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REV-1500 EX + (6-00)
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
OFFICIAL USE ONLY
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Fillmore, Alberta J.
DATE OF DEATH (MM-DD-YEAR)
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10-13-2005
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIAL)
07-18-1924
DATE OF BIRTH (MM-DD-YEAR)
FILE NUMBER
II 05
COUNTY CODE YEAR
SOCIAL SECURITY NUMBER
0943
NUMBER
193-12-7784
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
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o 1. Original Return
o 4. Limited Estate
[!] 6. Decedent Died Testate (Attach
copy of Will)
o 9. Litigation Proceeds Received
o
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2. Supplemental Return
4a. Future Interest Compromise (date of death after
12-12-82)
7. Decedent Maintained a Living Trust (Attach
copy of Trust)
10 Spousal Povertv Credit (date of death between
. 12-31-91 and 1-1-95)
o 3. Remainder Retum (date of death prior to 12-13-82)
o 5. Federal Estate Tax Return Required
o 8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
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NAME
James D. Bogar
FIRM NAME (If applicable)
Bogar & Hipp Law Offices
TELEPHONE NUMBER
717-737-8761
COMPLETE MAILING ADDRESS
One West Main Street
Shiremanstown, PA 17011
1. Real Estate (Schedule A)
2, Stocks and Bonds (Schedule B)
3, Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L) 0 Separate Billing Requested
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
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11. Total Deductions (total Lines 9 & 10)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
12. Net Value of Estate (Line 8 minus Line 11)
(1) 71,200.00 OFFICIAL USE ONLY
. .
(2) 145,567.00
(3) None
(4) None
(5) 97,923.55
(6) None
(7) None
(8) 314,690.55
(9) 13,081.62
(10) 462.63
(11 )
13,544.25
301,146.30
0.00
(12)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has
not been made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(13)
(14)
301,146.30
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
20. D
0.00
13,551.58
0.00
0.00
13,551.58
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
15.Amount of Line 14 taxable at the spousal tax rate, 0.00 x .00 (15)
z or transfers under Sec. 9116(a)(1.2)
0 (16)
i= 16. Amount of Line 14 taxable at lineal rate 301,146.30 x .045
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c.. 17. Amount of Line 14 taxable at sibling rate 0.00 x .12 (17)
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0
0 18. Amount of Line 14 taxable at collateral rate 0.00 .15 (18)
>< x
~ 19. Tax Due
(19)
>>BESURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH<<
Copyright 2002 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00RK
..
Decedent's Complete Address:
STREET ADDRESS
5401-23 Oxford Drive
CITY Mechanicsburg
STATE PA
ZIP 17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1 )
13,551.58
12,782.25
672.75
Total Credits (A + 8 + C)
(2)
13,455.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (0 + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund
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 + SA. This is the BALANCE DUE.
(3)
(4)
(5) 96.58
(SA)
(58) 96.58
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
Yes
o
o
o
o
o
o
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DATE
934 Valley Street
Enola, PA 17025
J-l..~-O&'
ADDRESS
DATE
ER THAN REPRESENTATIVE
ADDRESS
DATE
One West Main Street
Shiremanstown, PA 17011
, -2(.,- O~
For dates of death on or afte uly 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is 3% [72 P .S. 99116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. 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 the use of a
natural parent, an adoptive parent, or a stepparent of the child is 0% [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 4.5%, except as noted in 72 P .S.
99116 1.2) [72 P.S. 99116 (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. 99116 (a) (1.3)]. A sibling is
defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
..
Rev-1502 EX+ (6-98)
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Fillmore, Alberta J.
FILE NUMBER
21-05-0943
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller, neither being compelled \0 buy or sell, both having reasonable knowiedge of the relevant facts.
Real property which Is Jointly-owned with right of survivorship must be dIsclosed on schedule F.
ITEM
NUMBER DESCRIPTION
1 Real Estate - All that certain condominium unit situated in Village of Moreland IV, A
Condominium (the "Condominium"), Lower Allen Township, Cumberland County,
Pennsylvania, being known and numbered as 5401-23 Oxford Drive,
Mechanicsburg, Pennsylvania. The property was acquired by Alberta J. Fillmore,
single individual by Deed dated October 15, 1996 and recorded October 16, 1996 in
the Cumberland County Recorder of Deeds Office, a copy of said Deed being
attached hereto and incorporated herein. The above-described real estate is being
transferred to Dennis G. Fillmore, sole beneficiary of the Estate of Alberta J.
Fillmore. A copy of said deed of conveyance is attached hereto. Date of death
value as listed on the attached appraisal.
VALUE AT DATE
OF DEATH
71.200.00
TOTAL (Also enter on Line 1, Recapitulation)
71.200.00
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule A (Rev. 6-98)
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PARCEL NO. /3-2-l!-iCf/-2- ctS'itJ/-)-.,.3
THIS DEED,
Made the jf.)~ day of
(;x:!, TO f5. E/<.., 1996
BETWEEN VILLAGE OF MORELAND, INC., a
corporation, having an address at P.O. Box 367,
Pennsylvania 17339, Party of the First Part,
designated as Grantor
Pennsylvania
Lewisberry,
hereinafter
AND
ALBERTA J. FILLMORE, single individual, of 412 Wren
Court, Mechanicsburg, Cumberland County, Pennsylvania, Party of the
Second Part, hereinafter designated as Grantee.
WITNESSETH, that the said Grantor for and in
consideration of the sum of SIXTY-THREE THOUSAND NINE HUNDRED
($63,900.00) DOLLARS, lawful money of the United States of America,
to the Grantor in hand well and truly paid the by Grantee, at or
before the sealing and delivery of these presents, the receipt
whereof is hereby acknowledged and the Grantor being therewith
fully satisfied, does by these presents grant, bargain and sell,
release and confirm unto the said Grantee, their heirs and assigns,
ALL TrL~T CERTAIN condominium unit situated in Village of
Moreland IV, A Condominium (the "Condominium"), Lower Allen
Township, Cumberland County, Pennsylvania, being designated as UNIT
NO. 5401-23 in the Declaration of the Condominium, dated September
14, 1995, recorded September 22, 1995, in Cumberland County
Miscellaneous Book 504, Page 636, and the Declaration Plans of the
Condominium dated April 7, 1995, recorded September 22, 1995, in_
Cumberland County plan Book 70, Page 133, and the First Amendment
to Declaration of Condominium, dated October 3, 1996, recorded
October 3, 1996 in Cumberland County Miscellaneous Book 531, Page
714 and the plan dated September 26, 1996( and recorded October 3,
1996, in Plan Book 73, Page 33, under the provisions of the Uniform
Condominium Act of the Co~~onwealth of Pennsylvania, as amend~d
from time to time (Act of July 2, 1980, P.L. 286, No. 82).
BEING part of the same premises granted and conveyed by
Germantown Savings Bank to Village of Moreland, Inc., a
pennsyl vania corporation, by Deed dated September 3, 1987 and
recorded in the Office of the Recorder of Deeds in and for
Cumberland County, Pennsylvania, in Record Book X-32, Page 425.
UNDER AND SUBJECT to easements, covenants, restrictions,
reservations and rights-of-way of record.
aOOK 141/ PAGE 619
TOGETHER with all right, title and interest in and to the
Common Elements as more fully set forth in the aforesaid
Declaration of the Condominium and Declaration Plans, as amended
from time to time.
The Grantee, for and on behalf of the Grantee and the
Grantee's heirs, personal representatives, successors and assigns,
by the acceptance of this deed, covenants and agrees to pay such
charges for the maintenance of, repairs to, replacement or and
expenses in connection with the Common Elements as may be assessed
from time to time by the Executive Board in accordance with the
Act j and further, Grantee covenants and agrees that the unit
conveyed by this deed shall be subject to a charge for all amounts
so assessed and that, except insofar as applicable Sections of the
Act may relieve a subsequent unit owner of liability for prior
unpaid assessments, this covenant shall run with and bind the land
or unit hereby conveyed and all subsequent owners thereof.
The Grantee, for and on behalf of the Grantee and the
Grantee I s heirs, personal representatives, succcessors and assigns,
by acceptance of this deed, acknowledges that this conveyance is
subject in every respect to the Declaration, the Declaration Plans,
By-Laws and all amendments thereto; and the Grantee further
acknowledges that each and every provision of the foregoing is
essential to the best interest and for the benefit of all unit
owners therein. Grantee and all owners of units in the Condomonium
covenant and agree, as a covenant running with the land, to abide
by each and every provision of said documents.
The Grantee, for and on behalf of the Grantee,
acknowledges that the Grantee has received, no later than fifteen
(15) days prior to this conveyance I a full and complete Public
offering Statement for the Condominium and, therefore, waives any
and all rights under Section 3406(c) of the Act.
TOGETHER with all and singular the buildings,
improvements, ways, woods, waters, watercourses, rights, liberties,
privileges, hereditaments and appurtenances to the same belonging
or in anywise appertaining; and the reservation and reversions,
remainder and remainders, rents, issues and profits thereof, and of
every part and parcel thereof; AND ALSO all the estate, right,
title, interest, use, possession, property, claim and demand
whatsoever of the Grantor both in law and in equity, of, in and to
the premises herein described and every part and parcel thereof
with the appurtenances. TO a~VE AND TO HOLD all and singular the
premises herein descri.bed together with the hereeli taments and
appurtenances unto the Grantee and to the Grantee's proper use and
benefit forever.
-2-
BOO,~ 1411 PAGE 620
AND the Grantor covenant that, except as may be herein
set forth, they do and will forever specially warrant and defend
the lands and premises, hereditaments and appurtenances hereby
conveyed, against the Grantor and all other persons lawfully
claiming the same o~ to claim the same or any part thereof, by,
from or under it, them or any of them.
In all references herein to any parties, persons,
enti ties or corporations, the use of any particular gender or
plural or singular number is intended to include the appropriate
gender or number as the text of the within instrument may require.
Wherever in this instrument any party shall be designated
or referred to by name or general reference, such designation is
intended to and shall have the same effect as if the words "heirs,
executors, administrators, personal or legal representatives,
successors and assigns" had been inserted after each and every such
designation.
IN WITNESS WHEREOF, the Grantors have hereunto set their
hands and seals, or if a corporation, it has caused these presents
to be signed by its proper corporate officers and its corporate
seal to be affixed hereto, the day and year first above written.
Signed, Sealed and Delivered
in the presence of
or attested by
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BOOK 141 PAGt 621
COMMONWEALTH OF PENNSYLVANIA
SS. :
COUNTY OF CUMBERLAND
On this, the /6"/-1. day of DCiOBEL , 1996, before
me, a Notary Public, the undersigned officer, personally appeared
Earl L. Kurtz, President of village of Moreland, rnc., known to me
(or satisfactorily proven) to be the person named in the foregoing
ins.trument, and acknowledged that he executed the same for the
purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official
seal.
4iJli(J~
Notafy Public
My Commission Expires:
(SEAL)
Notarial Seal
John R. Beinhaur, Notary Public
Hampden Twp., Cumberland County
My Commission Expires March 13, 1999
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CERTIFICATE OF SUBSTANTIAL COMPLETION
VILLAGE OF MORELAND, A CONDOMINIUM
The undersigned, Charles W. Junkins, Professional Land Surveyor, hereby
certifies that he has inspected Unit No. 5401-23 of Village of Moreland IV, Village of
Moreland Condominium Lot No. 24, A Condominium, and that such units are
substantially completed.
This certificate is given pursuant to Section 3201 of the Uniform Condominium
Act of Pennsylvania of July 2, 198, t No.
COMMONWEALTH OF PENNSYLVANIA
SS:
COUNTY OF CUMBERLAND
On this, the 4/ >JS day of cJc h 6-V- , 1996, before me, a
Notary Public, the undersigned officer, personally appeared Charles W. Junkins, a
Professional Land Surveyor, known to me or satisfactorily proven to be the person
whose name appears in the foregoing Certificate and acknowledged that he executed
the same for purposes therein contained.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
fR~
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BPOK 147 PACE 623
ROBERT ENSMINGER APPRAISERS
REAL ESTATE and PERSONAL PROPER TY
3557 Ehnerloil A \'\~J~l:.~
Horril'hllrg, PA 1710').1131.
717-652..4111 Voi~~
7 J7-541..9444 Fa~
717-f(77..73~n Cl~1l
~ h re'l"C'\'mt1$;~~l(~l)m(:a~t. tlc1
November 28, 2005
~~,yJi!!m.ullJ1;~~J~~!
Dennis Fillmore
934 Valley St.
Enols, PA 17025
RE: Estate of Alberta Fillmore
Dear Mr. Fillmore:
In accordance with your request, I have appraised the personal property of Alberta
Fillmore, Deceased. The property is located at 5401 Oxford Dr., Unit 23,
Mechanicsburg, PA 17055.
The values shown have been arrived at after a careful study of the property. I
believe it to reflect a true measure of its market value as of November 11. 2005.
Market value is defined as being the most reasonable or probable price in terms of
money that real or personal property will bring in an open and competitive market
under all conditions requisite to a fair sale, the buyer and seller each acting
prudently and Imowledgeably. and assuming the price is not affected by undue
stimulus.
Taking into accounl all of the factors set forth in the pages thaI follow, it is the
opinion of the undersigned thalthe fair markel value of the personal properly is Two
Thousand Seven Hundred Dollars ($2,700.00.) Further, the value of the
Condominium unit, as detailed in the attached real estate appraisal, is Seventy-One
Thousand Two HI.mdred Dollars ($71,200.00.)
Employment in and compensation for making this appraisal are in no manner
contingent upon the value reported and I certify thai I have no financial inlerest in
the property appraised, present or contemplated.
Very truly yours,
KM;/~~
Rohert A. Ensminger
Form SCNLGL - 'WinTOTAL' appraisal software by a la mode. Inc. -1.aOO-ALAMOOE
Estate of Alberta Fillmore
Item_Description _
Value
_ $ 200.00
$ _ 50.00
~ _ 15.00
$ 20.00
$ 75.00
.$ _ 15.00
.$ . 20.00
$ _ 60.00
$ 200.00
$ 25.00
$ 45.00
$ 15.00
$ 45.00
$ 150.00
$_ 20.00
$ 30.00
$ 20.00
.$ 175.00
.$ 150.00
$ ;ZOO.OO
$ 350.00
.$ 125.00
$ . 25.00
$ 15.00
$ 15.00
$ 30.00
.$ 50.00
$ 30.00
$ 30.00
$ 400.00
$ 60.00
.$ 20.00
$. 20.00
TOTAL 2,700.00
SonyT~initron TV
,=anasollic:Stere() .
Panasonic VCR
_. __ "_0' '.
DVDJ)layer_.
Entertainment center
., ..... ,- .., -,.
Records/_ tapes, DVD's
Lam_ps- pair.
Drop leaf endtable
R,eclining sofa.
Reclining_~ocker
Round table
Folding table
Gliding cbair
Bookcase
HUrTlmel figurine
Contents of bookcase
Pictu re
Secretarydes~ __ _ __ ._
Hand painted plank bottom chair
Din_iIl9_tab[e&4 chairs
Corner.Cupboard
Contents of comer cupboard
Computer desk
Bookshelf
Bookshelf
Sharp..mirco,^!aye_ ()ven
[v1isc small.appliances
Sharp vaclJum
Misc. in kitchen
Maple bedroom suite
Lane cedar chest
Lamps
Linens
Page 1 of 1
Form SCNLGL - 'WinTOTAL" appraisal software by a la mode. inc. -1.800.AlAMODE
ROBERT ENSMINGER APPRAISERS
PRESENTS
APPRAISAL OF REAL PROPERTY
LOCATED AY:
5401 Oxford Dr
Record Book 147, Page 619
Mechanicsburg, PA 17055-5441
FOR:
Estate of Alberta Fillmore
c/o Dennis Fillmore, 934 Valley St., Enola, PA 17025
AS OF:
11/1112005
BY:
Robert A. Ensminger
Pennsylvania Certified Residential Appraiser
Certificate Number Rl-Q00952-l
ROBERT ENSMINGER APPRAISERS PHONE 717-652-4111
3557 ElMERTON AVENUE FAX 717-541-9444
HARRISBURG, PA 17109-1132 e-mail: threecomps@comcast.net
form GA5 - 'WinTOTAL' appraisal software by a ia mode, inc, -1.800-ALAMOOE
Pronertv Address 5401 Oxford Dr (;itv Mechanicsbum State PA Zio Code 17055-5441
Leoal Descrintion Record Book 147 Paoe 619 Countv Cumberland Unit No. 23
Assessor's Parcei No. 13-24-0791"{)03-U540123 Tax Vear 2005 R.E. Taxes ~ 0.00 Soecial Assessments S 0.00
Pro'ect NamelPhase No. Gates of Moreland Man Reference 25420 Census Tract 42041"{)11t.00-5
Borrower N/A Current Owner Estate of Alberta J. Fillmore Occunant r 1 Owner r IT enant c;(I Vacant
Prooertv riohts aooraised R Fee Sim Ie r leasehold I Monthlv Home Owners' Association Un~ Char e ~ 60.00
Sales PrIce $ N/A Date of Sale N/A Descriotion and""i amount of loan charneslconcessions to be naid b" seller 0.00
lender/Client Estate of Alberta Fillmore Address clo Dennis Fillmore 934 Vallev SI. Enola PA 17025
Annraiser Robert A Ensminaer Address 3557 ElmertonAve, Harrisburo, PA, 17109-1132
location l:! Urban ~ Suburban D Rural ~r:gI~~~~rJ P~~t family hOUSi~~E Predominant p~fC~ominium hoUsiAaE
condominium
Buill up o Over75% ~ 25-75% o Under 25% occupancy $ (000) (yrs) occupancy $ (000) (yrs)
Growth rate o Rapid ~Stable o Slaw k8J Owner ---.!.Q!L low ~ k8J Owner -2L Low -L
Property values o Increasing k8J Stable o Declining o Tenant ~p;~IHjgh-In~ o Tenant 140_. Hjgo. ~
Demand/supply 0 Shortage ~ In balance R Over supply I ~ Vacant (0-5%) . predol11inantLL k8J Vacant (0-5%) -r:21PredominanLl._. :.
Marketino time i'Xi Under 3 mos. 3-6 mos. Over 6 mos. Vacant 'over 5%\ 175 30 i n Vacant (over 5% 100 15
Present land use %: One Family ~, 2-4 Family ..L , Apartments .2.... , Condominium....1L , Commercial .2...., Industrial ~ , Vacant .2.... , Other -
land use change: k8J Not likely o likely o In process to
- Note: Race and the racial composition of the neighborhood are not appraisal factors.
_ Neighborhood boundaries and characteristics: The neinhborhood boundaries are Simnson Ferrv Road to the north Weslev Drive to the east Route 15
to the south and Allendale Rd. to the wesl.
Factors that affect the marketability of the properties in the neighborhood (proximity to employment and amen~ies, employment stability, appeal to market, etc.):
The subiect is loeated in lower Allen Townshio. There are manv lame emnlovers in the area and emnlovment stabilitv is verv aood as
evidenced bv the below averane unemolovment rate. Access to maior emolovment centers and r""ional shonnina malls is arovided bv the
Caoital Beltwav and the Interstate Hinhwav svstem. All amenities are available within a reasonable cammutinn distance.
Market conditions in the subject neighborhood (including support for the above conciusions related to the trend at property values, demand/supply, and marketing time
. . such as data on competitive properties for sale in the project and neighborhood, description of the prevalence of sales and financing concessions, etc.):
Interest rates are risina slowlv from the lowest nnint in over 40 vears. This has a tendancv to increase sales which does create shortaaes in
some markets and helns to Increase nrices as the affordabilltv index rises. The reaion tvoieallv does not exoerience the dislaeations of
economic slowdown due orimarilv to the stabilizinn effects of the state and federal novernments which make un almost 25% of the reoional
work force, however, an increase in interest rates and other market factors could strio awav recent orice oains. Overall proper1v values are
Specific zoning classnication and descrtption A-O Anartment-Office Topography Basicallv level
Zoning compliance k8J legal 1X10 Legal nonconfning (Grandfathered use) o lIiegal o No zoning Size Average for the area.
Hi hest and best use as imnroved Present use Other use lemlainl Density 19 units / acre
utilities Public Other Off-site Improvements Type Public Private View Averaoe for the area.
Electricity k8J Street Asphalt k8J 0 Drainage Average far the area
Gas 0 Curb/gutter Concrete k8J 0 Apparent easements Typical utilltv
Water k8J Sidewalk None 0 0 FEMA Special Rood Hazard Area DYes ~ No
San~ary sewer ~ Street lights None R R FEMA Zone C Map Date 9130/1977
Storm sewer Aliev None FEMA Man No. 421016B..{)1 (not orintedl
Comments (apparent adverse easements, encroachments, special assessments, slide areas, illegal or legal nonconforming zoning use, etc.): There are no apparent
easements encroachments or other conditions which would have an adverse effect on the value. A title search which is bevond the scope of
this appraisal, has not been conducted to discover anv adverse conditions associated with this nronenv.
No. of Stories ~ Exterior Walls ~ If Project Completed: If Project incomplete: Subject Phase:
No. of Elevator(s) ~ Roof Surtace ~ Total No. of Phases .L-. Total No. of Planned Phases_ Total No. of Units ~
Extsting/Proposed ~ TotaINo.ofParking~ Total No. of Units R-- Total No. of Planned Un~s _ Total No. of Units Completed~
n conversion, orig. use ~ Ratio (spaces/unils l.L..- Total No. of Units for Sale.!L..- Total No. of Units for Sale _ Total No. of Units for Sale ~
Date of Conversion ~ Type ~ Total No. of Unns Sold R-- Total No. of Un~s Sold ~ Total No. of Units Sold ~
Age (Yrs.) ~ Guest Partdng ~ Total No. of Un~s Rented ~ Totai No. of Units Rented _ Total No. 01 Units Rented .!J.!JL
Effective Aoe IYrs.l 9 Data Source Public records Data Source Data Source Public Records
Project Type: k8J Primary Residence o Second Home or Recreational o Row or Townhouse k8J Garden o Midrise o Highrise 0_
Condition of the project, quality of construction, unit mix, appeal to markeL etc.: Proiect an""ars to be in an overall aoad condition.
- Are the heating and cooling for Ihe Individual units separateiy metered? k8J Ves o No If no, describe and comment on compatibility to other projects in market area
and market acceptance:
Common elements and recreational facilities: Parkinn area sidewalks
Are the common elements compieted? k8J Yes 0 No Is the BuilderlDeveloper in control of the Home Owners' Association? 0 Ves k8J No
Are any common elements leased to or b the Home Owners' Association?'Fl Ves 1'5<1 No Ii Ves attach addendum descrtblna rental terms and ontions.
ROOMS Faver Uvina Dinino Kitchen Oen Familv Rm. Rec. Rm. Bedrooms # Baths Laundry Other Area Sa. Ft.
Basement
Levelt 1 Area 1 1 1 689
Level 2
Finished area above orade contains: 4 Rooms; 1 Bedroom s ; 1 Bathlsl; 689 Souare Feet of Gross Livino Area For Unit
GENERAL DESCRIPTION HEATING HI.Pump KITCHEN EQUIP. AMENITIES CAR STORAGE INSULATION
.. Roor No. 1 Type ~ Refrigerator k8J Rreplace(s) #_ 0 None 0 Roof _0
No. of Levels 1 Fuel ~ Range/Oven k8J Patio ~ Garage 0 Ceiiing _0
INTERIOR Materials/Condition Condition Avn. Disposal k8J Balcony - 0 No. of Cars Walls _0
Rooring CaroeVAveraoe COOLING HI.Pump Dishwasher k8J Deck 0 Open ~ Fioor _0
Walls Drvwall/Averane Central ~ Fan/Hood k8J Porch 0 No. 01 Cars 1 None _0
Bath Floor VinvUAveraae Other ~ Microwave c g Fence g Parking Space No. ~ Unknown k8J
Bath Wainscot Fiberalass/Averane Condnlon Avn, Washer,"rver Storane Assinned/Owned Assia -n
Condition of the unit, depreciation, repairs needed, quaiity of construction, remodeling/modernization, additional features (special energy efficient Items, etc.):
There is no functional or economic obsolescence. The sub"ect is in averane condition and no renairs are renuired. The roof anDears to be in
ood condition with no evidence of leaks on the interior.
_ Adverse environmental conditions (such as, but not limited to, hazardous wastes, toxic substances, etc.) present in the improvements, on the sile, or in the immediate vicinity 01 the
subject property: No adverse environmental conditions were noted on the date of insoeelion, however the aporaiser is not an expert in the
environmental sciences. All concerns should be addressed bv a nronerlv nualified evnert.
Freddie Mac Form 465 10-94
INDIVIDUAL CONDOMINIUM UNIT APPRAISAL REPORT
fileNo 0000116
Page 1 ot 2
Robert Ensminger Appraisers
Form PU2 - 'WinTOTAL' appraisal software by a la mode, inc. -1-BOO-ALAMODE
Fannie Mae Form 1073 10-94
!f ''', ,~u. UUUUIIUI I <.I,," Tr....t
INDIVIDUAL CONDOMINIUM UNIT APPRAISAL REPORT
Unit Charge $ 60.00 per mo. X 12 = $ 720.00 per yr. Annual Assessment charge per year/square feet at gross living area = $ 1.04
Is the project subject 10 ground rent? OVes cgJ No Ii yes, $ per year.
Utilities included in unit charge: I2:J None D Heat D Air Condliioning D Electricity o Gas o Water o Sewer
Note any fees other than reguiar HOA charges, for use of facilities None
- Compared to of her compelftive projects of similar quality and design, the subject unit charge appears: D High cgJ Typicai D Low
To properly maintain the project and provide the services anticipated, the budget appears: I2:J Adequate D Inadequate D Unknown
Management Group: i:8:I Home Owners' Association ODeveioper 0 Management Agent (Identify)
Quality of management and its enforcement of Rules and Regulations based on general appearance of project appears: i:8:I Adequate D Inadequate
Special or unusual characteristics in the Condominium Documents or other information known to fhe appraiser that would affect marketability (if none, so state)
As of 1/1/2006 unit charne will increase to $70.00 ner month.
ITEM SUBJECT COMPARABLE NO.1 COMPARABLE NO.2 COMPARABLE NO.3
Address and 5401 Oxford Dr Unit 23 5401 Oxford Dr Unit 22 1075 Lancaster Blvd. Unit 5 1074 Lancaster Blvd Unit 13
Proiect Name Gates of Moreland Gates of Moreland Sunnuild Sunnuild
Proxlmilv to Sublect "...',- II """ th"n .01 mile NW 0.4 miles SE 0.45 miles SE
Sales Price $ N/A $ 71.159 .,.:! $ 73 000 .' .:0 '. .'1 $ 72 000
Price/Gross Liv. Area $ r/J $ 103.28 r/:JI/,...,'..../.... $ 102.24 1/01...... ...... " $ 100.84 rid .
Data and/or Inspection MLS, STEB, Tax Assessor MLS, STEB, Tax Assessor MLS, GovernMax.com
Verification Sources
VALUE ADJUSTMENTS DESCRIPTION DESCRIPTION + 1- \ $ Mustmen DESCRIPTION + (-\ $ Adlustmen DESCRIPTION I + 1-\ $ Adlustment
Sales or Financing .--C ";. Conventional Cash Cony - Cost Help -1,800
Concessions . 86 DOM 4DOM l1DOM
Date of SalefTIme ....... :...........".... 5/17/2005 : 7/2812005 : 5/31/2005 :
Location Averane Averane : Averane : Averaoe :
Leasehold/Fee Simole Fee Simnfe Fee Simnle : Fee Simole Fee Simnle :
HOA Mo. Assessment 60.00 60.00 : 102.00 +3000 101.00 +3 000
Common Elements Parking area Parking area Parking area Parking area
and Rec. Facilities Pool Tennis court -500 Pool Tennis court -500
Proiect SizefTvoe Averane for area. Averane for area. Averane for area. Averane for area.
Roar Location One Two One One
View Averane for area Averane for area Averane Averaoe for area
Desion and Aooeal 1 BR Condo 1 BR Condo 1 BR Condo 1 BR Condo
Qualitv of Construction Br&Vin/Averaae Br&Vin/Averaoe : Br&Stucco/Avo : Br&Stucco/Avn :
Aoe 9 9 : 19 : +1000 17 : +800
- Condition Averaoe Averaoe Averaoe : Averane
. Above Grade Total Bdrms Baths Total Bdrms Baths : Total Bdrms Baths: Total Bdrms Baths:
Room Count 4 : 1 1 4 : 1 : 1 4 : 1 1 : 4 : 1 : 1 :
. Gross LivinQ Area 689 So. Ft 689 So. Ft : 0 714 So. Ft.: 0 714 So. Ft: 0
Basement & Rnished None None : None None :
Rooms Below Grade : :
Funelional Utilitv Averane Averane : Averaoe : Averane
HeatinnlCoolinQ Heat Pumn Heat Pumn : Central heat : -2500 Central heat -2 500
Enerav Efficient ttems Thennonanes Thennooanes : Thennooanes Thennooanes :
Car Storaae Off Street Parkinn Off Street Parkinn : Off Street Parkinq : Off Street Parkinn :
Balcony, Patio, Patio Balcony Courtyard Courtyard
Fireolacels), etc. None None Fireolace -1000 Firenlace -1000
:
Net Adi. ftotal) ':.' . rl + rl : $ rl+ I.l : $ rl+ fS(1 : $ 2000
Adjusted Sales Price ~\c<.. . NotC'.. ,.'1(, I .'Net.,.............% Net2$~1
of Comoarable ~,;'o.' ''11.1 $ 71159. . Gnis~ 11.0~1 $ 73 000 . Gross.13.3% $ 70 000
Comments on Sales Comparison (including the subject property's compatibiiity to other condominium units in the neighborhood, etc.): All of the comnarable sales are
one bedroom condominium units in the same nenerallocation as the sub'ect. Comoarable #1 is directlv above the subiect and is considered to
be the best comnarable. The comnarables establish the ranoe of value for the sub'ect nrooertv.
ITEM SUBJECT COMPARABLE NO.1 COMPARABLE NO.2 COMPARAIILE NO.3
Date, Price and Data No sales last 3 Not available Not available Not available
Source for prior sales years.
within vear of aooraisal Tax assessor
Analysis of any current agreement of sale, option, or listing of the subjecl property and analysis of any prior sales of sub~ct and camparables within one year of the date of appraisal:
There are no known anreements of sale or listinns of the nrone"" at the oresent time. It is exoected that the sub'ect will be offered for sale in
the near future.
INDICATED VALUE BV SALES COMPARISON APPROACH $ 71200
INDICA TED VALUE BY INCOME APPROACH (n Applicable) Estimated Market Rent $ 575 /Mo. x Gross Rent Muitiplier ~ = $ 71875
INDICATED VALUE BY COST APPROACH (AUach Ii Applicable) "',. $
This appraisal is made i:8:I'as is' o subject to the repairs, atterations, inspections, or conditions iisted below o subject to completion per plans and specifications.
Condition of Appraisal: This annraisal is made in as is condition. The attached addenda are a sionificant Dart of this reDort.
Rnal Reconciliation: The market data analysis is the best overall method to achieve the market value of a condominium. The cost aoproach was
0 considered to be invalid due to the undivided interests in the common elements. Value is supported by the income approach.
- The purpose 01 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 deflnmon that are stated in the aUached Freddie Mac Form 439jFannie Mae Form 1004B (Revised 6/93 ).
I (WE) ESTIMATE THE MARKET VALUE, AS DEFINED, OFTHE REAL PROPERTY THA TIS THE SUBJECT OFTHIS REPORT, AS OF 11/11/2005
(wHICHI~V;~NSP W~ECTIVEDATEOFTHISREPORT)TOBE$ 71,200
APPRAISE!: J ~ . ~ SUPERVISORY APPRAISER (ONLY IF REQUIREO): o Old o Did Not
Sianalure "- /1'" Sionature
Name Robert'A. Ensminner () Name Inspect Property
Date Reoort Sianed 11/28/2005 Date Reaort Sioned
State Certliication # RL-000952-L State PA State Certification # State
Or State License # State Or State License # State
Freddie Mac Form 465 10-94
Page2of2
Form PU2 - 'WinTOTAL' appraisal software by a la mode, inc. -t-800-ALAMODE
Fannie Mae Form 1073 10-94
Supplemental Addendum
Rle No. 0000116
Client
Pronertv Address
City
Appraiser
Estate of Alberta J. Fillmore
5401 Oxford Dr
Mechanicsbum
Robert A. Ensmincer
County Cumberland
State PA
Zip Code 17055-5441
Every effort has been made to conform to FNMA & FHLMC guidelines, and in most cases, an even
stricter interpretation of guidelines found common to most investors in the secondary market.
Since every property can not be compared to "ideal" sales, the appraiser must choose sales from
the market search which meet investor underwriting standards and guidelines established by the
professional association of which the appraiser is affiliated.
The appraisal has been completed without the benefit of a complete legal description. The size and
shape of the lot have been determined from Information obtained from tax maps, available plot
plans, multi-list services, developers plans, and/or surveys. Lot and block numbers are not
commonly available in this area. A title search, which is beyond the scope of this appraisal, is
generaliy necessary to determine lot and block numbers, plan book pages, adverse easements,
encroachments, deed restrictions and/or special assessments. Without a full title search, the
estimated value stated herein could be adversely affected, if at a later date any adverse conditions
are discovered.
The appraiser is not an expert in the environmental sciences. The appraiser is not aware of the
existence of RADON GAS and/or RADON DAUGHTERS, LEAD BASE PAINTS, LEAD IN THE PLUMBING
FIXTURES AND PIPES, ASBESTOS, UREA-FORMALDAHIDE FOAM INSULATION, SICK BUILDING
SYNDROME, PETROLEUM LEAKAGE, AGRICULTURAL CHEMICALS, OR OTHER HAZARDOUS
SUBSTANCES, and does not possess the knowledge or equipment necessary to test for such items.
If testing by qualified technicians indicates unacceptable levels of any hazardous substance or
condition, the appraised value may be adversely affected or voided.
Digital photographs have been used in preparing this appraisal report. The photographs have not
been retouched, air brushed or altered in in any form. Occasionally, it is necessary to enhance the
photographs to compensate for lighting conditions. This usually occurs In bright sunlight that casts
deep shadows. The actual photograph is not altered but is lightened to allow the reader of the
report to see objects in the photographs more clearly.
Digital maps are used in preparing appraisal reports. The mapping program automatically
determines the location of the subject property and the comparables sales, determines the distance
between the subject and the comparable sales and automatically places the distances in the
appropriate place on the appraisal form. The actual placement of the subject and comparables may
not be exact, but are close enough to allow the reader to find the properties, usually within
one-tenth of a mile of the actual location.
Digital floor plans are used in appraisal reports as necessary. Exterior dimensions are to scale and
are based on actual field measurements. Interior details may not be complete and are not to scale.
They are provided only to help the reader visualize the interior of the property and the general
layout of the home. The program calculates the square footage of the home based on the exterior
dimensions and places the results in the proper sections of the report. All calculations are detailed
on floor plan pages.
This report has been electronically prepared in compliance with USPAP guidelines and includes a
secure digital signature along with adequate security measures in place to protect the data
produced by the appraiser.
SCOPE OF WORK: The scope of work for this appraisal is defined by the complexity of this
appraisal assignment and the reporting requirements of this appraisal report form, including the
attached definition of market value, statement of assumptions and limiting conditions, and
certifications. The appraiser is to: (1.) perform a complete visual inspection of the accessable
areas of the interior and exterior areas of the subject property, (2.) inspect the neighborhood, (3.)
inspect each of the comparable sales at least from the street, (4.) research, verify and analyze data
from reliable public and/or private sources, and (5.) report his or her conclusions in this appraisal
report.
INTENDED USE OF THIS REPORT: The intended use of this appraisal report is for the
executor(s) of the estate to evaluate the property that Is the subject of this report and to report to
any taxing authorities the conclusions of this report.
INTENDED USER: The intended user(s) of this report is(are) the executor(s) of this estate.
FOI111 TADD - "WinTDTAL' appraisal software by a la mode, inc. - 1-800-ALAMODE
Subject Photo Page
Client
Pro ert Address
C'
A raiser
Estate of Alberta J. Fillmore
5401 Oxford Dr
Mechanicsbur
Robert A. Ensmin er
Co"n Cumberland
State PA
Zi Code 17055-5441
Subject Front
5401 Oxford Dr Unit 23
Sales prtce N/A
Gross Living Area 669
T alai Rooms 4
Total Bedrooms 1
T etal Bathrooms f
L~~on Avernge
View Average for area
Site Avernge for area.
Quality Br&Vin/Avernge
Age 9
Subject Rear
Subject Street
Form PIC3xS.sR - "WinTOTAL" appraisal software by a la mode, Inc. -1-600-ALAMOOE
Subject Interior Photo Page
Client
Pro e Address
Ci
A raiser
Estate of Alberta J. Fillmore
5401 Oxford Dr
Mechanicsbur
Robert A. Ensmin er
Count Cumberland
State PA
Zi Code 17055-5441
Subject Interior
5401 Oxford Dr Unit 23
Sales Price N/A
Gross Living Area 689
Total Rooms 4
Total Bedrooms 1
Total Bathrooms 1
Location Average
View Average for area
Site Average for area.
auality Br&Vin/Average
Age 9
Subject Interior
Subject Interior
Fonn PIC3x5.SI- 'WinTOT AL' appraisal software by a la mode, inc. - 1-8QQ-ALAMODE
Subject Interior Photo Page
Client
Pro ert Address
CII
A raiser
Estate of Alberta J. Fillmore
5401 Oxford Dr
Mechanicsbur
Robert A. Ensmin er
Co"n Cumberland
State PA
Z; Code 17055-5441
Subject Interior
5401 Oxford Dr Unit 23
Sales prtce N/A
Gross Living Area 689
T alai Rooms 4
T alai Bedrooms 1
T alai Bathrooms 1
~c~on Avernge
View Average for area
Stte Average for area.
Quality Br&Vin/Avernge
Ago 9
Subject Interior
Subject Interior
Fonm PIC3xS.sI- 'WinTOTAL' appraisal software by a la mode, inc. -1-600-ALAMODE
,
.... .... ----.. - . - -.. -
Building Sketch (Page - 1)
Client Estate of Alberta J. Fillmore
Prooertv Address 5401 Oxford Dr
Citv Mechanicsbura County Cumberland State P A Zio Code 17055-5441
Annraiser Robert A. Ensminoer
3.5' 15.00' 13.50'
wl-i ,_... .'......'.-
Patio <0
18.50'
Living Room
b
0
Bedroom Dining Area U;
b N
0
ai
~ CL
Utility Kitchen ~
-g
W.I.CL ::>
Bath ~
32.00'
Skllcllb\lApAIllV'"
Comments:
AREA CALCULATIONS SUMMARY LIVING AREA BREAKDOWN
Code Description Net Size Net Totals Breakdown Subtotals
GLlU Fi.rst Floor 689.00 689.00 Firs t Floor
PIP Porch 90.00 90.00 13.50 x 25.00 337 . 50
OTH Storage 21.00 21.00 18.50 x 19.00 351.50
Net LIVABLE Area ( Rounded) 689 2 Items ( Rounded) 689
Fonn SKT.BldSkl- "'MnTOTAL' appraisal software by a la mode. inc. -1.BOO.ALAMODE
Location Map
Client
Pro ert Address
Git
A raiser
Estate of Alberta J. Fillmore
5401 Oxford Dr
Mechanicsbur
Robert A. Ensmin er
Goun
Cumbertand
State P A
Zi Code 17055-5441
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Form MAP.LOC - 'WinTOTAL' appraisal software by a la mode, inc, -l,BOO.ALAMOOE
Client Estate of Alberta J. Fillmore
Pro e Address 5401 Oxford Dr
Cit Mechanicsbur
A raiser Robert A. Ensmin er
Rle No. 0000116
Count Cumberland
State PA Zi Code 17055-5441
APPRAISAL AND REPORT IDENTIFICATION
This appraisal conforms to!llle of the fOllowing definitions:
[8J Complete Appraisal (The act or process of estimating value, or an opinion of value, performed without invoking the Oeparture Rule.)
o Umited Appraisal (The act or process of estimating value, or an opinion of value, performed under and resumng from invoking the
Departure Rule.)
This report is!IDl: of the following types:
o Self Contained (A written report prepared under Standards Rule 2-2{a) of a Complete or Limited Appraisal performed under STANDARD 1.)
[8J Summary (A written report prepared under Standards Rule 2-2{b) of a Complete or Limited Appraisal performed under STANDARD 1.)
o Restricted (A written report prepared under Standards Rule 2-2{c) of a Complete or Limited Appraisal performed under STANDARD 1.
restricted to the stated intended use by the specified client or Intended useL)
Comments on Standards Rule 2-3
I certify that, to the best of my knowledge and belief
. The statements of fact contained in this report are true and correct.
. The reported analyses, opinions, and condusions -are limited only by the reported assumptions and limiting conditions, and are my personal,
impartial, and unbiased professional analyses, opinions and conclusions.
. I have no present or prospective interest in the property that is the subject of this report, and no personal interest with respect to the
parties involved.
. I have no bias with respect to the property that is the subject of this report or the parties involved with this assignment.
. My engagement in this assignment was not contingent upon developing or reporting predetermined results.
. My compensation for completing this assignment is not contingent upon the development or reporting of a predetermined value or direction in
value that favors the cause of the client, the amount of the value opinion, the attainment of a stipulated result, or the occumence of a
subsequent event directly related to the intended use of this appraisal.
. My analyses, opinions and conclusions were developed and this report has been prepared, in conformity with the Uniform Standards of
Professional Appraisal Practice.
. I have made a personal inspection ofthe property that is the subject of this report.
. No one provided significant real property appraisal assistance to the person Signing this certification.
To develo the 0 inion of value the a raiser erformed a com lete a raisal rocess as defined b the Uniform Standards of Professional
A raisal Practice. This means that no de artures from Standard 1 were invoked. Standard 1 establishes the criteria for the develo ment of a
real ro a raisal.
PURPOSE OF THE APPRAISAL:
The u ose of this a raisal is to estimate the fair market value of the sub' ect.
rice
;;~~~~:bEe:A. E~1! I! ~#~
Date Signed: 11/28/2005
State Certification #: RL-000952-L
or Stale License #:
State: PA
Expiration Date of Certification or License: 6/28/2007
SUPERVISORY APPRAISER (only If required):
Signature:
Name:
Date Signed:
State Certification #:
or State License #:
State:
Expiration Date of Certification or License:
o Did 0 Did Not Inspect Property
Robert Ensminger Appraisers
Form 105 - "WinTDTAL" appraisal software by a la mode, inc. -1-BOO-ALAMODE
DEfiNITION OF MARKET VALUE: The most probable prtce which a property should brtng in a competitive and open marl<et under all conditions
requisite to a fair sale, the buyer and seller, each acUng 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 specnied date and the passing of title from seller to buyer under conditions whereby: (1) buyer and seller are
typically motivated; (2) both parties are well informed or well advised, and each acting in what he considers his own best interest; (3) a reasonable time is allowed
for exposure in fhe open market, (4) payment is made in terms of cash in U.S. dollars or in terms of nnancial arrangements comparabie thereto; and (5) the price
represents the normal considerafion for the property sold unaffected by special or creative nnancing or sales concessions' granted by anyone associated with
the sale.
. Adjustments to the comparables must be made for speciai or creative financing or sales concessions. No adjustments are necessary
for those costs which are normally paid by sellers as a result of tradition or law in a market area; these costs are readily identifiable
since the seller pays these costs in virtually all sales transactions. Special or creative financing adjustments can be made to the
comparable property by compartsons to financing terms offered by a third party instMonal lender that is not already involved In the
property or transaction. Any adjustment shouid not be calculated on a mechanical dollar for dollar cost of the financing or concession
but the dollar amount of any adjustment should approximate the marl(et's 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 tor matters ot a legal nature that affect either the property being appraised or the title to it. The appraiser assumes that
the ti1Ie is good and marketable and, therefore, will not render any opinions about the title. The property is appraised on the basis of iI 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 Rood 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 Ihe property In question, unless specilic arrangemenls 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 vaiue, These
separate valuations 01 the land and improvements must not be used in conjunction wilh any other appraisal and are invalid il they are so used.
6. The appraiser has noted in Ihe appraisal report any adverse conditions (such as, needed repairs, depreciation, the presence of hazardous wastes, toxic
substances, etc,) observed durtng the inspecUon of the subject property or that he or she became aware of durtng the normal research involved in pertorming
the appraisal. Unless otherwise stated in the appraisal report, the appraiser has no knowledge of any hidden or unapparent condilions of the property or
adverse environmental condilions (including the presence of hazardous wastes, toxic substances, etc.) that wouid 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 cond~lons that do exist or for any engineertng or testing that might be required to discover whether such
condllions exist. Because the appraiser is not an expert In Ihe 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 fhem to be true and correct. The appraiser does not assume responsibility for the accuracy of such ~ems that were fumished by other
parties.
8. The appraiser will not disclose Ihe contents of the appraisal report except as provided for in the Unllorm Standards of Professional Appraisal Practice.
9. The appraiser has based his or her appraisal report and valuation conclusion for an appraisal that is subjecl to saUsfactory completion, repairs, or
alleralions on the assumption that completion of the improvements will be pertormed in a worl(manlil<e 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
(including conclusions about the property value, the appraiser's identity and professional designations, and reterences to any protessional appraisal
organizations or the firm with which Ihe appraiser is associated) to anyone other than Ihe borrowe~ the mortgagee or ~s successors and assigns; the mortgage
insurer; consultants; professional appraisal organizations; any state or federally approved financial institution; or any department, agency, or instrumentality
of the Un~ed States or any state or the Distrtct of Columbia; except that the lender/client may distribute the property description secUon of the report only to data
collecfion or reporting service(s) without having to obtain the. appraiser's prtor 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 01 2
Fannie Mae Fonm 10048 6-93
Robert Ensminger Appraisers
Form ACR - 'WinTOTAt." appraisal software by a la mode, inc. -1-800-ALAMOOE
APPRAISER'S CERTIFICATION: The Appraiser certifies and agrees that:
1. I have researched the subiect market area and have selected a minimum of lhree recent sales 01 properties most similar and proximate to the subject property
for consideration in the sales comparison anaiysis and have made a dollar adjustment when appropriate to reflect the market reaction to those items of significant
variation. If a significant item in a comparable property is superior to, or more favorable than, the subject property, I have made a negative adjustment to reduce
the adjusted sales price of the comparable and, if a significant item in a comparable property is inferior to, or less favorable than the subiect property, I have made
a positive adjustment to increase the adjusted sales price of lhe 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 reporl. I have not
knowingly withheld any significant Information from the appraisal report and I believe, to the best of my knowledge, that all statements and 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 fonn.
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. 1 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 ellher the prospective owners or occupants of the subject property or 01 the present
owners or occupants of the properties in the vicinJly 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 perlorming this
appraisal is contingent on the appraised value ollhe property.
6. I was not required to report a predetermined value or direction in vaiue that favors the cause of the client or any related party, the amount of the value estimate,
lhe attainment of a specific resuit, or the occurrence of a subsequent event in order to receive my compensation and/or employment tor p~rlorming tne appraisal. I
did not base the appraisal report on a requested minimum valuation, a specific valuation, or the need to approve a specific mortgage loan.
7. I perlonned this appraisal in conformity wllh the Uniform Standards of Professional Appraisal Practice that were adopted and promulgated by the Appraisal
Standards Board ot The Appraisal Foundation and that were in place as of the efiective 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 wnh the marketing time noted In the neighborhood section of this report, unless I have otherwise stated in the
reconciliation section.
B. I have personally inspected the inlerior and exterior areas of the subject property and the exterior of ail 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 subiect site, or on any site within the immediate
vicinJly of the subject property of which I am aware and have made adjustments for these adverse condllions 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 ot the adverse conditions on the marketability of the subject property.
9. I personaily prepared all conclusions and opinions about the real estate that were set forth in the appraisal report. Ii I relied on significant professionai
assistance from any individual or individuals in the perlormance of the appraisal or the preparation of the appraisal report, I have named such individual(s) and
disclosed the specific tasks perlormed by them in the reconciliation section of this appraisal report. I certify that any individual so named is qualified to perlorm
the tasks. I have not authorized anyone to make a change to any lIem in the report; therefore, if an unauthorized change is made to .the appraisal report, I will take
no responsibility for II.
SUPERVISORY APPRAISER'S CERTIFICATION: Ii a supervisory appraiser signed the appraisal report, he or she certifies 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 Ihe appraiser,
agree to be bound by the appraiser's certifications numbered 4 through 7 above, and am taking full responsibility tor the appraisal and the appraisal report.
ADDRESS OF PROPERTY APPRAISED: 5401 Oxford Dr, Mechanicsburg, PA 17055-5441
APPRAISER"
~~~~~ur~ObPd:mi!~~
Date Signed: 11/28/2005
State Certification #: RL-000952-L
or State License #:
State: PA
Expiration Date of Certilicatlon or License: 6/28/2007
SUPERVISORY APPRAISER (only If reqUired):
Signature:
Name:
Date Signed:
State Certification #:
or State License #:
State:
Expiration Date of Certification or License:
DDid
o Did Notlnspect Property
Freddie Mac Form 439 6-93
Page 2 of 2
Fannie Mae Fonn 10048 6-93
Form ACR - 'WinTOTAL' appraisal software by a la mode, inc. -1-800-ALAMODE
Tax Parcel No. 13-24-791-2-U5401~23
THIS INDENTURE,
MADE THE
J lP+\- day of J CtnLA.O-('~
(2006)
, two thousand six
BETWEEN
DENNIS G. FILLMORE, Administrator C.T.A. of
the Last Will and Testament of ALBERTA J.
FILLMORE, late of Lower Allen Township, Cum-
berland County, Pennsylvania, and DENNIS G.
FILLMORE, Individually, of Enola, Cumberland
County, Pennsylvania, parties of the first
part,
and
DENNIS G. FILLMORE, single person, of Enola,
Cumberland County, Pennsylvania, party of the
second part:
WHEREAS, the said Alberta J. Fillmore by her Last Will and
Testament, duly proved and recorded in the Cumberland County
Register of Wills Office, Pennsylvania, in Docket Book 21-05-
0943, Letters of Administration C.T.A. being issued on
October 25, 2005, provided, in pertinent part, as follows:
FIRST: I devise and bequeath all the rest, residue
and remainder of my estate of whatever nature and
wherever situate, including any property over which I
hold power of appointment and together with any insur-
ance policies thereon, to my son, DENNIS G. FILLMORE...
SECOND: In addition to all powers granted to them
by law and by other provisions of this will, I give the
fiduciaries acting hereunder the following powers,
applicable to all property, exercisable without court
approval and effective until actual distribution of all
property:
(A) To sell at public or private sale, or to
lease, for any period of time, any real or personal
property and to give options for sales, exchanges or
leases, for such prices and upon such terms (including
credit, with or without security) or conditions as are
deemed proper. This includes the power to give legally
sufficient instruments for transfer of the property and
to receive the proceeds of any disposition of it....
FIFTH: I nominate and appoint JANE A. BOWMAN, of
Pigsah Road, Shermansdale, Pennsylvania, as Executrix
of this, my Last will and Testament. In the event of
the death, resignation or inability to serve for any
reason whatsoever of the said JANE A. BOWMAN, I nomi-
nate and appoint ELWOOD BOWMAN, husband of JANE A.
BOWMAN, of Pigsah Road, Shermansdale, pennsylvania,
Executor of this, Last Will and Testament. . . .
The said JANE A. BOWMAN and ELWOOD BOWMAN re-
nounced their rights to administer the Estate and,
further, respectfully requested that Letters be issued
to DENNIS G. FILLMORE. Said Renunciation, being dated
October 20, 2005 was recorded in the Office of the
Register of Wills on October 25, 2005 and is a part of
the records of the proceedings of the Estate of Alberta
J. Fillmore, Docket Book 21-05-0943.
NOW THIS INDENTURE WITNESSETH, that the said parties of the first
part, by virtue of the power and authority aforesaid, in said
Will contained, and in consideration of the sum of One Dollar
($1.00) to him paid by the said party of the second part, at and
before the ensealing and delivery of these presents, the receipt
whereof is hereby acknowledged, has granted, bargained, sold and
conveyed, and does hereby grant, bargain, sell and convey to the
said parties of the second part, his heirs and assigns forever:
ALL THAT CERTAIN condominium unit situated in Village of Moreland
IV, A Condominium (the "Condominium"), Lower Allen Township,
Cumberland County, Pennsylvania, being designated as unit no.
5401-23 in the Declaration of the Condominium, dated September
14, 1995, recorded September 22, 1995, in Cumberland County
Miscellaneous Book 504, Page 636, and the Declaration plans of
the Condominium dated April 7, 1995, recorded September 22, 1995,
in Cumberland County plan Book 70, Page 133, and the First
2
Amendment to Declaration of Condominium, dated October 3, 1996,
recorded October 3, 1996 in Cumberland County Miscellaneous Book
531, Page 714 and the Plan dated September 26, 1996, and recorded
October 3, 1996, in Plan Book 73, Page 33, under the provisions
of the Uniform Condominium Act of the Commonwealth of Pennsylva-
nia, as amended from time (Act of July 2, 1980, P.L. 286, No.
82) .
BEING the same premises which the Village of Moreland, Inc., a
pennsylvania corporation, by Deed dated October IS, 1996 and
recorded October 16, 1996 in the Cumberland County Recorder of
Deeds Office in Deed Book 147, Page 619, granted and conveyed
unto Alberta J. Fillmore, single individual. The said Alberta J.
Fillmore died October 13, 2005.
TOGETHER with all and singular the rights, liberties, privileges,
hereditaments and appurtenances whatsoever thereunto belonging or
in anywise appertaining, and the reversions and remainders,
rents, issues and profits thereof, and all the estate, right,
title, interest, property, claim and demand whatsoever of the
said Samuel M. Simmons, Jr. at and immediately before the time of
his decease, in law or equity or otherwise howsoever, of, in, to
or out of the same:
TO HAVE AND TO HOLD the said granted premises to the said party
of the second part, his heirs and assigns forever.
AND the said parties of the first part, do covenant, promise,
grant and agree, to and with the said party of the second part,
his heirs and assigns, by these presents, that the said parties
of the first part, have not done, committed, or knowingly or
willingly suffered to be done, any act, matter or thing what-
soever, whereby the premises aforesaid, or any part thereof, is,
are, shall or may be charged or encumbered, in title, charge or
estate, or otherwise howsoever.
3
IN WITNESS WHEREOF, the said parties of the first part have
hereunto set their hands and seals the day and year above writ-
ten.
Signed, Sealed and Delivered
in the Presence of
/:2~/;l~
Dennis G. Fillmore,
Administrator C.T.A. of the
of Al erta J. Fillmo ;?
(SEAL)
t}JPrt/o
Estate
(SEAL)
Individually
COMMONWEALTH OF PENNSYLVANIA
SS.
COUNTY OF CUMBERLAND
On this, the 2~k day of J QnL\.Or'-1 , 2006, before me,
the undersigned officer, personally appeared DENNIS G. FILLMORE,
individually and as the Administrator C.T.A. of the Estate of
Alberta J. Fillmore, known to me (or satisfactorily proven) to be
the person described in the foregoing instrument, and acknowl-
edged that he executed the same in the capacity therein stated
and for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official
seal.
~()y) n LP c/ LJ~O;rvv0
Notary Public
My Commission Expires:
(SE.hL)
COMMONWEAlTll OF PENNSYlVANIA
NOTARIAL SEAl
BONNIE l. WIUlAMS. NOTARY PURUe
S1lIREMANSTOWN BORO., CUMBERLAND co.
MY COMMISSION EXPIRES APRil 18 2009
4
CERTIFICATE OF RESIDENCE
I do hereby certify that the precise residence and complete
post office address of the within named grantee is 934 Valley
Street, Enola, PA 17025.
~~
, 2006
PLEASE RETURN TO:
James D. Bogar, Esquire
One West Main Street
Shiremanstown, PA 17011
5
Rev-1503 EX+ (6-98)
*'
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Fillmore, Alberta J.
FILE NUMBER
21-05-0943
ESTATE OF
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM CUSIP VALUE AT DATE
NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH
1 23 shares of Met-Life 47.11 1.083.53
2 3,684 shares of PPL - Stock Account No. 3097164201 29.92 110.225.28
3 37 shares of Prudential Financial - Stock 63.27 2.340.99
4 United States Savings Bonds - Series EE (15 bonds), 31.917.20
Series E (4 bonds), value as listed on attached
Savings Bond Calculator
TOTAL (Also enter on Line 2, Recapitulation) 145.567.00
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule B (Rev. 6-98)
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. MetLife Stock Account Information System
Page 1 of 1
Perform another Search
Results for Social Security Number Ixx-xxx-7784"
as of October 13. 2005
Yes
Shares
23
Investor 10
806716137236
Policy
xxxxx6703
SSN Certified?
Number of Certified Shares. . . . . . . . . . . . . . . . . . . . . . . . . . .. 23
Number of Uncertified Shares. . . . . . . . . . . . . . . . . . . . . . . . . . . . 0
Total Shares. . . . . . . . . . . . . . . . . . . . . . . . . . .. 23
https://www.nefapps.nefn.comJDemutShares/default.cfin
1/20/2006
PPL Corporation
Two North Ninth Street
Allentown, PA 18101-1179
hlto://www.oolweb.com/
\ I I
'\1,'
',\..'/,'
. ..... # '
. ..'
ppl.~~~:
, TO
Investor Services ,
Toll Free Number 600-345-3085
Date December 19, 2005
Re: PPL Stock Account
Type of Stock: PPL Corporation Common Stock
CUSIP: 69351T-10-6
Account Number: 3097164201
Social Security Number: 193-12-7784
Account Registration:
Alberta J. Fillmore
Date of Death:
October 13, 2005
Number of Shares Currently Held:
1,842
1,842
In Certificate Form
In Direct Registration
In Dividend Reinvestment Plan
TOTAL SHARES
3,684 '
Number of Shares Held as of Date of Death:
3,684
In Certificate Form
In Direct Registration
In Dividend Reinvestment Plan
TOTAL SHARES
1,842
1,842
$29.92 Closing market price of Common Stock on New York Stock Exchange on
date of death or last business day prior to date of death.
Other Comments:
1,842 shares issued 2/14/97
1,842 shares issued 8/24/05 ( 2 for 1 common stock split)
PPL Corporation
INVE~TOR S~L-
C rt0tLUJ a..
I Cynthia A. Buchman
Sr. Investor Services Representative
Prudential
Financial
Transaction Statement
0001385266
ALBERTA J FILLMORE
5401 OXFORD DR
MECHANICSBURG PA 17055
NUMBER OF SHARES CREDITED
37,0000
TRANSFER AGENT ACCOUNT NUMBEIi
98480228
/11111/111/1111111111111111/
CUSIP NUMBER
744320 102
010098480228
PUl/PASSWORD. PLEASE KEEP CONFIDENTIAL
1951 4619
January 2002
'Ve're pleased to welcome you as a new stockholder of Prudential Financial, Inc.
On December 18, 2001, Prudential completed its conversion fi'om a mutual company to a stock company, As pmi of our
conversion, we are issuing stock to eligible owners of the company, This includes anyone who owned an eligible policy
or annuity conh'act as of December 15, 2000, You have received the number of shares listed above. Compensation for all
of your policies eligible for stock is induded in this statement.
This does not affect your insurance policy or annuity in any way.
Stock ownership is a benefit of holding an eligible policy or contract. It does not replace your policy or contract, or
change your benefits, cash values, eligibility for policy dividends or guarantees, You do not have to give anything up to
receive stock.
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How your allotment of shares was determined.
Company actuaries and extel11al advisors developed a plan for dividing the value of Prudential among its owners.
Factors such as the type oflife, annuity or health policy or contract you owned, the face value, and how long you owned
it determined hO\v many shares you received.
Your shares are registered on the books of Prudential Financial, Inc.
Prudential has engaged EquiServe Tmst Company, N.A., a provider of shareholder services, to hold your shares at no
cost to you. A stock certificate is not required to continue holding ym.rr shares in book-entIy form. The enclosed brochme
explains how to hold shares, transfer or sell shares, or obtain a stock certificate, through EquiServe. Note: If you would
like EquiServe to continue holding yom shares at no cost, no action is required. .
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A commission-free sales and purchases program will be available for certain shareholders in the future.
To patiicipate, you must own 99 shares or fewer and hold your shares in book~entry fonn as they are now. See back for
more infonnation.
'Vhat YOU should do now.
1) Ke~p this statement for your records.
2) Read the enclosed brochtrre for information on how you can hold, transfer or sell yom shat-es through EquiServe's
Sales Facility, or obtain a stock certificate.
SEE BACK FOR ADDITIONAL INFORMATION.
Quest~ons? Call 1-800-305-9404 weekdays from 8:00 a,m. to 7:00 p,m, (ET). For hearing impaired, call 1-800-619-2837,
Or visit prudential.equiserve.com .
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Page 1 of 2
Value As Of
10/2005
Bond Info
Series
Denomination
Serial Number
Issue Date
E Bonds
$ 1,000
Results
# Bonds Total Price Total Interest Total Value YTD Interest
19 $9,000.00 $22,917.20 $31,917.20 $838.00
Issue Interest Next Final
Serial Number Issue Date Series Denom Price Interest Value Rate Accrual Maturity Note
M14577932EE 04/1986 EE $1,000 $500.00 $1,021.60 $1,521.60 4.00% 0412006 0412016 IO~1l
M14577931EE 04/1986 EE 1,000 500.00 1,021.60 1,521.60 4.00% 0412006 04/2016 10,'i"
M14577930EE 04/1986 EE 1,000 500.00 1,021.60 1,521.60 4.00% 0412006 0412016 10;e11
M14577929EE 04/1986 EE 1,000 500.00 1,021.60 1,521.60 4.00% 0412006 04/2016 110,ell
M14577928EE 04/1986 EE 1,000 500.00 1,021.60 1,521.60 4.00% 0412006 04/2016 10:~ll
M14577927EE 04/1986 EE 1,000 500.00 1,021.60 1,521.60 4.00% 0412006 0412016 I!O,le.11
M14577926EE 04/1986 EE 1,000 500.00 1,021.60 1,521.60 4.00% 0412006 04/2016 l'Olel,\
M14577925EE 04/1986 EE 1,000 500.00 1,021.60 1,521.60 4.00% 04/2006 0412016 10"etl
M14577924EE 04/1986 EE 1,000 500.00 1,021.60 1,521.60 4.00% 0412006 04/2016 II0eII
M14577923EE 04/1986 EE 1,000 500.00 1,021.60 1,521.60 4.00% 0412006 0412016 10'~tj
M25773355EE 10/1987 EE 1,000 500.00 789.20 1,289.20 4.00% 0412006 1012017 IOil1
M25773354EE 10/1987 EE 1,000 500.00 789.20 1,289.20 4.00% 0412006 10/2017 I Dietl
M25773353EE 10/1987 EE 1,000 500.00 789.20 1,289.20 4.00% 0412006 1012017 10'i:!"1
M25773352EE 10/1987 EE 1,000 500.00 789.20 1,289.20 4.00% 0412006 1012017 10ell
M25773351EE 10/1987 EE 1,000 500.00 789.20 1,289.20 4.00% 04/2006 1012017 10elll
D100234904E 12/1972 E 500 375.00 2,191.60 2,566.60 1212002 MA 10 ell
D 100234905E 12/1972 E 500 375.00 2,191.60 2,566.60 1212002 MA 10 ell
D95218129E 11/1972 E 500 375.00 2,186.00 2,561.00 1112002 MA 10ell
D95218130E 11/1972 E 500 375.00 2,186.00 2,561.00 1112002 MA IDell
lViewlOI\ Viewing Bonds 1-19
Le end
Note Description
NI Not Issued
NE Not Eligible for Payment
P5 Includes 3-month interest penalty
MA Matured and Not Earning Interest
Please rate this service.
http://wwws. publicdebt. treas. gOY /B C/SB CPrice
12/1512005
~avmgs tlond Calculator Page 2 of L
(Please print and/or save this page before submitting your survey)
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http://wwws. publicdebt. treas.gov IB C/SBCPrice 12/15/2005
SERIES E
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FIVE YEARS AND TEN MONTHS FROM THE ISSUE DATE HEREOF WILL PAY
~!t1l!Qt:m~~~~~~~
Mr. Gordon J. Fillmore
11 Sharon Road
Enola, Pennsylvania
or-
Mrs. Alberta J. Fillmore
TMIS IOIlOlSIS$UUIUNO[llIA.UTHOIlITYor
JIG'TO '''IE TlIU"5 "'"0 CONDITIONS S''''UO
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OLLOWlNG IIIEC['" Of PAYMENT 111[1t[101l.
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FIVE YEARS AND TEN MONTHS FROM THE ISSUE DATE HEREOF WILL. PAY
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Mr. Gordon J. Fillmore
11 Sharon Road
Enola, Pennsylvania
or-
Mrs. Alberta J. Fillmore
TH'S SO"D IS .SSUtO UNatlt AUTHOIIIITY 0' T
Jlt' '0 'Hl nil"! ."0 (;01101'10'" nAnD
selllSlD A"O DAT(.O. A"ggnrvlJtlOSY....
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....T THE ORIGINAL MATURITY HEREOF WIL.t. PAY
~~~~y~~~
MrS. Alberta Fillmore
11 Sharon Road
Enols, Pa. 17025
or
Mr. Gordon Fillmore
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Rev-1508 EX+ (6-98)
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Fillmore, Alberta J.
FILE NUMBER
21-05-0943
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 VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Commerce Bank - Checking Account No. 513225961, date of death balance 2,359.12
$2,359.13, accrued interest $.01
2 Commerce Bank - Checking Account No. 536571995, date of death balance 3,524.94
$3,525.65, accrued interest $.71
3 Fulton Bank - Certificate of Deposit No. 328-0227102, date of death balance 5.067.57
$5,000.00, accrued interest $67,57
4 Omega Bank - Certificate of Deposit No. 173-0047238, date of death balance 51,586.14
$51,454.82, accrued interest $131.32
5 PSECU - Regular Shares (SOl) date of death balance $37.88; accrued dividend $0.01 37.89
6 PSECU - Money Market (S07) date of death balance $3,463.89; accrued dividend 3.466.94
$3.05
7 PSECU - Certificate of Deposit (551) date of death balance $18,739.05; accrued 18.738.05
dividend $16.76
8 The Patriot-News - Refund 41.90
9 UB Mutual - Automobile Insurance Refund 401.00
10 2004 Buick Century - Serial No. 2G4WS52J941231203 10,000.00
11 Personal Property - Value as listed on attached appraisal 2.700.00
TOTAL (Also enter on Line 5, Recapitulation)
97.923.55
(If more space is needed, additional pages of the same size)
Copyright (e) 2002 form software only The Lackner Group, Inc.
Form PA.1500 Schedule E (Rev. 6-98)
Commerce
"Bank~
November 15, 2005
James D Bogar
Jennifer B Hipp
Attorneys At Law
1 W Main St
Shiremanstown, PA 17011-6371
RE: Estate of: Alberta J Fillmore
Social Security #: 193-12-7784
Date of Death: October 13, 2005
Dear Sirs:
In reference to the letter regarding the above mentioned
Estate, we would like to inform you of the information that
we have researched and found.
Type: Checking
Account #: 513225961
Date Opened: 12/1/00
Date Closed: 10/28/05
Primary Owner: Alberta J Fillmore
Date of Death Balance: $2,359.13
Accrued Interest: $.01
Principal Balance: $2,359.12
Type: Checking
Account #: 536571995
Date Opened: 10/30/03
Date Closed: 10/28/05
Primary Owner: Alberta J Fillmore
Date of Death Balance: $3,525.65
Accrued Interest: $.71
Principal Balance: $3,524.94
Commerce Bank / Harrisburg, N.A.
P.O. Box 8599
100 Senate Avenue
Camp Hill, Pennsylvania 17001-8599
Commerce
"Bank~
If there are any questions or additional information that
is needed, please feel free to contact me at (717) 795-7118
ext. 3151.
Sincerely,
~~s'M~
Senior erF Specialist
Commerce Bank / Harrisburg, N.A.
P.O. Box 8599
100 Senate Avenue
Camp Hill, Pennsylvania 17001-8599
Fulton Bank
LISTENING.
November 3, 2005
James D. Bogar
One West Main Street
Shiremanstown, Pennsylvania 17011
Dear Mr. Bogar:
RE: Alberta J. Fillmore, deceased October 13, 2005
In response to your recent inquiry concerning the accounts maintained in the name of
the decedent, please be advised that the following accounts were open at the date of death:
CD # 328-0227102, open 6/10/2005, matures 6/10/2007, balance
$5,000.00 and accrued interest $67.57; paying 3.92%, in her name
only.
If you should have any further questions, please do not hesitate to contact me.
Very truly yours,
~~"-~-~
Karen D. Hillegas
Credit Inquiry Processor
t;UN FI DE1\l-r~Al
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~ H~,'-I fi-mVtnf i~J it,h n-:!1:/led @s .....l't.. ",'
answer to V'6?ur ifVJ'I~f"'" = rI' f~ mllL'&f fjf bus,mess (:
. ...,.....' J en IS r:r VC' r.- .
respoiisib~fh.' ic: ..'rsum' =j"~ t'.v, J ;ur cQnlic,2ntial U'
. ") .J 01,) . J ti" iJ" h'~ h !.
IIDlr1ion herp!r, f.;"Dre ,./. J ! Hl. u8nr( or c:ny of lis'
J '"~ SC'e"IS"'''~lr~~' I
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POBox 4887
Lancaster, PA 17604
fultonbank.com
1-800-FULTON-4
@ OMEGA BANK Membe,FDIC
11/03/2005
JAMES 0 BOGAR
ONE WEST MAIN STREET
SHIREMANSTOWN PA 17011
Dear Mr. Bogar,
This letter is in regard to the accounts that Alberta J. Fillmore held at our financial institution. Listed
below is the information that you requested.
Account Type:
Account Number:
Ownership:
Date Opened:
Balance as of 000
Accrued Interest:
Certificate of Deposit
173-0047238
Individual
11/16/2004
$51,454.82
$131.32 * See Note Below
If I can offer any further assistance, please contact me at your convenience.
*Note: Accrued interest is not included in Date of Death balance.
Sincerely,
~~
Felicia Shultz
Deposit Services Representative
Telephone 1-800-494-1810 ext 2061
Fax: (814) 231-7680
fshultz@omef.com
Page 1 of 2
PO Box 298 state College, PA 16804-0298 Customer Information Center, Toll Free: 1-877-861-7800
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PSE(~
the financiallinkTM
November 15, 2005
Account # 0193127784
JAMES D BOGAR
ONE WEST MAIN ST
SHIREMANSTOWN, PA 17011
Dear MR BOGAR:
The following is the status of ALBERTA J FILLMORE's account with PSECU as of the date of death.
Joint Owner's Name
Date of Death
Date of Birth
NONE
10.13.2005
07.18.1924
Share
S 01
S 07
S 51
Description
Regular Shares
Money Market
24 Month Certificate
Open date
03.19.1999
02.13.2002
11.22.2000
Balance
$ 37.88
3,463.89
18,738.05
Accrued Dividend
$ 0.01
3.05
16.76
Loan
L09
Description
VISA
Open Date
03.04.2002
Balance
$ 0.00
Accrued Interest
$ 0.00
The dividend earned from January 1, 2005 through the date of death was $441.08. We do not have safe deposit
boxes for our members.
If you have any questions, please call 234-8484 in Harrisburg or our toll-free number, (800) 237-7328. At the menu
prompt, enter 6 and then extension 2227.
~'
Me'''eFf:i~
Member Service Representative
Finance Support Unit
Pennsylvania State Employees Credit Union
Main Address; 1 Credit Union Place, Harrisburg, PA 17110.2990 . (717) 234.8484 . (800) 237.7328
('.\ Moiling Address; P.O. Box 67013, Harrisburg, PA 17106.7013 . (717) 777.2100 (TDD) . (800) 472.1967 (TDD)
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\~ Savings federally insured up to $100,000 by the National Credil Union Administration WWW . P see u. com
T~R
BUICK
COMPANY
"We take care of you "
The appraised value of a 2004 Buick Century with
serial number 2G4WS52J941231203 and 6,758 miles
is worth $10000.00 on 10-13-2005.
. ---
I~- ZCj-cJ-':J
4201 CHAMBERS HILL ROAD, HARRISBURG, PA 17111
(717) 564-2240 FAX (717) 564-2473
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ROBERT ENSMINGER APPRAISERS
REAL ESTATE and PERSONAL PROPERTY
.3557 Elmet'ton A\'em~~
H"rrisl"1f~. PA Iiltl9-1 132
717-652~4111 ''''\'.lh~,~
7[7-541-94+1 Fax
717-i!.11r73:~(l o.~11
lhf~t'('m'm,,:ri\.~()I1lC~
November 28, 2005
~~:'!Ll;:~~.mmg~;!:.n~'!
Dennis Fillmore
934 Valley St.
Enola, PA 17025
RE: Estate of Alberta Fillmore
Dear Mr. Fillmore:
In accordance with your request, I have appraised the personal property of Alberta
Fillmore, Deceased. The property is located at 5401 Oxford Dr., Unit 23,
Mechanicsburg, PA 17055.
The values shown have baen arrived at after a careful study of the property. I
believe it to reflect a true measure of its market value as of November 11, 2005.
Market value Is defined as being the most reasonable or probable price in terms of
money that real or personal property will bring in an open and competitive markel
under all conditions requisite to a fair sale, the buyer and seller each acting
prudently and knowledgeably, and assuming the price is not affected by undue
stimulus.
Taking inlo account all of the factors set forth in the pages that follow, it is Ihe
opinion of the undersigned lhallhe fair market value of the personal properly is Two
Thousand Seven Hundred Dollars ($:2,700.00.) Further, Ihe value of !he
Condominium unit, as detailed in the attached real estate appraisal, is Seventy-One
Thousand Two Hundred Dollars ($71,200.00.)
Employment in and compensation for making this appraisal are in no manner
contingent upon the value reported and I certify that I have no financial interest in
the property appraised, present or contemplated.
Very truly yours,
KMi/~~
Robert A. Ensminger
form SGNLGL - 'WinTOTAL' appraisal software by a Ie mode. inc. -l-BOO-ALAMOOE
Estate of Alberta Fillmore
~teI11Desc:ription
SonyT~initron JY
Panasonic Stereo
panaso~ni.c\jCR .....
DVDJJlayer~_ .._ ...
Entertainment center
Records,. tapes, DVD's
Lamps- pair~ ....
Drop leaf endtable
Reclining sofa..
Reclining.r9cker
Roundtabje
Folding table
Gliding chair
Bookcase
Hummelftgurir1e
Contents of bookcase
Picture
Secretary desk
Hand painted Qlan i<)ottomchair
Dinirl9Jabte&4 chairs
Corner.Cupbo(!rd . .. ... _..
Contents otcorner cupboard
Computer desk
Bookshelf
Bookshelf
Sharp__mirco~aye ()ven
fIIIiscsmi]/Lappliances
Sharp vaclJum.
Misc. in kitchen
Maple bedroo.m suite
Lane cedar .chest
Lamps
Linens
Page 1 of 1
TOTAL
$
L
i
$
$
$.
$'
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$.
$
$
$
$
$
.$
$
$
$
.$.
$
Fonn SCNLGL - "WinTOTAL' appraisal software by a la mode, Inc. -1-800.ALAMOOE
Value
200.00
50.00
15.00
20.00
75.00
15.00
20.00
60.00
200.00
25.00
45.00
15.00
45.00
150.00
20.00
30.00
20.00
175.00
150.00
200.00
350.00
125.00
25,00
15.00
15.00
30.00
50.00
30.00
30.00
400.00
60.00
20.00
20.00
2 700.00
REV-llSl EX+ (12-99)
*'
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Fillmore, Alberta J.
FILE NUMBER
21-05-0943
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 327.08
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address
City State Zip
-
Year(s) Commission paid
2. Attomey's Fees Bogar & Hipp Law Offices 10,725.00
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
4. Probate Fees 385.00
5. Accountant's Fees
6. Tax Retum Preparer's Fees
7. Other Administrative Costs 1,644.54
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 13,081.62
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA.1500 Schedule H (Rev. 6-98)
Rev-1502 EX+ (6-98)
.
SCHEDULE H-A
FUNERAL EXPENSES
contin ued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Fillmore, Alberta J.
FILE NUMBER
21-05-0943
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Pamela Zeigler - Funeral Luncheon
159.08
2
Pealers Flowers - Funeral Flowers
168.00
Subtotal
327.08
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA.1500 Schedule H-A (Rev. 6-98)
.
Rev-1502 EX+ (6-98)
ESTATE OF
.
SCHEDULE H-B7
OTHER
ADMINISTRATIVE COSTS
contin ued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Fillmore, Alberta J.
FILE NUMBER
21-05-0943
ITEM
NUMBER
AMOUNT
DESCRIPTION
1
Comcast - Cable Bill-Final
30.63
2
Liberty Mutual - Homeowner's Insurance
68.00
3
Liberty Mutual - Condominium Policy
41.85
4
Lower Allen Township - Sewer Bill-Final
33.00
5
Omega Bank - Fee for obtaining date of death balance in account
10.00
6
PA American Water Company - Water Bill-Final
30.85
7
PPL - Bill-Final
63.12
8
RESERVES: - Costs to conclude administration of Estate including filing fee for Pa.
Inheritance Tax Return, Inventory and First and Final Account; preparation of
personal and fiduciary income tax returns
850.00
9
Robert Ensminger Appraisers - Real Estate and Personal Property Appraisal
350.00
10
Verizon - Telephone Bill-Final
47.09
11
Village of Moreland IV - Condominium Fees
120.00
Subtotal
1,644.54
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B7 (Rev. 6-98)
.
Rev-1512 EX+ (6-98)
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLvANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Fillmore, Alberta J.
FILE NUMBER
21-05-0943
Include unrelmbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1 A. Bailey Wood, DDS - Oral Surgery-Final
VALUE AT DATE
OF DEATH
97.00
2 PPL Employee Services - Medical Insurance
310.00
3 West Shore Medical Service - Final Bill
55.63
TOTAL (Also enter on Line 10, Recapitulation)
462.63
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule I (Rev. 6-98)
REV-1513 EX.. (9-00)
*'
SCHEDULE ,J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
NUMBER
Fillmore, Alberta J.
NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
distributions, and transfers
under Sec. 9116(a)(1.2)]
FILE NUMBER
21-05-0943
ESTATE OF
RELATIONSHIP TO
DECEDENT
Do Not List Trustee(s)
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
I.
Dennis G. Fillmore
934 Valley Street
Enola, PA 17025
Son
Rest, residue
and remainder
Total
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
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
0.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule J (Rev. 6-98)
:
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LAST WILL AND TESTAMENT
OF
ALBERTA J. FILLMORE
''''\
I, ALBERTA J. FILLMORE, of Mechanicsburg, Cumberland County,
Pennsylvania, make, publish and declare this as and for my Last
Will and Testament, hereby revoking all other Wills and Codicils
heretofore made by me.
FIRST: I devise and bequeath all the rest, residue and
remainder of my estate of whatever nature and wherever situate,
including any property over which I hold power of appointment and
together with any insurance policies thereon, to my son, DENNIS
G. FILLMORE, provided that should he predecease me, then to my
grandson, JOSHUA K. FILLMORE.
SECOND: In addition to all powers granted to them by law
and by other provisions of this Will, I give the fiduciaries
acting hereunder the following powers, applicable to all proper-
ty, exercisable without court approval and effective until actual
distribution of all property:
(A) To sell at public or private sale, or to lease, for any
period of time, any real or personal property and to give options
for sales, exchanges or leases, for such prices and upon such
terms (including credit, with or without security) or conditions
as are deemed proper. This includes the power to give legally
sufficient instruments for transfer of the property and to
receive the proceeds of any disposition of it.
(B) To partition, subdivide, or improve real estate and to
enter into agreements concerning the partition, subdivision,
improvement, zoning or management of real estate and to impose or
extinguish restrictions on real estate.
(C) To compromise any claim or controversy and to abandon
any property which is of little or no value.
(D) To invest in all forms of property, including stocks,
common trust funds and mortgage investment funds, without re-
striction to investments authorized for Pennsylvania fiduciaries,
as are deemed proper, without regard to any principle of
diversification, risk or productivity.
(E) To exercise any option, right or privilege granted in
insurance policies or in other investments.
(F) To exercise any election or privilege given by the
Federal and other tax laws, including, but not necessarily being
limited to, personal income, gift and estate or inheritance tax
laws.
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(8) To make distributions to my herein named beneficiaries
in cash or in kind or partly in each.
(H) To borrow money from themselves or others in order to
pay debts, taxes, or estate or trust administration expenses, to
protect or improve any property held under my will, and for
investment purposes.
(I) To select a mode of paYment under any qualified retire-
ment plan (pension plan, profit sharing plan, employee stock
ownership plan, or any other type of qualified plan) to the
extent the plan or the law permits them to do so, and to exercise
any other rights which they may have under the plan, in whatever
manner they consider advisable.
THIRD: I direct that all inheritance, estate, transfer,
succession and death taxes, of any kind whatsoever, which may be
payable by reason of my death, whether or not with respect to
property passing under this Will, shall be paid out of the
principal of my residuary estate.
2
FOURTH: All interests hereunder, whether principal or
income, which are undistributed and in the possession of the
fiduciaries acting hereunder, even though vested or distribut-
able, shall not be subject to attachment, execution or sequestra-
tion for any debt, contract, obligation or liability of any
beneficiary, and furthermore, shall not be subject to pledge,
assignment, conveyance or anticipation.
FIFTH: I nominate and appoint JANE A. BOWMAN, of Pigsah
Road, Shermansdale, Pennsylvania, as Executrix of this, my Last
Will and Testament. In the event of the death, resignation or
inability to serve for any reason whatsoever of the said JANE A.
BOWMAN, I nominate and appoint ELWOOD BOWMAN, husband of JANE A.
BOWMAN, of Pigsah Road, Shermansdale, Pennsylvania, Executor of
this, Last Will and Testament. I direct that my Executrix, or
Executor, and their Successors, shall not be required to post
security or a bond for the performance of their duties in any
jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to
this, my Last Will and Testament, this 'J-...Y day of ~p, , 2003.
cd~J:~~.
~
ALBERTA J. FILLMORE
(SEAL)
3
Signed, sealed, published and declared by the above-named
Testatrix as and for her Last Will and Testament in our presence,
who, at her request, in her presence and in the presence of each
other, have hereunto subscribed our names as attesting witnesses.
"
"
~
Address
Address
4
c'
Register of Wills, Cumberland County, Pennsylvania
INVENTORY
, Deceased
No. 21-05-0943
Date of Death 10/13/2005
Social Security No. 193-12-7784
Estate of Alberta J. Fillmore
also known as
Dennis G. Fillmore
The Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory
include all of the personal assets wherever situate and all of the real estate located in the Commonwealth of Pennsylvania
of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of
the Decedent's death, and that the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except
that which appears in a memorandum at the end of this Inventory. l!We verify that the statements made in this Inventory
are true and correct. l!We understand that false statements herein are made subject to the penalties of 18 Pa. C. S.
Section 4904 relating to unsworn falsification to authorities.
Attorney:
James D. Bogar
I.D. No.:
19475
Signature:
Signature:
Firm: Boqar & Hipp Law Offices
Address: 934 Valley Street
Enola, P A 17025
Telephone: 717-315-9971
,-'--:
Address: One West Main Street
Shiremanstown, PA 17011
Telephone: 717-737-8761
Dated:
j, Z f.o~ 0 ~
Personal ProDertv
Cash.............................................................................................. .
Personal Property.........................................................................
Stocks/Listed................................................................................ .
Stocks/Closely Held......................................................................
Bonds........................................................................................... ..
Partnerships and Sole Proprietorships .....................................
Mortgages and Notes Receivable.... ......................... .......... ........
All Other Property.........................................................................
85,223.55
12,700.00
113,649.80
(-:-
31,917.20
Total Personal Property.... ......... ...... ......................
243,490.55
Total Real Property............. ........... ...... ............. .....
71,200.00
314,690.551
Total Personal and Real Property.........................
Total Out-of-State Real Property..........................
Rf.
Register of Wills, Cumberland County, Pennsylvania
INVENTORY
Estate of
Alberta J. Fillmore
No.
. Deceased
Date of Death 10/13/2005
Social Security No. 193-12-7784
also known as
Cash
Commerce Bank - Checking Account No. 513225961, date of death balance
$2,359.13, accrued interest $.01
2.359.12
Commerce Bank - Checking Account No. 536571995, date of death balance
$3,525.65, accrued interest $.71
3.524.94
Fulton Bank - Certificate of Deposit No. 328-0227102, date of death balance
$5,000.00, accrued interest $67,57
5.067.57
Omega Bank - Certificate of Deposit No. 173-0047238, date of death balance
$51,454.82, accrued interest $131.32
51.586.14
PSECU - Regular Shares (S01) date of death balance $37.88; accrued dividend
$0.01
37.89
PSECU - Money Market (S07) date of death balance $3,463.89; accrued
dividend $3.05
3.466.94
PSECU - Certificate of Deposit (S51) date of death balance $18,739.05; accrued
dividend $16.76
18.738.05
The Patriot-News - Refund
41.90
UB Mutual - Automobile Insurance Refund
401.00
Total Cash
85.223.55
Personal Propertv
2004 Buick Century - Serial No. 2G4WS52J941231203
10.000.00
Personal Property - Value as listed on attached appraisal
2.700.00
Total Personal Property
12.700.00
(Attach additional sheets if necessary)
Total Personal Property and Real Estate
314.690.55
Register of Wills, Cumberland County, Pennsylvania
INVENTORY
Alberta J. Fillmore
No.
Estate of
, Deceased
Date of Death 10/13/2005
Social Security No. 193-12-7784
also known as
Stock I Listed
23.0000 shares Met-Life
1.083.53
3.684.0000 shares PPL - Stock Account No. 3097164201
110.225.28
37.0000 shares Prudential Financial - Stock
2.340.99
Total Stock / Listed
113.649.80
Bond
United States Savings Bonds - Series EE (15 bonds), Series E (4 bonds), value
as listed on attached Savings Bond Calculator
31.917.20
Total Bond
31.917.20
Real Estate
Real Estate - All that certain condominium unit situated in Village of Moreland
IV, A Condominium (the "Condominium"), Lower Allen Township, Cumberland
County, Pennsylvania, being known and numbered as 5401-23 Oxford Drive,
71.200.00
Mechanicsburg, Pennsylvania. The property was acquired by Alberta J.
Fillmore, single individual by Deed dated October 15, 1996 and recorded
October 16, 1996 In the Cumberland County Recorder of Deeds Office, a copy
of said Deed being attached hereto and Incorporated herein. The
above-described real estate is being transferred to Dennis G. Fillmore, sole
beneficiary of the Estate of Alberta J. Fillmore. A copy of said deed of
conveyance is attached hereto. Date of death value as listed on the attached
Total Real Estate
71.200.00
2
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
NO. CD 006252
BOGAR JAM ES 0
1 W MAIN STREET
SHIREMANSTOWN, PA 17011
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
n______ fold
101
$96.58
ESTATE INFORMATION: SSN: 193-12-7784
FILE NUMBER: 2105-0943
DECEDENT NAME: FILLMORE ALBERTA J
DA TE OF PAYMENT: 01/30/2006
POSTMARK DATE: 01/30/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 10/13/2005
TOTAL AMOUNT PAID:
$96.58
REMARKS:
JAMES BOGAR
CHECK# 1013
SEAL
INITIALS: RSK
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS