HomeMy WebLinkAbout01-0858
PETITION FOR PROBATE and GRANT OF LETTERS
No.
To:
Register of Wills for the
Deceased. County of CUMBERLAND in the
Social Security No. 194-56-2293 Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the executor
in the last will of the above decedent, dated
and codicil(s) dated Au~st 7, 1997
21-01-858
Estate of SYLVIA K. GROSZ
also known as
named
,19_
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in CUMBERLAND
h is last family or principal residence at 229 SOUTH 1 th
CUMBERLAND COUNTY PENNSYL ANIA 1
Decendent, then 82 years of age, died SEPTEMBER 11, 2001
at Holv Spirit Hospital, Camp Hill, PA
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered fogrobate; was not the victim of a killing and was never adjudicated
incompetent: , . V\OV\ ~
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
, 19
$ 400,000.00
$
$
$
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
pre~ented herewith and the grant of letters Testamentary
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
theron.
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Allfirst Trust C01ll1>anv of PA..
N.A.. successor to Dauphin Deposit Bank
R liT High ~f"TPPf"
~~Tli&le, PA 17011
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA "1 S""
CUMBERLAND r ~
COUNTY OF .___~___ J
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and ber 0 etitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will a I . . t the estate according to law.
Sworn to or affirmed and
before me this 18th
September 20
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~o. 21-01-8~8
Estate of
SYLVIA K. GROSZ
, Deceased
DECREE OF PROBATE A~D GRA~T OF LETTERS
AND NOW SEPTEMBER 18 , 2001:F1_, 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 Au2Ust 7 , 1997
described therein be admitted to probate and filed of record as the last will of
SYLVIA K. GROSZ
and Letters TESTAMENTARY
are hereby granted to Allfirst Trust Company of PA., N. A. successor to Dauphin
Deposit Bank, c/o Thomas E. Markin, VP
~'rt2~<<~.:i:tJM~ //Q,,,-y
. ~lster of Ills
FEES
P b L E $ 305.00
ro ate, etters, tc..........
$ 36.00
Short Certificates( ).......... 00
x-pag~s. o.
RenuncIation ................ $
JCP $ ~.OO
TOTAL _ $ 352.00
Filed ........ ?~~~~.~~. ~'~'" ?9.q~.....
ATTORNEY (Sup. Ct. J.D. No.)
William A. Duncan, ID # 22080
ADDRESS
1 Irvine Row, Carlisle, PA 17013
717-249-7780 PHONE
atUL--~~
105.805 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 Recor~s Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
p
7622139
No.
21-01-858
~L~~
SEP 1 2 200t
Date
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
i Rev. 2J1I7
NAME Of DECEDENT IfltSl. MIddle. lM)
SEX
DECEOENT' USUAL 0CCUfWl0N
t' Iondd WClIl< dane CIunnQ....
at..... III; j18J'Ol'" ...ecSl
u.. lbusewue 1a
OECEOENT'S MAIUNG ADOflESS(SlJ_~. SIMe. ~CocM'
229 South 15th Street
Camp Hill, Pa 17011
"--__81...0
SYRI fIlE NUMBER
SOC....L SECURITY NIJM8ER
001
~o
MNIITIoI. STATUS. MMied SOAYMNO SPOUSE
NewwMlniecS, WIdDwecS. Ill...... ~_.......
~tsc-IYl
Widowed
Iwp.
Camp Hill
~.
210. westminster Cemetery ilL Carlisle, Pa
NAMEANDAOORESSOfFt\ClUlY 1903 ~ket Street
- er FUneral Ibme Canp Hill. Pau17011
UCENSE N\lMlIEA ORE SIGNED
~A ~~~
'V{tJ M 0-0'72553 - L *. St?ptern\:x?;- II/lOOI
WiUI CASE AEFERRED TO IoIEDlCAL ~?
... 0 Mll18
.... 2... _ be CIlftlI1IlMd by
...-_~dulh.
M. .
11. PART I: E_IIle...... iIljutie&OI ~.......,......, \Ile GuIh. 00 1lllI....1/le mode 01 dying, """".. carcUc:1lr '''MOIY .,'est,1IllldI or IlUII ,.....
liII only _ _ on NCIl.....
MlEDlATa CAUSIE tfV>M
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......."'-.-
~.. CIIIIldiIilIN
...." -.dInQ.~
_. E-.......YWG
CAUSIE CO--OI ..-v
...~-
...-.g",-.LAST
! :
DUE 10 lOR AS A CONSEQUENCe Of):
DUE 10 (OR AS ACONSEOUENCe OF):
.s AN AUTOPSY WEllE AU10PSY FINDINGS
. PEIlFOAMED? ~ PAlOfllO
COMPLETlOH 01 CAUSE
Of'DERH?
DATE Of lH.IURY
(WonIn. Day. ....\
MANNER OF DEATH
...... 1i'
Accident 0
Suicide 0
Homidde
Pending~ion
COuld IICII be de\efmIned
Yell 0 No~ V. 0 No 0
... 2Ib. :no
caRtlPtER tet.:k rriY onel
"CERTll'YlNG I'HYSIClAIIlPh~~ _dI dqlh _ ........IIl1VSC....IIA"'onclUl'lCedclea1l\ ana completed Ilem 231
T...._OI"'Y~, .......___.........c....e(.,...._......... 00.0..........0...... 0.... o. 0.......................
'PfIOHOIIHCIHG AND ceRTIFYING PHYIICtAN,~ boltl prClr1OUlll:lnCJ 0HItl Mldcertlfylno ID cau.. 01 esea""
T.... .... 01 lilY 1uIowledg., ...... _Wl'....t... _. dat., and plac., .... due to ... ca........... "'.nner _ ...1..... . . 0 . . . . . . . . . . . 0 0 . . . 0 . _ . _
"MEDICAl. EXAMINERlCORONER
On the baaI. ot....mln.tlon ancIIot Invest.tlOn.1n my oplnioa. cleath occur,ed.t the tlm., d.t., .nd ptace. and d..eto the c.....(.) and
.._.. atetecl.. . . . . 0 . 0 . . . . . 0 . 0 . 0 . . . . 0 0 . .. . . . 0 . . . 0 . . . . . 0 .., 0" 0 . .. . 0 . .... . . . . . . . . . . .... 0 . 0 . . . . 0 0 0 . . . 0 . . . . o' . . . . 0
:It..
REGISTRAR'S SIGNATURE AND NUMBER
33.
PART II: 0IllII..... COltlIlians--...._ cIealh.llul
ftlII--' in... ~_"",inP#oRT I.
TIME OF lNJUAY
INJUAV AT V\IOAK7 &lESCRl8E HOW INJURY OCCUAAED.
Yell 0 No 0
iCnst Ifill nub mesfnmeuf
nf
21-01-858
I, SYLVIA K. GROSZ, of 229 South 15th Street, Camp Hill, 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 any and all
other wills and codicils heretofore made by me.
FIRST. I direct that all my just debts and funeral expenses be paid from my estate as
soon after my death as practically and conveniently may be done.
SECOND. I direct that my remains be interred within my family's burial plot located in
Westminister Memorial Gardens, Carlisle, Pennsylvania, beside my beloved husband, C. Ernest
Grosz.
THIRD. I authorize my personal representative to expend funds from my estate, in such
amounts as my personal representative shall consider necessary and desirable for the purchase,
erection and inscription of a suitable marker for my grave.
FOURTH. I give, devise and bequeath any and all tangible personal property owned by
me at the time of my death unto my nieces, Linda 1. Chesky and Terri L. Tidd, in equal shares,
per stirpes
FIFTH. I give, devise and bequeath any and all real estate owned by me at the time of my
death, unto my nieces, Linda 1. Chesky and Terri L. Tidd, in equal shares, per stirpes
SIXTH. I give, devise and bequeath all the rest, residue and remainder of my estate unto
my nieces, Linda 1. Chesky and Terri L. Tidd, in equal shares, per stirpes
SEVENTH. I direct thai: any and all Inheritance, Estate and Transfer taxes imposed upon
my estate passing under my will or otherwise, shall be paid out of the principal of my residuary
estate.
EIGHTH. I hereby nominate, constitute and appoint Dauphin Deposit Bank. and Trust
Company, and or it's successor, as Executor of this my Last Will and Testament. I hereby
relieve my Executor from the necessity of posting security in connection with their duties, as
such, in any jurisdiction in which they may be called upon to act insofar as I am able by law to
do so. In addition to the powers conferred by law, I authorize my Executor, in it's absolute
discretion, to retain in the form received, and to sell either at public or private sale any real or
personal property owned by me at the time of my death.
NINTH. I have made, or may from time to time make, a written memorandum expressing
my desire to give certain items of personal property to specific persons. I urge my Executor and
beneficiaries to respect these wishes. Such a memorandum, if made, shall be stored in
conjunction with this Will.
IN WITNESS WHEREOF, I have hereunto set m~pand and seal to this, my Last Will
and Testament, consisting of two typewritten pages this 'f1L day of August, 1997.
~~k~
SYL vfA K. GROSZ
Signed, sealed, published and declared by the above named Testatrix Sylvia K. Grosz as and
for her Last Will and Testament, in the presence of us, who, at her request, in her sight and
presence and in the sight and presence of each other, have hereunto subscribed our names as
witnesses.
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COMMONWEALTH OF PENNSYLVANIA
SSe
COUNTY OF CUMBERLAND
I, Sylvia K. Grosz, Testatrix whose name is signed to the attached or foregoing instrument,
having been duly qualified according to law, do hereby acknowledge that I signed and executed
the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and
voluntary act for the purposes therein expressed.
JS . k~
SYL~SZ
Sworn or affirmed to and
acknowledged before ~, by
Sylvia K. Grosz this~day
of August, 1997.
Notarial Seal .
Cvnthia L. Darr, Notary PublIc
South Middleton Twp., ~umberland County
My Commission Expires Aug. 14, 2000
COMMONWEALTH OF PENNSYLVANIA
SSe
COUNTY OF CUMBERLAND
We, (jJfh ~ ,q 'lJ lA.r'\<-Ct t'\ , and /...1SQ. '12~ Sl-l n€- the witnesses whose
names are signed to the attached or foregoing instrument, being duly qualified according to law,
do depose and say that we were present and saw Sylvia K. Grosz sign and execute the
instrument as her Last Will; that she signed willingly and that she executed as her free and
voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the
Testatrix signed the will as witnesses; and that to the best of our knowledge, the Testatrix was at
that time eighteen (18) or more years of age, of sound mind and under no constraint or undue
influence.
Sworn or affirmed to and
subscribed before me by
tUm, A -DLAh (' tAN and
Lt ~ C-t O?, S>-h n €- , witnesses,
this 7Jf>day of August, 997.
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CERTIFICATION OF NOTICE UNDER RULE S.6(A)
NAME OF DECEDENT:
SYLVIA K. GROSZ
DATE OF DEATH: SEPTEMBER 1"1, 2001
WILL NO.
21-00858
ADMIN. NO.
TO THE REGISTER:
I certify that notice of beneficial interest required by
Rule S.5(a) of the Orphans' Court Rules was served on or mailed
to the following beneficiaries of the above-captioned estate on
DECEMBER 11, 2001
NAME
ADDRESS
Linda J. Cheskey 256 McAllister Church Road. Carlisle. PA 17013
Terry L. Tidd 244 McAllister Church Road. Carlisle. PA 17013
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except none
DATE: /c{l-~~/
Si/il!~(~)
Name Wi 11 i:lm A Tbm'-:ln, Rc:<v'; Y"~
Address 1 Trvinp Rnw
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CaT1i~lp, PA 1701~
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Telephone 717-24c)-77RO
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capacity:
Personal Representative
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COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 2001-00858
ESTATE OF SYLVIA K. GROSZ, DECEASED
-----------------------------------
-----------------------------------
FIRST AND FINAL ACCOUNT OF
Allfirst Trust Company of Pennsylvania, N.A., Executor
================================================================================
Date of Death:
September 11, 2001
Date of Executor's Appointment:
September 18, 2001
Date of First Advertisement of Letters:
December 21, 2001
Accounting for the period:
September 11, 2001 to
January 27, 2003
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
Purpose of Account: Allfirst Trust Company of Pennsylvania, N.A., Executor,
offers this account to acquaint interested parties with the transactions that
have occurred during this administration.
It is important that the account be carefully examined. Requests for
additional information or questions or objections can be discussed with:
Allfirst Trust Company of Pennsylvania, N.A.
8 West High Street
Carlisle, PA 17013
(717) 240-6707
OR
William A. Duncan, Esquire
One Irvine Row
Carlisle, PA 17013
(717) 249-7780
SUMMARY OF ACCOUNT
Estate of Sylvia K. Grosz, Deceased
For Period of 09/11/2001 through 01/27/2003
proposed Distributions
to Beneficiaries
PRINCIPAL
Receipts:
Per Inventory Filed 3-5
Net Gain (or Loss) on Sales
or Other Disposition
Less Disbursements:
Debts of Decedent
Administration Expenses
Federal and State Taxes
Fees and Commissions
Balance before Distributions
Distributions to Beneficiaries
Principal Balance on Hand
For Information:
Investments Made
Changes in Investment Holdings
INCOME
Receipts:
This Account
Net Gain (or Loss) on Sales
or Other Disposition
Less Disbursements
Balance Before Distribution
Distributions to Beneficiaries
Income Balance on Hand
Investments Made
Changes in Investment Holdings
COMBINED BALANCE ON HAND
Page
22-23
6-7
8
8-9
9
9-10
11
12
13-15
16-19
20
21
2
Current
Value
Fiduciary
Acquisition
Value
379,464.61 379,464.61
--------------- ---------------
--------------- ---------------
687.26
1,162.27
95,307.70
51,700.00
652,725.38
(25,589.77)
627,135.61
148,857.23
478,278.38
111,880.00
366,398.38
14,043.86
0.00
14,043.86
977.63
13,066.23
0.00
13,066.23
379,464.61
---------------
---------------
RECEIPTS OF PRINCIPAL
As Per Inventory Filed:
CASH:
$10,000 Allfirst Bank
Certificate of Deposit
#87008000146118 4.96% 10/21/02
Accrued interest
$10,000 Allfirst Bank
Certificate of Deposit
#87008000132168 5.10% 1/16/02
Accrued interest
$10,000 Allfirst Bank
Certificate of Deposit
#87008000149753 5.87% 5/13/05
Accrued interest
$10,000 Allfirst Bank
Certificate of Deposit
#87008000149761 5.87% 5/13/05
Accrued interest
$11,305.37 First Union
Certificate of Deposit
#247412061015824 6.16% 2/6/02
Accrued interest
$12,538.25 First Union
Certificate of Deposit
#247412065787506 4.16% 2/6/02
Accrued interest
$15,000 Allfirst Bank
Certificate of Deposit
#80000000202571 4.93% 11/27/01
Accrued interest
$16,800.57 First Union
Certificate of Deposit
#247412050817267 3.88% 6/19/03
Accrued interest
$17,429.15 First Union
Certificate of Deposit
#247412066196884 4.31% 1/16/02
Accrued interest
3
10,000.00
29.90
10,000.00
37.73
10,000.00
48.25
10,000.00
48.25
11,305.37
485.17
12,538.25
51.55
15,000.00
32.42
16,800.57
98.51
17,429.15
498.85
Fiduciary
Acquisition
Value
$19,951.46 First Union
Certificate of Deposit
#247412059786949 3.93% 8/13/02
Accrued interest
$20,000 Allfirst Bank
Certificate of Deposit
#80000002027611 5.10% 12/20/01
Accrued interest
$25,000 Allfirst Bank
Certificate of Deposit
#87008000147424 3.94% 11/22/03
Accrued interest
$27,242.85 First Union
Certificate of Deposit
#247412093684196 4.31% 3/1/02
Accrued interest
Allfirst Bank Checking Account
#0038902176
Accrued interest
Blair - Merchandise refund
First Union Checking Account
#1010008160371
Accrued interest
Harleysville Insurance -
Reimbursement of homeowners
insurance due to cancellation
Myers-Harner Funeral Home -
Refund
Rebate from Prevacid
Received from Paula Young -
Returned merchandise
The Patriot-News -
Subscription refund
US Treasury - 2001 Tax Relief
Check
PERSONAL PROPERTY:
Personal Property - Appraised
value
4
19,951.46
263.79
20,000.00
64.27
25,000.00
56.67
27,242.85
634.54
24,438.90
6.43
104.70
5,224.90
0.77
30.00
354.52
25.00
87.00
83.05
300.00
1,880.00
238,272.82
1,880.00
STOCKS/LISTED:
13,482 shares Allied Irish Bks PIc
Spons ADS
Accrued dividend
3,000 shares PPL Corporation
Accrued dividend
283,661.28
3,758.78
124,357.50
795.00
TOTAL RECEIPTS OF PRINCIPAL...............
5
412,572.56
652,725.38
--------------
--------------
10/19/01
10/19/01
12/16/01
12/24/01
01/17/02
01/28/02
02/11/02
02/11/02
GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS - PRINCIPAL
Gain
13,482 shares Allied Irish Bks PIc
Spons ADS
Net Proceeds
Fid. Acq. Value
3,000 shares PPL Corporation
Net Proceeds
Fid. Acq. Value
272,092.70
283,661.28
110,336.31
124,357.50
$15,000 Allfirst Bank
Certificate of Deposit
#80000000202571 4.93% 11/27/01
Net Proceeds
Fid. Acq. Value
15,000.00
15,000.00
0.00
$20,000 Allfirst Bank
Certificate of Deposit
#80000002027611 5.10% 12/20/01
Net Proceeds
Fid. Acq. Value
20,000.00
20,000.00
0.00
$10,000 Allfirst Bank
Certificate of Deposit
#87008000132168 5.10% 1/16/02
Net Proceeds
Fid. Acq. Value
10,000.00
10,000.00
0.00
$17,429.15 First Union
Certificate of Deposit
#247412066196884 4.31% 1/16/02
Net Proceeds
Fid. Acq. Value
17,429.15
17,429.15
0.00
$11,305.37 First Union
Certificate of Deposit
#247412061015824 6.16% 2/6/02
Net Proceeds
Fid. Acq. Value
11,305.37
11,305.37
0.00
$12,538.25 First Union
Certificate of Deposit
#247412065787506 4.16% 2/6/02
Net Proceeds
Fid. Acq. Value
12,538.25
12,538.25
0.00
6
Loss
11,568.58
14,021.19
03/11/02
$27,242.85 First Union
Certificate of Deposit
#247412093684196 4.31% 3/1/02
Net Proceeds
Fid. Acq. Value
27,242.85
27,242.85
08/16/02
$19,951.46 First Union
Certificate of Deposit
#247412059786949 3.93% 8/13/02
Net Proceeds
Fid. Acq. Value
19,951.46
19,951.46
10/24/02
$10,000 Allfirst Bank
Certificate of Deposit
#87008000146118 4.96% 10/21/02
Net Proceeds
Fid. Acq. Value
10,000.00
10,000.00
TOTAL GAINS AND LOSSES/PRINCIPAL...........
LESS LaSS.............................
NET GAIN OR LOSS. . . . . . . . . . . . . . . . . . . . . . . . . . .
7
0.00
0.00
0.00
0.00
25,589.77
(25,589.77)
--------------
--------------
25,589.77
10/19/01
10/19/01
10/19/01
10/19/01
10/26/01
10/26/01
11/09/01
11/09/01
11/29/01
04/02/02
04/02/02
10/19/01
11/02/01
11/09/01
11/15/01
-r -
DISBURSEMENTS OF PRINCIPAL
DEBTS OF DECEDENT
AT&T - utility expense
5.03
Borough of Camp Hill -
Utility expense
60.00
George M. Leader Family Corp
Nursing home expense
87.05
PP&L Electric Utilities -
Utility expense
68.73
PA American Water Company -
Utility expense
26.26
York Waste Disposal Inc. -
Utility expense
8.64
PP&L - utility expense
20.82
Verizon Communications -
Utility expense
37.54
PA American Water Company -
Utility expense
8.19
PA Department of Revenue -
State Personal Income Tax
Final PA-40
175.00
US Treasury - Federal
Personal Income Tax Final
1040
190.00
TOTAL DEBTS OF DECEDENT.............................
ADMINISTRATION EXPENSES
Chuck Bricker, Auctioneer -
Appraisal of household
contents
75.00
Robert R. Jones & Assoc. -
Appraisal fee
300.00
Merry Maids 595 - Cleaning
expense
74.20
Linda Cheskey - Expense for
lawn care
40.00
8
687.26
12/12/01
01/08/02
04/24/02
06/07/02
07/01/02
07/25/02
12/07/01
06/07/02
07/24/02
04/04/02
08/15/02
08/15/02
Duncan & Hartman, P.C. -
Probate filing fee
352.00
The Sentinel - Cost of
Advertising and proof of
publication
97.07
William A. Duncan - Reimburse
for Advertising in Cumberland
Law Journal
75.00
Cumberland County Register of
Wills, Agent - Filing fees
for PA Inheritance Tax Return
and Inventory
34.00
Cumberland County Register of
Wills - Probate filing fee
105.00
Allfirst Bank - Maintenance
fee on checking account
10.00
TOTAL ADMINISTRATION EXPENSES.......................
FEDERAL AND STATE TAXES
Cumberland County Register of
Wills, Agent - State
Inheritance Tax prepayment
90,000.00
Cumberland County Register of
Wills, Agent - State
Inheritance Tax balance due
4,581.21
Cumberland County Register of
Wills, Agent - PA
Inheritance Tax balance due
726.49
TOTAL FEDERAL AND STATE TAXES.......................
FEES AND COMMISSIONS
Raymond C. Keller, CPA -
Accountant fees for
preparation of Federal and
State Personal Income Tax
200.00
Allfirst Trust Company of PA,
N.A. - Executor's Fee
8,000.00
William A. Duncan - Attorney
fees
8,000.00
9
1,162.27
95,307.70
RESERVE:
Allfirst Trust Company of PA,
N.A. - Executor's Fee -
balance due
17,500.00
William A. Duncan - Balance
of Attorney fees
17,500.00
Estimated Filing Costs
500.00
TOTAL FEES AND COMMISSIONS..........................
TOTAL DISBURSEMENTS OF PRINCIPAL....................
10
51,700.00
148,857.23
--------------
--------------
T
Linda J. Cheskey
03/11/02
03/28/02
OS/24/02
10/03/02
12/04/02
Terry L. Tidd
03/11/02
03/28/02
OS/24/02
10/03/02
12/04/02
DISTRIBUTIONS OF PRINCIPAL TO BENEFICIARIES
Personal Property - 940.00
Distribution as per Paragraph
4th of the Will
Advance Distribution per 25,000.00
Receipt and Release
Advance Distribution per 10,000.00
Receipt and Release
Advance Distribution per 10,000.00
Receipt and Release
Advance Distribution per 10,000.00
Receipt and Release
--------------
55,940.00
Personal Property - 940.00
Distribution as per Paragraph
4th of the Will
Advance Distribution per 25,000.00
Receipt and Release
Advance Distribution per 10,000.00
Receipt and Release
Advance Distribution per 10,000.00
Receipt and Release
Advance Distribution per 10,000.00
Receipt and Release
--------------
TOTAL DISTRIBUTIONS TO BENEFICIARIES......
11
55,940.00
111,880.00
PRINCIPAL BALANCE ON HAND
# Units Description
Ark Money Market Portfolio
$10,000 Allfirst Bank Certificate of
Deposit #87008000149753 5.87%
5/13/05
$10,000 Allfirst Bank Certificate of
Deposit #87008000149761 5.87%
5/13/05
$16,800.57 First Union Certificate
of Deposit #247412050817267 3.88%
6/19/03
Accrued Interest Receivable
$25,000 Allfirst Bank Certificate of
Deposit #87008000147424 3.94%
11/22/03
Current Value
or as Noted
304,499.30
10,000.00
10,000.00
16,800.57
98.51
25,000.00
Fiduciary
Acquisition
Value
304,499.30
10,000.00
10,000.00
16,800.57
98.51
25,000.00
366,398.38 366,398.38
--------------- ---------------
--------------- ---------------
12
r
CHANGES IN INVESTMENT HOLDINGS - PRINCIPAL
$10,000 Allfirst Bank Certificate of
Deposit #87008000146118 4.96%
10/21/02
------------------------------------
09/11/01
10/24/02
inventoried
sold
$10,000 Allfirst Bank Certificate of
Deposit #87008000132168 5.10%
1/16/02
09/11/01
01/17/02
inventoried
sold
$10,000 Allfirst Bank Certificate of
Deposit #87008000149753 5.87%
5/13/05
09/11/01
inventoried
$10,000 Allfirst Bank Certificate of
Deposit #87008000149761 5.87%
5/13/05
09/11/01
inventoried
$11,305.37 First Union Certificate
of Deposit #247412061015824 6.16%
2/6/02
09/11/01
02/11/02
inventoried
sold
$12,538.25 First Union Certificate
of Deposit #247412065787506 4.16%
2/6/02
09/11/01
02/11/02
inventoried
sold
13
Cost
10,000.00
(10,000.00)
0.00
--------------
--------------
10,000.00
(10,000.00)
0.00
--------------
--------------
10,000.00
10,000.00
10,000.00
10,000.00
--------------
--------------
11,305.37
(11,305.37)
0.00
12,538.25
(12,538.25)
0.00
--------------
--------------
T
$15,000 Allfirst Bank Certificate of
Deposit #80000000202571 4.93%
11/27/01
------------------------------------
09/11/01
12/16/01
inventoried
sold
15,000.00
(15,000.00)
0.00
--------------
--------------
$16,800.57 First Union Certificate
of Deposit #247412050817267 3.88%
6/19/03
----------------------------------
09/11/01
09/11/01
inventoried
accrued interest receivable
16,800.57
98.51
16,899.08
--------------
--------------
$17,429.15 First Union Certificate
of Deposit #247412066196884 4.31%
1/16/02
09/11/01
01/28/02
inventoried
sold
17,429.15
(17,429.15)
0.00
--------------
--------------
$19,951.46 First Union Certificate
of Deposit #247412059786949 3.93%
8/13/02
09/11/01
08/16/02
inventoried
sold
19,951.46
(19,951.46)
0.00
--------------
--------------
$20,000 Allfirst Bank Certificate of
Deposit #80000002027611 5.10%
12/20/01
09/11/01
12/24/01
inventoried
sold
20,000.00
(20,000.00)
0.00
--------------
--------------
$25,000 Allfirst Bank Certificate of
Deposit #87008000147424 3.94%
11/22/03
09/11/01
inventoried
25,000.00
25,000.00
--------------
--------------
14
$27,242.85 First Union Certificate
of Deposit #247412093684196 4.31%
3/1/02
09/11/01
03/11/02
inventoried
sold
27,242.85
(27,242.85)
0.00
Allied Irish Bks Plc Spons ADS
09/11/01
10/19/01
13,482 shares inventoried
(13,482)shares sold
283,661.28
(283,661.28)
o
0.00
--------------
--------------
Personal Property
09/11/01
03/11/02
03/11/02
inventoried
distributed
distributed
1,880.00
(940.00)
(940.00)
0.00
--------------
--------------
PPL Corporation
09/11/01
10/19/01
3,000 shares inventoried
(3,OOO)shares sold
124,357.50
(124,357.50)
o
0.00
--------------
--------------
15
T
RECEIPTS OF INCOME
INTEREST
$10,000 Allfirst Bank Certificate of
Deposit #87008000146118 4.96% 10/21/02
--------------------------------------
12/21/01
01/23/02
02/22/02
03/21/02
04/19/02
OS/21/02
06/21/02
07/19/02
07/25/02
07/25/02
07/25/02
08/22/02
09/20/02
10/21/02
10.87
42.13
42.13
38.05
42.13
40.77
42.13
40.77
42.13
42.13
40.77
42.13
42.13
40.77
549.04
$10,000 Allfirst Bank Certificate of
Deposit #87008000132168 5.10% 1/16/02
12/19/01
01/16/02
07/25/02
07/25/02
07/25/02
4.19
43.32
41.92
43.32
43.32
176.07
$10,000 Allfirst Bank Certificate of
Deposit #87008000149753 5.87% 5/13/05
01/14/02
02/13/02
03/12/02
04/16/02
05/14/02
06/14/02
07/12/02
07/25/02
07/25/02
07/25/02
08/16/02
09/13/02
10/16/02
11/13/02
12/17/02
01/10/03
49.85
49.85
45.03
49.85
48.25
49.85
48.25
49.85
49.85
48.25
49.85
49.85
48.25
49.85
48.25
49.85
784.78
16
r
$10,000 Allfirst Bank Certificate of
Deposit #87008000149761 5.87% 5/13/05
-------------------------------------
01/14/02
02/13/02
03/12/02
04/16/02
05/14/02
06/14/02
07/12/02
07/25/02
07/25/02
07/25/02
08/16/02
09/13/02
10/16/02
11/13/02
12/17/02
01/10/03
$11,305.37 First Union Certificate of
Deposit #247412061015824 6.16% 2/6/02
02/11/02
$12,538.25 First Union Certificate of
Deposit #247412065787506 4.16% 2/6/02
02/11/02
$15,000 Allfirst Bank Certificate of
Deposit #80000000202571 4.93% 11/27/01
11/29/01
07/25/02
07/25/02
07/25/02
$17,429.15 First Union Certificate of
Deposit #247412066196884 4.31% 1/16/02
01/24/02
$19,951.46 First Union Certificate of
Deposit #247412059786949 3.93% 8/13/02
08/16/02
49.85
49.85
45.03
49.85
48.25
49.85
48.25
49.85
48.25
49.85
49.85
49.85
48.25
49.85
48.25
49.85
784.78
296.14
214.15
0.94
60.78
30.39
62.81
154.92
270.87
742.44
17
r
$20,000 Allfirst Bank Certificate of
Deposit #80000002027611 5.10% 12/20/01
--------------------------------------
12/20/01
07/25/02
07/25/02
07/25/02
$25,000 Allfirst Bank Certificate of
Deposit #87008000147424 3.94% 11/22/03
--------------------------------------
12/21/01
01/23/02
02/22/02
03/25/02
04/22/02
OS/22/02
06/21/02
07/22/02
07/25/02
07/25/02
07/25/02
08/22/02
09/20/02
10/21/02
11/26/02
12/23/02
01/22/03
$27,242.85 First Union Certificate of
Deposit #247412093684196 4.31% 3/1/02
03/11/02
Allfirst Bank Checking Account
#0038902176
07/25/02
07/25/02
07/25/02
07/25/02
07/25/02
Ark Money Market Portfolio
11/01/01
12/03/01
01/02/02
02/01/02
03/01/02
04/01/02
05/01/02
06/03/02
07/01/02
08/01/02
19.57
86.63
83.84
86.63
80.96
26.99
83.66
75.56
83.66
80.96
83.66
80.96
83.66
83.66
80.96
83.66
83.66
80.96
83.66
80.96
83.66
0.24
11.27
0.17
3.24
0.31
352.08
745.45
612.76
597.02
577.08
630.93
565.94
570.58
519.07
512.55
18
276.67
1,341.25
565.23
15.23
09/03/02
10/01/02
11/01/02
12/02/02
01/02/03
489.32
472.88
463.79
395.10
364.82
First Union Checking Account
#1010008160371
--------~-------------------
12/05/01
TOTAL INTEREST INCOME.....................
TOTAL RECEIPTS OF INCOME..................
19
7,869.37
2.92
14,043.86
--------------
--------------
14,043.86
--------------
--------------
01/27/03
DISBURSEMENTS OF INCOME
Allfirst Trust Company of PA,
N.A. - commission on income
977.63
TOTAL DISBURSEMENTS OF INCOME..................
20
977.63
--------------
--------------
# Units
Description
INCOME BALANCE ON HAND
Current Value
or as Noted
Ark Money Market Portfolio
13,066.23
13,066.23 13,066.23
13,066.23
Fiduciary
Acquisition
Value
--------------- ---------------
--------------- ---------------
21
# Units
PROPOSED DISTRIBUTIONS TO BENEFICIARIES
Current Value
or as Noted
Linda J. Cheskey
As per Paragraph FOURTH of the Will
Personal Property
(Distributed in Advance-see
page 11)
940.00
As per Paragraph SIXTH of the Will
Ark Money Market Portfolio
(Distributed in Advance-see
page 11)
55,000.00
$10,000 Allfirst Bank
Certificate of Deposit
#87008000149753 5.87% 5/13/05
10,000.00
$16,800.57 First Union
Certificate of Deposit
#247412050817267 3.88% 6/19/03
Accrued Interest Receivable
8,400.29
49.25
$25,000 Allfirst Bank
Certificate of Deposit
#87008000147424 3.94% 11/22/03
12,500.00
Ark Money Market Portfolio
158,782.77
245,672.31 245,672.31
158,782.77
22
Fiduciary
Acquisition
Value
940.00
55,000.00
10,000.00
8,400.29
49.25
12,500.00
Terry L. Tidd
As per Paragraph FOURTH of the Will
Personal Property
(Distributed in Advance-see
page 11)
As per Paragraph SIXTH of the Will
Ark Money Market Portfolio
(Distributed in Advance-see
page 11)
$10,000 Allfirst Bank
Certificate of Deposit
#87008000149761 5.87% 5/13/05
$16,800.57 First Union
Certificate of Deposit
#247412050817267 3.88% 6/19/03
Accrued Interest Receivable
$25,000 Allfirst Bank
Certificate of Deposit
#87008000147424 3.94% 11/22/03
Ark Money Market Portfolio
Less Portion Distributed in
Advance (see page 11)
23
940.00
55,000.00
10,000.00
8,400.28
49.26
12,500.00
158,782.76
.
940.00
55,000.00
10,000.00
8,400.28
49.26
12,500.00
245,672.30 245,672.30
158,782.76
491,344.61
-111,880.00
491,344.61
-111,880.00
379,464.61 379,464.61
-------------- --------------
-------------- --------------
IJ
.. ,
REQUEST FOR DISTRIBUTION
Accountant requests that distribution be determined by the Court in
accordance with the Petition for Distribution to be offered in evidence at
the audit of this account.
Ami;: ~JJ;; N_~A.'
/ "7AI~~ E I??~J.~
/,.//01'1 ~/l4(-'S'rIf)HPr.
Executor
25
.
I I ..
AFFIDAVIT
Allfirst Trust Company of Pennsylvania, N.A., Executor under the Last
Will and Testament of SYLVIA K. GROSZ, deceased, hereby declares under oath that
it has fully and faithfully discharged the duties of its office; that the
foregoing Account is true and correct and fully discloses all significant
transactions occurring during the accounting period; that all known claims
against the estate have been paid in full; that, to its knowledge, there are no
claims now outstanding against the Estate; that all taxes presently due from the
Estate have been paid; and that more than four months have elapsed since the
first complete advertisement of the granting of letters in this estate.
AllfirS:~@~.A.' Executor
-T/VOrYJAJ e. MtJ~I<-Jn/
Subscribed and sworn to i/lcq ~a/frJJ)q~7;
otary Public
~-"",-------,,~-.:;.-:_,
,,__.C'~_ NOTARIAL SEi>.L, '1
~ . D' Notar, Public
CynthIa L an, ; r'umbertand
. S,O" uth Middleton Twp" C ?u>r~tvAou'._v i 4,', ,200/\ ,',
A C 111miss\on ExpIre::> g. .---.,~...-
t..'lY 0 __-"..-
-_.......--.--
24
#
~
Regis_er of Wills of
CUMBERLAND
County, Pennsylvania
INVENTORY
Estate of Sylvia K. Grosz
No. 21-01-0858
Date of Death 09/11/2001
also known as
,Deceased Social Security No. 194 - 56 - 2293
I
!
I
Allfirst Tru t Com an of PA, NA,
Personal Represent tive(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the
personal assets wh rever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation
placed opposite ea h item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned
no real estate outsi~e of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this
Inventory. I /We ve~ify that the statements made in this Inventory are true and correct. I/We understand that false statements herein
are made subject tJ the penalties of 18 Pa, C.S. Section 4904 relating to unsworn falsification to authorities.
Name of
Attorney:
Wilfiam A. Duncan, Esquire
1.0. No.:
Signature:
Address:
Oner Irvine Row
Address:
8 W. High Street
Car/lisle, PA 17013
Carlisle, PA 17013-2923
Telephone:
Telephone: 717/240-6707
Dated:
..~- 1
Description
o
'....Value
~
(See continuation page(s) attached)
(Attach additional sheets if necessary)
Total:
652,725.38
NOTE: The Me orandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, (nc.
Form #RW-7 (1992)
,
Estate of:
Date of De~th:
County:
INVENTORY
Sylvia K. Grosz
09/11/2001
Cumberland
CASH:
$10,000 Allfirst Bank
Certificate of Deposit
#87008000132168 5.10% due 1/16/02
Accrued Interest
$10,000 Allfirst Bank
Certificate of Deposit
#87008000146118 4.96% due 10/21/02
Accrued Interest
$10,000 Allfirst Bank
Certificate of Deposit
#87008000149753 5.87% due 5/13/05
Accrued Interest
$10,000 Allfirst Bank
Certificate of Deposit
#87008000149761 5.87% due 5/13/05
Accrued Interest
$11,305.37 First Union
Certificate of Deposit
#247412061015824 6.16% due 2/6/02
Accrued Interest
$12,538.25 First Union
Certificate of Deposit
#247412065787506 4.16% due 2/7/02
Accrued Interest
$15,000 Allfirst Bank
Certificate of Deposit
#80000002027571 4.93% due 11/27/01
Accrued Interest
$16,800.57 First Union
Certificate of Deposit
#247412050817267 3.88% due 6/19/03
Accrued Interest
$17,429.15 First Union
Certificate of Deposit
#247412066196884 4.31% due 1/16/02
Accrued Interest
1
10,000.00
37.73
10,000.00
29.90
10,000.00
48.25
10,000.00
48.25
11,305.37
485.17
12,538.25
51.55
15,000.00
32.42
16,800.57
98.51
17,429.15
498.85
Estate of:
Date of Death:
County:
Sylvia K. Grosz
09/11/2001
Cumberland
$19,951.46 First Union
Certificate of Deposit
#247412059786949 3.93% due 8/13/02
Accrued Interest
$20,000 Allfirst Bank
Certificate of Deposit
#80000002027611 5.10% due 12/20/01
Accrued Interest
$25,000 Allfirst Bank
Certificate of Deposit
#87008000147424 3.94% due 11/22/03
Accrued Interest
$27,242.85 First Union
Certificate of Deposit
#247412063684196 4.31% due 3/1/02
Accrued Interest
Allfirst Bank Checking Account
#0038902176
Accrued Interest
Blair - Merchandise Refund
First Union Checking Account
#1010008160371
Accrued Interest
Harleysville Insurance -
Reimbursement of Homeowners
Insurance due to Cancellation
Myers-Harner Funeral Home -
Refund
Rebate from prevacid
Received from Paula Young -
Returned Merchandise
The Patriot-News -
Subscription Refund
u. S. Treasury - 2001 Tax
Relief Check
2
19,951.46
263.79
20,000.00
64.27
25,000.00
56.67
27,242.85
634.54
24,438.90
6.43
104.70
5,224.90
0.77
30.00
354.52
25.00
87.00
83.05
300.00
238,272.82
Estate of:
Date of Death:
County:
Sylvia K. Grosz
09/11/2001
Cumberland
PERSONAL PROPERTY:
Personal Property - Appraised
Value
1,880.00
STOCKS/LISTED:
13 82 shares Allied Irish Bks PIc
Spons ADS
Accrued Dividend
283,661.28
3,758.78
3.000 shares PPL Corp.
Accrued Dividend
124,357.50
795.00
TOTAL RECEIPTS OF PRINCIPAL...............
3
1,880.00
412,572.56
652,725.38
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
ALLFIRST TRUST CO OF PA N.A.
a WEST HIGH STREET
CARLISLE, PA 1 7013
_n__n_ fold
ESTATE INFORMATION: SSN: 194-56-2293
FILE NUMBER: 2101-0858
DECEDENT NAME: GROSZ SYLVIA K
DATE OF PAYMENT: 07/30/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 09/11/2001
NO. CD 001456
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $726.49
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: C/O WILLIAM DUNCAN
CHECK# 20331495
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
$726.49
MARY C. LEWIS
REGISTER OF WILLS
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
DUNCAN WILLIAM A
1 IRVINE ROW
CARLISLE, PA 17013
-------- fold
ESTATE INFORMATION: SSN: 194-56-2293
FILE NUMBER: 2101-0858
DECEDENT NAME: GROSZ SYLVIA K
DATE OF PAYMENT: 06/10/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 09/11/2001
NO. CD 001280
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $4,581.21
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$4,581.21
REMARKS: C/O ALLFIRST TRUST CO OF PA NA
CHECK# 20318476
SEAL
INITIALS: CW
RECEIVED BY:
REGISTER OF WILLS
MARY C. LEWIS
REGISTER OF WILLS
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
ALLFIRST TRUST CO OF PA NA
2 WEST HIGH STREET
CARLISLE, PA 17013
-------- fold
ESTATE INFORMATION: SSN: 194-56-2293
FILE NUMBER: 21 - 2001 - 0858
DECEDENT NAME: GROSZ SYLVIA K
DA TE OF PAYMENT: 12/10/2001
POSTMARK DATE: 0010010000
COUNTY: CUMBERLAND
DATE OF DEATH: 09/11/2001
NO. CD 000622
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $90,000.00
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$90,000.00
REMARKS: ALLFIRST TRUST
CHECK# 20263246
SEAL
INITIALS: AC
RECEIVED BY:
REGISTER OF WILLS
MARY C. LEWIS
REGISTER OF WILLS
17,. .R-;;?
BUREAU OF INDIVIDUAL TAXES
"- INHERITANCE TAX DIVISION
, DEPT. Z806Dl
~ARRISBURG, PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
07-22-2002
GROSZ
09-12-2001
21 01-0858
CUMBERLAND
101
.012
JUL
...").~
i~t)
.' -1
THOMAS MORKIN
ALLFIRST TRST CO OF PA
8 W HIGH S T t.
CARLISLE PA i~013
*
REY-1541 EX iFP 101-DZ)
SYLVIA
K
Allount Rellitted
(1)
(2)
(3)
(4)
(S)
(6)
(7)
.00
412~572.56
.00
.00
240~152.82
.00
97~800.00
(8)
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 ~
REY=is4j-ix-AFP-fol-:ozr-Noi'-ici--oF-'rtiliiifiTANCE-YAX-jfpPRAisiiiENT~--Ar.l-oWAiicE-oR-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF GROSZ SYLVIA K FILE NO. 21 01-0858 ACN 101 DATE 07-22-2002
TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE
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)
S. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
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 Subiect to Tax
I~ an assessment was issued previously, lines 14, 15 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 (IS)
16. Allount 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:
(I))
(10)
63,357.77
NOTE: To insure proper
credit to your account~
subllit the upper portion
of this forll with your
tax paYllent.
750~525.38
64.045 03
686,480.35
.00
686,480.35
(11))=
.00
.00
11,736.00
88,302.05
100,038.05
687.26
Ul)
(12)
(13)
(4)
.00 X 00 =
.00 X 045 =
97,800.00 X 12 =
588,680.35 X 15 =
TAX CREDITS:
. ..... ...n . ftlO~IO.a.'-1 l+J AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
12 10-2001 CDOO0622 4,736.84 90,000.00
06-10-2002 CDOO1280 .00 4,581.21
INTEREST IS CHARGED THROUGH 08-06-2002 TOTAL TAX CREDIT 99,318.05
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 720.00
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 6.49
TOTAL DUE 726.49
. 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.)
REV-1<470 EJ(~88)
,
'*
INHERITANCE TAX
EXPLANATION
OF CHANGES
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG PA 17128-0601
DECEDENT'S NAME
Grosz, Sylvia K.
FILE NUMBER
Daniel Heck
ACN
2101-0858
101
REVIEWED BY
ITEM
SCHEDULE NO.
G 1
EXPLANATION OF CHANGES
The exclusions are not allowable on implied life estate since the real estate does not
transfer until date of death.
ROW
Page 1
//}-c?- c?
, BUREAU OF INDIVIDUAL TAXES
" INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF DETERMINATION AND
ASSESSMENT OF PENNSYLVANIA
ESTATE TAX BASED ON FEDERAL
ESTATE TAX RETURN
*'
REV-48! EX AFP COI-02)
THOMAS MORKIN
ALLFIRST TRST CO OF PA
8 W HIGH ST l", _
CARLISLE C'tPA 17013
23
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
07-22-2002
GROSZ
09-12-2001
21 01-0858
CUMBERLAND
201
SYLVIA
K
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR FILES ~
iE''=4i3--Ei-~FP--(Oi:-025-----;-;-N()TiCE--oF--nETEiiMIN-ATIo-N-Aiin-As-sESStfENir----------------------------
OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN **
ESTATE OF GROSZ
SYLVIA
K FILE NO.21 01-0858
ACN 201
DATE 07-22-2002
ESTATE TAX DETERMINATION
1. Credit For State Death Taxes as Verified
18,804.14
2. Pennsylvania Inheritance Tax Assessed
(Excluding Discount and/or Interest)
95,301.21
3. Inheritance Tax Assessed by Other States
or Territories of the United States
(Excluding Discount and/or Interest)
.00
4. Total Inheritance Tax Assessed
95,301.21
5. Pennsylvania Estate Tax Due
.00
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
*IF PAID AFTER THIS DATE, SEE REVERSE SIDE (IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE
DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
/'7...JZ~
~ BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
*'
REV-IU7 EX AFP (01-02)
'02
-~ (
i lJ
,f) :\ 7
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
09-03-2002
GROSZ
09-12-2001
21 01-0858
CUMBERLAND
101
SYLVIA
K
THOMAS MORKIN
ALLFIRST TRST CO OF PA
8 W HIGH ST ("t ~
CARLISLE PA 17013
Allount Rellitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REY=i6'ifj-ix-AFP-fiff.:oz.r------...--iNifiiITANc'E-TAxsTA"TEMENT-ifF'-Accouiif--...---------------------
ESTATE OF GROSZ SYLVIA K FILE NO.21 01-0858 ACN 101 DATE 09-03-2002
THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW
IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 07-22-2002
PR I NC I PAL TAX DUE: .............................................................---...........................................................................................................................................................
100,038.05
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
12-10-2001 CDOO0622 4,736.84 90,000.00
06-10-2002 CDOO1280 .00 4,581.21
07-30-2002 CDOO1456 5.67- 726.49
.
TOTAL TAX CREDIT 100,038.87
BALANCE OF TAX DUE .82CR
INTEREST AND PEN. .00
. IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .82CR
SIDE 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 HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS. )
/7-P- !?
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG 1 PA 17128-0601
THOMAS MORKIN
AllFIRST TRST CO OF PA
8 W HIGH ST
CARLISLE PA 17~13
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF DETERMINATION AND
ASSESSMENT OF PENNSYLVANIA
ESTATE TAX BASED ON FEDERAL
CLOSING LETTER
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
*'
REV-7!' EX AFP (81-02>
11-24-2003
GROSZ
09-12-2001
21 01-0858
CUMBERLAND
202
SYLVIA K
Allount Rellitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WIllS
CUMBERLAND CO COURT HOUSE
CARLISLE1 PA 17013
NOTE: To insure proper credit to your accountl subllit the upper portion of this forll with your tax paYllent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR FILES ~
REV=73'6-EX--AFP-("oi---oii-----.i-NOficE--OF--liETE-iMiiiATiifti-Aifli-AS-SESSMENT-----------------------------
OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER ..
ESTATE OF GROSZ
SYLVIA
K FILE NO.21 01-0858
ACN 202
DATE 11-24-2003
ESTATE TAX DETERMINATION
1. Credit For State Death Taxes as Verified
181804.14
2. Pennsylvania Inheritance Tax Assessed
(Excluding Discount and/or Interest)
951301.21
3. Inheritance Tax Assessed by Other States
or Territories of the United States
(Excluding Discount and/or Interest)
.00
4. Total Inheritance Tax Assessed
951301.21
5. Pennsylvania Estate Tax Due
.00
6. Amount of Pennsylvania Estate Tax Previously Assessed
Based on Federal Estate Tax Return
.00
7. Additional Pennsylvania Estate Tax Due
.00
TAX CREDITS:
~~
~PAID AFTER THIS DATEI SEE REVERSE SIDE
FOR CALCULATION OF ADDITIONAL INTEREST.
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT .00
... BALANCE OF TAX DUE .00
~~ INTEREST AND PEN. .00
TOTAL DUE .00
(IF TOTAL DUE IS LESS THAN $11 NO PAYHENT IS REQUIRED
IF TOTAL DUE IS REFLECTED AS A ..CREDIT.. (CR) 1 YOU HAY BE
DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
()
/
1./"
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Sylvia K. Grosz
Date of Death: September 11, 2001
Will No.: 2001-00858
Admin. No.:
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. State whether administration of the estate is complete:
Yes b1 No 0
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 0
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties
in interest? Yes 0 No 0
c. Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the. Orphans' Court
1:'_ ( I and may be attached to ~s ^4-~ C
Date:~~(')3 \ ~
Signature
"
'< .',1
William A. Duncan, Esquire
Name
N
1 Irvine Row
Carlisle, PA 17013
c.::J
! - ':)
Address
,''-,\
~:::J
717-249-7780
Telephone No.
Capacity: 0 Personal Representative
-aCounsel for personal representative
.
REV-1500 EX +(6-00)
CAPB
HpRL
EplO
CRAC
KOTK
ES
I 7~ ~- r
OFFICIAL USE ONLY
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
D
E
C
E
D
E
N
T
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Grosz S Ivia K.
DATE OF DEATH (MM-DD-YEAR)
21-01-0858
YEAR
NUMBER
COUNTY CODE
DATE OF BIRTH (MM-DD-YEAR)
SOCIAL SECURITY NUMBER
194-56-2293
THIS RETURN MUST BE FilED IN DUPUCATEWlTH THE
Copyright (c) 2000 form software only The Lackner Group, Inc.
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
2. Supplemental Return
4a. Future Interest Compromise (date of death after 12-12-82) X
7. Decedent Maintained a Living Trust 1
(Attach copy of Trust)
D 10. Spousal Poverty Credit D
C P
o 0
R N
R D
E E
S N
T
NAME
Thomas Markin
FIRM NAME (If Applicable)
A11first Trust Com an
TELEPHONE NUMBER
of PA, NA
8 W. High Street
Carlisle, PA 17013-2923
COMPLETE MAILING ADDRESS
R
E
C
A
P
I
T
U
L
A
T
I
o
N
240-6 0
Real Estate (Schedule A)
Stocks and Bonds (Schedule B)
Closely Held Corporation, Partnership or
Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
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)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(1)
(2)
(3)
;",,0-
412,572.56
None
3. date of death
. Remainder Return prior to 12-13-82)
5. Federal Estate Tax Return Required
8. Total N umber of Safe Deposit Boxes
11. Election to tax undm Sec. 9113(A)
(Attach Sch 0)
. OFFICIAL USE ONLY
(8) 744,525.38
(11) 64.045.03
(12) 680,480.35
(13)
(14) 680,480.35
(15)
(16)
(17)
(18)
(19)
0.00
0.00
1l,016.00
88.302.05
99,318.05
(4)
(5)
None
240,152.82
(6)
None
91,800.00
63,357.77
687.26
C
o
M
P
T U
A T
X A
T
I
o
N
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
91,800.00
588,680.35
x
X
X
X
.0 0
.0 45
.12
.15
Form REV-1500 EX (Rev. 6-00)
\
1 Decedent's Complete Address:
STREET ADDRESS
229 South 15th Street
CITY
Carn Hill
STATE
PA
ZIP
17011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
99,318.05
0.00
90,000.00
4,736.84
Total Credits ( A + B + C) (2)
94,736.84
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + E) (3)
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)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line S + SA. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, A<?Et.'JT
mm!mml!!I!:!~!t:~!~~!,!~~,!~!!I~~~I~~tlt!~!II~I~~5~~~~~1~~II~~I!~~I~III~I~I!~~!"I~I":~~!::~~:~::i~~~6~:~:I~+~:!~t6~R~';!!:!!:!!:!!
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; . . . . . . . . . . . . . ~x ~x
b. retain the right to designate who shall use the property transferred or its income; .
c. retain 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? .See. Schedule .G .for. U:i.s.clo!?t.Jr:e. . . . . . . D
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
0.00
0.00
4,581. 21
0.00
4,581. 21
[RJ
[RJ
[RJ
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.
Allfirst Trust Company of PA, NA
- - -~ - ~-' - -~~~-~ - ?~-~~~~- - - - - - - - - - - - - - - - - - - - - - - - - - - - - --
Carlisle, PA 17013-2923
Allfirst Trust Company of PA, NA
- - -~ - ~-' - -~~ ~-~ - ?~-~~~~- - - - - - - - - - - - - - - - - - - - - - - - - - - - - --
Carlisle, PA 17013-2923
DATE
;tcf02-
DA E
:::::;::..:......... .
::::;:;:;::;:;::;::::::::::.::.:..:.......... .
. . ......:.:.::;:;=:::: ~:::: ;~;~:~~nn~nn~n:n:~: ';::;: :,;:;::::::::::
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. 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%
[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 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.S%, except as noted in 72 P.S. 9116( 1.2)
[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% [72 P.S. 9116(aX1.3)). 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.
Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00)
\ REV-150~ EX +(1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
FILE NUMBER
Sylvia K. Grosz
SSff 194-56-2293
09/11/2001
21-01-0858
All property jointly-owned with right of survivorship must be diselosed on Sehedule F.
ITEM VALUE AT DATE
DESCRIPTION UNIT VALUE OF DEATH
NUMBER
1 13,482 shares Allied Irish Bks Plc Spans ADS 21.04 283,661.28
Accrued Dividend 3,758.78
2 3,000 shares PPL Corp. 41.4525 124,357.50
Accrued Dividend 795.00
TOTAL (Also enter on line 2, Recapitulation) 412,572.56
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc.
Form REV-1503 EX (Rev. 1-97)
, REV -150~ EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Sylvia K. Grosz SS# 194-56-2293 09/11/2001 21-01-0858
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1
DESCRIPTION
$10,000 A11first Bank Certificate of Deposit #87008000132168
5.10% due 1/16/02
Accrued Interest
VALUE AT DATE
OF DEATH
10,000.00
37.73
2
$10,000 A11first Bank Certificate of Deposit #87008000146118
4.96% due 10/21/02
Accrued Interest
10,000.00
29.90
3
$10,000 A11first Bank Certificate of Deposit #87008000149753
5.87% due 5/13/05
Accrued Interest
10,000.00
48.25
4
$10,000 A11first Bank Certficate of Deposit #87008000149761
5.87% due 5/13/05
Accrued Interest
10,000.00
48.25
5
$11,305.37 First Union Certficate of Deposit #247412061015824
6.16% due 2/6/02
Accrued Interest
485.17
11,305.37
6
$12,538.25 First Union Certficate of Deposit #247412065787506
4.16% due 2/7/02
Accrued Interest
12,538.25
51.55
7
$15,000 A11first Bank Certificate of Deposit #80000002027571
4.93% due 11/27/01
Accrued Interest
32.42
15,000.00
8
$16,800.57 First Union Certificate of Deposit #247412050817267
3.88% due 6/19/03
Accrued Interest
16,800.57
98.51
9
$17,429.15 First Union Certificate of Deposit #247412066196884
4.31% due 1/16/02
Accrued Interest
17,429.15
498.85
Total of Continuation Schedu1e(s)
125,748.85
TOTAL (Also enter on line 5, Recapitulation) $ 240,152.82
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1508 EX (Rev. 1-97)
Estate of: Sylvia K. Grosz
Soc Sec #: 194-56-2293
Date of Death: 09/11/2001
Item
#
Continuation of Schedule E
(Cash, Bank Deposits & Miscellaneous Personal Property)
Description
Value at Date
of Death
10
$19,951.46 First Union Certificate of Deposit #247412059786949
3.93% due 8/13/02
Accrued Interest
263.79
19,951.46
11
$20,000 A11first Bank Certificate of Deposit #80000002027611
5.10% due 12/20/01
Accrued Interest
20,000.00
64.27
12
$25,000 A11first Bank Certificate of Deposit #87008000147424
3.94% due 11/22/03
Accrued Interest
25,000.00
56.67
13
$27,242.85 First Union Certificate of Deposit #247412063684196
4.31% due 3/1/02
Accrued Interest
27,242.85
634.54
14
A11first Bank Checking Account #0038902176
Accrued Interest
24,438.90
6.43
15
Blair - Merchandise Refund
104.70
16
First Union Checking Account #1010008160371
Accrued Interest
5,224.90
0.77
17
Har1eysvi11e Insurance - Reimbursement of Homeowners
Insurance due to Cancellation
30.00
18
Myers-Harner Funeral Horne - Refund
354.52
19
Personal Property - Appraised Value
1,880.00
20
Rebate from Prevacid
25.00
21
Received from Paula Young - Returned Merchandise
87.00
22
The Patriot-News - Subscription Refund
83.05
23
U. S. Treasury - 2001 Tax Relief Check
300.00
Estate of: Sylvia K. Grosz
Soc Sec #: 194-56-2293
Date of Death: 09/11/2001
Continuation of Schedule E
(Cash, Bank Deposits & Miscellaneous Personal Property)
Item
11
Description
Value at Date
of Death
125,748.85
REV -151~ EX + (1-97)
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Sylvia K. Grosz
09/11/2001
SSij 194-56-2293
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes.
ITEM
NUMBER
1
DESCRIPTION OF PROPERTY
RELAW8~~~I~ ~~'b~~~5tPM..~JJJ~~~1f.fr~EJF ~~~~RSFER.
ATTACH ACOPYOF THE DEED FOR REAL ESTATE.
On 10/3/91 the Decedent
transferred all of her title
and interest in her residence
property located at 229 S. 15th
Street, Camp Hill, PA to her
brother, Creeden E. Sunday and
his wife, Dolores W. Sunday,
but the Decedent continued to
occupy the residence rent free
and continued to pay all
utilities, maintenance, taxes
and repairs on the residence.
An implied retained life estate
is assumed. (Appraisal
Attached. )
DATE OF DEATH
VALUE OF ASSET
97,800.00
%OF
DECD'S
INTEREST
100.00%
2 Annuity Policy ijMA2705 Madison
National Life, formerly The
Midland Mutual Life Insurance
Company. The Decedent
Irrevocable assigned the above
referenced policy for value on
August 30, 1994, to the
Pennsylvania Funeral Services
CorporationjMyers-Harner
Funeral Home. No amount is
included under this Schedule G.
A small amount of the refund is
included under Schedule E.
TOTAL (Also enter on line 7, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc.
EXCLUSION
(IF APPLICABLE)
6,000.00
FILE NUMBER
21-01-0858
TAXABLE VALUE
91,800.00
91,800.00
Form REV-1510 EX (Rev. 1-97)
, REV-1512 EX +(1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Sylvia K. Grosz
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
B.
SSff 194-56-2293
FILE NUMBER
21-01-0858
09/11/2001
DESCRIPTION
AMOUNT
1
FUNERAL EXPENSES:
Myers-Harner Funeral Home
8,327.00
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s) Allfirst Trust Company of PA, NA
Social Security Number(s) / EIN Number of Personal Representative(s)
Street Address 8 W. High Street
City Carlisle State PA Zip 17013-2923
25,500.00
Year(s) Commission Paid:
2.
3.
Attorney's Fees William A. Duncan, Esquire
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
25,500.00
4.
Register of Wills
352.00
Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
1
Other Administrative Costs
Chuck Bricker, Auctioneer - Appraisal of Household Contents
75.00
2
Cumberland County Register of Wills - Reserve for Filing Fees
500.00
3
Linda J. Cheskey - Reimbursement for Lawn Care
40.00
4
Merry Maids - Cleaning Expense
74.20
5
Raymond C. Keller, CPA - 2001 Tax Preparation Fees
200.00
6
Robert R. Jones & Assoc - Appraisal of 229 S. 15th Street, Camp
Hill
300.00
Total of Continuation Schedule(s)
2,489.57
TOTAL (Also enter on line 9, Recapitulation) $ 63 , 357 . 77
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97)
Estate of: Sylvia K. Grosz
Soc Sec #: 194-56-2293
Date of Death: 09/11/2001
Item
If
Description
Continuation of Schedule H-B4
(Probate Fees)
Amount
1
Duncan & Hartman, P. C. - Reimbursement of Probate Filing Fee
352.00
352.00
Estate of: Sylvia K. Grosz
Soc Sec #: 194-56-2293
Date of Death: 09/11/2001
Continuation of Schedule H-B7
(Other Administrative Costs)
Item
If
Description
Amount
7
The Sentinel - Cost of Advertising and Proof of Publication
97.07
8
Allfirst Bank - Account Maintenance Fee
10.00
9
William A. Duncan - Reimbursement for Advertising Costs
75.00
10
Expenses on Sale of Securities
1,219.12
11
Allfirst Trust Company of PA, NA - Income Commissions
788.38
12
Estimated cost of filing final account
300.00
2,489.57
. REV-151~ EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERIT ANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Sylvia K. Grosz
SCHEDULE I
DEBTS OF DECEDENT,
MOR TGAGE LIABILITIES, AND LIENS
SSiI 194-56-2293
09/11/2001
FILE NUMBER
21-01-0858
Include unreimbursed medical expenses.
ITEM
NUMBER
1
DESCRIPTION
AT&T Corporation - Telephone Expense
AMOUNT
5.03
2
Borough of Camp Hill - Utility Expense
60.00
3
George M. Leader Family Corp - Balance for Room Charges
87.05
4
PA American Water Company - Utility Expense
34.45
5
Pennsylvania Dept of Revenue - 2001 Personal Income Tax
175.00
6
PPL Electric Utilities - Electricity Expense
89.55
7
United States Treasury - 2001 Personal Income Tax
190.00
8
Verizon - Telephone Expense
37.54
9
York Waste Disposal Inc. - Utility Expense
8.64
TOTAL (Also enter on line 10, Recapitulation) $ 687.26
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97)
, REV-151;3EX +(9-00)
SCHEDULE J
BENEFICIAR IES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Sylvia K. Grosz
09/11/2001
SSff 194-56-2293
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I. TAXABLE DISTRIBUTIONS [Include outright spousal distributions, and
transfers under Sec. 9116(a)(1.2)]
1 Linda J. Cheskey
256 McAllister Church Road
Carlisle, PA 17013
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Niece
2 Terry L. Tidd
244 McAllister Church Road
Carlisle, PA 17013
Niece
3 Creeden E. Sunday
and his wife
Dolores W. Sunday
Brother
and Sister-in-Law
FILE NUMBER
21-01-0858
AMOUNT OR SHARE
OF ESTATE
1/2 Share of
Residue
1/2 Share of
Residue
Residence
Property
91,800.00
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
(It more space is needed, insert additional sheets ot the same size)
Copyright (c) 2000 form software only The Lackner Group, Inc.
0.00
Form REV-1513 EX (Rev. 9-00)
REV -151~ EX + (9-00)
SCHEDULE K
LIFE ESTATE, ANNUITY
& TERM CERTAIN
Check Box 4 on Rev-1500 Cover Sheet
ESTATE OF FILE NUMBER
Sylvia K. Grosz SS# 194-56-2293 09/11/2001 21-01-0858
This schedule is to be used for all single life, joint or successive life estate and term certain calculations. For dates of death prior to 5-1-89,
actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit. Actuarial factors can be found
in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death on or after 5-1-89.
Indicate the type of instrument which created the future interest below and attach a copy to the tax return.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Copy #1
o Will
[K] Intervivos Deed of Trust
o Other
DATE OF BIRTH
Term of Years
Term of Years
Term of Years
1. Value of fund from which life estate is payable
2. Actuarial factor per appropriate table
Interest table rate - 0 3 1/2% 0 6% 0 10%
3. Value of life estate (Line 1 multiplied by Line 2)
$
0.00
0.00000
o Variable Rate
0.0 %
$
0.00
DATE OF BIRTH
Term of Years
Term of Years
1. Value of fund from which annuity is payable
2. Check appropriate block below and enter corresponding (number)
Frequency of payout - 0 Weekly (52) 0 Bi-weekly (26)
o Quarterly (4) 0 Semi-annually (2) 0 Annually (1)
3. Amount of payout per period
4. Aggregate annual payment, Line 2 multiplied by Line 3
S. Annuity Factor (see instructions)
Interest table rate - 031/2% 06% 0 10% 0 Variable Rate
6. Adjustment Factor (see instructions)
7. Value of annuity - If using 3 1/2%,6%, 10%, or if variable rate and period payout is at end of period,
calculation is: Line 4 x Line 5 x Line 6
If using variable rate and period payout is at beginning of period, calculation is:
(Line 4 x Line 5 x Line 6) + Line 3
0.00
o
o Monthly (12)
o Other ( )
0.00
0.00
0.0
%
0.0000
0.0000
0.00
0.00
NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through G of
this tax return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on Lines 13, 15, 16, 17 and 18.
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 2000 form software only The Lackner Group, inc.
Form REV-1514 EX (Rev. 9-00)
REV-151~ EX +(9-00)
SCHEDULE K
LIFE ESTATE, ANNUITY
& TERM CERTAIN
Cheek Box 4 on Rev-1500 Cover Sheet
ESTATE OF FILE NUMBER
Sylvia K. Grosz SS# 194-56-2293 09/11/2001 21-01-0858
This schedule is to be used for all single life, joint or successive life estate and term certain calculations. For dates of death prior to 5-1-89,
actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit. Actuarial factors can be found
in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death on or after 5-1-89.
Indicate the type of instrument which created the future interest below and attach a copy to the tax return.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Copy 1/2
D Will
D Intervivos Deed of Trust
D Other
DATE OF BIRTH
Term of Years
Term of Years
Term of Years
Term of Years
1. Value of fund from which life estate is payable
2. Actuarial factor per appropriate table
Interest table rate - D 3 1/2% D 6% D 10%
3. Value of life estate (Line 1 multiplied by Line 2)
$
0.00
0.00000
D Variable Rate
0.0 %
$
0.00
DATE OF BIRTH
Term of Years
Term of Years
1. Value of fund from which annuity is payable
2. Check appropriate block below and enter corresponding (number)
Frequency of payout - D Weekly (52) D Bi-weekly (26)
D Quarterly (4) D Semi-annually (2) D Annually (1)
3. Amount of payout per period
4. Aggregate annual payment, Line 2 multiplied by Line 3
5. Annuity Factor (see instructions)
Interest table rate - D 3 1/2% D 6% D 10% D Variable Rate
6. Adjustment Factor (see instructions)
7. Value of annuity - If using 3 1/2%, 6%, 10%, or if variable rate and period payout is at end of period,
calculation is: Line 4 x Line 5 x Line 6
If using variable rate and period payout is at beginning of period, calculation is:
(Line 4 x Line 5 x Line 6) + Line 3
0.00
o
D Monthly (12)
DOther ( )
0.00
0.00
0.0
%
0.0000
0.0000
0.00
0.00
NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through G of
this tax return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on Lines 13, 15, 16, 17 and 18.
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 2000 form software only The Lackner Group, Inc.
Form REV-1514 EX (Rev. 9-00)
, REV -151~ EX + (9-00)
SCHEDULE K
LIFE ESTATE, ANNUITY
& TERM CERTAIN
Check Box 4 on Rev-1500 Cover Sheet
ESTATE OF FILE NUMBER
Sylvia K. Grosz SS# 194-56-2293 09/11/2001 21-01-0858
This schedule is to be used for all single life, joint or successive life estate and term certain calculations. For dates of death prior to 5-1-89,
actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit. Actuarial factors can be found
in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death on or after 5-1-89.
Indicate the type of instrument which created the future interest below and attach a copy to the tax return.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Copy 113
o Will
o Intervivos Deed of Trust
o Other
DATE OF BIRTH
Term of Years
Term of Years
Term of Years
1. Value of fund from which life estate is payable
2. Actuarial factor per appropriate table
Interest table rate - 031/2% 06% 0 10%
3. Value of life estate (Line 1 multiplied by Line 2)
$
0.00
0.00000
o Variable Rate
0.0 %
$
0.00
DATE OF BIRTH
Term of Years
1. Value of fund from which annuity is payable
2. Check appropriate block below and enter corresponding (number)
Frequency of payout - 0 Weekly (52) 0 Bi-weekly (26)
o Quarterly (4) 0 Semi-annually (2) 0 Annually (1)
3. Amount of payout per period
4. Aggregate annual payment, Line 2 multiplied by Line 3
5. Annuity Factor (see instructions)
Interest table rate - 031/2% D 6% D 10% D Variable Rate
6. Adjustment Factor (see instructions)
7. Value of annuity - If using 3 1/2%, 6%, 10%, or if variable rate and period payout is at end of period,
calculation is: Line 4 x Line 5 x Line 6
If using variable rate and period payout is at beginning of period, calculation is:
(Line 4 x Line 5 x Line 6) + Line 3
0.00
o
o Monthly (12)
DOther ( )
0.00
0.00
0.0
%
0.0000
0.0000
0.00
0.00
NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through G of
this tax return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on Lines 13, 15, 16, 17 and 18.
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 2000 form software only The Lackner Group, Inc.
Form REV-1514 EX (Rev. 9-00)
~.
----.
.:~~r,."n....~.;."..._j._aJ.~"l"""!:<-~~1.i'''';' -..... .~
'..~ ':'i-:-',,",oi:'-y,.:-~'rl...Q..= ..
_.~,J....~____, ~.JlrdltT-
.'~
,..,B? -. .
----
ifjusf DlIt11 nub Wrsfamrnf
of
I, SYLVIA K. GROSZ, of 229 South 15th Street, Camp Hill, 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 any and all
other wills and codicils heretofore made by me.
FIRST. I direct that all my just debts and funeral expenses be paid from my estate as
soon after my death as practically and conveniently may be done.
SECOND. I direct that my remains be interred within my family's burial plot located in
Westminister Memorial Gardens, Carlisle, Pennsylvania, beside my beloved husband, C. Ernest
Grosz.
THIRD. I authorize my personal representative to expend funds from my estate, in such
amounts as my personal representative shall consider necessary and desirable for the purchase,
erection and inscription of a suitable marker for my grave.
FOURTH. I give, devise and bequeath any and all tangible personal property owned by
me at the time of my death unto my nieces, Linda 1. Chesky and Terri L. Tidd, in equal shares,
per stirpes
FIFTH. I give, devise and bequeath any and all real estate owned by me at the time of my
death, unto my nieces, Linda 1. Chesky and Terri L. Tidd, in equal shares, per stirpes
SIXTH. I give, devise and bequeath all the rest, residue and remainder of my estate unto
my nieces, Linda 1. Chesky and Terri L. Tidd, in equal shares, per stirpes
SEVENTH. I direct thai: any and aIi Inh;;:ritance, Estate a.id Transfer taxes imposed upon
my estate passing under my will or otherwise, shall be paid out of the principal of my residuary
estate.
EIGHTH. I hereby nominate, constitute and appoint Dauphin Deposit Bank and Trust
Company, and or it's successor, as Executor of this my Last Will and Testament. I hereby
relieve my Executor from the necessity of posting security in connection with their duties, as
such, in any jurisdiction in which they may be called upon to act insofar as I am able by law to
do so. In addition to the powers conferred by law, I authorize my Executor, in it's absolute
discretion, to retain in the form received, and to sell either at public or private sale any real or
personal property owned by me at the time of my death.
NINTH. I have made, or may from time to time make, a written memorandum expressing
my desire to give certain items of personal property to specific persons. I urge my Executor and
M ~... ~ ,...._-~=:.:..':~i.;;,;,~~~.~~,.~ ,:~ . ;,y.' i"<:'l,,,,""'fr;'/':S ;.':;*if~
beneficiaries to respect these wishes. Such a memorandum, if made, shall be stored in
conjunction with this WIll.
IN WITNESS WHEREOF, I have hereunto set m~Fd and seal to this, my Last Will
and Testament, consisting of two typewritten pages this 7f'\- day of August, 1997.
~~k~
SYL K. GROSZ
Signed, sealed, published and declared by the above named Testatrix Sylvia K. Grosz as and
for her Last Will and Testament, in the presence of us, who, at her request, in her sight and
presence and in the sight and presence of each other, have hereunto subscribed our names as
witnesses.
~M~~
.,
COMMONWEALTH OF PENNSYLVANIA
".~... ...1jtJ_
~r~r".'~~~o',,,, 1 .,
.
.
: SSe
COUNTY OF CUMBERLAND
I, Sylvia K. Grosz, Testatrix whose name is signed to the attached or foregoing instrument,
having been duly qualified according to law, do hereby acknowledge that I signed and executed
the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and
voluntary act for the purposes therein expressed.
J 'k&A1~~
SYL~SZ ~""-'c:r-
Sworn or affirmed to and
acknowledged before ~, by
Sylvia K. Grosz this7t5-day
of August, 1997.
Notarial Seal .
C nthia L. Carr, Notary Public
SOUth Jiddleton Twp., ~umber\and County
My Commission Expires Aug. 14, 2000
COMMONWEALTH OF PENNSYLVANIA
: SSe
COUNTY OF CUMBERLAND
We, (JJrh - ,q lJ u...~<-Ct 1'"'\ . and i-lSQ.? Sh ne... the witnesses whose
names are signed to the attached or foregoing instrument, being duly qualified according to law,
do depose and say that we were present and saw Sylvia K. Grosz sign and execute the
instrument as her Last Will; that she signed willingly and that she executed as her free and
voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the
Testatrix signed the will as witnesses; and that to the best of our knowledge, the Testatrix was at
that time eighteen (18) or more years of age, of sound mind and under no constraint or undue
influence.
Sworn or affirmed to and
subscribed before me by
t0m r ,q -D(/lh (' tJt/\/ and
~ ~C-t O? Sf-? n €- , witnesses,
this 7~ay of August, 997.
~ Public
Wft)t~c~
~J~
" ':>/!J" IJ'_I {,~j;
No\arial seal public
C\JfI\h\a L. Darr, N~~~t\and cou~~
"'_..... ~Midd\!lto~ ,.~,(p~es Aug. 14, 20
~y'comm\SS\on
/~ APPRAISAL
Personal Property of SYLVIA K I G R os 2 ES T..4rr -2.2 q S 1;2 CfTll ST, cAr{;; // /LL 1?.4,
AU094-L Date ItJ- //- /
ITEM VALUE
.Rr:~~~rrq-.No
'>-
',-': i .., {;'1
. - -' v
, :....1"
'-'-',J,
C ~.L OFF:rCE;:
;/
l\AL APPRA\SAL REPORl File No, 01100214
.",aryReport UNlfORM RES\OEN , State PI>. Zip Code 11011
_"pllon City Camp HIli County Cumbelland
. .,r Address 229 S. 15th Street 1,769.00Spec\a\ I\sse~smen\s $_~~A
'1 Description Attached 1ax '(ear 00101 RE.1axes $ \ . 10 er 111enant \ X Nacant
'A;::SSOf'S Parcel No 01-22-0826-089 , Current Owner Estate of, sylvia Gro~%. , OCCupa(nHtUDN~ :~y) HOA$ NIl>. IMo
N/A . . I PUD i I Condominium 3240
Borrower. . d Xi Fee Simplel, ! Leasehold proJect Type' , 'DC Map 20 A.2 CensUS Tract 01051
Property nghts appraIse I .. h Map Reference" '.
Neighborhood or Project Name Camp H~::orOug Oesaiplion and $ amount of loan chargeslconcessions to be paId by seller None
Sale Price $ NIA Date of Sate Address p, O. Box 190 Callisle, 1'(>,17013,
lender/Client AlIfirst Trust, 7800 Allentown Boulevard Harnsbur PA 17112
A 'ser Christo her M. Jones SRA Address. t Single family housi'l!' Present land use % Land us.e change.
ra.' U b X . Suburban 'Rural Predomman Prn5ij AG;j One family 85 X ,Nollikely likely
~:~I~~~n X ;v:rn75% 25-75%, Under25% ,0~~lIpancY$( ~5 Low (yrs60 2-4 family Oi1n process
G owIh rate Rapid X,, Stable , ,Slow', ,Owner 130+ High 90 Multi-family 0 To: -
r ". x'Stable \ ; Declining I j Tenant . I 15
Property value \ ,. ,Increasmg \ -~ i I I \ X I Vacant (0-5%) Predominant CommercIa
Demandlsupply , : Shortage Xjlnbalancer ,~r~uppy --"'Vacant over 5% 100+. 75+- ac land 0
Marl<.etin time' ',Under 3 mos. X : 3-6 mos. 'er mos. , not a ralsal factors,
Note: Race and the racial composition of the nelghborhttdt~re rth r:moyne Borough to the east, State Street to the south and 17th
Neighborhood boundaries and characteristics: Ma~ket Stree 0 e ~o ,
Street to the west. This is the southeastern section of the ~:~gro~imil 10 employment and amenities, ~mployment stability, appeal to mar~.et. etc.):
Factors that affect the marketability of ~he properties In the nelrhb~r C i The Yarea has good access to ellployment and necessary supporting
The ~"bject is 10,cated .In Camp HilI BO~~~~'07~~be%:~oym~~~ f~'r the region is considered to be in the metro Harrisburg/Camp Hill area.
servlc,es are aV,allable 10 thde ~OfOugh, ~ section of the township with similar dwellings. nere are commercial uses along the
The aforementIOned bOlln anes encompass Q . . d f . Iff' d d t L
. th t h' h 'IS residential These are mostly sUPportln9 shoppmg an pro esslona 0 Ices an 0 no "ave a
bordermg areas except to ewes, w IC, .
negative impact. . .
Markel conditions in the subject neighborhood (including support for the above conclusions related to the trend of prcperty values. demandrsuppl~, and marketrng IlIne
_ _ such as data on competitive properties for sale in the neighborhood, description of Ihe p~ev~'ence of saes and, financrng conce~slons, etc.):
County tax assessment records and multi-list statistic~ for t~e neighbor,hood indIcate that 11~ nel~hborhood price range IS stable. The
multi-list service also indicates a nanow list to sale price ratio of 97% WIth an average marketing tI~e of less than 120 days. Recently
interest rates have remained constant at their current relatively low rates and are expected to remain at the current levels through the
remainder of the fourth quarter of 2001. Presently financing is readily available and seller concessions are not prevalent.
Project Information for PUDs (If applicable) - - Is the developer/builder in control of the Horre Owner's Association (HOA)? , Yes X, No
Approximate total number of units in the subject project NIA Approximate total number of units for sale in the subject project NIA
Describe common elements and recreational facilities: NIA
Dimensions 40 X 150 x 40 x 150 ,Topography level at street grade
Site area .14 acre 6,000 square feet Corner Lot '. Yes I X ,No' Size Average for the area
Specific zoning classification and descriptionR2 -.limited Multi-Family Shape Rectangular..
Zoning compliance X i Legal! 'legal nonconforming (Grandlathered use) i ! Illegal r --1 No zoning Drainage Average for the area
Hi hest & besl use as im roved: I X: Present use i ' Other use ex lain View Houses&ShoppingCenter
Utilities Public Other Off-site Improvements Type Public Privae landscaping Average fot the area
Electricity X 100 Amperes Street Asphalt ' X . Driveway surface Alley
Gas X Curb/gutter Concrete i X i Apparent easements Normal utility
Water 'X" Sidewalk Concrete ~xl FEMA Special Flood Hazard Area ~--, Yes . X ~ No
Sanitary sewer : X Street lights Ves 'X, FEMA Zone Zone C Map Dale 12-11-1981
Storm sewer X Aile Rear X ' FEMA Ma No. 4203570001 B
Commenls (apparent adverse easements, encroachmenls. special assessments. slide areas. illegal or legal nonconforming zoning use. etc.): There are no apparent
adverse easements, encroachments or other special assessment conditions noted during the inspection.
GENERAL DESCRIPTION EXTERIOR DESCRIPTION
No of Units One Foundation Conc Block
No of Stories 1.50 Exterior Walls Brick
Type (DeUAtt.) Detached Roof Surface AspShingles
Design (Style) 2StyCpCd Gutters & Dwnspts. Galvanized
Existing/Proposed Existing Wondow Type Wood O/H
Age (Yrs.) 80 Storm/Screens X / X
Effective A e Yrs. 30 Manufactured House No
ROOMS Foyer Living Dining Kitchen Den
Basement
Levell
Level 2
FOUNDATION
Slab None
Crawl Space None
Basement Ves
Sump Pump None
Dampness See Comm
Settlement No Evidence
Infestation No Evidence
FamilyRm. Rec. Rm. Bedrooms # Baths
BASEMENT
Area Sq Fl
% Finished
Ceiling
Walls
Floor
Outside Entry
INSULATION
740 Roof
Ceiling
Walls
Floor
None
Unknown
I
iK!
1)( i
! X I
!
-0-
Exposed Jst
Block
Concrete
Yes-Door
Concl
Concl
None
Laundry Other Area Sq.
Ft.
740
740
475
2
Finished area above rade contains: 5 Rooms' 2 Bedroom s .
INTERIOR MaterialslCondition HEAliNG KITCHEN EQUIP CAR STORAGE:
Floors CP&Vn&HW/A Type HotWater Refrigeralor 1 None
Walls Plaster/Average Fuel Oil Range/Oven , Garage 1 # of cars
Trim/Finish Wood I Painted Condition Av . Disposal Attached
Bath Floor Vinyl/ Average COOLING Dishwasher : 2 l Detached XX
Bath Wainscot CeramiclAvg. Central None FanlHood Built-In
Doors Wood I Painted Other N/A Microwave Carport
Condilion NIA Washerto er Finished Drivewa Aile
Additional features (special energy efficient ilems, elc): The garage is 10 x 16, 10 x 22 front porch, 8 x 14 rear porch, fireplace in the living
room.
Condition of the improvements. depreciation (physical. functional and external), repairs needed, quality of construction. remodeling/additions. etc.
There were no functional obsolescence noted at the time of the inspection, External will be considered for the fact that the subject backs
upto a shopping center. The overall condition is reflected in the effective age, there was some knob and tube wiring noted in the basement.
Adverse environmental conditions (such as. but not limited to. hazardous wastes. toxic substances. etc.) present in the improvements. on the site
or in the immediate vicinity of the subject property: The subject property was built prior to 1978 and lead based paint may be present on or in
the ro e ,The a raiser is not an ex ert see attached Iimitin conditions,
reddie ac orm 70 6~93 ay ne arms for Windows 199 1 800- ~ T- Y1 PA .annie Mae orm 1004 6-93
Robert R. Jones Appraisers
I.
~.
.<-1 SITE VALUE = $
_..AtED REPRODUCTION COST-NEW-OF IMPROVEMENTS:
,~~iiing 1,215 Sq. Ft @ 69.68 = $ 84,661
Bsmt 740 Sq. Ft @ 16.75 = 12,395
Porches, Fireplace 8,750
GarayefCarport 160 SQ Ft @ 21.40 = 3,424
Total Estimated Cost New. . = $ 109,230
Physical Functional External
File No. 01100214
28,000 Comments on Cost Approach' (such as. source of cost estimate
site value, square foot calculation and for HUD, VA and FmHA,
the estimated remaining economic life of the property):
See attached Scope #5 for additional comments on the Cost
Approach. See Floor plan for gross living area calculations.
Less
Depreciation 40,9611
Depreciated Value of Improvements.
"As-is" Value of Site Improvements
INDICATED VALUE BY COST APPROACH,........
ITEM SUBJECT COMPARABLE NO. COMPARABLE NO.2 COMPARABLE NO.3
Address 229 S, 15th Street 139 S. 15th Street 215 S. 15th Street 122 S. 16th Street
~~ ~~ ~~ ~~
Proximity to Subject 0,10 MI NW 0,02 MI NW 0.13 MI W
Sales Price $ NIA $ 103,500 $ 105,500 $ 97,000
Price/Gross Liv. Area $ 0 $ 99.52____ $ 79.56 $ 82.55L:: .". .,"1<: 1
Data and/or Inspection Exterior Inspection Exterior Inspection Exterior Inspection
Verification Source ssessment Rcrds MLS/Assessment Records MLS/Assessment Records MLS/Assessment Records
VALUE ADJUSTMENTS DESCRIPTION DESCRIPTION. (.) I Adiustment .. DESCRIPTION . (.) I Adiustment DESCRIPTION . (-) $ Adjustment
Sales or Financing Conventional 0 F.H.A. -2,500 F.H.A. 0
Concessions 93 dom 0 34 dom 0 102 dom 0
Date of SalelTime N/A 08.16-2001 0 04-28-2000 0 10-23.2000 0
location Suburban Suburban 0 Suburban 0 Suburban 0
Leasehold/Fee Simple Fee Simple Fee Simple (} Fee Simple 0 Fee Simple 0
Site .14 acre ,14 acre o ,14 acre 0.14acre 0
View Houses&Comm. Houses&Comm. 0 Houses&Comm. 0 Houses -3,000
Design and Appeal 2StyCpCd . Avg. 2StyCpCd - Avg. 0 2StyCpCd - Avg. 0 2StyCpCd - Avg. 0
Quality of Construction Brick - Average Vinyl- Average 1,500 Brick - Average 0 Alum. - Average 1,500
Age 80 est 80 est 0 80 est 0 80 est 0
Condition verage Good -3,500 Good -3,500 Average 0
Above Grade Total ISd. .rmsl Balhs TotaIIB.dnm. .sl.Balhs TotallBdrmsl Baths Tota'IBdrm.sl Balhs
Room Count 5 2 1 5 2 1 0 6 3 1 0 6 2 1 0
Gross living Area 1,215SQ. H 1,040Sq H 3,500 1,326Sq H -2,200 1,175SQ. Ft. 800
Basemen! & Finished 100% /0% 100% / 0% 0 100% / 0% 0 100% I 0% 0
Rooms Below Grade None None 0 None 0 None 0
Functional Utility verage Average 0 Average 0 Average 0
Heating/Cooling otWater/None F.W.A./ CA -2,000 HotWater/None 0 HotWater/None 0
Energy Efficient Item Storm Units Storm Units 0 Storm Units 0 Storm Units 0
Garage/Carport 1 Car Detached None 1,000 1 Car Detached 0 2t Car Detached -3,000
Porch. Palio, Deck, Porches Porch-LgSunRm -5,000 Deck-Patio 500 Porch 1,000
Fireplace(s), etc. 1/Fireplace None 1,000 1/Fireplace 0 None 1,000
Fence, Pool, etc. None None 0 None 0 None
Other None ~<l.ne 0 None 0 None
NelAdj. (total) I -3,500 i~~+ 'j( $ -7,700 __+ LX";- $
Adjusted Sales Price -7.30 % Net -1.75 % Net
of Com arable 16.91 % Grs 100000 8.25 % Grs $ 97800 10.62 % Grs
Comments on Sales Comparison (including the subject property's compatibility to the neighborhood, etc.): SEE ATTACHED ADDENDUM
2,500 = $
=$
.=$
43,461
65, t69
4,000
97 800
-1,700
95 300
ITEM SUBJECT COMPARABLE NO.1 COMPARABLE NO.2 COMPARABLE NO.3
Date, Price, and Data None None None None
Source, for prior sales Assessment Assessment Assessment Assessment
within ear of a raisal Records Records Records Records
Analysis of any current agreement of sale, option, or listing of the subject property and analysis of any prior sales of subject and comparables
within one year of the date of appraisal: Other than the sale dates shown on the grid, I was unable to find any other transfer of the subject or
comparables over the past 12 months.
INDICATED VALUE BY SALES COMPARISON APPROACH.......... ..... ....... . .. , ... , ...... ... ... ... .. $ 97,000
INDICA TED VALUE BY INCOME APPROACH If A icable Estimated Market Rent $N/A !Mo. x Gross Rent Multi tier N/A N/A
This appraisal is made X '"as is' subject to repairs, alterations, inspections or condilions listed below ,subject to completion per plans and specifications
Conditions of Appraisal: The appraisal is completed in the "AS IS. condition. The date of inspec1ion is October 17, 2001, the appraisal is
completed as of the date of death which was September 11, 2001.
Final Reconciliation: The Sales Comparison Approach to value is considered to be the most accurate method of achieving an estimated
market value. The Cost Approach usually sets the high limit of value and is used to support the Sales Comparison Approach. The lack of
data to develop a monthly rent or multiplier forced the elimination of the Income Approach.
The purpose of this appraisal is to estimate the market value of Ihe real property that is the subject of this report, based on the above conditions and Ihe certification, contingent
and limiting conditions, and markel value definition Ihat are stated in the attached Freddie Mac Form 4391Fannie Mae Form 10048 (Revised 06/93 I
I (WE) ESTIMATE THE MARKET VALUE, AS DEFINED, OF THE REAL PROPERTY THAT fS THE SUBJECT OF THIS REPORT, AS OF September 11, 2001
(WHICH IS THE OAT OF INSPECTION AND THE EFFECTIVE DATE OF THIS REPORT) TO BE $ 97,000
APPRAISER: SUPERVISORY APPRAISER (ONLY IF REQUIRED):
Signature Signature! Did ' Did Not
Name Christopher Name Inspect Property
Date Report Signed Date Report Signe~
State Certification # Slate PA State Certification # State
annie Be arm 1004 6-93
ay
",ary Report UNIFORM RESIDENTIAL APPRAISAL REPORT
_"ptlon File No. 01100214
,yAddress 229 S.15th Street City Camp Hill State PA Zip Code 17011
.1/81 Description Attached County Cumberland
'Assessor's Parcel No. 01-22-0826-089 Tax YearOOlOl RE. Taxes $ 1,769.00Special Assessments $ N/A
Borrower N/A Current Owner Estate of S~lvia Grosz Occupant i' IOwner I lTenant I xl Vacant
Property rights appraised X: Fee Simple' Leasehold Project Type i PUD ; Condominium (HUDNA only) HOA$ N/A /Mo
Neighborhood or Project Name Camp Hill Borough Map ReferenceADC Map 20, A-2 Census Tract 0105/3240
Sale Price $ N/A Date of Sale N/A Descriplion and $ amount of loan charges/concessions to be paid by seller None
Lender/Client AlIlirst Trust Address P. O. Box 190 Carlisle, PA 17013
A raiser Christo her M. Jones SRA Address 7800 Allentown Boulevard Harrisbur PA 17112
Location Urban X . Suburban Rural Predominant Sin~le family housi'l!! Present land use % Lan,d use change
Built up X Over 75% 25-75% Under 25% occupancy '$!&OJ t?S) One family 85 X Nollikely Likely
Growth rate Rapid X:Stable ,Slow !Xiowner 65low 60 2-4 family Ollnprocess
Property value. Increasing ,)(iStable :. ,Declining i .JTenant 130+ High 90 Multi-family 0 To:
Demand/supply _~Shortage '!jlnbalancel_JOversupply ,J<.yacant (0-5%) Predominant Commercial 15
Marketin time Under 3 mos. X : 3-6 mos. I ; Over 6 mos. 'Vacant over 5% 100+- 75+- ac Land 0
Note: Race and the racial composition of the neighborhood are not appraisal factors.
Neighborhood boundaries and characteristics: Market Street to the north, Lemoyne Borough to the east, State Street to the south and 17th
Street to the west. This is the southeastern section of the Borough.
F actors that aHect the marketability of the properties in the neighborhood (proximity to employmen! and amenities, employment stability, appeal to market, etc):
The subject is located in Camp Hill Borough, Cumberland County. The area has good access to employment and necessary supporting
services are available in the borough. Much of the employment for the region is considered to be in the metro Harrisburg/Camp Hill area.
The aforementioned boundaries encompass a section of the township with similar dwellings, There are commercial uses along the
bordering areas except to the west, which is residential. These are mostly supporting shopping and professional offices and do not have a
negative impact.
Market condilions in lhe subject neighbcrhood (including support for the above conclusions related 10 the trend of property values, demand/supply, and marketing time
- - such as data on competitive properties for sale in the neighborhood, description of the prevalence of sales and financing concessions, etc.):
County tax aSsessment records and multi-list statistics for the neighborhood indicate that the neighborhood price range is stable, The
multi-list service also indicates a narrow list to sale price ratio of 97% with an average marketing time of less than 120 days. Recently
interest rates have remained constant at their current relatively low rates and are expected to remain at the current levels through the
remainder of the fourth quarter of 2001. Presently financing is readily available and seller concessions are not prevalent.
;/
Project Information for PUDs (If applicable) - - Is the developer/builder in control of the Home Owner's Association (HOAl? i Yes X, No
Approximate total number of units in the subject project N/A . Approximate total number of units for sale in the subject project N/A
Describe common elements and recreational facilities: N/A
Dimensions 40 x 150 x 40 X 150 Topography Level at street grade
Sitearea ,14acre 6,000 square feet Cornerlot!" :Yes f)(No Size Average for the area
Specific zoning classification and description R2 - Limited Multi-Family Shape Rectangular_.
Zoning compliance X': legali 'Legal nonconforming (Grandfathered use):- .~ Illegal r -1 No zoning Drainage Average for the area
Hi hest & best use as im roved'. I X: Present use, ' Other use ex lain View Houses&ShoppingCenter
Utilities Public Other Off.site Improvements Type Public Privale Landscaping Average fot the area
Electricity X 100 Amperes Street Asphalt X ! ; Driveway surface Alley
Gas X Curb/gulter Concrete ~J<.! Apparent easements Normal utilit}'
Water X' Sidewalk Concrete i X i FEMA Special Flood Hazard Area c", Yes X ',No
Sanitary sewer X Street lights Yes ; X' FEMA Zone Zone C Map Date 12-11-1981
Storm sewer X Aile Rear ! X ' FEMA Ma No. 420357 0001 B
Commenls (apparent adverse easements, encroachments, special assessments, slide areas, illegal or legal nonconforming zOl1lng use, elc.): There are no apparent
adverse easements, encroachments or other special assessment conditions noted during the inspection,
GENERAL DESCRIPTION EXTERIOR DESCRIPTION
No of Units One Foundation Cone Block
No. of Stories 1.50 Exterior Walls Brick
Type (Det/Att) Detached Roof Surface AspShingles
Design (Style) 2StyCpCd Gutters & Ownspts. Galvanized
Existing/Proposed Existing Window Type Wood D/H
Age (Yrs.) 80 Storm/Screens X / X
Effeclive A e Yrs. 30 Manufactured House No
ROOMS Foyer Living Dining Kitchen Den
Basement
Levelt
Level 2
FOUNDATION
Slab None
Crawl Space None
Basement Yes
Sump Pump None
Dampness See Comm
Seltlement No Evidence
Infestation No Evidence
Family Rm. Rec. Rm. Bedrooms # Baths
BASEMENT
Area Sq Ft
% Finished
Ceiling
Walls
Floor
Outside Entry
-0-
Exposed Jst
Block
Concrete
Yes-Door
INSULATION
740 Roof
Ceiling
Walls
Floor
None
Unknown
Concl
Concl
None
I i
I -- I
!J<.:
1\
XI
l-J
Laundry Other Area Sq.
FI.
740
740
475
2
Finished area above rade contains: 5Rooms' 2 Bedroom s . 1 Bath s ' 1 215S uare Feet of Gross Livin Area
INTERIOR Materials/Condition HEATING KITCHEN EQUIP. AMENITIES CAR STORAGE:
Floors CP&Vn&HWIA Type HotWater Refrigerator Fireplace(s) # Yes '1 None
Walls Plaster/Average Fuel Oil Range/Oven Patio None I Garage 1 # of cars
T rim/Finish Wood I Painted Condition Av . Disposal 1,-, Deck None Attached
, Bath Floor Vinyl I Average COOLING Dishwasher , X! Porch Yes ''21 Detached XX
Bath Wainscot Ceramic/Avg. Central None Fan/Hood Fence NIA Built-tn
Doors Wood I Painted Other NIA Microwave Pool None I _, Carport
Condition N/A WasherlD er: Finished Drivewa Aile
Additional features (special energy efficient items, etc.) The garage is 10 x 16,10 x 22 front porch, 8 x 14 rear porch, fireplace in the living
room.
Condition of the improvements, depreciation (physical, functional and ex!ernal), repairs needed, quality of construction, remodeling/additions, elc.
There were no functional obsolescence noted at the time of the inspection. External will be considered for the fact that the subject backs
upto a shopping center. The overall condition is reflected in the effective age, there was some knob and tube wiring noted in the basement.
A~ 1 .2
.annie Be orm 1004 6-93
;'
.v SITE VALUE " $
.,.AfED REPRODUCTION COST-NEW-OF IMPROVEMENTS:
,-,~iiing 1,215 Sq Ft. @ 69.68" $ 84,661
Bsmt 740 Sq. Ft. @ 16.75 " 12,395
Porches, Fireplace 8,750
Garage/Carport 160 Sq Fl. @ 21.40 " 3,424
Total Estimated Cost New. . "$ 109,230
Physical Functional External
File No. 01100214
28,000 Comments on Cost Approach (such as, source of cost estimate
site value, square foot calculation and for HUD, VA and FmHA,
the estimated remaining economic life of the property):
See attached Scope #5 for additional comments on the Cost
Approach. See Floor plan for gross living area calculations.
,,:' Less
Depreciation 40,9611 2,500 " $ 43,4~1
Depreciated Value of Improvements. " $ 65,~69
"As-is" Value of Site Improvements . "$ 4,000
INDICATED VALUE BY COST APPROACH. . . . . . , . . 97800
ITEM SUBJECT COMPARABLE NO. COMPARABLE NO.2 COMPARABLE NO.3
Address 229 S, 15th Street 139 S. 15th Street 215 S, 15th Street 122 S. 16th Street
~~ ~~ ~~ ~~
Proximity to Subject 0.10 MI NW 0.02 MI NW 0.13 MI W
Sales Price $ N/A $ 103,500 105,500 $ 97,000
Price/Gross liv. Area $ 0 $ 99.52____ $ 79.56 $ 82.55~ 4'11
Data andlor Inspection Exterior Inspection Exterior Inspection Exterior Inspection
Verification Source Assessment Rcrds MLS/Assessment Records MLS/Assessment Records MLS/Assessment Records
VALUE ADJUSTMENTS DESCRIPTION DESCRIPTION -0$ AdjtJslmenl . DESCRIPTION -OIAd~lSlment DESCRIPTION -(.)IAdiuslmenl
Sales or Financing Conventional 0 F .HA .2,500 F .H.A. 0
Concessions 93 dam 0 34 dom 0 102 dom 0
Date of Sale/Time N/A 08.16.2001 0 04.28.2000 0 10.23.2000 0
Location Suburban Suburban 0 Suburban 0 Suburban 0
Leasehold/Fee Simple FeeSimple Fee Simple 0 Fee Simple 0 Fee Simple 0
Site .14 acre .14 acre 0 .14 acre 0 .14 acre 0
View Houses&Comm. Houses&Comm. 0 Houses&Comm. 0 Houses .3,000
Design and Appeal 2StyCpCd . Avg. 2StyCpCd - Avg. 0 2StyCpCd. Avg. 0 2StyCpCd. Avg. 0
QualityofConstruclion Brick - Average Vinyl- Average 1,500 Brick - Average 0 Alum. - Average 1,500
Age 80 est 80 est 0 80 est 0 80 est 0
Condition verage Good -3,500 Good .3,500 Average 0
~~~: ~;~~~ Tota'5IBdrm~1 Baths1 Tota~IBdrm~IBaths1 0 Tota~IBdrm;1 Baths1 0 Tota~IBdrm~1 Baths1 0
Gross Living Area 1,215Sq Ft. 1,040Sq Ft 3,500 l,326Sq FI -2,200 l,175Sq. Ft 800
Basement & Finished 100% 10% 100%/0% 0100%10% 0 100%/0% 0
Rooms Below Grade None None 0 None 0 None 0
Functional Utility Average Average 0 Average 0 Average 0
Heating/Cooling HotWaterlNone F .W.A./ CA -2,000 HotWaterlNone 0 HotWaterlNone 0
Energy Efficienlltem Storm Units Storm Units 0 Storm Units 0 Storm Units 0
Garage/Carport 1 Car Detached None 1,000 1 Car Detached 0 2+ Car Detached .3,000
Porch, Patio, Deck, Porches Porch-lgSunRm .5,000 Deck.Patio 500 Porch 1,000
Fireplace(s), etc. 1/Fireplace None 1,000 l/Fireplace 0 None 1,000
Fence, Pool, etc. None None 0 None 0 None
Other None None 0 None 0 None
NetAdj (total) r-' .3,500 : _,+ 'x1- $ .7,700~i+ I.x.;- $ .1,700
Adjusted Sales Price -7.30 % Net .1.75 % Net
of Com arable 16.91 % Grs 100000 8.25 % Grs $ 97800 10.62 % Grs 95300
Comments on Sales Comparison (including the subject property's compatibility to the neighborhood, elc.): SEE ATTACHED ADDENDUM
ITEM SUBJECT COMPARABLE NO.1 COMPARABLE NO.2 COMPARABLE NO.3
Dale, Price, and Dala None None None None
Source, for prior sales ssessment Assessment Assessment Assessment
within ear of a raisal Records Records Records Records
Analysis of any current agreement of sale, option, or listing of the subject property and analysis of any prior sales of subject and comparables
within one year of the date of appraisal: Other than the sale dates shown on the grid, I was unable to find any other transfer of the subject or
comparables over the past 12 months.
. INDICATED VALUE BY SALES COMPARISON APPROACH.......... ..... ....... . ., . ... ....... ... '" ... .. $ 97,000
. INDICA TED VALUE BY INCOME APPROACH If A licable Estimated Market Rent $NIA /Mo. x Gross Rent Multi lier N/A NIA
This appraisal is made X ,'as is' subject to repairs, alterations, inspections or conditions listed below ,subject to completion per plans and specifications.
Conditions of Appraisal: The appraisal is completed in the "AS IS" condition. The date of inspection is October 17, 2001, tne appraisal is
completed as of the date of death which was September 11, 2001.
Final Reconciliation: The Sales Comparison Approach to value is considered to be the most accurate method of achieving an estimated
market value. The Cost Approach usually sets the high limit of value and is used to support the Sales Comparison Approach. The lack of
data to develop a monthly rent or multiplier forced the elimination of the Income Approach.
The purpose of this appraisal is 10 estimate the market value 01 the real property that is the subject of Ihis report, based on the above conditions and the certification, contingent
and limiting conditions, and market value definition that are stated in the attached Freddie Mac Form 439IFannie Mae Form 1004B (Revised 06193 ).
I (WE) ESTIMATE THE MARKET VALUE, AS DEFINED, OF THE REAL PROPERTY THAT IS THE SUBJECT OF THIS REPORT, AS OF September 11, 2001
(WHtCH IS THE OAT OF INSPECTION AND THE EFFECTIVE DATE OF THIS REPORT) TO BE $ 97,000
APPRAISER: SUPERVISORY APPRAISER (ONLY IF REQUIRED):
Signature Signature' i Did , i Did Nol
Name Christopher Name Inspect Property
Date Report Signed Date Report Signee!
Stale Certification # State PA State Certification # Slate
Freddie ac orm 0 -93
'V
----
7 0 6 United States Estate (and Generation-Skipping Transfer)
Form' Tax Return
(Rev. Jul>, 1999) Estate of a citizen or resident of the United States (see separate instructions).
'Department of the Treasury To be filed for decedents dying after December 31,1998
Internal Revenue Service For Paperwork Reduction Act Notice, see pa e 1 of the se arate instructions.
D 1 a Decedent's first name and middle Initial (and maiden name, if any) 1 b Decedent's iast name
e S lvia K. Grosz
P ~ 3a Legal residence (domicile) at time of death (county, state, and ZIP code, or 3b Year domicile established
foreign country)
a ~ Cumberland Count , PA 17011
n
t
1919
6a Name of executor (see page 4 of the Instructions)
Allfirst Trust Com an of PA, NA
OMB No. 1545-0015
2 Decedent's soc. sec. no.
194-56-2293
5 Date of death
6b Executor's address (number and street Including apartment or suite no. or rural route;
city, town, or post office; state; and ZIP code)
09/11 2001
Name and location of court where will was probated or estate administered 7bCase number
Cumberland Ct Court of Common Pleas, Or hans' Court Division 21-01-0858
If decedent died testate, check here ~ X and attach a certified copy of the will. 9 If Form 4768 is attached, check here ~
If Schedule R-l is attached, check here ~
Total gross estate less exclusion (from Part 5, Recapitulation, page 3, item 12).
Total allowable deductions (from Part 5, Recapitulation, page 3, item 23) . . .
Taxable estate (subtract line 2 from line 1) . . . . . . . . . . . . . . . . . .
Adjusted taxable gifts (total taxable gifts (within the meaning of section 2503) made by the decedent after
December 31, 1975, other than gifts that are includible in decedent's gross estate (section 2001(b)))
5 Add lines 3 and 4. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 Tentative tax on the amount on line 5 from Table A on page 12 of the instructions.
1 734,836.25
2 9,014.26
3 725,821.99
4 0.00
5 725,821.99
6 239,354.14
&
E
x
e 7a
c
u
t 8
o
r 10
1
2
3
4
6c Executor's social security number (see page 4 of the Instructions)
8 W. High Street
Carlisle, PA 17013-2923
52-2206238
P
a
7 a If line 5 exceeds $10,000.000, enter the lesser of line 5 or $17,184,000. If line 5 is $10,000,000
or less, skip lines 7a and 7b and enter -0- on line 7c. 7a
b Subtract $10,000,000 from line 7a . . . . . .. .............. 7b
cEnter 5% (.05) of line 7b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8 Total tentative tax (add lines 6 and 7c) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9 Total gift tax payabie with respect to gifts made by the decedent after December 31,1976. Include gift taxes by the decedent's
spouse for such spouse's share of split gifts (section 2513) only If the decedent was the donor of these gifts and they are
T Includible In the decedent's gross estate (see instructions) . . . . . . . . . . . . . . . . . . . .
10 Gross estate tax (subtract line 9 from line 8). . . . . . . . . . . . . . . . . . . . . . . . . .
a
11 Maximum unified credit (applicable credit amount) against estate tax. . . 11 220,550.00
x
12 Adjustment to unified credit (applicable credit amount). (This adjustment
may not exceed $6,000. See page 4 of the instructions.) ........ 12
C
13 Allowable unified credit (applicable credit amount) (subtract line 12 from line 11) . . . . . . . . . . .
o 14 Subtract line 13 from line 10 (but do not enter less than zero). . . . . . . . . . . . . . . . . . . . .
m
15 Credit for state death taxes. Do not enter more than line 14. Figure the credit by using the amount on line 3
Pless $60,000. See Table B in the instructions and attach credit evidence (see instructions).
u 16 Subtract line 15 from line 14. . . . . . . . . . . . . . . . . . . . . . . . . .
17 Credit for Federal gift taxes on pre-1977 gifts (section 2012) (attach computation) 17
a
18 Credit for foreign death taxes (from Schedule(s) pl. (Attach Form(s) 70S-CE.) 18
19 Credit for tax on prior transfers (from Schedule Q). . . . . . . . . . . . .. 19
20 Total (add lines 17,18, and 19). . . . . . . . . . . . . . . . . . . .
o
21 Net estate tax (subtract line 20 from line 16). . . . . . . . . . . . . .
n
22 Generation-skipping transfer taxes (from Schedule R. Part 2, line 10) .
23 Total transfer taxes (add lines 21 and 22) .............
24 Prior payments. Explain in an attached statement . . . . . . . . 24
25 United States Treasury bonds redeemed in payment of estate tax . . . . .. 25
26 Total (add lines 24 and 25) . . . . . . . . . . . . . . . . . . . . . . . . . .
27 Balance due (or over a ment) (subtract line 26 from line 23) ........
2
7c
8
0.00
13
14
15
16
0.00
0.00
0.00
0.00
0.00
-0-
239,354.14
0.00
239,354.14
220 550.00
18,804.14
18,804.14
0.00
0.00
0.00
0.00
0.00
N .A., Executor
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 executor Is based on ail Information of which preparer has any knowledge.
0.00
0.00
-----------------------------------------------------
-----------------------------------------------------
Signature of preparer other than executor
RGA
Copyright (c) 1999 form software only The Lackner Group, Inc.
Address (and ZIP code)
L,..;I c/,~ )...
~ f
Date
Date
Form 706 (Rev. 7-99)
Form 706 (Rev. 11-01)
Estate of:
Sylvia K. Grosz
SS# 194-56-2293 09/11/2001
Part 3 - Elections by the Executor
Please check the "Yes" or "No" box for each question. (See instructions be Yes No
1 Do you elect alternate valuation? . . . . . . . . . . . 1 X
2 Do you elect special use valuation? . . . . . . . . . . 2 X
If "Yes: you must complete and attach Schedule A-1.
3 Do you elect to pay the taxes in installments as described in section 6166? . . . . . . . . . . . . . . . . . . . . . . . . . .
If "Yes," you must attach the additional information described on page 8 of the instructions.
4 Do ou elect to ost one the art of the taxes attributable to a reversiona or remainder interest as described in section 61637
Part 4 - General Information (Note: Please attach the necessary supplemental documents. You must attach the death certificate.)
(See instructions beginning on page 9.)
Authorization to receive confidential tax information under Regs. sec. 601.504(bX2)(i); to act as the estate's representative before the IRS; and to make
written or oral presentations on behalf of the estate if return prepared by an attorney. accountant, or enrolled agent for the executor:
Name of representative (print or type)
Address (number. street, and room or suite no., city, state, and ZIP code)
I declare that I am the attorney/ certified public accountant! enrolled agent (you must check the applicable box) for the executor
and prepared this return for the executor. I am not under suspension or disbarment from practice before the Internal Revenue Service and am qualified
to practice in the state shown above.
Signature CAF number Date Telephone number
1 Death certificate number and issuing authority (attach a copy of the death certificate to this return).
7622137/Cornmonwealth of PA
2 Decedent's business or occupation. If retired, check here" 0 and state decedent's former business or occupation.
Housewife
3 Marital status of the decedent at time of death:
o Married
~ Widow or widower - Name, SSN, and date of death of deceased spouse .. _ _ g }._~:t;~!1_C: ~ _ ~_~r:~~_1: _ g~_~~ ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
----------------------------------------}.-~~:}.-~:~~-~~-----~~~~?!_~~?~-------------------------------
Single
Legally separated
Divorced - Date divorce decree became final ..
4a Surviving spouse's name
4b Social security number 4c Amount received (see page 9 of instructions)
0.00
5 Individuals (other than the surviving spouse), trusts, or other estates who receive benefits from the estate (do not include charitable beneficiaries
shown in Schedule 0) (see instructions). For Privacy Act Notice (applicable to individual beneficiaries only), see the Instructions for Form 1040.
Name of Individual, trust. or estate receiving $5,000 or more Identifying number Relationship to decedent Amount (see instructions)
Linda J. Cheskey 182-40-7811 N i ec e P-/2 Share of
Residue
314,011.00
Terry L. Tidd 182-40-7810 N i ec e 1/2 Share of
Residue
314,010.99
Creeden E. Sunday 172-26-9693 Brother 48,900.00
Dolores W. Sunday 202-20-6130 Sister-in- 48,900.00
Law
All unascertainable beneficiaries and those who receive less than $5,000. . . . . . . . . . . . . . . . . . . . . . . . . ...
Total. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Please check the "Yes" or "No" box for each question.
6 Does the gross estate contain any section 2044 roperty (qualified terminable Interest property (QTIP from a prior gift or estate) (see page 9 of the InstructJons)?
(continued on next page)
Copyright (c) 2001 form software only The Lackner Group,lnc.
725,821.99
Yes No
X
Page 2
Form 706 (Rev. 11-01)
Form 706 (Rev. 7-99)
Part 4 - General Information (continued)
Estate of S 1via K. Grosz
Please check the "Yes" or "No" box for each question.
7a Have Federal gift tax returns ever been filed? . . . . . , . . . . . . , , . . . . . . . . . . .
If 'Yes," please attach copies of the returns, if available, and furnish the following information:
7b Period(s) covered 7c Internal Revenue office(s) where filed
If you answer "Yes" to any of questions 8-16, you must attach additional information as described in the instructions.
8a Was there any insurance on the decedent's life that is not included on the return as part of the gross estate? . . , , , , , . , .
b Did the decedent own any insurance on the life of another that /s not included in the gross estate? . . . , . . .
9 Old the decedent at the time of death own any property as a joint tenant with right of survivorship in which (a) one or more of the other joint tenants was
someone other than the decedent's spouse. and (b) less than the full value of the property is included on the return as part of the gross estate? If "Yes,"
you must complete and attach Schedule E , . . , , , . . . . . , . . , . , . . . , , . . , . , . . . . . , . . , , . , . . . , , . . . .
x
10
Did the decedent, at the time of death, own any interest in a partnership or unincorporated business or any stock in an inactive
or closely held corporation?, .,.." .."...,..,....,.,......,.......
x
11 Did the decedent make any transfer described in section 2035. 2036, 2037, or 2038 (see the instructions for Schedule G beginning on page 11 of the
separate instructions)? If "Yes," you must complete and attach Schedule G .,.,....,....,."......,.....,.
12 Were there /n existence at the time of the decedent's death:
a Any trusts created by the decedent during his or her lifetime? . . . , . . , . . . . . , . , . . . . ' . . . . . .
b Any trusts not created by the decedent under which the decedent possessed any power, beneficial interest, or trusteeship?
13 Did the decedent ever possess. exercise. or release any general power of appointment? If "Yes," you must complete and attach Schedule H
14 Was the marital deduction computed under the transitional rule of Public Law 97 -34, section 403(eX3)(Economic Recovery Tax Act of 1981)?
If "Yes," attach a separate computation of the marital deduction, enter the amount on item 20 of the Recapitulation, and note on item 20 'computatlon
attached."
15 Was the decedent. immediately before death, receiving an annuity described In the "General" paragraph of the Instructions for Schedule I?
16
If 'Yes." you must complete and attach Schedule I . , . , , . . . . . . . . . , . , , . . , . , , . . , , . , , . , , ,
Was the decedent ever the beneficiary of a trust for which a deduction was claimed by the estate of a pre-deceased spouse under
section 2056(b)(7) and which is not reported on this return? If"Yes,"youmustattachanexplanatfon, . . . , . , , . . ,
x
x
Part 5 - Recapitulation
Item Gross estate Alternate value Value at date of death
number
1 Schedule A - Real Estate 1 0.00 0.00
2 Schedule B - Stocks and Bonds ' 2 388,201.91 412,572.56
3 Schedule C - Mortgages, Notes, and Cash 3 237,643.07 237,643.07
4 Schedule D - Insurance on the Decedent's Life (attach Form(s) 712), 4 0.00 0.00
5 Schedule E - Jointly Owned Property (attach Form(s) 712 for life insurance) . 5 0.00 0.00
6 Schedule F - Other Miscellaneous Property (attach Form(s) 712 for life insurance) . 6 2,509.75 2,509.75
7 Schedule G - Transfers During Decedent's Life (attach Form(s) 712 for life insurance) 7 97,800.00 97,800.00
8 Schedule H - Powers of Appointment 8 0.00 0.00
9 Schedule I - Annuities, 9 8,681. 52 8,681. 52
10 Total qross estate (add items 1 throuqh 9) . 10 734,836.25 759 206.90
11 Schedule U - Qualified Conservation Easement Exclusion 11 0.00 0.00
12 Total gross estate less exclusion (subtract item 11 from item 10). Enter here and
on line 1 of Part 2 - Tax Computation 12 734,836.25 759,206.90
Item
number Deductions Amount
13 Schedule J - Funeral Expenses and Expenses Incurred in Administering Property Subject to Claims 13 8,327.00
14 Schedule K - Debts of the Decedent 14 687.26
15 Schedule K - Mortgages and Liens . 15 0.00
16 Total of items 13 through 15 16 9,014.26
17 Allowable amount of deductions from item 16 (see the instructions for item 17 of the Recapitulation) 17 9,014.26
18 Schedule L - Net Losses During Administration . 18 0.00
19 Schedule L - Expenses Incurred in Administering Property Not Subject to Claims 19 0.00
20 Schedule M - Bequests, etc" to Surviving Spouse 20 0.00
21 Schedule 0 - Charitable, Public, and Similar Gifts and Bequests 21 0.00
22 Schedule T - Qualified Family-Owned Business Interest Deduction. 22 0.00
23 Total allowable deductions (add items 17 throuqh 22). Enter here and on line 2 of the Tax Computation 23 9 014.26
Page 3
Copyright (c) 1999 form software only The Lackner Group, Inc,
Form 706 {Rev, 7-99)
Forl"Q 706 (Re". 7-99)
Estate of:
SS# 194-56-2293 09/11/2001
SCHEDULE A - Real Estate
. For jointly owned property that must be disclosed on Schedule E, see the instructions on the reverse side of Schedule E.
. Real estate that is part of a sole proprietorship should be shown on Schedule F.
. Real estate that is included in the gross estate under section 2035, 2036, 2037, or 2038 should be shown on Schedule G.
. Real estate that is included in the gross estate under section 2041 should be shown on Schedule H.
. If you elect section 2032A valuation, you must complete Schedule A and Schedule A-1.
Sylvia K. Grosz
Item Description Alternate Alternate value Value at date of death
number valuation date
/ /
.-
Total from continuation schedules or additional sheets attached to this schedule.
TOTAL. (Also enter on Part 5, Recapitulation, paae 3, at item 1.) . 0.00 0.00
(If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.)
(See the instructions on the reverse side.)
Copyright (c) 1999 form software only The Lackner Group,lnc.
Schedule A - Page 4
Form 706 Schedule A (Rev. 7-99)
Form 706 (l1ev. 7-99)
Estate of: Sylvia K. Grosz
SS# 194-56-2293 09/11/2001
SCHEDULE B - Stocks and Bonds
(For jointly owned property that must be disclosed on Schedule E. see the instructions for Schedule E.)
Item Description including face amount of bonds or Unit value Alternate Alternate value Value at date of death
number number of shares and par value where needed for valuation date
identification. Give 9-dlalt CUSIP number.
1 13,482 shares Allied Irish Bks Plc 21.04 0/16/01 273,098.13 283,661.28
Spans ADS
Accrued Dividend on Item 111 ~0/16/01 3,758.78 3,758.78
@ $.2788 per share
Record Date 8/10/2001
Payable Date 9/28/2001
CUSIP #019228402
2 3,000 shares PPL Corp. 41.4525 ~0/16/01 1l0,550.00 124,357.50
Accrued Dividend on Item Ij2 ~0/16/01 795.00 795.00
@ $.265 per share
Record Date 9/10/2001
Payable Date 10/01/2001
CUSIP #709051106
Total from continuation schedules (or additional sheets) attached to this schedule
TOTAL. (Also enter on Part S. Recapitulation. paCle 3. at item 2.). . . . . . . . . . . . . . . .
388.201.91
412.572.56
(If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.)
(The instructions to Schedule B are in the separate instructions.)
Copyright (c) 1999 form software only The Lackner Group,lnc.
Schedule B - Page 12
Form 706 Schedule B (Rev. 7-99)
Forl'T] 706 (Re'l:. 11-01)
Estate of:
Sylvia K. Grosz
SS# 194-56-2293 09/11/2001
SCHEDULE C - Mortgages, Notes, and Cash
(For jointly owned property that must be disclosed on Schedule E. see the instructions for Schedule E.)
Item Description Alternate Alternate value Value at date of death
number valuation date
1 $10,000 Allfirst Bank Certificate of 01/16/02 10,000.00 10,000.00
Deposit #87008000132168 5.10% due 1/16/02
Accrued Interest 01/16/02 37.73 37.73
2 $10,000 Allfirst Bank Certificate of 03/11/02 10,000.00 10,000.00
Deposit #87008000146118 4.96% due 10/21/02
Accrued Interest 03/11/02 29.90 29.90
3 $10,000 Allfirst Bank Certificate of 03/11/02 10,000.00 10,000.00
Depos it #87008000149753 5.87% due 5/13/05
Accrued Interest 03/11/02 48.25 48.25
4 $10,000 Al1first Bank Certficate of 03/11/02 10,000.00 10,000.00
Deposit #87008000149761 5.87% due 5/13/05
Accrued Interest 03/11/02 48.25 48.25
5 $11,305.37 First Union Certficate of 02/06/02 11,305.37 11,305.37
Deposit #247412061015824 6.16% due 2/6/02
Accrued Interest 02/06/02 485.17 485.17
6 $12,538.25 First Union Certficate of 02/07/02 12,538.25 12,538.25
Deposit #247412065787506 4.16% due 2/7/02
Accrued Interest 02/07/02 51.55 51.55
7 $15,000 Al1first Bank Certificate of 03/11/02 15,000.00 15,000.00
Deposit #80000002027571 4.93% due 11/27/01
Accrued Interest 03/11/02 32.42 32.42
8 $16,800.57 First Union Certificate of 03/11/02 16,800.57 16,800.57
Deposit #247412050817267 3.88% due 6/19/03
Accrued Interest 03/11/02 98.51 98.51
9 $17,429.15 First Union Certificate of 01/16/02 17,429.15 17,429.15
Deposit #247412066196884 4.31% due 1/16/02
Accrued Interest 01/16/02 498.85 498.85
Total from continuation schedules (or additional sheets) attached to this schedule. . . . . . . 123 239.10 123 239.10
TOTAL. (Also enter on Part 5, Recapitulation, paqe 3, at item 3.). . . . . . . . . . . . . . . . 237 643.07 237,643.07
(If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.)
(See the instructions on the reverse side.)
Copyright (c) 2001 form software only The Lackner Group,lnc.
Schedule C - Page 13
Form 706 Schedule C (Rev. 11-01)
state of: Sylvia K. Grosz
oc Sec #: 194-56-2293
ate of Death: 09/11/2001
Continuation of Schedule C
(Mortgages, Notes, and Cash)
tern Description Alternate Alternate Value at
11 For securities, give CUSIP 11. Val. Date Value Date of Death
10 $19,951.46 First Union Certificate of 03/11/02 19,951.46 19,951. 46
Deposit #247412059786949 3.93% due 8/13/02
Accrued Interest 03/11/02 263.79 263.79
11 $20,000 A11first Bank Certificate of 12/20/01 20,000.00 20,000.00
Deposit #80000002027611 5.10% due 12/20/01
Accrued Interest 12/20/01 64.27 64.27
12 $25,000 A11first Bank Certificate of 03/11/02 25,000.00 25,000.00
Deposit #87008000147424 3.94% due 11/22/03
Accrued Interest 03/11/02 56.67 56.67
13 $27,242.85 First Union Certificate of 03/01/02 27,242.85 27,242.85
Deposit #247412063684196 4.31% due 3/1/02
Accrued Interest 03/01/02 634.54 634.54
14 A11first Bank Checking Account 110038902176 03/11/02 24,438.90 24,438.90
Accrued Interest 03/11/02 6.43 6.43
15 First Union Checking Account 03/11/02 5,224.90 5,224.90
111010008160371
Accrued Interest 03/11/02 0.77 0.77
16 Myers-Harner Funeral Home - Refund 03/11/02 354.52 354.52
-------------- ---..----------
123,239.10 123,239.10
-==
For.m 706 (R~v. 7-99)
Estate of:
Sylvia K. Grosz SS# 194-56-2293 09/11/2001
SCHEDULE D - Insurance on the Decedent's Life
You must list all policies on the life of the decedent and attach a Form 712 for each policy.
Item Description Alternate Alternate value Value at date of death
number valuation date
Total from continuation schedules (or additional sheets) attached to this schedule
TOTAL. (Also enter on Part 5, Recapitulation, paqe 3. at item 4.) . 0.00 0.00
(If more space is needed. attach the continuation schedule from the end of this package or additional sheets of the same size.)
(See the instructions on the reverse side.)
Copyright (c) 1999 form software only The Lackner Group,lnc.
Schedule D - Page 15
Form 706 Schedule D (Rev. 7-99)
Fq,rm 706 (l1ev. 7-99)
Estate of: Sylvia K. Grosz SS# 194-56-2293 09/11/2001
SCHEDULE E - Jointly Owned Property
(If you elect section 2032A valuation, you must complete Schedule E and Schedule A-1.)
PART 1. - Qualified Joint Interests - Interests Held by the Decedent and His or Her Spouse as the Only Joint
Tenants (Section 2040(bX2))
Item Description Alternate Alternate value Value at date of death
number For securities, give CUSIP number. valuation date
Total from continuation schedules (or additional sheets) attached to this schedule
1a Totals 0.00 0.00
1b Amounts included in qross estate (one-half of line 1a) 0.00 0.00
PART 2. - All Other Joint Interests
2a State the name and address of each surviving co-tenant. If there are more than three surviving co-tenants, list the additional co-tenants on an
attached sheet.
Name Address (number and street, city, state, and ZIP code)
A.
B.
C.
Item Enter Description Percentage Includible Includible
number letter for (including alternate valuation date if any) includible alternate value .alue at date of death
co-tenant For securities. give CUSIP number.
Total from continuation schedules (or additional sheets) attached to this schedule
2b Total other ioint interests . 0.00 0.00
3 Total ineludible joint interests (add lines 1b and 2b).
Also enter on Part 5, Reeapitulation, paqe 3, at item 5 0.00 0.00
(If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.)
(See the instructions on the reverse side.)
Copyright (c) 1999 form software only The Lackner Group, Inc.
Sehedule E - Page 17
Form 706 Schedule E (Rev. 7-99)
FQrm 706 (l3ev. 7-99)
Estate of: Sylvia K. Grosz SSff 194-56-2293 09/11/2001
SCHEDULE F - Other Miscellaneous Property Not Reportable Under Any Other Schedule
(For jointly owned property that must be disclosed on Schedule E, see the instructions for Schedule E.)
(If you elect section 2032A valuation, you must complete Schedule F and Schedule A-1.)
Did the decedent at the time of death own any articles of artistic or collectible value in excess of $3,000 or any collections whose
artistic or collectible value combined at date of death exceeded $10,OOO? . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If "Yes," submit full details on this schedule and attach appraisals.
2 Has the decedent's estate, spouse, or any other person, received (or will receive) any bonus or award as a result of the decedent's
employment or death? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If "Yes," submit full details on this schedule.
3 Did the decedent at the time of death have, or have access to, a safe deposit box? . . . . . . . . . . . . . . . . . . . . . . . . . . .
If "Yes," state location, and if held in joint names of decedent and another, state name and relationship of joint depositor.
Allfirst Bank Box ff1473-9
West Shore Plaza Joint with Mark L. K. Grosz,
Camp Hill, PA 17011 Brother-in-Law
If any of the contents of the safe deposit box are omitted from the schedules in this return, explain fully why omitted.
None
Item Description
number For securities, give CUSIP number.
Alternate
valuation date
Alternate value
1 Personal Property - Appraised Value
03/11/02
1,880.00
Value at date of death
1,880.00
2 Blair Co. - Merchandise Refund
03/11/02
104.70
3. Harleysville Insurance - Premium Refund
Homeowners Policy
03/11/02
30.00
4 Paula Young - Merchandise Refund
03/11/02
87.00
5 Patriot News - Subscription Refund
03/11/02
83.05
6 U. S. Treasury - 2001 Tax Relief Check
03/11/02
300.00
7 Prevacid - Product Rebate
03/11/02
25.00
Total from continuation schedules (or additional sheets) attached to this schedule
TOTAL. (Also enter on Part 5, Reca itulation, a e 3, at item 6.). . . . . . . . . . . . . . . . 2 509.75
(If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.)
(See the instructions on the reverse side.)
104.70
30.00
87.00
83.05
300.00
25.00
2 509.75
Copyright (c) 1999 form software only The Lackner Group, Inc.
Schedule F - Page 19
Form 706 Schedule F (Rev. 7 -99)
Form 706 (~ev. 7-99)
Estate of:
Sylvia K. Grosz ssg 194-56-2293 09/11/2001
SCHEDULE G - Transfers During Decedent's Life
(If you elect section 2032A valuation, you must complete Schedule G and Schedule A-1.)
Item Description Alternate Alternate value Value at date of death
number For securities, give CUSIP number. valuation date
A. Gift tax paid by the decedent or the estate for all gifts made by the
decedent or his or her spouse within 3 years before the decedent's
death (section 2035(b)). . . . . . . . . . . . . . . . . . . . . . . . .
B. Transfers includible under section 2035(a), 2036, 2037, or 2038:
Residence Property at 229 South 15th St. , 97,800.00 97,800.00
Camp Hill, PA. On 10/3/91, the decedent
transferred all of her title and interest
in her residence property to her brother,
Creeden E. Sunday and Dolores W. Sunday,
his wife, but the decedent continued to
occupy the residence rent free and
continued to pay all utilities, maintenance
taxes, and repairs on the residence.
An implied retained life estate is assumed.
Appraisal attached.
Total from continuation schedules (or additional sheets) attached to this schedule . . . . . .
TOTAL. (Also enter on Part 5, Recapitulation, paqe 3, at item 7.). . . . . . . . . . . . . . . 97,800.00 97 800.00
Item Description Alternate Alternate value Value at date of death
number valuation date
Total from continuation schedules (or additional sheets) attached to this schedule
TOTAL. (Also enter on Part 5, Recapitulation, paqe 3, at item 8.) . 0.00 0.00
SCHEDULE H - Powers of Appointment
(Include "5 and 5 lapsing" powers (section 2041(bX2)) held by the decedent.)
(If you elect section 2032A valuation, you must complete Schedule H and Schedule A-1.)
(If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.)
(The instructions to Schedules G and H are in the separate instructions.)
Copyright (c) 1999 form software only The Lackner Group, Inc.
Schedules G and H - Page 21
Form 706 Schedules G and H (Rev. 7-99)
FQrm 706 (F3ev. 7-99)
Estate of:
Sylvia K. Grosz
SS# 194-56-2293 09/11/2001
SCHEDULE I - Annuities
Note: Generally, no exclusion is allowed for the estates of decedents dying after December 31, 1984 (see page 15 of the instructions).
A
Are you excluding from the decedent's gross estate the value of a lump-sum distribution described in section 2039(fX2)? .
If "Yes," you must attach the information required by the instructions.
Item Description
number Show the entire value of the annuity before any exclusions.
Alternate
valuation date
Includible
alternate value
Includible
value at date of death
1 Madison National Life - Annuity Contract
ffMA2705 -
Beneficiary: Myers-Harner Funeral Home
03/11/02
8,681. 52
8,681. 52
Total from continuation schedules (or additional sheets) attached to this schedule
TOTAL. (Also enter on Part 5, Reca itulation, a e 3, at item 9.). . . . . . . . . . . . . . . . 8 681.52 8 681.52
(If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.)
Schedule I - Page 22 (The instructions to Schedule I are in the separate instructions.)
Copyright (c) 1999 form software only The Lackner Group, Inc. Form 706 Schedule I (Rev. 7-99)
Form 706.!Rev. 7-99)
Estate of:
Sylvia K. Grosz
SS# 194-56-2293 09/11/2001
SCHEDULE J -
Funeral Expenses and Expenses Incurred in Administering Property Subject to Claims
Note: Do not list on this schedule expenses of administering property not subject to claims. For those expenses, see the instructions for Schedule L.
If executors' commissions, attorney fees, etc., are claimed and allowed as a deduction for estate tax purposes, they are not allowable as a deduction in
computing the taxable income of the estate for Federal income tax purposes. They are allowable as an income tax deduction on Form 1041 if a waiver
is filed to waive the deduction on Form 706 (see the Form 1041 instructions).
Item
number
Description
Expense amount
Total amount
1
A. Funeral expenses:
Myers-Harner Funeral Home
8,327.00
Total funeral expenses. _........ _ _ _~ ~ ~?}..: 99__
B. Administration expenses:
Executors' commissions - amount ~ (Strike out the words that do not apply.).
1041 Deduction
2
Attorney fees .. amoun~(Strike out the words that do not apply.)
1041 Decuction
3 Accountant fees - amount~(Strike out the words that do not apply.).
4
Miscellaneous expenses:
1041 Deductions
Expense amount
Total miscellaneous expenses from continuation schedules (or additional sheets)
attached to this schedule.
Total miscellaneous expenses.
0.00
0.00
TOTAL. (Also enter on Part 5, Recapitulation, paqe 3, at item 13.).
8.327.00
(If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.)
(See the instructions on the reverse side.)
Copyright (c) 1999 form software only The Lackner Group, Inc.
Schedule J - Page 23
Form 706 ScheduJeJ (Rev. 7-99)
F,orm 706 (,Rev. 7-99)
Estate of:
Sylvia K. Grosz
SS# 194-56-2293 09/11/2001
SCHEDULE K - Debts of the Decedent, and Mortgages and Liens
Item Debts of the Decedent - Creditor and nature of claim.
number and allowable death taxes
Amount unpaid to date
Amount In contest
1 AT&T Corporation - Telephone
Expense
o
2 Borough of Camp Hill - Utility
Expense
o
3 George M. Leader Family Corp -
Balance for Room Charges
o
4 PA American Water Company -
Utility Expense
o
5 Pennsylvania Dept of Revenue -
2001 Personal Income Tax
o
6 PPL Electric Utilities -
Electricity Expense
o
Total from continuation schedules (or additional sheets) attached to this schedule
TOTAL. (Also enter on Part 5. Recapitulation. paqe 3. at item 14.) . .
Item
number
Mortgages and Liens - Description
Total from continuation schedules (or additional sheets) attached to this schedule
TOTAL. (Also enter on Part 5. Recaoitulation. paqe 3. at item 15.) . . . . . . . .
(If more space is needed. attach the continuation schedule from the end of this package or additional sheets of the same size.)
(The instructions to Schedule K are in the separate instructions.)
Copyright (c) 1999 form software only The Lackner Group. Inc.
0.00
0.00
0.00
0.00
0.00
0.00
Amount claimed as
a deduction
5.03
60.00
87.05
34.45
175.00
89.55
236.18
687.26
Amount
0.00
Schedule K - Page 25
Form 706 ScheduleK (Rev. 7-99)
Estate of: Sylvia K. Grosz
Soc Sec #: 194-56-2293
Date of Death: 09/11/2001
Continuation of Schedule K-l
(Debts of the Decedent)
Item
/f
Description
Amt unpd
to date
Amt claimed as
Amt in contest a deduction
7
United States Treasury - 2001
Personal Income Tax
o
0.00 190.00
8
Verizon - Telephone Expense
o
0.00 37.54
9
York Waste Disposal Inc. - Utility
Expense
o
0.00 8.64
236.18
Form 706 (Rev. 7-99)
Estate of:
Sylvia K. Grosz SS# 194-56-2293 09/11/2001
SCHEDULE L - Net Losses During Administration and
Expenses Incurred in Administering Property Not Subject to Claims
Item Net losses during administration Amount
number (Note: Do not deduct losses claimed on a Federal income tax return.)
Total from continuation schedules (or additional sheets) attached to this schedule
TOTAL. (Also enter on Part 5. Recaoitulation. oace 3. at item 18.) 0.00
Item Expenses incurred in administering property not subject to claims Amount
number (Indicate whether estimated. agreed upon. or paid.)
Total from continuation schedules (or additional sheets) attached to this schedule
TOTAL. (Also enter on Part 5, Recaoitulation, oace 3, at item 19.) 0.00
(If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.)
Schedule L - Page 26 (The instructions to Schedule L are in the separate instructions.)
Copyright (c) 1999 form software only The Lackner Group, Inc. Form 706 Schedule L (Rev. 7-99)
Form 706 (Rev. 7-99)
Sylvia K. Grosz SSp 194-56-2293 09/11/2001
SCHEDULE M - Bequests, etc., to Surviving Spouse
Election To Deduct Qualified Terminable Interest Property Under Section 20S6(b)(7). If a trust (or other property) meets the requirements of
qualified terminable interest property under section 2056(b)(7), and
a. The trust or other property is listed on Schedule M, and
b. The value of the trust (or other property) is entered in whole or in part as a deduction on Schedule M,
then unless the executor specifically identifies the trust (all or a fractional portion or percentage) or other property to be excluded from the election,
the executor shall be deemed to have made an election to have such trust (or other property) treated as qualified terminable interest property under
section 2056(b)(7).
If less than the entire value of the trust (or other property) that the executor has included in the gross estate is entered as a deduction on Schedule
M, the executor shall be considered to have made an election only as to a fraction of the trust (or other property). The numerator of this fraction is
equal to the amount of the trust (or other property) deducted on Schedule M. The denominator is equal to the total value of the trust (or other property).
Election To Deduct Qualified Domestic Trust Property Under Section 20S6A. If a trust meets the requirements of a qualified domestic trust
under section 2056A(a) and this return is filed no later than 1 year after the time prescribed by law (including extensions) for filing the return, and
a. The entire value of a trust or trust property is listed on Schedule M, and
b. The entire value of the trust or trust property is entered as a deduction on Schedule M,
then unless the executor specifically identifies the trust to be excluded from the election, the executor shall be deemed to have made an election to
have the entire trust treated as qualified domestic trust property.
Estate of:
Did any property pass to the surviving spouse as a result of a qualified disclaimer? . . . . . . . . . . . . . . . . . . . . . .
If "Yes," attach a copy of the written disclaimer required by section 2518(b).
2a In what country was the surviving spouse born?
b What is the surviving spouse's date of birth? /
c Is the surviving spouse a U.S. citizen? . . . . . . . . . . . . . .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
d If the surviving spouse is a naturalized citizen, when did the surviving spouse acquire citizenship?
e If the surviving spouse is not a U.S. citizen, of what country is the surviving spouse a citizen?
3 Election out of QTIP Treatment of Annuities. - Do you elect under section 2056(b)(7)(C)(ii) not to treat as qualified terminable
interest property any joint and survivor annuities that are included in the gross estate and would otherwise be treated as qualified
terminable interest ro e under section 2056(b)(7)(C)? (see instructions). . . . . . . . . . . . . .. ...........
Item
number
Description of property interests passing to surviving spouse
Amount
Altern. Value
Total from continuation schedules (or additional sheets) attached to this schedule
0.00
4
Total amount of property interests listed on Schedule M
Sa Federal estate taxes payable out of property interests listed on Schedule M . . . .. Sa
b Other death taxes payable out of property interests listed on Schedule M Sb
c Federal and state GST taxes payable out of property interests listed on Schedule M Sc
d Add items Sa, b, and c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 Net amount of property interests listed on Schedule M (subtract 5d from 4). Also enter on Part 5, Recapitulation,
a e 3, at item 20 ............................................ 6
(If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.)
(See instructions on the reverse side.)
Copyright (c) 1999 form software only The Lackner Group, Inc.
0.00
0.00
Schedule M - Page 27
Form 706 Schedule M (Rev. 7-99)
Form 706 (Rev. 7-99)
Estate of:
Sylvia K. Grosz SS# 194-56-2293 09/11/2001
SCHEDULE 0 - Charitable, Public, and Similar Gifts and Bequests
Yes No
1a If the transfer was made by will, has any action been instituted to have interpreted or to contest the will or any of its provisions
affecting the charitable deductions claimed in this schedule? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If "Ves," full details must be submitted with this schedule.
2
Did any property pass to charity as the result of a qualified disclaimer? .
If "Ves," attach a copy of the written disclaimer required by section 2518(b).
b According to the information and belief of the person or persons filing this return, is any such action planned? .
If "Ves," full details must be submitted with this schedule.
Item
number
Name and address of beneficiary
Character of institution
Amount
Altern. Value
Total from continuation schedules (or additional sheets) attached to this schedule
0.00
3
Total. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
0.00
4a Federal estate tax payable out of property interests listed above
4a
0.00
b Other death taxes payable out of property interests listed above
4b
0.00
c Federal and state GST taxes payable out of property interests listed above.
4c
0.00
d Add items 4a, b, and c. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4d
0.00
5 Net value of property interests listed above (subtract 4d from 3). Also enter on Part 5, Recapitulation, page 3, at
item 21 ..................................................... 5
(If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size.)
(The instructions to Schedule 0 are in the separate instructions.)
0.00
Copyright (c) 1999 form software only The Lackner Group, Inc.
Schedule 0 - Page .31
Form 706 Schedule 0 (Rev. 7-99)
Form 706 (Rev. 7-99)
.
Estate of:
Sylvia K. Grosz SS# 194-56-2293 09/11/2001
SCHEDULE P - Credit for Foreign Death Taxes
List all foreign countries to which death taxes have been paid and for which a credit is claimed on this return.
If a credit is claimed for death taxes paid to more than one foreign country, compute the credit for taxes paid to one country on this sheet and
attach a separate copy of Schedule P for each of the other countries.
The credit computed on this sheet is for the
(Name of death tax or taxes)
imposed in
(Name of country)
Credit is computed under the
(I nsert title of treaty or .statutej
Citizenship (nationality) of decedent at time of death
(All amounts and values must be entered in United States money.)
1 Total of estate, inheritance, legacy, and succession taxes imposed in the country named above attributable to
property situated in that country, subjected to these taxes, and included in the gross estate (as defined by statute) . 1 0.00
2 Value of the gross estate (adjusted, if necessary, according to the instructions for item 2) 2 734,836.25
3 Value of property situated in that country, subjected to death taxes imposed in that country, and included in the
gross estate (adjusted, if necessary, according to the instructions for item 3) 3 0.00
4 Tax imposed by section 2001 reduced by the total credits claimed under sections 2010,2011, and 2012 (see
instructions) 4 0.00
5 Amount of Federal estate tax attributable to property specified at item 3. (Divide item 3 by item 2 and multiply the
result by item 4.) 5 0.00
6 Credit for death taxes imposed in the country named above (the smaller of item 1 or item 5). Also enter on line 18
of Part 2, Tax Comcutation . 6 0.00
SCHEDULE Q - Credit for Tax on Prior Transfers
Part 1 - Transferor Information
Name of transferor Social security number I RS office where estate Date of death
tax return was flied
A
B
C
Check here ~D if section 2013(f) (special valuation of farm, etc., real property) adjustments to the computation of the credit were made (see
page 18 of the instructions).
Part 2 - Computation of Credit (see instructions be
Item
18)
Transferor
A
B
C
Transferee's tax as apportioned (from
worksheet, (line 7 ~ line 8) X line 35 for
each column) . . . . . . . . . . . .
2 Transferor's tax (from each column of
worksheet, line 20). . . . . . . . . .
3 Maximum amount before percentage re-
quirement (for each column, enter amount
from line 1 or 2, whichever is smaller) .
4 Percentage allowed (each column) (see
'instructions) . . . , . . . , . . , . . .
5 Credit allowable (line 3 X line 4 for each
column) . . . . . . . . . . . . . . , . .
6 TOTAL credit allowable (add columns A.
B, and C of line 5). Enter here and on
line 19 of Part 2. Tax Com utation
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00 %
0.00 %
0.00
Schedules P and Q - Page 32
Copyright (c) 1999 form software only The Lackner Group, Inc.
0.00
(The instructions to Schedules P and Q are in the separate instructions.)
Form 706 Schedules P and Q (Rev. 7-99)
; 110", )Hl'i RFV' 1/1;((.
Th~~ is (0 certify that the information here give~ is correctly copi~d rrol~ an onginal cc.~tifi(;lte of death duly filed with me as
Local Registrar. The original certificate will be torwarded to the State Vital Records Otflce tor permanent tiling.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
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J>.
r,tlary Report
,rl/IlIon
UNIFORM RESIDENTIAL APPRAISAL REPORT
File No. 01100214
"!
..,y'Add,ess229 S.15th Street City Camp-'":Ii11____ ___ Slate PA Zip Code. . 17011___
....,;i Description Attached-' . County Cumberland" "
Assessor's Parcel No. 01-22-0826-089 Tax YearOOI01 R.E Taxes $ 1,769.00Speclal Assessments $ N/A
Borrower NIA.. CurrenIOwnerEstateofSylv!~~r:o~z Occupant r--'Owner flTenant iXlVjlCltnL
Property' rights appraised 1 X i Fee Simple: i Leasehold Project Type l- ,PIJD I I Co!,dominium (f-\UDNA only) HOAS NI~_-- -- /Mo
Neighborhood or Project Name Camp Hill Borough Map ReferenceADC Map 20, A-2 Census Tract 010513240
.t. Sale Price $ NIA Date of Sale NIA Descriphon and $ amount of loan charges/concessions to be paid by seller None
~: Lender/Client Allfirst Trust Address P. O. Box 190 Carlisle, PA 17013
1; Aooraiser ChristoDher M. Jones SRA Address 7800 Allentown Boulevard Harrisburn PA 17112
--: Location Urban X Suburban Rural pre. dominant SiJ1~\e family housiWl Present land use % Land. use change
Built up X Over 75% .25-75% Under 25% occupancy t'&o1 ty~s1 One family 85. X .Not I",ely likely
'.,GlOwthrate ,Rapid X,Stable I ,Slow iX.Owner _ 65 Low 60 2-4 family 0 :rnprocess
?~ Property value L- i1ncreasing :_~jStable [__~Declining \ Tenant 130": .High 90 Multi-family 0 To: n_
;:, Demandlsupply ~J Shortage ~ In balance;...JOYer suPPlY i X ;Vacant (0-5%) Predominant Commercial 15
r'Marketinotime : Under 3 mos. X 3-6 mos. I iOYer6mos. --'Vacanl(over5% 100":- 75":- lvacLand 0
Note: Race and the racial composition of the neighborhood are not appraisal factors.
Neighborhood boundaries and characteristics: Market Street to the north, Lemoyne Borough to the east, State Street to the south and 17th
Street to the west. This is the southeastern section of the Borough.
Factors that affect the marketability of the properties in the neighborhood (proximity to employment and amenities, employment stability. appeal 10 market. elc.):
The subject is located in Camp Hill Borough, Cumberland County. The area has. good access to employment and necessary supporting
services are available in the borough. Much of the employment for the region is considered to be in the metro Harrisburg/Camp Hill area.
The aforementioned boundaries encompass a section of the township with similar dwellings. There are commercial uses along the
bordering areas except to the west, which is residential. These are mostly supporting shopping and professional offices and do not have a
negative impact.
Markel conditions in the subject neighborhood (including support for the above conclusions relaled to lhe trend of property values, demand/supply. and marketing time
- . such as data on competitive properties lor sale in the neighborhood, description of the prevalence of sales and financing concessions, etc.)
County tax assessment records and multi-list statistics for the neighborhood indicate that the neighborhood price range is stable. The
multi-list service also indicates a narrow list to sale price ratio of 97% with an average marketing time of less than 120 days. Recently
interest rates have remained constant at their current relatively low rates and are expected to remain at the current levels through the
remainder of the fourth quarter of 2001. Presently financing is readily available and seller concessions are not prevalent.
. ,~
::l Project Information for PUOs (If applicable) - -Is the developer/builder in control 01 the Home Owner's Association (HOA)? Yes X No
:I Approximate total number of units in the subject project NIA Approximate lotal number of units for sale in the subject project NIA
Describe common elements and recreational facilities: NIA
DimenSIOns 40 x 150 x 40 x 150 _ Topography Level at street grade
Site area .14 acre 6,000 square feet Corner Lot Yes 'X- No Size Average for the area
Specific zoning classification and description R2 - Limited Multi-Family Shape Rectangular
Zoning compliance X, Legal! 'Legal nonconfonnrng (Grandfathered use) r -Illegal I No zoning Drainage Average lor the area
Hiahest & best use as imoroved: X: Present use, fOther use (exolain) View Houses&ShoppingCenter.
,', Utilities Public Other Off-site Improvements Type Public Privale Landscaping Average lot the area
" Electricity X 100 Amperes Street Asphalt ,_~ ' _~ Driveway surface Alley
~ Gas X Curb/gutter Concrete _ u ,.!j Apparent easements Normal utility _
"Water X Sidewalk Concrete X, -: FEMA Special Flood Hazard Area ;-~ Yes X: No
.:' Sanitary sewer X Street lights Yes X FEMA Zone Zone C Map Date 12-11,1981.
Storm sewer X AIIev Rear , X ' FEMA Man No. 420357 0001 B
Comments (apparent adverse easements, encroachments, special assessments, slide ..eas, illegal Of legal nonconforming zoning use, elc.)' There are no apparent
adverse easements, encroachments or other special assessment conditions noted during the inspection.
GENERAL DESCRIPTION EXTERIOR DESCRIPTION
No. of Units One Foundation Conc Block
No. of Stories 1.50 Exterior Walls Brick
I.. Type (DeUAIt) Detached Roof Surface AspShingles
Design (Style) 2StyCpCd Gutlers & Dwnspts. Galvanized
Existing/Proposed Existing Window Type Wood DIH
Age (Yrs) 80 Storm/Screens X 1 X
Effective Aoe Yrs,) 30 Manufactured House No
ROOMS Foyer living Dining Kitchen _. Den
Basement
. Level 1 1 1 1
Level 2
FOUNDATION
Slab None
Crawl Space None
Basement Yes
Sump Pump None
Dampness See Comm
Settlement No Evidence
Infestation No Evidence
Family Rm. R~c, Rm. Bedrooms # Baths
BASEMENT
Area Sq Ft
% Finished
Ceiling
Walls
Floor
Outside Entry
INSULATION
740 Roof
-0- Ceiling
Exposed Jst Walls
Block Floor
Concrete None
Yes-Door Unknown
Concl
C onel
None
\
iKJ
j X,
:-Xl
2 1
Laundry Other AreaSq. F:L_
740
740
475
. _. -- -------
I
il
II
if
'I
ii
Finished area above orade contains' 5 Rooms' 2 Bedroomls\: 1 Bathls" 1 215Souare Feet of Gross Livino Area-
INTERIOR Materials/Condition HEATING KITCHEN EQUIP. ATTIC AMENITIES CAR STORAGE:
Floors CP&Vn&HW/A Type HotWater Refrigerator _~. None ._ Fireplace(s)# Yes ; 1 None :
Walls PlasterlAverage Fuel Oil Range/Oven! J5 ; Slairs ,. Patio None .. I __ Garage
" Trrm/Finish Wood 1 Painted Condijion Ava. Disposal L_I Drop Stair I Deck None ~ Attached
~, Bath Floor Vinyl I Average COOLING Dishwasher I Scuttle IXl Porch Yes ! 2 I Detached XX
Bath Wainscot CeramiclAvg. Central None FanlHood Floor _ Fence N/A ,_ Built-In
, " Doors Wood / Painted Other N/A Microwave ~__; Heated , _. Pool None Carport
. Condition N/A WasherJDrver' Finished Drivewav Allev
'. Additional fealures (spec.al energy efficient ilems, etc): The garage is 10 x 16, 10 x 221ront porch, 8 x 14 rear porch, fireplace in the living
room.
Condition of the improvements, depreciation (physical, functional and eXlernal), repairs needed. quality of construction, remodeling/additions, etc
There were no functional. obsolescence noted at the time of the inspection. External will be considered lor the fact that the subject backs
upto a shopping center. The overall condition is reflected in the eflectiveage, there was some knob and tube wiring noted in the basement.
1 # of cars
"Adverse environmental conditions (such as. but not limited to. hazardous wastes, toxic substances, etc,) present in the improvements, on the site
:.' or in the immediate vicinity of the SUbject property: The subject property was built prior to 1978 and lead based paint may be preser:tL"n or In
the aroaertv. The aaaraiser is not an exnert see attached limitino conditions.
FreddIe MAC Form 70 6-93 Day One or015 for ~"dows. 1997 1 800-GE'. .()A V 1 PAGE 1 OF 2 Home Mae I-o,n, 1004 fl-9J,
Robert R. Jones Appraisers
.'-
File No. 01100214
.,'
28,000 Comments on Cost Approach (such as. source 01 cost estimate
site value. square loot calculation and lor HUD. VA and FmHA.
the estimated remaining economic life of the property):
See attached Scope tiS for additional comments on the Cost
Approach. See Floor plan for gross living area catculalions. _ -
"SITE VALUE. = $
,.pltED REPRODUCTION COST-NEW-OF IMPROVEMENTS:
.._~;;ing 1,215 Sq Ft. @ 69.68 = $ 84,661
8smt 740 Sq. Fl. @ 16.75 = 12,395
Porches, Fireplace 8,750
Garllge/CarpolI 160 Sq. Fl. @ 21.40 = , 3,~?~
Total Estimated Cost New . = $ 10.9,230
Physical Functional External
Less
~ Oepreciation 40,9611 2,500 = $ 43,461
f Oepreciated Value of Improvements. . = $ ---~~,?69
~: "As-is. Value of Sne Improvements. . . = $ _ 4,000
INDICATED VAL E BY C ST APPROACH....... ., 97800
ITEM SUBJECT COMPARABLE NO. COMPARABLE NO.2 COMPARABLE NO.3
Address 229 S. 15th Street 139 S. 15th Street 215 S. 15th Street 122 S. 16th Street
~~ ~~ ~~ ~~
Proximity to Subject .' . 0.10 MI NW 0.02 MI NW 0.13 Ml W
,: Sales Price $ N/A $ 103500 ' 105,500 97,000
Price/Gross Liv. Area $ 0 $ 99.52 ~:, :.;";t"-'\^i', $. 79.56 :'H $ 82.551"w ,!"~'~-,' ''"It)
Data and/or nspection Exterior Inspection Exterior Inspection Exterior Inspection
Verilication Source ssessment Rcrds MLSlAssessment Records MLSlAssessment Records MLS/Assessment Records
VALUE ADJUSTMENTS DESCRIPTION DESCRIPTION 'f.)$~ DESCRIPTION . (.ISM,_.I DESCRIPTION .(.)S ...,.,.......1
Sales or Financing Conventional 0 F.HA -2,500 F.HA 0
Concessions 93 dom 0 34 dom 0 102 dom 0
Date 01 Salemme IA 08-16-2001 0 04-28-2000 0 10.23.2000 0
Location Suburban Suburban 0 Suburban 0 Suburban 0
LeaseholdlFee Simple Fee Simple Fee Simple 0 Fee Simple 0 Fee Simple 0
Site .14 acre ,14 acre ij .14acre 0.14acre 0
VIew ouses&Comm. Houses&Comm. 0 t1ous,es&Comm. 0 Houses -3,000
Design and Appeal 2StyCpCd - Avg. 2StyCpCd . Avg. 0 2StyCpCd - Avg. 0 2StyCpCd - Avg. 0
OuafityofConstruclKlfl Brick - Average Vinyl- Average 1,500 Brick. Average 0 Alum.. Average 1,500
Age 80 est 80 est 0 80 est 0 80 est 0
Condition Average Good -3,500 Good .3,500 Average ()
Above Grade Total ISdrmsl Balhs TotaIIB.dr"'!l1 Balhs TotallBdrmsl Baths TotaIIBdrms..' Baths
Room Count 5 2 1 5 2 1 0 6 3 1 0 6 2 1 0
Gross Living Area .,1,215Sq Ft 1,040Sq Ft . __.3,50.0 , __.1,326Sq Ft -2,200 1,175Sq. Ft. 800
Basement & Finished 100% 1 0% 100% 1 0% 0 100% /0% 0 100% I 0% 0
Rooms Below Grade None None 0 None 0 None 0
Functional Utilny Average Average . _ _ Q !overage . 0 Average 0
Heating/Cooling HotWaterlNone F.W.A./ CA-2,~00 HotWaterlNone 0 HotWater/None 0
Energy Efficient Item Storm Units Storm Units 0 Storm Units 0 Storm Units 0
Garage/Carport 1 Car Detached None 1,000 1 Car Detached 0 2+ Car Detached .3.000
Porch. Patio. Deck. Porches Porch.LgSunRm .5,000 Deck.Patio 500 Porch 1,000
Fireplace(s). etc. l/Fireplace None 1,000 1/Fireplace 0 None 1,000
Fence. Pool. etc. None None 0 None 0 None
Other None None 0 None 0 None
Nel Adj. (total) $ -3,500 +. X $ -7,700 I 1+ X i- $
Adjusted Sales Price -7.30 % Net -=1.75 iNet
of Com arable 16.91 % Grs $ 100000 8.25 % Grs $ 97800 10.62 % Grs $
Comments on Sales Comparison (including the subject property's compatibility to the neighborhood, etc.) SEE ATTACHED ADDENDUM.
..'
.1,700
95 300
ITEM SUBJECT COMPARABLE NO. COMPARABLE NO.2 COMPARABLE NO.3
Dale. Price. and Dala None None None None
Source. for pnor sales ssessment Assessment Assessment Assessment
within ar of a Bisal Records Records Records Records
Analysis of any current agreement 01 sale. option. or listing 01 the subject property and analysis of any prior sales 01 subJect and comparables
within one year of the date 01 appraisal Other than the sale dates shown on the grid, I was unable to find any other transfer of the subject or
comparables over the past 12 months.
INDICATED VALUE BY SALES COMPARISON APPROACH. ..............,.,........... .. .... .... .. . . .... $ 97,000
INDICATED VALUE BY INCOME APPROACH" A licable EslimatedMarl<etRent$N/A /Mo. x Gross Rent Multi ier N/A ,,$ NIA
This appraisal is made X' as is' subject to repairs. alterations. insl)eClions or conditions listed below subject 10 completion per plans and speciflC3lions
Condilions of AppraIsal The appraisal is completed in the "AS IS" condition. The date of inspection is October 17,2001, the appraisal is
completed as of the date of death which was September ii, 2001.
Final Reconciliation The Sales Comparison Approach to value is considered to be the most accurate method of achieving an estimated
market value. The Cost Approach usually sets the high limit of value and is used to support the Sales Comparison Approach. The lack of
data to develop a monthly rent or multiplier forced the elimination of the Income Approach.
The purpose of this appraisal is 10 eshmale Ihe market value of Ihe real property Ihat Is Ihe subject of this report, based on ,he above conditions and the certification. contingent
and ijmil1ng conditions. and market value delinition thai are slated in the allached Freddie Mac Form 439IFanme Mae Form l004B (Revised 06/93 ).
I (WE) ESTIMATE THE MARKET VALUE. AS DEFINED. OF THE REAL PROPERTY THAT IS THE SUBJECT OF THIS REPORT, AS OF September 11, 2001
(WHICH IS THE OAT OF INSPECTION AND THE EFFECTIVE DATE OF THIS REPORT) TO BE $97,000
APPRAISER: SUPERVISORY APPRAISER (ONLY IF REQUIR.EO):
Signat~ Signature ' Did i Did Not
'. Name Christopher Narne Inspecl Property
~! Date Report Signed Date Report Signed.
State Certification 11 State PA State Certificahon 11 State
r
red Ie Mae FOl'm 0 6- :\.Y 6-93
.~
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APPRAISAL
. .
Personal Property of SYLVIA 1<. G-Ros 2 EST-4r~ ..t.:Zq Su:2.CfTJ{ 5T,cAHfJ/-//LL Pc9J
AUD94-L
Date /,0-//- I
VALUE
ITEM
VALUE
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iGast mill anll wrstamrnt
of
1, SYLVIA K. GROSZ, of229 South 15th Street, Camp Hill, 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 any and all
other wills and codicils heretofore made by me.
FIRST. I direct that all my just debts and funeral expenses be paid from my estate as
soon after my death as practically and conveniently may be done.
SECOND. I direct that my remains be interred within my family's burial plot located in
Westminister Memorial Gardens, Carlisle, Pennsylvania, beside my beloved husband, C. Ernest
Grosz.
THIRD. I authorize my personal representative to expend funds from my estate, in such
amounts as my personal representative shall consider necessary and desirable for the purchase,
erection and inscription of a suitable marker for my grave.
FOURTH. I give, devise and bequeath any and all tangible personal property owned by
me at the time of my death unto my nieces, Linda 1. Chesley and Terri L. Tidd, in equal shares,
per stirpes
FIFTH. I give, devise and bequeath any and all real estate owned by me at the time of my
death, unto my nieces, Linda J. Chesley and Terri L. Tidd, in equal shares, per stirpes
SIXTH. I give, devise and bequeath all the rest, residue and remainder of my estate unto
my nieces, Linda 1. Chesley and Terri L. Tidd, in equal shares, per stirpes
SEVENTH. I direct that any and all Ir.h~ritance, ES""..ate and Transfer taxes h'"Ilposed upon
my estate passing under my will or otherwise, shall be paid out of the principal of my residuary
estate.
EIGHTH. I hereby nominate, constitute and appoint Dauphin Deposit Bank and Trust
Company, and or it's successor, as Executor of this my Last Will and Testament. I hereby
relieve my Executor from the necessity of posting security in connection with their duties, as
such, in any jurisdiction in which they may be called upon to act insofar as I am able by law to
do so. In addition to the powers conferred by law, I authorize my Executor, in it's absolute
discretion, to retain in the form received, and to sell either at public or private sale any real or
personal property owned by me at the time of my death.
NINTH. I have made, or may from time to time make, a written memorandum expressing
my desire to give certain items of personal property to specific persons. I urge my Executor and
..
..
.
....-__. , -'0.... __ *-~~4;~:,:~Iii-)5>itii JI ~br~~-..o;j.~'Itii-.~
beneficiaries to respect these wishes. Such a memorandum, if made, shall be stored in
conjunction with this Will.
IN WITNES~ ~HEREOF, I hav~ hereunto ~ m~Fd and seal to this, my Last Will
and Testament, coIlSlSting of two typewntten pages this 'Jf1l-day of August, 1997.
.,.2,~ it- ~
SYL K. GROSZ
Signed, sealed, published and declared by the above named Testatrix Sylvia K. Grosz as and
for her Last Will and Testament, in the presence of us, who, at her request, in her sight and
presence and in the sight and presence of each other, have hereunto subscribed our names as
witnesses.
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COMMONWEALTH OF PENNSYLVANIA
.
.
: S8.
COUNTY OF CUMBERLAND
I, Sylvia K. Grosz, Testatrix whose name is signed to the attached or foregoing instrument,
having been duly qualified according to law, do hereby acknowledge that I signed and executed
the instrument as my Last W1l1; that I signed it willingly; and that I signed it as my free and
voluntary act for the purposes therein expressed.
.3 "j( ~ J(\ '-\ rJ
SYL~~SZ ~-.JO
Sworn or affirmed to and
acknowledged before ~, by
Sylvia K. Grosz this~day
of August, 1997.
Notarial Seal .
Cynthia L. Darr. Notary PublIC
Sou\h Middleton Twp.. ~umbeTland County
My Commission Expires Aug. i 4, 2000
COMMONWEALTH OF PENNSYLVANIA
ss.
COUNTY OF CUMBERLAND
We, I.f.JY" _ ,q lJ ,^-r"\<"'0..11 . and l1SQ. '/? 5h lie.. the witnesses whose
names are signed to the attached or foregoing instrument, being duly qualified according to law,
do depose and say that we were present and saw Sylvia K Grosz sign and execute the
instrument as her Last Will; that she signed willingly and that she executed as her free and
voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the
Testatrix signed the will as witnesses; and that to the best of our knowledge, the Testatrix was at
that time eighteen (18) or more years of age, of sound mind and under no constraint or undue
influence.
O}4}Q)~MA-C~
;zt .~ ~
25i1" 1;.._ " ( (1:
Sworn or affirmed to and
subscribed before me by
VJm. A -DUin (' CAN and
1-1 ~Ct O?, Sfr n €- , witnesses,
this7~ay of August, "997.
/l ~ ,~
~ Public
Notarial Seal ~ub\\C
h\a L. oarr, ~~~~Tlancl cOIJ~6Y
..._.~ ~dl~\O!, i:1~pifes Aug. '\ 4. 20
tlU"" :COIT\IT\ISSIOf'l
t.A'J
I
7- p- f? COMMONWEALTH OF PENNSYLVANIA *'
BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT. 280601 NOTICE OF DETERMINATION AND
HARRISBURG, PA 17128-0601 ASSESSMENT OF PENNSYLVANIA
ESTATE TAX BASED ON FEDERAL
CLOSING LETTER IIE~-7U EX IFP nl-lIl)
DATE 11-24-200
ESTATE OF GROSZ SYLVIA K
DATE OF DEATH 09-12-200
. . FILE NUMBER 21 01-085
- COUNTY CUMBERLAN
THOMAS MORKIN ACN 202
ALLFIRST TRST CD OF PA AlIOunt lemitt d
8 W HIGH ST
CARLISLE PA 170i3
MAKE CHECK PAYABLE AND R EMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper cred t to your account, submit the upper portion of this for. ith your tax payment.
!=~_!_~~~_~l!_!_I!~~__I:.~~~_______~ ~_____I!~!_~~~__I:.l:!~~_~_!:'~_~!~~_~_~~_~_!~_l!I!_!_~~~':;______~ ----------------------
REV-736 EX AFP (01-02) __ NOTICE OF DETERMINATION AND ASSESSMENT
OF PENNSYL ANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTI R --
ESTATE OF GROSZ SYLVIA K FILE NO.21 01-0858 ACN 202 DATE 11-24-2003
ESTATE TAX DETERMINATION
1. Credit For State Deat Taxes as Verified 18,804.14
2. Pennsylvania Inherits ce Tax Assessed 95,301.21
(Excluding Discount a d/or Interest)
3. Inheritance Tax Asses sed by Other States .00
or Territories of the United States
(Excluding Discount a d/or Interest)
4. Total Inheritance Tax Assessed 95 301.21
5. Pennsylvania Estate T ~x Due .00
6. Amount of Pennsylvani . Estate Tax Previously Assessed
Based on Federal Esta ~e Tax Return .00
7. Additional Pennsylvan !ia Estate Tax Due .00
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
-IF PAID AFTER THIS DATE, SEE REVERSE SIDE (IF TOTAL DUE IS LESS THAN $1, NO PAYMENT I REQUIRED
FOR CALCULATION OF AOOITIDNA INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT"' ~~ ), YOU NAY BE
DUE A REFUND. SEE REVERSE SIDE OF THIS FO FOR INSTRUCTIONS.)