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HomeMy WebLinkAbout05-29-13 w . J Lsos61o1os REV-1500�"°'"„`°� PA Department of Revenue pennsylvaMe oFPIC1AL USE ONLY Bureau of Individuat Taxes ^�"`" "`°"° County Code Year File Num6er PO e0x z8o6oi INHERITANCE TAX RETURN ]�j Harrisbury,PA i7u8-o6oi RESIDENT DECEDENT �1 / '✓ 6O�� ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYVVV Date of Birth MMDDYYYY 09/02/2012 12/17/1924 DecedenPS Last Name Suifiz DecedenYs First Name MI MUNSON THERESA (`, (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name SuRx Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW m 1. Onginal Retum O 2.SupplemenWl ReWrn O 3. Remainder Retum(Da[e of Death Priorto 12-13-82) p 4. Limited Estate O 4a. Fulure Interest Compromise(date of O 5. Federal Estate Tax Return Required death after 12-12-82) m 6- Decedent Died Testate O 7. Decedent Maintained a Living Trust _ 8. Total Number of Safe Deposit Boxes (Attach Copy o(Will) (Attach Copy of Trust.) O 9. Litigation Proceeds Received O 10.Spousal Poverty Credit(Date of Death O 11. Election to 7ax under Sec.9113(A) Belween 12-31-91 antl 1-1-95) �(,�ttach Schadul@9) CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFOR IQ�II SHOULD BFDIRECA�O � Name Day[i�T�1lphone N�er rn C� _ c;� G� HEDY DISIMONI (90��4�4-�73 "= t^ --� ' ��. �'J t�r -.:�REf8F5EEA OF LS UBE ONLY First Lme of Address � � � �� - ' 501 EWING STREET , Second Line of Address � � J `ri City or PoSt OffCe State ZIP CodO DA7E FILED PRINCETON NJ 08540 correapondenrs e-maoi aaaress: Hedy.DiSimoni a@Infineum.com Under penalties of perjury,I declare that 1 have ezamined this retum,induding accompanying schedulas and afatements,and to llie bas[of my knovAedge arM belie�, tt is We,cortect end complete.Declaratlon of preparer o�her ihan the personal repiasentaWe is besed on all infortnation of which preparer has any knowledge. SIGNATURE OF4 R N RE SIBLEfOR FILING RF�TURN DATE �� 05/29/2013 ADDRESS 501 EWING ST E T, PRINCETON NJ 08540 SIGNATURE OF PREPA R OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORI(i1NAL FORM ONLY Side 1 L 1505610105 1505610105 � � . . . J 1505610205 REV-1500 EX(FI) RECAPITULATION 1. Real EsWte(Schedule A). .... ... . . . . ........ . . . . ...... . . . ..... ... . ... 1. 114,000.00 2. Stocks and Bonds(Schedule B) . . ......... ... . .. .... .. . .. ...... . ...... 2. 3,7$4.00 3. Closely Held Coryoretion,Partnership or Sole-Proprietorship(Schedule C) .. .. . 3. 0.0� 4. Mortgages and Notes Receivable(Schedule D) . ..... . . . . . ..... . . . . ..... . . 4. 0.00 5. Cash,8ank Deposits and Miscellaneous Personal Property(Schedule E)... . ... 5. 32,262.55 6. Jointly Owned Property(Schedule F) O Separate Billing Requestetl ... . . .. 6. 50,531.23 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested.. . . . . .. 7. 0.00 8. Total Gross Assets(total Lines 1 throuqh 7)...... .. . . ..... . . . . ... ... . . . . B. 200,577.78 9. Funeral Ezpenses and Administretive Costs(Schedule H).... . .. .... . . . . . . .. 9. 12,630.71 10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule I). ..... . . . . . .... 10. 2,482.8� 11. Total Dedudions(total Lines 9 and 10). ...... . . . . ..... .. . . ..... . . . . .... 11. 75,113.51 t2. Net Value of Estate(Line 8 minus Line 1t) . ... .. . . ..... . .. . ..... . . . . .... 12. 185,46427 13. Charitable and Govemmental BequesWSec 9113 Trusts for which an election to taz has not been made(Schedule J) .. ....... . . ..... . . .. .... 13. 0.00 14. Net Value SubJeet to Tax(Line 12 minus Line 13) ....... . . . . ..... . . . . .... 14. 185,464.27 TAX CALCULATION•SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 tazable at the spousal tax rete,or trensfers under Sec.9116 (a)(1.2)X.0_ 0.00 �5. 0.00 16. Amount of Line 14 taxable at linea�rate x.0 45 185,464.27 �6. 8,345.89 17. Amount of Line 14 taxable at sibling rate X .12 0.00 �7, 0.00 18. Amount of Line 14 tazable at collateral rate X .15 0.00 �8 0.00 19. TAX DUE . ... . . .. . . . . . .... 19. 8,345.89 . . ....... . .. . .. ...... . . . . ..... . . . . . ..... 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAVMENT p Side 2 � 1505610205 1505610205 J ,. � REV-1500 EX(FI) Pa9e 3 File Number DecedenYs Complete Address: DECEDENT'S NAME THERESA G. MUNSON STREETADDRESS � � ��� � � �� � 33 Cambridge Court cm __ srnre i iia _ Carlisle PA ' 17013 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (t) 8,345.89 2. CreditslPayments A.Prior Payments 0.00 B.Discount 0.00 Total Credits(A+B) (2) 0.00 3. Interest (3) 0.00 4. If Line 2 is greater than Line 1 +Line 3,enter the diflerence. This is me OVERPAYMENT. Pill in oval on Page 2,Line 20 to requeat a refund. (4) 0.00 5. If Line 1 +Line 3 is greafer than Line 2,enter the dAference.This is Me TAX DUE. (5) 8,345.89 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. ietain the nght to designate who shall use ihe property iransterred or its income .........................................._ ❑ � c. retain a reversionary interest .............................................................................................................................. ❑ � d. receive ihe promise for life of either paymenfs,benefts or care?.........................................._.......................... ❑ � 2. If death occuRed afler Dec.12,1982,did decedent transfer property within one year of death without receiving adequale consideration?.............................................................................................................. ❑ � 3. Did decedent own an"in trust for or payable�upon-death bank account or secunty at his or her death?.............. ❑ � 4. Did decedent own an individual retirement account,annuiry or other non-probate property,which confains a benefidary designation? ........................................................................................................................ � ❑ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART Of THE RETURN. 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 taz rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disdosure of assets and fling a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: . The tax rate imposed on the net value of transfers from a deceased child 21 years ot 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)(12)j. • The tax rate imposed on the net value of Vansfers to or for the use of the decedenYs lineal beneficianes is 4.5 percent,except as noted in[72 P.S.§9116(a)(t)J. • The tax rate imposed on the net value of transfers to or for the use oi the decedenPs siblings is 12 percent[(2 P.S.§9116(a)(1.3)].A sibling is defined, under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption. , ; _ LasT wrLL I, THERESA G. MUNSON, of the Borough of Carlisle, Cumberland County, Pennsylvania, declare this to be my Last Will and revoke any wills previously made by me. 1. I direct that any and all inheritance, estate and transfer taxes imposed upon my estate passing under my will or otherwise, shall be paid out of the principal of my residuary estate. IL I devise and bequeath my entire estate to my two children, Hedy Louise DiSimoni and Charles David Munson. IIL I appoint Hedy Louise DiSimoni and Charles David Munson to be executors of this my Last Will. IV. I direct that my personal representatives need not file bond in this or any otherjurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will this 11`� day of March, 2003. ��.-tit.� �J . �����..�t"+� (SEAL) The preceding instrument consisting of one (1) page(s) was on the date thereof signed, published and declared by THERESA G. Mi1NSON, the testator herein, as and for her Last Will, in the presence of us, who at her request, in her presence, and in the presence of each other, have subscribed our names as witnesses hereto. ��� �,/� ,,�/) / .��' l�-�rr C' �.f�� /.�-�_.,-�-i--. r _"�..��ta� �� r1-' ���;<<; STATE OF PENNSYLVANIA :. SS COUNTY OF CUMBERLAND :: We, THERESA G. MIJNSON, Frances H. Del Duca and Carol A. Monow, the testator and witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument as her Last Will and that she Uad signed willingly, and that she executed it as her free and voluntary act far the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testator, signed the will as witness and that to the best of her knowledge the testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. �'�-�c- ,�'l• �t-x.e-c,�- -�!.r� _r.�, .5�<��' ,���;� Testator � Witness ��'�-R-�. /Y !/ ����`�C' u� ,�(`�z' Witness REV-1502 EX+ (1242) �pennsylvania SCHEDULE A DEPARTMENT OF REVENUE INHERRANCETA%RENRN REAL ESTATE RESIDENT DECEDENT ESTATE OF: FILE NUMBER: THERESA G. MUNSON All rcal proDerty owned solely or as a tenant In ammon mutt be reported at hir market value.Fair market value is defned 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. 0.eal property fhat la Jolntty-owned wiM ripht of survivonhip must be dixloaed on Schedule F. Attach a copy of the settlement sheet if the property has been wld. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIFf10N 1 33 Cambridge Court,#33,Deed Book 30V Page 1097,Carlisle,PA 17013 114,000.00 TOTAL(Also enter on Line 1, Recapitulation.) ; 114,000.00 If more space is needed,use additional sheets of paper of the same size. APPRAISAL OF REAL PROPERTY LOCATED AT: 33 Cambridge q,R 33 Deed Book 30V Page 1097 CarNab,PA 17013 FOR: Hetly DiSimoni AS OF: 09/02/2012 BY: Susen B.BuMCholtler orveroRietl ApD��el Services 35 E.Hip�Sireel,Suile'101 Cerliab,PA 7707 aue.burkholtler�gmail.mm State Cetldrod Residentiel Appreuer,RL000659L Porm GA1—"WinTOTP1"appnisal saftware 6y a la mode,inc.—1-806pLAM0UE . • Summery Appraissl Report Diversifiad Appraisal Services RESIDENTIAL APPRAISAL SUMMARY REPORT RNNn: 020412M Ro Addmss'. 33 Camb' e Ct UnA A:33 Ci : Carisb Shte: PA L Cade: 17013 Cou ', CumberlaM La al Deuri fion: �eed Boak 30V Pa e 1097 Assesmr'sParcelN� 40-20.1794-028:U2B833 TuYeac 2012 N.E.Taxes:52394 5 ecialASSessmeMs:$0 Bortawer if lica6le: n.a. CurraM Owner of Hecord: Eatate o/7Tereae Munaon Ouu aM Ownar Tenent Market NeM ❑TmaM ulated qam VacaM PraxtT e'. Condominium Olher descnhe HOA:5225 i n ear ermoMh MarketArea Neme: Caduk Ma flefeance'. 20-1794 Census Trect 124 ProxlName: �mhntl eCouh Phase: 1 The ur se af tliis a �aisal is m tlevelo an a inian M�. Markel Value as defin ,or � oNer e af value descnba This re ort retlxfs the fal6wi value d mt CurteM,see cammeMS�. CurreiR ihe Ins ecfion Dam is Ne E/fecM1ve Uam pehos xfive Pms ectne roacMsde�ebedkriNse reisal: SelesComarisanA mach CostA mach IncameA mach SeeHecoicili�6onCommeMSenASweofWOrk Pm e ' hts mised: Fee Sim le LeeseMlO Leased Fee Other descn6e IMende011se: Toeetebluhvalueforstateinherilencetsn IMendad Ilser s reme ar e'. Eaate of Theresa Munson Cliert: Metl DiSimoni AAOress: 507 Ewin Street Princeton NJ 08540 reiser: Suaen B.Burk�olCer Addreas: 35 E.H' h Street Suile 101 Ca�lule PA 17013 Location�. Ilr6an SuburWn Hurel PraEominent CondominlumHoudng Pre�entLendUw ChenqelnLendUa BuiM u0� �I Uver 75X ❑25�75% n UMer 25% Occupency pp�CE AGE Ono-Uni[ 70% �Not Likey Growlh reh'. n flapiA �Stable ❑Slow �Owner $�000) (yrs) 2-0 Uid % �Likey' ❑In Pmcess• Pmvem values �Incaasing ❑smble ❑oeclirvy ❑TereM 1zs Law 10 Mure-unt % 'To�. OemanysuppN'. ❑SMrtaga �In Balance ]Over SuppN �VacaM(a5%) 780 Hi h 30 Comm'I 30 ffi MarkeA Eme'. ❑llMar 3 Mos.�3-fi Mos. ]Over 8 Abs. ❑VecaiA >5% 145 Pred 28 16 Market Area BounAaries,Uescnpfian,aM Market CanEitions(incWding suDDO�for ihe above chaactensACS enA treMS): MarkM mMXbn aro nood wilh aupoN entl tlemantl ao0���9 to be in Eeknce. Average maAcetinp time is 9010 120 tlava vrilh reasonade finenciiq terms beim reatliy ava'labb to quelfietl buyen.The suDiect neinhborhood is borEereE bv Ritrwr Highxey Oranoe Stroet South StroM and Alkn Roed. lnnng Classificatlan: Hg�DensAV ResideMial Oescnptlon: Enstirg um is permilletl in ihis zone. lnnnp Compfance: �Legal ❑L al mncamorminp randfatAaretl ❑Illa al ❑No zoning . G�ountl fleM(A aDDkable) $ 0/ CammeMS: None knwm Highert d Best Ose as imD�oved(ar as propaseA per plans S specXicafions�: �PreseM use,ar ❑OMer use(e�lein) ActualllseasafERectiveUate: SinobfamAVwntlominium Ilseasappaisedinihisrepart Si b(am' Summary af fNAhes�8 Best Use'. Singb femily corMOminium Utlltlles Public ONer PmviAer/�escnption OIF�XeImDrowment� Type Pu61k Privrte Oensily Awr e Flx6icity � L Street Meratlem � ❑ 5¢e 7 irsltortMaroa Gas ❑ � n.a. CuM1yGutler Concrete � ❑ TopoA�+VM Lewl Water � [ Sidewalk Concrete � ❑ Yew Reaidentiel SanAarySewer � [ StreelLighis Pob � ❑ Starm Sewer � [ Alla None � Otlnr sim elemems: ❑InsNe Lot ❑Comer Lat ❑Cul de Sac 0 UMer auM UtlFlies �OIAer Eesuihe FEMA 5 ec'I Fbod Hazard Area �Yes �No FEMN Fba0lane X FfMA Ma N 42041C0 FEMA Map Oate 03/18/2009 Sifa Cammema�. This�roiahborhootl u locatetl in a nice erea.Most Mmes aro niceN meinteined antl tM orounOS aro niceN landcrapetl wilh maturo OlaMinga.The meture trcw eM ehru W hide the hiohwey aM cN Oam on tM street iroiae.Thero ia a m�c o(reside�rtiel end wmmeiciel use in iM area. Ua9 soume s far m ect iMaimaSon Ne' hDOr aM rt a reisel�e rt PmectDescri uan ❑�etached ❑NawarTawnlnuse�Garden �Mid-Hise ❑Hi MNisa ❑Otlnr describe GenenlDe�crlpHonotPro�eet Sub�eetPhue # ttProMdCOmplekA 8 NProkctlnmmplete # xaf5rones 2 &GriarWalls Bnek Wtts 18 Phases 1 PlannedPhases N oi Elevatars 1 Naof Sunc�e Shi lea I1nBs Completed i6 UMS 18 Phmed Wits �Fxisting[Haposatl�Untl.Cans,Totel Y Perkinp 80 lliits Far Sale � Urvls far Sak � Onits for Sak Oesign(Style) Mitl-nae Natia(spaceyuM) 7ry UMS Sold 16 UnAS So10 i6 Ilnils SoN Actual Age hrs.) 29 Parkinp TyDe(s) Ger e b on etR UMS fleMetl 3 Wits HeMed 3 Uni6 flemed EffettiveA rs. 75 �untParlanp Onsireet 6rmerOccup.Uni6 130wnerOCw .I1Mts 130wnarOccup.WAs RoeciPnme Ocw c PrincialNesidenca SecoMHomeorFecrestionel TenaM Is tM devdo er@uilder in coiNal oi Ihe Homeowners'Assaiafian A? Ves No MenaBemeMGmup�. �Homeowners'RSSOCiafian ❑Oevebper ❑MaregemeirtApeM(nameafmareA�emegemorwmpairy�'. Was Ne pmject c�eateA by the canvxsian oi elostinp builtlinp�s)inm a wndaminum? ❑Yes �Na If Yes,descnbe 7ie onAinal use nntl Aate M comersian. Ne CCdfls apPlicable? ❑Yes [�Na �U�nown Havethe documeMS 6een reNewetl? ❑Yes 0 No Commm6: Prol��Commarts(caMNOn,Qualily ai cansimcVOn,complefion strtus,elc�: This oioiecl u canai0erod to he in a�.eram to uootl conEition Thu's near . major hiphwaya a�W with in roaaonehb commWinu tlutance to emobymeM shaooi�9 an pleees of wonh'D All unit haw a brick e�Gerior entl ��. am mnsidered to be in nootl conAilbn. 4, ,� Cammon ElemeMs and flxreational FaciM1ties: Lavms,sidewelka,cezebo. � �^�•,^^ CaqrqhlOYWlbyalamoCe,irc.ThiabimmeyEenpmducMUmadlietivMMUtwMMpamiaeim,haxrvx,elemotle,irc.mu�IbexlmvMeEpeEeMCe6kE. L ryW PormGPCONDO—"WmTOTAL"appraisalwlNiarehyalamode,inc.-1-BOQAIAMODE 5�'eoo� RESIDENTIAL APPRAISAL SUMMARY REPORT qNNa: 020472M Summary af wMOmihum pml�i budpet areysis k�Me curteM year(rf anayzed): The D�oi�buOpet wes not oroNtletl to the aooreiser. Mowewr the eporewer if not cualified to tletermiiro if thero are edeouate fees. O�herfeesfor�heuseafihepmjecthcilAies�otherthanrepularHOACherAea��. Naneknawn ComOared to other competitive pmjects M similar qualiry and desiAn,ihe subl��urvt charpe appeers [Hiqh �AvereA� �_]Law (M High ar Low,describe) Aa Nem em/sDecial ar uresual chemctxisfics of the pmjact�ased on the contlaminum dacumeirts,HOA maetinps,or olhx i�Aarmation)kmwn to the appreiser? ,��Vas �No If Ves,Aescnbe aM e�lan the eMect on value aM madeqbiliry, Y �. Wtt Char e:5 225 er momh X 12=$ 2 700.00 m eac Amual assassmert char e er ear er SF af GlA=$ 7.62 UfililiesincluAetlinttiellnAChere: None Heal � AirCantliAan Elechii Gas � Wakr Snver Cahle [i01he� Source(s�usedkrphysicslcheaeterisficsaFpmperty�. CNmvinspectlon ❑HeviousAppraisalF@s ❑MLS �AssassmerrtentliuNecoMS ❑Pnorinspectlan �Pm e Owner ❑Olher descri6e Data Sourcekr Gmss Livi Area AsseaameM roeorda �� Gn�nlOnciptlen FatMOrDaoAptlon FauM�tlen ❑WA Buwnent �I WA HMhq � FbarLacatian 2 FauMation Cor�erote Sla� None AreaSq.Ft. Type Fha #afLevNS 7 Fate�imWalls Bddc CrawlSpacaNOne %FrcsheA Fuel Elx DesiA�(Style) Ono-sto Boof Sudace Shin ba BasemeM None Cdliny �5us6ng ❑Proposed Gutters 6 Ur�pis.Aluminum SumD�mp[� Walls Coqlnp �' �UnderConstruction WiMowType D6Fhu Oampness ] Fbor CeMrel Yea Actual AAe(Vrs.) 29 StormScreens yes Setllemem OutsiOe EMry Olher EReclne A a rs. 15 IMeshtian � hbrlorDue�tlen �ppYnEa �Itic ]WA�mmltle� GrStanp� ❑None �, Fbors Ca et Belrigerata � Stlirs ❑ Freplace�s)#0 Waadstave(s)A O �Garage A � ��Walls D all NangyOven � UmpSpir I] Pa6o ❑Conred k TnMFinish WooA Disposal � Scuttle ❑Oeck ❑pppi M BeN Fbor Tde Dishwasher � Doorxay �;Parch TaGI Y af cars � BaMWainsco� D II FeqM1bod ❑ FWar [Fance [�Assgned Ooars WooO Mkmwave � Headd ❑ Pool �OwneO WashepD u 0 Fnshed ❑ 9aka 5 ue+Y s Finished area ebow rade corfei�u: 6 Nooms 2 Bedrooms 2 Bam s 1 688 S uare Feet af Gmss Livinp Area Abme Gnde Are tln hea6ip and coalinA�r tl�e indiviaual uMS separatey metmed? �Yes ❑No Qf Na,aescrioe� Atltlitlorel�eaWres'. Thia Cambritlpe CouR coMOminium a�e all b�ick on tM eberior.There aro hvo bedmom entl lwa full ba�hs Uescnbe tlw condition of Me pmperty(including Ohysical,functiorel an0 eMemal ahsolescence�: The iMerior of the Mme ie in ewrape to good eondition.the heat �m�was receMly roo�acetl. i � ii t �Yn'lBSE2lLh AIE ' AIEMIfEVE8I81f)pfpf62I880f�f8115IBf5Y��M105YG�BCIpfOpCM�OfOIENfBB}'88BPfI0fLIMBEROC�1YEAi�E0IM1158OU��52I. OamSaurces'. q��y�meMrecorda �1 rt Prior 5ub'ect Sale/Gartsfar Areysis of salytransfer Nstory anyor airy curreM agreemem o1 salyGStinp: No aab of tM subiect orooehv has teken Oate�. OB/22/1984 plece in tM peat throe vean. Pnce: 75 400 Source s'.Coukhoux 2nd Prior Su6'ect Sele/Transfer Dah: Pnce'. Saurce s: ��0�� CopyrqAt02W]py�I�moEe,irc.Thisbim mry he apmMCM u�unaMbE xiNau�writlm qimnYm,hvxrra,c W mode,in�.mu�be sbpMetlpeE W ceEkA. Foim GPCONUO—"WinTOTAL"appraisal soflware by a la motle,inc.—1-806A1AM0�E ���� RESIDENTIAL APPRAISAL SUMMARY REPORT R�nNp,; 020412M 311LESCOMPAfli80NRPPRO�CHTf1VAlUE Xdeveb TheSalesCOmparisanAp machwasnotAerelopedforihis reisal. FFATUHE SU&IECT COMPAPABLE SALE k 1 COIAPqApBLE SALE!2 COMPNWBLE SALE k 3 Address 33 Cambndpe Ct,p 33 29 Camhndpe CouA 23 Cambritlpe Court 15 Wilahire Weat Cerlele PA 17073 Carliale Ce�luk Ca�luM Pmject �amhritlpe Court Cem6ritlpe Court Camb�itlge CouM Mayappb VMege Phese 1 1 1 � Pmdm to Sub ect ::�: Lesa then 0.07 mibs 0.01 mile�N 3.35 mies SE � , 6ale Pnca 5 E . ,'�.;;�:5 114 900 '� "`:''x���'b 110 000 �`"',+ e.f`:S 723 000 SalePricyUtA S Is .n.E 68.BBIs k �` i.'S§ 66.95/s ft , fi`�'x$ 79.70/s ft:`4i ';+'r.," �ed5aurcas Coukhoux CauNhouse Court�ouse VarAication5aurces MLS MLS MLS VALUEAOJUSTMENB �ESCNIPTION DESCflIP110N +-SAd�ust OESCPIPTION +-SAdust OESCHIPfION +-SAd'ust. Sales or Fmncinp Cbeinq wst -4,000 Cloaiip wst -1,000 None known Carcessions Caa� Ceah Cas� �rteMSalqTime esof09/2/2012 O4/02/207� 08/31/2072 03/OS/2011 N'Ms A raised Fee Sim e Fee Sim b Fee Sim Fee Sim b Locatlon Aw Aeera e Aver Awre HOA Fees flMaMh 225 225 225 145 Comman flemeMS en0 Lawn,sidewalka Lawns,sidewelks Lawns,sidewelks Lawns,siEewalks flecreatiorel FacilAies Gazeba GazeEO Gazebo Gazebo Floor Lacatian 2 1 -1 000 1 -1 OUO 7 -7 000 Yax ReeitleMial Residential ResiAeMial Reaitlentiel Uesi n S le Ono-MO One-ato One-sto One-ato �ual' NConstmction Bnck Brkk Bnek Vn Brick +p000 A e 29 28 29 18 CaMNOn Awra to ootl A�e e Awra Arar A6oveGrade Tahl Btrma Baths Talal Bbms BeNS Tohl Btrms B�Ma Toml Bhma Batlu Hoom CouM 6 2 2 8 2 2 8 2 2 fi 3 2 Gross Livi Fina 7 fifie .fl. 1 888 s .tt. �ggg s .tl. �555 s .k. �3 4U0 BasemerrtdFinished Norro Noiro None None flaams Be6w Grade FurefionalUti� Avera Avere e Avere A�er¢ e Hea' Caali Heat um CA Heat um CA Heat um CA Fhe Ges CA Ere EflicieMlhms No�ro None None None Parki 1-car era e 1�car ara e 7rar a e None +5000 PorclyPatlWOxk None None None Petio New heat 8 air No +5 000 No +5 000 No +5 000 Net Ad'uslmaM otal + - $ + - 5 3 000 + - $ 14 4�0 Adjustetl Sale Poce ;4� ,,":r:�;:. ,,�. ot Gom arables ��t �'���v`a, , - § 11q g00 � S 173 00� � $ 137100 Summary of Saks Compansan Approach A 51000 oer mom etljusimeirt was made for ihe totel numDer of Sz 0�0 pe Dalh arM=1 000 0 hetl bath. Sales o�ro antl 2 wero uiven iM moel mneitleretion ainm t�ene Iwmea arc in ihe�eme asaociation a,o Indkekd Vdue SeW Com Nwn roaeh S 114 000 ���� Capy*'q�M21101ryelamoM,irc.ThisbimmeYaroP�cMumwMleExitliwtwrAMPeimiuim.hvxr.x,ahmotle.'n�.munbetlmaMeEpeAaMUetllletl. Farm GPCON00—'�nTOTAL"appraisal solhvam by a h mode,inc.—1-800.ALAMOUE N20�7 RESIDENTIAL APPRAISAL SUMMARY REPORT FlbNO.: �20412M INC01ffAPP110ACHT0VALUE Aeveb 0 ThelncamaA rwchwunotdevebeAfarthisepprvsal. FEATOHE SUBJECT COMPAFPBLE BEMAL N 1 WMPAMBLE NEMAL M 2 COMPAHABLE NEMAL#3 Addmss 33 Cem6iitlpe Ct,#33 Cerkab PA 17013 Project CamDridge Court P1186B 7 Probm to Su6ect •*� ' - ° `�"+ W CurremMo NeM $ w�ku �v�.: �,,g�g ,« ,v sr✓;,."a; 8 ,,.<.�r,,'L�".s$ HenVGIA $ /s .fl. .z . ��.+.5 /s tt ;.,":;. 5 Is R ;'8 / it. HeMCoiNOI ��Ves No Ves No� Ves� No Yes ���Na Dam Source s Oad of Lease s Lacafian Averg Yew e Y9 CaNiAOn Aver to aod AhaVBG�ade TdY BOma Betlu Total Bbms Batlu :.;=r'?::� Total Bbms BeNS "'�; ToW Btrms Baris Haom CouN 8 2 2 .`�sl��'. ',.;; Gfoss LiVf Afea 7 68B s .fl. 5 fl ^ 5 fl - 'a^�C. S fl lPoYlies Iwludad Summary of Income AppmacA pncluding suDDOrt br maAet mm aM GHMJ: �; 0 irvan N Mo Madat flem$ % Gmss Nmt Mulfi liar =$ MEIabE VYUe NKame h COSTAPPROACHTOVALIIE tt0eveb d TheCastAp raachwasnotdeve6padforihisaOD�eisal. Summary of CostAppraach�. IndlatedVdue :SdrCom onA raM 114000 CatA rouh(NEewb � Inmm� rweh(tlAevab d Frel flawncilie6on The$ales Comcarison aDOroach heirq mnsidered tM moat accurate in arnvirw et my final ooinbn o/value The lix:ome apomec�waa not coroiEeroO since this u einok famiN MrolFrw THS epP�vsal is made�"as is", ❑ subl�m compleXOn per plaim aM specAica6ons on Me basis M a Hypothetiwl CoMNan tlret ihe imprwemerrts have been completed, ❑su6jxt m Ne Fa6wing repairs ar atlera6ons on�he basis af a HyDO����Condi6on qwt ihe m0airs ar attxatians hava bean completeA, [�su6ject to Nn falbwinp requirad inspection 6ased on ihe FalreoNinary Assumpfian thnt Ne coMNan or deficimcy Aoea mt require al[ere6an or mpaic AooraueE in eurreM corWilion. TNS r ort is also sub�ect to otlwr etical CoMiCOns an�Vor E�mrdire Assum Aam as s ectlied in iha atlached adden0a. Bued on ths deg�es of In�peetbn ol ihe iuh�eet poperry,u IndlqbE 6ebw,MIMed 9aopa of Work,SGhment ol Auumptbn�snd Llmtllnq Condlllon; enA AppnueY�GrIMMbna,my(our)Opinlon ol ihe Meilret Velus(or othar apeelAeA wlue type),u dellned henln,ol Me rsl properly thet I�Me�ubkcl of ihd nport h: S 774,000 u of: 09/02/2012 ,whkh d ihs Nhdlw Ette ol ihlt eppnl�d. M Indleeted�horo,ihd Opinbn ol Velus h�u6Net W Hypothetipl ContlMbnt�nd/or EaVSOrdlnery Apumpibn�Includad In thb rcporl. See ethehsd eddends. A true aM camplete wpy M ihis mpoR ca�ins 14 paAes,ircluEinp aWbAS which am co�idered an irtepral part of ihe mport This apP�aisal repotl may not be properly unAerstoad witlnu[raferenca Oo Ne iMarmatian ca�ined in�he complete raport Attached Ediibi6', ❑ScopeofWoAC �LimitingCoitl/CeNfica6o� �NartativeAddendum �PMhpraphAEdmda ❑SlmtchAAAendum �MapAddeMa ❑AEEPoOreISales ❑CastA00eMUm ❑FbodAddeMUm ❑Manuf.HouseAdEendum e5cal ConOitlans E�eordire Assum Aons ❑ ClieiRCOMacC CliamName: HedyDiSimoni E-Mail: Address: 501 Evri Street Pnnceton NJ 08540 APPRAISER SUPERVISORV APPRAISER(If ropulred) or CO-APPRAISER(If applleable) �, �{.z.;.1u✓'�_ Supervisary ar AbprvsarName. SuaanB.Burkholtler Co-pppraiserName�. ComDercy'. Diwnifrod Aporei+al SeMCes Comparty: PMne'. 777-249-2758 Fex'. )77-258-4701 PMM: Faz'. E-Mail', sue.burkhdder�pmeil.com E-MaiC Oate of Feport(SgnaWre): 01/01/2013 Deh at flepo�(SqnaNre): " LicenseorCerfificafionN: RL000859L Stah'. PA LicemearCertificrtbnY', Sb�e: � Oesiprelion: StaHAporauer �esipnation: E�iratian�ak af License ar Cetldice6on: OB/30/2073 E�iretion Oste of Liceree or CetlAicatian: Inspxtlon of Su61�� �InNrio�6 E#erior ❑Exterior Onl� ❑None IrcpxGOn af Su61�'� ❑InMior 6 Erterior ;�Exterbr Ony �None Oaboflisxtion: 01/09/2012 Oakoflaecfion: ����^A Copyny�10200]byahmade.iu.ThisbimmrybereqoducMwmo9fltlxilhwimAMOeimiesion.howerer.elemo6,'mc.muNbee�bpMeEpetlenEareEiled. W Form GPCONDO—"WinTOTAL"appraisal soitware by a le mode,inc.—1-806ALAMO�E fl�ZO�� Supplemental Addendum FileNa.020412M Bormwer/Cfem n.a. Ro Addmss 33 Camhrid e Ct M 33 C' CarNek Cau Cumberland Shd PA L Cade 17013 LeMer Hed DiSimoni Atlditlonal Cammenfs: The aubjeq is older than(ve yeen old. All mechenical aystems inUuding heating,eleclrical end plumbing systema appear to 6e working atlequetaly. No wartenties ere implied in this statemant. One or more of t�a wmpereCle selea ero olderihen siz months old.Atthough there are compareble propenies in tha subject's area,nona heve sold recently, thereTOre,seles in ezceas of six monMa old heve to ba usetl. All three comparebles used were lhe best aveileble. ANhough Mere are other similer home in tha subjecfs neigh6orhood,none have sold recently.Therefore is wea necessery to use seles/urther then one mile from the subjecl property. The salea uaed ere the beat aveileble. This report has bean electronicelly prepered and transmitteA in compliance vrilh USPAP guidelines which inclu0es wri(icetion of the complete trensfer and delivery,digitally protected signatures antl eAequete sacunty measurea in place to proted tlete trensmitted by eppraiser. The Intended Uaer Mthis appreisal report is the Lender/Client. Tha Intendad Uee ia to evaluate the proparty that is Me subjed of this appraisel Tor e martgage(nance trensaction,aubjecl ta the rtatad Swpe of Wark,puryose o/the eppraiaal.ieporting requiremants of this eppreicel repotl Porm,and Defindion of Market Value. No additional Intentlatl Uaers ero idmtified by the appreiser. Tha appraiaer hes not hes any involvement in the property in the past three yeers. Tharc is an eHediva numbar of competing properties in the merket in thie erea.this indiceted that supply end 0amand ere in belence.Reasonable e�oaure pano0 is eatimated to 6e under 6 months.Typicel holding period is 5-7 years. Prlwry Notice Pursuant to the Gramm-Leach-Billey Acl oT 1999,e/lective July 1,2001,appreisera,elong with all provitlera of pereonel finandel sarvicea ara now required by federel lawto infoim their clienta of the policiea of lhe firm wkh regerd to tha privacy of t�e client nonpublic peraonal infoimetion. As professionals,we undarstand ihet your privacy is very impohant to you end are pleesetl to pmtide you vrith this informetion. In ihe wurse of perlorming eppreisel,wa mey collect what is knovm as"nonpublic personal inTOrtnation"about you.Thia in/ortnation is usad to(adlitate the services thet wa provide to you entl mey include the informedon provided to ua by you tlirectly or received by us fram othere with your authonretion. We do not tlisclose any nonpublic penonel infoimation obtainetl in the coune of our engegament with our Uienta to non�liated third peniea,ezcept as necessary or as roquired by lew. By wey of e�mple,a neceasary tlisclosure would ba to our intlapendent mntredon,and in certein situetions,ro unrelated ihird perty mnaultante who need to know that info�metion to assiat us in provi0ing appraisel servi�ea to you. All indepentlent contradon and any thiN peAy mneultanta we engege ere informed t�at any inb�metion they see ea part of en eppraisel is to be maintained in strict confldence within tha firtn. A tliadosure iaquirod by lewwould be a disclosure by us that ia ordered by a court of competent junadiction wRh ragerd to a legal action to which you ere pehy. We will ratain recortls releting to profeasional services thet we heva provided to you(or a reeaonable time ao t�at we aro better able to assiat you with your needa. In order to protecl yow nonpublic personal in/ormetion for unauthonzatl eccasa hy Ihird perties,we meintein physical,Nedronic antl procedurel sefeguerds thet camply vrith our profesaionel atanderda insuro ihe sacunry and integnty of your in/ortnation. SiA�eWm !' SiA�aNre Name Sua . u er Name DahSipned 0?/Od/20'13 UataSipned SgqCeNficafioni RL-000859-L State S�akCe�9fiafianB Sqte Or 59te Lke�e A S�a�e_ Or State Lkense k yyak Foim iA0U2—'�nTOTAB'app�isal sailwem 6y a la made,inc.—1-804ALAMODE Location Map Bormwer/Cfem n.a. Pro Address 33 Cambrid e Ct k 33 C' Cadiab Cau Cum6erlentl Spd pq L CoOe 770�3 LeMer Hed DiSimani .u��° a la mode inc: �.«.�. .W4.i {.M�� t�°Ra 4 � Wa9..n�" f a� ��9p �5 " �rC North Middkton ' ` °,p Township a "•,ne Caprivi `5�' "�e , i�,b_! . ..a� . �.;, ,. �a. � ..4M.. c �., _. .. .. .. . .. _ . �' . ��. i�„����tqs_ _ ^p`rn..,, . r � V' ' �p sr�i:er `�ktl k ll` � .�rvi!J�#�� P ,�1: . �av.. � q�R � 4 ..,.�.vn � n Caa...e.c YNSNPCxS —� V li"sNny . u_'.i:� �. . SMVrviI1PNE W � .� a.rA :`Ql��. ��� nmih Ftl H� P�� � � � � 4 � � � 11' g = F .. aN� �k-Gy � E � �° G65 � Pb p a` Bonny Breok q L(f� � � ,�� �� � �� .��.:s � ° � ��.� �°f vWµPd 1)�: d° rv,,� v�'` ��'`a e 3 �^ ..ni��. n i �5.� Q t OfdYO�k�M1 «� � q •.I:U(YIP!'�`: T.vp Hahon rµ���r��;,,, +x! l+'wevwxxe Dickinwn,n�: varorn� Township �y�y} 9�, I vnlu •�J� �,�.,..^d ruut Barni4 .* �._r, � Form MAP LOC—'�nTOIAL"appraisal saflware 6y a la made,inc.—1-B00.ALAMOOE Sub�ect Photos BortowedCimi n.a. Pro e Address 33 Cam6nd e Ct #33 C Carisb Cou Cumbenantl Shm Pq li Cade 17073 teMer H DiSimoni Sub�ect Front 33 Cambridge Ct,lt 33 Suh�sct Rear 8uh�ect Strsst Form PICPIX.TN—"WinTOTAL"sppraisal software hy a la maAe,inc,—1-BOPAlAM00E Photograph Addendum eormwer cfam n.a. Pro Addmss 33 Cambrid Ct p 33 C' Cadiak Cou CumbedarM STate Pq L CaOe 77073 Lender Hed DiSimoni . ',�; a .,,� ... � F y� 4 1� ��.r�.�3 � '� .9s� � .'1#. } �t i°t=: �{'. ✓� 3 � ?ii }� x k..�°t � Form G%CPIX—'�nTOTqL"appraisal soflware hy e la made,inc.—1-800.ALAIAOUE Photograph Addendum Bartawer/GfeM n.a. Pra Address 33 Cam6nd e q N 39 C' Carfsb Cau CumbeAentl Shh PA li Code 17013 Lentler Hed DiSimoni €,: i. ,�; �, �Hx it, a. ��". �"%� �"�3� �sa� �� 5q"- � :?�` Foim GPICPIX—"WnT07P1"appraisal software by a la moAe,irc.—i-800.ALAMOOE Photograph Addendum BormweqCfem n.a. Pro e Address 33 Cembrid e Ct R 33 C� Catliab Cau Cumbedend Stad pA L Code 17013 Lender Hetl DiSimoni ;� yjr �` � { krm G%CPIX—'WinTOTAL"appreisal soNwam by a Ia made,iic.—1-800.ALAMOOE Comparable Photo Page a�rz�rc� �.8. _ Ro e Atltlress 33Cambrfd Ct p33„_ .._. _. C Cedble Cou CumbetlaM State PA L Code 17013 Lmder Hed DlSimoni Compars6le 1 29 CambriEge Cuur1 I�"i ' I 'I' "'II Comparahla 2 23 Cambridge Court � `"�"" Comparabla 8 ^,�.* - i5 Wdpirite WsM � F :g ��k „/3 � i�jgM'Yv5�4i' S-..`.," � ..� ti,:�' +,t ,3��� Vi» .;4. .' ..'�.' foim PIGP6Y BR—��WmTOTAI"sPR��asl safiware h7 a la mode,u�c_—7�89aNAMl70E FAeNO.020472M OEFlXIIION OF IMpI�T VFWE: The mast pmhable prica wMch a pmDetly sMUN brinp in a campefifive aM oDen market uMx all coMNOns requisde la a fair sale, the buyer and seAer, each ac6np pmtleMy, kmwledpeaby and assuminp Ihe O�ice is mt attected 6y uMue stlmulus. Implicit in Mis definRion is ihe consummatbn of a sile as of a specAied date antl the D�sinp N tAk tmm sellar ta buyer uMx candi6o�s whereby: (1)�uyer and aeller are ypkaHy mofivad0�, (2)hath pa�tin ue weN iMormed or wel a0nsed,aM each actlnp in what he wnsiders Ns own best iiAemst, (3)a reasarehle fime is albwe0 for uposure in ihe apen madel;(4�DaymeM is maAe in Mrms af cash in LL5. dollars or in terms oi financial arrangemams camDarabk Mere[o; and(5)�he Drica represeMS Ne normal consiAention far iM pmperty sak unaflected hy s0�ial or creafive firencing or sales cantessions• g2Med by eiryone assaciatad wAh Me sala (Source', F�IC IMeregency Appraisil and Evaluatlan GuiAelines, Octo6er 27, 1994.) 'Adjus6nwrts N th compara6ks must be made far spxiil ar cmafive finencinp or sales coreessio�u. Na aAjustmerrts are necessary for tlwse costs which are normalty paid by sellers as a resutt N tradNon or law in a market area; these casis am maAiy idemdia6le since the sdler Days these cos6 in virNaNy all sales hensacfians. Speciil or creative finencinp eej��msm: can Oe me0e ta the comparable O�oOerty by camparisons m financing terms otteretl by a ihiN party ins6N6orel lender ihat is not already irnoNetl in ihe pmpMy m transaction. Arty aJlusMeM sMuq mt be cakukted on a mxhenical daYar tor doWr cost af Ne financinp ar cancession but Me doller amoum oi am/ a0lusMeM shouN appmumate tl�e markefs reacfian to ihe firencinp or concessians 6ased on ihe appraiser's IudpemeM. STATEMENT OF LIMITING CONDITIONS AND CENTIFICATION CONIINOEMANO WIING CONOf�ONB: The appaiser's certfiwfianthat appesrs in ihe aDP�aisal�eport is subject ta the fobwinp wntlNOns'. 1. The aDPraisar wil iwt be responsi6le kr metlas of a lepal reWre that aflect ahher tha pmperty 6einp appnised ar the title to d, The appraiser assumes tlqt tM title is goo0 anA marketable sM, Nnefore, wil mt reMer eM oDina�s ahaut Me title. The pmperty is valueA an tM besis nf it beinp unAU mspa�ihle awnership. 2. Am/sketcA prmqe0 in tM appreisal repon may show appmumate Uimensions M tAe impmvemmts and is includeA any ta assist the reader of Ne report in risustring the pmperty, The aDP�aiser hes maEe no survry of Me pmperty. 3. The epP�aiser will not give hstimo�ry or appear in cautl�acause he or she made an ap0�aisal oi tl�e pmpetly in quas9an, unless specific anangemems fo do so have been matle hefarehan0,ar as aMerxise raquired by law. 4. Airy distribufian W valuafion between IaM aM imprwemm6 in Me mport applies ony uMer Me mus4ny pmgram M utllization.These separek vaMUtions of the IanA anA impmvemeMS must ml 6a usetl in conjunction wM any atlw appnisal aM am invek A tl�ry are so usad. 5. The aDProisx Aas m knowledga N airy hidden ar urepDarerA coMNans of the prapeM1y ar advarse emiranmeMel condiGOns(reluding ihe presence of hezardous waste, muc su6stlnces,eh J Net wauld make Ne propdry more or less valuabk,aM hes assumeE tlnt there a�e iw such eontlNOna and mekes no AuaaMees ar wuraiNes, c�ress or implied, repardiig the caMNOn of the pmperty.TM appraser witl not he respamihk Far aM such coMNans that Ea eusi or kr arcy enpineenng or testiny tlpt mqM 6e required to Oiacover whetler suchcoMNOns eust. THS aDP�+isal rtportmust mt 6e cort�ideretl an anvimnmeMal assessmaR af Na su6ject pmperty. fi. The appraiser o6hined Ne iMormatlon, esfimahs, antl opirvo� Nat wxe mmresseA in tM apprtisal mport imm sources Ihat he or she wnsiders ta be mlia6le and beliares tMm fu be ima aM canect. TM apD�iser daes not assume asponsi6iYty far tAe accurary ot such Aems that were Wmshed by o�her parAes. 7. The apProiser wid wt discbse iha coNems af iM appraisal repoh �ept as Orovided for in Ne Uniform StaMards o1 Professional Appnisal PraeGro, aM a�ry app&aWe federal, state or bwl laws. 8. The appraiser has based Ms a her aOU�aisal report aM valua6an canclusan for an appreisal that is subla� m safisfactory complatwq repairs, or atlmstlons on Ma assump6on Nat completlan N the impmvemmR will he perfo�metl In a vroAOnaHiNe mamer. 9. The aDP�aiser must pmvide Ns ar her prior written conse�d before tM IeMer/cAeM specified in be apprtisal report can dis4ibNe ihe apprzisal repotl (incPodinp concWSwns abaut the propedy value, iha apprvser's i0enfiry and pmfesswnal desi0�ha�. aM relerences to airy pralessioml appnisal argatlntians or the firm wiM wtich the appniser is associehA)to a�ryom ather Man iha borrower, ihe martpagee or hs successors aN essipns;the martpage insumr, consuttents', professbnal appaisal orgama6ons; em/ steh or federely sppmved financial instiWfian', ar aRy depaNneM, aAency, ar inshummqliy oi ihe IlnAed States or any stah or Ne Dis6ict af Calumbia�, except tAat the Imder�clieM may distribNe Ne pmperty dascri0hon secfion af tM repotl onty ta data wlectlon or reporting servke(s) witlput havinp ta ablain tl�e appraiser's prior writlan ca�errt. The appraiser's wrilten eamem aM appraval murt also be ahmined 6efare ihe appraisal cen he comeyed hy anyoiro W Ne Dublic through adrerfisinp, Dubic relefions, nexs, sales, or aNer metlia. 10. The appraiser is not an emp6yee af Me compart/or iMividuel(s)aUerinp tliia repoR aM compensafion is not cominpeM upon Ihe repaNrp M a predNermined value or dimqion of value or upan en aetion or eveM raaultinp imm ihe aneysis, apirvans, wrclusions, ar ihe use oi this report. This asaipnmem is rwt based an a requiad minimum,specRic vilmfian,or ihe appmral N a laan. Page 7 of 2 Farm ACH2—"WinTOTAL"apD�isal saflware by a k made,inc.—1-B�0.NlAM00E FlNNo.020412M LEP11FlL11710N: The appraiser ca�ifies and agrees ihat. 1. The statdneMS of fact caMaineA in tlus report aa true aM cortect. 2. The reparted anayses, apiniore, aM conclusuns aa imited anly hy Ne repohed assump5ons aM IimNng con0itlans aM are my persanal, imDartal dlld IIII�IdSEd pN�l56101121 31GNS95, OpIIlORS, 211A COIIC�1151016. 3. Udess oNe�wise intlicated, I heve no preseM or prospective imeast in the propetly that is Ne subl� � 1Ns repart and m personal imerest iMe�est wAh aspect ta iM paNes imaNeO. 4. Ildess atlniwise iMicated, I heve DertarmeA no smices, as an appmisn or in eny atMr capacity, reqardinp �he Omperry Iha� is the suhject of mis mporl wiNin Ne thea�year pmbd immediatey D��eAing accep4rce of tl�is assipnndR, 5. I have m bias wAh respect N Ne pmpetly tl�at is ihe su6jxt ai ihis repaR ar Me paNes imroNed wAh Nis assignmmt. 6. My engagemeM in Mis assqnmeM was not caiNngeM upan dauehping ar repoNrp pre0etermine0 resutts. 7. My compensatlan for cample6np tlis assqimeM is not caiNnpeM upon me OnelopmeM or repoNnp o1 a predehrmined value or direction in value Nat fevars Ne cause N the clieK, iM amoum af Ne velue apinion, �he atlaiimert of a sfipulated msutt, or me oaurrmce of a suhseQUem eveM directl� related to Me iMeMed use of ihis apPraisal. 8. My anayses, oDinans, aM cancPoSiarts were deve6ped, aM tNs mport has 6een prepareA, in coMaimdy wM ihe Ilritorm StaMards af Pmfessiowl Appraisal Pracfice Mat were in efleM a� �he 6me tlis raport was papared. 9. IlNess otle�wise in0icateA, I have maAe a persorel inspecfion of ihe iMerior and mAeriar veas N the pmperty ihat is ihe subject of tNs repoq aM the n�leriors of all pmDerties listetl aa compaabks. 10. Wless aMeiwisa indkated, ro one pmvided siA��kaM real praperty apprzisal assistance to ihe person(s) sigMnp ihis cetlAicafion �if tAere ara eiwe06ons, the name af each iMividuel pmvidinp significaM mal pmperty apOrusal assishnce is sqtad dsewhere in tMS report�. ADDIIESE OF PROPERTY ANALYZED: 33 Cambnaae Ct #33 Cedisk PA 17013 APPMISER: SUPERVISORY or CO-�PPRAIEER (I}applicabls�: Sqnature'." SiB�dre'. Name: uaan B. uAc�olEer �ma: Ttle: StaRAppraiwr TNe'. Stlh C&fifitafion Y: Rl-OOOfi59-L SptO CertAica6on M'. or State License M'. or State Licaiae Y: State'. PA FMpireSon Oah af Ce�iticafion or License: OB/30/2013 Shte: Fxpiration Oah of CerNiwfion or Lkense: Date SIgnBA: 02/04/P013 �ete SiO�ed' .,] Oid [� Oid Not I�peet Prapary Pape 2 af 2 Farm NCH2—"WinTOTAL"apprzisal soflware by a la mode,inc.—1-B06A1AM00E } �. :. .� . ,� r; �. . . � � � :� L . y �. 's. � 3 ',a� �`ta��' a �s 3 r #� �+: : *-�r ,`� Ayy�,��� � ����^� w �` '�`!1�"�PRi�`���� �, � ��p< a ����nkyr MRI 4y�"a`{Zt.r.{'# A�k�; � f � fi � � �{.v .a �t ��a � z iM F 9 y� k :' �.. , l�q� � /�G i �'. q $ i � _�y } } �j : �.�.ry�,�, YY. a 'V £ Y :. ;���. � ��F C£ ,� �`�i". ,k #2'°�., , „� p �� �� ��S '�`� ._ . ` '`' � . .. . . ���N���Y�L"NY�E{(101�Oq[II� �i .., � ' 9 .: ' ���� �� i��kl9 �, '"°�°��� � � �. ��`` � . ,r "�'`��5$� 3 �� " _ d 3� .�","k .,''s� w"AE u z . �vt .. a���i����S i . e+� �"#5 `* x,q�°�"*� > �t � x ; ���" , %.�� � ��+' }�; ;�; � n3 ash ���;.' v bn Y' ,i.xF�Z;�T"?�`yn��, f � 3 Form SCA—"WmTOTAL"appraisal mflware by a la made,inc.—1-806ALAMODE REV-�5a;EX+(8-u) �pennsylvania SCi1EpNLE B DEPARTMEMOFNEVENUE INHERITANCETAXRETURN STOCKS & BONDS RESIDENT DECEDENT ESTATE OF FILE NUMBER THERESA G. MUNSON All property Jolntty owned with ApM of wrvivonhip must ba dimdosed on Sahedule F. REM VALUE AT DATE NUMBER DESCRIPfION OF DEATH 1� Allergan Inc.,44 shares common stock,$86 per share 3,784.00 TOTAL(Also enter on Line 2, Recapitulation) ; 3,784.00 If more space is needed,insert additlonal sheets of the same size Page 1 of 2 NewUSeRk?oglster Signln 4ap PreviewMallw(YlTOOlbar Mai MyY'� Vabool _._.._ ..'_"__._.. ...._.._ ._ . ..__"'__ — ,... .___" Searc;h SearohWeb ��'�, HOME INVESTING NEWS PERSONALFINANCE MYPORTFOLIOS EXCLUSIVES .... .__._. �. GBt QUOtBS Flnance Seamh ?ua,May 2A.Yil13,t0�.C2AM EUT�US Ma4 �s cwae In F Fisand 68 mins �. Uow 1L31/Nasdaq iO.Ot% . .. .... .. .. . .. . . . .. .. .. . ... . ... . .. .... .... .. . . . .. . .. . . . . � A�` . � I Ailergan Inc.(AGN)��vvs naa io Pomoiw��� �� ��ke zi'�. ��0.�4 t2.03(2.07%) io:oznMeor-NesaaaReeirmePa� __ _____� HistoricalPrices cNxi.�aic.irno..ro.: '�.,;;�yp;, Set Date Range . . .___ _.. ._ ..._.. .. . '�i Daily Sbn Datr.�'...Sep� 2 � 2012 Eg.Jan 1,2010 .?+;.Wcekly ena wta Sep� 2 2012 �� � �'a MoMhly ?��DiNdends Only ♦ � r First�Previous�Next�Wst __ _ __ __ . . . Prices Date Open High Low Close Vdume Atlj Close' Aug 31,2012 86.01 8@50 85.43 86.13 1,650,000 88.00 'Clax pnca aCjusteE tor tlivitlentls antl splib. First�Previous�Ne#��asi !�DOwnload to Spreadsheet Currency in USD. .. �„;..;�. � Ad Topics That Might I�terest You... 1. Penny S[ock Alerts 5. Business Opportunities � 2. 2013 Beat Energy Stocks 6. Hot Penny Stocks 3. List of Penny Stocks 7. Best Divitlentl Investments � 4. High-Dividend ETPs 8. Top Retirement Plans . %:eetl[ack nd'> http://finance.yahoo.com/q/hp?s=AGN&a=08&b=2&c=2012&d=08&e=2&f=2012&g=d 5/28/2013 REV-i5a8 EX+(o8-a2) j� pennsylvania SCIIEp11LE E �y� DEPARTMENTOFREVENUE CASH� BANK DEPOSITS &MISC. INHERITqNCETA%RETURN PERSONAL PROPERTY RESIOEPfr DECEDENT ESTATE OF: FILE NUMBER: THERESA G. MUNSON Include the proceeds of lidgatlon and the date the proceeds were received by the estate. All Property jolMly owned with riqM M survivonhip must be disdosed on ScAfldule F. ITEM VALUE AT DATE NUMBER DESCRIP'fION OF DEATH �. Sovereign Bank Checking account#1671011074 3,567.38 2 Sovereign Bank Savings account#2894019096 2,769.66 3 Piano,spinet 500.00 q Diningroomfumiture 1,000.00 5 Livingroomiumiture 1,000.00 g Bedraom fumiture 500.00 � Morgan Stanley Smith Bamey IRA account#341-907022-550 22,925.51 TOTAL(Also enter on line 5, Recapitulation) � 32,262.55 If more space is needed,use additional sheets of paper of the same size. � - � � � �Sov�`reigri 5t�ement Period 08/U7ti2 Td 09fO6t12 PREFERRED CHECKING For your convenience our Customer ContaaC Center is availabie irom 7 am-8 pm EST,7 days a week. CaH u&at t-877-SOV-6ANK{1-877-7fi$-22fi5}. Nearing impaired may ca�l 1-800�28-9'I27 (TTVJTDD). www.save reignbank.com OD000586 MSBT3778096 Oi 0006 TMERESA G MUNS4N q 6 6 0 10460 33 CAMBRiDGE CT CARLISLE PA 17013-2733 n0003t187 ���- °� ���� �2i 3��4p;��P� ' �'� . � 'S� �Y�'A. :Y� � t .i'[�J �x ��E �{� .��� w �t the Maney Yau Need j`x`�`��� � '= t �� �at Rates and More Flexibility � s �: �. �%e.,� � � ...� 3 � � � fi O T 4� o � ' ' �� ' �1�� *+���." Get grea#er financial flexibility and control aver your � �:�� " ;a �" ' ' borrowing needs with a Sovereign Personai line af � o ,��� � �-"< <. � Credit ot Laani o h,,�d ey M�l n�'w i 'f . . � '�"� "�5 "�'�'' Features & Benefits: b ;�� ` � �,. a �,�,� � � • Interest rates are tompetitive and Iawer than n�ar7y " "� " �°� ' credit cards o �" ��,�} � ���� � . � � �. ,���`` ' � �' : • No collaterai required m ��,s >�` �� �4 �` ` • Use your line or loan for just abaut anything: travel, � a�(.sd�`x r`.' ���' n �'Y� r�� �, ��' C�2bt COIl50�IC�dYlq11, Ill@(jICB� 2Xpe1152S, IT1dJOf pUfCf12525 v ". r �'k� � .; � n. . m �rt W ' 3 �.,#}. �v� 1 � �� �: �� �� ��� like appliances or furniture, a�d moee. � ` � * xe�� ���" � '" ' �� �+: � '�"�����" 1 To apply, stop by any Sovereign Branch, � , ta1) 1.877.4.50V.lClAN,or visit sovereignbank.com. >> . ; �,. ;s�,:,= r �*; ,r�- .. . ��a� Try Sovereign IdentityPratectarSM far 3(} days for just $1 �, This powerful suite of services warks to deted, intercept, resolve,and help prevent identity e �� theft. Get the identity fraud protection you need with Sovereign IdentiiyPratector`". �: �'-� A monihly fee of $14.99 will begin after your 30-day trial is complete, unless you call ` to tancel at 1.866.999.p427. peace af mind in 4 easy steps!To find out more,stop by a Saxe�n Branch,v�sit us at ' sovereignbank.com/idenfttyprotector or call 1.866.999.0634. ���«� � ,:�; . sovrtcm ea�k,u.n Is z Memtel Fn�c ana a vmo�ly ovmee.�bsie>y o�6anw saMa�acw,s n.o x�l smxrvp� 9ank.N R I��erclgn a�tl Sanlaitler a�tl Ils lago ae reOMeretl Iratlemak6 M Swnspn 8aik,N A aid PR�C. lO.f3 �� a�.+ws�r eecsn.��r.�r.«ureo-arcuae:aswsw���mme�maaas�ae:saaner��,�nas 167L1)t1074 THERESA G MUNSON Deposit Accounts Account Number Averege Daily Balance Current Balance STATEMENT SAVINGS 2894079096 $2,769.48 $2,769.66 Total Deposits 56,337.04 THERESA G MUNSON Acco�nt#167f01f074 Balances De sits/Credits +$2587.87 Avera eDail Balance $2,34728 Interest Eamed this Period $0.02 Paid last Year $0.78 'The interest earned and the interest paid may differ depending on when interest is credited to yow accoun[. Checks Posted Check# Date Paid Amount Refemnce Chxk N Dale Paid Amount Refercnce 798 08/17 $37.50 982867610 3 Check�s)Posted=5704.60 An asterisk(')indirates a skip in sequential check numbers. An(E)indicates check was converted to an elechonic item. Account Activity Date Description Additions Subtractions Balance OB-07 B inning Balance $2,775.94 08-07 DELTA DENTAL AUG 12 EFT080612 $30.62 $2,66778 0004 619 OB-09 DEBBIE JOHNSON ONLINE PMT720809� $300.00 $2,323.68 F 8728074P S OS-77 CHECK000000000798000000000798 $31.50 $1,992.18 OB-23 DEBBIE JOHNSON ONLINE PMT120823 $300.00 i $1,657.18 C 8787 P S 0830 DEBBIE JOHNSON ONLINE PMT120830 $300.00 $1 47125 C F 87 80 4POS 0837 US TREASURY 303 XXSOC SEC 083N2 $572A0 � $3,13Z25 ..A 09-04 CARL�SLE CORPORA PENS PMTS SEP 12 $5072 / $3,944.97 004440 09-06 INTEREST CREDIT LESS FED TAX WITHHELD $092 $3,892.38 ��Zofj 16 71 01/0 74 _ �Sovereigri � Account Activity (Cont.for Acct# 1671011074) Dffie Description Additions Subtractions Balance 0.00 09-06 Ending Balance $3,567.38 THERESA G MUNSON Account#2894019096 Balances De osits/Credits +$0.19 Avera eDail Balance $2,769.48 Interest Eamed this Period $0.19 Paid Last Year $4.18 'The interest eamed and the interest paid may diHer depending on when interest is credited to your account. 0 o Account Activity �°, Date Description Additions Subtractions Balance b08-07 Beginning Balance $2.769.47 0 0 0 � 09-06 Ending Balance $2,769.66 b 0 0 u o IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR F.LNCTRONIC TRANSFERS °w CAI,L YOUR CU57'OMF,R SERVICF,CENTER AT'!HG NUMBER SHOWN ON THE TOP OF YOUR STATEMENT OR WRIIE TO THE BANK 3 � FOR DF;Ri"I CARD ISSUES: FOR ALL OTHER ELF.CTROMC TRANSFER ISSUES: � Sovereip�Bank Sovemig�Bank � Atrn:Card Disputes Team Avn:Client Relations � MAI MB3 02 OS 10-421-CRI � P.O.Box 831002 P.O.Box 12646 o Roston,MA 02283J002 Reading,PA 19612-2646 0 r. Pleau contact us if you think information about an olectronic trens&r on your statement or receipt is wrong or if you need addi[ional into�mation about n an elecVOnic transfer on�he statement or mceipG We must hea[from you no latee[han 60 days aIler we sent you[he FIRST stamment on which the � error appeared. W • Tell us your name and account number. •Describe the clect�onic tmnsfer ertor or the elect�onic vansfer that you are unsuro about and • Tell us the dollar amoun[of[he suspected er�or. txplain as cleady as you can why you btlieve�hem is an c�mr o�why you need turthec miormation. If you iell us orally,we may require you to send your complaint oc question in writing within 10 business days. We will promptly investigate the matter and cell or write[o you with an enswer wi[hin 10 business days.If we necd mom time,we may[ake up ro 45 days to imeshKate your complaint or question.If we do,we wdl cmdit your accoun[within this 10-day pcnod fo�the amoun[you ihink is in error�so you wdl have the use of the money dueing the time it takes us to comple[e ouc investigatioa If wc ask you to put your complamt or question in wuting and we Ao not reccive if wi�hin 10 busincss days,we may choose no�to cmdit your accounl. Fo�eerors involving new accounts,point otselep�chases oe foreign t�ansections,we may take up to 90 days to investigete your complaint oc questiort For new accounts,we may take up m 20 business days ro cadit your account for the amount you ihmk is in ermr. We will tell you the msults of our imes[igation within 3 busicess days after compieting our investigation.If we decide them was no error,we will � senA you a wnuen explannriort You may ask for copies of Ihe dowments we used m our�mesnganon. IN CASF,OF F,RRORS OR QUESTIONS ABOUT OTHER'CRANSACTIONS ON YOUR STATEMENT You must contaa us within thirty(30)days alter you receive your statement if you think a transaction,oNe�[han an ekctmnic transfer,shown on your statement is wmng o�i(you need mo�e info�ma�ion abou[ihe iransection. You may contact your neaas[branch or ou�Customcr Con[act Cen4r at 877-SOV-BANK Customers with hearing impai�menls may call 500-428-91 L (TTY/TDD). We will invesligate you�dispu[e and lell you�he rosul[s of Iha�imesligation. paRe3 oj3 1677011074 __ —_ o � O � � N • � � � O tltS .�" � 1� 6i � � C � �i �. � S9 y l" �}`�;4'j.: (V �' U aa �� � E� �Ta T N � C i ' 9 t ;fi����'��� E m '��5�'N't`+1: f' C � � i Z ✓ � G S � � m 5 3 � #� �m � O a � � E ���.?�+;,a� �, p y ¢ � y�„ ��`ist � ', � � -`- � cs.� Te T iLS ' �`�} o"�- Q � '�Lg c y � � r p; �.� N p � � d 'u'�n 'g m �r m d °'_ •; �e g � (C� '�i'i,'�'� w 7 � �e Z m o 0 .�J � }1 '.� .� N" � C r �1 N Q c- m � � O '�i�^3G � L1. �' � �r C � '�i't� ,c � M jQ� g ' � �r � �; � ��, a Q� �, '�d �. � �yir � p� � �'G Y� 3�i r f- �'0'}w� t:,?�t�`� !n� � i �.' i u� � � . 3 . �z t �: v a ; �t �� , � �� r 3� i �{g ts"tat fz};. at . i } ����s ' ��t��*���k Ci u . . a a � i,�n, m N O k � � O � ` � y N �qi� � }y C N N j � ' M � � tq � ?rw4s:' M� � �� g m rN $g s �a m w E �'' � �ra zs 5 W � � �, ttt � Cq+ `G � � � O y'� i i��`- 2 a � � O O M m C W u � A � j; ,: N � � tr-� � �.M., N � o fP ' 'o � � v� ;:���ry � Z W ,Wjd � QO �� ,rQ o a+ e 6. �; � n �. � Ve ,1 aa rw � � �pU � E � °' ,i t pa w = � .� � N � � a� t, 1— � d � r � u; m '�5�.Y .. t9 � �y �+ SZ � �;' [ii o- i ,.� cO ..� {g W 2 � i r" w p ° ,`�e ¢ �'� tt;� 3, W Q J °� � '�2 m°, 5' �3 w S` `n ;'Fi' 1' tz ^ K c.7 5 .— 4V�' ¢ u�- � '. sjj�si W d Y N Y z �� 'S!, & z 2 M c? 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L O� E W �A C A � aF � 6L � H N u�. S TN L O y y ? € Oi� 'O U "r'J ii J ":� a:;' '� �L � � c $m � ..�, `o `m u � d � �C c E � E Y m � c m 5 �0 2 � `u 'Ot c � $ � �� � V :'RiiE r?>"� � E °�n' H m° a v�i � E o c� uai v`�'i a� n 1O n 3 ° � °u E o 5 o m 3 E ¢ ,Sn ¢ �' ° �'�' �' 'w $ °. HEV-i5o9 EX+(ot-io) � pennsylvania SCREpULE F DEPAPTMENT OF PEVENUE INMERITANCETRXRETURN ]OINTLY-OWNED PROPERTY RESIDEM�ECEDEM ESTATE OF: FILE NUMBER: THERESA G. MUNSON If an asee[became ioiMly owned witldn one year of the deceden!'s date of death,It mus[be reported on Schedule G. SURVMNG JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A.Charies D. Munson 4400 Cactus Hills Place, NW Son Albuquerque, NM 07114-5386 e•Hedy M. DiSimoni ' S01 Ewing Street Daughter � Princeton, NJ 08540-2705 G ]OINTLY OWNED PROPERTY: tEnet Dn7E DESCRIFfION OF PROPERTY %or DAre OF DFAn� IiEM FOR]OINT MADE INCLU�E fUME OF FINRNNL QISiIMION AND&JIK ACWUM NUMB9l OR SIMIWI �AIE OF�FA7H DECEDEMS VFLUE OF fiUMBER TENFNf ]OIM IDENrtFl7NG XUMBER.qTTqp7�EED FOR JOINRY HEID RFAL 2�TAlE. VFLUE OF qSSEf INTEREST DKEDBlfS INiE0.ESf 1. 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O ( °-Q'' g a J (� t� �� N t", O O p mQ � t r` � � �7 C G 4 Q � Q ~ �" �- 'p F ., �:� m y N y O C $ �1 a � f�� '� � � � � Q Y Y � '2 t C"�(z'x,���� LI~.. t�'� �� �� y,`6' hh� ,n,'�,� ,.S� m �-¢ -_. �� 4�,} � �7'�f't't' F,. f'j,�..�E �1 C� 2 ti#, rka! � z x - � � ���}r� '� �''' � '°, � o �� ty �??s.-�f,�� t 1-+ y � a � � �sr���' c y�i � � � y ou � L� ` V7 F� 41�' � F. .0 � u O �+ � � �. N+ p ` W w �� +���� Y �{; � S d � f. J P� ,�.' � q� " Q ti g'.n � w2 � `;` q� h r- Q �O . ...�., .. o W � O ti �Q � 2 �!y O� 6 � < REV-1510 E%+(98-09) � pennsylvania SCHEDULE G oevnr+.Me�roFReveHUe INTER-VIVOSTRANSFERSAND INHERITANCETAXRETURN MISC. NON—PROBATE PROPERTY RESIDENrOECEDENT ESTATE OF FILE NUMBER THERESA G. MUNSON This schedule must be completed and Flled if the answer to any af questions 1 thraugh 4 on page three of the REV-I500 is yes. DESCRIPTION OF PROPER7Y DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE REM �NQUOETHENhMEOFiXE1MN5FEREE,iHE1RAHR10N5HIP10U��EMPX� NUMBER iNEDAlEOfiRANSFER. ATTROIPCO%OFiHEDEEDPoRRFALESTATE. VALUEOFASSET INTEREST �r�rww� VALUE i. Sun Life Insurance Company oi America Mnuity Contract#A0089105801 � 30,000.00'� 100 30,000.00 � 0.00 TOTAL(Also enter on Line 7, Recapitulation) $ � 0.00 � If more space is needed,use additional sheets of paper of Me same size. SUN LIFE INSURANCE COMPANY OF AMERICA (Hereinafter called Th@ Company) 260 Peachtree Street, N.W. Atlanta, Georgia 30303 � This is a SINGLE PREMIUM DEFERRED ANNUITY POLICY.It is issued in consideration of the application and the payment of a Single Premium. 10 DAY RIGHT TO EXAMINE POLICY—This Policy may, at any time within 10 days after its receipt by the Owner, be returned by delivering or mailing it to the Company or to the agent through whom it was purchased.Immediately upon such delivery or mailing,the Policy will be deemed void from the beginning, and any premium paid will be refunded. Signed for the Company on the Issue Date of the Policy. !� �J � „ �rt�ln.✓l / <(�� Secretary President PC-301P Page 1 62892-PP10 TABLE OF CONTENTS PROVISIUN PAGE PROVISION PAGE Annuity Option Provisions 9 Definitions 3 Annuity Provisions 4 General Provisions 4 Cash Surrender Provisions 6 Table of Guaranteed Values 7 Death Benefit Provisions 8 Partial Withdrawal Provisions 6 I , PG301 P Page 2 62892-PP10 ANNUITANT: THERESA G MUNSQN CUN7RACT NUMBER: A0089i05�01 SiNGLE PREMIIIM : #2C,CCO,OC ISSUE DAT€ OF TNE CdNTRAGTs MAY 03• 1989 KET SIkG1E FRE�IUM: S20,OOO.OQ SEX ARG ISSUE AGE DF GUARANTEFQ MINI!!UN ANN�ITANT: FEMAIE — b4 IN7ERES7 RATES: ANNUIT� CGMNENCEMENT ALL AGLI£Y YEAAS 4.OQ$ CATE: 12117I194k 10 YEAR CERTAIN AN� LIFE MONTHIY iNtOMf A7 ANNUITY CUMNfNCEM€NT GATE. PER 3isD0U QF NET SIN6lE PREMIU�s 8A5ED GM GUARANT€EU MINIMUM INTEREST RATES: t8.83. tC+t�' ��_ . . ,�xa� � � , f�: E „ . . h !_ . . :� _ � = t ; ��� . . �. • �� . V� � . . - . � . � _ . .. . . . -i � . , . . tin�jwij .H� `°. a � 3ttM1 • ` '.. 'J�.; . . _ . � iC � . . . .. . ! { � ,.:a , � i . . _ . .. . ' .. . . . ., . .. , .. -L � . . . . . . , � t�' , . � � . 'i;a � i l : i ,. . . ' . �. . ' �"� ) � ! , ..,a ✓ L i )i Q A. � i'�fi : )A f '( .f': ' 1 . . _ ��d- ' � ; - . � . � _ . . " l. .. - . _ . n �F r ` A � !:it i i,: !. . ,. � . . , . � � . , . . � . � � -� .. . . i _ .. , : ___ ENDQRSEMENT The foilowing Provision is added to the policy: GUARANTEE 4F PRINCiPAI if you elect to surrender this Palicy,the Rroceeds payabia on surrender wili be at ieast equal to the Cash Surzender Value,less the amount of any partial withdrawals and partial annuity elections.This amount will be at least equal to the Single Premium you paid tess any previaus partiai withdrawats and amounts applied ta a partiai annuity eiectian,where,for ihe purposes of this provision, no interest will have been considered credited to the Single Premium,nor added to any partial withdrawal. This endorsement is attached to and made a part pf the policy as pf the Issue Date af the policy. SUN LtFE INSURANCE COMPANY OF AMERICA ,��'�>�`^"t ,� President E-328 62945-Et , , ENDORSEMENT TO POLICY The following provision is added to the policy: SURRENDER CHARGE WAIVER PROVISION The Surrender Charge specified in the policy will be waived for a period of 30 days commencing on the Policy Anniversary when and if the declared interest rate for the upcoming policy year is below the lesser of: A) 1 1/4% less than the initial interest rate credited to the policy, or B) 1 1l4% less than the interest rate credited to the policy in the previous policy year. During such 30 day period,the Cash Surrender Value will equal the Annuity Value. This endorsement is attached to and made a part of the policy as of the Issue Date of the policy. SUN LIFE INSURANCE COMPANY OF AMERICA �r<%(n✓/ � �'ay� President E-331 62754-E-1 � ENDORSEMENT Any reference to PREMIUM TAX in this Policy is hereby deleted in its entirety. This Endorsement is attached to and made a part of the Policy as of the Issue Date of the Policy. SUN LIFE INSURANCE COMPANY OF AMERICA ��f�� � .." � � ��C� President E-353 DEFINITIONS AGE is age as of the last birthday. ANNUITAN7 is a natural person shown on the Policy Schedule whose life determines the annuity benefits underthis Policy. ANNUITY COMMENCEMENT DATE is stated in the application and is shown on the Policy Schedule.This is the day we will start annuity payments if the Policy is still in force. ANNUITY OPTION PROVISIONS are the choices offered by us under which,upon written request,we will pay any proceeds due under this Policy in periodic payments. BENEFICIARY shall be as named in the application or as changed by written request signed while the Annuitant is living. Any change will take effect on the date it is signed,subject to any action taken or payment made by us before the request for change was recorded at our Administrative Office. CASH SURRENDER is the process by which the Owner terminates the Policy and receives the Cash Surrender Value from us. CONTINGENT BENEFICIARY is the person named in the application or as changed by written request signed while the Annuitant is living who becomes the beneficiary upon the death of the Beneficiary.Any change will take effecton the date it is signed, subject to any action taken or payment made by us before the request for change was recorded at our Administrative Office. GENDER used in this Policy will be masculine, unless the reference is to a female. ISSUE DATE is the date of receipt of the Single Premium for this Policy at our Administrative Office.This date is stated on the Policy Schedule. It is the date from which Policy Years and Anniversaries are measured. In measuring any time period, the first day will be included and the first day of the foilowing period will be excluded. NET SINGLE PREMIUM is the Single Premium received less any premium tax. NON-PARTICIPATING means a Policy under which no dividends from surplus are paid. OWNER means the Annuitant unless otherwise specified in the application or as changed by written request.The Owner may,subject to the rights of any Irrevocable Beneficiary or Assignee,exercise every right and option provided in this Policy. Unless otherwise designated in the application or in a later written request,the Beneficiary will become the Owner of this Policy upon the death of the Owner. PARTIAL ANNUITY ELECTION is the process by which the Owner may apply a portion of the Annuity Value to an Annuity Option prior to the Annuity Commencement Date. PARTIAI WITHDRAWAL is the process by which the Owner may withdraw a portion of the Cash Surrender Value. The written request for a partial withdrawal must be received:(a)during the lifetime of the Annuitant,and(b)before the Annuity Commencement Date in effect, subject to Poiicy Provisions. PREMIUM TAX is the amount of state premium tax, if any, imposed on this Policy. PROCEEDS means any amounts paid by us because of death, Surrender,or the Commencement of an Annuity. RESTRICTED OWNERSHIP means this Policy may not be transferred,sold,assigned,discounted,or pledged as security for the performance of an obligation, or for any other purpose,to anyone other than us, if: 1. This Policy is issued to qualify under Section 403(b)or 408 of the Internal Revenue Code; 2. This Policy is issued to qualify under the Self-Employed Persons Retirement Act of t962; 3. The Annuitant becomes the Owner upon termination of his employment under a plan defined in Section 401 of the Internal Revenue Code, unless the Owner requests otherwise at the time of transfer;or 4. Restricted Ownership is requested in the application. SINGLE PREMIUM is the sum of money in United States currency paid for this Policy. It shall become part of our general funds.If checks,drafts or money orders are used in remitting such payments,they must be currently dated and made payable to the Sun Lite Insurance Company of America. PC301 P Page 3 62892-PP10 Otdd-Z68Z9 b ab�d d 106-�d E�o Z uoildp�(;inuuy aapun apew eq o�a�e sluaw�(ed�i�(epyli!q y1�5 s,luellnuuy ey�ol�o!�d�ou `uoildp�3!nuuy�ue�apun apew aq o�sivaw�(ed�o� �(epyuiq 4198 s,�uel!nuuy ayl ueyl aalet aq a�ep luawaouawwo��(llnuuy ayl uso luana ou u� loa�a ui alep�uawaouawwo� �(linuuy ay� ol �oud s�ap �e isea� �e paniaoaa aq lsnw lsanba� yang aoi;;p anil��isiuiwpy ano �e paniaoa� isanbaa uall!�M�(q pal�a�e aq�(ew a�ea luawaouawwo�l�inuuy ani�awall��d'31V41N3W3�N3WW0�AlIf1NNV d0 3JNVH� •uoila�osip sl(lE 's�ol�a�id;o p�eog�no�(q pa�epap aq�(ew aled lsa�alu� wnwiuiw paalue�en�ay�;o ssaoxa ui lsaaalu� �o�oq si�toi�od siy��o�aley lse�a�u� wnwiuiW paalue�en�ayl 'S31tlFi 1S3d31N1 WfiWINIW U331NVliVf1J SNOISIAOad AlIf1NNb� �uawu6isse�(ue ol l�afqns a�e�aunnp ayl{o sl!�auaq pue suoildo`s146!�IIV'luawu6isse ue�o�(ouaioi;;ns�o�(�ip��en ay��o�a�qisuodsa��ou a�e aM�sn�(q pepaooa�si�(doo pei�iva�e ao luewu6�ssa�eui6��o ay�uayM�(�uo sn uo 6uipuiq aq��iM luawu6isse uy aaunnp ayl�q peu6isse aq l�ew 1!)o ued�(us�o�(oi�od siy�'�oa;�e ui si uoisinad diys�aunnp pal�!ASay ayl ssal�fl'1N3WNJISSV a�qel!a;�o;uou si pue sai�eioi;auaq siy pue luel(nuuy ayl ;o 1ltauaq anisn��xa eyl �o} si �toilod S!41 '1S3kl31NI 319V113�liO�NON �sailue��enn lou pue suoil�luasa�daa paaapisuoo a�e uoi�eoi�dde ayl ui apew sluauaa�els Ile �pns�;}o a�uasqe ay�ul 'l��aluoo aailua ayl wao}payoea�e uoil��Jdde ay�;o�(doo s pue Roi�od s�yl'l�tll11N0�3HIlN3 sluaw�(ed �3lnuue�eila�d 6uiuiswa��tus;o lualxa ayl ol�de�xa aleuiw�al II!M�(�!lod ayl'aapua��ng yse�ayl;o awi�ayl le l�a;;a ui senn uogoal3�3!nuuy�eiusd e;��pion pue��nu aq��inn�(oi�od siyl�o suoisinad��e`an�e��apua��ng yse�ay110�uaw/ed pue �apua��ng yse�e�a��y�sn ol pauanlaa aq lsnw�(�i�od siyl'�apua�mg yse�e slsanba��auMO a4�11 'H30N3Hdf1S HSt/� snne� yons{o s�uawa�inba� wnwiuiw ayl o� wao�uoo ol papuawe si a�els yons;o snne� ayl ylian�oiguoo ui si 'a�ea anss� ayl uo `yo�ynn�(oi�od siy��o uoisinad �(uy�pe�an��ap si 1!y�!yM w alels ayl)o snne�ayl�apun pa�a�d�a�ui aq��inn�(oi�od s�yl'SMtll31tl1S HlIM AlIWliOdNO� �saolipaao�o swie�� o�loafqns aq ��eys�(oi�od siyl aapun 1!{auaq�o�y6u ou �snne�a�qeoi�dde�(q palllwaad lualxa ayl ol'SWltll�1iO11U31i� �uaw�(ed yons yoea;o lualxa ayl ol�3!I!qe!I�no a6�eyosip��eys uoi�dp/�3!nuuy ue�apun sn!q apew s�uaw�(ed/�uy pied i!;aua8 yl�aa ao an�e�aapuaa�ng ysa��(ue�o�ua�xa ayl ol�1!I!qE!I Ile wa�pa6�eyosip aq II!M aM 'AlIll9Vil d0 3�dtlH�Sld �oua�ano sa1�1S Pa�iu� ui aq��in�pue�oayo Rq a�qe�(ed a�e sn Rq sluawRed IIV'ANVdWO�3H1 A91N3WAtld �uos�ad�aylo�o lua6e us/q apaw sauawalels�(us Rq punoq aq�ou��inn aM �oi�od siy�;o sw�al ayl anienn�o a6ueyo ol Pazi�oylna si�t�ela�oag ao 'ivapisaad aoi�e'luapisa�d ano�(�up �sanbaa uaAI�M Rq apew aq�snw Roi�od siyl)o swaalay�ui a6ue4���b"S3�NVH� SNOISIAOad ��da3N3J £OEO£ �!6�oa�`elue�ly M'N 'laa��g aa��yoead 09Z d�IFl3WV �OI.NVdWO�3�NtfdflSNl 3�I1 Nf1S aoi�;p ani�e�isiwwpy mo�e paniaoa� pue `sn o��(�o�os;siles w�o�e ui 6ui�i�nn ui lsanba�e sueaw 1S3f103F!N3111HM e�uawy;o�(uedwo�a�us�nsu� a;i� ung ayl sueaw Sfl Pu�`Hf10 `3M DETERMINATION OF ANNUITY VALUES.The Annuity Value wiil bethe Net Single Premium received pius accrued interest and adjusted for Partial Withdrawals and Partial Annuity elections.Interest will accrue from the date the premium is received at our Administrative Office to the earlier of:(1)the Annuity Commencement Date,(2)the date of Cash Surrender,or(3)the date of death of the Annuitant or Owner,whoever dies first. On any date that a Partial Withdrawal is made or a portion of the Annuity Value is apptied under a Partial Annuity Election,the Annuity Value will be adjusted as defined in the appropriate provisions. PREMIUM TAX. In the event that a premium tax is imposed on the Single Premium as of the Issue Date, such tax will be deducted from the Single Premium to calculate the Net Single Premium. In the event that a premium tax is imposed after the Issue Date,such tax will be deducted trom the Annuity Value at the earlier of: 1. the date such premium tax is due;or 2. the date that the Annuity Value is used to determine the value of annuiry payments,any proceeds payable upon death, or the Cash Surrender Value. AUTOMATIC ANNUITY COMMENCEMENT DATE.The Annuity Commencement Date is the date stated in the application when annuity benefits are to commence. In the event no Annuity Commencement Date is specified,the automatic Annuity Commencement Date will be the Policy Anniversary immediately following the Annuitant's 65th birthday. ANNUITY PAYMENT. Annuity payments are payable to the Annuitant unless otherwise designated. The first annuity payment is payable on the Annuity Commencement Date.The amount of each annuity payment will be determined on the basis of: 1. the Annuitant's sex and age on such date; 2. the Annuity Vaiue on such date;and 3. the Annuity Option selected by the Annuitant. Except for minimum guaranteed payments under an Annuity Option, it is a condition precedent to the payment of each annuity payment that the Annuitant is alive on the date that such payment is due.We may refuse to make an annuity payment until we receive satisfactory proof that the Annuitant is alive. Annuity payments will be computed using the 1971 Individual Annuity Mortality Table and interest at the guaranteed rate of 4% per annum. Prior to the payment of any annuity benefit under Annuity Options 2 or 3, we will calculate an alternative annuity benefit amount using our then current Single Premium Immediate Annuity Purchase Rates. This procedure is set forth in the Alternative Annuity Option Provision of this Policy. Annuity payments will be withheld until we receive evidence satisfactory to us of the Annuitant's sex and birthday. If the sex or age of any person receiving benefits,or any other fact determining benefits has been misstated,the annuity benefits payable shall be such as the actual Annuity Value would have purchased, determined by the correct sex, age, or fact, according to our rates in effect on the date that annuity payments were determined.Any overpayment or underpayment by us,with interest at the guaranteed rate of 4%per annum,compounded annually,shall be charged against,or added to,the payments to be made after such adjustment. CHANGE OF ELECTION OF ANNUITY OPTION. At any time during the AnnuitanYs lifetime and before the Annuity Commencement Date,the Owner may elect,revoke,or change the Annuity Option underwhich the annuity payments are to be made.The Owner must send a written request of such election, revocation,or change.We must receive your request at least 31 days prior to the Annuity Commencement Date.When such written request has been recorded by us,it will take effect as of the date the request was signed. We will not be liable for any action taken before recording such request. The present value of the total annuity payments to be made to the Annuitan[under the Annuity Option selected must be at least 51%of the present value of the total annuity payments to be made to the Annuitant and Beneficiary.We will determine such 51%requirement as of the Annuity Commencement Date.It will be based upon the mortality table and interest rates set forth in the ANNUITY OPTIONS PROVISIONS. 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In any case,any remaining amounts payable under a Partial Annuity Election will be paid to the Beneficiary. DEATH BENEFITS AFTER THE ANNUITY COMMENCEMENT DATE.If the death of the Annuitant occurs after the Annuity Commencement Date,then the Proceeds,if any,payable upon death will be as provided in the Annuity Option then in effect. ANNUITY OPTION PROVISIONS GENERAL ANNUITY PROVISIONS The Proceeds used to calculate the Annuity Option benefit will be the Annuity Value. If any annuity payment is less than$20,we may make payments less often in order to make each annuity payment at least$20. If the annual annuity payment would be less than$20,we may discharge our entire liability by payment of a single sum to the person entitled to such payment.The first payment under any Annuity Option will be payable on the Annuity Commencement Date. Additional interest, if any,will be paid in the amount and by the method determined by us. The values for Annuity Options 2 and 3 are based on the 1971 Individual Annuity Mortality Table with 4o/o interest.The values for Option 1 are based on 4% interest. PARTIAL ANNUITY ELECTION At any time during the lifetime of the Annuitant and prior to the Annuity Commencement Date in effect,the Owner may elect to have part of the Annuity Value made payable under the Annuity Options.Any amount applied to a Partial Annuity Election will be deducted from the Annuity Value as of the date such amount is applied.The Policy must be returned to us in order to exercise this option. The right to a Partial Annuity Election is subject to the following restrictions: 1. Any amount applied to Annuity Option 1 must be at least$3,000. 2. Any amount applied to Annuity Options 2 or 3 must be at least$10,000. 3. The amount of the remaining Annuity Value must be at least$3,000. ANNUITY OPTION 1—ANNUITY PAYMENTS FOR A SPECIFIED PERIOD. We will pay the Proceeds in equal annuity payments for a specified number of years.These payments may be on an annual,semi-annual,quarterly,or monthly basis. The Annuitant may specify any yearly period of not less than 5 years and not more than 30 years.The amount of each annuity payment is shown in Table 1. If the Annuitant dies while receiving annuity payments under this Annuity Option,we will pay to the Beneficiary the remaining payments, if any, in continuing instal�ments for the balance of the period specified. 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O K W j Q 'Z T l O �' ui �D ' �°_,a m� : w3a � �w � ' �� �' P—'� mqr •�� c nmp � pw = o �x.?� � . r� . �a � � �c : � o�o � m �... ro3 � � F �� f�J� � ^,� p ��v, �'< w o -i : ^f,s n o m w � : m �r� < �.� 3 o C}w °—' a� ,� c i° � o = ° _�°�o m� a � `�° : �'� � m.ro°' o i v�,'o �'3 `° �$°"c `° m�`° w m -� y ��O � � p D m c� tp m c '� ,'m ? ' ywmo.� ? : �::°•°--. 3o °om� i 3 �. +"v �3 �' �� o��i � 77aro -�_„vZ 'o 3 J'� ta � 0 � @ � nQ � p�'�� : O@ � t'f � 7��� � �'� � ( � if -�.1 = - `�� ?fT . � cmmm� � � w3 W w � y =. ; � p N � ^ -iw ; � 3n�i o C1 p '^^- mpan� y ' cvimc. : v;y ,`c� �. c' � ' c m ,� � � � � � � o «�+�� o d n-.._..�,. �y 1 �. � � ° ;K, .« I 3 �; =.a� �' : � ��b �,L ��?.:,_.�� 6� ��� � D� o'i � O a D � � � .-. Q 2> mm.e, ^' �i,K� N3 � o, i - .� ;° � a � �u� j� eop! m �.x'1 ,K� �KO m . °' w � � mm �+ � `� � � � c. � c � A� A 3 c m � �m .�o ° �1 °—N"°� 3 : � cm � ��m � a3 f.y�'n �:`� � �`c'� � � �,�e � ��.o v a�� � 3 ? � _� �0 3 a 'o N '�` � � °�' w�u'a m : � ci� m �m'�^ i a� mvi� m� � mo �� � o� o � � _. ,°a �-a �,K�� Q C7 Qt D �_:� � ❑ O ❑ I� . j NO GUARANTEED PERIOD. We wili pay the Proceeds in equal annuity payments continuing only during the life of the Annuitant. These payments may be on an annual, semi-annual, quarterly, or monthly basis. The amount of each annuity payment is shown in Table 2. TABLE 2 MONTHLY PAYMENTS PER 51,000 OF ANNUITY VALUE FOR LIFE UNDER OPTION 2 � __ _ _ MONTHLV ANNUITV PAYMENT FOR UFE -- Age of No Guaranteed 10 Years 7 5 Vears 20 VearS ��staliment Annurtant Period INo Fefund Certain Certain Certain Refund on Annuiry Upo��eathi Commencement Date Male Female Male Female Ma1e Femele Male Female Male Female 50 55.13 54 69 55.05 54.65 54.94 54.61 54.81 54.55 54.89 54.57 51 5.22 4J6 5.12 4.72 5.01 4.67 4.86 <.60 4.96 4.63 52 5-31 4.83 52� dJ9 5.08 4J4 4.92 4.66 5.04 4.70 53 5.41 4.92 5.29 4.87 5.76 4.80 4.98 4.�2 5.11 4J6 Sa 5.52 5.00 5.38 4.94 5.23 4.87 5.03 4.78 5.19 4.83 55 5.63 5.09 5.48 5.03 5.31 4.95 5.09 4.84 5.28 4.91 56 5J4 5.79 5.58 5.17 5.39 5A2 5.15 4.90 5.37 4.99 57 5.87 5.29 5.68 5.20 5.4� 5.10 5.21 4.97 5.a6 5.07 58 5.99 5.39 5.79 5.30 5.56 5.19 5.27 5.03 5.56 5.16 59 6.13 5.50 5.90 5.40 5.64 5.28 5.33 5.70 5.66 5.25 60 6.28 5.62 6.02 5.51 5.73 5.37 5.39 5.17 5.77 5.35 61 6.43 5.75 6.14 5.62 5.83 5.46 5.45 5.24 5.88 5.45 62 6.60 5.88 6.27 5.74 5.92 5.56 5.50 5.31 6.01 5.56 63 6J9 6.03 6.a1 5.86 6.01 5.66 5.58 5.39 5.13 5.68 6d 6.97 6.19 6.55 6.00 6.11 5.77 5.61 5.44 6.27 5.80 65 7.17 6.36 6.70 6.14 6.21 5.87 5.66 5.51 6.42 5.93 66 7.39 6.54 6.85 6.29 6.30 5.98 5J1 5.57 6.57 6.07 67 7.63 6J4 7.01 6.45 6.40 6.10 5.75 5.63 6J3 6.22 68 7.88 6.96 7.17 6.62 6.49 R.21 5.79 5.69 6.90 6.39 69 8.15 7.20 7.34 6.80 6.58 6.32 5.83 5.74 7.08 6.56 7G 8.44 7.46 7.51 6.98 6.67 6.43 5.87 5.78 7.27 6.74 71 8J6 7J4 7.69 J.1B 6J6 6.54 5.89 5.82 7.48 �6.94 72 9.10 8.05 7.87 7.37 6.84 6.64 5.92 5.86 7.70 7.15 73 9.47 8.39 8.05 7.58 6.91 6.74 5.94 5.89 7.93 7.37 74 9.97 8.75 8.23 7.78 6.98 6.83 5.96 5.91 8.18 7.61 75 10.30 9.15 8.41 7.99 7.05 6.97 5.97 5.93 8.44 �.86 The amount of each quarterly, semi-annuel end annual ennuity Dayment may be determined by multiplying the amount of the mon�hly annuity payment by 2.99. 5.95 and 11.79, respectively. 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MUNSON Decedent's debtc must be reported on Schedule I. ITEM NUMBER DESCR[PTION AMOUNT a. FUNERAL EXPENSES: 1' Hoffman Roth Funeral Home 2,216.02 2. Royer's Flowers 58.29 3. Luncheon at Comfort Inn&Suites 801.33 - 4. Lodging at Fairfield Inn 8 Suites 156.96 5. Priest(Fr. Schlaline) 250.00 e. Organist 150.00 �. Lector and altar servers 115.00 B. ADMINISTRATIVE COSTS: 1. Personal RepresenWtive Commissions: Name(s)of Personal Representative(s) Street Address _ ._ City State Z[P____.__ Year(s)Commission Paid:_ 2. Attorney Fees. . . 3. Family&emptian: pf decedenPs address is not the same as claimant's,attach explanatianJ . . Claimant Street Address City State ZIP_ Relatiunship of Claimant to Decedent __ .___. 4. Probate Fees: 323.50 5. AccounWnt Fees: 6. Taz Retum Preparer Fees: $5.58 �. PropertyMaintenance 8,124.03 Propedy Appraisal 350.00 TOTAL(Alsa enter an Line 9, Recapitulatian) ; 12,630.71 If mare space is needed,use additional sheets af paper af the same size. � --. rt PROM: Divers�ed Appraisal Services 35 E. High Street, Suite 101 INVOICE DAiE REhERENCE Cadisle, PA 17013 020472M 0?J04/2013 Phone: (717)249-2758 Fax (717)258-4701 TaxID Number206-36-6731 T0: Hedy DiSimoni DESCRiPT10N pMOUNT 30 Cambridge Court '�, 350.00 Cadisle,PA 17013 I i (Estate of Theresa Munson) I, .. . S� hlL ���� l ,� ', � F�� �� � ��� � � SUBTOTAL I 350.00 Rate % ADJUSTMENT I SUBTOTAL �I 350.00 Rate % ADJUSTMENT �I SUBTOTAL I 350.00 TOTAL = 350,00 Diversified Appraisal Services Farm D2NIN—"WinTOiAL"apPraisal saflware by a la made,inc.—1-BOGALAMODE __ _ REV-3532 EX+(12-32) j'�jpennsylvania SCHEDULE I � DEPARTMENTOFREVENUE DEBTS OF DECEDENT, [NHERITANCETA%0.ETURN MORTGAGE LIABILITIES &LIENS 0.ESIDEPfr DECEOENT ESTATE OF FILE NUMBER THERESA G. MUNSON Report debts incurred by tha decadent prlor to daath thM remalned unpeid at the dah of deeth,includinq unrcimbuned medicel e�enus. ]7EM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Property Taxes payable on 33 Cambridge Court,#33,Carlisle,PA 17013 2,354.80 2. 2012 PA State Income Taxes payable for Theresa G.Munson 128.00 TOTAL(Alsa enter on Line S0,Recapitulatian) ; 2,482.80 If mare space is needed,insert addftional sheets of the same size. REV-7513 E%+(01-19) . pennsyl�ania SCHEDULE 7 INHERITANCE TA%RENRN BEN E FICIARIES 0.ESIDENT DECEDENT ESTATE OF: FILE NUMBER: THERESA G. MUNSON RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRE55 OF PERSON(S)RECEIVING PROPERTY Do Not Llct Truatee(s) OF ESTATE I TAXABLE DISTRIBUTIONS[Include outright spousal distributions and transfers under Sec.9116(a)(1.2).] 1• Chades D.Munson,4400 Caclus Hills PI.NW,Nbuquerque,NM 87114 Son 50% 2. Hedy M.DiSimoni,501 Ewing St.,Princeton,NJ 08540 Daughter 50% ENTER DOLIAR AMOUNTS FOR D15TRIBUf10N5 SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. � NON-TAXABLE DISTRIBUTIONS A. SPOUSA�DISTRIBUTIONS UNDER SECf10N 9113 FOR WHICH AN ELECf10N TO TAX[S NOT TAKEN: 1. . . . . . . .. . . B. CHARITABLE AND 60VERNMENTAL DISTRIBUTIONS: 1. . . . . . .. . . . . . . . . . . TOTAL OF PART II—ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SFIEEf. # If more space is needed,use additional sheets of paper of the same size.