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HomeMy WebLinkAbout08-16-11• 1505610140 -'' REV-1500 EX (01-10) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 280601 2 1 1 1 0 6 2 6 Harrisbur PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 2 0 6 3 2 2 4 9 2 0 5 1 4 2 0 1 1 1 0 0 8 1 9 4 0 Decedent's Last Name Suffix Decedent's First Name MI B R A N D T N A N C Y K (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS MI FILL IN APPROPRIATE OVALS BELOW l Return i i 1 O ^ 2. Supplemental Return ^ 3. Remainder Return (date of death na g r . prior to 12-13-82) ^ 4. Limited Estate ^ 4a. Future Interest Compromise (date of ^ 5. Federal Estate Tax Return Required death after 12-12-82) 0 6. Decedent Died Testate ^ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) Litigation Proceeds Received ^ 9 ^ (Attach Copy of Trust) 10. Spo~lsal Poverty Credit (date of death ^ haOunder Sec. 9113(A) 11 • h S . between 12-31-91 and 1-1-95) c Attac ( ) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Daytime Telephone Number Name R O G E R B I R W I N E S Q U I R E 7 1 7 2~ 4 9 2~. X 5 3 ~i~ First line of address I R W I N 8 Second line of address 6 0 W E S T City or Post Office C A R L I S L E M c K N I G H T P C• P O M F R E T FOR FILI ETURN I~ REPRESENTATIVE S T R E E T State ZIP Code L P A 1 7 0 1 3 Correspondent's a-mail address: Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true-t~rect and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. OF 813 HAMILTON STREET SIGNATU F REPARER OT ER ~/~_ UHIt ~S-l~~ll RLISLE PA 17013 DATE„ ~~;b~ 60 WEST PrQMf~RET STREET L 1505610140 CARLISLE -~ i~OF.l~ILLS USEO~LY k ~• ~._., ~ _ i ~ :.~ `~, ~... { t._'._ ~ '..~ -.....- µ~~ ~',.1 - ~ . ~- ~ ~,.1 -, f ' '- _ ... . __.. .o i.i t..., _.. ~~ DATE FILED ~ . PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610140 f3 J 1505610240 REV-1500 EX NANCY K- BRANDY RECAPITULATION 1. Real Estate (Schedule A) .......... . ................................ 1, 2. Stocks and Bonds (Schedule B) .. , , , , , , .. . ........................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3, 9 2 0 0 0.0 0 4. Mortgages and Notes Receivable (Schedule D) ... ....... . ............... 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. 4 5 9 0 6 . 8 9 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... g, 7. Inter-Vivos Transfers & Miscellaneous N -Probate Property (Schedule G) Se parate Billing Requested ....... 7. 3 4 5 2 8 3. 8 6 8. Total Gross Assets (total Lines 1 through 7) ... , , , .... . ....... 8. 4 8 3 1 9 0. ? 5 9. Funeral Expenses and Administrative Costs (Schedule H) ..... . ............ s. 2 2 3 3 4. 9 4 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ............. 10. 1 6 3 1. 2 5 11. Total Deductions (total Lines 9 and 10) ..... ..... . .................... 11. 2 3 9 6 6. 1 9 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 12 4 5 9 2 2 4 . 5 6 an election to tax has not been made (Schedule J) ...................... 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) • ......................14. TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 4 5 9 2 2 4. 5 6 15. Amount of Line 14 taxable at the spousal tax rate or , transfers under Sec. 9116 16. Amount of Line 14 taxable 0 • 0 0 at lineal rate X .045 3 6 7 2 2 4. 5 6 17. Amount of Line 14 taxable 16' 1 6 5 2 5 . ], ], at sibling rate X .12 0 0 0 18. Amount of Line 14 taxable 1 ~' 0 . 0 0 at collateral rate X .15 9 2 0 0 0 . 0 0 18, 1 3 8 0 0. 0 0 19. TAX DUE ....... . ..............................................1s. 3 0 3 2 5. 1 1 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505610240 1505610240 J Decedent's Social Security Number 2 0 6 3 2 2 4 g a REV-1500 €X Page 3 Decedent's Complete Address: DECEDENT'S NAME NANCY K. BRANDY STREET ADDRESS 4 HILL STREET ciTY MT. HOLLY SPRINGS Tax Payments and Credits: ~ ~ Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments 28,808.85 B. Discount 1, 516.26 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. File Number 21 11 0626 STATE Zip PA_ 17065 (1) 30,325.11 Total Credits (A + B) (2) 30, 325.11 (3) (4) 0.00 (5) 0.00 Make check payable to: REGISTER OF WILLS, AGENT 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; ............................... ^ 0 c. retain a reversionary interest; or ....................................................... d. receive the promise for life of either payments, benefits or care? ............... 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................... ,..,._.,,..,,. ^ ...................................... 3. Did decedent own an "intrust for" orpayable-upon-death bank account or security at his or her death? ......... ^ Q 4. Did decedent own an individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? .................................................................................................. © ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse 3 percent [72 P.S. §9116 (a) (1.1) (i)j. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)j. 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 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)j. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)j. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)). Asibling is defined, undE Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX+ (01-10) pennsylvania SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT --'"""" ' FILE NUMBER: NANCY K. BRANDY 21 11 0626 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1. 4 HILL STREET, MT. HOLLY SPRINGS, PENNSYLVANIA 92,000.00 APPRAISAL ATTACHED TOTAL (Also enter on Line 1, Recapitulation.) I $ 92,000 00 If more space is needed, use additional sheets of paper of the same size. REV-1508 EX + (6-98) ' ' SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. IN R SIDENT DECEDENT N PERSONAL PROPERTY ESTATE OF FILE NUMBER NANCY K. BRANDY 21 11 0626 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER VALUE AT DATE DESCRIPTION OF DEATH 1. PERSONAL PROPERTY -APPRAISAL ATTACHED 849.00 2. I PNC BANK -CHECKING ACCOUNT #5140181096 3. ~ PNC BANK -SAVINGS ACCOUNT #5130331804 13,818.25 31,239.64 TOTAL (Also enter on line 5, Recapitulation) I ~ 45, 906 89 (If more space is needed, insert additional sheets of the same size) REV-1510 €X+ (08-09) .. pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER NANCY K. BRANDY 21 11 0626 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1. PNC INVESTMENTS 61,272.86 100.00 61,272.86 ALLSTATE ANNUITY #PA00076846 BENEFICIARY: JAMES BRANDY 2. PNC INVESTMENTS #17460526 284,011.00 100.00 284,011.00 BENEFICIARY: JAMES BRANDY TOTAL (Also enter on Line 7, Recapitulation) I $ 345,283 86 If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+ (10-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER NANCY K. BRANDY 21 11 0626 Decedents debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. HOLLINGER FUNERAL HOME 2. CARLISLE MEMORIAL SERVICE, INC. 8,695.00 1, 365.40 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City State ZIP Year(s) Commission Paid: 2, Attorney Fees: IRWIN & McKNIGHT, P.C. 10,730.00 3, Family Exemption: (If decedents address is not the same as claimants, attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: REGISTER OF WILLS 461.50 5 Accountant Fees: 6. Tax Return Preparer Fees: PATRICIA A. ROSENDALE, CPA 375.00 7. REGISTER OF WILLS -FILING FEE 30.00 8. CUMBERLAND LAW JOURNAL -ESTATE NOTICE 75.00 9. THE SENTINEL -ESTATE NOTICE 189.54 10. S.W. BARRETT REAL ESTATE -APPRAISAL ON REAL ESTATE 350.00 11. RECORDER OF DEEDS -FILING FEE 63.50 TOTAL (Also enter on Line 9, Recapitulation) I ~ .,., ,,,, ~,, If more space is needed, use additional sheets of paper of the same size. REV-151,2 EX+ (12-08) .. pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER NANCY K. BRANDY 21 11 0626 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 1. MET-ED -ELECTRIC 76.58 2. AERO ENERGY -FUEL OIL 803.61 3. HEMATOLOGY & ONCOLOGY CONSULTANTS OF PA -MEDICAL 219.38 4. CENTURYLINK -TELEPHONE 42.90 5. COMCAST -CABLE 284.47 6. QUANTUM IMAGING -MEDICAL 43.58 7. CAMP HILL EMERGENCY -MEDICAL 35.28 8. BOROUGH OF MT. HOLLY SPRINGS - WATER/SEWER 59.40 9. AZIZKHAN INTERNAL MEDICINE ASSOCIATES 66.05 TOTAL (Also enter on Line 10, Recapitulation) I $ 1,631.25 If more space is needed, insert additional sheets of the same site. REV-1513 EX+ (01-10) .. Pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: NANCY K. BRANDY ~1 11 n~~~ RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS (Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1. PAMELA STILL Collateral 92,000.00 18 S. BALTIMORE AVENUE REAL ESTATE MT. HOLLY SPRINGS, PA 17065 2. JAMES M. BRANDY Lineal 367,224.56 813 HAMILTON STREET REMAINDER CARLISLE, PA 17013 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT TAKEN: 1. 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ If more space is needed, use additional sheets of paper of the same size. S WILL OF NANCY ~C. BRANDY I, Nancy K. Brandt, of Cumberland County, Mt. Holly Springs, Pennsylvania, declare this to be my last Will and hereby r::voke all prior Wills and Codicils. 1. I direct that all my just debts, funeral expenses, gravemarker and administrative expenses shall be paid from my residuary estate as soon as practicable after my death. 2. I direct that all inheritan+~s, estate, transfer, succes`~ion and death taxes of any kind whatsoever which may be payable by reason of my death shall be paid out of my residuary estate. 3. I direct that my entire estate be distributed as follows: A. I direct that my real estate at 4 Hill Street, Mt. Holly Springs, Pennsylvania go to Pamela Still. B. Should Pamela Still predecease me, I direct that my real estate be sold and the proceeds qo to The Human Society, Citizens Fire Company #1 in Mt. Holly Springs and Vi~~ian Brandt in equal shares. C. I direct that a;l of my personal property go to James M. Brandt. 4. I appoint James M. Brandt Executor of this my last Will. 5. The Executor of this Will shall have the power to distribute my estate in kind or in cash, or partly in either. 6. I direct that no Executrix acting under this Will shall be required to enter bond in any jurisdiction. LAW OFFICES OF STEPHEN J. NOGG 19 S. HANOVER STREET SUITE 101 CARLISLE, PA 17013 IN WITNESS WHER , I have hereunto set my hand this day of , 201 Nanc K. Brandt • ~ • ,~ 1 The preceding instrument consisting of this and one other page a ' was on the day and date hereof signed, published and declared by Nancy K. Brandt as and for her last Will in the presence of us, who at her request, in her presence and in the presence of each other have subscribed our names as v~ritnesses hereto. LAW OFFICES OF STEPHEN J. HOGG 19 S. HANOVER STREET SUITE 101 CARLISLE, PA 17013 l ITNE S WITNESS AC~CNOWLEDGMENT State of Pennsylvania County of Cumberland ss I, Nancy K. Brandt, the Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my last Will; that I signed it willingly and as my free and voluntary act for the purposes therein express~d.A . ncy4K. Brandt LAW OFFICES OF STEPHEN J. HOGG 19 S. HANOVER STREET SUITE 101 CARLISLE, PA 17013 Sworn to or affirmed and acknowled fore me by Nancy K. B rixLthis /day of , 2 11 ~TARfAI gEAL ~-~w-., J. Hogg, HO~- ptebNc ~ eoro, Co~+berl® '~~ ~~~ 3, ~,~~ ;Notary Public/Attorn State of Pennsylvania County of Cumberland 5~ ss We#~ o .and ' ..~_ ~..1 J 1 ! orv _ the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testatrix sign and execute the instrument as her last Will; that the Testatrix signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the Testatrix signed the Will as a witness; and that to the best of our knowledge the Testatrix was at that time or more years of age, of sound mind and under no constraint o u influence. Sworn to or affirm n bscribed to before me by witnesses, this day of 2011. ~ G~ Nara,` ~~~ .. ~ ~ph°n J' HO~r ~'~' ~~~d~ary Pu is/Attorney BOrO: GoPl~~,~~ 'lo~~ ~ it ~Of1 ~ ~-'~1~A~ ~, fir:; AFFIDAVIT S. W. Barrett Real Estate 8~ Appraisal Services File No. 7 APPRAISAL OF t _, .~;... .. ~_~. --- .~. ~,;_ _ ,,;~~ .~ - 4; '.. Y.: s .:,~ '` „ .~.t , LOCATED AT: 4 Hill Street Mount Holly Springs, PA 17065-1307 CLIENT: Irwin 8 McKnight , 60 West Pomfret Street Carlisle, PA 17013 t, 1- tt ~' 1.1:~ ~~. ~. AS OF: ~'~ May 14, 2011 BY: Cassandra J. Crockett PA Certified Residential Real Estate Appraiser S. W. Barrett Real Estate 8 Appraisal Services File 06103/2011 Irwin 8 McKnight 60 West Pomfret Street Carlisle, PA 17013 File Number: 11-0108 In accordance with your request, I have appraised the real property at: 4 Hill Street Mount Holly Springs, PA 17065-1307 The purpose of this appraisal is to develop an opinion of the defined value of the subject property, as improved. The property rights appraised are the fee simple interest in the site and improvements. is: In my opinion, the defined value of the property as of May 14, 2011 392,000 Ninety-Two Thousand Dollars The attached report contains the description, analysis and supportive data for the conclusions, final opinion of value, descriptive photographs, assignment conditions and appropriate certifications. Respectfully submitted, Cassandra J. Crockett PA Certified Residential Real Estate Appraiser ' .•.__:r._.~i:a.1:Ar~rar~ic~lii~Of1A/'t File No. 11-0108 ~ rage a w . urns _ ..+.+•-•- Residential Appraisal Report File No. 11-0108 _ _ _ _ .. _ .._ ., nnuoeoeal t: CAI F N[)- 3 FEATURE SUBJECT t 129 West Pine Street t4 Street Rear 103 West Butler Stree 14 Chest u 4 A Hill Street ddress Mount Holi S rin s 17065 Mount Holl S rin s 17065 Mount Holl S rin s 17065 Mount Holl S rin s 170 30 miles W W 0 P roxini ro Sub' 0.14 miles WNW 0.37 miles NN . 95 000 S 109 900 S alc Price $ $ 96 000 ~ S 22 . fL a 87 n - 3 78.90 . is 00 1L S 91 00 0 . .S ale PricelGro~ t.iir. Area . . . . a Multi-list D ata Source s Multi-list Multi-list Courthouse Records d s Courthouse Records Courthouse Recor v erification sources DESCRIPTION + • s mt V ALUE ADJUSTMENTS DESCRIPTION DESCRIPTION + • s ustmem DESCRIPTION • s Conv 850 None -2 S ale or Financing , , ClsgCsts/USGA -5,500 CIsg.Csts/Conv DOM 6 Concessions DOM 20 DOM 305 6110 Date of Sale/fime 9110 5111 Suburban Suburban Suburban b Location an Subur Fee Sim le LeasehokllFee Si le Fee Sim le Fee Sim le Fee Sim le 0 Lot/Av .59 -7 500 S~ 0 Lot/Av .1 Lot/Av .11 LotlAv .0 Residential View Residential Residential Residential 5 Sto 1 . 1.S Sto 1.5 Sto 2 Sto Avera e era a Avera a A • of Conslntction v Avera 4 000 73 Yrs 42 Yrs -2 000 100 Yrs+/- e 61 Yrs v 9 500 A ~ -10990 10 Good • Av Go od 10% -9 600 Av /Go od 10% - ~;~n Avera c a ~ ~ Above Grade Tow saws esal~ Tar edrms ~° Taw asi~s 6 2 1 ~ Room Count 5 3 1 5 2 1 6 3 1 1G 9 630 1 204 . tL 5160 1 260 • h• 1 055 . Gross • ~ Area30.00 . 1 376 . n 7,500 Crawl Space ' easement&Fnished Full Bsmt/ NonelSlab 7,500 Fuli Bsmtl Rooms Below Grade Unfinished Unfinished 2 Bdrmlinferior 2 500 Functional ~ ~ Avers 2 Bdrmllnferior 2 500 Avera e EBB/None . Hea • -2 000 OFHAINone OFHNNone HPICA T ical Ener Efficientttems T ical T ical T ical 2 Car tiara a -10 000 rt OSP OSP OSP 0 DecklHearth 0 hl P 0 DecklFencin Porches/Fenc PorchlPatiolDeck orc Scrnd. Entries X + _ $ 530 + X - a 3190 + X - s 15 010 Net nt otal Net Adj. -13.7% Net Adj. 0.8% Net Adj. -3.4% Adjusted Sale Price 40.3% S 96 530 Gross 22.6% 3 91 810 Grt>SSAd• 38.2% S 94 890 GrossAd• . of All com ambles are similar in utili and location to the sub 8ct roe are verified closed su otsales ch re within the Borou h of Mt. Holt S rin s and are the best current) available. Limited-sales of 1.5 sto homes in t l es a sa in an a ended search. All of the com arable sales had some recen i d r re u sub ect's value ran have recent) occurre 351s .ft. for sale 1183 with a variance Of more than .25 acre. nd ad usted at l l . a us remodelin u atin com leted. Su Ad usted ran of value is 588 000 to 597.000 sa 592 000. COST AppROACN TO VALUE nt assessment data and recent local land sales. site value Comrtter-ts Site value from curre ........................ = S 30 000 $ ESTIMATED REPRODUCTION OR REPLACEMENT COST NEW OPINION OF SITE VALUE ........: F`... $ _ Dwellin • Source of cost data S . FL ~ s ............ = S ' from cost service Effective date of cost data r Comments on Cost h rose Inn area calculations reciation, etc. _ $ ch from Marshall/Swift-Valuation Service Gar /Car ort S . FL ~ S - _ $ Cost roa • handbook and local cost anal is was considered but Total Estimate of Cost•New ' cal Functional External _ deemed not credible due.to the a e of the im rovements. Less Ph Site value from Market Data. De reciation based on a ellife De reciation bserved condition and Market Data.Anal is. Estimated De reciatedCostallm rovements ................................ = S o remainin Economic Life is 35.40 ars. 'As-is' Value of Site Im rovements .. • .. • • • . • • • • • • • • • • • • • • • • • • • • • • • ° $ INDICATED VALUE BY COST APPROACH ...................... = S NIA INCOI~'APPROACM TO VALUE N/A X Gross Rent Multi tier NIA = S NIA Indicated Value Intone A roach Estimated Month Market Rent S • Summary of Income Approach (including support for market rent and GRM) NlA Indicated Value SalesCom arisonA roachS92 000 CostA roach fdevelo ed s NIA IncomeA roach ifdevelo i NIA anion of market value. Cost A roach and GRM were found ins ro taste for this Market Anal is consistent) su orts m o d to the Market Data Anal is. Su rtin file information substantiates these estimates. li e anal is. Greatest wei ht is a • This appraisal is made X 'as is," subject to completion per plans and specifications on the basis of a hypothetical condition that the improvements have been completed, d ^ subject to the following: l t e e ^ subject to the lofiowing repairs or alterations on the basis of a hypothetical condition that the repairs or alterations have been comp • sisal is for client onl nontransferable. Based on the scope of work, assumptions, limiting conditions and appraiser's certification, my (our) opinion of the defined value of the real property ,which is the effective date of this appraisal. that is the subject of this report is S 92,000 as of 5/14/2011 (DOD] ProOUad usNp Aq,plMgrc, 100.234.8727 www.aawen.tom Tlb Iqm Cap~ni01Y0 20052030 Ap OiMlbn b iS0 QWnt Sconces. ua.. N ~ n.s•vw. ,,, Psge 2 0l 1 (gPARn') Genmd Pup06e ~P>r~ ~ ~~~ ~,,.,_ ,. S.W. Barrett Real Estate iii Appraisal Services r oe~:rtonti~l onnraisal Renort File No. 11-0108 FEATURE SUBJECT COMPARABLE SALE N0.4 COMPARABLE SALE N0.5 COMPARABLE SALE N0.6 4 Hill Stnaet Address Mount Hull S rin s 17065 521 Chestnut Street Mount Holl S rin 17065 to Sub' t P O.g7 miles NNW r Sale Price sale Pricercro~ Liv. aea s S 0.00 . n ~ : S 110 000. s 57:38 . n s . ~ • n $ s ' n 3 ta sour s D Multi-list a verification sources Courthouse Records DESCRIPTION +(• s LUE ADJUSTMENTS DESCRIPTION DESCRIPTION + •) SMgustmem DESCRIPTION + - s VA Sale or Financing ns i C ~ None, Conv DOM 60 o oncess .Date of SalefT'ime Location Suburban 8110 Suburban ldlFee sim ie h L Fee Sim le Fee Sim le o ease site . Lot/Av .11 LotlAv .14 0 view Residential Residential ' n S 5 Sto 1 2 Sto ' of Consbuc6on . Aver Avera e A ~ 61 yrg 100 Yrs+1_ 4 000 q diti c Avera a Av .Good 10% -11 000 on on d G b Tout Buhl ToW Bdrms Buhl T~ ~~ Baths Tow ~~ ~~ ra e ove A Room Count 5 3 1 .8 4 1.5 -1000 . Gross ' ' Area30.00 1 376 . n 1 917 . n -16 230 . n s . n Basement&Finished Bebw Grade R Full i3smtl Unfinished Partial Bsmt/ Unfinished 2,500 ooms l ~ ti F Ave Avera e ona unc 1•ea' I' OFHAINone OHW/None Efficientltems E T it,.al T ical ne rt c OSP OSP ar PorchlPatlolDeck Scrnd.Porchl Porch/Fencin 0 t i E es r n Nel Ad' otal Adjtated Sale Price of Comoarables + X - Net Adj. -19.896 _ Grote 31.696 s 21 730 3 88 270 + Net Adj. 96 Gross -- - 96 S S . + Net Adj. ~ Gross '. ~ $ 3 File No. 11-0108 Appraiser's Certification The appraiser(s) certifies that, to the best of the appraiser's knowledge and belief: 1. The statements of tact contained in this report are uue and correct. raiser's ersonal, impartial, and unbiased 2. The reported anaryses, opinions, and conclusions are limited Dory by the reported assumptions and IimiUng conditions and are the app P professional anaryses, opinions, acrd conclusions. 3. Unless otherwise stated, the appraiser has no present or prospective interest in the property that is the subject of this report and has no personal interest with respect to the parties involved. 4. The appraiser has no bias with respect to the property that is the subject of this report or to the parties imoNed with this assignment 5. The appraiser's engagement in this assignment was not contingent upon developing or reporting predetermined results. 6. The appraiser's compensation for completing this assignment is not contingent upon the development or reporting of a predetermined value or direction in value that favors the cause of the client, the amount of the value opinion, the assinment of a stipulated resut4 or the occurrence of a subsequent event directly related to the intended use of this appraisal. 7. The appraiser's anatyses, opinions, and conclusions were developed, and this report has been prepared, in conformity with the Uniform Standards of Professional Appraisal Practice. 8. Unless otherwise noted, the appraiser has made a personal inspection of U-e property that is the subject of this report. 9. Unless noted below, no one provided significant real property appraisal assistance to the appraiser signing this certification. Significant real property appraisal assismnce provided bY: Additional Certifications: ;,, Definition of Value: XD Market Value ^ Other Value: ='i,, source of Definition: USPAP should bring in a competitive and open market under all f:~~ The most probable price in terms of money which a property I •'"i conditions requisite to a fair sale, the buyer and seller, each acting- prudently, knowledgeably and assuming the price is not ~~' affected by undue stimulus. rl 1 ~ I~m+•~~ ,r~.t: ~, I4i ';~i "I ,..-?r. (, ~-~ ,~ ;.~ ADDRESS OF THE PROPERTY APPRAISED: i 4 Hill Street 'i Mount Holi S rin s PA 17065-1307 EFFECTNE DATE OF THE APPRAISAL: 5/1412011 [DOD] °~ APPRAISED VALUE OF THE SUBJECT PROPERTY 3 92 000 ''~ APPRAISER i~''V, i~~'P~ Signature: ,;~{ Name: Cassandra J. Crockett _, State Certification # RL001348L ~` or License # or Other (describe): Score #' state: PA Expiration Date of Certification or License: 0613012011 irk Date of Signaure and Report: 0610312011 Date of Property viewing: 05/14/2011 (DOD] iii Degree of property viewing: ~( QX Interior and Exterior ^ Exterior Onty ^ Did not personalty view SUPERVISORY APPRAISER ~~~ Signature: Name: Steven W. Barrett, SRP~-a SRA, ASA _ State Certfication # GA000298L or license # RB026921 A State: PA Expiration Date of Certification or License: 0613012011 Date of Signature: 0610312011 Date of Property Viewing: Degree of property viewing: Olnterior and Exterior ^ Exteror Onry XO Did not personalty view Produte0 epeS Ap sohmre, aiu.zaa.s,u .................... Page 2 012 TM S.W. Barrett Real Estate 8~ Appraisal Services Ad oiwron a tw aans ~.~... ,,....-p..eprp_r..~..-_. (SPAR"') General Pupose ADPGP~ivx.iM OSOellmoe ~ ,. ~~ ~~~ - , ~~ ~- ~ .~ ~ , - -__ - -- _ -._-__ .__-- __ _ .. _ __ --_ _ -- - _____._ ---- --- -'-- _._ .__ --- -- _ '-- _ :~ ~ ~' r ~. ,. .~ ~. _~ _,. . __ _ . ----- -_ _._ -~ ,,..- _ ~ ~_~r_~ _ ,. _-- '-= _ _ _ ,~ ~jj•' _... _.._.----. _. _.__.. --' - .__.----__.-'. ._ __.. ._..__....------- --- _- _ ---- - ------ --'--' _ _._.. __ ----- ,~ : ~ .~ .. _.. _ ~_._ --- _. _. ~ --- _._ _ _ _ ___ --- _ ~ -- - _ - -- - -- _._ ~~,`: _. ---- -- ---- ___ ' ~_ ..~v ~ ----__- ' ,,,r' ------ - --- ---- . ;~-w. ~ J -- -- - - ._ _ --- - - -- --- - - - --- - ,' -- _ _ - _ .. - - ___ ._ _ - __ _ { __ _ _, _ _ _ - -- f --__.._._._. ..__ ....... ._ _.. _._._..__ ,. _ ..... -~ __- _ --' .- . / -- _ ~ / ._ - - -- _. _- --'- --_-- --~-=- - --- _ --- ~~ - - - - - _ __ _ -----'-- r-- ~_____~..-r _._-----' ~ ~F_ / ~ - - -.._ _. _. ..._--- __._ ~ ~/) _ ,. _... - --- ~,,_, _ _ C.'~' -._ -~ ~~- -- - - L:- _ .__ ----- -- __ ____ - , C~ ~ , ._.__ ;;. -- -/;? _ - -- /' •~_._ ' ~/~' ~~. -- ------ -- 1 .. .. 1 --- -- ---- - -~ -r-- - __ ~ ~ ~~ ~ -. _ _ .. _ - . __ ..------- - -- ~ -- ~,~ - - -- _ __..__ __ -- - _- ---- --_ - -. ., -----~---- -1~~-- - .__ _-- r~~ ~ ----_ _.---_---- - ..r ---_ __ _ -- - -- --- --- - ~._ .. ~ J --_.._._. __. -- - -~- _ ._ ~'F__ ------ - -- - - - ----- _._ -- __ -°- -- - ~ .. /~ ~ 5~ ,~ ~. ,... --- '~ ~; -- --- ___ _- •. ---- ~' __ _ __ _.. __._-- _. _--~-- ___. _ .. r., . __ _. ~ ~ ~ ~s -- - -- ---. ,E-- c. _.__...__ .._._ r _ .._ -- - -- - ~ r _ ..._--- 1-~z'__. _._.._ _.~.-. __ ___. ___ - ---_._ ,~ _,,,r,_ - --- - -- ..... ---- __ ~ C„ ~. _ .._i ~~~~~.~~~ _. .._. _.____.___~._._. .~_- ~'li -_._ ......... ... .. _ ._.. _.-. - _.._._ ~ f /~~_. ~" -~-----~- - ~.-~ __. _ .____ f------ __ .~ ------ -- -_- -- - -- -- ,. --- --- ~..~..> ____ __. _ F~ __ --- ~.. .._ _ __ _ :....~1~ . --.--- -- -~----- ------~--- I% ~ ~'. 1--1~ ---- --- --------- - -- -- -- - --- -- - -- - -. -- -- - --- - - --_ __ __ ___ - -------- ---~ -- - r ~ !, ~G~~ L'~ -- _.._ -- --- --- - - . _ _ ---- -- - - -- ~-- _--- - -- .~ _. --. ~G~~-' _--- __ . --- --- ---- ---- _._ ,~, ----- - --_ __-_- - -- _.1 ...J I _ r J _ --_-_ //~~ ~/f/~d "_ _.__.__~_ _ ___. _. _. __ ~f ., . _.... _.______..__. _. __- I ___._ ___.... __. i -_- „~.~....-". d _ __. - !.,~.~r ..r. ,~- - .~ ... -- - -.-- ------ . - -~ - ---- ._ _ --- ~L -- - - _~_ _. G~~ :..-__ . .' ~~jj F.~- ~...1 -_ ... ._. '4- __ - _ ._ N~ . -... - ----- i _ ~ ~ ---- - -----~-- _ ._._.__-,~~c _._.. -- ---- .._ ____. -- . ___ ~z __ . --- - --- - - - '~ ~. R --~- -- --- --- _.. ----~-- ,l _ _. .. y. !" ...nom _ D" - - - - - -- -. ,. .~ -- -- - s.,~.. _. - - -. _ -- ..- , _ ._.- . ,~ :.. ~f /~ _ - _.!. _. ~- --- -~---- - r --- - -- -- ,f - -- -~ ~ _ _ ~ -~ _ _ __ ~~i ------ ~ ---~---------_..._. _ _ __.. ~ ~.-_- --- ... - - - _.. _. - -- _.._ -- -- - -- -- -- _. _.. . _-..-_ 1 -- .. -. - - -- - - - Il -- - --- -..- ... _ --- ._ __ - - - -___ ..__ J _....~._.....__ .. ,_ ~--- -~~_. ___ ----y f . Q' ~ _ .. _ --- - - - _... - -- _. ~--- - - ------ ~ ~Q~ 1~ ~ - ---- - __ ~ ~" /9 --- - -- - - -. . _ _ _ . -- . ___.__ ___ __ ~.~- 473°00+ ,- - - _.-- 205.00 + _. i~~-171 °00+ ~- _- __ -- - __ 849 ° * ~ --- - 0 * ~_ __ _ _ - ~ ~~I i - -- ;.. - --- - _ _. _ _ _ _ - - fVO, ,;4j~ C, .lL i~v uniui~ `tIL 1UJ-L1`t1 ~~ • '~ DIG T#iE'WAY Jwne 20, 2011 Roger B Irwin, Esq. Irwin ~ McKnight P.C. West Pomfret Professional Bldg 60 W Pomfret 5t Carlisle, PA. 17013-3222 ~; Nancy K Brandt S5N: 206-32-2492 DOD: OS-14-2011 Dear Nir. Irwin: to our re uest for Date of Death (DOD) balances for the customer noted above, our In response y q records showthe~following: Checking Account Account # 5140181096 NANCY ~ gRANDT DOD balance: S 13,817.88 + 0.37 accrued interest Interest paid 01-01-2011 thru OS-14-2011$ 2.37 YTD Savings Account Account # 5130331804 NANCY K BRANDY DOD balance: S 31,237.17 + 2.47 accrued inter 4 tYTD Interest paid 01-91-2011 thru OS-14-2011 ~ 18.9 Established: 04-01-1963 Established: ~11-09-1990 sit accounts (IRAs, CDs, Checkiu~g and Please note that this office provides date of death balances for ode statements. If you need assistance with Savia~gs)• We do not process any snsapal t~nsarhons or p P our local PNC Bank breach an of these items, please call 1-888-PNC-BA~ (1-885-762-~65) °r st° by y Y office. Sincerely, National Financial Sezvxces Center PNC Bank, N.A. Member FDIC PaRP 1 of '~ ~u~~. Lv, Lv~ ~ ~ ~~LLniYi I IVV union `tIL IUJ-Ll`tl IV O. 0~+1~ f. L/L This message is intended for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient or the employee or agent responsible for delivering this message to the intended recipient, you are hereby nvtzf~ed that any dissemination, distribution Qr copying of this communications is strictly prohibited. If yvu have received this communication in envy, please notify me immediately by reply or by telephone at 800-762-.1775 and immediately destroy this faxed document. 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(A N ~ O ~p w ~ a _ ~ ~ ~c cn , .~ ~ m o ._. o ~ ~ ~ - ,~. n o c ... ~ o -~ ~.. ~ v, ~~ ~ C N N ~ ~~ o ~ m ~ m .~ ~~ ~ _.-r -~ m '~ ~ ~ a ~_ ~ ~ ~ O ~ ~ N IV ~ ~ .+~ C o o ~ ~ O C -t ~ ~ Al n ~ ~_ ~ ~ ~ IV ~ ~ R ~ V c N o ao ~ ~ O ~y ~ Z ~ v O 0 ~v o ~• c ~ O ~ o ' ~ ` 3 ~ m m a 6 0 o ~ o~~~ v m m ~ ~ ~ m --~ . ~ ~ ~~ m ~ A~ 0 ~ N ~ ~ . ~ f11 h m ~ -. N ~ ~ ~,~.v ~ ~ a v' N D 6 ~ h C a a: ~ N O N O y ~ ~ O ~ C o o m ~ _ A ~ ~ ~' O co 8 ~o O O D n ~ ~ c N `< 3 W ~ a N N ~ i ~ ~ a ~ su ~ N ` m N N .Q 3 0 N N (! ~ ~ 0 0 w ~, ~, a m -na ~~ 3 0 ~ -< m o ~ m D ~ ~i ~ O O ~ ~-« '-• NIN v 0 0 ~~ N A p C ~ i~ N N cn cn p O D 3 s n n 3 a n m w z m 0 ~_ C ~_ fA C ~i ~ ~ rro~~~ o~ ~ ~ . C ~ z '~'^^ V , + O r D ~~a~ wn ~' ~ xN~~ . ~- ~ " [TI ~ o ~ o ~ N w N A ~ ~ ~ ~ ~ ~ \^1 ~ lrf n S1 ~ tr . ~ ~ ~ j N o i ^ O o a. OJ ~~ y Z ~ ~ c ~' z ~ C -~ w _ ~ (0 ~ ~ ~ ~ _ ~• ~ ~ ~ A p x r° ~ C i~ i£ y~- O ~ O A O C O ~• O ~ Hollinger Funeral Home & Crematory, Inc. Eric L. Hollinger, Supervisor 501 North Baltimore Avenue Mount Holly Springs, Pennsylvania 17065 STATEMENT OF ~ GOODS AND SERVICES SELECTED Charges are only for those items that you selected or that are required. tf we are required by law or by a cemetery or crematory to use any items, we will explain the reason in writing below. You do not have to for embalm- If you selected a funeral that may require embalming, such as a funeral viewing, You may have to pay for embalming. PaY ants such as direct cremation or immediate burial. If we charged for embalming, we wW explain why below. ing you did not approve if you ~^~attatt~ ~~~# Dane of Death ~~ i`~-~~~ For flee Service of /y ` MKS ~ 4 ~ <- ~ ~~'rti t ~-~~ w ~~ `-A" \~S~e ~. t 7 O L 3 - Charge Lo• ~& A~•~ Ctty State Name ~-. CHARGE FOR SSBViCt3S SELECTED: 1. PROFESSIONAL SERVICES Services of Funeral DireaodStaff ...... S Embalming .....................5 Otter preparation of body .................:............ s S()B-TOTAL OF FROFBSSIONAL SFAVI(:FS ......... •A1 S 2. FACIII'IIES AND SERVICES Use ~ facilities and services for viewing (Vrsitatiort/V7ake) ........•. S Use of facilities and services for funeral cererttony ............ S Use of facilities and services for Memorial Service ............... S Use of equipment and services for graveside service ............. S Other use of facilities ...............................5 SUB-TOTAL OF FACQITB3S/EQU~T ...........A2 S 3. AUTOMOTIVE EQUIPMENT Vehicle to transfer remains to Funeral Home Lod .........................5 Hearse (Casket Coach) Lod .........................5 Limousine Lod .........................5 Family car Lod .........................5 Flower car or floral disposition Lod .......................5 Lead car etgy car Local ... .....................5 ., Car for rs Lod .........................5 Out of town transportation .......... S S SUB-TOrrAL OF AUT~OM011VE EQU~ .........A3 S TOTAL OF PROFESSIONAL SERVICES, PACII1rIF.S AND AVrOMOTiVE e,.~ ~ S 4~~ B. CHARGE FOR b~RCHANDISE SBIECTEDr Casket ......................... S X300 (Desaiptiort) ~ow~."I ~n0 ~M. Other Receptacle ................. S (Desaiptiort) Outer burial m~{ ............ ; S~;¢ ~?~ (Descripdori) `O'dc3>v~u L..r~ Acknowledgement ra . .......... S .. Register book(s) ..... ... S ... .. ` ~ Memory folders .... ... /..•.. S . , Prayer cards ...... . .......... S Temporary grave marker .. .......... S Burial clothing ......... .......... S Other clothing Cremation um ................... S (Description) O~ S s 'row.ti~cHANDISESt~.ECTED .................B s ~5® C. SPECIAL. CHARGES: Forwarding of remains to S (Funeral Home) Receiving of remains from _s (Funeral Horne) Immediate Burial ................. S Direct Cremation ................. S S SUB-TOTAL OF SPECIAL CHARGES ................C S D. CASH ADVANCED Opening Grave .................. S do ~~' Equipment .............. S~_ Lot and Deed ...................5 Newspaper Notices-Local .. r- .4 ~ .... S Newspaper Notices-Oubof-toavn :: °:' . S Telephone & Telegrams . • • • • • • • • • • • S ....... .. ........ Airfare .. ... S Clergy/Mass Offering ~-~-}~'•.°."•':`•~• • • S ~1 Pallbearers ..................... S Certified Copies of the Death 1S.'N.let . Ste. `~ Certificate ...................... S Police Escort ............... $--~•- Flowers ..... ~~~~•-............ S O Vatilt Service Charge ............... S _.S -a s o s _ S S SUB-TOTAL OF ADVANCES .......................D S X31 O We charge you for our services in obtaining: (~fJ' taab advances tbat are nrarlrrd~up) SOti~ARY OF CHARGES A. Professional Services, Facilities and Equipment, and Automotive S y~ 5 Equipment ..................... B. Merchandise .................... S-~~' C. Special Charges .................. S i ~ : ~ D. Cash Advances ..................5 S TOw. OF ALL SECTIONS .................. ..... PAID AT TASB OF OR PRIOR TO ARRANGffirt~11'S ......................... ..... S ~~,~ S BALANCE DUE ........................... ..... ~-~- $ ~A~NG REASON l ~ ` cemetery, or crematory requirements have required If any law, the purchase of any of the ' hated above, tie law `or~requirement is explained below. ' J qtr . R ` . +. 1 y..w I agree tint I have examined the items of goods and services selected above and found them to be rnmect and according to the arrangements of the cash. Ifor the~~~ receipt of a copy c~ this Statematt of Funeral Goods and ovtlthint that I have sufficlent funds available for paymen price B~ and services selected. I also agree to payment of S ~ ~- days. I agree to be jointly and severally liable with anyonedse who ~ r month amountlng to per year will be appfled to the unpaid balance beginning ~ days from the date e, f this ~ I will also pay to the Funeral Director aR costs paid by the Funeral Director to collect amounts I owe under ttris agreement. ~ eared after the date of this a rat will Those costs ma attorneys' fees, catrt costs and other casts. Arty additional services or merchandise ordered or requ greeme be cons' rt 'agreement thereof wiU be refl on the final bill or statement. C1 ~S 2oi~ (Seal) ~ ) (Date) (Seal) (Licensed Furit:ral Director) (Purchaser) ~p Funm1 t)heaor YEUAw Fl°'~a1 ~fOf Punic ~SO1AC 0 Penroylvania Funeral Duenors AsodfUon form -600 Revised 1/04 • Carlisle Memorial Service, Inc. DESIGNERS AND BUILDERS OF Cemetery Memorials . 41 South Bedford Street Carlisle, PA 17013 Telephone .(717) 243-5480 Please design and- build the following memorial Price .~~ W~ 23a~~~ Total Prig J ~ ~~r 7~ Date For ` ~' ~"'~ tG t . Address S'i 3 ~"'~ A 1i''L ~ L T D ~ ~'~ ~ ~ ~ ~-~s ~-~ ~ 1 7 e''1 Design No. ~ ~~ Material ~A t;c~ rl ~ ~ iA Die ~ ` ~ ~-/ b X 1 Base ':- ~A~ C~ ~ ~R~~~~ Markers Posts _ r Vases Price ~ ~ b~ ° ~~ Tax Deposit Balance Due Style of Letters , ~~ ' g ° ~~ Foundation to be furnished by ,a~T~B ~9~o MAy ~4._ZA~~ Material to be best selected monumental grade and to be tree from impertebtions and first class in every way. wont to be t~rnsnea in a woncmarmKe manner. ' I~ to be erected in ~= ~ ~ ~~ ~ Z.. ` Cemetery in or near This m~nena during the month of unless unavoidably delayed by labor troubles and other contingencies beyond our control and then as soon as possible. l~lditionai lettering and other work on thi§ memorial in the future is not included in the Contract Price. Title and right of possession and removal of said stone, monument or appurtenancres shall remain for alt purposes in Carlisle Memorial Service, Inc. until work and materials ordered are fully paid by purchaser or purchasers. In consideration of the,acceptance by Carlisle Memorial Service, Inc. of this order, the undersigned (hereinafter known as the purchaser) agrees to pay Carlisle Memorial Service, Inc. Dollars on or before the 15th day following the billing of the work or job upon completion thereof by Carlisle Memorial Service, Inc. Thirty (30) days from date of invoice a 1-1/29~o finance charge will be added to the unpaid balance. Said billing to be notice of completion thereof, this order shall become a contract between the purchaser and Carlisle Memorial Service, Inc. upon acceptance thereof irrthe space below by a duly authorized represen4ative of said Carlisle Memorial Service, inc. it being understood that this instrument upon such acceptance covers ail of the agreement between the purohaser and Carlisle Memorial Service, Inc. and that no agent or representative of Carlisle Memorial Service, Inc. has made any statements or agreements, verbal or written, modified or adding to the terms and conditions herein set forth. It is further understood that upon the acceptance of this order the contract so made cannot be cancelled, altered, or modfied by the purchaser or by any agent of Carlisle Memorial Service, Inc. in any manner except by agreement in writing between the purchaser and Carlisle Memorial Service, Inc. and it is hereby understood and agreed by all parties involved that in case of default by purchaser or purchasers, twenty-five per cent of the total original cost of the work or work and materials ordered, as the case may be, shall be a specified correct sum as liquidated damages which purchaser shall owe Carlisle Memorial Service, Inc. less any payment on account made prior to such default, this specification of damages to be due regardless of removal and taking possession of stone, monument or materials from purchaser or purchasers by Carlisle Memorial Service, Inc. upon following such default. (SEAL) 20~ ~ (SEAL) ~~ Ca sle Memorial Service, Inc. Approval By ~ ~ ~ ~ ~ ~ ~ ~ ~~ ~ s (SEAL) White: Office Copy; Canary: Customer Copy; Pink: alesman Copy; Gold: Deposit Copy customer 14S4U4: NANCY BR.ANDT • O Joe Kibe energy, y plant Foreman uville Road Carlisle, PA 1701 Office: 717-249-2021 : ---; y; Cell: 717-577-5832 _ /~'^ ~ ~ ~ ~ ~ Fax: 717-249-2023 '' e an Fue ~. -' `' 100 /o Ameri roener .com ~kibe@ae 9Y www.aeroenergy.com ~.. User: jkibe - Date: 06-10-2011 Customer ~: Customer # 143404 Custorrier Since 3/1/1990 Customer NANCY BRANDY Name Prefix, First Name, ~~"" Suffix _ . Addressl 4 HILL ST Phone # (717)486-3807 Home Address 2 _......~~_ City, State, MT HOLLY SPRIM PA ~ 17065 Email Zip Attributes Cat:22 12 Mth, bud f.o., ]une Bud± Ranking .. 2011 Tax PENNSYLVANIA Review Setup Information Jurisdiction On Hold? ~" Forecast• Heat & Hot Water ~•YPe Division CARLISLE ~~ Credit Credit Limit: $200 InformationPayment Terms: Net 30 Billing Addresses Account Status Active Delivery Type Automatic .~ Customer Type Residential ~: Auto Apply ~" Invoicing/StatementsResidential, When Past Due Cardlock Statements Group By Vehicle Customer $803.61 Balance Current $803.61 61 - 90 $0.00 Days 121. A~~d $0.00 Over 8u.:~ct $35.00 Plan F3alar~cp Last 6/6/2011 Last Statement Last Invoice State~~~ent Non-Budget Balance $0.00 31 - GO Days $0.00 91 - 12O Days $0.00 Deposit Balance $0.00 Monthly Budget $355.00 Payment Last 04/18/2011 Last Payment Date 5/10/201 Last Service Date 02/131 Delivery fj7~ r.;r' ~ ;~- Date ~ ~ • ` L' ~-' ,~~ `U b ~~ ~~ ~_. ~ 1......_....~ . f_~.__-__.. http://aeronet/aeroener~vsolutinn/fnrrr,i ictTPm.~•l~to .,~..~.~~----~----T~-^