HomeMy WebLinkAbout03-09-12i
1505610140
REV-1500 ~` ~°'-'°'
PA Department of Revenue OFFICIAL USE ONLY
Bureau of Individual Taxes
PO BOX 280601
INHERITANCE TAX RETURN County Code Year File Number
_ Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 1 1 0 1 9 8
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYW Date of Birth MMDDYYYY
1 8 3 1 2 4 6 5 6 0 1 2 9 2 0 1 1 0 2 2 6 1 9 2 5
Decedent's Last Name Suffix Decedent's First Name MI
A L S P A U G H R I C H A R D p
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name
MI
Spouse's Social Security Number
FILL IN APPROPRIATE OVALS BELOW
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death
4. Limited Estate
~
4a. Future Interest Compromise (date of prior to 12-13-82)
~ 5. Federal Estate Tax Return Required
^X
6. Decedent Died Testate
~ death after 12-12-82)
7. Decedent Maintained a Living Trust
8. 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 ~ 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
M A T T H E W A M c K N I G H T 717 2 4 9 2 3 53
First line of address
I R W I N &
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 OM F R E T S T R E E T
State ZIP Code
REGISTER OF WILLS USE ONLY
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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, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SI(~ATURE OF PERSOfJ.RESRON,816LE FOR FILING RETURN _.__
186~VVIRGINIA AVENUE CARLISLE PA 17013
SIGNATUF~ O~ CEP f1~pTHER THAN REPRESENTATIVE D/f1T~E `
ADD ESS / ~ ~/ ~l f}`/
60 WEST POMFRET STREET CARLISLE PA 17013
PLEASE USE ORIGINAL FORM ONLY
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Side 1
1505610140 1505610140 J
1505610240
REV-1500 EX
Decedent's Social Security Number
oecedent'sName: RICHARD 0• ALSPAUGH 1 8 3 1 2 4 6 5 6
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.
4. Mortgages and Notes Receivable (Schedule D) .......................... 4.
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. 1 5 3 5 6 . 4 4
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. 3 0 9 3 9. 1 7
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ^ Separate Billing Requested ....... 7.
8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 4 6 2 9 5. 6 1
9. Funeral Expenses and Administrative Costs (Schedule H) ........... .... ... 9• 5 8 8 8. 6 3
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ...... .... ... 10. 2 7 8 6 . 8 2
11. Total Deductions (total Lines 9 and 10) ........................ .... ... 11. 8 6 7 $ . 4 5
12. Net Value of Estate (Line 8 minus Line 11) ..................... .... ... 12. 3 7 6 2 0 . 1 6
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ............... .... ... 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) ............... .... ... 14. 3 7 6 2 0. 1 6
TAX CALCULATION -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.o _ 3 0 9 3 9. 1 7 15. 0. 0 0
16. Amount of Line 14 taxable
at lineal rate X .045 6 6 8 0. 9 9 1 s. 3 0 0. 6 4
17. Amount of Line 14 taxable
at sibling rate X .12 0. 0 0 17. 0. Q O
18. Amount of Line 14 taxable
at collateral rate X .15 0. 0 0 18. 0. 0 0
19. TAX DUE ............................................... .... ...19. 3 0 0. 6 4
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^
Side 2
1505610240 1505610240
REV-1500 EX Page 3
Decedent's Complete Address:
File Number
21 11 0198
DECEDENT'S NAME
R;CHARD O. ALSPAUGH _
STREETADDRESS ---
36 HSTREET
CITY STATE - ', ZIP
CARLISLE PA ~ 17013
Tax Payments and Credits:
~~ Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments _
B. Discount
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.
(1) 300.64
Total Credits (A + g) (2) 0.00
(3) 4.48
(4) 0.00
(5) 305.12
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 ..........................................................................................
.
....
^
a
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? ...................................... .
...........................................
..... ^
0
3. Did decedent own an "in trust 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? ............................................................................................. ..... ^ 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
::
__ -y_ _ ., - ,~
.__ __._ ,
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 is
3 percent [72 P.S. §9116 (a) (1.1) (i)].
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)]. 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)].
• 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)].
• 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, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1508 EX+ (11-101
pennsylvania
DEPARTMENT OF REVENUE
~ INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, ~ MISC.
PERSONAL PROPERTY
FILE NUMBER:
RICHARD O. ALSPAUGH 21 11 0198
Include the proceeds of litigation and the date the proceeds were received by the estate.
Atl property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER VALUE AT DATE
DESCRIPTION OF DEATH
1. M&T BANK -CHECKING ACCOUNT #9849044061 2,678.96
2. IM&T BANK -SAVINGS ACCOUNT #15004221128273 I 4,565.38
3. IM&T BANK -CERTIFICATE OF DEPOSIT #31003918611475 I 8,112.10
TOTAL (Also enter on Line 5, Recapitulation) I $ 15 356 44
If more space is needed, insert additional sheets of paper of the same size
1\ G V- i JuJ G/\T ~ V ~' 1 4'
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ca i Ai t ter: FILE NUMBER:
RICHARD O. ALSPAUGH 21 11 0198
If an asset was made jointly owned within one year of the decedents date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
A. PAULINE W. ALSPAUGH 1000 WEST SOUTH STREET SPOUSE
CARLISLE, PA 17013
B.
c.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE.
1. A. M&T BANK -CHECKING ACCOUNT
ACCOUNT #853909
2. A. 36 H STREET, CARLISLE, PA
ASSESSED VALUE
DATE OF DEATH DECEDENT'S D VALOUE OF TH
VALUE OFASSET INTEREST DECEDENT'S INTEREST
878.33 50. 439.17
61,000.00
TOTAL (Also enter on Line 6, Recapitulation)
If more space is needed, use additional sheets of paper of the same size.
E
50
30, 500.00
30,939.17
REV-1511 EX+ 110-09J
{ Pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
a RESIDENNDECEDENTTURN ADMINISTRATIVE COSTS
ESTATE OF
FILE NUMBER
RICHARD O. ALSPAUGH 21 11 0198
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION
A. FUNERAL EXPENSES:
1. HOFFMAN-ROTH FUNERAL HOME
AMOUNT
1,220.59
B• ADMINISTRATIVE COSTS:
1 • Personal Representative Commissions:
Name(s) of Personal Representative(s) DEBRA K. WHARAM
750.00
Street Address 186 VIRGINIA AVENUE
City CARLISLE State PA
zIP 17013
Year(s) Commission Paid:
2. AttomeyFees: IRWIN & McKNIGHT, P.C.
3.
Family Exemption: (If decedents address is not the same as claimants, attach explanation.) 2,175.00
Claimant
Street Address
City State
ZIP
Relationship of Claimant to Decedent
4• Probate Fees: REGISTER OF WILLS
261.50
5 Accountant Fees:
6, Tax Return Preparer Fees: PATRICIA A. ROSENDALE, CPA
350.00
7• REGISTER OF WILLS -FILING FEE
8. CUMBERLAND LAW JOURNAL -ESTATE NOTICE 30.00
9. THE SENTINEL -ESTATE NOTICE 75.00
10. CAREY'S DUMPSTERS -TRASH REMOVAL 187.54
11. REGISTER OF WILLS -SHORT CERTIFICATE 450.00
12. DIVERSIFIED APPRAISALS -APPRAISAL ON REAL ESTATE 4.00
13. NOTARY FEES 350.00
35.00
TOTAL (Also enter on Line 9, Recapitulation) $
If more space is needed, use additional sheets of paper of the same size. 5 888.63
REV-1512 EX+ (12.08)
• pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE(
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, 8 LIENS
ESTATE OF
FILE NUMBER
RICHARD O. ALSPAUGH 21 11 0198
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION VALUE AT DATE
OF DEATH
1. M&T BANK -RECLAMATION OF FEBRUARY, 2011 SOCIAL SECURITY PAYMENT 1,310.00
2. (CARLISLE BORO TAX ACCOUNT -REAL ESTATE TAXES
3. CARLISLE PETROLEUM -FUEL OIL
4. (STATE FARM INSURANCE -HOMEOWNERS INSURANCE
5. I BOROUGH OF CARLISLE -WATER/SEWER
TOTAL (Also enter on Line 10, Recapitulation) I $
If more space is needed, insert additional sheets of the same size.
500.09
512.85
397.94
65.94
KEV-151 Ca. EX+(01-10)
Pennsylvania
DEPARTMENT OF REVENUE
* INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
w~r~icvr:
RICHARD O. ALSPAUGH
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec. 9116 (a) (1.2).]
1. DEBRA K. WHARAM
186 VIRGINIA AVENUE
CARLISLE, PA 17013
2. PAULINE W. ALSPAUGH
1000 WEST SOUTH STREET
CARLISLE, PA 17013
FILE NUMBER:
21 11 0198
RELATIONSHIP TO DECEDENT
Do Not List Trusteels-
Lineal
Spousal
AMOUNT OR SHARE
OF ESTATE
6,680.99
30, 939.17
REAL ESTATE & JT.
ACCOUNT
I ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV 1500 COVER SHEET AS APPROPRIATE
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I $
If more space Is needed, use addltlonal sheets of paper of the same size.
LAST WILL AND TESTAMENT
I, RICHARD O. ALSPAUGH, of the Borough of Carlisle, Cumberland County,
Pennsylvania, being of sound and disposing mind and memory, do hereby make, publish and declare
this to be my Last Will and Testament, hereby revoking any and all former Wills or Codicils by me
made.
I.
I direct that all my legally enforceable debts, funeral expenses, testamentary expenses and all
inheritance taxes (whether such taxes may be payable by my estate or by any recipient of any
property) shall be paid from my residuary estate as soon as practicable after my decease and as part
of the administration of my estate. My personal representative shall have no duty or obligation to
obtain reimbursement for any such tax so paid, even though on proceeds of insurance or other
property not passing under this Will.
2.
I give, devise and bequeath all of my estate, whether real, personal or mixed property,
whether tangible or intangible, and wherever situated, unto my daughter, DEBRA K. WHARAM,
absolutely, with substitution of issue per stirpes.
3.
I nominate, constitute and appoint my daughter, DEBRA K. WHARAM, as Executrix of my
estate.
Page 1 of 4 Pages
R.O.A.
t
4.
I direct that my personal representative shall not be required to file a bond to secure the
faithful performance of her duties in any jurisdiction.
5.
I authorize and empower my personal representative, in her sole and absolute discretion, to
purchase or otherwise acquire and retain any investments or any property of any nature which I own
at my death; to sell, lease, pledge, mortgage, transfer, exchange, dispose of or grant options in regard
to any or all property of any kind forming a part of my estate for such terms and such prices as she
may deem advisable; to borrow money for any purposes connected with the protection and
preservation of my estate; to mortgage or pledge any real or personal property forming a part of my
estate or to join in or secure the partition of same; to compromise any claims or demands of my
estate against others or of others against my estate; to make distribution in kind and to cause any
share to be composed of cash, property or undivided fractional shares in property different in kind
from any other share; to employ agents, attorneys and proxies and to delegate to them such power as
my personal representative considers desirable and to pay reasonable compensation for such services
as may be rendered by such agents, attorneys and proxies; and to execute and deliver such
instruments as may be necessary to carry out any of these powers. In addition, I direct that my
personal representative shall have the power to conduct an inventory of any safe deposit box
necessary to the administration of my estate.
Page 2 of 4 Pages
l
R.O.A.
a
IN WITNESS WHEREOF I have hereunto set my hand and seal this 14~' day of April, 2009.
• ~ (SEAL)
Richard O. Alspau h
SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testator, as and
for his Last Will and Testament, in the presence of us, who at his request, have hereunto subscribed
our names as witnesses thereto, in the presence of the said Testator and of each other.
i ~JY/G
;'L
Page 3 of 4 Pages
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS.
I, RICHARD O. ALSPAUGH, Testator, 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 that I signed it as my free and
voluntary act for the purposes therein expressed.
Richard O. Alspaugh
Sworn or affirmfeAd,,to and~agcknowledged before me by RICHARD O. ALSPAUGH, the
Tes~g~n~~n~E4a~~~'F~Nt~~~~Ta '
Noharial seal
Karen S. Noel, Notary Pudic ~,
Carlisle Boro, Cumbeliarxf Courtly
My Commission Expires Dec. 8, 2011 NOt PUb11C
Member ~~rns\ I+~An~~ association of Notaries
COMMONWEALTH OF PENNSYLVANIA )
SS.
COUNTY OF CUMBERLAND
~-
We, and
the witnesses whos names are signed to the attached or foregoin nstrument, being duly qualified
according to law, do depose and say that we were present and saw RICHARD O. ALSPAUGH, the
Testator, sign and execute the instrument as his Last Will; that the Testator signed willingly and that
the Testator executed it as his free and voluntary act for the purposes therein expressed; that each of
us, in the hearing and sight of the Testator, signed the Will as witnesses; and that to the best of our
knowledge the Testator was at that time 18 or more years of age, of sound mind and under no
constraint or undue influence.
Address ~ (~ ~ ~~~.~::~
~~ _S' - :~
Address ~IJQ
~ ~
Sworn or affirmed to and subscribed before me this 14~'
N
G:\SBloom\Office -Estate Planning\SLB -Estate Planning\3602.Ih-will.3.doc
Page 4 of 4 Pages
of
Notarial Seal-~-
Karen S. Noel, Notary Public
I Carlisle Boro, Cumberland County
My Commission Expires Dec. 8 2011
~fembe Ivanta Assoclatton of Notaries
APPRAISAL OF REAL PROPERTY
LOCATED AT
36 H Street
Carlisle, PA 17013
Deed Book 17Z Page 583
FOR
The Estate of Richard O. Alspaugh
OPINION OF VALUE
sl,ooo
AS OF
January 29, 2011
BY
Susan B. Burkholder
State Certified Residential Appraiser, RL-000659-L
Diversified Appraisal Service
35 E. High Street, Suite 101, Carlisle, PA 17013
717-249-2758
sue. Burkholder@gmail. com
Fonn GA1V- TOTAL for Windows" appraisal sattware by a la mode, inc. -1-800-ALAMODE
Divers'fiied Appraisal Services
RESIAENTIAL APPRAISAL SUMMARY REPORT FdeNa: osos1'1A
rra nadress: 36 H Street C' . Cadisle Stale: PA L Code: 17013
F Cou Cumberland al Descd 'on: Deed Book 17Z Pa a 563
~ Assessor's Parcel #: 06-19-1641-065
Tax Year. 2011 R.E. Tares: $ 1 993.30 S eciai Assessmerrts: $ n.a. Borrower rf irble : n.a.
~'
H Current Owner of Record: Richard O. Als au h Occu ant: ^ Owner ^ Tenant Vacant ^ Manufactured Housin
Pro ect T e: PUD CondomMium Coo ratlve ^ Other describe HOA: $ er ear ^ er month
Market Area Name: Carlisle Boro h Ma Reference: 06.19-1641-065 Census Tract 120
The u ose of this a sisal is to deve~ an o inion of: Market Value as defined , or other of vakre describe
This r ort reflects the follovdn value rf not Current, see commends : ^ Current the Ins ' n Date is the Effective Dale Retros ectlve ^ Pros active
z roacfres Bevel ed fw this sisal: Sales Com arfsan ch Cos[ A ch Income A roach See Reconctliatlon Comments and Sco a of Work
Pro Ri tits ised: Fee Sim le Leasehold ^ Leased Fee ^ Otlrer describe
~ Intended Use: To establish value for State Inheritance Tax
ar
Intended Users name or Estate of Richard O. Ais au h
Client Estate of Richard O. Als au h Address: 36 H St reet Carlisle
raiser. Susan B. Burkholder Address: 35 E. H i h S Suite 101 Carlisle PA 17013
Location: Urban Suburban Rural Predonrirrant One-Unit Housing Preeerd Land Use Change in Land Use
Built up: ®Over 75% ^ 25-75% ^ Under 25% panty PRICE AGE One-Unit 70 % ®Not Likey
z
O Growth rate: ^ Rapid ®Stable ^ Slow ®Owner $(000) (yrs) 2-4 UnA 5 % ^ Likely * ^ In Process'
f. Properly values: ^ Increasing ®Stable ^ Declining ^ Tenant 60 Low 40 Mu10-Unit % ' To:
Demand/supply: ^ Shortage ®In Balance ^ Over Supply ®Vacard (0-5%) 250 Hi h 200 Comm'I 25 %
~- Madmti time; ^ Under 3 Mos. ®3.6 Mos. ^ Over 6 Mos. ^ Vacant >5% 100 Pred 75 %
c Market Area Boundaries, Desedptien, and Market Condidans (including support far the above charactedstlcs and trends): Established residential area with stable
ownership patterns within reasonable commuting distance to schools places of worship shopping and transportation The small amount of
~ wmmercral use has no adverse impact upon the marketability of the home The subject neighborhood is bordered by Spring Road PA Turnpike
F'! and Hanover Street.
W --
Y
K
~ -
Dimensions: I ular Site Area: .09 acre
Zoning Classfication: R2 Medium Density Residential Descdpten: E~dsting use is cennilted
Zoni Com liance: L al Legal ntxrcorrfarmi randfatlre ^ IIN al ^ No tonin
Are CCBRs a livable? ^ Yes ^ No ®Unlgrown Have the documents been reviewed? Yes ^ No Ground Rent rf a livable $ /
Highest 8 Best Use as improved: ®Present use, or ^ Other use (explain)
AcWal Use as of Effective Date: Single family dwelling _ Use as appraised in this report Single family dwelling
z' _
Summary of Highest 8 Best Use: Simile family dwelling
O -
h=
d --
v: UUlitles Public Other Provider/Description Ofhsitelmprovements Type Public Private Topography Level
w
Electricity ® []
Street Macadam ® ^ _
Size Typical for the area
m Gas ® ^ CurWGutter Concrete ® ^ Sh e I
~ rz r
~
y Water ® []
Sanitary Sewer ® [] Sidewalk Concrete
® ^ Drainage Appears adequate _
Street Lights Pole ® ^ Yew Average
Stann Sewer ® ^
Alle None ^ ^ _
Other sihe elements: ®Inside Lot Comer Lat ^ Cul de Sac ^ Unde round UUflties ^ Other describe
FEMA S ec'I Food Hazard Area ^ Yes ®No FEMA Flaad Zone X FEMA M # 42041 C FEMA M Date 3-16-09
Site Commends: The home is located in Carlisle Borough.
General Deacripdon Erdrilor Deealptlon Foundatlon Baarxnent None Hceting
# of Units 1 _ ^ Acc.Untt Foundation Concrete Block Slab None Area Sq. Ft. Type Fha
# of Stories 2 Exterior Walls Vin I sidin Crawl Space Partial % Flnished 0 Fuel Gas
Type ^ Det ^ Aft ~ Semi alt Roof Surface Shin les Basement Partial Cetling
Design (Style) Duplex Gutters 8 Dwnspts. Aluminum Sump Pump ^ Walls Cooling
® Frosting ^ Proposed ^ Und.Cons. Window Type Dbl-hun Dampness ^ Floor CerNal Yes
a~ AcWal Age (Yrs.) 76 ears StomVScreens Screens Settlement None Outside Entry No Otlrer
z+
Effective A e rs. 25 ears
infestation None ___
W.° Interior Description Appliances
R Attle ^ Nane Amenities Car Storage ®None
oars Caroet Refdgeralor ^
W Stairs ^ Fireplace(s) # Weadstove(s) # Garage # of cars ( Tot)
alls Plaster Range/Oven ^ Drop Stair ^ Patio Attach.
TrirNFlnish Wood Disposal ^ Scuttle ^ Deck Wood Detach.
w. Bath Roor Vinyl Dishwasher ^ Doorway ® Paroh Covered Bft-In
F Bath Wainscnt Plaster FaNHood ^
Floor ®
Fence _
Carport
Doors Wood Microwave ^
Heated ^
Pool _
Driveway
z Washer/D r ^
a Rnished ^ Surface
l i= ~ ~ ,,,N„~~ a w a••••°~ y~a~o ~unmma. o mums s neorocros 1 team(s) 1,200 Square Feet of Grass Livinc Area Above Grade
Describe me condition of the property (including physical, functional and external obsolescence): The interior was not remodeled or undated The home still has
a fuse box. There are cracks in the plaster walls and the floor covering are older an the kitchen and bath are older
ES ~ ®E ~T~ ~ ~ ~~ 2DDT br a Ia made, Inc. nos loan mry be reproduced emadaea vnrhart wdlRn pemoasan, hmvever, a la mode, inc. must be aclmowledged and creAfed.
Form GPRES2 -"TOTAL far Windows° appraisal software by a la mode, inc. -1-B00-ALAMODE 3/2007
R
O
y ESIDENTIAL APPRAISAL SUMMARY REPORT FlIeNa: ososr,A
My research did did not reveal any prior sales or transfers of tits subject property far the three years prior to tits eBective date of this appraisal.
Data Sources : Assessment records
1st Prior Suh'ect Sale/Transier Analysis of sale/transter history and/or arty currerrt agreement of sale/listing: The subject is not currentiv listed or under
Date: contract
~: Price:
LL Sources
Z. 2nd Prior Sub~ect Sale/Transfer
Date:
Pdce: _
Sources
SALES COMPARISON APPROACH TO VALUE if The Sales Com rison roach was trot deve ed for this a sisal.
FEATURE SUBJECT COMPARABLE SALE # 1 COMPARABLE SALE # 2 COMPARABLE SALE # 3
Address 36 H Street 153 Cedar Street 65 E. North Street 45 E. North Street
Carlisle PA 17013 Carlisle Carlisle Carlisle
Prottim' to Sub'
Sale Price
Sale Price/GLA
Data Sources
$
$
/s .tt 1.06 miles
$
$ 50.83 /s .tt
Courthouse
67 500 0.73 miles
$
$ 51.76 /s .tt
Courthouse
53 000 0.73 miles
$
$ 62.40 /s .tt
Courthouse
75 000
Uedfication Sources
MLS
MLS
MLS _
" VALUE ADJUSTMENTS
Sales or Rrrarrcing
Concessions
Date of Salome DESCRIPTION
As of 1-29-11 DESCRIPTION
None known
Conventional
2-4-10 + - $ Ad'ust DESCRIPTION
None known
Cash
6-18-10 + - $ Ad'ust DESCRIPTION
None known
Conventional
1-19-10 + - $ Ad'ust.
-' Ri hts A raised Fee Sim le Fee Sim le Fee Sim le Fee Sim le
Location Ave Similar Similar Similar
SM
dew ".09 acre
Avers a .05 acre
Similar +800 .04 acre
Similar +1 000 .05 acre
Similar +800
Desi n S le
Oual' M ConstNCtion
A e
Condition
Above Grade Du lex
Yn I sidin
76 ears
Fair to averse
ToW Bdrms Baths Similar
Alum sidin
91 ears
Su riot
TAW Bdmrs Baths
6 800 Attached
Alum sidin
141 ears
Similar
Total Bdrms Baths +2 000 Similar
Brick
140 ears
Su erior
TAW Bdrms Baths
-5 000
-7 500
Roam Courd 6 3 1 6 3 2 -2 000 6 2 1 6 3 1.5 -1 000
' Grass Livin Area
Basement 8 Finished
Rooms Below Grade 1 200 s .tt
Partial bsmt
None 1 328 s .tt
Full bsmt
None -2 600
-1,000 1 024 s .tt
Similar
None +3 500 1 202 s .tt
Full bsmt
None
Functional UBI'
Averse
Similar
Similar
Similar _
Hearin Conlin
Fha Oil
Fha Oil
Fha Gas
Fha Oil _
<. En Efficient Items
tiara e/Ca rt
Porch/Patio/Deck Nane
1-car ara a
Porch
None None
None
Porch
None
+3 000 None
None
2 rches
None
+3 000
-1 000 None
2-car are a
Porch balcon
None
-3 000
-1 000
z
o
H
rc --r --
a
~' Net Ad'usiment oral
v' Adjusted Sale Price
w of Com tables
a Summary of Sales Comparison Approach
~ property. -
^ + - $ 8 600 + ^ - $ 8 500 + - $ 16 700
Net 12:7-% Net 16:096 Net 22.3 %
Gross 24.0 % $ 58 900 Gross 19.8 $ 61 500 Gross 24.4 % $ 58 300
Sale number 2 was given the most consideration since this home was in similar condition to the subject
Indkated Value S:des Com orison roach $ s1 ooD
re~aenrm ~nm n~ ~ e nNa. ice. nay ~,,.......,~. ~ ...,....,......__...~....~ - -
--
[e~RE51®ER~TIAL
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Form GPRES2 -'TOTAL far lrndows' appraisal software by a la mode, inc. -1-1300-ALAMODE 312007
R ESIDENTIAL APPRAISAL SUMMARY REPORT
'
FlIeNn„ oso6,
,A
COST APPROACH TO VALUE The Cost h was not de d for this a sisal
.
Provide ode uate imonnation for re lication of the follovri cast ales and calculations.
Support for the opinion of site value (summary of comparable land sales or other methods far estimating site value):
' ESTIMATED REPRODUCTION OR REPLACEMENT COST NEW OPINION OF SITE VALUE ._.___.._.._._... -
~
O Source of cost data:
o
l' DWEWNG S .Ft @ $ _$
ua
ratio from cost service: Effective date of cost data:
Commems on C
t A
h S .Ft @ $ _$
a, os
pproac
(gross living area calculations, depreciation, etc.): g .R, @ $ _$
r- -
O -
S .Ft@$ _ _$
V =$
- Gars Ca S .R @ $ _$
- Total Estimate of Cost-New _$
- Less P ical Functional Exlemai
-- De reciation =$(
- De reciatedCostofim rovemems _........___....___.__.---....... _$
"As•is"Value of Site lm vemems _.......___..__.__....._ _. _$
- _$
- _$
Estimated Remaini Economic Lire rf fired : Years INOICATEDVALUEBYCOSTAPPROACH .
.$
x ..__._..__._.._....._,_.._._._._
INCOME APPROACH TO VALUE deve The Income roach was not deveb for this a ' al.
a! Estimated Momm Market Rem $ X Gross Rem M er = $ Indlemed Value Income roach
S
a; ummary of Income Approach (including support for market recd and GRM):
oc
a
-
W _
~ -
O -
V -
Z -
PROJECT INFORMATION FOR PUDs N table The Sub' ct is of a Flamed Unit Devel mein.
Le al Name of Pro' ct
e Describe common elemems and recreational facilities:
a -
Indicated Value by: Sates Comparison Approadt $ 61 000 Cost Approach (H developed) $ n.a. Incgnre Approach (N developed) $ n
a
.
.
Rnal Reconciliation The Sales Comparison approach being considered the most accurate in arriving at my final opinion of value The Income
approach was not considered since this rs an owner occupied single family dwelting The Cost approach was considered to be unreliable since
this rs not new construction and may be misleading to the reader
z --
0
J. This appraisal Is made ®"as is", ^ subject to completion per plans and specifications on the basls of a Hypothetical Condition that the improvemems hav
b
e
een
~ completed, ^ subject to the following repairs ar alterations on the basis of a Hypothetical Condition that the repairs or atteratiorts have been completed
^ subject to
,
z the following required inspection based on the Exbaominary Assumption that the condition or deficiency does not require aheration or repair. Appraised in current
v condition
.
W
0: -
^ This re ort is also sub' to other H etical Conditions and/or Exbaordina Assam 'ons ass fled in the attached addenda
.
Based on the degree of inapectlorr of the subject properly, as indkxted below, defined Scope of Work, Statement o} Assumptlons and Limitlng Cond(tlons
'
,
and Appreiser
s Certltlcatlons, my (our) Opinion of the Market Value (or other apectlkd value type), as defined herein, of the real Properly that Is the subject
of this report is: $ 61
000
,
as of: January 29, 2011 ,which is the ellectltle date of this eppreisal.
If indicated above, this Opinion of Value is subject to Hypotlretlal CondNione and/or Exbaordirrery Assumptlons included in this report See attached addenda.
A true and complete copy at this report comains 14 pages, including exhibits which are considered an integral part of the report This appraisal report may nm be
w' properly understood without reference to the imomra6on comained in the completh report.
_' Attached EtddbiLs:
~ ^ Scope of Work ®Limiting Cond/Certifications ®Narrative Addendum ®Photograph Addenda ®Sketch Addendum
~: ®Map Addenda ^ Additional Sales ^ Cost Addendum
Rood Addendum
Mamrl
House Addendum
~
a
.
a• ^ H etical Conditions ^ Exbaard' Assam 'ons ^
' Cliem Comact Cliem Name: Estate of Richard O. Alspaugh
_
E-Mail: Address: 36 H Street Carlisle
APPRAISER SUPERVISORY APPRAISER ('rf required)
or CO-APPRAISER (-rf applicable)
w ,Q~ ~
~~
~ ~"""'"'
a. Appraiser Name: Susan B. Burkholder Supervisory or
Co-Appraiser Name:
Comparry: Diversified Appraisal Service Company:
h Phone: 717-249-2756 Fax: 717-258701 Phone: ~ -
E-Mtil: sue.burkholderCa~gmail.com E-Mtil: ---
Date of Report (Signature): June 6, 2011 Date of Report (SrgnaNre): --
License or Cerfifiration #: RL-000659-L State: Pq License or Certibcation #: Spa
Designation: n.a.
Ex
i
ti
D
f Designation:
ra
p
on
ate o
License ar Certification: June 30.2011 Expiration Date of Ucense ar Certification:
Inspection of Subject ®Imedor 8 Erdedor ^ Extedor Only ^ None
' Inspection of SubjecC ^ Imertor 8 Extedor ^ Extedor Only ^ None
Date m Ins
on: Ma 5 2011 Dale of Ins action:
cooanorem xom na a n n,M. i~~ mi~,,,m,,.,.„ n., .~,..,..~ ....,....~~ _'~ - ---
Q~RESI®E~1T'IAL
_•. ______ _._.__..- ..._.__.....~.. ,.,....~„o„„., ,,,..~.a,, e,e namc, n,u. must ce acuiawKUgeu BIIO Cr001I2(I.
Form GPRES2 - °rOTAI for wndows° appraisal software by a la mode, inc. -1-800-AIAMODE 3/2007
Suoolemental Addendum ~~e~~~ ~~~„e
_- -- --
BorrowerGierd, n.a.
Pro a Address 36 H Street
C~ Carlisle Cou Cumberland State PA Z Code 17013
lender The Estate of Richard O. Als au h
Additional Comments:
The subject is older than five years old. All mechanical systems including heating, electrical and plumbing systems appear to
be working adequately. No warranfies are implied in this statement.
One or more of the comparable sales are older than six months old. Although there are comparable properties in the subject's
area, none have sold recently, therefore, sales in excess of six months old have to be used. All three comparables used were
the best available.
Scope of Work:
Scope of work is defined in the Uniform Standards of Professional Practice as being "the type and extent of research and
analyses in an assignment ° This includes the degree and extent of research and the data that is deemed as necessary to
develop a credible opinion of value for the property being appraised.
Privacy Notice:
Pursuant to the Gramm-Leach-Billey Ad of 1999, effective July 1, 2001, appraisers, along wfth all providers of personal financial
services are now required by federal law to inform their dients of the polities of the firm with regard to the privacy of the client
nonpublic personal information. As professionals, we understand that your privacy is very important to you and are pleased to
provide you with this information.
In the course of performing appraisal, we may tolled what is known as "nonpublic personal information" about you. This
information is used to facilitate the services that we provide to you and may include the information provided to us by you
directly or received by us from others with your authorization.
We do not disclose any nonpublic personal information obtained in the course of our engagement with our dients to
nonaffiliated third parties, except as necessary or as required by law. By way of example, a necessary disclosure would be to
our independent contractors, and in certain situations, to unrelated third party wnsuRants who need to know that information to
assist us in providing appraisal services to you. All independent contractors and any third party consuMants we engage are
informed that any information they see as part of an appraisal is to be maintained in strict confidence wfthin the firm. A
disclosure required by law would be a disclosure by us that is ordered by a court of competent jurisdiction with regard to a legal
action to which you are party.
We will retain records relating to professional services. that we have provided to you for a reasonable time so that we are better
able to assist you with your needs. In order to protect your nonpublic personal information for unauthorized access by third
parties, we maintain physipl, electronic and procedural safeguards that comply with our professional standards insure the
security and integrity of your information.
Porn TADD -'TOTAL for trndows~ appraisal software by a la mode, inc. -1-800-ALAMODE
Location Map
Borrower Cliefd n.a.
Pm a Address 36 H Street
C' Carlisle Cou Cumberland State PA Zi Code 17013 _
Lender The Estate of Richard O. Als au h
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Form MAP.LOC -"TOTAL for Windows' appraisal software by a la made, inc. -1-800-ALAMODE
Building Sketch (Page - 1)
Borrower Client n.a.
Pro Address 36 H Street
C' Carlisle Cou Cumberland State PA L Code 17013
Lender The Estate of Richard O. Als au h
10.0'
~~ 16.0'
43.0'
35.0' 35.0' 35.0'
16.0' 16.0'
SKETCH CALCULATIONS
A7:10.0x8.0= 80.0
~ A2 : 16.0 x 35.0 = 560.0
First Floor 640.0
na A3 : 16.0 x 35.0 = 560.0
__ Second Floor 560.0
Total Living Area 1200.0
Fonn SKT.BIdSkI -'TOTAL for Windows' appraisal software by a la mode, inc. -1-800-ALAMOOE
Subier_t Phntn~
BorrowerClierrt n.a. '
Pro a Address 36 H Street
C' Carlisle Cou Cumberland Stale PA Zi Code 17013
Lender The Estate of Richard O. Als au h
36 H Street
Subject Front
Subject Rear
Subject Street
Form PICPO(.TR - °TOTAL for Windows" appraisal software by a la mode, inc. -1-800-ALAMODE
PHOTOGRAPH ADDENDUM
Bortower Clierd n.a.
Pro a Address 36 H Street
C' Carlisle County Cumberland Stare PA Zo Code 17013
Lender The Estate of Richard O. Als au h
Form GPICPLX -"TOTAL for Windows" appraisal software by a la mode, inc. -1-800-ALAMOUE
PHOT06RAPH ADDENDUM
Bortower Clietd n.a.
Pro Address 36 H Street
C' Carlisle Cowdv Cumberland State PA Zo Code 17013
Lender The Estate of Richard O. Als au h
Form GPICPIX - TOTAL for Windows' appraisal software by a la mode, inc. -1-800•ALAMODE
Comea~ahla Phntn o9..e
Borrower Client n.a.
Pro Address 36 H Street
C' Carlisle Cou Cumberland State PA 7~ Code 17013
Lender The Estate of Richard O. Als au h
Comparable 1
153 Cedar Street
Comparable 2
65 E. North Street
Comparable 3
45 E. North Street
Fonn PICPIX.BR -"TOTAL for windows" appraisal software by a la mode, inc. -1 •B00-ALAMODE
APPRAISER'S CERTIFICATION: The Appraiser certifies and agrees that
1. I have researched the subject market area and have selected a minimum of three recent sales of properties most similar and pro>ornate TD the suhject property
for consideration in the sales comparison analysis and have made a dollar adjusbnent when appropriate to reflect the market reaction to those items of signrficant
variation. f a signtiicant item in a comparable property is superior to, ar more favorable than, the subject property, I have made a negative adjusbnent to reduce
the adjusted sales price of the comparable and,rf a signdirant item in a comparable property is interior to, or less favorable than tire subject property, I have made
a positive adjusbnent to increase the adjusted sales price of the comparable.
2. I have taken into consideration the factors Drat have an impact on value in my development of the estimate of market value in the appraisal report. I have not
knowingly withheld any signficaM intonnation from the appraisal report and I believe, to the best of my knowledge, that all statements and intormation in the
appraisal report are true and correct
3. I stated in the appraisal report only my own personal, unbiased, and professional analysis, opinions, and conclusions, which are subject only to the contingent
and IimNng conditions specked in tips form.
4. I have no present or prospective interest in the property that is the subject to this report, and I have no present or prospective personal interest or bias with
respect to the partlcipants in the transaction. I did not base, eitlter partially or complelaty, my analysis andlor the estimate of market value in the appraisal report
on the race, color, religion, sex, handicap, familial staWs, or national origin of eitirer the prospective owners or occupants of the subject property or of the present
owners or occupants of the properties in the vicinity of tire subject property.
5. I have no present ar contemplated tumre interest in the subject property, and neitirer my cunent or future employment nor my compensatlen for performing this
appraisal is contlngent on the appraised value of the property.
6. I was not required to report a predetermined value or direction in value that favors the rouse of the client or any related party, the amount of the value estimate,
the attainment of a spec'rfic resulh or the occurrence of a suhsequent event in order to receive my compensation andlor empbyment for pertorming the appraisal. I
did not base the appraisal report on a requested minimum valuation, a specific valuation, or the need to approve a specific mortgage loan.
7. I performed this appraisal in centomlity with the Un'rfonn Standards of Professional Appraisal Practice that were adapted and promulgated by the Appraisal
Standards Board of The Appraisal Poundation and that were in place as of the effective date of this appraisal, wtih the exception of the departure provision of those
Standards, which does not apply. I acknowledge Brat an estimate of a reasonable time for exposure in the open market is a condition in the definition of market value
and the estimate I developed is consistent with the marketing time noted in the neighborhood section of this report, unless I have otherwdse slated in the
reconciliation section.
8. I have personally inspected the interior and exterior areas nt the subject property and the exterior nt all properties listed as camparables in the appraisal report.
I further certify that I have noted any apparent or known adverse conditions in the subject improvements, an the subject site, er on any site within the immediate
vicinity ai the subject property of which I am aware and have made adjustments for these adverse conditions in my analysis of the properly value to the extent that
I had market evidence to support them. I have also commented about the effect of the adverse conditions on tire marketability of the subject property.
9. I personally prepared all conclusions and opinlons about the real estate that were set forth in the appraisal report. f I relied on significant professional
assistance from any individual or individuals in the perfomrance of the appraisal or the preparation of the appraisal report, I have named such individual(s) and
disclosed the specific tasks performed by them in tire reconclliation section of this appraisal report. I certify that any individual so named is qualified to perform
the tasks. I have not authorized anyone to make a change to any item in the repork therefore, it an unauthorized change is made to the appraisal report, i will take
no responsibility fora.
SUPERVISORY APPRAISER'S CERTIFICATION: ti a supervisory appraiser signed the appraisal report, he or she certifies and agrees that
I directly supervise the appraiser who prepared the appraisal report, have reviewed the appraisal report, agree wah the statements and conclusions of the appraiser
agree io be bound by the appraiser's certlfkations numbered 4 through 7 above, and am taking full responsibility fa the appreisal and the appraisal report
ADDRESS OF PROPERTY APPRAISED: 36 H Street, Carlisle, PA 17013
APPRAISER: SUPERVISORY APPRAISER (only if required):
Signature: Q_ Signature:
Name: Susan u o Name: -
Date Signed: June 6.2011 Date Signed: -
State Certification #: RL-000659-L State CenSflcation #:
or State License #: or 51ate License #:
Slate: PA Siate: -
Expiration Date of Certi0cation or License: June 30, 2011 Exfdration Date of Certilicatien or License:
Did Did Not Inspect Property
Freddie Mac Fann 439 6.93 Page 2 of 2 Fannie Mae Form 10048 6-93
Form ACR -"TOTAL for Wirrdows° appraisal software by a la mode, inc. -1-800-ALAMODE
Commgnwealth of Penasyivania 0$ 0582464
Department: of State
Bureau of Professional and Occupational Affairs
PO Rox 2649 Harrisburg Pti 1"105-2649
Certificate Type
Certffied Residential Appraiser
SUSAN B BURKHOLDER
35 EAST HIGW STREET
CARLISLE PA 17013
~'
Commissioner of Professional anJ Ottupational Attain
R
Certificate Status
Active ~
4
Initial Certification Date
Certificate 12!02/1991
Number
RL000659L Expiration Date
06/30/2011
Sipnalure
Form SCA -'TOTAL for Windows° appraisal software by a la mode, inc. - f -800-ALAMODE
r ~]AV- ^T 11 ~~
499 Mitchell Road, Millsboro, DE 19966 Adjustment Services
Irwin and McKnight PC
60 West Pomfret Street
Carlisle, PA 17013-3222
Re: Estate of Richard O Als au h
Social Security 183-12-4656
Date of Death: January 29 2011
Phone 888-502-4349
Fax (302) 934-2955
Feb ~~ 20,1
itj ,~ ,'~
~~~ J
- 9[
Dear Sir or Madam:
Per your inquiry on February 14, 2011, please be advised that at the time of death, the above-named decedent
had on deposit with this bank the following:
1 • Type of Account
Account Number
Ownership (Names ofl
Opening Date
Balance on Date of Death
Accrued Interest
Total
Checking Account
853909
Pauline WAlspaugh
Richard O Alspaugh
Debra K Wharam (POA)
11/09/87
$878 33
$ .00
$87833
2• Type of Account
Account Number
Ownership (Names oj~
Opening Date
Balance on Date of Death
Accrued Interest
Total
Checking Account
9849044061
Richard O Alspaugh
Debra K Wharam(pOA)
08/06/09
$2, 678.93
$ .03
$2, 678.96 - --- - - - -- -
•
3. Type of Account Savings Account
Account Number 15004221128273
Ownership (Names o, fl Richard O Alspaugh
Debra K Wharam(POA)
Opening Date 08/06/09
Balance on Date of Death $4,565.22
Accrued Interest $ .16
Total $4,565.38
4. Type of Account Certificate of Deposit
Account Number 31003918611475
Ownership (Names ofl Richard OAlspaugh
Debra K Wharam(POA)
Opening Date 10/1 S/09
Balance on Date of Death $8,111.10
Accrued Interest $ 1.00
Total ------------------------------------------------ ------------------
$8,112.10
For further account information, dosures and/or reimbursement of funds please call the Stonehedge Office at #717-240-4524.
We were unable to locate any safe deposit box for the above-mentioned decedent.
This letter does not indude any accounts in which the deceased may have been listed as Power of Attorney, Custodian of Uniform Transfer;,
ltepresenffitive Payee, or Trustee under a Written Ageement
Sincerely, ~1
I\`
Tammy Spencer
Adjustment Services
~~~ 5
..o,
FUNERAL HOME 8z CREMATORY, INC.
219 North Hanover Street
Carlisle, Pennsylvania 17013
717.243.4511
toll free 1.866.451.4511
fax 717.243.3723
vrowy.hoffmanroth.com
info@hoffmanroth.com
February 8, 2011
Debra K. Cobb-wharam
186 Virginia Avenue
Carlisle, PA 17013
Statement of Funeral Expenses for: Richard .Oliver Alspaugh, Sr:
Date of Death: January 29, 2011 Account Id: 16157-035
PACKAGE:
Traditional Funeral Service
TRADITIONAL FUNERAL SERVICE PACKAGE $ 4,550.00
Sub Total: $ 4,550.00
MERCHANDISE:
Casket: Mansfield $ 3,585.00
Outer Container: Monticello $ 1,420.00
Sub Total: $ 5,005.00
TOTAL FUNERAL HOME CHARGES: ~ $ 9,555.00
CASH ADVANCES:
Westminster Memorial Gardens $ 1,720.00
10 Certified Death Certificates at $ 6.00 each $ 60.00
Newspaper Notice -Sentinel $ 239.39
Newspaper Notice -Patriot $ 453.52
Clergy 2 @ 75 Ea $ 150.00
Organist $ 75.00
Video Tribute $ 82.68
Sub Total: $ 2,780.59
Total Funeral Expense: $ 12,335.59
Total Payments Made: $ 11,115.00
Payments Made:
Monumental Life Check 3400069630 Feb 8,2011 10,751.96
PreNeed Disc Discount PreN Feb 8, 2011 363.04
Balance: $_ ?.2p~,;~
Please return this portion with your Remittance.
Amount Enclosed
Richard Oliver Alspaugh, Sr.
Service ID#: 16157-035
SERVING OUR COMMUNITY SINCE 1 907
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* ~ " ACH/EDI Services
Buffalo, NY 14240-9975
*** This is an Advice *** (800) 724-2240
Date: Monday, February 07, 2011
RICHARD O ALSPAUGH
DEBRA K WHARAM
186 VIRGINIA AVE
CARLISLE PA 17013-1067
Subject: Notification of Death /Reclamation
Case Number: 32621
Funds Deposited to Account: ******4061
Funds Deducted from Account(s): ******4061 $1,310.00
This is to advise you that on 2/7/2011 we deducted from the account(s) shown above the amount of $1310, for
the SSA Direct Deposit of 2/3/2011.
Due to the fact that RICHARD O ALSPAUGH has passed away prior to the issuance of the credit, the Treasury
of the United States is requesting reimbursement. In accordance with Federal Regulations, direct deposits may
not be retained by the beneficiary unless the beneficiary lived through the entire month prior to the date of
issuance.
If the number of the 'account deducted from' is different from the account into which the funds were originally
deposited, the deduction is authorized under the bank's rules for right of offset because one or more of the
owners on both accounts are the same.
Should you have any further questions about this charge, please call and refer to the case number above.
This advice is provided to facilitate the reconcilement of your monthly account statement.
Respectfully,
ACH/EDI Services
M&T
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