HomeMy WebLinkAbout10-16-13 ®® �pp �g 1505610143
RE VA 5®® EX(02-11) 'f "{
OFFICIAL USE ONLY
PA Department of Revenue pennsylvania Goumy Coda Year File Nvmbar
Bureau of Individual Taxes °eP°""""'°`"sva"°`
PO 60X.280601 INHERITANCE TAX RETURN 21 13 0066
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
11 28 2012 07 23 1920
Decedent's Last Name Suffix Decedent's First Name MI
VON BERGEN ROBERT W
(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 FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
1. Original Return ❑ 2. Supplemental Return Prior Return❑ 3. n(Date of Death
Prior to 12-13-82
4. Limited Estate 4a Future Interest compromise ❑ 5. Federal Estate Tax Return Required
❑ (data of death after 12-12-B2)
Decatley o f ell)Testate T Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
6 (Attach Copy o
' (A C ❑ (Attach Copy of Trust)
❑ 9. Lifi adon Proceeds Received ❑ 10.Spousal PDV.%Gredit{Date of Death 11.Election to tax under Sec.9113(A)
9 between 12-31- 1 and -1-95) ❑ (Attach Schedule 0)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED,ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number -
EARL RICHARD ETZWEILER 717 @4 5600 : ::E1 I�
-r, _ ez
REGIST OF WILLS USE ON+Y-D
D t)7 U ED
First Line of Address T U� %x _ C o
105 N FRONT STREET n ❑ ❑ i
c� C
Second Line of Address ry r ITt
k+ W U)
DATE FILE
City or Post Office State ZIP Code
HARRISBURG PA 17101
I
retzwe ller @COmCast net
Correspondent's e-mail address. .
dules and statements,and to the best of my
Under penalties of perjury,I declare that I have examined this return,including accompanying sche -knowledge and belief,
it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
�IGN`TU E OF PERSO/N�RESPONSIBLE FOR FILING RETURN GATE
&412 Ai, 1 a L��6 (� J Jane Catalano (Bishop) GI 1 I 1
fADDREtA
11 Wild Rose Lane Mechanicsburg, PA 17055
SIGNATURE OF P ARER OTHER THAN REP ESENTATIVE DATE
Earl Richard Etzweiler
ADDRESS ✓�
105 N. Front Street, Harrisburg, PA
i Side 1
1505610143 1505610143 s$��V
1505610243
.J
REV-1500 EX
RECAPITULATION
1. Real Estate(Schedule A)-.........__......... .......... ........ .......... . 1 130 , 000 . 00
2, Stocks and Bonds(Schedule B)......... ................. ............. ................................ 2. 42 , 896. 70
S- Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C)......... 3.
4. Mortgages&Notes Receivable(Schedule D)........................................................ 4.
5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)............... 5. 58 , 434 . 63
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6.
7. inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) D Separate Billing Requested. 7, 74 , 606 . 05
S. Total Gross Assets(total Lines I through 7)..._.._..._.....__......._.._ 305 , 937 . 38
9. Funeral Expenses and Administrative Costs(Schedule H)....... ........... ....... 25 , 751 . 79
10, Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1).........._...._....,..... 10. 25 , 460 . 88
11. Total Deductions(total Lines 9 and 10).........._,_.............. ...................-.......... 11, 51 ,212 . 67
12. Net Value of Estate(Line 8 minus Line 11)................ 12, 254, 724 . 71
13. Charitable and Governmental Bad uests/Sec 9 113 Trusts for which
an election to tax has not been made(Schedule J)..........._.................................. 13.
14. Net Value Subject to Tax(Line 12 minus Line 13).....__...................................... 14. 254, 724 . 71
TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15, Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 15. 0 . 00
(a)(1.2)X.00
16. Amount of Line 14 taxable 254 , 724 . 71 16. 11, 462 . 61
at lineal rate X 045
17. Amount of Line 14 taxable
at sibling rate X A 2 0 . 00 17. 0 . 00
18. Amount of Line 14 taxable
at collateral rate X.15 0 . 00 18. 0 . 00
19- TAX DUE.__.......__.....-........._........._....._. ....................................-...-.1'.. 19. 11 , 462 . 61
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2
1505610243 1505610243
Rev-1502 EX+(0110)
SCHEDULE A
pennsylvania REAL ESTATE
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Von Bergen Robert W. 21-13-0066
All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property would he
exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts.
Real property that is jointly-owned with right of survivorship must be disclosed on schedule F.
Attach a copy of the settlement sheet if the property has been sold
Include acopy of the deed showing decedent's interest if owned as tenant in common.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Real Estate known as 604 N.State Street,Clarks Summit Borough, Lackawanna County, 130,000.00
Pennsylvania,being identified as Lackawanna County Pin#09014-040-02600,W-B-L 01 085
014,with the Deed being recorded in Lackawanna County Record Book 600, Page 98,
appraised by W. Nevin Gerber,a state certified appraiser and valued at$130,000.00
TOTAL(Also enter on Line 1, Recapitulation) 130,000.00
(If more space is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule A(Rev.01-10)
Rev-1503 EX+(6-98)
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Von Bergen Robert W 21-13-0066
All property jointly-owned with right of survivorship must bedisclosed on Schedule F.
ITEM CUSIP VALUE AT DATE
NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH
1 1,487.919 shares of PPL Corporation stock 28.83 42,896.70
TOTAL(Also enter on Line 2, Recapitulation) 42,896.70
(If more space is needed,additional pages of the same size)
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B(Rev.6-98)
Rev-1508 EXr(11.10)
SCHEDULE E
Pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Von Bergen, Robert W. 21-13-0066
Incicoe ll a proceeds of R gatbn antl tns die ihs Proceeds was received byy the estate.
All property joatly-ownedwith the right of survivorship must be tliscbsedort schetlule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Refund 107.90
2 Wells Fargo Certificate of Deposit#247432050781873 20,330.72
3 Wells Fargo Certificate of Deposit#247432050809002 18,405.64
4 Wells Fargo Checking Account#1000053138397 11,844.80
5 Wells Fargo Checking Account#8685996335 100.03
6 Wells Fargo Savings Account#1010302394775 5,643.24
7 Wells Fargo Savings Account#3014084790057 1,002,30
8 Personal property 1,000.00
TOTAL(Also enter on Line 5,Recapitulation) 58,434.63
(if more space is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule E(Rev. 11-10)
Rev-1510 Ex+(ob-09)
SCHEDULE G
pennsylvania ENTER-VIVOS TRANSFERS AND
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Von Bergen, Robert W. 21-13-0066
This scheduie must be completed mid filed Rthe answer to any of questions i through 4 on page three of the REV-1500 is yes.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE
NUMBER THE DATE O MTROANSFFEER.SA7TACH A COY OF THE DEED FO FOR AL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1 Wells Fargo Individual Retirement Account 7,352.80 7,352.80
#257430050305816 payable upon death to Decedent's
two daughters,Jane Bishop and Anne Phillips
2 Wells Fargo Individual Retirement Account 10,884.69 10,884.69
#257430050970718 payable upon death to Decedent's
two daughters,Jane Bishop and Anne Phillips
3 Wells Fargo Individual Retirement Account 9,253.38 9,253.38
#88946464816481 payable upon death to Decedent's
two daughters,Jane Bishop and Anne Phillips
4 Western National Life Insurance Company Annuity - 25115.18 100.000% 25,115.18
Contract No.FJ213907, payable upon death to
Decedent's two daughters,Jane Bishop and Anne
Phillips
5 Transfer to Jane Bishop within one year of death 25,000.00 100.000% 3,00400 22,000,00
TOTAL(Also enter on Line 7, Recapitulation) 74,606.05
(If more space is needed,additional pages of the Same size)
Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule G(Rev. 08-09)
ftEVt517 EXt I1D-09)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERENCE TAX RETURN
RESIDENT DECEDENT ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Von Bergen, Robert W. 21-13-0066
Decedent's debts must be reported on Schedule t.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 15,633.29
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zio
Year(s)Commission Paid
2. Attomev's Fees Etzweiler&Associates 6,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation) 3,500.00
Claimant Jane Bishop
Street Address 11 Wild Rose Lane
city Mechanicsburg State PA Zio 17055
Relationshio of Claimant to Decedent Daughter
4. Probate Fees 426.50
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 190.00
See continuation schedule(s) attached
TOTAL(Also enter on line 9, Recapitulation) 25,751.79
Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev. 10-09)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Von Bergen, Robert W. 21-13-0066
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Expenses
1 Fairlawn Cemetery, open grave 1,000.00
2 Glenburn Grill,funeral dinner 325.00
3 Jennings Calvey Funeral and Cremation Services, Inc., funeral expense 11,386.00
4 Michaeleen T.Sultzer,grave marker 2,181.29
5 Robert Miller Excavating Limited, foundation for monument 211.00
6 White's Country Floral,funeral flowers 530.00
H-A 15,633.29
Other Administrative Costs
7 Cumberland County Legal Journal, advertise estate 90.00
8 Etzweiler&Associates, photocopies, postage, notary fees,etc. 100.00
H-B7 190.00
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98)
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,:��.
'x..
Rev-1512 FX,(12 48)
SCHEDULE 1
pennsylvania DEBTS OF DECEDENT,
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MORTGAGE LIABILITIES AND LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Von Bergen, Robert W. 21-13-0066
Report debts incumed by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Alert Pharmacy, outstanding medical bill 50.35
2 American Water Co.,water bill -pd.01/20113 34.85
3 American Water Co.,water bill -pd.02/21/13 32.97
4 American Water Co.,water bill -pd.03/17/13 32.97
5 American Water Co.,water bill-pd.04117/13 34.00
6 American Water Co.,water bill-pd. 05122113 33.05
7 American Water Co.,water bill -pd. 06121/13 34.00
8 American Water Co.,water bill -pd. 07126113 34.04
9 American Water Co.,water bill -pd. 08117/13 33.09
10 American Water Co.,water bill -pd. 09120113 251.84
11 American Water Co.,water bill -pd. 12/20/12 33.68
12 Anne Phillips,yard work and dump fee 200.00
13 Anne Phillips,yard work, services 550.00
14 Clark Summit Fire Company 35.00
15 Clarks Summit Borough,sewer bill -pd.01/13/13 47.00
16 Clarks Summit Borough, sewer bill-pd.02/12113 47.00
17 Clarks Summit Borough,sewer bill-pd.03/20/13 47.00
Total of Continuation Schedules See attached
pages
TOTAL(Also enter on Line 10, Recapitulation) 25,460.88
(If more space is needed,additional pages of the same size)
Copyright(c)2008 form software only The Lackner Group, Inc. Form PA-1500 Schedule I(Rev. 12-08)
Rev S12 EX.(12-08)
SCHEDULE 1
pennsylvania DEBTS OF DECEDENT,
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MORTGAGE LIABILITIES AND LIENS
RESIDENT DECEDENT
continued
ESTATE OF FILE NUMBER
Von Bergen, Robert W. 21-13-0066
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
18 Clarks Summit Borough,sewer bill -pd. 04110113 47.00
19 Clarks Summit Borough,sewer bill -pd.05/16/13 47.00
20 Clarks Summit Borough,sewer bill -pd.06/20113 47.00
21 Clarks Summit Borough,sewer bill-pd.07/14/13 47.00
22 Clarks Summit Borough,sewer bill-pd.08110113 47.00
23 Clarks Summit Borough,sewer bill -pd. 09115113 47.00
24 Clarks Summit Borough,sewer bill -pd. 12/15/12 43.00
25 Judy A. Belch,Tax Collector, 2013.14 School Taxes 1,608.78
26 Judy A. Belch,Tax Collector,2013 County/Borough taxes 492.45
27 Messiah Lifeways Comm. Support Services,outstanding medical bill 121.26
28 Messiah Lifeways Nursing Home, check did not clear bank until after date of death 9,424.10
29 Messiah Lifeways Nursing Home, outstanding medical bill 8,174.10
30 PA Department of Revenue, 2012 income taxes 260.00
31 PPL Electric Utilities,electric bill-pd.01/03/13 13.63
32 PPL Electric Utilities,electric bill-pd. 02/02/13 17.04
33 PPL Electric Utilities,electric bill -pd. 03/03/13 18.27
34 PPL Electric Utilities,electric bill -pd. 05/05/13 17.28
Copyright(c)2008 form software only The Lackner Group, Inc. Form PA-1500 Schedule I(Rev. 12-08)
Rev-1512 EX-(12.08)
SCHEDULE 1
pennsyivania DEBTS OF DECEDENT,
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MORTGAGE LIABILITIES AND LIENS
RESIDENT DECEDENT
continued
ESTATE OF FILE NUMBER
Von Bergen, Robert W. 21-13-0066
ITEM - VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
35 PPL Electric Utilities,electric bill -pd. 05/28/13 17.04
36 PPL Electric Utilities,electric bill-pd.05131113 16,07
37 PPL Electric Utilities,electric bill-pd.06/27113 14.55
38 PPL Electric Utilities,electric bill -pd.08/03/13 54.85
39 PPL Electric Utilities,electric bill-pd.08131113 68.06
40 PPL Electric Utilities,electric bill-pd. 12/28/12 13.63
41 Silver Spring,outstanding bill 100,00
42 U.S.Treasury,return monthly Social Security benefit because Decedent did not live entire 1,526.00
month of November
43 UGI Penn Natural Gas, Inc.,gas bill -pd, 02/02/13 230.90
44 UGI Penn Natural Gas,Inc.,gas bill-pd.04/01/13 215.00
45 UGI Penn Natural Gas,Inc.,gas bill-pd.04127113 189.47
46 UGI Penn Natural Gas, Inc.,gas bill -pd.05/30/13 81.75
47 UGI Penn Natural Gas,Inc.,gas bill-pd.06107113 100.90
48 UGI Penn Natural Gas, Inc., gas bill -pd.06/21/13 51.17
49 UGI Penn Natural Gas,Inc.,gas bill -pd.07/26113 25.51
50 UGI Penn Natural Gas,Inc.,gas bill-pd.08/31113 25.56
51 UGI Penn Natural Gas, Inc.,gas bill -pd.09/20/13 28.40
Copyright(c)2008 form software only The Lackner Group, Inc. Form PA-1500 Schedule I(Rev. 12-08)
Re 4512 EX.11248)
SCHEDULE 1
pennsylvania DEBTS OF DECEDENT
DEPARTMENT OF REVENUE +
INHERITANCE TAX RETURN MORTGAGE LIABILITIES AND LIENS
RESIDENT DECEDENT
continued
ESTATE OF FILE NUMBER
Von Bergen Robert W. 21-13-0066
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
52 UGI Penn Natural Gas, Inc.,gas bill -pd. 12/20/12 182.77
53 Wells Fargo,check did not clear until after Decedents death 490.00
54 Wells Fargo,check did not clear until after Decedent's death 26.50
TOTAL(Also enter on Line 10, Recapitulation) 25,460.88
Copyright(c)2008 form software only The Lackner Group, Inc. Form PA-1500 Schedule I(Rev. 12-08)
REV-1513 EX.(01-10)
pennsyMania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Von Bergen, Robert W. 21-13-0066
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT (Words) (yg�)
Do Not TIM Trustee s
I TAXABLE DISTRIBUTIONS (include outright spousal
distributions,and transfers
under Sec. 9116(a)(1.2)]
Jane Bishop Daughter 50%, of residue of 118,024.52
11 Wild Rose Lane estate
Mechanicsburg, PA 17055
Anne Phillips Daughter 50% of residue of 118,024.52
500 Clinton Street estate
Dalton, PA 18414
Total 236,049.04
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate.
NON-TAXABLE DISTRIBUTIONS:
II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule J(Rev. 01-10)
,
6t Bill anx� C'Frotammt
1, ROBERT W. VON BERGEN, of 604 North State Street, Clarks Summit,
County of Lackawanna and State of Pennsylvania, 18411, being of sound and dis-
posing mind and memory, and not acting under duress, menace, fraud or undue
influence of any person whomsoever, do make publish and declare this to be my
Last Will and Testament, and do hereby expressly revoke all other and former
wills and codicils made by me.
1. 1 direct my executors, hereinafter named, to pay from my residuary
estate as expenses of administration the expenses of my last illness, all funeral
~ ----- (--'-----' the ----- of - ------,.~' if .....~~^y' , and all ^,~^^,, ^^""s
fer, inheritance, succession or other death taxes which may be payable under any
law of the United States, or of any state thereof, or of any other governmental
entity, upon or in respect of all property passing under this will, and all other IR
property includable for any reason as a part of my gross estate for the purpose
of the computation of any such taxes.
2. 1 hereby give, devise and bequeath to my wife, MILDRED M.
VON BERGEN, all of my estate whether real or personal, subject to just funeral
expenses and the terms and conditions of this will, of whatsoever kind or nature
and wheresoever situate, and to have and to hold absolutely, provided she
survives me by thirty (30) days.
3. In the event my wife, Mildred M. Von Bergen, predeceases me or
dies on or before the thirtieth (30th) day after my death, all the rest, residue
and remainder of my estate whether real or personal, of whatsoever kind or nature
and wheresoever situate, I give, devise and bequeath to my daughters, JANE
CATALANO and ANNE PHILLIPS, IN EQUAL SHARES, per stirpes.
4. I appoint my daughter, ANNE PHILLIPS, guardian of any property
which passes, either under this will or otherwise, including but not limited to
the proceeds of any policies of insurance upon my life, to a minor and with re-
spect to which I am authorized to appoint a guardian and have not otherwise
specifically done so. such guardian shall have the power to use principal as
well as income from time to time for the minor's education, support and welfare,
or to make payment for these purposes, without further responsibility, to the
minor or to any person taking care of the minor.
5. I nominate, constitute and appoint my wife, MILDRED M. VON BERGEN,
Executrix of this my Last Will, to serve without bond. In the event that my
wife, Mildred, fails to qualify or ceases to act as such executrix, I then nomi-
nate, constitute and appoint my daughters, JANE CATALANO and ANNE PHILLIPS, as
Co-Executrices of this my Last Will, or the survivor of them, to serve without
bond.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this 8th day
of November, 1995.
[SEAL]
Robert W. Von Berge
[2]
The foregoing instrument consisting of three (3) pages, including this page was
on the day of the date thereof, signed, sealed, published and declared by the
said Robert W. Von Bergen, the testator named herein, as and for his Last will
and Testament, in the presence of us
and in the presence of each other, have hereunto subscribed our names as wit-
nesses thereunto that the said testator at the time of the execution of said
will appeared to be of age, mind and memory.
j nr)
i
-{SEAL]
[Address]
r l is PA to
[SEAL)
[Address]
[3]
Ll'�9 #p!g11J
ile o._„�„�
Pra erpLA(Idregs 604 N State St
Csv Clarks$--st C.11 Lackawanna ~_ was PA 2io Co 18411
Lender None
APPRAISAL AND REPORT IDENTIFICATION
This Appraisal Report is gee ofthe following types:
❑Sell Contained (A written report prepared under Standards Rule 2-2(a),pursuant to the Scope of Way,as disclosed elsewhere in this report)
Summary (A written report prepared under Standards Rule 2-2(h) ,pursoantiothe Scope of Work,as disclosed elsewhere in this report.)
❑Restricted Use (A wrdfen report prepared under Standards Rule 2-2(c) ,pursuant to Me Scope of Work,as disclosed elsewhere In this report,
restricted to the stated intended use by the simplified client Or intended user.)
Comment$ on Standards Rule 2-3
1 sooty Mat,to the best of my knowledge and belief.
—The statements of fact contained in this mpod are me and cons!
—The reported analyses,opinions,and conclusions are limited only by the reported woureg non and Rumored Oara'ions and are my persona[Impanel,W impiased professional
analyses,opinion,and conclusions,
—Unless otherwl5e Indicated,I have no present or prospective Interest U the property ther le go s edits of 1%report and no perema ancest with respect to the parties Involved,
—been d6ereleo Indicated,I here penomdd no cervlcw,ea an elevated d In ant*usr egweliy,sweeping the presetting h the sub"of this paper within the Mrseyem '
wood Immadvaudy preeeding aaeptance of this nngnment.
—I have no bias wit)respect to the property that is the subject of this hard ache pates involved wait this assig;onel,
—My engagement in this assignment was not contingent upon eevefaping or nowast predetermined visuNe,
—My compensation for completing this assignment is trot contingent tear the governme nta aWNng of a predsamorm ed value a direction in value that favors the cause of the
client,the amount of the value opinion,the attainment of a stipulated result or to oceulrmin of a subsequent ever direcCy,related W am intended Use of this appraka. '
—My analyses,opinions,and conclusions wave compared,and(Ins mpod has bean prepared,M comorchy vat Ln Und em Standards al Limestone Appraisal prawn that were
in elect at the lima this open was prepared.
—Unless otherwise indicated,(have made a persona issuance of the properly suit ro the suited is this raped.
—Unless otherwise iri icaleL no ova provided significant real pmpetry appra!sai assWari,to g»pmsoMai sgmmg he nuficarm(d them am meows,the name of each
individual providing signgcaut real emparty appraisal assistance is send elsewhere in Cots megod)
Comments on Appraisal and Report Identification
Note any USPAP related issues requiring disclosure and arty State mandated requirements:
APPRAISER: SUPERVISORY APPRAISER(only n redoUed):
1( t
Signature: f/V. KAAJg Signature:
earn: W.Nevin Gerber i Name:
lesipnatow Strafe Cart fled AOOmiser 0nsprznon: _
tae Signed; 09127/2012 Undesired:
his Covenson#: RL00mtl50L _ Stale Cedi(ICation#:
r State License#: �^ or State License#:
tam; PA __,� State:
Kimgan Date of COrdicanon mLicence: 06/302013 Ern bate of Cortiodern ce License:
Supervisory Appowser transition N Subpcf Properly:
fictive Data of Appraisal: 0911712012 ❑Ua Not ❑Eaterm-raft tram street E]femora and Enterer
Farm 010 'WmTOTAL'appraisal software by a la mode,fee.-1-800-ALAMODE
Gerber Associates ragg rse-UT LW
l
v
Uniform Residential Appraisal Report Rle#
The purpose N this summary apErdinfil report is to pmvlde the volor Bead WRIT,accurate and ad o s rte4 ame,of h5e market vAM of the mored plopory, `
Pm Address 604 N State St„ Cit Clarks Summit Store PA ZgCode 16411
BaB0 er one OWnm a(PUbllc fleW d Robert W.Von Bergen CoU Lackawanna
Le lDes¢dpton Deed gook 600 e96
Assessor's Parcel# 090140400260 Tax Year 2012 .R.E.Taxes§ 3 087
NelphhaRwod Noma Ctadss SummR gorouah _ Ma�fctenCe 4?540 C¢nsus S(act d2 &it05.OD
Occupam I"i OWmf fib?snort �'VacaM cial Assessmen6§ 0 ❑PUO HOA§0 ❑per y¢ar
at month
" Pm a Ri h_ppA raised �Fee Simple �Leasehold ❑Other(tlescdbe)
'raneM7 Purchase TRnsdGWn ❑AEfinarxa Taansamion ®Otller(desptb¢} Decision Maki^ ng�_ i
Lander/Gleam None Atldre5s
Is tln subceciwoperty¢unEmly mtEmdlor safe ornaz itbEUn oRerud fa oats kf tice(wehr¢monihsrolrre EHEC9ve daro of ores�paa�? I'1 YES �Na
Re on data source 5 used 011edng pnce(s) and dah(s). Courthouse RecoMS antl GSAR MLS
10 one ❑did notanalyte Its conlractfar we forme subject purchase,transaction.Explain the resuts of to analysis of the contact for sale or any The analysis was not
wormed,
Cormact Price§ Date of Contact IS Ne pmaeM 3811¢r file oWflerN pn411C Re0m7 ❑YEe QNO Dafa$emest$)
is there any financial assistance(low changes,Sale eoneesslaru,0 or downpaymerd resistance,etc)to be paid by any party on behalf of the borrowed? ❑Yes 0 N
� a Yes s d thetatal dwar answer and descrbe theitemsfobe paid.
Note:Race andthe racial composition of the neighborhood am not appraisal factors.
d+F-bi»$rrfifis WhhodC :: 'I#r r- xhuii'... _ TRmN „',"j»+'Lw;'A4z: ga 7aC' _'�uPlaCid_tmid.I�a%it_
Location Suburban Rnml Vro Values Increasi� 5tabis Declinipg PRICE AGE One•Unt 60%
BUN-11 Over 75% 25-75% Under 25% Damand/Su Shoda a In Balance Over Supply § ODO rs 2-1 Unit 10%
Growth 16111 LLD mr6mths TO—LOW-1 C MuPoL-il _ %
Nei hbolhco l Boundartes The subject property is bordered on the north by Route 632 South by 600 High I OIL Commercial 20%
Scree asst le Route 507 and»est by Route 307. 237 Pred, 50 Othear to%
Nei hhomeod Oescd tan The su4 act property's located in a suburban area compneed of residential dwellings. Schpg shoppino antl houses of
w rshi real/2 mile distance,trom the subiact site.,The school dis(rict is Atun ton fits,
Market Con neon ioclotling support for the abouE conclusions) There are concessions present in Ihis market ends at this time. Mchansons money is
available units ra as bat YavoraMe. Prices are stable with demand ceN the same at the Drawl time, Exposure bare for similar properners in the
subject's market area is 166 days with a list price to sale once ratio of 95%.
Dimensions 82x114 Area 9x46 of 5h Rectan le 4law N'Res'__
spacific ZatdngCiassiticaton C-t Zanmg Ues0 'pn Commercial„
Zonin Core Hance Le al Le a ❑No Zoning n Illegal(describe)
7s IDS 'NestmN Cast use m sob eM as imaecnd jmw �per pms alld sperAf lal tm IXesw uea? Spa No t NO,despke beat and
bast use Is resent? commercial,
uHllllee Publk Mherlde ecrihe} Pubec Cora au We 011ro(le emanta-T publk Private
Private
X_�_ Street Macadam
Gas E 0 Santary Sewed n Alley None _
FEMA Special Bud Retard Area 71 Yes-9 No FBMAPmotl Zmre xy� FEMAM # 420527ODDIB PEMAhl Date 01107/20DO
Ara me WINE and oR s""rte impmvemebm troical for the market area? R Yes fj No It No essence
Are mere an adverse site conUitions at extemaltactors easmu rre encroachments¢nvimrxnEmal machine,land uses etct? ❑Yes N No I YES,describe
narel'Blieal rid'>1d *' ;?,".,![ '* 'F.oundaUbn s "'xTS�Pr Exle(Ion,Beubdptlonf.�iE'-'rmeledals/obndhbn Ihleridf, ,s'lvlg':matedele%epMRMn�
UPKaa CRLL]One wgh Apcesso Una Q,Corecrele Slalc Cmwl$pace Faurlda4on W@Ns Cindar.ApWA Rwrs HrdWdtLannnodavAv
#oi Stories 1 U101firsoment {jParbel Basemem Exterior Walls AlumemMAvera a Walls PlesterlAV ra e
Type®Oet.❑Att. L 5Aet7End Unit Bodement Area 1 ' tlMFnish Wood 26 oS T /AVere e
_._
Feist (]_PmpasEd .Untl¢r Coast.Basement Fadsh 0 %tiulimsfi Downspouts 81umenumAAv errcypa Batl+HOOr Ceramic TEWAro
Cut n S IS Rambler OmSme E%EA Some Pum Window Type Wood/DHlAvegi a bath Wainscot Ceramic TflefAys
Year BUilt 1950 Eedence,of Westaton Siam Saslylnsubted lnsulatad+Aver a Car Ste Nore
Effect" rs 40 - Dampness ❑Setiemen Scrams Screens/Avem a Drivewq—#of Cam 2 -
Alpc None Hearin FlVA HVVBB JLJ Radiant Amounts Woodstove s # 0 Driverwa Surface Stone -
tear Scrim {7trer Fuel Gas Fns _ ..—...
_ sbce{5j# f7.�Fenz None
❑Roar Scume Conlin Central Air Condtoning Pal eck Nona M Porch Porch Carod #of Cars 0
Flnlshetl Heated Ind141dnal 12-2 Otter DucUes Pool Nona El Otter None -1 AG Oet Bel
Appearems,0 RoMfishator X Han Oven Dishwasher 0 Disposed ❑Microwave ❑Washer/Dryer ❑Other describe
Rnished area above Tdeconminsi 6 Roams_ 3 Bedrooms 1.0 klam(sl ,1264 Square Feet of Grosg Living Area Above Grade
AdcN ieaNms tsmwial ensmY efliciaMitans,ate). 15p amp electric aarriae,wopai waMriines tasdc was lines as water heater. AN Utiiii7eaware
on at time of Inspection. Thera was rip need for re afire at time of mina etlon.
Oescite ma camdibon of the propeM(Inconling needed rtpvrs deformation Wwatigns rereadetng EkL C4;NUIEdatesin the don t5)nars'The
imoravements feaWre minor deferred mairMnence and hsicat deterioration due to normal wear and tear. The tlwalling has been ode uatet
maintained and ragWhom only minimal repairs to bulitling componenislmechanical systems and cosmofic repaim_Al?manor building components
here bean adequately maintained and area functionally adequate.
._.
Art Here anyyhvsical defmienpiesaadv¢rse cortlitipns chit attectm¢gvebtty soundness Or sBUCdralm��ty mtice pmmnM ..2 YES X No 9Yat,dergftlle
Does the three enemll conform to the nei hbpmoed lunctlonal ntl s le contliaon usE ponSauter,etc,)? X Yes No If No describe
Freddie Mac Farm 70 March 2005 UAB Version 9/2011 Page t of 6 Fannie Mae Form 1004 March 2W5
Form 1DD4UAD—'WinTOTAL`appraisal software by a to made,Inc.—1-000-ALAMODE
Uniform Residential Appraisal Report Fhe#
There are i comparable DropeNes cunefNy odered tot sale In tl1e su0kd neighbathovd au iA lW ja at cc from$ 100 000 ar$ 175 000
Thus we 7 c arable Saks fn dre su t hbomood w4Nn the ast hvejre monfis ran ging in Sale price from$ 100.000 W 17 175 000
FEATURE SUBJECT COMPARABLE SALE#1 COMPARABLE SALE#2 COMPARABLESALE#3
Adrkess 604 N State Sf 123 N State St 208 N State St 1175 Lackawanna Td
Clarks Summit PA 18411 Clarks Summit PA 18411__ Clarks SummN.PA 18411 _ Sough Abinolon 1"ownshi PA 184
Pmami to Subject ',!",S.0 27 mites SE 022 miles SE 1.22 rakes NVV
Sets Rice $ +}41+ "�uy +`,',;d$ 135 000 + + ^zrh $ 130 000 IW S 135,000
Sale Phi Liv.Area $ 102.84s.R.S 89 62 s { �a,3%!'- $ 81 38 a R $ 112 54 sefl r,W +"g+,y�PPm
Data Scale I .yvx *T 's+.?. GSAR MLS#t 54'DOM 6 GSAi?MLS#08-1695-DOM 767 GSAR MLS#t 0.4528 C OM 441
VeMCation Source l ° �u f^Y^�F,1'-�.5 Gnurihouse RawNS Courthouse Re rd Courthouse Records
VALUE ADJUSTMENTS DI ESCRIPTION DESCRIPTION + It Ad,siment DESCRPAON +T Adjustment DESCRPTION Adjustment
Sales or Rnaminp lr`-""I, , =`ArtnLth Arml.ih AnnLlh
Concessions !k _
' " "Cesh0 0 Conv'0 D Conv'0 0
gets of S me ifis+amnp5.gli+r'„l` A10 10-c69110 4 05110 03110 O sOY1202112 —� 0
Location NR N'Res: N-Rest— MR_, e,s'
LeasehoWDee to Fee Sim le Fes S' a _ Fee Simple Fee Si
She 9348 sf 11325 sf 0 10890 at 0 3,72 ac -15,000
View N'Res; N'(?es N'Ree N'Res' ,
Rambler Colonial 0 Colonial 0 Colonial 0
OnalilY at Construction p4 p4 04
Must 62 92 _ 3-w—o 75 _. +, 062
Candhnn C4 C4 C5 +10000 G5 +10000
Above Grade Tonal Brims. BANS Tdal Brims. Babe I Tdd Balms. Baths Total BdiTS. awdo
Roan Corm 5 3 1.0 61 3 1,1.0 --„— 6 3 1.0 _ 5 3 10 d
Grass Udnq Area _ 7 264 s R. _508 s n X800 1 4488 s{k -3 680 1 200 s R 0
Basemed8 hashed 1254sMsforu tODOstOsfwu 01224Sftfwu 0 1200sufDorm 0
Rooms BelawDollar
Wnctknal LAITY Roca-ge _- Avaraae - Arera a Avarao0
tkaAn Nn CrasrDuctiesa Oil/None +2000 Gas Noe +2000 Oil/Nona +2000
' Energy ERjcient hems None Nona None None
s Nos_ t ,am -1,50 2 Cari _-3 000 2 Car _ 3 WO
- PorcMPati eck Porch Porch Porch Porch
6320 F+,_�_$ E_000
Adjualso Bale Price #. ,v!,v+eaa *;Nat Adj. 1A% Net Adj. 4,9% Net Adj, 4.4%
of Cnarmes ”. by 11+? KVIQmssA'. &A%$ 1336200mu Ad- 15.1%S 136,320 Gore M, 272%S 1290UD
i did dm not research the sale orbarrsferhislory c the subjettympmtrand com arable sdes.gnoie lain
M research Edid 0 d net reveal any prior sales or transfers of the subject pmpady for the three years pdorla the eRective dale of this+ ralsala�
Data Saurce s Courthouse Rewrds
M research Flhd N aid named any rior sales or transfers f_ ecomparable sales for the ear nor to the date csale dihe comparable sale.
Data
Source(sl Courthouse Records 8 MLS _
Describe resotss of iheresearch and andysis of N Drear safe or transfer hislogy of the ro add monmewsm,sales armed wondered priorsales on urge 3i.
REM I SUBJECT I COMPARABLE SALE#1 COMPARABLE SALE#2 1 COMPARABLE SALE#3
to at Pilot SZIOT siw
Price at Prim Sale/ttsnsfer -i u _t r
Date Source S Courthouse Rew_Ms Courthouse Records&MLS Courthouse Records 8 MLS Courthouse Records&MLS
Eifadha Oats vi Dale Sconces 717!2012 '11712012 091171201 2 09l-0712012
Anaysis of prior sale or transfe r history of the sublet!property and comparable sales Aaearch of tax records did not reveal a transferof the aubleof pro in
the 36 momms color to ire e8eciive date of the raisai. A search of priql sac s of corn rabies did not reveal a sale of mmpa abios within the fast
2 months.
Summary of Sales Component Approach Comparable sales#1 and 02 were adjusted for being ostler then the subieQ cemoarables#2 and#3 ware
adjusted for being inferior in wndilian Oess modeMUDtlafetlf tom arable sale#3 was ad'usled for belt siluatetl n a jar er arcgl:all ware
adjusted accordingly. All comparable sales era located In the same madset ate as the subiect. $29.00 per square foot was used to ed'ust for
diffarerect in GtA. uaI " ht was ! don II comparable sates.
mosses!Vague by SOS Can ism Approach$ 130000 —
indicated Value :Saks Comparison A roach$ 130 000 CoatA roach(R develo S 0 jncome Apprnach(if dove $ 0
i ,determine the limit of)talue. The income sex
CorJ A roach-e mme net utilixetl for this report.
This apmakai k mada M'as k', 0 subject to cwnpontian per,Marrs and spac4kaGons on rice bask not a Typological=son that the impmvemenk have been
completed, 0 subject to the following repairs or aheromms on the basis of a hypothetical condition that the repairs at afte ratan have been completed or 0 subject m the
• follavdn re Nred in ecden based an the extaothreary asamn tiara that the conddiot or deficiency does not returns abammul or ar
(lased on a complete visual inspection of the Interior and sandier area of the sub act preq erN,defirand scope of work,statement of assumptions and lunfUng
comiltlonc,and appralee{s certlticcbM my{our}opinion of the market valor,es 11i of the real property that is the subject of this report Is
S 130,000 seat 0911712012 which is me date of in clop and the effective date of this aplarshod.
Freddie Mac Form 70 March 2005 UAD Version 9(2011 Pa90 2 of 6 Fannie Mae Form 1004 March 2005
form 1004UAD—'W aTOTAU appraisal saflware by a Is male,ina,--1-800-ALAMODE
Uniform Residential Appraisal Report FlkA
�,xar�if,��irc.;:.�*;y�aV��rYa' W5TAPPP6ACNd0YALUE6wtrcauiradWimnk MreY'•�tt< . $arisk�-+=:..4:rs ;%-r.-cx--+vr,>
Psorlde ad ate Hermitian far&a loner cEent N replicate the below cost Nwes and calculdai s.
SgRLft to the opinion Ms%e Yaha a coaparable LEA saes is aft meRpds for esfirety sAe vake neran,seen S40,000 to S8D000.
ESTWaTEO Ej REPRCOUCTIDN OR D REPLACEMENT COST NEW OWN OF SITE VALUE_ •5 00
SooRe ul seat data DWELLNG Soft.2 S =5
Ou t. is Ling fiorn coat atnta Effective dark M coal dab .FL S .$
Damrcnts Qa Casl AplxoaE�s area Catakflons C{E. =F
s SOL s _ =s
Total Esparta of Cost-How 4
Los ka Fosctaall Eakma
L)twatsasr I I .$
Depareclaan!Cast of Mt __ .S
'As34 Yaba S%e temna .$
Esiimkd Ecarmhlo Ute am YA Yews IN0UMI)VAi.UPRY005TAPPROACR _-$ 0
s■,r9ln•x,.:.wAt-. Wy-, INCOME APPROACH TO VALUE pmt mlicaltry Fanne Mee)ax;•i •- . i..e;::•.rr:
Esknated misafto Market Pent$ %Gras RerdlihWu .F kdkaedvake auonro h
Smarmy of Incense suppart for mott«m real O
aK: ^v •^ i...:lh..aca:.r PRWECT V RON FORRM(ROW Im bb '�,:, %':a +• " ,+:•r a','._>_¢;-
k tlw dery r rheoNddthefbnkawmre'nsscektion OA7 Yes No Un% s Dehchetl , Attached '
Provide Nei Ydareaft la PWs ONLYII Ne developerppulload developer Is hcmtal at N HOAaruT par w lean obftd dweft urRL
Norm of FmIW
lend water al owes Total number of uMk Tahlrumberounbsold
Taal nwderMnsnts sankd 7otairesmDesMUMefa seek Data s
Waa tlro atakd the tonrcssmn N eds build s ids a Pu01 Tes No %Yes data d CEnraabn.
Dares the ct carnOR any amIddae UMh7 Yes No Dan Seats
Ne am or&carouse ekmenb&Wancraton faAfts 7 Yaa ND 9NO deal.Tloe she sFaias at tlon.
Am the moron ekmeMs kastd to ar Ne NamCawmre'pssackilon7 Yes No %Yes desGlbe the seMa hums end ions.
OeuC.ceoanon eiemertb and rtertadonatae&lies.
Freddie Mat Fonts 70 March 2005 UADVerslongMil Pago3afli Fannie Mao Form 1000 March 2005
Form 1004UAD—YfiTOTAL'appraisal sothvaie by a to maps.fee—140"DDE
Lme sa r
Uniform Residential Appraisal Report Flex
This report form is designed to report an appraisal of a one-unit property or a one-unit property with an accessory unit;
including a unit in a planned unit development (PUG). This report form Is not designed to report an appraisal of a
manufactured home or a unit in a condominium or cooperative project. - '
This appraisal report is subject to the,following scope of work, Intended use, intended user, definition of market value,
statement of assumptions and limiting conditions, and certifications. Modifications, additions, or deletions to the intended
use, intended user, definition of market value, 0r assumptions and limiting conditions are not pemritted. The appraiser may
expand the scope of work to include any additional research or analysis necessary based on the complexity of this appraisal
assignment. Modifications or deletions to the certifications arc also not permitted. However, additional certifications that do
not constitute material alterations to this appraisal report, such as those required by law or those related to the appraiser's
continuing education or membership in an appraisal organization, are permitted.
SCOPE OF WORK: The scope Of work for this appraisal is defined by the complexity of this appraisal assignment and the
reporting requirements of this appraisal report form, Including the following definition of market value, statement of
assumptions and limiting conditions, and certifications. The appraiser must, at a minimum: (1) perform a complete visual
inspection of the interior and exterior areas of the subject property, (2) inspect the neighborhood, (3) inspect each of the
comparable sales from at least the street, (4) research, verify, and analyze data from reliable public and/or private sources,
and (5) report his or her analysis, opinions, and conclusions in this appraisal report.
INTENDED USE: The intended use of this appraisal report Is for the lender/client to evaluate the property that is the
subject of this appraisal for a mortgage finance transaction.
INTENDED USER: The intended user of this appraisal report is the lender/client.
DEFINITION OF MARKET VALUE: The most probable price which a property should bring in a competitive and open
market under all conditions requisite to a fair sale, the buyer and seller, each acting prudently, knowledgeably and assuming
the price Is not affected by undue stimulus. Implicit in this definition is the consummation of a sale as of a specified date and
the passing of tittle from seller to buyer under conditions whereby: (1) buyer and seller are typically motivated; (2) both
parties are well informed or wail advised, and each acting in what he or she considers his or her own best interest; (3) a
reasonable time is allowed for exposure in the open market; (4) payment Is made in terms of cash In U. S. dollars or in terms
of financial arrangements comparable thereto; and (5) the price represents the normal consideration for the property sold
unaffected by special or creative financing or sales concessions* granted by anyone associated with the sale.
*Adjustments to the comparables must be made for special or creative financing or sales concessions. No adjustments are
necessary for those costs which are normally paid by sellers as a result of tradition or law in a market area:these costs are
readily identifiable since the serer pays these costs in virtual all sales transactions. Special or creative financing
adjustments can be made to the comparable property by comparisons to financing terms offered by a third party institutional
lender that is not already Involved In the property or transaction. Any adjustment should not be calculated on a mechanical
dollar for dollar cost of the financing or concession but the dollar amount of any adjustment should approximate the market's
reaction to the financing or concessions based on the appraisers judgment.
STATEMENT OF ASSUMPTIONS AND LIMITING CONDITIONS: The appraiser's certification in this report is
subject to the following assumptions and limiting conditions:
1. The appraiser will not be responsible for matters of a legal nature that affect either the property being appraised or the title
to it, except for information that he or she became aware of during the research involved In performing this appraisal. The
appraiser assumes that the title Is good and marketable and will not render any opinions about the title.
2. The appraiser has provided a sketch in this appraisal report to show the approximate dimensions of the improvements.
The sketch is Included only to assist the reader in visualizing the property and understanding the appraiser's determination
of its size.
3. The appraiser has examined the available flood maps that are provided by the Federal Emergency Management Agency
(or other data sources) and has noted in this appraisal report whether any portion of the subject site is located in an
identified Special Flood Hazard Area Because the appraiser Is not a surveyor, he or she makes no guarantees, express or
Implied, regarding this determination.
4, The appraiser will not give testimony or appear in court because he or she made an appraisal of the property in question,
unless specific arrangements to do so have been made beforehand, or as otherwise required by law.
5. The appraiser has noted In this appraisal report any adverse conditions (such as needed repairs, deterioration, the
presence of hazardous wastes, toxic substances, etc.) observed during the Inspection of the subject property or that he or
she became aware of during the research Involved in performing the appraisal. Unless otherwise stated in this appraisal
report, the appraiser has no knowledge of any hidden or unapparent physical deficiencies or adverse conditions of the
property (such as, but not limited to, needed repairs, deterioration, the presence of hazardous wastes, toxic substances,
adverse environmental conditions, etc.) that would make the property less valuable, and has assumed that there are no such
conditions and makes no guarantees or warranties, express or Implied. The appraiser will not be responsible for any such
conditions that do exist or for any engineering or testing that might be required to discover whether such conditions exist.
Because the appraiser is not an expert in the field of environmental hazards, this appraisal report most not be considered as
an environmental assessment of the property.
5. The appraiser has based his or her appraisal report and valuation conclusion for an appraisal that Is subject to satisfactory
completion, repairs, or alterations an the assumption that the completion, repairs, or alterations of the subject property will
be performed in a professional manner.
Freddie Mae Form 70 March 2005 UAD Version 9/2011 Paga4of5 Fannie Mae Form 1004 March 2005
Farm 1004UAD—'WInTOTAL-appraisal safteaare by a la mode,sc.—i-A004 AMODF
Lrana xc at i/i
Uniform Residential Appraisal Report FIW#
APPRAISER'S CERTIFICATION: The Appraiser certifies and agrees that:
1. 1 have, at a minimum, developed and reported this appraisal in accordance with the scope of work requirements stated in
this appraisal report.
2. 1 performed a complete visual Inspection of the interior and exterior areas of the subject property. I reported the condition
of the Improvements in factual, specific terms. I Identified and reported the physical deficiencies that could affect the
livability, soundness, or structural Integrity of the property.
3. 1 performed this appraisal in accurdance with the requirements of the Uniform Standards of Professional Appraisal
Practice that were adopted and promulgated by the Appraisal Standards Board of The Appraisal Foundation and that were in
place at the time this appraisal report was prepared.
4, f developed my opinion of the market value of the real property that is the subject of this report based on the sales
comparison approach to value. I have adequate comparable market data to develop a reliable sales comparison approach
for this appraisal assignment. I further certify that I considered the cost and income approaches to value but did not develop
them, unless otherwise indicated in this report,
5. 1 researched, verified, analyzed, and reported on any current agreement for sale for the subject property, any offering for
sale of the subject property in the twelve months prior to the effective date of this appraisal, and the prior sales of the subject
property for a minimum of three years prior to the effective date of this appraisal, unless otherwise indicated in this report.
6. 1 researched, verified, analyzed, and reported on the prior sales of the comparable sales for a minimum of one year prior
to the date of sale of fine comparable sale, unless otherwise indicated in this report.
7, 1 selected and used comparable sates that are locationally,physically,and functionally the most similar to the subject property.
B. 1 have not used comparable sales that were the result of combining a land sale with the contract purchase price of a home that
has been built or will be built on the land.
9, i have reported adjustments to the comparable sales that reflect the market's reaction to the differences between the subject
property and the comparable sales.
10. t verified,from a disinterested source,all information in this report that was provided by parties who have a financial interest in
the sale or financing of the subject property.
11. 1 have knowledge and experience in appraising this type of property in this market area,
12. 1 am aware of,and have access to,the necessary and appropriate public and private data sources,such as multiple lisfing
services,tax assessment records, public land records and other such data sources for the area in which the property is located.
13. 1 obtained the Infurmadon, estimates, and opinions furnished by other parties and expressed In this appraisal report from
reliable sources that I believe to be true and correct.
14. 1 have taken into consideration the factors that have an impact on value with respect to the subject neighborhood, subject
property, and the proximity of the subject property to adverse influences In the development of my opinion of market value. I
have noted in this appraisal report any adverse conditions (such as, but not limited to, needed repairs,deterioration, the
presence of hazardous wastes, toxic substances, adverse environmental conditions, etc.) observed during the inspection of the
subject property or that I became aware of during the research Involved in performing this appraisal. I have considered these
adverse conditions in my rersysfs of the property value,and have reported on the effect of the conditions on the value and
marketability of the subject property.
15. t have not knowingly withheld any significant information from this appraisal report and,to the best of my knowledge, all
statements and information In this appraisal report are true and correct.
16. 1 stated in this appraisal report my own personal, unbiased, and professional analysis, opinions, and conclusions, which
are subject only to the assumptions and limiting conditions in this appraisal report.
17. 1 have no present or prospective interest in the properly that is the subject of this report, and I have no present or
prospective personal interest or bias with respect to the participants in the transaction. I did not base, either partially or
completely, my analysis andfor opinion of market value to this appraisal report on the race, color, religion, sex, age, marital
status, handicap, familial status, or national origin of either the prospective owners or occupants of the subject property or of the
present owners or occupants of the properties in the vicinity of the subject property or on any other basis prohibited by law.
16. My employment and/or compensation for performing this appraisal or any future or anticipated appraisals was not
conditioned on any agreement of understanding, written or otherwise, that I would report (or present analysis supporting) a
predetermined specific value, a predetermined minimum value, a range or direction in value, a value that favors the cause of
any parry, or the attainment of a specific result or occurrence of a specific subsequent event (such as approval of a pending
mortgage loan application).
19. I personally prepared all conclusions and opinions about the real estate that were set forth In this appraisal report. If I
retried on significant real property appraisal assistance from any individual or individuals in the performance of this appraisal
or the preparation of this appraisal report, I have named such individual(s) and disclosed the specific tasks performed in this
appraisal report. I certify that any Individual so named Is qualified to perform the tasks. I have not authorized anyone to make
a change to any item in this appraisal report, therefore, any change made to this appraisal is unauthorized and I will take no
responsibility for it.
20. 1 identified the lender/client in this appraisal report who is the individual, organization, or agent for the organization that
ordered and will receive this appraisal report.
Freddie Mac Form 7D March 2005 UAD version 9/2011 Page 5 of 6 Fannie Mae Form 1004 March 2005
Form 1004UAD—'WInTDTA6'appraisal racers by a lamadr.Wo,—f-AO4 AtAh1gDE
aae
Uniform Residential Appraisal Report
21. The lender/client may disclose or distribute this appraisal report to: the borrower; another lender at the request of the
borrower; the mortgagee or its successors and assigns; mortgage insurers; government sponsored enterprises; other
secondary market participants; data collection or reporting services; professional appraisal organizations; any department,
agency, or instrumentality of the United States; and any state, the District of Columbia, or other jurisdictions; without having to
obtain the appraisers or supervisory appraiser's (if applicable) consent. Such consent must be obtained before this appraisal
report may be disclosed or distributed to any other party (including, but not limited to,the public through advertising, public
relations, news, sales, or other media).
22. 1 am aware that any disclosure Or distribution of this appraisal report by me or the lender/client may be subject to certain
laws and regulations. Further, I am also subject to the provisions of the Uniform Standards of Professional Appraisal Practice
that pertain to disclosure or distribution by me.
23. The borrower, another lender at the request of the borrower,the mortgagee or its successors and assigns, mortgage
Insurers, government sponsored enterprises, and other secondary market participants may rely an this appraisal report as part
of any mortgage finance transaction that involves any one or more of these parties,
24. If this appraisal report was transmitted as an "electronic record" containing my"electronic signature;'as those terms are
defined in applicable federal writer state laws (excluding audio and video recordings), or a facsimile transmission of this
appraisal report containing a copy or representation of my signature, the appraisal report shall be as effective, enforceable and
valid as if a paper version of this appraisal report were delivered containing my original hand written signature.
25. Any intentional or negligent misrepresentadon(s) contained in this appraisal report may result in civil liability and/or
criminal penalties including, but tit limited to, fine or imprisonment or both under the provisions of Title 19, United States
Code, Section 1001, at seq., or similar state laws.
SUPERVISORY APPRAISER'S CERTIFICATION: The Supervisory Appraiser certifies and agrees that:
1. f directly supervised the appraiser for this appraisal assignment,have read the appraisal report,and agree with the appraisers
analysis, opinions, statements, conclusions, and the appraisers certification.
2. 1 accept full responsibility for the contents of this appraisal report including,but not limited to,the appraisers analysis,opinions,
statements, conclusions, and the appraiser's certification.
1 The appraiser identified in this appraisal report is either a sub-contractor or an employee of the supervisory appraiser(or the
appraisal firm), Is qualified to perform this appraisal,and is acceptable to perform this appraisal under the applicable state law.
4. This appraisal report complies with the Uniform Standards of Professional Appraisal Practice that were adopted and
promulgated by the Appraisal Standards Board of The Appraisal Foundation and that were In place at the time this appraisal
report was prepared.
S. It this appraisal report was transmitted as an "electronic record"containing my"electonic signature,"as those terms are
defined in applicable federal and/or state laws (excluding audio and video recordings), or a facsimile transmission of this
appraisal report containing a copy or representation of my signature, the appraisal report shall be as effective, enforceable and
valid as If a paper version of this appraisal report were delivered containing my original hand written signature.
APPRAISER r SUPERVISORY APPRAISER(ONLY IF REQUIRED)
Signature Signature
Name W.Nevin erber Name
Company Name Gerber Associates Company Name _
Company Address 406 N State Street Company Address _.
Clarks Sumr'r.A PA 18411.
Telephone Number (5701585.5500 Telephone Number
Entail Address aerbersasoc( apdx net Emall Address _-
Date of Signature and Report 09/27/2012 —, Date of Signature _
Effective Date of Appraisal 091172012 State Certification#
State Combustion# RI-001050L or State License#
or State License# _ State _
or Other(describe) State# Expiration Date of Certification or License
Stale PA
Expiration Date of Certification or License 061302013 SUBJECT PROPERTY
ADDRESS OF PROPERTY APPRAISED O Did not inspect subject property
6041,1 State St C3 Did inspect exterior of subject propertyfrorn street
Owed Summit PA 18411 -- ,- Date of Inspection _
APPRAISED VALUE OF SUBJECT PROPERTY$ t300 CJ Bid inspect interior and exterior of subject property
LENDER/CLIENT Date of Inspection
Name No AMC _-- --. COMPARABLE SALES
Company Name None
Company Address ❑ Did not Inspect exterior of comparable sales from street
Did inspect exterior of comparable sales from street
Email Address Date of inspection
Freddie Mac Form 70 March 2005 UAD Version 92011 Page 6 of 6 Fannie Mae Form 1004 March 2005
Form 10NUAD-1haTUTAV appraisal soitwa2 by a Is mode,fnc.-1800-NAMODE
e-e of iD
File No.
UNIFORM APPRAISAL DATASET(UAD)DEFINITIONS ADDENDUM
(,Saunter:Fannie Mae OADAppendirD.DADFrel(f-SpeeTc Standardization Requirements)
Condition Ratings and Definitions
Of
The Improvements have been very recently constructed and have not previously been occupied.The onfirs structure and all components are new
and the dwelling features no physical depreciation."
`Note.No wly ewstructed lrnpmremanlsbufffeaturemcyeMdmaM(leer artd/orcompmrents can be coushlerednewdvW lingspramied that the
dwelllogis placedon a t00%newfoundaban another moycledmaMna lsandMemeycledcomponents have been mhabilWaiedhe-manufacheed
fnhi like-newcondihon.Recently aonstructedlmprovementa thathave notheen previouslyoeeupied arennt considered`new"AdwyhaYe any
signllfcaMphysrcaidapreciatlan(i.e.,newiycomfrVIeddwet frngsthathaYebeen Yacantheran ealendedpadodoftime witlroul adequate
maiefenanceorupkeep).
C2
The improvements feature rig deferred malrupe ance,little or no physical depreciation,and require no repairs.Virtually all building components
are new or have been recently repaired,refinished,or rehabilitated.All outdated components and finishes have been updated andlof replaced
with components that meet current standards.Dwellings in this category either are almost now or have been recently completely renovated and
are similar in emdigm to new conshuctim.
C3
The Improvements are well maintained and feature limited physical depreciation due to normal wear and tear.Some components,but not every
major building component,may be updated or recently rehabilitated.The structure has been wed maintained.
C4
The Improvements feature some minor deferred maintenance and physical deterioration due to normal wear and tear.The dwelling has been
adequately maintained and requires only minimal repairs to huilding components/mechanical systems and cosmetic repairs.All major building
components have been adequately,maintained and are functionally adequate,
C5
The improvements feature obvious deterred maintenance and are in need of some sigi ifcar repairs.Some building components need repairs,
rehabilitation,or updating.The functional Wlhy and overall livability is somewhat diminished due to condition,but the dwelling remains
useable and functional As a rewdwree.
Ca
The improvements have substantial damage or deferred mahmenamm who deficiencies or defects that are severe enough to affect the safety,
soundness,or structural integrity of the Improvements.The improvements are in rood of substantial repairs and rehabilitation,including many
or most major cornpunents.
Duality Ratings and Definitions
at
Dwellings with this quality rating we usually unique structures that are individually designed by an architect fora spanned user.Such
residences typically are constructed firm installed architectural plans and specRcations and leature an exceptionally high level of workmanship
and exceptionally high-grade materials throughout the interior and exterior of the structure.The design features exceptionally high-quality
exterior refinements and ornamentrusan,and exceptionally high-quality interim refinements.The veakmansbip,materials,and finishes
throughout the dwelling are of exceptionally high quality.
D2
Dwellings with this quality rating are often custom designed for construction on an individual property owner's she.However,dwellings in
this quality grade are also found in hefgh-qualhy tract developments featuring modence constructed from hadhorh ai plans or from highly
modified or upgraded plans.The design features detailed,high quality exterior arnamentabon,high-quality,interior refinements,and detail.The
workmanship,materials,and finishes throughoutthe dwelling are generally of high or rery high quality.
03
Dwellings with this quality rating are residences of higher quality butt from individual or readily available designer plans in above-standard
residential tract developments or on An individual property owner's site.The design includes significant exterior ornamematlon and interiors
that are wet!finished.The workmanship exceeds acceptable standards and many materials and finishes throughout the dwelling have been
upgraded from"stock"standards.
O4
Dwellings with this quality rating meet or exceed the requirements of applicable building codes.Standard or modified standard building plans
are faced and the design includes adequate fenestration and some exterioromamentatem and interiormimemems.Materials,workmanship,
finish,and equipment are of stock or builder grade and may feature some upgrades,
IIAD Version 8/2011
Farm OADDEFINE—nAynTOTAL!appraisal sQtwam by a Is mo6e,Inc.-1-800-N MODE
UNIFORM APPRAISAL DATASET(UAD)DEFINITIONS ADDENDUM
(Source.Fannie Mae UAD Appendix D.UADFie/d-SpecNc Standard&aNan Requirements)
Duality Ratings and Definitions(continued)
Q5
Dwellings with this quality rating feature economy of construction and basic functionality as main considerations.Such dwellings feature a
plain design using readily available or basic floor plans featuring minimal fenestration and basic finishes with minimal exterior ornamentation
and limited interior detail.These dwellings meet minimum building codes and are constructed with inexpensive,stock materials
with limited refinements and upgrades.
Q6
Dwellings with this quality rating are of basic quality and lower cost;some may not be suitable for year-round occupancy.Such dwellings
are often built with simple plans or without plans,often utilizing the lowest quality building materials.Such dwellings are often built or
expanded by persons who are professionally unskilled or possess only minimal construction skills.Electrical,plumbing,and other mechanical
systems and equipment may be minimal or non-existent.Older dwellings may feature one or more substandard or non-conforming addhions
to the original structure
Definitions of Not Updated,Updated,and Remodeled
Not Updated
Little or no updating or modernization.This description Includes,but is not limited to,now homes.
Residential properties of fifteen years of age or less often reflect an original condition with no updating,g no major
components have been replaced or updated.Those over fifteen years of age are also considered not updated it the
appliances,fixtures,and finishes are predominantly dated.An area that is'Not Updated'may still be well maintained
and fully functional,and this rating does not necessarily imply deferr ed maintenance or physical/functional deterioration.
Updated
The area of the home has been modelled to meet current market expectations.These modifications
are limited in terms of both scope and coat.
An updated area of the home should have an Improved look and feel,or functional utility.Changes that constitute
updates include refurbishment and/or replacing components to meet existing market expectations.Updates do not
include significant alterations to the existing structure.
Remodeled
Significant finish and/or structural changes have been made that Increase utility and appeal through
complete replacement andfor expansion.
A remodeled area reflects fundamental changes that include multiple alterations.These alterations may include
some or all of the following:replacement of a major component(cabinet(s),bathtub,or bathroom tile),relocation
at plumbing/gas f xturea/appiiances,significant structural alterations(relocating walls,and/or the addition of)
square footage).This would include acomplete gutting and rebuild.
Explanation of Bathroom Count
Three-quarter baths are counted as a full bath in all cases. Quarter baths(baths that feature only a toilet)are not
Included In the bathroom count.The number of full and half baths Is reported by separating the two values using a
period,where the full bath count is represented to the left of the period and the half bath count is represented to the
right of the period.
Example:
3.2 indicates three full baths and two half baths.
UAD Version 9/2011
Form UADDEFINE—WiTOTAL'appraisal software by a la mode,Inc.-1-80-ALAMODE
T-am�vu v�f
UNIFORM APPRAISAL DATASET(UAD)DEFINITIONS ADDENDUM
(Sov"e:Fanole 4WVADApperncur g tlAOFre/6Speoilin StantlarrloarinnHequintments)
Abbraviatons Used in Data Standardization Text
'Abbre won w
ac �ACrea N m PoaI aWhere.? Is Nil mvlation
A Pik Ad acontto Park Area,Sire
A Pxv Ad'acentm Power[has Location
A Adverse Location
ArmLth Arms Len Sale Location&View
be Bathrooms Saleor Financin Concessions
or Bedroom Basement&Finished Rooms Below Gratle
B
Cash Beneficial Basemen B Finished Rooms Below Gratle
Casio Location&Ylaw
C S C' viewS ins View Sale or Financin 'Concessions
C Str C Street View Yew
Comm Commercial Influence Vlew,
n Contracted Date tacadgn
Conv Conventional Date of SaleTima
DOM Court ordered Sale Salear Financin
a Concessions
Oa aOn Market Saleor Financin Concessions
a . iratlon Date Data Sources
FRA Estate Estate Sale Date of Sdamme
Federal Housing Author Sete or Financin Concessons
GnCse Goff Course Sale or Flnancln Concessions
GffVw 6IfCEse Viaw Location
Ind Industrial View
in Interior Onl Stairs Location& -w
Loda Landfill Basement&Finished Roams Below Grade
LtdS ht LhmmoS of Localinn
Lisfin Listin View
N Mountain View Safe or Financin Concessions
N Neutral Vrew
IT Rd -
R Non-Arms Length Sale Location$View
B Bus Road Saleor Financin Concessions
° Other Location
Prk Park View Basement&Finished Rooms Below Grada
Pam Pastoral View View
PwrLn Power Lines Vim
PubTm Public Transportation View
rr ReCreational Rer. Room Location
Relo Relocation Sala Basement&Finished Rooms Below Grade
RED RE0 Sale Sale or Fin On Concessions
Res Residential Saleor Hnanem Concessions
RH USDA-Rural Housin Location&View
s Settlematx Data Sale or Financin Concessons
Short Short Sale Data of Sale/Time
sf 5 uare Feet Saleor Financin Concessions
s m S uare Meters Area,Site,Basement
Unk Unknown Area SRe
VA veterans)........ Date of Sale/Time
w WiBidrawn Date Sale or Financin Concessions
W0 Walk Out Basement Date of Safe/Fime
can Walk U Basement Basement&Finished Rooms Below Grada
WtrR Water F. . a Basement&Finished RaomS Bebw Gratle
Water View Location
Wands Wood View View
View
Other Appraiser-Defined Abbreviations
< bb vl _ ... . .,
-s bbls lotion May A ear....
OAD Version will t
Form UADDERNE—VIM TALI appraisal software by Ala mode,Inc.—I.gip,pLppAOCE
I Pape N11 or 1/I
Building Sketch
Borrower None
rropaily Address 604 N Stale St
ully Clarks Summit 3011V Lackawanna State
PA Zip Code 18411
Lender None
429
1M 0. Klche" Dining Elam Bedroom
a
b
lNinO ROOM
Be6mom Bedroom
20.0'
b
32.0
0mmenb:
AREA CALCULATIONS SUMMARY LIVING AREA BREAKDOWN
Coos U sr"'" n NO errs NO Totals D.W. auataYrs
OL111 First Floor 1264.0 1266.0 First Floor
2R.0 : 32.0 '106.0
20.0 r 28.0 560.0
Net LIVABLE Area (Rounded) 1264 2Items (Rounded) 1284
Fonn SKT.B]dSkl—'wnTOTAL'appraisal software by a Is mode,inc.—1-800-ALAMODE
LCese#12 of 17
Location Map
Bortovrtr None
RMIR Address 007 N State St
Wy Clarks Summit Cou Lackawanna Slate PA li Code 1ad17
Lender None
a la mode inc:
d'
�+•+na.vv� 01A
.0 `m _._ J.\ ^ Wrverty Cavnay Club
Comparable 3
1.22 ndles NW Ghn as
9� FsF
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A� P 7011. / \
Call atable 9.27 rolles SE
E 123 State Stre It
0 27 Ildles SE
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_ I Page#13 of 171 -
Subject Photo Page
Borrower None
Pm2eq Address 604 N State St
Ci Clarks Summit Cou Lackawanna State PA Zi Code 18411
Lender None
Subject Front
604 N State St
Sales Price
Grass Living Area 1,264
Total Booms 6
-% Total Bedrooms 3
Total Bathrooms 1.0
Location N;Res;
—i
yew N,Res;
Site 9348 of
Quality q4
9e Age 62
Subject Rear
^�a
8
Y
� r
Subject Street
Form PICPI%.SR—WnTOTAL'appraisal software by a la made,in,,—1-800-ALAMODE
UFO 914 UT I
SubJect interior Photo Page
04
Clarks Summit CET
La., Is _�f Lackawanna State PA Waste Tull
Sublect Kitchen
604 N State St
Sales PH"
Groas U%Jng Area 1.204
Test Rosins 6
TOW Bativeom 1.0
Location 1I
View N:Rft;
site 9346sf
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AV 62
Sublect Living ROOM
SubJect Bathroom
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Subject Interior Photo Page
Bo:rmrer None '
Address 604 N Slate SI
G Clarks Summit CMlrqlY Larkamnna Shb PA li Code 18411
Lc=r NO"
Subject Bedroom
SO4 N State St
Saes Price
Gross LMrO Area 1.264
'I Tatar Roams 6
Total Bedmums 3
Told Batluaoam 1.o
Looadon N;Res:
View N:Res:
1 x a Sh 9348 at
af'Tyyt�;�:: Age 62
1
R
Subject Bedroom
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Comparable Photo Page I Page#16 id l]I
Bonower None
Proplity Address 604 N State St
Ci Clarks Summit GOUMY Lackawanna State PA Zi Code 18411
Lender None
r ,t Comparable 1
123 N State St
Pmx.to Subject 0.27 miles SE
ryG}YP' Sales Price 135,000
Gross Living Area 1,508
Total Rooms e
Total Bedrooms 3
Total Bathrooms 1.0
Location N,Res,
View N;Res;
Site 11325 sf
Quality Q4
Age 92
A Comparable 2
208 N State St
Proc.to Subject 0.22 miles SE
Sales Nee 130,000
Glass Living Area 1,448
Total Rooms 6
Total Bedrooms 3
Total Bommoms 1.0
Location N;Res;
View N;Res;
site 10890 Of
Grady Q4
Age 75
u3 J c
-s Comparable 3
1175 Lackawanna Trl
/.anmpar Pmx.to Subject 1.22 miles NW
Sales Price 135,000
Gross Living Area 1,200
Total Rooms 5
Total Bedrooms 3
Total Bathrooms 1.0
Location N;Res;
View N,Res;
SRO 3.72 ac
Quality Q4
Age 62
Form PICPR.CR—'WinTll appraisal software by aIs mode,Inc.=1-800-ALAMODE
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OPTIONAL CASH PURCHASE ELECTION
Mail to: Shareminer Services PP01 3086629900 Enclosed is a U.S.dollar check drawn on a United states batik,
PPL a Collection,Stock
Direct Purc has e
Plan made payable to Shereowncr Services far; $
PO Box 64656
Sl Paui MN 551644856 Minf mum$25.00%loWnIM 125,000OO wnsonar
Phrase chap address as f dkated Sha erowner Services will process Yyowurr ppuurrchase Instructions
AR m taterad�o nw era MUST according to your Plan prospectusR+rachure upon receipt of ysur
9 sign on the back or this farm, property completed request which includes account number and o
company name.We wla not be liable for any calm arising out of
taflure to purchase shares an a certain date a at a specfn price.
v
MRS ROBERT
MIL RED VONBERGEN R fact C a,other than address Phm aces,Far submitted Rtegs this don(book
onty
MRS MILDRED VONBERGEN JT TEN attest Dkeet Purchase Plan shares,Far urea ct egsttm(book
604 N STATE ST entry)shares visit us online a refer to your Direct eglsuetlon
CLARKS SUMMIT PA 18611 statement.
IDI��e�p�irl�i���tmiio�umi�mpgq(I IVl�tim�mnniml�ll
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Direct Purchase Plan Account Statement
{ .... - efeF`. i'- . ;. _•. 's ""fP r nil, oEi' Ei': t0k1N :, ,� ,
Visit shareowneronline.com anytime to access account information,obtain forms,and complete
transactions. `.•-
U.S.telephmenumber.l•60D-34510 Local and Outride U.S.:651-4534129 CuslpO 69351T106 - P. tdi +
Account Summary PPL Corporation Common Stock Account N 3086629900
January 3, 2013
ROBERT VONBERGEN B Share Balances Record Date Current
MRS MILDRED VONBERGEN JT TEN Direct Purchase Plan 1,467.91.�_ 1,506,628
604 N STATE ST Can -0000 0.000 0.000
CLARKS SUMMIT PA 16411 Direct Registration 0.000 0.000
' Total Shares 1,487.919 1,506.628 '
2012 Year-To-Date Amounts
Current Dividend Gross Dividends Reinvested $2,062.72
Record Date 12110/12 Federal Tax Withheld $0.00
Payable Date 01/02113 Nonresident Allen Tax Withheld $0.00
Dividend Rate $0.36 State Tax Withheld $0.00
Account Value • Cash Investments $0.00
Market Value Date 01/03113 Service Charges Paid by You $0.00
Market Value Price $29.2000 Service Charges Paid by Company $2.00
Account Market Value $43,993.54 Commissions Paid by You $0.00
Tramertlon m Trenaacnan Grose Amount of Service NM Amount W Price Shares increased TMN Sterm
Setliemeni Date Typo Trenssctten charger Tansacnan per Share or0ecr,.mr! Heldin Plan
[,I D a x` 1,487,918
einvested lmma- a $0.00 6i - $28.6300 r '6.,0•'dl 1,506,628
�1 r�x lnlormati x taalwm.Well BaMCes uses F 1 1 !m rep }as s aavi . shoes-To idi as st rovlde r �i'"g and inclutle rhea 9 i '"&lire eii (iare amount.
YEAR: 2012 DIVIDENDS AND DISTRIBUTIONS OMB No.1545-0110 FORM-1099-DIV
ea .'n n'•FaN i'o 't 6 t I R a
'Am your tax documents.and more whoa signed Into your account in PPL Corporation PPL investor S..im
shareown cons neAam. Two North Nslh Sheet
• New uses'craft by Westing Sign Up Nowt Select Authentication to.and than Alostpvm PA tai01-1179 PP01 Fadeai IDA:23-2158tg2
check I do not have my AuthBn6callm ID. OEM
• Tex Information is also avallabie on our sulomated phone system at 3066629900 169-144809
800446-3086
• Investment Phan Participants:Total dividends reported may Include company Y1' 8" s 0 r '"I' - S
paid brokerage commission ond/or discounts on purchases.
$2,062.72 $2,062.72
ROBERT VONBERGE14 8 T4-dlr 's4dd€ 1 <`'d tin "i c8 2 TM
MRS MILDRED VONBERGEN JT TEN $0.00 $0.09
604 N STATE ST -c, $t '8 't• 2d""iwv 615'e'- "ai
CLARKS SUMMIT PA taunt _ -
$0.00 $0.00
'etl daKii t'n116 4 m.F2derel'Ifi8Stfi6 Y7 tkeltl
$0.00 $0.00
:ap r a For Recipiem:This is Important lax wonnaean and Is"In,rarnishad to the kcamai :'••r`' �'rFo' 8 511i1A any a('
2arommSyou;It NyonceneIstradto aiaare IRS nfemloos( penally moiber roods. be
mppaad on you It this Income la mxebM srH Iho IRS dMermMea IMaI it has sal been reposed. $0.00 N/A
PPL Corp., PPL Historical Quote - (NYSE) PPL, PPL Corp. Stock Price- BigCharts.com Page 2 of 1
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cbatvs4lN: 28.94
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e 28.71
Vnww: 2,743,833
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WESTERN J NATIONAL
L i f e I n s u r a n c e C 0 m P a n y
QUARTERLY GROWTH REPORT OF YOUR POLICY FOR THE QUARTER ENDING 12/31/2012
1-800-424-4990
#BWBCGWV •Contract Number FJ213907
>06483 3039941 001 008129 1
•Policy Date 12/29/1999
ROBERT W VON BERGEN •Annuitant Robert W Von Bergen
MILDRED M VON BERGEN •Policy Type Non-Qualified
604 N STATE ST •Agent Wells Fargo Wealth Brokerage Ins Ag
CLARKS SUMMIT, PA 18411-1089 •Composite
Annual Yield 3.50%
Important Messages
We are going green! Go on-line today at www.aannuityaccess.com to find out how to sign up for electronic
delivery of your quarterly statement
Account Information Current Quarter
10/01/2012 - 12/31/2012 Year- To - Date
Beginning Value 01/01/2012 - 12/31/2012
Interest 24,898.34 24,265.87
Accumulated Value 216.84 849.31
Surrender Value 25,115.18 25,115.18
25,115.18 25,115.18
Your surrender value as of 12/31/2011 was$24,265.87.
VL 14939-AGL VER1/2013
06483 3039941 008484 006484 00001100001
jennings (aloe
Funeral and Cremation Services,Inc.ce ,I
December 1, 2012
Mrs. Jane VonBergen Bishop
11 Wild Rose Lane
Mechanicsburg, PA 17050
Statement of Funeral Expenses for: Robert W. VonBergen
Date of Death: November 28, 2012
-FACILITIES AND PROFESSIONAL SERVICES:
Services of Director and Staff $ 1,995.00
Embalming $ 695.00
Dressing J Casketing/Cosmetology $ . 275.00
Use of Facilities!Staff for Viewing $ 595.00
Use of Facilities!Staff for Funeral Service $ 595.00
Equipment and Staff for Graveside Service $ 495.00
Sub Total: $ 4,650.00
MERCHANDISE:
Casket: 4036 WD ORANGE POPLAR $ 2,690.00'
Outer Container: 9006 Sentinel $ 1,560.00
Register Book $ 45.00
(100) Memorial Folders $ 45.00
(100)Acknowledgement Cards $ 45.00
Cemetery Equipment $ 225.00
Sub Total: $ 4,610.00
AUTOMOTIVE EQUIPMENT:
Transfer of Remains $ 395.00
Hearse $ 395.00
staff&service utility autos, secure permits,flowers, clergy,.etc $ 175.00
140 Miles @'$4.00 $ 560.00
Sub Total: $ 1,525.00
TOTAL FUNERAL HOME CHARGES: $ 10,785.00
CASH ADVANCES:
20 Certified Death Certificates at$ 9.00 each $ 180.00
The Times Tribune $ 271.00
Clergy Honorarium $ 100.00
Vocalist $ 50.00
Sub Total: $ 601.00
Total Funeral Expense: $ 11,386.00
Serving Fami lies for over 100 Years!
111 Colburn Avenue,Clarks Summit,PA 18411 (570)586-0811 fax 570 586-6890 Christopher C.Calvey,F(0 Supervisor Certified Preplanning Consultant
www.lonningsealvey.com
I MICHAELEEN T SULTZER PHONE:570-586-1391
226 NORTHERN BLVD. (DISPLAY LOT, OFFICE)
PO, BOX 75 BRANCH OFFICE
CHINCHILLA PA 18410-0075 PHONE: 570-342-9973
DEALER IN - MAUSOLEUMS - MONUMENTS - MARKERS FAX: 570-587-4839
"MARK EVERY GRAVE" (BRONZE - GRANITE - MARBLEY
ESTATE OF ROBERT VonBERGEN
DATE 212L-1 13
RR 3, BOX 258
DALTON PA 18414
IMPERIAL GREY GRANITE MONUMENT IN MEMORY OF ROBERT VonBERGEN
TO BE DELIVERED AND SET IN FAIRLAWN CEMETERY IN DALTON AS
PER ORDER.
TOTAL COST FOR THE ABOVE $ 2181 .29
LESS DISCOUNT 181 . 29
NET COST $ 2000.00
FREIGHT FROM VERMONT & 1 /2 OF SETTING COSTS 123.00
TOTAL COST $ 2123 . 00
PD ON ACCT BY ANNE PHILLIPS CHK 4572 DATED 2/4/13 700.00
BALANCE 1423. 00
10N c-n ax-Ncl,4,�
THANK YOU VERY MUCH FOR THE ABOVE ORDER.
NOTE: I AM ENCLOSING THE FINAL APPROVAL FORM. PLEASE CHECK TO
BE SURE THE SPELLING OF NAMES AND THE DATES ARE CORRECT,AND
IF CORRECT SIGN AND DATE THE FORM & RETURN IT IN THE ENCLOSED
ENVELOPE WITH THE SECOND PAYMENT OF $ 600. 00 SO THAT WE
MAY COMPLETE YOUR ORDER.
TERMS: 1/3 WITH ORDER, 1/3 UPON SIGNED APPROVAL, BALANCE UPON COMPLETION.
1-1/2 INTEREST PER MONTH THEREAFTER.
SPECIALTIES: DUPLICATE WORK - MONUMENT CLEANING - CEMETERY LETTERING-
>p
DRIVE.MECHANICSBURG,PA 17055 RESIDENT# I UNIT _ - --
71221 008 D 11 30 -61_
RESIDENT(Si
JANE BISHOP Mr. ROBERT W. VON BERGEN
11 WILD ROSE LANE
MECHANICSBURG,PA 17050 TOTAL AMOUNT DUE I Sg,1-1.211
DATE DUE 1231201_°
DATE DESCRIPTION RATE Uoy CHARGES CREDITS BALANCE
-Balance Forward 9,424.10
11/301201 PAYMENT RF.CF.WF.D-T-HANK V011M 9.424.10, 0.90
*** Nursing Care***
11/27/2012 RM/BRD-NURSING-SEMI-PVT 11/01-11/2 295.00 27.00 7,965,00: ".965.00
11/27/2012 AIR MATTRESS 11/01-11/27 5.00 27.00 135.00 1S.100.00
11/27/2012 PREVAIL BRIEF 1.40 41.00 57.40 $,14-.44
11/2712012 PUDDING CUP 1.25 4.00 5.00 5,162.40
11/27/2012 HEALTH SHAKES (PER CONTAINER) 0.30 39.00' 11.'0 S.I-4.1i1
JANE BISHOP s 3286
so-lz
RAYMOND C.BISHOP 7s411
11 WILDROSELN. 717-786-0155 > f't�:
MECHANICSBURG,PA 17060-1666 oak
Pa ,.,be n l / J/ t
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Order of
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P`1C Hank.M.A, 0!H
Cauat PA M
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1:03i3ri27381: 500082463511- 3286
RESIDENT# CURRENT OVER 30 OVER 60 OVER 90 OVER 120 TOTAL AMOUNT DUE
71221 8,114.10 0.00 0.00 0.00 0.00 S8,174.10,
RESIDENT NAME Mr.ROBERT W.VON BERGEN -
Please make check payable to Messiah Lifeways at Messiah Village.
A 1%Finance charge may be assessed on accounts for which payment has not been received by the due date. Thank you'
I€you have any questions or concerns about your bill,please address them directly to Fiscal Services at 790-8220. Thank You!
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ETLNNTILER AND ASSOCIATES
ATTORNEYS-AT-LAW
105 NORTH FRONT STREET
HARRISBURG; PA 17101-1436
Office hours:Mon.-FrL 8:00 a.m.-5:00 p.m.
(717)2:4-5600
Ea-1 Richard Frz eiler,Esquire -----
Christian S. Daghir,Esquire HALIFAX LINE
(717)896-3737
225 Market Street Fax Line: (717)234-5610 2 West Main street
Millersburg,PA 17061 Email Address: ret: e,eiler@comcast.net Elizabetbville,PA 17023
(717)692-2519 (717)362-8395
Office hours: Tues.And Fri. 4:00 p.m.-8:00 p.m. Ofrt e hours: Thurs. 7:00p.m.-9:00 p.m.
SaL 10:00 a.m.-12:00 noon
October 14, 2013
Register of Wills Office
Cumberland County Courthouse
M 1 Courthouse Square `— <'
Room 102 > - C" t` "
Carlisle, PA 17013
Re: Estate of Robert W. Von Bergen , 'v i— "'
No. 21-13-0066
°
Dear Sir or Madam:
Please find enclosed the original and one copy of the Inheritance Tax Return and the
original and one copy of the Inventory for the Estate of Robert W. Von Bergen. Would you
please time-stamp the extra copy and the enclosed signature pages and return them to my
office in the enclosed self-addressed postage prepaid envelope.
Please contact my office if you need anything further in this matter.
Sincerely yours,
Earl Richard Etzweiler
ERE:kIp
Enclosures
0:ZSTAT,DI TSTAMVMn .gm-Rnb VmC uvl