HomeMy WebLinkAbout12-15-05
REV-1500
OFFICIAL USE ONLY
FILE NUMBER
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE DEPT.
280601 HARRISBURG, PA 17128-0601
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
0277
21- 05-
COUNTY CODE
YEAR
NUMBER
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Rabenstine, Charles E.
DATE OF DEATH (MM-DD-YY) DATE OF BIRTH (MM-DD-YY)
3/15/2005 11/15/1923
(IF APPLICABLE) SURVIVING SPOUSE'S NAME
N/A
SOCIAL SECURITY NUMBER
193-18-5030
THIS MUST BE FILED IN DUPLICATE
WITH THE REGISTER OF WILLS
SOCIAL SECURITY NUMBER
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1. Original Return 0 2. Supplemental Return
4. Limited Estate 0 4a. Future interest Compromise
6. Decedent Died Testate 0 7. Decedent had Living Trust
o 3. Remainder Return
o 5. Fed. Est. Tax Return Req'd
8. Total number of SOB's
COMPLETE MAILING ADDRESS:
NAME:
Taylor P. Andrews, Esquire
FIRM NAME:
Andrews & Johnson
TELEPHONE NUMBER
717243-0123
Taylor P. Andrews, Esq.
Andrews & Johnson
78 W. Pornfret St.
Carlisle, PA 17013
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(1 )
(2)
(3)
(4)
(5)
(6)
$130,000.00
$77,520.00
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3.Closely Held Corporation, Partnership or Sole-Prop.
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Misc. Personal Prop.(Sch.E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Misc. Non-Propate Prop.
8. Total Gross Assets (total lines 1-7)
9. Funeral Expenses & Administration Costs (Sch H)
10. Debts of Decedent, Mortgage liabilities, & Liens
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 (13)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amnt of Line 14 taxable at the spousal 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
19. Tax Due
20 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
V,
$0.00
$85,783.41
$0.00
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(9)
(10)
$80,865.30
(8) $374,168.71
$29,878.41
$14,067.91
(11 )
(12)
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(7)
$43,946.32
$330,222.39
$330,222.39
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(15)
(16)
(17)
(18)
(19)
$0.00
$14,860.01
$0.00
$0.00
$14,860.01
$330,222.39
$0
$0
x.O_
x.045
x.12
x.15
Decedent's ComDlete Address:
STREET ADDRESS
12 Moore Circle
CITY STATE ZIP
Carlisle PA 17013
Tax Payments and Credits:
1. Tax Due
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discounts
Total Credits (A+B+C)
3. InteresUPenalty if applicable
D. Interest
E. Penalty
4.
TotallnteresVPentalty (D+E)
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
5.
If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
(1 )
(2)
(3)
(4)
(5)
(5A)
(58)
$14,860.01
$0.00
$0.00
$14,860.01
$14,860.0 I
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: yes no
a. retain the use or income of the property transferred:
b. retain the right to designate who shall use the property transerred or its income:
c. retain a reversionary interest: or
d. retain the promise for life of either payments 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 fo(' 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 disignation?
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IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of pe~ury, 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.
ADDRESS
ADDRESS
DATE/~/S: c::J.s-
DATE 12 lS:o~
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% [72P.S. Sec. 9116(a)(1.1 )(I)J.
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. Sec. 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 Juiy 1, 2000:
The tax rate imposed on the net value of transfers from a desaased 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. Sec. 9116(a)(1.2)J.
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. Sec. 9116(1.2) [72 P.S. Sec.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. Sec.9116(a)(1.3)]. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
SCHEDULE A
REAL ESTATE
ESTATE OF
FILE NUMBER
Rabenstine, Charles E.
21-05-0277
All real estate owned solely or as a tenant in common should be reported at fair market value with is defined as the price at which property would be
exchanged between a willing buyer and a willing seller, neither being compelled to sell, both having reasonable knowledge of the relevant facts.
Property jointly-owned with Right of Survivorship must be disclosed on Schedule F.
DESCRIPTION
VALUE AT DATE
OF DEATH
ITEM
NUMBER
Industrial Building at 130 Monarch Street, Littlestown, P A
As per appraisal by Commercial/Industrial Appraisal Services
[the fIrst 10 pages of this multipage appraisal report is attached. The entire report
will be made available on request to the Dept. of Revenue for examination]
$130,000.00
Total (also enter on Line 1, Recap)
$130,000.00
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COMPLETE SUMMARY APPRAISAL REPORT
INDUSTRIAL BUILDING
150 MONARCH STREET
LITTLESTOWN BOROUGH.
. ADAMS COUNTY, PENNSYLVANIA
FOR
MS. DONNA J.HOUSER
EXECUTRIX OF THE ESTATE OF CHARLES E. RABENSTINE
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CO~RCIAL~NDUSTRlALAPPRAISALSERVICES
I. RICK LOBIANCO
PENNSYLVANIA CERTIFIED GENERAL APPRAISER
CERTIFICATION NUMBER GA-000518-L
. EXPIRATION DATE-JUNE 30,2007
DAVID B. STRAUSBAUGH
PENNSYLVANIA CERTIFIED GENERAL APPRAISER
CERTIFICATION NUMBER GA-003478
EXPIRATION DATE-JUNE 30, 2007
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December 1, 2005
Ms. Donna J. Houser
Executrix of the Estate of Charles E. Rabenstine
c/o Mr. Taylor P. Andrews, Esq.
78 West Pomfret Street
Carlisle, P A 17013
Re:
Complete Summary Appraisal Report
Industrial Building
150 Monarch Street
Littlestown Borough
Adams County, Pennsylvania
Dear Ms. Houser:
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Pursuant to your request, we have inspected and appraised the above referenced property (tax
number: district 27, map 8, parcel 366 in order to estimate the market value ofthe Unencumbered
fee simple interest for estate planning purposes. .....
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There are two, one tOn cranes in the building which are considered personal property. The value
of the cranes was not considered in the m~ket value of the subject presented in this report.
A Phase I Environmental Site Assessment was performed by Gannett Fleming, Inc~, Camp Hill,
PA in September 2005. Three areas/items of interest were discovered during the investigation:
1.) The western portion of the site where plaster has been historically discarded. .
2.) A ravine area located in the northeast corner of the site where trash and debris
have accUmulated.
3.) An area west of the main building where mold shop wash area pit and floor
drains discharge to ground surface.
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It was reported that "While these items are of environmental concern to the property owner, it is
important to recognize that none of these issues is considered to be a recognized environmental
condition under the ASTM definition". Phase II environmental testing of the western portion of
the site where the plaster was discarded is currently in progress. The appraisers' recommend that
the client review the findings of the tests to determine if any further action is required. The value
reported in this appraisal assumes that the property is free of any contaminants.
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Ms. Donna J. Houser
Executrix of the Estate of Charles E. Rabenstine
December 1, 2005
Page 2
As agreed upon prior to the preparation of this appraisal, this is a summary appraisal report
completed under and subject to the requirements set forth in Standard 1 (developing) and
Standard 2 (reporting) of the Uniform Standards of Professional Appraisal Practice (USP AP).
The conclusions and the information deemed most relevant are included in this report.
Additional data relied upon in this valuation has been retained in the appraiser's files. The report
is intended solely for the internal use of the client, Ms. Donna J. Houser, peer review and
appropriate regulatory authorities. It may not be distributed to or relied upon by other persons or
entities without my written permission.
Consideration has been given to the uses for which the property could be employed, location,
condition, size, zoning, functional utility, sales and rentals of comparable properties,
reproduction costs and other pertinent data.
According to the data analyzed, the retrospective market value of the subject as of March 15
2005, the date of death, was:--
ONEHUNDREDTEITRTYTHOUSANDDOLLARS
($130,000.00)
The following report, subject to the attached limiting conditions and certification, is the data and
analysis upon which the above conclusion is predicated. ThiEr"letter is inv~lid as an opinion of
value ifdetached from the report. . " . .
Respectfully submitted,
COMMERCIAL/INDUSTRIAL APPRAISAL SERVICES
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1. Rick LoBianco
Pennsylvania Certified General Appraiser
Certification Number GA-000518-L
Expiration Date-June 30,2007
David B. Strausbaugh
Pennsylvania Certified General Appraiser
Certification Nuniber GA-003478
Expiration Date-JUne 30, 2007
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STATEMENT OF LIMITING CONDITIONS
This appraisal report is prepared for the sole and exclusive use of the appraiser's client. No third
partie~ are authorized to rely upon this report without the express written consent of the
appraIser.
This appraisal is to be used in whole and not in part. No part of it shall be used in conjunction
with any other appraisal. Neither all nor any part of the contents of this report shall be conveyed
to the public through advertising, public relations, news, sales, or other media, without the
written consent and approval of the author, particularly as to valuation conclusions, and the
identity ofthe Appraiser or firm, with which he is connected.
Possession of this report, or a copy thereof, does not carry with it the right of publication, nor
may it be used for any purposes by any but the client, without the previous written consent of the
Appraiser or the client; and in any event, only with proper qualification.
No responsibility is assumed by the Appraiser for matters that are of legal nature, nor is any
opinion on the title rendered. Good title is assumed.
This property has been appraised as though free of liens. and encumbrances, except as herein
described.
It has been assumed that the property will be efficiently managed and properly maintained.
The Appraiser herein, by reason of this report, is not required to give testimony in court with
reference to the property appraised, unless arrangements have been previously made.
Unless otherwise noted, it is assumed there are no encroachments, zoning violations or
restrictions existing that would affect the subject property. .
The current-(as-of the date of appraisal) purchasing power of the dollar is the basis for the value
estimates; no extreme fluctuations in economic cycles are anticipated.
The plans in this report are included to assist the reader in visualizing the property. The
Appraiser has made no survey of the property and assumes no responsibility in connection with
such matters.
Information, estimates, and opinions contained in this report, obtained from sources outside of
this office, are considered reliable, however, no liability for them can be assumed by the
Appraiser.
The value estimate is subj ect to these and to any other assumptions set forth in the body of this
report.
Unless otherwise noted in the body of this report, this appraisal assumes that the subject property
does not fall within the areas where mandatory flood insurance is effective.
It is assumed that there are no hidden or unapparent conditions of the property, subsoil, or
structures, which would render it more or less valuable. No responsibility is assumed for such
conditions or for engineering, which may be required to discover them.
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STATEMENT OF LIMITING CONDITIONS, CONTINUED
It is assumed that all required licenses, consents or other legislative or administrative authority
from any local, state, or national governmental or private entity or organization have been or can
be obtained or renewed for any use, on which the value estimate contained in this report is based.
Unless otherwise stated in this report, the existence of hazardous material, which mayor may not
be present on the property, was not observed by the appraiser. The appraiser has no lmowledge
of the existence of such materials on or in the property. The appraiser, however, is not qualified
to detect such substances. The presence of substances such as asbestos, urea-formaldehyde foam
insulation or other potentially hazardous materials may affect the value of the property. The
value estimate is predicated on the assumption that there is no such material on or in the property
that would cause a loss in value. No responsibility is assumed for any such conditions or for any
expertise or engineering lmowledge required to discover them. The client is urged to retain an
expert in this field, if desired.
"The Americans with Disabilities Act" (ADA) became effective January 26, 1992. The appraiser
has not made a specific compliance survey and analysis of this property to determine whether or
not it is in conformity with the various detailed requirements of the ADA. It is possible that a
compliance survey of the property, together with a detailed analysis of the requirements of .the
ADA, could reveal that the property is not in compliance with one or more of the requirements of
the Act. If so, this fact could have a negative effect upon the value of the property. Since the
appraiser has no direct evidence relating to this issue, he did not consider possible non-
compliance with the requirements of ADA in estimating the value of the property.
fuformation within this report regarding flood hazard zones has.been obtained from maps, where
available, provided by the Federal Emergency Management Agellcy (FEMA). It is understood
that these maps are difficult to read and not always accurate. The reader is advised that without
accurate maps the appraiser lacks the required training or background to determine with any
certainty whether the subject's land is located within a flood zone, The client is advised to
employ the services of an expert whose trail1ing allows'therntosubIl1it an accurate report The
results reported ;herein are general at best and are presented without finality.
Acceptance of and/or use of this appraisal report constitutes acceptance of the foregoing
assumptions and limiting conditions.
=:if!(J4j~
Pennsylvania Certified General Appraiser
Certification Number GA-000518-L
Expiration :p>ak!uge 30, 2007
Date: 1~/r9CI b
G~~,
David B. Strausbaugh
Pennsylvania Certified General Appraiser
Certification Number GA-003478
Expiration Date-June 30, 2007
Date: [1- d-.1-cS-
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SCOPE OF THE APPRAISAL
Inherent in the scope of the appraisal is the required research and analysis necessary to
prepare and offer a credible opinion of the market value of the subject property. The steps
undertaken in this particular evaluation are outlined as follows:
1. The subject property was inspected on November 21,2005 by David B. Strausbaugh of
CommerciallIndustrial Appraisal Services accompanied by Mr. Larry E. Flemmens, the building
tenant. David B. Strausbaugh of CommerciaVIndustrial Appraisal Services took photographs
appearing in this report on November 21,2005.
2. Neighborhood data was gathered from and based upon a personal inspection of the area
by David B. Strausbaugh and I. Rick LoBianco of CommerciallIndustrial Appraisal Services, as
well as information obtained from the Adams County Assessment Office and Littlestown
Borough.
3. Subject property data was based on a personal inspection and photographs gathered by
David B. Strausbaugh of CommerciallIndustrial Appraisal Services. Building measurements
were taken November 21, 2005 by David B. Strausbaugh of CommerciallIndustria1 Appraisal
. Services. . Title data was obtained. from the Adams County Recorder of Deeds .Office. Flood
plain data was obtained from maps prepared by the Federal Emergency Management Agency.
. Current assessment and millage information was procured from the Adams County Assessment
Office.
4. In estimating the highest and best use, an analysis was made of the data compiled in the
three (3) steps detailed above. Moreover, a study of similar industrial buildings was conducted.
The most relevant data is presented in the report for review.
5. In developing the approaches to value, the market data was collected from public
records;" the . files' of'CommerciallIndustria1 Appraisal Services, "otherappraisers; real estate
brokers, and persons knowledgeable 'of the subjectpropeW.rmarket place'and mwicipaloffices
in the Adams County area.
6. After assembling and analyzing the data defined herein, a final opinion of market value
was made.
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SUMMARY OF IMPORTANT FACTS AND CONCLUSIONS
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LOCATION: 150 Monarch Street, Littlestown Borough, Adams County, Pennsylvania
OWNERSHIP: Estate of Charles E. Rabenstine
LAND AREA: 3.412 acres
IMPROVEMENT: A one story concrete block building with 10,105 square feet including 1,080
square feet of dated office space (10.7% of the building total). The building was constructed in
1950 with an addition in 1957. Overall, the building is considered to be in fair condition.
TAX IDENTIFICATION NUMBER: District 67, Map 9, Parcel203A
IDENTIFICATION OF PROPERTY RIGHTS: Encumbered fee simple interest
OBJECTIVE OF THE APPRAISAL: To estimate the market value of the subject property.
FUNCTION OF THE APPRAISAL: For estate planning purposes
INTENDED USER OF THE REPORT: Solely for the use of the client, Ms. Donna J. Houser
APPRAISAL DATE: (Date of inspection) November 21,2005
DATE OF REPORT: December 1,2005
RETROSPECTIVE DATE: March 15,2005 (date of death)
DEFINITION OF MARKET VALUE
..-........ ..... .h..'....IIThe.most probable price which a'propertyshouldbringin a competitive and'open'"
"t"'r"lt:..,..'1TQ+" 'l..,.,rlO'l'" 1)11 -,.,.",....,rl;t;n't'lC" .....~l"1n;s;tA fA ".:1 f"~~1'" Cr:1L::. fh'A 'h1l''U,o.-r -::anA c.o.llp-r Pt;l""'h ~,....t;rio -nninp,,-tlu
~Ul~'\..vL. u..&.J.UVJ. aJ.J. vVJ.J.U.l.LoJ.V.LJ.Ct J.\..I'iI..LJ. .J.....v LoV U. .Lu.u. J..:Ju.J.V, r...L.LV VIoA.,J""",,J. """"'-J.~ U_.L.L,,",L ..........""'.L.I. -.............1.....:;, .t'.I.\,06.~_.............J'
knowledgeably, and assuming the price is not affected by undue stimulus. Implicit in this
definition is the consummation of a sale as of a specified date and the passing of title from seller
to buyer under conditions whereby:
a. Buyer and seller are typically motivated;
b. Both parties are well informed or well advised, and each acting in what he
considers his best interest.
c. A reasonable time is allowed for exposure in the open market.
d. Payment is made in terms of cash in U.S. dollars or in terms of financial
arrangements comparable thereto; and,
e. The price represents the normal consideration for the property sold unaffected by
special or creative financing or sales concessions granted by anyone associated
with the sale.
Source: Appraisal Standard Board - Uniform Standard of Professional Appraisal Practice - 2004
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SUMMARY OF IMPORTANT FACTS AND CONCLUSIONS, CONTINUED
FLOOD ZONE: Zone C - Reference Community Panel 421244B, Effective Date June 1, 1984
The property is not located within a designated flood hazard area.
ZONING: The subject property is zoned "Industrial/Employment District" by Littlestown
Borough. The subj ect is considered to be conforming to zoning.
MARKETING PERIOD: A reasonable marketing period is estimated at approximately nine to
twelve months given current market conditions and assuming competent brokerage.
HISTORY, OWNERSHIP AND OCCUPANCY: The subject most recently transferred from
Littlestown Pattern Works Inc. to Charles E. and Betty J. Rabenstine on February 8, 1989 for a
recorded price of$1.00 in a related parties transfer (Book 514, Page 1144). The subject building
is and has been utilized as an industrial building for years.
ENCUMBRANCE
The subject property has been occupied by Littlestown Pattern Works, Inc. since 1989. There
was a five year lease with a subsequent three year lease which expired September 31, 1996 at a"
rate of $2,500 per month ($2.96 per square foot) plus utilities, building maintenance, insunince
and real estate taxes. LittlestownPattem Works, Inc has continued to lease the subject on a
month by month basis since that time with the same terms.
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ASSESSMENT ANALYSIS: The current assessment of the subject property is $86,100. Reali Ii
estate taxes have been estimated on 31.75 mills for Littlestown Area School District, 8.00 mills I
for Littlestown Borough and 11.2991 mills for Adams County, totaling 51.0491 mills. This flat II
rate equates to total annual taxes of$4,395. _' ' /J
:~~~~~.~~Js~~rs U~~~t~~I;~~~~e:~;e~~:~~~~:sfr~~t%~~~~Thil~d~~~~-i- --. -, ...- ",.--.--11'
improvements over a given period of tL.'1le. I :
The high, est and best use of the subject as vacant is for one of the many allowable uses in an i,:"',:, ,i
Industrial/Employment District of Littlestown Borough. l:j
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The highest and best use of the property, As-Is, is an owner occupied industrial building. ' If Ii
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DESCRIPTION OF SITE AND IMPROVEMENTS
The subject property is located in the in the southern half of Littlestown Borough,
approximately one and one half miles north of the Maryland state line, and approximately ten
miles southeast of Gettysburg, the county seat. The site has approximately 285 front feet along
the south side of Monarch Street, a short dead end street. The major roadways through
Littlestown Borough are Routes 194 and 97, both two-way routes that intersect at or near the
center square in Littlestown Borough. Route 97 is one block west of the subject, and Route 194
is approximately one quarter mile north of the subject. Access to Route 15, the primary
north/south highway through Adams County, is approximately eight miles northwest of the
subject via Route 97. Route 30, the primary east/west highway through Adams County, is
accessible approximately nine miles northwest of the subject along Route 15.
The property is located in an Industrial/Employment zoning district of Littlestown
Borough. Directly east and north of the subject are industrial properties including Feeser
Trucking, Vista Machines and Old Furniture/Collectibles. West of the subject are older
residential dwellings and further south are newer residential developments.
The mostly rectangular shaped, basically level site has average visibility along Monarch
Street. Access to the property is from two curb cuts along the north side of Monarch Street: The-- -.--
western section of the site is brush and tree covered. The land to building area ratio is good,
'however due to the discarding of plaster in the western section of the site over the years,
significant site work may be required to ready the site for any future improvements. There is an
asphalt paved parking area along the east elevation of the building. The site has all public
utilities available. Exterior lighting is provided by lighting fixtures attached to the building. No
underground tanks have been disclosed. Penn Central Properties, Inc. and the Penn Central
Corporation reserves rights to all oil, gas, natural gas, casing-head gas, condensates, related
hydrocarbons and all products produced therewith in or under the property.
_ -" The' subject 18--a. one story COncrete block buildiiig;'~ith' 1O;105:~qhare feet mchiding'l;O'8D - ,--
square feet of dated office space (10.7% of the building total). The building was constructed in
1950 with an addition in 1957. Overall, the building is considered to be in fair condition.
The exterior of the building consists of concrete block walls, a rubber roof reported to be
less than two years old and in good condition, older industrial fenestration, metal gutters and
downspouts and building attached lighting.
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DESCRIPTION OF SITE AND IMPROVEMENTS, CONTINUED
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The interior of the building consists of an office area with 1,080 square feet in the
southeast comer of the building, two shop areas, a production are and a storage room. The office
area is from a single wood and glass entry door on the south elevation and consists of four private
offices, a women's restroom with a water closet and lavatory and a men's restroom with three
lavatories, two water closets, a urinal and a shower. The interior finish of the office is dated and
consists of vinyl tile flooring, drywall walls, a tile ceiling and fluorescent lighting.
The production area, shop areas. and storage rooms are all primarily open space. The
interior finish consists of concrete floors, concrete block walls, an insulated metal ceiling with
twelve feet clearance and fluorescent lighting. There is a 14 x 12 foot wood and glass garage
door at grade level along the south elevation, an 8 x 10 foot wood garage door which opens to a
raised concrete dock on the west building elevation and a lOx 10 foot metal garage door at grade
level along the west elevation. Additionally, there is a four foot deep, 12 x 20 foot floor pit
centrally located along the west building elevation.
The subject building has 400 amp, three phase electrical service, emergency lighting
(reported by Mr. Fleromens to be in-operable), gas fired 'forced air heat in the office area and gas
fired modineand radiant heat in the production.and shop areas.
Overall, the building is considered to be in fair condition.
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SCHEDULE B
STOCKS AND BONDS
ESTATE OF
FILE NUMBER
Rabenstine, Charles E.
21-05-0277
ITEM
NUMBER
All property jointly-owned with Right of Survivorship must be disclosed on Schedule F
DESCRIPTION VALUE AT DATE
OF DEATH
3040 shares in ACNB Corporation
Adams County National Bank
@ $25.50 per share
$77,520.00
TOTAL (also on line 2, Recapitulation)
$77,520.00
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANIOUS PERSONAL PROPERTY
ESTATE OF
FILE NUMBER
Rabenstine, Charles E.
Include the proceeds of litigation and the date the proceeds were received by the estate
All property jointly-owned with Right of Survivorship must be disclosed on Schedule F
DESCRIPTION V ALUE AT DATE
OF DEATH
21-05-0277
ITEM
NUMBER
Miscellaneos personal property. Summary of appraisal report attached.
Entire 40 page report with photos of many objects available for review.
1997 Buick Park A venue w 39,302 miles not included in this value.
This was included in appraisal but is reported on Schedule G
$9,905.00
2
Adams County National Bank - account 2044013
$1,919.51
3
PNC account #51-4042-0085
This account is in name of Donna J. Houser, but all funds in account were
funds of Charles E. Rabenstine. Donna J. Houser was his atty in fact.
$73,958.90
4
Decedent's estate has an expectation, but not yet a right to receive a refund
from Decedent's investment in a retirement cottage at Cumberland Crossing
Retirement Community. This will only become a right at such time as the
cottage that Decedent occupied at 12 Moore Circle is reoccupied by a new
occupant.
Copies of the Cottage residency agreement and correspondance are attached.
The expectation is for a refund of$194,607.90.
At such time as this becomes a right, a supplemental return will be filed.
TOTAL (also on line 5, Recapitulation)
$85,783.41
APPRAISAL REPORT
OF
PERSONAL PROPERTY
OF
Charles Rabenstine. deceased
date of death (d.o.d.) March 15, 2005
12 Moore Circle
Carlisle, P A 17013
for:
Donna Houser, Executrix
1314 Georgetown Circle
Carlisle, P A 1 70 13
AS OF:
d.o.d. March 15,2005
Reported on March 19,2005
tlY:
. . .
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IBIS APPR..MSAJIL
SER.VICES
11-.5N lia.noverSt.
'p'QBox 21-
(fd;Jls1~ PA1701J
(717) 245-5471-
fax2j8-9j02
f.bisds@ea.rti:J.Jlnlc.net
TABLE OF CONTENTS
Table of Contents
Appraisal Certificate
Appraisal Summary
Photograph & CD-ROM Instructions
Personal Property Listing
Location: Living Room
Location: Dining Room
Location: Entryway Closet
Location: Laundry Room
Location: Hallway
Location: Bedroom 1
Location: Master Bedroom
Location: Master Bathroom
Location: Garage
Location: Kitchen
Location: Television Room
Location: Sunroom
Location: Attic
Category: Computers & Electronics
Totals by Location & Computers/Electronics
Appraisal Summary (Copy)
References
Statement of Qualifications
Assumptions and Limiting Conditions
2
3
4
5
6
6
9
14
14
14
14
16
19
19
20
22
27
30
32
36
37
38
39
40
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12/14/2005 23:47
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APPRAISAL CERTIFICATE
r hereby certify that, upon the request for the estate appraisal of the personal property of
Charles Rabensti.ne, deceased, 12 Moore Circle Carlisle, PA 17013, I have personally and
physically inspected the listed person.al property. The personal property was appraised to
determine the FAIR MARKET VALUE, AS OF d.o.d Marth 15, 2005 & reported on
J\rlarch 19,2005. The date of inspection vvas March 04, ~OOS.
The information and values contain.::d in thi.s report are based upon my experience as an
appra.iser and other reliable sources, The personal property was found to be in GOOD to
EXCELLENT condition, unkss otherwise noted. Value.,; arc reported piece-by-piece,
and/or as a whole, All values reported have been detemnilled 'hith consideration to the
condition of the item, market conditions, and salability factors.
(~ (J IBIS APPRAISAL
~~~ /? VTC'ES
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PAGE 02/0<-1
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12/14/2005 23:47
7172438414
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APPRAISAL SUM11ARY
It i~ in my opinion, that as of cl.o.d. March 15,2005, the Fair Market Value of the
personal property of Chades Rabenstine~ deceased:
(Fifteen Thousand Nine Hundred Five Dollars and Zero Cents)
($15,905.00)
I~ . IBIS APPF~AISAL
~..~ . ~ SERVICES
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The report must be read in its entire1v. The Appraisal Summary ONLY is
not the aOOfaiSlll report.
PAGE 03/04
M -- ~
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4
Totals by Location and Computers & Electronics
Living Room $909.25
Dining Room $1,962.00
Entryway Closet $15.25
Laundry Room $45.00
Hallway $2.00
Bedroom 1 $364.50
Master Bedroom $764.75
Master Bathroom $1.25
Garage $6,296.00
Kitchen $208.75
Television Room $1,408.75
Sunroom $446.50
Attic $233.00
Computers & Electronics $3;248.00
TOTAL $15,905.00
36
Appraisal References
Brickers, Chuck E. Auction. 93 Texaco Rd. Mechanicsburg, P A 17050
Conestoga Auction Company, Inc. 768 Graystone Rd. Manheim, P A 17545
DeHart's Auction Services & Used Furniture. 1554 Holly Pike Carlisle, PA 17013
eBay. http://www.ebay.com
Gottshall, Jr., Roy Auctions. 113 Forge Rd. Boiling Springs, P A 17007
Hershey, Dan Auctioneering Service. 3 Brown Rd. Shippensburg, P A 17257
Kelley Blue Book. http://www.kbb.com
F. Loney, C.A.P.P., L.P.I. 2005. Personal Communication
Ocker, Carl E. Auction. 4401 Philadelphia Ave. Chambers burg, P A 17201 ..
Replacements. http://www.rep1acements.com
Rowe's Auction Service. 2505 Ritner Hwy. Carlisle, P A 17013
York Town Auction, Inc. 1625 Haviland Rd. York, PA 17404
38
Statement of Qualifications
Alyssa L. Loney, C.A.P.P.
Professional Designations and Certifications
C.A.P.P. - Certified Appraiser of Personal Property designation earned through course work
and classes provided by the Institute of Appraisal of Personal Property.
Archaeological Resources Protection Act - Certified to conduct investigations and damage
assessment that pertains to violations of the United States federal, state, and local laws
pertaining to archaeological sites and cultural properties. Including by not limited to the
Archaeological Resources Protection Act of 1979, National Historic Preservation Act of
1966, the Native American Graves Protection and Repatriation Act and the American
Antiquities Act of 1906.
Professional Accomplishments
.. State Historical and Underwater Archaeologist for the State of Louisiana.
.. Attended the Conservation of Indian Artifacts Symposium sponsored by the Smithsonian
Institution and the Tunica-Biloxi Indian Reservation, Marksville, Louisiana.
.. Director of the West Virginia University Historical Costume Museum.
.. ' Research Archaeologist! Artifact Instructor for CADW (Welsh Historic Monuments)/
University of York, England.'
.. Research and Preservation Specialist for the Maryland Historical Trust.
.. Presented and published works for national and international organizations including the
Society for Historical Archaeology, Middle-Atlantic Archaeology Conference, Southeastern
Archaeological Conference, Louisiana Archaeological Society, and the Maryland Historical
Trust.
Education
B.Sc.
Historical Textiles and Clothing, 1992, West Virginia University, Morgantown,
West Virginia, United States.
Medieval Archaeology, 1995, University of York, York, England.
Certified Appraiser of Personal Property, 2001, Institute of Appraisal of Personal
Property, York, Pennsylvania, United States.
Certified to conduct investigations and damage assessment that pertains to
violations of the United States federal, state, and local laws pertaining to
archaeological sites and cultural properties.
First Step Entrepreneurial Series, 2001, Kutztown University of Pennsylvania,
Small Business Development Center.
M.A.
C.A.P.P.
A.R.P.A.
S.B.D.C.
Presently
Director and Founder ofIbis Appraisal Services. Member of Institute of Appraisal of Personal
Property, American Society of Appraisers, Appraisers Association of America, International
Society of Appraisers, and Professional Coin Grading Service.
Conducts extensive on-site appraisals, assessments, analyses, and authentication of personal and
cultural property. Operates on local, national, and intemationallevels. Conducts research on all
objects considered personal and cultural property.
39
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PAGE 114/04
Assumptions and Limiting Conditions
The term "Fai; Market VaL.IC:", as used in this report, is defined as follows; The higherst price an
item would bring if the sale occurred under normal market conditions providing
1. neither tbe buyer or seller is acting under duress,
2. the property has been exposed on the open market for a reasonable length of time,
3. both the buyer and tl\e seller are aware of the potential assets and defects,
4. 00 unm:ual circumstances are present.
Th'.;. appraisal was based upon the following ass,lmptions, linlitations, and conditions:
]. The intormation contained in this report was gathered from sources cqn::;idered reliable,
personal examination, research of authentic.ity and comparable sales and/or auctIOn prices.
2. No responsibility i~ 85sumed for matters that are legal in l1ature, includi:lg, but not limited to:
the representa.tion of otllers concerning the value, 3Llthenticity, condition, origin, or
provenance of an item appraised.
3. The appra.iser assumed that a normal and careful ~xaminatjoll of the property was sufficient
to deterrnlne its quality and ('ondition and that no ex.traordinary examination procedures were
to be utilized, unless these were spedally requested and the expE:uditu:-e of funds therefore
autborized.
4. The appraIser's court attendance and expert te,still1tmy repOlt, ifreqiJ.ired, are not included as
part ofthb r(:PQrt. The appraiser does have the right to refuse testimony.
THE UNDERSIGNED HEREBY CERTIFtES;
1 That I have no inttrest now, ner have r had an interest in the past, nQr shall I
contemplate an iJ.,torc:;t II) the futcll'O, in the property covered by this appraisaL
2. That to the best of my knowledge and belief, all statements and information included
in this appraisal are true and based upon objective findings and that no pertinent
information has been knowingly withheld or deleted in this report.
,J. That neither thi;: t;:mplQyment to make thjs appraisal or GompMsation for doing so is
contingent Lipon the value of the property.
It is the finn belief of the appraiser that the lnformatiol\ furnished in this appraisal report and the
con.elusions drawn from this information are true and wrrect, but they are not guarantf;J~d.
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~ ADAMS COUNlY
NATIONAL BANK
March 31, 2005
Andrews & Johnson
Attorneys at Law
78 West Pomfret Street
Carlisle, PA 17013
Re: Estate of Charles E. Rabenstine
Dear Mr. Andrews:
The following information is being provided as per your request:
Acct. Type Account Account Accrued Ownership Date Date Joint
No. Principal on Interest to Account
D.O.D. D.O.D. Opened
Checking 2044013 $1,919.51 $00.00 Individual 1-1-60 N/A
Inquiries concerning ACNB Corporation stock information should be directed to the Registrar and Transfer
Company at 1-800-368-5948. If you need any additional information, please contact me at (717)338-2171.
Sincerely,
$ I L
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Lois Kime
Deposit Services
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F:\F1LESIDA TAFlLE\HOSPIT AL.DOC\546-AG 1>-.4
COTTAGE RESIDENCY AGREEMENT
for
CARLISLE RETIREMENT COMMUNITY CORPORATION
doing business as
CUMBERLAND CROSSINGS RETIREMENT COMMUNITY
One Langsdorf Way
Carlisle, P A 17013
717-245-0777 - 1-800-722-0267
for
Resident Name a /!tiP., ,1,J, l?~5 ~ le~f;,Jr
Cottage Address: 12 /l100,t;6 C:z c Ie.
Cumberland Crossings
Carlisle, P A 170 i3
[EOH Logo)
Revised: 3/98
a $500.00 administrative fee and the total of any expenses incurred by Sponsor for
customizing the cottage at the request of the Resident. Sponsor will pay the refund due to
.the Resident under this paragraph (b) within 30 days of the effective date ofterrnination of
this Agreement.
2. After Occupancy.
Unless one of the pro'1sions in paragraph 1 applies:
A. Resident shall be obligated to pay the Monthly Service Fee until the later of
the effective date oftennination ofthis Agreement or the date Resident surrenders possession
of the cottage, and
B. Resident selects the following refund option:
L Option A - Sponsor will refund ninety percent (90%) of the Residency Fee
previously paid by Resident.
Option B - Sponsor will refund an amour.~ equal to one-hundred percent
(%100) of the Residency Fee previously paid by Resident less one percent (1 %) of the
Residency Fee for each full or partial month of occupancy (the period between the
date on which the cottage is available to Resident for occupancy and the date on
which Resident surrenders possession of the cottage).
Under either above option, refund will be made only when possession of the cottage has been
surrendered to Sponsor and a replacement resident for the cottage has entered into a new
Cottage Residency Agreement, paid a new Residency Fee, and taken residency of the cottage.
Sponsor shaH have the sole authority to decide whether or not to accept the repl~cement
resident and to set the amount of the new Residency Fee.
C. From the amount to be refunded pursuant to paragraph (b), Sponsor may
deduct and retain a sum equal to:
(i) The portion of the Residency Fee applied by Sponsor, if any, to pay any
monthly Service Fees and other charges and to reimburse Sponsor for lost interest
income under Section 9, and
(ii) any other money owed by Resident to Sponsor for any reason whatsoever.
E. . . Additional Services. The following additional services ("Additional Services") will
be available on a fee-for-service basis:
1. Additional Housekeeping
2. Laundry Service for Personal Items
3. Catering for Special Occasions
4. Meal Delivery to Cottages
5. Guest Meals
6. Additional Resident Meals
7. Barber and Beauty Services
8. Additional Maintenance Services
9. Additional Transportation Services
Charges for Additional Services will be made in accordance with Sponsor's Disclosure of Charges
as theriin effect and shall be billed to Resident monthly after Additional Services are incurred.
Sponsor's current Disclosure of Charges is available in the Community's administrative offices.
F. Alteration to cottage. Resident may make alterations to the cottage at Resident's
\
cost subject in each case to the Resident's submission of architectural renderings and the Sponsor's
prior written approval. Any approved alteration ~ill be performed by Sponsor's maintenance staff
or by a contractor approved by Sponsor. The balance of the Residency Fee for refundability purposes
will be adjusted by the value of any approved st1l1ctural alterations made at Resident's expense as
determined by Sponsor. Resident, for safety reasons, agrees not to replace or add any locking devices
to the cottage. Sponsor will replace any defective locking device.
G. Advance Notice for Changes in Scope of Services. The Sponsor will provide at
least sixty (60) days advance written notice before any change in the scope of care or services
becomes effective. This notice requirement includes notification of any increase in charges for
Additional Services. Sponsor agrees not to unreasonably reduce the scope of care or services without
reasonable cause, including, without limitation, reductions in the scope of care or services resulting
from changes in law.
SECTION 4. INSURANCE BY RESIDENT.
A. Health and Long Term Care. As a condition of this Agreement, Resident shall
enroll, at Resident's own--expense, in Medicare (Parts A and B) or in an equivalent program that is
acceptable to the Sponsor. The Sponsor also requires that Resident obtain and maintain, at
9
degree of medical certainty, the mental or physical limitations necessitating the transfer 'Will be
pennanent in nature, Upon permanent transfer of a single occupancy resident, this Agreement will
terminate. In the event of such terinination, refund of the Residency Fee will be made pursuant to
the terms of Section 16.
If Sponsor determines as provided above, after consultation to the extent feasible with
Resident, Resident's family members or representatives and Resident's attending physician, that
Resident requires health care or services which the Community cannot provide, or is not licensed or
authorized to provide, Resident agrees to leave the Community for such care. Refund of the
Residency Fee will be made pursuant to Section 16.
B. Return to Residential Living. If, after a permanent transfer to the Assisted Living
Center or Skilled Care Center at Cumberland Crossings, Resident again meets the requirements of
entry for residency in a cottage, wishes to return to a cottage and meets current adlnissions criteria,
Resident will be given priority access status for a cottage.
SECTION 6. COSTS TO RESIDENT
A. Fees. Under the terms and conditions of this Agreement, Resident has the right to
reside at the Community and to receive the services described above. In return, Resident shall pay
the following fees:
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1. Residency Fee. Resident shall pay a Residency Fee in the aggregate amount
of ~/~ 1!:;"o . This Residency Fee may be paid in two installments. Thefirst installment
of$ O?/ 'Y'75 , shall be due at-the time Resident executes this Agreement. This first
installment shall be no less than ten percent (10%) of the total Residency Fee. The balance
of the Residency Fee, being $ /fc....:? (] 75 ,shall be due on or before the Occupancy
,
Date (failure of Resident to pay the balance ofthe Residency Fee on or before the Occupancy
Date shall be a breach of tlus Agreement by Resident, entitling Sponsor to exercise those
~emedies to which it may be entitled by law, and which remedies shall be deemed to include
the collection of interest on the amount of the balance of the Residency Fee at the'rate of2%
per month). The Residency Fee shall in no way be construed or interpreted to be a security
deposit. Prior to a Resident's Occupancy Date, all monies paid by Resident shall be held in
11
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April 2, 2002
Mr. Charles Rabenstine
12 Moore Circle
Carlisle, PAl 7013
Dear Mr. Rabenstine:
We have been reviewing the records for each cottage at Cumberland Crossings
Retirement Center and are updating any modifications or changes made to these cottages.
The modifications, when meeting the specified threshol<;l, are as follo',vs:
A. Greater than $ 250
B, A fixed item (excludes furniture)
C. Any construction modifications to the original floor plan
The corresponding monetary amounts will be added to your entrance fee and become pmi
of your refund option when you leave our community. The following are the particulars
for your cottage:
Refund Option
qno/,o ._ / '1'!./. b <':/ -;. r CJ
-~. '--.,/1
Entrance Fee
Modifications
$ 214,750.00
$ 1,481.00
Total eligible for refund
$ 216,231.00
If you have any questions or concerns regarding the above mentioned update, please
contact me at your em'liest convenience. Thank you.
Sincerely,
f/1rI ~f
Jeffrey Goodling
Chief Financial Officer
Cumberland Crossings Retirement Community
] LonQ'snmfWllv .. ri1rlj~lf': PA I7nn to 717_,)4~_QQ41
available person (other than Sponsor) as Resident's attorney-in-fact, which power of attorney shall
be at all times in effect and physically located in Sponsor's fIles.
SECTION 41. NOMINATE A LEGAL GUARDIAN
If Resident becomes unable to properly care for Resident's property and if Resident has made
no other designation of a person or legal entity to serve as guardian, (If under deed of trust or power
of attorney, then Resident hereby authorizes Sponsor to nominate a legal guardian to serve when
approved by a court as provided by law.
SECTION 42. SURVIVAL OF PROVISIONS
Any provision ofthis Agreement addressing matters arising or continuing beyond the date of
termination of this Agreement shall survive such termination.
SECTION 43. DISCLOSURE STATE1\1ENT
R.:-esident will receive a copy ofthe Annual Disclosure Statement every year. . ;/
/ -
The parties hereto agree to the foregoing tenns and conditions as of the ./!'J
of ~_ " ;; f:l intending to be legally bound.
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By:
\ RETIREMENT CO:M:M:UNITY CO ~
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Cumberland Crossings
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January 1, 2004
Disclosure Statement Required
By
The Continuing Care Provider Registration and Disclosure Act
Of
The Commonwealth of Pennsylvania
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TRESSLER L UTRERAN
SERVICES
DJ,l[.(Ot\ LUlhe:r:m Social Mtni;'rrle$
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The issuance of a Certificate of Authority does not constitute approval, recommendation
or endorsement of the facilities by the Insurance Department of the Commonwealth of
Pennsylvania, nor is it evidence of, nor does it attest to, the accuracy or completeness of
the information set out in this disclosure statement. .
I
Cumberland Crossinrzs
. IV.' Legal Requirements
Resident's Handbook
A. Disclosure Statement
A Disclosure Statement is provided to Residents mmually by the Executive
Director; this includes the Financial Statement of Cumberland Crossings.
B. Refunds
1. When the Resident relinquishes their cottage and terminates residency at Cumberland
Crossings Retirement Community, a refund Amount will be established as follows:
a. Cumberland Crossings will refund the established percentage of the
Residency Fee as described in the signed Residency Agreement upon
occupancy of the cottage. Cumberland Crossings will generate this
refund within 30 days of final payment by the new Resident.
2. When the Resident relinquishes the cottage and moves to a different level of care
within the Cumberland Crossings Retirement Community, the refund will be made
as follows:
a. The cottage refund Amount as established can be used to offset
the cost of Personal and Nursing Care.
b. Upon full payment of the cottage by the new Resident, a refund will
be calculated according to our Residents' Agreement Refund Policy.
The refund would reflect the deducted Amount applied to care in the
Personal Care or Skilled Nursing Center if applicable.
Revised Jl02
Page 25
Classic Plan: This plan offers the lowest Occupancy Fee. A resident choosing this plan will
be entitled to a refund of the refund amount paid less 4% of the refund amount after month
one and less an additional 2% per month in each month of occupancy from month two to
month forty-nine. After forty-nine months the resident will not be entitled to a refund.
Classic Plus Plan: This plan offers the mid-point Occupancy Fee. A resident choosing this
plan will be guaranteed no less than a 50% refund of the base purchase price paid. The
resident will be entitled to a refund of the refund amount paid less 5% of the refund amount
after month one and less an additional 1 % per month in each month of occupancy from
month two to month forty-six. After forty-six months, the resident will be entitled to a refund
of 50% of the refund amount with no further adjustments.
Estate Preservation Plan: This plan offers the highest Occupancy Fee. A resident choosing
this plan is guaranteed no less than a 90% refund of the base purchase price. The resident
will be entitled to a refund of the refund amount paid less 5% of the refund amount after
month one and less an additional 1 % per month in each month of occupancy from month two
to month six. After six months, the resident will be entitled to a Iffund of 90% of the refund
amount with no further adjustments.
The following two contract options are no longer offered at Cumberland Crossings:
Declining Refund: The Occupancy Fee is earned by Cumberland Crossings ata rate of 1%
per month for 100 months. If the resident vacates the cottage for any reason during the first
100 months, the resident will receive that portion of the Residency Fee that has not been
earned by Cumberland Crossings. After 100 months, the resident would no longer receive a
refund. This plan is similar to the Classic Plan described above; however, the declining
refund period is longer.
90% Refund: A 90% refund of the Occupancy Fee will be refunded when the resident
vacates and the cottage has been resold and occupied. The remaining 10% will be earned by
Cumberland Crossings at a rate of 1 % per month for the first 10 months of occupancy. This
plan is similar to the Estate Preservation Plan described above; however, the refund period is
slightly longer.
Should a sole cottage resident die, the refund shall be made to the estate, contingent on resale
and re-occupancy of the unit. When a cottage is occupied by two people, such as a husband
and wife, and one dies, occupancy passes to the surviving spouse. If a sole cottage resident
should marry, the occupancy passes to the surviving spouse.
Monthly Service Charges Include:
. Trash / recyclable collection at a location near the Cottage Unit;
. Maintenance of exterior building and grounds (including lawn care and snow removal),
interior public areas, building costs and custodial services for common areas (not
including the inside of Cottage Unit);
. Pest control on the grounds and in Cottage Unit;
. Maintenance of appliances provided by Cumberland Crossings;
. Maintenance; repairs and replacements of Cumberland Crossings; property and
equipment;
. Water and sewerage. Residents are responsible for all other utilities;
. Insurance for the exterior of Cottage Unit;
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c01\itBtRLAND CROSSINGS
RETIREMENT COMMUNITY
Diakon Lutheran Social Ministries
November 10,2005
Mr. Taylor P. Andrews, Esquire
78 West Pomfret Street
Carlisle, P A 17013
Dear Mr. Taylor,
I received your letter dated October 14, 2005 concerning the Estate of Charles Rabenstine
and the refund due to the estate on Cottage 12.
We hereby acknowledge that, pursuant to the contract executed by Mr. Rabenstine, when a
new resident pays a residency f~e for, and takes possession of, Mr. Rabenstine's cottage, a
refund in the amount of$194,607.90 will be payable to Mr. Rabenstine's estate. We will
begin processing the refund as soon as Mr. Rabenstine's cottage is reoccupied.
If you have any questions, please do not hesitate to call me at 717-240-6012. Thank you.
Sincerely,
ttlO~~
Executive Director
1 Langsdorf Way
Carlisle, PA 17013
Phone 717.245.9941
Fax 717.240.6017
Toll Free 1.800.722.0267
www.diakon.org
1)
CUM-BERLAND CROSSINGS
RETIREMENT COMMUNITY
Diakon Lutheran Social Ministries
November 30, 2005
Taylor P. Andrews, Esq.
Andrews & Johnson
78 West Pomfret Street
Carlisle P A 17013-3216
Re: Refund for Charles Rabenstine - Cottage Number 12
Dear Mr. Andrews:
I am writing in response to your letter of November 15,2005, requesting information
about the marketing of the above-referenced cottage at Cumberland Crossings
Retirement Community.
Cottage 12 was considered available as soon as it was surrendered by Mr. Rabenstine's
family in late June. Because of the length of time Mr. Rabenstine occupied the cottage,
the cottage required significant renovation, which was begun promptly after surrender.
However, even during the course of renovation, which is now almost complete, the
cottage was being shown. It is our policy that, if a prospective resident is interested in a
cottage undergoing renovation, we do everything in our power to expedite the Work:
No prospective residents have indicated interest in cottage 12 as of yet, however.
The cottage is listed as follows:
90% refund plan = $302,500
50% refund plan = $249,000
0% refund plan = $178,000
Cottage 12's floor plan is the largest floor plan offered at Cumberland Crossings,
consisting of a "Regency" plus a 350 square foot sun-room suite. For your information,
I have enclosed a current price list of all available cottages. There are currently 13
vacant cottages on campus: four Devonshires, four Heritages, one Windsor, two
Regencies, and two "sun-room" Regencies.
With respect to your question about the length oftime needed to re-occupy a cottage:
unfortunately, there is no standard answer available to that. Sales can be somewhat
seasonally dependent (e.g. older adults decide after a bad winter that they do not want to
have to clear sidewalks, etc. again and thus start exploring communities like
Cumberland Crossings). At times, we may have a spike in vacancies when a number of
cottage residents transfer to another level of care because of illness, etc., in which case,
a "buyer's market" is created and re-occupancy can take longer.
Phone
Fax
Toll Free
1 Longsdorf Way
Carlisle, PA 17013
717245.9941
717.240.6017
1.800.722.0267
www.diakon.org
Andrews, November 30, 2005
Page 2
Our team at Cumberland Crossings continues to actively market cottage 12. We
appreciate the concerns that families have in these situations and are making every
effort to resell the cottage. It is one of our most attractive and appeals to today's
retirees, who are interested in larger units. As I indicated in my letter of November 10,
we will begin processing the refund on the cottage as soon as the cottage is reoccupied.
Thank you.
Very truly yours,
8~1~~
Executive Director
Enclosure
SCHEDULE G
TRANSFERS
ESTATE OF
FILE NUMBER
Rabenstine, Charles E.
21-05-0277
ITEM DESCRIPTION OF PROPERTY TOTAL VALUE DECD.% EXCLUSION TAXABLE
INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND
NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE, OF ASSET INT (if applicable) VALUE
I
1 1997 Buick Park Ave. W 39,302 miles, transferred to $6,000 100.0% 0.0% $6,000
Donna Houser, daugher of decedent I
date of transfer: March 14,2005
This asset was included in the appraisal by
Ibis Appraisals attached as supplement to
Schedule E. I
Thrivent Financial Settlement Contracts
[annuities] all payable to Donna J. Houser,
daughter of decedent.
Contract numbers:
2 B2725285 $542.97 100.0% 0.0% $542.97
3 B2893802 $3,823.73 100.0% 0.0% $3,823.73
4 SOO16712 $9,953.29 100.0% 0.0% $9,953.29
5 SOO16756 $41,108.89 100.0% 0.0% $41,108.89
6 9108011 $8,197.86 100.0% 0.0% $8,197.86
7 9108012 $11,238.56 100.0% 0.0% $11,238.56
This schedule to be completed and filed if the answer of the question on the reverse of the cover is yes.
TOTAL (also on line 7, Recapitulation)
$80,865
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for Lutherans™
Death Benefit Information
Mpls Settlement Option Contract: B2725285
Deceased: Charles E Rabenstina
Date of Death: 03/15/2005
Oate prepared: 04/2812005
Claim Number: 345456
Death Benefit
Cost Basis
Taxable Gain
$
$
0.00
542.97
Total Death Benefit
$
542.91
Beneficiary Designation
Primary: Donna J Houser, Children Born/Adopted
First Contingent M Kenneth Houser, Son-in-law
Second Contingent: Brian K Houser. Grandchild, Michelle R Maim, Grandchild
Special Messages
1. IMPORTANT TAX REQUIREMENTS: Each beneficiary will be subject to federal income tax
withholding for their share of the taxable gain. Each beneficiary needs to complete the substitute
W-4P section on the Claimant's Statement. If NO withholding is desired. the first section in the
substitute W-4P should be checked. If the beneficiary DOES want withholding, the appropriate
section should be completed.
2. To assist the beneficiary in selecting a distribution method, you should refer to Income Tax Chart
No.1. This chart can be printed from InfoSourc9, Customer Service, Claims, Death Claims Tax
Charts.
u.::::~
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for Lutherans™
Death Benefit Information
Mpls Settle.ment Option Contract: B2893802
Deceased: Charles E Rabenstine
Date of Death: 03/15/2005
Oate Prepared: 04/28/2005
Claim Number: 345456
Death Benefit
Cost Basis
Taxable Gain
$
$
0.00
3,823.73
Total Death Benefit
$
3,823.13
Beneficiary Designation
Primary: Donna J Houser, Children Born/Adopted
First Contingent M Kenneth Houser, Son-in-law
Second Contingent: Brian K Houser, Grandchild, Michell9 R Maim, Grandchild
Special Messages
1. IMPORTANT TAX REQUIREMENTS: Each beneficiary will be subject to federal income tax
withholding for their share of the taxable gain. Each beneficiary needs to complete the substitute
W-4P section on the Claimant's Statement. If NO withholding is desired, the first section in the
substitute W-4P should be checked. If the beneficiary DOES want withholding, the appropriate
section should be completed.
2. To assist the beneficiary in selecting a distribution method, you should refer to Income Tax Chart
No.1. This chart can be printed from InfoSource, Customer Service, Claims, Death Claims Tax
Charts.
3. The values quoted i~ this claim kit reflect the manually calculated, approximate value of the contract
62893802 as of the date of death. Any payments that were disbursed from the contract 82893802
may not have been deducted from the values quoted in this claim kit. A payment of $49.45 was
disbursed after the date of death. This payment should be retumed to Thrivent Financial for
Lutherans.
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for Lutherans™
Death Benefit Information
Mpls Settlement Option Contract: S0016712
Deceased: Charles E Rabenstine
Date of Death: 03/15/2005
Date Prepared: 04/28/2005
Claim Number: 345456
Death Benefit
Cost Basis
Taxable Gain
$
$
0.00
9.953.29
Total Death Benefit
$
9,953.29
Beneficiary Designation
Primary: Donna J Houser, Children Bom/Adopted
First Contingent: M Kenneth Houser, Son-in-law
Second Contingent: Brian K Houser, Grandchild, Michelle R Maim, Grandchild
Special Messages
1. IMPORTANT TAX REQUIREMENTS: Each beneficiary will be subject to federal income tax
withholdIng for their share of the taxable gaIn. Each beneficialY needs to complete the substitute
W-4P section on the Claimant's Statement. If NO withholding Is desired, the first section in the
substitute W-4P should be checked. If the beneficiary DOES want withholding, the appropriate
section should be completed.
2. To assist the beneficiary in selecting a distribution method, you should refer to Income Tax Chart
No.1. This chart can be printed from InfoSource, Customer Service. Claims, Death Claims Tax
Charts.
~~-~-""'-vw v~.....~r lli'f 1'V1::1''''''' I .1.....,'"- ICOI. 1
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for Lutherans™
Death Benefit Information
Mpls Settlement Option Contract: S0016T56
Deceased: Charles E Rabenstine
Date of Death: 03/15/2005
Date Prepared: 0412812005
Claim Number: 345456
Death Benefit
Cost Basis
Taxable Gain
$
$
22.164.07
18,944.82
Total Death Benefit
$
41,108.89
Beneftclary Designation
Primary: Donna J Houser, Children Born/Adopted
First Contingent: M Kenneth Houser, Son-in-law
Second Contingent: Brian K Houser, Grandchild, Michelle R Maim, Grandchild
Special Messages
1. IMPORTANT TAX REQUIREMENTS: Each beneficiary will be subject to federal income tax
withholding for their share of the taxable gain. Each beneficiary needs to complete the substitute
W-4P section on the Claimant's Statement. If NO withholding is desired, the first sectIon in the
substitute W-4P should be checked. If the beneficiary DOES want withholding. the appropriate
section should be completed.
2. To assist the beneficiary in selecting a distribution method, you should refer to Income Tax Chart
No.1. This chart can be printed from InfoSource, CUstomer Service, Claims, Death Claims Tax
Charts.
3. The values quoted In this claim kit reflect the manually calculated. approximate value of the contract
50016756 as of the date of death. Any payments that were disbursed from the contract 80016756
may not have been deducted from the values quoted in this claim kit. A payment of $787.76 was
disbursed after the date of death. This payment should be retumed to Thrivent Financial for
Lutherans
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Death Benefit Information
Settlement Agreement Contract: 9108011
Deceased: Charles E Rabenstine
Date of Death: 0311512005
Date Prepared: 04/2812005
Claim Number: 345456
Death Benefit
Cost Basis
Taxable Gain
$
$
8,197.86
0.00
Total Death Benefit
$
8,197.86
e.neficiary Designation
Primary: Donna J Houser, Child(ren}-Named
First Contingent M Kenneth Houser, Son{s)-ln..Jaw
Second Contingent: Michelle R Maim, Brian K Houser, Grandchild(ren)-Named
Special Messages
1. To assist the beneficiary in selecting a distribution method, you should refer to Income Tax Chart
No.1. This chart can be printed from InfoSource. Customer Service, Claims, Death Claims Tax
Charts.
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for LutheransTtfI
Death Benefit Information
Settlement Agreement Contract: 9108012
Decoeased: Charles E Rabenstine
Date of Death: 03/15/2005
Date Prepared: 04/2812005
Claim Number: 345456
Death Benefit
Cost Basis
Taxable Gain
$
$
9,639.97
1.598.59
Total Death Benefit
$
11,238.56
Beneficiary Designation
Primary: Donna J Houser, Child(renrNamed
First Contingent M Kenneth Houser, Son(s)-in-Iaw
Second Contingent: Michelle R Maim. Brian K Houser. Grandchild{ren)-Named
Special Messages
1. IMPORTANT TAX REQUIREMENTS: Each beneficiary wlll be subject to federal income tax
wlthholding for their share of the taxable gain. Each beneficiary needs to complete the substitute
W-4P section on the Claimant's Statement. If NO withholding Is desired, the first section in the
substitute W-4P should be checked. If the beneficiary DOES want withholding, the appropriate
section should be completed.
2. To assist the beneflciary in selecting a distribution method, you should refer to Income Tax Chart
No.1. This chart can be printed from InfoSource, Customer Service. Claims, Death Claims Tax
Charts.
SCHEDULE H
FUNERAL EXPENSES, ADMINISTRATIVE
COSTS AND MISCELLANEOUS EXPENSES
ESTATE OF
FILE NUMBER
Rabenstine, Charles E.
21-05-0277
A.
ITEM DESCRIPTION AMOUNT
NUMBER
Funeral Expenses:
1 Hoffman Roth Funeral Home $8,334.65
2 Service expenses $395.85
Administrative Costs:
1 Personal Representive Commissions
Name of Personal Representative(s)
Social Security Number of Personal Representative:
Street Address:
City: State: Zip:
Year(s) commissions paid: " .,q,
2 Attorney fees to Andrews & Johnson to date at hourly rate $6,405.00
3 Family Exemption
Claimant
Street:
City: State & Zip
Relationship of Claimant to Decedent:
4 Probate Fees to Register of Wills $825.00
5 Accountant Fees $625.00
6 Appraisal fees $1,860.00
7 Advertising fees $252.45
8 Environmental Evaluation of Littlestown property to determine marketability $4,800.00
paid to Gannet Fleming
9 Bank fees for estate account $56.16
10 Occupancy expenses to clean out and surrender cottage, incl utilities $5,504.30
I 1 Attorney fees to Gregory B. Abeln, Esq. re environmental concerns $416.25
12 Hydrologist services regarding Littlestown property to Earth Resource Assoc. $403.75
13
14
15
16
17
18
TOTAL (also on line 9, Recapitulation) $29,878.41
Debts of decedent must be reported on Schedule I.
B.
SCHEDULE I
DEBTS OF DECEDENT
MORTGAGE LIABILITIES AND LIENS
ESTATE OF
FILE NUMBER
Rabenstine, Charles E. 21-05-0277
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
Quest - telephone long distance
$8.52
2
Met-Ed - electricity
$53.58
Real estate taxes on Littlestown real estate to Marilyn J. Basehoar
$1,628.41
West Shore EMS
$196.56
Sprint - telephone
$171.96
UGI
$205.89
Nationwide insurance
$25.00
Chase Visa Gold
$33.84
Andrews & Johnson - for services before dod
$507.50
Links 2 care - for home care
$2,188.00
Continuing Care Rx
$505.99
Cumberland Crossing skilled care
$8,510.43
Bankcard Serivices
$10.09
Andorra Radiology Assoc
$22.14
TOTAL (also on line 10, Recapitulation)
$14,067.91
SCHEDULE J
BENEFICIARIES
ESTATE OF
FILE NUMBER
Rabenstine Charles E
21-05-0277
"
ITEM NAME AND ADDRESS OF BENEFICIARY RELA TrONSHIP AMOUNT OR SHARE
NUMBER Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [include outright spousal diSlributions, and transfers under Sec. 9116(a)(1.2)J
1 Donna J. Houser, 1314 Georgetown Circle, Carlisle, P A
17013 Daughter residue
2 Brian K. Houser, 10807 Catron Rd., Perry Hall, MD 21128-
8956 Grandson 7%
3 Michelle Renee Maim, 106 Ellsworth St., Colorado Springs,
CO 80906 Granddaughter 7%
4 James Q. Maim, 106 Ellsworth St., Colorado Springs, CO
80906 Great Grandson 5% in Trust
5 Charles K. Maim, 106 Ellsworth St., Colorado Springs, CO
80906 Great Grandson 5% in Trust
6 Megan H. Maim, 106 Ellsworth St., Colorado Springs, CO
80906 Great Granddaughter 5% in Trust
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
N/A
B. Charitable and Governmental Bequests;
N/A
TOT AL CHARITABLE AND GOVERNMENTAL BEQUESTS (also enter on line 13, Recapitulation)
$0
.... ." .
LAST WILL AND TESTAMENT
OF
CHARLES E. RABENSTINE
I, CHARLES E. RABENSTINE, of Carlisle, Pennsylvania, having and possessing a sound
and disposing mind, memory and understanding, do hereby make, declare and publish this as and
for my last Will and Testament, hereby revoking and making void all former Wills and writings in
the nature thereof by me at any time heretofore made.
FIRST: I order and direct all my just debts and funeral expenses, together with all death taxes,
State and Federal, shall be paid from my residuary estate, as soon as practicable after my decease,
as a part of the expense of the administration of my said estate.
SECOND: I devise and bequeath all the rest, residue and remainder of my estate, whether
real, personal or mixed, of whatsoever kind and wheresoever situate, as follows:
a) Seven (7%) percent thereof to my grandson, Brian K. Houser.
b) Seven (7%) percent thereofto my granddaughter, Michelle R. MaIm.
c) Five (5%) percent thereofto my great-grandson, James Q. MaIm, subject to the trust
provlsions hereinafter set forth in Paragraph Third.
d) Five (5%) percent thereof to my great-grandson, Charles K. MaIm, subject to the trust
provisions hereinafter set forth in Paragraph Third.
e) Five (5%) percent thereof to my great-granddaughter, Megan H. Maim, subject to the
trust provisions hereinafter set forth in Paragraph Third.
f) The remaining baIance of my estate to my daughter, Donna J. Houser. In the event my
daughter, Donna J. Houser, predeceases me, I devise and bequeath her share to her issue, per
stirpes, who survive me.
Wj~<
/iJP:t-, ~:
\ /J
&-~ ~~~(SEAL)
Charles E. Rabenstine
" .. .
THIRD: In the event any of my great-grandchildren, Megan H. MaIm, James Q. MaIm, or
Charles K. MaIm, have not reached their twenty-first (218t) birthday at the time of my death, I
direct that the distributive share of each such great-grandchild shall be distributed unto Donna J.
Houser, and in the event she fails to qualify or ceases to act, then unto M. Kenneth Houser, and in
the event he fails to qualify or ceases to act, then unto Michelle R. MaIm, IN TRUST,
nevertheless for the following uses and purposes, and subject to the following terms and
conditions:
1. The Trustee shall pay to or expend and apply for the benefit of my beneficiary, so much of
the income and principal as Trustee, in their sole discretion, deems necessary for the proper
support, maintenance, welfare and education of my beneficiary, and any such distribution shall be
made only from the part of the trust property designated as being for the beneficiary benefited.
Any income not distributed shall be added to principal.
2. The Trustee shall pay over to each such beneficiary the then remaining balance of his or her
part when he or she attains the age of twenty-one (21) years.
3. No part of the income or principal of the property held under this trust shall be subject to
attachment, levy or seizure by any creditor, spouse, assignee or trustee or receiver in banlcruptcy
of any beneficiary prior to his or her actual receipt thereof The Trustee shall pay over the net
income and the principal to the parties herein designated, as their interests may appear, without
regard to any attempted anticipation, pledging or assignment by any beneficiary under a Trust,
and without regard to any claim thereto or attempted levy, attachment, seizure or other process
against said beneficiary.
4. I direct that the Trustee shall invest and reinvest the corpus oftrus trust in such investments
as shall constitute legal investments for Trustees under the laws of the Commonwealth of
Pennsylvania.
5. To sell, either at a public or private sale and upon such terms and conditions as the Trustee
may deem advantageous to the Trust, any or all real or personal estate or interest therein owned
Wi~~~Q
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~~~ ~~~-4'L--~(SEAL)
Charles E. Rabenstine
.. ill' .
by the Trust severally or in conjunction with other persons, and to consummate said sale or sale
by sufficient deed or other instruments to the purchaser or purchasers, conveying a fee simple
title, free and clear of all trust and without obligation or liability of the purchaser or purchasers to
see to the application of the purchase money or to make inquiry into the validity of said sale or
sales; also, to make, execute, acknowledge and deliver any and all deeds, assignments, options or
other writings which may be necessary or desirable in carrying out any of the powers conferred
upon the Trustee in this paragraph or elsewhere in this instrument.
6. To lease the real estate which may extend beyond the terms ofthe Trust hereunder.
7. To pay all costs, taxes, expenses and charges in connection with the administration of the
Trust, including a reasonable compensation to agents.
8. To do all other acts in their judgment deemed necessary or desirable for the proper and
advantageous management, investment and distribution of the Trust.
FOURTH: I nominate, constitute and appoint Donna 1. Houser as Executrix of this my
last Will and Testament, and in the event she fails to qualify or ceases to act, then I nominate,
constitute and appoint M. Kenneth Houser as Executor of this my last Will and Testament, and in
the event he fails to qualify or ceases to act, then I nominate, constitute and appoint Michelle R.
MaIm as Executrix oftrus my last Will and Testament; and I direct that they shall not have to file
bond in order to qualify as Executors in this my said estate.
IN WITNESS WHEREOF, I, Charles E. Rabenstine, the Testator, have to this my last
Will and Testament, subscribed my name and affixed my seal this 16th day of March, 2000. This
Will being written upon three typewritten sheets of paper and attached under one cover, the
preceding of which pages are identified by my signature.
~~ ~~~-4~~~SEAL)
Charles E. Rabenstine
Signed, sealed, published and declared by the above named Charles E. Rabenstine, the
Testator, as and for his last Will and Testament, in the presence of us, who, at his request and in
his pr~ e a d in the presence. of each other, ha.ve here. un.t.o. SUbSCrib.ed o.ur n.ames as witnesses
thereto... J"l"
. ' r l!a7:t7 ~~.
MIne Witness f
~ . JA ~/ /." if?
- . Addr~ j1. . --- ~A;dils"'-("/ ,71-
.. . 'i ..
COMMONWEAL TH OF PENNSYLVANIA:
: SS:
COUNTY OF ADAMS
We, Charles E. Rabenstine,
)6#( to lieI/;;;.
'- l>oz VI;.( ,K' .Ji. ,,"l e.S" , and
, the Testator, and the witnesses respectively, whose names are
signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the
undersigned authority that the testator signed and executed the instrument as his last Will and that
he had signed willingly and that he executed it as his free and voluntary act for the purposes
therein expressed, and that each of the witnesses in the presence and hearing of the Testator,
signed the Will as witness and that to the best of their knowledge the Testator was at that time
eighteen years of age or older, of sound mind and under no constraint or undue influence.
a~ ~~~~"-4'~<,"~ (SEAL)
~:tme,
Wltn
/)
,AJ/rll A'~~itne?~L '
Subscribed, sworn to and acknowledged before me by Charles E. Rabenstine, the Testator,
and s~scribed and sworn to before me by 2Ja.Wd K Janvs and
L2tJ T-/;~ &19/;; , witnesses this /6 T>"day of /httAC!A' ,2000.
~~-f"~
r-~~;~~~ 3;;~~~~~!
~ Up',...,,-.~ r--'t LJ.......n""'r' /- ''"''~_. o..~.t~~ Ii
g 'vlc;;.~y n. ~ ~:::i.,H,;~\, 'Jj.:.Jt~,~! ~""'~t(~ f1
I i\~y ~.r~~~~~~~c~i,E.~rt~~1:~~E~r~bLi3 I
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;l,:iS-Ttcr. Pe!':r!8yivvrlii~ /.,:tf.;Qc~r~t~ot1 ci hJ(~:E.ri~;~
~-_.._------.---~->---_._.+-,..."
"\~?b
~ Cv.".LL
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT DF 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
HOUSER DONNA J
1314 GEORGETOWN CIRCLE
CARLISLE, PA 17013
n_nn_ fold
ESTATE INFORMATION: SSN: 193-18-5030
FILE NUMBER: 2105-0277
DECEDENT NAME: RABENSTINE CHARLES E
DA TE OF PAYMENT: 12/15/2005
POSTMARK DATE: 1 2/15/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 03/15/2005
NO. CD 006106
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $11,491.07
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$11,491.07
REMARKS:
CHECK#1030
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
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
HOUSER DONNA J
1314 GEORGETOWN CIRCLE
CARLISLE, PA 17013
___nn_ fold
ESTATE INFORMATION: SSN: 193-18-5030
FILE NUMBER: 2105-0277
DECEDENT NAME: RABENSTINE CHARLES E
DATE OF PAYMENT: 12/15/2005
POSTMARK DATE: 12/15/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 03/15/2005
NO. CD 006107
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $3,368.94
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$3,368.94
REMARKS:
CHECK#1032
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS