HomeMy WebLinkAbout02-18-05 (3)
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0001
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
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DATE OF DEATH (MM-OD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
11/14/2004 4/12/1920
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (lAST, FIRST, AND MIDDLE INITIAL)
N/a
~ 1. Original Return
o 4. limited Eslale
06. Decedent Died Testate (~o:JfItofWill)
o 9. Litigation Proceeds Received
o 2. Supplemental Return
o 4a, Future Interest Compromise (date of death aftel' 12-12-82)
o 7, Decedent Maintained a LMngTrust (AlIadla:.pyofTIUSt)
o 10. SpousalPovertyCredit(dlde.of~betwil6lI12.-31J!1aN.11-1-9S1
OFFICIAL USE ONLY
FILe NUMBeR
21-..05-0007
COUNTY COllE
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NUMBER
YEAR
SOCIAL SECURITY NUMBER
THIS ReTURN MUST BE FILeD IN DUPLICATE WITH TIlE
REGISTER OF WILlS
SOCIAL SECURITY NUMBER
o 3. Remainder Return (dakt 01 dealh prior to 12-13-821
o 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
D 11,EIection 10 lax \ll1der Sec. 9113{A) 1"""''"'0)
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NAME
COMPLETE MAILING ADDRESS
FIRMNAME(lf_J
TELEPHONE NUMBER
27 W. High St., P.o. Box 261.
Carlisle, PA 17013
(1)
(2)
(3)
(4)
(5)
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1. Real Eslale (Schedule A)
2. Stocl<s and Bonds (Schedule B)
3. Closely Hald Colporafion, Partnership Of SOIe-ProprietooI1ip
4. Mortgages & Notes _ (Schedule D)
5. Cash, Bank Deposils & Misoal~naous Personal Property
(Schedule E)
6. Joill\ly Owned Property (Schedule f)
o Separate Billing Raquesled
7. Inler-VIVOS Transfers & MisoallaneollS Non-Probate Property
(Schedule G or L)
8, Total Gross _ (Iolal Lines 1-7)
9. Funeral Expenses & AdministratiYe Cosls (Schedule H)
10. Dobis of Deoedent, Mortgage Liabililies, & Liens (Schedule I)
11. Total Oeduction$ (Iotal Lines 9 & 10)
12. Net Value of Estate (Une 8 minus Une 11)
13. Chari1able and Governmenlal BequestsJSec 9113 Trusls for which an election to lax has not been
made ~ScheduIe J)
80,000.00
13,474.89
2,932.69
74,193.00
3,533.76
14,244.16
x.o_ (15)
x,o~ (161
x .12 (17)
x .15 (18)
(19)
19. Tax Due
CHECK HERE IF YOU ARE REOUESTING A REFUND OF AN OVERPAYMENT
OFFICIAL USE ONt",
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(8)
174,134.34
(5)
(7)
(9)
(10)
14. Net Va'" Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPUCABLE RATES
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15. Amount of Une 14 taxable at the spousal tax
rate, or lransfers under Sec. 9116 (a)(1.2)
159,890.18
16. Amount of Une 14 taxable allinear rate
17. Amount of Une 14 taxable at sibling rate
18. Amount of Une 14 taxable at collateral rate
20.0
(11)
(12)
(13)
14,244.16
159,890.18
(14)
159 ,890.18
7 ,NO 00
7,200.00
Decedpnt's <;:omplete Address:
I STREET ADDRESS
245 W. Baltimore Street
CITY
r.~rl;c:::lp
I STATE
PA
Tax Payments and Credits:
1. Tax Due (Page 1 Une 19)
2. CreditslPayments
A. Spousal Poverty Credit
B.PriorPayments
C. Discount 360. 00
(1)
,
I ZIP
17(111.
7,200.00
Total Credits (A + B + C ) (2)
360.00
3. InteresUPenalty ~ applicable
D. Interest
E. Penalty
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TotallnteresUPenalty ( 0 + E ) (3)
4. If Line 2 is greaterlhan Line 1 + Una 3, enterlhe difference. This is !he OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. ff Une 1 + Une 3 is grealer than line 2. enter !he difference. This is !he TAX DUE. (5)
6.840.00
A. Enler!he inleresl on !he tax due.
(SA)
6,840.00
B. Enter lhe tolal of Line 5 + SA. This is lhe BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedenl make a transfer and: Yes
a. retain lhe use or income of lhe property transferred;.......................................................................................... 0
b. retain !he righl to designate who shall use !he property transferred or its income; ............................................ 0
c. relain a reversionary interest or.......................................................................................................................... 0
d. receive lhe promise for life of el1her payments, benefits or care? ...................................................................... 0
2. If dealh occurred after December 12, 1982. did decedenl transfer property within one year of dealh
withoul receiving adequate consideration? .............................................................................................................. 0
3. Did decedenl own an 'n trusl for" or payable upon dealh bank account or security at his or her dealh? .............. 0
4. Did decedenl own an Individual RetiremenlAccount, annuity, or other non-probale property which
conlains a beneficiary designation? ........................................................................................................................ ~
No
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IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare that I have examiled !his return, including accompanying schedules and statements, and to the best of my knowledge and belief. It is true, correcl
and complete.
DecIaralion of preparer other than the pllf'SOO8I representative is based on aJ infonnation of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FlUNG RETURN DATE
'd>DRESS
OJJORESS
DATE
William P. Douglas 2/9/05
'or dales of dealh on or after July 1, 1994 and before January 1, 1995, lhe lax rate Imposed on !he nel value of transfers to or for !he use of lhe surviving spouse is 3%
72 P.S. ~9116 (a) (1.1) (I)J.
'or dates of dealh on or after January 1, 1995, lhe tax rate imposed on !he net value of transfers to or for lhe use of lhe surviving spouse is D% [72 P.S. ~9116 (a) (1.1) (iill.
Ille statute does not exemot a transfer to a surviving spouse from tax, and the staMory requirements for disclosure of assets and filing a tax return are still applicable even if
he surviving spouse is !he only beneficiary.
'or dales of death on or after July 1, 2000:
rhe tax rate imposed on lhe nel value of transfers from a deceased child twenty-one years of age or younger at death 10 or for lhe use of a natural parent, an adoptive parenl,
"a slepparent oflhe child is 0% [72 P.S. !j9116(a)(1.2)].
rhe lax rale imposed on lhe net value of transfers to or for the use oflhe decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)].
'he lax rale imposed on the net value of transfers to or for the use of !he decedent's siblings Is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an
ndividual who has at/east one parenl in common with the decedent, whether by bJood or adoption.
RE'.'''''''':I'''',~.
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COMMONWEAlTH Of PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF
Mildred M: Coulson
FILE NUMBER
21-05-0007
AU real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged
between a willing buyer and a willing seller. neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointfy-owned with
right of
survlYorshm must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
Real Estate - 245 W. Baltimore St., Carlisle, PA 17013
See attached appraisal
80,000
TOTAL (Also enter on line 1, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
80,000.00
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COMMONWEALTH Of PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
Mildred M. Coulson
FILE NUMBER
21-05-0007
ESTATE OF
All property jolntly-owned wilh right of .UNlYolSh'" must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION
1.
VALUE AT DATE
OF DEATH
U.S. Savings Bonds - See attached list
13,474.89
TOTAL (Also enter on line 2, Recapitulation) $
(ff more space is needed. insert additional sheets of the same size)
13,474.89
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COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
FILE NUMBER
Mildred M. Coulson
21-05-0007
Include the proceeds of iligation and the date the proceeds were received by the estate. All property jolntly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
2.
3.
4.
Blue Cross Refund
1991 Ford Escort Coupe - blue book value
Personal property
Sprint refund
123.77
2,000.00
800.00
8.92
2,932.69
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets ollhe same size)
REV-''''~'o'n '*
COMMONWEALTH OF PENNSYLVANIA
INHE~TANCE TAX ~URN
RESIDENT DECEDENT
SCHEDULE F
JOINTL Y.OWNED PROPERTY
ESTATE OF
Mildred M. Coulson
Ran ...et was made joint _In one year 011lle _. date 01 _. R must be reported on Schedule G.
FILE NUMBER
21-05-0007
SURVIVING J01NT TENANT(S) NAME
RElATIONSHIP TO DECEDENT
ADDRESS
A.
Barry.N. Coulson
B.
C.
36 Oak Park Ave., Carlisle, PA 17013
son
JOINTLY -OWNED PROPERTY:
lETTER DATE DESORJPTlON OF PROPERTY "OF DATE Of DEATH
ITEM FOR JOINT MADE Include name at filllh:lal institution and balk account number or simIIa' IcIentIfyilg number. Attach DATE Of DEATH DECO'S VAlUE OF
......ER TENANT JOINT deed ilrjoinlly_ rea-. VAlUE Of ASSET INTEREST DECEOENT'S MEREST
1. A. 6/3/8 M&T Bank, Account 706027 " l-S Co \2- .50 1,629.00
2. A. 6/3/8 M&T Bank, Account 15004200572920 77,474.46 .50 8,738.00
3. A. 6/3/8 M&T Bank, Account 31003911158383 46,021.01 .50 3,011. 00
4. A. 6/3/8 M&T Bank, Account 31003911165883 21 ,629.74 .50 10,815.00
TOTAL (Also enter on line 6, Recapitulation) $ 74,193.00
(If more space is needed, insert additional sheels of the same size)
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
FILE NUMBER
Mildred M. Coulson
21-05-0007
This schedule must be completed and flied if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY %OF
ITEM INClUDE THE NAME Of THE TRANSFEREE. THEIR RELATIONSHIP TO oeCEDENT AND ll-IE DATE OF TRANSFER DATE OF DEATH DECO'S EXCLUSION TAXABLE VALUE
ATTACH ACOPY OF THE DEED FORREAL ESTATE. VALUE OF ASSET INTEREST lFAPPUCABlE)
NUMBER
1. Conseco Annuity 2,533.76 100% 2,533.76
See attached information
2. Food Employers Labor Relations Assoc
FELRA & UFCW Pension Fund
lump sum death benefit 1,000.00 100% 1,000.00
See attached information
TOTAL (Also enteron line 7, Recapitulation) $ 3,533.76
(If more space Is needed, Insert additional sheets of the same size)
REV.""",:".n.
COMl.tONl'lEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Mildred M. Coulson
FILE NUMBER
21-05-0007
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1- Ewing Brothers 3,862.50
Westminister Cemetery 995.00
Wake Expenses 125.00
B. ADMINISTRATIVE COSTS:
1- Personal Rep....ntative.s Commissions
Name of Personal Representative (s)
Social Security Numbe~s) I EIN Number of Personal Rep....ntative(s)
Slreel Address
City State Zip
Y..~s) Commission Paid:
2. Attorney Fees Douglas Law Office 6,500.00
3. Fami~ Exemption: (If de<:edenfs address ~ not Ihe same as c1aimanfs. attach explanation)
Claimant
Slreel Address
City State Zip
Relationship of Claimant Jo Decedent
4. Probate Fees 230.00
5. Accountanfs Fees
6. Tax Return Plllparet'S Fees
7. Sara Todd Memorial Horne, last bill 1,611.00
8. PP&L 13.77
9. UGI 155.73
10. Borough of Carlisle 16.18
1l. Borough of Carlisle 16.35
12. Sprint 51. 55
13. S~ntinel Legal Ad 151.55
14. Cumberland Law Journal, legal ad 75.00
15. Richard W. Barrett, real estate appraisal 275.00
16. Borough of Carlisle 16.18
17. Register of Wills, filing fees, approximate 50.00
TOTAL (Also enter online 9. Recapitulation) $ 14,2.44.16
(If more space Is needed, insert additional sheets of the same size)
REV"''''':'''''.
COMMONWEALTH Of PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
FILE NUMBER
M<' A~ ,A M ('nul Qnn 21 05-0007
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Ust Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS (indude outright spousal distributions)
Barry N. Coulson son 1/2
1. 36 Oak Park Ave.
Carlisle, PA 17013
2. Michael D. Coulson son 1/2
Mall Road
Etters, PA 17319
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTiONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
(If more space is needed, Insert adartional sheets of the same size)
S. W. BARRETT REAL ESTATE & APPRAISAL SERVICES
Fie No. 05..0022
APPRAISAL OF
LOCATED AT:
245 West Bartimore street
Carlisle, PA 17013
FOR:
Dougl.s Law Offices
27 West High Street
Carlisle, PA 17013
BORROWER:
COULSON, Mildred. (Est.t.e)
AS OF:
November 14, 2004
BY:
CassandraJ.Crockett
Certified Residential Appraiser
124-126 NORTH HANOVER STREET, CARLISLE, PA 17013 717-243-6646 AND FAX 717-243-8627
s. W. BARRETT REAL EsTATE & APPRAISAL SERVICES
File No 05..0022
02/02/2005
Douglas Law Offices
27 West High Street
Carlisle, PA 17013
File Number: 05-0022
In accordance with your request, I have personally inspected and appraised the real property at:
245 West Baltimore Street
Carlisle, PA 17013
The purpose of this appraisal \s \0 estimate the marKet value of the subject property, as improved,
The property rights appraised are the fee simple interest in the site and improvements.
In my opinion, the estimated market value of the property as of November 14, 2004 is:
$80,000
Eighty Thousand Dollars
The attached report contains the description, analysis and supportive data for the conclusions,
final estimate of value, descriptive photographs, limiting conditions and appropriate certifications.
Respectfully submitted,
~~aJA<1-Y ClJJ
Cassandra J. Crockett
Certified Residential Appraiser
124.126 NORTH HANOVER STREET, CARLISLE, PA 17013 717~243-6646 AND FAX 717.243..8627
SUMMARV APPRAISAL REPORT
UNIFORM RESIDENTIAL APPRAISAL REPORT
05 0022
F
Property Description ileNo
P!.o2!i!~.c1~r!"~~}45 Wes~ Baltimore Street Citv Carlisle Slale PA ZioCode 17013
Le,<JI Oe~~.!E.IEx, See legal description/hill. map Countv Cumberland
~3e33~'s Parcel No. 04~21-O320-546 TaxYear 04/05 RE. TaxesS 1 586.00 Soec;al Assessments S N/A
Bcrro",er COULSON Mildred (Estate CurrenlOwner Same OCCIl!l;}!'l\ \ l~nel \ \ Tenanl \X\ Vacant
.. h:;Cdh fd',I~ JPor:Ji~"d 'X FeeSirrole I !Lea3eholdt ProiedTvoe I PUD , Condominium HUDNA onll') HOAS N/A IMo
_1-l!!9.~~h~?.0( Proiect Name Borouah Mac Reference 21.0320 Census Tract 0124.00
SJ)t?Price ~ NIt:>" _____ __Jl~leof_~3Ie N/A Descripl~n and $ amounl of loan charqes/concessfons 10 be p.:Iid bo sele( N/A
--'
L<<"oerlCI,,,nl Oouqlas Law Offices Address 27 West HiQh Street, Carlisle, PA 17013
A-~'~;~I~~; 'E~ssandra J, Crockett M6I,s~ 126 North Hanover Street Carlisle PA 17013
LocJtron ~Urban ~Suburban ~Rural Prlldominant Sing III family housing Presentlandl.lu% jlandusllchangll
occupancy PRICE AGE Or.elamily ~ ~No1likelY Olik@ly
Bu~t up o OVe~75% @25-75'~ Bunder25o.li l!OCll, ()f'1
Growth rate ; Rapid X Slable Slow 00 OWner ~low~ 2-4family~ In process
PfOperty vJlue~ 11] '"0''''"' ~ ".bI. 0 D.d'"'"' DTenanl 300... Hiqh 100 Mu!h-(a~)!.~To
DelT\;lni:ll~uppl)' U ShOrtage X lntaante 0 OvE!f:lUPf:iy 1X)Vacanl{o..s%) .?::;, Predominanl':::,\. Commercl.1l 2%
_M<lrkelir:9time nUnder31T()$. X 3-6 mos. nover6mos nV".nOlo"'~) 180 I 80 Instit'l 3%
Note: RJce Jnd the raciol composItion o! the neighborhood are not appra\"aI1acton.
N""9~,!lQrhood DoundJries and characterislics Subject is bounded on the north bv Pa.Turnpike' on the east and south bv 1-81' and on the
. ~~~Y_.9ranQe StreetlWellinnton Drive,
.
. Faclor~ thaI <If/eel the marketability 01 the properties in the neighborhood (proximity to employment and amllnities. employment stability. appeal 10 marke!. e!c.):
. ~.':l.t:>i~E~2!.~e.~Y is located in an established neiahborhood of homes both detached and attached adiacent to the Dickinson
~<?Jl~ge__~~P\Js. ShoPDino and other amenities are within walkina or short drivina distance, VMCA within one block, School
_s.y~tem i~_Carlisle District and local elementarv school is witnin ,5 mile. SMSA 42.3240.
Marke! conditions in the subjed neighborhood (inclUding support for the above conclusions related to the trllnd of propel1y values. demand/$Upply, and ~e\ill9\ime
.. such as dal3 on competitive properties for sale in the neighborhood. descriplion of the preville nee of sales and financing concessions. etc)'
,=,.r_()p~.!:!y' ~.,!l.!,!~s are currentlv stable with an averaae marketlna time of 80-100 days. Economic trends and lendina rates have
rE!rn':lir\~~J~yorable. Sales t:ol"\t:essiol'ls occur infrequently. There are new homes under construction in surroundinc
_r:!E!velopments as well as resales available in the neillhborhood.
-_.
B Pco;..' 'of"m.<loo fo' PUD'I" .ppli"bI'I' .1, th. ,,,.Iop""""'" '" .001", oflh. Horn. DwoO'" A..""Ii," IHDAi? . U YES N/~NO
, .b.PPfOXlmJ\e lolal nuniler of units in the subject project N/A . Approximate total number ofunits for sale In the subject project
Describe common elements and recreational fae~ilies: N/A
Dimensions See leQal description/tax ma~ Topograph~ Basicallv Level
S~e area .02 Acre M/L . . Corner lot U Yes lXJ No Size TVDtcal for area
SpeCIfic lonrng dasSI.flcahon andr~rlPtlon R-2 Medium Oensitv Residential Sr,a~ Rectanaular
Zoningcompllilnce 1X)legal Legalnonoon~(GrandfalIleredUS@}Ulne9al UNo:oning Drilinage AD[lears adelluate
H!g~est ~_~.e~1 use JS imoroved: X Presenl use Olher use fexolainl View Residential
Ut\h\\llS ?ubhc Orner Off-site Jmprovllments Type Public Pri...-ille L..andsc:lpng Tvoical
Electficlly IX] 3D Amp Street Asphalt ~ B Drivewa~ Surface N/A
Gas IX] Cufb/gut\iM' Concrete Apparenl easements None ADnarent
Walel IX] Sidewalk Concrete ~ R FEMA Special Flood Hazard Area U Yes _00 No
Sanitaryse~1 IX] Slreellighls AdeQuate fEM.b. Z{)ne C Map Oat, 2/3182
Storm sewer IXI "" To rear FEMAMaoNo. 425382A
Comments (apparent adverse easements, IInc(()achments, special assessments, slide areas, illegal or legal nonconforming zoning, use, elc.): There are no
aDDarent adverse easements encroachments or other adverse conditions,
GENERAL DESCRIPTION EXTERIOR DESCRlPTtON FOUNQ,6,T\ON eASEMENT INSULATION
No. ofUn~s One Foundal~n Block Slab None AreaSq.Ft. 528 R~ ~
No olSlories Two Exterior-Walls Brick Qaw'spao:;e None 'ilFinlslwd 5% Cei\n9_
Type (Del.lAtl.) Attached RoolSurfac& Slate/Rubber Bollsement Full Celing Oroo'd Tile Walls
De3igo{Style) TwnhOLlse Gullers& O'Nnspls. Aluminum SiJ~ Pu~ None Walls Paneled F10a ::==8
E~llrlg/P~OIlO~<j Existinq W\ndowType DoubleHunQ Da/Tllness None Obs, Flow Concrete None_
Age (Yrs.) 51 Vrs Stomv'Screens Yes Settlement None Obs, OutsidllEntry No c_
ElfectiveAoelYrs.l 15-20 Manufactl.lredHouSII No Infe'5\atior. None Obs.
. ROOMS Fooer Livinll Dinino K~chen 0," FamiloRm Rec. Rm. Bedrooms II Balhs laundrY Other AreaSllFt
Basemenl . Acea
level 1 1 1 1 528
. Level 2 3 1 528
.
Finished area..bove nradecoo!ains 6 Rooms' 3 Bedrooms. 1 Balh[s): 1056 SauareFeelofGrosslivinnArea
INTERIOR MalelkljslCondil~n HEATING KlTCHE.N EQUIP, mlC ,6,MENlnES CAR STORAGE'
Floors Hrdwd/Can>Ninvl Type FHA Refrigerator 0 None 8 FireplaCe(s)lI_ 0 Non& IX]
. Walls Drvwall/Panel Fuel Ga. RangelOven IX] Stairs Patio 0 G-al1~9' 1/.cfCilrs
TrimlFirlish Wood CondiionAverane Disposal 0 Drop Stair ~ Deck ~ Attach@d
BalhFloor Vinyl Tile COOLING Dishwasher 0 Scutlle Porch Rear Detached
Bath Wainscot OrvwaHfCeramic Cenllal None FanlHood IX] Floor R Fence Chain Link R Built.ln
Doors Wooden Othllf None Microwave R Heated PO" Carport
Averaqe Condition CondHionN/A WasherlOrver Finwd OfIVeWil N/A
Mditional features (special energy efficient ilems, etc.): .Some Danelina and a drocoed cei!inCJ still in nlace, currentf used as storaqe'
skvliqht in 2nd floor bath: Dorch rooffsofflts recentlv reolaced' fenced courtvard to rear.
Con~'I\iol'l of lhe improvements. depreciation (physical, functional, and external), repairs needed. qual~y of construclion remodeling/additions, etc. ImDrOVe
ments are in averaae condition with no ohvsical or functional inadequacies apparent.
.
Mverse env~onmental conditions (such as, but not limited to. hazardolls wastes, tox.ic. subs\ances, etC.) ple.sen\ in ,he improvements. on the site. or in lhe
Immediate vicinil~ of the subject properly: No adverse environmental conditions are annarentfdisclosed.
f~",."'",~ormIO 6-93
PAGE 1 OF 2
"_"~0C<_..'OfI,ll"'71''''''''"'_,,,,,,,
r......_r"""'OOlIl-93
Valuation Section
SUMMARY APPRAISAL REPORT
UNIFORM RESIDENTIAL APPRAISAL REPORT
25000
<I
ESTIMATED SITE VALUE
ESTIMATED REPRODUCTION COST-NEW OF IMPROVEMENTS:
Dwelling Sq,Ft@$_"'$
Sq.Ft@$_'"
GiIlagelCarpoi1 _~__ Sq Ft @$_ ::
Tolal E~I'lT\Jled Co~t New
. Le~~ Phy~ical I Functio1l31 I External
Qeplecokll\ _____._.l~_. .
DepletlJtedValueofl/Tllrovemenls
'A~-is' Value of Site Improvements.
INDICATED VALUE BY COST APPROACH
lTEM SUBJECT
245 West Baltimore Street
Address Carlisle
Ploximrt~toSub'ect
Saje~P!ice 1$ N/A
PricelGfo~ Lr.-, Ar.ea J! 0.00 III $
Data andlor ! Inspection
VerdlcallonSources ICHR
VAl..I.JEAD.IUS"TMENTS I DESCRIPTION
'$
Est, Remaining Econ. L~e
.\
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..
COMPARABLE NO.1
253 West Baltimore Street
Carlisle
0.00 Ml W
$
83.05 \ll
SaleSQ(FinanCll1g
Concessions
DattofSalelTime
Location
lea:;ehcldfi1eSi-fd>
Srie
.View
De~ion and Aoneal
0u::U otCoos1l\Jdion
,,,
Condition
MLS/Courthouse Records
DESCRIPTION l. . tAd .."".01
None, Cony :
DOM 128 :
5/04 :
Suburban Suburban
fee Simole Fee Sinmle :
Lot/Av" r.021 Lot/Avn .031:
Residential Residential
Twnhouse/Ava Twnhouse/Ava :
AvrsfBrick Avrs/Brlck :
51 Years 51 Yrs
Averane Suoerior
AooveGradt
Room Count
Gross Uvina Area
. Basen-enl&FniQled
Rooms Below Grade
FunctionalUtn~
HeatinQICoolino
EnelqyE.fh::ienlllems
_GaraqelCarpol1
Porch. Patio, Deck.
FireDlac<>lsl.etc
FencePool.etc
2
T...."OO"...' 801,,"
6: 3: 1.00
1 056 S\I.Ft
Full Bsmtl
Unfinished
AVeraNe
GFHA/None
Tvoical
On street
Porch/Crtyrd
'.
None
ToIIl'Il<<...' 8;1lht :
6: 3: 1,00'
1056 SO.ft :
Full Bsmtl
Unfinistled
Averane
GFHA/None
Tvoical
On street
PorchfCrtyrd
None
File No 05-0022
Comments on Cost Approach (such as, source 01 cost estimate
site value, square fool calculation and lor HUD, VA and FmHA, 'he
estimated remaining economicJife oflhe property):
Cost Aooroach~rfrom Marshall Swift Valuation Service
Handbook and local cost analvsisl was considered but
deemed ineffective for this rel'lort due to the ane of the
subject '"'rO'"'ert . Land value from Market Data
Comparison. Depreciation based on aQellife, observed
condition, and Market Data Analvsis. Estimated
Remaininn Economic Life is 35-40 vears.
.15
87700
COMPARABLE NO, 2
255 West Willow Street
Carlisle
0.07 Ml SW
$
$ 85.94 (/'l
COMPARABLE NO, 3
150 South Pitt Street
Carlisle
0,26 Ml NE
88,000
. '.
96500
-5000
Courthouse Records
DESCRIPTION I "'IU~I",,'",'"
None, Con v
DOM Unknown
3/03
Suburban
Fee Simole :
Lot/Avn r.051:
Residential
Twnhouse/Ava :
Ava/Brick
55 Yrs
Sunerior
1
66.74 ~
.5000
MLS/Courthouse Records
: DESCRIPTION I 'l'\' ~J.''''m'r>1
None, Cony :
DOM 36 "
7/04
Suburban
Fee Simole :
Lot/Avn 1.041:
Residential
Twnhouse/Ava :
AvolBrlck
100 Yrs+l.
Sunerior
o
ToIIl' B~...' e.1ll'
6: 3: 1,00'
1 024 S~~Ft :
Partial6smtl
Unfinished
Averane
GFHA/CA
Tvoical
1 C Intelrl Gar.
Deck
.5000
Tolil 'ear... , 8.lns :
o
5: 2: 1.50'
1446S".Fl
Full Bsmt/
Unfinished
Averane
EBBINone
Tvoical
On street
Porch/Crtyrd
-1,000
.9 BOO
None
-1500
-3000
1,000
NOr\e
Net Adi,1101al t X '$ 5000~X - '$ B500 ~t IX. '$
Adp;\e-dSal:esPOCe
of Comparable $ 82 700 $ 79 500 $ 80 700
Comment~ on Sales Comparis<;lrl (including the subject plopert1's tom1>alib~i\y \0 Ihe neighborhood elc) All com'::arables are similar In st"le utiJit
and location to the subject oroDertv. are verified closed sales and are the best currently available. All of the con1o;rable
sales had h-ad some rernodelinrs/un-datinn comnleted. Ranne of value is $79 000 to $83 000.
15800
ITEM SUBJECT COMPARABLE NO, 1 COMPARABLE NO.2 COMPARABLE NO.3
Date, Price and Dala
SOIlf't:efor prior $ales None None None None
wilhinvearofal\fY:lisal CHR Courthouse Records Courthouse Records Courthouse Records
Analysis 01 any current agreement of safe, option, Cftisting of the subje ctproper1yandanalysisofanypriorsalesafsubfedandrofT'4'arableswilhi1or.eyearof!hedateofa~
No orior sales within three Years were found.
INDICATED VALUE BY SALES COMPARISON APPROACH S 80000
. INDICATED VALUE BY INCOME APPROACH IfAnnlicalft Est~;ed 'Marke~ R~~'$ . N/A . ~. ~~R~~ Mu~'".,l;.", NIA:: S N/A
ThiS apprai~al is made Y0 'as~' U subjed to the repars, atleratiorls. inspections or oond~ions listed below 0 suojed 10 COfl1lIetillll per pjans and speclx:atioos
ConddlOMofAppralllal: The nrooertv has been aooraised in current condition. This aonraisal is for client on Iv nontransferable. See
attached addendum.
Fmal Reconciiatron: Cost and Market Analvsis consistentlv sunnort m" estimated market value. GRM anal"sis was found
inapprooriate for this analYsis. Greatest wei ht is a lied to the Market Data Analvsis. Su ortin file information
. substantiates these estimates.
The purpose o/Ihis appraisal is 10 estimate lhe marlret valli' of the r,al proper1y that is the sllbl,ct of this-report, hned an tile above to-r.drtioll$u\h&tertfJta\i:JrI, oon\~
and limiting cond~ions, and market value defin~ion lhat in! stated nthe attached Freddie Mac Form<l39lFannie Mae Form 10046 (Revised 6/93 )
. I (WE) ESTIMATE THE MARKET VALUE,AS DEFINED, OF THE REAL PROPERTY THAT ISTHE SUBJECTOFTH~EPORT,ASOF 11/14/2004
\WHICH IS THE OATE OF INSPECT10N ANjOTHEEFFECTIVEOATEOFTHISREPORT )TOBE$ .sO 000 1----....
APPRAISER: <' 1-' (/) f,i ,,} SU~SORYAPPRAlSER(dNU.YI~EQUIREQLj
sinnature /;', J" //.1 A (-;.'., ,t.",..ff S\!lna\..-'J ~ L/V I '--- (T ODid OOOidNot
Name Cassandra J. Crockett '/ Name Steven W. Barrett. SRPA. SRA lnsp.ct Property
Date Report Siqned 02/02/2005 Date Re""rt S"'ned 02/02/2005
Slale Certirlcalion ~ RL-001348.L Slale PA Stale Cenification /I GA-000298.L
Or State License II State Or State License II RB..()26921.A
FfOClileMocform 10 r...J Certified Residential PAGE 2 OF 2 certlfJed Genera. App
..od"'.........Cl.._..IOOll4I1n........_'om
Appraiser
Steven W. Barrett RE. Appr. SVc.
State PA
Stale PA
raIser f""'~Kf....,OOt 6-1oJ
, 5orrQwer: COULSON, Mildred IEstate) File No' 05.0022
Propellv Address: 245 West Baltimore Street Case No'
City: Carlisle State: PA Zip 17013
Lender Doualas Law Offices
.. -. --.-.-._- - ..__on__ - .--_.. - '-. -- ---- -- ..--...- -- ..-..
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90'
! ! ;b
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b
. Porch 7,0'
t: b
II tel.O' .
b
:;:jl- Balli t Ie
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I t .". '"
II <f' I
I Elecrroom
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b
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2nd Floor i
I ;j
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living Room
--- m__. .u_. ---,
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Sketch by Ape~ IV Windows'w
-
AREA CALCULATIONS SUMMARY llV1NG AREA BREAKDOWN
Cod. Oncliplion 51u ToUlls Bfukdown Subtotals
OLA> rtr.trloor 521.00 ril'.trloor
Jecon4r),oor 521.00 10!ILOO 16.0 . )3.0 528,00
,/0 Porch 161.00 161.00 .eooncll'loor
16.0 . 33.0 521.00
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,
,
*
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, TOTAL LIVABLE (rounded) 1056 2 Areas Tota\ lO56
..,...,.".,.. ,
--"
FLOORPLAN
124.126 NORTH HANOVER STREET, CARLISLE, PA 17013 717.243-6646 AND FAX 717-243-8627
..................... I r .H,J"- 1;;.1".... I 1 /- (1..... 1 U Auut:.;r"uulvl
J}orrQ~~cf..<?_ULSON, Mildred (Estate)
Property Address: 245 West Baltimore street
f.!!i: Cani~le
Lender: Doualas Law Offices
State: PA
Zip: 17013
\
..
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~",'
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File No.: 05-0022
Case No.:
FRONT VIEW OF
SUBJECT PROPERTY
Appraised Date: November 14, 2004
REAR VIEW OF
SUBJECT PROPERTY
STREET SCENE
........1...1...1::"'. t"'t'\vrt:t"\i (t"'HVIU~UUt::NUUM
, Borrower qOULSO~i1dred (Estate)
f!opertv Address: 245 West Baltimore Street
~: Car\ls!~_.
Lender: DOli~las Law Offices
State: PA
File No.. 05-0022
Case No :
Zip. 17013
FRONT VIEW OF
SUBJECT PROPERTY
Appraised Date:November 14, 2004
REAR VIEW OF
SUBJECT PROPERTY
STREET SCENE
~..9irower: .ggUlSON, Mildred (Estate)
Property Address: 245 West Baltimore Street
Cit'f, Carlis.le
Lender: DOllelas Law Offices
State: PA
Zip: 17013
File No.: 05.0022
Case No.:
~orrower; COULSON, M!ldred (Estate)
Property Address; 245 West Baltimore Street
City: Carlisle
lender: Dounlas Law Offices
State: PA
Zip; 17013
I
I
File No.: 05-0022
Case No.:
cOMPARABLe PROPeRTY PHOTO ADDENDUM
File.No
Case No.:
\( : l3:9.ffower, C9~L~ON, ~i1dred tEstate) .
,Property Address: 245 West Baltimore Stf~et
~ltV: Carlisle
lender: Doualas Law Offices
State: PA
":
-Vi. ,n
p...;'!.'.i.
I ~_:., ~
05-0022
Zip: 11013
COMPARABLE SALE #1
253 West Baltimore Street
Carlisle
Sale Dale: 5'04
Sale Price: $ 87,700
COMPARABLE SALE #2
255 West Willow Street
Carlisle
Sale Dale: 3/03
Sale Price: $ 88,000
COMPARABLE SALE #3
150 South Pitt Street
Carlisle
Sale Date: 7/04
Sale Price: $ 96,500
:"Borrow~r: C9-U_LS9~Milc!red (Estate).
I P~o~dress: 245 West Baltimore Street
9_1,~Y: Carlis-'~
lender: Oou las Law Offices
State: PA
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File No.. 05-0022
Case No;
Zip: 17013
COMPARABLE SALE #1
253 West Baltimore Street
Carlisle
Sale Date: 5'04
Sale Price: $ 87,700
COMPARABLE SALE #2
255 West Willow Street
Carlisle
Sale Date: 3103
Sale Price: $ 88,000
COMPARABLE SALE It3
150 South Pitt Street
Carlisle
Sale Date: 7104
Sale Price: $ 96,500
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Fie No 05~22
**- QUALIFICATIONS ..**-
l
I
i
The following chectc.ed items are SPECIFIC SPECIAL CONDITIONS that were identified by this appraiser during the
inspection of the subject property, the com parables sales. and their neighborhoods and locations. Unless otherwise
noted, the conditions that apply to the subjeet property or the comparable sales used DO NOT AFFECT THE MARKET
VALUE OR THE FUTURE MARKETABILITY OF THE SUBJECT PROPERTY BEING APPRAiSED. This is not a home
inspection service. This is an appraisal to estimate market value.
_1. The subject is located In a rural area and Is less than 25% built-up.
x 2. Commercial/lndustrlal uses are located within the subject's neighborhood. These uses are typical of simUar
neighborhoods.
_3. Vacant and undeveloped land uses are located within the subject's neighborhood. Then uses are typical for
the area.
_4. The predominant value to the neighborhood Is less than that of the market value of the subject property. This
is due to the very wide range of value of properties in the area and superior quality of the subject property.
_5. The subject property Is located In a F.E.M.A. Identified Flood Zone. Flood insurance coverage Is required and
suggested.
_6. Dampness i, noted In the basement of the subject. Standing or running water was not present on basement
floor. This condition is conside1'ed typical in dwemngs of this style.
_7. The subject property is serviced by private well and/or septic systems which is common for the area.
j._6. The subject is older than five(5) years. All mechanical systems including the heating, electrical and plumbing
systems appear upon a visual e:cterior inspection to be in working order. No warranties are implied in this statement.
_9. Repair items were noted in the comments section of the report. These comments on repair items are for
descriptive purposes only and are not required repairs. The Items listed are cosmetic In nature.
_10. The basement floor is a dirt floor. This condition Is common and typical for the area. and does not pose a
health or safety hazard.
_11. The subject property does contain functional obsolescence af noted in the report. This condition Is
considered tvplcal and common for the area and this style dwelling.
_12. The land value exceeds 30% of total value due to the high demand for vacant land in this neighborhood. Thl.
condition is considered common and typical for the neighborhood.
_13. The land 'Ialueexceeds 30% of total value. This is due to the large size of the site. This condition Is
considered to be typical and common.
_14. Individual adjustments were required that exceed 15%. These adjustments were required due to lack of more
similar com parables on that individual rating. All com parables used are the best available.
_15. Total adjustments exceed 25%. This Is due to the lack of comparable sales that were more similar in the
subject's market area. AU comparables used are the be5t available.
_x_16. One or more comparable sales are oldef than slx(6) months. Although there are comparable properties In the
subject's area, none have sold recently; therefore, sales in excess of six(6) months have to be used. All comparables
used are the best available.
_17. One or more com parables used were In excess of one (1) mile from the subject property. Although there are
compafabte properties in the immediate area, none have sold recently. Therefore, it was necessary to use comparable
$ales outside of the immediate area. All com parables used are located in similar neighborhoods and wfthln the same
marketing area. All com parables used are the best available..
_18. The electrical system was not connected during Inspection.
_19. The water service was not connected during Inspection.
_20. The heating system W8f shut down during Inspection.
_x_21. Roofing_Plumbin9-Electrlcal_x_Heating_certlfication(s) islare suggested.
22.. lnground swimming pool-, out buildings_are Included-,not InClUded_according to lender's
guidelines.
_23. According to lender's guidelines a maximum of_acres were considered for this valuation. Remaining
acreage was given no value.
F"k No 05-0022
u.....u.u..u QUALIFICATIONS *****....
_24. The subject property is located on a private road.
_25. Wood infestation inspection is suggested.
_26. Last recorded deed transfer: Date_N/A
, Consideration: $_N/A_.
_27. Proposed constrllctionlreno'latkm in accoro,ance to plans and specifications to be completed in a workm.n-like
manner.
_28. Seller is paying part or all of closing costs.
_,;_29. All comparable sales are verified closed sales.
_x_30. There are no special conditions or othef requkementsthat would affeet mar\tet value or future marketability in
the Appraisal Report.
CHECKED ITEMS ARE SPECIFIC SPECIAL CONOmONS THAT WERE IDENTIFIED BY THIS APPRAISER DURING
INSPECTION.
He No 05..0022
.- QUALIFICATIONS AUUUU
1
Confid~UaUty and S~urity Policy
We consider privacy to be fundamental to oW' relattonahipwith cl~ts. We are committed to maintaining the
confidentiality, integrity and security of clients' personal information. Internal policies have been developed to protect
this confidentiality, while allowing client needs to be served.
We restrict access to personal information to authorized Individuals who need to know this information to comply with
fedenl standartis to protect your nonpub1ic personal information. We do not disclose this information about you or
any former consumers or customers to anyone, except as permitted by law. The law per",its us to share this
information with our affiliates. The law also permits us to share this information with companies that perform
marketing.
When we share nonpubllc Information referred to above, the Information Is made available for limited purposes and
under controlled circumstances. We require third parties to comply with our standards for security and contientlality.
We do not permit use of eonsumeffcustomer Information for any other purpose nor do we permit third parties to rent,
sell, trade or otherwise release or disclose Information to any other party.
Education
As of the date of this report, I and/or Steven W. Barrett, SRPA, 8M, have completed the requirements under the
continuing education program of the Appraisal Institute.
FleNQ. 05-002.2.
DEFINITION OF MARKET VALUE: The most probable price which a property should bring in a competitive and open market
under all condi'llons requisite \0 a la'lf sale, the buyer and seller, each acling prudently, knowledgeably and assuming the price is not
affected by undue stimulus. Implicit in this definition is the consummation 01 a sale as of a specified date and the passing of tiUe from
seller to buyer under conditions whereby: (1) buyef and sellel are Iyplcally motivated; (2) both parties are wen 'mlormed or well advised,
and each acting in what he considers his own best interest; (3) a reasonable time is allowed for exposlJre in the open market; (4) payment
is made in telms of cash in U.S. dollars or in terms of financial arrangements comparable thereto; and (5) the pticefepresenls the normal
consideratIOn for the property sold unaffected by special or creative financing or sales concessions' granted by anyone associated with the
sale
"Adjustments to the campa rabies must be made for special or creative financing or sales concessions. No adjustments are necessary for
those costs which are nDlmally paid by sellers as a result 01 tradition or law in a market area; these costs are readily identifiable since the
seller pays these costs in virtually all sales transactions. Special or creative financing adjustments can be made to the comparable property
by comparisons to financing terms offered by a third party instituticnal lender that Is not already in....olved 11\ tne properlY or transaction. Any
adjustment should not be calculated on a mechanical dollar for dollar cost of the financing or concession but the dollar amount of any
adjustment should approximate the market's reaction to the financing or concessions based on the Appraiser's ludgment
STATEMENT OF LIMITING CONDITIONS AND APPRAISER'S CERTIFICATION
CONTINGENT AND LIMITING CONDITIONS: The appraiser's certification that appears in the appraisal report is subject 10 the
following conditions:
1 The appraiser will not be responsible for mallers of a legal nature that affect either the property being appl"aiwd 01' the title to it. The
appraiser assumes that the title is good and marketable and, therefore, will not render any opinions about the title The property is appraised
on the basis of it being under responsible ownership.
2 The appraiser has provided a sketch in the appraisal report to show appro)(imate dimensions of the improvements and the sketch is
included only to assist the reader of Ihe reporl"ln visualizing the properly and understanding the appraiser's determination of its size
3 The appraiser has examined tt\e available flood maps that are pro....ided by the Federal Emergency Management Agency (or other data
sources) and has noted in the appraisal report whether the subject site is located in an identified Special Flood Hazard Area. Because the
appraiser is not a surveyor, he ex she makes no guarantees, express or implied, regarding this determination
4. The appraiser will not give testimony or appear in court because he or she made an appraisal of the properly in question, unless specifi.c
arrangements to do so have been made beforehand.
5 The applaisel has estimated the value 01 the land in the cost approach at its highest and best use and the improvements at their
contributory value. These separate valuations of the land and imPfovements must not be used in conjunction with any other appraisal and
are invalid if they are SQ used
6 The appraiser has noted in the appraisal report any adverse conditions (Such as, needed fepaits, depreciation, the presence of hazardous
wastes, foxic substances, etc, ) observed during the inspection of the subject property Of that he or she became aware of during the norma!
research involved in performing the appraisal. Unless otherwise stated in the appraisal report, the appraiser has no knowledge of any hiddel\
or unapparent conditions of the property or adverse environmental COnditions (including the presence of hazardous wastes, toxic
substances, etc, ) that would make the property more Of less valuable, and has assumed that there are no such conditions and makes no
guarantees or warrant'les, express or lmplJed, regarding the condition of the property. The appraiser will not be responsible for any such
conditions that do exist or for any engineering or testing that might be required to discover whether such conditions exist. Because the
appraiser is not al\ expert in the field of environmental hazards, the appraisal reporl must not be considered as an environmental assessment
ofthepl"operty
7. The appraiser obtained the information, estimates, and opil\ions that were expressed in the appraisal report from sources that he or she
conSiderS to be reliable and believes them to be true and correct. The appraiser does not assume f8sponsibility for the accuracy of such
items that were furnished by other parties.
B. The appraiser will not disclose the contents of the appraisal' report except as provided for in the Uniform Standards of Professional
Appraisal Practice.
9. The appraiser has based his or her appraisal report and valuation conclusion for an appraisallhat is subject to satisfactory completion,
repairs, or alterations on the assumption that: completion of the improvements will be performed in a workmanlike manner"
to, The appraiser must provide his or her prior written consent before the lender/clie(\t specified in ttw. appl"aisal seport can dlstlibute the
appraisal report (including conclusions about the property value, the appraiser's identilyand professional designations, and references to
any professional appraisal organizations or the firm with which the appraiser is associated) to anyone other than the borrower; the
mortgagee or its successors and assigns; the mortgage insurer; consultants; professional appraisal organizations; any state or federally
approved financial institution; or any department, agency, or instrumentality of the United Slates or any state or the District of Columbia;
except that the lender/client may distribute the property description section of Ihe report only to data collection or reporling service(s)
without having to obtain the appraiser's prior written consent. The appraiser's written consent and approval must also be obtained before
the appraisal can be conveyed by anyone to the public through advertising, public relations, !'lews, sales, or other media
Freddie Mac Form 439 6.93
Page 1 of2
Fannie Mae Form 10046 6-93
Fie No. 05-0022
APPRAISERS CERTIFICATION: The Appraiser certifies and agrees that:
1. I have researched the subject market area and have selected a minimum of three recent sales of properties most similar and proximate
to the sublect property far consideration in the ~ales comparison analysis ana ha....e made a dollar adjustment when appropriate 10 reflect the
market reaction to those items of significant variation. If a significant item in a comparable property is superior to , or more favorable than,
the subject property, I have made a negative adjustment to reduce the adjusted sales price of the comparable and, if a significant item in a
comparable property is inferior to, or less favorable than the subject property, I have made a positive adjustment to increase the adjusted
sales pflce of the comparable
2. I have taken into consideration the factors that have an impact on value in my development of the estimate of market value in the
appraisal report. I have not knowingly withheld any signWcsnt information {tom the appraisal repmt and I believe, to the best of my
knowledge, that all statements and information in the appraisal report are true and correct.
3. I stated in the appraisal report only my own personal, unbiased, and professional analysis, opinions, and conclusions, which are subject
only to the contingent and limiting conditions specified in this form
4 I have no present or prospective interest in the property that is the subject to this report, and I have no present or prospective personal
interest or bias with respect to the participants in the transaction. I did not base, either partially Of completely, m~ al\al~sis and/or the
estimate of market value in the appraisal report on the race, color, religion, sex, handicap, famihal status, or national origin of either the
prospective owners or occupants of the subject property or of the present owners or occupants of the properties in the vicinity of the
subiectploperty.
5. ! have no present or contemplated future interest il'\ tl\e subject property, and neilhel my current or future employment nor my
compensation for performing this appraisal is contingent on the appraised value of the property
6. 1 was not required to report a predetermined value or direction in value that favors the cause of the client or any related party,
the amount of the value estimate, the attainment of a specific result, or the occurrence of a subsequent event In order 10 receive my
compel\Saliofl ar.d/of employment for performing the appraisal. 1 did not base the appraisal report on a requested minimum valuation, a
specific valuation, or the need to approve a specific mortgage loan.
7. t performed this appraisal in conformity with the Uniform Standards of Professional Appraisal Practice thai were adopted and
promulgated by the Appraisal Standards Board of The Appraisal Foundation and that were in place as of the effective date of this appraisal,
with the exceplion of the departure provision of Ihose Standards, which does not apply. I acknowledge that an estimate of a reasonable
time for exposure in the open market is a condition in the definition of market value and the estimate I developed is consistent with the
marketing time noted in the ne\ghborhood section of this re?ort, urness I ha'le otheTWlse staled in the reconciliation section
8. I have personally inspected the interior and exterior areas of the subject property and the exterior of all properties listed as comparables
in the appraisal report. I further certify that [have noted any apparent or known adverse conditions in the subject improvements, on the
subject site, or on any site within the immediate vicinity of the subject property of which I am aware and have made adjustments lor these
advelse cOfldi\icns ifl my analysis of the property value to the extent that I had market evidence to support them I have also commented
about the effect 01 the adverse conditions on the marketability of the subject property
9. I personally prepared all conclusions and opinions about the real estate that were set forth in the appraisal report. Jf I relied on
significant professionai assistance from any individual or individuals in the performance of the appraisal or the preparation of the apprais.al
report, I 'nave named such individual(s} and disclosed the specific tasks performed by them in the reconciliation section of this appraisal
report. I certify that any individual so named is qualified 10 perform the tasks. I have not authorized anyone to make a change to any item in
lhe report; therefore, if an unauthorized clIa~ is made to the appraisal feport, 1 wiU taka no responsibility tor it.
SUPERVISORY APPRAISER'S CERTIFICATION: If a supervisory appraiser signed the appraisal report, he or she certifies
and agrees that: I directly supervise the appraiser who prepared the appraisal report, have reviewed the apPfais.al report, agree with the
statements and conclusions of the appraiser, agree to be bound by the appraiser's certifications numbered 4 through 7 above, and am taking
fuli responsibility for the appraisal and the appraisal report.
ADDRESS OF PROPERTY APPRAISED: 245 West Baltimore Street. Carlisle, PA 17013
APPRAISER:
SUPERVISORY APPRAISER (only If required)
Sig","" 41L2~~#a.cflo#
N<'lme: Cassandra J. Crocke
Date Signed: 02102/2005
State Certification #: RL-001348.L
c.-Statelicense#
Slate: PA
Expiration Dale of Certification or license: June 30, 2005
Sig",l", ~_ l/J i'L- t-J-
Name: Steven W. Barrett, SRPA, SAA
Date Signed: 02/02/2005
State Certification #: GA-000298~L
or Stale license #: RB-028921-A
State: PA
&pita'lion Date of Certification or license: June 30, 2005
o Did 00 Did Not Inspect Property
Certified Residential Appraiser
Freddie MacFOfm 4396-93
CertitJed General Appraiser
Page20f2
Fannie Mae Form 10048 6-93
FARMERSm
TRUST"
TYPE, OF ACCOUNT (PeuONII) _
o lndividl.llll Ql40lrU - Survivorship
DEPOSIT ACCOUNT
SIGNATURE CARD
o Joint - No Surl/iwuhip
o InTrust For
o Uniform Gift to Minor
o Other
TYPE OF ACCOUNT, (Businessl
o SOle PToprietonhip 0 Corpol1ltion - Profit
o COt"porltion - Not for Pro';t
o Partnership
TYPE OF SERVICE
o Checking
o UninCOfponlted Allociation
o Other
...J
o N.O.W.
o Super N.a.W.
o Monev Mlrket Account
/
'0's.v;ngs
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o Oth<<
s.. Ch.ddnglnd SeYings PTogr..ns P.mphhlt for _y~ CNrvn, int..ftt. and oth. lMseriptlve information.
Opened By
Office
Initial Deposit $
Consisting Of 0 c.sh 0 Checks Identification
PrevioU$ Bank Rel.tionship
Present Accounu Othet" Than FTC
Employer No.1 \ \ , r,;\. '(>\ , ..
Employer No.2
Rel.tiwOf Friend '" ., " r-.(, I(
To Contact:
121
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Tele~"
Telephone
,. ~j .TelePh* l-
Telephone
.'
"
Otner Services ATM
Telephone Transfer
Direct Deposit
DOR!I)ANT ACCOU.NT FEE
Automatic Trlosfer
Automatic Paymeot
A fee will be cher98d if there is 00 activity io the accouot for
coo.ecutive davs. aod wilt be chllrged
forelch
WITHDRAWALS
day period that 1'10 activity occurs on the accouot.
_ days prior writteo ootice may be required to effectuate aoy withdra_ts.
No more thao _ preauthorized traosfers will be allowed per month.
No more thao _ checks may be drawn 00 the account.
ADDITIONAL FEES. CHARGES. OR S!~CIAL INSTRU.CTIONS
1 -l.\ .J} ;\ J i- i "-) I C-1 t'-.J . ..-/\,
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NAME . "_J "
NO.1 I' , , :"-"\.-'
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1iIIlIr1llic.-1(wtl_IlII......IlIIiIildDl~Mtlfttingllllfllllltalllf..11I.I1pDI1a1
iIIt........." Ifle .181\111~ Serkt....1IlI1if1ld NIIhllllillll!WlI_IIIlI.
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...lOlIIclupwlthhuldilg..10lllldfilclplJlt~..IIld'fOll_IIOl_lIlIlifitdthal
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* Asterisk Indicates Interest Reported Under This Number.
Custom Fofm 1642 Rllv.7185
OCol>~';g~1 IIlllJ. f.n.ne..' l.w fn'""~
STMT
ACTION
PROD CODE DDA
CURR CODE
ACTN POST EFFECTIVE
TRACE 10
* 11/16
CO
STFD 1
96 OP EBRN
COlD
ACCT
THF TRANSACTION STMT FORMAT 05/01/12 11.52.33
MS 50852 ACTION COMPLETE
01/12
MQWBKP99
706027 SHORT NAME COULSON MILDRED
PAGE 1 SEARCH FROM 104/11/16 THRU 105/01/12
CHECK NUMBER TRAN AMOUNT DIC BALANCE
DESCRIPTION
0697
5383457054 CHECK NUMBER 0697
0696
5383445852 CHECK NUMBER 0696
0695
5383429596 CHECK NUMBER 0695
0698
5533614432 CHECK NUMBER 0698
0699
5449710056 CHECK NUMBER 0699
12431997 3,256.12
CLOSEOUT
32.00
o
4,328.27
* 11/16
27.38
o
4,300.89
* 11/16
13.77
o
4,287. 12
* 11118
36.00
o
4,251.12
* 11/19
995.00
o
3,256.12
o
.00
PF: 1-HELP 3-PLVL 6-INQ 7-SB 8-SF 9-ASUM 11-CUTO -STSM
co
96 OP
COlD
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STFD 1 THF TRANSACTION STMT FORMAT 05/01/12 11.52.13
EBRN MS 50852 ACTION COMPLETE
STMT
ACT! ON
PROD CODE DDA
CURR CODE
ACTN POST EFFECTIVE
TRACE ID
12/03
I-GEN104120300007062 INTEREST
01/05
I-GEN105010500002710 INTEREST
01/12
I-GEN105011200000001 INTEREST
01/12 12431996
MQWBKP99 CLOSEOUT
15004200572920 SHORT NAME COULSON MILDRED M
PAGE 1 SEARCH FROM 104/12/03 THRU 105/01/12
CHECK NUMBER TRAN AMOUNT DIC BALANCE
DESCR I PT! ON
14.85 C 77,453.77
PAYMENT
17.51 C 77,471.28
PAYMENT
3.18 C 77,474.46
PAYMENT
77,474.46 D .00
PF: 1-HELP 3-PLVL 6-INQ 7-SB 8-SF 9-ASUM 11-CUTO -STSM
STFT 1 THF TRANSACTION STMT FORMAT 05/01/12 11.51.54
STMT CO 96 OP EBRN MS 50861 LAST PAGE OF TRANSACTIONS
ACTION COlD
PROD CODE CDA ACCT 31003911158383 SHORT NAME COULSON MILDRED
CURR CODE PAGE 3 SEARCH FROM 100/10/06 THRU 105/01/12
ACTN POST EFFECTIVE CHECK NUMBER TRAN AMOUNT DIC BALANCE
TRACE ID DESCRIPTION
09/02 45,839.96 C
CDSGN104090200001843 *RENEWED AT 1.09%, MATURES ON
01/12 181.05 C
I-GEN105011200000001 INTEREST PAYMENT GENERATED
01/12 12431995 46,021.01 0
MGWBKP99 PAYOFF ACCOUNT - WITHOUT PENALTY
45,839.96
03/02/05
46,021.01
.00
PF: 1-HELP 3-PLVL 6-INQ 7-SB 8-SF 9-ASUM 11-CUTO -STSM
STFT 1 THF TRANSACTION STMT FORMAT 05/01/12 11.51.30
STMT CO 96 OP EBRN MS 50861 LAST PAGE OF TRANSACTIONS
ACTION COlD
PROD CODE CDA ACCT 31003911165883 SHORT NAME COULSON MILDRED
CURR CODE PAGE 3 SEARCH FROM 100/10/06 THRU 105/01/12
ACTN POST EFFECTIVE CHECK NUMBER TRAN AMOUNT D/C BALANCE
TRACE ID DESCRIPTION
05/13 21,522.27 C
CDSGN104051300002009 *RENEWED AT 0.60%, MATURES ON
11/15 11/13/04 65.20 C
I-GEN104111300002029 INTEREST PAYMENT GENERATED
11/15 11/13/04 21,587.47 C
CDSGN104111500002398 *RENEWED AT 1.19%, MATURES ON
01/12 42.27 C
I-GEN105011200000001 INTEREST PAYMENT GENERATED
01/12 12431994 21,629.74 D
MOWBKP99 PAYOFF ACCOUNT - WITHOUT PENALTY
21,522.27
11/13/04
21,587.47
21,587.47
05/13/05
21,629.74
.00
PF: 1-HELP 3-PLVL 6-INQ 7-SB 8-SF 9-ASUM 11-CUTO -STSM
u.s. Savings Bond Redemption Receipt
Branch ID: 96
Redemption Date: 01/12/2005
ESTATE OF MILDRED M COULSON
36 OAK PARK AVE
CARLISLE, PA 17013
204-03-4595
Transaction Number: 1512410
Teller ID: ebrn7ge
Issue Interest Redemption
Serial Number Series Denom Date Issue Price Earned Value
1692705770-E E $25 05/1959 $18.75 $172.78 $191. 53
65099851-EE EE 100 04/1984 50.00 114.72 164.72
41706449-E E 200 04/1969 150.00 948.16 1,098.16
41846249-E E 200 07/1969 150.00 927.68 1,077.68
41846250-E E 200 07/1969 150.00 927.68 1,077.68
41074902-E E 200 01/1969 150.00 948.16 1,098.16
41074903-E E 200 01/1969 150.00 948.16 1,098.16
40508848-E E 200 11/1968 150.00 933.52 1,083.52
41074901-E E 200 12/1968 150.00 948.24 1,098.24
40508851-E E 200 12/1968 150.00 948.24 1,098.24
40508850-E E 200 12/1968 150.00 948.24 1,098.24
40508849-E E 200 12/1968 150.00 948.24 1,098.24
41074906-E E 200 03/1969 150.00 948.16 1,098.16
41074904-E E 200 01/1969 150.00 948.16 1,098.16
Total number of bonds redeemed: 14 Total Total Total
Price Interest Value
1 868.75 11 610.14 13 478.89
@~~
Custo r Signature Customer ID: DECEASED
High Street Carlisle Office
One West High St
Carlisle, PA 17013
717-240-4536
Page 1 Of 1
. .
[J)
WashlnQt:an
nat:lana.&
INSURANCE COMPANY
STATEMENT OF ACCOUNT VALUE
Washington National
Post Office Box 1980
Carmel, Indiana 46082-1980
1-800-866-9922
~
MILDRED M COULSON
245 W BALTIMORE ST
CARLISLE
PA 17013-3702
Annuitant: MILDRED M COULSON
.......__.............__.......... n.
....,....-.-...".,..'..",-,-...-."""".,-,-.',..,..,-.-,".
~N~~r
000148046
...-..,-,-,-,,,,.-.,.....,..",.,,._,_._,_.....,.. . ....... ....'.,...'._,."._..'."..."~.._'.-..",,.. .._,....".,.,.'_._._._....~..-c.
. . .....__........__u.__.. .....H......n.. _ .__.___....,... ,.__.,__........ ,..
S06:see;N..mtKif ~m~oate .'.~..;~~i.,l"..
204-03-4595 03/27/85 0000 9999 03/27/91
......~.... ....:<Po$teif.;<.
2,508.83 09/27/04
CONFIRMATION OF TRANSACTIONS
.,,,'",...'.-..,,,..,,-......",..,.....'....,,.,...
...R~:r~ri<!;j~!J;
092804
..........."..............,.................. .--.-.........--..--.....-...--.-..........,
.\.;..~,M!ng;~..;l;.. .+'\;;ii...~Mli!iJ..~..."i;';gW'; ...:.;.,,~~..~..........~.i
06/27/04
mteresl.~bit,jy:;~
.. It<ite....Pienq....llie>
SUMMARY OF ACCUMULATED VALU~.
03/27/93
03/27/94
03/27/95
03/27/96
03/27/97
03/27/98
03/27/99
03/27/00
03/27/01
03/27/02
03/27/03
03/27/04
698.50
INTEREST RATES
::.i.Jilt\;!~..Ji(Ri@.........
':'~~.'Q~iil4.:
4.000
4.000
4.000
4.000
4.000
4.000
4.000
4.000
4.000
4.000
4.000
4.000
.........._........................... .._n.....,...',..
:n9r.;~ C~I,.lt!<iriS
Most of Washington National's Annuities guarantee current
Interest rates for each contract year (WNPlans I and II)
or each wcalenda.... year beginning January 15 (WNPlans 11+
and IV). Funds In your annuity earn different Interest
rates based on the date deposits were made. The chart
at the left reflects the Hold money'" interest rates
currently In effect for deposits made during each twelve
month period listed In the wcontract yea.... column. The
last rate In the column is the wnew moneyW rate effective
for any deposits made during the current period.
.
Food Employers Labor Relations Association
and United Food & Commercial Workers
Pension Fund
10626 YORK ROAD
COCKEYSV1LlE, MARYLAND 21030-2341
TELEPHONE: (410) 663-6500
(800) 638-2972
www.associated-admin.com
4301 GARDEN CITY DRIVE
SUITE 201
LANDOVER, MARYLAND 20785-221 0
TELEPHONE: (301) 459-3020
WWW.8Ssociated-admin.COffi
FELRA & UFCW PENSION FUND
NON-SPOUSE BENEFICIARY ELECTION FORM TO REJECT OR ELECT
WITHHOLDING ON LUMP SUM DEATH BENEFIT PAYMENT
I,
I) a (" r i N - C-o J (So {) t\
~l\cit"'-J, \J.J\ QC0\Sbf\
, non-spouse beneficiary of
, a deceased participant of the
FELRA & UFCW Pension Fund, hereby make the following election:
(Check one)
I elect not to have any income tax withheld from my single-sum payment.
v
Yes, please deduct the required 10% Federal income tax withholding.
I understand that either way I am liable for any payment of tax payable on my lump
sum death benefit.
./
Beneficiary's Signature
Date
.
~
Food Employers Labor Relations Association
and United Food & Commercial Workers
Pension Fund
10626 YORK ROAO
COCKEYSVILLE, MARYLAND 21030-2341
TELEPHONE: (410) 683-6500
(800) 638-2972
WWW.8$sociafecJ.admin.com
4301 GARDEN CITY DflIVE
SUITE 201
LANDOVEA, MARYlAND 20785-2210
TELEPHONE: (301) 459-3020
www.assoelated.admin.eom
APPLICATION FOR DEATH BENEFIT
I hereby apply for the $1,000 lump sum death benefit, payable upon the
death of M.',-fi~ c.-OCH...SeJ ,(SSN OlD"- o3-4slfS" )
a retired participant. I enclose a copy of the Certificate of Death. The death
benefit should be mailed to me at the address shown below.
/
Signature of Beneficiary
Date
PLEASE PRINT:
NAME:
FULL ADDRESS:
SOCIAL SECURITY NUMBER:
DATE OF BIRTH:
PHONE NUMBER:
RELATION TO DECEASED PARTICIPANT:
ENCLOSURE: COPY OF CERTIFICATE OF DEATH