HomeMy WebLinkAbout04-28-15 Pennsylvania
1505618403
DEPARTMENT OF REVENIjfX(03-14)
REV-150110 OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN
Harrisburg PA 17128-0601 RESIDENT DECEDENT 21 14 0792
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
08 01 2014 12 03 1929
Decedent's Last Name Suffix Decedent's First Name MI
SOBOLEWSKI ELOISE D
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
1. Original Return 11 2. Supplemental Return 3. Remainder Return(date of death
prior to 12-13-82)
4. Agricultural Exemption(date of 5. Future Interest Compromise(date of E] 6. Federal Estate Tax Return Required
death on or after 7-1-2012) death after 12-12-82)
❑X 7. Decedent Died Testate ❑ 8. Decedent Maintained a Living Trust 9. Total Number of Safe Deposit Boxes
(Attach copy of will) (Attach copy of trust.)
10. Litigation Proceeds Received 11. Non-Probate Transferee Return 12. Deferral/Election of Spousal Trusts
(Schedule F and G Assets Only)
F] 13. Business Assets 14. Spouse is Sole Beneficiary
(No trust involved)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
ROBERT C SAIDIS (717 ) 243 6222
First Line of Address
26 W HIGH STREET
Second Line of Address
City or Post Office State ZIP Code
CARLISLE PA 17013
Correspondent's email address: rsaidis(a�ssr-attorneys.com
REGISTER OF WILLS USE ONLf Wti
t� i✓T1 rT1 ,.
REGISTER OF WILLS USE ONLY f7)
DATE FILED MMDDYYYY
d!1
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DATE FIL,�kAI Ra -t1
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Side 1
1111111111 fill 111111111111111111111111 IN
1505618403 1505618403
1505618411
REV-1500 IX
Decedent's Social Security Number
Decedent's Name: Sobolewski, Eloise D.
RECAPITULATION
1. Real Estate(Schedule A)....................................................................................... 1. 180-,000 -00
2. Stocks and Bonds(Schedule B)............................................................................ 2.
3, Closely Held Corporation,Partnership or Sole-Proprletorship(Schedule C)......... 3.
4. Mortgages and Notes Receivable(Schedule D).................................................... 4.
S. Cash.,Bank Deposits and Miscellaneous Personal Property(Schedule E).......... 5. 3,731-00
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............. 6. 49A06 -43
7. Inter-Vitus Transfers&Miscellaneous Noir-Probate Property
(Schedule G) Separate Billing Requested............ 7. 12 19 0 4 -61
8. Total Gross Assets(total Lines 1 through7)........................................................ 8. 245-1642-04
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 17-,710. 31
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10. 4-,749-67
11. Total Deductions(total Lines 9 and 10)................................................................ 11. 2 2,4 6 0-18
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 223-,181-86
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. 223-,181 .86
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
i transfers under Sec.9116
(a)(1.2)X.00 15. 11-00
16. Amount of Line 14 taxable
at lineal rate X .045 2231181-86 16. 10 A43- 18
17. Amount of Line 14 taxable ?
at sibling rate X.12 0.0 0 17.
18. Amount of Line 14 taxable
at collateral rate X.15 0.013 18. 0 .00 s
19. TAX DUE................................................................................................................ 19. 10,0 4 3 18 N
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑
Under penalties.of perjury,I declare I have examined this retum,'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 person responsible for filing the return Is based on all Information of which preparer has
any knowledge.
SAIGNAT E OF PER RESPONSIBL FiLI RETUR Vyllliam Grant Sobolewski _x�E- I 's
ADDRESS
186 Lon9street_Pjtf-q-,39ettysburg, PA 17325
SIGNATURE OF P.£f' REPRESENTATIVE RobertC.Saidis TE
ADDRES5/
26 W.High Streetl,!Carlisle(,PA
IIIIII
Side 2
1505618411
i5I1I�i�l VIII IIID IIID IIII IIII 1505 618 417.
REV-1500 EX Page 3 File Number 21-14-0792
Decedent's Complete Address:
DECEDENT'S NAME
Solbolewski, Eloise D.
STREET ADDRESS
19 San Juan Drive
CITY STATE ZiP
Mechanicsburg PA 17055
Tax Payments and Credits:
1. Tax Due(Page 2, Line 19) (1) 10,043.18
2. Credits/Payments
A. Prior Payments 2,171.13
B. Discount 114.27
Total Credits(A +B) (2) 2,285.40
3. Interest (3)
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4)
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) 7,757.78
Make Check Payable to: REGISTER OF WILLS, AGENT.
7
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;......... ........... .......... ............................................. ❑ 1�1
b. retain the right to designate who shall use the property transferred or its income;_............................... ❑ 1�1
c. retain a reversionary interest;or........................... ................................................................................... ❑ [il
d. receive the promise for life of either payments,benefits or care?............................................................ ❑ FAI
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?....... ❑
4. Did decedent own an individual retirement account,annuity,or other non-probate property which
contains a beneficiary designation?.... ............_...._..... ......__.........._.........__............_................. ❑
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1,1994 and before Jan.1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is 3 percent[72 P.S.§9116(a)(1.1)(i)).
For dates of death on or after January 1,1995,the tax 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
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an
adoptive parent,or a step-parent of the child is 0 percent[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 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)]. A sibling is defined,
under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
Rev-1502 EX+(12.12)
SCHEDULE A
pennsylvania REAL ESTATE
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Sobolewski, Eloise D. 21-14-0791
All real property owned solely or as a tenant in common must be reported at fair market.value.Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts.
Real property that is jointly-owned with right of survivorship must be disclosed on schedule F.
Attach a copy of the settlement sheet if the property has been sold
Include a copy of the deed showing decedents interest if owned as tenant in common.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Real estate situate at 19 San Juan Drive, Mechanicsburg, PA-See attached appraisal 180,000.00
TOTAL(Also enter on Line 1, Recapitulation) 180,000.00
(If more space is needed,additional pages of the same size)
Copyright(c)2012 form software only The Lackner Group, Inc. Form PA-1500 Schedule A(Rev. 12-12)
Main File No.SANJUANDR19 Page-#71
Central Penn Appraisals, Inc.
24 W Main Street
Shiremanstown,PA 17011
(717)737-4600
04/10/2015
W.Grant Sobolewski
186 Longstreet Dr
Gettysburg, PA 17325
Re: Property: 19 San Juan Dr
Mechanicsburg,PA 17055
Borrower: N/A
File No.: SANJUANDR19.
Opinion of Value:$ 180,000
Effective Date: 04/07/2015
In accordance with your request,we have appraised the above referenced property. The report of that appraisal is
attached.
The purpose of the appraisal is to develop an opinion of market value for the property described in this appraisal report,
as improved,in unencumbered fee simple title of ownership.
This report is based on a physical analysis of the site and improvements,a locational analysis of the neighborhood and
city,and an economic analysis of the market for properties such as the subject. The appraisal was developed and the
report was prepared in accordance with the Uniform Standards of Professional Appraisal Practice.
The opinion of value reported above is as of the stated effective date and is contingent upon the certification and limiting
conditions attached.
It has been a pleasure to assist you. Please do not hesitate to contact me or any of my staff if we can be of additional
service to you.
Sincerely,
John S. Boswell
License or Certification#: RL001405L
State: PA Expires:06/30/2015
john@paappraisers.com
Central Penn Appraisals,Inc.U17)737-4600
FROM: INVOICE
Bonnie Myers,Office Manager
Central Penn Appraisals, Inc INVOICE NUMBER-.._� .........
24 West Main Street
SANJUANDR19
Shiremanstown, PA 17011 DATES
Invoice pate: 04/10/2015
Telephone Number:717-737-4600 Fax Number: 717-737-9123 Due Date:
'REFERENCE
TO: Internal Order#:
Lender Case#:
W. Grant Soboieski Client File#:
186 Longstreet Dr FHA/VA Case#:
Gettysburg, PA 17325 Main File#onfarm: SANJUANDR19
E-Mail:
Other File#on farm: Private
Telephone Number: Fax Number: Federal Tax ID: 25-1733269
Alternate Number. Employer ID:
Restricted Appraisal Report
Lender: W.Grant Sobolewski Client: W.Grant Sobolewski
Purchaser/Borrower: N/A
Property Address: 19 San Juan Dr
City: Mechanicsburg
County: Cumberland State: PA Zip: 17055
Legal Description: Deed Book 00251, Page 00971, Lot 107J
'FEES
AMOUNT
Restricted Appraisal Reporf 400,00
SUBTOTAL 400.00
Main.File'No.SANJUANDR1 91 Pae#2
APPRAISAL OF REAL PROPERTY
Ilk ,.
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LOCATED. AT
1.9.San.Juan,Dr.:
Mechanic9burg, PA 17055 '..
Deed Book 00251;,,Page 00971,•Lot 107J
FOR
W.Grant Sobolewski
OPINION OF VALUE
180,000
AS OF
04/07/2015'
Central Penn Appraisals,Inc.(717)737.4600 Main File No.SANJUANDRI g Pa a#3
RESTRICTED APPRAISAL REPORT Private
File No.. SANJUANDR19
Property Address: 19 San Juan Dr City: Mechanicsbur State: PA Zip Code: 17055
H
County: Cumberland Legal Description: Deed Book 00251 Page 00971 Lot 107J
W
w Assessor's Parcel#: 42-29-2454-080
Tax Year. 2014 R.E.Taxes:$3,587 Special Assessments:$0 Borrower d applicable): N/A
Current Owner of Record: Sobolewski Robert E.&Eloise D. Occupant: ❑ Owner ❑ Tenant ®Vacant I❑ Manufactured Housing
N
Property Type: ® SFR 2-4 Family #of Units: 1 Ownership Restriction:
❑ ® None ❑ PUD ❑ Condo ❑ Coo
Market Area Name: Mount Allen Heights Ma Reference: PA Atlas 78 C1 Census Tract: 0116.05 ❑ Hood Hazard
The purpose of this appraisal is to develop an opinion of: Market Value as defined),or ❑ other type of value describe
This report reflects the following value if not Current,see comments): Current the Inspection Date is the Effective Date ❑Retrospective El Prospective
z A_pproaches developed forthis appraisal: ® Sales Comparison Approach ❑ Cost Approach ❑ Income Approach 0 Other.
uJ Property Rights Appraised: ® Fee Simple ❑Leasehold ❑Leased Fee ❑Other describe
z Intended Use: For Estate&Marketing Purposes.
US Under USPAP Standards Rule 2-2(b),this is a Restricted Appraisal Report,and is intended only for the sole use of the named client.There are no other intended users.The
Q client must clearly understand that thea raiser's opinions and conclusions may not be understood properly without additional information in thea raiser's work file.
Client: W.Grant Sobolewski Address: 186 Longstreet Dr.Gettysburg, PA 17325
Appraiser John S. Boswell Address: 24 W Main Street,Shiremanstown, PA 17011
FEATURE SUBJECT COMPARABLE SALE#1 COMPARABLE SALE#2 COMPARABLE SALE#3
Address 19 San Juan Or 900 Bonny Ln 34 Kim Acres Dr 4 Pocono Dr
Mechanicsburq, PA 17055 Mechanicsburg, PA 17055 Mechanicsburg, PA 17055 Mechanicsburg, PA 17055
Proximity to Subject 1.79 miles SW 0.23 miles NW 0.50 miles N
Sale Price $ $ 175,000 $ 210,000 $ 189,000
Sale Price/GLA $ /s .ft.$ 168.92/s .ft. $ 172.13/s .ft. $ 166.08/s .ft.
Data Sources Inspection MLS#10263273 MLS#10255874 MLS#10247042
Verification Sources Courthouse Online Courthouse Records Online Courthouse Records Online Courthouse Records Online
VALUE ADJUSTMENTS DESCRIPTION DESCRIPTION + $Adjust. DESCRIPTION + $Adjust. DESCRIPTION + $Ad just.
Sales or Financing Conv. Conv. FNA
Concessions Seller Help -7 000 None Seller Help -8,355
Date of Salelrime 03/31/2015-30 10/17/2014-61 04/25/2014-69
Rights Appraised Fee Simple Fee Simple Fee Simple Fee Simple
Location Average Average Average Average
Site 0.42 ac 0.31 ac +11,1100 0.31 ac +1,100 0.34 ac +800
View Avera a Avera a Avera a Average
Design(Style) Bi-Level Bi-Level Bi-Level Split-Level
Quality of Construction Ave.-Brk/Alu/T111 Ave.-Brk/Vin I 0 Ave.-Brk/Vin I 0 Ave.-Vinyl +5,000
Age 46 45 48 51
Condition Avera a Good -10,000 Good -10,000 Good -10,000
Above Grade Total Bdrms I Baths Total Bdrms Baths Total Bdrms Baths Total Bdrms Baths
Room Count 7 3 1 1.0 5 1 3 1 1.1 -2 000 5 3 1 1.1 -2,000 5 1 3 1 A 0
Gross Living Area 1,424 s .ft. 1,036 sq-ft- +9,700 1,220 sq-ft. +5,100 1 138 s .ft. +3,200
Basement&Finished Part Exposed Part Exposed Part Exposed Full Exposed 0
s Rooms Below Grade Rec Rm/Den/Bath Rec Rm/Den/Bath Rec Rm/Den/Bath Rec Rm/Den/Bath
a Functional Utility Average Average Avera a Average
w Heating/Cooling EBB/No CA EHP/CA -7,500 EBB/No CA OBBHW/No CA -3,5001
a Energy Efficient Items Typical for Area Typical for Area Typical for Area TvDical for Area
Q
Garage/Carpon 1 Gar. Integral 1 Gar. Integral 1 Gar. Integral 1 Gar.Attached -2 000
z
O Porch/Patio/Deck Full Porch Porch +2,000 Patio +2,000 Patio +2,000
Covered Deck Patio&Deck 0 Patio&Deck 0 Covered Deck
(L 1 Fireplace 1 Fireplace None +2 500 None +2,500
2 1 Fireplace/insert None +3,000 1 Fireplace/insert None +3,000
Q Shed&Fence None 0 Shed&Fence 2 Sheds 0
N In round Pool None 0 In round Pool -7,500 Enclosed Breezwa -4,500
LU
Net Adjustment(Total) ❑ + ® $ -10 700 ❑ + $ -t3 800 ❑ + ® - $ -11,855
(n Adjusted Sale Price Net 6.1% Net 4.2% Net 6.3%
of Comparables Gross 24.2%$ 164,300 Gross 14.4%$ 201 200 Gross 23.7%$ 177,145
Summary of Sales Comparison Approach It is noted that the Gross living Area for Comparable No. 1 is significantly less than that of the subject;
however,the sales chosen are the best available. Other comparables analyzed would have required less desirable adjustments and were not
used for that reason. Comp 2 is given the most weight in the final reconciliation of value as it is most similar to the subject in terms of location,
design,appeal and amenities. All 3 comparables are located in the same township,school district,and market area as the subject. It is noted
that Comparable Sale No.3 occurred over six months prior to the appraisal date. Comparables that sold within six months of the date of the
appraisal were significantly different in location,size,condition,special conditions,and/or style. In the appraiser's judgment the comparable
selected is a better indicator of value than more recent sales. Comparables sales used are all closed sales. Appropriate adjustments have
been made for all differences.
Main File No.SANJUANDR1 91 Pae#4
Private
RESTRICTED APPRAISAL REPORT File No.: SANJUANDR19
My research did X 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): County records online&Central Penn Multi-List, Inc..
O 1st Prior Subject Sale/Transfer Analysis of sale/transfer history and/or any current agreement of sale/listing: The subject is not currently found in the
w Date: 09/01/1973 local MLS.
5: Price: $43,500
w Source(s):Courthouse Online
W 2nd Prior Subject Sale/Transfer
Date:
Price:
Source(s):
Subject Market Area and Marketability: The subject is located in Mt Allen Heights Upper Allen Township and The Mechanicsburg Area School
District There are no foreseeable economic trends which might significantly influence market conditions in this area. The current mortgage
Ymarket offers a wide variety of conventional loans with competitive rates. As a result the terms of financing have little, if any,impact on sales
W prices If interest rates remain reasonable property values and marketability should be good. Current supply and demand are in balance.
gMarketing time averages 90 days as per MLS statistics. Interest rates are ranging from 3-6%with 0-3 points typically being paid for origination
or discount.
Site Area: 0.42 ac Site View: Average Topography: Level-Slope to Road Drainage: Appears Adequate
Zoning Classification: R-2 Description: Medium Density Residential
Zoning Compliance: ® Legal ❑ Legal nonconforming(grandfathered) ❑ Illegal ❑ No zoning
Highest&Best Use: ® Present use,or ❑ Other use(explain)
W Actual Use as of Effective Date: Single Family Residence Use as appraised in this report: Same
Opinion of Hi hest&Best Use: N/A
FEMA S ec'I Flood Hazard Area ❑Yes ® No FEMA Flood Zone X FEMA Map# 42041 CO286E FEMA Map Date 03/16/2009
Site Comments: Site has average site improvements average landscaping and typical maintenance. The rear yard is enclosed with fencing.
There are no apparent adverse easement encroachments or other adverse conditions on this site.
I
u) Improvements Comments: Hardwood flooring in the bedrooms;Whole house fan; Electric water heater;Wall mount ac&Ip heater in the family
z room;Chair rail in the dining room Special note:The inground pool and yard shed are given no value in this report due to their condition.
LU There is a mold problem developing in the basement level of the house. Overall the condition of the subject is classified as average.
W
O
ix
(L
21
Indicated Value by:Sales Comparison A roach$ 180,000
Indicated Value by:Cost Approach if developed)$ Indicated Value by:Income Approach if developed)$
Final Reconciliation This appraisal report has been prepared with the property in"as is"condition. No personal property has been included in this
valuation The fact that the seller is or is not paying any portion of the closing cost has no effect on the market value of the subject. The
subject property was vacant at the time of inspection Although the subject property was vacant at the time of inspection the utilities were
turned on and all mechanical equipment/utilities appeared to be in working order.This appraisal assumes a reasonable marketing period for
the subject property of three months The Market Approach reflects recent activity in the market place. In view of the age of these
p improvements the Cost Approach cannot be considered an accurate indicator of value. The Income Approach is inappropriate because few
I— single family houses are rented in this market Given the high quality of the available sale data the value indicated by the Market Approach is
:1 used as the final estimated value.
z This appraisal is made ® "as is", [:1 subject to completion per plans and specifications on the basis of a Hypothetical Condition that the improvements have been
p completed, ❑ subject to the following repairs or alterations on the basis of a Hypothetical Condition that the repairs or alterations have been completed, ❑ subject to
L) the following required inspection based on the Extraordinary Assumption that the condition or deficiency does not require alteration or repair:
a
❑ This report is also subject to other Hypothetical Conditions and/or Extraordinary Assumptions as specified in the attached addenda.
Based on the degree of inspection of the subject property, as indicated below, defined Scope of Work, Statement of Assumptions and Limiting Conditions,
and Appraiser's Certifications, my(our)Opinion of the Market Value(or other specified value type), as defined herein, of the real property that is the subject
of this report is: $180,000 ,as of: 04/07/2015 , which is the effective date of this appraisal.
If indicated above,this Opinion of Value is subject to Hypothetical Conditions and/or Extraordinary Assumptions included in this report. See attached addenda.
A true and complete copy of this report contains 14 pages, including exhibits which are considered an integral part of the report. This appraisal report may not be
w properly understood without reference to the information contained in the complete report.
2 Attached Exhibits:
X
® Scope of Work ® Limiting Cond./Certifications ❑ Narrative Addendum ® Photograph Addenda ® Sketch Addendum
® Map Addenda El Additional Sales 1:1 Cost Addendum El Flood Addendum ElManuf.House Addendum
a ❑ Hypothetical Conditions ❑ Extraordinary Assumptions Z Appraiser Certification ® Plat Map&Summary Pae ® Cover Letter&Invoice
Client Contact: Client Name: W.Grant Sobolewski
E-Mail: Address: 186 Longstreet Dr. Gettysburg, PA 17325
APPRAISER SUPERVISORY APPRAISER (if required)
Main File No.SANJUANDR191 Pae#5
Private
Assumptions, Limiting Conditions & Scope of Work Fileft: SANJUANDR19
Propeq Address: 19 San Juan Dr City: Mechanicsburg State: PA Zip Code: 17055
Client: W.Grant Sobolewski Address: 186 Longstreet Dr.GettysburgPA 17325
Appraiser. John S.Boswell Address: 24 W Main Street,Shiremanstown, PA 17011
STATEMENT OF ASSUMPTIONS&LIMITING CONDITIONS
—The appraiser will not be responsible for matters of a legal nature that affect either the property being appraised or the title to it. The appraiser
assumes that the title is good and marketable and, therefore,will not render any opinions about the title.The property is appraised on the basis
of it being under responsible ownership.
—The appraiser may have provided a sketch in the appraisal report to show approximate dimensions of the improvements, and any such sketch
is included only to assist the reader of the report in visualizing the property and understanding the appraiser's determination of its size. Unless
otherwise indicated, a Land Survey was not performed.
—If so indicated, 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 the appraisal report whether 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.
—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.
—If the cost approach is included in this appraisal,the appraiser has estimated the value of the land in the cost approach at its highest and best
use, and the improvements at their contributory value.These separate valuations of the land and improvements must not be used in conjunction
with any other appraisal and are invalid if they are so used. Unless otherwise specifically indicated,the cost approach value is not an insurance
value, and should not be used as such.
—The appraiser has noted in the appraisal report any adverse conditions (including, but'not limited to, needed repairs, depreciation,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
normal research involved in performing the appraisal. Unless otherwise stated in the appraisal report,the appraiser has no knowledge of any
hidden or unapparent conditions of the property, or adverse environmental conditions (including, but not limited to,the presence of hazardous
wastes,toxic substances, etc.)that would make the property more or less valuable, and has assumed that 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 testing that might be required to discover whether such conditions exist. Because the
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.
—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 not assume responsibility for the accuracy of such items
that were furnished by other parties.
—The appraiser will not disclose the contents of the appraisal report except as provided for in the Uniform Standards of Professional Appraisal
Practice, and any applicable federal, state or local laws.
—If this appraisal is indicated as subject to satisfactory completion, repairs,or alterations, the appraiser has based his or her appraisal report
and valuation conclusion on the assumption that completion of the improvements will be performed in a workmanlike manner.
—An appraiser's client is the party (or parties) who engage an appraiser in a specific assignment. Any other party acquiring this report from the
client does not become a party to the appraiser-client relationship.Any persons receiving this appraisal report because of disclosure requirements
applicable to the appraiser's client do not become intended users of this report unless specifically identified by the client at the time of the
assignment.
—The appraiser's written consent and approval must be obtained before this appraisal report can be conveyed by anyone to the public,through
advertising, public relations, news, sales, or by means of any other media, or by its inclusion in a private or public database.
—An appraisal of real property is not a 'home inspection' and should not be construed as such. As part of the valuation process,the appraiser
performs a non-invasive visual inventory that is not intended to reveal defects or detrimental conditions that are not readily apparent. The presence
of such conditions or defects could adversely affect the appraiser's opinion of value. Clients with concerns about such potential negative factors
are encouraged to engage the appropriate type of expert to investigate.
The Scope of Work is the type and extent of research and analyses performed in an appraisal assignment that is required to produce credible
assignment results,given the nature of the appraisal problem,the specific requirements of the intended user(s)and the intended use of the
appraisal report.Reliance upon this report,regardless of how acquired,by any party or for any use,other than those specified in this report by
the Appraiser,is prohibited.The Opinion of Value that is the conclusion of this report is credible only within the context of the Scope of Work,
Effective Date,the Date of Report,the Intended User(s),the Intended Use,the stated Assumptions and Limiting Conditions,any Hypothetical
Conditions and/or Extraordinary Assumptions,and the Type of Value,as defined herein.The appraiser,appraisal firm,and related parties assume
no obligation,liability,or accountability,and will not be responsible for any unauthorized use of this report or its conclusions.
Under USPAP Standards Rule 2-2(b),this is a Restricted Appraisal Report,and is intended only for the sole use of the named client.There are no
other intended users.The client must clearly understand that the appraiser's opinions and conclusions may not be understood properly without
additional information in the appraiser's work file.
In developing this appraisal,the appraiser has incorporated only the Sales Comparison Approach. The appraiser has excluded the Cost and
Income Approaches to Value,due to being inapplicable given the limited scope of the appraisal. The appraiser has determined that this appraisal
process is not so limited that the results of the assignment are no longer credible,and the client agrees that the limited scope of analysis is
appropriate given the intended use.
Main File No.SANJUANDR1 91 Pae#6
Private
Certifications FileNo.: SANJUANDR19
Property Address: 19 San Juan Dr GO: Mechanicsburg State: PA Zip Code: 17055
Client: W. Grant Sobolewski Address: 186 Longstreet Dr.Gettysburg, PA 17325
Appraiser John S.Boswell Address: 24 W Main Street,Shiremanstown, PA 17011
APPRAISER'S CERTIFICATION
I certify that,to the best of my knowledge and belief:
—The statements of fact contained in this report are true and correct.
—The credibility of this report, for the stated use by the stated user(s), of 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.
—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 to the 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 this 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 time this report was prepared.
—I did not base, either partially or completely, my analysis and/or the opinion of value in the appraisal report on the race, color, religion,
sex, 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.
—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 person(s) signing this certification.
Additional Certifications:
DEFINITION OF MARKET VALUE*:
Market value means 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 and 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 acting in what they consider their own best interests;
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.
*This definition is from regulations published by federal regulatory agencies pursuant to Title XI of the Financial Institutions
Reform, Recovery, and Enforcement Act(FIRREA) of 1989 between July 5, 1990, and August 24, 1990, by the Federal Reserve System
(FRS), National Credit Union Administration (NCUA), Federal Deposit Insurance Corporation (FDIC),the Office of Thrift Supervision (OTS),
and the Office of Comptroller of the Currency (OCC).This definition is also referenced in regulations jointly published by the OCC, OTS,
FRS, and FDIC on June 7, 1994, and in the Interagency Appraisal and Evaluation Guidelines, dated October 27, 1994.
Client Contact: Client Name: W.Grant Sobolewski
E-Mail: Address: 186 Longstreet Dr. Gettysburg, PA 17325
_ APPRAICFR I CI IPFRVICr1RV APPRAICFR (if rarniiraril
Main File No.SANJUANDR:19: Pa a#7
Subject Photo Page
Borrower N/A
Pro Address 19 San Juan Dr
City Mechanicsburg County Cumberland State PA Zip Code 17055
Lender/Client W.Grant Sobolewski
Subject Front
19 San Juan Dr
Sales Price
Gross Living Area 1,424
j.N
Total Rooms 7
Total Bedrooms 3
Total Bathrooms 1.0
Location Average
View Average
Site 0.42 ac
Quality Ave.-Brk/Alu[TI I I
Age 46
Subject Rear
Subject Street
iu�A
...........
Main File No.SANJUANDRI9 Pae#$
Photograph Addendum
Borrower N/A
Propeg Address 19 San Juan Dr
Ci Mechanicsburg County Cumberland State PA Zip Code 17055
Leader/Client W.Grant Sobolewski
Street Side
1W
' - rt
Y*
Side Missing Aluminum Facia
ell
Main File No.SANJUANDR1 91 Pa=e#9
Photograph Addendum
Borrower N/A
f2p2q Address 19 San Juan Dr
city Mechanicsburg County Cumberland State PA Zip Code 17055
Lender/Client W. Grant Sobolewski
j
Foyer Living Room Dining Room
.+
Xrrim
lily
Kitchen Level 1 Family Room Hall Bath
a
Bedroom Bedroom Bedroom
Mai
ll { t S
Main File No.SANJUANDR191 Pae#10
Comparable Photo Page
Borrower N/A
PrortV Address 19 San Juan Dr
city Mechanicsburg County Cumberland State PA Zip Code 17055
Lender/Client W.Grant Sobolewski
Comparable I
900 Bonny Ln
Prox.to Subject 1.79 miles SW
Sales Price 175,000
Gross Living Area 1,036
Total Rooms 5
Total Bedrooms 3
Total Bathrooms 1.1
Location Average
View Average
Site 0.31 ac
07
Quality
Ave.-BrkNinyl
�A "7
Age 45
_yY
-4 X E4
Comparable 2
34 Kim Acres Dr
Prox.to Subject 0.23 miles NW
Sales Price 210,000
Gross Living Area 1,220
Total Rooms 5
Total Bedrooms 3
tit Total Bathrooms 1.1
Location Average
View Average
Site 0.31 ac
Quality Ave.-BrkNinyl
Age 48
�A
Comparable 3
4 Pocono Dr
Prox.to Subject 0.50 miles N
Sales Price 189,000
Gross Living Area 1,138
Total Rooms 5
Total Bedrooms 3
Total Bathrooms 1.0
Location Averaoe
Main File No.SANJUANDR1 91 Pae#11
Building Sketch
Borrower N/A
Propeq Address 19 San Juan Dr
Ci Mechanicsburg County Cumberland State PA Zip Code 17055
Lender/Client W.Grant Sobolewski
4' 12'
Inground Swimming Pool
i
i
Z i Family
i Room
Cov. Deck
[64 Sq ft]
i
32'
Dining
Bedroom Bedroom Kitchen Room
v
bo First Floor
N [1424 Sq ft] V
v
L
Living
Bedroom Bath U) Room
Foyer
Porch
176 Sq ft
44'
12' 32'
Utility
& m
Den Laundry Z
0
y Basement
N c [896 Sq ft]tD obo
N
M FP
� Bath
'm
V)
TOTAL Sketch by a la mode,inc. Area Calculations summary
Aerial Ph6to / Plat Map
Borrower • N%A` _;<
Pro a .Address 10:$":Juan Dr .
Ci MdcFiarncsbur Cout Cumberland State PA Zi Code 17.055
lender:/Client W.Grant SoboleWAi
y
R
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Main File No.SANJUANDR1 91 Pae#12
Location Map
Borrower N/A
Pro a AddreSS 19 San Juan Dr
city Mechanicsburg County Cumberland State PA Zip Code 17055
Lender/Client W. Grant Sobolewski
�Or
a la mode, IrIG+ ark
r
wvtvo
Rassmoyne Industrial Park
m 1104 f •� ;; `h`�J- -
nia_Tpke-.=a:-w ke
pennsytvania�Tp
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- tamberl�o�Pk,,, ¢ E,tiMi�+diTs9 Hill Rd
Gate or
Heaven
Ceroete 15
Windi' ill
Il
is
y5 /'MP 4 Helt W Rd !P9,
aao 114 pt
�� �txaoY
Comparable
Acres34 D r w
114 Nt��
Mechanicsburg, + ' 17055
1ltlll'
Bowi-nansdale
1
��SVu R�
{� _ Yellow
Cereerehk
MssrehColege e
s-
;
a
Granham Pade a,b tcr
nom�
o
r r z
rr'et to I-I r R ��utc3ltd
+ 1 � r + + 1 ii F Saf10n
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wches
Greek rr o
Rev-1508 EX+(08-12)
SCHEDULE E
pennsylvania CASH, BANK DEPOSITS; & MISC.
DEPARTMENT OFPERSONAL PROPERTY )
INHERITANCE TAXAXRETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Sobolewski, Eloise D. 21-14-0792
Include the proceeds of litigation and the dale the proceeds were received by the estate.
All property jointly-owned with the right of survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 2011 Buick Century-See attached Kelly Blue Book Value 3,154.00
2 Erie Insurance-Refund of car insurance 257.00
3 Erie Insurance-Refund of home owners insurance 320.00
TOTAL(Also enter on Line 5, Recapitulation) 3,731.00
(If more space is needed,additional pages of the same size)
Copyright(c)2012 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev. 08-12)
Rev-1509 EX+(01-10)
pennsylvania SCHEDULE F
DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Sobolewski, Eloise D. 21-14-0792
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. William Grant Sobolewski 186 Longstreet Drive Son
Gettysburg, PA 17325
B.
C.
JOINTLY OWNED PROPERTY:
DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM LETTER DATE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DEGD'S DECEDVALUE OF
ENT'S INTEREST
NUMBER FOR JOINT MADE NUMBER OR SIMILAR IDENTIFYING NUMBER.ATTACH DEED FOR VALUE OF ASSE INTEREST
TENANT JOINT JOINTLY-HELD REAL ESTATE.
1 A 06/22/2011 Members 1st FCU Certificate of Deposit 1,518.48 50.000% 759.24
#33167-45-See attached letter from Members
1st Federal Credit Union dated March 13,
2015
2 A 02/25/2011 Members 1st FCU Certificate of Deposit 20,145.32 50.000% 10,072.66
#33167-46-See attached letter from Members
1st Federal Credit Union dated March 13,
2015
3 A 10/04/2010 Members 1st FCU Certificate of Deposit 3,942.65 50.000% 1,971.33
#33167-48-See attached letter from Members
1st Federal Credit Union dated March 13,
2015
4 A 11/25/2011 Members 1st FCU Certificate of Deposit 3,400.88 50.000% 1,700.44
#33167-54-See attached letter from Members
1st Federal Credit Union dated March 13,
2015
5 A 09/09/2009 Members 1st FCU Certificate of Deposit 25,486.39 50.000% 12,743.20
#33167-55-See attached letter from Members
1st Federal Credit Union dated March 13,
2015
Total of Continuation Schedule 3ee attached page
TOTAL(Also enter on Line 6, Recapitulation) 49,006.43
(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-1509 EX+(01-10)
pennsylvania SCHEDULE F
DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT continued . ._ _ . ..,
ESTATE OF FILE NUMBER
Sobolewski, Eloise D. 21-14-0792
If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G.
JOINTLY OWNED PROPERTY
DESCRIPTION OF PROPERTY %OF DATE OF DEATH
LETTER DATE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DECD'S
ITEM FOR JOINT MADE NUMBER OR SIMILAR IDENTIFYING NUMBER,ATTACH DEED FOR DATE OF DEATH VALUE OF
NUMBER TENANT JOINT JOINTLY-HELD REAL ESTATE. VALUEOFASSE7 INTEREST DECEDENT'S INTEREST
6 A 04/11/2011 Members 1st FCU Certificate of Deposit 22,610.80 50.000% 11,305.40
#33167-56-See attached letter from Members
1st Federal Credit Union dated March 13,
2015
7 A 12/29/2010 Members 1st FCU Certificate of Deposit 3,812.89 50.000% 1,906.45
#33167-58-See attached letter from Members
1st Federal Credit Union dated March 13,
2015
8 A 10/14/2010 Members 1st FCU Certificate of Deposit 7,293.74 50.000% 3,646.87
#33167-63-See attached letter from Members
1st Federal Credit Union dated March 13,
2015
9 A 09/04/2007 Members 1st FCU Checking Account#33167 1,660.92 50.000% 830.46
-11 -See attached letter from Members 1st
Federal Credit Union dated March 13,2015
10 A 09/04/2007 Members 1st FCU Savings Account#33167 1,135.17 50.000% 567.59
-00-See attached letter from Members 1st
Federal Credit Union dated March 13,2015
11 A 05/24/2013 Members 1st FCU Savings Account#33167 7,005.57 50.000% 3,502.79
-05-See attached letter from Members 1st
Federal Credit Union dated March 13,2015
TOTAL(Also enter on Line 6, Recapitulation) 49,006.43
Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule F(Rev.01-10)
A MAR 16 2015
MEMBERS 111
FEDERAL CREDIT UNION
REGULAR SAVINGS ACCOUNT:
Account Number/Suffix 33167-00
Date Account Established 04/11/1983
Principal Balance at Date of Death $1,135.17
Accrued Interest to Date Of Death $0.00
Total Principal and Accrued Interest $1,135.17
Name of Joint Owner W- Grant Sobolewski
Date Joint Added 09104/2007
INVESTMENT SAVINGS.ACCOUNT:
Account Number/Suffix 33167-05
Date Account Established 05/24/2013
Principal Balance at Date of Death $7,006.57
Accrued Interest to Date of Death $0.00
Total Principal and Accrued Interest $7.006.57
Name of Joint Owner W. Grant Sobolewski
Date Joint Added 05/24/2013
CHECKING ACCOUNT:
Account Number/Suff ix 33167.11
Date Account Established 04/09/1986
Principal Balance at Date of Death $1,660.92
Accrued Interest to Date of Death $0.00
Total Principal and Accrued Interest $1,660.92
Name of Joint Owner W. Grant Sobolewski
Date Joint Added 09104/2007
IRA CERTIFICATE:
Account Number/Suffix 33167-18
Date Account Established 10/25/2011
Principal Balance at Date of Death $12,904.61
Accrued Interest to Date of Death $0.00,
Total Principal and Accrued Interest $12,904.61
Name of Beneficiary W. Grant Sobolewski
MEMBERS 1sT
FEDERAL CREDIT UNION
Tessa L Klugh
Lending Insurance Support Specialist
March 13, 2015
Estate of: ELOISE D SOBOLEWSKI
Date of Death: 08101/2014
Social Security Number:401-32-6791
5000 Louise Drive - RO.Box 40 - Mechanksburg,Pennsylvania 17055 (800) 283-2328 www.memberslst.org
1-4
CERTIFICATE OF DEPOSIT: MEMBERS MERAL ME=UNION
Account Number/Suffix 33167-45* 33167-46
Date Account Established 05/23/2012 02/2512011
Principal Balance at Date of Death $1,518.48 $20,145.32
Accrued Interest to Date of Death $0.00 $0.00
Total Principal and Accrued Interest $1,518.48 $20,145.32
Name of Joint Owner W. Grant Sobolewski W. Grant Sobolewski
Date Joint Added 06/22/2011 02/2512011
*Rollover from CD 33167-53 opened 06/2212011.
CERTIFICATE OF DEPOSIT:
Account Number/Suffix 33167-48 33167-64
Date Account Established 10/04/2010 11/25/2011
Principal Balance at Date of Death $3,942.65 $3,400.88
Accrued Interest to Date of Death $0.00 $0.00
Total Principal and Accrued Interest $3,942.65 $3,400.88
Name of Joint Owner W. Grant Sobolewski W. Grant Sobolewski
Date Joint Added 10/04/2010 11/25/2011
CERTIFICATE OF DEPOSIT:
Account Number/Suffix 33167-55* 33167-56**
Date Account Established 06/15/2012 07/13/2012
Principal Balance at Date of Death $25,486.39 $22,610.80
Accrued Interest to Date of Death $0.00 $0.00
Total Principal and Accrued Interest $25,486.39 $22,610.80
Name of Joint Owner W. Grant Sobolewski W. Grant Sobolewski
Date Joint Added 09/0912009 04/11/2011
*Rollover from CD 33167749 opened 09/09/2009,
"Rollover from CD 33167-:51 opened 04/11/2011.
CERTIFICATE OF DEPOSIT.
Account Number/Suffix 33167-68* 33167-63**
Date Account Established '08/03/2012 01114/2012
Principal Balance at Date of Death $3,812.89 $7,293.74
Accrued Interest to Date of Death $0.00 $0.00
Total Principal and Accrued Interest $3,812.89 $7,293.74
Name of Joint Owner W Grant Sobolewski W. Grant Sobolewski
Date Joint Added 12/29/2010 10/14/2010
*Rollover from CD 33167-62 opened 12129/2010.
**Rollover from CD 33167-50 opened 10/14/2010.
MEMBERS I sT FEDERAL CREDIT UNION
Tessa L Klugh or
Lending Insurance Support.Specialist
March 13, 2015
Estate of: ELOISE D SO]BOLEWSKI
Date of Death:0810112014
Social Security Number: 401-32-6791
5000 Louise Drive - P.O.Box 40 - Mechanicsburg,Pennsylvania 17055 - (800) 283-2328 - www.tnemberslst.org
Rev-1510 EX+(08-09)
SCHEDULE C
pennsylvania INTER-VIVOS TRANSFERS AND
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Sobolewski, Eloise D. 21-14-0792
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
ITEM DESCRIPTION OF PROPERTYINCDATE OF DEATH i4 OF DECD'S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFERSATfACH THEIR OPY of THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1 Members '1st Federal Credit Union IRA Certificate 12,904.61 12,904.61
#33167-18-See attached letter from Members 1st
Federal Credit Union dated March 13,2015.
Beneficiary is William Grant Sobolewski
TOTAL(Also enter on Line 7, Recapitulation) 12,904.61
(If more space is needed,additional pages of the same size)
Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule G(Rev.08-09)
REV-1511 EX+(08-13)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX
RESIDENT DECEDENT RETURN ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Sobolewski, Eloise D. 21-14-0792
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
Myers-Buhrig Funeral Home
8,584.32
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zip
Year(s)Commission Paid
2. Attorney's Fees Saidis, Sullivan & Rogers 3,500.00
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation)
Claimant
Street Address
City State Zip
RelationshiD of Claimant to Decedent
4. Probate Fees 410.50
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 5,215.49
See continuation schedule(s)attached
TOTAL(Also enter on line 9, Recapitulation) 17,710.31
Copyright(c)2013 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.08-13)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Sobolewski, Eloise D. 21-14-0792
ITEM
NUMBER DESCRIPTION AMOUNT
Other Administrative.Costs
1 Central Penn Appraisals Inc. -Appraisal of Real Estate 400.00
2 Cumberland Law Journal_Advertise Letters 75.00
3 Lawnscapes,Inc. 157.64
4 Lawnscapes,.lnc. 198.30
5 Lawnscapes,Inc. 163.24
6 Lawnscapes,lnc. 174.90
7 PPL Electric 222.00
8 PPL Electric 454.00
9 PPL Electric 222.00
10 PPL Electric 443.01
11 PPL Electric 208.22
12 PPL Electric 377.90
13 PPL Electric 252.53
14 Republic Services-Trash bill 45.45
15 Republic Services -Trash bill 45.45
16 Republic Services-Trash bill 45.45
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
Sobolewski, Eloise D. 21-14-0792
ITEM
NUMBER DESCRIPTION AMOUNT
17 United Water 18.40
18 United Water 36.53
19 United Water 17.97
20 United Water 11.75
21 United Water 11.81
22 United Water 11.81
23 Upper AllenTownship-Sewer bill 112.00
24 Upper Allen'Township-Sewer bill 112.00
25 Valley Times-Star-Advertise letters 121.25
26 Verizon 354.08
27 Verizon 184.50
28 Verizon 184.50
29 Verizon 184.50
30 Verizon 184.65
31 Verizon 184.65
H-67 5,215.49
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1,500 Schedule H(Rev.6-98)
Rev-1512 EX+(12-12)
SCHEDULE 1
pennsylvania DEBTS OF DECEDENT,
DEPARTMENT OFMORTGAGE LIABILITIES AND LIENS
RET
INHERITANCE TAXAXRETURRNN
RESIDENT DECEDENT
ESTATE OF [FILE NUMBER
Sobolewski, Eloise D. 21-14-0792
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Dennis Zerbe,Treasurer-real estate taxes 1,774.31
2 Ethyl Cassel-house cleaning 75.00
3 Francisca J. Noy-caregiver 1,550.00
4 Francisca J. Noy-caregiver 30.00
5 Griswold Home Care 129.50
6 Lawnscapes,Inc. 280.42
7 Live-In Care•of PA, Inc. 350.00
8 PPL Electric 196.00
9 Republic Services -Trash bill 39.03
10 United Water 36.57
11 Upper Allen Township Sewer bill 112.00
12 Verizon 177.04
TOTAL(Also enter on Line 10, Recapitulation) 4,749.87
(If more space is needed,additional pages of the same size)
Copyright(c)2012 form software only The Lackner Group, Inc. Form PA-1500 Schedule I(Rev. 12-12)
REV-1513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Sobolewski, Eloise D. 21-14-0792
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT (Words) ($$$)
0 Not List Trustee(sl
ITAXABLE DISTRIBUTIONS [include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2))
William Grant Sobolewski Son 100%residue of
186 Longstreet Drive estate
Gettysburg, PA 17325
Total
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate.
NON-TAXABLE DISTRIBUTIONS:
II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule J(Rev.01-10)
LAST WILL AND TESTAMENT
OF
ELOISE D. SOBOLEWSKI
I, ELOISE D. SOBOLEWSKI, of Upper Allen Township,
Cumberland County, Pennsylvania, being of sound and disposing
mind, memory and understanding, do hereby make, publish and
declare this as and for my Last Will and Testament, hereby
revoking all other Wills and Codicils heretofore made by me.
FIRST
I direct the payment of my just debts and expenses of my
last illness and funeral from my estate as soon after my death
as conveniently may be done. I direct my body be interred in my
vault at Rolling Green Cemetery
SECOND
I give, devise and bequeath all the rest, residue and
remainder of my estate to my son, WILLIAM GRANT SOBOLEWSKI, per
stirpes .
THIRD
I direct that any and all inheritance, estate, and transfer
SAIDIS taxes imposed upon my estate passing under this Will or
3HUFF,FLOWER
& LINDSEY otherwise shall be paid out of the principal of my residuary
AMRNEYS•AT-I AW
ZG W. High Street
Carlisle,PA estate.
FOURTH
In addition to the powers conferred by law, I authorize any
personal representative acting under this instrument, in his
absolute discretion:
A. To retain in the form received, or to sell either at
public or private sale any real or personal property;
B. To exercise any options to subscribe for stocks,
bonds, or other investments;
C. To join in any plan of lease, mortgage,
consolidation, exchange, reorganization or foreclosure of
any corporation in which my estate or any trust may hold
stocks, bonds or other securities;
D. To sell, transfer, convey, mortgage., pledge, lease
or exchange any property, real or personal, which at any
time may form part of my estate, for the payment of debts
or taxes, or for any purpose of administration or
distribution, for such prices and upon such terms as my
personal representative, in his sole discretion, may deem
wise, and to execute and deliver deeds of conveyance or
SAIDIS transfer thereof;
SNUFF,FLOWER
& LINDSEY E. To make settlements and compromises on such terms as
MORNEYS-04AW
26 W.High Street
Carlisle,PA my personal representative in his sole discretion may deem
wise without the necessity of obtaining any court approval
thereof;
2
F. To make distribution hereunder either in cash or
kind, as my personal representative in his discretion may
deem wise.
FIFTH
I do hereby nominate, constitute and appoint my son,
WILLIAM GRANT SOBOLEWSKI, to act as Executor of this my Last
Will and Testament .
SIXTH
I direct that no personal representative,_ guardian, trustee
or other fiduciary appointed under this instrument shall be
required to give bond for the faithful performanceof their
duties in any jurisdiction.
IN WITNESS WHEREOF, I, ELOISE D. SOBOLEWSKI, have hereunto
set my hand and seal to this my Last Will and Testament,
consisting of three typewritten pages, the first two of which
bear my signature in the margin for. identification, this C2
day of " L'L01. 20-!N-.
;JEIodis�eD.
Sobolewski
SAID.IS
SHUFF,FLOWER
& LINDSEY
ATMRNEYS-AT-I AW
26 W. High Street
Carlisle,AA
3
Signed, sealed, published and declared by the above-named
ELOISE D. SOBOLEWSKI, Testatrix, as and for her Last Will and
Testament in the presence of us, who have hereunto subscribed
our names at her request as witnesses thereto, in the presence
of said Testatrix an of each other.
ADDRESS
ADDRESS
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
We, Eloise D. Sobolewski., Karim k1bd and
ftrj's��ove r , the Testatrix and witnesses, respectively
whose names are signed to the foregoing or attached instrument,
being first duly sworn, do hereby declare to the undersigned
authority that the Testatrix signed and executed the instrument
as her Last Will and Testament and that she signed willingly and
that executed as her free and voluntary act for the purposes
therein expressed, and that each of the witnesses, in the
presence and hearing of the Testatrix signed the Will as
witnesses and that to the best of their knowledge the Testatrix
was at the time eighteen (18) or more years of age, of sound
mind and under no constraint or undue influence.
Eloise D. Sobolews
,Wi ess
SAIDIS ,Witness
SNUFF,FLOWER
& LINDSEY Subscribed, sworn to and acknowledged before me by Eloise
ATn)RNBYS•AT*LAW D. Sobolewski, the Testatrix, and subs r 'bed to and sworn or
xs W.High Street
Carlisle,PA affirmed to before me by 'Kc��.rr� ! . R/ and
Witnesses, this 4? day of _
2001
uo ssiwwo,AW /
1�0pZ'6Z 7eV4 satLun bWo8 01911,
�juno'')PUtelaegwnvawso 9111'es ____---------
011gnd�{Bagrls>amo�
Notary Public
4