HomeMy WebLinkAbout07-24-13 (2) � zs�sbLOloti
REV-1500 Ex��,_,o, `�`
PA Department of Revenue Pennsylvama OfFlCIAI.USE ONLV
Bueeau of FndlviduatTaxes `""`"�" � Gounry GbCe Year f0.e Numher
P4 a0x zsospi INHERITANCE TAX RETURN � �� t p �, y
Warrisburg,PA 1ry1z8-o601 RESIDE,NT DECE�ENT t �'-r �
� ENTER DECEDEN7INPORMATION BELOW
Social SecuriTy Numbar Date of Death MMpDYYYY pate of Birth MMDDWYY
1pt2612012 07/01/1927
Decedenfs Last Neme Suffx DecedenYS Firsi Name MI
8rehm Naomi R
(If Appliaable)Enter Surviving Spouse's Information Below
Spouse's Last Name SuKx Spouse's First Name MI
Spouse's Social Seauriry Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH TME
REGIBTER OF WIl.�5
PILL IN APPROPRIATE OVALS BELOW
(� 1.qriginal R9turn Q 2.SUpplemental Rgturn p 3. Rbmainder RetUm(date of tleath
prior to i2-1&82)
p 4.l.imited Estate O 4a.Futurm Interest Comprortuse(date of p 5. Federa!Es�ate Tax Ret�m Requiretl
death afterl2-12�82)
� 6. Decedent Died Tes[ate O 7. Decedent Mainteined a Living Trust 0 8. Total Num6er of Safe Depbait Boxes
(Attach Copy of W iUj (Attacb Copy of TrustJ
O 9.Litigatio�Pinczeds Received O 16.Spnusai Poverty Credit{da2e W death O 91. Etection to fax u�tder Sac.9ti 9(A)
between 123'i-91 and 1-1-95) (Attach Sch.O)
CORRESPON�ENT- THI9 SECTION MUST BE COMPIETED.ALL CORRESPONOENCE AND CdNflDENTIAL 7pX INFORMA710N SHOULD BE DIRECTEp T0:
Name Qaytlme Telephone Number
Mark W. Aiishpuse, Esq. (7i7) 682-4006
REGISTER ItLS USE 4µC.y.'
� �..5 c,� � %57
e�„ ; c_ „'" �
First line of atldress �
n'; .. c:- �:� q,� .
�] ; �. . ' .:d7 ,
4833 Spring Raad ;� ha ' '-� '
Second iine af address ' � - . � � '�-T ,
,' � �... -.,} < �, �,.::
' � �T
City or Post 4ffice Stafe ZIP Code
DA4'�PIi.ED f.,.,,� f��
'.., r�r ;' .,�.�
Shermans Dale PA 17090 -• � �:� �
_�
correspondenrs e-mai�aadress: mark�lchrist�aniawyersofutions.com
Untler penalties of peryury,I aeclare that i have examinetl Mis retum,including accompenying schedules antl stalements,end�o the best a(my knowledga an0 belief,
it is ime,carrecf and canplele.DeclarsOpn of prepere�other than the personal rgpresentetive is besetl on all information of which preparer has any knowlatlge.
SIGNATURE Ob�ERSq►FRESP�g+SIBiE FO �s14�NG RE7URN �TDATE
�t J 1..�� 7�...�.,.... 7 `2? "� 3
ADDRES$
800 Upland Street, M hanicsbur , PA 17055
SIGNATURE OF P AR ER T NTATtVE � �
ADDRESS
4833 'ng Road, Shermans D e, PA 1709p
PLEAS�U8E ORE6ItiAL FORM ONIY
Side 1
� 15C15611�1�1 150561D1�1 �
�
J 1505610105
REV-7500 EX
Decedent's Social Security Number
oec�ae�rs Nama: Brehm, Naomi R.
RECAPITULATION
i. Real Estate(Schedule A). . .... ... .. . .. ... .. .. ... . . ..... .. . .. .... ... .. 1. 165,000.00
2. Stocks and Bonds(Schedule B) ... . .... ... .. .. ... .. . ...... ... .. .. . .. .. 2. 0.00
3. Closely Heid Corporation, Partnership or Sole-Proprietorship(Schedule C) .. ... 3. 0.00
4. Mortgages and Notes Receivable(Schedule D)... ... . . .. .. . .. .. ... . . ..... 4. 0.00
5. Cash,Bank Deposits and Misceilaneous Personal Property(Schedule E). ... ... 5. 5,556.19
6. Jointly Owned Property(SChedule F) O Separate Billing Requested .... ... 6. 34,206.85
7. Inter-Vivos Transfers 8 Miscellaneous Non-Pro6ate Property
(Schedule G) O Separete Billing Requested... ... ,. 7. 0.00
8. ToWI Gross Assets(total Lines 1 through 7). .... ..... .. .. ... .... ... ... .. 8. 204,783.04
9. Funeral Ezpenses and Administretive Costs{Schedule H).... .. .. ... ... .. ... 9. 41,275$8
10. Debts of Decedent,Mortgage Liabilities,anU Liens(Schedule I) . ... .. . .... ... 10. 14,283.30
it. 7otal Deductions(total Lines 9 and 10).... .. ... .. .. . .. .... . .. ... .. ... .. 11. 55,558.68
12. Net Value of Eatate(Line 8 minus Line ii) . .. ..... ..... .. .. ... .... ... ... 12. 149,204.36
13. Charitabie and Governmental BequestslSec 9113 Trusls for which � � �� �� �
an election to taz has not been matle(Schedule J) . . .. . .. .. .. ... ... .. .. ... 13. 0.00
14. Net Value Subjed to Tax(Line 12 minus Line 13) .... .... . .. ... .. .. ... ... 14. 149,204.36
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount ot Line 14 taxable
atthe spousaltax rate,or
transfers under Sec.9116
(a)(12)X.0_ 15. 0.00
i6. Amount of Line 14laxable
at�ineal rate x.0 45 149,204.36 �g. 6,714.20
17. Amount of Line 14 taxable � � ���� � � � � �
at sibling rate X.12 17. 0.00
18. Amount of Line 14 taxable � � � �� � ��� � ��� � � � �
at collateral rete X.15 18. 0.00
19. Tnx DUE .. . .. .. . .. . .. .. .. . _ ..... .. . .... . .. . .. .... ... .... . .. ... .. 19. 6,714.20
20. FILL IN THE OVAL IF YOU ARE REOUESTING A REFUND OF AN OVERPAYMENT p
Side 2
� 1505610105 1505610105 �
REV-1500 EX Paga 3 Fik Number
Decederrt's Complete Address:
DEGEDENTSNAME
Naomi R. Brehm
S7REE7AOQRESS � .� .�—��'--' '--
4d05 Carlisle Road
CtTY --._ `__. ___._ --.---- STAT£ . ZI� p �
Gardners PA ' 17324
Tax Rayments and Credlts:
t. Tax Due(Page 2,Line 19) (1) 6,]1420
2. CredAS/Paymants
A.Prior Payments 4,900.00
..__---.....___---..........---._..
B.Discaunt 257.89 5,157.$9
----------------_----- TotalCretiits(A+B) f2} �.
3. Interest �
� (3} _ 0.�U
. 4. if L'rne 2 is greater than line t+��3,enter fhe diKererice. This is the 4VERPAY4AfNT.
Fiii in oval o�Page 3,line 24 to request a rePornf. (A} 0.00
5. N Line 1 +Line 3 is greater ihan Line 2,enter the difference.This is the TAX DUE. (5) 1,558.31
___.
i
Make check payabie to: REGlSTER OF WlL�S,AGENT.
PLEASE ANSWER THE FOLLdWING QUESTIONS BY PLACING AN"X" IN THE APPROPRIATE BLOCKS
1. Did decederrt meke a transfer and: Ye5 Np
a. retain the use or income ot the praperty transferred:.......................................................................................... 0 0
b. retain the righl ro designate who shail use the property transferred or its income:........................................_.. ❑ ❑x
c. retain a rerers�nary interest oc.......__...._..._.........._.........._........................................................................... ❑ �
d. receive ihe promise for life oF either Payments,benefiis or o2te?....._........................................................_..... ❑ 0
2. If death boeurred after pec.12,1982,did decedent transfer property within one year of death
withoutreceivingadequatemnsideration?.._............................_.._......................._............_....__.__.__............... ❑ 0
3. Did decedent ovrn an m trus#for"ar payebte-upon�death 6ank sccoum ar sacunty at his or tcer death7.............. ❑ 0
4. Did decetleni own an individual retirement accouni,annuiry or other non-probate property,which
containsabenefciarydesignation? ............_,................................................................................................_....... ❑ �
IF THE ANSWER T4 ANY OF THE ABOt+E QUESTf4NS IS YES,YOU MUST COMPIETE SCHEDULE 6 kNd FILE iT AS PART OF THE R£i'URN.
For dates of death on or after July t,1994,and aefore Jen.t,1995,the tax rete imposed on the net value ot transfers to w for 4he use of the surviving spouse is
3 percent[72 P.S.§9118(a}(1.1)(i}].
For dates of death on or efter Jan. 1, 1995, the tax rete Imposed on the net value of Vansfers to or for the use o( the surviving spouse is 0 percent
[72 P.S. §9N6 (a) (1.1) (ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the staWtory requirements for disclosure of assets and
filing a tax retum are stili applicaWe sven it the surviving spouse is itre only benef�ciary,
For daies of death on or after July 1,2000:
. The tax rate imposed on the net value af transfers hom a deceased chiltl 21 years of age or younger at death to or ior tlte use of a natural pareM, an
adoptive parent or a stepparent oi the child is 0 percent(72 P.S.§911fi{a)(12}�.
• The tax rate imposed pn the neE value of transfers to or fat the use of #he decedent's Iineal heneficieries is d.5 percent, except as nated in
72 P.S.§9116(1.2)[72 P.S.§9N6(a)(1)1.
s The tax rate imposed on the net value of Vansfers to or for the use of the decedenPs siblings is 12 percent[72 P.S.§9716(a)j1.3)f.A sibling is defned,under
3ection 9162,as an individual who has at least one parent in comman with the decedent,wheiher by bload or adop#ion.
ftEV-1592 Bx+ (11-0&)
`� pennsylvania SCHEI�U�E A
INHERITANCETAX REfURN REAL ESTATE
RESIOENT OECEDENT
ESTATE 4F , PIIE NUM$ER
Brehm, Napmi R. 21-12-1174
All reaf proparty owned solely or as a tenant in cammen must 4e reporced at tair markat vatus.Falr market value is Cafined as the price at which pmperty
w4uld be exchanged between a wiAing buyer aod a wiliin9 selier,neither being compelled to buy or sell,bokh having rea5o�ahle knowledge a#the relevant facks.
� Reai property that is jobrtiy-owned with right of survivorthip must be disNased on ScAedule P.
Attach a cnpy of the settlement sheet if the property has been sold.
ITEM 7ndude a copy of the deed showing decedentY interest if awned as tena�t in c4mmon. VALUE AT pATE
NUFABER OF DEATH
CESCRIFTtpN
...""—_. .. ._ ""'. "....
1 Residential real estata with improvementa thereon loaated at 4405 Cadisle Road, 185,�OO.OQ
Dickinson 7ormship,Gardners,Camberland County,Pennsylvania
� TOTAI.(Also enter on Line l,Recapituiation.) � 185,000.04
If mnre space is needed,insert additional sheeks M the same size.
REV-1508 EX+(6-98)
SCNEDIILE E
� COMMONWEALTH OF PENNSYLVANIA CFWH, BANK DEPOSITS� � MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Brehm, Naomi Z� �2 ���4
InGude the proceeds ot litigation and the date the proceeds were received by ihe eslate.
All prop�rty�olntlyownad with right oi aurvivonhip must be diaclosetl on Sohedule F.
ITEM VAIUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Personal property auction proceeds-Dan Hershay AucGon Service,LLC 5,263.53
2. Thrivent Financial for Lutherans account no.3870559 25.06
3. United Healthcare Services,Inc.refund checks 267.60
TOTAL(Also enter on line 5, Recapitulation) S 5,556.19
Qf more space is needed,insert additional sheets of the same size)
REV-i5o9 E%f(Dt-ta)
� "=j' pennsytvania �iCNEDULE F
DEPAPiMENTOfPEVENUE �OYNTLY-OWNED PROPERTY
INNERITANCE TA%RETURN
RE$]�ENT DECEpENT
ESTATE 4F: FII.E NUMBER:
Brehm, Naomi R. 21-12-1174
If an asset became jantlq awned within one ysar ef the detedeM's date uf death,k must be repar[ed ot�ScheduM Gt.
SUl2VN1NG 70INT TENANT{5)NAME(S} ADDRESS RElATI6N5HlP Tp DECEDENT
A� Lori Ann Brehm 519 Highldnd Court daughter
Caflisie, PA 17013
6.
I
C,
�OINTLY OWNED PROpER'ry:
�ei7E0. DAtE DESCR[PiTON OF PROPERTV %OF oATE oF oearn
ITEM FOR]OIM MADE INCUlOE NPME OF FINANCIFL INSTI1l1II0N AND d4NK ACCOU�T NUMBER OR SIMILIR DATE OF OfATH OECfDEM5 VAlOE OF
NUMBER iENANT ]OINi iDENRFYIN6 NUMBER.ARACH�EEQ f�R 101fiTlY NEt�ftE4L ESTAIE. VALVE�F ASSEf 7NtEREST DE{EpE(iT`5 7tiiEpEST
�' A' Ot1191t2 M&T9ankeheckingeccountno.7228168 63,383.83 50% 31,691.92
2. A. �t/19/12 M&T Bank checking savings accoum no.15004t98312347 5,029.85 5p^Io 2,514.93
TOTAL{Also enter an Une 6,Reqpitulation} $ ���Q��$`�
tf more space is needed,use addidonal sheets of paper of the same size.
Rk'V-ISll E%+(10-09)
��i `� penr�sytvania SCH6Dt1LE N
` ae'"ATmenroFAevenuE PUpIERAL EXPENSES AND �
rnnearrnNCernxaeruaN ADMINISTRATIVE COSTS
NE9DENT DECEDENT
ESTATE OF FltE NUMBER
Brehm, Naomi R. 21-12-1174
DacedenYS de6tc mus!be reported en&hadule I.
ITEM
NUMBER pESCRIDTION AMpUNT
A. FUNERALEXPENSES:
1' Hollinger Funerai Home&Crematory,inc.
a. Professional services,faciiities,au#omotive equipmem 5,i Sp.Dp
b. Merchandise 2,945A0
c. Grave opening,cemetery equipme�t,newspaper ads,cletgy and various cash advances 1,743.00
B. ADMINISTRAFIVE COSTS:
i. Persana�Represer,tative Commissions: 9,900A0
NBme(s)of Personal Represent8tive(s) RiCk@y L. Bf@hf11
street nddress_804 Upland Sfreet _
city Mechenicsburg _ ___stace pA Z�p 17055
Year(s2 Commissinn Paid: 2013 _ _
2. Attomey Fees:
6,000.00
3. Pamily Exemption:(If decedmt`s address k nat the same as tlaimant's,attact��plana6ff�.J 3,504.dd
Claimanc Lori Ann Brehm
Street Address 518 Highland Gourt
City �ari'tSle State PA ZtP 17013
neietionship of aaima�c co oecedenc_daughter(who has moved since date of deathL_
4. probata Fees: 3�$.50
5. Accountant Fees:
6. Tax Retum Preparer Pees',
� Cum6erlarid County Register of Wilfs-flling fee for inheritance fax retum 1 b.04
s. CumbedandLawJoumai-estateadvertising 75.7p
s. Central Penn Busirress dournal•estate adverti5ing 22t.00
��. M&T Bank-check prinGng fce for Estate checking accoun# 15.�4
�t. Capitol City Oil-heating oil delivery at decedenYs property 461.25
SEE ATi'ACHED CONTINUP+TION PAGE 14,870.89
TOTA!(Aisa enter on l.ine 9,Recapitulatian} ; d���7`���8
if more space is nee6ed,use additlonel sheets of paper oi[he same size.
Est. Naomi R. Brehm
No. 21-12-1174
SCH H CONTINUATION
Item No. Description Amount
12 Mahlon Thrush - property mainterance at decedenYs property $770.00
13 Starner's Electric - necessary repairs to well pump at decedenYs property $2,554.32
14 Bender Boys, Inc. - trash removal from decedent's property $2,000.00
15 Various miscellaneous household items (smoke detector, door knobs, etc.) $89.78
16 2013 County/Municipal real estate taxes $482.04
17 Cumberland Waterproofing - repair and prevent water damage $3,600.00
18 Lititz Mutual Insurance Company- homeowner's insurance premiums $377.00
19 Met-Ed - electric utility at decedenYs property $321.38
20 Home Depot - dehumidifier fnr use at decedenYs home $301.37
21 S.W. Barrett Real Estate - appraisal of decedenYs property $375.00
TOTAL SCH H CONTINUATION PAGE $10,870.89
!�v-isiz ex,� uz-oal
� ? pennsylvania SCHEDULE I
�;..
i�
DEPARTMENTOFREVENpE Ly!EBTS OF DECEDENT,
rnHeanANCErnx neruaN MORTC+AGE LIABILITIES & LIENS
RESIDENT DECEOENT -
ESTATE 4F FtLE NUFfBER
Brehm, Naomi R. 21-12-1174
Repok dehta inaurrod 6y tAe decedent pdor to death tbat rcmained unpsid at tde dah of desth,fnclu4ing unrcimbuned medical expanaes.
ITEM VRtUE AT OATE
Hl7MBER DESCRIPTION OF DEATH
1 Chapel Pointe Retirement Center-ladging final invoice 13,734.50
2. Milienium Pharmacy Systems-prascriptions 519.94
3. Century Link accouot no.313035148-telephone bill 28.86
TOTAL{Nso enter on i.ine 10,Recapitulatian} � '14,2&3.3Q
If more space is needed,insert additional sheets ot the same Size.
HEV-1513 E%+ (O1-10)
� ��� pennsylvan9a SCHEDULE �
,��
tlEPAFTMENi OFREVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESt�EftlT DECEDENT
ESTATE OF: FStE NUMBER:
Brehm, Naomi R. 21-12-1174
RElATIONSH]P TO pECE�ENT AMOUNT OR SHARE
NUH6ER NAHE AN6 ADDRE55 4F PER56N{5)RECEM,IG PROPERTY Do Nct tirt Tn�itee{s) OF ESTATE
I TAXAetE DISTRIBtJTtONS[Include outright spousai distributions and t2nsfers under
Sec.9118(a)(1.2).]
1. Rickey L.Brehm san 5p°/a
800 Upland Street,Mschanicsburg,PA 17055
2. Cori Ann Brshm daughter 94%
519 Higland Coud,Carlisle,PA 17013
ENTER DOLLAR AMOUM'S FOR DISTRIBUT[ONS SHOWN ABOVE tlN LINES 15 THROUGH 18 OF REVd500 COVER SHEE7,AS APPROPRIATE.
II NON-TA7tkBiE 6ISTRIBUTIONS
A. SPOUSAL Ot5TRIBUitONS UNDER SECftON 9113 FOR WHIGH AN ELELTION TO TAX IS NOT TAKEN:
1.
(
I
B. CHA0.[TABLE AND GOVERNMENTAL DISTRiBUTIQN5:
i.
74TAL OF PART II—EKFER TOTAi.NQN TAXABIE DISTRIBUTIONS ON I.INE 13 6F REV-1560 COVER SHEET. $
If mare space is needed,use additional sheets of paper of the same size.
T ,' ._.__„
LAST T�ILL AND TESTAMENT
I, NAONIT R RREHM, af Dickinson Township, Cumberland County, Peansylvania,
declare this instrumart to be my I.ast WiU and Testsment, hereby expressiy revokuzg all Wills
and Codieils heretofore made by me.
i. T dir�t mq ezecutor w pay all of mp debts, fvnsral and adrninistrative enpenses as
soon as map be dane ebnvea'senUy after my decease.
2. I auT�orize and eangow�es my�ecutor to sell any realty o�by rne at my ckath,and
n�rt specifioalIy devised herein, at either publia or private sale, and to give good a�ul suf�ciant
deeds therofor, in fx simpIc,as T could do if liv'sng.
3. I devise mid bequr,ath all oF my estate of every nature and whm�ever situate ta my
husband,Donald E.Brehm,providing he shall survive me by siscty days.
4. Should the gi8 in Paragaph No. 3 not talce e£fxt, I devise and bequeath alt of my
estate of every nature an3 wherevcr siGsate ea follows:
(aJ I .3irect thst Lori Ann Bcehm shall be able to live in my house at 44d5
Cerlisle Raad, Gardners, as Jpng as she is gingle and es lottg as ahe deaires to and actually daes
live in my house. She is to pay the tax.es, insurance, utilities and upkeep as long as she lives in
the housc.
(b} All my fiuniture,dishes and other personal propexty is to stay in my house
a&long aa L.ori Anu lives therc aud when she lesva the house peamanently,tho personal propaa�ryy
is to be divided between my daughter, Lari Ann Brehm and my son,Rickey L.Brehm,shaze atid
share a1�1ce, t� �;
�� � �,�
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— _ .. ._ ,,.- m� w......sm
W:u�v n��mK,� n �..... .
{o) (f aad when Lari Ann lcaves my house permanently,the praperty shall be
spld and the balance o£the znoney shall be di+rided between myr two children, slst�re and share
s]ike,and
(d} Ail t2�resk,re�idue and zensainder ofmy estate,I give to iny two children,
shan snd s3�ares at�ce. �
5. I rnrminate and appoint Dot�ai&E.Brehm to be the exxutor of this my last Wiii aad
Testmnent; he is to serve as such withou# baud. Shaald he die before my death, retaou�s or
rafiLSO to serve foz any reason, ar dio leaving any af my cstate tsnadmirustentti, I nominate and
appoint Rickey L. BreBm and Lori Ann Brehm, as substitutc e�zecuLars, also W seive as such
without bond,with the sama powers as mre given herein to my e�ecutor.
6. I hereby suggeat that my personal representativG retain the servlces of Irwin,
McKnight 8c Hughes,as attameys in the settlement of my estata.
IN WITNESS WFIEREOF,I have hereunto set my hand and seal this t�"� day of April,
1997.
�is.d�meer ,�"j��,i�{.+-nst (SEAL)
NAt}MI R.$RLHIMS
Sigtud, sealed, gubiished and declared by 24'AOMi R �REHM, t!u alwve naznecl
testatri�c,as aud far h�r Lask Wi12 and T�tament,in the prese�►ce of us,who at her r�uest,in her
presence sad in tho presence of cach other have subscribed our names as wimesses hereto.
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� . �' '� i 4 4SmNb 8 L �?b,yk,,�8�6 d"e^ �'fi HJfx°�' L �Yv � G��� � . .. . .. .
' � �. E '��{�.��qg��"ls? '4 C������� ��'��Y �)�,�� ^�H.�yC`�'H .
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.4C`�NUNr7EDGM�NT ANZ?AFFI�AVIT
WE,NAOMI �t. BREHM, CFIERYL L. CLEL,ANU and MARTHA L. NOEL, the
tesfatrix and witnesses respectively, whose names are signed to the foregoxng instrument, being
fu'�t duty swora, do hereby declsre to t6e undetsigned aufl»rity khat tiie testatrix signed aad
ac�uted the instruxnent as her Last Will and that she haci signed willingly, and that she executed
it as her fi�ee and valuntary ad for the purpose herein e�ed, and that esch of tht witne�es,
in the presentx and hearing of the testatrix, signed the Will as a witneas attd that to the best of
their knawledge tha testatrix was,at that time,eigtrteen yesrs of age or oIder, of�und mi�and
under no constraiat or undue influence.
' �h�r � Ip AA� .�V1LV
Df Mi R BREffiK
�
'1tI.L.G'i.ELADiD
,�.�P
-�MARTSA L.NOEL �
COMMONWEALTAf OF PENNSYZ.VANIA .
. SS:
ca�o� cvt�s�.r,.ivg .
Subscribed, swom W and acknowledgad bafore me by, NAOMX R B1tEHM, tYit
teatatrix hexeia snd subseribed aad swom ta 6efare me by CFIERIZ L. GLELAND and
MARTHA L.NOEIy witr►�this i�" day of April, 1997.
r'r`�-� �. �'b�.
Publie
AtY�B.�Na�brr Pu�oec
�CkR.3,20�
tMclltMr.PW�MYYnM1 Ai90dSU0n OflIOlA.tks
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_ _ _ _ .
S.W. BARRE7T REAL ESTATE AND APPRAISAL SERVICES
� FileNO.13-0777
APPRAISAL Of
� �
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- � s�; �•;,�.E�
M 3 ir;t' �� {''
LOCATEDAT:
M05 Carllale Road
Gartlnen,PA 17324-9080
C LI ENT:
Merk W.Allshouse,Esquire
C83S SpAng Road
Shertnana Dale,PA 17080
AS OF:
Jury 17�2073
BY:
Stan A.Skowronek
PA Certifle0 Resitlentlal Real Estate Appreiser
S.W. BARRETT kEAL ES7ATE AND APPRAISAL SERVICES
Fik No.15-0771
07N812073
Mark W.FUlshouse,Esquire
�833 Spdng Road
Shermans Dale,PA 17090
File NutM�er: 13-0177
In accordance with your requesl, I have appraised the real property aC
�406 Cadlsle Road
Gartlners,PA 175248090
The purpose of this appraisal is to develop an opinion of lhe defined value of ihe subject property,as improved.
The properry rights appraised are the fee simple interest in the site and improvemenis.
In my opinion,the defined value of the property as of �wy t�,zOt3 is:
5765,000
One Muntlred Sizty-Flve Thouaantl Dollarm
The attached report conlains the descriplion, analysis and supportive data for the concWsions,
final opinion of value, desttiptive photographs, assignment conditions and appropriate certifications.
RespeaNully aubmilteE
��— w, ut .�w,,�a»k
5fan A.Skowronek
PA CeNHetl Residential Real Eatab Appraiser
, _ . . .__ _ ...
SUMMARY APPRAISAL REPORT
Summary Residential Appraisal Report FileNO 73-0171
The purprsedtrusaqrtaisai reportktnprovitle Nectiem witha ue�ibieoqmondthe EeGmpvNUeotthesu'�eq property.9iren theuaentleG useoithe aqrcaisal.
t�cNa�nenrcttWedthetAqrkW.AibFwuse E uire Emai�NtA
Giertaddess 48935 � Rpatl Cii ShertnansDab s�a�ePA z' i'f088
Mdaorei imera�d u=er s T�.a IMantleA User pf this a reisal re oR Is the CIIeM, Nq additional Intentlatl Usern are ermHlatl wlNOUt
eRnlsNan of th a Ise s.
oxc�dea use The i � Uts ia to sva{uate the ti+at is Me sub ec#W this a hiak to vida the Giertt wfith an
urate antl su o Mon af vaiue.
Pr natlress4405 CaHkN Roed cit Gardnera smte PA zi 17334909p
Ownerdwo�caecrvaBrehm DpnaldE&NaomiR cou CumbeAand
l Desuipun Daed - k 170 e 447 �
ASSessa'sPmwirf}$-39- 18A09 (dnYna2012 RE.Taxa33UO2.00
iki Mor�waxame Dkkiil Townshi Me aekrence3&22t6 Cenwsrrer,61RJ.61
�hLSA 15¢A F $IIII LP.85Phdtl f tlMCllbe
M research tlitl notreveala iasaleswVanslersul�hewdeuaaaMVfalMNreeVearspialotheelladivetleleoftNSaowaiul.
pi�m5a�e�lransler'. Dare 7N8ft848 PnceE1 Sarrns Courdtouae
nnalyssMmiwsa+eatranstatesorycittewqeapr�tp(armcanparades�es.�app�ede; No �ttenafaBOfNfaw widtlnfhe t36
months nor wara th a rior transfers of the COm ere6leg WIMin 12 rt10Mh8 0€Hfah 8818 dat9.
�sings.opionsamscoMraasasmtneettecuveeareu��heeppraisai ThesubectcurreMl IstlstetlforsaleonNeCeMralPennMUlt6liMS stem.
tt was inal tist�on�112812013 for 188 900. No suhs nt chan
Nel :.:11Mtl'4�ks '.�'. DlfbNnitt�q ....:'.£h11e�� f%fYJB�C ��.'�.� WeSR1YLeM1dU�a➢b �'.
Laanon Urban $uburb8n Rwal Pro hyValu95 Inues9n Slade peclinin PRICE AGE Ore-Untl 411%
&&�ti OY2r75% 5�75% Ur�Ge25% Oemaod'. ShaU 1nBalairce OverSU I SOOQ LdlJnil 0%
C±wth Sg�E Siow Aia � ie�ce U�3Mh5 3-6mtlu Us6tMh5 13(1l� 20 tAA§�F ' �%
N&yh0orhootl80u�denes T�19 AU @Cl 16 bOLLItA9d 011 MB IIOKh E Hunters Rn un the east 225 h 706 Commerrini Q%
BAldmore Pk on tha uth Prost Rtl entl on Me wNt Carllale Rtl. 770 Pretl. 50 ounr Vac 60%
qeyneornooe oesctlpdon •sub ia lopatptl alod a seconda rostl ulaled M homea pf va in slzo s le antl ual . tt is
Wkhin ebse xim to emmenilFas SUCh as setrools a 1 and am i ment
MeMNCOnaUOn5linGUtlingsuppo�IrvNeabweconQUSiqns) SBaAltae�edAtltlandum
qmensions 95.Y1xi817$x191.68z20.46x` nrea.9 aC Sha e I uler View O en count
S 'cZOni Clessifica�ion MORO zoni f�wi 'on Mefllurll Dens R6aitlant191lOflICe
Zdun Co iance le� I.e INarconfaim Gra�WlaNe�eAUSe NqZO' II nl CesulEe
15t�ehigt�seM6e9taeMtlrew�}etlprap�tYaz��ared(aasprapq5adperGa�saM - Iticewesertuse? Yes tia CNO.tlescr9e _
UUlltles Publlc OtM1er Oeacllba Publlc OtM1er desctlbp p¢sllelmomwnenL�Type Pu�llc Pflvetu
Ekarki Wa�er Street Meeadam
G¢5 N011@ SarWar Sewet ANe fi01i@
Sise Co�ms PMvate xqter antl san i startn Me Canmon to the area md have mf adYerse aftect u n markgtabli .
•145.53x1b0. The a b et is not m a FEMA apecial fiootl hazard area r Ma iw2041C0404E1Eatad 03 16 20091ZOne X.
Unts One OnevdArc.uil �COrcre�e5lab Crew15 �� FauntlafimWa�s Con601klAv� Flaas � HW/C fUAv���
Molstaies 1 FullBasemem GeNeIBdSEmBM eneiwrwalls BdCkIAV WeAS D aNAv
T Oet. Att. SDH1EnCUMt B85ementAr¢a 9�9 .R. RmlSUileCe CO�II Sh 18IAY TnMFimsh WtlOUTAY
ar ta+aercm�t. �u�irasn 104v c,uaesaGbnn AluminuMAv a�nfla« V) UAv
pe'n St e Retich pnsiaeE xit s Pum vhntlowr pouMe Hu A Bamweiasctt D IitAv
Vear9WIt1980 SlamSeshnisJ,ateO Th61T1811Av CazStwa e None
EHecrive e r5 20 Screens VBSIAV pivew koiCars Y
nmc xo.�e Meaun fwa xw aa6am nmerieies Wooes�m�es rb Onvewe sunaceMacadam
IX s�a� 5�eas � � fu�Bli Fae Sr1 F�cetWne W latCms 2
Flaa SNple Cp011n CemldiAilContliEwN Va4o700CkC0t1C PWChEt1CI8d Car rt ♦OlCars 0
Fi�shetl B�ed liltlivitluel Olher Pad tl Otll&NOIIB AV. Del. BuilFin
R 'ances ftef' Ma Ra. Oven pisAwasher [F al Mlpbxave W&SherlD r OIMr Oescnbe
fbdstwAareaaGwe ade ro: 6ROans 38edrt+oms 18aths 1364 refeetdGross " NeaAbmeGeade
Ms�tiona�.em�es iroM vHed rch. Sitle BeseMSed h. Rear atlo. 11at24 a�8�1 sheds. 12x24 sMC hes eieCtric_
88sement has a la e kkChen aiM.8 haN.
commemsm�raimprovemens Im rovameMe are in avero e contlidon with no h sieal orfunctlonal inad uaeies aotetl.
��M . 1MrWw^9.MAZMae.tl92NAlE1x�n.xaM.mn 1M1ifimfA09n°XMMO�aWxmdlSO[lym`.iWwxM[..NANaN�MyW.
P&f01d� 19P4fl°)foinal%Y(NM4��M�p}t6��10
SUMMARY APPRAISAL REPORT
Summary Residential Appraisal Report F��NO �a-0m
FEATURE SUBJECT WMPARABLESNLEN0.1 GOMPARPBLESAIEND.P COMPARA9LESALEN0.3
MOS Culiale Roetl 75 Frost Raad 1749 Myentown Roatl 788 Bakimore Pike
ndaess Gardnew PA 17324 GaNners PA 17324 GeMnew PA 17324 Gardnan PA 17324
vroxim wsu�ea 7.41 miles 39E 0.32 mllea SSE 1.84 milas ENE
5ele Pnce f ?� s 174 000 '� ::" E 180 000 (! f 195 000
sakaiirecrosti+.ure� S 0.00 rt. f 112.88 rt �.' s 124.22 n .��' ('�f 718.88 .rt
Deta Souce s ..'�� CPMLS 70248572 CPMLS 702�1955 CPMLS 70Y78087
VaificaUOnSmrces �:Courthouse Courthouse CouRhouse
VFWEADJUSTMENTS �ESCRIPTION �ESCRIPTION .14sa' � DESCRIPTION .pt su�i DESCRIPTION .115 �
Sele a FiiuMing :! SS,220 CI.Csb d,700 None�Caah 56�360 CI.Csts 0
Conceuions `::Conv DOM 110 DOM 36 Conv DOM 27
oareofsalertime :''. OU29/2013 03N8120i3 08127@073
Loranon Subur�an SuburDan Suburban Suburban
teauhdNFeeSim e F� Sim le FaaSim le FceSlm le feeSim le
si�e .9 ac 1.03 sc 0 2.07 ac -b 850 1.54 ac J 200
view O n count O en count O n coun O n couM
Desi n s k �nch Ranch Ranch Raneh
W dCOnstrunim A 2 e Aven e� Avare e A�eIB
Pcwai n 53 YeaB 27 Ysars J 000 48 YeaB 0 68 Yaaia 0
cammon A en e Avata e Avero e Av Good S°b -9750
Ab]V¢Gfd4P LNY BE�ms BAM idal BA�ms BTM 1cW �m5. 9allrs iWl BEims Batlii
RoomCount 6 3 1 7 7 1.1 -2500 5 7 7 6 3 Y -5000
cross uui Prea30.00 1 364 .rt. 1 544 .n. -5 400 7 288 s.n. 0 1 6�3 .n. �8 370
BasemeM a Finished PeRial Bsmt Full Bsmt 0 Full Bsmt 0 Full Bamt 0
RoomsBelavCratle Kltchenl.bBth Bath 0 Unfinished b000 FemROOm 2600
Functwnal uolit A� a Avele e Avere e Avere a
Neatin Codin MWB&NOne HWBBICA d000 FWAINOne FWNCA -4000
erwr EmrieMnems �- e None None Nona
car e�ca 2�Cu Gan e Overaz2CGa -2 000 Ove�sz2CGa e -2 000 2 Car G�re e
aucwPa�doeck PMIPeUEndPOr EnclPOrcNPrt 1000 EndPOrch 2000 CovNDeek a000
1 F�P None 3000 1 FIP 1 F/P
S�atls Shed 7500 None 3000 Shetl 1500
FlnlshaCAttic None 5000 None 5000 None 5000
NetA'zment dal S 70500 5 7750 8 18320
Ptljus�edSalePnce 1 NMNdj. $.0% NdAdj. 4.6% NMAGj. •9.4%
dCwn arades � ��� Gon ', 78A% f 763500 Cmss '. 14.3% 5 167150 Gmss . 217% f 178880
sum m saies Co aeson� �ch� O Inlon of value ren e M S78S 000 to 5177 000. Tha elosin eoat ad ustment for tom 2ble N1
re resenfa the amo��et of Me clasin co�ts above the flnal Ibt rlce. No elosin cost ad ustment la mWa for com rable#3
sinca H solA at the �nel Ilst rice. Su lus acrea e ad ustments are made at S6 000 r acre. These are t�e best sala
com anbles know �to ba avallable.
MP TQVA
Sne vawe commems A two ear revlew of IanC seles did not loeate an suNable salas wlMin the sub'ecta market theretore tha�
o inion ot value for� e ske is Wsetl u on the 2070 tax asseasmenl of 08 S00 which is a sub acNva value. The o inlon of
value for Ma sub x site-537 000.
ESTIMATED REPR WCTIONOR REPIACEMENTWSTN:W OPINIONOFSITEVALUE_. ..._.... .......-E 37000
5ourceolwaaete owellin .Ft�S .=E 0
Qlld� ldAll IfW11�5I521NfB fR2LUV¢081EGWAatU .FL@{ .=3 0
CommentsonCOS� h �IVI areecakNetionSG �e11M.Elt.
Cost A roach tlea� a r InOkator of value. The Gara a�cer n 0 s.Ft c s .-E 0
EsGmatadRamalnin EconomleLife-40 sars raeiEVimmedewi�New .=f 0
�� Less Ph ial FuMUOnaI Exlernal
oe reciatlon =t �
Oerecia�edCOUdlm ovemens..... -E 0
'AS�is"Vaba ol5ite lm vemeMS =5
IN�ICATE�VALUEBYCOSTAPPROACH...................... -f O
EsUmeleaMOmhl MarkelReAf � 0.00 %GrossReMMUIU ie 0.00 =5 0 Indi[ateOValue Income A
SummaryoflncomeApproachf��ludrgsuppartlormadHreMaMGRM) fJIA
Mel�otlsantllecM1m u sem lo e0' 7� SalesCOm a onrl oacM1 CostA macM1 IncomeA oecM1 Other.
quussimWmHMasantltxbdq.�esemqoyeG.inGWi�greasonmremlWirganappmecn�ovalue�. TheSdasCOm hsonA roiG�wafusetlqMeDeal
intlicrtor of value. TM Income A roach is not feasible Aue to lack o(sulteble renfal ma�teet dad. The Cost A ch la
deemetl e oor Ind108tor of value tlue W the e e o(t�e sub aCt
kecwmiiiawn canmercs�. Th MsACet Data Ma sis su rte o Inlon of value for the sub aet The Coat A roaeh was not
tleemad an a ro rl�te intlicator of value anO therefore waa not inclutle0 hereln.The Income A roac�we�aleo tleematl
Ina ro rlate forNb anal als.
Based on�he scope of work,assumptions,limi[ing contlitions and oppalser s certification,my(our)opinion otthe definetl value of the real properry tha[is
[M1esubJeclofmi5repatasof 07N1@013 .wM1ichlslM1eeff¢[[ivetlaleof[hl5dppraisal.is:
❑X sngie poin�E 185 000 X Range S 165000 to S 777000 ❑Grea�ertnan ❑�essthan f
TNSapp�aisalisma7e X 'esis." wbjal�acomple�lonpn�lansa�spetiHCaGmsonNebasi5dahypIXheUCalconCitiontAatUeimprovemerRSAevebcenwmpleletl.
❑wb,MtolheldlouiigrepairswaNeralionson�heba5i5dahypAhelicalcpbiUOnNallherepairsoraheratimshavebeencompleled ❑ wbjMtotM1eldbxing:
The ro has bean e nisetl in curtent cunEkion. This IS farthe clienG uae onl .
nee.m�si�ynG.a..eew.z.v.ernw�...x�..m.mm �rv,mmeror9�°mwm�awm,�awcwisse.mn..axN{�n�n.
��` . P�eldl �9PPP")GMVNWIg'e��M1605bA14
S.W.Barrett Real Estate&Appreisal Services
_ _.
S:IMMPRYAPPRAISAL REPQitT
Summary Residential Appraisal Report F�ieNO. �s-0���
5cape gf Work Assumptions a�e umlCi�g Gondt6ons -
$cope oiwork istlefinetl��rtihe tlnito�m StaeNatdsof Pr�fessionalappreisei Precticeas'ihetyp¢ardeMent of FestarchatM analyses ina�
assignmenc"In shat scope ofwork is simply whacmeappralser tlia antl tl�id not do tlunng thecourse of che assignment.u incluaes,wus nnt
IlmitMto�.thd Extenttowhicn Ihe pmperty is Itlentifletl zntl inspectetl,tne rype nntl ettentof tl9�a resea¢hed th2 type antl 5xt9nt of analysps npplietl
� toarriveampinionsorconclus�pns.
ThescoQe W ttvsappraisai antl ensuirtt�6iscussia�inih�srepc�iarespecific W iYrerreetlsofiheciierG otlxr in9rkifietl inten42d�sersar�tl tnt�e
interMed u5eafthe repwt ihis reportwasprepmetlforthe sc�iean�exciusivpu5eaf�heciier,tgaOIXher iaerrtitie0�intentletl users fqrthe IticrHiirep
Inrendetl use antl rts use byeny other parties I'„pro�i0ltetl.ihe appralse�is noY�asponsibie/o�unauthaiz¢A use of[he report.
i'M1¢appfal5!!f 5 CCrtificalion p�J�5p2fing in[M1i5 flp(JYaisal fepOYl i5 fiu�jec[[olI1ClOIIOwing W ntlitiOY15 antl lo Sulh blM1ef sF¢cifiCCtlY1tl1[ionsas dYC
se[forlM1 by rhe appmiser in�herepon.All exVnexalnary aswmptions antl hyp(Hnencal condl[ions are sta[etl'm(he reponand might M1ave affsct8tl[he
tl55;gnment[@SWtS
�.iheapp�aiseraswmesmrespomibTAytama0.er5oiakgeVnaiueaRecingllceacpetlyaAM�tlatit'retheretqrvstlaesNeap�a�rre�ranyo{i�anaspthafitle.whicha
assumetl m be good antl marketable.The popeny is appaised esthougA untler respon4da pwcership.
2.Nny skeUh in�his repM may shnw 8pp'oximele dmBIY90n5 an0 is irclutl9tl Only N assist�h0 YP3Aer in viwali[Ihy HM propMy.TiIB 2ppai5¢Aas mBtlC n0 wrvey dth2 rNOpely.
3.itaappraise'isrotre�ireGtag+eu�emunymappeermcwrtbecausedhevingmatletheappraisaiwilhr�lerencemtMqoprrtyi�q�estim,uNe.ssarran9ementshavebren
p�5aus�ym�kUcetMa.
4.NlNAerall,nwBmJpeROf�hecon!¢nldthislepal,copyaaNefinetlidUeRW�inUWinytAn[IUSionsazro�iRproperlyvalue,UreitleMAydllieapplahtv.poies5ionaldWSiyn&iaLS. �
nf�he firm Wth wllich�he appaisei i5 fAn�Uetl),shell hH u5e01a any puY�NJSPS Ey artyone 6N the ctiem antl IXh&iAentletl users d5 id¢Mifietl in�Ais YEpqt,nor shall fi bP,coMeyttl by
9�ryone tothe puhlic thagh ativxNNng.public rtlatlo0s,nEmS,sales,or MbH meda.vNIwN the wrAlen conunl IX[he appaiuv.
5.TMdpptaisC(dili�rot85Cip5EtlBtpX¢NSaI4tN58Q�M215s1�ePUtuf1855f26VkedbyH�IiC9MElawadsSFlbC.iflQtlintheUtldIX111$19�Martlso-lPf(i�855iqW Appf8iS81PBtVCe
fi.InMma6ort eSUmares.andapiniom Iwr�ishedroMe appraaer,ami ctMair�ec inUerepat,were obtainetl Bom saxces ccn9dvretlre&ade aM beNevedro Cevce amiconec[
HOWE�Er,w ms�iDn9dlily(d BctUYMy 0l5uch items IWNSh2tl In Ne apPl'fli5er is aswme(16y IhC epPraise�.
P.Th¢eFpfd159!d$WIII¢SlhBtfhINP.dfQ IIOIIIdd20IX UI1flP�18RlII C0�6U005 L.`Ih¢FlOPM'f,�bStiI.IX SW[NIBS�Whlth Wql�RpdIX�l IIIC!¢IX�MS VB�UBGE.ThP d�YMSBf BAlIfMS
OORSDORSIdIIlylpfSV[hMIY�1110115,b10!¢ngnttYingIXtE5�in9,whic11101g111b¢!¢quifetl�odI5C0YElSWhlaL1IX5.ThiSdqlfai581i5tlIXdn¢nvilp110C11101055P55m¢n1011�INPfO�aM
sho-.�e n�be cora�dseG as wr.i�.
tl.iheappra�ser5petislizesin�hcvaWatlonWreaipapolyaMisnotatrome�nspenor,W'��kgcamrxta.8n+4YUMerujneer.asmiarexpen.urAe55ahernisendeJ.TMappraiser
dtlnaco�duq�heinensiverypeol%eldoDServa�onsnllhekintlintentletllnseekanetiuuvttpropeM1ytlNeas.TM1eNewingolMapopertyardanyimporememsislmpurywsesa!
develapng an opinm oltM tlefinetl value af Ihe proparty,giventhe immtlntl use oiiMSassiqnmed.Stalemenls regerdng coMqnn xm�asetl on wrlace observaAms only.TM
appraisn claims no spetial eRperUSeregarding issues indudrg,dn naGmttetlto�.lounAatbn sdllemem.basemeM mduue prodems,wood Aemoyiry�a dner�insecls,peainlestaiim,
retla�gas,kaGitIDSedPa'ux.rtsMaenrimro�remai¢wwi.!s UMessottreMSeb..kraeed�¢chnMCalsystemswerenUactivateGatestetl. q..W�
StladppteiY�YQ(q(Sr�q4itltml�94SW'IOtli�ti05Eth0CN11Hiioti011i2pY0p�tj&SfftE�ef&S�OUfEpESm[P18h5BY£EO(0¢t4LiS IIRC�Mf9I5urvRCdeNde�MDWdgedbi*��M..pqJ81�HI
eKpa�s N inspeci and atlOress arees ol concern.II neqmrve conGieons are Nuwxe4 the oqninn dvalue meybe eRMetl.
Ilnless o[Il¢f W i5E noletl.[Il¢Oppl2i5¢f a55U0105 Che compOnCtltS Cha[con5litpLL'[he subjecl nYtl(JPIfY impfOVCfl1POl�5)afe fuM1tl¢rt@n[ally sOUn4311tl in
wO�kingo�tlbf.
�Y��9NthEP��YbYthP9pX05&Wb5611MEtl10t2�y915N`+8ME2tEd5 UYES4IX`��.SEtKk¢daNiCSBlPP�C(AMSF�A[Cd5tv6'¢t�t�SM52l1.ThEd�SLN'StlllIXtf@VE
Nmnure.Boor cmrerirgs a dMr items iha map rewkt trre vie.wi�g d the{xopeny.
9.Appraisels iMdving hypdhelical eqltliUOns rHelEllo c9mpleXan oI�pw cMAruclion,repairS a alleraUOn arP ba5¢7 on Ue aswmyMidt lhal such ttlma¢Iion,atteration or re�fairs vNl
be compelmtly perlamed.
ip tkdess6ieutt&�tledusedtlesappraiseispedkcNAyeKNMesnwesIXpropatyinsurarKecoverage,eNSappaisxlshouMeKKbeuS�ravKnpu'p�ses.aep'uluc+ibna
R�n<ox��m�M coss apaasN�e�rv�a�p«,es«ey,gumthe ahn«a�seduce as�x rx�mv�us�m�sn�is�y
IObeconsistgnt'AiUNedefl�idon011n5utableValu¢tMpropertyii15uro1M8C9veregtl�6e
11.TM12 ACI�i91t2fdl PUI[b5fl fn�UP�aiShc R¢(X1fC�CiPAR'°:I51'IPC IOl20tlEll fOf pF8111 Vd�Sd[G0115 fYldl RQNl2 d fA001E MdE 1Q04�ff2d412 MdG�Q(Ofrtl.
niso known��;[he Uniform ResMential Appralsal Report�URAR).
Ad�aiora�Cwnments ae�a�ed io5core0(Work.aswmptionsarq Limiting Cor.tlitrons
""'" %M[N�.tiqPOHrvM5Rp3y8131rx.vM:h.pM irySpmGq��f1°A]S.MpAOLWndI50LIdImSVmS,pc�Nypf�R!ydp9f
Papr!]tll 19PM"'ICaneMPUryosoe{�aiPyml�dAl6ET•io
M.0
SUMMARY APPRAISAL REPORT
SummaryResidentialAppraisalReport Faerio +3-ont
Ap�aisePS CertiPiration
1'neapprai5ar�s)cMifies tbat tothe bestot[hreappraiser's kmmfetlge antl beliet.
7,Th¢S�dIPIfRI'I$Cr�BLi[pHdI1Rd III��iS RPIXlBR WC 211d CORtt1.
2.Thereporte6anely5ez,aqnions.antlanclusionsareGmneGOAybytbereponedassump16n5andN�mtingconONOnsantlareNeappreisMSpersowl,impm�ial.andunbiasetl
prWesvonai xnat}sez e�vnians.�d cox�siars.
3.Uniessafhmti:e5lated.thedp�sefhasnopeseMaptospeCiveirketeginlircpmpetlytR54isUewtjectMNkrepartantlhesnopetsonairMaegwG�reSpMtndfepdNes
imd�ee.
4.Theappai�¢rhasnobias�tithre5petl�oUeprop�ty�nblisthesuqwlnithisreponorrothppaniesinvdvetlunlhUisasignment.
5.TReapprase'seiqage,mertintNSasvgnrt�errtwasmtmnc»gertupanckveWqrigar¢pmtMgpreGM¢rmmetlmvdcs.
6.fieappa6efscompen�IOrmmpieriryMSasSig�memisndcoM»geMU�wn;hetlevefopmemarepertirigMapr�mirm,lv��a�ractioninraMretliatfaaqsiheca�rseW
the clien�,Ue amwmMMe vaNe opi�on,l�e aueinmanlol a Aip�la!eJreSUA,a tM occurreitce o!a subseq�em evmt tirectly relaletl b Uce immtled use o(tMS appraisal.
�.T�e approisew's analyses,opinions,aitl contlusons were Jevelope0,zntl Uis repott nas Iieen preperetl.In runlamiry xith�M Unifnm 5tanderds o!prNessional Appraisal Pravtice.
tl.IMessahnwise mted Ne apprelser hes made a personalinspettiw d the prcpmy Net isMewtyeuoitMSrepott.
4.UtdessrMedbebar.romre�rouiCedS&yufxaMrediPro�enYapP��M5i5Wrcetothe2ppraiursigin4lirtCe�tifica6an.5i9rdiear:trealpmpxky��assaten:ep(OV,ticdbi:
Atltlttional CartlFlCZCians
Defini[ionotVaiue: QNarke[Yakue �OihxValue: _
Sarceui�n:USPAP
The mort probabla pAce In tertna of money whlah a propeHy shouW bAng in compatidve and apen market undar an
�onAkiona requiaita tp a fair aale,the buyer and eellar,each actlng prudently,knowledgably and assuming 4he price Is not
afteUeO by undue stlmulus.
MDRE55 W"fNE PROPERTYAPPRAISEQ
neoe cani ie aoea
6artlnsrs PA 1731�i-8p9p
EffECTNE DATE OF TME�PPRAI5AL 0717712Q13
RPPRAISEDYRtUE OF THE SUBIECTPR6PERTY S 18$U�
APPRAtSER $UPERVISORYAPPRAISER
S�ance: `�"'�'"' 7./! . �+�4�47�A Sig��ae: � � / f
Name-. Shn A.$itowrolKk Name�. StevB�SRPA,SRA.ASA�
5urece�mKenon,r RL0p18'I2L swtec�vnlir.sum+ GA000288L
aLicereee �� orLkeirsea
aatrer(revnoe): Statel: w�s: PA
Stare:PA G�mwnOaceMCeWka�matkmze �8730t201b _
EApirationoeteoiCe�carianalkmse�. 08130/2015 oa�eors���: o�nano�s
Dateo�5ignatureeMaepart�. 07H812017 , oateotPOpartyvievAy�.
Da�eolProperlyViexing: 07M1/2013 �egreedpropenyviexing�.
p¢9eedPrOp&tkNemfg: Qird¢tiaaMExNrim QE#eia0rty QOi6nRpe5a�eNYNew
(�mrx�anaExi«� (�e�a,ry Daa�m�ureny�r
eim.mv.e�owwse.em.z�arn�,...a�a.vm meti.mrm�N�'mosminnau.maimuamnsaw.sm..xmqewwnm.
P�l<dd (9PAP°I��'�EIMy5e0m��mM L�p10
fA� 100M6
... _. S.W.earteli Real Estata 8 Appralsal5ervices
A
Iient: Merk W.AI u Ee i , Filtl No.'. 13-0171 �
ProoertvACOrece -0405CMi&BROad eaeNO.:
CAY�. Gartlrers Sfa�: PA ZiP tT32C-A490
Wighborhqotl tMrkatGtlnAitions
tiaUSeb rMio appraaimatery 98%.i have conaHtared rcievant compefitire Iistie�gs aeuitor centract othNngs in tht
periormpnoe af Mk eppnisai antl in the trenaMg informaNOn repoRan in Hrb aecHan. N s trena is Indkafed,i have
apachad an atlEantlum providinp relevant compeHtive IlstlnplcoMract offadnp tlata. Local multl-Ilat deta InClcAtas
stable merkM In Ne past calendar year wIM no eppreciation In the subjects market area,wNh an evanpe marketing
tkne W 90-780 tlrys. Ecanomic trands antl tending nha h0rp remained favonble. Sales co�asipns are occuring
mors trequantiy;�however,thera is no known prevels�e of unuswF aeliarfinancing concessiom w buytlow�ts.
There are nkw�omea Untler conatlu9Non(n aurf0urtding deVeiopement6,es wefl as reselo evell8bie in the
neighbplhoo0.
naGenn.vrippto(1
_ _ _ .
SUBJECT PROPERTY PHOTO ADDENDUM
ClienC Merk W Allshouse Esouire File No.: 13-0171_
Properlv Address�4405 Carlisle Road Case No.:
C0.Y'Gardnen - Sla�e' PA ZiP. 773249090
���� FRONT VIEW OF
SUBJECTPROPERTY
�
��� Appraised Date:�uty 77,sots
� �'° ..,�14 I .":
Appraised Value:S t66,000
,i
�,e,.. xq`t(; i;
� ��.�
' �� '�e� t t� �'vi�1 �yk1� 'i.
� li
REAR VIEW OF
SUBJECTPROPERTY
� j
i-
�` fdl i wS ��t!'7revr�
��}f� i l f'r'ia uWR'.
����' ��'r �� STREETSCENE
� l ��ji '
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� ..
�`rR, fl�
I�ryu�
i�" �
(.
#I..
..;_..�..i
� I �f . Y��i� ...
II
I�� ����� ( �� I��i�l �� ��I�� ��I��'i�i
.__ - _. . _._
COMPARABLEPROPERTYPH4TOADDEF7DUM
CIfCnC Merk NI All�houca Esauire „ FlI¢NO.: 13A171 „
ProperN Address�MOS Carlisle Road CaSe No.:
C' :CaarGners SI2lC:PA Zi :17324-9(IBO
a���t''
' av37: COMPARABL.ESALE#t
� ����4��Zi�P�Iy� ..
R
a fi��l'��i i�'� 76 Proat Rosd
��,. �¢ t���3�� CiaNrreis.PA 4T324
' 1���l�(�'f ' � �`;'� Sale�ate:0u29M01�
}
a
, +_��t��{j,e��tv� i� $gle Price:$17d,000
� a t
V�+
I
CCIMPARABLESALEN2
1149 MyanWwn RoaE
° �'�:r:.i�s�"���� G�rUnew�PA173t4
tlt� �� t(�f��l
�����at"� Ii�J���lPPY,f.,�i±(' i � SaleDa[e:03fM18l2073
t� I�
°'��� ��� "��u� �' 5aie Price:4,so,o�
�t,I�� i k �1
�t�{,4� �,�„+ t , �
�— i{ ��
� COMPARABIESALE#3
�����'u ,r:" 7 r{" 1r �(
� 4 � I I r�:;i e ^;�� , r� k���a"��G j��i � i
, ; 7da Bammore PP�e
6artlmrs,PA 1732A
5ale Date:OB727no13
Sale Price'.5 195,OOa
���
�
CIiHiC MarkW Allshouae Esqufre _ , FiI�No.: 73-0171
Ptopertv Address;4105 Cadisle Road C85&No.: _
C' :GaMners � .. Stat¢:PA Zi : 773YM908p
�"- ....... Slde V'rew
:�' �fl,
3III
e
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�� �� i�— 81tlB ViBw
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1 3� tR��9.,
�� � �
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l
Pia�a_wigPO Wm�.N.i]IHi1lrvx.aw.r,O.rMA FMil101BM10
CII2nC Msrk W.Allahousa,El4uire Fi¢NO.: 73-0171 I
Ptq>ert�Address:MOS Caniale Road CeSe No.: �.
Ck :S#adnern � Stale:PA Zi :773]4-809U
��I „ �IIIII IIIII� ������ WorkshoW3lred
! � �� y„„ s'e
�y x �
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s �
F * Ef
,� ��
�
� � �� III�I l
i, ..
Unheatatl FlnishW Anlc Area
��',�, • ..:,i..; No Inclutled In GLA
."t=.�.
+;,.� ','7$.
�E�:
ij.
� ��.a,� — Unheatad Plnishatl AttM Area
���_� � �� r (opposite vi6w}.Natiqciudetl in GlA
�i�i��pat� � ii
„ I H'fN��'' � �,z;� � i���.Gr+s,�(j(�'t i (��t�
! ��
%Mp9✓ag�d�%hwe�2MA111narmq�tl�n R1t9101lA�0
FLOORPLANSKETCH
: Mark W.IUlshouse Es tre F�le Na.: 13-0177
Pt04e7tY AdflrCSS:d+4�CxIIaIe RosG CaSe No.:
Cdy'Garonert� StBt¢:PA Zip:77324�9Q90
�J �
�:
y fnnCCbCa�"Y3d¢ .''
i&b
Na[h a�drwm � �'�'�
� Kitchen �'� '
Bedroom •�d•'•
, .� . ..
. �v . ,
.o'
� ,�`
Livin9 Di�ing
8edroom
�Coverecanfh`
•'•'�.:�..'.. .
a.mx�..w.m.,•
Commentb:
Af+��'� CALCULflTKNVS 9LflIAMi41tY ��.', LNINKd AF�A 81��AifF76VwN �
coa u+� rrauor wa� � Ia�w�e�
6IIS 8izat ilaor 236�,0 11bt.0 Pisat 81acr
4j8 Pozeb 80.0 18.0 s 2_D 35.0
Pat1p 138.0 58.6 s 2�.0 1246.0
a c1o��C 8oxch 20tl.0 64d.0 2.0 s 16.0 32.0
Net IIVABLE Area (rwaded) 1384 3ltems (roundetl) i364
(
LOCAIION MAP
CfiCnt: /Mrk W.AIlshousa.Esauire filE NO.: 19-0171
Pro�ertv Address:aa6d cant��e Roaa Case P�.:
C� :Gartlneni 5teie:PA I :1T7T49p90
�.. . .. ' _.... �
}� ��q,�
. Y'p. oetRd
P
�h
�
�
S° �
rc� ��
�.
.�
<�q(�
- Cnmparable Sele 3
�� 788 Baltimore Pike
. � Gardners,RA 17324
(I.H4 miles ENE)
� �. ,y�`, �.a�'
FItiR#£Z`.5 RUrt o �"
Toland�� "hr� ' .. �.
Sublect �° .
4405 Cadisie Rd �� �
Gerdners,PA Y732a q;� � " S��,p
��Rd �
�
ti�
a�
4
� UrttoryGnarcM�d �
i ai' Comparabie Saie 7. -
�� '�� 1149 Myerstawn Rd - �
� Gardner5,PA 17324
4 (Q.32 miie5 SSE) . �. �
�,'9'�a ComparabVe Sale i � � �'
�' 75 Fros[Rd :,y
Gardners,PA 17324 �
{1.41 miles SSE) �- ��;sts��- q ,_.
: o�'a+%
� � ut
as � n
�.y¢'a` yr� Uriah . m,� �r$.
G ��qp � *
i�� ' �z� - ��C# . ��a� � .
'�� � p� �
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. �� �4� �g �i+
� #
� " � . ilaytieugUtaho
. �•� . . ','9VbilA'J� 1 r',i1�1 ._ JIr, 4lt„�.,Ii�S'.f��rlS.�.3i
° . �� � i3m!{&a _,-,,,1
,� i
t I
1���1�� m�_ . .
Gielt: MeAc W.A{hhauae Es ulre __ file No.: �?-0171
Pr�tv A�lress:ad06 ca�i�s�e itoad Case Na.:
Cit :Gerdnets $t8te:PA Z� :173249096
, ++
1
ea
r
G���
Q4
Y15 RIA1 �
kynp p•
�b
` 5ubject w
4445 Carlisle Road vp"°g,M
Gardners, PA 1732�-9Q90 _
o�a
�
' �
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Fload hNormatian
FlootlMap Leg�nd cm,m��.ity:a2f seo-oicaciNSOrv.rowNSww oa
pbq¢�p�g Praperty ia nos Irz a FEMA speclaf'BuuO hezard xea.
�R�����n��� Mp{rNermber'420b5C0iO4E biakDn�e:03!i820tk3
PaM*I�.Utp4E PiP$�.42647
NxvWtlMNIM106avalMbYwb^A� 2�ane:%
wwY..na�asy�aayw�nooamo
� ann�way+aarw!�c«an�.wcaytu�.a
� ilu00N�kHHf NelRmYrotIP.SmmkafiiaWMAYnt86M�Mk.XiWR{F£RC1tuwA�imaitrfi�SY
� rcprauntadpnn«warranmwn.ro ury pe.ry caroamrg�t�e amtdr.t.eae�euy oe
FYOO��y�IM�Y3x�11 wloAy hYMfG mmpie[4nane of iiMSS�ryoa7 rePdrt.inOvtivp phY werzant%of inerchaMUEtliry M
Naa+M1�WbMWUtlOUIWiMDMNeOC�RMYIti Mnaxn�ornpnMtuinrPqOre�m�we�merYO'HCrioMLtr.ni�thrvv4lxrmel�N
ilootl�egw1 Malthevv anw IWabilkD�e q^>�kd peny fw Kny iana w naK�sn ct
� N++s+M�anar9`O�nh�EFNM.i tMSfl�wdrsWn. _�
( ..... .. .. f�kNO.13-q171
"'«`*"'*QUALIFICATIONS`"`"""•*
T�e foilowing chackatl iterru are SFECIFIC$PECIAI CONDITIQNS that were IAe`ttlHed by this appniser Uuring the
inspecGOn of Na iubjxt peupert{.tlts camparabies sei�a,anG ttce�r(reighbortroads a�d bcaUons. Unkts oq»twise
noled.Ne conAlNOm that appiy M the suDJect property o�the compawbie salee uged p0 NOT AFFECT iHE MARKET
VALUE pR THE FUTURE MAf3KETABILITV OF THE SUBJECT PROPERTY BEING APPRAISED. Thia ia nM a home
inspectlon servlee. This is an approisal to eatimate market value.
_t. The su6jact is incata6 in a rurat area and is iess than 25%Duift.up.
2. Commerclal/lntlustdal uses are located wlNin the subJecYS nelghbnr0ood, Thase uses am typlcal of almllar
nelghhol'h0otls.
z_3. Vacant antl umleveloped Iand uses are loeatetl within the au6]ecYS neighbarfiootl. mese us�are rypksi Mr
the aree.
_4. TM predominant velue in tha aeigh6whaod is less than Mat of the market value of the aubJect proparly. This
is dua ta ttre vary wWe rsnge of va�ue of propeeties In tha area and superior qua�tty of ine su6jaet property.
5. Tha sub�ect pmperry is locetetl in a F.E.M.A.Identlfletl Flooe 2one. Flaod ineunnce coverage Ia required antl
suggested.
8. DOmpnea8 IE twt9d in the 688ement Ot N1B subjeet. Ste�mfg or runNng watBr was r1M pro8stlt ar isBBCment
floor. 7hia contlkio�IS conaitleretl typical in dwellinga of thls style.
x_7. The su6Ject property is serviced by private well entl/or septic aystems which is common for the area.
_x 8. The su6�act is oider tfisn livet5}yesB. Rii machanicai systems inclutling the herti�,alectrkai and piumbing
syateme appear upon a vlaual exterlor inspecNon to be in working order. No warranUes are fmplled In thla shtement.
_S. Repair ttems were nocsd In the comments aectlon aC Me repoK. Theae commenb o�repdr kems are for
tlascriptiae purpoaes onFy antl are rw#required repsin. Tha items i�tad ere cosmetk in naWro.
10. The baaemenR tloor Is a dirt floor. Thle sondition Is aommon and typical fpr the area.and doen nat poee a
health or sa/ety hazaM.
if. Tht sut�Ject property dces coroain tu�cllonai n6aoieseence as nWed in Me report. This ewfdltbn is
considered rypieal and�ommon forthe aroa aml this siyle dwelling.
12. The land velue exceetle 30°k ot Wtel value due to the high tlemand far vacaM lantl In Nls neighborhood. This
condition is caeniCeret7 cnmmon a�typkei for the neighborhootl.
73. The land value axceeda�0%of total value. 7his is due to the large aize of tha site. This tonditton is
considered to be typipal antl common.
14. Indiv�uii adjustmeMS were required thM enceed 15Ye. These adjustments were�aqulred dus to iaok 4f mare
simiier comparo4ies on thet individuai reEi�. AII comparabies used are%he beat avaflabFe.
15. 7oGl aAJuaGnenb excepd 25%. 7his is due to the laek of comparable sales Chst were more similar le the
EubjeGt'3 markel L�Ba. All Gompef8�es usBG ere the best 8Ya71aWe.
18, pne or more compara6ie sales sre oltlar'han slx(9)montha, Although thara ere compatabie propeAes in the
aubJecPS area,none hsve soltl recently; tnerafore,sales In excess ot eix(8)moMha heve to be uaetl. All comparablea
uaetl are the best evailable.
x_t7, One or more comparables ueed were in 3xcsaa of onr i4)mile from t0s subjeet pmpsRy. Althnugh ifiere are
compal8ble propBAlea In the Imm6dia�e arei,none hava BpM Bcently. TherefOn,it wes neCes3ary to uap CompenEiB
salea oubitle of tbe ImmWiate area. AII comparoblea uead are IocaHd in similar neighhorhoode an0 withln the same
meAcet4ng area. All GomparaWee uaed are the 6est avaflakle.
_18. The efaatrlcat system was not conveotetl o�ri�g inspxtian.
_19. The weter service waa not aonnected during inepecfion.
_29. The htaHng aystem waH shut tlown during I`u(le�Y3on.
_21. Rooflng_,Plumbing�ElecMCal�Heating_._certlFlCatlan�s)Islare Buggeetatl.
_22. inground swimming�ni„out buiM+ngs_are inckuded„nM Inciudad_accoMinB ta lender's
guideilnes.
23. Aecortling to le�tlefs guidellnea a maximum of_acres were consitlered for Nia valuaClon. Remalning
acreege was given no velue.
��
fileNO.13�171
..... _ ...�
"»""""QUALIFICATIONS*"""*`
_2A Tt�e su6Je�t property is iocated on e prWate r�d.
_Y5. Wootl IntesWtian inspectlon is suggestetl.
:_28. tast recoMad desd transfer: 4ate�OttOWt998�.Cansidaratibn:;_1.60
_27. Propoaed conatructlonirenqwtion in accortlanca M plana antl apecificatlons to be compiahd in a wodcmandike
manner.
_28. SelMr is peying part or ati of alosing cpsts. �
z_28. All tomparable sales are verifled cloaed eales.
_x_30. There are no xpecial corMitions or othet�aquirementR that w8uld atfect market value or fuCUre marlcetaMlily In
the Ap�Nabai Report.
_31, AMC fee was requlred in order to accept thls appralsal request.
� �
f4e No.1S-0171
"""'•"*'QUALfFICATIONS*"*""'
ConRdentiality ami Security Policy
We consider prtvacy ta be funtlame�rtai tn our Yelatfonahip witff Mients. We are commHted to mplM:aini�tfie
conHdentlaliry,IMaghty and security of cllents'personal InlormaNOn. Intemal polloies have bean tleveloped to protect
this confldeMlallty,whlle allowing client neetls to be served.
Wa rectrict accesa to persanat i�fortnrtbn to authorized indlviAua�who treetl M know this informaHan to cqmpy with
fedxal etandaMa to protect your nonpubllc pbrsonal informatlon. We do not dbcloae thia lnfprmefion a6out you or
any former consumen or customen to anyone,eacept aa permltted by law. 7ha law permits us ta aharo Nle
infarmatlon with our attlliatea. The law alao permita us to ahare this Infomiatlon with companlns that peAOrm
msrkati�g.
When vro share noopublic inPormatlon referred to aDOVe,the infortnetfon la matle avallable for Ilmitatl purppslrs antl
under apntmlletl circumstances. We require third peAles tq eomply with our standaMs for securlty and con8entlalHy.
we do not pemtlt usa W consumerfcuatomer intormation tor any other purpose nor do we permit NiM parties to nnt,
seil,trada or otherwiae reieesa or dbcbae inPornatior�ta¢�y other party.
EAucatitln
As of q5e date W tliis report,t arMtor Steven W.Bamtt,SRPA,SRA,ASA have compieletl the reqNrements ueiGer the
mntinuing etlucation pr�ram M the Appreisai OisNkuta qnd tfie American Society of Appreisen.
USPAPADDENDUM FapNO. �a-ov1
Bwrpwer; Naorrd R BREHM Estate
PropeM1y Address:MOS Cadlsie Road .
CAy; Gardnan Counry�. Cumbadand S�ale: PA Zip Cotle: 773249090
( lentlra: Mafk W lUl�house Esauire
Reasona6le F.xposureTime
Mp opinion of a reasonable exposur0 time for ihe Suhjecl propeny at the markel value stated in this report is:80-180 Aavs
Additional Cenifications
QX i have pc+(wmed P70 sa-vices.as a�apprais�qr in any oihtrc capecity.t�dirig the�fiperty tt��th2 St�jecS td tlus rep�t within the iMee-pear
periotl unmediately preceding acceprance oi th�s assiqnment.
(]I HAV E peAametl services,as an appraiser a in arolher capaciry,regarding Ne pmperry that is the wbJect of this repotl wHhin the three�year
perioa immediatety preceding acceptance of tlris assignment 7S�ose services are Aescri6etl in the comments below.
Additional Comments
RPPRAISER: SUPERVISORYAPPRAIS[R(onlyiFreq4lf¢tl):
5ignaWre� � �+'� ""�'"'�*'o"'� SignaWra; .j�m � '�
Name: $Nn A.Sk nek Name�. ���an W Bsrlelt SRPA $RA ASA�
pe�5�,pp: tl7t1814415 Date Signea: OTl18J2U13
SiateCen�ca6ond: R�157'tl � S�ateCert'dfcatan#:{iA0W288�
or Stale Lkense F:�. or Stale�if,enSe#:
or ONM(dBSCfibe): ..S121e#: Stal2: ?A ..
Staie: PA Expire6on 6ete af Cerlifqslion or Lkense: ��0f2015
E�atiwiDazeMGeRQ�c&ion�license: ��20tS ��iwryf�praiserinspeaionofSuCjectR�erty:
EfEectiaeDateofAppaisal:�TIt1120t3 (}{�O�idNOt �Exterwr-adyGansYeei ❑imera`�atldE�aiW
%u6ptlwigPO Wwe.�].IH9)31nn.v.W!b.mn IISPM�.Mi4l111013
DAN HERSHEY AUCTIONEERING SERVICES LLC �i�3 I
���� 3504
790 WE$T HIOH 9'TREEf '7 /�7 /? �
p CARU3LE,PA 17073 Df.� G 4 J . �
3 ^ I ^ �j'
� PAYTO E �'y\ vl . ��5��!',/'..�� �
ORDER O
� ` - ( �DOLLARS 8���:�
� � ��� � . � � . . . . _ �. �
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DAN HERSHEY A�JCTION SERVICE� LL�
790 West High Street
Carlisle, PA 17013
(717) 532-4647
Steve Ege ?17-385-5438 Cell � Chris Bream 717-226-1924 Gell
g",,'. 3,;�%�, c.s�,%wT�' f< �
SELLERS NAA+1�', 1 X f�:e I,�',tttt° �Tv.. 'rcxcuc�A�, ' w S ;;1 ° � �
ADDRESS '�'�Ie�S c��.,r:,,fr. �ts� �P:.c�a.�, .� PHONE �I�" �'�`5" �,�c' �''
OTHER c'�`6t� v�f a,*�d` � �'G�+�«:c�6*Kg /.7'�v.SSA[JCTIONEER % � �
AUCTION DATE/LOCATION �'P�`� � G? � � � CLERK °la
DESCRIPTI{�N OF MEtRCHANDISE
sM,�
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„ � � � •.,a��wwi, f' ' prff u.,,.,,�,.�;k? .any �u°,_, W1Cr�4�� fi(p� �Q'a{�.f���E� ��'qt� ��i�t � .J r <fyf` ' + �'�a
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�r' il^:°<A F iyBG '�'�Q}" �p.»� "�iCx��ld ".i ��'�.1CiQiGya ��tLl�pff°^.: �"GS�� lASK/ Ne� �W�� "!at(�; � ''ayy>,-�ca��� et�e�,�itjk.Ki,"w;
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^t,..,�y»t tti�i.��`��t7�+'�{.Ql�,k"�{�i�t{S 1 1� +4�.11�V:�{t�� t�i..k�3�� �.}11+�j£�{$P'rj`r. ��04���£t�.'�� `s�;t'�k'` �:, t., �rlc'tLQ.,'{. .� ;��.{R=.
I Commission the Auctioneers to sell the merchandise to the highest bidder by Fublic Auction. Merchandise
to be sold as is & grouped as necessary to obtain bids. I certify that I arn the owner oc authorized representa-
tive of the merchandise, goods andlor property and have good title and the right to sell and that they aze#ree
from all incumbrances. I agree to accept all responsibi33ty for prpviding merchantabie title and for detivery a£
title to the purchasec. I agree to hold harmless the Auctioneers against atiy claims of the nature referred to in
this e_��a, fee applied if appiicabie.
� ./'o ./f,ai�<. ;r"r�,�-..,�.. G=',�e�- e.
AUCTION SI TURE � � SELLERS SIGNATURE
`;e l� k . ��'
Total Sales (Clerking Tickets Attached) $ `���
Less Sale Expense:
., .-_ . �
,,,z.�, " '�-.'e� .l ,._ —
, % Comrnission Auctioneer $ �» ,� �, �
.�
�o Gommission Cierks $
�3
pTHER:, �
TOTAL SALE EXPENSE DEDUCTEL7 $
4, . �� I�°;."
< <
SELL£RS Sd�T S _3 .+-..�f? ,,:. ± .>
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AUCT O�GNA'�URE
�Thrivent Fit�antial for Lutherans�
���.�,��,�+,�,�
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RICKEY L BREFN�1, E�CUTOR
800 UPLAI�STREET
MECHANICSBURG, PA 17055
Plw�nUln Mb wuc�abrpur rwoNS.
Check No. Date '
G620751 11 19 12
Amant
$25.06
RICKEY L. BREHN. E7CBCOT�R
DIBBURSMENT FROM 3670559
. _ �_ _ . _ _ _
. _ __ _
. t t , _
L A4C985l86B164 FREE�C E KYIN6 � DECA08JAN.07,�2033 1 FE 1
00 0 04319M N!1 017
000004928FIDSi5d9D01701W130102000000 � 14235
�� ESTATE OF NAOMI R BREHM
�� RICKEY L BREHM, EXEC
800 UPLAND ST
MECHANICSBURG PA 17055
INTERE3T EA�D FOR STATEIIENT PERIOD 0.00 HICH STREET-CARLISLE �
ACCOUNT SUMMARY
<siU. E . , ..r i ;> s. 't ;, _. . � _ '
110. ND. Al10UpT ND. AIIDINIT�;
21�240.11 6 .60 , 4 . 0.00 1e�0l1.86
ACCOUNT ACTIVITY
. ,�E T�.. :��:�. ;,� ' ::. .. �. � �. i�r....', :
12-06-12 6ECIIMIIIC lALANCE � / t21,240.11
12-14-12 CHEqC MRlER 0019 V 2�,1.00 21�019.11
12-20-12 MET-ED BILL PVM 00000000000l305 ��49.26 20,969.a3
12-26-12 CHEq( NUIrER 0304 ✓2�b54 32 16,415.51
12-27-1 CNECII MMER 0303
0.00 16,275.b1
12-26-12 CMECK MlII6ER 0301 6�.25 17�614.26
01-02-13 DEPOSIT 17,650.l6
O1-Oi-13 DEPOSIT 231.00 16�l61.66
(.�n r�Fiat.
EIOINC 6ALANCE �t � f�1P1�� !16 061.66
/ KEVBANK NATIONAL ASSOGA7qN
siitted NealthCare Svs Inc ��
Po Box 29180 DATE 11-15-2012 CHECK N0. 00922701 150
, Hot Sprinqs AR 71913
'����
Pay THIRTif-SO(ANO 60/100 DOLLARS
To Tha Order of
ESTATE OF NJ10MI 6 BRfIMI
- 4405 CARLISLE ROAD
� m 6ARDNERS PA 17324-9090 ; �
"IIII�'ll�l'III�II��II'IIIIIi1'I"1111'1�'IIIIII�I�hI����l�ld� ��p�o�N�
��'OOD092270U�' �:04i207040�: 3509935i78LL�i•
� ��111�
499 Mitchell Road,Millsboro,DE 19966 AdjusYment Services
� Phooe 886-502-0349
F ax (302)934-2955
November 23,2012
Mark W.Allshouse,Esquire
4833 Spring Road
Shermans Dale,PA 17090
Re: Bstate of Naomi R. Brehm
ocial Securiry: 162-22-0993
Date of lleath: October 26. 2012
Deaz Sir or Madam:
Per yow inquiry on November 15,2012,please be advised that at the time of death,the above-named decedent
had on deposit with this benk the following:
1. 7�pe ofAceount CheckingAceouM
AccountNumber 1228188
Ownership(Names o,n Rickey L.Brehm(POA)
Lori Aro�Brehm(added 01/19/1011)
Naomi R B�ehm
DonaldE.Brehm(Deleted 10/I&/2011)
Opening Date 09/19/1994
Bdance on Dote ofDeath $63,383.53
Aceruedlnterest $ 00
__
Tota! 563,383.83
2. lype ofAccarott SrningsAccount
AccountNrortber 15004198312347
O�mership(Names oJJ Riekey l.Brehm(POA)
Lori Ame Brelun(added 01/19/2011)
NqomiR Brehm
IJonaldE.Brehm(Deleted 10/1&/2011)
OpeningDate 11/07/2012
Bdance on Dote ofDeath $5,029.43
Acenied Interest $ .42
------'-----_._._.._----------------------'-°-._...
Totd 85,029.85
__ _ _
Hollinger Funeral Home &Crematory, Inc.
Eric L. Hollinger,Supervisor
5oi North Baltimore Ave. • Mount Holly Springs,Pennsylvania i�o65
�717) 486-3433
S'CITEMENT OF FUNHRAL GOODS AND SA.RVICES SELECTED
Cturgns arc only for those itmis that you ulecttd or that are req�ired.If we are reqWred by law or by a cemetery or aemarory to uu any i[m�s,we wW
uplain the rcaean in wricing below.
If you sdected a fucecal tlut y require embahning,such az a funeral viewin6.you may have[o pay(w embalrtting.You do`wt have w pay for embolm-
ing You did na approve' 1 �n�e enta " es�dir�.a��crematlon m immediete bunsl.If we chargecl[or anbaMing�we wW explsin why below.
Aor the Servitt of �� Laa/9 Date o(Wi1h
cn��:.YE[,� �f�l�_a4,Or�y�s�f ,�d �e��i,gc ,�.4 !7�yC
Name Addreu Ciry �Sqte�
A CBAAGB POA SHRVI(89 SEIPCfBD: Orhn dorhing
I. PPOPESSIONAL SERVICBS
Services of Fwenl Dieec[od5uff...... 5 f/'� Uemntlon um ...................f
EmWlming .....................S �''� (Deacnp[ian)
C!����� .[K/�.�i�'� 0'fFQ;R S
S � S— �(y��.
..._. ..�.._..._.... 'ttTIM1l�HM1D6E S�8f1'PD .................e 51dL73T
SU8dO7M1,OP PAOPHBSIONAL S�V[CB4.........nl 5
G SPPAAL IXAHGB9:
2. FApLITIPS AND SEftVIGES JJ Fawardin8 of rtmairo ro
UK Of(�Cl�ipld 9M b!R'�[f.6 fd�( �dn s
hemn8(�'iaimuov74Lke) ( P��S �^"'� Mnl Home) �,�..�_�
Uee dluWVa and u�Wca//��,/ Recei.ing o�•"
:for Ponael ammonY 77' �r/ 5 � _�5_
Uee d f�tllYks anE xrvias fw � ��
MemoriW Smke ...............5_ ImmMia il ...... . ....S
Ilu of cqulpmrnc nM% m�on .......�....y_
!or&�veeide xrvice '�.. .�✓ f—
OtheruseoFfacJaia SOb7'OTAI.OP9PflQALCBAWP9 ................0 f_
D.G9H ADV
..........................._5— opeNng Gme . ....S�l�Q
SOB-TOLV.OPPMLI7'�S/HQII�YI'...........A2f_ Caveh�Y�IWV�^�?�/l�QS .�.�
3. AUTOM017VE BQUIPMENT W a�DeM .......p�......r....S
Vehide ro wvfa re�roins ro Punml Home Newsppc Navc�WCY�//......S�
NewaRVtt No6c�-Out
laaal .. ... ... .....S G"/ TeNPMa¢'1"T�4pum . �
Hearu(Caske�Coach) .
� .. . ...., .,. S—�j�
........ ......f ✓ OfkMg , ...... ....5_110.'1
umwame n . . ....s_
Ionl __.........._.._..,..5 ��•�y�((gn,����,�t.!."..
PamilY cu CertJ�arc , 1/ {T 7`^�.....f�
Wd .........................f_ Pdke ........ ...........S
Flmver ar w flonl diapmi�ion ��� ��
S
Lor�i .........................f `� Vewt Servitt Guge...........�..�..S�
te�d caddegy rnr s
I.00l . .................f V� S�
Car for pWlbnrm r
Lonl .........................$_
Ooc M town mmporetlon ..........5_ ��j��
f— 906-i07ALOPADVAN�4
9U&7tYGfL OP A07'OY071VS .....�....... ..._D �/T�
.. . flQOQMH97.........A9 S .J.^..� �
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p�'re ��c�sldlGJ. .A � —7i���°'�Fd�ATlzr7l/.—"
B.C9�RCR�ji �9WPCl8D: SU�AfAYY OP CXAYfi�S 7�/•2
� Caket�.:..... ..........f A.vmf�iaW&rvlux�Padiuea aM
. ... ,QT/'!/ eW�P�mt�dAU[amolive
� `_�'�7 ¢qolpmen� .......,__.........5�
C'�•�SF� B.nwdu�diee ... ...S
an«x�ap,a� _..�... . .......f_ c.sx��B�e ._. . f�a�p�
(DeecAWe^> D.CssM1 Adwnca .... ...S_LISJ..... 5�0�9�
Ouurbuvl In . S 7'OIHLOPALL�(.TlDNS . . /r!I �/J�.
ca���m�„m,a, i� "eaw�c�rre�Y� s 9��
•.M �� . _ ., _ . _ ew�eice�e .�1.�'aJ::e'R� ,;, s;t5 m?,�
G�eBOUrbqok(s)Gl.�/��AG7'{� , .i.. �)O/I}�/jte/6 `���HL� ,,..
Q,��r;,,� �J f�'(/Jm� �
f/�1em«y folders�.�fJ�C'}R!�'�!5 /V -L7�y' y
Pnyer�sMs ... ...... . ....S_ If vry law.�nMay�or aevrola�Y 29uLaonnD hve rcquYM the purcluae
o�f ^Y of tlie rtevu liaed above.the 6w w rt.qu4mim[bi�
��ir� ClAYL7"L:l�YJ .�6Y// /!/T�f
��grce�hn��Aeve a.mmea Ne aeme w qoods�nd.ervicu ukaed xtove sna rau,a mem m ee mrtea ana accrndinq m�u smnge�mare�n.ve reyunaa.t admoMeaqe
receip�of a co%of thu Sremmmt d Punrnl Goods vM Sevitte Selecttd.1 rtprcten[Wt 1 have nufPcirne fvnde anilubk for pymass d tlK oth qke im the goo0n
aM servica ulttttd.1 ako agiee m make paY��of S wltlfm daye.t a�ee ro be p'vWy vd samlly Ihbk wIN m9a^�elrc wfio
signs below.A latt ChaBe ot ptt mom�ainOUnWg W ptt Ym�wW be apptled ro Ihe unpaid 6abrc<begNN'vlg d9y!
fmm Ne Eate of Nu agreement I will olro paY��e Pwnal D4etta W rcaw�ubk coaa paid by'he e����al aecw a wllaa amww t ows uMe.Jib ag�eanau.
Th05[CGl6 IN}'IM�UdC YOOI�I�Yb ktl�COY1� VTb illd d�ICf lOWB..M�'9��1�M0�SGIVICCS Of IOUf�1911dNC OfdGIX�Of fCqYUICd i�IR 1�1C diR Of I�Y6 igR.C111C11I WW
be considertd pun N Nb aqreement aM the con thereU aW be rcAetld on�he FmW bill ar unttmene.
«�� 3�� �,�,�,.. ' uGi a� ao�a
� ce�rcn��� -
/ i rte)D � J�
(Sn�`�.. ,l- ' .:'. .a..� _ �.f�-,� � Y� �^i'Q��9'3a2�..
OhvaYM' PurcN0.rtndeAewlWi �PYKI11Cl�� NrXi+IDYCn �Cn�TOlOVfleMIMCU PCRdbm
fOafl'GOO RGNeGd 1/Oh
RECEIPT FOR PAYMENT
GLENDA FARNER STRASBAUGH Receipt Date: 11/07/2012
Cumberland County - Register Of Wills Receipt Time: 11:44:36 �
One Courthouse S4uare Receipt No. : 1071981
Carlisle, PA 17Q13
BREHM NAOMI R
Estate File No. : 2012-01174
Paid By Remarka: RICKEY L HREHM
DMB
____------------------- Receipt Distribution --------------------
Fee/Tax Description Payment Amount Payee Name
PETITION LTRS TEST 310.00 CUMBERLAND COUNTY GENERAL FUN
RENUNCIATION 5.00 CUMBERLT�ND COUNTY GENERAL FUN
WILL 15.00 CUMBERLAND COUNTY GENERAL FUN
SHORT CERTIFICATE 20.00 CUMSERLAND WUNTY GENERAL FUN
JCS FEE 23.50 BUREAU OF RECEIPTS & CNTR M.D
AUTOMATION FEE 5.00 CUMBERLAND COUNTY GENERAL FUN
_____'_'_'_"___
Check# 1123 $3'78.50
Total Received. . . . . . . . . $378.50
CUMBERLANOLAWJOURNAL
32 S4UTH BEDFORD $TREET
CAR�.ISLE,FA 17013
r.ie: ���»xaa-a+se Fa.:t»>�z�waees
December 7,2012
Cumba�iand Law Joumal is pubiished every Friday by dre Cumbetland Gounty
Ber Assoclation and is designated by the Caurt of Common Plaas as the official legei
publicetion for Cumberland County and the legal newspaper for puolication of legal
notices.
TO: Mark W.Ailshouse, Esquire
RE: Nsomi R. Brahm Estate
Legat adveRiserr�ents must ba recelv�f by Friday Naon. AIl legat advertising
muet be paid in advance. Make afi cfiecks payabia to: Cumberiand Law Joumai.
=�s�======s=====�;s====z=====__�_=====��s�==—=°=_____��_____���==
Advertisement inserted on foliowing dates:
November 23, November 30,and December 7,2�12
Advertising Cost $ 76.00
Proof of Pubiication $ 0.00
Second Proaf Request $ 0.00
Payment received $ 75.40
Total Amaunt Due S Y 0.00
Becky H. Margenthal, Executiva Director
1 N V 4 1 C E
15p0 Paxtori Strebt
JtJURNAL � HBYYISburg,PA771p4 NBp/2012
( MU�TIMEDIA T.71J•236-4304
F.m•zas-6aos oaaeRx: aer�z
w�vW.lournalmultimedia.com TERMB: Ne134 Diy9
INV014E TO-- ----- ADV6RT18ER--
Chrfstian�awyer SotuNbns,LlC CfiHS6an laveyer Sdutions,llG
Accounts Payabie
4933 Spring Roed
Shermans Dale,PA 17090
ixvo�C�Nt3:Adwrqaer
DE9CRIPTION OF CHAR6E8 COST �. CREDR e BAI.AqCE
PUBLICATt6N; CLAESIFIEDICENTRAI PENN BUS..IHNL
COVERDATE: i1r3N2072 TNEME:CtASSIFIEDA67CEN7RALPENNBUSINESSJOUR
MIE C►RG:
PE9CRiPTON OF AD:
Legellisling: EstateolNeomiRBrehm
REPlB):
MARKSUNDAY
91ZE: LECiN.LISTING, PAGB: 221.00
CaOFt:8&W 0.06
SPACE$UWTOTAL 221.00
• BAI.ANCE DUE: 221.00
_ _
_ GSt-c�-L� 7teC°.A1�1�'
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Spring Garden Account History
1'800-7242440 •••'81&i
9MMt ��- Frea Checking
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Oi�03�2013 Demilnofawila6b .
01/022p13 DEPO$�T �t.� �.�
��M8�2012 CNEq(NUMBER0301 . S38.B0 $17.860.88
12/272p72 Ch�ECI(NUMBEpp30�
�7•� $17,87428
1?J2&2072 CNEq(NUL�Eq q3py
$140 00 siaz�ssi
��'� S18,I15.51
12/2N2012 MET-Ep &LL PYMT pppppppppp�
E<9.28 820.888.&9
1?11M2p12 CHEq(NUMBEp ppp9
' 11�3ppt012 MET.Ep BILLPVMT pppppppppppppg� �1.� 521.018.11
, ���,�,p� 583.87 527.210.71 �
NUMBEROOD7
5131.61 �t.�.M
' 11/27/Zp12 DEIU ECWA•(.C.
' _ 31574 �.�.�
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LOYE'S HONE CENTER3, INC.
CARLISLE PA 17013 LOYE'S HOME CENiERS, INC. BSO EASi NIBN SfAEEf
E MANAGFA MARC COCHRAN 717 249-1771 B50 EAST NIBX SiREET CAALISLE, PA 17013 01D 15B-A00
00007 56007 O1/12/13 01:47 PM �AA��SLE, PR 170I3 (7177 258-7700
IER TAMMY - TMR701 — SRLE —
— SRLE — � SALESC 51710TS2 1579974 iRANSt: 9qOR27 01-OS
11500fi84 68SCHLPGEREY <A� SALES�; 5f710JNB 1726798 iRAM51: 10220t15 01-Pfi-13
9 REY SCHLAGE
i1.87 11.22 1/6fi0 EB FNTAY NNB PLYM P3.97
SUBTOTAL 11.22 <2071fi BEDROOM DC FAONi-LOAD SMO 1Y.91 155550 OUTUOOR iINFR Y 2-OUiIET 15.58
$ALE$ TAX 0.66 dP0718 I(lTCHEN DC SXOIIE ALARX 1P•91 BYB/PACK SOIAA BATiERY 900N 7.98
TOTAL 511.90
CASCH� � 12.�- SUBIOiAL: 25.9� SUBTOiAL; /7.53
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IA�I LASN : Y7.5D iNV010E 0991� iOtAL: SU.38
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CARLI N ERPA�4T015-8373 KEEP THIS PORTION FOR YOUR RECORD
7EMP -RETURN SERVICE REQUESTED
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BREHM,DONALD E 8 NAOMI R � � ������
4W5 CAMtLISLE RD
GARDNERS PA 47S2d�Q96 ,
To review the assessmerrt data for this praperty, gq to:
www.cou►thouse�nline.com>Assessmentt'�ffice>Cumbsr(and>PropertyRecorsla.
Then�+nter contro;N U$CO2tl23 and paseword CUt.ry�76LV
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Payab'e To: GAR4LYN R MGtAllt Hottrs: MAR-OCT MUN 8-9PM T4lES 9-12 NOON
1W4 PMlE ttOA6 � APR' S 6-SPM
CARLISC�PA 1T0'id-9 7 � . N04�8 BY APPT ONLY
t " "� h ` � ��13 . NQ 3��7,SUN 4R HOLIDAYS 9HI No: 222
PHONE(277)486-68tl7 ��� �' Bill pate: 3/1113
� nitpty � Gon2tcN Na: OSpQ2423
MAF NO� 0839-2Ztfi-00& � �"""Y -lue: 4and:36,Bp0 improvemeot:'l72,100 Total:208,600
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lOT 368 PB 74 P6 Y�$., — —
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44q6 CARLISI.E RD I �2��4 5181.88 5541.06
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.
Lititz Mutual Insurance Company
�J W W W.LITITZMU7'UALCOM
INSURED COPY
RENEWAL PREMIUM INVOICE
DATE OF NOTICE:01/15I2013 POLICY NUMBER POLICY PERIOD
fROM TO
HOMEOWNER Prior Balance Due: S HO 0179562 O6 03IOBI2013 03I06/2014
Policy Premium: S 744.00 DONALD BHEHM
Total Due: S 744.00 NAOMI BHEHM
4405 CARLISLE RD
DONALD BREHM GARDNERS PA 17324-9090
NAOMIBREHM
4405 CARLISLE RD DANNEfl'S INC CODE:0022500
GARDNERS PA 17324-9090 PO BOX 705
BIGLERVILLE PA 17307-0705
TELEPHON E: 717-677-8733
Pavment amounts do not reflect deqosits or oavments made �f you have eny questions ebout this invoice or your policy,
WhB� DOIiCY WBS IS8U9d. please contact your agent at the number liated above.
Pay In Full 2-Pay Plan 4-Pay Plan For additionel payment options please
Payment Due Date Peyment Due Date P ent D, te visit www.lkitzmutual.com or call
1 $ 744.00 03I06/2073 $ 372.00 03/08/2073 186.00 03I08/207 717-626-4751 or pay by Electronic
2 8 377.00 09I0612013 $ 191.00 OB/06I2013 Funds Trensfer (EFT) fiom your bank
3 S 191.00 09I08/2013 account or with Visa, MasterCard, or
q S ta�.00 �zios�zot3 Discover.
" Lititz Mutual Insurance (;ompany
� W W W.L1TiTZMU1'UAI,.COM
INSURED COPY
INSTALLMENT PREMIUM INVOICE
DATE OF NOTICE:05/07I2013 � POLICY NUMBEH POLICY PE1110D
FROM TO
HOMEOWNER MINIMUM PAYMENT S 791.00 110 0179562 OB 03/OBI2073 03/0812014
DONALD BHEHM
NAOMIBREHM
4405 CARLISLE RD
DONALD BREHM GAHDNERS PA 77324-8080
NAOMIBREHM
4405 CANLISLE R� DANNER'S INC CODE:0022500
GARDNERS PA 17324•9090 PO BOX 705
BI6lERVILLE PA 17307-0705
TELEPHONE: 777-677•8733 '
If you have sny questlona ebout Mb invoice or your poliey,
pleese coMact your egeM at the numbx liated above.
STATEMEM OF ACTIVITY
DATE DESCRIPTION AMOUNT
02120f2013 POLICY ISSUED 5 744.00
02I20I2073 PAYMENT HECEIV�D 8 1788.001
05/07/2013 SERVICE CHAHOES S 5.00
S
8
g
$
s
s
s
CURRENT BALANCE S 583.00 PBgB 1 Of 1
Remainin Instaliment(s)
Due Date Amount Due
09I06/2013 191.00
12I06/2013 191.00
,..,.4��.y �pp.K ,�w�.�-„cyovvv w�y N7tlV'C9b'Wtl-'.�e au�ap ryxumed IIrJ. .—
-t,��.�.W��.te.��,......................�............................_.W.�......�."'_'_...""_'""' "...._. . � . , ..
�
� _� cJ &II Based On�. Estimeled Meter Reading, Page i of 2
A£��� ProratcdBill November 02, 2012 �3
g��P�� ������ ������� Account Numb 02i 323�
' BIII For: DONALD E BREHM � ����'�, �l��� ��6n �n "f, 4�����
4405 CARLISLE RD
G4RDNERS PA 17324 Due Date: November 26� 2012
�
� 'ci a °� r r i r � i
� To reQort an emergency or an oulege,call 24 houro a day 1-988-5444877. For Customar Service,call 1AW-545-7741. For Payment Optbns,call
t-&J0.962-48d8. Pay yau biii online at wwrw.fvsi�gycap.cam
BI�tssud 6y:Mef•Ed.P4 8ox 1fi001,Resdmg PA 19652•6061
'ifi li I �.:.;4-: :'�. r �,�„�I. � i w ��..'i P� ,9 m u 4 � i ., : .. .s � 6F. . ._ _.
To avdd a 7.50% late Payment Charge bea�c� added to your bdl, Previnus 8atance 79.83
�Gny tlie Amumrt tRir bY ihe Due Qate. PaymentstA�ustments -7383
Your cunent PRICE TO COMPARE far generation and trzrromiesion BaMoce ri Bt�ing on Nov 02,3012 8.06
Ran Mel-Ed is lis�ed belax. For yau to save,a supplier's�rice must Met•Ed -Consumption 89.87
��' Amount Uus Nov 28 2612 567-81
Standtrd Rnidentltl-OG@211i#it•7.32 cmk pM itWH . . . ,- -
Customer reserves ihe right io shop tor an eiechic suKpNer. � , .; �. ... . >::` ,y-:,s ,..
Your nent meter r�ding is scheduled for Nov 30,2D12. �3� 20�Z KWH Reading(Esiimate1 42.561
Sep 29,2012 KWM Reading(Acluaq 42,081
Your bill includes $3.86 in PA Wxes, of which $2.39 is PA grass KWHused �
�ece�ls t� -,�s°.• i �f�t,u - " � G�r
�w a qp:g-�w e OQ:B'SaP1�3-�QPu�W u�4$V84-Z9&�'4 te suopdp#���d�'J
'��uta(6�va D�ea�paiir a�es ua wsqewm�ui aP!nax!We'i�a�w�si II!9�ams a�ew o#+xW�!�"�YI!9�noF w sa6re�p
ryRZ� Bi118esed On�. Ac�ual Meter Readin9 Page/of�2
��� November 30. 2012
Billing Psrbd: Nov 01 to Nov 29,2072 for 26 days ACCO�N�U 021 $23 248
BIII POr: DCINALD E BREHM �,�1�� '� � I,'�, i iV�h; "'�I i9�u i2 Eat i �!�'�.
4405 CARLiStE RD
GARDh�RS PA 1732A DU8 DBEB: DBCBt 0, 2Q12
,,' ii i i
eport an emergency or�wtage,ca�24 haws a day 1-88&5k4�4877. For Cusfomer Service,caq .
Ta t 1�45d5-7741. For Aaym�t Optiau,cati .
1�800.962-48A$. Pay yaur biN onfioe at www.firstenergycap.can
Bill issuad by:MeFEd,PO Boz 16001,Reading PA 19612-fi001
a.. �„ , �. i � �•, .i .: , �.. �: �i��:,� a
,i i , .�.! . ,. ::; ,�� . �
To avad a 1.5tH5 LaEe ?ayment Charge barg sdded ta your GN, Previous 8aieace 63.81
plrsse pay the AmouM Dua by the Due Date. PaymentslAcyuatmems -G3,61
Ytwr current PR�CE TO C9MPARE for generetion and transmission 9�laece rt BIIIMg on Nov 90,2012 p.W
from Met-£d is listed bebw. For you to save,a s�pti¢r's ptice must �_Ed -Consumption A9.28
be knrer. AawuM�re Dx 20 2b12 .26
Spodud Realdmtla!•OOOTiNAtt-7.36 ce�s per KWN ,.iL ., . .... �. � i^..i ,.:
Guetqmer reserves�he nght ta shop fa an eleciric supplier. �'- � n� � '
Your esxt mster reading wlll be estlmated.See 1he haak of the bdl N°v 29,20�2 KWH R�ng(Actuaq 42,912
to praeide a cusWmer readirg tt/.lart 62,2913. Nw Ot,2012 KWH Readuig(Estimatea 42,561
Yow biN inciudes $2.99 in PA taues, af which $1.85 is PA grass .KWiiused ' .. ' _351
� i i' ��:a �'„:
_ _ . ., _�_ ._, ..,_.._..__.,__._,_.�,.,._..
8�l1�4���"suwsanb mo,S�amsue ae^s2N e ua�a�da>> ��V ,�...�_� ""..�,.•."`9`"",..""""„"." u v„�,. ���,��zy�
� ! E " �'G ��0�-9'���P009'�P�'�aYV�09 t7L1�P�'i�8't la e�tuag t�uatsn9lR�
a�ep 2np aya am�aq sn�oquo�ase�d �u;w��e p3�a�y mo,t�noc�s�uiebwa��a suw�sanb 6wpiq aney noh��
��, � 8i�Based On�. Est�maacd Mete�Readirg, Pa�t of 2
q��:�,,,�,,,�,\ Prorated BiII January d4, 2013 �
Account Number 10p 021 323 249
Bflling Perbd:Nov 30 to Jan 02,2013 for 94 days �rR ^�+*A^-�^^�-
Bi0 For. DOt1a.tD E BRENM 1�1�1E,1E L}UI �'7"H �,�_�
9AOSGARLISiERD �� ��
6ARDNERS PA 17324 Due Date: Jan 'Z7�20i�
( - ."'Y? i:1. :S
To repad an emergency ar an ou�age,aa1124 twurs a day i-88$�64¢d8Tl. Por Cusiomer Service,ca81-806�5-05-7741. Far Paymeni Qplar,s,cail �
1•800-962�4848. Pay your bill online at www.firstenergycory.com
BIII Issued by:Met-Ed,Pp Box 160f11,Reading PA 19612-6001
- -, .. ... ., :i i �. ..:? .°` -;.. -:- , .
, �.� --- « ,�.;..Fi ,. .�... � .,.� ��-
To avoid a 1.5Q% Lale Payment Charge being added to your bill, Previous 6alance 4928
please pay the pmouM Due by the Due Da�e. PaymeNS/Ac�ustmenro -4929
Your arren�PRtCE TO CONPARE fa genera6on artd transmission Balance xt Biiling en Jan W,2015 0.00
from hiet-Ed is iisted 6ebar. Fa yau to satre.a s�iets price must Mat-Ed -Consumpvan T7.�
be lawec AmouM Due Jan 21 2q13 577.95
Shndxd Recida�al-WOR111A71-B.BB teMs per KWH , . . ..:... �.
Cuslomer reserves ihe right�o shap for en eleclric supplier. '�' � `� ���
Yc.�r nezt meter rea�Yng is sche�Y�ed ta oaur an or �ut ��02,2013 KWH R�dng{Estimate) �-03,472
Jan 31.2613. ��,�12 KWH fteark�{Actuat} 42.912
__ ___ __.__ _.---. __ _,_._-- 566
w u W y' w e�7.y ncNu3-napuuW tlq)tj gpyy'Zf3ki�-t}B AiiW{tl0 N�Qd�
� . �,0ua��e!$�aua pue sa�npaUos ale�uo unqewiolm ea�noid oue laeno�s�nm mn6 am���o�,�e�,������•=•ew^,��.^^� .,^..,c._.._
y� page 1 of 2
� �
eats�ea,: Aonre!t�e�er�� pebruaty41 2�13
Account Nu 021 323 249
• AHe�HHrW��MN �i ^p....
� g{b{n$Pf(iod:JM Cii lfl JLfl a9��2043 kY�'2i d�' ��. Y 4� �'� ��I� I J�� �
em wr: ESSATE{�DONALD E BREFit# CiltB D8S8: FEhT4li8fY 21. 2413
4405 CARUSIE R6
GARDNERS PA 17324
� i �; F;:,�...�.,u-��„r�""v; " F �:'+ b " ', .e `F is . ,�iM n�. i i;
�.:�; � .. 4�;. .. ..
To repor�an emergency or an oule9e.ca1124 hours a day t,B88-S44-d877 For Cusianer Se(v+ce ca�i'�6"`.�'n�5 ��P�'�t Optw�s,c�
�.gpp,ggz.qgqg, pey your bill online at www.0retenergywrp.wm
gµ�y��py:Met-Ed.PO Box 16001.Reading PA 19612-6007 .'.
�. ,�o-L�'�„� �� .
�t ,��o G i�..r,r ,..�:. � .. ,.� ,::,,.,,. .� . ;; .. . �,: ... � 3732
to our bill, Prevwus Balance 0.06
To avod e 1.5696 Lete Payment Charge being added Y p�menYSlAdjustments y�.�
pieaeg P�Y thellmowd Oue M'the Due Dete g�apu�9��9 on fs6 Ot,2015
SO COIAFARE fa 9eneeatias e�nd hansmisswn 77.54
Yau current PRit� � � m�: fi1et.Ed -Cw�sum{?1!a' � i70.5i
fran Met-Ed is hsled below. Fa you fo save,a eupq�ers P� �uM Dus Fab 21 20t1 �,._.
be bwer. � ��� �"�
Sbndard RaaldanBe�.000'L111N1-6.BB ceMc P��H i �:I: � :'. 43,338
G��teserxs the rght to shap tor an electric aupplier. ,y��,3t,2Qi3 KWH Reading lAcW21) ... q3.141
Your�tt matet re�in9+�ti M�stlmated-See the k�c of ihe b� ,�03.2{713 KWti Rea�n9(EsUmatel M197
to prwide a custaner r�dm9 a/Mer 04,2013. KWN used _ 'i r __
Your bill includes 52.02 in PA texes. of wNch $125 is PA gross —
W,,.,w�r.,nwwia�s�g x�r,m'.)B Nls 9w�Jn0 A'lli
v��d,�nn. ��....,h..,r....�.. ...�...._.._.._ .. . - .
���
� an e�a a,: �t�,a�a�a� P'9°�°�
May 06, 2d13
""'�"°'�"°"" Acaount Numk 1 323 2A8
B��Pii�O�:Apr����s�i�iQf��� k'� �� � I�Y ��,'�1 . ri �i�'� ,=
BW For: ESTA'tE OF OONN.D E BREHM � �. 't��,�r ,
44q5 CARLISLE RD Dua Date: M , ,813
. GJ+RDNERS PA 173't4 �
i , ,-:
.:�a.. -2 tir.., r ,a„ i y 7i.iy,fx4 H ..,..,iT.. .V ,r�.cl. v. i i6t�K «i:,:....� . v " :f%ii n .p ,� , .
.�..,I'a repat a�emergency a a�r autege,c�124 twws a dry 5�8&544-4877. Fa Cuslaner Service.caq i�00�5d"r77d1, Far Paymeni Opiions.caN
1�(1p,96Q.4848. Pay yuur bill onli�ef www.fimtenergycap.can
901 Uswd by:Met-Ed.PO Bon ifi001.Reeding PA 19612�6061
,a.� e - ::';U �. '�as�dl� : �r � ;�ti
Ta evoid a 1.5046 Late Peyment Charge aeing addad io your bifl, Previaus BaVar�ce .. .77.43
pl�se Qay�he AmouM Due b�'1he Due Daie. PaymantstAd�stm�ts 0.06
Yau curcent PRK:E TO CAIAPARE fa genereiion and ira�mission 93Wnce rt BiNing bn MaYY OIF.2017 •17.At
from Met-Ed is lisled belaw. For yqu io save,a supp�iePs price must �qry�d -Caroumpte�n »•�
bebwer. Aao�Dw 24 2015 S7S.Y4
54n8aN MaqdsMW•0002111671•&i4 taKS per NWH � ..n. r. �. . �i�:��: ;.
custaner r�err+es ihe r+�tt ta skrp fw an eleciric sipWier. " � 43�871
Yaur n�t matet readng 'ss scherhtled to ocsur on a alwut �Y 02,2613 KWH Readinq{Est�netej 43,�
J�43.20]3. ��3NWHReedirg{Actual) i86
Yax bd{ incWdes 51.91 in PA ts�ces, of which $7.18 is PA gtoas .. r .o- � .
_ �IAx ._. _._.-
-�va�a mlB�aua ue sa os a ea uo uoi ew m --_,�,.,, .._,.,., ..�_.. --.:,,.,.ca,w,..-__...w,_.-..-r�,.-„
94 P IM�4 1 ! bJ.apro�d pue'}�xiioa s qiq�noR ams eHew o�Hay we�bce'qp moA uo seBiey�
yaUlea�o62o'SUOisenbino6wx.suonnrannv�im�a�h��nn �����d,..��,._.����.,.,.,�,.v...,.., r................ .. .. .. . _. .
� �-re i BiN Based On: Estimatetl Meter Reading Pag°7 of�2
,,R„�,�o,,�,,\ July 05, 2013
������������ AccouM Number: 100 02/ 323 249
8ill Fm: ESTATE OF pONALD E 6REHM .'�a°��
� 4405 CARLISLE RD �� �� � �� 2013 � �
GARONERS PA 77324 DU@ D8rt8: dUly 2b,
/ ::. .. . . ... ,i :.:..: .p, :..:,. . . ,� .. . . ,. ,. . ,. . . r,„. ., �. ..
To repari ao emergenCy ar an au6aga.e�2A haxs a day 1�888�5444877. For CusMmw Service,call t-800.545-7741. Fw Payment Options,csl�
i-80D�9fi2�b848. Pay yau bill online at www.festenery�ywry.com
B�huued by:Me4Ed.PO Bmc 16001,Readng PA 19612-G001
a;
"RE�MNDERN0110E" Praviaus9a�ance 18.53
When thia bil�wae prepared,your aatount had an unpeid t��troe. tf PeymerdstAdjtisimenls 0�0
you have alreaAj male ihis paym�t, thaMc you. if not, pbase g�q��gy�onJW6S.?At3 18.57
p�P�r'PBY llie werdre anrourrt. f,�us 4f yai heve q�estwns w(a Ma4Ed -Co�anptian 2728
infarmalio�a�papment arr8rgeman5. Lstc Paymeat Cherges 0.28
Ta a�aid a 1.50% {.ate PaymeM Charge b�g ad�ed ta your bJl. T�Cunart qwrges 2T.68
P��PH}hel4tqouMDatbYtheDueOete. AmowdDus .Md2S S .W
Yax cwrent PRICE TO IWMPARE fa geneialion and iraosmiasion •:�.:�p„i.,..
6om Met-Ed is IiateG below. Fa you to save,a suppliers qice muet ��.�13 KWH R
c eedug{EStimeleJ 44�703
-- �..�._.._.43.ASZ..
��....� ,
More savin�.
Mor�e doin±�:"
6000 CARCiSLE PIKE MECH PA 17055
S1�E MANAC�R TEt�7 1'�RRY t717>795-9602
CASHIER�BROOKE150�LK5862t�2�13 02:17 PM
&�34922CM1329 i2ET!#iN AIR �q� 7.84
107i10 RETt�2N AIR GE?ILGE 170 WHITE •
03172409876i] LEADERHUE �A> ��47
6' HpSE REEL LEADER HOSE
Q34A��7IX.R�OEF�1M70LR <AY 269.00
SUBTOTAf. 2B4•31
SALES TAx 17.06
T�q( $301.37
Xx7f7{7tX81$4 TA
qI,1TH COOE 008330
�I2���9�15�3�7/ 2 1 �
RET4�tN POI.IGY DEFIIVITIONS
PtK.ICY TD IlAYS POt_ZCY ExPIRES �
a 1 gp 10114l2013
THE HOME DEPOT RESERVES TI� RIGH7 TO
LIMIT / DENY RETURNS. PLEFSE SEE THE
- RETt�2F1 P4t.ICY�TA�$ZN STQRES FOR
When you �rovide a cheok as paYment,
yfra�uYh�'1oheck to o�'ocsss enfor�emtt�aen
Eiectronic F�+ds Transfer' «FT} °"'
dr��ocessWtherPeV��t ascaucheckr
trarw;actton. You also authorize,us to
pr�ess credit ad,$ust�errts, if
appticahte., If Yau�' PaY� }s
returned unpaid, vou authorize us to
o�lleot your qaymenx and the Raturn Fae
amount below bY EFT(s> or draft(s>,from
ya�' acco�mt. Ifi Yau �"e S��tt�ng a
corporate ohedc. V�u ��i8 t}i�ss
r���po���e�esentetiverized
�cu�ston�rjrservice}at$1-c�}812��
ELECTRONIC CI#CK _,,,,1�
RETtN2td FEE AFKI�NT �
i�chant ID:
MIERCN 7RACE TD 2tI13ff7121417_4120.10_0353
CHECK NUMBER
�PROVAL COI� 140q310000021766008330
BUY ONLIt� PSCK-t�' IN S7{�RE
AYAILABLE NON ON HOMEDEPOT.COM.
CONVENIENT, EASY AND MOST ORDERS
READY TN LESS THAN 2 HOUR5I
x xx Rfc'iexx%xx'exxx:ezxxftRk x axx#*1X�K�szxxx'KY
ENTEFt FUf-+. A C:HANCE
Tp yyrN ,q $5 G100
HOME DA��t �I�T
., .. ., ._.__ �.�:.� �o.� r.,�..ioro
��uu�i
S.W. BARRETT REAL ES7A7E ANb APPRAISAL SERVICE$ ,
r�No,13-0tlt
••+•••,••INVOICE•••,•••••
File NUmbeC 13-0171 07N812013
Estata W Nwmi 6nhm
°h Mark W.Alls�ouse,EBquire
48�3 Sprl�g Road
ShermPns Dala,PA ttp90
InVOICC#: 13-0177
OrderDale: os�2aza73
ReferencelCase#;
PO Number:
4105 GAiele ROad
GaMnen,PA 1732�•9090
Appnisal Se�rvi¢e6 $ �75.06
$
� __""'__"_"'
Imqi[¢TOt&V $ 5Td.00
State Sales Taz c� S o.00
�� {S )
Depusit (S j
.'-'..........
Ambunt�Ue S 37b.00
TetmS: ?aya6le Upon Recelpt-Piease,reference Ne flk number
Pleasa Make Check Payable To�.
S.W.B�m`tt Real Eatate 6 Appraisal Services
5U5 South Marwver Stree[
Cadi5le,PA 17013
Fed,I.D.X:2368�G�864
YOUR SING�E SOURCE...Profasaia�ai,EftkbrK$arvice
THANKVOU
�u1 uy 13 U�: 3?.p p. l
�'hapel Poante � " ���,
`�::�g:;�':� ?�s� ,.�
atCarlisle `:�Lr�-�-� `-
774 56U7H HANOVFR SFREET,GARUSLE,PA 17013-4105 ��
QUESTIONS?CALL: 71 249-1363
RESIDENT# UNIT STMT.DA E
13431 M21-A 0T105I20I3
Mrs.Naomi Brehm RESIOE S
Rick Brehm Mrs.Nsomi Bre6m
800 Upland 5t
Mechanicsburg,PA 39055 TOTAL AMOUNT DUE
pATE DUE U p Recei t
DE7ACH AND RETURN 7HIS POR710N WITH YOUR f2EMITTANCE $
. ........... ...........- -- .........°-- . °°---°--- ............ ............_......---...._.........°--.. ..,...- --°-....---- --- ...............Al.+1S7UNi'.ft�MI.T.L�P..
OATE � DESCRIP'TiON . . . . �� . . �� �GHARfdE5 CREDITS BALANGE
Balaace Forward O.DO
09/OS/2012 Hair Care-Set/Comb Out 1 9.25 9.25
09/04/2012 Room and Board Ptivate-HC{!9lOS-U9109 5 1,525.00 1,534.25
Q912b12012$air Care-Cat only 1 10.23 2,SA4.54
09/30J2012 Itoom and Board Private-HC Oy110-09/30 21 5,565.00 7,109.50
10/Ol/2012 oom and Board Private-HC 10/01-10/31 31 8,215.00 15,32450
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ftESiaENT NAME�g.Haoalt Breltm F6"""g-0'
CHAYEL POINTE AT CAR.LISLE,770 SOUTA HANO VY!'�'.R.STREET,CA.RLiSLE,PA 17013-4103
Millennfum Phcy.Systems Mechanicst
5p20 Ririer Road,Suite 110
�9echanicsburg PA, 17455 �, � �
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INVOICE
09130/2012 AccouM Number. �N����Z
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j c/o Rick Brehm 013+{3i
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Mechanicsdurg PA,17085 i,� ..x.�„�,,,,,,�,�,,,t„�,
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invo+ce Date;tS9130/2092,Aa�k:CHAP5197,BREHM,NAOMf,Chapai Poirrte NG,A,i}ani�s,MAichaei
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09/0572052 4425415 30.fl0 87253�02W�iffiIUt0.2s14� $ 25.85 5 0.00 S 25.85 RX
09/05/2012 6565A51 51.00 ��81�-15�07�-ot��ioata� $ 4.0o c 8 o.W $ 4.0o RX
09/05/2012 8585452 11.00 �527�O�pa6rot 0.125 MG $ 6.89 c $ 0.W $ 8.88 RX
09J05/2012 6565509 13.00 Quinidine Glucanata CR Oral Tabdak Eztendetl Releaee 324 Mi3 $ 8.00 c $ 0.00 $ 9.06 RX
534891l147-0t
p9l05l2012 8565510 14.70 �eb'rv�e 1 Jnn�a�atlon Aeroeol 10&1 B MCG/ACT $ 42.00 C $ 0.00 $ . 42.00 RX
09!{15l2(?t2 4025476 1 AO $�aml$��I Tablel o.z5 MG $ 6.70 $ 0.00 $ 6.70 RX
49t05t2f}12 d0254$3 1.� AIMamlemOraiT�l�o2SMG $ 5.70 $ O.pO $ 5.70 RX
872b30t�100-50
09/06J24�2 85654C9 6.00 9en��re tic�ornt T�25 MG $ 4.40 c S 0.00 $ 4.00 RX
56762 1980-01
09/08/2012 8565450 25.Oi1 Aeoirin Ont Tabrot Ctrewa6ie 81 MCU $ 1,� $ 0,� $ 1.95 OFC
8221t-0164-96
09/OBl2012 8568112 255,W Remevrm External Cream 50% $ 4826 $ 6.00 $ 48.28 RX
58980-0980-9p
09I10/2012 4025543 30.W �Unrexolam Oral 7ablmt o25 MG $ 25.85 $ 0.00 $ 25.65 RX
87253-OBO0-5tl
09/11/2012 8567929 40.q0 6uePIRCne HCI Oral Tablet 15 Mtl $ 8.00 c $ 0.00 $ 8.00 RX
0059f-0719-60
08192l2012 6566124 59.00 Sertrali�HC10rz1 T�25 MG $ 4.00 C $ 0.00 $ 4.00 RX
16714-C811-O6
CHt1512012 4025415 30-C� 111o�amlam Oro1 Ta�425 MG $ 25.85 $ p.00 $ 25.SS RX
BMb3-0900-50
091t9M012 8568192 255.�0 Remaven Eatnrns�cream 36'w $ A8.28 $ O.OD $ 48.2fi RX
50980�0880-9b
09/18l2012 8572p66 52,00 Am�odtPins 8e6vIaM Oral Tablet 5 MG $ 4.00 c $ 0.06 $ 4.� RX
88382-0722-08
09/24l2012 4025415 30.Otl Alaramlem Oral Tablet 026 MG $ 25.85 $ 0.06 $ 25.85 RX
97253�09W-60
09/26/2012 8576198 90A0 AlGUterol-Iprstropium Inhaladan Sqlution 2.5-O.b MG/3ML $ 8.00 c $ 0.00 $ 8.00 RX
p0487-p207.p1
09I26I2072 2031817 30.00 M«ohi�SuNate $ 24.04 c $ 0.00 $ 24.04 RX
Oo65b-040A,44
49/28I2092 8580277 12.00 AeMaminopMn Recml SupposROrv 650 MG $ 5.18 $ 0.00 $ 5.18 DTC
aseoa-or�-a3
Q9J28t2012 4Q26070 30,OQ t.waucem Intensd Oret ConcenVate 2 MGfML $ 63.03 $ 0.00 $ 53.03 RX
60654-3532-na
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09Y29(2012 6580834 12.00 Prochlorcerezine Ractal Su000aitorv 25 MG $ 8.00 c $ 0.00 $ 8.00 RX
00713-0135-12
$�.. 0.00$� 0.00 ".. : ; $ � _ .. 0.00 $ 0.00 $�� p�p ' ��, , ,°1 ;+ii.5 ., r��;!�P,N;:�, r.� ' !n;
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Alen�us�m Phcy.Systems Mechanicst
5020 Ritler Road,Suite 110 I
M�fcaburg PA, 17055 .:
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INVOICE
10J31t2412 AceountNumber: cwa�tta�
NAQMIBREHM
do R�ek arehm � 013431
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Mechanksburg PA, 17055 .�3�cg��.� Y`wt0t., PVT'
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Piease Dataeh Hare and ReWrn Top Portian WHh Yoar Payment
Invoice Date:10f37/2�12,AcctlkCHAP1197,BREHM,NAOMI,Chapel Poime NC,A.Oaniels,Michael
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�Ot I20'12 8585450 18.00 Asoirin Orel Tadet chpwrEb et MG $ 1.$Q $ 0.00 $ 1.99 OTC
82211-01dY9! .. ..
I01/2012 6585451 SO.OQ Atendd Orei Tebbt 100 MG $ 4.qp c $ 6.00 $ A.00 RX
00781-160�d1
101l2D'12 6565452 t3.00 Diaoz�nOniTadeeo.t2sMG $ 7.58 c $ Q.00 $ 7.18 RX
OOS2T-Y32414
101/2012 858812A 30.00 Sartali�HCI Oral7abWt 25 MG $ 4.Qp c $ 0.00 $ 4.00 RX
t8714-p81t-05
ro�rzo�z e5ezazs eo.00 ���+.rr�aa��.a�c,sa+ca s s.oa � S a.ao $ e.� wc
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IO1I2012 6572086 30.Op Ambdipins BsrAaro qnl Tabbt 5 M4 $ 4.W c $ 0.00 $ 4.00 RX
88382-0122-06
J0412612 6566502 54.40 Sau+a�poa»ets 3adfum+h�TaWN 8.BS0 MG $ 1.99 $ 6.00 S '1.99 dFC
O�SS�10
/07/2012 8586112 255.00 Ramawn EYtamal crsam 50% S qg.2g $ 0.00 $ 4826 RX
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/17/2072 8587594 14.00 Aspirin Oni Tabiet Chew�Me 81 M0 $ 7.99 $ 0.08 $ 1.99 OTC
822tt-0288-9e
Y25t2012 8598842 15.� ��e��OoMthatmic Sdutlat i% $ 52.10 $ 0.00 $ b2.tp RX
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Chariotte.NC 2820i-Y8i9
pocourK Neme: NAOMI SREHM AND LQRI EREkM Page: 1 of 5
Acaaunt Numbar: 313�14& Bifl Dffie: Dec.44.2412
Cantact Numbars CurnerM Cher�aes$ummary oano�we� ,
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1-800-201-4058 � CenWryLiMci.ocaiServicas 3 2a.66
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F�Sp�sd Intsrnet T�oh S�eport 24t1
1-900-788-38fJ0
DleFup IMOrnN 2417 Tech Support .
t-888-872•7813
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