HomeMy WebLinkAbout07-21-14 (2) 1 15D5610143
J REV-1500 EX(02.11' tis�
OFFICIAL USE ONLY
PA Department of Revenue Pennsylvania County Code Year File Number
Bureau of Individual Taxes
PO BOX.280601 INHERITANCE TAX RETURN 21 13 1087
Harrisburg,PA 17128.0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
188 32 2501 09 28 2013 11 23 1938
Decedent's Last Name Suffix Decedent's First Name MI
HAIR MEARL E
(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
x❑ 1. Original Return E] 2. Supplemental Return 3. Remainder Return(Date of Death
Prior to 12-13-82)
❑ 4. Limited Estate ❑ 4a.Future Interest Compromise S. Federal Estate Tax Return Required
(date of death attar 12-12-82)
g Decedent Died restato 7, Gecedepi Haut teed a Living Tmst 0 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Dopy et IMI)
9. Litigation Proceeds Received 10.09owe I Pgv-Jtr-9Ce alt{Da�es�I Death 11.Election to tax under Sec.9113(A)I. (Attach Schedule 0)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
GEORGE F DOUGLAS III ESQ 717 249 6333
REGISTER WILLS US�26NLY
C0 .x- =1
First Line of Address ��(_, r Z
354 ALEXANDER SPRING RO v+ (V r= ��
cn !�
Second Line of Address
OC__ T
D ILED — ~= n
City or Post Office State ZIP Code D W �Al O
CARLISLE PA 17015 `D
Correspondent's e-mail address: gdouolasnasaizmannhuahes.com
Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief.
It is true,correct and complete tee.{I/��D�Seeccllar tion of preparer other than the personal representative is based on all Information of which preparer has any knowledge.
SI RE OF PER ON RES WlHLE FOR FILING RETURN ATEO� ,J
Russell C. Hair 7l/ p �—/
ADDFIESS
119 Maple Drive Mechanicsburg PA 17050
SIGN TURE OF PREPARER OT THAN REPR ENTATIVE� DATE / CL
--- t George F Douglas, III Esq. AT 1 T
ADD ESS
354 Alexander Spring Road, Suite 1, Carlisle, PA 17015
1505610143 Side 1 1505610143
0
1 1505610243
-J REV-1500 EX
- Decedent's Social Security Number
Dewdenrs Name: Hair, Mearl E. 188 32 2501
RECAPITULATION
1. Real Estate(Schedule A).......................... - - - 1. - 140 , 000 . 00
.....:.....................................................
2. Stocks and Bonds(Schedule B)............................................................................. 2.
3. 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. 54, 060 . 86
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6. 51 , 521 . 26
7. Inter-Vivos Transfers&Miscellaneous I�oq Probate Property
(Schedule G) u Separate Billing Requested............ 7. 325, 203 . 51
8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 570 , 785 . 63
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 35 , 695 . 68
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10. 4, 388 . 78
11. Total Deductions(total Lines 9 and 10)................................................................ 11. 40, 084 . 46
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 530 , 701 . 17
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. 530 , 701 . 17
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 530 , 701 . 17 16. 23 , 881 . 55
at lineal rate X .045
17. Amount of Line 14 taxable 0 . 00 17. 0 . 00
at sibling rate X.12
18. Amount of Line 14 taxable 0 . 00 18. 0 . 00
at collateral rate X.1 5
19. TAX DUE............................. 19. 23 , 881 . 55
...................................................................................
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 1K
Side 2
1505610243 1505610243 J
REV-1500 EX Page 3 File Number 21-13-1087
Decedent's Complete Address:
DECEDENT'S NAME
Hair, Mearl E.
STREETADDRESS
119 Maple Drive
CITY STATE ZIP
Mechanicsburg PA 17050
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 23,881.55
2. Credits/Payments
A. Prior Payments 22,752.30
B. Discount 1,131.58
Total Credits(A +B) (2) 23,883.88
3. Interest (3)
4, If Line 2 is greater than Line 1 + Line 3,enter the difference. This is the OVERPAYMENT. (4) 2.33
Check box on Page 2,Line 20 to request a refund
5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5)
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;.................................. B
c. retain a reversionary interest:or............................................................................................................... 8 x
d. receive the promise for life of either payments,benefits or care?............................................................
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?.................................................................................................................... ❑
3. Did decedent Own an-in trust for or payable upon death 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?.................................................................................................................. ❑x ❑
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 172 P.S.§9116(a)(1.1)(1)).
Fordates of death on or after January 1,1995,the lax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S.§9116(a)(1.1)(ii)]. The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and
fling a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 years 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 172 P.S.§9116(a)(1.2)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S.§9116(a)(1.3)1. 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 4502 EX+(01-10) -
SCHEDULE A
pennsylvania REAL ESTATE
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Hair, Mearl E. 21-13-1087
All real property owned solely or as a tenant In common must be reported at fair merkot value.Fair market value is defined as the pace at which pmpery would be
exchanged beMrocn a willing buyer and a willing9 seller,neither being compelled to buy or sell,both having reasonable knor ledge of the relevant,leas.
Real property that Is Iolntlyawned with right of survvomhip must be disclosed on schedule F.
Attach a copy of the settlement cheat If the property has been sold
Include a copy of the dead showing decedent's interest If owned as tenant In common.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Real estate situate at 119 Maple Drive, Mechanicsburg, Silver Spring Township, Cumberland 140,000.00
County, PA
TOTAL (Also enter on Line 1, Recapitulation) 140,000.00
(If more space is needed.additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group, Inc. Forth PA-1500 Schedule A(Rev.01-10)
Rev1508 EX-(71.10)
SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Hair, Mead E. 21-13-1087
Include the proceeds of Ihlganon and the date the proceeds were received by the estate.
NI property JolMlyowned with the right of suMvorshlp must be disclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Citizens Bank,Checking Account No. 564-1 11,934.38
2 1977 Ford Bronco taken in kind 50.00
3 2002 Ford Explorer taken in kind 3,000.00
4 2012 Buick Enclave 28,000.00
5 Household goods taken in kind 2,000.00
6 Blue Cross-refund unused premium 121.80
7 Commonwealth of Pennsylvania-2013, PA40 income tax refund 67.00
8 Medicare-reimbursement for medical expenses paid 118.16
9 Medicare-reimbursement for medical expenses paid 13.99
10 Medicare-reimbursement for medical expenses paid 428.20
11 Medicare-reimbursement for medical expenses paid 92.27
12 Medicare-reimbursement for medical expenses paid 79.58
13 U.S. Treasury-2013, 1040 income tax refund 8.113.00
14 Verizon -refund 42.48
TOTAL(Also enter on Line 5, Recapitulation) 54,060.86
(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-1509 F-X-(01-10)
pennsylvania SCHEDULE F
DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Hair, Mearl E. 21-13.1087
If an asset was made joint within one year of the decedent's date of death.It must be reported on schedule G.
SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT
A. Russell C. Hair 119 Maple Drive Son
Mechanicsburg, PA 17050
B. John T. Hair 43 Cumberland Drive Son
Mechanicsburg, PA 17050
C.
JOINTLY OWNED PROPERTY:
DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM LETTER DATE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATEOFDEATH DECD'S
NUMBER FOR JOINT MADE NUMBER OR SIMILAR IDENTIFYING NUMBER.ATTACH DEED FOR VALUEOFASSET INTEREST DECEDENT'S INTEREST
TENANT JOINT JOINTLY-HELD REAL ESTATE.
1 A 09/17/2012 Members 1st Federal Credit Union,Certificate 50,040.68 50.000% 25,020.34
of Deposit No. 200999-0042
2 B 10101/2011 Members 1st Federal Credit Union,Certificate 51,069.32 50.000% 25,534.66
of Deposit No.200999-0041
3 A 10/01/2001 Members 1st Federal Credit Union, Money 1.866.07 50.000% 933.04
Management Account No.200999-0005
4 A 01119/2001 Members 1st Federal Credit Union, Regular 66.43 50.000% 33.22
Savings Account No.200999-0000
TOTAL(Also enter on Line 6, Recapitulation) 51,521.26
(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 F(Rev.01-10)
Rev-1stoFx.(oe-oe( .
SCHEDULE G
pennsylvania INTER-VIVOS TRANSFERS AND
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF NUMBER
Hair, Mearl E. [FILE 1-13-1087
This schedule must be completed and fleal it the onsrer to any of Questions 1 through 4 on page three of the REV-150 Is yes.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECo•S EXCLUSION TAXABLE
NUMBER THINCLUDE TE NAME TRAAFNSFER.ATTACH A COPY OF THE DEED FOR ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1 Citizens Investment Services-IRA No. L7C-052841 - 325,203.51 100.000% 325,203.51
Equal beneficiaries are decedent's children, Russell C
Hair and John T. Hair
TOTAL(Also enter on Line 7, Recapitulation) 325,203.51
(It 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)
REV-1511 Ex.(10.99)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE RESIDENT DEC TAX ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Hair, Mearl E. 21.13-1087 _
Decedent's debts must be reported on Schedule 1.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 17,251.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City Slate DO
Year(s)Commission Paid
2. Attorney's Fees Salzmann Hughes, P.C. 7,500.00
3, Family Exemption: (If decedent's address is not the same as claimant's,attach explanation) 3,500.00
Claimant Russell C. Hair
Street Address 119 Maple Drive
city Mechanicsburg State PA Zio 17050
Relationshio of Claimant to Decedent _Spouse
4. Probate Fees 533.50
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 6,911.18
See continuation schedule(s) attached
TOTAL(Also enter on line 9, Recapitulation) 35,695.68
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
Hair, Mearl E. 21.13.1087
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Expenses
1 Myers-Buhrig Funeral Home-funeral expenses 17,251.00
H-A 17,251.00
Other Administrative Costs
2 Accu-Fast Appraisal-real estate appraisal 325.00
3 Citizens Bank-estate checkbook fee 9.99
4 Citizens Bank-service fee for statement 2.00
5 Citizens Bank-service fee for statement 2.00
6 Citizens Bank-service fee for statement 2.00
7 Citizens Bank-service fee for statement 2.00
8 Citizens Bank-service fee for statement 2.00
9 Citizens Bank-service fee for statement 2.00
10 Citizens Bank-service fee for statement 2.00
11 Comcast-cable service 223.17
12 Home Paramont Pest Contras-pest control service 127.20
13 McCafferty Ford-repairs needed to sell the Ford Explorer in order to administer the estate 1,163.82
14 Opossum Lake Accounting Inc.-2013 income tax return preparation 305.00
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Hair, Mearl E. -
21.13-1087
ITEM
NUMBER DESCRIPTION AMOUNT
15 Penn National Insurance-minimum automobile insurance premium due 100.00
16 Penn Waste, Inc. -refuse service 48.14
17 Penn Waste, Inc. -refuse service 38.14
18 Penn Waste, Inc. -refuse service 38.14
19 Penn.American Water-water service 36.40
20 Penn.American Water-water service 31.65
21 Penn.American Water-water service 49.81
22 Penn.American Water-water service 30.12
23 Penn.American Water-water service 25.43
24 Penn.American Water-water service 78,15
25 Penn.American Water-water service 83.83
26 Penn.American Water-water service 52.16
27 PPL-electric service 53.26
28 PPL -electric service 39.46
29 PPL-electric service 52.99
30 PPL-electric service 77,25
31 PPL -electric service 69.04
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev.6-98)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Hair, Meari E. - 21.13.1087
ITEM
NUMBER DESCRIPTION AMOUNT
32 PPL-electric service 85.36
33 PPL-electric service 132.46
34 PPL-electric service 84,48
35 Russell C.Hair-reimbursement for travel and postage expense in order to administer the 66.50
estate
36 Russell C. Hair-reimbursement for travel and postage expense in order to administer the 43,42
estate
37 Salzmann Hughes,PC-closing costs and final fees for income tax preparation,postage and 500.00
miscellaneous contingencies in order to administer the estate
38 Silver Spring Township Authority-sewer service 99.14
39 Silver Spring Township Authority-sewer service 109.14
40 Superior Plus Energy Services-heating oil 884.07
41 Superior Plus Energy Services-heating oil 776.72
42 Superior Plus Energy Services -heating oil 14.00
43 Superior Pius Energy Services-heating oil 787.16
44 The Patriot-News -Legal advertising 109.52
45 The Sentinel-Legal advertising 147.06
H-B7 6,911.18
Copyright(c)2002 form software only The Lackner Group, Inc, Form PA-1500 Schedule H(Rev,6-98)
Rev-1512 E%-(12-08)
SCHEDULE 1
pennsylvania DEBTS OF DECEDENT,
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MORTGAGE LIABILITIES AND LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Hair, Mearl E. 21-13-1087
Report debts Incurred by the decadent prior to death that remained unpaid at the date of death.Including unrolmbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 AT&T-phone service 37.29
2 Citizens Bank-credit card balance 28,90
3 Comcast-cable service 216.47
4 Heartland-balance due on account 161.88
5 Mainhart -air conditioning service 195.00
6 Manor Care Health Services -balance due on account 2,636.00
7 MSHMC Physicians Group-3/4/2013 medical service 92,27
8 Penn.American Water-water service 37,79
9 PPL-electric service 44,58
10 Shugart Lawncare-balance due for three months lawn care services 500.00
11 Silver Spring Township Authority-sewer service 117.00
12 Special Event Emergency Medical Services-balance due on account 244.28
13 Verizon-phone service 77,32
TOTAL(Also enter on Line 10, Recapitulation) 4,388.78
(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-1517 EX.(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN- - BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Hair, Mearl E. 21-13-1087
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER- PERSON(S)RECEIVING PROPERTY ' ' DECEDENT (Words) ($$$)
Do Not LIM Tm5teabil
I TAXABLE DISTRIBUTIONS (include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2)1
1 Russell C. Hair Son Sch. F Items 265,576.56
119 Maple Drive 1,3,4
Mechanicsburg, PA 17050 Sch. G 1/2 Item 1
112 Residue
2 John T.Hair Son Sch. F Item 2 265,124.61
43 Cumberland Drive Sch. G 112 Item 1
Mechanicsburg, PA 17050 112 Residue
Total 530,701.17
Enter dollar amounts for distributions shown above on lines 15 through loon Rev 1500 cover sheet,as appmp riate.
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)
RE6# D r� OF 4 c
REC,Ajj j}r is
'I (lE ' i�j'fiIL] A {��ESTAIiENT OF KARL E. HAIR
Iof the Township of Silver Spring,
CU
County of Cumberland' e.nd State of Pennsylvania, being of sound
and disposing mind, memory and understanding, do make , publish
and declare this my Last Will and Testament.
1.
I direct the payment of all my just debts and funeral
expenses as soon after my decease as the same can be conveniently
done.
2.
I .give, devise and bequeath my House and Lot of Ground
situate in Silver Spring Township, Cumberland County, Pennsylvania,
presently known and numbered as 119 Maple Drive, Itechaniosburg,
Pennsylvania, together with any and all the contents thereof, to
my sons RUSSELL C. HAIR, absolutely and unconditionally.
3.
I give and bequeath all the rest residue and remainder
of my estate, of whatsoever nature and wheresoever the salts
may be situate, to my two (2) sons, to wit, RUSSELL 0. HAIR
and JOHN T. HAIR, share and share alike, per stirpes.
-1-
LASTLY, I nominate, constitute and appoint my son,
RUSSELL C. HAIR, Executor of this my Last Will and Testament
and in the event that my said son, should predecease me, or
should he be unable or unwilling to serve in such capacity for
any reason, then in such event, I nominate , constitute and appoint
my son, JOHN T. IIAIR, Executor of this my Last Will and Testament,
in his place and stead,
IN WITNESS WHEREOF, I have hereunto set my hand and seal
this _ day of November, A. D. , 1996- (SEAL)
Mearl E. Hair
-2-
Signed, sealed, published and declared by the above
named, MEARL E. HAIR, as and for his Last Will and Testament,
who have subscribed our names hereto as
in the presence of us,
witnesses, at the request of said testator, in his presence and
in the presence of each other.
COMMONWEALTH OF PENNSYLVANIA ) SS.
COUNTY OF CUMBERLAND )
I� MEARL E. HAIR the teatat or
whose name is signed to the attached or foregoing instrument, having
been duly qualified according to law, do hereby acknowledge that I
signed and executed the instrument as my Last Will and Testament;
that I signed it willingly; and that 1. signed it as my free and volun-
tary act and deed, for the purposes therein contained.
Sworn and affirmed to and acknowledged before me b r1
DIEARL E. HAIR , the testator tills
>, A. D. 1998
day of *T .
Pte�aar1 E. H
lotary Public
.E._seed yy
Med+ P��
COMMONWEALTH OF PENNSYLVANIA ) SS my W3009"d�fi°s
ylp�ia
COUNTY OF CUMBERLAND
We, the undersigned, J. ROBERT STAUFFER
and SUSAll A. I4CCOY the witnesses whose names are
signed to rile attached or foregoing instrument, being duly qualified
according to law, depose and say drat we were present ,a sign aand hexe-
testator IMARL E. HAIR
cute the instrument as hi Lset Will and Testament; that the
said testator
14EARL E. IIATR executed it as
hlsA=Xfree and voluntary act for th-- y e Purp°ass therein expressed;
that each of us, iu tile hearing said
o tile sight Ofoflroureknowle ge, the
rred
the Will as witnesses; _
testator was, at ills time, eighteen duress years of
of sound mind, and under no constraint,
Sworn and subscribed tobefor
me this f
1O
November ' "m&-ei Sear
Mealyn E.tVI gwm,Notary PuW
D1119 900.quateriiind C.0umy
My I.Pours fen Expeec Nov.6,Ml
ti MmrrMr,Psuaylrano Acsaciatloa W Nofirieo
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APPRAISAL OF REAL PROPERTY ;K
LOCATED AT: =`
119 Maple Dr
See Cumberland County Deed Book 23;Page 533 .�
Mechanicsburg,PA 17050
"z
FOR:
Russell Hairr;r
`.' 119 Maple Drive *'
Mechanicsburg,pa 17055
1,3
AS OF: 5 <
09!28/2013
Z;
BY: u
Robert I.Cassel
836 Tamanini Way N
Mechanicsburg,PA 17055
Phone 717$14 53801 Fax 717 790 8724
e-mail/rcassel @accu•fast.net , 5
www,accu-fast.net ;�i
Cover Page ............................................. 1
..
Table of Contents ............................................................. ........................................................ 2
........................................................................................
CoverLetter ...................................................................................................................................................................................................................... 3
Summary of Salient Features............................................................................................................................................................................................. 4
5
URAR ...............................................................................................................................................................................................................................
SubjectPhotos.................................................................................................................................................................................................................. 11
SubjectPhotos..............:................................................................................................................................................................................................... 12
SubjectPhotos Interior................................................................................:..................................................................................................................... 13
—— . - Subject Photos Interior.................4.... ............................................................... 14
Subject Photos Interior...................... 15
............................................................................................................. .
ComparablePhotos 1.3..................................................................................................................................................................................................... 16
BuildingSketch(Page-1)................................................................................................................................................................................................. 17
LocationMap..................................................................................................................................................................................................................... 18
. .
Flood Map............................................................................................................................................................................................................................. 20
..................... 19
LegalDescription..............................................................................................................................................................
UADDefinitions Addendum ...............................................................................................................................................................................4.............. 21
USPAPIdentification ...........................................................................................................................................................................................4..........4.4 24
SupplementalAddendum .........................................................................................................................................................................................4........ 25
EnvironmentalAddendum-Appraiser..................................................................................................................................................................4.........4... 26
..
Appraiser's Certification(License).............................................................................................................. ......................................4....................4........, 28
Appraiser's E&0....................................................................................................................................................................................................4.4....... 29
V GliG,1,VG1 1 v v
Robert Cassel
Accu-Fast Appraisals
836 Tamanini Way
Mechanicsburg, PA 17055
Phone: 717-514-5380
Fax : 717-790-8724
Email rcassel @accu-fast.net
Russell Hair - - - --- - --
119 Maple Drive
Mechanicsburg, PA 17050
RE: 119 Maple Drive, Mechanicsburg, PA 17050
Dear Mr. Hair;
Pursuant to your request, I have prepared a COMPLETE APPRAISAL/SUMMARY REPORT of the
property referenced in the"Summary of Salient Features"which follows.
The accompanying report is based on a site inspection of improvements, investigation of the subject
neighborhood area of influence, and review of sales, cost, and income data for similar properties.
This appraisal has been made with particular attention paid to applicable value-influencing economic
conditions and has been processed in accordance with nationally recognized appraisal guidelines.
The value conclusions stated herein are as of the effective date as stated in the body of the appraisal, and
contingent upon the certification and limiting conditions attached.
Please do not hesitate to contact me if I can be of additional service to you.
Respectfully,
Robert Cassel
PA Certified Residential Appraiser
Subject Address 119 Maple Dr
Legal Description See Cumberland County Deed Book 23; Page 533
. City Mechanicsburg
-County - ..... Cumberland
State PA
Zip Code 17050
Census Tract 42041-0118.02
Map Reference Franklin 2963-B-5
Sale Price $
Date of Sale
Lender Russell Hair
Lender/Client Russell Hair
Size(Square Feet) 1,117 - -
Price per Square Foot $
Location N;Res;
Age 58
Condition C3
Total Rooms 5
Bedrooms 3
Baths 1.0
Appraiser Robert I.Cassel
Date of Appraised Value 09/28/2013
Final Estimate of Value $ 140,000
Neighborhood Name Saver ti nn ..._ .._. _..__ . ._........___. _
Occupant F1 Owner ®Tenant ❑Vacant Special Assessments$ 0 ❑PUD HOA$ 0 per year per month
Property Rights Appraised ® Fee Simple 0 Leasehold ❑ Other(describe)
Assignment Type El Purchase Transaction Refinance Transaction ® Other describe Estimate Market Value
Lender/Ciient Russell Hair Address 119 Maple Drive Mechanicsburg, a 17055
Is the subject property currently offered for sale or has it been offered for sale in the twelve months prior to the effective date of this appraisal? ❑Yes M No
Report data sources used,off ering rice s and date(s). Data source Tor the offering information is the local Multi-List service.
I ❑did L❑did not analyze the contract for sale for the subject purchase transaction.Explain the results of the analysis of the contract for sale or why the analysis was nut
erformed.
: Contact Price$ Date of Contract Is the property seller the owner of public record? ❑Yes ❑No Data Source(s
Is there any financial assistance{loan charges,sale concessions,gift or downpayment assistance,etc.)to be paid by any party on behalf of the borrower? ❑Yes ❑ No
If Yes,report the total dollar amount and describe the items to be paid.
Note:Race and the racial composition of the neigghbo rhood are not appraisal factors.
Neighborhood Characteristic One-Unit Housing Trends One-Unit Housin Present Land Use
Location 0 Urban ®Suburban ❑ Rural I Property Values IncreasinQ IN Stable ❑ Declining PRICE AGE One-Unit 55%
Built-up []Over 75% ®25.75% ❑ Under 25% Demand/S y l ❑Shodage ® In Balance E] Over Supply $ 000 s _ -4 Unit 1 %
; Growth ❑Rapid ®Stable low Marketing Time ❑ Under 3 mths ®3.6 mths FJ Over 6 mths 50 Low 0 Multi-Famil 3%
Neighborhood Boundaries The subject neighborhood is bounded by Interstate 81 to the north Route 581 1,000 High 200 Commercial 15%
to the east Route 641 to the south and Route 114 to the west. 180 Pfad. 40 Other 26'%
Neighborhood Description Subject has access to all necessary supporting facilities including schools,public parks,transportation,shopping, and
houses of worship, Avers a Droperty maintenance programs observed. Employment is within 15-30 minute drive. §teady prices and MLS
statistics demonstrate stable demand for the area. Present Land use"Other"is 26%vacant land.
Market Conditions including support for the above conclusions There are no foreseeable economic factors that might adversely influence the marketabilitv
[Are lue of the subject. Interest rates are averaqe to ood-3%to 9%. Loan discounts are 2-3%. Concessions are not uncommon in this area
sual) have little impact on the market value.
sions See Attached Deed Area 16117 sf Shape Ro hl Rectan ular View N;Res;
Specific Zoning Classification R-1 Zoning Description Residential
Zoning Compliance Legal ❑ Legal Nonconforming(Grandfathered Use) ❑ No Zoning ❑ Illegal(describe)
highest and best use of subject roe as improved or as proposed per plans and specifications)the resent use? Yes ❑ No It No,describe
s Public Other(describe) Public Other(describe) Oft-skeImprovements-T Public Private
Electricity ® ❑ Water ® ❑ Street Asphalt ® ❑
❑ ❑ None Sanitary Sewer . Alley None ❑ ❑
Special Flood Hazard Area Yes X No FEMA Flood Zone X FEMA Map# 42041 CO257E EEMA IV Data 03/16/2009
utilities and off-site improvements typical for the market area? ®Yes 0 No If No,describe
Are them any adverse site conditions or external factors(easements encroachments,environmental conditions,land uses,etc.)? ❑ Yes ® No If Yes,describe
No apparent adverse easements encroachments,special assessments or other n ative influences were noted. Subject however,to an
easements encroachments-assessments,etc,of record.
General ascrl tlon Foundation Exterior Description materials/condiflon Interior materials/condition
Unts ... One ❑ One with Accessa Unit ® Concrete Stab ❑ Crawl S ce Foundation Wails Concrete Siab/Av Floors Car ,Vni Ctile/Av
#of Stories 1 _Full Basermrd__LJ Partial Basement Exterior Wails VinyVAvq Walls D ail/Av
Type Z Det. ❑ Aft. ❑ S-Det./End Unit Basement Area 0 s 'I'L Roof Surface Shin le/Av Trim/Finish Wood/Avg
Existho F Proposed Under Const.Basement Finish 0 % Gutters&Downspouts Aluminum/Avg Bath Floor Ceramic Tile/Avg
Design(Style) Ranch LJ Outside Ent (E)t ❑Sump Pump Window Type Double Hun A Bath Wainscot Ceramic Tile/Avq
Year Built 1955 Evidence of ❑ Infestation Storm SastOnsulated lnsThermlAyg Car Storage D None
Effective Age(Yrs) 15 Years+/- ❑ Dampness Settlement Screens Yes/Avg ® Driveway #of Cars 2
Attic Z None Haatin M FWA fl I HWBB fl I Radiant Amenit es Woodstove s # 0 Driveway Surface Gravel
❑ Drop Stair ❑ Stairs LJ Other Fuel oil ❑ fire laces # 0 Fence None Cara e #of Cars 0
Floor Scuttle Coof n Central Air Conditioning Patio/Deck CvPat M Porch Front Cov Car on #of Cars 0
❑ Finished Heated Individual ❑ Other ❑ Pool None Other Shed ❑ Att. Det. ❑ Built-in
Appliances Z Refrigerator 0 Ranoe/Oven El Dishwasher ® Disposal ® Microwave El Washer/Dryer 0 Other describe
Finished area above grade contains: 5 Rooms 3 Bedrooms 1.0 Baths 1,117 Square Feet of Gross Living Area Above Grade
. Additional features(special ener y efficient items,etc.). Energy items are similar to other properties in the area of like age and condition,
Describe the condition of the pro erty(including needed repairs,deterioration,renovations,remodeling,etc.). C3:Kitchen-updated-eleven to Frftaen years
a o;Bathrooms-updated-eleven to fifteen years a o;All improvements are in avers a condition with no ra airs re uired. No Functional or External
inadequacies were noted at the time of inspection. All utilities were on a functioning at the limo of ins action.
Are there any physical deficiencies or adverse conditions that affect the livability,soundness,or structural integrity of the property? ❑Yes ® No If Yes,describe
rroxiinfly ru ouu cue - _
Sale Price $ - $ _ 125,000 000-Y ' $ 160 000
Sale Price/Gross Liv.Area $ s .ft.$ 106.29 s .tt, $ 127.85 s .tt. $ 137.93 s .tt.
Data Source(s) - CPMLS#10227475;DOM 54 CPMLS#10240603•DOM 12 CPMLS#10235703;DOM 95
Verification Source(s) -Public Records Public Records Public Records
VALUE ADJUSTMENTS DESCRIPTION DESCRIPTION + - $Adjustment DESCRIPTION +- $Adjustrnent DESCRIPTION +(-)$Adjustment
Sales or Financing Arml-th Arml-th Arml-th
Concessions FH 5917 p FHA 5000 0 FH 0 0
Date of Sale/Time - of 1/12c10/12 0 s09/13-cO7/13 O s08113:c07113 0
Location NRes; MRes NRes' MRes
Leasehold/Fee Sim le Fee Simple Fee Simple Fee Sim le Fee Simple
Site 16117 sf 10454 sf 0.6970 sf 0 14375 sf 0
View N Res• N Res MRes MRes
Design(Style) Ranch Ranch Ranch Ranch
Quality of Construction 04 04 Q4 03 -3,000
Actual Age 58 59 061 0 38 0
Condition C3 C3 C4 -6 000 C3
Above Grade Total 1Bdrms.I Baths Total Bdrms. Baths Total Bdrms. Baths Total Btlrms. Baths _
Room Count 5 3 1-0 6 3 1 O 0 6 3 1.0 0 5 3 1.1 -4,000
Gross Lying Area 1,117 s .tt. 1 176 s .ft 0 1,142 s .ft. 0 1,160 s .ft. 0
Basement&I'mished Osf 1176sfOsfwu -5,000 Osf 1160sf624sfwo -5,000
Rooms Below Grade 1 rrObrl.ObaOo -10 040
Functional Utility Average Average Avera a Avera e
Heatin /Coolie OilFWAICAC OilFWA/NoAC +5,000 OilFWA/CAC EBB/No AC +5 000
,• Ener Efficient items jyaicalA e/Area T icalA e/Area T picalAgelArea T icalA e/Area
Gara e/Car od Off Street Off Street Off Street 1 Car Aft Gar 3,Ogq
Porch/Patio/Deck Porch Cov Patio Porch
,-,Cov Patio Porch Deck 0 Parch Deck 0
fir Iace/Woodstove None None None
•
Upgrades Average Average Average Avera e
Upqrades Average Average Average Average _
• Net Adjustment(Total) 0 + IS _0 + ® - $ -6,000 ❑ + - $ 20.0 0
Adjusted Sale Price Net Adj. 0%1 Not Net Adj, 12,5%
of Com arables Gross Ad'. 8.0%1$ 125 000 Grass Atl'. 4.1% $ 140 000 Gross Ad. 18.8% $ 140,000
did did not research the sate or t ansfer history of the subect ropedy and camparabie sales.8 not azplain
M research ❑ did ® did not reveal any prior sales or transfers of the subject property for the three years prior to the effective date of this appraisal.
Data Source(s) Local multi-list and county tax records
My research ®did 0 did not reveal arty prior sales or transfers of the comparable sales for the year prior to the date of sale of the comparable sale.
Data Sources Local multi-list and county tax retards
Report the results of the research a d analysis of the prior sale or transfer history of the subject property and comparable sales(report additional prior sales on page 3.
ITEM SUBJECT COMPARABLE SALE#1 COMPARABLE SALE#2 COMPARABLE SALE#3
Date of Prior Sale/Transfer 01131/2013
Price of Prior Sale/Transfer $85 500
Data Source(s) Public Records-Multi List Public Records-Mufti List Public Records-Mufti List Public Records-Mufti List
Effective Date of Data Sources 12/02/2013 12/02/2013 12/0212013 12/02/2013
Anal sis of prior sale or transfer history of the subject DF01)(10 and comparable sales Comparable two kLeviousl transferred as a short sale.
Summary of Sales Comparison Approach Sales used are the most recent similar and nearest closed sales available. The comparable sales indicate a
value range of approArnatety$125,000 to$140,000 with the subject property failing within the range in terms of conditions and amenities offered.
Comparable two was given the most weight in the final analysis of value because it is a recent sale of a similar size and AtyleL home with no
basement located in the same develo ment as the subject.
Indicated Value by Sales Comparison Approach$ 140,000
Indicated Value by:Sales Comparison Approach$ 140,000 Cost Approach(if developed)$ Income Approach(if developed)$
The Sales Comparison Analysis is the most reliable approach to value. The Cost Approach is not appropriate for properties the age of the sub'ept
• and was not developed. The lnrome_2pargach to value is not considered reliable in estimating value for owner occupied single family,residential
_
properties and was not utilized in this aDpraisat.
This appraisal is made FJ "as is", ❑ subject to completion per plans and specifications on the basis of a hypothetical condition that the improvements have been
completed, ❑subject to the following repairs or alterations on the basis of a hypothetical condition that the repairs or alterations have been completed, or ❑subject to the
• following reouired inspection based on the extraordinary assumption that the condition or deficiency does not require alteration or repair: The indicated Estimate of Value
APPRAISERS INDEPENDENCE STATEMENT
-NO EMPLOYEE DIRECTOR OFFICER OR AGENT OF THE LENDER OR ANY OTHER THIRD PARTY ACTING AS A JOINT VENTURE
PARTNER INDEPENDENT CONTRACTOR APPRAISAL MANAGEMENT COMPANY OR PARTNER ON BEHALF OF THE LENDER HAS
INFLUENCED OR ATTEMPTED TO INFLUENCE THE DEVELOPMENT REPORTING RESULT OR REVIEW OF THIS ASSIGNMENT
THROUGH COERCION EXTORTION COLLUSION COMPENSATION INSTRUCTION INDUCEMENT INTIMIDATION BRIBERY OR IN ANY
OTHER MANNER. i HAVE NOT BEEN CONTACTED BY ANYONE OTHER THAN THE INTENDED USER(LENDER/CLIENT AS IDENTIFIED
ON THE FIRST PAGE OF THE REPORT BORROWER OR DESIGNATED CONTACT TO MAKE AN APPOINTMENT TO ENTER THE
PROPERTY.
I am stating that I have not performed an a raisal service with re and to the subject roe in the three ears roceedi this assignment.
The appraisal was ordered in compliance with Appraisal Independence"AIR"and Mortgagee Letter 2009-28.
COST APPROACH TO VALUE(not!Nutted by Fannie Mae)'
Provide adequate information for the lender/client to replicate the below cost figures and calculations.
Support for the opinion of Site value(summary of comparable land Sales or other methods for estimating site value The subject's site value is based on a review of
sales of similar vacant land.
ESTIMATED REPRODUCTION OR El REPLACEMENT COST NEW OPINION OF SITE VALUE.............................................._.--------------- =S 35,000
Source of cost data DWELLING S .Ft.@ S ............1 =$
Ouahty rating from cost service Effective date of cost data S .R.@ S ........... =$
Comments on Cost Approach ross living area calculations,depreciation,etc. IianceAllowance ............. =S
Garage/Carp oa S .Ft.@ S ........ =S
` The Cost Approach is not applicable and is considered inappropriate for Total Estimate of Cost-New ........_... =S
properties the age of the subject and was not developed for this Less Physical lFunctionat lUemat
appraisal. Depreciation I I =S
Depreciated Cost of Improvements .................................................... =$
"As-is'Value at Site Improvements .--._..................__..------_....----.._.. =$
Estimated Remaining Economic Life(HUD and VA on 50 Years INDICATED VALUE BY COST APPROACH......................_..._._..........=S
INCOME APPROACH TO VALUE(notr uiredb FannleMae)
Estimated Monthly Market Rent S X Gross Rent Muni tier =S Indicated Value py Income AODFoach
Summary of Income Approach(including support for market rent and GRM The Income Approach to value is not considered a reliable indicator of value for
sin le family owner occupied properties and was not utilized in this appraisal
PROJECT INFORMATION FOR PUDs(if applicable)
Is the develo edbuilder in control of the Homeowners'Association OA? Yes No Unit type(s) Detached Attached
Provide the following infomaton for PUDs ONLY if the develo ertbuilder is in control of the HOA and the subject property is an attached dwelling unit.
Legal Name of Project
Total number of phases Total number of units Total number of units sold
Total number of units rented Total number of units for sale Data source(s)
Was the project created by the conversion of existing building(s) into a PUD? El Yes No If Yes,date of conversion.
Does the project contain any multi-dwelling units? Yes 0 No Data Source
Are the units,common elements,and recreation facilities complete? 0 Yes Ej No If No,describe the status of completion.
I1115 appla15al
statement of assumptions and limiting conditions, and certifications. Modifications, additions, or deletions to the intended
use, intended user, definition 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. Modifications or deletions to the certifications 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 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 title from seller to buyer under conditions whereby: (1) buyer and seller are typically 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
readily identifiable since the seller pays these costs in virtually 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 appraiser's 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 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 satisfactory
completion, repairs, or alterations on the assumption that the completion, repairs, or alterations of the subject property will
2. 1 performed a complete visual inspection of the interior and exterior areas of the subject property. i repuueu uie cuiwtt/ui,
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 accordance 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. I 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. f 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. I 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 the comparable sale, unless otherwise indicated in this report.
7. 1 selected and used comparable sales 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 wilt be built on the land.
9. t 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. 1 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 listing
services, tax assessment records, public land records and other such data sources for the area in which the property is located.
11 1 obtained the information, 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 analysis of the property value, and have reported on the effect of the conditions on the value and
marketability of the subject property.
15. 1 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 property 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 and/or opinion of market value in 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.
18. My employment and/or compensation for performing this appraisal or any future or anticipated appraisals was not
conditioned on any agreement or 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 party, or the attainment of a specific result or occurrence of a specific subsequent event (such as approval of a pending
mortgage loan application).
19. 1 personally prepared all conclusions and opinions about the real estate that were set forth in this appraisal report. if i
relied 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 perforated 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.
report may be disclosed or distributed to any other party (including, out not umneu tu, uie puuut, uuuoun
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 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 (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 misrepresentation(s) contained in this appraisal report may result in civil liability and/or
criminal penalties including, but not limited 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. 1 directly 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 certificaton.
2. 1 accept full responsibility for the contents of this appraisal report including, but not limited to, the appraiser's analysis, opinions,
statements, conclusions, and the appraiser's certification.
3. 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.
5. 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 (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 SUPERVISORY APPRAISER (ONLY IF REQUIRED)
Signature�i /1 z/�� ® Signature
Name a Name
Company Name Accu-Past Appraisals Company Name
Company Address 836 Tamanini way Company Address
Mechanicsburg, PA 17055
Telephone Number (717)514-5380 Telephone Number
Email Address rcassel(Waccu-fast.net Email Address
Date of Signature and Report 12/08/2013 Date of Signature
Effective Date of Appraisal 09/28/2013 State Certification#
State Certification # RL139417 or State License #
or State License # State
or Other(describe) State # Expiration Date of Certification or License
State PA
Expiration Date of Certification or License 06/30/2015 SUBJECT PROPERTY
ADDRESS OF PROPERTY APPRAISED ❑ Did not inspect subject property
119 Maple Dr ❑ Did inspect exterior of subject property from street
Mechanicsburg, PA 17050 Date of Inspection
APPRAISED VALUE OF SUBJECT PROPERTY$ 140.000 ❑ Did inspect interior and exterior of subject property
LENDER/CLIENT Date of Inspection
Name No AMC COMPARABLE SALES
Company Name Russell Hair
Company Address 119 Maple Drive, Mechanicsburg,pa 17055 ❑ Did not inspect exterior of comparable sales from street
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Total Roorm 1,117
Total Bathrooms
Locafion 10
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I Interior
f,
Subject Interior
119 Maple Dr
Sales Price
Gross Living Area 1.117
Total Rooms 5
Total Bedrooms 3
Total Bathrooms 1.0
Location N;Res;
_. . . Yew N;Res;
Site 16117 sf
Ouality Q4
Age 58
Subject Interior
Subject Interior
i
+,;, ,�,- . • .•. _ ,+ Comparable 1
110 Maple Dr
Prox to Subject 0.05 miles NE
i. Sale Price 125,000
R
#.,r'`u. " �. �p••
Gross Living Area 1,176
Total Rooms 6
Total Bedrooms 3
Total Bathrooms 1.0
Location N;Res;
View N;Res;
Site 10454 at
Quality 04
Age 59
Comparable 2
5 Poplar Dr
jl Prox to Subject 0.10 miles NE
t Sale Price 146,000
Gross living Area 1,142
Total Rooms 6
Total Bedrooms 3
Total Bathrooms
_ --•��_.�_.,_ "�j ,;'�"`* ;x. Location N;Res;
r ' Yew N;Res;
�^ - M Site 6970sf
7v — Quality 04
Age 61
Comparable 3
4 ?• .'f+' :����.": 2 Jeffrey Dr
+ `y« „* �?• t' Prox to Subject 0.69 miles E
Sale Price 160.000
Gross Living Area 1,160
• '.� y yt. t `r :rri.rte t 'r+,y�:*i.s Total Rooms 5
r'�'£• }�' i ' t_ tt y Total Bedrooms 3
Total Bathrooms 1.1
' t "�—, >•„- :^-- ; -,.3 ,.ai�-"+',�'. Y,<- / 1� - Location N;Res;
View N;Res;
w
Site 14375 sf
s g-;
Quality 03
Age 38
'rF L. ail;.n `hrt �r'. ♦i �c:�+""r _.,:.des„ _ ,a i
�.c'«,-Irth �Xa�,:r:'ot4 ,..;:. '✓.fi.��`�v���.:r.:\..w: ~�
21'
c Covered Pa ro
FBedm. Beth KRChen
in
ry
m lNhg Room
Pbrth
Bedroom
8'
16'
Sew MMm sseaasero a�
Commends:
AREA CALCULATIONS SUMMARY LIVING AREA BREAKDOWN T
r coda Ce calpdon Nat.SLw Net Tdale '
' Breakdown Subtotals j
P/P First Floor 1117.00 1117.00 :First Floor
P/P Porch 210.00 37.0 x 25.0 925.00 -
Porch 56.00 266.00 12.0 x 16.0 192.00.
a la mode inc:
� y
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reek Rd i
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d
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Melwood Ln
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a
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- Carlisle Pike Carlisle--Pike _
Subject
119 Maple Dr
Silver /
pow
Comparable 3
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�.jJ fJ e'r � ��,,g }'1� •'^c t;3ar�tr '�d" y� .� sG�Y'<✓�+,(.o�+�.A�i+..��77;„�y�};' t {•
Vs
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n)nna l.ni nne fannanw ni*n ilme.rd slaty-Aim, '
.,. .
!tA'Ti!'AEN GARY R. MORGAN and JEAN 6. MACAW, his wife, of the
TOwnshiP of Silver Spring, County of Cumberland and 6tato of Penn-
$ylvanls,
'reUt
I '" tkanrors.
axd AEARL L. HAIR, Of the TaYmahlp Of Silver Spring,
County Of Cumberland "4 State of Pennsylvania,.
i
' I
Gundre •
• it'tTNt:SVh77/.tent fn matLkmUw at the Sure of 2welva Thousand One Hundred
for -five and 62/1(10• 1811,165.621 ib/lnn.
In AnJ MR.1h.ry ,IM xhca l In AnMr aek*Aw( 1gc4 t111abf OAnfer ads Aan6e mane
sml c+nrre to/Ac rnW 9mnfro , ALL THAT CERTAIN tract or parcel of land
at tuate-in Silver Spring Township, Cumberland County. Pennsylvania,
mart particularly bounded and describeit in accerdance with a survey
Add Pion thereof Bede by A. P. Raffemporgar, Registered Surveyor.
anted November 22. 1958, as fallovet ,
DEGINNIIIG At a point.marked by • *take on the southern aid* of
'MAPIa,Driva, three hundred Sixty (3601 foot wet of the Southwest
career of the intersection of Maple Drive and Oak 8traeti thane
+ Siang land now or iota of Earl wolf, south 21 degrees 48 nfnutsa
seat. one hundred eighty and twenty-flee hundredths 1180.25) fast
to a stake At a tornerl thence mouth 63 degrees 27 Minoter. "At. ,
I seventy-one and eighty- even hundredths (71.87) feat to a ournert
thence north 28 degrees 3 minutes wet, am hundred eighty-one and
sixteen hundredths (181.36) feet to a stake OH the southern side of
Maple Drive storesaldi thenw along the samo, north 63 degrees 31
minutes east, sixty (60) feet to the plane of BEGINNING. f•.
i, Doing the greater part of Lot Na. 61 and a erianqulor pie" of `
ground adJu"t thereto on a plan of lots entitled "Plan of Lots
In the silver Spring Oewlopment Company-, meet by 0. Martin Rolland, w
{ Registered professional Engineer, dstid August 4. 1931 And filed j
+j October 29, 1953 in Plan Book d, page Si Cumberland County records.
Having thereon erected a ore-story dwelling. .1
OEING the name pmvdto* Midi John Keefcu, Jr. and Anna o. soak*.
his,wife, by their dee4 dated December 19th, 1958, and recorded in'
the Office of the ROCOrder of Deed$ in and for Cvmborlsad County in
Hoed BocA V, Volume 18, page $76, granted Had comeyed Onto Gary A. :I
MOrgm, "e of the Grantors herein. .!"r
{, ccc735 THIS CMIYEYAMCL 28 MADE 8URJSCf. NOtl8VIM, to the mortgags of Gary t;
.f7 R- Mar9dA to M. A. Clarke Mortgage Company, dated Da"mbar 19th, 19SI r)
(`7 And recorded in the Recorder's office aforesaid in Mortgage book 388.
page 496, aAd Assigned by W. A. Clarke Mortgage Company to Matto-
N politan Life Insurance Company on the some data, as appears by the
�, •_ assignment rawrded in Miswllamow Book 138, page SS4t the present
principal balance des an said Mortgage is $10,145.62 . pay"A4 of
';? xhich ie aoswmd by the Grantees herein.
f bLDf'�►�� �It��4`.!L !S .,71,.9 �`+QI(�icttLaM 4 tIII ti'��� i.:
c rr f' ''i ' }i`'A. } 'kit` ♦'i .1' !.4.: ��_.`-. iii
fiY 41Np`i v I �'�rU ( 69-r Fyn
n•?r �3 t�+;i1U' � ILi u1�tLj !L"yl��iti:1 1�litf
[[ f
i.� o�+'wannei 1
C1
The improvements have been very recently constructed and have not previously been occupied.The entire structure and all components are new
and the dwelling features no physical depreciation."
-Note:Newly constructed improvements thatfeature recycled materials andlorcomponenls can be considered new dwellings provided that the
dwelling is placed on a 100%new foundation and the recycled materials and the recycled components have been rehabilrtatedlre-manufactured
into like-new condition.Recently constructed improvements that have not been previously occupiedare not considered"new"if they have any
significant physical depreciation(Z e.,newly constructed dwelings that have been vacant loran extended period of time without adequate
maintenance or upkeep).
C2
The improvements feature no deferred maintenance,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 and/or replaced
with components that meet current standards. Dwellings in this category either are almost new or have been recently completely renovated and
are similar in condition to new construction.
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 well maintained.
f 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 building components/mechanical systems and cosmetic repairs.All major building
components have been adequately maintained and are functionally adequate.
Cs
The improvements feature obvious deferred maintenance and are in need of some significant repairs.Some building components need repairs,
rehabilitation,or updating.The functional utility and overall livability is somewhat diminished due to condition,but the dwelling remains
useable and functional as a residence.
C6
The improvements have substantial damage or deferred maintenance with deficiencies or defects that are severe enough to affect the safety,
soundness,or structural integrity of the improvements.The improvements are in need of substantial repairs and rehabilitation,including many
or most major components.
Quality Ratings and Definitions
01
Dwellings with this quality rating are usually unique structures that are individually designed by an architect for a specified user.Such
residences typically are constructed from detailed architectural plans and specifications and feature 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 ornamentation,and exceptionally high-quality interior refinements.The workmanship,materials,and finishes
throughout the dwelling are of exceptionally high quality.
02
Dwellings with this quality rating are often custom designed for construction on an individual property owner's site.However,dwellings in
this quality grade are also found in high-quality tract developments featuring residence constructed from individual plans or from highly
modified or upgraded plans.The design features detailed,high quality exterior ornamentation,high-quality interior refinements,and detail.The
workmanship,materials,and finishes throughout the dwelling are generally of high or very high quality.
03
Dwellings with this quality rating are residences of higher quality built 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 ornamentation and interiors
that are well finished.The workmanship exceeds acceptable standards and many materials and finishes throughout the dwelling have been
upgraded from"stock"standards.
04
Dwellings with this quality rating meet or exceed the requirements of applicable building codes.Standard'or modified standard building plans
are utilized and the design includes adequate fenestration and some exterior ornamentation and interior refinements.Materials,workmanship,
finish,and equipment are of stock or builder grade and may feature some upgrades.
05
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.
06
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 additions
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, new homes.
Residential properties of fifteen years of age or less often reflect an original condition with no updating,If no major
components have been replaced or updated.Those over fifteen years of age are also considered not updated If 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 deferred maintenance or physical/functional deterioration.
Updated
The area of the home has been modified to meet current market expectations.These modifications
are limited in terms of both scope and cost.
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 and/or 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
of plumbing/gas fixtures/appliances,significant structural alterations(relocating walls,and/or the addition of)
square footage).This would include a complete 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.
Aeoreviation''" ^.°°'!!!T'�7FFBtf_ryg(ner '�"�RT�}..,,� , .(ICIUS'nllvlo'rlUa"nwra•rnaeanr r.ra ,. o,,,
ac Acres Area, Site
AdPrk Adjacent to Park Location
Ad'Pwr Ad' cent to Power Lines Location
A Adverse Location&View
Armt.th Arms Lenath Safe Sale or Financing Concessions
be Bathrooms Basement&Finished Rooms Below Grade
br Bedroom Basement&Finished Rooms Below Grade
B Beneficial Location&View
Cash Cash Saie or Financin Concessions
CtySky —City Yew Skyline View View
C Str Ci Sireet View View
Comm CammeretaI influence Location
c Contracted Date Date of Sale/Time
Conv Conventional Sale or Financing Concessions
CvOrd Court Ordered Sale Sale or Financing Concessions
DOM Days On Market Data Sources
e Expiration Date Date of Salelrime
Estate Estate Sale Sale or Financing Concessions
FHA Federal Housing Authority Sale or Financing Concessions
GlfCse Goff Course Location
Glfvw Golf Course View View
Ind Industrial Location&View
in Interior Only Stairs Basement&Finished Rooms Below Grade
Lndfi Landfill Location
LtdS ht Limited Sight View
Listing Listing Sale or Financing Concessions
Mtn Mountain View View
N Neutral Location&View
NonArm Non-Arms Length Sale Sale or Financing Concessions
Bs Rd Busy Road Location
o Other Basement&Finished Rooms Below Grade
Prk Park View View
Pstv Pastoral View View
Pwrt-n Power Lines View
PubTrn Public Transportation Location
rr Recreational Rec Room Basement&Finished Rooms Below Grade
Relo Relocation Sale Sale or Financing Concessions
REO REO Sale Sale or Financing Concessions
Res Residential Location&View
RH USDA-Rural Housing Sale or Financing Concessions
s Settlement Date Date of Sale/Time
Short Short Sale Sale or Financing Concessions
st Square Feet Area,Site,Basement
s m Square Meters Area,Site
Unk Unknown Date of SalefTime
VA Veterans Administration Sale or Financing Concessions
w Withdrawn Date Date of Saleirime
we Walk Out Basement Basement&Finished Rooms Below Grade
wu Walk Up Basement Basement&Finished Rooms Below Grade
Wtrfr Water Frontage Location
Wtr Water View View
Woods Woods View View
Other Appraiser-Defined Abbreviations
Abbreviation !Full Name Fields Where This AbbravigDon May ',
This Appraisal Report is 00 of the following types:
❑ Self Contained (A written report prepared under Standards Rule 2-2(a) ,pursuant to the Scope of Work,as disclosed elsewhere in this report.)
® summary (A written report prepared under Standards Rule 2-2(b) ,pursuant to the Scope of Work,as disclosed elsewhere in this report.)
Q Restricted Use (A written report prepared under Standards Rule 2-2(c) ,pursuant to the Scope of Work,as disclosed elsewhere in this report,
restricted to the stated intended use by the specified client or intended user.)
Comments on Standards Rule 2-3
1 certify that,to the best of my knowledge and belief:
—The statements of fact contained in this report are true and correct
—The reported analyses,opinions,and conclusions are limited only by the reported assumptions and limiting conditions and are my personal,impartial,and unbiased
professional analyses,opinions,and conclusions.
—Unless otherwise indicated,I have no present or prospective interest in the property that is the subject of this report and no personal interest with respect to the parties
involved.
—Unless otherwise indicated,i have performed no services,as an appraiser or in any other capacity,regarding the property that is the subject of this report within the three-year
period immediately preceding acceptance of this assignment
—I have no bias with respect to the property that is the subject of this report or N parties involved with this assignment.
—My engagement in this assignment was not contingent upon developing or reporting predetermined results.
—My compensation for completing this assignment is not contingent upon the development or reporting of a predetermined value or direction in value that favors the cause of the
client,the amount of the value opinion,the attainment of a stipulated result,or the occurrence of a subsequent event directly related to the intended use of Nis appraisal.
—My analyses,opinions,and conclusions were developed,and this report has been prepared,in conformity with the Uniform Standards of Professional Appraisal Practice that
were in effect at the firm this report was prepared.
—Unless otherwise indicated,I have made a personal inspection of the property that is the subject of this report.
—Unless otherwise indicated,no one provided significant real property appraisal assistance to the persons)signing this certification fit there are exceptions,the name of each
individual providing significant real property appraisal assistance is stated elsewhere in this report).
Reasonable Exposure Time
My Opinion of Reasonable Exposure Time for the subject property at the market value stated in this report is: The appraiser has
analyzed the subject's market and determined that the typical exposure time is approximately 3 to a months.
Comments on Appraisal and Report identification
Note any USPAP-related Issues requiring disclosure and any state mandated requirements:
This review is made under the extraordinary assumption that all information pertaining to the sub'ect or comparable sales taken from mini-list
or public records is complete and accurate.
APPRAISER: SUPERVISORY APPRAISER (only if required):
Signature: � �.d Signature:
Name: RofleMfGasse Name:
Designation: Designation:
Date Signed: 12/08/2013 Date Signed:
prospecuve personai imeresr of ums wnn,eayc,.,t
Every effort has been made to conform to FNMA, FHLME and FHLBB guidelines and, in most cases,an even stricter
interpretation found common to most investors in the secondary market.
The appraiser has chosen what are believed to be the best comparable sales available from the market search. Adjustments in
the"SALES COMPARISON ANALYSIS"are based on market extraction, not cost figures. Occassionally it is necessary to use
comparables that have adjustments exceeding 10% of the comparable's sale price, that have net adjustments more than 15%
of the comparable's sale price, that have gross adjustments exceeding 25%of the comparable's sale price,that are located
more than three miles from the subject and/or that occurred more than six months prior to the date of the appraisal.
Since not every subject property can be compared to"ideal"comparable sales, the appraiser has chosen the best sales
available from the market search which most closely conform to investors underwriting guidelines.
rtUwuubuem rCusseil Hair - r
*Apparent is defined as that which is visible,obvious,evident or manifest to the appraiser.
This universal Environmental Addendum is for use with any real estate appraisal._Only the statements which have been checked by the appraiser apply
to the property being appraised.
This addendum reports the results of the appraiser's routine inspection of and inquiries about the subject property and its surrounding area. It also states what assumptions
were made about the existence(or nonexistence)of any hazardous substances and/or detrimental environmental conditions. �fte a°praiser is not an a rt enyli theM
)nspili {Qj and therefore might be unaware of existing hazardous substances and/or detrimental environmental conditions which may have a negative effect on the safety and
value of the property. It is possible that tests and inspections made by a qualified environmental inspector would reveal the existence of hazardous materials and/or detrimental
environmental conditions on or around the property that would negatively affect its safety and value.
LL
"X"Drinking Water is supplied to the subject from a municipal water supply which is considered safe.however the only way to be absolutely certain that the water meets
published standards is to have it tested at all discharge points.
Drinking Water is supplied by a weR or other non-municipal source. it is recommended that tests be made to be certain that the property is supplied with adequate pure
water.
"X" lead can get into drinking water from its source,the pipes,at all discharge points,plumbing fixtures and/or appliances.The only way to be certain that water does not
contain an unacceptable lead level is to have it tested at all discharge points.
*X"The value estimated in this appraisal is based on the assumption that there is an adequate supply of safe,lead-free Drinking Water.
Comments
XX"Sanitary Waste is removed from the property by a municipal sewer system.
_Sanitary Waste is disposed of by a septic system or other sanitary on site waste disposal system.The only way to determine that the disposal system is adequate and in
good working condition is to have It inspected by a qualified inspector,
XX"The value estimated In this appraisal is based on the assumption that the Sanitary Waste is disposed of by a municipal sewer or an adequate property permitted ahemate
treatment system in good condition.
Comments
XX"There are no appaNl signs of Soil Contaminants on or near the subject property(except as reported in Comments below). it is possible that research,inspection and
testing by a qualified environmental inspector would reveal existing and/or potential hazardous substances and/or detrimental environmental conditions on or around the
property that would negatively affect its safety and value.
"X"The value estimated in this appraisal is based on the assumption that the subject property is free of Soil Contaminants.
Comments
X
X"All or pan of the improvements were constructed before 1979 when Asbestos was a common building material.The only way to be certain that the property is free of
friable and non-triable Asbestos is to have it Inspected and tested by a qualified asbestos Inspector,
—The improvements were constructed after 1979.No apparent friable Asbestos was observed(except as reported in Comments below).
"r The The value estimated in this appraisal is based on the assumption that there is no uncontained friable Asbestos or other hazardous Asbestos material on the property,
Comments
XX*There were no apparard leaking fluorescent lght ballasts,capacitors or transformers anywhere on or nearby the property(except as reported in Comments below).
XX"There was no aaii arem visible or documented evidence known to the appraiser of soil or groundwater contamination from PCBs anywhere on the property(except
as reported in Comments below).
"X"The value estimated in this appraisal is based on the assumption that there are no uncontained PCBs on or nearby the property.
Comments
"X"The appraiser is not aware of any Radon tests made on the subject property within the past 12 months(except as reported in Comments below).
"X" The appraiser is not aware of any indication that the local water supplies have been found to have elevated levels of Radon or Radium.
�X_The appraiser is not aware of any nearby properties(except as reported in Comments below)that were or currently are used for uranium,thorium or radium extraction
or phosphate processing.
XX' The value estimated in this appraisal is based on the assumption that the Radon level is at or below EPA recommended levels.
_.,There are anoarent signs of USTs existing now or in the past on lie subject property,it is recommended that an Inspection By a qualniea w I inspector oe c otameo to
determine the location of any USTs together with their condition and proper registration if they are active;and If they are inactive,to determine whether they were
deactivated in accordance with sound industry practices.
=X"The value estimated In this appraisal is based on the assumption that any functioning USTs are not leaking and are property,registered and that any abandoned USTs are
free from contamination and were property drained,filled and sealed.
Comments
q 77 "" t-<. NEARBY H OUS WASTE SITES a
"X" There are no app;uggi Hazardous Waste Sites on the subject property or nearby the subject property(except as reported in Comments below).Hazardous Waste Site
search by a trained environmental engineer may determine that there is one or more Hazardous Waste Sites on or in the area of the subject property.
"X"The value estimated in this appraisal is based on the assumption that there are no Hazardous Waste Sites on or nearby the sub)eot property that negatively affect the
value or safety of the property.
Comments
- UREA FORMALDEHYDE tUFFt) INSULATION -
_X" All or part of the improvements were constructed before 1982 when UREA loam insulation was a common building material.The only way to be certain that the
property is free of UREA formaldehyde is to have it inspected by a qualified UREA formaldehyde inspector.
The improvements were constructed after 1982.No applint UREA formaldehyde materials were observed(except as reported in Comments below).
"X"The value estimated in this appraisal is based on the assumption that there is no significant UFFI insulation or other UREA formaldehyde material on the property.
Comments
AINT
"X" All or part of the improvements were constructed before 1980 when Lead Paird was a common building material.There is no aapparent visible or known documented
evidence at peeling or flaking Lead Paint on the floors,wags or ceilings(except as reported in Comments below).The only way to be certain that the property
is free of surface or subsurface Lead Paint is to have it inspected by a qualifed inspector.
_The improvements were constructed after 1980.No appA[ent Lead Paint was observed(except as reported in Comments below).
"X"The value estimated In this appraisal is based on the assumption that there is no flaking or peeling Lead Paint on the property.
Comments
UTION
"X"There are no app ra_em signs of Air Pofiugon at the time of the inspection not were any reported(except as reported in Comments below).The only way to be certain
that the air is free of pollution is to have It tested.
"X"The value estimated in this appraisal is based on the assumption that the property is free of Air Pollution,
Comments
"X" The site does not contain any appatettt Wetlands/Flood Plains(except as reported in Comments below).The ordy way to be certain that the site is free of Weflands/
Flood Plains is to have it inspected by a qualified environmental professional.
=X" The value estimated in this appraisal is based on the assumption that there are no Wetlands/Flood Plains on the property(except as reported in Comments belowJ.
Comments
MISGELLANEOUS ENVIRONMENTAL HAZARDS
'X"There are no other appateat miscellaneous hazardous substances and/or detrimental environmental conditions on or in the area of the site except as indicated below:
Excess Noise
Radiation+ Electromagnetic Radiation
_ Light Pollution
Waste Heat
T Acid Mine Drainage
Agricultural Pollution
_ Geological Hazards
_ Nearby Hazardous Property
Infectious Medical Wastes
Pesticides
Others(Chemical Storage+Storage Drums,Pipelines,etc.)
"X" The value estimated in this appraisal is based on the assumption that there are no Miscellaneous environmental Hazards(except those reported above)that would
1s. .n .�9.II37Z
Commonwealth Of Pennsylvania 12 0 43429
lle artun nt, f State
Bureau of'Profssionl=and4CS cupational Affairs
PO 13o/2K49'ilaI risbur 1 05-2649
4� Y�
Certificate Type !� tf 7i p Certificate Status
rL Certified Residential Appraiser U 'e�w::, 'K Active
QrnJ4t'`
initial Certification Date
1011812006
ROBERT I CASSEL Certificate
836 Tamanini Way Number
MECHANICSBURG PA 17055
RL139417 Expiration Date
0 613012 01 5
1'enunis<iuufi ul N,ifs,imml:uuI Oce... H4MCd Alan,.
LEXINGTON INSURANCE COMPANY
WILMINGTON,DELAWARE
Admini,trsev orfrrera-100 Summa Shat,Berton,Mamdmztn 62i 10
Certificate Number. 018391094.01
This Certificate,forms a part of Master Policy Number. 01838997M
Renewal of Master Policy Number.- 018309876
YOUR RISK PURCHASING GROUP MASTER POLICY IS A CLAIMS MADE POLICY.
READ THE ATTACHED MASTER POLICY CAREFULLY
THE AMERICAN ACADEMY OF STATE CERTIFIED APPRAISERS
CERTIFICATE DECLARATIONS
1. Name and Address of Certificate Holder Robert 1.Canal dfbls
Accu•Fast Appraisals
836 Taminini Way
Mechanicsburg PA 17066
2. Certificate Period: Effective Date: 12104113 to Expiration Date. 12/04114
12:01 e.m.Leal Time at the Address of the Insured.
2s. Retroactive Date: 12104110 J
12:01 a.m.Low!Time at the Address of the insured. 4
3. Limit of Liability: S 1,000,000 each claim
S 1,000,000 aggregate limit
4. Deductible: 6 2,600 each claim
5. Professional Covered Services Insured by this policy are:REAL ESTATE APPRAISAL SERVICES
G. Advance Certificate Holder Premium: 6 1,420
7. Minimum Earned Premium: 26%or 6 366 E
Farms and Endorsements: ;
PRG 3150(10105)Real Estate Appraisers Professionst Liability Declarations,PRG 3512(07112)Real Estate Appraisers
Professional Liability Coverage Form.76713(07/12)Addendum to the Declarations
Additional Endorsments applicable to this Certificate only:
None
Agency Name and Address. INTERCORP,INC.
143"West Main Street
Ephrata,PA 17522.1346
IT IS HEREBY UNDERSTOOD AND AGREED THAT THE CERTIFICATE HOLDER AGREES TO ALL TERMS AND CONDITIONS AS
SET FORTH IN THE ATTACHED MASTER POLICY.
THIS POLICY IS ISSUED BY YOUR RISK PURCHASING GROUP. YOUR RISK PURCHASING GROUP MAY NOT BE SUBJECT TO
ALL OF THE INSURANCE LAWS AND REGULATIONS OF YOUR STATE STATE INSURANCE INSOLVENCY GUARANTY FUNDS
ARE NOT AVAILABLE FOR YOUR RISK PURCHASING GROUP.
)a� x 7 County.Cumberland
Authorized Representative OR
Countersignature(in states where applicable) Date: December 2,2013
PR0 3562(101411)
ARCitizens Bank One Citizens Drive
Riverside,RI 02915
1. Mearl E Hair, account #610070-564-1 established 06/06/1966
2. There was no change of ownership
3. There were no accounts closed within the prior year
4. $4.81 interested accrued for 2013 on account 610070-564-1
5. Date of death balance: 11,934.38
0 RBS
St
m
MEMBERS 1"
FEDERAL CREDrr UMON
REGULAR SAVINGS ACCOUNT:
Account Number/Suffix 200999-00
Date Account Established 01/19/2001
Principal Balance at Date of Death $66.43
Accrued Interest to Date of Death $.01
Total Principal and Accrued Interest $66.44
Name of Joint Owner Russell C. Hair
Date Joint Ownership Established 07/19/2004
INVESTMENT SAVINGS ACCOUNT:
Account Number/Suffix 200999-05
Date Account Established 10/01/2011
Principal Balance at Date of Death $1,866.00
Accrued Interest to Date of Death $.07
Total Principal and Accrued Interest $1,866.07
Name of Joint Owner Russell C. Hair
Date Joint Ownership Established 10/01/2011
CERTIFICATE OF DEPOSIT:
Account Number/Suffix 200999-41 200999-42
Date Account Established 04/30/2012' 09/17/2012
Principal Balance at Date of Death $51,025.54 $50,000.00
Accrued Interest to Date of Death $43.78 $40.68
Total Principal and Accrued Interest $51,069.32 $50,040.68
Name of Joint Owner John T. Hair Russell C. Hair
Date Joint Added 10/01/2011 09/17/2012
'Rollover from certificate 200999-51, originally established 10/01/2011.
SAFE DEPOSIT BOX: NONE
E BE RS 1ST FEDER REDIT UNION
anie Ile A. Kline
Lending Insurance Support Specialist
January 9, 2014
Estate of: MEARL E. HAIR
Date of Death: 09/2812013
Social Security Number: 188-32-2501
5000 Louise Drive • P.O. Box 40 • Mechanicsburg,Pennsylvania 17055 • (800) 283-2328 • wwwmemberslst.org
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FILE COPY
BUREAU OF INDIVIDUAL TAXES pennsyLVania
PO BOX }00601 Pennsylvania Inheritance Tax :/ ,iT
HARRISBURG PA 17120.0601 Information Notice C.17 OEPAR7MENT OF REVENUE
aou- n [.eorx iee.ia
And Taxpayer Response
FILE NO.2713.1 057
REVISED NOTICE " ' AC'N 13152623
DATE 10-2_ 2013
Type of Account
Estate of NIEARL E HAIR Rerfificate,avings
SSN 189-32-2501 hecking
Date of Death 09-28-2013 rust
RUSSELL C HAIR County CUPOSERLAND n
114 MAPLE DR w �u m
MECHANICSBURG PA 17050-2765 „ 0 7 M o
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MEMBERS 1sT Fcu provided the department with the information below indicating that at the death of the
above-named decedent you were a joint owner or beneficiary of the account identified.
Account No.200999 Remit Payment and Forms to:
Date Established 10-01-2011 REGISTER OF WILLS
Account Balance $ 1,866.07 1 COURTHOUSE SQUARE
Percent Taxable X 50 CARLISLE PA 17013
Amount Subject to Tax S933.04
Tax Rate X 0.045
Potential Tax Due S 41.99 NOTE': If lax payments are made within three months of the
decedent's date of death,deduct a 5 percent discount on the!ax
With 5%Discount (Tax x 0.95) S(see NOTE') due. Any inheritance tax due will become delinquent nine months
after the date of death,
FART
1 Step 1 : Please check the appropriate boxes below.
A []No tax is due. I am the spouse of the deceased or I am the parent of a decedent who was
21 years old or younger at date of death.
Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount
shown above as Potential Tax Due.
B MThe information is The above information is correct, no deductions are being taken,and payment will be sent
correct. with my response.
Proceed to Step 2 on reverse. Do not check any other boxes.
C EJ The tax rate is incorrect. ❑ 4.5% 1 am a lineal beneficiary(parent,child,grandchild,etc.)of the deceased.
(Select correct tax rate at
right, and complete Part 12% 1 am a sibling of the deceased.
3 on reverse.)
15% All other relationships (including none).
D [:]Changes or deductions The information above is incorrect and/or debts and deductions were paid.
listed. Complete Part 2 and part 3 as appropriate on the back of this form.
E ®Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax
inheritance tax form Return filed by the estate representative,
01n1=0ir rn Stec)2 on reverse. Do not check any other boxes.
PART
2 Debts and Deductions
Allowable debts and deductions must meet both of the icllowing criteria:
A. The decedent was legally responsicle for payment.and the eswe is insufficient to pay the deductible items.
B. You paid the debts after the death of the decedent and can furnish proof of payment if re;,ue=_ted by the department.
(If additional space is required,you may 2;tach 6 1,2"x 11"sheets of paper.)
Date Paid Payee Description Amount Paid
Total Enter on Line 5 of Tax Calculation) $
PART Tax Calculation
3 if you are making a correction to the establishment date(Line 1)account balance(Line 2), or percent taxable(Line 3),
please obtain a written correction from the financial institution and attach if to this term.
1. Enter the date the account was established or titled as it existed at the date of death.
2. Enter the total balance of the account including any interest accrued at the date of death.
3. Enter the percentage of the account that is taxable to you.
a. First,determine the percentage owned by the decedent.
i. Accounts that are held "in trust for"another or others were 100%,owned by the decedent.
ii. For joint accounts established more than one year prior to the date of death,the percentage taxable is 100%divided
by the total number of owners including the decedent. (For example:2 owners = 50%,3 owners=33.33%,4 owners
=25%, etc.)
b. Next,divide the decedent's percentage owned by the number of surviving owners or beneficiaries.
4, The amount subject to tax is determined by multiplying the account balance by the percent taxable.
5. Enter the total of any debts and deductions claimed from Para 2.
6. The amount taxable is determined by subtracting the debts and deductions from the amount subject to lax.
7. Enter the appropriate tax rate from Step 1 based on your relationship to the decedent.
If indicating a different tax rate, please state Official Use Only E]AAF -
Your relationship to the decedent: PA Department of Revenue'
1• Date Established t
2. PAD '
Account Balance 2 $ =,<r
3. Percent Taxable 3 x 2
_.
4. Amount Subject to Tax 4 $ 3 c ;�
5. Debts and Deductions 5 4 , it
6. Amount Taxable 6 $ 5 • • .t .
7. Tax Rate 7 x 7• `, ` ;;- •„*, '�=
8. Tax Due 8 $ 8'.' .,[
9. With 5% Discount (Tax x .95) 9 x
Step 2: Sign and date below. Return TWO completed and signed copies to the Register of Wills listed on the front of this form,
along with a check for any payment you are making. Checks must be made payable to"Register of Wills,Agent.” Do not send
payment directly to the Department of Revenue.
Under penalty of perjury, I declare that the facts I have reported above are true,correct and complete to the best of my knowledge and
belief.
Work
Home 12 181 ?-C 12
Taxpayer Signature / -�-'�, &. , y-Tefephone Number Date
IF YOU NEED FURTHER ASSISTANCE, CONTACT PENNSYLVANIA DEPARTMENT OF REVENUE
me rr�rrT nFFir;F. OR THE INHERITANCE TAX DIVISION AT 717.787-8327. SERVICES FOR
- • • •-•wry rncAUtnlr. MPPOS ONLY: 1-800-447-3020
i
pennsylvania
Pennsylvania Inheritance Tax eG,ARTNENT OF REVENUE
BUREAU OF INDIVIDUAL to%S y
PO BOX 080601 Information Notice •u �sa [. �•'��'=
HARRISBURG PA 17125-0631 And Taxpayer a' er Response
FILE N0.2113-108i
ACN 1315382=
• REVISED NOTICE ' ' ' DATE 10-29-2013
Type of Account
Savings
Estate of N'IEARL E HAIR Checking
SSN 182-32-2501 Trust
Date of Death 09.28-2013 x Certificate
County CUt,IBERLAND
RUSSELL C HAIR 71 ';0
119 MAPLE DR n `'' rn
ITl n
MECHANICSBURG PA 17050-2765 C o ;7 o
vca 3 �' C
rr1 = �, N t•,_ r^
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aboveRnamed decedenilyoudwere a department
o joint ownertortbenefic beneficiary the laccoudnt denntified at the death of the
Remit Payment and Forms to:
Account No. 200999 REGISTER OF WILLS
Date Established 09-17-2012 1 COURTHOUSE SQUARE
Account Balance $50,040.68 CARLISLE PA 17013
Percent Taxable X 50
Amount Subject to Tax $25,020.34
Tax Rate X 0.045 NOTE': If tax payments are made within three months of the
Potential Tax Due
1L.125.92 duce Anysndheielanceiax due will become delinquent ninetmonths
With 5% Discount (Tax x 0.95) $ (see NOTE') — after the date of death.
PART Step 1 : Please check the appropriate boxes below.
1 arent of a decedent who was
/+ No tax is due. I am the spouse of the deceased or I am the p
21 years old or younger at date of death.
Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount
shown above as Potential Tax Due. payment will be sent
g The information is The above information is correct, no deductions are being taken,and
correct. with my response.
Proceed to Step 2 on reverse. Do not check any other boxes.
,etc.) of the deceased.
C The tax rate is incorrect. 4.5% 1 am a lineal beneficiary (parent, child,grandchild
(Select correct lax rate at
right, and complete Part 12% 1 am a sibling of the deceased.
3 on reverse.)
15% All other relationships (including none).
D Complete Part 2 and part 3 as appropriate on the back or this form.
Changes or deductions The information above is incorrect andlor debts and deductions were paid.
listed.
E Asset will be reported on R e an oiled by tthle estate has been or representative.will be reported and tax paid with the PA Inheritance Tax
inheritance tax form Proceed to Step 2 on reverse. Do not check any other boxes.
ocv_i rnn
PART Debts and Deductions
2
Allowable debts and deductions must meet both of the following criteria:
A. The decedent was legally responsible for payment, and the estate is insufficient to pay the deductible items.
B. You paid the debts after the death of the decedent and can furnish proof of payment if requested by the department.
(if additional space is required. you may attach 8 1/2"x 11"sheets of paper.)
Date Paid Payee Description Amount Paid
Total (Enter on Line 5 of Tax Calculation) $
PART Tax Calculation
3 If you are making a correction to the establishment date(Line 1) account balance(Line 2),or percent taxable(Line 3),
pleaso obtain a written co,rection from the financial institution and attach it to this form.
1. Enter the date the account was established or titled as it existed at the date of death.
2. Enter the total balance of the account including any interest accrued at the date of death.
3. Enter the percentage of the account that is taxable to you.
a. First,determine the percentage owned by the decedent.
i. Accounts that are held "in trust for"another or others were 100%owned by the decedent.
ii. For joint accounts established more than one year prior to the date of death, the percentage taxable is 100%divided
by the total number of owners including the decedent. (For example: 2 owners = 50%, 3 owners=33.33%, 4 owners
=25 0%, etc.)
b. Next,divide the decedent's percentage owned by the number of surviving owners or beneficiaries.
4. The amount subject to tax is determined by multiplying the account balance by the percent taxable.
5. Enter the total of any debts and deductions claimed from Part 2.
6. The amount taxable is determined by subtracting the debts and deductions from the amount subject to tax.
7. Enter the appropriate tax rate from Step 1 based on your relationship to the decedent.
If indicating a different tax rate, please state OfflClal Use Only AAF r
k'
your relationship to the decedent: PA Depa'rfinent of ,Revenue
J Jw f k
1. Date Established 1 PAD " s;
2. Account Balance 2 $
3. Percent Taxable 3 x
2 � r
4. Amount Subject to Tax 4 $ 3
5. Debts and Deductions 5 ''
5
6. Amount Taxable 8 $
7. Tax Rate 7 x
8. Tax Due 8 $
9 With 5%Discount (Tax x 95) 9 x
Step 2: Sign and date below. Return TWO completed and signed copies to the Register of Wills listed on the front of this form,
along with a check for any payment you are making. Checks must be made payable to "Register of Wills,Agent:' Do not send
payment directly to the Department of Revenue.
Under penalty of perjury, I declare that the facts I have reported above are true,correct and complete to the best of my knowledge and
belief.
Work "1 t_l 0`19-b3 3s
1211 1§I 20;3
H ome
Taxpayer Signature (�� �S 1 r\ Telephone Number Date
IF YOU NEED FURTHER ASSISTANCE, CONTACT PENNSYLVANIA DEPARTMENT OF REVENUE
DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717 787-8327. SERVICES FOR
TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800 447-3020
BUREAU BE INDIVIDUAL IAXES Pennsylvania Inheritance Tax pennsyivama
HARISBU30601 DEPARTMENT OF REVENUE
ARR133UR0 PA 17123-0601 Information Notice
And Taxpayer Response FILE NO.21 n
ACT 13153625 0 �
DATE 10-10-2013
Type of Account
Estate of MEARL E HAIR Savings
SSN 168-32-2501 Checking
Date of Death 09-28-2013 Trust
JOHN T HAIR County CUMBERLAND X Certificate,
43 CUMBERLAND DR
MECHANICSBURG PA 17050-1897
nt
77 G> O
MEMBERS I ST Fcu provided the department with the information below indicating:lhal jl�i thet eat(T,oi the
above-named decedent you were a joint owner or beneficiary of the account identified. ,; —
Remit Payment and Forms to,J t'
Account No.200999 ' ' ? -- o
Date Established 10.01.2011 REGISTER OF WILLS —
Account Balance $51,069.32 I COURTHOUSE SQUARE -
CARLISLE PA 17013
Percent Taxable X 50
Amount Subject to Tax $25.534.66
Tax Rate X 0.045 NOTE': If tax payments are made within three months of the
Potential Tax Due $1,149.06 decedent's date of death, deduct a 5 percent discount on the tax
With 5%Discount (Tax x 0.95) $(see NOTE') due. Any inheritance tax due will become delinquent nine months
after the date of death. . . -
PART Step 1 : Please check the appropriate boxes below.
1 '
A F�No tax is due. lam the spouse of the deceased or I am the parent of a decedent who was
21 years old or younger at date of death.
Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount
shown above as Potential Tax Due.
8
The information is The above information is correct, no deductions are being taken,and payment will he sent
correct with my response. ,
Proceed to Step 2 on reverse. Do not check any other boxes.
C 0The tax rate is incorrect. 04.5% 1 am a lineal beneficiary (parent,child, grandchild,etc.) of the deceased.
(Select correct tax rate at
right,and complete Part 12% 1 am a sibling of the deceased.
3 on reverse.) -
E] 15% All other relationships (including none).
D FChanges or deductions The information above is incorrect andlor debts and deductions were paid.
listed. Complete Part 2 and part 3 as appropriate on the back of this form.
E Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax
inheritance tax form Return filed by the estate representative.
REV-11500. Proceed to Step 2 on reverse. Do not check any other boxes.
Please sign and date the back of the form when finished.
PART
2 Debts and Deductions
z
Allowable debts and deductions must meet both of the following criteria:
A. The decedent was legally responsible for payment,and the estate is insufficient to pay the deductible items.
B. You paid the debts after the death of the decedent and can furnish proof of payment if requested by the department.
(Ii additional space is required,you may attach 8 1/2"x 11"sheets of paper.)
Date Paid Payee Description Amount Paid
Total Enter on Line 5 0l Tax Calculation $
PART Tax Calculation
3 If you are making a correction to the establishment date (Line 1)account balance(Line 2), or percent taxable(Line 3),
olease obtain a written correction from the financial Institution and attach it to this form.
t. Enter the date the account was established or titled as it existed at the date or death.
2. Enter the total balance of the account including any interest accrued at the dale of death.
3. Enter the percentage of the account that is taxable to you.
a. First,determine the percentage owned by the decedent..
I. Accounts that are held"in trust for"another or others were 100%owned by the decedent.
ii. For joint accounts established more than one year prior to the date of death,the percentage taxable is 100%divided
by the total number of owners including the decedent. (For example:2 owners=50%,3 owners=33.33%.4 owners
=25%,etc.)
b. Next, divide the decedent's percentage owned by the number of surviving owners or beneficiaries.
4. The amount subject to tax is determined by multiplying the account balance by the percent taxable.
5. Enter the total of any debts and deductions claimed from Part 2.
6. The amount taxable is determined by subtracting the debts and deductions from the amount subject to tax.
7. Enter the appropriate lax rate from Step 1 based on your relationship to the decedent. .a ...i„ _
It indicating a different tax rate,please state 1Z' . _ +. R
f Offjoal M&ADhly EFM15� g
your relationship to the decedent: +" r "
�: 4 PA Ospartfhei*6 -Rexenssl:
1. Date Established
2. Account Balance 2 $ P
1 Percent Taxable 3 Xt
4. Amount Subject to Tax 4 $ ! s a S aka E
5. Debts and Deductions 5 'n4rt".rE ` {rj
6. Amount Taxable 6 $ 5
7. Tax Rate 7 x _____-. ..k. r. Yx;zv xa vas'aaacrs ;ac's�sacar r?d
8. Tax Due 8 $
9. With 51%Discount(Tax x.95) 9 x �` *-: 7777r.
Step 2: Sign and date below, Return TWO completed and signed copies to the Register of Wills listed on the front of this form,
along with a check for any payment you are making. Checks must be made payable to"Register of Wills,Agent.' Do not send
payment directly to the Department of Revenue.
Under penalty of perjury, I declare that the facts I have reported above are true,correct and complete to the best of my knowledge and
belief. �t _
Work "l ti —o+ 4 R 5 333
1 �r Horne
Taxpayer Signature _. a� �S�h , Telephone Number Date
IF YOU NEED FURTHER ASSISTANCE, CONTACT PENNSYLVANIA DEPARTMENT OF REVENUE
DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FOR
TAXPAYERS WITH SPECIAL HEARING A!'tiWOR SPEAKING NEEDS ONLY: 1-800-447-3024
Ju1. 11, 2014 12: 37PM No. 4929 P. 1
PO Box 42025
y� Citizens Providence,RI 02940
Investment Services
7uly 11,2014
Attorneys Office
AtmL Tammy Siegrist
Fax#717.249.7334
RE:Account Number:L7C052841
Registration: Citizens Bank
Traditional IRA
FBO Mearl E Hair Equal Beneficiaries are decedent's children:
Russell C. Hair and John T. Hair
Dear Mr.Hair:
I am writing with regard to the correspondence recently received in our office regarding the above referenced account.
On behalf of our firm,please extend our sincerest condolences to the family of Mearle E Hair.
In accordance with your request,I am providing a summary of Mr,Hair's account in the table below as of the 01030 Of
business on September 28,2013.
Security CUSIP Number of Price per Share Total
Number Shares
BANK DEPOSIT SWEEP
PROGRAM .QCCOQ 11,460.27 $1.00 $11,460.27
ALBEMARLE CORP ALB 2,000 $62,77 $125,540.00
MICROSOFT CORP MSFT $31211 $6,654.00
NEWMARKET CORP NEU 400 $288.22 $115,288.00
TRANSOCEAN LIMITED
COMCHF15 RIC 349 $44.92 $15,677.09
EATON VANCE GLOBAL
DIVIDEND INCOME A EDIAR 6,435.644 S7.86 S50,584.16
X14 I .LI.I„v „ iL`� n )G , ' Iii' Ip� r�. 4�r mIr17 I 5 1 I
�6 � ar "°I l�����i;�l ��l�h•!'(� 94i hf2l , I11� k .42Pa
a J3
i fntl,�'iwrLr'0111+
If you have any questions please call us at 1.800-9424300,Option 3,Monday through Friday from 8:30 a.m.to 5:00
p.m.,ET. We will be happy to assist you.
Sincerely,
l�q,�xl�re r�'Euo�,
Jasmine Rivera
Operations Specialist
Secudtlos,Insurance and Investment Advisory Services offered through CCO Investment Services Corp.Member FINR4,SIPC.770 Legacy Place,
MLP240,Dced&OMW(v.ya0)942-8300.CCO Investment Services Corp.is an affiliate of RBS Citizens,N.A.and Citizens Bank of
Pennsylvania.
0 RBS
Securities and Insurance Products are -NOT FDIC INSURED•NOT BANK GUARANTEED•MAY LOSE VALUE
NNnT a ncpns IT-NCIT INM IRFD BY ANY FEDERAL GOVERNMENT AGENCY