HomeMy WebLinkAbout02-0747PETITION FOR PROBATE and GRANT OF LETTERS
Estate of f~,~ r/u k' ~~~rl No. ~~ ~~ ~7 y'
also known as To:
Register of Wil s for the
Deceased. County of ~ ~ L in the
Social Security No. / lye? ~ 3 `/~ ~ ~ % `T Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut.6,~i~t named
in the last will of the above decedent, dated ~'r2cY-•~- /5. , 191~~
and codicil(s) dated
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in ~-~ ~~"~""' ' `~ County~nnsyly n with .
h_v,~~ last family or principal~esidence at ~ar~ r~P ~c1.2~-t c'r~-~ r~~~ ~t~~/
t>'1_z :mac r..c~.f. ~~cGGku ~, b .'Y % '7c ~', ~;' ~/~i6Ltc~~~ ['s~ //J', ~ f_, ,._,u ~ -~~ „ ~:. ~
~ (list street, number and niQncipalify) G
Decendent, the "~ years of age, died ~l e~[~ .~~ ~ ~'. a5 xrn , ~ ,2r'n ^ ,
at ~ `~f'c: ~ ~ I ,.)cam. .
Except as follows, decedent did not marry, was not divor c~ and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property $ ~~-`'~`
(If not domiciled in Pa.) Personal property in Pennsylvania $
(If not domiciled in Pa.) Personal property in County $
Value of real estate irtP~nnsylvania --~ $ •~c'~C1.~0
situated.. as follows: ~ c-~u;,.JC'e~r~ !,~'~'tL.~,t /~at~ia.,-,~~'~! u'X.~ ~ / ~i2 ~~;u.,-[r ~-~.,.ti~
e~~~ , J`,r~ S a
hL'G
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters ~~5.tr~rn~n ~[t~
(testamentary; adminis lion c.t.a.; administration d.b.n.c.t.a.)
theron.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA 1
COUNTY OF L[.''t.nz~.~~.k...~u, r~L ~ S3
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed - <,.~.G~2. r.,
before me this 5th day of ~•
my "1002 ~ c ,~ i ~ ~nn /~e ~ ~ ~n,(~', ~~-~ ~
_ ~
Donna M. Otto actin eg e r y
of Wills
~7 ~d-%5~
No.
zl-2oo2-747
Estate of ~~ R. LEAK ,Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW August 19th, pgt 2002 in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated March 15th, 1991
described therein be admitted to probate and filed of record as the last will of
Karla R. Lear
and Letters Testamentary
are hereby granted to Lori Lynn Hockenberry
FEES
Probate, Letters, Etc.......... ~ 115.00
Short Certificates( 5) .......... $ 15.00
Renunciation ................ $
x-Pages (2) ~ 6.00
JCP
TOTAL S1
Filed . Au~uS.t .19th,..200.2 ............ .
,.
Register of W' s
Donna M. Otto, acting Register of W~
Thomas D.Gould, Esquire
ATTORNEY (Sup. Ct. I.D. No.)
2 East Main Street
.ADDRESS
Shiremanstown, PA 17011
PHONE
(717) 731-1461
MAILED LETTERS 'i'O ATTORNEY 'T'HOMAS GOULD ON 8 / 19 / 2002
his is ro cerrif5~ that the information here given is correctly copied fi-our an origil~al certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the ~CarC Vital Records Office for permanent ~iling.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
P 8391965
No.
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COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • 41TAL RECORDS
CERTIFICATE OF DEATH
_
NAME Of DECEDE NTIFnv. MgWe a9I
~
SEK
Female ..........c ..~.~ocn
SOCUI SECURITY NUMBER
192
34
6577
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FATHER'S NAME IFra Mndf.Ur) Paul Schaeffer
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MOTHER'S NAMEIFn1. Mddle. M«CSrS«n«n) Dorothy Jones
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SIGNATURE OP RAL SER LICE E dA ACTING AS SLIC LICENSE NUMBER NAME AND ApOF1E$S OF FACNJTY
- n. am FD-012662-L m Myers Funeral Home, Inc. 37 East Main Street Mechanicsburg, Pa 17055
wMn M+w YrowbOpf, Murry attested a11M umA, d«a arq Plats slala0 LICENSE NUMBER GATE SIGNED
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REGIST R SIGNATURE ANO NUMBER DATE FILED(MWI. Day vserl
._ L~-~,~~1-mil ,, ,, ~ aoo~
Q
21-2002-747
LAST WILL AND TESTAMENT OF KARLA R. LEAR
KNOW ALL MEN BY THESE PRESENTS, That I, Karla R. Lear,
of the Borough of Mechanicsburg, t:.c,unty of Cumberland and State of
Pennsylvania, do make, publish, a:!d declare this instrument to be
my Last Will and Testament, hereb~.~ revoking and making void any and
l
all former Wills by me at any ti~~~~: heretofore made.
FIR5T: I direct the Execu':-.rix hereof to pay all my just
debts, funeral expenses and costs of administration as soon as
ccnveniently may be done after my death. I further direct the
Executrix hereof to pay all inheritance, estate, transfer and
succession taxes which may be ie~.T._ed or assessed upon any
property which is included as par~~_ vi ri~y gross estate for the
'Ji~r~O`38 O~ ~nV SiiCh taX.
SECOND: I give, devise sn{ .~equeath unto my daughter, Lori
Lynn Hockenberry, the rest, resid,~.e and remainder of my estate,
realty and personalty, howsoever ~~esignated wheresoever situate
provided that she is living on tht-: thirtieth (30th) day after the
date of my death .
THIRD: In the event that n.y daughter, Lori Lynn Hockenberry
does not survive me or does not survive by the said period of
thirty days, then in that event, I give, devise and bequeath all
the rest, residue and remainder of my estate to Joseph Kurt
Rudolph.
~ FOURTH: I appoint my said daughter, Lori Lynn Hockenberry,
to be Executrix of this my Last Will and Testament. I do hereby
give to the Executrix hereof full power, discretion and authority
at any time or times to sell, at private or public sale, mortgage,
lease, pledge, exchange or otherwise deal with or dispose of the
property comprising my estate as deemed best, to settle and
compound any and all claims in fa,ror of or against my estate as
deemed best and, for any of the' f,:~regoing purposes, to make,
execute and deliver any and ali d_:eda, mortgages, contracts,
leases, bills of sale or other instruments necessary or desirable
therefor.
FIFTH: In the event my said daughter, Lori Lynn Hockenberry,
fails to or refuses for any reason to serve as Executrix of this my
Last Will and Testament, then in that event I appoint Joseph Kurt
Rudolph as Executor of this my La~:~t Will and Testament.
LASTLY: I direct that no fiduciary appointed by this, my
Last Will and Testament, shall be required to give bond and that
if, notwithstanding this direction, any Bond is required by any
law, statute or rule of court, nc Surety shall be required
thereon.
IN WITNESS WHEREOF, I have set my hand and seal to this, my
Last Will and Testament, consisting of three (3) typewritten
pages on the margin of which (except this page) I have affixed my
initials this 15th day of __ March , A.D. 1991.
_ ~.
Signed, sealed, published an,:i declared by Karla R. Lear, the
above named Testatrix, as and for her Last Will and Testament, in
the presence of us and each of us, who at her request, and in her
presence, and in the presence of each other, have hereunto sub-
scribed our names as attesting witnesses.
j ~.~ ~ :, 't~, . ~,~. _. 1
,'
21-2002-747
codicil
(each) a subscribing witness to the will presented herewith, (each) being duly qualified according to
law, depose(s) ar~d say(s) that ~ Jam- present and saw
the testat~:~ ~, sign the same and that ~~ ~'-t ~ ~~ ° 2`L ~~N~ /~_ signed as a witness at the
request of testate i x in l~_ presence and (in the presence of each other) (in the presence of the
other subscribing witness(es)). ~ j
Sworn to or affirmed and subscribed before ' ~ v' "'~~
me this 19th day of ~ j '~ (Name) ~ ~ ~
Au st ~ 2002 ~`,J~.(/ ~ ~ V~ ~ M~Gtif~~f~
~~ (Address)
` Tt
Donna M. Otto, acting egis er li~±~ ~ ~ `" ~J ~ -
of Wills ~ (Nam
.k~l~~
i~1~=~1~~ ~„- ~7~~"s
dress)
REGISTER OF WILLS OF COUNTY
OATH OF NON-SUBSCRIBING WITNESS
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
familiar with the signature of _ ,
codicil
testat of (one of the subscribing witnesses to) the will presented herewith and
codicil
that believes the signature on the will is in the handwriting of
to the best of knowledge and belief.
Sworn to or affirmed and subscribed before
me this
REGISTER OF WILLS O /w `~~/~ ~~~ COUNTY
OATH OF SUBSCRIBING WITNESS
_ day of
19
Register
!Name)
(Address)
(Name)
(Address)
REGISTER OF WILLS OF COUNTY
OATH OF SUBSCRIBING WITNESS
(each) a subscribing witness to
law, depose(s) and say(s) that _
codicil
swill presented
the testat ,sign the same and that _
request of testat in t~__ presence
other subscribing witness(es)).
Sworn to or affirmed and subscribed befgFe
me this da of
1
Register
21-2002-747
(Name)
(A dress)
(Nam
(Address)
REGISTER OF WILLS OF Cumberland COUNTY
OATH OF NON-SUBSCRIBING WITNESS
Lori Lynn Hockenberry
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
I am familiar with the signature of _ Karla R. Lear
codici
testatr'~ of (one of the subscribing witnesses to) the will presented herewith and
codicil
that 1 believed the signature on the it is in the handwriting of
Karla R. Lear
to the best of mY knowledge and belief.
Sworn to or affirmed and subscribed before
me this 14th day of
August lax 2002
~~ ~ ~ .cJ
Donna M. Otto actiJ^_ Fte si.er of~glS~s
ith, (each) being duly qualified according to
present and saw
signed as a witness at the
the presence of each other) (in the presence of the
!Name) '
/~-~~~~~~~ (Address) ~~ ~ 7U5~5
(Name)
(Address)
i7-q) i 4-
c>
OFFICIAL USE ONLY
REV -1500 EX + (6-00)
CAPB
HpRL
EplO
CRAC
KOTK
ES
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
D
E
C
E
D
E
N
T
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG. PA 17128-0601
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Lear Karla R.
DATE OF DEATH (MM-DD-YEAR)
SOCIAL SECURITY NUMBER
192-34-6577
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
21-02-0747
COUNTVCODE
YEAR
NUMBER
DATE OF BIRTH (MM-DD-YEAR)
REGISTER OF WILLS
SOCIAL SE U I Y NUMB R
06
X 1. Original Return
4. LImited Estate
X 6. Decedent Died Testate
(Attach copy of Will)
D 9. Litigation Proceeds Received
3 date of deal
. Remainder Return prior to 12-13-82)
5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
2. Supplemental Return
48.. Future Interest Compromise (date of death after 12-12-82)
7. Decedent Maintained a Living Trust
(Attach copy of Trust)
D 10. Spousal Poverty Credit
(date of death between 12-31-91 and 1-1-95)
o
o
11. Election to tax under Sec. 9113(A)
(Attach Sch 0)
P NAME COMPLETE MAILING ADDRESS
C
0 0 James D. Hu hes Es 60 West Pomfret Street
R N FIRM NAME (If Applicable) West Pomfret Professional Bldg.
R D
E E IRWIN McKNIGHT & HUGHES Carlisle, PA 17013
S N
T TELEPHONE NUMBER
C
o
M
T C
A T
X A
T
I
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N
R
E
C
A
P
I
T
U
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A
T
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9-
1. Real Estate (Schedule A) (1) 56,000.00
2. Stocks and Bonds (Schedule B) (2) None
3. Closely Held Corporation, Partnership or (3) None
Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D) (4) None
5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 7,126.00
(Schedule E)
6. Jointly Owned Property (Schedule F) (6) None
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) -0-
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7) (8)
9. Funeral Expenses & Administrative Costs (Schedule H) (9) 16 ,484.83
10. Debts of Decedent, Mortgage Liabil~ies, & Liens (Schedule I) (10) 47,966.95
11. Total Decluc:llons (total Lines 9 & 10) (11)
12. Net Value of Estate (Line 8 minus Line 11) (12)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13)
made (Schedule J)
14. Net Value Sub'eel to Tax (Line 12 minus Line 13) (14)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
(1,325.78)
OFFICIAL USE ONLY
63,126.00
64 .451. 78
(1,325.78)
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(aX1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20.
(15)
(16)
(17)
(18)
(19)
.0 0
.045
.12
.15
0.00
0.00
0.00
0.00
0.00
(1,325.78)
x
X
X
X
CopyrIght (c) 2000 form software only The Lackner Group, Inc.
Form REV-l500 EX (Rev. .-00)
,
Decedent's Complete Address:
STREET ADDRESS
128 W. Portland Street
CITY I STATE I ZIP
Mechanicsburl! PA 17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
0.00
Total Cred~( A+B + C) (2)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
! ~:!:: i! Hi:: i
TotallnterestlPenalty ( D + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference, This is the OVERPAYMENT.
Check box on Page 1 Line 20 10 request a refund (4)
5. If Line 1 + Line 3 is greater than line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58)
Make Check Payable 10: REGISTER OF WILLS, AGENT
:::i!!:mJlmlIW .::!ii ~il:::!;!m;!!i:;:;i i!l!!!!I,;!!!!! wm~!,:;;;i!;;;' ;::::::;i:!:;,,:;!:;!:!j:!!!l~!!!!!!:!i: . ;;:;:;~;;;:!1:::iI1!I:W,!:;::;:::!::!)::!;:!!i!!lll!!!ill!!;lli:ml]:!::!:!!:::!!::
:!:!;:!il! :!:!!!i:;!~. .:::~::!mJw:~!;..!i!!!!!!!!ii .J!..!m:[! ,. iji!!i]iiij!i.!::,:i;;:;;:;: .:!!!!i!!i~! !m~:!l!!!:i[i:i!!i;;!:i!;i';i
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BL.OCKS.
1. Did decedent make a transfer and: Yes No
8. retain the use or income of the property transferred; . . . . . , . . . ~ ~
b. reta.in the righ~ to de~ignate who shall use the property transferred or its income; . X
c. retain a reversionary Interest; or . . . . . . . . X
d. receive the promise for life of either payments, benefits or care? . . . . . X
2. If death occurred after Oecember 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .
3. Did decedent own an ~in trust for~ or payable upon death bank account or security at his
or her death? . . . .
~. Did decedent own an Individual Retirement Account, annuity, or other non-probate property
which contains a beneficiary designation? . . .
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
0.00
0.00
0.00
0.00
0.00
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[]]
o
Under penalties of perjury, I declare that I have examined this return, Including accompanying schedules and statements, and to the best of my knowledge and belief, it is true,
correct and complete. Declaration of preparer other than the personal representative Is based on an information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
DATE
~,j2.~"lNa
DATE
For ates of d th on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to orfor the use of the
us. is 3"10 [72 P.S. 9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. 9116 (a) (1.1) Oi)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets
and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a stepparent of the child is 0"10 [72 P.S. 9116 (a) (, .2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%., except as noted in 72 P.S. 9116(1.2)
[72 P.S. 9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(a)(1.3)]. A sibling is defined. under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
CopyrIght (c) 2:000 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00)
REV-1502 EX +(1-97)
SCHEDULE A
COMMONWEALTH OF PENNSYLVANIA REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Karla R. Lear SS# 192-34-6577 06/30/2002 21-02-0747
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price
at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable
knowledQe of the relevant facts. Real DroDerty which is iointly-owned with riaht of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 128 W. Portland Court, Mechanicsburg, PA - (contract attached) 56,000.00
TOTAL (Also enter on line 1, Receo~ulation) $ 56,000.00
(If more space is needed, insert additional sheets of the same size)
Copyright (e) 1996 form software only CPSystems, Inc. Form REV-1502 EX (Rev. 1-97)
REV-1508 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Karla R. Lear
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
SS1F 192-34-6577
06/30/2002
FILE NUMBER
21-02-0747
Include the proceeds of litigation and the date the proceeds were received by the estate. All propertY jointly-owned with the right of
survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1
DESCRIPTION
1995 Dodge Intrepid, 60,000 miles
VALUE AT DATE
OF DEATH
5,500.00
2
Internal Revenue Service - 2002 income tax refund
1,126.00
3
Miscellaneous personal property
500.00
TOTAL (Also enter on line 5, Recapitulation) $ 7,126.00
(If more space is needed. insert additional sheets of the same size)
Copyright (e) 1996 form software only CPSystems, lne. Form REV-1508 EX (Rev. 1-97)
REV-1510 EX +(1-97)
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TJIJ< RETURN
RESIDENT DECEDENT
ESTATE OF
Karla R. Lear
SSfI 192-34-6577
06/30/2002
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes.
FILE NUMBER
21-02-0747
DlfS~RIPTION OF PR~PERTY %OF
ITEM INCLUDE H NAMg OF THE TRA SFEREE THEIR DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
RELATIONSHIP TO DECE ENT AND THE DATE OF TRANSFER.
NUMBER ATTACH ACOPYOFTHE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE)
1 DECEDENT WAS UNDER AGE 59 338,937.74 100.00% 338,937.74 0.00
1/2 - PA State Employees
Retirement System
TOTAL (Also enter on line 7, Recapitulation) $ 0.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems,Inc:.
Form REV-1510 EX (Rev. 1-97)
REV.1511 EX +(1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Karla R. Lear
SSfI 192-34-6577
FILE NUMBER
21-02-0747
06/30/2002
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION
A. FUNERAL EXPENSES,
1 Myers Funeral Home
B.
AMOUNT
3,031. 00
ADMINISTRATIVE COSTS,
1. Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2.
3.
Attorney's Fees IRWIN McKNIGHT & HUGHES
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant Lor i L. Hockenberry
Street Address 128 W. Portland Street
City Mechanicsburg State PA Zip 17055
Relationship of Claimant to Decedent daughter
5,000.00
3,500.00
4.
Register of Wills
141. 00
Probate Fees
5.
Accountant's Fees
100.00
6. Tax Return Preparer's Fees
7.
1
Other Administrative Costs
Coldwell Banker Homesale - settlement charges
4,480.00
2
Cumberland Law Journal
75.00
3
Register of Wills, filing fees
25.00
4
The Sentinel - Legal
92.83
5
Thomas D. Gould, Esquire - fees
40.00
TOTAL (Also enter on line 9, Recap~ulation) $ 16,484.83
(If more space is needed, insert additional sheets of the same size)
CopyrIght (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97)
REV-1512 EX + (1-97)
COMMONWEALTH OF PENNSVLVANIA
INHERITANCE TAX RETURN
AESIDENT DECEDENT
ESTATE OF
Karla R. Lear
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES AND LIENS
SSI! 192-34-6577
06/30/2002
FILE NUMBER
21-02-0747
Include unreimbursed medical expenses.
ITEM
NUMBER
1 Borough of Mechanicsburg
DESCRIPTION
AMOUNT
47.52
2
Capital One, credit card
193.26
3
CPS Auto Loan Servicing Center - payoff Dodge
4,124.86
4
Midland Credit Management Inc., credit card
1,046.75
5
National City Mortgage
42,336.73
6
Penn Power & Light Co.
117.83
7
United Water Co.
100.00
I
TOTAL (Also enter on line 10, Recap~ulation) $ 47,966.95
(If more space is needed, insert additional sheets of the same size)
CopyrIght (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97)
REV -1513 EX + (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCET/J,X RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
Karla R. Lear
SSff 192-34-6577
06/30/2002
FILE NUMBER
21-02-0747
REL~TIONSHIP Iu uECEDENT AMOUNT OR SHARE
Do Not List Trustee(s) OF ESTATE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I. TAXABLE DISTRIBUTIONS [Include outright spousal dIstrIbutions, and
transfers under Sec. 9116{a)(1.2)]
1 Lori L. Hockenberry
8 Fairfield Lane
Mechanicsburg, PA 17050
Daughter remainder
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS,
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET S
0.00
(If more space is needed, insert additional sheets of the same size)
CopyrIght (c) 2000 form software only The Lackner Group, Inc.
Form REV-1513 EX (Rev. 9-00)
Decedent's Complete Address:
STREET ADDRESS
128 W. Portland Street
CITY I STATE I ZIP
Mechanicsbure: PA 17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
0.00
Total Credits (A + B + C) (2)
0.00
3. InterestIPenalty if applicable
D. Interest
E. Penalty
!!ii!i:i!iWiH
:!:!!i!i!!i!i!!i!i
TotallnterestlPenalty ( D + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line S + SA. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
:::::i!L;::::::;::::m::L:::::::!::;;;::::::::i::;::mim!il!l!!ii:::::i!Ui;mm:::::::::immmmmmmmii!i!!!!!U!l!!!!!!!,.!i:::i!IIJll!!lil::::::!i!IJmHi!!!!!::..:!W!::;1!!!!I!!!!!!iillililli!il111;!llli!iii
i!!i!ii:L:::i:::::);j;i;11;j;;r;;:;':1!!:;i;:.;,;;;;;;;;;;;;;;;;:;::::::::i!ii:;;:;::;::;;;;;,;....
PLEAsE ANSWER THE FOLLOWlfilGHQUESTIONSByHpLACING AlliH"X,iINTHifAi>PROPRIATEBLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; . . ~ ~ix
b. retain the right to designate who shall use the property transferred or its income; .
c. retain a reversionary interest; or .
d. receive the promise for life of either payments, benefits or care? . . . .
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .
3. Did decedent own an "in trust for" or payable upon death bank account or security at his
or her death?
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property
which contains a beneficiary designation? . . . .
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
0.00
0.00
0.00
0.00
0.00
D
D
rn
rn
[X]
D
Under penalties of perJury, I declare that I have examined this return, Including accompanying schedules and statements, and to the best of my knowledge and belief, It Is true,
correct and complete. Declaration of preparer other than the personal representative Is based on all Information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
DATE
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
DATE
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is 3% [72 P.S. 9116 (a)(1.1) (I)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0"10
[72 P.S. 9116 (a) (1.1) (in]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets
and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a stepparent of the child Is 0% [72 P.S. 9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5"10, except as noted in 72 P.S. 9116(1.2)
[72 P.S. 9116(aX1)).
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(aX1.3)]. A sibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
CopyrIght (c) 2000 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00)
LAST WILL AND TESTAMENT OF KARLA R. LEAR
I~V/
KNOW ALL MEN BY THESE PRESENTS, That I, Karla R. Lear,
of the Borough of Mechanicsburg, c.ounty of Cumberland and State of
Pennsylvania, do make, publish, and declare this instrument to be
my Last will and Testament, hereby revoking and making void any and
all former Wills by me at any ti!l'e heretofore made.
FIRST: I direct the Executrix hereof to pay all my just
debts, funeral expenses and costs of administration as soon as
conveniently may be done after my death. I further direct the
Executrix hereof to pay all inheritance, estate, transfer and
succession taxes which may be levied or assessed upon any
property which is included as pai"_ of my gross estate for the
purpose of any such tax.
SECOND:
I give, devise and bequeath unto my daughter, Lori
Lynn Hockenberry, the rest, resid..'e and remainder of my estate,
realty and personalty, howsoever ':!esignated wheresoever situate
provided that she is living on thG thirtieth (30th) day after the
date of my death.
ip!1.J
r
THIRD:
In the event that my daughter, Lori Lynn Hockenberry
does not survive me or does not survive by the said period of
thirty days, then in that event, I give, devise and bequeath all
the rest, residue ,and remainder of my estate to Joseph Kurt
Rudolph.
FOURTH:
I appoint my said daughter, Lori Lynn Hockenberry,
to be Executrix of this my Last Will and Testament.
I do hereby
give to the Executrix hereof full power, discretion and authority
at any time or times to sell, at private or public sale, mortgage,
lease, pledge, exchange or otherwise deal with or dispose of the
property comprising my estate as deemed best, to settle and
compound any and all claims in favor of or against my estate as
deemed best and, for any of the foregoing purposes, to make,
execute and deliver any and all ddeds, mortgages, contracts,
leases, bills of sale or other instruments necessary or desirable
therefor.
FIFTH:
In the event my said daughter, Lori Lynn Hockenberry,
fails to or refuses for any reason to serve as Executrix of this my
Last will and Testament, then in that event I appoint Joseph Kurt
Rudolph as Executor of this my Last Will and Testament.
LASTLY:
I direct that no fiduciary appointed by this, my
Last Will and Testament, shall be required to give bond and that
if, notwithstanding this direction, any Bond is required by any
law, statute or rule of court, no Surety shall be required
thereon.
IN WITNESS WHEREOF, I have set my hand and seal to this, my
Last will and Testament, consisting of three (3) typewritten
pages on the margin of which (except this page) I have affixed my
initials this
15th
day of
March
, A.D. 1991.
~ I /?' '..?
,,' "/' / '''C''
\ ~VL,'~~" y. 0" YJ//'_
Signed, sealed, published and declared by Karla R. Lear, the
above named Testatrix, as and for her Last Will and Testament, in
the presence of us and each of us, who at her request, and in her
presence, and in the presence of each other, have hereunto sub-
scribed our names as attesting witnesses.
n
'.:}t.\.f:;", K, Ldl.;-.<2'\
Q) uLL ~I ()
V~Z /!J. f<i~
STANDARD AGnEE~lENT VOl{ THE SALt OF REAL ESTATE
A/S.2K
rhi< lonl' rCc-,'mnl.Jld,'J and al'I)f(l,'~d IN. l'>ul ""I ~'''lC.tCJ to ,,,e 11,., ,he memher, l.r tll.l'~n",yhallja A,jod"lion or REALTORS"- IPARI
i ))liJ}.~R'S-!mSI~SS RELATlq~~H.IPWIJH ~I.ICENSE\) nROKEIt..... ""~?J
IIIROKER(Call1l)lln~)~ -..;1..oC.../~_ PIIONE ~~/Cfr)
\l)nRI~SS ~ FAX _ ~--~
\ DR::~F R ;;;-;;';::~GI NT , OR ,~;.LER. D'"g".',d Agen",) f,,, "U'" If .ppli"bl<. -tJ~-a.rt/A"
~lker Is~~~~~'~0_~~~~~~I~r and is alan: 0 AGENl FOR 8L'\ER 0 I RAM; \CIION L1CEN~EF,
~.' YEWS BUSI~~.~TIO>'i:HII: WITI! PA LICENSED nROK.ER
nROKER(Complmn_ . . .~-".~PHONE.,..,~~.l~_
ADDRESS -- .. .... .- ' --'-V~~-:.1!:/-~
I BROKER I:~;I:ijl~A.GEN;r l.i)R-8l~ER. nesigllll~-;d Agent(sJ for Hu)'er, if applicable:.. "'1J
OR
Broker is NOT the Agent for lluH~r and is alan: 0 M;J<:NT .FOR SELl.Eft 0 SUHAGENT FOR SELLER 0 TRANSACTION LICENSEE
L:::::: .
When the same IJ,roker is Agent for Seller and Agent for BII~'er, Broker is a Dual Agent. All of Broker's licensees are also nual Agents lJNtESS
there al'e separate Designated Auenls for Buyer and Sl'lIer. If the same Licensee is designated for Seller lUld Hilyer, the Licensee is a Uual Agent.
I. [l7il3 lI\12e~~nh d..,d ?J1~_ 0,r. dd7J ~
SELl.ER(S), -C~ of- - ~,: ~
_..~__..__.tl---,- ~.l.CL'7' F-Lt:'Gv' "..
, ' ,. ,called "SeUer," and
DUf~~(~~~~~~ Ad~'Ch'44-/'.A.L2~Ir
,called "Hllp;~r."
,is between
]fj
2, ['ROI'ERTY (1-98) Seller hcrt'b)' agrees to sell and convey 10 BII)'el', who hel'eby agrees to purchase:
ALL THAl' CI<:RTAIN lot ~JTJ'iece of grou wil~lJIldings and im,erm'ements Ihereo e' ed, ir any. know""as:
_L;l.J'---"Y.~.n, .~. 1ft
-----1J~. mUle
Co~~oL~~-~" JI-~ in the Com nwealthnfPenns)'lvania.ZipCode.L /J
Idenlilkatlon (e.g., Tax 10 #; Parcel #; tot. B1rn:k; Deed ROI)k, Page, Recording Hatl')
H
I,i ,.
, ,
0'11
H
'iJ
-d..AI,f'~ ~
TERl\IS (1.02) .g(~ ~
(Al ~:~~a~el'l'ice -_~~ 1'_.
which will be paid ~O~(~:~ nu.:lt~~..+.nc /:--. 4-1"
I, C~sh or cbet:k" r~is J(~eelllenl:
1, ('\;\'0\\ \)[ dlec\i. within ~ days of the exet:ullon of this Agre,ement:
U.s. Dollars
$ ~..clE2- ('/'{)
$
$
$ .::r5 _ Pt/lJ. {iiI'
TOTAL $ ~~ttJ--
(B) Deposits paiJ on UC(I)unt of pUKhase pri.:e to be held by Broker for Seller. unless other.....ise stated tU:l'e:
,.
4. Cash.cashicr's orcel'tifiedcneckatt;,m{' n(f,e\tlcment'
".
--.....--.-...-----.--~-------rT:---_.._._._-_.
SCller'swrittellapprova!~eOnlJIbef()re: ,~_---t;2{~~~
SetHeJllL'llt to be 01\ -L _ ~, ~ ~tJiJ 3. . ' or before if Buyer and Seller agree.
ConvcyulJt:efmm Seller','ill be by fet' silllple dct"d of special \.varra nty Ullless otherwise stated here:
tel
(D'I
I,E)
,ii
IF) Payment uf transfer taxes will b.: divided el'Jually between Buyer and Seller unless utherwise staled hele:
"
(G) At time of s.:ltkment, the luUowing .....i1l be ,uljllsted pro-wta on a daily ba,is between Huyer and Seller, reimbursing where applicable: taxes ,,'
(se..lltformation Reganljng Tax Proration); rents; inlert'st un muflgagt' as,umptions; <:ondominium kes and homeowner assoch\ti\-'I\ fees, if
ally; watn ~I1lJJQr sew"r ft'es, if any, together \\'ith any ot[1er IiclHthle municipal service, The o:;harges arc to be pro-rated for the peliod(s)
wvned: Sella will PL1) up to and induding: tht' date (11' seulement: BU~ier will pay For all days following M.'tllemenl. unless otherwise slated 'j;)
ller..:: _.._____~___,______,.~~______~__
ill
4. FIXTURf,S & ()E\tSONAL \'ROPI<:Rl'Y (1.00)
(A) ,INCLUDED in this ,al.. tlnd pun:hllse price arc an existing itelm permanently installed in the Propeny, free of liens, induding plumbillg;
healing; lighling li,t1ll'es lincluding chandeliers ane! cdiing fansl; watel' treatm,:,lt s'ys\i:}n\>; pl.ml and :-;pa equipment; garage duor openers
and lrUllslIlitters; ldevisillll antennas: shruhl.Jcr)', plamings and [Inpotted trees; any remaining heating and cooking fueb stored on the
Propcn)i al lhe tillle 01 seLlJement; walllu waU ,arpeting; wimluw covering h;ordwarc, shades and blinds; built.in air couditiollers', built-in
uppliances;anJthcrang<,iovcnunle"sotherwiseswtcd,Alsoinduded:._.~
Ill) LEASED item., (not owned by Seller):
lC) EXCLUDED fiJ\.tu\'e~ awJ ilem~: ~_'
,"
5. DATESrnl\lE IS OF THE ESSENCE (1~02)
"1 (A) The said dalt' for selllemelll and all other dates and times r..rerred to fur the ped<>nllanee of <IllY or the obligations of Ibis Agreement are
agreed 10 bc ('f the ,",sene.:: of this Agreement and are binding.
(8) For [he l'Ulposes of this Agre"m"Il1, number of days will I'll." counted frolll the date 01 e;>;cO:;Ulioll, by excluding the Jay this Agreemem was
exe~'uted and ittdnding (he last day of lhe time period,
(Ci TIle date '-'{ "clt\ement \~ IK't e:\1endcd h) ally other provisiun uf this Agreement and may ollly be extended by mutual wriU<'1l agreement 01
I.hcpartks.
(Dl ("enain (im.. periods are plc-prinkd in this Agreement as a CUllVell1<:n<:e to tile lluyer (lnd Selley, All,:! pII':'prilitcd lime periods He ncgPtlab\e
ill1d Hlay be ch~nged hy slriking out the pre-primed text and insening ~ different time period acceptable to all parties
Ruyerlnitlals: -~Jl-'b_------ A/S.2K Pug..l ors Seller InitiHIs:~L
m Pennsylvania A.soclatlon of COP"RlGHT P~:NNSYLVANlAAS.sOCIATlON OFRK-\LTORSOXl tOOl.
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10 If lluvcl js l",i ."tllslled \.\'ith the (ouJitiu]j of tht' Property as stated in any writren I~J"'!!, Lillyer will:
o Ollti(;nl, \Vithin the time gh'ell for completing Inspections:
I An'cpl the Propelty with the infommtion staled ill the repor1(s) and ag,ee to the RELEASE set forth in paragraph 25 of this Agreemem, OR
2 TCn11inate this Agreement in writing by notice to Seller, in which case all deposit monies paid on account of purchase price will be returned
pWlllptly to Buyer ..od this Agrcllment will be VOID, OR
3. Enler into a mutu1llly acceptable wrillen agreemelll with Seller providing for any repairs or improvement,; to the Propelty allJ/or any credit
tv Buyer at senlement, as may be m:ceptahlc to the mortgage lend~r, if auy.
Sllould efforls to rcach a lllUtulllly al:ceptable agreemenl fail, BuYt'r mu,;t choose to H<':l:epllhe Pmpeny or tenllinute lhisAgn:emenl within
the timl' ghen for I'ompleting inspections and according to the pro\'isioll~ in paragraph S(e) (Option 1) I and :!.
o Optiun 2, Within the time given for completing inspections:
1 Al:CepL the I'ropcrty with the, informalion slilted in the report(s) and agree to the RELEASE set fOl1h in paragraph 25 of this Agreement,
UNLESS the towl ,;;()~tlo l:Orred the l:ondilions l:untained in the repurt(s) is more thilll $
2, If the lotal cost to corl'cel the conditions contained in the repOlt(s) EXCEEDS the amount specified ill paragraph S(eJ (Option 2) I,
Buyer will deliver the reportls) tu Seller wlthinlhe time ~hen fur inspectiun,
11 Seller will, within _.....1......... DAYS ofrcl:eiving lhe repottis), inform Buyer in wriling of Seller's chui~e to:
ill Makc repairs before scnlemclll so that the remaining wst 10 repair conditillns conmined in the repon(s) is less lhan or eyual to
the amount specified in paragraph 8 tCl (Option 2) 1.
(2) Credit Huyer at settlemeut for the difference between the eSlimmcd cost of repairing the l:omlitions contained in the report(s)
and the amoulll speciJicd in paragraph Il (el (Option 2) I. 'nlis option must be uCl.:cptablc to the lllongage lender, ifuny,
0) Not lIlilke repairs and notl:redil Bu}'er al ~eltlement for any costs 10 repair conditions contained in thll reportls).
h. lf ScJll~r chooses 10 mak.r repain; or l:fedit.Buyer at settlement as spe<.;iticd in paragraph 8 (e) (Option 2) 2, Buyer will accept the
Properly :md agree to Ihe RELEASE set forth in paragraph :!5 of this Agreement.
If Seller choos~s not to make repairs and not to trcdit Buyer al scalement, or if Seller fails to choose any uplion within the tillle
given, Buyer will, within ~ DAYS:
tll Accept the Property with the infomlatioll stated in the repun(s) and agree 10 the RELEASE set forth in paragraph 25 of this
Agreement, OR
(2) Teffilinatc tltis Agreement in writing by notke tll Seller, in which case all deposit monies paid on account of pun;ha~e price will
be relurncd promptly to Buyer and this Agreement will he vom.
I), ~lD IN.'ESTA nON INSP.:CTlON CONTINGENCY (1-02)
,;x.. WAIVED. BUyertlnderslands that Buyer has the option to reqtiest that the Property be inspected for wood infestation by a ccnified Pest Control
Operator. BUYER WAIVES THIS OPTION and agrecs 10 lhe RELEASE set forth in paragraph 25 of thiS Agreement
o ELECTED
(A) Wilhin_ DAYS (15 days ifnut speti1ied) of the execution of this Agreement, Buyer, at Buyer's expense, will obtain a written "Wood-
Destroying Iust'ct Infestation lnspectioll Report" froill a tertified Pest Control Operator and will deliver it and an supporting documents and
drawing~ provided by the Pest Control Operator to Seller. The report is to be made satisfactory to and in compliance with applicable laws, murt-
gugc lenders, and/or Federal Insuring and Guaranteeing Agency requirement~, if any_ The inspection will inelude all readily visible and
accessihle areas of all stI1ll:1ures on thll Property eXl:epl tl1C following structures, which will not be inspected:
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10) If lhe inspel'ljoll reveals ,~vidcnce of ilctive infe..,tatiun(s), Seller agrees, at Seller's expen:;e and before selllement, to treat for attive infesta-
tion(s), in accordan..:e with appHcable la\>"s
(C) Jfthe impcctioll reveals damuge frpl!l <lctil'einfestalion(s) or previuus infestation(s). Uuyer, at Buyer's expense, has the option to ohtain a writ-
ten report hy a profession:.lI contractor, home inspection seryice, or stmctural engineer that i,; limited to stmctural damage to lhe Property caused
by wood.destruying organisms and a propos;!.1 to repair the damage. Buyer will deliver the structural damage report and corrcttive proposal tn
Seller wilhin _1.__ DAYS of Jdhering the original inspeClion report.
(Dl \Vithin _~__ DAYS of fCl:eiring the i>lrlll'turill damage report and correttive proposal, Seller will advise Buyer whether Se'llcr will repair, at
Seller's expense and befurc senlemelll. any structural damage fmm a(;llve or previous inrc~tatiun(s).
(F) [f Seller chouscs tll rep<lir structural dmnuge reveakd hy the report, Buyer agrees to actept the Property a~ repaired und agrees \() the RELEASE
sel forth in paragraph 15 ,)flhisAgretlllenl.
(F) If Sclkr chooses nOl to repair slntetural dalllilgc revealed hy the report or fails tu respund withinlhe lime given, Buyer, within -----1._ DAYS,
will notily Seller in writing of Buyer's choice to:
I. Accept the Pl'llpcrty with the ddeclS revealed by the inspet.tion, without ahatemcnt of pricc, aud agree tD the RELEASE set forth in pilra-
gmph 25 Ilfthis Agreement, OR
Make Ihe repairs before sculemenl. if required by the mortgage lender, if any, al Buyer's expense and wilh Seller',; permissiun, which will
not bc 1l1ll'l'[Isonabl} withheld, in which case Buyer accepts the Property and agree, to lite RELEASE set forth in paragmplt 25 of this
Agreemellt. If Seller denies Buyer permission to make the repairs, Buyer may, within ~ DAYS of Seller's denial, tenninate this
Agreemenl in writing, in whith l:ase all deposit mouics paid on ~tcoulltuf purchase prite will be returned promptly to Buyer and this
Agreel1lt]]t will he YOID, OR
3. Terminat," this Agreemenl, in which case aU dllPOsi\ monies paid on accolllllnf pUKhase pri,'e will hl~ returned promptly to Buyer and
this Agreement will be YOID.
Ill. RESIDENTIAL I"E..\I>-lIASEH I)AINT HAZARD REUl1CTlON ACT NOTICE REQUIRED FOR I'ROPERTlES
Bl.j.lJ..T IJEHJRE 1971'1 (1-02)
)I!;( NOT APPLlCABLE
o APPLICABLE
(I\l Seller rcpre~enls thlll Sdler has nil knowledge concerning thc'TIl'esente of lead-based paint and/or lead-based paint hazards in Ill' ahOlIl the
Property, unlcssche.:ked below.
o Seller has knolYJ..'dge of the presl~nle of leotd-based paint and/or Iead.based puint hazards in Dr about the Property. (Provide the basis for
dNnmining lhut lead-based paint andllJl" hazards exi,;l, the 10cation(Sl, lhe condition of (he painted surfaces, and other availahlc infonnu"
lion cOllceJT\illg Selkr's knowledge of lhe presence of lead-based paint and/or lead-based paint hazards.)
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l{eell;:d;JR;p;;~;-Scll.;-i~-~p(lrts or ;:;;;'::;11S Pertaining to leaJ-hased pail]l ~;;lV{)r leact::h;;ed paint hazards in or ahout th~-P~operty,
unless chetkcd below.
o Seller has provided Buyer with ill! availahle records and reports pertuilling to lead-based paint antUm lead-based paint hazards in or ahou!
the Property. (Listdoclllllentsl
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Hu)'er's Al"knowledgemcnt: Buycr ha~ received the pamphlet Pro[f('1 YtJl/r F(lmilyf;"Ol1l Lead ill }flUr Home and has read the Lcad-'Vaming
Slulell1ellt c,olltained in thlS Agreement (see Environlllelllal Nnlil:e~1. Buyer has reviewcd Seller's disdosnrc uf knownlead-huscd paint amUur
lcad-basl'd paint hazards, as identified in paragraph IOtA) llnd has received the records and reports'pertaining to lead-based paint and/or leau-
based paim hazards idelltHkd in paragruph 10(13). .
UU.H'r'slnitlals __'~~_~__"_~._ Date
RISK ASSESS1I.IENT/JNSI'ECTlON: Buyer acknowledges that before Buyer is obligutcd to buy a residenlJ::l dwelling built heforll t971l, Buyer
has __JL D.i\YS to conduct <l ri~k assessmenl or inspel:tion ufthe Property for the Jlre~em:e of lead-hused paint and/or lead-based p:lltlt haJ.l\rds
\VAIVf~D. Buyer llllllerslands lhat Buyer hllS lhe right to cOndUl'tll risk assessment (]r impcttion of lhe Property 10 deleJT\linc the presence of
k:lll-hascJ paint am_Uor lead-bused paiul haz.u'ds BUYER WAIVES THIS RIGHT and agrees to the RELEASE set forth in puragraph 15 of
thJ,~Agn'cment
o El.ECnm
I Bllyer, at FllIyer"s expcllso:, chouses to ohtain a risk ussessmenl alldJor inspedion of the Property for lead.hased paint and/or leud-based
. . paint ha/ar~ The, Ii,k u.~se~~ment andJllJ" inspection wil: bL" completed wilhin .---liL DAYS of the execution of rllisjg11~flll
Iluyerlmhats:__ ~V--_'_--- AlS-2K Pal::e.' uf8 Sellerlnitiuls: -J,.=--A~-,~--~-
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Ie) ill till' CWnl <IllY notices (including viu!<llions) and assessments are received after exeCLlliull uf this Agreement and before seUlement, Seller will
notify Buy.:r in writing, \I.'ithin _,1_ DAYS of receiving the lJotice or usscssmelll, that Seller will:
1 Comply with nO!ice~ and assessments at Seller's expt'nse, in which ('a~e Buyer a..:cepts the Property and agrees to the RELEASE set forth
in paragraph 15 uf litis Agreement, OR
2. Not comply with nOli{;e~ and assessments llt Seller's e.\peme.
If Sclb' ChllUSCS lIot to comply with notk~s [U)(l assessnu:nts, or fails wilhin Ill; time given to notify BUyel" If Seller wiu compl)', Buyer
will nulity Sellcr within _:5__ DAYS in wliling that Buyer will either
<l COlllply with notices amJ <lssessments <It Buyer's expense and i'lgreL' to the RELEASE set funh in paragraph 25 of this Agrremt'nt. OR
b Tenuillute this Agreement, iu v,'hich case all deposit monies paid U11 account of purchase price will be returned promptly 10 Buyer
am! this Agreement will be YOlO.
If Buyer fails to lIolify Sl.'lIer withint!tc lime given, IJllyer accepts the Property and agrft's to the REl.EASE set forth iu para-
grnph 25 of this Agreement.
(0) . ~Uyel.' ~ rnxl tl.lat ac('cs.s to a public road Illay t',,'quire issu~net' of a highway olxupancy pen1lit from the Depa~mellt ~'ransp<}r ation.
_11'1 HU}'erIIIIIH1ls;__r~_{L______ AIS.2KI'age50fS SellerlnilJab:~'
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Scikr ~gw,-,\ (L-' luuie' ~".J p!ovidG iln'c',,, I., Ill", un-sil\.' (or illdividlWn wulo:r syst<.'l11, ifapplicilhk, ~l Selle-r', f_'IW,llst', if lC'.jUlt't.U hy lhe',
iU"l'ec.tioll n'lllpCIl1)', Sdkl'a!sll agrees to rc"itllle the l'rop-t:'l1y, ;It ~elJer's expen,e. prior tll .<,dtletnenL
:'. HIli\.' repurl rcve<ll~ thai the watn .,,'rvi<.:c doe, not meet the minimum standard, of un)' upplicabl;: governmelltal umhLllily ;md/oc filii, to
salhfy ll1e le<juiremenh fur 'juality audioI' qualltity ,cl hy the lllol1g;\ge kmler, it un)'. thell SeJkr will, within-----.L.....- DAYS of rc'-'eipl of
th;: repon, notify Buyer in writing uf Seller's choke 10:
<I. Upgrade the wat;:r senice to the minimum a,'cep(ilble lexch, before settlement, in whieh case Buyer aCl:epts llle Property and .lgrec....
to the RELEASE set furth in paragraph 25 of lllis Agreement, OR
b. Nut upgratle tht: w'-llt:lservil:t:.
4. If Seller dluclSC~ llUt to upgrildc: the service to minimum ucc~ptablc le\'el~, ur r"ils to respund within the time ghen, Buyer will, within
_.....1.___ DAYS, eith~r:
At'l'cpt th~ I'wperty and the water service <llld, ifrequired by the mUJ1gage lender, if any, amI/or any governmental authority, upgrade
tlw wilter servin: berme settlement or within the time rel.jllircd by the mongagc lender. if uny. mlll/ur all)' govemmentill aUJhority. at
Buyer's cxpense Ulld with Seller's pcrmhsioll. which will nut be unreasonably withheld, and agree to the I<ELEASEsel forth in para-
graph 25 of this Agreem~nt. If Seller dcnies Buyer penni~siun 10 upgrade the w(I\er service, Buyer may, within~ DAYS of
Scller-'s dellial, terminate Ihi~ Agreement in writing, ill which case all deposit monies paid on UCCOllO( of purchase price will he
returned promptly to Duyer and this Agreement ....'i11 be YOID, OR
b. Ti:rminate this Agreement in writing, in wliich case all deposit monies p;tid on account of purchase price will be relumed prompdy
to Buyn and this Agrecment will be YOID.
STATUS 0.1<' SEWER (1~02,
(A) _ ~~epresents Ihat the Property is served hy:
~ PuNk :')ewer
o ImJivitllml On-Iut SI:wage Disposal System (See Sewage Nutice 1)
o Individll,lI On-lot SI:wage Disposal Systt:lll in Proximity to Wdl (See Sewage Notice I: see Sewage Notice 4, if applicable)
o Community Sewag(~ Dispmal System
o Tcn-ai:re Pennil Exemplion (See Sewage Noticc 2)
o Holding Tank (See -Sewage Notice 3)
o NOlie (See Sewage N"til:c 1 )
o NOlle A\'ailable/Pennit Limitations ill Effect (See Sewage, Notice 5)
o __~._._.____
(8) INDlVllJlJAL ON-LOT SEWAGE IllSI'OSAL lNSPECnUN CONTINGENCY
o WAIVED, Buyer ackllolVledge~ that Buyer has thc option to request an individual on-lot sewage disposal inspection of tile Propel1y, BUYER
WAIVES Tl-llS Ol~nON and agrees to the RELEASE set forth in paragraph 25 of this Agreement.
o ELECTED
I, Buyer hus tht: oplicH, within ~ DAYS (15 days if not specified) of the t:xccutlilll of this Agreement aud at Buyer's expense, to
deliver tll Seller a wl111en inspectiolJ rep0l1 by a yualified, professional inspector of the individual oll-lot sewage disposal system.
2. Sdkr. at Sclkr's exreme, agre;:s, if ami as required by the inspection CDmpan)', tn locate, pl'Uvide access to and empty the individual on,
lul sewage disposal ~yslem, Sdlt:r also agrees 10 restore the Propeny, at Seller's expense, prior to settlement.
If the report reveal:; defects that do nol rC4uire e.\pansion or replacement of the existing sewage disposal system, Seller will, within
------!"--., DAY~ 01 receipt of the report, nutify Buyer ill writing of Seller's choice tf!'
a, COITe!.'t the dereclS beforc sellh:ment, including retests, al Seller's ;:xpt:nse', in which l'ase Buyer accepts the Property and agn:e~ to
tll<:" RELliASE set fm1h ill paragraph 25'ofthisAgreement, OR
b NOletllTCcltllt'def.'ct,
4 If S"ller ch"o,e's not tn ('('rrec'l the defect,. 01 if Sdler fails to r"'~pond within the time given, Buyer will, within ~ DAYS, either:
Atxept Ule Prppert)' i.llld the system and, if required by the- mortgage lender, if any, and/or any governmental auth(lrity, correct Ute
tierccts befllre settlement or within the time required by the m0l1gage lemkr, iLmy, and/or any governmental amhorily. at Buyer's
sole expense alld with Seller'~ permission, which will not be unrea~onably I-vithheld, and agree to the RELEASE set forth in para"
graph 25 of this Agreement. If Seller denies Buyer pcrmissiol1lO correct the defects, Buyer mllY, wilhin ---1....... DAYS 01 Seller's
deni,!!, t('mUll"tc t!!is Agre'emel1t in writing, in which case all deposit Jllonies paid on account of purchase price will be (('!LImed
promptly to Buyer und this Agreement will be YOID, OR
h. Terminme this Agreement in writing, in which case all LIe-posit mOllics paid Oll account of purchase price- will be- relullled
promplly to Buyer and this Agreement will be VOID.
If the report reVt'uls the need to expund or repla('e the existing individual on,lot sewage disposal system, Seller may, within _~ DAYS
of receipt of the rep'J(1, submil a mrre('live proposal to Buyer. lbe corrective proposal will include. but not be limited 10. lhe name of the
rell1edi~lion company; Jlro~isions for payment, including retests; and a pmjected completion dale far con'ective measures. Wilhin
----.i__IJA).S of receiving Seller's C\lIu:ctiw proposal. or i~ no con'eclh;e proposal is l1.'Ceived within the time given, Buyer will:
a. AgrCt' 10 the tenus of the eorrel'li ve proposal, if any, in writing, in which case Buyer accepts the Pwperty and agrees to the RELEASE
set follh in paragfllph 25 of this Agre<.:ment, OR
b. Accept the Property and the system and, if reqnired by the mot1gage lender. if any, and/or any governmental ilUlhorilY, cotTectthe
(leieers befure seulemelll or within the time reyuired 1>y the mortgag~ lender, if any. anti/or [tny govet'ntllental authority, at Buyer's
so!c expense and with Selkr's pcrmissiun, which will not be unrea.,onably withheld, and agree to lhe RELEASE sel fm1lt in p~ra.
graph 25 of this A!--'TeCmCllI. If Seller denies Buyer pemlission to coueclthe defects, Buyer may, within ~ DAYS of Seller's
denial, terminate this Agreement in writing, ill which case all <.Iepositmrmic:s paid on a;;count of purchase price will be rrtllInrd
prumptly to Buyer antlthis Agreement will be YOID. OR
c Terminale this Agreement ill writing, in which case all depositlllonies paid on aCl'ount uf purchllse price will be retumed pl'l1mptly
to Buyer and this Agreement will be YOID. .
NOTICES, ASSESSJ\1ENTS & CI~RTlF(CATES OF OCCUPANCY (1-02)
(Al Seller repre"enlS, <1S of SeHer's execution of this Agreemenl, that no public improvement, cundOlnillium or homeowner association assessll1ent~
llIne been milde against Ihe Property which remain unpaid. ant! that no notice by any gove11lment or public authority has been served upou
Seller or anyone on Seller'" bdmlf, indudiug nutices rclating to viulations or LOlling. housing, building, safety or lire urdinan('es which remain
IllKlllTeeted, llmlthut Sellcr l\l~of no conditio J hat would constitute violation of allY such ordinances which remains uncom:cted, unless
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(B) Seller knuws of no other potential notices (including violations', and asseSSlllcnts except as follows:
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THi );OU,OWIMi .-\I'PLlES TO PRIWt<:UnES THAT ARE )'Alfl 01: A l'Oi"i})o"HNIUM un A I'LANNEl> CO'li\lU!'il ry.
(Ai Within ~~ DAYS 01 Ihe eXeCllli(lD uf this A&reement, Seller will ~ubmit a IC4t1~st 10 the assOI.:iatiull lor u Certificul~ uf Resale alld the duc-
ument" 1H~ee~~ary to cnutJlc SellGr to comply with Ibe Act. The Act pro~ides [LWI the a~sociati(m is \'cq~tired to pnwidc thc&e d\l(ul\vmts within
JO da,'s vi' Seller's reqUc~l.
1131 S.::lkr' will promptly deliver (u Buyn all dO(;Umtlits rw:ived hUll' I]l(: l.lss0ciation. Uflucllhe Act, Selkr is nol Iiahle to Buyer f(1rthe failure of
dclay oj' lh~ aSMlcl.llioll[C' provide the Cel1Jfi:alc III a timely manlier, Dur IS Sellct halllc wl:luycr tor allY emmeous informutj(lll pnlvlJcd oy
the assudulion anJ indud~d in Ihe Cel1ifkalc.
lei Buyer may lkclal'e this A~reell\ent VOtD at lllW time ttdure BlJyer\ lCl,;cipt lit th.;: \\~soci\\tiQll '.\oculnents alK\ tcr 5 uays therc"ftcr, OR umil
,dtlcfllent, whidJ('yer o..:.:ur,,, first. Buyer's notjce ded<lring rhi~ AgreemenT void mllst be in writing; thereafter all dep<)~il monies willlJe
n:tllrnedIII Bllyer.
\DI lJlthe event tll; a,sudation ha:; the right tl) buy the Property (right of fiN refusal), llnd the association cxerdse5 that right, Seller wiD reimburse
BUln for all monics paid by Buyer ou a~rllunt nfpurchase price and for any costs incurred by Buyer for: (1) Title search, title insurance and/or
n\c~hanic, lie,n illsuran<:e, (11.' fee for <:\mcdlatiuu of same, if i'.ny; (2) F100d insurance ',md/or fwe illsutanCe wilh extended CO'ieIllge, mine sub-
sidence insurance, or fee for call1.:dlatioll of same, if any; (3) Appraisal fees ~nd charges paid in advance to mongage knder, jf any,
23. ~1AINTENANCE & RISK OF LOSS (1.02)
C'\) Seller willmailltaill the Pwpeny, grounds, fixtures, ~md any personal propeny specilkally scheduled hcreiu in its present condition, norma!
",ear and karexcepled.
(8) III th\' e\"~l1.\ any ~y:',h:m Of "'Pllh,Ill\.:e incluued ili the ~a\e ol"tI)C Pmpeny faih and Seller does nOI repair or replace the item, Se11er will promptly
notify Buyer in writing of Seller's rlmice to:
1 Repair or replace the failed system or appliance before settlement or credit Buyer al sell!cment for the fail' market value of the failed sy~-
tem iJI appliance (thi> option must be acceptable to the mortgage lender, if anYI. In each case, Buyer accepts the Property and agrees to
the RELEASE set fo:'th in p~ragraph 25 of tbis Agreement, OR
Nll\ lepair or replace the 1"ill.\ed s)'slem or applIance, and not ere-dit Buyer at settlement for the fair market value of the failed sy~tem or
appliance. If Seller d(.'es nl\{ repair, replace or oller a credit for lhe failed system or appliance, or if Seller fails to lIotif)' Hu)"er IIf Seller's
dwice, Buyer wi1! notify Scl1er in wtiting wilhin ~ DAYS or before sculement, whichever is sooner, that Buyer will:
a. Accept the Property ~U1d agree to the RELEASE set fOlth in paragraph 25 of this AgreemeOl, OR
h. Tennillate this Agreement, in which case all deposit monies paid on account of purchase pri<:.:e will be retumeJ promplly to Buyer
<lm\ lh\.s ApCl:lllcnt 'sill be YOlD.
tel Sdler will hcw' risk uf losf, frolll /'ire l1r other casualties until time of ~elt1cment. In the event of damage by fire or other casualties to <lny prop-
erty induded in lhis sale that is not repaired or replaced {lrior to settlement, Buyer will have the option of rcsciwii\\g this Agl"celnen\ <lIIU
promptly receiving all lIltmies paid on account of purchase pdcc or of accepting the Propelty in its then condition together with the proceed~
(If any iusurance recovery obtainable hy Seller. Buyer is herehy notified that Buyer may insure Buyer's equitahle intel"\~sl in this Propeny (\, of
\he \\me \)f cxeculi'>n of tl1is Agreement
2..t WAl"ER Of'CONTINGENClES (1.02)
If thi:; A);reePKtIl is i.:ontingellt on BUYCj'5 tight to in.\pen ilnd/or repair the Pl"Operty, nUler'!; failure hI ~~et'Ci,!>e IUly u1'lh\)cr's options wit\}in
th~ time limits set forth in Ulis Agn-ement will COllJ;litute a WAIVER of tb~1 cUl~lillgencr.alltt Buyer Ilccepts lbe Propert)' and o~rees tn the
RELEASE scl forth in parograph 25 uf this Agn.'~llIellt.
25, llELf~Mm (1.02)
Ilu~-cr Ill'nb} l"clea~e.\i, <JuU c1aim~ ami fun'\'el' disdmrges SELLER, ALL BROKERS, their LICI~NSEES, EI\1PLO\~EI<:S, and all)' OFfI.
CER nr PARTNUt uf an) om~ of them and auy othel'l'f;RSON, FIR1\I, OJr COm'ORATION wbo ma) \It liable by or thrllugh them, frllm
llll~ anil ull dililllS, losses or demand8, induding, lJut not limited to. persnm\; injuries and property damage and all of the COllsequl'llces therl'.
of, whether n('W tnllwlI or 1I01. which m8~' lidsI' from the pres~ll(:r of termites or otber IHlod.boring inseds, radon. le8d.bll.~ed paint 11l1Z.
.\f(\~, en"iWllllll'lItul halnrd~, an.' ddcc~ III tile indhidlllll nn.lot srwage disposal system (\1' deficiende~ ill lhl" Oil-sill' water scniee system,
(lJ' UIIJ deCeds O[ n/lldiliullS on the PropeI1). ,should Sellt'r be in default uuder lhe terms .,r this Al!reemt"lt, this rdellse does not deprhe
Buyer of lln~' right to pursue lIoy n'uredies th.at urn)' be tnl\Uahlt' urn.kr h\w \w equi1y. This release wi\! sllnhe settlement.
26, REPRESEN1~\TlONS (1-02)
1.\) Buyn lItHla~;(allds Ilul ~ny n:pl'cselltaliom;, c1ajJl]_~, advertising, prol)]\lliolla] al'tivitic~, bl'Ochure, ur plan, of allY kind maue by Seller. Brokers.
their lkensel'" empJ'I}ec.s, (ljTkers. or pllrtners an~ nnt a pill1 of this Agreement unkss l'\pressl} incorporaled or stated in thi:i A~rcflllenl. It is
funh..:r unti":lsl",,,j thaI tlii, A~reelllt'nt (oiHaim tlu~ whole agr~ellleJlI hetl,'cen Seller and Buyer and there arc no other (enm. nbii!l<ltiol1s,
Clwt'llant.', n'ptesentation~. S(<\tnn('nt~ (lr ((mditi\\l\~, mal q; ulhe1>\'be of any ',;.iut'. whal!'.oev<:r concemlng Ihis sale. Furthermore, thi'
'\.l:'ll'<'Jl1e!ll \'.'ilI nul lie' alt~red, al1lt'tldcd, dmngcd. or JIludified except in writing executed hy the partie,.
IB I Jt i.~ ll11r'lerstnud Ihal HU}er has inspected the l'mperl)" herm!! signillg this AgTt'elllent (im:luding fixture.s alld an}' pl'rsonaIIJropel.t~
J;pedficullJ Sl:bedull'd herein). or IIlIS waived Ihe right II) do so, and has agreed to purchasl' the Propert}' in it.. present cimditiulIlluless
utlu~n,-jM~ stilII'd ill this Agreement. 811}er llcknowledges thai Brokers, Iheil' llt.:cnst't'S. employees, ofiit"ers or partners ha~'t' nol mildI'
au trute\ll'lldt'nt eJ;ll.minatiun o:w d~t\:rmil1\l;t\"1\ 1){ tll\' ll\ruttI\Ta\ soundness IIi the PI.Opcrt)", tbe age or conclltiuu of the compOnl'uts, en\'i.
runmenta! Cfluditiol1s, thE permitted uses, or of conditions existing in the locale when' the I'mperty is situated; nor have tbey made a
meehanital illspel:tion nf any of the systems contained therdn.
10 All)' I'Cpail~ required hy this AgreL'lllent will be completed ill a workmanlike manller
11)) Brol.."lt~i m~y pt'rfe>rtll ~ervices to a_s,isl unrepresenteJ partie~ ill complying \\jlh tlie lenns of thi~ AgreemO'"nt.
iE\ The h\."adll\~~. cal'ti(;l',l;. ;md hoe tlllmbeTs in l\lis Agreement ~U"e lll.;'ant only to make it easl.;'r to find the paragraphs
27. DEFAUI.:r (1-02)
(,YI Seller has the nption of lelaining Ill! SUIllS paid hI Buyer, including the deposit mOllics, ShOlM Buyer:
J. F;;il to m;;kc any additional payments as specified in pllragraph 3; OR
2, hUllish fab,' or incomplete inform;Jtion to Seller, Brok.er(s), or the 1ll0Jtgage lender, if any, conceming Buyel'"s legal or fimulcial stalu"
\'1' f;ul tt, Cl'\:rpeT<Jte in'lllC pTlJt:essing of lhe mortgage loan applkation. which act5 would re5ult in the failure to obt~in the approval of a
mllrtgage lo,m t:ommitmlO'nt; OR
<. Vi~llate or fail to l'ulfi11 WId (!erlorm any other tenn~ or cowlitioth of this Agrec\l\enl.
(ll) UI1I~ss otherwise dlefked in paragraph 27 (Cl, Seller may c1ed to retain those sums paid hy Buyer, inclllding deposit monies, in one of the
klllowingnHlnners:
I. Onacl'Ollntofpurchaserrice;OR
2. A" monies to be applit'd to Seller's danUlges; OR
:~. As liquidated danlag{~s for such hreach
(el ~ SeHer is limited to rewining sums paid by Buyer, including deposit mouies. as liquidated damages.
(D) If Seller r.'tilins illl sums paid by Buyer, including deposit monies, as liquidated damages pursuanllo parab'Taph 27 (B) or (C!. Buyer and Seller
will he released fWlII 6mhtr liabilily or ol1hgation and this Agreement wi1J be VOID.
'" 28. MEDIATION (7-96)
o NOT AVAilABLE
o WAIVED. Hu)'el and Seller Ullder~tand that rhey may choose to mediate at a latn date. sh,)[lld a dispute arise, but that there wjll be tlo ubli.
_._. ..,gmion on the part ,)1' any patty 10 do ~o.
~ ELE<-':TED
IA) Buyer ;md Sclln will try to resotve ailY di~pute or c1llim tJliltmay adse from this Agreement through medialion, in accordance with the Rules
and Pwt:edure, of the Home Sellers/Home Buyers Dispute Res(llmion SystellL Any <>.gr<:ement rc;!Ched t\w\}u~h a mediatitm confen:nce uud
signed hy tile pat1ie, will behinJing.
(3) Huyer lind Seller adlltl\\'bJge that they hilve receiled, l'eild.. and understaud the Rules an.:l Procedures of Ill(' lIome SdlersfHomc Buvcrs
lbrute Rt~.';n\Jltinn S)'~\em (sre Mediation No\it:e'J .
(e1 fins agreement lumedtatt' dt~putes at1smg Inlm tl1lSAgleelllent Will SUlll\e settlement
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29. SPECIAL CLAUSES (1-02)
(A) The following are part of Ihis Agr~ment If checked:
o Salt: & Settlement of Other PropertY
Contingency Addendum (PAR Form SSP)
o Sale & SettlementorOthe! rmperty Contingency
with Right to Continue Marketing Addendum
(PAR FonD SSp-eMI
o Settlement or Other Property Contingency Addendum (PAR Fonn SOP)
o Tenan1.0ccupied Property Addendum (PAR Fonn TOP)
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(B)
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8t1)'cr Ilnd Seller acknowledge rt'{'eiving a copy of this Agreement at the time of signing.
iii)!; NOTICE TO PARTIES: WHEN SIGNED, THIS AGREEMENT IS A MINDING CONTRACT, Return by facsimile Iran~misslon (FAX) of this
1,'i6 Ag!'l~enlellt, and aIL addenda, bearing Ute signatunslJf aU parties., ~0l\stitute:; acceptance OfUlis i\gr~ment. Parties tuthis transaction aTe advised
bill to corumlt 811 altlJrney before signing if they desire legal advice.
I;il,j
bilg ~ Buyer has rt"ccived the Consumer Notice as adopted by the State Real Estate COUlmission at 49 Pa. Code ~35.336.
H i{1 K Buyer has received a statement of Buyer'S estimated closing costs beflJre signing this Agreement.
;i (I ~ Uuyer tIllS read and unlli'rstands the uotices and explanatory infurmation s.et forth in this Agrttffitllt.
i.ll' ~ Buyer has received a Seller's Propcrt.y Disclosurt" Statement before signing this Agreement, if required by la\\' (see Information Regarding
j,I:, the Real Estate Seller Disclosure Law).
!,H 'R Buyer ha.~ l'c('t'i\'l~d the Deposit ,MOlley Notice (for eoopcratiH sales \\'hen UrokCf for Seller is holding deposit mone)') before signing (his
il" Agreement.
Ml}
I.!'! Bl'YER'S MAILING ADIJRESS:
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'''' BUYER'S CONTACT NlJMBER,";;--7/7 - 737 -~'/. _ /
;,,~"! WITNEss~_-r- BUYER --,~~,----,---
'j;'~ SS#
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DAT,,~3
DATE_~
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BUYER
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BUYER
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Lih SeHer hel-e\,y llpproves 1111' abow Cllnlruct IlllS (datei
'11 <lnd in consjde,~lioll of l11e services remlrred in procuring the Buyer, Seller agrees 10 pay the named Bmker for Seller a fee of
lil, ot/from the herein specified sale plice. In Ihe evenl Buyer defijults hereunder. any monies paid on account will be divided -----,"-_
1';'-1 Seller, ~,,___,_~, Broker for Seller. but in liD event will the sum paid It) the Broker for Seller exceed the ab{)ve specified Broker's fee
1,',1,1
i'~\' 0 Sell__r has TN."ehed thc Consumer Notice as adopted by the State Real Estale COlllmission at 49 Pa. Code ~35.336,
'i)r, 0 Seller l13s rc..dnd a statement of Seller's cstilllllled df)Sinll costs bl'fore signing this Agreement
r:J.' 0 Sell!'r has read Ilnd understauds the notices and explanatory infurmation s('t forth in this Agreement.
::.:: SE[LER'SMAnJNG'\[)DRESS'_~.:;;-::~,p~~Js~ ") ----
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SELLER
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HATE
h:;ll
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Brokcr'~/Lkellsees' Cl'f"liJicatlons (cheek ail that are applicable): ~!;(
(; ,.) 0 Rl'garding Lead.Ullsed I'aint Hazards Disclusure: Required if I'roperty was buill befure 1978: The unuCTSigned Licensees involved in f:,-j
\'i,.\ thi~ trans::lrlion. Oil behalf of themselves and tllCir brokers, certify that their staWments iiJC uue 10 the best of their knuwledge and beJief. f'A
Ii,;; Ackllowh;,dg~'ment: The Licensees iilVulved in lhis transaction haw informed Seller of Seller's obligations under The Residential Lead-Based (b:i
Paint HU/.anl Redudion A;;l. 41 U,S.c. ~-1-852(d), an.d arc aware uf their rCI'.pl.111Sihili\y tll en:mre \:\lmp\i<lOl:.e. n!;i}
f;,;;',
Regarding l"lIA l\lortgages: 111e undersigned Li~cnsees involved in this tran~action, un behalf of themselves aud their brokers, cellify that
tlte terms of this COlltn.lct for pmdmse are tJue to tht:' best of their knowledge and hebef, and that allY other agreement entered into by any 01
Ihese part.i...s in c0nnc,t:tiol) with {hi, transaction is atrached to this Agreement
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Rt'garding J\flodiallon: The undersigned 0 Broker for SelIc!
pm'agraph28 of Ihis Agreement
o Br(Jker for Bllyer agree to submil to mediation illlK'(:ordance with t:'jl
6ijJ
hi' BROKER FOR SELLER (CompallJ Name)
Cjh" ACC,WTEnHY ___~_".__~_ DATE_____~,__~_
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:,n nROKERFORBU\~. :o..,>a..rN.m,' .... PO~P~_~~_ ~'_~ .
f.h'l ACCEI'TEU BY V-ftIIl_-- ",__.' __~ ~__'_ _ __ ___ nfu__3 iif.,.!,7- _..___
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CERTIFICATE OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Karla R. Lear
Date of Death: June 30, 2002
Will No. 2002-00747
TO THE REGISTER:
I certify that notice of estate administration required by
Rule 5.6(a) of the Orphans' Court Rules was serviced on or mailed
to the following beneficiary of the above-captioned estate on
August 28, 2002.
Name Address
LORI LYNN HOCKENBERRY 128 WEST PORTLAND STREET, UNIT 11,
MECHANICSBURG, PA 17055
Notice has now been given to all persons entitled thereto under
Rule 5.6(a).
Date . ~l~/O2, a~
Thomas D. Gould, Esquire
I.D. # 36508
Attorney For Lori L. Hockenberry
2 East Main Street
Shiremanstown, PA 17011
(717) 731-1461
ESTATE OF KARLA R. LEAK,
TO THE CLERK OF ORPHANS COURT:
IN THE COURT OF COIrIIrtON PLEAS
CUN~ERLAND COUNTY, PENNSYLVANIA
NO. 2002-00747 ORPHANS
WITHDRAWAL OF APPEARANCE
Please withdrawal my appearance in the above captioned matter.
Date: c}'YJ F~yP~~ .~~ ~-QJ2
~.
Thomas D. Gould, Esquire
I.D. # 36508
2 East Main Street
Shiremanstown, PA 17011
ENTRY OF APPEARANCE
Please enter my appearance in the
ptioned matter.
Date : 10!22/2002 / L `~`"
~~mes ~~ Hughes, Esquire
IRWIN kicRNIGHT ~ HIIGHES
60 W~t Pomfret Street
Ca~isle PA 17013
x'17-249-2353
(#58884)
.---
ALrI'HORIZED TO PR4CTICE L96i' N
MCVNESOTA, WISCONSIN, IOWA,
SOL"I'H DAKOTA, COLORADO,
MONTANA , NE\A' YORK
AIQD tVASHINGTON, D.C.
WRITER'S DIRECT DLAL NtiMBER
October 1, 2002
Clerk of Court
Cumberland County Courthouse
1 Courthouse Square
Carlisle, PA 17013
RE: Estate of:
Court File No:
Our Client:
Our File No.:
Dear Sir or Madam:
Messerli
Kramer
professional association
AITORNEYS .Af LAW
3405 ANNAPOLIS LANE NORTH
SGITE 300
PLYMOti TH, MINNESOTA $5447-5344
Karla Lear
21-02-747
Midland Credit Management, Inc.
02-32825-0
TELEPHONE (763) 548-7900
FACSIMILE (763) 548-7922
TOLL FREE I-800-795-4205
Enclosed herein for filing please find the Written Statement of Claim in duplicate in connection
with the above referenced estate.
Please stamp the duplicate Written Statement of Claim to acknowledge receipt and return in the
self-addressed, stamped envelope enclosed.
Should yo}~ have any questions, please do not hesitate to contact the undersigned.
.1
Y firs t ly,
e' se i & Kramer P.A.
I
~,tii 1 '
i iam .Hicks
Derrick N. Weber
Enclosure
PCIJQ2-32825-0
IMPORTANT NOTICE
THIS CO.'~ID'IL':S"ICATION IS FROM A DEBT COLLECTOR AND IS AN ATTEMPT TO COLLECT A DEBT. ANY INFORNL~TION OBTAINED WILL BE USED FOR THAT PURPOSE.
Court of Common Pleas of CUMBERLAND County
ORPHANS' COURT DIVISION
Estate of
Karla Lear, Deceased.
Notice of claim by Midland Credit Management, Inc.
filed pursuant to Section 3532(b) (2), of
the PEF Code.
To the Clerk of the Orphans' Court:
No. 21-02-747
Enter the claim of Midland Credit Management, Inc. in the amount of $1,046.75, against the above
entitled estate. The claim is unsecured.
The decedent, who resided at , 128 W Portland St Apt 11, Philadelphia, died on Unknown. Written
notice of said claim was given to Thomas D. Gould, if known to claimant, at Thomas D. Gould, Attorney
at Law, 2 East Main Street, Shiremanstown, PA,
17011 on ctob r'l, 2002.
f ~~
' t ~~
~:~i ..
Authorized Agent for Claimant
c/o Messerli & Kramer, P.A.
3405 Annapolis Lane North
Suite 300
Plymouth, MN 55447
pac.frm/02-32825-0
io-sscxE~.vso~
Derrick N. Weber, #241623
Messerli & Kramer, P.A.
3405 Annapolis Lane North
Suite 300
Plymouth, MN 55447
COURT OF COMMON PLEAS OF CUMBERLAND COUNTY
ORPHANS' COURT DIVISION
No. 21-02-747
Estate of Karla Lear, Deceased.
Notice of claim by
Midland Credit Management, Inc.
filed pursuant to Section 3532(b) (2) of the PEF Code.
William C. Hicks, #142505
Derrick N. Weber, #241623
Messerli & Kramer, P.A.
3405 Annapolis Lane North
Suite 300
Plymouth, MN 55447
763-548-7900
Court of Common Pleas of CUMBERLAND County
ORPHANS' COURT DIVISION
Estate of
Karla Lear, Deceased.
Notice of claim by Midland Credit Management, Inc.
filed pursuant to Section 3532(b) (2), of
the PEF Code.
To the Clerk of the Orphans' Court:
No. 21-02-747
Enter the claim of Midland Credit Management, Inc. in the amount of $1,046.75, against the above
entitled estate. The claim is unsecured.
The decedent, who resided at , 128 W Portland St Apt 11, Philadelphia, died on Unknown. Written
Authorized Agent for Claimant
i c% Messerli & Kramer, P.A.
3405 Annapolis Lane North
Suite 300
j Plymouth, MN 55447
William C. Hicks, #142505
Derrick N. Weber, #241623
Messerli & Kramer, P.A.
3405 Annapolis Lane North
Suite 300
Plymouth, MN 55447
pac.frm/02-32825-0
notice of said claim was given to Thomas D. Gould, if known to claimant, at Thomas D. Gould, Attorney
at Law, 2 East Main Street, Shiremanstown, PA, 17011 on tob ~ ~, 2002.
A ~~
f ~ /
iasscx~. vso~
COURT OF COMMON PLEAS OF CUMBERLAND COUNTY
ORPHANS' COURT DIVISION
No. 21-02-747
Estate of Karla Lear, Deceased.
Notice of claim by
Midland Credit Management, Inc.
filed pursuant to Section 3532(b) (2) of the PEF Code.
William C. Hicks, #142505
Derrick N. Weber, #241623
Messerli & Kramer, P.A.
3405 Annapolis Lane North
Suite 300
Plymouth, MN 55447
763-548-7900
~~
Court of Common Pleas of CUMBERLAND County
ORPHANS' COURT DIVISION
Estate of
Karla Lear, Deceased.
Notice of claim by Midland Credit Management, Inc.
filed pursuant to Section 3532(b) (2), of
the PEF Code.
To the Clerk of the Orphans' Court:
No. 21-02-747
Enter the claim of Midland Credit Management, Inc. in the amount of $1,046.75, against the above
entitled estate. The claim is unsecured.
The decedent, who resided at , 128 W Portland St Apt 11, Philadelphia, died on Unknown. Written
notice of said claim was given to Thomas D. Gould, if known to claimant, at Thomas D. Gould, Attorney
at Law, 2 East Main Street, Shiremanstown, PA,
17011 on tob r~ 1, 2002.
~~
-~
Authorized Agent for Claimant
c/o Messerli & Kramer, P.A.
3405 Annapolis Lane North
Suite 300
Plymouth, MN 55447
William C. Hicks, #142505
Derrick N. Weber, #241623
Messerli & Kramer, P.A.
3405 Annapolis Lane North
Suite 300
Plymouth, MN 55447
pac.frm/02-32825-0
io-ss~xeV.vso>
COURT OF COMMON PLEAS OF CUMBERLAND COUNTY
ORPHANS' COURT DIVISION
No. 21-02-747
Estate of Karla Lear, Deceased.
Notice of claim by
Midland Credit Management, Inc.
filed pursuant to Section 3532(b) (2) of the PEF Code.
William C. Hicks, #142505
Derrick N. Weber, #241623
Messerli & Kramer, P.A.
3405 Annapolis Lane North
Suite 300
Plymouth, MN 55447
763-548-7900
l
r
Court of Common Pleas of CUMBERLAND County
ORPHANS' COURT DIVISION
Estate of
Karla Lear, Deceased.
No. 21-02-747
Notice of claim by Midland Credit Management, Inc.
filed pursuant to Section 3532(b) (2), of
the PEF Code.
To the Clerk of the Orphans' Court:
Enter the claim of Midland Credit Management, Inc. in the amount of $1,046.75, against the above
entitled estate. The claim is unsecured.
The decedent, who resided at , 128 W Portland St Apt 11, Philadelphia, died on Unknown. Written
notice of said claim was given to Thomas D. Gould, if known to claimant, at Thomas D. Gould, Attorney
at Law, 2 East Main Street, Shiremanstown, PA,
William C. Hicks, #142505
Derrick N. Weber, #241623
Messerli & Kramer, P.A.
3405 Annapolis Lane North
Suite 300
Plymouth, MN 55447
pac.frm/02-32825-0
17011 on tob ~, 2002.
~~ ~
Authorized Agent for Claimant
clo Messerli & Kramer, P.A.
3405 Annapolis Lane North
Suite 300
Plymouth, MN 55447
io-sscx~. vso>
t
COURT OF COMMON PLEAS OF CUMBERLAND COUNTY
ORPHANS' COURT DIVISION
No. 21-02-747
Estate of Karla Lear, Deceased.
Notice of claim by
Midland Credit Management, Inc.
filed pursuant to Section 3532(b) (2) of the PEF Code.
William C. Hicks, #142505
Derrick N. Weber, #241623
Messerli & Kramer, P.A.
3405 Annapolis Lane North
Suite 300
Plymouth, MN 55447
763-548-7900
1
ESTATE OF
KARLA R LEAR
To the Clerk of the Orphans' Court:
Enter the claim of CAPITAL ONE
Acct. 5291151755592357
In the amount of $193.26 ,against the above entitled estate.
The decedent, who resided at 128 W PORTLAND ST 11 MEGHANICSBURG PA 17055
died on
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYLVANIA
06/30/2002
Deceased No. 2002-747 of 2001
Written notice of said claim was given
to LORI LYNN HOCKENBERRY ,if known to claimant, at
(Personal Representative or counsel)
128 W PORTLAND ST, MEGHANICSBURG, PA 17055 on
December 26, 2002
(Date)
I ~~
Claimant's Counsel
~~' ~.
`:
~, ` ~
(Claimant)
~.
Address: 5330 East Main Street, Suite 200
Columbus, Ohio 43213
Address
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STATE OT VTRG1NiA )
ss:
INnEPGNDTNT CITY }
LIMTI'FD PO'Wr.R OT ATTORNF,Y
Now comes Mike Stevens, a representative of Capital One,
and hereby appoints Estate luformation Services, i~~c. as its attorney-in-fact for the
purpose of executing, filing, amending, and/or withdrawing estate claims with probate
courts anti/or executors throushout the United Stales on behalf of Capital One.
Tae it known that this Limited Power of Attorney will be abolished upon the
termination of the contrachtal agreement between Estate Information Services, Inc. ant)
Capital One.
a~
DATI/D this
day of~"`b° ~ , 2001.
CAPITAL ONr
By: _ / /
Ils: Director
Printed Nagle: Michael Stevens
Sworn to an subscirbed before me this ~~ day of September, 2001, a Notary
Public in and for the State of Virginia.
otary P i
My Commission xpires: tY1C~~~ 51-~~~
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYLVANIA
ESTATE OF
KARLA R LEAR
To the Clerk of the Orphans' Court:
Enter the claim of CAPITAL ONE
Acct. 5291151755592357
In the amount of $193.26 ,against the above entitled estate.
The decedent, who resided at 128 W PORTLAND ST 11 MECHANICSBURG PA 17055
died on
06/30/2002
to LORI LYNN HOCKENBERRY
(Personal Representative or counsel)
128 W PORTLAND ST, MECHANICSBURG, PA 17055
December 26, 2002
(Date)
,if known to claimant, at
on
~.,~
(Claimant) ~ ~
_J
Address: 5330 East Main Street, Suite 200
Columbus, Ohio 43213
~1~
Claimant's Counsel
,Deceased No. 2002-747 of 2001
Written notice of said claim was given
Address
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STATE OT `fTfRG1NiA )
ss:
IN>7FPENDr,NT CITY )
LTMfTFD POWCR OT ATTORNEY
Now comes Mike Stevens, a representative of Capital One,
and hereby appoints Fstute iuformatian Services, Tnc. as its attorney-in-fact for the
purpose of executing, filing, amending, and/or withdrawing estate claims with probate
cauris and/or executors throughout the United States on behalf of Capital One.
13e it l:nawn that this Limited Power of Attorney will be abolished upon the
termination of the contractual agreement between Estate Information Services, Inc. and
Capita! One.
a~
DAT>/D tlyis
day of r~~o r , 200 ] .
CAPITAT, ONT
By:
ils: Director
Printed Nanie: Michael Slevens
Sworn to an subscirbed before methis -iC~._ day of September, 2001, a Notary
Public in and far the State of Virginia. • ,~ ~ ~/~
My Commissian'Expires: ~~f~"L 5]7.~5~
Gulf State Credit, LLC
Portfolio Support Department
P.O. Box 105460
Atlanta, Georgia 30348-5460
~~- 7i/~
Phone: 800-619-3419
Fax: 678- 417- 5075
FEBRUARY 24, 2003
KARLA LEAR
128 W PORTLAND ST APT 11
MECHANICSBURG, PA 17055-7415
STATEMENT OF ACCOUNT
Debtor's Name:
Creditor:
Account Number:
Original Creditor:
Original Account Number:
Write Off Date (Charge Off Date)
Principle Balance:
Balance Due:
Interest Rate:
KARLA LEAR
PALISADES ACQUISITION I,LLC
80113848537
MONTGOMERY WARD
80113848537
08/19/97
$3,977.64
$4848.05
17.3
This communication is from a debt collector for the purpose of resolving a dispute or to collect a debt. Any information
obtained will be used for that purpose.