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Home My WebLink About02-23-06 , r ~\~':-1500 EX + (6-00) '* REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 OFFICIAL USE ONLY FILE NUMBER 21 -0 51054 cooNh"'Cc5i5E ---VEAR- - - NUMBER- - ~ Z W C w o w c DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) GOTTSHALL SR. DATE OF DEATH (MM-DD-Year) KENNETH DATE OF BIRTH (MM-DD-Year) E. SOCIAL SECURITY NUMBER 1 7 1 - 2 8 - 2 5 6 0 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER W I- ~ :$ en oa:~ w 11.0 :z: 00 og:~ 11. <C 11/21/2005 03/24/1936 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) [Xl 1. Original Return D 4. Limited Estate D 6. Decedent Died Testate (Attach copy of Will) D 9. Litigation Proceeds Received D 2. Supplemental Return D 4a. Future Interest Compromise (date of death after 12-12-82) D 7. Decedent Maintained a Living Trust (Attach copy of Trust) D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) D 3. Remainder Return (date of death prior to 12-13-82) D 5. Federal Estate Tax Return Required _ 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec. 9113(A) (Attach Sch 0) NAME COMPLETE MAILING ADDRESS ROGER B. IRWIN ESQUIRE 60 WEST POMFRET STREET FIRM NAME (If Applicable) IRWIN & McKNIGHT TELEPHONE NUMBER 717 249-2353 CARLISLE PA 17013 I- Z w Q Z o 11. en w a: a: o o z o i= <t ..J ::t ~ ii: <t o w a: z o ~ I- ::t a.. :E o o >< <t I- 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) ~ OFFICIAL-USE ONLY 85,000.00 1,947.26 11,290.90 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 19. Tax Due 0.00 X _ (15) 45,634.03 X .045 (16) 0.00 X .12 (17) 0.00 X .15 (18) (19) 6,064.80 (8) 104,302.96 16. Amount of Line 14 taxable at lineal rate 12,845.09 45,823.84 (11 ) (12) (13) 58,668.93 45,634.03 17. Amount of Line 14 taxable at sibling rate (14) 45,634.03 18. 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KENNETH E. FILE NUMBER 21 05 1054 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION PNC INVESTMENTS - ACCOUNT #3883-7108 107.907 SHARES AMERICAN HIGH INC CL A AHIYX @ $12.09 PER SHARE VALUE AT DATE OF DEATH 1,304.60 2. PNC INVESTMENTS - ACCOUNT #3883-7108 34.927 SHARES INC. FUND OF AMERICA CLA AMECX A $18.40 PER SHARE 642.66 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1 947.26 REV-1508 EX + (6-98) * SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COW\10NWEALTH OF PENNSYLVANIA .INHERIT ANCE TAX RETURN RESIDENT DECEDENT ESTATE OF GOTTSHALL. SR. FILE NUMBER KENNETH E. 21 05 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. 1054 ITEM NUMBER 1, DESCRIPTION PNC BANK - CHECKING ACCOUNT #5004172865 2. PERSONAL PROPERTY - APPRAISAL ATTACHED VALUE AT DATE OF DEATH 5,044.90 6,246.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 11 290.90 REV-1511 EX + (12-99) .* C0f1\110NWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF GOTTSHALL. SR. KENNETH Debts of decedent must be reported on Schedule I. E 21 FILE NUMBER 05 SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS 1054 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Ronan Funeral Home 4,950.10 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees Irwin & McKnight 6,000.00 3. Family Exemption: (If decedents address is not the same as claimanfs. attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Register of Wills 296.00 5. Accountants Fees 6. Tax Return Preparer's Fees Patricia A. Rosendale, CPA 400.00 7. Register of Wills, Filing Fee 30.00 8. Notary Fees 40.00 9. Cumberland Law Journal, Estate Notice 75.00 10. The Sentinel, Estate Notice 129.77 11. Roy D. Gottshall, Appraisal on Personal Property 70.00 12. S.W. Barrett Real Estate, Appraisal on Real Estate 300.00 13. Closing Costs on Sale of Real Estate 554.22 TOTAL (Also enter on line 9, Recapitulation) $ 12845.09 (If more space is needed, insert additional sheets of the same size) REV-1512 EX + (6-98) ow SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF GOTTSHALL. SR. FILE NUMBER 1054 KENNETH E. Include unreimbursed medical expenses. 21 05 ITEM NUMBER DESCRIPTION 1. M& T Bank, Loan Payments on Home Equity Loan #023000000034942 2. Dauphin Oil Company, Fuel Oil 3. HCR Manor Care, Nursing 4. Carlisle Regional Medical Center, Medical 5. West Shore EMS, Ambulance 6. Suburban Energy Services, Propane 7. Sprint, Telephone 8. Met-Ed, Electric 9. M& T Bank - Installment Loan #110 001 6358650 0001 10. M&T Bank - Home Equity Loan #23000000034942 11. Union Plus Credit Card - Mastercard #5432 3590 7011 6279 12. Lowe's Credit Card #822 2039 029560 6 13. Sears Gold Mastercard #5121 07184812 1707 14. Borough of Mt. Holly Springs - Water/Sewer 15. Comcast Cable - Utility VALUE AT DATE OF DEATH 1 ,371.95 1 ,678.12 3,534.00 1 ,024.44 72.00 9.83 168.15 256.37 256.24 21,762.10 3,229.49 5,047.16 6,379.05 1 06.44 64.50 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 45 823.84 Continuation of REV-1500 Inheritance Tax Return Resident Decedent GOTTSHALL, SR. Decedent's Name KENNETH E. Page 1 21 05 1054 File Number Schedule 1- Debts of Decedent, Mortgage Liabilities, & Liens ITEM NUMBER DESCRIPTION AMOUNT 16. Andorra Radiology, Assoc. - Medical 864.00 SUBTOTAL SCHEDULE I 864.00 GRAND TOTAL SCHEDULE I $ 45,823.84 REV-'513EX+(* COMMONWEALTH OF PENNSYLVANIA I~HERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES NUMBER I. 1. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Kenneth E. Gottshall, Jr. 203 E. Pine Street Mt. Holly Springs, P A 17065 Denise E. Gottshall 7 Pine Road, Apt. 203 Mt. Holly Springs, PA 17065 Charlotte Gottshall Williams 6 Winder Crescent Newport News, VA 23606 FILE NUMBER 1 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE Lineal Lineal Lineal 15,211.35 1/3 Remainder 15,211.34 1/3 Remainder 15,211.34 1/3 Remainder ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET n. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 2. 3. 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) REV.,5,3EX+<* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES GOTTSHALL SR. NUMBER I. KENNETH E. 1. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Kenneth E. Gottshall, Jr. 203 E. Pine Street Mt. Holly Springs, PA 17065 Denise E. Gottshall 7 Pine Road, Apt. 203 Mt. Holly Springs, P A 17065 Charlotte Gottshall Williams 6 Winder Crescent Newport News, VA 23606 FILE NUMBER ?1 05 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Lineal Lineal Lineal 1054 AMOUNT OR SHARE OF ESTATE 1/3 Remainder 1/3 Remainder 1/3 Remainder ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET ll. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 2. 3. 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) s. W. Barrett Real Estate & Appraisal Services File No. 05-0707 APPRAISAL OF LOCATED AT: 420 North Walnut Street Mt. Holly Springs, PA 17065 FOR: Irwin & McKnight 60 West Pomfret Street Carlisle, PA 17013 BORROWER: Kenneth Gottshall, Sr., Estate AS OF: November 29,2005 BY: Cassandra J. Crockett I i I ! I I I I I I i I I I I i i I I , ! i I I i i I I I I I ~ S. W. Barrett Real Estate & Appraisal Services r-- i I ! File No. 05-0707 I l___. 12/09/2005 Irwin & McKnight 60 West Pomfret Street Carlisle, P A 17013 File Number: 05-0707 . I n accordance with your request, I have personally inspected and appraised the real property at: 420 North Walnut Street Mt. Holly Springs, PA 17065 The purpose of this appraisal is to estimate the market value of the subject property, as improved. The property rights appraised are the fee simple interest in the site and improvements. In my opinion, the estimated market value of the property as of November 29,2005 is: $85,000 Eighty-Five Thousand Dollars The attached report contains the description, analysis and supportive data for the conclusions, final estimate of value, descriptive photographs, limiting conditions and appropriate certifications. Respectfully submitted, {' />' / '\ () ,it/II LA4>L<'-V<..-("JG.,~~. ~ ./ Cassandra J. Crockett..... Certified Residential Appraiser Property DescriDtion SUMMARY APPRAISAL REPORT UNIFORM RESIDENTIAL APPRAISAL REPORT Land use change 00 Not likely 0 likely o In process To: Market conditions in the subject neighborhood (including support for the above conclusions related to the trend of property values, demand/supply, and marketing time - - such as data on competitive properties for sale in the neighborhood, description of the prevalence of sales and financing concessions, etc.): Prooertv values are currently stable with an averaae marketina time of 80-100 days. Economic trends and lendina rates have remained favorable. Sales concessions occur infreQuently. There are new homes under construction in surroundina develooments as well as resales available in the neiahborhood. . Project Information for PUDs (If applicable) - - Is the developer/builder in control of the Home Owners' Association (HOA)?D YES UNO '" Approximate total number of units in the subject project N/A Approximate total number of units for sale in the subject project N/A Describe common elements and recreational facilities: N/A Dimensions See leaal description/tax map Topography level to sloping Site area .23 Acre MIL Corner Lot 0 Yes 00 No Size Tvoical for area Specific zoning classification and description R-1 Residential District Shape Rectanaular Zoning compliance 00 Legal 0 Legal nonconforming (Grandfathered use) 0 Illegal 0 No zoning Drainage Aooears adeQuate Hiahest & best use as imoroved: fXT Present use n Other use (explain) View Residential/Commercial Utilities Public Other Off-site Improvements Type Public Private Landscaping Typical Electricity 00 200/100 amD Street Asphalt 00 0 Driveway Surface N/A Gas 0 Propane Curb/gutter None 0 0 Apparent easements None Apparent Water 00 Sidewalk None 0 0 FEMA Special Flood Hazard Area 0 Yes 00 No Sanitary sewer 00 Street lights Adequate ~x ~ FEMA Zone C Map Date 3/18/1980 Storm sewer rxl Allev To rear IX I I I FEMA MaD No. 420365 Comments (apparent adverse easements, encroachments, special assessments, slide areas, illegal or legal nonconforming zoning, use, etc.): There are no aoparent adverse easements encroachments or other adverse conditions. GENERAL DESCRIPTION No. of Units One No. of Stories Two Type (Det./Att.) Detached Design (Style) 2 StOry Existing/Proposed Existina ~ Age (Yrs.) 100/15 Y rs. n Effective Aae 'Yrs.) 15-25* ; ROOMS Faver LivinQ ;1 Basement ~ Level 1 1 1 ;; Level 2 EXTERIOR DESCRIPTION Foundation Block/Conc Exterior Walls BrklBlklFrm Roof Surface M eta I Gutters & Dwnspts. Aluminum Window Type DoubleHung Storm/Screens Partial Manufactured House No DininQ Kitchen Den FOUNDATION Slab None OaMSpare Partial Basement Partial Sump Pump None Dampness None Obs. Settlement None Obs. Infestation None Obs. Family Rm. Rec. Rm. Bedrooms BASEMENT Area Sq.Ft. 950 % Finished 0% Ceiling Unfinished Walls Block/Cone Floor Dirt/Cone Outside Entry Yes INSULATION Roof 00 Ceiling 00 Walls 00 Floor 00 None c=J Unknown 0 # Baths Laundrv Other Area Sq.Ft. 3 1 .5 Area 1,216 533 Area 1 ~ ~ Finished area above Qrade contains: 6 Rooms; 3 Bedroomls): 1.5 Bath(s); 1 749 Sauare Feet of Gross Livinq Area ; E J;: INTERIOR Materials/Condition HEATING KITCHEN EQUIP. ATTIC AMENITIES CAR STORAG : ~ Floors CarpetlVinvl Type BBHW Refrigerator 0 None 0 Fireplace(s) #Brick 00 None 00 .. Walls Plaster/Panel/OW Fuel Oil Range/Oven 00 Stairs 0 Patio 0 Garage # of cars I Trim/Finish Wood CondttionGood Disposal 0 Drop Stair 0 Deck Two 0 Attached Bath Floor Vinvl COOLING Dishwasher 00 Scuttle 0 Porch Rear 00 Detached Bath Wainscot Orvwall/Fbrals Central None Fan/Hood 00 Floor 00 Fence Wooden 00 Built-In Doors Wooden Other None Microwave [KJ Heated ~ Pool Qx Carport Averaae** Condition ConditionN/A Washer/Dryer n Finished I I Enclosed Porch IX I Drivewav N/A ~ Additional features (special energy efficient items, etc.): Some remodelina/up-datina has been comoleted: new kitchen with breakfast bar. ~ bathllaundrv area some newer floorina. furnace reDlaced. new electric service' two frame storage sheds. ~ Condition of the improvements, depreciation (physical, functional, and external), repairs needed, quality of construction remodeling/additions, etc.: See Attached ~ Addendum. No oersonal orooertv was included in the reported value. Adverse environmental conditions (such as, but not limited to, hazardous wastes, toxic substances, etc.) present in the improvements, on the site, or in the immediate vicinity of the subject property: No adverse environmental conditions are aooarent/disclosed. eddie Mac Form 70 6-93 PAGE 1 OF 2 Produced using ACI software, 800.234.8727 www.aciweb.com Fannie Mae Form 1004 6-93 Borrower: Ke-nneth Gottshall, Sr., Estate Property Address: 420 North Walnut Street City: Mt..- Holly Springs Lender: Irwin & McKnight ADDENDUM State: PA File No.: 05-0707 Case No.: Zip: 17065 Condition of Improvements "'Improvements on first floor have had some remodelinglup-grading completed, new kitchen/bath, and are in average-good condition with some trim, etc. to be completed. Second floor has not been renovated and Is In fair condition, with gravity heat, deteriorated plaster walls, and original linoleum flooring over wood. The .5 bath is a walk-through room with modern tiolet and sink/vanity installed. The original home was constructed of brick and frame with a block addition added In the 1950's. T-111 and vinyl siding have also been added. Some unfinished exterior trim, gutters, etc. There are two separate basements, each has partial concrete and partial dirtlstone floor, with Interior access to one half and exterior access to the 2nd [unexcavated dirt walll partial crawl space separates the two areas]. Addendum Page 1 of 1 Ie o. - ESTIMATED SITE VALUE . . . . . . . . . . . . . . .. . . . . . . . . . . . = $ 30.000 Comments on Cost Approach (such as, source of cost estimate, ESTIMATED REPRODUCTION COST -NEW OF IMPROVEMENTS: site value, square foot calculation and for HUD, VA and FmHA, the Dwelling ., Sq. Ft. @ $ = $ estimated remaining economic life of the property): Sq. Ft. @ $ = Cost Approach (from Marshall/Swift Valuation Service ~'. = handbook and local cost analvsisl was considered, but '" Garage/Carport _Sq.Ft. @$ = deemed not credible due to the aae of the ~ Total Estimated Cost New = $ improvements. Site value from Market Data. ~ Less Physical I Fu~ctio"n~1 r . E~~r~~I' . Est. Remaining Econ. Life: Depreciation based on aaellife observed condition and . Depreciation . = $ . Market Data Analysis. Estimated remaining Economic Depreciated Value of Improvements . . . . . . . . . . . . . . . . . . . = $ Life is 35-40 years. "As-is" Value of Site Improvements. . . . . . . . . . . . . . . . . . . = $ INDICATED VALUE BY COST APPROACH. . . . . . . . . . . = $ [:- ITEM SUBJECT COMPARABLE NO.1 COMPARABLE NO.2 COMPARABLE NO.3 [; 420 North Walnut Street 644 Baltimore Pike 320 North Baltimore Avenue 8 Mountain Street r^\' Address Mt. Hollv Sorinas Gardners Mt. Holly Springs Mt. Hollv Springs ~, ~' , Proximity to Subject 2.7 MI SE 0.21 MI ESE 0.69 MI ESE f, Sales Price $ N/A $ 95000 $ 84,900 $ 99,500 t i Price/Gross Liv. Area $ 0.00 ltJ $ 63.33 ltJ $ 91.49 ltl 78.97 rtJ I $ ~il Data and/or Inspection Multi-list Multi-list t' Multi-list ? Verification Sources CHR Courthouse Records Courthouse Records Courthouse Records ~ VALUE ADJUSTMENTS I I I r DESCRIPTION DESCRIPTION + (-) $ Adjustment DESCRIPTION + ( -) $ Adjustment DESCRIPTION + (-) $ Adjustment Sales or Financing None,Conv , None, Conv I None,Conv , I , I I Concessions DOM 52 I DOM 63 , DOM 113 ~ , 0 I t Date of SalelTime 7/05 I 5/05 , 3/05 I I , I Location Suburban Suburban I Suburban , Suburban , I I , Leasetro'Fee SimIe Fee Simple Fee Simple I Fee Simple I Fee Simple , I I Site Loti Ava r .231 ' Loti Avg r .661 I -2 500 Loti A vg [.26] , 0 Lot/ A va r.24] I 0 , I I , View Resid/Comm. Resid/Cntrvsd I Residential , Residential , , I I .~ Design and Appeal 2 Storv/ A va 1.5 Story/Avg I 2 Story/Ava I 1.5 Story/Ava , I , , Quaity of Construdbn Average Average I Averaae , AveraCle , , I , , Age 100 Yrs+/- 65 Yrs , 75 Yrs I 55 Yrs , , I , . Condition Averaae/Unf* Superior 150/0 I -14000 Suoerior 15% I -13.000 Superior 15% I -15 000 , I , Above Grade Total ' Bdrms I Baths Total: Blkms I Baths I Total: Blkms I Baths I Total : Bdrms ' , f! I , Baths I Room Count 20 6: 3: 1.50 4: 2: 1.00 : 500 4: 2: 1.00 : 500 5: 2: 1.00 : 500 Gross Livinq Area 1 749 So.Ft. 1,500 SQ.Ft. , 5000 928 SQ.Ft. , 16 400 1 260 So.Ft. 9800 : I I I Basement & Finished Partial Bsmtl Partial Bsmt/ I Crawl Space I 3,000 Full Bsmtl , e I I I I \ I ~ Rooms Below Grade Dirt Floor Dirt Floor , Cone/Some Fin. 0 -3 500 I , I Functional Utility Gravity Heat Superior I -2 000 Superior I -2 000 Suoerior I -2 000 , , I Heating/Cooling OHW/None OHW/None I EBB/None I OFHAlNone I , , I , Energy Efficient Items Typical Typical I Typical I Typical I I , I Garage/Carport None OSP I -1,000 OSP I -1 000 1 Car Garaae , -4,000 I I Porch, Patio, Deck, Enclosed Porch/ Porches/Sheds I Patio/Deck 0 Breezeway/ I , I , Fireplace(s), etc. Porch/DecklFP , I Porch/FP , I , I I I Fence, Pool. etc. Sheds/Fencina I I , I I , I I , I I , Net Adj. (total) l J + [X) . :$ 14.000 rX + l J- :$ 3.900 r 1 + fxl- :$ 14.200 ~ Gross: 26.30/0 Gross: 42.30/0 Gross: 35.00/0 i, Adjusted Sales Price of Comparable Net: -14.70/0 $ 81 000 Net: 4.6% $ 88,800 Net: -14.3% $ 85,300 ;; Comments on Sales Comparison (including the subject property's compatibility to the neighborhood, etc.): All com parables are similar in location to : the subject property, are verified closed sales and are the best currentlv available. Limited sales of homes in subject's value range have recentlv occurred, reauirina an expanded search. None were found with an unfinished 2nd floor. Ranae of value is $81 000 to $89,000. ITEM SUBJECT COMPARABLE NO.1 COMPARABLE NO.2 COMPARABLE NO.3 Date, Price and Data 7/1/2003 10/20/2003 f Source for prior sales None None $69,900 $74,000 within year of appraisal CHR Courthouse Records Courthouse Records Courthouse Records Analysis of any current agreement of sale, option, or listing of the subject property and analysis of any prior sales of subject and comparables within one year of the date of appraisal: No further recorded sales within three years were found. INDICATED VALUE BY SALES COMPARISON APPROACH. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 85 000 J INDICATED VALUE BY INCOME APPROACH (If Applicable) Estimated Market Rent $ N/A /Mo. x Gross Rent Mu~iplier Nt A = $ N/A This appraisal is made IKl "as is" o subject to the repars, atterations, inspections or conditions listed below o subject to completion per plans and specifications, Conditions of Appraisal: The prooertv has been appraised in current condition. This appraisal is for client onlv. nontransferable. See attached addendum. Final Reconciliation: Cost and Market Analysis consistently sunoort mv estimated market value. GRM analysis was found ~ inappropriate for this analvsis. Greatest weight is annlied to the Market Data Analvsis. Supporting file information substantiates these estimates. The purpose of this appraisal is to estimate the market value of the real property that is the subject of this report, based on the above conditions and the certification, contingent and limiting conditions. and market value definition that are stated in the attached Freddie Mac Form 439/Fannie Mae Form 1004B (Revised 6/93 ). I (WE) ESTIMATE THE MARKET VALUE, AS DEFINED, OF THE REAL PROPERTY THAT IS THE SUBJECT OF THIS REPORT, AS OF 11/29/2005 (WHICH IS THE DATE OF INSPECTION AND THE EFFECTIVE DATE OF THIS REPORT) TO BE $ 85,000 - . APPRAISERt/ C) IJ ff SUP~~APP~(crLY~UI1jE9): ODid [K) Did Not SiQnature A'.l,-L(/).// // ~.. .. (~,~~<,,"c'*:~"_ .. Sianatur -___ il Name Cassandra J. Crockett .7 - Name Steven W. Barrett, SRPA, SRA Inspect Property Date Report Signed 12/09/2005 Date ReDort Signed 12/09/2005 State Certification # RL-001348-L State P A State Certification # GA-000298-L State P A Or State License # State Or State License # RB-026921-A State P A ddie Mac Fam 70 6-93 Certified Resloentlal Certified General AI raiser Fannie Mae Form 1004 6-93 Valuation Section ~ SUMMARY APPRAISAL REPORT UNIFORM RESIDENTIAL APPRAISAL REPORT \ppraiser PAGE 2 OF 2 Produced using ACI software. 800,234,8727 www.aciweb.com Steven W. Barrett R.E. Appr. Svc. F'I N 05 0707 pp SKETCH/AREA TABLE ADDENDUM Case I File No 05-0707 Pr<?p~rt.1' ~9i~~~_ ~~~~~~~~~n~~ ~!,"~t q_ity.. ~~~~II~. ~~i~~__.__.__~___ BOrH)wer._ _~erlrlet~h~~~~I!-~~r:!.~~!~!e ~ender/Cljenl. 'rY'i'in & ~.~K_r:!i~t~.. Appra.iser Name Cas~an.d~~~'_~E9~~!!!_. _~~~n!y Cumberland State PA ~ip.._ 17065 Lie Address 60 ~_est Pom.!~~t Street~ Carlis/~. PA 17013 (\pPLAcJdress 20.0' 3.5' Bedroom b ~ Bedroom --ra ~ Enclosed Porch rul i 440' E o o -0 Q) en Allie b -i N 20.0' .>t: U Q/ o U o o ~ 24.0' .5 B. Wood Deck b g 2nd Floor 5.0' ~f' __, . . Dining Area j'-l-- ..'.......'....... ...~........-. . ... t.....-,.... -e---- Living Room b -<i ('/ b N M Kitchen I I I I I , '_I Bath 24.0' Entry b cO Porch ~(]I 28.0' 20.0' Comments: Scale: 1 = 12 Second Floor Second Floor pip Wood Deck Porch Enclosed Porch Wood Deck First Floor 20.0 X 32.0 640.00 1748.50 24.0 x 24.0 576.00 Second Floor 224.00 20.0 x 24.0 480.00 240.00 3.5 x 15.0 52.50 60.00 764.00 . TOTAL LIVABLE (rounded) '1749 4 Areas Total (rounded) 1749 APEX SOFTWARE 800.858.9958 Apx810o-w Apexl\ ....WIJVL.'-". .- n.vre:;n I , rnv I V Jo\UUr:::nUUM E3orrower: Kenneth Gottshall, Sr., Estate Property Address: 420 North Walnut Street City: Mt. HOJly Springs____ _____ _ Lender: Irwin & McKni ht State: PA i ,/ 'I i 'I I I I I I I i r I ! I j ! I I I ! I I ! I I ! I I I I j- I ! I I I I I I ! i I I ! I I j I I I i --- --0.---..---- ---------.-1 I I i ! I I I I t I I I I I ! i File No.: 05-0707 Case No.: ?ip;_1706? FRONT VIEW OF SUBJECT PROPERTY Appraised Date: Novem ber 29, 2005 Appraised Value: $ REAR VIEW OF SUBJECT PROPERTY STREET SCENE Borrower: Kenneth Gottshall, Sr., Estate Property Address: 420 North Walnut Street Gity: Mt. H()IJy~p~ings lender: Irwin & McKni ht State: PA I ! ! i I I i I I I i i f '-------- I i I I i I L- I I I i I I I I I I I i ! i \ II File No.: 05-0707 Case No.: ___Zip_:11965 ~......... .......---. ..-. -..... ..---..---..--... B::-:-rower: Kenneth Gottshall, Sr., Estate Property Address: 420 North Walnut Street City: Mt. Holly Springs Lender: Irwin & McKtti ht State: PA r-- I I i I I I I ! I I i r------~--- ,'III: File No.: 05-0707 Case No.: ?ip: 17065_ COMPARABLE SALE #1 644 Baltimore Pike Gardners Sale Date: 7/05 Sale Price: $ 95,000 COMPARABLE SALE #2 320 North Baltimore Avenue Mt. Holly Springs Sale Date: 5/05 Sale Price: $ 84,900 COMPARABLE SALE #3 8 Mountain Street Mt. Holly Springs Sale Date: 3/05 Sale Price: $ 99,500 LOCATION MAP ~ /} t ~ . f ,/ CJ ) ~, ( ~ \ I \ / 1 .: \" . -' - -.- ;'1----- -- ~ -c;6e,-- ---- ~ 11./1 #:' ! .I r-V' CEDAR 31 I / 0' ,/ (' \" .' I 't,"f/ / (l_J'//8' : f--r1 N E S 1 / "{Gr Comp } \ -----------~ ( - \" ~j/! .........../ \r ! \\~,( : . /' I .~/" '~~~ '\\f ~ \0'0' ~ \ .~ '~ \,~). ~,\:" )<~ \ ' )1 rl" : '/ ~;- -\~ ~, {. J: -\ <);v/ "./ ~!W"% ~"r- 0-~ q"r- Borrower: Kenneth Gottshall, Sr., Estate Property Address: 420 North Walnut Street City: Mt.-Holly Springs Lender: Irwin & McKni ht r--- I' <><;)/ \ '\' - i ~~~~ / 0 I i /--\ '//AJ ~ I '/ \/ c I I ------. '\ '-, ./ ~ --- ( .I File No.: 05-0707 Case No.: State: P A Zip: 17065 -~, \ \," '--. -~, s' c\ 0Ct'~/ ? ~ ~ ~ ) '.... / " ~ / "' -:/ J '" ./" '~ \ //~ (,.9 ~ t ~ rS ~ '" (q Jf c; MAP(C)1984-200 3.49 miles Prepared by: Steven W. Barrett R.E. Appr, Svc. (717) 243-6646 lID Address Date Price RM BR Bath $QFt Proximity S 420 N WALNUT ST N/A N/A 6 3 1.5 1749 0.00 NI 1 644 BALTIHORE PIKE 7/05 95000 4 2 1 1500 2.7 N1 SE 2 320 N BALTIHORE AV 5/05 24900 4 2 1 928 0.21 HI ESE 3 6 HOUUTAIN ST 3/05 99500 S 2 1 1260 0.69 HI ESE _____-.1 +'" CI.) CI.) ~ +'" en ..... ::s c - ro ~ ..r:: +'" ~ 0 z 0 0 . N N q- ~ CU J... 0 - c. >< L&J u '- <( D:: (f) LIJ --- ....... I C- O 1.0 Z --- 0 oof--J --- 0 w --- x oof--J CL oof--J (J) x N x ?- m a... m ,....... '--' r l' , ~ I- 0 '--" N ~ "--" (J) <:( C c E ~ > oof--J U 0 :2 .8- 0 ""0 co Z ~ :;:; .-' +-' U co ro ro co >. U) ~ ~ ~ ~ ro -' ....... ....... r-I r-I ""0 W lJ) lJ) lJ) lJ) I/) ID ID (J) () CD CD ::J 0:: u u u u ~ ~ ~ ~ .- <( ro ro co ro CL n n n n File No. 05-0707 ********* QUALIFICATIONS ********* -l , I I I I I i i The following checked items are SPECIFIC SPECIAL CONDITIONS that were identified by this appraiser during the inspection of the subject property, the com parables sales, and their neighborhoods and locations. Unless otherwise noted, the conditions that apply to the subject property or the comparable sales used DO NOT AFFECT THE MARKET VALUE OR THE FUTURE MARKETABILITY OF THE SUBJECT PROPERTY BEING APPRAISED. This is not a home inspection service. This is an appraisal to estimate market value. _1. The subject is located in a rural area and is less than 25% built-up. _x_2. Commercial/lndustrial uses are located within the subject's neighborhood. These uses are typical of similar neighborhoods. _3. Vacant and undeveloped land uses are located within the subject's neighborhood. These uses are typical for the area. _4. The predominant value in the neighborhood is less than that of the market value of the subject property. This is due to the very wide range of value of properties in the area and superior quality of the subject property. _5. The subject property is located in a F.E.M.A. Identified Flood Zone. Flood insurance coverage is required and suggested. _6. Dampness is noted in the basement of the subject. Standing or running water was not present on basement floor. This condition is considered typical in dwellings of this style. _7. The subject property is serviced by private well and/or septic systems which is common fOr the area. _x_B. The subject is older than five(5) years. All mechanical systems including the heating, electrical and plumbing systems appear upon a visual exterior inspection to be in working order. No warranties are implied in this statement. _9. Repair items were noted in the comments section of the report. These comments on repair items are for descriptive purposes only and are not required repairs. The items listed are cosmetic in nature. _x_10. The basement floor is a dirt floor. This condition is common and typical for the area. and does not pose a health or safety hazard. _x_11. The subject property does contain functional obsolescence as noted in the report. This condition is considered typical and common for the area and this style dwelling. _x_12. The land value exceeds 30% of total value due to the high demand for vacant land in this neighborhood. This condition is considered common and typical for the neighborhood. _13. The land value exceeds 30% of total value. This is due to the large size of the site. This condition is considered to be typical and common. _14. Individual adjustments were required that exceed 15%. These adjustments were required due to lack of more similar com parables on that individual rating. All com parables used are the best available. _x_15. Total adjustments exceed 250/0. This is due to the lack of comparable sales that were more similar in the subject's market area. All com parables used are the best available. _x_16. One or more comparable sales are older than six(6} months. Although there are comparable properties in the subject's area, none have sold recently; therefore, sales in excess of six(6) months have to be used. All com parables used are the best available. _x_17. One or more com parables used were in excess of one (1) mile from the subject property. Although there are comparable properties in the immediate area, none have sold recently. Therefore, it was necessary to use comparable sales outside of the immediate area. All com parables used are located in similar neighborhoods and within the same marketing area. All com parables used are the best available. _18. The electrical system was not connected during inspection. _19. The water service was not connected during inspection. _20. The heating system was shut down during inspection. _21. Roofing_Plumbing_Electrical_Heating_certification(s) is/are suggested. _x_22. Inground swimming pool_, out buildings_x_are included_x_,not included_according to lender's guidelines. _23. According to lender's guidelines a maximum of_acres were considered for this valuation. Remaining acreage was given no value. - File No. 05-0707 ********* au ALl F I CAT 10 NS ********* --l r- _24. The subject property is located on a private road. _25. Wood infestation inspection is suggested. _x_26. Last recorded deed transfer: Date_7/16/1975_, Consideration: $1,350 _27. Proposed construction/renovation in accordance to plans and specifications to be completed in a workman-like manner. _28. Seller is paying part or all of closing costs. _x_29. All comparable sales are verified closed sales. 30. There are no special conditions or other requirements that would affect market value or future marketability in the Appraisal Report. CHECKED ITEMS ARE SPECIFIC SPf;CIAL CONI?ITIONS THAT WERE IDENTIFIED BY THIS APPRAJSER DURING INSPECTION. l -- File No. 05-0707 DEFINITION OF MARKET VALUE: The most probable price which a property should bring in a competitive and open market under all conditions requisite to a fair sale, the buyer and seller, each acting prudently, knowledgeably and assuming the price is not affected by undue stimulu~.. Implicit in this definition is the consummation of a sale as of a specified date and the passing of title from seller to buyer under conditions whereby: (1) buyer and seller are typically motivated; (2) both parties are well informed or well advised, ~nd eac~ acting in what he considers his own best interest; (3) a reasonable time is allowed for exposure in the open market; (4) payment IS made In terms of cash in U.S. dollars or in terms of financial arrangements comparable thereto; and (5) the price represents the normal consideration for the property sold unaffected by special or creative financing or sales concessions* granted by anyone associated with the sale. * Adjustments to the comparables must be made for special 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 comparisons to financing terms offered by a third party institutional lender that is not already involved in the property or transaction. Any adjustment should not be calculated on a mechanical dollar for dollar cost of the financing or concession but the dollar amount of any adjustment should approximate the market's reaction to the financing or concessions based on the Appraiser's judgment. STATEMENT OF LIMITING CONDITIONS AND APPRAISER'S CERTIFICATION CONTINGENT AND LIMITING CONDITIONS: The appraiser's certification that appears in the appraisal report is subject to the following conditions: 1. The appraiser will not be responsible for matters of a legal nature that affect either the property being appraised or the title to it. The appraiser assumes that the title is good and marketable and, therefore, will not render any opinions about the title. The property is appraised on the basis of it being under responsible ownership. 2. The appraiser has provided a sketch in the appraisal report to show approximate dimensions of the improvements and the sketch is included only to assist the reader of the report in visualizing the property and understanding the appraiser's determination of its size. 3. The appraiser has examined the available flood maps that are provided by the Federal Emergency Management Agency (or other data sources) and has noted in the appraisal report whether the subject site is located in an identified Special Flood Hazard Area. Because the appraiser is not a surveyor, he or she makes no guarantees, express or implied, regarding this determination. 4. The appraiser will not give testimony or appear in court because he or she made an appraisal of the property in question, unless specific arrangements to do so have been made beforehand. 5. The appraiser has estimated the value of the land in the cost approach at its highest and best use and the improvements at their contributory value. These separate valuations of the land and improvements must not be used in conjunction with any other appraisal and are invalid if they are so used. 6. The appraiser has noted in the appraisal report any adverse conditions (such as, needed repairs, depreciation, the presence of hazardous wastes, toxic substances, etc. ) observed during the inspection of the subject property or that he or she became aware of during the normal research involved in performing the appraisat Unless otherwise stated in the appraisal report, the appraiser has no knowledge of any hidden or unapparent conditions of the property or adverse environmental conditions (including the presence of hazardous wastes, toxic substances, etc. ) that would make the property more or less valuable, and has assumed that there are no such conditions and makes no guarantees or warranties, express or implied, regarding the condition of the property. The appraiser will not be responsible for any such conditions that do exist or for any engineering or testing that might be required to discover whether such conditions exist. Because the appraiser is not an expert in the field of environmental hazards, the appraisal report must not be considered as an environmental assessment of the property. 7. The appraiser obtained the information, estimates, and opinions that were expressed in the appraisal report from sources that he or she considers to be reliable and believes them to be true and correct. The appraiser does not assume responsibility for the accuracy of such items that were furnished by other parties. 8. The appraiser will not disclose the contents of the appraisal report except as provided for in the Uniform Standards of Professional Appraisal Practice. 9. The appraiser has based his or her appraisal report and valuation conclusion for an appraisal that is subject to satisfactory completion, repairs, or alterations on the assumption that completion of the improvements will be performed in a workmanlike manner. 10. The appraiser must provide his or her prior written consent before the lender/client specified in the appraisal report can distribute the appraisal report (including conclusions about the property value, the appraiser's identity and professional designations, and references to any professional appraisal organizations or the firm with which the appraiser is associated) to anyone other than the borrower; the mortgagee or its successors and assigns; the mortgage insurer; consultants; professional appraisal organizations; any state or federally approved financial institution; or any department, agency, or instrumentality of the United States or any state or the District of Columbia; except that the lender/client may distribute the property description section of the report only to data collection or reporting service(s) without having to obtain the appraiser's prior written consent. The appraiser's written consent and approval must also be obtained before the appraisal can be conveyed by anyone to the public through advertising, public relations, news, sales, or other media. Freddie Mac Form 439 6-93 Page 1 of 2 Fannie Mae Form 100486-93 REV-1502 EX + (6-98) -* COMMONWEALTH OF PENNSYLVANIA 'NHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER GOTTSHALL. SR. KENNETH E. 21 05 1054 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real proDertv which is iointly-owned with riaht of survivorship must be disclosed on Schedule F. SCHEDULE A REAL ESTATE ITEM NUMBER 1. DESCRIPTION 420 N. WALNUT STREET, MT. HOLLY SPRINGS, PENNSYLVANIA VALUE AT DATE OF DEATH 85,000.00 \\~ TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 85 000.00 File No. 05..0707 APPRAISERS CERTIFICATION: The Appraiser certifies and agrees that: 1. I have researched the subject market area and have selected a minimum of three recent sales of properties most similar and proximate to the subject property for consideration in the sales comparison analysis and have made a dollar adjustment when appropriate to reflect the market reaction to those items 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 subject property, I have made a positive adjustment to increase the adjusted sales price of the comparable. 2. I have taken into consideration the factors that have an impact on value in my development of the estimate of market value in the appraisal report. I have not knowingly withheld any 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 form. 4. I have no present or prospective interest in the property that is the subject to this report, and I have no present or prospective personal interest or bias with respect to the participants in the transaction. I did not base, either partially or completely, my analysis and/or the estimate of market value in the appraisal report on the race, color, religion, sex, handicap, familial status, or national origin of either the prospective owners or occupants of the subject property or of the present owners or occupants of the properties in the vicinity of the subject property. 5. I have no present or contemplated future interest in the subject property, and neither my current or future employment nor my compensation for performing this appraisal is contingent on the appraised value of the property. 6. I was not required to report a predetermined value or direction in value that favors the cause of the client or any related party, the amount of the value estimate, the attainment of a specific result, or the occurrence of a subsequent event in order to receive my compensation and/or employment for performing the appraisal. I did not base the appraisal report on a requested minimum valuation, a specific valuation, or the need to approve a specific mortgage loan. 7. I performed this appraisal in conformity with the Uniform Standards of Professional Appraisal Practice that were adopted and promulgated by the Appraisal Standards Board of The Appraisal Foundation and that were in place as of the effective date of this appraisal, with the exception of the departure provision of those Standards, which does not apply. I acknowledge that an estimate of a reasonable time for exposure in the open market is a condition in the definition of market value and the estimate I developed is consistent with the marketing time noted in the neighborhood section of this report, unless I have otherwise stated in the reconciliation section. 8. I have personally inspected the interior and exterior areas of the subject property and the exterior of all properties listed as comparables in the appraisal report. I further certify that I have noted any apparent or known adverse conditions in the subject improvements, on the subject site, or on any site within the immediate vicinity of the subject property of which I am aware and have made adjustments for these adverse conditions in my analysis of the property value to the extent that I had market evidence to support them. I have also commented about the effect of the adverse conditions on the marketability of the subject property. 9. I personally prepared all conclusions and opinions about the real estate that were set forth in the appraisal report. If I relied on significant professional assistance from any individual or individuals in the performance of the appraisal or the preparation of the appraisal report, I have named such individual(s) and disclosed the specific tasks performed by them in the reconciliation section of this appraisal report. I certify that any individual so named is qualified to perform the tasks. I have not authorized anyone to make a change to any item in the report; therefore, if an unauthorized change is made to the appraisal report, I will take no responsibility for it. SUPERVISORY APPRAISER'S CERTIFICATION: If a supervisory appraiser signed the appraisal report, he or she 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 the appraiser, agree to be bound by the appraiser's certifications numbered 4 through 7 above, and am taking full responsibility for the appraisal and the appraisal report. ADDRESS OF PROPERTY APPRAISED: 420 North Walnut Street, Mt. Holly Springs, PA 17065 APPRAISER: SUPERVISORY APPRAISER (only if required) ~~/) 'l } ~~~:t:ur~a~:jr~i j:t1~~e:J. (~."JL f/-. Date Signed: 12/09/2005 State Certification #: RL..001348..L or State License #: State: PA Expiration Date of Certification or License: 6/30/2007 Signature: Name: Steven W. Barrett, SRPA, SRA Date Signed: 12/09/2005 State Certification #: GA..000298..L or State License #: RB-026921..A State: P A Expiration Date of Certification or License: 6/30/2007 o Did 00 Did Not Inspect Property Certified Residential Appraiser Freddie Mac Form 439 6-93 Certified General Appraiser Page 2 of 2 Fannie Mae Form 10048 6-93 {~,:;.~/) /.- ...., ~r --' .'. /- . ~",.~z /,.;~~: ./ l-...!.......:>,~~-..,~_..~.'- . ._~<. ~_::-' :':' "".,, :~~-~~ :/ ..-- .....'"",~.,. ~.'.~."f'... , t~/:~,,:::c~<~ ,/... ./.,..r" ~..~-6~~. ... .~.. .':. rA~-_J<'~'''~ r ",/.,,"f~j~~": ,,,."-" ~....' ....J! ;I>: ~:2!:f-..>t"7 7" i~.::,.4~'f-:\;:2 ;.:;..:2 / ,.:;'''' . . /'/// /". /' ,.~7 ~~~~;~ ./ ~ ~__....~ ." ',~"!-: (i_.~ ..:;.~ .~ [, ~._ /~~..,..,_'.'._~;.:'~" _: ~:-."_;.'. ___ . 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""'_ -.J '-It':;..,,: ';;6.~~.--:"', ~4':~ ! .....'" #'/ ~ ,,::!;(~';':';; 1 I I I 1 ~,:-_....,.";:'" r',,~d''"'' .I::" ,~.< ~.-/ ,J1_.,....,.~P' ij c,.... ,.-..... :z ~-818.00+ .If . -- 402-00+ f-l.f -296.00+ II/ -- 4,730-00+ ....3.'.'"'" -"'.... ,,' " ,_.JI ~,_:_"":~~:,~"""""",,~,~,'__'.".'/"~' ",;-:",,/.-.~, ',_/~.~ ~,~o .~"',,,;.,.~:,.<.;,. ~ 1;;.... .~.~..Z'...t:,,~~...~' . -: r;;::.' _ _ ..;_.. ,~-r.. _'~., _ " ..-.__ ."" :J' '-::-.::::?:~:"~~_""'"~.;t>:....:. ~:" S', , ..- c-::" .:~;:~i.- ,I ./ f .:.':7':~:, ';;/"'-''::'C;' / ..-""iI /' ra:;) _ _ ,<:;.c'~~.,"_~ ~l Z-;-% '<E } /J" ~____~' '. , " , (,.'0 ,A",~ / ,,' -',7'- /&"0'-' / ~ ">/ 6,245-* 0-* __."'J /" ." ,'t....-~-c:- -- --','L'\~,\-/ .:~--- /' ."_ ~ Y-~~~~"~~~2-/; ~;.-::~..-/ ./' --;-;-_....__ ./ ' "t' ..~c:.. -:...r'/' {...- c::.- cc.e,;p ~/: - - . /' '--c:~c-.--:>__ , -=- ' .e. c..._<,,~ 6:, '-t: " . -. /~? ,/'/,/ // ( /" r / c:.<::;'- ,-NCB8I'iK 412 768 3458 ~ PNCBAl\f( December 22., 2005 Roger B. Irwin West Pomfret Professional Building 60 West Pomfret Street Carlisle, PA 170l3-3222 RE: Estate of Kenneth E. Gottshall, Sr., deceased SSN: 171-28...2560 000: 1 ]/21/2005 Dear Mr. IrWin: In response tb your request for Date of Death balances for the customer noted above, our records show the following: Checking Aecount Account #5004 172865 Established 08/25/2003 KE"N'NETH E GOTTSHALL SR DOD balance: $5,044.90 (non-interest bearing) The decedent maintained Investment Accounts (INV #378922] 1) and (!NY #38837108). For further information, you may contact the Brokerage Department at 1-800-762-6111. Please note that this Dffic~ only provides date of death bala.ilces for deposit accounts (IPu\s, CDs, Checking and Savings accounts). We do Dot process any financial tranS3(tioDs or provide statements. If you need assistance with any cfthese items, please call1-888-PNC..BA1~K (1-888-762-2265) or stop by your local PNC Bank branch office. Sincerely, ~~ 1-800-762..1775 P7-PFSC-04-F 500 first Ave. Pittsburgh PA t 5219 lVl~mbcr FDIC 0, PNC1NVESTMENTS Member NASI) and slPe January 9, 2006 l~'D', ,.., ~~... @...ltU\WW..".,ill]\,.I,...., t l ~ U,._"'H kJ ~ u~ \f . ~ .,J 1'..J Irwin & McKnight West Pomfret Professional Building 60 West Pomfret Street Carlisle, Pennsylvania 17013-3222 Attention: Roger B Irvin RE: Estate of Kenneth E. Gottshall, Sr. Date of Death: November 21,2005 Social Security #: 171-28-2560 Dear Mr. Irvin: Mr. Kenneth E Gottshall, Sf. had two accounts with PNC Investments. They are as follows: Individual Investment Account #3883-7108 Owner of Account - Kenneth E Gottshall Account established on OS/21/2003 Dividends on this account were reinvested. This account, on the date of death, contains Mutual Funds as follows: 107.907 shares American High Inc CL A AHIYX @ $12.09 per share (, j[LI,ft, D 34.927 shares Inc Fund of America CLA AMECX A $18.40 per share . ~~Y). &.~. J Traditional Individual Retirement Account #3789-2211 Owner of Account - Kenneth Gottshall, Sf. Account established on 01/12/2001 Dividends on this account were reinvested. This account, on the date of death contained a Mutual Fund as follows: 333.965 shares American Balanced FO CL B BALBX @ $18.16 per share. --' nD ,/ I if. L( t, I Zt I L. 4-- . , A irH'TniH:r of HF tiNe Finandd S<.'rvi(,fs GrmA}' 2 East Main Street Mechanicsbur~J Pennsylvania 17055 wVlJw.pnci nvestrrl e nts.com Important Investor Information: Securities and brukerage services ;)re provided by PNC Investments LtC. member NASD Jod SIPe. .A.nnuities and oHwr insurance products 3fe offered by PNC Insurance Services. Inf. d licensl:'d insur;:lnce agency. .---' . I . l\ilay Lo~e V:1Jue i f5H -No &Ulk Gll<UlU1lc(J G J an uary 9, 2006 Page 2 Estate of Kenneth E. Gottshall, Sr. The only beneficiary named on the IRA is his spouse A Ruth Gottshall at 100%.. In order to disburse the monies we will need a distribution form signed by Ruth. In order to disburse the monies in Account #3883-7108, it will be necessary to set up an estate account with the Executor as the signer. I have the Death Certificate you provided, but in addition I will need an original Short Certificate. Please give me a call at (717) 601-4003 for an appointment for the Executor to set up the Estate Account. If you have any questions please feel free to give me a call. Sincerely, (lit ;;?~ Charles E. Little, CFP Vice President Senior Financial Consultant CEL/djp · m M&fBank 499 Mitchell Road, MiIIsboro, DE 19966 Mail Code DE-MB-12 Phone (888)502-4349 Fax (302) 934-2955 December 2, 2005 Law Offices Invin & McKnight West Pomfret Professional Building 60 West Pomfret Street Carlisle, Pennsylvania 17013-3222 ~~~~uw~~ Re: Estate of I<.enneth E Gottshall Social Securitv: 171-28-2560 Date of Death: November 21.2005 i Dear Sir or Madam: Per your inquiry dated November 29,2005, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Installment Loan- Account Number 110001 63586500001 Ownership (Names ofJ Kenneth E Gottshall * Opening Date 06/09/04 Balance on Date of Death $3.809.77 ** This amount is not to be used for payoff purposes. For a payoff balance, please call 1-800-724-2440. Current Balance $3,767.69 ** This amount is notapayoffbalance. 2. Type of Account Home Equity Loan Account Number 23000000034942 Ownership (Names oj) Kenneth E Gottshall * A Ruth Gottshall * Opening Date 02//5/01 Balance on Date of Death $22,705.54 ** For Insurance Information and a payoff amount, please call 1-800-724-2440. Current Balance $22,635.28 ** This amount is not a payoffbalance. Please be advised, there was no safe deposit box found for the above decedent. * For further account information, regarding ownership, closures and/or reimbursement of funds, etc., please call the number listed above or the High Street Carlisle Office # 717-240-4536. Sincerely, ~t2;J;:/&~r Nancy Clagett Records Management FEB, 21. 2006 4:21PM NO, 8948 P. 2 ,/~", 'fl:1 M&l' Credit Services, ILC A Subsidiary of M~i Bank One Fountain Plaza. F.O. Box 4005, Buffalo, NY 14203 BOO 636 2826 Consumer Lending Department February 21, 2006 The Estate of Kenneth Gottshall C/O Irwin & McI<night, Attorney's at Law 60 vVest Pomfret Street Carlisle, P A 17013-3222 Re: Kenneth Gottshall Account # 110-63586500001/023000000034942 Dear Karen Noel; In response to your request on 02-17-06, this notice will confirm that the payoff on the above-referenced account, as of 02-23-06 on account nmnber 1106358650001 is $255.04 with daily per diem of $03. The payoff on account number 023000000034942 as ot.2-23- 06 is $21,762-10 \vith daily per diem of$4.27. Please forward the payment to: M&T Bank 11 00 Wehrle Drive Willi amsville, N e\v Yark 14221 Attn: Luveena A Ward If you have any questions about this account, or need further assistance, please call me at (800) 639-8784 ext. 4563, or direct 716-635-4563. c? ?/~ Luveena A vVard Estate Specj alist DAUPHIN OIL CO., INC. P. O. Box 600 ST'A"EM' E'N. T Carlisle, PA 17013 . '"I ". (717) 243-5515 . ~ Heating · Air Conditioning · Sales & Service P\ Y:\IENTS RECEI\r:n\YTEi< \!)OVE \).\n WILL .\PPEAR ON THE .'.tEXT"-!TUEMF!'d. DELIVERY ADDKESS IF lJIloFERE0iT TIL\:'>l H!LUN(; \HIlHESS KEN GOTTSHALL 420 N WALNUT ST MT HOLLY SPR PA 17065 KEN GOTTSHALL 420 N WALNUT ST MT HOLLY SPR PA 17065 AMOUNT ENCLOSED $ PLEASE DETACH ,\J'JD RETURN THIS TOP STUB WITH YOUR PA Y:\lENT 12/26/05 01/13/06 Beginning FUEL OIL Payment - Thank You 14938 -361.31 i 1316.77 955.42 WE ACCEPT MOST MAJO CREDIT CAR S /)'1 i) 1/. .,',,~ iJ}ii{{}tL I I al'VL\f~/1 r. I v I.. ~) + nib (<< .Ut)J! (:~ lJz,c ,0/ c1 iJL ((ct.C .f\ (1"'"", \ ; \ \ l '\) J Yf'YJ:{.;i/1-lr I c) I U j I I I I j I I I I PAST DUE BAlANCES - , . CURRENT BUDGET PAYMENTS 0.00 TOTAL ~,ION-BUOGET CHARGES 0.0 CFIUWNT 30 DA YS 611 DA YS 90 DAYS & OVER 0.0 331.35 0.00 624.0 I'I; FINANCE CHAR(a~ ON ACCOl'NTS OVER 30 DAYS, TH1S RATE APPLlES TO PAST DUE BALANCE.S OVER 30 DAYS FROtvllNVOICE DArE. ANNUAL PERCE~TAGE RATi,: (;F \0" DAUPHIN OIL CO., INC. · CARLISLE, PA 17013 · (717) 243-5515 ~ --------- --- " ~ 25. 1:S. s?'. r....... .. t"'.. i'. If. .... 1/. Si-.' ...... !if ":a ill :I ... .. ..... .- ~ ' ~IZI -c _.. :I:r...:::S c .1' 2fCl ~a."-E5!:'~I'-= Gj~ !~;@~J~;; ~~I;! !I,.. i'~"OiI N Q.. 9 IJ........ .... at It . .... ." ;; ! ~ ....c: "'OC .,.. ,_.. . .' - ...... .... C'. I;' II O"t "C ?5 ft' C lIP' lI~i--1 8!! :<1 0""0 ""m -Cr- riio< ,,~m zz~ 990 3 !i 3: m m ~ \ ~'"' \ ~ U""e ~\ G i) U 0 Cl /' \, ~ G ~c ~ v V if ( :":1 V 'I _,.~__,~.___.<__.....-,......""""",,,,,,,,,,,"",.oo-''''''''--- . _.- '-- ",."--~ - .,...._-~-_.- -- , 03111.::10 )i83H80 $a3A13~~ ocrv':> '(j80 HS'f~O lNnOMf 'asn aP!4a^ JOlOIM J,()j le6alloN I ^eM46!H 1*0 'asn 9tQBXEl. JO! 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MANORCARE CARLISLE 372 940 WALNUT BOTTOM ROAD CARLISLE, PA 17013 (/17)-'249-0085 GENISE GOTTSHALL FOR KENNETH GOTTSHALL 7 PINE ROAD APT 205 MOUNT HOLLY SPRINGS, PA GOTTSHALL, KENNETH E 12/01/05 BALANCE FORWARD 171365 rl E 0 I CAR E A MeR co INS ROOt/j 106 --A 25235 11/01/05 11/21/05 12/31/05 PAYMENT DUE UPON RECEIPT THIS is t~OT A B!LL.. b'q d This amount has been . !ile to your insurance cornpany 3,534,,00 :3 ,) S34, I(H) . 007852 858HMA 000623L .. · CARLISLE RECIONAL P.o. Box 4100 ~\.1 E DIe ALe EN T E R Carlisle, PA 17013-4100 ADDRESS SERVICE REQUESTED IF PAYING BY CREDIT CARD, FILL OUT BELOW AND SEE REVERSE SIDE CHECK CARD USING FOR PAYMENT o .0 _10 MASTERCARD ' DISCOVER >X~>U VISA o AMERICAN EXPRESS ACCOUNT NO. STATEMENT DATE BALANCE DUE - 10/24/2005 7520122 10/10/2005 $1,0'~ ~ MAKE CHECKS PAYABLE TO: GOTTSHAll, KENNETH E SR 420 N WALNUT 5T ~ MT HOllY SPRG PA 17065 o 11111111111111111111111111111111111111111111111111111111111111 CARLISLE REGIONAL MEDICAL CENTER 246 PARKER ST. P.O. BOX 4100 CARLISLE PA 17013-4100 1111111111111111111111111111111111111111111111111111111111111I - CJ ~1'::)ase l)i~}(:K it abUJ8 aUCi;"'3SS is 'ncorrecr 2nd :ntjicat'3 change on reverse side. TO iNSURE ?ROPEP. CREQIT ~:::TjPN Tl-'i!:3 F!A;TICN THE ENCLOSED ENVELOPE. DATE PATIENT ACCOUNl NO. DATE OF SERVICE TYPE OF SERVICE 7520722 08/09/2005 OUTPATIENT TOTAL CHARGES 1,141.48 PATIENT NAME GOTTSHALL, KENNETH DESCRIPTION PAYMENT/ADJUSTMENTS CAT SCAN 08/31/05 08/31/05 09/13/05 10/07/05 10/07/05 MEDICARE CONTRACTUAL ADJUSTMENT MEDICARE PAYMENT INSURANCE PAYMENT MEDICARE CONTRACTUAL ADJUSTMENT MEDI CARE .. PAYMENT 881.39- 143.05- 117.04- 881.39 143.05 PAYMENTS AND CHARGES RECEIVED AFTER THE STATEMENT DATE WILL BE REFLECTED ON THE NEXT STATEMENT. ACCO'UNT BA~Nr:f OU~ -~ ; ~ - ...... ~."'~ $1,024.44 MESSAGES The amountshown on this. statement is outstanding at this time. Your prompt payment willb~ greatly appreciated. FOR BilliNG QUESTIONS, PLEASE CAll: (717) 218-8852 ~ =;::4 10/24/2005 J . ~ - === == ---- - - - - - ---- - ~ - - - - == - - - - - iiiiiiiij;ijjji PACE INTERNATIONAL MASTERCARD STATEMENT KENNETH E GOTTSHALL Ie Page 1 of 1 BALANCE SUMMARY ACCOUNT SUMMARY PAYMENT SUMMARY ACCOUNT NUMBER TOTAL CREDIT LIMIT TOTAL CREDIT LIMIT AVAILABLE PAST DUE AMOUNT PREVIOUS BALANCE PAYMENTS/CREDITS PURCHASESIDEBITS $3.115.11 5432-3590-7011-6279 $308.00 $8,500 $0 $107.00 $415.001 $0.00 $35.00 MINIMUM PAYMENT' ICURRENT PAYMENT DUE" PAYMENT DUE DATE 02/04/06 STATEMENT DATE 01/10/06 , See reverse side for an explanation of these amounts. FINANCE CHARGE NEW BALANCE $39.38 $3,189.49 TRANSACTION SUMMARY (For additional transaction detail go to www.unionpluscard.com ) fRAN POST TRANSACTION REFERENCE AMOUNT DATE Qlli. DESCRIPTION NUMBER CHARGES l CREDITS 01/05 01/05 LATE CHARGE ASSESSMENT 1999999998000099180 $35.00 I IF YOU ARE UNABLE TO SEND YOUR PAYME;NT TODAY, PLEASE CALL 800-201-0071 TO DISCUSS A REPAYMENT ARRANGEMENT. FINANCE CHARGE CALCULATION This is a no grace account. Grace period information on back Average Daily Balance Daily Days Periodic In Billing Rate C yele .04178% 30 .04178'%, 30 .04178% 30 04178% 30 .04178% 30 .04178% 30 .00000% 30 .00000% 30 Nominal ANNUAL FINANCE CHARGE Annual PERCENTAGE At Periodic Cash Advance/ Percentage RATE Rate Transaction Fees Rate $4.85 $0.00 15.25% 15.250% $2.54 $0.00 15.25% 15.250% $18.67 $0.00 15.25% 15.250% $6.63 $0.00 15.25% 15.250% $1.96 $0.00 15.25% 15.250% $4.73 $0.00 15.25% 15.250% $0.00 $0.00 19.99% 19.990% $0. 00 $0.00 5.90% 5.900% Ii) ~ BONUS CHECK $386.61 PURCHASES $202.38 STATEMENT CHECK $1,489.57 S fA fEME NT CHECK $528.74 BONUS CHECK $156.51 BONUS CHECK $377.26 CASH ADVANCES $0.00 PROMOTIONAL PURCHASES $0.00 ::!: ,.... C') 1= ::!: I- en 1:r QUESTIONS? 24-HOUR CUSTOMER SERVICE 1-800-622-2580 OUTSIDE USA, COLLECT: 1-702-243-1575 TOO HEARING IMPAIRED: 1-800-655-9392 ~ Manage your account online at: www.unionpluscard.com 010272 E 10 o00ooo3000 N STMT57 D 6 ??oo5408 PLEASE DETACH AND RETURN BOTTOM PORTION WITH YOUR PAYMENf: To Assure Proper '~redit Please Write Your Account Number On Your Check .I MAIL PAYMENTS TO: UNION PLUS CREDIT CARD PO BOX 17051 BALTIMORE MD 21297-1051 LJ MAILINQUI RIES TO: UNION PLUS CREDIT CARD PO BOX 80027 SALINAS CA 93912-0027 UP1 'ACE Account Number New Balance $3,1 89.49 Payment Due Date 02/04/06 5432-3590~70tt-6279 Current Payment Due $415.00 Make checks payable to UNION PLUS CREDIT CARD. Please write your account number on your check. Do not fold, staple or clip. Do not send cast1. Please send your payment 7 days prior to the payment due date to ensure timely delivery. Amount Enclosed $ S-00002328 000000700000 KENNETH E GOTTSHALL 420 N WALNUT ST MOUNT HOLLY SPRINGS PA 17065-1504 1.11111...111111111.111.1..1111.1.1.1111111111111.1111111.1111 UNION PLUS CREDIT CARD PO BOX 17051 BALTIMORE MD 21297-1051 '11'.1.1111111.".111111.'.11111111.11.1"1111..1.11 543235907011627900041500003189496 ..J ..J c( I ~ o (!J z w ~ ':CD -3e -~ ~~ _0 C .. :I.! g~ o .. ctd 1: .. E ~ " Q. CD o GO ~ ~ o ii ... " C '" ~ iii ~ U) CO .CD E~ eN ~o men ~~ cn~ ~N CN ~DO 8= o.Q <~ .z -.1: ~~ 00 .....:l . et8 g ~ g d ~ U) ~ .5 ~ :I IJ ~ t:! M ~ U) 4.D 0) en ~<rF ~ .. II c o ~ It ~ ns U 1; ~ ('f) C"' ~ en U; ~ ~ ~I + o <<:) o 0 o 0 ~ .. ~I ~ ~ z ('f) c.; C( ~ co Z u: ...!.. + U o 0 o 0 o 0 ~ .. u j ~ &1 ~ a..~ II: 0 I- " ,... ('f) C") cO cO ..- .,.. co co ~<rF ~ .. ) (') 0 (') en 0 ~ wlriM N ('f) co ~~~ I w CJ II: ~ ~ I (3 w ~ ~~~ ~~~ 65~ i I ~~~ I I I I I:i,:::l. j ~I ~ ~ CO) im:iii: .1:1, ~ DO iI9- iiilii!! 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N ~ CI ..0 CI CICl N ..... N = 3 '" N CI CI CI '" CI CI ..... ..... ~~i' ~ ~ ~ o cu :0 o G) ::3 :0 G) Ul :::l G) m cu CD 0: uj Lu ;: o ....J B .::t:. ~ .r: o :; o >. :€ ~ ~ t:: o Q. m ;E 'Iii E "C I:: cu ..c: o m Q) o .':: :EI~[:i 0 :jl!i .f. '.~.. 0 I!!i!li ll!i! ..... U) o U) It) en N o en (') o N N N a) D D . D D D D D fFJ- >0- m Qi 1i. E o o C :J o E ClS .: u:: "C QJ C C III .t: (J QJ > III .t: o "C QJ > o E QJ > C'll .t: <<Ii QJ > .. CITi ( P.". E JACKSC ~ ~ l - - - - - - - iiiiiiiiiiiiiii iiiiiiiiiiiiiii - - - - - - - - - - - - - - - - - - - - - - - - - '" SEA RS Gol d MasterCard Account Number: 5121-0718-4812-17071111111111111111111111111111111111111111 i Account Payment Total Amount Enclosed $ $6,180.49 12/20/05 $668.00 Make Checks Payable to s~~efedit Cards Change of Address? ..-------' 111.111. ..111,".11.. .1.1. II .11.1.1.11... .1111111.111. ..1.1111 KENNETH E GOTTSHALL 0002715 420 N WALNUT ST HT HOLLY SP PA 17065-1504 1.1..1..11'111.1"1111111...1.111.11.1.11111'11..1.1 PO BOX 182156 COLUMBUS OH 43218-2156 0000 5121071848121707 0618049 0066800 0000000 e"fLi Sears Gold MasterCard Account Number 5121-0718-4812-1707 1 OF2 Customer Service 1-800-669-8488 Billing Cycle Closing Date Account Balance 11/22/05 $6,180.49 Total Credit Lin.e Available Credit Line Cash Access Line $12,500.00 $6,319.51 $2,500.00 Available Cash $2,500.00 Amount Over Credit Line Amount Past Due Current Minimum Due T atal Minimum Due $0.00 + $407.00 + $26100 = $668.00 Payment Due Date 1 2/20105 Account Summar Previous Balance Payments & Credits Purchases & Debits Other Charges FINANCE CHARGES Account Balance $5,981.93 $0.00 $0.00 $39.00 $159.56 6 180.49 Current Activity Trans Post Description Charges/ Date Date Credits 11-20 11-20 LATE PAYMENT FEE $39.00 THE APR ON YOUR ACCOUNT HAS BEEN INCREASED FOR ONE OF THE FOLLOWING REASONS: YOU FAILED TO MAKE PAYMENT TO US ON THIS OR ANY OTHER ACCOUNT THAT YOU HAVE WITH US OR TO ANY OTHER CREDITOR WHEN DUE, YOU EXCEEDED YOUR CREDIT LINE ON THIS OR ANY OTHER ACCOUNT YOU HAVE WITH US, OR YOU MADE A PAYMENT TO US ON THIS OR ANY OTHER ACCOUNT YOU HAVE WITH US THAT WAS NOT HONORED BY YOUR BANK. ] THE AMOUNT DUE SHOWN ABOVE INCLUDES A PAST DUE AMOUNT. YOU SHOULD SEND THE ENTIRE AMOUNT DUE NOW. IF PAYMENT HAS BEEN MADE RECENTLY, THANK YOU. r~ I l Andorrjl Radiology Assoc., P.C. PO Box 8"92 Concofdville P A 19331 ~ 3 A J J:. Ivn:. 1\1 I Statement Date: 01/12/2006 Account Number: ARA-9313737 I I j Amount Due: $252.00 For billing questions, please call 888-434-6170 Billing Office Hours: 9am - 4pm Mon - Fri 1111/111/0 /11111/llIlllf 11111I1111111111 , III UII 1111 III ~lllllllf III Patient: KENNETH E GOTTSHALL,SR MAKE CHECK PAYABLE & REMIT TO: *11 **AUTO**3-DIGIT 170 02102 1'11111...111"111111.1.1'11.11.1.1.1111..1111111.11111.1.1..1 Kenneth E Gottshall,Sr 420 N Walnut Street Mount Holly Springs PA 17065-1504 111.111.1"1111'1111'11.111111.1 Andorra Radiology Assoc., p.e. PO Box 892 Concordville PA 19331 ( AMOUNT PAID "- r------ \ ~ (. DETACH HERE, AND RETURN THIS TOP PORTION WITH YOUR PAYMENT " USINQ .THE RETt.JAN_E~VE._~fW_~~Ng~9S_E.P_______ DOCTOR CHRISTOPHER LADD MD ERNEST CAMPONOVO MD ERNEST CAMPONOVO MD RICHARD E KRAUS, :MD CHRISTOPHER LADD :MD JAY S ROSENBLUM MD CHRISTOPHER LADD :MD CHRISTOPHER LADD MD Location of Service: CARLISLE HSP IP Patient: KENNETH E GOTTSHALL,SR TAX ill 233016413 DIAGNOSIS 197.2 CODE 71010 71020 71010 71020 71020 71020 71020 71020 .0 PLEASE CHECK BOX IF ABOVE ADDRES~~\lr1~~J~~~g~Mhq~~~-BRJ1Q~~02722 CHEST SINGLE VIEW CHEST TWO VIEWS CHEST SINGLE VIEW CHEST TWO VIEWS CHEST TWO VIEWS CHEST TWO VIEWS CHEST TWO VIEWS CHEST TWO VIEWS WE BILLED MEDICARE FOR YOUR SERVICES BUT THEY HA VB NOT RESPONDED TO US. PLEASE CALL US SO WE MAY RESOL VB YOUR ACCOUNT. AMOTJNI DATE 06/20/05 06/20/05 06/20/05 06/30/05 06/24/05 06/27/05 06/28/05 06/22/05 $27.00 $33.00 $-27.00 $33.00 $33.00 $33.00 $33.00 $33.00 BALANCE DUE: $252.00 Account Number: ARA-9313737 Statement Date: 01/12/2006 Andorra Radiology Assoc., p.e. PO Box 892 Concordville PA 19331 MB~SINC1-01 08616-00021 02-0607638-001-001057 -1lQQ2Z22____ For billin~ questions,~~~~_ caIL888-AI4:Jil70______ STATE~1ENT Andorra~adiology Assoc., P.C. PO Box ft92 ConcolrlviIle P A 1933 1 Statement Date: 01/12/2006 Account Number: ARA-7504652 J Amount Due: $612.00 For billing questions, please call 888-434-6170 Billing Office Hours: 9am - 4pm Man - Fri Patient: KENNETH E GOTTSHALL,SR L AMOUNT PAID ~\\ ~ -) Ilnllllllllllllllll~ IIIII~ IIIII UII~ II 11111111111111111111 III 1I1II MAKE CHECK PAYABLE & REMIT TO: *11 **AUTO**3-DIGIT 170 02098 111.111'1111111111111.1.1'11.11.1.1.1111111111111.11111.1.1..1 Kenneth E Gottshall,Sr 420 N Walnut Street Mount Holly Springs PA 17065-1504 111.111.1111111.11111111111111.1 Andorra Radiology Assoc., p.e. PO Box 892 Concordville PA 19331 (DETACH HERE., AND RETURN THIS TOP PORTION WITH YOUR PAYMENT . .. USIN.q}HE RETURN ~NY~L9E.~_~~J.g'=Q~~_Q.___~, o PLEASE CHECK BOX IF ABOVE ADDRESS1~~~~l:lgffiB~AA5A~OO~~~~B~1~~~02718 DATE DOCTOR RICHARD E KRAUS, rvID RICHARD E KRAUS, rvID RICHARD E KRAUS, rvID RICHARD E KRAUS, rvID CODE DESCRIPTION TUMOR IMAGE (pET) FULL BODY CHEST TWO VIEWS UIS GUIDANCE RENAL BIOPSY THORACENTESIS \ . I AMOT~.______I i $208.00 $33.00 $106.00 $265.00 06/16/05 06/16/05 06/16/05 06/16/05 78813 71020 76942 32000 WE BILLED MEDICARE FOR YOUR SERVICES BUT THEY HAVE NOT RESPONDED TO US. PLEASE CALL US SO WE MAY RESOLVE YOUR ACCOUNT. Location of Service: CARLISLE HSP OP BALANCE DUE: $612.00 Patient: KENNETH E GOTISHALL,SR Account Number: ARA-7504652 Statement Date: 01112/2006 TAX ill 233016413 DIAGNOSIS 162.9 Andorra Radiology Assoc., P.C. PO Box 892 Concordville PA 19331 \'-____________M.BMStNC1-0108~6-00...Q;2P~8-06QI6.~1:QQ.1QS,3:i1OQ.2I1L~pr bil1i~g_~~!ion~~~~ c~!L~88-4H:-6170______._._...... 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 IRWIN ROGER B ESQ 60 W POMFRET ST CARLISLE, PA 17013 nnn__ fold ESTATE INFORMATION: SSN: 171-28-2560 FILE NUMBER: 2105-1054 DECEDENT NAME: GOTTSHALL, KENNETH E SR DATE OF PAYMENT: 02/23/2006 POSTMARK DATE: 02/23/2006 COUNTY: CUMBERLAND DATE OF DEATH: 11/21/2005 NO. CD 006362 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $50.85 I I I I I I I I TOTAL AMOUNT PAID: $50.85 REMARKS: IRWIN ET AL CHECK# 022761 SEAL INITIALS: VZ RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS Inventory of the real an personal estate of KENNETH E. GOTTSHALL" SR. , deceased 1. 420 N. Walnut Street, Mt. Holly Springs, Pennsylvania $85,000.00 2. PNC Investments - Account #3883-7108 -107.907 Shares $1,304.60 3. PNC Investments - Account #3883-7108 - 34.927 Shares $642.66 4. PNC Bank - Checking Account #5004172865 $5,044.90 5. Personal Property $6,246.00 TOTAL $98,238.15 .......-~ '~~. !'..,~) c.,,) -",1 ':_,) : -.) \..~~' ~b COMMONWEAL TH OF PENNSYL VANIA COUNTY OF CUMBERLAND Kenneth E. Gottshall. Jr. : SS the Estate of Kenneth E. Gottshall. Sr. , being duly sworn according to law, deposes and says that he is the Executor of Pennsylvania, deceased and that the within is an inventory made by , late of Borough of Mount Holly , Cumberland County, Kenneth E. Gottshall. Jr. , the said Executor of the entire estate of said decedent, consisting of all the personal property and real estate, except real estate outside the Commonwealth of Pennsylvania, and tha.t the figures opposite each item of the Inventory represent it's fair value as of the date of decedent's death. swor~ andlubscribed before me, this,~ day of February , 2006. ~ '/J. Ii I ,JJ!/ I r)/. 7utf/ I COMMONWEALTH OF PEN'NSyLVANIA Notarial Seal } Karen S. Noel, Notary Public C.-liile Boro, Cumberland County My Commission Expires Dec, 8, 2007 Date of Death .&:. Day ~~J~~}4 Kenneth E. Gottshall, Jr., Executor 203 E. Pine Street Mount Holly Springs. P A 17007 Address 11 Month 2005 Year INSTRUCTIONS 1. An inventory must be filed within three months after appointment of personal representative. 2. A supplement inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheets may be attached as to personalty or realty. 4. See Article IV, Fiduciaries Act of 1949. -.::t Ir) c ,....... I Ir) C I ,....... N o Z >-c ~ o ~ z ~ ~ Z ~ >- ~ ~ ~ ~ 0... E-t ~ 0 ~ ~ a::: ~ ~ 0... ..J ~ ~ ..J <r:: 0 u... ~ ~ o Z a::: o 0 ~ Z ~ <r:: 0... ~ CI'; ..J ..J <r:: ::r: ~ ~ o o uj ::r: ~ ~ Z ~ -d o \n ro o u o a ~ -2 ro ;> >. \n I:: C o 0... ~ 15 :;:j o U "'0 = ..:g l-< o .D ~ :; u "'0 ~ u:: ..::< o o ~ V 1-0 '5 v O!l ~ 0... C/:J ~ >-.. -S 0 ~ E .~ g o:i<r:: ,....... c ::r: c = o ~ fA- 1-0 V o ~ 4-< o o ...... ro .....J