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HomeMy WebLinkAbout06-26-12 (2) 1505610105 REV-1500 Lx coa =='tFq lw7 enns lvania OFFICIAL USE ONLY PA Department of Revenue P " E Y Bureau of Individual Taxes `"°"""` County Code Year File Number POBOxz8o6oi INHERITANCE TAX RETURN ~ Harrisburg, PA ty1z8-o6o1 RESIDENT DECEDENT ~' ~ ~ Z U Q ~ .~ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 10/01 /2011 10/18/1943 Decedents Last Name Suffx Decedent's First Name MI Boyer.... Thomas S (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILE D IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return (Date of Death Prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) O~ 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 6. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trus[.) O 9. Litigation Proceeds Received O 1 U. Spousal Poverty Cretlit (Date of Death O 11. Election to Tax under Sec. 9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT- THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number Ronald E. Johnson, Esq (717) 243-0123 REGISTER OF WILLS USE ONLY N First Line of Address ~ O ^~ ~ 78 West Pomfret Street ~~~~ _ c ~ ~~~ N - Second Line of Address G W j Ol D/MT~ ::.•.f ~ h ILED City or Post Offce State ZIP Code ~ ~ C'7 Carlisle PA 17013 ~' c~ "~ a, Correspondent's a-mail address: rejOhnsOn@pa.net Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is tme, correct and complete. Declaration of preparer other than the personal, representative is based on all informelion of which preparer has any knowledge. SIGNATURE OF PERSON RESPQNSIBLE FOR FILING RETURN DPTE ~ ADDRESS / - c/o 78 West Pomfret Street, CarlisJ~, PA 17013 c/o~78 West Pomfret S~feet, Carlisle, PA 17013 ' PLEASE USE ORIGINAL FORM Side 1 1505610105 1505610105 REV-1500 EX (FI) Decedent's Name: Th OrtlaS S. RECAPITULATION 1. Real Estate (Schedule A) ............................................. 1. 2. Stocks and Bonds (Schedule B) ....................................... 2. Decedent's So 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages and Notes Receivable (Schedule D) ........................... 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ....... 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested........ 7. 8. Total Gross Assets (total Lines 1 through 7) ............................. S. 216, 000.00 0.00 0.00 0.00 55,601.25 0.00 43,678.50 315,288.75 9. Funeral Expenses and Administrative Costs (Schedule H) ............. ...... 9. 35,551.33 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ......... ...... 10. 235,284.05 11. Total Deductions (total Lines 9 and 10) ........................... ...... 11. 270,835.38 12. Net Value of Estate (Line 8 minus Line 11) ........................ ...... 12. 44,453.37 13. Charitable and Governmental Bequests/Sec 9113 Trusts 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. 44,453.37 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0_ 15. 0.00 16. Amount of Line 14 taxable at lineal rate X .0 _ 16. 0.00 17. Amount of Line 14 taxable at sibling rate X .12 17. 0.00 18. Amount of Line 14 taxable 44 453.37 6 668 00 , at collateral rate X .15 18. , . 19. TAX DUE ...... ............................................... .. 19. 6,668.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O 1505610205 Side 2 1505610205 1505610205 REV-1500 EX (FI) Page 3 Decedent's Complete Address: File Number .~/- /Z - 003 ~ DECEDENT'S NAME Thomas S. Boyer STREET ADDRESS 1353 Georgetown Circle CITY STATE ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. CreditslPayments A. Prior Payments B. Discount 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (1) 6, 668.00 Total Credits (A+ g) (2) 0.00 (3) 0.00 (4) 0.00 (5) 6,668.00 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 transferred or its income ...................................... ...... ^ c. retain a reversionary interest ........................................................................................................................ ...... ^ d. receive the promise for life of either payments, benefts 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 far" orpayable-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 benefciary designation? .................................................................................................................. ...... ~ ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE 13 AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from lax, and the statutory requirements for disclosure of assets and fling a tax return are still applicable even if the surviving spouse is the only benefciary. For dates of death on or after July 1, 2000: e The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal benefciaries is 4.5 percent, except as noted in [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings Is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. LAST WILL AND TESTAMENT OF THOMAS S. BOYER I, THOMAS 5. BOYER, of the Borough of Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking all other wills and codicils heretofore made by me. FIRST: I direct that all my just debts and funeral expenses, including my grave marker, if any, shaIi be paid from the assets cf my estate as soon as practicable after my decease. SECOND: I give, devise and bequeath the residue of my estate, of every nature and wherever situate, to my Mother, NELDA H. BOYER. ' ~ ~ THIRD: Should my Mother, NELDA H. BOYER, fail to survive me, then and in that event I give, devise and bequeath the residue of my estate, of every ~; nature and wherever situate, equally, to my cousins, PATRICIA F'UHRMAN and LINDA OLSON, provided that should either of my cousins predecease me their share shall be distributed to their issue, per stirpes, living at the time of my death, and in default of ~°c such then-living issue, such share shall be aided to the share for my other cousin or her issue. FOURTH: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. FIFTH: I nominate, constitute and appoint my Mother, NELDA H. BOYER, Executrix o£ this my Last Will and Testament. Should my Mother, NELDA H. BOYER, fail to qualify or cease to act as Executrix, I appoint FARMERS TRUST COMPANY, of Carlisle, Pennsylvania, Executor of this my Last Will and Testament. SIXTH: I direct my Executrix and her successors shall not be required to give bond for the faithful performance of their duties :in this or any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, consisting of two (2) typewritten pages, each. identified by my signature, this ~ ~' day of U , 1995. __ ~~,Q~ ~ ~~iL~ (SEAL) Thomas S. Boyer Signed, sealed, published and declared by the above-named Testator, THOMAS S. BOYER, as and for his Last Will and Testament, in the presence of us, who, at his request, in his sight and presence, and in the sight and presence of each other, have hereunto subscribed our names as_witnesses. COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND ) I, THOMAS S. BOYER, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowled ed before me by THOMAS S. BOYER, the Testator, this _~' _ day of U~ 1995. _~ ~ ~_(SEAL) Tho~~m,~las S. Boyer, T~estfator Notary Public .~-, PdOTARIAI SEAL AFFIDAVIT BRENDA L. BRFNM, NDTARY PUBLIC CARLISLE FORD, CUMBERLAND CAUNTY COMMONWEALTH OF PENNSYLVANIA ) MY COMMISSIDN EXPIRES JANUARY 6, 1996 SS. COUNTY OF CUMBERLAND ) We, RONALD E. JOHNSON and ~ c~ky' /~_ ,~~;, ,the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testator sign and execute the instrument as his Last Will and Testament; that THOMAS S. BOYER signed willingly and that he executed it as his free and voluntary act for the purpose therein expressed; that each of us in the hearing and sight of the Testator signed the Will as witnesses; and that to the best of our knowledge the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn, or affirmed to and subscribed to before me by RONALD E. JOHNSON and fem.:.-E .~~. G~.~,~ w witnesses, this d7 - day of ~~~~ 1995. ~. , ~ Notary Public tdOTARtaI SEAL BRENDA L. B~ENM. NOTARY PUBLIC MY CDMM SS ONDE%PINES JAMUABY~B, aev-tsoa ex+ ftt-csi ~' pennsylvania SCHEDULE A :.ti7 OEPAflTMENT OF gEVENUE INHERITANCE TAX RETDRN REAL ESTATE RESIDENT DECEDENT ESTATE OF FILE NUMBER Thomas S. Boyer 21-12-0033 All real property owned solely or as a tenant in common must 6e reported at fair market value. Fair market value is defined as the price at which property would be zxchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonahle knowledge of the relevant facts. Real property that isjointlyawned with right of survivorship must he disclosed nn 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 DESCRIPTION i. ~ ALL THAT CERTAIN tract of land sitaute in the Borough of Carlisle, Cumberlan County, Pennsylvania being Lot No. 79 on Phase IV of Walnut Court recorded in Cumberland County Plan Book 62, Page 117. Having thereon erected a residential townhouse dwelling known and numbered as 1353 Georgetown Circle, Carlisle, PA 17013 See Deed Book 178, Page 1038. Nelda H. Boyer died May 26, 1999 thus vesting full fee simple title in Thomas S. Boyer. See appraisal attached. 216,000.00 TOTAL (Also enter on Line 1, Recapitulation.) I $ 216,000.00 [f more space is needed, insert additional sheets of the samz size, B-H Npencv Appraisal Services Property Address: 1353 Georgetown Circle Carlisle, Pa ll013 Prepared For: Estate of Thomas 5. Boyer Deceased: 1353 Georgetown Circle Carlisle, Pa. 17013 Prepared As Of: 0¢ober 1, 2011 (D.O.DJ Prepared By: G. Arthur Calaman, Pa. Cert# RL-139418 B-H Agenq App2isal Services 163 N. Hanover Street Carlisle, Pa. 1]013 The purpose of this Appaisal is to Establish "Market Value" ONLY: NOT to be used far Mortgage Financing Appraised Value for the Subject Property: $216,000.00 Form protleoetl Gy Um1e0 Systems Sollware Lpmpany ~BDD 969-9121 www.uniletlsyslems.cpm File No. ¢100212 Paoe z4 NOT TO BE USED FOR MOftTGA6E FINANCING PURPOSES RESIDENTIAL SUMMARY APPRAISAL REPORT Fne # oleonz The purpose of this summary appaisal 2pod(Is fa provide the dierd wdh an accurate, and adequalelysuppo)ted, dpinlon of the market value of the sdb~ed Droperty. 'P Properly Atltlress 1353 Georgetown Lirde Cily Carlisle Stale Pa Zip Cade 17013 Oorrower (il aDPlicable) N/A Owner el Public Record Nelda H. and Thomas 5. Boyer Courtly Cumberland Legal Description See Attached Deed Copy from DB ll8 PGs 1038/1039 Assessor's Pdltel # 50-21-0324-075 Tax Year 2011/2012 R.E. Taxes $ 4,280.00 (m/L) Neighborhood Name Walnut Court Townhouses Map flel¢rence (50) 21-x329-0]6 Tax M¢p Census Trdd 0124 Occupant ^Ownet^Tenant Vacant Special Assessmenls$NOne Known ^PUD HCA$60,00 per year per month Property Rights ApDraisetl XFee Simple Leasehold Other (describe) Assignment Type Purchase Transaction ^ Aelinance Transaction ®Other (descrihe) To Establish Value for Estate Purposes Is the subled property currently ollered for sale or has it been altered for sale in the Iwelve months prior to the effective date of Ihis appraisal? ^Yes No Repotl data source(s) used, altering price(s), and date(s). CPML shows no record of far sale, listing, or otherwise in the pas[ 12 months for the subject address The purpose of This appraisal is m develop an opinion of Market Value (as delinetl), or ^ Other (describe) This report allects the )allowing value (il not Current, see comments) Curren) (the Inspection Oale Is the Ellecllve Dale) k Retmspegive Prospective ADProaches tlevelop¢d for this appraisal Sales Comparison Approach Cast Approach Income Approach (See Reconciliation Comments and Scope of Work) Intended Use To establish most probable "Market Value" as defined by USPAP (contained within this report) as per date of death of Che decedent Thomas 5. Boyer, which was October 1, 2011. Intended User(s) (by name ar type) Estate of Thomas S. Boyer and other potential Intended Users as [o be determined by the Client - Client Name Estate of Thomas S. Boyer Client Address Deceased: 1353 Georgetown Circle, Carlisle, Pa. 17013 Client GpnldLt Attorney Ronald E. 3ohnson ]17-243-0123 ClienlEmail rejohnson@pa.net A raiser Name G. Arthur Calaman, Pa. Cert.# RL-139418 Ap raiser Address 163 N. Hanover Street, Carlisle, Pa. 1]013 Nate: Race and the racial composition of the neighhomood are not appraisal factors. Nel hoorhootl Characterlstlcs One-Unit Housin Trends: -One-Unit Housln .:Present tind.Use%. Location^Urban ~'1 Suburban ^Rural Property Values^Increasing ^Glable Declining PRICE AGE One-Unit 60% Built-up Over 75% X 25-75% Under 25% Demand/Supply Shortage In Balance Over Supply $ (000) (yrsf 2-4 Unit e % -Growth Rapid XSlable Slow Marketing Time Untler3mlhs 3-6 mfhs Over6mths 5443 Low 0* Multi-Family 5% - Neighborhood Boundaries Subject is situated in the 3rd Ward annex of the Carlisle Boro, and Is bounded to [he 690<* High 100+* Commercial 15 % - north by S.R. 11; to We east by Wilson St; to the south by Hillside Dr, to the west by Valley Meadows Park. 120-150* Pred. 60+* Other 12 % Neighborhood Description Subject is situated in a residential area amidst a townhome neighborhood of mixed style properties. Major roadways, employment, shopping, and schools are within reasonable driving tlis[anre. UCilities as well as fire and police protection are present and adequate for the area. Market Conditions (including support for the ahove conclusions) Employment, mtg ates,& Inventories have remained fairly stable in the area, and although interest rates are fluctuating and activity is slow, the market is slow, but stable. Appreda[ion has had no increase over the past 2 years, but I haven'[ seen as much of a decline in values as in other parts of the nadon. Marketing time for similar properties would be 90 days or less, but could be up to 180 days. Dimensions 26.0 F x 160.0 L x 28.0 B x 160.0 R Area 4,480.00 SgFt Shape Rectangular View Residential Specilic Zoning Classilicatipn R 2 Residential Zoning Description Residential Zoning Compliance ®Legal ^ Legal Nonconlorming (Grantlfathered Use) ^ No Zoning Illegal (describe) Is the hlghesl and best use of the sub]ecl Droperty as Improved (or as Droposetl Der plans and specifications) the present use? ~ Yes No If No, descrihe Utilities Puhlic Dther (descrihe) Puhlic Other (describe) OfFSite Improvements-Type Puhlic Private Electricity Q ^ Water ® ^ Street Paved ® ^ Gas X Sanitary Sewer Alley Yes FEMA Special Flood Hazard Area? Yes No FEMA Flood Zone x FEMA Map # 42041[ 0229E FEMA Map Date 03/162009 Are the utilities and olf-site improvements typical for the market area? ®Yes ^ No II No, descrihe Are there any adverse rile conditions or external )odors (easements, encroachments, environmental conditions, land uses, etc.)? [] Yes No If Yes, describe None Known, but Also see Text Addendum Page..... General Descrl ton l Foundation : Exlerlor Descritlan "rnaterlals/ccntlitlon Interioi. matetlals/doMlllon Units One One with Accessory Unil Concrete Slah Crawl Space Foundation Walls Blk & Superior wall: Average Floers Oak/cptlun: Fair to Ave. # of Stories 1 1/2 I~ Full BaSemenl ^ Padial Basement Exterior Walls BricWvinyl: Average/Good Walls Drywall: Aveage Type ^ Del. [I Ati ^ S-Delhntl Unil Existing Proposed Under Consl. Design (Style) Townhouse Basement Area 1400 (m/L) sq. a. Basement Finished 75 % Outside Enlry/Exil Sump Pump Root Surface Shingle: Goad Cullers & Downspouts Alummum~. Aveage/Good Window Type Dbl Hung Thermo: Aveage/Good Trim/Finish wood: Aveage Bath Floor VinN: Average Bdlh Wainscot N/A Year BUill 19W(m/L) Evidence of ^Inleslalion Storm Sash4nsulaletl Thermo Car Srorae ^NOne Elledive Age (Yrs) 10-lz yrs (m/LJ ^Dampness Settlement Screens Some ®Driveway #ol Cars 1 Attic None Drop Slart__ Stairs Floor Scuttle Finished ^Healed Appliances Relrigerator Range/Ove Heating X FWA HWBB Radiant ^ Other Fuel Gas Cooling ®Cenbal Air COndiliening ^Intlivitlual ^Other n Dishwasher ©Disposal Microw Amenities WoodSlove(sl # 0 Fireplace(s) # 1 Fence Privary ®Patio/Deck Patio OPofeh Front slab Pool N/A ^Other N/A ave Washer/Dryer Other (descrihe) Driveway Gutlace Macadam Garage # of Cars 2 ^Carporl #of Cars ~Atl. Det. ^Built-in Finished area above grade contains: 6 Rooms z Bedrooms 2.00 Bath(s) 1864 S¢uare Feet of Gross Living Area Above Grade _ Additional features (special energy efficient Items, etc.) Basement Is Flnlshed Into a large family room w/eleRric baseboard heat. Finish is of drywall, wood wainscot w chair ail, drop ceiling and carpeted floor cover. D¢5¢rlh¢ th¢ condition Of me DIOPerly (Including n¢¢d¢d r¢pd1f5, d¢I¢rlprdlgn, BpeVatlonS, fdmodeing, ¢IC.I Home 5 ip average condition, with ex[eptlOn t0 Floor covering which has need of replacement. Inferior re-painting is also a must for updating purposes. Oak Flooring is average to good. There was no physical, Ponctional or external obsolescence observed. Na needed major repair was noted at the time of inspection.., no repairs were In progress. Quality of construRion is average [o [he area and period. Are there any physcal deficiencies or adverse conditions that affect the Ilvablllty, soundness or strucWral integrity of the properly? ^Yes ©No II Yes, descrihe None observed..also see feat addendum page Does the properly generally conlonn to the neighborhood (lundlonal utllily, style, condillan use conslrudlon et c.)1 ~' Yes ^ Ne I' Nn, tleswihe ~~~~~ Form Omnucetl by Uniktl Systems SOllwme Company(B00)9fie-a72i vfwrv.unil[dsyslcros.com (Rev O6/pd) O~H Agency Rppraisal SerJmes File Nu 0100212 Page#6 RESIDENTIA! SUMMARY APPRAISA! REPORT File # DlDOZIz FEATURE SUBJECT COMPARABLE SALE # t COMPARABLE SALE # 2 COMPARABLE SALE # 3 Address 1353 Georgetown Circle Carisle, Pa 1]013 1228 White Birch Lane Carlisle, Pa ll013 1346 Georgetown Circle Carlisle, Pa 1]033 1341 Georgetown Circle Carlisle, Pa IJO13 Proximity t0 Subled P 0.0] MI 0.02 MI 0.04 MI Sale Price $N/A $226,000 : 8215,000 : $210,500 Sale Price/Gr055 Lrv. Area $ N/A Sq. It. $121.24 sp M '.' $114.24 sq fl $112.93 sq II Ddld Source(s) = CPML &CCCN CPML &CCCH CPML &CCCH Verilica(ion Source(s) -' Drive-by Ext. [nspecG On Drive-by Ex[. Inspecti on Drive-by Ext. Inspecti on VALUE ADJUSTMENTS DESCRIPTION DESCRIPTION +(-tSAdlwlmem DESCRIPTION +(-)SAduslrnent DESGRIPiION +y SAAlusrmenl Sale or Financing CODL¢s61OOS ' : Conventional N/A Conventonal N/A Conventional N/A Ddte of Shce//Ime :'. 12/19/2011 10/31/2011 10/24/2011 LOCalien Ave2ge/Good Same Same Same Leaseholtl/Fee Simple Fee Simple Fee Simple Fee Simple Fee Simple SII¢ 0.10 acre (m/L) 0.10 acre (m/L) 0.10 acre (m/L) 0.10 acre (m/L) View Residential Similar Similar Similar Design (Style) Townhouse Townhouse Townhouse Townhouse Duality Df CDnslruction Ave2ge/Good Average/Good Average/Goad Ave2ge/Good Actual Age 15 yrs. (m/L) 21 yrs. (m/L) 18 yrs. (m/LJ 15 yrs. (m/L) Condition Avenge Ave2ge/Goad -5000 Average/Goad -5000 Ave2 ge/Good -5000 Above Grade Total Bdrms. Baths Total Bdrms. Baths Total Btlrms. Baths Total Btlrms. Baths Raem Count 6 2 2.00 7 2 2.00 7 2 2.00 6 2 2.00 Gross Living Ar¢d 1864 Sq. lt. 1864 Sq. II. 3882 sq. h. N/A 1869 sq, tt. Basement & Finished ROOms Below Grade Full Concrete One Full Concrete One Partial Concrete Nane Known 2500 5000 Partial Concrete None Known 2500 5000 Functional Uliily Ave2ge Average Average Average H¢dling/GOOling FHA/Central Air FHA/Cen[21 Air FHA/Cent21 Air FHA/Central Air Energy Ellicienl IlemS None observed Nane Known None Known None Known Garage/Carport 2 Car Att. 2 Car Integral 2500 2 Car Att. 2 Car Att. POrch/Pdt10/Deck Porch/Patio Cvrd.Porch/Deck -1000 Cvrd.POrch/Patio -ID00 Porch/Patio EMedor Finish Brick/Vinyl BrICWUmyI BrickNinyl Brick/unyl Fireplaces etc. (1) Fireplace None Known 2800 (1) Fireplace None Known 2800 Appeal Above Ave2ge Similar Similar Similar Net AtljuSlmenl (Total) + - $ -700 ®+ - $ 1500 ®+ - $ 5300 Adlusled Sale Pnce of Compolable5 - Net Adj. % Gross Atll. % $ 225300 Net Atlj. % Gross Adj. % $ 2165D0 Nel Adj. Gross Adj. % $ 215000 - I did tlitl not research the sale or transler history of the sublect property and comparable sales. If not, explain My research tlitl did not reveal any Drior sales or Vanslers of the subject properly for the Three years prior to the efleclive dale of This appraisal. Dald $ource(S) CCCN Assessment Records My research tlitl tlitl not reveal any prior sales or translers of the comparables sales far tht year prior to the date of sale cf the comparable sale. _ Data Source(s) CCCH Assessment Records Report the results of the research and analysis of the prior sale or Transfer history of the subject pmpeny and comparable sales (report additional prior sales on Dage 3). ITEM SUBJECT COMPARABLE SALE # 1 COMPARABLE SALE # 2 COMPARABLE SALE # 3 Dale of Prior Shc¢/Gd05fer 06/09/1998 0]/30/2007 02/04/1994 10/W/199] Price of Prior Sale//ransfer 51]0,000.00 $235,ODO.DO $149,175.00 $153,500.00 Data Source(S) Deetl CCCH Assessment Records CCCH Assessment Records CCCN Assessment Records EIfeLINe Date Ot Uala Soome(5) 01/18/2012 01/19/2012 01/19/2012 01/19/2012 Analysis of prior sale or Irdnstet history o(Ihe sublect Dmpetly and comparable sales Subject is not, and has not been listed I'or sale within the last 12 months [o the best of [he app2iser's knowledge. Subject and compa2bles last transferred ownership on [he dates above, and have not been resold since then to the best of the app2iser's knowledge. Summary ol8ales Compari5p0 AgplWth Appraiser searched CCCN sales recoks as well as multi-list for the best comparables to the subject of the analysis. The compaable properties used in this analysis are in my opinion the very best available at [he present, and having been sold within the most recent months of [he past year. All are relative in proximity, with in the same complex, and as similar as possible In naNre, style, size and condition; #2 and #3 are the same model. Adjustmentr have been made to compensate for differences in the compa2bles where necessary. No adjustment was necessary to calculate above ground finished living area as each is less than 100 sq. ft. Condition was verifed by Realtor comments and multi-list interior photos. No adjustment was made for date of sale since [here has been no up or down value change for the area In the pas[ year. Oates of sale in the grid section are from County RecoMS no[ MLS. Indicated Value by Sales Comparison Approach $ 216,000.00 l~r~r~lr1 Form proeucen fiy UnileO Systems 6ollware Company(eo019e9-B]Z]wvw.uniletlsyslems.rom (flev 06/00( RESIDENTIAL SUMMARY APPRkISAL REPORT Fue re Oloonz Indicated Value by: Sales Comparison Approach $ u6,ooo.oo Cost Approach (if developed) $ rv/A Income Ap roach (il developed $ N/A Final AecOncilialion See "Final Reconciliation" on Text Addendum page... - This appraisal is made ®"as is", ^ suhjecl to completion per plans and speciliwlieds on the basis of a hypothetical contlilion That the improvements have keen completed, ^ subject Ie the fallowing repairs or alterations on the hasis of a hypothetical contlilion that the repairs er alteratiens have peen mmpleleQ or suhjecl to the following required inspection based on the extraordinary assumption Ihat the contlilion or deficiency does not require allerali0n or repair: See Text Addendum page... ^ This repod is also suhjecl to other Hypothetical Conditions and/or Edraordinary Assumptions as specified in the atlache0 addenda. Based on the degree of inspection of the subject properly, defined Scope of Work, Statement of Assumptions and Limiting Conditions, and Appaiser's Certifications, my (our) Opinion of the Market Value (or other specified value type), as defined herein, of the real properly That is the subject of This repod is $ 236,gdg.dd , as of October I, mn (o.o.o.) , which is the effective date of this appraisal. II indicated above, this Opinion of Value is suhjecl to Hypothetical Conditions and/or Edraordinary Assumptions included in this report. See attached addenda. A Irue and complete copy of This report contains 1J total pages, including the attached exhlbils (intllcaletl below) which are conslderetl an Integal pan of the report. Thls appraisal report may not he properly understood without reference to the information contained in me complete report. ® Scope of Work ^ Additional Sales Atldentla ©Deed/Legal Description ^ Hypolhellcal Contlltlons ®Narralive Addenda ^ ^ Edraordinary Assumptions ®Phologaph Atldentla ^ _ ®Limiting Conditions/Certifications ®Map Atldentla ^ ^ Cost Atldentla ®Skelch Addenda ^ ^ Income Atldentla ^ Fleotl Atldentla ^ (®Nob Developed) '.'. LD$T APPAOAGH TO VAWE Provide adequate information for (he client to replicate the below cost figures and calculations. Support for the opinion of site value (summary of comparahle land sales or ether methods for estimating site value) N/A ESTIMATED REPflOOUCTION OR ^REPLACEMENTCOSTNEW OPINION OFSITE VALUE„,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,_$ N/A - Source of test data rv/A Dwelling Sq. FL @ $ _ $ Duality mling Irom cost service Hledive date el cost data Sq. FL @ $ _ $ = Comments on Cosl ADPmach (gross Ilving area calculations, depreciallon, etc.) _ $ _ Due to the age of the subject improvements, the Cost Appmaeh [o value was Gdrdge/Cdrpeli Sq FL @ $ _ $ not used. The Cost Apprpach is only considered far dwellings of "New TOldl Estimate el Cosl-New = $ N/A Construction' or for an aRUal physical age of less than five years. If is the L6a5 Physical Functional Edernal opinion of this appraiser [hat the "Cast Approach" to value is inadequate and Depreciation = $ ( ) no[ appropriate in an analysis of a dwelling & improvements of [he actual Depreciated CoSI pl Impmvemenls ,,, _ $ physical age of this subjeR, and would not yield an actuate represen2tion 'AS-is"Valueol$ile Impmvemenls ,,,,,,,,,,,,,,, ,,,,,,,,,,,_$ of Market Value. It was therefore not considered. _ $ Estimating flemaining Economic Life N/A Years Indicated Value by Cosl Approach ............. _.... _..,.,.,_$ N/A j~Nat Developed) ''°INCOMEAPPflOACH TO VAWP Estimated Monthly Market Rent $ N/A X Gross Rent Multiplier N/A = $ N/A Indicated Value by Income Approach Summary of Income Approach (including support for market rent and GflM) See "Final Remndliation" on Te# Addendum Page.... (~INot Developed) PROJECT INFORMATION FOA PUOs Is the develeper/builder in control of the Homeowners'ASSOCialipn (HOAf? Yes Ne Unil type(s) Detached ~ Attached Provide the following information Ipr PUGS ONLY it the developer/builder is in conlml of the HOA and the subject properly is an ahached dwelling unit. Legal name of pmjecl This entire section is N/A to the subject property. Total number of phases Total number of units Total numher of units so10 - Total number of units rented Total numher of units for sale Dala source(s) ' Was the pmjecl cr6aletl by the conversion of existing building(s) info a PUD? ^ Yes ^ No II Yes dale of conversion. Does the project contain any multi-dwelling unils7 Yes No Dala source(s) Are the units, common elements, and recreational facilities complete? ^ Yes ^ No If N4 describe the status of completion. Are the common elements leased Ie or by the Homeowners' Association? ^ Yes ^ Ne II Yes, describe the rental terms and opliens. Describe common elements and recreational facilities. ~~~I~~ Form prpLUCetl ey WileO Sys¢ma SOliware cwnpany (a00(969-a121 wn6a.unile6spsfems.eom (nev O6ro6) B-H Agency Fppraisal Semites Flle No. 0100212 Page #] 0100212 SCOPE OF WORN The Scope of Work is the type and extent of reseamh and analyses performed In an appraisal assignmen! that Is requlmd Io produce cmtllble assignment results, given the nature of the appraisal pmhlem, the specific requirements of the intended user(s) and the intended use of the aparaisal report. Reliance upon this report, regardless of how acquired, by any party or for any use, other than those specified in Ibis report by the Appaiser, is prohibited. The Opinion of Value That is the conclusion eI Ihis report is credible only within the context of the Scope of Work, Edeclive Dale, the Dale of Report, the Intended user(s), the Intended Use, the slated Assumptions and Limiting Conditions, any Hypothetical Conditions and/or EzVaordinary Assumptions, and the Type of Value, as defined herein. The appraiser, appaisal firm, and related parties assume no obligation, liability, or accountability, and will not be responsihle for any unauthorized use of This report or its conclusions. Additional Comments (Scope of Work, Extraordinary Assumptions, Hypothetical Conditions, etc.): A physical inspection of the subject property was made and although due diligence was exercised, the appaiser Is not an expert or certifed in such matters as pest infestation and control, structural engineering, roofing and other mechanicals of the property. No responsibility shall be assumed by the appraiser for defects and conditions not tlisdosetl or readily apparent in the course of a normal appaisal inspection. Appraiser is noI qualified as a builder or contractor, bWlding inspector, or whole house inspector, or home inspection spedalisq and has done a limited visual inspection of the properry looking for obvious conditions, and for the purpose of de[ermining an opinion of value; no inspection of any cowl space (if present), ar Into hidden or concealed areas was made. The appraiser does no[ [es[ appliances, plumbing, heating /air conditioning or eleRrical system. The appraiser does a limited visual inspection of the roofing hom the ground, and is not qualified Co ascertain condition of same. The purpose of an appraisal inspection Is to ascertain location, size of improvementr, physical chaacteristics and geneal conditions of the property. Also see text addendum page for conditions of appraisal. Seller concessions are relatlvely common In this marketplace, normally in the form of Buyer closing costs assistance. It has become more and more common to see closing cost assistance on an agreement of sale, but usually not exceeding the allowable guidelines of up to 6%. These concessions affect seller net, but do no[ necessarilyhave any effect on [he actual sale prices. No adjustment is normally made if the assistance falls within these paameters. STATEMENT OE ASSUMPTIONS AND LIMITING CONDITIONS • The appraiser will not be responsible for matters of a legal nature Ihal affect either the property being appraised or the title to il. The appraiser assumes that the title is good and marketable and, therefore, will not renderany opinions about the title. The property is appraised on the oasis of it being under responsihle ownership, • The appraiser may have provided a sketch in the appraisal report to show approximate dimensions of the improvements, and any such sketch is included only to assist the reader of the report in visualizing the properry and understanding the appraiser's determination of its size. Unless otherwise indicated, a Land Survey was not performed. • It so indicated, the appraiser has examined the available flood maps Thal are pmvided by the Federal Emergency Manage~menl Agency (or other data sources) and has noted in the appraisal report whether the subject site is located in an identified Special Flood Hazard Area. Because fhe appraiser is not a surveyor, he or she makes no guarantees, express or implied, regarding this determination. • The appraiser will noI give testimony ar appear in court because he or she made an appraisal of the property in queslien, unless specific arrangements to do so have been made 6elorehanQ oras otherwise required by law. • If the cost approach is included in Ihis appraisal, the appraiser has estimated the value of the land in the wsl approach al its highest and bes(use, and the improvements at Iheir conVihWOry value. These separate valuations of the land and improvements must not be used in conjunction with any other appraisal and are invalid it they are soused. Unless otherwise specifically indicated, the cost approach value is not an insurance value, and should not be used as such. • The appraiser has noted in the appraisal report any adverse conditions (including, but not limited lo, needed repairs, depreciation, the presence of hazardous wastes, toxic substances, etc.) observed during the inspection of the subject property, or Ihal he or she became aware o' during the normal research involved in performing the appraisal. Unless otherwise stated in the appraisal report, the appraiser has no knowledge o1 any hidden or unapparent contlilions of the property, or adverse environmental conditions (including, but not limited lo, the presence of hazardous wastes, toxic sudslances, etc.) Thal would make the property more or less valuable, and has assumed that Ihere are no such condlllons and makes no guarantees or warranties, express or Implied, regartling the condition of the properly. The appraiser will not he responsible for any such conditions that do exist or for any engineering or testing Thal might he required to discover whether such contlilions ezisl. Because the appraiser is not an expert in the field of environmental hazards, Ule appraisal report mull nol6e considered as an environmental assessment of the properly. • The apPaiser obtained the inlormalion, estimates, and opinions That were expressed in the appraisal repoN Irom seurces that he or she consltlers to be reliable and believes them to he true and correct The appraiser does not assume responsibility for the accuracy pf such items that were furnished by other parties. • The appraiser will not disclose the contents of the appraisal report except as provided for in the Uniform Slandartls of Professional Appraisal Practice, and any applicable federal, stale or local laws. • II Ihis appraisal is indicated as subject Io salisfadory completion, repairs, or alterations, the appraiser has based his or her appraisal report and valuation conclusion on the assumption Ihal completion of the improvements will be performed in a workmanlike manner. • An appraiser's client is the party (or parties) who engage an appraiser in a specific assignment Any other party acquinnq Ihis report from the client does not hecomea party to the appraisepclienl relatlonshlp. Any persons recelving Ihis appraisal repotl because of dlsclosuro recuirements applicable to the appraisers client do not became intended users of Ihis report unless speciti tally identified 6y the client aI the time of the assignmeul. • The appraisers written consent and approval mull 6a obtained before this appraisal report can 6e conveyed 6y anyene to the puhllq through advertising, public relations, news, sales, or by means of any olhei media, or by its inclusion in a private or public database. • An appaisal of real property is not a'home inspecljon' and should not be consW ed as such. As pad of the valualien process, the apOralserpedorms a non-invasive visual inventory Thal is not Intended to reveal tlelecls or deVlmenlal condlllons that are not readily apparent. The pmsence of such condllions or tlelecls could adversely allecl the appraiser's opinion of value. Clients with concerns about such potential negative factors are encouraged to engage the appropriate type of expert to investigate. Fn,m n,naimnA ~v Ilnilr,l Cv~lrm• Gnllrvar. fmm~anv IPMI aRa.P])] www ~~n~lean.dems mm ,tie.. n[me, B-H Agency Fppraisal5ervicas File NO. 0100212 Page#e file# 0100212 DEFINITION OF MARKET VALUE* Markel value means the moll probable price which a propetly should bring In a competitive and open market underall conditions requisite to a lair sale, the buyer and seller each acting prudently and knowledgeably, and assuming the price is not agecle0 by undue stimulus. Implicit in this definifien is the consummation of a sale as of a specified dale and the passing of title hom seller to buyer under conditions whereby: • Buyer and seller are typically motivated; • Both parties are well informed or well advised and acting in what they consider (heir own hell interests; • A reasonable lime is allowed for exposure in the open market; • PaymeN is made in terms of rash in LLS. dollars or in terms of financial arangements comparable thereto; and • The price represents the normal consideration for the property sold unaflecletl by special or creative financing or sales concessions granted by anyone associated with the sale. *This definition is hom regulations published by federal regulatory agencies pursuant l0 Tide XI of the financial Institutions Reform, Recovery, and Enlorcemem Act (FIRREA) of 1989 between July 5,1990, and Augusl24, 1990, by the Federal Reserve System (FRS), National Cretlil IJnion Atlminislralion (NCUA), Federal Deposit Insurance Corporation (FDIC), the Dtllce of Thrill Supervision (OTS), and the Office of Comptroller of the Currency (DGC). This tlellnlllon is also mferenced in regulations jointly published by the OCC, OTS, FRS, and FDIC on June 7, 1994, and in the Interagency Appraisal and Evaluation Guidelines, dated Dctoher 27, 1994. APPRAISER'S CERTIFICATION - I certify that, to the hest of my knowledge and belief: • The statements of tact contained in this report are True and correct. The credibility of this report for the slated use by the staled user(s), of the reported analyses, opinions, and conclusions are limited only by the reported assumptions and limiting conditions, and are my personal, imparlfal, and unbiased professional analyses, opinions, and conclusions. I have no present or prospective interest in the properly Thal is the sublecl of this report and no personal interest with respect 1o the parties involved. I have no bias with respect to the property Thal is the subject of this report or to the parties involved with this assignment. My engagement in this assignment was not contingent upon developing or repotling predetermined results. My compensation tar completing This assignment is not contingent upon the development or reporting of a predetermined value or direction in wlue that favors the cause of the client, the amount of the value opinion, the aVainmenl of a stipulated result, or the occurrence o1 a subsequent even) directly related Ie the intended use of this appraisal. My analyses, opinions, and conclusions were developed, and this repotl has keen prepared, in conlormily with the Uniform Standards of Professional Appraisal Practice that were in eflecl aI the lime This report was prepared. I did not base, either partially or completely, my analysis and/or the opinion of value in the appraisal report on the race, color, religion, sex, handicap, familial status, or nalinnal origin of either the prospective owners or occupants of the sublecl properly, or of the present owners or occupants of the propetlies in the vicinity of the subject pmpedy. Unless otherwise indicated, I have made a personal inspection of the property that is the sublecl of This report. Unless otherwise indicated, no one provided significant real propery appraisal assistance to the person(s) signing this cetlificatien. Additional Certifications: Appraiser(s) signature has been digitally signed by secured measures. APPRAISER /~/ ///~/~~ Signature _ /'xL- ([L'" Name G. Arth alaman Company Name a-n Agency Appraisal Services Company Address 163 N. Hanover Street Telephone Number pll) 243-1000 eM 216 Email Atltlmss bhappraisal@cpmcast.net Dale of Signature and Report o1/z0/zo12 Slate Cedllledlion # RL-139418 or Stale License # Stdte PA Expiration Date of Cerlilicalion or License o6/3o/zpi3 Subject lnspeclion ® Interior and Ezlerior Exterior Only None lnspeclion Dale January 1], 2012 SUPERVISORY APPRAISEq (ONtY IF REOUIREO) Signature Name Company Name Company Address Telephone Number Email Address Dale of SignaWre Slate Cerlilicalion # or Stale License # Stale Expiration Dale of Cerlilicalion or License Subject Inspection Inleri0r and Exterior j] Ezlerior Only None Inspection Dale nEV-t5D8 EX+ (u-io) pennsylvania SCHEDULE E !~1 ^EP.4PTMENTOFREVENUE CASH, BANK DEPOSITS & MISC. [NnsRrTnNCE Tnx RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Thomas S. Boyer 21-12-0033 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Checking account -PSECU (S4) 2. Savings account -PSECU (see letter attached) (.i1) 3. Orange Savings Account no:10468421-ING Direct (see letter attached) 4, Unchased check - GEICO Direct -refund due for adjustment to automobile insurance policy 5, Uncashed check -Victor G. Sliko on behalf of Veterans Administration g, Net proceeds from sale of 2006 Subaru automobile Gross proceeds: $14,500 Loan payoff: $4,502.26 (see Cumberland Vally Motors chec4: attached) 7, Chase Auto Finance -refund of overpayment on automobile loan g. JP Morgan Chase -abandoned property department - uncashed check g, Net proceeds from sale of personal property Total sales $24,316.50 Commission: $8,510.77 (see statement from Rowe's Auction Service attached) 1 p. U.S. Treasury - 2011 income tax refund 11. Card Services - refund of overpayment 24, 397.54 6.51 1, 419.04 1, 093.38 1,192.00 9, 997.74 3.05 22.82 15, 805.73 1, 660.00 3.44 TOTAL (Also enter on Line 5, Recapitulation) $ I 55,601.25 If more space is needed, use additional sheets of paper of the same size. PSE[i~ Andrews & Johnson Attomevs at Law Ronald E. Johnson 78 West Pomfret St Carlisle. PA 17013 Re: THOMAS S BOYER, Deceased. PSECU Reference # 6525872661069 Dear Attorney Johnson: 01/20/2012 The above referenced person has an account with PSECU which was opened on August 22, 1983. The Share accounts were individually held by THOMAS S BOYER. The following are the Date of Death Balances for THOMAS S BOYER's acrount with PSECU: Account Date of Death Balances Interest -October 1 (S1) -Savings $ 6.51 $ 0.(10 (S4) -Checking $ 24,397.47 $ 0.(17 The account has been closed. If you have any questions, please contact me at (717) 234-8484 or toll-free at (800) 237-7328, press 6, extension 3120. Sincerely, / ~_ 1 Sandy Fag1 y ~ j Member Service Representative - .. __ - PSECU Pennsylvania State Employees Credit Union P.O. Box 67013, Harrisburg, PA 1 71 06-701 3 • 717.234.8484 • 800.237.732E! • » psecu.com THIS CREDIT UNION IS FEDERALLY INSURED BY THE NATIONAL CREDIT UNION ADMINISTRATION. EQUAL OPPORTUNITY LENDER. t7 ~ O O H G Hn ~m ~ ~. ~' p o ~ ~ o ,R1 H G N 7' o H R M ( j i p7 ~ C ,, o ~ ~ a x ~ i] N [ s z n ~; ~ m H ~ ~ `"' rn w rt J '7." W gyn . ~ ~ ~ ~' ~ o = ~ ~ H c~ _ ~ H 5 ~ tO b rt C ' ? H r~ C ~ ~ ~ b ro • w v ~' O ~ a ~ N .~ O ~ H v ~ O1 W :: ' ~* m [7 c ~ N ~ ~ ro ~ ro Q N c ~ {'l C ~ O fa O ~ H N N W ~ w O 0 . _. _.. O t7 w ~ k H o ~ m a w b b J rt ro m w r- a 0 .a m ~, r 0 ~., m n W = a o r m ~ n 4 r = ~ ti •~ z c ~ m rv o m ~ n O N ELI ~ m r ~ O ~ v V ~ T ~ O o ~ m = ~ m yny w ro Zi cn y r'wx ti O y ~~ ~ n W H $[] r Ctl v WZJ1 J111C L9-11 D z m 0 m a z ~~ Cm d a H N a z '.Y m rt k m N .a R~ rP H 0 d o N 0 N ~ D N .~ o m N N M * D ~ ~ O ~ z -i L~ ~QO~o °4 ro~~~ o ~ _ ~ ~ cNi ~ N, ~ C ~ H 1 G -. ~' ~ :r A G ~ ¢ G yy R ~ ~ ~ r w cc fD _o ~ w x N Q ^! A 0 w n„ 1 x n D D m }~ ~D~ n~~ rn m o ~ w F b N w CD C!1 .p W ING_ -DIRECT _~ ~ .~- .-~o~~E;,~ January 17, 2012 Andrews & Johnson Attorneys at Law Attn: Ronald E Johnson 78 W Pomfret St Carlisle, PA 17013 Dear Ronald, Per your request, our records show the following ING DIRECT account(s) for Thomas S Boyer: Account Type: Orange Savings Accounts"" Account Ownership: Individual Open Date: 04-25-03 Balance as of 10-01-11: $1419.04, including interest earned of $10.73 We need more information to settle the ING DIRECT account(s) for the estates of Thomas S Boyer. To complete the settlement, please send us: • A Letter of Direction, signed by all executors o Include the mailing address if a check is to be issued • A certified Letter of Administration, with the original court signature and dated within the last 60 days, with the impressed seal Questions? Call us at 1-888-464-0727 from 8 AM to 8 PM, 7 days a week. Thanks. MEMBER FD~C P.O. Box 60, St. Cloud, MN 56302-0060 LENDER www. i ngd irect. com `' ,. --, 2505 Ritner Highway Carlisle, PA 17015 Bill Rowe (AU 1538L) 249-1978 215-1044 574-1008 Dave Rowe (AU 2295L) Auction Is Action C¢ZZ "Rowe" For S¢tisf'¢ction SELLERS NAME 'S~ _ `~L>,~tn.~ ~ S i~~`~a~= ~. _DATE I "1~'tz- ADDRESS d ~~" ~ ~=~:,-~,.= -u..~..3~ ~.r,~~=- _ PHONE v ~ 5~-'9 ~-1 OTHER _ ~~'+-+---~ Lc 1~ *- t- e= ~ 3 _ AUCTIONEER % ~ `y AUCTION DATE/LOCATION _T- ~~ DESCRIPTION OF' 1VIERCI-IANDISE CLERK % `~~ j~1.~-y~r3~.~ r1.a •4't.~;Jl~\ -L-a~T C~ .~.~' ~<.t ~(.~ ~. ~_ <l. ~t-r G-C.~ " - RZ ,~.'C,i cS~L`°i (,t5 ~'t~z:`" .- ~%.3-V4J iJz "-L~:i•: - :'L-.. ~i.A-vL~ w3cs.`~~ } ZzdO- S£_S 7. ~9w Sl~~ ,+-i ~ ~ t ~~ i.. .~. S x"`22 > Ct.-:~' Y ' S La C_c~i ~::=i., _Ct i,":3`~~7 - "1~~i-'~'i fCW-ay' t~l zk ~ ~.dy` ~-°.' •..s4S_ .~ d,.`.L c .4v~"'_ ,s..:..:..z. t7'Siis» ~~C,e-ZZ ` ,Z- ~:~' ~- ~F Zda-•~ ~-' ~Lda.Lc57 ~' 6t=zsr - - ~ - ~ - 1 ~ ~ t ~- ~ , L .!~ .~ :..~ -. ~ c - -~. I Commission the Auctioneers to sell the merchandise to the highest bidder by Public Auction. Merchandise to be sold as is & grouped as necessary to obtain bids. I certify that I am the owner or authorized represen- tative of the merchandise, goods and or property and have good title and the right to sell and that they are free from all incumbrances. I agree to accept all responsibility for providing merchantable title and for delivery of title to the purchaser. I agree to hold hazmless the Auctioneers against any cLiims of the nature refereed to in this agreement. ;~ ``--` AUCTION'SIGNATURE Total Sales (Clerking Tickets Attached) ~ Less Sale Expense: % Commission Auctioneer ~ % Commission Clerks OTHER: ~~ -*' _ _ ; SELLERS SIGNATURE l -~ TOTAL SALE EXPENSE DEDUCTED .._~ ,,._, ~- SELLERS NET 5 RE`/-.l5t0 EX+ ;u9-09) pennsylvania SCHEDULE G DEPARTMENT ~E REVENl1E INTER-VIVOS TRANSFERS AND INnEarTaNCE TAx aeruRN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Thomas S. Boyer 21-12-0033 This schedule must he 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 INaueE mE xu~E OrmE mANSVEaEE,~ea aEUnoeswP ro oecEUENr arm raE OnreaEranrvsEER. ATrACe ACOVr or rxE OEEO roa asAl ESrArE. DATE OF DEATH VALUE OF ASSET "'/°OF DECD'S INTEREST EXCLUSION (~FnvaucnetE) TAXABLE VALUE 1. AVIVA Life and Annuity Co. formerly American Investors Life -annuity policy no: 604369 AAI 43,687.50 100 43,687.5( Transferees: Patricia Furhman, cousin - 50% Linda Warfield, cousin - 50% See benefciaries named in application and 1 112 212 01 1 letter to Patricia Fuhrman setting forth her 50% share at $21,843.75. (both attached) Linda Warfield received the same amount TOTAL (Also enter on Line 7, Recapitulation) $ 43,687.50 If mare space Is needed, use additional sheets of paper of the same size. Application for Equity Indexed Deferred Annuity a~~uc arrNIrrvES Aoxs L~~ Annuitant TFtoMR~ 5 ~~~ F,rst Na es to appear on mnbeU) M 1 Last Name fo- Ig- 14Y3 ~~ - 7j''~- (o(~~ ~~Male ^ Female Date al &rm 6ouef aecunN Number "°ca2USi.-~ p.~ al _7i7 a43-`~y5~ Gty Slate Lp Code Phone Number Joint Annuitant First Name (az m appear on conVad) M I Lest Nama It appllphte ^Mafe ^ Female Daro of BcN Soual Sewrrty Nvmtxa- Atldress CnY State ]gyp Cotle Plwne Number Q Owner II Othef than First Name of IMrMUaI N Entdy (es ro appear pn oxRract) M I last Name Annullant Clry State Lp CpdeCptle Phone NumWr ^ Male ^ Female SSN a Tex 10. Number Dale of Bvlh Relebonshfp tp Annwlanl(s) Note: If the Owner is not a natural person, please prowtle supportng documentaLOn. ' aQ Joint ^ Male ^ Female Owner Ffrt Nama (es m appear on mnttad) M I last Name Not appllphle b quaLfied Data o/ Bvlh SSN or Tex I O Number Relebcnship to Mnuflanl(sl CoM2ets Cly State Lp Code Ptwrre Number 0 Contingent ^ Male ^ Female Owner Fast Nama (as ro appear on mntracq M I Lest Nama If Owner and Annurtanl are Dale of B¢lh SSN or Tex 10. Number Relabcnship b Mnurtant(s) dltferent Clry State Lp Code Phone NUrnbar Qs Benefiaaries QAT(?Il'IA f~19 }-I~MAN r~~5~^~ ~ Unless athelwise Pnm a ry Benefi ua ry 1 RelationsY lip to Annultant(s) Percent' . ~~r~9az 'mulEpte ~ r ~ ~ ~t ~t ( ~ ~ Lt~DA w'H I~CC (LW [ ~ ~b~Jr ~ ~ B m efi sut vm n g en Pae ~~~~ Pnmary Beneficiary 2 ~ Relatlonshfp to Annuitant(s) Percent' must wtal too vn- share equally perram If a henefir~ary Is Pnmary Beneficiary 3 Relatonshlp to Annuitant(s) Percent' rrot a naWml person, mdWe name and gate 'Percentages All beneficares Contingent Beneficiary 1 RelattOnship to Annuitant{s) Percent' for Conhngent aenefiranes must be INm9 must Inlal tog t th ti f a e me o appllcalian Contingent Benefiuary 2 Relatlonshfp to Annuitant(s) Percent' pB1cent , ®7 PfOdUCt ~F'' Contract FOrm.,J, ~~ ~~--r~ (~1 ~ ~, ~s~-+µ/ CWT -r,n ~/~ ~AAC , Rider(s) .1.1`~+l.~l~t[1 _C ---{fir ~t.~(7~ AILAPP (06!06) PA Page 1 AILAP P (06106) PA 56497 56497 .~y •~ ra n,i <J'7 -7 .-y -`r AV l VA Aviva Life and Annuity Company 7700 Mills Civic Parkway West Des Moines IA 50266-3862 Mail Processing Center: P.O. Box 10433 Des Moines IA 50306-0433 Tel 888 266 8489 vrww.avivausa.com November 22, 2011 Patricia Fuhrman c/o Andrews 8 Johnson, Attys at Law 78 West Pomfret St Carlisle PA 17013 Re: Thomas Boyer Policy Number: 604369AAI Dear Ms. Fuhrman: On behalf of the Company, we wish to extend our deepest sympathy to the family and friends on the loss of Thomas Boyer. We understand this is a difficult time and would like to make the process of filing the claim as effortless as possible. The enclosed General Instructions will provide you with the information required to process the claim. You are a listed beneficiary on this policy. Please complete the enclosed Claim Form and provide a copy of the death certificate that documents the cause and manner of death. If the death occurred outside the United States we will require a certified original death certificate showing cause and manner of death. We have enclosed a return envelope for your convenience. The Death Benefit provided by this policy is the Accumulated Value (your share is approximately $21,843.75 as of the Annuitant's date of death). In order to complete our records, we would appreciate if you would send the original policy along with the claim paperwork. However, failure to do so will not delay settlement. Upon receipt, this claim will be given our prompt attention. We hope to hear from you within 30 days. If you should have any questions, or need additional assistance, please do not hesitate to contact our Customer Service Department toll-free at 1-888-266-8489. Cordially yours, ~~~: -`'~f'' Samuel Howells Claims Director Enclosures: 10034 cc: David Steele Aviva USA Corporation Aviva Life and Annuity Company Aviva Lile and Annuity Company of New York Aviva Investors North America, Inc. REV-i Sa EX+(10'09) ~' pennsylvania DEPARTMENT OF FlEVENLE INHERITANCE TAX RETURN RescoENT oeceoENr SCIiEDULE Fi FUNERAL EXPENSES AND ADMINISTRATIVE COST5 ESTATE OF FILE NUMBER Thomas S. Boyer 21-12-0033 Decedent's debts must he reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' Ewing Brothers Funeral Home 3,170.00 z. Carlisle Memorial -grave marker 975.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) PatrlCla FUhrman street address 23 Crandle Drive city Carlisle state PA ZIP 17015 Year(s) Commission Paid: 2012 z. AttorneyFees,to Andrews & Johnson, attys - see attached letter 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant Street Address City _ State ZIP Relationship of Claimant to Decedent 4. ~ Probate Fees: 5. I Accountant Fees: 6. Tax Return Preparer Fees: ~ G. Arthur Calaman -real estate appraisal e. The Sentinel -advertise estate s. Cumberland Law Journal -advertise estate lo. Slate Employees Retirement System (SERB)-reimbursement for overpayment i ~. US Treasury-2011 payment made on account at time of requesting extension to fle tz. CenluryLink -telephone 7, 500.00 14, 500.00 387.50 140.00 375.00 189.54 75.00 1, 833.43 2, 000.00 51.54 __ __ TOTAL (Also enter on Line 9, Recapitulation) $ If more space is needed, use additional sheets of paper of the same size. SCHEDULE H -continued Funeral Expenses, Administration Costs and Miscellaneous Expenses ESTATE OF FILE NUMBER Thomas S. Boyer 21-12-0033 13. GE Capital -credit card payment $725.00 14. UGI-utility bill $65.00 ] 5. Chase Bank -credit card payment $569.45 16. 21~` Century Insurance -auto insurance premium $2937 17. PP&L-utility bill $52.55 18. CenturyLink -telephone $49.91 19. GE Capita] -credit card payment $125.00 20. UGI-utility bill $64.00 21. Chase Bank -credit card payment $569.45 22. PP&L -utility bill $52.54 23. 21s` Century Insurance- auto insurance premium $66.72 Items 12-23 were paid by direct deductions from Decedent's PSECU checking accour,.t listed on Schedule E, Item 1 from his date of death on October 1, 2011 to date account was closed) 24. UGI-utility bill $308.66 25. PP&L-ntilitybill $17432 26. CenturyL,ink -phone bills $28735 27. West Walnut Court Homeowners Association -homeowner fee from October 1, 201 I thru July 1, 2012 $600.00 28. Register of Wills-filing fee $15.00 29. Reserve for closing and accounting $1,200.00 TOTAL (alsoenreronline9,Aecapiwletion) $35,55133 ANDREWS & JOHNSON Attorneys at Law 78 West Pomfret Street Carlisle, PA 17013-3216 TAYLOR P. ANDREWS RONALD E. JOHNSON Estate of Thomas S. Boyer 21-12-0033 Attachment to Schedule H, Item B2 Telephone (717) 243-0123 Telefax (717) 243-0061 The fee set forth as Item B2 on Schedule H is slightly more than that proscribed by the Johnson Estate. However, the administration of this estate has been more complicated than the average estate. The decedent lived alone when he died October 1, 2011. The Cumberland County Coroner took possession of the decedent's home and would not provide access thereto until a personal representative had been appointed. The Executor named in the Will was the decedent's mother who had passed in 1999. M&T Bank, successor to Farmers Trust Company was the named back up Executor. At the time of the decedent's death it was impossible to determine what his assets may have been except that all parties were aware that the mortgage on the real estate exceeded the fair market value ofthe home. His only other obvious asset was a 2006 Subaru automobile which we believed lrad a lien against it. After reviewing the known and suspected assets and debts, M&T Bank declined to serve as Executor. The residuary beneficiaries were both cousins but had had little contacted with the decedent in the last several years before he died and had no knowledge whatsoever as to his financial affairs. On January 9, 2012 over 3 months after the decedent's death, Patricia Fuhrman was appointed Administratrix, c.t.a. of the estate. At that time we were able to obtain access to the home which was somewhat in shambles and with financial papers strewn around the home in various parts. In addition, during the period from the decedent's death on October 1, 2011 to January 9, 2012 because of the mail delivery system at the decedent's home; no mail had been delivered to the decedent and rather it had been returned to the sender's thereof. Accordingly it has been very difficult to recreate the decedent's financial affairs from the point when the personal representative was appointed. The personal representative along with the other residuary beneficiary agt•eed to pay an attorney's fee based on an hourly rate with a minimum fee of $14,500. It is impossible at this time to determine if the hourly rate might exceed the minimum fee agreed upon, so the minimum fee has been included as a deduction. ANDREWS & JOHNSON f~ ~~~ Ronald E. Jo , ion, Esquir~ REV-1512 EX+ (12-09) ~' pennsylvania ~7 DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHE®ULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF FILE NUMBER Thomas S. Boyer 21-12-0033 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 1 Bank of America - mortgage on 1353 Georgetown Circle, Carlisle, PA 17013. Mortgage and note dated February 18, 2011 with the frst payment in the amount of $1,216.56 due on April 11, 2011. Last payment made before decedents death was the payment of September 2, 2011 Principal balance due at date of death (see mortgage note and amortization schedule attached) 2. Borough of Carlisle -water/sewer-disconnected due to nonpayment 3. Gulf Card Services - mastercard account no: 5148-9296-7006-5814 4. Direct TV account no: 64204988 5. ADT Security System account no: 119901438 6. GE Capital Retail Bank account no: 6034-6202-3766-3234 TOTAL (Also enter on Line 30, Recapitulation) $ If more space Is needed, Insert additional sheets of the same size. 228,169.72 176.89 1,476.08 676.16 166.20 4,619.00 235,284.05 Print Story aA: erheanant Amortization [able for $229,883.00 Page 1 of 8 Mont1U Year Payment Principal Interest Total balance ', Paitl PaiA Interest ' Apri12011 $1,216.56 $282.66 $93390 $93390 $229,60D.34 '. ' May 2011 $1,216.56 $28381 8932.75 $1,866.65 $229,316.53 June 2011 $1,216.56 $284.96 $931.60 $2,798.25 $229.031.57 July 2011 $1,21656 $286.12 8930.44 $3,728.69 $228.745.45 j Aug. 2011 $1,216.56 $287.28 $929.28 $4,657.97 $228,458.17 '. Sept 2011 $1,216.56 $288.45 $928.11 $5,586.08 $220,16972 Oct 2011 $1,216.56 $289.62 $926.94 $6,513.02 $227,880.10 i ' Nov. 2011 $1,216.56 $290.80 $925]6 $7,438]8 $227,58930 '., Dec. 2011 $1,216.56 $29198 $924.58 $8,363.36 $227,28].33 ', Jan. 2012 $1,21656 $293.16 $92340 $9,286.76 $227,004.16 ", _ Feb. 2012 $1,216.56 $294.36 $922.20 :610,208.96 $226,709.81 ', Mar. 2012 $1 216.56 $295.55 $921 Ot :611,129.97 $226,414.26 '. APri12012 $1,216.56 $2%.75 $919.81 :612,04978 $226,117.50 ''.. May 2012 $1,216.56 $297.% $918.60 :612,968.38 $225,81955 ',, : June 2012 $1,216.56 $299.17 $917.39 :613,885.77 $225,520.38 '. ~ July 2012 $1,216.56 $3D0.3B $916.18 ;614,801.95 $225,22D.D0 '. ', Aug. 2012 $1,216.56 $301.60 $914.96 ;615,716.91 $224,918.39 '. ', Sept 2D12 $1,216.56 $3p2.83 $913]3 ;616,63064 $224,615.55 ' '., Oct. 2012 $1,216.56 $304.06 $912.50 :61],543.14 $224,311 Sp ', Nov. 2012 $1 216.56 $305.29 $911.27 ;618,454.40 $224,006.21 '. ', Dec. 2012 $1,216.56 $306.53 $910.03 :619,36443 $223,699.68 '. ', Jan. 2013 $1,216.56 $307]8 $908.78 :620,273.21 $223,391.90 ' '. Feb. 2013 $1 216.56 $309.03 $907.53 521.18074 $223,082.87 '. '. Mac 2013 $1,216.56 $31029 $906.27 :622,08] 01 $222,772.58 '.. I Apri12013 $1,216.56 $31155 $905.01 :622,99203 $222,461.D3' ' May 2013 $1216.56 $312.81 $90375 523,895.77 $222,14822 June 2013 $1,216.56 $31408 $9p2.4B :124,]98.25 $221,834.14 July 2013 $1,21656 $315.36 $90120 $25,699.45 $221,518]8 Au92013 $1,216.56 $31664 $899.92 :126,599.37 $221,202.14 '. Sept. 2013 $1,216.56 $317.93 $898.63 :127,49801 $220,884.21 '. Oct. 2013 $1216.56 $319.22 $897.34 328,395.35 $220,56500 '.. I. Nov. 2013 $1,216.% $320.51 $896.05 629,29139 $220,244.40 Dec. 2013 $1,21056 $321.82 $894]4 630,186.14 $219,922.67 Jan. 2019 $121 fi.56 $323.12 $89344 531,079.5] $219,599.54 i '. Feb. 2014 $121 fi.5fi $324.44 $892.12 931,971.70 $219,275.11 Mac 2074 $1,216.56 $325 ]5 $890.81 9132,86250 8218,949.35 '.. Apn12014 $1,216.56 $32]08 $889.48 9133,751.98 $218,622.27 : May 2014 $1,216.56 $328.41 $888.15 934,640.14 $218,293.87 ' June 2014 $1216.56 $329.79 $886.82 935,52696 $217,964.13 http://www.bankrate.eam/system/util/print.aspx?p=/calculators/mortgages/mortgage-calcul... 6/20/2012 Bankrczte.cm Gtrmprehensive. Objective. Free. NOTE aOYEA Loan #: NEA231230 MIN: 100288210000534376 Case#:446-0260713-703 February 18, 2011 BALTIMORE Maryland [Date] [City] [State] 1353 GEORGETOWN CIRCLE, Carlisle, PA 17013 [Property Address] I. PARTIES "Borrower" means each person signing at the end of this Note, and the person's successors and assigns. "Lender" means REAL ESTATE MORTGAGE NETWORK, INC. and its successors and assigns. 2. BORROWER'S PROMISE TO PAY; INTEREST In return for a loan received from Lender, Borrower promises to pay the principal sum of Two Hundred Twenty-Nine Thousand Eight Hundred Eighty-Three And 00/100 Dollars (U.S. $229, 583.00), plus interest, to the order of Lender. Interest will be charged on unpaid principal, from the date of disbursement of the loan proceeds by Lender, at the rate of Four And Seven-Eighths percent (4.875%) per year until the full amount of principal has been paid. 3. PROMISE TO PAY SECURED Borrower's promise to pay is secured by a mortgage, deed of trust or similar security instrument that is dated the same date as this Note and called the "Security Instrument." That Security Instrument protects the Lender from losses which might result if Borrower defaults under this Note. 4. MANNER OF PAYMENT (A) Time Borrower shall make a payment of principal and interest to Lender on the first day of each month beginning on April 1, 2 011. Any principal and interest remaining on the fast day of March, 2 041, will be due on that date, which is called the "Maturity Date." (B) Place Payment shall be made at 70 GRAND AVENUE, SUITE 109, RIVER EDGE, NJ 07661 or at such place as Lender may designate in writing by notice to Borrower. (C) Amount Each monthly payment of principal and interest will be in the amount of U.S. $1, 216.56. This amount will be part of a larger monthly payment required by the Security Instrument, that shall be applied to principal, interest and other items in the order described in the Security Instrument. (D) ABonge to this Note for payment adjustments If an allonge providing for payment adjustments is executed by Borrower together with this Note, the covenants of the allonge shall be incorporated into and shall amend and supplement the covenants of this Note as if the allonge were a part of this Note. [Check applicable box.] ^ Graduated Payrnent Allonge ^ Growing Equity Allonge ^ Other [Specify] 5. BORROWER'S RIGHT TO PREPAY Borrower has the right to pay the debt evidenced by this Note, in whole or in part, without charge or penalty, on the first day of any month. Lender shall accept prepayment on other days provided that Borrower pays interest on the amount prepaid for the remainder of the month to the extent required by Lender and permitted by regulations of the Secretary. If Borrower makes a partial prepayment, there will be no changes in the due date or in the amount of the monthly payment unless Lender agrees in writing to those changes. ~ 36.23 Page I of 2 FHA Mulds[a[e Fixed Rate Note - 07/09 4 NEA231230 6. BORROWER'S FAILURE TO PAY (A) Late Charge for Overdue Payments If Lender has not received the full monthly payment required by the Security Instrurnent, as described in Paragraph 4(C) of this Note, by the end of 15 calendar days after the payment is due, Lender may collect a late charge in the amount of Four percent (4.000%) of the overdue amount of each payment. (B) Default If Borrower defaults by failing to pay in full any monthly payment, then Lender may, except as limited by regulations of the Secretary in the case of payment defaults, require immediate payment in full of the principal balance remaining due and all accrued interest. Lender may choose not to exercise this option without waiving its rights in the event of any subsequent default. In many circumstances regulations issued by the Secretary will limit Lender's rights to require invnediate payment in full in the case of payment defaults. This Note does not authorize acceleration when not permitted by HiJD regulations. As used in this Note, "Secretary" means the Secretary of Housing and Urban Development or his or her designee. (C) Payment of Costs and Expenses If Lender has required immediate payment in full, as described above, Lender may require Borrower to pay costs and expenses including reasonable and customary attorneys' fees for enforcing this Note to the t;xtent not prohibited by applicable law. Such fees and costs shall bear interest from the date of disbursement at the same rate as the principal of this Note. 7. WAIVERS Borrower and any other person who has obligations under this Note waive the rights of presentment and notice of dishonor. "Presentment" means the right to require Lender to demand payment of amounts due. "Notice of dishonor" means the right to require Lender to give notice to other persons that amounts due have not been paid. S. GIVING OF NOTICES Unless applicable law requires a different method, any notice that must be given to Borrower under this Note will be given by delivering it or by mailing it by first class mail to Borrower at the property address above or at a different address if Borrower has given Lender a notice of Borrower's different address. Any notice that must be given to Lender under this Note will be given by first class mail to Lender at the address stated in Pazagraph 4(B) or at a different address if Borrower is given a notice of that different addres. 9. OBLIGATIONS OF PERSONS UNDER THIS NOTE If more than one person signs this Note, each person is fully and personally obligated. to keep all of the promises made in this Note, including the promise to pay the full amount owed. Any person who is a guarantor, suuety or endorser of this Note is also obligated to do these things. Any person who takes over these obligations, including the obligations of a guarantor, surety or endorser of this Note, is also obligated to keep all of the promises made in this Note. Lender may enforce its rights under this Note against each person individually or against all signatories together. Any one person signing this Note may be required to pay all of the amounts owed under this Note. BY SIGNING BELOW, Borrower accepts and agrees to the terms and covenants contained in this Note. - BORROWER - THOMAS S BOYER - DATE - [Sign Original Only) ~ 36.23 Page 2 of 2 FHA Multistate Fixed Rate Note - 07/09 REV-1513 EX+ (Ol-1U) 'jl' pennsylvania I SCHEDULE ] ~ °E`"R~"'E"'°"~E~E"°E BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER: ESTATE OF: 21-12-0033 Thomas S. Boyer RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distrihutions and transfers under Sec. 9116 (a) (1.2).] 1. Patricia Fuhrman, 23 Crandle Drive, Carlisle, PA 17013 cousin 50% 2. Linda Olsen Warfield, 12454 Mirey Branch Road, Laurel, DE 19956 cousin 50% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRiBUT10N5 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 DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ if more space is needed, use additional sheets °f paper of the same siee.