HomeMy WebLinkAbout01-1144 FX
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IN THE COURT OF COMMON PLEAS
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OF CUMBERLAND COUNTY
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PENNA.
STATE OF
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CAROl. A
F'TTR,TlIl\TIC' ,
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No. 01-1144 CIVIL TF.Rl'I
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Plaintiff
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VERSUS
JAMES A. FURJANIC,
Defendant
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DECREE IN
DIVORCE
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AND NOW,
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DECREED THAT
CAROL A. FURJANIC
, PLAINTIFF,
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JAMES A. FURJANIC
, DEFENDANT,
AND
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ARE DIVORCED FROM THE BONDS OF MATRIMONY,
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THE COURT RETAINS JURISDICTION OF THE FOLLOWING CLAIMS WHICH HAVE
BEEN RAISED OF RECORD IN THIS ACTION FOR WHICH A FINAL ORDER HAS NOT
YET BEEN ENTERED; NONE,
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The provisions of the parties' M~rr;~gp ~prrlpment Agreement
dated April 24, 2003, are incorporated by reference but shall
not be deemed merged into this Decree in Divorce,
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FETrERHOFF AND ZILU
ATTORNEYS AT LAW
200 N, THIRD STREET - SUITE 800
p,O, BOX 1161
HARRISBURG, PENNSYLVANIA 17108-1161
WILLIAM A. FETTERHOFF
TELEPHONE
717.232.7722
FAX
717-233-4965
October 24,2002
E. Robert Elicker, II, Divorce Master
Office of Divorce Master
9 North Hanover Street
Carlisle, PA 17013
Re: FUIjanic v, FUIjanic
No, 01-1144 Civil
Dear Mr, Elicker:
In response to your letter of October 23,2002 I enclose copies of the Pre-Trial Statement
and the Inventory, the originals of which were filed with the Prothonotary in Cumberland County
Court October 22, 2002, I also enclose the Income and Expense Statement, filed with the
Prothonotary on October 17, 2002, All of these documents were served on opposing counsel on the
date filed,
Sincerely,
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William A. Fetterhoff
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Enclosure
cc: James A. Furjanic
Cara Y. Boyanowski, Esq,
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DALEY LAW OFFICES
1029 SCENERYDRlVE' HARRlSBURG, PA 17109' INBOX@DALEYLAWOFFICES,COM' (717) 657.4795' FAX (717) 657.4996
November 21, 2002
Prothonotary
CUMBERLAND COUNTY COURTHOUSE
High and Hanover Streets
Carlisle, PA 17013
RE: Furianic v, Furianic
Dear Sir or Madam:
Enclosed, please find one original Plaintiff's Pre-Trial Statement, as well as, three copies
of same, Kindly file the original document with your office, time-stamp the remaining copies, and
return same to me in the enclosed self-addressed, stamped envelope,
Also enclosed, please find one original Amended Inventory under Ru1e 1920.33, as well
as, three copies of same, Again, kindly file the original document with your office, time-stamp the
remaining copies, and return same to me in the enclosed self-addressed, stamped envelope,
Thank you for your kind attention,
Sincerely yours,
CAB/cb
Enclosures
cc: Carol A Fwjanic
William A Fetterhoff, Esquire
E. Robert Elicker, II, Divorce Master
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DALEY LAW OFFICES
1029 SCENERY DRIVE . Hi\.RRlSBURG, PA 17109 . INBOX@DALEYLAWOFFICES,COM . (717) 657.4795 ' FAX (717) 657-4996
October 11, 2002
E. Robert Elicker, II, Divorce Master
Office of Divorce Master
9 North Hanover Street
Carlisle, PA 17013
Re: Furjanic v, Furjanic
No. 01-1144 Civil
Dear Mr, Elicker:
Pursuant to your request, I am forwarding to you the Certification indicating that discovery
is complete in the above-captioned divorce action,
Very truly yours,
:pap
Enclosure
cc: William A. Fetterhoff, Esquire
Carol A. Furjanic
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FEITERHOFF AND ZILU
ATTORNEYS AT LAW
200 N, THIRD STREET. SUITE 800
P,O, BOX 1161
HARRISBURG. PENNSYLVANIA 17108-1161
WILLIAM A. FETTERHOFF
TELEPHONE
717-232-7722
FAX
717.233.4965
October 22, 2002
E, Robert Elicker, II, Divorce Master
Office of Divorce Master
9 North Hanover Street
Carlisle, PA 17013
Re: Fmjanic v, Fmjanic
No, 01-1144 Civil
Dear Mr, Elicker:
Enclosed please find a Certification indicating that discovery is complete in the above-
captioned divorce action,
Sincerely,
0J-~
William A. Fetterhoff
Irs
Enclosure
cc: Cara A Boyanowski, Esq,
James A. Futjanic
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OFFICE OF DIVORCE MASTER
CUMBERLAND COUNTY
COURT OF COMMON PLEAS
9 North Hanover Street
Carlisle, PA 17013
(717) 240-6535
E, Robert Elicker, II
Divorce Master
Traci Jo Colyer
Office Manager/Reporter
West Shore
697-0371 Ex!. 6535
October 23, 2002
Cara A. Boyanowski
Attorney at Law
DALEY LAW OFFICES
1029 Scenery Drive
Harrisburg, PA 17109
William A. Fetterhoff, Esquire
FETIERHOFF & ZILLI
200 North Third Street
Suite 800
Harrisburg, PA 17101
RE: Carol A. Furjanic vs. James A. Furjanic
No. 01 - 1144 Civil
In Divorce
Dear Ms, Boyanowski and Mr. Fetterhoff:
Both counsel have certified that discovery is complete; therefore,
we will not be dealing with any outstanding discovery issues at the time
of the pre-hearing conference.
This action was commenced by the filing of a complaint in divorce
on February 27,2001, raising grounds for divorce of irretrievable
breakdown of the marriage and indignities, The complaint also averred
that the parties separated December 26, 2000. Therefore, I assume that
we will either have the parties sign affidavits of consent or one of the
parties will file a 3301(d) affidavit averring a two-year separation
immediately following December 26, 2002. Therefore, there is no need to
proceed on any indignities claim.
The complaint also raised the economic claims of equitable
distribution, alimony, alimony pendente lite and counsel fees and
expenses,
In accordance with P,R.C.P. 1920,33(b) I am directing each counsel
to file a pretrial statement on or before Monday, November 25,2002.
Upon receipt of the pretrial statements, I will immediately schedule a
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Ms. Boyanowski and Mr. Fetterhoff, Attorneys at Law
23 October 2002
Page 2
pre-hearing conference with counsel to discuss the issues and, if
necessary, schedule a hearing,
Very truly yours,
E, Robert Elicker, II
Divorce Master
NOTE:
Sanctions for failure to file the pretrial statements are set
forth in subdivision (c) and (d) of Rule 1920,33.
THE ORIGINAL PRETRIAL STATEMENT SHOULD BE FILED
IN THE MASTER'S OFFICE AND A COPY SENT DIRECTLY
TO OPPOSING COUNSEL.
FAILURE TO FILE PRETRIAL STATEMENTS AS DIRECTED
BY THE MASTER MAY RESULT IN THE MASTER'S
APPOINTMENT BEING VACATED.
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DALEY LAW OFFICES
1029 SCENERY DRIVE' HARRISBURG, PA 17109' INBOX@DALEYLAWOFFICES,COM . (717) 657.4795 . FAX (717) 657.4996
April 24, 2003
E. Robert Elicker, II, Esquire
Divorce Master for Cumberland County
9 N. Hanover Street
Carlisle, PA 17013
RE: Furianic v, Fwjanic
Dear Master Elicker:
Enclosed, please find two (2) copies of the Marriage Settlement Agreement entered into
by the parties on April 24, 2003, Since the parties have settled all of their outstanding economic
claims, kindly cancel the Master Hearing scheduled for Monday, April 28, 2003 at 9:00 a,m, and
revoke your appointment as Master in this case,
Thank you for your kind attention,
Sincerely yours,
a;~~0
CAB/cb
Enclosures
cc: Carol A. Fwjanic
William A. Fetterhoff: Esquire
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Cara A Boyanowski, Esquire
Counsel for Wife
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AGREEMENT
BETWEEN
CAROL A. FURJANIC
AND
JAMES A. FURJANIC
William A Fetterhoff, Esquire
Counsel for Husband
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TABLE OF CONTENTS
SECTION I:
Introduction
SECTION II:
General Provisions
SECTION III:
Alimony and Alimony Pendente Lite
Provisions
SECTION N:
Property Distribution Provisions
SECTION V:
Closing Provisions and Execution
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SECTION I
INTRODUCTION
THIS AGREEMENT made this ~J.JJij) day of ~ ' 2003, by and
between CAROL A. FURJANIC ("Wife") and JAMES A. ANIC ("Husband").
WITNESSETH:
WHEREAS, Carol A. Furjanic, Social Security Number 185-38-6096, was born on
September 28, 1949, and currently resides at 186 Stonehedge Lane, Mechanicsburg, Cumberland
County, Pennsylvania 17055,
WHEREAS, James A. Furjanic, Social Security Number 202-36-7201, was born on May 8,
1948, and currently resides at 96 Deerfield Road, Camp Hill, Cumberland County, Pennsylvania
17011.
WHEREAS, the parties hereto are Husband and Wife, having been married on February 13,
1982, in Harrisburg, Dauphin County, Pennsylvania,
WHEREAS, the union of the parties produced no children.
WHEREAS, diverse unhappy differences, disputes and difficulties have arisen between the
parties, and it is the intention of Wife and Husband to live separate and apart for the rest of their
natural lives, and the parties hereto are desirous of settling fully and finally their respective financial
and property rights and obligations as between each other, including, without limitation, the settling
of all matters between them relating to the ownership of real and personal property, the equitable
distribution of such property; the settling of all matters between them relating to the past, present and
future support and/or maintenance of Wife by Husband or of Husband by Wife; and, in general, the
settling of any and all claims and possible claims by one against the other or against their respective
estates,
NOW, 'THEREFORE, in consideration of the mutual promises, set forth herein and for other
good and valuable considerations, Wife and Husband, each intending to be legally bound hereby agree
as follows:
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SECTION n
GENERAL PROVISIONS
1. MUTUAL CONSENT DNORCE
The parties intend to secure a mutual consent, no fault divorce pursuant to the provisions of
Section 330l(c) of the Divorce Code of 1980, as amended and will execute the documents necessary
to effectuate a divorce under those provisions concurrently with the execution of this Agreement,
2. EFFECT OF DNORCE DECREE
The parties agree that unless otherwise specifically provided herein, this Agreement shall
continue in full force and effect after such time as a final decree in divorce may be entered with
respect to the parties,
3. AGREEMENT TO BE INCORPORATED BUT NOT MERGED IN DNORCE
DECREE
The provisions of this Agreement may be incorporated by reference but shall not be deemed
merged into any judgment or decree for divorce obtained by either party, This agreement shall
survive any such final decree of divorce, shall be entirely independent thereof, and the parties intend
that all obligations contained herein shall retain their contractual nature in any enforcement
proceedings, whether enforcement is sought in an action on the contract itself or in any enforcement
action filed to the divorce complaint.
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4. DATE OF EXECUTION
The "date of execution" or "execution date" of this Agreement shall be defined as the date
upon which it is executed by the parties if they have each executed the Agreement on the same date,
Otherwise, the "date of execution" or "execution date" of this Agreement shall be defined as the date
of execution by the party last executing this Agreement,
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5. ADVICE OF COUNSEL
The provisions of this Agreement and their legal effect have been fully explained to Wife by
her attorney, Cara A. Boyanowski, Esquire, The provisions of this Agreement and their legal effect
have been fully explained to Husband by his attorney, William A. Fetterhoff, Esquire, The parties
acknowledge that they fully understand the facts and have been fully informed as to their legal rights
and obligations, and they acknowledge and accept that this Agreement is, in the circumstance, fair
and equitable and that it is being entered into freely and voluntarily, after having received such advice
and with such knowledge and that execution of this Agreement is not the result of any duress or
undue influence and that it is not the result of any collusion or improper or illegal agreement or
agreements,
6. TAX PROVISIONS
The parties believe and agree, and have been so advised by their respective attorneys, that the
division of property heretofore made by this Agreement is a non-taxable division of property between
co-owners rather than a taxable sale or exchange of such property, Each party promises not to take
any position with respect to the adjusted basis of the property assigned to him or her or with respect
to any other issue which is inconsistent with the position set forth in the preceding sentence on his
or her federal or state income tax returns,
The parties have heretofore filed joint federal and state tax returns. Both parties agree that
in the event any deficiency in federal, state or local income tax is proposed, or any assessment of any
such tax is made against either of them, each will indemniJY and hold harmless the other from and
against any loss or liability for any such tax deficiency or assessment and any interest, penalty and
expense incurred in connection therewith, Such tax, interest, penalty or expense shall be paid solely
and entirely by the individual who is finally determined to be the cause of the misrepresentations or
failures to disclose the nature and extent of his or her separate income on the aforesaid joint returns,
7. PERSONAL RIGHTS
Wife and Husband may and shall, at all times hereafter, live separate and apart, They shall
be free from any contact, restraint, interference or authority, direct or indirect, by the other in all
respects as fully as if they were unmarried, Each may, for his or her separate use or benefit, conduct,
cany on and engage in any business, occupation, profession or employment which to him or her may
seem advisable, Wife and Husband shall not molest, harass, disturb, or malign each other or the
respective families of each other nor compel or attempt to compel the other to cohabit or dwell ~~()._-
any means whatsoever with him or her, Date 0; separation: December 26, 20~'f .
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8. MUTUAL RELEASES
Except as otherwise expressly provided by this Agreement:
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A Each party hereby absolutely and unconditionally releases and forever discharges the
othe'r and the estate of the other for all purposes from any and all rights and obligations which either
may have or at any time hereafter have for past, present or future support or maintenance, alimony
pendente lite, alimony, equitable distribution, counsel fees, costs, expenses and any other right or
obligation, economic or otherwise, whether arising out of the marital relationship or otherwise,
including all rights and benefits under the Pennsylvania Divorce Code of 1980, its supplements and
amendments, as well as under any other law of any other jurisdiction, except and only except all
rights, agreements and obligations of whatsoever nature arising or which may arise under this
Agreement or for the breach of any provision thereof Neither party shall have any obligation to the
other not expressly set forth herein,
B. Each party hereby absolutely and unconditionally releases and forever discharges the
other and his or her heirs, executors, administrations, assigns, property and estate from any and all
rights, claims, demands or obligations arising out of or by virtue of the marital relationship of the
parties or otherwise, whether now existing or hereafter arising. The above release shall be effective
regarcUess of whether such claims arise out of any former or future acts, contracts, engagements or
liabilities or the other or by way of dower, curtsey, widow's rights, family exemption or similar
allowance, or under the intestate laws, or the right to take against the spouse's will, or the right to
treat a lifetime conveyance by the other as testamentary, or all other rights of a surviving spouse to
participate in a deceased spouse's estate, whether arising under the laws of Pennsylvania, any state,
commonwealth or tenitory or the United States, or any other country. It is expressly understood,
however, that neither the provisions of this release nor the subsequent entry of a divorce decree are
intended to defeat the right of either party to receive any insurance proceeds at the death ofthe other
ofwhic:h she or he is the named beneficiary (whether the beneficiary designation was made prior or
subsequent to execution hereof), nor to defeat the right of either party to receive any legacy, bequest
or residuary portion of the other's estate under his or her will, or to act as personal representative or
executor if so named by the will of the other, whether such will was executed prior or subsequent to
this Agreement.
C, Except for any cause of action for divorce which either party may have or claim to
have, and except for the obligations of the parties contained in this Agreement and such rights as are
expressly reserved herein, each party gives to the other by the execution of this Agreement an
absolute and unconditional release and discharge from all causes of action, claims, rights or demands
whatsoever, in law or in equity, which either party ever had or now has against the other.
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9. FINANCIAL DISCLOSURE
The parties have disclosed to each other and they are each aware of the extent of each other's
income, assets, liabilities, holdings and estate, Each of the parties aclmowledge that he or she is
aware of his or her right to seek discovery including, but not limited to, written interrogatories,
motions for production of documents, depositions and all other means of discovery permitted under
the Pennsylvania Rules of Civil Procedure, Each party is satisfied that no additional information is
necessary for the execution of this Agreement.
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PRESERVATION OF RECORDS
Each party will keep and preserve for a period offoUT (4) years from the date of their divorce
decree all financial records relating to the marital estate, and each party will allow the other party
access to those records in the event of tax audits.
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11. WAIVER OR MODIFICATION TO BE IN WRITING
No modification or waiver of any of the terms hereof shall be valid unless in writing and
signed by both parties and no waiver or any breach hereof or defuult hereunder shall be deemed a
waiver of any subsequent default of the same or similar nature,
12. REMEDIES IN THE EVENT OF A BREACH
Any party breaching this Agreement shall be liable to the other party for all costs, including
reasonable counsel fees incurred by the non-breaching party to enforce his or her rights under the
provisions of this Agreement subsequent to the date of execution of this Agreement, regardless of
whether litigation is instituted. In the event of default of any of the provisions of this Agreement by
one of the parties, the remedies available to the other are cumulative and include all remedies at law
and in equity, including those for breach of contract, under theories or equity, under the Domestic
Relations Code as amended, including Section 3105 of the Domestic Relations Code (which includes
contempt) as if this Agreement had been an Order of Court, and shall not be limited to those remedies
specifically referred to in this Agreement.
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13. LAW OF PENNSYLVANIA APPLICABLE
This Agreement shall be construed in accordance with the laws of the Commonwealth of
Pennsylvania,
14. AGREEMENT BINDING ON HElRS
Except as may otherwise be provided, this Agreement shall be binding and shall inure to the
benefit of the parties hereto and their respective heirs, executors, administrators, successors, and
assigns,
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15. INTEGRATION
I
This Agreement constitutes the entire understanding of the parties and supersedes any and all
prior agreements and negotiations between them, There are no representations or warranties other
than those expressly set forth herein,
16. OTHER DOCUMENTATION
Wile and Husband covenant and agree that they will forthwith (within ten (10) days at most
after demand thereof) execute any and all written instruments, assignments, releases, satisfactions,
deeds, notes or such other writings as may be necessary or desirable for the proper effectuation of
this Agreement.
17. NO WAIVER OF DEFAULT
This Agreement shall remain in full force and effect unless and until terminated under and
pursuant to the terms of this Agreement. The failure of either party to insist upon strict perfonnance
of any of the provisions of this Agreement shall in no way affect the right of such party hereafter to
enforce the same, nor shall the waiver of any breach of any provision hereofbe construed as a waiver
of any subsequent default of the same or similar nature, nor shall the waiver of any breach of any
provision hereof be construed as a waiver of strict performance of any other obligations herein,
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18. SEVERABlLITY AND INDEPENDENT AND SEPARATE COVENANTS
The parties agree that each separate obligation contained in this Agreement shall be deemed
to be a separate and independent covenant and agreement, If any term, condition, clause or provision
ofthis Agreement shall be detennined or declared to be void or invalid in law or otherwise, then only
that term, condition, clause or provision shall be stricken from this Agreement and in all other
respects this Agreement shall be valid and continue in full force, effect and operation, Likewise, the
failure of any party to meet her or his obligations under anyone or more of the paragraphs herein,
with the exception of the satisfaction of any conditions precedent, shall in no way avoid or alter the
remaining obligations of the parties,
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19.
MANNER OF GIVlNG NOTICE
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Any notice required by this Agreement to be sent to Wife shall be sent by certified mail, return
receipt requested, to Carol A Fwjanic 186 Stonehedge Lane, Mecbanicsburg, Pennsylvania 17055,
or counsel for Carol A Fwjanic, or such other address as Wile from time to time may designate in
writing.
Any notice required by this Agreement to be sent to Husband shall be sent by certified mail,
return. receipt requested, to James A Fwjanic, 96 Deemeld Road, Camp Hill, Pennsylvania 17011,
or counsel for James A FUljanic, or such other address as Husband from time to time may designate
in wriling,
20. HEADINGS NOT PART OF AGREEMENT
Any headings preceding the text of the several paragraphs and subparagraphs hereof are
inserted solely for convenience of reference and shall not constitute a part of this Agreement nor shall
they affect its meaning, construction or effect,
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SECTION m
ALIMONY AND ALIMONY PENDENTE LITE PROVISIONS
1. ALIMONY
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The parties aclmowledge and agree that the provisions of this Agreement providing for
equitable distribution of marital property are fair, adequate and satisfactory to them and are accepted
by them in lieu of and in full and final settlement and satisfaction of any claims or demands that either
may now or hereafter have against the other for support, maintenance, alimony pendente lite or
alimony. Husband and Wife further, voluntarily and intelligently, waive and relinquish any right to
seek from the other payment for support, maintenance, alimony pendente lite or alimony_
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SECTION IV
PROPERTY DISTRIBUTION PROVISIONS
1. PERSONAL PROPERTY
Husband and Wife do hereby aclmowledge that they have previously divided their tangible
personal property including, but without limitation, jewelry, clothes, furniture, furnishings, rugs,
carpets, household equipment and appliances, pictures, books, works of art and other personal
property, Wife agrees that all of the property in the possession of Husband shall be the sole and
separat~' property of Husband; and Husband agrees that all of the property in the possession of Wife
shall be the sole and separate property of WIfe. The parties do hereby specifically waive, release,
renounC\~ and forever, abandon any claims which either may have with respect to the above items,
which shall thereafter be the sole and exclusive properly of the other,
2. RETIREMENT BENEFITS
The parties agree that Wife shall retain sole ownership and possession of all of her retirement
benefits arud plans, including, but not limited to, the Lincoln National Life Insurance Group (Financial)
Annuity, the Travelers Life and Annuity, and the Fidelity Investments 401(k) Plan, and Husband
specifically releases and waives any and all interest, claim or right that he may have to these assets,
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Wife shall assume sole responsibility for all outstanding loans on her retirement plans and
benefits,
3. BANK ACCOUNTS
Husband and Wife are the owners of individual bank accounts, Husband and Wife agree that
these accounts shall be the sole and separate property of the person in whose name they are titled and
each party waives any right, title or interest they may have in the other parties' account,
4. AUTOMOBILES
The parties are the owners of a 1995 Mitsubishi automobile, Husband and Wife agree that
this automobile shall be the sole and separate property of Husband, and Wife waives any right, title
or interest she may have in this vehicle,
The parties further agree that they were the owners of a 1990 Volvo automobile during the
course of their marriage, The parties sold this vehicle and received the sum of$4,500,OO, The parties
acknowledge that these proceeds were equally divided between them, to their mutual satisfaction,
5. CURRENT LIABlLITIES
Husband agrees to be solely responsible for satisfYing all payments on the Citibank
MasterCard credit card debt (Account number 5410-6548-4547-4219) and the Bank One Visa credit
card debt (Account number 4417-1259-7248-7718), By accepting sole responsibility of these debts,
Husband shall keep Wife and her property, successors, assigns, heirs, executors and administrators
indemnified and held harmless from any liability, costs or expenses, including attorney's fees, which
may be incurred in connection with the above listed liabilities,
Wife agrees to be solely responsible for satisfYing all payments on the Members First Federal
Credit Union Visa credit card debt (Account number 4287-5900-0036-4451), By accepting sole
responsibility of this debt, Wife shall keep Husband and his property, successors, assigns, heirs,
executors and administrators indemnified and held harmless from any liability, costs or expenses,
including attorney's fees, which may be incurred in connection with the above listed liability,
Wife and Husband represent that they have taken all steps necessary to make sure that no
credit cards or similar accounts exist as of the date of execution of this Agreement which provide for
joint liability, From the date of execution of this Agreement, each party shall use only those credit
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cards and accounts for which that party is individually liable,
6. WAIVER OF PAYMENT OF LEGAL FEES
Each party hereby agrees to be responsible for any legal fees incurred on their behalf,
7. AFTER-ACOUIRED PROPERTY
Each of the parties shall hereafter own and enjoy, independently of any claim or right of the
other, all items of property, be they real, personal or mixed, tangible or intangible, which were
acquired by him or her after the parties' date of separation, with full power in him or her to dispose
of the same as fully and effectively, in all respects and for all purposes, as through he or she were
unmarried,
8. REAL ESTATE
A Marital Residence - The parties acknowledge that they are the owners of certain real
property known as 96 Deerfield Road, Camp Hill, Cumberland County, Pennsylvania 17011
(hereinafter referred to as "Marital Residence"), which is subject to a mortgage and a Home Equity
Loan, The parties agree as follows with respect to the Marital Residence:
(1) Husband agrees that within thirty (30) days following the date of
execution of this Agreement, he will prepare and file all documentation necessary to
apply for a mortgage, in his sole name, for the Marital Residence, Furthennore,
Husband agrees that he will complete the refinance of the mortgage within one
hundred twenty (120) days following the date of the execution of this Agreement,
(2) Simultaneous with the refinancing of the marital residence, Wife shall
execute all documents necessary, including a deed, to transfer all of her right, title and
interest in the Marital Residence to Husband, Thereafter, Husband shall be the sole
and separate owner of the Marital Residence,
(3) Wife agrees that simultaneous with the refinancing of the marital
residence, any and all title policies and any other policy of insurance with respect to
the Marital Residence shall be endorsed to reflect Husband as sole owner thereof and
further agrees that Husband shall be entitled to receive any payments thereafter due
under any such insurance policies.
12
"
,
I
(4) Except as otheIWise provided herein, simultaneous with the signing of
this Agreement, Husband shall be solely responsible for all costs, expenses and
liabilities associated with or attributable to the Marital Residence regardless of when
the same shall have been incurred including, but not limited to, mortgage, home equity
loans, taxes, insurance premiums and maintenance and Husband shall keep Wife and
her property, successors, assigns, heirs, executors and administrators indemnified and
held harmless from any liability, costs or expense, including attorney's fees, which may
be incurred in connection with such liabilities and expenses or resulting from Wife's
ownership interest in said property,
~
(5) In the event Husband does not qualifY for a new mortgage, Husband
agrees to list the marital residence for sale. The parties agree that Wife shall not be
held responsible for any costs, repairs, or sale deficiencies, associated with the sale of
the marital residence, The proceeds of the sale shall be divided in the following
fashion:
}, Satisfy all remaining liens against the real property;
2, Satisfy all closing costs and necessary expenses incurred
in the sale of the real property;
3. Pay any remaining net proceeds to Husband,
The parties agree that the price and terms of sale shall be the fair market value
of the property,
(The rest ofthis page was left blank intentionally,)
13
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.
SECTION V
CLOSING PROVISIONS AND EXECUTION
Each of the parties has carefully read and fully considered this Agreement and all of the
statements, terms, conditions, and provisions thereof prior to signing below,
IN WITNESS WHEREOF, intending to be legally bound hereby, the parties hereto have
set their hands and seals on the date indicated below,
~
b' ~4V~
AROL A
V -;-{-O?
DATE
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JAMES A FURl
L/-"?O-CJ :s
DAlE
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CAROL A. FURJANIC,
Plaintiff
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
: CIVIL ACTION - LAW
: NO, 01- //"1'1
C;u~l~E:ILn\
v,
JAMES A. FURJANIC,
Defendant
: IN DIVORCE
NOTICE TO DEFEND AND CLAIM RIGHTS
YOU HAVE BEEN SUED IN COURT, If you wish to defend against the claims set forth
in the following pages, you must take prompt action. You are warned that if you fail to do so, the
case may proceed without you and a decree of divorce or annulment may be entered against.you by
the Court. A judgment may also be entered against you for any other claim or relief requested in
these papers by the Plaintiff. You may lose money or property or other rights important to you,
including custody or visitation of your children,
When the ground for the divorce is indignities or irretrievable breakdown ofthe marriage,
you may request marriage counseling, A list of marriage counselors is available in the office of the
Prothonotary, Cumberland County Courthouse, I Courthouse Square, Carlisle, PA 17013,
IF YOU DO NOT FILE A CLAIM FOR ALIMONY, DIVISION OF PROPERTY,
LAWYER'S FEES, OR EXPENSES BEFORE A DIVORCE OR ANNULMENT IS GRANTED,
YOU MAY LOSE THE RIGHT TO CLAIM ANY OF THEM.
YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT
HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET
FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP.
CUMBERLAND COUNTY BAR ASSOCIATION
LAWYER REFERRAL SERVICE
2 LIBERTY AVENUE
CARLISLE, PA 17013
717-249-3166
1-800-990-9108
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NOTICIA
Le han demandado a usted en la corte, Si usted quiere defenderse de estas demandas
expuestas en las paginas siguientes, usted tiene viente (20) dias de plazo al partir de la fecha de la
demanda y la notificacion, U sted debe presentar una apariencia escrita 0 en persona 0 por abogado
y archivar en la corte en forma escrita sus defensas 0 sus objeciones alas demandas en contra de su
persona, Sea avisado que si usted no se defiende, la corte tomara medidas y puede entrar una orden
contra usted sin previo aviso 0 notificacion y por cualquier queja 0 alivio que es pedido en la peticion
do demanda, Usted puede perder dinero 0 sus propiedades 0 otros derechos importanates para usted.
LLEVE ESTA DEMANDA A UN ABODAGO INMEDIATAMENTE. SI NO TIENE
ABOGADO 0 SI NO TIENE EL DINERO SUFICIENTE DE P AGAR TAL SERVICIO, VA Y A
EN PERSONA 0 LLAME POR TELFONO A LA OFICINA CUY A DIRECCION SE
ENCUENTRA ESCRITA ABAJO PARA AVERIGUAR DONDE SE PUEDE CONSEGUIR
ASISTENCIA LEGAL,
CUMBERLAND COUNTY BAR ASSOCIATION
LAWYER REFERRAL SERVICE
2 LIBERTY AVENUE
CARLISLE, P A 17013
717-249-3166
1-800-990-9108
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CAROL A, FURJANIC,
Plaintiff
v,
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
: CIVIL ACTION - LAW
: NO, 6/. /ft/'f G;;..t-raw-
JAMES A, FURJANIC,
Defendant
: IN DIVORCE
COMPLAINT IN DIVORCE
COUNT I
DIVORCE
AND NOW comes the above Plaintiff, Carol A. Fmjanic, by her attorney, Kathleen Carey
Daley, Attorney at Law, and seeks to obtain a decree in divorce from the above-named Defendant,
upon the grounds hereinafter set forth:
1. The Plaintiff, Carol A. Furjanic, is an adult individual who resides at 96 Deerfield
Road, Camp Hill, Cumberland County, Pennsylvania 170 II,
2, The Defendant, James A. Fmjanic, is an adult individual who resides at 96 Deerfield
Road, Camp Hill, Cumberland County, Pennsylvania 170 II.
3, The Plaintiff and Defendant are sui juris, and both have been bona fide residents of
the Commonwealth of Pennsylvania for a period of more than six months immediately preceding
the filing of this Complaint.
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4, The Plaintiff and Defendant were married on February 13, 1982, in Harrisburg,
Dauphin County, Peunsylvania.
5. Neither Plaintiff nor Defendant is in the military or naval service of the United States
or its allies within the provisions of the Soldiers' and Sailors' Civil Relief Act of the Congress of
1940 and its Amendments,
6. The cause(s) of action and section(s) of Divorce Code under which Plaintiff is
proceeding are:
A. Section 3301(a)(6), Defendant has offered such indignities to the
Plaintiff, the innocent and injured spouse, as to render her condition intolerable and
life burdensome,
B, Section 3301 ( c), The marriage of the parties is irretrievably broken,
After ninety (90) days have elapsed from the date of the filing of this Complaint,
Plaintiff intends to file an Affidavit consenting to a divorce, Plaintiff believes that
Defendant may also file such an Affidavit.
C. Section 330 1 (d), The marriage of the parties is irretrievably broken,
The Plaintiff and Defendant separated on December 26, 2000.
7. There have been no prior actions in divorce between the parties.
8. Plaintiffhas been advised of the availability of counseling and that Plaintiff may have
the right to request the parties to participate in counseling,
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9. The parties may enter into a written agreement with regard to support, custody,
visitation of children, alimony and property division. In the event that such an agreement is executed
by the parties, the agreement may be incorporated by the Court into the final Decree of Divorce,
WHEREFORE, Plaintiff requests your Honorable Court to enter a Decree in Divorce,
divorcing Plaintiff and Defendant.
COUNT II
EQUITABLE DISTRIBUTION
10, Paragraphs I through 9 of this Complaint are incorporated herein by reference as
though set forth in full.
II, Plaintiff and Defendant have acquired property, both real and personal during their
marriage from the date of their marriage until December 26,2000, the date of their separation,
12, Plaintiff and Defendant have been unable to agree as to an equitable division of said
property.
WHEREFORE, Plaintiff requests your Honorable Court to equitably divide all marital
property,
. COUNT III
ALIMONY
13. Paragraphs I through 9 of this Complaint are incorporated herein by reference as
though set forth in fulL
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14. Plaintiff lacks sufficient property to provide for her reasonable means and is unable
to support herself through appropriate employment.
15, Plaintiff requires reasonable support to adequately maintain herself in accordance
with the standard ofIiving established during the marriage.
WHEREFORE, Plaintiff requests your Honorable Court to enter an award of alimony in her
favor.
COUNT IV
ALIMONY PENDENTE LITE, COUNSEL FEES, COSTS
AND EXPENSES
16, Paragraphs 1 through 9 of the Complaint are incorporated herein by reference as
though set forth in full.
17, Defendant earns in excess of $85,000 gross per year and has assets which have not
yet been ascertained,
18, Plaintiff has employed counsel, but is unable to pay the necessary and reasonable
attorney's fees for said counsel.
19, Plaintiff is unable to sustain herself during the course of this litigation.
WHEREFORE, Plaintiff requests your Honorable Court to enter an award of Alimony
Pendente Lite, interim counsel fees, costs and expenses, until final hearing and thereupon award such
additional counsel fees, costs and expenses as deemed appropriate,
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I verify that the statements made in this Complaint are true and correct. I understand that
false statements herein are made subject to the penalties of 18 Pa,C.S.A, 94904 relating to unsworn
falsification to authorities.
By: ~(/~
Carol A. FU1janic~Pla' tiff
Date:
o{/~~/o/
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Kat leen Carey Daley, Esq 1
Attorney No. 30078
1029 Scenery Drive
Harrisburg, PA 17109
(717) 657-4795
By:
Attorney for Plaintiff
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CAROL A. FURJANIC,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
vs.
NO. 01 - 1144 CIVIL
JAMES A. FURJANIC,
Defendant
IN DIVORCE
ORDER OF COURT
AND NOW,
this ~ day of
2003, the economic claims raised in the proceedings having
been resolved in accordance with an agreement dated April
24, 2003, the appointment of the Master is vacated and
counsel can file a praecipe transmitting the record to the
Court requesting a final decree in divorce.
BY THE COURT,
cc: Cara A. Boyanowski
Attorney for Plaintiff
P.J.
William A. Fetterhoff
Attorney for Defendant
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CAROL A. FURJANIC,
Plaintiff
: IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
: CIVIL ACTION - LAW
v,
: NO. 01-1144 CIVIL TERM
JAMES A. FURJANIC,
Defendant
: IN DIVORCE
AFFIDAVIT OF SERVICE
Kathleen Carey Daley, Esquire, being duly sworn according to law, deposes and says that she
is an attorney at law duly authorized to practice in the Commonwealth of Pennsylvania, and that on
the 3rd day of March, 2001, she did serve upon James A. Fwjanic, the Defendant in the foregoing
case, a true and correct copy of the Complaint in Divorce by sending to him, by certified mail,
restricted delivery, to 96 Deerfield Road, Camp Hill, Pennsylvania 17011. The receipt for said
Complaint is attached.
Said copy ofthe Complaint was duly endorsed with notice to Defendant to appear and answer
or the matter would proceed without him,
Sworn to and 1SCribed before me this
~day of b Q~~.1.MA.. ,2002
By:
(I..".
K thleen Carey Daley,
Attorney No, 30078
1029 Scenery Drive
Harrisburg, P A 17109
(717) 657-4795
Attorney for Plaintiff
NOTARIAL SEAL
PATRICIA A. PATTON, Notary Public
Lower Paxton Twp" Dauphin County
M Commission Expires June 20, 2006
3. Se e Type
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4. Restricted Delivery? (Extra Fee)
2. Article Number (Copy fr;z:rviSb1- l D qs L-\ q Lo
PS Form 3811, July 1999 - DomeStic Retum Receipt
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Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
. Print your name and address on the reverse
so that we can return the card to you.
. Attach this card to the back of the mailpiece,
or on the front if space permits.
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CAROL A. FURJANIC,
Plaintiff
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
: CIVIL ACTION - LAW
v.
,: NO. 01-1144
JAMES A. FURJANIC,
Defendant
IN DIVORCE
AFFIDAVIT OF CONSENT
1. A Complaint in Divorce under ~3301(c) of the Divorce Code was filed on February
27,2001.
2, The marriage of Plaintiff and Defendant is irretrievably broken and ninety (90) days
have elapsed from the date of filing and service of the Complaint,
3, I consent to the entIy of a final decree of divorce after service of notice of intention
to request entry of the decree,
I verilY that the statements made in this Affidavit are true and correct, I understand that false
statements herein are made subject to the penalties of 18 Pa,C,S,A. ~4904 relating to unsworn
falsification to authorities,
Date:
c.f ~ J, rt~() ~
By: ~~~~
Carol A. FUJjanic, PI iff
Social Security No, / g 5' ' '3 r- ~ 0 fie.
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CAROL A. FURJANIC,
Plaintiff
,: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
'. CIVIL ACTION - LAW
v.
~
~ NO. 01-1144
JAMES A. FURJANIC,
Defendant
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IN DNORCE
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WANER OF NOTICE OF INTENTION
TO REQUEST ENTRV OF A DNORCE DECREE
UNDER 153301(0 OF THE DNORCE CODE
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1. I consent to the entry of a final decree of divorce without notice.
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2. I understand that I may lose ri~ts concerning alimony, division of property, lawyer's
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fees or expenses if I do not claim them before! a divorce is granted.
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3. I understand that I will not be fvorced until a divorce decree is entered by the Court
and that a copy of the decree will be sent to me immediately after it is filed with the Prothonotary.
I verifY that the statements made in thi~ affidavit are true and correct, I understand that false
statements herein are made subject to the p~nalties of 18 Pa.C.S.A. ~4904 relating to unsworn
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Date:
i ~)y ~1f3.
By: ~d~
Carol A FUIjanic( . tiff
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CAROL A. FURJANIC,
Plaintiff
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
v.
NO. 01-1144
JAMES A. FURJANIC,
Defendant
:
IN DNORCE
AFFIDAVIT OF CONSENT
1. A Complaint in Divorce under ~330 1 (c) of the Divorce Code was filed on February
27,2001.
2. The marriage of Plaintiff and Defendant is irretrievably broken and ninety (90) days
have elapsed from the date of filing and service of the Complaint.
3. I consent to the entry of a final decree of divorce after service of notice of intention
to request entry of the decree.
I verifY that the statements made in this Affidavit are true and correct. I understand that false
statements herein are made subject to the penalties of 18 Pa.C.S.A. ~4904 relating to unsworn
falsification to authorities.
Date:
~.. ).t:P' -c:r:5
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BY:~U-/ A.~M:?Z"'?<"?-
James A. FUIjanic, D endant
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Social Security No. A/;l .' 3(.,. ," 7&10)
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CAROL A. FURJANIC,
Plaintiff
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
: CIVIL ACTION - LAW
v.
: NO. 01-1144
JAMES A. FURJANIC,
Defendant
:
: IN DNORCE
WANER OF NOTICE OF INTENTION
TO REQUEST ENTRY OF A DNORCE DECREE
UNDER 63301(C) OF THE DNORCE CODE
1. I consent to the entry of a final decree of divorce without notice,
2. I understand that I may lose rights concerning alimony, division of property, lawyer's
fees or expenses if I do not claim them before a divorce is granted.
3. I understand that I will not be divorced until a divorce decree is entered by the Court
and that a copy of the decree will be sent to me immediately after it is filed with the Prothonotary.
I verifY that the statements made in this affidavit are true and correct. I understand that false
statements herein are made subject to the penalties of 18 Pa.C.S.A. ~4904 relating to unsworn
fulsification to authorities.
Date:
9- ~o - 03
By:
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CAROL A. FURJANIC
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
Plaintiff
vs.
CIVIL ACTION - LAW
01 - 1144
NO. CIVIL
19
JAMES A. FURJANIC
IN DIVORCE
Defendant
STATUS SHEET
DATE:
ACTIVITIES:
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CAROL A. FURJANIC,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
vs.
NO. 01 - 1144 CIVIL
JAMES A. FURJANIC,
Defendant
IN DIVORCE
TO: Cara A. Boyanowski
Attorney for Plaintiff
William A. Fetterhoff
, Attorney for Defendant
DATE: Friday, October 4, 2002
CERTIFICATION
I certify that discovery is complete as to the claims
for which the Master has been appointed.
OR IF DISCOVERY IS NOT COMPLETE:
(a) Outline what information is required that is not
complete in order to prepare the case for trial
and indicate whether there are any outstanding
interrogatories or discovery motions.
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(b) Provide approximate date when discovery will be
complete and indicate what action is being taken
to complete discovery.
DATE
COUNSEL FOR PLAINTIFF
COUNSEL FOR DEFENDANT
NOTE:
PRETRIAL DIRECTIVES WILL NOT BE ISSUED FOR THE
FILING OF PRETRIAL STATEMENTS UNTIL COUNSEL HAVE
CERTIFIED THAT DISCOVERY IS COMPLETE, OR OTHERWISE
AT THE MASTER'S DISCRETION.
AFTER RECEIVING THIS DOCUMENT FROM BOTH COUNSEL
OR A PARTY TO THE ACTION, IF NOT REPRESENTED BY
COUNSEL, INDICATING THAT DISCOVERY IS NOT
COMPLETE, THE DIRECTIVE FOR FILING OF PRETRIAL
STATEMENTS WILL BE ISSUED AT THE MASTER'S
DISCRETION. HOWEVER, IF BOTH COUNSEL, OR A
PARTY NOT REPRESENTED, CERTIFY THAT DISCOVERY
IS COMPLETE, A DIRECTIVE TO FILE PRETRIAL
STATEMENTS WILL BE ISSUED IMMEDIATELY.
THE CERTIFICATION DOCUMENT SHOULD BE RETURNED
TO THE MASTER'S OFFICE WITHIN TWO (2) WEEKS OF
THE DATE SHOWN ON THE DOCUMENT,
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CAROL A. FURJANIC,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
Vs.
NO. 01 - 1144 CIVIL
JAMES A. FURJANIC,
Defendant
IN DIVORCE
RE:
Pre-Hearing Conference Memorandum
DATE:
Monday, February 24, 2003
Present for the Plaintiff, Carol A. Furjanic,
is attorney Cara A. Boyanowski, and present for the Defendant,
James A. Furjanic, is attorney william A. Fetterhoff.
This action was commenced by the filing of a
complaint in divorce on February 27, 2001, raising grounds for
divorce of irretrievable breakdown of the marriage and
indignities. Both counsel have indicated that the parties
will sign affidavits of consent and waivers of notice of
intention to request entry of divorce decree so that the
divorce can be concluded under Section 3301(c) of the Domestic
Relations Code.
The complaint also raised economic claims of
equitable distribution, alimony, alimony pendente lite and
counsel fees and costs. Attorney Boyanowski is going to check
with her client to see if her client wishes to pursue the
factor of marital misconduct as that factor relates to wife's
alimony claim. If she does intend to pursue testimony on that
factor, she is to advise the Master within two weeks of
today's date of her intention to do so. Otherwise, we will
not entertain any testimony on that factor relating to
alimony.
The parties were married on February 13,
1982, and separated December 26, 2000. This is the second
marriage for both parties; both parties have children to prior
marriages but no children together.
wife is 53 years of age and resides at 186
Stonehedge Lane, Mechanicsburg, Pennsylvania, where she lives
alone. She has a Bachelor of Arts degree and works as a nurse
at Holy Spirit Hospital, She is directed to prepare an
income statement which she shall bring along with her to the
hearing to be scheduled in these proceedings on the issue
relating to the value of the real estate. wife has not
raised any health issues. She is not receiving or paying
alimony pendente lite or spousal support.
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Husband is 54 years of age and resides in the
marital residence at 96 Deerfield Road, Camp Hill,
Pennsylvania, where he lives alone, Husband has a Bachelor's
degree and currently his employment status is uncertain. He
is also directed to file an income statement to bring along to
the hearing to be scheduled on the real estate value. Husband
has not raised any health issues. He is not paying or
receiving alimony pendente lite or spousal support.
The parties own a residence at 96 Deerfield
Road, Camp Hill, Pennsylvania. We have two appraisals and
counsel are going to update the appraisals to a current value.
We are going to schedule a separate hearing to have the real
estate appraisers testify as to values so the Master can
establish a value for purposes of equitable distribution.
Counsel are also directed to bring along to the hearing
current payoff statements for the mortgage and home equity
line. In the event, however, that husband decides to list the
property for sale, the need to pursue the appraisals will be
rendered moot and we will not need to have a hearing on that
issue. The Master points out that if husband decides to list
the property for sale, the cost of sale will be shared by both
parties. However, if he determines around the time of the
hearing or at the hearing date that he has changed his mind
and decides at that point he wants to list the house for sale,
there will be no sharing of the costs of sale. We have plenty
of time now if husband makes that decision to get the house on
the market and hopefully benefit from a listing during the
springtime. If husband decides he is going to list the
property for sale, he should let attorney Boyanowski, through
his counsel, know within two weeks of today's date. She will
not, within that time, proceed to have her expert do any work
on the appraisal until she has received notice from Mr.
Fetterhoff regarding a sale. If she has not heard anything
within the two-week period from today's date, she can assume
that she needs to go forward and prepare for the hearing.
Wife has a pension with the Lincoln National
Life Insurance Group and a Fidelity 40l(k) plan. Those values
will have to be updated. According to wife's counsel the
values have decreased substantially since the time this action
was initiated.
There are certain bank accounts with Member's
1st, Commerce and Mellon Bank. Those accounts have been
listed in the pretrial statement. Counsel can let the Master
know at the time of the hearing whether they can stipulate to
the values for purposes of equitable distribution. There is a
Travelers Life annuity listed on the pretrial statement of
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wife for $178.13. Apparently that is the cash value left in
the policy after taking away the amount of the loan that is
due on that policy. We will need to know who is going to be
responsible for the payment of the balance on that loan and we
will need to know what that balance is for purposes of
determining the debt obligations of the parties at the time of
distribution of the assets.
Wife is going to determine whether she wants
to pursue the matter of a value of a one-third interest
husband has in his mother's property which grants her a life
estate. The property is located in Steel ton and wife will
have to decide whether she feels the anticipated value in the
increase in that property is worth the expense of having an
appraisal done and having an actuarial computation done
dealing with how the life estate may affect the interest that
husband has in that property.
Husband has a 1995 Mitsubishi automobile and
counsel need to establish a value on that vehicle as of the
date of separation noting also that there was a lien against
the vehicle at that time. The parties did split the proceeds
of a 1990 Volvo which was sold for $4,500.00.
With respect to the household tangible
personal property, counsel have looked at some lists which
have been attached to pleadings filed in this action and
another list which attorney Boyanowski is going to provide Mr.
Fetterhoff, Counsel need to determine whether they are going
to have to establish values for the property in each of the
parties' possession to use in the equitable distribution
computation.
The marital debts include a Citibank
MasterCard and a Bank One Visa which husband is paying and a
Visa which wife is paying. We can establish by the
attachments to the pretrial statements apparently the
separation balances due on these accounts and upon doing so we
can establish the credit that each party is entitled to
receive for assumption of the payment of the specific debt
involved. According to counsel, husband is paying the
Citibank MasterCard and the Bank One Visa and wife is paying
another Visa account.
A hearing is scheduled for the purpose of
hearing the real estate experts to establish a market value
for the property at 96 Deerfield Road, Camp Hill,
Pennsylvania, for Monday, April 28, 2003, at 9:00 a.m. As
previously noted, counsel will bring to the hearing the income
statements of the parties; the payoffs on the mortgage and
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home equity line; an apprai\sal, if necessary, for the
personalty; and a computatilon regarding the credit that may be
due to either party on acco~nt of debt that has been paid or
will be assumed by each of ithe parties. In addition, counsel
should have a value for the: 1995 Mitsubishi and current
statements for the retirement plans of wife. Also, counsel
should bring to the hearing; affidavits of consent and waivers
of notice of intention to request entry of divorce decree to
be signed by both parties so that the divorce can proceed
under Section 3301(c) of the Domestic Relations Code. Notices
of the hearing will be sent; to counsel and the parties. If
it is determined that we do not need the testimony of the
experts, nevertheless, counsel and the parties should appear
at the Master's office on Monday, April 28, 2003, with the
information directed by thel Master to be provided on that
date.
E. Robert Elicker, II
Divorce Master
cc: Cara A. Boyanowski I
Attorney for P1aintitf
william A. Fetterhof~
Attorney for Defendapt
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CAROL A. FURJANIC
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
: CIVIL ACTION - LAW
v.
JAMES A. FURJANIC
: NO.
01 - 1144
: IN DIVORCE
ORDER AND NOTICE SETTING HEARING
TO: Carol A. FUIjanic
Cara A. Boyanowski
, Plaintiff
, Counsel for Plaintiff
James A. FUIjanic
William A. Fetterhoff
, Defendant
, Counsel for Defendant
*
You are directed to appear for a hearing to take testimony on the outstanding
issues in the above captioned divorce proceedings at the Office of the Divorce Master, 9
28th
North Hanover Street, Carlisle, Pennsylvania, on the
April 2003 at 9:00
day of
a.m., at which place
and time you will be given the opportunity to present witnesses and exhibits in support
of your case.
By the Court,
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George offer, President Ju!e
Date of Order and
Notice: 2/25/03
By:
Divorce Master
IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR
TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU
CAN GET LEGAL HELP.
CUMBERLAND COUNTY BAR ASSOCIATION
2 LIBERTY AVENUE, CARLISLE, PA 17013
TELEPHONE (717) 249-3166
* TESTIMONY WILL BE LIMITED TO THE REAL ESTATE EXPERTS.
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CAROL A. FURJANlC,
PLAINTIFF/Respondent
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
v.
NO. 01-1144 Civil Term
JAMES A. FURJANlC,
DEFENDANT/Petitioner
IN DIVORCE
PETITION FOR EMERGENCY RELIEF
PURSUANT TO
23 Pa. C.S.A. ~3502 (e) and ~3505
AND NOW, this ,;<.;)..~ day of May, 2001 comes James A FUIjanic, Defendant above-
named (hereinafter "Petitioner") by his attorney, Marilyn C. ZOO, Esquire, who petitions this
Honorable Court for an Emergency Order prohibiting Plaintiff Carol A. FUljaniC, (hereinafter
"Respondent") from disposing of, alienating or encumbering any of the marital assets in order to
defeat equitable distribution in the above-captioned case and who, in support hereof, avers as follows:
1. On February 27,2001, Respondent filed a Complaint in Divorce.
2. In said Complaint, Respondent requested an equitable distribution of the parties'
marital assets.
3. The parties have lived separate and apart since December 26,2000. On May 19,
2001, Respondent vacated the marital residence at 96 Deerfield Road, Camp Hill, PA; Petitioner
continues to occupy the residence.
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4. Sometime in March, 2000, Respondent removed multiple pieces of expensive crystal
from the marital residence. These items are marital property.
5. Sometime after the filing of the Divorce Complaint, Respondent removed 14 pieces
of expensive jewelry from the marital residence. These items were gifts from Petitioner to
Respondent and are marital property.
6. Effective April 1, 2001, Respondent removed Petitioner from her health insurance
coverage. At the time, Petitioner had no other coverage. The removal was accomplished without
his knowledge or consent.
7. Petitioner was away from the marital residence on Saturday, May19, 2001. When he
returned that evening he found Respondent and her family in the process of emptying the residence
of the parties' personalty, at least some of which was marital property.
8. The property was being removed without Petitioner's prior knowledge or consent.
9. When he had to leave the residence again, Petitioner returned to find additional
property had been removed and that his bedroom had been ransacked. At least some of this
additional property was marital.
10. Petitioner has now learned that Respondent has had phone service to the residence
disconnected.
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11. Petitioner will have to continue to be absent from the marital residence in order to go
to work and attend to personal business. He is concerned that Respondent will return to the
residence and remove additional property and/or ransack other rooms.
12. The car loan on the vehicle Petitioner drives is paid out of Respondent's checking
account because she is the first signatory on the loan. In the past, Petitioner has given Respondent
a monthly check to reimburse her for this payment.
13. On May 18, 2001, Petitioner offered Respondent a check to cover the May car loan
payment. Respondent refused to accept Petitioner's check and stated that she was going to let the
car be repossessed.
14. All of this conduct suggests an intent in Respondent to dissipate marital assets and/or
to deny Petitioner access to these assets and/or his lawful right in them and to defeat equitable
distribution in this case.
15. It may be some time before this case is resolved; the parties' marital assets must be
protected until that time.
16. An Order in the nature of an injunction must be entered immediately against
Respondent to prevent. her dissipation of marital assets and to preserve the status quo otherwise.
17. Respondent must be ordered to provide a complete inventory to Petitioner of all
property removed and of the current location thereof.
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WHEREFORE, DefendantlPetitioner prays this Honorable Court for an Emergency Order
prohibiting Plaintifi7Respondent from dissipating, disposing, transferring, alienating, encumbering or
otherwise affecting in violation of Petitioner's rights thereto any marital asset, including but not
limited to all personalty, financial accounts, bank accounts, credit cards, and automobiles and further,
requiring her to provide Petitioner with a complete inventory ofall property removed from the marital
residence and of the current location thereof. He further prays that this Court order that so long as
Det'endantlPetitioner continues to reimburse her for payment of the loan on his car, and until other
arrangements can be made, Plaintifi7Respondent shall make the payments on this loan.
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Marilyn C. Zilli, Esq
Fetterhoff and ZOO
200 North Third Street, Suite 800
Harrisburg, P A 171 0 1
(717) 232-7722
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VERIFICATION
I verify that the statements made in the foregoing dooument
are true and correot to the best of my knowledge, understanding,
and belief. I understand that false statements herein are made
subject to the penalties of 18 Pa. c.s. 54904 relating to unsworn
falsification to authorities.
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CERTIFICATE OF SERVICE
A true and correct copy of the foregoing document was delivered to the person or office listed
below by first class mail on the date indicated, as follows:
Kathleen Carey Daley, Esq.
1 029 Scenery Drive
Harrisburg, P A 17109
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Marilyn C. Zilli, Esq .
Fetterhoff and ZOO
200 North Third Street, Suite 800
~sburg,PAI7101
(717) 232-7722
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CAROL A. FURJANIC,
Plaintiff/Respondent
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
vs.
01-1144 CIVIL
CIVIL ACTION - LAW
JAMES A. FURJANIC,
DefendantJPetitioner
IN DIVORCE
IN RE: PETITION FOR EMERGENCY RELIEF
ORDER
AND NOW, this !;'~
day of June, 2001, this matter having been called for
hearing, following conference with counsel in Chambers, the following order is entered without
an admission by either party concerning the allegations in their pleadings.
It is ordered and directed that:
1. Neither party shall sell or dissipate any marital asset without an accounting to the
other party;
2. Neither party shall sell, liquidate or dissipate any interest in real estate, any retirement
fund or any insurance policy without further order of court;
3. Each party shall assume sole responsibility for their individual automobile expenses;
and
4. In addition to the items which the wife has already removed from the marital
residence, she is herewith granted possession of the following household items:
Kitchen table with four chairs
Two brass and glass etageres
Ficus tree (family room)
One LR (living room) clock
Two LR chairs
Two LR lamps
One LR coffee table
One LR end table
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CUMBERLAND COUNTY
PENNSYLVANIA
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One round (12") LR table
MBR dresser w/mirrOT (wife's)
One night stand
One plant stand (premarital)
One mirrored stand
Two MBR wall pictures
China
One-half the rugs
One-half the pots and pans
Silverware
The remaining personal property of the parties shall remain in the possession of the husband,
defendant/petitioner.
BY THE COURT,
Kathleen Carey Daley, Esquire
For the PlaintifflRespondent
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Marilyn Zilli, Esquire
For the Defendant/Petitioner
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CAROL A. FURJANlC,
PLAINTIFF/Respondent
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
v.
NO. 01-1144 Civil Term
JAMES A. FURJANlC,
DEFENDANT/Petitioner
IN DIVORCE
ORDER
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AND NOW, this :;t ~ day ofMa~O 1, after due consideration of the attached Petition
for Emergency Relief, it ~~"e\tw~ llult Pl:n~~p:;::rt: prohibited from disposing,
alienating or in any way encumbering any property subject to equitable distribution in this case. ~
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o J 1,.11 fi!JBam :- -Willi 'IRtihke Cellll't is MOOed IlllEt' all pI8J11!~' pa:~1I ha'.'llliun nllY rd tQ
~ tJlp. o.illfactili''iref lllll:k JlRl'liall. In the meantime, Plaintifi7Respondent shall also provide
Defendant/Petitioner with a complete inventory of all of the property she removed from the marital
residence and of its current location. .4 ~ta..,\ eM. ~ ~~ ~11.~
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BY THE COURT'
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CAROL A. FURJANIC,
Plaintiff
IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
: CIVIL ACTION - LAW
v.
: NO. 01-1144
JAMES A. FURJANIC,
Defendant
: IN DIVORCE
INVENTORY
UNDER RULE 1920.33
Plaintiff files the following inventory of all property owned or possessed by either party at
the time this action was commenced and all property transferred within the preceding three years.
Plaintiff verifies that the statements made in this inventory are true and correct. Plaintiff
understands that false statements herein are made subject to the penalties of 18 Pa.C.S.A. 94904
relating to unsworn falsification to authorities.
Date:
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By:
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INVENTORY
FURJANIC v. FURJANIC
Date of Marriage - 02/13/82
Date of Separation - 12/26/00
MARITAL ASSETS
Assets Husband's Wife's Master's Notes
Value Value Value
Real Estate
Marital Residence: $153,600.00 $180,000.00 Mortgage of approximately
96 Deerfield Road (His Appraisal) $68,000.00 and Home Equity Loan
Camp Hill, PA 17011 Equity: of$84,000.00 at separation.
$50,000.00 Current debt balance unknown, but
should total less than $125,000.00
Husband 1/3 Ownership in Mother's $10,000.00 Increase in value during marriage.
. Residence in Steelton, Pennsylvania
Retirement Assets
The Lincoln National Life Insurance Date of
Group (Financial) Separation
Annuity Value:
Wtfe $26,277.32
Current
Value:
$20,971.65
(As of 6/30/02)
Travelers Life and Annuity Date of Outstanding Loan against account
Wife Separation in amount of$5,708.95 as of
Value: 06130/02.
$365.25
. Current
Value:
$178.13
(As of 6/30/02)
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Assets Husband's Wife's Master's Notes
Value Value Value
Fidelity Investments Date of Current val.ue includes post
401(K) Plan Separation separation contributions of
Wife Value: approximately $14,000.00.
$54,029.96
Current
Value:
$46,284.72
Bank Accounts
Members First Account $2,900.00 Value at Date of Separation:
WIfe $2,900.00
Current Value:
$25.00
Commerce Bank Account $0.00 Value at Date of Separation:
Wife $0.00
Current Value:
$1,200.00
Mellon Bank Checking Account $3,000.00 Value at Date of Separation:
No. 884-017-4117 $3,000.00
Husband Current Value:
$1,400.00
Mellon Bank Checking Account $0.00 Value at Date of Separation:
No. 100-024-4630 $0.00
Husband Current Value:
$1,100.00
Automobiles
1995 Mitsubishi $7,500.00 Purchased in February, 1997 for
Husband $19,000.00.
No lien exists on vehicle.
1990 Volvo $0.00 $0.00 Vehicle was sold for $4,500.00 and
proceeds were split between
. parties.
1999 Diamante $0.00 $0.00 Leased vehicle.
Wife
.MARfl'AL ASSETS
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Assets Husband's Wife's Master's Notes
Value Value Value
Miscellaneous
Household Goods and Furnishings Nominal Nominal Already split between parties.
LoanslDebts
Citibank Mastercard Credit Card Date of Non-marital Husband's debt for personal and
No. 5410-6548-4547-4219 Separation recreational expenses.
Husband Balance:
$12,000.00
Current
Balance:
$12,500.00
Bank One Visa Credit Card Date of Non-marital Husband's debt for personal and
No. 4417-1259-7248-7718 Separation recreational expenses.
Husband Balance:
$3,000.00
Current
Balance:
$0.00
Visa Credit Card Date of Joint Names.
No. 4287-5900-0036-4451 Separation Account used for marital expenses
Balance: by Wife and personal expenses.
$1,800.00
Current
Balance:
$2,188.08
MARITAL ASSETS
Mark Heckman Real Estate Appraisers
File No. 96deerfi
APPRAISAL OF
Single Family Residential
LOCATED AT:
96 Deerfletd Road
Camp Hill, PA 17011
FOR:
BORROWER:
Carol Furjanic
AS OF:
December 1, 2001
BY:
Luann E. Knudsen
RL-003086-L
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Mark Heckman Real Estate Appraisers
Proft."" D,so"ftllo. UNIFORM RESIDENTIAL APPRAISAL REPORT FiI. No. 96deerti
ProoertvAddress 96 Deerfield Road cnv Camo Hill Slale PA ZiDCode 17011
leoal DeSttlDllon Deed BOtlk 30F Paae 1173 ) Countv Cumberland
Assessor's Parcel No. SEE MAP REFERENCE NUMBER TsxYear 2001 RE. Taxes $ 2451.85 SoeciaIAsselmm9rrts$ -0-
Borrower Furianlc Carol CurrenlOwn&/' Furianic Occuoanl: XI Owner Tenant I I Vacant
" Pronertvrinhtunnra~ Xl FeeSinmle I I Leasehold I Pro"eclTvne I PUD 1 CondominiumlHUDNAonM HOA$ -O~ JMo.
Neiohborhood orProiecl Name Allendale MaoReferance 13-25-0010-240 CensusTracl 0110
Sale Price$ NA Dale of Safe NA Desaiotion and $ amount o(loan charaeslconcesslons 10 be nail' bvsel{er NA
Lender/CUent Carol Fur'al"lJc Address
ADoraiser Luann E. KnUdsen Address 1309 Brid e Street : New Cumberland PA 17070
location W Urban ~ Suburban ~ Rural i'redomlnant Single family housing Present land use % Land use change
Bultup 00 Over75'J(. 025-75% 0 Under25% occupancy f(~E ~f One family ~ 0 NotJikely 0 Likely
GrowIhrale 0 Rapid 00 Stable 0 Slow 00 Owner ~ Low ~ 2-4family ~ 00 In process
Property values 00 Inaeasillg 0 SIable 0 Declining 0 Tanant 300 Hiah 90 MuUH'arTiy -----=:- To: Residential from
Demandfsupply 0 Shortagl! 00 lnl:Bmce 0 OvS'WIW 00 VaranI(GS%) ;t<w% Predominant I{g~ Convnercial 7% vacant
Markelinatime n ~nder3trm ~ ;-6 mos. n ~ver6mos. n _(m..-5"1 140-190 I 10-60 Vacant \ 10%
NotEI': Race and the racial eompo'slHon of the neighborhood ara not appraisal factors.
Neighborhood boundaries and characteristics: The sublect orooertv Is located in Lower Allen Townshio. To locate the best comoarables
: available the aDora/ser may have to extend search Mrameters to similar nelahborhoods within the market area.
. Factors thai affect thei'rnaibtabilily 'pf the properties in the neighborhood (proximity to employment and amenities, employment slabDity, appeal to market, etc.):
. This suburban ner~hborhood has relativelv easy access to emolovment and services and is comoetitive with other neiahborhoods in
" the aeneral area. :Most have similar amenities. Market activity indicates averaae or better acceDtance in the:market Dlace. No
unfavorable factors were observed which would adversel effect marketabilitv.
Market conditions in the subj9'ct neighborhood (including support for the above conclusions related to the trend of properly values, demand/supply, and marketing time
.. such as dala on comp&litilre prop~rlies for sale in the neighborhood, description of the prevalence of sales and financing conpessions, etc.):
THIS IS A "COMPLETE 'APPRAISAL - SUMMARY REPORT". There are no fore:seeable economic trends which mioht sinnificantlv
influence market conditions iri this area. The current mortaaae market offers a wide varietY of conventional loans with comDetitive
interest rates. As a result the!terms of financino have little if any, imnact on sale I1rices. If interest rates rerriain reasonable I1rol1ertv
values and marketabili 'should be stable.
. Project Information for PUDs (If applicable) ~ -Is the deve]operlbu~der in control ofthe Home Owners' Association (HOA)? U YES U NO
Approximatetotal number ofunils in the subject project NA Approximate total number ofunils for sale in the subject project
Describe common elements and recreational facilities:
Dimensions 100 X216X<,11.4S X 156 Topography Sloped To Rear
Sileam .67 Ac Comer Lot U Yes lAJ No Size Tvolcal for area
Specific zoning classification and description R1 Sinale Familv Established Residential Shape Irrenular
Zoning compliance ~ Legal ~ legaInonCXI'~'';''il(Gmndfalhereduse) Ulllegal U Nozoning Drainage Appears adeauate
Hklhesl&besluseasimnmvecl: IXIPresenluse I lotherusefeynlain) View Averaae
Utilities Public other Off-site Improvements Type Public Private landscaping Averaae
Erecfrici/y 00 200 aml1s Slreel Asphalt (gJ 0 DriVeway Surface Asphalt
Gas 0 None Curb/guitar Concrete 00 0 Apparent easements None Observed
Water 00 Sidewalk Concrete 00 0 FEMA Special Rood Hazard Alea U Yes ~ No
Sani/ary sewer 00 Streetlights None Q g FEMAZone C Map Date 9/30/77
Stormsewer IXI AIIell None I I I I FEMA MaD No. 421016B/H&I-02
Comments (apparent adverse easements, encroachments, special assessments, slide areas, illegal or legal nonconforming zoning, use, etc.~ The site
imorovements and servIces to the site are adeauate and acceotable in this market. There are no apparent adverse easements
encroachments or other adverse conditions on this site. The steep tononranhv of this site ,restricts its utilitv.
GENERAl DESCRIPTION EXTERIOR DESCRIPTION FOUNDATION BASEMENT
No. of Units 1 Foundation Co Block Slab None AleaSq.Ft. 1312
No.ofStories 2 ExIeriorWalls BrickfT111 OaMSpace None %Finished 0
Type (DeI./Att.) Detached Roof Surface Shinale Basement FB/Exposed Ceiling Unfinished
Design (Style) Conternp. Gutters & Dwnspls. Aluminum SurrpPuIqlYes Walls Co Block
ExislinglProposed Existino WindowType Casement Ins Dampness None noted RoO/' Concrete
Age(Yrs.) 17 SlormfScreens YesNes Selllemenl None noted outsideEntry Yes
EffecliveAaefVrs.\ 10 ManufacluredHouseNO Infestation Nonenoted
. ROOMS Fover Livina Dininll Kitchen Den Familv Rm. Rae.. Rm. Bedrooms # Baths
Basement
Levell
. Level2
INSULATION
Roof 0
CeBing-OO
Waifs -00
""",-0
None-O
u""""""===O
x
.5
2
AreaSlI.FI.
1,312
1.312
1072
o
2384 SlIuare Feet of Gross LivinllArea
CAR STORAGE:
None 0
Garage2
Attached
Detached
Built-In
Carport
Drivewav 2
Laundrv
Other
x
3
Loft
7 Rooms' 3 Bedroom'st
HEATING KITCHEN EQUIP. ATTIC
Type HP Refiigeralor 0 None
Fuel Elec Range/Oven 00 Stairs
CondilbnAVO. Disposal 00 Drop Stair
COOUNG Dishwasher 00 Scuttle
Central Yes Fan/Hood 00 Roor
other None Microwave 00 Heated
CondilionAva. WasherJDrver n Finished
Additional features (special energy efficient items, etc.): See Attached Addendum.
2.5 Bath's'.
AMENmES
o FJreplace(s)#L-
o Patio
00 Ded<
o Porch
00 Fence
R Pool
2
Fmished area above lIrade contains:
INTERIOR
A'''''
. Walls
Trim'Finish
Bath Roor
BathWainscol
0,,",
Materials/Condition
HW/CtlCPWin/Ave
Drywall/AVe
Wood/Ave
Vinyl/Ave
FiberQlass/Ave
Flush/Ave
00
o
00
00
o
R
#ofcars
Condition of the irnprovemenls, depreciation (physical, functional, and external), repairs needed, quality of construction remodeling/additions, etc.:
Addendum.
See Attached
Adverse environmental conditions (such as, but not limited to, hazardous wastes, toxic substances, etc.) pr~sent i~ the improvements, on the site, or .in th,.
. . . . . No adverse environmental conditions were observed In the lmorovements on the site, on In t e
immedlatevlcllllty of the subject property:
immediate vicinity of the subject oropertv.
~reMl&ldacl'orm1O e..93
PAGE10F2
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Valuation See<tlon
Mark Heckman Real Estate Appraisers
UNIFORM RESIDENTIAL APPRAISAL REPORT
File No 96deerfi
ESTIMATED SITE VALUE. .......................... = $
ES11MATED REPRODUCl10N COST-NE'iV OF IMPRO\oiEMENTS:
DweOing 2,384 Sq. Ft. @$ 57.25 = $ 136.484
8,",1.1312 Sq.A.@$----g:so = 12,464
~ Porch/Deck/2 Fireol~ces - = 14,000
. """""""" ~Sq.R @$ 12.50 = 8.400
: Tolal Eslimated Cost New"j I - = $ 171,348
Less 60 P~ysical Fu~cli~n~I' f . E~~~~l . Est. Remaining Econ. Life: 50
. """'""" $28420 . I = $ 28.420
OeprecialedValueoflrnprovements................... "$
'As-is"ValueofSitelrnprovemenls.......... ........ "$
INDICATED VALUE BY COST APPROACH. . . . . . . . . " ,,$
ITEM I SUBJECT COMPARABLE NO.1
96 Deerfield Road 209 Deerfield Road
Address Camp,Hill Camo Hill
.p;.;~;;ih,foSu&iSct ;i~ti%%ff...;{tlfjJjftiA1l2 Slacks
SalllllPrice $ NA~ x:'i ;'$$
_LN."'" $ 0.00 ~ $ 77.65 ~"". =
Data and/or Inspection Assessment Records & MLS
Verification Sources
VALlJEAIlIUSTMEN1S_N DESCRIPTION H.'$Ad_ DESCRIPTION I H.'$Al!TUllmenl DESCRIPTION
Salllll or Financing. Conventional Conventional Conventional
Concessions None Known None Known None Known
DateofSale/TIme 6/12101: 5/31/01 : 712101 :
localion Averaae Averaoe Averaoe Averaoe
leasetddIFeeShde Fee Simole Fee Simole: Fee Simole: Fee Simore
Site .67 AclSloned .32 AclAverane : .44 AclAveraae : .44 AclAveraae :
View Averaoe Averaae Averaae Averaae
Desian and ADDeal 2 Storv/Averaoe 2 storv/Averaae : 2 Storv/Averaoe : 2 Storv/Averaoe :
O:J:fivdCorGnltfun Avera!1e Averaae : Averaae : Averane
Atle 17/10 20/10 17115 +5000 25/10
Candnion AVE:lraoe Averaoe : Less than Ave +5 000 Averaae :
Above Grade Total'ednns' BaIbs ToIal'Bdrms' Balhi : ToIal'Bdrms' Balhi : ToIal'Mms' Ilalhs :
RoomCaunt 7: 3: 2.50 8: 4: 2.50' 7: 4: 2.50' 7: 4: 2.50'
GrossLMnaArea 2384Sa.A. 2447Sa.A.: -1600 2340Sa.Ft.: 2362Sa.Ft.:
. BasemenI&FI'IBhed F BsmtlExposed Full Basement +1,000 Full Basement +1,000 Full Basement
Rooms BelowGrade Unfinished Rec Room -7500 Unfinished Unfinished
Functional Ul'lh AVE:lraoe Averaae : Averaae : Averaoe :
HeatinlllCoolina EHP/Central Air GFAlCentral Air : GFAlCentral Air : OHW/Central Air:
. EIIAfmIEfficlentllerm T for Area T for Area T for Area Tvo for Area
GaraaelCarport 2 Car Garaae/Att 2 Car GaraaelAtt : 2 Car Garage/Att : 2 Car Garaae/Att :
Porch, Patio, Deck, POtch & Deck Porch & Patio Porch & Patio Porch & Patio
Firenla"""s' ete. 2 Fireolaces 1 Fireolace +1 500 None +3500 1 Fireolace
Fence, Pool ete. Central Vacuum Security System : None : +500 None
other Good Kitchen Florida Rm/Gd-Ki : -7500 Averaoe Kitchen: +1 000 Averaoe Kitchen :
Net Adi,ftola" - '$ 14100"'+ - '$ 16000_+ . '$
Adi stedSalesPrice ~lm ' WJ @ ~ 'x %
!IU x 1M (4h Jillt-=:::::
ofComnarable $ 175900 x > $ 169000 x,,:f;.,.,. $
Comments on Ssles Comllarlson (including the subject property's cornpaftbility to the neighborhood, ate)' See Attached Addendum
35 000
Comments on Cost Approach (such as, source of cost estimate"
site value, square foot calculation and for HUD, VA and FmHA, the
estimated remaining economic life of the properly):
Estimated Reoroduction Cost-New-of-rmorovements is
calculated usina the Marshall and Swift Residential Cost
Handbook and local cost analysis. Estimated site value [s
based on Jocal market analvsis. Deoreciation Is estimated
usina the economic aae-Iife method and market analysis. No
obsolescence was observed.
142926
2500
180 400
COMPARABLE NO.2 COMPARABLE NO.3
91 Deerfield Road 432 Candlewyck Road
Camo Hill Carnn Hill
Same Block .25 Mile
190 000 ~;: ., Y:;&Y%'y' :<::,,'WA $ 153000 :<< ~.. 4#l:~4k'1 $ 174000
$ 65.38 I;zI "f,," {, .; $ 73.67 lZl '~W~-?/. ." ,Jttr
Assessment Records & MLS Assessment Records & MLS
t., IdrneI1l
+1,000
+1500
+500
+1000
4000
176000
COMPARABLE NO.1
No prior sale other
than that listed above.
COMPARABLE NO.2
No prior sale other
than that listed above.
COMPARABLE NO.3
No prior sale other
than that listed above.
ITEM SUBJECT
Date, Price and Data None
Scwceftrpia~
wilhinvearofaoDraisal
Analysis of any current agreement of sale, option, or listing of the wbject properly and analysis of any prior salllll of subjed and COJI1)llI'iIblllll wihln one year of the dale of appraisal:
Accordino to information orevided bv the multi-list services in this reaion the subiect orenertv has not been listed for sale within the
oast year.
'ND'CATED VALUE BY SALES COMPARISON APPROACH ............................................. .......$ 176000
IND[CATEDVAWEBYI~cOMEAPPROACH(JfAnDlr.able) Etltimated Market Rent $ N/A 1M0.xGrossRenlMuRinlier N/A "$ NA
This appraisal is made ~ Oasis" 0 subjectlotherepan,aIterations,inspeclionscrcorKlti::lnslistedbelow U subjectto~tionperplansandsper.iK:aOOns.
CondnKlns of Appraisal: See Attached Addendum.
FmaJ Reconciliation: See Attached Addendum.
The purpose of this appraisi31 isto estimate the markel value of the real properl ythatisthesubjectofthisreporl,basedontheaboveconditionsandthecertilicalion,conl81gent
and limiting conditions, and market value definnion thai are stated in the attached Freddie Mac Form439lfannie Mae Form 1004B (Revised ).
I (WE) EST1MATETHE MARKETVALUE,ASDEFINED, OF THE REAL PROPERTY THAT ISTHESUBJECTOFTHISREF'ORT,ASOF 12/1/01
. [WHICH ISTHE,qATE Of:: INSPECTION AND. THE EFFECTIVE DATEOFTHIS REPORT)TO BU 176,000 .
APPRA1S~~:.t:'" .G' Jl:.A " ~PERVlSORYAPPRAlSER(ONL.YIFREQUIRED):
Sillnat . 1 L. ./1 fl..n Slllnature
Name, Luanfl E. Knudsen Name
Datel(e.oorl SiQned 12/1/01 Date Rellorl Sillned
State Certification II RL-003086-L State PA State Certification #
Or State license # State Or Stale License #
oDo oDldNol
Inspect Properly
State
Slale
FreddleMacForm70ll-93
PAGE20F2
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mark heckman real estate appraisers
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ADDENDUM
Borrower. Furianic. Carol
Property Address: 96 Deerfield Road
CitY: CamD Hili
Lender: CarolFu~anic
File No.: 96deetfl
Case No.:
stale: PA
ZID: 17011
Additional Features
Architectural shingle roof 3 years old; skylights 3 years old; bar sink in kitchen; ample kitchen cabinets; built in griU; hot
water dispenser; corner appliance garages; down lights in kitchen; stained woodwork; storage area over garage; oak railing
on stairs to loft; guilt-In shelves in family room; living room has cathedral ceiling with skylights; laundry has sink and
laundry chute; central vacuum system; fireplace in living room extends to ceiling with flue inn lower level for future fireplace;
all bedrooms have walk-in closets; french doors from bedroom to loft; double sinks in both baths; whirlpool tub in master
bath.
Condition of Improvements
These improvements are of average quality frame design and reflect average maintenance. Property reflects normal
physical depreciation and no deficiencies are noted. Utility of floor plan is typical for a house of this age and style and
should receive average acceptance in the market place. No unusual functional obsolescence or external inadequacies were
observed. The bathrooms, kitchen, mechanical equipment, and other features meet current standards for houses of this
age In this market.
Comments on Sales Comparison
After a thorough search of all available market data, the three sales used are considered to be the best indicators of value.
Appropriate adjustments have been made for all differences. All three sales are considered to be reliable indicators of
value, and are weighted similarly in the final reconciliation. Days on market: Comparable No.1: 11 days: Comparable No.
2: 148 days; Comparable No.3: 6 days. Comparable sales used are all closed sales. All three comparable sales are
located in the same market area as the subject and would be considered by the same prospective purchaser of all were on
the market at the same time as the subject. No adjustment was made for the subjecfs larger lot as its utility is restricted by
the steep rear slope.
Conditions of Appraisal
This appraisal report has been prepared with the property in "as is" condition. No personal property has been included in
this valuation. According to records provided by the county assessment office, the subject property has not transferred in
the past year.
Final Reconciliation
This appraisal assumes a reasonable marketing period for the subject property of four months. The Sales Comparison
Analysis reflects recent activity in the market place and is given the most weight The Cost Approach tends to set the upper
limit of value and the Market Approach is considered the best indicator of value. The Income Approach is inappropriate
because few single family houses are rented in this market. In view of the age of these improvements, the Cost approach
cannot be considered an accurate indicator of value. See attached appraiser's certification and Statement of Limiting
Conditions.
AddendumPage1of1
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DIMENSION LIST ADDENDUM
. Borrower: 'Furianic, Carol
Property Address: 96 D~rfield ROEld
Cit . Cam Hill
File No.: 96deerfi
Case No,:
Slate: PA Zi : 17011
GROSS BUILDING AREA (GBA)
GROSS LIVING AREA (GLA)
AAa(,) ,..,
living 2,384
level 1 1,312
Level 2 1,072
Level 3
Other
4.368
2,384
%ofGBA
54.58
30.04
24.54
Basement
Garage
1.312
672
30.04
15.38
Area Measurements Area Type
Measurements Factor Total Level 1 Level 2 Level 3 other Bsmt. Garage
~.OO x 40.00 x ----1 '" 960.00 IRI 0 0 0 IRI 0
-.W..JlQ x 22 00 x -----1 '" 352.00 IRI 0 0 0 IRI 0
~ x 30.00 x ----1 " 720.00 0 IRI 0 0 0, 0
--16..QQ x 22.00 x ----1 '" 352.00 0 IRI 0 0 0 0
----1.,QQ x 672.00 x ---1 " 672.00 0 0 0 0 0 IRI
_x_x_= 0 0 0 0 0 0
_x_x_= 0 0 0 0 0 0
_x_x_'" 0 0 0 0 0 0
__x_x_= 0 0 0 0 0 0
_x_x_" 0 0 0 0 0 0
__x_x_" 0 0 0 0 0 0
_x_x_'" 0 0 0 0 0 0
_x_x_= 0 0 0 0 0 0
_x_x_'" 0 0 0 0 0 0
_x_x_= 0 0 0 0 0 0
_x_x_" 0 0 0 0 0 0
_x_x_" 0 0 0 0 0 0
_x_x_= 0 0 0 0 0 0
_x_x_" 0 0 0 0 8 0
_x_x_" 0 0 0 0 0
_x_x_" 0 0 0 0 0 0
_x_x_" 0 0 0 0 0 0
_x_x_= 0 0 0 0 0 0
_x_x_" 0 0 0 0 0 0
_x_x_= 0 0 0 0 0 0
_x_x_" 0 0 0 0 0 0
_x_x_" 0 0 0 0 0 0
_x_x_" 0 0 0 0 0 0
_x_x_" 0 0 0 0 0 0
_x_x_" 0 0 0 0 0 0
_x_x_= 0 0 0 0 0 0
_x_x_" 0 0 0 0 0 0
_x_x_" 0 0 0 0 0 0
_x_x_" 0 0 0 0 0 0
_x_x_" 0 0 0 0 0 0
_x_x_'" 0 0 0 0 0 0
_x_x_" 0 0 0 0 0 0
_x_x_" 0 0 0 0 0 8
_x_x_= 0 0 0 0 0
_x_x_" 0 0 0 0 0 0
_x_x_= 0 0 0 0 0 0
_x_x_'" 0 0 0 0 0 0
_x_x_" 0 0 0 0 0 0
_x_x_" 0 0 0 0 0 0
__x_x_" 0 0 0 0 0 0
_x_x_= 0 0 0 0 0 0
_x_x_'" 0 0 0 0 0 0
~x_x_" 0 0 0 0 0 0
~x_x_" 0 0 0 0 0 0
~x_x_= 0 0 0 0 0 0
~x_x_" 0 0 0 0 0 0
__x_x_'" 0 0 0 0 0 0
~x_x_" 0 0 0 0 0 0
Thloram.....poduooclonlhoACIDo\lObpnlo/tRapldFOIlTB.,...m(800)VlW127
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F~e No. 96deerfi
DEFINITION OF MARKET VALUE: The most probable price which a property should bring in a competitive and open market
,Under all conditions requisite to a fair sale, the buyer and seller, each acting prudently, knowledgeably and assuming the price is not
affected by undue stimulus. Implicit in this definition is the consummation of a sale as of a specified date and the passing of title from
seller to buyer under conditions whereby: (1) buyer and seller are typically motivated; (2) both parties ate 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
il) 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 doUar 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:
1. The a,ppraiser will not be responsible for matters of a legal nature that affect either the property being appraised or the title to it. rhe
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
il)c1uded 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 beforeh~hd.
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 ahd improvements must not be used In conjunction with any other appraisal and
are invalid if they are so used.
6. The appraiser has noted in the appraisal report any adverse conditions (such as, needed repairs, depreciation, the presence of hazardous
wastes, toxic substances, etc. ) observed during the inspection of the subject property or that he or she became aware of during the normal
research involved in performing the appraisal. Unless otherwise stated in the appraisal report, the appraiser has no knowledge of any hidden
Or unapparent conditions of the property or adverse environmental conditions (including the presence of hazardous wastes, toxic
substances, etc. ) that would make the property more or less valuable, and has assumed that there are no such conditions and makes no
guarantees or warrantfes, 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 engineerihg 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.
1. The appraiser obtained the information, estimates, and opinions that were expressed in the appraisal report from sourCes that he or she
considers to be reliable and believes them to be true and correct. The appraiser does not assume responsibility for the accuracy of such
items that were furnished by other parties.
B. The appraiser will not disclose the contents of the appraisal report except as provided for in the Uniform Standards of Professional
Appraisal Practice.
9. The appraiser has based his or her appraisal report and valuation conclusion for an appraisal that is subject to satisfactory completion,
repairs, or alterations on the assumption that completion of the improvements will be performed in a workmanlike manner.
10. The appraiser must provide his or her prior written consent before the lender/client specified in the appraisal report can distribute the
appraisal report (including conclusions about the property value, the appraiser's identity and professional designations, and references to
any professional appraisal organizations or the firm with which the appraiser is associated) to anyone other than the borrower; the
mortgagee or its successors and assigns; the mortgage insurer; consultants; professional appraisal organizations; any state or federally
<lpproved financial institution; or any department, agency, or instrumentality of the United States or any state or the District of Columbia;
~xcept that the lender/client may distribute the property description section of the report only to data collection or reporting service(s)
without having to obtain the appraiser's prior written consent. The appraiser's written consent and approval must also be obtained before
the appraisal can be conveyed by anyone to the public through advertising, public relations, news, sales, or other media.
I=reddie Mac Form 439 6~93
Page 1 of2
Fannie Mae Form 10MB 6-93
~
.
~<!:H!'"
File No. 96deerfi
APPRAISERS CERTIFICJ). TION:, The Appraiser certifies and agrees that:
1. I have researched the subject market area and have selected a minimum of three recent sales of properties most similar and proximate
to the subject property for consideration in the sales comparison analysis and have made a dollar adjustment when appropriate to reflect the
market reaction to those iteme; of significant variatioo. 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 inferiot to, or less favorable than the subject property, I have made a positive adjustment to increase the adjusted
sales price ofthe 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 ref:Jort 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 prospElctive 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 andlor the
estimate of market value in thE'i 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 !:lppraisal is contingent on the appraised value of the property.
6. 1 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 estim~te, the attainment of a specific result, or the occurrence of a subsequent event in order to receive my
compensation andlor 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 furth13r 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 conditfons on the marketabffity 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. r 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 responsibility for it.
SUPERVISORY APPRAISER'S CERTIFICATION: If a supervisory appraiser signed the appraisal report, he or she certifies
and agrees that: I directly sup(trvise 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 clOd the appraisal report.
ADDRESS OF PROPERTY APPRAISED: 96 Deerfield Road, Camp Hill, PA 17011
APPRAISER:
Signature:~/a.."'" t": lf4u~fV
Name: tGann E. Knudsen
Date Signed: 12/1/01
State Certification #: RL-003086-L
orStateLiceflS6#:
State:PA
Expiration Date of Certification or license: 06/30/03
SUPERVISORY APPRAISER (only If required)
Signature:
Name:
Date Signed:
State Certification #:
Of state Urensa #:
state:
Expiration Date of Certification or license:
o Did 0 Did Not 'nspeel Property
Freddie Mac Form 439 6.93
Page20f2
Fannie Mae Form 1004B 6.93
~"
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,
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Mark Heckman Real Estate Apprajsers
USPAP COMPLIANCE ADDENDUM
FUeNo.
Bon-ower Furianic, Carol
Property Address 96 Deerfield RoaCt
Ci!y Camp Hill
Lender/Client Carol Furianic
"'......
County Cumberland
State~ZipCode 17011
Client Reference #
Onlv those items checkedrxl below aDDlv to this reDort.
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The purpose of the appraisal is to pr1)vide an opinion of market vaiue of the subject property as defmed in this report. on behalf of the appraisal
company facilitating the assignment forthe referenced client as the intended user oftbe report. The only function of the appraisal is to assist the
client mentioned in this report in evaluating the subject property for lending purposes. The use of this appraisal by anyone other than the stated
intended user, or for any other use than the stated intended use, is prohibited.
The purpose oftbe appraisal is to pr1>vide an opinion of market value of the subject property, as defmed in this report, on behalf of the appraisal
company facilitating the assignment for the referenced client as the intended user of this report. The only function of the appraisal is to assist the
client mentioned in this report in evaluating the subject property Real Estate Owned (REO) purposes. The use of this appraisal by anyone
other than the stated intended user, Or for any other use than the stated intended use, is prohibited.
The purpose ofthis appraisal is to , on behalf of the appraisal company facilitating the assignment for
the referenced client as the intended 1Jser of this report. The only function of the appraisal is to assist the client mentioned in this report in
evaluating the subject property for . The use of this appraisal by anyone other than the stated intended
user, or for any other use than the stated intended use is prohibited.
o
00 This is a Complete Appraisal written in a Summary Report format and the USPAP Departure Rule has not been invoked.
o This is a Limited Appraisal written il] a Report format and the USPAP Departure Rule half been invoked as di~clo~ed in
the body or addenda of the report. The client has agreed that a Limited Appraisal is suffi~ient for its purposes.
00 The appraisal is based on the infomuUion gathered by the appraiser from public records, other identified sources. inspection of the subject
property and neighborhood, and selel.ltion of comparable sales, listings, and/or rentals witbin the subject market area. The original souree of the
comparables is shown in the Data Source section of the market grid along with the source of confinnation, if available. The original source is
presented first. The sources and data are considered reliable. When conflicting information was provided, the souroe deemed most reliable has
been used. Data believed to be unreliable W1I$ not included in the report nor used as a basis for the value conclusion. The extent of analysis
applied to this assignment may be further imparted within the report, the Appraiser's Certification below and/or any otber Statement of Limiting
Conditions and Apprai~er's Certification such as may be utilized within the Freddie Mac form 439 or FalUlie Mae form 1004b (dated 6193), when
applicable.
- " '. ' " . , ..: -'. "-' '- "~ ' '~ . *-w- - _' ~ * -, "",-;1t
00 A reasonable marketing time for the 4ubject property is 120 day(s) utilizing market conditions pertinent to the appraisal assignment.
o A reasonable exposure time for the sltbject property is day(s).
-....-
ox . _ - ~ .. __ ,_, m., . _ :;,'l$. ,- - , ~ .
I certify that, to the best of my knowledge and belief:
The statements of fact contained in this report are true and correct.
The reported analyses, opini~ns. and conclustions are limited only by tbe reported assumptions and limiting conditions, and are my personal,
impartial, and unbiased profwsional analyses, opinions, and conclusions.
I have no present or prospective interest in the property that is the subject ofthis report, and no personal interest with respect to the parties
involved, unless otherwise stated within the report.
I have no bias with respect tt) the property that is the subject of this report orto the parties involved with this assignment.
My engagement in this assignment was not contingent upon developing or reporting predetermined results.
My compensation for compllilting this assignment is not contingent upon the development or reporting ofa predetermined value or direction in
value that favors the cause of the client, the amount ofthe value opinion, the attainment of a stipulated result, or the occurrence of a subsequent
event directly related to the intended use of this appraisal.
My analyses, opinions, and llonclusions were developed, and this report has been prepared, in conformity with the Uniform Standards of
Professional Appraisal Practice.
I have 00 or have not 0 l11ade a personal inspection of the property that is the subject of this report. (if more than one person signs this report,
this certification must c1earl:f specify which individuals did and which individuals did not make a personal inspection of the appraisal property.)
No one provided significant professional assistance to the person signing this report. (If there are exceptions, the name of each individual
providing significant profeSSional assistance must be stated.)
NOTE: In the calfe of any conflict with a client provided certification (i.e.. Fannie Mae or Freddie Mac). this revised certification shall take
recedence.
Supervisory Appraiser'S Cel:tifl.cation: 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 bl)und by the appraiser's certifications numbered 2-7 and 9 on the second page of Freddie Mac Form 439 6-93/Fannie
Mae Fonn 1004B 6-93, Or the; th,ird page of Form 205S, and am taking full responsibility for the_ appraisal report.
"W~ M: .. Wi ~,~~ . K~1illiW
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APPRAI2
Signatu,re. / 'UA1A1 r:' 'Jf1/..dlJel1 )
Name;lt'Uann E. Knudsen'
Date the Report was Signed: 12/1/01
State Certification #: RL-003086-L
orStateUcense#:
State:PA
Expiration Date of Certification or Ucense: 96/30/03
SUPERVISORY APPRAISER (only ifrequtred):
Signature:
Name:
Date the Report was Signed;
Sta1eCertiiication#:
or State License #:
State:
Expiration Date of Certification or License:
o Didinspectsubjectproperty 0 InspectedComparables
o Interior&EKterior 0 Interior & Exterior
o Exterioronly 0 Exterioronly
USf'APCompllanceAdd.~.4199
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Borrower: Carol Furianic
?rooittvAddless:96 Deemeld Road
Citv: Camo Hit!
Lender:
SUBJECT PROPERTY PHOTO ADDENDUM
FiW-No.: ~eeifi
-Case No.:
State:PA
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FRONT VIEW OF
SUBJECT PROPERTY
Appr.lised Dale: 12/1101
Appraised Value.: $176.000
REARVIEWOF
SUBJECT PROPERTY
STREET SCENE
.
BOrrower: Carol Furianfc
flI1mertvMdress:96 Deerfield Road
CYr'l: Camo ~I\l
Lender.
SUBJECT PROPER:rY PHOTO ADDENDUM
File ffo.:' 96deerli
Case No.;
t
state: PA
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Zio: .17011
FRONT VIEW OF
SUBJECTPROPER:rY
Appraised Date: 1211ffi1
Appraised Va'ue; $176.000
REAR VIEW OF
SUBJECT PROPER:rY
STREET SCENE
Borrowe,r: F:urianlc, Carol
Prcioertv Address: 96 Deerfield Road
Clt : earn Hi1\
COMPARABLE PROPERTY PHOTO ADDENDUM
File No.: 96deerfi
Case No,;
~tit~: PA
Zi : 1i611
. ..-'"-
"'''-:>':'~
COMPARABLE SALE #1
209 Deerfield Road
Camp Hill
Sale Date: 6f12101
Sale Price: $ 190,000
COMPARABLE SALE #2
91 Deertield Road
Camp Hill
Sale Date: 5K:J'110'1
Sale Price: $ 153,000
COMPARABLE SALE #3
432 Candlewyck Road
Camp HiJI
Sale Date: 712101
Sale Price: $ 174,000
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. n Lincoln '
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Financial Group@
The Lincoln National Life Insurance Company
TDA Client Services
PO Box 9740
Portland ME 04104-5001
ii-, ".,AY
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CAROL A. FURJANIC
414 N 4TH 5T
LEMOYNE PA 17043-1665
Plan Number: 569
Employer ID: 560
Plan: HOLY SPIRIT HOSPITAL PARTNERSHIP
SAVINGS PLAN
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Questions? Contact a Service Representative at
1-800-341-0441
Value Snmmary Dollar value Net Gain! Unit value Number of units Dollar value
as of 3/31/2002 activity . loss 6/30/2002 6/30/2002 as of 6/30/2002
894150+006
INDEX 5,752.54 .. 789.24- 30.4491 163.0032 4,963.30 ~
~
GROWTH I 5,031.70 934.09- 30.7347 133.3221 4,097.61 .
0
:0
SMALL CAP 6,660.06 575.01- 20.7101 293.8207 6,085.05 ~
ro
EQUllY-INC 6,460.74 635.05- 21.9316 265.6300 5,825.69 *
0
Totals $23,905.04 $2,933.39- $20,971.65 ~
w
:0
~
Value by source SALARY EMPWYER 0
0
0
of contributions DEFERRAL MATCH TOTAL 0
0
as of 6/30/2002 ~
=
$16,161.59 $4,810.06 $20,971.65 ;;
~
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New Contribution Contract number Contribution Period Interest Rate
Interest Rates
894150+006 04/01/2002-06/30/2002 4.95%
Notifications
Please contact Lincoln Life within 30 days of receipt of this statement if information or investments are
not accurate. Lincoln Life reserves tbe right to limit its liability if inaccuracies are not reported promptly.
,,' .d.'.'
Prospectus~s and various financial reports are available upon request. Please keep in mind that the.l\inds
supporting the variable annuity are not public funds and are only available through insurance company
contracts.
Securities offered through Lincoln Financial Advisors and other broker/dealers with effective selling
agreements.
--
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101998 Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates.
Plan: 569 E~ployer ID: 56G
page 1 of 6
,~_,-L_,~ ~_ .......~~
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ANNUITY SERVICES
ONE TOWER SQUARE
HARlfORD,CT 06183-4053
Your Servicing Agent
CIl'5TRlU
Your Plan-Type is:
Tax Shelterp.d Annuity
Your Product Type is:
T~flex
0000701 J - 00000001 - Cpl L.lOO3
CAROL A FURJANIC
414 N 4TH ST ..
lEiv\OYNE, PA 17043
Account Number
Issue Date
Case Number
8520262
05/11 /1989
802267
@ Questions? Please Contact:
Customer Service
1-(800) 842-9406
YOUR INVESTMENT SUMMARY yOUR OUTSTAi\!DINGlOAN SUMMARY
This Quarter
Year to Date
Beginning Balance
Total Payments
Net Loan Activity
T 01.11 Withdrawals
Other
Change in Investment Value
$212.83
$().OO
$17.00-
$0.00
$0.00
$2.10
$24S.02
$0.00
$71.H7-
$0.00
$0.00
$4.9H
LOAN 1 - effeclive 11/9/1993
Outstanding Loan Principal
$5,708.95
Your defaulted loan amount is not included in your totdl
value and WiJ5 or will be reported to the Internal Revenue
Service as a taxable distribution.
1~!'J[jlN!;~~AJA,,!CE ___==-===:::'==:::'~}!~l;!~=-===-:$jZ.lh!~J
YOUR INVESTMENT STRATEGY
TOTAL ASSETS CURRENT CONTRIBUTIONS
/-ixed
"100% f-Flexer
fixed
100% T-Flex CT
100%
Fixed
Additional Annuity Features
CD NEWS
Your alll/uily Co[ltract provides for J death benefit equal to YOtll' cOJ/lr"c/ vdlue.
for d complete explanation of the death benefit please refer 10 your contract.
Please review your statement for accuracy. Any errors need to be
reported within 90 days of receipt
@l
Your Internet Access: www.lrJvelersla.coln
Lcwinlf); YOllr Social Security NUIHIJer ([Jo slashes or ddshes).
PLl5sword: For first time users please ellieI' YOllr Date of Uirlh IMfdDDYY)
- 99185~j9389960~}699 1 of 2
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Holy~pirirH()$pital
#BWNFXQN
ENV#40q14223
40 58940 73116A
CAROL A FUR,!ANJC
414 4TH srR~q
lEMOYNE, PA 17Q43
Y(J~tAce<<1>.!;IfJt'$urnr11cn-y
Bllginnin9Blll~I)Cl\ .
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Cha@llin Aoqo~ntVal~e
. Eri<linitlllalll.nell. .
Addifi6i1l!)ln)ormatiQn
. Divl~ericls&.lnleresl
$$1 ;30~.70
'958,31
. '92~.51
>6,908,80
$46;284.72 .
$76.36
y Q(jrPllr~.orilil'allte'o1'R!llurn.
TtlisP.eHQd ..... . .. ". . -13.2%.
Yearti:lOale ...... .... . ..... .;' ....... .......:-15,0%
yo~rPerso~al RljteofF\elqmis c;alqU!ljllldwith ~.liinll:we.ighted'"
fqri)1ula,,,,ipllly us~.bY'fi,,*,qii!l~~~!Yststo. eajbUI"'lein\ie~llJ1ent
earr!!hg~,_,:, It,' r;e,fl~t~AheJ1;!~u!ts 'pf-:yp,~,t::r~w~~~Q(fl~I~<1tiQ~~ :a_s,
weU Ilsa~Ylj<ili0lY' intbe~lllnacpo~h!(s)' showrj.; ~herear"other
Persq~ajR,ueef FleliJrriformulas. .~se~WalfrJ"YYillld.dlfferenl..
re~,ults:.,- Reme'!i,p'erttli:tt' p:~sl perfc;jrrit~h(ji:f,i's__htrg,u.a,:ranfee of tutu're
results. ' ", "',
'''''''''"''!l~~~dir,":",'~'b'''''''''",
.. ~ . '.
a~tireRlenl S~vjngs Statement
April 1 ,2002. - June 30, 2002
~ For online acceSSi fOQon at:
http://www:tidelity.com/atwork
For information, c"II:(800) 343-0860
YO!JI' Ass(\fAnoeation
II stocks 94%
o Boncls 6%
you....'. '';n.~e...~. t.m..ents..~regUrr~..nt.IY.lil.I.QC."ted amo. ngthediSpl"y. e.d.
aSS"l i=laSSes. Percentages andlolals may nolbe exact due to
rounding: '. .. . '.
ThllAddfiionalFu~d Information sectio~lists the allocation of
your.QlendedfundS, . .
': '.': " ':"-:, '-"',' ,,'" , ',-- .'.' : '-', '.-,'. :':':'. -,<.,'-",.' ,",
M~';k~t~al~~~fVO~t~e'~oUnl '.. ....
This section dlsPlllYs the valueofyour"cCOU!it'lor the'Perlod, in both shares and cli>ilar.s,
:sflareson Shar,eli.qn Price on Pr;c.e,on MatkefVallle
Investment 03131/21J02 06/3012lJ02 0313112lJ02 . 06130/2002 . on 03/3112lJlJ2
Stoc.klnves!ments $40,157.!l8 $35,n1.42
Fidelity Grow & Inc 602,713 624.697 $37.60 $33.61 22,662.01 20,~9M7
Fidelity Growlh Co 352.59.3 369,585 $49.62 . $3.9.87 17,495.67 14,735.35
Blended Investments' $11,14!l.02 $10,553.30
Ficl Freedom 2020 885.307 920.078 $12.59 $11.47 11,146.02 Wi553.30
Remember that a. dividend. payment tt}'fund shiaf'eholt;ters-reduc8_s the share 'price at the fun(j, so a decrease in the share price for the statement
period does ,not nec'essarily rs'ned lower fund performance'.
* Some of your investments ,are cl'<.'lssUied as a Bfended Fund Investment. Blended Investrnents may include a mixture 6f stocks, bonds,
aneVor sh9rt-term a&sets; 'Please refer'to:th~ "Additional Fund Information" section to determine_ tb8 ~llocatjQn of,your_blended investments'
uhd'erlyihg,as,sets. The asset breakdown-'of your, portfolio is, reflected in the pie chart in'the "As~~h",lIoc,ation" Section.
Please read this statement carefuUy. Any error must be reported to Fid~'li.ty, Investments within 90 days.
1422340014223 0001 20020709 40313
Fidelity Jrtvestments, P.O. Box 770002, Cincinnati, OH 45277-0090
Page 1 of 5
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CAROL A. FURJANIC,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
vs.
CIVIL ACTION - LAW
NO. 01 - 1144 CIVIL
JAMES A. FURJANIC,
Defendant
IN DIVORCE
RESCHEDULED PRE-HEARING CONFERENCE
TO: Cara A. Boyanowski
, Attorney for Plaintiff
William A. Fetterhoff
, Attorney for Defendant
A pre-hearing conference has been scheduled at the
Office of the Divorce Master, 9 North Hanover Street,
Carlisle, Pennsylvania, on the 24th day of February, 2003,
at 1:30 p.m., at which time we will review the pre-trial
statements previously filed by counsel, define issues,
identify witnesses, explore the possibility of settlement
and, if necessary, schedule a hearing.
Very truly yours,
Date of Notice: 1/30/02
E. Robert Elicker, II
Divorce Master
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CAROL A. FURJANIC,
Plaintiff
: IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
: CNIL ACTION - LAW
v.
: NO. 01-1144 Civil Term
JAMES A. FURJANIC,
Defendant
: IN DNORCE
MOTION FOR APPOINTMENT OF MASTER
Carol A. Furjanic, Plaintiff, moves the Court to appoint a Master with respect to the
following claims:
(X) Divorce
( ) Annulment
(X) Alimony
(X) Alimony Pendente Lite
(X) Distribution of Property
( ) Support
(X) Counsel Fees
(X) Costs and Expenses
and in support ofthe motion states:
1.
requested.
Discovery is complete as to the claims for which the appointment of a Master is
2. The Defendant has appeared in the action by his attorney, William A. Fetterhoff,
Esquire, of Fetterhoff & Zilli, P.O. Box 1161, Harrisburg, Pennsylvania 17108-1161.
3. The statutory grounds for divorce are: SS 3301(a)(6), 330l(c) and 3301(d) of the
Divorce Code.
4. Check the applicable paragraph(s):
() The action is not contested.
() An agreement has been reached with respect to the following claims:
(X) The action is contested with respect to the following claims: equitable
distribution, alimony, alimony pendente lite, counsel fees, costs & expenses
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5. The action does not involve complex issues oflaw or fact.
6. The hearing is expected to take 1 day.
7. Additional information, if any, relevant to the motion:
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ANDNOW, ~ /7 ,2002, [:j3JM adtiutJ-
Esquire, is appointed aster with respect to the following claims:
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BY THE COURT:
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CAROL A. FURJANIC,
plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
vs.
NO. 01 - 1144 CIVIL
JAMES A. FURJANIC,
Defendant
IN DIVORCE
TO: Cara A. Boyanowski
, Attorney for Plaintiff
william A. Fetterhoff
, Attorney for Defendant
DATE: Friday, October 4, 2002
CERTIFICATION
~I certify that discovery
for which the Master has been
is complete as to the claims
appointed.
OR IF DISCOVERY IS NOT COMPLETE:
(a) Outline what information is required that is not
complete in order to prepare the case for trial
and indicate whether there are any outstanding
interrogatories or discovery motions.
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(b) Provide approximate date when discovery will be
complete and indicate what action is being taken
to complete discovery.
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DATE
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COUNSEL FOR PLAIN~F ( )
COUNSEL FOR DEFENDANT (-)
NOTE:
PRETRIAL DIRECTIVES WILL NOT BE ISSUED FOR THE
FILING OF PRETRIAL STATEMENTS UNTIL COUNSEL HAVE
CERTIFIED THAT DISCOVERY IS COMPLETE, OR OTHERWISE
AT THE MASTER'S DISCRETION.
AFTER RECEIVING THIS DOCUMENT FROM BOTH COUNSEL
OR A PARTY TO THE ACTION, IF NOT REPRESENTED BY
COUNSEL, INDICATING THAT DISCOVERY IS NOT
COMPLETE, THE DIRECTIVE FOR FILING OF PRETRIAL
STATEMENTS WILL BE ISSUED AT THE MASTER'S
DISCRETION. HOWEVER, IF BOTH COUNSEL, OR A
PARTY NOT REPRESENTED, CERTIFY THAT DISCOVERY
IS COMPLETE, A DIRECTIVE TO FILE PRETRIAL
STATEMENTS WILL BE ISSUED IMMEDIATELY.
THE CERTIFICATION DOCUMENT SHOULD BE RETURNED
TO THE MASTER'S OFFICE WITHIN TWO (2) WEEKS OF
THE DATE SHOWN ON THE DOCUMENT.
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CAROL A. FURJANIC,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
VS.
CIVIL ACTION - LAW
NO. 01 - 1144 CIVIL
JAMES A. FURJANIC,
Defendant
IN DIVORCE
PRE-HEARING CONFERENCE
TO: Cara A. Boyanowski
, Counsel for Plaintiff
William A. Fetterhoff
, Counsel for Defendant
A pre-hearing conference has been scheduled at the
Office of the Divorce Master, 9 North Hanover Street,
Carlisle, Pennsylvania, on the 27th day of January, 2003, at
9:30 a.m., at which time we will review the pre-trial
statements previously filed by counsel, define issues,
identify witnesses, explore the possibility of settlement
and, if necessary, schedule a hearing.
Very truly yours,
Date of Notice: 11/26/02
E. Robert Elicker, II
Divorce Master
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CAROL A FURJANIC,
Plaintiff
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
v.
NO. 01-1144 Civil Term
JAMES A. FURJANIC,
Defendant
IN DIVORCE
DEFENDANT'S ANSWER
TO COMPLAINT IN DIVORCE
Count I
L Admitted.
2. Admitted.
3. Admitted.
4. Admitted.
s. Admitted
6. A. Denied. In fact, it is Plaintiff who has offered such indignities to the Defendant, the
innocent and injured spouse, as to render his condition intolerable and life burdensome.
B. Neither admitted nor denied.
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C. Neither admitted nor denied.
7. Admitted.
8. Neither admitted nor denied. By way of further answer, Defendant has been advised of the
availability of counseling and does not request same. (See Affidavit attached.)
9. Neither admitted nor denied.
WHEREFORE, Defendant prays this Honorable Court to deny Plaintiff's request for a
divorce as clearly premature.
Count n
10. No response required.
11. It is admitted that the parties have acquired property during their marriage.
12. Neither admitted nor denied.
WHEREFORE, Defendant prays this Honorable Court to deny Plaintiff's request for equitable
distribution as clearly premature.
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Countm
13. No response required.
14. Denied. Plaintiff is gainfully employed, earning close to $3,500.00 per month, net pay. She
remains at the marital residence and is currently paying only some of the joint debt. She has health
insurance through her employment and contributes to a 40l(k) account.
15. Neither admitted nor denied.
WHEREFORE, Defendant prays this Honorable Court to deny Plaintiff' srequest for alimony.
Count IV
16. No response required.
17. Admitted in part; denied in part. Defendant has only earned the salary noted since January
8, 2001. He has no assets not currently known to Wife. These assets include only his interest in the
marital residence and personalty, his car, his interest in the parties' joint checking account and his
interest in Plaintiff's 401(k).
18. Neither admitted nor denied.
19. Denied. Plaintiffis fully able to sustain herself during the course of this litigation. Defendant
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is not able to do so.
WHEREFORE, Defendant prays this Honorable Court to deny Plaintiff's request for alimony
pendente lite, counsel fees, costs and expenses.
Respectfully submitted,
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.ynC. ZOO, E
Fetterhoff and ZOO
200 North Third Street, Suite 800
Harrisburg, PA 17101
(717) 232-7722
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CAROL A FURJANIC,
Plaintiff
v.
IN THE COURT OF COMMON PLEAS
:! CUMBERLAND COUNTY, PENNSYLVANIA
:1
NO. 01-1144 Civil Term
.1
JAMES A. FURJANIC,
Defendant
:1
IN DIVORCE
AFFIDAVIT bF COUNSELING
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I, James A. Fwjanic, being duly sworn! according to law, depose and say:
1
1. I have been advised of the availab~ of marriage counseling and understand that I may
request that the Court require that my spouse imd I participate in counseling.
2. I understand that the Court maintains a list of marriage counselors in the Domestic
Relations Office, which list is available to me llpon request.
3. Being so advised, I do not request tli.at the Court require that my spouse and I participate
in counseling prior to a divorce decree being llanded down by the Court.
I understand that false statements her~in are made subject to the penalties of 18 Pa. C.S.
~4904 relating to unsworn falsification to authbrities.
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VERIFicATION
I verify that the statements made in the foregoing document
are true and correct to the beet of my knowledge, understanding,
and belief.
l: uhderstand that. false statements herein are made
subject to the penalties of 18 Pa. C.S. !i4904 relating to unsworn
falsification to authorities.
Date: ~ -:"/~ -0/
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CERTIFICATE OF SERVICE
A true and correct copy of the foregoing document was delivered to the person(s) or office(s)
listed below by first class mail on the date indicated, as follows:
Kathleen Carey Daley, Esquire
1029 Scenery Drive
Harrisburg, P A 17109
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200 North Third Street
Suite 800
Harrisburg, P A 17101
(717) 232-7722
CAROL A. FURJANIC,
PLAINTIFF /Respondent
: IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
: CIVIL ACTION - LAW
v.
: NO. 01-1144 Civil Term
JAMES A. FURJANIC,
DEFENDANT /Petitioner
: IN DIVORCE
ANSWER AND NEW MATTER TO THE PETITION FOR EMERGENCY RELIEF
PURSUANT TO
23 Pa. C.S.A. & 3502(e) and & 3505
AND NOW, this 5 ft'""aay of June, 2001, comes Carol A. Furjanic, Plaintiff, in the
above-captioned matter, who files an answer to the petition of James A. Furjanic, the Defendant,
who has sought an emergency order prohibiting the Plaintiff from disposing of, alienating or
encumbering any of the marital assets in order to defeat equitable distribution in the above-captioned
case as follows:
1. ADMITTED.
2. ADMITTED.
3. ADMITTED in part, DENIED in part. It is admitted the parties have lived separate
and apart since December 26, 2000. It is admitted that the Respondent vacated the marital residence
at 96 Deerfield Road, Camp Hill, Pennsylvania, in the early morning hours of May 19, 2001. The
Respondent vacated the marital residence because she feared for her safety. Her husband returned
to the home in the early morning hours, was drunk and engaged in out of control behavior. The
Respondent believes that the Petitioner continues to occupy this residence and further, that he has
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changed the locks to this jointly owned property.
4. ADMITTED in part, DENIED in part. It is admitted that the Respondent moved
pieces of crystal from the marital residence. These items were a gift to the Respondent from her
mother, who is now deceased. It is denied that these items were marital property. However, the
Respondent does intend to account for these items and submit the determination of their status to the
jurisdiction of this Court. Based upon the Defendant's outrageous conduct, the Petitioner wanted to
protect these items from being destroyed in the event that the Defendant sought to destroy them in
a drunken rage.
5. ADMITTED in part. It is admitted that the Respondent has removed her jewelry from
the marital residence, some of which were gifts from the Petitioner to the Respondent and may have
been marital property. It is denied that the Respondent did so to defeat any marital claim that the
Petitioner may have to these items, but rather to ensure that the items were not lost or destroyed by
the Defendant.
6. DENIED. It is denied that the Respondent removed the Petitioner from her health
insurance coverage without knowledge or consent of the Petitioner. Respondent believes that the
Petitioner had coverage available to him and the Respondent notified him of the fact that she was
going to make an election for insurance coverage for the coming year several months prior to the
insurance change.
7. ADMITTED in part and denied in part. It is admitted the Petitioner was away from
the marital residence on Saturday, May 19, 2001. On that date, the Respondent, fearing for her
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personal safety was removing items of her clothing and some other property from the marital home.
No attempt was made to secret these items in any way from the Petitioner.
8. ADMITTED.
9. DENIED. It is denied thatthe bedroom ofthe Petitioner was ransacked. It is admitted
that personal property was removed from the house, all of which will be accounted for by the
Petitioner.
10. ADMITTED. The phone service to the residence was disconnected as it was in the
Respondent's name.
11. ADMITTED. No responsive pleading is required of the balance of this averment.
12. ADMITTED.
13. DENIED. It is denied that the Respondent stated she was going to let the car be
repossessed. The Respondent indicated that the Petitioner needed to make new arrangements to pay
for this car loan.
14. DENIED. It is denied that this conduct suggests an intent in Respondent to dissipate
martial assets and/or deny Petitioner access to these assets and/or his lawful right in them and/or to
defeat equitable distribution in this case. These actions were meant solely to provide the Respondent
with a safe and secure residence where she may remain until a final determination is made in this
matter.
15. ADMITTED. It is admitted that there may be some time before this case is resolved.
However, there is no requirement that the parties' marital assets be protected until that time.
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16. DENIED. It is denied that an Order in the nature of an injunction must be entered
against the Respondent to prevent her dissipation of marital assets and to preserve the status quo
otherwise. The Petitioner is seeking to use this special relief to gain an economic advantage in this
divorce in that he has refused to list the marital home for sale and seeks to possess and enjoy all
aspects of the marital estate to the exclusion of the Petitioner.
17. DENIED. It is denied the Respondent must be ordered to provide a complete
inventory to Petitioner of all property removed and of the current location thereof. An inventory of
the assets is attached hereto as Exhibit "A."
WHEREFORE, the Plaintiff'Respondent prays this Honorable Court to deny the Emergency
Order claimed by the DefendantlPetitioner to prohibit the Plaintiff'Respondent from dissipating,
disposing, transferring, alienating, encumbering or otherwise affecting in violation of Petitioner's
rights thereto any marital assets including, but not limited to, all personalty, financial accounts, bank
accounts, credit cards and automobiles. It is further requested that the Order to provide the Petitioner
with a complete inventory of all property removed from the marital residence and the current
location thereof be denied. Finally, it is directed that the Court deny the DefendantlPetitioner's
request that the Plaintiff'Respondent continue to make payments on the Defendant's car loan.
NEW MATTER
18. The Petitioner has a history of alcohol abuse and is currently in a probationary
program with the court related to this conduct.
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19. The Respondent, in the earlymoming hours of May 19, 2001, was awakened by her
husband's shouting and cursing. She was so fearful of her husband that she attempted to call the
police to seek assistance only to find that her husband had disabled the telephone.
20. The Respondent remained in her bedroom during this time while her husband turned
the stereo to a very loud volume. When she thought he had passed out, she ran through the house,
grabbed her keys and left the residence. She then went to her daughter's apartment seeking help.
21. The Respondent's daughter called the Lower Allen Township police for assistance.
A police officer went to the residence but was unable to get anyone to answer the door. He reported
hearing loud music.
22. The Respondent returned to the marital residence the following morning with her
daughter as this was the location where she was to have a bridal shower on that day.
23. The Petitioner refused to accommodate the Respondent when she asked him to
cooperate in the arrangements for the bridal shower by permitting her to use the home for that
purpose.
24. As a result of the conduct ofthe Petitioner, emergency arrangements were made to
move the bridal shower to the home of another relative.
25. The Respondent returned later that day and took the items listed on Exhibit "A" with
her, which includes both marital and non-marital property.
26. The conduct of the Petitioner has made it impossible for the Respondent to continue
to reside at the marital home and she has been forced to establish a new home for herself during the
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pendency of the divorce.
27. The Petitioner has significantly greater income than the Respondent and the
Respondent has been advised that she has an alimony pendente lite claim against him during the
pendency of the divorce.
28. In a letter, dated April 26, 2001, counsel for the Respondent notified counsel for the
Petitioner that she would expect the Petitioner to pay the expenses related to the first and second
mortgage in lieu of the alimony pendente lite claim.
29. The Respondent believes that this constitutes a reasonable arrangement regarding the
parties' financial obligations until a divorce is finalized.
30. It is believed that the Petitioner will not cooperate in any reasonable fashion to permit
the Respondent to remove any additional personal property from the marital home.
31. The Respondent has prepared a list of the items she wishes to take from the property
as well as a list of items which will remain with the Petitioner. This is attached hereto as Exhibit
"B."
32. The Respondent requests the court to enter an Order directing the Petitioner to make
these items available to the Respondent.
WHEREFORE, the Plaintiffi'Respondent requests this Honorable Court to deny the claim of
the DefendantJPetitioner and to enter an order directing the following:
A. The DefendantJPetitioner shall pay all expenses related to the home including,
the first and second mortgages, all utilities, taxes, etc., related thereto, his car loan, and any other
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debts for which the PlaintiffiRespondent would be jointly liable, in a timely fashion.
B. The PlaintiffiRespondent shall be authorized to remove the property listed on
Exhibit "B" from the marital residence.
Date:
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Kleen Carey Daley, Es
Attorney No. 30078
1029 Scenery Drive
Harrisburg, PA 17109
(717) 657-4795
Attorney for PlaintiffiRespondent
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VERIFICATION
Upon my personal knowledge, information and belief, I, Carol A. Furjanic, do hereby
verify that the facts averred and statements made in the foregoing Answer and New Matter to the
Petition for Emergency Relief are true and correct.
I understand that false statements or averments therein made will subject me to the
criminal penalties of 18 Pa.C.S.A. g4904 relating to unsworn falsification to authorities.
Date:
{p' 5/0 I
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By: ~
Carol A. Furjanic, Plamtl f
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EXHIBIT A
Toaster (gift to Wife from children)
Blender (gift to Wife 1970)
Can opener
Mixer
Andrea's bedspread, mattress, box spring
Chest of Drawers (Wife's sister Patty's)
Infant Jesus statue (gift from Wife's Godmother to Wife)
Two wrought iron candle stick holders (gift to Wife from sister)
Anniversary mantle clock (10 year HSH award - Wife)
Five picture frames (Eric and Andrea's photos)
Five Boyds bears (gifts to Wife from Andrea)
Three decorative platters (gifts to Wife from mother)
Musical figurines (gift to Wife)
Two Oriental statuettes (gift to Wife from mother)
Three Carousel horses (gift to Wife from co-workers)
Wine decanter with two glasses
Brass tray
Brass bed head and footboard (purchased by Wife 1980)
Clothing
Shoes
Wine and Water Goblets (gift to Wife from mother)
Stereo
Three paintings (gifts to Wife from sister prior to marriage)
Two wall hangings
Two small wall pictures (gift to Wife 1974)
Jewelry:
Diamond Tennis Bracelet (gift to Wife for 40th Birthday)
Diamond Ring (prior marriage diamond)
Miscellaneous Bracelets (Value: $100.00 - $300.00)
Miscellaneous Necklaces/Chains
Onyx and Diamond Earrings (Value: $100.00 - BJ's)
Pearls (Wife's mother)
Silver Jewelry from Flea Market
Movado Watch (gift to Wife for 50th Birthday)
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EXHIBIT B
Household Items
Lawnmower
Snowblower
Gas Grill
Tools
Yard Equipment (Shovels/Rakes/Etc.) /
Big Screen Television
Two sets of fireplace screens and accessories
One Family Room Coffee Table
One Family Room Sofa Table
Two Family Room Etageres
Two Family Room Lamps
Mahogany DR Table wi eight chairs
Ficus Tree (Family Roo
Washer/Dryer
Refrigerator
Televison/VCR (MBR)
VCR (FR)
Dresser (MBR)
Night Stand
One BR Lamp
Dresser (Eric's Room)
Headboard/Night Stand (Eric's Room)
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.'. Kitchen Table wi Four Chairs -
" Two Brass and Glass Etageres
(1' icus Tree (Dining Room)
One LR Clock
Two LR Chairs
Two LR lamps
\ One LR Coffee Table
One LR End Table
One Round (12") LR Table
MBR Dresser wi mirror (Wife's)
One Night Stand
One Plant Stand (pre-Marital)
One Mirrored Stand
Two MBR Wall Pictures
China
Yz Rugs
Yz Pots and Pans
Silverware
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CAROL A. FURJANIC,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
vs.
NO. 01 - 1144 CIVIL
JAMES A. FURJANIC,
Defendant
IN DIVORCE
TO: Cara A. Boyanowski
, Attorney for Plaintiff
william A. Fetterhoff
Attorney for Defendant
DATE: Friday, October 4, 2002
CERTIFICATION
I certify that discovery is complete as to the claims
for which the Master has been appointed.
OR IF DISCOVERY IS NOT COMPLETE:
(a) Outline what information is required that is not
cq~plete in order to prepare the case for trial
and indicate whether there are any outstanding
interrogatories or discovery motions.
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(b) Provide approximate date when discovery will be
complete and indicate what action is being taken
to complete discovery.
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NOTE:
PRETRIAL DIRECTIVES WILL NOT BE ISSUED FOR THE
FILING OF PRETRIAL STATEMENTS UNTIL COUNSEL HAVE
CERTIFIED THAT DISCOVERY IS COMPLETE, OR OTHERWISE
AT THE MASTER'S DISCRETION.
AFTER RECEIVING THIS DOCUMENT FROM BOTH COUNSEL
OR A PARTY TO THE ACTION, IF NOT REPRESENTED BY
COUNSEL, INDICATING THAT DISCOVERY IS NOT
COMPLETE, THE DIRECTIVE FOR FILING OF PRETRIAL
STATEMENTS WILL BE ISSUED AT THE MASTER'S
DISCRETION. HOWEVER, IF BOTH COUNSEL, OR A
PARTY NOT REPRESENTED, CERTIFY THAT DISCOVERY
IS COMPLETE, A DIRECTIVE TO FILE PRETRIAL
STATEMENTS WILL BE ISSUED IMMEDIATELY.
THE CERTIFICATION DOCUMENT SHOULD BE RETURNED
TO THE MASTER'S OFFICE WITHIN TWO (2) WEEKS OF
THE DATE SHOWN ON THE DOCUMENT.
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CAROL A. FURJANIC,
Plaintiff
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
v.
NO. 01-1144
JAMES A. FURJANlC,
Defendant
IN DIVORCE
PRE-TRIAL STATEMENT
On behalf of Carol A. FUljanic, the plaintiff in the above-captioned action, Cara A.
Boyanowski, Esquire, does hereby file the following pre-trial statement for consideration of the
Court:
I. Marital Assets - Attached hereto please find a listing of all marital assets including
their value, date of valuation, detennination of whether any portion is non-marital and any liens or
encumbrances thereon, and a listing of non-marital assets, their value, date of valuation, and any liens
or encumbrances thereon:
See Inventory.
2. The names and addresses of each expert whom the Plaintiff intends to call at trial
includes the following:
Luann E. Knudsen, real estate appraiser. In the event Plaintiff decides to call
additional experts, the names and addresses of the experts will be provided to
Defendant prior to trial.
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3. The Plaintiff intends to testifY at trial. If any additional witnesses are identified, their
names and addresses will be provided to Defendant prior to trial.
4. A list of all exhibits which the Plaintiff intends to offer into evidence:
A. The Inventory of Plaintiff, Wife.
B. The Income and Expense Statement of Plaintiff, Wife.
C. Appraisal of Marital Residence, dated December 1, 2001.
D. Any additional exhibits will be forwarded to Defendant prior to trial.
S. The gross income of the Plaintiff from all sources including payroll deductions, recent
state and federal income tax returns and pay stubs:
Income and Expense Statement includes this information.
6. A listing of the expenses of the Plaintiff:
Income and Expense Statement includes this information.
7. The valuation of pension or retirement benefits and a calculation of the marital portion
thereof and the facts and documentation upon which the party relies to support the valuation:
See Inventory.
8. Claim for counsel fees:
The Plaintiff has made a claim for counsel fees, costs and expenses.
9. Tangible personal property values:
The Plaintiff will testifY as to the values of all tangible personal property in
question.
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10. Listing of marital debts:
See Inventory.
11. The Plaintiff makes the following proposed resolution of the economic issues:
A. The parties' jointly titled real property, located at 96 Deemeld Road, Camp
Hill, Cumberland County, Pennsylvania, shall be sold.
B. Distribute all marital assets in the following fashion: 65% to Plaintiff and 35%
to Defendant.
C. All household goods and furnishings presently in the possession of Plaintiff to
remain the sole and separate property of Plaint iff and all household goods and
furnishings presently in the possession of Defendant to remain the sole and
separate property of Defendant. Since assets are of nominal value, no specific
value should to be assigned to the household goods and furnishings in either
party's possession.
D. Defendant shall assume sole responsibility for the outstanding balance on his
Citibank Mastercard Credit Card debt, with an approximate balance of
$12,000.00.
E. Defendant shall assume sole responsibility for any balances remaining on his
Bank One Visa Credit Card.
F. Plaintiff shall assume sole responsibility for the outstanding balance on the
jointly titled Members First Visa Credit Card debt, with an approximate
balance of$2,200.00.
G. Defendant to pay Plaintiff's counsel fees, costs and expenses associated with
the divorce action.
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Defendant to provide Plaintiff with an appropriate alimony payment.
Respectfully submitted:
DALEY LAW OFFICES
Cara A Boyanows
Attorney No. 68736
1029 Scenery Drive
Harrisburg, PA 17109
(717) 657-4795
Attorney for Plaintiff
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CAROL A. FURJANIC,
Plaintiff
: IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYL VANIA
: CNIL ACTION - LAW
v.
: NO. 01-1144
JAMES A. FURJANIC,
Defendant
: IN DNORCE
INCOME AND EXPENSE STATEMENT
UNDER RULE 1920.31
I hereby file the Statement of Income and Expenses required under Rule 1920.31 and verifY
that the information therein contained is true and correct to the best of my knowledge, information
and belief.
I understand that false statements herein are made subject to the penalties of 18 Pa. C.S.A.
94904, relating to unsworn falsification to authorities.
Date:
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By:
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Carol A. FUJ:jani.Q,A'lain;. f
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Date of Marriage:
Fi'ph~1JnrF J?, 1 QR?
Case Name:
PUrjnnir 11 P1Jrjnn7"r
Date of Separation:
npf'pmhpy 71l 7nnn
INCOME AND EXPENSE STATEMENT
of
CAROL A. FURJANIC
Other Benefits
Husband's Income Gross:
Net:
Wife's Income Gross:
$53,690
Net:
$32,838
Monthly Expenses: Monthly Payment Total Amount Owed
Mortgage $835.00
Home Equity
Utilities $242.00
Upkeep/Maintenance
Household Help
Car Loans $366.00
Insurance: Car $44.00
Homeowners $10.00
Health $70.00
Tuition/Daycare
Credit cards: Master Card
VISA $150.00 $2,400
Moving Expenses X2 $20.00
Cell Phone $17.00
Medical Expenses $50.00
Clothing $150.00
Food/Supplies $450.00
Entertainment $100.00
Vacations
Memberships $40.00
Other Child Support! Alimony
Legal Fees $125 to $550
Totals: $2,669 to $3,094
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EMPLOYEE NAME
FURJANIC, CAROL A
FOR PERIOD ENDING
06/29/02
PTO VAC
144.44
RATE
24.28
STD SIC
269.30
S5N
185-38-6096
OEPT
6510
EMPLOYEE NUMBER
185386096
NET PAY CURRENT
1,263.20
GROSS CURRENT
2,065.08
ADVICE NO.
124182
NET PAYYTD
19,497.61
GROSS YTD
29,411.77
E.ARNINGS HOURS RATE CURRENT YTD DEDUCTIONS CURRENT YTD
1REG 44.25 24.28 1,086.64 24.142.04 401(k) 165.20 2,G56.49
28.00 24.28 679.84 2.136.64 DENTAL 4.00 49.00
2PTO se FIT 362.43 4.098.67
3HOLlDA B.OO 24.28 194.24 776.96 HSMP 21.14 272.65
MEDWI 29.56 421.60
OT PREM 4..25 12.64 54.57 520.06 PA WlH 57.09 814.08
WKNO AN 12.00 4.14 49.68 750.38 WSHORE 29.94 29.94
OASDI 126.41 1.802.72
EX LlF 0.11 1.55 I UWAY 0 5.00 70.00
EOUC 1,007.62 VISION 1.00 14.00
OPT.HS 10.00
ON CALL 72.00 LO-CUM 273.46
CHARGE I 4.00
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TOTAL EARNINGS 92.25 $2,065.08 $29,411.77
ACH BANK ACCOUNT AMOUNT
ACH COMCHE Ace! 513244707 1 .263.2C i
,
I TOTAL DEDUCTIONS $801.77 $9.912.6 I
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CAROL A. FURJANIC,
Plaintiff
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
: CNIL ACTION - LAW
v.
: NO. 01-1144
JAMES A. FURJANIC,
Defendant
: IN DNORCE
INVENTORY
UNDER RULE 1920.33
Plaintiff files the following inventory of all property owned or possessed by either party at
the time this action was commenced and all property transferred within the preceding three years.
Plaintiff verifies that the statements made in this inventory are true and correct. Plaintiff
understands that false statements herein are made subject to the penalties of 18 Pa.C.S.A. 94904
relating to unsworn falsification to authorities.
Date:
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By:
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Carol A. FU1janic, PI4p.tiff.'/
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INVENTORY
FURJANIC v. FURJANIC
Date ofManiage - 02/13/82
Date of Separation - 12/26/00
MARITAL ASSETS
Assets Husband's Wife's Master's Notes
Value Value Value
Real Estate
Marital Residence: $153,600.00 $180,000.00 Mortgage of approximately
96 Deerfield Road (His Appraisal) $68,000.00 and Home Equity Loan
Camp mll, P A 17011 Equity: of$84,000.00 at separation.
$50,000.00 Current debt balance unknown, but
should totaI less than $125,000.00
Husband 1/3 Ownership in Mother's $10,000.00 mcrease in value during marriage.
. Residence in Steelton, Pennsylvania
Retirement Assets
The Lincoln National Life Insurance Date of
Group (Financial) Separation
Annuity Value:
Wife $26,277.32
Current
Value:
$20,971.65
(As of 6/30/02)
Travelers Life and Annuity Date of Outstanding Loan against account
Wife Separation in amount of $5,708.95 as of
Value: 06/30/02.
$365.25
Current
Value:
$178.13
(As of 6/30/02)
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Assets Husband's Wife's Master's Notes
Valne Value Value
Fidelity Investments Date of Current value includes post
401(K) Plan Separation separation contributions of
Wife Value: approximately $14,000.00.
$54,029.96
Current
Value:
$46,284.72
Bank Accounts
Members First Account $2,900.00 Value at Date of Separation:
Wife $2,900.00
Current Value:
$25.00
Conullerce Bank Account $0.00 Value at Date of Separation:
Wife $0.00
Current Value:
$1,200.00
Mellon Bank Checking Account $3,000.00 Value at Date of Separation:
No. 884-017-4117 $3,000.00
Husband Current Value:
$1,400.00
Mellon Bank Checking Account $0.00 Value at Date of Separation:
No. 100-024-4630 $0.00
Husband Cwrent Value:
$1,100.00
Automobiles
1995 Mitsubishi $7,500.00 Purchased in February, 1997 for
Husband $19,000.00.
No lien exists on vehicle.
1990 Volvo $0.00 $0.00 Vehicle was sold for $4,500.00 and
proceeds were split between
parties.
1999 Diamante $0.00 $0.00 Leased vehicle.
Wife
MARITAL ASSETS
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Assets Husband's Wife's Master's Notes
Value Value Value
Miscellaneous
Household Goods and Furnishings Nominal Nominal Already split between parties.
Loans/Debts
Citibank Mastercard Credit Card Date of Non-marital Husband's debt fur personal and
No. 5410-6548-4547-4219 Separation recreational expenses.
Husband Balance:
$12,000.00
Current
Balance:
$12,500.00
Bank One Visa Credit Card Date of Non-marital Husband's debt for personal and
No. 4417-1259-7248-7718 Separation recreational expenses.
Husband Balance:
$3,000.00
Current
Balance:
$0.00
Visa Credit Card Date of Joint Names.
No. 4287-5900-0036-4451 Separation Account used for marital expenses
Balance: by Wife and personal expenses.
$1,800.00
Current
Balance:
$2,188.08
MARITAL ASSETS
"lJlark Heckman Real Estate Appraisers
File No. 96deerfi
APPRAISAL OF
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Single Family Residential
LOCATED AT:
96 ,Deemed Road
Camp Hill, PA 17011
FOR:
BORROWER:
Carol Furjanic
AS OF:
December 1, 2001
BY:
Luann E. Knudsen
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UNIFORM RESIDENTIAL APPRAISAL REPORT
Procertv Des<;riDtion File No. 9Sdeerii
Property Address 96 Deerfield Road cnv Camo Hill Slale PA Zip Code 17011'
leca! OescrioUon Deed Book 30F Paae 1173 County Cumberland
Assessor's Parcel No. SEE MAP REFERENCE NUMBER Tax Year 2001 RE. Taxes $ 2,451.85 Special Assessments $ -0-
Borrower Furianlc Carol Current Owner Furianic Occtloanl: IX! Owner I I Tenant I Vacant
.. Prooertvric!hls8lUlraised IX FeeSimnle I I leasehold I ProieclTvoa I PDD I I CondominiumfHUDNAonlv\ HOA$ -0- IMo.
Neiohbamood or Pro'eel Name Allendale Man Reference 13-25-0010-240 CensusTrncl 0110
Sale Price $ NA DaleofSaleNA Desaj lion and $ amount olloan charaes/concessions to be naij bvseller NA
LenderlClienl Carol Furianic Address
Aflllra;Ser Luann E. Knudsen Address 1309 8rid e Street New Cumberland PA 17070
location ~ Urban ~ Suburban l=J Rural Predominant Single family housing Present land use % Land use change
Built up [EJ Over 75% D 25-75% D Under 25% occupancy PRICE AGE Onefamlly~ o Nolliko, OUko,
$(())1) (jfs)
Growfh rale D Rapid 00 Stable 0 Slow 00 Owner ~low~ 24m.., ----.lli. 00 Jnprocess
Properly values ~ Increasing D Slable D Declining Drenanl 300 Hoh 90 "",,",,miy To: Residential from
Demand/supply R ~hortage [KJ In baance 0 OVerstl~ ooV"",,,(O'%) &;tM Predominant t'i.0 Commercial ~ vacant
Marketin" lime Under3 rrns. 003-6 mos. n Over 6 mos. nvacanlIOW..s';l 140-190 10.60 Vacant 10%
Note: Race and the racial composition of the neighborhood are not appraisal factors.
Neighborhood boundaries and characteristics: The subiect property is located in Lower Allen Township. To locate the best comoarables
. available the appraiser may have to extend search parameters to similar nelahborhoods within the market area.
.
. Factol'tllhat affectlhe markelabilily of the properties in the neighborhood (proximily to employment and amenities, employment stabnily, appeal 10 market, elc.):
~ This suburban neiohborhood has relativelv easy access to emolovment and services and is comnetitive with other neiQhborhoods in
.. the oeneral area. Most have similar amenities. Market activity indicates averaQe or better acceptance in the market place. No
unfavorable factors were observed which would adverselv effect marketabilitv.
Market conditions in the SUbject nelghborhood (includlng support for the above conclusions related 10 the lrend of properlyvafues, demand/supply, and marketing time
..such asdala on compelilive properliesforsale in the neighborhood, description of the prevalence of sales and financing concessions, etc.):
THIS IS A "COMPLETE APPRAISAL - SUMMARY REPORT". There are no foreseeable economic trends which mioht sionificantlv
influence market conditions in this area. The current mortnane market offers a wide varietv of conventional loans with competitive
interest rates. As a result the terms of financina have little if any. impact on sale prices. If interest rates remain reasonable. oropertv
values and marketability should be stable.
. Project Information for PUDs (If applicable). - Is the developer/buDder in control oftha Home Owners' Association (HOAl? UVES UNO
Approxlmatetolal number of unils in the subject project NA Approximate tolal numberofunils for sale in the subject project
Describe common elements and recreational facilities:
Dimensions 100 X216 X 211.48 X 156 Topography SloDed To Rear
S~e area .67 Ac Comer lot U Ves lXJ No Size Tvoical for area
Specific zoning classification and description R1 Sina]e Familv Established Residential Shape IrreQular
ZoningCClmpliance [&] legal /Xlq legaInonco'pr;"9(Grandfalhereduse) Uilfegal U Nozoning DraInage Appears adeauate
Hlrlhest & best use as inmroved: X Present use Otheruse{exlllainl V.. Averaoe
Utilities Public Olher Off-slte Improvements Type Public pm-ate Landscaping Averaoe
E1ec1ric~y 00 200 amps 5"" Asphalt 00 0 Driveway Surface Asphalt
G.. o None Curb/guHer Concrete 00 0 Apparent easements None Observed
Water 00 Sidewalk Concrete 00 0 FEMA Special Flood Hazard Area U~ Yes _~ No
Sanilarysewer ~ Streetlights None R R FEMA Zone C Map Dale 9/30177
Slormsewer All.. None FEMA Map No. 421016B/H&I-02
Comments (apparent advel'tle easements, encroacliments, special assessments, slide areas, illegal or legal nonconforming zoning, use, etc.): The site
Improvements and services to the site are adenuate and acceotable in this market. There are no aDDarent adverse easements,
encroachments or other adverse conditions on this site. The steep tOPoQraphv of this site restricts its utilitv.
GENERAL DESCRIPTION EXTERIOR DESCRIPTION FOUNDATION BASEMENT INSULATION
No. ofU,,~s 1 Foundation Co Slock Slab None AreaSq.Fl. 1312 Roo' 0
No. of Stories 2 ExteriofWalls BrickfT111 Cla<MSpace None % Finished 0 Ceiling -00
Type (Det./Atl.) Detached Roof Surface ShJnale Basement F8/Exposed Ceiling Unfinished WaUs -00
Design (style) Contemo. GuHers & Dwnspts. Aluminum SUfl1) PUrlll Yes Walls Co Block R=-O
Exisling/Proposed ExistinQ WlndowType Casement Ins Dampness None noted Roo< Concrete None-O
Age (Yrs.) 17 StormlSaeens YeslYes Selllement None noted Oulside Enlry Yes "'""" ==0
EffectiveAnefYrsJ 10 Manufactured House No Infeslation None noted
. ROOMS Fover livina Dinino K~chen 0" FamilvRm. Rec.Rm. Bedrooms # Baths laundN 01"" AreaSa.FI.
Basement 1312
level 1 X 1 1 1 1 .5 X 1.312
. level 2 3 2 LoR 1,072
. 0
Finished area above llradeCClntains: 7 Rooms' 3 Bedrooms' 2.5 Bathlsl: 2384s are Feel of Gross LivinaArea
INTERIOR MaterialsfCond~ion HEATING KITCHEN EQUIP. ATIle AMENITIES CAR STORAGE:
Rool'$ HW/CtlCoWin/Ave Typ. H? Refrigerator 0 None 0 Fireplace(s)#L- 00 None 0
. Walls Drywall/Ave F,. Elec RangefOven 00 Stairs 0 Patio 0 Garage2 # of eats
TrirrJFinish Wood/Ave CondaionAva. Disposal 00 Drop Stair 00 Deck 00 Allached 2
Bath Floor Vinvl/Ave COOLING Dishwaslier 00 Swtlle 0 Porch 00 Detached
BalhWainsrol Fiberalass/Ave Central Yes Fan/Hood 00 Floor 00 Fence 0 BuiH-In
Doors Flush/Ave OIher None Microwave f81 Heated R Pool R Carport
CondilionAva. Washer/Drver Finished Drivewav 2
Addaionalfealures{spedal energy effident items, etc.): See Attached Addendum.
Condilion of the improvements, depreciation (physical,funclion al,andexternal),repairsneeded,quaJilyofconslruclionremodeling/addilions,etc.: See Attached
Addendum.
.
Adverse envronmental conditions (such as, bul nollimited fo, hazardous wastes, toxic substances, ate.) pr~sent i~ the improvements, on fhe.site, or .in the
. . . . . . I . No adverse environmental conditions were observed In the Improvements on the Site, on In the
Immedlatevlcmllyoffhesub/ecfpropery.
immediate vicinity of the subject prooertv. FannTeM.eFlr/II10046-9)
F,eddieM.cForm10 (9)
PAGE10F2
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Valuation Section
Mark Heckman Real Estate Appraisers
UN1FORM RESIDENTIAL APPRAISAL REPORT
35.000
File No. 96deerfi
Comments on Cost Approach (such as, source of cost estimate,
site value, square foot calculation and for HUD, VA and FmHA, the
estimated remaining economic life of the properly):
Estimated Reproduction Cost-New-of-Imorovements is
calculated usina the Marshall and Swift Residential Cost
Handbook and local cost analvsis. Estimated site value is
based on local market analvsis. Depreciation is estimated
usinQ the economic ace-tife method and market ana)vsis. No
obsolescence was observed.
ESTIMATED SITE VAlUE. ....... H................. = $
ESTIMATED REPRODUCTION COST-NEW OF IMPROVEMENTS:
Dwelling 2.384Sq.Ft.@$ 57.25 = $ 136,484
Bsmt. 1312 Sq. Fl. @$----g:so = 12,464
. Porch/Deck/2 Fireolaces - = 14,000
"""''''''''''' ~Sq.Ft. @$~ = 8,400
Total Estimated Cost New = $ 171,348
Less 60 p~ysical"i FU~cl;o~~1 r . E~~~~i . Est. Remaining Econ. life: 50
. Dep'eciation $28,420 I " I - $ 28,420
Depreciated Value of Improvements ................... = $ 142928
'As-is" Value ofSite Improvements. .................. = $ 2,500
INDICATED VALUE BY COST APPROACH. . . . . . . . . = $ 180 400
ITeM SUBJECT COMPARABLE NO.1 COMPARABLE NO.2
96 Deerfield Road 209 Deerfield Road 91 Deerfield Road
Address CarnD Hill Camp Hill Camp Hill
Proximity to Subiect ~Yt+Mf$JM.W 2 Blocks Same Block
Sales Price $ NA ,7-/':::-- Jffilli.~ $ 190 000 _W>.f;fo((' ",.,,,.,_." $
.""","",Lif._ $ 0.00 ~ $ 77.65 ~ MC.:.' .., w. . $ 65.38 ~ WJ
Data and/or Inspection Assessment Records & MLS Assessment Records & MLS
Verification Sources
VALUEADJUSTMENTS DESCRIPTION DESCRIPTION t ~('l$Adjllilmenl DESCRIPTION I '(-\$AdIlll1menl DESCRIPTION , ~f.\$Mlustment
Sales or Financing Conventional Conventional Conventional
ConceS$io/Is None Known None Known None Known
DateofSa!efT"rme 6/12/01; 5/31/01 : 712101
locallon Averaae Avera e Averaae Averaae
l..easeIddtfeeSi Fee Sim Ie Fee Sim Ie: Fee Simple: Fee Simcle
Site .67 AclSloped .32 AclAveraae : .44 AclAveraae : .44 Ac/Averaae :
View Averaae Averaae Averaae Averaae
Desion andA!loeal 2 Storv/Averaae 2 Storv/Averane : 2 Sto IAvera e : 2 Storv/Averaae :
CuaivofConsl1ucfun Averaae Averaae : Averaae : Averaae
Ace 17/10 20/10 17/15 +5000 25/10
Condition Averaoe Averaoe : less than Ave: +5 000 Averaae :
Above Grade Tal:&I'E\ltm$' BaI!lJ ToIal'O.nns' Batll$ : ToIal'Bdrms' 1I.1ho : ToIBl'6/kmJ' BBlIB :
RoomCOllnl 7: 3: 2.50 8: 4: 2.50' 7: 4: 2.50' 7: 4: 2.50'
GtossLivinllArea 2384SlI.Ft. 2447Sa.FI.: -1,600 2340Sa.Ft.: 2362S.FI.:
. Basement&Frlished F BsmtlB:posed Full Basement +1,000 Full Basement +1,000 Full Basement
Rooms Below Grade Unfinished Rec Room -7500 Unfinished Unfinished
Functional UIBitv Averaae Averaae Averaae: Averaoe :
HeatinaICoolinll EHP/Central Air GFAlCentral Air : GFAlCentral Air : OHW/Central Air:
Effi::imt ltefm T for Area T for Area T for Area Tvo for Area
GaraoelCarJlort 2 Car Garaae/Att 2 Car Garaae/Att : 2 Car Garaae/Att : 2 Car Garace/Att :
Patch, Patio, Deck, Porch & Deck Porch & Patio Porch & Patio Porch & Patio
Firellla~sl etc. 2 Fireolaces 1 Fireolace +1 500 None +3500 1 Fireolace
Fence Pool efe. Central Vacuum Securi S stem : None : +500 None :
Other Good Kitchen Florida Rm/Gd-KI : -7500 Averace Kitchen: +1 000 Averaae Kitchen :
Net Adi.,folall + X _ '$ 14100~+ ~ '$ 16000"'+ _ is
MjllstedSalesPri::e '., '*' ~v. '~ii ~ $
ofComDarable $ 175 900 ~.,:; "" $ 169 000 ~ $
Comments on Sales Comparison (indudJng the subject property's compatibaity to the neighborhood, etc). See Attached Addendum.
COMPARA8lE NO.3
432 Candlewyck Road
Carno Hill
.25 Mile
153 000 \.tJ1ht~lWffA@ $
P._: $ 73.67 tzl .
Assessment Records & MLS
174,000
'-->$J
+1,000
+1500
+500
+1000
4000
178 000
COMPARABLE NO.1
No prior sale other
than that listed above.
COMPARABLE NO.2
No prior sale other
than that listed above.
COMPARABLE NO.3
No prior sale other
than that listed above.
ITEM SUBJECT
Date, Price and Dala None
SouR:efctpic:rsales
vdhinvearofaDoraisal
Analysis of any CtIlrent agreement of sale, option, or lis!ing of the subject property and analysis of any prior sales of subject and cofl1)3rables lrihin one year oflhe date of appraisal:
Accordln(l to information Drovided bv the multi-list services in this recion, the subiect property has not been listed for sale within the
past Year.
INDICATED VALUE BY SALES COMPARISON APPROACH ........ ................... ...... ..........$
INOICATEDVALUEBYINcOMEAPPROACH//fAnnljcable\ Eslimated Markel Renl $ N/A JMo.xGrossRentMulliolier N/A =$
This appraisal is made 00 "as is" _l). subject to lherepahl, aIIerations, inspedionsa- oond~ionslisted below 0 subjed toCCl'f1llelion perplans and specilX:alions.
Cond~ionsofAppraisal: See Attached Addendum.
176,000
NA
Final Reconciialion: See Attached Addendum.
The purpose oflhis appraisal is to estimate the market value of the real property thai is the subject of this report, based on the above col\d~ions and the certification, oontingenl
and limfting condftions, and market value definftion that are slated in theatlached Freddie Mac Form439IFannie Mae Form 10MB (Revised ).
I (WE) ESTIMATE THE MARKET VALUE, AS DEFINED, OF THE REAL. PROPERTY THAT IS THE SUBJECT OFTHlSREPORT,ASOF 12/1/01
. (WHICH IS1HE9ATEOF INSPECTION ANDTHEEFFECTIVEDATEOFTHISREPORT)TO BE$ 176,000 .
APPRAIS:~J" _ b" j/ ," ~ S~PERVlSORY APPRAISER (ONLY IF REQUIRED):
Si!lnatl.l~a.--:/t1') L. tuMtri,J.L:'f\ SIQnalure
Name. lJJ~nn E. Knudsen Name
Date Freport SiQned 12/1/01 Date Repor! Sianed
Slate Certification '# RL-003086-L Slate PA Slate Certificalion #
Or Slale license # Slate Or State license #
ODid ODidNot
InspedProperly
Stale
State
FreddleM.cf001l706-93
PAGE 2 OF 2
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mark heckman real estate appraisers
FarlllleMaefCfml0045-9J
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ADDENDUM
Borrower: Furianic, Carol
Property Address: 96 Deerfield Road
City: Camp Hill
Lender: Carol Furjanic
File No.: 96deerfi
Case No.:
State: PA
Zip: 17011
Additional Features
Architectural shingle roof 3 years old; skylights 3 years old; bar sink in kitchen; ample kitchen cabinets; buflt in grill; hot
water dispenser; corner appliance garages; down lights in kitchen; stained wobdwork; storage area over garage; oak railing
on stairs to loft; guilt-in shelves in family room; living room has cathedral ceiling with skylights; laundry has sink and
laundry chute; central vacuum system; fireplace in Jiving room extends to ceiling with flue inn lower level for future fireplace;
all bedrooms have wark~in closets; french doors from bedroom to loft; double sinks in both baths; whirlpool tub in master
bath.
Condition of Improvements
These improvements are of average quality frame design and reflect average maintenance. Property reflects normal
physical depreciation and no deficiencies are noted. Utility of floor plan is typical for a house of this age and style and
should receive average acceptance in the market place. No unusual functional, obsolescence or external inadequacies were
observed. The bathrooms, kitchen, mechanical equipment, and other features meet current standards for houses of this
age in this market.
Comments on Sales Comparison
After a thorough search of all available market data, the three sales used are considered to be the best indicators of value.
Appropriate adjustments have been made for all differences. Air three sales are considered to be reliable indicators of
value, and are weighted similarly in the final reconciliation. Days on market: Comparable NO.1: 11 days; Comparable No.
2: 148 days; Comparable NO.3: 6 days. Comparable sales used are all closed sales. All three comparable sales are
located in the same market area as the subject and would be considered by the same prospective purchaser of all were on
the market at the same time as the subject. No adjustment was made for the subject's larger lot as its utility is restricted by
the steep rear slope.
Conditions of Appraisal
This appraisal report has been prepared with the property in "as is" condition. No personal property has been included in
this valuation. According to records provided by the county assessment office, the subject property has not transferred in
the past year.
Final Reconciliation
This appraisal assumes a reasonable marketing period for the subject property of four months. The Sales Comparison
Analysis reflects recent activity in the market place and is given the most weight. The Cost Approach tends to set the upper
limit of value and the Market Approach is considered the best indicator of value. The Income Approach is inappropriate
because few single family houses are rented in this market. In view of the age of these Improvements, the Cost approach
cannot be considered an accurate indicator of value. See attached appraiser's certification and Statement of limiting
Conditions.
AddendumPage1of1
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DIMENSION LIST ADDENDUM
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Borrower: 'Furianic, Carol
Property Address: 96 Oeerfield Road
CiN: Ca"'D Hili
File No.: 9Sdeerfi
Case No.:
State: PA ZiD: 17011
GROSS BUILDING AREA (GBA) 4,368
GROSS LIVING AREA (GLA) 2,384
Area{s) ,"" %ofG8A
Living 2.384 54.58
Level 1 1,312 30.04
Level 2 1.072 24.54
level 3
oth"
Basemenl 1,312 30.04
Garage 672 15.38
Area Measurements Area Type
Measurements Factor Total Level 1 Level 2 Level 3 Other Bsmt. Garage
24.00 x 40. DO x -----1 " 960 DO [gJ 0 0 ~ [gJ ~
16.00 x 22.00 x ----1 '" 352 00 [gJ 0 0 [gJ
24.00 x 30.00 x ----.1 = 720.00 0 [gJ 0 0,
16.00 x 22.00 x ----1 '" 352 00 0 [gJ 0 0
----1,QQ x 672.00 x ----.1 '" 672 00 0 0 0 B 0
_x_x_= 0 0 0 0 B
_1:._X_= 0 0 0 0 0
_x_x_= 0 0 0 0 0 ~
_.l:_x_= 0 0 0 B 0
_x_x_= 0 0 0 0
_X_X_'" 0 0 0 ~ 0
_x_x_= 0 0 0 0 B
_x_x_= 0 0 0 0
_x_x_= 0 0 0 0
_x_x_= 0 0 0 8 0 8
_x_x_= 0 0 0 0
_X_.l:_= 0 8 0 0 8
_X_X_'" 0 0 0
_x_x_= 0 0 0 0 ~
_x_x_= 0 0 0 0
_x_x_= 0 0 0 0
_X_.l:_= 0 0 0 0
_X_.l:_= 0 0 0 0 ~
_x_x_= 0 0 0 0
_x_x_= 0 0 0 0
_x_x_= 0 0 0 0
_x_x_" 0 0 0 B 0
_x_x_= 0 0 0 0
_x_x_= 0 0 0 0 0
_X_X_'" 0 0 0 ~ 0 8
_x_x_= 0 0 0 0
_x_x_= 0 0 0 0 B
_x_x_= 0 0 0 0
_x_x_= 0 0 0 0 B
_X_X_'" 0 0 0 0 0
_X_X_" 0 0 0 B 0 0
_X_X_" 0 0 0 0 0
_x_x_= 0 0 0 B 0 B
_1:._X_" 0 0 0 0
_1:._x_= 0 0 0 8 0 0
_)(_1:._= 0 0 0 0 0
_)(_x_= 0 0 0 8 0 0
_)(_x_= 0 0 0 0 0
_x_x_= 0 0 0 ~ 0 0
_x_x_= 0 0 0 0 0
_)(_x_= 0 0 0 0 0
_x~x_= 0 0 0 0 0
~x_x_= 0 0 0 0 0
~X~)(_= 0 0 0 ~ 0 0
_x~x_= 0 0 0 0 0
~x_x_= 0 0 0 0 0
_x_x_= 0 0 0 0 0
_x_x_= 0 0 0 0 0
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File No. 96deerfJ
DEFINITION OF MARKET VALUE: The most probable price which a property should bring in a competitive and open market
under all conditions requisite to a fair sale, the buyer and seller, each acting prudently, knowledgeably and assuming the price is not
affected by undue stimul~s. Implicit in this definition is the consummation of a sale as of a specified date and the passing of title from
seller to buyer under conditions whereby: (1) buyer and seller are typically motivated; (2) both parties are well 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. doUars 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 COl1cessions* 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
seUer 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:
1. The appraiser will not be responsible for matters of a [egal natura 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 tesponsible 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 beforeh~nd.
5. The appraiser has estil11ated the valUe of the land In the cost approach at its hIghest and best use and the improvements at their
contributory value. These $eparate valuations of the land and Improvements must not be used in conjunction with any other appraisal and
are Invalid if they are so used.
6. The appraiser has noted in the appraisal report any adverse conditIons (such as, needed repairs, depreciation, the presence of hazardous
wastes, toxic substances, etc. ) observed during the inspection of the subject property or that he or she became aware of during the normal
research involved in performing the appraisal. Unless otherwise stated in the a-ppraisal report, the appraiser has no knowledge of any hidden
or unapparent conditions of the property or adverse environmental conditions (including the presence of hazardous wastes, toxic
substances, etc. ) that would make the property more or less valuable, and has assumed that there are no such conditions and makes no
guarantees or warranties, express or irj1pfJed, 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 aM believes them to be true and correct. The appraiser does not assume responsibility for the accuracy of such
items lhat were furnished by other parties.
8. The appraiser will not disclose the contents of the appraisal report except as provided for in the Uniform Standards of Professional
Appraisal Practice.
9. The appraiser has based his or her appraisal report and valuation conclusion for an appraisal that is subject to satisfactory completion,
repairs, or alterations on the assumption that completion of the improvements wllJ be performed in a workmanlike manner.
10. The appraiser must provide his or her prior written consent before the lenderlclient specified in the appraisal report can distribute the
appraisal report (including c:onclusions about the property value, the appraiser's identity and professional designations, and references to
any professional appraisal organizations or the firm with which the appraiser is associated) to anyone other than the borrower; the
mortgagee or its successor~ 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 servlce(s)
without having to obtain the appraiser's prior written consent. The appraiser's written consent and approval must also be obtained before
the appraisal can be conveyed by anyone to the public through advertising, public relations, news, sales, or other media.
Page 1 of2
Fannie Mae Form 10048 6-93
Freddie Mac Form 439 6-93
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F~e No. 96deerfj
APPRAISERS CERTIFICATION: The Appraiser certifies and agrees that:
1. I have researched the subject market area and have selected a minimum of thtee recent sales of properties most similar and proximate
to the subject proJ:lerty 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 propElrty 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 kno~ingly 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
on/yto the contingel'1t and limiting conditions specified in this form.
4. I have no pres$nt 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 tor petformlng 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. [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 th$ 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 My 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 ofthEl adverse conditions on the marketability of the subject property.
9. I personally prlJpared 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 responsibility 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: 96 Deertield Road, Camp Hill. PA 17011
APPRAISER:
Signatur~. J~b.C>"," 1< /t;lL~tl/
Name: ~~. Knudsen
Date Signed: 12/1/01
State Certification #: RL-003086-L
or State License #:
state: PA
Expiration Date of Certification or License: 06/30/03
SUPERVISORY APPRAISER (only if required)
Signature:
Name:
Date Signed:
State Certification #:
or State License #:
State:
Expiration Date of Certification or License:
o Did 0 Did Not Inspect Property
Freddie Mac Form 439 6~93
Page 2 of2
Fannie Mae FOfm 1004B 6.93
"' I~
Mark Heckman Real Estate Appraisers
USPAP COMPLIANCE ADDENDUM
File No.
Borrower Furianic. Carol
Property Address 96 Deerfield Road
City Camp Hill
Lender/Client Caroll=ur"anic
Order #
County Cumberland
State ~ Zip Code 17011
Client Referenoe #
o
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The purpose .~the appraisal is to provide an opinion of market value ofthe subjeot property as defined in this report, on behalf of the appraisal
c~mpany f~lhtating the assignment for the referenced client as the intended user of the report. The only function of the appraisal is to assist the
chent mentioned in this report in evaluating the subject property for lending purposes. The U5e ofthis appraisal by anyone other than the stated
intended user, or for any other use than the stated intended use, is prohibited.
The purpose of the appraisal is to provide an opinion of market value of the subject property, as de'fined in this report, on behalf of the appraisal
oompany facilitatlng the assignment for the referenced olient as the intended user of this report. The only function of the appraisal is to assist the
client mentioned in this report in evaluating the subject property Real Estate Owned (REO) purposes. The use of this apprai5al by anyone
oCher chan the stated intended user, or for any other use than the stated intended use, is prohibited,
The purpose ofthis appraisal is to , on behalf of the appraisal company facilitating the assignment for
the referenced cIif.1nt as the intended user ofthi5 report. The only function ofthe appraisal is to assist the client mentioned in this report in
evaluating the subject property for . The U5e of this appraisal by anyone other than the stated intended
user, or for any other use than the stated intended U5e is prohibited.
o
00 This is a ComplErte Appraisal written in a SUmmary Report fonnat and the USPAP Departure Rule has not been invoked.
o This is a Limited Appraisal written in a Report fonnat and the USPAP Departure Rule has been invoked as disclosed in
~~
1RI
The appraisal is b4lled on the infonnation gathered by the appraiser from public records, other identified sources, inspection oflhe subjoot
property and neigbborhood, and selection of comparable sales. listings, andlor rentals within the subject market area. The original source of the
comparables i5 shllwn in the Data Source section of the madeet grid along with the source ofconfinnation, if available. The original source i5
presented first. The sources and data are considered reliable. When conflicting infonnation was provided, the source deemed most reliable has
been used. Data ~lieved to be unreliable was not included in the report nor used as a basis for the value conclusion. The extent of analysis
applied to this assignment may be fbrtber imparted within the report, tbe Appraiser's Certification below andlor any otber Statement of Limiting
Conditions and Appraiser's Certification such as may be utilized within tbe Freddie Mac fonn 439 or Fannie Mae form 1004b (dated 6193), when
applicable.
.
00 A reasonable marketing time for the subjCllt property is 120
o A reasonable exp~ure time for the subject property is
.
day(s) utilizing market conditions pertinent to the appraisal assignment.
day(s).
I certify that,. to tbe best of my bowledge and belief:
The stateR\ents of fact contained in tbis report are true and correcl.
The reported analyses, opinions, and conclustions are limited only by the reported assumptions and limiting conditiom, and are my personal,
impartial, and unbiased professional analyses, opinions, and conclusions.
1 have nQ present or prospective interest in the property tbat is the subject of this report, and no personal interest with respect to the parties
involved, Ilnless otherwise stated within the report.
I have no bias with respect to the property that is the subject of this report or to the parties involved with this assignment.
My engagement in this assignment was not contingent upon developing or reportiag predetermined results.
My compeJ:1satioa for completing this assignment is not contingent upon the development or reporting of a predetermined value or direction in
value that favors the cause of the client, the antount of the value opinion, the attainment ofa stipulated result, or the occurrence of a subsequent
event directly related to the intended use of this appraisal.
Myanalys<::s, opinions, and conclusions were developed, and this report has been prepared, in confonnity with the Uniform Standards of
Professionl\l Appraisal Practice.
I have 00 or have not 0 made a personal inspection oftbe property that is the subject of this report. (ifmore than one person signs this report,
this certifiClatioa must clearly specify which individuals did and which individuals did not make a personal inspection of the appraisal property.)
No one prOvided significant professional assistance to the person signing this report. ('fthue are exceptions, the nBltte of each individual
providing s.ignificant professional assistance must be stated.)
NOTE: In the case of any conflict with a client provided certificotion (i.e., FannieMae or Freddie Mac), this revised certification shall take
recedenctJ.
Supervisory Appnlser'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 tbe .statements and conclusiollS ?f
the appraj~er. agree to be bound by the appraiser's certifications numbered 2.7 and 9 on the second page of FreddIe Mac Fonn 439 6-93/Fanme
Mae Form l004B 6-93, or the th.ird page of Form 2.055, and am taking full responsibility for the, appraisal report. _
APPRAISERtl
Signature:7SttaA1A'J t.' ~~t)
Name:it'Gann E. Knudsen '
Date the Report was Signeli: 12/1/01
State Certification #: RL-003086-L
or State Liceme #:
State: PA
ExpirationDate ofCertificillion or License: 06/30/03
Sigaature:
Name;
Date the Report was Signed:
State Certification #:
or State License#:
State:
Expiration Date of Certification or License:
o Did inspect subject property 0 Inspected Comparable5
o blterior&Exlerior 0 lnterior&Ext.erior
o Extericromy 0 Ext.erioronly
USPAPCompliaoceAdderdum.4199
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Borrower: Carol Furianic
Pfooomr-'Ad"lisess: 96 O~rfieCd Road
c\~-. earn'>) 't\"\\\
lender:
SUBJECT PROPERTY PHOTO ADDENDUM
Fire No.: 96deerfi
Case No.:
State: PA
I
I
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Zio: 17011
FRONT VIEW OF
SUBJECT PROPERTY
Appraised Date: 12/1101
Appraised Value: $176.000
REAR VIEW OF
SUBJECT PROPERTY
STREET SCENE
BOrrower: Carol Furfanic
'?ta'P.'C't'w MdIe$S:9G Deemed Road
Citv: Camp Hill
Lender.
SUBJECT PROPERTY PHOTO ADDENDUM
File No.: 96deerfi
- -case No..:
state: PA
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lio: 17011
FRONT VIEW OF
SUBJECT PROPERTY
Appraised Dele: 12/1101
Appraised Value; $176.000
REAR VIEW OF
SUBJECT PROPERTY
STREET SCENE
"
Borrowe,r: Fur;i!mio, Carol
?'iopen\l P\Ml'ess.. sa Deeli\e\d R,oad
Cit : eam Hili
COMPARABLE PROPERTY PHOTO ADDENDUM
FiJiiNo.: 96deerfi
Case No.:
State: PA
.. ..~.,~
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\
"
Zi : 17011
COMPARABLE SALE #1
209 Deerfjeld Road
Camp Hill
Sale Date: 6/12/01
Sale Price: $ 190,000
COMPARABLE SALE #2
91 DeerfieJd Road
Camp Hill
Safe Date: 5/31/01
Sale Price: $ 153,000
COMPARABLE SALE #3
432 Candlewyck Road
Camp Hill
Sale Date: 712101
Sale Price: $ 174,000
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Financial Group@
The Lincoln National Life Insurance Company
TDA Client Services
PO Box 9740
Portland ME 04104-5001
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CAROL A. FURJANIC
414 N 4TH 5T
LEMOYNE PA 17043-1665
Plan Number: 569
Employer ID: 560
Plan: HOLY SPIRIT HOSPITAL P AR1NERSHIP
SAVINGS PLAN
o
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Questions? Contact a Service Representative at
1-800-341-0441
Value Summary Dol/ar value Net Gain! Unit value Number a/units Dollar value
as of 3/31/$002 activity , loss 6/30/2002 6/30/2002 as of 6/3012002
894150+006
INDEX 5,752.54 " 789.24- 30.4491 163.0032 4,963.30 ~
~
GROWTH I 5,031.70 934.09- 30.7347 133.3221 4,097.61 .
0
SMALL CAP 6,660.06 575.01- 20.7101 293.8207 6,085.05 "'
~
EQUITY-INC 6,460.74 : 635.05- 21.9316 265.6300 5,825.69 w
0
~
0
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Total. $23,905.04 $2,933.39- $20,971.65 g;
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Value by source SALARY EMPWYER 0
0
0
of contributions DEFERRAL MATCH TOTAL 0
0
as of 6/3012002 ~
0
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$16,161.59 $4,810.06 $20,971.65 ~
~
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New Contribution Contract number Contribution Period Interest Rate
Interest Rates
894150+006 04/0112002-06/30/2002 4.95%
Please contact Lincoln Life within 30ldays of receipt of this statement ifinfonnation or investments are
not accurate. Lincoln Life reserve. thel right to limit its liability if inaccuracies are not reported promptly.
Prospecb:~~s ~nd various financial rep~rt. are available upo~ request. Please keep in mind that the 'fiinds
supporting the variable annuity are not public funds and are only available through insurance company
contracts.
Notifications
Securities offered through Lincoln Financial Advisors and other broker/dealers with effective selling
agreements.
<<:>1998 Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates.
Plan: 569 Employer ID: 560
page 1 of 6
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ANNUITY SERVICES
ONE TOWER SQUARE
HARlfORD, cr 06183-4053
Your Servicing Agent
C11ISIREU
Your Plan-Type is:
lax Sheltered ,\nnully
Your pmduct Type is:
"I-Hex
00(0701).00000001 . C[llllOO)
CAROL A FURJANIC
4/4 N 4TH ST .
LEMOYNE, PAI7043
Account Number
Issue Date
Case Number
8520262
05/1 VI 989
802267
@
Questions? Please Contact:
Customer Service
1-{8001842-9406
YOUR INVISIMfNT SUMMARY
YOUR OUlSIANOiNGLOAN SUMMARY
This Quarter
Year to Date
LOAN 1 - effective 11/9/1993
Outstanding Loan Principal
$5,7011.95
B"Kinning Balance $212.83 $245.02
Tofal Payments $0.00 $0.00
Net Loan Activity $17.00- $71.87-
Totar Withdrawals $0.00 $0.00
other $0.00 $0.00
Change in Investment Value .$2.30 $4.98
~:N..P.iHGMLAI"lCE ---==--=~==~:::::::::~-"::"Jm~13::-:':=::::::':':fiz.8.11.]
Your defaulted loan amount is not included in your total
value and was 01 will be reported to the lntemal Revenue
Service as a taxable distribution.
YOUI~ INVESTMENT STRATEGY
TOTAL ASSETS
CURRENT CONTRIBUTIONS
I-ixed
"100% r -flex CT
fixed
'100% T .Flex CT
100%
fixed
CD NEWS
dditional Annuity Features
our annuity contract provides for a death benefit equal to your cO/Jir"ct vd/ue.
.or a cvmplete explanation of the death benefit, please refer /0 YOllr corllract.
please review yot/( stalement for accuracy. Any errors need to be
reported wilhln 90 diqS of receipt.
@l
Your !nternet Acct.'55: www./ravelersla.co/n
Login 10: your Social Security NLllilher (no slash~'", or (/~ls~)es) .
PJ5sword: For first time lIsers plCd5f.' enter your Date 01 Hirth (MMOlJYY)
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"'~' ForQnliri".acce,ss,legori .at: ..' ..
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CAROL A FURJ.AN~C.
414 'HIl STREET
LEI10YNE ,PA q043 .
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YourAccounfSummafy
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. . .... '$51'30"3:70 .
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'..:-$;900.:80 .'
$46,284.72
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Emplov"rCbhtributions .'
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'.' Di~id~~dsitlotei;'st... ,;.c,. ':j"}~"[~':"~i;~~~,r:~ ,.j,,'~\,.'~ ~ ;..( '.'
VoUr Pel'!lbna.!Hate. oJ Fl"turn. . .'
'Tftfsi?"iki".. ..... ..>., .',i{3'2%
Yeartpnate' "." _:', "". ",__..~... .:"', "~~', :""':~::'~;.;:f5~q%',
Y04r P~rson,aJ, 8a~':of ReJurn)s',Gaic~la,teq with :?' ti~~~wei;~'t,ed', .'
': ;forn:i!Jt~/ Wid,e'.y irse,d"bY_: iin_qnflal'~n~.IY,$t'~'-)6:,~tculate:,jh~Gs.tio~'nf
'.." 'ea~o:'ings~,: :l~ 'r.e.fl~Qts ihe -rl$.sut~ .ofYOll,r kiYe~fu1'?ri_~ ,~ele,~tions!~~:::
.' :.' .well:~s 'ahy,.~ctivity in the~prar1' a,cCoynt(s) Sh01tJ;(1:,,'There 'at-!'!' p,th~r. ','
. . : Pers6"i1ai:Rate:o'(R~tu'rh fonnUJa~.'~use((that,'~~y,\deld)jif(E3'rehL _' ,'_',
. ,r,e'su.'it~; R~m~;m~er ih~~' p'~~t.p~ricirm~n'cej..s' nO'9~~fa~~~~ of)~ture'.' -
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'. The Addiiiorial Fund Information sectioOlisistliealloc.ation,
Y.ourble~dedfUlid~: . '. ."
...... , -:-.. . """ '- ..,;.' -.' .... ......,' '.
Marke'lValueofVourAccounf . . . ." .... . .
This:secti9n ~spla:ys' the 'varue,o'fy~ur accoiuil for,the peti9d, in b6th ~hares 'and dollars':
"",-..
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Investment ,03/. 1/2002 .' .06. 0/2002 ,03;;J1/2002 06/30/2002 on,03/31/2002
,"
Stock' Investments .$40;157,68 $35,731.42
Fidelity .Grcw &. lric 602.7.13' 624,697 $37:60. $33:61 22,662.01 20..996,07
Fidelity Growth Co 352'.593 369.585 $49,62 . $3~.81 17.495.67 '14)35.35
Blended Investments' $11;146.0.2 $10;553.30
Fid Freedom 2020 . 885,307 - 11,146.02 .10,553.30
Remember that a dividend payment to 'f.und shareholders"'reduces the share price of the funq/ so ~ decrease in the share price for the statement
peri~d does not necessarily re,!lect lower fund perfonnance.
. Some of yOUI' investments are classifieq as a Blended Fund Investment. Blended Investments__may include a mixture of stocks, bonds,
ano/or sl:iort~term assets; Pleas'e r~fer to the "Acfditfdnsd Fund Information" sectiof) to determine the allocation of your bli;mded investments'
, ,ul)derlyihg 'assets. The ,asset breal<d~n of your portfolio is reflected jn the pi'e chart in the "A::;:set Al!oca,ion", Section.
" '.
Please'~ead this statement carefully. Any error must be reported to Fidelity -Investments withili 90 days,
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14223 . 400.14223 000.1 .200.20.70.9 4038. . .
Fidelity Investments, P.O. Box 77aoo.2,'Cincinnati,OH 45277.00.90
Page 1 of 5
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CAROL A. FURJANlC,
Plaintiff
, : IN THE COURT OF COMMON PLEAS
, : CUMBERLAND COUNTY, PENNSYLVANIA
': CIVIL ACTION -LAW
v.
': NO. 01-1144
JAMES A. FVRJANIC,
Defendant
: IN DIVORCE
AMENDE.p INVENTORY
UNDER RULE 1920.33
,
Counsel for Plaintiff, Cara A Boyanowski, Esquire, files the following amended inventory
I
of all property owned or possessed by either party at the time this action was commenced and all
I
property transferred within the preceding threelyears.
Counsel verifies that the statements made in this inventory are true and correct. She
I I
understands that false statements herein are made subject to the penalties of 18 Pa.CS.A. 94904
relating to unsworn falsification to authorities. Counsel is signing this amended inventory due to the
unavailability of Plaintiff
~
Date: I ~ -U'O~
Blhl~llPntIJi\ll1iEb
Cara A Boyanowski, Esquire
Counsel for Plaintiff
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AMENDED INVENTORY
FURJANIC v. FURJANIC
Date of Marriage - 02/13/82
,
Date of Separation - 12/26/00
MARITAL ASSETS
Assets Husband's Wife's Master's Notes
Value Value Value
Real Estate
Marital Residence: $153,600.00 $180,000.00 Mortgage of approximately
96 Deerfield Road (His $68,000.00 and Home Equity
Camp Hill, PA 17011 Appraisal) Equity: Loan of $84,000.00 at separation.
$50,000.00 Current debt balance
approximately $139,400.00.
Husband 1/3 Ownership in Mother's $10,000.00 Increase in value during marriage. I
Residence in Steelton, Pennsylvania
Retirement Assets
The Lincoln National Life Date of
Insurance Group (Financial) Separation
Annuity Value: ,
Wife $26,277.32
Cnrrent
Value:
$16,921.58
(As of 9/30102)
-
Travelers Life and Annuity Date of Outstanding Loan against account
Wife Separation in amount of $5, 708.95 as of
Value: 06/30/02.
$365.25
Current
Value:
$178.13
(As of 6/30/02)
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.
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Assets Husband's Wife's Master's Notes
Value Value Value
Fidelity Investmeuts Date of Current value includes post
401(K) Plan Separation separation contributions of
Wife Value: approximately $14,000.00.
$54,029.96
Current
Value:
$40,498.78
Bank Accounts
Members First Account $2,900.00 Value at Date of Separation:
Wife $2,900.00
Current Value:
$25.00
Commerce Bank Account $0.00 Value at Date of Separation:
Wife $0.00
Current Value:
$1,200.00
Mellon Bank Checking Account $3,000.00 Value at Date of Separation:
No. 884-017-411.7 $3,000.00
Husband Current Value:
$1,400.00
Mellon Bank Checking Account $0.00 Value at Date of Separation:
No. 100-024-4630 $0.00
Husband Current Value:
$1,100.00
Automobiles
1995 Mitsubishi $7,500.00 Purchased in February, 1997 for
Husband $19,000.00.
No lien exists on vehicle.
1990 Volvo $0.00 $0.00 Vehicle was sold for $4,500.00 and
proceeds were split between
parties .
999 Diamante $0.00 $0.00 Leased vehicle.
Vife
MARITAL ASSETS
~ .. b, "~iItiill!III !i\CI;.J ,.=-
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~ ~
,
.
.
Assets Husband's Wife's Master's Notes
Value Value Value
Miscellaneous
Household Goods and Furnishings Nominal Nominal Already split between parties.
LoansJDebts
Citibank Mastercard Credit Card Date of Non-marital Husband's debt for personal and
No. 5410-6548-4547-4219 Separation recreational expenses.
Husband Balance:
$12,000.00
Current
Balance:
$12,500.00
Bank One Visa Credit Card Date of Non-marital Husband's debt for personal and
No. 4417-1259-7248-7718 Separation recreational expenses.
Husband Balance:
$3,000.00 .
Current
Balance:
$0.00
Visa Credit Card Date of Joint Names.
No. 4287-5900-0036-4451 Separation Account used for marital expenses
Balance: by Wife and personal expenses.
$1,800.00
Current
Balance:
$2,188.08
MARITAL ASSETS
~
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MLNINQ/SCREEN02 01 087
.
LOAN MASTER INFORMATION tPART11)
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*Notes FURJANIC JAMES A
Loan: " ,7,7,0,2,0,6,1,5,
177020615
1st/2nd Mtg Cd 1
Property Type 11
G/L Type 02
Buydown Code N
First Due Date
rnt Paid-To Dt
Sch pmt Date
Reg Pmt
payment Due Dt
P&I Due
Escrow Due
Curr pmt Due
Late Charges Due
Total Past Due
Total Accr rnt
Total Amt Due
Loan Type 1
Orig Term 360
Auto pymt N
Subsidized N
2/01/85
10/01/02
11/01/02
831. 85
11/01/02
602.68
229.17
831. 85
.00
.00
.00
831.85
11/07/02 11:23
Branch 087 State PA status 0
SPECIAL FUNCTION CODES ON LOAN
rnt Calc Method 2 ARM Type 01
Int ColI Method 0 payment Frequency M
Billing Method 3 Participation N
Risk Code N Per Diem 8.677015277
Remaining Term 136
Orig Amount
Origination Date
Pay-Off Date
P & I Pmt
Orig Maturity 8/12/13
Curr Maturity 2/01/14
Interest Rate 5.000
Escrow pmt 229 .17
A.P.R. Rate 5.875
~
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716.43
.00
.00
25.38
.00
.00
103,000.00
8/12/83
0/00/00
602.68
Current Principal
Total Escrow Bal
Assigned Escrow
Unassigned Escrow
Prepaid Unapplied
Accrued Escrow Int
Accrued Interest
Buydown/Subsidy Bal
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1'11~.L!n\11:ill!1'IIlliQfl~lLJfe In~urance Company
Mll'cQltl~~l:lrcltJQfltSetvicing Center
?O'ab~~74b
Portland ME 04104-5001
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Annuity Statement
""#"'~. , A" 6/~~/20q.?:::._.,p;d;2002
"4;~F l' /~;.", cfii',J ,."ll Jf ,-'Il. .,'
'i! _a<,"'" J<V 01"'\ .,llf """, Jf("f ~11~",;l '11< ..!~'
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OOQ645
G~ROL A. FURJANIC
4X4>N 4TH ST
tEMOYNE PA 17043-1665
Participant !D: 141039
Plan Number: 569
Employer !D: 560
Plan: HOLY SPIRlT HOSPITAL PARTNERSHIP
SAVINGS PLAN
Questions? Contact a SeIVice Representative at
1-800-341-0441
Value Summary Dollar value Net Gain! Unit value Number of units Dollar value
a:;:if 6/30/2-002 activity loss 9/3012002 9/30/2002 Qsof 9130/2002
894150+006
INDEX 4,963.30 870.75- 25.1072 163.0032 4,09255 ~
~
GROWTH I 4,097.61 784.63- 24.8494 133.3221 3,312.98 .
~
SMALL CAP 6,085.05 1,269.88- 16.3881 293.8207 4,815.17 ~
~
EQuITY.INC 5,825.69 1,124.81- 17.6971 265.6300 4,700.88 ~
~
0
0
0
Totals $20,971.65 $4,050.07- $16,921.58 ~
~
co
Value by source SALARY EMPLOYER :;
0
DEFERRAL 0
of contributions MATCH TOTAL 0
0
as of 9/3012002 :;
$13,044.42 $3,877.16 $16,921-58 ~
~
~
~
New Contribution Cor/tract number Contribution Period Interest Rate
Interest Rates
894150+006 07/01/2002-09/30/2002 4.85%
Notifications
Please contact Lincoln Life within 30 days of receipt ofthis statement if information or investments are
not accurate. Lincoln Life reserves tbe rightto limit itsliability if inaccuracies are not reported promptly.
Prospectuses and various financial reports are available upon request. Please keep in mind that the funds
suppor;;ip.g,the vai-1ahle -a!fn:uity 3~r~ not public fumls ~md: aT~ only- availabie through i.nsuTIUiCe_ cOtnpany
contracts.
p, ~
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~
Securities offered through Lincoln Financial Advisors and other broker/dealers with effective selling
agreements.
"" Bulletin Board
""""'"
~
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!!!!
-
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Demand a raise - and get it! Simply increase your contribution to your retirement savings plan and you
could lower your taxable iricome. It's as good as a raise. So review your household budget. A small
increase noW could make a big difference in your future. For more information, call your Lincoln
representative at (800) 341-0441. Thank you for partnering with Lincoln for your retirement .and
planning needs.
-
~
ii!iiii
;;;;
~
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<<::>1998 Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates.
Plan; 569 Employer ID: 560
page J of 4
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. Reti.remetlt. Savings Statemeht.
July 1, ;2002 : September 30, 2002
28325 40028325 . 0001.20021009 4038 .
Fidelity Investments, P.O. 80)(770002, Cincinnati, OH 45277:0090
"..; "- ." ~
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Holy Spirit Hospital
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ENV#4i:r02$32$ .
40 5894073116 A
'~ . For dnlin'e. adceiis; log on at:
http://wWW.fide.lfty:com/atwork
For information, call: (800)343-0$60
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CAROL A FURJANIC
186..STONEHEDi>E lANE
MECJ.JANICSBURG, pA l70!';5
, ' '. ','" ""
Your Accounf~ummary.
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Your Pei~clna:r"at~ 01 Return . '.. .
:This Period-1:5::SO/';,
, Year 't0~'bate _, :..' ~8.1%
, your Pe:rso'll~ 'Rate of Re,turn is:Cf1ICOI?ted'Wjtli'',~'Wn~:~~erglited.' . .
, formula,,~l~ly LJsed by nr)~~:ciarari:alyst$,t.o'parc<ulate"inves~en'(' .:,.'
. 'eamings:' .jfr'etlects the"'re$ults.()f.YOLil:','irive~tmerifse'ectioiis.is,, ... '
'.we.I.,a'S:Clny,ac~VitY'in,the(pj~J}'ixd:;b6nl(s):sh~~_n,', There:ar~ 'other
'~er,~'n~/ lla~~,-91 R,~tlJrn~ 16ITn~I~~ ~sei;f:ihat'~,,:Yi~,!d :di!f~f~tlt ' "
results; Remember th~t past' ~liormar~e' 1$' '0:0.' guarahteeicf. f,utur~ '
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$9;657:(>4
9,657.64
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Rememb~r"that a dividend 'paym'ent to fU/Jd s~a(eholders reduces"the share price of the fund, $o'"a decrea~GJc in th.e share. price for the state~~nt
period does not necessarily re;flect lower fund performance.
.. Some of your irw<'!stments 'are classified as'a Blende.d Fund Investment Blended Inve.s~f1:1ents may include a mixture of stocks, bonds,
and/or sho~t-term assets. Please rsfoar to the "Additional'Fund Information," secti9n tQ determine: the allocation of your blended investments'
underlying assets, The asset breakdown ,of your portfolio is ~fl.ecte.d in the pre ch::'!rtidthe "Asset. Allo.cation" Section.
Please read this statement carefully. Any error must be reported to Fide(ity Investments within 90 days.
"
,
. .
Beginninil eai~nce. .. . .... .
E)"Tlployee (;bhtfibutiqr"is. . .
Employer C9ntributloQS '.
Ghilnge.it'rAi;cdulitV"lii.e .'
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lhis :sEiction disp,ra:Y~ the v~.ue ~t your ~<<Q~':"t'f9.~al~ Pt?riod, in both'$h9fes:~r:Jp dollars.'. '
;' In vestment .
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. $3(';,731.42
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CAROL A. FURJANIC,
PLAINTIFF
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYL VANIA
.
V.
NO. 01-1144
.
JAMES A. FURJANIC,
DEFENDANT
IN DIVORCE
.
~NTORY
UNDER RULE 1920.33
Defendant files the following inventory of all property owned or possessed by either party at
.
the time this action was commenced i1ndall property transferred within the preceding three years.
. - "
Defendant verifies that the statemeirlirilade in this inventory are true and correct. Defendant
understands that false statements herein are made subject to the penalties of 18 Pa.C.S.A. ~4904
.
relating to sworn falsifications to authorities.
.
Date: ~
;;~ (}oo.;:2.
(
.
I
.
.
r
.
.
.
.
.
Assets
Real Estate
.
Marital Residence:
96 Deemeld Road
Camp Hill, PA 17011
.
.
Husband's 1/3 Ownership in Mother's
Residence in Steelton, Pennsylvania
INVt:NTORY
FURJANIt v. FURJANIC
I
Date ofMkiage - 02/13/82
I
Date ofSepfation - 12126/00
I
MARIl1AL ASSETS
I
Husba~d's
Valu~
Wife's
Value
- -~".~,-"~- ~ ~.-- ,-, _'H"_'_~~ - '.,-..j-. .1"". .1
Comments
E. J. Koppenhaver Apraisal:
Exhibit 1.
Mortgage balance as of
12/31/00: $69,318.00.
Exhibit 2.
Home Equity Loan balance as
of 12/16/00: $83,913.72.
Exhibit 3.
Total debt as of 12/31/00:
$153,231.72
Non-marital. Deed transfer
of July 2, 1996 for estate
planning. Mother retains
life estate. Exhibit 4.
.
.
.
,
$153,60p'.00
Apprais8.1
5/23/01 '
$176,000.00
Appraisal
12/01/01
d
Non-maHtal
I
$10,000.00
Asserted
.~ ".,~."-" ..., .~ '.""'"""--'"~" ..
.
.
Retirement Assets
. The Lincoln National Life Assurance $26,277'.82 $26,277.82 Date of separation. Agreed.
Group (Financial) Annuity 12/31/00 Exhibit 5.
$20,971,65 $20,971.65 Present. Agreed.
. 06/30/02
,
Travelers Life and Annuity $365.25' $365.25 Date of separation. Agreed.
Wife : 12/31/00 The "loan" of $5,708.95 as of
. 6/30/02 was taken against the
cash value at the time (approx.
1994), was used for marital
expenses, and there is no
obligation of repayment.
. Exhibit 6.
$178.13 $178.13 Present. Agreed.
06/30/02
.
Fidelity Investments 401(k) Plan $54,029.96 $54,029.96 Date of separation. Agreed.
Wife 12/31/00 Contribution of Wife after
12/30/01 was $6,442, which
. subject to same market decline
would now be $5,514.
Exhibit 7.
.
$46,284.72
$46,284.72
06/30/02
Present. Agreed.
.
.
.
.
Bank Accounts
. Members First Account
Wife
$2,900.00
$2,900.00
No statement. Agreed.
Commerce Bank Account 0 0 No statement. Agreed.
. Wife
Mellon Bank Checking Acct. $3,080.40 $3,000.00 See statement. Exhibit 8.
No. 884-017-4117 01/10/01
. Husband
Mellon Bank Checking Acct. 0 0 No statement. Agreed.
No. 100-024-4630
. Husband
. Automobiles
1995 Mitsubishi Present Kelly $7,500.00 Date of purchase: 1995
Husband Blue Book Asserted Purchase price: $19,000.00
Trade-In: $3,545.00 Balance due at 12/16/01 =
. Retail: $5,700.00 $5,122.99
Mileage at purchase: 1l,OOOmiles
Mileage at 12126/00: 82,000 miles
Mileage present: 124,500 miles
Exhibit 9.
.
1990 Volvo 0 0 Vehicle sold, proceeds divided.
Agreed.
.
.
.-,
.
.
1999 Diamante
Wife
$2,000.00
o
Asserted
Leased. Lease expires
October, 2002. Lease-end
purchase available at
$2,000.00 below wholesale
market value.
.
.
Miscellaneous
.
Household Goods and Furnishings
$18,000100
o
Asserted
Wife removed approximately
$13,000.00 of goods and
furnishings the total value of
which was approximately
$18,000.00. Husband
proposes an equal division.
.
. LoanslDebts
Citibank Mastercard Credit Card $11,314!12 0 Upon separation, Defendant
No. 5410-6548-4547-4219 Asserted to was left with approx.
be non-marital $15,000.00 of credit card debt,
. whilePlaintiffassumed approx.
$1,800.00. Defendant
proposes an equal division, as
joint marital debt.
Exhibit 10.
.
Bank One Visa Credit Card $3,046.49 0 See Statement. Exhibit 11.
No.4417 -1259-7248- 7718 Asserted to
be non-marital
.
.
~ ~.
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"" '-i";;~
.
.
Members First Visa Credit Card
. No. 4287-5900-0036-4451
$1,864.52
$1,800.00
Agreed marital debt.
Exhibit 12.
.
Income
2001:
$69,264.00
$57,627.00
Present incomes. See 200 1
Income Tax returns, and W2s.
H: Exhibit 13; W: Exhibit 14.
.
Projected 2002:
$42,542.00
$58,000.00
Wife: Total income during 18
years of marriage: $666,268,
or 41 % of total marital
income. Exhibit 15.
.
.
Husband: Total income during
18 years of marriage:
$974,924, or 59% of total
marital income. Exhibit 16.
See Social Security statements.
.
.
Date: DJ, 83, Jct5J-
,
. 91\
William A. Fetterhoff, Esquire
200 North Third Street, Suite 800
Harrisburg, PA 17101
(717) 232-7722
.
Counsel for Defendant
.
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.
.
EXHIBITS
.
I. Appraisal of Real Estate.
2. Waypoint Bank Mortgage.
.
3. Members First Home Equity Loan.
4. Kathryn Furjanic Real Estate.
.. 5. Lincoln Financial Group.
6. Travelers Life and Annuity.
7. Fidelity Investments.
. 8. Mellon Bank Checking.
9. Mitsubishi (1995).
10. Citibank Mastercard.
.
II. Bank One Visa.
12. Members First Visa.
. 13. Income ofJames FUljaniC, (2001 and present).
14. Income of Carol FuIjanic, (2001 and present).
15. Lifetime Earnings of Carol Furjanic (Social Security).
.
16. Lifetime Earnings of James Furjanic (Social Security).
.
.
IFilB No. 010510AI Paoe#21
.
.
RESIDENTIAL APPRAISAL REPORT
.
.
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APPRAISALS BY E.J. KOPPENHAVER
.
Property Location: 96 Deerfield Road
Book-F Volume-30 Page ~ 1173
Camp Hill, PA 17011
.
Borrower. N/A
Client: Zilli, Marilyn
200 North Third Street
. Harrisburg, PA 17102
EffeCtive Date: 5-23-01
Prepared By:
E. J. Koppenhaver
.
.
...
- '."-
2116 Southpoint Drive
Suite B
Hummelstown. PA 17036
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.
Form GA7 - "TOTAL 2.000 lor Windows' apPrtJ~al software by a la mode, inc. -1-800.ALAMOOE
E.J.Koppenhaver
;~" ,-
.
IFileNo 010510Al Paoe#31
-"",,,-
.
Appraisals by E. J. Koppenhaver
2116 South point Drive
SuiteB
Hummelstown, PA 17036
Phone: 717-583.0306
.
ZIIII, Marilyn
200 North Third Street
Harrisburg, PA 17102
Re: Property: 96 Deerfleld Road
Camp Hill, PA 17011
Borrower: N/A
File No.: 01051 OA
.
In accordance with your request, we have appraised the above referenced property. The report of
that appraisal is attached.
The purpose of this appraisal is to estimate the market value of the property described In this
appraisal report, as improved, in unencumbered fee simple title of ownership.
.
This report Is based on a physical analysis of the site and improvements, a locational analysis of the
neighborhood and city, and an economic analysis of the market for properties such as the subject.
The appraisal was developed and the report was prepared in accordance with the Uniform Standards
of PrOfessional Appraisal Practice.
The value conclusions reported are as of the effective date stated in the body of the report and
contingent upon the certification and limiting conditions attached.
It has been a pleasure to assist you. Please do not hesitate to contact any member of our staff If we
can be of additional service to you.
.
For the firm,
.
.
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.
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.
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".
SUMMARY OF SALIENT FEATURES
Form SSD - "TOTAL 2000 for Windows" appraisal software by a la mode, inc. -1-800-ALAMODE
IRleNa 010510AI Paoe#41
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E.J, Koppenhaver IFile No. 010510AI Paae#51
Suo:.~:!o#~ralsal Report UNIFORM RESIDENTIAL APPRAISAL REPORT 'II,No. ~~~~~~:
Pro e Address 96 Deerfield Road C earn Hill State PA ZI Code 17011
LnlDescrl tion Book w F Volume ~ 30 Pa--;;e-1173 Countu Cumberland
Assessor's Parcel No, 13-25-0010-240 Tax Year 2001 R.E, Taxes 'l: 1 920.00 Sn~~;~1 ^.~essmBnts t 0.00
Borrower N1A Current Owner Furlanic James & Carol Occunanl: f7I Owner Tenant I Vacant
.. Pro e rI htsa raised FeeSimnle I Leasehold ProectT e PUD Condominium UDNAonlvl HOA!tNlA /Mo.
Nei h~arhood or Pra.ect Name Lower Allen Townshi Ma Reference ADC70900 20H4 Census Tract 0109
Sale Prlce N/A Date of Sale N/A Oescsi tion amount of loan ch~m~~/~nncesslonsto be naid bu ~o\l~r None
Lender Client ZIIIi Mari~ Address 200 North Third Street Suite 800 Harrisburn PA 17102
Annraiser E. J. K~nhaver Address 2116 Southnoint Drive Suite B Hummelstown PA 17036
Location 0 Ur~an ~ Su~ur~an bd Rural Predominant p~r~elamllYho~~~ Presentlanduse% Land use change
Built up [:gj Over 75% 0 25-75% 0 Under 25% occupancy $(000) (yrs) One family 90 [:gj Not likely 0 Likely
Growth rate 0 Rapid [;gJ Sta~le 0 Slow [:gj Owner 120 Low --1Q....... 2-4 family 0 lrl process
Property values Dlncre~ing !8JSta~le o DeclinIng DTenant 250 Hinh 40 Multi-famlly_ To.
Demand/supply Q~hortage ~In~alance o Oversupply [g]Vacanl(IJ-5%)-Predomlnant-Commerclal
Marketin" time Under 3 mos. I I 3-6 mos. n Over 6 mos, n Vac 'over 5%' 185 20 Vacant 10
Note: Race and tho racial composlllon of the neighborhood are not appraisal factors.
Nejgh~orhood ~oundaries and characterlstics: Nei"'hborhoOd is bounded on the east bv Interstate 83 on the west bv Yellow
Breeches Creek on the north b" Cedar Cliff Drive on the south bv Yellow Breeches Creek.
... Factors that affect the marketability of the properties In the nejgh~orhood (proximity to employment and amenities, employment sta~mty, appeal to market etc,):
MSA #3240. The sub'ect Is located in Lower Allen Townshl;" Cumberland Countu PA. The nelnhborhood is comnosed
of a com atible blend of slnnle famllv detached homes in the medium ~Ice ranne. There are severallar e em 10 ers
located nearb and It Is an easy commute to the othe~ lar"'e e~ment centers of the "'reater metro olltsn Harrisbur
area. All amenities and ma or traffic arteries are convenient to the sUblect ~onel"h'.
.
.
.
Market conditions in the sUbject neighborhood (Including support lor the above conclusions related to the trend of property values, demamlJsupply, and marketing lime
--suchasdataorlcompetiUvepropertiesforsaleinthenelgh~(lfhood, descrlptiorlofthe prevalerlce of sales and financing concessions, etc,):
General marketin'" conditions In the area are rated as "'ood as of the date of this EIODralsal. TVDicalloan discounts In the
area are one to three:::oints and are enerall aid bv the buyer with no narticiDation from the seller.
.
.
... Projectlnformetion for PUDs (If appllca~le) - - Is the developer/builder irl corrtrol of the Home Owners' Association (HOA)? U Yes 0 No
Approximate total nUm~er of untts in the su~ject project Approximate total num~er of units for sale In the su~ject project
Descrl~e common elemerlts and recreational faciltties:
Dimerlsions 100x'216x211.48x156.18 Topography Stee Slo etoRear
Site area 26.735SaFt Corner Lot DYes [:gj No Size Averane
Specific zoning classification and description Rwl Establlshed'SIrv:;le Famil" Residential Shape Rectan"'ular
ZonIng C<JmplJance jgI Legal rvtD Legal nOnCOnf~i~9 (Gran~f~~er~;~\use) D Illegal 0 No zoning Drainage Ave~e
I u'.~-:&bestuseasim roved: Preserltuse Other use ex~!ain View Avera e
UtmUes PtJ~lIc Other Off-sllelmprovements Type Pu~lic Private Landscaping Averane
Electricity [8:] 200 Am':'~ Slreet Asohalt jgI 0 Drlveway Surface Asnhalt
Gas 0 Cur~/gulter Concrete 0 jgI Apparent easements None Noted
Water ~ Sidewalk Concrete 0 jgI FEMA SpecIal Road Hazard Area 0 Yes [:gj No
Sanitary sewer jgI Streetlights None -b! b! FEMAZone "e" Map Date 9~30w77
Storm sewer ~ Aile" None I I I I FEMA Man No, 4210168 I panel# 02
Commerrts (apparent adverse easements, encroachments, special assessmerlts, slide areas, iIIB\1al or legal nonconforming zoning use, etc,): There are no
a......arent easements or encroachments or other conditions that would have an adverse effect on the marketabllltv of the
subiect nronertu.
GENERALDESCRIPTlON
No. of Units One
No. of Stories Two
Type (DetJAIt.) Detached
Deslgrl (Style) 2 Stor"
Existing/Proposed Exlstlrr-
Age (Yrs.) 17
Effecli"^o, Nrs.1 10
ROOMS Fo.;;r
Basement
Levell
Level 2
EXrERIOROESGRIPTION FOUNOATlON
Foundatiorl Block Sla~ N1A
Exterior Walls Brlck&Frm Crawl Space N1A
Roof Surface AsnhaltShinn Basemerrt 100%
Gutters & Dwnspts. Aluminum Sump Pump No
Window Type DoubleHunn Dampness None Noted
Storm/Screens Therm~ane Settlemerrt None Noted
Manufactured House No Itltestalion None Noted
Dinrw;- Kitchen Den Famil Rm. Rec. Rm. Bedroo s
BASEMENT
AreaSq.Ft 1311
% FinIshed 0
Ceilino Joists
Walls Block
Roor Concrete
Outside ErltryYes
INSULATION
Roo! D
Ceiling==:rgJ
Walls_12I
Floor 0
NOrle ==: 0
Urlkno~D
.
.
.
Liv~
# Baths
Laund
Other
AreaS,Ft,
1311
1311
952
3
0.1
2
Loft
1
1
1
.
FinIshed area above nrade C<Jntafns:
INTERIOR Materlals/Condition
- Floors Car~et/Averane
Walls ~aIVAvera"'e
Trlm/Finish Colonial/A v::-
Bath Floor Vlnul/Averane
Bath Wainscot Fiber"'lasslAvn.
Doors LuanJA-y.:;:-
7 Rooms. 3 BedroolJlfS\.
HEATING KITCHEN EQUIP. ATTIG
Type Htnumn Refrigerator 0 None 0
Fuel Elec Range/Oven ~ Stairs 0
Cond'tion-AY;;: DIsposal [:gj Drop Stair [:gj
COOLING Dishwasher [:gj Scuttle D
Central Yes Fan/Hood [:gj Floor D
Other No Microwave [:gj Heated 0
Condition ,;,y;.-. Washe~;n~'er n FInIshed n
Addiliorlal features (special erlergy efficient nems, etc.): Rear deck covered front orch central vacuum.
2.1 Bath/sl'
AMENmES
Rreplace(s)#~D
Patio D
Deck Rear l:8:I
Porch Front [g]
Fence 0
Poo! D
n
2263
S uareFeetofGrossUvlnnArea
CARSTOFlAGE:
None 0
Garage
Attached
Detached
Built-In
Carport
Drivewa"
#ofcars
2 Car Atl.
Asnhalt
.
CondlUon of the improvements, depreciation (physical, functional, and external), repairs needed, quality of construction, remodeling/additions, etc,: There is no
functional or economic obsolescence. There are no '':'h~sical inade":uacles and no renalrs renuired. The roof aDDears to
be in ood condition with no evidence of leaks on the Interior.
Adverse environmerllal conditiorls (such as, ~ut not limited to, hazardous wastes, toxic su~stances, etc.) present in the Improvements. on the site, or irlthe . .
immedJate vicInity of the su~ject property,: At the time of ins"'ectlon there were no annarent adverse hazardous conditions
located at the subiect :':';o;"'ertu.
.
Freddie Mac Form 70 6193
PAGE! OF2
FannIe Mae Form 1004 6193
Form UA2 - 'TOTAL 2000 for Windows' appraisal software ~y a la mode, inc, -1-800-ALAMODE
.
.
.
.
.
.
.
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110.729
15.417
7.000
8.911
142.057
=$
UUUUUUmuu =$
uu.uuuuu.uu =$
'UU'UUU'Ummuuu -$
COMPARAlllE NO. 1
109 B'acksmlth Road
Cam Hili PA 17011
0.15 miles
N/A
'" 80.68'"
Inspection on Data Bank
5-23-01 Llstln A ent
DESCRIPTION DESCRIPTION
Conv/149DOM :
o '
11-30.00
Good
Fee 81m Ie
10019 S Ft
Avera e
28to fGood
Brk&V'n/Av .
20
Avera e
Total:Bdrms: Baths:
6 : 3 : 2 :
1982 S.R.:
100%/75%
!File No. 010510AI Paae #61
010510A
UNIFORM RESIDENTIAL APPRAISAL REPORT FileNo. 010510A
$ 30 000 COmments on Cost Approach (such as, source of cost estimate, stte value,
square foot calculation and for HUn, VA and FmHA, the estimated remaining
economic life of the property): The Marshall and Swift Valuation
Service was used to calculate the re laeement cost
of the sub"ect ro e . Estimated remalnl"
economic life Is estimated to be 50 ears.
Avera e
Fee 81m Ie
26 735 8 Ft
Avera e
25to fGood
Brk&FrmlAv .
17
Avera e
Total : Bdrms: Baths
7 : 3 2.1
2263S .R.
100%/0%
Avera e
Heat urn
Thermo anes
2CarAtt.
Porch,Deck
2 Fire laces
None
Avera e
Heat um
Thermo anes
2CarAtt.
Stoop,Deck
Woodstove
In roundPool
---. ~
I U1 --:-",-- ~
___L~
23681
118400
8000
156,400
COMPARABLE NO.2
91 Deerfleld Road
Cam Hili PA 17011
0.02 miles
159 900
14250
+ -$Ad' st.
-5000
-3 000
.1000
+1800
+2,000
.1500
.2 000
+1000
COMPARABLE NO. 2
COMPARABLE NO. 3
Val lonSectlo
ESTIMATED SITE VALUE .
ESTIMATED REPRODUCTION COST.NEW-OF IMPROVEMENTS:
Dwelling 2.263 Sq. Ft. @$ 48.93 '= $
1311 Sq. R.@$ 11.76
_ A lIances Porch Deck
: GaIage/Cerport 624 Sq. Ft @$ 14.28
. Total Estimated Cost New ..._...................__..._ $
.. Less Physical Functional External
Depreciation 23.6811
Depreciated Value of lmprovemenls
"As.is" Value of Site Improvements .
INDICATED VALUE BY COST PPROACH
ITEM SUBJECT
96 Deerfleld Road
Address Carn Hill PA 17011
Proxim' toSubecl
Sales Price
Pric GrossLivin Area
Dalaand!or
VerificationSollrce
VALUE ADJUSTMENTS
Sales or Rnanclng
ConcessIons
Date of Sal me
Location
Leasehol FeeSimle
Sile
View
Desi nandA eal
ual' ofConstructlon
e
Condition
Above Grade
RoomCollrn
Grosslivin Area
Basemenl&Finlshed
Rooms Below Grade
FunctionalUtil
Heatin Coolln
.. Ene Efflclenlllems
Gara Ca olt
Porch,Patio, Deck,
Fire laces etc.
Fence Poolelc.
+ -$Ad st.
.5000
-2000
+1,000
.4 200
.4,500
.2 000
.2000
COMPARABLE NO. 3
201 Hearth Roed
Cam Hili PA 17011
0.23 miles
153 000
65.38 '"
Data Bank
Listin A ent
DESCRIPTION
Convl148 DaM
o
5.31.01
Avera e
Fee Slm Ie
191708 Ft
Avera e
8 Iltlvi/Good
Stn&FrmlAv .
17
Avera e
Total :Bdlms: Baths:
8 : 4 : 2.1 :
2340S .Ft:
50% 1 0%
1300
143 800
None
C.C.T.A.O
None
C.C.T.A.O
+ $ Adusl.
66.56 '"
Data Bank
Listin A ent
DESCRIPTION
Conv/81 DaM
o
1-26-01
Good
Fee 81m Ie
13939 S Ft
Avera e
2510 1Good
8tn&A'utAv .
36
Avera e
Total :Bdrms: Baths:
8 : 3 : 2.1 :
2141 S .R.:
50% I 0%
COMPARABLE NO. 1
o
+2,000
Avera e
GFWAlCentral
Thermo anes
2CarAtt.
Porch,Deck
None
None
+2 000
Avera e
GFWAlCentral
Storm Units
1 CarAtt.
Scrnd Porch
1 Fire lace
None
ITEM
Dale,PriceandData
Source,forpriorsales
ithin earofa ralsal
Analysis of any current agreemenl 01 sale, option, or Jisting OfSllbject pro perty and analysis of any prior sales 01 subject and comparables within one y ear of the dale of appraisal:
There is currentl no contract endln on the sub"ect ro e
INDICATED VALUE BY SALES COMPARISON APPROACH .
INDICATED VALUE BY INCOME APPROACH If A Iicable EslimaledMarkelRenl $ nfa Mo, x Gross Renl MulU Iier
Tl1is appraisal is made "as Is' subject to the repairs, allerations, Inspections or condllions Ifsted below sllbiectto completion per plans & specnications.
CondRions of Appraisal: This a ralsal is made in " AS IS ' condition. The attached addenda are made an Inte ral art of this
a ralsal.
Final Reconciliation: The direct sales com arison a roach Is considered to be the most accurate method of achlevln fair
market value. Insufficient data was available to develo the Income a roach. The cost a roach su orts the re orted
value.
- ne purpose of this appraisal is to esUmate Ihe markelvalue of the real propertylh at is Ihe subject of Ihls report, based on the above conditions and the certil1catio n,contingenl
. and limiting conditions, and market value definRion Ihal are slated in Ihe attached Freddie Mac Form 4391FNMA form 10046 (Revised 6/93 ).
I (WE) ESTIMATE THE MARKET VALUE, AS DERNED, OF THE REAL PROPERTY THAT IS THE SUBJECT OFTHIS REPORT, AS OF 5-23~Ol
(WHICHISTH TE FINSPECTlO NDTHE EFFECTIVE DATE OF THIS REPORnTO BE $ 153.600
APPRAlS SUPERVISORY APPRAISER (ONLY IF REQUIRED):
Slnatu Slonature
Na e .J. er Name'
OateRe e 1 DaleRe ortS! ned
Stale Certification # RL-001154-L Stale PA Stale Certil1cation #
Or Stale Llcense # Stale Or Stale Llcense #
Freddie Mac Form 70 6193 PAGE20F2
FOIm UA2 - 'TOTAL 2000 for Windows' appraisal software by a la mode, inc. -HOO-ALAMODE
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SUBJECT
None
C.C.T.A.O
None
C.C.T.A.O
6300
I
153 600
o Did ~DidNot
InspeclProperty
Slate
Stale
Fannie Mae FolID1004 6-93
.
lRleNo.010510AI Pane #71
Borrower N/A
Pro e Address 96 Deerfield Road
C Carn Hill
Lender ZUII Maril n
FileNo.010510A
Cou Cumberland
StatePA
ZI Code 17011
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APPRAISAL AND REPORT IDENTIFICATION
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This Appraisal conforms to JlI1ll of the following definitions:
~ Compiete Appraisal
The act or process of estimating value, or an estimate of value, performed without invoking the
Departure Provision.
D Limned Appraisal
The act or process of estimating value, or an estimation of value, pertormed under and resulting
from Invoking the Departure Provision.
This Report is JlI1ll of the foliowing types:
D Seif Contained Report
A written report prepared under Standards Rule 2.2(A) of a complete or limited appraisal pertormed
under Standard 1.
~ Summaty Repori
A written report prepared under Standards Ruie 2.2(B) of a complete or limited appraisal pertormed
under Standard 1.
D Restricted Report
A written repori prepared under Standards Rule 2.2(C) of a complete or limned apprelsal pertormed
under Standard 1.
Comments on Appraisal and Report Identification
Note any departures from Standards Rules 1.2, 1.3, 1.4, plus any USPAP.relafed issues requiring disclosure:
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E.J.Koppenhaver
Form 101 - "TOTAL 2000 for Windows" appraisal software by a la mode, inc. -1.800.ALAMODE
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IRle No n10510AI Paoe #BI
MULTI-PURPOSE SUPPLEMENTAL AODE:rIDUM
FOR FEDERALLY RELATED TRANSACTIONS
~.J.Koppenhaver
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Borrower/Client N/A
Pro e Address 96 Deerfleld Road
C' Cam Hill Coun Cumberland
lender ZIIII Maril n
Stal. PA
ZI Code 17011
This Multi.Purpose Supplemental Addendum for Federally Related Transactions was designed to provide the appraiser with a convenient way to comply with the current
appraisal standards and requirements of the Federal Deposit Insurance Corporation (FDIC), the Office of the Comptroller of Currency (DC C), The Office of Thrift
Supervision (OTS), the Resolution Trust Corporation (RTC), and the Federal Re~erve.
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This MuitiMPurpose Supplemental Add~ndum is for use with any appraisal. Only those
statements which have been checked by;the appraiser apply to the property being appraised.
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I3J PURPOSE & FUNCTION OF APPRAISAL
The purpose of the appraisal is to estimate the market value of the subject p ropertyas defined herein. The function of the appraisal is to assist the above-named
lender in evaluating the subject property for lending purposes. This is a Fed~rallY related transaction.
I3J EXTENT OF APPRAISAL PROCESS
I3J The appraisal Is based on the Illformation gathered by the appraiser fro mpublic records, other identified sources, Inspection of the subjecl property and
neighborhood,and selection of comparable sales within the sub]ec tmarketarea. The original source of the comparables is shown in the Data Source section
of the market grid along with the source of confirmation, if available. The original source is presented first. The sources and data are considered reliable.
Whell conflicting information was provided, the source deemed most feliable has been used. Data believed to be unreliable was not included In the report nor
used as a basis for the value conclusion.
I3J The Reproductlon Cost is based on Marshal and Swift Valuation Service
supplementedbytheappraise~sknowledgeofthelocalmarkel.
I3J Physical depreciation is based on lhe estimated effectlve age of the sub jectproperty. Functional and/or extemal depreciation, if present is specilically
addressed In the appraisal report or other addenda. In estimating the site value, the appraiser has relied on personal knowledge of the local markel. This
knowledge Is based on prlorand/orcurrentanalysis of slte sales andlor ab straction of site values from sales 01 improved properties.
I3J The subject property is located in an area 01 primarily owner-occupied single family residences and the Income Approach is not considered to be meallingful.
Forfhfs reasoll,fhe fncome Approach was not used.
0 The Estimated Markel Rellt and Gross Rent Multiplier utilized in the Income Approach are based on the appraiser's knowledge 01 the subject market area.
The rental knowledge is based on prlorandlorcurrentrental rate surveys 0 I residential properties. The Gross Rent Multiplier is based on priorand!orcurrent
analysis of prices and market rates lor residential properties.
0 For Income producing properties, actual rents, vacancies and expenses h avebeen repcrtedand analyzed. They have been used 10 project future rents,
vacancies and expenses.
I3J SUBJECT PROPERTY OFFERING INFORMATION
According to Owner the subject property:
[gI has notheeo olfel'P.d for sale in the past 30 days.
Discnrrenllvofleredforsalefor$
D~forsaleWllhinthepast30daysfor$
D Offering information was considered in the final reconciliation 01 value.
[gI OIlering information was not considered inlhefinalreconciliationolv alue.
D Otleringinformatlonwasnotllvailllble Thereasonsforunavailabilily,andthestepstakenbytheappralserareexplained later In this addendum.
I3J SALES HISTORY OF SUBJECT PROPERTY
According to Cumberland Countv Tax Assessment Office thesub]ectproperty:
I3J bas nottraosferred In the past twelve months.
0 bastransferredinthepasttwelvemonlhs.
0 All prior sales which have occurred In the past twelve months are listed bel owandreconclledtotheappraisedvalue,ellherinthebodyolthereportor
Intl1eaddenda. .
Date Sales Price Document # Seller Buyer
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I3J FEMA FLOOD HAZARD DATA
I3J SUbject property Is notlocmed In a FEMASpeclal Aood Hazard Area.
0 Subjectproperty~inaFEMASpeciaIFloodHazardArea.
Zone FEMA Map/Panel # Map Dale Name of CommunIty ,
"C" 4210168 I Pane'# 02 9.30-77 Lower Allen TownshlD I
0 The communily does not narticinate in the National Flood Insurance Pro gram.
I3J The community does nartlclDate In the National Rood Insurance Program.
I3J ItiscoveredbyarMUlaIprogram.
0 IIjscoveredbyan~program.
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Page1ot2
Form MPA - 'TOTAL 2000 lor Windows. appraisal software by a la mode, inc. -1-800.ALAMODE
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Iflle No. 010510AI Palle #91
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I8J CURRENT SALES CONTRACT
I8J The subjecl property Is currenllvntlt under cnntract
D The contracl and!or escrow instructions were nnl avallahlp. for review, The unavailability of the conlractis explained later in tile addenda secti on,
D The contract and/or escrow instructions were rp.vip.wp.ri. The following summarizes the contract:
I Contract Date Amendment Date Contract Price Seller I
I . Furianic James & Carol I
D The contract indicated that personal property was nntfnr.lllrlerl In the sal e.
D The cllntractindj~ated that personal property was...inkIude.d. Jtconslsted of
I8J Estlmaledconlributoryvalueis$
Personal property was notlnr.lnded In Ihe final value estimate.
D PersonaJproperty~lnthefinalvalueestimate.
D The conlractlndicated nnlfnancino cnncp.ssinns or other Incentives .
D The cOnlractil1dicatedfhefollowlrm conr.p.ssinm: or incentives:
I8J If concessions or Incentives exist, the comparables were checked for similar concessions and appropriate adjustments were made, if applicable, so
thatthetinal valueconcfusion Is Incompliance wifII the Market Value defined lIerein.
I8J MARKET OVERVIEW IncJudeanexplanatlonofcurrentmarketcondlllonsandtrends.
0-3 months is considered a reasonable markeUng period for'the subject property based on ComDarable Sales
I8J ADDITIONAL CERTIFICATION
The AppraisercertKies and agrees that:
(1) Theanalyses,opinlonsandconclusionsweredeveloped,andthlsreport was prepared,lnconformltywlththe Uniform Standards of Profess lonal
Appraisal Practice ("UsPAP'), except that the Departure Provision of the UsPAP does nol apply.
(2) Their compensation Is notcontingenl upon the reporting of predetermined value or direction in value that favors the cause of the clienl the amount
ofthevalueestimate,theattainmentofastiplJlatedresul~ortheoccurrenceofasubsequentevent
(3) This appraisal assignment was not based on a requested minimum v~uatlon, a specific valuation, or the approval of a loan.
18J. ADDITIONAL (ENVIRONMENTAL) LIMITING CONDITIONS
The value esllmated Is based on the assumplion l/)atthe property is notnegali vely affected by the existence of hazardous substances or detrimental
environmental conditions unless othelWlsestated in this report. The appfil\serls nClt an expert in the IdenijfJcation of hazardous substances ordelrimental
environmentalcondllions. The appra/ser's rouline Inspection of and Inquiries about the subject pro perty did not develop any InformaUon that indicated
any apparent significant hazardous substances or delrimental environmen~1 conditions which would affect the property negatively unless otherwise staled
in this report. Jtls posslblelhattests and Inspections made by a qualllled hazardous subs tanceandenvlronmentalexpertwouldreveallheexistenceOI
hazardoussubstancesordetrimentalenvlronmenlalcondlllonsonoraroun,dthepropertythatwouldnegativelyaffectitsvalue.
D ADDITIONAL COMMENTS
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I8J APPRAISER'S SIGNATURE & LICENSE/CERTIFICATION
A.'S"&~ Effective Date 5-23-01 DatePrepared 6-4-01
ppralsers Jgna
Appraise~s Name~) . J. enhaver Phone # ~17 1 583-0306
State PA ~ I8JCertification# RL-001154-L Tax 10 #
I8J CO-SIGNING APPRAISER'S CERTIFICATION
D Theco-signlngappraiserhaspersonallvimi,np.ctedthesubjectproperty,bQlhlnsldeandout, and has made an exteriQrlnspecllQn 01 all comparable sales
listed in the report. The report was prepared by the appraiser under direct supervision oflhe co.sl gningappralser. The co-signing appraiser accepts
responslbllltyfQrthe contents oflhe repQrtlncludlng the value concluslQns and the limiting conditions, and confirms lhat lhe certlflcations apply
lullyto the co-signing appraiser.
I8J The co-signing appraiser has nnt np.rsonallv inspected the InterlQro flhe subject property and:
I8J has nntlm;nected the exterior 01 lhe subject property and ali cQmparable sal es listed In the report.
D has lnspllcledlhe exterior of the subject property and all comparable sales lis ted In lhe report.
I8J The report was prepared by the appraiser under dlre<:l supervision of the co-s Ignlngappralser. Theco.signlng appraiser accepts resPQnslbllilyforlhe
conlents of the report, Includlnglhe value conclusions and the Ilmll1ng CQn ditions, and CQnfJrms lhalthe certiflca!ions apply fully ro lhe cQ.slgnlng
appralserwllhtheexceptiQnolthecertiflcationregardingphyslcallnspecUons. The above describes the level 01 inspection perlQrmed by the
co-signing appraiser.
D The co-signing appraiser"s level 01 Inspection, Involvement In lhe appraisal process and certilicatiQn are cQvered elsewhere In lhe addenda section
01 this appraisal.
I8J CO-SIGNING APPRAISER'S SIGNATURE & LICENSE/CERTIFICATION
Co-::!nlng Effective Date Date Prepared
App ser"sSignature
Co-Signing Appraiser's Name (prinl) Phone # 17171 583-0306
State DUcense [g! Certification # RL-001154-L Tax 10 # 25-1718810
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Page2of2
FOIm MPA - "TOTAL 2000 IQr Windows' appraisal softWare by a la mode, Inc. -1-800.ALAMDDE
<!:
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IfiJe No. 010510Al Paoe#101
Supplemental Addendum
file No. 01 051 OA
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Borrower/Client N/A
Pro e Addr&Ss 96 Deerfield Road
C Cam Hili Coun Cumberland
lender znn Maril n
State PA
Zi Code 17011
.
IT IS NOTED THAT COMPARABLES NUMBER 1 OCCURRED MORE THAN SIX MONTHS AGO. THESE
COMPARABLES WERE USED DUE TO THE LACK OF SIMILAR COM PARABLES CLOSING WITHIN THE S'X
MONTH TIME FRAME AND ARE THE BEST TO ACCURATELY REFLECT THE MARKET VALUE OF THE
SUBJECT PROPERTY.
COMPARABLES NUMBER 1 VARY IN PRICE PER SQUARE FOOT BY MORE THAN $10.00 PER SQUARE FOOT.
THESE COMPARABLlOS WERE USED BECAUSE THEY BEST REPRESENT THE MARKET VALUE AND
MARKETABILITY OF THE SUBJECT. NO BETTER COMPARABLES WERE AVAILABLE FOR USE 'N THIS
APPRAISAL.
ALL COM PARABLES ARE VERIFIED SOLD AND SETTLED PROPERTIES.
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Signature
Nam. E.J. 0 h r
Date Signed 1
S"~ColiJJoaIjon# RL-001154-L
Or State Ucense #
Signature
Name
Date Signed
State~SlateCertiflcatlon#
State_OrStateUcense#
E.J.Koppenhaver
Form TAOD2 - 'TOTAL 2000 for Windows. appraisal software by a la mode, Inc. -1-800-ALAMOOE
Slate
State_
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!FIfeNo.0105lOAIPaIlB#111
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DEF~NITION OF MARKET VALUE: The most probable price which a property should bring in a compellUve and open market under all condltioflS
reqUls~te to a fair sale, the. buyer and seller, each act!ng prudently, knowledgeably and assuming the price Is not affected by undue stimulus. ImplicK In this
def~nJt!Df) Js .IhB ctm.wmmallOll ~t a sals as at a Specltled date and the passing of liUe from seller to buyer under COndlliofls whereby: (1} buY6f and sellar 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; 54) payment is made in terms of cash In U.S. dollars or In terms of finaflcial 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
lh8sals.
* Adjustments to the. comparables must be made for special or creative financing or sales concessions. No adjustments are flecessary
for those costs wnlch are normally paid by sellers as a resuK 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 Ilnanclng 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
appraise~sjudgement.
STATEMENT OF LIMITING CONDITIONS AND APPRAISER'S CERTIFICATION
CONTINGENT AND LIMITING CONDITIONS: The appraise~s certification that appears In the appraisal report is subject 10 the following
conditions:
1. The appraiser will not be responsible for mailers of a legal flature that affect either the property being appraised or the title to It. The appraiser assumes that
thetll1e Is good and marketable and,therefore, will nol render any opinions aboutthetllle. The property Is appraised on the basis of il being under responsible
ownership.
2. The appraiser has provided a sketch in the appraisal report to show approximate dimensions 01 the improvements and the sketch is Included only to assist
the reader 01 the report In visualizing the property and understandIng the appraise~s delem1lnatlon of Its size.
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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 respoflSlbility for the accuracy of such Items that were furnished by other
parties.
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3. The appraiser has examined the avallab]e 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]s located in an identified Special Rood Hazard Area. Because the appraiser is not a surveyor, ~e or she makes
noguararrfees,eKpressorimplled,regardlClgthisdtl'termlnatkm.
4. The appraiser will nol give testlmony or appear In court because he or she made an appraisal olthe property In question, unless specific arrangements to do
so have beefl 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 wtth aflY other appraisal and are invalid U they are so used.
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6. The appraiser has noted In the appraisal report any adverse conditions (such as, needed repairs, depreciation, the presence ol hazardous wastes, toxic
substances, etc.) observed du~ng the inspection of the subject property or that he or she became aware of du~ng the normal research Involved In performing
lh8 applaisaJ. Unless oflumwse stated in Ihe applaJs.a1 lepo1f, Ih8 appraiser has no knowledge of any hidden or unapparent conditions of the property or
adverse eflvironmental conditions (including 1I1e presence of hazardous wastes, toxic substances, etc.) that would make the property more or less valuable, and
has assumed thai there are no such conditions and makes no guarantees or warranties, express or implied, regarding the condition 01 the property. The
appraiser will not be responsible for any such condltfons that do exist or for any engineering or testing that might be required to discover whether such
condIlkms exist Because the appralsBf Is IWf an expert In the I/e/d of environmental hazards, Ih8 appraJsa/ lepDJt mllst not be CDnsidered as an
environmental assessment of the property.
8. The appraiser will not disclose the contents of the appraisal report except as provided for in the UnWorm Standards of ProfeSSional Appraisal Practice.
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9. The appraiser has based his or her appraisal report and valuation conclusion for an appraisal that is subject to satisfactory completion, repairs, or
alteratkms on the assumptiDn thaI compJetiDn of the improvements wlll be perfonned in a workmanlike manner.
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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
Onc]uding conclusions aboul the property value, the appralse~s Identity and professIonal designations, and references to any professIonal appraisal
organizations or the firm with which the appraiser is associated) to anyone other than the borrower; the mortgagee or "s Sllccessors and assigns; Ute mortgage
Insurer; cOflSultants; professional appraisal organizatioflS; any state or federal]y approved financlallnstilutlon; or any department agency, or instrumentality
of the United Stales or any state or the District of Columbia; exceptthatthelender/cllent may distrIbute the property descrIption sectlofl of the report only to data
collection or reporting servlce(s) wtthout having to obtain the appraiser's prior wotten consent. The appraiser's written consent and approval must also
be obtained belore the appraisal can be conveyed by anyone to the public through advertising, public relatiofls, news, sales, or ofher meara.
Freddie Mac Form 4396-93
Page1ol2
fannie Mae Fonn 1004B 6-93
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E.J.Koppenhaver
Form ACR - "TOTAL 2000 for Windows. appralsalsoltware by a la mode, inc. -1-BOO.ALAMODE
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IAle No. 010510Al Paoe #121
APPRAISER'S CERTIFICATION: The Apprnlser certilies and agrees ~at:
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1. I ~aVe researched IhBsubjecl marlretareaamJ have Mlected a minirrnlm 01 !hree recenfsal8s 01 properties IWJst slmUar and proximate to Ihe subject property
for consideration in the sales comparison analysis and ~ave made a dollar adjustment when appropriate to rellect the market reaction to those items of signilicant
variallon. II a slgnlllcantitem in a comparable property Is superior 10, or more lavorablethan, the subject property, I have made a negatlve adJustment 10 reduce
the adjusted sales pnce 01 the comparable and, II asignilicantitem In a comparable property Is inleriorto, or less lavorable than the sUbject properly, I have made
a positive adjustment to increase the adjusted sales price 01 the compa rable.
2. I have taken into consid~ration the factors that have an impact on value In my development 01 the estimate 01 market value in the appraisal report I have not
knowingly withheld any significant Information from the appraisal report and I believe, to the besl of my knowledge, that all statements and Information in the
appraisal report are true and correcl
3. I slaled In the appraisal repart only my own personal, unbiased, and professional analysis, opmions, ami conclusions, which are subject only to th6 contingent
and Ilmlting 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 10 the pal1lclpants in lhetransaction.1 did not base, either partially orcomplBlely, my analysis andiorthe estimate of mail<etvaluelnthe appraisal report
on the race, color, religion, sex, handicap, lamlllal status, or national origin of either the prospective owners or occupants 01 the subject property or of the present
owners or occupants 01 the propel1les in the Vicinity of the slJbiect 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 lavors the cause 01 the client or any related party, the amount of the value estimate,
the attainment of a specfflc reSUlt, or the occurrence 01 a subsequent event In order to receive my compensation aml!or employment for perfolTTling the appraisal. I
did not base the appraisal report on a requested minimum valuation, a specKle valuation, or the need to approve a specKle mortgage loan.
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9. I personally prepared all conclusions and opillions about the real estate that were set lorth 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 01 the appraisal report, I have named such Individual(s) and
disclosed the specUlctasks performed by them In the reconciliation section of this appraisal report I cel1lfy that any individual so named is qualified to perform
the tasks. I have not authorized anyone to make a change to anyttem in the report; therefore, II an unauthorized change is made to the appraisal report, I will take
no responsibility for It.
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7. I perfolTlled this appraisal in conformity with the UnlfolTTl Standards of Prolessional Appraisal Practice that were adopted and promulgated by the Appraisal
Standards Board 01 The Appraisal Foundation and that were In place as of the effective dale of this appraisal, with the exception 01 the departure provision oflhose
Standar~s, which does not apply. I acknowledge that an estimate of a reasonable time for exposure in the open malket is a condition In the definition of market value
and the estimate I developed Is consistent with the marketing time noted In the neighborl1ood section of this report, unless I have otherwise stated In the
reconciliation section.
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8. I have personally inspected the interior and exterior areas 01 the subject property and the exterior 01 all properties listed as comparables In the appraisal report.
I further certUy that I have noted any apparent or known adverse conditions In the subject improvements, on the subject slle, or on any site within the Immediate
minity of the Sllbject p.ropBfty of whIch J am aware and have made adjustments for these adverse conditions In my analysis 01 the property value to the extent that
I had market evidence to support them. I have also commented about the effect 01 the adverse conditions on the marketability 01 the subject properly.
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SUPERVISORY APPRAISER'S CERTIFICATION: II a :supervlsory appraiser signed the appraisal report, he or she certifies and agrees that:
I direcl1y supervise the appraiser who prepared the appraisal report, have reviewed the appraisal report, agree with the statements and conclusions of the appraiser,
agree 10 be bound by the appraisers cel1llications numbered 4 through 7 above ,land am taking full responsibility for the appraisal and the appraisal report.
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ADDRESS OF PROPERTY APPRAISED: 96 Deerfiel~ Road. Camo Hill. PA 17011
SUPERVISORY APPRAISER (anly II requlrod):
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APPRAISER: A
--
Name: .K e a er
DateSlgne. It-
StateCe~lIcation#: R -001154.L
orStaleUcense#:
Slate: PA
Expiration Date of Certification or License: 6/30/2001
Signature:
Name:
Date Signed:
Slate Cel1llicatlon #:
orStateLlcense#:
State:
Expiratlon Date 01 Certification or License:
o Did [8'J Did Not Inspect Property
.
freddreMacform439a-93
PiJQB2012
Form ACR - 'TOTAL 2000 for Windows' appraisal software by a la mode, inc. -1.800.ALAMODE
FannleMaeForml0D4B6-93
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IFlleNo o10510A\ Paoe#131
Subject Photo Page
Borrower lien! N/A
Prooertv Address 96 Deerfield Road
Ci/l! Cam Hill
lender ZilIi Maril n
Countv- "Cumberlana
State PA
Cad 17011
.
Subject Front
96 Deerfleld Road
Sales Price N/A
Gross living Area 2.263
TalalRooms 7
Total Bedrooms 3
TotalBa1hrooms 2.1
Location Average
View Average
Site 26,735 SqFt
Quaflty Brk&FrmlAvg.
Age 17
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Subject Rear
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Subject Street
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Form PIC3x5.SR - "TOTAL 2000 for WindowS" apprais~1 softWare by a la mode, Inc. - 1.800.ALAMOOE
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IFileNo 01051DAI Paoe#141
Subject Photo Page
Borrower ffen N/A
o e Address 96 Deerfleld Road
i Carn Hill
Lender Zilli Maril n
C n Cumberland
SI PA
Ii Co f7011
.
Subject Front
96 Deerfield Road
Sales Price N/A
Gross Uving Area 2,263
Total Rooms 7
TotafBedrooms 3
Total Bathrooms 2.1
Location Average
View Average
Site 26,735 SqFt
QUality Brk&FrmlAvg.
Age 17
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Subject Rear
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Subject Street
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Subject Interior Photo Page
Borrower Iient N/A
Pro e Addres 96 Deerfield Road
Ci Cam Hill
lender Zilli MariI n
Coun Cu-mberland-
tate PA
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Zi ode 17011
Subject Interior
96 Deerfield Road
Sales Price NJA
Gross Living Area 2,263
TolalRooms 7
TolalBedrooms 3
Total Bathroorns 2.1
Location Average
View Average
Slte 26.735 $qFt
Quality Brk&FrmfAvg.
Age 17
Subject Interior
Subject Interior
Form PIC3x5.SJ - "TOTAL 2000 for WindowS" appraisal ~ottware by a la mode, inc. -1-800-ALAMODE
.
Comparable Photo Page
8orrowerClient N/A
Pro e A dress 96 Deerfie!d Road
Cft Carn Hill
Lemler Zilli Maril n
Coun - CUmberland
S1al PA
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IFUeNo 01QS10AI Pane #161
Ii de 17011
Comparable 1
109 Blacksmith Road
Prox. to Subject 0.15 miles
Sa/ePrice 159,900-
GrossUvlngArea 1,982
Total Rooms 6
To1a1Bwrooms 3
TotalBathrooms 2
location Good
View Average
Site 10019 SqFt
Quality Brk&VlnlAvg.
Age 11
Comparable 2
91 Deerfield Road
Prox. to Su~ject 0.02 miles
SaJePrice 153,000
Gross LIving Area 2,340
Total Rooms 8
Total Bedrooms 4
Total Bathrooms 2.1
Localillfl Average
View Average
Site 19170 SqFt
Quality Stn&l=rmfAvQ.
Age 17
Comparable 3
201 Hearth Road
Prox. to Subject 0.23 mlles
Sate Price 142,500
Gross living Area 2,141
Total Rooms 8
Total Bedrooms 3
Total Bathrooms 2.1
location Good
View Average
Site 13939 $qFt
Quality Stn&AlulAvg.
Age 36
Form PIC3x5.CR - ~TOTAL 2000 forWlndllws' apprai~al software by a fa mode, inc. -1-80Q..ALAMODE
IFlleNo.010510At PaoB#171
.
",omparable Multilist Photos 1.3
BO/rower. Client N/A
Pro e Ad 96 Deerfield Road
City Camo Hill Count\' CUIT!!,erland
lender Zilli Maril n
State PA
ZloCode - 17011
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LISTINGS~ S:':~1
J.()9 BUAClCSlrr'rR PA:M'
lPRlt.L S1S9.~()0. >>0=
ALLICNDALi::
COMPARABLE #1
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Wll'S':t' SIlOrol: s"l:t l)i.~
St.lltou" S&~ J."_76J.~7S00
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MIte 'I'imo-l~9 ttou".. Info...!'SR OTIlER
...../2_!'Ull&0_ttlIJ.ffl..eb.(")
Parkin!O"......1.rAC'lif:ll.2CARS
Own"", Dlfo_. .SAru\IVA fl$RNMJDO 1,0<:11; Box.. .CPLB
DEr...RT .!I~. EX 19. U.\LL.!:...'lUALfo WAY, IUIlLAL'KSM1TIl RD
Warranlfw.
se...eua SE.T1' SUb-'I'yp4 SF" tiey CA.'!? HlLt. t.ht: ""ieo $1~9,900.
MIte 'I'bM. 149 OU Ml<1: D"~... 11130/2000 Soeto D.t., 121~912000
salo Offic.' <:;,\002 Sill.. prieo$ j59S00 :POi....
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&arch (lk'k
Uill
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n DI!:ZRF:r1:Ltl
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ALt.&NDAL::.
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Belh W,lh'''''''n (bellowill)
~1L.-10060?a2 1l.Il#- Ar.....-6 Uun-LC~I!. oU.LEIor
Nkt. TiIae-14~ lIoU"" Info.. .4B!'. TltAl)lTrON1..l,
..'I1-l"UU & 1~RlI1f BII~h(,,)
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Ovn.,,:, :tnf<:>__.c ANNtJNun Lock Il=...c:pr:a
St...eU"1JI;O:-l.~;TyJ:laSF
Uir-S3S TO !;XI9.GO THRI!
UGHT.UAI.l.F.(l."nALE:.1.IVRFlLV.tOCUI..Dc_SAC NSE ON
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C:iey CAHP HILL Lia" Pl:i",", $159,999.
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WES'I' ffHOJlE. Sch Di"t.
St"t.l>aSltTT
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"'/:;>-l"UJl!.l-H.Il.IfJ:4tbls)
Pu'lcina...l CAli, GAlU',GE:
Oom.." :r:nfo...MF'....O"J.\Nr.S&F.LI>INF. 7&J'14~a Lock Bex...C:PKI.'
llir...lJ3S 1'0 EXIT 19. [J,\IJ.E:-IOA1.F. WA)'. RIRI.,\CKSMml. RnIE^RTIl.
"~:3rrnn[)._ \'o.:~
seo.t:u. SETI' Suh_'t'y;go SF C:\.'='Y (.:;I.).IP RILl. Liae pd.".. $14~ ~oo,
llkt'l::\."". 91 Off W<t !lot.., t2n/~ot)t) Sett Da.1:0, 11~6:1O)Ol
:;.3", Of He"" III'!/lS' Salo pric..S 14;J-$()O I",\>"
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IFile No. 010510AI Paoe#181
Building Sketch
BorrowerClie I N/A
Pro e Address 96 Deerfield Road
Ci Carn Hili
lender ZUU Marl! n
Cou Cumberland
S"" PA
Zi Code 17011
.
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40.0'
Bath Bath
Bedroom n:r
b T Bedroom
ci DL
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I- Bedroom -ON ten ICL
6.0' j.::.:
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g Loft
17.0'
17.0'
40.0'
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24.0'
m Family -
PR -
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Dining b
b ~
gj Garage
17.0' -
b
~ " UP
~ living
24.0'
23.0'
Sl<'I'~ .IV_.....
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",g~;el\lleWLA'F19NS5.UMMAaY L1VING~;;iP!'.BAE~~0WN;
I~\'I' ,~,Im.\Pt1~li '~,," . . - . '~Ize .totals Brea~Qwn .Subtotals
GI.>1 First P'loor 1311.00 1311.00 First Floor
GLl\2 Second Floor 952.00 952.00 23.0 . 40.0 920.00
... Garage 624.00 624.00 17.0 . 23.0 391.00
Second Floor
17.0 . 40.0 6S0.00
'.0 . 17.0 102.00
10.0 . 17.0 170.00
TOTAL LIVABLE (rounded) 2263 5 Areas Total (rounded) 2263
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IAle No. 010510AI Pane #191
Building Sketch
Borrowe~ Client N/ A
Pro e Address 96 Deerfield Road
C Cam Hill
Lender ZilJj Marjl n
Coun Cumberland
State PA
Zi Code 17011
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IFlle No 010510AI Paoe #201
Plat Map
Borrowe~ Client N1A
CP~ e Address 96 Deerfleld Road
I Carn Hill
lender ZiIIi Maril n
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Cumberlan
Zi Code 17011
SIaIe PA
Parcel Number 13-25~001 0-240
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IAle No. 010510AI Pane #211
Flood Map
80rrowerClient N/A
Pro e Address 96 Deerfield Road
CI Cam Hill
Lender ZiIIi Maril n
Coun Cumberland
Slate PA
II Gode 17011
.
Flood Map # 4210168 I Pane # 02 I Date 9.30~n
Flood Zone "C II
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Pro e Address 96 Deerfield Road
C' earn Hili
lender ZiIIi Maril n
Coun Cumberland
State PA
Zi Code 17011
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IRte No. 010510AI Paoe #231
Legal Description
Borrower, Client NJA
Pro e Address 96 Deerfield Road
C' Cam Hill
Lender ZiIIi Maril n
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COlln Cumberland
Slate PA
Zi Code 17011
ant-10th dait of Ju.i.e
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BETWJJ:iJN
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t.IID STATE D&VELOPlmIl', INC., !l, c:orp01'attQn o:r;W:ted aAd ex:bt!ng
UIJdet:' .th.t;l 18;10'9 of the Comao:nrealtb ,of' P~S1'lnn1a, v1th offi.(lea
at 316 Lemp Post. Lane. Camp Rill. Pc.. 1'70Ht the G:n:n1;f;'Il' horo1Q.i
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JAMES A. F'tJRJAh"IC and QAROL A. FlJRJ'J.liIC~ hi. VU'9" parliies or tAct
lJeoond part., t.iut GnDtss.Il harein. ." .,.., ~ ~ ~ .....
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WITNESSETH, tMt t1I.e said
~Alltor
forenlmCOl18i~Unl.o/tUftomof 1WJ!::,VE Til0USA2lD DOLLJJ\S (&12,000.00)
lawfuI.mon.r; <Df the Vfli.Wf,b'~&" tJf A~ ".to
thG I@ Granteas
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",612 aM hlll paid bV
a.i elld bBfo-rt th4 6oaJill/1 c.M d6l:i'l1cry ~I ,^N' llrosetlL7,
the ~Gtl41t lIIMrerJ/ is IuNbv ~"IWn8l6ci'gd, au grctnkd, OOT".I1~i-. 1O!d, ~d,
Btl/l!ogCrl, 'l'tktutd a,.d confi'mGd, (trod b1t th~.l'Q pr-ilten!a dooQ qrant, bGrodn, ,flJ,
l1limq., ~I/~f!, t'(!/ttule mut et'l~fil'Wl unto tJu ~aU Ciran'teut thflll- he1:rs .
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ALL TJU.I OERTAIN PA,ll.cst known as Lot. #142 SGot1on "FiI Ailllndale, Loyer mon
TOlomsh1PJ Ou:nba1'land CQUQtTJ Penns,yl.v&nUt ""...cording to a. PllUl of Allem1s.le
tor MirJ. Stll.ta DO\l'olopm.ant, bo., by- WilUnm. :So \\Uttoek, R.P.E. ~ted March 31,
197B.. ::-eeol"&'.g in Plan lliok 15, Pase 2St bounded And. dG:>ol"ibed in l'leoordarae(l, w1,tA
said plan as i'ollOTJ81
BEGINNIN'O (1,.1:.- a PQint on the lIIout.hwe.Jtern right-of-vq 11ne of ilooo. !:rut Road,
s. 50 root rj,.sht-oi'-lIn)", lla1d p:;l,1nt !,;.eing loo.at(u,l. QIl,g, 'l"ererencoo. ~ 11 IlIOl1,1.th-
6Q.St.6:'l.y clirection' along t,h., soutl:.ern right-'lf'--.roy line of Del;1;:otield Road.
a dlst!1DC:u of" 1,13'.54 feet f:rM. a O\U"V1'l \1ith a radius of 15 feet; and a.tl. arc lentth
0::' 21.(i~ L'tltlt. Q<mneatiDg thE! IlQut-hern r1ght-<J1'-.....;y Un'i:' or D{j0t"l'hl~ Road vith -t:.hl'l
southol:'.l'I. tiE:;'l.t-of......~ li~e of FhldllltQne Road. a ~ 1'00-;;' right-of-vqj thence
along thQ a-o....t.hern right,~o:-vq Una of ~od O:,,~t IWad"on t,hft ~e or a. 0UI'\"e
aurvi1lg<tC' 'tH""lettd;ayiJ:Ig _&,,1"I.d1U8 Or -175.00 !'eet, Aft- ~!'O"'"l~li,>l)t- ,100.;00' ,feet
to a pc.1,l\t at; th~ SOllthw~ito ~Ol'lJ.or of ~t 111411 liheoee alone Lot #141 1!0l.$Jl,!r7
dsgr'Gi;':r'08'1Db1n1i&a:-14' OOQ~d$ aut, . ~Q. ,of 216.00 tee{, t", 6. point. at tb~
Al1llnda1,"',1teoroati:l.onnl I.ree.J thenoo aJ.ong the Allo~d.\lJ.Q ReertlQtional .\:'(1& aouth
44 degree. sa lIliriutea $) seoonda loIftt, a. d1/ltane8 of 211.48" feat to. II. l>>~t at
'the e:O\1theutern e.c.rnal," of Lot 1i97j tbe.nQ8 al>lr.& lot 1/9"/ ZI~.th 44- tiep... 23 :m1ml.tea
4&~fnllGCa14B vUt._',6 d1l1tLt.Dce pi 1~.1a fl5"t, to ~ poJ,J:.lr lilui pl~u~& ot !\eg1lu'l1Dlh Said
lot oontllm1ng 26,~.756 t1q,UIl.:'o f'Qet and i.s .3UbjQct t.o (I, ~':tocil aW-f;lary sewer
e.nd dra.1-nn.ge eaSlE!m'itJ1t and a 1; loot It..~ ut1lity es3a:nent as' Doted on thg fi:zlal
Subd1tis10t1. Plan of Sect10Il "'Fl1 AJ.len4ale by Wldtt...'lck &: HlU"tn.a:ll., Robert. G. Jiartmm;
Jr.. P.s.. Alsa known aa 10~ 'Ilool!.cre6t Road
:BEnTO: a ~ of the sme prm.r;gs which Nll.'t1Q:H'l1 Lend & hv~stIllG~ OOJll.~ b1' deed
dated. Novcbor 28, '197.3, an~ rsc.ol'&ld :!.l'l. tbe Oftice . o( tho R4lcorder ot ))ood, ;,f'
Cumberl.a:C.d County, Pe:maylvan1a, in Deed Book ~K~ Volmn... 25, i'Lge 1058 poanted. al'.d
COr."'Q'8.I1,1,llJ,to Hid StalOe DeveJ.op:ient. ~.. the Grantor bOl"elb.
StroJ1::1T t.,. eueme.::.t4 ulltl'iotiQnI; lUIa building ~Q" of RacoI'd
S11BJ'E..."T -to Prot.ect.tve coveJ:ltJAta l'ecorGed in Ctubvland Couut.;r aillcorQ.er c1: Deeds
otrioo :I.n >f!..ecellancO'll.a ibClk 158, Page 24>.
~~30 i~.:~i.17J
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BUILDING ~REA ADDENDUM
IFile No. 010510AI Paae#241
.
Borrower N/A
Pronertv Address 96 Deerfleld Road
Cilv Cam Hill
Lender ZIIII Marilvn
fileNo. 010510A
COUnfv Cumberland I
State PA
ZinCode 17011
.
Gross Living Are. (GLA) 2.263 s.l.
Gross Building Are. (GBA) 4,198 s.l.
Areas S'quareFoolage
Basement 1.311 s.f. -..M % of GBA
Level 1 1.311 s.f. 21% 01 GBA
Level 2 952 s.f. ~%ofGBA
Level 3 0 s.f. ---'1% 01 GBA
Garage 824 s.f. ~%ofGBA
Other 0 s.f. ~%oIGBA
.
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Area Dimensions Type of Are. Level
Measurements Factor Area living Bsmnt Garage OIher On, TWD Thre<l
1311.00 X ~ X -----.1..QQ = 1.3111.00 ~ 0 0 0 ~ 0 0
952.00 X ~ X ~ = 952.00 ~ 0 0 0 0 ~ 0
24.00 X 26.00 X ~ = 624.00 0 0 ~ 0 0 0 0
1311.00 X ~ X ~ = 1.311.00 0 ~ 0 0 0 0 0
- X - X - = 0 0 0 0 0 0 0
- X - X - = 0 0 0 0 0 0 0
- X - X - = , 0 0 0 0 0 0 0
- X - X - = 0 0 0 0 0 0 0
- X - X - = 0 0 0 0 0 0 0
- X - X - = 0 0 0 0 0 0 0
- X - X - = 0 0 0 0 0 0 0
- X - X - = 0 0 0 0 0 0 0
- X - X - = 0 0 0 0 0 0 0
- X - X - = 0 0 0 0 0 0 0
- X - X - = 0 0 0 0 0 0 0
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'~' '.' '^.w...... "\a~.ay" .........M,.. ....,.....lvn.......,L.
VoWt ,',' '~' ",". ,'~
I '" . SAN K
It LOAN NUMBER
0077020615
!17-~ I I
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~....,. '.-Ira.~'L
RO. Iiloll 1711, Harrl."'LII"" Penn...IVllInla 1710&-1711
lbll Free: 1-866-WAVPOINT (I-B66:'Si!9-7646) . www.waypolntbank.com
LOAN STATEMENT
WAYPOINT BANK
INTEREST RATE
5.875
ORIGINAL AMOUNT
103,000.00
STATEMENT DATE
12/31/00
JANaS A P'lJRJANIC AND
CAkOL A PURJANIC
96 DBERFIELD RD
CAMP "ILL PA 17011-8469
It
TRANSACTION TRAN
It TYPB DATI!:
01/01/00PMT
ESC. ADD
02/01/00_ 2/1$/0
03/01/00* 3113/~'
~S PM'!'4/11/
COom:'Y. , LOCAL..-r, ,,'
04/01/00~4/11/q
05/01/'00_5/15/0
06/01/0'0_6/13/0
m~~~Q
~7/0.1/00_. 1117/0
TAXES PM'!' 7/25/0
SCHOOL TAX
08/01/00_ 8/.11/0
09/01/00_ 9/11/'0,
.10/01/00ptltt 10/11/0
-Ll/01/00PMt 11/14/0
12/01/00_ 12/11/0
ESC. IN'l'. 12/30/0
Ese INT po. .U/30/J):
.
SSN 185-38-6096
PROPER'l'Y ADDRESS-
96 DEbPIELD RD
CAMP HILL, PA 17011
-- - -- LOAN ACTIVJ:'l'Y -- -- -
TitAN
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PAGE
1
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ESCROW
llATE PRINCIPAL
CHAaGE BALANCE
PRI~CIPAL INTbEST
.00
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ANNUAL ESCROW ACCOtrnT INP'ORMATION
PRIm AND INT PAYMENT
. ESCROW PAYMENT
631.09
237.49
BEGINNING ESCROW BALANCE
PLU.S DIi:POStTS
TAXES lJISBURSED
INSURANCIi: OISBURSED
MISCELLANEOUS DIS:9uaSED
'1'O'1'AL PAYMENT
INTERES'l' ON ESCROW
.
.
868.58
27.30
ENDING ESCROW BALANCE
72454.94
72454.94
72158.38
71880.57
71880.57
71601. 40
71320.86
71038.95
71038.jfj
70755.65
70755.65
70470.97
70184.89
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Men:lberslST
FI;J)ERAL CRF:l)IT UNION
.
P.O. Box 40 " MechOlnicsburg, PA 17055~0040
(717) 697-11"1
TOll FREE (.BOO) 283-2328
www.members1st.org
HIST
36445-02L FURJANIC/CAROL A
10(11/02 10:17 AM BR:06
Ty S!PR
pe Amount Interest Fee
VR ~~~.~~ ~~7.?? .~~
TFR FROM SHAREJ'i;' 36445-00
75T 03161211 12131601 PTTF V~ 352.28478.72' .00
TFR FROM SHA~ES36445-00
47T 021601 021601 PTTF YR'299.08 531.92 .00
TFR FROM SHARES . . 36445-00
'6T 011601 011601 PTTF VR 2,?7.19 , .533.81 .0083616.53
TFR FROM. SHARES." .', ..... 36445-00
77T 121600 12160121 PTTF VR :312.49518.51 .. 0121 )~B.';313. 7'2
TFR FROM SHARES'. ,...36445-00
47T 111600 111600 PTTF VR 293.34537.66 .00
TFRFROM SHARES 36445-00
. *More In Fi~e- Continue?* , '. c'
MEMBERS 1ST FSDERA~ GREDITUNION
-~J PARAMETERS: [
In
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Post
'Date
041G01.
Eff
Da,te
041(;;01
Tran
Code
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SIGNATURE
Balance,
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82965.17
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83317,45
84226.21
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VOI~ch Seq C
Number Numb 0
C!1 4154e
0 29929
0 1336
0 22673
0 15297
'0 29096
DATE: [10/11/02]
]
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other
.
GENERAL INTERPT
PRINT
MAIL
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main
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day o7~'
BETWEEN KATHRYN A. FURJANIC, widow, of
of Steelton, County of Dauphin, State of Pennsylvania,
called Grantor,
'"
THIS DEED made the ~
1996
thE! Borough
hereinafter
-AND-
.
MICHAEL M. FURJANIC, THOMAS R. FURJANIC, AND JAMES A. FURJANIC, to
be held as tenants in common, hereinafter called Grantees.
.
This transfer is exempt from realty transfer tax as a transfer
from parent to children.
WITNESSETH,
'1'hat
said Grantor for and in
Qonsiderat;;i.on of the llilo1111 gf eme ( 1Il ;1,. QO) c1Q:LJ.IIi;li;" llin4 C11:lhllll'
,
II
consideration paid by the said Grantees to the said Grantor, at and
before signing arid delivery of these presents, the receipt whereof
is hereby acknowledged, have 9ranted, bargained, sold, and
II
conveyed, unto the said Grantees and Grantees' heirs, successors
and assigns the premises described on Exhibit "A" attached hereto
and incorporated herein by reference;
II
TOGETHER with all buildings, improvements, woods,
. of""'
ways,
rights,
,liberties ,.
privileges,
hereditament
and
.
appurtenances, to the same belonging, or in any ways appertaining,
and any reversions, remainders, rents, issues and profits thereof,
II
and of every part and parcel thereof, including any interests
specifically set forth on Exhibit "A", if any. And also, all the
estate, right, title, interest, property, possession, claim, and
demand whatsoever, both in law and equity, of the Grantor of, in
.
and to the same'.
.
1\'"
TO HAVE AND TO HOLD the said premises, and the
· appurtenances, hereby granted to Grantees and Grantees I heirs,
successors and assigns, to and for the only proper use, benefit
and behoof of the said Grantees and Grantees' heirs, successors.and
. assigns forever, under and subject to the conditions set forth on
Exhibit "A", if any.
.
AND the said Grantor hereby covenants and agrees that
Grantor will warrant specially the property hereby conveyed.
,
· IN:WITNESS WHEREOF I the said Grantor has hereunto set
Grantor's hand and seal the day and year first above written.
.
SIGNED, SEALED AND DELIVERED
.
.
: ss:
IN THE PRESENCE OF US
.
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55:
COUNTY OF DAUPHIN
:
ON THE ~d day o~\(..L , 1996,
~~~4iQ ~n and ~O# _.~d oo~~~y ~~~.~e., ~he
before me, a notary
Uftderst9fted otticer,
I
personally
appeared KATHRYN A. FURJANIC,
known to me (or
satisfactorily proven) to be the person whose name is subscribed to
~ the within instrument, and acknowledged that she executed the same
for the purpose therein contain~d, and desired the same might be
reQQrQed e. .uGh,
t
IN WITNESS WHEREOF, I hereunto set my hand and official.
seal.
.
0, ,j}r:U Il
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.
kl (J Y--I4-L l/ M b I /~ j
I
Title of Officer
My Commission Expires:
',.", ..
The address of the
NOTARIAL SEAL
BARaARA A. LANE, Notary Public
Slaallon ~roOaU\ltlin Cour.tY
My Commlssion~ires Juna 5, 2000
within-named
.
Grantees is;
.
100 Riverview St.
Steelton, PA.
.
.
.
.
.
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.
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.
.
.
.
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EXHIBIT A
At,t. ~i'l.e"!I. lIIi1l'l.''i!"d.l'l lees el:' !,ieees of land s!eulI.ee in ehe
Township of swatara, County of Daup
hin and state of Pennsylvania, bounded and described as follows, to
wit:
BEGINNING at a point on the eastern side of Boyer Alley, said
point being on the soUthern line of Lot 236; henoe eastwardly along
the southern line of Lot No. 2,36 one hundred fifty~nine (159) feet,
more or less, to a point on the western side of Fourth Street;
thence northwardly along the western side of Fourth Street; thence
i"iQi"'1!i~W.lI'd:l,y .;!.Ol'\W '1UUI W'UI'\Ulll'fllli!l..e.' I!'eu~"l!li'l. 1II'l!l'l.'... el'le aUftllll:'iIltl
twenty three (123) feet, more or less, to a point; thence
westwardly along line of property of Enlri sakai one hundred fifty-
nine (159) feet more or less, to a point on the eastern line of
Boyer Alley; thence southwardlyalonq the eastern line of Boyer
Alley .one hundred twenty-three (123) feet, to the plaoe of
BEGINNING.
BEING Lots Nos. 235 and 236 on plan of Lots of Riverview
Addition to Enhaut, as laid out by Jacob C. Boyer, said plan being
rQ~QrQ.Q ~n ~b.A.o.~d.# of ~..<<.Qfr~d. L" /lift. fO~ Q."'~~1'l CO"I'l'l!lY
in Plan Book "H",' Page 62, and also being a tract of land seventy-
five (75) feet in width and one hundred fifty-nine (159) feet in
depth immediately adjaoent to said lots and to the north thereof,
and shown on the above mentioned plan as a larger lot marked
"sold".
BEING the same premises Miko Furjanic and Mary M. Furjanic,
his wife, by their deed dated January 29, 1941, and recorded in the
Office for the Recording of Deeds in and for Dauphin county in Deed
Book "0", Volume 25, paqe470,qranted and oonveyed to Miko F.
Furjanio and Mary Mo' Furjanio, his wife. The. said Mary M. Furjanic
having predeoeased her 'husband Miko F. FurjaniC, title to the
aforementioned premises beoame vested in Miko F. Furjanic by the
Grantor herein by virtue of the laws of Pennsylvania relating to
tenancies by the entireties:
BEING the same premises as Miko F. Furjanio, widower, by his
deed dated January 21, 1952, and reoorded in the Office for the
Recording of Deeds in and for Dauphin county in Deed Book "T",
volume "35", paqe 131,gran.ted andcon'\reyed to Miohael A. Furjanic
and Kathryn A. Furjanio, his wife. The said Miohael A. Furjanio
having predeceased his wife' Kathryn. A.Furjanic, title to the
aforementioned premises became '\rested in Kathryn A. Furjanic by the
Grantor herein by virtue of the laws of pennsylvania relating to
tenancies by entireties.
2002 REAL EStATE TAX NOTICE FOR CENtRAL bAUISHIN SCHOOL DISTRICT
CAre TSiu.'NiJMS!;j\"'''" ..... -~~--'T
July 1, 2002 I 03618
PROPERTY LOCATION:
98 RlVERVIEW ST
PROPERTY IDENTIFICATION NO.:
MM!; Iillollilll'le '......A.~1il 1S:
Luanne Gustin-DeFrank
599 Eisenhower Blvd.
PO Box 3255
Harrisburg, PA 17105-3255
(717) 564-6155
M-W-F 9-4PM; 7-9PM ONLY ON 8/29
Drop Box Available
SEE DETAILS IN TWP. NEWSLETTER
& 12/30.
***********AUTO**5-DIGIT 17113
~NiI:l: iii ldlllCAllll:i *tI. 'RIti:Qlllr.ll a
tuRJANIC JAMES
100 RIVERvtEW ST
STEELTON PA 17113-2648
1".111..,1",11,,,11,,11,,,1,1.11,,,1,,11..1,1111I11,,,1,,,11
TAXES MllLAGElTAX RATE TAX AMOUNT
SCHOOL DISTRICT 10.6949 ML $1 023.49
TAXES ARE DUE AND PAYABLE. DO NOT ALTER TAX AMOUNT. DISCOUNT AND
. PENALTY HAVE BEEN COMPUTED FOR V.OUR cONveNIENCe.
IF YOU DESIRE A RECEIPT, ENCLOSE A SELF-ADDRESSED, STAMPED
ENVELOPE WITH YOUR REMITTANCE.
AppIlOS""AO lor Ho,,"eolead! Ifarmoleaa l8lIel~olaA e'e IIl/eile.le eA"~ellll
. on December 15th from the Dauphin Co. Tax Assessment Office, the local
school district business office, and other selected locations thro~ghoutthe
County. An original must be filed with the Dauphin County Tax Assessment
Office on or before March 1 st of the following year.
11
63 051 034
ASSESSMENT
ORIGINAL ASSESSMENT $
, HOMESTEAD ExCLUSION $
. FARMSTEAO iXCLUSION $
NET ASseSSMeNT $
95,700
o
o
95,700
Swatara Twp
The annual assessment appeal filing deadline with the
Board of Assessment Appeals for tax year 2003 is
August 1, 2002.
IF YOUR TAXES ARE IN ESCROW PLEASE FORWARD
THIS BILL TO YOUR MORTGAGE COMPANY
DURING THIS PERIOD
i~~~;II'I~1
;!~._;I'
~OVEM1'lE~~~~M~~k; .
;;5'WPeqal' .pe '. ..~it:
;;'\FT1:RDEdEiii~~:~;!icJln;
.; 10'{;; Penally Pa~perii>d ....
PAY THIS AMOUNT
..'.-.-,-.-','--'-'-'--., ,
;~~~~;:;~2
67
1,125~94
Unpaid TOIxes WlI~ Be 'furned over For Collection After DeCEMBER 31,
2002. ~elinque~t Tax To Be Paid To Dauphin County Tax Claim Elureau
with additlonal_ c,harges.
11111~IIIBUt~1I1
.. Keep this portion for your records .A
..,. Detach a~~d.letum bottom portion with your payment ..,.
00:957 .
PAvMENTCOUPON
DO NOT FOLD
=~ig ~~~L M & THo~A'D
100 nVERvtEW ST S '1'00'1
S'l'EELTON 1>A 17113-2648 AUG 2 I.. 1...
'. G .:n.oeFranK
Luanne Gustin-DeFrank LUanne. us.. "'''as.
599 Eisenhower Blvd. S.....i>'I'ra.,.,.'P. ,f..
PO Box 3255 ,........ ...
Harrisburg, 1>A 11105-3255 & 12/30. 1I11~1111111_111_llllj
II 2002 REAL ESTATE TAX NOTICE FOR
CENTRAL DAUPHIN SCHOOL DISTRICT
Swatara Twp
PROPERTY OWNER:
'i.
REMIT TO:
II
(717) 564-6155
M-W-F 9-4PM; 7-9PM ONLY ON 8/29
Drop Box Available
SEE" DETAILS IN TWP. NEWSLETTER
JULY - AUGUST'
2% Oiscount pa ment Period
SEPTEMBER. OCTOBER
Gross Payment Period
$1,023.49
1,003.02
!DATE
I July 1, 2002
II PROPERTY LOCATION:
98 RIVERVIEW ST
i PROpeRTY
110 NO.:
I SILL NUMseR
i
i
03618
63
034
051
NET ASSESSMENT
$95,700
MILLAGE iT AX RATE
10.6949 ML
..5"01
NOVEMBER-DECEMBER
5% Penally Payment Period
AFTER DECEMBER 31, 2002
10% Peqalty Payment Period
$1,074.67
$1,125.84
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'::'{:"!iJ.; i PI8DNu:tj'~69' ,
":,':;,f., /!Ii',; l,' ~:!01rcf~:~JHo$>IT&. PARTNERSihp
::-~:-:':Jf.:::~!)~':"':. :::" !.. SA~-;ij,N: ~ :
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Financial Group~
The Lincoln National Life Insurance Company
TDA Client Services
PO Box 9740 "
Portland ME 04104-5001 'e
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653
CAROL A. FURJANIC
414 N 4TH ST
LEMOYNE PA 17043-1665
Plan Number: 569
Employer 10: 560
Plan: HOLY SPIRIT HOSPITAL PARTNERSHIP
SAVINGS PLAN
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Questions? Contact a Service Representative at
1-800-341-0441
Unit value Numberofu1Iits Dollar value
6130/2002 6/30/2002 as of 6/3011002
.
~
30.4491
30.7347
20.7101
21.9316
163.0032 4,963.30 x
~
133.3221 4,097.61 .
0
293.8207 6,085.05 e
~
265.6300 5,825.69 w
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0
0
0
$20,971.65 :::
w
e
!Il
0
TOTAL 0
0
;;J
$20,971.65 ~
;::
Interest Rate
4.95%
.
New Contribution
Interest Rates
Contract number
Contribution Period
894150+006
04/01/2002-0613012002
,~
Notifications
Please contact Lincoln Life within 30 days of receipt of this statement if information or investments are
not accurate. Lincoln Life reserves the right to limit its liability if inaccuracies are not reported promptly.
; .-....
Pro.pectuses and various financial reports are available upon request. PleBse keep in mind that thefilnds
supporting the variable annuity are not public funds and are only available through insurance company
contracts.
.
Securities offered through Lincoln Financial Advisors and other broker/dealers with effective selling
agreements.
--
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to 1998 Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates.
Plan: 569 Employer IV: 560
1;
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page 1 of 6
L.~ji
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ANNUITY SERVICES
ONE TOWER SQUARE
HARIIORD,CI06183-4053
You, Servicing Agent
CmSJRE[f
Yoor Plan-Type is:
T ;0: Shek<.m Annully
Ynur Pmdtld Type is:
T-F1ex
00t}QS6S?_~~)_~,C;D1HT012
. OIF..... ....'1...\ '.--....,...'"..lil.,.."'..ll.. -"".i... .,....
96 i5C'Crifijj'R:;:~" .'
0I1111j Hill, P/\ 17011
Account Number
IS!llIeOatc
Case Number
8520262
05/11{1989
802267
.
<1'1> questioN' Please Contact~
Customer Service
1 ~8OI~ 842-9406
. YOIJR INVfS1MfNT SUMMARY
YOUR OlJlSIANl>ING lOAN SUMMARY
This Quarter
_~__. :-~u,'''_.
~eginf1ing Balance
T .,Iall'alltll........
Net loait ActivIty
Total Withdrawals
. Other
- Change in 'nvestment Value
~NPIN![I[.i.r:ANCE
YOUR INVeSTMeNT SfRAlTGY .
TO I A' ASSETS
$365.25
$0.00
$:12.92-
$0.00
$0.00
$4.48
:i....~l
_{i'-1f5';{,;c,~ _., ..: ,-;:,~_~?';:
lOAN 1 .. elll""v. 11/9/1993
Outstanding loan Principal
Nexl Pay.ment Due Oale
Amt)IJUIIj;,Je
$5,299.40
5 f) /21X.l
"~7,7'
:=J
Your (lelclll/fed loan dmolltll ;s run Indlul(,({;1I YOllr 'ot.1f
va'fIf~ and will be rf.'poned,o the 'IIIenMI ReW'IIUl! Sf'rvkr
as a taxable distribution.
ClJRR1N f CONl RIBU liONS
--.-"--.. -
.
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Fixed
100% ;1-F1ex CI
Fixed
100% l-rlexCT
108%
fi."ed
CD NEWS
. Additional Annuity feature.
Welcome 10 our newly revised CJll.1tfPrly ~I.lfem(>nl. Wi' hnfJ(~
rhill you find the I"lonuaflon helpful .lnd easy 10 I'f'.lcl. Wi' '"we
encfosed a , 'ow to Redd Your Statement brodlllre which
conlaIns addiflOfl.11 ;,,(onnalloll.
.
, Please rev;ew your stdrenrenf for .1ccuracy. Any errors ne('tI,o be
,eponed w'll,'n 90 days of remlpl.
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t 'C:;l'''~;)lfif''
Your '"femet Access: www.rra\fl>Iersla.com
log'" 10: your Sodal Security Number (no s/asltes or dds/res}
Password: for n.., lime use.. pfea"" emer your Dale of Blnh fMMlJDYY}
9918599389%09699 1 of 2
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ANNUITY SERVICES
ONE TOWER SQUARE
HARIIORD,CT 06183-4053
Your Servicing Agenl
ClTlSTRtU
Your Plan-Type is:
Tax Sheltered ^nnuity
Your Product Type is:
T-f1ex
0000701 J. ?0ooooo1 - C(l1L1CJl)]
CAROL A fURJANIC
414 N 41H ST "
lEMOYNE, PAI7043
Account Number
Issue Date
Case Number
8520262
05/11/1989
802267
.
@
Questions? Please Contact:
Customer Service
118001842-9406
.
YOUR INVISIMFNT SUMMARY YOUR OlJTsrANDlNG10AN SUMMARY
This Quarter
Year to Date
Be~inning Balance $212.R3
Tolal Paymen.ts. $0.00
Net Loan ActIVIty $37.00-
aotal Withdrawals $0.00
Otl~ $O.Otl
Change in Investment Value $2.30
IENplN.G_ilA~~NCE ___=-===--=--=-=:::::::::==~:Jj!!i:1 J~
$245.02
$0.00
$71.117-
$0.00
$IUIU
$4.98
-==::::::::f:iZIh1:[!
LOAN 1 - eff<'ClIve 11/9/1993
Outstanding Loan Principal
$5,708.95
Your defaulted 10.10 ~mounr ;s not incluckd in rr"r toMI
value and waN W will be ",ported (0 fhe lnlema Revenue
Setvice as a taxable distribution.
.-O{ m INVESTMENT STRATEGY
rmAL ASSETS
CURRENT CONTRIBUTIONS
i!D
HXE'd
100%, f-Flex CT
Fixed
1000/.. T -Flex CT
'"
100%
Fixed
Additional Annuity features
CD NEWS
rill/if .-wlll/it)' c.ofllra.- ct provides ior a df.'.HII be~t't11 equal to.YOIlr COlllr,le1 vd/ue.
~f ,I ctJllI}!/f.fP eXfll,Jn,1lioll oftlw death Jxmetit pledse reiN to YOUf conlract.
Please review YOl',. stalemenf for accuracy. Any errors need to be
repol1ed within 90 days of receipt.
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Your !lIr('n!et Ac:n.'.'>s; www.tr.JVelt.f...Ja.cnm
'_oBio /f); YOllr Social S('mrily NlItil!Jer (1l0SI,'Is/Je,'i Of ddShc<;)
P,Issword: For first limp. users p/edse elller YOII/' Dare of Hirlh (MMnOyy)
tlUS(j938()9(,09699 1 of 2
.
Fidl.~/jlyf' Inreslmenls<!>
Holy Spirit Hospital
Retirement Savings Statement
January 1, 2001 - March 31, 2001
Social Security Numbar: 185-38-6096
..
.
#BWNF)(QN
CAROL A FURJANIC
96 DEERFIELD ROAD
CAMP HILL. PA 17011-8469
ENV#40032332
405894073116 A
IE For information: Call 1 (800) 343.0860
Internet Address: hllp://www.fidelity.com
For online account access:
Fidelity Net8enefits: http://natbenefits.non-profits.com
.
Your Account Summary
Your Asset Allocation
.
Beginning Balance
Employee Contributions
EmplOlrer Contribu1ions
Change in Account Value
Ending Blalance
Additionallnformallon .
. tiIVIdM<I& iii IHI&,.'"
$54,029.96
907.83
977.72
-9.359.68
$46,555.83
$101.49
. Stoc~s 94%
. Bonds 6%
.
Your Personal Rate of Return
This Period -16.9%
YeaTlo Date -16.9%
Your Personal Rate of R9tul1'l is calculated with the time-weIghted
formula, a j10rmula widely used by Roanclal analysts to calculate the
lnveslment earnings of a portfolio. It reflects the results of your
Investment selections as well as any activIty in Ihe account. There
are other Personal Rate of Return formulas used that may yIeld
different results. Remember that past performance is no guarantee
of future results.
Your investments are currently allocated among the displayed
asset classes. Percentages and totals may not be exact due to
rounding.
The Additional Fund Information section lists the allocation of
your blended funds.
.
Market Value of Your Account
This section displays Ihe value of your account for tho period, In bolh shares and dollars.
.
Shares on Shares on Price on Price on It'7irkefv;'iiie ar et aue
Inve tment 12/31/2000 031311200 131/2000 03131/200 iirt12/3 000.' 0 0313112001
Stock Inv,estments $43,288.67 $36,536.79
Fideiity Grow & Inc 516.928 537.001 $42.10 $37.41 21,762.67 20,089.21
Fidelity Growth Co 301.358 314.005 $71.43 $52.38 21,526.00 16.447.58
Blended Investments' $10,741.29 $10,019.04
Fid Freedom 2020 737.726 764.229 $14.56 $13.11 10,741.29 10,019.04
110 .. , "
c 5
.
.
Please read this statement carefully. Any error must be reported to Fidelity Investments within 90 days.
32332 40032332 0001 20010407 4038
Fideiity Investments, P.O. Box 770002. Cincinnati, OH 45277-0090
185386096
Page lof4
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Holy Spirit HOI'.p~al
Statement Period: 01/01/2001 to 03/31/200t
Social Security Number: 185.38.6096
Market Value of Your Account (continued)
.
Remember that a dividend payment 10 fund shareholders reduces the share pricQ of tho fund. 10 R decrGlGSlo In the ahar. price for the atatement period
does nor necessarily reneet tower fund performance.
.
. Some of your Investments are classified as a Blended Fund Investment. Blended Investments may include a mixture of stocks, bonds,
and/or short.term asselt!. Please refer 10 the "Additional Fund Informalton" secUen to detarmlna the allocatIon or your blended Inv9stments' underlvlnQ
assets. The asset breakdown of your portfolio Is reflected In the pie chart In the ~Asset Allocatlon~ Section.
Your Contribution Elections as of 04/06/2001
This section displays the funds in which your future contributions will be invested.
. Employee Employer Employer
IlI~WW&Wll!lIt11i .~ ~-'"~... . H'. ..Delflifl" <~ . ..,- . -~/flR r R',l'1j8flt . 1)1t2nI':.f/~
Fidelity Grow & Inc 40% 40% 40% 40%
Fidelity Growth Co 40% 40% 40% 40%
Total 100% 100% 100% 100%
". Your Account Activity
Use this section as a summary of lransactiOI1S that occurred in your account during the statement period.
. Elilployee Employer Employer Tolal For
Aclivilv CJeferrtlf Milich 801/0ver Dlscrlll/(?narv Plan
Beg~nini ialance $10,1$3.4& $5,358,88 $35,75i:3i $2,224'15 $54,029.9,
""'''!III. .lIlIl/iIluIllI"' 1I11?l1 1.1.1111 II II. II Ill?.
Employer Contributions 0.00 453.91 0.00 523.81 977. 72
. Change in Account Value .1,890.32 -948.33 .6,087.19 .433.84 .9,359.68
Ending Balance $9,710.92 $4,864.46 $29,666.13 $2,314.32 $46,555.83
I Vesting Percentage 100.000/0 40.00 % 100.000/0 40.00 %
Vested Balance $9,710.92 $1,945.78 $29,666.13 $925.73 $42,248.56
, Dividends & Interest $20.44 $10.26 $66.17 $4.62 $t01.49
A Message From Fidelity
" --'" '".
Tired of paying so much to Uncle Slllri?",~y Y(lutselfih!ltelld andltlwet yout 2001 Income tax biU by making pre.tax contributions to
your retirement savings plan. These contributions are deducted from your paycheck before income taxes are taken out, reducing the
amount you will owe next spring in federal, state and local income taxes. Be"er yet, your retirement plan money grows lax.deferred
until you w~hdraw it. Visit Fldel~y Ne1BenefitsSM or call your plan's toll free number to review your contribution amount today. Make
sure you are ge"ing the full benefit of your retirement savings plan. Pre-tax contributions are subject to the annual IRS dollar limll.
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129297
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1
32332 40032332 0001 20010407 4038
Fidelity Investments: P.O. Box 770002, Cincinnati, OH 45277-0090
185386096
Page 2 of 4
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'. R~titementSavingSStatement
. Aprtil,'2002 : JiJne 30, 2002'
HolySpirlrHospitaf" . .
.
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#BWNFXClN
CAROL A FURJANlC
414 4TH STREET
lEHOVNE, PA 17Q43
". - .'
. ..' "-'- '
. Eflv#4Qa14223
<lO$a~Q.7(hlIlA
. C'Jr F6I()nline~ccess,IOgon at:
hltp1/'NwW,ligelify.coll)latWor!(
For inlo(lIlaliolj, call: (800)343~860
I
. -, " '. . ' .
Your AccounfsUj1\mary .'.
.. .Voljr,Asj~fAlloQaaion.
.
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-.- ,.' .'
1il"llll\lif!'\O'.IIiI'\\l.,','II,j.I\II!~~ . ",
Emp16ype'~llfril:lutlons., 9113.1
girlpr6y~r. CPll.frlbiJiiiiti.s" ". .....;..,iift&t
Chiln!1.'1t\~66Uhf\lalue ...............'..~...'.'.~'~...:.i ".'.".:;.~.>
Erldll1gplilllll~e ..... ~j.;'!'7,'l2
Addl'ilil1lll'l~;~ftltlltiilri . '. ..... .....
+Oiviilll~d~~"lnt~rest ../'. <,'
. Yoil~~eri~~~~Ii(~ofR~~u'rIf.' .\;.
"~~~f;r~~~>..... .... ......... ".:,.
YourPll{Sooal'Ri1tiiofFl~lUlnl." .
formula, W1lileiy I.lll~lill>y Ilnai1Cllil) :.
earnings. II riOffect!; the IJl~UI$ aliI'
well as atiy tictivify in ttli> pla/1 aiXlOllrif(t),tlillw. '. ,. ." .;;~~~r:. ..'
PersMal flatiOol fleturn formu!liilt#l#lIja1ro!W,yl.olI!i'.i:lin.l".iil" ."
r~sulls. Rei1l!lm\l<jr\hat flllsl p~rflit",#hG~'l~Ii9,'ilii~i'lilill!..oifil!~",. .
resulls, '> .' .... ,. .
,:, . ,>.'
, ,;. '..~ -, '
: ';:1 ,: ~,: '
,rll'St(\CkS 94%. .
. ;i,I'~nd!l6o/.
<<'c''"-'
. C', :'(:'/";~';-"
" "', ,.'. '~
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. <.,"':.'
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.
~~iiQ~~r;~~~*~,~~~gP6~$e~:f.i~:~0 '
,.rl1~~dillll'i..,.,....... ......... ..' .... ..'
.' . ThJ;~iii~hall=imd 1t1(ormatians~lion lists the allocation 01
YQurl)l.etideil~flds. ..,... ' ..
.
, , .",., , .'
, _ '-"' _'. _:'-: ~' ;.:. .' "~ .'. -:", ',0., , ~ . ,. ' '
MarketV~luet1.fVtl\&rAllaiuht.. '. . ...
This section displays thl> valu~ ofYoiur ...6Ouri/;,Oi-ih\l period,'inbl>thshariO$ atId dOllars.
Shar!1I'.ClIl f1h retion t>;/ti/ilOp .' MarJiet Va,lue
Investment :i '2 06'....:.! 06. .'
. .1
Stock Investmllnts $40,151'.$8 $35,7:l1.42
Fidelity GrOW & Inc 602;713 El24.697 $37.60 $33.61 22,662.Ql 20,996.07
Fidelity Growth Co 352.593 369,585 $49.62 $39.87 17.495.67 14,735.35
Blended Investments' $11,146;02 $10,553.30
Fid Freedom 2020 885.307 920.078 $12.59 $tl.47 11,146.02 10,553.30
.
Remember that a dividend payment 10 fund shariOhold~rsredu~s the shar~ price of the 'und. to iI decrease In the share price for the slatement
period does not n~c~ssarily r~fleet low~r fund perfomlanclO. .
.
. Som~ 01 your inveslm~nt!; ar~ classified as a Bl~nded Fund Inveslrn~nl. Blend~d Inv~slrnenls may Inetude a mix""e of stocks, bonds.
and/or shorHerm assets. Please refer to t~e "Additional Fund Information" section to determine the allocation of your blended investments'
underlying assels. The assel breakdown of your portfolio is reflected In the plIO chart in th~ "Asset Allocation" Section.
Please read this statement carefUny. Any error must be reported 10 Fidelity Investments within 90 days.
14223 40014223 0()01' 200207()9 40313
Fidelity Investments, P.O. Box 770002, Cincinnati, OH 45277-0090
Page 1 01 5
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Mellen Bank
.
PERSONAL BANKING STATEMENT
DIR~CT INQUIRIES TO.
aSAAg"w~~r'HNfteGION
CEDARClIFF
1510 CEDARClIFF DR
CAMP HIll PA 17011-7713
717-731-4858
o
.
.
1...11I...11I....""...11I,,1,,1,,1.1\,,1.1,, 1.1".1\,,\..1.1
JAMES A FURJANIC
96 DEERFIELD RD
CAMP HIll PA 17011-8469
00778
0126
884-017-4117
PAGE 1 OF 4
STATEMENT
FROM OI~IO~Ol THRU 02~O.~01
.
.
INTUIT INC. IS OFFERING QUICKENIRJ TURBOTAXIRJ FOR THE WEBISMJ FOR
FEDERAL AND STATE TAX RETURNS, WITH THE CONVENI~NCE OF FILING ONLINE
WITH THE APPROPR~ATE AGENCY. VIS~T WWW.HELLON.COM~TAXCENTER AND LET
TORBOTAX ASK THE QUESTIONS AND DO THE HATH.
REI.ATIONSHIP SUMMARY
DEPOSIT ACCOUNTs
PERSONAL CHECKING
TOTAL
BALANCE
....315.25
"',315.25
LOAN ACCOUNTs
OUTSTANDING
.
.
OPENING BALANCE .AS OfOl~10~01
TOTAL DEPOSIts ~~01HE~40QITtONSI~LUOING INTEREST CREDITED THIS PERIOD
TOTAL .CHECKS""!D otH'-R. WITljIlIlAWALS INCLUDING FEES AND CHARGES THIS PERIOD
CLOSING BALANCE AS Of IlV08~Dl
AVERAGE ACCOUNT BALANCE
3,080.40
+7~810.87
-6 .576.02
4,315.25
3~.503.10
,A.~C.O~~,"t0:~!~Ct:I:~:~ly,g;~mi,:~~~~~1.ft~~',~11j;;~11,:0~!:(~1i;k'{:'~;jf\~~(,~lth(P:~~9:!>!i~~).~t ,,', '. -;,
.
DATE
POSTED
Ol/lD~Ol
DESCRIPTI\l.N
OPENING BALANCE
DEPOSITS
AND OTHER
ADDITIONS
CHECKS
AND OTHER
WITHDRAWALS
DAILY
BALANCE
3~080.40
01/11~Ol
DEPOSIT
REF ;000002800160590
MIse AUTOMATED CREO ST BARNABAS CORR
'111111111PAYROLL A7R 00010101110
01/11 HELLON ATH HITHORAHAL #004238
CEDAR CLIFF CAMP HILL PA . . .
156.00
2,115.7'
.
300.00
5~052.19
II
01/16~01 01/14 HELLON ATH WITHDRAWAL #00"'6'3
CEDAR CLIFF CAMP HILL PA
CHECK # 7'7
CHECK # 7'8 . . , . . .
CHECK # 79' . . . . . .
01/18/01 01/18 HELLON ATH HITHDRAWAL #005155
CEDAR CLIFF CAMP HILL PA , .
200.00
388.00
250.00
868.58
3,345.61
2"'0.00
3,105.61
.
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I'1!QERAL ClmDrr l..INlON
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'Ty S/PR
pe Amount Interest Fee
VR .00 1.00.00
TFRFROM SHARES, 36445-11
16T 04.1501 041601 PTTF VR 350.3<::. ?5.58. 00
'ST 031..01 1<i~~~Qllpn!" ~~R,F~O:j;:,~~e:E~~iO!l!" ..~6445~~~
TF',R FROM SHARES u' . 36it4:5-11
47T 021601 021601 PTTF VR 355.60 31.40 .00
TFR FROM SHARES.. 36445-11
011601 PTTF VR 353.28 33.72 .00
. TFR, FROM SHARES 36445-11
121600 PTTF VR- - 352~ 12 . 34.88 .00
TFR FROM SHARES 36445-11
*More In File - Continue?*
MEMBERS 1ST FEDERAL CREDIT UNION
J TRAN CODE: ( . IPARAMETERS-: t-
.
P.O. Box 40 '. Mechanicsburg, PA 17055~0040
(717) 697-1 W1
TOLL FREE (800) 283-2328
www.members1st.org
HIST
.
ID
FURJANIC/CAROl. A
3644::H2J1L
46T
Post
Date
051601
Ef'f
Da,te
051601
Tran
Code
PTTF
16T 011601
'7T- 1216rlJ0
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1NTERPT
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10/11/02
10: 15 AM
BR:06
Balance
3693.03
Vouch
Number
o
Seq
Numb
1184
C
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.3j;93.1ZJ3
13
4542
4~""a.Sti
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4414.11
1336
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o 22673
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o 15297
DATE: (101 11/02J
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HELP
main
.
10JOi/2002 04:26 FAX 2159222618
Kelley BIllie Book Used Car Values
14105
Page 1 on
ROGER W MAIN
.. Ie....,. Wae JIook
~ .,.". Trusted A_tee
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N_CIIr "ridllll'
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Expert advice
Blue Book Trade..ln Report
Pennsylvania. October 7,2002
1995 Mitsubishi 3000GT Coupe 2D
._ -K .
~ ,~~ '" .F:'"''''
. .;.::
Buy a New Car
Buv a Used c..qr
List Your Car fO,r_5a1e
Online
Free lemon Ch~c:k
Financlno Q.uote
Insurance Q!.!.Qte.
Warranty Ouot~
Payment Calculptor
Engine: V6 3.0 Liter
Trans: 5 Speed Manual
Drive: Front Wheel Drive
Mileage: 124,500
Equipment
Air
Conditioning
Power
Steering
Power
Windows
Power Door
locks
Tilt Wheel Premium
Cruise Control Sound
AM/FM Stereo Dual Front Air
Cassette Bags
Dual Power
Seats
Alloy Wheels
Consumer Rated
Condition:
Fair
"Fair" condition means that the vehicle probably has
some mechanical or cosmetlc defects, but is still in safe
running condition. The paint, body and/or interior need
work to be performed by a professional in order to be
htlp:Jlwww.kbb.comlkblki.dIlJkw.kc.ur?kbb.P A:769086;P A041 &17011 ;t&39;Mitsubishi; 1 ~.. Ion 12002
.
.
10/0712002 04:26 FAX 2159222616
Kelley Blue Book Used Car Values
ROGER W IIAIN
@O~
Page 2 012
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sold. The tires need to be replaced. There may be some
repairable rust damage. The value of cars in this
category may vary widely. A clean titl~ hlstorv is
assumed. Even after significant reconditioning this
vehicle may not qualify for the Blue Book Suggested
Retail value.
.
Trado-In Value $3,545
Trade:-in value represents what you might expect to
receive from a dealer for this consumer owned vehicle.
Keep in mind that the dealer must then absorb the cost
of m<llking the vehicle ready for sale, advertising, sales
commissions, arranging financing and insurance and
standing behind the vehicle for any mechanical or safety
probllems.
.
.
f ~ BLue 800JI; 'WU.1,tE
. FEE.DILICK
Get iOI~rivate Party Value
Get Invoice & MSI3.P on New Cars
.
Copyright @ 2002 by Kelley Blue Book Co., All Rights Reserved.
Sep.Oct 2002 Edition. The information in this report was printed
from the Kelley Blue Book Web sIte (www.kbb.com) and Is
intended for the personal use of the customer only and may not
be sold or transmitted to another party. We assume no
responsibility for errors Qr omlssions.(v.02091)
.
.
I
xpert advice
.
.
b1tp://www.kbb.comlkblki.dllJkw.kc.ur?kbbJ.A;769086;PA041 &17011 ;t&39;Mitsubishi;1 ~... 101712002
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Kelley Blu,~ Book Used Car Value$
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ROGER W MAIN
I1li03
Page I of' 2
. DO your NEW CAR homework
Blue Book Private Party Report
Pennsylvania. October 7,2002
1995 Mitsublshi 3000GT Coupe 20
. . .
""', --.., h
-. -
",-.,00;;'" ~- ~.
. _ t-,- ...$_
,,-. 1;-.
Buy a ~ew Car
Buy a U$ed Car
list Your Car por Sale
Online
free Lemon ~,hecK
Finane/no Q.u..Qte.
Insurance Ql).Qtg,
Warranty Ouote
Print "Ear Sale" Sign
Payment Cak;ulator
.
. .
Engine: V6 3.0 Liter
Trans: 5 Speed Manual
Orlve: Front Wheel Drive
Mileage: 124,500
Equipment
Air
ConditIoning
Power
Steering
Power
WIndows
Power Door
Locks
Tilt Wheel Premium
Cruise Control Sound
AM/FM Stereo Dual Front Air
Cassette Bags
Dual Power
Seats
Alloy Wheels
Consumer Rated
Condition:
Fair
"Fair" condition means that the vehicle probably has
some mechanIcal or cosmetic defects, but Is still in safe
running condition. The paint, bOdy and/or interior need
http://www.kbb.comJkb/lc:LdIJJkw.kc.ur?kbb.PA;I39%6;PA041&1701 1 ;p&722;Mitsubishi;... lOn12002
.
.
lu,or/2VC2 U~:~6 PAX ~1~~i~~Bi8
Kelley Blue Book Used Car Values
kOGER II' It..l.1N
IilI04
Page 2 of2
.
.
work to be performed by a professional in order to be
lOlQld, 'The tires; need to pj;} rj;}pl;!lced. There ml!lY be some
repalr'able rust damage, The value of cars in this
category may vary widely. A clean title hlsto..n Is
assunned. Even after significant reconditioning this
vehicle may not qualify for the Blue Book Suggested
Retail value.
.
Private Party Value $5,700
Private Party value represents what you might expect to
pay for a used car when purchasing from a private party.
. It may also represent the value you might expect to
receive when selling your own used car to another
private party.
.
t l. DLU~ IIO:OK V"I.U~
. FEBlIUCM:
Get l!l.Us~d Car Trade-In Value G~t Invoice &.I'1SRP 01'1 New Cars
.
.
Copyright @ 2002 by Kelley Blue Book Co., All Rights Reserved.
Sep;'Oct 2002 Edition. The information In this report was printed
from the Kelley Blue Book Web site (www.kbb.com) and IS
intended for the personal use of the customer only and may not
be sold or transmitted to another party. We assume no
resporlsibflity for errors or omissions.(v.02091)
.
I
~, > "
_. . .00 your NEW CAR homework
.
.
http://www.kbb.comJkblki.dll/kw.kc.ur?kbb.P A; 139966:P A041&1701 1 ;p&722;Mitsubishi;... 101712002
.
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DUPLICATE COPY
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JAMES A FURJANIC
96 DEERFIELD RD
CAMP HIll PA
17011
CITIBANK
1'.11. 1I11X 11117
S HACKENSACK, NJ
USA 07606-8117
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10/26 9DKSK4"9
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PAYMENT THANK YOU
BURLINGTON COA00000984 NORTH BRUNSWI NJ
YARDLEY INN YARDLEY PA
UBERS TIRE SALES AND S CAMP HILL PA
PURCHASES"FINANCE CHARGE"PERIODIC RATE
Receive your bills online from anywhere.
With Ci~ibank(R) Bill Manager! you ~ecqiv$, r~viewp
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INTERESTED IN RECEIVING INFORMATION ABOUT
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DEALS AND SERVICES! SIMPLY VISIT
WWW.EMAIL.CITIBANKCARDS.COM. GIVE US YOUR EMAIL
ADDRESS AND WE'lL KEEP YOU UP TO DATE!
._ Amount Du.
A('cmlnt 9l.lmmllty
Previous
Balance
.
r\1!"(h~o;;ps
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115.50
255.00
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Cardmember Statement
a...Com~ON.lJNEACCESStayaurA~ v-.,~
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FIRST USA 5ANK, NA
P.O. BOX 15153
WILHINGTON DE 19886-5153
1".111,1..1..1,1..1..11...1.1....11.1.1...11111..11
JAMES A FURJANIC
96 DEERFIELD RD
CAMP HILL PA 17D11-3469
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1~14-24S-3673 (OUTSIDE, US) oA1leo:lLett
1~4C6-J301(S1 Elpml111)
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1".0. BOX 15153
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BILLING INQUIRY
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CARDMEMBER ACI'IVlI'YSUMMARY
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12/2' '2'2D 2A69:216PK.OOBKl.YD6 AOL'"ONLINESER.V1CE.l~O SOo..679.~VA 2l.95
t2l15 12I1~ 2464000PJA60P4TEE ~a CHECK WILMINaTCN DE: '2,f;l2.00
IVI!> IV1~ -FINANCE CHARGE- TRANSl\CllON FEE 50'"
0lI03. OJ'"~ 744171203014A9KK!> PAYMENT. THANK YOU 3S0.00CR
OJ/IO OJ/IO PERIODIC RATE -PINllNCECHARGE- 3.1.9&
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This Statement is a Facsimile - Not an Original
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Thank you for continuing to use your Bank One
CreditVOIDe vVOI&latVOlOe have built with you
and your continued business is important to us. Please let us
know if there is anything we can do to service your account.
.
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COMPUTBRSFOR COLLBOBI $1'UDENTS AND PAR&fTS, APPLY BY PHONE
1-888.ilJ6~..2f70 OR. VISIT OUR. WlB S1TEATWWW.EDUCATIONONEtCOM
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This Statement is a Facsimile - Not an Original
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HEHBEj~S 1ST FEDERAL CU
?~ ~~x ~9 - ~xs~ '
MECHAINICSBURG PA 17055-0040
-~fZ]
023236.01.01 Jl
I CARD NUM8E~
4287 5900 0036 4451
PLEASE SUBMIT ADDRESS CHANGES ON THE DETACHABLE ENVELOPE FlAP ONLY. lliF~AYMEl/Tm
ctOSINQOATE'(~1 f'n""NEWBAlANCe~.;'~1 i .MINrMUMPAVM....,- I IpAVM....,-oueOArel $ ill' --
12/15/100'. 1864.52" 38.00 01/09/01 .
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1,..III...III,",.,II,.,III..I..I..i.Il.,I.I..I.I.,.II.,I..I,1
CAROL A FURJANIC
JAMES A FURJANIC
96 DEERFIElD ROAD
CAMP HILL PA 17011-8469
MAXE CHECK PAYABLE TO:
1.1,1...11.1...11I...1...1...11I1....1..1,1..11.1..1
VISA
PO BOX 77044
MADISON
WI 53707-1044
44 4287 5~00 003b 4451 00003800 0018b452 7
.. __~ RE;!1}flt-J THISfO~.m~l?!JF:lg.r.I3Q!"FfI.9B~IT
._ __ [)() NOT STAPLE CHECK
'Clog,. b'~. 1'.-""-''''<' CA . NUMB." '~''''".''' 11..."CReon:~'1
NG ,'IJ::.-...'S ,_ "0'_" ..... _R!?,.._. R"",~ ....'~,..'~ '.~" UMIT - ,
12/15/110 '.!;; 4287 5900 0036 4451 11000
SEND '~UIRIES TO:
CUSTOMER SERVICE
PO BOX 30495
TAMPA FL 33630
9135 (717) 795 6032
",'";- RE":E~~MiMeEFl~-;' :'-,
'~--:""DESCFuI'oTION
I\MOuNr
. ..,'.-.
CAlII' HILL PI.
244550111323032411247945 7299 11 20 i. 1& LA WEIGHT LOSS CENT
CAMP H~LL PI.
240462411337033890049136 . 5399 12 04 2 02 NEWS CENTER WEST ~N
LEIIOVIIE PA
243017203~a980064604247 5947 12 04 2 02 L~GHTN~NG BUG
NEW CUHBERLAH PA
24121260339000i60613556 5719 12 05 2 03 OLDE FARMHOUSE SHOPPE
HALIFAX PA
2439900(1340i'96050~01839 5999 12 06 2 04 BATH&80DY 00000507
CAllI' H~LL PI.
2439900CI34821ii40~42472 5999 i2 86 2 04 P~ER 1 1211 000011409
CAMP Il~LL PA
2439900113412iii40340152 5999 12 87 :1 oi P~ER 1 1211 000011409
CAMP H~LL PA
---------..----~----------~ ---- PAYME S. AD STHENTS AND OTHERS ------------------
742S75911333001005243741' 0000 11 28 1 2S AYHENT RECE~VED .. THANK YOU
YOU HAVE EARNED t1.S7 tM CASHBACK $0 FAR tHXS YEAR!
. ;" . . .
. . . . .
TO REPORt ;. LOST OR STOLEN CARD PLEASE CALL,
aOO-321i-1l678..,..c..UT STUI-I.FTER HRS __.___~__.___ 'c..____.___ ...- ..
717-795-6032 . HEMBERS 1ST F.C.U.
TO OBTAII! AC~ INFORMATION 24 HOURS A DAY CALL.
800-299-91142 . '"
. . . . .
YOUlt CREDIT CARD ACCOUNT INFORMATION ~S NOW ONL~NE!
V~SlIT IIlIII.HEHBERS1ST .ORG TO V~EW ACCOUNT AND PAYMENT SUltHARY
FROII THE PR~VACY OF YOUR OWN PERSONAL COMPUTER.
. . M . . . .
FOR tilE IIEW YEAR, UsE YOUR SCOREcARD '- THE CARD THAT C~VES YOU CASHDAck.
399.20
18.51
25.42
31.47
10.60
55.29
61. 33
100.00-
, ,
- CORRES :0~ F1NANCE. ,ANNUAL ACCOUNT ,.
~ _A~ _.:.~ ~._tt.... CfiARaG ~ _I ~si~AliE FlAft sUMMARY' ,~""~ '''T
~ 7. PREVIOUS 8Al.ANCE; _ 1
MINIMUM 'AYMfiNT l'imoHA8u~;r;':' 625,81
CASH -Mhx- 0.00
" PAST DUE _ - CREDmI: ~.)",,"f;--""'- 0.00
PAVMENTiF"",~'- 100.00
OVE:mJMJT ANOFEES lNSURANCe.':;-~~';.:.. 0.00
OTHER CHAMES 0 . 00
o L TOTALMINPAYMEftlT ~~~~.~.E_. 20
NEW iW.ANCE~~.J;",'
FINANCE CHARGE CALCULATION ETHOD~ CREDIT CASH ADVANCE, A
.SEE REVERSE SIDE FOR eXPlANATION . .
NOTE: IF YOU HAVE A VARIABLE RATE ACCOUNTTHE PERIODIC RATE AND ANNUAL peRCENTAGE RATE (APR) MAY VARY.
NOTICE! SEE REVERSE SlOE FOR IMPORTANT JNFORMAnON AND 91LUNO RIGHTS SUMMARY MAY. 1996
28
23 IRA deduction (see page 27} .
24 Student loan interest deduction (see page 28) .
25 Archer MSA deduction. Attach Form 8853 .
26 Moving expenses. Attach Form 3903
27 One~half of self.employment tax. Attach Schedule SE
28 Self -employed health insurance deduction {see page 30}
29 Solf.omployed SEP, SIMPLE, and quellllad plans
30 P(malty on early withdrawal or savings
313 Alimony paid b Recipient's SSN ...
32 Add line~ 23 thmugh 318 .
33 Subtract line 32 from Une 22. This is our ad O5S income
For Disclosure. Privacy Act, and Paperwork Reduction Act NotiCe. see page 72.
. ~ 1040
Label
{S(~ l
instructIons A
.
. on page 19.) E
Use the IRS l
labet H
Otherwise, E
please print .
or type. E
Presidential
Election Campaign
. ISoo Oft 19.1
Filing Status
Check only
one bOle
5
,. 6a
Exemptions
b
c
Jf mom than six
S dnpcndcnts.
see page 20.
.
Income
Attach
Forms W-2 and
W-2G here.
Also atUich
Form(s)1099-R
if tax was
withheld.
.
Jf you did not
get a W-2,
see pnge 21.
.
Enclose. but do
not attach, any
payment. Also,
ploAse use
Form 1040~V.
.
Adjusted
Gross
Income
.
.
IRS 1J1ioU OI~1 -On .lot \\Irllg Of Maple trI this S .>Ilel!,
,20 OMS No, 1545-0074
Your 'Social security number
;?, ~: .l": /.2.""
Spouse's social !l9Curity number
/. .'-; 3 y; a ,~
. important! .
You must enter
your SSN(s) above.
You Spouse
Dves ~(., Dves DNo
Single
Married filing jaint retum (even if 'Only one f1ad incamel
Married fillng Sflparate rmum, Enter spouse's SOCiA! security 1"10 above and fuJJ name here .... tAIf'_~i A. r~ "...'./~ ~...;, '~-
Head of hou~ehold (with qUAlifying person). (SeA page 19.) Ifthe qualifying person is n child hut not your depenrlr'!Pt,
enter this child's name here, ....
Qualif In widow{er with de endent child ( ear souse died .... ). (See a e 19.)
Yourself.lr your parent (or someone else) can claim you as a dependent on his or her tax}
return,donotcheckbox6a . . . ... . . . . ... .
S
1<-'
, ~
Depmtol!'lot ul ttle Trellsury-lntarnHI R(-!venue Service
U.S, lndividualln<lome Tax Return
For the year Jan. 1.Dec. 3-1, 2001, or Other tax ytiar oogmn'ing
Your frrst name and initial last name
,- --
~(Q)01
I""
,2001. ending
u .' .-;414// C-
last namp.
Home address (number and street). " you hav~ a P.O. box. see page 19,
- ,- "~",(j) R[).
City, town or post office, state. and ZIP code, f you have a foreign address, see page 19.
'1', IL (. J ')?' II
Note. ecking nYes" will nO< change your tax or reduce your refund.
ou, or Our S OU.SQ If flUn a oint return, Want $3 to 0 to this fund?
Apt. no.
."
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pause . , .
Dependents: (2) Dependent"s (3) Oependem's (4l,~:rqua,:irying
socfafsccuritynumber relationship to childf(l(chlldtax
(l)FlrftIOarn& LaSlflame "'u I ''.<!!!It:r.1!!J-
0
0
: 0
0
.. 0
d Total number of excm Ions claimed
7 Wages. salaries, tips, etc. Attach form(s) W~2
8a Taxable interest. Attach Schedule B if required
Tax-exempt interest. Do not include on line 8a
Ordinary dividends. Attach Schedule B if required
Taxable refunds, credits, or offsets of stnte 'and local income taxes (see page 22)
Alimony received
Business income or (105::;). Attach Schedule C or C.EZ .
Capital gain or ~OSS). Attach Schedule 0 if required. If not required. check here'" 0
Other gains or ~osses). Attach Form 4797 . .........."
Total IRA distributions . ~ L-J b Taxable amount {see pilge 23}
Total pensions and annuities ~ LJ b Taxable "mount (see page 23)
Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E
Farm income or (loss). Attach Schedule F
Unemployment compensation " . . . . . . . . .
'Social security benefits . I 20a I I b Taxable amoum (see page 251
Other income. List type and amount (see p8_ge 271 _"._____.-__________nn.-______"..
Add the amounts in the for rl ht column for lines 1 thrau h 21. This is ourtotallnc.ome"
23
24
25
26
21
28
2
30
31.
b
9
10
11
12
13
14
15.
16a
11
16
19
20a
21
22
8b
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Cat.. No. 11320B
"'
"
,.., '-~_Ik
No. flfbowes
checked on
6a and 6b
No. of your
children 00 6c
who:
. Ilv/lodwlth yOIl
. dkl not live with
)'OUdU9to divorte
or separation
(see pago 20)
Dependenls on lie
nol enl1m!d above _
Add numbers [l]
entemd on I
lines above lit '
-'--' .;r<;"" )::.,..
].::> <1..'1
9
10
11
12
13
14
15b
16b
11
16
19
20b
21
22
I\"7
. -;
Fonn 1040 12001)
Payments 59
60
61.
b
62
63
64
65
66
Refund 67
Direct ISa
deposit? See .. b
page 51 and
fill In 68b. ~ d
68c, and Bad. 69 Amount of line 67 uwant liicito our2002 tax'" 69
Amount 70 AmOunt you owe. Subtract tine 66. from IIne- 58. For details on how to pay, see page 52 ...
71 Estimated tax em:llt, ,Also include- on Une 70. . .' 71
Do you want to allow another person to discuss this return with the IRS {see page 53)1 0 Yes. Complete the following. 0 No
.
Form 10-10 (lOOl)
.
Tax and
Credits
Standard
DedUCltion
fUf'-
. People who
checked any
bo~ on linp.
35a or 35b or
Wl10 enn be
claimed f.lS a
(jf~pendent.
see page 31.
. All others:
Single,
'&4.550
Head of
household,
16,650
MmrifldfJIing
jointly or
Qualifying
widowfer).
'P . 600
M.arried
filing
separ<ltely,
L $3.BOO
.
.
"
Other
Taxes
.
If you have a
qualifying .
child, attach
Schedule EtC.
"
.
Third Party
Designee
Sign
Here
""''IISIIllUI1i
~;"-'~."
"~-, ~
'"-.,
1i;.1iwa.a.
-~.~ Ii"j'
,- ,J"',......~ }~~:
34
35.
b
36
37
38
39
40
41
42
43
44
41
46
47
46
49
50
51
52
53
54
II
56
57
58
Amount from line 33 (adjusted gross income) " _' " ...
Check if: 0 You were 65 or older, 0 Blind; 0 Spouse was 65 or older.
Add the number of boxes checked above and enter the total here .
If you are married filing separately and your spouse itemizes deductions, or
yo~ W6fft a fhJ"!~li~lUl $ll~", M~ JiUtJP ~l\ fJ",tI !l~Bf~", t,tim . , . . . . ill ... Q
itemized deductions (from Schedule A) or yout standard deduction (see left margin) . .
Subtract line 36 from line 3" .
If line 34 is $99,725 or less, multiply $2,900 by the total number of exemptions claimed on
line 6d. If line 34 is over $99,725, see the worksheet on page 32 .
Taxable income. Subtract line 38 from line 37. If line 38 is more than line 37, enter -0-
Tax (see page 33). Check If any tax is from a 0 Form(s) 881" b 0 Form "972
Alternative minimum tax (see page 341. Attach Form 6251 .
Add lines 40 and 41
Foreign tax credit. Attach Form 1116 If required .
Credit for child and dependent crlre expenses. Attach Form 2441
Credit for the elderly or th~ dl!9abled. Auecl1 Sc:hedum R .
Education credits. Attach Form 8863 .
Rate reduction credit:. See the worksheet on page 36.
Child tax credit (see page 37) . .
Adoption credit. Attach form 8839 0
OUler credits from: a 0 Form 3800
cO Form 8801 d 0 Form (specify)
Add lines 43 through 50. These are your total credits
Subtract line 51 from line 42. If line 51 Js more than line "2, enter .0- 0
Oalind.
o ... 35a
43
44
46
46
47
48
49
b 0 Form 8396
50
Self-employment tax. Attach Schedule SE 0
Social security and Medicare tax on tip income not reported to employer. Attach Form 4137
TAlC ClI'I quoUfl"'d plan., 1rn;ll.Idlng lRA-fl, Md dthlit t.lC.fQ~d t;t:t;ountt, AtUlcl1 f:Qfm ~329 If l'tKluirOd
Advance earned InC()tne credit payments from Form(s) W-2 0
Household employment taxeS. Attach Schedule H
Add lines 52 throu h 57. This is ur total tax ....
Federal income tax withheld from Forms W~2 and 1099 0
2001 estimated tax payments and amount applied from 2000 return
Earned Income credit (ElC) . . 0 . .
Nontaxable earned income . t 61 b I
Excess social security and RRTA tax withheld (see page 51)
Additional child tax credit. Attach Form 8812 .
Amount paid with request for extension to file (see page 51)
Other payments, Check If ~i>m . 0 Form 2439 b 0 Form 4136
Add lines 59, 50, 613. and 62 throu h 65. These are ur tmal
,-r:r
PafJe 2
f~ '""'-;7
..
38
39
40
41
42
I J b '" (
.
Joint return?
See p.ge 19,
Keep a copy
for your
records.
.
Paid
Preparer's
Use Only
.
t..~ C_'
~,). 7'
I " (, I
."
51
52
53
54
66
56
57
58
}I ? t. I
J -
Designee's Phone Personal identification ~
name ~ no. ... () numberlPIN)", ~
Under penalties of perjury, I declare that I have examined this return and accompanying s~ules and statements., and to the best of my knoWledge dnd
belief, they are true. correct. and complete. Peclaration'of preparer (other than t/ll(payer) i$ based 01'1 all information of Which preparer has any knowledge.
/.~ Date Your occupation
/ ~.J-4-<-t...-- ; 0;
a joint n, both must s~gn: Ontc Spouse's_ occupation
Preparer's,t..
signature'
Firm's namf! (or ~
yours if self-employed), ,
address, nnd ZIP code
Date
Check if
sclf-empto dO
EIN
Phone no.
Form 1040,,001)
Oepaflment of the Treasury
Internal Revenue Ser)lk:e ,199)
Name(s) shown on Form- 1040
~ /Uti'S
Medleal fll!llllan, lla nllllrr.lyda 8""""...,almbY_ ., iIlIid ~y am...,
and 1 MediCal and dental expenses (see pa e A,2) , , ,
Dental 2 Enter amoum from Form 1040, line 34, 2
Expenses 3 Mukiply line 2 above by 7,5% (,075), . . . ,. 3
4 Subtract line 3.from line 1. If line 3 is morn than line 1. enter ,0,
5 State and local income taxeS , . 5
& Real estate taxes (see page A,Z) , . . ' , " &
7 Personal property taxes. , . . , , , . ,. 7
8 Other taxes, List type and amount ~ ,..."...,.."......
~ AdciiinesS'throii'ti'ii:---'-":":''':'':''':'':''''-'':'':''.
'tI''''''lil 10 HIlIi'HI ffillrnlilllllt\iIIi'lIlIlhd P/llhlll NlIlllflld III ~y IlIl Flltm lQ.g
You Paid 11 Home mortgage interest not reported ro you 011 Form 1098, If paid
(See to the person from whom yoo bought the home, see page A.3
page A.3,) and show that perl;on's name. identifying no.. and address ~
". 1f4.1lIJ~~-
It
SCHEDULES A&B
(form 1040)
.
It
Taxes You
Paid
{See
page A.2,}
.
.
Note.
Personal 12
interest Is
not
deductible. 13
1
Gifts to 15
Charity
If you made a 1&
gift and got a
benefit fOr it. 17
see page A~4. 18
.
.
Casualty and
Theft losses 1 ~
Job Expenses 20
and Most
Other
Miscellaneous
Deductions
.
21
(See 22
page A-5 for
expenses to
deduct here.)
.
23
24
25
26
Other 27
Miscellaneous
Deductions
Total 28
Itemized
Deductions
"~
,..... '" ~ ~d
.
"' ,.". " ~~...=. - 'I'
~""""'~",iltii-
Schedule A-Itemized Deductions
(Schedule B is on back)
OMB No. 1545-0074
. Anach to Form 1040. . 5eelnstructlons for Schedules A and B (form 1040).
~@01
Attachment
S 'uenee No. 01
Your social security number
"",,;l. : 3'0: -, .J-v .
7-6.
11
Points not reported to you on Form 1098, See page A-3
forspecialrules. . . . , . _ . . . . . .
Investment interest Attach Form 4952 if required, (See
page A,3,) . . . . . . . . . . . . . .
Ii
Gifts by cash.or check. If you made any gift of $250 or
more, see page A.4 . . . . . . . . . _ .
Other than by ClIsh or check. If any gift of $250 or more,
see page A.4, You must attach Form 8283 if over $500
Carryover from prior year . . . . .
Add lines 15 thtou h 17, . . . . . . . .
12
13
,Ol.,
, 3 '7(./
IT10
CasYOI or theflloss(es), Attach Form 4684. (See
Unreirnbursed employee expenses-Job travel, union
dues, job education, etc, You mUst attach Form 2106
or 2106.EZ if requiled, (See page A.5.) ~.........m...
'..2'.."'.,.."....-.............-....'...-..;;....'......,.
.. I."!'iMI.. al.f.1i! k, _:.: .8.'.<..:( aK!i'. .~.. .1.'),.f1..".....
Tax preparation fees ';.;,..". /.'~#II:~. . . .
Other expenses-lnvestment, safe deposit bOx, etc. List
tyP<1 and amount ~......................___.___...........
. ;JJ;.1.. .s;.~~",!l.:,,: &. s !o.t!t.~ i. ~.f?Jdf~f(~~/Jft....
Add lines 20 through Z2 . . . . . . . . . .
Emer amount from Form 1040, line 34. 24 It. . ~
Mukiply line 24 above by 2% (,02),
Subtract line 25. frtlm line 23, If line 2 is more than line 23, enter .0.
Other-from list on page A-6. List type and amount ~ .............---.............
p
......,..............................---.......--...................-.-.....................
Is Form 1040. line 34, over $132,950 (over $66.475 if married filing separately)?
o No. Your deduction is not limited. Add the amounts in the far right column }
for IiMs 4 through 27, Also, enter this amount on Form 1040, line 3G, . ~
~es. Your dedUction may be limited. See page A,G for the amoont to enter.
.
For Paperwork Reduction Act Notice, see Fonn 1040 instructions.
Cat. No. 11330X
Schedule A (form 1040) ZOOl
.
--- -
- -- "~- ,. "'
.
Fmm 2106..EZ
Un reimbursed Employee Business Expenses
~@01
Department 01 t/':te Treasury Attachment
Internal Ravenue ServiCe (2) .. Attach to Fonn 1040. SeQuence No. 54A
Occupation in which you incurred expenses Social security number
,-Af>le /~A"'I '-' ~es Ac>.'3..: '1)0)
. Vou May Use This Form Only if All of the Following Apply.
. Yay are ari employee deduCtinll' 'K!)en... litlrlillwlillllll III Yllyr 11111.
· You do not get reimbursed by your employer for any expenses (amounts your employer included in box 1 of your Form W-2 are
not considered reimbursements).
· If you are claiming vehicle expense, you are using the standard mileage rate for 2001.
Caution: You can use the standard mileage rate for 2001 only if, (a) you owned the vehicle and used the standard mileage
. rate for the first year you placed the vehicle in service or (b) you leased the vehicle and used the standard mileage rate for the
portion of the lease period after 1997.
;~__"U......,
<-'1 ,
HoliIiIIII
-, - --'X'-g_~k1i
OMS No. 1545-1441
mrm
Figure Your Expenses
1 Vehicle expense using the standard mileage rate. Complete Part II and multipy line 8a by 341'2", . ~ ..' ~.,'
(,cdl -
, , , , , , , , , , , , , , ,
2 Parking fees, tolls, and transportation, including train, bus, etc., that did not involve overnight ~,s
travel or commuting to and from work 2 ~
3 Travel expense while away from home overnight, including lodging, airplane, car rental, etc. i {3.r
Do not include meals and entertainment 3 -
4 Business expenses not included on lines 1 through 3. Do not include meals and entertainment 4
5 Meals and entertainment expenses; $ I. q "fg'" x 50% (.50) (Employees SUbject to
Department of Transportation (DOT) hours of service limits; Multiply meal expenses by 60% 5 17;1 10
(.60) instead of 50%. For details, see instruCtions.) .
6 T"tIll.lIil1.II.... Add linea 1, lhrough $, linter hero and on 1111.,10 Of Sohlldlilll fA, (Fllfm 10411).
(Fee-baSis state or local gOVernment offioials, quamled performing artists, and Individuals with ~jS;J SO
disabili\ies:, See the ins\ruc\loJ'\S for ~Decial rule,S on where 10 enter Ihis amount.). . . . ' 6
.
.
. lmII, Information on Your Vehicle. Complele this part only if you are claiming vehicle expense on line 1,
7 When did you place your vehicle in service for bUSiness use? (month, day, year) ~ ..j~... I ....1...... I .<:l..&....
8 Of the total number of miles you drbve your vehicle during 2001, enter the number of miles you used your vehicle for:
a Business ....../4/..":7..::)...-:.-::...... b Commuting ......,Q,./.y~...h.... c Other .....If.-:;.H.?.2..........
9 Do you (or your spouse) have another vehicie available for personal use? , . . . . c:rYes 0 No
10 Was your vehicle available for personal use during Off-duty hours? B"Ves 0 No
11 a Do you have evidence \0 support yout deduction? . . ~s 0 No
b If "Ves,' is the evidence wrltl,en? . ....... L:rTeS 0 No
Purpose of Form
You may use Form 2106-EZ instead of Form
2106 to claim your unreimbursed employee
business expemses if you meet all the
requirements listed above Part I.
For Paperwork Reduction Act Notice, see back of form.
.
General Instructions
Section references are to the Internal
Revenue Code.
.
A Change To Note
The standard mileage rate has been
increased to :';4'h cents for each mile of
business use in 2001.
.
.
.
Recordkeeping
You can,!ot, deduct expenses for travel
(including meals, unless you used the
standard: meat._ allowance), entertainment,
gifts. or use of . Car or other listed property,
unless you keepracords to prove the time.
place, busfnllllSPurpose, business
releilonshlp (for entertainment and gifts), and
amounts of these expenses. Generally, you
must also have reeel!)ts for all lodging
expenses (regardless of the amount) and any
other expen$e of $75 or more.
Cat. No. 206040
Additional Information
For more details about employeB business
expenses, see:
Pub. 463, Travel, Entertainment. Gift, and Car
Expenses
Pub. 529, Miscellaneous Deductions
Pub. 587, Business Use of Your Home
(Including Use by Day.Care Providers)
Pub. 946, How To Depreciate Property
Form 2106-EZ (2001)
.
.
.
1 Wages, tips. other eomp 2 Federal income tax wilhheld
m83.15 13960.76
3 Social security wagC!s 4 Social security tall" withheld
m83.15 4797.76
5 Medicare Wilges and tcps 6 Medicare tax withheld
m83.15 1122.06
b Emplll}'f!! Idef\lifit~lion number d Ell\lIloyell's SClcial security number
23-2108853 202-36-7201
~pToy8(S:Il;lme, address, and ZIP code
America Service Group
Prison Health Services, Inc.
105 Uestpark Drive, SUIte 200
Brentwood, TN 37027
" ,
\ 1 Sor;(~\ sec\lnty tips 8 Allocated tlps
,
9 Adv3rlce EIC payment 10 Dependent care benefits
~ 11 NOflquallfiea plans 12a See instruclionsfor box 12
I,. '''.'''r;~ '... ; I, "M,..
. '~'I" r=r '''"I
',_L," ,
i 140lt1er c12c
I :1
c12d
:1
e Employee's fIrst nama and initial Last Name
JAMES ALAII FURJANIC
96 DEERFIELD RD
tCAMP HILL, PA 17011
f Employee's ~dd~ss and ZIP code
15 Slate Emploven 5la,te IDnumber 16 State wages, tips, ele.
PA 113328095 m96.55
m~te mcome tax ,. local wages, bps, etc.
2164.29 11055.20
i19 local Income tax 20 Locality name
~ 436.26 PAPhIJadel........Cky...Re
-2 Wage and Tax Statement E!UUJo 01ll8No'5.(5.0oo9
Copy C ~r EMPlOY",S RE.COROS.ISIl''' NOCk!eta ~IOV'" on back of
Copv CI. Department of the Treasurv . Internal Revenue Service
.
.
.
2001
Year To Date Earnings
.
,~
<< "~:il1 1!i.~,'
Year To Date Deductions
,.ProBus/ness
Pretax Health Plan
Pretax Dental Plan
Pretax EE Life 2X
~.... Term D; .....it lty 8011
Group Tenm Lffe>$SOOOO Offset
ASGPHS-104
SOCia! Security NO
202-36-7201
Salary
Retroactive Pay
tlol iday Pay Non-worked
paiel lo.eve
Group Tenm Life> $50000
005-001876-17011
JAMES AlAN FURJANIC
96 DEERFIElf) RD
CAMP HILL, PA 17011
74844.92
287.20
1634.60
11107.69
86.60
MantaISl:al:us:
Married
Exemptions/Allowances'
Federal: 2/0
Resident State 2/0
286.71
58.33
432.82
980.40
86.60
-
-
Th\~ information is be\nglufnrshed \0 the Internal Revenue SeNICe If yO\! al"e requiTed to file a tax Tetum. a
negligence penalty or other sanctron may be imposed on you rfthis Income is la"able and you fall to report It
"-
"I
.~.............~
LJiitif' c_ _l~;~~
~ ill......""""""".....- , 0
Em 10 ~
JAMES FURJANIC
C.ode
ASGPHS
Pavxrout>
1
Earnin s
Salary
Paid Leave
Grou Term Life >. $50000
Total Gross
Rate
33.6500
Id
~o3328
Stalus
-36,7201< Married
Division I Department
PHS11 0102
Taxes
Federal Incom'lT""
SocIal SecUIl\Y(FlCA)..
Federal Madl""".' .
PennsyIV""lilIncOma Tax. .'
Philedel hla .C' N, R.. Phil
Total
PreTax Deductions
PrelaxHila1th.' PIIIfl .
Prelax 0811181 PI<!ri
ptetax EELIfel!X.
Total
.-
10.00
AfterTax Deductions
Long T arm Disability 50l(,
Group Term L1fe';$50000 0Ifsel
Total
Net Pay
.
io.oo
,
11ll14.22
(;Ud;.' ~o
- I
tv e.+- -to
-
5475.90
2335..35
546.17
. 1053.88
1507.39
10918.69
219.96
39.91
327.06
!88.1I!
637.13
27.56
664 . 69
Exem lions! Allowances
US-Sup p
NumlX'.T
00165920
Hire Dale
0110801
Period Start
0618/02
Period End
06/29/02
pa Irdlc
07/12/02
Memo Entries Currenl Year To Dale
SId HourS 'Accumulator - Salary 1040.00
CurreD[ Year To Date
we a.- W_32IIO.40 37887.01
tvo~K.pp
},4)
/lJOJ1) - rl< /
~/{ ;:,"/</,P"; '54C- IJe'J"< f, M <4-
C>,o ;. lOG T te S - ", ff/ZvlC
130 c .14.J~eK : 'i. '7, ~oo ~'-r'
f-I,~?- - r J"t, 'Jew')..
f.,( ).'YotJ. ~ -a 3~" ,;2 5 ?, . "1.c. ...
fo/1'IIJ~ .)7, 335. <71 - /,'100.'-
~ Jj) ,135,p
America Service Group - 105 We;tpark Drir' Suite 200 Brenlwood, TN 37027
I.
.
.
.
"ProBuslness
H
. ~ " . .
~ .-.
........-,.
~'=.I.....
6.","" .. I
,.- 'liJlii.iiiIiJliiWIi
m~~~'
,-
I CHECK NUMBER SEa. NUMBER I
. 01437229 BENEFIT CHECK 001105
~-
OlaIMant'. Na",a e.., .... Acol, No, WII.k 1 ! ""'cunt W..k . Amololnt OffIC. PQM
JAMES A FURJANIC 202-36-7201 09-14-02442.00 09-21-02 442.00 0996 UC
INSTRUCTIONS Federal Withholding Tax I Cumulative Tax Withheld
This is your unemployment oompensation cMok for the benefit week(s)
. indicated on the check and above. If you are entitled to this oheck as OFFICE AOORESS
defined by the PA Unemployment Compensation Law. oarefully detaoh it LANCASTER UC SERVICE CENTER
at the perforations and cash promptly. It you feel you are not entitled to 60 W. WALNUT STREET
this check or the check Is for an improper amount, please return it to your LANCASTER PA 17603-3015
Jcb Center or UC Servloe Center, do not ca9h it.
..
Ilillll"ln~"111
TIPS FOR USING PENNSYLVANIA TELECLAIMS--PAT
. Know your social security number !lnd PIN.
· . If you are calling to file your claim, you may skip the menus by entering 1-3-1 Immediately after PAT answers your call.
. If you worked during the week you are claiming, know the amount of your gross earnings, holiday pay, vacation pay, or
if you were absent from work when work was available, the amount you would have earned if you had not been absent
from work. .
'Jl!i . DO NOT hang up until PAT tells you that your claim has been accepted or that your answers have been saved. If you
hang up prematurely, your clairn may not be flied proper1y.
· You can find out when to file your next claim by accessing the benefit payment Inquiry option. Immediately after PAT
answers your call, enter 1-2-1. your social security number and PIN, as instructed, and then 5.
. . After filing your biweekly claims for benefits, you maycall PAT the next day to see if your payment has been processed.
Generally, your payment will be mailed or deposited Into your specified bank account (If you have direct deposit) within
two buslness'days. DO NOT call your UC Service Center regarding your payment until 7 to 10 days after you have flied
for your benefits.
.
FOLD ON PERFORATION, THEN DETACH CAREFULLY
~L-\II :I:lt.......[.Itltll,'jl=~..:'.l.....'..I',IIJ..e:t.t..)..I:.:{.,~r(~:I'lilll".fl\!..:n.~~M 'l":I~It:':'.::I\lI.i:tI;H.'I:"'JIf'.'::I.'l~I'.:1Utl.:':I:lfhll.Il::l2..'.:ltfl:1
. 09/14/02$442.00 09/21/02 $442.00 0996 UC
W Kl
F
~~..
01437229
PAY f-iJlh. t Hund.1ted fl..... ghty
TO THE ORDEROF '. '. .
CHECK NO.
09/24/02
-
c:
.
o
o
<t
DATE
VOIO AFTER 30 DAYS
-
Q;
c:
<l>
co
'.
: ~';
. .l!**884. 00 I
/2 '.~.'~,c .~~.... .
&!!t1" ,
TREASURER OF PENNS VANIA
JAMES A FURJANIC.
96 DEERFIELD RD . .
CAMP HILL PA 1 701H34~9
.>-'",,:
I'."
jj
:~-~~rn/.'1'l;j~II~[<<Il:1"::.I:l:.O{'lat"I~j...'il"'I,,'.:l:I~'1l"':1~1-.......I'.~f.I..'tl'!:~:l:.lIll'.liU:{.I'II.:t'J..lINt1IIU..[C1:J.i"''''.:S:II;:....JU'..:S:h','.'_:I~
11"0 ~1.~7 2 2'111" .:o~ ~ ~o ~o 21.':
00000 ~oll' 088 I.
~.~~' >-.~. L
.".
.",,'
- ;;;.-'"'-~
'-'--IJ!!
.
,~ l' 040 Depa.rtment of the Treasury-Internal Revenue Service 6))((\\01
~ U.S. JndlviduaJ Income Tax Return ~\Q; IL)
IRS Use Only Do (lot write or staple in this space.
label
For the year Jan. 1-Dec. 31. 2001. or other tax year beginning
?Z,r'fi~oz. and inilial,4 Last na~ /J
'ira joint return. spo~use"s Ilr~t n~me qnt4 /1'lltlijl (...~llll1am~
,20
OMS No. 1545.0074
Your social security number
Ifs. i3ib6ft.
SPJiuse's saC,ial ''leu, rity nurn, ber
ll'$:/...~.r;"~~1
.
(See
Instructions
on page 19.)
Use the IRS
label. H
Otherwise. E
pl'taSe print ~ City, town or post office. state, and ZIP c~. If you have a forei n address, see page 19.
or~a t ~ ~
Presidential
Election Campaign ...
{See page 19.1 r
1
2
3
4
i
B
E
L
JANIe....
Home address (number and street). If you have a P.O. box. see page 19.
Apt. no.
A Important!
A
You must enter
your SSN(s) above.
.
5
6a
Note. Ch king "Yes" will not change your tax or reduce your refund.
Do you, or your spouse if filing a joint return, want $3 to go to this fund?
Single
Married filing joint return (even if only one had income) 4 __
Married filing separate retum. Enter spouse's social seourity no, above and full name "'ere,~ ~i.5 . h~dt/'.
Head of household (with qualifying person). (See page 19.) If the qualifying person Is a child but not your dependent,
enter this child's name here. ..
QuaIl ;og w;dow{er) with dependent child (year spouse died ,.,. }. (See page 19.}
Yourself. If your parent (or someone else) can cla;m you as a dependent on his or Iler tax}
return, do not check box 6a . . . . . , . . . , . . . . .
b 0 S
~
You Spouse
DYes ~ DYes DNo
.
Exemptions
Filing Status
Check only
one box.
c
pouse ...
Dependents: (2) Dependent's (3) Dependent's {41_~.ilQualilyjng
(1) First name social security number relationship to Chil1r~:.'~.~\
last name "OU credIt see e20
, 0
0
0
0
, 0
, 0
No. of boxes
checked on
6a and 6b
No. 01 your
children on 6c
who:
. Itvedwilh you
. did not live wilh
you due 10 divorce
or separatton
(see page 20)
Dependents 011 6c
notenteredabDve_
Add numbers [!]
enleredon
IlnesalJove....
$3 .s-y
.L
1&
If more than six
dependents,
see page 20.
. d Total numt:;ler of exemptions claimed
7 Wages, salaries, tips, etc. Attach Form(s) W-2
Income 8a Taxable interest. Attach Schedule B if required
Attach b Tax~exempt interest. 00 not Include on line 8a 8b
Forms W-2 and 9 Ordinary dividends. Attach Schedule B if required 9
W-2G here. 10 Taxable refunds, credits, or offsets of state and local income taxes (see page 22} 10
Also attach
.. Form(s) 1099-R 11 Alimony received 11
if tax was 12 Business income or (loss). Attach Schedule C or C~EZ 12
withheld. 13 Capftal gain or (loss), Attach Schedule 0 if required, If not required, check here .... 0 13
14 Other gains or (losses). Attach Form 4797 . 14
If you did not 15a Total IRA distributions . ti:J 8' b ~ax~bl~ a~ou~t (s~e ~ag~ 23; 15b
gel. W-2, 16a 16b
see page 2 '1. Total pensions and annuities 16a b Taxable amou~t (see page 23)
I 17 Rental real estate, royalties, partnerships, S corporations, trusts. etc. Attach Schedule E 17
Enclose, but do 18 Farm income or (loss). Attach Schedule F 18
not attach, any 19 Unemployment compensation . 19
payment. Also, 20. Social security benelits . I 20a , " b ~ax~bl~ a~ou~t (s:e ~ag~ 25) 20b
please use
Form 1040-V, 21 Other income. List type and amount (see page 27) .........................-.......... 21
22 Add the amounts in the far right column for lines 7 through 21. This is your total income ... 22
23 IRA deduction (see page 27) , 23
t Adjusted 24 Student loan interest deduction (see page 28). 24
Gross 25 Archer MSA deduction, Attach Form 8853 . 25
Income 26 Moving expenses, Attach Form 3903 26
27 One-haif of seif-employment tax, Attach Schedule SE 27
28 Self-empioyed he.lth insurance deduction (see page 30) 28
~ 29 Self-employed SEP, SIMPLE, and qualified plans 29
30 Penalty on early withdrawal of savings 30
31a Alimony paid b Recipient's SSN lII>- 31a
32 Add lines 23 through 31 a .
33 Subtract line 32 from line 22. This is your ad'usted gross income ~
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see page 72. Cat. No:12600W
.
SCHEDULES A&B
(Form 1040)
.
Department of thl!l Treasury
Intel1'al Revenue Service tL)
Name{s) show
Attachment
r.-- Attach to Form 1040. ~ See Instructions for Schedules A and B (Form 1040). Sequence No. 07
fi,r. ~rsocl~~c~oom~
~, r-w Y, f,&Cl{
.
Medical
and 1
Dental 2
Expenses 3
4
Taxes You 5
Paid 6
(See 7
page A-2.) 8
9
Interest 10
You Paid 11
(See
page A-3.)
.
,.
Note.
Personal 12
interest is
not
deductible. 13
14
Gifts to 15
Charity
If you made a 16
gift and got a
benefjf for it, 17
see page A~4. 18
.
:t
Casualty and
Theft Losses 19
Job Expenses 20
and Mosl
Other
MIscellaneous
Deductions
.
21
(See 22
page A-5 for
expenses to
deduct here.)
.
23
24
25
26
Other 27
Miscellaneous
Deducllons
Total 28
Itemized
Deductions
~~
~.;..
. ,
~~. ~~ .-"
~ .
OMS No. 1545-0074
(Schedule B is on back)
Schedule A-Itemized Deductions
~@01
Caution. Do not include expenses reimbursed or paid by others.
Medical and dental expenses (see page A-2) .
Enter amount from Form 1040, line 34. 2
Multiply line 2 above by 7.5% (.075). . . . . 3
Subtract line 3 from line 1. If line 3 is more than line 1. enter -0-
State and local income taxes . 5
Real estate taxes (see page A-2). . . . . . .. 6
Personal property taxes. . . . . . . . . .. 7
Other taxes. Ust type and amount ......... _.... _.... _ _.
Add lines 20 through 22. . . . .
Enter amount from Form 1040, line 34. 24
Multiply line 24 above by 2% (.02) . . 25
Subtract line 25 from line 23. If line 25 Is more than line 23, enter -0-
Other-from list on page A-6. List type and amount" .-.-...._...-......._.........
Add 'lines "s' tlii-o'w' rtl"s':":" ':'.:. ~ .".. ~""."":":"':":"',
Home mortgage interest and points reported to you on Form 1098
Home mortgage interest not reported to you on Fonn 1098. If paid
to the person from whom you bought the home. see page A-3
and show that person's name, identifying no., and address ..
Points not reported to you on Form 1098. See page A-3
for special rules. . . . . . . . . . . . .. 12
Investment Interest. Attaoh Form 4952 If '''''lulrec1. (S.."
page A-3.) . . . . . . . . . . . . . .. 13
Add lines 10 through 13. . . . . . . . . . .
Gifts by cash or check. If you made any gift of $250 or
more, see page A-4 . . . . . . . . . . . .
Other than by cash or check. If any gift of $250 or more,
see page A-4. You must attach Form 8283 If over $500
Carryover from prior year
Add lines 15 throu h 17. . . . . . . . . . .
Casualty or theft loss(es). Attach Form 4684. (See page A-5.)
Unreimbursed employee expenses-Job travel, union
dues, job education, etc. You must attach Form 2106
or 2106-EZ If required. (See page A-5.) .. ..._...........
Tax preparation fees . . . . . . . . . . . .
Other expenses-investment, safe depcsit box, etc. List
type and amount ~.._..._...._.._........__._..............
~
~
tf.rJ
.Jon
9tftJ
d '/.5
....__......_.._.._....n.....__.............__...............-.........--..........-..........
Is ~(m 1040. line 34, over $132,950 (over $66,475 if ~arried fil~ng separately)?
[2] No. Your deduction is not limited. Add the amounts In the far nght ~olumn }
for lines 4 through 27. Also, enter this amount on Form 1040, line 36. ."
o Yes. Your deduction may be limited. See page A-6 for the amount to enter.
For Paperwork Reduction Act Notice, see Form 10-4C instructlons.
Cat No. 12614-K
Schedule A (Form 1040) 2001
Standard
Deduction
for-
. People who 36
checked any
110< on .Ii"o 37
<.Itu~ I':tf ~el!l .q~
who can be 38
claimed as a .
dependent,
see page 31.
. All others:
Singre.
$4,550
Head of
household,
$6.650
I Married fHing
, jointly or
r Qualffying
I W>:I\'.wor),
J Married
I fHing
I separately.
$3,800
.
Form 1040 (2001)
Tax and
Credits
.
.
.
,~
Other
Taxes
..
Payments
If you have a
qualifying
child, attach
Schedule EIG.
.
Refund
.
Direct
deposit? See
page 51 and
fill in 68b,
68c, and 68d,
Amount
You Owe
Third Party
Designee
Sign
Here
.
.
Joint return?
See page 19.
Keep a copy
for your
records.
Paid
Preparer's
Use Only
~- _L
L, - I~_~- ,,- ,.~--"" ~ i ~1
Il!Ilrit4
Page 2
5,"{
o Blind.
~ 35a
34 Amount from line 33 (adjusted gross income) . . . . .
35a Check if, 0 You were 55 or older, 0 Blind; 0 Spouse was 65 or older.
Add the number of boxes checked above and enter the total here .
b If you are married filing separately and your spouse itemizes deductions, or
you were a dual-status alien, see page 31 and check here , ~ 35b 0
Itemized deductions (from Schedule A) or your standard deducti~n (see left margin) .
Subtract IIn. 36 from lin. 34 . . . , , , . . . .
If line 34 Is $99,725 or less, multiply $2,900 by the total number of exemptloe" alai",... SA
line 6d. If line 34 is over $99,725. see the worksheef on page 32 .
Taxable income. Subtract line 38 from line 37. If line 38 is more than line 37, enter -Q-
Tax Isee page 33). Check ~ any tax is from a 0 Formls) 6814 b 0 Form 4972
Alternative minimum tax (see page 34). Attach Form 6251 .
Add lines 40 and 41
Foreign tax credit. Attach Form 1116 if required
Credit for child and dependent care expenses. Attach Form 2441
Credit for the elderly or the disabled. Attach Schedule R .
Education credits. Attach Form 8863 .
iII.fi t8~H8tl.~ ~1.~li, ~.. 1~8 W~'M.~'" M ~.Q. ~8 ,
Child tax credit (see page 37)
Adoption credit. Attach Form 8839 .
Other credits from: ,,0 Form 3800
c 0 Form 88Q1 d 0 Fcrm (specify)
51 Add lines 43 t"rough 50. These are your total credits
52 Subtract line 51 from line 42. If line 51 Is more than line 42, enter -0- .
53 Self-employment tax. Attach Schedule SE .
54 Social security and Medicare tax on tip income not reported to employer. Attach Form 4137
55 Tax on qualrfied plans, InCluding IRAs, and other tax~favored accounts. Attach Form 5329 if required
55 Advanoo ..mod Income crodlt payments from Form(s) W-2 .
51 Household employment ta~ea. Artsc" 18ehed\Jl. H
58 Add lines 52 throu h 57. This is your total tax
59 Federal Income tax withheld from Forms W-2 and 1099
60 2001 esllmated tax payments and al11OUn! applied from 2000 relurn
61 a Earned Income credit (Ele). ...
b Nontaxable earned income , I 61 b I
62 Excess social sacurity and RRTA tax w~hheld (see page 51) 62
63 Additional child tax credit. Attach Form 8812 . 63
64 Amount paid wit" request for extension to file (see page 51) 64
65 Other payments. Check If from 00 Form 2439 b 0 Form 4136 65
66 Add lines 59, 60, 61a. and 62 through 65. These are your total payments . ~
67 If line 66 is more than line 58, subtract line 58 from line 66. This Is the amount you overpaid
68a Amount of line 67 you want refunded to you . ...
~ b Rdutlng number 0 Savings
... d Account number
69 Amount of line 67 au want a ned to our 2002 estimated tax ~ 69
70 Amount you owe. Subtract line 66 from line 58. For details on how to pay, see page 52
71 Estimated tax penalty. Also include on line 70 . 71
Do ycu want to allow another person to discuss this return with the IRS (see page 53)? 0 Yes. Complete the following. Q..HtS
39
40
41
42
43
44
45
46
.,
48
49
50
p7
-5.2-
IH
S-.:u
t;-l/l
-
~
s::;
43
44
45
46
j,7.
. 48
49
b 0 Form 8396
50
~
51
52
53
54
55
56
~
,-
~
59
60
61a
Designee's Phone Personal identification ~
name .... no. .... ( number (PIN) .... LL-L-L--L-J
Under penalties of perjury, I d$Clare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and
belief, they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Your oc;;:;
Daytime phone number
Preparer's ~
signature r
Finn's name (or ~
yours if self*employed),
address, and ZIP code
Date
~ Spouse's Slgnatur.. If a .
Spouse's occupation
'U.S. Government Printing Office: 2001 - 474.058
Form 1040 (2001)
.
....... .,
~"' L
......._,_w._._ _.
(if ......_1 /1:-'-
FASTI Us.
.
W2W
2001
dT
5t t
W2W
('f.mN" Ir45fJOM Form - age an ax a ement
7 ~~-":I~I S,]cUlily lips 1 Wages, lips, o5e~r443Iio.n 5 S 2 FetleraJ Income lax withheld
6918.27
8 Allocated lips , Social securitEt69;; 71 . 2 . Social secutllyllloX wilhhekt
3526.02
, A'lv;,\[1..e EICpeymenl , MedlcareW3-sS311dlips 6 MedJcatela)lwllhheld
6871.2' 824.63
OMS No. 1545.QOOB Fonn - aae an ax tatement 1
7 SoclalsecUtilytJps 1 WagM, lips, ~h~r C()mpensallon , F!lderalincom61a~ wllhhgl!j
53443.59 6918.27
e AlIocal~lips , Social secuS 6a~e71 . 25 . Satial securhylaxwill;h01(l
3526.02
, ActvanoeElCpaym81l1 5 """"""'g'6 '87'1. . 25 8 Medlcsrs !a;.rwifhhekJ
824.63
.
E'_mrloy~r's name, address. and ZIP code
e Employe(s. namo, address, and ZIP code
HOLY SPIRIT HOSPITAL
503 NORTH 21ST STREET
CAMP HILL PA 17011
10 Dependent care bEmelns J 11 NonquaNfIed p!aM
b Employer idenlificaUon number
. 23-1512747
d En'pfcyee'5 sodal SllCurily number
185-38-6096
-~~
;,. ~"
""'-j -,
dT
s
200
HOLY SPIRIT HOSPITAL
503 NORTH 21ST STREET
CAMP HILL PA 17011
.
128 See Irstructlons lor box 12
I C, 1.10
12"
I
fa D9pQrldllnt"l:\rfIbetlef<<l; 1'1 Nonquall!rltdpftln,
b E201e~15ci2 747
d Employee'3 social secutlly number
185-38-6096
DI
,12C I
i
!12d f
13 ~. f =j{1 I :r-~
":.'c, ""...,'.""
3427.66
140111<;1
DNTE
MED
VISE
1401her
DNTE
MED
VISE
149.19
589.34
19.00
149.19
589.34
19.00
.
e ElT1ployee~ nama, address, and ZIP code
'i~!~,~,!r~~wi~~&;fi;i.i:
a Employae's name, address, and ZIP code
12aSee~Sll'uclionsforbo)( 12
C , 1.10
12. 1
i D 3427.66
12' I
I
e12d I
!
13 ~"=- I ~~...." I ~r::oly
'-"'-'/"
, . 0 ~ ',+.'~_"_~
i-f'o,"'_;';"
17043
CAROL A. FURJANIC
4 U "I TN STREET
LEMOYNE PA 17043
16 Sla,ewg6'870'.15 17 slaleinrS92. 40
LEMOYNE PA
lSp!ata 3 im5or27a~r7number
11 Stale Income lax
1592.40
.
COpy C For EMPLOYEE'S RECORDS
TI,." ,nl(jtm~lk><l Is being filml$lIeo:110 tho rnlemaf Aevenue SeMee. If you are
rO<l\"'wllofileB!axrelurn,anegllgllfltllpllnaltyoro!tlorsanctlonmaybeifllpos9d
O"y"".r!nlsincom"'is!,xable~you-(anlOllIllorlil.
Dept. 01 the Treasury .. IRS
{s:r~J'c~=re
Depl. of Ihe Treasury -- IRS
COpy 9 To Be Fited With Employee's FEDERAL Tax Return
This jnforrnalion is being furnished 10 the Infemal F1evenue Service
Fonn W-2 Wa e and Tax St!!tement 2001
~'lf!ll' F......II""me'lf~h'llId,Ill'
3 Social secuS 6a~a71 . 25 4 Sod;:!l securily 3XSi26d . 02
6 Medl'carelaxwifhheld
824.63
1SS1ate Employer'$ state 10 numbel 16 Slalewages, tips, elc. 17 Slala income lax
'PA f2315T2747"" .._-'--' 568'70': 15 '1592:4
18 toealwages, Hps, ala. '9 Local ineoma laK 20 l.oatlilyname
., 5762'7-:68 576: 27 CUmber
i";;I~ ~l.! l~_Hj-iiljljl:l
'. 7 Sac1alS6CUrUyl/ps
S Medicare wages and lips
56871.25
~
:~'i
6 r,tlocatedtlps
3 SOCial sIlCurilSw6gS 71 . 2
5 M&dlcare w~s and ~s
~687L2
9 Advance ErG pavmenl
9 ArJvanr.e F.IGpayment
f'mployer'sname, a.ddress, and ZIP code
e Employer's nama, address, and ZIP code
.
HOLY SPIRIT HOSPITAL
503 NORTH 21ST STREET
CAMP HILL PA 17011
HOLY SPIRIT HOSPITAL
503 NORTH 21ST STREET
CAMP HILL PA
17011
10 Oapenlkml care benafrts
11 Nonqualiliedplans
.
10 Derwndrml care benefits J 11 Nonquatilied plans
b Employer identi!icatlon IlUnlber
23-1512747
d Fmploye<l'S social seculilynurnber
185-38-60'96
b E~3~di512m
d Employee'ssoclalsecu~n\ll11ber
185-38-6096
140fher
DNTE
MED
VISE
'" C I
!
(!b DI
12c I
~
'" I
1
13Slo\lllO<ll _n-wpany
~,.... I ""x I ~~.
1.10
3427.66
14 Ofho'J,
DNTE
MED
VISE
149.19
589.34
19.00
149.19
589,34
19,0'0'
e EmplOyee's name, address, and ZIP code
e f'fll_rlny(!e's Ilame, address, and ZIP cod$
~
CAROL A. FURJANIC
414 4TH STREET
CAROL A. FURJANIC
414 4 TH STREET
LEMOYNE PA 170'43
LEMOYNE PA
17043
1:, ,,1,1te Employer's slale 10 number
16 State wages, lips,elc. 11 Slllte i[1comelall:
P .3151274'7'"
56'870".15 "1592':40'
HI l.o(:<1lw<1gf1S, lips,etc.
19 Locatincornefl-lx
20 localilyname
57627:68
57 6:'27dCumb-eT '
Depl. of lhe Treasury .. IRS Copy 2 For Employee's
State, City or local
Income Tax Return
Copy 2 For Employee's
State, Cily or local
):lr.ome 1.'1)r Aeturn
l2'
f C
12'
! D
l2c
!
'"
1
13
1.1(
3427.6E
Dppl. of lhe Trea!;ury n
. I
I"",,~ _,'. .
. it!:
,. (~.h'l
g Holy Spirit Hospital
.
EMPLOYEE NAME SSN EMPLOYEE NUMBER ADVICE NO.
FURJANIC, CAROL A 185-38-6096 185386096 124182
FOR PERIOD ENDING RATE DEPT NET PAY CURRENT NET PAYYTD
06129/02 24.28 6510 1,263.20 19.497.61
PTO IVAel STO ISICI GROSS CURRENT GROSS YTD
144.44 269.30 2,065.08 29,411.77
.
.
EARNINGS HOURS RATE CURRENT YTO DEDUCTIONS CURRENT YTO
1REG 44.25 24.28 1,oa5.64 24,142.04 401(k) 165.20 2.056.49
2,136.64 DENTAl 4.00 49.00
2PTO SC 28.00 24.28 579.84 FIT 362.43 4,098.67
3HOUOA a.oo 24.28 194.24 776.96 HSMP 21.14 272.65
MIWWI 29.56 421.50
OT PREM 4.25 12.84 54.57 520.58 PA WlH 57.09 814.08
WKND RN 12.00 4.14 49.68 7SO_38 WSHORE 29.94 29.94
OASDI 126.41 1,802.72
EX lIF 0.11 1.55 UWAYO 5.00 70.00
EOUC 1,007.62 VISION 1.00 14.00
OPT.HS 1000
ON CAlL 72.00 LO-CUM 273.46
CHARGE 4.00
---... $29,411.77
TOTAl EARNINGS 92.25 52,Q55.08
ACH BANK ACCOUNT AMOUNT
ACH COMCHE Acct 513244707 1.263.20 I
TOTAl DEDUCTIONS $801.77 $9.912.61
.
It
· r
L.___
..., ..._ ..__4..'._'
It
.
t
~
-,'" "~
':I
.
Your Social Se~qdJ;)tSt.t,ment
.....,.ud ..pee"'''' for Care. A. FurJule .
" '. , ,
.
50539
~-~',.....
J60EERFlf.:LO RO
emp IIILL PA 17011-8469
I, ..lit... m......II. ..111..1..1..1.11..1,1..1,1...11..1..1.1
.
,
_'o<'"l
f~ -~ ~"' , --'''';',,- I~ -I:i\:tii'-':
~
~!!#
June 13, 2000
. .
See InsIde lor your
persons' In10nnallon -~
T What' Sodal Setutlt,y Means to You
..
We are pleased 10 send yoll this Sodol Ser:uritg
Stotementlo help you undenlat1d what Social
Security means to yoll and your family. We
enC<lurnge you to ust It In IlI11nnlng your
financial future. As the law requires, we will
send yolla new Stotemelltshowlng your
updated earnings record and your potenllal
benefits each year. YoU sholJld tecelve It about
HI'.I mlllllh. Ntllfll/flll' "''''I.,
Be sure 10 read Ihls statement carefully. If you
Ihink there might be a mistake, Illease let us
know, Thal's Important because YOllr benefits
will be based on our record of your Iifellme
".lImlngs. Remember, the future's In your hands
when you read your Sodal Secttrify Statemellt.
Social Seeurlty I. fot people .f "Iages...
Social Security Is more than 8 retirement
program. It ClI/1 hell' you Whether you're young
or old, male or f"male, single or with II fllmlly. It
can provide benefits U you become severely
disabled and help sUPllot! your family when
you die. And It's illerI' for you when yoU rellre.
Work 10 !tuUd . leeure 'alure...
Social Security Is the largest source of Income
for most elderly Americans and plays 8 major
role In keeping them oulof poverty. . But Social
Security can't do it 11I1. Sodlll Security benefits.
Were not Intended to be tile only source of
Income fot you and Y01Jr family wilen YOU retire.
You'll need to suwleltlen! your benen.. from a
pr.nslon, sllVlngs or In\l~tm@nls. Think or Social
Security a.~ a foundaUon on wIdell to build your
financial future.
.
i~
.
.
.
AlKtul Sodal Seeurlty., fulun...
Will Social Sec\.lrlty be Ihere when you rellre?
Of course It will. But changes will be needed to
meet the demands of the times. We',e IMng
longer, healthier lives; 76 million Ubaby
boomers" will slart rellrlng In about 2010; and,
. in OOoul30 years. Ihere will be nearly twice as
many older Americ:ans as there lire today.
/!I1I-11ll ~fI'" ftllW till.. ,It llll'" t...
than It pays out In benefiu. flie excess funds are
credited to Social Security', trost funds, which
are elll>ected to grow to over $4 trillion bdore
we need to use them to pay benefils. In 2015. we
will begin to pay oul more In benefits limn we
collect In taxes. By 2037, the trost funds will be
exhausted and the payrollJaxes colleded will be
enough to I'lIY only IIbout 72 percent of "euefib
owed. We're working to resolve IIII~se Issues. For
more Information abollt the presenl and what
may lie ahead, (""II liS to ask for II copy of the
booklet, The FUtllre o( Sndal Security.
;j: .g,("'.~
Ke"neU, S, Al,rel
CIII"miuio"e, nI Sod.' Spcllrity
What'. In.lde...
T Your EsUmated Benefits. . . . . .. . . . . . . . . . . . 2
T You, Eamlngs Record ................... "
. T Some Facb abo,,' ~...;., Security. . . '
T UYou tle.d ~lo..l"foll"allon ,............ ,1
'f To Relfued nil. statement I" SP811hh , . , , , ,. 4
(nmr Solicitnr /I"" /)eclorncid" ell E~<1'mi()1)
111.11(.111
.
06 nool! Oll.~ 27765
"'~. ~
.~
,
-...........~ -
lj{i'~
:It
"'If lIelp U.. Keep Your Earnings ~ecord Accurate
.
You, your employer and Social Security share
responsibility for the accuracy of YOllr earnings record.
From Ihe nrst year yml tJelllln \\'t)rklng, we recorded
YOllr report"d earnings under \'(lUr name and Sociat
Security /lUmber. Since then, we have updated your
record each Ume YOllr employer (or YOll. If \'(lu're
self-employed) reported yoUr earnings.
T ~hke SUh! We have recorded every year
you worked.
T Check the earnings to s.... If lhey .re corred.
YOll are the only person who can look at the earnlo!!,
chart and know whether it Is complete. If YOll workrcl
for more than one employer during the y.ar, or if you
had both earnings and self-employmenllncom.. w.
combined \'(lur earnings for that year.
T Remember. there Is a 11m II on the amount of
earning. on whtch !'Ou pay !lodal Security taKea
each year. This limit usually Increases yeOtly. Only
the maximum amount that was taxable will a""..,
on the chart. (For M.dlcare taxes. the maximum
earnings amount began rlslnllln 1991. Since 199~,
011 of your earnings are laxed for Medicare.)
T Ad rill'" 1lWllY If any of your earnings are .hown
Incorrectly. Call as at 1.800-772-121:1. If "0..1"'.,
have your W-2 or tax return for those years .vail.hl._
(If you live oulslde the U.S., follow Ihe directions at
the bottom of palle 4.)
.
Remember, it's your earnings - not the amount of
11Ixes you paid or the number of credits you have - that
de' ermIne your benefit amount. When we figure that
amount. we base It on your average earnings over your
lifetime. If our records are wrong. you may not receive
all the benefits to which \'(lU are entitled.
T RevIew Ihli chart cMdulty using your own
documents (pay stubs. W-2 forms and tax returns)
10 make sure our Information is correcl.
.
'11
.
Your Earnlnlls Record at a ~Ianc. Yonr Tued Your TMed YfIt. Tued
' YOllrTu:e
YeRrs 'YoU SocI,1 Se.urll, M..dlr:.re Ye_" You Soc'" 5<<urlly M"dkare
w..lced Earning> Earnings Worked -"II> Ear......
1966 $ 116 $ tl6 1990 $ 32.946 $ 32,9~6
1967 315 315 1991 3U59 34.159
1968 669 669 1992 36,799 36,799
1969 695 695 1993 37.167 37,167
1991 37.7~0 37,740
1970 2.920 2,920 1995 39,912 39,912
1971 7,800 7,800 1996 36.'127 36,427.
1972 7,688 7,688 1997 47,670 47,670
1973 8,046 8,046 1998 50,327 50,327
1974 1,853 1,853 1999 53,510 53,510
1975 0 0
1976 993 993
1977 2.344 2,344
1978 9,963 9.963
1979 12,359 12.359
1980 13,512 13.512
1981 16,877 16.877
1982 19,893 19.893
1983 21.730 . 21.730
1984 23.275 23,275
1985 24,332 24.332
1986 25.708 25,708
1987 26,892 26,892
1988 29.493 29.493
1989 31,568 31,568
To.... Ofer your wo"'lntl tanelt
.
.
.
.
Esumated !ales ror Social Securily: Estimated !ales paid ror Medicare:
You \llIld: MI.060 Yoll p3fd: $9.537
Yollr employers p"id: M 1,061 YOllr employers paid: $9,531
Notel tlyoo 11ft .lr-tm,lo,..., yoo ,a, the total to on ,..... net ..amlng..
3
111111111
06 DOOF. OIlS 21765
.
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T Help Us Keep Your Earnings Record Accurate
't..:::::. -:'.: .:.:...===::. :"=::.~.>:':.:::::-;:-..::-.o:r....:.::=_:::.:...::~...:''':::_--:=:' ':':::::::'~":-:-':-:':":. -:::'":':::- .~:;:::-:':!:-:-=:'-,::;':::-::', :-_: :-::T"':V;-.- "~"~' .-.--.-. .~.._---
You, )'o"r employer and Socl41 Security share
responsibility for the acClmlCy of your earnings record.
Since you beglln working, we recorded your reported
earnings under your name and Social Security numbu.
We have updated your rocord each time yqur employer (or
you, if you're self.employed) reported YOur earnings,
Remember, it's your earnings, not the amount of tlxes
YOU paid or the number of credits you've earned, that
determine your benefit amount. When we figure tlJat
amount, we base it on your average earnings over your
lifetime. If our records are wrong, you may not receive
all the benefi ts to which you are entitled.
... .......... lids l!Ium ~ using your own records
to make sure our information is correct and that
we've recorded each year you worked, You're the only
pmon who C(ln look at the earnings chart md know ... CloIl us right aWI\Y at 1-800.772-1213 (7 ..m.-7 p.m.)
whether it is complete, if any earnings for years bet"" Jast year are shown
Some or all of your earnings [tOm last year may not incorrectly. H possible, have your W.2 or lax return
be ID:own' on )IOUt"Statem.mt~It ewJd be that we- .-.------ for thQw,years himdy,.{lf.you li~ oulside.lhe. U .S,
were still processirtg last year's earnings reports follow the directions at the bottom of Page 4.)
.
.
.
II
Your Eam/dgs ReaJrd at a Glance
f Q\.Ir Th.1I:ed
Year~ You SocW Security
Worked Earning>
Your 1'ax~
MMkare
Earning<
when your Statement was prepared, Your oompl.t.
earnings for last year will be shown on next year's
Statement. Note: If you worked for more than
one employer during "'W year, Or if you had both
earnings aDd self.emplOyment income, we combined
your earnings for the year,
1htre', a 1fmIt...... ~ fit eamhtgs on which
)llIllpe,y Soc:Ia1 s.......lb ....llIIdt.year, The limit
incnases yearly. Only the muimum taxable amount
wiIl appear on your earnings chart. (For MediC(lre
taxes. the maximum earnings amount began rising
In 1991. Since 1994, all of your earnings are taxed (or
Medicare.)
11
1963 $ 517
1964 24 Medicare began
1965 611 in 1966
1966 1.650 $ 1,650
1967 2,354 2,354
1968 1,560 1.560
1969 4,901 4,901
1970 7,153 7,153
1971 7,435 7,435
1972 8.783 8,783
1973 10,093 10,093
1974 12.573 12,513
1975 13.896 13.896
1976 15,300 15,300
1977 16,500 16.500
1978 11.766 11:766
1979 9,212 9,212
.. .. .#"-......-- -'"~.~'--_.
Your Tmd Your taX~d
Yem rou Social Seamly Medi.c:l\(e-
Workel! I!.rnings EarnIng,
1980 $ H,528 $ 14.528
1981 7,432 7,432
1982 32,400 32.400
1983 35,700 35.700
1984 37,800 37.800
1985 39,349 39,349
1986 42,000 42.000
1987 43,800 43.800
1988 45.000 45,000
]989 48,000 48.000
1990 51,300
1991 53,400
1992 55,500
1993 8,065
1994 49,807
1995 61,200
1996 62,700
---"l%T"-'-"'---5-I,600 -'-'."
1998 34,278
1999 72,600
2000 75,000
2001 Not yet recorded-
;,
.
51.300
71.260
96,628
8,065
49.807
64.849
67~212
54.600 ..,
34.278
77,876
75,000
.
Totals over :your working eareerl
Estimated taxes for Social Security: Estimated taxes paid for ~1edicare:
Y 'd' <61.702 You paid: $15.208
ou pal ,~ 'd $1508'
Your employers paid: $61.614 Your employers pal : , ~
Not", If yon IOns sell-employed, you pay the total b,x on j'Our ...t eantmg".
.
3
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.
.
CERTIFICATE OF SERVICE
. A true and correct copy of the foregoing document was delivered to the person or office listed
below on the date indicated by first class mail, addressed as follows:
.
Cara Y. Boyanowski, Esq.
1029 Scenery Drive
Harrisburg, PA 17109
.
.
.
Date[)e1.';3 800:1-
(
L0~Ai
William A. Fetterhoff, Esquire
Fetterhoff and Zilli
200 N. Third Street, Suite 800
Harrisburg, P A 17101
(717) 232-7722
.
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CAROL A. FURJANIC,
Plaintiff
: I IN THE COURT OF COMMON PLEAS
: I CUMBERLAND COUNTY, PENNSYLVANIA
: CIVIL ACTION - LAW
v.
: NO. 01-1144
JAMES A. FURJANIC,
Defendant
: IN DIVORCE
INCOME AND EVENSE STATEMENT
UNDER RULE 1920.31
I hereby file the Statement of Income ~d Expenses required under Rule 1920.31 and verify
i
that the information therein contained is true 8Illd correct to the best of my knowledge, information
!
and belief.
I .
I understand that false statements herein are made subject to the penalties of 18 Pa. CS.A.
~4904, relating to unsworn falsification to au~orities.
!
Date:
r;//J tln,
, /'@/J~ -.
By: {4t ,(,( ~d
Carol A. FUIja.nVlai f
~~ , , d , , " , ""1 ,.;1:',,,",. '"c,,~,>,;:. :",~'I, .. ,''';;-''.. -.,,"~, ","'.e-;;," , <'-';t;,,'L'" '" . ',. v;.L .. ."-'-,
Date of Marriage:
Fnhrum:)' l'? 191/7
Case Name:
H1J';jnnif' 1) H1Jrjnnif'
Date of Separation:
n'N'pmhpr 7fl. 7nnn
INCOME AND EXPENSE STATEMENT
of
CAROLA. FURJANIC
Other Benefits
Husband's Income Gross:
Net:
Wife's Income Gross:
$53,690
Net:
$32,838
Monthly Expenses: Monthly Payment Total Amount Owed
Mortgage $835.00
Home Equity
Utilities $242.00
Upkeep/Maintenance
Household Help
Car Loans $366.00
Insurance: Car $44.00
Homeowners $10.00
Health $70.00
TuitionlDaycare
Credit cards: Master Card
VISA $150.00 $2,400
Moving Expenses X2 $20.00
Cell Phone $17.00
Medical Expenses $50.00
Clothing $150.00
Food/Supplies $450.00
Entertainment $100.00
Vacations
Memberships $40.00
Other Child Support! Alimony
Legal Fees $125 to $550
Totals: $2,669 to $3,094
~ ,
...
J1JJil~*
{lW J H.y .." HM,H"
EMPLOYEE NAME SSN EMPLOYEE NUMBER ADVICE NO.
FURJANIC, CAROL A 1 85-38-6096 185386096 124182
FOR PERIOD ENDING RATE DEPT NET PAY CURRENT NET PAY YTD
06/29/02 24.28 6510 1,263.20 19.497.61
PTO (VACl STO (SICl GROSS CURRENT GROSS YTD
144.44 269.30 2,065.08 29.411.77
EARNINGS HOURS RATE CURRENT YTD DEDUCTIONS CURRENT YTD
1REG 44.25 24.28 1,086.64 24.142.04 401(k) 165.20 2,056.49
2,136.64 DENTAL 4.00 49.00
2PTO SC 28.00 24.28 679.84 FIT 362.43 4,098.67
3HOLIDA 8.00 24.28 194.24 776.96 HSMP 21.14 272.65
MEOWI 29.56 421.60
OT PREM 4.26 12.64 54.57 520.58 PA W\H 57.09 814.08
WKNO RN 12.00 4.14 49.68 750.38 WSHORE 29.94 29.94
OASDI 126.41 1,802.72
EX L1F 0.11 1.55 UWAYO 5.00 70.00
muc 1,007.62 VISION 1.00 14.00
OPT.HS 10.00
ON CALL 72.00 LO--CUM 273.46
CHARGE - 4.00
TOTAL EARNINGS 92.25 $.2,065.08 $29,411.77
ACH BANK ACCOUNT AMOUNT
ACH COMCHE Acct 513244707 l,263.2C
TOTAL DEDUCTIONS $801.77 $9,912.61
..-.-.- --.'- -- -----
..... ...- .---.....-
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CAROL A. FURJANIC,
PLAINTIFF
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
V.
NO. 01-1144
JAMES A. FURJANIC,
DEFENDANT
IN DIVORCE
INCOME AND EXPENSE STATEMENT
UNDER RULE 1920.31
I hereby file the Statement ofIncome and Expenses required under Rule 1920.31 and verifY
that the information herein contained is true and correct to the best of my knowledge, information,
and belief.
I understand that false statements herein are made subject to the penalties of 18 Pa.C.S.A.
~4904, relating to unsworn falsification to authorities.
~OdobL ICp( dcce-
By: "
James A. FUljanic, Defe ant
Date:
,,~'
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-- ---'~"-'-"- -,,,>--~- - ".""," ~',g ,~~,-".- ~'" - -~,' -'-"-""""~".,' ~.. '-, _'n' ,"" i,\;
CAROL A. FURJANIC,
PLAINTIFF
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
V.
NO.Ol-1144
JAMES A. FURJANIC,
DEFENDANT
IN DIVORCE
INCOME AND EXPENSE STATEMENT
of
JAMES A. FURJANIC
Husband's Income: 2001 2002
Gross: $77,416.57 $49,745.96
Net: $51,649.83 $28,179.67
Wife's Income:
Gross: $57,627.68 Same
Net: $46,622.82 Same
Monthlv Expenses
Home
Mortgage:
Electric:
Telephone
Water:
Sewer:
$1,660.00
175.00
23.00
44.00
25.00
(includes taxes and insurance)
Insurance
Auto:
Life:
Health
$45.00
56.00
350.00
Automobile
Fuel:
Repairs:
$80.00
30.00
Medical
Doctor:
Dentist:
$20.00
20.00
Personal
Food:
Credit card:
Clothing:
Barber:
Cable TV:
Legal Fees:
$450.00
300.00
25.00
16.00
36.00
300.00
Total:
$3,655.00
Checking:
Savings:
$1,000.00
2,000.00
Liauid Assets
-
~ ~"
.
~~
~ 1040
Dep<lrlmefll ollhtt TU18sury-lnlernal f~evef1up. Servk:e
us. IMividuallncome Tax ~eturn
For the year Jan. t-Dec. ~1. 2001. or oIll1lr tax year beginning
Yo~rst name and Initial laost name
. ~
1/ .'
'-/~/J..// C-
~@01
Label
199)
.2001. ending
IRS u~ ani
,20
l
A
B
f
(s(~C
instructions
on page 19.)
Use the IRS
label.
Otherwise.
plcnse print
or type.
Presidential
Election Campaign ~
(See a e 19.1 "
1
2
3
4
If Ii Joint return, c;pnu!\f!''i first name ;,"d initixl
lli<;t n8mp.
Apt. no.
H
E
.
E
Filing Status
Chock only
I !tl~l I1tllt.
5
Exemptions
If more than six
dependents,
see page 20.
d
Income 7
8a
Attach b
Forms W-2 and 9
W-2G here. 10
Also attach
Form(s) 1099-R 11
if tax was 12
withheld. 13
14
If you did not 15a
get a W-2, 18a
;;f!e prlge 21. 17
Enclose, but do 18
not tlttnch. Clny 19
pilymcnt. Also, 20a
plcnse use
Form 1040wV. 21
22
Total number of exam tons claimed
Adjusted
Gross
Income
Wages, salaries, tips. etc. Attach Form(s) W.2
Taxable interest, Attach Schedule B if required
Tax-exempt Interest. Do not include on line 8a
Ordinary dividends. Attach Schedule B iF required
Taxable reFunds, credits, or offsets of state and local income laxes (see page 22)
Alimony received
Business Income or Oossl. Attach Schedule C or C.EZ .
Capital gain or (loss). Attach Schedule 0 if required. If not required, check here" 0
Other gains or (losses). Attach Form 4797 . ............
Total IRA distribUtions. ~ L-J b Taxable amount (see page 23)
Total pensions and annuities l.1!!J L-J b Taxable amount (see page 23)
Rental real estate, royalties, partnerships, S corporations, trusts. etc. Attach Schedule E
Farm income or (loss). Attach Schedule F
Unemployment compensation . . . . . . . . . .
Social security benefits . I 20a I I b Taxable amount (see page 25)
Other income. List type and amount (see page 27) _____..__..._________h..._._....__
Add the amounts in the rarrl htcolumn for lines 7 throu h 21. This Is our total Income ....
23
24
25
26
27
28
29
30
31a
8b
23 IRA deductitm (see page 27) .
24 Student loan interest deduction (see page 28) .
25 Archer MSA deduction. Attach Form 8853 .
26 Moving expenses. Attach Form 3903
27 One.half of self.employrnent tax. Attach Schedule SE
28 Self-employed health Insurance deduttlon (see page 30)
29 Self-employed SEP, SIMPLE, and quallf1~d plans
30 Penalty on earty withdrawal of savings
31a Alimony paid b Recipient's SSN ~
32 Add lines 23 through 31 a .
33 Subtract line 32 from line 22. This is our ad usted
For Oisclosure, PriVacy Act. and PaPBfWork Reduction Act NOllee. see page 72.
.~
Cat. No. 113208
'f2i till
,
On f1UIWIUeOl slaple In llli:.spal:e.
OMB No. , t545-OO74
Your social security number
;,(C.... : 3"-: /2.~~.
Spouse's social security number
... Important!
You must enter
your SSN(s) above.
You Spouse
OVes~(., OVesONo
.~
...
No. ot:ltoIes
th~on
6a aoo,,6b
No.or,your
d1ildAtn on 6e
...~
o liv(!d wllh you
. did ~llive wit~
you dJl~ to: dilrorce
ors~iuation
(see p~'20)
D~~ on 6C]
nolen<<iredabove:_
AdO ~~......... .. '[j]
enlete(I:on :
lines;ISbod'" 'i
-, ,';i."'~""
, "
).
. ,
"- ~I
Single
Married filing joint return (even if only one had income)
Married filing separate return. Enter spouse's social security no, above imd full name here .... .(Ale..~..! A. .r=u jo.:.j"~..,> ',.
Headof household (wit.h qualifying person). (See page19.)lrthe qualifying person is a c.hild but not yourdependp.l1t.
ni'lh,r Oil.@MII<<'. "itiflN i'I'H'i:I: IP _, . ,__ ,_ . , ,. , ............_"__~....-..m"'""-."'-
Quail n widow(er) with de endent child ( ear s USe died ... ). (See a e 19.)
8a 0 Yournelf. If your parent (or someone else) can claim you as a dependent on his or her tax}
return, do not <:heckbox 6a . . . .. . . . ." . . .
b Spouse.,....... "
c Dependents: (Z) Dependent's (3) D~pcndent's (4~ if quIl.iirying
. social security numbm- relallonshtplo thild fa' child lax
(1) First name Last name u Cl'l!dit see. 20
o
o
o
o
9
10
11
12
13
14
15b
16b
17
18
19
2Qb
21
22
~.I
Form 1040 1200')
~
'''''''''"'~0_.'
. -,
,
"~
,-"_....~"
Form 10-10 (2001)
Tax and
Credits
Standard
Deduction
fo<-
. People who 36
Chl!ckcd any
box on line 31
35<1 or 35b or
who can bu 38
cl<limed as a
dr-pendent,
~ie-e page 31.
. All nth($rl\~
Single,
'Ii4.550
Head of
housf!hotd,
$6.650
MllrrrP.fjfiHng
jointly or
Qualifying
widow{er),
$7.600
Married
filing
separately.
03.800
Other
Taxes
Payments
If you have a
qualifying,
cl1rtd, attach
Schedule EIC.
Refund
Direct
deposit? See
pa!;le 51 and
fill In 6Bb,
6Se, and 68d.
Amount
y,
Third Party
Designee
Sign
Here
Joint return?
See P"ge 19.
Keep a copy
for your
records,
Paid
Preparer's
Use Only
.1..;,-
.
~I ' ~
iuilir ,.-
r Illllti~:it'l;
Page 2
((" h7
o Blind.
. ... 35a
34 Amount from line 33 (adjusted gros5 income) . . . . . . . . .
358 Check if: 0 You were 65 or oldm, 0 Blind; 0 Spouse was 65 or older,
Add the number of boxes checked above and enter the total here .
b If you are married filing separat(~ly and your spouse itemizes deductions, or
you were a dual.status alien, see page 31 and check here . . ... 35b 0
Itemized deductions (fi'om Schedule A) or your standard deduction (see left margin) .
Subtract line 36 from line 3<1 .
If line 34 is $99,725 or less, multiply $2.900 by the total number of exemptions claimed on
line 6d. If line 34 is over $99.725, see the worksheet on page 32 .
Taxable income. Subtract line 38 'rom line 37. If line 38 Is more than line 37, enter -o~
1". (ltnl'l Pl'Igt 33). Ch.~K I' MY tit. 1~ f't()m d 0 fl'nrm(l'Io) S81<1 b 0 Fmm 1\1i)7:l
Ahemathre minimum tax (see page 34), Attach Form 6251 .
Add lines 40 and 41
Foreign tax credit, Attach Form 1116 If required
Credit for child and dependent CHre expenses. Attach Form 2441
Credit for the elderly or the disabled. Attach Schedule R.
Education credits. Attach Form BB63
Rate reduction credit. See the worksheet on page 36.
Child tax tredit (see page 37)
Adoption tredit. Attach Fonn 8839 .
Other credits from: a 0 Form 3800
. 0 Fo,,,, 81l<l1 d 0 FOrM ('POOIl'Y)
.51 Add lines 43 through 50. These are your total credits
52 Subtract line 51 from line 42, If line 51 Is more than line 42, enter -0- .
53 Self-employment tax. Attach Schedule SE .
54 Social security and Medicare tax on tip income not reported to employer. Attach Form 4137
55 Tax on qUl:llified plans, including IMs. and other tax-favored accounts. Attach Ferm 5329 if required
56 Advance earned income credit payments from Form(s) W-2 .
51 Household employment taxes. Attach Schedule H
58 Add lines 52 throu h 57. This Is ur total lax
59 Federal income tax withheld from forms W.2 and 1099
\. 60 2001 estimated tax payments and amount applied from 2000 mtllTn
61 a Eam" I"t'ome credit (EIC) .
b Nontaxable earned Income . I 81 b I
62 Excess Social security and RRTA tax withheld (see page 51) 62
63 Additional child tax credit. Attach Form 8812 . 63
64 Amount ~aid with request for extension to me {see page 51) 64
65 Other payments. Check if from a 0 Form 2439 b 0 Form 4136 65
66 Add lines 59. 60, 61a, and 62 throu h 65. These are urtotaf ments . ...
61 If line 66 Is more than line 58, subtract line 58 from line 66. This is tt1e amount you overpaid
68a AmountQfllne67~. . . . . . . ."
. b Routing number ~ . c Type.D Checkln9 D Savings
III- d Account number
69 Amountot line 61 want a to our 2002: estimated tax ... 69
70 A~untyou owe. Subtract line 66 from line_ 58. For details On how to pay, see page 52 ...
11 Estimated tax alt . Also include on line 10 . 11
00 you want to allow another person to discUSS th~s return with ttJe IRS (see page 53)? 0 Yes. Complete the following. 0 No
cS
39
40
41
42
43
44
45
46
47
48
49
50
38
39
I
41
42
I) b i.:; f
~
43
44
45
46
47
48
49
b D Fo.-m 8396
.~
)1 ? l.. I
.~
59
60
61.
I r: (,
i.
Oesignee.s Phone Pefsooal identification ~
name .. no. .. {I number (PIN) , .. ~
Under penalties of pe~my. I deGlafe that I have examined this retllrn and accompanying schedules aild statements. and to the best of my knowledge ilnd
belief. tl1ey are true. cOlfed, and complete. Declaration'of pfeparer (Of her than taxpayer) IS based on an infon'natlon of Which preparer has any knowledge.
)-0tIf 5i (Z. . Your occupa.tlon Daytime phone number
/ . / ~
~-J.../~'----t.... "c.;
a joint m, both must sign. Date Spous.e;s occupation
P.reparer's ~
sIgnature ,
Firm'.. name (Qr ~
yours If self-employed),
address, and ZIP code
Date
Check if
self-employed 0
EIN
Phone no,
Foon 1040 12001J
-"~. ,
SCHEDULES A&B
(Form 1040)
Deparlmelll oflhe Treasury
lnlern~1 Revellue Service (99)
~~
,~'^"
.
Schedule A-Itemized Deductions
OMS No. 1545.0074
(Schedule B is on back)
.... Attach to Form 1040. .... See Instructions for Schedules A and B (Form 1040).
~@01
Attachment
Sequenee No. 07
Yow socials8Curity number
~.1 ! '!Pt.1'l l' '.).c. ;
on Form 1040
"",,,,S , 0
Caution. Do not incl1Jde expenses reimbursed or paid by others.
1 Medical and dental expenses (see pa e A-2). . .
2 Enter amount from Form 1040. III.. 34 . 2
3 Mukiply line 2 above by 7.5% (.075). . . . .. 3
4 Subtract .lirie 3 from line 1. If line 3 is more than line 1, enter .0-
5 State and local income taxes . . 5
6 Real estate taxes (see page A.2). . . . . .. 6
7 Personal propeny taxes. . . . . . . . .. 7
8 Other taxes. List type and amount ~ ....................
9 Aci,iiiriesstliffiu"t;'ii:":' ..:..:' ..:..:.' ': ,.:'.:'..:' ':" .
10 Home mortgage interest and points reported to you on Form 1098
11 Home mortgage interest not reported to you on Form 1098. If paid
to the person from wf10m you bought the home. see page A-3
and show that person's name, identifying no., and address ~
Medical
and
Dental
Expenses
Taxes You
Paid
(See
page A.2.)
Interest
You Paid
(See
page A.3.1
Note.
Personal 12
Interest Is
not
deductible, 13
14
Gifts to 15
Charity
If you made a 16
gift and gut a
benef~ for it:. 17
see page A-A. 18
Casually and
Theft losses 19
Job Expenses 20
and Most
OIlier
Miscellaneous
Deductions
21
ISee 22
page A-5 for
expenses to
deduct here.)
23
24
25
26
OIlier 27
Miscellaneous
Deductions
Total 28
Itemized
Deductions
<[f-l
(..co
11
Points not reported to you on Form 1098. See page A.3
for special rules. . . . . . . . . . . .. 12
Investment interest. Attach Form 4952 if required. (See
page A-3.) . . . . . . . . . . . . .. 13
Add lines 10 throu h 13. . . . . . . . . . .
Gifts by cash or check. If you made any gift of $250 or
more, see page A.4 . . . . . . . . . . .
Other than by cash or check. If any gift of $250 or more,
see page A.4, You musl attach Form 8283 If over $500
Carryover from prior year
Add lines 15 throu h 17. . . . . . . . .
<i-If., 4- Oll
, J 7(.1
I '3'") C'
Casual or theft loss(es). Attach Form 4684. (See
Unreimbursed employee expenses-job travel, union
dues, job education, elc. You must attach Form 2106
or 2106.EZ If required. (See page A-5,) ~ ............h.
:: F';;'~: :ji :~(.::~;:ii.~~:~;;~~:;';:::};:;::: ::: :::
Tax preparation fees J;f.)(.. JI!'-'t#,,<t-J.... . . .
Other expenses-investment. safe deposit box, etc. List
type and amount ~""'h""""'''''''''''''''''''''hh
.,$.IJ.. ..s;.1/1<~" 4. '" &. S!o.l!I..~ .~.f?'*~f-'.yN.krr'"
Add lines 20 through 22 . . . . . . . . . .
Enter amount fromJorm 1040. line 34. 24 II. . ~
Mukiply line 24 above by 2% (.02) . . . . . 25
Subtract line 25 from line 23. If line 25 is more than line 23, enter -0-
Other-from Iisl on page A.6. list type and amount ~ .............................
p..
_ __ _ n~~.. ______n' ____ __... _ _ .~_ ____ ___ __ ..___.. _____._ _... _.. _ __ .__ _ _ ____n.... ___ _n. --..
Is Form 1040, line 34, over $132,950 (over $66,475 if married filing separately)?
o No. Your deduction is not limited. Add the amoums in the far right column }
-r for lines 4 through 27. AlSo, enter this amount on Form 1040, line 36. . ~
ur Yes. Your deduction may be limited, See page A.6 for the amount to enter.
For Paperwork Reduction Act Notice. see Form 1040 instructions.
Cat. No. 11330)(.
Schedule A (Form 1040) 2001
ilii-
" I
Fonn
2106.EZ
Unreimbursed Employee Business Expenses
~@01
Deoanment of the Treasury
Internal Revenue ServiCll (2)
Your name
... Attach to Fonn 1040.
Occupation in which you incurred expenses
,J..es
Attachment
Sequence No. 54A
Social security number
.;;>c).:3b: '1}C/
ILl I'll V
You May Use This Form Only if All of the Following Apply.
· Yl)\i ."" .n .rt1t/llly.. i!l1kI~.llnll '."p."_.. Qltrl~\illllll. II> VCIYr J"'IO,
· You do not get reimbursed by your employer for any expenses (amounts your employer included in box 1 of your Form W-2 are
not considered reimbursemenls).
· If you are claiming vehicie expense, you are using Ihe standard mileage rate for 2001.
Caution: You can use the standard mileage rate for 2001 only If: (a) you owned the vehicle and used the standard mileage
rate for the first year you placed the vehicle in service or (b) you leased the vehicle and used the standard mileage rate for the
portion of the lease period after 1997.
~-
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OMS No. 1545-1441
1m)
Figure Your Expenses
1 Vehicle expense using the standard mileage rate. Complete Part II and multipy line 8a by 34 v,<t ,~ ...'
t.Ma) . . ; i"-'"-' -
2 Parking fees, tolls, and transportation, including train, bus, etc., that did not involve overnight -~ ~ S"
travel or commuting to and from work 2 ~
3 Travel expense while away from home overnight, Including lodging, airplane, car rental, etc. i '7 3r
Do not include meals and entertainment 3 -
4 Business expenses not included on lines 1 through 3. Do not include meais and entertainment 4
5 Meals and entertainment expenses: $ /. q 'i'5" x 50% (.50) (Employees subject to
Department of Transportation (DOT) hours of service limits: Multiply meal expenses by 60% </7 .J ~o
(.60) instead of 50%. For details, see instructions.) . 5
& TOtll .MIII.I1.... AilIlllin.. 1 th"""'llh S. IIll1lQf MM' 11M 111\ !illllll!! If 8'1\111\1\1111 II eft.fll1 1111111).
(Fee-basis $tale or local government officials, qualified performing artists, and individuals with 'ill S.1 SO
disabilities: See the instructions. for s[Jeclal rules on where to enter this amount). .. . . . 6
DllDIJ
Information on Your Vehicle. Complete this part only if you are claiming vehicle expense on line 1.
7 When did you place your vehicle in service for business use? (month, day, year) ~ ...I;J.... I .___L... I .(;.."....
8 Of the total number of miles you drove your vehicie during 2001, enter the number of miles you used your vehicle for:
a Business ......l41-.7..)...~-::.___.. b Commuting ......,Q..LY;C......... c Other .....Jf.~..L.t.?2..........
9 Do you (or your spouse) have another vehicle available for personal use? . . . . . C'fYes 0 No
10 Was your vehicle available for personal use during off-duty hours? 0"'Ves 0 No
11 a Do you have evidence to support your deduction? . QAres 0 No
b If "Yes," is the evidence written? ...... Gl-Yes 0 No
General Instructions
Section references are to the Internal
Revenue Code.
Recordkeeping
You cannot deduct expenses for travel
(including meals, unless you used the
standard meal allowance). entertainment,
gifts. or use of a car or other listed property.
unless you keep records to prove the time,
place. business purpose. business
relationship (f_or entertainment and gifts), and
.mounts of thtlSe exp.nstlS. G.n....lIy, you
must .\to II.... _\111. Ie! .~ Ia!lglng
.xpens.s (regardless of the amount) and any
other expense of $75 or more.
A Change To Note
The standard mileage rate has been
increased to 34'h cents for each mile of
business use in 2001.
Purpose of Form
You may use Fen'll 2106-EZ instead of Form
2106 to claim your unreimbursed employee
business expenses if you meet all the
requirements listed above Part I.
For Pap.rwork Reducllon Act Nollce, .ee back of fonn.
Cat. No. 206040
Additional Information
For more details about employee business
expenses. see:
Pub. 463, Travel. Entertainment. Gift. and Car
Expenses
Pub. 529, Miscellaneous Deductions
Pub. 587, Business Use of Your Home
(Including Use by Day-Care Providers)
'lib, 0411. Hew 'fa i:)@lltl!e\ll\ll flHl)llll\y
Fonn 2106-EZ (2001)
.~
'1" w'J'J~<;. lipS, other compo 2 Federal incQme tax withheld
___ m83.15 13960.76
3 Socl.;)1 ~e(;Ullty wages 4 Social security tal( withheld
___.. m83.15 4797.76
5 M.,...j"::arewages and hps 6 Medicare tax withheld
! m83.15 1122.06
ti" f:mIlIQy~r id~l\hfica!fQn number d Employee's social security number
23-2108853 202-36-7201
'--(': F;;;pl;;;:';i-s-;.,a;;;e'. address. and ZIP code
America Service Group
Prison Health Services, Inc.
105 \Jestpark Drive, Suite 200
Brentwood, TN 37027
"- -"7 So,I"! ,>ecurily tips
8 Allocatedtips
9 ',dv.,nc.e EiC payment
10 Dependent care benefits
11 r~()'h:lu;Ji,fled plans
12a ,See instructions for box 12
e I 116.4Q
T"n;l..,.~, 12b
0" :--1
c 12c
: I
c 12d
: I
13-""iO";,,., ....,""....
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14 Other
e Ernpl~y"l~.~ first name and imtial
last: Name
.IAMES ALAN FURJANIC
96 OFERFIELO RD
, CAMP HILL, PA 17011
i
f ~mployf'te's address and ZIP code
;ts--:'Sbte ~mPio~r's stale 10 number 16 State wages, tips, etc.
, PA t13326096 m96.55
:17 S~:~t<:> I!1come tal( 18 Local wages. tips, etc.
I 2164.29 11055.20
:t9 l.ac<tl If1~C\me tax 436.26 20 Locality name
PAPhll8delphl.CilyN.Re
W~2--~V';;J!;' <lnd Tal( Stamment I2UU.L OMIlNo l~'.~OOB
C"l>'i C f." fMf'LOYEE'"S RECORD5..jSe. Notice 10 ~oYe& on b&ck of
Cnf'V Cl !' f:'f)mtm~nt of the Treasurv. Internal Revenue Service
2001
Year To Date Earnings
"
'."".........',J
Year To Date Deductions
,.ProBuslness
Salary
Retroactive Pay
Hol iday Pay Non-worked
Paid Leave
Group Tenm life> $50000
005-001876-17011
JAMES ALAN FURJANIC
96 DEERFIELD RD
CAMP HILL, PA 17011
74844.92
287.20
1634.60
1307.69
86.60
Pretax Health Plan
Pretax Dental Plan
Pretax EE life 2X
long Term DisabiLity 50%
Group Tenm lffe>$50000 Offset
ASGPHS-104
Soc.aISecurityNQ
202-36-7201
This information is being furnished to the Internal Revenue Service. If you are required tQ file a tal( return, a
negligence penalty Qr ather sanclIon may be Imposed Qn YQU If this income IS taxable and you fall to report it
MarltalSlatus:
Married
ExemptionsfAllov.ranc:es
Federal: 2/0
Resident State 2/0
286.71
58.33
432.82
980.40
86.60
liiilllii.
I~,"plovcc
JAMES FUAJANIC
Code
ASGPHS
Earnin s
Salary
Paid leave
!3roup Term life > $50000
, Total Gross
PaY7P
ld
603328
Social Securitv
202'36-7201
Division
PHSl
Rate
Units Current
33.6500
96.00 3230.40
Taxes
Federal Inoome Tax
Sociel Secutlty (FlCA)
Federel Modicate
Penmiy1varila_-lncome Tsx
~bllpd~I!lbIM Cli\V 1/- Ri'\IO ! I:'blll
Total
PreTax Deductions
Pretax, Health Plan
Pretax Den1ai Plan
Pre"'" EE life 2X
Total
AfterTax Deductions
Long Term Disability ~
Group Term Ufe>$50000 Offset
Total
Net Pay
3230.40
872.21
200.28
46.84 '
90.45
. ,.,'\9
1336.18
0.00
0.00
1894 .22
f <-to
\.0<J0';'
ru <e-k- 40
-
~rtment.
01oa..
5475.90
2335.35
548.17
1053.88
ll1ll?'"
10918.69
219.98
39.91
327 .08
586 . 95
637.13
27.56
664.69
~ ,
--.. " ,_.
~ '.Qi:'liit:i',,L;ti
Slalus
Married
Exemptionsl Allowances
US-Sup P,
Period Sllltt
Number
Hire Date
Memo Entries Current Year To Date
SId Hours Accumulator . Salarv 1040.00
Current Year To Date
W2 GI"06$ WlIII88 3230.40 37667.01
(yO-tK-<> /.?
)/1>
j?Jo;t) - rl< ,
~f{ F/<l'p.,J~-e Ue'.?<Lcf,1J,/4
OJ!.) ;"0 (, T I? S - -1 ff/lOX
1.;, 0 (). !6.J~ek : ". 'l( 100 r
f-" D60~ - r >1'1. "11..,,;01,
b( ).'Yo~ ~ "' 3'8, .)53. '1,1, ..
~/J.'l/~1-: .)7, 3.35'. J'l - I,?-Ou"O-
~ J.o /35,;;'7
America Service Group ~ 105 Wcstpark Drive, Suile 200 Brentwood, TN 37027
"ProBuslness _i
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"
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l'"~n,i'
CHECK NUMBER
01437229
SEa. NUMBER
001105
(l'"Ii'hllnt'. Nom. IQ61 thiii'h Alledt NO, W"k' ! AIM.""' W.'k I AMCJwl1f Qtfl.. I PQM
JAMES A FURJANIC 202-36-7201 09-14-02:442.00 09-21-02 442.00 0996
---- ! UC
INSTRUCTIONS Federal Withholding Tax I Cumulative Tax Withheld
This is your unemployment compensation check for the benefit week(s)
indicated on the check and above. If you are entitled to this check as OFFICE ADDRESS
defined by the PA Unemployment Compensation Law, carefully detach it LANCASTER UC SERVICE CENTER
at the perforallons and cash promptly. If you feel you are not enlllled to 60 W. WALNUT STREET
this check or the check Is for an improper amount. please return It to your LANCASTER PA 17603-3015
Job Center or UC Service Center, do not oash it.
BENEFIT CHECK
"
IIII~I~~~~~I~I~IIIII
TIPS FOR USING PENNSYLVANIA TELECLAIMS--PAT
* Know your social security number and PIN.
* If you are calling to file your ciaim, you may skip the menus by entering 1-3-1 immediately after PAT answers your call.
* If you worked during the week you are claiming, know the amount of your gross earnings, holiday pay, vacation pay, or
if you were absent from work when work was available, the amount you would have earned if you had not been absent
from work.
* DO NOT hang up until PAT tells you that your claim has been accepted or that your answers have been saved. If you
hang up prematurely, your claim may not be flied properly.
* You can find out when to file your next claim by accessing the benefit payment inquiry option. Immediately after PAT
answers your call, enter 1-2-1, your social security number and PIN, as instructed, and then 5.
* After filing your biweekly claims for beneflts,you may call PAT the next day to see if your payment has been processed.
Generally, your payment will be mailed or deposited Into your specified bank account (If you have direct deposit) within
two business days. DO NOT call yoUr UC Service Center regarding your payment until 7 to 10 days after you have filed
for your benefits.
Fi~r U. C. C+i6t:J<, R'cEiVGO A(1?R(;Xifllll1ely ~/y 5, 2t;I2-
FOLD ON PERFORATION. THEN DETACH CAREFULLY
e..tW.~'[' I IliIMf=~I.:"'-"""VI'jlll.'l!!fI'I.'l:':'~IIt~(C't:t'1IIN'.'I~.'~I:::i.:;:m."
'JTI:I[ti:.:I'::I~I.)......;t"I:a'.n.I.:::I."~I..;tlllll:8:1:[.II'.i..=......:1 [&1:1
60.-_122
'313
01437229
09/14/02 $442.00 09/21/02 $442.00
w
CHECK NO.
PAY E-i-ght HundM.d E-i-gh;ty
TO THE ORDEROF .
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O~~T") '.l!'; - -,~~ .l",,,,. .." .
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. - i~'''''>-_:S-;~ , ....!'.::~&~...r"'!, I
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09/24/02
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DATE
VOID AFTER 30 DAYS
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[$**884.00 I
JAMES A FURJANIC
96 DEERFIELD RD
CAMP HILL PA 17011-8469
&~,
TREASURER OF
~
,
PENNS VANIA
.."'''1''"
"'0~":l7 2 2'1'" .:0:1 ~:l0 ~O 2"':
00000 ~o", 088..
. ~~f~":'<}:!:2i'f~.~';'" 1~ il'IINt-RII:H:,l ~ :I.tt{*'~~ "I.m ~.....W,'iI.:::t:lM.l:I:i:__'UIJl~[.)..':{t{toI ~ :.iIlYI I': 1.111.: 1.1.'II([t-.U..{t1:I"I"l'J::I:II~'''''I'I''''=:IM'' :I~
'"'' '" "'" --,--,," "".'.,"..",,,,,,,,, "'j
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i
CERTIFICATE OF SERVICE
A true and correct copy of the foregoing document was delivered to the person or office listed
below on the date indicated by first class mail, addressed as follows:
Cara Y Boyanowski, Esq.
1029 Scenery Drive
Harrisburg, P A 171 09
Datel)~ lfa ~
[
iIliam A Fetterhoff, Esquire
Fetterhoff and Zilli
200 N. Third Street, Suite 800
Harrisburg, PA 17101
(717) 232-7722
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,
CAROL A. FURJANIC,
PLAINTIFF
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYL VANIA
V.
NO. 01-1144
JAMES A. FURJANIC,
DEFENDANT
IN DIVORCE
PRE-TRIAL STATEMENT SUBMITTED BY DEFENDANT
[pa. Rule Civ. Proc. 1920.33(b)]
Date of marriage: February 13, 1982
Date of separation: December 26, 2000
1. Assets: See Inventory. Defendant reserves the right to amend and/or supplement as
necessary.
2. Expert witnesses: Defendant will present the appraiser of the real estate, E. J.
Koppenhaver.
3. Other witnesses: Plaintiff, Defendant; no others anticipated at this time. Defendant
reserves the right to call other witnesses as necessary.
4. Exhibits: The exhibits will be statements showing the value of the accounts/assets, the
extent of the parties' liabilities, the property appraisals, pay stubs, and income tax returns. Defendant
reserves the right to introduce other exhibits as necessary.
5. Gross/net income, tax returns and six (6) months of pay stubs: See Income and
Expense Statement.
6. Expenses: See Income and Expense Statement.
7. Pension/retirement benefits: See Inventory.
.,--
~ '" ,-.
,
8. Defendant does not anticipate any dispute concerning the division of the parties'
tangible personal property, except that the value of such property removed from the marital home by
Plaintiffupon separation greatly exceeds the value of such property she left for the Defendant, which
inequality in distribution must be corrected by cash reimbursement to Defendant.
9. Debts: See Inventory.
10. Evidentiary issues: None anticipated at this time.
11. Proposed resolution of economic issues: Defendant proposes that he receive 59"10 of
net marital assets, based on the proportion of his contribution to the marital estate during the 18 years
of marriage, and based on the current incomes of Defendant and Plaintiff.
Respectfully submitted,
William A. Fetterhoff, Esqui~
200 North Third Street, Suit 800
Harrisburg, PA 17101
(717) 232-7722
Counsel for Defendant
Date: 5ci. J~ d-oQ?,.
'---
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CERTIFICATE OF SERVICE
I
A true and correct copy of the foregoing document was delivered to the person or office listed
below on the date indicated by first class mail" addressed as follows:
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Cara Y.!soyanowski, Esq.
1029 Sc~neryDrive
Harrisburg, PA 17109
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Date: Uo .
;).:2. r:90()';l
William A. Fetterhoff, Esquir
Fetterhoff and Zilli
200 N. Third Street, Suite 800
Harrisburg, P A 17101
(717) 232-7722
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CAROL A. FURJANIC,
Plaintiff
IN THE COURT OF COMMON PLEAS
. CUMBERLAND COUNTY, PENNSYLVANIA
CIVlL ACTION - LAW
v.
NO. 01-1144
JAMES A. FURJANIC,
Defendant
IN DIVORCE
I
I
AMEND D INVENTORY
UNDE RULE 1920.33
Counsel for Plaintiff, Cara A BoyanQwski, Esquire, files the following amended inventory
1
of all property owned or possessed by eitheJj party at the time this action was commenced and all
property transferred within the preceding thr~e years"
I
Counsel verifies that the statements I made in this inventory are true and correct. She
understands that false statements herein are tbde subject to the penalties of 18 Pa.C.S.A ~4904
I
relating to unsworn falsification to authoritiesl Counsel is signing this amended inventory due to the
unavailability of Plaintiff
Date: Il-~ -QP:..,
By~~b
Cara A. Boyanowski, Esquire
Counsel for Plaintiff
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AMENDEpINVENTORY
FURJANIC v. FURJANIC
I
Date of~iage - 02/13/82
Date of Separation - 12/26/00
Assets Husband's Wife's Master's Notes
Value Value Value
Real Estate
Marital Residence: $153,600.00 $180,000.00 Mortgage of approximately
96 Deerfield Road (His $68,000.00 and Home Equity
Camp Hill, PA 17011 Appraisal) Equity: Loan of $84,000.00 at separation.
$50,000.00 Current debt balance
approximately $139,400.00.
Husband 1/3 Ownership in Mother's $10,000.00 Increase in value during marriage.
Residence in Steelton, Pennsylvania
.
Retirement Assets
The Lincoln National Life Date of
Insurance Group (Financial) Separation
Annuity Value:
Wife $26,277.32
Current
Value:
$16,921.58
(As of 9/30/02)
Travelers Life and Annuity Date of Outstanding Loan against account
Wife Separation in amount of$5,708.95 as of
Value: 06/30102.
$365.25
Current
Value:
$178.13
(As of6/30/02)
MARITAL ASSETS
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Assets Husband's Wife's Master's Notes
Value Value Value
Fidelity Investments Date of Current value includes post
401(K) Plan Separation separation contributions of
Wife Value: approximately $14,000.00.
$54,029.96
Curreut
Value:
$40,498.78
Bank Accounts
Members First Account $2,900.00 Value at Date of Separation:
Wife $2,900.00
Current Value:
$25.00
Commerce Bank Account $0.00 Value at Date of Separation:
Wife $0.00
Current Value:
$1,200.00
Mellon Bank Checking Account $3,000.00 Value at Date of Separation:
No. 884-017-4117 $3,000.00
Husband Current Value:
$1,400.00
Mellon Bank Checking Account $0.00 Value at Date of Separation:
No. 100-024-4630 $0,00
Husband Current Value:
$1,100.00
Automobiles
1995 Mitsubishi $7,500.00 Purchased in February, 1997 for
Husband $19,000.00.
No lien exists on vehicle.
1990 Volvo $0.00 $0.00 Vehicle was sold for $4,500.00 and
proceeds were split between
parties.
1999 Diamante $0.00 $0.00 Leased vehicle.
Wife
MARITAL ASSETS
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Assets Husband's Wife's Master's Notes
Value Value Value
MisceUaneous
Household Goods and Furnishings Nominal Nominal Already split between parties.
Loans/Debts
Citibank Mastercard Credit Card Date of Non-marital Husband's debt for personal and
No. 5410-6548-4547-4219 Separation recreational expenses.
Husband Balance:
$12,000.00
Current
Balance:
$12,500.00
Bank One Visa Credit Card Date of Non-marital Husband's debt fur personal and
No. 4417-1259-7248-7718 Separation recreational expenses.
Husband Balance:
$3,000.00
Current
Balance:
$0.00
Visa Credit Card Date of Joint Names.
No. 4287-5900-0036-4451 Separation Account used for marital expenses
Balance: by Wife and personal expenses.
$1,800.00
Current
Balance:
$2,188.08
MARITAL ASSETS
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MLNINQ/SCREEN02 01 087
LOAN MASTER INFORMATION (PART 1)
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11/07/02 11:23
Lpan: , , ,7,7,0,2,0,6,1,5, *Notes FURJANIC JAMES A
177020615
1st/2nd Mtg Cd 1
property Type 11
G/L Type 02
Buydown Code N
Branch 087 State PA status 0
SPECIAL FUNCTION CODES ON LOAN
Int Calc Method 2 ARM Type 01
Int ColI Method 0 Payment Frequency M
Billing Method 3 Participation N
Risk Code N Per Diem 8.677015277
Remaining Term 136
First Due Date
Int Paid~To Dt
Sch pmt Date
Reg pmt
Payment Due Dt
P&I Due
Escrow Due
Curr pmt Due
Late Charges Due
Total Past Due
Total Accr Int
Total Amt Due
Orig Maturity 8/12/13
Curr Maturity 2/01/14
Interest Rate 5.000
Escrow Pmt 229.17
A.P.R. Rate 5.875
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716.43
.00
.00
25.38
.00
.00
Loan Type 1
Orig Term 360
Auto pymt N
Subsidized N
Orig Amount
Origination Date
pay-Off Date
P & I Pmt
103,000.00
8/12/83
0/00/00
602.68
2/01/85
10/01/02
11/01/02
831.85
11/01/02
602.68
229.17
83~.85
Current principal
Total Escrow Bal
Assigned Escrow
Unassigned Escrow
prepaid unapplied
Accrued Escrow Int
Accrued Interest
Buydown/Subsidy Bal
.00
.00
.00
831. 85
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Financial Group" - - >'!l ,,4jr' "
,O'The Lincoln National Life Insurance Company ,,// j1U'" < 6/30/2,002~J/.~3(J/2002
~- Lincoln Retirement Servicing Center /' n A .LJJr-'
::CPO Box 9740 t--" ..I' 'Jf-"L~V
~ Portlanil ME 04104-500 I '"
i
000645
CAROL A_ FURJANIC
iC: 414 N 4TH 5T
,c, LEMOYNE pA 17043-1665
Participant ID: 141039
Plan Number: 569
Employer ID: 560
Plan: HOLY SPIRIT HOSPITAL PARTNERSHIP
SAVINGS PLAN
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Questions? Contact a Service Representative at
1-800-341-0441
t. Value Summary Dollar value Net Gain! Unit value Number of units Dollar value
a3 ~f 6130/2002 activity loss 913012002 9130/2002 as of 913012002
8941:50+006
INbEX 4,96330 870.75- 25.1072 163.0032 4,092.55 "'
GROWTH I 4,097.61 784.63- 24.8494 1333221 3,312.98 Il
~
SMALL CAP 6,085.05 1,269.88- 16,3881 293.8207 4,815.17 :::
EQUlTY-INC 5,825.69 1,124.81- 17.6971 265,6300 4,700.88 "
g
0
Totals $20,97\.65 $4,050.07 - $16,92\.58 *
~
Value by source SALARY EMPWYER :;
g
of contributions DEFERRAL MATCH TOTAL 0
0
~
as of 9/30/201J2 0
$13,044.42 $3,877,16 $16,921.58 ~
~
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New ContribUltion Contract number Contribution Period Interest Rate
Interest Rates
894150+006 07/01/2002-09130/2002 4.85%
Notifications
Please contact Lincoln Life within 30 days of receipt of this statement if information orinvestments are
not accurate. Lincoln Life reserves the right to limit its liability if inaccuracies are not reported promptly.
Prospectuses and various financial reports are available upon request. Please keep in mind that the funds
supporHng.th~ va:'1<ihle ::HlllUity <ire not public fumis an.d ar~ only available through ~nsUiance cdmp~ny
contracts.
Securities offered through Lincoln Financial Advisors and other broker/dealers with effective seUing
agreements.
;;;;;;;;;;;;; Bulletin Board.
-
-
;;;;;;;;;;;;;
;;;;;;;;;;;;;
-
;;;;;;;;;;;;;
""""
;;;;;;;;;;;;;
-
Demand a raise - and get it! Simply increase your contribution to your retirement savings plan and you
could lower your taxable income. It's as good as a raise. So review your household budget. A small
increa-se now coulcJ. make a big difference in your future. For more iriformation, call yo~ Lincoln
representative at (800) 341-0441. Thank you for partnering with Lincoln for your retirement ,and
planning needs.
-
==
;;;;;;;;;;;;;
-
;;;;;;;;;;;;;
""""
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@1998Lincoln Financial Group is the marketing name fo:r Lincoln National Corporation and its affiliate~.
Plan: 569 Employer ID: 560
page 1 of 4
I..
Fid~:'ilyO~/nveSlmenIS@
Holy Spirit Hospital
.
Retirement Savings Statement
July 1, 20.0.2 - Septerober 3D, 20.0.2
#BWNFXQN
ENV#4o.o.28325
40. 58940. 73116 A
CAROL A FURJANIC
186 STONEHEDGE LANE
MECHANICSBURG, PA 17055
~ Fo(online access, log on at
htlp:llwww.fidelity.com/atwork
For information, call: (80.0.) 343-0.860.
Your Account Summary
Your Asset Allocation
Beginning B,lIance
Employee Contributions
Employ.sr Contributions
Change in Account Value
Ending Balance
. $46,284.72
1,038.28
454.27
-7,278.49
$40,498.78
Additional Information
+ Dividends & Interest
$51.10.
II Stocks 93%
. Bonds 7%
Your Personal Rate of Return
This Period '--1.5,5%
Year to Date . -28. 1 %
Your Personal Rate of Return i~ calculated with a time-weighted
formula, widely used by ftnancial analysts to calculate investment
earnings. It reflects the results pf your,investment selections as
well as any activity htha plan accQunt(s) shown. There,are other
Personal Rate of Return formula.s used that may yj~ld different
results. Remember that past performance is no guarantee- of future
results.' ,
Your investments are currently allocated among the'displayed
asset classes. . Percentages' and totals may not be exact due to
rounding. .
Th.e Additional Fund InformatIon se~tion iists.the allocation of . .
your blended funds.
Market Value of Your Account
This section displays the value of your account 'for the period', in both'shares and,dollars.'
mvestment Shares Oil Shares on Price on Price on Market ValLiC Vlatket ila ue
.o6i30/2002. Q9/30/2002 .06/3012002 (19130/2002 an 06130/2002 on 09130/2002
Stock Investments ~$35,731.42 $30,841.14
Fidelity Grow & Inc 624.697 64.5.475 $33.61 $28:82 20.,996.0.7 18.60.2.59
Fide lity Growth Co 369.585 386.318 $39.87 $31.68 14,735_35 12,238.55
Blended Investments' $10.,553.30 $9,657.64
Fid Freedom 2020. . 920..078 . 947.757 $11.47 $10.19 1 0,553.30. 9,657.64
Remember that a dividend payment to fund shareholders reduces the share price of the fund, so a decrease in the share. price for the statement
period does not necessarily reflect lower fund performance.
... Some of your investments are classified as'a Blended Fund Investment Blended Investments may include a mixture of stocks, bonds,
and/or shortMfterm assets. Please ref~r to the "Additional Fund Information" section to determine the' allocation of your blended investments'
underlying as::;ets. The asset breakdown of your portfolio is re"ected in the pie chart in the "Asset' Allocation" Section.
Please read'this statement carefully. Ar,y error must be reported to Fidelity Investments within 90 days.
28325 40.0.28325 0.00.1 20.0.21 0.0.9 40.313
Fidelity Investments, P.O. Box 770.0.0.2, Cincinnati, OH 45277:0.0.90
Page 1 of 5
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CAROL A. FURJANIC,
Plaintiff
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
v.
NO. 01-1144
JAMES A. FURJANIC,
Defendant
IN DIVORCE
PRAECIPE TO TRANSMIT RECORD
To the Prothonotary:
Transmit the record together with the following information, to the court for entry of a
divorce decree:
1. Ground for divorce: irretrievable breakdown under ~3301 ( c) of the Divorce Code.
2. Date and manner of service of the complaint: A copy of the Divorce Complaint was
served upon Defendant, by first class mail, certified, restricted delivery, on March 3,
2001.
3. (Complete either paragraph (a) or (b).)
(a) Date of execution of the affidavit of consent required by ~3301(c) of
the Divorce Code: by Plaintiff April 24, 2003; by Defendant: April 20, 2003.
(b )(1) Date of execution of the affidavit required by ~3 30 1 (d) of the Divorce
Code: N/ A; (2) Date of filing and service of the Plaintiff's Affidavit upon the
respondent: N/A.
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4. Related claims pending: None.
5. (Complete either (a) or (b).)
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( a) Date and manner of service of the notice of intention to file praecipe to
transmit record; a copy of which is attached: Nt A.
(b) Date Plaintiff's Waiver of Notice in ~3301(c) Divorce was filed with the
Prothonotary: May 5,2003.
Date Defendant's Waiver of Notice in ~3301(c) Divorce was filed with
the Prothonotary: May 5,2003.
Respectfully submitted,
DALEY LAW OFFICES
Q~~~b
Supreme Court I.D. No. 68736
1029 Scenery Drive
Harrisburg, P A 17109
(717) 657-4795
Attorney for Plaintiff
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AGREEMENT
BETWEEN
CAROL A. FURJANIC
AND
JAMES A. FURJANIC
Cara A Boyanowski, Esquire
Counsel for Wife
William A. Fetterhoff, Esquire
Counsel for Husband
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TABLE OF CONTENTS
SECTION I:
Introduction
3
SECTION II:
General Provisions
4
SECTION III:
Alimony and Alimony Pendente Lite
Provisions
10
SECTION IV:
Property Distribution Provisions
10
SECTION V:
Closing Provisions and Execution
14
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SECTION I
INTRODUCTION
~
THIS AGREEMENT made this $:4 Jh day of , 2003, by and
between CAROL A. FURJANIC ("Wife") ~d JAMES A. ANIC ("Husband").
WITNESSETH:
WHEREAS, Carol A. Fwjanic, Sdcial Security Number 185-38-6096, was born on
September 28, 1949, and currently resides at, 186 Stonehedge Lane, Mechanicsburg, Cumberland
County, Pennsylvania 17055.
WHEREAS, James A. Fwjanic, SociJi Security Number 202-36-7201, was born on May 8,
1948, and currently resides at 96 Deemeld Road, Camp Hill, Cumberland County, Pennsylvania
17011.
WHEREAS, the parties hereto are Husband and Wife, having been married on February 13,
1982, in Harrisburg, Dauphin County, Pennsylvania.
WHEREAS, the union of the parties produced no children.
WHEREAS, diverse unhappy differences, disputes and difficulties have arisen between the
parties, and it is the intention of Wife and Husband to live separate and apart for the rest of their
natural lives, and the parties hereto are desirous of settling fully and finally their respective financial
and property rights and obligations as between each other, including, without limitation, the settling
of all matters between them relating to the ownership of real and personal property, the equitable
distribution of such property; the settling of all matters between them relating to the past, present and
future support and/or maintenance of Wife by Husband or of Husband by Wife; and, in general, the
settling of any and all claims and possible claims by one against the other or against their respective
estates.
NOW, THEREFORE, in consideration of the mutual promises, set forth herein and for other
good and valuable considerations, WIfe and Husband, each intending to be legally bound hereby agree
as follows:
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SECTION II
GENERAL PROVISIONS
1. MUTUAL CONSENT DIVORCE
The parties intend to secure a mutual consent, no fault divorce pursuant to the provisions of
Section 3301( c) of the Divorce Code of1980, as amended and will execute the documents necessary
to effectuate a divorce under those provisions concurrently with the execution of this Agreement.
2. EFFECT OF DIVORCE DECREE
The parties agree that unless otherwise specificaIly provided herein, this Agreement shall
continue in full force and effect after such time as a final decree in divorce may be entered with
respect to the parties.
3. AGREEMENT TO BE INCORPORATED BUT NOT MERGED IN DIVORCE
DECREE
The provisions of this Agreement may be incorporated by reference but sha11 not be deemed
merged into any judgment or decree for divorce obtained by either party. This agreement shaIl
survive any such final decree of divorce, sha11 be entirely independent thereof; and the parties intend
that all obligations contained herein shall retain their contractual nature in any enforcement
proceedings, whether enforcement is sought in an action on the contract itself or in any enforcement
action filed to the divoTce complaint.
4. DATE OF EXECUTION
The "date of execution" or "execution date" of this Agreement sha11 be defined as the date
upon which it is executed by the parties if they have each executed the Agreement on the same date.
Otherwise, the "date of execution" or "execution date" of this Agreement sha11 be defined as the date
of execution by the party last executing this Agreement.
4
5. ADVICE OF COUNSEL
The provisions of this Agreement and their legal effect have been fully explained to WIfe by
her attorney, Cara A Boyanowski, Esquire. The provisions of this Agreement and their legal effect
have been fully explained to Husband by his attorney, William A. Fetterhoff, Esquire. The parties
acknowledge that they fully understand the facts and have been fully informed as to their legal rights
and obligations, and they acknowledge and accept that this Agreement is, in the circumstance, fair
and equitable and that it is being entered into freely and voluntarily, after having received such advice
and with such knowledge and that execution of this Agreement is not the result of any duress or
undue influence and that it is not the result of any collusion or improper or illegal agreement or
agreements.
6. TAX PROVISIONS
The parties believe and agree, and have been so advised by their respective attorneys, that the
division of property heretofore made by this Agreement is anon-taxable division of property between
co-owners rather than a taxable sale or exchange of such property. Each party promises not to take
any position with respect to the adjusted basis of the property assigned to him or her or with respect
to any other issue which is inconsistent with the position set forth in the preceding sentence on his
or her federal or state income tax returns.
The parties have heretofore filed joint federal and state tax returns. Both parties agree that
in the event any deficiency in federal, state or local income tax is proposed, or any assessment of any
such tax is made against either of them, each will indemnify and hold harmless the other from and
against any loss or liability for any such tax deficiency or assessment and any interest, penalty and
expense incurred in connection therewith. Such tax, interest, penalty or expense shall be paid solely
and entirely by the individual who is finally detennined to be the cause of the misrepresentations or
failures to disclose the nature and extent of his or her separate income on the aforesaid joint returns.
7. PERSONAL RIGHTS
WIfe and Husband may and shal~ at all times hereafter, live separate and apart. They shall
be free from any contact, restraint, interference or authority, direct or indirect, by the other in all
respects as fully as if they were unmarried. Each may, for his or her separate use or benefit, conduct,
carry on and engage in any business, occupatiGll, profession or employment which to him or her may
seem advisable. WIfe and Husband shall not molest, harass, disturb, or malign each other or the /lr-:Y-
respective families of eac~ otJ.1er nor compel or attempt to compel the other to cohabit or dwell by f1t?
any means whatsoever Wlth him or her. Date of separation: December 26, 2000.
~'f
5
8. MUTUAL RELEASES
Except as otherwise expressly provided by this Agreement:
A. Each party hereby absolutely and unconditionally releases and forever discharges the
other and the estate of the other for all purposes from any and all rights and obligations which either
may have or at any time hereafter have for past, present or future support or maintenance, alimony
pendente lite, alimony, equitable distribution, counsel fees, costs, expenses and any other right or
obligation, economic or otherwise, whether arising out of the marital relationship or otherwise,
including all rights and benefits under the Pennsylvania Divorce Code of 1980, its supplements and
amendments, as well as under any other law of any other jurisdiction, except and only except all
rights, agreements and obligations of whatsoever nature arising or which may arise under this
Agreement or for the breach of any provision thereof. Neither party shall have any obligation to the
other not expressly set forth herein.
B. Each party hereby absolutely and unconditionally releases and forever discharges the
other and his or her heirs, executors, administrations, assigns, property and estate from any and all
rights, claims, demands or obligations arising out of or by virtue of the marital relationship of the
parties or otherwise, whether now existing or hereafter arising. The above release shall be effective
regardless of whether such claims arise out of any former or future acts, contracts, engagements or
liabilities or the other or by way of dower, curtsey, widow's rights, family exemption or similar
allowance, or under the intestate laws, or the right to take against the spouse's will, or the right to
treat a lifetime conveyance by the other as testamentary, or all other rights of a surviving spouse to
participate in a deceased spouse's estate, whether arising under the laws of Pennsylvania, any state,
commonwealth or territory or the United States, or any other country. It is expressly understood,
however, that neither the provisions of this release nor the subsequent entry of a divorce decree are
intended to defeat the right of either party to receive any insurance proceeds at the death of the other
of which she or he is the named beneficiary (whether the beneficiary designation was made prior or
subsequent to execution hereof), nor to defeat the right of either party to receive any legacy, bequest
or residuary portion of the other's estate under his or her will, or to act as personal representative or
executor if so named by the will of the other, whether such will was executed prior or subsequent to
this Agreement.
C. Except for any cause of action for divorce which either party may have or claim to
have, and except for the obligations of the parties contained in this Agreement and such rights as are
expressly reserved herein, each party gives to the other by the execution of this Agreement an
absolute and unconditional release and discharge from all causes of action, claims, rights or demands
whatsoever, in law or in equity, which either party ever had or now has against the other.
6
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9. FINANCIAL DISCLOSURE
The parties have disclosed to each other and they are each aware of the extent of each other's
income, assets, liabilities, holdings and estate. Each of the parties acknowledge that he or she is
aware of his or her right to seek discovery including, but not limited to, written interrogatories,
motions for production of documents, depositions and all other means of discovery permitted under
the Pennsylvania Rules of Civil Procedure. Each party is satisfied that no additional information is
necessary for the execution of this Agreement.
10. PRESERVATION OF RECORDS
Each party will keep and preserve for a period offour (4) years from the date of their divorce
decree all financial records relating to the marital estate, and each party will allow the other party
access to those records in the event of tax audits.
11. WAIVER OR MODIFICATION TO BE IN WRITING
No modification or waiver of any of the terms hereof shall be valid unless in writing and
signed by both parties and no waiver or any breach hereof or default hereunder shall be deemed a
waiver of any subsequent default of the same or similar nature.
12. REMEDIES IN THE EVENT OF A BREACH
Any party breaching this Agreement shall be liable to the other party for all costs, including
reasonable counsel fees incurred by the non-breaching party to enforce his or her rights under the
provisions of this Agreement subsequent to the date of execution of this Agreement, regardless of
whether litigation is instituted. In the event of default of any of the provisions of this Agreement by
one of the parties, the remedies available to the other are cumulative and include all remedies at law
and in equity, including those for breach of contract, under theories or equity, under the Domestic
Relations Code as amended, including Section 3105 of the Domestic Relations Code (which includes
contempt) as if this Agreement had been an Order of Court, and shall not be limited to those remedies
specifically referred to in this Agreement.
7
13. LAW OF PENNSYLVANIA APPLICABLE
This Agreement shall be construed in accordance with the laws of the Commonwealth of
Pennsylvania.
14. AGREEMENT BINDING ON HEIRS
Except as may otherwise be provided, this Agreement shall be binding and shall inure to the
benefit of the parties hereto and their respective heirs, executors, administrators, successors, and
assigns.
15. INTEGRATION
This Agreement constitutes the entire understanding of the parties and supersedes any and all
prior agreements and negotiations between them. There are no Tepresentations or warranties other
than those expressly set forth herein.
16. OTHER DOCUMENTATION
Wife and Husband covenant and agree that they will forthwith (within ten (l0) days at most
after demand thereof) execute any and all written instruments, assignments, releases, satisfactions,
deeds, notes or such other writings as may be necessary or desirable for the proper effectuation of
this Agreement.
17. NO WAIVER OF DEFAULT
This Agreement shall remain in full force and effect unless and until terminated under and
pursuant to the terms of this Agreement. The failure of either party to insist upon strict performance
of any of the provisions of this Agreement shall in no way affect the right of such party hereafter to
enforce the same, nor shall the waiver of any breach of any provision hereofbe construed as a waiver
of any subsequent default of the same or similar nature, nor shall the waiver of any breach of any
provision hereof be construed as a waiver of strict performance of any other obligations herein.
8
18. SEVERABll.JTY AND INDEPENDENT AND SEPARATE COVENANTS
The parties agree that each separate obligation contained in this Agreement shall be deemed
to be a separate and independent covenant and agreement. If any term, condition, clause or provision
of this Agreement shall be determined or declared to be void or invalid in law or otherwise, then only
that term, condition, clause or provision shaIl be stricken from this Agreement and in all other
respects this Agreement shall be valid and continue in full force, effect and operation. Likewise, the
failure of any party to meet her or his obligations under anyone or more of the paragraphs herein,
with the exception of the satisfaction of any conditions precedent, shall in no way avoid or alter the
remaining obligations of the parties.
19. MANNER OF GIVING NOTICE
Any notice required by this Agreement to be sent to Wife shall be sent by certified mail, return
receipt requested, to Carol A. FUIjanic 186 Stonehedge Lane, Mechanicsburg, Pennsylvania 17055,
or counsel for Carol A. FUIjanic, or such other address as Wife from time to time may designate in
writing.
Any notice required by this Agreement to be sent to Husband shall be sent by certified mail,
return receipt requested, to James A. FUIjanic, 96 Deerfield Road, Camp Hill, Pennsylvania 17011,
or counsel for James A. FUIjanic, or such other address as Husband from time to time may designate
in writing.
20. HEADINGS NOT PART OF AGREEMENT
Any headings preceding the text of the several paragraphs and subparagraphs hereof are
inserted solely for convenience of reference and shall not constitute a part of this Agreement nor shall
they affect its meaning, construction or effect.
9
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SECTION m
ALIMONY AND ALIMONY PENDENTE LITE PROVISIONS
1. ALIMONY
The parties acknowledge and agree that the provisions of this Agreement providing for
equitable distribution of marital property are fair, adequate and satisfactory to them and are accepted
by them in lieu of and in full and final sett1eme'lt and satisfaction of any claims or demands that either
may now or hereafter have against the other' for support, maintenance, alimony pendente lite or
alimony, Husband and Wife further, voluntaryy and intelligently, waive and relinquish any right to
seek from the other payment for support, maintenance, alimony pendente lite or alimony.
SECTION IV
PROPERTY DISTRIBUTION PROVISIONS
1. PERSONAL PROPERTY
Husband and Wife do hereby acknowledge that they have previously divided their tangible
personal property including, but without limitation, jewelry, clothes, furniture, furnishings, rugs,
carpets, household equipment and appliances, pictures, books, works of art and other personal
property. Wife agrees that all of the property in the possession of Husband shall be the sole and
separate property of Husband; and Husband agrees that all of the property in the possession of Wife
shall be the sole and separate property of Wife. The parties do hereby specifically waive, release,
renounce and forever, abandon any claims which either may have with respect to the above items,
which shall thereafter be the sole and exclusive property of the other.
2. RETIREMENT BENEFITS
The parties agree that Wife shall retain sole ownership and possession of all of her retirement
benefits and plans, including, but not limited to, the Lincoln National Life Insurance Group (Financial)
Annuity, the Travelers Life and Annuity, and the Fidelity Investments 401(k) Plan, and Husband
specifically releases and waives any and all interest, claim or right that he may have to these assets.
10
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Wife shall assume sole responsibility for all outstanding loans on her retirement plans and
benefits.
3. BANK ACCOUNTS
Husband and Wife are the owners of individual bank accounts. Husband and Wife agree that
these accounts shall be the sole and separate property of the person in whose name they are titled and
each party waives any right, title or interest they may have in the other parties' account.
,
4. AUTOMOBILES
The parties are the owners of a 1995 Mitsubishi automobile. Husband and Wife agree that
I
this automobile shall be the sole and separate property of Husband, and Wife waives any right, title
or interest she may have in this vehicle. I
I
The parties further agree that they were the owners of a 1990 Volvo automobile during the
course oftheirmaniage. The parties sold this ~ehicle and received the sum of$4,500.00. The parties
acknowledge that these proceeds were equally divided between them, to their mutual satisfaction.
I
5. CURRENT LIABILITIES
Husband agrees to be solely responsible for satisJying all payments on the Citibank
MasterCard credit card debt (Account number 5410-6548-4547-4219) and theBank One Visa credit
card debt (Account number 4417-1259-7248-7718). By accepting sole responsibility ofthese debts,
Husband shall keep Wife and her property, successors, assigns, heirs, executors and administrators
indemnified and held harmless from any liability, costs or expenses, including attorney's fees, which
may be incurred in connection with the above listed liabilities.
Wife agrees to be solely responsible for satisfYing all payments on the Members First Federal
Credit Union Visa credit card debt (Account'number 4287-5900-0036-4451). By accepting sole
responsibility of this debt, Wife shall keep Husband and his property, successors, assigns, heirs,
executors and administrators indemnified anq held harmless from any liability, costs or expenses,
including attorney's fees, which may be inc4ed in connection with the above listed liability.
Wife and Husband represent that thej have taken all steps necessary to make sure that no
credit cards or similar accounts exist as of the date of execution of this Agreement which provide for
joint liability. From the date of execution of fhis Agreement, each party shall use only those credit
11
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cards and accounts for which that party is indi~dually liable.
6. WAIVER OF PAYMENT OF LEG~ FEES
Each party hereby agrees to be respon!nble for any legal fees incurred on their behalf
I
7. AFTER-ACOUIRED PROPERTY I
I
Each of the parties shall hereafter own] and enjoy, independently of any claim or right of the
other, all items of property, be they real, pe~sonal or mixed, tangible or intangible, which were
acquired by him or her after the parties' date of separation, with full power in him or her to dispose
of the same as fully and effectively, in all respects and for all purposes, as through he or she were
unmarried.
8. REALESTATE
A. Marital Residence - The parties acknowledge that they are the owners of certain real
property known as 96 Deerfield Road, Camp Hill, Cumberland County, Pennsylvania 17011
(hereinafter referred to as "Marital Residence"), which is subject to a mortgage and a Home Equity
Loan. The parties agree as follows with respect to the Marital Residence:
(1) Husband agrees that within thirty (30) days following the date of
execution of this Agreement, he will prepare and file all documentation necessary to
apply for a mortgage, in his sole name, for the Marital Residence. Furthermore,
Husband agrees that he will complete the refinance of the mortgage within one
hundred twenty (120) days following the date of the execution of this Agreement.
(2) Simultaneous with the refinancing of the marital residence, Wife shall
execute all documents necessary, including a deed, to transfer all of her right, title and
interest in the Marital Residence to Husband. Thereafter, Husband shall be the sole
and separate owner of the Marital Residence.
(3) Wile agrees that simultaneous with the refinancing of the marital
residence, any and all title policies and any other policy of insurance with respect to
the Marital Residence shall be endorsed to reflect Husband as sole owner thereof and
further agrees that Husband shall be entitled to receive any payments thereafter due
under any such insurance policies.
12
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(4) Except as otherwise pr<~vided herein, simultaneous with the signing of
this Agreement, Husband shall be so.ely responsible for all costs, expenses and
liabilities associated with or attributabl~ to the Marital Residence regardless of when
,
the same shall have been incurred including, but not limited to, mortgage, home equity
loans, taxes, insurance premiums and q1aintenance and Husband shall keep Wife and
her property, successors, assigns, heirs,! executors and administrators indemnified and
held harm1ess from any liability, costs or expense, including attorney's fees, which may
I
be incurred in connection with such lil\bilities and expenses or resulting from Wile's
ownership interest in said property.
(5) In the event Husband d~es not qualifY for a new mortgage, Husband
agrees to list the marital residence for sale. The parties agree that Wife shall not be
held responsible for any costs, repairs, br sale deficiencies, associated with the sale of
,
the marital residence. The proceeds ;of the sale sha1l be divided in the following
fashion: I
1. Satisfy all remaining liens against the real property;
2. Satisfy ljll closing costs and necessary expenses incurred
in the sale of the real property;
3. Pay anyi remaining net proceeds to Husband.
The parties agree that the price:and terms of sale shall be the fair market value
of the property. '
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SECTION V
CLOSING PROVISIONS AND EXECUTION
Each of the parties has carefully read and fully considered this Agreement and all of the
statements, terms, conditions, and provisions thereof prior to signing below.
IN WITNESS WHEREOF, intending to be legally bound hereby, the parties hereto have
set their hands and seals on the date indicated below.
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CAROL A FURl
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JAMES A FURl~C
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