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01-1144
CAROL A. FU1LIANIC, Plaintiff V. JAMES A. FURJANIC, Defendant : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 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 fights important to you, including custody or visitation of your children. When the ground for the divorce is indignities or irretrievable breakdown of the marriage, you may request marriage counseling. A list of marriage counselors is available in the office of the Prothonotary, Cumberland County Courthouse, 1 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 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. Usted debe presentar una apariencia escrita o en persona o por abogado y archivar en la corte en forma escrita sus defensas o sus objeciones a las 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 o notificacion y por cualquier queja o alivio que es pedido en la peticion do demanda. Usted puede perder dinero o sus propiedades o otros derechos importanates para usted. LLEVE ESTA DEMANDA A UN ABODAGO INMEDIATAMENTE, SI NO TIENE ABOGADO O SI NO TIENE EL D1NERO SUFICIENTE DE PAGAR TAL SERV1CIO, VAYA EN PERSONA O LLAME POR TELFONO A LA OFIC1NA CUYA DIRECCION SE ENCUENTRA ESCRITA ABAJO PARA AVERIGUAR DONDE SE PUEDE CONSEGUIR ASISTENCIA LEGAL. CUMBERLAND COUNTY BAR ASSOCIATION LAWYER REFERRAL SERVICE 2 LIBERTY AVENUE CARLISLE, PA 17013 717-249-3166 1-800-990-9108 CAROL A. FURJANIC, Plaintiff V. JAMES A. FURJANIC, Defendant 1N THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION- LAW NO. IN DIVORCE COMPLAINT IN DIVORCE COUNT I DIVORCE AND NOW comes the above Plaintiff, Carol A. Furjanic, 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 17011. 2. The Defendant, James A. Furjanic, is an adult individual who resides at 96 Deerfield Road, Camp Hill, Cumberland County, Pennsylvania 17011. 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. 4. The Plaintiff and Defendant were married on February 13, 1982, in Harrisburg, Dauphin County, Pennsylvania. 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 3301(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 Plaintiffmay have the right to request the parties to participate in counseling. 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 1 through 9 of this Complaint are incorporated herein by reference as though set forth in full. 11. Plaintiffand 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 1 through 9 of this Complaint are incorporated herein by reference as though set forth in full. 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 of living established during the marriage. WHEREFORE, Plaintiffrequests 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. Plaintiffis unable to sustain herself during the course of this litigation. WHEREFORE, Plaintiff requests your Honorable Corot 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. 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 l 8 Pa.C.S.A. §4904 relating to unsworn falsification to authorities. Carol A. Furjanic, Plaffitiff Date: By: 1029 Scenery Drive Harrisburg, PA 17109 (717) 657-4795 Attorney for Plaintiff CAROL A. FURJANIC, : Plaintiff : VS. : JAMES A. FURJANIC, : Defendant : IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 01 - 1144 CIVIL IN DIVORCE ORDER OF COURT AND NOW, this ~ day of n~g's 2003, the economic claims raised in the proceedi 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 William A. Fetterhoff Attorney for Defendant ~U :'f : CAROL A. FURJANIC, Plaintiff JAMES A. FURJANIC, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CWIL ACTION - LAW NO. 01-1144 C1VIL TERM IN DIVORCE AFFIDAVIT OF SERVICE Kathleen Carey Daley, Esquire, being duly sworn according to law, deposes anti 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. Fmjanic, 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 of the Complaint was duly endorsed with notice to Defendant to appear and answer or the matter would proceed without him. Sworn to and ~bscribed before me this ~day of ~,d ~q1~o_4%1~ ,2002 NOTARIAL SEAL PATRICIA A. PATTON. Notary Public LoweF Paxton Twp., Dauphin County My Commission Expires June 20, 2006 By: K Attorney No. 30078 1029 Scenery Drive Harrisburg, PA 17109 (717) 657-4795 Attorney for Plaintiff · Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery ia 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 mailplece, or on the front if space pan-nits. 1. Article Addressed to: PS Form 3811, July 1999 C.S Domestic Return Receipt 102595-99-M- 178g CAROL A. FURJANIC, Plaintiff JAMES A, FURJANIC, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 01-1144 IN DIVORCE AFFIDAVIT OF CONSENT 27,2001. 2. A Complaint in Divorce under §3301(c) of the Divorce Code was filed on February The marriage of Plaintiff and Defendant is irretrievably broken and ninety (90) days have elapsed fi.om the date of filing and service of the Complaim. 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 unswom falsification to authorities. Date: (_/f~ ~/~(J 5 By: Carol A. Furjani~ Socia S ,dtyNo. CAROL A. FURJANIC, Plaintiff JAMES A. FURJANIC, Defendant : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : CIVIL ACTION - LAW : : NO. 01-1144 : : IN DIVORCE WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER §$301(C) OF TIlE DIVORCE CODE 1. I consent to the entry of a final decree of divorce without notice. 2. 1 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. 1 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 fried with the Prothonotary. I verify that the statements made in this affidavit are tree 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. Carol A. Furjani<, PtFaintiff CAROL A. FURJANIC, Plaintiff JAMES A. FURJANIC, Defendant : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : CIVIL ACTION - LAW : : NO. 01-1144 : : IN DIVORCE AFFIDAVIT OF CONSENT 27,2001. 2. A Complaint in Divorce under §3301(c) of the Divorce Code was filed on February The marriage of Plaintiffand Defendant is irretrievably broken and J~inety (90) days have elapsed fi.om 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 unswom falsification to authorities. By: James A. Furjanic, Defendant Social SecufityNo. fltD~- ,~& -- CAROL A. FURJANIC, Plaintiff JAMES A. FURJANIC, Defendant : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : CIVIL ACTION - LAW : : NO. 01-1144 : : IN DIVORCE WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER §3301(C) OF THE DIVORCE 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 ifI 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 at~er it is filed with thc 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 unswom falsification to authorities. Date: ,//...-'/ . lades ^. Fu&~c, Defiant CAROL A. FURJANIC VS. JAMES A. FURJANIC Plaimiff Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW 01 - 1144 NO. CIVIL 19 IN Iii VONCE STATUS SHEET DATE: ACTIVITIES: CAROL A. FURJANIC, Plaintiff vs. JAMES A. FURJANIC, Defendant IN THE COURT OF CO~ON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 01 - 1144 CIVIL IN DIVORCE TO: Cara A. Boyanowski William A. Fetterhoff Attorney for Plaintiff Attorney for Defendant DATE: Friday, October 4, 2002 CERTIFICATION I certify that discovery is complete as to tlhe claims for which the Master has been appointed. (a) OR IF DISCOVERY IS NOT COMPLETE: 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. (b) Provide approximate date when discovery wilZ~ 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 ?OR THE FILING OF PRETRIAL STATEMENTS UNTIL CO~qSEL 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. CAROL A. FURJANIC, Plaintiff Vs. JAMES A. FURJANIC, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 01 - 1144 CIVIL 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. 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 ~r. 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 401(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 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 Steelton and wi~e 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 tangi[ble 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 do£ng so we can establish the credit that each party is entitled '5o 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 home equity line; an appraisal, if necessary, for the personalty; and a computation regarding the credit that may be due to either party on account of debt that has been paid or will be assumed by each of the parties. In addition, counsel should have a value for the 1995 Mitsubishi and current statements for the retirement plans of wife. Aisc, 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 the Master to be provided on that date. cc: Cara A. Boyanowski Attorney for Plaintiff William A. Fetterhoff Attorney for Defendant E. Robert Elicker, Divorce Master CAROL A. FURJANIC V. JAMES A. FURJANIC IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 01 - 1144 1N DIVORCE ORDER AND NOTICE SETTING HEARING TO: Carol A. Furjanic Cara A. Boyanowski , Plaintiff , Counsel for Plaintiff James A. Furjanic , Defendant William A. Fetterhoff , 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 North Hanover Street, Carlisle, Pennsylvania, on the 28th day of April 2003 9:00 , at 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, George l~r. Hoffer, President Judge 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. CAROL A. FURJANIC, PLAINTIFF/Respondent JAMES A. FURJANIC, DEFENDANT/Petitioner IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 01-1144 Civil Term IN DIVORCE PETITION FOR EMERGENCY RELIEF PURSUANT TO 23 Pa. C.S.A. §3502 (0 and §3505 AND NOW, this c~,~r'~ day of May, 2001 comes James A. Furjanic, Defendant above- named (hereinafter "Petitioner") by his attorney, Marilyn C. Zilli, Esquire, who petitions this Honorable Court for an Emergency Order prohibiting Plaintiff Carol A. Furjanic, (hereina~er "Respondent") fxom 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 fried 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. 4. Sometime in March, 2000, Respondent removed multiple pieces of expensive crystal fi.om 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 fi'om the marital residence on Saturday, May 19, 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. 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 ~iven 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. WHEREFORE, Defendant/Petitioner prays this Honorable Court for an Emergency Order prohibiting PlaintitFRespondent from dissipating, disposing, transferring, alienating, encumbering or otherwise affecting in violation of Petitioner's rights thereto any marital asse~, 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 of all property removed fi.om the marital residence and oftbe current location thereof.. He further prays that this Court order that so long as Defendant/Petitioner continues to reimburse her for payment of the loan on his car, and until other arrangements can be made, PlaintifffRespondent shall make the payments on this loan. Date Marilyn C. Zill~ Esqu~ x Fetterhoffand Zilli 200 North Third Street, Suite 800 Harrisburg, PA 17101 (717) 2a2-7722 VERIF~CATION are 2ru~ and correct to ghe bee2 off my knowl~dqe, understanding, and belief. I undere~and ~ha~ falee etatemente herein are made eubJeet to the penalties of 28 Pa. C.~. t4904 relatinq to un,worn falsification to authorities. 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. 1029 Scenery Drive Harrisburg, PA 17109 Marilyn C. Zilli, Esqui~J ~ Fetterhoff and Zilli 200 North Third Street, Suite 800 Harrisburg, PA 17101 (717) 232-7722 0 CAROL A. FURJANIC, Plaintiff/Respondent VS. JAMES A. FURJANIC, Defendant/Petitioner IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA 01-1144 CIVIL CIVIL ACTION - LAW 1N DIVORCE IN RE: PETITION FOR EMERGENCY RELIEF ORDER AND NOW, this fi' ~' 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 PENNsYLVANiA One round (12") LR table MBR dresser w/mirror (wife's) One night stand One plant stand (premarital) One mirrored stand Two MBR wall pictures China One-half the rags 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 Plaintiff/Respondent Marilyn Zilli, Esquire For the Defendant/Petitioner :rim ~AY 2 4 CAROL A. FURJANIC, : PLAINTIFF/Respondent : JAMES A. FURJANIC, DEFENDANT/Petitioner IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 01-1144 Civil Term : IN DIVORCE ORDER AND NOW, this ~% day of May, 2001, a~er due consideration of the attached Petition for Emergency Relief, it la hereby or~i~l th& PlalntiflTRespondent is prohibited fi.om disposin~ alienating or in any way encumbering any property subject to equitable distribution in this case. O~k.l"~-" rsn'~"- :- ~,-~ u ~1 thc C~ts.t i~ nclkqe8 tlutt all ~l~l- tlr' t'~itfaetion of I~oth porlio£. In the meantime, PlaintiflTRespondent 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. ~ ~1~.~.~, c~ I1 .'_ ~o ordered that g~ lnng oq rs,~ond~ls~ot[fi~..ct con~',~s to roimb~*~ her for ~ ~ ..,cat ofths k~ ~ :gs c-a~, ,-.d ,,',I~;~ o~er a,.~,.,~m~ats ¢~/I 1~ l~one, plol,,.:"~B.~opondc-..t shall .. -~t~ the CAROL A. FURJANIC, Plaintiff V. JAMES A. FURJAN1C, Defendant : EN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : CIVIL ACTION - LAW : : NO. 01-1144 : 1N DWORCE 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. §4904 relating to unswom falsification to authorities. Date: Carol A. Furjanic, Pla~l/ff ~/ INVENTORY FURJAN1C v. FURJANIC Date of Marriage - 02/13/82 Date of Separation - 12/26/00 Assets Real Estate Marital Residence: 96 Deerfield Road Camp Hill, PA 17011 Husband 1/3 Ownership in Mother's Residence in Steelton, Pennsylvania Retirement Assets The Lincoln National Life Insurance Group (Financial) W~ffe Travelers Uffe and Annuity Wife MARITAL ASSETS Husband's Wife's Value Value $153,600.00 (His Appraisal) $180,000.00 Equity: $50,000.00 $10,000.00 Date of Separation Value: $26,277.32 Current Value: $20,971.65 (As of 6/30/02) Date of Separation Value: $365.25 Current Value: $178.13 (As of 6/30/02) Master's V~lue Notes Mortgage of approximately $68,000.00 and Home Equit~ Loan of $84,000.00 at separation. Current debt balance unknown, but should total less than $125,000.00 Increase in value during marriage. in mount of $5,708.95 as of 06/30/02. Assets Fidelity Investments 40~(K) Plan Wife Bank Accounts Members First Account Wife Commerce Bank Account Wife Mellon Bank Checking Account No. 884-017-4117 Husband Mellon Bank Checking Account No. 100-024-4630 Husband Automobiles 1995 Mitsubishi Husband 1990 Volvo 1999 Diamante v~rffe MARITAL ASSETS Husband's Wife's Value Value Date of Separation Value: $54,029.96 Current Value: $46,284.72 $2,900.00 $0.00 $3,000.00 $0.00 $7,500.00 $0.00 $0.00 $0.00 $0.00 MastePs Value Notes Current value includes post separation contributions of approximately $14,000.00. Value at Date of Separation: $2,900.00 Current Value: $25.00 Value at Date of Separation: $0.00 Curront Value: $1,200.00 Value at Date of Separation: $3,0OO.00 Current Value: $1,400.00 Value at Dale of Separation: $0.00 Curre~ Value: $1,100.00 Purchased in February, 1997 for $19,000.00. No lien exists on vehicle. Vehicle was sold for $4,500.00 and proceeds were split between parties. Leased vehicle. Asses Miscellaneous Household Goods and Furnishings Loans/Debts Citibank Mastercard Credit Card No. 5410-6548-4547-4219 Husband Bank One Visa Credit Card No. 4417-1259-7248-7718 Husband Visa Credit Card No. 4287-5900-0036-4451 MARITAL ASSETS Husband's Wife's Master's Value Value Value Nominal Nominal Date of Separation Balance: $12,000.00 Current Balance: $12,500.00 Date of Separation Balance: $3,000.00 Current Balance: $0.00 Non-marital Non-marital Date of Separation Balance: $1,800.00 Current Balance: $2,188.08 Notes Already split between parties. Husband's debt for personal and recreational expenses. Husband's debt for personal and recreational expenses. Joint Nmnes. Account used for marital expenses by Wife and personal expenses. Mark Heckman Real Estate Appraisers APPRAISAL OF Single Family Residesltial LOCATED AT: FOR: BORROWER: Carol Furjanic AS OF: December 1, 2001 BY: Luann E. K~udsefl RL-OO3086-L Mark Heckman Real Estate Appraisers Property Description UNIFORM RESIDENTIAL APPRAISAL REPORT F,. No. 96deerti pmper~yAddress 96 Deedield Road City Camp Hill State PA Z~C.~de 17011 LegidDescriptiea Deed Book 30F, Page1173 , C~nty Cumberland _.. B~ Furianic. Carol ~n~ ~ Furjanic O~pa~: [xl ~n~ ~ ] T~aM ~ ~ V~nt Pm~y~h(sap~ [Xl F.S~e [ ~ L.s~dd I Pmj~Type [ ] PUD [ ] Condo~bm(HU~Aonly) ~ -0- ~aup ~ ~75% ~ 25-75% ~ Undo25% occupancy PRICE AGE~) O~ 82% ~ ~lk~y ~ L~ ~h rote ~ Rap~ ~ StaUe ~ Sl~ ~ ~n~ I(~ 90 L~ New 24 ~ 1% ~ rn ~ Pm~y v~ ~ I~sing ~ Staae ~ ~in~g ~ TenaM 300 H~h 90 ~ To: Residential from M~et~gl~ ~U~3~ ~3~s. ~6~. ~(~) 140-190~ 10~0 (Vacant) 10% THIS IS A"COMPLETE APPRAISAL- SUMMARY REPORT". There are no foreseeable economic trends which might significantly values and marketability should be stable. Dimensbns 100 X 216 X 211.48 X 156 Sitearea .67Ac ComerLot L~ Yes [~J No Specific zoning c~assificafion and desoription R'i Sinqle Family Established Resident[aP Zoningcmn~iance [] Legal [] Legelr,3rcer~aTri~(Graad~themdu~e) [J la,gal L) Nozoning Electrify [] 200 amps Street Asphalt {~ [] Gas [] None Cu~gutt~ Concrete [] [] Wate~ [] Sidewalit Concrete [] Sanitary sewer [] Slmet lights None [] [] Topography Sloped To Rear Size Typical for area Shape Irregular Drainage Appears adequate FEMASp~Rcx~dHazardAme [J Yes ~J No improvements and services to the site are adequate and acceptable in this market. There are no apparent adverse easements, encroachments, or other adverse conditions on this site. The steep topography of this site restricts its etility. 3 2 Roo~s HW/Cb'CptNin/Ave Type HP Refrigerator [] None Additionel features (special energy efficient it erns, et c,): See Affached Addendum. Loft 1,072 0 Condition of the improvemenls, deprecialion (physical, functional and external), repairs needed, quality off construction remodeling/additions, etc.: Addendum. See AEached Adverse environn~nt el conditions (such as, but not ~imit ed lo, hazardous wastes, toxic substances, etc.) present in the improvements, on the site, or in Ihe immediate vicinity of the subject property: No adverse environmental conditions were observed in the improvements, on the site, on in the immediate vicinity of the subject property. Valuation Sec. tlon E~TlidATED StTE VALUE ........................... = $ ESTIMATED REPRODUCTION COST44EW OF IMPROVEMENTS: Dwelring 2,384 Sq. Fl. {~$ 57.25 = $ 136,484 Esmt. 1312 Sq.R. Q$ 9.50 = 12,464 Porch/Deck/2 Fireplaces 14,000 ~ 672 Sq.R. Q$ 12.50 = 8,400 Less 80 Physical IPu,~bn~l External Est. Remal.ingEco~.Life: 96 Deerfield Road 200 Deedield Road ,Addres~ Camp Hill Mark Heckman Real Estate Appraisers UNIFORM RESIDENTIAL APPRAISAL REPORT F,.N=. 96deerfi 35~00(~. Comments on Cost Approach (such as, source of cost eaHmate,. Estimated Reproduction Cost-New-of-Improvements is Handbook and local cost analysis. Estimated site value is _~ 142,928 2,500 180,400 COMPARABLE NO. 2 COMPARABLE NO. 3 _ 91 Dee~eld Road 432 Candlewyck Road Camp H Camp Proximity Io Subjed ' Data and/~ Inspection ,~s~essment I~ecords &'-MLS A~sessment Re~o~ds & ML-S ,~sessment ~ecords ~-MLS Conventional None Known Average Fee Simple 44 Ac/Avera~3e Averaqe 2 Story/Average Average Less than Ave 7! 4~ 2,50i -1,600 2,340 $q. FI. +1.000 Full Basement ~7,500 Unfinished Averaqe GFA/Central Air Typ for Area 2 Car Garage/Afl Porch & Patio +1,500 None None -7,500 ~._~wr~it ch e[~ Fee Simple .44 Ac/Average Average 2 Story/AveraCle Average +5,000 25110 +5,000 Average 71 4; 2.50 +_1 ~000 Av_~e r a g e...~Kit c h e [1 ' ,'.~,. 2.~,' +1,000 +1,500 +500 +1,000 Commenls on Sales Comparison (i~cluding the subject property's compatibility to the neighborhood, etc. ); S~e Att acl~ed ~,dd~ndum:" w~lhin year dappraisalS~ce f~ ~sa~s than that listed above, than that listed above, than that listed above. T~isappraisalisn~de L~ 'asis' L~ sut3~dt°themFa~,ailera~i°~k~Pedi0*m~'cc~-~;~'mrded~4ow LI s~bjedtoc~ionperp/ansandspeca't~ions. Final R~conciiation: See Attached Addendum. Narre L~u~n~ E. Knudsen Name Insped properly ADDENDUM Additional Features Arcbitectural shingle roof 3 years old; skylights 3 years old; bar sink in kitchen; ample kitchen cabinets; built in grill; 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; doubre 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 deprebiation 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, Idtchen, mechanicar equipm ant, and other features meet current standards for houses of this age in this market. Comments on Sales Comparison After a thorough search of ell 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 sates are considered to be reliable indicators of value, and are weighted simirady in the final reconciliation. Days on market: Comparable NO. 1:11 days; Comperable No. 2:148 days; Comparable No. 3:6 days. Comparable sales used are a~[ closed sales. Ail three comparable sales are located Jn 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 proper[,/has been ineiuded in this valuation. According to records provided by the county assessment office, the subject property has Hot transferred in the past year. Final Reconciliation This appraisal assumes a reasonable marketing period for the subject property of four months. The Sales Comparison Analyeis reflects recent activity in the market place and is given the most weight. The Cost Approach tends to set the upper rimit 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. Jn 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, Borrower: Fudanic, Carol Property Address:96 Deerfleld City: Camp H I DIMENSION LIST ADDENDUM State: PA File No.: 96deedi Case No.: Zip: 17011 GROSS BUILDING AREA (GBA) 4,368 GROSS LIVING AREA (GL.A) 2,384 24.00 40.00 18,0o 24.00 30.00 16.oo 22.00 1.oo 672.00 Factor Total 960,00 352.00 720.00 352.00 672.00 ~ea ~pe Level1 Level2 Level3 ~her Bsa. Garage O [] O [] [] [] O [] O O O O O [] [] O O O [] O O [] O O O [] [] O [] O O 0 O O [] [] [] [] [] O [] [] O O O [] O [] i O [] [] [] [] O 0 O O [] 0 O Fie No. 96deerfi DEFINITION OF MARKET'VALUE: . The most probable price which a property should bring in a competitive and open market under afl conditions requisite fo a fair sale, the buyer and seller, each acting prudently, knowledgeably and assuming the price is not affected by undue stimulus, Impgcit 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,B, dollars or in terms of financial arrangements comparable thereto; and (5) the price represents the normal consideration for the properly 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 financJng 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 properly or transaction. A~y 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 ~' concessiofls based {x~ 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 wifi not be responsible for matters of a legal nature that affect either the property being appraised or the title to it. The appraiser assumes that the title is good and marketable and, therefore, will not render any opinions about the title. The property is appraised on the basis of it being under responsible ownership. 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 visual[zing the property and understanding the appraisers determination of its see. 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 r~ guarantees, express or implied, regarding this determination. 4. The appraiser wifi not give testimony or appear in court because he or she made an appraisal of the property in question, unless specific arrangements to do so have been made beforehand. 5. The appraiser has estimated the value of the land in the cost approach at its highest and best use and the improvements at their contributory value. These separate valuations of fha land and improvements must not be used in conjunction with any other appraisal and are invalid it they are so used. 6. The appraiser has noted in the appraisal report any adverse conditions (such as, needed repairs, depreciation, the presence of hazardous wastes, toxic substances, etc. ) observed during the inspection of the 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, otc. ) that would make the property more or less valuable, and has assumed that there are no such conditions and makes no guarantees or warranties, express or implied, regarding the condition of the property. The appraiser will not be responsible for any such conditions that do exist or for any engineering or testing that might be required to discover whether such conditions exist. Because the appraiser is not an expert in the field of environmental hazards, the appraisal report must not be considered as an environmental assessment of the property. 7. The appraiser obtained the information, estimates, and opinions that were expressed in the appraisal report from sources that he o~ 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. 8. The appraiser will not disctsse the contents of the appraisal report except as provided for in the Uniform Standards of Protsssional g. The appraiser has based his or her appraisal report and valuation conclusion for an appraieal that is subject to satisfactory completion, repairs, or alterations on the assumption that completion of the improvements will be performed in a w~-kmanlike 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 approved financial institution; or any department, agency, or instrumeprality of the United States or any state or the District of Columbia; except that the Jenderlctient 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. Freddie Mac Form 439 6-g3 Page 1 of 2 Fannie Mae Form 1004B 6-93 No. 96deedi APPRAISERS CERTIFICATION: , The Appraiser certifies and agrees that: 1. I have researched the subject market area and have selected a minimum of three recent sales of properties most similar and proximate to the subject property for consideration in the saias 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 mo~e favorable than, the subject property, I have made a negative adjustment to reduce the adjusted sales price of the comparable and, if a significant item in a comparable property is inferior to, or less favorable than the subject property, I have made a positive adjustment to increase the adjusted saJes price of the comparable. 2. I have taken into consideration the factors that have an impact on value in my development of the estimate of market value in the appraisal report. I have not knowingly withheld any significant information from the appraisal report and I believe, to the best of my knowledge, that all statements and information in the appraisal r elx~'~ are frue and o0erect. 3. I stated in the appraisal report only my own personal, unbiased, and professional analysis, opinions, and conclusions, which are subject (>nh/to the contingent and limiting conditions specified in this form. 4. I have no present or prospective interest in the property that is the subject to this report, and J 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 eubject property, and neither my current or future employment nor my compensath3~ for performing this appraisal is contingent on the appraisod va~ue 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 m~'tgage lean, 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 reda'~, 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 comparablas in the appraisal report. I further certify that I have noted any apparent or known adverse conditions in the subject improvements, on the subject site, or on any site within the immediate vicinity of the subject property of which I am aware and have made adjustments for these adverse conditions in my analysis of the property value to the extent that r had market evidence to support them. I have also commented about the effec~ of the adverse conditions on the marketabil~ of the subject property. g. I personally prepared all conclusions and opinions about the real estate that were set forth in the appraisal report. If I relied on significant professional assistance from any individual or individuals in the performance of the appraisal or the preparation of the appraisal report, I have named such individual(s) and disclosed the specific tasks performed by them in the reconciliation section of this appraisal report. I certify that any individual so named is quarified to perform the tasks. I have not authorized anyone to make a change to any item in the report; therefore, fi an unauthorized change is made to the appraisal repot, r ~1 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 repot't, 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 respensibllify for the appraisal and the appraisal report. ADDRESS OF PROPERT"YAPPRAISED: 96 Deerfield Road, Camp Hill, PA 17011 APPRAISER: SUPERVISORY APPRAISER (only if required) Signature: Name: Date Signed: State Cert[ficofion #: or State License ~ State: Expiration Date of Catiflcafion or License: [] Did [] Did Not Inspect Property Freddie Mac Form 439 6-93 Page 2 of 2 Fannie Mae Fc~m 1004B 6-93 Mark Heckman Real Estate Appraisers USPAP COMPLIANCE ADDENDUM File ~rmw~ Furjanic, Caro~ Or.r# Proi~nyAdd~sa 96 Deerfield Road city Camp Hill ¢ou.ty Cumberland State PA Zip Cod~ 17011 APPRAISER: Sme: PA Bon'ower: Carol Furjanic ProLite,Address:96 Deeffield Road City: Camp Hill Lender:. SUBJECT PROPERTY PHOTO ADOENDUM _ File No.: ~6dee~ Case No.: State: PA 7¥: 17011 FRONT VIEW OF SUBJECT PROPERTY Appraised Date: t~/1/01 Aplxaised Value: $176,000 REAR VIEW OF SUBJECT PROPERTY STREET SCENE 8ofl'ower: C,a~ Furjani~ PmfledyAddn~s~:~ Deerfl~dd R~d City: ~p Hill LeftoVer:. SUBJECT PROPERTY PHOTO ADDENDUM Fde No.: 96deerfJ Case No.: State: PA Zip: 17011 FRONT VIEW OF SUBJECT PROPERTY Apprai~l Value: $176,00o %:. REARVlEWOF SUBJECT PROPERTY STREET SCENE S(~rower: Furjanic, Carol Pr(~per~y Address: 96 Deerfield Road City: Camp Hill COMPAP. ABLE PROPERTY PHOTO ADDENDUM File No.: g6deerfi Case No.: State: PA ZiI~: 17011 COMPARABLE SALE #1 209 Deerfield Road Camp Hill Sale Date: 6/12/01 Sale Price; $ t90,000 COMPARABLE SALE 91 Deen~eld Road Camp Hilt Sale Date: 5/31/01 Sale Price: $153,000 COMPARABLE SALE#3 432 Candlewyck Road Camp Hill Sale Date: 7/2/01 Sale Price: $174,000 SKETCH ADDENDUM rlL'mcoln Financial Group® The Lincoln National Life Insurance Company TDA Client Services PO Box 9740 Portland ME 04104-5001 CAROL A. FURJANIC 414 N 4TH ST LEMOYNE PA 17043-1665 Group Annuity Statement 3/31(2002- 6/307 2002 Plan Number: 569 Employer ID: 560 Plan: HOLY SPIRIT HOSPITAL PARTNERSHIP SAVINGS PLAN Questions? Contact a Service Representative at 1-800-341-0441 Value Summary Dollar value Net Gain/ Unit value Number ~f units Dollar value as of 3/31/2002 activity, loss 6/30/2002 6/312/2002 as of 6/30/2002 894150+006 INDEX 5,752.54 GROWTH I 5,031.70 SMALL CAP 6,660.06 EQUITY-INC 6,460.74 Totals $23,905.04 Value by source of contributions as of 6/30/2002 New Contribution Interest Rates SALARY DEFERRAL $16,161.59 789.24- 30.4491 1613.0032 4,963.30 934.09- 30.7347 133.3221 4,097.61 575.01- 20.7101 293.8207 6,085.05 635.05- 21.9316 265.6300 5,825.69 $2,933.39- $20,971.65 EMPLOYER MATCH TOTAL $4,810.06 $20,971.65 Contract number Contribution Period Interest Rate 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 the fight 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 fimnds supporting the variable annuity are not public funds and are only available through insurance company contracts. Secufities offered through Lincoln Financial Advisors and other broker/dealers with effective selling agreements. ©1998 Lincoln Financial Group is the marketing name for Lincoln National Co~oration and its affiliates. Plan: 569 Employer ID: 560 page 1 of 6 ANNUITY SERVICES ()NE TOWER SQUARE fIARII()RI),CI 06183-4053 CAROL A FI;RJANIC 414 N 4111 S£ LEMOYNE, PA 17043 Your Servk:in~ Agenl CIflSIREI [ Your Plaf~-Type i~: Tax Shelle~ed A:muily Your pn~duct Type is: f-Flex Custon~er Service 14800) 842-9406 YOUR INVLS-IMtN] SUMMARy This Quarter Year to Date Be,Ainning Balance $212.83 $24S.02 Toial Payments $0.00 $0.00 Net Loan Activity $37.00 $71.87 Total Withdrawals $0.00 $0,00 Other $0.00 $0.00 Change in Investment Value $2.30 $4.98 YOUR OI ) 1S IANi)ING LOAN SUMMARY LOAN 1 -effective 1 I/9/19!)3 Outstanding Loan Principal $5,708,95 YOI JR INVES [MEN [ SIRA [[:GY I O IAL ASSEI'S CURRI N T CONTRIBUTIONS 100% T-IlexCf 100% I-FIe):CI Additional Annuity Features (~) NEWS ;~aported within 90 days of receipt. Holy Spirit Hospital Retirement Savings Statement April1, 2002- June 30, 2002 #BWNFXQN CAROL A FURJANIC 414 4TH STREET LEMOYNE, PA 17045 ENVY40014223 40 58940 73116 A ~' For online access, log on at: htr p ://Www.fidelity.com/atwo rk For information, call: (800) 343-0860 Your Account Summary Beginning Balance Employee Contributions Employer Contributions Change in Account Value Ending Balance Additional Information e Div,dends & Interest $51,303.70 958.31 923.51 -6.900.80 $46,284.72 $75.36 Your Personal Rate of Return This Period -13.2% Year to Date - 15.0% Your Personal Rata of Return is calculated with a tJme-weightad formula, widely used by financial analysts to calculate investment earnings It reflects the results of your investment selections as weft as any activity in the plan account(si shown There are other Personal Rate of Return formulas used that may yield different results. Remember that past pedormance is no guarantee of future results. Your Asset Allocation · Stocks 94% · Bonds 6% 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 the value of your account for the period, in both shares and dollars. Sharas on Shares on Price on Price on Investment 03/31/2002 06/30/2002 03/31/2002 06/30/2002 Stock Investments Fidelity Grow & Inc 602.713 Fidelity Growth Co 352.593 Blended Investments* Fid Freedom 2020 885.307 Market Value on 03/31/2002 Market Value on 06/30/2002 $40,157,68 $35,731.42 624.697 $37.60 $33.61 22,662.01 20,996.07 369.585 $49.62 $39.87 17,495,67 14,735.35 $11,146.02 $10,553.30 920.078 $12.59 $11.47 ~F1,146.02 10,553.30 Remember that a dividend payment to fund shareholders reduces the share pdce of the fund, so a decrease in the share price for the statement period does not necessarily reflect Iowar fund performance. ' Some of your investments are classified as a Blended Fund Investment. Blended Investments may include a mix:ute of stocks, bonds, and/or short-term assets. Please refer to the "Additional Fund Information" section to determine the allocation of your blended investments' underlying assets. The asset breakdown of your portfolio is reflected in the pie chart in the "Asset AJIocatian" Section. Please read this statement carefully. Any error must be reported to Fidelity Investments within 90 days. 14223 40014223 0001 20020709 403B Fidelity Investments P.O. Box 770002, Cincinnati, OH 45277-0090 Page 1 of 5 CAROL A. FURJANIC, Plaintiff VS. JAMES A. FURJANIC, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAi~D COUNTY, PENNSYLVANIA : CIVIL ACTION - LAW : : NO. 01 - 1144 CIVIL : : IN DIVORCE RESCHEDULED PRE-HEARING CONFERENCE TO: Cara A. Boyanowski William A. Fetterhoff , Attorney for Plaintiff , 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 CAROL A. FURJANIC, Plaintiff JAMES A. FURJANIC, Defendant IN THE COURT OF COMMON PLEAS CLrMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 01-1144 Civil Term IN DIVORCE MOTION FOR APPOINTMENT OF MASTER Carol A. Furjan'lc, 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 of the motion states: 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: §§ 3301(a)(6), 3301(c) anti 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 clff~ms: equitable distribution, alimony, alimony pendente lite, counsel fees, costs & expenses The action does not involve complex issues of law or fact. The hearing is expected to take 1 day. Additional information, if any, relevant to the motion: Date: 121-11-04 Esquire, is appointed l~laster with respect to the following claims: BY THE COURT: CAROL A. FURJANIC, Plaintiff vs. JAMES A. FURJANIC, Defendant IN THE COURT OF COMI~O~' PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 01 - 1144 CIVIL IN DIVORCE TO: Cara A. Boyanowski William A. Fetterhoff Attorney for Plaintiff Attorney for Defendant DATE: Friday, October 4, 2002 CERTIFICATION I certify that discovery is complete for which the Master has been appointed. as to the claims (a) OR IF DISCOVERY IS NOT COMPLETE: 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. (b) Provide approximate date when discovery will be complete and indicate what action is being taken to complete discovery. DATE COUNSEL FOR ~I~N FF 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, (DR 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. CAROL A. FURJAi~IC, Plaintiff VS. JAMES A. FURJANIC, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLA/~D COUNTY, PENNSYLVAi~IA CIVIL ACTION - LAW : NO. 01 - 1144 CIVIL : : IN DIVORCE TO: PRE-HEARING CONFERENCE Cara A. Boyanowski , Counsel William A. Fetterhoff , Counsel for Plaintiff 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 CAROL A. FURJ~C, Plaintiff JAMES A. FURJANIC, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 01-1144 Civil Term IN DIVORCE DEFENDANT'S ANSWER TO COMPLAINT IN DIVORCE Count I 1. Admitted. 3. Admitted. 4. AdmiRed. 5. 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. Noither admired nor denied. C. Neither admitted nor denied. 7. Admitted. 8. Neither admitted nor denied. By way of fitrther answer, Defendant has been advised of the availab'dity 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 H 10. No response required. 11. It is admired 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. Count IT! 13. No response required. 14. Denied. Plaintiffis gainfully employed, esmingeloseto $3,500.OOpormonth, netpay. 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 401(k) account. 15. Neither admitted nor denied. WHEREFORE, Defendant prays this Honorable Court to denyPlalntiW s request for alimony. Count Iv 16. No response required. 17. Admitted in part; denl~ 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/merest in the parties' joint checking account and his interest in Plaintiff's 401 (k). 18. Neither admitted nor denied. 19. Denied. Plaint'~ffis fully able to sustain herself during the course of this litigation. Defendant 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. Date Respeetfiflly submitted, Fetterhoffand Zilli 200 North Third Street, Suite 800 Harrisburg, PA 17101 (717) 232-7722 CAROL A. FURJANIC, Plaintiff JAMES A~ FURJANIC, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 01-1144 Civil Term IN DIVORCE AFFIDAVIT OF COUNSELING I, James A. Furjanic, being duly sworn according to law, depose and say: 1. I have been advised of the availability of marriage counseling and understand that I may request that the Court require that my spouse and 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 upon request. 3. Being so advised, I do not request that the Court require that my spouse and I participate in counseling prior to a divorce decree being handed down by the Court. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. §4904 relating to unswom falsification to authorities. VERIFICATION ! verify that the statements made In the foregoing document and belief. ! understand that. false e~atementa herein are made subject to the penalties of 18 Pa. C.$. ~4904 relating to unsworn falsification to authorities. 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, PA 17109 200 North Third Street Suite 800 Harrisburg, PA 17101 (717) 232-7722 ;-'3 0 H~ ~J - H ~J CAROL A. FURJANIC, PLAINTIFF/Respondent V. JAMES A. FURJANIC, DEFENDANT/Petitioner : 1N THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : CIVIL ACTION - LAW : : NO. 01-1144 Civil Term : : 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 ,.~- ~/'*"'day 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 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, ttowever, 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 herj ewelry 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 personal safety was removing items of her clothing and some other property from the ~nafital home. No attempt was made to secret these items in any way from the Petitioner. 8. ADMITTED. 9. DENIED. It is denied that the bedroom of the 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 fight 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. 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 Defendant/Petitioner 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 Defendant/Petitioner'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. 19. The Respondent, in the early morning 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 of the 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 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 §~shion 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 f~om the property as well as a list of items which will remain with the Petitioner. This is attached hereto as Exhibit 32. The Respondent requests the court to enter an Order directing the Petitioner to make these items available to the Respondent. WHEREFORE, the Plaintiff/Respondent requests this Honorable Court to deny the claim of the Defendant?Petitioner and to enter an order directing the following: A. The Defendant/Petitioner 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 debts for which the Plaintiff/Respondent would be joimly liable, in a timely fashion. B. The Plaintiff/Respondent shall be authorized to remove the property listed on Exhibit "B" from the marital residence. Date: Ka*thl6en Carey Daley, Es~L0ire Attorney No. 30078 1029 Scenery Drive Harrisburg, PA 17109 (717) 657-4795 Attorney for Plaintiff/Respondent VERIFICATION Upon my personal knowledge, information and belief, I, Carol A. Furjanic, cio hereby verify that the facts averred and statements made in the foregoing Answer and New Matter to the Petition for Emergency Relief are tree and correct. I understand that false statements or averments therein made will subject me to the criminal penalties of 18 Pa.C.S.A. §4904 relating to unswom falsification to authorities. Date: Carol A. Furjanic, Plainti~'f EXHIBIT A Toaster (girl to Wife from children) Blender (girl to Wife 1970) Can opener Mixer Andrea's bedspread, mattress, box spring Chest of Drawers (Wife's sister Patty's) Infant Jesus statue (girl from Wife's Godmother to Wife) Two wrought iron candle stick holders (girl 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) Jim EXItlBIT B Household Items Snowblower Gas Grill Tools Yard Equipment (Shovels/Rakes/Etc.) Big Screen relevision 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 w/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) Carol Kitchen Table w/Foux Chairs Two Brass and Glass Etageres /~cicus Tree (Dining Room) One LR Clock Two LR Chairs Two LR lamps One LR Coffee Table One LR End Table One Round (12") LR lYable MBR Dresser w/mirror (Wife's) One Night Stand One Plant Stand (Pre-Marital) One Mirrored Stand Two MBR Wall Pictures China V2 Rugs V2 Pots and Pans Silverware CAROL A. FURJANIC, Plaintiff vs. JANES A, FURJANIC, Defendant IN THE COURT OF COM~40N PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 01 - 1144 CIVIL IN DIVORCE TO: Cara A. Boyanowski William A. Fetterhoff Attorney for Plaintiff 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: 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. (b) Provide approximate date when discovery will be complete and indicate what action is being taken to comDlete discovery. DATE 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. CAROL A. FURJANIC, Plaintiff JAMES A. FURJANIC, Defendant : IN THE COUR'I' OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : CIVIL ACTION - LAW : : NO. 01-1144 : : 1N DIVORCE PRE-TRIAL STATEMENT On behalf of Carol A. Furjanic, the plaintiff in the above-captioned action, Cara A. Boyanowski, Esquire, does hereby file the following pre-trial statement for consideration of the Court: 1. Marital Assets - Attached hereto please find a listing of all marital assets including their value, date of valuation, determination 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 Plaimiffimends to call at trial includes the following: Luann E Knudsen, real estate appraiser. In the event Plaintiffdecides to call additional experts, the names and addresses of the experts will be provided to Defendant prior to trial. 3. The Plalntiffintends 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 Plalntiffintends 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. 5, The gross income of the Plaintifffrom 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 Plainti~ Income and Expense Statement includes this information. 7. The valuation &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 PIaintiffhas 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. 10. 11. Listing of marital debts: See Inventory. The Plaintiffmakes the following proposed resolution of the economic issues: The parties' jointly titled real property, located at 96 Deerfield Road, Camp Hill, Cumberland County, Pennsylvania, shall be sold. Distribute all marital assets in the following fashion: 65% to Plaintiffand 35% to Defendant. All household goods and furnishings presently in the possession of Plaintiffto remain the sole and separate property of PlainthTand 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. Defendant shall assume sole responsibility for the outstanding baiance on his Citibank Mastercard Credit Card debt, with an approximate balance of $12,000.00. Defendant shall assume sole responsibility for any balances remaining on his Bank One Visa Credit Card. 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. Defendant to pay Plaintiff's counsel fees, costs and expenses associated with the divorce action. H. Defendant to provide Plaintiffwith an appropriate alimony paymem. Respectfully submitted: DALEY LAW OFFICES Attorney No. 68736 1029 Scenery Drive Harrisburg, PA 17109 (717) 657-4795 Attorney for Plaintiff CAROL A. FURJANIC, Plaintiff JAMES A. FURJANIC, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 01-1144 IN DIVORCE INCOME AND EXPENSE STATEMENT UNDER RULE 1920.31 I hereby file the Statement ofhicome 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. §4904, relating to unswom falsification to authorities. Date: Carol A. Furjani~91ain~f'f Case Name: Date of Marriage: Date of Separation: Rehr~arj2 1 ?, 19R? Decpmher ?6. INCOME AND EXPENSE STATEMENT of CAROL ~4. FURJANIC Other Benefits Wife's Income Net: $53,690 $32,838 Monthly Expenses: Mortgage Home Equity Utilities Upkeep/Maintenance Household Help Car Loans Health Tuifion~aycare Credit cards: Master Card VISA Montlt~Payment $835.00 $242.00 $366.00 $44.00 $10.00 $70.00 $150.00 Total Amount Owed Lease $2,400 -Moving Expenses X2 $20.00 Medical Expenses $50.00 >'~ ;~ Clothing $150.00 5%; ; !] '''' ~' Food/Supplies $450.00 i. ': . Legal Fees $125 to $550 Totals: $2,669 to $3,094 Holy Spirit Hospital EMPLOYEE NAME SSN FURJANIC, CAROL A 185-38-6096 FOR PERIOD ENDING RATE DEPT 06/29/02 24.28 6510 PTO IVAC) STD (SIC) 144.44 269.30 EMPLOYEE NUMBER 185386096 NET PAY CURRENT 1,263.20 GROSS CURRENT 2,065,06 ADVICE NO. 124182 NET PAY YTD 19,497.61 GROSS YTD 29,4~ 1,77 EARNINGS HOURS RATE CURRENT YTD 1REG 4,4.25 24,28 1,086.64 24,142.04 2PTO SC 28.00 24,2~ 679.84 2,136.54 3HOLIDA 8.00 24.28 194.24 776.86 OT PREM 4.25 12.84 54.57 $20.58 WKND RN 12.00 4.14 49.68 750.38 EX L~F O. 11 1 EDUC 1,007.82 ON CALL 72,00 CHARGE 4.00 DEDUCTIONS 4Ol(kl DENTAL HSMP MED W/ PA W~H WSHORE UWAY 0 VISION OPT-HS LO-CUM CURRENT 165,20 4.00 362.43 21.14 29.56 57.09 29,94 126.41 5.00 1.00 YTD 2,056 49 4,098 272. 421. 814. 70.( 10.£ 273.4 TOTAL EARNINGS 82.25 $2,055.08 $29,411.77 ACH BANK ACCOUNT AMOUNT ACH COMCHE Acct 513244707 1,263,20 TOTAL DEDUCTIONS ,?,~01.77 $9,912.5 ~ CAROL A. FURJANIC, Plaintiff JAMES A. FURJANIC, Defendant 1N THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 01-1144 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. §4904 renting to unsworn falsification to authorities. Date: Carol A. Furjanic Plant, tiff ,.' '~ INVENTORY FURJANIC v. FURJANIC Date of Marriage - 02/13/82 Date of Separation - 12/26/00 Assets Real Estate Marital Residence: 96 Deerfield Road Camp Hill, PA 170 Husband 1/3 Ownership in Mother's · Residence in Steelton, Pennsylvania Retirement Assets The Lincoln National Life Insurance Group (Financial) Annuity Wife Travelers Life and Annuity Wife MARITAl, ASSETS Husband's Wife's Master's Value Value Value $153,600.00 (His Appraisal) $180,000.00 Equity: $50,000.00 $10,000.00 Date of Separation Value: $26,277.32 Current Value: $20,971.65 (As of 6/30/02) Date of Separation Value: $365.25 Current Value: $17g13 (As of 6/30/02) Notes Mortgage of approximately $68,000.00 and Home Equity Loan of $84,000.00 at separation. Current debt balance unknown, but should total less than $125,000.00 Increase m value during marriage. Outstanding Loan agdmst accormt in amount of $5,708.95 as of 06/30/02, Assets Fidelity Investments 401(K) Plan Wife Bank Accounts Members First Account Wife Commerce Bank Account Wife Mellon Bank Checking Account No. 884-017-4117 Husband Mellon Bank Checking Account No. 100-024-4630 Husband Automobiles 1995 Mitsubishi Husband 1990 Volvo 1999 Diamante Wife MARITAL ASSETS Husband's Wife's Value Value Date of Separation Value: $54,029.96 Current Value: $46,284.72 $2,900.00 $0.00 $3,000.00 $0.00 $7,500.00 $0.00 $0.00 $0.00 $0. O0 Master's Value Notes Current value includes post separation contributions of approximately $14,000.00. Value at Date of Separation: $2,900.00 Curtain Value: $25.0O Value at Date of Separation: $0.00 Current Value: $1,200.00 Value at Date of Separation: $3,0O0.00 Current Value: $1,400.00 Value at Date of Separation: $0.00 Current Value: $1,100.00 Purchased in February, 1997 for $19,000.00. No lien exists on vehicle. Vehicle was sold for $4,500.00 and proceeds were split between parties. Leased vehicle. Assets Miscellaneous Household Goods and Furnishings Loans/Debts Citibank Mastercard Credit Card No. 5410-6548-4547-4219 Husband Bank One Visa Credit Card No. 4417-1259-7248-7718 Husband Visa Credit Card No. 4287-5900-0036-4451 MARITAL ASSETS Husband's Wife's Master's Value Value Value Nominal Nominal Date of Separation Balance: $12,000.00 Current Balance: $12,500.00 Date of Separation Balance: $3,000.00 Current Balance: $0.00 Non-marital Non-marital Date of Separation Balance: $1,800.00 Current Balance: $2,188.08 No~s Already split between parties. Husband's debt for personal and reereafional expenses. Husband's debt for personal and recreational expenses. Jo'mt Names. Account used for marital expenses by Wife and personal expenses. Mark Heckman Real Estate Appraisers APPRAISAL OF Single Family Residet~tfal LOCATED AT: 96 Deerfield Road Camp Hill, PA 17011 FOR: BORROWER: Carol Furjanic AS OF: December 1, 2001 BY: Luann E, K~udsen RL-003086-L Mark Heckman Real Estate Appraisers Pr.operty Des~r p on UNIFORM RESIDENTIAL APPRAISAL REPORT Fire No. 96deen~ .P~ope~;yAddres$ 96 Deen~eld Road City Camp Hill Sla(e PA Z~)C~de 17011 ' . Bomwer Fudanic, Carol ~e.~ Owner Furianic O~panl: ~A~ O~ L J Tenant [ J Vaunt ~peHy~hlsappm~ed ~X} FeeSim~e [ J Leaseh~d ~ Pro~e~Type [ ~ PUD LI Condo~m(HU~A~y) HOA$ -0- /Mo. ~h rote ~ Rap~ ~ SfaUe ~ Sl~ ~ 0~ 90 L~ New 24 fa~y ~efi.~ ~ U~3~ ~ 3~. ~ ~erS~s. ~ ~.(~es) 140-1g0 ~ 10-60 (Vacant) 10% THIS IS A "COMPLETE APPRAISAL - SUMMARY REPORT". There are no foreseeable economic trends which might significantly Sl~earea .67Ac Can~Lol LJ Yes L~J No Size TypicaJ forarea Zoningc~m~iance [] Legal ~ Legaln(~awieg(Gmnd~hemduse) [J liteg~J U Nozoning DraYage Appears adequate E~eclr~y [] 200 amps Slreel Asphalt [] [] Drivewa), Surface Asphatt Floor Concrete None Laund~7 Other Area Sq.R. X 1,312 Loft 1,072 0 OAR STORAGE: Addendum, immediate vicinity of the subject property, GweJl~g 2,3845q. R. @$. 57.25 =$ 136,484 Bsmt. t312 Sq. Fl, @$ 9.50 = 12,404 _ Porch/Deck/2 Fireplaces 14,000 ewage~r~ 672 Sq. Fb @$ 12.50 = 8,400 Less 60 Physical J Functional J Exlema{ Esl, Remaining Econ. L#e; 96 Deen~eld Road 209 Deedield Road A_d.~res~s, ~ HiI~ Mark Heckman Real Estate Appraisers UNIFORM RESIDENTIAL APPRAISAL REPORT F~oNo. 96deerfi 35,000 Comments on Cost Approach (such as, source of cost estimate, Estimated Reproduction Cost-New-of-Improvements is calculated using the Marshall and Swift Residential Cost Handbook and local cost a~alysis. Estimated site value is 142,928 2,500 COMPARABLE NO. 2 Camp Hill 91 Deerfieid Road Camp H II DESCRIPTION Conventional None Known 5/31/01 Average Fee Simple .44 Ac/Average Average 2 Story/Average 7/2/01 Average Fee Simple .44 Ac/Average Average 2 Story/Average Average Average 17/15 +5,000 25/10 Less than Ave +5,000 Average 7; 4~ 2.50! 71 4~ 2.50i *t,O00 Full Basement i +1,000 Fuji Basement -7,500 Unfinished Unfinished Typ for Area ,; ]~/p for Area 2 Car Garage/Afl ' 2 Car Garage/Att Porch & Patio : Porch & Patio +1,500 None ~ *3,500 1 Fireplace None ' +500 None +1,000 +1,505 +500 Other Good Kitchen Florida Rm/Od-Ki. --: ..... -7,500~e~_Kitchen .... ~ +1~ 000_ Avera._ g.e~Kitchen_ ... i +1,000. ~"'"'='": ' 'i ...... ....... :~._~x'..:s '4:,":L~x · ._'.. :. '~::2._x... ~. ~ I1Eg I SUBJECT COMPARABLE NO. I COMPARABLE NO, 2 COMPARABLE NO. 3 ~ate, Price and DafaI None No prior sale other No prior sale other No prior sara other SoJr~ ~p~'sales than that listed above, than that listed above, than that {{sted above. Thisappta/s~ismade ~j 'asis' ~subjedlolherepai~,aJ{erotimm, ins~ionsc~c~nd~Jo~sl~edbek~v ~subjedtoccr~ot~enpe-piansa~dspeotf~albr~ Name L.u;~n~t E* Knudsen Dale ~ep~t Si~ned 12/1/01 Stale Cer~h'-cation # RL-OO3086-L Signature [~Uid ~Did Not mark heckman real estate appraisers ADDENDUM 'BorrOWer: Furjanic, Carol File No.: gDdeerff PropeHyAddress: 96 Deertield Road Case NO.: c~ty: CampHilJ State: PA Zip: 17011 Lender: Carol Furjanic Additional Features Architecturat shingle root 3 years old; skylights 3 years old: bar sink in kitchen; ample kitchen cabinets; built in gfill; hot water dispenser; corner appliance garages; down lights in kitchen; stained woodwork; storage area over garage; oak raifing on stairs to loft; gbilt-in shelves in tsmily room; riving room has cathedral ceiling with skyflghts; laundry bas sink and tsundry chute; central vacuum system; fireplace in living room extends to ceiling with flue inn lower level for tuture fireplace; ag bedrooms have walk-in closets; trench doom trom bedroom to loft; double sinks in both baths; whirlpool tub in master bath, Condition of Improvements These improvements are of average quality trame design and reflect average maintenance. Property reflects normal physJca~ deprecJafion 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 obsbiescence or external inadequacies were observed. The bathrooms, kitchen, mechanicar 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 soles used are considered to be the best indicators of value. Appropriate adjustments have been made for all difference~. AJI three sal~ are considered to be reliable indicators of value, and are weighted simi[arty In the final reconciliation. Days on market: Comparable No. 1: t 1 days; Comparable No. 2:148 days; Comparable No. 3:6 days. Comparable sales used are all dosed sa~es. A~I three comparable soles are located in the same market area as the subject and wou~d 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 utirity 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 properly 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 reasonabre marketing period for the subJect property ct four months. The Saris 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 va~ue 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. Property Address: 96 Deertield Road City: Camp Hill DIMENSION LISTADDENDUM State: PA File No.: 96deerfl Case No.: Zip; 17011 GROSS BUILDING AREA (GBA) 4,368 GROSS LIVING AREA (GLA) 2,384 _24.00 x !6.00 x _22,00 1,00 ~672.00 1 352.00 3~2.oq 672.00 ~ea ~pe Level1 Level2 Level3 ~her Garage Fro No. g{~deerfl DEFINITION OF MARKET VALUE: The most probable price which a property should bring in a competitive and open market under all conditions requisite fo a fair sale, the buyer and sefier, each acting prudenlly, knowledgeably and assuming the price is not affected by undue stimulus. Implicit Jn 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 ara 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 mede in terms of cash in U.S. dofiars 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 *Adjustments to the comparables must be made for special or creative financing or sales concessions. No adjustments are necessary for those costs which are normaity paid by sellers as a result of tradition or Jaw in a market area; these costs are readily identifiable since the salter pays these costs in virtually all sales transactions. Specia~ or cceafive 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 he calculated on a mechanical dollar for dctlar cost of fha financing or concession but the dctlar amount of any adiustment should approxJmats the market's reaction to the financing or concessions based on the ,~pr aiseYs judgment. STATEMENT OF LIMITING CONDITIONS AND APPRAISER'S; CERTIFICATION CONTINGENT AND LIMITING CONDITIONS: The appraiser's certification that appears in the appraisal report is subiect to the forowing conditions: 1. The appraiser will not be responsible for matters of a legal nature that affect either the property being appraised or the title to it. The appraiser assumes that the title is good and marketable and, therefore, will not render any opinions about the title. The property is appraised on the basis of it I~ing ur~ra' responsible ownership. 2. The appraiser has provided a sketch in the appraisal report to show approximate dimensions of the improvements and the sketch is included en~y to assist the reade' of the report in visualizing the proper~y and understanding the appraise¢'$ determination of its size. 3. The appraiser has examir~ed the available flood maps that are provided by the Federal Emergency Management Agency (or other data sources) and has noted in the appraiser report whether the subject site is located in an identified Special Flood Hazard Area. Because the appraleer is not a surveyor, he or she makes no guarantees, ex,ess or imprled, regarding this determination. 4. The appraiser wgl not give testimony or appear in court because ha a' she made an appraisal of the property in question, unless specific arrangements to do so have been made beforehand. 5. The appraiser has estimated the value of the land in the cost approach at its highest end best use and the improvements at their contributory value. These separate valuations at 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 repaks, depreciation, the presence of hazardous wastes, toxic substances, otc. ) observed during the inspection of the subject property or that he or she became aware of during the normal research involved in porforming 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 warranties, express or implied, regarding the condition of the property. The appraiser will not be responsible for any such condfiions that do exist or for any engineering or testing that might be required to discover whether such condgions exist. Because the appraiser is not an expert in the field of environmental hazards, the appraisal repo~t must not be considered as an environmental assessment of the properly, 7. The appraiser obtained the information, estimates, and opinions that were expressed in the appraisal report from sources that he or she considers to be reliable and believes them to be true and correct. The appraiser does not assume responsibility for the accuracy of suci~ items that were furnished by other parties. 8. The appraiser wifi not disclose the contents of the appraisal report except as provided for in the Uniform Standards of Professional Apprarsal Practice. 9. The appraiser has based his or her appraisal report and valuation conclusion for an appraisal that Js subject to satisfactory completion, repai~, or alterations on the assumption that completion ct the improvements will be performed in a workmanlike manner. 10. The appraiser must provide his or her prior written consent before the lender/cfienf 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 organizationa or the firm with which the appraiser is associated ) to anyone other than the borrower; the mortgagee or ifs successors and assigns; the mortgage insurer; consultants; professional appraisal organizations; any state or federally approved financial institution; or any department, agency, or instrumentality of the United States or any state or the District of Columbia; except that the lender/client may distribute the property description section of the report only to data collection or reporting service(s) without having to obtain the appraiser's prior written consent. The appraiser's written consent and approval must also be obtained before the appraisal can be conveyed by anyone to the public through advertising, pubtis relations, news, sales, or other media Fredde Mac Form 439 6-93 Page 1 of it Fannie Mae Form fOO4B 6-93 P~e No. g6deerfi APPI~AIIER$ CERTIFICATION: The Appraiser certifies and agrees that: 1. I have researched the subject market area and have selected a minimum of three recent sales of properties most similar and proximate to the subject property for consideration in the sales comparison analysis and have made a dollar adjustment when appropriate to reflect the market reaction to those items of significant variation. If a significant item in a comparable property is superior to, or more favorable than, the subject property, I have made a negative adjustment to reduce the adjusted sales price of the comparable and, if a significant item in a comparable property is inferior to, or less favorable than the subject property, I have made a positive adjustment to increase the adjusted sales price of the comparable. 2. I have taken into consideration the factors that have an impact on value in my development of the estimate of market value in the appraisal report, I have not knowingly withheld any significant information from the appraisal report and I believe, to the best of my knoMedge, 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 profussional analysis, opinions, and conclusions, which are sub)ecl only to the contingent and limiting conditiofls specified in this form. 4. I have no present or prospective interest in the property that is the subject to this report, and I have no present or prospective personal interest or bias with respect to the participants in the transaction. I did not base, either partially or completely, my analysis andlo~ the estimate of market value in the appraisal report on the race, color, religion, sex, handicap, familial status, or national origin of either the prospective owners or occupants of the subject property or of the present owners or occupants of the properties in the vicinity of the subject property. 5. I have no present or contemplated future interest in the subject property, and neither my current or future employment nor my compensation for pedorming this appraisal is contingent on the ap~'aised 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 emptayment for performing the apprainal. I did not base the appraisal report on a requested minimum valuation, a specific valuation, or the need to approve a specific mortgage k)an. 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 ~ developed is consistent with the marketing time noted in the neighborhood section of thin report, uctess I have otherv~se stated in the recondliation section. 8. I have personagy inspected the interior and exterior areas of the subject property and the exterior of ag properties listed as comparables in the appraisa~ report. I further certify that I have noted any apparent or known adverse conditions in the subject improvements, on the subject site, or on any site within the immediate vicinity of the subject property of which I am aware and have made adjustments for these adverse conditions in my analysis of the property value to the extent that I had market evidence to support them. I have also commented about the effect of the adverse condihens on the marhetab~lity of the subject property. 9. I personally prepared all conclusions and opinions about the rea] estate that were set forth in the appraisal report. If I relied on signi6cant professional assistance from any individual or individuain 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 reconcigaiton section of this appraisal report. I certify that any individual so named is qualified to perform fha tasks. I have not author~ed anyone to make a change to any item in the report; thereto'e, if an unau~hedzed change is made to the appraisal report, ] will take no responsibility for it. SUPERVISORY APPPu~ISER'S CERTIFICATION: ff a supervisory appraiser signed the appraisal report, he or she certi6es and agrees that: I direclly 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 ta~ing full responsibility f~ the appraisal and the appraisal report. ADDRESS OF PROPERTYAPPRAIIED: 96 DeerBeld Road, Camp Hill, PA 17011 APPEAISER: Name: ~uann E. Knudsen Data ~gned: 12/1/01 Stata: PA SUPERVISORY APPRAISER (only if required) Signature: Name: Date Signed: State Certification #: State: [] Did [] Did Not Inspect Property Freddie Mac Form 439 6-93 Page 2 of 2 Fannie Mae Form 1004B 6-93 Prope~yAddress 96 Deerfield Road Camp Hill Lend,r/Cliff Carol Furjanic Mark Heckman Real Estate Appraisers USPAP COMPLIANCE ADDENDUM File No. County Cumberland state PA Zip Code 17011 Client Refcr~cc # APPRAISER: Dam th~ Repod w~ Signed: 121UO~ Bon-ower: Carol Fu~ien[c Properly,Address: 96 Dee~eld Road City: Camp Hill ' Lend~': SUBJECT PROPERTY PHOTO ADDENDUM File No,: 96deerli Case No.: State: PA Zip: 17011 FRONT VIEW OF SUBJECT PROPERTY /~oFaisad Value: $170.000 REARVIEWOF SUBJECT PROPERTY STREET SCENE Borrows:Carol Fu~anic ProperlyAddress:96Deedi~d Road City:Camp Hill Lender:. SUBJECT PROPERTY PHOTO ADDENDUM File No.: 96deedi Case No.: State: PA 7~p: 17011 FRONT VIEW OF SUBJECT PROPERTY Appraised Date: 12/1/01 Appraised Value: $176,000 REAR VIEW OF SUBJECT PROPERTY STREET SCENE Borrower: Furjanic, Carol Pmpe~¥ Address: 96 Deerfield Road C y; Camp H COMPARABLE PROPERTY PHOTO ADDENDUM File No.: 96deedi Case No.: State: PA Zip: 17011 COMPARABLE SALE #1 209 Deerfield Road Camp Hill Sale Date: 6/12/01 Sale Price: $190,000 COMPARABLE SALE #2 91 Deen3eld Road Camp Hill Sale Date: 5/31/01 Sale Price: $153,000 COMPARABLE SALE#3 432 Candlewyck Road Camp Hill Sale Date: 7G/01 Sale Price: $174,000 SKETCH ADDENDUM HLincoln Financial Group® The Lincoln National Life Insurance Company TDA Client Services PO Box 9740 Portland ME 04104-5001 663 CAROL A. FURJANIC 414 N 4TH ST LEMOYNE PA 17043-1665 Group Annuity Statement m/2oo2- /: 0/2oo2 Plan Number: 569 Employer ID: 560 Plan: HOLY SPIRIT HOSPITAL PARTNERSHIP SAVINGS PLAN Questions? Contact a Service Representative at 1-800-341-0441 Value Summary 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 GROWTH I 5,031.70 SMALL CAP 6,660.06 EQUITY-INC 6,460.74 Totals $23,905.04 Value by source of contributions as of 6/30/2002 New Cont~bufion lnterestRates SALARY DEFERRAL $16,161.59 789.24- 30.4491 163.0032 4,963.30 934.09- 30.7347 133.3221 4,097.61 575.01- 20.7101 293.8207 6,085.05 635.05- 21.9316 265.6300 5,825.69 $2,933.39- $20,971.65 EMPLOYER MATCH TOTAL $4,810.06 $20,971.65 Contract number Contribution Period Interest Rate 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 the right to limit its liability if inaccuracies are not reported promptly. Prospecid}es and various financial reports are available upon request. Please keep in mind that the fiinds supporting the variable annuity am 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. ©1998 Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates. Plan: 569 Employer ID: 560 page 1 of 6 ANNUITY SERVICES ONE TOWER SQUARE NAR I FORD, C [ 06183-4053 CAROL A FURJANIC 414 N 4]t-t SI- LEMOYNE, PA 17043 Questions? Please Contact: Customer Service 1 ~800) 842-9406 YOUR JNVI~S IM[!NT SUMMARY This Quarter Year to Date Beginning Balance .$212.83 $245.02 Tofal Payments $0.00 $0.00 Net Loan Acti vlty $ 37.00- $ 71.87- Total Withdrawals $0.00 $0.00 Other $0.00 .$0.00 Change in Investment Value .$2.30 .$$4.98 YOUR OU IS IAND[NG'LO~N SUMMARY LOAN I -ef[bctive 1 I/9/1993 Outstanding Loan Principal $5,708.95 YOUR INVES1MISNT S~'RA FEGY I'O-I-AL ASSETS CURRENT CONTRIBUTIONS .100% Fixed l ixed Fixed 100% r-FlexCf 100% I-FlexCl' Additional Annuity Features (~ NEWS Please review your stalemenl for accuracy. Any errors need to be reported wilh#l 90 d~ ys of receipt. i185993899609699 Holy Spirit Hospital #BWNFXQN CAROL A FURJANIC ~14 4TH STREET LEMOYNE, PA 17045 ENV#40014223 405894073116 A Retirement Savings Statement April 1,2002 - June 30 2002 ~' For onUne access, log on at: http ://www.f delity.com/atwork For informal on, call: (800) 343-0860 Your Account Summary Beginning Balance Ending Balance Additional Information · Dividends & Interest $51,303.70 - 958.31 923.51 -6,900 80 $45~284.72 $75.36 Your Personal Rate of Return This Period -13 2% Year to Date -15:0% Your Personal Rate of Return is ca culated with a t me-we ghte~ form,u/a, widely used by firtancial analys S 0 cal~u ate n~estment earninge. It reflects he resu ts of yo~r nvestmen se ee one as well as any activily Jn the elan account(s) shown. There are other Personal Rate of Return Iormulas used that may yield different results. Remember that past per[ormance ~s no guarantee of future results. Your,Asset Allocation Stocks 94% Bonds 8% Your The Addit onal Fund nformation section lists the allocaUon of your blended funds. Market Value This section diselays the l, in both shares and dollars. Shares on Shares on Price on Price on Market Value Market Value investment 03/31/2002 06/30/2002 03/31/2002 06/30/2002 on 03/31/2002 on 06/30/2002 Stock Investments $40,157.68 $35,731.42 Fidelity Grow & lac 602.713 624.697 $37.60 $33.61 22.662.01 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 $1~0,553.~30 Fid Freedom 2020 885.307 920.078 $12.59 $11.47 11 r-~6 np Acc~un[~Total ' ...... -- ....... , ..... J,,i.,3.,.,, $5! ,303.7(..._! I $46,284.72__, Remember mat a dJvk]el~d uaynlent to fund shareholders reduces me share price of the fund, so a decrease in the snare ~rice for the sramment period does nol necessardy reflect lower fund performance. . · Some of your Investmenm are classified as a Bieneed Fund Investment. Blendea Investments may Include a mJxlure of stocks, BOnds. and/or short-term assets Please refer to the "Additional Fund Information" section to determine the allocatron of your blended investments' underlying assets The asset Dreakaown of your portfolio is reflected in the pie chart in the "Asset Allocation" Section Please read/his statement carefully. Any error must be reported to Finality/hvestments within 90 days. 14223 40014223 0001 20020709 403B Fidelity Investmems. P.O. Box 770002, Cincinnati, OH 45277-0090 Page ~ of 5 CAROL A. FU1LIANIC, Plaintiff JAMES A. FURJANIC, Defendant : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : CIVIL ACTION - LAW : : NO. 01-1144 : : IN DIVORCE AMENDED INVENTORY UNDER RULE 1920.33 Counsel for Plaintiff, Cara A. Boyanowski, Esquire, files the following amended 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. Counsel verifies that the statements made in this inventory are true and correct. She understands that false statements herein are made subject to the penalties of 18 Pa.C.S.A. §4904 relating to unsworn falsification to authorities. Counsel is signing this amended inventory due to the unavailability of Plaintiff Counsel for Plaintiff AMENDED INVENTORY FURJANIC v. FURJANIC Date of Marriage - 02/13/82 Date of Separation - 12/26/00 Assets Real Estate Marital Residence: 96 Deerfield Road Camp Hill, PA 17011 Husband 1/3 Ownership in Mother's Residence in Steelton, Pennsylvania Retirement Assets The Lincoln National Life Insurance Group (Financial) Annuity Wife Travelers Life and Annuity Wife MARITAL ASSETS Husband's Wife's Value Value $153,600.00 $180,000.00 (His Appraisal) Equity: $50,000.00 $10,000.00 Date of Separation Value: $26,277.32 Current Value: $16,921.58 (As of 9/30/02) Date of Separation Value: $365.25 Current Value: $178.13 (As of 6/30/02) Master's Value Notes Mortgage of approximately $68,000.00 and Home Equity Loan of $84,000.00 at separation. Current debt balance approximately $139,400.00. Increase in value dunng marriage. Outstanding Loan against account in amount of $5,708.95 as of 06/30/02. Assets Fidelity Investments 401(K) Plan Wife Bank Accounts Members First Account Wife Commerce Bank Account Wife Mellon Bank Checking Account No. 884-017-4117 Husband Mellon Bank Checking Account No. 100-024-4630 Husband Automobiles 1995 Mitsubishi Husband 1990 Volvo MARITAL ASSETS Husband's Wife's Value Value Date of Separation Value: $54,029.96 Current Value: $40,498.78 $2,900.00 $0.00 $3,000.00 $0.00 $7,500.00 $0.00 $0.00 Master's Value · Notes Current value includes post separation contributions of approximately $14,000.00. V~ue ~ Date of Separation: $2,900.00 Cu~ent Value: $25.00 V~ueatDateofSeparafion: $0.00 Current V~ue: $1,200.00 Value atDateofSeparafion: $3,000.00 Cu~entVahie: $1,400.00 Value ~ Date ofSeparafion: $0.00 Cu~ent V~ue: $1,100.00 Purchased in February, 1997 for $19,000.00. No lien exists on veh/cle. Vehicle was sold for $4,500.00 and proceeds were split between parties. 999 Diamante $0.00 $0.00 Leased vehicle. Vife Asses Miscellaneous Household Goods and Furnishings Loans/Debts Citibank Mastercard Credit Card No. 5410-6548-4547-4219 Husband Bank One Visa Credit Card No. 4417-1259-7248-7718 Husband Visa Credit Card No. 4287-5900-0036-445l MAR/TAL ASSETS Husband's Wife's Master's Value Value Value Nominal Nominal Date of Separation Balance: $12,000.00 Current Balance: $12,500.00 Date of Separation Balance: $3,000.00 Current Balance: $0.00 Non-marital Non-marital Date of Separation Balance: $1,800.00 Current Balance: $2,188.08 Notes Already split between parties. Husband's debt for personal and recreational expenses. Husband's debt for personal and recreational expenses. Joint Names. Account used for marital expenses by Wife and personal expenses. MLNINQ/SCREEN02 01 087 LOAN MASTER INFORMATION (PART 1) 11/07/02 11:23 Loan: 177020615 lst/2nd Mt9 Cd i Loan Type Property Type 11 Orig Term 360 G/L Type 02 Auto Pymt Buydown Code N Subsidized ,,,7,7~0,2,0,61,5, *~otes FURJANIC JAMES A Branch 087 State PA Status 0 SPECIAL FUNCTION CODES ON LoAN Iht Calc Method 2 ARM Type 01 Iht Coll Method 0 Payment Frequency M Billing Method 3 Participation N RiSk Code N Per Diem 8.677015277 Remaining Term 136 First Due Date 2/01/85 Iht Paid-To Dt 10/01/02 sch Pmt Date 11/01/02 Reg Pmt 831.85 Payment Due Dt 11/01/02 P&I Due Escrow Due Curr Pmt Due Late Charges Due Total Past Due Total Accr Iht Total Amt Due Orig Amount Origination Date Pay-Off Date P & I Pmt 602.68 229.17 831.85 .00 .00 .00 831.85 103,000.00 8/~2/83 o/oo/oo 602.68 Current Principal Total Escrow Bal Assigned Escrow Unassigned Escrow Prepaid Unapplied Accrued Escrow Int Accrued Interest Buydown/Subsidy Bal Orig Maturity 8/12/13 Curr Maturity 2/01/14 Interest Rate 5.000 Escrow Pmt 229.17 A.P.R. Rate 5.875 716.43 .00 .00 25.38 .00 .00 ' UILmcoln Financial Group® The Lincoln National Life Insurance Company Lincoln Retirement Servicing Center PO Box 9740 Portland ME 04104-5001 00064~ CAROL A. FURJANIC 414 N 4TH ST LEMOYNE PA 17043-1665 Group Annuity Statement 6/30/2002 - fti$0/2 00 2 Participant ID: 141039 Plan Number: 569 Employer ID: 560 Plan: HOLY SPIRIT HOSPITAL PARTNERSHIP SAVINGS PLAN Questions? Contact a Service Representative at 1-800-341-0441 Value Summary Dollar value Net Gain/ Unit value Number of units Dollar value ~ · '~ ~ activi~ loss as of aa of ~,/30r~O0.~ 9/30/2002 9/30/2002 9/30/2002 894150+006 INDEX 4,963.30 GROWTH I 4,097.61 SMALL CAP 6,085.05 EQUITY-INC 5,825.69 870.75- 25.1072 163.0032 4,092.55 784.63- 24.8494 133.3221 3,312.98 1,269.88- 16.3881 293.8207 4,815.17 1,124.81- 17.6971 265.6300 4,700.88 Totals $20,971.65 $4,050.07- $16,921.58 Value by source of contributions as of 9/30/2002 SALARY EMPLOYER DEFERRAL MATCH $13,044.42 $3,877.16 TOTAL $16,921.58 New Cont~bution Interest Rates Contract number Contribution Period Interest Rate 894150+006 07/01/2002-09/30/2002 4.85% 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 l/ability if inaccuracies are not reported promptly. Prospectuses and various financial reports are available upon request. Please keep in mind that the funds sappociing the vaiSable a_,:naity are not p~o, o funus ,_.,m a., only ava~ ab e hint ~ ~ insurance company contracts. Securities offered through Lincoln Financial Advisors and other broker/dealers with effective selling 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 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. ©1998 Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates. Plan: 569 Employer ID: 560 page l of 4 Fidelity Investments ® Holy Spirit Hospital Retirement Savings Statement July 1, 2002 - September 30. 2002 #BWNFXQN CAROL A FUEJANIC 186 STONEHEDGE LANE MECHANZCSBURG, PA 17055 ENVY40028325 40 58940 73116 A ~ For online access. Jo§ on aT: mtp ://www.fidelity. com/atwork For information, call: (800] 343~0860 Your Account Summary Beginning Balance Employee Contributions Ern~)~0yer Contributions Change in Account Value Ending Balance S46,284.72 t ,038.28 454 27 -7,278.49 $40,498,78 Additional Irlformatiort + Dividends & Interest $51.10 Your para?Iai Rate of Return This Penod -15.5% Year to Date -28.1% Your Personal Rate of Return is calculated with a time-weighted formula, widely used by financial analysts to calcu ate investment earnings. It r~flects the resu ts et your investment selections as well as any activity in the plan account(s) shown. There are other Personal Rate of Return formulas used'that may y eld different results: Remember that past pedorrnance is no guarantee of future results. Your Asset AllOcation Stocks 93% BOnds 7% rounding. The Additional Fund Information section lists the allocation of your blended funds. Ih'shares and aollars Investmenf 06/30/2002 09/30/2002 06/30/~002 09/30/2002 Stock Investments Fidelity Grow & Inc 624 697 645.475 $33.61 $28.82 Fidelity Growth Co 369.585 386.319 $39.87 $31.68 Blended Investments' Fid Freedom 2020 Ace~untTa{al 920.078 Market Value Market Value on 06/30/2002 on 09/30/2002 $35,731.42 $30,841.14 20.996.07 18,602.59 14,735.35 12.238.55 $10.553.30 $9,657,64 ~0,553.30 9.557.64 $46~284,72 $4~;491L78 947.757 $11.47 $10.19 Remember that a dividend payment to fund shareholders reduces the share price of the luna. so a decrease in the snare orice for the stutement petted ooes not necessarily reflect lower lund performance underlying assets. The asset breaKaown of your portfolio is reflected in the pie chart in the "Asset Allocation" Section Please read this statement careCully Any error must be reported to Fidalit) investments w~lr n 90 aays 28325 40028325 0001 20021009 403B Fid~ ify Investments. P.O. Box 770002. CincinnatL OH 45277-0090 Page 1 of 5 INVENTORY FURJANIC v. FURJANIC Date of Marriage - 02/13/82 Date of Separation - 12/26/00 MARITAL ASSETS Assets Real Estate Marital Residence: 96 Deerfield Road Camp Hill, PA 17011 Husband's 1/3 Ownership in Mother's Residence in Steelton, Pennsylvania Husband's Wife's Value Value $153,600.00 $176,000.00 Appraisal Appraisal 5/23/01 12/01/01 0 $10,000.00 Non-marital Asserted 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. Retirement Assets The Lincoln National Life Assurance Group (Financial) Annuity $26,277.82 $26,277.82 12/31/00 Date of separation. Agreed. Exhibit 5. $20,971.65 $20,971,65 06B0/02 Present. Agreed. Travelers Life and Annuity Wife $365.25 $365.25 12BI/00 Date of separation. Agreed. 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 O6/3O/O2 Present. Agreed. Fidelity Investments 401 (k) Plan Wife $54,029.96 $54,029.96 12/31/00 Date of separation. Agreed. Contribution of Wife after 12/30/01 was $6,442, which subject to same marke~ decline would now be $5,514. Exhibit 7. $46,284.72 $46,284.72 06/30/02 Presem. Agreed. Bank Accounts Members First Account Wife $2,900.00 $2,900.00 No statement. Agreed. Commerce Bank Account Wife 0 0 No statement. Agreed. Mellon Bank Checking Acct. No. 884-017-4117 Husband $3,080.40 01/10/01 $3,000.00 See statement. Exhibit 8. Mellon Bank Checking Acct. No. 100-024-4630 Husband 0 0 No statement. Agreed. Automobiles 1995 Mitsubishi Husband Present Kelly Blue Book Trade-In: $3,545.00 Retail: $5,700.00 $7,500.00 Asserted Date of purchase: 1995 Purchase price: $19,000,00 Balance due at 12/16/01 = $5,122.99 l~ffleage at purchase: 11,000miles Mileage at 12/26/00:82,000 miles Mileage present: 124,500 miles Exhibit 9. 1990 Volvo 0 0 Vehicle sold, proceeds divided. Agreed. 1999 Diamante Wife $2,000.00 0 Leased. Lease expires October, 2002. Lease-end purchase available at $2,000.00 below wholesale market value. Miscellaneous Household Goods and Furnishings $18,000.00 0 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. Loans/Debts CitibankMa~ercard Credk Card No. 5410-6548-4547-4219 $11,314.12 0 Assened to benon-marital Upon separation, Defendant was let~ with approx. $15,000.00 of credit card debt, while Plaintiffassumed approx. $1,800.00. Defendant proposes an equal division, as joint marital debt. Exhibit 10. Bank One Visa Credit Card No.4417-1259-7248-7718 $3,046.49 0 Asse~edto be non-marital See Statement. Exhibit 11. Members First Visa Credit Card No. 4287-5900-0036-4451 $1,864.52 $1,800.00 Agreed marital debt. Exhibit 12. Income 2001: $69,264.0O $57,627.00 Present incomes. See 2001 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 statemems. William A. Fetterhoff, Esquire 200 North Third Street, Suite 800 Harrisburg, PA 17101 (717) 232-7722 Counsel for Defendant EXHIBITS 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. Appraisal of Reai Estate. Waypoint Bank Mortgage. Members First Home Equity Loan. Kathryn Furjanic Real Estate. Lincoln Financial Group. Travelers Life and Annuity. Fidelity Investments. Mellon Bank Checking. Mitsubishi ( 1995). Citibank Mastercard. Bank One Visa. Members First Visa. Income of James Furjanic, (2001 and present). Income of Carol Furjanic, (2001 and present). Lifetime Earnings of Carol Furjanic (Social Security). Lifetime Earnings of James Furjanic (Social Security). Exhibit 1 IRle No. 010510AI Paae #21 RESIDENTIAL APPRAISAL REPORT APPRAISALS BY E.J. KOPPENHAVER 96 Deerfield Road Book-F Volume-30 Page-Il73 Camp Hill, PA 17011 N/A Zili[, Marllyn 200 North Third Street Harrisburg, PA 17102 E, J, Koppenhaver 2116 Southpoint Ddve Suite 0 Hummelstown, PA 17036 Form GA7 -- "TOTAL 2000 for Windows' appraisal software by a la mode, inc. -- 1-800-ALAMODE File No. 01051GAI Paae #31 Appraisals by E. J. Koppenhaver 2116 Southpoint Drive Suite B Hummelstown, PA 17036 Phone: 717-583-0306 200 North Th[rd Street Harrisburg, PA 17102 Re:Property: 96 Deerfleld Road Camp Hill, PA 17011 Borrower: N/A File No.: 010510A 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 Iocatlona] 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 sttached. 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, ]File No. 010510Al Paae SUMMARY OF SALIENT FEATURES Subject Address Legal Description City County Zip Code Census Tract Map Ralerence 96 Deerfield Road Book - F Volume - 30 Page- 1173 Camp Hill Cumberland PA 17011 0109 ADC70900 20H4 Sale Pdce $ N/A Date of Sale N/A Borrower/Client NVA Lender Zilli, MarJlyn Size (Square Feet) 2,263 Pdce per Square Foot $ aedmoms 3 App~ser Date ol Appraised Value E. J, Koppenhaver Final Esdmate ol Va~ue $153,600 Form SSD -- "TOTAL 2000 for Windows" appraisal software by a la mode, inc, -- 1-800-ALAMODB El. Koppenhaver IRis No. 010510AI Paps #51 01051OA Summa, Report UNIFORM RESIDENTIAL APPRAISAL REPORT P0, Ro. 010510A Prope~ Address 96 Deedield Road Cit~ Camp HIll State PA Zip C0de 17011 Le0al Descdpgon Book - F Volume - 30 Page - 1173 C0untv Cumberland Assessor'sParcelNo. 13-25-0010-240 Tax Year 2001 R.E Taxes $1,920.00 Seeda~ Assessme~s $ 0.00 Borrower N/A Current Owner FurJanic, James & Carol Occupant: ~ Owner ~ Terrain ~ Vacant Praperb/dqnts aparalsed ~<~ ~ee Simple J I Leasehold Neiqhberbppd or project Name Lower Allen Township Sale Pdce $ N/A Date of Sale FDA Ahhralser E.J. Koppenhaver Location L~ Urba~ ~ Suburban ~J Rurat Bald up [] Over 75% [] 25-75% [] Under 25% Growth rate [~ Rapid, [] Stable [] SlOW Pmpe~ values [] Increasing [] Stable [] Declining Demand/supply [] SapHage [] In balance [] Oversupply Ma~tinqtime []Under3mos.~3-6mos. ~Over6mos. Project Type J / PUD I J Condominium {HUD/VA only) HOA$ N/A /Mo. Map Reference ADC70900 20H4 Oepsus Tract 0109 Address 200 North Third Street Suite 800, Harrisburg, PA 17102 Address 2116 South~polflt Drive Suite B, Hummelctown, PA 17036 Predominant ~l.n~e thmlty hou~ p,e$ent land u. % Land u. ohaoge occupancy $(O00)rn'~c ~uc(ym) One famity 90 [] Not iikaly [] Likely [] Owner 120 Low fO 2-4 family -- [] In process [] Tenant 250 HiQh 40 Mula-famtly- To: [] Vacant (0-5%) ~, Predominant [ Commercial ~ Vac.10ver 5%1 185 20 Vacant 10 Neighborhood boundapes and charanteNsflcs: NeJqhborhood Is bounded on the east bv Interstate 83, on the west by Yellow Breeches Creek, on the north bv Cedar Cliff Drive, on the south bv Yellow Breeches Creek. Factors that affect the markethbiIBy 0fthe properbes in the ne[ghbothm~d (F0~rnity to employment and ameqi~es, employment stability, appeal to markeL etc.): MSA #3240. The sublect is located In Lower Allen Township, Cumberland County, PA. The neighborhood is composed of a compatible blend of single family detached homes in the medium price range. There are several large employers located nearby and it is an easy commute to the other large employment centers of the greater metropolitan Harrisburg area. All amenities and major traffic arteries are convenient to the sublect property. Market conditions in the subject neighborbood (including support for the above conclusions related to the ~nd d properly values, deman6/sppply, and markeUng time -- suck as data on competitive Rroge~es for sale in the neighborhood, desckpPon of the prevalence of sales and financing concessions, etc.); General marketing conditions in the area are rated as good as of the date of this appraisal, Typical loan discounts in the area are one to three points and are generally paid by the buyer with no participation from the seller. Proj~ln~'metlon for PUPs (If applicable) - - Is the developer/buither in control of the Home Owners' Associetion (HOA)? LJYes UNo Approsmete total number of units in the subject project Approximate total number of unds for sale in the subiect project D)meflsions 100 x 216 x 211.48 x 156.18 SDs area 26,735 SgFt Corner Lot [] Yes [] No Z0nthgcompIiance [] Legal [] Legalnonconforming (Grandththereduse) ~ Iltegal [] N0z0ning Ethctdcity [~ 200 Amps Street Asphalt [] [] Gas [] Curb/gutter Concrete [] [] Water [] Sidewalk Concrete [] [] Sanitary sewer [] Streetlighth None [] [] Storm sewer ~ Alley None ~ ~ Topograpky Steep Slope to Rear Size Average Shape Rectangular Drainage Average View Average Landscaping Average Ddvew~y Sudace Asphalt Apparent easements None Noted FEMA Special Rood Hazard Area ~1 Yes [] NO FEMA Zone "C" Map Date 9-30-77 FEMA Map NO. 421016S / Panel# 02 Design (S~e) 2 Stor~ ExisUng/Proposed Existing Age(Yrs.) 17 Effecgve A(~e (Yrs,) 10 ROOMS rover Living Sasement Level 1 1 1 Level 2 Rnishap area above qrage contains: Colonial/Avp. subject property. No. of ungs One Foundation Block Slab N/A Area Sq. Ft. 1,311 Roof [] NO. of Stodes Two E~dor Walls Brlck&Frm Crawl Space N/A % Finished 0 Ceiling [] Type(DeL/Att.) Detached RoofSudace AsphaltShlng Basement 100% Ceiling Joists Walls [] Gutters & Dwnspts. Aluminum Sump Pump No Walls Block Roar _-- [] Window Type DoubleHung Dampness None Noted Floor Concrete None [] Stab'n/Screens Thermopane $ethement None Noted Outside Dnb,/Yea Unkeowo. [] ~4anutacturedHouse NO Dthino K~chen 7 Rooms; Inthstahon None Noted Den FamlyRm. Rep. Rm. Bed:ms #Baths 3 Dedroom~s); 2.1 Bath(s); KITCHEN EQUIP. ATTIC AMENITIES Type Htpump Refdgeraor ~] None [] Fireplace(s)# Fuel Elec Range/Oven [] Stairs [] Retio Condgion Avg. Disposal [] DropStair [] Deck Rear COOUNG Dishwasher ~'~ Scurde [] Porch Front Cenbal Yea Fan/Hood ~x~ Floor [] Fence 0t~er No M/tinware ~ Heated [] Poth Condition Avq, Washer/Dryer ~ Fthisked ~ s (special energy efficient items, etc.): Rear deck, covered front porch, central vacuum, OondiUon of the improvements, daprecia~ol~ (pkysical. functional, and e~mal), repairs neaped, quality of consmJcapn, remodeling/additions, etc.: There ia no functional or economic obsolescence. There are no physical JnadeetuaoJes and no repairs required. The roof appears to be in good condition with no evidence of leaks on the Interior. Laurld~ Other Area~Sa. rth Loft 952 2,263 Sq Jars root of Gr0ss Uvinq Area D~R STORAGE: [] None [] [] Garage # of cars [] Oetacbed [] Duth-ln [] tarpon ~ 0dvewav Asphalt loCated at the sub~ect property. Freddie Mac Form 70 6/93 PAGE 1 OF 2 Fannie Mae Form 1004 6/93 Form UA2 -- 'TOTAL 2000 for Windows' appraisal soRware by a la mode, inc. -- t-800-ALAMODE [File Nq. 010510A[ Pace #6l 010810A ~tlonSentthn UNIFORM RESIDENTIAL APPRAISAL REPORT FboNo. 010510A £STIMATED SITE VALUE = $ 30~000 ComrnenMoflCoMApproach(sucbas, sourceofcoofesBmale, siMvaruai ESTIMATEO REPRODUCTION COST-NEW-OF IMPROVEMENTS: Dwelling 2,263 Sq. Ft. @$ 48,93 = $ 110~729 1,311 Gq, Ft. @$ 11.76 = 15~417 Appliances, Porch,Deck 7,000 Garage/Caim~l 624 Sq. Ft. @$ 14.28 = 8~911 Total Estimated Cost New = $_ 142~057 Less Physical Funcbonal External Depreciation 23,681 I I =$ 23.681 Depreciathd Value of Improvemanta .......... =$ 118,400 · As-la" Value of Site Irnprovementa = $ 8,000 INDICATED VALUE BY COST ~PPROACH ............ $ 156,400 square foot calculation and for HUG, VA am~ FmHA, the estimated ~emaining economic lite of the property): Tbs Marshall end Swlff Valuation Service was used to calculate the replacement coat of the subject properb/, Estimated remaining economic life is estimated to be 50 years. ITEM r SUBJECT COMPARABLE NO. 1 COMP.~J~,B LE NO. 2 I COMPARABLE NO. 3 96 Deerfield Road 109 Blacksmith Road 91 Deerfield Road 1201 Hearth Road AddresB Camp Hill PA 17011 Camp Hill, PA 17011 Camp Hill, PA 17011 ICamp Hill, PA 17011 Ro~mitv to Subject -~'~es 0.02 miles [ Sales ~ce $ N/A m 159 900 ~ 153 000 ~142 500 Pdce/GrossLivtaoArea $ ~$ 80.68~bI~ $ 65.:38~$ 66.56~I Data and/or ~ALUE AOJUSTMEN3S Concessions Date of Said/~me Locabon Leasebold/Fee Simple Piew DesiGn and Appeal APe Gondilop Room Count Gross Uvinq Area BasemeRt & Rofshed Rooms Below Grade HeMind/Coolinq ~;~ Eneray Ethclant Items Garap~/Camort Porch, POfM, Deck, Rreplac~ta), etc. Fence. Pool, etc. Inspection on Data Bank DESCRIPTION Fee Simple 26,735 SgFt 2Story/Good Brk&Frn'JAvq. Average Total '.Bdrmsl Baths 2,263 Sa. Ft. 100%/0% HeaItpump 2 Car Att. Porch,Deck 2 Fireplaces None Listing Aoent DESCRIPTION ': +(-)$ Adjust. Conv/140 DOM: $0 11-30-00 Good -5,000 Fee Simple 10019 SgFt Average 2Story/Good Brk&VIn/Avq. -2,000 20 Average TthallBtamsl Baths: 6 i 3 ; 2 i +1,000 1,982 SM. Ft. i +4,200 100% / 75% -4,500 Average Heatpump Thermopanes , 2 Car Att. Stoop,Deck Woodstove +2,000 IngroundPool -2,000 Data Bank Listing Agent DESCRIPTION Cony/148 DOM $0 Average Fee Simple 19170 SgFt Average SpOtlvl/Good Stn&Frm/Avg. Average Total iBitrms J Baths 2,340 Sq. Ft 50% / 0% G FWA/Central : 2 Car Att, None None Data Bank Listing Agent +(-)$ AdiuM. DESCRIPTION Cony/81 DOM $o Good Fee Simple 13939 SqFt Average 2Stow/Good Stp&Alu/Avg. 36 Average T0a isdrmH 0 2,141 Sq. Ft. +2,000 50% / 0% Storm Units I Car Att. Scrnd Porch +2,000 I Fireplace None +(-)$ An~s~ -5,000 -3,000 +1~000 +1,800 +2,000 +1,500 +2~000 +1,000 ~-$ 6,300 -+i~dJ~B~'~, ~[? 4,000 1,300 RItjuofed Sales Pdceof Comparable 193,600' ~1~$ 157.000 Commeofs on Sales C0mpadson (including the subject pr0ped3's compaItbiMy t0 the neighborhood, etc.): All comparables are homes located in the ANendale development. These comparables set the range of value for the subject property. ~tofe Ceriffaiabon # RL-OO1154-L Itr Stofe License # Freddie Mac Form 70 6~3 ITEM SUBJECT COMPARABLE NO. 1 COMPARABLE NO. 2 COMPARABLE NO. 3 Date, Pdce and Data None None None None withinSource,~ar for of pdor appraisalsales C.C.T.A.O C.C.T.A.O C.C.T.A.O C.C.T.A.O Analysis of any current agreement th sale, option, or IJsItng of subject properbj and analysis of any pd0r sales of subject and comparables within one year of the dam of appraisal: There Is currently no contract pendlnp on the subject property IRDICATED VALUE BY SALES COMPARISON APPROACH $ -- 153.600 rNDICATEDVALUE BY INCOME APPROACH (It Applicable} Estimated Market Rent $ n/a ~o. x Gross Rent Mu~plier = $ _ [hie appraisal is made ~ 'as is" L~ subject to the reItaire, aIteraItons, inspections or conditions listed baiow U subject to compleiton per plaJ~.S & speciitcafions. ;ondifione of App~aJsab This appraisal is made in "AS IS ' condition. The attached addenda are made an Inteprel part of this appraisal ~inai Reconciliation: The direct sales comparison approach Is ~onsidered to be the most accurate method of achieving fair market value. Insufficient data was available to develop the income approach. The cost aoproach supports the reported value. the puth0se nt this appraisal is to esUmaof the ma,tat value of the real prope~ that is the subject nt this report, based on the &bove c0pditio~ and the ce~icabon, contingent and Jimitofg condiMons, and marke~ value daiMiiton thai are staofd in the aUached Freitdie Mac Form 439/FNMA fo~ 1004B (Rews~ 6/93 ;(WE) ESTIMATE THE MARKET VALUE, AS OERNEU, OF THE REAL PROPER3'Y THAT IS THE SUBJECT OF THiS REPORT, AS OF 5-23-01 E DATE OF THIS REPORT) TO BE $ 153.600 SUPERVISORY APPRAISER (ONLY IF REQUIRED}: Sioflathre [] Cid [] Did Not Name Inspect Rope~ Data Repan~ Staned State PA State Coniston # State State Or State License # State PAGE 2 OF 2 Fannie M~e Form tO04 6-93 Form UA2 -- "TOTAL 2000 for Windows" appraisal soflware by ~ la morie, inc, -- 1-800oALAMODE Sorrower N/A ProPe~Address 96 Deerflald Road cih' Camp HIll Lender Z , Marllyn Coun[y Cumberland State PA IFIle No. 010510AJ Pa=e #71 File Ne. 010510A ZIo Code 17011 APPRAISAL AND REPORT IDENTIFICATION This Appraisal conforms to ~ of the following definitions: [] Complete Appraisal The act or process of estimating value, or an estimate of value, performed without invoking the Departure Provision. [] Limited Appraisal The act or process of esUmating value, or an estimation of value, performed under and rasu[ting from invoking the Departure Provision. This Report is one of the following types: [] Serf Contained Report A written report prepared under Standards Rule 2-2(A) of a complete or limited appraisal performed under Standard 1. [] Summary Report A written report prepared under Standards Rule 2-2(8) of a complete or limited appraisal performed under Standard 1. [] Restricted Report A written report prepared under Standards Rule 2-2(C) of a complete or limited appraisal performed under Standard 1. Comments on Appraisal and Report Identification Note any departures from Standards Rules 1-2, 1-3, 1-4, plus any USPAP-releted issues requiring disclosure: E,J, 1(oppenhaYer Form iD1 -- 'TOTAL 2000 for W~ndows" apprai$~ $ofiware by a la mode, inc. -- 1-000-ALAMODE tFile NO. 010510AI Paae #81 MULTI-PURPOSE SUPPLEMENTAL ADDENDUM FOR FEDERALLY RELATED TRANSACTIONS E.J. Kpop~qhaver Sorrower/ClimR N/A Property Address 96 Dee.'field Road City CampHiR County Cumberland State PA ZipCode 17011 Lender Z , Marilyn This MulU-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 Co~poration (FDIC), the Office of the Comptroller of Currency (OCC), The Office of Thrift Supervision (OTS), the Resolution Trust Corporation (RTC), and the Faperal Reserve. This Multi-Purpose Supplemental Addendum is for use with any appraisal. Only those statements which have been ehecked by the appraiser apply to the property being appraised, [] PURPOSE & FUNCTION OF APPRAISAL The purdose of the appraisal is to e~mate the market value of the subject gmpody as degned herein. The Iunction of the appraisal is to assist the above-named Lender in evaluapng the subject property for lending purposes. This is a Federally related transaction. [] EXTENT OF APPRAISAL PROCESS [] The appraieal is based on the informagon gathered by the apwalser from poedc records, other idengged sources, inspecgon th the subject pmpo~ an~ neighborhoed, and sel~cgon of comparable sales within the subject marknt area. The odginal source of the comparedles is shown in the Data Source s~cfion of the market gdd along w~ti the source of confirmaiion, if available. The odginal source is presented first, The sources and data are considered mliabJe. When congicgng inthrm~iion was provided, the soume deemed moat ~eJiable has been used. Baa believed to de unraliable was not included in the rep~1 nor used as a basis Mr the value concJualon. [] TheRaproduction¢oMisbasedon Marshal and Swiff Valuatlon Service supplemented by the appraiser's knowledge of the local market. [] Physical dapmciagon is based on the esgmaMd effective age ut the subject property, Funcgonal and/or exthma~ dapreciapon, g present, is specigcaUy addressed in the appraisal repod or other addenda. In estimagng the site value, the appraiser has relied on personal knowledge of the local market, This knowledge is tiased on pdor and/or current analysis o~ site sales and/or abstraction of site values from sales of improved proper[les. [] The subjeat pmpeRy is located in an ama of pdmknly owner~cupled single thmily realdences and the thcome Approach is not considerap th be mea~thglul. For this reason, the income Approach was not used. [] The EMimated Market Rent and Gross Rent Mulgplier ublizap in the Income Approach are based on the appraiser's I~owiedge of the subjedt rnarkat area. The rental knoededge is based on prior and/or current ~ental rate surveys of residential pmpeRes. TPe Gross Rent Multiplier is based on prior and/or current analysis of pdces and market rates for residential properties, [] For income producing prope~Jes, actual rents, vacancies and expenses have been regoded and analyzed. They have poen used to project future rents, [] SUBJECT PROPERTY OFFERING INFORMATION According to Owner the subject prope~: [] has nut been oRered for sale in the POM 30 days. [] is cunentiv ofthred lor sale for $ [] wa~ effmad thr sale within the past 30 days thr $ [] Offering informalJon was conaledred in the final reconcll~pon ut value. [] FEMA FLOOD HAZARD DATA [] gubject properly is not located in a FEMA Spocial Flood Hazard Area. [] Subjeat property i~ [ocaled in a FEMA Special Rood Razm-d Area. "C" 421016B / Panelth 02 9-30-77 [] The cm~munity does not narticiapta in the National Flood Insurance Program. [] *~he community does nartlci~ate in the National Flood Insurance Program. [] It is covered by a redutar orogram. [] It is covered by an ememencv program. Page 1 M 2 Fo~ MPA -- "TOTAL 2000 for Wiedows' appraisal soft'ware by a la mode, inc. -- 1-tiOO-ALAMODE Name of Community Lower Allen Township IFile No. 010510AI Paae #91 [] CURRENT SALES CONTRACT [] The subject property is currendv nof under coofract. [] The contract and/or escrow instructions were no1 availaate for review. The unavadabildy of the contract is explained later in the addenda section. $ Fudanlc, James & Carol [] ADDITIONAL CERTIFICATION The Appraiser certifies and agrees that: (1) The anaiyses, opinions and concluaions were devaioped, and this report was prepared, in cooformity with the Untiorm Standards of pmatsaio~ai Apprasal Practice ('USPAP'), except that ate Departure Provision of the USPAP does not apply. (2) Their compensation is not contingeot upon the reposing of predetermined value or dlreation in value at at favors ate cause of ate claint, the amount of the value estimate, ate attainment of a stitiaiaatd result, or ate occur~enc~ of a sutisequent event. (3) This appraJsai assignment was not based on a requested minimum valuation, a stiecffic vaiuation, or the approval of a loan. [] ADDITIONAL (ENVIRONMENTAL) LIMITING CONDITIONS [] APPRAISER'S SIGNATURE & LICENSE/CERTIFICATION Appraiser'sSigna~ Effective Date 5-25-01 DaatPrepared 6-4-01 Appraiser's Namee ~en~]enhaver Phone at ~Z17 } 583-0306 State PA CerdficaUon ~ RL-O01154-L Tax ID # [] CO-SIGNING APPRAISER'S CERTIFICATION [] The co-signing apDraiser tins tiersonally instiecatd the subject property, pont inside and out, and tins made an extedor inapection of all comparatde sales [] The co-aignatg appraiser has not tiersonaily insr~catd the atatdor of the subject praperiy afld: co-$igni~lg appraiser. Co-SiQatng Appraser's Signature Effective Date Date Prepared Co-Signingkppraiser'sName(~dnt) Phone# (7171 583-0306 State . [] License [] Ce~fication# RL-OO1154-L TaxlD~ 25-1718810 Pape 2 of ti Form MPA -- 'TOTAL 2000 for Windows' appraisal soflvare by a la mode, inc. -- 1-800-ALAMOOE Borrower/Client N/A RopmlyAddres$ 96 Deer~leld Road City Camp Hill Lender Zflll, Marilyn Supplemental Addendum County Cumberland State PA Rle No. 010510A Zip 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 COMPARABLES CLOSING WITHIN THE SIX 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 COMPARABLES WERE USED BECAUSE THEY BEST REPRESENT THE MARKET VALUE AND MARKETABILITY OF THE SUBJECT. NO BE'r'FER COMPARABLES WERE AVAILABLE FOR USE IN THIS APPRAISAL. ALL COMPARABLES ARE VERIFIED SOLD AND SE'I-FLED PROPERTIES. Signature Signature Name E.J. Name Form TADD2 -- "TOTAL 2000 for Windows* appraisal software by a la mode, inc. -- 1-SOO*ALAMODE DEFINITION OF MARKET VALUE: The mosS pmpable pdce which a property should bring in a compeknve and open market under ail condalons requisite to a lair saIe, the buyer and seller, each aknng pmdenUy, knowledgeably anq assuming the pkne is not affected by undue chmulus. Implicit in this knitnition is the consummation ct a sale as of a spacBikn date end the passing of title from seller to buyer under conditions whereby: {I) buyer and seller are typically mknvatnd; (2) bo~ pa~es a~e well inforTnnd or wkn advised, and each acting in w~at he considers his own best interest; (3) a masonchle time is allowed for exposure In the open market; (4) payment is made in terms ut cash in U.S. dollars or in terms of financial arrangements oomparaMe thereto; and (5) the pdce appraiser's iudgemenh STATEMENT OF LIMITING CONDITIONS AND APPRAISER'S CERTIFICATION CONTINGENT AND LIMITING CONDITIONS: The appraiser's cerBficahon that appears in the appraisal rep~ is subject to t~ following conalknns: 3. The appraiser kns examined the available fl~d maps that ate pmal~ed by the Federal Emergency Management Agency (or other data sources) and has noted in the appraisal report whether the subject site is tecsskn in an identified Special Rood HaZard Area. Because the ng~-alser is not a surveyor, he or she makes no guarantees, express or implied, rngardalit this dssermiflknon, 8. The appraiser will not disclose the contents o~ tee appraisal report except as pmvlknd for in the Uniform Standards of Prolessional Appraisal Pracitce. 10, The appraiser must provide his or her prior wdtlen consent before the lekner/knent spaciflkn in the appraisal report can disthbute the appraisal report (including conclusions knout the propady value, the appraiser's ldenthy ~d wutessional designations, and references to any prutessional appraisal organiza~ns or the firm with which the appraiser is associated) to anyone other than the borrower; the mortgngee or its successors and assigns; the modgage insurer: consuknnte; profesaionai app~sal organizations; any state or federally apprOved financial inkntstJon; or aay department, agency, or inssmmentality of the United States or any state or 1he Dis'~of of Columbia; except that the lender/ssiect may distrtbute the prope~y descdpiton section of the report coty to data cknecknn or repo~ng ser'~ice(s) without having to obtoin tee appraiser's g~r written consent. The appraiser's wdtten consent and approval must also be obtained before the appraisal can be conveyed by anyone to the public through adverUsing, public relknons, news, sales, or other media. Fannie Mss Form 10048 8-93 No. 0105t0AJ Page #121 APPRAISER'S CERTIFICATION: The Appralse~ cenfties and agrees that: 7. I per/ormed this appraisal in conformity with the Uniform Standards of Prnfessional Appraisal Practice that were aBoptad and promulgated Ny the Appraisal Standaofs Board of The Appraisal ~oundedon and that were in pace as of the effective date of this appraisal, with the excepUon of the dapallme Ixovision d those Standards, which does not apply, I aclmowledge that an estimate of a reasonable time 1or eapos~re in the open reader is a condition in the defialBon of market value and the estimate I developed is consistent with the mari(edng time noted in the neigtibmhoed section of this report, unless I have other,¥tse stated in the reconciliation section, I had mad(et ealtience to support them. I have also commented about the effect of the adverse conditions on the marketabil~ of the sub[ant property. no ;aeponsibility for it. SUPERVISORY APPRAISER'S CERTIFICATION: If a supervisory appralsm signed the appraisal reporL he or she ceftiNes and agrees that: I directly supervise the appraiser who ptapared the appraisal report, have ~eniewed the appraisal raporL agree w~ the statements ~nd connfuslons nt the appraiser, ag[ee to be bound by the appraiser's cenfficedons numbered d through 7 above, and am taking furl tesponsibllity for the appraisal and the appraisal report, ADDRESS OF PROPERTY APPRAISED: 96 Deerfield Road, Camta Hill, PA 17011 Signature~r5 Date SIgne State Ce 4-L State: PA Expiration Date of Bo~fic~on or License: 6/30/2001 SUPERVISORY APPRAISER (only if required): Name: Date Signed: State Ceritiicedon #: State: Ex~lraUon Date of Cedificedon or License: [] Did [] Did Not Inspect Properly Freddie Mac [~rm 439 6-93 Page 2 nf 2 Fannie Mae Fom~ 1004B 6-93 Form ACR -- 'TOTAL 2000 for Windows' appraisal soft~vare by a la mode, inc. -- 1-806-ALAMODE [Borrower/Client N/A ProDe~Address 96 Deerfleld City Camp Hill Road Lender Z Ill, Marllyn Subject Photo Page County Cumberland State PA ZipC~e 17011 Subject Front 96 Ceerfleld Road Subject Rear Subject Street Form PZC3x5 SR -- "TOTAL 2000 lot Windows" appraisal software by a la mode, [nc. -- 1 -B00-ALNI40DE Borrower/Client N~A ProDs~Addr~s 96 Deerfield Road Ci~, Camp Hill Lender Z ,Mar yn Subject Photo Page Count' Cumberland St~ PA IRle No. 010510AI Paoe #141 Zip Code 17011 Subject Front 96 Deerfleld Road Sales t~se N/A Gross Living Area 2,263 ~'~1 Rooms 7 Total Bedcooms 3 ~otal Bathrooms 2.1 Location Average View Average Site 26,735 SqFt Quality Brk&Frm/Avg. Age 17 Subject Rear Subject Street Form PTC3X5.SR -- ~TO~rAL 2000 lot Windows" appraisal software by a la mods, inc. -- 1 oSO0-ALA~vIODE ]Borrower/Client N/A Rrog~dvAddres$ 96 Deerfieid Road City Camp Hill Lender Z i, Marllyn Subject Interior Photo Page County Cumberland State PA Zio Code 17011 Subject Interior 96 Deerfield Road Sales Price N/A Gross Living A~ea 2,263 Total Rooms 7 TO~I Bedrooms 3 T~I B~throoms 2.1 Loc~tion Average View Average Site 26,735 SqFt Quality Brk&Frm/Avg, Age 17 Subject Interior Subject Interior Form PIC3xS.SI -- 'TOTAL 2000 for Windows" appraisal software ~y a ia mode, inc. -- ~-800-ALAMODE Bortower/Cllect N/A Proc~rtYAddress 96 Deerfleld Road Lender Zllll, Marilyn C~ Camo Hill Comparable Photo Page CounN Cumberland State PA IRle No. 010510AI Paae #161 ZioC~e 17011 Comparable 1 109 Blacksmith Road Pmx. to Subject 0.15 miles Sale P~ce 159,900 Gross Lialng Area 1,982 T~tal Rooms 5 Total Bedrooms 3 Total Bathrooms 2 Lecagon Good View Average Site 10019 SqFt Quality Brk&Vin/Avg. Age 11 Comparable 2 91 Deerfleld Road Pmx. to Subject 0.02 miles Sale Pdce 153,000 Gross Living Area 2,340 Total Rooms 8 Total Bedrcems 4 Tatat Bathrooms 2.1 LccaGon Average View Average Site 19170 SqFt Quality Stn&Frm/Avg. Age 17 Comparable 3 201 Hearth Road Pmx. to Subject 0.23 miles Sale Pdce 142,500 Gross Living Area 2,141 Total Rooms 8 Tctal Bodrooms 3 Total 6athmoms 2.1 Form PIC3xS.CR -- "TOTAL 2000 for Wifldaws" appraisal software by a la mode. inc -- 1-80O-ALAMODE BOrTower/Client N/A Pro~e~ Address 96 Deerfleld Road Cliv Camp Hill Lender Z , Marllvn uomparable Multilist Photos 1-3 Cour~ Cumberland State PA IFile No. 010510AI Paae #171 ZioC~e 17011 COMPARABLE #1 COMPARABLE#2 COMPARABLE #3 Form GPtC3XS.LST -- "TOTAL 2000 for Windows' appraisal software by a la mode, inc. -- 1-800-ALAMODE BorTower/Client N/A Prol~Address 96 Deerfield Road Ci~, Camp HEll Lender Z ,Marlyn Building Sketch C~unt~ Cumberland State PA [File No. 010510AI Paae Zip Code 17011 40,0* Laun DA AREA CALCULATIONS SUMMARY LIVING AREA BREAKDOWN TOTAL LIVABLE (rounded) 2263 5 Areas Total (rounded) 2263 Fo~ SKT.BLDSKI -- 'TOTAL 2000 for Windows" appraiSal software by a ~a mode, inc, -- 1-800-ALAMODE Building Sketch County Cumberland State PA IFile No. 010510AJ Paae #191 26735 SqFt t.~ ~,,,. Form SKT,BLOS~(I -- "TOTAL 2000 for Windows' appraisal software by a la mode, inc, -- 1-800-ALAMODE Bo~wer/Client N/A Prope~ Address 96 Deerfleld Road City Camp Hill Plat Map County Cumberland State PA Parcel Number 13-25-0010-240 IFIle N0~ 010510AI Paae #201 ~pCode 17011 J Borrower/Client N/A Pr0pe~Address 90 Deerfield Road City Camp Hill Lender Zilli, Marilyn Flood Map County Cumberland State PA Flood Map # 421016~, Pane # 02, Date 9-30-77 Flood Zone "C" Zi[~ Code 17011 Form MAP,Flood -- "TOTAl. 2000 for Windows" appraisal software by a la mode, i~c. -- 1-800-ALAMOOE Borrower/Clie~ N/A Prope~Add~s 96 Deerlleld Road City Camp Hill Lender Z II, Marl vn Location Map County Cumberland State PA IFile No. 01U510AJ ~aoe #221 ~oCode 17011 Form MAP,LOC -- q'OTAL 2000 for Windows" appraisal soitware by ~ la mode, inc. -- I*800-ALAMODE Borrower/Client N/A Proo~t¥ ^~iress 96 Deerfleld Road Lender Zllli, Marllyn ¢~ Camo Hill Legal Description Coun[v Cumberland St~t~ PA IFIle No. 010510AI Paoe #231 zioc~e 17011 Fo~ MAP Legal -- "TOTAL 2000 for Windows" appraisal solt~are by a I~ mode, inc. -- 1-800-ALAMODE Pro~mWAddress 96 Dee,'field Road BUILDING AREA ADDENDUM County Cumberland Slate PA IFlle No. 010510AJ ~'age #24[ Zip Code 17011 Gross Living Area (GLA) Gross Building Area (GBA) 2~263 S.f. Basement 1,311 s.f. 3~1% of GBA Lever 2 952 s.f. 2~3 % Of GBA Level3 0 s,f. ~0% of GBA Garage 624 s.f, 1~5% of GBA Area Dimensions Type of Area Level 1311.00 X 1.00 X 1.00 = 1,311.00 [] [] [] [] [] [] 952.00 X 1.00 X 1.00 = 952.00 [] [] [] [] [] [] 24.00 X 26.00 X 1.00 = 624.00 [] [~] [] [] [] [] 1311.00 X 1.00 X 1.00 = 1,311.00 [] [] [] [] [] [] x x = [] [] [] [] [] [] x x = [] [] [] [] [] [] x x = [] [] [] [] [] [] x x = [] [] [] [] [] [] --x -- x = [] [] [] [] [] [] x x = [] [] [] [] [] [] __x __ x = [] [] [] [] [] [] x x = [] [] [] [] [] [] x x = [] [] [] [] [] [] x x = [] [] [] [] [] [] Form CLC -- "TOTAL 2000 tot Windows' appraisal so,ware by a la mode. inc. -- J-800-ALAMODE Exhibit 2 ~0, BOX 1711, H~'rrl~buvg. Pannmulv~'nla 171OG-1711 Toll FreE: I-SE;6-WAYPOINT (i-866-929-764E;) · ~r~4w.wa~jpolntbank.com LOAN STATEMENT PAGE 1 WAYPOINT BANK ~NUMB~ 0077020615 INTEREST RATE 5.875 ORIGINAL AMOUNT 103,000.00 STATEMENT DATE 12/31/00 JAMES A FUKJANICAt~D CAROL A FURJANIC 96 DEERFIELD RD CAMP HILL PA 17011-8469 SSN 185-38-6096 PROPERTY ADDRESS- 96 DEERFIELD RD CAMP HILL, PA 17011 TRANSACTION T%'PE 01/01/00~:~(T ESC. ADD 02/01/00~T 03/01/00P~T co~m.'~ & ~ 04/01/00PMT 4/11/0 05/01/00Pt'~T 5t 06/01/00~q'~T ZNS,PW~ ~/I~/0~ 07/0~/00~ ~/1~/0( T~S ~ 7~ 08/01/00~ 09/01/00~ 9/11/00 lO/O~/OO~ ~o/1~/o0 .*..' 11/01/00~ 11/14/00 .~ 12/01/00~ 12/11/00 ESC. ~. 12/30/00 " ESC I~ ~ 12/30/00~'"" ,;~, TRAN TEAN LATE DATE AMOUNT PRINCIPAL INTEREST ESCROW CRARGE 1/12/0 .00 2/01/0 .00 2115/o .oo 3/13/o .o0 4/1~/o .oo 35~.92 .00 3~.55 .GO 3~i~18 .00 3.58 ~30 .00 ANNUAL ESCROW ACCOUNT INFORMATION .00 .00 .00 .00 .00 .00 .00 .00 .00 PEIN AND INT PAYMENT 631.09 ESCROW PAYMENT 237.49 TOTAL PAYMENT 868.58 IlvrkkZST ON ESCROW 27.30 BEGINNING ESCROW BAL4%NCE PLUS DEPOSITS TAXES DISBURSED INSURANCE DISBURSED MISCELLANEOUS DISBURSED PRINCIPAL BALANCE 72454.94 72454.94 72158.38 71880.57 71880.57 71601.40 71320.86 71038.95 710~8,9E 70755.65 70755.65 70470.97 70184.89 69897.41 69608.53 69318.23 69318.23 69318.23 69,318.23 878.87 3,408.50 2,491.73 383.79 .00 ENDING ESCROW BALANCE 1,411.85 Exhibit 3 Members/s P.O Box 40 * Mechan~$burg, PA 17055-0040 (717) 697-1161 TOLL FREE (800) 283-2328 www.memberstst.org NCUA HIST 36445-02L FURJANIC/CAROL A 10/11/02 10:17 AM BR:06 ID Post Elf 'Date Date i6T e41601 04t&II '75T 031601 031601 47T 021601 021601 ~6T 011601 011601 T~'an Ty S/PR Code pe AIount Intel'est Fee TFR FROM SHARES 36445-00 PTTF VR 3~2. ~8 478.7~ · 00 TFR F~M SHARES 3644~-00 PTTF VR ~. TFR FROM 8HARE8 36445-00 PTTF VR 897. 19 ~33.81 .00 TFR FROM 8HARES 36445-00 77T 121600 121600 PTTF VR 31~,49 TFR FROM 8HR~ 36445-B0 47T111600 111600 PTTF UR · More In File - ~ERS 1ST FE~R~ CREDIT UNI~ ID: [ ] TRAN CODE: [ ] PARA~TERS~ [ other GENERAL INTERPT PRINT MAIL Vouch Seq C Nuaber Numb O · 1336 · 22673 · 15297 · 29096 DATE:[10/11/02] ] ] HELP main Exhibit 4 THIS DEED made the -~ day o~~. 1996 BETWEEN KAT~IRYN A. FURJANIC,wi'Jdow, ~of the Borough of Steelton, County of Dauphin, State of Pennsylvania, hereinafter called Grantor, -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, That said Grantor for and in consideration paid by the said Grantees to the said Grantor, at and before signing and delivery of these presents, the receipt whereof is hereby acknowledged, have granted, bargained, sold, and conveyed, unto the said Grantees and Grantees' heirs, successors and assigns the premises described on Exhibit "A" attached hereto and incorporated herein by reference; TOGETHER with all buildings, improvements., woods, 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, 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, demand whatsoever, both in law and equity, and to the same'. possession, claim, and of the Grantor' of, in TO HAVE AND TO HOLD the said premises, and the appurtenances, hereby granted to Grantees and Grantees' 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 aqrees that Grantor will warrant specially the property hereby conveyed. IN~WITNESSWHEREOF, the said Grantor has hereunto set Grantorfs hand and seal the day and year first above written. SIGNED, SEALED AND DELIVERED IN THE PRESENCE OF US SS: COUNTY OF DAUPHIN SS: ay of~t~ , 1996, before me, a notary 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 contained, and desired the same might be IN WITNESS W~EREOF, I hereunto set my hand and official seal. My Commission Expires: The address Title of officer NOTARIAL SEAL BARBARA A. LANE, Notary Public Steelton Bom. Oaupflin Couf~'Y My CommJ~on Expires June B, 200n of the within-named Grantees is: 100 Riverview St. Steelton, PA. EXHIBIT A Township of Swatara, County of Daup bin 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; hence eastwardly along the southern line of Lot No. 236 one hundred fiftyrnine (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 twenty three (123) feet, more or less, to a point; thence westwardly along line of property of Emri Sakai one hundred fifty- nine (159) feet more or less, to a point on the eastern line of Boyer Alley; thence southwardly along the eastern line of Boyer Alley one hundred twenty-three (123) feet, to the place 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 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 adjacent 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 "O", Volume 25, page 470, granted and conveyed to Miko F. Furjanic and Mary M. Furjanic, his wife. Thesaid Mary M. Furjanic having predeceased her husband Miko F. Furjanic, title to the aforementioned premises became vested in Miko F. Furjanic by the Grantor herein by virtue of the laws of Pennsylvania relating to tenancies by the entiretiesJ BEING the same premises as Miko F. Furjanic, widower, by his deed dated January 21, 1952, and recorded in the Office for the Recording of Deeds in and for Dauphin County in Deed Book "T", volume "35", page 131, granted and conveyed to Michael A. Furjanic and Kathryn A. Furjanic, his wife. The said Michael A. Furjanic having predeceased his wife Kathryn A. Furjanic, title to the aforementioned premises became vested in Kathryn A. Furjanic by the Grantor herein by virtue of the laws of Pennsylvania relating to tenancies by entireties. Luanne Gustin-DeFrank 599 E~senhower Blvd. PO Box 3255 Harrisburg, PA 17105-3255 2002 REAL ESTATE TAX NOTICE FOR CENTRAL DAUPHIN SCHOOL DISTRICT July 1, 2002 I 03618 (717) 564-6155 M-W-F 9-4PM; 7-9PM ONLY ON 8/29 & 12/30. Drop Box Available SEE DETAILS IN TWP. NEWSLETTER ******************-***** 17113 FURJANI C JAMES 100 RIVERVIEW ST STEELTON PA 17113-2648 I,,,lll,,,I,,,ll,,,ll,,ll,,,I,hll,,,I,,ll,,I,II,,,ll,,,I,,,ll :PROPERTY LOCATION: 98 RIVERVIEW ST IpROPERTY IDENTIFICATION NO 63 051 034 ASSESSMENT [ORIGNALASSESSMENT $ 95,700 HOMESTEAD F_XCLJSION $ 0 FARMSTEAD EXCLUSION $ 0 NET ASSESSMENT $ 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. Ii:.T:-' TAXES MILLAGE/TAX RATE TAX AMOUNT ._ S~H~OO~ DISTRICT 10.6948 ML $1,023.49 TAXES ARE DUE AND PAYABLE. DO NOT ALTER TAX AMOUNT. DISCOUNT AND PENALTY HAVE BEEN COMPUTED FOR YOUR CONVENIENCE DURING THIS PERIOD PAY THIS AMOUNT JULY -AUGUST " 2% Discount Psymmtt Period $ 1,003.02 iF YOU DESIRE A RECEIPT, ENCLOSE A SELF-ADDRESSED, STAMPED ENVELOPE WITH YOUR REMITTANCE. SEPTEMBER - OCTOBER Gross Peynmflt Pedod $ 1,023.49 on Oecember 15th from the Dauphin Co. Tax Assessment Office, the local school district business office, and other selected locations throughout the County An original must be filed with the Dauphin County Tax Assessment Office on or before March 1st of the following year. NOVEMBER * DECEMBER $ 1,074.67 AFTER DECEMBER 31. 2002 10~ Penalty Payn'~,nt Period $ 1, ].25.84 2002 REAL ESTATE TAX NOTICE FOR CENTRAL DAUPHIN SCHOOL DISTRICT Swatara Twp PROPERTYOWNER: FUBJANIC MICHAEL M & FU~JANIC JAMES REMIT TO: 100 RII~F;IEWST B'~..~:TO. ~R ].7113~2~4B AUG ~ 8 2OOZ ~uanne Gustin-DeFrank 99 Eisenhower Blvd. PO Box 3255 Harrisburg, PA 17105-3255 PAYMENTCOUPON '~^T~ DONOTFOLD , J=[¥ 1, 2002 i PROPERTY LOCATION: I 98 RIVERVTEW ST i PROPERTY !lO NO.: 63 051 ~ NET ASSESSMENT Luanne $,aa.tara Twp. -~rea~. $95,700 ~7~7~ 564-6155 - - 9-4PM; 7-gPM ONL~ ON 8/29 & 12/30. Drop ~ox Available SEE-DETAILS IN TWP. NENBL~-L-L'F--R i BILL NUMBER 03618 034 MILLAGE / TAX RATE 10. 6948 HL I lllllllll[ll llllfllJllllllr llJrll ]lllJllfllllJlllllllrlllllliflll[ JULY. AUGUST 2% Discount..~PaYment?~..eriod SEPTEMBER - OCTOBER Gross Payment Period NOVEMBER - DECEMBER 0% Penalty Payment Period AFTER DECEMBER 31, 2002 10% Penalty Payment Period $1,023.49 $1,074.67 $1,125.84 Exhibit 5 ~ 163~0032 5,813.p3 133,3221 i :205.820'/~ 765.'~; 6,038.08 . 6~13.93 ~omp~ny I Fl Umcoh Financial Group® The Lincoln National Life Insurance Company TDA Client Services PO Box 9740 Portland ME 04104-5001 CAROL A. FURJANIC 414 N 4TH ST LEMOYNE PA 17043-1565 Plan Number:. 569 Employer ID: 560 Plan: HOLY SPIRIT HOSPITAL PARTNERSHIP SAVINGS PLAN Questions? Contact a Service Representative at 1-800-341-0441 Value Summary Dolla-r value Ne'/" Gain/ Unit value Number of tTnit~ 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 SMALL CAP 6,660.06 575.01- 20.7101 293.8207 6,085.05 EQUITYqNC 6,460.74 635.05- 21.9316 :265.6300 5,825.69 Totals $23,905.04 $2,933.39- $20,971.65 Palue by source $ALAR¥ BMPLOYER of'contributions DEFERRAL MATCH TOTAL as of 6/30/2002 $16,161.59 $4,810.06 $20,971.65 New Contribution Interest Rates Contract number Contribution Period Interest Rate 894150+006 04/01/2002-06/30/2002 4.95% Notifications Please contact Lincoln Life within 30 days ofrecelpt of this statement if information or investments are not accurate. Lincoln Life r~serves tho right to lim/t its liability if inaccuracies are not reported promptly. Prospectuses and various financial reports are available upon request. Please keep in mind that the fimds 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. 998 Li.coln Financial Group is the marketing name for Linco}n National Coq~oration and its affiliates, Plan: 569 Employer ID: 560 page Exhibit 6 . ~terly Statement ^r~t ~l FY S[RVlCES ~ .n, )1 A Furjanic 9~, Deerfield Road ~ .~q) t Iii], PA 1701 I YmJr Servicjln~ A~enl CI11SIRI [ ! This Quarter H)I^I ASSII5 YOLJR OtJIfilANI)IN(; I ()AN St JMMARY LOAN 1 - elfin(lye I I/9/1993 Oul~tam:lin$ Loan Prindp~l $5,299.40 CLJRRI N I CON 1RIBt J I I()NS !oo% fixed F Ixe~l Fixed AdJ~lional A.nuify Features :]:)NEWS that you fii~l th~' #,fom~atkx~ holl)6~l and ~a~y to m..L W~, hat ~ ! ~ p;in ID: yc~tr.go~ tal Sec.rily Number (no Pa,:~word: For first lime u~e~ please epter your Date of BMh (AIMI)DYY) re~..m~l within go days ~f receipt. 17043 YOlSr flan-Tyl~e b: Tax Sheltered Annuily Your F~ct Type ~: l-Flex Acc~ Numar 8520262 Issue Oate 05/11/1989 Case Numar ~2267 Y( )1 Il( INVI ~ r ,X~I N1 SUMMARY This Quarter Year !o Date [le/l, lnni.g Ihlar~ce $212.8] $245.02 Tot,ti P;~ymenls $0.00 $0.00 ~el [nan Adivil~ $37.00- $71 Chaoge in Invesl..~nt Value $2.30 $4,98 YO(JR Oi J 5 lANDING LOAN SUMMARY LOAN I - effecrive 1 I/9/~r993 Outs/andin§ Loan Principal $5,708.95 VOl )l? INVI Sl,'ql),ll' S1RA[I-(;Y fi)iAI /\SS[IS Ct/RRI:N1- CONTRIBUTIONS Fixed ixed f ixed 100% LilexC'f 100% L-Flex(;[ i&§tion,71 Annui(r [~atures (~ NEWS tet~o~ted wlthiu 90 d~ys of receipt. Exhibit 7 Fideli~ ~ Investments ~ Holy Spirit Hospital #BWNFXQN CAROL A FURJANIC 96 DEERFIELD ROAD CAMP HILL, PA 17011-8469 ENV#40032332 40 58940 73t16 A Retirement Savings Statement Jaflua~y f, 200~ ~ Match 3t, 200t SeeialSeeurit¥ Number: 165-36-6096 ~' For information: Call 1 (800) 343-0860 Internal Address: http://www.fidelity.com For online account access: Fidelity NetBenefits: http://netbenefils.non-profits.com Your Account Summary Beginning Balance Employee Contributions Employer Contributions Change in Account Value Ending Balance Additional Information ~ Dh~le~t~l~ I Inlaraat $54,029.96 907.83 97~72 -9,359.68 $45,555.83 Your Personal Rale of Return This Period - 16.9% Year to Date -16.9% Your Personal Rate of Return ts fo~ula, e fm~ ~ely us~ by inveslmenl ear~ngs of a p~ffo~. It re~s ~e msulls al y~r Investmenl selects as well as ~y ac~l~ in ~e a~unt. ~ere am o~er Per,hal Rale o~ Ream f~dias us~ ~at may y~M different results. Reme~ ~at ~sl ~ Is no ~1~ Your Asset Allocation [] Stoc,ks 94% [] Bonds 6% Your investments are currently allocated among the displayed assel classes. Percentages and totals may not be exact due to rounding. The Add~lional Fund Information seclion lisls the allocation of your blended funds. Market Value of Your Account ~l~ts section displays the value of your account tot the period, In both shares and dollars. Shares on Investment Stock Inveatments Fidelity Grow & Inc 5~6.928 Fidelity GraPh Co 301.358 Blended Inveelmenle* F~ Free~m 2020 737.726 Shares on Price on Price on 03/31/2001 12/31/2000 03/31/2001 $43,288.67 537.001 $42.10 $37.41 21,762.67 314.005 $71.43 $52.38 21,526.00 St0,74t,29 764.229 $14.56 $13.11 10,741.29 Market Value on 03/31/200 ~ $36,536.79 20,08921 16,447.58 $10,019.04 10,019.04 Please read this statement carefully. Any e~ror must be reported Io Fldollly Investments within go days 32332 40032332 000! 20010407 403B Fidelity Investments, P.O. Box 770002, Cincinnati, OH 45277-0090 185386096 Page 1 of 4 I~toly Spirit Ho,,,pilal Statement Period: 01/01/200 f to 03/3 !/2001 Social Security Number: 185-38-6096 Market Value of Your Account (continued) do~s not necessarily reflect lower load performance. * Some of your inveslments are classlCied as · Blended Fund loveslrnent. Blended Investments may Include a mixture ot stocks, bonds, and/or short-term assets. Please rater to the 'Additional Fund thformallon" secllon to determine the allocation ~f y~ur blended Investments' und~rlvinq a~sets The asset breakdown ot your porttdlo is reflected in the pie chart in the "Asset Allocation" ,~ecflon. Your Contribution Elections as of 04/0612001 Thi~ section displays the funds in which your future contributions will be invested. Fidefily Grow & lac Fidelity Growlh Co Total Employee Employer Employer 40% 40% 40% 40% 40% 40% 40% 40% 1~% 1~% I~% 1~% Your Account Activity Ute thi~ section as a summary of Iransactions thai occurred in your account during Ihe statement period. · Employee Employer Employer Total For Ac~itv J)eferrel Match Rollover Discretionary Plan Beginning Balance $10,693.41 !~,358.88 $35,753.32 $2,224.35 $54,029.96 Employer Conlributions 0.00 453.91 0.00 523.81 977.72 Change in Account Value -f,890.32 -948.33 -6,087.19 -433.84 -g,359.68 Endi~g Balance $9,710.92 $4,864.46 $29,666.13 $2,314.32 $46,555.83 Vesting Percentage 100.00 % 40.00 % 100.00 % 40.00 % Vested Balance $9,710.92 $1,945.78 $29,666.13 $925.73 $42,248.56 Dividends 8, Interesl $20.44 $10,26 $66.17 $4.62 St0t.49 A Message From Fidelity Tired of paying so much to Uncle Sam? Pay yourself Instead and lower your 2001 income tax bill 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,l, axes. Better yet, your retirement plan money grows tax-deferred until you withdraw it. Visit Fidelity NetBenefitsSM or call your plan s toll free number to review your contribution amount today. Make sure you are getting lhe full benefit of your retirement savings plan. Pre-tax contributions are subject lo the annual IRS dollar limit. 129297 32332 40032332 0001 20010407 4038 Fidelity Investments, P.O. Box 770002, Cincinnati, OH 45277-0090 185386096 Page 2 ol 4 Fidelity InveS tment$ · Holy Spirit Hospital Retirement Savings Statement April 1, 2002 - June 30, 2002 #BWNFXQN CAROL A FURJANZC 414 4TH STREET LEMOYNE, PA 17045 E~V#400i4223 ~' For online access, log on at: http://www.fidelity.com/atwork For information, call: (800) 343-0860 Your Account Summary Employee Contributions Employer Contributions Change in Account Value Ending Balance Additional information · Dividends & interest 958.31 923.51 -6,900.80 S46,284.72 $75.36 Your Personal Rate of Returrl This Period ~13.2% Year to Date Your pm'sontu Rata of Return formula, widely used by flrtanc~aJ armiysts to seioulate IrNelt truant earnings, rt reflects the results of y0~Jr JnYesth'lent selections as well as any activity in the plan account(s] ehow~. Them are other PersonaJ Rate of Return forrrtules used that may yield different results. Remember that past psrfarmance Is no guarantee of future results Your Asset Allocation [] Stocks 94% · Bonds 6% Your investments are cUrrehtly allocated among the displayed asset classes. Per~entagea ~d totals may not be exact due to round,g. The Additional Fund Information section lists the allocation of your blended funds. Market Value of Your ACcount This secfio~ displays the value of yOur account lar the petted, in both shares amd de#ers. Shares on Shares on Price on Price on Market Value Market Value Investment 03/31/2002 06/30/20p2 03/31/2002 06/30~002 0n03/31/2002 on06/30/2002 Stock Investments $40,157.68 $35,731.42 Fidelity Grow & Inc 602.713 624.697 $37.60 $33.61 22,662.01 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 885.307 620.078 $12.59 $11.47 11,146.02 10,553.30 Remember that a dMdend payment to lund shareholders reduces U~e share prfce of the fund, so a decrease in He share price for the statement period does not necessarily reflect Jower fund performance. ' Some et your investments are classified as a Blended Fund Investment. Blended investments may iociude a mixture et stocks, bonds, and/or short-term assets. Please refer k~ the "Additional Fund Ir~formatJon" section to determine the atiocation of your blended investments' underlying assets. The asset breakdown of your portfolio Is reflected in the pis chart in the 'Asset AJlocatio~' Section. Please read this statement carefully. Any error must be reported to Fidelity fnvestments within 90 days. 14223 40014223 0001 20020709 403B Fidelity Investments, P.©. Box 770002, Cincinnati, OH 45277-0090 Page 1 of 5 Exhibit 8 Mellon Bank PERSONAL BANKING STATEMENT CEDARCLIFF 1510 CEDARCLIFF DR CAMP HILL PA 17011-7715 717-731-4858 I,,,111,,,111,,,,,,11,,,111,,I,,I,,I,I1,,I,1,,I,1,,,11,,I,,I,I JAMES A FURJANZC 96 DEERFIELD RD CAMP HILL PA 17011-&G69 00778 0126 88~-017-~117 PAGE I OF ~ STATEMENT FROM 01/10/01 THRU INTUIT INC. ZS OFFERING QUZCKEN(R) TURbOTAX(R) FOR THE HEB(SM) FOR FEDERAL AND STATE TAX RETURNS~ H~TH THE CONVENZENCE OF F~LING ONLINE HZTH THE APPROPRIATE ASENCY. VZSZT I'A~.MELLON.COM/TAXCENTER AND LET TURBOTAX ASK THE RUESTZONS AND DO THE MATH. RELATIONSHIP SUMMARY DEPOSTT ACCOUNI~ pERSONAL CHECK'rRG TOTAL BALANCE 4,31S.~S LOAN ACCOUNTS PERSONAL CHECKING ACCOUNT 884-017-4117 LACCOUN~ SUHMARY OPENTNG BALANCE AS OF 01/10/01 TOTAL DEP~Z~ ~ Oll~ER ADOZTZ~ ENCLU~IZKq~ INTEREST CREDITED THES PEREOD TOTAL cHECKS ~ (~rHER NZTNO~LS Z~LUOZNO FEES ~ CHARt, ES THIS PERZOO AVERAGE ACC~ BALANCE IACCOUNT ACTIVITY DATE pOSTED DESCRZPTZOfl 01/10/01 OPENENG BAL~qCE DEPOSZTS CHECKS AND OTHER AND OTHER ADDITIONS H~THDRAHALS 01/11/01 DEPOS/T REF O00000;800160sgo HZSC AUTOMATED CRED ST BARNABAS CORK CEDAR CLIFF CAMP HILL PA .............. ~00.00 01/16/01 01/18/01 01/1~ MELLON Al14 H~THDRAHAL SOOq693 CEDAR CLZFF CAMP HELL PA ....... 200.00 CHECK · 797 .................. ~68.00 CHECK · 7":)6 .................. 2S0.00 CHECK · 799 ................... 868.58 01/18 MELLON ATM MZTHDRANAL ~0051~S CEDAR CLZFF CAMP HELL PA .............. 2qO.O0 OUTSTANDING +7,810.87 J DALLY BALANCE Exhibit 9 P.O. Box 40 · Mechanicsburg, PA 17055~040 (717) 697-1161 TOLL FREE (800) 283-2328 www,mernbersl st.org HIST 36445-01L FURJANIC/CAROL R 10/11/02 10:15 AM BR:06 ID Post Elf Tran Date Date Code 46T 051601 051601PTTF 16T 041601 041601 PTTF Ty S/PR pe Amount Interest Fee Balance UR .00 1.00 .00 3693.03 TFR FROM SHARE~ 36445-11 YR 360.3~ P-,6.68 .00 3693.03 TFR FROM BHARE!B 36~45-11 Vouch Seq C Number Numb 0 · 1184 · 4542 47T 021601 021601 PTTF 16T 011601 811601 PTTF ~7T'1216~ 121600 PTTF *Moee In VR 3~5.60 31.40 .00 I'FR FROM SHARE8 36445-11 UR 353.~ 33.72 TFR FROM BHARE8 ~ ~6445-11 UR 35~,1~ 34.~B TFR FROM SHAEES ~6445-11 File - Continue?# ID:[ 4414.11 4769.71 ~R~ 1ST FEDERAL CREDIT UNION ] TRAN CODE: [ ] I~RRRIflETEI~B,~ ~: :~: ~ GENERAl_ INTERPT PRINT MAIL 1336 2~673 15297 DATE~[10/ll/02] ] ] HELP main 10/07/2002 0,1:26 FAX 2159222618 ROGER W ~iAIN Kelley Bluc Book Used Car Values Page Blue Book Trade.In Report Pennsylvania · October 7.2002 t995 Mitsubishi 3000GT Coupe 2D Engtne: V6 3.0 Liter Trane: 5 Speed Manual Drive: Front Wheel Drive Mileage: 124,500 Equipment Air Conditioning Power Steering Power Windows Power Door Locks Buy a New Buv a Used Ist Your Car Free Lemon Che.~ Financing o_uDte Insurance Warranty Ouot.~ Payment Calcul.ator 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 work to be performed by a professional In order to be hup://w,ww.kbb.com/kb/Ici.dll/lcw3cc.ur?kbb.PA;769096;PA041 & 17011 ;t&39;Mitsubishi; I ~,.. 10/7/2002 ~.0/07/2002 04:26 F,~X 2/.5922261~ ROCER Kelley Blue Book Used Car Values Page 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 title history is assumed. Even after significant reconditioning this vehicle may not qualify for the Blue Book Suggested Retail value. Trade-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 making the vehicle ready for sale, advertising, sales commissions, arranging financing and insurance and standing behind the vehicle for any mechanical or safety problems. Get a private Party Value Get Invoice & MS.RP on New Cars Copyright © 2002 by Kelley Blue Book Co., All Rights Reserved. Sep-Oct 2002 Edition. The Information In this report was prlntecl 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 or omlssions.(v.02091) httl~'ff/w,amv.kbb.com/kbaci.dllffkw.kc.ur?kbb.P A;769086;p A041 & 1 ?011 ;t&39;Miisubishl;1 !.,. 10/'//2002 Kelley Blue Book Used Car Yalue$ Page t of' 2 Blue Book Private Party Report Pennsylvania · October 7, 2002 1995 Mitsubishi 3000GT Coupe 2D Engine: V6 3.0 Liter Tren$: 5 Speed Manual Drive: Front Wheel DHve Mileage: 124,500 Equipment Air Conditioning Power Steering Power Windows Power Door Locks Buy a New Car Buy a_U..sed_C~ List Your CaE.For Sale Free Lemon Flnanclnq QqoJ~ Insurance _.Warranty Ouote Print "F_or Sale" Sign Payment 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 ht~p://www.kbb.com/kb/ki_dlt/kw.ke.urgkbb.PA; 139966;PA041 & ! 7011 ;p&722;MitsubishL;... 10/7/2002 Kelley Blue Boo~k Used Ca~ Values Page 2 o work to be performed by a professional In order to be repairable rust damage. The value of cars In this category may vary widely. A clean title history Is assumed. 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 I~ay for a used car when i~urchaslng from a private party, Tt may also represent the value you might expect to receive when selling your own used car to another private party. Car Trade-In Value Get Invoice 8t M_SIaP on New Car; Copyright © 2002 by Kelley Blue Book Co., All Rights Reserved. Sap-Oct 2002 Edition. The informaUon 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 transmlttsd to another party. We assume no resl~on$1billty for ef furs or omlsslons.(v.0209!) hu~:~vw~bb~m~kb~d~d~k~v~kc~kbb~PA;~9966~PA~4~1?~;~722;Mitsu~shi."~ 10/7/'2002 Exhibit 10 DUPLICATE COPY 365484547421913141202350053178 c ti' CITIBANK P.O. BOX ltl7 JAMES A FORJANIC S HACKENSACK, NJ 9~ DEERFIELD RD USA 07~O&-Bll7 CAHP HILL PA 17011 Citibank Platinum Select'" It/Z~/O0 $15500 $8350 11/17 62080q2qlPAYMEHT THANK YOU ]O/2GIlO/2619DKSKqwB~BURLINOTON COAOOOOO9Bq NORTH BRUNSHI NJ ]O/?B~IO/ZB]MTTY~$SSIYARDLEY INN YARDLEY PA II/22111/22187KTJB161UBERS TIRE SALES AND S CAMP HILL PA IPURCHASESwFINANCE CHARGENPERIODIC RATE 1-800-950-5118 SIOUX FALLS, SD $3985 Receive your bills online from anywhere. for Account Online et ~r~.uccountonline.com end experience Citibank(R) Bill Manager for yoursolf, N~wNew FINANCIAL SOLUTIONS pagewww#w Visit our now FINANCIAL SOLUTIONS page St ~,citibankcards.com ~o take advantage of exciting new products and services a11 ~n one convenient location on our wabsite. INTERESTED IN RECEIVING INFORMATION ABOUT YOUR ACCOUNT AND THE LATEST CITIBANK(R) ONLINE DEALS AND SERVICES? SIMPLY VISIT HHN.EMAIL.CITIBANKCARDS.CO~, GIVE US YOUR EMAIL ADDRESS AND HE'LL KEEP YOU UP TO DATE! $3985 -231.00 89.95 177.6S 7~.15 115.50 11514.12 11314.1~ w,,w,.~ am~, o~ 23S. O0 ?t FASE REFER TO TIlE REVERSE S/DE OF THE ORIGINAL STATEMENT FOR PAYMENT XNFORtlATX~. $81 Exhibit 11 Cardmember Statement h,,lll,l.,h.l,l,,I,,Ih,,hl,,,,il,hl.,ll,,h,II 41ifl[_=ONE. This Statement is a Facsimile - Not an Original Thank you for continuing to use your Bank One Credit~l I~le vl~1~lDela~e have built with you and your continued business is important to us. ?leas~ let us know if thoro is anything we can do to service your account. ~r~t USA B~mk, N.A. This Statement is a Facsimile - Not an Original Exhibit 12 023236,01.01 MEMBERS IST FEDERAL CU PO BOX 40 o VISA HECHANICSBURG PA 1765s-oo40 4287 5900 0O36 4451 CAROL A FURJANIC JAMES A FURJANIC 96 DEERFIELD ROAD CAMP HILL PA 17011-8469 VISA PO 10X 77044 MADISON W! 53707-1044 44 4287 59DO 0D36 4451 §DOD38D0 D0186452 ? P~r~"n,A:UdTH~ePC~**~:~~.~.~ ...... OONOT~APUSCHECK ~,, .... l l,~.:~ ,Il ~:.~,,J PO Box 3o~9s TA~A FL 12/1S/QO' ,. 4287 SSQQ 0036 4401 11000 913S (717) 796 6032 ~~n~ . ~ ~1~%,~ . ,, -. ~ ~LL PA 7299 11 il 11 lO'LA WX~ L~ ~ 33630 399.20 CARP gILL PA 12 Iq L2 $e NEgs CENTER t~$T IN 18.Sl LEHOYME PA ~M ~ERL~ PA 1~ 80 L2 O~ ~ FA~E ~PE 31.47 ~Ll~ PA 12 O& i~ 04 BATHI~Y OO000SO7 lt. OO C~ HZLL PA C~ HZLL PA C~ ~LL PA 74287ASJ333001HS243741~' OHO 1[ 28 lLX 28 PAYNENF RECEIVED - TM Y~ Y~ HA~ E~D 51.57 ZN ~A~ ~ FAR THIS YEAW! ?O iE~ A L~T ~ IT~EN ~RD ~ CALLt &OO-32So{&TB ~LBT ITLM - AFaR ~ ?A?-79S-6~32 ~ERS 1ST F.C.U, TO ~TAIN A~ ZW~TZ~ ~ ~S A ~Y CALLt PAYHENI*S~ ADJUSTHEgTS ~ OTH~RS ................................ CUR~ PUR~ ~716.3~ ~.20~3x ]4.&ok ~0.74" 14,~~ 1317;97 CURR CASH 0.OO 1,20{3X 14.J0X 0,00 ~4~T~+~:' 6{J.ll PREV PURCfl o.oo 1,2o83~ 14.sox o.oo 30.o0~ ,,~. o.oo PREV CASH O.O0 .57~0~ 6.90X O.OO .P~. - ~, 0.00 OLD PURCH 0.00 .O000~ .OOX 0.00 O;~0 PA~~ lO0*O0 ~~ ~,'~ ~' 0.00 D C ~0000~ ,00~ 0.00 o..o o.oo 0,00 ~~: 0,00 AYS~ZN CYCLE 28 ' TOTAL 20'74 FINANCE CHARGE CALCULATION NETHODN 'SEE REVERSE SIDE FOR EXPLANATION CREbX~ PURCHASES~ O CA-~H' ADVA4CE, A NOTE: IF YOU HAVE A VARIABLE RATE ACCOUNT THE PERIODIC RATE AND ANNUAL PERCENTAGE RATE (APR) MAY VARY. NOTICE: EEE REVERSE SIDE FOR IMPORTANT INFORMATION AND BILLING RIGHT9 SUMMARY MAY, Exhibit 13 1040 Label U.S. Individual Income Tax Return ~@01 [,~,, /~"~q~ · Important! · Election Campaign ~ Note. C~necking "Yes" will not'change your tax or reduce your refuPd. Filing Status Exemptions sen paqe 20, d 7 Income sa Attach b W-2G here. Al~o attach 10 Form(s) 1099-R 11 if tax was 12 withheld. 13 14 If you did not 15a 22 23 Adjusted 2a Gross ~s Income 26 33 ~]ur SSN(s) above. 1 Single 2 . Married filing joint rntum (even if only (>ne had income) 5 QualEyinq wMow(er) wffh dependent child (year s~u~ di~ W ). (See paqe 19.) : : ~ (~ p~e 20) Wages, sa~des, ~ps, etc. Attach Form(s} W-2 ........... 7 -~ ~ ? ~' ~ ] ' ~ Tax-~x~ i~terest. ~ n~ incl~e o. line 8a . I 8b I ~ ~ S~:ial s~ur~ ~s . I Z0a ~ I ~ b raxab~ amoum ~see pa~ 251 lob Add the a~u~s ~ the lor r~ht co,mn for fines 7 throuqh 21. This is your ~ I~ ~ 22 ~'~ *~ / ~ !~'~ Student loan interest deduction (~oe page 28}. 24 Archer MSA deductio~. Attach Form 8853 .... 25 Moving expenses. Attach Form 3903 ..... 26 One*half of ~elf-employment tax. Attach Schedule SE . 27 Self-employed health insurance deductlo~ (see. page 30) 28 S01f,employed 5EP, SIMPLE, on;] quafifled p~ns , , ~9 Penalty on early withdrawal of savings ..... 30 Add lines 23 through 31a .................. 32 Subtract line 32 from line 22. This is ycxJr adjusted gross income ..... ~ 33 form 1040 12cml Tax and 34 Credits 38a b 44 51 52 Other 53 Taxes s4 56 Payments ss qLlali~i~g [ b 66 Refund 67 Amount You Owe Third Party Designee Sign Here Keep a copy for y~ur Paid .,g..,u.~ ~ Preparer's Use Only .d,~-.~, ~.~ ZIP c~e ~' AmoJJnt from line 33 (adjimh!d gross income) ........... Ch(~k if: ~ You ~re 65 ~ dd(~r, ~ Bl~d; ~ S~e wa5 65 (~ (~d()r, · emized d~u~ions (from Schedule A) or ~ur s~n~rd ded~tion (see left margin). Taxable i~o~. Subtra~ line 38 from line 37 ff Ifne 38 is more than line 37, emer Tax(s~pa~33) C~ck if any tax is ~m a ~ Fo~(S)~814 b ~ Form 4972 . . Other credits from: a ~ Fo~m 38~ b ~ F~m 8396 c~ Form 8801 d ~ F~m (~ci~) ~her pa~s Ch~kifff~ a~F~m 243g b~ F~4136 85 Add lines 59, ~. 61a. and 62 ~rough 65. ~e~ are ~ur t~M ~s .... Amount of Erie 67 u wa~ ref~ to ~ou ............. ~at~e '' '-~ De, YO~ ~cy~t~n SCHEDULES A&B (Form 1040) Taxes You Paid (See p~ge A-2 ) Medical and 1 Dental 2 Expenses 3 4 5 6 7 8 9 11 You Paid (See page A-3.) Note. personal 12 inlerest is not deductible. 13 14 Gifts to 15 Cha~ty If you made a 16 gill and got a Casualty and Theft Losses 19 Job Expenses 20 and Mos~ ~her Miscallanegus Deductions 21 (See 22 23 24 25 26 Other 27 Miscellaneous Deductions Total 28 Itemized Deductions Medical and dental expenses (see page A-2) . . . Em~ amount from Form 1040, line 34. { 2 ] Multiply line 2 above by 7,5% (.075) ...... Subtract line 3 [rom line 1. If line 3 is more than line 1, enter Real estate taxes (see page A-2) ....... 6 Personal property taxes .......... 7 Other taxes. Li~ type and amount · .................... _8 Add lines 5 thmuqh 8 .................... Home mortgage i~emst r.X repated to )~u o~ Form 1098. If paid to the pers(x~ from whom you bou~h~ the h(~ne, see page A-3 and show that pe~cTn's name, ide~ffying no., and address · Points not reported to you on Form 1098. See page A-3 for special rules ............. 12 thvestment interest. Attach Form 4952 if required. (See page A-3.) .............. 13 Gifts by cash or check. If you made any gift of $250 or more, see page A*4 ........... 1 other than by cash or check. If any gift of $250 or more, see page A-4. You must anach Form 8283 if over $5(30 16 Carryover from prior year ......... 17 Add lines 15 throuqh 17 ................... Schedule A---itemized Deductions o~a no, ~s,~o~ ,s o. 2@01 i ~c.~ -~, Casualty or theft loss(es). Attach Form 4684. (See page A-5.) ...... 19 Uoreimbursed employee expenses--job travel, union dues, ~ob education, etc. You must attach Form 2106 or 2106-EZ if required. (See page A-5.) I,' ............... _./~.. ~.(.~. ~... :~ j~ ~/~_ ~ :~...~-~ ......... zo ~$'~ Tax- "- ~preparation fees '~..~..~,~.,~,~',¢-~, ! . . ' other exponses-qnvestment, safe deposit box, etc. List typ~: and amount ~ ......................................... - Add lines 20 through 22 .......... ~"'- ~" "'/- 23 enter ~mount ~rom eo~ m~0. ~e ~,. I z4 I ?? ~'/Z-I Multipiy line 24 above by 2% (.02) ...... 2~ / Subtract line 25 from line 23. If line 25 is more than line 23. enter -0- . . 28 other--from list c~ page A-6. List ~pe and amount · ............................. Is Form 1040, line 34, over $132.950 (over $66,475 if rnerded filing separately)'? [] No. Your deducfiee is not limited. AddtheamountsinthefarrightcoJumn for line~ 4 tl~ough 27, Also, enter this amount on Form 1040, line 36./ ' · [~Yes. Your deductioo may be limitea. See page A-8 for the amount to enter. 1040) 2001 2106-EZ Unreimbursed Employee Business Expenses Attach to Form 1040. OMB No. 1545-1441 Se~3uence NO. 54A Social securl~ number You May Use This Form Only if All of the Following Apply. · You do not get reimbursed by your employer for any expenses (amounts your employer included in bo~ I of your Form W-2 are not considered reimbureements). · 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: (al 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, Figure Your Expenses I Vehicle expense using the standard mileage rate. Complete Part II and multipy line 8a by 34V2¢ 2 Parking fees, toils, and transportation, including train, bus, etc., that did not involve overnight travel or commuting to and from work ................... 3 Travel expense while away from home overnight, including lodging, airplane, car rental, etc. Do not include meals and entertainment .................. 4 Business expenses not included on lines 1 through 3. Do not include meals and entertainment 5 Meals and entertainment expenses: $ /, q ~') x 50% (.50) (Employees subject to Department of Transportation (DOT) hours of service limits: Multiply meal expenses by 60% (.60) instead of 50%. For details, see instructions.) ............... 6 Total exlaeneaa, Add linee 1 thnaugh 5, Enter here end on line ag of aahedule A (Poi'~n 1040), (Fee-basis state or local government officials, qualified performing artists, and individuals with disabilities: See the instructions for special rules on where to enter this amount.) ..... 4 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~ .../-~3... / .... / ..... / .~ ~ .... 8 Of the total number of miles you drove your vehicle during 2001, enter the number of miles you used your vehicle for: a Business ...... .J.~t..~7..-~..~.~. ...... b Commuting ...... .~.,..~...~.~ ......... c Other ..... /~'~...~..~..~- ......... 9 Do you (or your spouse) have another vehicle available for personal use? ........... ~es [] No 10 Was your vehicle available for personal use during off-duty hours? .......... ~"'Yes [] No 11a Do you have evidence to support your deduction? ................ [~/Yes [] No b If "Yes,' is the evidence wriEen? ........................ L~.'~s [] No General Instructions Section references are to the Internal Revenue Code. A Change To Note The standard mileage rate has been increased to 34Y~ cents for each mile of business use in 2001. Purpose of Form You may use Form 2106-EZ instead of Form 2106 to claim your unreirnbursed employee business expenses if you meet all the requirements listed above Part I. Recordkeeping You cannot deduct expanses 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 pu~poee, business relationship (for entertainment and gifts), and amounts of these expenses. Generally, you must also have receipts for all lodging expenses (regardless of the amount) and any other expense of $75 or more~ Additional Information For more details about employee bumness For Paperwork Reduction Act Notice, see back of fo~Tn. Pub. 463, Travel, Entertainment. Gift, and Car Expenses Pub. 529, Miscellaneous Deductions Pub. 587, Business Use of Your Home (including Use by Day-Cam Providers) Pub. 94~, How To Depreciate Property Cat. No. 20604Q Form 2106-EZ ......... 77~-5~8] . 15 13960.76 77383.15 4797.76 Am. rica Service Group Prison Health Services, Inc. 105 ~estpark Orive, Suite 200 JAMES ALAN FURJARIC 96 DEERFIELD RD 2001 Satary 748z~.92 Retroactive Pay 287.20 Hotiday Pay #e~-~orked 1634.60 Paid Leave 1107,69 Group Term Ltfe· SSOOO0 8~.60 .ProBusiness Year To Date Deductions Pretax fleBtth Pta~ Pretax Oenta[ Ptan Pretax EE Life 2X 286.71 58.33 432.82 980~&0 86.60 005-001&76-17011 JAMES ALAN FURJANIC 96 DEERFIELD RD CAMP HILL, PA 17011 ASGPHS-104 20;'-36- 7201 #arried JAMES FURJANIC A~_GPHS PHS1 0102 01108101 EarninRs Paid Leave G~ro~up Term Life Tatnl Gros~ Units ~ Current 3230.40 38253.96 Texes Federal Interne T~x Soa~ S~-un~ (RC~) F~ M~ P~y~ I~e T~ ~il~l~ ~ N-~ (Phil) To~l 872.21 5475.90 L:~O.~ 233~.35 4~.84 546.17 g0.45 105~.88 126.40 1507.39 1336.18 10918,69 Pretax EE Life 2X 327.0~ Long Term Disability 50% 637.13 Group Term I. Jfe>$50000 Offaat L~7,56 F. xem ptions/Allowa nc~ NtJml~,r 06116102 , 07t 12/p2~ Memo Entries Std Houm Accumulator - Salmy W2 Q~ W~ 3230.40 37667.01 America ,':,crvice Group - 105 Westpark Drive, Suile 200 Brenlwoc)d, 'IN 37027 .ProBuslness _ ~ CHECK NUMBER i 01437229 i~A_M_ES A FURJANIC INSTRUCTIONS This is your unemployment compensation check for the benefit week(s) [ndlcated on the check and above, If you are entitled to this check es defined by the PA Unempioymsnt Compensation Law, carefully detach it at the perforations and cash promptly, If you feel you are not entitled to Job Center or UC Service Center, do not cash it, SEQNUMEER BENEFIT CHECK oo1 o 202-36-7201 09-14-02i442.00 09-21-02!4~2.00 0996 UC Fedsral~thhoidlngT~ I CumulativeTax~thheld OFFICEADDRESS LANCASTER UC SERVICE CENTER 60 W. WALNUT STREET LANCASTER PA 17603-3015 TIPS FOR USING PENNSYLVANIA TELECLAIMS--PAT * Know your social security number and 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. * 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 filed 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 benefits,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. 01437229 CHECK NO. PAY E~q/t~ Hu_ndrcd E~.gk~g Fou-...'~ TO THE ORD~ OF ,, ~.= 09/24/02 DATE VOID AFTER 30 DAYS JAMES A FURJANIC '' 96 DEERFIELD RD CAMP HILL PA 17011-8469 ~ TREASURER O ""0 i,[,:[ ? ;~ ~q,' ':0~, ~:.0 &O ~1.~: 00000 ~O.l' 08.°,1. Exhibit 14 1040 Label on page t g} e Use the IRS L L~beL H or type. E Presidential k~ Election Campaign ~ {See page 191 1 U,S. Individual Income Tax Return irs Use Only-OD not write c¢ staple in this s ase .20 OMB Ne. 1545 0074 Your social securit~ number ~ Impo~ant~ ~ Apt, no. Note. CheCking 'Yes' will not change your tax or reduce your refund, Do you. or your spouse it filing a joint return, want $3 to go to this fund? __ Single your SSN(s) ~beve. · · []Yes ~ ~]Yes []"o Filing Status Check only Exemptions see page 20. 2 3 4 5 6a b c .~/~ Married filing joint return (even if only one had income) Married filing separate return. Er,ter spouse's soctal security no. above and full name here· .'~_~_~ S Head of household (with qualifying person). (See page 19) If the qualifying person is a child but not your d~pendent, enter this child's name here. ~ youQUa!if¥ing widow(er) with dependent child (year spouse died · ). (See page 19.) rself. If your parent (or someone else) can claim you as a dependent on his or her tax'1~ Nh. al boxes return, do not check box 6a / checked on / ............... 6a and 6b E~ Spouse ................ 1~) Debe,dent's (d)~l ,ua,lying Ho. o! your Dependents: 12) Dependent's children ~n 6c you credit (see pade 2Q, L · lived with you __ [] (~ee page 20) Wages, salaries, tips, otc. Attach Form(s) W-2 ............ 7 Taxable interest, Attach Schedule B if required ............ 8a Tax-exempt interest. Do not include on line 8a . . . J ab I I Ordinary dividends. Attach Schedule B if required ........... 9 Taxable refunds, credits, or offsets of state and local income taxes (see page 22) . 10 Alimony received ..................... 11 Business income or (loss). Attach Schedule C or C-EZ ........... 12 Capital gain or (toss). Attach Schedule O if required. If not required, check here · [] _ 13 Other gains or (losses). Attach Form 4797 .............. 14 Total pensions and annuitie~ 16a b Taxable amount (see page 23) 16b Farm income or (loss). Attach Schedule F ............... 18 Unemp&oyment compensation ................. 19 Social security benefits . I 20a I I I b Taxable amount (see page 25) 20b Other income. List type and amount (see page 27) .................................... 21 Add the amounts in the far right column for tines 7 through 21. This is your total iocome · ~.~/~/22 IRA deduction (see page 27) ......... 23 Student loan interest deduction (see page 28). 24 ~ Archer MSA deduction. Attach Form 8853 ..... 25 Moving expenses. Attach Form 3903 ...... 26 One-half of self-employment tax. Attach Schedule SE 27 Self-employed health insurance deduction {see page 30) ~28 Self-employed SEP, SIMPLE. and qualified plans Penalty on early withdrawal of savings ...... 30 Alimony paid b Recipient'$ SSN · : : 31a Add lines 23 through 31a ................... 32 Subtract Iine 32 from line 22. This is your adjusted gross income ..... · 33 ~ ~'~ ,.~ Cat. No. 12600W Form 1040 (2001) For Disclosure, Privacy Act, and Paper*work Reduction Act Notice, see page 72. d 7 Income sa Attach b Forms W-2 and 9 W-2G here. tO Also attach Form(s) 1099-R 11 if tax was 12 withheld· 13 If you did not 15a get a W-2, 16a see page 21. 17 Enclose, but do 18 not attach, any 19 payment. Also. please use 20a Form 1040-V. 21 22 23 Adjusted 94 Gross 25 Income 26 27 28 29 30 3ta 32 33 SCHEDULES A&B (Form 1040) ~.l,,r. al Revenue S~'~ice (L) Medical and Dental Expenses Taxes You Paid (See page A-2.) Interest You Paid (See page A*3,) Note. 14 Gifts to 15 Charit~ If you made a 16 gift and got a benefit for it, 17 see page A-4. 18 Casualty and Theft Losses t9 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 Caution. Do not include expenses reimbursed or paid by others. -"~/~ :: I Medical and dental expenses (see page A-2) .... 2 Enter amount from Form 1040, line 34, I 2 I [ ~/~/, 3 Multiply line :Z above by 7.5% (.075) ....... 3 4 Subtract line 3 from line 1, If line 3 is more than line !, enter -0- . ..... 4 5 State and local income taxes ......... 5 6 Real estate taxes (see page A-2) ........ 6 "7~/~ ._~.~- 7 Personal property taxes ........... 7 -- 8 Other taxes. List type and amount I1~ .................... ~/,,~/, -- 9 Add lines 5 through 8 .................. ..,...,.,.-... , ~-~ 10 Home mortgage interest and points rel3orted to you on Form 1098 10 'c~' ~¢~._~ ' 11 Home mortgage interest not reported to you on Form 1098. If paid to the person from whom you bought the home, see page and show that person's name, identifying no.. and address I~ Points not reported to you on Form 1098, See page A-3 for special rules .............. 12 Investment interest. Attach Form 4952 if ~equtred. (See page A-3.) ............... 13 Add lines 10 thraugh 13 .................... 14 Gifts by cash or check, If you made any gift of $250 or ~c~/'~ more, see page A-4 ............ ~,-'l ~' ~d'........7/////.4. Other than by cash or check, if any gift of $250 or more, ~/x see page A-4, You must attach Form 8283 if over $500 J--I Carryover from prior year .......... ] 17 Add lines 15 through 17 .................... 18 Schedule A ltemized Deductions No. oo7, (Schedule B is on back) ~®01 Anachment A~ach to Form 1040. I~ See Inst~ctions for Schedules A and 8 (Form 1040). Seque,ce NO. 07 Casualty or theft loss(es). Attach Form 4684. (See page A-5.) ....... 19 Unreimbureed employee expenses-job travel, union/~/~/......~/x...///~//~ dues, job education, etc. You must affach Form 2106 or ~106-EZ if required. (See page A-5.) ~ ............... T~ preparation fees ............ Other expenses--investment, safe depcsit box, etc. List type and amount ~ ....... Add lines 20 through 22 ........... 2[.23 Enter amount from Form 1040, line 34. I ~4 I Multiply line 24 above by 2% (.02) ....... r26 Subtract line 25 from line 23. If line 25 is more than line 23, enter -0- . . Other--from list on page A-6. List ~pe and amount ~ .............................. ~7 For Paperwork Reduction Act Notice, see Form 1040 instructions. I~.~¢m 1040, line 34, over $132,950 (over $66,475 if married filing separately)? I~1 No. Your deduction is not limited, Add the amounts in the far right column1 b.//~2,8 . ~ ,.,~../,~x~. ~ for lines 4 through 27. Also, enter this amount on Form 1040, line 36. } . [-I Yes' Y°urdeducti°nmaybolimited'SeepageA-6f°rtheam°untt°enten ) ~~ Cat. No. 12614K Schedule A (Form 10~) ~01 F~rm 1040 (2001) Tax and 34 Credits 35a ~3eduction b [°~°P'e 36 checked any who can be 38 see page 31. 39 · All others: 40 SinQfe. 41 S4.550 Head of 42 $6650 44 MRrried filing jointly or 45 Qualiyng 46 51 52 Other s3 Taxes s4 55 58 58 Payments s9 i % 60 If you have a 61a child, attach } Schedule EIC. 62 63 64 65 66 Refund 87 Direct 68a deposit? See I~ b page 51 and 68n, and 68d. 69 Amount 7o YOU Owe 71 Third Parrot Designee Sign Here Joint return? See page 19. ~(eep a copy for your records. Paid Preparer's Use Only Page Amount from line 33 (adjusted gross income) ............ Check if: [] You were 65 or older, [] Blind; [] Spouse was 65 or older, [] Slind, Add the number of boxes checked above and enter the total here .... ~ 35a L 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 Itemized deductions (from Schedule A) or your standard deduction {see left margin). Subtract line 36 from line 34 ................... 37 ~'~ Ifline34is$99,725orless, multiply,2,9~bythetotalnumberofexemptienaelelmee.~ ~ line 6d. If line 34 is over $99,725, see the worksheet on page 32 ........ 38 Taxable income. Subtract line 38 from line 37. If line 38 is more than line 37, enter -0- Tax (see page 33). Ch~k if any tax is from a ~ Form(s) 8814 b ~ Form 4972 40 Alternative minimum ~x {see page 34). A~ach Form 6251 .......... 41 Add lines 40 and 41 .................... Foreign tax credit. Affach Form 1116 if required .... Credit for child and dependent care expenses. A~ach Form 2441 44 Credit for the elderly or the disable. A~ach Schedule R. 45 Education credits. A~ach Form 8863 ........ 46 Child t~ credit {see page 37) .......... 48 Adoption cr¢it. A~ach Form 8839 ......... 49 Other credits from', a ~ Form 3800 b ~ ¢o~ 8396 c ~ Form 8801 d ~ Form (specie) Subtract tine 51 from line 42. If line 51 I~ more than line 42, enter -0~. ..... ~ 52 Self-employment t~. Attach Sch~ule SE ............... 53 Social s~ufi~ and M~icare tax on tip inco~ not repod~ to employer. A~ach Form 4137 54 T~ on qualifi¢ plans, including IR~, and other t~-favored accounts, AEach Fo~ 5329 if required . 55 Advance eam~ income cr~lt payments from Fo~(s) W-2 .......... 56 Add lines 52 through 57. ~is is your to~l tax ............ Federal income tax withhe[d ,rom Forms W-2 and 1099.. 59 ~ ~/~ Earned income credit EIC) 61a Nont~abl~ eam~ income . . ~ 6lb ~ ~ ~ ~ Exces~ social secufi~ ahd RRTA tax withheld (see page 51) 62 Additional child tax credit. Attach Form 8812 ..... 63 Amount paid with request for e~ensio~ to file (see page 51) " Othor oagmo~. Ghoek i~ from a ~ ~o~ 2430 b ~ Fo~ 413~ Add lino~ 50, ~0~ Ola, and ~2 lhrou~h ~5. ~o*~ aro your total ~a~m~nt~ .... If line 66 is more than lina 58, subtract line 58 from line 66. This is the amount you ore.aid 67 Amount of line 67 you want refunded to you ............. Amountofline67youwantappliedtoyour2002estimatedtax ~ ~ 69 ~ Amount you owe. Subtract line 66 from line 58, For details en how to pay, see page Estimated t~ penalty, Also include on line 70 ..... ~ 71 ~ 68a Do you want to allow another person to discuss this return with the IRS (see page 53)? [] Yes. Complete the following. ~ Designee's Phone Persona~ identification name ~. no. I~-( ) ri.tuber(PiN) ~. I I t t I ] Under penaRies of Perlury, I declare that I have examined this return and accompanying schedu es and statement~, and to the best of my knowledge ar~ belief, they are a,ue, correct, and complete. Declaration o! precarer (other than ~4~xpayer) is based on all information of which preparer has any knowledge. Firm's name (or · · address, and ZIP code r DGte ! . , , , ; :....~ Phone no. ( } Form 1040 (200t) F~mW'2 Wage and Tax Statement P001. , w~. ~, ~.r,~,~'~'"~" 2 6918 27 ' 53443 .59 ' ~ ~"'""~71.2~ 3526 - 0~ .~.r.~ ,'~"' ~ 824 - 63 HOLY SPIRIT HOSPITAL 503 NORTH 21ST STREET CAMP HILL PA 17011 ~3-1512747 ~85-38-6096 '"[~NTE 149 . 19 MED 589 . 34 vISE 19.00 MOYNE PA 17043 -- ~'~'"'~ "' ' 7 27 Cu~er ' ' 8 5 6 Fo,,, W-2 Wage and Tax Statement ~ ~1 [] 53443 . 59 69 I ~ . 27 ' '~"~'"'~ '~' ~ 56 ~ 71 . 25 352 <, - 2 824 HOLY sPIRIT HOSPITAL 503 NORTH 21ST STREET CAMP HILL PA 17011 1 . 10 .... ~,,~..,~i~- .~.~, ~ D..L_ 3427 66 3427.66 23-1512747 -------~ ' ~5- 38-~096 ~ DNTE 149 · 19 i I '~ MED 589 · 34 ,3 ~ [ [ %U vise oo CAROL A. FURJANIC MoYNE PA 17043 9~-~,. ~.~o~.~.,,~.,o..,~- P"s'"~'~;'~%0 151 1592.40 PA 23'1512747 /~° ' ~ 5762/ ~ COPY B To Be Filed With Employee's FEDERAL Tax Return ~..W-2 Wage and Tax Statement 2001 53443 .b~ ' ~ ~,,, .,~,.~ ~. ~"'~ '~ ~6~71 . 25 3526.02 3526 . 02 , ~,~.,. ,~. w~,~.~ 4 . 63 '~'~'" '~'"~ "~'71 . 2 E ~ --a~paymen' S 568~1 · 25 824 . 63 HOLY SPIRIT HOSPITAL 503 NORTH 21ST STREET CAMP HILL PA 17011 '2 ~-1512747 -- L85-38-6096 __ DNTE 149.19 NED 589 . 34 c, 19.00 V~E CAROL A- FURJANIC s ~871.25 1 . 10 3427.66" 5~- 1512747 1~5-38-~096 DNTE 149 . 19 MED 589.34 VISE 19 . 00 CAROL A. FURJANIC 414 4TH STREET HOLY sPIRIT HOSPITAL 503 NORTH 21ST STREET CAMP HILL PA i79~1 Holy Spirit Hospital EMPLOYEE NAME SSN FURJANIC, CAROL A 185-38-6096 FOR PERIOD ENDING RATE DEPT 06129/02 24.28 6510 P?O (VAC~ STo (SIC) 144.44 269.30 EARNINGS HOURS RATE CURRENT YTD IF~E¢~ 44,25 24.2~ 1,086.64 24,142.04 2PTO SC 28,00 24.28 679,84 2,~36.64 3HOLIDA 8.00 24.28 194,24 776.96 PREM 425 12.84 54.57 520.58 W F, f',t D RN 12.C0 4.14 49,68 750,38 [_IF 0.11 1.55 Er~UC 1,007.62 CALL 72,00 !~HA~GE 4.00 EMPLOYEE NUMBER 185386096 NET PAY CURRENT 1,263.20 GROSS CURRENT 2,065,08 ADVICE NO. 124182 NET PAY YTD 19,497.61 GROSS YTD 29,411.77 DEDUCTIONS CURRENT YTD 401 (k) 165.20 2,056.49 DENTAL 4.00 49.00 F/T 362.43 4.098.6T HSMP 21.14 272.65 MED WI L~J.56 421.60 PA W~H 57.09 814.08 WSHORE 29.94 29.94 OASDI 126.41 1,802.72 UWAY 0 5,00 70,00 VISION 1.00 14.00 OPT-H~ 10 0(~ LO-CUM 273.46 ~ OTAL EARNINGS 92.25 $2.065.08 ~,411.77 ACH BANK ACCOUNT AMOUNT ,~ CH COMCHE Acct 513244707 1,263,20 TOTAL DEDUCTIONS $9,9~2.5~ Exhibit 15 Your Social Security Statement rr~par~d eep~elnl~ fo~ ~arol A. Furjanle June 13, 2000 50539 96 DEERFIELD RD CAMP IllLL PA 17011-8469 I,,.111,,.111,,,,,11,,111..I.,I,.I.I1.,I,1,.I.1,,,11,1,,I,I See Inside for your persons1 Informnflon y What'Social Securit Means to You We are plezsed Io send YOu this Social St.~rlfp State,~.,t to help you understand what Secufl~ means lo you and ~ur family. We en~u~e you to use it In planning ~ur financiM future. As the I~ re~lres, we will send ~u a n~ Sta~d shying ~ur npdMed earnings rm~d md your potential benefl~ ~ch year. You ~hoUld t~l~ it Be sure lo read Ihl~ $l~ll ~refully. H you think there mlRht be · mi~ke, pleMe let u~ kn~. Thars impo~t ~use your beneffi~ will be b~ed on our record of ~ur lifellme e~rnln~. Remember, the future's in ~ur hands when ~u r~d ~ur S~al ~td~ S~ S~ufl~ is f~ ~b of dl,,... Sodal Se~u~ty is more ih~ a retirement program. It can help you whelher you're yonng ot old, rage or female~ single or wllh a hmfly. ~11 pro, de benefits if ~u become s~rely dl~bl~ m~d heJp su~o~ your hmily when ~u die. And irs U]ere ~or ~u when ~u reUre. Wo~ to bund a sm Social Se~,rily is file larger sonrce of Income for most elderly A~rl~s ~d pla~ a ~or r~le in ke~l.~ tllem out of ~. But Soci~ S~rity ~n't do it all. S~ ~u~ beneflb. were not intended to ~ the only sour~ of inco~ foe you ~d ~ur hmily wh~ ~u retire. You'll need to su le t ~ur ~nefl~ from a pension, ; lflg or I ffimenls. Think 0fS0d ~ecuriiy M a foundation off which to build your financial fuh, re. About ~-Ial S.~udty'. farm... Will $odal Securtly be there when yoo Of co.~ It ~11. Bat chanK~ will be needed m~t the ~mds of the tim~. We're IonKer, he,thief Ii~; 76 million "baby boome~' will sb~ retiring In ~ut 2~10: and, in ~out 30 yea~, there will ~ nearly ~ice many older Americas ~ the~ are Iod~y. limn it pn~ o.[ iff benefits. ~le ~eM fi,rids nre ~lted Io S~nl 5ecufl~'s t~s~ funds, whkh are ~ to Krow lo over $4 trillion I:efnre we n~d to u~ them to pay ~neflts. In 2015, we will b~in to pay out more in ~nefits tha. we collect in i~. By 2031, lhe trust fimds wilt be exhaust~ and lhe payroll ~ collected will be enoogh to pay only aleut 72 ~r~nt of be. egis ow~. We're working to r~ol~ these Isa.es. For more InformaUon abont the present and what may lie abed, ~ll us to Mk for a copy of the ~oklet, ~e ~ht~ of S~al · Ke,neU, $. Al,fei CommiMi(mer What's Imide... Your EsUmaled Benefi~ .................. Your Earnings Record ................... ~me Farts n~.l ~.~i~l If You riced Flme hdunu,~tim~ .............. To Request ~ls gblement In ~o,ld~ ....... (Para Solicil~ Ibm I)eclor~idn Ill] IIIllill Iii llelp Us Keep Your Earnings Record Accurate You, your employer and Social Security share responsiblllly for the accuracy of your earnings record. From Ihe first year you L, eg~m working, we recorded your reported earnings ~nder your name and Social ~ecurity number. Since Ihen, we have updated your record each time your employer (or you, I1' you're self~employed) reported your earnings. Remember, It's your e~rnlnlls -- nnt the amount of luxes you paid or the number of credits you have -- that determine your benefit amount. When we figure that ~ ammmt, we base it on your averaSe earnings over your lifetime. If our records are wrong, you may not receive all the benefi~ to which you are entitled, Check the earnings lo see I1' they are correct. You are the only person who can look at the earnlo~ chart and know whether It IR complete. I1' you ,~,ork.d for more than one employer durtnfl the year, or il' w.. had both earnings and sell-employment tacoma, we combined your earnings for that year. · Remember, there la a limit on the amount of earnings on which you pay gKlal ~eeurRy taxes each year. This fimlt usually Increases yearly. Only Ihs maximum amount that was taxable will appear on the chart. (For Medicare taxes, the maximum earnings amount began rlslnl~ in 1991. ,qince 1994, oil of your earnings are taxed for Medicare.) Review thli chart carefully using your own d~cuments (pay stubs, W-2 torres and tax returns) to make sure our informalion is correct. · Make sure We have recorded every year you worked. Act rt~hl away II any o1' your earnings are shown incorrectly. Call us al 1-800-772-121N. If pnsslble, have your W-2 or tax return I'nr tho~e year~ avnilahle. (If you live oulside the tLS., follow the direHinns at the bottom ol pare 4.) Your Earnings Record at a (~fance Worked tarrd,,Js F. ar,d.fs Worked 1966 $ 116 $ 116 1967 315 315 1968 669 GGg lOGO 69~ 695 1970 2.920 2.920 IgTl 7,800 7.800 1972 7,688 7,688 1073 8,046 8,046 1974 !,853 1,853 1975 0 0 1976 993 ~93 1977 2,344 2,344 1978 9,963 9.963 1970 12,359 12,359 1990 $ 32.946 S 32.946 1991 34,159 34.169 1992 36.799 36.799 1993 37,167 37,167 1994 37,740 37.740 1995 39,912 39.912 1996 36,427 36,42~ 1997 47,670 47,670 1998 50,327 50,327 1999 53,510 53,510 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 Torah rfer your workl,q[ ea~ert Estimated taxes i'ur Social S~urlty: Estimated tMes paid ~or Medicare: You paid: $4 I.OfiO Yin! paid: $9,5,17 YmJr employers paid: $41,061 Your employers paid: $9,537 Iqotet If yoo Irn self-employed, yolt pay the total ta~ on jmur net emrnlnfj. ' Ilfllillligflflill]lfllllll Exhibit 16 Prevent identtt~ the~pr~tect your ~cia]l Securily number Your Social Security Statement Prepared especially for James A. Furjante bfarch 19 2002 96 DEERFIELD RD CAMP HiLL PA ]7011-8469 I,,,III,,,III,,,.,II,.IIL,L,I,,gL,I,I,,I,I,,,IL,I,,I,I Se~ inside for your personal information What Social Security Means to You - We're sending you this Socdal S~c~rity Statemen! to help you underst~d what Sodat S~ud~ me~ to you and your t~mily. We hope you'll use'it in planni~ your fi~andal future. ~ch ye~, a~ut ~ree months before your blr~y, ~'11 send you a ~ Xt~t~t shrug ~ur u0~ted ~rn~ reco~ and your potenti~ benefits. Be sure ~ read this Sta[~t ~re~. If~u Hfink there m~ be a miser, pl~e let us know, ThaVs important ~use ~ur ~nefits will be ~sed on our record of your lffeUme carnies. Remember, the future's in ~ur hands when you read ~ur SociM ,yeet~/t~ Statement. It can help you whe~er you're ~ or old, ~le or female, si~gl~ or wlth a fam~y. ~'s there for you when you re~re, but ifs more ~an a re~rement prog~ Social Securi~ can p~vide ~efi~iI~O ~e~me disabled and help sup~ y~r family when ~u die. Social Security now takes in more in taxes than it payS out it~ benefits. The excess funds are credited to Social Security's trust 5un&, which are expected to grow to over $4 trillion before we need to use them to pay benefit& In 2016, we'll begin paying more in benefits than we collect in taxes. 13), 2038, the trust fimds viii be exhausted and the payroll taxes co~lected will be enoufah to pay only about 73 percent of benefits owed. We'll need to resolve long-range financial issues to make sure Social Security will provide a foundaUon of protection for future generations as it has done in the past. Be sure to visit w~.ssa.~ou on the Ioternet to use the Benm~t P/armem to help you plan your financial future; calculate ct~tomized estimates of your filture benefits; apply for retirement benefits; subscribe to enow3 for up-to, ate news ~bout Social Secnrib; programs and benefits; and correct or change your Social Security is the largest source of income for most elderly Americans and plays a major role in keeping them cut of povet~. But Social Security can't do it all. Social Security was not Intended to be lt~e sole source of income when you retire. You'll ~lso need a pension, savings or investments. Think of Social SecurSty as a Foundation on which to bu~Id your financial/utnre. Changes will be needed to meet the demands of ~he tirn~s. We're living longer and healthier lives, 79 million "baby boc~ners~ are approaching retirement, and in about 30 years, there wfl! be nearly twice as many older Americans as tho~ are today. ~'eplacement ~ar'd by re¢luesti~ a form SS-5. We will cent;hue to add ooJJn~ servJce~ to ~ake it as easy and convenient as l~ssibte for you to do business with 30 Anne B, Barnhar t What's Inside ... T Your Estimated Benefits ................. · Your Earnings Record ................... · Some Facts About Social Security ........ ~ If You Aired Mole Information ............. · To Request This Statement In Spanish {Para $offcitar brna DeclaracMn en Esl~rIoD I Ililll ji I1 1 i1111 i!111 Ill IIII R[,]GEIVED FROM:71? 787 9199 P.OI lO'c/ 6616 Help Us Your You, yot~r employer and Social Security 8h~re responsibility for the accuracy of your earnings record. Since you began working, we recorded ~our reported earnings under your name and Social Securib/number. We have u~ated your record each time your employer (or you, i1 y~l're self-employed) reported your earnings. Remember. it's your earnings, not the amount of Oxes you paid or the number of credits you've earned, that determine your benefit amounL g~en we figure that mnount, we base it on your average earnings over your lifetime. If our records are wrong, you may not receive al/the benefits to which you are entitle& ,~ ~ ~ ~ ~ using your own records to make sure our information is correct end that we've recorded each year you worked. You're the only per, on who can look at the eamin~ chart and know whether it is complete. Some or all of yollr earnings from ~ ~ n~)~ not when your $talarnan! w~ prepared, Your complete earnings for last year will be shown on ne~t year's ,~taternent_ Ig~ ~ you ~rked for more one emplo~ dug~ ~ year, or if you had both e~ and self-emp[~ment in,me, we combi~ your ~min~ for t~ ~v~ ~ ~ ~ ~ ~. ~e limit incr~ ~1~. Only the m~mum t~[e amount ~1} app~ on ~ur eamin~ c~ (~or Medicar~ ~es, ~e ~mum earnings amount ~gan rising In 199L Stn~ 1~4, ~1 of your earnln~ are taxed for · ~ ~ 141~ a*a~, at 1-800-772-1213 (7 a.m.-7 //any earnings for years I~fm,~ l~t yel~r are showu incorrectly, If possible, have your W-2 or tax rettm~ be ~ on yotrr~dta~e,~,.~'vR ¢ou~ be that we ............ ~or those years handy. ~(If.you live outside the U.S, were s/i~l processing I~t year's earnings reports follow the directions at the bottom of Pase Your T~ed You~ Taxe,t Your Taxed Your T~xed Ye~s Yo. ~d~ ~ ~care Y~ You ~ ~ly ~i~ic~e Worked ~gs ~s Work~ ~n~ ~m 1963 1964 1965 1966 1967 1968 1969 ]970 1971 1972 1973 1974 1975 1976 lgTT 1978 1979 517 1980 $ 14,528 $ 14,528 24 Medicare began 1981 7.432 7.432 61I in 1966 1982 32,400 32.400 1,650 $ 1,650 1983 35.700 35,700 2.354 2,354 1984 37.800 37.800 1.560 1,560 1985 39,349 39,349 4,901 4 901 1986 42,000 42.000 1987 43.B00 43.800 7',153 7,153 1988 45,000 45,000 7.435 7,435 1989 48,000 48.000 8.783 8,783 10,093 10,093 12,573 12,573 13,896 13.896 15,300 15.300 16,500 16,500 11,766 11.766 1990 51.300 51,300 1991 53,400 71.260 1992 55,500 96.62a 1993 8,065 8,065 1994 49.807 49.807 1995 61,20<) 64,849 9,212 9,212 1996 62,700 67,212 ..... ' ...................... 199-Z ............ 54.600 ..... 64,600 1998 34,278 34,278 1999 72.600 77.876 2000 75,000 75.000 2001Notyetrecorded- Totnls owr yowr workio-~ career:. Estimated taxes [or Social Security: Estimated taxes paid for Medicare: Yo~ paid: $61,702 You [',aid; $15,20,5 Your employers paid: $61,644 Your emplo~rs paid: $15.083 CERTIFICATE OF SERVICE A tree 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 200 N. Third Street, Suite 800 Harrisburg, PA 17101 (717) 232-7722 CAROL A. FURJANIC, Plaintiff JAMES A. FURJANIC, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CWIL ACTION - LAW NO. 01-1144 IN DIVORCE 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 tree 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 unswom falsification to authorities. Date: By: Carol A. FurjanigAglain~f Case Name: Furjania v Furjania Date of Marriage: Date of Separation: ~'al~r:mry I ~, 19R2 INCOME AND EXPENSE ST,4TEMENT of CAROL .4. FURJANIC Husband's Income Wife's Income Monthly Expenses: Mortgage Home Equity Utilities UpkeepfMaintenance Household Help Car Loans Insurance: Car Homeowners Health Tuitinn/l)aycare Credit cards: Master Card VISA Moving Expanses X2 Cell Phone Medical Expenses Clothing Food/Supplies Entertaiment Vacations Memberships Other Child Suppo~Alimony Legal Fees Totals: Net: Gross: Net: MonthlyPayment $835.00 $242.00 $366.00 $44.00 $10.00 $70.00 $150.00 $20.00 $17.00 $50.00 $150.00 $450.00 $100.00 $40.00 $125to$550 $2,669to$3,094 $53,690 $32,838 Other Benefits Total Amount Owed Lease $2,400 Holy Spirit Hospital EMPLOYEE NAME SSN FURJANIC, CAROL A 185-38-6096 FOR PERIOD ENDING RATE DEPT 06/29/02 24.28 6510 PTO (VAC) STD (SIC) 144.44 269.30 EMPLOYEE NUMBER 185386096 NET PAY CURRENT 1,263.20 GROSS CURRENT 2,065.08 ADVICE NO. 124182 NET PAY YTD 19,497.61 GROSS YTD 29,411 ~77 EARNINGS HOURS RATE CURRENT YTD 1REG 44.25 24.28 1,086.64 24,142,04 2PTO SC 28.00 24.28 679.84 2,136.64 3HOLIDA 8.00 24.28 194,24 776.96 OT PREM 4.25 12.84 54.57 620.58 WKND RN 12.00 4.14 49.6~ 750.38 EX LIF 0.11 1.55 EDUC 1,007.62 ON CALL 72.00 CHARGE 4.00 DEDUCTIONS CURRENT YTD 401 (k) 165.20 2,056.49 DENTAL 4.00 49.00 FIT 362.43 4,098.67 HSMP 21.14 272.65 MED W/ 29.56 421.60 PA W~H 57,09 814,08 WSHORE 29.94 29.94 OASDi 126.41 1,802.72 UWAY 0 5.00 70.00 VISION 1 00 t4.00 OPT-i-iS 1 LO-CUM 273.46 TOTAL EARNINGS ACH BANK ACH COMCHE 92.25 $2,065.08 $29,411.77 ACCOUNT AMOUNT Acct 513244707 1,263,20 TOTAL DEDUCTIONS $801.77 $8.9~2.5f CAROL A. FURJANIC, PLAINTIFF JAMES A. FURJANIC, DEFENDANT IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 01-1144 : IN DIVORCE 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 herein contained is true and correct to the best of my knowledge, information, and belief. I understand that false statemems herein are made subject to the penalties of 18 Pa.C.S.A. §4904, relating to unswom falsification to authorities. CAROL A. FURJANIC, PLAINTIFF IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 01-1144 JAMES A. FURJANIC, DEFENDANT IN DIVORCE INCOME AND EXPENSE STATEMENT 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: Net: $57,627.68 Same $46,622.82 Same Home Mortgage: Electric: Telephone Water: Sewer: Insurance Auto: Life: Health Monthly Expenses $1,660.00 175.00 23.00 44.00 25.00 (includes taxes and insurance) $45.00 56.00 350.00 Automobile Fuel: Repairs: Medical Doctor: Dentist: Personal Food: Credit card: Clothing: Barber: Cable TV: Legal Fees: Total: Checking: Savings: $80.00 30.00 $20.00 20.00 $450.00 300.00 25.00 16.00 36.00 300.00 $3,655.00 Liquid Assets $1,000.00 2,000.00 1040 Label Presidential ~- Election Campaign Filing Status Exemptions 7 Income 8a Attach b For~ts W-2 and 9 W-ZG hem. 10 Form(s) 1099-R 11 22 Adjusted 2~ Gross zs Income 26 27 30 33 U.S.°"~ ............. Individual'"'"' ..... IncomeY-' ......... ~'~Tax ........... ReturnS'"" .... 2®011 I Note. ~king "Yes" will ~change y~r tax ~r r~uce Do you, ~ your sp~se if fling e joint r~urn, want $3 to go to this fund? . Single Important[ · ~ur $$N(s) above. You Spouse Married filing j~rlt return (even if only ()ne had income) . 6a [] yourself. If your p~re~t (or someone t~se) can claim you as a deper~dent on his or her tax ] return, do n~ check box 6a .............. ~ b ~ Spouse ..................... / . . [] [] [] [] [] Wages, salaries, tips, et(: Attach Form(s) W-2 ........... 7 Taxable interest. Attach Schedule B if required ........... Tax-exempt interest. Do n~ include on line 8.. I 8b [ I Ordina~ d~ide~s. Attach Schedule B if required .......... 9 Taxable refunds, credos, or offs~s of stye and local income taxes (see page 22) . . Alimony mceiv~ ..................... 11 Business income or 0oss). ABach Schedule C or C-EZ .......... 12 Capital gain or Ooss). A. ach Schedule D if required, If not required, check hem ~ ~ Other gains ~ Oosses). Attach F~m 4797 ............. 14 Total IRA distributions . b Taxable amou~ {see page 5(x:ial s~urffy ~AS . 120. I I ~ b Tax~le amoum (see ~e 25} 20b 1040 G, eOl) Tax and 34 Credits 3sa Other a3 Taxes s4 Payments 59 I b 63 64 Refund 67 Anlount 70 You Owe Third Party Designee Sign Here fc~ ~our Paid Preparer's Use Only Amount from llne 33 (adjusted gross income) ........... Ch,.~.k il': [] You warp. 65 o~ older. ~ Bl~d; ~ S~e was 65 [~ ~der. ~ Blind. you were a duaLstatus alien. ~e page 31 and check here ...... Ite~zed d~u~ions (from Schedule A) ~ ~ur s~ndard ded~tion line 6d If line 34 is over $99.725. s~ the ~)fkshe~ on pa~ 32 ....... Ta~ble i~o~. Subtract llne 38 fr~ tine 37. If tine ~8 is more than line 37. e~er 0- A~emati~ minim ta~ (~ee page 34). Attach Fo~ 6251 ......... Add lines 40 and 41 ................... Foreign tax credit. Attach Form 1116 if required .... 43 Other credits from: a [] Form 3800 b [] Fc~m 8396 ~/~//~/~x~. k youm if setf -employedL self -emplo~d [] ( Fo~m 1040 (2001) Add lines 43 through 50, These ;are your total credits Self employment tax. Attnch Schedule SE ............... Nontaxable eam~ income . . I 61b I ~her pa~e~s Ch~kifk~ a[~F~m2439 b~ F~m4136 Amount of line 67 ~u wa~ ~d~ to ~ ............. SCHEDULES A&B (Form 1040) Schedule A--Itemized Deductions oma No. 1545-0074 (Schedule B is off back} ;~®01 · Attach to Form 1040. · Se~ Instructions for ~u~s A a~ B ffo~ 1~. 5~ ~o, 07 Medical Caution. O~ not i~dude expenses r eimbume~ or paid by others. and I Medical and de~al expels (~e pa~ A-2). . 1 Ex~n~s 3 Mu~iply line 2 above by 7.5% (.075) ...... 3 4 Sub~a~ line 3 f~m li~ 1, If line 3 is ~re than line 1, enter -0- . .... 4 Taxes Y~ 5 State and I~al income taxes ........ 5 Paid 6 Real estate taxes (~e page A-2) ....... 6 (See 7 Personal pro~y taxes .......... 7 page A-2,) 8 ~her taxes. List ~ and a~unt ~ .................... 8 9 Add lines 5 thmuqh 8 .................... 9 (See to the ~r~ Imm ~m ~ ~g~ ~ ~, ~ ~ A-3 p~ge A~3,) and s~ ~at ~'s ~, id~g no., a~ add~ ~ Pemonal 12 Points not re~Aed to you on Form 1098. ~e page A-3 not for special rules ............. 12 d~du~lble, 13 Investment i~erest. A~a~ Form 4952 if required, (See page A-3.) .............. 14 Add lines 10 throuqh 13 ................... 14 Gifts tO 15 Gifts by cash of ~eck. If you made any gift of $250 or Cha~ more, see page A-4 ........... 15 If y~ m~de a lo ~her than by cash or check. If any gift or S250 or mom, gi~ and ~ a see page A-4. Y~ m~t a.ach Form 8283 if over $5~ 16 ~n~it ~r ~ 17 Carryover from pdor year ......... 17 see page A-~. 18 Add lines 15 throuqh 17 ................... Cas~ a~ The~ L~s 19 Casualty or theft loss(es). A~ach F~m 4684. (~e page A-5.) ...... 19 and ~M dues, job eduction, etc. You m~t a~ach Form 2106 (See 22 ~her exp~s~nve~ment, ~fe deposit box, etc. List page A*5 [or ty~ and amou~ ~ ........................................ 23 Add lines 20 through 22 .......... 23 25 Mu~iply line 24 a~ve by 2% (.02) ...... 26 Sub~a~ line 25 from line 23, If line 25 is ~m than line 23, emer -0- . . . 26 ~ 27 Other~[rom list ~ p~e A*6. List ~pe and a~ ~ ............................. ~i~s 27 To~I 28 Is Form 1040, line 34, over $132,950 (over $66,475 il ~rfied filing ~rately)? Itemized ~ No. Y~r d~u~ is ~ limit. Add ~ a~ms in t~ far rig~ c~umn Deductions for lines 4 ~ough 27. Nso, e~er this amount ~ Fo~ 1040, li~ 36.~ · ~. Your deeucti~ may be li~. ~ ~ A-6 f~ ~e am~m to emer. 28 Schedule A (Form 1040) 2001 OMB No. 1545-1441 ~o~ 2106-EZ Unreimbursed Employee Business Expenses Inlemat Revenue eel',ce t21 I~ Attach to Form 1040. Seouence No. 54A You May Use This Form Only if All of the Following Apply. · 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. F~ Figure Your Expenses Vehicle expense using the standard mileage rate. Complete Part II and multipy line 8a by 34'~¢ 2 Parking fees, toffs, and transportation, including train, bus. etc., that did not involve overnight travel or commuting to and from work ................... 2 °-{ ~ ~ ~ 3 Travel expense while away from home overnight, including lodging, airplane, car rental, etc. Do not include meals and entertainment .................. 3 / "7 '~ ~'~ ~ 4 Business expenses not included on lines 1 through 3. Do not include meals and entertainment 5 Meals and entertainment expenses: $ /, ~' ~:~'" x 50% (.50) (Employees subject to Department of Transportation (DOT} hours of service limits: Multiply meal expenses by 60% (.60) instead of 50%. For details, see instructions.) ............... (Fee-basis state or local government officials, qualified performing artists, and individuals with disabilities: See the instructions for special rules on where to enter this amount.) ..... 4 ~ 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~ ....,(-~... / .... ,~ ...../ .~..~. .... 8 Of the total number of miles you drove your vehicle during 2001, enter the number of miles you used your vehicle for: a Business ...... Z~)..~..3..~.-. ...... b Commuting ...... .,~. ,. ?. .?. ~.. ......... c Other ..... /5~..z~.~ .......... 9 Do you (or your spouse) have another vehicle available for personal use? ........... ~_'_~es [] No 10 Was your vehicle available for personal use during off-duty hours? ............. [~"Yee [] No 11a Do you have evidence to support your deduction? ................... [~Yes [] No b If "Yes," is the evidence written? General Instructions Section references are to the Internal Revenue Code. A Change To Note The standard mileage rate has been increased to 34'/~ cents for each mile of business use in 2001. Purpose of Form You may use Form 2106-EZ instead of Form 2106 to claim your unreimbumed employee business expenses if you meet all the requirements listed above Part L For Paperwork Reduction Act Notice, see back of for~. ......................... ~,~res [] No Recordkeeping You cannot deduct expenses for travel (including meals, unlees 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 (for entertainment end gifts), and amounts of the~e expenses. Generally, you must al~o have re~tept! I~' all IoQgln~ expenses (regardless of the amount) and any other expense of $75 or more. Call No. 20604Q Additional Information For more details about employee busmess expenses, see: Pub. 463, Travel, Entertainment. Gift, and Car Expenses Pub. 529, Miscelraneous Deductions Pub. 587, Business Use of Your Home {Including Use by Day-Care Providers) Form 2106-EZ (20m) 77-583.15 13960.76 77583.15 &797.76 ~8~. 15 11ZZ.06 _ 2~- 2108855 20Z-36-7201 America Service Group Prison Health Services, inc. 1(1~ ~tpark Drive, Suite 200 2001 Year To Date Earnings SaLary Retroactive Pay Holiday Pay Non-worked 16~.60 Raid Leave la07,69 Group Term Life · $50000 86.60 .PToBusiness Pretax Health Plan Pretax Dental PLan Pretax EE Life 2X Lon~ Term OieabiLity Group Terla Life>$500OO Offset Z8~.71 50.33 432.82 980,40 86.60 JAMFS ALAN FURJANIC r?¢~ DFERFIELD RD CAMP HILL, PA 17011 005 - O018?6 - 17011 JAMES ALAN FURJANIC 96 DEERFIELD RD CAMP HILL, PA 17011 ASGPHS-104 202-36-~01 Married JAMES FURJANIC Earnings Salary Paid Leave ~royp Term Life > $50000 . Total Gross PayRroup Id ~ial Securily Stair,s F. xem plion~Allowa nces Number 603328 202-36-7201 Married U~-Sup P~5~,X O0165920 PHS1. 0192. .... pllJ~l131 . O~l lf~lO&. .gTJ t~JD= Rate Units Taxe~ Federal Income Tax Social Securlly (FICA) Federal Medicare Penneylvanla Income Tax TPhi!l~d~ohll ~ N-R~ (Phi, I) oral PreTex Deductions Pmtax {--leatlh Plan Pretax De~ffal Plan Pretax EE Ltlo 2X Total AfterTax Deductions Long Term Diaabilit~ 50~ Group Term Llfe>$500~O Off,et Total Net Pay 872.21 5475.90 200.28 2335.35 46.84 546.17 ,o,,6.69 ./p / 219.96 327.08 O. O0 586.95 O. ~ 664.69 America Service Group - 105 Weslpark Drive, Suite g00 Bmnlw(xM, q'N 37027 .ProBuslness _ ";H EC K NUMBER 2_[~_3_7p 29 J ,JAMES A FURJANIC INSTRUC?IONS SEQ NUMBER BENEFIT CHECK OOllO , See, e.e, A.et, No, W4r~k I ! Anleunt Waek a ! Amount Offioe i IDGM 202-36-7201 09-14-02 442.00 09-21-02 442.00 0996 !UC Federal W~thholding Tax I Cumulative Tax W~thheld OFFICE ADDRESS LANCASTER UC SERVICE CENTER 60 W. WALNUT STREET LANCASTER PA 17603-3015 Thi~ is your unemployment compensation check for the benefit week(s) indicated on the check and above. If you ere entitled to thio check as defined by the PA Unemployment Compensation Law, carefully detach it at the perforations and cash promptly. If you feel you are not entitled to this check or the check is for an improper amount, please return It to your Job Center or UC Service Center, do not cash it. TIPS FOR USING PENNSYLVANIA TELECLAIMS--PAT * Know your social security number and 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. * 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 filed 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 benefits,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. FOLD ON PERFORATION, THEN DETACH C;,REFULLY SSN WEEK 1 WEEK 2 OFF PGM JAMES A FURJANIC 96 DEERFIELD RD CAMP HILL PA 17011-8469 01437229 CHECK NO. 09/24/02 DATE VOID AFTER 30 DAYS *'884.00 CERTIFICATE OF SERVICE A tree 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: Cam Y. Boyanowski, Esq. 1029 Scenery Drive Harrisburg, PA 17109 am A. Fetterhoff, Esqu'lre y ~ Fetterhoff and Zilli ~ 200 N. Third Street, Suite 800 Harrisburg, PA 17101 (717) 232-7722 CAROL A. FURJANIC, PLAINTIFF IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 01-1144 JAMES A. FURJANIC, : DEFENDANT IN DIVORCE PRE-TRIAL STATEMENT SUBMITTED BY DEFENDANT [Pa. Rule Civ. Proc. 1920.33(b)] Date ofmarfiage: February 13, 1982 Date of separation: December 26, 2000 necessary. Assets: See Inventory. Defendant reserves the fight to amend and/or supplement as 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 fight 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 fight 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 Plainfiffupon 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% 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, Harrisburg, PA 17101 (717) 232-7722 Counsel for Defendant CERTII~ICATE 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 200 N. Third Street, Suite 800 Harrisburg, PA 17101 (717) 232-7722 CAROL A. FURJANIC, Plaintiff JAMES A. FURJANIC, Defendant : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : CIVIL ACTION - LAW : : NO. 01-1144 : : IN DIVORCE AMENDED INVENTORY UNDER RULE 1920.33 Counsel for Plaintiff, Cara A. Boyanowski, Esquire, files the following amended inventory of all property owned or possessed by either party at the time this action was conunenced and all property transferred within the preceding three years. Counsel verifies that the statements made in this inventory are true and correct. She understands that false statements herein are made subject to the penalties of 18 Pa.C.S.A. §4904 relating to unsworn falsification to authorities. Counsel is signing this amended inventory due to the unavailability of Plainfi~ Counsel for Plaintiff AMENDED INVENTORY FURJANIC v. FURJANIC Date of Marriage - 02/13/82 Date of Separation - 12/26/00 Assets Real Estate Marital Residence: 96 Deerfieid Road Camp Hm, PA 17011 Husband 1/3 Ownership in Mother's Residence in Steelton, Pennsylvania Retirement Assets The Lincoln National Life Insurance Group (Financial) Annuity Wife Travelers Life and Annuity Wife MARITAL ASSETS Husband's Wife's Master's Value Value Value $153,600.00 $180,000.00 0tis Appraisal) Equity: $50,000.00 $10,000.00 Date of Separation Value: $26,277.32 Current Value: $16,921.58 (As of 9/30/02) Date of Separation Value: $365.25 Currem Value: $178.13 (As of 6/30/02) Notes Mortgage of approximately $68,000.00 and Home Equity Loan of $84,000.00 at separation. Current debt balance approximately $139,400.00. Increase m value during marriage. Outstanding Loan against account in mount of $5,708.95 as of 06/30/02. Asses Fidelity Investments 401(K) Plan Wife Bank Accounts Members First Account Wife Commerce Bank Account Wife Mellon Bank Checking Account No. 884-017-4117 Husband Mellon Bank Checking Account No. 100-024-4630 Husband Automobiles 1995 Mitsubishi Husband 1990 Volvo MARITAL ASSETS Husband's Wife's Value Value Date of Separation Value: $54,029.96 Current Value: $40,498.78 $2,900.00 $0.00 $3,000.00 $0.00 $7,500.00 $0.00 $0.00 Master's Value · No~s Current value includes post separation contributions of approximately $14,000.00. Value at Date of Separation: $2,900.00 Current Value: $25.00 Value at Date of Separation: $0.00 Current Value: $1,200.00 Value at Date of Separation: $3,000.00 Current Value: $1,400.00 Value at Date of Separation: $0.00 Current Value: $1,100.00 Purchased in February, 1997 for $19,000.00. No lien exists on vehicle. Vehicle waS sold for $4,500.00 and proceeds were split between parties. 1999 Diamante $0.00 $0.00 Leased vehicle. Wife Assets Miscellaneous Household Goods and Furnishings Loans/Debts Citibank Mastercard Credit Card No. 5410-6548-4547-4219 Husband Bank One Visa Credit Card No. 4417-1259-7248-7718 Husband Visa Credit Card No. 4287~5900-0036-4451 MARITAL ASSETS Husband's Wife's Master's Value Value Value Nominal Nominal Date of Separation Balance: $12,000.00 Current Balance: $12,500.00 Date of Separation Balance: $3,000.00 Current Balance: $0.00 Non-marital Non-marital Date of Separation Balance: $1,800.00 Current Balance: $2,188.08 Notes Already split between parties. Husband's debt for personal and recreational expenses. Husband's debt for personal and recreational expenses. Joint Names. Account used for marital expenses by Wife and personal expenses. MLNINQ/SCREEN02 01 087 LOAN MASTER INFORMATION (PART 1) 11/07/02 11:23 Loan: ,,,7,7,0,2,0,6,1,5, *Notes FURJANIC JAMES A 177020615 lst/2nd Mtg Cd 1 Property Type 11 G/L Type 02 Buydown Code N Branch Loan Type 1 Orig Term 360 Auto Pymt N Subsidized N State PA Status 0 SPECIAL FUNCTION CODES ON LOAN Iht Calc Method 2 ARM Type 01 Int Coll Method 0 Payment Frequency M Billing Method 3 Participation N Risk Code N Per Diem 8.677015277 Remaining Term 136 First Due Date Iht 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 2/0i/B5 iO/Oi/02 ii/OS/02 831.85 11/Ol/O2 Orig Amount Origination Date Pay-Off Date P & I Pmt 602.68 229.17 831.85 .00 .00 .00 831.85 103,000.00 8/i2/83 o/oo/oo 602.68 Ori9 Maturity 8/12/13 Curr Maturity 2/01/14 Interest Rate 5.000 Escrow Pmt 229.17 A.P.R. Rate 5.875 Current Principal ,~ 62,474.5 .~/~/ Total Escrow Bal '~7I~ Assigned Escrow 716.43 Unassigned Escrow .00 Prepaid Unapplied .00 Accrued Escrow Iht 25.38 Accrued Interest .00 Buydown/Subsidy Bal .00 fiLm_coin Financial Group' The Lincoln National Life Insurance Company Lincoln Retirement Servicing Center PO Box 9740 Portland ME 04104-5001 000645 CAROL A. FURJANIC 414 N 4TH ST LEMOYNE PA 17043-1665 Grou£ Annuity Statement 6/30/2002- ,?]J'a)2002 Participant ID: 141039 Plan Number: 569 Employer ID: 560 Plan: HOLY SPIRIT HOSPITAL PARTNERSHIP SAVINGS PLAN Questions? Contact a Service Representative at 1-800-341-0441 Value Summary Dollar value Net Gain/ Unit value Number qf units Dollar value as af 6/30/2002 activity loss 9/30/2002 9/30/2002 as of 9/30/2002 894150+006 INDEX 4,963.30 GROWTH I 4,097.61 SMALL CAP 6,085.05 EQUITY-INC 5,825.69 870.75- 25.1072 163.0032 4,092.55 784.63- 24.8494 133.3221 3,312.98 1,269.88- 16.3881 293.8207 4,815.17 1,124.81- 17.6971 265.6300 4,700.88 Totals $20,971.65 $4,050.07- $16,921.58 Value by source of contributions as of 9/30/2002 SALARY EMPLOYER DEFERRAL MATCH $13,044.42 $3,877.16 TOTAL $16,921.58 New Cont~bution lnterest Rates Contract number Contribution Period Interest Rate 894150+006 07/01/2002-09/30/2002 4.85% 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. Prospectuses and various financial reports are available upon request. Please keep in mind that the funds suppOr;4ng the variable a.,:naity are not public funds and a.m only available thn)ugh insurance company contracts. Securities offered through Lincoln Financial Advisors and other broker/dealers with effective selling 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 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. ©1998 Lincoln Financial Group is the marketing nan~ for Lincoln National Corporation and its affiliate~. Plan: 569 Employer ID: 560 page 1 of 4 Holy Spirit Hospital Retirement Savings Statement July 1,2002 - September 30, 2002 #BWNFXQN CAROL A FURJANIC 184 STONEHEDGE LANE HECHANICSBURG, PA 17055 ENV~O028325 405894073116 A ~' For online access, log on at: http ://www.fidelit y:com/atwork For information, call: (800) 343-0860 Your Account Summary Beginning Balance Employee Contributions Employer Contributions Change in Account Value Ending Balance Additional Information · Dividends & Interest $46,284.72 1,038.28 454.27 -7,278.49 $40,498.78 $51.10 Your Personal Bate of Return This Period -15.5% Year to Date -28.1% Your Personal Rate of Return is calculaten with a time-walgt~ted formula, widely used by financial analysts to calculate investment earnings. It reflects the results of your thves~nent selections as well as any activity in the plan account(s) shown. There are other Personal Rate of Return formulas used that may yield different resutts. Remember that past performance is r~ guarantee of future results. Your Asset Allocation [] Stocks 93% [] Bonds 7°/. Your investments are currently allocated among the displayed asset classes. Pementages 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 the value of your account for the period, tn both shares and dollars Shares on Shares on Price on Price on Market Vahle Market Value Investment 06/30/2002 09/30/2002 06/30/2002 09/30/2002 on 06/30/2002 on 09/30/2002 Stock Investments S35,731.42 $30,841.14 Fidelity Grow & Inc 624.697 645.475 $33.61 $28.82 20,996.07 18.602.59 Fidelity Growth Co 369,585 386,318 $39.87 $31,68 14.735.35 12.238.55 Blended Investments* Fid Freedom 2020 920,078 A~OURt Total ~: ;:! '::?: i~:: ~. :i'::~.:.:~ $10,553.30 $9,657.64 947.757 $11.47 $10.19 10.553.30 9.657.64 ': ':.=' $46,28a,,,72 Remember that a dividend payment to fund shareholders reduces the share pdce of the fund., so a decrease in the share prise for the statement period does not neceasadly reflect lower fund ~erfurmance ' Some of your investments are ctassified as a Blended Fund Investment. Blended Investments may include a mixture of stocks, bonds and/or short-term assets Please refer to the "Additional Fund Information" section to determine the allocation of your blended investments' underlying assets The asset breakdown of your portfolio is reflected in the pie chart in the "Asset Allocation" Section Please read this statement carefully. Any error must be reported to Fidelity Investments within 90 Gays. 28325 40028325 0001 20021009 4038 Fidelity Investments P.O. Box 770002, Cincinnati. OH 45277-0090 Page 1 of .~ CAROL A. FU1LIANIC, Plaintiff JAMES A. FURJANIC, Defendant : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : CIVIL ACTION - LAW : : NO. 01-1144 : : 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 Plainfifl5 April 24, 2003; by Defendant: April 20, 2003. (b)(1) Date ofexecution ofthe affdavit required by §3301 (d) ofthe Divorce Code: N/A; (2) Date of filing and service of the Plaintiffs Affidavit upon the respondent: N/A. 4. Related claims pending: None. 5. (Complete either (a) or (b).) (a) Date and manner of service of the notice of intention to file praecipe to transmit record; a copy of which is attached: N/A. (b) Date Plainffl~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 Supreme Court I.D. No. 68736 1029 Scenery Drive Harrisburg, PA 17109 (7 ! 7) 657-4795 Attorney for Plaintiff AGREEMENT BETWEEN CAROL A. FURJANIC AND JAMES A. FURJANIC Cara A. Boyanowski, Esquire William A. Fetterhoff, Esquire Counsel for Wife Counsel for Husband TABLE OF CONTENTS SECTION I: Introduction 3 SECTION H: General Provisions 4 SECTION III: Alimony and Alimony Pendente Lite Provisions 10 SECTION IV: Property Distribution Provisions 10 SECTION V: Clos'mg Provisions and Execution 14 SECTION I INTRODUCTION THIS AGREEMENT made this ~L] ~J~ day of , 2003, by and between CAROL A. FURJANIC ("Wife") and JAMES A. FURJANIC ("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 Count2.~, Pennsylvania 17011. WHEREAS, the parties hereto are Husband and Wife, having been married un February 13, 1982, in Harrisburg, Dauphin County, Pennsylvania. WI~EREAS, the union of the parties produced no children. WI~EREAS, 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 lmst, 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 agalnsl 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 intendingto be legally bound hereby agree as follows: SECTION 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 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 DIVORCE DECREE The parties agree that unless otherwise specifically provided herein, this Agreement shall continue in full force and effect at~er such time as a final decree in divorce may be entered with respect to the parties. AGREEMENT TO BE INCORPORATED BUT NOT MERGED IN DIVORCE 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. 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 pan'y last executing this Agreement. 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 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 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, carry 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 bya any means whatsoever with him or her. Date of separation: December 26, 2000~ 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 fi-om any and all rights and obligations which either may have or at any time hereat~er have for past, present or future support or maimenance, 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 forevea' discharges the other and his or her heirs, executors, administrations, assigns, property and estate fi-om 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 fight to take against the spouse's will, or the right to treat a lifetime conveyance by the other as testamentasy, 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 beneficiaxy 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 ofaetion, claims, rights or demands whatsoever, in law or in equity, which either party ever had or now has against the other. 6 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 ail other means of discovery permitted under the Pennsylvania Rules of Civil Procedure. Each party is satisfied that no additionai information is necessary for the execution of this Agreement. 10. PRESERVATION OF RECORDS Each party will keep and preserve for a period of four (4) years from the date (fftheir divorce decree all financial records relating to the maritai estate, and each party will ailow the other party access to those records in the event of tax audits. 1 I. WAIVER OR MODIFICATION TO BE IN WRITING No modification or waiver of any of the terms hereof shail be valid unless in writing and signed by both parties and no waiver or any breach hereof or default hereunder shail 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 ail 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 A4;reemertt, 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. 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 shail inure to the benefit of the parties hereto and their respective heirs, executors, administrators, successors, and assigns. 15. INTEGRATION This Agreement constitutes the emire understanding of the parties and supersedes any and ail prior agreements and negotiations between them, There are no representations or warranties other than those expressly set forth herein. 16. OTHi~R DOCUMENTATION Wife and Husband covenant and agree that they will forthwith (within ten (10) days at most at~er demand thereof) execute any and ail 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 shail 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 oftbe provisions of this Agreement shall in no way affect the right of such pm'ty hereafter to enforce the same, nor shall the waiver of any breach of any provision hereof be construed as a waiver of any subsequem default of the same or similar nature, nor shail the waiver of any, breach of any provision hereof be construed as a waiver of strict performance of any other obligations herein. 18. SEVERABI! JTY AND INDEPENDENT AND SEPARATE COVENANT._~S 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 shall be stricken from this Agreement and in all other respects this Agreement shall be valid and continue in full force, effect and operation. LLkewise, the failure of any party to meet her or his obligations under any one 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 cerfitied mail, return receipt requested, to Carol A. Furjanic 186 Stonehedge Lane, Mechanicsburg, Pennsylvania 17055, or counsel for Carol A. Furjanic, 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. Furjanic, 96 Deerfield Road, Camp Hill, Pennsylvania 17011, or counsel for lames A. Furjanlc, 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 affect. 9 SECTION m ALIMONY AND ALIMONY PENDENTE LITE PROVISIONS 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 settlement and satisfaction of any claims or demands that either may now or hereafter have against the other for support, maimenance, alimony pendente lite or alimony. Husband and Wife further, voluntarily and intelligently, waive and relinquish any right to seek fi.om the other payment for support, maimenance, alimony pendente lite or alimony. SECTION IV PROPERTY DISTRIBUTION PROVISIONS 1. PE]~SONAL PROPERTY Husband and Wife do hereby acknowledge that they have previously divided their tangible personal property including, but without limitation, jewelry, clothes, furniture, furnishings, rags, 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 &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 BENEF1TS The parties agree that Wife shall retain sole ownership and possession of all ofber 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 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 fight, title or interest they may have in the other parties' account. 4. AUTOMOBILES The parties are the owners ora 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 ora 1990 Volvo automobile during the course of their marriage. The parties sold this vehicle and received the sum of $4,500.00. The parties acknowledge that these proceeds were equally divided between them, to their mutual satisfaction. 5. CURRENT LIAB1]LITIES Husband agrees to be solely responsible for satisfifing all payments on the Citibank MasterCard credit card debt (Account number 5410-6548-45474219) 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 cards and accounts for which that party is individually liable. WAIVER OF PAYMENT OF LEGAL FEES Each party hereby agrees to be responsible for any legal fees incurred on their behalf.. 7. AFTER-ACQUIRED PROPERTY Each of the parties shall hereafter own and enjoy, independently of any claim or fight of the other, all items of property, be they real, personal or mixed, tangible or imangible, 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. Fur~hemaore, 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 refinanc'mg of the marital residence, Wifi~' 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 rr~rital residence, any and all title policies and any other policy of insurance with respect to the Marital Residence shah be endorsed to reflect Husband as sole owner thereof and further agrees that Husband shah be entitled to receive any payments thereafter due under any such insurance policies. 12 (4) Except as otherwise 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 malmenance and Husband shall keep With and her property, successors, assigns, heirs, executors and administrators indemnified and held harmless fi.om any liability, costs or expense, including attorney's fees, which may be incurred in connection with such liabilities and expenses or resulting fi.om 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: 1. Satisfy all remaining liens against the real property; 2. Satisfy all dosing 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 of this page was left blank intentionally.) 13 SECTION V CLOSING PROVISIONS AND EXECUTION Each of the parties has carefully read and fully considered this Agreement ~md all of the statemems, 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. CAROL A. FURJANICL/ IN THE COURT OF COMMON PLEAS OF CUMBF_.RLAND COUNTY STATE OF PF_NNA. CAROL A P~I~JANIC, Plaintiff V~RSUS JAMES A. FURJANIC, Defendant DECREE IN DIVORCE No, 01-1144 CIVIL T'~RM AND NOW, DECREED THAT AND JAMES A. CAROL A. FURJANIC FURJANIC ARE DIVORCED FROM THE BONDS OF MATRIMONY. , ~_~0~3' , IT IS ORDERED AND ,PLA} NTI fF, ,DEFENDANT, The provisions of the parties' Marri~g~ $~ttlement Agreement dated April 24, 2003, are incorporated by reference but shall not be deemed merged into this Decree in Divorce. THE COURT RETAINS JURISDICTION OF THE FOLLOWING CLAIMS WHICH HAVE BEEN RAISED Of RECORD IN THIS ACTION FOR WHICH A FINAi ORDER HAS NOT YET beeN ENTERED; NONRo