuation Section
Complete Appraisal Analysis - Summary Appraisal Report
UNIFORM RESIDENTIAL APPRAISAL REPORT
File No. cazar
ESTIMATED SITE VALUE ....................................... = $
ESTIMATED REPRODUCTION COST-NEW-OF IMPROVEMENTS:
Dwelling 624 Sq. Ft @ $ 50.00 = $ 31,200
Piers N/A Sq. Ft ~ $ N/A = 2,000
Deck = 2,000
Garage/Carport N/A Sq. Ft ~ $ N/A = N/A
Total Estimated Cost New ........................... $ 35,200
Less 70.0 Physical Functional External
Depreciation 24,640 j = $
Depreciated Value of Improvements ............................... = $
"As-is" Value of Site Improvements ................................ = $
INDICATED VALUE BY COST APPROACH 50,560 = $
ITEM I SUBJECT I COMPARABLE NO. 1
40,000
24,640
10,560
Incl
50.
Comments on Cost Approach (such as, source of cost estimate,
site value, square foot calculation and for HUD, VA and FmHA, the
estimated remaining economic life of the property): The cost
estimates used in the Reproduction Cost Approach are
derived from local builders costs and Marshall & Swift
Residential Cost Manual for the construction of similar
single family dwellings. The Marshall & Swift Cost
Manual is a replacement cost manual.
Remaining Economic Life: 15 Remaining Physical Life: 15
COMPARABLE NO. 2 COMPARABLE NO. 3
9-1-35 Lake Alden
Address D~
Proximity to Subject
& 9-1-73 Lake Alden
Miles
Sales Pdce $ $ 30
Price/Gross Liv. Area $ [~
Data and/or ~ection Inspection
Verification Source Public Record Public Record
VALUE ADJUSTMENTS DESCRIPTION
Sales or Financing
Concessions
Date of Sale/Time
Location
2, 3A, 25, 26A Como 107 Lake Lorrain Rd
Twp Lorrain
14 Miles Miles
$ 50, $ 70
$ 59.52 99.43
Leasehold/Fee Simple
Site
)ection Inspection
Public Record
DESCRIPTION + (-) $ Adjustment DESCRIPTION + (-) $ Adjustment DESCRIPTION + (-) $ Adjustment
Conv.
1/2002 Closed 12/2002 Closed Closed
Suburban/Avg Suburban/Avg Suburban/Avg
+5,000
View :front
Design and Appeal
Quality of Construction
Age
Condition
Above Grade
Room Count
Gross Living Area
Basement & Finished
Rooms Below Grade
Functional Utility
Fee Simple
0.2217ac/Btr
Heating/Cooling
Ranch/Avg
Average
A47/E35
[Fair , ,
t Total : Bdms! Baths
624 sq. Ft.
Piers
N/A
No Well/Septic
Unknown
IA65/E35
N/A '
Total ~ Bdms i Baths
N/A sq. Ft.
N/A
N/A
N/A
N/A
+5,000
Avemge ,
Total i Bdms ~ Baths
412:1.00
840 sq. Ft.
Urawlspace
N/A
Average
Avg/None
-5,000
-2,160
-2,000
-10,000
Good/Lakefront
Ranch/Avg
Average
A42/E20
Average
Total i Bdms i Baths
4, 2, 1.00
704 sq. Ft.
Piers
N/A
Average
None
Energy Efficient Items None N/A None None
None
Patio
Fireplace
None
-2,000
N/A
N/A
N/A
Garage/Carport
Gross 52.3%
Net-32.3% $ 33,840
Porch, Patio, Deck,
Fireplace(s), etc.
None
Deck
None
None
N/A
Fence, Pool, etc.
Net Adj. (total) ' $ 15,000
Adjusted Sales Pdce Gross 50.0%
of Comparable Net 50.0% $ 45,000
None
None
None
None
Gross 36.1%
Net-30.4% $
-7,50~0
-5,000
-800i
-10,00C
+2,000i
-21,300
48,700
Comments on Sales Comparison (including the subject property's compatibility to the neighborhood, etc.): Comp Cf 1 is over 6 month's old but is used
due to it's similarities to the subject and it's location in the same immediate neighborhood. Comp Cf 1 is smaller in size
because of having only one rear lot with no improvements. *** See Additional Comments ***
ITEM I SUBJECT COMPARABLE NO. I COMPARABLE NO. 2 COMPARABLE NO. 3
Date, Price and Data
Source, for pdor sales
within year of appraisal
~N/A Public Red
Shows No
Sales/3 Years
N/A-Public record
shows no sales
>revious 12 months.
N/A-Public record
shows no sales
~revious 12 months.
N/A-Public record
shows no sales
)revious 12 months.
Analysis of any current agreement of sale, option, or listing of the subject property and analysis of any pdor sales of subject and comparables within one year of the date of appraisal:
None known.
INDICATED VALUE BY SALES COMPARISON APPROACH
....................................................................................... $ 40,000
INDICATED VALUE BY INCOME APPROACH (If Applicable) Estimated Market Rent $ N/A /Mo. x Gross Rent Multiplier N/A = $ N/A
This appraisal is made ~ "as is" ~J subject to the repairs, alterations, inspections or conditions listed below ~ subject to completion per plans and specifications.
Conditions of Appraisal: The value reported is predicated upon the sewage enforcement officer of Dyberry Township issuing a sewage
~ermit for the construction of an on site sewage system on the subject property.
Final Reconciliation: The Direct Market Analysis Method is given most weight in the Final Reconciliation and is supported by thc
The Income Approach was not used due to the limited utility of single family homes as income properties.
)raisal/Summary Report
The purpose of this appraisal is to estimate the market value of the real prepedy that is the subject of this report, based on the above conditions and the certification, contingent
and limiting conditions, and market value definition that are stated in the attached Freddie Mac Form 439/Fannie Mae Form 1004B (Revised 06/93 ).
(WE) ESTIMATE THE MARKET VALUE, AS DEFINED, OF THE REAL PROPERTY THAT IS THE SUBJECT OF THIS REPORT, AS OF September 21, 2003
(WHICH IS THE DATE OF INSPECTION AND THE EFFECTIVE DATE
APPRAISER: ot/~oo~ljo~ ~
Signature
Name George A. M
OF THIS
Date Report Signed September 25, 2003
State Certification # RL-000583-L
State PA
Or State License #
REPORT} TO .~t $ 40,000
Signature ~' ~-- ~ - iF' ""~/~ Did ~ Did Not
Name Milton D. Rocker Inspect Pmpe~
Date Report Signed September 25, 2003
StateCefl~tion~ ~-000692-L State PA
State Or State License #
State
Freddie Mac Form 70 e-93 12 CH.
PAGE 2 OF 2 Fannie Mae Fora1 1004 e-93 j
The Roegner Appraisal Group I
File No.ca~ar
Borrower or Owner N/A
Property Address 9-1-35 Lake Alden
ci~ Honesdale co.n~ Wayne State PA
Lender or Client Estate of Lillian F. Cazer
Zip Code 18431
The purpose of the appraisal is to develop a supported value opinion relative the subject property. The Uniform Standards of
Professional Appraisal Practice defines the market value conclusion as an opinion of market value and not as an estimate of
m~r? ~ ~fh~ ~ed u~? of this ~raisal i~ the named client and or the named client's assimas.
_ The scope of the appraisal includes inspection of the subject property as indicated in the appraisal, visits to the sub'
and competing marketing area, research of sales, listings and rentals within a competitive distance and research
reliable sources of information including multi-list systems, tax assessment records and Realtor Records. The information
obtained was then analyzed and processed into recognized approaches to value as presented in the appraisal.
information collected in the course of research to complete the appraisal assigmment for the stated client is not disclos
' nonaffiliated third parties except as necessary, to complete the assignment or as required by law. The function of the
is to assist the lender in collateral evaluation and or portfolio management.
s the subject property currently listed3 [] Yes X~ No
Has the property sold dudng the pdor year? [] Yes [] No
List Price: $ N/A
If yes, describe below
What is your estimate of marketing time for the subject property? 3 to 6 Months months Descdbe below the basis (rationale) for your estimate?
Local Realtor Records indicate that typical marketing times for properly priced properties in the subject neighborhood ran
3 to 6 month's.
Does the transaction involve the transfer of personal property, fixtures, or intangibles that are not real property? [] Yes [] No
If yes, provide description and valuation below.
No value is given to any personal property.
1. The acceptance of this appraisal assignment by the appraiser was not based on a requested minimum valuation, a specified valuation, or an approval of the loan.
2. The appraiser certifies that the compensation for this appraisal is not contingent upon the reporting of a predetermined value or direction in value that favors the cause of the
client, the amount of the value estimate, the attainment of a stipulated result of the occurrence of a subsequent event.
3. This appraisal has been prepared to conform with the Uniform Standards of Professional Appraisal practice CUSPAP") adopted by the Appraisal Standards Board of the
Appraisal foundation, except the Departure Provision, unless otherwise stated below.
4. The appraiser has disclosed within this appraisal report, or below, all steps taken that were necessary or appropriate to comply with the Competency provision of the USPAP.
~5. The appraiser certifies use of a digitally enhanced signature with access protected by a password.
Date: September 25, 2003 Appraiser(s):
Date: September 25, 2003
Form953
George A. Motsko
Milton D. Roegner
Copyright (c) 1991, 1992 Software for Real Estate Professionals
The Roegner Appraisal Group
Revision, 1/92
File No. cazar
Borrower or Owner N/A
Property Address 9-1-35 Lake Alden
City Honesdale county Wayne state PA zip Code 18431
Lender or C,ent Estate of Lillian F. Cazer
NEIGHBORHOOD MARKETABILITY
It is typical for property values to deviate by more than 10% from the predominate value; This condition has
no affect on the marketability of the subject property.
There are commercial uses located along the arterial highways leading into the neighborhood. There are no
commercial uses which would have any detrimental affect on the marketability of the subject property or it's
enjoyment for residential purposes.
The large tracts of State and Federal recreational lands, lakes, rivers and wetlands which exist in the county
contribute to the percentage of vacant land in the subject's marketing area. This condition provides
recreational opportunities in the marketing area and as such has no adverse affect on the marketability of the
subject property.
COMMENTS ON SALES COMPARISON
The large tracts of state recreational lands, privately owned woodlands lakes, rivers, and wetlands which
exist in the county contribute to the distance of greater than one mile between the subject and the
comparable sales # 2 and # 3.
The comparable sales are located in similar neighborhoods with similar appeal to the market and are
approximately equidistant to shopping, services and employment.
The Roegner Appraisal Group
File No. cazar
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 fair sale, the buyer and seller, each acting prudently, knowledgeably
and assuming the price 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 from 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 interest; (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 for 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 the seller pays these costs in virtually all sales transactions. Special or
creative financing adjustments can be made to the comparable property by comparisons to financing 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 financing or concessions but the dollar
amount of any adjustment should approximate the market's reaction to the financing or concessions based on the
appraiser's judgment.
STATEMENT OF LIMITING CONDITIONS AND APPRAISER'S CERTIFICATION
CONTINGENT AND LIMITING CONDITIONS:
is subject to the following conditions:
The appraiser's certification that appears in the appraisal report
1. The appraiser will not be responsible for matters 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 the title. The property is appraised on the basis of it being under responsible ownership.
2. The appraiser has provided a sketch in the appraisal report to show approximate dimensions of the improvements
and the sketch is included only to assist the reader of the report in visualizing the property and understanding the
appraiser's determination 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 located in an
identified Special Flood Hazard Area. Because the appraiser is not a surveyor, he or she makes no guarantees,
express or implied, regarding this determination.
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 the value of the land in the cost approach at its highest and best use and the
improvements at their contributory value. The separate valuations of 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, the
presence of hazardous wastes, toxic substances, etc.) observed during the inspection of the subject property or that
he or she became aware of during the normal research involved in performing 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 written consent before the lender/client specified in the appraisal
report can distribute the appraisal report (including conclusions about the property value, the appraiser's identity
and professional designations, and references to any professional 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 collection or reporting
service(s) without having to obtain the appraiser's prior written consent. The appraiser's written consent and
approval must also be obtained before 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 I of 2 Fannie Mae Form 1004B 6-93
File No. cazar
APPRAISER'S CERTIFICATION: The Appraiser certifies 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 items 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 the 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 price of the comparable.
2. I have taken into 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 appraisal
report and I believe, to the best of my knowledge, 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 the 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 of 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 contingent 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 estimate, 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 performed 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 effective date of this appraisal, with the exception of the departure provision of those Standards, which does
not apply. I acknowledge that an estimate of 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 noted in the
neighborhood section of this report, unless I have otherwise stated in the reconciliation section.
8. I have personally inspected the interior and exterior areas of 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 site, 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 that I had market evidence to support them. I have also commented about the
effect of the adverse conditions on the marketability of the subject property.
9. I personally prepared all 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 of the appraisal report, I have named such individual(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 to make a change to any item in the report; therefore,
if an unauthorized change is 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 to 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: 9-1-35 Lake Alden, Honesdale, PA 18431
APPRAISER:
uame: George A. IV~oisko'
Date Signed: September 25, 2003
State Certification #: RL-000583-L
or State License #:
State: PA
Expiration Date of Certification or License: 06/30/05
SUPERVI~ APPRAISER (only if required):
Signature: _/ '~ ~)~- ~
Name: Milton D. Roegner
Date Signed: _September 25, 2003
State Certification #: RL-000692-L
or State License #:
State: PA
Expiration Date of Certification or License: 06/30/05
[~ Did ~ Did Not Inspect Property
Freddie Mac Form 439 6-93
Page 2 of 2
Fannie Mae Form 1004B 6-93
The Roegner Appraisal Group
File No. cazar
Borrower or Owner N/A
Property Address 9-1-35 Lake Alden
city Honesdale County Wayne State PA zip Code 18431
Lender or Client Estate of Lillian F. Cazer
APPRAISER'S CERTIFICATION:
The following Certification statements are in addition to and may supercede the signed Appraiser's Certification attached to this
appraisal report. This Appraiser's Certification is compliant with the current edition of the Uniform Standards of Professional
Appraisal Practice.
I certify that, to the best of my knowledge and belief:
The statements of fact contained in this report are true and correct.
The reported analyses, opinions, and conclusions are limited only by the reported assumptions and limiting conditions, and are my
personal, impartial, and unbiased professional analyses, opinions, and conclusions.
I have no present or prospective interest in the property that is the subject of this report, and no personal interest with respect to
the parties involved.
I have no bias with respect to the property that is the subject of this report or to the parties involved with this assignment.
My engagement in this assignment was not contingent upon developing or reporting predetermined results.
My compensation for completing this assignment is not contingent upon the development or reporting of a predetermined value or
direction in value that favors the cause of the client, the amount of the value opinion, the attainment of a stipulated result, or the
occurrence of a subsequent event directly related to the intended use of this appraisal.
My analyses, opinions, and conclusions were developed, and this report has been prepared, in conformity with Uniform
Standards of Professional Appraisal Practice.
I (We) have made a personal inspection of the property that is the subject of this report.
No one provided significant real property appraisal assistance to the person(s) signing this report.
PURPOSE, INTENDED USE, AND INTENDED USER OF THE APPRAISAL:
The purpose of the appraisal is to estimate the market value of the subject property, as defined in this report, as of the effective
date of this report. The intended use of the appraisal is to assist the client in estimating the value of the subject property. The
intended user of this report is the stated client. No one else should rely on the estimate of value or any other conclusions contained
in this appraisal report.
ANALYSIS AND REPORT FORM:
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 comparable data described in the Data Source section of the market grid along with the source of
confirmation is provided, where 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 or used as a basis for the value conclusion. The extent of the analysis applied to this assignment is
stated in the Appraiser's Certification included above and attached to this report.
DEFINITION OF INSPECTION
The term "Inspection", as used in this report, is not the same level of inspection that is required for a "Professional Home
Inspection". The appraiser does not fully inspect the electrical system, plumbing system, mechanical systems, foundation system,
floor structure, or subfloor. The appraiser is not an expert in construction materials and the purpose of the appraisal is to make an
economic evaluation of the subject property. If the client needs a more detailed inspection of the property, a home inspection, by a
Professional Home Inspector, is suggested.
DIGITAL SIGNATURES
The signature(s) affixed to this report, and certification, were applied by the original appraiser(s) or supervisory appraiser and
represent their acknowledgements of the facts, opinions and conclusions found in the report. Each appraiser(s) applied his or her
signature electronically using a password encrypted method. Hence these signatures have more safeguards and carry the same
validity as the individual's hand applied signature. If the report has a hand-applied signature, this comment does not apply.
The Roegner Appraisal Group
File No. cazar
Borrower or Owner NYA
Property Address 9-1-35 Lake Alden
city Honesdale County Wayne State PA Zip Code 18431
Lender or Client Estate of Lillian F. Cazer
OP1NION OF MARKET VALUE VS ESTIMATE OF MARKET VALUE
The current Uniform Standards of Professional Practice defines the market value conclusion as an opinion of market value and not
an estimate of market value.
Signature:
Name: George A. M~ko ' v
Date Signed: September 25, 2003
State Certification #: RL-000583-L
or State License #:
State: PA
Expiration Date of Certification or License: 06/30/05
Signature:
Name: Milton D. Roegner
Date Signed: September 25, 2003
State Certification #: RL-000692-L
or State License #:
state:PA
Expiration Date of Certification or License: 06/30/05
~ Did [~ Did Not Inspect Property
The Roegner Appraisal Group
File No.
PHOTOGRAPH ADDENDUM
ao.o~,~ o~ o~ N/A
~^dows 9-1-35 Lake Alden
c~ Honesdale co.~ Wayne stye PA z~pco~ 18431
Lender or Client
FRONT VIEW OF
SUBJECT PROPERTY
REAR VIEW OF
SUBJECT PROPERTY
STREET SCENE OF
SUBJECT PROPERTY
File No. Ca ~Z;~l'
Borrower or Owner N/A
PmpertyAddress 9-1-35 Lake Alden
City Honesdale County Wayne state PA Zip Code 18431
Lender or Client Estate of Lillian F. Cazer
24'
6,I
10'
10'
8,I
Deck
24'
24'
Living Area
First Floor 624 112
Porches/Patios
Deck 240 68
First Floor
24.0 X 24.0 = 576,0
8.0 X 6.0 = 48.0
Total 624.0
SKETCH-IT 1-800-523-0872
The Roegner Appraisal Group
PHOTOGRAPH ADDENDUM
~c~'er or Ownor N/A
~ ^a~ 9-1-35 Lake Alden
Honesdale Co~ Wayne state PA ap coa~ 18431
Le~der or Client
COMPARABLE #1
9-1-38 & 9-1-73 Lake
Price $30,000
Priee/SF
Date 11/2002 Closed
Age N/A
Room Count -
Living Area N/A
$40,000
COMPARABLE #2
3A, 25, 26A Como
Preston Twp
Price $50,000
Price/SF 59.52
Date 12/2002 Closed
Age A65/E35
Room Count 4-2-1.00
Living Area 84O
$33,840
COMPARABLE #3
107 Lake Lormin Rd
Lake Lorraia
Price $70,000
PrieedSF 99.43
Date 08/2002 Closed
Age A42/E20
Room Count 4-2-1.00
Living Ama 7O4
$48,700
File No. Ca~l 7j~r
LOCATION MAP
~-.~,o, o~ O*n~ N/A
P.~o~s 9-1-35 Lake Alden
c~ Honesdal¢ coun~ Wayne SUe PA
Lender or Clieot
18431
The Roegner Appraisal Group
BUREAU OF INDTVTDUAL TAXES
/NHERITANCE TAX DTVTSTON
DEPT. 180601
HARRTSBURG, PA 17118-0601
FREDERICK D CAZER
220 REESE RD
EARLVILLE
COMMONNEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF ZNHERITANCE TAX
APPRA[SEHENT, ALLOHANCE OR DISALLOHANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
'~ ...... ~-'- ;~*' O[ DATE 01-12-200q
~,_~ :~ - ,j'.' ~'J~i~S ESTATE OF CAZER
DATE OF DEATH OZ-Z3-ZO03
FILE NUMBER 11 03-036q
FEB 25 A8:30 COUNTY CUMBERLANO
AON ~ 01
I
REV-1;q? EX AFP (01-03)
LTLLTAN F
MAKE CHECK PAYABLE AND RENZT PAYMENT TO:
REGISTER OF MILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THZS LINE ~ RETAIN LONER PORTZON FOR YOUR RECORDS ~
REV-1547 EX AFP (01-03~ NOTICE OF INHERITANCE TAX APPRAZSEMENT~ ALLONANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF CAZER LILLIAN F FZLE NO. 21 03-036q ACN 101 DATE 01-12-200q
TAX RETURN HAS: (X) ACCEPTED AS FTLED ( ) CHANGED
RESERVATION CONCERNZNG FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
I Real Es~a~o {Schedule A)
2 S~ocks and Bonds (Schedule B)
$ Closely Hold S~ock/Perthorship [n~oros~ (Schedule C)
Mortgages~No,es Receivable (Schedule D)
Cash/Bank DeposA~s/MAsc. Personal Proper~y (Schedule E)
6 JointLy Owned Proper~y (Schedule F)
7 Transfers (Schedule G)
8 To,al Asso~s
APPROVED DEDUCTIONS AND EXEMPTIONS:
9 Funeral Expenses/Ada. Costs/Misc. Expenses (Schedule H)
10 Debts/Mortgage Liabil~1os/Liens (Schedule I)
11 To'al Deductions
12 Ne~ Value of Tax Re~urn
(1)
(2)
(3)
(6)
(7)
(9)
qO~O00.O0
268~867.91
O0
O0
11~839.01
O0
NOTE: To insure proper
cred~ ~o your account,
subm~ ~he upper por~on
of ~his fora wi~h your
~ax payment.
1031266.12
(a) qZ3,973.0q
(10)
22,793.82
15
NOTE:
1~150.12
(11) 2~.g~.g~
(12) q00,029.10
Chari~cablo/governmen~:al Boques~cs; Non-elect:ed 9115 Trusts (Schedule J) (15)
No~ Value of Es~a~o Subjec~ ~o Tax (lq)
Zf an assesseent ~as issued previously, lines 14, 15 and/or 16, 17,
reflect figures that include the total of ALL returns assessed to date.
.00
q00,029.10
ASSESSMENT OF TAX:
15. Amoun~ of L/ne lq a~ Spousal ra~o
16. Amount: of L/ne lq ~:axablo a~ Lineal/Class A ra~e
17. Aeoun~ of L/ne lq a~ S~bling ra~o
18. Amoun~c of L/no lq ~caxablo at Collateral/Class B ra~e
19. Principal Tax Duo
TAX CRED]:TS
PAYMENT RECETpT DISCOUNT
DATE NUMBER INTEREST/PEN PAID (-)
11-20-2003 COOO3Z6q .00
18 and 19 will
ZF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
(15). .00 x O0 : .00
(16). qOO,OZ9.10 x Oq5: 18,001.31
(17), .00 x 12 = . O0
(18), .00 x 15 = .00
(19)= 18,001.31
AMOUNT PAID
18,001.31
TOTAL TAX CREDIT I 18,001.31
BALANCE OF TAX DUEl .00
INTEREST AND PEN. .00
TOTAL DUE .00
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS RE~U~RED.
IF TOTAL DUE IS REFLECTED AS A 'CRED/T' (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.}
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(D--~4)
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Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 1/10/2005
CAZER FREDERICK D
220 REESE ROAD
EARLVILLE, NY 13332
RE: Estate of cAZER LILLIAN F
File Number: 2003-00364
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) 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 two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
ThiS filing will become delinquent on: 2/23/2005
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
GLENDA FARNER ~
REGISTER OF WILLS
cc: File
Counsel
Judge
STATUS REPORT UNDER RULE 6.12
Name of Decedent: I- f //1"" r {! <t :z e__
Date of Death: '2./ A J /,2 or:]
, /
Will No.:
A llO '3 - 0 J (, 'f
Admin. No.: .z / - 0 3 -0 J 6' Y'
Pursuant to Rule 6.12 of the Supreme Court Orpha11s' Comi Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes 0 No 0
2. If the answer is No, state when the personal repreJi,entative reasonably believes
that the administration will be complete: J e /iJ t' .z tro!) *'
.
3. If the answer to No. I is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes No 0
b. The separate Orphans' COUli No. (if any) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties
in interest? Yes 0 No 0
c. Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the Orphans' Court
and may be attached to this rep~;/ 0 Cl
Date:J-.J/3/-Z(')o, .~~. ~
~'/ Slgntture
Ff..-e clef' I~ i<. n (1,- 2-.~
Name
'::.)
2;1.0 lfef'';;f'
Address
R-l F~t/Ie u t 133JZ
I
(p 0 7 - 33 S - AI S-1 tn~ 3 I J- - (. '1/.3.z 3 <7
Telephone No.
Capacity: !25] Personal Representative
o Counsel for personal representative
1\
Pe~''1j S,,/,. tlt r"o; <2-r-f;.
J
PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF
THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY
UNTIL COMPLETION
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Gannon, Shirley
Date of Death: March 31, 2002
Estate No.: 2002-:00364
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect
to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes X No
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete:
(date)
3. If the answer to No.1 is yes, state the following:
A. Did the personal representative file a final account with the court?
Yes No X
B. The separate Orphans' Court No. (if any) for the personal representative's
account is: (Not Applicable in Dauphin County)
C. Did the personal representative state an account informally to the parties in
interest? Yes X No
D. Copies of receipts, releases, joinders and approvals of formal or informal
accounts may be filed with the Clerk of the Orphans' Court and may be attached
to this report.
Date: 04-19-05
)(-~~~/>~.
Signature
Kathleen Gannon
Name (Please type or print)
2024 Lincoln street
Camp Hill, PA 17011
Address
(MAH:rmtlAM3)
717-761-1557
Telephone No.
Capacity:
X
Personal Representative
Counsel for Personal Representati~
R.W.-58
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT 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
CAZER FREDERICK 0
220 REESE ROAD
EARLVILLE, NY 13332
____un fold
ESTATE INFORMATION: SSN: 064-44-9284
FILE NUMBER: 2103-0364
DECEDENT NAME: CAZER LILLIAN F
DATE OF PAYMENT: 12/16/2005
POSTMARK DATE: 12/14/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 02/23/2003
NO. CD 006119
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $3J69.00
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$3,769.00
REMARKS:
CHECK# 322
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
Cumberland County Registrar of Wills
1 Courthouse Square
Carlisle, P A 17013
To Whom It May Concern;
Enclosed please find a supplemental inheritance tax return for the estate of Lillian F.
Cazer, file number 21-03-0364.
The previous return dated 11-17-2003, showed a real estate property valued at
$40,000.00. This property has been sold for $123,755.33 cash to the estate. Attached is a
check in the amount of $3, 769.00 to cover the inheritance tax due on the difference
between the sale price and the previously appraised value.
Also enclosed, please find a copy of the documentation of sale dated December 9,2005.
If there are any questions, please contact me at the address below.
Thank you for your attention to this matter.
Sincerely, ()/1J
2Lj~)?~~
i'~~Ck D. Cazer, Executor
220 Reese Rd.
Earlville, NY 13332
315-691-3239
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. COMMONWEAlTHOF
, PENNSYLVANIA
DEPARTMENT OF REVENUE
_ DEPT. 280601
, . HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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DECEDENT'S NAME (LAST, FIRST, AND MIJDLE INITIAL)
Cazer, Lillian F.
DATE OF DEATli (W-DD-YEAR)
02123/03
FI.E NUMBER
21 03
0364
coom COlE
IUo1IIER
DATE OF BIRTH (MM-D[)'YEAR)
02117/15
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGI TER oP WILLS
(IF APPUCABLE) SURVIVING SPouses NAME (LAST, FIRST, AND MIDDLE INITIAL)
D 1. Original Return
D 4. Limited Esla18
D 6. Decedent Died TesllIle (AItadl cq>y d WI)
D 9. Litigation Proceeds Reoeived
~ 2. Supplemental Return
D 48. Future Interest Compromise (dIlI8 or de8Ih 81111"12.12-82)
D 7. Decedent Maintained a Living Trust (AItadlcq>ydTIUIl)
D 10. Spousal Poverty Credit (dIlI8 ofde8lh......, 12-31-91 and 1.1-85)
1. Real Esla18 (Sdledule A)
2. Stocks and Bonds (Sdledule B)
3. CIosaIy Held Corporation, Partnership or SoIe-Proprietorship
4. MoI1gages & Notes Reoeivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Joirrtly Owned Property (Schedule F)
D Separate Billing Requested
7. Inw-VIVOS Transfers & Miscellaneous Non-Proballl Property
(Schedule G or L)
8. TataI Groa AsHIs (toIaI Lines 1-7)
9. Funerel Expenses & Administndive Costs (Sdledule H)
10. Deb1s of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. TataI Ded~ (1oIa1 Lines 9 & 10)
12. Net Value of EsIBe (Line 8 minus Line 11)
13. Charitable and Governmental BaqueslslSec 9113 Trusts for which an election to tax hes not been
mede (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCnONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal1ax
raIll, or transfers under Sec. 9116 (a)(1.2)
NAME
Frederick D. Cazer
FIRM NAME(If~)
TELEPHONE NUMBER
(315) 691-3239
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16. Amount of Line 14 taxable at Iineal.r:a\ll
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at colaterel raIll
19. Tax Due
C" f\., ~t 'I "J,I .~RE ,.' 'JI.t '.llf,( :. f;OF FlJl\l,'Jf .u, J.l r,F'Avr,~ENT
COMPLETE MAlUNG ADDRESS
220 Reese Rd.
Earlville, NY 13332
(1) 83,755.33
(2)
(3)
(4)
(5)
(6)
(7)
(8) 83,755.33
(9)
(10)
(11)
(12)
(13)
(14)
83,755.33
x.O_ (15)
83.755.33 x.O~ (16)
x .12 (17)
x .15 (18)
(19)
3,769.00
3.789.00
eft
,
Decedent's Complete Address:
STREET ADDRESS
4833 East Trindle Rd
- CRY Mechanicsburg I STATEpA I ZIP 17055
,Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. CreditslPayments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1) I
I
I
3. IntereslJPenalty if applicable
D. Interest
E. Penalty
Total Credits (A + B + C ) (2)
TotallnterestlPenalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Une 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(5)
(SA)
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
3,769.00
3,769.00
3 769.00
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROP lATE BLOCKS
No
[iJ
[iI
iii
[iJ
1. Did decedent make a transfer and: Yes
a. retain the use or income of the property transferred;.......................................................................................... 0
b. retain the right to designate who shall use the property IIansferred or its income; ............................................ 0
c. retain a revenlionary interest; or.......................................................................................................................... 0
d. receive the promise for life of eilher payments, benefits or care? ...................................................................... D
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. D
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. D
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a bene1iciary designation? ........................................................................................................................ D
iii
iii
[iJ
IF THE ANSWER TO NIY OF THE ABOVE QUE noNS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT S PART OF THE RETURN.
IChecUII n1"""""" nI m" beet 01 my knawtedge nI bIII8f, It it true,
wIich pr.,..r haI "" knDwIIdgB.
ADDRESS
&00
For dates of death on or after July 1, 1994 and bebre January 1, 1995, the tax rate imposed on the net value of IIansfers t> or for the use of the rviving spouse is 3%
(72 P.S. S9116 (a) (1.1) (i)].
For dates of death on or alter January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse' 0% [72 P.S. S9116 (a) (1.1) (ii)).
The stabJte does not lWlIIIDt a Iransf8r to a SlIViving spouse from tax, and the stalutory AlqUirements for disdosure of assets and fling a relum are still applicable even If
the surviving spouse is the only beneficiary.
For dat88 d dedi on or after July 1, 2000: I
The tax rate imposed on the net value at transfers from a deceased child twenty-one years of age or younger at death to or for the use d a parent an adoptive parent
or a stepparent dthe child Is 0% [72 P.S. S9116(a)(1.2)}.
The tax rate imposed on the net value of transfers to or for the use at the decedenfs lineal beneficiaries is 4.5%, except as noted in 72 P.S. 5911 1.2) [72 P.S. S9116(a)(1)).
The tax retB impo&ed on the net value d transfers to or for the use d the decadent's siblings is 12% [72 P.S. S9116(a)(1.3)). A &IIIlng is ned, under Section 9102, as an
individual who has at least one parent in common with the decedent whether by blood or adoption.
~
~: Settlement Charges
700. Total Sales/Broker's Commission: (based on price) $126,900.00 @ % Paid from Paid from
Division of Commission (line 700) as follows: Borrower's Seller's
rof Funds at Funds at
702. Settlement Settlement
703. Commission paid at Settlement $ 0.00
704.
800. Items Payable in Connection with Loan
801. Loan OriQination Fee (1.0%) to The Honesdale National Bank $1,100.00
802. Loan Discount
803. Appraisal Fee to Milton RoeQner $225.00
804. Credit Report to Experian $10.00
805. Lender's Inspection Fee
806. MortQaQe Insurance Application Fee
807. ProcessinQ Fee to The Honesdale National Bank $90.00
808. Flood Certification Fee to The Honesdale National Bank $13.00
809. Document Preparation Fee to The Honesdale National Bank $275.00
810.
811.
812.
813.
814.
900. Items Required by Lender to Be Paid in Advance
901. Interest from I I to I I @$ I I per day
902. Mortgage Insurance Premium for
903. Hazard Insurance Premium for one year to Foremost Insurance Company ($412.00 PO C)
904.
905.
1000. Reserves Deposited with Lender
1001. Hazard insurance months ~ $ per month $ 0.00
1002. MortQaQe insurance months ~ $ per month $ 0.00
1003. City property taxes months ~ $ per month $ 0.00
1004. County property taxes months ~ $ per month $ 0.00
1005. Annual assessments months ~ $ per month $ 0.00
1006. months ~ $ per month $ 0.00
1007.
1008.
1009. Aaareaate AccountinQ Adiustment
1100. Title Charges
1101. Settlement/closinQ fee
1102. Abstract/title search
1103. Title examination
1104. Title insurance binder
1105. Document preparation to Nicholas A. Barna, Esquire $250.00
1106. Notary fees $15.00
1107. Attorney's fees Matthew L. MeaQher, Esquire / Nicholas A. Barna, Esquire N/C $250.00
(includes above item numbers
1108. Title insurance to Commonwealth Land Title Insurance Company (reissue) $894.38
(includes above item numbers
1109. Lender's coveraQe
1110. Owner's coveraQe - $126,900.00
1111.
1112.
1113.
1200. Government Recording and Transfer Charges
1201. RecordinQ fees: Deed $30.50 MortQaQe $38.50 Release $69.00 $ 0.00
1202. City/county tax/stamps: Deed $2,538.00 Mortgage $1,269.00 $1,269.00
1203. State tax/stamps: Deed MortQaQe $ 0.00
1204.
1205.
1206.
1300. Additional Settlement Charges
1301. Reimbursement for obtaininQ and filinQ exemplified record to Nicholas A. Barna, Esquire $70.00
1302. J. A. Conaway - EPA lien search $10.00
1303.
1304.
1305.
1306.
1307.
1308. /
1400. To+". ~ement Charges rr ~is ~ umber Transfers to Lines 103 & 502 Above) $3,955.38 $1,854.00
~~ )~ CERTIFICATION
I h.~ oa;;/:;~~: S ~ tatement and to the best of my m~ and belief, it is a true and accura tatement of all receipts and
disbursemen made n my c unt 0 mei n.'is transaction. I further certify tha h e rece()ed-" In_1 ement Statement.
-, ~ e:. . Seller /:1'41 ,,/// ~v A.I_.A.. Borrower
rstate of Lillian(- Caze1'1iy Frederi~ D. Cazer .<---'"' paul~. Meaghe(j
Seller -I. J.I -- a. '7..... ~ A' L,..." Borrower
Sandra A. Meag r
e HUD-1 Settlement Statement which I have prepared is true and accurate account of the funds which were received and
. as p of the settlement of this transaction.
Settlement Agent
~
December 9,2005
Date
. atthew L.:. Meagher, Esquire
WARl'IING: It is a crime to knowingly make false statements to the United States on this or any other similar form. Penalties upon conviction can include a fine and imprisonment. For details see: Title 18 U.S.
Code SeCtion 1001 and Section 1010.
~DEPA~TMENT OF HOUSING AND URBAN DEVELOPMENT (OMB # 2502-0265)
~~UD-1 UNIFORM SETTLEMENT STATEMENT
B. Type of Loan
1.[ ] FHA 2.[] FmHA 3.[] Conv. Unins. 6. File Number: 7. Loan Number: 8. Mortgage Insurance Case Number:
4.[]VA 5.[]Conv.lns. 05-434
C. NOTE: This form furnishes a statement of settlement costs. Amounts paid to and by the settlement agent are shown. Items marked
"(p 0 c )" were paid outside the closing; they are shown for informational purposes and are not included in the totals.
. . . .
D. Name & Address of Borrower: E. Name, Address & TIN of Seller: F. Name & Address of Lender:
Paul M. Meagher & Sandra A. Meagher Estate of Lillian Cazer c/o Frederick D. Cazer The Honesdale National Bank
206 Beech Grove Road 220 Reese Road 733 Main Street
Honesdale , PA 18431 Earlville , NY 13332-9629 Honesdale , PA 18431
G. Property Location: TIN of Seller: I H. Settlement Agent:
Alden Road Place of Settlement Matthew L. Meagher, Esquire
Dyberry Township Hamill Law Office Honesdale, PA 18431
Wayne County, PA Honesdale, PA 18431 I. Settlement Date: I December 9,2005
J. Summary of Borrower's Transaction
100. Gross Amount Due from Borrower:
K. Summary of Seller's Transaction
400. Gross Amount Due to Seller:
101. Contract sales price $126,900.00 401. Contract sales price $126,900.00
102. Personal Property 402. Personal Property
103. Borrower's settlement charges (line 1400) $3,955.38 403.
104. 404.
105. 405.
Adjustments for items paid by seller in advance Adjustments for items paid by seller in advance
106. School taxes 12/9/2005 to 6/30/2006 $ 415.57 406. School taxes 12/9/2005 to 6/30/2006 $ 415.57
107. School taxes 12/9/2005 to 6/30/2006 $ 86.70 407. School taxes 12/9/2005 to 6/30/2006 $ 86.70
108. County taxes 12/9/2005 to 12/31/2005 $ 11.12 408. County taxes 12/9/2005 to 12/31/2005 $ 11.12
109. County taxes 12/9/2005 to 12/31/2005 $ 2.32 409. Country taxes 12/9/2005 to 12/31/2005 $ 2.32
110. POA Dues 12/9/2005 to 12/31/2005 $6.03 410. POA Dues 12/9/2005 to 12/31/2005 $6.03
111. 411.
112. Escrow for improvements to HNB $8,100.00 412.
113. 413.
120. Gross Amount Due from Borrower $139,477.12 420. Gross Amount Due to Seller $127,421.74
200. Amounts Paid by or in Behalf of Borrower: 500. Reductions in Amount Due to Seller:
201. Deposits or earnest money $5,000.00 501. Excess deposit (see instructions)
202. Principal amount of new loan(s) $110,000.00 502. Settlement charges to seller (line 1400) $1,854.00
203. Existing loan(s) taken subject to 503. Existing loan(s) taken subject to
204. 504. Payoff of first mortgage
205. 505. Payoff of second mortgage
206. 506.
207. 507.
208. 508.
209. 509.
Adjustments for items unpaid by seller Adjustments for items unpaid by seller
210. City/town taxes to $ 0.00 510. City/town taxes to $ 0.00
211. County taxes to $ 0.00 511. County taxes to $ 0.00
212. Assessments to $ 0.00 512. Assessments to $ 0.00
213. to $ 0.00 513. to $ 0.00
214. 514.2005 CountylTownship #9-1-35 $185.30
215. 515.2005 CountylTownship #9-1-70 $38.66
216. 516.2005/06 School #9-1-35 $817.81
217. 517.2005/06 School #9-1-70 $170.64
218. 518. POA Dues from 2000 through 2005 $600.00
219. 519.
220. Total Paid By/for Borrower $115,000.00 520. Total Reduction Amount Due Seller $3,666.41
300. Cash at Settlement From/to Borrower 600. Cash at Settlement To/from Seller
301. Gross amount due from borrower (line 120) $139,477.12 601. Gross amount due to seller (line 420) $127,421.74
302. Less amounts paid by/for borrower (line 220) $115,000.00 602. Less reductions in amount due seller (line 520) $3,666.41
303. Cash I~I from 101 to Borrower $24,477.12 603. Cash I~I to 101 from Seller $123,755.33
Substitute Form 1099 Seller Statement
The information in Blocks E, G, H, I & line 401 (or, if line 401 is asterisked, line 403 and 404) is important tax information and is being
furnished to the Internal Revenue Service. If you are required to file a return, a sanction will be imposed on you if this item is required to be
reported and the IRS determines that it has not been reported. If this real estate is your principal residence, file Form 2119, Sale or
Exchange of Principal Residence, for any gain, with your income tax return; for other transactions, complete the applicable parts of Form
4797, Form 6252 and/or Schedule D (Form 1040). You are required to provide the Settlement Agent (named above) with your correct
taxpayer identification number. If you do not provide the Settlement Agent with your taxpayer identification number, you may be subject to
civil or criminal penalties imposed by law. Under penalties of perjury, I certify that the number shown on this statement is my correct
taxpayer identification number.
(Seller)
(Seller)
REV-1502 EX+ (6-98)
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Lillian F. Cazer
FILE NUMBER
21-030364
All rnl 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 nust be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1. Properly located at 9-1-35 Lake Alden, Previous assessed value based on 2002 sales, $40,000
Actual sale price:
Less amount previously reported and taxed:
126,900.00
3,144.67
123,755.33
40,000.00
83,755.33
83,755.33
Sum of adjustments:
Cash to Estate:
Total difference to be taxed:
TOTAL (Also enter on line 1, Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
83,755.33
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Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013 .
Phone: (717) 240-6345
Date: 1/13/2006
CAZER FREDERICK D
220 REESE ROAD
EARLVILLE, NY 13332
RE: Estate of CAZER LILLIAN F
File Number: 2003-00364
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after
July I, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by:
2/23/2006
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
~~~
'-'
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Counsel
Judge
02-28-2006
CAlER
02-23-2003
21 03-0364
CUMBERLAND
101
APPEAL DATE: 04-29-2006
(See reverse side under Objections)
Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +--
REV:is47-EX-AFP-C03:0si-NOTicE-OF-iNHERiTANCE-TAX-APPRAisEMENT:-ALLOWANCE-OR---------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
LILLIAN F FILE NO. 21 03-0364 ACN 101
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
~ I
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
FREDERICKD CAlER
220 REESE RD
EARLVILLE
NY 13332
ESTATE OF
CAlER
REV-1547 EX AFP (06-05)
LILLIAN
F
TAX RETURN WAS: (X) ACCEPTED AS FILED
CHANGED
DATE 02-28-2006
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Stock/Partnership Interest (Schedule C) (3)
4. Hortgages/Notes Receivable (Schedule D) (4)
5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) (5)
6. ~ointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
NO. 01
83.755.33
.00
.00
.00
.00
.00
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Hisc. Expenses (Schedule H) (9)
10. Debts/Hortgage Liabilities/Liens (Schedule I) (10)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequestsj Non-elected 9113 Trusts (Schedule ~)
14. Net Value of Estate Subject to Tax
.00
.00
ll1)
ll2)
ll3)
ll4)
NOTE: If an assessment was issued previously, lines
reflect figures that include the total of ALL
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15)
16. Amount of Line 14 taxable at Lineal/Class A rate (16)
17. Amount of Line 14 at Sibling rate (17)
18. Amount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CREDITS.
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
83,755.33
nn
83,755.33
.00
483,784.43
14, IS and/or 16, 17, 18 and 19 will
returns assessed to date.
.00 X 00 =
483,784.43 X 045 =
.00 x 12 =
.00 X 15 =
ll9)=
.00
21,770.31
.00
.00
21, 770.31
.
. .. II...... I R...."'....-I (+1 AHOUNT PAID
DATE NUHBER INTEREST/PEN PAID (-)
11-20-2003 CD003264 .00 18,001.31
12-14-2005 CD006119 .00 3,769.00
BALANCE OF UNPAID INTEREST/PENALTY AS OF 12-15-2005 TOTAL TAX CREDIT 21,770.31
BALANCE OF TAX DUE .00
INTEREST AND PEN. 351. 05
TOTAL DUE 351.05
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. (\
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DU~
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
Cumberland County Registrar of Wills
1 Courthouse Square
Carlisle, P A 17013
Feb. 19,2006
To Whom It May Concern;
Enclosed please find a status report for the estate of Lillian F. Cazer, file number 21-03-
0364.
The estate had remained open while the sale of the Lake Alden property was being
completed. Please find a copy of the documentation of sale dated December 9, 2005.
Once all appropriate taxes are paid, her headstone is set, and any other expenses paid, a
final distribution to the heirs will be made.
If there are any questions, please contact me at the address below.
Thank you for your attention to this matter.
~J::ev . f ~ c~~
Frederick no-ir, Executor
220 Reese Rd.
Earlville, NY 13332
LL 31,.5:691-3239
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STATUS REPORT ul\iTIER RULE 6.12
Name of Decedent: .. 1.. J J !; ~~ F C /r "2 .;.,~
Date of Death: 6l. - 2-.3- 1..-00 3
Estate No.:
1../- 03 - 03 &. ~
9
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following
with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes 0 No m
2. If the answer is No, state when the personal r=ntative reasonably believes that
the administration will be complete: ,J..1:..1y ~ Of't
3. lithe answer to No.1 is Yes, state the following:
a. Did the personal representative file a final account with -the CoUrt? .
Yes 0 No 0
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties in
interest? Yes 0 No 0
c. Copies of receipts, releases, joinders and approval of formal or infonnal
accounts may be filed with the Clerk of the Orphans' urt and may be
attached to this report.
Date:~(;
~q
S'
r;ej€l,[~l(
Name
~;(o
]....ddress
)C e (" "'-' 4"
I) (h '^- ~ 'fJ'-
)(~ E~~,tlts 'If
(3/)~t 91--J~3 7
Telephone 1'--To.
L:'.._
Capacity: Ki Pel:"so:ual P,-epresenIa:ive
o COi..lDsel for personal representa:tive
(~
Beneficiary Disbursements to Date:
Frederick D. Cazer (25%)
Allstate Annuity
Morgan Stanley Stock Portfolio
Lake Property Sale
Paul G. Cazer
(25%)
Allstate Annuity
Morgan Stanley Stock Portfolio
Lake Property Sale
Elizabeth D. Cazer (12.5%) Allstate Annuity
Morgan Stanley Stock Portfolio
Lake Property Sale
Patricia I. Cazer (12.5%) Allstate Annuity
Morgan Stanley Stock Portfolio
Lake Property Sale
Wilson D. Cazer (12.5%) Allstate Annuity
Morgan Stanley Stock Portfolio
Lake Property Sale
Constance M. Cazer (12.5%) Allstate Annuity
Morgan Stanley Stock Portfolio
Lake Property Sale
$ 25750.26
$ 67876.50
$ 29815.50
$ 123442.26
$ 25750.26
$ 67876.50
$ 29815.50
$ 123442.26
$ 12875.13
$ 33938.25
$ 14907.75
$ 61721.13
$ 12875.13
$ 33938.25
$ 14907.75
$ 61721.13
$ 12875.13
$ 33938.25
$ 14907.75
$ 61721.13
$ 12875.13
$ 33938.25
$ 14907.75
$ 61721.13
Total Disbursements to Estate Beneficiaries to Date (2/19/06) $ 493,769.04
Lillian F Cazer Estate Income and Disbursements
From Sale of Alden Lake Cottage Property
Amount Realized from sale (See attached)
$ 123755.33
GHS Account # 62247S70 tota112/10/2005
$ 129449.98
Additional P A Estate Tax on sale
(0.045 % of the difference between
appraisal of$ 40,000 and sale price)
- $ 3769.00
Filing Fee
- $ 15.00
Additional Probate Fee
- $ 105.00
Residual
$125,560.98
DISBURSEMENTS 12/26/2005 (from sale of Alden Lake Property):
Paul G. Cazer (25 %)
Constance M. Cazer (12.5 %)
$ 29815.50
$ 14907.75
$ 14907.75
$ 14907.75
$ 14907.75
$ 29815.50
$ 116,162.00
Elizabeth D. Cazer (12.5 %)
Patricia I. Cazer (12.5 %)
Wilson D. Cazer (12.5 %)
Frederick D. Cazer (25 %)
TOTAL DISBURSEMENTS 12/26/2005
Reserved toward 2005 estate tax, headstone,
partial executor's fee, accountant's fee and
final beneficiary disbursement.
$ 9,398.98
Cumberland County Registrar of Wills
1 Courthouse Square
Carlisle, P A 17013
To Whom It May Concern;
Enclosed please find a supplemental inheritance tax return for the estate of Lillian F.
Cazer, file number 21-03-0364.
The previous return dated 11-17-2003, showed a real estate property valued at
$40,000.00. This property has been sold for $123,755.33 cash to the estate. Attached is a
check in the amount of $3, 769.00 to cOver the inheritance tax due on the difference
between the sale price and the previously appraised value.
Also enclosed, please find a copy of the documentation of sale dated December 9, 2005.
If there are any questions, please contact me at the address below.
Thank you for your attention to this matter.
~ellJ. 7~
~~ D. Cazer, Executor
220 Reese Rd.
Earlville, NY 13332
315-691-3239
'ilGHS
EJi FEDERAL CREDIT UNION
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ESTATE OF LILLIAN F CAZER
FREDERICK D CAZER
220 REESE ROAD
EARLVILLE, NY 13332
CChorlce Americ....
GUAADIANe SAFETY GREEN WDGN
REV-1500 EX (6-00)
REV-1500
FILE NUMBER
21 03
0364
'* COMMONWEALTH OF
PENNSYLVANIA
. H DEPARTMENT OF REVENUE
. DEPT. 280601
'.r{ . HARRISBURG. PA 17128-0601
INHERITANCE TAX RETURN
RESIDENT DECEDENT
COUNiY CODE YEAR
NUMBER
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DECEDENT'S NAME {LAST, FIRST, AND MIDDLE INITIAL)
Cazer. Lillian F.
SOCIAL SECURITY NUMBER
064-44-9284
DATE OF DEATH (MM-DD-YEAR)
02123/03
DATE OF BIRTH (MM-DD- YEAR)
02117/15
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D 1. Original Return
D 4. Limited Estate
D 6. Decedent Died Testate (Attach ~y of VYiII)
D 9. Litigation Proceeds Received
~ 2. Supplemental Return
D 4a. Future Interest Compromise (date of dea1h after 12-12.a2)
D 7. Decedent Maintained a Living Trust (Attach ~ ofTrusl)
D 10. Spousal Poverty Credit (date of dealh between 12.31.91 aR:l1-1-95)
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
D 3. Remainder Return (date of dea1h prior to 12-13-82)
D 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (At1ach Sch 0)
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THIS SECnoN MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
Frederick D. Cazer 220 Reese Rd.
FIRM NAME (IfAWiai>Ie) Earlville. NY 13332
TELEPHONE NUMBER
(315) 691-3239
(1 ) 83,755.33
(2)
(3)
(4)
(5)
(6)
(7)
(8) 83,755.33
(9)
(10)
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
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)
13. Charitable and Governmental Bequests/See 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
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
x .0 _ (15)
83,755.33 x.O~. (16)
(11 )
(12)
(13)
(14)
83,755.33
16. Amount of Line 14 taxable at lineal rate
3,769.00
(19)
3,769.00
17. Amount of Line 14 taxable at sibling rate
x .12 (17)
x .15 (18)
18. Amount of Line 14 taxable at collateral rate
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
19. Tax Due
20.0
Decedent's Complete Address:
STREET ADDRESS
4833 East Trindle Rd
CITY Mechanicsburg I STATEpA I ZIP
17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. CreditslPayments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1 )
3,769.00
Total Credits ( A + 8 + C ) (2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
TotallnterestlPenalty ( D + E ) (3)
4. If Line 2 is greater than line 1 + line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than line 2, enter the difference. This is the TAX DUE.
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(5)
(5A)
(58)
3,769.00
A. Enter the interest on the tax due.
3,769.00
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN I.X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ................................... ..................... ......................... ......... 0 [iJ
b. retain the right to designate who shall use the property transferred or its income; ............................................ D [iJ
c. retain a reversionary interest; or....... .................... ..... ........ ...... ................. .... ..... .................. ..... .............. ..... ........ D I1f]
d. receive the promise for life of either payments, benefits or care? ...................................................................... D [iJ
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? . ............ ..................... ..................... ........................ ......... ...... ................ D ~
3. Did decedent own an lIin trust forI! or payable upon death bank account or security at his or her death? .............. D ~
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary desig nation? ........................... ..... ................... ................... ....... .:........ ........... ............ .......... D ~
IF THE ANSWER TO ANY OF THE ABOVE QUE TIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
ADDRESS
. 9 schec1Jles end sta1ements, and to the best of my knowledge end belief, it is true, mned end complete.
'on f which preparer has any knowledge.
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SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
JJZ
DATE
ADDRESS
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. 99116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (ii)J.
The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if
the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent an adoptive parent
or a stepparent of the child is 0% [72 P.S. 99116{a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)}.
The tax rate imposed on the net value of transfers to or for the use of the decedenfs siblings is 12% [72 P.S. 99116(a)(1.3)]. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common with the deceden~ whether by blood or adoption.
REV-1502 EX+ (6-9.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF
Lillian F. Cazer
FILE NUMBER
21-030364
All rul 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 M.lst be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1. Property located at 9-1-35 lake Alden. Previous assessed value based on 2002 sales, $40,000
Actual sale price:
126,900.00
3,144.67
123,755.33
40,000.00
83,755.33
83,755.33
Sum of adjustments:
Cash to Estate:
less amount previously reported and taxed:
Total difference to be taxed:
TOTAL (Also enter on line 1, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
83,755.33
U.S'. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT (OMS # 2502-0265)
.,- A. HUD-1 UNIFORM SETTLEMENT STATEMENT
B. Type of Loan
1.[] FHA 2.[] FmHA 3.[] Conv. Unins. 6. File Number: 7. Loan Number: 8. Mortgage Insurance Case Number:
4.[ ] VA 5.[] Conv. Ins. 05-434
C. NOTE: This form furnishes a statement of settlement costs. Amounts paid to and by the settlement agent are shown. Items marked
n(p 0 c)" were paid outside the closing; they are shown for informational purposes and are not included in the totals.
. . .
D. Name & Address of Borrower: E. Name, Address & TIN of Seller: F. Name & Address of Lender:
Paul M. Meagher & Sandra A. Meagher Estate of Lillian Cazer c/o Frederick D. Cazer The Honesdale National Bank
206 Beech Grove Road 220 Reese Road 733 Main Street
Honesdale , PA 18431 Earlville , NY 13332-9629 Honesdale , PA 18431
G. Property Location: TIN of Seller: I H. Settlement Agent:
Alden Road Place of Settlement Matthew L. Meagher, Esquire
Dyberry Township Hamill Law Office Honesdale, PA 18431
Wayne County, PA Honesdale, PA 18431 I. Settlement Date: I December 9, 2005
J. Summary of Borrower's Transaction
100. Gross Amount Due from Borrower:
K. Summary of Seller's Transaction
400. Gross Amount Due to Seller:
101. Contract sales price $126,900.00 401. Contract sales price $126,900.00
102. Personal Property 402. Personal Property
103. Borrower's settlement charges (line 1400) $3,955.38 403.
104. 404.
105. 405.
Adjustments for items paid by seller in advance Adjustments for items paid by seller in advance
106. School taxes 12/9/2005 to 6/30/2006 $ 415.57 406. School taxes 12/9/2005 to 6/30/2006 $ 415.57
1 07. School taxes 12/9/2005 to 6/3012006 $ 86.70 407. School taxes 12/9/2005 to 6/30/2006 $ 86.70
108. County taxes 12/9/2005 to 12/31/2005 $ 11.12 408. County taxes 12/9/2005 to 12/31/2005 $ 11.12
109. County taxes 12/9/2005 to 12/31/2005 $ 2.32 409. Country taxes 12/9/2005 to 12/31/2005 $ 2.32
110. POA Dues 12/9/2005 to 12/31/2005 $6.03 410. POA Dues 12/9/2005 to 12/31/2005 $6.03
111. 411.
112. Escrow for improvements to HNB $8,100.00 412.
113. 413.
120. Gross Amount Due from Borrower $139,477.12 420. Gross Amount Due to Seller $127,421.74
200. Amounts Paid by or in Behalf of Borrower: 500. Reductions in Amount Due to Seller:
201. Deposits or earnest money $5,000.00 501. Excess deposit (see instructions)
202. Principal amount of new loan(s) $110,000.00 502. Settlement charges to seller (line 1400) $1,854.00
203. Existing loan(s) taken subject to 503. Existing loan(s) taken subject to
204. 504. Payoff of first mortgage
205. 505. Payoff of second mortgage
206. 506.
207. 507.
208. 508.
209. 509.
Adjustments for items unpaid by seller Adjustments for items unpaid by seller
210. City/town taxes to $ 0.00 510. City/town taxes to $ 0.00
211. County taxes to $ 0.00 511. County taxes to $ 0.00
212. Assessments to $ 0.00 512. Assessments to $ 0.00
213. to $ 0.00 513. to $ 0.00
214. 514. 2005 CountylTownship #9-1-35 $185.30
215. 515.2005 CountylTownship #9-1-70 $38.66
216. 516.2005/06 School #9-1-35 $817.81
217. 517.2005/06 School #9-1-70 $170.64
218. 518. POA Dues from 2000 through 2005 $600.00
219. 519.
220. Total Paid By/for Borrower $115,000.00 520. Total Reduction Amount Due Seller $3,666.41
300. Cash at Settlement From/to Borrower . 600. Cash at Settlement To/from Seller
301. Gross amount due from borrower (line 120) $139,477.12 601. Gross amount due to seller (line 420) $127,421.74
302. Less amounts paid by/for borrower (line 220) $115,000.00 602. Less reductions in amount due seller (line 520) $3,666.41
303. Cash I~I from 101 to Borrower $24,477.12 603. Cash I~I to 101 from Seller $123,755.33
- -
Substitute Form 1099 Seller Statement
The. information in Blocks E, G, H, I ~ line 401 (or, if lin~ 401 is asterisked, line 403 and 404) is important tax information and is being
furnished to the Internal Revenue Service. If you are required to file a return, a sanction will be imposed on you if this item is required to be
reported and the IRS determines that it has not been reported. If this real estate is your principal residence, file Form 2119, Sale or
Exchange of Principal Residence, for any gain, with your income tax return; for other transactions, complete the applicable parts of Form
4797, Fo~m 6~52 ~nd/or Schedule D (Form 104.0). You are required to provide the Settlement Agent (named above) with your correct
t~x.payer I.d~ntlficatlon ~u",!ber. If you do not provide the ~ettlement Agent with your taxpayer identification number, you may be subject to
CIVil or cnmlnal penalties Imposed by law. Under penalties of perjury, I certify that the number shown on this statement is my correct
taxpayer identification number.
(Seller)
(Seller)
J
5 ttl t Ch
e emen arges
00. T~t~I.Sales/Broker's Commission: (based on price) $126,900.00 @ % Paid from
DIVISion of Commission (line 700 as follows' Paid from
01. . Borrower's Seller's
02. Funds at Funds at
03. Commission paid at Settlement Settlement Settlement
04. $ 0.00
[l0. Items Payable in Connection with Loan
31. Loan Origination Fee (1.0%) to The Honesdale National Bank $1,100.00
32. Loan Discount
33. Appraisal Fee to Milton Roegner
34. Credit Report to Experian $225.00
35. Lender's Inspection Fee $10.00
36. Mortgaae Insurance Apolication Fee
37. Processing Fee to The Honesdale National Bank $90.00
38. Flood Certification Fee to The Honesdale National Bank
)9. Document Preparation Fee to The Honesdale National Bank $13.00
10. $275.00
11.
12.
13.
14.
)0. Items Required by Lender to Be Paid in Advance
)1. Interest from I I to 1 @$ I lperday
)2. Mortgage Insurance Premium for
;~: Hazard Insurance Premium for one year to Foremost Insurance Company ($412.00 POC)
35.
000. Reserves Deposited with lender
001. Hazard insurance months ) $ per month $ 0.00
002. Mortgage insurance months l $ per month $ 0.00
003. City property taxes months ( $ per month $ 0.00
004. County property taxes months ( $ per month $ 0.00
005. Annual assessments months ( $ per month $ 0.00
006. months ( $ per month $ 0.00
007.
008.
009. Aogregate Accounting Adiustment
100. Title Charges
101. Settlement/closing fee
102. Abstract/title search
103. Title examination
104. Tme insurance binder
105. Document preparation to Nicholas A. Barna, Esquire $250.00
106. Notary fees $15.00
107. Attorney's fees Matthew L. Meagher, Esquire I Nicholas A. Barna, Esquire N/C $250.00
(includes above item numbers
iOB. Title insurance to Commonwealth Land Title Insurance Company (-reissue)- $894.38
(includes above item numbers
09. Lender's coverage
10. Owner's coverage - $126,900.00
11.
12.
13.
-)0. Government Recording and Transfer Charges
)1. Recording fees: Deed $30.50 Mortgage $38.50 Release $69.00 $ 0.00
12. City/county tax/stamps: Deed $2,538.00 Mortgage $1,269.00 $1,269.00
13. State tax/stamps: Deed Mortgage $ 0.00
4.
5.
J.
]. Additional Settlement Charges
i. Reimbursement for obtaining and filing exemplified record to Nicholas A. Barna, Esquire $70.00
~. J. A. Conaway - EPA lien search $10.00
) .
1'\
To+"""~ement Charges (r his ~ umber Transfers to Lines 103 & 502 Above) $3,955.38 $1,854.00
~ie;j:j;f~: S ~ ~ I~ CERTIFICATION
en !atement and to the best of my m and belief, it is a true and accura tatement of all receipts and
,emen made n my c unt 0 ~ me i ,~iS transaction, I further certify lha h e rece~ed - - - ---1 emenl Statement
. , . ~ ---'" Seller . //41 .... /// ~ce "7' ,_ ..1.._ Borrower
.. ~ "\.
.tslale of Lillian(- Cazerlly Frederi(l;'O. Cazer ~ paul~. Meaghe(j 1. -
Seller I A -A U. ~"V\1 A ~/t.../ Borrower
Sandra A. Meag r
e HUD-1 Settlement Statement which I have prepared is true and accurate account of the funds which were received and
. as p of the settlement of this transaction.
Settlement Agent December 9, 2005 Date
atthew L. Meagher, Esquire
;: It is a crime to knowingly make false statements to the United States on this or any other similar form. Penalties upon conviction can include a fine and imprisonment. For details see: Title 18 U.S.
ion 1001 and Section 1010.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
I' -
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
CAZER FREDERICK 0
220 REESE ROAD
EARlVlllE, NY 13332
-------- fold
ESTATE INFORMATION: SSN: 064-44-9284
FILE NUMBER: 2103-0364
DECEDENT NAME: CAZER LILLIAN F
DATE OF PAYMENT: 03/13/2006
POSTMARK DATE: 03/09/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 02/23/2003
NO. CD, 006429
ACN
ASSESSMENT
CONTROL
NUMBER
A.MOUNT
101 I $351 .05
I
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TOTAL AMOUNT PAID:
$351 .05
REMARKS:
CHECK# 331
SEAL
INITIALS: MG
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WillS
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BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
REV-1607 EX AFP (03-05)
FREDERICK D CAZER
220 REESE RD
EARLVILLE NY 13332
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
04-10-2006
CAZER
02-23-2003
21 03-0364
CUMBERLAND
101
LILLIAN
F
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE
~
RETAIN LOWER PORTION FOR YOUR RECORDS
+-
REV-1607 EX AFP (03-05)
*** INHERITANCE TAX STATEMENT OF ACCOUNT ...
ESTATE OF CAZER LILLIAN F FILE NO.21 03-0364 ACN 101 DATE 04-10-2006
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 02-28-2006
PRINCIPAL TAX DUE: 21,770.31
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
11-20-2003 CD003264 .00 18,001.31
12-14-2005 CD006119 .00 3,769.00
03-09-2006 CD006429 351.05- 351.05
TOTAL TAX CREDIT 21,770.31
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
If IF PAID AFTER THIS DATE, SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
~--
f \i
~
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 2/07/2007
CAZER FREDERICK D
220 REESE ROAD
EARLVILLE, NY 13332
RE: Estate of CAZER LILLIAN F
File Number: 2003-00364
Dear Sir/Madam:
This notice is to serve as a reminder that the Status Report by
Personal Representative under .Rule 6.12 is due on the below listed
date.
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 two
(2) years of the decedent's death, shall file with the Register of
wills a Status Report of completed or uncompleted administration.
This filing is due by:
2/23/2007
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
~~~
I .
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
Pa. O.C. Rule 6.12 STATUS REPORT
REGISTER OF WILLS OF L LC '1-11 ~ -e-/~ ) '^- vi I COUNTY, PENNSYL VANIA
Name of Decedent:
it IlIA ~l F:
r; ;;2~ ~ btJ3
C j(. z... e r-
Date of Death:
File Number:
~ I 03 .- cL3 r; Aj
Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of
the above-captioned estate:
1. State whether administration of the estate is complete: . . . . . . . . . . . . . . . . . . .. t1?1 Yes DNa
2. lfthe answeris No, state when the personal representative
reasonably believes that the administration will be complete:
3. lfthe answer to No.1 is YES, state the following:
a. Did the personal representative file a final account with the Court? . . . . . .. ~ Yes D No
tJ.- f! ~ ~jt(: d
b. The separate Orphans' Court No. (if any) for the personal
representative's account is:
c. Did the personal representative state an account
informally to the parties in interest? . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ~Yes DNa
Dale
~: ~ / / ~.. / t) G
-..::.: I l~. /
" .
d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be
filed with the Clerk of the Orphans' Court and may be attached to thi eport.
4L~< C
~'...
--...;
Capacity: ~Personal Representative o Counsel
r;. f' j e I'- {~ I( (). (' /.. 2. <e- r---
Name of Person Filing this Form . I
2.;2..() R.ees.-e )fd.
Address / / J (y
E tt 1"-1 Y'I t ! l' )IV t / .3 3 3 2..
,/S-~& 71- 3:ZJ 9
Telephone
:--_""-
Form R W-I 0 rev. 10.13.06
J
Final Beneficiary Disbursements, 12/31/2006
Frederick D. Cazer (25%)
Allstate Annuity
Morgan Stanley Stock Portfolio
Lake Property Sale
Final Distribution
Paul G. Cazer
(25%)
Allstate Annuity
Morgan Stanley Stock Portfolio
Lake Property Sale
Final Distribution
Elizabeth D. Cazer (12.5%) Allstate Annuity
Morgan Stanley Stock Portfolio
Lake Property Sale
Final Distribution
Patricia I. Cazer (12.5%) Allstate Annuity
Morgan Stanley Stock Portfolio
Lake Property Sale
Final Distribution
Wilson D. Cazer (12.5%) Allstate Annuity
Morgan Stanley Stock Portfolio
Lake Property Sale
Final Distribution
Constance M. Cazer (12.5%) Allstate Annuity
Morgan Stanley Stock Portfolio
Lake Property Sale
Final Distribution
Final Total Disbursements to Estate Beneficiaries
$ 25750.26
$ 67876.50
$ 29815.50
$ 5000.72
$ 128442.98
$ 25750.26
$ 67876.50
$ 29815.50
$ 5000.72
$ 128442.98
$ 12875.13
$ 33938.25
$ 14907.75
$ 2500.36
$ 64221.49
$ 12875.13
$ 33938.25
$ 14907.75
$ 2500.36
$ 64221.49
$ 12875.13
$ 33938.25
$ 14907.75
$ 2500.36
$ 64221.49
$ 12875.13
$ 33938.25
$ 14907.75
$ 2500.36
$ 64221.49
$ 513,771.92
Lillian F. Cazer Estate Expenses
Brennan & Brennan Funeral Home $ 5109.00
Home Instead Senior Care $ 50.00
West Shore EMS $ 373.25
Register of Wills (Initial Inheritance Tax) $18001.31
Register of Wills $ 15.00
Registrar of Wills (Death Certificates) $ 21.00
Register of Wills Agent (Additional Inheritance tax) $ 3769.00
Register of Wills $ 15.00
Register of Wills $ 105.00
Hamilton & Musser (Accountant) $ 200.00
P A Dept Revenue $ 450.00
United States Treasury $ 63.83
United States Treasury $ 4094.00
United States Treasury $ 62.00
Roegner Appraisal Group (Lake Property) $ 300.00
Joan M. Donofry Tax Collector (Lake Property) $ 783.96
PP&L (Lake Property electric) $ 33.87
Joan M. Donofry Tax Collector (Lake Property) $ 714.34
Nationwide Mutual Fire Insurance (Lake Property) $ 135.00
Joan M. Donofry Tax Collector (Lake Property) $ 144.95
Hamilton & Musser (Accountant) $ 375.00
Nationwide Mutual Fire Insurance (Lake Property) $ 135.00
PP&L (Lake Property electric) $ 75.00
PP&L (Lake Property electric) $ 36.00
PP&L (Lake Property electric) $ 19.89
PP&L (Lake Property electric) $ 20.31
PP&L (Lake Property electric) $ 20.00
Executor Fee (Including expenses) $ 15000.00
Additional Expenses
Register of Wills
United States Treasury
Hamilton & Musser (Accountant)
Arthur Bryant Funeral Home (Gravestone)
Additional Executor Fee (Including expenses)
$ 351.05
$ 37.00
$ 200.00
$ 1550.00
$ 6000.00