From a longtime user: Good value.

Sorry to start off like this, but I first found it (around 2005?), even before Nuance acquired it....maybe? Nuance had Paperport, then it added PDF Creator, I think. I've been in the business thirty years, so I sometimes forget who acquired/developed/released which product when. :)
Regardless, I found it because I wanted a cheaper alternative to Acrobat. I tried PDF Creator (4, I think), at first for simply printing-to-PDF LONG before word processors had that built in.Then I started using editing features, cropping/resizing, secure signatures. I've only installed Advanced PowerPDF at one law firm, they used it for Bates Stamping. Other than that, it's been the standard version, and it's worked great for me and for my customers. I still think of it as Nuance, even though the Kofax acquisition is what? A couple of years old already. Regardless, the product is still good, and I recommend it.

It was mostly easy to use. Average end-users mostly can't figure out the signature feature on their own, and therefore most of my users prefer not to use it, even after I show them how. They'd sooner insert a JPG of their signature. Not as good, but it works for them.

Comments, text boxes, signatures, adding/inserting/removing pages.