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HomeMy WebLinkAbout09-22-06 I' I , REV-1500 EX + (6-00) *' W I- lI:<Ul Uii2l1: wQ,u :z:~g uQ,llI ~ OFFICIAL USE ONLY COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DE CEDENT FILE NUMBER II DECEDENT'S NAME (LAST. FIRST, AND MIDDLE INITIAL) I- : Clever, James W. z W :DATE OF DEATH (MM-DD-YEAR) ! DATE OF BIRTH (MM-DD-YEAR) C ~ : 01-08-2006 : 03-20-1938 ~ : (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST. FIRST AND MIDDLE INITIAL) I x · 1. Original Return LJ 4. Limited Estate ~ 6. Decedent Died Testate (Attach copy of Will) D 9. litigation Proceeds Received 2. Supplemental Return LJ COUNTY CODE YEAR SOCIAL SECURITY NUMBER 192-30-0852 06 0058 NUMBER THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WillS SOCIAL SECURITY NUMBER n L-J 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach copy of Trust) 10 Spousal Pover:tY- Credit (date of death between . 12-31-91 and 1-1-95) ~ 3. Remainder Return (date of death prior to 12-13-82) [J 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes I- Z W Q Z o Q, Ul W II: II: o U iNAME I Jerry A. Weigle, Esquire i FIRM NAME (If applicable) 11 Weigle & Associates, P.C. TELEPHONE NUMBER 717/532-7388 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship z o i= :5 ;:) l- e: c:( u W a::: 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) D Separate Billing Requested 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) COMPLETE MAILING ADDRESS 126 East King Street Shippensburg, PA 17257 (1) (2) (3) (4) (5) (6) (7) 104,950.00 None C) c; None:~"'i ' ~o None .> r- :<Sj 24,729.92; .)/~ ". > - c:) Nonec::;~' I) Non e~ (9) (10) 16,637.30 8,798.59 (11) (12) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o i= ~ ~ Q. ::& o u >< ~ 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. D 0.00 x .00 (15) 104,244.03 x .045 (16) 0.00 0.00 x .12 (17) x .15 (18) (19) CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. . :>:>;SE.SU~e To,ANsvveRALL Qljg~il~N~f:o~~I$VE~~J!Slbg~NI)'RE'CHECK MATH << Copyright 2002 form software only The Lackner Group, Inc. OFFICIAL USE ONLY r-...:> <= <::;:;) c:::n CI? f71 -0 N N ):::lo> :x \..0 N .-r' IT') CJ C) ?3 r..n d ~~."; C) .: ,", ,., (-) ,_ IT; '-') ('::'J (8) 129,679.92 25,435.89 104,244.03 0.00 104,244.03 0.00 4,690.98 0.00 0.00 4,690.98 Form REV-1500 EX (Rev. 6-00; ( Decedent's Complete Address: STREET ADDRESS 264 Whitmer Road, Shippensburg, CITY Shippensburg !STATE PA 1ZIP 17257 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 4,000.00 210.53 Total Credits (A + B + C) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (0 + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is thEOVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE. A. Enter the interest on the tax due. B. Enter the total of line 5 + 5A. This is theBALANCE DUE. 4,690.98 4,210.53 (3) (4) (5) 480.45 (5A) (5B) 480.45 Make Check Payable to: REGISTER OF WILLS, AGENT 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transferred;............................................................................. D b. retain the right to designate who shall use the property transferred or its income;................................ D c. retain a reversionary interest; or............................._........................................................--................. 0 d. receive the promise for life of either payments, benefits or care?........................................................... 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.. ...... ..... .............. ............. ... ......... .... ....... ..... ............ ........ ............ ....... ..... 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... 0 4. Did decedent own an Individual Retirement Account, annuity. or other non-probate property which contains a beneficiary designation?.........................................................................................--.................... 0 [!] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of petjury. 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, carr an comll Declaration of par oth than the personal representative is based on all information of which pre parer has any knowled e. SIG S FILING RETURN ADDRESS Ja es E. Clever PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 9 Ivy Lane Shippensburg, PA 17257 ADDRESS 264 Whitmer Road Shippensburg, PA 17257 ADDRESS 126 East King Street Shippensburg, PA 17257 No [!] [!] [!] [!] [!] [!J 9-11-2~ DATE cr- / ~ --o{}; DATE For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. 99116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (ii)]. The statutedoes not exemota transfer to a surviVing spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 99116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 99116 1.2)[72P.S.~9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 99116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. I " PA Inheritance Tax Return Signature of Additional Fiduciaries ESTATE OF FILE NUMBER Clever, James W. 21-06-0058 Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. Signature #3 (J,,. . '~~ 4.. ~ Bridget A. Pugh 5 Ivy Lane Name Address1 Address2 City, State, Zip Shippensburg, PA 17257 '\ l-t1}Ofo Date .. ; Rev-1502 EX+ (6-98) *' SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Clever, James W. FILE NUMBER 21-06-0058 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 Jolntly-owned with right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION 1 Real Estate - located at 264 Whitmer Road, Shippensburg, Southampton Township, Cumberland County, PA, including tracts bequeathed in Paragraphs Second and Third of Will VALUE AT DATE OF DEATH 104.950.00 TOTAL (Also enter on Line 1, Recapitulation) 104.950.00 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form P A-1500 Schedule A (Rev. 6-98) " Rev-1508 EX+ (6-98) . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Clever, James W. FILE NUMBER 21-06-0058 ESTATE OF Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION 1 SKF - final paycheck VALUE AT DATE OF DEATH 812.00 2 U. S. Treasury - 2005 federal income tax refund 939.00 3 Orrstown Bank Checking Account #103001534 2.788.69 Accrued interest on Item 3 through date of death 0.33 4 Orrstown Bank Savings Account #703001854 160.92 Accrued interest on Item 4 through date of death 0.06 5 Orrstown Bank savings account deposit in transit at date of death 1,129.12 6 1999 Ford F450 XL Truck 11.800.00 7 2002 Ford Taurus 4.025.00 8 Guns 410.00 9 Miscellaneous personal property - proceeds of sale 3-26-06 274.80 10 Personal Property 2.390.00 TOTAL (Also enter on Line 5, Recapitulation) 24.729.92 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) .- -< . REV-1151 EX+ (12-99) *' SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Clever, James W. Debts of decedent must be reported on Schedule I. FILE NUMBER 21-06-0058 ESTATE OF ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached 8,122.80 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number{s) I EIN Number of Personal Representative{s): Street Address City State Zip - Year(s) Commission paid 2. Attorney's Fees Weigle & Associates, P.C. 3,150.00 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 Register of Wills, Cumberland County 302.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 5,062.50 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 16,637.30 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 ScheduleH (Rev. 6-98) ,- Rev-1502 EX+ (6-98) . SCHEDULE H-A FUNERAL EXPENSES continued COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Clever, James W. FILE NUMBER 21-06-0058 ITEM NUMBER DESCRIPTION AMOUNT 1 Fogelsanger-Bricker Funeral Home 6.573.40 2 Lester Williams - monument 1.083.00 3 Premier Events - funeral reception 466.40 Subtotal 8.122.80 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA.1500 Schedule H-A (Rev. 6-98) .- Rev-1502 EX+ (6-98) . SCHEDULE H-87 OTHER ADMINISTRATIVE COSTS continued COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Clever, James W. FILE NUMBER 21-06-0058 ITEM NUMBER DESCRIPTION AMOUNT 1 Cumberland Law Journal - advertising Letters Testamentary 75.00 2 Dennis Gotshall, Auctioneer - appraisal of personal property 85.00 3 Fort Chambers, Inc. - appraisal of guns 30.00 4 John Kissinger Surveying - survey of real estate prior to subdivision 4.500.00 5 Linda K. Klein - notary fees 13.00 6 News Chronicle - advertising Letters Testamentary 125.75 7 Register of Wills, Cumberland County - filing PA Inheritance Tax Return 15.00 8 Register of Wills, Cumberland County - filing Family Settlement Agreement 100.00 9 Sailhamer Real Estate - appraisal fee 100.00 10 Weigle & Associates, P.C. - reimbursement for postage, xerox copies, and long distance telephone calls 18.75 Subtotal 5.062.50 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 ScheduleH-B7 (Rev. 6-98) Rev-1512 EX+ (6-98) *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYlVANIA INHERITANCE TIIX RETURN RESIDENT DECEDENT ESTATE Of Clever, James W. FILE NUMBER 21-06-0058 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1 Chambersburg Hospital VALUE AT DATE OF DEATH 730.90 2 Chambersburg Hospital 555.46 3 Chambersburg Hospital 20.80 4 Credit Management Company 232.12 5 Ford Credit - payoff of 2002 Ford Taurus 4.162.22 6 Orrstown Bank Checking Account #103001534 - checks clearing after date of death 368.08 7 Shippensburg Family Practice 106.46 8 Sprint - final billing 28.67 9 Summit Cancer Services 663.41 10 Vivian F. Coy, Tax Collector - 03-01-2006 county real estate taxes 321.41 11 Vivian F. Coy, Tax Collector - 07-15-2006 school real estate taxes 1.609.06 TOTAL (Also enter on Line 10, Recapitulation) 8,798.59 (If more space is needed. additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group. Inc. Form PA.1500 Schedule I (Rev. 6-98) .- REV-1513 EX+ (9.00) *' SCHEDULE .J BENEFICIARIES ESTATE OF COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT NUMBER I. 1 2 3 4 5 Clever, James W. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal oistributions, and transfers under Sec. 9116(a)(1.2)] Tammy S. Ackerman P. O. Box 572 Marshall, MO 65340 FILE NUMBER 21-06-0058 SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) RELATIONSHIP TO DECEDENT Do Not List Trustee/s) Daughter Real Estate + 1n of residuary 14,892.00 George A. Clever 264 Whitmer Road Shippensburg, PA 17257 Son Real Estate + 1/7 of residuary 14,892.00 James E. Clever 9 Ivy Lane Shippensburg, PA 17257 In Trust FBO Jeffrey W. Clever 264 Whitmer Road Shippensburg, PA 17257 Bridget A. Pugh 5 Ivy Lane Shippensburg, PA 172~7 Son 14,892.00 1/7 of residuary Son 1n of residuary 14,892.00 Daughter 1n of residuary 14,892.00 See continuation schedule attached Continuation 29,784.03 Total 104,244.03 Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet II. NON-TAXABLE DISTRIBUTIONS: A SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 ScheduleJ (Rev. 6-98) SCHEDULE J BENEFICIARIES (Part I, Taxable Distributions) ESTATE OF: James w. Clever 192-30-0852 01/08/2006 Item Name and Address of Person(s) Share of Estate Amount of Estate Number Receiving Property Relationship (Words) ($$$) 6 Stacy M. Rossi 4300 Burkley Street Harrisburg, PA 17109 Daughter 2n of residuary 29,784.03 Total 29,784.03 1 ~. " LAST 1r7LLAND TESTAMENT I, James W. Clever, presently residing at 264 Whitmer Road, Shippensburg, Southampton Township, Cumberland County, Pennsylvania 17257, being of sound mind, memory and disposition, do hereby make, publish and declare this my Last Will and Testament, hereby revoking and making void all wills by me at any time heretofore made. FIRST. I order and direct the payment of all my legally enforceable debts and funeral expenses as soon as may be convenient after my decease. SECOND. I devise, devise and bequeath a more or less triangular tract of real estate, which is yet to be subdivided and containing approximately three (3) acres more or less to my son, George A. Clever, absolutely. Said real estate is a part of my real estate more fully described in Cumberland County Deed Book J, Volume 22 at Page 423 and is bounded on one side by Whitmer Road, on another by Sumac Lane, and on another side by a stream. Any and all subdivision costs shall be borne by my estate. Any and all death taxes attributable to this bequest shall be borne by the said George A. Clever. THIRD. I give, devise and bequeath a certain tract of real estate, consisting of approximately 1-1/4 acres, along Township Route Number 314 known as 294 Whitmer Road, Shippensburg, Southampton Township, Cumberland County, Pennsylvania (Lot #3 as per a subdivision plan recorded in Cumberland County Plan Book 32 at Page 24), to my daughter, Tammy S. Ackerman, absolutely. Any and all death taxes attributable to this bequest shall be borne by the said Tammy Sue Ackerman. FOURTH. I give, devise, and bequeath all of the rest, residue and remainder of my estate, real, personal and mixed, whatsoever and wheresoever situate, to my children, as follows: A. 2/7 of my estate to my daughter, Stacy M. Rossi, on a per stirpes distribution basis; B. 1/7 of my estate to my son, James E. Clever, on a per stirpes distribution basis; C. 1/7 of my estate to my daughter, Bridget A. Pugh, on a per stirpes distribution basis; D. 1/7 of my estate to my son, George A. Clever, on a per stirpes distribution basis; E. 1/7 of my estate to my daughter, Tammy S. Ackerman, on a per stirpes distribution basis; F. 1/7 of my estate to my son, George A. Clever, IN TRUST, for the benefit of my son, Jeffrey W, Clever, who is ~e.~~nt1y incarcerated in State prison with the following powers: /' //~// ',//~;~"'/' . .' v /'__~;/./ _:.._/:.~~1"~ {/(..{~:>-;!:/le-.!2-t (SEAL) ........,. ~- ~....~ WEIGLE & ASSOCIATES, P.c. - ATTORNEYS AT LAW -- 126 EAST KING STREET - SHIPPENSBURG. PA 17257-1397 I, The power and obligation to expend the income towards the health, support and maintenance of the said beneficiary; 2. The power and obligation to expend the principal, within the discretion of the said Trustee, if the income is insufficient, towards the health, support and maintenance of the said beneficiary; 3. The power to sell any and all real estate, within the discretion of the said Trustee; 4. The power and obligation to distribute the balance of principal and interest, if any remaining, if and when the said beneficiary is released from prison, without the necessity of a formal adjudication of the Trustee's Account in the Court of Common Pleas of Cumberland County, upon the receipt of a good and valid release. Should the said Jeffrey W. Clever die while in prison, any remainder of principal and interest shall be distributed to my son, George A. Clever, absolutely; 5, The principal of the Trust and the income therefrom shall be free from the debts, liabilities, and engagements of those beneficially interested therein, and shall not be subject to assignment by him or her, nor to attachment or execution under any legal, equitable or other process for the enforcement of judgments or claims of any sort against them, either individually or collectively; and 6. In the event the above-mentioned person is unable to accept the position of Trustee, I then name, constitute and appoint James E. Clever, as Trustee, with the same powers and obligations hereinbefore stated. G. I have specifically omitted any bequests to the family of my deceased son, Kevin W. Clever, under this my Last Will & Testament, as I have otherwise provided for the said Kevin W. Clever during his lifetime. FIFTH, I nominate, constitute and appoint my children, James E. Clever, presently residing at 9 Ivy Lane, Shippensburg, Pennsylvania 17257; George A. Clever, presently residing at 264 Whitmer Road, Shippensburg, Pennsylvania 17257; and Bridget A. Pugh, presently residing at 5 Ivy Lane, Shippensburg, Pennsylvania 17257, or the survivor thereof, to be the Co- Executors of this my Last Will and Testament,.. .... .. /~-.-..-.- I l /)- iJ/ /'l .<) / I ~; ... .'. (~...' ~~XJ, /' (;-~~EAL) .'/ ,//:~::/ I' "".. i..,/ WEIGLE & ASSOCIATES, P.c. - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397 SIXTH. I direct that my personal representative(s) shall not be required to give bond for the faithful performance of their duties in any jurisdiction. SEVENTH. Unless otherwise stated in this my Last Will and Testament, I hereby direct that all federal, state and other death taxes payable because of my death, with respect to the property forming my gross estate for tax purposes, whether or not passing under this Will, including any interest or penalty imposed in connection with such taxes, shall be considered a part of the expense of administration of my estate and that such be paid out of the rest and residue of my estate. EIGHTH. I direct my Executor to retain the services of Jerry A. Weigle, Esquire, with offices located at 126 East King Street, Shippensburg, Pennsylvania 17257, with respect to the settlement of my estate due to his familiarity with my affairs. IN WITNESS WHEREOF, I, James W. Clever, have hereunto set my hand and seal to this ~y ~ast ~ill and T~stamen7t written on Three (3) t)ages, the first two (2) pages signed for IdentlficatlOn only, this:2 day of 0(' to!J t: r ,2004. .~o>'._"--'- (SEAL) WEIGLE & ASSOCIATES, RC - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397 This instrument was by the Testator, on the date hereof, signed, published and declared by him to be his Last Will and Testament, in our presence, who at his request and in the presence of each other, we believing him to be of sound and disposing mind and memory, have hereunto subscribed our names as witnesses. Jot iu~.lA f(. T UQ Q ./". /l&;~-/~ d Juy ?J...Jl cZ~ COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND I, James W. Clever, the person whose name is signed to the foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. ~CZ". // fA . /' ~ . /.,../ ///' t..../' Sworn or affirmed to and acknowledged before me by !~es W. Clev Testator, this'L.WtL day of . o j NO IAL SEAL Jerry A. W ,:lle, Notary Public Shlppensburg. PA Cumberlalld County Commission Exoires October 7. 2006 , '- WEIGLE & ASSOCIATES, RC. -- ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397 COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND We, rlft,e~ c (A L . tome ?a r/r /1"( ~ j)- frey and ~O()\Ze I . \le _r\ , the witnesses whose names are signed to the foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw James W. Clever, the Testator, sign and execute the instrument as his Last Will; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator, signed the will as witnesses; and that to the best of our knowledge the Testator was at the time eighteen (18) or more years of age and of sound mind and under no constraint or undue influence. Jl~D- A I crr]Q ~;--La,_ d ~ ~~L;c ~~b Sworn or affirmed to and subscribed before me by?ft+,3~C;A Lr hrn-€- ~ rr;; i (/ c. c~. J~ 1~/'-f"1 tI ) and1:rrA<.e r.(r wi . sses, this "t da; of . Or , ) NOTA AL SEAL Jerry A. Weigle, Notary Public Shippensburg, pt>. CLimberlatld CountYn My Commj~~~~~~f~~5)cto~~r 7, 200u WEIGLE & ASSOCIATES. RC, - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG. PA 17257-1397 SailfuuneJt, fileal utate,J tIC " 494 East King street Shippensburg,Pa. (717) 532-6059 Fax: (717) 530-5181 Estate of: James W Clever 264 Whittner Road & 29 Sumac Lane Shippensburg,Pa. 17257 February 13,2006 This analysis has"not been perfonned in accordance with the unifQnn Standards of professional practice which requires valuers to act as inbiased, disinterested third parties with impartiality, objectivity and independence and without accommodation of personal interest, it is not to be construed as an appraisal and may not be used as such for any pui'pose. In response to your request for a comparable market analysis of Real Estate for the Estate of James W, Clever. I am senQing you my estimation of current market value. The property is located in the Township of Southampton, Cumberland County, Pennsylvania. Located at 264 Whitmer Road & Sumac Lane. Real Estate parcel #39-14-0167-016. Property consists of 44.79 acres with frame dwelling. Property has abandoned vehicles, scrap metal and materials and misc. items that need to be cleaned up . The surrounding area is in fair condition of other homes similar to subject property. I am sending you my estimation of current market value. Upon my review of the property The subject property does need cosmetic repairs inside and outside, and other maintenance items. Selling property in" AS IS" condition. See attached plot plan and deeds. Also Copy of Tax Assessment Database. Listing price range $99,900 to $110,000. Sailhamer Real Estate, Inc. Barry Negley - Realtor "" 494 East King Street Shippensburg P A 17257 ""-. 1ir~15-91 P 026,164,655 ~! 000 05 12 06 34 AUSTIN, TEXAS 2307 54667088 20092800 130 OCLEV 111.11111I1111.1.1.1.111.111I11111111I1.1.1111111.1,11111111.1 JAMES E CLEVER JAMES W CLEVER DECO 126 E KING.ST SHIPPENSaURGPA 17257-1326 Check No. 2307 54667088 PHILA TAX REFUND 12/05 88 $****939*00 -:000000 5 ~BI: 5 ..Sa& ?OSa ~Il. alia so I:r March 7, 2006 . TO: Law Offices of Weigle & Associated, P.C. 126 East King St. Shippensburg, PA 17257 /" FROM: Todd L. Miller Cuse Service Specialist P.O. BOX 250 SHIPPENSBURG PA 17257-0250 MAR - 9 2006 .t- RE: ESTATE OF James W. Clever DATE OF DEATH: January 8, 2006 IT IS HEREBY CERTIFIED THAT THE ABOVE NAMED DECEDENT HAD, ON THE ABOVE DATE, THE FOLLOWING ACCOUNTS WITH ORRSTOWN BANK: . CHECKING ACCOUNTS ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPAL & ACCRUED INTEREST 103001534 James W. Clever 12/06/99 $2,788.69 $.33 SAVINGS ACCOUNTS ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPAL & ACCRUED INTEREST 703001854 James W. Clever 01/10/00 $160.92 $.06 ChecklnglSavlngslClub Debit O~t!.. ....1IZ:U()6 Cu~ornjt~N~rn~ . James wi Clever (deed) Description Account Number 103001534 Cn~g.. ..... ::J;_= .(77) COiTeCtiOn ~~~~~~ ~.~ P Gilson. .. . '.': . -. ':':', -. -' ~ . Savings (58) Regular wId (50) Closing Acct. CIW2 (51) Closing Acct. Customer Signature ~t1"t> 8 __ . ~ . l ~.. :'.-. .:-. :.~ (~;2}:;~'///C;~'i:.~\~;\}-::~: ~-:7:~:i,~.J.~L'. '>'~'-;.~'<~i';::. .~..'.:;.; ~~;:~'('~";':';.:'. .:,',". . .', ...."..:.::,>.,-::. or ...v._,.,........: . . ..' 'L;.~".' .... ".:_:' ..... ."'..:. .:.~-' ...:..;....,.,. :.... '_':-""'~":':~a-;' ....':~~... ...' ,..' ~:.......'- '- Ch.icktriltsavlngslClub . Debit Account Number . 70~001854 a'Q;; "James w. Cl-1; Cdec!ll De$c:riPtion ton PRf"Jlf"". .Sll'l'nttn"'" . . -. ...1Jebit (66);i;M~A-Debit ('r~t8<>rrection . (59f.PI~i"9:~qct. ... . .. . .... . . (S2)HCSfiitetOwntnvestment Withdrawal . Ptep.~By .;P Gilson Savings (58) Regular wid (50) Closing Acct. Club (51) Closing Acct. 1,tto ,10 . Customer Signature ~ ~ f=> 1~ .to",. . t~~. .. \ . - .. ~~::..:~:L.:.:l:~.::.~>_: <:: .~':; :'.. . ...-.i;:........--. .. .... '~'~"'i.0--"<-'::';,:~ '." ". . .<'".-. .-- .....,: .-....,.-......- ..:-.....:.. ;.; . ..... ~;.:,_.. I ,.---- APPRAISAL OF PERSONAL PROPERTY OF THE ESTATE OF JAMES W. CLEVER. 264 WlDTMER ROAD. SIDPPENSBURG. P A ON JANUARY 30. 2006: Wooden table & 4 chairs Whirlpool refrigerator (not working properly) Gas stove (not working) Miscellaneous pots & pans Miscellaneous dishware in cupboards 2-Piece living room suit (shows much wear) Small Gibson upright freezer (older model) Bookshelf / Miscellaneous knick-knacks Coffee table RCA television on stand 2 Common table lights @$ 5.00 2 VHS tape cabinets @$ 15.00 Miscellaneous VHS tapes 10-Gun wooden gun cabinet Double mattress & box spring on frame 2 Matching end tables @$ 5.00 Modem wooden wardrobe 2 Modem chest of drawers @$ 5.00 Frigidaire automatic washer Amana clothes dryer Delta 4-in. jointer Craftsman combination belt/disc sander Band saw (older model) Miscellaneous hand power tools Picture framing vise Craftsman 10-in. table model band saw Industrial vertica1/horizontal metal band saw (needs new switch) Forney F -100 arc welder H.D. vise Work bench Home-made grinder Miscellaneous drill bits K&F floor model drill press Metal lathe 3-Phase electric metal chop saw 3 Bench grinders @$ 10.00 Craftsman chest-on-chest tool cabinet Miscellaneous hand tools Mity Mite arc welder Pipe vise John Deere STX 30 riding lawn mower Lawn Chief 14 h.p. riding lawn mower (needs some work) - $ 25.00 $ 15.00 $ no value $ 25.00 $ 5.00 $ 5.00 $ 25.00 $ 5.00 $ 20.00 $ 5.00 $ 40.00 $ 10.00 $ 30.00 $ 15.00 $ 55.00 $ 20.00 $ 10.00 $ 10.00 $ 10.00 $ 45.00 $ 35.00 $ 60.00 $ 55.00 $ 20.00 $ 25.00 $ 10.00 $ 40.00 $ 55.00 $ 30.00 $ 10.00 $ 20.00 $ 20.00 $ 40.00 $ 60.00 $ 275.00 $ 30.00 $ 30.00 $ 60.00 $ 75.00 $ 30.00 $ 25.00 $ 175.00 $ 75.00 -2- 2002 4-door Ford Taurus SES with 3.0L V-6 engine, full power and 77,000 miles.......................................... ...... ............. Clark forklift (older model) Acetylene tanks Starcraft 14-ft. boat & trailer (older model) Mercury 20 h.p. outboard motor (older model) Craftsman radial arm saw (older model) Lincoln 225 amp arc welder Sears table saw (rough) Tow-behind sandblaster (as is) 1999 Ford F450 XL Super Duty dual wheel truck with V-8 diesel engine, wooden flat bed, and 19,072 miles (dent in back of cab)............... Makeshift sawmill Planer (as is) TOTAL: APPRAISED BY: ~....;.., /dtid, Dennis L. Gotshall, Auctioneer/Prop. Dan Hershey Auctioneering Service PA Lie. #AU-002306-L 3 Brown Road Shippensburg, PA 17257 j8'z/S' -1,(/\c/l- , J t ~ , - CUV' _ L(O"LS- ------ 2390 --- -- $ 4,025.00 $ 125.00 $ 95.00 $ 150.00 $ 75.00 $ 45.00 $ 60.00 $ 20.00 $ 25.00 $ 11,800.00 $ 125.00 $ 40.00 $ 18,215.00 . . . t s-/-a fe D 0 LP {:..- tf~ ~.91't1c:. 5 0. C" LE U i /G ----,~,..~------~-~~---_.-~- -----......_.~---^ - if\.. ~J Q/ / L~"ct'rY'7 I. 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