HomeMy WebLinkAbout11-03-05 (3)
.... ....
~
REV-1500 EX(05-04)
PA Department of Revenue
Bureau of Individual Taxes
Dept 280601
Harrisburg, PA 17128-0601
15056041046
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
County Code Year
21 05
File Number
00712
ENTER DECEDENT INFORMATION BELOW
Social Security Number
160-16-0680
Date of Death
Date of Birth
08052005
06021920
Decedent's Last Name
Suffix
Decedent's First Name
SMITH
HELEN
MI
H
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's First Name
MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE BOXES BELOW
[!] 1. Original Return
o 4. Limited Estate
[!] 6. Decedent Died Testate
(Attach Copy of Will)
o 9. Litigation Proceeds Received
Spousal Poverty Credit (date of death 0 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. 0)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTiAl TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
717-763-()88~
02.
04a.
07.
010.
Future Interest Compromise (date of
death after 12-12-82)
Decedent Maintained a Living Trust
(Attach Copy of Trust)
~ 8. Total Number of Safe Deposit Boxes
Supplemental Return
o
o
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
LORRAINE NAGY
;'..")
Firm Name (If Applicable)
KERN AND COMPANY
First line of address
2331 MARKET STREET
Second line of address
f",.)
O.
..,
I
City or Post Office
State
ZIP Code
DATE FILED
CAMP HILL
PA
17011
Correspondent's e-mail address:KERN@PANETWORK.COM
Under penalties of perjury. I declare that I have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
DA~
10 :&1 OJ
DATE
/0 'PIS:- 0
KERN AND COMPANY, P.C., 2331 MARKET STREET, CAMP HILL, PA 17011
PLEASE USE ORIGINAL FORM ONLY
Side 1
L
15056041046
4W4645 3.000
15056041046
~
. ...
.
--.J
15056042047
REV-1500 EX
Decedent's Name: HELEN SMITH
RECAPITULATION
1 . Real estate (Schedule A)
. . . . . . . . . . . . . . . . . . . . . . . . . 1.
2. Stocks and Bonds (Schedule B) .
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C). :I.
4. Mortgages & Notes Receivable (Schedule D). . . . . . . . . . . . . . 4.
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
(Schedule G) D Separate Billing Requested.
8. Total Gross Assets (total Lines 1-7). . . . . . . . . .
Decedent's Social Security Number
160-16-0680
2.
16,323
5.
8,617
6,752
238,847
6.
7.
8.
270,539
9. Funeral Expenses & Administrative Costs (Schedule H).
. 9.
3,331
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I).
10.
11. Total Deductions (total Lines 9 & 10). . . .
11.
12. Net Value of Estate (Line 8 minus Line 11) .
13. Charitable and Governmental Bequests/See 9113 Trusts for which
an election to tax has not been made (Schedule J).
12.
13.
14. Net Value Subject to Tax (Line 12 minus Line 13)
14.
266,573
TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2)X.0_
16. Amount of Line ~~axable
at lineal rate X .rfl_
17. Amount of Line 14 taxable
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate X .15
15.
266,573
16.
17.
18.
19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 19.
20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 20.
Side2
L
15056042047
4W4646 3.000
635
3,966
266,573
11,996
11,996
D
15056042047
--.J
.' ...
REV-1500 EX Page 3
Decedent's Com lete Address:
DECEDENT'S NAME
HELEN SMITH
STREET ADDRESS
148 EASTERLY DRIVE
File Number 00712
CITY
MECHANICSBURG
STATE
PENNSYLVANIA
ZIP
17050-
Tax Payments and Credits:
1. Tax Due (page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1 )
11,996
600
Total Credits (A + B + C) (2)
600
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.
Fill in box on Page 2, 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)
11,396
A. Enter the interest on the tax due.
(5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(58)
11,396
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1 . Did decedent make a transfer and:
a. retain the use or income of the property transferred; . . . . . . . . . . . . . .
b. retain the right to designate who shall use the property transferred or its income;
c. 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes No
[KJ D
D [!]
D [KJ
D ~
D [KJ
D [KJ
[!] D
FILE IT AS PART OF THE RETURN.
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND
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 three (3) percent [72 P.S. 39116 (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 zero (0) percent
[72 P.S. 99116 (a) (1.1) (ii)]. The statute does not exemot 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 use of a natural parent, an
adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. 99116(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 four and one-half (4.5) percent, except as noted in
72 P.S. 89116(1.2)[72 P.S. 89116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. 89116(a)(1.3)]. A sibling is defined,
under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
4W4647 1.000
.' REV-1503 ,;!')( + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
HELEN SMITH
00712
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPllON
VALUE AT DATE
OF DEATH
3,489
12,834
2
1.734.007 SHARES APX SHORT DURATION U.S. GOVT FUND
4,404.105 SHARES APX HIGH YIELD BOND FUND - A
4W4696 1000
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
16,323
(. #'
REV-1508 EX + (6-98)
COMMONWEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
HELEN SMITH
FILE NUMBER
00712
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
DESCRIPTION
FURNITURE AND HOUSEHOLD GOODS
CLOTHING AND PERSONAL BELONGINGS
REFUND - SUNRISE ASSISTED LIVING
IDS LONG TERM CARE CLAIM PAYMENT
NEW CUMBERLAND CREDIT UNION
VALUE AT DATE
OF DEATH
1
2
3
4
5
500
500
3,625
3,875
117
4W46AD 1.000
TOTAL (Also enter on line 5 Recapitulationl $
(If more space is needed, insert additional sheets of the same size)
8,617
I' ...,
REV-1509 EX + (6-98)
COMMONWEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
HELEN SMITH
SCHEDULE F
JOINTLY-OWNED PROPERTY
FILE NUMBER
00712
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A. TINA SMITH
6092 31ST AVENUE, NORTH
ST. PETERSBURG, FLORDIA 33710
DAUGHTER
B. KAREN TATELA
10E HIGHLAND ROAD
PARKESBURG, PA 19365
DAUGHTER
c.
JOINTLY-OWNED PROPERTY:
lETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BAi'I< ACCOUNT DATE OF DEATH DE CD'S VALUE OF
ruABER OR SIMILAR IDENTIFYING r-ulBER ATTACH DEED FOR
NUMBER TENANT JOINT JOINTLHELDREAL ESTATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST
1. A. 1999 BANK OF AMERICA CHECKING ACCT 757.59 50% 378.80
ACCT# 3665519247
2 A&B 1998 M&T CHECKING ACCT 19,120.45 33.33% 6,372.85
ACCT# 79960278
TOTAL (Also enter on line 6, Recaoitulation) $ 6,751.65
4W46AE 1.000
(If more space is needed, insert additional sheets of the same size)
It .'
REV-1510 EX + (6-98)
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
HELEN SMITH
FILE NUMBER
00712
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTlON OF PROPERTY
ITEM l.cLlDE TfE N^ME OFTfE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT A~ DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE
NUMBER TfE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPUCABLE) VALUE
1, PRINCIPLE RESIDENCE 95,000 100% 95,000
148 EASTERLY DRIVE
MECHANICSBURG, PA 17050
(LIFE ESTATE)
2 AMERPRISE ANNUITY 113,672 100% 113,672
ACCT# 0930-0719-8357-9-004
(APX RETIREMENT ADVANTAGE NQ)
3 AMERPRISE ANNUITY 29,736 100% 29,736
ACCT# 0930-0702-2653-3-004
(RATE ADVANTAGE 3 NQ)
4 IRA AMERPRISE INVESTMENTS 439 100% 439
ACCT# 0931-0277-8993-8-004
TOTAL (Also enter on line 7, Recapitulation) $ 238 847
(If more space is needed, insert additional sheets of the same size)
,. REV-1511l!X+ (12-99)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
HELEN SMITH
FILE NUMBER
00712
ITEM
NUMBER
A.
B.
4.
5.
6.
7.
8
9
10
4W46AG 1.000
Debts of decedent must be reported on Schedule I.
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
LIBERTY FORGE - FUNERAL LUNCHEON
1,134
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address
City
State
Zip
Year(s) Commission Paid:
2. Attorney Fees
3. 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
Probate Fees
Accountant's Fees
190
Tax Return Preparer's Fees
KERN AND COMPANY, P. C .
CENTRAL PENN APPRAISALS, INC.
RAMSEY MOVERS
BANK FEES - BANK OF AMERICA
MAIL ROOM - SHIPPING COSTS
1,000
300
612
7
88
TOTAL (Also enter on line 9, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$
3,331
.
,
REV-1512 EX + (12-03)
COMMONWEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
HELEN SMITH
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
00712
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including un reimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
35
7
126
83
7
39
338
1.
2
3
4
5
6
7
MCI
UNITED WATER
CONCORD PHARMACY
SILVER SPRING TOWNSHIP
VERIZON
PENN WASTE
WESTFIELDS CONDO ASSOC.
4W46AH 1.000
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
635
"
REV-1513 EX+ (9-00)
SCHEDULE J
BENEFICIARIES
COMMONWEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
HELEN SMITH
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
TINA SMITH
6092 31ST AVENUE, NORTH
ST. PETERSBURG, FLORDIA 33710
KARIN TATELA
10 E. HIGHLAND ROAD
PARKESBURG, PA 19365
GABRIEL TATELA
62 SANITA ROAD
HOLMES, NY 12531
JOSEPH TATELA
115 LION DRIVE
HANOVER, PA 17331
MARY CATHERINE TATELA
10 E. HIGHLAND ROAD
PARKESBURG, PA 19365
2
3
4
5
00712
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
DAUGHTER
DAUGHTER
GRANDCHILD
GRANDCHILD
GRANDCHILD
FILE NUMBER
AMOUNT OR SHARE
OF ESTATE
93,980
93,980
26,204
26,204
26,204
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
4W46AI 1.000
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space IS needed. Insert additional sheets of the same size)
.
FiLE 1F"ol/-05-t5()7/;;J.,
'3a(/h~ cv
FEE SIMPIJE DEED
::: ::; '.
i'j'~/[1.~t~;"~';i;' ~);' J:.L'DS
, '.. " ":<l:..!iD COUllTr- f',\
'S8 SfP 2lj Pr/ 1 lj6
THIS INDENTURE, made the -.l!:i!!:::. day of September in the year of our
Lord One Thousand Nine Hundred Ninety-eight (1998).
BETWEEN Helen H. Smith, a widow, of Silver Springs Township,
Cumberland County, Pennsylvania, Grantors, Party oUbe FIrst Part,
A
N
D
Helen H. Smith, a widow, of Silver Springs Township, Cumberland County,
Pennsylvania, for a life estate Interest, and Karen F. Tatela, a married woman, o'f
Parkesburg, Pennsylvania, and TIna L. Smith, a married woman, of Saint Petersburg,
Florida, for the remainder Interest, Grantees, Parties of the Second Part,
WfI'NESSETH that the said Party of the First Part, for and in consideration of
the sum of ONE DOLLAR and No/IOO Dollars ($1.00), lawful money of the United States of
America, well and truly paid by the said Parties of the Second Part to the said Party of the First
Part, at and before the sealing and delivery of these presents, the receipt whereof is hereby
acknowledged, have granted, bargained, sold, aliened, enfeoffed. released, conveyed and
confirmed and by these presents do grant, bargain, sell, alien, enfeoff, release, convey, and
confirm unto the said Helen H. Smith, a widow, a life estate Interest In the said premises for
herself, and to Kareu F. Tutela and TIna L. SmIth, the remainder Interest, Grantees, Parties
of the Second Part, their heirs and assigns.
.' ALL THAT CERTAIN condominium dwelling unit ~ituated in Westfields Condominium in the
Township of Silver Spring, County of Cumberland and Commonwealth of Pennsylvania,
BEING'designated and known as Unit No. 33 in the Declaration of Condominium and Declaration
Plan of said Condominium as recorded in the Office of the Recorder of Deeds in and for
Cumberland County, Pennsylvania, in Miscellaneous Record Book Volume 371, Page 12, (as
amended by a First Amendment thereto dated April 6, 1990, and recorded on the same date in said
Recorder's Office in Miscellaneous Record Book Volume 378, Page 940) as required and in
accordance with the provisions of the Pennsylvania Uniform Condominium Act (Act of the
provisions of the Pennsylvania Uniform Condominium Act (Act of July 2, 1980, P.L. 286, No.
800K 185 PAtE 975
"
82; 68 Po. C.S.A 3101 et seq., as amended); Second Amendment thereto dated November 19,
1990 and recorded in Miscellaneous Book 389, Page 767 in Cumberland County Recorder of
Deeds Office.
TOGETHER with an undivided 5.263% interest in Common Elements as more particularly
defined, limited, subject to adjustment and set forth in the aforesaid Declaration of Condominium
and Declaration Plans, and together with the right to use any Limited Common Elements
applicable to the Unit being conveyed herein pursuant to said Declaration of Condominium and
Declaration Plans.
BEING the same premises which Leonard R. Smith and Helen H. Smith, his wife, by their deed
dated September 4, 1998 and recorded in the Cumberland County Recorder of Deeds Office in
Book 145, Page 679, granted and c(Jm'e~!ed unto Helen H. Smith grantor herein.
EXEMPT FROM TRANSFER TAX AS A CONVEYANCE FROM PARENT TO CHILDREN'.
UNDER AND SUBJECT, NEVERTHELESS, to all restrictions, reservations, conditions,
covenants, easements and rights-of-way of prior record including provisions, easements, covenants
and restrictions as contained in the Declaration of Condominium and Declaration Plans.
THE GRANTEE, for and on behalf of the Grantee, acknowledges that the Grantee bas received,
no later than fifteen (15) days prior to this conveyance, a full and complete Public Offering
Statement for Westfields Condominium and, therefore, waives any and all rights under Section
3406 (c) of the Uniform Condominium Act, as amended.
SAID premises baving a post office address of 14g Easterly Drive, Mechanicsburg, PA 170.55.
TOGETHER with all and singular, the tenements, hereditaments and
appurtenances to the same belonging or in anywise appertaining, .and the reversion and reversions,
remainder and remainders, rents, issues, and profits thereof: AND ALSO all the estate, right,
title, interest, property, claim and demand whatsoever, both in law and equity, of the sald Party
of the First Part, of, in. to or out of the said premises, and every part and parcel thereof.
TO HAVE AND TO HOLD the said premises, with all and singular the
appurtenances, unto the said Parties of the Second Part, their heirs and assigns, to and for the only
proper use and behoof of the said Karen F. Tatela, a married woman, and Tina L. Smith, a
married woman, their heirs and assigns forever, the remainder interest as herein conveyed, and
with Helen H. Smith, a widow, reserving a life estate interest for herself.
AND THE SAID Party of the First Part, for her, her heirs, executors and
administrators, do by these presents, covenant, grant and agree to and with the said Parties of the
Second Part, their heirs, executors and administrators, that they the said Party of the First Part,
their heir~ all and singular the hereditaments and premises hereinabove described and granted or
mentioned and intended so to be, with appurtenances, unto the said Party of the Second Part, her
50DK 185 PACE 9'76
heirs, executors and administrators, against the said Party of the First Part and her heirs and
against all and every other person or persona whomsoever, lawfully claiming or to claim the same
or any part thereof, by, from or under him, her, them or any of them, shall and will, by these
presents, WARRANT AND FOREVER DEFEND.
IN WITNESS WHEREOF, the said Party of the First Part, have hereunto set
their hands and seals the day and year first above written.
Signed, Sealed and
Delivered in the Presence of
WJ!LA
~ ~ ~ldJ
Helen H. Smith
(SEAL)
COMMONWEALTH OF PENNSYLVANIA )
:SS
COUNTY OF CUMBERLAND )
On this, the ~ day of S"tffi.un~ I' ,1998, before me, a Notary
Public, the undersigned officer, personally appear Helen H. Smith, a widow, known to me (or
satisfactorily proven) to be the persona whose names are subscribed to the within instrument, and
aCkno~ tha~.they executed the same for the purpose therein contained.
~ . ." ITNESS WHEREOF, I hereunto set my hand and official seal.
. . ~ .
.~
I hereby certify that the prcci
I t.t f ~I f~1y 1)"'1':"-
>>taJ,("~~~i t?A I ~rr
JJ~ m. ~.J.L
Notary Public
_rial So..
DIona M.lI/nhh. NottIY PublIc
~~~;,~~~~
;{fQr .' ,:'.(
. .-~iJ~~"!'r"~':'-:'.f.:.~I_\
.''';:;#;.<;,..,....I~~..'',.;;''''. :,->.'
,.,,...~~ ,.1 .,
t rney for Grantee: ..' ,,>, ,.,' ...t'.~,l.~,~;.,::
. . ,~:..., .-.,:...., ,,, . I, ."
:'~.:'~:~~:"'~-Jf:(~J_,,,.t;;; .
Slala of Pannsylvanla } ''''''''~''.~!o.'!t" J'&.o.,:p,...,;.... .r.'
CountyofCurnborland 86 .,.... ,..~~>-t" ".,'.,<,
~ecordad in tha offioe for tha raCOr;g~fa...:ds'''' J1". .tf.l./'!iIn.?""
l. ~q and fOf""!!!!1ber1and County. _:,. ,/A'tf~:i4'1~:.. '...
i all-BOoll.~.vor_Paija 5... '
lnass my hand a RBI of offlc f
car~hlS f 1
eOOK 185 PAGE 971
[File No. EASTERL Y1481 Paoe #2]
F; CE 1f-
t2-; ~ D5- 007/;).,
CENTRAl PENN APPRAISALS, INC.
24 WEST MAIN STREET
SHIREMANSTOWN PA 17011
August 24, 2005
TINA SMITH
6092 31ST STREET AVE. NORTH
ST PETERSBURG, FL 33710
Re: Properly:
Borrower:
File No.:
148 EASTERLY DRIVE
MECHANICSBURG, PA 17050
N/A
In accordance with your request, we have appraised the above referenced properly. The report of that appraisal is
attached.
The purpose of this appraisal is to estimate the market value of the properly described in this appraisal report, as
improved, in unencumbered fee simple title of ownership.
This report is based on a physical analysis of the site and improvements, a Iocational analysis of the neighborhood and
city, and an econom Ie analysis of the market for properties such as the subject. The appraisal was developed and the
report was prepared in accordance with the Uniform Standards of Professional Appraisal Practice.
The value conclusions reported are as of the effective date stated in the body of the report and contingent upon the
certifICation and limiting conditions attached.
It has been a pleasure to assist you. Please do not hesitate to contact me or any of my staff if we can be of additional
service to you.
Sincerely,
~~
SUMMARY OF SALIENT FEATURES
Subject Address 148 EASTERLY DRIVE
Legal Description DEED BOOK 00185, PAGE 00975
City MECHANICSBURG
County CUMBERLAND
State PA
Zip Code 17050
Census T raet 0118.02
Map Reference HBG. ADC 18 E7
Sale Price $ -----
Date of Sale INSP.8-1 0-05
Borrower / Clierrt N1A
Lender TINA SMITH
Size (Square Feet) 864
Price per Square Foot $
Location AVERAGE
Age 15
Condition AVERAGE
T DIal Rooms 4
Bedrooms 2
Baths
Appraiser JOHN S. BOSWEll
Date of Appraised Value 08-10-2005
Final Estimate of Value
$ 95,000
Form SSD - 'TOTAL for Windows" appraisal software by a la mode, inc. -1-800-ALAMOOE
IRle No. EASTERL Y1481 Paoe #31
Prooertv Address 148 EASTERLY DRIVE Citv MECHANICSBURG State P A Zin Code 17050
I Mal Descrintion DEED BOOK 00185, PAGE 00975 Countv CUMBERLAND Untt No. U33
Assessor's Parcel No. 38-23-0571-190.-U33 Tax Year 04/05 R.E. Taxes $ 1,146.98 Snecial Assessments $ NON E
Pro'ect Na"",lPhase No. WESTFIELDS IN SILVER SPRING TOWNSHIP MaD Reference HBG. ADC 18 E7 Census Tract 0118.02
Borrower N/ A Current Owner SMITH, HELEN H. ESTATE OCCUDant IX] Owner il Tenant IX] Vacant
Prooertv rinhts aooraised fX1 Fee Simnle I I Leasehold I Mon1l1lv HDme Owners' Association unn Charoe $ 55.00
Sales Price $ -- Date of Sale INSP.8-1D-05 Descriotion and $ amount of loan chames/concessions to be oaid bv seier N/A
Lender/Client TINA SMITH Address 6D92 31ST AVENUE, NORTH ST PETERSBURG FL 33710
IAn;;;;jser JOHN S. BOSWELL Address 24 W. MAIN STREET SHIREMANSTOWN, PA 17011
Location DUrban c><J Suburban o Rural =:: Si~family~ ==. Condominium hOUSi~
o Over 75% [;8J 25-75% o Under 25% fIllC A E !'\lICE A E
Bui~ up (000) (yrs) occupancy (000) (yrs)
Growth rate o Rapid [;8J Stable o Slow c><JOwner ~ Low ~ [;8J Owner r--1-QQ- Low ~
Property values c><J Increasing o Stable o Declining o Tenant 350+ Hinh 150 o Tenant 175 Hiah 15
Demand/supply ~ Shortage ; ~ In balance R Over supply [;8J Vacant (0-5%) Predominant c><J Vacant (0-5%) I Predominant I
Marketim time Under 3 mos. 3-6 mos. Over 6 mos. Fi Vacant {over 5%1 140 25 l Vacant lover 5%1 140 12
Present land use %: One Family ~, 2-4 Family ~ , Apartments ~ , Condominium ~ , Commercial ~, Industrial ~ , Vacant ~ , Other ~
Land use change: o Not ikely o Likely c><J In process to SINGLE FAMILY AND COMMERCIAl
lote: R_ .... IIIe 11IC1.' c_,osIt1on of .... ............... .re _ ."rel.., toe.....
Neighborhood boundaries and characteristics: RT 11 TO THE NORTH, RT 114 TO THE EAST, RT 76 TO THE SOUTH, AND LOCUST POINT ROAD
TO THE WEST.
Factors that affect the marketabiltty of the properties in the neighborhood (proximtty to employment and amenities, efllJlayment stabiltty, appeal to market, etc.):
This suburban neillhborhood has most oublic utilities available relativelv easy access to emolovment and services, and is comoetitive with other
neiahborhoods in the oeneral area. Most have similar amenities. No unfavorable factors were observed which would adverselv effect
marketabilitv. Market activitv indicates averaoe or better acceotance in the market olace. HOA FEE PAID QUARTERLY (cj) $165.00.
Mar1cet candttions in the subject neighborl1ood Qncluding support for the above conclusions related to the trend of property values, demand/supply, and marketing time
- - such as data on co~ve properties for sale In the project and neighborllood, description of the prevalence of sales and financing concessions, etc.):
There are no foreseeable economic trends which minht sinniflcantlv influence market conditions in this area. The current mortoaoe market
offers a wide varietv of conventional loans with com""titive rates. As a result, the terms of linancino have little, if any imoact on sales prices. If
interest rates remain reasonable. orooertv values and marketabilitv should be aoad. Current sunnlv and demand are in balance. Marketinll time
averaaes 0-60 days as ""'r MLS statistics. Interest rates are ralY1ino from 5-7% with 0-3 nnints tvnicallv beim naid for oriaination or discount.
Specific zoning classification and description RESIDENTIAL Topography LEVEL
Zoning compfiance [;8J Legal 1Xl0 Legal nonconforming (Grandfathered use) o Illegal o No zoning Size TYPICAL FOR AREA
Hinhest and best use as imnroved Present use n Other use I.mt.in\ Oenstty TYPICAL FOR ZONING
UtlIIIes PubBc Other 0If-slle Improvements Type PubBc Private View AVERAGE
ElectTictty (SJ 200 AMP Street ASPHALT [;8J 0 Drainage APPEARS ADQUATE
Gas 0 NONE Curblgulter CONCRETE c><J 0 Apparent easements NONE OBSERVED
Water c><J Sidewalk CONCRETE [;8J 0 FEMA Special Flood Hazard Area DYes c><J No
Santtary sewer ~ Streetlights POLE ~ R FEMA Zone C Map Date 3/3/1992
Storm sewer AlIev NONE FEMA MaD No. 4203700020C
Comments (apparent adverse easements, encroachments, special assessments, slide areas, illegal or legal nonconforming zoning use, etc.): Site has averalle site
imorovements averaae landscaoina. and tvoical maintenance. There are no aooarent adverse easement, encroachments, or other adverse
conditions on this site.
No. of Stories ~ Exterior Walls ~ II Project Completed: II Project Incomplete: Subject Phase:
No. of Elevator(s) ~ Roof Surface ~ Total No. of Phases _ Total No. of Planned Phases~ Total No. of unns -
ExistingtT'roposed ~ Total No. of Parking~ Total No. of Untts _ Total No. of Planned Untts ~ Total No. of unns Completed_
II conversion, orig. use ~ Ratio (spaceS/unitsR.!- Total No. of Units for Sale_ Total No. of Units for Sale ~ Total No. of unns for Sale _
Date of Conversion ~ Type ~ Total No. of Units Sold _ Total No. of Units Sold ~ Total No. of Units Sold -
Age (Vrs.) ~ Guest Parking ~ Total No. of Untts Rented_ Total No. of Units Rented ~ Total No. of Units Rented _
Effective Ane IYrs.l 10 CURB SIDE Data Source Data Source Data Source
Project Type: c><J Primary Residence o Second Home or Recreational c><J Row or Townhouse o Garden o Midrise o Highrise 0_
Condition of the project, QUaltty of construction, untt mix, appeal to market, etc.: ALL ARE AVERAGE.
Are the heating and coofing for the Individual units separately metered? c><J Yes o No II no, describe and comment on compatibiltty to other projects in market area
and market acceptance:
Common elements and recreational facilities: COMMON GROUNDS AND OPEN SPACE.
Are the common elements completed? c><J Yes 0 No Is the BuilderlDeveloper in control of the Home Owners' Association? 0 Yes c><J No
Are anv common elements leased to or bv the Home Owners' Association? n Yes !:xl No If"s attach addendum describinn rental terms and ootions.
ROOMS Faver Livino Dinino Kttchen Den Family Rm. Rec. Rm. Bedrooms # Baths LaundrY Other Area So. Ft.
Basement SLAB
Levell 1 AREA 1 2 1 X 864
Level 2
Finished area above orade contains: 4 Rooms; 2 Bedroom(s); 1 Bath(s); 864 Souare Feet of Gross Livino Area For Untt
GENERAL DESCRIPTION HEATING HEAT KITCHEN EQUIP. AMENITIES CAR STORAGE INSULATION
Floor No. 1 Type PUMP Refrigerator 0 Fireplace(s) #_ 0 None [;8J Roof _0
No. of Leveis 1 Fuel ELEC. Range/Oven [;8J Patio REAR [;8J Garage 0 CeiBng GOOD c><J
INTERIOR Materials/Condition Condition GOOD Disposal [;8J Balcony 0 No. of Cars [] Walls GOOD [;8J
Flooring CPTNlN - GOOD COOUNG Dishwasher (SJ Deck 0 Open Floor SLAB 0
Walls DRYWALL - GOOD Central YES FanlHood c><J Porch 0 No. of Cars None _0
Bath Floor VINYL - GOOD Other NONE Micmwave ,R Fence R Parking Space No. ~ Unknown - R
Bath Wainscot FIBERGLASS - GD. Condition GOOD Washer/flrver AssionedlOwned ASS. Condition of the untt, depreciation, repairs needed, qualtty of construction, remodeling/modernization, additional features (special energy eflicient tterns, etc.):
OAK KITCHEN CABINETS' STORAGE SHED WITH ELECTRIC PANEL' ELECTRIC WATER HEATER.
Adverse environmental conditions (such as, but not limited to, hazardous wastes, toxic substances, etc.) present in the improvements, on the stte, or in the immediate vicintty of the
subject property: There are no annarent adverse environmental conditions observed unnn ins""ction of the imorovements the site or in the
immediate vicinitv of the subiect orooertv
Freddie Mac Form 465 10-94
INDIVIDUAL CONDOMINIUM UNIT APPRAISAL REPORT
IFile No. EASTERLY1481 Paoe #1]
File No EASTERL Y148
Page 1 of 2
Central Penn Appraisals, Inc. (717) 737-4600
Form PU2 - 'TOTAL for Windows' appraisal software by a la mode, inc. - 1-800-ALAMOOE
Fannie Mae Form 1073 10-94
Un~ Charge $ 55.00 per mo. X f2 = $ 660.00 per yr. Amual Assessment charge per year/square feet of gross living area - $ 0.76
Is the project subject to ground rent ? Dyes ~No n yes, $ per year.
lIIilities included in un~ charge: ~ None D Heat D Air Conditioning D Electric~ D Gas D Water D Sewer
Note any fees other fhan regular HOA charges, for use of facilities NONE KNOWN
Compared to other compe1itive projects of similar QUality and design, the subject un~ charge appears: o High ~ Typical D low
To properly maintain the project and provide the services anticipated, the budget appears: ~ Adequate D Inadequate D Unknown
Management Group: ~ Home OWners' Association 0 Developer D Management Agent (klentify)
aual~ of management and ~ enforcement of Rules and Regulations based on general appearance of project appears: ~ Adequate D Inadequate
Special or unusual characteristics in the Condominium Documents or other information known to the appraiser that would affect marketabil~ (~ none, so state)
No snecial or unusual characteristics were observed within the condominium documents that would have any adverse effect on marketabililv or
aoneal of the subiect oroject or unit.
ITEM I SUBJECT COMPARABLE NO.1 COMPARABLE NO.2 COMPARABLE NO.3
Address and 148 EASTERLY DRIVE 135 EASTERLY DRIVE 155 EASTERLY DRIVE 131 EASTERLY DRIVE
Proiect Name WESTFIELDS WESTFIELDS WESTFIELDS WESTFIELDS
Proxim~ to SUbiect 0.06 miles 0.02 miles 0.06 miles
Sales Price $ - 1$ 97 900 1$ 96,500 1$ 86 900
Price/Gross liv. Area $ rjJ$ 105.50 rjJ 1 $ 93.42 rjJ 1 $ 92.84 rjJl
Data and/or INSPECTION ASMT RECORDSIMLSIAGENTI ASMT RECORDSIMLSIAGENTI ASMT RECORDSIMLS/AGENTI
Verification Sources SETTLEMENT DEPT. SETTLEMENT DEPT. SETTLEMENT DEPT
VALUE ADJUSTMENTS OESCRIPTION DESCRIPTION 1+ l-l $ Adius1men OESCRIPTION 1+ (-) $ Adlus1men DESCRIPTION 1+ (-) $ Adjustment
Sales or Financing CONV. CONV. FHA
Concessions NONE KNOWN NONE KNOWN NONE KNOWN
Date of SalelTime 06-17-05 I 1 : +700 04-08-05 I 1 : +1600 04-30-04 I 1 +5 900
location AVERAGE AVERAGE : AVERAGE : AVERAGE :
leaseholdlFee Simple FEE SIMPLE FEE SIMPLE : FEE SIMPLE : FEE SIMPLE :
HOA Mo. Assessment 55.00 55.00 : 55.00 : 55.00 :
Common Elements COMMON COMMON COMMON COMMON
and Rec. Facilities GROUNDS GROUNDS GROUNDS GROUNDS
Proiect Size/TvDe TYPICAL TYPICAL TYPICAL TYPICAL
Roor location AVERAGE AVERAGE AVERAGE AVERAGE
View AVERAGE AVERAGE AVERAGE AVERAGE
Desion and Anneal 1 STORY EOR 1 STORY EOR : 1 STORY ROW +2,500 1 STORY EOR
Qual~ of Construction AVE. - BRKlVIN AVE. - BRKlVIN : AVE. - BRKlVIN : AVE. - BRKlVIN
e 15 15 : 16 : 14 :
Condition AVERAGE AVERAGE : AVERAGE : AVERAGE :
Above Grade Total Bdrms Baths Total Bdrms Baths: Total Bdrms Baths : Total Bdrms Baths:
Room Count 4 : 2 1 5 : 2 1 : 5 : 2 : 1.5 : -1,500 5 : 2 : 1 :
Gross livino Area 864 SQ. Ft. 928 SQ.' Ft. : 1,033 so. Ft. : -2,500 936 SQ. Ft. :
Basement & Finished SLAB SLAB SLAB SLAB
Rooms Below Grade NIA NIA NIA N/A
Functional lIIil~ AVERAGE AVERAGE : AVERAGE : AVERAGE
HeatinolCooino EHPICA EHPICA : EHP/CA : EHPICA
Enerov Efficient nems TYP FOR AREA TYP FOR AREA : TYP FOR AREA : TYP FOR AREA :
Car Storaoe ON STREET ON STREET : ON STREET : ON STREET :
Balcony, Patio, PATIO PORCH I PATIO -1,500 BALCONYIPATlO: -1,500 PORCH I PATIO -1,500
Fireolacelsl, etc. NONE NONE NONE NONE
NONE NONE : NONE : NONE :
Net Adi. ItotIIl il+lXl- :$ 800 il + 1Xl- :$ 1400 f)(I + il- :$ 4400
Adjusted Sales Price Net 0.8 ~ I Net 1.5 ~ I Net 5.1 ~I:
of Comparable Gross 2.2 ... $ 97,100 Gross 9.9'" $ 95100 Gross 8.5 'II. $ 91,300
Comments on Sales Comparison Oncluding the subject property's compatibil~ to other condominium units in the neighborhood, etc.): See attached addenda.
ITEM SUBJECT COMPARABLE NO. 1 COMPARABlE NO. 2 COMPARABLE NO. 3
Date, Price and Data 09-24-1998 NO PRIOR SALE NO PRIOR SALE NO PRIOR SALE
Source for prior sales $1.00 WrrHIN 3 YRS WITHIN 3 YRS WrrHIN 3 YRS
withi/1 "-'lr of .nnraisal COURT HOUSE OF EFC DATE. OF EFC DATE. OF EFC DATE.
AMysis of any cunent agreemenl of sale, option, or listing of the subject property and anaysis of any D/iOr sales of subject and comparables within one yea- of the dale of appraisal:
The subiect is not known to be under any oDtion for sale or aareement of sale as of the effective date on this reoort.
IIlICATED VALUE BY SAlES COMPARISON APPROACH --. $ 95 000
IIOICATED VALUE BY INCOIlE APPROACH (If Applicable) Estimated Market Rent $ N1A /Mo. x Gross Rent Multiplier 0.00 = $
IIlICATED VALUE BY COST APPROACH (Attach ~ Applicable) -~
Ttis appraisal is made ~ 'as is' o subject to the repairs, alterations, inspections, or conditions isted beklw D subject to completion per plans and specifications.
Condition of Appraisal: This aooraisal reoort has been oreoared with the oronertv in "as is" condition. No personal nronertv has been included in
this valuation. See attached aooraiser's certification and statement of limitino conditions.
Final Reconcitiation: See attached addenda.
The purpose of this appraisal is to estimate the market value of the real property that is the subject of this 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 439ifanrie Mae Form f 0048 (Revised 6/93 ).
I (WE) ESTIMATE TIE MARKET V AWE, AS DEFINED, OF THE REAL PROPERTY THAT IS THE SUBJECT OF TItS REPORT, AS OF 08-10-2005
(WIICH IS ~0~ OF INSP)~L AND THE EFFECllVE DATE OF TItS REPORT) TO BE $ 95,000
APPRAISER: HN S. BO LL SUPERVISORY APPRAISER (ONLYFREllUIlED):
Sinnature ~ Sionature D Did o Did Not
Name JOM S. riOSl1'1ELL Name Inspect Property
Date Reoort Sioned 8-24-05 Date Reoort Sioned
State Certification # PACERT RL-001405-L State PA State Certification # State
Or State license # RM-050503-A State PA Or State license # State
freddie Mac Form 465 10-94
INDIVIDUAL CONDOMINIUM UNIT APPRAISAL REPORT
IFile No. EASTERlYI4B1 Paoe #51
Page 2 of 2
Form PU2 - 'TOTAL for Windows" appraisal software by a la mode, inc. -1-8oo-AlAMODE
Fannie Mae Form 1073 10-94
Supplemental Addendum
IRle No. EASTERL Y1481 Paoe #ID
Rle No. EASTERL Y148
Borrower/Clen! N/A
Pro"""" Address 148 EASTERLY DRIVE
City MECHANICSBURG County CUMBERLAND
Lender TINA SMITH
State P A
liD Code 17050
. CondolPUD: Sales ComDarison Comments
All three sales are considered to be reliable indicators of value, and are weighted similarly in the final reconciliation. In order to
find com parables sales it was necessary to use less recent sales. It is noted that Comparable Sale NO.3 occurred over six
months prior to the appraisal date. Com parables that sold within six months of the date of the appraisal were significantly
different in location, size, condition, special conditions, and/or style. In the appraiser's judgment the comparable selected is a
better indicator of value than more recent sales. Time adjustments are based on appropriate research of the market data in the
market area. Comparables sales used are all closed sales. Appropriate adjustments have been made for all differences.
. CondolPUD: Final Reconciliation
This appraisal assumes a reasonable marketing period for the subject property of three months. The Market Approach reflects
recent activity in the market place. The cost and income approahes to value are not applicable. Given the high quality of the
available sale data, the value indicated by the Market Approach is used as the final estimated value. THIS IS A SUMMARY
REPORT OF A COMPLETE APPRAISAL.
APPRAISER ACKNOWLEDGEMENT
APPRAISERS ACKNOWLEDGES AND AGREES, IN CONNECTION WITH ELECTRONIC SUBMISSION OF APPRAISALS, AS
FOllOWS:
THE SOFTWARE UTILIZED BY THE APPRAISER TO GENERATE THE APPRAISAL PROTECTS SIGNATURE SECURITY BY
MEANS OF A DIGITAL SIGNATURE SECURITY FEATURE WHICH LOCKS THE REPORT WITHIN OUR OFFICE AND CAN
NOT BE ALTERED BY ANYONE OTHER THAN OUR OFFICE.
APPRAISER CERTIFICATION
APPRAISER STANDARDS
I acknowledge and certify that (I) my appraisal of the above referenced property may be used in a federally related financial
transaction subject to requirements of Title XI of the Financial Institution Reform, Recovery and Enforcement Act of 1989
(FIRREA"); (ii) the appraisal must comply with FIRREA and the applicable regulations implementing Tille IX of Firrea; and (Iii)
the appraisal was completed in accordance with USPAP.
APPRAISER COMPETENCY
I certify that I am fully qualified and competent by training, knowledge, and experience to perform this appraisal.
APPRAISER INDEPENDENCE
I represent and certify that (I) the appraisal assignment was based not based on a requested minimum valuation, a specific
valuation, or the approval of a loan; (Ii) my employment was not conditioned upon the appraisal producing a specific value or
value within a given range; (iii) my future employment is not dependent upon an appraisal producing a specific value; (iv) my
employment, compensation, and future employment are not based upon whether a loan application was approved; (v) neither
me nor any person with an ownership interest in the company employing me, is related to or has any ownership or other
financial interest in, either the builder/developer, seller, buyer, mortgage broker, or real estate broker/salesperson (or any
person related to any of them) involved in the transaction for which this appraisal was requested, or with the most recent sale or
refinancing of any property used as a comparable property in this appraisal, and (vi) I am not aware of any facts which would
disqualify me from being considered an independent appraiser.
APPRAISAL INSTITUTE CERTIFICATION
I certify that, to the best of my knowledge and belief, this report analyses, opinions and conclusions were developed, and this
report has been prepared, in conformity with the requirements of the Code of professional Ethics and the Standards of
Professional Appraisal Practice of the Appraisal Institute.
I Certify that the use of this report is subject to the requirements of the Appraisal Institute relating to review by its duly
authorized representatives.
Fonn TADD - "TOTAL for Windows" appraisal software by a Ia mode, inc. -1-800-ALAMODE
IFile No EASTERLY1481 Paoe #Z1
DEFINITION OF MARKET VALUE: The most probable price which a property should bring in a competitive and open market under all conditions
requisite to a fair sale, the buyer and selier, each acting prudently, knowledgeably and assuming the price is not affected by undue stimulus. Implicit in this
definition is the consummation of a sale as of a specified date and the passing of tite from seller to buyer under conditions whereby: (1) buyer and seller are
typically motivated; (2) both parties are well informed or well advised, and each acting in what he considers his own best interest; (3) a reasonable time is allowed
for exposure in the open market, (4) payment is made in terms of cash in U.S. dollars or in terms of financial arrangements comparable thereto; and (5) the price
represents the normal consideraton for the property sold unaffected by special or creatve financing or sales concessions' granted by anyone associated with
the sale.
'Adjustments to the comparables must be made for special or creatve financing or sales concessions. No adjustments are necessary
for those costs which are normally paid by sellers as a resuh of tradition or law in a market area; these costs are readily identmable
since the seller pays these costs in virtually all sales transactions. Special or creative financing adjustments can be made to the
comparable property by comparisons to financing terms offered by a third party institutional lender that is not already involved in the
property or transaction. Any adjustment should not be calculated on a mechanical dollar for dollar cost of the financing or concession
but the dollar amount of any adjus1ment should approximate the markers reaction to the financing or concessions based on the
appraiser's judgement.
STATEMENT OF LIMITING CONDITIONS AND APPRAISER'S CERTIFICATION
CONTINGENT AND LIMITING CONDITIONS: The appraiser's certification that appears in the appraisal report is subject to the following
conditions:
1. The appraiser will not be responsible for matters ot a legal nature that affect ehher the property being appraised or the fite to it. The appraiser assumes that
the title is good and marketable and, therefore, will no1 render any opinions about the tite. The property is appraised on the basis of it being under responsible
ownership.
2. The appraiser has provided a sketch in the appraisal report to show approximate dimensions of the improvements and the sketch is included only to assist
the reader of the report in visualizing the property and understanding the appraiser's determination of its size.
3. The appraiser has examined the available flood maps that are provided by the Federal Emergency Management Agency (or other data sources) and has noted
in the appraisal report whether the subject site is located in an identified Special Flood Hazard Area. Because the appraiser is not a surveyor, he or she makes
no guarantees, express or implied, regarding this determination.
4. The appraiser will not give testimony or appear in court because he or she made an appraisal of the property in Question, unless specific arrangements to do
so have been made beforehand.
5. The appraiser has estimated the value of the land in the cost approach at its highest and best use and the improvements at their contributory value. These
separate valuations of the land and improvements must not be used in conjunction with any other appraisal and are invalid h they are so used.
6. The appraiser has noted in the appraisal report any adverse conditions (such as, needed repairs, depreciation, the presence of hazardous wastes, toxic
substances, etc.) observed during the inspection of the subject property or that he or she became aware of during the normal research involved in performing
the appraisal. Unless otherwise staled in the appraisal report, the appraiser has no knowledge of any hidden or unapparent conditions of the property or
adverse environmental conditions Oncluding the presence of hazardous wastes, toxic substances, etc.) that would make the property more or less valuable, and
has assumed that there are no such conditions and makes no guarantees or warranties, express or implied, regarding the condition of the property. The
appraiser will not be responsible for any such conditions that do exist or for any engineering or testing that might be required to discover whether such
conditions exist. Because the appraiser is not an expert in the field of environmental hazards, the appraisal report must not be considered as an
environmental assessment of the property.
7. The appraiser obtained the information, estimates, and opinions that were expressed in the appraisal report from sources that he or she considers to be
reliable and believes them to be true and correct. The appraiser does not assume responsibility for the accuracy of such items that were furnished by other
parties.
8. The appraiser will not disclose the contents of the appraisal report except as provided for in the Unitorm Standards of Professional Appraisal Practice.
9. The appraiser has based his or her appraisal report and valuation conclusion for an appraisal that is subject to satisfactory completion, repairs, or
aherations on the assumption that completion of the improvements will be performed in a workmanlike manner.
10. The appraiser must provide his or her prior written consent before the lender/client specified in the appraisal report can distribute the appraisal report
Oncluding conclusions about the property vakJe, the appraiser's identity and professional designations, and references to any professional appraisal
organizations or the firm with which the appraiser is associated) to anyone other than the borrower; the mortgagee or its successors and assigns; the mortgage
insurer; consuhants; professional appraisal organizations; any state or federally approved financial institution; or any department, agency, or instrumentality
of the United Slates or any state or the District of Columbia; except that the lender/client may distribute the property description section of the report only to data
collection or reporting service(s) without having to obtain the appraiser's prior written consent. The appraiser's written consent and approval must also
be obtained before the appraisal can be conveyed by anyone to the public through advertising, public relations, news, sales, or other media.
Freddie Mac Form 439 6-93
Page 1 of 2
Fannie Mae Form loo4B 6-93
Central Penn Appraisals, inc. (717) 737-4600
Form ACR - "TOTAL for Windows" appraisal software by a la mode, Inc. -l-8oo-AlAMDDE
IFile No EASTERL Y1481 Paoe #ID
APPRAISER'S CERTIFICATION: The Appraiser certifies and agrees that:
1. I have researched the subject market area and have selected a minimum of three recent sales of properties most similar and proximate to the subject property
for consideration in the sales comparison analysis and have made a dollar adjustment when appropriate to reflect the market reaction to those items at significant
variation. n a signnicant item in a comparable property is supertor to, or more favorable than, the subject property, I have made a negative adjustment to reduce
the adjusted sales price of the comparable and, n a significant item in a comparable property is inferior to, or less favorable than the subject property, I have made
a positive adjustment to increase the adjusted sales price of the comparable.
2. I have taken into consideration the factors that have an impact on value in my development of the estimate of market value in the appraisal report. I have not
knowingly withheld any signITicant information from the appraisal report and I believe, to the best of my knowledge, that all statements and information in the
appraisal report are true and correct.
3. I stated in the appraisal report only my own personal, unbiased, and professional analysis, opinions, and conclusions, which are subject only to the contingent
and limiting conditions specified in this form.
4. I have no present or prospective interest In the property that is the subject to this report, and I have no present or prospective personal interest or bias with
respect to the participants in the transaction. I did not base, either partially or completely, my analysis and/or the estimate of market value in the appraisal report
on the race, color, religion, sex, handicap, familial status, or national origin of either the prospective owners or occupants of the subject property or of the present
owners or occupants of the properties in the vicinity of the subject property.
5. I have no present or contemplated future interest in the subject property, and neither my current or future employment nor my compensation for pertorming this
appraisal is contingent on the appraised value of the property.
6. I was not required to report a predetermined value or direction in value that favors the cause of the client or any related party, the amount of the value estimate,
the attainment of a specific resutt, or the occurrence of a subsequent event in order to receive my compensation and/or employment for performing the appraisal. I
did not base the appraisal report on a requested minimum valuation, a specific valuation, or the need to approve a specnic mortgage loan.
7. I performed this appraisal in confomity with the UnHorm Standards of Professional Appraisal Practice that were adopted and promulgated by the Appraisal
Standards Board of The Appraisal Foundation and that were in place as of the effective date of this appraisal, with the exception of the departure provision of those
Standards, which does not apply. I acknowledge that an estimate of a reasonable time for exposure in the open market is a condition in the definition of market value
and the estimate I developed is consistent with the marketing time noted in the neighborhood section of this report, unless I have otherwise stated in the
reconciliation section.
8. I have personally inspected the interior and exterior areas of the subject property and the exterior of all properties listed as comparables in the appraisal report
I further certify that I have noted any apparent or known adverse conditions in the SUbject improvements, on the subject site, or on any site within the immediate
vicinity of the subject property of which I am aware and have made adjustments for these adverse conditions in my analysis of the property value to the extent that
I had market evidence to support them. I have also commented about the effect of the adverse conditions on the marketability of the subject property.
9. I personally prepared all conclusions and opinions about the real estate that were set forth in the appraisal report n I relied on significant professional
assistance from any individual or individuals in the performance of the appraisal or the preparation of the appraisal report, I have named such individual(s) and
disclosed the specHic tasks pertormed by them in the reconciliation section of this appraisal report. I certHy that any Individual so named is qualified to perform
the tasks. i have not authorized anyone to make a change to any item in the report; therefore, if an unauthorized change is made to the appraisal report, I will take
no responsibility for it.
SUPERVISORY APPRAISER'S CERTIFICATION: If a supervisory appraiser signed the appraisal report, he or she certnies and agrees that:
I directly supervise the appraiser who prepared the appraisal report, have reviewed the appraisal report, agree with the statements and conclusions of the appraiser,
agree to be bound by the appraiser's certHications numbered 4 through 7 above, and am taking ful responsibility for the appraisal and the appraisal report.
ADDRESS OF PROPERTY APPRAISED: 148 EASTERLY DRIVE, MECHANICSBURG, PA 17050
APPRAISER:
S~nawre: t~
Name: JO S. L
Date Signed: 8-24-05
State Certification #: PACERT RL-001405-L
or State License #: RM-Q50503-A
State: P A
Expiration Date of CertITication or License: 6/30/07
SUPERVISORY APPRAISER (onl, if required):
Signawre:
Name:
Date Signed:
State CertHication #:
or State License #:
State:
Expiration Date of CertITication or License:
o Did
o Did Not Inspect Property
Freddie Mac Form 439 6-93
Page 2 of 2
Fannie Mae Form 10048 6-93
Form ACR - "TOTAL for Windows" appraisal software by a la mode, inc. -1-800-ALAMODE
. ,
SUbject Photo Page
Coo CUMBERLAND
IFile No. EASTERLY1481 Paoe #9]
State PA
Zi Code 17050
SUbject Front
148 EASTERLY DRIVE
Sales Price ---------
Gross living Area 864
Total Rooms 4
Total Bedrooms 2
Total Bathrooms 1
location AVERAGE
~ew AVERAGE
Site TYPICAL
Quality AVE. - BRKNIN
Age 15
Subject Rear
Subject Street
Form PICPIX.SR - "TOTAl for Windows' appraisal software by a la mode, inc. - 1-800-ALAMOOE
Comparable Photo Page
IRle No. EASTERLYl481 Paoe #lQJ
Borrower/Client Nt A
Pron""" Address 148 EASTERLY DRIVE
Citv MECHANICSBURG Countv CUMBERlAND State P A Zin Code 17050
Lender TINA SMITH
Comparable 1
135 EASTERLY DRIVE
Prox. to Subject 0.06 miles
Sale Price 97,900
Gross Living Area 928
Total Rooms 5
T oIal Bedrooms 2
T oIal Bathrooms 1
Location AVERAGE
View AVERAGE
Sije TYPICAL
1MI1ity AVE. - BRKNIN
Age 15
Comparable 2
155 EASTERLY DRIVE
Prox. to Subject 0.02 miles
Sale Price 96,500
Gross Living Area 1,033
Total Rooms 5
Total Bedrooms 2
Total Bathrooms 1 .5
~c~on AVERAGE
View AVERAGE
Sije TYPICAL
Quality AVE. - BRKNIN
Age 16
Comparable 3
131 EASTERLY DRIVE
Prox. to Subject 0.06 miles
Sale Price 86,900
Gross Living Area 936
T oIal Rooms 5
T oIal Bedrooms 2
Total Bathrooms 1
Loc~on AVERAGE
View AVERAGE
Sije TYPICAL
Quality AVE. - BRKNIN
Age 14
Form PICPIX.CR - 'TOTAL for Windows' appraisal software by a la mode, inc. -1-800-ALAMODE
IFile No. EASTERL Y14S1 Paoe #1 j]
Borrower/Clen! N/ A
Prooertv Address 148 EASTERLY DRIVE
Citv MECHANICSBURG County CUMBERLAND State PA Zin Code 17050
Lender TINA SMITH
Building Sketch (Page - 1)
4.0' 20.0'
~I Concrete in
Patio ....:
c
oil
Bedroom ;:: Dining
Area
~ Knchen ~
>- Bath
1:
.. '"
a.
living
Bedroom Room
Entry
24.0'
SlaellchIwApexIVW~-
Coomenls:
AREA CALCULATIONS SUMMARY LIVING AREA BREAKDOWN
Code Description Size Toea.. Break_n Subtotals
GLA1 Fi.rst Fl.oor 864.00 864.00 First Fl.oor
PIP Concrete Pa tio 150.00 150.00 24.0 " 36.0 864.00
O"B Storage 30.00 30.00
TOTAL LIVABLE (rounded) 864 1 Area Total (rounded) 864
Form SKT.BldSkl- 'TOTAL tor Windows' appraisal soltware by a la mode, inc. - 1-800-ALAMODE
IFile No. EASTERLY1481 Paoe #121
Borrower/CWen! NI A
Prooertv Address 148 EASTERLY DRIVE
Citv MECHANICSBURG Countv CUMBERLAND State PA Zin Code 17050
Lender TINA SMITH
Location Map
\
1.
llf'"
I
\
<;\
MapPoint
...... '"
qio"
~'"
""","",
s
I'
~
,~
lJ
J
.....,<, -....'"
,V'
......1
.
~
cJ<t*V'
....
../
J
,f
4-.""'4/
.............
<t <t
/,
~
I
i
1.-
\
..
"\ ,~
<;l
\\ \ ~
\\\ <;\~ i
~ -'" g 'f#'....... ~
",uP* ~ ;, \
J i 9 dl,.l;. ~
"I! .'~ '? ...;p."" ",-,", 4\~ ~
'i __, ~"""""... '" ..." __..~
1. /~~ .'~ \ "\ ",,,* OJ '" ,........~
\J _'- \ '" \
" 9l tJI.l. ~
... t "0'" \J 9;<
. . t \ tt c-,
""",,' ~ " /\\
I "\
.... ....
_$I.
<1_""
//""'"
".
~ ~ ~~
_"'n \
i""",.. ~ ~..........'"
...'"
~ .. ~.... -;
~.., ~
\ ~ ..
~ "\ ~.....'"
~ .
..
"-
"
9>
~
-'"
\
'"
,,,.
"",,'"
t ,a
.,,""
'I-
~
"
;;!
~
".....
"~-
---'"
o
&chi_andS31lou
-...0.;,.. P'n ~
",,,,,*,,,
... .......
~..c...r".
\
'I'
"~
"'~~
~
..~~~"-.
.'"--~~
"'-=:::~
"'~
"'.
\
1.
...
i
g
""- -'" \
".~ 1-
~~~
~'~~~::.",,,...,,,,,,.~
.-'" '"
""",'"
~~
",<Jo
./ ..
./
~
J
\
1.
~;p
II
.j
~""'l,
\
\
..... '"
''l,
~ <t
'I
''l,
~
~
/
~
IIllolKlIlI __~.
"u..-.""
Form MAP.LOC - "TOTAL for Windows' appraisal software by a la mode, inc. -1-800-ALAMOOE
. ,
F/ C-E #
c:2/ - 05- 00 7/;;?
LAST WILL AND TESTAMENT
of
HELEN H. SMITH
I, HELEN H. SMITH, widow of LEONARD R. SMITH, of 148 EASTERLY DR., MECHANICSBURG,
CUMBERLAND County of Pennsylvania, being an emancipated adult of sound and
disposing mind, DO HEREBY designate this my LAST WILL and TESTAMENT revoking any
and all wills and codicils made by me prior to the date set hereinafter.
GENERAL PROVISIONS
Article I.
EXECUTOR
Section 1.01 NAMED.
(a) I do hereby name KARIN F. TATELA and TINA L. SMITH to act as executor(s) of my estate, or
whichever of them shall be living in my state of residence at my death. They may split their
duties, if I own real estate in more than one state, so that the administration of my estate shall
be the most efficient.
(b) In the event that the above-named executor(s) shall fail to qualify or cease to act, the
beneficiaries shall elect a new executor.
Section 1.02 RIGHTS and PRIVILEGES.
They shall have all the rights and privileges accorded by law and the specific rights and
responsibilities set forth hereinafter which shall be exercisable without court authorization.
Section 1.03 FEES and BONDS
(a) The executors named hereinabove shall receive NO FEES
(b) It is further provided, that my executors shall serve without bond and shall be held harmless
unless the damages were caused by gross incompetence, gross negligence or actual intent to
defraud.
Article II. MANAGEMENT PROVISIONS
I, hereby, authorize my EXECUTOR(S) in his/her/their discretion:
Section 2.01 To retain and/or invest in all forms of real and personal property, without being confined
to those investments authorized by any statutory list, without being required to diversify and
regardless of any principle of law limiting delegation of investment responsibility of executors;
- 1 -
lnit.
LAST WILL and TESTAMENT of HELEN H. SMITH
Section 2.02 To compromise claims and to abandon any property which, in my executors' opinion, is
of little or no value;
Section 2. 03 To sell at public or private sale, to exchange or to lease for any period of time, any real
or personal property, and to give options for sales or leases;
Section 2.04 To join in any merger, reorganization, voting-trust plan or other concerted action of
security holders, and to delegate discretionary duties with respect thereto;
Section 2.05 To partition, subdivide or improve real estate and to enter into agreements concerning
the partition, subdivision, improvement, zoning or management of any real estate in which my
estate has an interest and to impose or extinguish restrictions on any such real estate;
Section 2.06 To employ and to rely upon advice given by investment counsel, to delegate
discretionary authority to make changes in investments to investment counsel, and to pay
investment counsel reasonable compensation; in addition to any fees otherwise payable to my
executors;
Section 2.07 To employ a custodian, to hold property unregistered or in the name of a nominee
[including the nominee of any institution employed as custodian), and to pay reasonable
compensation to the custodian; in addition to any fees otherwise payable to my executor;
Section 2.08 To borrow, and to pledge property, real or personal, as security for repayment of any
funds borrowed;
Section 2. 09 To operate any business of which I was the owner on the date of my death, to the
extent permissible under the law, and/or to hire such employees/managers to continue such
business until it can be sold or otherwise distributed; and
Section 2. 10 Except for such specific instructions set forth hereinafter, to distribute in cash or in kind.
(a) The executor(s) MAY in their sole discretion make distributions of property on behalf of a
beneficiary to such other persons as the executor may deem to be in the best interests of the
beneficiary, but the executor(s) cannot be compelled to do so.
(b) The executor(s) in distributing the assets of the estate should consider the nature and use of
the asset, and to the extent possible, in their discretion, distribute the asset to the beneficiary
who would most benefit from its receipt.
Article III. FUNERAL
I, hereby, direct my executors to pay for all expenses incurred in my cremation/funeral,
including, but not limited to, cemetery plot, casket, vault, embalming, funeral home's services,
death certificates, etc. including such costs that are reasonable thereto.
- 2 -
lnit.
. .
LAST WILL and TESTAMENT of HELEN H. SMITH
Article IV. DEBTS and BILLS
Section 4.01 I, hereby, direct my executors to undertake whatever actions are reasonable and
prudent to collect all sums owed to me at the time of my death, including, but not limited to,
loans (whether secured or unsecured), dividends, interest, unpaid wages, insurance proceeds,
and damages under law or in equity, etc.
Section 4.02 I direct the executor(s) to pay all debts owed by me individually upon receipt of due
proof of both the existence of the debt, and the correct amount owed.
(a) Provided, that such debts are unsecured by any property, real or personal.
(b) If, however. the debt is secured:
(i) it shall be paid if a specific bequest to pay such debt is made herein;
(ii) otherwise:
1) the debt shall pass with the property to the appropriate heir. Unless,
2) the secured property is sold by the estate, then the debts secured by that
property shall be satisfied.
Article V. TAXES and FEES
Section 5.01 I direct the executors to pay from my estate all taxes due, whether as income taxes,
estate taxes, inheritance taxes, transfer taxes or personal property taxes, which are payable
because of my death.
Section 5.02 In addition, they shall pay all fees necessary for the changes in ownership which are
caused by my death.
Section 5.03. Such TAXES and FEES shall:
(a) First, be paid from my residual estate; and if that is insufficient,
(b) they shall be apportioned between the specific bequests set forth hereinafter.
(c) Should my estate be insufficient to pay such taxes and fees, then the executors shall seek
contributions for such unpaid taxes and fees from those assets which passed outside of my
estate, but which are included in my taxable estate for Federal Estate and state Inheritance
and Estate Taxes, in proportion to the amount of such taxes and fees generated by each such
asset.
- 3 -
Init.
. , t,
LAST WILL and TESTAMENT of HELEN H. SMITH
Article VI. KNOWLEDGE and DEFINITIONS
Section 6.01 Being aware that each state has different laws relating to the definition of "estate" and
the rights of survivors, and, further, that the definition of "taxable estate" as set forth by the
Internal Revenue Service, includes many types of property which are not included in my estate
under Pennsylvania law, I, hereby, state that for purposes of this WILL:
(a) "estate" shall mean and be equivalent to the probatible estate as defined under Pennsylvania
law;
(b) "taxable estate" shall mean the "gross estate" as defined by the Internal Revenue Service, and
(c) "residual estate" shall mean my estate after deducting all SPECIFIC BEQUESTS and
HOUSEHOLD and PERSONAL EFFECTS as set forth, hereinafter.
Section 6.02 "Spouse" shall mean that person who is my spouse on the date of my death, and use of
a proper name to describe my spouse shall not be an indication of my intention to leave
anything to the named person, unless such person is my spouse on the date of my death.
Section 6.03 "Child(ren)" shall mean the natural child, adopted child, step-child either legitimate or
illegitimate, whether a product of the appropriate union or otherwise, whether now existing or
born hereafter.
Section 6.04 "Applicable Exemption Amount" shall mean that amount which when added to any prior
"taxable" gifts would yield under the then applicable lifetime exclusion a net "Federal Estate
Tax" of ZERO ($ 0.00) DOLLARS, plus such additional amount which would generate "Federal
Estate Tax" equal to the Death Tax Credit for such taxes owed to the state of domicile.
Article VII. COMMON DISASTER and SURVIVORSHIP
Section 7.01 If any person, who is an heir under this WILL, by name or relationship, shall fail to
survive me by 60 days, for any reason, they shall be deemed, for the purpose of inheriting under this
WILL, to have died one day before my death and the estate shall be distributed accordingly.
Section 7.02 If I for any reason die within 90 days after the death of a joint owner of property, I
hereby direct my executor(s) to disclaim my inheritance of such property and it shall be treated as
"Tenants in Common". My estate is only to receive the appropriate value of my ownership of such
property as if it had been partitioned on the day immediately preceding the joint owner's death.
Where multiple properties are co-owned with the same co-owner, the executor is permitted to group
such properties, such that the total received by my estate is equal to the appropriate value.
Article VIII. SPENDTHRIFT PROVISIONS
- 4 -
lnit.
LAST WILL and TESTAMENT of HELEN H. SMITH
No beneficiary may sell, give or otherwise transfer his or her interest in income or principal
hereunder. No person having a claim against a beneficiary may reach any such interest
before actual distribution and/or payment to the beneficiary.
Article IX. POWERS OF APPOINTMENT
Any power of appointment which I may have at the time of my death shall NOT be exercised by
any provision of this WILL either explicitly or implicitly.
BEQUESTS and GIFTS
Article X. HOUSEHOLD and PERSONAL EFFECTS
Section 10.01 If at the time of my death, I am unmarried with lineal descendents, I hereby give
any and all articles of personal or household use, including automobiles, in which I own any
interest to such of my daughters as they shall mutually agree to distribute. Except that any
such SPECIFIC BEQUEST, set forth hereinafter, shall take precedence over this provision to
the extent of any conflict in interpreting such provisions. The value of all articles so distributed
shall be included when calculating such beneficiary's appropriate residual share of my estate.
Article XI. SPECIFIC BEQUESTS
Any specific bequests set forth herein shall be included from any residual shares of the beneficiaries
as calculated hereinafter.
Section 11.01
NONE
Article XII. RESIDUAL ESTATE
Except for such specific bequests and HOUSEHOLD and PERSONAL EFFECTS as
set forth herein, I do hereby leave my RESIDUAL ESTATE as follows:
Section 12.01 If I am unmarried at the time of my death, I direct all my property, whether real or
personal, tangible or intangible, to be sold and the proceeds to be distributed with one share
of such amount going to each person or group as enumerated herein:
- 5 -
lnit.
LAST WILL and TESTAMENT of HELEN H. SMITH
(a) KAREN F. TATELA, and
(b) TINA L. SMITH, and
(c) my grandchildren as a singular group,
now living or hereafter born, whether named hereinabove or not, in equal shares, per stirpes;
Section 12.02 If, at the time of my death, I am both unmarried and have no surviving lineal
descendants, I direct that all property be sold and the proceeds received therefrom
shall be distributed in accordance with the laws of descent in Pennsylvania.
[THIS SPACE IS INTENTIONALLY LEFT BLANK]
- 6 -
Ini 1.
. ,
LAST WILL and TESTAMENT of HELEN H. SMITH
SIGNATURE
Intending to be legally bound by the terms and conditions set forth above, comprising a total of
8 printed pages, which includes this page and the affidavit, and further having initialed each of
said pages, and for such terms and conditijnS to b~inding on my executor(s), heirs, and
descendents, I do this ,~ day of ,11,J1I(J.fi1 f , 1991, affix my sign
before the witnesses and notary set forth hereinbelow.
,7Ie&~/ 7/ ~~'~
HELEN H. SMITH
WITNESSES
We, the undersigned witnesses, personally knowing the testator of this LAST WILL and
TESTAMENT, and having the testator state to us that this is the testator's LAST WILL and
TESTAMENT, did witness the testator affixing his/her sign hereinabove on the date set forth
above.
4-Jr1;, V~_
WitneT Signed
~k j.J, e"7peY-
- Printed
~LJ() (cJYf~,-G'rJ7 5ulk /oy
Address
J;hf/ I,);" r; . 8j OJ /0
/
~<~e j l fJ... k-'J
- Printed
:fLO Cvr~" Ck-,:Je, )u, ~ /0'1
Address
J+tJv('VI'sJ~c})) PA /7-//0
- 7 -
lnit.
..
LAST WILL and TESTAMENT of HELEN H. SMITH
AFFIDAVIT
COMMONWEALTH of PENNSYLVANIA
)
))
)
s.s.
COUNTY of DAUPHIN
I, THE UNDERSIGNED, a Notary for DAUPHIN County and Commonwealth, knowing or having
proven the identities of the testator and witnesses, above, and having seen each individually
set their hands and signs, and further, determining that such action was voluntary for each
such person, I do hereby set my sign and seal on the date aforesaid.
Notarial Seal
Robert J. Kreidler, Notary Public
Susquehanna Twp.. Dauphin County
My Commission Expires Oct. 14,2002
MM'lbef, Pennsylvania Association ot Notaries
- 8 -
Init.
"
SEP-13-05 03:50 PM BENKOVICH AND ASSOCIATES 7177616282
~. ~
P.02
}~I LE t:t
01/ - OS-- 007/c)
..
Wendy Seipel
08/30/2005 05:09 PM
To: John A Benkovich/FieldIWH/AEFA@AMEX
cc:
Subject: 11716144 8 HELEN H SMITH - DEATH SETTLEMENT
REQUIREMENTS - PLEASE DO NOT DELETE
IDS Life Insurance Company
American Express Funds
Amerlprise Certificate Company
Amerlprise Brokerage
70100 Amerlprise Financial Center
Minneapolis, MN 55474
August 30, 2005
JOHN A BENKOVICH JR
AMERIPRISE FINANCIAL SERVICES
4661 TRINDLE RD
CAMP HILL, PA 17011-5603
Dear JOHN A BENKOVICH JR:
Thank you for your recent inquiry regarding HELEN H SMITH's accounts. These are the values of the accounts as
or08/05/2005.
Mutual Funds
Account Number
012434718644002
0125347]864 3 002
Total Value
$3,488.92
$12.883.57
# of shares
734.007
4.404.105
Asset Value Per Share
4.750
2.910
Annuities - Post 1985
Account Number
93007022653 3 004
930071983579004
931027789144004 P/O
93102178993 8 004 P/O
Total Value
$29,735.86
$11,3671.7
$0.00
$439.29
The date of death values provided are for estate tax purposes and are not a value to be paid. Accounts may be
subject to market fluctuation as governed by each product. Please note that the values indicated for any Life
Insurance product(s) reflect the gross death benefit at date of death, nol the cash value. Values for any proprietary
mutual funds include accrued dividends as applicable.
We appreciate the opportunity to be of service to you. Please contact us if you have any questions.
Sincerely,
Wendy Seipel
Death Settlements Processing Team
70100 Ameriprise Financial Center
Minneapolis, MN 55474
1-800-862-7919, Option 5, I
~