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HomeMy WebLinkAbout08-10-10 (5)15056051058 REV-1500 EX (06-05) OFFICUIL USE ONLY PA DepaMlent of Revenue County Code Year File Nlxnber Bureau oflndMdualTaxes INHERITANCE TAX RETURN PO BDx zao691 09 574 Hanisburg, PA 17128-0601 RESIDENT DECEDENT Social Security Number Date of Death Date of Birth 160-07-9509 '05/12/2009 01/12/1919 Decedent's Last Name Suffix Decedent's First Name MI Tacey Stephany (H Appllcable) Enter Survlving Spouse's Informatbn Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED 1N DUPLICATE WITH THE REGISTER C!F WILLS FILL IN APPROPRIATE OVALS BELOW _::~; 1. Original Return ,, ,., 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~°"~;z 4a. Future Interest Compromise (date of i, ~v 5. Federal Estate Tax Return Required death after 12-12-82) 6. Decedent Died Testate i 7. Decedent Maintained a Living Trust B. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of death d ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-t-95) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number Peter J. Russo (717) 591-1755 Firm Name (If Applicable) ti C `~ REGISTER Or~f E ON ~ ~ Law Ofc of Peter Russo ~~ E CTi A ' r" F , First line of address ~ ~' rT7 ` .: i? 5006 E. Trindle Road - ~ ..~ ~ a .rah ~ r ~'l ~ ` ` ' ` -~ 7 Secand line of address ' ±~ r_ ,,i„ Suite 100 _,.p ' ~ -+ iV _ = ~~ _ ..... City or Post Office DATE FILED State ZIP Code :: ~ f"a p"~ ': Mechanicsburg PA ' 17050 Correspondent's a-mail address: PrUSSO~pJf12W.COrn Under penalties of perjury I deGare that I have examined this return, includirg axompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. DeGaretbn of preparer other than the personal representative is based on all information of which preparer has any knowledge. SI E OF PE N RE SIBLE FOR FILING RETUR DyATg Q `'/~~r~ !c'1 DRS 3 ~>Q'r ~r- ~~ l~hg .~r-n- S_ ~/-} /70d~ SIGNATU~~RlE72'OF PREPAR R OTHER THAN REPRESENT E ~ DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 t_ 15056051058 15056051058 ~~ REV-1500 EX 15056052059 o~edanr8 Name: Stephany Tacey RECAPITULATION Decedent's Social Security Number '160-07-9509 1. Real estate (Schedule A) ............................................. L 2. Stocks and Bonds (Schedule B) ....................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages 8 Notes Receivable (Schedule D) ............................. 4. i 193,900.00 5. Cash, Bank Deposits S Miscellaneous Personal Property (Schedule E) ..... ... 5. ' 5,543.97 8. Jointly Owned Property (Schedule F) c -, Separate Billing Requested .... ... 6. 966,133.79 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) s Separate Billing Requested..... ... 7. ', 8. Total Grosa Aasats (total Lines 1-7) ................................. ... 8. ', 1,165,577.76 9. Funeral Expenses & Administrative Costs (Schedule H) ................... .. 9. ' 56,358.46 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............. .. 10. 79,490.00 11. Total Deductions (total Lines 9 8 10) ................................. .. 11. ', 135,848.46 12. Nst Value of Estate (Line 8 minus Line 11) ............................ .. 12. 1,029,729.30 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which `" an electlon to tax has nol been made (Schedule J) ...................... .. 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... .. 14. 1,028,728.30 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0_ I 15. 16. Amount of Line 14 taxable at lineal rate X .0 _ ' 1g, 17. Amount of Llne 14 taxable at sibling rate x .12 1,026,366.65 17. 123,164.00 18. Amount of Line 14 taxable 3,362.65 ' at collateral rate X .15 19. 504.40 19. TAX DUE ....................................................... .. 1s. 123,888.40 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT --; 15056052059 Slde 2 15056052059 REV•1500EX Pags3 Decedgnt's 1 1636 Benner Street CITY Philadlephia Address: Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. InteresflPenaKy if applicable D. Interest E. Penalty FIN Number. 09 574 DECEDENTS SOCIAL SECURITY NUMBER 160-07-9509 STATE ZIP PA 19149 (1) 123,668.40 Total Credits (A + B + C) (2) 2,190.16 Total InterestlPenalty (D + E ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. FIII In oval on Page 2, Lins 20 to request a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (3) 2,190.16 (4) (5) 125,858.56 (5A) 125,858.56 (5B) 125,858.56 Make Check Payable to: REGISTER OF WILLS, AGENT -, niVi uijNhi rci~ 7 i'y IN. ~~_. ,;.eaaiw i~liaiii~ t, ,ll m .i..r. ii ~t r.i PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :................................................................................... ....... ^ b. retain the right to designate who shall use the property transferred or its income :..................................... ....... ^ c. retain a reversionary interest; or ................................................................................................................... ....... ^ d. receive the promise for life of either payments, benefits or rare? ............................................................... ....... ^ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideretan? ....................................................................................................... ....... ^ 3. Did decedent own an "in wst for" or payable upon death bank account or security at his or her death? ....... ....... ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designatfon? ................................................................................................................. ....... ^ ^x IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. h s f ~ rxx~°6 t pS vcr 9 I ai"i~ ~., i f ~ i i7 ii S;~a2 ,.. ."+°s~yi ...~ 56, a. ~i I 465, _. .~ri., ~i a .~i i 3 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent (72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX+ (11-08) Pennsylvania SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE ~ ~ RESIDENT DECEDENT ESTATE OF FILE NUMBER Stephany Tacey 09-574 All real property owned solely or u a tenant In common moat be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a wGling seller, neither being compelled tD buy or sell, both having reasonable knowledge of the relevant facts. Resl properly that is joinNyrowned with right of survivarshlp must be dladosed on Schedule F. Atladl a copy of the settlement sheet if the property has been sold. ITEM Include a rnpy of the deed showing decedent's interest if owned as tenant In common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1' 1636 Benner Property 129,900.00 2. 3752 Fox Dale Lane, Florida 64,000.00 _ TOTAL (Also enter on Line 1, Recapitulation.) ; 193,900.00 If more space is needed, insert addkional sheets of Me same size. q. St3lt10T11eTlt Stat8Tri2IIt U.S. Department of Housing and Urban Devebpment n r...,..a i ..... OM9 Geerovd Ne. 2502-0285 (smites t i/3020n91 1. 1SIFHA 2. (]FmHA 3. pConv. Unins. 4. VA 5. .Ins. 6. File Number AS•17203' 7, loan Number 090410 B. Mortgage Insurance Case Number 441.9385502 C.NOIe: iumtmraa'(p.o.arWmsF5i0a,bbSruaw~sSbvnRn.nrMNwt/Nmrimp.paward~Srotiradwii,IMbrsb. TiOeEXp(easSetlleme(tl$Tetem WMNINO:Sb.cRm bbgsYeymalmgM MMMMtbblM lhMbd 8lsga on5n ar ~watlbr SYnYSrAOnn PrWir,Pari awMcsw, ~, w,a.. e..nd ~ FatlrsLdL w5: Tin. to u. s. Csa. b«roe 7051 Sna saaorr tDia Pdnled 092 ,al 11:08 BC D. NAME OF BORROWER: Anna Copper AODRE 1636 Bamx PMIadN ie PA 19149 E. NAME OF SELLER: Estab of Stephsrly Tatey, Deuased ADDRESS: 1323 r Drive Boi9n tin s PA 17007 F. NAME OF LENDER AAKO Inc. dlbla Boulward MorWape ADDRESS: 35N Brkdol Pike Build PA 19020 G. PROPERTY ADDRESS: 1636 Bennx Stree6 Phlladelphla, PA 19149 PhlladN is C H. SETTLEMENT AGENT: Albhte Abstract, Inc., TebphoM: 215.6395900 Fax: 215.639.7051 PLACE OF SETTLEMENT: 3331 Street Road Bkt 2 Suite 115 Bertpkarr PA 19020 I. SETTLEMENT DATE: 0928Cl009 J. K. 100. GROSS AMOUNT DUE FROM BORROWER 400. GROS8 AMOUNT DUE TO SELLER t 1. 129900.00 401. Contract sales 129900.00 102. Personal 402. Personal 103. Settlement m baroxrer 1400 9409.18 403. 104. 404. 105. 405. Ad nts for ibrn5 id Selbr i n advanm Adustmsrd5 for hems id b eslbr i n atlvanos 106. C' ADRTr 09128109m12131109 308.35 Rawnlao(es 09128fO8m12131f09 308.35 109. 409. 110. 410. 111. di1. 1 f 2. 412. 120.OROSS AMOUNT DUE FROM BORROWER 1~ 618.13 420.OR088 AMOUNT E TO SELLER 130 208.35 200. AMOUNTS PA87 BY OR ON BEHALF OF BOR ROWER 500. REDUCTIONS IN Ni DUE TO SELLER 201. ' aeamest 1500.00 501, nbwdione 202. Prind arnouM d naw mans 127548.00 602. Settbnletn sdbr line 1400 22385.94 203. E><is5 ban m 503. S su ' m 204• P d F Loan 205. 505. 205. PFHA 3000.00 506. 207. 507. 208. 508. 209. Ad ustmeMs for tteme un d sellx Ad u for items un d sNbr 213. wh a 1291129 513. wls 129/129 214. w ch 22.85 514. w s ch 22.85 215. Selby Aesisl 7794.00 515. Se4er Abaist 7794.00 218. WBS Use No as 516, W Use No Ad as reed 217. 577. t ~ 516. 219. 220. TOTAL PAID BYIFOR BORROWER 300. CASH AT SETTLEMENT FROM OR TO BORR 138862.85 OWER 519. 520. TOTAL REDUCTI AMOUNT DUE SELLER 800. CASH AT SETTLEMENT TO OR FROM SELLE 30 269 R 301. G due hom txarowx Gne t 20 302. nta barower i 1 ~ 18.13 139 .85 601. Grass amount due m seNer 9ne 420 130 208,35 602 redarbrt amou due belbr line 520 30 202.89 303. CASH TO BORROWER 214.72 603. CASH TO SELLER 1 005.66 bUrSySTpf~illbrE FORK/WSSELLER STATeMSNT: 7IN Y/amVroeoarbYmC llNbnbmGnlbtoot tFainisYU,adbbn,p saMnstb Sb M,4r1151 Rmwm59wriw. rYau ih nG,rW bIID•MUn. w X01 N,w~s eo,a «wawfio~Raw.bLbafs~is m ibm'r npiMblw npoYS rtlNEIB MYimiw lMilwMOwnrpapd. 7A. CaNSd 6Yx Nb buiDSOm SELLWl WSTRUCTIarB: SturW mNbwrair nriero,SM Farmt715.6NaE,sl,npsdP,ielpM Rssllsrsr, rsr r,yS.klwN 7mrNmns 4s rd,m; br elhr brrsaliary, awnpw Sm.pplasgs prod Farm 1757. Fwma7St /W> SnrOM D ffam 10rD1. numON,pi,mNES.WpebCh+l>tlll,b151pYbrbF byoa.C Cy W. ~ICwIFF S~INM mnumbr~MeMl~ar,Nb b ~pn+iC. Yav Cafsq gNSMIOtEM syeNnar~.Ym ~rwner. ~~ I SELLER(b)SWIiATU ,r' bELLER(S) NEW NssWd AtIDRESb: Y.J. Kf N\IIRI\I VI IIVNryI\V I4\i .SETTLEMENT STATEMENT nflnFxnrasR SANIPmanr Svarnm PrintM nDY)AINYIO ~11n~'W A(: L. SETTLEMENT CHARGES PAID FROM PAID FROM 700. TOTAL SALESBROKER'S COMMISSION Wtsd on 129 90D.00 6. : 7 794.00 BORROWER'S SELLER'S Division of canmissgn Tine 700 as ro6ows: FUNDS AT FUNDS AT 701. $ t0 Penn Li R•N Esfrte SETTLEMENT SETTLEMENT 702. S 7 794.00 to Penn Lib Ral Estate 703. Commission 'd at Settlement T 794.00 704. to Penn Libe Real Estate 395.00 395.00 800. REMS PAYABLE IN CONNECTION WTtH LOAN 801. Loan ' inatiw F 96 802 Loan Discount % 803. A alsal Fee ro AAKO Inc. tllbla Bottlward M P.O.C. 350.00 Bu er 804. Credit Re to AAKO Inc. dlbl• Boulevard • 25.00 MIP to HUD 2193.88 . F Ce ' pon to AAKO Inc. dr'b1a Boulward Mo a • .00 . Doc M 'c Dow t Pre o AAKO Inc. dlbla Boulward Mo 35.00 806. PHFA Un to AAKO Ina. dlWa Boulward Mort a 15.00 809. Commitment Fee to AAKO Inc. dlbls ulward MOrt • 32 .00 810. 811. 900. REMS REQUIRED BY LENDER TO BE PAID IN ANCE 1.1 Fran 10Po112009 19.fi561 3 51.97 902. Mon Insurerlce Premium ror ro 903. Hazard Insurance Premium fa to All • Imuranee 614.68 904. 905. 1000. RESERVES DFpOSRED WITH LENOER FOR 1001. Hazard Insurerlce 3 mo. 51.20 Imo 153.80 11102. MoR Insurance mo. 51.11 hno 1003. C' Tax 10 mo. 98.72 Imo 987.211 1004. Cw Tax mo. Imp' 1005. SGad Taxes mp. !mo 1009. ata Anal to AAKO Ina. dlbla Boulward s •256.10 0.00 1100. TTfLE CHARGES 1101. to tee ro Allstate Inc. 50.00 1102 AIKDaCI a title search 1103. Title examination 1104. TBIe insurance binder 1105, menl 11 . N 8 ro Alisfate d Ina. 25,00 25.00 1107. ABOme s fees indudes algae items No: 1106. Title Insurance ro Allsfats AhsVa Inc. 1008,75 includes above iOBms N0: 1109. Lenders 127 546.00 11t0.tavnersPd' 129900.00 •1008.75 1111. 100 No Yx11 300 900 E ro Allstate At1•tra Inc. 150,00 1112 Dortieslics Alistab Inc. 20,00 ~.~ 1113. Closi SvClb ro Alla}ate Abstra Ina 75,00 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recadin F 208.50 178.50 x,00 1202. CB ICoun 897.00 1941.50 1948.50 1203. State Tad Desd 1299.00 849.50 849.50 1204. Record M As ro Allstate A Ina 353.00 1205. Corner-EmaitiF to Allstate Inc. gp,00 1300. ADDTfIONAL SETTLEMENT CHARGES 1301. CB Certl'xa5on to Cae•rw 150.00 1302 Pest Ins ro AI iM Exterminad 85.00 1303. InheR.Tax to HOLD 7 794.00 1304. 8116125275 ro POW 30.00 1305. a821147t00 O9 r.e.lmt m PMIadN hla of Rwenw P.O.C. 1 164.73 SNI•r 1 .0161692001638001 to WaGr Rwenw Burgtl ' 79.84 1307. Raof & Heali r a ShiA Flood 3 ~.~ 1100. TOTAL SETTLEMENT Ct1ARGES enter fines 103 Sedan J and 502 Section 9409.78 22 385.84 I har nl.niy mvaad nr XU61 9atllwllwx SYIr1wx arE m xy art a mrrlup.Ygp and bNie(kr a tllla and amuaM Yalalnry d aY rawpb rid aiWnamWi ma0a m my aaolrlt «q ms axe Ihaxwr Inara nniwampYanM HUPt aatlYmrn SlaYnlMa. AI~;~ I Lc ~~'_iL~-r ENW ast.awy Taeey, Oaens~a ' ois~sr~ij~,/Clr=-~ ~lcGm,Gy~,G Sri ~-f ;. --~- ~WMNFIO: RIa ACRMETO IOIOWFIQT MAai FALSE STATEMENTS TO THE TIIa XUC-1 wniarllr.~Plpr.dw atru rN am+r. scarper Nh trr~aobn. I1IMIED STATE6 ON TIle OR ANY BMS.M FORM. PENALTxie UPON CONNCTaN INn wit FIaNMbpa di~hlaaatl yl rpp~p~~~K CAN SaUlOE A fFA: A1a1 e1FRI80NMENT. FOR OETALS SEE TRLE 1e: U. S. CODE 9ECTgN 1001 AND SEC710N 1010. APPRAISAL OF REAL PROPERTY LOCATED AT: 3752 Fox Dab Ln Beacar Square Urrit 11-8 Pb 9 Pg 89 Lot 1326 Dr 466 Pg 143 Holiday, FL 34691-1342 FOR: Law OlRces of Peter J. Russo, P.C. 5006 E. Trindb Road AeecFrenicwbrrg, PA 17050 AS OF: Jury 30, 2009 BY: Kara L. Sedbk SLCert.Res.Rea. #RD7303 Jay Appraisals, Int. 7251 Box Elder Drive, Port Rkhey, FI. 34668 TEL: 727-646-1868 FAX 727-232.1529 www.leyaPPrarsals.com JaY ADPraIsaB, Inc. Fam GA2 - WnTOTAL' appraisal sdlware ty a la made, Irc. - i-804ALM100E JayAppreisals, Inc. 7251 Box Ek1er Drnre Port Richey, Fl. 34668 Law Offices of Peter J. Russo, P.C. 5006 E. Trindle Road Mechanicsburg, PA 17050 Re: Property: 3752 Fax Dale Ln Holiday, FL 34891-1342 Bonower. N!A File No.: 2678 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 vaNte of the property described in this appraisal report, as improvetl, in unencumbered fee simple title of ownership. This report is based on a physical arrelysis of the s&e and improvements, a bwtlonel analysis of the neighbortaod and city, and an economic anaysis of the market for properties such as the subject. -The appreisal was devebped and the report was prepared in accordance with the Un'rform Standards of Professbrral Appraisal Practice. The value wnclusbns reported are as of the effective date stated In the body of the report and contingent upon the certlficatbn arxl limding cond'dare atladred. It has been a pleasure to assist you. Please tlo rat hesitate a centact me if 1 can be of adddbnal service to you. Sincerely, ~~ Kara L Sedlak St.Cert.Res.Rea. RD7303 Scnen Of Wnrlr rnow, Borrower/C6ent NIA Pro Address 3752 Foz Hale Ln C Holida Cou Pasco State FL L Code 34691-342 Lender Law Clifices of Peter J. Russo P.C. USPAP Report Requirements Per the revised USPAP guidelines, as of July 1, 2006, this report qual~es as a summary appraisal report. In the preparation of this appraisal, the appraiser made a physical inspection of the subject site and improvements, and sufficient exterior photographs to adequately characterize the property appraised. The subject neighborhood was also inspected to assist in their determination of the neighborhood characteristics. This information was analyzed in order to document the various environmental, social, governmental and economic factors that influence value. Data regarding the sales of residential land and improved properties were collected and verged by Public Record. The valuation of the property inducted the Sales Comparison Approach, Income Approach and Cost Approach. The three approaches were then reconciled into a final estimate of value. If any of the three approaches were omitted, an explanaflon can be found in the reconciliation and/or additional comment section of the Form 1004. Limit of liability of Jay Appraisals, Inc. and independent contractors is limited to the fee collected for preparation of the report. There is no accountability or liability to any third party. The appraiser reserves the right to alter, revise, or rescind any of the statements, findings, opinion, value estimates or condusions upon any subsequent study or analysis subsequently becoming known to him or her. The appraiser has examined fkxxi maps that are provided by the Federal Emergency Management Agency and has noted in the report whether the subject site is located in an identified spade/ food hazard area. Because the appraiser is not a surveyor, he or she makes no guarantees, expressed or implied, regarding this determination. The dient is urged to have the subject property surveyed, with the flood elevations shown. Florida has sink hde, (subsidence) and it is assumed that the soil is sound. Any changes to the original report, causes the entire report to be null and void, regardless of the degree of the change. The appraiser has a true copy of the original report. The report should be viewed only in its entirety. No attempt should be made to separate or segregate any entry herein. Acceptance of, and or use of the appraisal report constitutes the acceptance of the above conditions and assumptions. Signalise ~i~d~ Name Kara L. Sedlak DaOe Slgrled August 03.2009 State CeNflcaOOn # St.Cert.Res.Rea.RD7303 Stale FL Or State license # State Signature Name Date SigneO Stale CerOfiwBOn # State Or Stale IJcense # __ _ State Fam TA002 - •N'InTOTAL• appraisal sellware 6y a 0 mode, Inc. -1-800-ALAbtODE Scnoe of Work Clarification File NO. ~Fta Borrower/Cleri NIA a Address 3752 Fox Dale Ln CI Holid C Pasco State FL L Code 34691-1342 Lender Law Ottlces of Peter J. Russo P.C. CLARIFICATION OF ASSUMPTIONS, LIMITING CONDITIONS, CERTIFICATIONS AND SCOPE OF WORK The fotlowing is rested in order b define terms as They are used in the appraisal report. This is not intended b be a modification of the certificetion, but a dadficaflon, which is required to be in mmpgance with USPAP. The URAR appraisal fain was used b report the results of my appraisal. The scope of work explanations discussed here and within the body d the report, reference by number and page, the Scope of Work, Assumptions and Lsniting Conditions and Certifications as shown on pages 4~ of the FNMA Fain 10041Freddle Mac Form 70 b further define, clarity and document what the appraiser(s) did and a did not do in ceder b devebp the appraisal and repot the value opinion, based on the complexity of this appraisal assignment and a as a result of a supplementary Agreement a Engagement Lefler as accepted by the appraiser(s) and client identified within the appraisal report. If, no written spedfic and a supplemental Scope of Wak was agreed upon with the client (pda to accepting qte assignment, by formal engagement letter and included in ttus report) the Scope of Wodr outlined here and within the report, ~ considered to be representative of what typical users of appraisal services would regain: and in general, what appraisers would provide as reasonable, acceptable and sufficient fa the stated intended user's needs. HOUSING MARKET TRENDS & CONDITIONS (Pg 7): Under "One-Unit Housing Trends; the boxes selected were based on an anatysis of the'short real estate trends (3 to 6 years).' This type of anatysis is identified and spectfied in "The Appraisal of Real Estate," by the Appraisal Institute and also considered in "Essential of Real Estate Economics' -Fifth Edition. While consideration was given to trends identified by the Case-Steiger Index, OFHC-0 and NAR reports, these rcrdexes ~d reports portray trends at the MSA level where as the trends iden6fusd by the appraiser fa the'One~Jntt Housing Trends' of the URAR reflect trends at the neighborhood level, which may differ from area wide housing trends. SCOPE OF WORK (Pg 4 8 Pg 5, Csrt. 2): Item (1) - fl sMrrld be noted that the Appreiser(s) concluded a visual inspection of only the readily accessble areas of the property, vievdng arty those canponents of the property which were dearty visible from the ground or Aoor level. No tests were made of the mechanical, plumbing and electrical systems. Such tests are not within the standard guidelines d FNMA or FHLMC. Canments an the condition of the foundation, roof, exterior, inteda, floes, mechanical, plumbing, electrical, insulation and all other matters relating to the construction of the subject property are based on a casual observation a,ty, which may have been limited by the placement of personal propeAy, tumishirgs, etc. so as b preclude observation of the items bkidced by same. Unless stated elsewhere in the repot, there was no observation of the attic, aawl space a compatents that are hidden within walls other areas that would not be visible by a typical visitor b the home. Although the repot may oi0e a general rating of the adequacy and a condition (based on observation only) H should be dearly understood that these statements are a general guide fa cempadson purposes (as pert of the valuation process) and are not a detaAed report on the physical and a operetional ccedition of these items. The appraiser(s) is not an expert in these matters and any opinion stated is advisory based only upon observation. This report is not a home Inspection. While others may choose to rely on the report, they should not ray on tt b disclose condition and defects. Such knowledge goes beyond the scope of this appreisal end as such, comments on observed corrditrons given in this report should not be taken as a guarantee that a problem does not exist. The fotlowing chart is b assist the intended user in comprehending the scope of a complete visual inspedian: Coin Mb Ylsual b action Includes: Coin to Visual Ins dlon DosslDid NOT Include: List the amenities Testln or activalm mechanical s stems Vx;w readi observable exterior areas Adivatin a fiances View readil observable inteda areas Observation of crawl ces and attics Note ati of materials and wakmanshi Observaton of areas not readil accessible Measure the exterior of the im rovements Buildin Code coin nce'rssues Observe the Aoa an and room o Movin furniture a rsonal Assess the functional of the Mold Assessment Note the su ' 's cronformi b the market area. Renavin or mov' Aoa covedn s Nde I deli n. Testin or ins ction of the well and se tic. Observe the general condition of the improvements, including a Re rfln rsonal ro samptlng of closets, windows, electrical switches, and doors. RooT Condiflon r d an observation from round level. Ph re h exterior and view site around the i vements Radon Assessment Items (2, 3, 4, 3 5) where tl states inspect the nelghborhood'tlu observatkm was limited b ddving through the area and a representative number of streets, reviewing maps and other appropriate data including observing the comparebles from flee street, o determine the general factors That may hfluence the vakre of the subject property and research o the extent further defined in the sections below. REPAIRSIDETERIORATION (Pg. 4, Item 5 /4 Pg. 5, CeR 2): The terms deficiency & Iivabtltty have not been defined in the appraisal report. An effort was made b report ONLY those repair items that, in the appraiser's opinion, affect sateN. adecuacv. and marketability of the p~drty. Dej~or 'ron " tent wiN Ure age of the Mme has not been itemized. SignaNre /~/~ L SlgnaAse Name Kara L. Sedlak Name Daffi Signed August 03.2009 Dam Signed State Certltkatien # St.Cert.Res.Rea.RD7303 State FL State Cdttticatlon # State Dr State license # State _ Dr State License # State Form TADD2 -'WinTOTAI' appraisal software by a b mode, inc. -1-80o-ALM10DE Scone of Work Clarification FiM Nn 9R1A BoroweVCiat NIA Pro Address 3752 Fox Dale Ln C Holida Ccu Pasw State FL L Code 34691-1342 Lender taw Ofices of Peter J. Russo P.C. E7QENT OF DATA RESEARCH - SALESILISTINGS (Pg. 5, Cert. 5 thru 9): Sales & listings of the subject property and comparebles were researched, verified, analyzed 8 reported le compliance wiN Certlflcetions 5 Nm 9 of this URAR. Sales data (indudkrg listed, dosed, pending and expired) of propeNes that are geographiplly, physicatiy, functionalty and economically similar to the subject property and Nat reflected curent buyer and setter actions were researched and considered. If necessary and applicable, the appraiser(s) also researched canpareble land and improved sales, income and expense information and conswction costs; conixrtred sales information (as noted under'EXTENT OF INFORMATION VERIFICATION; (see next sedron) and analyzed Ne information in applying the approach(es) used. Depending upon the avatlabtiity and retiatdlity of various data sources, Ne appreiser(s) used a combination of reasonably available infortrefian from dtylcounty records, real estate agents, owner's comments, buyer's description, assessors records, multiple lisfing service (MLS) data, brochures, web site listings and visual observation to identify Ne relevant characterstlcs df the subject property. Comparables were selected based on physical, functlonal, ecorromic and location characteristics wiN the sales cited in the report considered to be most relevant to the analysis of subject property. These sales were adjusted to the subject m reflect the market's reaction (g any) to differences. In areas experiencing fluctuating market conditions and as directed by supplemental guidelines fresh FNMA, listing and pending sales data was also considered akxrg wiN Ne impact ('rf any) of foredosure short sale activity and such data was considered in the final value opinion if it was relevant to the value opinion. It should be noted Nat the presence of foredosure activity and or short sales does nM autanaticatiy constitute a shift in Ne market. This type of activity may or may not have a bearing on Ne subject property and is evaluated on a property-by ~xoperty basis. EXTENT OF INFORMATION VERIFICATION (Pg. S, Cart 70 & 13): Representative samples of disinterested sources for information and data verification inrJude but are not limked to CountylCity online records -Recorder, Treasurer, Zoning, GIS, Online Assessor Property Databases -Sales, PropeAy Charederisfics, Personal observation -Condition, Location, Physical attributes, Real Estate Trensactlon Dedaretion docoments -Sale date, Personal property. In addition, Ne subjecys market area was examined to detem>ine the demand for and marketability of properties similar to the subject. When and where possible, Ne applcable information was verified vdN sources deemed to be reliable and a disinterested party or corroborated wiN a 3~ party source. In some ceses, Ne rtrotivations of Ne parties or other factors (terms, arms-IengN transactions, etc.) may not have been avatiable and Ne data was used at "Face value as factually accurate.' The appraiser(s) was not supplied with a survey of Ne subject site, did not check lend records for recoMed easements and has reported only apparent easements and encroachments. Unless oNervrise stated wiNin Ne report, no effort was made to ascertain whether the sutljed is wihin Ne appropriate selbadcs, as dictated by zoning, buikling or other regulafions. RELATNE TO /70 ON THE APPRAISER'S CERTIFICATX)N: fl must be understood Nat same information retrieved has no disinterested party (i.e. Ne purchase agreement, etc.) and any informaton regarding the improvements per the owner that are not verfiable (i.e dates of maintenance, etc.) have no way of being confirmed by a disinterested third party. Disinterested Nird parties are considered to be: title companles, escrow officers, county records, assessor records, Mlcrobase and MLS. PUBLIC 1 PRIVATE DATA SOURCES (Pg. S, Cert 12): My (our) appaisal prectice is limited ro Plnsllas, Hillsborough, Hernando and Pasco County, Fbrida. I have access to public data via Ne county records; Ne Multiple Listing Service; Marshall 8 Swift national cost estimation service, ibod data and maps, abng wiN private infortnafion contained wiNin my offxx files Nat is considered necessary and appropriate for Nis assignment. ADVERSE FACTORS (Pg 4 item 5 & Pg. 5, Cert.14): As cited in the "Assumptlons & LimNng Conditions," s subjective and open ro broad interpretation. Most properties will have a forth of physical depreciation, deficiency or livability issues, dependent upon the standards of the party observing Ne property. A property cadd also be impeded by a wide-range of factors internal or external to the properly Nat maybe considered'adverse" b'y someone. Absent detailed 6rerdives and spedfic guidelines from the client, Ne appraiser(s) made a visual inspection of the property and its market enveonmeM (as rked elsewhere in Ne Scope of Work) and noted factors that may impact Ne marketability and livability to potential buyers based upon the appraiser's knowledge of the market and a as evidenced by sales of properties with similar or comparable: conditions. Such items noted in Ne report were considered wiNm the valuation approaches Nat were applied to Ne analysis. Whie same n Ne market may consider fa(dors such as drug labs, registered sex offenders, criminal activity, interkn rehabilitation factiities halfway houses or similar uses as'adverse,' unless cited within Ne report, Ne appraiser(s) has made no attempt to imesfigate or discover such activities as part o(this assignment, unless such factors were readily apparent and obviously impacting Ne subject property as evidenced by market data. If the intended user has concerns in Nese areas, it is highly recommended Nat they secure Nis infomratlon from a reliable source. DISCLOSUREIDI5TRIBUTION (Pg. 8, CaK. 27 & Cert. 23): Regardless of who paid for this assignment, Ne intended user is Doty Ne dient stated wihin Ne report The appraisal and report may be inappropriate for use by parties other than the intended user and could place Nem at risk. Despite Ne means of possession of the repot, Nis appraisal should not be used or relied on by anyone other than the stated intended user and for the statedlmtended purpose. CerfiftcMbn 23 -Per FNMA -"The Intended User of Nis appraisal report is Ne Client The Interl~Jsa is t~ ate rty that is Ne subject of this appraisal for fair market value, subjad to the stated Scope of Work, Sigmsxe ~y~, Signature Name Kara L. Sedlak Marne Daffi Signed August 03. 2009 Daffi Signed State Cdtllica~ri # St.Cert.Res.Rea.RD7303 Slate FL State Ceriflirason # State_ Or State Lkdrse # State_ Or State Cleanse # State Form TADD2 - WxiTOTAL' appraisal software by a b mode, inc. - t-~0.A1 AA~DE Scorae of Work Clarification FJe Nn 7a,a Bortower C&ed NIA Ro Address 3752 Foz Dale Ln C' Holida Cou Pasco State FL Code 34691-1342 Lender Law Offices of Peter J. Russo P.C. purpose of the appraisal, reporting requirements of this appraisal report form, and Definition of Markel Value. No additional Intended Users are identified by the appraiser." THE VALUE OPINION: The value opnion stated in the report is based on my (our) analysis and considers the productivity, economic and physical conditions of the property Doty as of the date of value dted. As market conditions change, this value oprdon may not be valid in another time pedod. Personal property a dtler items that may be included witll a sale a transfer of the property were excluded from the value unless such items are necessary for the operations of the property (garage door remotes, pod remotes, etc) and would normally be a part of the mechanical a operational equiprtrent that is considered realty and or cusbmady transferred with the property. INSPECTION: A visual observ~on of the unobsWCted, exposed surfaces of ready accessible areas from stand'mg height. LIVING AREA: Living area is defined as legal, finished, pertnanentty heated andlor coded living space contiguous with other living area and regarded by a typical purchaser as being habitable and as having living utility. Unless dherwise spedfidd and the reason given why, the visual observabon excludes the attic, the aawl space, any unfinished basement and bebw grade storage. This report is not Intended fa use by the bortower for purposes of identifying any adverse conditions ro the subject's systems and components which might be revealed by an inspection by licensed professionals n any relevant field. This appraisal report does not guarantee that the subject property is free of undetected problems, possible defects a environmental hazards that could exist. The appraiser is not a licensed home inspector and the appraisal report is not a home inspection. The appreisel repot cannot be relied upon to disclose any hidden defects that are not apparent from a visual observabon of the surfaces of the subject property from standing height without moving any personal possessicns. The testing of systems (strudurel, mechanicel, electrical, HVAC, plumbing, etc.) and any components (such as appliances, doors, windows, etc.) lies outside the scope of work of 1Ms appraisal assignment. The purpose of Cris appraisal is to devebp an opinion of market value of the property as described in the appraisal report. If the cost approach to value was devebped fa this appraisal report, it was developed to furCrer support the indicated value of the sales compadson approach to value. This report is rat mended to be util¢ed for insurance purposes. This report is intended to be uClked for tai market value only. This report is not intended fa any other use. The appraiser will not give professional tesCmony kr court: unless prig arrangements have been made wCh the cttent(s). As of the effective date of this appraisal report, no prig artangements have been made. This form,1004, was requested by client. INTENDED USER: This appraisal report, and the contents herein are intended to the exclusive use of the client that is specified in the body of the appraisal report andla its assigns. This report is specficalty not blended fa use by the lxxrower and should not be relied upon by the borrower. Receipt of a copy a Cie original appraisal repel by parties listed in #21 of the Appraisers Certification a any other parties does not obligate the appraiser and does not make them an intended user of the appraisal repoR this appraisal was prepared fa the client named on page 1 fa the purpose of providing fair market value and is not intended for any other use a purpose. In addition, the scope of this assignment is specfic to the needs of the dent named on page 1. INTENDED USEIPURPOSE: The intended use and purpose of the repot is b aid the dent in detemdning fair market value. The purpose of this appreisal repel, unless otherwise stated, s to determine the Market Value for the referenced subject property. Relative b #23 of the Appraisers Certification, 'rf other parries dose to rety on the report, the appraiser is not obligated to such parties and tt does not result in such parties becoming an intended user. Possession of Cris report, a any copy thereof, does not tarty with tt Cie right of pubticadon, nor may it be used for other purpose than its intended use. This report may not be used for any other purpose, a by any person or corporation other than the client or the parry to whom the report Ls issued under Client as named herein. DEVELOPMENT OF THE ASSIGNMENT - SCOPE OF WORK: The assignment of CNS appreisal was accepted to determine market value an opinion of value based on the exposure of the Subject in a competitive and open market under conditions requisite for a fair sale Tor cash a cash equivalent, typical marketing end exposure time, typicatiy knowledgeable and motivated buyers and sellers. This appraisal report is intended fa use only by the client named herein and those associates, instibttions, and agencies dkecdy related b the spedfic interded use herein only. Use of this report by others s not intended by the appraiser. This report is intended for use only in the acqui~tion for fair market value. A parry receiving a copy of this report as a consequence of disclosure requirements applicable b the appreisers client does not became an intended use of this report unless the dent spedflcalty intended them at the time of Cre appraisals assignment. The Subject property was legalty identfied by data gathered from online county public records, and was physicatty identified by personal on-site inspection. The sellerl bortower was found to be the legal owner of records. Fa the purpose a this appraisal, inspection may include measudng the subject property, and a visual examination of the overall structure. No warranty fa structure, site or components is given, nor should it be assumed. This appraisal was devekrped by gathering information from MLS, county public data sources, and proprietary data sources. Sales that have dosed within the past 90 days may not be available in public records. The appraiser makes no warranty as to bt s¢e, dimensions, a specific zoning conformity as accuracy lies wChkl the agency providing the data. OMy real property was considered, personal property was rat used to determine an opinion of value. The market area characteristics and sales trends were anatyzed using the gathered infortnatlon. Comparable sales were sektcted by finding recently dosed sakes that were deemed most similar to the subject. CrCerta fa this selection process included proximity b the subject, date end cond'dans of sale, site size and bcation, view, quality of consWction, candtbn of Cie property, total living area, functional utlity, and amerities. The sales comparison ap the re nt pproach, and Me income approach were considered'm the fortnula0on of this report. Onty those approaches Signature jy~ SigmWre Name Kara L. Sedlak Marie Date Signed August 03. 2009 Oaffi Signed State CertlfMadan # St.Cert.Res.Rea.RD7303 State FL State Cerfification # Skte Or State Ucense # State _ Or State Ucense # __ _ _ State Form TAll02 - WmTOTAL• appraisal software by a b mode, inc. -1 A~ALAMODE Scone of Work Clarification Rye Nn. ~a,a Borrower/CMem N/A Pre Address 3752 Fox Dale Ln C' Hdida C Pasco State FL D Code 34691-1342 Lender Law Offices of Peter J. Russo P.C. applicable to the subject wee used. No departure was invoked to the purposes of developing or reporting this appraisal. This is a summary report of a complete appraisal. All krarm (actors affecting marketability have been considered in the preparation of this report. HIGHEST AND BEST USE ANALYSIS: Real estate is values in terms of Its highest and best use N vacant and available for deveopment to its highest and best use. Highest and hest use maybe defined as that which is legalty permissible and most probable use of the property that will provide the greatest velum to the land as of the etTective date of the appraisal. Highest and best use must meet four criteria; 1. Physicatly possible; 2. Legally pemussible; 3. Flnanciagy feasible; 4. Maximafiy productive. The subject properly appears to be legally zoned for iLS current use. It appears to enjoy a good appeal b the market. The most teasble use of the subject property as of the effective date of the appraisal is its cunent use as an enproved property based on the above defined criteria fa determining highest and best use. EXTRAORDINARY ASSUMPTIONS: This appreisal was completed under the extraordinary assumption that; all improvements have been legaly permitted and conform to kxxl zoning and code ordinances; that there ere no zoning violations ar pending zoning changes that would adversely affect tlae subject property; the subject is free from entxoachmenl a easement violations, the subject is structurelty sound and free of wood-0eslroying organisms, tltat no undisdosed a noted deterred maintenance a detrimental condition of swcture, site or components exist, That the information gathered from aN data sources is reliable and accurate; that no spectal assessments or tax districts exit that were not disclosed and that the presence of arty spedal tax districts does not effect the subject's market value and marketability, and, that no additional faders exist that were not apparent or discbsed al the fens of the inspection that could affect the appraiser's opinion of market value. It is furttrer assumed that no unusual environmental hazards a site conditions exist that would be detrimental to the property, the improvements, a the occupants of the shuctures. USE OF DIGRAL SIGNATURES: The definition of signature in a signed certification under USPAP is as follows: SIGNATURE ^ personalized evidence indicatlng authenticafion of the work performed by the appraiser and the acceptance of the responsibility for content, analysis, and the conclusions in the report. Comment: A signature can be represented by a hand written mark, a digkized image conlrolbd by a personalized idantiflcadon number, or other media, where the appraiser has sole personalized control of affbdng slgnaharo. (USPAP, p.4)DOOOMENT-PDF-SECURITY: The lender/client is to represent and warrant that the appraisal report was created by the appraiser identfied on the appraisal report and that the apprelsal report Is the complete and unaltered report submitted by the identified appraiser. If a report is'unlocked' all the infomtafion will become null and void and NO ONE should then rely on the report for ANY purpose LAND VALUE RA7T0: The Land Value Rath (LVR) is calculated by dividing the subject's site value (see cost approach) by the final market value estimate. LVR's in excess of 30%are possibly associated with the fofiowing condtons: t. premium price paid for lot with appealing characteristics such as gor course, preserve, a water views; 2. smaN residentlal acreage sites narmalty assoaated with renchette properties, PUD developments and manufactured housing txxnmunities; 3. depeaelng value of improvements an a site of increasing value; 4. a limited suppty of building sites witlrin a madret area wtlh an increasing demand for such sites. COST APPROACH (Pg. 5, Cert. 4): The cost approach is typically utitzed when improvements are new, near new s are of an unusual construction method. This approach's onty considered appropria~ when sufficient land; building sites, etc. are available b a potential purchaser so as to make txxrshuction of Impovements elrtdlar to the subject, a viable alternative to purchasing the subject. In areas where vacant sites (similar to the subject property in bcafian, zoning, use and utility) are rat available to a potential purchaser, use of the cost approach and reliability as the same as a value indicator could be misleading. When the Cost Approach is not deemed necessary in the development of a reliable value operion, d was excluded and sudr exdusiat has been so stated with the body of the report. The Cost Approach is not applrable for this appraisal due to the age of fhe subject, lade of reliable vacant land sales and the high degree of imprecdsion inherent in estimating elements of Physical, Functional and Extemel depredation fs homes more than 5 years dd. In the appresser's judgment, any estimate of the subject's value pursuant to the Cost Approach would be highty unreliable and might be misleading. Additionafiy, the surrounding area is tulty developed end adequate land sales are rat avagable fa anatysis. The Cost Approach was inducted at the request of the diets but is not gven any weight s censideration in the final value cendusbn. If the cost approach was used ft represents the 'replacement cost estimate; and is fa valuation purposes oMy. " If the cost approach was presented, a service such as'Marshati 6 Swift' (a similar source) was used to devebp the estimate. The site value opinion is based on one of several methods: extraction, allocation, the developmental metltod a from a review 6 analysis of sales of similar sites within the market area. INCOME APPROACH (Pg. S, Cert. 4): The income approach is typicaly utigzed when sufficient invests owned properties exist with the subject's immediate area a neighbodtaod and when investors regulady acquire such properties that are equally desirable to the subject for the express purpose of the incenre they provide. Whie rentals may exist in any area, their presence abne should not be considered as proof of a viable rental a investor marketplace. As such, in areas dominated by'owner occupied' units, tl may be inappropriate to employ the income approach, unless the approach Beady represents the motivations and actions of investors in the marketplace as it relates to the subject property and immediate area. If the approach is inducted witlrin the report, fi was because sufident data was found to support conclusions by the appraiser(s) that fi was appropriab and meaningful b the anatysis and value opinion. If the approach was not included, fi was the appraiser's opinion that the data was msuffiaeM to provide a useful and meaningful conclusion. Sigmbxe Name Kara L.-Sedlak Dad Signed August 03.2009 State CerUIlCadon # St.Cert.Res.Rea.RD7303 State FL Or State License # State SigreWre Name Data Signed _ State Caldiradon # Or State Ucense # form TAOD2- •WInTOTAI• appraisal software by a b mode, inc. -1-801}ALAMODE Uniform Residential Appraisal Report Fle# 2618y The d this sunera 'sal d is to rovde tle kndsldsll with an accurate and a su rkd, o Idon d tle madcel value of the sub'ed Address 3752 Foz Dale Lane CI Holida State FL Za Code 34691-1342 Bartdws N/A Owrer of PUfNic Recofd Ste ha Tace Gou Pasco Desc flat Beacon uere Untt 11-B Pb 9 P 89 Lol 1328 or 468 P 143 Assessa's Parcel # 24-26-15-0800-00001-3260 Talc Year 2008 R.E. Taxes S 1 475.00 Nsnle Beacon care Aia Reference S24 T26 R15 CenSas Tract 0304.02 Owvrs Tsera Vacant S sal Assessmsas S 0.00 PUD HOA E 0.00 r rtedh RI iced Fee Leasehdd 01sr descdhe As T PudeseTrarsacdm RellrranceTransactim Oder describe FairMerketValue Lands sad Law Offices of Peter J. Russo P.C. Address 5006 E. Trindb Road Suhe 100 Machani bu PA 17050 Is die s c odered to sak a has h been odered to sak in the twelve months ' r to the edectlve dare of tNs a relsal? Yes Na data 50aCe S used s and date S . Local multi b listi servbe ublic records and coon records. I ^ did ®did not areryu the tassel fa sak is the subkct gachase transactlan. Er~lain the results d the analysis of the cordrect to sak a why the anatysis was not amen. FMV Contrail Pdce S FMV Dale of Cadrad N/A k tle seller the owner of obit record? Yes No Data Souroe s NIA Is dere arty financial assistance (ban charges, sak caccesskns, pelt a dowryaymsd assistance, etc.) to be paid by any party on behalf nt Me borrows? ^ Yes ^ No B Yes n the total dour amoud and ~scdbe the ttars to ce ad. 0"00 N/A t1ae:Raeeertdtlteradd tithe laatwodenrrot fuetaa. . = ~3M, T~mk i- one-uNC aYea.Kl.na[lae% Loeetiorl Urban Suftlafen Rural Pro Vases Increas Stable Decid PRICE AGE One•Untt 95 % BuAI Over 75% 25-75% Under 25% DensrndrS Shorts h Balance Ovs Su S Bog 2-0 UMt 1 % Growtll d Stable Sbw Marketl Time Urds 3 mMs 3-6 mtls Ova 6 mtls 23 Low 03 Multl-Farm 1 % ' hbahood Boundades North Trouble Creek Road South Dark ton Road West b Streuber 275 Hi 45 Commercial 2 % Memorial H' hwa Fa1at b US 19. 67+/- Pred. 30.40 Otler 1 % Dasai ' Market area consists dmari of s' farm residential Fausi . Constnxtbn main) wncrete bkxklstucco and frame. Stnxtures and sttes to be well maintained. Ne' hbori commercial Interests are rimarl retell torweMeM stores small offaes and rofessbnal ractices. Fan tint schools rks recreational fatttides and ma'or trans nation are ail w4dlin dose rodm Atarkat Condlias to the dove concNisioes P values have declined after 2-3 err riod of re 'd increases coo led wtth a sknvdown in gabs have bed irneMOrias to near 2 err s levels in some area causl increased market) times and dowmrerd ressure On ask' rites with some seiers offers concessions ardlor b r iraentives. Oimasias 70 x 85 FTIMOL - No Su Prov. Ives 5 950 S .Ft. She a Recta ular View ResidentiaVA ' lull Cksstlicadon00R4 Zo Desc tbn S" le Famil Residential tai arnce L Nonceniami Grendfathered Use No 2orli al desalbe k the t and best use d sub' t as i veil or as sed sands idcatlors tle tint use? Yes No B No, descdbe UIMtln Pimlk t)acerlduaMl PcdNe pher(tleteribe) ON-eb rovecneMe-T PubBC PrNeN Elechic' Waft Street Paved As haft Gas None Selih Sawar None FEIAA $ Fbod HeZSd Area Yea ND FEMA Food Zone B FEMA M # 12023003350 fEMA NW Date 3115/1984 Are tle ui'tltles and elf-stte to tle market area? Yes No B No describe Are tlere adverse site axd%as a endamel hctas easemarlls, encroarJrneds slvironmslml caditlorls, Isrd uses, ale. ? Yes No d Yes, descdbe No unfavorable easements enaoachmerds a adverse cord'dbns rated at time of ins bn. The flood zone shoukf be determined more accrrate with an elevations . No adverse erwironmer481 rand' bre were noted at time M ins ion. The a miser is not a ualified ernkonmental a n. tiMfral - , ~ ~ . 'EklMlef gala/rAndNbq ~(IMMbE Urns Ore Ore vdlh lMt Conaete Slab Crawl S ce Foundatlon Walls Con.sWb/A Fbers C t!v A # of Skrks One Fua BaSemad Partlal Basarsrd Eakdor Weis Con.BIWF.Ro A Walt D IUPlester/A T Der Atl S-DalErd UNt Basement Arce N/A .tt. Roof Surface C.T1ie/A TdmrFdsh WoodlA Fidstl eel IAds Cora Basemem finish NIA % Cutlers 8 Downs uls Aluminum/A Bath Fbor Ca VA RandJA Ou6tide E /Felt Sum Pu Wadow T e Jabusie/A Bath Wainscot Tile/A Year Buitl 1989 Evidence of mkstatlon Skrm SasMrsukted AIm.Awni A Car Stag None ENecdve A rs 20 Da ness SeWarlad Saeens FuNA Ddvewa # elf Cars 1 Attic Nale Fkatl FWA Fi1V88 Radiard Amaides Woodstove s # Ddvewa Surface Concrete ltro Stale Stales Otler Fad Electric fl kce s # Fence Chain link Gera # al Cars 1-CAR Roar ScNtle CooN CaNal Ak Cadido Patlo/Deck Scm Perch O NCvd Ca # of Cars Rnished lkakd fMiWdual Otler WaIUuM Pod OBIS Att. DeL Bulb-In antes Refd rata en pshwasher Dis I Mkrawave Washer r Oder describe Fnli6lled area shove rode camains: 6 Roars 2 Bedrooms 2 BaN s 1306 uare Feel of Gross LNi Area Above Grade Addiional teabae5 S 'al elfiaera itsns tile.. The sub'ed has an o Ncovered rch screen atio s rink r s rem chain link fence and an ettacf>adl~ar era Desabe Ife cadidon of de mckdin needed ins, dekdoralbn reravations remodein tilt.. The sub ect is in avers a condition. The utildbs were on at time of ins edion. Are dare a scat detkiscdes or adverse condifbrs dst affect tle fnaW , soundness, or structural led of the ? Yes No B Yes, descdbe The sub a errs a be M stnadnrrel wnditbn. No furational or eMemal obsolescence observed. Ones die Cdllontl to the rd decd rctlanal lb le, cad"Non, use, comtrottion, etc. ? Yes No I1 No, descdbe The sub'ect ro coMOrms and is tom fable to to die ne' hborraod. Freddk Mac Form 70 March 2005 Page 1 of 6 Fannie Mae Fomn 1004 March 2005 frorm 1004 -'WinTOTAL' appraisal sdlware by a la mode, inc. -1.804ALAMODE Uniform Residential Appraisal Report ~,. ~R RY There are 64 co table es c oNeed fa sob in tle sub' nd 1~odg od in a from E 41 000 to E 129 000 There are a5 co table sales ht Ble sub' wirin the i MveNe ngntl ts i in sob rice from S 45 000 to S 70 000 FEATURE SUSIECT COMPARABLE SALE # 1 COMPARABLE SALE # 2 COMPARABLE SALE # 3 Address 3752 Foz Dale Lane 3708 Greyton Drive 4021 Cashmere Drive 3823 Cheswick Dave HoBda FL 34691-1342 New Port Riche FI. 34652 New Port Riche FI. 34652 Holid FI. 34691 to C ' 0.57 miles N 0.78 mibs NE 0.38 mlbs N Sob Price E F ~ " ~" " S 70 000 ~ ° ',^ °'" E 65 800 = ' : E 60 000 Sob Pdceltrass Llv. Ara S s .tt. 65.54 .h '~ - ?' ~ S E 61.61 s .tt a; S 82.78 s .h. Data Spate s '-: MBs #7389448 Mls#7380567 Mls #7409414 Ver#katkn Sarre S Public Rec Ext Ins action Public Rec Ext Ins action Public Rec Ext Ins ectfon VALUE ADJUSTMENTS DESCRPTgN OESCRPTgN + - E Ad smrere DESCRPTpN + - E Ad' stored OESCRPiHN! + - S Ad smterd Sales a flnarrcNrB -. New FHA All Cash New Conv Conassials T kal T ical T ical Date d SaleJRme ozteros cam oaratroe crowed asneroa cwsea Lxadon seams uerNA usdA urdA a ueNA Leasdlold/Tee SI b Fee Sim b Fee Sim b Fee Sim b Fee Sim b Site 5 950 .Ft. 5 525 sf/mot 5 100 sNmol 5 481 sf/mot New Residert0aVA ResideMiaVA ResideMiaVA RasidentiaVA Des RarziYA RarzAtlA RaraIVA RaraNA M Canstructbn Con.Bik/A Con.BIk/A Con.BIk/A Con.BIWA Actrral a 40 ors 38 ors 38 Years 41 ors Caraitlon Ave a Ave a Aver Aver e Above Grade Trial Berms. Batlis ides Brims. Gals Teel Brims. Balls +2 000 Trial Bams. Batlu Roan Count 6 2 2 6 2 2 6 2 1.5 5 2 2 Gross UN Area 1 306 s .ft. 1 068 s .tt. +q 760 1068 .tt. +q 760 956 s .tt. +7 000 BaSelMad 8 flNstkd None None None None Roans Bebw Grade None None None None Fralctlone 1118 Ad oats Ad oats Ad oats Ad oats OOf WalWnitlRadieM Cemrat ~ -5 000 Cemral -5 000 Central -5 000 Elflcied bens Ebc Fens Ebc Fans Ebc Fans Ebc Fans Ah i-Car Gar Ad 1-Car Ger Att 1-Car Gar Att 1-Car Gar PoadVPa8W0ack O NCvd oroh O NCvd h O NCvd oroh O NCvd orch Screen Pa0o Screen Patio Encl Patio -1 000 Eral PaBo -1 000 O n Patio +1 500 None None None Nana None Nona None None None Net Ad' shnem oW + - E -1 240 + - E 780 + - E 3500 Adjusted Sob Pdte Na Adj. 1.8 % Net Adj. 1.2 % Na Adj. 5.8 % of C abbe ~"~~ . ,.. floss Ad'. 15.4 % E 68 760 Gras$ Ad . 19.4 % $ 68 560 Gr0.4S Ad'. 22.5 % $ 63 500 I did did not research ihE sob a transfer of the su o and t sales. B not, sin PublicyCoun records indicate that the sub'ect ro has no ualified transfers in the 36 months riot to the effective date of this a sisal re rt. researoh did di0 pat reveal ~ r sales or transtes ai the sub' ro fa the three ears dot to dw eNeclNe date of tlYs sisal. Dale Space s Mb Pub8c/Co records. Realist research did rid ar revel r sales or transfers d the c table sales to the ear to the dale of sate d Ble c arable sale. Gala Space S Mls PubBcyCo records. Realist fife resuKs of tlw research and a sb d the sale or trelsla hislo of tlc sub' t and c sees addi0onal dot sales on e 3 . ITEM SUBJECT COMPARABLE SALE a`1 COMPARABLE SALE #2 COMPARABLE SALE a'3 Dab of Pda Sab/Trersfa October 1969 December 1989 Me 1997 March 2004 Price of Prbr Sale/Trensfa 16 700 3000 4500 $0 u8claim deed Data Spaces Pu RecalRealbt Pub RecslRealbt Pub RecslReal'st Pub RecslRealist Egecdve Date d Data Sources Jul 30 2009 Ju 30 2009 J 30 2009 Ju 30 2009 sis of 'a sale a transfer Nst d the sub' all re table sales The sub ea ro is rat current listed and has rat bean listed in the rt 12 months rbr to this a sisal re rt. The sub act slaws no ualified sale or transfer wBhin 36 months riot to this a sisal re rt. Coin 's #1 and #3 coin rebb's record Indicate no ualBbd trenslars w8hin 12 months riot to this a sisal re ort. Ses AddRbnal Comments. Su d Sales C rison ch In err at a 11na1 vat all sobs were iven ual considereUon and are deemed reliable indicators of value. All of the sales are boated in the sub'ect's market area Beacon uare . The a raiser was unable to find coin table sales whhin 6 months cbsed sobs riod with ra central heat and ak aAho h k b not uncommon in t sub'ed's market area. Coin 's #1 #2 and #3 are rat short sales a bank owned. Bank owned and short sales make over SOYo of the sub'ect's market area and are creati dowrnvard ressure on sales rites. Ad'ratments were made accordi in the rid above.Tlve sub'ed k tom stable w8h the ne hborhood. Sea Additlonal Comments. Indcabd Veue b Saks Co on ch E 84 000 bdir~d VNue .Sets roach; 84 000 Coat A OI devdo I S 118159 Incase roach (B d ~ S NIA Botlr the costa roach and sales tom rkon a roach were used in [he final reconciliation of value. The most wa' ht was iven to the sale's tom orison a roach in the final recortdlbtbn of value in this a sisal re TMs appraise is made ®'as is', ^ subject b axrpb8on pe plans and speciflca8ors on the basis of a hypodldical condlBon that the improvenlerls have been cmgbted, ^ subject to Bre fobatnq repairs a aBeatlars a the basis cl a hypolhetiral condAian that the repairs a ahea8ore have been completed, or ^ subject b the talowl r uked Errs traced m rile eeraaai assu on that the conddion err de0cfenc does not dre a8aatlon a Ir. No ersonal ro b included in this re .Lot dimensions are not uarerdeed 'd curve brat roWdetl. rry~ ere d~efmof the rat ro ~ of wok, ataFemeM of aaeumpUona end limiting one apprs~ i ~~ mtr jour) opiniar market value the wb(ect o} thta re ort b ~ , , p E 64 000 aof Ju 30 2009 whkh b the deb of in ion and the eNecBVe desk u Freddie Mac Fonn 70 March 2005 Page 2 of 6 Fannie Mae Form 1004 March 2005 Form 1004 -'WinTOTAL' appraisal software by a la node, inc. -1-B00•ALAMODE tlntfform Rlesidential Appraisal Report ~.. ~F~ 'Ne Morhood" -The su 'ect ro is a 1-st ranch si b faro residerae located in Beacon uare in Hdida Fkxida. The sub'ect b within 5 miss of US 19 GuB of Mexico Beacon uare Park GuM Harbors GON Course Howard Co Perk and North ea Medical Center. Market data s eats a dedld marital b 30% wittin tits st 12 montlu wBh a ore Ume of three to six months on awn e. Su and demand indicates an over s of homes. There are irrlial s' ns of stabiization as the level of dedine has decreased s' nifirre with oM minimal amount of comectbn reaazed over the rovbus several months. Addi[bnal market comectbn is sdll aMld ated in the future market conditions conclusions were ar rt based n the ana b of the median sales rites of tom tl ro r8es In the sub'ecl overall market area as weN as market condtions anal ~s of selected aired sales. Anecdotal market data relewM ecoramk indk:elors as well as discussion wih bcal reel estate rofessbnals. "SaNs Com orison" - All tom amble's utiN~d are kxated in the sub'ecCs market area Beacon uare . It Is the a raiser's o inion that the tom ambles used in this a sisal ro rt are the most rollable indkatore of wlue awilabla that are similar in total ste area total livi area des' n a el a e view and amertUes. The sub'eG does not haw central heat and AIC. The most we' M was iwn to the sale's tom risen a roach in the final reconcliatbn of wlue in this a mLsal re rt. "PUD bfortnatbn" -The s ~ed is rat a member of a HOA homeowners association. "Marketab " - The su 'ect is in aver a cordiion and has ra adverse or alive effect's on the marketab li of the su 'ed ro .There are minor deferred maimenance issues such as' the Master bedroom ceili has a haitine crock. No deductbn deemed warranted but was wnsidered in the final reconciliation of wlue. "Coro arebMs: Da on Market" Information obtained in kxal Mls. est Pasco Board of Realtors Coro . #1 on .listed for 79 900 on 12118108 and cbsed on 2/16/09. Dom 60. Coro . #2 on .listed for 84 900 on 10118108 and dosed on 3131/09. Dom 164. Coro . #3 od .listed for 90 000 on 516/08 and a 'red on 4/30109. Active for 000 on 511109 and dosed on 6!18109. Dom 408. Coro . #4 0 ' .listed for 109 900 on 7/22/08 and reduced sewml times to 79 900 on 2/2/09 and Gosed on 4/3/09. Dom 255. "Hbto of Sub M Pro "The sub'ed is rat listed and has rat been listed in the ast 12 months rbr to Nis a Taal re ort. The su ~ect shows no ualified sales or tmrtsfers 36 morths ' r to [his a else! IWe ,,.. Provide to irdormaBon to the krder/dlent to eta Bia bebw cost ores and cakvmtlals. Su fa the n 01 stle vakre su d c lad Sales a opts rleBlods for estl SI$ VBUB Land wlue s damred irom market extraction and recent tom arable sales in the sub'ecPs market area. ESTIMATED REPRODUCTION OR REPiACEAENT COST NEW OPWON OF SITE VALUE------------------.._...__---------_--------- =S 18000 Source of COST data Marshall and SwiftlBoeckh LLC DWELLHG 1306 S .ft. S 95.57 ..........._ =S 124 814 Oua ratl from cost servke A EBectlve dab d coal data 06/2009 N/A S .H. S _........... =E Comments on Cost A ch s area calcl4tlora, iatlar, etc. =S Estimated re IacemeM costs were darkred from Marshall and Swift. Gard a 513 S .F1. S 24.t 1 ._____ =S t2 368 Tohl Estlmate of COSt•rkw ------------- =S 137 182 'AS-ls" value of she im rowments irtdudes chain link fares drivewa concrete waNCwa and landsca i Less site! FuncBonal Exterul reclatlon 45 723 =S 45 723 ed Cast of I - _______ =E 91 459 'As-IY Value of Stte I rmleBS ......._._...------.....--------------..---. =S s 700 Estimated Remalri ECOIgrtiC Life UD arid VA o 40 Years NdNCATED VALUE BY COB'T APPROACH ............................................ =f 116 159 P, . APPpOAtfltltlY ~ MN)~: Estimated M Market Red S ND X Gross Rerd a ND = S ND ~ Indkated Value Income roach Summa of Intone ach includi su to market red end GfAt See of work. . ti , ~ .. Is the de r/builde in control of Ble Homeowners' ASSecIaWn ? Yea No Udt s Demched Attached Provide Bra fdbwl hdomalion to PUDs Oftl_Y H the Nulke Is in control of Ba HOA ant tla sub' t is an attached dwetln unlL L I Name of Pro d Total raxn6er al ases Total nunbe of arils Total numher of untts sold Total rarmbe of uNts rented Total nurba d arils for sak Data source s Was the ro' ct created b the camersion of ads drid' s Into a PUD? Yes No B Yes, date d comerslOn. Does Bre o t codain a muXi-dwell unBs? Yes No Data Source Are Bie units, commn elenwms and recrealbn facilBes ? vas No B No, describe tla status of c ~ n. Are the corranon ekmerss leased ro a b the Honaoalies' Associatbn? Yes No tl Yes, describe tlw rental terms and Describe common elements and reaeatlonal fadltla. Freddie Mac Form 70 March 2005 Page 3 of 6 Fannie Mae Form 1004 March 2005 Form 1004 - NYInTOTAI' appraisal sotteare by a la mode, inc. -1-B00-ALAMODE Tarov unnorm rtesiaerma~ This report form is designed to report an appraisal of a one-unit property or a one-unit property with an accessary unk; including a unk in a planned unk development (PUD). This report form is not designed to report an appraisal of a manufactured home or a unk in a condominium or cooperative project. This appraisal report is subject to the following scope of work, imended use, intended user, definkion of market value, statement of assumptions and limiting conditions, and certifications. Modifications, addkions, or deletions to the intended use, intended user, definition of market value, or assumptions and limiing conditions are not permitted. Tha appraiser may expand the scope of work to include any addtional research or analysis necessary based an the complexity of this appraisal assignment. Modifications or deletions to the cert'rfications are also not permitted. However, additional certifications that do not constitute material atteretions to this appraisal report, such as those required by law or those related to the appraiser's continuing education or membership in an appraisal organization, are permitted. SCOPE OF WORK: The scope of work for this appraisal is defined by the complexity of this appraisal assignment and the reporting requiremems of this appraisal report form, including the following deflnttlon of market value, statement of assumptions and limiting conditions, and cerirficatons. The appraiser must, at a minimum: (1) pertortn a complete visual inspection of the intertor and extertor areas of the subject property, (2) inspect the neighborhood, (3) inspect each of the comparable sales from at least the street, (4) research, vedfy, and analyze data from reliable public and/or private sources, and (5) report his or her analysis, opinions, and conclusions in this appraisal report. INTENDED USE: The intended use of this appraisal report is for the lender/cliem to evaluate the property that is the subject of this appraisal for a mortgage finance transaction. INTENDED USER: The intended user of this appraisal report is the lender/client. DERNRION OF MARKET VALUE: The most probable pdce which a property should bdng in a competitive and open market under all candtions requiske to a fair sale, the buyer and seller, each acting pmderdry, knowledgeably and assuming the price is not affected by undue stimulus. Implick in this definition is the consummation of a sale as of a specified date and the passing of tkle from seller to buyer under condtions whereby: (1) buyer and seller are typically motNated; (2) both parties are well informed or well advised, and each acting in what he ar she considers his or her own best interest; (3) a reasonable time is allowed for exposure in the open market; (4) paymem is made in terms of cash in U. S. ddlars or in terms of financial arangements comparable thereto; and (5) the prce represems the normal consideration for the property sold unaffected by special or creative financing or sales concessions' granted by anyone associated with the sale. 'Adjustments to the comparables must be made far special or creative financing or sales concessions. No adjustments are necessary for those costs which are normally paid by sellers as a resuk of tradition or law in a market area; these costs are readily identifiable since the seller pays these costs in virtually all sales fransactions. Special or creative financing adjustments can be made to the comparable property by comparisons to financing terms offered by a third party institutional lender that is not already involved in the property or transaction. Any adjustmem should not be calculated on a mechanical dollar for dollar cost of the financing or concession but the dollaz amount of any adjustmem should approximate the mamket's reaction to the financing or concessions based on the appraiser's judgment. STATEMENT OF ASSUMPTIONS AND LIMITING CONDRIONS: The appraiser's certification in this report is subject to the following assumptions and limiting conditions: 1. The appraiser will not be responsible for matters of a legal nature that affect etther the property being appraised or the tkle to it, except for information that he or she became aware of during the research involved in pertortning this appraisal. The appraiser assumes that the title is good and marketable and will not render any opinions atrout the title. 2. The appraiser has provided a sketch in this appraisal report to show the approximate dimensions of the improvements. The sketch is included only to assist the reader in visualizing the property and understanding the appraiser's determination of its s¢e. 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 this appraisal report whether any portion of the subject ske is located in an idenfrfied Special Flood Hazard Area. Because the appraiser is not a surveyor, he ar she makes no guaramees, express or implied, regarding this determination. 4. The appraiser will not give testimony or appear in couR because he or she made an appraisal of the property in question, unless specdic artangemems to do so have been made beforehand, or as otherwise required by law. 5. The appraiser has noted in this appraisal report any adverse condtions (such as needed repairs, deterforation, the presence of hazardous wastes, toxic substances, etc.) observed dudng the inspection of the subject property or that he or she became aware of during the research involved in pertorming the appraisal. Unless otherwise stated in this appraisal report, the appraiser has no knowledge of any hidden or unapparem physical deficiencies or adverse conditions of the property (such as, but no[ limited to, needed repairs, deterforadan, the presence of hazardous wastes, toxic substances, adverse environmental conditions, etc.) that would make the property less valuable, and has assumed that there are no such conditions and makes no guaramees or warranties, express or implied. The appraiser will not be responsible for any such condtions that do exist or for any engineedng 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, This appraisal report must not tie considered as an environmental assessment of the property. 6. The appraiser has based his or her appraisal report and valuation conclusion for an appraisal that is subject to satisfactory completion, repairs, or alterations on the assumption that the completion, repairs, or akerations of the subject property will be performed in a professional manner. Freddie Mac Form 70 March 2005 Page 4 of 6 Fannie Mae Forth 1004 March 2005 Fonn 1004 -'WmTOTAL' appraisal sdhrare by a la mode, inc. - t-8l1aALAMODE To Uniform Residerrtlal Appraisal Report Fkx 2618 APPRAISER'S CERi7~ICATION: The Appraiser certifies and agrees that: 1. I have, at a minimum, developed and reported this appraisal in accordance with the scope of work requirements stated in this appraisal report. 2. I performed a conglete visual inspection oT the interior and exterior areas of the subject property. I reported the condition of the improvements in factual, specific terms. I ident'rfied and reported the physical deficiencies that could affect the livability, soundness, or structural integrity of the property. 3. I pertonned this appraisal in accordance with the requirements M the Unfform Standards of Professional Appraisal Practice that were adapted and promulgated by the Appraisal Standards Board of The Appraisal Foundation and that ware in place at the time this appraisal report was prepared. 4. I developed my opinion of the market value of the real property that is the subject of this report based on the sales comparison approach to value. I have adequate comparable market data to develop a reliable sales comparison approach for this appraisal assignment. I further certity that I considered the cost and income approaches to value but did not develop them, unless otherwise indicated in this report. 5. I researched, verified, analyzed, and reported on any current agreement for sale for the subject property, any offering for sale of the subject property in the twelve months prior to the effective date of this appraisal, and the prior sales of the subject property for a minimum of three years pror to the effective date of this appraisal, unless otherwise indicated in this report. 6. I reseazched, verified, analyzed, and reported on the prior sales of the comparable sales for a minimum of one year prior to the date of sale of the comparable sale, unless otherwise indicated in this report. 7. 1 selected and used comparable sales that are locationally, physically, and functionally the most similar to the subject property. 8. I have not used comparable sales that were the result of combining a land sale with the cormact purohase price of a home that has been built or will be built on the land. 9. I have reported adjusbnerrts to the comparable sales that reflect the market's reaction to the differences between the subject property and the comparable sales. 10. I verified, from a disinterested source, all information in this report that was provided by parties who have a financial Interest in the sale or financing of the subject property. 11. I have knowledge and experience in appraising this type of property in this market area 12. I am aware of, and have access to, the necessary and appropriate public and private data sources, such as multiple listing services, tax assessment records, public land records and other such data sources for the area in which the property is located. 13. I obtained the inormaton, estimates, and opinions famished by other parties and expressed in this appraisal report from reliable sources that I believe to be true and correct. 14. I have taken into consideration the factors that have an impact on value with respect to the subject neighborhood, subject property, and the proximity of the subject property to adverse influences in the development M my opinion of market value. I have noted in this appraisal report any adverse conditions (such as, but nM limited to, needed repairs, deterioration, the presence of hazardous wastes, toxic substances, adverse environmental condhions, etc.) observed during the inspection of the subject property ar that I became aware of during the research involved in pertorming this appraisal. I have considered these adverse conditions in my analysis of the property value, and have reported on the effect of the conditions on the value and marketability of the subject property. 15. I have not knowingly withheld any sign'rficaM information from this appraisal report and, to the best of my knowledge, all statements and infomlatan in this appraisal report are true and correct. 16. I stated in this appraisal report my own personal, unbiased, and professional analysis, opinions, and conclusions, which are subject only to the assumptbns and limiting conditions in this appraisal report. 17. I have no presets a prospective interest in the property that is the subject of this report, and I have no present ar 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 opinion of market value in this appraisal report on the race, color, religion, sex, age, marital status, handicap, familial status, or national origin of ehher the prospective owners or occupants of the subject property or of the presets owners or occupants of the properties in the vicinity of the subject property or on any other basis prohibited by law. 18. My employment and/or compensation for pertomung this appraisal or any future or anticipated appraisals was not conditioned on any agreement or understanding, written or otherwise, that I would report (or present analysis supporting) a predetennlned specific value, a predetermined minimum value, a range or direction In value, a value that favors the cause of any party, or the attainment of a specific resort or occurrence of a specific subsequent event (such as approval of a pending mortgage loan applkation). 19. I personally prepared all conclusions and opinions abort the real estate that were set forth in this appraisal report. If I relied on significant real property appraisal assistance from any individual ar individuals in the pertormance of this appraisal or the preparation of this appraisal report, I have named such individual(s) and disclosed the specific tasks pertomted in this appraisal report. I certify that arty individual so named is qual'died to perform the tasks. I have not authorized anyone to make a change to any item in this appraisal report; therefore, any change made to this appraisal is unauthorized and I will take no responsibility for it. 20. I identdied the lender/client in this appraisal report who is the individual, organization, or agent for the organization that ordered and will receive this appraisal report. rreaaie mac roan ru nnarcn zoos Pago 5 of 6 Fannie Mae form 1004 March 2005 Form 1004- ~WInTOTAL• appraisal saflware by a la mode, Inc. -1-800•ALAMOOE T.ane„ uniform Kes~aermai Appraisal rteport ~,# 26,8 21. The lender/client may disclose or distdbute this appraisal report to: the borrower; another lender at the request of the borrovrer; the mortgagee or its successors and assigns; mortgage insurers; govemment sponsored enterprtses; other secondary market participants; data collection or reporting services; professional appraisal argan¢ations; any department, agency, or instmmentality of the UnRed States; and any state, the Distdct of Columbia, or other jurisdicfions; without having to obtain the appraiser's ar supervisory appraiser's ('d applicable) consent. Such consent must be obtained before this appraisal report may be disclosed or distributed to any other party (including, but not limited to, the public through advertising, public relations, news, sales, or other media). 22. I am aware that any disclosure or distdbutlon of this appraisal report by me or the lender/client may be subject to certain laws and regulations. Further, I am also subject to the provisions of the Un'rfonn Standards of Professional Appraisal Practice that pertain to disclosure or distribution by me. 23. The borrower, another lender at the request of the borrower, the mortgagee or its successors and assigns, mortgage insurers, govemment sponsored enterprises, and other secondary market participants may rely on this appraisal report as part of any mortgage finance transaction that involves any one or more of these parties. 24. If this appraisal report was transmitted as an "electronic record" containing my "electronic signature; as those terms are defined in applicable federal and/or state laws (excluding audio and video recordings), or a facsimile transmission of this appraisal report containing a copy or representation of my signature, the appraisal report shall be as effective, enforceable and valid as 'rf a paper version of this appraisal report were delivered containing my original hand written signature. 25. Any intentional or negligent misrepresentatton(s) contained in this appraisal report may result in civil liability and/or criminal penalties including, but not limited to, fine or imprisonment or both under the provisons of Tftle 18, United States Code, Section 1001, et seq., or similar state laws. SUPERVISORY APPRAISER'S CERTIFlCATI0N: The Supervisory Appraiser cert'rfies and agrees that: 1. I directly supervised the appraiser for this appraisal assignment, have read the appraisal report, and agree with the appraiser's analysis, opinions, statements, conclusions, and the appraiser's certification. 2. I accept full responsibil'dy far the contents of this appraisal report including, but not limited to, the appraiser's analysis, opinions, statements, conclusions, and the appraiser's certification. 3. The appraiser idenfrfied in this appraisal report is either asub-carrtractor ar an employee of the supervisory appraiser (or the appraisal firm), is qual'rfied to pertorm this appraisal, and is acceptable to perform this appraisal under the applicable state law. 4. This appraisal report complies with the UnNorm Standards of Professional Appraisal Practice that were adopted and promulgated by the Appraisal Standards Board of The Appraisal Foundation and that were in place at the time this appraisal report was prepared. 5. If this appraisal report was transmitted as an "electronic record" containing my "electronic signature," as those terms are defined in applicable federal and/or state laws (excluding audio and video recordings), or a facsimile transmission of this appraisal report containing a copy or representaton of my signature, the appraisal report shall be as effective, enforceable and valid as ff a paper version of this appraisal report were delivered containing my original hand written signature. APPRAISER Kara L. Sedlek Signature nw~ Name Kara?L Sedlak Comparry Name Jay Appraisals, Inc. Comparry Address 7251 Box Elder Drive. Port Richev. FI. 34668 Telephone Number 727-b46-tes9 Email Address Kam@1Jayappraisals.com Date of Signature and Report August 03.2009 Effective Date of Appraisal Julv 3d, 2009 State Certification # St.Cert.Res.Rea.RD7303 or State License # SUPERVISORY APPRAISER (ONLY IF REQUIRED) Signature Name Company Name Company Address Telephone Number Email Address Date of Signature State Ceramcation # ar State License # State or Other (describe) State # Expiration Date of Certification or License State FL Expiration Date of Certrfication or License t v3onoto SUBJECT PROPERTY ADDRESS OF PROPERTY APPRAISED 3752 Fox Dale Lane Holiday, FL 34691-1342 APPRAISED VALUE OF SUBJECT PROPERTY $ 64.000 LENDER/CLIENT Name Ashley R. Sipe Company Name Law Offices df Peter J. Russo. P.C. Company Address 5006 E. Trindle Road, Suite 100 Mecharicsbura, PA 17050 Email Address asipeQpirlaw.com ^ Did not inspect subject property ^ Did inspect exterior of subject property from street Date of Inspection ^ Did inspect interior and extedor of subject property Date of Inspection COMPARABLE SALES ^ Did not inspect exterior of comparable sales from street ^ Did inspect exterior of comparable sales from street Date of Inspection Freddie Mac Form 70 March 2005 Page 6 of B Form tlg4-•WmTOTAI• appraisal saltware by a b mode, inc.-1-a04ALAh10DE Fannie Mae Form 1004 March 2005 uniform Resider>tlal Aonralsal Report ~: z~ ay FEATURE SUBJECT Address 3752 Fox Dale Lane Holida FL 34691-1342 COMPARABLE SALE #4 3679 Rockaway Drive Holkfa FI.34691 COMPARABLE SALE #5 COMPARABLE SALE #6 Prod to Sub cl Sala Price Sale RicelGross Liv. Arw Data Source a E FMV E s .tt. - 0.77 miles NW - E 82900 E 40s5 s .n. Mls#7356112 S E s .n. - ' E E s .tt. VerMicadm Sources VALUE AD~AISTMENTS DESCRRTION Publk Rec Ext I DESORPTION ' n + - S Ad' DESCRIPTION + - S Ad' DESORPTION + - S Ad' smreM Saks a flnancirq Carcessials New Corry T kal Date of SakRme Locatbn a ~a~n arosroe a wwn LeaseholdlFee S k Fee Sim W Fee Sim Sne 5950 .Ft. 5950 .Ft. Ylew ReskfentiaVA ResidertiiaVA Desl n S b RarrchlA RarxJUA of CoreWctbn - Actual A e Con.BIWA 40 rs Con.BIWA 37 Years CondiBon Averse Ave e Above Trial Bdrms. Bahl Trial Brims. Bates Trial Bdrms. BaMS Trial Btrms. Bghs floanCoud 6 2 2 7 3 2 Gross Lid Area 1 306 .n. 1 536 5 .n. ~ 600 s .n. a .n. Besemad 8 fldshed Roars Bebw Grade None None None None FurrcBonal UBI tbaB Coda Ad oats WalluniURadiant Ad oats Central -5000 E Effkierd I[ems Gera Elec Fans Att 1-Car Gar Elec Fans None +3 000 PorcfVPatlo/Deck O NCW rch O NCvd rch Screen PatlB Screen Path Screen Patb Nen6 None Net Ad' slnlem oml None Nona None None + - S a + - S + - S Adjusted Sab Price Net Adj. 10.5 % Net Adj. % Net Adj. % or c atlas Groaa ad'. Zo.o x s 56 300 Groaa Ad'. % s Groaa Ad . % E R rl the resWm of the research ant an is of the or sak a transfer of Ble su ' and c ebb sobs addBonal 'a sales on 3 . ITEM SUBJECT COMPAW~BLE SALE # 4 COMPARABLE SALE # 5 COMPARABLE SALE # 6 Date of Prior SaklTransfer October 1969 Janus 2005 Price of Rbr Sak/Transfa 16 700 114 900 D~a Sources Pub Recs/Realist Pub RecslRealist ENeclive Date of Dam Sources Jul 30 2009 Ju 30 2009 Aro sis of rbr sak a bansta Nst of Ble sub'ecl xd c sales The sub'ed ro is not curve listed and has not been listed within 1 months rior to this a sisal re .The sub~ecCS records indkate no ualified transfer within 38 months rior to Otis a reisal re rt. Com rwi has ro uaAfied sales a transfers within 12 monOts rior to O~ a sisal re rt. Ana Is/CamlBraS Com #4 is kxated in the sub ed's knmediate market area eeawn S uare. Com #4 isa short sale. Com #4 was added to furthers rt the value of Ore sub'eax ro Freddie Mac Form 70 March 2005 Faatie Mae Form 1004 March 2005 Fonn 1004.(AC) -'WinTOTAL' appraisal scllware by a la node, Inc. -1-80QAtAM00E Tacey Market Conditions Addendum to the Appraisal Report ~~,, zs16 The purpose d tlrs addeMurl h to provide thelender/dkN with a clwr and actuate u~derstandirq d the market treMs and condNims prevaleN in the subject . TNs is a addendum fw aN sal re wdh an elf¢cpve date an w aper dl 1, 2009. Pro Address 3752 Foz Dale Ln C Holida State FL ZIP Cade 34691-1342 Borrower N/A lndnretkru: The appraiser mid use the ktormatlon regtired on this form as the basis for fgslher contusions, and must provide support for those conclusions, regarding Iqusirg hells and ovdaN rrerket mndlpans as repotted In pa Ndghbahood sectlon d the appraisal report form. The appraiser must fiN in aN die information to the ederd h is avdkde all reNable and met provde analysts as Indlcakd below. N any regdred data Is unavaikbk err Is considered umdiabk, the appraiser must provide an agrmnatlort tt k recagrl¢ed gut oat aN data sources wN be able ib provide deb fw tlw shaded areas bebw; p tt is avaikde, however, the appraiser must include die data h the anaysis. tt dab saunas provide tlN regdred Idonnalion as an average irskad d tla median, pie appraiser should mpwt the available pgure and idedify h as an average. Sales and Nspngs oast be propeNes that compete wpb the subject properly, dekrmirad by appying Ole criteria pat waub be used by a prospective buyer d the su .The must an atkmllas b pie doh, such as seasdral markets, new canshucpon, forecbsures, eJC. Prlw 7-12 Morris Prior 4~ Merdhs Cured - 3 Modts Overall Trard dal # d C ode 26 13 6 bcreasi Stable DecNN Abso pon flare Dial Sales411oN1s 4.33 4.33 2.00 Increasi Stable DecNN Trial # d rode Acpve ' s 45 59 ,.. 64 Oec1 Stale Morals d Housl S oht LLSp Ab.Rak 10.a 13.8 32.0 Dell Stable Nrcreas MedinBeMlLW. DOI&Y/LYt% Rior7-12Mdtl6 Prtdr4{MaMs CumeN-3MoNhs OverdlTreM Medkn C bk Sob Price 57 250 57 000 83 000 bcreasi Stable OecNN Madan C bk Saks On Market 48 22 284 DecNN Stable flltfed$I NteAan Co noble List Rice 83 000 84 900 65 750 fro Stable DBCN Megan C noble Lis Da on Marled - 174 tt)g 122 Staple Nr:fces Medlin Sale Price as % d list Price 93.50 88.85 94.74 klcreasl Stable DscNN Sdar- er, builder, e0c. d flnancid assistance lent? Yes Nd DecNN Stable hrcreas' Firplain k detail pie sder concessions k'erds for pa past 12 mwdhs (e.g., sekr coruibutlons incrgsed from 3%to 5%, increasing use d buydowns, closing costs, condo fees, dc.. pis common fa seNar to contribute 3% to 8% in cbsi costs and re aids. FHA loans allow u to 6% for seller corrcessbns end ere ve common bans in rode s market. - Are forecbslre sales REO sales a lotto in pie marled? Yes No p n nckd' ps holds in 6 s all sales d forxbsed ro es . Alive active with cordraq ndi sales and cbsed sobs revealed over 50% of REO's all short sale ro anise make u the sub'ect's market area. Cik Bala souces fw above Ndwmation West Pasco Board of Realtors MLS o Summarlte pa above irdmnapon as srgpat fw your taxcksiors in pie Ndgfbahood sectbn d pre appraisal report farm. p you used arty addPoand idarmatbn, such as an are d erdi sales anNor eel and wNdrawn Nsp , k fwmdate r corcksias vide boll an kretbn and su rt for our concksiors. Active active with coMrect MI sales and ckased sales were upNted in Chia Torm. Pro rtias from 1000.1600 in Irvi area no ool no water view and wphln 1 mile of the sub'ed a was upiized in tlus form. pthe baunttinamrdoeiriumw ,txan the P Nerve: Sub' eel Doh Prior 7-12 Meals Pda 4-8 Mudhs CuneN - 3 Mona Overall Trend Tdhl # d tale Saks Sepled bcreasi Stable DecNN Role ohl Sddedllvlarats Increasi Stable DeGiN Total # d Actlve s Stabb horses Montle d Untt Su dal ~ Ab.flak - 8hde bcr~s Are forecbsure sales (REO sales) a faulty b tle proj ect? Y~ No pyres, itdkah pa numbs d REO Nsprgs and elglkin pre bends in Nspngs and sales d faecbsea es. Summarize tla above trends and address pa im d on pa su ' t uat and ' SI natare SI e iser Name Kara L. Sedlak S i A raiser Name Co Name Ja sisals Inc. - C Name Ca Address 7251 Box Elder Drive Port Riche FI. 34668 Co Address State LitensdCertipcaNon # sr.CertRen.Rm.RD73d3 Shk FL Stale LlcensdCertllkatlon # State EmaN Address Kare~.layappreisals.own Email Address rrawro mac ram r i marcn [ula Page l w l Fannie Mae Farm 10D4M(; MBICn 2W9 Form 10MMC2 -'WinTOTAL• apprasal software by a k mode, inc. -1-p04ALAMODE Subject Photo Page BorrowalClenl NIA Address 3752 Fox Dale Ln C Holide Cou Pasco State FL L Code 34691-1342 LendG Law Offices of Peter J. Russo P.C. Subject Front 3752 Fox Dale Lane Sates Pdce FAAV Grdss Lbing Area t,3oa Total Roans s ToW Bedroans 2 Total Balhroans z Location emm~,QUwa,~ VIEW ResidentiaYAvg SItC 5,950 Sq.Ft. ~Uaity Con.BlklAvg Age 40 years Subject Rear Subject Street Form PIC3x5.SR -'WInTOTAL' appraisal software by a to mode, inc. -1-800-ALAMOOE Subject Interior Photo Page Banower/CYeiq NIA f4 Address 3752 Fox Dale Ln Ci Holida COU Pasco State FL L Code 34691-1342 Lends Law Offices of Peter J. Russo P.C. Subject Interior 3752 Fox Dale Lane Sales Price FMV 6rossUringArea 1,306 Total Rooms 6 Total Bedrooms 2 Total Bathrooms z Locatbn a~xy~nre V8W ResidentiaVAvg Sete 5,950 Sq.Ft. QUaNty Con.BlklAvg Age 40 years SubjsfK Interior Subject Interor Farm PIC3x5.S1-1gInTOTAL• appraisal software tY a la mode, inc. -1-8lXFALAMWE Subject Photos BorrawelCkrd NIA Pro Address 3752 Fox Dale Ln C' Holida Cau Pasco State FL L Code 34691-1342 Lender Law Offices of Peter J. Russo P.C. Subject Interior 3752 Fox Dale Lane Subject Interior Screen Patio Foan PIC3x5.TH -'WinTOTAL' appraisal sotlware by a la made, inc. -1.80QALAMODE Comparable Photo Page BOnOwer lent NIA Pro Address 3752 Fox Dale Ln Ci Holida Cou Pasco State FL D Code 34691-1342 Lender Law Offices of Perer J. Russo P.C. Comparable 1 3708 Grsyton Dmre Prox. t0 SUbjeCt 0.57 miles N Sale Pdce 70,000 Gross living Area 1,068 Total Rooms 6 Total Bedrooms 2 Total Bathrooms z Location BaxmWuare/Aq View ResidentlaVAvg Sde 5,525 sf/mot ~Ualdy Con.Blk/Avg Age 3a years Comparable 2 4021 Cashmere Drive Prox t0 Subject 0.78 mibs NE Sale Price 65,800 Gross living Araa 1,068 Total Roans 6 TOW Bedrooms 2 TOW Bathroans 1.5 Location eaemnaqurelAq Yew ResidentiaVAvg Site 5,100 sf/mot t]ua6ty Con.BIWAvg Age 38 nears Comparable 3 3623 Cheswick Drive RWL t0 SUbjeCl 0.36 miles N Sale Pdce 60.000 Gross living Area 956 Total Rooms 5 ToW Bedrooms 2 Total Bathrooms 2 LOCatlOrl BexansquadAq YeW ResidentiaVAvg Bde 5,481 si/mot lleagly Con.BlklAvg Age a1 years Fam PtC3r6.CR -'WinTOTAI' epprdisal SeOware 6y a h mode, inc. -1-800-ALAMOOE Comparable Photo Page BOnOwer/Ctlen< NIA Pro Address 3752 Foz Dale Ln C Holga C Pasco Slate FL D Code 34691-1342 Lends Law Ofices of Peler J. Russo P.C. Comparable 4 3679 Rockaway Drnre l'rax. to Subject 0.77 miles NW Sales Pdce 62,900 Gross Liarq Area 1,536 Total Roorts 7 Total Bedrooms 3 Total Bagraoms 2 Location BeemnaquaMA~g Yew Residen6aVAvg Site 5,950 Sq.Ft. Oualily Con.Blk/Avg Age 37 Years FOan PIC3z5.CR -'WinTOTAL' appraisal sogware 6y a la mode, inc. - t-BIXFALAMODE Building Sketch BORewsi/CReat N/A Pro Address 3752 Fox Dale Ln Ci Holida C Pasco State FL 21 Coda 3469 7-1 342 Lender Law Offices of Peler J. Russo P.C. Ie.a zl.n I FAMILY ROOM N b i SCREEN '' ~ PATx) I lAUlORY MASTER MASTER gpTM KITCHEN BEDROOM LMNr ROOM ATTACHED b 1 GW ^,~ b GMAOE ~ DBIEKi ROOM BATH zi.a I i e tB.a BEDROOM POAC~ -' I J m.a S.a aMY,MMe R' Forrn SKT.81dSld -'WmTOTAL' appraisal software by a la mode, Inc. -1-If0QALAAAODE Building Sketch BonowerlCGerd NIA Pro Address 3752 Fox Dale Ln CI Holida C Pasco State FL D Coda 34891-1342 Lender Law Offices of Peter J. Russo P.C. Coda AREA CALCULATIONS SUMMARY 0.azrlptlan NatBW Nal Tohb GL711 Pizat Ploor 1306.0 1306.0 P/P OPN/CW PORCH 55.0 SCAN PAT10 35x.0 X09.0 GAR ATT 1-CAA Gi1AA0a: 513.0 513.0 Net ENABLE Area (Rounded) 1306 LNING AREA BREAKDOWN SuMaUla Pirat Ploor 12.0 : 16.0 192.0 20.0 a 32.0 610.0 11.0 : 21.0 231.0 lo.o : 21.o zlo.o 4 hems (Rounded) 1306 First Floor GLA1 ATT 1-CAR GARAGE GAR 12.0 x 16.0 ~ 192.0 19.0 : 27.0 519.0 20.0 r 32.0 ~ 60.0 11.0 : 2a.0 ~ 261.0 10.0 : 21.0 . 210.0 Area total (Rounded) = 1306 Area tots (Rounded) = 513 OPN/CVD PORCH PIP SCRN PATIO P/P 5.0 : 11.0 ~ 53.0 12.0 : 25.0 ~ 300.0 6.0 r 9.0 . Sa.O Area total (Rounded) = 55 Area total (Rounded) = 354 Form SKT.BIdSkI -'WmTDTAL• appraisal soMrdre by a la mode, inc. -1-t10D~ALAMODE Location Map Banowa/Cient N/A Pro Address 3752 Fox Dale Ln CI Hot C Pasco Sdte FL - Code 34691-1342 LefldB Law Ofices of Peter J. Russo P.C. Fdm MAPLOC -'YYinTOTAI' appraisal software by a la mode, Inc. -1.80QAWdODE Plat Map BOrrOwOf/CtleM NIA Pro Addfess 3752 Fox Dale Ln C' Holida Cou Pasco State FL L Code 34691-1342 Lefxlef Law OfAces of Peter J. Russo P.C. 3290 3300 3 FQX DALE: LN 33 3250 3260 33 2500 2510 ~ 25 Fann MAPPLAT -'NAOTOTAL• appraisal sollware by a la mode, inc. -1-BDo-ALAAgDE Aerial Photo BomowegCfalt NIA Pro Address 3752 Fox Dale Ln C Holida Cou Pasco State FL ~ Code 34691-1342 Lender Law Offices of Peter J. Russo P.C. form MAP.PLAT -'H4nTOTAL' appraisal soilWefe by a la mode, inc. -1-80QALAAMIDE COPY OF LICENSES Borrower Cdent NIA Pro MOress 3752 Fox Dale Ln C Holide Cou Pasco State FL D Code 34691-1342 Lender Law Offices of Peler J. Russo P.C. Fam MAP.fTood - WinTOTAL' appraisal Seflware by a la made, Inc. -1.800~ALAMODE REV-1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SC11Ep11LE E CASH, BANK DEPOSRS, & MISC. PERSONAL PROPERTY E5TA7E OF FILE NUMBER Stephany Tacey 09-574 __ __ Include the proceeds of litlgatiori`end the date the proceeds were received by the estate. All pmparty ~olndyowned wRh Hyht of survivorship must be disclosed on Schedule F. to more space s needed, insert additional sheets of the same size) Seller: Theodore Cheski DATE: December 12, 2009 1323 Asper Drive oiling Springs, PA 17007 Sold to: Richard and Haidee Farrell 69 Dutton Mill Road Aston, PA 19014 DESCRIPTION AMOUNT 1983 Cadillac Deville 4 door Coupe -Sold as is condition $ 500.00 TOTAL $ 500.00 • ~ ~~" ~~ The Power of Vehicle Information :c[om .:i avrva ~ u~ i •t salt a µ~ Autos Classic Cars Motorcycles Boats Recreation Vehicles Manufactured Homes Buy a Price Guide Free Insurance Ouote ~ See Your Credit Score $0 ~ Buy a Vehide ~ Sell a Vehide ~ Gat Pricing Find Your Classic May 23, 2010 Cadillac print this page ,~ email this page PRICING ZIP 17007 m °°~°r AutoTrader Classics Original MSRP: ;16,441 Low Average Retail Retail Rets11 Free Insurance Quote Base Puce $1,225 $2,550 $3,500 Free Insurance Quote Options 1 ril,y~ ® I~LM! D'elegence Package 5% 5% 5% TOTAL PRICE ;1,286 ;2,678 ;3,674 Know your Credk History NEXT STEPS Free Online Credil Score ® Insure Your Investment Looking to Buy a Classic? See Your Credit Score $0 Looking to Seli Your Classic? Trusted Partners New Car Prices, Reviews & Info Car Care Center Low Retail Value Vehicle History This vehicle woukl Ge in mechanically functional condition, needing only minor reconditioning. The exterior paint, trim, and interior would show normal wear Classic Car Resources , needirp only minor recoMitioning. Mey also tx3 a deteriorated restoration or a very poor amateur restoration. Most usable "as-is". Colledor Insurance Guide Classic Car Buying Tips Some of the vehicles in this publication could be considered "Deity Drivers" end are Car Care Center not valued as a classic vehicle. When determining a value for a daily driver, d is recommended that the subarxiber use the low retail value. Note: This value does not represent a "parts caP. Average Retail Valw This vehicle would be in good condition overall. It cook! be an older restoration or a well-maintained original vehicle. Completely opereble. The exterior paint, trim, and mechanics ere presentable and serviceable inside end out A "20-footeY'. High Retail Value This vehicle would be in excellent condition overall. It could be a completely restored or an extremely well maintained odginal vehicle stxtwing very minimal wear. The exterior paint, trim, and medtanics are not in need of reconditioning. The interor would be in excellent condition. Note: This value does ~ represent a "100 Point" or 'YF 1" vehicle'. "'100 Point' or "# 1" vehicle is rwt driven. It would generally be in a museum or transported in an endased trailer to concourse judging and car shows. This type of http://www.nadaguides.com/default.aspx?LI=1-22-1-5013-0-0-0&1=1 &w=2... 5/23/2010 Bodv SNIe > Make > Y~r > Model & Trim > Options > Ussd Values 1983 Cadillac Devllle 4 Door Sedan REV-i5o9 EX+ (oi-io) it Pennsylvania L~ DFPA(iTMENT OF REVENUE INHERRANCE TA% RETURN RESIDENT DECEDENT SCNEp11LE F ]OINTLY-OWNED PROPERTY ESTATE OF: FILE NUMBER: Stephany Tacey 09-574 If an asset became jointly owned within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING]O1NT TENANT(S)NAME(5) ADDRESS RELATIONSHIP TO DECEDENT A• Theodore Cheski B. C. 70INTLY OWNED PROPERTY: 1606 Benner Street, Philadelphia, PA 19149 ~ Brother REM NUMBER LETTER FOR JOfNT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FlNANCIAL INSniUTION. AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACX DEED FOR JOINTLY XELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECEDENT'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1. A. PNC Bank Checking Account 14,372.53 50 7,186.27 2. A PNC Bank Money Market Account 143,149.33 50 71,574.67 3. A PNC Bank CD 54,312.70 50 27,15fi.35 4. A UBS 1,590,533.00 50 795,266.50 5 A 1634 Benner Street Philadelphia 129,900.00 50 64,950.00 TOTAL (Also enter on Line 6, Recapitulation) I $ 966,133.79 If more space is needed, Llse additional sheets of paper of the same size. C?li3 Acgravai Pfo. 2502-0255 A. 'zttlemznt Statement ~ s. Type of Loan t-5. Loan Type Fv4 I - - ~-- i=irs~ American Tithe insurance Gon~pany 1s~aaz~a Fit 5l b e um sr 6. ~!r'ia! Statee;ent ------ 7. Loan P;umber 3980031770 8, Margage Insurance Case Numbsr 461.9376864 C. Note: This form is furnished to give you a statement of actual setUementcests. Amounts paid to and by the settlement agant ere showm, items marked "{POCj` were pz~d onside this closing; th:y are shown here for informational purposes and are not inc;uded in foe totals. D• Name of Sorrower: Juan Escobar Hernandez 1634 Benner St, Philadelphia, PA 19149 e. Name of Seiler: Theodore Cheski by his agent Janine PA. Parrett F. Name of Lender: Huntingdon Valley Bank 650 Louise QriveSuite 160 I,Narminster, PA 18974 G. Property Location: 1634 Benner St, Philadelphia, PA 19149 k H. Settlement Agent: first American Title Insurance Company I I• Address: 472 California Road, Suite 30D, Quakertown, PA 1$951 Settlement Date: 09/1812009 Place of Settlement Address: MiS Print Date: 091t812009, 4:13 PM 6718 Rising Sun Ave, Philadelphia, PA 19111 Disbursement Date: 09!1812009 _~ J. Summary of Borrower's Transaction K. Summary of Seller's Transaction p 100. Gross Amount Due Fram Borrower 400. Gross Amount Due To Seller 101. Contract Sales Prica 129,900.00 401. Contract Sales Price ' 29,900.00 102. Personal Property 402. Personal Property r ~ 1 D3. Settlement charges to borrower {tine 1460) 9,507.94 403. Total Deposits 104. 1 404. 1D5. 405. Adjustments for items paid by seller in advance Adjustments for items paid by seller in advance 166. City/tavrn taxes 09118/09 to i2r3i/09 @51184.73/yr 340.81 406. Cityltotvn taxes 09/18/09 to 12f31109 @51184.731yr 340.81 107. County taxes I 407. Count/ taxes 108. Assessments 408. Assessments 109. 110. 409. 410. 4 111. 112. 411. 412. --## 113. 413. 114. 414. 115. i 415. 120. Gross Amount Due From Borrower 139,748.75 420. Gross Amount Due To Setter 1iSQ,24t).81 200. Amounts Paid By Or In Behalf of Sorrower 5D0. Reductions in Amount Due to Seller 201. Deposit or earnest monay 501. Ercess deposit (see instructions) 2D2. Principal amount of rew loan(s) 127, 543.00 562. Se",lement cbames (line 1400) I I 33,21,• 5.50 203. "existing loan(s) taken subjact 503. Existing loan(s) taken subject ! 204. Earnest tvlarey Deposit 1,000.00 ~ 504. Payoff of first mortgage lean 265. 505. Payoff of second mongage loan i 206. 506. 2069 City Taxes to City of POC-S 51,184.73 207. 507. zaa. sos. ~ 2d9. ~ 509. Adjustments for items unpaid by seller Adjustments for items unpaid by setter p 210. Cityrtown taxes 510. Cityltawn taxes i 211. County taxes ~ 5 i 1. County taxes m, ~~ nav wuroe Warminster, PA 18974 wv Properly Location: 1634 Benner St, Philadelptia, PA 19149 9 Setileme~nt Agent: First American Title tnsttrance Company i• n.~a..,..... wo r..rs.....:., o....a e..:a,. ann n.,we.t..,.,., DA ~4o6d Settlement Date: 0911812009 6 ace of Settlement Address: MiS Print Date: 09118(2009, 4:13 PM '18 Rising Sun Ave, Philadelphia, PA 19111 Disbursement Date:091t8t2009 i~ Summary of Borrower's Transaction 10. Gross Amount Due From Borrower K. Summary of Seller's Transaction a 400. Gross Amount Due To Setter 11. Centraci Sales Price 129,900.00 12. Personal Property 401. Contract Sales Price ' 29,900.00 ~ 402. Personal Property i3. Settlement charges to borrower (line 1400} 9,507.94 403. Total Decosi{s 14. )5. 404. , 405. djustments for items paid by seller in advance Adjustments for items paid by seller in advance 16. City/town taxes G9t18/09 to 12/31109 @51184.731yr 340.81 406. Cityltown taxes 09!18!09 to 12131!09 @$1184.Tslyr 340.81 17. County taxes 407. County taxes l8. Assessments 408. Assessments )9. I 409. 10. I 410. 11. i 41 t I2. 412. 13. 14. 413. 4t4. !5. 415. 20. Gross Amount Due From Borrower 139,748.75 420. Gross Amount Due To Seller 1 i 60,240.81 )0. Amounts Paid By Or In Behalf of Borrower 500. Reductions in Amount Due to Seiler )1. Deposit or earnest money 501. Excess deposit (see instructions} ~ ]2. Principal amount of new loan(s) 127, 543.00 502. Settlement charces (ling 1400) ~, 33,245.50 ( )3. Existing loan(s) taken sub;ect ' 543. Existing loan(s) tzken subject 1 )4. Earnest Money Deposit ~ 1,000.00 504. Payoff of first mortgage iozn ~5. 505. Payoff of second mortgage iozn )6. 506. 2009 City Taxes tv City of PODS $1,184.73 )l. 507. D8. SDB. D9. 509. djustments for items unpaid by seller Adjustments for items unpaid by seller 10. Cityltown taxes 510. Citylicvm taxes 11. County taxes 5 i 1. County taxes 12. Assessments ' 512. Assessments 13. Seller Assist 14. l4'zterlSewer Service Charge OSlt81D9 to D9/18,ro9 6,090.50 24.03 513. Selizr.4ssist 514. Waterl5evaer Sen~ice Charge 08(18109 to 09118/09 6,0 24.03 io. ' 515. iG. 516. 17. I Si7. ~ -~ 18. 518. 19. 519. 20. Total Paid BytFor Borrower 134,657.53 520. Total Reduction Amount Due Setter 59,36O.Os 00. Casfi At Settlement FromRo Borrower 600. Cash At Settlement To?From Seller -~ 01. Gross amount due from Borrower (!ine 120} 135,748.75 601. Gross amount due to Seiler (line 420) 1;66,240.8 e 02. Less amounts paid bylfor Borrower (line 220) 134.657.53 602. Less reductions in amounts due to Setter (tine 520) :19,366.63 03. Cash (X Fram) (To) Borrower 5,091.22 603. Cash (K To} ( Fram} Sslter i i )0,880.78 -he HUD-1 Settlement Statement which I have prepared is a curate account of this transaction. I have caused or will cause the fur:ds to be tisbursed in accordance with this statement. Z ', f >ettlement Agent: / "~~ `~"~"~'"~`-' Date: ~3 ~ ~ ~1=` ~ ~ 'See " ~'e No. .5746750 ,dernent Charges 8 „+: Total SaleslBroker's Commission based on price 5129,900.00 @ D.OODD%= $0.00 Paid from P tid ; rom Drrsion of Commisslon'(lire 700) as follows Borrower's 3e11er's 701. $3,897.00 to Penn Libedy Real Estate -- funds at Settlement funds at Settlement 702 S3,897.00 to 111S Realrj 703. Commission paid at Settlement 704. Supplemental Summary 595.00 7,794.00 395.00 800. Items Pa able in Connection vrith Loan 801. Loan Origination Fee 1.0000%-Huntingdon Valley Bank 1,253.50 802. loan Discount 803. Appraisal Fee - Allen Appraisals POC-B 5400.00 -~ 804. Credit Report - Credstar POC-B 511.62 805. Lenders Inspection Fee 800. tv;ortgege Insurance Application Premium 807. Assumption Fee 808. Cocument Preparation fee -Huntingdon Valley Bank 375.00 809. Flood Certification fee ~ Wolters Kluvrer POC-8 $8.48 810. LPIDU -Fannin hAze I POC-B 54.90 811. LPiDU -Fannie Mae POC-L 530.10 812. LPIDU -Huntingdon Valley Bank 30.10 813. Commitment Fee - Huntingdon Valley Bank 475.00 814. Courier fee -Huntingdon Valley Bank 75 00 Supplemental Summary . 900. Items Re wired b Lender to be Paid in Advance 901. Interest 09118!09 to 101@1109 @519.4854001day -Huntingdon Valley Bank 253.31 902. Mortgage Insurance P mium -Huntingdon Valley Bank 2,193.63 903. Hazard Insurance Premium for 904. Insurance Premium to Allstate c!o Bruce Howard Insurance Agency 646.15 905. Supplemental Summary ( - 1000. Reserves De asited ifh Lender 1001. Hazard Insurance 3 rrlo(s) @553.85lmo 161.55 1002. t;tortgage Insu2nce 0 o(s) @557.101mo 1003. City Property Taxes t mo(s} @598.721mo 1004. County Property Taxeg 1005. Annual assessments 1,085.92 o c ( r 1006. ~ 1007. 1008. Aggregate AccountingtAdjustmeni -367.97 i 1100. Title Char es i 1101. Settlement or closing fbe -first American Titie Insurance Company 135 00 11102. Abstract or title search . i 103. Tine examination ' 1104. Title Insurance Binder; i 1105. Document Fee ~ 1106. Notary Fen f --~ i 107..4ttomey Fee ! -~ ' (includes above item numbers:) ' 1108. Title Insurance -See ¢upplemental page for breakdrnvn of individual fees and payees 1 008 75 includes above item dumb..rs. Banc Rete 1109. Lenders coverage $1 7,543.00 1110. Owners coverage 51~9,900.D0 Premium: 51.008.75 1111. PA END 900 (ALTA 8 "j - First American Title Insurance Company 50 00 1112. PA END 300 -First American Tit!a Insurance Company 1 i 13. PA END 100 -First American Title Insurance Company 1114. Electronic Product - E ail Cocs -First American Title Insurance Company . 50.00 50.00 35 00 r i" + 1115. Overnight Delivery Se ice and Handling Fee - Ficst American Title Insurance Company . 1 S SO 1116. Prepare Deed - First FsEmerican Title Insurance Company . 65 00 . 1117. ' 1200. Government Recordin and Transfer Char es - - --y 1201. 'Recording fees: Oeed 5186.50 Nodaage 5756.50 Release 50.00 343.C0 ° 1202. 'City/county tax/stamps: Deed 53,897.60 Mortgage 50.00 1,948.50 1,9 0 1203. `State tax/stamps: Deed 51,299.00 Mortgage 50.00 649.50 649.50 1 [04. Rerord Poerar cf A oritey S8.50 --- M - 1's00. Additions! Setttemertt Char es --~ 1301. Survey to 1302. Pest Insoection to ~ r 1Q 313. Commitment Fee -Huntingdon Valley Bank p 475.D0 314. Courser Fea - Huntingdon Val!ay Bank g 75.40 supplemental Summanl 300. Items Required by Lendero he Paid in Advance -- 301. Interest 0 *18;09 to 10191/09 @519.485400!day -Huntingdon Valley Sank t 253.31 ~ +' ±02.~ iv'ortgage Insurance Pnymium -Huntingdon Valley Bank 2,193.63 a ?03. Hazard Insurance Premium for v t 's04. Insurance Premium to Allstate c/o Bruce HowaN Insurance Agency 640.15 } , )D5. -~ supplemental Summary t f~i l C 1000. Reserves Deposited#~.ifh Lender --z i 001. Hazard Insurance 3 mo(s) CmS53.851mo 161.55 ~ -( !002. C4ortgage Insurance 0{mo(s) @557,10/mo i o A03. City Property Taxes i'~ mo(s) @598.721mo 1,055.92 004. County Prooerty Taxes ! 3 005. Annual assessments ~ 008. Agg2gateAccountingjAdjustmeni •367 97 ~ --`" - t 4 100. TitleCha,ges a ~~ ~. ocweuiam ui cwsmy ;te - rusr Hmenean nne msuranrz CcmpanY ~. 135 00 p 102. Abstract or title sezrcH . - -- c u 103. Title examination ! } .C4. TdL Inswance Bmder, E ~ 105. Document Fee } ~ ~ iDo. Notary Fea ( f d 107. Attorney Fee S (includes above item numbers: ) -4 108. Title Insurance -See Supplemental page for breakdown of individual fees and payees k i ,008.75 r -- includes above item ntimbers: Basic Rate ---a 109. Lenders coverge 51c7,543.00 ; 4 1 i0. Owner's coverage 512p9,9D0.D0 Premium: 51,008.75 ---? 111. PA END 900 (ALTA 8{!) - Fust Amercan T;de Insurance Company ° 50 00 112. PA END 300 -First American Title Insurance Company . t SD OO i 13. PA END 100 -First Amedcan Title Insurance Company . 5O C0 114. Electronic Product - E ail Docs -first American Title Insurance Company . 35.00 -~ t ; 115. Overnight Delivery Se ice and Handling Fee - First Amedcan Title Insurance Company 116 Pre are D d Fi t 15.50 r . p ee - rs erican Title lnsurance Company " 65 DO 117. ( - r ; 3 20D. Government RecordMr and Transfer Char es --{ 201. `Recording fees: Deed 5186.5D Mortgage 5156.50 Refezse 50 00 t 343 00 202. City;county tax/stamps. Deed 53,897.G0 Mortgage 50.00 ' 1,948.50 s 1 948 50 S 203. State taxlstamps: Deed 51,299.00 Mortgage 50.00 649.50 , . 649 50 204. Record Power cf Atto ey . 205. 88.50 2C6. } __ ~ 300. Additional Settlemerrc Char es --~ 301. Survey to 302 Pest Inspect;on to ~ 303. Final PG4N from 9840 io 9646 (0 bat) to Philadelphia Gas Works tt 304. U&0 Reimbursernent to Ray Caceres 16. SD E ~a 0 305. Inhertance Tax Escrow to Law Offices of Pete; J Russo P.C. `-- , 306. Contracting Work to Q}iveira Contracting 2D,OD0.OO 307. Termite Cert to Alpinet ermite & Pest Control E 500.00 308 85.00 . 309. i 310. 311. ! i a 312 ( ( 313. t a 314. E f upplemental Summary ( a 3 9 g 700. Total Settlement Chirges (enter on lines 103 t Section J znd 5112 Secti K 9,507.94 33 245.30 , , on ) , i SPP 4iinnl ,~ t i D r a , -- f ~ - {` Supplameritai Page HUD-i Battlement Statement ~ir~t ,~rn~ricar~ ~"i~9~ ~ns~rance Cc~mpan~t ' ~ Fst~a! Statemertt =ile ~~ ''57kS75Q Loan ffo. 3080031770 Settlement Daie: OSIi 812009 Borrower Name & Address: Juan Escobar Hernandez 1634 Benner St, Phi{adelphia, PA 19149 Seller Name & Address: Theodore Cheski by his agent Janine PA. Parrett Paid Frcm P~dd From Settlement Charges continued Section L Borrouxr's .Seller's . Funds at f unds at Settlement Sa ttiement 704. Su Iemental Summa 990.00 _ 705 Broker Services to MIS Reai 595.00 706 Conve ncin Services ~ Penn Jibe Real Estate 395.G0 1106. Su plementai Summary 1,008.75 s a ALTA 2006 Owners P li -First American Title Insurance Com n 1,008.75 12D1. Supplemental Summa 343.00 a Record Grant Deed - FirstAmedcan Reccrdin 186.50 b Record IJnrt a e -First American Recardin 156.50 1202. Su lementai Summary 3,897.00 a CI Documents Tra sferTax-FirstAmedcanReconfin 1,948.50 1,948.50 1203. Su lemental Su ry 1 299.00 a State Documents T nsfer Tax -First American Recordin 649.50 649.50 The following Section is restaffed from the Settlement Statement Page i 300. Cash At Settlement FrdmfTo Borrower 600. Cash At Settlement TalFrom Seiler 301. Gross amount due from Borrower (lino 120) 139,748.75 601. Gross Amount due to Seller (line 420) 1 3Q,24Q.81 302. Less amounts paid byHor Borrower (line 220) 134,657.53 601. Less reductions fn amounts due to Seiler (line 520) 59,360.03 303. Cash (X from) (To) Barrower 5,091.22 603. Cash (X To) ( From) Seiler aO,88O.78 i have carefully reviewed the HUD•1 Settlement Statement and to the best of my knowledge and'nelief, it is a true and accurate statement of ail rece'spts and distributions madeeon my account or by me in this transaction. 1 further certify that I have received a copy of the NUD-1 Settlement Statement. 4 t BUYER(S;: U~,~,i Juan Es ~l5 ~ G Cc:~htS~~' r Hernandez ~. l~, l ~= ~'19cej~~~"'_ ;~ ,~ SELLER(Sj: ,-- ~, T . dove Cher' ' y his agen Janifa ~. F rreii ._^ .. BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128.0601 :mvasu cs •tr cu-w: INFORMATION NOTICE AND FILE N0. 51 TAXPAYER RESPONSE ACN 09135957 DATE 06-15-2009 THEODORE J CHESKI 1636 BENNER ST PHILADELPHIA PA 19149-3434 EST. OF STEPHANY TACEY SSN 160-07-9509 DATE OF DEATH 05-12-2009 COUNTY PHILADELPHIA REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS RDOM 180, CITY HALL PHILADELPHIA, PA 19107 TYPE OF ACCOUNT SAVINGS CHECKING TRUST ® CERTIF. PNC BANK NA provided the Department with the information below, which has been used in ealeulatinp the potential tax due. Records indicate that st the death of the above-nomad decadent, you ware a ioint owns r/banaf ieiary of this account. If you foal the information is incorrect, please obtain written correction from the financial institution, attach a copy to this fora and return it to the above address. This account is taxable in accordance with the Inha ritance Tax laws of the Cowmonwealth of oen.^sylYa.^.!_. Pia...,., ..11 :'..?) :B: ...2? uit: 4uas.icas. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0000318D0306477 Date 11-10-2006 To ensure proper credit to the account, two Established copies of this notice must accwpaw payment to the RaBister of Wills. Nake chock Account Balance 54, 393.71 payable to "Raaistar of Wills, Aaent". Percent Taxable X 50.000 Amount Subject to TaX $ 196 27 86 NOTE: If tax payments era ^sda within three . , months of the decedent's date of death, Tax Rata ~( , 1 2 deduct a 5 percent discount on the tax due. Potential Tax Due g 3,263.62 Any Inheritance Tax due will became delinquent nine months after the data of death. P T TAXPAYER RESPONSE ~ 1 ,,. ~~ ,,; A. ~ The abore information and tax due is correct. Remit pavmenL to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, or chock box "A" and return this notice to the Register of Willa and an official assessment will be issued by the PA Department of Revenue. ONE BLOCK B. ~ Tha above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tex return ONL Y to be filed by the estate repro santative. C. ~ The above informs fen is incorrect and/or debts and deductions ware paid. Complete PART 2~ and/or PART ~ below. PART If indlcatin9 a different tax rate, please state ~~ ~" relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Dua 1 2 ~ a X 4 s 5 - 6 ~ T X 6 ~ PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PATn Under penalties of perjury, I declare that the facts I have reported above are true, gcorrlet and complete to the best of my knowledae and belief. HOME C `L/5~ ~!1/%/ ) 7~~ ~J~ ~ l:dC`~ e . ~~-~~ ~-~.~,<.. WORK C ) ~ o TAXPAYER SIGNA URE TELEPHONE NUMBER DATE BUREAU OF INDIVIDUAL TAXES PO 60X 280601 WIRRISBUR6 PA 17128-0601 INFORMATION NOTICE AND FILE N0. 51 TAXPAYER RESPONSE ACN 09135959 DATE 06-15-2009 THEODORE J CHESKI 1636 BENNER ST PHILADELPHIA PA 19149-3434 EST. OF STEPHANY TACEY SSN 160-07-95D9 DATE OF DEATH 05-12-2009 COUNTY PHILADELPHIA REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS ROOM 180, CITY HALL PHILADELPHIA, PA 19107 TYPE OF ACCOUNT ® SAVING CHECKI~ TRUST CERTIF. PNC BANK NA Provided the Department with the infpreatipn below, which has boon used in eeleulstine th• potential tax due. Reeo rds indicate that at the death of the above-naeod decedent, you were a ]Dint owner/beneficiary of this account. If you foal th• information is incorrect, please obtain written correction from the financial institution, atteeh a copy to this fore and return it to the abovo adds ss. This sceount is tm[ebl• in aeeordaneo with the Inha ritanco Tax laws of the Commonwealth pf Ponnsvlvaniw. Pleasw ew71 (7l7) 7g7-ail? with m:utions, - COMPLETE PART 1 $ELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 000008609567492 Data 05-02-2005 To ensure proper credit to the account, two Establishod epvies of this notice must aeewparor Account Balance g 2 7 6 4 6 1 4 3 payment to the Resister of Wills. Make check " . , payable to Raaistar of Wills, ABOnt". Percent Taxable X 50.000 Amount Subject to Tax $ 71 638 23 NOTE: If tax payments era made within three . , months of the deceda nt's date of death, Tax Rate ~( , 12 deduct a 5 percent discount on the tax due. Potential Tax Dua g 8 596.59 Aro Inheritance Tax due will become dolinauont , nine months of tar the date of death. P T TAXPAYER RESPONSE ~ ~ ,. . A. ~ The abovo inforaation and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain CHECK s discount or ovoid interest, or chock box "A" and return this notice to the Rapister of 0 N E Wills and an official assessment will be issued by the PA Department of Rovonue. BLOC K B. ~ Tha above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return ONL Y to bo filed by the estate rap resentative. C. ~ Tha abovo informs ion is iota rrect and/or debts and deductions ware paid. Complete PART 2~ and/or PART ~ below. PART TAX LINE If indicstin9 a different tax rata, please state relationship to decadent: RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS 1. Date Establishod 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Dua 1 z g 3 X 4 g 5 s g T X a g PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have raportad abovo are t/ru/e, corregct and complete to the bast of my knowledge and belief. HOME C.~/ ) Y ~ ~ 7 ;' T _ ~/; k<~'L'C; ~F• ~_ j~ t '~_~_xF~,c_. WORK ( ) ~ ~S BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PD BOX 280601 HARRISBURG PA 17128-0601 ^ COMMONWEALTH OF PENNSYLVI DEPARTMENT OF REVENUE IA NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-1549 EX AFP (01-09) DATE OB-24-2009 ESTATE OF TACEY STEPHANY DATE OF DEATH 05-12-2009 FILE NUMBER 21 09-0574 COUNTY CUMBERLAND SSN/DC 160-07-9509 THEODORE J CHESKI ACN 09135958 1636 BENNER ST APPEAL DATE: 10-23-2009 PHILADELPHIA PA 1 9 149-34 34 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALDN6 THIS LINE ~ RETAIN LOWER PORTION FUR YOUR kEl'OkDS #'~' ------------------------------------------------------------------------------------------- REV-1548 EX AFP CO1-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLDWANCE OF DEDUCTIONS. AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE OB-24-2009 ESTATE OF TACEY STEPHANY DATE OF DEATH D5-12-2009 COUNTY CUMBERLAND FILE NO. 21 09-0574 S.S/D.C. N0. 160-07-9509 ACN 09135958 TAX RETURN WAS: CX) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: pNC BANK NA ACCOUNT N0. 000008619294723 TYPE OF ACCOUNT: ( )SAVINGS Q() CHECKING C )TRUST C )TIME CERTIFICATE DATE ESTABLISHED 12-22-2006 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: 14,449.26 X 0.500 7;224.63 .00 7,224.63 X .12 866.96 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THiS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID C-) AMOUNT PAID 06-30-2009 PH027030 43.35 866.96 TOTAL TAX CREDIT 910.31 BALANCE OF TAX DUE 43.35CR INTEREST AND PEN. .00 TOTAL DUE 43.35CR IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ^ IF TOTAL DUE IS LESS THAN S1. NO PAYMENT IS REpUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" C CR). YOU MAY BE DUE A REFUND. Janine Farrell From: <chick.robinson~ubs.com> To: <farrellisland~mcast.net> Sent: Monday, June 01, 2009 11:41 AM Subject: May, 12, 2009 Date of death value--$1,590,533. Again, my heartfelt condolences. Warmest regards, Chick Robinson Please do not transmit orders or instructions regarding a UBS account electronically, including but not limited to a-mail, fax, text or instant messaging. The information provided in this a-mail or any attachments is not an official transaction confirmation or account statement. For your protection, do not include account numbers, Social Security numbers, credit card numbers, passwords or other non-public information in your a-mail. Because the information contained in this message may be privileged, confidential, proprietary or otherwise protected from disclosure, please notify us immediately by replying to this message and deleting it from your computer if you have received this communication in error. Thank you. UBS Financial Services Inc. UBS International Inc. UBS Financial Services Incorporated of Puerto Rico UBS AG UBS reserves the right to retain all messages. Messages are protected and accessed only in legally justified cases. 5/24/2010 REV-t51; EX+ ; 1U-09) Pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND iNHERRANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Stephany Tracey 09-574 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: t' Edward J. Petner Funeral Home 11,185.00 2 Our Lady of Crestochowa Cemetery 850.00 3 Kulinski Memorials 175.00 a. Kerrigan's Florist 428.00 5. Luncheon 607.47 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: $ 3 7 , 0 61.5 7 - $1, 17 7.13 35,884.44 Name(s) of Personal Representative(s) Janine Farrell Street Address City State ZIP Year(s) Commission Paid: ***$1,177.13 represents reimbursed expenses on Sch. I, 2. Attorney Fees: Line 11 * * * 6,343.55 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant tD Decedent 4. Probate fees: 885.00 5. Accountant Fees: 6. Tax Return Preparer Fees: 7. TOTAL (Also enter on Line 9, Recapitulation) I # 56,358.46 If more space is needed, use additional sheets of paper of the same size. 0 0 C R r R S D R ~7[]m<-rmp p7JDC') ---- SmpSQ S C7 D ~ ~ ~ •• m N ~ ~ , ~ ~ ~ 1 ! ^M. ~! a - «~ " ` Y . ~ ° t=A ~ y S,. ~ n 1 ' - m.,. .. Z m ? d -~ ~ ` f...7 r r-~ • °~ a ~~ ~ .! yyy.,~~~ { ~ ».. 4 ~ ~ ~ { rt ~ m L ~. Z.. ,,,~ ,,~ . O 1 ~.,,;? ~~ 5 5 ~. 3 ~~~,~... , ~ .... m .. r ~ ~ ~ ~ ,H, ~ l r ~w'.p O . ~~44 , ,,,,,,, ~ -~ ~ C7 ~ 3 ~' "' Al ~ x , c ~ w r ~ n G~ J~ ~ a/i 'x 1 ~ ~'] ~. .., ~ ~ ~ ~ ` ~~ m r D = > D ~ z 2 f7 D `_' Zo m ° ~ a ~ m a ' ~ (D 1 (D Z~ ~ m ~ N rt' m z O F cai m ~ m ~ C7 f ~ ~ m c = < b n Ci C3. _ m ~ m: C7 a ~ T~ ~ v G' ~ m O °1 r JJ n C rn y' n o m ~ m (7 ~ ~ ~ ~ O C ~ 3 RJ m N O v m 4 m 2 y N o m p ~ N _ ~. z . a ~ ~' t.<,~ ~' z ~ 7 p w o m (C~~~ ~ Y ~ ~ xy~ ~ ~ ~ ? a a~ ~~ '~ ~ ~ ~~ e p -e ,yam so m ~' ro YJ t ~ ~ ®®® ~ a r°~ ~~ t~ `' ~ ~, ~4 i ..} ,~~ 1 '~,j~~- 4~ (Family Own d and Ope~d~, ~~' ~~r"j' .~ "' '_, Edward J. Petner Jr., Supervisor • " -- 6421 Frankford Avenue (At Levick Street) ""~--~- Philadelphia, PA 19135 (215)338-1466 Mrs. Janine Farrell 1323 Asper Drive Boiling Springs, PA 17007 Funeral Expenses for Stephany Tacey PROFESSIONAL SERVICES Services of Funeral Director & Staff Embalming, Preparation and Sanitary Care Dressing & Cosmetology Hairdressing Date of Death: May 12, 2009 OTHER STAFF AND RELATED FACILITIES Funeral Ceremony at another facility TRANSPORTATION Transfer of Remains to Funeral Home Hearse Limousine Lead Car /Clergy Caz Flower Car MERCHANDISE Casket - U-46 Tapestry Rose Vault -Tremont-Concrete-Marble Sealer CASH ADVANCES Pallbearers Newspaper Notice-Local Church -/Clergy Acknowledgement Cards Register Book Prayer Cards Blanket/Hankerchief Plate & Cross Priest at Cemetery 20 Death Certificates @ $6 ea TOTAL CHARGES PAYMENTS & ADJUSTMENTS May 13, 2009 Paid BALANCE DUE: ~~~ a r~`~ ~ ~..~`~ " $ 10,730.00 ~:x $ 1,725.00 $ 870.00 $ 395.00 $ 60.00 $ 395.00 $ 300.00 $ 350.00 $ 300.00 $ 75.00 $ 275.00 $ 3,180.00 $ 1,770.00 $ 300.00 $ 380.00 $ 350.00 $ 20.00 $ 50.00 $ 40.00 $ 50.00 $ 80.00 $ 100.00 $ 120.00 $ 11,185.00 -$ 10,730.00 $ 455.00 OUR LADY OF CZESTOCHOWA CEMETERY P.O. BOX 2049 ~OYLESTOWN, PA 18901 Date: 1~ ~ ~ Receipt No a -~ c. , Name: `/%l(. Address: /6 «~,~~~~ Grave(s) ......................................................................................$ Perpetual care ...........................................................................$ Interment (Opening, Closing, Services) ................................$ Interment (Cremation) ............................................................$ ~7J Lei -__ Foundation .................................................................................$ Granite Cross(es) ......................................................................$ Engraving on the Cross(es) .....................................................$ Vault(s) .......................................................................................$ Funeral Mass .............................................................................$ Chapel Service ..........................................................................$ Mausokum ................................................................................$ Other ...........................................................................................$ T I Received $ `~ % " l~~ --, Received sy , caC ~ ~ KULINSKI MEMORIALS 809 South Main Street Manville, New Jersey 08835 ~C. `~/ c~~ ~~~ 1-800-458-5467 TEL: (908) 722 - 3130 FAX: (908) 253 - 0027 MONUMENT /MARKER JOB ORDER ORDER DATE: ,[ SANDBLASTING ^ POWERWASH /CLEANING ^ RESETTING ^ REPAIR ^ BRONZE PLAQUE ~' FAMILY NAME ON MONUMENT or MARKER MEMBER /FIRST NAME LOCATION OF MONUMENT /MARKER CEMETERY; SECTION: ROW #: PLOT #: TOWN: STATE: COLOR OF STONE: STYLE: INSCRIPTION TO BE SANDBLASTED / PLAQUE TO BE ORDERED: KUUNSq NtJ:MORIALS MUST EE PAID IN PULL PRK)R TO ANY! ALL WORK TO DC CONTRACTED. KUUNSiO MEMORULL.S OR AGENTS, WILL NOT OE RESPONSIELE FOR ANY DAMAGE TO THE.STONE OR PLAQUE DUE TO ALTERING /CLEANING /RESTORING / RESETTMIG. REQUESTED BY NAME: "z ADDRESS: PHONE #: BASE PRICE .......................... $ `,, . ADDITIONAL WORK ............... $ PERMIT FEE ..........................$ TOTAL DUE ... ... ... ... ................$ PAID IN FULL CASH CHECK # Please sign and date below. Keep the YELLOW copy for your records and return the WHITE copy to us with your check for $ .When received, we will schedule your order for sandblasting. 7 emu. Signature• Date:-'` **8pN0UET** PedP1~r8~x~218 9e i_al~aska, 94 p0U1 0151 3002 C8 8an4u _.. __- NL ' -.--Gst 0 02PM . U9 O Chk T55 M yAg _- _ _.._._- __. 6.00 ~ ~~ 3 ,5 ~ 1.~: ~~~Jf~~ Lr5,4~,t , 3,75 Ylitl~'aL1N~' r,~, JuICE 2,GC ~ 10.00 ~.;u4.e i ~, diet S DA 1.5U OU 2 O "; i;L~3 ~ SPRITE . q,00 3gg,U0 8` LO Lunch Buffet 29. 3 MISC FOOD 96 14 20%Ban Drat ~~? 20i~.~ UEP '~aDEEPI 428.85 35 ~~/BEER/SHIN .;/A BEVERAGE 33. 21.50 27.03 4 ; g6,i Tax Service Chgs 200.00 47 ' PAYMENT 7 . q p p3:39PM T01A1. ,~~~ ;: ,~~~~F:,, ;ou for Nesu'+ ~~l'~~ ~d1de~ COCK' N BULL CONTRACT Event Name: Tacey Luncheon Contact: Mark Farrell Mailing Address: 1323 Asper Drive Time: 1:30 pm End Time: 5:30 pm Event Date: 5/18/2009 Phone Number: (717) 241-2489 Wiltlng Springs, PA 17007 Estimated Guest Count: 30 Terms and Conditions DEPOSIT: A nonrefundable deposit of $200 is required a confirm your date. Cash or check preferred for initial deposit. MENU 9ELECTION3: Menu selections are required one (1) month prior to yow wart No food or beverage other than the contents of this package will be permitted to be brought in by the host or guest unless specific arratigematts have b~ made with our tearing department. Accommodations can be made for guests with special dietary needs. A cake cutting fee of $1 per person will apply a special occasion cakes provided by dte guest. BEVERAGE: According to Pennsylvania Liquor Control Board Iaw, all Peddler's Village establishmrnts card any individual who appears 30 years of age or younger. Without proper ID we will not serve anyone appearing 30 years of age or younger. Please remind yow guests to have propea iD when ordering alcoholic beverages. PAYMENTS: Final payment is due at the conclusion of your event. Payment can be made by cash, check or major credit card. GUARANTEE: You are required to submit a guaranteed number of guests and individual entt6e counts (if sit-down meal) by 11:00 a.m ten (10) days prior to yow event i, after this time you may not lower your gnaranae. If a guarantee is not submitted by the deadline, the estimated head count indicated on yow sig<ied contract will stand as yow guarantee; charges will be made accordingly. MINIIVIUM: 20 guts aro the minimmn number icgi»red for all banquet fimctions scheduled in a private room If yow final guest count falls below the ZO person minimum required, a room rental fee of $100 will be added to yow final bill. PRICING: All prices quoted herein are applicable for 6 months from counsel ties. Commitments beyond this time period aro subject to proportionate increases to meet the increased cost of food, beverage, and other costs of operation existing at the time of the event. SERVICE CHARGES: All food and beverage items are subject a 6 percent Pemisylvania sales tax and 20 percent gratuity. Pennsylvania Tax Exemption numbers roost be completed on the proper form and submitted with your signed contrail. ROOM ASSIGNMENTS: Rooms are assigned according a the anticipated number of guests and specific requirements of the function. Should your guest count increase or decrease significantly from your originally estimated number of guests, Peddler's Village reserves the right a reassign the room as needs dictea. Requests for specific rooms will be honored when possible, but cannot be guaranteed. Person signing contract agrees to be responsible for any damage done to the premises during the time of function. CHILDREN: Child's portions and selections sre available at a special price if requested in advance. The price applies a d»]dren between 3 and 10 years of age. LINENS: House linen is provided at no additional charge for all banquet functions. CANCELLATION POLICY: In case of cancellation, notice must be given in writing. If your function cancels more than 120 days prior to your function date, your initial deposit will be refunded. If your function cancels less than 120 days prior to your function date, the deposit will remain nonrefundable. PLEASE SIGN AND RETURN ONE (1) COPY OF THIS CONTRACT INDICATING THAT YOU HAVE READ AND ARE IN AGREEMENT WITH THESE TERMS. WE APPRECIATE YOUR BUSINESS AND LOOK FORWARD TO WORKING WITH YOU. CLIENT SIGNATURE & DATE CATERING MANAGER SIGNATURE & DATE Deposit Amount Enclosed: $ L ~a ~( c;~S e' ~~" i-t-- ~ ~ ~-~"`'D r 3/18/09 CEN~0 N ~ M. ~~~ RECEIPT FOR PAYMENT GLENDA FARNER STRASBAUGH Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17613 TACEY STEPHANY Estate File No.: 2009-00574 Paid By Remarks: JANINE M FARRELL AJW ------------------- Fee/Tax Description PETITION LTRS TEST WILL SHORT CERTIFICATE RENUNCIATION JCP FEE AUTOMATION FEE Check# 4412 Total Received......... Receipt Date: 6/19/2009 Receipt Time: 10:37:09 Receipt No.: 1057201 Receipt Distribution ----- Payment Amount Payee Name 810.00 CUMBERLAND COUNTY GENERAL FUN 15.00 CUMBERLAND COUNTY GENERAL FUN 40.00 CUMBERLAND COUNTY GENERAL FUN 5.00 CUMBERLAND COUNTY GENERAL FUN 10.00 BUREAU OF RECEIPTS & CNTR M.D 5.00 -------- ----- CUMBERLAND COUNTY GENERAL FUN $885.00 $885.00 BUREAU OF INDIVIDUAL TAXES PO BOX 280431 HARRISBURG PA 17128-0431 STEPHANY E TACEY 1636 HEMMER ST PHILADELPHIA COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE PERSONAL INCOME TAX PREASSESSMENT NOTICE PEV-ii4t EX KP <01-{5) DLN: 081210429835 DATE OF NOTICE: AUG 06 2009 SOCIAL SEC. NUM: 160-07-9509 ASSESSMENT #: NDT ASSESSED TAX YEAR: 2008 PREASSESSMENT AM OUNT 2593.99 BALANCE(S) DUE FOR Y OUR ACCOUNT AS OF AUG 16 200 9: ~-+ BALANCE INCLUDES ESTIMATED TAX UNDERPAYMENT PENALTY ~-~- OWED PAID BALANCE PA 19149-3434 ATE/UNDER .00 .00 .00 EST PNLTY 82.99 .00 82.99 LEGAL .00 .00 .00 INTEREST .00 .00 .00 TAX/RFD 2511.00 2511.00 .00 2008 BALANCE DUE x2.99 PLUS OTHER TAX YEAR( S) LIABILITIES (SEE REVERSE SIDE OF NOTICE) .00 TOTAL DUE NOW - (PLEASE PAY THIS AMOUNT USING THE ENCLOSED COUPON) 82.99 THE FIGURES SNOWN BELOW REPRESENT AMOUNTS AS ORIGINALLY REPORTED ON YOUR 2008 TAX RETURN OR AS ADJUSTED 8Y THE DEPARTMENT. ORIGINAL OR ADJUSTED AMOUNTS lA. GROSS COMPENSATION ...................... 0 1B. SCHEDULE UE EXPENSES ........................ 0 1C. COMPENSATION ................................ 0 2. INTEREST (SCHEDULE A) ....................... 10,140 3. DIVIDENDS (SCHEDULE B) ...................... 34,671 4. NET INCOME OR LOSS .......................... 0 5. TAXABLE SALE - GAIN OR LOSS ................. 36,981 SA. CAPITAL GAIN EXCLUSION ...................... 0 6. RENTS, ROYALTIES. PATENTS, COPYRIGHTS...,... 0 7. ESTATES AND TRUSTS (SCHEDULE J) ............. 0 8. GAMBLING AND LOTTERY WINNINGS ............... 0 9. GROSS TAXABLE INCOME (ADD LINES 1C,2-5,6-8). 81,792 10. OTHER DEDUCTIONS(MEDICAL, HEALTH, TUITION).N 0 11. NET PA TAXABLE INCOHE(LINE 9 MINUS LINE 10). 81,792 12. TAX LIABILITY (MULTIPLY LINE 11 BY .03070).. 2,511 13. TAX WITHHELD (f ROM W2'S) .................... 0 14. CREDIT FROM PREVIOUS TAX YEAR ............... 0 15616 ESTIMATED TAX 6 EXTENSION PAYMENTS.......... 0 17. TAX WITHHELD AS REPORTED ON NRK-1........... 0 18. TOTAL CREDITS (ADD LINES 14-17) ............. 0 198. NUMBER OF DEPENDENTS ........................ 0 21. TAX FORGIVENESS CREDIT ...................... 0 22. RESIDENT CREDIT (SCHEDULE G) ................ 0 23. CREDITS (SCHEDULE OC) ....................... 0 24. TOTAL CREDITS (ADD LINES 13,18,21-23)...... 0 25. TAX OUE (LINE 12 MINUS 24) .................. 2,511 26. PENALTIES AND INTEREST ...................... 28. OVERPAYMENT (LINE 24 MINUS 12) .............. 29. REFUNDED .................................... 0 30. CREDITED TO NEXT YEARS ESTIMATED TAX........ 0 31-35. TOTAL DONATi0N5 (LINES 31-35)............ 0 THE REASONCSJ FOR THIS NOTICE ARE AS FOLLOWS: AN UNDERPAYMENT OF ESTIMATED TAX PENALTY HAS BEEN ADDED TO YOUR ACCOUNT. PENNSYLVANIA LAW REQUIRES THAT ALL TAXPAYERS WHO EXPECT TO RECEIYE AT LEAST 58,000 OF PA TAXABLE INCOME, WHICH IS NOT SUBJECT TO EMPLOYER WITHHOLOfNG, FILE A DECLARATION OF PENNSYLVANIA ESTIMATED TAX AND MAKE INSTALLMENT PAYMENTS DURING THE TAX YEAR. THIS INFORMATION IS LISTED IN THE TAX INSTRUCTION BOOKLET, WHICH ACCOMPANIES THE TAX FORMS EACH YEAR. AN UNDERPAYMENT Of ESTIMATED TAX IS DETERMINED WHEN THE AMOUNT OF TAX PREPAID IS LESS THAN 90 PERCENT OF THE ACTUAL TAX SHOWN ON THE ANNUAL RETURN. IF THE PREPAYMENT WAS NOT 90 PERCENT OF THE TAX SHOWN ON THE RETURN, YOU MUST PAY INTEREST FOR UNDERPAYMENT OF ESTIMATED TAXES. INTEREST IS FIGURED SEPARATELY FOR EACH INSTALLMENT DUE GATE. IF YOU FEEL THAT THIS PENALTY WAS ADDED IN ERROR. PLEASE COMPLETE AND SUBMIT AN REV-1630. THE REV-1630 IS AVAILABLE ON REVENUE'S WEB SITE AT WWW.REVEMUE.STATE.PA.US OR YOU CAN ORDER THE FORM FROM THE DEPARTMENT'S 24-HOUR AUTOMATED FORMS ORDERING MESSAGE SERVICE BY CALLING 1-800-362-2050. ANY UNPAID BALANCES WILL REDUCE OR ELIMINATE ANY FUTURE REFUND. TO APPLY YOUR PAYMENT PROPERLY, PLEASE USE THE ENCLOSED PAYMENT COUPON (REV-364(). IF YOU DO NOT REPLY WITHIN 30 DAYS FROM THE DATE OF THIS NOTICE OR PAY THE AMOUNT DUE, YOU WILL BE ASSESSED. YOU WILL THEN HAVE THE RIGHT TO APPEAL TO THE DEPARTMENT. IF YOUR CASE HAS BEEN PLACED WITH A COLLECTION AGENCY YOU MAY BE SUBJECT TO ADDITIONAL FEES FOR COLLECTION COSTS. UNDER ACT 40 OF 2005, ADDITIONAL COLLECTION COSTS, INCLUDING BUT NOT LIMITED TO FEES OF UP TO THIRTY-NINE (39X) OF THE AMOUNT DUE, AND ATTORNEY FEES INCURRED IN SECURING PAYMENT. MAY BE IMPOSED ON ANY LIABILITY N07 PAID PRIOR TO REFERRAL TO A COLLECTION AGENCY OR CONTRACT COUNSEL. ~~~ ~1~7 #~~ ~- SEE REVERSE SIDE FOR MORE INFORMATION REV-7512 'cXk (12.08) ~~~`~~~ • ~~ ~ Pennsylvania SCHEDULE I DEPAflTMENT OF flEVENUE DEBTS OF DECEDENT, INHERRANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Stephany Tacey 09-574 Report debts Incurred by the decedent prior to death that remained unpaid at the date of death, Including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH t • AARP/Chase Credit Card 983.20 2 Safety Deposit BoxlBank Fees 72.25 3 John Hopkins 102.70 4. Pasco Co Fire/Rescue from 1998 34.87 5. Dave's lawn Service 563.00 6. Sonnie's Truserv Hardware 650.00 7. Bekins A-1 Movers Inc (moving and storage of personal effects afters sale of home) 1,410.00 8. Closing Cost from Sale of House -1636 Benner Street 30,202.69 9. Closing Cost from Sale of House -1634 Benner Street 39, 360.03 10. Nazareth Hospital 940.92 11. Executrix Expenses -Gas, Stamps, Packing, Supplies and Shredder 1,177.13 12 Kara L. Sediak, Jay Appraisals 275.00 13 Graham Motor -Cadillac 88.96 14 Pasco County Utilities Services 122.99 15 Water Revenue Bureau 165.28 16 Progress Energy 142.86 17. Verizon 575.89 18. WSI 74.64 19. William Stuart 1,747.00 20 Allstate 87.42 21 PECO 278.66 22 PGW 276.13 23 Comcast 115.39 23. Department of Revenue g2.gg 24 TOTAL (Also enter on Line 10, Recapitulation) ; 79,490.00 If more space is needed, insert additional sheets of the same size. ~~~ Comcast® `' ° VIslt us on the web at www Comcast com ACCOUNT DATE TOTAL d NUMBER DUE AMOUNT DUE 1}~1 09513136428.01-3 ON RECPT ~ O O ~.DD / Indicates the Comca: services you subscribe t STEPFIANY TACEY ~ How to reach us... For service at: 1634 BENNER ST PHILADELPHIA PA 19149-3434 11400 Northeast Ave. 1-800-COMCAST Report Service Issues 24 hours a day, 7 days a week Sales and Billing available lam - 1 Opm daily Our Lobby Hours: M - F: B:OOam - 7:OOpm, Sat: 8:30am - S:OOpm, Sun:12:00pm - 4:30pm News from Comcast If your bill reflects a credit balance of $1.00 or over, a refund will be sent to you automatically. If the credk is under $1.00, please return this notice to us or call customer service at (215) 673-6600 for a refund. If your bill reflects an amount due Comcast you may prevent future collections efforts by remitting the balance due and returning all cable equipment. Summary of Charges statement Prepared iorol/o9 Billed from 11/01/09 Previous Balance 200.55 Comcast Cable Television 138.16 cr Taxes, Surcharges & Fees 9.39 cr Total Due $~3,qD Detail of Charges on back i ~~~ Y Ck camcast~ Comcast Cable 4008 N. DuPont Hwy. New Castle, DE 19720 1-800-Comcast www.comcast.com STEPHANY TACEY 1634 BENNER ST PHILADELPHIA, PA 19149S Re: Account 9513-136428- 1 Date:9/30/2009 Total Balance Due: $62.39 Total Value of Equipment: $0 Dear STEPHANY TACEY, We would like to take a moment to thank welcome you back in the future; we would things you may have overlooked. you for your business and we also like to remind you of some A recent review of your account indicates we have not yet received payment for services provided prior to your account being disconnected. If payment has been made, please disregard this notice; if not, in order for us to close your account and for you to avoid further collections activity, we require your final payment of $62.39. Additionally, failure to return equipment will result in additional charges of Up t0 $525.00 for each piece of equipment. The equipment charges will be added to your final balance before your account is written off and turned over to a collection agency. Failure to make your final payment may negatively impact your credit report by having this account listed as a collections account. For your convenience, you may call us at 1-800-COMCAST to make your final payment via check by phone or credit card. You may also make your payment and return any equipment to your local office (see back for locations). You also have an option to have any equipment retrieved from your address, please contact us for further details. If you have any questions or would like to reconnect your service, please feel free to call us at t-800- COMCAST. Sincerely, Comcast Collections t~ a ~s ,~~~~ a ., ~. , ~,~ .r, IS' 1ES~c:Q .. .. ~ a_i W c •~ a a o m a ~ W W N 8 (/~ m_ ~ a a 0 41 V1 5 a> c~ W Q W J a~ wg ~ z Q O J ~ 2; ag (/~ m ~ a 0 = 3~ y~ Q b C7 Q~ =a a' Js Q f J_ 2; ag ~Y° i~ ci io :: c ~ y J ~ •~ O N ~ _ ~ Q F.. 7 ~~ ~ _ m a~ ~" d ~ U ~ ~ ~ LLJ ~ ` N N N ~ dJ ~ ~ y ~ n. c f0 L Y ~ ~ ~ J •E ~ U w C m .` v N .C d d ~ l6 ~. C7 0] Q F- LLL 2 OC N N -~~ h Q W ~ ~ o ~' h ~ ~ W~~ ~ U to o Z a~~ J ~ ~ `o YZ~ h o V c ama z ~ J 2 O ~ V W M ~ ~i m Q N~a ~ ^ M ~ O O ~ _ M .. 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U ~- O O N O t"' CL O N L U v U C !0 C LL N O m m t .n m .~ c 0 0 Y m a N m N a N rn? io L U m 0 m OD c .- LL '"' O L m ~ 0 F- E N 9 C 7 O m 0 +• m a d N R d a N rnT t U V c ~ W c LL V ;~ ? O t O C O E°- E M N N m v DO 0 7N pN v~ ~' vQ w~ .~ ~ _ a U ~ 0 ~ M °' o am '_ o ~a ~3 '' a 'o .n° " ~~ q •. c; '_m E~ c 0 '« w m a n y T Q a V O m~ m~ °i o am =0 ~a ~~ T~ «a a~ my tll c3 'm ¢O V O 0 m d ~; PHILADELPHIA GAS WORKS 800 W. MONTOOMEHY AVENUE. PHILADELPHW, PA 19122-0050 ' MONTHLY STATEMENT ~ From 08/14/09 thru 09/15/09 Billing Cyc% Number: 11 ,/ Account for: STEPHANY TACEY 1636 BENNER ST PHILA PA 19149-3434 /~ ~~ 1 S ~~ 1 r ~1 Payments Summary 1 09/08/09 Check Billin S S 19.60 g ummary. Past Due Amount 50.00 _. _._..._ .5~[reaL..Gharges. ._..._:, ._ _ . 521.16 Total Amount Due By Oct 09, 2009 $21.16 Page: 1 of 2 Billing Date: 09/17/C Account Number: 043613928 GENERAL INFORMATION CONTACT US Gas Leaks & Emergencies 215 235-1 Billing & General Information 215 235-1~ Appliance Service 215 235-2~ Theft of Gas 215 684-6. Foreign Language Assistance 215 235-11 Hearing impaired TTY Line 215 236-41 Representantes Clue Hablan Espanol 215 235-2 Web Site - www, pgworks. com CUSTOMER SERVICE CENTERS (Hours 9 a.m. - 5 p,m./ Center City 1 137 Chestnut St. (M, T, TH, F) Germantown 210 W. Chelten Ave. (T, W, F) S. Philadelphia 1601 S. Broad St. (M, W, TH) Frankford 4410 Frankford Ave. (T, TH, F) N. Philadelphia 1337 W. Erie Ave. (M, W, TH) W. Philadelphia 5230 Chestnut St. (M, T, W,F) To avoid Finance Charges please pay total amount due by the due date. Finance Charge is calculated at 1.5% monthly. (18% yearly) Questions or complaints about your bill? Please call ua before the Due Dete et 215-235-1000. Or write to: POW P.O. Box 3500, Phila., PA 19122.0050 O ~ O 00 ~ N ~ m ~ M •-- ~ (O M O E N ~ ~ z O ~ W ~ O > u m Q N 8 N_ N m 6 ~ g ~~ Q ~~ as _` a6 W c a~ J ~ 3 ag :,:'Sx ~" ~_ y ~ ~ 0 W U z~ J ~ U W W C N O O M O LO <n r- O u) 00 O ~ n N O O M O CO ~ .- .- N fp ~ ~ N ~ Ln ~!~ ~ Lq LO L1) M M M 00 M M M N N N LO N N N LO Ln In Liz l0 to l17 ~ ~ ~ ~ ~ ~ ~ N N N N N N N U O ~ O a 3 N ~ w U ~ ~ d m d ~ W J ~ 01 ~ y } ~ a~ ~ Q ~ ~ d m m ~ E ~ ~ ~ ~ a .o W N ~ ~ N N ~ ~ d ++ d1 y ~ ~ ~ o. m Y ~ d U' J .~ C y ~ C p C O y J 01 .~ ~ Ol ,C d N ~ a a~ m o a C7 m Q FL- LL 2 OC 0 ~ W O~j A H O W p Z O ~ ` N LL r ~ ~ W > d f' ~n Z a ~_ o ~, F.crn p Z ~ yarn O ~ o o o aM z ~ ~ m 4rfMm LL LL = LL = LL. 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PHAADELPHUI, PA 78122-0050 MONTHLY STATEMENT From 08/14/09 thru 09/15/09 Billing Cyc% Number: 1 1 Account for: STEPHANY TACEY ' 1636 BENNER ST ` PHILADELPHIA PA 19149-3434 Payments Summary 09/08/09 Check T $24.77 Past Due Amount $0.00 Curre:,t Charges $35.73 Total Amount Due By Oct 09, 2009 535.73 r ~~~G'~,~ ~ y~ ~' ~ .~ `~ Pag Billing Date: 1 of 2 09/17/0 Account Number: 811612527 GENERAL INFORMATION CONTACT US Gas Leaks & Emergencies 215 235-1: Billing & General Information 215 235-1( Appliance Service 215 235-2( Theft of Gas 215 684-6: Foreign Language Assistance 215 235-1( Hearing impaired TTY Line 215 236-4f Representantes (2ue Hablan Espanol 215 235-2' Web Site - www. pgworks. com CUSTOMER SERVICE -ENTERS (Hours 9 a.m. - 5 p.m.) Center City 1 137 Chestnut St. (M, T, TH, F) Germantown 210 W. Chelten Ave. (T, W, F) S. Philadelphia 1601 S. Broad St. IM, W, TH) Frankford 4410 Frankford Ave. (T, TH, F) N. Philadelphia 1337 W. Erie Ave. (M, W, TH) W. Philadelphia 5230 Chestnut St. (M, T, W,F) ~~ L ~I ri t ~' ~? `~1 To avoid Finance Charges please pay total amount due by the due date. Finance Charge is calculated at 1.5% monthly. (18% yearly) Queationa or compleinta about your bill? Please call ue before the Due Date et 215-235-1000. Or write to: PGW P.O. Box 3500, Phila., PA 19122-0050 ._~ , ~ 3• H m O y ~ 7 N 7 N• aQ~ m o3i ~ ~ .~o~ D S N ~ N O C N N N Q N ~ ' ~ ~ O C < ~ m .~~. ~ m o' _,; a ~ ~m ~• ~ ~• ~ <p~. a~ m N ~ O O m 'o d r; 1 ~ ~ ~ w ~m v 3~ °.: m m ~, a n ='• ~a f0 d < 3 O N C ~ C~ ~ y . ~ O o ~ ~ m a~i m m a N O C N l N ~ 3 < d 7 p A ~ 3 N O O 7 CD "'~ v m 0 D -~ J ~ ao 0 ~• 0 0 rn ~ ~ ~ 7 (O W N S S 7pP 7pC ~ ~ ~ O CWT1 can O t i W J f/1 ~ ~: ni m n ~c w = °c V1 w D '~+ ~ ~ Z o 7 ~ ~ 1 `° ° D DW m V 0 0 V p ~• 3 n ~ c o, a ~z v ~ N ~ 0 ~1 Z r m m Z ? m~ m® ~~ o? D W O o m m. O. ~ O. ~ n m O p ~. O Qo o0i o m °' '° o ? r ~ ~c ~ ~ f < d 3 °' c~ c~ y ~; m m~ n ~ ro rn y m~ fp m N ~ y ~• m ~~ m _ _ c~ m co N W? d) ~ J C ~ N ~ y ~' m O ~ G ~ ~ < ~ N ~ d N > .+ N S N S O ~• N m 3 W S N 3 ~ m N p .r ~ ~ O fD •+ ~ N C cD• O 01 ;y 7 ~ ~ '6 •,Ni m D '.N' D I,Ni D y o ~ 3 ~ ~< -1 ,~ 3 N N N N N N N N J J J J J J J N N N O) N N N T 2 V = T W W W QD W W W CJ1 ~ Gi A C71 CJ1 U1 ~ ~ ~ ~ i N_ ~ -+ O N J J V D O 01 cOii O -N+ cn rn o w o o N m m n ~ O r D z n ~ C ~ ~ 3 _~ O '~ ~"~ g F= 'r Z~ ~v 9 ~ <_ ~D m ''=D ~N 6 s ~ 's ~ ~~ m ~ N 8 D ~ m o ~' m 3 .~ ~ Z a1 C c m DD J J -+ O ~ J O V J O N vt ~ Pages 1 Name: LOUIS TACEY Service Address: 1636 BENNER ST, PHILADELPHIA ~ ~ /~ Phone Number: 215-744-2418 ~ lJ ~ Account Number: 38430-00607 Issue Date: 05/05/2009 ~! I General Information Next scheduled meter reading: June 4, 2009 Payment Information: PECO Energy, 2301 Market St, Philadelphia, PA, 19101, walk-in business hours Monday through Friday 8:30AM to S:OOPM. For additional payment options, go to www.peco.com/ehome. If you have any questions or concerns, please call 1-800-494-4000 befiore the due date. To pay by phone, call 1-877-432-9384. (A convenience fee will apply.) Si tiene alguna pregunta, favor de llamar al numero 1-800-494-4000 antes de la fecha de vencimiento. Meter Information Read Meter Load Reading Meter Reading Date Number Type Type Previous Present Diff Mult X Usagc 05/04 038165099 General Service Tot kWh 6279 ACT 6354 ACT 75 1 7' Total kWh Used............75 Current Period Electric Residential Service Customer charge Generation Charges Transmission Charges Distribution Charges Transition Charges State Tax Adjustment Total current charges Service 04/05/2009 to 05/04/2009 - 29 Days $5.18 75 kWh X $0.06600 4.95 75 kWh X 0.00550 0.41 75 kWh X 0.04810 3.61 75 kWh X 0.02920 2.19 -0.06 516.28 Other Basic Charges Thank you for your payment of 515.24 Total amount due 516.28 When paying in person, please bring the entire bill. P~~ge 1 Name: LOUIS TACEY Service Address: 1636 BENNER ST, PHILADELPHIA Phone Number: 215-744-2418 Account Number: 38430-00607 Issue Date: 06/04/2009 General Information Next scheduled meter reading: July 6, 2009 mation: PECO Energy, 2301 Market f t I St, Philadelphia, PA, 19101, walk-in busine~ n or Paymen hours Monday through Friday 8:30AM to S:OOPM. For additionalleasfeeca11p1,800~494-4000 befc cerns p www.peco.com/ehome. If you have any questions , or con the due date. call 1-877-432-9384. (A conve by phone a To nience fee will apply.) , y p Si tiene alguna pregunta, favor de llamar al numero 1-800-494-4000 ant es de la fecha de vencimiento. Meter Information Read Meter Load Reading Meter Reding Present Previous X U Diff Mult Date Number Type Type 06/03 038165099 General Service Tot kWh _ _ - 6354 ACT 6437 ACT - 83 1 Total kWh Used............83 Current Period Electric Residential Service Service 05/04/2009 to 06/03/2009 - 30 Day 55.18 Customer charge 83 kWh X 50.06600 5.48 Generation Charges 83 kWh X 0.00550 0.46 Transmission Charges 83 kWh X 0.04810 3.99 Distribution Charges 83 kWh X 0.02920 2.42 Transition Charges -0.07 State Tax Adjustment S17.46 Total current charges Other Basi c Charges ,~~~' ~~ ~ Thank you for your payment of 516.28 , ~ ly ~ ~ S17.46 Total amount due ~~ .. When paying in person, please bring the entire bill_ Page 1 Name: LOUIS TACEY . Service Adclre~s: 1636 BENNER ST, PHILADELPHIA ~t ~l~ Phone Number: 215-744-2418 ~ \\ Account Number: 38430-00607 V Issue Date: 07/06/2009 ~ V ~y~•', General Information ~ ` Next scheduled meter reading: August 4, 2009 Payment Information: PECO Energy, 2301 Market St, Philadelphia, PA, 191.01, walk-in business hours Monday through Friday 8:30AM to S:OOPM. For additional payment options, go to www.pc~co.com/ehome. If you have any questions or concerns, please call 1-800-494-4000 before the due date. To pay by phone, call 1-877-432-9384. (A convenience fee will apply.) Si time alguna pregunta, favor de llamar al numero 1-800-494-4000 antes de la fecha de vencimiento. Meter Information Read Meter Load Reading Meter Reading Date Number Type Typa previous Present Diff Mult X Usa ~ U7/OS 038165099 General Service Tot kWh 6437 ACT 6654 ACT _ ___ 217 1 21; Total kWh Used ...........217 Current Periad Electric Residential Service Service 06/03/2009 to 07/05/2009 - 32 Days Customer charge $5.31 Generation Charges 217 kWh X $0.06600 14.32 Transmission Charges 217 kWh X 0.00550 1.19 Distribution Charges 217 kWh X 0.04810 10.44 Transition Charges 217 kWh X 0.02920 6.34 State Tax Adjustment -0.13 Total current charges 537.47 Other Basic Charges Thank you for your payment of $17.46 Total amount due 537.47 ,._ _ _ _ When payin g in person, please briny the entire bill. ~" ~' Page 1 NamA: LOUIS TACEY ~y ~l% Service Address: 1636 BENNER ST, PHILADELPHIA j"t ~ Phone Number: 215-744-2418 ~--~hJ1t` " Account Number: I D 38430-00607 08 04 2009 ~ ~~ ,`Lf u ssue ate: / / ~ General Information Next scheduled meter reading: ~ieptember 2, 2009 Payment Information: PECO Energy, 2301 Market St, Philadelphia, PA, 1 9101, walk-in business hours Monday through Friday 8::SOAM to S:OOPM. For additional payment options, yo to www.peco.com/ehome. ]f you have any questions or concerns, please cal l 1-800-494-4000 before the due date. To pay by phone, call 1-877-432-9384. (A convenience fee will apply.) Si tiene alguna pregunta, favor de llamar al numero 1-800-494-4000 antes de la fecha de vencimiento. Meter Information Read Meter Load Reading Meter Reeding Date Humber Type Type Previous Present Diff Mult X- Usay[ 08/03 038165099 General Service Tot' kWh 6654 ACT 6741 ACT 87 1 8: Total kWh Used ............87 Current Period Electric Residential Service Service 07/05/2009 to 08/03/2009 - 29 Days Customer charge $5.31 Generation Charges 87 kWh X $0.06600 5.74 Transmission Charges 87 kWh X 0.00550 0.48 Distribution Charges 87 kWh X 0.04810 4.18 Transition Charges 87 kWh X 0.02920 2.54 State Tax Adjustment -0.07 Total current charges 518.18 Other Basic Charges Thank you for your payment of $37.47 Total amount due 518.18 4Jh en payiny in person, please bring the entire bill. ~, _ ,f <~~, , ~.. , - r~ ~~ Page 1 Name: LOUIS TACEY Service Address: 1636 BENNER ST, PHILADELPHIA `~~~ Phone Number: 215-744-2418 ~~~'' Account Number: 38430-00607 Issue Date: 09/02/2009 General Information Next scheduled meter residing: Octokier 2, 2009 Payment Information: PECO Energy, x:307 Market St, Philadelphia, PA, 19101, walk-in business hours Monday through Friday 8:30AM to S:OOPM. For additional payment options, go to www.peco.com/ehome. If ;you have an~• questions or concerns, please call 1-800-494-4000 before the due date. To pay by phone, call 1--877-432-9384. (A convenience fee will apply.) Si tiene alguna pregunta, favor de llamar al numero 1-800-494-4000 antes de la fecha de vencimiento. Meter Information Read Mater 1-oad Readiny Meter Reading Data Number Type Type Previous Present Diff Mult X Usage 09/01 038165099 General Service Tot kWh 6741 ACT 6889 ACT 148 1 14ri Total kWh Used ......,....148 Current Period Electric Residential_ Service Service 08/03/2009 to 09/01/2009 - 29 Days Customer charge $5.31 Generation Charges 148 kWh X $0.06600 9.;7 Transmission Charges 148 kWh X 0.00550. 0.81 Distribution Charges 148 kWh X 0.04810 7.12 Transition Charges 148 kWh X 0.02920 4.32 State Tax Adjustment -0.09 Total current charges 527.24 Other Basic Charges Thank you 'For your payment of 518.113 Total amount due 527.24 rrlhen payin g in person, please briny the entire bill. Page 1' Name: LOUIS TACEY Service Address: 1636 BENNER ST, PHILADELPHIA Phone Number: 717-961-0401 Account Number: 38430-00607 Issue Date: 09/30/2009 General Information Oct~~ber 2, 2009 Next scheduled meter reading: 2301 Market St, Philadelphia, PA, 19101, walk-in business Payment Information: PECO Energy, ment options, go to hours Monday through f-riday 8:30AH to S:OOPM. For additionallease call 1-800-494-4000 before www.peco.com/ehome. If you have any questions or concerns, p the due date. To pay by phone, call 1-877-432-9384. (A convenience fee will apply. Si tiene alguna pregunta, favor de llamar al numero 1-800-494-4000 antes de la fecha de vencimiento. Meter Information Load Reading Rmd Mater Type Date Nmpber TYPe __ -- - _ - 09/29 038165099 General Service Tot kln'h Total kWh Used .......-.•.229 Current Period Electric Residential. Service Customer charge Generation Charges Transmission Charges Distribution Charges Transition Charges State Tax Adjustment Total current charges Other Basic Charges Thank you for your payment of X27.24 Total amount due Meter Reading Provious _Prosent__ Diff _ Mult X Usaye _ - 1 2J9 6889 ACT 7118 ACT 229 Service 09/01/2009 to 09/29/2009 - 28 Oays $5.31 229 kWh X $0.06600 15.11 229 kWh 229 kWh X 0.04810 11.01 229 kWh X 0.02920 _0.13 539.25 ~~~~ ~ ~~ 339.25 When P~y~ng in Person, please bring the entire bill_ Page 1 Named GEORGE A WAGNER ~ /' Service Address: 1634 BENNER ST, PHILADELPHIA ~ ~ .I Phone Number: 215-743-7798 ~ ~' I Account Number: 35336-01803 ~•`~ i`J~ Issue Date: 05/05/2009 \///""" i~ General Information Next scheduled meter reading: ]une 4, 2009 Payment Information: PECO Energy, 2301 Market St, Philadelphia, PA, 19101, walk-in business hours Monday through Friday 8:30AM to S:OOPM. For additional payment options, go to www.peco.com/ehome. If you have any questions or concerns, please call 1-800-494-4000 before the due date. To pay by phone, call 1-877-432-9384. (A convenience fee will apply.) Si tiene alguna pregunta, favor de llamar al numero 1-800-494-4000 antes de la fecha de vencimiento. Meter Information Read Meter Losd Reading Meter Reading Dete Number Type Typo Previous Prasant Diff Mult X Usage 05/04 038631512 General Service Tot kWh 31356 ACf 31590 ACT 234 1 23~ Total kWh Used ...........234 Current Period Electric Residential Service Customer charge Generation Charges Transmission Charges Distribution Charges Transition Charges State Tax Adjustment Total current charges Service 04/05/2009 to 05/04/2009 - 29 Days $5.18 234 kWh X $0.06600 15.44 234 kWh X 0.00550 1.29 234 kWh X 0.04810 11.26 234 kWh X 0.02920 6.83 -0.13 j39.87 Other Basic Charges Thank you for your payment of 567.75 Total amount due $39.87 When paying in person, please bring the entire bill. Page 1 Name: ~ G t_ R Service Address 1634 E3ENNER ST PHILADELPHIA Phone Number: 2 - - Account Number: 35336-01803 Issue Date: 06/04/2009 General Information Next schedules meter reading: ]uly 6, 2009 Payment Information: PECO Energy, 2301 Market St, Philadelphia, PA, 19101, walk-in business hours Monday through Friday 8:30AM to S:OOPM. For additional payment options, go to www.peco.com/ehome. If you have any questions or concerns, please call 1-800-494-4000 before the due date. To pay by phone, call 1-877-432-9384. (A convenience fee will apply.) Si tiene algurla pregunta, favor de llamar al numero 1-800-494-4000 antes de la fecha de vencimiento. Meter Information Read Meter Loed Date Number Type _ 06/03 038631512 General Service Total kWh Used ...........146 Current Period Electric Residential Service Customer charge Generation Charges Transmission Charges Distribution Charges Transition Charges State Tax Adjustment Total current: charges Reading Meter Reading 7y~ Previous Present _ Diff Mult X _ Usage Tot kWh 31590 ACT 31736 ACT 146 1 146 Other Basic Charges Thank you for your payment of $39.87 Total amount due Service 05/04/2009 to 06/03/2009 - 30 Days $5.18 146 kWh X $0.06600 9.64 146 kWh X 0.00550 0.80 146 kWh X 0.04810 7.02 146 kWh X 0.02920 4.26 -0.09 $26.81 ~~~~ ~-/~ ~ 526.81 When paying in person, please briny the entire bill. Page 1 Name: Service Address, Phone Number: Account Number: Issue Date: General GEggGE A WAGNER 1634 BENN R®;1 PHILADELPHIA 215='/A3~TT9E~ 35336-01803 07/06/2009 ~ ~? '~~'~~~ u Information ~~ Next scheduled meter reading: August 4, 2009 Payment Information: PECO Energy, 2301 Market St, Philadelphia, PA, 19101, walk-in business hours Monday through Friday 8:30AM to S:OOPM. For additional payment options, go to www.peco.com/ehome. If you have any questions or concerns, please call 1-800-494-4000 befor the due date. To pay by phone, call 1-877-432-9384. (A convenience fee will apply.) Si tiene alguna pregunta, favor de llamar al numero 1-800-494-4000 antes de la fecha de verlci mi ento. Meter Information Read Mater Date Nua6er Load Type Reading Meter Readin g _ 07/05 038631512 _ General Service T YPe __ Tot kWh _ Previous___ Present____ Diff__ Mult X Usac Total kWh Used ...........175 _ 31736 ACT 31911 ,4Cf 175 -- 1 1: Current Period Electric Residential Service Customer charge Generation Charges Transmission Charges Distribution Charges Transition Charges State Tax Adjustment Total current charges Other Basic Charges Thank you for your payment of 526.81 Late payment charge Total other charges Service 06/03/2009 to 07/05/2009 - 32 Days $5.31 175 kWh X $0.06600 11.55 175 kWh X 0.00550 0.96 175 kWh X 0.04810 g,42 175 kWh X 0.02920 5.11 -0.11 531.24 $0.40 50.40 When paying in person, please bring the entire bill. ~ e ~- ~ " >;``:, Page 1 Name: GEORGE A WAGNER Service Address: 1634 BENNER ST, PHILAiJELPHIA Phone Number: 215-743-I/98 l~~'~/ Account Number: 35336-01803 Issue Date: 08/04/2009 /-~ General Information , •'~ 1V Next scheduled meter reading: September 2, 2009 Payment Information: PECO Energy, 2301 Market St, Philadelphia, PA, 19:101, walk-in business hours Monday through Friday 8:30AM to S:OOPM. For additional payment options, go to www.peco.com/ehorne. If you have any questions or concerns, please call 1-800-494-4000 befiore the due date. To pay by phone, call 1-877-432-9384. (A convenience fee will apply.) Si tiene alguna pregunta, favor de llamar al numero 1-800-494-4000 antes de la fecha de vencimiento. Meter Information Road Mater Load Reading Meter Reading Date Number Type Type previous Present Diff Mult .X Usagt 08/03 038631512 General Service Tot kWh 31911 ACT 32055 ACT 144 1 14. Total kWh Used ...........144 Current Period Electric Residential Service Service 07/05/2009 to 08/03/2009 - 29 Days Customer charge $5.31 Generation Charges 144 kWh X 50.06600 9.50 Transmission Charges 144 kWh X 0.00550 0.79 Distribution Charges 144 kWh X 0.04810 6.93 Transition Charges 144 kWh X 0.02920 4.20 State Tax Adjustment -0.09 Total current charges S26.64 Other Basic Charges Thank you for your payment of $31.6~F Total amount due (26.64 When paying in person, please briny the entire bill. Page 1 Name: GEORGE A WAGNER G II~~ ~~ Service Address: 1634 BENNER ST, PHILADELPHIA ~J Phone Number: Z15-743-7798 Account Number: 35336-01803 Issue Date: 09/02/2009 General Information Next scheduled meter reading: October 2, 2009 Payment Information: PECO Energy, 2301 Market St, Philadelphia, PA, 19101, walk-in business hours Monday through Friday 8:30AM to S:OOPM. For additional payment options, go to www.peco.com/ehome. If you have any questions or concerns, please call 1-800-494-4000 befiorr the due date. To pay by phone, call 1-877-432-9384. (A convenience fee will apply.) Si tiene alguna pregunta, favor de llamar al numero 1-800-494-4000 antes de la fecha de vencimiento. Meter Information Read Meter Load keading Meter Resdiny Data Number _ Type _ _~_ _ Type Previous Prssent Diff Mult X Usay 09/01 038631512 General Service lot IcWh 32055 ACT 32157 ACT 102 1 10 Total kWh Usec1...........102 Current Period Electric Residential Service Service 08/03/2009 to 09/01/2009 - 29 Days Customer charge 35.31 Generation Charges 102 kWh X 40.06600 6.73 Transmission Charges 102 kWh X 0.00550 0.56 Distribution Charges 102 kWh X 0.04810 4.91 Transition Charges 102 kWh X 0.02920 2.98 State Tax Adjustment -0.07 Total current charges S20.42 Other Basic Charges Thank you for your payment of 526.64 Total amount due 520.42 When paying iri person, please bring the entire bill. ~ yg~y h ,. ... ..: ^r~ts ~.t ~ ^C ,f Page 1 Name; GAGE A WAGNER Service AddresS~1634 I~~NNER ST, PHILADELPHIA Phone Nurnber:~~ 717]Z41-2489 Account Number:-°35336-01803 Issue Date: 09/21/2009 General Information Next scheduled meter reading: October 2, 2009 Payment Information: PECO Enerny, 2301 Market St, Philadelphia, PA, 19101, walk-in business hours Monday through Friday 8:3OAM to S:OOPM. For additional payment options, go to www.peco.com/ehome. If you havE~ any questions or concerns, please call 1-800-494-4000 before the due date. To pay by phone, call 1-877-43i:-9384. (A convenience fee will apply.) Si time alguna pregunta, favor de llamar al numero 1-800-494-4000 antes de la fecha de vencimiento. f~e~ter information Read Meter Load Reading Metar Reading Date Number Type Type Previous Present ~ Diff Mult X Usay~ 32195 ACT 09/18 038631512 General Service Tot kWh 32157 ACT 38 1 3 Total kWh Used ............38 Current Period Electric Residential Service Service 09/01/2009 to 09/18/2009.- 17 Days Customer charge $3.01 Generation Charges 38 kWh X 50.06600 2.51 Transmission Charges 38 kWh X 0.00550 0.21 Distribution Charges 38 kWh K 0.04810 1.83 Transition Charges 38 kWh X 0.02920 1.1.1 State Tax Adjustment -0.03 Total current charges 58.64 Other Basic Charges ~r7/Ic`r/' ~ Thank you for your payment of '620.42 _ ~`~ ~~ Total amount due 58.64 When paying in person, please bring the entire bill. Wade Ins Agency 143 E Roosevelt 1 Fi Philadelphia, PA 19120 pon u,iu,inn,n,inu,inuiiuiuiuiiuiui„iiniinuii, STEHANY TACEY & THEODORE CHESKI 1636 BENNER ST PHILA PA 19149-3434 To pay in full $5x7.7 Minimum premium amount due Installment fee Minimum amount due by July 8r 2009 ~~ Allstate You're in good hands. ~~~~ ~I~~ Information as of June 17, 2009 Policyholder Page 10 Stehany Tacey & Theodore Cheski Polic number 918 551865 Your policy provided by Allstate Property and Casualty Ins Co 1636 BENNER ST 1 PHILA PA 19149.3434 $43.92 Effective July 8, 2009 through 3.50 July 8, 201012:01 a.m. standard time $47.42 Your Allstate agency is Wade Ins Agency You may pay the minimum, or any amount up to the remoining $527.70 premium amount. If you pay (215) 324-2500 ~ D `' D r ~ ~ i ~~G less thou $527.70, we will charge fhe $3.50 installment /ee. We will provide an updated schedule of 7` V"~- 11 payment on your next bill. Pleose see the back of this bill for payment schedule and history. ~ ~ ~ ~ ~~(jp Ways to pay Automatic payment plans Your payments can be automatically deducted from your bank account, credit, or branded debit card. You can choose to pay monthly or all at once. Visit our online Customer Care Center or contact your Allstate agent to apply. Online banking Be sure to enter 9185518650708 as the account number and P.O. Box 3575 Akron, OH 44309-3575 as the payment address. Automated phone service (1-800-901-1732) or wwwallstate.com Pay using your bank account, credit or branded debit card. Register to view your bill online at our Customer Care Center at www.allstate.com. See the "What you should know' section in this bill for additional payment information. I ~~~ Detach bottom portion here • 620fi9 I` J \ S s a ;n C~. ~ 1 1 f ~ ` ~~ O r m r*. o _ ry ~ v ~. 11 ~ ~ f4 ~- ~~ ~ ~ l"= ~ V ~ ts` r®- v ~ r ~ ^ ~ S ~ ~ rm A `N COO z _. c ~' ~° ' ' ~ ~ U m ~ ti ~ -~1 -1 41 O ~ ~z m -_~ ~' c ~ ~ ~ ~ Q fJ ., T _~ ~ .; `M ~ ~' I~. R ~ °~ ~ ~ r ~ ~ 5 ~'V ~ ~ 1 ~' D O m (7 ~. m~ ae ~~ ,~ c ~~ ~ U ` 0 'Ci v ~ ~, ~ ~ ~ ~~ W ~ 5 ~ ~ v ~ ~ ~ O ~ r ~ ~ ~. ' fJ } i ~ ~, ~ ~ cn ~l~ ~ t ~ ~ `~~ N m ~~ ~ a ~ ~ ~ ~ ~ ~ ~ ~ d ~ ~ m ~ I fl _ ~ 4 ~ , ~ ~ ~ ro -1 --~ fA ~ ~ ~ $ ~ -- _._ _. ___ ma s c~°~. ~ ~ c ~ a U ~ V, o o c] ~. a O o 4 0 o o d C `J a C ~ G '~ H ~ -, 's , ~ Q o +~ ~ro j ~ 1 3 0 o m m a ~ .`~ ~i ., C V =~ v ~ ~P . ~~ o~~ ~ ~' ° o ~ V ,~ w ...:~ ~ x. ~ N ~: ~ •.~. ~a3~ ~ ~~ w ~ ~• ~ V `° ~ ~ ~ A -- _. 10 ~g~ 1N101 /~ S~~ /sh~ XNl ,,,a ~:i~ ,,~~ t~~~ ~~~N~ QO ~ 1V1019fIS 30 OANI SIFLL WO!!d JIVd 3 d 1, ,0 p - S~JC~a ~--~ ! W °l~' ~, ~ .,1~7 ~~ !.~.,~~ S~t~ vn Hti ~ r' ~ + ov 8~ ' ~ ? ~ d ~nowv 3 l ~rod lNn Noudldasaa uo ~iir~~- -~r sy, ~w~r+ rv~{~ ! ~ Slr2 Jt~~a~-~ G5£0-Lfii8 (LZL) i69t~£ "L~ `~pPRoH doo-I a[IMuosey~ TfiZ£ caw--n~,~ ~.~nn~s u~~ilYi~ ~ n• • J •,. ~~ 1 Wavle 3ervt r WASTE SERVICES OF FLORIDA, INC. PASCO HAULINCa 6800 OSTEEN ROAD NEW PORT RICHEY FL 31653 INVOICE Page 1 of 1 For invoice inQuiries, cell: 727-847-9100 Customer No.: 0048-045166 SERVICE CODE DESCRIPTION REFERENCE QUANTITY AMOUNT DATE Balance Forward 0.00 Payments 0.00 Adjastmenta 0.00 Invoices 0.00 (0001) LOUIS A TACEY 3752 FO}IDALE LN HOLIDAY, FL QUARTERLY TRASH SERVICE 37.32 Site Total 37.32 ~~ / (..mot 1~~3 Invoice Date Invoce # Reference Total Tbis Invdce Account 4/30@009 0001278312 $37.32 Starts Current 31 - 60 Days 61- 90 Days Over 90 Days Total Account Balance $37.32 $0.00 $0.00 $0.00 $37.32 Remarks: THE BOARD OF COUNTY. COMMISSIONERS HAS APPROVED A RATE INCREASE FOR 2009-WHICH HAS BEEN REFLECTED ON YOUR CURRENT INVOICE...THANK YOU FOR YOUR PATRONAGE Did you know that you can pay your WSI invoice online? Please Wsit www.wastettrvicesinc.com aadclick on the "Online BIII Payment" menu option to payyour invdce online. "" To evoM late fees, payment must be posted ro youreccouM wlthln 30 days of yourlnvoice dale. "" Bank returned checks wlll lre electronicallyre-presented to your bank and you nary be responsible for a resulting proceatdng Tee. ~_ s ~~.., WASTE SERNCES OF FLORIDA, INC. PASCO HAULING ~' 68000STEENROAD Page 1 of 1 NEW PORT R/CHEY FL 34653 Waste s~rvicaa IN`JOIC''Lj' For invoice inquiries, call: 727-847-9100 11 \ 1 Customer No.: 0046-045166 SERVICE CODE DESCRIPT[OX REFERENCE QtiA~TITY AMOI'\T DATE Balance Forward 37.32 Pavmcnls 37.32 Adjustments 0.011 Invoices 0.011 (Ol1U I) LOL7S :1 TACEY 3752 FO?O7ALE W HULDJAY, Fl. ^~ ' QI:ARTERLY TR,LSH SER\7CE ~ 37.32 Sitc'folal ~ n 1\ 37.32 Invoke Date invoice # Reference Total This Invoice Account 7/3]!2009 0001338794 537.32 Stdtres Current 31 - 60 Dsy~s tit - 90 Days Over 90 Days Total Account Balance 537.32 50.00 50.00 50.00 537.32 Remarks: THE BOARD OF COI7NTY CO:~fMISSIONGRS HAS APPROVED A RATE INCREASE FOR 2009--- WHICH HAS BEEN REFLECTED ON YOUR CURRENT IN\+OICE..: CHANK YOC FOR YOUR PATRONAGE Did you know that you can pay your WSI invoice online? Please visit mevr.wasteservicesinc.comend click on the "Online BIII Payment" menu option to payyour Invoice online. "" To avoid late tees, payment must be posted to your account within 30 days of your imolce date. "" Bank returned checks will be electronicallyre-presented to your bank and you maybe responsible for a resulting processing tee. ~~~ ~~ LOUIS TACEY Account Summary Provlous C_hargos $ 37.85 Payment Received Apr 18. Thank You. - 37.85 BMance S .00 Navy Charges Verizon (page 3) $ 26.53 ATBT(page 3) 11.56 Total Now Charges Dw May 19, 2009 $38.09 To avoid a late payment charge, payment must be received before May 26, 2009. Total Duo S 38.09 ~~~~1 ~,~~1 . Oft _. Billing Date: 04/25/09 Page 1 of 6 Telephone Number : 727 845-3607 830527 Account Number: 1 5 5324 06951 421 1 9 03 How to Reach Us : See page 2 !~ '~~ ~ Pay OMy When You Stay at Home or Away Wlth the Verizon Seasonal Plan, you can suspend your phone service for up to nine months while you're away and pay NO FEES. Keep the same phone number One call to fake care of it all: 1-888-260-4494. Movh-pT 1-866-VZ-MOVES One call gets you up 8 running! Count on the Verizon network to make at least one part o/ your move easier. Across the street or across the nation all you need is one call to Verizon to set up your Internet, phone & digital TV in your new home in no time. Service availability varies. Billing Date: 08/25/09 Page 1 of 6 Telephone Number : 727 845-3607 830527 Account Number: 15 5324 0695142119 03 How to Reach Us : See page 2 LOUIS TACEY Account Summary Previous Charges _ $ 38.09 Payment Received Jun 11. Thank You. - ~•~ Balance S .00 New Charges Verizon (page 3) $ 26.53 AT&T(page 3) 11'56 Total New Charges Due Jul 19, 2009 S 58.09 To avoid a late payment charge, payment must be received before Jul 26, 2009. Total Duo S ~'~ t t-"~'' bet More, Sava Moro. Let Us Help. At Verizon. we want to make sure you're getting the best services at fhe best value -from phone and Internet, to TV and money-saving bundles. Call 1-888-265-7527 today, and together we'll evaluate your current services, and find ways to I save you even more. I ~~ f-s~-vz-irwvES ~ ~ MovlnpT 1-8B6-VZ-MOVES 1~~ One call gets you up ~ running. /~ t~ Count on the Verizon network to make at least one part of your move easier. Across the street or across the nation all you need is one call to Verizon to set up your Internet, phone & digital TV in your new home in no time. Service availability varies. ,~.~!~ STEPHANY TACEY 1638 BENNER ST PHILA PA 19149-3434 Manage Your Account Phone Number Account Number Billing Date My Account at verizon.com/billview 215-743-7796 215 743-7798 930 52Y 5/2/2009 Quick Bill Summary Previous Balance No Payment Received Balance Forward Uerizon News Talk Endlessly Without Time Limit Verizon Freedom Essentials lets you keep in touch with unlimited calling across the U.S. and Canada. You also get Home Voice Mail, Caller ID & Call Waiting for only $49.99/mo. Call 1-877-698-7502 to sign up today. Subject to taxes, fees & terms. 4~~r.. 1 New Charges $83.47 $.00 $83.47 Voice Services (See pg 3) $44.99 Taxes, Fees & Other Charges $14.12 Total New Charges Due by May 28, 2009 ~, pf'~ ~~ $59.11 Total Amount Due `~~ `,~~ . ~,,- $142.58 ~,'~~:. C Thank you for registering on Verizon.com. Manage Your Account Phone Number Account Number Billing Date My Account at verizon.com/billview 215-743-7798 Verizon News talk Endlessly Without Time Limit Jerizon Freedom Essentials lets you keep in ;ouch with unlimited calling across the U.S. and Canada. You also get Home Voice Mafl, Caller ID 8 Call Walting for only $49.99 a month Call 1-888-240-8917 to sign up today. Subject to taxes, fees & terms. Moving? 1-866-VZ-MOVES One call gets you up & running! Count on the Verizon network to make at least one part of your move easier. Across the street or across the netion all you need is one call to Uerizon to set up your Internet, phone & digital TV in your new home in no time. Service availability varies. Get More, Save More. Let Us Help. At Verzon, we want to make sure you're getting the best services at the best value - fromphone and Internet, to TV and money-saving bundles. Call 1-888-652-8111 today, and together we'll evaluate your current services, and find ways to save vnu even more. 215 743-7798 930 52Y 7/2/2009 Quick Bill Summary for STEPHANY TACEY Previous Balance -$83.47 __ No Payment Received $.00 _.._ Credit Balance '$83.47 New Charges Voice Services Taxes, Fees & Other Charges Total New Charges Due by July 29, 2009 Total Amount (See pg 3) $44.99 $14.45 $59.44 -$24.03 #~ '. 1~._i iv r... ...... A':.. veri~on LOUIS TACEY Account Summary Previous_Charges _ _____$_38.09 Payment Received Jul 17. Thank You. 38.09 Balance New Charges $ .00 Verizon (page 3) _ $ 26.65 AT&T(page3) __ _ 11.70 T_otai New Charges Due Aug 18, 2009 __ $38.35 To avoid a late payment charge, payment must be received before Aug 25, 2009. _ _ _ Total Dua a 38.35 ~~~, i LOUIS TACEY ~~ ~~ Account Summary Previous Chargos $ 38.35 Payment Received Aug 10. Thank You. - 38.35 Bal~tce $ .oo New Charges Verizon (page 3) $ 26.65 ATBT(page 3) 11.70 Total New Charges Due Sep 18, 2009 $38,35 To avoid a late payment charge, payment must be received before Sep 25, 2009. Total Dw ~ 38.35 Billing Date: 07/25/09 Page 1 of 6 Telephone Number : 727845-3607 830527 Account Number: 15 53240695142119 03 How to Reach Us : See page 2 ~~N~. •~~. Qrt the Wireless Phorw You Deserve Purohase any Verizon Wireless Phone from your Verizon Pfus Store with No Money Down and up to 10lnterest Free Payments on your Verizon Bifl. Colt i-800-483-6697 to (ind a Store. Cnarpes !o Venzon BUI are Subject Bo CredHApproval. OlAarends 9V30~09. Y'a~'~~~ Movlnp7 i-866-VZ-MOVES One call gets you up & running! Count on the Verizon network to make at least one part of your move easier. Across the street or across the nation all you need is one call to Verizon to set up your Internet, phone 8 digdal TV in your new home in no time. Service availability varies. " / '~ Billing Date: OB/25/09 Page 1 of 6 Telephone Number : 727 845-3607 830527 Account Number: 15 5324 0695142119 03 How to Reach Us : See page 2 ~~ -~. Sto Instant SavYrps Off Your Next Wireless Phone! Bring in this Bill to Your Local Verizon Plus Store and Take S10 Off Any New Verizon V/irebss Phone. Call 1-800-483-8897 to find a Store. Verizon Plus. We Add Savings. LimiT t PerCus~mer. O1ferEnds 10/3909. Oat More, Saw Mora. a~ ~~a ql At Verizon, we want to make sure youYe getting the best services at the best value -from phone and /ntemet, to N and money-saving bundles. Cal! 1-888-852-8111 today, and together w~e'i! evaluate your current services, and find ways to save you even more. ~- ~ U 1 /e1Y,11 LOUIS TACEY Account Summary Previous Charges $ 38.35 Payment Received Sep O8. Thank You. - 38.35 Balance $ ,00 Now Charges Verizon (page 3) $ 26.71 AT&T(page 3) 11.70 Total New Charges Dw Oct 19, 2009 3 38A1 To avoid a late payment charge, payment must be received before Oct 26, 2D09. Total Duo ~ 38.41 -- ~ ~ j(~~ ~`' ,,~;3 Billing Date: 09/25/09 Page 1 of 6 Telephone Number : 727 845-3607 830527 Account Number: 15 5324 0695142119 03 How to Reach Us : See page 2 ~~ii ~~o. Ovt Mon, Save Mon At Verizon, we want to make sure you're getting the best services at the best value -from phone and Internet, to TV and money-saving bundles. Call 1-888-852-8111 today, and together we'll evacuate your current services, and find ways to save you even more. Movb-p7 1.86&VZ-MOVES One call gets you up & running. Count on the Verizon network to make at least one part of your move easier. Across the street or across the nation all you need is one call to Verizon to set up yourlnternet, phone & digital TV in your new home in no time. Service availability varies. ~~~-~•. ~O-1• i t/ . ~h~ Manage Ycur Account Phone Number Account Number Billing Date My Axount at verizon.com/billview 727-845-3607 15 53240695142119 03 10/25/2009 ~Verizrm News ~_ Get More, Save More Call 1-888-610-7288 to make sure you're getting the best Verizon services at the best value -from phone and Internet, to N and money- saving bundles. Together we'll evaluate your current services, and find ways to save you even more. Moving? Let Verizon Help Carl 1.866.VZ.MOVES to bring the power of the Network to your new home. We can connect your N, Internet & phone quickly -maybe before you're finished unpacking. Plus, we have Bundles to fit your needs and your budget. Service availability varies. $10 Instant Savings! Bring in this Bill to Your Local Verizon Plus Store and Take $10 Oft Any New Verizon Wireless Phone. Call 1-800-483-6697 to find a Store. Verizon Plus. We Add Savings. Umit 1 Per Customer. Offer Ends 11/30/09. Quick Bill Summary for LOUIS TACEY Previous Balance Payments Received Oct 6 __ _ _ ___ Balance Forward New Charges $38.41 -$38.41 - $.00 Voice Services (See pg 3) $16.98 ._ _ Taxes, Fees & OtherVerizon Charges $9.63 _. Other Providers (See P9 4) $11.63 Total New Charges Due by November 18, 2009 538.24 rotas Amount Uue ny November ~a, 2009 $3s.2a ~~ ~~~ ~`~% /""F Manage Your Account ~/ Phone Number Account Number Billing Oate 8/2/2009 `^~ My Account at verizdn.com/b0lvlew 215-743-7798 215 743-7798 930 52Y Quick Bill Summary for verizon News, ___ STEPHANY TACEY Staying In Touch Made Easy! Get unlimited residential calling across the previous Balance __ -$24.03 U.S. with Verizon Freedom Essentials. Plus, get Caller ID, Call Waiting & Home Voice Mail -- --- No Payment Received - _. __ $.00 _ .__ _.:. . (where available) for Just $49.99/mo. Call Cretin Balance -$24.03 t-877-896-6066 for details. Terms & resMctions apply. New Charges _. _ -__ _._.._.-_ _ _ . _ __. Get More, Save More. Voice Services (See pg 3) -- --- $44.99 - - $ia.aa At Verizon, we want to make sure you're Taxes, Fees & Other Charges _.___ -. --- _ _. s~ '~ getdngthe best services at the best value - Total New Charges Due by August 31, 2009 • from phone and Internet, to TV and money-saving bundles. Call Total Amount Due by August 31, 2009 5.40 ~ _/`~ Manage Your Account / Phone Number Account Number Billing Date My Account at verizon.com/billview ~. 215-743-7798 ` 215 743-7798 930 52Y 6f212009 Verizon News Talk Endlessly Without Time Limit Verizon Freedom Essentials lets you keep in touch with unlimited calling across the U.S. and Canada. You also get Home Voice Mail, Caller ID & Call Waiting for only $49.99/mo. Call 1-898-240-8917 to sign up today. Subject to taxes, fees & terms. Quick Bill Summary for STEPHANY TACEY Previous Balance $142.58 Payments Received (See pg 3) -$285.16 Credit Balance -5142.58 New Charges Voice Services (See pg 3) $44.99 Taxes,Fees & OtherCharges $14.12 Total New Charges Due by June 29, 2009 559.11 Total Amount -$83.47 ~„/~ ~ Manage Your Account Phone Number Account Number Billing Date ~h My Account at verizon:com/biliview 215-743-7798 215 743-7798 930 52Y 9/2/2009 Verizon News QuICk BIII Summary for STEPHANY TACEY Important Information This is a reminder that pricing for your FiOS previous Balance $35.40 TV has Increased this month. Go to myverizon.com or call 1-877-881-6283 to Payments Received Aug 22 -$35.40 team about our exc(ting new products, Balance Forward $.DO bundles and ways you may be able to save. Staying In Touch Made Easy! Get unlimited residential calling across the U.S. with Verizon Freedom Essentials. Plus, get Caller ID, Call Waiting & Home Voice Mail (where available) for Just $49.99/mo. Call 1-888-747-5771 for details. Terms & restrictions apply. Manage Your Account New Charges Voice Services (See pg 3) $44.99 Taxes, Fees & Other Charges $14.44 Total Naw Charges Due by September 30, 2009 559.43 Total Amount Due by September 30, 2009 $59.43 Phone Number Account Number Billing Date 215.743-7798 930 52Y' 10/30/2009 My Account at verizon.com/bilWiew 215-743-7798 News Get More, Save More Call 1-888-610-7288 to make sure you're getting the best Verizon services at the best value -from phone and Internet, to TV and money- saving bundles. Together we'll evaluate your current services, and find ways to save you even more. Moving? Let Verizon Help Call 1.866.VZ.MOVES to bring the power of the Network to your new home. We can connect your TV, Internet & phone quickly -maybe before you're finished unpacking. Plus, we have Bundles to fit your needs and your budget. Service availability varies. Verizon Foundation Visit Thinkflnity.org for thousands of FREE educational resources forteachers, students, parents and the after-school community. Quick Bill Summary for STEPHANY TACEY Previous Balance $34.14 _ _. Payments Received Oct 12 -$34.14 Balance Forward $.00 New Charges Total New Charges $•~ Total Amount $.00 Revised Final BIII Thank you for latdng us serve you. ~.' .1~~ ^ STEPHANY TACEY 1636 BENNER ST PHILA PA 19149-3434 Aanage Your Account Phone Number Account Number Billing Date Ay Account at Verizon.com/billvfew 215-744-2418 215 744-2418 345 67Y 4/2672009 Verizon News Moving? 1-866-VZ-MOVES One call gets you up & running! Count on the Verizon network to make at least one part of your move easier. Across the street or across the nation all you need is one call to Verizon to setup your Internet, phone & digital TV in your new home in no time. Service availability varies. Get Category Search Now from 411 Bu: 41' why Plu, Sea Quick Bill Summary Previous Balance $74 77 Payments Received Mar 30 -$36.94 Balance Forward $37.83 New Charges Voice Services (See pg 3) $28.49 Taxes, Fees & Other Charges $914 Total New Charges Due by May 26, 2009 $37.63 Total Amount Due $75.46 5 ~~ ~ ~/~ ~j r ~~~ , ,I Manage Your Account Phone Number Account Number Billing Date My Account at verizon.com/billview 215-744-2418 215 744-241.8 345 67Y .5/26/2009 Quick Bill Summary for STEPHANY TACEY Previous Balance $75.4E Payments Received May 8 -$75.4E Balance Forward $.00 New Charges Voice Services (See pg 3) $28.49 Taxes, Fees & Other Charges $9.05 Total New Charges Due by June 22, 2009 $37.54 Total Amount Due by June 22, 2009 $37.54 4~ ~~~~\ ~~~ ,~, k J -- ~~,T' a Manage Your Account Phone Number Account Number Billing Date My Account at verizon.com/biliview 215-744-2418 '' 215 744-2418 345 67Y 6/26/2009 Verizon News. - Get More, Save More. Let Us Help. At Verizon, we want to make sure you're getting the best services at the best value - from phone and Intemet, to TV and money-saving bundles. Call 1-888-265-7527 today, and together we'll evaluate your current services, and find ways to save you even more. Moving? 7-866-UZ-MOVES One call gets you up & running! Count on the Verizon network to make at least one part of your move easier. Across the street or across the nation all you need is one call to Verizon to set up your Intemet, phone 8 digital TV in your now home in no time. Service availability varies. Quick Bill Summary for STEPHANY TACEY Previous Balance Payments Received Credit Balance $37.54 (See pg 3) -$150.54 -$113.00 New Charges Voice Services (See pg 3) $28.49 __. _ __ _ Taxes, Fees & Other Charges $9.05 Total New Charges Due by July 22, 2009 $37.54 Total Amount -$75.46 `~~ Manage Your Account Phone. Number Account Number Billing Date My Aocaunt at verizon.comlbillview 215-744-24f8 2fi5 744-Q418 345 67Y' 7/28/2009 van Quick Bill Summary for STEPHANY TACEY Talk Endlessly Without Time Limit With Verizon Freedom Value you can keep in touch with unlimited calling across the U.S. 'and Canada. 51gn up for only $44.99/mo & call your loved ones w/o worrying about the bill. Call 1-888-240-8918 today. Subject to taxes, fees & terms. Moving? 1-866-VZ-MOVES One call gets you up & running! Count on the Verizon network to make at least one part of your move easier. Across the street or across the nation all you need is one call to Verizon to setup your Intemet, phone & digital TV in your new home In no time. Service availability VaflB9. Get More, Save More. Let Us Help. At Verizon, we want to make sure you're getting the best services at the best value - from phone and Intemet, to N and money-saving bundles. Call 1-888-652-8111 today, and together we'll evaluate your current services, and find ways to save you even more. Previous Balance -$75.46 No Payment Received $.00 Credit Balance _$75.46 New Charges Voice Services (See pg 3) $28.47 Taxes, Fees & Other Charges $g,21 _ _ _ ..._. Total New Charges Due by August 24, 2009 $37.68 Total Amount ~7,Tg Manage Your Account Phone Number Account Number Billing Date ~~1 My4ccount at verizon.com/billview 215.744-2418 215 744-2418345 57Y 8/2620tlg verizgn News Quick Bill Summary for Important Information STEPHANY TACEY This is a reminder that pricing for your FiOS N has Increased this month. Go to Previous Balance -$37 78 --. myverizon.com or call 1-877-881-6283 to No Payment Received - ___- leam about our exciting new products, $.00 Credit Balance bundles and ways you may be able to save. -537.78 Staying In Touch Made Easy! ~ New charges et unlimited residential calling across the U.S. and to Canada with Verizon Freedo - __ _ ._-. Uoice Services ---- ee pg 3) $28 49 m Value for a great low price of just $44.99/mo. Taxas, Fees & other Charges $9.12 One low price and the best of the Network. _ _ _ Total New Charges Due by September ZZ 2009 ~- Call 1-877-896-6077 for details. Terms & restrictions apply. , $37.61 Total Amount _$,,17 ~ Get More, Save More At Verizon, we want to make sure you're getting the best services at the best value - from phone and Internet, to N and money-saving bundles. Call 1-888-652-8111 today, and together we'll evaluate your current services, and find ways to save you even more. I~,,,~'~' Manage Your Account Phone Number Account Number Billing Date My Account at verizon.com/blllview 215-744'-2418 .`215 744-24t8 345 67Y 9/30/2009 Verizon News ~ Quick Bill Summary for Get More, Save More STEPHANY TACEY At Verizon, we want to make sure you're getting the best services at the best value - Previous Balance -$.17 from phone and Internet, to TV and No Payment Received $,Op money-saving bundles. Call 1-888-652-8111 today, and together we'll _ -- . Adjustments __ __ _ _. _-. _._ -----_.._. (See pg 3) $g,gg evaluate your current services, and find ways Balance Forward - 58.52 to save you even more. Moving? 1-866-VZ-MOVES One call gets you up & running! Count on the Verizon network to make at least one part of your move easier. Across the street or across the nation all you need is one call to Verizon to setup your Internet, phone & digital TV In your new home In no time. Service availability Var18S. ~'""~ UI Verizon Ne (1 Get More, Save More New Charges Voice Services Taxes, Fees & Other Charges - _ - - -- Totel New Charges Total Amount Dine r------ Ravlsad Hnal 8ilr"" ~ ""'^-t ng us Marrs you. $.00 Manage Your Account Phone Number Acxount Number Billing Oate My Account atverizon.comlbillview 215-743-7798 215.743-7798-:930 52Y 9/30/2009: Quick Bill Summary for STEPHANY TACEY At Verizon, we want to make sure you're gettlng the best services at the best value - from phone end Internet, to TV and money-saving bundles. Call 1-888-852-8111 today, grid together we'll evaluate your current ~rvlces, and find ways to save you even more. Moving? 1-866-VZ-MOVES One call gets you up & runnng! Count on the Verizon network to make at least one part of your move easier. Across the street or across the nation all you need is one call to Verizon to ~t up your Internet, phone & digital TV in your) new home in no time. Service availability caries. Go Green. In Your New Prius Now Verizon customers can enter for a chance to win a 2010 Toyota plus, a Daily Instant Win $100 Visa virtual account or a trendy Tote bag. For details go to verizon.com/pogreen. It's never been easier to do your part and maybe drive in style at the same time. No Previous Balance - - -- __---------- -------- --- $59.~ No Payment Received Balance Forward _ _ -- -- ...--- --$59.4 New Charges -___ __ - . Voice Services __ --- - -_(See pg 3) -- -- --- --- -$19.51 _... Taxes, Fees & Other Charges --- --- - - Total New Charge; _. -$25.2t To_tai Amount Due -Please Pay Now `" $34.14 Rwraad FIB Pay your bill enllm at Yeriza~.com/payRnalbHl To avoid referral to an ouWds collsctlon apancy, ~ hIH amount Is due upon receipt. _. ~. , ~ .> `~,~ !~ ~ ~~I (See P9 3) -$6.65 -$1.87 ---- -$8.52 STATEMENT OF ELECTRIC SERVICE MAY 2009 74657 09467 c_.__ -_ PAYMENTS RECEIVED AS OF APR 27 2009 39.11 THANK YOU PIN: 535706834 METER READINGS !TER N0. 005672381 PRESENT (ACTUAL) 007634 °REVIOUS (ACTUAL) 007566 DIFFERENCE 000068 TOTAL KWH 68 HOMEWIRE BASIC RS-1 001 RESIDENTIAL SERVICE BILLING PERIOD..04-15-09 TO 05 -14-09 29 DAYS CUSTOMER CHARGE ENERGY CHARGE FIRST 1000 KWH 68 KWH ~ 6.569000 ABOVE 1000 KWH 0 KWH a1 6.56900C FUEL CHARGE FIRST 1000 KWH 68 KWH a 5.60000C ABOVE 1000 KWH 0 KWH a 6.60000C +~TOTAL ELECTRIC COST GROSS RECEIPTS TAX TOTAL CURRENT BILL TOTAL DUE THIS STATEMENT - ~, ~~ ~~ :~' ~~ ~J 3.95 8.03 3.79 :00 3.81 .00 15.63 .40 19.98 1~ 9.9~ `~' Progress Energy STATEMENT OF ELECTRIC SERVICE ~~,~M ~ ~~~ ~e~y 74657 09467 JUNE 2009 SIN: 535706834 1AETER READINGS TER N0. 005672381 PRESENT (ACTUAL) 007732 'REVIOUS (ACTUAL) 007634 )IFFERENCE 000098 TOTAL KWH 98 PAYMENTS RECEIVED AS OF JUN 03 2009 19.98 TNANK YOU HOMEWIRE BASIC RS-1 001 RESIDENTIAL SERVICE BILLING PERIOD..05-14-09 TO 06 -15-09 32 DAYS CUSTOMER CHARGE ENERGY CHARGE FIRST 1000 KWH 98 KWH B 5.669000 ABOVE 1000 KWH 0 KWH a 6.569004 FUEL CHARGE FIRST 1000 KWH 98 KWH 0 5.b0000C ABOVE 1000 KWH 0 KWH a1 6.600000 *TOTAL ELECTRIC COST GROSS RECEIPTS TAX TOTAL CURRENT BILL l ~ TOTAL DUE THIS STATEMENT 1~ ~, ~~~3q 8.03 5.46 .00 5.49 .00 3.95 18.98 .49 23.42 `~ Progress Energy PIN: 535706834 METER READINGS 4ETER (~. 005672381 'RESENT (ACTUAL) 007835 'REVIOUS (ACTUAL) 007732 )IFFERENCE 000103 TOTAL KWH 103 ~i~ `v PrO9reSS EI1P.rgy STATEMENT OF ELECTRIC SERVICE JULY 2009 . • 74657 09467 PAYMENTS RECEIVED AS OF JUL 06 2009 23.42 THANK YDU HOMEHIRE BASIC 3.95 RS-1 001 RESIDENTIAL SERVICE BILLING PERIOD..06-15-09 TO 07 -15-09 3 0 DAYS CUSTOMER CHARGE 8.03 ENERGY CHARGE FIRST 1000 KWH 103 KWH a 5.569000 5.74 ABOVE 1000 KWH 0 KWH a 6.569000 .00 FUEL CHARGE FIRST 1000 KWH 103 KWH a 5.600000 5.77 ABOVE 1000 KWH 0 KWH a 6.600000 .00 *TOTAL ELECTRIC COST 19.54 RATE ADJUSTMENT 1.18 GROSS RECEIPTS TAX •53 TOTAL CURRENT BILL 25.20 TOTAL DUE THIS STATEMENT ~~ STATEMENT OF ELECTRIC SERVICE 74657 09467 AUGUST 2009 PIN: 535706834 METER READINGS METER N0. 005672381 PRESENT (ACTUAL.) 007929 PREVIOUS (ACTUAL) 007835 DIFFERENCE 000094 TOTAL KWH 94 PAYMENTS RECEIVED AS OF JUL 31 2009 25.20 THANK YOU !HOMEWIRE BASIC RS-1 001 RESIDENTIAL SERVICE BILLING PERIOD..07-15-09 TO 08-13-09 29 DAYS CUSTOMER CHARGE ENERGY CHARGE FIRST 1000 KWH 94 KWH 8 5.569000 ABOVE 1000 KWH 0 KWH ~ 6.569000 FUEL CHARGE FIRST 1000 KWH 94 KWH a 5.600000 A80VE 1000 KWH 0 KWH 8 6.600004 *TOTAL ELECTRIC COST RATE ADJUSTMENT GROSS RECEIPTS TAX TOTAL CURRENT BILL TAT w• w..~ T..~.. ..- ..-..~ 1 `G~~1 3.95 8.03 5.23 .00 5.26 .00 18.52 1.14 .50 24.11 STATEMENT OF ELECTRIC SERVICE v Progress Energy ' f~ 1.~ 74657 09467 , SEPTEMBER 2009 ~ ~ ~~~ PIN: 535706834 METER READINGS TER N0. 005672381 °RESENT [ACTUAL) 008033 'REVIOUS [ACTUAL) 007929 )IFFERENCE 000104 (OTAL KWH 104 `~' Progress Energy PAYMENTS RECEIVED AS OF AUG 21 2009 24.11 THANK YOU HOMEWIRE BASIC RS-1 001 RESIDENTIAL SERVICE BILLING PERIOD..08-13-09 TO 09-14-09 32 DAYS CUSTOMER CHARGE ENERGY CHARGE FIRST 1000 KWH 104 KWM a 5.569000 ABOVE 1000 KWH 0 KWH a 6.569000 FUEL CHARGE FIRST 1000 KWH 104 KWH a 5.600000 ABOVE 1000 KWH 0 KWH a 6.600000 *TOTAL ELECTRIC COST RATE ADJUSTMENT GROSS RECEIPTS TAX TOTAL CURRENT BILL TOTAL DUE THIS STATEMENT STATEMENT OF ELECTRIC SIERVICE OCTOBER 2009 8.03 5.79 .00 5.82 .00 3.95 19.64 1.18 .53 25.30 vF~ 74657 09487 . 'IN: 535706834 DETER READINGS .TER N0. 005672381 QESENT (ACTUAL) 008133 4EVIOUS (ACTUAL) OQ,0;33 D=FERENCE O~f1D0 1TAL KWH 100 PAYMENTS RECEIVED AS OF SEP 22 2009 25.30 THANK YOU HOMEWIRE BASIC RS-1 001 RESIDENTIAL SERVICE BILLING PERIOD..09-14-09 TO 10-15-09 31 DAYS CUSTOMER CHARGE ENERGY CHARGE FIRST 1000 KWH 100 KWW 8 5.569000 ABOVE 1000 KWH 0 KWH 8 6.569000 FUEL CHARGE FIRST 1000 KWH 100 KWW a 5.600000 ABOVE 1000 KWH 0 KWM a1 6.60000G *TOTAL ELECTRIC COST RATE ADJUSTMENT GROSS RECEIPTS TAX TOTAL CURRENT BILL TOTAL DUE THIS STATEMENT ~~~ .~., al 8.03 5.57 .00 5.60 .00 3.95 19.20 1.17 .52 24.84 23 4.84 ~n~~~~i~iun~~i~n~~~~uu~~u~u~u~~u~~~~n~~ii~i~~~~~~~~ TACEY STEPHANY & CHESKI 1634 BENNER ST PHILADELPHIA PA 19149 SERVICE ADDRESS _ 1634 BENNER ST ~- ACCOUNT NUMBER 016-16920-01634-001 INCLUDES PAYMENTS . ON OR BEFORE 04/23/09 04/23/09 0904 0096185 41R ~X ~~~~ URRENT BALANCE: SERVICE CHARGE USAGE CHARGE PAYMENT MADE 04/14/09 ~n~~~~i~nui~~i~n~~i~nn~~n~n~n~~u~n~n~~n~n~i~~~i) TACEY STEPHANY & CHESKI 1634 BENNER ST ~._,~ .~„ ~~ ~- PHILADELPHIA PA 19149 ~~~ ~ ,~. 05/22/09 ~ 0905 ~ 0096185 ~ 41R PAY BY PHO WEB PREVIOUS BALANCE CURRENT BALANCE: 877-309-37 .PHILA.GOV SERVICE CHARGE TT.CAf;F. f'HARf;F 03/12859 104/12889 I 3 21.89 13.27 35.16 SERVICE ADDRESS 1634 BENNER ST ACCOUNT NUMBER 016-16920-01634-001 INCLUDES PAYMENTS ON OR BEFORE 05/22/09 Q4/12889 05/12899 I 1 21.89 a_a~ 35.16 26.31 I1~1111111111111111~11~11111111111111111111111~111,~I~~I1111~1 1634YBENNERAST & CHESKI PHILADELPHIA PA 19149 .....,~:,...._.,.._...,t.:.:,, :.::::.::::.:::. ~A»<: ,j; 06/22/09 0906 0096185 REVIOUS BALANCE URRENT BALANCE: SERVICE CHARGE USAGE CHARGE FAYMENT MADE 05/ NT AMOUNT 36.92 SERVICE ADDRESS 1634 BENNER ST ---»- ACCOUNT NUMBER 016-16920-01634-001 INCLUDES PAYMENTS ON OR BEFORE o6/2z/o9 41R 1 05/12899 1 06/12899.1 O 21.89 0.00 27.55 21.89 ooosa~ of Nhllaaeipnia vvateri5ewer Sul lions? Call: 215-686-6880 :ount Information Customer Name TACEY STEPHANY &CHESKI Service Address 1634 BENNE Account Number - 34-001 $49.44 -$108.03 vice Information Prey Pav Adjustments Current Charges Usage Charge Service Charge Total Account Balance Olnnno Dw fhiC Llmnllnt ~~ Water ~Eev+eawe Bureau Phila~lphia Revenue DepaRment lalll 1NA tinulti'rrJ k'hJa.. NA IYIILiI lw.+ B+Iling Date Includes Payments through Charges Hccouni aarar $22.60 -$35.99 lon 07/0809 Thank You!) -$110.91 $2.88 $22.60 07/22!09 07/22!09 ent Due $0.00 $22.60 -$35.99 $0.00 J A S O N t) J F M A M J J I1111111111111111111111111111111111111111111111111111111111111 .STEPHANIE TACEY 1636 BENNER ST PHILADELPHIA PA 19149 ~ \,~~1 ~S`~i~ LAST PAYMENT MADE 04/ PAYMENT AMOUNT 21.89 SERVICE ADDRESS ~~ 1636 BENNER ST -+- ACCOUNT NUMBER 016-16920-01636-001 INCLUDES PAYMENTS ON OR BEFORE 04/23/09 03/17/09 104/17/09 114 114 0 21.89 0.00 21.89 SERVICE ADDRESS ~~ 1636 BENNER ST --^- ACCOUNT NUMBER 016-16920-01636-001 INCLUDES PAYMENTS ON OR BEFORE 05/22/09 I1111111111111111111111111111111111111111111111111111111111111 STEPHANIE TACEY 1636 BENNER ST PHILADELPHIA PA 19149 i~'3:•ev... e.: ~v: .:: at }~~~ ~G.i.. u..e~i`; . fa:::~S2~.'^.::`: uz.;eaco:::r.•..: ~ l 05/22/09 xi: ~ PAY BY PHO WEB 877-309-37 ' .PHILA.GOV ~. . . URRENT BALANCE: SERVICE CHARGE USAGE CHARGE 04/23/09 ~ 0904 ~ 0096187 ~ 41R 0905 ~ 0096187 ~ 41R PREVIOUS BALANCE CURRENT BALANCE: SERVICE CHARGE USAGE CHARGE 04/17/09 105/18/09 114 115 1 21.89 4.42 21.89 26.31 I,,,III,I,,,,,II,I„II,I,,,,II„I„I„II„I„I„II„tl,,,,ll,l STEPHANIE TACEY 1636 BENNER ST PHILADELPHIA PA 19149 ~ f;~a-- n ,_~: ~,' SERVICE ADDRESS 1636 BENNER ST ACCOUNT NUMBER 016-16920-01636-001 . INCLUDES PAYMENTS ON OR BEFORE 06/22/09 06/22/09 ~ 0906 ~ 0096187 ~ 41R REVIOUS BALANCE URRENT BALANCE: SERVICE CHARGE USAGE CHARGE PAYMENT MADE 05/29/09 NT AMOUNT 22.98 THANK 89237836 ;ity of Philadelphia Water/Sewer Bi luestions? Call: 215-686-6880 21.89 4.42 27.58 26.31 oa ater>~renu~eBureau Philadelphia Revenue Department I-iOl JFI. l3nulwrcal Phtla.. k'A 191tr!-Ilmi account Information Customer Name ST CEY Billing Date 07/22/09 Service Address 36 $ENNER S Includes Payments through 07/22/09 Account Number 016-1 - - 1 $53.89 Service Information 1.0 0.8 os 0.4 o.z -$99.21 Adjustments Current Charges Usage Charge Service Charge urges HCCVUra oa:ar $22.60 -$22.72 (on 07/08/09 Thank You!J -$102.09 $2.88 Payment 0 $0.00 $22.60 $22.60 Total Account Balance 05/18/09 06/16/09 115 116 1 -$22.72 Vl (G ~cm~ ~ ~rnn~~ ~Dmrnv Z v~~oZ =~m~m ~~~~~ °o~" ~~v~~ ~mOZ~ p Z ~ Z m° ~OCm~ ~~m~rn D~~zW Q ~ ZO ~ ~• ~m .,mz~~ ~~~Z? ~'o~~~ ~~.~in0 ~ z ''m p0 T Z Z m L7Op ~~v ~, m ~~~ ~vo ~,~ o~m z m '~'~ z ~~m Svc ~m~ -=i zZ ~ ~ ~ ~ 3 ~z e ~3 om o~ -~ A Z ~O ~ N 3 ~~ v 0 0 n N ~ o T D s a b A ~ ~ Z, ~ ~ o. c m °-' cn c N e ? m . ~ ~ S O .~.~, C ~ (7 ? d J rn ~ cn T m ~ ~ yI ~ ~ ~ `~ 3 ~ A n fD C J ~ ,~, ~ D ~ n 7 ' O v_ ~ ~ tDimc o ~ j '~' v OO o ~ isiy ~ 3. ~ • . . ~ N ~ D m 3 d -+~ ~ ~ Q ~ ~ ~; ~ c~ O ''r °' ~ ? ~ ~ O ~ c ~ ~ ~ o~~ J Q'~m ~ ~ ` °m~ ~ D rv ozz Cn ~~ O N• w ~D ~ H _ `a ~ ~~ ~_ ~ N ~ N 0 ~ ~ ~ ao o ~ 0 c a~~ `° c ~ ~ v M fD o ~ N A ' ~ ~ ~ A 'Y J ~ V .+ ? 0 ~ ~ ~oo -. ~ io ~ N SN o , v o ,~ t T ~~p ~~ '~ ~~ J W o a o , N A O~ no i~ PASCO COUNTY UTILITIES SERVICES BRANCH 7508 LITTLE ROAD P.O. DRAWER 2139 NEW PORT RICHEY, FL 34656-2139 NEW PORT RICHEY (727) 847-8131 DADE CITY (352) 521-4285 LAND O LAKES (813) 996-7341 05/08/2009 SERVICE FROM 04/02/2009 TO 05/07/2009 PREVIOUS READING 000277000 CURRENT READING 000277000 GALLONS USED 0 0 0 0 SERVICE ADDRESS 3 7 5 2 FOX DALE L N ACCOUNT NUMBER 306-36-5 031-0-02 CURRENT CHARGES PA 19149-3434 88.37 88.37 6.95 13.38 .r ^ '~{ ~ Vim} f,l I ~ ~'? ly ,.~ 20.33 TOTAL DUE 2 0 . 3 3 DUE DATE APPLIES TO CURRENT CHARGES ONLY. UNPAID PRIOR BALANCE MAY RESULT IN IMMEDIATE DISCONNECTION OF SERVICE CRITICAL WATER SHORTAGE. REDUCE YOUR USE. TACEY, LOUIS A 1636 BENNER ST PHILADELPHIA PRIOR BALANCE PAYMENTS WATER CHARGES SEWER CHARGES ADJUSTMENTS OTHER CHARGES: LABORATORY TESTS SEPTAGE FIRE HYDRANTSILINES BACK-FLOW RECLAIMED WATER LANDFILL SLUDGE IMPACT FEES FINE INTEREST OTHER PASCO COUNTY UTILITIES SERVICES BRANCH 7508 LITTLE ROAD P.O. DRAWER 2139 NEW PORT RICHEY, FL 34656.2139 rvtW PORT RICHEY (727) 847-8131 DADE CITY (352) 521-4285 LAND O LAKES (813) 996-7341 06/10/2009 SERVICEFRC)M 05/07/2009 TO 06/08/2009 PREVIOUS READING 000277000 CURRENT READING - 000277000 GALLONS USED 0 0 0 0 SERVICE ADDRESS 3 7 5 2 f O X DALE L N ACCOUNT NUMBER 306-36-5031 -0-02 TACEY, LOUIS A 1323 ASPER DR BOILING SPRINGS PA 17007-961 ~,~\aaad ~~ PRIOR BALANCE PAYMENTS 20.33 20.33 WATER CHARGES 6 . 9 5 SERVER CHARGES 1 3.38 ADJUSTMENTS OTHHER CHARGES:. LABORATORY TESTS SEPTAGE FIRE. HYDRANTS/LINES $ACK-FLOW PAY YOUR BILL ONLINE! 60 TO WWW.PAYPASCO.COM RECLAIMED WATER AND USE YOUR ACCOUNT NUMBER ABOVE AND THE LANDFILL • FOLLOWING 6 DPGIT PIN CODE ---> 856781 KLUDGE ..IMPACT FEES FINE INTEREST OTHER CURRENT CHARGES 20.33 TOTAL DUE 20.33 DUE DATE APPLIES TO CURRENTCWARGES ONLY: UNPAID PRIOR BALANCE MAY RESULT IN IMMEDIATE DISCONNECTION-0F SERVICE PASCO COUNTY UTILITIES SERVICES BRANCH 7508 LITTLE ROAD P.O. DRAWER 2139 NEW PORT RICHEY, FL 34656-2139 NEW PORT RICHEY (727) 847-8131 DADE CITY (352) 521-4285 LAND O LAKES (813) 996-7341 TACEY, LOUIS A 1323 ASPER DR BOILING SPRINGS PA 17007-9616 ~,la~o~ \~ ~~ 07/09/2009 SERVICE FROM 06/08/2009 TO 07/07/2009 PRIOR BALANCE 20.33 PREVIOUS READING 000277000 PAYMENTS 20.33 CURRENT READING 0 0 0 2 7 7 0 0 0 WATEFd CHARGES 6. 9 5 GALLONSUSED_. 0000 SEWER CHARGES - -1-3.38 SERVICE ADDF@ESS-37 5 2 f 0 X DALE LN ADJUSTMENTS ACCOUNfi NUMBER 3 0 6- 3 6- 5 0 31 - 0- 0 2 OTHERS CHARGES: L,~4BORATORY TESTS SEPTAGE FIRE HYDRANTSILINES BACK-FLOW PAY YOUR BILL ONLINE! GO TO WWW.PAYPASCO.COM RIECLAIMED WATER AND USE YOUR ACCOUNT. NUMBER ABOVE AND THE LANDFILL FOLLOWING 6 DIGIT PIN CODE ---> 856781 SLUDGE If\VIPACT FEES FINE INTEREST CaTHER CURRENT CHARGES 20.33 TOTAL DUE 2 0 . 3 3 DUE DATE APPLIES TO CURRENT CHARGES ONLY. UNPAID PRIOR BALANCE MAY RESULT IN IMMEDIATE DISCONNECTION OF SERVICE REMINDER: CURRENT WATERING RESTRICTIOWS REMAIN IN EFFECT. PASCO COUNTY UTILITIES SERVICES BRANCH _., _ 7508 LITTLE ROAD P.O. DRAWER 2139 NEW PORT RICHEY, FL 34656-2139 NEW PORT RICHEY (727) 847-8131 DADE CITY (352) 521-4285 LAND O LAKES (813) 996-7341 08/11/2009 SERVICE FROM 07/07/2009 To 07/31/2009 PREVIOUSFtEADING 000277000 CURRENTFtEADING 000277000 GALLONS USED 0 0 0 0 SERVICE ADDRESS 3 7 5 2 FOX DALE L N ACCOUNT NUMBER 306-36-5031 -0-02 TACEY, LOUIS A 1323 ASPER DR BOILING SPRINGS PA 17007-9616 ~~~ia PRIOR BALANCE 2 0 . 3 3 PAYMENTS 2 0 . 3 3 WATER CHARGES 6 . 9 5 SEWER'CHARGES 13.38 ADJUSTMENTS __ _ _. OTHER CHARGES: LABORATORY TESTS SEPTAGE FIRE HYDRANTS/LINES BACK-FLOW PAY YOUR BLLL ONLINE!-GO TU WWW.PAYPASCO.COM RECLAIMED WATER AND USE YOUR ACCOUNT NUMBER ABOVE- AND THE LANDFILL FOLLOWING 6` DIGIT PLN CODE ---> 856781 SLUDGE IMPACT FEES FINE INTEREST OTHER- CURRENT CHARGES 2 0 . 3 3 TOTAL DUE 2 0 . 3 3 DUE DATE APPLIES TO CURRENT CHARGES ONLY UNPAID PRIOR BALANCE MAY RESULT IN IMMEDIATE DISCONNECTION OF SERVICE REMINbER: CURRENT WATERING RESTRICTIONS REMAIN IN EFFECT. PASCO COUNTY UTILITIES SERVICES BRANCH 7508 LITTLE ROAD P.O. DRAWER 2139 NEW PORT RICHEY, FL 34656-2139 NEW PORT RICHEY (727) 847-8131 DADE CITY (352) 521-4285 LAND O LAKES (813) 996-7341 09/09/2009 SERVICE FROM 07/31 /2009 TO 09/02/2009 PREVIOUS READING 000277000 CURRENT READING 000277000 GALLONS USED 0000 . SERVICE ADDRESS 3 7 5 2 F O X D A L E L N ACCOUNT NUMBER 306-36-5031-0-02 PAY YOUR BILL ONLINE! GO TO WWW.PAY.PASCO.COM AND USE YOUR ACCOUNT NUMBER ABOVE AND THE FOLLOWING 6 DIGIT PIN CODE ---> 856781 q'~~ ~ ~~ TACEY, LOUIS A 1323 ASPER DR BOILING SPRINGS PRIOR BALANCE PAYMENTS WATER CHARGES SEWER CHARGES ADJUSTMENTS OTHER CHARGES: LABORATORY TESTS SEPTAGE FIRE HYDRANTS/LINES BACK-FLOW RECLAIMED WATER LANDFILL SLUDGE IMPACT FEES FINE INTEREST OTHER CURRENT CHARGES TOTAL DUE PA 17007-9616 20.33 20.33 6.95 13.38 20.33 20.33 DUE DATE APPLIES TO CURRENT CHARGES ONLY UNPAID PRIOR BALANCE MAY RESULT IN IMMEDIATE DISCONNECTION OF SERVICE .. PASCO N NEW PORT R 10/12/2009 TACEY, LOUIS A COUNTY UTILITIES SERVICES BRANCH 1323 ASPER OR 7508 LITTLE ROAD BOILING SPRINGS P.O. DRAWER 2139 EW PORT RICHEY, FL 34656-2139 ICHEY (727) 847-8131 DADE CITY (352) 521-4285 LAND O LAKES (813) 998-7341 SERVICE FROM"09 / 02 /2009 TO 1 b/ 01 / 2009 PRIOR BALANCE PREVIOUS READING 000277000 PAYMENTS CURRENT READING 000277000 GALLONS USED 0 0 0 0 SERVICE ADDRESS 3 7 5 2 FOX DALE L N ACCOUNT NUMBER 306-36-5031 -0-02 9SY PAY ONLINE: GO TO WWW.PAYPASCO.COM VD USE YOUR ACCOUNT NUMBER ABOVE-'AND THE ALLOWING 6 DIGIT PIN CODE ---> 856781 r ~". ~'~ ,r r ~` ~ ~~:: ... f~3+~--' PA 17007-9616 20.33 20.33 WATER. CHARGES 7.16 SEWER CHARGES 14.18 ADJUSTMENTS OTHER CHARGES: LABpRATORY TESTS SEP'~AGE FIRE HYDRANTS/LINE S BACK-FLOW RECLAIMED WATER LANdFILL SLUDGE )~ ~ ~ J ~ IMPACT FEES (~~ FINE .~ INTEREST OTHER CURRENT CHARGES TOTAL DUE 21 .34 21.34 DUE DATE APPLIES TO CURRENT CHAF2GES ONLY. UNPAID PRIOR BALANCE MAY RESULT IN IMMEDIATE DISCONNECTION OF SERVICE PASCO UTILITIES:"FOCUSED ON SERVICE, COMMITTED TO EXCELLENCE" RATE CHANGES EFFECTIVE 10/01/2009 259270 41awa Store p115 64D© Bustleton Aue Philadelphia, Pa Date ©8/24/D9 Time ©7:54:15 Auth q ©75©59 UISA 508b Pump Gallons Price ip 19.©41 $2.b14 Product Amount UNLEADED $50.D8 Total Sale $5©.©© TNRNK YOU FpR FUELING AT WR4IA t G's'.~ 'O -.. ~' C :Y - r fU if :/ ~+z c - _ ,~ 7C f-+ .l J, Y. -t U U ~ ' r^~n ^ i/: Cl.i tJ^~ IJ X11 C i. .~. WL'1COn^C -r,n K'~et .err +.... Store #14 899 North U.S. Route 15 d111~burgg F'A 17014 717-432-0144 Stgre:0014 Appr:01315 Fump (1'0 : 02 Regulars '~ ~2,559/G Volume: 15.357 Gal Gam Totai: X41.86 Total X41.86 rJi3a X7(kXXi{XX5{5lXk5086 09/04/2009 11:32:29 abogeeTotalpAmnunt accgrd i r-~g to Eard Ie~uer Hgraement. ~iHY' GCr A"~'v'.+,'~ER- ELSE rF ~ r, ~-~ c . ~ a v - a'o V , tv Z ~ m .-I c Z ~ - v.' m r ;;-' .: _ to x c. c ~. W •-- .. 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S ~r~ in Jr ^ ^ ^- DTI Jl L^ ~C • _• , • ~ ~ F ; 25927© 4lawa StoYe ri115 64rJ0 Bustleton Ave Philadelphia, Pa Date 04/14/04 Time 13:05:07 Auth # ©302©B UISR 5©86 Pump Galipns Price D1 15.4tr2 $2.559 Product Amount UNLEADED $4©.82 Total Sale $4©.82 THANK YGU FOR FUELING AT WAWA xxxx~*~x ~-x ac^x*~*~~n ~cx GIANT FL!EL 830 Nvrth U.S. 15 Di114burg~ FA f717; 502-1371 -------------------- Date 09/18/09 Timc 09:41:12am Tran#: 467 Auth#: 093810 Tyyppe US X}{XXXXXXXXXXSQ?4 Product: Regular Unl Pu~ao# 1 ~P~,~„t~ ~ ._ : 2.259 Cad"' K . 21.450 Arri-' ~r^~ 4^0.46 5nv:nga: 4.c9 Tote. l 48.46 THANK YOU PLEASE CO"!c AGAIN YOU REDEEMED 200 GAS EXTRA REWARDS POINTS FOR A SAU3NGS ?.20 PER GALLON TOTALING X4.29 THIS PURCHASE `iN NNIY -' tD c0 lp f.1 p. ~ ~ lfv ~ IL7 WW WO ~ N r^~ ~' Q I•^V O U ~ O Z , ww C ~-- W~~OI~D Z S ~ pp ¢ O Oh-- I` ~ ~ Q k ~J ~ RO~ Mn W Z Y H ~ C:W ¢~ Q J~ O~ ~ ^ ¢~Y ' ^ J Y { ~ ~Q 1-1 p of ti ~ O-lv/ ~ OW7! h- f" ate C O U -- ~~,~ d~~ ¢ UO y r= r. * . . .. ~ N t ~~ ~: 1. , . ~, _ , _ r, i ~ . , I w I rJ i. ,-~-~ _ _ ~ , 4 8r9r?0 eta . `^ ~ - ~ ~ y m .~ - r~.~ ~,, - : ` - ~ She 4 534 etz: ~ ' ~ . ~ :f ~. ~ ' ; -„ - .. -n ~~- 'J ~ , 5 ` 3834 M . . ° ^ ~ J ~ ,; = = _ ~ Mo ,~, treat r ° ' r p ~f r_ ti~ 1r' .~~ ; 1 ~, .,_ -ter _ ~., -- kr - .- r a,. P gen • ~' A 19541 (.~ • „ ' ~ ~ rt ;~ ~ ~ _ . (61 _ ~ ~ r _ 0) ~ Sto r 440 w : _ , ~r Appr:07 ; ._ -. ~ mo ~ ~ --- +~ PA 19543 14 ~s Unleaded ~ ~ " $ 599x8 Volum : ` ; ' • 38 e 7 ~ Gal ~ ~ • ~~ t I~, ~c~ III rn -+.•.~A ~ri tC~U1 a iU -'.r ~ ;I. fi ~. „ t13~ .GAS rOtAl'.. ~ ;~1. .~„~ ,1 ,f,(, .. J ul row F 41. r. .. ~~ , t , , ~._ ~ - :JI ' $45.19 ~ ~~ , ~~ Total '` ' „ r 1)~I C. •f LO V~ ••t ' e i r ft i i 4i r. II %) f Ill ~^ ~~ $45.19 t' . i ~~~: rf74,P .• ~ •J f~i 1 Irll l J n U . n J t. ~ it Nl Q'' I~1 r,~ ii -~ea . t~ 7 Ilt,l iL} IY' I I .,1 111 1 < 'll I)1 v I Ill 1 I Ill ~ I , ^ ~ ~ I II 1II !ll 'Jtfl ' "• I' r s ~ rtJhJ . 1tu ~ i, -`,J t (7J T5 ti ( 1 ~ . ' '~~ ( h j s ~/ ~ Y J ; ~ ~ l 14 v 1 r 4i up -u~ t u . s ttil L~J ~TJ ~ , s .. ~, -_'J !~ i ` I) I u, ~, . IL ' 111 i - 1 ~ + ~/yy ~/~ / / ; ^~ XXXXXXXX 5094 ^ I r CI n t! 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A194 _ ____.__.._ . _-_. ~ m••1 C 3 W N~ to 94W 94 ~ ++ 94 0 ~I }~. r ~{ O +~ .9E •, N N o a,* a 9F ~ ~ 94 vld..~ rd ••r o ro *~ m~ The UPS Stare - #3763 X94 caN •i ..r d • •.. 94 # •rsw to * e94 275 Cumberland Parkway 010''3= ~~ V O ~a ~ 94 Y ~.+ 3(. 94 e-•94 Mechtanlcshurg PA 17055-5671 rAl73m o9*E ~ g~ ~~ ~ e~ ~ ~r ~~ , (717) 795-8616 LL~47 V7•.+* Id•N~ ..m ~0' f.Z 0 94E•IW9E •-r ^r ~ -~ 94 o t:. ¢ a rn a m a ~ E• 94 94 09/09/09 12:52 PM P!e are the ane stop for all your sflippir}g, postal and business need s. tvtr~-~ rntn UI Oi L9 ~ tY V tl' 41.1 QI +' t,, U) J mcJ 4 lSl tb [V Iti ~ Y1 1 tr1 • • { c )~ • 5 ' ~ We offer all the services you nee d 0) r` CI'i(L COlT1 `~~ ' • ~ , 6J !tr t0 • ' k t. ~i-- Il rti t. n I t li 111 to keep ynurbr rsiness going + tvn i ; t, l _ r~1 . . 1. r'Icrv at n;?c rv >`J li) t : ~t <1 `~ "' ~°" ~°`v `~' •• N X 41 m ; t ~: IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIILIIIIIIIIIIIIIIIIHI IIII~ 912Y L U _S N 9 [~ (] L • • a., :~ U dJ Z5 S o ~ .o to •• m z rt v a o ~~ tnv v •• .. ~ r- ~ ' x .~ ~, r . c. Iv ~ e~ t(r> o ~ ~~.~ ci 001 001045 (001) TO $ 22 omtri_.ti o a a a1~• n+~ ~ i x ~ ~ u a} > Gruund Residential . a +)o~ r+ +J a :s v o ar a 3 rn [7[1 ~ O N to a tL tr a c~ t- co is I~ re ro~ .L := Tracking# 11863EW10321723652 ---- - OU2 001045 (001) TO $ 19.1 Ground Residential Tracking# 1Z863E4'11U327125994 ~nc0~ Oo oa'+~ o+o+ M ~ !~ SUbTotal $ 41..1 ~, ~'~' ""~ O MN! ~ „°, M _ Q Total $ al.i L ~ ~ N •• X ~ N y ~ c x `-' o ~ VISA $ 41 i n -F~ c 3 ~o ~ ~ ~r ~ _:. c •r X v+ •«.~ c ACCOUNT NUMBER * *~*~**~**** . *50! rl~~•r /'9MMMM ~M~ ~' X O •r BOILING SPR NGS PO BOILING SPRINGS, Pennsylvanier 170079601 4134870007 -0098 09/09/2009 (800)275-8777 01:28 :10 PM Sales Receipt ---- - Product Sale Unit Final Description Qty Price Price $s.eo 1 $s.so $s.ao Forever Stamp PSA Dbl-Sd Bkit $8.80 1 $8.8U $8.80 Forever Stamp PSA Dbi-Sd Bklt Total: Paid by $1~ Visa $17.60 Account #: XXXXXXKXXXXX5094 Approval #: 032738 Transaction #: 106 23 903111144 Order stamps at USPS.com/shop or call 1-800-S'Camp24. Gc to USPS.com/clicknship to print shipping labels with postage. For other information call 1-80U-ASK-IJSPS Bill#: 1000201763348 Clerk: 03 All sales final on stamps and postaye Refunds for guaranteed service<„ only Thank you for your busines<.: XXXXXXXXXxxX*xXxXXXXXXxXxX*XXX*XXXY:XX*XX XXXXXXXXXXXXXXxXXXxXXxxXXXXxXxXXxxY:XXXxX HELP US SERVE YOU BETTER Go to: http:ilyx.gallup.com/pos TELL US ABOUT YOUR RECENT POSTAL EXPERIENCE YOUR OPINION COUNTS XXXXXXXXXXXXXXXXxXXXXXXxX'XXXxXXXxXf:xX X:tx XXXXXXXXX:YXXXXxXXXXXXXXXXxX%xxxxxXx*xxxX Customer Copy i ^ „; Q ., ~ t • ~ ~~; :;y M, that was easy, Low prices. Every item. Every day. 126 South 32nd Street CAMP HILL, PA 17011 (711) 731-1761 1504942 1 001 23729 ;ALE 1644 09/09/09 11.28 PRICE ITY SKU REWARDS NUMBER 3410302453 SPLS 16 SHEET MICR 239.99 .718103096263 1 pRp PRICE $34.99 34.99 ~ 477250 Salesperson #1504942 274.96 SUBTOTAL -10.00 Caupon No. 2267628883944548 X110 off the purchase of $100 or mare E~cpiration Date; 10/17/09 TOTAL 15.90 Standard Tax 6.00X $28o,Ba Visa Card No.: XXXXXXXXXXXX5094 CS] Auth No.. 012757 280.88 If you return any of the items above, the value of the Staples coupon(s) used may be proportionally distributed to all items purchased. -rp-EpL ITEMS 2 r 4 fyri 4 '~+,'i ~ ~y§ ~J4rt" ~ a ~ t*.Y staf~~~ r \\1~Y' PP (.. ~ g ~ J IM1~. ( ~ q ~~'. ~~ ~' '"~p x ~ Y ~ Y ~ c ii 0 3 d c rv d N 3 N T O c n y 3 ~^ $ y rn 3 ~ O ~ d o ~ C C i d p ~ ~ d ~ S C ~ 9 A ~ ~ Y N ~3 ~ o~ ~ o w A no .. 3 N V N C ~ p 3 N O n xa %~ x$ ' x x ~" x x K O O W ~ '~ ~ O m D = ~ ~ O .~. O c F A ~ 3 .- O t~ 1 C m C T O 00 O~ r0 x x !n N O C a r ~+ ~+ VI N 3 .J p r r 3 O O! N r ili ~ 7 N f tl J x fGi l r W? ~ O N 'O V 2 ~ ~ ~ 5° og i `" a~ o a fif ~ a .. z ~ ~ ~~ m •n 3 ... o ' 1 N r ~ ~ N ~ y ~~ y ~ ~ W loll !f ~ ~ ~ a A a d G ~ 6 U1 N N A C N ~ ' ~ ~ Q • j ~ g O In ~ i0 ° ° p 3 o o m g o a ,~ ~ pp ~ N - a a d '~ X N C W N1 fR Y Y M iF W W ~ V1 OD V Y VI ~ Q N N to N In N N ~` O A V ~O ;Fj} O N ~^ .P A A ~D !l~ O to d a Q~ W ^-j C9 n N ~• yp~ V4 ~~ CUSTOMER #: 500597 128478 Graham Motor Company, .Inc. * INVOI CE * 1402 Holly Pike MARK FARRELL Carlisle, Pennsylvania 17015 3 2 3 AS PER DR Tel. (717) 243-3066 • (800) 992-4743 • Fax (717) 249-7 OILING SPRINGS, PA 17007-9616 PAGE 1 Web Site:http://www.grahammotors.com OME:717-241-2489 CONT:N/A E-mail: service~grahammotors,com US: 717-240-5530 CELL: SERVICE ADVIS R: 112 KAREN MCBETH . L <' L C ' E - M1ti EN/ 0 ' > AC; Ns: DLR :GRAHAM A EMISSION EXEMPTION 100D EMISSION EXEMPTION 125 CBM MISC MCI FEE CCC PARTS: 0.00 LABOR :4.1 Liter DFI AXL:FEB00 19.95 19.95 2.40 TOTAL LINE A: 19.95 2.40 22.35 20.00 2.00 22.00 ****************** B STATE INSPECTION 99 STATE INSPECTION 125 CBM -MISC PA STATE STICKER *********** 20.00 CCC 2.00 PARTS : 0. 0 0 LABOR ~ ~~~ 2 0. 0 0 OTHER : 2. O q TOTAL `~,INE B NEXT INSPECTION DUE'~AU~.LfST 2010 TIRES 7 ALL BRAKES 9/B FRO ~ '. REAR ~"`""'~ .._. _ ~- C OIL & FILTER CIT.P~NGE"~'J;"'`L°~L7BE 40 OIL `& ^FTLTTR CHANGED,.... LUBE 125 CBM ;, 17.21 1 192102(~5~'FTIy!'E1~ 7.52 7.52 1 6'~-~ ~~ ~'. `' ~ 14y~,85,. ~~_1~ . 8~ PARTS: ~ 22.37 LABOR.a~. 17.21 OTHER: 0.00 °'T'Ofi~ "~TI~Ei C": -- ***,r*******~?,¢t**********************,r*******,r**.~k`***** D CHECK BELTS, FLUIDS, HO.S AND TIRE PRESSURES r 3 9B ALL ITEMS CF~~CK OIY . 999 CC's ~ 0.00 a :, PARTS : 0 . 0 0 LABOR : 0 :~ ~~ ; ,. ~ ..~' ~ TOTAL LINE D ********>t***~*tc**~ * ~** ~~****~******* ~~ ~j~,I ~~ c ~< ~ Its ~~ 17.21 7.52 14.85 39.58 0.00 0.00 ON BEHALF OF SERVICING DEALER, I HEREBY CERTIFY THAT THE AT M N OF DI The tactor warrant con tlt t ll ;p~SIGRIPTION ~~~ Tf3Y`ALS "' ' ~~~ IN FORMATION CONTAINED HEREON IS ACCURATE UNLESS OTHERWISE y y s ~s a u of the w ti i h LABOR AMOUNT OWN. SERVICES DESCRIBED WERE PERFORMED AT NO CHARGE TO arran es w t resDa¢t to th l f hi i I ! 57.16 NER. THERE WAS NO INDICATION FROM THE APPEARANCE OF THE HICLE OR OT e sa e o t s tem\ tems. The Seller hereby expressly diselairrla all PARTS AMOUNT 2 2 , 3 7 HERWISE, THAT ANY PART REPAIRED OR REPLACED warranties either express or GAS OIL LUBE DER THIS CLAIM HAD BEEN CONNECTED IN ANY WAY WITH ANY implied, including env Implied , , 0 , 00 ' CIDENT, NEGLIGENCE OR MISUSE. RECORDS SUPPORTING THIS LAIM ARE AVAIL BL warranty of merchantability, or fitness for a particular purpose. SUBLET AMOUNT 0.00 A E FOR (t) YEAR FROM THE DATE OF PAYMENT NOT FIC Seller neither assumes .nor MISC. CHARGES I ATION AT THE SERVICING DEALER FOP INSPECTION BY authorizes any other perooh to 4 .40 MANUFACTURER'S REPRESENTATIVE. assume for it any Iiatiility In connection with the sale of this TOTAL CHARGES 83.93 Item/Items. LESS INSURANCE Q . Q Q SALES TAX 5 03 (SIGNEDI DEALER, GENERAL MANAGER OR AUTHORIZED PERSON f0A7E1 U TOMER SIGNATURE . PLEASE PAY THIS AMOUNT $$ ~: Kate L Sedlek Jey Appreisab, Inc 7251 Box Elder Drive Port Richey. FI. 34668 Tebphone Number: 727-646-1869 Fax Number. 727.232-1529 lb: Ashley R. Sipe Law Offices of Peter J. Russo, P.C. 5008 E. Trindle Road Suite 100 Mecharresburg, PA 17050 TebplgMIMp11Wr: (717) 591-1755 Abmab Numbx: Fax Number: (717)591-1756 E-WI: asipe~pjrlaw.com INVOICE 2618 07/30!2009 Internal Order M: LeMer Cue M: CNeM Fie X: Mein Flb M oniaml: 2818 OtherFleMoeform: Tacey Federal Taz 10: 20-2735659 Empbyer b: Leader: Lew OlOcee of Paler J. Russo, P.C. Client: Law Offices of Peter J. Russo, P.C. Purchaeer/BortoeMC NIA PropMIF Addreu: 3752 Fox Dale Ln Cfly: Holiday COUflly: Pasco SMe: FL Ap: 34691-1342 LegY Daalptf0a: Beacon Square Uni 11-8 Pb 9 Pg 89 Lot 1326 or 466 Pg 143 ~ FuN Appraisal 275.00 SUBTOTAL ! z75.oo Check N: Wb: Deaalptlon: Chedt N: Dsta: Ducriptlon: Chedt M: DNe: Deacriptbn: SUBTOTAL i DOTAL DUE ; 27s.oo fdnn NNS-1HInTOTAL' appraisal somvare by a la motle, inc. - 1-800-ALAMOOE Jay Appraisals, Inc. d 7 O T d 3 '6 Q R 7 L v 0 0 L w a 3 ~. x s d .O ,L i` a R 3 ~_ r 7 9 ~ d Q W C :~ ~. = r a F E V ~. O T d y .r . a t i V w O ~ i ~ 3 ~ R ~ ~ Cil N i ~ C a+ C ~' i Giya y a as ~ r" u L i+ a ~n ~ ~W3 O v T s 3 ~ ~ u ~> ec •_ «. ' y n/ ~ YI ~ y ~ ~ ~ H ~ A ~ ~ G ar y ri C A ~ a a °~ e W ~ • O O ~J ¢ L 3 d d ~ r7 S _a ~ d '' S ~ ~ u ^ = ~ C u y d T."" ~ ~~ `~ . oo ~ a ~ S ^ •~, O w ~ O .~. n a ~.-~ i LL 0~1~ O~f~ O~f~ O~f~ 0~1~ ~ h v ~ Of O1 Cf 01 O1 r r r r r a fIlHNNH F, ." w Obi Off Obi Off Off J F- ~ :J O1 e1 d1 Of 01 rrrrr „~j ~ ~ ~~,ds~.d- a G = Z W a ~ W ~ D Z O S ! 01 tV z ~~ ~ a ~ ~Y. ~ R a ~~ D ~~ o N a = a O a'. W Q F' M 2 ~ o ~ ~ ~~ ~ ~ qK p~ ~OY '. S F-O =C~ . ~ =Si im a . d Q . fn h ~ W Prl i.., r~ rrrrr -^~ ~ 3 c ~ i rr ili / ~ rM. ~. C ~ ~g~~ ~, 4v.1 p 0 00 ""'`" 0. O e O n a N e n e 0 e M 0 M 533-8767 `_- SONNIES TRUSEFRV HARDWARE "Service is Our Middle Name" 6519 ROOSEVIELT BLVD. ROOSEVELT PLAZA SHOPPING CENTER PHILADELPHIf+I„ PA 19149 ' _ `~ Q s Customer ~_ Date Order No. _ Name ~ ~ Address ~~Jy SOLD BY CASH C.O.D. CHARGE ON CCT, RET~. PAID OUT Gc~r I^ /1' I~Iull~l nl NO O 6 C' ~ SALES TAX TOTAL 5D8 All claims and returned goods ,UST be accompanied by this bill. r I"! RECD BY p~ggg, ~e NoM Ameke. AN rigAb reserved. • 0305 ~ ~ ,. ~_z Aa ~--N ~ r --~ O tp 01 V V O~ N S A W ~ N J a ~ O ~ '~ i C A m C ! ~ ~ , ~ ~ ~ ~ ~ =tl ~ - "~ m ; _ i ~ ~ m ~ ,.:, ~ n A N ~..I ~ N V D ( ~ .~ ~ 0 ~` ~ a ~ r a , O Z o ~ a i .i i ~ ~ ~ --RCC ~Y ~'= ~ S ~~ ~ ~ ~ ~ . ~ 1 m F a 1 ~ D ~ ~ ~ ~ o ~ O CO ~ ~ ~` \ n n ~ m (~ (~ A CD W < 1 ..~ i r y ~~ ~ ~ ~T ~ ~ m ~ rr; ~ -~ ~ ~ ~ gg I~ f C i ti ~ ~ ~ c~ f ~ ti ~ A `N ~ ~I ~ I ~ I ~, ~ ..-- - - .... . .. ...... .... i ~-.. . ~ - 1- ~ a i a J N M m ~o N r O m m m m z n m ~y I ~ --+ ! ~ ~ -'~ -- --~ `-~' r,~ I O -~ ~I ~ ~ - ,~ ~ ~ I I ! ~ ~ <i ?~ ~ ~ v I I m ~ m c ~ rn n ~ l w z ~~ ~ ~ m a z o ( ~ ~ C m { ~ ~ ~ • o a ~, a ~ ~ Y ca, 1 ~ CiD ~ I ~ z A 7J 'O ' ~ ~ i W ~ ~P c0 O'~ O) ~ n < ~ I h ~ ~ I~l' O m ( ~ I j ' J ~ 3 I ~ ' ~ ~ ~ ~ 1 I ~ ~ m ~ i -' ~~ l ~, t I j I --- ; :., P C M m m s N r -n °n O 77 rc; m m m (.l `~... ~'~ '„ .,~~~ `~ ~' C~ t _; ~, ~- 5°'p fi, °Po„ tea, ,~,„"-~ {..£"'Aa ~~ 0 .... ....... ..... ~ O a ¢ U ~ m a ~ a Z ~ r ~,(~ 01 O w O ~ O 'Q 4 ~' x V J . ~ Oa w ' ~ in o to .c ~" U ~ ~ N D O a ~ ¢ w ~r. ,,., ~ uj FQ~ o ~ } u O w ¢ u i o 4 ~ ¢ o ~ J O u V Z QQ Q V O N M w N C ~ n ~ ~ ~ ~ r Q a g Q 0 w ~ U n ~a a O 2 Z \.. __ ~ ~ w ¢ O a U U M ~ a W O ti \a N \ ° U ' a `~ > m o z i ~ n O J ~N N ((W,~~ 2 W LL Q7 (~ W ~Y CO ~ O) p C *" ~, LL Q ro a N m ~ _y ~ N fl v a W Y m ~ o_ .~ ~ N W Nazareth Hospital Payment Processing Center - PMD 10604 Justin Dr. Des Moines IA 50322-3755 ~~ ~~ Nazareth Hospital 51~~ P`~ i~i~ Stephany Tacey PMD0017A-01 87979-0000333-1308 5 55-0 01-000 087-N000674 May 04 2009 Patient Name: TACEY, STEPHANY Service Date: 03/18/2009 PC #: 6903366 Account No: 1612-N020349130 Account(s) Balance: $858.18 PLEASE RETAIN THIS PAGE FOR YO~JR RECORDS Insurance Summary Our records indicate the following insurance has been filed for you. If ithe information is not correct, please complete the form on the back of this statement and return it to Prefetrred Medfcal Deposit(PMD). PRIMARY Insurance: MEDICARE - A & B Address: PO BOX 1089 GS/Z: PITTSBURGH, PA 15230.1089 ID Number: 160079509A GrouplPlan: Employer: NRET SECONDARY Insurance: AETNA USHC TRAD CHOI Address: P O BOX 981106 C/S/Z: EL PASO, TX 79998-1106 n) Number: W 11024219001 Group/Plan: 00655233 Employer: NRET TERTIARY/THIRD Insurance: Address: C/S/Z:, ID Number: Group/Plan: Employer: Account Summary DATCt9) OF SERVIDE PROVIDER OF SERVICE DESORI~TION CMAROEB/ PAYMENTe DUE FROM PATIENT 03/18/09 -03/20/09 Nazareth Hospital Discharge balance $24,624.46 Additlonal Charges $0.00 MEDICARE - A & B PMT/ADJ -$23,556.46 AETNA USHC TRAD CH PMT/ADJ -$209.82 Total Patient (Payments $0.00 Other AdJustments $0.00 YOU PAY: $$58.18 May 04, 2009 PMD0017A-0167979-0000333.130a555-001-000087-1!000674 N G18TCE01 01001001UD101 BR001 "TCE• ROOSEVELT EMERGENCY PHYSICIA PO BOX 41481 PHILADELPHIA, PA 19101-1481 0 I_V VIII'II'llill'II'II~II'1111I111 ~11'III'11'II'U~~11~11II IIII' b 262618-00002D3491303-02 #BWNJFDB STATEMENT OF ACCOUNT (1) Statement Date: Ma 15, 2009 ACCOUNT NUMBER: ZZR203491303 Patient Name: STEPHANY TACEY Tax ID #: 43-1964648 Account Balance: 344.69 Amount Pending Insurance: 30.00 Amount Due From Patient (Current): X4.69 Amount Due From Patient (Past Due): 30.00 Pay rnis a1r10Urlt: s~a.ea PLEASE REMIT PAYMENT E "PAYMENT DUE BY" DATE. THANK 1 Please refer to coupon below for pays instructions. #OOOOOOZZR4216738# STEPHANY TACEY 1634 BENNER ST PHILADELPHIA PA 19149-3434 ACCOp nT U@T811 ate N escnphon harge ad y a y unt ram First Ina Odor Inc. Patbnt Ad stsd Inwrence BALANI 03/17/08 1 99291 "GRIT CARE, 1ST 5955.00 HRSICIOUESS' DX:427.31 OR. STANTOWNAZARETH HOSPITAL 04Y29108 MEDICARE CONTRACTUAL ALLOWANCE 5-731.57 04Y28108 - -'+tWCARE PAYMENT 5-17874 .. _ .. 05109109 : °r+NIO"CLAIM DENIED-CO-INSURANCE 8-0.00 , SIr 03I17NDD 2 93042 RHYTHM STRIP INTERPRETATION 545.00 DX:427.31 DR. STANTONMAZARETH HOSPoTAL 04/29108 MEDICARE CLAIM DENIED -BUNDLED 5-0.00 SERVICES 04120/08 MEDICARE CONTRACTUAL ALLOWANCE SA5.00 Sr TOTALS: sl,ddo.oo s-ne.7a so.ao so.oo s-n9s7 so.oo 544.& Important Messages: This stalerwnt b for the duact freatmerd antllor supervision d care you recently received from an,Emergency Physicbn at NayarsM Hospital. you maY abo W responsibb. Therefore, shotdd you receive a bill from the hospeal or other physicians far charges in mnnecdon!with this vbd, d wil not ncluda the items Ibtad onthra statement. "Payment Plans" Aiccepted Questions about this statement? / ' ame de Lunes a Viernes? -Call 1-800-355-2470 Monday throng Friday 9:30AM -4:OOPM. Your automated system access code is 0291- 03491303, or you can send Elmail to billing_questions~e care.com. Please detach and return bottom portion with your remittance. Place Codes: IH=In Patient. OH=Out Patient.- ER=Emergency Room Date ICD9 CD PL` Description Amount Balance Balance forward last stet 0.0 03/16/09 927.31 O 99213 OFFICE VISIT EST PT 100.0 09/01/09 MED MEDICARE PAYMENT -52.1 04/01/09 MCDS MEDICARE DISALLOWANC -39.8 05/07/09 USDN AETNA DENIED 0.0 ' ~ J v` r 1. /~ ~` Current Amount Past Due Amount Please Pay This Amount : $ 13.03 $ 13.03 $ 0.00 LEE A CELIO. MD 2701 HOLME AVE, STE 208 PHILA, PA 19152 Tex LD. 232453793 Tel: 810!734-0811 PetieM: TACEY,STEPHANY ~~ STATEMENT SEE REVERSE SIDE FOR IMPORTANT BILLINGI INFORMATION 0308-39 ~ r ! Place Codes: 1H=In Patient OH=Out Patient ER=Emergency Room Date ICD9 CD PL" Description Amount Balance Balance forward last stat 0.0( 03/20/09 928.0 IH 99232 SUBSEQUENT HOSPITAL ARE 125.0( 09/10/09 MED MEDICARE PAYMENT -55.9( 09/10/09 MCDS MEDICARE DISALLOWANC -55.1: 05/09/09 USDN AETNA DENIED 0.0( lX l Current Amount Past Due Amount Please Pay This Amount : $ 13.88 $ 13 98 $ 0 00 . . EDWARD J. MC6INLEY. M.D. P.C. 2701 HOLME AVE., STE.304 PHILA., PA. 19152 Tic I.D. 232070186 Tsl: 810/734-0811 STATEMENT Patient: TACEY,STEPHANY SEE REVERSE SIDE FOR IMPORTANT BILLINQ INFORMATION o3os • sss Date ICD9 CD PL' Description Balance Balance forward last statement 0.0( ~3/22/D9 428.0 OL GO180 PHYS CERT (PT NOT PRESENT) FOR 100.0! 05/26/09 MED MEDICARE PAYMENT -44.1 05/26/09 MCDS MEDICARE DISALLOWANCE _49,g; 08/06/09 USDN AETNA DENIED 0.0( ,` ~'~ Current Amount Past Due Amount Please Pay This Amount : $ 71.04 $ 11.04 $ 0.00 i cc a rtes tr, nen 2701 HOLME AVE, STE 208 PHILA, PA 19152 Tax I.D. 232453793 Tel: 810/734.OBt 1 PedeM: TACEY.STEPHANY I~~~~ STATEMENT SEE REVERSE SIDE FOR IMPORTANT BILLING INFORMATION osoe - iza -._T_,__.. ~.. _..__ - - _...m. __.___ Slatement date: . Mrnayeyouraaoountonlins: ,. ~~ 04/07109-.05/06109 ,bf" rsditc~Sli ~ f ~ ~~>~~ ~ 00 nt: ;0 .. ed. ~ . . Mlnlmum PayTS Payment DurDate: 05/31109 AddlUonfN coM~°t lniormawttlon conveniently bated on reverse side . u~~m_r>•r ay0e 04ia t9atl R~ .~o-- ---- ---- ~~f c p gW $729.74 Total.Cradit lJne 500 ~ ,999 ~ aA Prevbus Bhlsnce Ra t, Ct9dItM -ffi728.74 y~ Ceah Dents +$560.09 Avafl4ble Credit Cash Access Line f Caeh ,~ ~6 939 ~~~ . `~~ . n . Purohae~, ~ Available or New tlalence .. iruf! t°11(11 kf~Y 56't ou - cr,,a,, ,,,,,...-_.__ i~ri's geC~ycU'ri~ew'~rddstwww.ehdse.t~mVaarp. ' ~ itnsa tii 'C Ifb~ftif` or' oee 1-800.283F1211. ,. Date of, • ~°.a or Iran Lion t~esoritttlQi]. -7'2$.74 Payment -Thank You 95.46. 04117 CVS PHARMACY #0371 4103 PHILADELPHIA PA 96.63 04106 CpMCAST p-~fLLY 800-COMCA5T PA 95.16 04111 tlRY Cl~ f?F11CAp~L!'HIA,wAI'E 8004874567 PA ~ ~ 21.89 ~; • • ~. • ~ OAI10 CITY DF pHII,AgEI:PHI/>L WATE gpp.48Z4687 PA.. ' 9.96 , 1~,f0. . D~'C 80D-A47A667 CA 3.96 04110 , :; , , ~ OPC800-487+1587 CA 49.69 04!'10 - ACME MARIGB"L3 #7704 PHILADELPHIA PA 108.63 04!16. CV$Ph1ARMACY ({0971 403 PHILADELPHIA PA 29.99 04116 DLH" PTH DR LEONARDS-877.856-7798 NJ 24.96 04/21 MSN TV 800469.3288 CA 71.25 04/28: PECO 900-494.4000 PA 18.74 04!27 PEC0800.494-4000 PA 04127 Nl~ `~ ~ ' ~ Finance Charge; Transaction Pais / ' Acautnulaked FINANCE due To' ~ Da}y peri«Ifo Rata Corraep. Average Daily a Fin Charge lance Perlodtc Rate.: 3ervioe Chang B GNARG~g ~.~ , ~. a ale APR Category 90 days In cy ~ ~ ffio.oo $0.00 ~.~ 24% 15 ~ ~'~ -~- . ~.~ yo.00 0 purohasea V .tl41769 V :06271% 19.24% - ,$0.00 Caeh advances Tote finance charges ' Rats (APR}: 0'00% riod, end other lmpo E1fMStlvtr Annual pKaplaq~ nce computation metffod, grat•.g pe bpll rtent informatlon. e n for plpa6e sae Infarrnatl+xr About Youc,Acoount e@!cflO v~hen YRu c rry a Yrafancg on any transaction cetagory• a ~ y ,,, {ran ctiori fees ;~r~ponQq+OFApp'~ ~ ratg of lnter~gi~rw p d f ~~~: y°ur total tindr~+ bharg08 • u ent e R $ ' s a e s r Pr ha Effecriva AP ~ h arhrarriw;~8~bafaMceridn~ierfees`-+~P eUc~~ae cas OOOpy IAA DC 3869 128100000'CO65~ 09/0610r Psp!-1 of 4 000 N Z ~ . 0000003 FIS~6 C ~ X p0071N8133(f5' Total polrtte eanved this year 716 Pointe to ~plra on statement data in January 2012 y gam 1 point for every eligible $1 you spend on pun xe: l;lient: Chase Bank USA, N.A. ~ ~ I Client ACCt#: 6358 Reference: 1529595 Balance: $#23.11 ~~ V ~ +To the Estate of STEPHANY TACEY: Our client Chase Bank USA, N.A. recently received notification tfiat STEPHANY TACEY passed away. Initially, on behalf of our client and our office, please accept ourcondolences: This account wasseferred to our office because we are specialists in the area of deceased account care; and because STEI'HANY TACEY was a ~•alued account holder: As it is our goal to assist family members/low•ed ones through this process, enclosed is an infornational leaflet providing helpful. tips; guidance and support during this diffi~illt time of managing the final affairs of STEPHANY TACEY. At this time.. we are seeking information regarding the Estate of STEPHANY TACEY, including information about who is administrating the final affairs; if there is not an Estate. While fainih• members and/or lrned onesare-not personally liable for this account. the are tn~ing to contact the party handling the finataffairsto ensure the properresolution of the accotmt. Please contact our office of 8ti6-918-2936 to provide infonmation about the Estate. and to speak tvitli our specially trained deceased can; agents. Sincerely. Plnllips & Cohen Associates. Ltd. Though our goal is to assistfamily ntembers/loved ones during this difficult time, the are required b}• law to provide you with the infarnr-tian-belaw. ' ** IMPORTANT CONSUMER INFORA4ATION ** Unless you notify this aflice within thirty (30) days after receiving this notice that yrou dispute the validity of tl»s debt or anx portion thereof, this office will. assume this debt isyalid. If you motif}' this office in t~~riting within thirty. (30) da}5 from receiving this notice, this office x711: obtain verification of the debtor obtain a copy of a judgment and mail you copy of such verification or judgment. If you request this office in writing within thirty (30) days of recei~>ing t~tis notice.: this office will provide you with die name and address of the. original creditor, if different from the current creditor. Thhs communication is from a debt collector. This is an attempt to collect a debt and any information obtained will be used for thatpulpose. ' Phillips & Cohen Associates, Ltd. • 1002 Justison Street • Wilmjnjaton, DE 19801 • 866-918-2936 (QESP yt0:T030:000236:001:1000:09211: SP09: PC.4L105:01: PCALl03