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Y J Date of Binh MMDDYYYY 04/17/1936 Decedent's Flrs1 Name _ Mi Esther K Spouse's First Name MI _ ... Spouse's Social Secudty Number TH1S RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 1505610101 OFFICULL U8E ONLY REV-1500 al°'-'°' ''>~ PA Department of Revenue ~n~va~a County Code Year File Numb r Bureau of Individual Taxes INHERITANCE TAX RETURN ?`` II- ,~y~~ PO BOX ZBO6oi RESIDENT DECEDENT cZ` 1 °LL7 u.,.a..,,,.... oe ,~, ~k_r,f:m Social Security Number Date of Death MMDDYYYY 232-&0-1516 01/24/2011 Decedent's Last Name Suffix Miller (If Applkable) Enter Surviving spouse's InfotTnedon Below Spouse's Last Name Suffix Decease FILL IN APPROPRIATE OVALS BELOW Ob 1. Original Retum O 4. Limited Estate O 6. Decadent Died Testate (Attach Copy of Will) O 9. Litigation Proceetls Received O 2. SupplemeMaf Retum O 4a. Future Interest Compromise (date W death after 12-12-62) O 7. Decedent Maintained a Living Trust (Attach Copy of Trust) O 10. Spousal Poverty Credit (date of death between 72-31-91 and 1-1-96) :ORRESPONDENT - TNI8 SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND Name Louis Fazekas First line of address 6043 Edward Drive Second line of address O 3. Remainder Return (date of deaM prior to 12.13-62) O 5. Federal Estate Tax Retum ReGuired _ 6. Total Number of Safe Deposit Boxes O 11. EleAion to fs~ under Sac. ~'IT3(A) (Attach SC _ ~ iv -c I IU ~_ i;7 G;!-> 7`T: '.r; - -, - - -. ,; TAX INFORMATION _ Daytime TeN 1;717) 64: City or Post Office State ZIP Cade Mechanicsburg PA 17050 REGISTE v.. CLB USE'1i LY ~.1 ~ ~._ _- - ~7 -, ` - !. DATE FILED i_: '7 rn n 'n Correspondent's a-mail addroas: IOUIS.T82@KaSL US.afRly.Inll _ Under penalties of perjury I declare that I have exam(ned mla return, including acmmpenying schedules and statemenffi, end to the best of my knowledge and ballet, it 5 true, correct and complete. Geclerel'ron W preparer other than the personal representadre is beaetl on all IMormatbn of which preparer has erry knowledge. SIGNATUR~Eq~ PERSON~F eoNSIBLE FOR FILING RETUwy DATE ~`.<,..;1:~.4>ssiewi. E.ce~.r.'Fer S/~/a2o/2 6043 Edward Drive, Mechanicsburg, PA 1705D SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L, 1505610101 1505610101 1505610105 REV-1500 EX Decedent's Sodal Seventy Number _ Decedent's Name: ~ 23,'2.60=1516 RECAPRULATION _ __ _ 1. Reai Estate (Schedule A) .......................................... ... 1. ~ 139,000.00 _. _.. _ _. 2. Stocks and Bonds (Schedule B) .................................... ... 2. 0.00 3. Ciose(y Heid Corpo2fion, Partnership or Sole•Proprtetarship (Schedule C) .. ... 3. 0.00 4. Mortgages and Notes Receivable (Schedule D) ........................ ... 4. D.00 5. Cash, Bank Deposits and Misrrellaneous Personal Property (Schedule E).... ... 5.. 50,508.00 6. Jointly Owned Properly (Schedule F) O Separate BNAng Requested .... ... 6. 0.00 7. Inter-Vivos Transfew & Misoelleneoua Non-Probate prbperty (Schedule G) O Separate Billing Requested..... ... 7. 0.00 8. 7ota1 Gross Assets (total Lines 1 through 7) .......................... ... 8.. 759,608.00 9. Funeral Expenses antl Administrative Costs (Sdredule H) ................ ... 9. 6,479.00 10. Debts of Decedent, Mortgage L+abilities, and Liens (Schedule I) ........... ... 10.. 3,257.00 11. Total Detluetlons (total Lines 9 and 10) .............................. ... 11. 9,736.00 12. Net VaWe of Estate (Line 8 minus Line 11) ........................... ... 12. 179,772.00 13. Chartable and Governmental Bequests/Sec 9113 Trvsts for which an election to tax has not been made (Schedule J) ...................... .. 13. 0.00 14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... .. 14. 179,772.00 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 ta7Wble at the spousal tax rate, or transfer; under Sec. 9116 - - _ (a)(1.2) X .0 0 0.00 15. D.00 16. Amount of Line 14 taxable at lineal rate X .0 45 8,090.00. 1g, 8,090.00 17, Amount of Line 14 taxable at sibling rate X .12 0,00 17. 0.00 18. Amount of Line 14 taxable 0 00 __ 0 00 . at wllateml rate X .15 16 . 19. TAX DUE ....................................................... .. 19. 8,090.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 1505610105 1505610105 t REV-1500 EX Page 3 Flle Number Decedent's Complete Address: D CEDENTS NAME Esther K. Miller STREET ADDRESS 10 Kevin Road crrv Mechanicsburg srATE PA ziP 17050 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This Ls the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. Total Credits (A+g) (2) (4) (t) (3) 435.00 8,090.00 D.00 0.00 5. if Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 8,525.00 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 trensiemed or its income : ...................................... ...... ^ c. retain a reversionary interest; or .................................................................................................................... ...... ^ d. receive the promise for life of either payments, benefts or care? ................................................................ ...... ^ 0 2. If death occurred after Dec. 72,1982, did decedent transter property within one year of death without receiving adequate consideration? ....................................................................................................... ...... ^ 3. Did decedent own an "in trust for" orpayable-upon-death bank account or security at his or her Beath? ........ ...... ^ 4. Did decedent own an individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? .................................................................................................................. ...... ^ 1F THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)j. For dates of death on or after Jan. 1, 1995, the tax mte imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)). The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disGosure of assets and filing a tax return are still applicable even d the surviving spouse is the only beneficiary. For dates of death on or after Juty 1, 2000: • The tax rate imposed on the net value of transters from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adopfive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common vd01 the decedent, whether by bbod or adoption. 0.00 REV-1502 E%+ (11.-OS) ~ Pennsylvania SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF FILE NUMBER Esther K. Miller 2011-00264 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property that is fointlyowned with right of survlvorehip must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH OESCRIP'fION Single family home -10 Kevin Road, Mechanicsburg, PA 17050 ~ 139,000.00 TOTAL (Also enter on Llne 1, Recapitulation.) I ¢ 139,000.00 If more space is needed, insert additional sheets of the same size. REV-1503 EX+ (6-98) scNEOU~E s COMMONWEALTH OF PENNSYLVANIA STOCKS ~ BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Esther K. Miller 2011-00264 All property JolMlyowned wMh rlpht of surWvorshlp must be dhklosed on liehedule F. (If more space is needed, insert additlonal sheets of the same size) - REV-15D4 EX+ (6-98) S~H~~`eZ~ w CLOSELY HELD CORPORATION, COMMONWEALTH OF PENNSYLVANIA PARTNERSHIP OR - iN RESIDENT DECEDENTRN SOLE-PROPRIETORSHIP ESTATE OF FILE NUMBER Esther K. Miller 2011-00264 Qf more space is needed, insert additional shee4s of Me same size) REV-507 EX+ (6-98) SCHEDULE D COMMONWEALTH OF PENNSYLVANIA MORTGAGES &1 CNOTES INHERITANCE TAX RETURN REL'ENABLG RESIDENT DECEDENT ESTATE OF FILE NUMBER Esther K. Miller 2011-00264 All property jofntlycwned with right of survivorship must he disclosed on Schedule F. (If more space is needed, insert additional sheets of the same size) REV-i5D8 EY,+ (11-iDJ ~ ' Pennsylvania SC11EDtILE E ' DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDEM DECEDENT ESTATE OF: FILE NUMBER: Esther K. Miller 2011-00264 Include the proceeds of litigation and the date the proceeds were receivetl'~ by the estate. All properly joIMIY owned with right of survlvorshlp must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. M&T Bank, 5528 Carlisle, Pike, Mechanicsburg 17050. Estate Acct. 9853807239 34,690.00 -Estate Acct. Includes check 2 checks from New Cumberland Federal Credit Union (NCFCU) NCFCU, 345 Lewisbeny Rd, New Cumberland, PA 17070 -NCFCU Savings Acct.#040681, Balance $17,561.92 -NCFCU Savings Lde Ins. Payment $2,796.09 -MET Life Savings deposit to M&T Bank $14,332.21 3. M&T Bank, Checking Acct 60574097 & Savings Account, Acct. 15004219415062 8,818.00 q. 2003 Toyota Camry 7,000.00 TOTAL (Also enter on Line 5, Recapitulation) § I 50,508.00 If more space is needed, use additional sheets of paper of the same size. REV-1509 E7(+(01-10) ~~ '" Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCNEp11LE F JOINTLY-OWNED PROPERTY ESTATE OF: FILE NUMBER: Esther K. Miller 2011-00284 It an asset lbcsme 1oiMly owned wkhin one year of the daudaM's date of death, k mart be reported on Schedule G. SURVNING JOINT TENANT(S) NAME(S) ~ ADDRESS RELATIONSHIP TO DECEDENT A None 8. C. JOINTLY OWNED PROPERTY: REM NUMBER LETTER FOR ]DINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FlNANCIAL INSRNRON AND BANK ACNUNT NUMBER OR S1MIlAR IDENRFI7NG NUMBER. ATTAQI DEED PoR ]DINKY HEIR REAL ESTATE. DATE OF DEATH VALUE OF ASSEr %OF DECEDENf5 INTEREST DATE OF DEATH VALUE OF DE®ENi'S INTEREST 1. A. None 0.00 TOTAL (Also enter on Line 6, Recapitulation) I § 0.00 If more space is needed, use additional sheets of paper of the same size. REV-1510 E%+ (OS-09j ~ pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND ' wNERrrANCE rnx RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Esther K. Miller 2011-00264 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 NUMBER DESCRIPTION OF PROPERTY INQUDE iNE NWE DF 111E TRANSF&EE, (HEIR REIATIDNSNIP TO DE®ENf AIA 111E DA1E OfiRAN3ER. ATlAD1ACDPf OFfie GEED fDR R[NL ESTATE. DATE OF DEATH VALUE OF ASSIT 95 OF DECD'S INTEREST EXCLUSION 4F AWlIUa TAXABLE VALUE I. None 0.00 TOTAL (Also enter on Line 7, Recapitulation) ; I 0.00 If more space is needed, use additional sheets Df paper of the same sae. REV-1511 EX+ (10-09) ~ Pennsylvania DEPARTMENT OF REVENGE INHERRANCE TA% RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF fILE NUMBER Esther K. Miller 2011-00264 Decedent's debts must be reported on Schedule I. A. FUNERAL EXPENSES: t' Myers Funeral Home Rolling Green Cemetery Bench Engraving Reception B. 1. ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City Year(s) Commission Paid: 2. Attorney Fees: 3. Family Exemption: ([f decedent's address is not the same as claimant's, attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 9. Probate Fees: 5. Accountant fees: 6. Taz Return Preparer Fees: 7. State 2IP 4,009.00 970.00 1,550.00 TOTAL (Also enter on Line 9, Recapitulation) I ¢ 6,479.00 If more space is needed, use additional sheets of paper of the same size. REV-1512 EX+ !12-08) ~ `pennsylvania SCHEDULE I DER^nrNENT O'REVE"uE DEBTS OF DECEDENT, INHERRANCE TAX RETURN MORTGAGE LIABILITIES Bt LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Esther K. Miller 2011-00264 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. tr more space is neetletl, insert atltlitional sheets of the same size. REV-1513 E%+ (Ol-iD) ~ pennsylvania SCHEDULE J INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT Esther K. Miller 2011-00264 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY l10 No[ List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1. Rose E. Fazekas Daughter 33.33% 2. Rhonda L. Ouimet Daughter 33.33% 3. Rochelle Gomboc Daughter 33.33% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUT1ON5 ON LINE 13 OF REV-1500 COVER SHEET. I; ~ If more space is needed, use additional sheets of paper of the same size. .. REVd514 Ex+(409) _` ~ Pennsylvania °EPA0.TMENT OF REVENUE _ Bucau oflndiviEuat Taxes PO aox ia(1601 Ramslxxg vn 1»?a-osor SCIIEpULE K LIFE ESTATE, ANNUITY & TERM CERTAIN (CHECK BOX 4 ON REY-r5oo COVER SHEET) ESTATE OF FILE NUMBER Esther K. Miller 2011-00264 This schedule should be used for all single-life, joint or wccessive life estate and tens-certain ralwlations. Por dates of death prior to 5-1-89, actuarial factors for single-life calculations can be obtained from the Department of Revenue. Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death from 5-1-89 to 4-30-99, and in Aleph Volume for dates of death from 5-1-99 and thereafter. Indicate below the type of Instrument that created the future interest and attach a copy of it to the tax return. ^ till ^ Itttervivos Deed of Trust ^ Other NAN OF LIFE TENANT DATE bF BIRTH-" N DATE OF DEATH ; "LIFE ESCATE S$ PAYABLE None ^ Life or ^ Term of Years ^ Life or ^ Tenn of Years ^ Life Or ^ Term of Years ^ Life or ^ Tenn of Years ^ Life or ^ Tenn of Years 1. Value of fund from which life estate is payable .........................................$ 2. Actuarial factor per appropriate table ............................................... . Interest table rate - ^ 3.5% ^ 6% ^ 10°h ^ Variable Rate % 3. Value of life estate (Line 1 multiplied by Line 2) ....................................$ NAME OF LIFE ANNUITANT DATE OF BIRTN • DATE OP DEATH ANNIIf1Y S PAYABLE _ ^ Life or ^ Tenn of Years ^ Life or ^ Tenn of Years ^ Life or ^ Term of Years ^ Life or ^ Tenn of Years 1. Value of fund from which annuity is payable ...................................... .....$ 2. Check appropriate block below and enter corresponding number ............. ... . Frequency of payout - ^ Weekly (52) ^ Bi-weekly (26) ^ Monthry (12) ^ ~uarterry (4) ^ Semi-annualry (2) ^ Annualry (1) ^ Other ( ) 3. Amount of payout Par period ................................................... .....$ 4. Aggregate annual payment, Line 2 mutiplied by Line 3 .............................. .... . 5. Annuity Factor (see instructions) Interest table rate - ^ 3.5% ^ 6% ^ 10% ^ Variable Rate 6 Ad)ustment Factor (See instructions.) ............................................ .... . . 7. Value of annuity - If using 3.5, 6, ar 10%, or if variable rate and period payout is at end of period, calculation is Lina 4 x Line 5 x Line 6 ............ . ......... .....; If using variable 2te and period payout is at beginning of period, calculation is (Line 4 x Line 5 x Line 6) + Line 3 .......................................... .....$ NOTE: The values of the funds that create the above future interests must be reported as part of the estate assets on Schedules A through 6 of the tax return. The resulting life or annuity interest should be reported at the appropriate tax rate on Lines 13 and 15 through 18 of the return. If more space a needed, use additional sheets of the same size. REV-1645 EX+ (11-09) pennsytvarria INHERITANCE TAX SCHEDULE L-1 DEPggTMENT DF gEVEN1IE INHERRANCE TA%REfURN RESIDEM DECEDEM REMAINDER PREPAYMENT ELECTION -ASSETS- I. ESTATE OF FILE NUMBER Es f~ K. K,11~-~ ao~~ - oozb~ II. ITEM NO. DESCRIVTION VALUE A. Real Estate (Please describe.) Total Value of Real Estate $ (Include on Section II, Line C-1 on Schedule L.) B. Stocks and Bonds (Please list.) Total Value of Stocks and Bonds $ (Include on Section II, Line C-2 on Schedule L.) C. Closely Held StocWPartnership -Please list. (Attach Schedule C-1 and/or C-2.) Total Value of Closely Held/Partnership $ (Include on Section II, Line C-3 on Schedule L.) D. Mortgages and Notes (Please list.) Total Value of Mortgages and Notes $ (Include on Section II, Line C-4 on Schedule L.) E. Cash and Miscellaneous Personal Property (Please list.) Total Value of Cash/Miscellaneous Personal Property $ (Include on Section II, Line C-5 on Schedule L.) [II. TOTAL (Also enter on Section II, Line C-6 on Schedule L.) $ If more space is needed, attach additional sheets of paper of the same size. REV-1646 E:x+ (11-09) pennsytvania INHERTTANCE TAX SCHEDULE L-2 DEPI1gTNENT OF gEVENl1E INHERITANCE TAI(RETURN REMAINDER PREPAYMENT ELECTION , RESIDENT DECEDENT -CREDITS- I. ESTATE OF FILET NUMBER II. ITEM NO. DESCRIPTION AMOUNT A. Unpaid Liabilities Claimed against Original Estate and Payable from Assets Reported on Schedule L-1 (please list) Total Unpaid Liabilities $ (include on Section II, Line D-1 on Schedule L) B. Unpaid Bequests Payable from Assets Reported on Schedule L-1 (pleasr. list) Total Unpaid Bequests $ (include on Section II, Line D-2 on SchedulE~ L) C. Value of Assets Reported on Schedule L-1 (other than unpaid bequests listed under "B" above) that are Not Included for Tax Purposes or that Do Not Form a Part of the Trust. Calculation as follows: Total Non Includable Assets $ (include on Section II, Line D-3 on Schedule L) III. TOTAL (A15o enter on Section II, Line D-4 an Schedule L) $ If more space is needed, attach additional sheets of paper of the same size. REV-1647 E%+ (02-10) y, ~ ` pennsylvania DEPARTMENT OF REVENUE INHERtrANCE TAX RETURN RESIDENT DECEDENT SCHEDULE M FUTURE INTEREST (Check Box 4a on REV-s5oo) ESTATE OF FILE NUMBER Esther K. Miller 2011-00264 This schedule is appropriate only for estates of decedents who died after Dec. 12, 1982. This schedule is to be used for all future interestr where the rate of tax that will be applicable when the future interest vests in possession and enjoyment cannot be established with certainty. Indicate below the type of instrument that created the future interest and attach a copy to the tax return. ^ Will ^ Trust ^ Other I. Beneficiaries NAME OF BENEFICIARY RELATIONSHIP DATE OF BIRTH AGE TO NEAREST BIRTHDAY 1 None 2. 3. 4. 5. II. For decedents who died on or after July 1, 1994, if a surviving spouse exercised or intends to exercise a right of withdrawal within nine months of the decedent's death, check the appropriate box below and attach a copy of the document in which the surviving spouse exercises such withdrawal right. ^ Unlimited right of withdrawal ^ Limited right of withdrawal III. Explanation of Compromise Offer: IV. Summary of Compromise Offer: 1. Amount of future interest ....................................................... $ 0.00 2. Value of Line 1 exempt from taz as amount passing to charities, etc. (Also include as part of total shown on Line 13 of REV-1500.) ........ $ 3. Value of Line 1 passing to spouse at appropriate tax rate Check one. ^ 6%, ^ 3%, ^ 0% ....................$ (Also include as part of total shown on Line 15 of REV-1500.) 4. Value of Line 1 taxable at lineal rate Check one. ^ 6°h, ^ 4.6% ..........................$ (Also include as part of total shown on Line 16 of REV-1500.) 5. Value of Line 1 taxable at sibling rate (12%) (Also include as part of total shown on Line 17 of REV-1500.) ........ $ 6. Value of Line 1 taxable at collateral rate (15Mo) (Also include as part of total shown on Line 18 of REV-1500.) ........ $ 7. Total value of future interest sum of Lines 2 thru 6 must a ual Line 1 0.00 ( Q ) .......................$ If more space is needed, use additional sheets of paper of the same size. 4/27/t2 E X GRANTED TEMPLATE SubJect Extension fetter for John R Miller From "Heimbach,Amber"<aheimbach@pa.gov> Date Monday, October 24, 2011 11:03 am To "'louis.faDekas@us.armymil'" <louis.faaekas@us.army.mil> ' ~C111S~/tVc'~~'l18 DEPARTMENT OF REVENUE ,,,,, ,,,,,,,.....y ,,,,...~~y.. ,., ..sing sent from an unmonitored accoun'd. Please do not reply. Re: Estate of John R Miller File Number 2111-0229 Dear Sir or Madam: This is in response to your letter of Esther K Miller 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 April 24, 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 infomlal hold period. IGndly 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. Sincerely, Laurel Fulmer Supervisor Inheritance Tax Division IfulmerCa state. pa. us Rease do not reply to this email. This mailbox is not monitored and you w ill not receive a response. For assistance, visd us on the w eb at www.revenue.state.pa.us or call us at 717-787-8327 The information transnitted is intended only for the person or entity to w horn it is addressed and may contain confidential andtor privileged rreterial. Any use of this inforrretbn other than by the intended recipient is prohibited. ff you receive this rtessage in error, please send a ropy e-rreil to the sander and delete the material from any and aA computers. https:/lwebmail.us.amn y.mii/pdnt. html 4/27/12 The following message is being sent from an unmonitored account From "Blattenberger, Linda" <Iblattenbe@pa.gov> ~ Date Friday, October 21, 2011 2:30 pm To "'LOUIS.FAZEKAS@US.ARMY.MIL"' <louis.fa7ekas@us.armymil> eni evrcnicinni ~n~ee ei en n_oenircn Tn THE ESTHER MILLER ESTATE TILL 04/24/12 p£11tiSyEY~f11~ DEPARTMENT 4F REVENUE The following message is being sentlrem an unmonitored account Please do notreply. Re: Estate of JOHN MILLER Social Security No.: WA Date of Death: 06/25/11 Dear Sir or Madam: This e-mail is to verify that you have been granted an extension of 6 months which will terminate on 09!25/12 . This is an extension of time to file, not an extension of time to pay. Interest will begin to accrue on any unpaid Pennsylvania inheritance tax as of 03/25/12. As no county file number has been issued, this extension cannot be entered into the Department's computer. A copy of this e-mail should be attached to both copies of the Pennsylvania inheritance tax return when it is filed with the Register of Wills in CUMBERLAND County. ff you have any questions concerning this a-mail, please contact me at 717-787-8327. Sincerely, Laurel Fulmer, Supervisor Inheritance Tax Division Please do not reply to this email. This mailbox is not monitored and you will not receivE a response. For assistance, visit us on the web at www.re~enue.state.pa.us or call us at 717-787-8327 The information transmitted is intended only for the person or entity to whom it is addressed and may contain confidential and/or privileged material. Any use of this infommation other than by the intended recipient is prohibited. Ifyou receive this message in error, please send a reply a-mad to the sender and delete the material from any and all computers. https://webmail.us.army.mil/print.html 1/1 ~lll~illilll~llllla~l~l~lllalllllllllla~l in n ~ o w S a ~ o U O ~ G ~, E ~ ~ m Z o ~F ~ $ .~ u J ~ 5 S o m o .- .c w ,- E o ,; ~ N ~ z ~ ~ ~ a ~ a ~ r Z O ~ U °p r' J O C p ~ o ,o H-yo~z o~°°° ~ Z O Z Q m m ~ O~~J HUa~ 0 u~ 0 _r w ~ a J_ ~ ~O ~~ wV xw ~X w ~ LL N ~ ~ ~ ~YOm ~Nac`~i ~ HuQ.Oz ~ W Vl W = N w ~ ~ V ° ~~~~ ~ ~~ >`~>s~ Hampden Office If you have any questions, please call our Telephone Banking Center at 1-800-724-2440 Today's Date: Business Date: 04/02/11 04/04/2011 ` Time: 10;39 AM Checking Deposit $14,332.21 ****7239 6109 /O6 33 Q ~ ~~~ ~~>,~ Hampden Office ~I If you have any questions, please call our Telephone Banking Center at 1-800-724-2440 Today's Oate: Business Date: 04/02/2011 04/04/2011 Time: 10:39 A.M ' Checking ****7239 Total Balance: $31,669.25 Available Balance: $17,557.04 Thanks for visiting us today. We are happy to assist you! Or-,~ ~ na ~ ~ctilc¢nc-~' ~~-/~CL1: yJLPOS/ t" Thanks for visiting us today. We are happy to assist you! PAGE ~~ NEW CUMBERLAND FEDERAL CREDIT UNION Tour Community Credit Zlnion CU. Box 65tl n New Cumberland, IA 17070. www.ncravonline.o.g (717)774-7706 • (800) 716-2328 • Fax: (717) 774-7996 STATEMENT OF ACCOUNT 1 SHRED-IT TRUCK 4-30 YDRKEXPO SCHOLARSHIP ENTRY DUE 5-13 COLLEGE FUNDING SEMINAR 5-26 2.75% NEW-USED CAR 60 MO 4.74% HOME EQUITY TO 120 MO 351 1 AV 0.335 LIIIIIIIIIILIIIId11111111L111JdI1111Jd1111111111111111 JOHN R MILLER 10 KEVIN ROAD MECHANICSBURG PA 17050-6802 JointUvners ~ 040681 ESTHER MILLER FnoM ro 030 111 3311 7MNSACT1oN oAiE EFFECTNE GarE DESCRIPTION AMOUNT FINAN CHAR CE GE FEES FINE / S 9ALANGE 0301 PREVIOUS BALANCE S1-PRIMARY SHARES 17561 0303 WITHDRAWAL CHECK -1'7556 2 5 P-ESTATE OF ESTHER K. MILLER 0331 DIVIDEND 4 5 7HE ANNUAL PERCENTAGE YIELD EARNED IS 0.2 . 0331 NEW BALANCE DIVIDEND IS CALCULATE 5 USING A DAILY BALANCE METHOD. OVERDRAFT AND RETURNED ITEM FE S SUMM R i I TOTAL FOR I TO AL ------ ----- I THIS PERIOD ---------------I-------------- I YEA -T -DA E TOTAL OVER -------- RAFT FEES I S 0.00 --I--- i - --- S -- --- 0.0 - ------ TOTAL RETU NED ITEM FEES I S 0.00 I S 0.0 TAX YE R 201 0: REPORTED DIVIDENDS 67:72 TOTA FINAN E CHA GE 0.0 TOTAL DIVIDEND YEAR-TO-DATE TOTAL FINANCE CHARGE YEAR-T4DATE ror.n mrhpa anew iRn,.wnp.. G~~m rgw0, n owr alo, adn m reWmd ror an b•m to u:e ~noemal Reaerwa SaMOe f« Ods 7 . 3 4 0 . 0 0 n+acnTES EFFErnvE oArE NOTICE: See revelae side for important information 0800351 r• BUREAU DF iNDIV IDUAL TAXES PD Box zegsal HARRISBURG PA 17128-0601 ~a exv-~sas xx ur ue~ou YtNNJTLVANIA 1NHERITAMCE INFORMATION NOTICES AND TAXPAYER RESPONSE -'~ M'I'6 ( L' FILE N0. 21 11-0264 ALN 11126207 DATE 04-19-2011 ROSE E FOZEKAS 6043 EDWARD DRIVE MECHANICSBURG PA 17050 EST. OF ESTHER K MILLER S5N 232-60-1516 DATE OF DEATH. D1-25-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS TD: REGISTER OF WILLS 1 COURTHOUSE SpUARE CARLISLE PA 17013 TYPE OF ACCOUNT ® SAVINGS CHECKING TRUST CERTIF. M 9 T BANK provided the Department with the information below, which has been used in calculating the o otm tial kaN. due. Roeords indicate that at the death of the above-nemetl tlo ceden4. you wen a joint owno r/boneficiay of to is account. If you feel the information is incorrect, of ease obtain written correction from the financial :institution, attach a cony to this fora and return it to the above adtlre ss. This account is taxable in accordance with the Inns rikanco Taz lm,s of the Commomrealth of Pennsylvania. Please call (717) 797-9327 with Questions. COMPLE7E PART 1 BELOW It SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 15004219415062 Date 01-24-2009 Estahllshatl A<count Balance Percent Taxable Amount Sub1e<t to Tax Tax Rate Potential Tax Due $ 13,194.23 X 50.000 s 6.597.12 To ensure proper credit to the account, two copies of this notice must aceompary pavaent to the Register of Wills. Make ena ck payable to "Register of Wills, Agent". NOTES If tax pavwents era wade within three non the of the tl¢eadont's data of tleath, tladuct a 5 portent discount on the tax due. Aro Inheritance Tax due will bacons delinquent nine months after the date of death. A. ^ The above information and tax due is correct. Reait pavaent to the Resistor of Wills with two copies of this notice to obtain r C HECK a discount or avoid interest, ar check box "A•• and return this notf c¢ to the Register of I ONE -~ Wills antl an official asse assent will be issued by the PA Department of Revenue. L BLOCK B. ~ The above assek nos been or will bo repo rked antl tsx paid wikh the Pennrylvania Inheritance Tax return ONLY to be filed by the •stata rep resentativa. C. ~ Tha above informs xon is incorrect and/or debts and detluetions wero paid. Comp L to PART ~ and/or PART ~ below. PART If Sntl is atlns a different tax rate, plc ass state re latlonshSp to decetlent: TAX RETURN - COMPUTATION LINE 1. Data EstaDlishetl 2. Account Balance i. Percent Taxable 4. Amount Subj a<t to Tax 5. Debts and Deduetlons 6. Amount Taxable 7. Tax Rate 9. Tax Due OF TAX ON JOINT/TRUST ACCOUNTS 1 2 S 3 X 5 6 ~ T X 8 $ Untler penalties of perjury, I tleclare that the facts I have reportatl above are true, correct antl complete to the best of my knowietlge one DelS ef. HOME C ) WORK C ) TAXPAYER SIGNATURE TELEPHONE NUMBER DATE PART 1JG615 NtlU Yp1JY611Y19J l.LN 11'IRY DATE PAID PAYEE DESCRIPTION AMOUNT PAID rcnnJTLYAn1A dnntK11A1'11.C IAA. INFORMATION NOTICE BUREAU OF INOIYIOUAL TA%ES AND FILE N0. 21 11-0264 PO BOX 260601 TAXPAYER RESPONSE AcH 11126206 IURRI SBURG PA 17126-0601 DATE D4-19-2011 eFV.I56 fM fiV IOP OU ROSE FOZEKAS 6043 EDWARD DR MECHANICSBURG PA 17050 EST. OF ESTHER K MILLER SSN 232-60-1516 DATE OF DEATH 01-25-2011 COUNTY COMBERLAND REMIT PAYMENT AIND FORMS T0: REGISTER OF TWILLS 1 COURTHOUSE SgUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKI N+ TRUS7 CERTIF. M ~ T BANK provitl ad 4ha Depa rtwant with the info nation bel w, which has been usetl in calculating the potential teoc due. Records indicate 4hat at the tleath of the above-nawetl dacetle nt, you we ra n ipi nt owner/banef iciay of this account. If you feel the inf orwation is ineo treat, please obtain written correction frow the financial institution, attach a eopir to this fon and return i.t to the above adtlrass. This account is taxable in accordance with the Inhe ritamee Tex laws of the Cooonwealth of Pennsylvania. Please call (717) 767-6.327 with pw scions. COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 60574097 Date 03-29-2006 To ensure proper credit to the account, two Established eopfa:: of this notice wust aecowpsny paywnt to the Resistor of Wills. Nake cheek Account Balance 4 441 .96 s payable to ''Register of Wflls, Agent". Percent Taxable X 50.000 NDTEI If tax paywents era wade within three Amount SuD}act to Tax S 2322D.99 eon the of the tleeatlent's Gate of death, Tax Rate X , 045 deduct a 5 percent discount an the to due. Aro Inheritance Tax due will becowe tlelinguant Poten+tlal Tax Due S 99.94 nine wonths after the date of death. P~T TAXPAYER RESPONSE 1 A. ~ The above inf orwation and tax due is correct. Rewit pavwent to the Resister of Wi11s with two copies of this notice fo obtain CHECK a discount or avoid iota ra st, or chock box "A" antl return this notice to the Register of ONE ~ Wills antl an official assesswent sill be issued by the PA Oeoariwant of Reranue. BLOCK B. ~ Tha above asset has been or will De reported and tax paid with the Pennsylvania Inheritance lax return ONL Y to be filed by the estate representative. C. ~ The above info na Son is incor roct and/or debts antl deductions note paid. Cowplete PART 2~ andlor PART 3~ below. PART If intli eating a different tax rate, please us tats ^2 relationship to decetlent: TAX RETURN - COMPUTATION LINE 1. Da t:a Established 2. Account Balance 3. Percent Taxable 4. Amount Sub}act to Tax 5. Dehts and Detluetions 6. Amount Taxable 7. Tax Rata 8. Tax Due OF TAX ON JOINT/TRUST ACCOUNTS 1 _ - -. 2 S 3 X 4 5 6 T X 8 ~ Under penalties of par}ury, I declare that the facts I have rePOrtetl above are true, eor tact antl complete to the best of my knoWletlge antl belief, unMC r 1 WORK C ) TAXPAYER SIGNATURE TELEPHONE NUMBER DATE PART UCDIJ AKU UCUUI:IlUKJ l:LA1KCU DATE PAID PAYEE DESCRIPTION AMOUNT PAID Four Generations... Celebrating Life, Honoring Traditions M~~ERS `funeral Came, ~7nc BOYD L. MI'ER5, JR., Supervfso 37 E. MAIN STREET MECHANICSBURG, PENNSYLVANIA 1705 (717)766-3421 STATEMENT OF FUNERAL GOODS AND SERVICES SELECTE',D Charges are only for those items that you selected or that are required. If we ate required by law or by a cemetery' or crematory to use any items, we will explain in writing below. If you selected a funeral that may require embalming, such as a funeral with viewing, you may have to pay far embalming. You do not have to pay for mbalming ou did not a xove if le4red a~rrj~ eme such as r~ect tre anon or i mediate burial. If we char ed for embalmin we i eta I ' h~jbelow. For the Seesri<:e of ~5,t~t g ~- ~ ' `-L ~`' ~-~ B Date of Death ~ c-a° ~ Charge to: A. CHARGE FOR SERVICES SELECTED: I. PROFESSIONAL SERVICES Services of Funeral DirectodStaff .... !~ Embalming ...................... E ^ Other preparation of body ............................... f SUB-TOTAL. OF PROFESSIONAL SERVICES......... Al f~r~ 2. FACILITIIiS AND SERVICES Use of foci' ' ervices for ~ ~'` viewi isitatio ake)...... ... sy_>rv=_ Use of facilities and services for funeral ceremony .. , ...... ... i `~ Use of facilities and services for ~ Memorial Service .. .. ~ Use of equipment and services - for gnneside service .......... ... f C~. - Other use of facilities f ...+ ~( SUB-TOTAL OF FACILITIESVEQU[PMENT ........... A2 f~,jw 3. AUTOMOTIVE EQUIPMENT Vehicle to transfer remains to Funeral H Local ........................ .... Hearse (Coke[ Coach) ~ Local ....................... .... f Limousine Local ....................... .... f Family r~.~ Other clothing Cremation urn .................. . (Description) _ 1 Zb OTHER t CU ''L~I~ f U,~ -0 fT f t.•^ f Z4~` TOTAL MERCHANDISE SELECTED .................. B 3 C. SPECIAL CHARGES: Forwarding of amains to f (Funeral Home) Receiving of remains from f (Funeral Home) Immediate Burial . ........... . ... f Direct Cremation .c,.i. ~- .. .. f,,,_,,,t~(q 5 / /.1 SUB-TOTAL OF SPECIAL CHARGES ................ C i D. CASH ADYANGED Opening Grave ................ .. f Cemetery Equipment ............ .. f Lot and Deed ................ . .. f Newspaper Notices--Local ....... .. fZpG.. Newspaper Notices--Out-of-town.. .. f/~~^.' Te{ephone & Telegrams ......... .. f Airfare ....... . ....... ... . . ClergylMass Offerinl; ............ f .. f ~~ Pallbearers .................... .. E Certified Copies of rherDe~ ~ t/f ~ ~ /b f f E Roland Johnson Appraisal Services 0007053 APPRAISAL OF A SINGLE FAMILY RESIDENCE LOCATED AT: 10 Kevin Rd. Mechanicsburg, PA 17050 FOR: Louis Fazekas BORROWER: NA AS OF: August 29. 2011 BY: Roland D. Johnson, SRA RL-001737-L Roland Johnson Appraisal Services 0007053 09/02/2011 Louis Fazekas File Number: 10kevin Dear Mr. Louts Faukas: In accordance with your request, I have appraised the real property at: 10 Kevin Rd. Mechanicsburg, PA 17050 The purpose of this appraisal is to develop an opinion of the market value of the subject property, as improved. The property rights appraised are the Fee simple interest in the site and improvements. In my opinion, the market value of the property as of August 2s, 2011 is: $139,000 One Hundred Thirty-Nine 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. Reapeodully, Roland D. on, SRA RL-001737- Sute Certified Appraiser APPRAISER'S LICENSE FaI11]leMae SINGLE FAMILY 0007053 D~skton Und~rwelpr Owntlt~Uv~Malysls APPra1sN Report FkeNn.: 1okeYin THIS SUMMARY APPRAISAL REPORT IS INTENDED FOR USE BVTHE LENDER/CLIENT FOR A MORTGAGE FINANCE TRANSACTION ONLY. R en Atltlress 10 Kevin Rtl. C' Mechanicsbu Stale PA Zi Cotle 17050 Le al Descri ' DEED BOOK 23C PAGE 266 Caml Cumberland Assessofs Parcel NO. 10-19-1604-083 Tax Vex 2011 RETaxes81608.41 ial ASwasnwnlsB N/A Borrower NA CurerAOxner ESUer Miller Ocw ant: Owner Tenant X Vacant Nei hborhootl or R ' Name Ham en Tw R ' T PUD Contlomnium HOAE N/A IMO. Sales Price Y NA Dale of Sale NA Desai lioNE amount of ban char concessions to be id b sewer NA Pr rt rl hiss shed X Fee Sim Leasehol0 Ma Reference 2847-2B Cenws Tract 113.05 Note: Race and the recial com itionrd[he ne' hborhood are no[a sisal factors. Lawlion Urban Suburban Rural PropeRy values Inueasing Stable Declining Singlefemilyhousirp E AGE PRICER R IC BuAI Up ®OVer75% ^ 25-05% ^ Under25% Oemandsuppty ^ Shortage ® In Oabnce ^OVawppty P f(DOgj bns) E( ~ N NA Growth rate Ra' SmDle Slow Marks' Ame Untler3 mos. 3-6 mos. Ova limos. 110 Low 0 Low NeigAbahoa0 bwMaries The sublect's neighborhood is bound to the North by Conodoguinet Creek, to 375 H' h 70 NA H h NA the West by Lambs Gap Rd W the South by Cadise Plke and to Ne East bV Route 581. ; /s Pretlominem PretlomimnY~*.11 140 45 NA NA Dimensions 70 x 125 Ske area 8750 Sg.FL Shape Rectangular Specific zoning dauifv:alion alxl description Residential Suburban-Sin le-Permit Dwellln sPertnitled Zwing wmpliance ^X Legal ^ Legal waoMaming (Grandlamaetl use): Illegal, attach tlescriplian No zoning Hi hell aM best use of su ' d ro en as im vetl a as ns and 5 ' iwlions : X Presem uw Other use atach dewri n. Utilities Public Other Public Oma OR-shelrrproeemen6 Type Pudic PrNale Elecbkity X^ 200 AMP Water X^ Sveel Asphalt Q ^ Gas Sanler sewer X Alle Nemae ad.Trse sieoxdioms Cacwime emmclxtxvls sktlexms dc. Ves X No II Ves atach dent' ' Soace(s) used fa physical charaderMicS d X Imeria antl exterior inspectiw Exlerla bspeclion hen sbeel Previous appraisal files ~ Prier In ion Ro owner X Omer Desuibe: Real Quest Professional. Famil Member. MLS X Assessment and mx records No.dStaiesi T Da.lAV. Detached ElaerbrWalls Vin I BFick RaofSWace Shln k Manulacbretl Hwsin Yes X No Does the o all codamm me ne' hbarlwotl in termsdri ,contlAion, and cwsVUCfion mauxias? X Ves No If NO, atach tlesa' ' n. Are (here any a pamm Dhysiwl Defckmcies or contlitbns that vroue artm the swntlness a svudural inlegnly d Um improvenreMS a the Ibabilay dthe propemJ.+ Ves X No If Yes, attach descri lion. Are there airy apparem adverse env'aonmenml cend'Aions (harar0ws wastes, toxic wbsmrces, etc) presem in the improvenlems, on the ske, a in the immediate vicinity of the sab'etl art Ves X No If Ves evech tleuai ion. I researched the wbjed marks area fa comparable listings antl sales Thal are the most similar aM proximate to the subject properly. Myraseachroveaetlaldald 5 sales ranging in sales price lromE 125.000bf 165.000. Myreseachrevraktlaroldd 6 Islbgs rangirgeliA price lram8 135,000 tof 165,000. Theam ss dthe wm arable sales below reBegs market reaction bs nificam variations belv2en the sales antlthew' o FEATURE SUBJECT SALE1 SALE2 SALE3 10 Kevin Rd. 6015 William Dr. 432 Linden St. 11 Donald St. Address Meehanic sbur Mechanicsbur Mechanicsbur Mechanicsbur Pmt to Su ' 1 i, 1 ~ 0.23 miles E 1.06 miles SSW 0.32 miles SE Sales Rice NA E :r';~, • •='.."-' f 149 900 ' ~ " file ~--E 149 900 -E 137 000 PIIrrlGrasL'x. Neer E 0.00 P7 f 130.010 i 1F ' >;; f 92.130k ': ~ 5 f 137.000 Dale 6 Vag. Sauces ' 'I' MLS & Tax Records MLS & Tax Retards MLS & Taz Recods VALUEAD1U57ME DESCRIPTION DESCRIPTION •Ils DESCRIPTION .lis DESCRIPTION .Us Sales a Financing "i'~ a r~ i+ nt n es Cancessbns I t 313 -2 500 Yes D OM DOM 31 -5 843 Y Yes DtOM 83 -0000 Dated SaelTime 04-15-2011 04-29-2011 06-30-2011 LocaUOn Suburban Suburban Suburban Suburban Sie .20 Acre .20 Acre .49 Acre -1 500 .20 Acre view Ave a Averse Averse Avers e oe'n 51 a Ranch Reneh Ranch Ranch Adual rs. 43 Years 53 Years 46 Years 43 Years Condllion Averse Avere a Averse Averse ; Above Gretle rmi ' earn: ~ earns rmm ~ m~ enm ; `,#."', 1wi ' eanm • e.m: i ;. rmn ~ mnm • ern: ,y, Room Cwnl 6 3 11.50 6~ 3~ 1.00 2,000 7 I 3 I 1.50 I 5 I 3 I 1.00 ~ 2,000 (toss " Nm 1400 . FL 1 153 S . Ft; 3 700 1 627 S . FU -3 400 1 000 . FL' 6 000 Beseneixtl Fkidatl Full Basement Full Basement Full Basement Full Basement Roams Bebw Grade L-Sher FR Den Unfinished 8000 UMlnished 6000 FR 3000 Ga a None 1-Car Ca rt -3 000 None None Heat/Coolin Elec BBMo CA Gas FA/CA J 000 Elec RadICA -3 000 ties FA/CA -3 000 Re Irs Yes No -3 000 No 3 000 No -3 000 Net '. I X a - ~ 8 200 X - ~ f 10 743 X - ' 8 1 000 AOjaetl Saks Rice ,gl tL v ~! ~ f" ~ ~~ ~ d ',t; ~ Y of Com rabies '1 ' n d' E 150 100 = E 139157 ~~ f 136 000 Dared Rer Saes None 05-05-2006 07-05-2007 11-09-2006 Prices Prier Saes O f 153000 f i f 1 Analysis of any wrre nl agreement of sale, o ption, or listing of the subject properly and anarysis of the prig sales of wbjed end wmparabes: Aeeordin to informe9on rov ided D the multi-li st services in Nis re Ion the sub' a ro has not been listed for sale within the st 3 errs. Summary of sales wmparison antl value wndusbn'. See Addendum This appraisal is made X -as~is'. or wbjeGbcanpeliw per pram aM SpecipwaUws on the bass ofa hyyodteacal cantlitbn Udihe improvements have been canpeleda sub d is the followin re airs, eherelions a caMilions: BASED ON AN EXTERIORINSPECTION FROMTHE STREETOR AN X INTERIORANDEX7ERIORINSPECTIONIESTIMATE'IHEMARKETVALUEASDEFINED. OF THE REALPROPERTVTHATISTHESUBJECTOFTHISREPORT TOBEE 139000 ,AS OF 08-29-2011 10CN. PAGE 1 OF 3 rannm mere ruin awe o =u nmm,a,q xci wu.o. woiu em «..r:ow:o..am ~ SINGLE FAMILY 0007053 Desktop llndorwrltsr quantitative AnslyNs Apprat11N1 Report Fik No: tOkevin Project lniormationfor PUDS(il applirable)-IS the devebperNWber In comml oNhe Nome Owners'ASSOCIaIIen IHDA)? Ves No Provide the following inlamalion la PUDS only if me developerlbuikler is in conaol of me HOA end the su6jed popmy is an attached dwelling unit: Taal number dphases Total number of units Total rrumoexaunils sob Taal armlxrduNS raaM Total number of unks far sak Gala Source(s) Was me pojea created 9y the conversion o! existing buibings info a PUD] ^ Yes No II yes, state dale of conversion. Ocesthe project comain any muhi-tlweNirg alms? ^Ves ^ No Data Sane, Are the common elements completed? ^Ves ^ No If No, describe status el complabn: Are any common elements leased to or by the Home Owners' Association] Ves No If yes, aaach addendum describing remal lams arW options. Descrbe wmmon ekmems and reaealional lacilties: Project Informationfor Condominiums (il applicaole)-~IS the tleveloperlbuiltler in control of the Home Owners' Association (HOAI? Yes No Provide the following informatbn fa all CoMOmkvum PmjeIXS~. Taalrurrga dphases Total number of units Total number of units sold Tdal ntmbaduds xatetl Total rmmber of units fa sale Daly Source(s) Was me prged created by the conversion of existing builtlirgsinloa contlominium7 Ves No II ,dale ofcorNesion: Proj¢d Type: ^ Primary Residence ^ Second Home ar Recreational ^ Rowa TOwnhase ~Gartlen ^ Mibise Highrise Condition of lne project, gwlhy of corxvudion, unit mix, etc: Are the common elements compleletl7 Ves No If No, describe slalua of completbn. Are arty common elements leased to or by the Home Ownas'ASSaialion7 Ves No It yes, avach addendum tlescnbinq remal terms ono options. Describe common elemems and reaeadonal iacilnies PURPOSE OF APPRAISAL; The purpose of This appraisal is to estimate the market value of [he real property that is the subject of this report based on a quantitative sales comparison analysis for use in the mortgage finance transaction. DEFINITION OF MARKET VALUE The most probable price which a properly 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 dare and the passing of title from seller to buyer under conditions whereby: (11 buyer and seller are typically motivated; (2) both parties are well informed or well advised, an0 each acting in what he considers his own best interest (3) a reasonable time is allowed for exposure in the open market; (4j 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 wish the sale. ' Adjustments to the comparables must be made for special or creative financing or sales concessions. No adjuslmenls are necessary for those costs which are normally paid by sellers as a result of tradition or law in a market area: these casts are readily identifiable since the seller pays these costs in virtually all sales transactions. Special or creative financing adjuslmenls 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 adjustmem should not he calculated on a mechanical dollar for dollar cost of the financing or concession but the dollar amount of any adjustment should approximate the market's reaction to the financing or concessions based on the appraiser's judgmjern. STATEMENT OF LIMITING CONDITIONS AND APPRAISER'S CERTIFICATION CONTINGENT AN D LIMITING CONDITIONS: The appraiser's certification Thal appears in the appraisal report is subject to the following conditions: 1. The appraiser will not be responsible for matters of a legal nature that affect either the property being appraised or the lisle to i1. 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 any required sketch in the appraisal report [o show approximate dimene.ions of the improvements and the sketch is included only to assist the reader of the report in visualizing [he properly and understanding the appraiser's determination of its size. 3. 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. 4. The appraiser has noted in the appraisal report any adverse conditions (such as, hul not limited to, needed repairs, the presence of hazardous wastes, toxic substances, etc.) observed during the inspection of the subject property or that he ar 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, tozic substances, etc.) that would make the property more or less valuable, and has assumed Thal there are no such conditions and makes no guarantees or warranties, ezpressed or implied, regarding the condition of the property. The appraiser will not be responsible for any such conditions chat do exist or for any engineering or testing Thal might he 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. 5. The appraiser obtained the information, estimates, and opinions that were expressed in the appraisal report from sources that he or she considers to he reliable and believes Them to he true and correct. The appraiser does not assume responsibility for [he accuracy of such items that were furnished by other parties. fi. The appraiser will not disclose the contents of the appraisal report except as provided for in the Uniform Standards of Professional Appraisal Practice. 7. The appraiser muss provide his or her prior wrillen consent before the lender/client specified in the appraisal report can distribute the appraisal report (including conclusions about the properly value, the appraiser's Identity and professional designations, and references ro 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 inslrumentafny of the Unii:ed States or any state or the District of Columbia; except That the lender/client may dislnbute the report to data collection or reporting service(s) without having to obtain the appraiser's prior written consent The appraiser's wrillen 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. FI. The appraiser has based his or her appraisal report and valuation conclusion for an appraisal that is subject to completion per plans and specifications on the basis of a hypothetical condition that the improvements have been completed. ti. The appraiser has based his or her appraisal report and valuation conclusion for an appraisal that is subject to completion, repairs, ar alterations on the assumption That completion of the improvements will be performed in a workmanlike manner. IoCH. PAGE 2 OF 3 Fannie Mae Fam 3055 996 0007053 and agrees 1. I performed This appraisal by I1) personally inspecting from the street the suhject property and neighborhood and each of the compoarable sales (unless I have otherwise indicated in this report that I also inspected the inferior or the su61~ec1 properly); (2) collecting, confrming, and analyzing data from reliable public andlor private sources; antl (3) reporting the results of my mspecnon and analysis in this summary appraisal report. I further certifyy That I have adequate information about the physical characteristics of the subject property and the comparable sales to develop this appraisal, 2. I have researched and analysed the comparahle sales and offeringsllistings in the subject marker area and have reported the comparable sales in Ihis report that are the hest available for the subject property. I further certify that adequate comparable market data exists in the general market area to tlevelop a reliable sales comparison analysis for the subject properly. 3. I have taken into consideration the factors that have an impact on value in my development of the estimate or market value in the appraisal report. I further certify That I have nosed any apparent or known adverse conditions in the suhject improvements, on the subject site, or on any site within the immediate vicinity or the subject property of which I am aware, have considered These adverse conditions in my analysis of the properly value to the extent that I had market evidence to support them, and have commented about the effect of the adverse conditions on the marketability of the subject properly. I have not knowingly withheld any significant information Irom the appraisal report and I believe, to the best of my knowledge, Thal all statements and information in the appraisal report are true and correct. 4. 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 Ihis form. 5. I have no Present ar prospective interest in the properly (hat is the subject of Ihis repgrl, and I have no present or prospective personal interest or bras with respect to the participants in the transaction. I did not base, either partially or completely, my analysis andlor the estimate of market value in the appraisal report on the race, color, religion, sex, age, marital status, handicap, familial status, or national origin or either the prospective owners or occupants or the subject property or of the present owners or occupants of the properties in the vicinity of the subject property or on any other basis prohibited by law. 6. I have no present or conlemplatetl future interest in the subject properrq, and neither my current or future employment nor my compensation for performing this appraisal is contingent on the appraised value of the property. 7. I was not required to report a predetermined value or direction in value Thal favors the cause of the client ar any related party, the amount or the value estimate, the attainment or a specific result, or the occurrence of a subsequent even) in order to receive my compensation antllor 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. 8. I estimated the market value of the real properly that is the subject of this report based on the sales comparison approach to value. I further certify that I considered the cost and income approaches to value, 6uL through mutual agreement with the client, did not develop them, unless I have noted otherwise in this report. 9. I performed Ihis appraisal as a limited appraisal, subject to the Departure Provision of the Uniform Slantlards of Professional Appraisal Practice That were atlopled and promulgated by the Appraisal Slantlards Board of The Appraisal Fountlalion and That were in the place as of the effective dale of the appraisal (unless I have otherwise indicated in this report that the appraisal is a complete appraisal, in which case, the Departure Provision does not apply). 10. I acknowledge that an eslimale of a reasonable lime for exposure in the open market is a condition in the definition of market value. The exposure time associatetl with the eslimale of market value for the subject properly is consistent with the marketing lime noted in the Neighborhood section of this report. The marketing period concluded for the su6Ject properly at the estimated market value is also consistent with the marketing lime noted in the Neighborhood section. 11. 1 personally prepared all conclusions and opinions about the real estate that were set forth in the appraisal report. I further certify that no one provitled significant professional assistance to me in the development o(Ihis appraisal. SUPERVISORY APPRAISER'S CERTIFICATION: If asupervisory appraiser signed the appraisal report, he or she cerliried and agrees that; I directly supervise the appraiser who prepared the appraisal report, have examined the appraisal report for compliance wish the Uniform Standards or Professional Appraisal Practice, agree wish the statements and conclusions or the appraiser, agree l0 tie bound by the appraiser's certifications numbered 5 through 7 above, and am Taking lull responsibility for the appraisal and the appraisal report. SUPERVISORY APPRAISER (ONLY IF REQUIRED): Company Name: F Company Address: Signature: Name: Company Name: _ Company Atldress: Date of ReporUSgnatae: ~/02/2011 Date of RepoNSignatae: Slate CeNfication N: RL-001737-L Stale CeNflcation M: or Stale License 8: or Stale License P: State: PA Slate: Expiration Dale o(Cenificafion or License: 00/30/2013 Expiration Date of Cenificallon a License: ADDRESSOF PROPERTYAPPRAISED: SUPERVISORY APPRAISER: 10 Kevln Rd. SUBJECT PROPERTY Mechanicsburg PA 17050 ~ Drd rqt inspect wbjecl property ^ Did inspect extaia of subject property from sUeet APPRAISEDVALUEOF THESUBJECT PROPERN8139000 ^Did inspect inleda and exleda of subject properly EFFECTIVE DATE OF APPRAISAL/INSPECTION 08-29-2011 COMPARABLE SALES ^ Did na inspect exfeda of comparable sales Uom sheet LENDER/CLIENT: ^ Did inspect ekteda d comparable sales rran Street Name: Company Name: NIA Company Address: i. PAGE i0F? Fannie Mee Fmm Yo55 9~9fi nom.ea~ xiwiwae eoo rvem«..~e.om Roland Johnson Appraisal Services ADDENDUM ~~,.~. ~ File No: 10kawn °^°^~•Atltl ass' 10 Kevi Rd Case Nn. 0007053 Cq' Mach I b State' PA Z' ' 1]050 Lender WA Summary of Market Dau Ater a thorough search of all available market data, the three sales used are the bast Indicators of value. Appropriate adjustments have been made for all differences. An adjustment was made to the'SITE" of Comparable Sale No. 2. Its significantly larger lot size is considered superior to that of the subject. Tha subject does nave defertetl maintenance. The floors, plumbing, and amenities of the ballroom and powder room are in the process o(being replaced. Interior painting o(rooms is needed to make subject marketable. Cost to cure is estimated at $3,000. A deduction of $3,000 will be made to the Comparable Sales for'Repairs" in the Sales Comparison Analysis. This appraisal report has been prepared with the property in'as is' condition. No personal property has been included in this valuation. This appraisal assumes a reasonable marketing period for the subject property of four months. The Market Approach reflects recent activity in the market place and is given the most weight. THIS IS A SUMMARV APPRAISAL REPORT. THIS SUMMARV APPRAISAL REPORT IS INTENDED FOR USE BV THE CLIENT TO ESTIMATE INARKET VALUE FOR ESTATE TAXES ONLY. THIS REPOR715 NOT INTENDED FOR ANV OTHER USE. Flood Info: 420360 OOtOC ZoneX 01-05-1998 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 15 PAGES. Adaarrlm rags t a t Boaawa NA Fik No. 10kevin Pro Atltlress 10 Kevin Rtl. C' Mechanicabu Cam Cumberland Slate PA Zi Code 17050 Lentler N/A APPRAISAL AND REPORT IDENT7FICA710N This Appraisal Report is per gof the for lowi ng types: ^ Self Contained (A written report prepared under Standards Rule 2-2(a), pursuant to the Swpe of Work, as disclosed elsewhere in this report.) ® Summary (A vrtitten report prepared under Standards Rule 2.2(b), pursuant to the Scope of Wok as disclosed elsewhere in this repwlJ ^ Restrictetl Use (A written repot prepared under Standards Rule 2-2(c), pursuant to Ne Scope of Work, as disdosetl elsewhere in This report, restricted to dte stated intended use by the specified ckeM a intended user) Comments on Standards Rule 2-3 I certify that, to the best of my knowledge and bekeF. The statements of tact containetl in this repod are hue and cared. The reported anah/ses, opinions, and conclusions are Vimited only by the reported assumptions and Nmithrg conditrons, and are my personal, impartial, and unbiased professional analyses, opinions anq conclusions. I have no (or the specified) present or prospective interest in the property that is the subject of this report, and no (or the specified) personal interest with respect to the parries involved. I have no bias wHh respect to the property that is the subject M this repod a the parhes involved wiN this assignment. My engagement in this assignment was not contingent upon tleveloping or reponirlg predetermined results. MY compensatron fa completing this assignment is trot corNmgeM upon the developmem a reporting of a predetermined value a direction in value That favors the cause of the dienL the amount of the value opinion, the attainment of a stipulated result, a the occurrence of a subsequent event directty related to the intended use of this appraisal. My analyses, opinions and conclusions was devebpetl and This repod has been preparetl, in conformdy with the Unifam Standards of Professional Appraisal Practice. I have (or have not) made a personal inspection of Ne property that is the subject of this report. No one provided significant real properly appraisal assistance to the person signing This cen~cadon. (Il there are exceptions, the name of each individual providing sgnifcant real property appraisal assistance is slated elsewhae in this repalJ :omments on Appraisal and Report Identification Note any USPAP related issues requiring disclosure and any S[a[e mandated requirements: $Ignalae: _ ~_- Name: Rota d D. Joh Date Signetl: 09!02!20 State Cenihcation a: RL-001737-L or State Lcense r: State: PA Expiration Date of CenOCation or License: 0613012011 Eflenive Date of Appaisaf. Au9u5t 29. 2011 sUPERVI50RV APPRAISER (only iFrequiretl). Signature. Name Date Signed: State CedNCadan d: or State License B: State. Expiration Date of Cerlifrcation or license. Supervisory Appraaer kspenion ar5ubject Property: ^ Ditl Not ^ Exleria-only from sneer ^ Interior and Emerior fl[Natl i¢ug xCl vAU've. 49 2I461t1 w,w,niwaPwn nIMFNSION I IST ADDENDUM GROSS BUILDING AREA (G BA) 2492 GROSS LIVING AREA (GLA) 1.400 Area(sl Atea %dGIA %of GBA Living 1400 56.16 Levels 1 400 100.00 56.18 Level2 Level3 Olhel G6A Basement ~ 1092 43.82 Garage D Area Measurements Area Type Measurements Factor To[al Levelt Level2 Level3 O[tlef esmc. Garage 2s.oo „ az oa „ ~ = 1.oss.oo DD ^ O D ^O ^ 140o x zs.oo „~= soa.oo © p D D D D x - - x __ x _ __ - x x _ - x x x - 0 0 0 0 0 - xx_= 0 - _ -„-„- ^ D D ^ o ^_ x - x _ x x - ° ° ° - x _ ^ ^ D ^ ^ __ - x x - x ~ " - ° x o ° ° ° ° ° - - ° o o o ^ o -"-"- _ D D D ^ o x x x x ~ O O O ~ O x x O - x x x - x - X - X x x M ~ z x ~ x - - x x ^ x - ° ° ° ° ° x x ^ D o ^ ^ x x x __ x __ x ~ a % ~ x x x = O O O O O D -„- _ x ~ _ x 0 0 0 ~ - 0 ^ xx _ x - x _ x x x x= D ^ D D D O x x _ x _ x x x _ x _ x ._ - x x - 0 0 0 ^ D x x X X x x x - x __ _ x - x _ X ~ R x - x LOCATION MAP PA 1 SU BJECT PROPERTY PHOTO ADDENDUM iortaxer. NA File NO.: 10kevin I'ropedV Addr¢55: 10 Kevin Rd. Case No.: 0007053 (:IN: Mechanicsburg Slal¢: PA 2iD: 17050 l.¢ndef: N/A FRONT VIEW OF SUBJECT PROPERTY Appraised Dale: August 29, 2011 Appraised Value: 8139,000 REAR VIEW OF SUBJECT PROPERTY STREET SCENE SUBJECT PROPERTY ADDITIONAL PHOTO ADDENDUM BORONer: NA File NO.: 10kevin PfDOerly Addre55' 10 Kevin Rd Case NO ~ 0007053 CdV' Mechanicsbum Slare: PA ZID: 17050 Lender: NlA FRONT VIEW SIDE VIEW SIDE VIEW meuew,yno.rtw,2. eoozuem.w....ro~ vxn+mero~o SUBJECT PROPERTY ADDITIONAL PHOTO ADDENDUM CBOfrOwer: NA Fik No.: tOkevln P(ooeRY AddroSS:10 Kevin Rd. Case No.: 0007053 CiN'. Mechenicslwrd State: PA Zio'. 17050 _endef: N/A REAR VIEW STREET VIEW PoOr.MwIyPG Sgwum, BJ]IL 8131 w~rxMe6om M~i~O~BiJ10 SUBJECT PROPERTY DEFERRED MAINTENANCE PNOTO ADDENDUM Borrower. Nn File No.: 10kevin Pr00eIN Addr¢55:10 Kevin Rd. Cese N0.: 0007053 CdV: Mechanicsburn State: PA ZID: 17050 Lender: NlA BATHROOM FLOOR BATHROOM FLOOR BATHROOM FLOOR Notml~tigilGlf7we. &0311H131 w,w.x~.om g1Tf lUfPN~O SUBJECT PROPERTY INTERIOR PHOTO ADDENDUM Bgrrower. NA File No : 10kevin Prooegy Addfe55:10 Kevin Rd. Case No.. 0007053 Ci1V: Mechanicsburg Slale: PA Zlg: 17050 LeMef: N/A POWDER ROOM LIVING ROOM /DINING ROOM KITCHEN wmnaiwyeciaae~amzumzr...x.anam vxmmeww 7 n ~~ ~~ ~~ o~