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REV -1500 EX + (6-00)
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
COUNTY CODE
FILE NUMBER
D
E
C
E
D
E
N
T
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Moore Kathr Ro ers
DATE OF DEATH (MM-DD-YEAR)
OFFICIAL USE ONLY
21-05-0682
YEAR
NUMBER
DATE OF BIRTH (MM-DD-YEAR)
soaALSECU~TYNUMBER
232-42-2567
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
CAPB
HpRL
EplO
CRAC
KOTK
ES
X 1. Original Return
4. LImited Estate
X 6. Decedent Died Testate
2. Supplemental Return
4a. Future Interest Compromise (date of death after 12-12-82)
7. Decedent Maintained a Living Trust
(Attach copy of Will) (Attach copy of Trust)
D 9. litigation Proceeds Received D 10. Spousal Poverty Credit
(date of death between 12-31-91 and 1-1-95)
o
D
3. date of death
. Remainder Return prior to 12-13-82)
5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
11. Election to tax under Sec. 9113(A)
(Attach Sch 0)
C P
o 0
R N
R D
E E
S N
T
NAME
Marlin R. McCaleb Es .
FIRM NAME (If Applicable)
Law Offices-Marlin R. McCaleb
TELEPHONE NUMBER
COMPLETE MAILING ADDRESS
219 East Main Street
P. O. Box 230
Mechanicsburg, PA 17055
R
E
C
A
P
I
T
U
L
A
T
I
o
N
691- 0
Real Estate (Schedule A)
Stocks and Bonds (Schedule B)
Closely Held Corporation, Partnership or
Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(1)
(2)
(3)
130,000.00
16,091. 97
None
(4)
(5)
None
311,124.86
(6)
7,012.21
152,799.87
26,313 . 52
546.54
C
o
M
P
T U
A T
X A
T
I
o
N
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(a)(1.2)
16. Amount of Line 14 taxable at lineal rate 590,168.85
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20. X
x
X
X
X
.0 0
.0 45
.12
.15
OffiCIAL USE O~L Y
t-j
I
, !
,
,
i
;
}
(8) 617,028.91
(11) 26,860.06
(12) 590,168.85
(13)
(14) 590,168.85
(15)
(16)
(17)
(18)
(19)
0.00
26,557.60
0.00
0.00
26,557.60
Copyright (c) 2000 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
537 Brighton Place
CITY I STATE I ZIP
Mechanicsburg PA 17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
26,557.60
0.00
Total Credits ( A + B + C) (2)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
141.90
Total Interest/Penalty ( D + E) (3) 141.90
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4) 0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 26,699.50
A. Enter the interest on the tax due. (SA) 0.00
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B) 26,699.50
Make Check Payable to: REGISTER OF WILLS, AGENT
:mm:::::::i~:t;~i;~::~~~:~~k;:~~~:::~:g;~Cd~I:~~III~U~~f~@:~g:::~~;:~[!~!;!~;~!l~~!l:li;~!:;:;'~~";~~:~::~~~!~:g~;~;;~~~:~t~d:~s;U::/:
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; . . . . . . . . . . . . . ~ ~x~
b. retain the right to designate who shall use the property transferred or its income; .
c. retain a reversionary interest; or. . . . . . . . . . . . . . . . . . . . . . . . . .
d. receive the promise for life of either payments, benefits or care? . . . . . . . . .
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. D [!]
3. Did decedent own an "in trust for" or payable upon death bank account or security at his
or her death? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D [!]
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property
which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [K] D
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, It is true,
correct and complete. Declaration of preparer other than the personal representative Is based on all Information of which preparer has any knowledge.
SIGNATUR :~ P~R; :RE;jS:BLE/OR,Fj7i:T.URN _ _ _~~~~_I!~i~_~~~~_~ ~~~_<:~ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ __
L,~' ~1j~ Mechanicsbur , PA 17055
::'~~~~,;';~:;, iiii;;i;il~;~~if:f~~~~~~~~g~:~:~~;;:;~~~;;:';i;;i:::i;,-:,';i,:,,;;,':'-,,;,mm, !~;:;~:;:~
DATE
41~/c)~
DATE '
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is 3% [72 P.S. 9116 (a) (1.1) (0].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. 9116 (a) (1.1) Oi)). The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets
and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 9116 (a) (1.2)).
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116( 1.2)
[72 P.S. 9116(a)( 1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(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.
Copyright (c) 2000 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00)
LAW OFFICES
ARLlN R, McCALEB
LAST WILL AND TESTAMENT
I, KATHRYN ROGERS MOORE, of the Township of Upper Allen, County of
Cumberland and Commonwealth of Pennsylvania, being of sound and disposing
mind, memory and understanding, do make, publish and declare this as and for my
Last Will and Testament, hereby revoking and making void all former wills and
codicils by me at any time heretofore made.
FIRST. I order and direct that all my just debts and funeral expenses be paid
by my Co-Executors, hereinafter named, as soon as conveniently may be done after
my decease.
SECOND. I give and bequeath all of my jewelry unto my daughter, JUDY L.
GOBLE, of Mechanicsburg, Pennsylvania, if she survives me.
THIRD. I give, devise and bequeath all the rest, residue and remainder of my
Estate, real, personal and mixed, whatsoever and wheresoever situate, in equal
shares unto my children, namely: JUDY L. GOBLE, of Mechanicsburg, Pennsylvania,
and JOHN D. ROGERS, of Stafford, Virginia, share and share alike, absolutely and
in fee simple.
Provided, however, that if either child predeceases me leaving lawful issue to
survive me, then I order and direct that the share provided above for such deceased
child shall be paid over and distributed unto his or her said lawful issue, per
stirpes, said issue to take the ancestor's share by representation and not per capita.
J
LAW OFFICES
MARLIN R. McCALEB
FOURTH. I nominate, constitute and appoint my daughter, JUDY L. GOBLE,
Guardian of any property which passes either under this Will or otherwise to minor
issue of my son, JOHN D. ROGERS, and with respect to which I am authorized to
appoint a Guardian and have not otherwise specifically done so. Such Guardian shall
serve without bond and shall have the power to use principal as well as income from
time to time for the minor's education, support and welfare without regard to the
ability of said minor's parents to provide for such education, support or welfare; or to
make payment for these purposes without further responsibility to the minor, the
minor's parents, or to any person taking care of the minor; or in the event the funds
held by the Guardian for any minor become, in the opinion of the Guardian, too small
for proper and efficient administration, to deposit such funds in an interest-bearing
account on behalf of the minor. I further authorize and direct that my said Guardian
shall have the power to invest and reinvest, alter, vary and change investments and
reinvestments at her discretion and shall not be limited to the class of securities in
which fiduciaries are authorized by law or rule of court to invest fiduciary funds.
LASTLY. I nominate, constitute and appoint my children, JUDY L. GOBLE and
JOHN D. ROGERS, Co-Executors '..mder this, my Last \'\Till and Testament, but if for
any reason either of them shall fail to qualify as such Co-Executor or cease so to
serve, it shall not be necessary to appoint a substitute Co-Executor to serve in his or
her place, but in such event my remaining Co-Executor shall serve with full power and
authority as if he or she had been named herein as my sole Executor or Executrix, as
-2-
LAW OFFICES
MARLIN R McCALEB
the case- may be.
IN WITNESS WHEREOF, I, KATHRYN ROGERS MOORE, have set my hand and
seal to this, my Last Will and Testament which consists of four (4) typewritten pages
have affixed my signature this ---d.i day of
to each of which
IP1~
I '-.
, A.D., One Thousand Nine Hundred Ninety-Five (1995).
(SEAL)
The preceding instrument, consisting of this and three (3) other type-written
pages, each identified by the signature of the Testatrix, was on the date thereof signed,
sealed, published and declared by KATHRYN ROGERS MOORE, the Testatrix therein
named, as and for her Last Will and Testament, in the presence of us, who, ather
request, in her presence, and in the presence of each other, have subscribed our names
as witnesses hereto.
~ '
. RYLlCl. d.
, U
~w~.~~-'S~
('I, ~ D'lJ~f) 0 Q A. if
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COMMONWEALTH OF PENNSYLVANIA )
SS.
COUNTY
OF CUMBERLAND
)
We, KATHRYN ROGERS MOORE, GLORIA J. CROSSLEY and FORREST DAWSON
MOORE, SR.; the Testatrix and the witnesses, respectively, whose names are signed to
the attached or foregoing instrument, being first duly sworn, do hereby declare to the
undersigned authority that the Testatrix signed and executed the instrument as her Last
Will and Testament and that she had signed willingly, and that she executed it as her
free and voluntary act for the purposes therein expressed, and that each of the
witnesses, in the presence and hearing of the Testatrix was at the time eighteen years
of age or older, of sound mind and under no constraint or undue influence.
?_~ N.oV\j~o"- a~'\ u1f'-\ cS(\,
Witness
Subscribed, sworn to and acknowledged before me by KATHRYN ROGERS MOORE,
the Testatrix, and subscribed to before me by GLORIA J. CROSSLEY and FORREST
DAWSON MOORE, SR., witnesses, this ,;?g')'1{ day of ;t(tWl.~L ,
1995.
LAW OFFiCES
MARL-IN R. McCALEB
// ). /}
~Ld/$ $tt#()~k-
Notary Public
~!Jec;~,~~:iI~~sG~LI/~)i{~~~;!~;~~~~;g~~!r;' .
~/:y Commission Exp!~es Dec. 14, 19~d'
Member, Pennsylvani;; i,,,.""~;-'t."~rf.\1 ,,"",'
...... n.......___<...rf::::.. w; I...' i\lOto.rt6$
~EV-1502 EX + (1-97)
SCHEDULE A
COMMONWEALTH OF PENNSYLVANIA REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Kathryn Rogers Moore SS# 232-42-2567 06/20/2005 21-05-0682
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 property which is jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM DESCRIPTION VALUE AT DATE
NUMBER OF DEATH
1 Condominium Unit, - known as 537 Brighton Place, Mechanicsburg 130,000.00
(Lower Allen Township), Cumberland County, PA, having been
acquired by Decedent and her husband, Forrest Moore, by deed of
Geneva Properties, Inc., dated 09/12/1994, recorded in Deed Book
112, Page 81. The said Forrest Moore died 03/25/1998.
TOTAL (Also enter on line 1, Recapitulation) $ 130,000.00
(If more space is needed, insert additional sheets of the same size)
C:oovriaht (c) 1996 form software only CPSystems, Inc. Form REV-1502 EX (Rev. 1-97)
Borrower/Client Kathrvn E. Moore FileNo. 5412001
Prooertv Address 537 Brinhton Place
City Mechanicsbura Countv Cumberland State PA Iin Code 17055-5483
Lender N/A
..
TABLE OF CONTENTS
Invoice ............................... .............. ....... ..... ............ ........................................................... ................. ............ ................. ........... ............. ........................ 1
Summary of Salient Features .................... ................... ......... ................. ..... ............... ............... ....... .......... ......................... ......... ................. ..................... 2
Letter of Transmittal............ ...... ....... ...... ........... .......... ............... ............ ................... ............. ............... .......... ....... .......... ........... ..................... ................ 3
USPAP Identification ......................................................................................................................................................................................................... 4
URAR ..................................... ........................................................................................................................................................................................... 5
Additional Comparables 4-6 ............................................................................................................................. ................................................................. 1
Buildin!! Sketch (Pa!!e - 1) ................................................................................................................................................................................................. 8
Subject Photos ... ...... ........... ............... ...... ...... ...... ................... ......... .... ......... ..... ......... ..... ............ ................ ....... .......... ........... ............ ............. ....... ......... 9
Comparable Photos 1-3 ...... ..... ..... .... .............. ..... ....................... ...... ........................................................ ................ ...... ........................................... ........ 10
Comparable Photos 4-6 ............................... .... ....... ...... ........ ................ ................ ........ ........ ..... ............ ......... ........ .......................................... ................. 11
Location Map ..................................................................................................................................................................................................................." 12
Statement of Limitin!! Conditions ................ ................... ........................................................... ............. ...... ..................... ............. ............. ....................... 13
Form TOCP - "TOTAL for Windows" appraisal software by a la mode, inc. - 1-800-AlAMODE
IFile No. 55080091 Page #31
~"
J.H. Troup Appraisals, Inc.
1271 Eisenhower Blvd
Harrisburg, PA 17111
(717) 939-8380 '.
December 14, 2004
N/A
Re: Property:
Borrower:
File No.:
537 Brighton Place
MechanicsburQ, P A 17055-5483
Kathryn E. Moore
S508009
In accordance with your request, we have appraised the above referenced property. The report of that appraisal is
attached.
The purpose of this appraisal is to estimate the market value of the property described in this appraisal report, as
improved, in unencumbered fee simple title of ownership.
This report is based on a physical analysis of the site and improvements, a locational analysis of the neighborhood and
city, and an economic analysis of the market for properties such as the subject. The appraisal was developed and the
report was prepared in accordance with the Uniform Standards of Professional Appraisal Practice.
The value conclusions reported are as of the effective date stated in the body of the report and contingent upon the
certification and limiting conditions attached.
It has been a pleasure to assist you. Please do not hesitate to contact me or any of my staff if we can be of additional
service to you.
Sincerely,
~
~~
John H. Troup, /II
IFile No. S5080091 Page #71
UNIFORM RESIDENTIAL APPRAISAL REPORT
MARKET DATA ANALYSIS
These recent sales of pro~erties are most similar and ~roximate to sul!ject and have been considered in the market analysis. The description includes a dollar adjustment, reflecting
market reaction to those i ems of significant variation etween the sUb~ect and comparable properties. If a significant item in the comparable ~roperty is superior to, or more
favorable than, the subject property, a minus (-) adjustment is made, us reducing the indicated value of the subbect. If a significant Item in t e comparable is inferior to, or less
favorable than, the subject property, a plus (+) adJustrmlnt is made, thus increasing the indicated value of the su Uect.
ITEM SUBJECT COMPARABLE NO. 4 COMPARABLE NO. 5 COMPARABLE NO. 6
537 BriQhton Place 555 BriQhton Place 556 BriQhton Place 588 BriQhton Place
Add,,,, Mechanl"~",~ 11 I Mech~n""b",~ PA 17055 Meehani"b",", PA 17055 Mechan""b",", PA 17055 .
Pmom',toS"biect .04 mile' _
Sales Price $ N/A $ 149000 $ 1499 $ 137000
Price/Gross Livino Area $ r:b $ 90.47 r:b $ 106.31 r:b $ 97.16 r:b
Data and/or Inspection MLS#1 01 04575 MLS#1 01 04524 MLS#10097037
Verification Sources Public Records Public Records Public Records Public Records
VALUE ADJUSTMENTS DESCRIPTION DESCRIPTION : +(-)$ Adjust. DESCRIPTION : +( -)$ Adiust. DESCRIPTION , +H$ Adiust.
,
Sales or Financing _ Cooventional , Cash , Conventional ,
, , ,
, , ,
Concessions None Disclosed None Disclosed None Disclosed ,
Date of Sale/Time 9/20/04 : 9/15/04 : 1/29/04/ :
Location Suburban/Ava Suburban/Ava. : Suburban/Ava. : Suburban/Avo. :
Leasehold/Fee Simole Condo Condo : Condo Condo :
Site Common common : common common
View Suburban AveraOi Suburban/Avo. , Suburban/Avo. Suburban/Avo.
,
Desiqn and Anneal Condo 2 stOry , 2 stOry 2 stOry
. ,
- Oualitv of Construction Alum/Ava Alum/Ava Alum/Ava Alum/Ava
11 vears 12 vears , 12 vears 15 vears
- Aqe ,
,
Condition Avo. AVQ. , AVQ. Avo.
. ,
- Total :Bdrms: Baths Total :Bdrms: Baths: Total :Bdrms: Baths: Total: Bdrms:
. Above Grade Baths
- Room Count 6 , 2 , 2.5 6 , 2 : 2.5 , 6 , 2 : 2.5 , 6 , 3 : 2.5 :
, , , , , ,
Gross Livina Area 1,020 SIl. Ft. 1,647. SIl. Ft. : -8,220 1,410. SIl. Ft.: -3 480 1,410. Sa. Ft.: -3 480
- Basement & Finished Slab Slab , Slab , Slab :
, , ,
Rooms Below Grade , , ,
Functional Utilitv Avo. Avo. , Avo. : Avo. :
,
Heatina/Coolina EHP/CA EHP/CA , EHP/CA , EHP/CA ,
, , ,
Enerav Efficient Items Standard Similar : Similar , Similar ,
, ,
Garaqe/Caroort 1 Car Garaae 1 Car Garaae , 1 Car Garaqe : 1 Car Garaoe ,
, ,
Porch, Patio, Deck, Scr. Porch Patio/C Porch , Patio/Porch , Porch ,
, , ,
Fireolace(sl. etc. 1 Fireolace 1 Fireolace , 1 Fireolace , 1 Fireolace ,
, , ,
Fence Pool etc. , , ,
, , ,
, , :
~: , ,
Net Adi. (total) 622OM$ 3460MI 3480
Adjusted Sales Price
of Comoarable 140780 $ 146,420 $ 133 520
Date, Price and Data No prior sales witi
Source for prior sales within the past 3
within year of aooraisal vears
Comments:
-
Market Data Analysis 6-93
Form UA2.(AC) - "TOTAL for Windows" appraisal software by a la mode, inc. - 1-800-ALAMODE
IFile No. 55080091 Page #9
Borrower/Client Kathrvn E. Moore
Pronertv Address 537 Briohton Place
City Mechanicsburo CounlV Cumberland State P A Zin Code 17055-5483
Lender NtA
Subject Photo Paqe
Subject Front
537 Brighton Place
Sales Price Nt A
GLA 1,020
Total Rooms 6
Total Bedrms 2
Total Balhrms 2.5
Location SuburbanlAvg
View Suburban Average
Site Common
Quality AlumtAvg
Aile 11 years
Subject Rear
Subject Street
Form PIC4x6.SR - "TOTAL for Windows" appraisal software by a la mode, inc. - '-800-ALAMODE
IFile No. 55080091 Page #101
Comparable Photo Paqe
Borrower/Client Kathryn E. Moore
Prooertv Address 537 Briahton Place
City Mechanicsbura Counlv Cumberland State PA liD Code 17055-5483
Lender N/A
Comparable 1
592 Brighton Place
Proximity .05 miles
Sale Price 130,000
GLA 970
Total Rooms 6
Total Bedrms 2
Total Bathrms 2.5
Location Suburban/Avg.
View Suburban/Avg.
Site Common
Quality Alum/Avg
A!le 14 years
Comparable 2
567 Brighton Place
Proximity .04 miles
Sale Price 139,900
GLA 1,722
Total Rooms 6
Total Bedrms 2
Total Bathrms 2.5
Location Suburban/Avg.
View Suburban/Avg.
Site Common
Quality Alum/Avg
AQe 12 years
Comparable 3
540 Brighton Place
Proximity .2 miles
Sale Price 149,000
GLA 1,686
Total Rooms 7
Total Bedrms 2
Total Bathrms 2.5
Location Suburban/Avg.
View Suburban/Avg.
Site Common
Quality Alum/Avg
A!le 11 years
., ",,-""-'~ '",,,,
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0:.. _ll'iOOO:-ALAMODI
~orm,P;IG~K~.CR,: ~ "TOTALfor.Windows',appcaisalsortwarebV a.la.mode,
IFile No. 55080091 Page #121
Location Map
Borrower/Client Kathrvn E. Moore
Property Address 537 Briahton Place
City Mechanicsbura County Cumberland State PA liD Code 17055-5483
Lender N/A
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Form MAP.LOC - "TOTAL for Windows" appraisal software by a la mode, inc, - 1-BOO-ALAMODE
IFile No. S5080091 Page #131
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 stimulus. Implicit in this
definition is the consummation of a sale as of a specified date and the passing of title from seller to buyer under conditions whereby: (1) buyer and seller are
typically motivated; (2) both parties are well informeq or well advised, and each acting in what he considers his own best interest; (3) a reasonable time is allowed
for exposure in the open market; (4) payment is maoe 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 judgement.
STATEMENT OF LIMITING CONDITIONS AND APPRAISER'S CERTIFICATION
CONTINGENT AND LIMITING CONDITIONS: The appraiser's certification that appears in the appraisal report is subject to the following
conditions:
1. The appraiser will not be responsible for matters 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 appraisal. 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 1004B 6-93
Advanced Statistical AppraisalS of PA, Inc.
Form Ar.R - "TOTAL for Windows" appraisal software by a la mode, inc. - 1-800-ALAMODE
REV-1503 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
Kathryn Rogers Moore
SSff 232-42-2567
06/20/2005
21-05-0682
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
DESCRIPTION UNIT VALUE
NUMBER OF DEATH
1 217.6649 shares Dominion Resources, Inc. , - common 73.93 16,091. 97
stock.
TOTAL (Also enter on line 2, Recapitulation) 16,091. 97
(If more space is needed, insert additional sheets of the same size)
Copyright (e) 1996 form software only CPSystems,lne.
Form REV-1503 EX (Rev. 1-97
~EV-1508 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Kathryn Rogers Moore ssg 232-42-2567 06/20/2005 21-05-0682
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
DESCRIPTION
Cash in Decedent's possession.
VALUE AT DATE
OF DEATH
5.00
Members 1st FCU, - Regular Savings Account #148400-00, principal
balance as of D.G.D.
25.00
Members 1st FCU, - Checking Account #14800-11, principal balance
as of D.G.D.
3,915.44
Members 1st FCU, - Checking Account #14800-11, interest accrued
to D.G.D.
0.45
Members 1st FCU, - Money Management Account #148400-05, principal
balance as of D.G.D.
24,061. 87
Members 1st FCU, - Money Management Account #148400-05, interest
accrued to D.G.D.
15.53
Members 1st FCU, - Certificate of Deposit #14800-41, principal
balance as of D.G.D.
7,859.15
Members 1st FCU, - Certificate of Deposit #14800-41, interest
accrued to D.G.D.
19.60
Navy Federal Credit Union, - Share Certificate Acct.
#10483090640011, principal balance as of D.G.D.: $26,437.41;
dividend accrued to D.G.D.: $71.07.
26,508.48
2001 Toyota Camry XLE Sedan 4D, - automobile.
9,865.00
CNA, - long-term care insurance premium refund.
188.74
Delta Dental, - dental insurance premium refund.
50.59
Financial Network Investment Corporation, - Brokerage Account
#5FN 595642.
85,648.00
Household goods, contents, - furniture and furnishings.
1,050.00
Jewelry - (two (2) lady's gold diamond rings).
100.00
Lincoln Benefit life Co., - Annuity #LBFll14963, payable to
Decedent's Estate; value as of D.G.D.
149,833.01
Navy Federal Credit Union, - VISA credit card refund.
7.08
Total of Continuation Schedule(s)
1,971. 92
TOTAL (Also enter on line 5, Recapitulation) $ 311,124.86
(If more space is needed. insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-150B EX (Rev. 1-97)
Estate of: Kathryn Rogers Moore
Soc Sec #: 232-42-2567
Date of Death: 06/20/2005
Continuation of Schedule E
(Cash, Bank Deposits & Miscellaneous Personal Property)
Item
#
Description
Value at Date
of Death
18
U. S. Treasury, - refund of Decedent's 2005 federal income tax.
1,950.83
19
USM, - refund.
21.09
1,971.92
REGULAR SAVINGS ACCOUNT:
Account Number/ Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
CHECKING ACCOUNT:
Account Number/ Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
MONEY MANAGEMENT ACCOUNT:
Account Number/ Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
CERTIFICATES OF DEPOSIT:
Account Number/Suffix
Date Account Established
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
Estate of: KATHRYN R. MOORE
Date of Death: June 20, 2005
Social" Security Number: 232-42-2567
tv
MEMBERS 1st
FEDERAL CREDIT UNION
148400 -00
12/30/1994
$25.00
$.00
$25.00
None
148400 -11
04/04/1998
$3,915.44
$.45
$3,915.89
None
148400 -OS
11/03/1999
$24,061.87
$15.53
$24,077.40
None
148400 -41
02/19/2002
$7,859.15
$19.60
$7,878.75
None
MAE_RS 1ST I)?'ERAL CREDIT UNION
~~ alO;t-
Denise A. Wolfe
Insurance Services Su ervisor
October 7 I 2005
5000 Louise Drive. po. Box 40 · Mechanicsburg, Pennsylvania 17055 . (717) 697-1161 . www:members1st.org
NAVY .
FEDERAL
-
Credit Union
PO Box 3000 · Merrifield VA · 22119-3000
In reply refer to:
219879
20 October 2005
Ms. Judy L. Goble
537 Brighton PI
Mechanicsburg, P A 17055-5483
Dear Ms. Goble:
On behalf of Navy Federal's staff and membership, I wish to extend our heartfelt sympathy to
you and your family on the loss of your mother.
On 20 June 2005, your mother's share savings account reflected a balance of $6,960.29. Due to
her age, the shares earned no Life Savings Insurance. Our explanatory flier is enclosed.
Transactions on the account since the date of death resulted in an available balance of $7,803.87
as of 17 October. As joint owners of the account, you and John D. Rogers are entitled to equal
portions of the share balance.
Your mother's Sharechek account had a balance of$9,381.48 on 20 June. Her Defense Finance
and Accounting Service (DF AS) direct deposit of $703.97 and her Civil Service direct deposit of
$2,224.00 were received and credited to the Sharechek account on 30 June. The funds from both
deposits have been deducted and returned to the paying agencies. In view of all transactions
involving the Sharechek account since her death, that balance as of 17 October was $1,902.95.
As sole joint owner of the Sharechek account, you are entitled to these funds. For the purpose of
disbursement, they have been transferred to the share savings. The enclosed check for $5,804.89
represents the funds to which you are entitled.
Your mother also maintained a share certificate with Navy Federal. At the time of her death, her
five-year share certificate had a balance of $26,437.41. Dividends increased the certificate
balance to $26,938.96 as of 18 October. Since ajoint owner was not named on the certificate,
your mother's estate is entitled to these funds. For disbursement purposes, they were transferred
to her share savings on 18 October. The enclosed check for $26,938.96 has been made payable
to the estate with you as Executrix.
Your mother's Visa account was not covered by Loan Protection Insurance or by a Payment
Protection Plan. The Visa balance of $4.95 was paid on 11 July. Her share savings, Sharechek,
share certificate and Visa accounts are now closed.
Access Number 219879
Page 2 of3
On 20 June, your mother's Individual Retirement Account (IRA) reflected a certificate balance of
$152,443.29. On 1 July, a disbursement of$506.60 was made from the IRA. We withheld
Federal taxes of$101.32 from that amount and forwarded a check for the remaining $405.28 to
your mother. An additional disbursement of $506.59 was made from the IRA on 1 August. We
again withheld Federal taxes of$101.32. A check for the remaining $405.27 was sent to her.
The estate's attorney returned $810.55 to us, the total amount ofthe checks sent from the IRA
after your mother's death. The funds were placed in her share savings and are included in the
funds disbursed by check from that account. They were not returned to the IRA since you
requested that the funds from her account be sent promptly. We understand you are aware that
the two IRA withdrawals will show as normal withdrawals rather than death withdrawals.
In view of the disbursements from your mother's IRA after her death, and dividends credited
each month, the IRA balance was $153,924.32 as of 18 October. As beneficiaries of the IRA,
you and John are entitled to equal portions of this balance. We have transferred the funds to
which you are entitled to a beneficiary IRA established in your name under account number
1048309908, control number 0004. This is a temporary account designed to hold the funds on
deposit until they are disbursed in accordance with your written instructions. A new beneficiary
may not be named on a temporary account. Weare prevented from accepting contributions for
crediting to the beneficiary account. In addition, since your mother was over 70Yz, the required
minimum distributions had begun from her IRA, and these distributions must be continued or
accelerated from the beneficiary IRAs opened for you and John. The present balance of your
beneficiary IRA is $76,962.16.
Your beneficiary IRA will remain open until you have had an opportunity to make a decision
regarding disbursement of the funds. Please provide us with your instructions as soon as
possible, but no later than 30 September 2006, the last day allowed by IRS regulations. We have
provided an IRA Beneficiary Options sheet that includes information regarding all distribution
options available to you. Please note that the "Five-Year Rule" option under Sections A and B
on the form is no longer available. Please indicate your preferences regarding disbursement and
tax withholding, and return the sheet to us in the envelope that is also provided for your
convenience. If we have not received your response by 30 September 2006, we will distribute
the entire balance by 31 December 2006. This payout is irrevocable and will not be reversed.
To satisfy Internal Revenue Service requirements, you must withdraw $1,013.19 of your
mother's 2005 required minimum distribution (RMD) from your beneficiary IRA by
31 December of this year. When responding, please include your instructions for this
distribution, being sure to indicate of Federal taxes should be withheld.
NAVY e
FEDERAL
SM
Credit Union
In reply refer to:
27 December 2005
Marlin R. McCaleb
Attorney at Law
PO Box 230
219 Main Street
Mechanicsburg, P A 17055
,.-
RE: Kathryn E. Moore Estate .
Dear Mr. McCaleb:
As requested, I am providing you with the following information regarding the Navy Federal
Credit Union accounts of Mrs. Moore.
The accrued dividends on Mrs. Moore's share savings account number 1048309-007 and Share-
chek account number 1048309-700 from 1 June 2005 through 20 June 2005 were $4.77 and $.03,
respectively. In addition, the accrued dividends on her share certificate account number
1048309-064,0011, and Individual Retirement Account.number 1048309-908, 0003, from
1 June 2005 through 20 June 2005 were $71.07 and $356.58, respectively. Our enclosed check ii!
for $7.08 represents a credit on Mrs. Moore's Visa credit card account.
Should you have any questions, please call me toll-free at 1-800-883-3323, extension 42302,
between 8:00 a.m. and 4:30 p.m., Eastern time, Monday through Friday. You may also reach me
by fax at 1-703-255-7963.
Sincerely,
cDVlI.~
~. h~~ll
CA:ak
Enclosure:
Check
Navy Federal
Credit Union
po Box 3000
Merrifield VA 22119-3000
navyfcu.org
K~lue'~~Private Party Pricing Report - Toyota, Camry
Page 1 of
Kelley Blue BOoik
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,. . L .... L .6'. . ............. ""
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:~:~:~~~~~~~:
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Consumer Rated Condition: Fair . .. '-, ....".. .
"Fair" condition means that the vehicle has some mechanical or cosmetic defects and :::::~. ...... ...... .::
needs servicing but is still in reasonable running condition. This vehicle has a c1eantLtle :::::~~~::
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Private Party Value Search LQ~al.l,L~tinq~ l1-ist This_Car for:_Sal~ $9,865 ~:~:~~~~~~..~(
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no warranty (other than the continuing factory warranty). The final sale price may :::::-......... .....................::
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Equipment
Air Conditioning
Power Steering
Power Windows
Power Door Locks
Tilt Wheel
Cruise Control
AM/FM Stereo
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Multi Compact Disc
Premium Sound
Dual Front Air Bags
ASS (4-Wheel)
Leather
Dual Power Seats
Sliding Sun Roof
Rear Spoiler
Alloy Wheels
httn://www.khb.com/kblki.dll/kw.kc.ur?khh.PA:l R9320:P A041 Rr170'i'i'~prl+nRr7??'TrlV{)b.')nnl o!--?nr
1 nil Q /')nn
~ l:~l}SJ1,;ir!~~~~~;
Member SIPC
Member INGAdvisor Network
Andrew Steele
Registered Representative
September 1, 2005
Marlin R. McCaleb
Frankeberger Place
219 East Main Street
P.O. Box 230
Mechanicsburg, P A 17055
RE: Kathryn E. Moore
Dear Marlin,
The value of account 5FN 595642 as of the date of death, June 20,
2005, was $85,648.00.
The value of the Lincoln Benefit annuity as of the date of death
was $149,833.01.
Sincerely,
{).kr-~
W. Andrew Steele
V.P. Financial Advisor
W AS/maj
~lK
MEMBERS 1"
INVESTMENT SERVICES
Located at Members 1st Federal Credit Union
5000 Louise Drive
Mechanicsburg, PA 17055
717.795.6051
800.237.4054
717.795.5176 fax
steeiea2@members1st.org
Investments are: not NCUA insured, may lose value, not a deposit, not a credit union guarantee and not insured by any federal government agenry.
M1'UMM~S
.Wewett.y ~to~e,
O. 34 WEST MAIN STREET
MECHANICSBURG, PA 17055
APPRAISAL
Phone: 717-766-9422
APPRAISAL
Appraisal for:
Estate of Kathryn Moore
04/10/2006
I. Lady's 14 karat yellow gold diamond nng. Ihe nng has a .07 pOInt round bnlhant cut diamond set Into a box
head 14 karat yellow gold mounting. The mounting shows much wear.
Estate value: $50.00
2. Lady's 14 karat yellow gold diamond ring. The ring has a .04 point round brilliant cut diamond set into a box
head mounting in 14 karat yellow gold. The mounting shows much wear.
Estate value: $50.00
This appraisal constitutes our carefully studied opinion of
o the retail replacement cost through our facilities
m the distress sales nature value
of the article(s) described above insofar as the mounting(s)
have permitted observation. We assume no liability with
respect to any action that may be taken on the basis of this
appraisal.
~ f(\J) .
(;0 . I r . Y \ lL/\/VVl/~
, , Appraiser
REV-1509 EX + (1-97)
SCHEDULE F
JOINTL V-OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Kathryn Rogers Moore
06/20/2005
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SS1I 232-42-2567
FILE NUMBER
21-05-0682
A.
SURVIVING JOINT TENANT(S) NAME
Judy L. Goble
ADDRESS
537 Brighton Place
Mechanicsburg, PA 17055
B.
John D. Rogers
1691 S. Ft. Valley Road
Madison, VA 22727
c.
RELATIONSHIP TO DECEDENT
Daughter
Son
JOINTLY -OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
ITEM FOR JOINT MADE Include name of financial institution and bank DATE OF DEATH DECO'S VALUE OF
account number or similar Identifying number.
NUMBER TENANT JOINT Attach deed for jointly- held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTERES
1 A,B 07/12/94 Navy Federal Credit Union, 6,965.06 33.33% 2,321.45
- Share Savings Acct.
111048309007 opened 07/12/94
in names of Decedent, John
D. Rogers and Judy Lee
Goble as JTWRGS. Principal
balance as of D.G.D. :
$6,960.29; dividend accrued
to D.G.D.: $4.77.
2 A 07/09/94 Navy Federal Credit Union, 9,381.51 50.00% 4,690.76
- Sharechek Acct.
111048309700 opened 07/09/94
in names of Decedent and
Judy Lee Goble as JTWRGS.
Principal balance as of
D.G.D. : $9,381.48 ; dividend
accrued to D.G.D. : $0.03.
TOTAL (Also enter on line 6, Recapitulation) $ 7,012.21
(If more space is needed insert additional sheets of the same size)
Copyriqht (c) 1996 form software only CPSystems, Inc.
T
Form REV-1509 EX (Rev. 1-97)
NAVY ~
FEDERAL
Credit Union
PO Box 3000 u Merrifield VA · 22119.30(
In reply refer i
219879
20 October 2005
Ms. Judy L. Goble
537 Brighton PI
Mechanicsburg, P A 17055-5483
Dear Ms. Goble:
On behalf of Navy Federal's staff and membership, I wish to extend our heartfelt sympathy to
you and your family on the loss of your mother.
On 20 June 2005, your mother's share savings account reflected a balance of $6,960.29. Due to
her age, the shares earned no Life Savings Insurance. Our explanatory flier is enclosed.
Transactions on the account since the date of death resulted in an available balance of $7,803.87
as of 17 October. As joint owners of the account, you and John D. Rogers are entitled to equal
portions of the share balance.
Your mother's Sharechek account had a balance of$9,381.48 on 20 June. Her Defense Finance
and Accounting Service (DFAS) direct deposit of$703.97 and her Civil Service direct deposit of
$2,224.00 were received and credited to the Sharechek account on 30 June. The funds from both
deposits have been deducted and returned to the paying agencies. In view of all transactions
involving the Sharechek account since her death, that balance as of 17 October was $1,902.95.
As sole joint owner of the Sharechek account, you are entitled to these funds. For the purpose of
disbursement, they have been transferred to the share savings. The enclosed check for $5,804.89
represents the funds to which you are entitled.
Your mother also maintained a share certificate with Navy Federal. At the time of her death, her
five~year share certificate had a balance of $26,437.41. Dividends increased the certificate
balance to $26,938.96 as of 18 October. Since a joint owner was not named on the certificate,
your mother's estate is entitled to these funds. For disbursement purposes, they were transferred
to her share savings on 18 October. The enclosed check for $26,938.96 has been made payable
to the estate with you as Executrix.
Your mother's Visa account was not covered by Loan Protection Insurance or by a Payment
Protection Plan. The Visa balance of $4.95 was paid on 11 July. Her share savings, Sharechek,
share certificate and Visa accounts are now closed.
NAVY .
FEDERAL
8M
Credit Union
In reply refer to:
27 December 2005
Marlin R. McCaleb
Attorney at Law
PO Box 230
219 Main Street
Mechanicsburg, P A 17055
"
RE: Kathryn E. Moore Estate
Dear Mr. McCaleb:
As requested, I am providing you with the following information regarding the Navy Federal
Credit Union accounts of Mrs. Moore.
The accrued dividends on Mrs. Moore's share savings account number 1048309-007 and Share-
chek account number 1048309-700 from 1 June 2005 through 20 June 2005 were $4.77 and $.03,
respectively. In addition, the accrued dividends on her share certificate account number
1048309-064,0011, and Individual Retirement Accountnumber 1048309-908, 0003, from
1 June 2005 through 20 June 2005 were $71.07 and $356.58, respectively. Our enclosed check :1
for $7.08 represents a credit on Mrs. Moore's Visa credit card account.
Should you have any questions, please call me toll-free at 1-800-883-3323, extension 42302,
between 8:00 a.m. and 4:30 p.m., Eastern time, Monday through Friday. You may also reach me
by fax at 1-703-255-7963.
Sincerely,
ILlli
\ f ~ n
I ~wY-
C1J. urrell
CA:ak
Enclosure:
Check
Navy Federal
Credit Union
PO Box 3000
Merrifield VA 22119-3000
navyfcu.org
REV-1510 EX + (1-97)
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Kathryn Rogers Moore
SS11 232-42-2567
06/20/2005
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes.
FILE NUMBER
21-05-0682
DESCRIPTION OF PROPERTY %OF
ITEM RELAW8~MAW lWb~~~5~UtINEJ~~~1fIT~EJF t~~~RSFER. DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
NUMBER ATTACH ACOPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE)
1 Navy Federal Credit Union, 152,799.87 152,799.87
- Traditional IRA Plan
Acct. 1110483099080003,
payable upon death to John
D. Rogers and Judy Lee
Goble. Principal balance
as of D.G.D. : $152,443.29;
dividend accrued to D.G.D. :
$356.58.
TOTAL (Also enter on line 7, Recapitulation) $ 152,799.87
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc.
Form REV-1510 EX (Rev. 1-97)
REV-1S11 EX +(1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Kathryn Rogers Moore
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
1
2
3
B.
1.
2.
3.
4.
SSif 232-42-2567
FILE NUMBER
21-05-0682
06/20/2005
DESCRIPTION
AMOUNT
FUNERAL EXPENSES:
Browning Funeral Home, Kingswood, WV, - funeral services.
3,500.00
Home Monumental Works, Terra Alta, WV, - engraving marker.
68.90
Ma1pezzi Funeral Horne, Mechanicsburg, PA, - funeral services.
7,820.50
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) / EIN Number of Personal Representative(s)
Street Address
City
Zip
State
Year(s) Commission Paid:
Attorney's Fees Law Offices -Marlin R. McCaleb
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
13,125.00
City
Relationship of Claimant to Decedent
State
Zip
5. Accountant's Fees
Probate Fees
Register of Wills
457.00
6. Tax Return Preparer's Fees
7.
1
2
3
4
5
6
Other Administrative Costs
Bobby Rahal Toyota, - auto inspection and repair.
285.44
Cumberland Law Journal, - advertising Letters.
75.00
J. H. Troup Appraisals, Inc. - appraisal of real estate.
300.00
Larry Vallier, Appraiser, - appraisal of household contents.
50.00
Mumma's Jewelry Store, - appraisal of diamond rings.
75.00
PNC Bank, - checkprinting fee for bank account.
28.08
Total of Continuation Schedule(s)
528.60
TOTAL (Also enter on line 9, Recapitulation) $ 26,313.52
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97
REV-1512 EX +(1-97)
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, AND LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Kathryn Rogers Moore
FILE NUMBER
21-05-0682
SS11 232-42-2567
06/20/2005
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1 Bon-Ton, - account payable.
10
11
12
AMOUNT
35.35
2
Christian Broadcasting Network, - account payable.
20.00
3
Comcast, - account payable.
42.66
4
Hecht's, - account payable.
96.16
5
James Holland, CPA, - account payable.
150.00
6
Navy Federal Credit Union, - account payable.
4.95
7
PA Department of Revenue, - Decedent's final state income tax
(2005).
37.00
8
Partners in Women's Healthcare, P.C. - account payable.
35.72
9
PP&L, - account payable, utility.
81.08
Reiman Publications, - account payable.
23.98
Sprint, - account payable, utility.
8.56
United Water of PA, - account payable, utility.
11.08
TOTAL (Also enter on line 10, Recapitulation) $ 546.54
(If more space is needed, insert additional sheets of the same size)
Copvriqht (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97)
REV-1513 EX +(9-00)
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERIT ANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Kathrvn Rogers Moore
06/20/2005
SSif 232-42-2567
NUMBER
I.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and
transfers under Sec. 9116(a)(1.2)]
1
Judy 1. Goble
537 Brighton Place
Mechanicsburg, PA 17055
2
John D. Rogers
1691 Ft. Valley Road
Madison, VA 22727
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Daughter
Son
FILE NUMBER
21-05-0682
AMOUNT OR SHARE
OF ESTATE
297,429.80
292,739.05
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON- TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 2000 form software only The Lackner Group, Inc.
0.00
Form REV-1513 EX (Rev. 9-00)
Register of Wills of
CUMBERLAND
County, Pennsylvania
INVENTORY
Estate of Kathryn Rogers Moore
No. 21-05-0682
also known as
Date of Death 06/20/2005
,Deceased Social Security No. 232-42-2567
Judy L. Goble,
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 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 Decedent owned
no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this
Inventory. I /We verify that the statements made in this Inventory are true and correct. I/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.
1.0. No.:
06353
pe~:;::.:::rn'~enrnl"e 7/4. .M~
Judy . Goble
Signature:
Name of
Attorney:
Marlin R. McCaleb Esq.
Address:
219 East Main Street
Address:
537 Brighton Place
Mechanicsburg, PA 17055
Mechanicsburg, PA 17055
Telephone: 717/691- 7770
Telephone: 717/697 - 2246
Dated:
Description
Value
(See continuation page(s) attached)
I"
1_ c.,
. ,
. -, I
.; \
I~ - -~)'
(Attach additional sheets if necessary)
Total:
457,216.83
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at theeleetibR-of.the'persbr1al representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
eoared by the Pennsylvania Bar Association
I=nP"1'Yt #AW-7 (1QQ?1
/
INVENTORY
Estate of:
Date of Death:
County:
Kathryn Rogers Moore
06/20/2005
Cumberland
CASH:
Cash in Decedent's possession.
5.00
Members 1st FCU, - Regular
Savings Account #148400-00,
principal balance as of
0.0.0.
25.00
Members 1st FCU, - Checking
Account #14800-11, principal
balance as of 0.0.0.
3,915.44
Members 1st FCU, - Checking
Account #14800-11, interest
accrued to 0.0.0.
0.45
Members 1st FCU, - Money
Management Account
#148400-05, principal
balance as of 0.0.0.
24,061. 87
Members 1st FCU, - Money
Management Account
#148400-05, interest accrued
to 0.0.0.
15.53
Members 1st FCU, - Certificate
of Deposit #14800-41,
principal balance as of
0.0.0.
7,859.15
Members 1st FCU, - Certificate
of Deposit #14800-41,
interest accrued to 0.0.0.
19.60
- 1 -
Navy ~ederal Credit Union, -
Share Certificate Acct.
#10483090640011, principal
balance as of D.O.D.:
$26,437.41; dividend accrued
-to D.O.D.: $71.07.
PERSONAL PROPERTY:
2001 Toyota Camry XLE Sedan
4D, - automobile.
CNA, - long-term care
insurance premium refund.
Delta Dental, - dental
insurance premium refund.
Financial Network Investment
Corporation, - Brokerage
Account #5FN 595642.
Household goods, contents, -
furniture and furnishings.
Jewelry - (two (2) lady's gold
diamond rings).
Lincoln Benefit life Co., -
Annuity #LBF1114963, payable
to Decedent's Estate; value
as of D.O.D.
Navy Federal Credit Union, -
VISA credit card refund.
U. S. Treasury, - refund of
Decedent's 2005 federal
income tax.
USAA, - refund.
-2-
26,508.48
9,865.00
188.74
50.59
85,648.00
1,050.00
100.00
149,833.01
7.08
1,950.83
21. 09
62,410.52
248 , 714 . 34
STOCKS/LISTED:
217.66 shares Dominion Resources,
Inc., - common stock.
16,091. 97
REAL ESTATE/PA:
Condominium Unit, - known as
537 Brighton Place,
Mechanicsburg (Lower Allen
Township), Cumberland
County, PA, having been
acquired by Decedent and her
husband, Forrest Moore, by
deed of Geneva Properties,
Inc., dated 09/12/1994,
recorded in Deed Book 112,
Page 81. The said Forrest
Moore died 03/25/1998.
130,000.00
TOTAL RECEIPTS OF PRINCIPAL...............
-1-
16,091.97
130,000.00
457,216.83
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT 280601
HARRISBURG, PA 17128,0601
REV,1162 EX(11,96)
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
RECEIVED FROM:
GOBLE JUDY L
605 WAYNE DRIVE
MECHANICSBURG, PA 17055
____~u_ told
ESTATE INFORMATION: SSN: 232A2-2567
FILE NUMBER: 2105-0682
DECEDENT NAME: MOORE KATHRYN ROGERS
DATE OF PAYMENT: 04/28/2006
POSTMARK DATE: 04/28/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 06/20/2005
NO. CD 006622
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $29,699.50
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 5034
SEAL
INITIALS: MG
RECEIVED BY:
R!=(;I~T!=R n!= WII I ~
$29,699.50
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX( 11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
GOBLE JUDY L
605 WAYNE DRIVE
MECHANICSBURG, PA 17055
n____n fold
ESTATE INFORMATION: SSN: 232-42-2567
FILE NUMBER: 2105-0682
DECEDENT NAME: MOORE KATHRYN ROGERS
DATE OF PAYMENT: 04/28/2006
POSTMARK DATE: 04/28/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 06/20/2005
NO. CD 006628
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $26,699.50
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 5034
SEAL
INITIALS: MG
RECEIVED BY:
REGISTER OF WILLS
$26,699.50
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS