HomeMy WebLinkAbout02-0837
PETITION FOR PROBATE ana l:d(ANT U.l' ~J..~.J.a~
No.
To:
Register of Wills for the
Deceased. County of Cumber land in the
Social SecurilY No. 180-32-1735 Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who M/are 18 years of age or older an the executrix
in the last will of the above decedent, dated April 25
and cOdicil(s) dated March 24. 1970
Name executor, husband, Gordon D. Willi~ died MarCh ~, ~UU:l; pame.la ti.
Willis (Rosnick) named cont~ngent Execu ix
Blare of Helene E. Will;i.s
also kno wn as
named
.19 68
(state relevant circumstances. e.g. reaunciaUon. dealh of exeauor. ecc.)
Decendem was domiciled at death in Cumberland 6JeCwountv. Pennsylvania, with
n PI . . lasLfaOlHy.or orin.cipal residence at 510 Hillside Roaa,Cl1n1lJer.larld
Borough, cumoer .lartd county, 'Pennsy.l vama
(list Street. number aad ItlWICipajilYJ
Decendem. then 81 years of age, died Seotember 12,. 2002 . 19
at 510 Hillside Dr., New tumberland, CUmberland COunty, t'A"'-
~~~. ..-- . .
E.lcepI i.sr allows. d~t:edem did not marry, was not divorced and did not have a child born or adopted
~fter execution of the win offered for probate; was not the victim of a killing and was never adjudicated
Incompetent: .
Oecendem at de:lth owned property with estimated values as follows:
(If domiCiled in Pa.) All personal property S 1 00 . 000.00
(If not domiciled in Pa.) Personal property in PennsylVania S
(If not domiciled in Fa.) Personal property in County S
Value of real 5~ate in Pennsylvania $.100,000-00
situated as follows: .510 Hillside Road, Borouqh of New CUInberlaild,
Cumber land County. PP..nIlSV 1 vania
WHEREFORE. petitioner(s) respeclful1}. request(S) the probate of the last will and codicil(s)
presented herewith and the grant of letters teSTrllT1PnTrlry
(lcstamCJllary; administration CoLa.; administration d.b.n.c.t.a.)
theron.
t 4 ~ tJ;:uA, NL;+ ~~ ~ ~~
~ ~ Pamela H. Willis (Rosnick)
:~ 4000 clover lea street
Iii-: Pittsbllrnh, PA 15227
E~ '--"="
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=
011
ti)
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA } sa
COUNTY OF . alMRF.RTAND
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to [he best of the knowledge and belief of petitioncr(S) and that as personal represen-
la[ive(s) of [he above de=lent p..moner(s) wiD wfJfJmd tntly ~ni~ ~ estate ~ng to law.
Sworn to or affirmed and subscribed {'-l('~ t1 W~ IJ~ ~ ~ ~~
before me this 17th daY.Of. p;ITTlPlrl H Willis Rosnick 0'lI~..
~~~~~io~f,,\~~+~ I r~-B8-Il-
'"
"-
No.
Estate of
Helene E. Willis
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW SEPTEMBER 17, 2002 xW I in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated ApT; 1 7.1), 1968 andMarch 24, 1970
described therein be admitted to probate and filed of record as the last will of Helene E. Willis
and Letters Te..c;t..affiE>ntaxy
are hereby granted to Pamela H. Willis Rosnick
~
,'.J
iCf;) S
TOTAL _ S
Fiied . .9. -:- 1 7 - 2 0 0 2
mai le.d. Fa. afry ',g.": i 7":.20.02.....
10.50
235.00
12.00
12.50
5.00
274.50
Gerald J. Shekletski #40486
codici 1 FEES
Probate. Letters. Etc. ........... S
Shore Cenificates( ).......... S
X~~ll.tHl5n E;~~.r:<;t. .l?~9.~~.. S
AlTORNEY (Sup. Ct. 1.0. No.)
414 Bridqe st., New Cumberland, PA 17070
ADDRESS
PHONE
. ',"'1
t7 S;: (j'J LL dJ;; -'0
( "
REGISTER OF WILLS OF CUMBERLAND COUNTY
OATH OF SUBSCRIBING WITNESS
:21 - 0.2-9.2.1
Charles H. stone
codicil and
6cuk} a subscribing witness to the will presented herewith, (MOb> being duly qualifieci according to
law, depose(s) and say(s) that he was present and saw
Helene E. WilllS
signed as a witness at the
(in the presence of the
C!h~oiJ .~
CHARLES H. S'IONE (Name)
414 Bridge st., New Curi1ber land, PA 17070
the testat rix . sign the same and that hp
request of testat rix in /1 er presence and .
other SUbscribing witness(es)).
Sworn to or affirmed and subscribed before
me this J (, ~ day of
JY>r ~~W~
4L -If, ' Jo
~ if' r~.
(Address)
(Name)
NOTARIAL SEAl
KAYE R. LUCKEY, Notary Public
New Cumberland Boro. CUrnt8Jand Co.
My Commission expires MIRh 11, m
(Address)
REGISTER OF W 5 OF '" COUNTY
OAT~ OF NON- B~CRl8lNG w~SS
'\
~ .....
-, '
- , . "'. '", '
(each) a stim,criber heret~ :1ch) being duly ualified according'~ law, depose(s~and say(s) that
~ familiar with t~ signature of' .
~ codicil
witnesses ) the will ~sented here\ 'th and
codicil "
iieves the signa re on the will is in the handwriting of
'\
'\
\,
\.
to (he best of
Sworn to or at Inned and subsc .
me this
Regisrer
(Address)
COdtcil
(each) a subscribin witness to the will
law, depose(s) and say
e and that
presence and (in the
'\
\, (Name)
\
'\=)
(N~me)
REGISTER OF WILLS OF
OATH OF SUBS
~
the Iestat
request of tes t in
other SUbscribing witness(es)).
"-,
Sworn to or affirmed 'in~ subscribed befo
me this ,day of '"
\'\\ 19 "\,\
\
"
Regisrer
(Address)
REGISTER OF WILLS OF ('flMHRRT.AND COUNTY
OATH OF NQN-SUBsCRIBING WITNESS
I Q{J - OJ.. - 'X'..37
.
Pamela H. Rosnick
(~ a subscriber hereto, ~) being duly qualified according to law, depose(s) and say(s) that
9hp ; s familiar with the signature of Helene E. Willis
codicil and
testat rix of ) the will presented herewith and
codicil and
that she believes the signature on the will is in the handwriting of
her mother, Helene E. Willis
to (he best of
her
knowledge and belief.
y~~ '12.~
Sworn to or affirmed and subscribed before
me this 17th day of
SEPTEMBER ~9xX
(Namz) PAMELA H. ROSNICK
4000 Cloverlea St., Pittsburgh, PA 15227
(Address)
(Name)
(Address)
H105.805 REV 9/86
This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
8387758
No.
-t?,./ , /.'
/J /~1? [."'>2../'';''>) '<<~C,=>",.,::>A-~
tlAt..4V ...." _...-'~ F
Local Registrar (/
Fee for this certificate, $2.00
p
SEP 1 4 2002
Date
144 Rev. 1/91
COMMONWEALTH OF PENNSYLVANIA. OEPARTMENT OF HEALTH. VITAL RECOROS
CERTIFICATE OF DEATH
(Coroner)
NAME Of DECEDENT (F"". "'iddle, L....
Helene
E
Willis
SEX
2. Female
STATe FilE NUMBER
SOCIAL SECURITY NU"'BER
UNDER 1 DAY O,t(fE OF BIRTH BIRTHPlACE (City and PlACE OF DEATH (Check only one S88IOSlructions on othar Side)
HatHs Minutes (Month, Day, '$at) Stale Of FOftMgfl COI.JOlfY) HOSPiTAl:
July 9,1921 Lebanon Inpationl 0 ERIOutpalien.O OOA 0
~ ~ k
CI BOAO OF DEAlH FACILITY NAME (II/lOt inslItuttOn, gIve str881 and number)
3. 180-32-1735
DATE OF DEATH (Monlh, Day, Year)
o. September 12, 2002
~d"O
510 Hillside Road
...New Cumberland, PA 17070
FATHER'S NAME 1Ft... ..._, La...
government
DECEDENT'S
ACTUAL
RESIDENCE
(See V'tstructions
on other sidEll
w.s DECEDENT EVER IN
U.S. ARMED FORCES?
Yes 0 No nr 1M2'
12. A 1. ~-L
.7..SI... Pennsylvania
RACE. American Indian. Black. White, etc.
e~ite
'0.
New Cumberland
510 Hillside Drive
Ie.
DECEDENT'S USUAL OCCUPATION
(~WOOt~~:O~u~:'.l~
. 11 ,lab technician 11 ~tate
DECEDENT'S MAIliNG ADDRESS (SIr"', CiI,ITown, Slate. lop Code'
KIND OF BUSlNESS/INDUSTRV
MARITAL STATUS -......rIed
New, Marrktd, Wktowed.
Divorced (Spedly)
owido'Ned
SURVIVING SPOUSE
(H wile. gl\/8 maiden name)
'lb.
Cumberland
Did
'*-
liY.in.
township? 17d.~ :...~~=oI New Cumberland
MOTHER'S NAME: (Fifsl. MiddIEl, Matden Surname)
17e.0 Yos.,*-_ln
twp.
cIIylboro
Remov., ~om s....O
DATE Of DISPOSITION
("''''''''.Day,Year,
o 9-16-2002
L~ff~'tl't'2848 L
22b.
10 Ih8 belt al my knowledge, death occurred at lhe lime, date and place .aled.
(SignalureandTilIeJ
Olivet Cemetery
E AIlD ADDRESS Of IN<1~fQ'
artnemore ~Hb~S,Inc.
22<,
LICENSE NUMBER
.f.irview Twp., PA
New Cumberland,PA 17070
UCEHSEE OR PERSON ACTING AS SUCH
Gastrointestinal Hemorrha e
DUE lO (OR AS A CONSEQUENCE OF):
DATE SIGNED
(Month. Day, Year)
231>. 23c.
w.s CASE REFERRED lO ME~ EXA...,NERiCORONER?
V.. ~ NoD
21.
i::':"" PARTA: ~=:-.:=..u~~~1
I onset and deeth
1
,
!
230.
TIME OF DEATH Ap rx . DATE PRONOUNCED DEAD ("'on... De" Year,
20. 2:00 A..... H. September 12, 2002
27. PART I: Ent.the diMasee. tnjuries Of complications which caused the death. Do IlOI enter the mode of dying, such.. caJdiac 01 respiratory arrest, shock or hean Inure.
Lilt only one cauee on each line.
b.
DUE lO (OR ASA CONSEQUENCE 0Fj:
c.
DUE lO (OR AS A CONSEQUENCE 0Fj:
~ Homlcide 0
-. 0 PendinglnY08ligatiOn 0 3011.....
Suicide 0 Coutd not be determined 0 ::'~~C~(~~~~I~tt home. (arm, street, laclory, o"ice
210. 21b. 21. 300.
C~~C;::~~~l.. (Physician certifying cause 01 ct8ath when ¬hel physician has pronounced death and completed hem 23)
Tothebntoh..yknowledge.deathoccUtNdduetotheCMlM(a).ndmannerHetllted....................................... .
d,
WERE AUTOPSV FINDINGS
~LE PRlORlO
COMPLETION Of CAUSE
OF DEATH?
"'ANNER OF DEATH
DATE OF INJURY
(Month. Day, Ye,uj
TIME OF INJURY
INJURV AT WORK? DESCRIBE HOW INJURV OCCURRED.
Natural
Yes 0 NoD
Ves 0
No 0
3Oc.
LOCATION (Street. Cl1y1Town, Slale)
o
Coroner
-PRONOUNCING AND CERTIFYING PHYStCIAN (Physician both ptOOCltJflCing death and certifying to cause of death)
To tho bool 01 mr kno......... _..........., tho _. dolo. .................. to tile _.,.... _.. oIoMd.. . . . . . . . . . , .
DATE SIGNED I"""'''. Da" Year)
o 3'e. .'d. Se tember 13
NAME AND ADORESS Of PERSON WHO COMPlETED CAUSE Of DEATH
(1Ieon27,TypeorPrin' Michael L. Norris, Coroner
~ 6375 Basehore Road, Suite #1
32. Mechanicsburg, Pa. 17050
DATE FILED e..."""'. De" Year,
2002
'lIEIlICAL E~ERICOllONER
On the bal. of examlnatlon and/or Inveatlgatton.ln my opinion, death oc:curred at the Ume, d"', and place, and due to the cauae(a) and
mannerustated................................................................................................. .
31..
REGIST~~: ~',;,.'",",,~~ ~ ;>:~~,.(<#~~+:Z...~",~:;l ~/~;::"---- bl,~ ~ 1/ l' I
...
~
LAST WILL AND TESTAMENT
OF
HELENE E. WILLIS
I, HELENE E. WILLIS, of the Borough of New Cumberland,
County of Cumberland and State of Pennsylvania, being of sound
mind and memory, do hereby make, publish and declare this to
be my Last Will and Testament, hereby revoking and making void
any former Wills or testamentary dispositions heretofore made.
I..
I give, devise and bequeath all of my estate, real and
personal, and wheresoever situate, to my husband, GORDON D.
WILLIS, if he survives me. If my said husband, Gordon D. Willis,
does not survive me then I give, devise and bequeath all of my
said estate to my daughter, PAMELA H. WILLIS, or her issue.
II.
If I a survived by~~neither my husband nor issue, then
I give, devise and queath 11 of my said estate_as__~Qllows:
.. _~..._A~ --
One--half to my hus'rsa3rd's brothers, CLYDE WILLIS and
HARRY WILLIS, in-~ a,l shares, or their issue, per
stitpes, and:. ~~,'
' ``~ f
One-half to my niece, VICKI JO OH. %~ ~2'f~`"~ ~~
7 -/
.'
',`.'
III.
In addition to powers given them by law, my Executor
Page 1 of 4 pages
and his successors and any guardian acting hereunder shall have
the following powers, applicable to all property held by them,
effective without court order and until actual distribution:
(a) To retain any property received by them,
including the stock of any corporate
fiduciary acting hereunder;
(b) To sell real estate for any purpose,
publicly or privately, for such prices
and on such terms as they may deem proper,
without liability on the purchasers to see
to application of the purchase moneys;
(c) To compromise controversies;
(d) To distribute in cash or kind or both at
such valuations as they may fix;
(e) To hold investments in the name of a nominee.
IV.
~I appoint CUMBERL~iND COUNTY NATIONAL BANK A RUST
COMPANY, of - Cumberland, Pennsylvania, ardian of any property
which passes, eit r under this W' or otherwise, to a minor and
with resp - is authorised to appoint a guardian and
1
have not otherwise eci~ica ~ done so. Such guardian shall
i
have the pow to use principal as w 1 as income from time to
time f the minor's support, education (in ding college, both
_, ,,.
gra uate and undergraduate) and welfare without regard to hi-s-nr
~,, C f.ar~~,~,~r;
Page 2 of 4 pages
_parent's ability to provide for suc.h_._.~-~.~sc~"rt, education and
__
welfare, or to make p~.y~n ~~-~for.-...these purposes, without further
responl"i y, to the minor or to ~-he minor's parent or to any
pe sr on taking care of the minor . ''l""~~~'' ~ ``-~`~«"' `~ `''' ~~%'~~
V.
_._.
If ~~,,.,`survive my husband, I appoint as guardian of the
~.,
person of my minor,~`~hter, PAMELA H. WILLIS,"any of the follow-
ing persons who may be able a~~willing to serve in the following
order of preference: My brother, A ~.,,UHRICH, my husband's
brotl~re~~, HARRY WILLIS, and my sister, JOYCEOH.
,; ,
VI.
I appoint my husband, GORDON D. WILLIS; Executor of this
Will. If my said husband, Gordon D. Willis, fails to qualify or
ceases to act for any reason, I appoint my daughter, PAMELA H.
WILLIS, Executrix of this Will, if she has attained the age of
twenty-one years and if not, -I--~,~~~' r__,_,~...~ ^''"~ ~.
~'~'A'K: R= R --YRt°1-+r~r~- ~' X e - ~ ,..L - r1 .~ _ yy i a. 1 . z-~^-~^re,+e~.~..{y~"'-Ct'tC ~g
•
p€~-se~rs-~u`~3~:~t, I-_-a~ppn-~r~~--E-U~~° °-~.'S~"~~"// //p~ ~,/~y~
....._... -........,.-_~_..~ ~~~'~~ ~7 C~~~C..~==~ r `~ ~"~ Zj 0 ~ Jam/
AND ~'R~T~T----~ °~'~5" f
IN WITNESS WHEREOF, I, HELENS E. WILLIS, have hereunto
set my hand and seal this ~;Z,~,day of ~-% 196~~.
/~~' ~~z.~%-~' ~'J J //~~~~~~i' _ (SEAL )
SIGNED, SEALED, PUBLISHED and DECLARED by the above-
Page 3 of 4 pages
named Testatrix, as and for her Last Will and Testament, in the
presence of us, who at her request, in her presence, and in the
presence of each other, have hereunto subscribed our names as
witnesses.
,; -~ , y.L2 ,Z
Witness
Witness
1 i
Address r7
`/~~? -C Z/ .( ~.tb~ G-~. f 0.u, ~~ f p
Address
Page 4 of 4 pages
CODICIL TO
LAST WILL AND TESTAMENT
OF
HELENE E. WILLIS
~~-m~~~31
I, HELENE E. WILLIS, of New Cumberland, Pennsyl-
vania, hereby declare this to be a codicil to my Will, dated
April 25, 1968.
FIRST: I revoke Paragraph II of my said Will and
direct that in its place the following paragraph be substi-
tuted:
_ ~ __ __ __ _ ~.us~an -- --
-'II.,
. _-nt~r--~i s~3u~_7_._ th~n._ ___-give ~__ ------ -f>f
e s t -- .- -_ a-dish. r i t e d`-rrr ~~ a~-=~ar~,--~ t~ e r~.~. n
ry Wi ow, L~I~IA" • •
SECOND: I revoke Paragraph VI of my said Will and
direct that in its place the following paragraph be substi-
tuted:
"VI. I appoint my husband, GORDON D. WILLIS,
Executor of this Will. If my said husband, Gordon
D. Willis, fails to qualify or ceases to act for
any reason, I appoint my daughter, PAMELA. H. WILLIS,
Executrix of this Will, if she has attained the age
t ~_..~.
of twenty-one years an~~~~~; I---a
-b~ot~~- ^~~F~HPTGur-~=o,,,,~-ci__o~-phis -Will. - I f _.
~torre _of-~-t~---~~~egt~ing--p~ers-ems--tali€y or act, I
:.. .
' -- ~ .. ;
THIRD: In all other respects I ratify and confirm
my Will dated April 25, 1968.
IN WITNESS WHEREOF, I have hereunto set my hand and
seal this ~~ay of ~,~~ 1970.
~, ~ fC~e~~l-lam ~Q~-(SEAL )
SIGNED, SEALED, PUBLISHED and DECLARED by the above
Page 1 of 2 pages
named HELENE E. WILLIS, as and for a codicil to her last Will
and Testament, in the presence of us, who, at her request, in
her presence and in the presence of each other, have hereunto
subscribed our names as witnesses.
Witness A ress
ness A ress
~~,.C'/J.:'G /':.''r-may"~ f~ ~s fd~~~i~l~i'
(/
~.-
' yr" ~,~~j.
.~+_
~j ~ Gt
/gyp .~~.~~~i.~-~-~
~~ ~
Page 2 of 2 pages
Inventory of the real and personal estate of
HID.li'I\lR E Wl:T LIS
deceased
REAL ESTATE
1. 510 Hillside Road, New Cumberland, PA 17070
PERSONAL PROPERTY
1. $100.00 U.S. Series EE Savings Bond
Serial Number C65058902EE
Issue Date 07/1984
2. $100.00 U.S. Series EE Savings Bond
Serial Number C65058901EE
Issue Date 07/1984
3. $ 50.00 U.S. Series EE Savings Bond
Serial Number L495412690EE
Issue Date 12/1991
4. Waypoint Bank checking account #700002985
5. Waypoint Bank Savings account #760000341
.~-
6. ~998 Buick Century automobile
YIN #2G4WY52M1W528347, Title Number 51979280301WI
7. ~aypoint Bank dividend check
8. Patriot News refund check
9. ~€entrai Penn AAA refund check
10. Keystone Health Plan Central Senior Blue
Premium refund check
11 . Waypoint Financial Corp. Common stock (56 Shares)
TOTAL REAL ESTATE
TOTAL PERSONAL PROPERTY
TOTAL REAL ESTATE AND
PERSONAL PROPERTY
$119,000.0
148.2
II
I
I
I
148.2
46.5
9,312.6'
3,591.0
7,125.01
5.61
47.6(
48.5:
54.0(
985.04
$119,000.0(
21,242.12
$140,242.12
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
I
J
55:
being duly
PAMELA H. RaSNICK
SWORN
according to law, deposes and says that he is the Executrix
of the Estate of Helene E. Willis
late of Boro1J.9"h...-QLt'1eYLJ~YmJ:;~t'I~d ------ , Cumberland County, Pa., deceased and that the
within is an inventory made by PaIlEla H. Rosnic~ ., the said Executrix
of the entire estate of said decedent, consisting of all the personal propt!rty and real estate, except real estate outside
the Commonwealth of Pennsylvania. and that the figures opposite each item of the Inventory represent it's fair value
as of the date of decedent's death.
and subscribed before me,
l' cp~ {{. r!do~
(RCe~ c:L.
~ 2002
executor . Administrator
Pamela H. Rosnick
4000 Clo'v'crlca. st.Pittsburqh, PA
Address 1 5227
Date of Death
12
September
2002
Day
Month
Year
INSTRUCTIONS
I. An inventory must be filed within three months after appointment of personal representative.
2. A supplement inventory must be filed within thirty days of discovery of additional assets.
3. Additional sheets may be attached as to personalty or realty
4. See Article IV. Fiduciaries Act of 1949.
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CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Helene E. Willis
Date of Death:
September 12, 2002
Will No. 2002-00837
To the Register:
I certify that notice of beneficial interest required by
Rule 5.6(a) of the Orphans' Court rules was served on or mailed
to the following beneficiaries of the above captioned estate on
October 26, 2002.
Pamela H. Rosnick
4000 Cloverlea St.
Pittsburgh, PA 15227
Notice has now been given to all persons entitled thereto under
Rule 5.6(a).
Date:
1/ }.;/IdJ-
Gerald . Shekletski, Esquire
414 Bridge Street
New Cumberland, PA 17070
717-774-7435
Capacity:
Personal Representative
X Counsel for Personal
Representative
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
SHEKLETSKI GERALD J ESQ
POBOX E
NEW CUMBERLAND, PA 17070
-------- fold
ESTATE INFORMATION: SSN: 180-32-1735
FILE NUMBER: 2102-0837
DECEDENT NAME: WILLIS HELENE E
DATE OF PAYMENT: 12/10/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 09/12/2002
NO. CD 001933
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $13,807.02
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$13,807.02
REMARKS:
CHECK# 7512
SEAL
INITIALS: AC
RECEIVED BY:
REGISTER OF WILLS
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
. REV-1500E.X(6-00)
OFFK::lAL USE ONLY
./
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG. PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
/'?-~- /.;:v
FILE NUMBER
21
coutm' CODE
2002
YE"R
_00837 __
NUMBER
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INlTlAL)
!z Willis I Helene E.
~ DATE OF DEf>. TH (MM-DD-YEAR) DA 1E OF BIRTH (MM.DD-YEAR)
~ 09/12/2002 7/9/1921
W (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST, AND MIDDLE INITIAL)
C
SOCIAL SECURllY NUMBER
180-32-1735
THIS RETURN MUST BE FILED IN DUPUCATE WITH THE
REGISTER OF WILLS
SOCIAL SECURllY NUMBER
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04.
06
09.
Limited Estate
o 2. Supplemental Return D 3. Remainder Return (date of death prior to 12-13-82)
D 4a. Future Interest Compromise (date of death after 12-12-82) D 5. Federal Estate Tax Return Required
o 7. Decedent Maintained aUving TNst {Attact\crypycfTrust) ~ B. Total Number of Sate Deposit 80xes
o 10. Spousal Poverty Credit (dale of death belw"n 12.31-91 ard 1.1-95) D 11. Election to tax under Sec. 9113(A)(AltachSchO)
Original Return
Decedent Died Testate (Attach copy of Wlllj
Litigation Proceeds Reeeived
....
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THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAl TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAIL.ING ADDRESS
Gerald J. Shek1etski, Esq.
FIRM NAME (If Applicable)
Stone, Lafaver & Shekletski
TELEPHONE NUMBER
414 Bridge St.
P.O. Box E
New Cumberland, PA 17070
(717) 774-7435
3. Closeiy Held Corporation, Partnership or sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Scheaule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E) (5)
Z 6. Jointly Owned Property (Schedule F) (6)
0 o Separate Billing Requested
i=
:3 7. Inter-Vivos Transfers & Miscellaneous Non.Probate Property (7)
:;j (Schedule G or L)
l-
ii: 8. Total Gross Assets (total lines 1-7)
...:
U
w 9 Funeral Expenses & Administrative Costs (Schedule H) (9)
Cl:
10. Debts of Decedent, Mortgage liabilities, & Liens (Sdledule I) (10)
11. Total Deductions (total Unes 9 & 10)
119,000.00
1,328.12
0.00
0.00
20,184.40
0.00
OFFIQAl USE ONI... y
1. Real Estate (Schedule A)
(1)
2. Stocks and Bonds (Schedule B)
(2)
210,625.83
351,138.35
is)
28,167.01
0.00
(13)
28,167.01
322,971.34
0.00
(11)
12. Net Value of Estate (line 8 minus line 11)
13 Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
(12)
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of line 14 taxable at the spousal tax 0.00
z rate, or transfers under Sec. 9116 (a)(1.2)
0
;:: 16. Amount of Line 14 taxable at lineal rate 322,971.34
'"
I-
::0 0.00
"- 17. Amount of line 14 taxable at sibling rate
'"
0 0.00
U 18. Amount of Line 14 taxable at collateral rate
><
'" Tax Due
I- 19.
(14)
322,971.34
(19)
0.00
14,533.71
0.00
0.00
14,533.71
x .00 _ (15)
x .045-- (16)
x .12
(17)
x .15
(18)
20.
o
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPA YMEN
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
2W46451,OOO
Decedent's Complete Address:
STREET ADDRESS
510 Hillside Road
CITY
New Cumberland
,
!
I STATE
PA
I ZIP
17070
Tax Payments and Credits:
1. Tax Due (Page 1 Line 1 g)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
14,533.71
0.00
0.00
726.69
3. Interest/Penalty if applicable
O. Interest
E. Penalty
Total Credits (A + 8 + C) (2)
726.69
0.00
0.00
Total Interest/Penalty (0 + E) (3)
0.00
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund
(4)
5. If line 1 + Line 3 is greater than line 2, enter the difference. This is the TAX DUE.
(5)
13,807.02
A. Enter the interest on the tax due.
(5A)
0.00
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
(58)
13,807.02
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred;. . . . . . . . . . . . . . .
b. retain the right to designate who shall use the property transferred or its income;
c. retaln a reversionary interest or . . . . . . . . . . . . . . . . . . . . . . . .
d. receive the promise for life of either payments, benefits or care? . . . . . . . .
2. If death occurred after December 12. 1982, did decedent transfer property within one year of death
without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . .. D
3. Did decedent own an "in trust for'" or payable upon death bank account or security at his or her death?D
4. Did decedent own an Individual Retirement Account. annuity, or other non-probate property which
contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. [Xl []
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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.
Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge
Yes
No
D
D
D
D
[XI
[XI
[XI
[XI
IXJ
IXJ
SIGNATURE OF P ON RESPONSIBLE FOR FllI~ RETURN
~ +-I.. f6:,~
ADDRESS
4000 Cloverlea St.
DATE
Id.-d..'o~
ox
PA 17070
ADDRE! S
New
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. 99916 (a) (1.1) (i)].
For dates of death on or after January " 1995, the tax rate imposed on the net value of transfers to or forthe use of the surviving spouse is 0% [72 P.S. ~ 9116 (a) (1.1) (ii)]
The statute does not exempt a transfer to a surviving spouse from tax, and the statutol)' requirements for disclosure of assets and filing a tax return are still applicable even if
the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one 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% [72 P.S, ~ 9116(a)(1 .2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~ 9116(1.2) 172 P.S. ~ 9116(a)(1)]
The tax rate imposed on the net value oftransfers to or for the use of the decedent's siblings is 12% (72 P.S. ~ 9116(a)(1.3)]. A sibling is defined, under Section 9102, as an
mdivldual who has at least one parent in common with the decedent, whether by blood or adoption.
W46461.QOO
OF
HELENE E. WILLIS
:2/ - O,a.. - 8;3,
I, HELENE E. WILLIS, of the Borough of New Cumberland,
County of Cumberland and State of Pennsylvania, being of sound
mind and memory, do hereby make, publish and declare this to
be my Last Will and Testament, hereby revoking and making void
any former Wills or testamentary dispositions heretofore made.
I.
T gi~ef devise and bequeath all of my estate, real and
personal, and wheresoever situate, to my husband, GORDON D.
WILLIS, if he survives me. If my said husband, Gordon D. Willis,
does not survive me then I give, devise and bequeath all of my
said estate to my daughter, PAMELA H. WILLIS, or her issue.
II.
On - to my husba
HARRY WILLIS, i
stirpes, a~/""""
/
one-7t"o'my niece,
~~..-u- l/I ..d
;l../'i/f Y
If I a
neither my huspand nor issue, then
11 of my.silr;;/estate as ws:
~;:/
//",...
"s brothers, CLYDE WILLIS and
1 shares, or their issue, per
I give,
III.
In addition to powers given them by law, my Executor
Page 1 of 4 pages
and his successors and any guardian acting hereunder shall have
the following powers, applicable to all property held by them,
effective without court order and until actual distribution:
(a) To retain any property received by them,
including the stock of any corporate
fiduciary acting hereunder;
(b) To sell real estate for any purposo,
publicly or privately, for such prices
and on such terms as they may deem proper,
without liability on the purchasers to see
:~
to application of the purchase moneys;
(c) To compromise controversies;
(d) To distribute in cash or kind or both at
such valuations as they may fix;
(e) To hold investments in the name of a nominee.
IV.
COMPANY, Pennsylvania~ ardian of any property
which passes, this W to a minor and
with res c au thor i~ ed to appoint a guardian and
have not done so. Such guardian shall
have the as I as income from time to
minor's support, education ~ing college, both
and undergraduate) and welfare without rega~~~r
/k&/>,--'> S' <</4",
.' /' /,., /~7'
arent's ability to provide for sue
r , education and
welfare, or
n
ese purposes, without further
respons ty, to the minor or to the minor's parent or to any
-----~-----
person taking care of the minor. /1~/ cf t't~..v /0/,<-/9'/
V.
my husbaw..i, I ap't'\.:int as guardiar.. c! the
-~
person of my minor hter, PAMELA H. WI!,-LIS, -any of the follow-
ing persons who may be -willing to serve in the following
order of prefer~ce: My brother,
/----
brota.e'f';'HARRY WILLIS, and my sister,
UHRICH, my husband's
VI.
OH. 'l
~bti'~
, /,y"lfl/
I appoint my husband, GORDON D. WILLIS, Executor of this
Will. If my said husband, Gordon D. Willis, fails to qualify or
ceases to act for any reason, I appoint my daughter, PAMELA H.
WILLIS, Executrix of this Will, if she has attained the age of
twenty-one years and if not, ,-1 -Yr-
1..,,..1
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-
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p.s!.-6 eft... uu.n 1 i r~
t, t..-al"'t'o':..t: €:':"'......;- flJj
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AND 11<fJ51 =~M!'AI.y Ex"..."...", vI tl 'f mil. ~t' #~-t7',.z:;~:/~/
IN WITNESS WHEREOF, I, HELENE E. WILLIS, have hereunto
set my hand and seal this .2~day of
7<~
%~f/ / 202/:.//
,l96L
(SEAL)
...\......, .,h....~fp_
named Testatrix, as and for her Last Will and Testament, in the
presence of us, who at her request, in her presence, and in the
presence of each other, have hereunto subscribed our names as
witnesses.
/~ ~4~
Ck'CM (; ;:J#~
)/~/Cu ~e /.
Address J .
Witness
71W/ /! ~ ,^,>Q/J: ! ~
Address
l!
CODICIL TO
LAST WILL AND TESTAMENT
OF
HELENE E. WILLIS
J/-o.;J..- sa,
I, HELENE E. WILLIS, of New Cumberland, Pennsyl-
vania, hereby declare this to be a codicil to my Will, dated
April 25, 1968.
~IRS~: 1 revoke PaLa~~a~h LL of my s~id Wijt ~nd
direct that in its place the following paragraph be substi-
tuted:
'III.r--.LL .L GUl :;uLvl"iitJ .....y ae1CReE' 8131 ..'..H)UcUIU
-nOL~~ rM^R I Aivc, dcvl~~ _ft_ ~_~__a~R all af
, I
~ ~aiJ. t:;:;~l:.aLt;~ L-V lUy dd.u~lll..t:L r~~ela ::0 ;lu:ioand ~~
.~~~;~#~:~:g~~;!~~~!~}E.~~/d/.
SECOND: I revoke Paragraph VI of my said Will and
direct that in its place the following paragraph be substi-
tuted:
"VI. I appoint my husband, GORDON D. WILLIS,
Executor of this Will. If my said husband, Gordon
D. Willis, fails to qualify or ceases to act for
any reason, I appoint my daughter, PAMELA H. WILLIS,
Executrix of this Will, if she has attained the age
of twenty-one years ana .:.r uut., I appaint ttry
-l>.vLl.er, GARL 1lI1RISlI, ExeeuteI of thio Wtll. If
~~:~~= . ~~ i~~,,~~r:~~i:'~ ~~:.e~~ I ~:~~-fy--<>r-..ct",--l:~ . _
~~:~: ::; ~ :r ~tl: Nii-t.l . ~~~iV /cy~/y/
THIRD: In all other respects I ratify and confirm
my Will dated April 25, 1968.
IN WITNESS WHEREOF, I have hereunto set my hand and
seal this ~ay of ~, 1970.
~ h_ 4~ ./f. ///J'/~
(SEAL)
SIGNED, SEALED, PUBLISHED and DECLARED by the above
, ...._,- .'.-'.
named HELENE E. WILLIS, as and for a codicil to her last Will
and Testament, in the presence of us, who, at her request, in
her presence and in the presence of each other, have hereunto
subscribed our names as ~tnesses.
C:{2c//~
Witness
~.M."'~ \~J..~
VI ness '
l?v.u ~~0/?
Address
\~ .In.') G'<r--Q'''~Q ui). ~... .
irlldress
~~~:d7~~~.
~Z~/?~~~~fr~~~
~~~~~~~~
~4-/e::r~~~..z;--~
q~~
,:T /~l: ~~
CY-"~:l:J /99/
REV-1502EX. (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF
Willis, Helene E.
FILE NUMBER
21-2002-00837
All real property owned solely or as a lenanlln common must be reported at fair market VilIlue. Fair market value is defined as the price at which property WQu\d be exchanged
between a wiliing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge 01 the relevant facts. Real property which Is jointly-owned with
right of survivorship must be disclosed on Schedule F.
VALUE AT DATE
OF DEATH
119,000.00
N0U'B~R DESCRIPTION
1. All that certain piece or parcel of land
situate in the Borough of New Cumberland,
County of Cumberland, Commonwealth of
Pennsylvania, known as 510 Hillside Road,
New Cumberland, PA. ...Being the same
premises which Gordon D. Willis and
Helene E. Willis, husband and wife, and
Clyde J. Willis, single man, by their
deed dated March 4, 1959, and recorded
March 5, 1959, in the Office of the
Recorder of Deeds of Cumberland County,
Pennsylvania, in Deed Book Y, Vol. 18,
Page 480, granted and conveyed unto
Gordon D. Willis and Helene E. Willis,
husband and wife. Gordon D. Willis died
March 25, 2002, whereby title to the
aforesaid real estate vested in his
surviving spouse, Helene E. Willis, the
decedent herein, by operation of law.
2W46952000
TOTAL (Also enter on line 1, Recapitulation)
(If more space is needed. insert additional sheets of the same size)
$
119 000.00
',",' ww. BntlgcSLrccl/{calty .com
25-2.1-nRII-21.~Nc\\t'1I1lln
ProDertv D..orIDUon Fllo No. 1000202k
ProDortv Addross 510 Hillside Rood Cltv New Cumberland Stale P ^ llo CDde \7070
l..al Doscmtlon Book V-18 PaDe 480 Countv Cumberland -
Alsossor's Parael No. 25-24-0811-215 .-.-----.---
Tax Voar 2002-3 RE. Taxos S 1.474 Soeclal Assessments S n/a
Bono_ nla CUlTsnt Owner Estate of Willis. Ilelen E. OccuDanl I I Ownor [ ) Tananl lli~ac~;!
.. ProD_ riohts an"'~ed I xl Foo SlmDIo I Iloasohold I Prolact TVDO I I PUO I I Condominium IHUDN A on~) HOAS nla IMo
Nalohbortlood Of Protoct Name Boroul!h of New Cumberland MaD Rafaranca ADC HIlG 21 I A-5 Census Tract 0107 -.--.-
SaloPrIooS nla Date of Sale nla Desaiotlon and S amount of loan charQ9sJconcessklns to be oak! bv seller none known
--~~--.- ---
lend..ICUont STONE LAF AVER & SIIEKLETSKI Addra" 414llrld.e Street P.O. Ilox E New Cumberland. I'A.!7070
ADorals.. Tammie K. Sheaffer Addrass 1002 BridDe Street Suite 100 New Cumberland. I' A 17070
Location \..,juman ~ Suburban W Rural Predominant Slnglo family houelng Present land use % Land use change
BuHtup 0.Over75% (KJ 25.75% 0 Undor 25% occupancy PRICE AGE One family 60% (KJ Not likaly [] Likely
1(0001 t""
GrDwth ,ala 0 Rapid (KJ Stabla o Slow (KJ Ownar 75 Low New 2.4 family 10% [] In proca"
Property valuos B Incroaslng (KJ Slablo o Declining o Tenant 350 HIDh 100+/- MultI-family 15% To'
Domand/supp~ n Shortaga ~ ~ boIiral Oav.."-I'Pf (KJ Vaar/ (%%) Predominant Commercial 15%
Mar1<o1lno limo Und.. 3 mos. X 3.6 mos. n Over 6 mos. nVlI2IltOWli5%1 I ..
125 50 )
Note: Race and the racial composition of the neighborhood are not appraisal factors.
Neighborhood boundaries and characteristics: The neighborhood is bounded by Interstates Routes 83 & 76 (Pennsylvania II rnpike) as well as the
. Susauehanna River located alon2 the Boroul!h of New Cumberland. ~.-'
Factors that affect the marketability of the properties in the neighborhood (proximity to employment and amenities, employment stClbllity. appeal to markel, etc):
The subiect is located in an established residential nei2hborhood oonsistine orimarilv of single familv detached one and two-stOry home....
_.~-_._._-.-.
.. Emnlovrnent centers in the City of Ilarrisburg are a 10 minute commute. Nei~hborhood shoppin~. parks, sch(x)ls. and most services are withi~~~.___
minute drive. Emnlovrnent stability and appeal to the market are considered aVera~e.
.- ~---_..-.- __'_m
--~--- ..- -- --- - ..-- ----. -. -
Market conditions In the subJect neighborhood (Including support for the above conclusions related to the trend of property values, demand/supply. and marketing time
.. such 8S data on competitive propertIes for sale In the neighborhood. descrIptIon 01 the prevalence of sales and financing concessions, etc_)'
Consistent with other neighborhoods in this area, homes in the subject neighborhood have experienced moderate appreciation in recent years.
Conventional FHA. and V A financinR. are readily available with occasional sales concessions. Interest rates remai!1 r..,vorahle. and ha\-'c.!~~~~~!J}'.
declined. Based on the average condition ofthe subiect pronerty, a marketing period ofless than six months is proiectc~_ Ii.)r the ~~!~'_~!~~~~!!~~~g~
rnarketinll orice not in excess of20% of the opinion of value concluded in this report and compe!ent brokerage. -~_.,-.~-_.-
. Project Information for PUOI (If applicable) - - Is the developer/builder In control of the Home Owners' Assoclallon (HOA)? LJ YES lKJ NO
Approximate total numb8l' of units In the subject project nla Approximate total number of units for sale In the subject project nla
Describe common elements and recreallonal facilities: nla
Dimensions see lelml descriotion Topography s lopes up from grade ---- ------
Site area .20 acres Corner lot 1XI Yes U No Size typical lbr area -----
Specific ltmlng classlflcatlon and description R-I Residence Shape irregular ------.----.
Zoning compliance (KJ logal 0 Legal nonconfoon~g (Grandfolhored usa) U lIIagal U No zoning Drainage appears adequate --.--
Hl!lhost & bost uso as Imorovad: rXr;,rosant uso h Other usa laxDlaln\ View average -~.. .----. -~.._.
UtilitIes PubBc Other Oft.llte Improvements Typa Public Private Landscaping tvpical
Eloctrlclly (KJ ~___~_ Slreet macadam (KJ 0 Driveway Surface concrete .. ------.
Gas (KJ___ Curb/gutter concrete (KJ 0 Apparent easements none apparent
Waler (KJ _______.__.______ Sidewalk concrete (KJ 0 FEMA Special Flood Hazard Area TI V;;;lKl"N",; ..
Sanitary sewer ~ ------- S~oalllghts pole fEi R FEMA Zone 7_Hnc C Map Date I:11i::77__.._.
Storm sewer Allav none FEMA MOD No. 420366b
Comments (apparent adverse easements. encroachments, special assessments, slide areas, illegal or legal nonconforming zoning. USA. elc.)' No arp~!cnl ~~~~~~
easements or encroachments were noted or disclosed.
GENERAL DESCRIPTION EXTERIOR DESCRIPTION FOUNDATION BASEMENT INSULA liON
No. of Units one Foundation concrete Slob none Area Sq.Ft 822 Roof LJ
No. of Stories snlit level Exterior Wafts brick OaoMSpace 0% % Finished 0%* Ceiling [J
Typo (DoI.IAtl.) detached Roof Surface asnhalt shln21e Basement 100% Ceiling wood ioist Walls LJ
Design (Stylo) solit level Gutters & Ownspts. aluminium Sump Pump none noted Walls cone. hlock Floor U
ExlsllnglProposed existinR Window Typo wood D. H. Dampness none noted Floor concrete None 0
Ago (V...) 43 +/- Storm/Saeens yes/yes Settlement none noted Outsija Enhy yes u_~ [Xl
Effoctlvo AGo fY".1 10 Manufactured House no Infestation none noted
ROOMS Favor lIvlna Dinino Kllchon Don FamilY Rm. Rec. Rm. Bedrooms . Baths Laundry Other Aroa SoFt
Bosamont I 822
Lovell I I I 525
Lavol2 2 1.5 621
Rl~ed area above endo conlalns: 5 Rooms' 2 Bedroom s . 1.5 BaWs): I 146 Sauaro Foot of Gross lIvlna Araa
INTERIOR MalorlalslCondRlon HEATING KITCHEN EQUIP. ATTIC AMENITIES CAR STORAGE:
Floors caroetIavera2e Typo FHA Refrigerator 0 None 0 F.aplaca{s)' . I (KJ None 0
WaRs Dlaster/averallC Fuo' I!llS RangeJOven 0 Sla.s 0 Patio 0 Garage #ofcars
woodlaveraae Condllonaver...e 0 0 -~._--- 0
TrlmlFln~h Disposal Drop Star Doel< Atlached
Bath Floor viovl/av""",,, COOLING Dishwasher 0 Scuttle (KJ Porch 8' x 14' (KJ Detached
Bath Wolnscol fiber.lass/av""",,, Can~al yes FanlHood 0 Floor 0 Fence 0 Built-In I
woodlav""",,, R R --'.-- . - 0
Doors Other none Mlaowave Heated Pool Carport
Kitchen Floor vinvl/averaoe Condllonav""",,, Washerll"kver -_-.~-_._._--- n
Finished Drlvewav concrete
Addltlona"ooturos(spoclalonorgy omclant 1I0ms. otc.): See Attached Addendum.
-~
Condition of thelmprovemsnts, depreciation (physical, functional, and external), repairs needed, quality of constructlon remodeling/additions, elc.' See Attached
Addendum.
-"---------.-
Adverse environmental conditions (such as, but not limited to, hazardous wastes. toxic substances, etc.) present in the Improvernenls, on the site. or in lhe
Immediate vicinity of the subject property: No adverse environmental conditions noted. Ilowever, the appraiser is not a'\ ,:xpert in this field and makes ..
no claims as to the existence of undesirable oonditions.
UNIFORM RESIDENTIAL APPRAISAL REPORT
RW:t, MIl: Form ro G-93
PAGE 1 OF 2
Tli,brn_fIIOOI"*,tr1Illt1W:I~rtRltpi<lfrnn.!I'j'!I",,,(00!l)23411721
FamillMallF<l"m 10001 693
Vllultlon Slellon
\\ \\ W.HIILlgC.'\lll:l:lI{CUII) .UJlll
UNIFORM RESIDENTIAL APPRAISAL REPORT
ESTIMATED SITE VALUE ......................... = $
ESTIMATED REPRODUCTION COST.NEW OF IMPROVEMENTS:
Dwelling ____ Sq. FI. @ $____. = $ ___
Sq. Fl. @$____._ = _____
.
Aoe
Condftlon
Above Grade
Room Count
Gross LlYlno Area
. B8semen1 & Fil~hed
Rooms Below Grade
Functional UIII1tv
.
Heaftno/Coollno
EI18IlIY EllIcIent ftoms
Garaoe/Caroort
Porch, Pallo, Dack,
Froolacet,l. etc.
Fence Pool etc.
nla
suburban
fee slmole
.20 acres
busv stJinferior
solillevellave
brick/verv eoo<l
43 +1- vears old
verv eood
29 000
25-2-l-0811"215Nl'\\('lIll1ll
File No 1000202k
Comments on Cost Approach (such as, source of cost estimate,
slla value, square fool calculatIon and for HUD, VA and FmHA, thA
estimated remaining economic ilia of the properly)"
Uecause the age ofthe property makes estimating accrued
depreciation extremely speculative, the cost approach is considered
unreliable and ha'i not been developed.
=
nla
COMPARABLE NO.2
620 Ilrookhaven Road
New Cumberland
5 blocks
$ 138 500
III $ 146.25 III
MLS end Puhlic Records
Exterior insoection
1""1_
$119900
$ 128.51 III
MLS and Public Record,
Exterior insnectinn
I + (-)$Adh./Slment
DESCRIPTION
conventional
closed sale
5-02
DESCRIPTION
conventional
closed sale
.
: GlnlJe/C1IJlOII _ Sq. FI. @ $ _m__'. =
Total Estimated Cost New " S
. ~rtJn PhYS~11 Fu~ct~n~' L Ert:r~:'__. = :;IRe,"aln:~E:n~ffa
Depreciated Value of Improvements . . . . . . . . " S ___ __________
.As-Is. Value of Site Improvements. . . . . . . . " $
INDICATED VALUE BY COST APPROACH. . . . . . . . . .. = $
ITEM I SUBJECT COMPARABLE NO. I.
5]0 lIillside Road 517 Eighth Slreet
Addres. New Cumberland New Cumberland
Proxlmltv 10 Sublect 3 blocks
Sale. PrIce $ nla
PItca.\3rossLIv.Area $ 0.00
Data and/or inspection
Ver1ftcatlon Sourcea orooerlv owner
VAlUE AllliSIMENTS DESCRIPTION
Sales or Financing
Concessions
Date of Salemme
locaUon
LeeseIdl.fea SImIa
Sfte
VIew
Daslon and Aooeel
d~
Tell! ' Bcims' Beh Tell! : &tma I B8lhs
5: 2: 1.50 6: 3: 1.50 I
I 146 SoH. 947 SoH. :
full basement full exposed
2 rooms.C(mc.block 2 rooms
avera2e avera2e
FHNCA HWBB/CA
Iypical Ivnical
I car inlelUal ~ar~' I car earaee
covered porch porch. deck
I fireolace I fireolace
no fence no fence
12-01
similar
fee simvle
.34 acres
ouiet sUsuverior
I storv/averalZe
brick/vnvl/vttv Rood :
42 +1- vears old
similar
fee simnle
.17 acres
-10,000 ouiet sUsutlerior
solit level/ave
hrk & alum/avg
45 +/. years old
g{)O~
+2,500
-10,000
+5.000
v
+3,000
TotaI;Mms: Boths~
6: 3: 2.00:
933 SQ.Ft. :
full tmsement
2 nXlms
average
FIIA/CA
tvnical
no IZsrasze
porch
I fireolace
no fence
+2,000
-LOOO
+3,200
-2,500
-J500
COMPARABLE NO.3
IO:U Swarthmore Road
New Cumberland
6 hlocks
$ 105,000
$112i4 III
MLS ;md Puhlic Records
Exterior inspection
DESCRIPTION [-:U!~i~!...
C{lI1\CntipIH11
closed sale
12-01
similar
ICe simple
.15 acres
Quiet st/superior
split level/avg
hrk & alum/avg
47 +/~ years old
-10.000
-----_._---
15.000
-2,500.
average _ :_________~~I~O
T~~Mms: Baths 1
6: 3: LSO:
933 SqFt ~._______'_J,~IIII
filII hascment
unfinished
15.000
average
FIIAlCA
.!}-pical _______~_____
I car integral gara~__~
porch
no fireplace
no fence
+ 2.000
.--.-.-.-.-..-
NetAdl.ftotal1 I I. Ixl. '$ 13,000 I I. Ixl- '$
AdpsledSalesPrt:a Groos: 13.7% G....: 21.9%
0' Comparable Net: -9.4% S 125500 Net: -0,7%
Comments on Sales Comparison (Including tha subject property's compallblllty to the neighborhood, etc. ):
ROO TxT:;- r 1-
Gross: 28.8%
$ 119.100 Nel: 9.7%
See AlIached Addendum.
1--
COMPARABLE NO. I.
No sale during past twelve
months.
.
COMPARABLE NO.2
No sale during past twelve
months.
'$
10.200
----------..
$
115.200
--.---.------
COMPARABLE NO.3
No sale during past twelve
months.
ITEM SUBJECT
Date, Price and Data No sale during
Sotrca for prtor sales past Iwelve
__01_ months.
Analysts of any currenl agreemenl of sale, option, or listing of the subject property and analysis of any prior sales of subject and comparables within one year of the dale of appraisal:
The subiect i. not currentlv Iisled for sale nor has it sold durinelhe vasl vear.
INDICATED VALUE BY SALES COMPARISON APPROACH ...... .............. ... . . $ 119,000
INDICATED VALUE BY INCOME APPROACH If E.tlmaled Marf<at RentS nla Mo. x Gross Rent Mulltoler nla = $ na
Thlo approloallo meda 00 'a.Io' U subject to Iha repan, al_, ~speclk>n. or condlllons Isted balow U subject to complertJn per plans and spaclllcartJns
CondIIons 01 AppaIsaI: Personal orooerlv Is not included in the valuation, This Is a comvlele summery reDOrI (See allached addenda for a more
detailed exvlanatlon), The Insoectlon date was 9112/02 wllh Ihe effective date ofthls reDOrI as of 10/7/02 Ihe dale of dealh of the owner.
Filal Reconciliation: All three es 10 value were considered. However the market area lacks an adeauate number of renlal sales 10 use Ihe
Income . Most welehl was Riven 10 Ihe markel data due 10 Ihe aee ofthe suhiect.
The purpo.e of thlo 8pproloallo to e.tlmata the mar1<at value of tha real proparty thai 10 the ,ubJect of this report, basad on lha abova condlllon, and Ihe certlllcartJn, conllngenl
end imMing condltlonl, end m8rl1et valu8 d8ftnltlon lf1alll1l staled ~ tha aftached Freddie Mac Form 43gIFanale Mae Form 1004B(Revlsad 6193 ).
IlWEJ EST1MATE THE MARKET VALUE, AS DEFINED, OF THE REAL PROPERTY THAT IS THE SUBJECT OF 1HIS REI'ORT, AS OF 9/12/2002
.
(WHICH IS THE DATE OF INSPECl10N AND THE EFFECTIVE DATE OF THIS REPORT) TO BE $ 119 000 %:
APPRAISER: I / ~ till SUPERVISORY APeIiA1SER (ONL-Y IF IiJOulfED . / /
Slanal..e ~<<~ d. ,C;r}ur<f/ Slanalure'- -/C;I/JiIJlU' If_I 'nglli)oid OOidNol
Name Karen L. Scholl Name Tamm(e K. Sheaffer //r Inspect Propelly
D81e Report Slaned 10/15/2002 Date Report Slaned 1011 5/02 ? v
Stale Certlftcatlon' Assistant to the State Certified Appraiser State P ^ State Certification # GA-000S68-L
Or Slale lk:ense I Stata Or State license t
FreddleMlcFa-m1O 8.m
PAGE 2 OF 2
TtiIb-m_p"orlndmll,"ACI~,,",' Il"l'i<I"mM.ymm(flOO)1:M Bl]7
Affiliated Appraisers & (:nnsultants
Slale P^
State
Fllnnl"M.....,Fmnl004 1l9:J
ADDENDUM
Borrower: niB
p__S: 510 Hillside Road
City: New Cumbar1and
Lender: STONE LAFAVER & SHEKLETSKI
FII~ N9,:_1Q.00202k___~ ..___ . ._
C~s_~ ~o.:_25.24-0811-?t~NeY/CumB
Sla~~P~_.__Zip_1707(i.,.~_:=u- ,':"
Additional Features
The brick fireplace (from floor to ceiling) located In the living room has a decor alive wood mantle. It also has decoralive
crown molding matching the wood mantle both wllh an attraclive dental design and glass enclosure doors on the fireplace
opening. The kitchen cabinets are knotty pine with formlca counters and a built.ln bar dividing the kitchen from the dining
area. A bullt.ln corner china cabinet can be found in the dining room. A covered porch is located off the dining room.
The main bathroom has a pocket door and recessed lights in the ceiling above sink area. The powder roorr off the large
bedroom contains a pedestal sink. The house contains a whole house fan.
Condition of Improvements
The house is in good condition and appears to have been adequately maintained. No significant functional or external
inadequacies were observed. The basement area below the first level living space is below grade, unfinished and unhealed
area with the furnace, hot water heater elc. The basement area under the second level living area is above grade, is
heated and has a drvwall ceiling with primarily painted concrete block walls and tile noor in the officeliaundry area, and has
been classified as u",finished basement area in this appraisal report because It Is not of the same quality finish as the living
space on the upper levels. However, this level of finish is considered typical in the market place for fhis age and design (ie.
split level) of dwellings in this area. There is also a one car integral garage under the second level living area that is
primarily above grade.
Comments on Sales Comparison
Due to limited sales within the subject's neighborhood, it was necessary to search past six months for sale #2 &
#3. All sales were selected based on their similar design, age, quality, and proximity to the subject property.
Sale #1 Is a ranch In excellent condition and was selected because of the recent sale date and proximity to the
subject and establishes the high end of the neighborhood's price range. The subject has only two bedrooms and
the three comparables have three bedrooms and no adjustment for this difference was made because the
adjustment Is In the GLA differences. Gross living area adjustments were made at the rate of $15 per square
foot for differences over 100 SF. All sales were considered reliable and were given similar weight In the value
conclusion.
Conditions of Appraisal
Scope of the Limited & Restricted Appraisal Subject to The Uniform Standards of Appraisal Practice
(USPAPI Departure Provisions
This is a Summary Complete Appraisal Report Intended to comply with the reporting standards set forth under
Standards Rule 2-2b of the Uniform Standards of Professional Appraisal Practice. As such it represents only a
summary discussion of the data, reasoning, and analysis that were used in the appraisal process to develop the
Appraiser's opinion of value. The scope of the Appraisers investigation, and the depth of discussion contained
In the report are specific to the needs of the Client, and for the stated purposes of the Client with regard to
potential mortgage collateral only. Supporting documentation that Is not provided In the report is retained in the
Appraiser's files and or file memoranda, and It may be necessary to review this material in order to more fully
understand the data, reasoning, & analysis summarized In this report. The Appraiser wilt NOT be responsible
for any un-authorized use of this report, or of any of It's component parts. The Appraiser Is NOT expert as to
matters of a legal, environmental, engineering, or mechanical nature. Rather the Appraiser's expertise is in
market analysis and valuation methods. Therefore, this report should not be confused with an expert
Investigation of: legal or environmental Issues, engineering matters, structural components, heating & cooling
systems of components, plumbing systems & components, electrical systems & components, or of the
mechanical condition of any built-In appliances. lacking any evidence to the contrary, ALL structural,
mechanical, electrical, & plumbing systems, as well as any built-In appliances, have been ASSUMED to be fully
safe and serviceable operational condition for the purpose of this report. Additionally, In the case of properties
which are not served by or connected to public water and/or sewer systems: an adequate & potable supply of on
site well water, and/or a fully operational on lot septic system have been ASSUMED herein. Lacking
Information to the contrary, It has been further ASSUMED that there are no adverse environmental conditions or
hazards either on the Subject's premises, or within It's vicinity which are of a nature which would adversely
Impact the property's value.
Addendum Page 1 of 1
SUBJECT PROPERTY PHOTO ADDENDUM
Borrower: ola File No.: IOOO202k
property Address: 510 Hillside Road Case No.: 25-24-081 1-215Ne\\OunB
City: New Cumberland Stale: P A Zip: 17070
Lender: STONE LAFA VER & SIII'KLETSKI
FRONT VIEW OF
SUBJECT PROPERTY
REAR VIEW OF
SUBJECT PROPERTY
STREET SCENE
DIMENSION LIST ADDENDUM
. Booower: nla
Properly Address: 510 Hillside Road
City: New Cumberland
lender STONE LAFA VER & SHEKLETSKI
State: P ^
File No.: 1lI00202k
Case No.: 25-24-0811-2ISNewCmnO__
__.....1lP.: 17070 ___._~_==
GROSS BUILDING AREA (GBA) 2,292
GROSS LIVING AREA (GLA) \,\46
Area(s)
Are.
living
level 1
level 2
level 3
Other
1.146
525
621
% ofGBA
50.00
22.9\
27.09
Basement
Garage
822
324
35.86
14.14
Area Measurements Area Type
Measurements Factor Total Level 1 Level 2 Level 3 Other B5mt. Garage
--- ---. ...-- -- - -- .
21.00 x 25.00 x --1 ~ 525.00 00 0 0 0 00 0
23.00 x 27.00 x --1 ~ 621.00 [] 00 [] [J U U
---..11.00 x _E-OO x _1 ~ .___~n.oo 0 0 0 U lRJ 0
12.00 x 27.00 x --1 ~ 324.00 [] [] 0 lJ 0 00
---.._-...._- x --- x ~ 0 [] 0 [J LJ 0
_. x ---- x ------ ~ _'..0' ._n__ LJ U LJ lJ 0 []
--- x _u.uu X - ~ L1 lJ U LJ U U
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x -~_._-- x -------- ~ U [] 0 U U U
-- x ------ x -....- .. ~ ------- - 0 0 0 [J U U
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x -- x -----.-. ~ --- L1 0 0 0 [] 0
x ~---- x - ~ --.-----.--- 0 0 0 0 0 0
--- x ---- x ---......- ~ - -..-- 0 [] 0 0 0 0
x -- x ----- = -_......- -- 0 L1 0 0 [J LJ
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COMPARABLE PROPERTY PHOTO ADDENDUM
Borrower: ala File No.: 1000202k
. Property Address: 510 Hillside Road Case No.: 25-24-0811-215Nc\\CumB
City: New Cumberland State: PA Zip: 17070
Lender: STONE LAFA VER & SHEKLETSKI
COMPARABLE SALE #1
517 Eighth Street
New Cumberland
COMPARABLE SALE #2
620 Brookhaven Road
New Cumherhmd
COMPARABLE SALE #3
1033 Swarthmore Road
New Cumberland
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MADE IRE 4th d.J' "f
0,1; TIr~"s,."" Ni,u HundT"{ "nd Ftit.y-nine
Ma reh
(1959)
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.,buffn CORDON!). WILLIS and HELENE E. ~IILLIS. hiE wi fe. and CLYDF. .J. ~IILLlS.
lIingle IIIln. of thl!l Borough of New CUIIlberlsnd. Count.y of Cnmb<>rland
and State of Pennsylvan:l:!. GRANTORS. parties of tho first part
AND
GCRDON D. \HLLI8 and IlELENE E. ~lILLIS; his 'fife, of the Borough of
New C\lIIbe1"1El1'ld; Count.y of CUlIIberland and State of Penn:JylvanL"\,
GRANTEES; parties
of ,Ir_ uco"d pa"l.'
~(fftsid.eratitJfl "f tlu
.itnPBBPt~. TI",I II" .",id tn, I i"5
.,,,,,. ~f One Dollar Cil.OO)
"1 Ilu ft.,/I 1fT' 11 /'cr' r!nd '17
ItJ'lll/lI/ tlM1U)' t~f th,. Ullit",! f){ntc.' (~( ...11110'/(',7. 'i/''';/ ,rnd r"'/~" t,,"'d />)' tI,t' {did tn}' ics ,:1 (/"
J~CtJ"tl "a,'f fa flu snit; pm'! 199 '~f '/'r fi".f:( /,,,,.,. ,rt fflUf /'''(('1"'' ,hI' ~f"rd"'I.J-,' rtf'" drh7'O)' f'f (1,'/\.
"r~5a't.rt flu 1'CO:II" ,,'!t('r-t!".f i.f: lu,..t!h" na',,,,,,,rrd;:,,,d, have gran/rd. Aftt"grtiltt.l.
Sttld, alicH~d, r'Pf.f('o(T,.,{, rrl"Hrtf, ("('1""'-"("(/ rutrlum!inl.'t'r/. ,,",11'1' '!rnt: /'I"'~r,!rf ri,. -""Ht!, !:r11'(IU',:,
Jell. ali~", n'f~~t1. rt'luI.fr, r;("lII1't'Y If"d o'~~p,.m UNtf'l rlu ,(('(f'd t",( 'ies r,f ,1,( .\f'(l'"d fr1'-'1 t.hrdr
Itei,',{ t1l1d t1 BiS-'Ot
All that certain piece or parcel of l:md sHuRte in thfJ Borough of New C\lI11heTlAnd,
; Count.y of CUIllberlnnd and State of renn"ylvania, more plrt.i c-uhrJy rmunde,l .,nel
described as follows, to wit:
BEGINNnt; at e. po:tnt. the "outhlol.."t corne". of B,mcon Roed Mvl f1illsidp
F.oll.d; thence alont; Hilhide Road South 1(, dcgre(!s J minute" [<;qst, " ell "bne" of
eighty-au llnd eight.y-seven hUrrl,'edth<l (B6.B7) r..et to a point; thpnce :1outh 73
degrees 57 minutes ~re",t, a dist.'-'nce of one hundredt"enty ()20) f<'!"t t.o n point;
t.hence tJorth 16 degre"", 3 minute~ viest, " dist.ance of forty-t_hree ",nd nin~ tent.h"
t....3.']) feet t.o the Southerly line of Beacon Hoe.d; thence "long "",,-con l1n"<1, Nor!."
54 degree.. 15 minut.es ~aet, a dl~tlU1ce of on" h1U1dred tw",nty-""vPn ".nd forty-oi"
hUlldredths ~1.27 .46) fet!!t to the "eat.erly line of l1illBida near!, the plAce of
BEGINNING.
BEING a part. of the ,mnm prern.i,'"'''' ~*Iich ]'emo.vnc Tru"t C,.,mrCUlY, ,\,jm~ni,,-
trator; d.h.n.c.t.e.. of the Last vlil.l and Testament of Annie Jl"l1C'HT"'n, d"ce,-"wd,
Harion C. Leih, surviving Exeeutru of th" Last lIillltnd '1'"".blm"nt. of l':mm".:.
Letb. deceased lInd Frl\nk R. Letb; II and IHlli 1'. Lelb, hb "Ue, by their cte"d
dated June 20, 1955 and recorded in the Cumberland County HecoJ,ler'" Dfficp in
Deed Book "P" Vol. 16. pace 475. granted ~nd conveyed unto Gordon D. lUllJ" ".nd
C~e J.vli1lis; pert.iM of the first part. hereto.
NEW C;JI'.lrr:mMlIJ
BOflOllGl1 AlID S::1l001 nl'iTn":r
REAl. ESTt.TF. l~/\I~SIT" Ty' vi
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25-24-0811-215NcwCu
File No. 1000202k
DEFINITION OF MARKET VALUE: The most probeble price which a properly should bring In a competitive and open market
under all condlllons reQulsUe to a fair sale, the buyer and seller, each acting prudentiy, knowledgeably and assllmlng the price is not
affectad by undua sllmulus. 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 Iypically motivated; (2) both parlles are well informed or well advised,
and each acllng in what he considers his own best Interest; (3) a reasonable lime Is allowed for exposure In the open market; (4) payment
Is made In terms of cash in U.S. dollars or In terms 01 financial arrangemenls comparable thereto; and (5) the price represents the normal
consideration for the property sold unaffected by specla' or creative financing or salas concessions' granled by anyone associated wilh the
sale.
'Adjustments to the comparables must ba made lor special or creative financing or sales concessions. No adjuslments are necessary lor
those costs which are normally paid by sellers as a resuil of tradillon or law in a market area; Ihese cosls are readily identifiable since the
seller pays these costs In virtually all sales transacllons. Special or creatlva financing adjuslments can be made to the comparable property
by comparisons to financing terms oflered by a Ihird party inslilutlonallender that Is not already Involved in the property or transacllon, Any
adjustment should nol be calculated on a mechanical dollar for dollar cost 01 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 LIMITING CONDITIONS AND APPRAISER'S CERTIFICATION
CONTINGENT AND LIMITING CONDITIONS: The appraiser's certification that appears in the appraisal report is subjecl to the
following conditions:
1. The apprelser will not be responsible for matters of a legal nature Ihal affect either the property being appraised or the title to it. The
appraiser assumes that tha title Is good and markelable and, therefore, will not render any opinions about the lIt1e. rl1e property is app<aised
on the basis 01 it being under responsible ownership.
2. The appraiser has provldad a sketch in the appraisal report to show approximate dimensions of the improvements and the sketch is
inciuded only to essist the reader of the report in visualizing the property and understanding Ihe appraiser's determination of its size.
3. The appraiser has examined tha available flood maps that are provided by the Federal Emergency Management Agency (or other data
sources) and has noted In the appraisal report whether the subject sile is located In an identified Special Flood Hazard Area. Because the
appraiser Is not a sun/eyor, ha or she makes no guarantees, express or implied, regarding Ihis delermination.
4. The appralsar 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 mada beforehand.
5, The appraiser has estimated the value of the land in the cost approach al its highest and best use and the improvements al their
contributory value. These separate valuations of the land and improvemenls must not be used in conjunction with any olher appraisal and
are Invalid W they are SO used.
6. The appraiser has noted in the appraisal report any adverse conditions (such as, needed rapairs, depreciation, the presence of hazardous
wasles, toxic substances, etc. ) observed during the Inspection of Ihe subject property or thai he or she became aware of during the normal
research Involved In performing the appraisal. Unless otharwise stated in the appraisal reporl, the appraiser has no knowledge of any hidden
or unapparent conditions of tha property or adverse environmental conditions (including the presence of hazardous wastes, toxic
substances, etc. ) Ihat would make the property more or less valuabla, and has assumed Ihal there are no such conditions and makes no
guarantees or warranties, express or Implied, regarding the condition of the property. The appraiser will not be responsible for any such
conditions that do exist or for any engineering or tesllng that might be required to discover wl1elher such conditions exist Because Il1e
appraiser Is not an expert In the field of environmental hazards, the appraisal report must not be considered as an environmental assessment
of the property.
7. The appraiser obtained the Information, estimates, and opinions that were expressed In the appraisal report from sources that he or she
considers to be reliable and believes them to be true and correct The appraiser does nol assume responsibilily for the accuracy 01 such
items that ware furnished by other parties,
8. The appraiser will not disclose the conlents of the appraisal report except as provided for In the Uniform Slandards of Professional
AIlpralsal Prac\lce.
9. The appralsar has based his or her appraisal report and valuation conclusion lor an appraisal that Is subject 10 satislactory completion,
repairs, or aiteratlons on the assumption that completion of Ihe Improvements will be performed in a workmanlike manner.
10, The appraiser must provide his or har prior written consent befora the lander/client spacified in the appraisal report can distribute the
appraisal report (Including conclusions about the property value, the appraiser's Idantlty and professional designations, and relerences to
any professionat appraisal organizallons or the firm with which the appraiser is associated) to anyone other than the borrower; the
mortgagee or Its successors and assigns; the mortgage Insurer; consultants; profasslonal appraisal organizations; any slale or federally
approved flnanclallnslltullon; or any department, agency, or Instrumentality of the United States or any slale or the District 01 Columbia;
except that the lender/client may distribute tha property description section of the report only to data collection or reporting service(s)
without having to oblaln the appraiser's prior written consent. The appraiser's written consent and approval musl also be obtained before
the appraisal can be conveyed by anyone to the pUblic through advertising, public ralatlons, news, sales, or olher media.
Freddie Mac Form 439 6-93
Page f of2
Fannie Mae Form 1004B 6-93
25-24-0811-2I5NcI\Cu
File No I000202k
APPRAISERS CERTIFICATION: The Appraiser certifies and agrees thaI:
1. I have rasaarchud tha subject markat area and have selected a minimum of three recent sales of properties most similar and proximate
to tha subject property for consideration in tha sales comparison analysis and have made a dollar adjustment when appropriate to reflect the
markat raacllon to thosa Items of significant variation. If a significant item In a comparable property is superior to , or more favorable than,
tha subjact property, I hava mada a negative adjustment to reduce the adjustad salas prica of the comparable and, if a significant item in a
comparabla prop arty is Infarlor to, or less favorable than the sub/ecl property, I have made a positive adjustment to increase lhe adjusted
sales price of the comparable.
2. I have ta~en Into consideration the fectors that have an Impact on value In my development of the estimate of market value in Ihe
appraisal report. I have not knowingly withheld any significant information from the appraisal report and I believe, to the best of my
knowledge, that all statements and InfOfmatlon in the appraisal report are true and correct.
3. I stated In the appraisal report only my own personal, unbiased, and professional analysis, opinions, and conclusions, which are subject
only to the contingent and limiting conditions specified in this form.
4. I have no present or prospactiva Intarest In the property that Is tha subjeclto this raport, and I have no present or prospective personal
Intarest or bias with raspact to tha participants in the lransactlon. I did not base, eilher parlially or complelely, my analysis andlor the
astimate of mark at valua in the appraisal raport on the race, color, religion, sex, handicap, familial status, or national origin of either the
prospactlve owners or occupants of tha subject property or of tha present owners or occupanls of Ihe properties in the vicinity of the
subjact property.
5. I have no prasent or contemplated future interest in the subject property, and neither my current or fulure employment nor my
compensation for perfOfmlng this appraisal is contlngenl on the appraised value of the property.
6. I was not requirad to report a predetarmined valua or direction in valua that favors the cause of the client or any related parly.
the amount of the value estimate, the attainment of a specific result, or the occurrence of a subsequent event in order to receive my
compansatlon and/or amployment for parforming tha appraisal. I did nol base Ihe appraisal report on a requested minimum valualion, a
specific valualion, or the need 10 approve a specific mortgage loan.
7. I performed lhls appraisal In conformity with the Uniform Standards of Professional Appraisal Praclice that were adopted and
promulgated by tha Appraisal Standards Board of The Appraisal Foundation and that were in place as of the effective date 01 this appraisal,
with lhe exception of the departure provision of those Standards, which does not apply. I acknowledge thaI an estimate of a reasonabie
lime for exposure In the open market Is a condition in Ihe definition of market velue and lhe estimate I developed is consistenl with the
marketing time noted in the neighborhood section of this report, unless I have olhBlWise stated in lhe reconcilialion seclion.
6. I have parsonally Inspacted the Interior and axterlor areas of the subject property and lhe exterior of all properties listed as comparabies
in tha appraisal report. I further cartlfy that I hava noted any apparent or known adverse conditions in the subject improvements, on the
subjact site, or on any site within tha Immediata vicinity of lhe subject properly of which I am aware and have made adjustments for these
advarsa conditions In my analysis of tha property value to the extent that I had market evidence to support them. I have also commented
about the elfact of tha adverse condnions on the markelability of the subject property.
9. I parsonalty prapared all conclusions and opinions about the real estate lhat were set forth in the appraisal report. If I relied on
significant professional asslstanca from any Individual or individuals in the performance of the appraisal or the preparalion of the appraisal
report, I hava named such individual(s) and disclosed the specific tasks performed by them in the reconciliation section of 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
tha raport; therafora, "an unauthorizad changa is made to tha appraisal report, I will take no responsibility for it.
SUPERVISORY APPRAISER'S CERTIFICATION: If a supervisory appraiser signed the appraisal report, he or she certifies
and agraas that: I directly suparvlse tha appraiser who pre par ad the appraisal report, have reviewed the appraisal reporl, agree with the
statamants and conclusions of tha appraiser, agrea 10 ba bound by the appralsar's certifications numbered 4 throu[,h 7 abova, and am taking
full rasponslblllty for tha appraisal and the appraisal report.
ADDRESS OF PROPERTY APPRAISED: 510 lIi11side Road. New Cumberland, P A 17070
APPRAISER:
SUPERVISORY APPRAISER (only If requIred)
Signature: {..clTU.N..;::/ Sdc4J
Name: Karen L. Scholl ,
Date Signed: /(j/1'f/2"02..
Stata Certification I/: Aut to State erllfled General Appraiser
or Stala license ,:
Stata: P A
Expi'alion Data of Cert~catlon Of License:
-j;fjlU;J<-~;' ;{._Vt
Signatura:
Name: Tammie K. Sheaffer
Dala Signed: . (tI
State Certification #: GA.O 568-L
Of Stata License #:
State: P A
Expiration Date of Certification or License: "'nircs 6/30/11.!
L-
[XJ Did 0 Did Not Inspect Property
Pennsylvania General Certified Appraiser
Fr~ddla Mac FOfm 439 6-93
Pennsylvania General Certified Appraiser
Page 2 of 2
Fannie Mae Form 100486-93
A1>PRAIS[R QUALIFICATIONS TAMMIE K. SII<AFF<R
EdautloD Johns Horkins University, Baltimore, MarylRrld
MS. Real E!ltate. Investment Portfblio Emphasi!l. 1999
Pennsylvania State tJniver.tity, Pennsylvania
OS. Public Policy, 1981
UcultllCertl . Real E!tafe 8roker's Licen~ . Ptnn~lvania and Maryland
. Gene"t Apt'lraise1"~ Certification. 1991
Ttttlmoav District of Columbia, lIarrisbutg. and York Bankruptcy Courts;
Cumberland, Dauphin and York County Board of Assessment Apreals; and lIarrishurg City Zoning
Hearing Board
hbUeatlo.. Trend Watch 1999. Study of the Washington D.C. and Baltimore commercial real estate markets with a
fucus on office, industrial, retail and hotel land uses.
1098 - Prntllt Bridet Stnd Rutty, LLC, New CUl11buland. Punsytvanll
Ma.lellm Member
Founded a fun.service rea' estate brokerage, con~l\ing. and appraisal finn ser\'ing tl1e eight counties in
Soulh Central Pennsyh'ania. Prepare marketing (ifralegie!l for complelt income producing portfhliM of
investmenl real estate of variou!l (Iroperty ty{teS. Assist real property ownen with leaseAmy, sell. and
hold decisions. Review commercial leases for hath lessee and les.'ior. Prepare real ~l8lf 8pprnisals ror
condemnation. e!rtale, divorce, liligalion, liquidation, mortgage financing, nnd tax as.<:ess lIenf reduction
purposes. Reposition wasting aSseI!I, negoliate zoning led amendments, and ma1l:irTlize returns hy
reducing operating e1l:penses and increasing income for property owners.
1m to 2000 ALLF1RSTMORTGAGf: CORPORATION B.ltimore', Md.llarrlshllrg ,t: York. PA
A!lsl!ltlDt Viet Prtsldtnt: Senior AODnlstr. Crtdl. Division
Acted as an internal commercial real estate con!lullant for developing strategies for ma1l:imizing hoth
e1l:isting and new relationships. Created and presented commercial real e!llate underwriting and
credit analysis workshofl!i for all commercia1 retationslaip omcen. Prepared discounted cash tlo\'
analyses uti1i:r.ing both E1I:cel and AROUS for existing and proposed properties Assisted
RelatinnshiJl Manager!'. with credit e.na1ysis and \lnderwriting of complex. commerci.al rea\ eslnle
loans. Contacted several appraisers for price and turnaround time. Prepared commercial and
residential8.flpraisals for internal hank use. York Rank Adopt-A-lIollse project mana~er,
1990 to 1998 The York B.nk.. s.b5ldlny of Flnt MlryllDd Bnc::orp l"rrl~hurJ( and York. rA
DtDlrtmtl. Mllla2er lad Rtvltw ADoulsl. nmrrr
Acted as Chief Appraiser and coordinated valuation of the entire commercial real estate rortfol io for
the credit division and assisted with the risk ratings for loan review Developed an approved
aPl'r81ser "st.. Prepared engagement 1et1ers aReI nego1i.a1i.ng contract for services and rnic\\ed
completed appraisals for FIRRf::A and tlSPAP compliance for entire commercial real estate
portfolio. Assisted Relationship Managers with credit analysis and underwriting of comf\lex
commercial real estate loan,. Contacted severalllppraisers fOf price and turnaround lime. Prepared
and approved contractual enSagement leuer. Prepared commercial and residential apprnis.,ls for
internal bank u!'Ie. Served as the York Bank Adopt.A-House projecl manager.
1990 _ Presta. Amll..d Appral~rs & Consultanl5. Nrw Cumbuland Ptno!l.ytvanla
Owner! Anonlser
Preplred arrraisa)s for this lUll-service real estate brokerage. consulting. and IWmi!'.l\l (inn
.9Mel990 Cltkorp Mortellle. TrnoH, Punsyl.nl.
Staff Amraiser Prepared \lR^R appraisals and field reviews for mortgage financing 10 he packaged
.nd sold in the secondary mortgage market.
1989~1991 Rothm.n, Sthubrr. '" Rud, Rultors@, Ltmoynt. Pennsylvania
Associale Broker
Repre5ented buyen and sellers of real property. Preptred legally binding agreements of sale. le1lses. and
msuket;na contracts. Prepen::d appraisals for this full-service real estate brokerage, consulling. and
appraiSllI finn.
AlmlltIo.. . N.tional As..~ciation ofRea1tor.l, ((1M Candidate, Chicago,llIinoi!!
ADDI'alu'lutttale Counes Real Estate Ptinciples - D<<embet 1989
Standards of Professional Practice, Part A and 0, February 1990
Capitalization Theory and Techniques. Part A and B. October 1990
Residential Valuation, March 1991
Litigation Valuation, September 1992
BMic Valuation Procedures. February 1993
Discounted Cash Flow Analysis. March 1993
R.,es, Ratios, and Reasonableness, 1994
Standards of Professional Praclice. Part B, Oecember 1994
CommerciallResidenlial Appraisal Review, 1994
SIa_ofrrofes.iomll PncHee, Pan A, February 1995
Real Eslale Risk Analy.ls, 1996
Appraisal Reporting of Complex Resldenllal Properties, 19%
Rates. Ratios. and Reasonableness. 19%
Appraisina Nunina Homes and Assisted Uvina Facilities, 1997
Appraisal Reporting ofComp'ex Residential Properties. 1998
101 - Fundamentals of Real Estale Invemmenllnd Tuation, 1989
407- Financial Analy!ll!, 1998
102 - Mlnket Analysis and Demographic Analysis, 1999
eClAl C..ne.
KAREN L. SCHOll
QUALIFICATIONS
EXPERIENCE
July 2002-current
Bridge Street Realty, LLC
Assistant to the State Certified Appraiser
Assist in the preparation of residential and commercial
appraisal consultation and analysis for form and
narrative appraisal reports for mortgage financing,
estates, tax appeals, and litigation purposes.
April 2000-June 2002
First National Bank of Marysvllle
Bank Teller
Trained bank tellers for 30 day period, handled
customer transactions, balanced the ATM machine and
restocked dally, sold various financial investments.
1980-1982
Specialty Bakers
Production Coordinator
APPRAISAL
EDUCATION
Real Estate Institute. Camp Hi!!J>A
USPAP - 15 Hours June 2002
Residential Sales Comparison Approach 30 Hours June 2002
Mechanlcsburg Area High School Graduated 1975
Prooertv Tvoes Aooraised
Single Family Dwellings
Condominiums
Two - Four Family Units
Multifamily Commercial Conversion Units
Farms
Garages
Residential Vacant Land and Building Lots
"lEV.1503E-X+\1.971
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE B
STOCKS & BONDS
Willis, Helene E.
FILE NUMBER
21-2002-00837
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1. 56 Shares Waypoint
Financial Corp. Common Stock
held in book form, account
number 4038070006. 56 x
$17.59/share = $985.04
DESCRIPTION
VALUE AT DATE
OF DEATH
985.04
2 $100.00 U.S. Series EE
Savings Bond, Serial Number
C65058902EE, Issue Date
07/1984. Issue Price
$50.00, Interest 98.28,
Total Value $148.28
148.28
3 $100.00 U.S. Series EE
Savings Bond, Serial Number
C65058901EE, Issue Date
07/1984. Issue Price
$50.00, Interest $98.28,
Total Value $148.28.
148.28
4 $50.00 U.S. Series EE
Savings Bond, Serial Number
L495412690EE, Issue Date
12/1991. Issue Price
$25.00, Interest $21.52,
Total Value $46.52
46.52
2W46963000
TOTAL (Also enter on line 2. Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
1,328.12
Historical Prices
.1 U.=,\.. l U.l i
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http://table.finance.yahoo.comld?a=8&b= 12&c=2002&d=8&e= 12&f=2002&g=d&s=wypt 11/22/2002
Helene E. Willis 180-32-1735
510 Hillside Road
New Cumberland, Ea. l'1~flfP
OR
Gordon Willis
JULY 1984 _ ___
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Helene E. Willis 18032-1735
510 Hillside Road
New Cumberland, Ea. 17070
OR
Gordon Willis
~~~-~~~-------
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SERIES EE
INTEftEST CEASES 30 YEA".
,.1110.. ISSUE DATI!:
180 32 1735
12
1991
70 HELENE E WILLIS
510 HILLSIDE RD
NEW CUMBERLAND
040
L-0-495-412-690-EE
017070
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PA 17070
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Di,c 1.2.. ...1.991
1:0000 l:j000 71:0:1
Savings Bond Calculator
Page 1 of 1
, Value As Of
110/2002
,uplilite'
Help
Savinc
~
Bond Info
Series
Denomination
Serial Number
Issue Date
I EE Bonds
-.:J
$1100 -.:J
Resu lis
# Bonds
3
Total Price
$125.00
Total Interest
$218.08
Total Value
$343.08
YTDInt
$13.2
Serial Number
Issue Interest
Issue Date Series Denom Price Interest Value Rate
07/1984 EE $100 $50.00 $98.28 $148.28 3.56%
07/1984 EE 100 50.00 98.28 148.28 3.56%
12/1991 EE 50 25.00 21.52 46.52 6.00%
Next Final
Accrual Maturity
C65058902EE
C65058901EE
L495412690EE
01/2003 07/2014
01/2003 07/2014
12/2002 12/2021
le end
Note Description
NI Not Issued
NE Not Eligible for Payment
P5 Includes 3-month interest penalty
ME Matured (Exchangeable for HH)
MN Matured (Not Exchangeable for HH)
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http://wwws. pub1icdebt. treas.gov/BC/SBCPrice
10/8/2002
REV-1508 EX + (1.97)
COMfv1ONvVEAL TH OF PENNS'ftVANIA
IN-iERlTAN:E TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Willis, Helene E.
FILE NUMBER
21-2002-00837
I nclude the proceeds of litigation and the dale the proceeds were received by the estate. All property jolntly-owned with the right of sulVfvorshlp must be disclosed on Schedule F.
ITEM
NUM8ER
DESCRIPTION
1. Wapoint Bank Checking Account Number
700002985.
VALUE A T DATE
OF DEATH
9,312.60
2 Waypoint Bank Savings Account Number
760000341.
3,591. 09
3 1998 Buick Century Automobile, VIN
#2G4WY52M1W528347, Title Number
51979280301WI. Blue Book Value
7,125.00
4 Waypoint Bank Dividend Check.
5.60
5 Patriot News Refund Check.
47.60
6 Central Penn AAA Refund Check.
48.51
7 Keystone Health Plan Central Senior Blue
Premium Refund Check.
54.00
2W46AD2.000
TOTAL (Also enter on line 5. Recanitulation\ $
(If more space is needed, insert additional sheets of the S13me size)
20,184.40
10/21/2002
STONE LAF AVER & SHEKLETSKl
414 BRIDGE ST
NEW CUMBERLAND P A 17070
/ Waynolnt
, IBANK
The infonnation which you requested on the account(s) of HELENE WILLIS
(Social Security Number 180-32-1735) is/are as follows:
Account Number
Class of Account
700002985
CHECKING
760000341
SA VINaS
06/29/92
3589.15
1.94
3591.09
Date Opened 04/1 0/81
Principal Balance 9312.60
Accrued Interest
Balance at Date of 9312.60
Death
Account Ownership SOLE
Name of Joint
Owner, if any
Date Ownership
Was Established
SOLE
Account Number
Class of Account
Date Opened
Principal Balance
Accrued Interest
Balance at Date of
Death
Account Ownership
Name of Joint
Owner, if any
Date Ownership
Was Estab Iished
Additional
Information
Requested
786524308
IRA
03/27/95
21801.53
310.45
22111.98
SOLE
PAMELA
ROSNICK- f}fdl/i;.(;c,1iR Y
03/27/95
~;~~
SENIOR SERVICES REP.
P.O. Box 1711. HARRISBURG. PENNSYUlANIA 17105-1711
Toll FrEE '-866-WAYPOINT (1-866-929-7646) . IN YORK AREA 717/815-4500 . www.waypointbank.com
R!::v.151O EX + 11-971
COMMONWEALTH OF PENNSYLVAN)A
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Willis, Helene E.
SCHEDULE G
INTER.VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
FILE NUMBER
21-2002-00837
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION Of PROPERTY o/~~_
ITEM INCLUDE THE N.4ME OF THE TRANSFEREE. THEIR RELATIONSHIP TO OATEOF DEATH DECO'S EXCLUSION TAXABLE VALUE
NUMBEF DECEDENT ANOl'rlE DATE Of TRANSFER. ATTACH A COPY OF THE VALUE OF ASSET IFAPf'\JCABLEl
DEED FOR REAL ESTATE INTEREST
1. MetLife Account Number 166,815.12 100.00 2,000.00 164,815.12
550005899.
2 Waypoint Bank IRA Account 22,111. 98 100.00 0.00 22,111.98
Number
786524308.
3 Fu1 ton Bank IRA #390-1418001. 422.22 100.00 0.00 422.22
4 Fulton Bank IRA #390-1918052, 836.78 100.00 0.00 836.78
5 Fulton Bank IRA #390-1955551. 3,424.91 100.00 0.00 3,424.91
6 Fulton Bank IRA #390-1956994. 3,071.97 100.00 0.00 3,071. 97
7 Ful ton Bank IRA #391-1910111. 3,061.61 100.00 0.00 3,061.61
8 Ful ton Bank IRA #391-1910323. 1,596.65 100.00 0.00 1,596.65
9 Ful ton Bank IRA # 460-1463530. 510.51 100.00 0.00 510.51
10 Fulton Bank IRA #460-1964488 2,055.91 100.00 0.00 2,055.91
11 Fulton Bank IRA #523-0030208. 8,718.17 100.00 0.00 8,718.17
TOTAL (Also enter on line 7, Recapitulation) $ 210,625.83
(If more space is needed. insert additional sheets of same size.)
ZW46AF zooo
Met Life
Page 1 of 2
Confirmation Statement
MetLife
P.O. Box 22030
Tulsa, OK 74121-2030
11 1(800) 638-7732
.9:~ www.metlife.com
Overnight Address
MetLife
12902 E 51st Street
Tulsa, OK 74131-6700
5/20/02
Non-Qualified
HELENE E WilLIS
001 -0295
HELENE E WilliS
.....
.....
.....
-
HELENE E WILLIS
510 HILLSIDE ROAD
NEW CUMBERLAND, PA 17070
ROBERT STENGlE
(717) 691-5900
Account Summary
Account Balance on September 23, 2002
$0.00
Transaction
Date
Transaction
Description
Dollar Amount
of Transaction
Unit
Value
Unit(s) this
Transaction
9/23/02
Death Benefit
Fixed Interest Account
$166,815.22
$166,815.22
Met Life'
FOR IRA ACCOUNTS ONLY: Is this a rollover contribution? _Yes No
If nol, for which tax year are you making this contribution?
Mail-in Stub
Please make your check(s) payable 10 MelLife. DO NOT
SEND CASH. Write your account number on the check(s)
and mail 10:
HELENE E WilLIS
MetLife
P.O. Box 371537
Pittsburgh. PA 15250-7537
HELENE E WilLIS
For change af address please complete below:
Street Address .... ....................................... .............
City ................................ State ....... Zip ..........
550005899
67:305002-001-0295
'"1111111111111111111l1li1"111111111111111111111111111111111111111111111111111111111111111111
October 9, 2002
F\1lton Bank
CAPITAL DIVISION . LANCASTER/CHESTER DIVISION
DROVERS BANK DIVISION . GREAT VALLEY DIVISION
(717)291-2589
Gerald]. Shekletski
Stone, LaFaver & Shekletski
414 Bridge St. PO Box E
New Cumberland, P A 17070
Dear Mr. Shekletski:
RE: Helene E. Willis, deceased September 12, 2002
In response to your recent inquiry concerning the accounts maintained in the name of
the decedent, please be advised that the following accounts were open at the date of death:
IRA#
390-1418001
390-1918052
390-1955551
390-1956094
391-1910111
391-1910323
460-1463530
460-1964488
523-0030208
BALANCE
416.95
826.33
3,413.78
3,049.06
3,047.74
1,593.16
504.41
2,049.68
8,697.33
ACC
INT
5.27
10.45
11.13
22.91
13.87
3.49
6.00
6.23
20.84
OPEN
4/25/02
8/10/96
8/1 6/97
7/18/97
7/18/02
8/16/02
4/25/02
8/24/94
8/22/97
ROLL OVER
nI.
8/10/00
8/16102
7/18/02
nI.
nI.
nI.
8/24/99
8/22/02
If you have any further questions, please do not hesitate to contact me.
RATE
6.20
6.20
4.40
4.88
2.96
2.96
5.83
5.83
4.16
Very truly yours,
~,~~~i~L
Credit Confirmation Processor
POBox 4887 Lancaster, PA 17604
www.fultonbankcom 1-800-FULTON-4
MATURITY
8/10/04
8/10/04
8/16/07
7/18/07
10/1 8/03
11/16/03
8/24/04
8/24/04
8/22/07
REV-ISH EX.. i1-91}
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX REl1JRN
RESIDENT DECEDENT
ESTATE OF
W~llis, Helene E.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21-2002-00837
Debts of decedent must be reDorted on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A FUNERAL EXPENSES:
1. parthemore Funeral Home & Cremation Services, Inc. 8,334.80
1303 Bridge St.
New Cumberland, PA 17070
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions 0.00
Name of Personal Representative(s)
Social Security Number(s) / EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Allorney Fees Name: Gerald J. Shekletski, Esq. 17,507.00
3. Family Exemption: (If decedent's address is not the same as claimant's. attach explanation) 0.00
Claimant
Street Address
City Slate Zip
Relationship of Claimant to Decedent
4. Probate Fees 285.00
5. Accountant's Fees 0.00
6 Tax Return Preparer's Fees 0.00
7. Legal Advertising - CUlIlberland Law Journal. 75.00
8 Legal Advertising - The Patriot News. 108.43
9 Mt. Olivet Cemetery - Grave Opening 700.00
10 Bridge St. Realty LLS - House Appraisal Fee. 325.00
11 PPL 82.79
12 PAWC - Water Bill 28.07
:rota~ ~rom cont~nuat~on pages.... fLU. ~L
TOTAl (Also enter on Hne 9, Recapitulation) $ 28,167.01
2W46A02000
(If more space is needed, insert additional sheets of same size)
REV.1513 EX., (9.00)
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYt. VANIA
INHERITANCE TAX REl1JRN
RESIDENT DECEDENT
ESTATE OF
Willis
NUMBER
I.
Hel.m" E.
1.
NAME AND ADDRESS OF PERSON(S} RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions. and transfer
under Sec. 9116 (aj (1.2)j
Rasnick, Pamela H
4000 Clover lea St.
Pittsburgh, PA 15227
FILE NUMBER
21-2002-00"37
RElATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Daughter
AMOUNT OR SHARE
OF ESTATE
322,971.34
ENTER DOLlAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH lB, AS APPROPRIATE, ON REV-1500 COVER SHEET
II. NON- TAXABLE DISTRIBUTIONS;
A SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
2W4BA11,OOO
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV.1500 COVER SHEET
(If more space 15 needed. Insert addItional sheets of the same size)
$
0.00
/?- ,J?R- /0;2/
\,
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
'*
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
REV-1547 EX AFP 101-031
GERALD J SHEKLETSKI ESQ
STONE ETAL
PO BOX E
NEW CUMBERLAND PA 1707a~4802
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
~.PUNTY
ACN
02-10-2003
WILLIS
09-12-2002
21 02-0837
CUMBERLAND
101
HELENE
E
Allount RelliUed
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV=is'4,-ix-AFP-('(jr=03Y-Noi'-ici--OF-YNHiiiiTAirCE-YAir'AppRAisiirENY-,--ALrOwANcE-ifli-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF WILLIS HELENE E FILE NO. 21 02-0837 ACN 101 DATE 02-10-2003
TAX RETURN WAS: (X) ACCEPTED AS FILED
) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
U)
(2)
(3)
(4)
(5)
(6)
(7)
119.000.00
1. 328 .12
.00
.00
20.184.40
.00
210.625.83
(8)
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
351,138.35
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
UO)
28,167.01
.00
Ul)
(2)
(3)
(4)
28.167 01
322,971.34
.00
322,971.34
I~ an assessment was issued previously, lines 14, IS and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Allount of Line 14 at Spousal rate (15)
16. AlIOunt of Line 14 taxable at Lineal/Class A rate (16)
17. Allount of Line 14 at Sibling rate (17)
18. Allount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
NOTE:
.00
322,971.34
.00
.00
X 00 =
X 045 =
X 12 =
X 15 =
(9)=
.00
14,533.71
.00
.00
14,533.71
TAX CREDITS:
KC\;C.LI"I l+J AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
12-10-2002 CDOO1933 726.69 13.807.02
TOTAL TAX CREDIT 14,533.71
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
STATUS REPORT UNDER RULE 6.12
~
d~
Name of Decedent: Helene E. Willis
Date of Death: September 12, 2002
Will No. 2002-00837
To the Register:
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court
Rules, I report the following with respect to completion of the
administration of the above-captioned estate:
1 .
Yes ~
State whether administration of the estate is complete:
No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will
be complete:
3. If the answer to No.1 is Yes, state the following:
(a) Did the personal representative file a final
account with the Court? Yes No X
(b) The separate Orphans' Court No. (if any) for the
personal representative's account is: N/A
(c) Did the personal representative state an account
informally to the parties in interest? Yes~ No
(d) Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with
the Clerk of the Orphans' Court and ma be attached to this
report. ~
Gerald Shekletski,
414 Bridge Street
New Cumberland, PA 17070
717-774-7435
Date: December 2, 2003
Capacity:
Personal Representative
X
Counsel for Personal
Representative