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HomeMy WebLinkAbout08-23-06 REV-1500 EX (6-00) OFFICIAL USE ONLY COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG. PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ~L COUNTY CODE ~L OO~___ YEAR NUMBER I- Z W C W U W C DECEDENTS NAME (LAST. FIRST. AND MIDDLE INITIAL) Dietz John DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 12/27/2005 1/31/1912 (IF APPLlC.A,BLE) SURVIVING SPOUSE'S NAME (LAST. FIRST, AND MIDDLE INITIAL) R SOCIAL SECURITY NUMBER 217-12-9564 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER W I- ~~cn Ull::~ wll.U :z:OO Ull::....I ll.lD ll. <( W1 04 W 6. 09 Original Return Limited Estate Decedent Died Testate (Attach copy of Will) o 2. Supplemental Return o 4a. Future Interest Compromise (date of death aHer 12-12-82) o o o 3. Remainder Return (date of death prior to 12-13-82) ~ 5. Federal Estate Tax Return Required Litigation Proceeds Received 7. Decedent Maintained a Living Trust (Attach copy ofTrust) L 8. Total Number of Safe Deposit Boxes 10. Spousal Poverty Credit (date 01 dealn belween 12-31-91 ard H-95) 0 11. Election to tax under Sec. 9113(A) (Allacn Sen 0) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS I- :z LU a :z o Cl. en LU 0:: 0:: o (,) Stanley A. Smith, Esquire FIRM NAME (If Applicable) One South Market Square RHOADS & SINON LLP TELEPHONE NUMBER 717-233-5731 P. O. Box 1146 Harrisburg, PA 17108 3. Closely Held Corporation. Partnership or Sole-Proprietorship (3) 4. Mort(lages & Notes Receivable (Schedule D) (4) 5. Cash. Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) Z 6. Jointly Owned Property (Schedule F) (6) 0 CJ Separate Billing Requested i= <t ...J 7. Inter..Vivos Transfers & Miscellaneous Non-Probate Property (7) => (Schedule G or L) l- ii: 8. Total Gross Assets (total Lines 1-7) <t U W 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 0::: 10. Debts of Decedent. Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 283,250.00 1,017,969.49 0.00 OFFICIAL USE OijL Y 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 0.00 222,116.74 11,066.87 r'-...; 10,576.00 (8) 70,884.50 1,544,979.10 37,092.87 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) (12) 107,977.37 1,437,001.73 (11) (13) 50,000.00 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (14) 1,387,001. 73 15. Amount of Line 14 taxable at the spousal tax Z rate. or transfers under Sec. 9116 (a)(1.2) o ~ <( 16. Amount of Line 14 taxable at lineal rate I- ::l ~ 17. Amou nt of Line 14 taxable at sibling rate o U 18. Amount of Line 14 taxable at collateral rate >< ~ 19. Tal( Due 0.00 x .0 ~(15) x .0 ~(16) x .12 (17) x .15 (18) (19) 0.00 60,165.08 0.00 1,337,001. 73 0.00 50,000.00 7,500.00 67,665.08 1'3~ 20 . l:':.J CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 3W46451.000 ~ Decedent's Complete Address: S1REET ADDRESS 37 Kensin ton S are Cumberland County CI1Y Mechanicsbur STATE PA ZIP 17050- Tax Payments and Credits: 1. Tax DUEl (Page 1 Line 19) 2. Cred its/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 67,665.08 0.00 68,000.00 3,383.25 Total Credits (A + B + C) (2) 71,383.25 3. Interest/Penalty if applicable D. Interest E. Penalty 0.00 0.00 Total Interest/Penalty (0 + E) (3) 0.00 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) 3,718.17 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 A. Enter the interest on the tax due. (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check to: REGISTER 0.00 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred;. . . . . . . . . . . . . . . b. retain the right to designate who shall use the property transferred or its income; . c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . . d. receive the promise for life of either payments, benefits or care? . . . . . . . . . 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . ., D 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? [R] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. [i] D IF THE ANSWER TO ANY OF THE ABO TIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Yes [K] [K] D D D D Ul ~ No ug D SIGNATURE Q ~ preparer has any knowledge Harrisburg, PA ADDRESS PO Box 1146 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 99916 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net vaiue of transfers to or for the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (ii)] The statute does not 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 chiid 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 139116(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. 9 9116(a}(l)]. 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. 9 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 biood or adoption. 3W4646 1000 ATTACHMENT TO FORM REV-1500 Estate of: Date of Death: 88#: John R. Dietz 12/27/2005 217-12-9564 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. {:r j' / /' LJc.~",(~~)ci C (h r~ j~'+-L~ ^'-___ Eliz eth Ann Brown, Co-Executor COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE REV-1502 EX + (6-98) ESTATE OF FILE NUMBER John R Dil~tz 21 06 0016 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 NUMBER 1. 45% undivided interest in real property M14 Crystal Lake Blvd, Census Tract #1106, situate in Carbondale, Lackawanna County, PA, more particularly described at Deed Book 1420, page 502 (2 parcels: lot #1, 2, 9 & 13, 17, 18). Erected on this property is a seasonal cottage with limited facilities and amemi ties. Valued per attached appraisal. VALUE AT DATE OF DEATH 28,350.00 2 Condominium situate at 37 Kensington Square, Hampden To~mship, Cumberland County, mOl,e particularly described in Del~d dated August 31, 1994, and recorded in the Cumberland County Recorder of Deeds' Office at Record Book 00111, page 00126, et seg. Valued per sale price, see attached Settlement Sheet 254,900.00 TOTAL (Also enter on line 1, Recapitulation) $ 283,250.00 3W469S 1000 (If more space is needed, insert additional sheets of the same size) REV-1503 EX' (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE B STOCKS & BONDS FILE NUMBER John R Die:tz 21 06 0016 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1.800 Shares ABBOTT LABS CUSIP: 002824100 DESCRIPllON VALUE AT DATE OF DEATH 32,604.00 2 10,639.449 Shares ALLIANCEBERNSTEIN HIGH YIELD CL A SHS Mutual Fund CUSIP: 01860E106 62,134.38 3 3,284.799 Shares ALLIANCEBERSTEIN BD FD CORP BD PTFIJ A Mutual Fund CUSIP: 018528802 39,319.04 4 2,227.035 Shares ALLIANCEBERSTEIN BD FD CORP PTF B Mutual Fund CUSIP: 018528885 26,613.07 5 15,000 Par AMBlRIDGE BORO PA WTR AUTH WTR REV BDS Mat: 05/01/2006 4.3% Financial Tim'Bs Interactive Data CUSIP: 023339CZ5 Interest accrued to 12/27/2005 15,060.15 100.33 6 25,000 Par ARMSTRONG CNTY PA G.O.BDS Mat: 06/01/2009 4.6% Financial Times Interactive Data CUSIP: 042325CZ1 Interest accrued to 12/27/2005 25,737.50 83.06 7 700 Shares AT&T, INC. CUSIP: 00206R102 17,279.50 'Total from continuation schedules 799,038.46 3W4696 1.000 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 1,017,969.49 Estate of: John R Dietz 217-12-9564 Schedule B (Page 2) Item No. Description Value at Date of Death 8 Barclay Huntington Limited Partnership This is a quasi-publicly traded partnership. The Executors have no i.nformation on the partnership other than the fact that it is inactive and deemed to be wort:hless. This information was pro,\rided by the managing partner, Stanford Management Group. 0.00 9 6.333% ownership in Centerview Associates Limited Partnership This is a quasi-publicly traded limited partnership. DecE~dent I s ownership was valued per distribution of sale proceeds and expected payment from reserve. (See attached letter) 48,267.00 10 25,1000 Par COC;~LICO SCH DIST PA LANCASTER G.O. BDS Mat: 02/15/2010 4.625% Fin,ancial Times Interactive Data CUSIP: 191258JW3 Interest accrued to 12/27/2005 25,720.00 423.96 11 4,813.786 Shares EATON VANCE INVT TR PA LTD MUN A Mutual Fund CUSIP: 27826H578 49,389.44 12 4,411.044 Shares EATON VANCE MUNS TR PA MUN A Mutual Fund CUSIP: 27826L280 43,625.23 13 632 Shares HE\'ifLETT PACKARD CO COM CUSIP: 428236103 Dividend accrued on 12/27/2005 18,245.84 50.56 14 80 Shares HOSPIRA INC COM CUSIP: 441060100 3,505.60 Total (Carry forward to main schedule) 189,227.63 Estate of: John R Dietz 217-12-9564 Schedule B (Page 3) Item No. Description Value at Date of Death 15 2,000 Shares MORGAN STANLEY EMER MKTS DEBT COM CUSIP: 61744H105 Dividend accrued on 12/27/2005 20,610.00 768.20 16 1,200 Shares MUNI:VEST FD II INC COM CUSIP: 62629P105 Dividend accrued on 12/27/2005 19,194.00 110.40 17 1,000 Shares MUNIYIELD QUALITY FD II COM CUSIP: 62630T104 Dividend accrued on 12/27/2005 12,495.00 67.00 18 2,666 Shares NUVI~EN MUNICIPAL VALUE FUND, INC. CUSIP: 670928100 Dividend accrued on 12/27/2005 25,806.88 168.75 19 600 Shares PFI:?;ER INC COM CUSIP: 717081103 14,289.00 20 15,1000 Par PLEASANT VY PA SCH DIST G 0 BDS Mat: 03/15/2007 3% Financial Times Interactive Data CUSIP: 728776NX9 Interest accrued to 12/27/2005 14,919.75 127.50 21 3,742 Shares PNC Financial Services Group, Inc. CUSIP: 693475105 238,365.40 22 5,000 Shares RITE AID CORP COM CUSIP: 767754104 17,525.00 23 10,000 Par US Savings Bond SER EE, issue date 9/1/1992, CUSIP, @105.76 CUSIP: 912540GJ4 10,576.00 24 10,000 Par US Savings Bond SER EE dated 1/1/1993, CUSIP 912540GN5, @103.68 CUSIP: 912540GN5 10,368.00 Total (Carry forward to main schedule) 385,390.88 Estate of: John R Dietz 217-12-9564 Schedule B (Page 4) Item No. Description Value at Date of Death 25 10,000 Par US Savings Bond SER EE dated 1/1/1993, CUSIP 912540GN5, @103.68 CUSIP: 912540GN5 10,368.00 26 10,000 Par US Savings Bond SER EE dated 1/1/1993, CUSIP 912540GN5, @103.68 CUSIP: 912540GN5 10,368.00 27 8,014.449 Shares VAN KAMPEN TAX EXEMPT TR HI YLD MUN PT B Mutual Fund CUSIP: 92113R200 87,437.64 28 3,952.96 Shares VAN KAMPEN TAX FREE INCOME FD INTR MUN INCMA Mutual Fund CUSIP: 920940301 42,138.55 29 70,000 Par WES~~ SHORE PA AREA HOSP AUTH H REV BDS Mat: 01/01/2017 5.65% Financial Times Interactive Data CUSIP: 955817CM1 Interest accrued to 12/27/2005 72,174.20 1,933.56 Total (Carry forward to main schedule) 224,419.95 REV-150B EX + (6-9B) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ~:ESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF John R Dietz FILE NUMBER 21 06 0016 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 VALUE AT DATE OF DEATH 1 2001 Cadillac DeVille Sedan automobile Valued per sale price 12,700.00 2 1991 EZ Loader Trailer and 18' EBT'ide boat w/3. 0 mercury motor 3,000.00 3 PNC Bank Checking Acct. #5140079809 Interest accrued to 12/27/2005 28,674.92 1. 79 4 MeJ:.ril1 Lynch MM Acct. #569-23337 139,457.99 5 MeJ::rill Lynch Bank USA MM, Acct. #569-23338 33,441.66 6 Refund, AARP Healthcare 313.00 7 Refund, Comcast 4.41 8 Re1:und, Journal Publications 48.71 9 Refund, National Geographic 28.33 10 Rej:und, Newsweek 19.45 11 Rej:und, WSJ 154.78 12 Refund, Wyoming Wildlife 30.00 13 Return of prepaid taxes on sale of residence 653.70 14 Household and personal articles Valued per attached appraisal 3,588.00 3W46AO 1000 TOTAL (Also enter on line 5 Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 222,116.74 REV-1509 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERIT,oNCE TAX RETURN RESIDENT DECEDENT ESTATE OF John R DiE~tz SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER 2106 0016 If an aS~iet was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINTTENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Brown, Elizabeth Ann 1650 Mudlick Road, Julian, PA 16844 Daughter B. Dietz, Robert J 740 Brentwater Road, Camp Hill, PA 17011 Son c. Leister, Anne (See contination page) JOINTLY-OWNED PROPERTY: ITEM NUMBER lEfTEH FOR JOINT TENAl\rr DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE /'-1I\ME OF FINANCIAL INSTITUTION AND BANK ACCOUNT N....M&R OR Sf MILAR IDENTIFYING NUMBER ATTACH DEED FOR JOINTLY.HELD REAL ESTATE DATE OF DEATH VALUE OF ASSET %OF DECO'S INTEREST DATE OF DEATH VALUE OF DECEDENTS INTEREST 1. A. 1 C 12/2/1992 PNC Bank Savings Acct. #5130135598 Interest accrued to 12/27/2005 1,991.27 50.0000 995.64 0.45 50.0003 0.23 2 A 10/31/1986 8,500 Par US Savings Bonds, Series EE, joint with daughter, Elizabeth Ann Brown, valued per attached schedule. Decedent provided the funds for purchase of these bonds. 12,682.00 50.0000 6,341.00 3 B 10/31/1986 5,000 Par US Savings Bonds, Series EE, joint with son, Robert J. Dietz, valued per attached schedule. Decedent provided the funds for purchase of these bonds. 7,460.00 50.0000 3,730.00 3W46AE 1.000 TOTAL (Also enter on line 6 Recanitulation\ $ (If more space is needed, insert additional sheets of the same size) 11,066.87 Estate of: John R Dietz 217-12-9564 Schedule F Part 1 (Page 2) Name Address Relation C Leister, Anne 82 Trotting Hill Lane, Bluff ton, SC 29910 Step-grandchild REV-1510 EX + (6-98) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF John R Di.etz FILE NUMBER 21 06 0016 ITEM NUMBEF 1, 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. DESCRIPTION OF PROPERTY INCLUJE TI-E NAJvlE OF T1-E TRA.NSFEREE, THEIR RELATIONSHIP TO DECEDENT AND TrE CATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION (IF APPliCABLE) TAXABLE VALUE Gift Annuity Agreement with the Catholic Diocese dated 10/18/1988, original value $56,399.50. Dece,dent was the sole annuitant unde,r this agreement. No beneifit was payable at decedent's death to decedent's estaLte or to any other beneficiary. 0.00100.0000 0.00 0.00 2 Gift Annuity Agreement with the Catholic Diocese dated 01/10/1990, original value $50,058.33. DecE!dent was the sole annuitant under this agreement. No benefit was payable at decedent's death to decedent's estate or to any other bem!ficiary . 0.00100.0000 0.00 0.00 3 One-Life Gift Annuity Agreement with Drexel University dated 05/31/1995, original value $27,000. Dec,edent was the sole annuitant und,er this agreement. No benefit was payable at decedent's death to decedent's estate or to any other beneficiary. 0.00100.0000 0.00 0.00 4 Gift Annuity Agreement with Holy Spirit Hospital dated 6/24/1988, original value $79,053. Decedent was the sole annuitant under this Agreement. No benefit was payable at decedent's death to decedent's est.ate or to any other beneficiary. 0.00100.0000 0.00 0.00 Total from continuation sched les . 10,576.00 TOTAL (Also enter on line 7. Recapitulation) $ 10,576.00 (If more space is needed, insert additional sheets of the same size) 3W46AF 1.000 Estate of: John R Dietz Schedule G (Page 2) Item No. Description DOD Value of Asset % Interest 5 Gift Annuity Agreement with Holy Spirit Hospital dated 1/6/1989, original value $40,086.14. Decedent was the sole annuitant under this agreement. No benefit is due at decedent's death to decedent's estate or to any other beneficiary. Decedent was the sole annuitant under this agreement. The entire balance at death passed to Holy Spirit Hospital 0.00 100.0000 6 10,000 Par US Savings Bond, Series EE, titled in the name of decedent, Payable On Death to decedent's daughter, Elizabeth Ann Brown. 10,576.00 100.0000 Total (Carry forward to main schedule) Exclusion 0.00 0.00 217-12-9564 Taxable Value 0.00 10,576.00 10,576.00 REV-1511 EX + (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF John R Dietz FilE NUMBER 21 06 0016 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. iJDK Catering, Inc. l!'uneral luncheon 693.56 Total from continuation schedules . 16,074.12 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees 29,500.00 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 1,030.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Abstract Enterprises, title search, Crystal Lake property 85.00 2 AT&T, service to residence 100.62 Total from continuation schedules . 23,401. 20 3W46AG 1.000 TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) $ 70,884.50 Estate of: John R Dietz Item No. 2 3 217-12-9564 Schedule H Part 1 (Page 2) Description Amount l~yers-Harner Funeral Home, Inc., :Euneral and burial services 11,139.00 West Shore Country Club Balance due, including funeral :t"eception 4,935.12 Total (Carry forward to main schedule) 16,074.12 Estate of: John R Dietz 217-12-9564 Schedule H Part 7 (Page 2) 3 Hampden Township, sewer/trash 248.00 4 Hobbie Auctions Appraisal of household and personal articles 375.00 5 KSCA (condo fee) 207.63 6 ]~arie Huber, tax collector, Hampden Township 538.47 7 Merrill Lynch, CMA fee 125.00 8 PAWC, service to residence 75.72 9 PNC Bank, checking account charges 80.23 10 PNC Bank, estate account checks 56.52 11 PNC Bank, safe deposit box rental 105.00 12 PP&L, service to residence 1,004.66 13 R. Wm. Wire Associates, PC, preparation of decedent's final income tax returns 785.00 14 Rhoads & Sinon LLP Reimbursement for out-of-pocket expenses and reserve for final expenses 500.00 15 RSR Appraisers & Analysts, appraisal of condominium 350.00 16 Ruddy Realty, appraisal of Crystal lake property 275.00 17 Seller's settlement charges on sale of residence 18,413.00 18 The Patriot News Company, advertising Grant of Letters Testamentary 168.75 19 Verizon, service to residence 93.22 Total (Carry forward to main schedule) 23,401. 20 REV-1512 EX + (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF John R Dietz SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21 06 0016 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including un reimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. PNC Checking Account, direct pa~nents, deductions and checks clearing after death 18,548.80 2 Direct pa~ents from decedent's checking account posted after death: AARP Health Care, 156.00; Hampden Township, utility bill, 124.00; PAWC, 35.21 315.71 3 Drexel University, balance due on pledge 10,000.00 4 PA Department of Revenue, 2005 PA income tax due, PA 40 9.00 5 PNC Bank, Bankcard Services Balance due 3,035.98 6 T-Mobile, final bill 12.38 7 The New York Times, balance due 4.50 8 US Treasury, 2005 Federal income ta:x:, 1040 4,451.00 9 West Shore Country Club, final bil.l, flowers 715.50 3W46AH 2.000 TOTAL (Also enter on line 10. Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 37,092.87 REV-1513 EX+ (9-CO) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF John R Dietz NUMBER I 1 NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Elizabeth Ann Brown 1650 Mudlick Road ;rulian, PA 16844 22.5% interest real property, :14 , 175 . 00 in Crystal Lake Schedule A, RELATIONSHIP TO DECEDENT Do Not List Trustee(s) FILE NUMBER 21 06 0016 AMOUNT OR SHARE OF ESTATE Daughter 674,596.43 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 8,500 Par US Savings Bonds, Series :fi:E, Schedule F Inventory Value: 6,341.00 10,000 Par US Savings Bond, Series EE, Schedule G Inventory Value: 10,576.00 50% of Residue: 643,504.43 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 Good Shepherd Catholic Church 3435 Trindle Road Camp Hill, PA 17011 3W46All000 Cash bequest, Item Six of Will TOTAL OF PART 11- 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) 25,000.00 $ 50,000.00 Estate of: John R Dietz 217-12-9564 Schedule J Part 1 (Page 2) Item No. Description Relation Amount 2 Robert J. Dietz 740 Brentwater Road Camp Hill, PA 17011 22.5% interest in Crystal Lake real property, Schedule A, :L4, 175.00 5,000 Par US Savings Bonds, Series EE, Schedule F Inventory Value: 3,730.00 50% of Residue: 643,504.43 Son 661,409.43 3 .lume Leister 82 Trotting Hill Lane Bluff ton, SC 29910 PNC Bank Savings Acct. #5130135598 Inventory Value: 995.64 Accrued: 0.22 Step-grandchild 995.87 4 Jean R. McGowan 205 E. Marble Street Mechanicsburg, PA 17055 Cash bequest, Item Four of Will None 50,000.00 Estate of: John R Dietz 217-12-9564 Schedule J Part 2 (Page 2) Item No. Description Amount 2 Holy Spirit Hospital North 21st Street Camp Hill, PA 17011 Cash bequest, Item Five of Will 25,000.00 3 ESTATE OF JOHNR. DIETZ SSN: 217-12-9564 DOD: 12/27/2005 PENNSYLVANIA INHERITANCE TAX INDEX TO EXHffiITS Document 1. Last Will and Testament 2. Appraisal of Crystal Lake property, Lackawanna County, P A 3. Settlement sheet for sale of residence, 37 Kensington Square, Hampden Township, Cumberland County, P A 4. Letter relating to Centerview Associates Limited Partnership .- ). Appraisal, household and personal articles 6. Valuations of EE bonds 7. Copies of annuity agreements Return Reference Page 1, line 6 Schedule A, Item 1 Schedule A, Item 2 Schedule B, Item 9 Schedule E, Item 14 Schedule F Items 2 and 3 Schedule G, Item 6 Schedule G, Items 1 thru 5 ~ LAST WILL AND TESTAMENT OF JOHN R. DIETZ BE IT REMEMBERED, That I, JOHN R. DIETZ, of Mechanicsburg in the County of Cumberland, State of Pennsylvania, being of sound mind, memory and understand do make and publish this my Last Will and Testa- ment, hereby revoking and making void all former Wills and Codicils by me at any time heretofore made. And First, I direct that my funeral be conducted in a manner corresponding with my estate and situation in life, and that all my just debts and funeral expenses be paid as soon as possible after my de!cease. And to such estate as it has pleased Almighty God to entrust to mE~, I di s-~o.~e of the same in the following manner: ITEM ONE: I direct that all inheritance, estate and death taxes due by reason of my death be paid by my Executor out of my residuary estatem as an expense of administration of my estate. ITEM TWO: I hereby exercise all powers of appointment which I may have at the time of my death, and all property subject to such powers shall be included in my estate and be governed by the provisions of this Will, except any Power of appointment given to me in any instrument executed by my wife, Elizabeth Dietz. ITEM THREE: I give and devise my interest in the original Dietz cottage at Crystal Lake, Fell Township, Lackawanna County, pennylvania, to my issue then living, per stirpes. ITEM FOUR: I give and bequeath the sum of FIFTY THOUSAND DOLLARS ($50,000.00) to Mrs. Jean R. McGowan, East Marble Street, Mechanicsburg, Pennsylvania, if she survives me. ITEM FIVE: I give and bequeath the sum of TWENTY-FIVE THOUSAND DOLLARS ($25,000.00) to Holy Spirit Hospital, East Pennsboro Township, Cumberland Township, Pennsylvania, of which I am a member of the Board of Managers. ITEM SIX: I give and bequeath the sum of TWENTY-FIVE THOUSAND DOLLARS ~25,000.OO) to the Church of the Good Shepherd, Camp Hill, Penn- sylvaria, of which I am a member. ITEM SEVEN: If my wife, Elizabeth Dietz, survives me, I give and bequeath to her the sum of TWO HUNDRED THOUSAND DOLLARS ($200,000.00). ITEM EIGHT: All the rest, residue and remainder of my property, real, personal and mixed, wheresoever situate, not disposed of in the preceding portions of this Will, I give, devise and bequeath as follows: ~ ONE-HALF (~) thereof to my son, Robert J. Dietz, ab- sOlutE!ly and forever, if he survives me. If my said son predeceases me, I give and bequeath One Quarter (~) of his share to his wife, if in the sole judgment of my Executor she was at the time of my son's death, liv-. ing with him as his wife; the remaining Three-Fourths (3/4), or, if my son's wife is nc,t living at the time of my death, or is not entitled to receive the aforesaid One-Quart.er (~) share as set forth above, then the whole share shall go to my son's then liviing issue, per stirpes. 1]1 The remaining ONE-HALF (~) thereof to my daughter, Elizabeth Ann Brown, if she is living at the time of my death. If my said daughter is not then living, One-Half (~) of her share shall go to her husband, if in the sole judgment of my Executor he was, at the timE! of my daughter's death, living with her as her husband; the other One-"Half (~), or if said husband is not living at the ~ime of my death, or is not entitled to receive a one-ahlf share as set forth herein, the whole share shall go to my daughter's then living issue, per stirpes. If at the time of my decease, my son or my daughter, shall have predeceased me, as the case may be, and has no spouse or issue entitled to share in his or her share, then the entire share of the deceased son or daughter, as the case may be, shall go to the surviving son or daugh- ter. If at the time of my death, none of the foregoing beneficiaries is living or entitled to receive any of said assets, then all of said assets shall be distributed as follows: ill 40% thereof to the Holy Spirit Hospita"l, East Penns- bora Township, Cumberland County, Pennsylvania, of-which I am a member of the Board of Managers; ill 40% thereof to the Church of The Good Shepherd. Camp Hill, Pennsylvania, of which I am a member; 111 20% thereof to my Alma Mater, Drexel University, Philadelphia, Pennsylvania, of which I am a Trustee. ITEM NINE: I direct that my personal representatives herein named be permitted to qualify and serve without Bond regardless of place of residence at the time of my death. ITEM TEN: I nominate, constitute and appoint my son, Robert J. Dietz, and my daughter* Elizabeth Ann Brown, or the survivor of them~ Co-Executors of this my L~st will. If, for any reason, both of them should fail or cease to act, PNC Bank, Inc., New Cumberland, pennsyl- vania, as substituted Executor. All references in this Will to my Executor shall refer to my Co-Executors, successor Executrix or executor as the case may be. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this /.3!J, day of JtffJ(! , 2002. (SEAL) Signed, sealed, published and declared by the above named Testator, as and and for His Last Will and Testament, in the pre- sence of us, who have subscribed our names at his request as Wit- nesses thereto, in the presence of the said Testator, and of each 940 gre",I"Vt::'M ~~ef2 Gn1~ ~/i ~A.. /'/011 , 6"!3IoL 110 O/~k ~ [/Mfr" Ihu.... ~ /7/J/ THE VALUATION OF THE CRYSTAL LAKE, LACKAWANNA COUNTY, PA REAL PROPERTY IS BASED UPON THE FOLLOWING APPRAISAL OF THE ENTIRE PROPERTY ($63,000) MULTIPLIED BY DECEDENT'S INTEREST IN THE PROPERTY (45%). $63,000 x .45 = $28,350. ~ RUDDY REALTY 25 N. Main Street, Carbondaie, PA 18407 (570) 282-4463 Fax (570) 282-4389 February 24, 2006 SUBJECT PROPERTY: John Dietz Estate M14 Crystal Lake Blvd. Carbondale, Pa 18407 Lackawanna County REQUESTED BY: Rhoads and Sinon L.L.P. JoAnn Seker, Paralegal for Stanley A. Smith One South Market Square POBox 1146 Harrisburg, Pa 17108-1146 (717) 237-6705 .This is a restricted appraisal report of a Limited appraisal. This report is made based on instructions received from the client The appraiser has established that the client understands the limited utility of this restricted appraisal report and has established that.a restricted appraisal report is suitable for their intended use.. Respectfully, ~y~ Appraiser MEMBER: National Assn. of Realtors Pennsylvania Assn. of Realtors Greater Scranton Board of Realtors Greater Scranton Multi List Service ~RUDDY REALTY 25 N. Main Street, Carbondale, PA 18407 (570) 282-4463 Fax (570) 282-4389 JOHN DIETZ ESTATE M14 CRYSTAL LAKE BLVD CARBONDALE, P A 18407 LACKA W ANNA COUNTY DOD: DECEMBER 27,2005 The purpose of this appraisal is to estimate the Market Value of the above referenced property as of December 27, 2005. Based 'on a property inspection and study thereafter it is my opinion that the Fair Market Value being Fee Simple Interest ofM14 Crystal Lake Blvd. Carbondale, Pa is: *$63,000.00* (SIXTY THREE THOUSAND DOLLARS) ~1?" fY)A Thomas J. ~O Appraiser --- - - -- - -- - --r--"/ Scranton Tax Information Map': 01501010014 Muni Code: 74 Ward: 01 Block: 0040 Lot': 0300 Parcel: 00000 Owner..N_: BOMMER MARY & CHAGNON Land Value: 500 Imp Value: 3500 BRITA Owner 2027 KRIEBEL RD Owner LANSDALE Location: CRYSTAL Address: CltylStatelZlp: PA 19446 LAKE Total 4000 Dimensions: 47X75X47X75 exempt Code: Valuation: Deed Book: 1420 Deed Page: 0502 Date Acquired: 04/0211992 Dwelling Type: R02 Consideration: Subdivision Name: Last Action 03130/93 Date: http://www.scrantonpamls.com/cgi-scr/SD _ disp?funcXXl I=tx _ tax&dispXX2I=2&TX_ L... 2/1 0/2006 Property Address: M14 Crystal Lake Blvd. Census Tract: 11 6 City: Carbondale County:Lackawann~tate:~ZipCode: 18407 Legal Description:Deed: 1420 Paqe: 502/2 parcels: lot#1 ,2,9 & 13,17,18 ~r I Occupant: Vacant/Seasonal Map Referencel501-1-14 Sale-Price:.S- NA Date of Sale: NA Loan Charges I conc~ssions to be paid by Seller: NA Real Estate Taxes: :1>755.52 Tax Year: :WUb ~/Client: Attorn~Stanley A. Smith o Urban ~ Suburban 0 Rural D Leasehold D Condominium (HUDN A) D De Minimis POO NEIGHBORHOOD ANALYSIS Good Avg. Fair Poor Employment Stability D Q9 D D CAnvmimce of Empmymmt D D [XJ D o Under 25% Convmimce of Shopping D D [XJ D Coovenience of Schools D D [X] D Adequacy of Public Transportation D D 00 D Recreation Facilities [XJ D D D Property Compatibility D [Xl D D Protection from Detrimental Condition D []g D D o In Balance 0 Over Supply Police and Fire Protection D Q9 0 D Gmenll Appearance of Properties D Q9 0 D MARKETING TIME 0 Under 3 Mos. :r9 3-6 Mos. 0 Over 6 Mos. Appeal to Marl<et [XJ D 0 0 PRESENT LAND USE % LAND USE CHANGE PREDOMINANT SINGLE FAMILY HOUSING Single Family gO ~ Not likely OCCUPANCY PRICE AGE 2-4 Family 2 0 Likely ~ Owner $ Yrs. Multi-Family 0 Tenant 35 LOW 1 / 8 Din Process Commercial rec To: 0 Vacant (0 - 5%) 375 mGH 90 Industrial jU ~ Vacant (Over 52:0)1 Predominant Vacant 190 50 Note: Race or the racial composition of the neighborhood are not considered reliable appraisal factors: COMMENTS: Nice lake communi t wi th seasonal and year round use. Diversified residential homes (sizes, styles, prlces All nei hborhood factors affecting marketability are Dimensions 4. x Site Area 7125 sq. ft. Zoning Classification Residential HIGHEST & BEST USE: Present Use Yes HOA $1 Mo.: --- DOver 75% ~ 25-75% o Rapid o Stable ~Slow [Jl: Increasing o Stable o Declining ~ Shortage Public [X] D Water D Sanitary Sewer 0 Storm Sewer 0 Other Site Improvements Type Street Macadum Curb I Gutter None Sidewalk None Street Lights None Alley None Public [XI D o D D Private o D o o o good. Topography Level Sae Narrow-small Shape Rectangluar Drainage Appears adaquate View Good-Lake Landscaping Fair Driveway None Apparent Easements FEMA Flood Hazard FEMA * Map I Zone None Yes* _No~ Corner Lot No Zoning Compliance Yes Other Use No Sespool COMMENTS (Apparent adverse easements, encroachments, special assessments, slide areas, etc. There are 2 descriptions on the deed making up the 1 parcel. Lot and lots 13,17,18 - 47.5 x 75 for a total lot dlmenslon GENERAL DESCRIPTION EXTERIOR DESCRIPTION FOUNDATION BASEMENT Units 1 Foundation Piers Slab Area Sq. R~ Stories 2 Exterior Walls vinyl Crawl Space Plers % Finished 0 Type (Det.! Att) Det. Roof Surface A-S Basement ---- Ceiling--=:-- Design 2 story Gutters & Dnspts. Alum Sump Pump ---- Walls --- Existing Yes Window Type Wood Dampness --yes- Floor Proposed No Storm Sash Wood Settlement Yes Outside Entry Under Const No Screens Yes InfestationNone Vis - Age- Years 80 Manuf. Home No Other ---- Effective Age (Yrs. 70 Other ROOMS Foyer Living Dining Kitchen Den Fam Rm Rec Rm Bed Baths Laun Basement Level I Level 2 ) : IakE fnnt oro::erty. 47. 1,2,9 = tf7.'5 x75 of 47.5xI50. INSULATION Roof Ceiling Walls Boor None unknown Adequacy Poor Energy Efficient Items: fnnt. o o o o o o Other Area SF o 616 616 ---L. ~ -----L- 2- ~ Finished area above grade contains: SURFACES Mat I Cond Floors VW/fair Walls~ Trim! Finish W:xx:l/Fair Bath Floor Lin::l1iun/Fair Bath Wainscot Wa11b:ard Doors w:xxiIFair 8 Rooms Bedrooms 1 KITCHEN EQUIP. ATTIC Refrigerator lXJ None D Range I Oven IKJ Stairs D Disposal D Drop Stair D Dishwasher 0 Scuttle rn Fan I Hood 0 Boor D Compactor D Heated 0 Wash! Dryer D Finished D Microwave 0 D Intercom D D Attached D DetachedO Built-In 0 Adequate Iuadequate Electric Door 0' o o House Entry D Outside Entry 0 Basemmt EntryD Baths 1232 SF of Gross Living Area IMPROVEMENT ANALYSIS ~ ~~P~ Quality of Construction L-...J L-1 L.A..J L-..J Condition oflmprovements D CJ rn D Room Sizes! Layout 0 0 [X] D Oosets and Storage D 0 D [1D Energy Eflicimcy D 0 []g D PIumb.(Adequacy&Cond.) D D 0 IX] Elect. (Adequacy & Cond.) 0 0 [X] D KilCab(Adequacy&Cond.)D D D [XJ Compatible to Neighborhood 0 0 [Xl 0 Appeal & Marketability D [XJ 0 D Est Remaining Economic Life 15 Est Remaining Physical Life 2J Fire lace(s}:rt:.crE # 1 CAR STORAGE: No. Cars _Garage 0 Cond Carport 0 None 00 ADDITIONAL COMMENTS: Seasonal cottaqe. No basement, infqfTiripn~ p'p~trio heat water source is from lake or another landowners well. HEATING Type Ela::t Fuel Ele:tricity Condition ~ Adequacy _ COOLING NA Central Other Condition Adequacy _ only, ......--... ~ ;:.tc:l...~~,~ ...-- '--........... . ii -----7'o.l .. o O- J> @ .... 02102106 -BHOADS&SINON LLP F'v 717 232 1459 _____ 15:21 ~.__ I4i 005 - .. c. 1---.----- ~ 31j x 1/1/" .. ,~ .11 .37 J.' ----"1 ~~ J '" '? 1. :.- '< ~.~ .~~ 1'\ Cl 75' ; I" C. /1". 17~.r 17 ~ '< ,,> ...., ~ 1J J .co.GIIJ ~.Ja:!I2:~__'.":: 4(, _, P ~4Z 'I~ .;Ill 3~ ....f. .:J.s' ""~. -'" l8 ~ - .Y!) ?J~~ .~ . /'1IU U 1ifl .?~~ . T~I\C<:o uu,,~ 1011' 15H $ If, ..1 L1~ ~ 14. 15 1 ..Il~f." 10 1J-,~ ~,,,,,, ,~.~. .j !J. .> " . <:.1 c" TI :~ ~ ~I ' 12. i,j t.- 19'-(,: I 'Ii) i:, I ~ ~l I ~: 7 IS I 11 'i'~ ..L-_. ~l I ;130'-(J" -.--.-- .-. ---'<;:r :-71 -'-;;. 00' yY . -? ,.;i ~ --.--~:'S"-=--.- ~. - ~ . 7 of' -=-'=2:::..:.~=::::~_,," .......'- .~ 2' ;. ~'<' ~~'\" ~\~- -- .</r;"~:7~":h",.lIbki c '( ':\ ~1 a.. l.ll." . If,- " -,rJI7-~ ~~'~/~. "'v ..-.... -l"" { .t....\ l ''V( RHOADS&SINQN LLP _ 141004 02/02/06 15:21 FAX 717 232 1459 -' ~ NIP D.C. KENY.ON \-- S 19" W /55.0" I;::: 1'1 -.. '" ~ N/F LOllISE R. CAY C) C5 Cl:) -.. PARCEL TWO L IJ..J o i' t1) 2i3 ~ C) l.l.J I I TOWNSHIP ROAD (40. R/w:l POINT "AU POINr"S" . S/9"W" ~- (;7.5' - 33.0' 87.5' -;... -- I -- /00.5' ----~ P.O.S. ~I I . ~ CIl K . '6"~ ::::! ~U\ 01 ZO'Access cosemeflt ~~- . ~l \ ~~ I I I " ':'--II I PARCEL ~I ONE ~I I SI9"W-47.5, I P.O.B.I -- ..... I ~_J . ~ . <:;) N/F l{j ::::! I~ PERUCHI Q II I~ ~Il ::;, ~.:.: I~ r-..;'- '.' .~\ V) ~ ,91,,1'- 'i"S/1V r o G lI>% r>'l, :lJ-n 1 27.5' N/F JOHN R. DIETZ ,WIL.LIAM BERGEN I RITA FORTUNER BRITA CHAGNON MARY BOMMER :z o >- ....4 'w 2:"" Ii ci ~ C) ~ o .. -< CI .- f',. ts) CONe MON S !!3"W.47.5' en ~ . I ~I ~1 '.'- CRYSTAL LAKE LANDS OF J~HN'R.. DIETZ FELL TOWNSHIP. LAc!KAWANNA COUNTY, PA PREPARED JUNE,1992 SCALE: ,"= 40'. VRYSTAL LAKE first district ,.-' -- i . ,TOWNSI:UP .'~ I; _ - - . ,- ~. ) I .',:,i,:~-I I' 'I ~- "(== SIMPSON d '~I'.'= , f" ,li_ .~~ "xII -" -----j~ ./i :-':'<"f::.- ;,;~- ~',,:';tj"_ ,~- ReccJ )-14-'13 .. ;])0 IY20 r~" fCl So i ~ 1'101 DfE9-1ND. OR &1'-1 COPYIIGIlT 1NI"1V AU.-8TATI LEGAL SUPPLY CO. OHECOMMllICIE ORM!. CRANFORD N.J. 07011 -1 wlIta ilttb .Made tM second day of ninety-two (1992) April ~~ , i" tM year Ni-neteeft hundred a.nd fSetuJem WIlLIAM J. URGEN and EDITH C. BERGEN, his wife, of Tarpon Springs', Pinelles County, Florida, parties of the first part, hereinafter called the Grantors, AND MARY K. BOMMER, ,of Lansdale, Montgomery County, Ploonsylvania, and, BRITA CHAGNON, of Schenectady, Schenectady County, New York, parties of the second part, hereinafter called the Grantees, DIIit:nt.sllet1J, T1la.ti"~of the SUlll of One Dollar ($1.00) and natural love and affection - - . - - - - - - - - .iJ!IItD, i" ha.nd pa.id, tM -receipt WMreof iI hsreby a.c1mowledged. tM Ia.id gra.1Itors do hereby gra.nt a.nd c:cnwey to tM aa.id gra.1\ta s, their heira a.nd a&igna, ALL the right, title and interest of the Grantors hereinabove named. in and to all those certain lots, pieces or parcels of land situate, lying and being in the Township of Fell, County of Lackawanne and Commonwealth of Pennsylvania, more ~articularly bounded and described as follovs: BEGINNING at a point distant twenty-eight and three-tenths (28:3) feet on a course of South Seventy-one Degrees East (S nO E) from-the "High Water Mark" on the shore of Crystal'Lake; thence South Nineteen Degrees West (5 190 W) forty-seven and one-half (47 1/2) feet to corner of Bonnie Brae Avenue, on plot of lots hereinafter mentioned; thence along'the northerly line of said Avenue Soutb Seventy-one Degrees East (S 710 E) seventy-five (75) feet to corner of Lot Number Thirteen (13) on plot hereinafter mentioned; thence along the westerly line of said Lot Number Thirteen (13) North Nineteen Degrees East (N 190 E) forty-seven and one-half (47 1/2) feet to line of land now or formerly of D. C. Kenyon; thence along line of land now or late of the said Kenyon North Seventy-one Degrees West ,(N 710 10/) seventy;-five (75) feet to the place of beginning. BEING L~ts nuDberedOne (I), Two (2) and Nine (9) on plot of lots prepared by Andrew Mitchell, Jr., and to be duly recorded. BEING the same premises conveyed to Andrew Mitchell, Jr., by Andrew Mitchell, Sr., by ~ccc dat~d August 16, 1919, and recorded in T~ckawanna County Deed Book 284 at page 420. Together with the right-of-way as conveyed by D. C. Kenyon to Andrew Mitchell, Sr., by deed dated November 2, 1895, and recorded in Lackawanna County in Deed Book 137 at pllge 193. The above lots are conveyed subject to all reservations and conditiona as contained in prior deeds in the chain of title, it being further understood that the Grantees herein, their heirs and assigns, may use in common with other lot owners the strip of land between the said lots and the shore of Crystal Lake for parking purposes. ALSO BEING the same premises conveyed by Andrew Mitchell, Jr., to William Machell and John A. Dietz, as tenants in common, by deed dated the 26th day of February, 1921, and recorded in Lackawanns County in Deed Book 314 at page 242. The said William Machell subsequently died intestate, seized of an undivided one-half interest in and to the above described premises. By deed dated March 3, 1947, recorded on March 22, 1948, in Deed Book 479, page 567, the heirs at law and next of kin of William Machell and their respective spouses joined in a deed as Grantors with John A. BOOk Itl201:, SQZ. '.' Station: View9 - 02128/2006 3:22:49 PM LACKAWANNA COUNTY Ins\.# 199300710 - Paoe 2 I I I I L. t. Dietz, widower, conveying the premises hereinabove described to John R. Dietz, Walter Dietz, Mae Bergen and Rita McArdle, the Grantors rherein named being Albert Machell and Rachael ~chell, his wife, Raymond Machell and Anabell Machell, his wife, Clara Miller, unmarrieo,.Ruth Shea and Harold Shea, her husband, and Kathryn Wilson and Woodrow Wilson, her husband, being all of the heirs at law and next of kin of William Machell and their spouses, and John A. Dietz, widower, as hereinbefore referred to. Hae Bergen, one of the.Grantees named in the said deed, died testate on the fifth day of March, 1980, and under the terms of her Last Will and Testament, dated January IS, 1973, filed for probate on April 21, 1980, in the office of the Register of Wills of Lackawanna County to No. 410, Year 1980, recorded in Will Book 192, page 57, devised her entire estate, which included her one-fourth interest in the above described premises, to her husband, William J. Bergen, one of the Grantors herein. Walter Dietz, also one of the Grantees named in the deed of March 3, 1947 (Deed Book 479, page 567), hereinabove recited, died testate February 21, 1981, and under the .terms of his Last Will and Testament, filed for probate in Lackawaona County on April 3, 1981, to Estate No. 361, Year 1981, devised his entire estate, which included his one-fourth interest in the above described premises, to his nieces, Mary K. Bommer and MAry Brita Chagnon (a/k/a Brita Chagnon), Grantees herein named, in equal portions,share and share alike. AND ALSO, ALL the right, title and interest of the Grantors herein named in and to all those certain lots, pieces or parcels of land situate, lying and being in the. Township of Fell (erroneously referred. to as the Township of Fee in a prior conveyance), County of Lackawanna and Commonwealth of Pennsylvania, more particularly bounded and described as follows: BEGINNING at a point distant one hundred three and three-tenths (103.3) feet on a courae of. (South) Seventy-one Degrees East (S 110 E) from the "High Water Mark" on the shore of Crystal Lake; thence South Nineteen Degrees West (S 190 W) forty-seven.and.one-half (47 1/2) feet to Bonnie Brae Avenue on unrecorded plot of lots hereinafter mentioned; thence along the northerly line of said Avenue.South Seventy-one.Degrees Esst (S 710 E) seventy-five (75) feet to a point on the westerly line of the Township Road (40 feet wide); thence along the westerly line of said Township Road North Nineteen Degrees East (N 190 E) forty-seven and one-hslf (47 1/2) feet to a point at line of land now or formerly of D. C. Kenyon; thence along line of land now or late of the said D. C. Kenyon North Seventy-one Degrees West (N 710 W) Beventy~five (75) feet to a point, the point and place of beginning. BEING Lots numbered 13, 17 and 18 on an unrecorded Plan of Lots prepared by A. Hitchell, Jr., in 1918. C".) f5 E: ~ x Q '" -. BEING part of the same premises which Northeastern.National Bank and Trust Company, et sl., by their deed dated December 22, 1965, granted and conveyed unto John R. Dietz, et ux., which deed is recorded in the office of the Recorder of Deeds in and for Ls,ckawanna County in Deed Book 632, page 165. Mary ll. Dietz, wife of John R. Dietz, died on November 15, 1981, whereupon title to the premises passed by operation of law to John ll. Dietz, the 8urviving tenant by the entireties. The said John R. Dietz, widower, subsequently intermarried with Elizabeth L. Dietz, both of whom joined in a deed conveying the above described Lots numbered 13, 17 and 18 to William Bergen, Rita Fortuner (formerly and prior to remarriage Rita McArdle), Brita Chagnon and Mary. Bommer (Grantees herein), children of William Bergen and Mae Bergen (deceased), and to John R. Dietz, said deed being dated December 31, 1983, and recorded on February 21, 1984, in Lackawanna County Deed Book 1100, pages 371-374, inclusive. On September 14, 1985. the aaid WilliBIII Bergen, alkla William J. Bergen, widower, one of the Grantors herein. intermarried with Edith C. Bergen, who joins in this deed as a Granto~ to convey to the Grantees herein named her ~nchoate interest in and to the premises hereinabove described. The above lots are conveyed suLject to the same. reservations, restrictions, exceptions and conditions as sre contained in prior deeds in the chain of title. The intent and purpose of this deed is to convey to Mary 1:. BOIIIIIler and Brita Chagnon, Grantees herein, all of the right. title and interest of William Bergen, alkla William J. Bergen, in Lots I, 2 and 9 hereinabove described, acquired by him under the Last Will and Testament of Mae E. Bergen, deceased (Estate No. 410, Year 1980), ss well as all of his right, title and interest in Lots 13, 17 and 18 hereinabove described, acquired by him by virtue of the deed of John R. Dietz and Elizabeth L. Diet&, his wife, to WilliBIII Bergen, et al., dated December 31, 1983 (Deed Book 1100. pages 371-374), as by reference thereto will more fully appear. Thia conveyance by WilliBIII J. Bergen and Edith C. Bergen, his wife, to Mary K. BOIlIIIlBr and Brita eliagnon, being a conveyance from parent to child, is not subject to the real estate transfer tax imposed by the Commonwealth of Pennsylvania of any political subdivision thereof. On the.assessment records of Lackewanna County. Lots I, 2 and 9 567). above described, are designated as Hap No. 01501-010-014 Lots 13, 17 and 18 (Deed Book 1100, page 372), above described, Map Bo. . . (Deed Book 479. page . and are designated as r \..J v v Station: View9 - 02/28/2006 3:22:49 PM LACKAWANNA COUNTY In51.# 199300710 - Paoe 3 ,~ ~ ~ '- warrant spec:1dly tM propmy Mreby CO'A~ , , - )n Dlitnt1ts JllI4utuf. sa.id gra,ntm' aMve lamwftto sClt their a.M scala tAt da.1I cmd yea,. firtlt above 1DrittmL Station: View9 - 02/28/2006 3:22:49 PM i\nb tAt sa.id grantor s riD h.8rebv ~. &tzdtb anb Idtumh 3n tJrt )JrutnttiJf STATE OF FLORIDA CIt.lnmtIl Df PINELLAS .A&il o..tAU,IMa~of ~ MM. f 1I11. I' 92 ,he/r>rf- , a Notary Public, IM~qOicor.perIOIIalI'4ppoorod WILLIAM.1. BERGEN and EDITH C. BERGEN. his wife. 1,~~:UI~~ . - -", -'... 11 I', . ",.. ~\...:..:.~.~ /i;.':'.. .. =m-~~ to lit IM""";'s tuAoae """" s sre IId>aeribed to 1M witAi.. i . r~~w-....;fra! tMYi"~~::~~~'a~~i ~.- ~'U <1'r"{'U8l\~"~~ :- -I/f OF'F"(t\~" I QbrDlUllIUwtaltJJ uf Jnutliuhnmta ~ BB. CIt.lnmtIl Df 0.. tAu, 1M dlvtof 1I , /Nif.,.,- IM..~ qOicor, porIOII4llr 4pptC1red g 11) /molUll to _ (or .~, pI'OU01I/ to lit 1M pet'tOI\ tullou...._ IId>aeribed to tIul witAi.. i_-. and admowl<<lqe4 Uuzt M .-..t<<IIM 14..../"" 1M J1"rpoII tMrft" "",""iNd. IN WITNESS WHEREOF, I Iwwo Mrnnto HI "', /land And BB<Jl. 1 "" c. c "" .) htrtby attrtffy t1Ia.t tAt preciBe address of~. ntee . Brit1fa 383-SVly Rd., Schenectady, NY 12309, and the ,.- Grantee. Mary K. B01lllHr. :l.s , 2027 Kriebel Road, Lansd~l~, PA 19446. Attorney for Grantors LACKAWANNA COUNTY Ind 'it 1QQ~nn71n _ p""n", II - &tatt tIf <llnuntutlf 0.. tAil. tAt My of IM~ oJfi<er. ~ 4PJM'4...t JUl. Zj . beJon.... lm/lIIIIllA> IIIe (01' aatiV'tJClority f1"1"""J III be 1M pmon lIIIIoU _ I1Ibaeribed III 1M !IIitiIi1l i...~ .."d ocl<1Iowlfdged lluIt 1M cucute<l1M _101' tM ,...",.,.. WM1I 00lIt4iMd. IN WITNESS WHEREOF. I Mw /MreIPIID Nt "" /uUIll.."d U4l. 0') in !... ~t:!8~O~8 IClg ~[:! f.:~ ci iVl.ci i~ * III d ~ ." . · i ---i- W ~ ~Bg;w ~ ; '" II~i ~ ~. E! . ~ghil ii~ii!~ ~ s s ;..Qy Ceo..i..,.. h~' nUS uocu.:no.l il Rccrd.d In 1M n'"",d., ot Oc.d. Off;~ of lac:kawarn., C"'~~"f t''r.,:"r,-/yC'n":t. ....\.\~Sz:l~~ ."~ ~v ....'t. ~.#~~:Y:.~-:.t>..~,. ~: (~. ~'?~>;~~:~ .. = \. .,.:,J::f,. I '" -.. ~e \ ,",-y:;P f ~:: ~~'... ../:: ~ .~.~.~. <;.~ ~ "'~I "EN,~1":.~~" ;l:~~~'.i:'''''' ..// (.. ~ //' . i./f...[.-._e::f~ r< A.... Marle hcrOft Record.r of DNd. \ N '" ~ 0- ...... . ~ 0- to ~ ~ '" ~ OlO N III 0 ... ..c:l "" ... 0 . CO ~ ..... fo"'" ~I ~~~ .. ..... . II 0 "'II 15l; ...... ",,," ~ Cl '0 l< . = E-t .... g o Ql ~"'';l fa ... t\ .... ..; I 'ti' ~o g ~ ~..:~ \ ~ ~ <) ::3 ..; ~ ... i ~ <tLnmnumwea1tll nf \h1l1t6Uluania <tLnuntU nf tBa" 1lturtbtb in the Offic8/or Reeording o/DeeiU i1\. Q!f1,tljor in Deed Book No. page EU. DitlttSll ""11 haM aM wz.! o/O.ffi.c6 this "11 of AmIO Domi1\.i J9 .oor.1.420~G 501- ~ Station: View9 - 02128/2006 3:22:49 PM ~ LACKAWANNA COUNTY R<<nrder v ln~t 11: 1QQ::\nf)71IJ - p~(1 \'7":;'~':,,- "7f'~' \,_...'. ;.,-f.....,-.". ; ".,;.~;;y(~' "",,"'. ~ l":;--..':S ~ ,j;;'fOl) : ~B;L,., P3:'-~12 R<.':cJ 2 - 21-81-/ No. 536 FEE-SOIPLE DEED-Type"'"itet 'flCUi5 3J t!il:e~turf~ manp wl1r }let "11 "I Deoember " '" tA. lira' 01 0'" L-o,.,1 0.. , ;. Thou.and !tOfu fI....,lntI ond :light:r-nree (198}). .~, .; " ''';'~ 1Brtw1plt JOHN R. DIJ:lZ AND ELIZABftIl L. mA"lZ, his vUe, of the Borough of Camp llill, Count,. 'of CuIlIber~and. mId'State of PennB1'l-nnia. hereinafter. '".;":V,I!C.:J. cau.ed the Parties of the F1.rR Part~ . ~ ...'\';;;'~': .,i'~;~-,' ':....:<..;::. ~~i.~: 7 . .,,~~~~~.~~.~: " ,""*.'.~- A lII.,.D --"'~l{\I:'" ./ '..>':"'. ,'. _ 1r,.__.:,' " r......~....~..~'!.::.,:-,. , VILLIAH BE:IlGUf AND RIfA J'OIcru~oarCarbODdal.e, Lackawaima'" . , . ~ . .;_.- .' '~': ,~~:.r'., .'" Count,., Pe~l~; BRIi!A CHAGNON. of Sch~nectad1' S~enectad:r Count,.. New ... \ - "'<;. -, ., York{MAllY BOMMER.' ~fLansdsle; Montgomer,-}:ount,-, p~iVauia..and JOHN R. ~ . "". '" J2Im of Camp llill. Cumberland. Count,-, Penna,.l-nnia, .here1.U.fter called ,the pc-ties ~~,,~..,~,..,1..', (c;,.::gt~. , ' \ .':j ~:,~: l, ~ ';: . "~(' "'i-'," . , ' ';;;_~'-i,::-'4~-~:;'" c .':. ~'~;;;~-":~::;. < f f,~:."i'f~ ~"'I t . , ~ 1 . "~ ..);:'1, 'jI, ' :;t~l "~ \':~.,;~-. 1 '1 ,.,";, ~~' .' '. .,.,,~~.. "I lite .ceG.d parI, 1iitltr.6sdh.TIl., Ih~ .,ddparl bs DI tla~'t~t part, 1~'~'Gfti'i~ ,'("iAde'~~i." ',' 01 'he,..,m 01 . .. '.~>" J'o~: .-:~H':t.UJ.dred. ;J)cilI.ar~ ).. .. ". .' .-.;; .!c;:.~ '..~~'. -.'. ;':~::'. . .. Dollar., lau:ful ",,,"eIJ oj t11f~ Ulliled .'<;tai~. orl'lIleri~')',rell oltd--,rul!/ pOirl Ii; 'the .a'ill p;.rt 'i~. oj tl,e : <<Cqnd pan to the .id pan bs'~~J the Jird part. ", lI",ib~Jo~"tite .t:ollftg "nddellrenl'of 0.,..,. . . , . ."~ I :,.. ~~'" . ''-''~~',,-~;~j',~Pl!'''!~':;'~'i' ,,:"~~;'.. _. " ","eAt., Ihe receipt dereoJ i. herebIJ ackltol~~edged,~; '" '. "".:'t~'!8:);,,.j;9)2~~':~;'! ...'X..);::, ",."nt,.d, bargaint'd, .old, aliened, en/eoJJcd. rr:1eo,ed,,/xJJlreyed and eG,,-/irlllt'd omt'by tlte.e prt!u.t. do 'gront. I",rgl/i.. ..11.1111,., ~"f";,I/. reiea~e. c'o~rry, OIJ',...."fi~ ~~i~.ti";..;"i4""rl-J~a'~~t..i :l;:::"":=:1S~...~F!L~~~'~~'!ii~;t: Lackavanna and State of Penns,'lvania.""boundecl BD4 described as f~ova,,:to 'Wit: " :>f.' " ", '. ~ 'f'.;;': ~>" ...:\~ ~ - "'. :~~:-,.' y.p:'\. ." ;'.,.;;;:~'~~ . BEGIlUiING at a point distant one hundred three' and. thre_tentha (103.3), teet on.' ':"c.,' .> a course of lIeven~';'one (710) degrees Eaatlroll "High Vater Mark" on the-: shore ' ':"'~..; of Cr.rs~ Lake; .;': ",:'" '-;.';':i (\:.r''''''~'r'''-7~~(,~;;t'~~;~';0:7;;~~~'?~~.';~ffl!.'-~'g~. ./t4f.J TBnfCil South nineteen degrees Vest (S 190 V), fort~-B8VeD.' and. On_half' C'+7m feet' ~. to Bomde Brae Ave:me on unrecorded plot of~ lots ,hereinafter mentioned;--;:: . ':,:."c;"-:~ .. ,":::~ ;..:.....':".>~:-:.." _ .~~,=i.~. .... '." ._.~-'). . ~CE alOng the northerl,- line of ~d ATe.~ue, South~~nent:r~cme"d.gr8e'8'"2ast ">' (S 710: X), anent,- ti va (1'5) feet to. a poin~ on thit woat~r1:r ~e of ~the.;;~, ~cnm.ship ]load . (lI() feet .lIide); . :.- ,;:f:;-i;~~:'A~< ;.~t~~'~"&11~1~~;' ,~~~*~~Mf~7.j,,' ~f}~~ ~CJi: al~~ 1:heu~est~rij- l~e "of add ~ii~hip llo&ct NO,rth ~etee~l'de~;& C':,., .";~~ East (.1' '19 E) i', fort,.-seTen 8Dd. one-~~'!:)!-~m>. feet:.too~ point at lin~,;~f l.and. ,:;~"'~",' now ~ fcirmer1:r ~f7~~,.,f:.~':~~;.' , r;~i~~~ii;'.::6'i.:;)~i~;;':';:\j.~~;.:~&.tri;~JfC: 'dt1i:,~:; ~CJ: slang line, of.laDd now~or 1ate}0!<the said D;' ,C'- XeJ11Oni"Horthseventy':on.;"";.r~~; degrees Vest '(IC .'i'~o;V);':'aevent;r-tiv."('i'5) feet toa point. the int ai2d~placafr~' : "!" of BmIHNIXG. ,g~~t~~;'i~:~{~':~:~ ~'.:r'l~>--'" i'~",',~'~~t&&'f~~' . '~';T~~~~;:>'i:;~'r';; ;'i, I I Station: View9 0 02128/2006 3:23:08 PM LACKAWANNA COUNTY Inst.# 198401428 - Paoe 2 - 'c.iI.ot-';"~Dumbered"l.3; '11 and 18 'em ~ unrecorded Plan of Lata prepared b,. . A.:Mi:JChen;'~':Jr;,.~.1I;)1918~~l;!;..:-,;" ~,'Jri' '^~. ~~ "::,",-,, ". ~"-,, ~'. ~ . ~n:~,~'.~~~r~~~~~;\).1~a;ii-t~:'~*J.t-:i~~'_: ~"'~I."~-~:-;.~$_~:~~:G'- :~~. ~~"~. ~~~-~., .' ;':""" "l-." '~G~.'of~'~~~~~~~~;8 vh1Ch Northe~tetn National B8Dk'tUu1 rrwst '. CO~i' ~t: aJ: : 11:1 ).~~~ deed d8.ted December ~22" ,1965. granted...xu!, conn,-ed <. ...~to. John' a., Dietz .,et 1:1%. . which deed 111 recorded in .the Office ot the , '~!"t~er'ot'J)eed6 .11(8ildt:or tac:k.&;;aJU1& ~Ull.t,.i11 Deed, Book 6:52. Page 165. .. ~'~~~<':~A~~I~.:l.~~~::;:'Ct~,~::~";""~~~~)~~}t~;"~':t. ~~f .~ ',.:{~i'.:. .... ,,' '. '_' --,:_~'.~~~. ;'-',' "', ._,?; AND :th:~ ;&fc:iresaic!Ha.:ri(l!~~Dietz died NOTelllber lS~' 1981norhereb,- 'title >!c:.Gt.~C!j-1Jl,!!~,.R.));.~i, .~esuni~ tanant .o_~ the"tenan~-b,--the_ erlt1ret1elS""~".~ """":I:':"'::;.',~: ' ::f. ,'.,,"," '., "'.c?"', " " .n.''''~'''_.'~'~Ap''~h~ -t-..... ~~. </im-<.~'..'...-r'i .:, -;t....;,.....;:j...~...~..- ....... \::~;~~.ms. ~'. 'tt~!{~~ri%i}g;~~:'~;:Lc '.:#i:.~'~ ...., -~r "~,',i.~~,~ '::~i:;;'~" '}~~~!~i'/~ - ~, >:i"0~~!~?p:t)~~7t-<L ,i~: A~~.,; . ..'. ", . /. ~. ';;.. ~'.:-: .Ji!UNICIPAUry .~ ~:~~~!'; lRANSr~~':-7;; ~ "0 ~ " .:,- ,. ':,'" :~.- "~~ ( AG[Nf i',~, ";,L.~::.,, ...:4-~,"_"_--;,,_, -;. " '. .;~.~ ;j~ ''';fi!~;<jJ'~'-'':~;''::'>l'';o~ . ;.cn . ;COMMONWEAtTH OF f~VANIA == f:2'r,,:. f_~~o ~ 0 01 ~,?: c:> ~~ .;;;.._ ~ _ . = ,.~~ :;~.., ,t r :.~~;.. . ~-, .---~- ~ ~ c::t ,:.:~::;::"<>;,~:;~~i,~'~~~,;". :. - '-'.1- ";;:, . . .:.~ . .\~.~~~t>. ;: PA[L 373 - '-:..'i-'>. Station: View9. 0212812006 3:23:08 PM LACKAWANNA COUNTY Inst.# 198401428 - Pace 3 .,-,,'.-':-,"""" :' ':"':~' :""~:r.:r:,,' a "; '~;,-. .', .;. ;:'!:'~b it .1 ~ .. .', i:'L,: ':"i- .' mng1?t~l'r ",",II ,dl an-d ....gular, tll, tene"'''''t.. Il.reditcamellt. ca!Wi cappurte..an<le' eo u... ....... hlen!},..!} 0" i.. a..IIu...... capperlai..in" and the ",,,",i.,.. and retlerrio-.... ,.emainder and ~_cai"diT>. .....ta, i.tBUe., .."d prujif. thereol; "-nil IIt5D all Ihe .,tat., righI, title, "'t"""d, pt"Opttrty, d"... .!Wi d_a..d tDhot.o~, both i.. ta", a"d equity, 01 th, .aid purt ies 01 tll.. Ivet pt.rl, 01, h.. to ,.,. out 01 tM raid premUe., ....d '"""'" purt a..d TiGrc.1 th!"MJl " ,. ."1: wn ijaut anb tn lJnlb 1M llIid pnmim, .;f,. caU orad ri..gu~ 'tM appurt_cu. ....,. the aoid port ies 01 Ue aec:o..d pori. their Mir. and aang,... to and lor the only prop... .... orad b..1uJfI oj the ,caid JlGri ies ' 01 tile .lICond JlGri, their heir. and aarill1" , lorefleY', ,,~ 'J. ,; t ',J :, ," '{, '\'. . .:,i, ~r ~.. (;--' forthe1llBelves, th~ir,' ':! t~h! ...:.:~_ \./.~..' ~~/\:i~;'" ",:::];;jJ;,\' \~., I.;:.. '- ~~~,~:". .,. .> by tM" pr.....t., ~..t, grGntond ca!/t"IJ' .0 caowl l their"":' . ",; Mir. ca.." the :First Part, for .thelllSelves, ,their .+ '" . ~";'-:"-;~:: "" .... ",'-'-. . .. .' :~ !\nb TBBiiAJD Parties of the Firat Part, , .~ . ""'"', ~ecutor. cand ..4..in..t....to,.., .to . ooil. tM ,aid JlGri iea 01 the .eoorad pori, caarigrq, IMt the7 the ,caid Parties of :~..,.,.. . ".1' .. ~.. '. ,'" _.:....... ,'~., I'; i,qt,.. . . -{ ...- ';'!.:':::';,::.n"~"-"- " ,::~..~,~:'", \!lb.t?..... , I . ,'. . . .t.- <' ~.,. . l'L ... . . & t'l" '. 1- l .' . t r . .~. .&. t -! . . '-. f ~ \~:l' \~J~' 1-,.,) "":.,, ki,.. call Gnd ringuta,. Ih. Aereditamellt. ....d premUfI' Aerei....b01>8 d..cribtld GIld grGnted or1mctiJ""'''d/J/ .:' " cradinlended.o to be,witAappurienoncu, u..l~the .aid pori ies ':of the .econd p~rl~'>:the~.r ,:;.~'?~ ..,.,.. and aa,i,.." caucaira" Ihe .aid pori ills \ oj the Ji"" pori and their ,-- Il.ei,.. ~n\f;~.~i"d -cUI ~ : t,) ; . carad tn:erg otlulr per.on '0,. ~'o... ~hOfJ"o"""", ,l4llJfuIly el4imira, Of' to'cta.m tke .011'18;, "r"Oii:y port ~::':-/::'i, tlLereof,' .~ a..d will, br fll.eH rwea....t., w ARR.'(N~ ~Q :1!Q.R:,.. " ': ',.' FrYER DEPEND'~ ;,." ,.~.;~r-':i/-'t;<: :::"'~~(.12'i(Y' ",.t\ 1Ju liUnt55 liQl'rl'nf 1M aoid peart ~~~s:'::, ",~.,;~~~~~;.~~ ~"~,;:'" ":vr""":~,~"",,,,,: ~...ev"to.d th.1r~ :.1a.1Wla ."ef 'eG18 tAt". .~.. 'OM lIfUJr' J!!:!!. obo" 'tDrittenw . ;-_."l- . .,;; -''''"'. '.'.'1 . . V.' . .::i .; J ." ,.;': -:,'r' ., ~.~ \"~} .- ::"':;. ." 8t1D~, &ued and DeUyered : j:, dJl ~ PreaeDce of ~.~ . . .... 'I ....<::m~--~,.~._......:..:.:.....::.~..~ llo0K1100 fACE ,374 __.........__..._..............___.............................w...... ~l. ......................_...._...,......"............._...___.... :, (8EA1: J '~f '. ............._.....;...__.....~::<.~:..;;~..-":.:.;_.~;._;..; .,'(SBAL I "";,:' ...........7::--::::~_.~~:~?-~C'~~'-' :': ,IU::j2;:~~~#AL1::2~tl:. -" r '''.i . "'-,;).. i":~.. -"'--._..._.....~_........~~...~:._._~.._:..._....__.- ;;.,:;~~~:.:f7~~~:" 1:, I ...j ----......---...-......--..-.................. . . , :.~ (-, ':j,:.) .....i,... ~, Station: View9 ,02128/2006 3:23:08 PM LACKAWANNA COUNTY Ins1.# 198401428 ' Paae 4 ~f~J~~~ ~~~:~ ,."" ""t.::~' ~" . ...-:.~:r~" . '.,,-" ," ~,- ._.~~,~ . ,~::~-'l:"~' .;;\:.:~~; ,~ ,,!j',,;,i3.:;i !'~~f,I~~?f~' -;, ;;;; . ....."t....l:-.....1.11;:t....\=:'...,... ~..~..1'3%. ~...,'.~. '. " ~~~~i{~~*~.~Ji~I~1:~4'::'~;:..ic'.- . J;\.f)n1hu, t1ae., ----=.,~~"dtz]/ ol.~._.-....~~..._.._,~.___._....___, lD...M, lI~ore ...~ :'::1~.;$.;. .....;'>,-;;.i"::.'~....~,~:....;: -;-J, 'No1;1lr'r1Publ'ic"'""~"",:";;,,,,,,.,.. - :""'. . ,'~ '., ."""', ", ~,.~':::"~-"="'.'-""'--''1~-_._._._.._--_.., the flMllI"rign.ed wcr~ ~oruzlllf G~.' ;: ..J.abl:i..E.;..Diet.z...md..El.it.a'ti'e1.h:JO..:Iliett....lIiA_lCitl:.-__._ '::>, :_ " '< ~"~j,:;i";:?~~7:-~. :;:?~'~i::~'< ~.;' ~~~~:~!r.~a.!.~J~~~I,/~ci~~)?o llf:tlu(~~ollf~.:.';~:;f,_'::h~.e "ame ":"-~_ .ull.on"lleCl tfl".'. ~.'\ . tAe ft,t1fl"~flI.tl"llml!ftt. Gild Gcbo.lCledge4 t1l1rt ~f' ~:..~ lIe.X....::,..:.. ezecuted tie .ome tor tll..'Putiio~'~,,,~ ~..:"..~f..co"U.:...t~i~~~.... -2 .....~;~...- f::~ ,~.. :-..~':.. .al.~::.::,.!>,.,' ~ ',,_, -', 4: ....,'\'~\\\;...l;--t './~t:,": ~,~, "w'''~4' .,....~.. <~'II._. .-..........., , , ..~;w~n.:;8:S.JVHE~Ot:. 'i.lI~re~nt~!I;~:::~~ ,,~~~=;;.~ ~lfl~la'i .eat' :'~:'.,,:-. ;t~.~~\,.rft:.~~.~,;:v . _ . /' '.. ".,." .;.~. ::-":;-"-!~~:':'::f': t~,.; . '-"~", " ""-to;,.., .' " < j co> ~ 1..........~ ~j.~....j\,M; ". ~ ~. l' . ---....-._::....~ ...... ___...__.,__~.......____. I(.""t(~ .:t.~~+. :.: :or;"L:~: ,.....~:..~,..-;.~;~~<~;.:4'~tt~~.:. .,~ ..:.. '''~~';C.b'.:.. '~~:utl ~,.a._'I!:"'\~Tlr:I",,' }j;:;" ...... 'c, ' . . f . '. . .",oI.~ :c.. -, .,. .J/1I comm,,'tOlt' ezplre,: ...-....- _"::"~"__:':'\:.!=-i:Y..I('...t..LII"lJC~... ..;;t;!. iii.!f\;_.....'{~~~~~~~~:t~~~~.~~r~~t~~.: .:..... ,...... '. '~ flri~~ r<~t~t~:~,:f .ri,.::' E-t.. r... ..J..n.....,.,: i.... foot ! ~!hj-..l.~oi.::i .,.~{fr.'f.;..~l. - I ~ ~~. .~ ~~i\.- ~~ ~;-~'i --r~:~ = ~-; i j ...: IS: . · 2t '.":: . '" II ~~ 'i~ ll~E01F~f~Efo..~~. ~ I =1 II: ~i . ~: .';: :..... ,! 'l! ~.!. ~ I ih Zt! I ~ 291M ttq !"o i 1. .fl:ll/fl..~~.'";~;.__.L.. :: ~ . l::: .= =R1' -= ~ r !.._ z ; $:E }.~~j:. ~"" V t'L. j i :.- ;;'PS..i-f.f... ~lff!-() (). e ~ . '-'r '" ~ . '-"".'.'.~. .'- ,,";:l'J':'.~~ ~. i:, ~~.c~ { '~ -:..~ .;!'"'.;t,:. r\' ~:, ';~~;,'~' I. i .,;\'.:.\:~~:~i:' I ~.~:~,;~:,~~:,t~~~ , !1'- ;,c.;;;;' '.l- Ea 1.-;: . . f. A ~ '. -..~.:;: ~-I~;:_jY : !2:; .... -", :'--_'Y- I it! il ~~~* .e a 'p; ~ , Q I. .~ fb ,,~. '. .: .;;" ::-~-';~:'~. ,,; ::,~ '.' . r ..... 1 " = .C'~;\ ~ i::~1~~~;~' !:I'" !! ":f ~ t -; II: ell o ":f' ~:.".,~t~<, _. .:' :'~.~y ::'~'~':; f-> ~\ - ',' ...~' :-:;~~,:,~..~ .-. ,." .;.::..:.,....-.:....._ _ ~..i, 4 _. OOJlMONWEALTH OFPENlo'SYLl-'.A.NIA . } ...... .:U~KJ.w.mL_."':':".______ comITY~ 58: lRrtor~rll' In the Office for Recording of Deeds, Mortgages, etc., in and forthe,Coun:tYof _~~~~._......._......:....:. in Deed Book. Vol. ..;.~~...... Page s .371-374... i,ncJ.. . Witn1'55 MyH~tidand Se~l of Office,: this .............~~:''-....................h...h.. day of '~,~i;' .:~+;~$:;.O...:.~......,'.......:.....;.""~i.........'....~.<.-.o.:.......,....:,~.:.~:.~:..o......~..,...:....~.:...::'...".~....:.:...........~:_.....,..:...........,....rr.....:..'....:.'..:.....:::...:,:...~.....:...,:.....3.......?-.:'~.;_.:'..:.".~.n~~...D...W..~.,',........co.......:~.........:.'...,...m......,......l_......,.....~~:...........l.:...~:....n.:..:.._._.......,....1...'...~..........._....,....]~....,.....9..:":....~.'D.....,..:""'.i.:_ :.:~..if.~..:,.::..~..............:.~: "JlS:;....;.._(.._..:...~....:...:~...'......_.._:......J.,.... ltt4:~r,'...~.',.,.':.,~..'..~.:_..._...".....:,..'.....:....'.'.:....'......:.." ';" U0:, --~t: ,- ,'~~ ~~ >, .:..,.~;~~~;::.:~~:~i#4;,~~~~~~~~;~?- :'.+1~=--:;.; ; :~'F;';~~;.~;"<.~'::" Station. View9 . 0212812006 3:23.08 PM LACKAWANNA COUNTY lnst.# 198401428 - Pane 1 PHOTOGRAPH ADDENDUM OOM:~rIClient Rhoads and S i lion L. L. P. Property Address M14 Crystal Lake Blvd. City Carbondale County Lackawanna State Pa ~ John Dietz Estate Z'pCode 18407 FRONT OF SUBJECT PROPERT REAR OF SUBJECT PRO PERT' STREET SCENE 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 n~t 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: (I) buyer and seller are typically motivated; (2) both parties are well informed or well advised. and each acting in what he considers his own best interest; (3) a reasonable time is allowed for exposure in the open market; (4) payment is made in terms of cash in U. S. dollars or in terms of financial arrangements comparable thereto; and (5) the price represents the normal consideration for the property sold' unaffected by special or creative financing or sales concessions* granted by anyone associated with the sale. *Adjustments to the comparables must be made for special or creative financing or sales concessions. No adjustments are necessary for those costs which are normally paid by sellers as a result of tradition or law in a market area; these costs are readily identifiable since the seller. pays these costs in virtually all sales transactions. Special or creative financing adjustments can be made to the comparable property by comparisons to financing terms offered by a third party institutional lender that is not already involved in the property or transaction. Any adjustment should not be calculated on a mechanical dollar for dollar cost of the financing or concession but the dollar amount of any adjustment should approximate the market's reaction to the financing or concessions based on the appraiser's judgment. STATEMENT OF LIMITING CONDITIONS AND APPRAISER'S CERTIFICATION CONTINGENT AND LIMITING CONDITIONS: The appraiser's certification that appears in the appraisal report is subject to the following conditions: I. 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, depreG:iation, 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 conditi6ns 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 ",;ere furnished by other parties. 8. The appraiser will not disclose the contents of the appraisal report except as provided for 10 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 as'sociated) 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 l11ust 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 I of 2 Fannie Mae Form 1004B 6-93 Pnnn.. IV Worm." APPRAISER'S CERTIFICATION: The Apprai,er certifle, and agree' that: 1. I have researched the subject market area and have selected a minimum of three recent sales of properties most similar and proximate to the subject property for consideration in the sales comparison analysis and have made a dollar adjustment when appropriate to reflect the market reaction to those items of significant variation. If a significant item in a comparable property is superior to, or more' favorable than, the subject property, I have made a negative adjustment to reduce the adjusted sales price of the comparable and, if a significant item in a comparable property is inferior to, or less favorable than the subject property, I have made a positive adjustment to increase the adjusted sales price of the comparable, 2. I have taken into consideration the factors that have an impact on value in my development of the estimate of market value in the appraisal report. I have not knowingly withheld any significant information from the appraisal report and I believe, to the best of my knowledge, that all statements and information in the appraisal report are true and correct. 3. I stated in the appraisal report onlY my own personal, unbiased, and professional analysis, opinions, and conclusions, which are subject only to the contingent and limiting conditions specified in this form. 4. I have no present or prospective interest in the property that is the subject to this report, and I have no present or prospective personal interest or bias with respect to the participants in the transaction. I did not base, either partially or completely, my analysis and/or the estimate of market value in the appraisal report on the race, color, religion, sex, handicap, familial status, or national origin of either the prospective owners or occupants of the subject property or of the present owners or occupants of the properties in the vicinity of the subject property. 5, I have no present or contemplated future interest in the subject property, and neither my current or future employment nor my compensation for performing this appraisal is contingent on the appraised value of the property, 6, I was not required to report a predetermined value or direction in value that favors the cause of the client or any related party, the amount of the value estimate, the attainment of a specific result, or the occurrence of a subsequent event in order to receive my, compensation and/or employment for performing the appraisaL I did not base the appraisal report on a requested minimum valuation, a specific valuation, or the need to approve a specific mortgage loan, 7. I performed this appraisal in conformity with the Uniform Standards of Professional Appraisal Practice that were adopted and promulgated by the Appraisal Standards Board of The Appraisal Foundation and that were in place as of the effective date of this appraisal, with the exception of the departure provision of those Standards, which does not apply. I acknowledge that an estimate of a reasonable time for exposure in the open market is a condition in the definition of market value and the estimate I developed is consistent with the marketing time noted in the neighborhood section of this report, unless I have otherwise stated in the reconciliation section. 8. I have personally inspected the interior and exterior areas of the subject property and the exterior of all properties listed as comparables in the appraisal report. I further certify that I have noted any apparent or known adverse conditions in the subject improvements, on the subject site, or on any site within the immediate vicinity of the subject property of which I am aware and have made adjustments for these adverse conditions in my analysis of the property value to the extent that I had market evidence to support them. I have also commented about the effect of the adverse conditions on the marketability of the subject property. 9. I personally prepared all conclusions and opinions about the real estate that were set forth in the appraisal report. If I relied on significant professional assistance from any individual or individuals in the performance of the appraisal or the preparation of the appraisal report, I have named such individual(s) and disclosed the specific tasks performed by them in the reconciliation section of this appraisal report. I certify that any individual so named is qualified to perform the tasks. I have not authorized anyone to make a change to any item in the report; therefore, if an unauthorized change is made to the appraisal report, I will take no responsiblity for it. SUPERVISORY APPRAISER'S CERTIFICATION: If a supervisory appraiser signed the appraisal report, he or she certifies and agrees that: I directly supervise the appraiser who prepared the appraisal report, have reviewed the appraisal report, agree with the statements and conclusions of the appraiser, agree to be bound by the appraiser's certifications numbered 4 through 7 above, and am taking full responsibility for the appraisal and the appraisal report. ADDRESS OF PROPERTY APPRAISED: M14 Crystal Lake Blvd. Carbondale, Pa 18407 APPRAISER: S;",rure ~~ Name: Thomas J. Ruddy IRudd ' 1 ty Date Signed: March 8, 2006 State Certification #: or State License#: BA005038L State: P A Expiration Date of Certification or License: 6-30-07 SUPERVISORY APPRAISER (only if required): Signature: Name: Date Signed: State Certification #: or State License #: State: Expiration Date of Certification or License: D Did D Did Not Inspect Property Freddie Mac Form 439 6-93 Page 2 of 2 Fannie Mae Form 10048 6-93 villa NV. l:5Ul:-oZ65 ..n A. B. TYPE OF LOAN: 1.oFHA , FmHA 3. OCONV. UNINS. 4-DVA 5.0CONV.INS. U.S. .RTMENT OF HOUSING & URBAN DEVELOPMENT 6. FILE NUMI 17. LOAN NUMBER: SETTLEMENT STATEMENT 85-038.003 8. MORTGAGE INS CASE NUMBER: t. .OTE: This fonn is furnished to give you a statement of actual settJement costs. Amounts paid to and by the settJement agent alll shown. llems merleed 7POCr weill paid outside /he closing; /hay are shown here for infonnationBl purposes and are not included in /ha tolels. 1.. .... (COUTURE.PAULAPFDm5-038.OD3I<t) D. NAME AND ADDRESS OF BUYER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER: Paul A. Couture and. Estate of John R. Dietz Elizabeth R. Couture 37 Kensington Square Mechanicsburg, PA 17050 G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 25-1857112 I. SETTLEMENT DATE: 37 Kensington Square Midstate Abstrad Company Mechanicsburg, PA 17050 May 24, 2005 Cumbertand County, Pennsylvania PLACE OF SETTLEMENT 2331 Mar1<et Street Camp Hill, PA 17011 J. SUMMARY OF BUYER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION 100. GROSS AMOUNT DUE FROM BUYER: 400. GROSS AMOUNT DUE TO SELLER: 101. Contract Sales Price 254 900.00 401. Contrad Sales Price 254900.00 102. Personal Prooertv 402. Personal PropertY 103. Settlement Chal'!les to Buyer Line 1400 4 628.25 403. 104. 404. 105. 405. Ad'uslments For items Peid Bv Se/ler in edvance Ad'uslments For Items Paid Bv Sal/ar in advance 106. CitvlTown Taxes to 406. CitylTown Taxes to 107. County Taxes OS/24/06 to 01101/07 334.19 407. Countv Taxes OS/24106 to 01/01/07 334.19 1" C;chool Taxes 05124/06 to 07/01/06 213.73 408. School Taxes OS/24/06 to 07/01106 213.73 1 ,ewer Proration OS/24106 to 07/01/06 52.20 409. Sewer Proration OS/24/06 to 07/01106 52.20 110. Condo Fee - May OS/24/06 to 06101/06 53.58 410. Condo Fee - Mav OS/24/06 to 05101/06 53.58 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BUYER 260,181.95 420. GROSS AMOUNT DUE TO SELLER 255,553.70 200. AMOUNTS PAID BY OR IN BEHALF OF BUYER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. Oeposit or earnest money 10 000.00 501. Excess Deposrt ISee Instrudions\ 202. Princioal Amount ot New Loan s 502. Settlement Charlles to Seller (Line 1400 18413.00 203. Existina loants taken sub'ed to 503. Existino iaan sl taken subied to 204. 504. Payoff of first Mortgage 205. 505. Payoff of second Mortaa e 206. 506. 207. 507. Deposrt disb. as proceeds) 208. 508. 209. 509. Ad'uslments For Items Unoaid Bv Sallar Adiuslmants For llems Unpaid Bv Sallar 210. CitvlTawn Taxes to 510. CllvlTown Taxes to 211. CountvTaxes to 511. Countv Taxes to 212. School Taxes to 512. School Taxes to 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. Escrow for Inheritance Taxes to Rhoads & Sinon LLP 10 000.00 218. 518. 219. 519. 220. TOTAL PAID BYIFOR BUYER 10,000.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 28,413.00 3P" '=ASH AT SETTLEMENT FROMITO BUYER: 600. CASH AT SETTLEMENT TO/FROM SELLER: ~. ;ross Amount Due From Buyer (Line 120) 260181.95 601. Gross Amount Due To Seller (Line 420) 255 553.70 30~. Less Amount Paid BvlFor Buyer (Line 220) ( 10,000.00) 602. Less Redudions Due Seller (Line 520) ( 28,413.00 303. CASH ( X FROM J( TO) BUYER 250,181.95 603. CASH ( X TO) ( FROM) SEL.L.ER 227,140.70 Buyer~aJ4~ Paul A. Couture ---.. ~ c.f--- Ell eth R. Couture Seller The undersigned hereby acknowledge receipt of a completed copy of pages 1&2 of this statement & any allachments re!ened aga L. SETTLEMENT CHARGES 'l00. TOTAL COMMISSION Based on Price $ 254,900.00 @ 6.0000 % 15:294.00 PAID FROM PAID FROM Division of Commission 7/ine 700} as Follows: BUYER'S SELLER'S 701. $ 7,647.00 to Rothman, Schubert & Reed FUNDS AT FUNDS AT 702. $ 7,647.00 to The Homestead Group,lnc. SETTLEMENT SETTLEMENT 703. Commission Paid at Settlement 15,294.00 to fa 811u.ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Oriaination Fee % to 802. Loan Discount % to 803. Appraisal Ft!e . to 804. Credit Report to 805. Lender's Imlpection Fee to 806. Mortaage Ins. ADD. Fee to 807. Assumption Fee to 808. 809. 810. 811. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From to @ $ Jday ( days %) 902. MIP Totlns. for LifeOfLoan for months to 903. Hazard Insurance Premium for 1.0 years to 904. 905. 1000. RESERVES D~POSITED WITH LENDER 1001. Hazard In:surance months $ Der month 1002. Mortaaae Insurance months $ Der month 1003. CitvlTown Taxes months $ oer month 1004. County Tiilxes months $ Der month 1005. School Tilxes months @ $ per month 1006. months @ $ oer month 1007. months @ $ per month 1008. months lID $ oer month .211\1\_ TITLE CHARGES .1 Settlement or Closina Fee to 11 uZ. Abstract or Title Search to 1103. Title Examination to 1104. Title Insurance Binder to 1105. Electronic Document PreD. to 1106. Closing Service Letter to 1107. Attorney's Fees to (includes above item numbers: J 1108. Title Insurance to MIDST ATE ABSTRACT 1 633.75 (includes above item numbers.11 02 1103 & 1104 I . 1109. Lender's Coverage $ 1110. Owner's Coverage $ 254,900.00 1,633.75 1111. Endorsements 100, 300, 8..1 1112. Notary Fee to Midstate Abstract Company. 5.00 1113. Notary Fee Midstate Abstract Company 1114. Overnight Fees & Handling 1115. Transaction Fee to Rothman, Schubert & Reed 150.00 1116. Transaction Fee to The Homestead Group, Inc. 100.00 1117. Tax Certification to Marie Huber, Treasurer 10-19-1604-217-UB-37 5.00 1118. Home Warranty to American Home Shield 13661644 415.00 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording Fees; Deed $ 40.50; Mortgage $ , Releases $ 40.50 1202. Citv/Countv Tax/Stamos: Deed 2549.00' Mortaaae 2 549.00 1203. State TcIx/StamDs: Deed 2.549.00; Mortaaae 2 549.00 1204. 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Survey to .nO? Pest Ini.Dection to Biechler & Tillerv Inc. POC:B35.00 ..1 Cull Home InsDection to Biechler & Tillerv Inc. POC:B275.00 1 ~~ .. Associlltion Initiation Fee to Kensinaton Sauare Condominium Assn. 300.00 1305. 1400. TOTAL SETTLEMENT CHARGES tEnter on Lines 103, Section J and 502, Section K) ./7 4,628.25 18,413.00 By signing page 1 atlhis sla18men~ the signataries acknowledge receipt at a completed copy at page 2 atthla lwa page alatemenl~ - P 2 Midstate Abstract Company ...._oU.l____.t ^__..I- Calculation of value of Centerview Associates Limited Partnership: Check received, decedent's share, proceeds of liquidation of Partnership assets $47,000.00 Estimated share of reserved funds 1,267.00 $48,267.00 SMG PROPERTY MANAGEMENT, INC. March 23, 2006 Dear Ccntcrvicw Partner: SMG PROPERTY MANAGEMENT, INC. March 23, 2006 Dear Centerview Partner: As you can see by the enclosed distribution, we have good news to report. We recently sold the property for $5,450,000. After payment of debts, brokerage fees and other expenses, we had approximately $760,000 of cash remaining. We held back reserves of approximately $20,000 and distributed the balance to the partners (see enclosed check). As many of you might remember, we took over management of the apartments in the early 1990's and secured a HUD loan to prevent a foreclosure of the property. Since then, it has been a long uphill battle to maintain/upgrade the physical asset and increase revenue to the point where we could sell the property for an amount that would return a substantial portion of the partners' original investment. We are pleased to say that we have achieved this goal. The cash distributions from the sale will return approximately 70% of the partners' original capital contribution. We will wrap up the partnership affairs this year and file a final tax return. Final distribution of any remaining cash will be done at year end. If you should have any questions, please do not hesitate to call. Sincerely, MD/ma Encl. 9021 TOWN CENTER PARKWAY BRADENTON, FLORIDA 34202 (941) 907.8788 FAX (941) 907.8789 HOBBIE AUCTIONS 901 N. 2nd Street Harrisburg, PA 17102 Phone: (717) 233-0115 Fax: (717) 230-8996 Email: bill@hobbieauctions.com January 13, 2006 Robert Dietz 741 Brentwater Road Camp Hill, PA 17011 Re: Estate of John R. Dietz, Deceased 37 Kensington Square Mechanicsburg, PA 17055 Dear Mr. Dietz: Pursuant to your request, on January 4, 2006, I inspected items in the Estate of John R. Dietz, Deceased, located at 37 Kensington Square, Mechanicsburg, P A 17055. Based on my experience as an antique dealer for over twenty.:five years and an auctioneer for over fifteen years, it is my opinion that the value for estate evaluation purposes of the inspected items is as follows: Familv Room: Artificial Christmas tree. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. $10.00 RCA TV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 50.00 Family photos. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. -0- (3) Lenox religious figurines ................................................. 75.00 Religious cross in frame, and glass cross. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 10.00 Drawers: Cloth............................................................ -0- Games, books, puzzles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 5.00 Plastic car model, and cassette tapes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 40.00 RCA TV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 75.00 NC sound system ......................................................... 25.00 Angel statue, and phone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 5.00 Bookshelfwith books, and miscellaneous household storage. . . . . . . . . . . . . . . . . . . . . . . . 25.00 VCR tapes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 5.00 Wood TV trays. . . . . . . . . . . . . . .. . . .. . . . . . . . . .'.. . . . . . . . . ... . .. .. .. . . . . . . . . . ... 5.00 Goose statue............................................................... 1.00 Geometric pattern rug, approx. 9' x 12' ......................................... 15.00 Robert Dietz Estate of John R Dietz, Deceased January 13, 2006 Page 2 Cireen leather couch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " 50.00 Green leaf form floor lamp .................................................. 25.00 Oak glass top coffee table ................................................... 10.00 Contents: Books . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1.00 ~v1atching end table. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 10.00 White leather easy chair with ottoman. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 75.00 Lamp table ......... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 5.00 Ivy form lamp. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 20.00 Matching bookshelf with books and records . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 25.00 Lincoln statue, and crosses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ; . . . . . . . . . . . . . . . . " 5.00 (2) frames, and Santa on wall. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 5.00 Stuffed toys, and pillows ..................................................... 1.00 Oak magazine rac~ and table and contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 10.00 Balance ofitems in Family Room.. . . . . . . . . . . , . .. .. .. . . .. .. . , . ... . . ... ... . .. , ,. 5.00 Dininsz Area: Wall cabinets: Miscellaneous storage .......................,..,............... 10.00 (3) shelves stemware, glass Christmas trees, bird figurines, glass award plaque, religious items ....,..................................... 20.00 Personal photos .....""................................................ -0- Wine, and rack . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . : . . . . . . . . .. 5.00 Formica oak breakfast table and (4) chairs .......................,........,..... 30.00 Kitchen: Contents of Upper Cabinets: Everyday glass and china, some food . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 25.00 Contents of Bottom Cabinets: Everyday pots and pans, storage, some food, miscellaneous ....................... 25.00 Contents of Counters: Krups coffee maker, toaster, knife set, miscellaneous ............................. 5.00 Built in refrigerator ........................................................ 75.00 Front Hall: Driftwood table with glass top . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . 60.00 Nature form lamp. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 45.00 Hand thrown vessel with water lily ............................................. 5.00 Statue of Mary on pedestal. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 10.00 Closet: Clothes ........................................................... -0- Miscellaneous. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 5.00 -:.--- Robert Dietz Estate of John R. Dietz, Deceased January 13, 2006 Page 3 LivinlZ Room: Bamboo shelves . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .. 40.00 Creche scene of (1 0) Hummel figurines ....................................... 100.00 (8) figurines, some Hummel ................................................ 200.00 (5) pieces Belleek . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75.00 Miscellaneous china, and figurines ............................................ 20.00 (2) pieces Lalique type female nude figurines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 60.00 (2) Swarovski figurines ..................................................... 50.00 Lenox dolphins. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40.00 Lenox swan .............................................................. 50.00 (11) piece fine crystal and porcelain figurines and vases. . . . . . . . . . . . . . . . . . . . . . . . . . .. 50.00 Personal photos ............................................................ -0- Cat and baby figurines ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 5.00 Porcelain eagle, rough ...................................................... 10.00 Rattan living room set: Couch, love seat, (2) coffee tables, library table, (2) ottomans, spring rocker ..................................... 125.00 (12) Lenox bird figurines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 360.00 Fireplace tools ............................................................. 5.00 Pair of bronze wheat form lamps. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 50.00 Large Winter Scene print, edition number 934/1000, approx. 4' x 5' .................. 25.00 Approx. (20) pieces Swarovski crystal figurines. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 200.00 Wood "nut and bolf' clock .................................................. 10.00 Balance of items in Living Room ............................................. 10.00 DininlZ Room: Newer oak dining set: Table, (8) chairs, (2) china closets. . . . . . . . . . . . . . . . . . . . . . . . .. 150.00 Approx. (42) pieces stemware, some painted .................................... 60.00 Ice bucket, glass candlesticks, vases ........................................... 25.00 Service for (12) newer Wedgewood china . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 75.00 Religious papier mache plate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 5.00 Pattern glass pitchers, vases, Fostoria candlesticks. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 50.00 (6) wall hangings .......................................................:.. 15.00 Console record player ....................................................... -0- Rattan tea cart ............................................................ 40.00 Personal photos ............................................................ -0- Collector plate ............................................................ 10.00 Robert Dietz Estate of John R. Dietz, Deceased January 13,2006 Page 4 patio: Patio table and chair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 10.00 H..eligious statue ............................................................. 10.00 Bath: ===: ])irt Devil vacuum " . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . .. 5.00 Dirt Devil upright vacuum. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.00 Personal storage, and towels .................................................. 5.00 Closet: == (10) prints and paintings ..................................................... 75.00 ]~ewer rugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 25.00 Table leaf. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. -0- po stairs Bath: .All personal, and towels. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 5.00 Closet: Two drawer file cabinet with personal storage ................................... 10.00 Shoe rack with shoes. . . . . . . . . .. . . . .. . . . . . . . . . . . . . . . .. . . " . . , . . . . '" . . " . . . .. 5.00 Three drawer file cabinet with personal storage .................................. 15.00 (3) cardboard files with personal storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. -0- Shoes and clothing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. -0- Hoover vacuum ........................................................... 20.00 Desk accessories and mail box bank. ........................................... 10.00 Landini! Area: Kneehole desk ............................................................ 50.00 Contents: Miscellaneous storage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " 5.00 Hewlett Packard computer set up. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25.00 Many personal photos ....................................................... -0- Recliner .................................................................. -0- Walker ................................................................... -0- Brass lamp ............................................................... 10.00 Bedroom # 1: Closet: All clothes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. -0- White bamboo form (5) piece bed set .......................................... 50.00 Family photos. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " -0- Robert Dietz Estate of John R. Dietz, Deceased J:anuary 13,2006 Page 5 Seashell lamp . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " 5.00 Large frame with flowers print ................................................ 5.00 (2) frames . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 5.00 (:brome towel rack . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 5.00 Balance of items in Bedroom #1 ............................................... 5.00 Bedroom #2: C:loset: Clothes ........................................................... -0- Natural wood bamboo form (4) piece bed set: Bed, bedside table, dresser, tall chest. . . . .. 75.00 Dresser Contents: Decoy lamp . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 10.00 Personal storage ........................................... -0- Box of jewelry . .... . . . . . . . . . .. . . . . . . .. . . . ., .. . . . . . . '" . .. . 40.00 Knick knacks, and miscellaneous . . . . . . . . . . . . . . . . . . . . . . . . . . . " 20.00 Clothes .................................................. -0- Tall Chest Contents: Clothes ............................................... -0- Personal photos . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. -0- Bedside Table Contents: Personal............................................ -0- Lounge chair and foot rest. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40.00 Pair of owl lamps .......................................................... 10.00 Vase form table lamp . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., 5.00 Wood valet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 5.00 Prayer stand .............................................................. 10.00 Bath: ==== Closet: Clothes ........................................................... -0- Towels, and personal ................................................ 5.00 Balance: Personal storage and supplies .................................. -0- Garage: 2001 Cadillac Sedan DeVille, power, 37,200 miles ............................ 13,015.00 (4) Shelves of household storage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 5.00 Baskets of miscellaneous wrapping paper; stools, canes, garden hose .................. 5.00 Knights of Columbus sword ................................................. 30.00 (6) various wreaths . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. -0- Christmas items .......................................................... .. 5.00 Tool box with storage ...................................................... 10.00 Lawn and garden tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 20.00 Aluminum ladder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " 10.00 Robert Dietz Estate of John R. Dietz, Deceased January 13,2006 Page 6 (5) Drawers: Teak face, golf plaques, family photos. . . . . . . . . . . . . . . . . . . . . . . . . . . . . " 25.00 'Tools on wall ............................................................. 25.00 Canes and walkers .......................................................... -0- Box of family photos ..................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. -0- Cabinet: Ornaments and holiday seasonal decorations, silk flowers. . . . . . . . . . . . . . . . . " 10.00 Shelves: Aluminum cookware, and miscellaneous storage... . .. . . . . .. . . . . . .. ... . . ... 5.00 Balance of items in Garage ............................................... 10.00 Total: $16,603.00 If you have any questions, please don't hesitate to call me. Thank you for allowing me to be of service in this matter. Smceroy, /AJ;jj;) It L William W. Hobbie Hobbie Auctions ADJUSTMENT TO APPRAISAL: Total appraisal $16,603.00 Less value of Cadillac (page 5) reported as a separate item on tax return (13,015.00) Adjusted value of household and personal articles $ 3,588.00 () :..:- o o () c 3 CD ::l ur Q) ::l 0- U>o CD ~ ::l co CIl ::< o c ..., :J Q) 3 ~ '< o o () c 3 CD ::l ur -- o co' N N CIl c:r ~ . -.. . '"tI:!!:a " en )> , , 0- 0- CT o-OOC) o ::l ::l :l ::lo.o.Cl. 0. -. -. --. CJl CJl Q' :E OJ OJ :;.. OJ -'" CJl (f) (f) )> (")~~c: g; ~. ro' (;, :T CJl Cl. CD ;;-;;- OJ ~"""' """' ~i ::l m m-, OmmC) . ;;~~~;(") xg;g;~~7" () _. :J ~ :T CIl en' :5' 0 ~ ~ ~ crJ ::l co CD CD :-. 0. CD 0. 0. ;:l. :E 0. _. _. CD OJ _::l ::l C~ CJl QOOC~(") """"l -, ..... OJ OJ OJ OJ CJl ::l~~ :T ICDCD CD I"""" . 0.1 0- fu s:: ;z 5" i g ~~ r~ O'OJ...... - .""'l <0 CT . 0-'< <00 C ...... -..j:J m --<0 C:l..X -. <0 OJ --. , CJlO::lcno- 0- 0. ;Z 0 ~.~ S'O::l c5 a. Q.. ~-: a. "C35.~a~ i=5'~ ~ !!! CJl CD 0- ti5' m 0. CD OJ .-. X o __w~2:() ::l~3~~~ OJCDg~~e3 0. 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I) tIl:tl 3 ~"> tIl' I CIl ~ ~ ~~ ~ g ~! ~ ~ ~ ~"" ~ ~ ~ I ::!. 111 Q (ll~ a 5--!~ ~~ l~ \CI:~ l~~ a f ~~ o I......,~~Q 0 ~ I~~~~~~ ~ ~ w o ~ ~ ~ ~ i DREXEL UNIVERSITY ONE-LIFE GIFT ANNUITY AGREEME1'-.t"f Drexel University, a Pennsylvania educational nonprofit corporation, located in Philadelphia, Pennsylvania, (hereinafter caned the "University"), agrees to pay to JOHN R DIETZ, with a mailing address of P.O. Box 485, Camp Hill, PA 17001 (hereinafter called the "Donor"), for the Donor's life, an annuity or annual sum of $2,592.00, from the date hereof, in equal quarterly installments of $648.00 on the last day or March, June, September and December. The first installment shall be payable as ofJune 30, 1995 and shall be prorated. The obligation of the University to make annuity payments shall terminate with the payment preceding the death of the Donor. This annuity is nonassignable, with the exception that it may be assigned to th.e University. The University certifies that the Donor, as e'\ridence of the Donor's desire to support the work of the University and make a charitable gift, has this day contributed to the University the property listed on Schedule" AfI attached hereto, receipt of which is hereby acknowledged, to be used for the general purposes of Drexel University. , The age of the Donor to his nearest birthday is 83. This annuity shall be governed by the laws of the Commonwealth of Pennsylvania. IN WITNESS WHEREOF, and intending to be legally bound, the University has executed this instrument to be effective the 31st day of ~1ay 1995. DREXEL UNIVERSITL- By:... ~~ Bert Landa u Senior Vice President for Finance and Adn1inistration ~...".nnoo..I..):5l.we~~.ge. /.. l. 'R}i....">. <<0-. . I' ,~ ,fo~lt R. Dl~tz, ... {/ " ?-}7.~ /2,- Q'64 Social Seem'ity Number HOLY SPIRIT HOSPITAL GIFT ANNUITY AGREEMENT GIFT ANNUITY AGREEMENT, made by and between John R. Dietz (the "Donor"), and Holy Spirit Hospital of the Sisters of Christian Charity ("Holy Spirit"), a non-profit charitable organization, incorporated under the laws of the Commonwealth of Pennsylvania, with its principal office at North 21st Street, Camp Hill, Pennsylvania. Holy Spirit hereby agrees and binds itself and its successors to pay to the. Donor during his life, an annuity or annual sum of $6,877.60'" in quarterly payments of $1,719.40'on the 30th day of March, June, September and December of each year, commencing with a first payment of $1,850.22 to be made on September 30, 1988. The obligation to pay this annuity shall terminate with the payment for the quarterly periOd immediately preceding the quarterly period in which the death of the annuitant occurs, and upon making such last payment, Holy Spirit shall be discharged from all further responsibility or obligation under this agreement. This annuity is non-assignable. Holy Spirit hereby certifies that the Donor, desiring to promote the work of Holy Spirit and in consideration of the execution of this gift annuity agreement, has contributed to Holy Spirit on June 24, 1988, 4,054 shares of CCNB Corporation common stock having an aggregate fair market value of seventy-nine thousand and fifty-three dollars ($79,053.00)~ receipt of which is hereby acknowledged, to be used for the work of Holy Spirit as designated by its Board of Directors. IN WITNESS WHEREOF, the Donor and Holy Spirit have duly signed and sealed this agreement in triplicate on this sixth day of July, 1988. Witness: Donor Attest: Holy Spirit Hospital of the Sisters of Christian Charity ~. L ~. By: ....ct /u C- ,,1..../ ~"U LeE Sister Ursula Frei, S.t.C. President HOLY SPIRIT HOSPITAL GIFTS ANNUITY AGREEMENT GIFT ANNUITY AGREEMENT, made by and between John R. Dietz (the "Donor"), and Holy Spirit Hospital of the Sisters of Christian Charity ("Holy Spirit"), a non-profit charitable organization, incorporated under the laws of the Commonwealth of Pennsylvania, with its principal office at North 21st Street, Camp Hill, Pennsylvania. Holy Spirit hereby agrees and binds itself and its successors to pay to the Donor during his life, an annuity or annual sum of $3,607.76 in quarterly payments of $901.94 on the 30th day of March, June, September and December of each year, commencing with a first payment of $901.94 to be made on March 31, 1989. The obligation to pay this annuity shall terminate with the paYment for the quarterly period immediately preceding the quarterly period in which the death of the annuitant occurs, and upon making such last paYment, Holy Spirit shall be discharged from all further responsibility or obligation under this agreement. This annuity is non-assignable. Holy Spirit hereby certifies that the Donor, desiring to promote the work of Holy Spirit and in consideration of the execution of this gift annuity agreement, has contributed to Holy Spirit on January 1, 1989 cash of $40,086.14, receipt of which is hereby acknowledged, to be used for the work of Holy Spirit as designated by its Board of Directors. IN WITNESS WHEREOF, the Donor and Holy Spirit have duly signed and sealed this agreement in triplicate on this sixth day of January 1989. Witness: ~ >n. L~2-A~ Attest: / L~~OlY Spirit Hospital of the Sisters of Christian Charity /L~~J / BV: ~ ~ ~ ~~.e. Sister Ursula Frei, S.C.C. President