HomeMy WebLinkAbout11-17-11 (2)1505610148
REV-1500 EX (01-10)
OFFlCIAL USE ONLY
PA Department of Revenue County Code Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURN 2 ], 10 116 5
PO BOX 280601
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
303-48-6529 10072010 05051944
Decedent's last Name Suffer Decedent's First Name MI
ROBERTS JACQUELYN A
(If Applicable) Ertter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name M I
Spouse's Social Security Number
FILL IN APPROPRUITE BOXES BELOW
® 1. Original Retum
^ 4. Limited Estate
® 6. Decedent Died Testate
(Attach Copy of Will)
^ 9. Litigation Proceeds Received
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
^ 2. Supplemental Retum
^ 4a. Future Interest Compromise (date of
death after 12-12-82)
^ 7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
^ 10. Spousal Poverty Credit (date of death
between 12-31-91 and 1-1-95)
CORRESPONDENT - THIS SECTION MUST 8E COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Numbfa
r*
71?-730-2
LINDA J - LUNDBERG -> VP . ~-
REGISTER Oirj11~11L4~8E ONCYti
~A~
~rn~ -J
First line of address
4242 CARLISLE PIKE
Second tine of address
P•0- BOX 308
City or Post Office
CAMP HILL
State ZIP Code
PA 17011
prior to 12-13-82)
^ 5. Federal Estate Tax Retum Required
8. Total Number of Safe Deposit Bones
^ 11. Election to tax under Sec. 9113(A)
(Attach Sch. O)
^ 3. Remainder Retum (date of death
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Correspondent's e-mail address: LINDA • L U N D B E R G a P N C• C O M
Under penalties of perjury, I dedare that I have examined this nrtum, induding accompanying schedules and statements, and to the hest d my knowledge and belief,
it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of vfiich preparer has any knowledge.
P O.VBOX 308 `~ CAMP HILL, PA 17001-0308
SIGNATURE OF PREPARER OTHER THAN REPRESENTATNE DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610148 1505610148
9M4647 4.000
J n,-~Y
~~~
___J 1505610248
REV-1500 EX
Decedent's Social Security Number
303-48-6529
oecedeM'sName ROBERTS JACQ UEL YN A
RECAPITULATION
1. Real Estate(ScheduleA)- 1. 430,000.00
2. Stocks and Bonds (Schedule B) . .. .. .... .. .. .. .. 2. 0 • 0 0
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) , 3, 0 • 0 0
4. Mortgages and Notes Receivable (Schedule D) 4, 0 • 00
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) 5. 4 31, 2 5 4.51
6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested g, 0 • 0 0
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Properly
.
Requested
arate Billin
~ S
7
0 • 0 0
.
g
ep
(Schedule G) .
8. Total Grows Assets (total Lines 1 through 7) .. .. ... 8. 861, 254.51
9. Funeral Expenses and Administrative Costs (Schedule H), .9. 111, 661.0 3
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) 1 a. 3 2 3 , 0 6 3.2 9
11. Total Deductions (total Lines 9 and 10j , . 11. 4 3 4 , 7 2 4.3 2
12. Net Value of Estate (Line 8 minus Line 11) . 12. 4 2 6 , 5 3 0.19
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) , , , . , , , . .. .. 13. 4 2 6 , 5 3 0.19
14. Net Value Subject to Tax (Line 12 minus Line 13j . 14. 0 • 0 0
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(aj(1.2> x .o LJ_ 0.0 0
15.
0.0 0
16. Amount of Line 14 le
4
0.0 0
at lineal rate X .0
0.0 0 16.
17. Amount of Line 14 taxable
0' 0 0
at sibling rate X .12 0. 0 0 ~ 7.
18. Amount of Line 14 taxable
at collateral rate X .15 0. 0 0
18.
0. 0 0
19. TAX DUE .. 19. 0 • 0 0
20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
1505610.248 1505610248 J
9M4848 4.000
REV-1500 EX Pape 3
Fite Number
Decedent's Com late aaciress: C y .b u y y d~
DECEDENTS NAME
STREET ADDRESS
CITY STATE ZIP
Tax Payments and Credits:
1. Tax Due (Papa 2, Line 19)
2. Credits/Payments
A. Prior Payments 0.0 0
B. Discount 0 • ^ 0
(1) 0.00
Taal creait$ t A + s > (2) 0.0 0
3. Interest
[3) 0.0 0
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in box on Page 2, Line 20 to request a n~fund. (4} 0 ' 0 0
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0 ' 0 0
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: 0
a. retain the use or income of the propeAy transferred; ..... ...
e
' ^
; ...... ...
ed or its incom
b. retain the right to designate who shall use the property transfen
c. retain a reversionary interest; or ....... ... .. .
d. receive the promise for life of either payments, benefits or care? ........... ...... .
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death ^
without receiving adequate consideration? ... ^
3. Did decedent own an "in trust for" or payable-upon-death bank account or security at his or her death?
4. Did decedent own an individual retirement account, annuity, or other non-probate property, which ^
contains a beneficiary designation? ............................. .. .
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE R AS PART OF THE RETURN.
For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is
3 percent [72 P.S. §9116 (a) (1.1) (i)].
For dates ~ death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or fa the use of the surviving spouse is 0 percent
[72 P.S. §9116 (a) (1.1) (ii)). The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax return are atilt applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an
adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(x)(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 percent, except as noted in
72 P.S. §9116(1.2) [72 P.S. §9116(x)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)j. Asibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
9M4877 2.000
REV-7502 EX+ (Ot-10)
Pennsylvania
DEPARiG@riOf REVENUE
NJF~tIrANCE TAX RETURN
ESTATE OF:
SCHEDULE A
REAL ESTATE
FILE NUN~ER:
JACOUELYN A. ROSERTS 21 10 1165
AH real property owned soNly or as a MnaM to common must ba reported at fair market valor. Fair market value is deed as the price at whidt property
would be exchanged between a willing buyer and a wilting selbr, neither being oompelbd to buy or sell, bath having reasonable knowledge dthe rebvant facts.
Real property that t: jointiyowned wNh tight of survivorship must ba dtscbsed on Schedule F.
awass5 2.000 If more space is needed, use additional sheets of paper of the same size.
REV-1503 EX + (8.98)
SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS ~ BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
4TAC UELYN A ROBERT3 21 10 1165
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
3W4896 1.000 (If more space is needed, insert additional sheets Of the same size)
REY-1507 EX + (8.91p
SCHEDULE D
CoMiAONNIEALTH OF PENNSYLVANIA MORTGAGES ~ NOTES
IN ~~ T~ SRN ~C~~E
ESTATE OF FILE NUMBER
JACQUELYN A. ROBERTS 21 10 1165
At1 property johWy-owned wHh rf9ht oT suMvorshfp must M d(sclosed on Schedule F.
3W4tiAC 1.000 (If more space is needed, insert additional sheets of same size)
REY-1508 EX + (69th
SCHEDULE E
COA~IIONVVEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, 8r MISC.
IN ~~ ~~RENRN PERSONAL PROPERTY
ESTATE OF FILE NUMBER
JACQUELYN A. ROBERT3 21 10 1165
Include the proceeds of litigation and the date the proceeds were received by the estate.
AY properly Jointiyowntd with the rlgM of survfvoahip must bs discbsed on SchsduN F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 3CIVEREIGN BANK
CHECKING ACCOUNT #2561001318
BALANCE 10/07/10 29,561.17
ACCRUED INTEREST 2.41
TOTAL 29,563.58 29,563.58
2 CHASE BANK
REFUND DUE TO CANCELLATION OF ENROLLMENT IN CHASE
PAYMENT PROTECTION PLAN 463.31
3 THE SENTINEL
REFUND DUE TO CANCELLATION OF NEWSPAPER DELIVERY 23.83
4 CRYSTAL ART IMPORTS INC.
REFUND DUE TO RETURN OF MERCHANDISE PRIOR TO DEATH 55.00
5 THE TOG SHOP
REF<JND 6.80
6 THE PATRIOT-NEWS
REFUND DUE TO CANCELLATION OF NEWSPAPER DELIVERY 112.75
7 MY HOME MAGAZINE
REFUND DUE TO CANCELLATION OF SUBSCRIPTION 16.63
8 INTERIOR DESIGN MAGAZINE
REE'tJND DUE TO CANCELLATION OF SUBSCRIPTION 7.48
9 REIMAN PUBLICATIONS
REFUND DUE TO CANCELLATION OF TASTE OF HOME MAGAZINE
SUBSCRIPTION 4.33
10 OHIO NATIONAL LIFE INSURANCE COMPANY ANNUITY # E1670521
PAYABLE TO THE ESTATE.
VALUE AS OF 10/07/10 PER ATTACHED LETTER FROM OHIO
NATIONAL FINANCIAL SERVICES 85,225.51
11 WERNER PUBLISHING CORP
REFUND DUE TO CANCELLATION OF OUTDOOR PHOTOGRAPHER
MAGAZINE SUBSCRIPTION 8.17.
Total from continuation schedules 315,767.12
TOTAL Also enter on line 5 R ' ulation $ 431, 254.51
3w4ttnD 1.000 (If more space is needed, insert additional sheets of the sane s¢e)
Estate of: JACQUELYN A. ROBERTS 21 10 1165
Schedule E (Page 2)
Item Value at Date
No. Description of Death
12 FAMILY CIRCLE MAGAZINE
REFUND DUE TO CANCELLATION OF SUBSCRIPTION 4.33
13 1~RC;~AN STANLEY SMITHBARNEY INDIVIDUAL RETIREMENT ACCOUNT
# 724-6C464-10 PAYABLE TO THE ESTATE.
VALUE AS OF 10/07/10 PER ATTACHED ESTATE TAX SECURITIES
VALUATION STATEMENT. 223,521.61
14 THE HARTFORD SAFE HAVEN PROGRAM # 500597054
BALANCE 10/07/10 39,759.47
ACCRUED INTEREST 23.97
TOTAL 39,783.44 39,783.44
15 TIME INC SHARED SERVICES
REFUND DUE TO CANCELLATION OF REAL SIMPLE MAGAZINE
SUBSCRIPTION 20.00
16 REIMAN PUBLICATIONS
REFUND DUE TO CANCELLATION OF BIRDS & BLOOMS MAGAZINE
SUBSCRIPTION 4.33
17 PROCEEDS OF INTERRA CREDIT UNION A/C # 306469 20.27
18 CAT FANCY
SUBSCRIPTION CANCELLATION REFUND 5.56
19 VICTORIA MAGAZINE
SUBSCRIPTION CANCELLATION REFUND 15.00
20 BETTER HOMES ~ GARDENS
MAGAZINE SUBSCRIPTION CANCELLATION REFUND 45.38
21 ERIE INSURANCE GROUP
HOMEOWNERS INSURANCE POLICY CANCELLATION REFUND 592.00
22 CASH 291.94
23 BETTER H~3 ~ GARDENS
REFUND FOR BOOK RETURNED PRIOR TO DEATH 32.76
24 NET IRS REFUND RE DECEDENTS 2010 FEDERAL INDIVIDUAL
INCOME TAX RETURN AS FOLLOWS:
REFUND 5,427.00
LESS PAYI~NT - 4,750.00
NET REFUND 677.00 677.00
Total (Carry forward to main schedule) 265,013.62
Estate of: JACQUELYN A. ROBERT3
Schedule E (Page 3)
Item
No. Description
25 GROSS PROCEEDS OF SALE OF 2002 HONDA CIVIC AUTOMOBILE
26 GROSS PROCEEDS OF SALE OF 1986 AUDI AUTOMOBILE
27 GR033 PROCEEDS OF SALE OF HOUSEHOLD CONTENTS
28 FOOD NETFfORK MAGAZINE
SUBSCRIPTION REFUND
29 FOR INFORMATIONAL PURPOSES ONLY:
THE DECEDENT WAS RECEIVING A MONTHLY QUALIFIED PENSION
FROM FIDELITY INVESTMENTS. ALL BENEFITS TERMINATED AT
THE DEATH OF JACQUELYN A ROBERTS WITH NO FURTHER
BENEFITS DUE HER HEIRS OR THE ESTATE.
30 FOR INFORMATIONAL PURPOSES ONLY:
THE DECEDENT WAS RECEIVING A MONTHLY NONQUALIFIED
PENSION FROM FIDELITY INVESTMENTS. ALL BENEFITS
TERMINATED AT THE DEATH OF JACQUELYN A ROBERTS WITH NO
FURTHER BENEFITS DUE HER HEIRS OR THE ESTATE.
21 10 11.65
Value at Dat®
of Death
9,400.00
.900.00
40,441.50
12.00
0.00
0.00
Total (Carry forward to main schedule) 50,753.50
REV-1509 t7C+ (01-10)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
REetDENT DECEDENT
ESTATE OF:
SCHEDULE F
JOINTLY-0WNED PROPERTY
FILE NUMBER:
JACQUELYN A. ROBERT3 21 10 1165
ff an asset became jolNtty owned vritldn one year of the decedeirt's date of death, R must be reported on Schedule G
SURVNNG JOMTBJANT(S) NAWE(S)
JOINTLY OWNED PROPERTY:
RELATIOlJSHP TO OI~BQf
R~
NLeiB92 UTTER
FOR JDINT
TBdANT GATE
~~
JONT DESCRPiION OF PROPB~TY
pNAUOE NAME6 FlWINWLNN:TRU110H AND BANK ACCg1Nf NUMlER OR SIMUR
K7ENT6YIM6NUMlER.ATTACNOEEDFORJaNTLYHELDRFAIESTATE.
- ~TE~~'ATI'I
VALLEOFASSET 96 OF
S
NTSZ!-ST Dare OF t]EATH
VALUEOF
D6CEDB~(1'S1Vi>~T
None
TOTAL (Also enter on Line 6, Recapitulation} S
0.00
svwaAE 2.000 ff more space is needed, use additional sheets of paper of the same size.
REV-1510 EX + (08-09)
Pennsylvania
DEPARTMENT OF REVENUE
IrkERRANCf TAX RETURN
RESIDENT' DECEDENT
SCHEDULE G
INTER VIVOS TRANSFERS AND
MISC. NON-PROBATE PROPERTY
JACQUELYN A ROBERT3 __ 21 10 1165
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
ITEM
NUMBE DESCRIPTION OF PROPERTY
NCL6pE7{E N4AE OF TF£ 1RAMSFEREE, TlEIR RELATIONSNP TO DECEDENT APD
T1f pg7E pF7RM8FER ATfACNA00PY DF TFE DEED FOR REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET ,
/o OF DECD'S
THEREBY EXCLUSION
APPUCABL TAXABLE
VALVE
~ • None
TOTAL (Also enter on line 7, Recapitulation) $ I 0.00
If more space is needed, use additional sheets d paper d the same sae.
8w4eAF 2.000
REW1511 EX+(10~0~
Pennsylvania
DEQARTAENrOF REVENUE
lTANCE TqX RETURN
RESAFM OECEDENi
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
JACQUELYN A. R0SERT3 21 10 1165
Decedent's debts must be reported on Schedule 1.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1, MALPEZZI FUNERAL HOME
FUNERAL SEVICES .2,029.65
Total from continuation schedules .
B. ADMINISTRATNE COSTS:
1. Personal Representative Commissions:
Name(s) of Personal Representative(s) PNC BANK N. A.
Street Address 4242 CARLISLE PII~
City CA14P HILL State PA ZIP 17011
Year(s) Commission Paid:
2. Attorney Fees:
3. Family Exemption: (If decedent's address is not the same ~ claimant's, attach e~lanation.)
Claimant
Street Address
4.
5.
6.
7.
1
2
9W48ACa 2.000
City State ZIP
Relationship of Claimant to Decedent
Probate Fees:
Accountant Fees:
Tax Return Preparer Fees:
PNC BANK
REAL ESTATE APPRAISAL FEE
THE SENTINEL
LEGAL ADVERTISING
Total from continuation schedules
TOTAL (Also enter on Line 9, Recapil
If more space is needed, use additional sheets of paper of the sane size.
11,573.32
3.4,450.00
29,588.00
501.50
355.00
219.40
32,944.16
Estate of: JACQUELYN A. ROBERTS
Schedule H Part i (Page 2)
Item
No. Description
2 RIETH ROHRER EHRET FUNERAL HOME
FUNERAL SERVICES
3 ALWAYS IN STONE
GRAVE MARI~R
21 10 1165
Amount
8,950.75
2,622.57
Total (Carry forward to main schedule) 11,573.32
Estate of: JACQUELYN A. ROBERTS
Schedule H Part 7 (Page 2)
3 CUI~ERLAND LAW JOURNAL
LEGAL ADVERTISING
4 SE3 INSURANCE BROKERAGE SERVICES INC
LIABILITY INSURANCE
5 REGISTER OF WILLS
TWO SHORT COURT CERTIFICATES
6 ROWES AUCTION SERVICE
AUCTIONS EXPENSES AS FOLLOWS:
AUCTION C01~8rlI33ION 16 , 213.82
OTHER AUCTION
EXPENSES 1,452.20
TOTAL EXPENSES 17,666.02
7 BOSWELL, TINTNER & PICCOLA
LEGAL SERVICES RENDERED COVERING RICHARD ROBERTS
ESTATE IN CONNECTION WITH THE SETTLEMENT OF
JACQUELYN A. ROBERTS ESTATE
8 ESTII~iTED REAL ESTATE SELLING EXPENSES AS FOLLOWS:
1$ TRANSFER TAX 4,300.00
OTHER CLOSING COSTS 500.00
TOTAL 4,800.00
21 10 1165
75.00
3,138.00
8.00
17,666.02
670.50
4,800.00
Total (Carry forward to main schedule) 26,357.52
Estate of: JACQUELYN A. ROBERTS 21 10 1165
Schedule H Part 7 (Page 3)
9 EXPENSES RE MAINTENANCE AND UPIQ:EP OF 130 MILLERS
GAP ROAD, ENOLA PA 17025 AS FOLLOWS:
SADLER OIL CO, FUEL OIL, 10/2010 TO 04/2011,
2,279.16
SCOTT3 LAWN SERVICE, LAWN MAIN., 12/2010, 103.46
ALL SEASON LANDSCAPE, LAWN MAIN., 10/2010 TO 09/2011
z,192.eo
PP& L ELECTRIC, ELECTRIC SERVICE, 11/2010 TO
09/2011,
608.89
COL~ICAST CABLE, CABLE SERVICE,
11/10, 57.43
PENN WASTE INC, TRASH REMOVAL,
01/2011 TO 09/2011, 133.05
VERIZON, TELEPHONE SERVICE, FINAL BILL, 01/26/11,
211.85
ESTIMATED ADDITIONAL EXPENSES
1,000,00
TOTAL EXPENSES 6,586.64
6,586.64
Total (Carry forward to main schedule) 6,586.64
REV-1512 EX * (12-OB)
pennsytvania
SCHEDULE I
DEPARn~HroF REVENUE DEBTS OF DECEDENT,
rM~TANCerAxRETURN MORTGAGE LIABILITIES ~ LIENS
RESDEMDECEDENT
ESTATE OF FILE NUMBER
JACQUELYN A. ROBERTS 21 10 1165
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NlA1ABER DESCRIPTION OF DEATH
1• PNC AlDRTGAGE LOAN # 0001859268
6.875$ DUE 02/01/33.
BALANCE AS OF 10/07/11
$ 260,595.54 260,595.54
2 COb9CAST CABLE
CABLE SERVICE 143.61
3 AMEICAN E3~RESS
FINAL BALANCE DUE 2.99
4 ALL SEASON LANDSCAPING
LAWN SERVICE FOR SEPTEMBER 2010 63.60
5 AZIZKHAN INTERNAL MEDICINE ASSOC
MEDICAL SERVICES 95.63
6 140FFITT HEART & VASCULAR
MEDICAL SERVICES 27.84
7 CAMP HILL EMERGENCY PHYSICIANS
MEDICAL SERVICES 43.98
8 TALBOT3
CREDIT CARD BALANCE 3,699.30
9 RED COOPER
BALANCE A/C# 13715669 64.90
l0 PHILLIPS 6 COHEN ASSOC LTD
GOOD FAITH PAYMENT ON CITIBANK MASTERCARD A/C # 1599 2,000.00
11 CHASE CARD SERVICES
FINAL BALANCE DUE ON A/C 4185 8716 4132 7567 7,170.00
12 CHASE CARD SERVICES
FINAL BALANCE DUE ON FREEDUTI A/C 5417 1622 8.121 5362 12,478.00
13 .CHASE CARD SERVICES
FINAL BALANCE DUE ON SLATE CHASE A/C 4366 1610 2115 5700 13,378.00
14 PHILLIPS 6 COHEN ASSOC LTD
FINAL BALANCE DUE CITIBANK MA3TERCARD # 1599 10,771.16
Total from continuation schedules ~ 12,526.74
BW<BAH 2.000
TOTAL (Also enter on Line 10, Re
If more space is needed, insert additional sheets of the same size.
Estate of: JACQUELYN A. ROBERTS 21 10 1165
Schedule I (Page 2)
Item
No. Description Amount
15 CAPITAL ONE BANK (USA) NA
FINAL BALANCE DUE ON VISA A/C #5954 9,437.00
16 HOLY SPIRIT HOSPITAL
MEDICAL SERVICES 935.00
17 SILVER SPRING ~!~~ULANCE ASSOC
A1~IDULANCE SERVICES 77.65
18 SOVEREIGN BANK CHECKING ACCOUNT X22561001318.
CHECKS ISSUED PRIOR TO DEATH BUT HONORED SUBSEQUENT
THERETO AS FOLLOWS:
CK 4380 43.79
CK 4405 270.30
CK 4410 135.00
TOTAL 449.09 449.09
19 BOSWELL, TINTNER 6 PICCOLA
LEGAL 3EVICES PROVIDED PRIOR TO DEATH 1,630.00
Total (Carry forward to main schedule) 12,528.74
REV-1513 EX+ (Ot-10)
Pennsylvania
Ol~AR11tFM OF REVENUE
INHERITANCE TAX RETURN
RESIDENTDECEDENT
SCHEDULE J
BENEFICIARIES
FILE NUMBER:
J UELYN A. RO RTS 21 10 116
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
1 TAXABLE DISTRIBUTIONS [fndude outright spousal distributions and transfers under
Sec. 9116 (a) (1.2).]
1.
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 1 B OF REV 1500 COVER SHEET, AS APP ROPRIATE.
[I NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBU110NS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
7.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1• See Attached
1
TOTAL t>F PART 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. S 426 530.19
swaeAl 2.000 If more space is needed, use addidatal sheets of paper of the same size.
Estate of: JACQUELYN A. ROBERTS
Schedule J Part 2B (Page 1)
Item
No. Description
1 COLONIAL WILLIAMSBURG FOUNDATION
P.O. BOR 1776
WILLLAMSBURG, VA 23187-1766
RESIDUARY ESTATE
INVENTORY VALUE: 426,530.19
21 10 1165
Amount
426,530.19
LAST WILL AND TESTAMENT
OF
JACQUELYN A. ROBERTS
Introductory Clause. I, JACQUELYN A. ROBERTS, a resident of and domiciled in the
Township of Silver Spring, County of Cumberland and Commonwealth of Pennsylvania, do
hereby make, publish and declare this to be my Last Will and Testament, hereby revoking all
Wills and Codicils at any time heretofore made by me.
I was married to RICHARD E. ROBERTS. My husband, RICHARD E. ROBERTS,
died on May 10, 2006. I have no children.
ITEM I
Direction to Pay Debts. I direct that all my legally enforceable debts, secured and
unsecured, be paid as soon as practicable after my death. If at the time of my death any of the
real property is subject to a mortgage, I direct that the mortgage debt be paid at the time when
my Executor sells the real property.
ITEM II
Direction to Pay All Taxes from Residuary Estate. I direct that all estate, inheritance,
succession, death or similar taxes assessed with respect to my estate herein disposed of, or any
part thereof, or on any bequest or devise contained in this my Last Will (which term wherever
used herein shall include any Codicil hereto), or on any insurance upon my life or on any
property held jointly by me with another or on any transfer made by me during my lifetime or on
any other property or interests in property included in my estate for such tax purposes be paid
out of my residuary estate.
ITEM III
Direction to Sell Tangible Personal Property. I direct that all of my tangible personal
property shall be sold by my Executor as expeditiously as can be done in order to receive the
highest price obtainable for the sale of each item within the time deemed reasonable by my
Executor. The proceeds from the sale of each item shall be added to my residuary estate to be
distributed as set forth in ITEM V.
ITEM IV
Direction to Sell Real Property. I direct that my Executor shall sell my real property,
including my residence and any real property that I have acquired during my lifetime, as
expeditiously as can be done in order to receive the highest price obtainable within a time
deemed reasonable by my Executor. The proceeds of the sale of my real property shall be added
to my residuary estate to be distributed as set forth in ITEM V.
Last Will and Testament of Jacquelyn A. Roberts Page 1
ITEM V
Outright Gift of Residuary. After payment of debts, taxes, and expenses of
administration, Igive and bequeath all the rest, residue, and remainder of my property of every
kind and description (including lapsed legacies and devises) wherever situate and whether
acquired before or after the execution of this Will, to If my husband shall not survive me, then I
give bequeath to THE COLONIAL WILLIAMSBURG FOUNDATION, Williamsburg,
Virginia, One hundred (100%) percent of the rest and residue of my estate, my net estate. If the
gift property meets the requirements for establishing a named endowment fund at Colonial
Williamsburg, then it shall be designated as the Jacquelyn A. Roberts and Richard E. Roberts
Endowment Fund (the "Fund") in the books and records of The Colonial Williamsburg
Foundation. The property comprising this gift may, for investment purposes, be merged with the
general endowment fund of The Colonial Williamsburg Foundation. The investment and
spending policy for the Fund shall be the same as that for the general cndo-v~n-~ent fund of The
Colonial Williamsburg Foundation. The amount spent from the Fund each year shall, insofar as
is practical, be used for the support and maintenance of Colonial Williamsburg's gardens in the
Historic Area. If, in the opinion of the Trustees of The Colonial Williamsburg Foundation, or
their successors, the need for funds for the purposes described above no longer exists at some
future date, the Trustees, or their successors, are authorized to use these funds in the best interest
of The Colonial Williamsburg Foundation.
ITEM VI
Naming the Executor, Executor Succession, Executor's Fees and Other Matters.
The provisions for naming the Executor, Executor succession, Executor's fees and other matters
are set forth below:
(1) Naming the Corporate Executor. I hereby nominate, constitute and appoint as
Executor of this my Last Will and Testament PNC BANK, N.A. and direct that it shall serve
without bond.
(2) Naming Corporate Successor or Substitute Executor. Except as otherwise
provided herein, if PNC BaNx, N.A. or any successor as herein defined should fail to qualify as
Executor hereunder, or for any reason should cease to act in such capacity, the successor or
substitute corporate Executor shall be some other bank or trust company qualified to do business
in the State of my domicile at the time of my death, which successor or substitute shall be
designated by the court having jurisdiction over the probate of my estate.
(3) Fee Schedule for Corporate Executor. For its services as Executor, the corporate
Executor shall receive an amount determined by its Standard Fee Schedule in effect and
applicable at the time of the performance of such services. If no such schedule shall be in effect
at that time, it shall be entitled to reasonable compensation for the services rendered.
(4) Change in Corporate Fiduciary. Any corporate successor to the trust business of
the corporate fiduciary designated herein or at any time acting hereunder shall succeed to the
capacity of its predecessor without conveyance or transfer.
Last Will and Testament of Jacquelyn A. Roberts Page 2
ITEM VII
Definition of Executor. Whenever the word "Executor" or any modifying or substituted
pronoun therefor is used in this my Will, such words and respective pronouns shall include both
the singular and the plural, the masculine, feminine and neuter gender thereof, and shall apply
equally to the Executor named herein and to any successor or substitute Executor acting
hereunder, and such successor or substitute Executor shall possess all the rights, powers and
duties, authority and responsibility conferred upon the Executor originally named herein.
ITEM VIII
Powers for Executor. By way of illustration and not of limitation and in addition to any
inherent, implied or statutory powers granted to Executors generally, my Executor is specifically
authorized and empowered with respect to any property, real or personal, at any-time held under
any provision of this my Will: to allot, allocate between principal and income, assign, borrow,
buy, care for, collect, compromise claims, contract with respect to, continue any business of
mine, convey, convert, deal with, dispose of, enter into, exchange, hold, improve, incorporate
any business of mine, invest, lease, manage, mortgage, grant and exercise options with respect
to, take possession of, pledge, receive, release, repair, sell, sue for, to make distributions or
divisions in cash or in kind or partly in each without regard to the income tax basis of such asset,
and in general, to exercise all the powers in the management of my Estate which any individual
could exercise in the management of similar property owned in his or her own right, upon such
terms and conditions as to my Executor may seem best, and to execute and deliver any and all
instruments aid to do all acts which my Executor may deem proper or necessary to carry out the
purposes of this my Will, without being limited in any way by the specific grants of power made,
and without the necessity of a court order.
Testimonium Clause. IN WITNESS WHEREOF, I have hereunto set my hand and
affixed my seal this the 1~~_ day of November, 2007.
ACQ EI,YN A. ROBERTS
Attestation Clause. The foregoing Will was this the ~ ~`' day of November, 2007,
signed, sealed, published and declared by the Testatrix as and for her Last Will and Testament in
our presence, and we, at her request and in her presence, and in the presence of each other, have
hereunto subscribed our names as witnesses on the above date.
of ~-+'Y - Y ~ v ~ '~-,..~.• r-y I vim,
1 of ~~~ T i~
Last Will and Testament of Jacquelyn A. Roberts Page 3
r ti
PROOF OF WILL
COMMONWEALTH OF )
PENNSYLVANIA
Self-Proving Affidavit
COUNTY OF DAUPHIN )
We, JACQUELYN A. ROBERTS, and. Jeffrey R. Boswell and
Diane E. Grissinger ,the Testatrix and the witnesses, respectively, whose names are
signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the
undersigned authority that the Testatrix signed and executed the instrument as her Last Will and
that she had signed willingly (or willingly directed another to sign for her), and that she executed
it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses,
in the presence and hearing of the Testatrix, and in the presence of each other, signed the Will as
witness and to the best of our knowledge the Testatrix was at that time eighteen years of age or
older, of sound mind, and under no constraint or undue influence.
Ste; ~`~.>`.R.,~..u GZ. ~ .`~'1~:.~ L.T2.~,-1'~,
JA QU ~ YN A. OBERTS
,~-~---
Witn
Witness
Subscribed, sworn to, and acknowledged before me by JACQUELYN A. ROBERTS, the
Testatrix and subscribed and sworn to before me by Jeffrey R . Bo some 11 and
Diane E. Grissincxer ,witnesses, this the 14th day of November, 2007.
~-~-~-~ eel)
Notary Public for Pennsylvania
My Commission Expires: oZ G o2a //
COMMONWEgLTH OF PENNSYLVANIA
Notarial Seel
Commie L Handy, Notary Public
Member, Pen~eylvantp
~olAtlon of Wofarlae
Last Will and Testament of Jacquelyn A. Roberts
Page d
:_:~::
-::
~~~~~~- pennsylvan~a
DEPARTMENT OF REVENUE
)uiy 7,,2011
Edward L Glassman, Jr.
PNC Bank NA
Trust Tax Department
1500 Market St, 4th Flo6r
Philadelphia, Pa 19103
Re: Estate of Jacquelyn A Roberts
File Number 2110-1165
Dear Mr. Giassman:
This is in response to your letter of June 28, 2011 concerning the inheritance tax
return due in the above referenced estate.
Since it is apparent that you will be unable to file a tax return in the near future, the
estate record will be placed in an informal hold status for an additional period of six (6)
months so that the department will initiate no enforcement activity until January 6, 2012.
At the end of that period we would ask that you contact us to provide an updated status for
our file. The return may be filed at any time during the informal hold period.
Kindly note that this action will avoid the imposition of a penalty for failure to make a
timely return. However, it does not prevent interest from accruing on any tax remaining
unpaid after the delinquent date.
Thank you for your cooperation, and, if I may be of any further assistance, please
feel free to contact my office.
Bureau Of Individual Taxes 15~' Floor Strawberry Square I Harrisburg, PA 17128 l 717.787.6505 I www.revenue.state.pe.us
Inheritance Tax Division
ifulmer(c~state.pa, us
f
Roland Johnson Appraisal Services
3936388
rye no. ~
A SINGLE FAMILY RESIDENCE
LOCATED AT:
130 Millers Gap Road
Enola, PA 17025-1011
FOR:
PNC Bank - VYealth Management
BORROWER:
Jacqueline A. 8 Richard E. Roberts
AS OF:
October 7, 2010
BY:
Roland D. Johnson, SRA
RL-001737-L
r1
P r
3938388
File NC. 1
01/07/2011
PNC Bank -Wealth Management
File Number: 130millersgap
Dear Lender.
In accordance with your request, I have appraised the real property at:
130 Millers Gap Road
Enola, PA 17025-1011
The purpose of this appraisal is to develop an opinion of the market value of the subject property, as improved.
In my opinion, the market value of the properly as of odober7, 201o is:
5430,000
Four Hundred Thiriy Thousand Dollars
The attached report contains the description, analysis and supportive data for the conclusions,
final opinion of value, descriptive photographs, Limiting conditions and appropriate certifications.
Respectfully,
Roland D. n, SRA
RL-Q01737-
State Certified Appraiser
i~
..
APPRAISER'S LICENSE
~OR~; Jacque me A. ichard oberts Fle NO.: 130millersgap
Pf~ttY AddfBSS:130 Millers Gap Road ~~ NO,; 3936388
C_NY: Enola State: PA Zi0. 17025-1011
• PNC Bank -Wealth Mana ement
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.SINGLE FAMILY
3938388
Uniform Residential Annraisal RPnnrt n_w ,3nmiunr¢nnn
The w se of this summa a raisal re is to rovide the lender/client with an accurate•and acts uatet su orted, o 'nion of the market value of the subject o
130 Millers Ga Road ~ Enola PA 17025-1011
Ja ueline A. 8 Richard E. Roberts Ow„~, d p~ Retard Richard E. & Ja ue A. Roberts Cumberland
• DEED BOOK 0361 PAGE 0725
l ~ 38-04-0367-019 Taz Year 2010 R.E. T 4,336.76
Name Silver S Townshi Refaeru:e 2740 84 Cerata Tmcr 118.01
Tero Y N/A ptgp frOA N/A
Fee ' Cher describe
r r ~ T describe Estimate value for the estate of Richard & Ja Roberts
PNC Bank -Wealth Mane t
a fa b the efi 've date d ' a Yes
Report data sowce(s) used, ofiakg price(s), and date(s). Atxordi to the Central Penn Multi-List the su ' has not been listed /offered for sale in the
st 12 months.
I did did not analyze the contract for sale fa the sWjecr pachase tratsacdon. Explain the restrls dthe analysis dthe contracr fa sale a why the analysis was not performed.
Is the the owns d hit Yes Db
B tlrare airy fironpal assisiarua (ban chages, sale , gift a dowrgreyment assatance, ea.) to be paid by airy party an behNf dthe borrower! Yes No
fi Yes, repot die tom dda arrrorxR and de5aibe the items to be paid. f
v bass ' .. n e _ 70 %
75% 75% nder % X b g~nro -4 rit %
Marked Tune UrMer 3 mda X3-6 mda Ova 6 1 ~ low 0 %
Neighborhood BorxMeries See Attached Addendum 500 h 100 Conurlacid %
425 pmd• 10 scant 30 %
Neigtlbahood Desrriptirul The Su ' s nei hbtxttood has ave characteristics. The su ' s ne' hborhood sits at the foot of the Blue
Mountains. The sites are wooded with beautiful views. Em meet, retail, rks and schools are in dose roxi .There is eas
access 1b Routes 944, 114 and 81.
Merkeccaw66als(aaiu6rgsupporttortheabover~a~ons) There are economic trends that are influend market conditions in tltis ar8a. The current
market offers historical low interest rates. The area unem meat rate is bek>rv the current national ave
AS Per Tax Assessment Retxxds 2.50 Acres I ular Y1e1r,
• C Conservation Z ~ Sin le Fermi Dwellin Permitted.
L GrarMf llse No Zorri describe
b the highest and best use ddre subject PmPatY ~ (a as P Pa Plata and spedficatrora) the presetd use? X Yes No fiNo, describe.
I Ik r rbe Public Other Ibe Offsite lm rovements-T Public Private
200 AMP Water Well Street haft
sewer Se tic
ves No F MA Z C FEMA Ma a 42037 000056 FEMA p~ 5-2-1983
' f the ~ Yes No HNo
/YetllBre anyadverse sitewrr6tions a erdartalfactors (easements, axraadrneMS, enriramrartd rnrrdrliora, lend uses, eft,)? Yes X No fives, describe. Site has
site i , above a e landsca i ,and maintenance. There are no a rent adverse easements, encroachments,
err othnt advetse conditions on this site. Private wells and stems are common in this area and do not affect the market value of
the su
': r ~ _ ~` r s g'~
u.. .a.. ,..., .... ,... ~ _,. ... ._.,
eadl b Faruletbn W Poured ConlGtxxi V ,C C
2 F Partial Exterior Wals Brick, IlGood D IUGood
1315 . ~, Sh' le/Good T • xiah Wood/Grxx!
Fuiah 0 Aluminum/Good CT/Good
2" E IMrtdowT Dbl Hu Good /Good
y 1994 Evidenced bteaadon Smrm SeSNtratlaed Insulated/Gotxl ~ None
&10 Yes/Good g
Fugn X Ra nt i hak
F OiI F• ~ 1 Wood * 2
Ak porch COY id
Bove certaka: 8 Rooms 3 BerYooms 2.5 3,247 Feetd • • ArroAbove
Ad6tiortd teatirms (special energy effiderrt Bans. erc.). Water heated by furnace. Insulated windows. Fire
Desptbe the eortdliarr dthe property (uNtldmg needed mpais, deterioration, rertovatiora, rartodPirrg, etc.). These im rovements are Of uel' frame n
aRd reflect maintenance. The bathrooms, kitchen. mechanical ui nt, and other features meet current standards for harass of
tiffs ih this market The mechanical ui merit was lNt and in waki order.
Aretlrere any physical defiriendes a adverse rnrrdrb'ora drat afiecr the fivabilily,soundness, a strtrcrlral i^b9fiY d the pmpertyr Yes No fixes, describe.
Ones the property generaly cartorm b the rreiglrborltood (harcoorrd I~ity, style, wrrd6ork use, wravtxdon, etc.)? Yes No fi No, describe. Floof Ian '
tztil , d ' n, and and should receive rtce in the market lace. No unusual functional obsolescence or
external i tzacies were observed.
rw.u.. c,... in w.w.nrc ....,-__._.._.--LL-----
Page 1 dfi ' _ ___ _,- ,__r. _._ ~...c..erun. ~ ~ 06 at~06
r
SINGLE FAMILY
3936388
Uniform Residential Annraical Rannrt ~~...u ~~nrr,ator~„sr,
3 ~
3
FFA R ECT
130 Millers Gap Road
Enola _ in
COMPA E N0.1
8210 Run Cross Lane
Erlola in kom 400,000 to 475,000
400 000 475 000
MP LE . 2 P . 3
2 Clairbum Drive 7 Meadow View Court
Mechanicsbu Mechanicsbu
' m ~ -
' 2.73 miles E
f 450 000 2.52 miles SE
; ,. '', -' s 410 000 2.89 miles SSE
~ '>~
000
S 450
`
liv.
s
v s S ~
mtL
~',d R ~ ' ,
=Y :w ~ '; 1382
1 ~ .. -`~ .
Central Penn Mufti List
Cou Tax Assessment 150 74 ~h x .. -
Central Penn Multi Ust I,
Coun Tax Assessment ,
- ~>~
130.97
Central Penn Multi List
Coun Tax Assessment
1 THE DESCRIPTION ~ Rlpj
58e a Felendng * `
az:~ 3t~ ~ ~ ,4 t ~ ~
~. Conventional
No aDOM 7 Conventional
~ 22-200952 Conventional
5-14DOM 11
Suburban Suburban Suburban Suburban
~; Fee Sim Fee Sim Fee Sim le Fee Sim le
2.50 Acres
Good .43 Atxe
Good 8,200 .55 Atxe
Good 5,900 .58 Acre
Good 5,800
2-Sto 2-Sto 2-Sto 2_~
Good Good Good Good
17+h Years 5 Years 7 Years 8 Years
Good Good Good Good
Above Grade
Roan Count 8 3 2.5 9 4 2.5 8 4 2.5 8 4 2.5
30.00 3,247 ~; 3,258 R 0 2,720 p, 15,800 3,436 R -5,700
Basement a Falisrad
Grade Fu1U1315 Sq.Ft
Unfinished Full Basement
Unfinished Full Basement
FR, BR, Bath
-14,000 Full Basement
FR, BR, Betil
-14,000
A e A Ave e A
OiIHWBB/CA GasFWA/CA GasFWAlCA GasFWA/CA
Insul. Windows Insul. Windows Insul. Windows Insul. Windows
2-Car Ga 3-Car Gars -5,000 2-Car Gara a 3-Car Ga _5,000
Fi
Fence CovPorch, Patio
1-Fire lace
Fence CovPorch, Deck
1-Fire ace
None
2,000 Deck
1-Fire ace
None 2,000
2,000 CovPtx,Pat, DK
3-Fire ace
Fence -2,000
~i,00p
a
' . - 3,200 . _ 11,700 . 24,900
AdjusfedSalePrice ~ .+_~C"w ~,...:' NaA~. 0.796
2.9
453 200 NetAdj. 2.996
9.7
421 700 NetAt~. -5.596
8.1
425 100
1 d'q did not research the sak a trarlsta history d'tlte subject preplmy and canparade sales. d not, explain
not sties a d la to the efi dace dtllis isal.
umlleriand Cou Tax Assessment Records.
a sales tra d Lathe to dated tithe blesale.
Cum nd Tax Assessment Records.
the mid 'tithe atrarafer ' and hie a sales on
CT PARABL L N0.1 MPARABL SALE N0.2 P L SA . 3
d Pda Saldfronsfer B-17-1993 5-30.2007 11-13-2003 4-30.2004
ransfa $50,000
Tax Assessment Records $1
Tax Assessment Retxxds $58,000
Tax Assessment Records $397,700
Tax Assessment Records
10.7-2010 10.7-2010 10.7-2010 10-7-2010
A~Sisdpdasaleatronstalistaydmewbjeapmpertyandco,rparadesales DATE OF PRIOR SALEITRPtNSFER CONTINUED:
COMP 1: 12~-2008 for $517,108; 1-30-2004 for $440,000
3: 4-15-2003 for $88,000
A TIVE LISTING 4: 8-15-1999 for $53,000; 9-3-1997 for $45,000
Summary d5ales Carlparison Approach. See Attadled Addendum
430 000
V t I rI 430,000 cost cn Ifdevel 421,100 Loco n Ifdevelo N/A
Addendum
This appraisal is made 'ac'ts; subjedto completion per plans and speciAcatiorls on the basis d a hypodreECaf card6orr the tlm improvements have been eanple6ad,
^ SuhjeG to the falowing tepees a alter~ons on the basis d a hypathe0cal taldbort the the repairs a akera6ons have been completed, a ^ subject to the klowirtg regtred
espaceon based on the extraadirlary assumption that die axldei'ar a deficierwy doe not rerpere akeraUOn a repair:
Based on a complete visual inspection of the interior and exterior areas of the subject property, defined scope of work, statement of assumptions and limiting
condltlons, and appraiser's certification, my (our) opinion of the market value, as deFlned, of the real property that is the subject ofthls report Is S 430,000
10.7-2010
es,w u.. e,.~.nw,.e~ .._.,_ ___._--
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RtNand Johnson Appraisal Services
SINGLE FAMILY
3936388
Uniform Residential Appraisal Report FaeNo. 130millersgap
;~a~f~>
to
Suppat(oFtheapinionds'tevdue(ydconparo6lelandsaksarotl~ermetliodstaestimaUngsRevalue) Summa ofc7om Fable landsal@s
Su ftN the 'nion of site value.
T N OP SRE V ........................................ = 100,000
d MarahaN & Swig Residential Handbook 3,247 , Ft ~ 87.80 „,,,, „„, . 284,437
E d 03/01!2010 Bsmt:1315 ,~,~ 20.26,,,..,,,,,,= 28842
Amenities 24,000
Cost-New-of-Im Ms is calculated 880 .~,~ 31.71,,,,,., ....= 21,583
the Marshall and Residential Cost Handbook and kraal T d .~,,, ............ _ 358,842
taD~ an .Estimated siee vak6e is based On local market 80 F I E
. l>e Is estimated usi the economic life 153,496 53,498
method and market a 's. No obsolescence was observed. Cost d „ .............................:. 303,148
• ' • ................................ = 18,000
52 421 100
N/A N/A = N/A V I
stemnry or klcane Approach Gndu6ng support to maker rant mid GRM)
in Y
INrLY ~ in is an
T T
T
the ~ intaaPtm? Y No MYes deteolcornersion.
~ Y No
lYelheuis,mmnmdemerls,andrea~dontedAie.,mmplete? Yes No ~No.desaibethesteWSdampletlon.
Are the carmen elemerAS leased ro a by the Homeowners' Associ~on? Yes No dyes, desaibe the relltef terms and ap6ons.
Describe wmnorl ekmeMS and n;creational tacides.
F w03e6YC Fmn A WN 11106 11hOnswspa0wOm0e0a osdop.enup6mss~wnpegtxa~Z1 Fwnk6Ye fORP lOD1MIRA 1006
VeOe ] de 1061 KOlwaS
SINGLE FAMILY
3936388
Uniform Residential Appraisal Report FAeNo. 130millersgap
This report form is designed to report an appraisal of a one-unit property or a one-unit property with an accessory unit; including a
unit in a planned and development (PUD). This report form is not designed to report an appraisal of a manufactured home or a unk
in a condominium or cooperative project
This appraisal report is subject to the following scope of work, intended use, intended user, definition of market value, statement of
assumptions and limiting conditions, and certifications. Modifications, additions, or deletions to the intended use, intended user,
definition of market value, or assumptions and limiting conditions are not permitted. The appraiser may expand the scope of work
to include any additional research or anaysis necessary based on the complexity of this appraisal assignment Modifications or
deletions to the certifications are also not permitted. However, additional certifications that do not constitute material alffirations
to this appraisal report, such as those required by law or those related to the appraiser's cartinuing education or membership in an
appraisal organization, are permitted.
SCOPE OF WORK: The scope of work for this appraisal is defined by the complexity of this appraisal assignment and the
reporting requiremenffi of this appraisal report forth, induding the folkwing definition of market value, statement of assumptions
and limiting conditions, and certifications. The appraiser must, at a minimum: (1) perform a complete visual inspection of the
interior and exterior areas of the subject properly, (2) inspect the neighborhood, (3) inspect each of the comparable sales from at
least the street, (4) research, verify, and analyze data from reliable public and/or private sources, and (5) report his or her analysis,
opinions, and conclusions in this appraisal report
INTENDED USE: The intended use of this appraisal report is for the lender/client to evaluate the property that is the subject of
this appraisal for a rartgage finance transaction.
INTENDED USER: The intended user of this appraisal report is the lender/client.
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
tide from seller to buyer under conditions whereby: (1) buyer and seller are typicely motivated; (2) both parties are well infomred
or well advised, and each ailing in what he or she considers his or her 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 finandal artangements
comparable thereto; and (5) the price represents the normal consideration for the property sold unatiected by spedal or creative
finandng or sales rxxrcessions• granted by anyone associated with the sale.
•Adjustmenffi to the oomparables must be made for spedal or creative finandng or sales concessions. No adjustments are
necessary for those cosffi which are nornaly paid by sellers as a result of tradition or law in a market area; these cosffi are readiy
identifiable since the seller pays these cosffi in virtualy all sales transactions. Special or creative finandng adjustimenffi can be
made to the comparable property by comparisons to financing tem>s offered by a third party institutional lender that is not already
involved in the property or transaction. Any adjustment should not be cak;ulated on a mechanicel dollar for dollar cost of the
finandng or concession but the dollar amount of any adjustment should approximate the markets reaction to the finandng or
concessions based on th6 appraiser's judgment
STATEMENT OF ASSUMPTIONS AND LIMITING CONDITIONS: The appraiser's certification in this report is subject to the
fotk>wing assumptions and limiting conditions:
1. The appraiser will rrot be responsible for matters of a legal nature that affect either the properly being appraised or the tide
to it, except for information that he or she became aware of during the research involved in performing this appraisal. The
appraiser assumes that the title is good and marketable and will not render any opinions about the title.
2. The appraiser has provided a sketch in this appraisal report tb show the approximate dimensions of the improvemenffi. The
sketch is included ony to assist the reader in visualizing the property and understanding the appraiser's determination of iffi 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 this appraisal report whether arty portion of the subject site is kx~ted in an identified Special
Fkwd Hazard Arta. Because the appraiser is not a surveyor, he or she makes no guarantees, express or implied, regarding this
determination.
4. The appraiser wGl not give testimony or appear in court because he or she made an appraisal of the properly in question,
unless specific arrangements to do so have been made beforehand, or as otherwise required by law.
5. The appraiser has noted in this appraisal report any adverse oondtons (such as needed repairs, deterioration, 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 research involved in perfiorming this appreisal. Unless otherwise stated in this appraisal report, the appraiser has no
knowledge of any hidden or unapparent physical defidendes or adverse conditions of the property (such as, but not limited th,
needed repels, deterioration, the presence of hazardous wastes, toxic substances, adverse environmental conditions, etc.) that
would make the property less valuable, and has assumed that there are no such conditions and makes no guarantees or
waranees, express or implied. The appraiser will not be responsible for any such conditions that do exist or for any engineering or
testing that might be required fA discover whether such conditions exist. Because the appraiser is not an expert in the field of
environmerrtal hazards, this appraisal report must not be considered as an environmental assessment of the property.
8. 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 the completion, repairs, or alterations of the subject property will be
performed in a professional manner.
Fmdae AYc Fpm r0 Mseh 2005 7hY bmwr pedmtl an lm 11CI OMbp„rt R~11FpnmryYp„ lei Fp'ie 5118 Fam tODr 5MN11005
Pegeld6 tool_o6m7opc
SINGLE FAMILY
3936388
Uniform Residential Appraisal Report raeNo. 130millersgap
APPRAISER'S CERTIFICATION: The Appraiser certfies and agrees that:
1. I have, at a minimum, developed and reported this appraisal in accordance with the scope of work requirements stated in this
appraisal report.
2. I performed a complete visual inspection of the interior and exterior areas of the subject property. I reported the condition of
the improvements in factual, specific terms. I identfied and reported the physical deficlencies that could affect the livability,
soundness, or structural integrity of the property.
3. I performed this appraisal in accordance with the requiremenffi of the Uniform Standards of Protessbnal Appraisal Practice
that were adopted and promulgaffid by the Appraisal Standards Boar! of The Appraisal Foundation and that were in place at the
time this appraisal report was prepared.
4. 1 developed my opinion of the market value of the real property that is the subject of this report based on the sales comparison
approach to value. I have adequate comparable market data to deveop a reliable sales comparison approach for this appraisal
assignment I further certify that I considered the cost and income approaches to value but did not develop them, unless otherwise
indicated in this report.
5. 1 researched, verified, analyzed, and reported on any current agreement for sale for the subject properly, any offering for sale
of the subject property in the twelve months prior to the effective date of this appraisal, and the prior sales of the subject property
for a minimum of three years prior th the effective date of this appraisal, unless otherwise indicated in this report.
6. t researched, verified, analyzed, and reported on the prior sales of the comparable sales for a minimum of one year prior to the
date of sale of the comparable sale, unless otherwise indicated in this report.
7. I selected and used comparable sales that are bcationaly, physically, and functionaly the most similar to the subject property.
8. I have not used comparable sales that were the resuR of combining a land sale with the contract purchase price of a home
Drat has been built or will be built on the land.
9. 1 have reported adjustmenffi to the comparable sales that reflect the market's reaction to the differences between the subject
property and the comparable sales.
10. I verified, from a disinterested source, all information in this report that was provided by parties who have a financial interest in
the sale or financing of the subject property.
11. I have knowledge and experience in appraising this type of properly in this market area.
12. I am aware of, and have access to, the necessary and appropriate public and private data sources, such as multiple listing
services, tax assessment records, public land records and other such data sources for the area in which the property is located.
13. I obtained the information, estimates, and opinions furnished by other parties and expressed in this appraisal report from
reliable sources that I believe to be true and correct.
14. I have taken into consideratbn the factors that have an impact on value with respect to the subject neighborhood, subject
properly, and the pro~dmity of the subject property to adverse influences in the devebpment of my opinion of market value. I have
noted in this appraisal report any adverse conditions (such as, but not limited to, needed repairs, deterioration, the presence of
hazardous wastes, toxic substances, adverse environmerrtal conditions, etc.) observed during the inspection of the subject property
or that I became aware of during the research involved in performing this appraisal. I have considered these adverse condtions in
my analysis of the property value, and have reported on the effect of the conditions on the value and marketability of the subject
property.
15. I have not knowingly withheld any significant information from this appraisal report and, to the best of my knowledge, all
statements and infortr5ation in this appraisal report are true and correct.
16. 1 stated in this appraisal report my own personal, unbiased, and professional anaysis, opinions, and conclusions, which are
subject ony ~ the assumptions and limfing conditions in this appraisal report.
17. I have no presets or prospective interest in the property that is the subject of this report, and I have no present or prospective
personal interest or bias with rasped to the particlpanffi in the transaction. 1 did not base, either partially or oompletey, my
analysis and/or opinion of market value in this appraisal report on the race, odor, religion, sex, age, marital status, handicap,
familial status, or national origin of either the prospective owners or oawpanffi of the subject property or of the present owners or
oaxrpanffi of the properties in the vicinity of the subject property or on any other basis prohibited by law.
18. MY employment and/or compensation for performing this appraisal or any future or anticipated appraisals was not conditioned
On any agreement or understanding, written or otherwise, that I would report (or present analysis supporting) a predetermined
speclflc value, a predetermined minimum value, a range or direction in value, a value that favors the cause of any party, or the
attainment of a speclflc result or occurrence of a specific subsequent event (such as approval of a pending mortgage loan
applicatbn).
19. I personally prepared all conclusions and opinions about the real estaffi that were set forth in this appraisal report. If I relied on
signiflcant real property appraisal assistance from any individual or individuals in the performance of this appraisal or the
preparation of this appraisal report, I have named such individual(s) and disclosed the spedfic tasks performed in 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 this appraisal report; therefore, arty change made to this appraisal is unauthorized and I will take no responsibility for it
20. 1 identiRed the lerrder/Giant in this appraisal report who is the individual, organization, or agent for the organization that ordered
and will receive this appraisal report.
Fmtl0k Mlc f000 r061sGi12005 iMabmwl0n>dn0on11~MJ rt~er .wm~emRxarP FeMeUee Fam tUMMrdi CODS
P1065 d6 7001 060]]006
SINGLE FAMILY
3936388
UflllUfm Kt351QefILi81 HPpI-81S81 K@p0f[ FtleNO. 130millersgap
21. The lender/diets may disclose w distribute this appraisal report to: the borrower, another lender at the request of the borrower,
the mortgagee w ifs successors and assigns; mortgage insurers; government sponsored enterprises; other secondary market
partcipanrts; data collection or reporting services; professional appraisal organizations; any department, agency, or instrumentality
of the United States; and any state, the District of Columbia, w other jurisdid'ans; without having to obtain the appraiser's or .
supervisory appraiser's (rf applicable) consent Such consent must be obtained before this appraisal report may be disclosed or
distributed m any other party (inducting, but not limited to, the public through advertising, public relations, news, salmi, or other
media).
22. 1 am aware that any disclosure w distribution of this appraisal report by me w the lender/client may be subject to certain laws
and regulations. Further, I am also subject to the provisions of the Uniform Standards of Professional Appraisal Practice that
pertain to disclosure w distribution by me.
23. The borrower, another lender at the request of the bortower, the mor~agee or its successors and assigns, mor~age insurers,
govemmeM sponsored enterprises, and other secondary market participants may rely on this appraisal report as part of any
mortgage finance transaction that involves any one or more of these parties.
24. H this appraisal report was transmitted as an "electronic record' containing my "electronic signature,' as those terms are
defined in applicable federal and/or state laws (excluding audro and video recordings), w a facsimile transmission of this appraisal
report oontafning a copy or representation of my signature, the appraisal report shall be as effective, enforceable and valid as ff a
paper version of this appraisal report were delivered containing my original hand written signature.
25. Any intensional w negligent misrepresentation(s) contained in this appraisal report may resuR in clvil liability andlw criminal
penalties including, but not limited to, fine w imprisonment or both under the provisions of Title 1 B, United States Code, Section
1001, et seq., or similar state laws.
SUPERVISORY APPRAISER'S CERTIFICATION: The Supervisory Appraiser certifies and agrees that
1. I directly supervised the appraiser for this appraisal assignment, have read the appraisal report, and agree with the appraiser's
analysis, opinions, statements, conclusions, and the appraiser's certification.
2. 1 aa:ept full responsibility for the contents of this appraisal report including, but not limited to, the appraiser's analysis,
opinions, statements, conclusions, and the appraiser's certification.
3. The appraiser identified in this appraisal report is either asub-contractor or an employee of the supervisory appraiser (or the
appraisal finny, is qualified to perfiortn this appraisal, and is acceptable to perform this a sisal under the a
pp pplicable state law.
4. This appraisal report complies with the Uniform Standards of Professonal Appraisal Practice that were adopted and
promulgated by the Appraisal Standards Board of The Appraisal Foundation and that were in place at the time this appraisal
report was prepared.
5. If this appraisal report was transmitted as an 'electronic record' containing my 'electronic signature; as those terms are
defined in applicable federal and/or state laws (excluding audio and video recordings), or a facsimile transmission of this appraisal
report cxx~ining a copy or representation of rry signature, the appraisal report shall be as effective, enforceable and valid as if a
paper version of this appraisal report were delivered containing my original hand written signature.
APPRAISER
Signature
Name Role D. Joh
Company Name Rota ohnaon 'sal Services
Company Address 662 Somerset Street
Harrisburg, PA 17111
Tebphone Number 717-561-4884
Email Address r~'otinsonappr~comcasinet
Date of Signature and Report 01/07/2011
Effective Date of Appraisal 10-7-2010
State Certification # RL-001737-L
w State License #
or Other (describe) State #
State PA
Expiration Date of Certification or License 06/30/2011
SUPERVISORY APPRAISER (ONLY IF REQUIRED)
Signature
Name
Company Name
Company Address
Telephone Number
Email Address
Date of Signature
State Certification #
w State License #
State
Expiration Date of Certification or License
ADDRESS OF PROPERTY APPRAISED
130 Mipers Gap Road
Enola, PA 17025-1011
APPRAISED VALUE OF SUBJECT PROPERTY $ 430,000
LENDER/CLIENT
Name
Company Name PNC Bank -Wealth Management
Company Address
Email Address
SUBJECT PROPERTY
^ Did not inspect subject property
^ Did inspect exterior of subject properly from street
Date of Inspection
D Did inspect interior and exterior of subject property
Date of Inspection
COMPARABLE SALES
^ Did not inspect exterior of comparable sales from street
D Did inspect exterior of comparable sales irom street
Date of Inspection
~a
Rdand Johnson Appraisal Services
SINGLE FAMILY
3936388
Uniform Residential Aonraisal Reoort rePnro 130millersaao
F SUBJECT PARABLE SALE ND.1 COMPARABLE SALE N0.5 COMPARABLE SAL
130 MiNers Gap Road
Enola ~ 7 Wheatland Drive
Mechanicsbu
->
- 2.27 miles SE
S f 472.301 ~ _ f _` ' f
Lx. Nee s ~ ~ K S 132.58 R .., . ; R "~ - - D R`~-~-~~ _`
,s
` Central enn Multi List -
~:_ f x .. ^ ~s, ° Cou Tax Assessmenn
DESCRIPTION RIPI'ION DE RIPTpN DESCRIPTION
SekarFamndng „~,~,:-
~'~
-.~ :
~ ` '
Adive Listin
DOM-17
Suburban Suburban
ee Fee Sim
2.50 Acres 3.1 Ames -1,800
Good Good
2-St 2-St
Good Good
17+1-Years 11 Years
Condition Good Good
Above Grade
r~omCaieR 8 3 2.5 10 5 3.5 -5,000
30.00 3,247 R 3,582 R -9,500 ,R
Besement3Fiiished FuIU1315 Sq.Ft.
Unfinished Full Basement
FR
-5,000
A A
iIHWBB/CA GasFWA/CA
Insul. Windows insul. Windows
2-Car Ga 3-Car Gara a -5,000
k CovPorch, Patio Patio, Deck
1-Fi lace 2-Fi -3,000
enoe Fence None 2,000
List/Sale Ratio -14,200
+ - f 41,500 + - f 0 + - 0
A~usbed $HI@ RICE 4 ~' z >" `'
T~~ '~ :'` ' ' Net AdJ -8.896
9.
430 801 Net AdJ. 096
0
0 Net Adf. 096
0
0
E T ARABLE LE N0.1 COMPARABLE SALE N0. 5 C P LE . 6
8-17-1993 2-2-2010
$50,000 $1
Tax Assessment Records Tax Assessment RecoMs
10-7-2010 1o-7-zo1o
StMnnry or Saks Compedson approach
_._..__._... ..---. ~ _.._.~...v,.-....--- .,~-....._..... ~...~,.«a~, ~~o~
SINGLE FAMILY
_ 3936388
Uniform Residential A~~raisal Report Fie No. 130millersgap
f R SUBJECT COMPARABL SALE N0.7 MPARAB E SALE N0.8 COMPARABLE SALE N0.9
130 Millers Gap Road
Enola
--~- ~---= s - - s -.~7 S
Sale ' . Mea S O sQ. R R . ;;. ' . .' S R 0. ~~ ~ r' ~'
DESCRIPTIOM RIPTION DESCRIPTION DESCRIPr
Sale a Famncing
~
k
S+.":
Subultan
Fee '
2.50 Aces
Good
2-St
17+/- Years
Good
AboveGrade
~~ 8 3 2.5
30.00 3,247 fl , ti !t
Basemen 6 Fatished Fu1U1315 Sq.Ft
Unfinished
•
A
Oi1HWBf3/CA
Insul. Windows
2-Car Ga
CovPorch, Patio
Fi 1-Fi ace
once Fence
. s 0 ~ = 0 - 0
A~6edSakPdce ;~:. ~~ ~:. NetA~. 096 NetAg. 096 NelAg. 096
COMPARAB SA LEN0.7 COMPARABLE SALE .8 C P .9
8-17-1993
350,000
Tax Assessrtiern Records
10.7-2010
summry d sales comparison A~road~
rwaoewc ramp n rrRa mos narom..spaaceamu~ ~a m.+~•~•~~m~an rents rase ram a~a rra~ zoos
,~m~
ADDENDUM
BOtrOWer• acq me . & b E. File No.: 130mrllersgap
Drrvvrrv Ar4lracr 130 Millers Gap Road CSSe NO.: 3936388
~jty Enola State: PA ZID: 17025-1011
• PNC Bank -Wealth Mana emerrt
Neighbofiood Boundaries
The subjects neighborhood is bound to the North by The Blue Mountains, to the West by Township Line, to the South ny Wertzville
Road, and to the East by Township Line.
Commerrts on Sales Comparison
After a thorough search of the subjects market area, there were no suitable comperebles that settled within the past 90 days. The
appraiser added an active listing to further support the estimated value of the subject property. The comparebles used are the best
available. After a thorough searoh of all available market data, the three sales used are considered to be the best indicates of value.
Inauffidsnt sales in dose proximity to the subject properly require the appraiser to extend search parameters. In order to find
comparable sales h was necessary to use less recent sales. Appropriate adjustments have been made for all differences. It is noted
that Cortrparable Sale Nos. 1, 2, 3 have four bedrooms and Alive Listing No. 4 has five bedrooms while the subject has three. Other
sales with three bedrooms were significantly different in location, s¢e, age, ar-dlor design, and were rxrt used for that reason. Those
drown are the bast available. An adjustment was made to the "SITE" of Active Listing No. 4. The significanty larger bt size is
considered superior m that of the subject. An adjustment was made to the "SITE" of Comparable Sale Nos. 1, 2, 3. Their signficantly
smaller bt sizes are considered inferior to that of the subject.
Final RecorrcillaUon
Due to the age of the subject property, the Cost Approach is not considered an indicator of value in this report. This appraisal report
has been pr~ared with the property in "as is" condition. No personal propeAy has been inducted in this valuation. This appraisal
assumes a reasonable marketing period of three months. The Market Approach reflects recent activity in fhe market place and is
given the nwst weight.
I osrtiry, as the appraiser, that I have complied with the Home Valuation Code of Conduct in all aspects of the appreisal process.
THIS IS A SUMMARY APPRAISAL REPORT. THE INTENDED USER OF THIS APPRAISAL REPORT IS THE LENDER/CLIENT. THE
INTENDED USE iS TO EVALUATE THE PROPERTY THAT IS THE SUBJECT OF THIS APPRAISAL FOR THE ESTATE OF
RICHARD & JACQUELYN ROBERTS, SUBJECT TO THE STATE SCOPE OF WORK, PURPOSE OF THE APPRAISAL, REPORTING
REQUIREMENTS OF THIS APPRAISAL REPORT FORM, AND DEFINITION OF MARKET VALUE. NO ADDITIONAL INTENDED
USERS ARE IDENTIFIED BY THE APPRAISER.
PLEASE NOTE THAT THIS APPRAISAL CONTAINS A DIGITAL SIGNATURE THAT IS PASSWORD PROTECTED. USE OF THIS
DIGITAL SIGNATURE REPRESENTS THE "ORIGINAL" APPRAISAL.
THIS APPRAISAL REPORT CONTAINS 25 PAGES.
SINGLE FAMILY
3938388
nA~r-Ircr (`nnrtitinnc Arilrtanrlum t[n the ADDraisal Rt?DOft fie No. 130millersgap
The purpose dthis addendum is a provide the hxda/dent wih a dear and aaaate understanduig dtlie market Vends and ca~ais pre+ralent in the suhjed ireghhahood. Tltis is a required
kr n ~ at a tier 12009.
130 Millers Ga Road Enola PA L 17025-1011
J ueline A. & Richard E. Roberts
Instructions: The appraise must roe the irdanraion required on ills ram as the basis fa NsRre cardusiaa, and must provide support br those corrdusiora, regar6rrg haairrg trends and
overea make axdaiorrs as reported in the Ndghbortaod section d the appraisal repot tam. The appraiser must tii in aB the idormation to the aMre it is avaaable and retrable and must provide
arrelysis es indrated bebw. B arty required data is unavalabk a is consideed wreiade, the appraise must provde an explanation. h is rerngrized that rot dl data soaces adB be able m
provide ilea to the shaded seas below; B i is avaiabk, however, the apprase mat krcltdetire data in the analysis. B data sauces provide the regrred intametion as an average instead dthe
mediae the appaise should resort the arai~k figrre acrd ideraify i as an average. Sales and ftsGngs mat be properties tlrat aarpae v6tir the subject property, determined by appykrg the allele
Rio 7-12 kbnlhs Pdor 4-6 k~bntla Glarert - 3 A~bMts Ovaal Trend
3oklid Saks 2 1 0 Stable
• dy 0 33 0 33 0 Stale.
7'aW i of AcBve ' ~ ~' ' ~*~ ~ s'; 3 ~ ~ ` , • r ,.~'
... ,.
Rion 7-12 klaehs Rion 4-6 MaMls CrarerR - 3 Madhs Pmae Trend
itediur SdeP~ 430 000 450 000 0 ~naeau X srnbie Decinir
ai MekBt 79 11 0 !Dediroi stable
liyt Rke ., 2 439 900
`" ".jv 342
mMarket -
Mcdian Sale Rice as %d list Rtes 94.51 % 97.85% 0% stable
Sete bolds etc. fmarrod assistance Yes No ~~
Explain M ddai the sekr corrcesskns trends to the past 12 maahs (e.g., sells wruibutrons irraeased tronr 396 to 5%, increasing use d buydowrrs, dosing vests. condo tees, options, etc J.
Seller txt trends have remained stable.
Are kredosae sales (REO else) a facto in the market? Yes X No Byes, explain (rrdu6rg the trends in istings and sales d taedosed propeties).
Gledlasaaceskraboveidamation. Central Penn Multi List
Summedze the above intametion as support to you corrdusions in the Neghborhood section d the apprlsl repel tam. B you used arty adddarel idamation, such as an analysis d
pendxg sales artdbr expired and widr6awn isirgs, to formaate you cerdusions, provide bath an explanation and support for you corrcNuiora.
In trends sht>tar the total number of com cable sales stable. Median sales remain stable and d son-the-market show a
rte, valt~ have remained stable in the st twelve months.
Ifthestrbectlsaunftlnacondominiumorc ive 'act, letethefollowi 'ectName:
pga Rio T-T2 Madre Rio 4-5 Montle Crrrerrt - 3 hbrahs Oveal Trend
T i d Sdes Shhle
Rate dW Slade
r .. ~, y ~ _". ,_q rry~
MadadUrit oral' . Ab.Ram .. ,„ •. ..
Are taedtnrre sales (REO sales) a tailor a the prejecrt Yes ';~ No B yes, irrdcete ere mmher d REO listings and expkrn the trends m Irstings and sales dloredosed properties.
Sunneize the above trends and address the krpad on the subject oral and projex.
APPRAISER SUPERVISORY APPRAISER (ONLY IF REQUIRED)
Signature Signature
Natrte Rda D. Name
..Company Name sort isal Services Company Name
Company Address 88 Street Company Address
State tlcensefCertlfication # L-001737-L State PA State License/Certification # State
E~jl A~regg fjohnttonappr~COrrtcastnet Email Address
100231fnteeeraeeeb.mn Feeds Mee Form 100a1C March 2008
FmdaeMK Form tl Mezh 1000 ~~~~ P~egelett ~.~
DIMENSION LIST ADDENDUM
GROSS BUILDING AREA (GBA) 5,242
GROSS LIVING AREA (GLA) 3,247
Meals) Area %ofGliA
~9 3,247 81.94
Level 1 2,051 39.13
Level2 1,196 22.82
Level 3
Olfrer
Basemerq 1,315 25,09
Garage 680 12.97
Area Measurements Area Type
Measurements Factor Total Levell Level2 Level3 Other Bsmt. Garage
28.00 x 48.00 x 1 = 1.196.00
7.00 x 17.00 x 1 = 119.00
18.00 x 48.00 x 1 738.00 ® ^ ^ ^ ^ ^
26.00 x 48.00 x 1 1.198.00
2a.oo x 27.0o x?- ~8~00 ^ O D O
2.00 x 18.00 z 1 32.00 O
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~1is~an NEpaommme M.i w~penrupvmms7senww ~.w.r~.
uorrower J me A. ichard .Roberts Frk No. 130mi 1 a
Address 130 Millers Ga Road
C Enola Cou Cumberland State PA Code 17025-1011
Lerrda PNC Bank - tAdealth Mana ement
APPRAISAL AND REPORT IDENTIFICATION
this Appraisal Report is ongof the following types:
Setf Contained (A written report prepared undEx Standards Rule 2.2(a), pursuant to the Scope of Work, as discosed elsewhere irl this report.)
® Summary (A written report prepared render Standards Rule 2-2(b), pursuant to the Scope of Work, as discosed elsewtere n trris report.)
^ Restricted Use (A written report prepared caber Standards Rule 2-2(c), pursuant to the Scope of Work, as disclosed ere in this report
restricted to the stated intended use by the specified cNent a intended user.)
on Standards Rule 2-3
Comments on Appraisal and Report Identification
Note any USPAP related issues requiring disClowre and any State mandated requirements:
SUPERVISORY APPRAISER (only if required):
Signatue: Signature:
~; R D. Jgit Mame;
~ ; 01 ro7/20 Date signed:
State terl6catlort # RL-0 1737-L State Cert~iCadon #:
a Staff License!: a State License #:
Step; PA State:
Ezpkadon Date of l,ert~Cadon a Ucense: 06/30/2011 Fxpkation Date of Cetdficadon a License:
Y Appraiser aaper.0on of subjet[ Property:
Efiectlve pate of Appraisal; 10-7-2010 Did Not ^ Exterior-ardy from street ^ Irderia and Extefia
mruw.spm.semmeraaa~..~a~sa..~0oditH+m usnwoeoo~aas
LOCATION MAP
Rnrrrwuor• Jacqueline A. & Richard ot3erts File No.: 130millersgap
PfODeil11 /~ra55.130 Millers Gap Road Case NO.: 3936388
Ciry• Enda State: PA ZID: 17025-1011
• PNC Bank -Wealth Man ement
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SU BJ ECT PROPE RTY PHOTO ADDENDUM
Borrower: aoQ one File No.: 13 m~ ersgap
property gddfe5S;130 Millers Gap Road Case NO.: 3936388
~i~y: Enola State: PA Zip: 17025-1011
• PN Bank -Wealth Ma ment
FRONT VIEW OF
SUBJECT PROPERTY
Appraised Date: t~ober 7, 2010
Appraised Velue: $ 430,000
REAR VIEW OF
SUBJECT PROPERTY
STREET SCENE
SUBJECT PROPERTY ADDITIONAL PHOTO ADDENDUM
BOROWef: aOQ~ one ~ rts F11e NO.: 13 mi ersgap
gddreSS:130 Millers Gap Road Case NO.: 3936388
Ci~r, Enola State: PA ZID: 17025-1011
• PNC Bank - Wlsalth Mana ement
FRONT VIEW
FRONT VIEW
REAR VIEW
SUBJECT PROPERTY ADDITIONAL PHOTO ADDENDUM
Borrower: aoq ine A. & and its File NO.: 130millersgap
PrODertV A~Ire~;130 Millers Gap Road Case No.: 3938388
City: Enola State: PA ZID: 17025-1011
• PNC Bank -Wealth Mana ement
SUBJECT FRONT VIEW
SUBJECT REAR VIEW
SUBJECT PROPERTY INTERIOR PHOTO ADDENDUM
LMNG ROOM
KITCHEN
DINING ROOM
SUBJECT PROPERTY INTERIOR PHOTO ADDENDUM
Borrower: acq ine a rts File No.: 13 mil ersgap
property Addregg;130 MNlers Gap Road Cage Np•; 3936388
City: Hole State: PA ZID: 17025-1011
• PNC Bank -Wealth Mana ement
SUNROOM
FAMILY ROOM
HALF BATHROOM
SUBJECT PROPERTY INTERIOR PHOTO ADDENDUM
gpROy~: acque ine o File No.: 130rrn ersgap
pity /{~~g~;130 Millers Gap Road Case NO.: 3936388
,~Sy: Errola State: PA ZID: 17025-1011
• PNC Bank -Wealth Ma ement
BATHROOM
BEDROOM
BATHROOM
' SUBJECT PROPERTY INTERIOR PHOTO ADDENDUM
BOROWef: aGq ine o File No.: 13om1 ersgap
PfODEYb Addre55;130 Millers Gap Road Case NO.: 3936388
City: Enola State: PA ZiD: 17025-1011
• PNC Bank -Wealth ement
COMPARABLE PROPERTY PHOTO ADDENDUM
~~ ac9 me File No • 13omi ersgap
~~~~;130 Millers p Road CBSe NO.3936388
~~ Eno18 State' PA ZID• 17025-1011
• PNC Bank -Wealth Mana ement
COMPARABLE SALE #1
6210 Run Cross Lane
Enota
Sale Date: 11-9-2009
Sale price: S aso,ooo
COMPARABLE SALE #2
2 Clairbum Drive
Mechanicsburg
5812 Date: 12-22-2009
Sale Price: S 410,000
COMPARABLE SALE#3
7 Meadow vew Court
Mechanicsburg
Sale Date: 5-1a-2010
Sale Price: S 450,000
COMPARABLE PROPERTY PHOTO ADDENDUM
ne ~ o rts File N .: mi a
property /lddregg;130 Millers Gap Road Case No.: 3936388
City: Enaa State: PA Zip: 17025-1011
• PNC Bank - WeaNh Mana meet
COMPARABLE SALE #4
7 Wheatland Drive
Mechanicsburg
Sale Date: DOM-17
Sale Price: S 472,301
COMPARABLE SALE #5
Sale Date:
Sale Price: S
COMPARABLE SALE #6
Sale Date:
Sale Price: S
IMAGED
Ohio National
Financial Services.
December 23, 2010
ESTATE OF JACQUELYN ROBERTS
46 PNC BANK, E3~ECUTOR
ATl N LdNDA J LUNDBERG, VP
PO BOX 308
CAMP HILL, PA 17001-0308
Re: Annuity Contract No. E1670521
JACQUELYN ROBERTS, Deceased
Dear Exocutor,
One Fuiancial Way
Cincinnati, Ohio 4Sz¢:
Post Office Box z37
Cincinnati, Ohio 4Szoi-oz;~
Telephone Sr3.794-bioo
www.ohioaationaI.com ~~~
RE~E~
JAN 0 4 2011
PA
You indicated m us that you want us co remit to the Estate of Jacqueline A. Roberts, as the ~ '
beneficiary under the above-referenced annuity, the cona~act value. The Este is due 1009~b of the
contract value. Accordingly, we have sent our check is the amount of $88,929.30 under separate
cover which oquals the cantracr value as of the last valuation period, including die effect of the death
benefit adjustment, if any.
Because the wntract value on the earlier of (1) the daft we received the proof of death or (2) 90 days
after the Annuitant's death exceeded the highest death benefit amount under the contractor the
rider(s), if auy, there was no death benefit adjustment.
The contract value on die date of death before the death benefit adjustment was $85,225.51. You
may need this information for estate tax purposes.
This was a qualified contract, so the amount we paid you is fully taxable, Next January, you will
receive on behalf of the Estate a Form I099R for the taxable incaome of $88,929.30.
Payment of these proceed s satisfies our obligation under the above-refercncxd annuity wntract.
If you :have any questions or concerns regarding this hatter, please dti not hesitate to contact me at
1-888-925-6446, or 513-794-&879 or a-mail kru.therford@ohionazianai.com.
Sincerely, .
xi~beriY S..Riitherfncd ~......... .
Annuity claims Examiner
Endosute
cc: Dennis Shank & Jenniefrr Conway, Morgan Stanley Smith Barney 10277 - 209953
The Ohio National Life Insurance ComQany
Ohio Nadanel Life Assurance Corporation
Issues sorted by secvrit
X ESTATE TAX SECORITIES VALDATICN PAGE NO. 1
AccoDNT: z727ooa X604 9
73 Nam of Estate: JACQUELYN A ROBERTS
DATE OF DEATH: Thursday, October 7 2010
ITEM CUSIP NO. 68ARES/ DESCRIPTION PRICE HIGH/ASK I,OW/HID MEAN SECORITY ACCRUED COMMENTS
PAR VALUE DATE PRICE PRICE PRICE. VALIIE DIV/INT
1) 110122108 200 BRISTOL-1~CERS SQIIIHB CO 10/07 27.4000 27.2201 27.31005 5,462.01 NYSE
COM
DIV $0.3200 EX 09/29/2010 REC 10/01/2010 PAY 11/01/2010 64.00
2) 3364188K3 3,000 FIRST SIGNATURE BK TR CO 10/07 100.6355 100.63550 3,019.07 NASDAQ
CD 4410
Iat. From: 06/17/2010 to 10/07/2010 37.00
3) 35906A106 48 FRONTIER COMMUNICATIONS INC 10/07 8.4900 8.3400 8.41500 403:92 NYSE
COM
4) 369604103 200 GENERAL ELECTRIC CO 10/07 17.1200 16.8500 16.98500 3,397.00 NYSE
CCM
DIV $0.1200 EX 09/16/2010 REC 09/20/2010 PAY 10/25/2010 24.00
5) 453320301 3,073.25 50 IItCOME FD AMER INC 10/07 16.1000 1.6.10000 49,479.41 MOT FUND
CL C
6) d5664E1D7 3,500 ING GLOBAL EQTY DIV G PRENI O 10/07 11.4100 11.3220 11.36600 39,781.00 NYSE
COM
7) 464287465 420 ISHARES TR 10/07 57.1200 56.2000 . 56.66000 23,797.20 PACIFIC EX
MSCI EAFE IDX
8) 464287655 400 ISHARES TR 10/07 69.0800 67.9200 68.50000 27,400.00 PACIFIC EX
RUSSELL 2000
9) 464287689 600 ISHARES TR 10/07 66.8000 66.03D0 68.41500 41,049.00 PACIFIC EX
RUSSELL 3000
10) 494366103 100 AT~rTtT~Y CLARK CORD 10/.07 66.3400 65.8400 66:09000 6,609.00 NYSE
CCM
11) 92343V104 200 VERIZON COMMDNICATIONS 10/07 33.5700 32.8600 33.70250* 6,740.50 NYSB
CCM
;DIV. EX 10/06/2010 REC 10/08/2010 PAY 11/01/2010 0.48750 *Added to Mann Price
12) 993077106. 16,258.5000 CITSBANR NA SORTS DAKOTA BANK 16,258.50 0.00 MANUAL
PRINCIPAL CASH
Graced Totals 223,396.61 125.00
Total Principal plus Accrued interest and dividends 223,521.61
1 `~ ,`~
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Thii report was prepared usiag APPRAISB Ver. 7.4.1 software, as EVALSD~TICN SERVICES, IIiC. product.
Phone 201 784 8500. Visit ou; web sites at WNW.APPRAISENJ.COM and NWIt.C0STBASI3.INF'O.
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