HomeMy WebLinkAbout06-06-06 (2)
REV-1500 EX + (6-00)
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OFFICIAL
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
II
0290
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
-- -~~-'-~- -----_._-~-_.-
I- 1 DECEDENT:S NAME(LAST, FIRST, AND MIDDLE INITIAL)
~ . :E!:Ft~~~(~~:~D~~~R)A. I DATE OF BIRTH (MM-DD-YEAR)------
~ 03-11-2006 I 09-11-1925
~ (IF'i\rPLICABLEliiURVIVING-SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL)
06
COUNTY CODE._ YEAR ....._" .._I\I!LMBER_~
201-18-3386
I x 11. Original Return [J 2. Supplemental Return
I-I 4. Limited Estate [] 4a. Future Interest Compromise (date of death after
12-12-B2)
[x] 6. Decedent Died Testate (Attach 7. Decedent Maintained a Living Trust (Attach
copy of Will) copy of Trust)
9. Litigation Proceeds Received [] 10 Spousal Poverty Credit (date of death between [J 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
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THIS SECTION MUST BE COMPLET(:.o-;ALLCORRESPriNo-ENCEANo-CONFlo-ENTIAL'fAXII\lf"()RlVI~"l"IONSHOULD BE DIRECT'ED TO:
NAME COMPLETE MAILING ADDRESS
M i C h a_~"Il:.._13. a n 9 ~_ ___
FIRM NAME (If applicable)
SOCIAL SECURITY NUMBER
THIS RETURN MUST BE FILED IN OUPLlCA TE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
o 3. Remainder Return (date of deeth prior to 12-13-B2)
[] 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
429 South 18th Street
Camp Hill, PA 17011
(1 ) 135,000.00
(2) 23,089.81
(3) None
-~~--~---~--~-
(4) None
(5) 64,031.36
---~-,
(6) 1,924.33 \'0
N
(7) 34,838.78
(8) 258,884.28
(9) 15,237.99 _.__.._.~-----"-----
-~~----~,---
(10) 2,904.80
(11 )
18,142.79
240,741.49
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TELEPHONE NUMBER
717/730-7310
(12)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has
not been made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(13)
0.00
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
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4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
Separate Billing Requested
7 . Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L) 1__1 Separate Billing Requested
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
(14)
240,741.49
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
Copyright 2002 form software only The Lackner Group, Inc.
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
20.0
0.00
10,833.37
0.00
0.00
10,833.37
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
15.Amount of Line 14 taxable at the spousal tax rate, 0.00 x .00 (15)
or transfers under Sec. 9116(a)(1.2)
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0 (16)
i= 16.Amount of Line 14 taxable at lineal rate 240,741.49 x .045
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ll. 17.Amount of Line 14 taxable at sibling rate 0.00 x .12 (17)
==
0
u 18. Amount of Line 14 taxable at collateral rate 0.00 .15 (18)
>< x
~ 19. Tax Due
(19)
;.> BE SURE TO ANSWERAL(. QUESTiONS ON REVERSE SIDE' AND RECHECK MATH <<
Form REV-1500 EX (Rev_ 6-00:
Decedent's Complete Address:
STREET ADDRESS
46 South 39th Street
CITY Camp Hill
STATE PA
ZIP 1 7011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1 )
10,833.37
10,291.70
541.67
Total Credits (A + B + C)
(2)
10,833.37
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (0 + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is thEOVERPA YMENT (4)
Check box on Page 1 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE. (5)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is theBALANCE DUE (58)
0.00
0.00
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;............................................................................. Iii
b. retain the right to designate who shall use the property transferred or its income;................................ l'x'l
c. retain a reversionary interest; or............................................................................................................ ~\
d. receive the promise for life of either payments, benefits or care?........................................................... Ix]
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?........................................................... --................................................... x
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?........ I LiJ
4. Did deced.ent own an Individual Retirement Account, annuity, or other non-probate property which, _',
contains a beneficiary designation?............................................................................................................... I I IX,l
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 Ihis relurn, including accompanying schedules and stalements, and to the best of my knowledge and belief, it is true, correct and
comple~. Declaration~f prep~rer other than the personal representative is based on all information of which preparer has any knowledge. m___.._________ ____~~
N RESPONSIBLE FOR FILING RETURN ADDRESS DATE
735 Ashurst Road
Havertown, PA 19083
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DATE
51
ADDRESS
)/. /
.0. 4- P. cift:TT----
429 South 18th Street
Camp Hill, PA 17011
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. 99116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. 99116 (a) (1.1) (ii)). The statutedoes not exempt a transfer to a sUlViving spouse from tax, and the statutory requirements for disclosure
of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a
natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 99116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S.
99116 1.2)[72 P.S. 99116 (a) (1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 99116 (a) (1.3)]. A sibling is
defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Rev-1502 EX. (6-98)
.
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Wertz, Dorothy A.
FILE NUMBER
21-06-0290
ESTATE OF
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 relevanl facts.
Real property which is jointly-owned with right of survivorship must be disclosed on schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1
Real Estate - 46 South 39th Street, Hampden Township, Pennsylvania (see appraisal
attached)
135.000.00
TOTAL (Also enter on Line 1, Recapitulation)
135.000.00
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule A (Rev. 6-98)
[ikNo. OB-OOll'Paoe #11
File No. 06-007
f
April 24, 2006
RSR Appraisers & Analysts
3 Lemoyne Drive
Suite 100
Lemoyne, PA 17043
Bangs Law Office
A TIN: Michael Bangs, Esquire
429 S. 18th Street
Camp Hill, PA 17011
RE: Estate of Dorothy A. Wertz
46 South 39th Street
Camp Hill, PA 17011
Dear Mr. Bangs:
Pursuant to your request, I have prepared a Complete Appraisal,
Summary Report for the property captioned in the "Summary of Salient
Features" which follows.
The accompanying report is based on a site inspection of
improvements, investigation of the subject neighborhood area of influence,
and review of sales, cost and income data for similar properties.
This appraisal has been made with particular attention paid to the
applicable value influencing economic conditions and has been processed
in accordance with nationally recognized appraisal guidelines.
The retrospective market value conclusion stated herein is as of the
date of death of Dorothy A. Wertz, on March 11, 2006; as stated in the body
of the appraisal and contingent upon the certifications and limiting
conditions attached. .
Please do not hesitate to contact me, if I can be of additional service to
you.
Respectfully,
~l I/~~'
\,_.. -;(...J......... I~
" Pamela M. Reitenbach
PA Certified General Real Estate Appraiser
HlI1ll OCIJR - 'lOl11l1or WIndows' appraIsal sollware by a la mode, Inc. -1-800-lIlIlMODE
irlle NO. U\)-o-'!JJX~g!'..!tfJ
SUMMARY OF SALIENT FEATURES
Sublect Address 46 South 39th Street
Legal Description Deed Book 22F, Page 208
- City Camp Hill
~ County Cumberland
State PA
..
Zip Code 17011
Census Tract 25420-0113.04
Map Reference ADCMap3117,J2
: Sale Price $ NA
- Date of Sale NA
Borrower I Client Michael L. Bangs, Esquire
Lender NA
Size (Square Feet) 968
Price per Square Foot $
.
Location Average
Age 55 years
-
- Condition Average
Total Rooms 5
-
Bedrooms 3
Baths 1
Appraiser Pamela M. Reitenbach, PA Certified General Real Estate Appraiser
-
Date of Appraised Value March 11, 2006; Date of Death of Dorothy A. Wertz
- Final Estimate of Value $ 135,000
Form SSD - "TOTAL for Windows" appraisal software by a la mode, Inc. -1-800-ALAMODE
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Pamela Rettenbach
[fife Nojfs-DD71 P.illlJL~
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rJj,Jperty Address 46 South 39th Street Citv Camp Hill State PA Zip Code 17011
Il. ~!Ial.Q~llon Deed Book 22F Paae 208 Countv Cumberland
J:;~essor's Parcel No. 10-21-0275-319 Tax Year 05/06 R.E. Taxes $ 1,137.10 Soecial Assessments $ None
Bor,ower NA Current Owner Dorothv A. Wertz Occuoanl: I l Owner \"\ Tenant rY1 Vacant
Pronertv nnhts anoralsed IXI Fee Simole I I Leasehold ProlectTvne I I PUD II Condominium IHUDNA onlv) HOA $ NA /Mo.
N.ll.i.QhborhoQQ,QLProlect Name Hamoden Townshio/Hamnden Gardens Mao Reference ADC MaD 3117 J2 Census Tract 25420-0113.04
~fr1fLLJ'I!I Date of Sale NA Oescrto1lon and $ amount ot loan charnes/concesslons \0 be oald by seller NA
~d~r/Cllent Michael L. Bangs, ESQuire Address 429 South 18th Street Camo Hill PA 17011
Aonra/ser Pamela M. Reitenbach Address 2159 Market Street Camo Hill PA 17011
Localion Urban t8.:J Suburban IJ Rural Predominant _~n~e family housing Preaentland uae % Land uae change
Over 75% r:xJ 25-75% o Under 25% occupancy PRI AGE One family ~ [Xl Not likely U Likely
Built up $(000) (yrs)
Growth rata Rapid kX-'J Stable o Slow [8J Owner ~Low~ 2-4 family ~ [J In process
Property values I>< Increasing IJ Stable D Declining D Tenant 400+ Hlnh 100+ Multi-Iamily -L- To:
Demand/supply Shortage kX:J In balance 0 Over supply ~ Vacant (0-5%) ~"li\ Predominant I:'/)")i. Commercial 10.
Mark~tllliL!l~, Under 3 mos. i5<1 3-6 mos. n Over 6 mos. Vac./over 5%\ 120-150 45-60 Vacant 3
Note: Race and the racial compolltlon of the neighborhood ara not appraIsal factorl.
Neighborhood boundaries and charactertstlcs: The neighborhood boundaries are indicated on the enclosed neighborhood map in the addenda of ttJiL
_!!ill.ort, ImmflQiate neighborhood is residential in nature.
: Factors that affect the marketability of the properties in the nelghbolllOod (proximity to employment and amenmes, employment stability, appeal to market, etc.):
~ _Schools, shoP(ling, employment. recreation and houses of worship are all within a 15-30 minute driving time of the subject property. Average
.. .ill:QJJtmY maintenance programs were observed. Employment stability is good due to the State Capital in Harrisburg, the Armv Supplv Depo!l!L.
New Cumberl<!'!fL and the Naval Supelv Depot in Mechanicsbura. SteadY orice increases and MLS statistics show a aood demand for the area.
The subie9J?~erty is located just south of Market Street which is one of this areas major roadwavs connecting Camp Hill with Harrisburg and
_1y1'!.lO_l:!~nics9urg.
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 competitlve properties for sale In the neighborhood, descrtption of the prevalence of sales and financing concessions, etc.):
..Qountv tax records and MLS statistics show prices to be stable. The MLS shows that the tvpical marketing time for the area is 3-6 months.
Mortgage funds are readily available with conventional loans being 6.50% to 7.00% interest. fixed 30 vear, 95% mortQaQe with up to three
J1Qir1~Sellers are not reQuired to offer sales or financing concessions, but seller assistance is occurring.
- Project Information for PUOI (If applicable) - -Is the developer/builder in control of the Home Owners' Association (HOA)? [J Yes [J No
Approximate total number of untts in the subject project Approximate total number of units for sale in the subject prolect
Describe common elements and recreatlonal faciltties:
Dimensions 120' x 63.40' : oer enclosed leaal descrintlon Topography Generally level
Site area 7,608 square feet or 0.19 acre Comer Lot C><;J Yes o No Size Average for area
Specific zoning classification and descnptlon R-S Residential - Suburban Shape Rectangular
Zoning compliance IJ Legal [g] Legal noncontorming (Grandfathered use) 0 Illegal o No zoning Drainage Appears AdeQuate
Hinhest & best use as Imnroved: !Xi' Present use Ii Other use levnlaln' View Average far area
Utilities Public Other Off-site Improvements Type Public Prtvate Landscaping Average for area
Electrtcity [><J Street Macadam ~ 0 Drtyeway Sullace Concrete
Gas [Xl Curb/gutter Concrete [8J 0 Apparent easements Standard utilitv easements
Water [>(] Sidewalk Concrete [8J [J FEMA SpeCial Flood Hazard Area [J Yes [8J No
Sanitary sewer ~ Street lights AdeQuate ,~ R FEMA Zone X-5eD Map Date 3-02-1993
Storm sewer Allev None FEMA Man No. 420360 0010B
Comments (apparent adverse easements, encroachments. special assessments, slide areas, Illegal or legal nonconforming zoning use, etc.): Standard
easements for electric, telephone, etc. There were no known or apparent adverse easements, encroachments, or conditions that would
neQativelv imoact on the value of the subiect pronertv. (See Addendum\
GENERAL DESCRIPTION EXTERIOR DESCRIPTION FOUNDATION BASEMENT INSULATION
No. of Units One Foundation Concrete Block Slab No Area Sq. Ft. 968 Roof _[J
No. of Stones One Extertor Walls CedarNinvl Crawl Space No % Finished 0 Ceiling _ [J
Type (Oet./Att.) Detached Roof Surtace AsnhalUShinnle 8asement Full Bsmt Ceiling Unfinished Walls _ [J
Design (Style) Ranch Gutters & Dwnspts. Alum/Alum Sump Pump Yes Walls Con cr. Blk Floor _[J
Existlng/Proposed Existino Window Type Dble Huno/Slide Dampness None noted Floor Cement None _[J
Age (Vrs.) 55 vears Storm/Screens ThermalYes Settlement Due To Aae Outside Entry No Unknown_ ~
Effective Aoe IYrs.\ 20 +1- years ManUfactured House No Infestation None noted
ROOMS Fover L1vinn Dininn Kitchen Den Familv Rm. Rec. Rm. Bedrooms # Baths Laundrv Other Area So. Ft.
- Basement Hook-up 968
:
Levei 1 1 Eat-in 3 1 Hook-uo 968
- Level 2
-
Finished area above made contains: 5 Rooms' 3 Bedroomls\' 1 8ath s\: 968 S uare Feet ot Gross L1vinn Area
INTERIOR Matertals/Conditlon HEATING KITCHEN EOUIP. ATTIC AMENITIES CAR STORAGE:
- Floors CmtNinvl/Cer/Avg Type FHA Refrtgerator 0 None 0 Fireplace(s) # _ [J None [J
Walls Wd Panel/Ava Fuel Gas Range/Oven [8J Stairs [J Patlo FrtiRear ~ Garage # of cars
Trim/Rnlsh Wood/Ava Condmon A veraQe Disposal [] Drop Stair [J Deck [J Attached
-~
8ath Floor Ceramic Tile/Avo COOLING Dishwasher kX:J Scuttle kX:J Porch [] Detached
-~
8ath Wainscot Ceramic Tile/Ava Central Yes Fan/Hood kX:J Floor 0 Fence [J Built-In
-~
Doors Wood/Steel/Ava Other No Microwave kX:J Heated 0 Pool .~ Carport ~~
CondltlonAveraae Washer/Drver Fi Finished r4 Shed Drtvewav 2 Cars
Addltlonal teatures (special energy efficient nems, etc.): Subiect has newer kitchen with wood cabinets, Formica counter tops, gas range, dishwasher
built-in microwave and recessed lighting. -~
Condition of the Improvements, depreCiation (physical, functlonal, and extemal), repairs needed, quality of construction, remodeling/addnions, etc.: (See
Ad_clendum)
-
--,.
Adverse environmental conditions (such as. but nof Iimtted to, hazardous wastes, toxic substances, etc.) present in the Improvements, on the sne, or in the
immediate vicinity of the subJect property.: The llrooertv is of an aae where lead based naint mav be Dresen!. The market does not llenalize the
I orooertv. but the client should be advised of its nossible existence. It is assumed that it is not nresen!. If the client has a (See Addendum\
UNIFORM RESIDENTIAL APPRAISAL REPORT
FII N 06 007
Freddie Mac Form 70 6193
PAGE 1 OF 2
Form UA2 - "TOTAL for Windows" appraisal soffware by a la mode, inc. -l-BOO-ALAMOOE
Fannie Mae Form 10D4 6/93
Ir~No. D6-iIDlL
Val AleNa. 06-007
ESTIMATED SITE VALUE = $ Comments on Cost Approach (such as. source of cost estimate. stte value.
ESTIMATED REPRODUCTION CDST-NEW-OF IMPROVEMENTS: square foot calculation and for HUD. VA and FmHA. the estimated remaining
Dwelling 966 Sq. ft. @$ = $ economic life of the property): The Cost Approach will generally result
966 Sq. ft. @$ = in an excellent estimate of value if the buildino is new or
~ f---- = reasonablv new and the imnrovements reflect the hi91lest and
Garage/Carport ~1~ Sq. fl. @$ _~ = best use of the land. However, when item~h'y~__
Total Estimated Cost New = $ deoreciation must be estimated an area ()!jl,J<lflEl_ment is __
- Less Physical functional Extemal involved which is subiect to error. The Cost An~oach was ~
Depreciation I I =$ utilized due to the subject's aoe. ~~~--
Depreciated Value of Improvements =$
"As-Is" Value of Site improvements =$
INDICA TED VALUE BY COST APPROACH =~-
---------'lEt,1 I SUBJECT COMPARABLE NO. 1 COMPARABLE NO. 2 COMPARABLE NO.3
46 South 39th Street 6 South 39th Street 3813 Chestnut Street 4611 N. Clearview Drive
Address Ca"llD!ill PA Camo Hill PA Camo Hill PA Camo Hill PA
Proxlmllv to Subiect 10.19 miles 0.16 miles D.71 miles
Sales Price I~ NA :2.';::'.' ..:.::A",:.:.::!t 132 Mft 152 500 .iR.S";.:;:.I~ 135 000
Price/Gross Living Area rth 96.03 120.17 liJlf::.Y':':.. 136.641iJ ....
Data and/or Inspection Int. & Ext Inspection; Grantor MLS, Agent, and MLS, Agent, and
Verlllcatlon Source Crt. Hse Records Crthse Records & ADD. Files Courthouse Records Courthouse Records
VALUE ADJUSTMENTS OESCRlPTION OESCRIP1\ON +(-\$ Adllls\. DESCRIPTION +(-\$ Adlus!. OESCRIPTION : +H$ Adjust.
Sales or financing Conventional : Conventional Conventional
Concessions .... None Costs -3325 None
Date of Sale/Tlme .. 10-06-05/FSBO : 9-30-05 8 DOM 8-16-05/10 DOM
Location Averaoe Eoual Averaoe Averaoe
~LdlFee Slmole Fee Simole Fee Simole Fee Simple Fee Simnle
Srte 0.19 acre 0.19 acre : 0.22 acre 0.16 acre
View Averaae/Street Eoual : Eaual Eaual
.QlliI.n_~al Ranch Ranch Ranch Ranch
Qualitv of Construction Averaoe Averaae Averaae Average --
Ane 55 vears 51 vears 53 years 47 vears --
Condl~on Averaae Suoerior -3 000 Superior -6 000 Sunerior -3,000
Above Grade Total : Bdrms: Baths Total : Bdrms : Baths: T alai : Bdrms : Baths Total : Bdrms : Baths ~
Room Count 5 : 3 1 6 : 3 1 : 5 '3 : 1 : 5 : 3 : 1
- lill!sS livina Area 968 Sn. ft. 1 384 Sn. ft. : -6 200 1 269 Sn. ft. : -4500 988 Sn. ft. : 0
- Basement & finished Full Bsmt. Full 8smt. : Full 8smt. Full Bsmt.
- Rooms Below Grade Unfinished Unf/Shower : -100 Unfinished Familv Room -f,,000
: functional Utllitv Averaae Averaoe : Averaae : Averaae
Heatln~oolilliL FHA & Cent. Air H. W. & Cent. Air : FHA & Cent. Air : FHA & Cent. Air
- Enerov EMlclent Items Averaoe A verane : Averaae Averaae
Garaae/Camon Caroort Off Street : +1000 Garaoel x 1 -1 500 Caroort
--
Porch, Patio, Deck, Patio's Front Porch Porches/Patio -500 Patio
Fireolace Fireolace Nnne :
flreolaceis) etc. None -1500 -1500
fence, Pool etc. Shed None None : Shed :
: ._-
'"..,~ ~ "'OOidt 17325 TT+ I')(f-$ 5,000
Adjusted Sales Price. ": ..... :,,:;;;..",:,'1
of Comnarahle 123 1 DO 135 17 5 ",;" n:h 130 DOO
Comments on Sales Comparison (Including the subject property's compatlbiltty to the neighborhood, etc.): After a Ihorouoh search of all available data, the
comparables chosen were considered the best available. Adiustments were made to reflect substantial differences between the comparabl~
..Q!"QiJerties and the subject. The adjustments that were made reflect the typical actions of buyers and seller in the marketplace. All compar!,~
were considered eQually. All sales were adiusted 10 reflect the subject's need for a roof. Sale #2, further adjusted for having a remodeled bath.
All sales had newer remodeled kitchens. Due to a limited suoDlv of homes for sale in the subiect's market area it is believed that the subject's
market value falls in the upoer limited of value.
ITEM SUBJECT COMPARABLE NO.1 COMPARABLE NO.2 COMPARABLE NO.3
Date, Price and Data NA NA NA NA
Source, lor prior sales NA NA NA NA
Jlilllln..Year of annralsal Crthse Records Courthouse Records Courthouse Records Courthouse Records
Analysis of any current agreement of sale, option, or listing of subject property and analysis of any prior sales of SUbject and comparables within one year of the date of appraisal:
"prior sales of the comparable properties occurred more than one year ago. The subject is not currently under contract or risted in the open
market. Subject has not transferred within the past three years. ---
INDICATED VALUE BY SALES COMPARISON APPROACH $ 135,000
INDICATED VALUE BY INCOME APPROACH III AllIlilcable\ Estimated Market Rent $ '''0. x Gross Rent Mumnller ~~.
This appraisal Is made [Xl "as is' LJ subject to tho repairs, aherations, inspoctions or condrtlons listed below [] subject to completion per pians & spec"ica~ons.
CooditJons 01 Appraisal:
Rnal Reconciliation: Due to the lack of rental data, the Income Approach was considered inappropriate and not utilized. Greatest weight is give!!...!L
.the Sales Comparison Approach since it reflects the typical actions of buyers and sellers in the marketplace. Cost Approach not utilized due to
~ age of the subject property. .* Date of Death of Dorothy A. Wertz.
- 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 abovo conditions and the certification, contingent
and limiting conditions, and market value dellnllion that are stated In the attached Freddlo Mac Form 439/fNMA form 1004B (Revised June 1993 ).
- I (WE) ESTIMATE THE MARKET VALUE, AS DEAN ED, OFTHE REAL PROPERTY THAT IS THE SUBJECT OF THIS REPORT, AS OF March 11 , 2006 ..
(WHICH IS THE DATE OF INSPECTION AND THE EFFECTIVE DATE OF THIS REPORT) TO BE $ 135,000
APPR~EIf:-~~.~ SUPERVISORY APPRAISER (ONLY IF REQUIRED): L ] Did [J Did Not
Slgnat 8-_... j . _.~ Signature
Name Pamela M. Reitenbach, .PA Cert. Gen R. E. Appraiser Name Inspect Property
Date Report Signed April 24, 2006 Date Report Signed
State Certnication it GA001804 State PA Slate Certification it State
Or State License it State Or State License it State
UNIFORM RESIDENTIAL APPRAISAL REPORT
Freddie Mac Form 70 6193
PAGE 2 OF 2
form UA2 - "TOTAL for Windows" appraisal software by a la mode, Inc. - 1-BDO-ALAMODE
Fannie Mae Fonn t004 6-93
Supplemental Addendum
IFile No. Qjj~ill
File No. 06-007
Borrower/Client NA
J:[Q~ddress 46 South 39th Street
Cjty~jl-'-!1P-1:l ill
Lender Michael L. Banas Esauire
County Cumberland
State PA
Zip Code 17011
SITE, Conl'd:
Under current zoning the subject site is considered as a legal non-conforming use due to minimum lot size and width
requirements.
CONDITION OF THE IMPROVEMENTS, Cont'd
House appears to need a roof. Bath is dated which will decrease market appeal. Interior ofthe home needs painted. The home
is considered to be in average condition. The construction quality is typical for the area. The estimated effective age is below
the actual age due to maintenance, condition, and comparison to competing neighborhoods. Physical depreciation is attributed
to age and deferred maintenance. No functional or economic obsolescence was observed.
ADVERSE ENVIRONMENTAL CONDITIONS, Cont'd:
concern then a qualified expert in this area should be contacted. There are no known or apparent adverse environmental
conditions that would negatively impact on the sale of the property.
FINAL RECONCILIATION, Cont'd:
The retrospective market value conclusion stated herein is as of the date of death of Dorothy A. Wertz on March 11, 2006: as
stated within the body of the appraisal, and contingent upon the certification and limiting conditions attached.
SCOPE OF WORK
Observation of the exterior and walk through observation of the interior of the subject property. Exterior measurement of the
dwelling. Review of REDS courthouse data and Central Penn Multi-List, Inc. records. Review the county tax online information,
county tax map, zoning, and FEMA flood maps. Verifying, if possible comparable land and building sales information with
broker, agent, seller or buyer.
SPECIAL LIMITING CONDITIONS:
This appraisal is not a home inspection and the appraiser is not acting as a home inspector when preparing the report. The
client has the right to have the home inspected by a professional home inspector. When performing the inspection of this
property, the appraiser visually observed areas that were readily accessible. The appraiser is not required to disturb or move
anything that obstructs access or visibility. The inspection is not technically exhaustive. The inspection does not offer warranties
or guarantees of any kind.
The appraiser is not a home or environmental inspector. The appraiser provides an opinion of value. The appraisal does not
guarantee that the property is free of defects or environmental problems. The appraiser performs an inspection of visible and
accessible areas only. Mold may be present in areas the appraiser cannot see. A professional home inspection or
environmental inspection is recommended.
If the property is sold, this appraisal is subject to satisfactory inspection reports including, but not limited to: wood infestation,
building inspections, etc.
SUPPLEMENTAL CERTIFICATIONS:
I certify that,
..
This COMPLETE APPRAISAL / SUMMARY APPRAISAL REPORT was prepared by Pamela M. Reitenbach for the
exclusive use of Michael Bangs, Esquire representing the estate of Dorothy A. Wertz (intended user/client). The intended use
of this appraisal report is for estate settlement purposes. Estimated market value is the most probable price in terms of cash or
in terms of financial arrangements equivalent to cash. The information and opinions contained in this appraisal set forth the
appraiser's best judgment in light of the information available at the time of the preparation of this report. Any use of this
appraisal by any other person or entity, or any reliance or decisions based on this appraisal are at the sole responsibility and at
the sole risk of the third party. I accept no responsibility for damages suffered by any third party, as a result of reliance on or
decisions made or actions taken based on this report.
In my opinion, the reasonable exposure time linked to the value opinion is up to 180 days.
I further certify that. to the best of my knowledge and belief:
- The statements of fact contained in this report are true and correct.
- The reported analyses, opinions, and conclusions are limited only by the reported assumptions and limiting conditions,
and are my personal, impartial, and unbiased professional analyses, opinions, and conclusions.
- I have no present or prospective interest in the property that is the subject of this report or to the parties involved with this
assignment.
- My engagement in this assignment was not contingent upon developing or reporting predetermined results.
- My compensation for completing this assignment is not contingent upon the development or reporting of a predetermined
value or direction in value that favors the cause of the client, the amount of the value opinion, the attainment of a stipulated
result, or the occurrence of a subsequent event directly related to the intended use of this appraisal.
- My analyses, opinions, and conclusions were developed, and this report has been prepared, in conformity with the
Uniform Standard of Professional Appraisal Practice.
- I have made a personal inspection of the property that is the subject of this report.
- No one provided significant professional assistance to the person signing this report.
- Pamela M. Reitenbach has made a personal inspection of the property that is the subject of this report.
Pamela M. Reitenbach
PA State Certified General Real Estate Appraiser
FormTADD - 'TOTAL for Windows' appraisal software by a la mode, Inc. -1.800-ALAMODE
~-=oo7rPaQe #61
DEFINITION OF MARKET VALUE: The most probable price which a property should bring In a competitJve and open market under all conditions
requisite to a fair saie, the buyer and seller, each acting prudentiy, knowledgeably and assuming the price Is not affected by undue stimulus. Impllctt In this
dellnltlon Is the consummation of a sale as of a specnJed date and the passing of title from seller to buyer under condttions whereby: (1) buyer and seller are
typically motivated; (2) both parties are well Infonned or well advised, and each acting In what he considers his own best Interest; (3) a reasonable time Is allowed
tor exposure In the open market; (4) payment is made In tenns of cash In U.S, dollars or In tenns of financial arrangements comparable thereto; and (5) the price
represents the nonnal 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 tor special or creative tlnanclng or sales concessions. No adjustments are necessary
for those costs which are nonnally paid by sellers as a resutt of tradition or law In a market area; these costs are readily Identitlallle
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 tenns 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 certl\ication that appears In the appraisal report Is subject to the tollowlng
conditions:
1. The appraiser will not be responsible for matters of a legal nalure that affect either the property being appraised or the litle \0 II. 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 01 the report In visualizing the property and understanding the appraiser's detennlnation 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 delennlnation.
4. The appraiser will not give testimony or appear In court because he or she made an appralsal 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 theiF contributory value. These
separate valuations of the land and Improvements must not be used In conjunction wnh any other appraisal and are invalid It 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 sublect property or that he or she became aware at during the nonnal research Involved In perfonnlng
the appraisal.... Unless otherwise stated In the appraisal report, the appraiser has no knowledge of any hidden or unapparent conditions ot the property or
adverse environmental conditions (Includlng 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 condmon 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 hazams, 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 correcl. The appraiser does not assume responsibility for the accuracy of such lIems that were fumlshed by other
parties.
8. The appraiser will not disclose the contents of the appraisal report except as provided for In the Unlfonn Standards of Professional Appraisal Practice.
9. The appraiser has based his or her appraisal report and valuation conclusion lor 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 wrtllen 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 relerences to any pro1esslonal appraisal
o1'1Janlzatlons 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 Inslttution; 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 ot Ihe report only to data
collection or reporting service(s) wnhout having to obtain the appraiser's prior wrtllen 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 Fonn 439 6-93
Page 1 01 2
Fannie Mae Fonn 10048 6-93
Pamela Reltenbach
Fonn ACR - 'TOTAL for Windows' appraisal software by a la made, Inc. -1-800-ALAMOOE
!Eile No. 06-00,
APPRAISER'S CERTIFICATION: The Appraiser certifies and agrees that:
1. I have researched the subject market area and have selected a minimum of three recent sales of properties most similar and proximate to the subject property
for consideraUon in the sales comparison analysis and have made a dollar adjustment when appropriate to reflect the market reaction to those lIems of significant
variation. If a significant lIem 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, II a significant lIem 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 Info011aflon 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 fOO11.
4, I have no present or prospective Interest in the property tlIatls the sublectto this report, and I have no present or prospective personal Interest or bias wllh
respect to the participants in the transaction. I did not base, ellher partially or completely, my analysis and/or the estimate of market value in the appraisal report
on the race, color, religion, sex, handicap, familial status, or national origin of ellher the prospective owners or occupants of the subject property or of the present
owners or occupants of the properties In the vicinity of the subject property.
5. I have no present or contemplated Mure interest in the subject property, and neither my current or future employment nor my compensation for perto011ing 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 pertormlng the appraisal. I
did not base the appraisal report on a requested minimum valuation, a speclllc valuation, or the need to approve a speclllc mortgage loan.
7. I perto011ed this appraisal in confo011i1y with the Unllorm Standards of Professional Appraisal Pracflce 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 condllion In the definition of market value
and the estimate I developed is consistent wnh the marketing time noted In the neighborhood secflon of this report, unless I have othelWise 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 certny that I have noted any apparent or known adverse condilions In the subject Improvements, on the subject slle, or on any site within the immediate
vlclniIY of the subject property of which I am aware and have made adjustments for these adverse condltlons 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 condltlons 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. II I relied on slgnlllcanl professional
assistance from any Individual or Individuals in the perto011ance of the appraisal or the preparation of the appraisal report, I have-named such Indlvldual(s) and
disclosed the specific tasks pertormed by them in the reconciliation secflon of this appraisal report. I certity that any Individual so named Is qualllled to perto011
the tasks, I have not authorized anyone to make a Change to any lIem In the report: therefore, II an unauthorized change Is made to the appraisal report, I will take
no responsibility for It.
SUPERVISORY APPRAISER'S CERTIFICATION: II a supervisory appraiser signed the appraisal report, he or she certllles and agrees that
I directiy 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: 46 South 39th Street, Camp Hill, PA 17011
APPRAISER:
Signat~ )c:~~, .\..J:::;,.\__
Name: Pamela M. Reitenbach, PA Cert. Gen. RE Appraiser
Date Signed: April 24, 2006
Stale Certllicaflon #: GAo01804
or Slate license #:
State: PA
Expiration Dale at Certitlcatlon or License: June 3D, 2007
SUPERVISORY APPRAISER (only If required):
Signature:
Name:
Date Signed:
State Certification #:
Of Slate license #:
State:
Expiration Date of Certlllcation or license:
o Old
[J Old Not Inspect Property
Freddie Mac Form 439 6-93
Page 2 01 2
Fannie Mae F00111004B 6-93
FOO11 ACR - 'TOTAl for Windows' appraisal software by a la mode, inc. -1-800-ALAMDDE
Rev-1S03 EX+ (6-98)
.
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Wertz, Dorothy A.
FILE NUMBER
21-06-0290
ESTATE OF
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM CUSIP VALUE AT DATE
NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH
1 Vanguard - Short-Term Investment-Grade Fund Inv. 10.47 5.465.11
2 Vanguard - Life-Strategy Conservative Growth Fund 15.74 7.777.40
3 26 Series EE Savings Bonds - ($50.00 denomination; 1.534.40
Payable on Death)
4 49 Series EE Savings Bonds - ($50.00 denomination; 3.203.30
joint ownership)
5 51 Series EE Savings Bonds - ($100 denomination; 5,109.60
payable on death)
.
TOTAL (Also enter on Line 2, Recapitulation) 23.089.81
(If more space is needed. additional pages of the same size)
Copyright (c) 2002 form software only The Lackner GrouP. Inc.
Form PA-1500 Schedule B (Rev. 6-98)
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!R-24-2006 MON 09:09 AM
FAX NO.
P. 02
f'-"
'.J:. Ij\~
(I' . '~~
. ' ".> Vanguard"~
April 12, 2006
P.O. Box 2600
Volley FOlgCl, PA 19,182-2600
www.vDI10uard.com
ESTATE OF DOROTHY A WERTZ
46 S 39TH ST
CAMP HILL PA 170114205
Various Funds
09897185236
Dear Executor:
We are responding to your telephone call notifying us of the death of Dorothy A.
Wertz, and requesting a valuation of the above-referenced account on March 11,
2006. First, please accept our condolences for your loss.
Since that date was a non~business day, we are providing the values for March
10, 2006, On that date, the number of shares, price per share, and the value of
each fund were as follows:
~
~
Fund Name S
Prime Mone Mafket 53
"_..~ ~ .., ,.....--~
GNMAFundl~ 6
Short~Term Inve'stment- 5
Grade Fund Inv
LifeStrategy Conservative 4
Growth Fund
,.-...,-- ~....._..-
hares Price Value
1269.81'(r~ ~
$1JlO $53,269.81
34 .287 10.19 $6,463.38
21.978 $10.47 .- ~-$5,465.11
9"4:-'117 -,.....-..... ,..
$15.74 $7,777.40
~.- ............."
Accrued Dividends (through the date of death, and if applicable) and the funds'
share price on March 13, 2006 (the business day following the date of death) are
listed below. Note: As of this date, the funds' share balance remained the same.
............---...--..-
Fund Name
_ ~_, Prime Money MarkeI.~,:~'."
GNMA Fund lnv
Short-Term Investmen~
Grade Fund Inv
LifeStrategy Conservative
Growth Fund
---, -, ..",.""
Accrued Divid.mds
$69.45
$9.64
$6.85~-
N/A
Share Price
$1.00
$1 o~f('--
$10A7"--
$15.76
IfR-24-2006 MON 09:09 AN
FAX NO,
P. 03
If you have any questions or need further assistance, please contact a member
of our Transition Specialist Team at 1-888.237-9045. We are available Monday
through Friday from 8 a.m. to 8 p.m., Eastern time.
Sincerely,
Client Services Department
rd
50679838
. Rev-1S08 EX+ (6-98)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Wertz, Dorothy A.
FILE NUMBER
21-06-0290
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with the right of survivorship must be disclosed on schedule F.
ITEM
NUMBER DESCRIPTION
1 Refund from Home Instead Care
VALUE AT DATE
OF DEATH
176.03
2 Refund from IRS (2005 taxes)
85.00
3 Refund from The Patriot News
14.30
4 Refund from Comcast Cable
15.90
5 Refund from IRS
447.52
6 Refund from State Farm - Unused automobile insurance premium
1.32
7 Refund from State Farm - Unused homeowners insurance premium
258.10
8 Sale of 1998 Chevrolet Lumina
3.300.00
9 Vanguard - Prime Money Market Fund
53.269.81
10 Vanguard:;. GNMA Fund
6.463.38
TOTAL (Also enter on Line 5, Recapitulation)
64.031.36
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 ScheduleE (Rev. 6-98)
BILL OF SALE
The Estate of Dorothy Wertz, by and through the Executor, John T. Wertz, sells all of its
right, title and interest in and to the 1998 Chevrolet Lumina automobile for the sum of Three
Thousand Three Hundred and 00/1 00 ($3,300.00) Dollars, to Lerew Morrison.
Date: April 21, 2006
A~
Jorur~/Wertz, E~~~_
/R-24-2006 MON 09:09 AM
FAX NO.
P. 02
8','
. ,. '\.
.0' ."~ .."i>, Vanguard'"
April 12, 2006
P.O, Box 2GOO
Valley FOlgtl, PA 19.182-2600
www.van\)uard.com
ESTATE OF DOROTHY A WERTZ
46 S 39TH 8T
CAMP HILL PA 17011-4205
Various Funds
09897185236
Dear Executor:
We are responding to your telephone call notifying us of the death of Dorothy A.
Wertz, and requesting a valuation of the above-referenced account on March 11,
2006. First, please accept our condolences for your loss.
Since that date was a non-business day, we are providing the values for March
10, 2006, On that date, the number of shares, price per share, and the value of
each fund were as follows:
...
...
.
_0\-.0'1"'1 ............ ..-
hares Price Value
,269.81.0~ .. -....,
$1.:9~O $53,269,81
34.287 10.19 $6,463.38
21.9'78' $10.47 ---$5,465.11
'9-4':111 -,~._....... ,p $7,777 AD
$15.74
- - ...................
Fund Name 5
Prime Mone Market 53
.--.- ..,., ",...----
GNMA Fund Inv 6
Short,Term Investment- 5
Grade Fund lnv
----_....,.--
UfeStrategy Conservative 4
Growth Fund
Accrued Dividends (through the date of death, and if applicable) and the funds'
share price on March 13, 2006 (the business day following the date of death) are
listed below. Note: As of this date, the funds' share balance remained the same.
Accrued Dividends
$69.45
$9.64
$6.85
Fund Name
_ ._.__ Prime Money MarkeI:,:~= ~
GNMA Fund Inv
Short-Term Investmen~
__ Grade Fund .trr'!,."-
LifeStrategy Conservative
Growth Fund
__." _, 'M'...T".....
Share Price
$1.09.. ....___
$10.17
$ 15.'47'
N/A
$15.76
JPR-24-2006 MON 09:09 AM
FAX NO.
P. 03
If you have any questions or need further assistance, please contact a member
of our Transition Specialist Team at 1-888-237-9045. We are available Monday
through Friday from 8 a.m. to 8 p.m., Eastern time.
Sincerely,
Client ServIces Department
rd
50679838
Rev-1509 EX+ (6-98)
.
SCHEDULE F
JOINTLY-OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Wertz, Dorothy A.
FILE NUMBER
21-06-0290
ESTATE OF
If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A. John T. Wertz
735 Ashurst Road
Havertown, PA 19083
Son
B. Mary Ann Metcalf
240 North 27th Street
Camp Hill, PA 17011
Daughter
C.
JOINTLY OWNED PROPERTY:
DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM LETTER DATE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH
FOR JOINT MADE DECO'S VALUE OF
NUMBER TENANT JOINT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR VALUE OF ASSET INTEREST DECEDENTS INTEREST
JOINTLY-HELD REAL ESTATE.
1 B 2/28/2005 Commerce Bank - Checking Account 50.09 50.000% 25.05
0536894579
2 A 8/6/1981 M& T Bank - Checking Account #967351 1,929.33 33.333% 643.11
3 A 7/29/1985 PSECU - Regular Share Account 5.11 50.000% 2.56
4 A 12/5/2001 PSECU - Money Market Account 2.507.21 50.000% 1,253.61
-
TOTAL (Also enter on Line 6, Recapitulation) 1,924.33
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule F (Rev. 6-98)
~~Y-23-2006 04:34
COMMERCE WIRE-ACH
7177956128
P.02
Commerce
"Bank~
M.;iy 23, 2006
Bang's Law Office
429 S 13th St
Camp Hill, PA 17011
RE: Estate of: Dorothy A Wertz
Social Security #: 201-18-3386
Date of Death: March 11, 2006
Dear Sirs:
In reference to the letter regarding the above mentioned
Estate, we would like to inform you of the information that
we have researched and found.
Type: Checking
Account #: 536894579
Date Opened; 2/28/05
Date.Closed: 4/10/06
Primary Owner: Dorothy A Wertz
secondary Owner: Mary Anne Wertz Metcalf
Date of Death Balance: $50.09
Accrued Interest~ $0
principal Balance: $50.09
If there are any questions or additional information that
is needed, please feel free to contact me at (717) 412-
6130.
Sincerely,
~NXh ~ 1Y)~
Wanda J Morris
Senior erF Specialist
Comrnerce Bank I HarriSburg, N.A.
P.O. Box 8599
100 Senate Avel'\ue
Camp Hill, Pennsylvania 17001-8599
TOTAL P.02
m1 M&TBank
-1')') t\lilt'hdIIZl\ild, MillsblHD, DE 19966 Mail Cod~ DE-MB-12
Phol1~ (SSg) 502-4]49
Fax (]02) 9]4-2955
April 12, 2006
Bangs Law Office
Attorneys At Law
.t29 South 18th Street
Camp Hill, Pennsylvania 17011
He: ISlat~J)orothEA Wertz
Social Securitv: 201-18-3386
Dale of Death: March 11, 2006
D~ar Sir or Madam:
[)er your inquiry dated April 4, 2006, please be advised that at the time of death, the above-named decedent had on deposit
with this bank the following:
I,
Tvpe ujA ccounI
Checking Account
A (,(,U/lnl Number
967351
Oll'nt!/'ship (Names oj)
Mary Ann Wertz Metcalf*
Dorothy A Wertz *
John T Wertz *
Opening Dule
08/06/8/
J]u/unce on Date of Death
$/,929,33
Accmed Inlerest
$
0.00
To(,:i
$1,929.33
Pleasl' bl' advised, there was no safe deposit box found for the above decedent.
* Fur further accuunt information, regarding ownership, closures and/or reimbursement of funds, etc., please call
the Trindle Ruad Ofliee # 717-737-2308.
Sincerel) .
L,=!??.J :>?;/ C?:::;;,viJ
N~lncy Clagett
Reclll'ds Management
PSE(~
the financiallinkTM
April 10, 2006
Account # 8804500182
MICHAEL L BANGS
429 SOUTH 18TH ST
CAMP HILL, PA 17011
Dear MR BANGS:
The following is the status of DOROTHY A WERTZ's account with PSECU as of the date of death.
Joint Owner's Name
Date of Death
Date of Birth
JOHN T WERTZ - JOINT TENANT W/ROS
03.11.2006
09.11.1925
Share Description Open date Balance Accrued Dividend
SOl Regular Shares 07.29.1985 $ 5.11 $ 0.00
S 04 MoneyHandler 0.00 0.00
S 07 Money Market 12.05.2001 2,507.21 1.70
S 51 12 Month Certificate-3 04.19.2005 3,149.64 2.55
S 54 60 Month IRA Certificate 02.14.2005 34,689.14 44.19
Loan Description Open Date Balance Accrued Interest
L 01 PSL Loan 07.16.1986 $ 0.00 $ 0.00
The dividend earned from January 1,2006 through the date of death was $26.64. We do not have safe deposit boxes
for our membBfs,.
If you have any questions, please call 234-8484 in Harrisburg or our toll-free nwnber, (800) 237-7328. At the menu
prompt, enter 6 and then extension 2227.
Sincerely,
~~
Member Service Representative
Finance Support Unit
Pennsylvania State Employees Credit Union
Main Address: 1 Credit Union Place, Harrisburg, PA 17110-2990 . (717)234-8484 . (800) 237-7328
. Mailing Address: po. Box 67013, Harrisburg, PA 17106.7013. (717) 777.2100 (TOO) . (800) 4721967 (TOO)
Snvings ledcrnlly Insured up 10 $100.000 by the National Credit Union Administration www.psecu.com
Rev-1510 EX+ (6-98)
'*
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PE.NNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Wertz, Dorothy A.
FILE NUMBER
21-06-0290
ESTATE OF
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
ITEM Dt::::iL;KIP IluN Ul- t-'KuPERTY DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE
NUMBER INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
THE DATE OF TRANSFER. ATTACH A COpy OF THE DEED FOR REAL ESTATE.
1 PSECU -12 Month Certificate of Deposit 3.149.64 100.000 3.000.00 149.64
transferred to joint tenancy with right of
survivorship with son, John T. Wertz, on April
19, 2005.
2 PSECU - 60 Month IRA Certificate 34.689.14 100.000 34.689.14
...
TOTAL (Also enter on Line 7, Recapitulation) 34.838.78
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 ScheduleG (Rev. 6-98)
PSE(~
the financial IinkTM
April 10, 2006
Account # 8804500182
MICHAEL L BANGS
429 SOUTH 18TH ST
CAMP HILL, PA 17011
Dear MR BANGS:
The following is the status of DOROTHY A WERTZ's account with PSECU as ofthe date of death.
Joint Owner's Name
Date of Death
Date of Birth
JOHN T WERTZ - JOINT TENANT WIROS
03.11.2006
09.11.1925
Share Description Open date Balance Accrued Dividend
SOl Regular Shares 07.29.1985 $ 5.11 $ 0.00
S 04 MoneyHandler 0.00 0.00
S 07 Money Market 12.05.2001 2,507.21 1.70
S 51 12 Month Certificate-3 04.19.2005 3,149.64 2.55
S 54 60 Month IRA Certificate 02.14.2005 34,689.14 44.19
Loan Description Open Date Balance Accrued Interest
L 01 PSL Loan 07.16.1986 $ 0.00 $ 0.00
The dividend earned from January 1,2006 through the date of death was $26.64. We do not have safe deposit boxes
for our membeF6.
If you have any questions, please call 234-8484 in Harrisburg or our toll-free number, (800) 237-7328. At the menu
prompt, enter 6 and then extension 2227.
Sincerely,
v;~
Meacie Fai/}a)
Member Service Representative
Finance Support Unit
Pennsylvania State Employees Credit Union
Main Address: 1 Credit Union Place, Harrisburg, PA 17110.2990 . (717) 234.8484 . (800) 237.7328
. Moiling Address: P.O. Box 67013 ,Harrisburg, PA 1 7106.7013 . (71 7) 777 .2100 (TOO) . (800) .j 72 1 967 (TOD)
Savings federally insured up to $100,000 by the National Credit Union Administration www.psecu.com
REV-1151 EX+ 112-99}
*'
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Wertz, Dorothy A.
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21-06-0290
ESTATE OF
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 8,195.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Social Security Number(s) I EIN Number of Personal Representative(s):
Street Address
City State Zip
-
Year(s) Commission paid
2. Attorney's Fees Michael L. Bangs 5,000.00
.
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees 310.00
5. Accountant's Fees 250.00
6. Tax Return Preparer's Fees
7. Other Administrative Costs 1,482.99
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 15,237.99
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 6-98)
. Rev-1502 EX+ 16-98)
.
SCHEDULE H..A
FUNERAL EXPENSES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Wertz, Dorothy A.
FILE NUMBER
21-06-0290
ESTATE OF
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Myers-Harner Funeral Home, Inc.
8.195.00
Subtotal
8.195.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-A (Rev. 6-98)
Rev-1502 EX. (6-98)
*'
SCHEDULE H-B7
OTHER
ADMINISTRATIVE COSTS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Wertz, Dorothy A.
FILE NUMBER
21-06-0290
ESTATE OF
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Cumberland Law Journal
75.00
2
Forney's Remodeling - Work done at residence
1.000.00
3
RSR Appraisers - Real estate appraisal
300.00
4
The Sentinel
107.99
Subtotal
1,482.99
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA.1500 Schedule H-B7 (Rev. 6-98)
Rev-1512 EX+ (6-98)
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Wertz, Dorothy A.
Include unreimbursed medical expenses.
FILE NUMBER
21-06-0290
VALUE AT DATE
OF DEATH
ITEM
NUMBER DESCRIPTION
1 ABWA Dues
2 Buddi
3 Capital Area Carpet Cleaners
4 Chase VISA
5 Comcast Cable
6 Hampden Township - SewerlTrash (April-June)
7 Harrisburg Pharmacy
8 Larry B. Shoop, CPA
9 Links 2 Care - (3/12/06)
10 Links 2 Care - (3/5/06)
11 Marie Huber, Treasurer - 2006 County/Township real estate tax
12 Marie Huber, Treasurer - 2006 Personal Tax
13 PA American Water Company - 2/8/06 to 3/10/06
14 PA American Water - 3/10/06 to 4/11/06
15 PA American Water
16 PP&L Electric - 2/10/06 to 3/14/06
17 PP&L Electric - 3/14/06 to 4/12/06
Total of Continuation Schedule(s)
27.00
63.44
63.60
9.99
64.55
124.00
8.00
130.00
740.00
615.00
235.29
10.00
33.76
15.96
15.09
46.97
47.52
See attached page
2,904.80
TOTAL (Also enter on Line 10, Recapitulation)
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule I (Rev. 6-98)
Rev-1512 EX+ (6-98)
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Wertz, Dorothy A.
FILE NUMBER
21-06-0290
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
18 Quantum Imaging 11.74
19 Quantum Imaging 11.74
20 State Farm - Homeowners Insurance 290.00
21 UGI - 2/17/06 to 3/21/06 95.00
22 UGI 119.00
23 UGI - 3/21/06 to 4/20/06 95.00
24 Verizon 32.15
TOTAL (Also enter on Line 10, Recapitulation)
2,904.80
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule I (Rev. 6-98)
REV-1513 EX+ (9-00)
*'
SCHEDULE ..
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
NUMBER
Wertz, Dorothy A.
NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
distributions, and transfers
under Sec. 9116(a)(1.2)]
FILE NUMBER
21-06-0290
ESTATE OF
RELATIONSHIP TO
DECEDENT
Do Not List Trustee/51
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
I.
1
Mary Ann Metcalf
240 North 27th Street
Camp Hill, PA 17011
Daughter
One-half
2
John T. Wertz
735 Ashurst Road
Havertown, PA 19083
Son
One-half
Total
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
0.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 ScheduleJ (Rev. 6-98)
La.IiI1; ""ilV":lll & Te.1;a.I'n..en.1;
I, DOROTHY A. WERTZ, of Camp Hill, Pennsylvania, declare this to be my Last
Will and revoke any Will previously made by me.
FIRST: I declare that all my just debts and funeral expenses, including my grave
marker and all expenses of my last illness shall be paid from my residuary estate as soon as practicable
after my decease as a part of the expense of the administration of my estate.
SECOND: I bequeath my automobiles, household and personal effects and other
tangible personal property of like nature (not including cash or securities), together with any existing
insurance thereon to, JOHN T. WERTZ AND MARY ANN WERTZ-METCALF, per stirpes,
to be divided among them by my Executor with due regard for their preferences in as nearly equal
shares as practicable. Any such article allotted to a minor may, as my Executor thinks advisable,
either be delivered to the minor or any person to hold for the minor, or be sold and the proceeds paid
to the Guardiau.as provided in paragraph FOURTH hereof
THIRD: I devise and bequeath the rest and residue of my estate of every nature and
wherever situate to JOHN T. WERTZ AND MARY ANN WERTZ-METCALF, per stirpes.
FOURTH: I appoint JOHN T. WERTZ Guardian of any property which passes
either under this Will or otherwise to a minor and with respect to which I am authorized to appoint
a Guardian and have not specifically done so, provided that this appointment of a Guardian shall not
supersede the right of any fiduciary in his or her discretion to distribute a share where possible to the
minor or to another for the minor's benefit. Such Guardian shall have the power to use principal as
1
well as income from time to time for the minor's support and education (including college education,
both graduate and undergraduate), without regard to his or her parents' ability to provide for such
support and education, or to make payment for these purposes, without further responsibility, to the
minor or to the minor's parents or to any person taking care of the minor. Should JOHN T.
WERTZ fail to qualifY or cease to act as Guardian, I appoint MARY ANN WERTZ-METCALF
as Guardian.
FIFTH: The interests of the beneficiaries hereunder shall not be subject to
anticipation or to voluntary or involuntary alienation.
SIXTH: My Executors and Guardians shall have the following powers in addition
to those vested in them by law and by other provisions of my Will applicable to all property, whether
principal or income, including property held for minors, exercisable without court approval, and
effective until actual distribution of all property:
I. To retain any property which I may own at the time of my death or which
may at any time be in their hands, or to exchange or otherwise dispose of any such property, at public
or
or private sale, without application to Court, on any terms, including the extension of credit, which
they deem advisable.
2. To acquire, by purchase or otherwis,e, any property, real or personal,
without being limited by any provision of law which restricts investments by fiduciaries and without
regard to any principles of diversification, including but not limited to common and preferred stocks,
bonds, mutual funds, common trust funds, secured and unsecured obligations, and mortgages.
3. To acquire and pay for, exercise, or sell any options or subscription rights
in connection with securities or any other property.
2
4. To hold securities in the names of nominees or in bearer form.
5. To operate, repair, alter, improve, insure, grant options upon, mortgage,
partition, or lease for any period of time any real property or interest in real property which at any
time forms part of my estate or of any Trust herein created.
6. To retain and pay, as an expense of administration, accountants, attorneys,
bookkeepers, investment advisors, stenographers, and other assistants.
7. To borrow money from any source and for any purpose, including but not
limited to the payment of taxes, and to pledge or mortgage any assets of my estate as security for
money borrowed.
8. To pay any gift and to make distributions of my estate in cash or in kind,
or partly in each, and to a\1ocate property to any gift other than ratably.
10. To determine whether to claim deductions available to me or to my estate
on estate tax or on income tax returns, and to determine whether to use date of death or alternate
valuation date values for estate tax purposes, in such manner as she considers advisable and with or
.
without making any adjustment between income or principal or among beneficiaries due to any such
determination, as they, in their discretion, decide.
SEVENTH: I appoint JOHN T. WERTZ, Executor of this my Last Will. Should
the said JOHN T. WERTZ fail to qualifY or cease to act as Executor, I appoint MARY ANN
WERTZ-METCALF, Executrix of this my Last Will.
3
...
EIGHTH: I direct that my Executor and their successor shall not be required to give
bond for the faithful performance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand this ~ (j day of
~ 'JI,'-Q _ ,1995.
....
4
..
The preceding instrument consisting of this and four (4) other typewritten pages, each
identified by the signature of the Testator, DOROTHY A. WERTZ, was on the day and date thereof
signed, published and declared by DOROTHY A. WERTZ the Testator therein named, as and for
her Last Will, who, at her request, in her presence, and in the presence of each other have subscribed
our names as witnesses hereto.
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NAME /
Luh2t~ 04,
ADDRESS f
~tLLf\.4-~hl'll I ~ .,\tYJ
NAME('\
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( ADDRESS
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...
COl\tIMONWEAL TH OF PENNSYLVANIA:
SS.
COUNTY OF CHESTER
WE, DOROTHY A, WERTZ, JlJ1l/.hfC, A-\~\hS ,Jkkl)'<1 t. ~l'LrVIld~~t1
and i . C. '~u.' . . . ,Jhe Testatrix and the witnesses, respectively, whose names are
signed to the 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, andthat each of the witnesses, in the presence and hearing of the Testatrix, signed
the Will as witnesses and that to the best of their knowledge the Testatrix was at that time eighteen
(18) years of age or older, of sound mind and under no constraint or undue influence.
... ...
~\) tt LV,;2. ,,:J(}nIu Cl60\
-
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6
..
.'
Sworn, subscribed to and acknowledged before me by DOROTHY A. WERTZ and
J)a-t."J n L.
subscribed and sworn to before me by the witnesses, Mt'LYi Q, A-H~;", c;
r' ' l( -)' tJ- t1-. J
2:::> 1t.v\f\lA:-l (~6 1'1 , and I (j.( ,\,., , (, ,W.vt l~s ~ day of \., "'-It\'';''
~Zz ,- . 1/~Y1\
i/ _/ ..-; .;, / ,/ )
:L t'u t?:/it I {.<./~.o~
NOT AR Y PUBLIC
~ --.
f\\uL1(i~;~1 ~~(:;<~~j
Melin::b T )' l\k!:lr\! Public
\N~~:/L, Ch~:::~~ i.'~)r ,COiJnty
My' t'()llHnIi3c~l()n IViarcil 'I, 199f,)
l\:I;~~r;;So~::'~;;~;'I;';~~;i~":,J~\';;;;~';~~~~~,~::~~;jE7ti~~:~:-on~oi;~3s
":.
7
, 1995.