HomeMy WebLinkAbout02-18-14 � , 1505610140
REV-1500 EX (02-11)(FI)
PA Department of Revenue
OFFICIAL USE ONLY
Bureau of Individuai Taxes � INHERITANCE TAX RETURN County Code Year File Number
Po sox 2soso� 2 1 1 3 0 7 5 0
Harrisburq,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDOYYYY
� 7 0 2 2 0 1 3 0 3 2 9 2 0 1 3
DecedenYs Last Name Suffix DecedenYs First Name M�
V A N D E R G R I F T E L I Z A B E T H H
(If Appiicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Su�x Spouse's First Name M�
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
Q 1.Original Retum � 2.Supplemental Return � 3. Remainder Retum(Date of Death
Priorto 12-13-82)
� 4.limited Estate � 4a. Future Interest Compromise(date of � 5.Federal Estate Tax Retum Required
death after 12-12-82)
QX 6.Decedent Died Testate � 7.Decedent Maintained a Living Trust 8.Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
� 9.Litigation Proceeds Received � 10.Spousal Poverty Credit(Date of Death � 11. Election to Tax under Sec.9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
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J A C Q U E L I N E A K E L L Y 7 1 7 c-'�-; 4 1 _� 5 .5 ,�.�
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REGIS_T�R�flF WILLS�E ONLI( '
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First Line of Address
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J A N L B R 0 W N & A S S 0 C � ti-r�- � '��
Second Line of Address �z-, �' `�`•' - � ''°
:_.. �.,� �.��
8 4 5 S I R T H 0 M A S C T S T E 1 2 �` ;
City or Post Office State ZIP Code DATE FILED
_ _ _
H A R R I S B U R G P A 1 7 1 0 9
CorrespondenYs e-mail address: JqCKIE c�JANBROWNLAW.COM
Under penal�es of peryury,l declare that I have e �ned this retum,inGuding accompanying schedules and statements,and to the best of my knowledge and belief,
it is We,corzect and complete.DeGaration of p r other than the personal rep tative is based on all information oF which preparer has any knaaledge.
SIGNATURE OF PERSON PONSIBLE F ILI G TURN OA /
� �
ADDRESS
1545 BEECHWOOD BO L VARD PITTSBURGH PA 15217
SIGNA RE OF PREP ER OT ER T REPRESENTATNE DATE
ADDR S v I
84 SIR THOMAS CT; TE 12 HARRISBURG PA 171p9
PLEASE USE ORIGINAL FORM ONLY
Side 1
� 1505610140 1505610140 �
� 1505610240
REV-1500 EX(FI) DecedenYs Social Security Number
oecedenrsName: ELIZABETH H • VANDERGRIFT
RECAPITULATION
1. Real Estate(Schedule A) �•
2 1 5 0 0 0 . 0 0
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . .
2. Stocks and Bonds(Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2• '
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) . . . . . 3. •
4. Mortgages and Notes Receivable(Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . 4. •
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . . . . 5. 1 1 3 6 6 9 . � 3
6. Jointiy Owned Property(Schedule F) ❑ Separate Billing Requested . . . . . . . 6. •
7. Inter-Vivos Transfers&Miscellaneous N -Probate Property 5 1 6 � 2 5 . 2 1
(Schedute G) � Separate Billing Requested . . . . . . . 7.
8. Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . ... .. . . . .. . . 8. 8 4 4 6 9 4 . 2 4
9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9• 3 4 8 2 1 . 2 5
10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule I) . . . . . . . . . . . . . 10. 1 0 2 3 3 . 5 4
11, Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 4 5 � 5 4 . 7 9
12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . .. . . . .. . ... . 1z• 7 9 9 6 3 9 . 4 5
13. Charitable and Governmental Bequests/Sec 9113 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. 7 9 9 6 3 9 . 4 5
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116
(a)(1.2)X.0 _ � . 0 O 15. O . � 0
16. Amount of Line 14 taxable
at�inea�rate X.045 7 8 9 6 3 9 . 4 5 �6. 3 5 5 3 3 . 7 8
17. Amount of Line 14 taxable
at sibling rate X.12 0 . 0 � 17. � . � 0
18. Amount of Line 14 taxabie
at collateral rate x.15 1 0 0 0 D . 0 0 �8. 1 5 0 0 . 0 0
19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 3 7 0 3 3 • 7 8
20. FILI IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑X
Side 2
� 150561�240 1505610240 �
REV-1500 EX(FI) Page 3 File Number
Decedent's Complete Address: 2� 13 0�50
DECEDENTS NAME
ELIZABETH H.VANDERGRIFT _
STREET ADDRESS
11 BLACKMORE COURT _
CITY STATE ZIP
CAMP HILL PA 17011
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 37,033.78
2. Credits/Payments
A.PriorPayments 35,392.00
B.Discount 1,851.69
Total Credits(A+B) (2) 37,243.69
3. Interest
(3)
4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT.
Fill in oval on Page 2,Line 20 to request a refund. (4) 209.91
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 0.00
Make check payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred ...................................................................... ❑ X❑
b. retain the right to designate who shall use the property transferred or its income ............................... ❑ ❑
X
c. retain a reversionary interest ..................................................................................................... ❑ X❑
d. receive the promise for life of either payments,benefits or care? ....................................................... ❑ �
2. If death occurred after December 12,1982,did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... ❑ 0
3. Did decedent own an'in trust for"or payable-upon�ieath bank account or security at his or her death? ......... ❑ ❑X
4. Did decedent own an individual retirement account,annuity or other non-probate property,which
contains a beneficiary designation?.................................................................................................. 0 ❑
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 tax rate imposed on the net value of transfers to or for the use of the sunriving spouse is 0 percent
[72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and
filing a tax return are 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 of age or younger at death to or for the use of a natural parent,an
adoptive parent or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)J.
• The tax rate imposed on the net value of transfers to or for the use of the decedenYs lineal beneficiaries is 4.5 percent,except as noted in p2 P.s.§s��s(a)(���.
• The tax rate imposed on the net value of transfers to or for the use of the decetlent's siblings is 12 percent[72 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.
REV-1502 EX+(12-12)
pennsylvania SCHEDULE A
DEPARTMENT OF REVENUE
REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
ELIZABETH H. VANDERGRIFT 21 13 0750
All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property
would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts.
Real property that is 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.
ITEM Include a copy of the deed showing decedenYs interest if owned as tenant in common. VALUE AT DATE
NUMBER OF DEATH
DESCRIPTION
1. 11 Blackmore Court, Camp Hill PA 17011 215,000.00
see attached appraisal
TOTAL(Also enter on Line 1,Recapitulation.) $ 215 000.00
If more space is needed,use additional sheets of paper of the same size.
REV-1508 EX+(08-12)
pennsylvania SCHEDULE E
DEPARTMENTOFREVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN
RESIDENTDECEDENT PERSONAL PROPERTY
ESTATE OF: FILE NUMBER:
ELIZABETH H. VANDERGRIFT 21 13 0750
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. PNC Bank 80,364.83
Checking account 5004489328
2. PNC Bank 19,196.86
Savings account 5140065693
3. Hartford insurance; refund 403.34
4. Wells Fargo; IRA payment of RMD after death 1,095.00
6. 2006 Toyota Sienna CE 12,609.00
see attached Kelley Blue Book value
TOTAL(Also enter on Line 5,Recapitulation) $ 113 669.03
If more space is needed,use additional sheets of paper of the same size.
REV-1510 EX+(08-09)
pennsylvania SCHEDULE G
DEPARTMENTOFREVENUE INTER-VIVOS TRANSFERS AND
INHERITANCETAXRETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ELIZABETH H. VANDERGRIFT 21 13 0750
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
DESCRIPTION OF PROPERTY
ITEM INCLUDETHENAMEOFTHETRANSFEREE,THEIRRElATIONSHIPTODECEDENTAND DATEOFDEATH %OFDECD�S EXCLUSION TAXABIE
NUMBER THE DATE OF TRANSFER.ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1. Welis Fargo Advisors 204,409.34 100.00 204,409.34
IRA Account#7937-2983
beneficiaries: 50% to son, Craig Vandergrift
50%to Trustee of testamentary trust f/b/o daughter, Susan
Mease
2. Jackson National Life Insurance Company 128,622.81 100.00 128,622.81
Annuity Contract 1006412587
beneficiaries: 50%to son, Craig Vandergrift
50%to Trustee of testamentary trust f/b/o daughter, Susan
Mease
3. Lincoln National Life Insurance Company 62,326.35 100.00 62,326.35
Annuity Contract#953119652
beneficiaires: 50%to son, Craig Vandergrift
50%to Trustee of testamentary trust f/b/o daughter, Susan
Mease
4. Lincoln National Life Insurance Company 120,666.71 100.00 120,666.71
Annuity Contract#953106415
beneficiaries: 50%to son, Craig Vandergrift
50%to Trustee of testamentary trust f/b/o daughter, Susan
Mease
TOTAL (Also enter on Line 7,Recapitulation) S 516 025.21
If more space is needed,use additional sheets of paper of the same size.
REV-1511 EX+(10-09)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCETAXRETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ELIZABETH H. VANDERGRIFT 21 13 0750
DecedenYs debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Myers Harner Funeral Home 8,746.00
2. Rolling Green Cemetery 2,075.00
3. Luncheon 905.81
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s)
Street Address
City State ZIP
Year(s)Commission Paid:
2, attomey Fees: Jan L. Brown &Associates 19,000.00
3, Family Exemption:(If decedenYs address is not the same as claimanYs,attach explanation.)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees: Cumberland County Register of Wills 443.50
5 AccouncantFees: 2013 Income Tax Return preparation fee 250.00
6. Tax Retum Preparer Fees: PBPkS& COf11p8t1y; fiduciary tax prep 305.00
7, Cumberland Law Journal; legal adve�tising 75.00
8. The Sentinel; legal advertising 178.92
9. Debbie Lupold, Treasurer; 2013 real estate tax 2,404.72
10. J.H. Troup Appraisers; real estate appraisal 300.00
11. Cumberland County Register of Wllls; Petition to Substitute Trustee filing fee 15.00
12. Craig L. Vandergrift; reimbursement for out of pocket mailing and parking expenses 93.30
13. PNC Bank; check image fees 7/2013-9/2013 9.00
14. Register of Wills; FSA filing fee 20.00
TOTAL(Also enter on Line 9,Recapitulation) $ 34 821.25
If more space is needed,use addi6onal sheets of paper of the same size.
REV-1512 EX+(12-12)
pennsylvania SCHEDULE I
DEPARTMENTOFREVENUE DEBTS OF DECEDENT�
INHERITANCETAXRETURN MORTGAGE LIABILITIES& LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ELIZABETH H. VANDERGRIFT 21 13 0750
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Homelnstead Senior Care; outstanding bilis 6,458.60
2. East Pennsboro Ambulance; outstanding bill 88.00
3. ADT Security; outstanding bills 81.86
4. US Treasury; 2012 taxes 1,999.35
5. Gran-U-Lawn; outstanding bill 43.23
6. Jan L. Brown and Associates; outstanding legal fees 1,142.50
7. PNC Bank;; outstanding check 4833 cleared after death 420.00
TOTAL(Also enter on Line 10,Recapitulation) $ 10 233.54
If more space is needed,insert additional sheets of the same size.
REV-1513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
ELIZABETH H. VANDERGRIFT 21 13 0750
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec.9116(a)(1.2).]
1. Debra G. Graham, daughter Lineal
11 Blackmore Court, Camp Hill, PA 17011 1/3 of residuary& Sch A
2. Craig L. Vandergrift, son Lineal
1545 Beechwood Boulevard, Pittsburgh, PA 15217 1/3 of residuary&Sch G
3. Susan L. Mease, daughter(c/o Nathan Shuman and Andrea Lineal
Shuman as Co-Trustees of testamentary trust) 1/3 of residuary& Sch G
417 East Marble Street, Mechanicsburg PA 17055
4. Jill Keiter, friend Collateral 10,000.00
3670 North 4th Street, Harrisburg PA 17110 specific bequest
per Will
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
jI. NON-TAXABLE DISTRIBUTIONS;
A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. �
If more space is needed,use additional sheets of paper of the same size.
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LAST WILL AND TESTAMENT
OF
ELIZABETH H. VANDERGRIF'T
I, ELIZABETH H. VANDERGRIFT, now domiciled in Cumberland County,
Pennsylvania, declare this to be my Last Will and Testament. I revoke all other wills and codicils
that I may have previously made.
Article I
My just debts and expenses of my last illness, funeral,and administration of my estate shall
be paid by my Executor from the principal of my residuary estate as soon as practicable after my
death.
Article II
All inheritance,estate,and succession taxes(including interest and penalties thereon,but not
including any generation skipping tax) payable by reason of my death shall be paid out of and be
charged generally against the principal of my residuary estate without reimbursement from any
person. In the event that my residuary estate is not sufficient to satisfy such payments, then such
payments shall be equitably apportioned among those beneficiaries to whom any benefit from my
estate accrues, in the proportion that the value of the property or interest received by a beneficiary
bears to the total value of the property and interests received by all such beneficiaries.This provision
is not a waiver of any right which my Executor has to claim reimbursement for any such taxes which
become payable as the result of any property over which I have the power of appointment.
- 1 -
bear in mind my goal that the trust funds be used as a supplemental source of funds for DEBRA
G. GRAHAM over her lifetime and not be disbursed immediately over a short period of time.
C. My Trustee, in his sole discretion, shall have the power to sell the real property at
11 Blackmore Court, Camp Hill, Pennsylvania in the event that the Trustee determines that
DEBRA G. GRAHAM is unable to maintain responsibility for all utilities, taxes and other
associated expenses. The proceeds from any sale of the property shall be held in this Trust for
DEBRA G. GRAHAM according to the terms and conditions hereunder.
D. Upon the death of DEBRA G. GRAHAM or in the event that DEBRA G.
GRAHAM predeceases me, then any remaining Trust fimds, including income and principal.
shall be distributed to her children, per stirpes.
E. No beneficiary or remainderman of this Trust shall have any right to alienate,
encumber, or hypothecate his or her interest in the principal or income of the Trust in any
manner, nor shall any interest be subject to claims of his or her creditors or liabie to attachment,
execution, or other processes of law.
Article VI
All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever
situate, I give,devise and bequeath IN EQUAL SHARES to my son,CRAIG L.VANDERGRIFT,
of Allegheny County, Pennsylvania, to my daughter, DEBRA G. GRAHAM,and to my daughter,
SUSAN L. MEASE,of Cumberland County,Pennsylvania. The share for SUSAN L.MEASE shall
be held IN TRUST in accordance with the terms and conditions of Articles IX, XI, and XII.
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If any of my beneficiaries predecease me or fail to survive me by thirty (30) days, I give,
devise and bequeath his or her share to his or her issue who survive me, per stirpes, or if he or she
has no issue,the share(s)are to be added equally to the other shares. In the event that my grandson,
JASON COLEBAUGH, is a beneficiary under this Wiil, then his share shall be held IN TRUST
according to the terms and conditions of Articles X, XI and XII.
It is my intent that all my property, including property passing under my Last Will and
Testament as well as my property passing outside of my Last Will and Testament (including my
annuities and IRA accounts), be divided equally between all three of my children. In the event that
one or more of my children inherit more than the others, taking into account both probate and
nonprobate property,then it is my wish that that child or children gift some of his/her inherited funds
to the other child(ren) to make the distribution equal among all my children.
Article VII
[ understand and direct that my life insurance, annuities, individual retirement accounts
(IRAs), in trust for bank accounts and any other assets on which I may designate a beneficiary will
pass to the beneficiaries that I have named and will not be controlled by the distribution provisions of
this Will. I also understand and direct that any assets I own jointly with another with rights of
survivorship or a presumed rights of survivorship(whether the joint ownership was created before or
after this Will) will pass to the surviving joint owner and distribution of such assets will not be
controlled by the provisions of this Will.
Article V1U
If any person or entity other than me singularly or in conjunction with any other person or
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entity directly or indirectly contests in any court the validity of this Will, including any amendments
or codicils thereto,then the right of that person or entity to take any interest in my estate shall cease,
and that person or entity shall be deemed to have predeceased me.
Article IX
In the event that a Trust is created by or as a result of any part of this Will for SUSAN L.
MEASE, the terms and conditions of the Trust shall be as fallows:
A. Qualified Retirement Pian Accounts: My Trustee may exercise the authority and
discretion provided for in this Article over any of my qualified retirement plan accounts
and benefits to which a trust created under this Article is a beneficiary. The powers
granted in this Article are in addition to, and not in limitation of, all other powers granted
in this Will and under the law.
1. I direct my Trustee to instruct my IRA provider or provider of any of my
qualified retirement benefits to divide my IRA and/or qualified retirement benefits
into separate equal shares for each beneficiary. and for the share for SUSAN L.
MEASE under the name '`Trust share for SUSAN L. MEASE created under
ELIZABETH H. VANDERGRIFT's Last Will and Testament".
2. Designated Beneficiarv Requirements: [ direct my Trustee to comply with
those provisions of the Code and applicable United States Treasury Regulations
that allow a trust created under this Article, or any trust share, to be treated as a
Designated $eneficiary of any qualified retirement plans or qualified retirement
benefits for purposes of determining the distribution period under Code Section
401(a)(9). These requirements are currently set forth in Section 1.401(a)(9)-4
Q&A 5 and Q&A 6 of the Treasury Regulations and call for my Trustee to fumish
certain documents to the plan administrator by October 31 of the year following
my death.
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3. Separate Accounts: Ifthere are multiple beneficiaries entitled to ownership of
the Account simultaneously, I direct that each such beneficiary's proportionate share
of the Account shali be treated as a separate account, payable solely to such
beneficiary,within the meaning of Proposed Treasury Regulation§1.401(a)(9)-8,A-
3, and that the Account shall be deemed divided (as of the date of my death) into
separate accounts, in proportion to the relative amounts payable to the respective
beneficiaries,with one such separate account payable to each of my beneficiaries for
purposes of determining the amount required to be distributed to each beneficiary
under § 40l(a)(9) of the Internal Revenue Code. So long as the separate accounts
remain commingled,all investment gains and losses incurred in the Account shall be
allocated among the separate accounts pro rata, that is, in proportion to the relative
values of the separate accounts. A distribution from the Account to any beneficiary
(or a transfer from the Account to a separate individual retirement account,still in my
name and payable to such beneficiary)shall be charged to that beneficiary's separate
account (reducing its value for purposes of subsequent allocations of investment
gains or losses). The beneficiaries shall be entitled, by joint written instructions to
the Provider,to have the Account partitioned into multiple Accounts,corresponding
to each beneficiary's separate account, as of or at any time after my death, to the
maximum extent such division is permitted by law to occur without causing a
deemed distribution of the Account. Following such partition the newly created
separated Accounts shall be maintained as if each were an Account in my name
payable solely to the applicable beneficiar}�,and no beneficiary shall have any further
interest in or claim to any Account other than the separate Account representing his
or her interest.
4. Withdrawal of Required Minimum Distributions: Each year, including the
year of my death, my Trustee shall withdraw from qualified retirement plan
benefits payable to any trust created under this Article the Required Minimum
Distribution(s) for that year.
- 6 -
5. Required Conduit Distributions: Notwithstanding any other provision of
this Will, my Trustee is directed to distribute any and all amounts withdrawn from
any qualified retirement plan benefits payable to any trust created under this
Article to SUSAN L. MEASE. The distributions may be made to SUSAN L.
MEASE on a quarterly or monthly basis, as the Trustee sees fit. The purpose of
this paragraph is to qualify this trust created under this Article as a "conduit trust"
under Treasury Regulation Section 1.401(a)(9)-5, A-7, Example 2. This
paragraph is to be interpreted, and to the extent necessary modified, by my
Trustee, effective ab initio to the date of my death, to constitute a conduit trust for
purposes of the required minimum distribution rules. My Trustee may deduct
trust expenses prior to payment to SUSAN L. MEASE provided deduction of
expenses does not disqualify conduit trust status.
6. Restriction on Payments from Oualified Retirement Plans: I direct that
qualified retirement plan benefits not be used or applied on or after December 31
of the calendar year following my death for payment of my debts, taxes, expenses
of administration or other claims against my estate or for payment of estate,
inheritance or similar transfer taxes due on account of my death.
7. Distributions to Unqualified Beneficiaries: If any trust beneficiary under
this Article is not an "individua(" within the meaning of Section 401(a)(9) of the
Code and the applicable regulations, my Trustee may, by December 31 of the year
following the year of my death, distribute that beneficiary's entire interest
outright, and free of the trust, to the beneficiary if, in my trustee's sole and
absolute judgment, failure to make the distribution would jeopardize the trust's
treatment as a Designated Beneficiary under Section 401(a)(9) of the Code and
applicable regulations.
lf�the value ofan interest is na� readily ascertainable for any beneficiary
who is not an individual, my Trustee may settle and agree upon a reasonable value
with the beneficiary and distribute the amount agreed between the Trustee and the
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. .4E. >- ,
beneficiary. Any settlement must, however, be completed and distributed before
December 31 of the year following the year of my death.
B. Distribution of Income: My Trustee shall distribute the income to SUSAN L.
MEASE, which could be done on a quarterly or monthly basis, but not less than annually.
C. Distribution of Principal: My Trustee has the discretion to expend and apply so much
of the net income and so much of the principal of�the Trust as the Trustee shall consider
advisable for the support,health,care and education(including college,trade school,or other
similar training or education)of SUSAN L. MEASE. The Trustee may decide to establish a
regular schedule of disbursements to SUSAN L. MEASE as the Trustee sees fit based on
SUSAN L. MEASE's needs and comfortable lifestyle. Before making disbursements, the
T'rustee shall bear in mind my goal that the trust funds be used as a supplemental source of
funds for SUSAN L. MEASE over her lifetime and not be disbursed immediately over a
short period of time.
Provided, however, that prior to taking any distribution from a qualified retirement
plan, my Trustee shall first determine whether a distribution would be subject to any state or
federal penalty taxes. My Trustee shall take all reasonable precautions to ensure that a
distribution from any qualified retirement plan is treated as a qualified distribution and
reduce or avoid application of state or federal penalty taxes to the distribution.
D. Distribution Upon the Death of Susan L. Mease• Upon the death of SUSAN L.
MEASE,any Trust funds remaining, including income and principal,shall be distributed to
her issue, per stirpes, subject to being held IN TRUST according to Articles X, X1 and XII if
a share would be designated for JASON COLEBAUGH.
E. Optional Termination of Trust: Notwithstanding any other provisions hereof, my
Trustee may, in my Trustee's sole discretion and at any time, terminate this Trust created
under this Article if the amount thereof does not warrant the cost of continuing said trust
or if its administration would be otherwise impractical. lJpon such termination, my
Trustee shali pay the principal and any accumulated or undistributed income of such trust
to SUSAN L. MEASE.
- 8 -
F. Definitions: For purposes of my Will and for the purposes of any trust established
under my Will, the following definitions shall apply:
(a) "Account"means the"Individual Retirement Account,""Individuai Retirement
Trust,""Roth Individual Retirement Account"or"Roth Individual Retirement Trust,"which
is estabiished and maintained under§ 408 or§ 408A of the Code.
(b) "Code"means the"Internal Revenue Code"and any references to the"Code"or
to its provisions are to the Internal Revenue Code of 1986, as amended from time to time,
and the corresponding Treasury Regulations, if any. References to the "Treasury
Regulations,"are to the Treasury Regulations under the Internal Revenue Code in effect from
time to time. If a particular provision of the Internal Revenue Code is renumbered, or the
Internal Revenue Code is superseded by a subsequent federal tax law,any reference shall be
deemed to be made to the renumbered provision or to the corresponding provision of the
subsequent law, unless to do so would clearly be contrary to my intent as expressed in my
will. The same rule shall apply to references to the Treasury Regulations.
(c) "Death Benefit"means all amounts payable under the Account on account of my
death.
(d) "Designation Date" means December 31 of the year following the year of my
death,or any other date established by Treasury Regulations or other tax law authority as the
final date for determining whether a trust meets the requirements for the beneficiaries of the
trust to be treated as having been designated as beneficiaries under Section 409(a)(9)of the
Internal Revenue Code.
(e) "Income" means the income earned inside any Account or other Retirement
Benefit.
(� "Principal" means the date of death value of any Account or other Retirement
Benefit.
(g) "Provider" means the Account custodian and its successors in that office.
- 9 -
(h) "Qualified Retirement Benefits": The term `'qualified retirement plan"means a
plan qualified under Section 401 of the Internal Revenue Code, an individual retirement
arrangement under Section 408 or Section 408A or a tax-sheltered annuity under Section
403. The term "qualified retirement benefits" means the amounts held in or distributed
pursuant to a plan qualitied under Section 401, an individual retirement arrangement under
Section 408 or Section 408A,a tax-sheltered annuity under Section 403 or any other benefit
subject to the distribution rules of Section 401(a)(9).
H. Irrevocabilitv: Any trust created by my Will shall be irrevocable upon my death.
I. Spendthrift Clause: No beneficiary or remainderman of this Trust(s)shall have any
right to alienate,encumber,or hypothecate his or her interest in the principal or income of the
Trust(s) in any manner, nor shall any interest be subject to claims of his or her creditors or
liab(e to attachment, execution, or other processes of law.
Article X
In the event that a Trust is created by or as a result of any part of this Will for JASON
COLEBAUGH, the terms and conditions of the Trust shall be as follows:
A. To expend and apply so much of the net income and so much of the principal of the
Trust as the Trustee shall consider advisable for the support, health, care and education (including
college, trade school, or other similar training or education) of JASON COLEBAUGH for his
lifetime.
B. Upon the death of� JASON COLEBAUGH, any remaining trust principal and
accumulated income shall be distributed to his children, per stirpes.
C. No beneficiary or remainderman of this Trust shall have any right to alienate,
encumber, or hypothecate his or her interest in the principal or income of the Trust in any manner,
- 10 -
nor shall any interest be subject to claims of his or her creditors or liable to attachment,execution,or
other processes of law.
Article XI
I hereby appoint CRAIG L.VANDERGRIFT and/or my grandson,NATHAN SHUMAN,
of Teaneck, New Jersey. as Co-Trustees of any Trusts created in this Will. In the event of any
disagreement between CRAIG L. VANDERGRIFT and NATHAN SHUMAN, then my
granddaughter,SOPHIA VANDERGRIFT,shall have the authority to resolve the disagreement and
make the final decision.
Article XII
In order to carry out the purposes of the Trusts established by this Will, the Trustee, in
addition to all other powers granted by this Will or by law, shall have the following powers over the
Trust estate, subject to any limitations specified elsewhere in this Will:
(a) to retain in the form received and/or to sell either at public or private sale, any real
estate or persona( property except that which I specificaliy bequeath herein,
(b) to manage real estate,
(c) to invest and reinvest in all forms of property without being confined to legal
investments, and without regard to the principal of diversification,
(d) to exercise any option or right arising from the ownership of investments,
(e) to compromise claims without court approvai and without consent of any beneficiary,
(� to file fiduciary/income tax returns and pay the tax due fior any year for which such a
return is required,
- I1 -
(g) to make distributions in cash or in kind.or in both,and to determine the value of any
such property,
(h) to employ any attorney, investment advisor,or other agent deemed necessary by my
Executor or Trustee; and to pay from my estate reasonable compensation for all their services,
(i) to conduct along with or with others, any business in which I am engaged in or have
an interest in at the time of my death,
(j) to receive reasonable compensation in accordance with their standard schedule of fees
in effect while their services are performed, and
(k) to resign as Trustee at any time by giving written notice to ail beneficiaries.
Article XIII
I nominate, constitute, and appoint CRAIG L. VANDERGRIFT as Executor of my Last
Will and Testament. In the event of the renunciation, death, or inability� to act. for any reason
whatsoever of my Executor, I nominate, constitute and appoint my granddaughter, SOPHIA
VANDERGRIFT,of Washington. D.C., as successor Executrix of my Last Will and Testament. I
direct that my Executor or successor Executrix he permitted to serve without bond and in addition to
those powers granted by law, I grant them power to distribute in cash or in kind in like or in unlike
shares and to file any qua(ified disclaimer I could have filed if living. My Executor or successor
Executrix shall receive reasonable compensation for services rendered to my estate.
Article XIV
In addition to the powers conferred by law, I authorize my Executor and successor Executrix,
in his/her absolute discretion:
- 12 -
(a) to retain in the form received and to sell either at public or private sale,any real estate or
personal property except that which I speciticallv bequeath herein,
(b) to manage real estate,
(c) to invest and reinvest in all forms of property without being confined to legal
investments, and without regard to the principal of diversification,
(d) to exercise any option or right arising from the ownership of investments,
(e) to compromise claims without court approval and without consent of any beneficiary,
(� to file any federal income tax return for any year for which ( have not filed such return
prior to my death,
(g) to make distributions in cash or in kind, or in both, and to determine the value of any
such property,
(h) to employ any attorney, investment advisor, or other agent deemed necessary by my
Executor; and to pay from my estate reasonable compensation for all their services,
(i) to conduct alone or with others, any business in which I am engaged in, or have an
interest in at time of my death,
(j) to file any qualified disclaimer I could have if living, and
(k) to receive reasonable compensation in accordance with their standard schedule of fees in
effect while their services are performed.
- 13 -
IN WITNESS WHEREOF, I, ELIZABETH H. VANDERGRIFT, hereby set my hand to
� (�
this my Last Will and Testament, on ,1��Q o�v 2013.
� � ; �
,
ZABETH H. VANDERGRIFT
In our presence, the above-named ELIZABETH H. VANDERGRIFT signed this and
declared this to be her Last Will and Testament and now at her request, in her presence, and in the
presence of each other, we sign as witnesses.
Name Address
��� �G � - ��l6� �� l T��
� t �� �
� L� ������
1 -z�a�
- 14 -
I, ELIZABETH H. VANDERGRIFT, Testatrix, who signed the foregoing instrument,
having been duly qualified according to law,acknowledge that I signed and executed this instrument
as my Will, and that I signed it willingly as my free and voluntary act for the purposes therein
expressed.
Sworn to or affirmed and
acknowledged before me by
ELIZABETH H. VANDERGRIFT, the Testatrix
on �i�►12 0� L� , 2013.
, < 1 r � � �J" � "�(�/�'�f � '�j`�`'1" ,7_
tary ublic ELIZABETH H. VANDERGRI T
NOTARIAL SEAL
JAC�UEUNE A KELLY
Not�ry PuDlic
LOWER PAXTON TWP.,DAUPHIN COUNTY
My Commission Expires Dec 17, 2015
We, the undersigned witnesses who signed the foregoing instrument, being duly qualified
according to law, depose and say that we were present and saw the Testatrix sign and execute this
instrument as her Will; that she signed and executed it willingly as her free and voluntary act for the
purposes therein expressed;that each of us in her sight and hearing signed the Will as witnesses,and
that to the best of our knowledge, that she was at that time eighteen (18) years or more of age, of
sound mind, and under no constraint or undue influence.
Sworn to or affirmed and
subscribed to before me
ey��tRE i�4 _ �uRS� �� q,7
and''�,c�v�c—,�,4� �-c�QS �'7- s ,
witnesses, on J�A n� .�..C� , 2013.
— -.�- �--�
� Witness
�
otary ublic �
NOTARIAL SEAL
JAC�UELINE A KELLY - 1 S -
Notary Public
LOWER PAXTON TWP.,DAUPNIN COUNTY
My Commission Expires Dec 17,2015
_ _
P #1
�°M: INVOICE
John Troup
J.H.TrouP, aPPraisers r-� � ��� �'_,^
1271 Eisenhower Boulevard
Harrisburg,PA 17111 A
10/23/2013
Tekplwne Number. Fax Number:
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T�: Mt@mel Ofda N:
Jacqueline A Kelty ���X:
Jan L.Brown 8 Associates CIkM FNe N:
845 Sir Thomas Ct
Suite 12 �+IainFdeMonfam:
Hanisburg,PA 17109 Other F�e N on fortn:
Tekphone Number. Faz Number. Federal Tez ID:
ARemate Number. E-Nai: Empbyer ID:
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Lender:Jan L.Brown&Associates Client: Jan L.Brown&Associates
Purchaser/Bortower:N/A
Propel'ly Addresf: 11 Blackmore Ct
City:Camp Hill
COUnty:Cumberland StetE:PA Lp: 17011
Legel Descriptlon:Deed Book 34F Page 1195 US 10/26/7989
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Summary Appraisal Report 300.00
SUBTOTAL : soo.00
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SUBTOTAL :
TOTAL DUE $ `soo.00 �
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�� Form NNS—�WinTOTAL•appraisal software by a la mode,inc.—1-80o-ALAMODE
JH Troup,Inc.Appraisers(717)939-8380
CPao�
Uniform Residential A raisal Re ort �,�
There are 2 co arable ro ies cwr ottered fa sale in the sub' t nei hborhood ra i In ice from S 213 900 to S 249 900
Thue are 3 co arable sales in the sub' nei hbataod witliin the ast Iwdve months ra i in sale rice from E 205 000 to S 215 000
FEATURE SUBJECT COMPARABLE SALE#1 COMPARABLE SALE�2 COMPARABLE SALE#3
Address 11 Blackmore Ct 47 Victoria Way 5 Chester Rd 13 Blue Spruce Dr
Cam Hill PA 17011 Cam Hill PA 17011 Enola PA 17025 Enola PA 17025
Pro�dmi to Sub'ect `0.22 miles NE 1.57 miles NW 2.29 miles NW
$ak PriCe E 3 205 000° S 210 000 " a 215 000
Sale RicelGoss Liv.Area S s .fl.5 114.14 5 .fl. E 138.89 s .ft. S 134.54 S .ft. '
Data So�ece s '.MLS#10233130•DOM 12 MLS#10239293�DOM 2 MLS#1023318TDOM 6
VerifiCaUon Sourte s Assessment Data Assessment Data Assessment Data
VALUE A0.IUSTMENTS DESCRIPTION DESCRIPTION +- S Ad'ustmenl DESCRIPTION +- S Ad'usiment DESCRIPTION +- a Ad'ustrnenl
Sales or Rnancing qrmLth ArmLth ArmLth
Cancessiais ;Conv0 FHA�5000 -5 000 Cash•0
Date o1 SalelTime s04/13�c02/13 s07/13•c06/13 s03/13•c02/13
��� N�Res N•Res' N�Res� N�Res�
leasehdd/Fee SI k Fee Sim te Fee Sim le Fee Sim le Fee Sim le
S�� 22 216 si 9147 sf 0 16117 sf 0 9583 sf 0
��' MRes MRes N•Res MRes
Desl n S e Ranch S Iit Level 0 Ranch Ranch
�ual of ConSWctlon Q4 Q4 Q4 Q4
Acpial A B 23 26 0 8 -5 000 11 -5 ppp
CoMi�on C4 C4 C4 C4
AbOYe Gf2de Tafal Bdrms. Batls Totai Bhms. 8atls TOlal Bdrtns. Baths Takl Bdnns. Batl�s
R����M 6 3 2.0 6 3 2.1 -2 000 5 3 2.0 0 6 3 2.0
�U� �� 1 918 S.ft. 1 796 s .ft. +3 660 1 512 S.ft. +t 2 180 1 598 5 .tl. +9 600
Basement 8 RNshed 1918sfOsfwo 1752sf500siwo 0 1512sfOsf 0 1598si0sfin 0
Rooms Bebw Grade 1 rrObrO.ObaOo -5 000
Fw�onal t1Uli Avera e Avera e Avere e qvara e
. Heatl ooN GFWAICA Gas/CA 0 EHP/CA 0 EHP/CA p
.' Ener Effklenf Items Standard Similar 0 Similar 0 Similar p
: Gara Ca ort 2 Car Gara e 2 Car Gara e 2 Car Gara e 2 Car Gara e
PorCNPatlQ+DeCk Pch E Pch Dck Deck +3 500 Deck +3 500 Pch Pto Sun R 0
' Flr C oodstave 1 Fire lace 1 Fire lace None +2 5pp Nane +Z�p�
' �� 51� �� + • E 160 + • S 8 180 + - S 7 100
Adjusted Sale Pdce •Net Adj. 0.7% Net Adj. 3.9 96 Net Adj. 3.3%
af C �ables . I„ �ross Ad'. 6.9%S 205 160 G�oss Ad'. 13.4% S 218 180 C�oss Ad'. 8.0%a 222 100
� I did did raf research Uie sale or transfer histo of Uie sub'ect ro antl com rable sales.If not, in
research did did irot reveal a rior sales a Vansfers ot the sub ect for the ihee ears rior to the ettective date of tHs a raisai.
Data Source s MLS
research did did not reveal a rior sales or transfers of the co rable sales tor the ear rior to the date oi sale of tha co rabk sale.
Data Sowce s MLS
R ihe resutts of the research and an sis of tl�e ria sale w Oansier hisb of U�e sub eCt o and co rable sales r addido�al rior sales on a 3.
ITEM SU&IECT COMPARABLE SALE#i COMPARABLE SALE#2 COMPARABLE SALE�3
Date ol Prlor Salr/Transfer
Price ot Pria Saleliranster
Dehe SotxCe 5 Coun Records Assessment Data Assessment Data Assessment Data
Eftective Uate o(Data Sauce s 10/18/2013 10/18/2013 10/18/2013 10/18/2013
Ma sis Of a sale or transter hist of the sub eC� o and Co arable sales Research ot sub"ect and com arables show no a licable rwr sale
histo .
Su ol Sales Co arison roaCh Ail sales are cbsed transactions as r the verification source idenCrf'�d. Focus was laced on findi
transfers that are similar in size amenities and condition to the sub'ect. After a tho h search oi the market the above sales were considered
the most re resentative of the sub'ect,Due to the limfted number of transactions similar to the sub'ect it was necessa to select sales over s(x
months old sales and sales located more than one mile from the sub'ect.Com arables listed on the re rt are considered to be ood indicators of
value based on their simila to the sub'ecL Com rables were selected from the sub'ecPs ne' hborhood or com eti nei hborhood.
Ad ustments were made accordi to the markeNs' ction to the differences.
.�
kid'�cated VaN�e Sales Co arison roach 215 000
I�k�ted Value .Seles Com rison Cost A roach(K develo )S Income oach fH develo 1 S
The market a roach is the best a roach for this ro and the one for which the most reNable data is ava�able. The income a roach is rat
� a licable to the sub ect because the b r is more interested in the amenities than the income the ro e would roduce.
� This appraisal Is made�'as is', ❑ subject to canpletlon per plans and specificaBons on qie basis oi a hypotl�etkal candiBon Nat 7ie improvements have been
canpleted, ❑subject to Vie to9owing repairs a aAeratlons on the basis o1 a hypoUieUcal coMitlon ihat the repairs a atteratlons have been completed,or�subject W the
• fobwi r uired ins an based on the e�raordire assu tlon that the cond(tlon or detfcienc does rot r ufre atteratbn or r ir. The sub ect is a ralsed in its
reseM conditlon as of the effective date of this a raisal.
� Based on e complete visual Inspectfon of the intwior and exterior areas oi the subject pro deflned scope of worlc,statement of assumptions and I(mitfng
conditlons,and appra(ser's ceRficatlon,my(ou�opinfon of the market value,as def(rred,of �e real property that Is the subject ot thls report is
S 215 000 as ot t0/18i2013 which ia fhe date of Ins lon end the effective date of this a ratsal.
freddie Mac Fortn 70 March 2005 UAD Version 9/2011 Page 2 of 6 Fannie Mae Form 1004 March 2005
Farm 1004UA0—'WInTOTAL•appraisal sottware Ay a la mode,inc.—1-800-ALAMODE
�
Uniform Residentiai A raisal Re ort F�„�
This report form is designed to report an appraisal of a one-unit property or a one-unit propeRy with an accessory unit;
including a unit in a planned unit development (PUD). This report form is not designed to report an appraisal of a
manufactured home or a unft in a condominium or cooperative project.
This appraisal report is subject to the following scope of work, intended use, intended user, definition of maricet value,
statement of assumptions and limiting conditions, and cert'rfications. Mod'rfications, additions, or deleGons to the intended
use, intended user, definftion of market value, or assumptions and limiting conditions are not permitted. The appraiser may
expand the scope of work to include any additional research or analysis necessary based on the complexity of this appraisal
assignment. Mod'rfications or deletions to the cert'rfications are 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 appraisa� assignment and the
reporting requfrements of this appraisal report form, including the following definition of market value, statement of
assumptions and limiting conditions, and certrfications. The appraiser must, at a minimum: (1) pertorm a complete visual
inspection of the interior and exterior areas of the subject property, (2) inspect the neighborhood, (3) inspect each of the
comparable saies 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.
DEFlNITION 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 seiler, each acting prudently, knowledgeably and assuming
the price is not affected by undue stimulus. Implicit in this definition is the consummation oi a sale as of a spec'rfied date and
the passing of title from seller to buyer under conditions whereby: (1) buyer and seller are typicaliy motivated; (2) both
parties are well informed or well 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
readiiy identifiable since the seller pays these costs in virtually atl 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 dol�ar cost of the financing or concession but the dollar amount of any adjustment should approximate the markeYs
reaction to the financing or concessions based on the appraiser's iudgment.
STATEMENT OF ASSUMPTIONS AND LIMITING CONDITIONS: The appraiser's certitication in this report is
subject to the following assumptions and limiting conditions:
1. The appraiser will not be responsible for matters of a legai nature that affect either the property being appraised or the tftle
to it, except for information that he or she became aware of during the research involved in pertorming this appraisai. The
appraiser assumes that the tiUe is good and marketabie and will not render any opinions about the title.
2. The appraiser has provided a sketch in this appraisal repoR 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 s¢e.
3. The appraiser has examined the available flood maps that are provided by the Federal Emergency Management Agency
(w other data sources) and has noted in this appraisal report whether any poRion of the subject site is located in an
idenFrfied 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 appralser will not give testimony or appear in court because he or she made an appraisal of the propeRy 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 propeRy or that he or
she became aware of during the research involved in performing the appraisal. Unless otherwise stated in this appralsal
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, trncic substances,
adverse environmental conditions, etc.) that would make the propeRy 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
condfions that do exist or for any engineering or testing that might be required to discover whether such conditions exist.
Because the apprafser is not an expert in the field of environmental hazards, this appraisal report must not be considered as
an environmental assessment of the property.
6. The appraiser has based his or her appraisal report and valuation conclusion for an appraisal that is subject to sa6sfactory
completion, repairs, or alterations on the assumption that the completion, repairs, or alterations of the subject propeRy will
be performed in a professional manner.
Freddle Mac Fortn 70 March 2005 UAD Verslon 9/2011 Page 4 of 6 Fannle Mae Form 1004 March 2005
Form 1004UAD—'1MnTOTAL'appraYSal software by a la mode,inc.—1-8p0-ALAMODE
Ceaa�
Uniform Residential A raisal Re ort F��
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 Unfted States; and any state, the District of Columbia, or other jurisdictions; without having to
obtain the appraiser's or supervisory appraiser's ('rf applicable) consent. Such consent must be obtained before this appraisal
report may be disclosed or distributed to any other party (including,but not limfted to, the public through advertising, public
relations, news, sales, or other media).
22. I am aware that any disclosure or distribution of this appraisal report by me or the lendedclient may be subject to certain
laws and regulations. Further, I am also subject to the provisions of the Uniform Standards of Professional Appraisai 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, govemment sponsored enterprises, and other secondary market participants may rely on this appraisal report as part
of any mortgage finance transaction that involves any one or more of these parties.
24. If this appraisal report was transmitted as an "electronic record"containing my"electronic signature," as those terms are
defined in applicable federal and/or state laws (exc�uding audio and video recordings), or a facsimile transmission of this
appraisal report containing a copy or representation of my signature, the appraisai 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 misrepresentation(s) contained in this appraisal report may result in civil liabifity and/or
criminal penafties including, but not limfted to, fine or imprisonment or both under the provisions of Title 18, United States
Code, Section 1001, et seq., or similar state laws.
SUPERVISORY APPRAISER'S CERTIFICATION: The Supervisory Appraiser certifies and agrees that:
1. I direcUy supervised the appraiser for this appraisal assignment,have read the appraisal report,and agree with the appraiser's
analysis, opinions, statements, conclusions, and the appraiser's ceRification.
2. I accept full responsibility for the contents of this appraisal report including,but not limfted to,the appraiser's analysis, opinions,
statements, conclusions, and the appraiser's certification.
3. The appraiser ident'rfied in this appraisal report is efther a sub-conVactor or an employee of the supervisory appraiser(or the
appraisal firm), is qualified to pertorm this appraisal, and is acceptable to perform this appraisal under the applicable state law.
4. This appraisai report complies with the Un'rform 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.
5. It this appraisal report was transmitted as an "electronic record"containing my"electronic signature," as those terms are
defined in applicabie 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 repoR shall be as effective, enforceable and
valid as if a paper version of this appraisal report were delivered containing my original hand wntten signature.
APPRAISER SUPERVISORY APPRAISER(ONLY IF REQUIRED)
Signature ` Signature
Name hn H T Name
Compa Na J.H.rrouo,APpraisers Company Name
Company dress �2�t Eisennower eivd Company Address
Harrisburq,PA 17111
Telephone Number (7t71939-838o Telephone Number
Email Address 1hVOUp(o�lhtroup.com Email Address
Date of Signature and Report �orz3�zo�s Oate oi Signature
EffecGve Date of Appraisal 1on8i2ot3 State Certification#
State Cert'rfication# RL-000001-L Of StBtC L'ICenSe#
or State License# State
or Other(describe) State# Expiration Date of Cert'rfication or License
State PA
Expiration Date of Certification or License O6/30l2015 SUBJECT PROPERTY
ADDRESS OF PROPERNAPPRAISED O Did not inspect subject property
11 Blackmore Ct ❑ Did inspect exterior of subject property from street
Camp Hill,PA 17011 Date of Inspection
APPRAISED VALUE OF SUBJECT PROPERTY$ 2�5,000 ❑ ��d inspect interior and eMerior of subject property
LENDER/CLIENT Date of Inspection
Name No a�nC
Company Name Jan�.erown 8 Associates COMPARABLE SALES
Company Address 845 Sir Thomas Ct.SuRe 12,Harcisbursi,PA � Did not inspect exterior of comparable sales from street
���� ❑ Did inspect exterior of comparable sales from street
Email Address Date of Inspection
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�ender Jan L.Brown 8 Associates
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Ro Address 11 Blackmore Ct
C' Cam Hill Cou Cumberland State PA Zi Code 17011
Lender Jan L.Brown 8 Atsociates
Mechanicals
11 Blackmore Ct
Sales Price
� G.L.A. 1,918
Tat.Raoms 6
Tot.Bedrms. 3
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C Cam HiH Cau Cumberland SWte PA Z Code 17011
Lender Jan L.Brown 8 Associates
Comparable 1
47 Victoria Way
Prox to Subj. 0.22 milas NE
Sales Price 205,000
G.L.A. 1,796
Tot.Roorta 6
Tot.Bedrms. 3
Tot.Batlrms. 2.1
location N;Res;
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�r G.L.A. 1,512
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13 Biue Spruce Dr
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Sales Price 215,000
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JAN L. BROWN & ASSOCIATES
ATTORNEYS AND COUNSELORS AT LAW
.TAN L. BROWN,ESQUIRF BRENDA F. KEPHART.LEGAL ASSISTANT
.TACQUELINE A. KELLY,ESQUIRE JUDITH A. EBERSOLE,ADMINISTRATIVEASSISTANT
CHRISTA M. APLIN,F,SQUIRE MELISSA L. SMITH,LEGAL ASSISTANT
TRICIA J. BELANSEK,LEGAL ASSISTANT
C�7 __t't
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February 14, 2014 'F�� . ---� `r
�
�� ��
Register of Wills �-�` - . :;
Cumberland County Courthouse `��-�� c,,, ;-r;
One Courthouse Square :�=' �` ��'� �=;
c_� ..:z
Carlisle, PA 17013 "'
Re: Estate of Elizabeth H. Vandergrift
Estate No. 2013 00750
Executrix: Craig L. Vandergrift
Gentlemen or Ladies:
Enclosed please find the following items for filing with the Register of Wills:
1. An original and one copy of the Inventory.
2. An original and two copies of the Inheritance Tax Return.
Please time stamp and return our file copies of the Inventory and Inheritance Tax Return.
Also,please provide us with the appropriate receipts.
If you have any questions, feel free to contact this office.
Sincerely,
°—� (�v�v�t� -
Jacqueline A. Kelly
JAK/tjb
Enclosures
cc: Craig Vandergrift
Olde English Gap • 845 Sir Thomas Court • Suite 12 • Harrisburg, PA 17109
Telephone(717)541-5550 • Fax(717)541-9223 • Email:JLBassoc@janbrownlaw • www.janbrownlaw.com