Loading...
HomeMy WebLinkAbout04-16-15 REV-346 EX(03-09) 3460009101 ESTATE INFORMATION SHEET pennsylvania FOR REGISTER'S OFFICE USE ONLY DEPARTMENT.1 REVENUE County Code Year File Number DECEDENT INFORMATION: Enter data as it will appear on all documents submitted to the Department 47 Decedent's Social Security Number Date of Death Date of Birth 09/11/2014 08/03/1953 Last Name Suffix First Name MI Chen Ai Hua TYPE FILING: Fill in oval to indicate the nature of the return to be filed with the department. O Probate Return O Joint Assets Only CK) Non-probate Assets Only G Litigation Purposes(no other assets) LETTERS GRANTED: Fill in oval to indicate the nature of the proceedings at the Register of Wills Office. (Attach additional sheets if explanation is necessary.) G7 Testamentary O Administration Car, No Letters C=) Other(Please Explain.) ATTORNEY/CORRESPONDENT INFORMATION: Enter all information for the attorney or individual to receive tax information and correspondence. Last Name Suffix First Name MI Chen Kong Supreme Court I.D.# Telephone Number Attorney/Correspondent's e-mail address: (917)353-9993 First Line of Address 7 Hedge Row Lane Second Line of Address City or Post Office State ZIP Code Carlisle PA 17015-9800 PERSONAL REPRESENTATIVE INFORMATION: Enter all information for the personal representative(s)of the estate authorized by the Register of Wills. Executor/Administrator Social Security Number Telephone Number co Last Name Suffix First Name n ci i SAI mi C ' © n p First Line of Address l� �7 .1 . .. .«yv v. S ♦ ..to-.- .:t♦.T,, Y.✓- -. • sM.i v .. ..... Y �./ r— !—'� 1�T. OCCIAL t�3 0140P Second Line of Address L7 TRANSACTla t`at�UND 1 "T'1 C City or Post Office State ZIP Code 03 Complete general estate information questions and indicate additional personal representatives on reverse side. PLEASE USE ORIGINAL FORM ONLY Side 1 L 3460009101 3460009101 J pennsylvania 1505614105 -THE.T01­" EX(03.14)(FI) REV-1500 OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number INHERITANCE TAX RETURN 7-­ PO BOX 280601 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 1109112014 108031953 Decedent's Last Name Suffix Decedent's First Name IMI Chen i Ai Hua (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last NameSuffix Spouse's First Name MI Zhang ......I [­-, -*--*,*"-1 '! Jin E THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW c@D 1.Original Return C=:) 2.Supplemental Return C:) 3. Remainder Return(date of death prior to 12-13-82) C=) 4,Agriculture Exemption(date of C=:) 5.Future Interest Compromise(date of c= 6. Federal Estate Tax Return Required death on or after 7-1-2012) death after 12-12-82) C=3 7. Decedent Died Testate C=:) 8. Decedent Maintained a Living Trust 0 9. Total Number of Safe Deposit Boxes (Attach copy of will.) (Attach copy of trust.) 10. Litigation Proceeds Received C=:) 11. Non-Probate Transferee Return C=) 12. Deferral/Election of Spousal Trusts I (Schedule F and G Assets Only) C=:) 13. Business Assets C=) 14.Spouse is Sole Beneficiary (No trust involved) CORRESPONDENT— THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number Kong J. Chen l '(917) 353-9993 First Line of Address 7 Hedge Row Lane Second Line of Address City or Post Office State ZIP Code Carlisle PA 117015 . .......... ...... ............... Correspondent's email address: REGISTER OF WILLS USE ONLY REGISTER OF WILLS USE ONLY DATE'FILED MMDDYYYY DATE FILED STAMP PLEASE USE ORIGINAL FORM ONLY Side 1 � i iiiiii iiiii . 1 056 41 1505614105 .J 1505614205 REV-1500 EX(FI) Decedent's Social Security Number Decedent's Name: Ai Hua Chen RECAPITULATION 1. Real Estate(Schedule A). .. ...... ......... . ...... 157,000.00 2. Stocks and Bonds(Schedule B) ... .............___..........__ 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . .. . . 3. 4. Mortgages and Notes Receivable(Schedule D) .. .. .. ... .. . .. .. ..... .. .... 4. 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E). . .. .. . 5. 2,882.10 6. Jointly Owned Property(Schedule F) C=:) Separate Billing Requested ... 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) C=:) Separate Billing Requested..... ... 7. • 0.00 8. Total Gross Assets(total Lines 1 through 7). . . .. .. .... ... .. . .. .. . .. .. .. . 8. 159,882.10 9. Funeral Expenses and Administrative Costs(Schedule H)..... .. ... . . . .. .... 9. 46,828.00 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)... .. .. . . .. . ... 10. 226,303.29 11. Total Deductions(total Lines 9 and 10)................ ........... 11. 273,131.29 12. Net Value of Estate(Line 8 minus Line 11) .. .. .. .. .. . .. .. . .. ..... .. ... . . 12. 0.00 13. Charitable and Governmental Bequests/See.9113 Trusts for which an election to tax has not been made(Schedule J) .. .. .. ... . .. .. .. . .. .. . . . 13. 14. Net Value Subject to Tax(Line 12 minus Line 13) . . . .. ..... . . .. . . .. .. .. .. 14. 0.00 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 0.00 (a)(1.2)X.0- 15. 0.00 16. Amount of Line 14 taxable at lineal rate X.0 0 0.00 16. 0.00 17. Amount of Line 14 taxable at sibling rate X.12 0.00 17. 0.00 18. Amount of Line 14 taxable at collateral rate X.15 0.00 18. 0.00 19. TAX DUE .. .. .. .. . .. .. .. . . . .. .. . .. .. .. ... . ... .. . .. . .. .. ... . . .. . ... 19. 0.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT C=:) Under penalties of perjury,I declare 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 person responsible for filing the return is based on all information of which preparer has any knowledge. SIGNATUROF PERSON RESP NSIBLE FOR FILING RETURN DATE ADDRESS Z.A SIGNATURE dF PREPARER THER THAN PERSON RESPONSIBLE FOR FILING THE RETURN DATE ADDRESS Side 2 1 056 4205 1505614205 REV-1500 EX (FI) Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME Ai Hua Chen STREETADDRESS 7 Hedge Row Lane CITY STATE ZIP Carlisle PA 17015 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 0.00 2. Credits/Payments A.Prior Payments B.Discount (See instructions.) Total Credits(A+B) (2) 0.00 3. Interest (3) 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2,Line 20 to request a refund. (4) 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 0.00 Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred .......................................................................................... ❑ b. retain the right to designate who shall use the property transferred or its income ............................................ ❑ c. retain a reversionary interest .............................................................................................................................. ❑ E d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ 2. If death occurred after Dec. 12, 1982,did decedent transfer property within one year of death without receiving adequate consideration?.............................................................................................................. ❑ N 3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?.............. ❑ N 4. Did decedent own an individual retirement account,annuity or other non-probate property,which contains a beneficiary designation? ........................................................................................................................ ❑ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994,and before Jan. 1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent[72 P.S. §9116(a)(1.1)(i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(11)(ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a step-parent of the child is 0 percent[72 P.S.§9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S. §9116(a)(1.3)].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. REV-1502 EX+(12-12) pennsylvania SCHEDULE A UV A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Ai Hua Chen All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts. Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common, VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1' 50%interest in real estate located at 7 Hedge Row Lane,Carlisle,PA 17015 157,000.00 per attached appraisal TOTAL(Also enter on Line 1, Recapitulation,) $ 157,000.00 If more space is needed,use additional sheets of paper of the same size. PARCEL : 40.24 0760 052 THIS DEED MADE THE ' day of ` , in the year of our Lord TwcS'Thousc�nd Two l21. BETWEEN KURTSCHUTZ AND INGEBORG SCHUTZ, hUsbbnd and:Wife, of Cumbeland County,,Pennsylvania. hereinditer orsl and Al H.UA CHE 4.A,Ni3 K©N6,J.CHEN, .VA-T-ICER AND SOIQ, of Cumbedchd County, Pe'nnsyivanio.herelnaffer (Grantees) WITNESSETH, that•ih tonsidetdtion.of Iwo Muhdred Fifty five Thou$dnd and,p0!•l00 ($255;000.00) in bond paid,th6 eceipt whereof is.hera# y ockno..Wedged,the's4id grantors do hereby..gront and convey to t'he:so ld grcarifees,their heirs and.assigns• as tenants by the>entlreft, ALL this tract ofland situated,in South.Middfdton Township, Curhbe'rlohd Cou6ty. Rpnnsylvania, bounded pnd•described as follows BEGINNING'ot a paint ori Eastern fide-of Hedg& Row laho.on the dividing 11i 9 between Lots Nos., 1 and 2 on the hereinafter menficined Plan of..lots thence by sold dividing line, North 88 degrees,35 minutes East 156.*02 feet to a point:thence by land now or f6rmerly Of tvb Otto,SoUth 1•dogfed 25•rrifhU!es.9dst 119.32 feast fc? a point;•thence by the Ndrfhern side of a:arc o.ased,sfteef;Soufh:88 degrees 35 minutes West*54.7 feet to a p'rofnt:'thence by the some on ©.curve to the left having a radius of 325 feet,an are. distance of 74.1.6 teat to•13 point;thence by the same; orf a curve to the tidht having o•rgdiut of 36 feet,.gn,arc distance.,of 47:12 feet to a point on the East side of Hedge Row Lame; thonces by fhe East side of Hedge R:ow Lahe,'On a GttNe to the-left having a todGus•of.325•feet, art orc distance 01•8817 feet to the Place of BEGINNING., BEING Lot No, 1'of Section-J-1 of the:Pian of'lob known'as Fotge-Road Acres•bs recorded In the Office-of.the•.Recorderof Deeds for Cumberland Cflunfy In Plan Book 23,-Page.28. BEIN-The some premises which Marlin M Bisitop;.St.,and,We M.Nsi h.op, husband and wlfo, by Beed dated.December 15,•1994,,which Deed is recorded in.the Office•4f the.R.ecordet of Deeds in* and fbr Curnberland County!n;Deed Book 116, Page 652, ®ranted and conveyed tb.Kurt Schutz grid Ingeborg Sphutz, husband and wife, Grantors herein. SUBJECT,.however to the tettrictions and conditions of rocbxd. Max 2.32 AAAiGS AND the sold Grantors her6by Covenant and Agree 4hot they will warrant specially'the property herebyconveyed. IN WITNESS WHEREOF,staid gfantors.hdVe het?euntoset their hands,and seals the day and year above written. SIGNED,SEAMED AND DELIVEREI) F , IN THt PSS T ']� . ingeborg Schutz C04MONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND ;ss On this, the t7 day off. JkKe,, 2002 b,O,fore.me, the,undersigned.officer .personally appeared Kurt Schu#z4nd lhgeborg Schutz, tf sbgitd and wife, kn to me'(pr sgtisfgc,iodjy proven) to)Do tho persons whose'ndmes are swbscrlb, c the within instrurinent,and'acknovoedged that they.executed the sorne.f purpotes therein contcllned, lM WITNESS WHERE F', I heraiUint my hand orild official real. y. 0AL e��e�' Wit° t)VUSE it�a r> . IS 'l �tsi+aenrc.fi Officer I do hereby certify that-the precise resr eace anti co plete post b dddress of the v6ttiin ndmed.grantees.Is '7 ,ice C We PA. DATED: ..MAO Atforney for.Grantee COMMONWEALTH OF PENNSYLVAt4lA. County.of ;ss (RECORDED can,this day tit. Ce ily finis to be reeord D.2002, in the Aeaordei es office:of-the P41d aud County, In 069d Pook*Volt . Cumberland Go'jbtY e.in � g , di under imy,horid cand fhe sell of the said • ffice:the date above written. . Recorder. P ecadet ofDeeds WK 24 ��c��:�► ' PAS ii7b �; '� a, �1 Summary Appraisal Report LNd 0424320323 Uniform Residential Appraisal Report File# 69562203 Theurpori_•of ihiL su w rwisal re on is la mvMe the lender/diens vAlh an atru rnte. and adequaloty supported.opinion of the mflrkct value of the subject pro c Provedross_7 Hedoe Row Ln.- _ C11r Car6sh slate PA zie cont 17015 - __ -----..__- RnrrowerKong_Ji Chen_ Owner of Public Record Kon Ji 8 AI Hua Chen C^unry Cumberland --_-._...._.. ......... Lcoal Descript— Recorded in Deed wl.00252,,pg1168 -_.-..----- '---..-_......._..... .-. __.................. Assessor.Parcel a 40240760052 7o.Yeo, 2015 R.E.Taxes s 3 563 Neighborhood Name S.Mid dlei(xl Tmv_ Map Ro1crcnce40240760052 Census Trad0125.02 Occu ons X w oner( I Tenan t Vacant Spacial Asaassmenta S 0 ' PUD1•IOA 4 0 I j P^-r Property Right.ApPrnised ALX I Fee Simple 'Lcas.ehold I__ ,o1hH(dcs_vl_DOI --_._.-_......._............____..__.-_ ....... -_ , _-._--.—_.._...__..... rs»r er mon P _ t .... Assignment T e i ;Purchase Trgnsadion Ir�Refinwnoc Trnnraeiion I 1 Other(dennibe) Lender/Client WCIS Filrgo Bank.N.A.•0032640 Address HarcisburgPA 17112, Is(he subject properly currently offered for sale or has it bwrn offered for sale in th._..e tynelve anlhs prior to the eftecty dale of the appraisal? r Yes I X NO --_..._.. _— m Ration dal» sourcaL.) used, onan.p l,d.:efs). ah.d dare(■>. Hrbg mss Cumb C(? , I L i did 1—i did not analy>,e the controd far.Ne far the cubed purchase transaction. Eml^in the resulia o1 the analysis or the centrad lar sale or why the analysis w»a not parfonned. Centra.Pnm S Date of centrad -Is Ihe.pmprrry cello the owner al putNic rOcoM?� Is there any linanclal assistance ()Oon dharpes.sale conetasione,pin or el—poymem...Lrtancc.010.1 to be Paid by any parry ort behalf of the barrow.,? If Yr.,repon the total dollar amount and desnlbc the items to be.paid: — Note:Race anti the racial composition of the nei hborhood are nota racal factors_ Neighborhood Chamotonstics 1 one-Unit Housing Trends Ono-Unit Hausinq Pascoe Land Use __.._.•—..__ --_.___••_--_ _ a � --_..._.._.— -___........._._..� Stable }Dedinin PRICE AGE i Onr Unil 75 Lowti.n ;Urban X Suburban) Rut•al I Properly VAWtci_ Innen inp p -_....._ -- Ouilt-UP ;_X Over 75%—,25-75yo ; j Untle25% Demand/SuPPNj Shannpu X InDWahux OverS�ppN N0001 (yrs) 2-4 Un11 �• ^. S "/. — __.. — --�--....—_ - _ Growth i Repid X Stable Slow Marketing Tlrhx --Under mlh$_X 1 36 mins OverD mihs i150 Lwr 0' Mutt-FAmay '% _._......._� table , __._..__ -..._.. - s.._..._----. - I ._..............- Nr-inhborhood Bnumfarirs Bp-U.!Ld4d�.(1(tti 4.Y_Y_4t�3LL41.5outh by R7 173 easl.by_the,,.,.,,,,,,-_,__._____..__. .___._._.-H:ph SO! C. Memel 20 � ._............... --.---__..-- - 9�0---Paw:. --- 20 Oine'..__...--.-..---._..._-% N.IQhhorhood Dewlplfon The bubjep,l,�b IotaleA in Sou h Middleton Twp.-approx.2 miles west of h C ,lisle 8orou�l h and,yfii+)_eaLv aecnss tp__-,__-„__-,_-_ _-____. mp;l_@uPDol�aElf Lias incluQ ng schools.medical services snOpying,e)Jploymon( sec.realign ani churches Tse sy_byes-1-adj -(I-loo ---... nota art 0f,_1he Mayapple Golf Course. _ _-__ -_-_......._. _..._.__...._..-.....-__ ■ Market Conditions finduding support for the above condtlsions> {nteresl rates are still reasannble and.in the 3.6%rPM� - jnancjn0 are common l0 the area and usually,are 3 to 5%-oi the urchase price. ,_-__.-_-_--- not provided _nnotproyided Arca 17�¢Os( SLnPc -jayular Vhew spedfic zoning aPsslncaepn_RM _ zoning DesniP”^n Residential mediuensity Zoning Compliance 1 X I.r_pnl .•....' 'L. til Noneonf.nrhuhg(Grandfelhe:rad Use) No Zoning- Illep_al Isthehiphr-Stand beduse oflhe subi0ct propenyes improved oras proposed perplanc and aPedlirations)Ihe present use? rX Ycs NP Ii Nn,describe single faniFi dNe�lrt�C_ __. -•-----.- -_._.... __.____....._._.._.. _..— Utilities Pum blie Other(d...ribe) — publie�reribe) -- ONaite lrnpreverne:nbs-Type-Public- Private: - -- ._ 5 F_l.etridly ! X i Water j 7. X i piW ' ' Gas - I t nOnP, Sonitay Scwcr.__� . Alley none FEMA Spedal Flood 11»xard Aro. Yesry F CMA Map Date 0311 91 X No FEMA Flood Zone FEMA Map Na.Q2041CQ2�i,2E Are the utilitl-and orf-slte Impro,remen ifal far the market are X Ycs Ne.II No.describe env .;;s _ _ - Arc IMrr. A od,rorce Bite mr,d•lionr.or rthdomM faddy(eosemenla,aneroachmentL. irnnm0ntni rYhndilions,land utas,Ota)? Ycs ' X No If Yes.desnlbe_---- ._.__........ ......^.)'_..__.__.......__...__.._.-.._..................-................ ...._... .-..._...-.- -_...._ 3 _. _ Public water and sewer areon to the sutget!.area.No adverse easements of encrgchmenls we L)Dved. �- g _-......._... ....................._- -_._- faerrnt Oaseripllen Fowhd■Non cn—ior to—nod.. .., —terkisfoordition.---interior m■t■6■1.1—ndltion Units)X One One wlih AccessoryUnll I Cnnnele Slab Cmwl Space Fourafalion Walls CC]) (QQ Floors ILL' —_ -J __—.__.... ._— —..—_ ....__ V of Stones 2 -- i X 3 Full Basement �Penial D.—.1 Extariar wall,. Type!X Der. 'I An.•. S-DOVEnd Unit Basemant Area 2 818 sa.n• Raor surtarA as halt/d rrimrFinisn wDodtCd � 1 _ ..._.�-._. fig....-_._._-._..-.. --..-- X C-xhalinpLL Prnpoce<i undo.con Bflaemeni Fini.h 0 q Gunerc R Dovmspouts aNml d 8a0h Floor vinyVod Ocsin (Style) [Xllonial X Outsirlr-Ent /Exit ` 'sump Pump WindnwT pe dblhun I d Bath Wainscot Illsirld Year Bull 19% Evidence eri �Infasmtion storm SashAnsutalad alUm(pd _- Car si^rafx- -_---- EIIe.tivrs n r. 15 Srrnan. Jug alu i X OrivowoY w of Cars 6 nolo i ,Nnna _ Ftnminn l X i Y-wA I I+wH6h i !A-1— nmen(tiee j!_. f Woodstove(s1w 0 Drlvc�.ray sun! �pncretc•.....---- -r7 re I Drosmi,' � �5 st»hro .—.__. mar I runt elec }X�F_upl»a:(n)<7 Fe..ee ruin. __x-oampf�n or ears__.5... --'- i !Fld- P !!--,StlhWr- CnoOnp X Cw,Kgl All O.ndilioninp X Pbtio/Dock 110 Porch rev _ Cwrpon 6 of t.9re 0 1 � -ed Heeled !IndlMtlhh»I ! oma, P.ei X other X 1 An. DalX Buaun A liones X I RetrI eralor I X Ran c/Oven i X Dinhw-.her! X Dis .:all Mirrow:hvel XWachor ar 1 Other describe) nishearca above gredc contain.: 9 Rooms -_-_4 Br•.drooms 3_0 findh(sl -2,464 Spuaro Fcet al Gra-_Livintl Area Above Grado - AAAnional tealums (sprdal-energy efndanl items, etc.) Updates_recenl shingled roof.recent vinyl sides and outters,,basement finishgd Qak ._.- __. _ kitchen,idle over 4-car attached garagerear porches�atio.Iront stoop,. __... Desnibe Ilx: fAlld)f10n of the prepeM (indudinn needed renAlrs, detedarntion, renovations, raahodelinp, etc.). C3;N0 ti dates In the rjOr 15- years,'well maintained colonial•.good,.conditlon --........_....... .... -- Are there any piryslaf)dendene)cs or adverse cAndttons that one.t,0 livabiary:noun tln0sc.or atnr.urot Inleprily of the MoPeny7 !Yea X No 11 Yrs,describe Docw thn oraaerry., oanrsrnM fanmrm 10 this neiphbnmood (functional utl(ty, sale. randitid., use,_consuv.bn. etc.)? � X i Yea No_tt No,dea.ibr. .-- Freddie Mac Form 70 March 2005 UAD Veroion 9/2011 Page 'I of 6 Fannie Mae Form 1004 March2005 Eyer Appraisals,Inc. APR-02-2015 10:20 96% P.001 T2 Summary Appraisal Report I-N#0424320323 Unifo... Residential Appraisal Report File 0 69582203 I!L �,E,lh- . .......... 9910t0__ ,n-.a- 18 wmp,rnhl,.sato.in Ina seMjccl nciphnorlwod•vitwn the f-I t-1-mnnlhs TrIging in"to price(,.-S 285.000 to S 327 500 TURI SUBJECT ___COIAPARA LE SALE 1 COMPARABLE SALE V 2 COMPARABLE. 3 7 Hedge Row Ln 'S Maid' Circle 9 GreenvAch Or i65 Derbyshire Or Address I Madison 17015 1 CairlslO%PA 17015 Carisle -439........ 17015 [Carlisle.FLA�170I5 0.62 miles SW miles SWI 0.47 miles SE Sale Price 5 s 327. Wool205,000 3 285.000 sq.It is stun,A� SE 1102 U0079 n_ Are 25iRA;Q0-M-L--.- IHrbg mIs9 1025§158:QQM iH W08 QM1 I�L 9 MIS#IQ_ %Q -94 Firb C 11-fir"IS DimbCoP-R Hrbomb_umbCoP-R., --- VALU-ADJUSTMENTS DESCRIPTION : DrSCRIPTION wj-)S A.)-1111-L DESCRIP1f0N *(-5 2AaruSlm¢nt DESCRIPTION Sol..,Financing ArrnLth ;Arnl-th jAnnLth S.Recssi. Co, - - to5 01-14;CD04 A jf��L R,Rin -![LFIs2 eIB:Res:Res i�wSt._ FftSi- :Fee Scopic_.__ -_. FSe-Smp ',D _T2cpIon-i?.1 T2 coicniai 103 19 •8 OLOR!1 ------------- Q Cohditinn Q An-Grade _10tall tTn%.L EIt JLi Tolai Sd- Baht. 8.ns Room Count .1 2.2 109 .10650 J .930! 2634 S—t 4 Finished 2g18sfOstwo 11334&fOsfin -5.9361317sI1000sWvo i --6.OD411054sf1W5!wu -7,056 -1.000 iaV0 .......... rlcatin p in 11K 0 Erwrgy Efficient IiemS ilhBimo wind Imerrrro_w+nd ' �Ih wind____ lthermo wind ! 12ga4dw -6000 t29 6 W-W jprh&pstp. c_2 sto It A et Ldfu 1,�T�,W-� .634 9 0-6! 7-06 !L_ i X I Adj-l.d S.1,Pricrtt Net Adj. 0.19 ly. Nct Adj. 108 1 Net Adj- 1095 *A j of Cr-obl.. Adi. 12.33 326,8661G,-os6Ad-- 15,97 /-is 285.904 Gross Adj. 11.65 IS 316.2ffi did-(- ( did not rnseardr ih¢sale or t ansier history at the subject proPeftp.and fAmpanbie.S,aies. i(nisi,explain i tlld X i did not 1- 1 Any prim. o-r. err th-o' P Rrb-,govii, My re Search did X i did not rcv¢aI a transfers 01 the camparobin srflee rpr the prior year t,the dateo,e,'fle 2!Ne comparable aok. Dan 5ourc,(sI Is subject properly and co-Pa-ble-1- colas P.Pe.3). ITEMSUBJECT COMPARASLE SALL#I COMPARABLUSALC#2 COMPARADLESALF93 Do.,of Pd.r SaaelTranster Data spurcerr> P-L Hrbp rn�,.ggr Hr iHrb mls,CumbC b an CL _±-Inis of prior safe or Iran .tory-I ' and nate;t — -I,-s-subject ........... .......... ..........---------- --------- .......... UA -PL sales.Secpt�dary we gh1 otcomp, The subject paGS are cons deTed to be In Simi see all neighborhoods equally-Iv-htm-aa_K1-qq_pj�r k- _q�__The_in_ victual Ad- _r)�ents.on thrid.ye_rg.AgrL%eqfrpm-asgMiLLa-oaAf - !hestj i tho4q-MAc_hedpAiCk�na ys!s Extraction n d Market-Eea-Pli ---T-he-n OkO-A 9 4s A-MP s.are�C q!q Ld-qc.c,I o1e_i..n ni1a rcomoetinn ---__-__ neighbarhoods,_and,buygrs_woirl6 see cell-neighbor{tgods_equua8v when makrgg•.puTchasmadecj.�ions_Phptos are appraiser Eite rive Phoios�_ -,.,,,-._-__•,.•___..,___ lrdicamd V.J.c by Sa1.. 0-p-iso. App-act,5 314,DDO ..±11!tiad. Value - Salas �tAps?!qao!L(if dw-!?Fnj) 123 466 3 2114,M (- -�Jf dovabpadlJ 7�hjL�nQne,applgiLghf1qmtgLsAL0A neededestablish Rik .LaAar imp -y-EanInAe- ------- --q- -A-;i- -Ikq-coe -ws�h-� -tawired tf-- -4 rt p!�pn y,._MosL abjqd tLe ialion of a I r-jpLqp ............... _g_ weight given to the sales comparison r2q2.h. .......... con,dilln.that the t-i This appraisal . -d. I-.,p--n4 1- t-1-or-hypothetical completed,1 subject 1a it,.following I-co.in,of alt-ao-on it,.basis.1.hypothetical canlffli-that the-P-1--1 eh--fi-1-b- lNlowtnit -Qui ed Inspection based an the ext-ardina In lion Ihpt.!l, atasaa on a =I"In visual inspootion, cf ths hodat and 9"Or 2MAS of this subject property, defined scope of work, sellamind of assumptions and lienifing • candlacm, and appraisers certification, try (aur( opinion of the Market value, as definad, of kiw ml property tHat is tin subject of HAS mPon is S 314,000 -- . -of 0312512015 1 t-Alch is the data of Impaction and tho off-tivo dion of IN. a sol. Freddie Mac Fc,,-70M.,ch200S U^D Vmrsi-912017 P.q. 2 of 6 Fannie Mae Form 1004March,2005 ryer Appraisals,Inc. APR-02-2015 10:21 96% P.002 xT4 Summary Appraisal Report LN#0424320323 Uniform Residential Appraisal Report File* 69562203 'I have_pAfctne4jqjqr h- tfLed ices,as n appraiser qr.in any other capaci y.regarding the !0 Fly that the�jb ect of this J,qAc _J_a�v __A_ _j_ -W qcsP-tnnLeA(1h1s-ag Fee rnerLtL'Pi�r coin onenl .of!qdefiqlli.0.. f-wthe value-RLvr-tqnje-tr-q-qfvp_lqAedjhs a-pw4jseLMt.gtAe- veJqpv-qPiL-io—a of reasonable ....... I hatyAigoo ini L. The dSLnJLjqn VqWq the r_p9yidedF_appieLk e iacjudqr a tq&sAaLbiqpApp re _ me-standardsftu—e2-2L1@)N1-2jPJUv ajd_Z-ZAqjjvQLas added the janItLaM_Ltqj That the opinion of txpqsu!gj tM� If gyp o op _ .1 _ in compliance with Stan ids Rpe -lhe.rqpIt- v"l e._.'Lhe appraisal dues aqi that ft operty s free of defects-Aygranl�q -R�_ qnv,ronornerttal problems.Th(k I. farftls�A ftin-SAKLI(In o,f vislble anti accessible are n ._H profes.ionat home inspection or ........... nvironmen al inspection The appraiser is tlkw__re_of any underground fttl stijt�iLkq_nk — n the grope anteif so isJLa _jjqldL ...... ........... !e.-jA".ppLojkt competent to c(�Frnt ele.L s re I�n acqjZrdqn the c�qLnp cy.pLqvisL It Q AE...JILe i!Le! sAcjkpdji JA��Mqq _pL_ kipqr_ SL�vjtL_ j��tn_ knA.L_&P_ _gppg _t�_ an independent capAcjLy__ar�C(Le al p- The ---------............. arcil ini Fly no relationship with env ovtn.qpL_qAtLin_vofved with,the-ma—ised-py-orly • E-theintended .............. Note- Under the con 0enliA!kptqKi_sjorL4_qj_y3PAP,the appraiser cannot discuss the earn lPIPd innr;tkal or appraisal-' 6orrQwer.ThfLqp i�sp kqet rs.L Iftlit 1-11 111 ntfQM. and�rds Of Prqj(tjsicF Ar_Ai _q_ kiLMIL t�thjl -Lq--SIqAA'P-LkLS AP_(jJ_ RgLApp!aisa1 n nyjwso-t!"Wq—(he Aful and funQiqq�nal-ftjirne of ms EXPAnIpED SCOPE OF WORK STAT INLEt!.T ALLhe reqt�qLqjfeljept this jappraisal{ej)qLjhsL lteqn ep;kreO.to cqi2pjigFjqUniform Appraisal'Qatasel(qLDJ-tram Fanfktt .Mae LMq_fe _d_tk.LAa_t.ThtQKQLjiqt�tj_he_?pp.aiA responses ;i,pg6 jI;fq- fini ip_ns appraise g,4,.dqT k21tf�M.&d!g It an aftquLtgAMo form tion in Y. _qklaL_ _ tour sp..qf businpALrg_Urdjgj the s_qbjgct and LcqMPaL;lhle PMI�rlti ,Some O'd h SA-M -vd I NOT_ha4,tie pApALt"j!X tkyeEiyk dmj;kljqjqn1 mjy.. eater rec _r"quL_ _y_� jqinL� isii>n And. [9ti?NLoty.Ln-!he data than is jact lly-w-f—eclor typical orrR?LqgtL- aggl rsq..PL ..I!- _quality ratings jaswell qjgrqssqrp L mLied L eSjqe�qinq - -- , Not every Atm-qql_qtthe O. _. pralseraid qol move-any_p a_bjjj _.cqacem lqEp.an_ LA�ZajL!o the p� top E!y,to discloseorreveal s!(uNure.nor did the obqtLe st(qq4LtL enclosed encased gthervrise probe(he qp�Le�yq_ffL _ Cle—dare aene, ILkbtatned ftqM bq tjirrlitfiq-jo the local MLS scor,.jqwb1pAssessor firl ne resqurces. Rqns,Flelqo�ArL e unitsLqLherwise noted b the apga INTENDED_USER CLAf21FlGATIQN,_ __^_,,. z,A&jhqji fh(L( May rl(!IjLqq in the a Faisal Commttniiy about the distinction klthv_peu-arfig-s he(otlowinAaddlUonal statement to lug„used, -wken the User of this appraisal this pip 'e tQ the stated Scape of Ytark,,purpose of the appraisal. inc [eqtL eMgenjs_af this appraisal sLl te I fand_�ef Markel additional Intended Users are identified 4 hf�.ppALskr.._'** e & I jCcrrhrnnts .. LL- dditic Flat COST APPROACH VAAJJP (- -94-d kar F-t. W-) Providn adequate h t—von formpienderlerientforepu L-le IhS. Support for the opinion of site It and sales or other n,elhodn for esilenating site opinion Land value derived from cgMpajq*land satesikSl�gs it the subjpclj�qaLand,s j"Maj HRBGMLSA1022,801410157140 REFILACI-210IFNIF COST NEW OPINION Or SITE VALU;......... ON �110N OR ........ f east data Marsha 2 tfL4..5q. (M .......................s 221,760 OvMity rating from cast tend pad Effective date foost ldlittw. SQ.rL Q S 20.CO .-/ ._A�MT 2,818 .............. Comments on Coat Approatri{grass living area ralotdations.deprr.riahon,rlct _ _,_,__QLher afea 2651 S F ft Gast er s ztnd4N�i Cast Hqqit -aqv'(*!!-*” _I 70 -t.tM s 25.00 s 42_550 onA�M. ived fromsimilarI ............... _335§70 land S31e5,;__ Lass Physical I ..I Eldamal -- oeprei.1j.. 77,204 -S( 77104 1_2tPrSciawnd Co!jl of I-Plo .................... ...............-.................... 'A.-& VnIvc .1 Site lenplo--ta..................I-...........-..................... 5.000 T— Esfarwl "0 R—htha r-e-1.Life, (HUD and VA-1y) so ;eprsl tT-led Value By Cost Appronch..............-....................-...................=5 323466 4W-d 61L -6 Mfit 11" 0 -S and_GRm) T)Le income aj) roach was Lnot q.iLqd.due to a tla4ik at properties needed to produce a GRM. PROJECT 01FORWIFION FOR PUO* lie •Pop-bwl is the dovNapcnh�inder In anntrai I I Yes r the A—i,tiall tHOA)? Na W�t rvoeW I., Puoa ONLY It the d-cloportbuildc, ip in —I a( the HOA and the -blow property is on artachftd5�weIlnq Unit. • Legal name ofprojocl Tot.l-reze'of Total n-b.,el-h-, r of units said Total rhumba,W omit.--o 'T.tm numb.,at-11e I.,-le Delo Sou .�yos_dle pmjeC,created by Tho�conversion or existing building(s)onto a PUD? No• Does me Pra3ect contain any Yes No Data source(n) ------- Are the unitat 2runot, elements,and recreation facilities cornowe? ------- -Y-,7 Na It Ye.,de--,Whe the 1-W t.--and.0-- Clo.c,ib.aanxrhnn ele-nts end �.-1 taej1!!!- _.__.......,.__--....._..—._...,.»....__..—.--_—_- Freddie Mac Form 70 March 2005 UAD Version 3/2011 Page 3 of 6 Fannie Mae Forrn.1004 March 200S Eger Appraisals.Inc. APR-02-2015 10:24 96% P.004 �5 Summary Appraisal Repot Lt4#0424320323 Uniform Residential Appraisal Report Filen 68562203 This report form is designed to report an appraisal of a one-unit property or a one-unit property with an accessory unit: including a unit in a planned unit development (PUD). This report form Is not designed to report an appraisal of a manufactured tome or a unit in n condominium or cooperative project. This appraisal report is subject to the following scope of work, intended use. intended user, definition of market value, statement of assumptions and limiting conditions. and certifications. Modifications, additions. or deletions to the intended use, intended user, definition of market value, or assumptions and limiting conditions are not permitted. The appraiser may expand the scope of work to include any additional research or analysis necessary based on the complexity of ih)s appraisal assignment. Modifications or deletions to the certifications are also not permitted. However, additional certifications that do not constitute material alterations to this appraisal report, such as those required by law or those related to the appraiser's continuing education or membership in an appraisal organization, are permitted. SCOPE OF WORK: The scope of work for this appraisal is defined by the complexity of this appraisal assignment and the reporting requirements of this appraisal report form, including the following definition of market value. Statement of assumptions and limiting conditions, and certifications. The appraiser must, at a minimum: (1) perform a complete visual Inspection of the interior and exterior areas of the subject property, (2) inspect Ilse neighborhood, (3) inspect each of the comparable sales from at least the street, (4) research, verify, and analyze data from reliable public and/or private sources, and (5) report his of her analysis, opinions, and conclusions in this appraisal report. INTENDED USE: The intended use of this appraisal report is for the lender/client to evaluate the property that is the subject of this appraisal for a mortgage finance transaction. INTENDED USER: The intended user of this appraisal report is the lender/client. DEFINITION OF MARKET VALUE: The most probable price which a property should bring in a competitive and open market under all conditions requisite to a fair sale, the buyer and seller. each acting prudently, knowledgeably and assuming the price is not affected by undue stimulus. Implicit in this definition is the consummation of a sale as of a specified date and the passing of title from seller to buyer under conditions whereby: (1) buyer and seller are typically motivated: (2) both parties are well informed or well advised, and each acting in what he or she considers his or her own best Interest: (3) a reasonable time is allowed for exposure in tho open market; (4) payment is made in terms of cash in U. S. dollars or in terms of financial arrangements comparable thereto; and (5) the price represents 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 comparables must be made for special or creative financing or sales concern-.ions. No adjustments are necessary for those costs which arc normally paid by sellers as o result of 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 Institutional lender that is not already involved in the property 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 judgment. STATEMENT OF ASSUMPTIONS AND LIMITING CONDITIONS: The appraiser's certification in this report is subject to the following assumptions and limiting conditions: 1. The appraiser will not be responsible for matters of a legal nature that affect either the property being appraised or the title to it. except for information that he or she became aware of during the research involved in performing this appraisal. The appraiser assumes that the title is good and marketable and will not render any opinions about the title. 2. The appraiser has provided a sketch in this appraisal report to show the approximate dimensions of the improvements. The sketch is included only to assist the reader in visualizing the property and understanding the appraiser's determination of its size. 3. The appraiser has examined the available flood maps that are provided by the Federal Emergency Management Agency (or other data sources) and has noted in this appraisal report whether any portion of the subject site is located in an identified Special Flood Hazard Area. Because the appraiser is not a surveyor, he or 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 property in question, unless specific arrangements to do so have been made beforehand, or as otherwise required by law. S. The appraiser has noted in this appraisal report any adverse conditions (such as needed repairs, deterioration. the presence of hazardous wastes, toxic substances, etc.) observed during the inspection of the subject property or that he or she became aware of during the research involved in performing this appraisal. Unless otherwise stated in this appraisal report, the appraiser has no knowledge of any hidden or unapporent physical deficiencies or adverse conditions of the Property (such as, but not limited to, needed repairs, deterioration, the presence of hazardous wastes. toxic substances, adverse environmental conditions, etc.) that would make the property less valuable, and has assumed that there are no such conditions and makes no guarantees or warranties, express or implied. 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 an expert in the field or environmental hazards, this appraisal report must not be considered as an environmental assessment of the property, 6, The apprAiser has based his or her appraisal report and valuation conclusion for an appraisal that is subject to satisfactory completion, repairs, or alterations on the assumption thatthe completion, repairs, or alterations of the subject property will be perlormed in a professional manner. Freddie Mac Form 70 March 2005 UAD Version 9/2011 page 4 of 6 Fannie Mae Form1004 March2005 Eyer Appraisals,Inc. APR-02-2015 10:26 96% P.005 A6 Summary Appraisal Report LN#0424320323 Uniform Residential Appraisal Report File 69562203 APPRAISER'S CERTIFICATION: The Appraiser certifies and agrees that: 1. 1 have, at a minimum, developed and reported this appraisal in accordance with the scope of work requirements stated in this appraisal report. 2. 1 performed a complete visual inspection of the interior and exterior areas of the subject property. 1 reported the condition of the improvements in factual, specific terms. I Identified and reported the physical deficiencies that could affect the. livability, soundness, or structural integrity of the property. 3. 1 performed this appraisal in accordance with the requirements of the Uniform Standards of Professional Appraisal Practice that were adopted and promulgated by the Appraisal Standards Board of The Appraisal Foundation and that were in Place at the time this appraisal report was prepared. 4. 1 developed my opinion of the market value of the real property that is the subject of this report based on the sales comparison approach to value. 1 have adequate comparable market data to develop a reliable sales comparison approach for this appraisal assignment. I further certify that I considered the cost and income approaches to value but did not develop them, unless otherwise indicated In this report. 5. 1 researched, verified, analyzed, and reported on any current agreement for sale for the subject property, any offering for sale of the subject property in the twelve months prior to the effective date of this appraisal, and the prior sales of the subject property for a minimum of three years prior to the effective date of this appraisal, unless otherwise indicated in this report. 6. 1 researched. verified, analyzed, and reported on the prior sales of the comparable sales for a minimum of one year prior to the date of sale of the Comparable sale, unless otherwise indicated in this report. 7. 1 selected and used comparable- sales that are localionally, physically. and functionally the most similar to the subject properly. a. 1 have net used comparable sales that were the result of combining a land sale with the contract purchase price of a home that has been built or will be built on the land. 9. 1 have reported adjustments to the comparable sales that reflect the market's reaction to the differences between the subject property and the comparable sales. 10. 1 verified, from a disinterested source, all information in this report that was provided by parties who have a financial interest in the sale or financing of the subject property, 11, 1 have knowledge and experience in appraising this type of property in this market area. 12. 1 am aware of, and have access to, the necessary and appropriate public and private data sources, such as multiple listing services, tax assessment records, public land records and other such data sources for the area in which the property is located. 13. 1 obtained the information. estimates, and opinions furnished by other parties and expressed in this appraisal report from reliable sources that I believe to be true and correct. 14. 1 have taken into consideration the factors that have an impact on value with respect to the subject neighborhood, subject property, and the proximity of the subject property to adverse influences in the development of my opinion of market value. f have noted in this appraisal report any adverse conditions (such as. but not limited to, needed repairs, deterioration, the Presence of hazardous wastes, toxic substances, adverse environmental conditions. etc.) observed during the inspection of the subject property or that I became aware of during the research involved in performing this appraisal. I have considered these adverse conditions in my analysis of the property value, and have reported on the effect of the conditions, on the value and marketability of the subject property. 15. 1 have not knowingly withheld any significant information from this appraisal report and, to the best of my knowledge, all statements and information in this appraisal report are true and correct. 16. 1 stated in this appraisal report my own personal, unbiased, and professional analysis, opinions, and conclusions, which are subject only to the assumptions and limiting conditions in this appraisal report. 17. 1 have no present or prospective interest in the property that is the subject of this report, and I have no present or prospective persanal interest or bias with respect to the participants in the transaction_ 1 did not base, either partially or completely. my analysis and/or opinion of market value in this appraisal report on the race, color, religion. sex. age, marital status, handicap, familiar 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 subject property or on any other basis prohibited by law, 18. My employment and/or compensation for performing this appraisal or any future or anticipated appraisals was not conditioned on any agreement or understanding, written or otherwise, that I would report (or present analysis supporting) a Predetermined specific value, a predetermined minimum value, a range or direction in value, a value that favors the cause of any party, or the attainment of a specific result or occurrence of a specific subsequent event (such as approval of a pending mortgage loan application). 19. 1 personally prepared all conclusions and opinions about the real -state that were set forth in this appraisal report. If I relied on significant real property appraisal assistance from any individual or individuals in the performance of this appraisal or the preparation of this appraisal report, f have named such individual(&) and disclosed the specific tasks performed in this appraisal report. I certify that any individual so named is qualified to perform the tasks. 1 have not authorized anyone to make a change to any item in this appraisal report; therefore, any change made to this appraisal is unauthorized and 1 will take no responsibility for it. 20, 1 identified the lender/client in this appraisal report who is the individual, organization, or agent for the organization that ordered and will receive this appraisal report. Freddie Mac Form 70 March 2005 UAD Version 9/2011 Page 5 of 6 Fannie Mae Form 1004 Ma—h2005 Eyr Appraisat,Inc. APR-02-2015 10:27 96% P.006 T7 Summary Appraisal Report LN#0424320323 uniform Resiclential Appraisal Report File te 69562203 21. The lender/client may disclose or distribute this appraisal report to: the borrower: another tender at the request of the borrower, the mortgagee or its successors and assigns: mongagc insurers: government sponsored enterprises: other -secondary market participants: data collection or reporting services: professional appraisal argonizations; any department, agency, or instrumentality of the United States: and any state, the District of Columbia• or other jurisdictions; without having to Obtain the appraiser's of supervisory appraiser's (if applicable) consent- Such consent must be obtained before UNIn appraisal report may be disclosed or distributed to any other party (including, but not limited to, the public through advertising, public relations, news, sales, or other media). 22, 1 am aware that any disclosure or distribution of this appraisal report by me or the lendericlient may be subject to certain laws and regulations, Further. I am also subject to the provisions of the Uniform Standards of Professional Appraisal Practice that pertain to disclosure or distribution by me. 23. The borrower, another tender at the request of the borrower• the mortgagee or Its successors and assigns, mortgage insurems, government sponsored enterprises, and other secondary market participants may rely an this appraisal report or, pan of any mortgage finance transaction that involve-- any one or more of these ponies. 24. If this appraisal report was transmitted as an "electronic record" containing my "electronic signature." as those terms are defined in applicable federal and/or state IrNwz (awctuding audio and video recordings), or a facsimile transmission Of this appraisal report containing a copy or representation Of my signature, the appraisal report shall be as effective, enforceable: and valid as if a paper version Of this appraisal report were delivered containing my original hand written signature. 25. Any intentional or negligent misrepresentation(s) contained in this appraisal report may result in civil liability and/of criminal penalties including• but not limited to, fine or imprisonment or both under the provisions of Title 18, United States Code, Section 1001, et seq., or similar state laws. SUPERVISORY APPRAISER'S CERTIFICATION: The Supervisory Appraiser certifies and agrees that: 1. 1 directly supervised the appraiser for this appraisal assignment, have read the appraisal report. and agree with the appraiser's analysis, opinions, statements, concWsions• and the appraiser's certification. 2. 1 accept full responsibility for the contents of this appraisal report including, but not limited to, the appraiser's analysis, opinions. statements, conclusions, and the appraiser's cenification. 3. The appraiser identified in this appraisal report is either a sub-contractor or an employee of the supervisory appraiser (or the appraisal firm), is qualified to perform this appraisal, and Is acceptable to perform this appraisal under the applicable state law. 4. This appraisal report complies with the Uniform Standards of Professional Appraisal Practice that were adopted and Promulgated by the Appraisal Standards Board of The Appraisal Foundation and that were in place at the time this appraisal report was prepared. S. If this appraisal report was transmitted as an "electronic record" containing my *,electronic signature," as these terms are defined In applicable federal and/or state laws (excluding audio and video recordings), or a facsimile transmission of this appraisal report containing a copy or representation of my signature, the appraisal report shall be as effective, enforceable and valid as if a paper version of this appraisal report were delivered containing my original hand written signature. APPRAISER SUPERVISORY APPRAISER(ONLY IF REQUIRED) Signature Signature Name Aaron R.EV Name Company Name jliye,A Company Name Company Address P.O.Boz 742 CompanyAddross ChamFxrsburc PA 17201 Telephone Number Telephone Number Email AddressAft Email Address yrAL .............. Date of Signature and Report 0312 Date of Signature ....... Effoctiw Onle of Appralaal 9-30§990- State Cor0cation;; State Certification 2 RL000833t or State License or State License 1,9 State or Orhw State 9 E)mIration Date of Certification or License State PA Emi,ation Date of Certification or License SUBJECT PROPERTY ADDRESS OF PROPERTY APPRAISED E_ ad not inspect subject property Z_lJJ9AdbffMLn Old Inspect exterior of stibloct property from street Cantle.PA 17015 Date of Inspection APPRAISED VALUE OF SUBJECT PROPERTY S_314(&0_. Did Inspect I.-tuallor and exterior of Subject property LENDERtCLiENT Date of Inspection ....................... Name COMPARABLE SALES Company Name Wei Faro L@lr�_tJA.-1)03264a_ Company Add,ess Harrishu PA 17112 Did not I mpect exterior of comparable sales from street Did inspect traoria,of comparable sales from street Email Address Data of ln.pmtion Freddie Macrorm 70March2005 UAD Version 9/2011 Page 6 of 6 Fannie Mae Form 1004 March2005 Eyes Appraisal,.Inc. APR-02-2015 10:28 96% P.007 REV-15o8 EX+(08-12) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Ai Hua Chen Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Wells Fargo Checking Acccount#3957746146 1,872.21 2. Wells Fargo Savings Account#3957742624 1,009.89 TOTAL(Also enter on Line S, Recapitulation) $ 2,882.10 If more space is needed,use additional sheets of paper of the same size. Wells Fargo Way2Save° Savings Account number: 3957742624 ■ July 1,2014-September 30,2014 ■ Page 1 of 5 L Questions? Al HUA CHEN WARD Available by phone 24 hours a day, 7 days a week: KONG JI CHEN GDN 1-800-742-4932 7 HEDGE ROW LN TTY.,1-800-877-4833 CARLISLE PA 17015-4327 En espanol: 1-877-727-2932 0 1-800-288-2288 (6 am to 7 pm PT,M-F) Online: wellsfargo.com Write: Wells Fargo Bank,N.A.(345) P.O.Box 6995 Portland,OR 97228-6995 You and Wells Fargo Thank you for being a loyal Wells Fargo customer.We value your trust in our company and look forward to continuing to serve you with your financial needs. IMPORTANT ACCOUNT INFORMATION Enhancements coming to your transaction descriptions including cash back detail Over the next few months,you will notice changes to the descriptions for debit,ATM or prepaid card transactions.These enhancements provide more detail about your transactions,and include new descriptions for purchases with cash back.For debit, ATM,or prepaid card merchant purchases with a request for cash back,the transaction description will include the words"cash"or "cash back,"and may include the dollar amount of cash requested. Merchant-Issued Debit Cards Are you using a merchant-issued debit card to make purchases(i.e.,Target®REDcard)?These unique purchasing cards(which typically provide reward points or discounts)are issued by a retailer when you provide them your Wells Fargo checking account and routing numbers. There are some very important differences between the merchant-issued purchasing card(not issued by Wells Fargo) and your Wells Fargo-issued debit card. When you use a merchant-issued card to make a purchase,the transaction is not immediately sent to Wells Fargo to confirm if your account has available funds.These transactions do not immediately reflect as pending withdrawals nor do they reduce your available balance.Instead,the merchant sends the transaction to Wells Fargo as an automatic payment(ACH)transaction-and this is typically one to three days AFTER you made the purchase.When the purchase amount is sent to Wells Fargo for payment,the transaction will be paid with funds in your account,or if your account has insufficient funds to cover the transaction we may pay the transaction into overdraft(at the bank's discretion),or return it unpaid.If the transaction is paid into overdraft or returned unpaid,you may be assessed an overdraft or returned item fee. If the item is returned,the merchant may also charge a returned item fee and they will more than likely resubmit the transaction which could cause additional fees if there is not enough money in the account.As a result,it is very important for you to keep track of these purchases to avoid overspending. (345) Sheet Seq=0253053 Sheet 00001 of 00003 Account number: 3957742624 ■ July 1,2014-September 30,2014 ■ Page 2 of 5 • Activit/summary Account number: 3957742624 Beginning balance on 7/1 $1,009.87 Al HUA CHEN WARD Deposits/Additions 0.02 KONG JI CHEN GDN Withdrawals/Subtractions 0.00 Pennsylvania account terms and conditions apply Ending balance on 9/30 $1,009.89 For Direct Deposit use Routing Number(RTN): 031000503 Interest summary Interest paid this statement $0.02 Average collected balance $1,009.87 Annual percentage yield earned 0.01% Interest earned this statement period $0.02 Interest paid this year $0.07 Transaction history Deposits/ Withdrawals/ Ending daily Date Description Additions Subtractions balance 7/31 Interest Payment 0.01 1,009.88 8/29 Interest Payment 0.01 1,009.89 Ending balance on 9/30 1,009.89 Totals $0.02 $0.00 The Ending Daily Balance does not reflect any pending withdrawals or holds on deposited funds that may have been outstanding on your account when your transactions posted. If you had insufficient available funds when a transaction posted,fees may have been assessed. Monthly service fee summary For a complete list of fees and detailed account information,please see the Wells Fargo Fee and Information Schedule and Account Agreement applicable to your account or talk to a banker.Go to wellsfargo.com/feefaq to find answers to common questions about the monthly service fee on your account. Fee period 07/01/2014-07/31/2014 Standard monthly service fee$5.00 You paid$0.00 How to avoid the monthly service fee Minimum required This fee period Have any ONE of the following account requirements Minimum daily balance $300.00 $1,009.87 ❑ Daily automatic transfer from a Wells Fargo checking account $1.00 $0.00 ❑ ^ Save As You Go transfer from a Wells Fargo checking account $1.00 $0.00 ❑ Monthly automatic transfer from a Wells Fargo checking account $25.00 $0.00 ❑ ^ The fee is waived when the primary account owner is under the age of 18(19 in Alabama) Fee period 08/01/2014-08/31/2014 Standard monthly service fee$5.00 You paid$0.00 How to avoid the monthly service fee Minimum required This fee period Have any ONE of the following account requirements Minimum daily balance $300.00 $1,009.88 0 Daily automatic transfer from a Wells Fargo checking account $1.00 $0.00 ❑ A Save As You Go transfer from a Wells Fargo checking account $1.00 $0.00 ❑ Monthly automatic transfer from a Wells Fargo checking account $25.00 $0.00 ❑ ^ The fee is waived when the primary account owner is under the age of 18(19 in Alabama) Account number: 3957742624 ■ July 1, 2014-September 30, 2014 ■ Page 3 of 5 Monthly service fee summary(continued) Fee period 09/01/2014-09/30/2014 Standard monthly service fee$5.00 You paid$0.00 How to avoid the monthly service fee Minimum required This fee period Have any ONE of the following account requirements Minimum daily balance $300.00 $1,009.89 El Daily automatic transfer from a Wells Fargo checking account $1.00 $0.00 ❑ A Save As You Go transfer from a Wells Fargo checking account $1.00 $0.00 ❑ Monthly automatic transfer from a Wells Fargo checking account $25.00 $0.00 ❑ A The fee is waived when the primary account owner is under the age of 18(19 in Alabama) 'Zero is displayed because you did not meet the minimum amount required for a single transaction of this type. AM/AM Other Wells Fargo Benefits Borrowing options to help you meet your goals What if you could reduce your higher interest rate loan payments,be prepared for the unexpected,pay for education costs,or remodel your kitchen?Would you?We can work with you to help you find the borrowing options that may be right for you,including: Auto Loans Credit Cards Home Equity Loans or Lines of Credit Personal Loans or Lines of Credit Private Student Loans Learn more today at wellsfargo.com/borrowing. IMPORTANT ACCOUNT INFORMATION The Wells Fargo Consumer Account Agreement will be updated effective October 29,2014,and the Terms&Conditions for Wells Fargo Consumer Debit Cards will be updated effective November 15,2014,to clarify that if you attempt to make a debit card purchase that causes you to exceed your daily purchase limit,we may,in certain circumstances,authorize that debit card transaction provided you have a sufficient balance to cover the purchase.Your daily limits are subject to periodic review and are subject to change based on account history,activity,and other factors.(Not available for certain accounts such as Teen Checking,Opportunity Checking°,and savings accounts.) For more details,refer to the Consumer Account Agreement Addenda at wellsfargo.com/wfonline/consumer_deposit_acct_fee or contact your local banker. Excess Activity in a Savings Account Regulation D and the Bank limit certain types of withdrawals and transfers from each savings or money market account to a combined total of six(6)per monthly statement period(exceptions to the statement period may apply).The limited items include all transfers and payments through Online Banking(including Mobile and Text Banking)or the telephone(automated and banker-assisted); pre-authorized transfers and withdrawals(including recurring and one time);checks and debit or ATM card purchases;transfers for Overdraft Protection;transfers and payments to Wells Fargo credit cards,lines of credit,and loans;and all wires(whether in person,on the telephone or online). Except for wire transfers,there are no limits on withdrawals or transfers made in person,at an ATM or Wells Fargo banking location or any types of deposits. Sheet Seq=0253054 Sheet 00002 of 00003 Account number: 3957742624 ■ July 1,2014-September 30, 2014 ■ Page 4 of 5 An excess activity fee of$15 is assessed for transactions exceeding the limit and accounts that exceed the limit on more than an occasional basis will be converted to a checking account(or closed).If the withdrawal and transfer limit is reached,we may decline transfers and withdrawals for the remainder of the monthly statement period(exceptions to the statement period may apply)to help you avoid a fee and account conversion or closure. For additional information,see your Account Agreement,talk with a local banker,or call the number on the top of your statement. Account number: 3957742624 ■ July 1,2014-September 30, 2014 ■.Page 5 of 5 Worksheet to balance your account General statement policies for Wells Fargo Bank Follow the steps below to reconcile your statement balance with your ■ To dispute or report inaccuracies in information we have furnished to a account register balance. Be sure that your register shows any interest Consumer Reporting Agency about your accounts. You have the right to paid into your account and any service charges,automatic payments or dispute the accuracy of information that Wells Fargo Bank,N.A.has ATM transactions withdrawn from your account during this statement furnished to a consumer reporting agency by writing to us at Wells Fargo period. Servicing,P.O.Box 14415,Des Moines,IA 50306-3415. Please describe the 0 Enter the ending balance on this statement. $ specific information that is inaccurate or in dispute and the basis for the dispute along with supporting documentation. If you believe the © List outstanding deposits and other information furnished is the result of identity theft,please provide us with credits to your account that do not appear on an identity theft report. this statement. Enter the total in the column ■ In case of errors or questions about your electronic transfers, to the right. telephone us at the number printed on the front of this statement or write Description Amount us at Wells Fargo Bank,P.O.Box 6995,Portland,OR 97228-6995 as soon as you can,if you think your statement or receipt is wrong or if you need more information about a transfer on the statement or receipt. We must hear from you no later than 60 days after we sent you the FIRST statement on which the error or problem appeared. 1.Tell us your name and account number(if any). 2.Describe the error or the transfer you are unsure about,and explain as Total $ + $ ( clearly as you can why you believe it is an error or why you need more information. 3.Tell us the dollar amount of the suspected error. © Add 0 and©to calculate the subtotal. _ $ � We will investigate your complaint and will correct any error promptly. If DQ List outstanding checks,withdrawals,and we take more than 10 business days to do this,we will credit your account other debits to your account that do not appear for the amount you think is in error,so that you will have the use of the on this statement. Enter the total in the column money during the time it takes us to complete our investigation. to the right. ■ In case of errors or questions about your Direct Deposit Advance -- service Number/Description Amount If you think your bill is wrong,or if you need more information about a transaction on your bill,write us at Wells Fargo Bank,P.0.Box 6995, Portland,OR 97228-6995 as soon as possible.We must hear from you no later than 60 days after we sent you the first bill on which the error or problem appeared.You can telephone us,but doing so will not preserve your rights. In your letter,give us the following information: 1.Your name and account number 2.The dollar amount of the suspected error 3.Describe the error and explain,if you can,why you believe there is an error.If you need more information,describe the item you are unsure about. You do not have to pay any amount in question while we are investigating, but you are still obligated to pay the parts of your bill that are not in question.While we investigate your question,we cannot report you as delinquent or take any action to collect the amount you question. Total $ $ QE Subtract D-1 from©to calculate the adjusted ending balance. This amount should be ^ the same as the current balance shown in your l�f register. _ $ I ©2010 Wells Fargo Bank,N.A.All rights reserved NMLSR ID 399801 Member FDIC. roEn Sheet Seq=0253055 Sheet 00003 of 00003 Wells Fargo ValuesM Checking Account number: 3957746146 ■ August 20,2014-September 18,2014 ■ Page 1 of 4 • Questions? Al HUA CHEN WARD Available by phone 24 hours a day, 7 days a week: KONG JI CHEN GDN 1-800-742-4932 7 HEDGE ROW LN TTY.,1-800-877-4833 CARLISLE PA 17015-4327 En espanol: 1-877-727-2932 4 1-800-288-2288 (6 am to 7 pm PT,M-F) Online: wellsfargo.com Write: Wells Fargo Bank,N.A.(345) P.O.Box 6995 Portland,OR 97228-6995 You and Wells Fargo Account options Thank you for being a loyal Wells Fargo customer.We value your trust in our A check mark in the box indicates you have these company and look forward to continuing to serve you with your financial needs. convenient services with your account(s). Go to wellsfargo.com or call the number above if you have questions or if you would like to add new services. Online Banking Q Direct Deposit z Online Bill Pay Auto Transfer/Payment r] Online Statements 0 Overdraft Protection ✓Q Mobile Banking F] Debit Card My Spending Report Z Overdraft Service El D IMPORTANT ACCOUNT INFORMATION Enhancements coming to your transaction descriptions including cash back detail Over the next few months,you will notice changes to the descriptions for debit,ATM or prepaid card transactions.These enhancements provide more detail about your transactions,and include new descriptions for purchases with cash back.For debit, ATM,or prepaid card merchant purchases with a request for cash back,the transaction description will include the words"cash"or "cash back,"and may include the dollar amount of cash requested. Merchant-Issued Debit Cards Are you using a merchant-issued debit card to make purchases(i.e.,Target'REDcard)?These unique purchasing cards(which typically provide reward points or discounts)are issued by a retailer when you provide them your Wells Fargo checking account and routing numbers. There are some very important differences between the merchant-issued purchasing card(not issued by Wells Fargo) and your Wells Fargo-issued debit card. When you use a merchant-issued card to make a purchase,the transaction is not immediately sent to Wells Fargo to confirm if your account has available funds.These transactions do not immediately reflect as pending withdrawals nor do they reduce your available balance.Instead,the merchant sends the transaction to Wells Fargo as an (345) Sheet Seq=0014524 Sheet 00001 of 00002 Account number: 3957746146 ■ August 20,2014-September 18,2014 ■ Page 2 of 4 automatic payment(ACH)transaction-and this is typically one to three days AFTER you made the purchase.When the purchase amount is sent to Wells Fargo for payment,the transaction will be paid with funds in your account,or if your account has insufficient funds to cover the transaction we may pay the transaction into overdraft(at the bank's discretion),or return it unpaid.If the transaction is paid into overdraft or returned unpaid,you may be assessed an overdraft or returned item fee.If the item is returned,the merchant may also charge a returned item fee and they will more than likely resubmit the transaction which could cause additional fees if there is not enough money in the account.As a result,it is very important for you to keep track of these purchases to avoid overspending. Activity summary Account number: 3957746146 Beginning balance on 8/20 $2,287.56 At HUA CHEN WARD Deposits/Additions 1,470.12 KONG JI CHEN GDN Withdrawals/Subtractions 1,885.47 Pennsylvania account terms and conditions apply Ending balance on 9/18 $1,872.21 For Direct Deposit use Routing Number(RTN): 031000503 Overdraft Protection Your account is linked to the following for Overdraft Protection: ■ Savings - 000003957742624 �_—_ — ----�--—-- ----------—- --� Transaction history -4 Check 1 J Date Number Description 8/22 11048 Met-Ed Check PY mt 082114 1048 000- - r 8125 Deposit Made In A Branch/Store 9/9 Deposit Made In A Branch/Store 9/10 SSA Treas 310 Xxsoc Sec 091014 xxi Chen for\N1'Be'Ai Che 9/11 ^1049 Jpmchase Bank NA Check Pymt 0910 Ending balance on 9/18 UUU Totals The Ending Daily Balance does not reflect any pending withdrawals S transactions posted. If you had insufficient available funds when a h — - - -- — ^ Converted check:Check converted to an electronic format by yc returned,copied or imaged. ��r Summary of checks written (checks listed are also displayed in i 5 Number Date Amount Number - v 1048 8/22 201.99 1049 Monthly service fee summary For a complete list of fees and detailed account information,please see the Wells Fargo Fee and Information Schedule and Account Agreement applicable to your account or talk to a banker.Go to wellsfargo.com/feefaq to find answers to common questions about the monthly service fee on your account. Fee period 08/20/2014-09/18/2014 Standard monthly service fee$9.00 You paid$0.00 How to avoid the monthly service fee Minimum required This fee period Have any ONE of the following account requirements Minimum daily balance $1,500.00 $1,872.21 Q Account number: 3957746146 ■ August 20,2014-September 18,2014 ■ Page 3 of 4 Monthly service fee summary(continued) How to avoid the monthly service fee Minimum required This fee period Total amount of qualifying direct deposits $500.00 $307.00 ❑ Monthly service fee discount(s)(applied when box is checked) Online only statements($2.00 discount) VCNc Other Wells Fargo Benefits Borrowing options to help you meet your goals What if you could reduce your higher interest rate loan payments,be prepared for the unexpected,pay for education costs,or remodel your kitchen?Would you?We can work with you to help you find the borrowing options that may be right for you,including: Auto Loans Credit Cards Home Equity Loans or Lines of Credit Personal Loans or Lines of Credit Private Student Loans Learn more today at wellsfargo.com/borrowing. IMPORTANT ACCOUNT INFORMATION The Wells Fargo Consumer Account Agreement will be updated.effective October 29,2014,and the Terms&Conditions for Wells Fargo Consumer Debit Cards will be updated effective November 15,2014,to clarify that if you attempt to make a debit card purchase that causes you to exceed your daily purchase limit,we may,in certain circumstances,authorize that debit card transaction provided you have a sufficient balance to cover the purchase.Your daily limits are subject to periodic review and are subject to change based on account history,activity,and other factors.(Not available for certain accounts such as Teen Checking,Opportunity Checking°,and savings accounts.) For more details,refer to the Consumer Account Agreement Addenda at wellsfargo.com/wfonline/consumer_deposit_acct_fee or contact your local banker. Sheet Seq=0014525 Sheet 00002 of 00002 Account number: 3957746146 ■ August 20,2014-September 18,2014 ■ Page 4 of 4 Worksheet to balance your account General statement policies for Wells Fargo Bank Follow the steps below to reconcile your statement balance with your ■ To dispute or report inaccuracies in information we have furnished to a account register balance. Be sure that your register shows any interest Consumer Reporting Agency about your accounts. You have the right to paid into your account and any service charges,automatic payments or dispute the accuracy of information that Wells Fargo Bank,N.A.has ATM transactions withdrawn from your account during this statement furnished to a consumer reporting agency by writing to us at Wells Fargo period. Servicing,P.O.Box 14415,Des Moines,IA 50306-3415. Please describe.the ❑A Enter the ending balance on this statement. $ specific information that is inaccurate or in dispute and the basis for the dispute along with supporting documentation. If you believe the © List outstanding deposits and other information furnished is the result of identity theft,please provide us with credits to your account that do not appear on an identity theft report. this statement. Enter the total in the column ■ In case of errors or questions about your electronic transfers, to the right. telephone us at the number printed on the front of this statement or write Description Amount us at Wells Fargo Bank,P.O.Box 6995,Portland,OR 97228-6995 as soon as you can,if you think your statement or receipt is wrong or if you need more information about a transfer on the statement or receipt. We must hear from you no later than 60 days after we sent you the FIRST statement on which the error or problem appeared. 1.Tell us your name and account number(if any). 2.Describe the error or the transfer you are unsure about,and explain as Total s ; $ clearly as you can why you believe it is an error or why you need more information. © Add❑A and©to calculate the subtotal. $ 3.Tell us the dollar amount of the suspected error. = � We will investigate your complaint and will correct any error promptly. If DQ List outstanding checks,withdrawals,and we take more than 10 business days to do this,we will credit your account other debits to your account that do not appear for the amount you think is in error,so that you will have the use of the on this statement. Enter the total in the column money during the time it takes us to complete our investigation. to the right. ■ In case of errors or questions about your Direct Deposit Advance — service Number/Description Amount If you think your bill is wrong,or if you need more information about a transaction on your bill,write us at Wells Fargo Bank,P.O.Box 6995, Portland,OR 97228-6995 as soon as possible.We must hear from you no later than 60 days after we sent you the first bill on which the error or problem appeared.You can telephone us,but doing so will not preserve your rights. In your letter,give us the following information: 1.Your name and account number 2.The dollar amount of the suspected error 3.Describe the error and explain,if you can,why you believe there is an error.If you need more information,describe the item you are unsure about. You do not have to pay any amount in question while we are investigating, but you are still obligated to pay the parts of your bill that are not in question.While we investigate your question,we cannot report you as delinquent or take any action to collect the amount you question. Total $ $ ❑E Subtract❑D from©to calculate the adjusted ending balance. This amount should be ^ the same as the current balance shown in your _ $ I Lf register. 02010 Wells Fargo Bank,N.A.All rights reserved NMLSR ID 399801 Member FDIC.ii.— REV-1510 EX+(08-09) pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Ai Hua Chen This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE INCLUDE THE NAME OF THE TRANSFEREE,THEIR RELATIONSHIP TO DECEDENT AND NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST IF APPLICABLE VALUE 1, Wells Fargo IRA Account#5628-5637.Decedent's wife,Jin E,Zhang,was 30,671.94 100 100.00 0.00 100%beneficiary. TOTAL(Also enter on Line 7, Recapitulation) $ 0.00 If more space is needed,use additional sheets of paper of the same size, I n � 9 to .a Z z (DD GKSWILDHKS 000032 rlr�lr,lr�llrlr,�rlr111111111111,hJill rrrrn,rrl„IrIll lurl�111 Al HUA CHEN(DECD) `^ FCC CUSTODIAN TRAD IRA 7 HEDGE ROW LN $ . ... CARLISLE PA 17015-4327 ro � O CL . C n (n ra _.__ �_. ca. ., _.._. ...... ...... O 3 O m m o c cp_ .. ' m „-n cn X y th o� p O O (D �C1Q�co DID pcm 0) O OODGD � (3� foo fir"z a Z{�? v x a a o;r c-� tsi � A -h 0 c 0 CD a w S m O v Q c c N � S. ITl �. ...) m1. m�t1 o`r�'v1 a0 � UQ CL En ,-I rn n cn m m lD z� ' �z-nr� � I > �p -11>;u Ln o S2 O z Q)h m .-<0 N b I X, x C7 S T ^t C7 t o C) Z I G7 oa --I rn U c jG3� Amo TO ?�^ rn Cp Dz o 0 as Lo �;�'c ac D m 0 L ^ /�y" Ir pm 2) z N r s p O O i.(. p Z o�cr Duets , o � 2Io bQ `G rn a0� U� x'13' U) > Zm N co < -4 D gip' a x - p o -i o pp Irt o o 11 0 ilk n m y(n OEM Z `� N mm " �m Cl �-n n O A co < 4 ZC7 m x' m D ttt p 0zz � m i cn p �r4 -{yo n -< CF) --jcv m o- D; 3 rngo -3 (n o 0 a^ Opn a 3 w j va Qto Z m 07 r O X 6 ,�., com o N o 'o to 8z @ m -4 n> ro z T v D Z �- (Do cc �m � 3�tKm � ym or -,330- _ q C N `KCatrmpm� ode �2.'abm O'x� m4�mm capat>p e e m�a ` A1.8 A) 0 yymm$3w."»m Li a- t� 'oa139 »o ao .� y3rWy c sz o _ �mzi Dom/ Ss- Z. mmsmtam'e� a arocmmaiPn°oy3ron`D �mmo4 5$ a Dco ON 02 � mst 2:1 »3_=fi 3n�mapa $'m�p�0�ga_�cHtc mp_3 .0cH_.�v � n^o� -�A .X H cm3»ymcy:; .ra: �hA2 •S°ap -3ao O .2 n0� � tt)clrm - i V1 aQoma yygy�c.v$ � $$»ay_ apo .m$c�ppOryD� me@'�y �c�pm ^; C7 N? �rd O' 3 r a' O r `D W m yrp �•_ a ^ y'� Vim O a-� a cmm?mm��a Coco ao3oAwam�c7f4,3.w Ai a�scro nv3 �cm3?i � O s.toyr3."' Kfq•`^m^o mcx m�a^j( no mm�-o'� a mogm Q,�, poja ,�185.0 amroy�mAz °cm3 m �a 3m ag7* Qm� iav, H Q zl?rocw� � . pam3'((°pp' Di ��. �C� m��'Q33^mS'd� a�a'tr'm�c2 '°' ohm$ 3o �� mm� , "7 th 3 m y ry 147 y q ti N fi b' •-�n' G A 4'1 p..... ycmyFrp amv m3�Flmo0 L cl cm,om� oRi0o8 cx 210- -r� � Ai S-9 Sm Sm01 'm Sm y31~m$ Nt°amcm'm' a3�9 '�°�'�r°o �ro3°_.n8$v�iw �N ti 3 mNa 9.7'N p o,co Q$ma O�•tD4NS"a1 ao tm�s�"�Q.�c'O?`c ~C _� �L O e �MQ qm mm3• ••�• y0mTj O•c3y 3C mmmtn Q� O Oy ? m CK OK�%�� 'h �►• roKaa°m 3m�mm�S' =m»O3m-'��k'cno`3a' t» �►wq C o o y- a a Q Q Ci m •O O, d m..O•-. Q y� 6 p� ,a"/pl I'M -. r �• �v34 y3mr'�c` m Qmym �°} a?ys$c p cn$3�� -°omw m= w M$ ayaiq 5Rt '1 '►• (� Caomm mpQm- r mo _3 Qus as ?- m=D a 9O Q a tip 5C• m•O., a 9Z m. J-3-8 -0�iOa'• N Q�ym pmp� a'y7 �•�..." _°q(C� A•Cy y `C L��°a ZO wm�5'�p)yi mOtD f7O'NN myai[� y�t�i �'m �090 mom• �! Cyaotr ro C ^� �ao.cc 3v OmO MO mn 05 !Y O m`i n 0 M"'h aoKa° fla33- , o mm - c^ » m a G ? O• ym 3_ oc'roc°yQ;o^o' LSyvo 4-w 0 m 'cm +�ya''_=. "++. �D'�"a•a.••, w 3'_3 3.»y m q w o m v '*m m$;'m �°'chi p•3 m._w a•,rynm x siry mo�m chi »a.'moo ya •�•►� :'p'C'c^O'oro omG m�y CaaW oy$m'�a3y O'oD0 y�r -o -r0¢`5 y•$ml4m (�y•2v 7!07�;ONCty Om Q, gIoa ymmliO0O � 0CLr w 2Qo •---.... a•�S'--., 3 4f a...,. tr� m m w o m�_C m Ps � m m o n C •� Ai �+ 0005mw m awl6 cp a m 033'mc3wrm3y tr° a» 'w 3y=g- ,ra oom 5', M 9a m3mm<� anmmm aS3 mQ y �mdm'o_tpS "�► a- a'-3 c a' rn'- rn_-m 3�. 't K m S m a ^ .= ro a �' �° °7 N�Q¢Symfiam m°:=o 'O- 3 m m7�O Vi mqm Ht 3Cimp3.aam �$ aa74?3' O.mmyK�Ct Qam xcm m rp 47G �"�• �.-OQ.^i m"Vi "'W S QOK Qh�mOQrp NmQ a- m 0 as S �...a O !'.• O m cx ro a m r ro_ m'ro S aam�'b3'' c3a mom$ c�wmw'3�to•»°imQS..�,8c�°a5- `anti So nr`0 u'``. n•4 •O• p• p A.-.. y m -..Q 4 a. a•.O am m 4i0 °' i c?5b'oN3°y 2mren r' (J+0o mp Q ao qm Q g cyy .ooo e0- mmm 5aO3tj,mmp p C CO m O wa .� , c�mom p^m�mtr Qw cK_.0 'Do.mxt,0(DDQm�"3y ° °c° nma 'rnm �Z dl•am cx mmq-'S�J� mO-N�O',~,X11 Tn'c9 O � yS~K �J fi •!n ..3 , O < m.�. 2 Q1 C y m a r-.� .asl o m a Q+ -,. c S7 $c3'mcns� bam m� ria m" n�'m�rommo' acs° omo00tx00 'n � 0M c e ,_ o :ro ,o 0100 aro � ane�maam �3Hay dcvi°`° a =amQ°�ro$_yncQvF mmy�y cmcc 8cmro`s� q`zo3 d�my3 a'3a�3mm �mmmSmca mp o343e m S �yc a- pmocnmu'o `•3y3'm3� $ �h•mAA p-Rgpt.aalwtr.'am=SKa$como om co,mra ca. m QO O y Q.r ` cc°w3m� ahmnmK oqc uy3'�mansmmroowi °bn� dao '�w �mo rKm T wCD 2,'4�3°� � °o nmW y4mmK3=mm°al h Cc,,,- .0@°cr�MN c' °� 5002m3g c v �Na2m��a a3• Q3y3.�NCaa tin`-.'1� amQda CN�.m�m40aa mm�C 'art ID 82 vSN Oz@V1S-T m fn m n`7 Tii' mm x m�°omm`� m mcu' s Ftym m . Q m om=m N't000a < m$ o Qmat � ^Gm �K`�'`x' m o�fp ID ON'yyro 'mri C�'�S� �j aSKa mon o �133�n'a n1 o.a 0 $$;..-�_. 2 g'n ro Op.. .,G C$m'"i tl�O fG �1:'z Im C r`'x, ray,N . a n 1,ZNy a-9-y�ro.bi.. ry¢7 a'[Cl N g3-• 3w' Oro 0m$ro oo' N CO cacAbl �fny cim °r3oNo o,. �mmq ro�nc^^. 3 w aQ Ef�a o mo�$`� a �o ;o;: QwQa40 ^., o''c0 KOoI ^' s-au7 '' nia"._aZ$d•m'Q cc Kl`lmc'4 m00. O0 0, mmy�bC mya nm2 fybco.Z`� _3 JO ?c o�Tti3 am a CQpWcf� �$pmo- 3a0. mm 't7 mmg�G��mayrD o=�vK ga m a moo »�°tfu�Ooa�c$DaT o3fii= �p-.amm a °�? + 0 $^� m �'•CN 3��N b�,m u? O' o�a as AW�Qj•�:.n m O.O C 7 n <mrCa 0a0 rnm bD o'a m C5 �► aO $m3$a � mm� �omP m �`i�3°�aov�� 3Zmr^c m<oN ca �4TrnaN G ym 0z-,KA- aym vermin'' amA,-gaf-, in' !!?! a.0 mya m o m� S QWak memo m O ° g ada3 Q C oya.vmm mot C°4$o owxo$ go�3 l5 b' 3 tn3@�n��° ya a O[n LI Sal .T m ti.y 3 Q C!O C��..5 y y,„'. m c a `C Gl'N n N'm0 C t6 m-� mn C m- G a s mr a.a mmol am 1-040 °�a aoay. 0 WR c° `'� w'c $' � $�»mm .? omo� N d n t$'l°m9 °Gv °O n3BC am o Orrs4—ii&X-COW �' y .ohm, ao��•'c„Ra »'� my �' ;� '�a'N IIi CL Or``imy S2- s.�_. 3p30'. ,, - ll -;Vu^7�5'm»�oc� pl a .,�y@�' �K m m aa. Iri'OQ OO y{D'a�" ° 'J^ GIp CI a•� 3a cdm^ ti^$ 3=tom 4° � �?p{y0% l� 3b3•b 4.Q,s a3fm,°�.$�3 LZ a -.r?l a C•+ GG m p=7m O ti...y j•a.c mm Qp co• y.L�.`c'c 3°r H $O's acQy-f3. a �• roar c'5 ap mCG°lm'm 8R °?.8' o�mb�a,a�Rbn Gi Z$.o 4yS.DommoeRm.. Zf tQ m 3 c�0 y •'�' q, 'n m vai m RI mm•y"�m to m o 9' N N C+�i`G m--.�c m zmp 3'ti C °0 aZi mQmm �m q c fi� °ot �ry7a cQn`0 bwa-'°m3' 3$b ro co- mon ��m °dl0000on. ovmiCa vro0 mwmc3ro N oa at ,03t) awt° am�m�m ano comm ymvS�O mo il• S ra c�o33wpg0 w"o, r7�t o0)m_Z2 mm�b'Z� _. N'ro M^'.� .11Lm �•hq aC.;� m jaCC ro`V ,'m Z -Oy v$�o,y�+H'a p° Ivo'-ym m o oO1 1G H 'fpbm• c=mmym m3�'� -440 (D C N G cdN 3 .7 m m wl?N O�Q SJ VO s'm'' ~ror 00°`25-�Om mK m �^ m aoa t romo O' QO o- �g30O N 3.d o a ro �'H n 3'=• .m m,~{,,� D.? ltN _Am 3 . m Qfi O'7m ,�ao tag ° $o'''a oL3mM�' 2'-. a htn� n»mr b. 0 s,9 Oa0 m�3 yam OOQ as ,�'"a+S Qnm m na Qssmm Fm-, mw0 3 to roaa$ym $m 3cnm$m�fio 6,0 m c' Ci a y a0O .a..,t^n cm"g 0'_41 =.��f^ mQx-1?'O AC zm •b;t aemr� Soc a. 3 mG0.-..' ma w"y'� oZx n$G°c� m �01 o y co'm� o3V 4m $03°y'oa o''3mrm ras_ m�4` $yoro qo3 y' CWC mSO z' 7 4?C Z QUN'm0 Qa •a+• yyC y,'7O Q� ma 047' a'H 'O y0 O-pOaaS�•ryaa "m "0 -n m O m y a N N S.- $"m N L? O m C�-.fi o co ; ro 3' cm^- �o4i zz �c ,s. m�?w 2Sd°o�nn� > mn3~ $$gym ^.N$m oyv �bDac�nm°?m3� ^az o0 io°`r _aT �v7mo%5' 30 mG`m `tin X00 �33 'mu mpyy. m aro m m°m3nTo`c In' m y al r No e° nao�a pyo ba-n$oVQa ,Scam m$-` ymnm'n(Op o`�°" pwn»Go•�^rg�m.Nb•mccro3ocT 39G�°Ktr o•�•g�ro��a W40 wa a m3Oc3-ym H$ - ma ONoaocOfiov C. 5` CoC mIY»gnF.,.0,mrou. z 3Smmoo33Y oros� ucrOK� z3 a�m 00 S COG C.m ,0an'z0-•fn `^•rm =x mCWMagmw o y'co 3 w $ y Cay m p n aomomm�tnC)cnC} p c O CO mm g * aa - tQ a) (n Nam ro 0 _ < a o G � OL Er .~i W r: ry OL CD � x A cn m w woa m a �ao0) N ab y > S' con D © WO0 co c)6io a 5•�' N C X O LU �y 004 O c z ID CO ECL m c �_wro C d Off os N y m m tCDD O, :t D �3 � 2 m m d n n O P, o � m mm rp yry _« Q a y N j 4 0 Tc W p W x a � o nm to Ulrn y! 0 4D 0 OD is D FCL 0 a �c�a t� O to .__.. �t4 "o n W W Q 'C} 0 N N Q N O to rn V a ` a m QL` m o m CD -� 0000 0p ga -0 OL {� om Q) Zo° 0) a —I v { "fin (, (D m ' nb Fr y co0ON z a o �\ � oacn cz aaV o lb 0 � C c � c� � c am ~� 1S S'c ro 4 4 = N �• z- g� a > D — m �cc) o CNv 0z r y ° c W rn cD m e a �� m m nr `D ryro n y cn z0 zc o m ;� (Dm �d a Q o 0o m� oa�i -a .0 o o L". to O a 0 o ov m 3 (D ~. 3 3 `C co 9, o c o 00co, 0 ��„ cu �rD m , (D3 w� � 'N. tD V(0 -0 N X c' o op -9, :3° (D m 3 00oco) D, ro _�0 o > > Q. 0) 5 al to CA N O m a Dr q J> 7C' 0 to ti cu m m_a � C/) 71 cp c1� m Zc cr cn M v =� n -'17 � Z m (D N N (-) K o - n a 2 N d9 ,Sw m N Q3 O fC} m NO C 4 Q Q p m C7 �D O _td CJ' N { O o O �' m. 0 = 0 N ro N N Ct1 � q . � ■ ■ . � � � 3 0 � ■ . c � ] � 2 � 0IkZ10 E - � -Q ; § § KIS / ƒ ® § _ (n. Eo % /} � k C _ CL _ \ � E r . 01 �§ Cl) . z � � Cl) 2 0 »� -» q/qs c\ C$ � (n0 /w 0 n C:N) p2 m 22 e $} 2� Cl) $2 0 & � 00 I > d 40 _0) o_0)I ;u oogoo - ca k \ ±kb� R 00 C?, % - & / CD k& a ® . �{ . goo m f ® k / � {'o CL v -� F l- o " 1 DD 1 Z1 °' p'0 m C? 'rJ tti o mtD (D mm � c� C i CD J -� t b �' L) Z. d L5- Z Z rte",Z O A+ w C i (a 0 -4 m m'rn "" S w m'Z r C ? � 0- 3 0 � ,-� o 2 roc a m 2 �O a J UN-• aoi c u, z C Sst ro(D zO b ar nfi m 4 o r o a- 5� >0 m rD m C -, ;u 4 7 � 1 'K y 00 co w ~ `D n A C? O �! � f -4 Z (D ai r A �7 D ! Ct C 7 Iz (D o a o rr w n �O 3 a� _ o O c m to rn A a' ra , o z A{zy Pr CL �x n o %+m _ 00 M cn N j i].4' C a) N=��Z �p O Vi z v:, y C:�z O ' s --� N c_. °r°a A oz 0 fD j c`n n v y nOrn UQ ! fr> �p C f O :u; i s N F a A ¢>C Z 0 OX D ry {n + b OD r C (D p- cn f llfr eA- d A S i 1 V C V or 10 o o`z o "al A w -i m o to > -4 03> -n n -n go =r r- 0 0 -0 .3 < X j3 00 o 0 T, 0 (D (p c (D x 0 z q) -n 0 — --(D (n (a 0 -0 w CL = — — M ;:;: 3 0 woo 0 W,< 0 0 " 0 c 0 co> a) -0 N. =3 M4 = tA (D Z co<> (D 0 �; g) 0 :3 0 rn m 5 C) 5� 0 iF C-* 0 0 • (D 0 4�- z 0 p Z K) --i 0 fD N) CO Q. 3 cr 0 <D 0 0 0 0 o. ;o 0 w m Z CD O) -n> oC) c C� > o 0 o ao —o I (n T 0 z z z OD <. C: -10 o ;rN rn G) m 10 cn cL > C)5 rn fl K3 rn G) z n m> W o -0 0 m C) M Fom ct Z cn,> -;04 (DO G) M m C: + CD (D m o 3 z m < 0) cn (D ;u 0 ?5 10 m m m . m > z X00 00 0 0 -n z > ? s =3 w 0 Ln 0tO 0 m 4 Cl) Z M CP 0 0 0 00 0 0 (Dcp 0 (D cr 0 (D m mm cl mo T, m CL=r 0 3 c 0"o _O0 (D — (D 0 0 0 3 :3 En < -0 CD OC cl, o w 'on CD. mlDoatO u' 0 OZ O:c ID 0 G.r+ rQ m M CL OC oc 0 OD C — (1) > 0 U) CD 0* > > ::3 CD CD 0 :3 0) 0 0 M ::3 0 U) tn En (D z wo C: m 0 0-0 :E ta CL 0) 3 CD 0 -h Z:- 0 m CD — m 0 co 2.oao :3 0 c K3 0Z o) CD m o Z rn - w 77 m — r- 0 - 0) m 0) r+ =- t- CD -10 0 -n po a m 1 0 Cn CD U) = —W 0 = �, = (3) a) 0 U) a N);u —co 0 CL a o 0 3 < 6> < 3 (A NO 0 M 0 0 0) o CD rn - c CL -4 m U) < co 3 0 - 0 N0 tQ 0 C� �$ (n 0 0 ID U,8 0 tTt 0 M V to 0 0 0 :3 x x x X Xa w :3 CD m CL CL 0 CL M 0 0 m :3 ro cc 0 m Ln 0 0 7V 0) cD to 0 o (D n 0 0 0 0 CD to Gh Z. T CD of°n 001-1m, rj m00 m M .04 V1m0`0 (D L OR 0 :caro ' M �3 a ro ro a O ro � I ro k' ° im G X C '-� ro0 3 W W om`c zjo -ttArt� '=cn !a! az;ip @ !I z` ca=m CL OG7,0 r°uo =1 ry sH a (nQ7iz � S z y �' �. � Nr offj°' 0r p O n' toy° z � cn> o �7mp mrn' •�,.-, CD coo wr � r W Fm @'t7 A I ' .B. I Ha°=''.Q7 E mnr�n 1p gm „ z ° c ° D ro � Q i :z oo0 co�� .. U)0N° Ij ro' ° n mm0A ✓� ! ( o��� pp C! @�� ,hx�i�� m+tmr�i .e0<0 mc�l-zi p° !�uZrjzl� p_njzMIZ jro _. .._ - .. _.. .. _ .._ ^V 0 j r m -- - - O m �-.,,N na��, Hca �1z x��o ° a a, 0 viZ n , X0a) �n �JJ� O ='0 ! i ¢gw ro 'ID cn j 1 in N32�• i 0Z (D to� rn I D� n OC �C z = cF Cy IZM MOcur _ ..# mc4m LDUt(Ny app i CN C7 ppm G)I� i ! W 2v m 8 D' o�m i x ' -i0 oma. S: � � m f-n _ Z n _ Vt x m O C>! ny°p ori C7 R'1 zr-a � coc o0)T1 c4jro r{�OO w'{ V `tndKTi �� G �0 I � La rola boa - 1 w ->'q, cb 07, `raro �� Lri ha: c I O � IX> z ~g'�3� 00 -0_' 1CD -� QKIOD C O �a�•� o r-.._ Z st] �+ d M91. O 1 N Vii 181 W Ch Oil oj°?icm,m cn ro REV-1511 EX+(08-13) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Ai Hua Chen Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Boe Fook Funeral Services, Inc.,41 Canal St.,New York, NY 10002 38,078.00 2 The Kensico Cemetery,273 Lakeview Avenue,Valhall, NY 10595-grave 6,000.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City State ZIP Year(s)Commission Paid: 2. Attorney Fees: 3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: 5. Accountant Fees: 6. Tax Return Preparer Fees: 7. C. R. Powers--Furnace replacement and repairs to 7 Hedge Row Lane,Carlisle, PA(50%) 2,750.00 TOTAL(Also enter on Line 9, Recapitulation) $ 46,828.00 If more space is needed,use additional sheets of paper of the same size. Page I BOE FOOK FUNERAL SERVICES, LLC 41 Canal Street (Entrance: 5 Ludlow Street) Tel.:212-966-0218 New York,NY 10002 Fax:212-966-1102 www.fookfu nera I group.co in Number: BF149346 F.Use of the facilities Date: September 17,2014 1. Use of the facilities for visitation....... $ 500.00 Name of Deceased: Ai Hua Chen,PRVV6 2.Use of the facilities for the funeral.......... $ 250.00 3.Other use of the facilities(specify)......... Date of Death: September 11,2014 Place of Death: Camp Hill,PA $ NIA ITEMIZATION OF FUNERAL SERVICES AND MERCHANDISE SELECTED $ N/A G.Livery The following are the charges for the services,merchandise,and livery 1.a.Hearse or............................................... $ 450.00 you have selected. You will not be charged for any item you do not b.Alternative vehicle.................................. $ NIA choose unless it is necessary because of other selections you have (Specify Type:) made. Any such charges are explained below. 2.Flower vehicle............................................ $ 400.00 I. FUNERAL HOME CHARGES 3. Limousine(s).............................................. $ N/A (Indicate NIA for items of service and/or merchandise that are not Specify number:0 @$0.00/Limousine provided) 4.Pallbearer car............................................ $ N/A A.Alternative Services 5.Passenger car(s)....................................... $ N/A Specify number: Q@$N/A/Car 1.Direct Cremation............................................... $ N/A 6. Lead/Clergy car(s)................................... $ N/A 2.Direct Burial....................................................... $ N/A Specify number: 0@$N/A/Car H.Merchandise B. Transfer of remains to the funeral establishment 1.Casket....................................................... $ 23,880.00 including personnel,equipment and vehicle. $ 500.00 a.Supplier: Batesville Casket Company,Inc. C. Preparation of Remains b.Model name or number: 711 President Carved Top 1.Embalming(including use of preparation c.Material:Species of wood: Solid Mahogany room)................................................................. $ 500.00 weight or If you select a funeral for which this firm or Kind of Metal: Solid Mahagony gauge: requires embalming such as a funeral with d. Interior Pearl Velvet viewing, you may have to pay for embalming. or alternative container........................ $ N/A You do not have to pay for embalming you do (describe) not approve if you select arrangements such as 2.Outer Interment Receptacle..................... $ 5,800-00 direct cremation or direct burial. If we charge a.Supplier Crews Farrell Mead Vault Company for embalming,we will explain why below. b.Model name or number Bronze Triune 2.Other Preparation(including use of preparation c.Material Bronze,Trilon And Concrete room but excluding embalming) 3.Urn............................................................ $ N/A a.Topical Disinfection....................................... $ N/A a.Description b.Custodial Care............................................... $ 1,680.00 I.Additional Service and Merchandise Selected(Describe and show price) c.Dressing/Casketing...................................... $ 300.00 1.Register Book........--......--........--...... $ 50-00 d.Cosmetology................................................. $ 150.00_ 2.Memorial Cards 0/Prayer Cards 0........... $ N/A e.Restoration............................................I....--. $ N/A 3.Acknowledgment Cards - 0.................... $ N/A f.Hairdressing................................................... $ N/A 4.Crucifix/Cross........................................ $ N/A 9.Other(specify)............................................... $ N/A 5.Flowers.................................................... $ N/A h. ...................................................................... $ N/A 6.Clothing or Burial Garments..................... $ N/A 7.Monument................................................ $ N/A D.Arrangements 8.Name Plate.............................................. $ 80.00 Basic arrangements: including funeral director, 9. ....... ....................... ............... $ N/A other staff, equipment and facilities to respond to 10. ..........................-................................... $ N/A initial request for service, the arrangements conference, securing of necessary authorizations 11. ........ ...... ......--...... $ N/A and coordination of service plans with parties 12. .......... .....................11....................... ...... $ N/A involved in the final disposition of the deceased. $ 430.00_ 13. .......-............ ......... .......................... $ N/A E.Supervision(Funeral Director and Staff) J.Limited Services 1.Supervision for Visitation............................... $ 500.00 1.Forwarding remains to............................... $ N/A 2.Supervision for Funeral Services................... $ 300.00 2.Receiving remains from............................. $ N/A 3.Supervision for Memorial Services................. $ N/A 4.Supervision for Graveside Services............... $ NIA TOTAL OF FUNERAL HOME CHARGES......... $ 35,770.00 5.Other Supervision .................................I....... $ N/A AUTHORIZATION INITIAL. II,Cash Advances Page 2 These are estimated charges for items to be paid to others. We will charge you no more for these I tems than is actually paid the third parties. (Describe and show estimated charges). 1.Kensico Cemetery.......................... ......... ....... $ 1,664.00 2. 10 Certified Death Cert.at 9.00 ea................... $ 90.00 3.Pallbearers...................................................... $ 300.00 - Total Adjustment to Fui4ril Charges`:..:............ $ N/A 4. Burial Permit........_.......... ............................. $ 40.00_ ADJUSTW, J.,1 --111 38,07&00 5. ............___.......... ...... ...... $ N/A Zj Credit................ ,_W).... 6 ..................................................... .......... $ N/A' 2,578.00 7.Cemetery Sat Addition Charge....,................. $ 214.00 BALANCE OF FUNERAL CHARGES.............. $ 35,500.00 8. ........................................................................ $ N/A IV.EXPLANATION OF CHARGES ...... ....................._.................... ................. $ N/A_ Explain charges for embalming and for any items that are not 9 required by law but may be necessary because of cemetery 10. ..... ...... ........... ...... ......... ...... $ N/A_ requirements,crematory requirements or other selections made. 11. .............................. ...................... ................. $ N/A_ Use of Staff and Facilities for Visitation-$1,000.00 12. __......__.....__...... ......__.... ....... $ N/A_ Use of Staff and Facilities for Funeral-$550.00 ESTIMATED TOTAL OF CASH ADVANCES............ $ 2,308.00. Family Selected Embalming,Casket And Vault III SUMMARY OF CHARGES 1. FUNERAL HOME CHARGES............................ $ 35,770.00 2.CASH ADVANCES............................................ $ 2,308.00 TOTAL FUNERAL CHARGES.................................. $ 38,078.00- Signature of Licensed Funeral -Date Aniana Perallon ADDITIONS OR ALTERATIONS OF SERVICES AND MERCHANDISE Printed or Typed Name of Funeral Director SELECTED. The following changes represent items of service and/or Acknowledgment of Receipt merchandise order altered subsequent to the original funeral agreement. I have received thl itemization of funeral services and merchandise selected. &_Aa ti-, /07 air AUTHORIZATION INITIAL. _Wlnaturi� V Date PUBLIC NOTICE: THE NEW YORK STATE DEPARTMENT OF HEALTH IS RESPONSIBLE FOR LICENSING AND REGULATING NEW YORK STATE FUNERAL DIRECTING UNDER THE PUBLIC HEALTH LAW. YOU MAY CONTACT THE DEPARTMENT AT: BUREAU OF FUNERAL DIRECTING, NEW YORK STATE DEPARTMENT OF HEALTH,433 RIVER STREET.,SUITE 303,TROY,NEW YORK 12180-2299. EXCLUSION OF WARRANTY, The only warranties,express or implied,granted in connection with the goods sold with this funeral service are the express written warranties,if any,extended by the manufacturers thereof. No other warranties and no warranties of merchantability or fitness for a particular purpose are extended by the funeral director. CONTRACTUAL AGREEMENT STATEMENT OF GOODS AND SERVICES SELECTED The funeral Home named in the above itemization of Funeral Services & Merchandise Selected agrees to render the services and furnish the merchandise specified in said itemization, and the undersigned purchaser(s) agrees to p y for the same the sum 35,500.00 under"Terms of Payment"referenced below. J:W Aniana Perallon Printed or Typed Name of Funeral Director Signature of Licensed Funeral Director The undersigned purchaser(s) hereby attest to the following: (1) I/We authorized the above named funeral home EI to embalm 0 not to embalm the deceased named above. (2) IA/Ve were shown a Casket Price List and Outer Interment Receptacle Price List before the showing of Caskets and Outer Interment Receptacles. (3)I/We were given/offered for retention a General Price List upon the beginning of a decision of funeral arrangements and/or selection of services and merchandise, (4)The above itemization of Funeral Services&Merchandise Selected has been read by(to)me/us and I/We acknowledge receipt of a copy of same and a copy of this Contractual agreement. TERMS OF PAYMENT: This account becomes due. If bill remains unpaid beyond a late charge of 1.50%per month(annual rate)18.00%may be added to the unpaid portion of the balance due.Purchaser(s)agrees to pay reasonable attorney fees,court costs and other courts costs of collection if incurred in the collection of this debt. 1,or We,having read the above,accept and approve same,and jointly and severally promise to pay the sum stipulated in the Itemization of Funeral Services and Merchandise Selected,plus charges for any additional services and merchandise as ordered by me/us,said payment to be made according to the TERMS OF PAYMENT set forth above. Mr. Kong Ji Chen Name of Purchaser or Co-Purchaser Name of Purchaser or Co-Purchaser Name of Purchaser or Co-Purchaser MR. MR. MR. MRS. MRS. MRS. —miss miss miss Signature oT Ptirchaser or Co-Purchaser Signature of Purchaser or Co-Purchaser Signature of Purchaser or Co-Purchaser 7 Hedge Row Lane Address Address Address Carlisle,PA 17015 City and State Zip Code City and State Zip Code City and State Zip Code Phone Number Phone Number Phone Number 122-80-8979 Social Security Number Social Security Number Social Security Number Case # i „ Q 19 : /�- 3 ?. s L 11 ]f 1A 1-94 Of A Description Quantity Price Amount Remarks in Photo & Frame t Basket t [a Wreath X(A Z) Flowers Livery ( ko -� Tolls / Mileage Arr A/q A/gyp' 4 Blanket Clothing .tc/ , Banner Band 4A#L91A . Rhult $200 Video Record St Birches THE KENSICO CEMETERY Cash Sale Agreement 273 Lakeview Avenue Valhalla,NY 10595 Computer#: Tel: (914)949-0347 - Fax: (914)949-0803 00111759 KENSICO E-Mail:KensicogKensico.Org Contract#: man"M A Conti"OF CUM AGREEMENT FOR PURCHASE OF CEMETERY LOT M 0606 (KENSICO) Inventory Page: M-0-H 1. THE KENSICO CEMETERY("Kensico")agrees to sell and the undersigned buyer(s)("Buyer")agree(s)to purchase the burial rights in the following cemetery lot or lots("Lot")for cemetery purposes only: 2. Lot#/Number of Graves: Birches Lot#96 1,Gr.I& Gr#2 Purchase Price: $ 12,000.00 Interment Depth: Single Depth Form of Pymt:lqwa(,a Down Payment: $ ?I Area: (Approx. Sq.Ft.): -Jx13=9I Balance: $ con C10 Remarks: 3211 Monument Area The Balance of the Purchase Price shall be payable in full with acceptable funds on or before_171L ;�,, 22�3 the Due Date.,but not to exceed ninety(90)days from the date of acceptance of this Agreement by Kensic6. 3. In Addition to the Purchase Price of your burial lot,an interment fee and other related costs are required at time of burial. 4. If Purchaser fails to make payment in full on or before the Due Date,Kensico may cancel this Agreement and because of the difficulty to determine actual damage,retain all payments received as liquidated damages. 5. Until payment of the full purchase price with funds satisfactory to Kensico,Buyer shall have no rights in the Lot or be able to install a memorial or make any burials in the Lot. 6. Upon receipt of the full purchase price, Kensico will issue a Deed conveying the use of the Lot as a place for burial of the human dead. 7. Interments, installation of a memorial,planting and sale of the Lot shall be subject to the Rules and Regulations of the New York State Cemetery Board,the General Rules and Regulations of Kensico as amended,and the Section or Area Restrictions on the reverse side of this Agreement. 8. Buyer has read the Section or Area Restrictions on the reverse side of this Agreement and received a copy of Kensico's General Rules and Regulations,all of which shall survive and be effective after delivery of the Deed. 9. This Agreement has been read by the Buyer and contains all the terms agreed upon and supersedes any oral agreements or representations made by anyone on behalf of Kensico.This agreement may be changed or varied only in writing,signed by Kensico and the Buyer. 10.This Agreement may not be transferred or assigned by Buyer without first obtaining Kensico's written consent. 11.The effectiveness of this Agreement is subject to its execution by an authorized officer of Kensico and the terms shall survive delivery of the Deed. )4 The Buyer has executed this Agreement on the ol�--- day of Signature Name Address Tel/E-Mail X Mr.Kong Ji Chen 7 Hedge Row Lane,Carlisle,PA 17015 (917)353-9993 Tenancy: ACCEPTED:THE KENSICO CEMETERY (1D#13-1715053) By: k 2eza (Rpm./Vice Pres.) Date of Acceptance: Kensico Representative: Richard Weber Signature: Date: 3/25/2013 Type of Need: Pre Need 0 3 Month El To Be Collected 0 Accepted Cemetery Copy 0 Accepted Buyer Copy O.Jnitial Buye?Copy'\ (SEE REVERSE SIDE OF AGREEMENT FOR SECTION OR AREA RESTRICTIONS AND LO-_ THE KENSICO CEMETERY SECTION OR AREA RESTRICTIONS The following Restrictions apply to the Section or Area in which your Lot is located: The Birches: 1. Monuments: * On lots with areas of 500 square feet or more,one upright monument will be permitted,centered at least one foot from the rear line of the lot, with a maximum of 50%of the width of the lot and a maximum overall height of 54"including a base 10"high and not more than 18" in width. * On lots which exceed 280 square feet,but limited to a maximum of 499 square feet,one upright monument will be permitted, centered at least one foot from the rear line of the lot,with a maximum of 50%of the width of the lot and a maximum overall height of 48"including a base 8"high and not more than 18"in width. * One upright monument will be permitted on lots,other than the above,which exceed 180 square feet,centered at least one foot from the rear line of the lot. The maximum width of the monument shall not exceed 50%of the width of the lot and shall not exceed 42" overall height, including a base 8"high and not more than 18" in width.(Lots cannot be combined to create a lot exceeding 180 square feet in order to erect a monument exceeding 32"overall height.) * One upright monument will be permitted.on any two-grave lot,centered at least one foot from the rear line of the lot. The maximum width of the monument shall not exceed 50%of the width of the lot or combination of lots. The monument shall not exceed 32"overall height, including a base 8"high and 12"wide. * On single graves,only one interment or up to four remains shall be permitted in each grave. All memorials shall be flush granite and set at the head of the lot or graves. No planting is permitted on single graves. * The upright monument and base must be of the same approved quality granite. *The sides and ends of all bases must be left in the natural rock finish. The Cemetery is not responsible for damage to upright monuments, bases,or flush memorials. * A written application for a permit shall be submitted to the Cemetery describing in detail the proposed memorial with a plan of the lot showing the size and location to scale,including all elevations. 2. Planting: * Planting with approved shrubs will be permitted on either side of an upright monument only if an endowment agreement,in form satisfactory to Kensico,is executed by the Lot Owner and the amount of the endowment is deposited with Kensico before any planting is permitted.. * A permit from the Cemetery Office is required before anyone may plant,which includes flowers or placement of shrubs, wreaths,winter coverings or floral tributes on any lot in this Section. Planting without a permit is subject to removal without notice. Artificial flowers are permitted only in the months of December through March and must be removed before April 1. 3. Interments: * This is a single depth interment area. Lot Diagram f i l L Chester S.Day President KENSICO Chief Executive Officer and Treasurer MORE THAN A CENTURY OF CARING August 12, 2013 Mr. Kong Ji Chen COMPUTER 00111759 CONTRACT#: M 19605 DEED#: 506514 DEED DATE: 8/12/2013 7 Hedge Row Lane SECTION: Birches Carlisle, PA 17015 LOCATION: Sec-BIR Lot-961 Grv-1-2 -SGL,-SGL Dear Mr. Kong Ji Chen, Thank you for your payment in full for your contract with The Kensico Cemetery dated 4/2/2013. Enclosed is the original deed for your records. The original deed has been electronically recorded in the database of The Kensico Cemetery. If you have not already received your contract, a copy of your contract is also enclosed. Our toll free telephone number is 1-888-KENSICO (1-888-536-7426) and our e-mail address is kensico@kensico.org. Please feel free to call, write or e-mail us concerning your cemetery needs. Sincerely yours, Chester S. Day Enclosure The Kensico Cemetery-P.O.Box 7-Valhalla,New York 10595.1-(888)536-7426 Jax:1-(914)949-0803•www.kensico.org-e-mail:kensico@kensico.org Invoice Number Ca RPOWERS 21 5. Hanover 1 Suite 1 � 49 Carlisle, PA 17013 R14-11 (717) 241-5988 All Payments Due Upon Completion VISA Heating Air Conditioning - Plumbing • Electrical Services - Duct Cleaning r Bill To Date Emergency Service Service PMP A/- p t /r 1 Q Q Billing Address Job Address , city - State Zip.Code City r - ,6tafe Zip Code Home Phone Work Phone Tech , �.�� Code qComplete � Incomplete 'I `C I r) !s Report' ,Fme.S i,✓ '� / ; f.� ;,, 65%of Payment Up Front-15%After 1st Day-20%When Complete i �i.r. ?,, _" fir" �, ,( AIR CONDITIONING HEATING OTHER '` f All Payments Due Upon Cornptetion i %._ r' > t° �:,,f✓ I Cash Check Credit ;. COMMERCIAL ACCOUNT INVOICES MUST BE PAID WITHIN 30 / DAYS. {F NOT PAID 1010% t°EVERYDAYAFTER THAT. PDTO E AFTER-10 DAYS, /1)tlr �*11`x ' 20 NO WARRANTY OR REFUNDS ON LABOR FOR SERVICE WORK il^gym rte- �s Q Clean or replace air filters !Q Amp draws .� Q Clean and check condensate drains Q Tighten all electrical connections Q Check and adjust tan belts Q Check safety controls f j Q Lube motors and bearings Q Vacuum Clean Unit 2814484643 Q Ambient Temperature Q Examine comb.chamber PF4MNA042LgqAAAAMFG CODE I CODE DE FAR CoolooE E6MIFII Q Examine heat exchanger ttf Supply temperature Return temperature Q Clean or replacs oil filter (1 Head pressure Q Check gas valve Suction pressure Q 'Special notes-see Tech.Report it n Check controls!thermostat �) -Check voltages I sr ,K r. mF P y j Qi4id1 �filt"� 'n" 1� C11'dC]/ Show-up Charge Total Hours t Material Used Reclaiming Equipment Preventive Maintenance Program/Contract I MNRS Sales Tax 4 } r�"t "�C.,,v✓,=.. i"-1C...�� w'� / KJ`/l"+ ��,R,,,...+"W6........ - .�6 ;v:-?"77 � 1`R.��; e_1 �ki dd- m'iY' .'� This is your invoice. Y m°aw Please P8 from This invoice and approved. SERVICE TICKET/ PREVENTIVE MAINTENANCE PROGRAM /CONTRACT FORM Invoice Number S21 S, Hnover S., Suie. (717) 241-5988 Cm R. POWER Carliale, PA 17013tte 1 R14-IJ Ask All Payments Due Upon Completion I 'VISA Heating Air Conditioning Plumbing - Electrical Services Duct Cleaning Bill To Date Emergency Service Service PMP A Billing Addrdssjob Address 7 City Stat", Zip Code city State ZlpCode Home Phone work Phone, Tech Code Complete Incomplete Semftoj�"rt. L_ port 65%of Payment Up Front-15%After 1 st Day-20%When Complete AIR CONDITIONING HEATING OTHER All Payments Due Upon Completion Cash Check Credit COMMERCIAL ACCOUNT INVOICES MUST BE PAID WITHIN 30 171 DAYS. IF NOT PAID 10%WILL BE APPLIED TO BALANCE AFTER 10 DAYS, 2%EVERY DAY AFTER THAT. NO WARRANTY OR REFUNDS ON LABOR FOR SERVICE WORK IQ Clean or replace air filers = Amp draws Clean and check condensate drains = Tighten all electrical connections Check and adjust fan belts = Check safety controls Lube motors and bearings = Vacuum Clean Unit Ambient Temperature = Examine comb.chamber Supply temperature = Examine heat exchanger Return temperature = Clean or replace oil filter Head pressure = Check gas valve Suction pressure = *Special notes-see Tech.Report Check controls I thermostat Check voltages ary Wil Used 'T �c -Amount art summ .0 Show-up Charge Total Hours Material Used Reclaiming Equipment Preventive Maintenance Program/Contract MHRS Sales Tax TO This is your invoice. The above work is authorized Please Pay from This Invoice and approved. SERVICE TICKET PREVENTIVE MAINTENANCE PROGRAM / CONTRACT FORM REV-1512 EX+(12-12) pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Ai Hua Chen Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Chase Mortgage Loan#1547180666 226,303.29 TOTAL(Also enter on Line 10, Recapitulation) $ 226,303.29 If more space is needed,insert additional sheets of the same size. i%&u3 Nage 1 of 2 CHAS Nn Customer Service 1-800.848-9138 Monday-Friday 8 a.m.-midnight(ET) Saturday a a.m.-a p.m,(ET) Deaf or Hard of Hearing (TTY) 1-800.582.0542 chase.com I�II��l�E�'IIIIEI���IEIIrE�rEIEIE'I�rEErlrlr��+lEluEl�Il�l���llr s9203 Mso z anis c- sn2 PA 11 ago Mortgage Loan Statement At HUA CHEN Loan Number 1547180666 7 HEDGE ROW LN Statement Date 03117/2015 CARLISLE PA 17015-4327 Property Address 7 Hedge Row Ln Carlisle,PA 17015 Total Amount Due $1,880.37 Payment Due Date 05/01/2015 A late charge of$67.10 may apply if received after 05/1612015. Loan Overview(as of 03/17/2015) Explanation of Amount Due Original Principal Balance $250,000.00 Unpaid Principal Balance $226,303.29 Principal $399.13 Interest Rate 5.00000% - interest $942.93 Escrow Balance $3,383.19 Escrow Payment{Taxes and/or Insurance} $338.31 Monthly Payment $1,680.37 Past Payments Breakdown Prior Fees/Charges $0.00 Paid Since Last Statement Paid Year-to-Date Fees/Charges Since Last Statement $0.00 Principal $397,47 $1,187.47 Total Amount Due $1,880.37 Interest $944.59 $2,838.71 Escrow Payment(Taxes and/or Insurance) $338.31 $1,014.93 Total $1,680.37 $5,041.11 `transaction .Activity Since Your Last Statement(includes Fees/Charges) Transaction Date Description Total Received Principal Interest Escrow Fees Unapplied Funds 03/17/2015 PAYMENT $1,680.':7 $397.47 $944.59 $338.31 Important Messages If applicable,your IRS Form 1098(Mortgage Interest Statement)is available at chase.com/TaxStatement.Most accounts can be viewed online. Servicemember Protections:You may be entitled to certain legal rights and protections if you or any owner or occupant of your home are or recently were on active duty or active service as a federal or state Military Servicemembet,or if you're a dependent of such a Servicemember.For more Information,please call us at 1-877-469.0110, 1.318.340-3308 if you're calling from overseas,or 1-800.682-0542 for TTY services. If you receive or expect to receive an insurance claim check for damages to your home,you can visit chase.comtinsuranceCiafm for information about our claim process.If you have any questions,please call us at 1.866-742.1461 Monday through Friday from 8 a.m.to midnight and Saturday from 8 a.m.to 8 p.m.Eastern Time. , s c r�x I�w �IIIIIIYWII IIY IOW ��mnni Pe da Return to: pppGR6 Nations Lending Services Ohio Attn: Recording Department 3700 Corporate Drive Suite 200 Columbus, OH 43231 Prepared By: Lynette Taylor 1820 E Sky Harbor Circle S Floor 02 Phoenix, AZ 85034 Parcel Number: 40 24 0760 052 Premises: 7 HEDGE ROW LN, CARLISLE,PA 17015 Mortgage Definitions. Words used in multiple sections of this document are defined below and other words are defined in Sections 3, 11, I3, 18,20 and 21.Certain rules regarding the usage of words used in this document are also provided in Section 16. (A) "Security Instrument"means this document,which is dated August 13,2010,together with all Riders to this document. (B) "Borrower"is AIHUA CHEN,Single Man. Borrower is the mortgagor under this Security Instrument. (C) "Lender"is JPMorgan Chase Bank,N.A.. Lender is a National Banking Association organized and existing under the laws of the United States.Lender's address is 1111 Polaris Parkway,Floor 4J, Columbus, OH 43240 . Lender is the mortgagee under this Security Instrument. PENNSYLVANIA-Single Family-Fannie Fannfe MaelFreddie Mac UNIFORM INSTRUMENT VMPID Form 3039 1101 Wolters Kluwer Financial Services 201008123.5.0.0.400220100318Y Initials ii. JH Page 1 of 20 (D) "Note"means the promissory note signed by Borrower and dated August 13,2010. The Note states that Borrower owes Lender two hundred fifty thousand and 00/100 Dollars(U.S.$250,000.00) plus interest.Borrower has promised to pay this debt in regular Periodic Payments and to pay the debt in full not later than September 1,2040. (E) "Property"means the property that is described below under the beading"Transfer of Rights in the Property." (F) "Loan"means the debt evidenced by the Note,plus interest,any prepayment charges and late charges due under the Note,and all sums due under this Security Instrument,plus interest. (G) "Riders"means all Riders to this Security Instrument that are executed by Borrower.The following Riders are to be executed by Borrower[check box as applicable]: ❑ Adjustable Rate Rider ❑ Condominium Rider O Second Home Rider O Balloon Rider ❑ Planned Unit Development Rider O 14 Family Rider ❑ VA Rider ❑ Biweekly Payment Rider ❑ Other(s) [specify] (H) "Applicable Law"means all controlling applicable;federal, state and local statutes,regulations, ordinances and administrative rules and orders(that have the effect of law)as well as all applicable final,non-appealable judicial opinions. (1) "Community Association Dues,Fees, and Assessments"means all dues,fees,assessments and other charges that are imposed on Borrower or the Property by a condominium association,homeowners association or similar organization. (3) "Electronic Funds Transfer"means any transfer of funds,other than a transaction originated by check,draft,or similar paper instrument,which is initiated through an electronic terminal,telephonic instrument,computer,or magnetic tape so as to order,instruct,or authorize a financial institution to debit or credit an account.Such term includes,but is not limited to,point-of-sale transfers,automated teller machine transactions,transfers initiated by telephone,wire transfers,and automated clearinghouse transfers. (K) "Escrow Items"means those items that are described in Section 3, (L) "Miscellaneous Proceeds"means any compensation,settlement,award of damages,or proceeds paid by any third party(other than insurance proceeds paid under the coverages described in Section 5)for: (i)damage to,or destruction of,the Property;(ii)condemnation or other taking of all or any part of the Property; (iii)conveyance in lieu of condemnation;or(iv)misrepresentations of,or omissions as to,the value and/or condition of the Property. 1547180666 PENNSYLVANIA-Single Family-Fannie MaelFreddie Mac UNIFORM INSTRUMENTn form 30381/01 VM PO i(./ Vaoners Ktuwer Financial Services 201008123.5.0.0.4002201003U9Y Inldals page 2 o120 •H r WON a uwn�rr.rr.��nm.n.v (M) "Mortgage Insurance"means insurance protecting.Lender against the nonpayment of,or default on,the Loan. (N) "Periodic Payment"means the regularly scheduled amount due for(i)principal and interest under the Note, plus(ii)any amounts under Section 3 of this Security Instrument. (0) "RESPA"means the Real Estate Settlement Procedures Act(12 U.S.C. Section 2601 et seq.)and its implementing regulation,Regulation X(24 C.F.R.Part 3500),as they might be amended from time to time,or any additional or successor legislation or regulation that governs the same subject matter. As used in this Security Instrument,RESPA refers to all requirements and restrictions that are imposed in regard to a"federally related mortgage loan"even if the Loan does not qualify as a "federally related mortgage loan"under RESPA. (P) "Successor in Interest of Borrower"means any party that has taken title to the Property,whether or not that party has assumed Borrower's obligations under the Note and/or this Security Instrument. Transfer of Rights in the Property. This Security Instrument secures to Lender: (i)the repayment of the Loan, and all renewals,extensions and modifications of the Note;and(ii)*the performance of Borrower's covenants and agreements under this Security Instrument and the Note.For this purpose, Borrower does hereby mortgage,grant and convey to Lender the following described property located in the COUNTY [Type of Recording Jurisdiction] of Cumberland[Name of Recording Jurisdiction]: See Title Report See Attached which currently has the address of 7 HEDGE ROW LN[Street]CARLISLE [City],Pennsylvania 17015 [Zip Code] ("Property Address"): TOGETHER WITH all the improvements now or hereafter erected on the property,and all easements, appurtenances,and fixtures now or hereafter a part of the property.All replacements and additions shall also be covered by this Security Instrument.All of the foregoing is referred to in this Security Instrument as the "Property." BORROWER COVENANTS that Borrower is lawfully se:.sed of the estate hereby conveyed and has the right to mortgage,grant and convey the Property and that the Property is unencumbered,except for encumbrances of record. Borrower warrants and will defend generally the title to the Property against all claims and demands, subject to any encumbrances of record. THIS SECURITY INSTRUMENT combines uniform covenants for national use and non-uniform covenants with limited variations by jurisdiction to constitute a uniform security instrument covering real property. Uniform Covenants. Borrower and Lender covenant and agree as follows: 1.Payment of Principal,Interest,Escrow Items,Prepayment Charges,and Late Charges.Borrower shall pay when due the principal of,and interest on,the debt evidenced by the Note and any prepayment ///��� 1547180666 PENNSYLVANIA-Single Family-Fannie MaelFreaaie Mat UNIFORM INSTRUMENT mal--l�Fonn 3039 1(01 VMPO Wolters Khlwor Financial Services 201008123.5.0.0.40022010031 BY Inidals: Page 3 of 20 r charges and late charges due under the Note.Borrower sha.11 also pay funds for Escrow Items pursuant to Section 3. Payments due under the Note and this Security Instrument shall be made in U.S. currency. However,if any check or other instrument received by Lender as payment under the Note or this Security Instrument is returned to Lender unpaid,Lender may requ:.re that any or all subsequent payments due under the Note and this Security Instrument be made in one or more of the following forms,as selected by Lender:(a)cash;(b)money order;(c)certified check,bank check,treasurer's check or cashier's check, provided any such check is drawn upon an institution whose deposits are insured by a federal agency, instrumentality,or entity;or(d)Electronic Funds Transfer. Payments are deemed received by Lender when received at the location designated in the Note or at such other location as may be designated by Lender in accordance with the notice provisions in Section 15. Lender may return any payment or partial payment if the payment or partial payments are insufficient to bring the Loan current.Lender may accept any paymen:or partial payment insufficient to bring the Loan current,without waiver of any rights hereunder or pr judice to its rights to refuse such payment or partial payments in the future,but Lender is not obligated to apply such payments at the time such payments are accepted.If each Periodic Payment is applied as of its scheduled due date,then Lender need not pay interest on unapplied funds. Lender may hold such unapplied funds until Borrower makes payment to bring the Loan current.If Borrower does not do so within a reasonable period of time,Lender shall either apply such funds or return them to Borrower.If not applied earlier,such funds will be applied to the outstanding principal balance under the Note immediately prior to foreclosure.No offset or claim which Borrower might have now or in the future against Lender shall relieve Borrower from making payments due under the Note and this Security Instrument or performing the covenants and agreements secured by this Security Instrument. 2.Application of Payments or Proceeds. Except as otherwise described in this Section 2,all payments accepted and applied by Lender shall be applied in the following order of priority:(a)interest due under the Note; (b)principal due under the Note;(c)amounts dc.e under Section 3. Such payments shall be applied to each Periodic Payment in the order in which it became due.Any remaining amounts shall be applied first to late charges, second to any other amounts due under this Security Instrument,and then to reduce the principal balance of the Note. If Lender receives a payment from Borrower for a delinquent Periodic Payment which includes a sufficient amount to pay any late charge due,the payment may be applied to the delinquent payment and the late charge.If more than one Periodic Payment is outstanding,:Lender may apply any payment received from Borrower to the repayment of the Periodic Payments if,and to the extent that,each payment can be paid in full. To the extent that any excess exists after the payment is applied to the full payment of one or more Periodic Payments, such excess may be applied to any late charges due.Voluntary prepayments shall be applied first to any prepayment charges and then as described in the Note. 1547180666 PENNSYLVANIA-Single Family-Fannie Mae/Freddie Mac UNIFORM INSTRUMENT fam 3039 1101 VMPCJ Wolters Kluwer Financial Services 201008123.5:0.0.40022010031 SY Initiak: Page 4 of 20 'H Any application of payments,insurance proceeds,or Miscellaneous Proceeds to principal due under the Note shall not extend or postpone the due date,or change the amount,of the Periodic Payments. 3. Funds for Escrow Items.Borrower shall pay to Lender on the day Periodic Payments are due under the Note,until the Note is paid in full,a sum (the"Funds")to provide for payment of amounts due for; (a)taxes and assessments and other items which can attain priority over this Security Instrument as a lien or encumbrance on the Property;(b)leasehold payments or ground rents on the Property,if any;(c) premiums for any and all insurance required by Lender under Section 5;and(d)Mortgage Insurance premiums,if any,or any sums payable by Borrower to Lender in lieu of the payment of Mortgage Insurance premiums in accordance with the provisions of Section 10.These items are called"Escrow Items." At origination or at any time during the tern of the:Loan,Lender may require that Community Association Dues,Fees,and Assessments,if any,be escrowed by Borrower,and such dues, fees and assessments shall be an Escrow Item. Borrower shall promptly furnish to Lender all notices of amounts to be paid under this Section. Borrower shall pay Lender the Funds for Escrow Items unless Lender waives Borrower's obligation to pay the Funds for any or al;.Escrow Items.Lender may waive Borrower's obligation to pay to Lender Funds for any or all Escrow Items at any time.Any such waiver may only be in writing. In the event of such waiver,Borrower shall.gay directly,when and where payable,the amounts due for any Escrow Items for which payment of Funds has been waived by Lender and,if Lender requires, shall furnish to Lender receipts evidencing such*payment within such time period as Lender may require. Borrower's obligation to make such payments and to provide receipts shall for all purposes be deemed to be a covenant and agreement contained in this Security Instrument,as the phrase"covenant and agreement" is used in Section 9.If Borrower is obligated to pay Escrow Items directly,pursuant to a waiver,and Borrower fails to pay the amount due for an Escrow Item, Lender may exercise its rights under Section 9 and pay such amount and Borrower shall then be obligated under Section 9 to repay to Lender any such amount. Lender may revoke the waiver as to any or all Escrow Items at any time by a notice given in accordance with Section 15 and,upon such revocation,Borrower shall pay to Lender all Funds,and in such amounts,that are then required under this Section 3. Lender may, at any time,collect and hold Funds in an amount(a) sufficient to permit Lender to apply the Funds at the time specified under RESPA,and(b)not to exceed the maximum amount a lender can require under RESPA. Lender shall estimate the amount of Funds due on the basis of current data and reasonable estimates of expenditures of future Escrow Items or otherwise in accordance with Applicable Law. The Funds shall be held in an institution whose deposits are insured by a federal agency,instrumentality, or entity (including Lender,if Lender is an institution whose deposits are so insured)or in any Federal Home Loan Bank.Lender shall apply the Funds to pay the Escrow Items no later than the time specified under RESPA.Lender shall not charge Borrower for holding and applying the Funds,annually analyzing the escrow account, or verifying the Escrow Items, unless Lender pays Borrower interest on the Funds 1547180868 PENNSYLVANIA-Single Family-Fannie Mae/Freddie Mae UNIFORM INSTRUMENT Form 30391/01 i VMPO Wolters Kluwer Financial Services 201008123.5.0.0.400220100318Y Initials L Page 5 of 20 'H 1 and Applicable Law permits Lender to make such a charge:.Unless an agreement is made in writing or Applicable Law requires interest to be paid on the Funds,Lender shall not be required to pay Borrower any interest or earnings on the Funds. Borrower and Lender can agree in writing,however,that interest shall be paid on the Funds. Lender shall give to Borrower,without charge,an annual accounting of the Funds as required by RESPA. If there is a surplus of Funds held in escrow,as defined under RESPA,Lender shall account to Borrower for the excess funds in accordance with RESPA.If there is a shortage of Funds held in escrow,as defined under RESPA, Lender shall notify Borrower as required by RESPA,and Borrower shall pay to Lender the amount necessary to make up the shortage in accordance:with RESPA,but in no more than 12 monthly payments. if there is a deficiency of Funds held in escrow,as defined under RESPA,Lender shall notify Borrower as required by RESPA,and Borrower shall pay to Lender the amount necessary to make up the deficiency in accordance with RESPA,but in no more than 12 monthly payments. Upon payment in full of all sums secured by this Security instrument,Lender shall promptly refund to Borrower any Funds held by Lender. 4.Charges; Liens.Borrower shall pay all taxes,assessments,charges,fines,and impositions attributable to the Property which can attain priority over this Security Instrument,leasehold payments or ground rents on the Property,if any,and Community Association Dues,Fees,and Assessments,if any.To the extent that these items are Escrow Items,Borrower shall pay them in the manner provided in Section 3. Borrower shall promptly discharge any lien which has priority over this Security Instrument unless Borrower:(a)agrees in writing to the payment of the obligation secured by the lien in a manner acceptable to Lender,but only so long as Borrower is performing such agreement;(b)contests the lien in good faith by,or defends against enforcement of the lien in, legal proceedings which in Lender's opinion operate to prevent the enforcement of the lien while those proceedings are pending,but only until such proceedings are concluded;or(c)secures from the holder of the lien an agreement satisfactory to Lender subordinating the lien to this Security Instrument.If Lender determines that any part of the Property is subject to a lien which can attain priority over this Security Instrument,Lender may give Borrower a notice identifying the lien. Within 10 days of the date on which that notice is given,Borrower shall satisfy the lien or take one or more of the actions set forth above in this Section 4. Lender may require Borrower to pay a one-time charge for a real estate tax verification and/or reporting service used by Lender in connection with this Loan. S. Property Insurance.Borrower shall keep the improvements now existing or hereafter erected on the Property insured against loss by fire,hazards included within the term"extended coverage,"and any other hazards including,but not limited to,earthquakes and floods,for which Lender requires insurance. This insurance shall be maintained in the amounts(including deductible levels)and for the periods that 1547180666 PENNSYLVANIA-Single Family-Fannie Mae/Freddie Mac UNIFORM INSTRUMENT n Form 3039 1/01 VMPO Wolters Wuwor Financial Services 2010D8123.5.0.0.4D022010031 BY Initials: Page 6 of 20 'H Lender requires. What Lender requires pursuant to the preceding sentences can change during the term of the Loan.The insurance carrier providing the insurance shall be chosen by Borrower subject to Lender's right to disapprove Borrower's choice,which right shall not be exercised unreasonably. Lender may require Borrower to pay, in connection with this Loan,either: (a)a one-time charge for flood zone determination,certification and tracking services;or(b)a one-time charge for flood zone determination and certification services and subsequent charges each time remappings or similar changes occur which reasonably might affect such determination or certification.Borrower shall also be responsible for the payment of any fees imposed by the Federal Emergency Management Agency in connection with the review of any flood zone determination resulting from an objection by Borrower. If Borrower fails to maintain any of the coverages described above,Lender may obtain insurance coverage, at Lender's option and Borrower's expense.Lender is under no obligation to purchase any particular type or amount of coverage.Therefore, such coverage shall cover Lender,but might or might not protect Borrower,Borrower's equity in the Property,or the contents of the Property,against any risk,hazard or liability and might provide greater or lesser coverage than wits previously in effect.Borrower acknowledges that the cost of the insurance coverage so obtained might significantly exceed the cost of insurance that Borrower could have obtained. Any amounts disbursed by Lender under this Section S shall become additional debt of Borrower secured by this Security Instrument.These amounts shall bear interest at the Note rate from the date of disbursement and shall be payable,with such interest,upon notice from Lender to Borrower requesting payment. All insurance policies required by Lender and renewals of such policies shall be subject to Lender's right to disapprove such policies,shall include a standard mortgage clause,and shall name Lender as mortgagee and/or as an.additional loss payee.Lender shall have the right to hold the policies and renewal certificates. If Lender requires, Borrower shall promptly give to Lender all receipts of paid premiums and renewal notices. If Borrower obtains any form of insurance coverage,not otherwise required by Lender, for damage to,or destruction of,the Property,such policy shall include a standard mortgage clause and shall name Lender as mortgagee and/or as an additional loss payee. In the event of loss,Borrower shall give prompt notice to the insurance carrier and Lender, Lender may make proof of loss if not made promptly by Borrower. Unless Lender and Borrower otherwise agree in writing,any insurance proceeds, whether or not the underlying insurance was required by Lender, shall be applied to restoration or repair of the Property,if the restoration or repair is economically feasible and Lender's security is not lessened.During such repair and restoration period,Lender shall have the right to hold such insurance proceeds until Lender has had an opportunity to inspect such Property to ensure the work has been completed to Lender's satisfaction,provided that such inspection shall be undertaken promptly. Lender may disburse proceeds for the repairs and restoration in a single payment or in a series of progress payments as the work is completed.Unless an agreement is made in writing or Applicable Law requires interest to be paid on such insurance proceeds,Lender shall not be required to pay Borrower 1547180666 PENNSYLVANIA-Single Family-Fannle Mae/Freddie Mac UNIFORM INSTRUMENT Form 3039 1101 VMP® Wolters Kluwer Financial Services 201008123.5.0.0.400220100318Y Initials' Page 7 of 20 any interest or earnings on such proceeds. Fees for public adjusters,or other third parties,retained by Borrower shall not be paid out of the insurance proceeds and shall be the sole obligation of Borrower. If the restoration or repair is not economically feasible or bender's security would be lessened,the insurance proceeds shall be applied to the sums secured by this Security Instrument,whether or not then due, with the excess, if any,paid to Borrower. Such insurance proceeds shall be applied in the order provided for in Section 2. If Borrower abandons the Property,Lender may file,negotiate and settle any available insurance claim and related matters.If Borrower does not respond within 30 days to a notice from,Lender that the insurance carrier has offered to settle a claim,then Lender may negotiate and settle the claim.The 30-day period will begin when the notice is given. In either event,or if Lander acquires the Property under Section 22 or otherwise,Borrower hereby assigns to Lender(a)Borrower's rights to any insurance proceeds in an amount not to exceed the amounts unpaid under the Note or this Security Instrument,and(b)any other of Borrower's rights(other than the right to any refund of unearned premiums paid by Borrower)under all insurance policies covering the Property, insofar as such rights are applicable to the coverage of the Property.Lender may use the insurance proceeds either to repair or restore the Property or to pay amounts unpaid under the Note or this Security Instrument,whether or not then due. 6.Occupancy.Borrower shall occupy,establish,and use the Property as Borrower's principal residence within 60 days after the execution of this Security Instrument and shall continue to occupy the Property as Borrower's principal residence for at least one year after the date of occupancy,unless Lender otherwise agrees in writing,which consent shall not be unreasonably,,vithheld,or unless extenuating circumstances exist which are beyond Borrower's control. 7. Preservation, Maintenance and Protection of the Property; Inspections.Borrower shall not destroy,damage or impair the Property,allow the Property to deteriorate or commit waste on the Property. Whether or not Borrower is residing in the Property,Borrower shall maintain the Property in order to prevent the Property from deteriorating or decreasing in value due to its condition.Unless it is determined pursuant to Section 5 that repair or restoration is not economically feasible,Borrower shall promptly repair the Property if damaged to avoid further deterioration or damage. If insurance or condemnation proceeds are paid in connection with damage to,or the taking of,the Property,Borrower shall be responsible for repairing or restoring the Property only if Linder has released proceeds for such purposes. Lender may disburse proceeds for the repairs and restoration in a single payment or in a series of progress payments as the work is completed.If the insurance or condemnation proceeds are not sufficient to repair or restore the Property,Borrower is not relieved of Borrower's obligation for the completion of such repair or restoration. 15471 Bowe PENNSYLVANIA-Single Famlly-Fannle Mee/Freddie Mac UNIFORM INSTRUMENTForm 3039 1101 VMP® WoBers Kluwer Financial Services 201008123.5.0.0.4002201003i9Y Initials Page 8 o120 Lender or its agent may make reasonable entries upon and inspections of the Property.If it has reasonable cause,Lender may inspect the interior of the improvements on the Property.Lender shall give Borrower notice at the time of or prior to such an interior inspection specifying such reasonable cause. 8. Borrower's Loan Application.Borrower shall be in default if,during the Loan application process, Borrower or any persons or entities acting at the direction of Borrower or with Borrower's knowledge or consent gave materially false,misleading,or inaccurate information or statements to Lender(or failed to provide Lender with material information) in connection with the Loan. Material representations include, but are not limited to,representations concerning Borrower's occupancy of the Property as Borrower's principal residence. 9. Protection of Lender's Interest in the Property and Rights Under this Security Instrument.If (a)Borrower fails to perform the covenants and agreements contained in this Security Instrument,(b) there is a legal proceeding that might significantly affect Lender's interest in the Property and/or rights under this Security Instrument(such as a proceeding in bankruptcy,probate,for condemnation or forfeiture, for enforcement of a lien which may attain priority over this Security Instrument or to enforce laws or regulations),or(c)Borrower has abandoned the Property,then Lender may do and pay for whatever is reasonable or appropriate to protect Lender's interest in the Property and rights under this Security Instrument,including protecting and/or assessing the value of the Property,and securing and/or repairing the Property. Lender's actions can include,but are not limited to; (a)paying any sums secured by a lien which has priority over this Security Instrument; (b)appearing in court;and(c)paying reasonable attorneys'fees to protect its interest in the Property and/or rights under this Security Instrument,including its secured position in a bankruptcy proceeding. Securing the Property includes,but is not limited to, entering the Property to make repairs,change locks,replace or board up doors and windows,drain water from pipes,eliminate building or other code violations or dangerous conditions,and have utilities turned on or off. Although Lender may take action under this Section 9, Lender does not have to do so and is not under any duty or obligation to do so. It is agreed that Lender incurs no liability for not taking any or all actions authorized under this Section 9. Any amounts disbursed by Lender under this Section 9 shall become additional debt of Borrower secured by this Security Instrument.These amounts shall bear interest at the Note rate from the date of disbursement and shall be payable,with such interest,upon notice from Lender to Borrower requesting payment. If this Security Instrument is on a leasehold,Borrower shall comply with all the provisions of the lease. If Borrower acquires fee title to the Property,the leasehold and the fee title shall not merge unless Lender agrees to the merger in writing. 10. Mortgage Insurance. If Lender required Mortgage Insurance as a condition of making the Loan, Borrower shall pay the premiums required to maintain the Mortgage Insurance in effect.If,for any reason, the Mortgage Insurance coverage required by Lender ceases to be available from the mortgage insurer 1547180666 PENNSYLVANIA-Single Family-Fannie MaefFraddle Mac UNIFORM INSTRUMENT Form 30391101 VMP® Wolters Kluwer Financial Services 201008123.5.0.0.4002201003'BY Initials: Page 9 of 20 'H 1 J C_ that previously provided such insurance and Borrower was required to make separately designated payments toward the premiums for Mortgage Insurance,Borrower shall pay the premiums required to obtain coverage substantially equivalent to the Mortgage Insurance previously in effect,at a cost substantially equivalent to the cost to Borrower of the Mortgage Insurance previously in effect,from an alternate mortgage insurer selected by Lender. If substantially equivalent Mortgage Insurance coverage is not available,Borrower shall continue to pay to Lender the amount of the separately designated payments that were due when the insurance coverage ceased to be in effect. Lender will accept,use and retain these payments as a non-refundable loss reserve in lieu of Mortgage Insurance. Such loss reserve shall be non-refundable,notwithstanding the fact that the Loan is ultimately paid in full,and Lender shall not be required to pay Borrower any interest or earnings on such loss reserve..Lender can no longer require loss reserve payments if Mortgage Insurance coverage(in the amount and for the period that Lender requires)provided by an insurer selected by Lender again becomes available,is obtained,and Lender requires separately designated payments toward the premiums for Mortgage Insurance.If Lender required Mortgage Insurance as a condition of making the Loan and Borrower was required to make separately designated payments toward the premiums for Mortgage Insurance,Borrower shall pay the premiums required to maintain Mortgage Insurance in effect,or to provide a non-refundable loss reserve, until Lender's requirement for Mortgage Insurance ends in accordance with any written agreement between Borrower and Lender providing for such termination or until termination is required by Applicable Law. Nothing in this Section 10 affects Borrower's obligation to pay interest at the rate provided in the Note. Mortgage Insurance reimburses Lender(or any entity that purchases the Note)for certain losses it may incur if Borrower does not repay the Loan as agreed.Borrower is not a party to the Mortgage Insurance. Mortgage insurers evaluate their total risk on all such insurance in force from time to time,and may enter into agreements with other parties that share or modify their risk,or reduce losses.These agreements are on terms and conditions that are satisfactory to the mortgage insurer and the other party(or parties)to these agreements.These agreements may require the mortgage insurer to make payments using any source of funds that the mortgage insurer may have available(which may include funds obtained from Mortgage Insurance premiums). As a result of these agreements,Lender,any purchaser of the Note,another insurer,any reinsurer,any other entity,or any affiliate of any of the foregoing,may r.-ceive(directly or indirectly)amounts that derive from(or might be characterized as)a portion of Borrower's payments for Mortgage Insurance, in exchange for sharing or modifying the mortgage insurer's risk,or reducing losses.If such agreement provides that an affiliate of Lender takes a share of the insurer's risk in exchange for a share of the premiums paid to the insurer,the arrangement is often termed"captive reinsurance."Further. 1547180686 PENNSYLVANIA-Single Famty-Fannio Mae/Freddie Mac UNIFORM INSTRUMENT j j Farm 30391/01 VM PO jYtl Watters Kluwer Financial Services 201008123.5.0.0.400220100318Y Initials: Page 10 of 20 (A) Any such agreements will not affect the amounts that Borrower has agreed to pay for Mortgage Insurance, or any other terms of the Loan. Such agreements will not increase the amount Borrower will owe for Mortgage Insurance, and they will not entitle Borrower to any refund. (B) Any such agreements will not affect the rights Borrower has - if any - with respect to the Mortgage Insurance under the Homeowners Protection Act of 1998 or any other law. These rights may include the right to receive certain disclosures, to request and obtain cancellation of the Mortgage Insurance, to have the Mortgage Insurance terminated automatically, and/or to receive a refund of any Mortgage Insurance premiums that were unearned at the time of such cancellation or termination. 11.Assignment of Miscellaneous Proceeds; Forfeiture. All Miscellaneous Proceeds are hereby assigned to and shall be paid to Lender. If the Property is damaged,such Miscellaneous Proceeds shall be applied to restoration or repair of the Property,if the restoration or repair is economically feasible and Lender's security is not lessened.During such repair and restoration period,Lender shall have the right to hold such Miscellaneous Proceeds until Lender has had an opportunity to inspect such Property to ensure the work has been completed to Lender's satisfaction,provided that such inspection shall be undertaken promptly. Lender may pay for the repairs and restoration in a single disbursement or in a series of progress payments as the work is completed. Unless an agreement is made in writing or Applicable Law requires interest to be paid on such Miscellaneous Proceeds,Lender shall not be required to pay Borrower any interest or earnings on such Miscellaneous Proceeds.If the restoration or repair is not economically feasible or Lender's security would be lessened,the Miscellaneous Proceeds shall be applied to the sums secured by this Security Instrument,whether or not then due,with the excess, if any,paid to Borrower. Such Miscellaneous Proceeds shall be applied in the order provided for in Section 2. In the event of a total taking,destruction,or loss in value of the Property,the Miscellaneous Proceeds shall be applied to the sums secured by this Security Instrument,whether or not then due,with the excess, if any,paid to Borrower. In the event of a partial taking,destruction,or loss in value of the Property in which the fair market value of the Property immediately before the partial taking,destruction,or toss in value is equal to or greater than the amount of the sums secured by this Security Instrument immediately before the partial taking, destruction, or loss in value,unless Borrower and Lender otherwise agree in writing,the sums secured by this Security Instrument shall be reduced by the amount of the Miscellaneous Proceeds multiplied by the following fraction; (a)the total amount of the sums secured immediately before the partial taking, destruction,or loss in value divided by(b)the fair market value of the Property immediately before the partial taking,destruction,or loss in value. Any balance shall be paid to Borrower. 1547180668 PENNSYLVANIA-Single Family-Fannie MaelFroddle Mae UNIFORM INSTRUMENTJ ) f Farm 3039 1101 VMPO Ytt (.,�. Wolters Kluwer Financial Services 201008123.5.0.OA00220100318Y initiats. Page 11 of 20 1 1 - - --- - - �tr•rrrt� ren w In the event of a partial taking,destruction,or loss in value of the Property in which the fair market value of the Property immediately before the partial taking,destniction,or loss in value is less than the amount of the sums secured immediately before the partial taking,destruction,or loss in value,unless Borrower and Lender otherwise agree in writing,the Miscellaneous Proceeds shall be applied to the sums secured by this Security Instrument whether or not the sums are then due. If the Property is abandoned by Borrower,or if, after notice by Lender to Borrower that the Opposing Party(as defined in the next sentence)offers to make an award to settle a claim for damages,Borrower fails to respond to Lender within 30 days after the date the notice is given,Lender is authorized to collect and apply the Miscellaneous Proceeds either to restoration or repair of the Property or to the sums secured by this Security Instrument,whether or not then due. "Opposing Party"means the third party that owes Borrower Miscellaneous Proceeds or the party against whom Borrower has a right of action in regard to Miscellaneous Proceeds. Borrower shall be in default if any action or proceeding,whether civil or criminal,is begun that, in Lender's judgment,could result in forfeiture of the Properly or other material impairment of Lender's interest in the Property or rights under this Security Instrument. Borrower can cure such a default and, if acceleration has occurred,reinstate as provided in Section 19,by causing the action or proceeding to be dismissed with a ruling that,in Lender's judgment,precludes forfeiture of the Property or other material impairment of Lender's interest in the Property or rights under this Security Instrument.The proceeds of any award or claim for damages that are attributable to the i mpairment of Lender's interest in the Property are hereby assigned and shall be paid to Lender. All Miscellaneous Proceeds that are not applied to restoration or repair of the Property shall be applied in the order provided for in Section 2. 12.Borrower Not Released;Forbearance By Lender Not a Waiver.Extension of the time for payment or modification of amortization of the sums secured by this Security Instrument granted by Lender to Borrower or any Successor in Interest of Borrower shall not operate to release the liability of Borrower or any Successors in Interest of Borrower. Lender shall not be required to commence proceedings against any Successor in Interest of Borrower or to refuse to extend time for payment or otherwise modify amortization of the sums secured by this Security Instrument by reason of any demand made by the original Borrower or any Successors in Interest of Borrower.Any forbearance by Lender in exercising any right or remedy including,without limitation,Lender's acceptance of payments from third persons, entities or Successors in Interest of Borrower or in amounts less than the amount then due,shall not be a waiver of or preclude the exercise of any right or remedy. 13.Joint and Several Liability; Co-signers; Successors and Assigns Bound. Borrower covenants and agrees that Borrower's obligations and liability shall be joint and several.However,any Borrower who co-signs this Security Instrument but does not execute the Note(a "co-signer"): (a)is co-signing 1547180666 PENNSYLVANIA-Single Famlry-Fenn a MaelFraddie Mac UNIFORM INSTRUMENT Form 30381101 VMP® Wolters Kluwer Financial Services 201008123.5.0.0.40022010031 BY Initial Page 12 of 20 'H this Security Instrument only to mortgage,grant and convey the co-signer's interest in the Property under the terms of this Security Instrument;(b)is not personally obligated to pay the sums secured by this Security Instrument; and(c)agrees that Lender and any other Borrower can agree to extend,modify, forbear or make any accommodations with regard to the terms of this Security Instrument or the Note without the co-signer's consent. Subject to the provisions of Section 18,any Successor in Interest of Borrower who assumes Borrower's obligations under this Security Instrument in writing,and:is approved by Lender,shall obtain all of Borrower's rights and benefits under this Security Instrument. Borrower shall not be released from Borrower's obligations and liability under this Security Instrument unless Lender agrees to such release in writing. The covenants and agreements of this Security Instrument shall bind(except as provided in Section 20)and benefit the successors and assigns of Lender. 14. Loan Charges.Lender may charge Borrower fees for services performed in connection with Borrower's default,for the purpose of protecting Lender's interest in the Property and rights under this Security Instrument,including,but not limited to,attorneys'fees,property inspection and valuation fees. In regard to any other fees,the absence of express authority in this Security Instrument to charge a specific fee to Borrower shall not be construed as a prohibition on the charging of such fee.Lender may not charge fees that are expressly prohibited by this Security Instrument or by Applicable Law. If the Loan is subject to a law which sets maximum loan charges,and that law is finally interpreted so that the interest or other loan charges collected or to be collected in connection with the Loan exceed the permitted limits,then: (a)any such loan charge shall be reduced by the amount necessary to reduce the charge to the permitted limit;and(b)any sums already collected from Borrower which exceeded permitted limits will be refunded to Borrower. Lender may choose to make this refund by reducing the principal owed under the Note or by making a direct payment to Borrower. If a refund reduces principal,the reduction will be treated as a partial prepayment without any prepayment charge(whether or not a prepayment charge is provided for under the Note). Borrower's acceptance of any such refund made by direct payment to Borrower will constitute a waiver of an; right of action Borrower might have arising out of such overcharge. 15. Notices. All notices given by Borrower or Lcnder in connection with this Security Instrument must be in writing. Any notice to Borrower in connection with this Security Instrument shall be deemed to have been given to Borrower when mailed by first class mail or when actually delivered to Borrower's notice address if sent by other means.Notice to any one Borrower shall constitute notice to all Borrowers unless Applicable Law expressly requires otherwise. The notice address shall be the Property Address unless Borrower has designated a substitute notice address by notice to Lender.Borrower shall promptly notify Lender of Borrower's change of address. If Lender specifies a procedure for reporting Borrower's change of address,then Borrower shall only report a change of address through that specified procedure. 1547180866 PENNSYLVANIA-Single FamYy-Fannie Mae/Freddie Mac UNIFORM INSTRUMENT ) ,} Form 3039 1/01 VMP® Wolters Kluwer Financial Services 201008123.5.0.0.400220100318Y Initials: Page 13 of 20 There may be only one designated notice address under this Security Instrument at any one time.Any notice to Lender shall be given by delivering it or by mailing it by first class mail to Lender's address stated herein unless Lender has designated another address by notice to Borrower.Any notice in connection with this Security Instrument shall not be deemed to have been given to Lender until actually received by Lender. If any notice required by this Security Instrument is also required under Applicable Law,the Applicable Law requirement will satisfy the corresponding requirement under this Security Instrument. U.Governing Law; Severability; Rules of Construction.This Security Instrument shall be governed by federal law and the law of the jurisdiction in which the Property is located.All rights and obligations contained in this Security Instrument are subject to any requirements and limitations of Applicable Law. Applicable Law might explicitly or implicitly allow the parties to agree by contract or it might be silent, but such silence shall not be construed as a prohibition against agreement by contract.In the event that any provision or clause of this Security Instrument or the Note conflicts with Applicable Law,such conflict shall not affect other provisions of this Security Instrument or the Note which can be given effect without the conflicting provision. As used in this Security Instrument: (a)words of the masculine gender shall mean and include corresponding neuter words or words of the feminine gender;(b)words in the singular shall mean and include the plural and vice versa;and(c)the word"may"gives sole discretion without any obligation to take any action. 17. Borrower's Copy.Borrower shall be given one copy of the Note and of this Security Instrument. 18.Transfer of the Property or a Beneficial Interest in Borrower.As used in this Section 18,"Interest in the Property"means any legal or beneficial interest in the Property,including,but not limited to,those beneficial interests transferred in a bond for deed,contract for deed,installment sales contract or escrow agreement,the intent of which is the transfer of title by Borrower at a future date to a purchaser. If all or any part of the Property or any Interest in the Property is sold or transferred(or if Borrower is not a natural person and a beneficial interest in Borrower is sold or transferred)without Lender's prior written consent,Lender may require immediate payment in full of all sums secured by this Security Instrument. However,this option shall not be exercised by Lender if such exercise is prohibited by Applicable Law. If Lender exercises this option,Lender shall give Borrower notice of acceleration.The notice shall provide a period of not less than 30 days from the date the notice is given in accordance with Section 15 within which Borrower must pay all sums secured by this Security Instrument.If Borrower fails to pay these sums prior to the expiration of this period,Lender may invoke any remedies pennitted by this Security Instrument without further notice or demand on Borrower. 1547180666 PENNSYLVANIA-Single Family-Fannie Mae/Freddie Mac UNIFORM INSTRUMENT Form 3039 1/01 VMP® Wolters KWwer Financial Services 201008123.5.0.0.40022010031BY Initial Page 14 of 20 'M 19.Borrower's Right to Reinstate After Acceleration.If Borrower meets certain conditions,Borrower shall have the right to have enforcement of this Security Instrument discontinued at any time prior to the earliest of.(a)five days before sale of the Property pursuant to any power of sale contained in this Security Instrument; (b)such other period as Applicable Law might specify for the termination of Borrower's right to reinstate;or(c)entry of a judgment enforcing this Security instrument.Those conditions are that Borrower: (a)pays Lender all sums which then would be clue under this Security Instrument and the Note as if no acceleration had occurred; (b)cures any default of any other covenants or agreements;(c) pays all expenses incurred in enforcing this Security Instrument,including,but not limited to,reasonable attorneys'fees,property inspection and valuation fees,and other fees incurred for the purpose of protecting Lender's interest in the Property and rights under this Security Instrument;and(d)takes such action as Lender may reasonably require to assure that Lender's interest in the Property and rights under this Security Instrument,and Borrower's obligation to pay the sums secured by this Security Instrument,shall continue unchanged. Lender may require that Borrower pay such reinstatement sums and expenses in one or more of the following forms,as selected by Lender:(a)cash;(b)money order;(c)certified check, bank check,treasurer's check or cashier's check,provided any such check is drawn upon an institution whose deposits are insured by a federal agency,instrumentality or entity;or(d)Electronic Funds Transfer. Upon reinstatement by Borrower,this Security Instrument and obligations secured hereby shall remain fully effective as if no acceleration had occurred.Howeve-,this right to reinstate shall not apply in the case of acceleration under Section 18. 20.Sale of Note; Change of Loan Servicer; Notice of Grievance.The Note or a partial interest in the Note(together with this Security Instrument)can be sold one or more times without prior notice to Borrower. A sale might result in a change in the entity(known as the"Loan Servicer")that collects Periodic Payments due under the Note and this Security Instrument and performs other mortgage loan servicing obligations under the Note,this Security Instrument,and Applicable Law.There also might be one or more changes of the Loan Servicer unrelated to a sale of the Note.If there is a change of the Loan Servicer,Borrower will be given written notice of the change which will state the name and address of the new Loan Servicer,the address to which payments should be made and any other information RESPA requires in connection with a notice of transfer of servicing. If the Note is sold and thereafter the Loan is serviced by a Loan Servicer other than the purchaser of the Note,the mortgage loan servicing obligations to Borrower will remain with the Loan Servicer or be transferred to a successor Loan Servicer and are not assumed by the Note purchaser unless otherwise provided by the Note purchaser. Neither Borrower nor Lender may commence,join,or be joined to any judicial action(as either an individual litigant or the member of a class)that arises from the other party's actions pursuant to this Security Instrument or that alleges that the other party has breached any provision of, or any duty owed by reason of, this Security Instrument,until such Borrower or Lender has notified the other party(with such notice given in compliance with the requirements of Section 15)of such alleged breach and afforded 1547160666 PENNSYLVANIA-Single Family-Fannie Mae/Freddie Mac UNIFORM INSTRUMENT Form 3039 1101 VMP® Wolters Kluwer Financial Services 201008123.5.0.0.4002201003'BY InitialsA Page 15 o120 •H 1 'G i the other party hereto a reasonable period after the giving of such notice to take corrective action. If Applicable Law provides a time period which must elapse before certain action can be taken,that time period will be deemed to be reasonable for purposes of this paragraph.The notice of acceleration and opportunity to cure given to Borrower pursuant to Section 22 and the notice of acceleration given to Borrower pursuant to Section 18 shall be deemed to satisfy the notice and opportunity to take corrective action provisions of this Section 20. 21.Hazardous Substances.As used in this Section 21:(a)"Hazardous Substances"are those substances defined as toxic or hazardous substances,pollutants,or wastes by Environmental Law and the following substances: gasoline, kerosene,other flammable or toxic petroleum products,toxic pesticides and herbicides,volatile solvents,materials containing asbestos or formaldehyde,and radioactive materials; (b)"Environmental Law"means federal laws and laws of the jurisdiction where the Property is located that relate to health, safety or environmental protection; (c) "Environmental Cleanup" includes any response action,remedial action, or removal action,as defined in Environmental Law;and(d)an "Environmental Condition"means a condition that can cause,contribute to,or otherwise trigger an Environmental Cleanup. Borrower shall not cause or permit the presence,use,disposal,storage,or release of any Hazardous Substances,or threaten to release any Hazardous Substances,on or in the Property.Borrower shall not do,nor allow anyone else to do,anything affecting the Property(a)that is in violation of any Environmental Law,(b)which creates an Environmental Condition,or(c)which,due to the presence,use, or release of a Hazardous Substance,creates a condition that adversely affects the value of the Property.The preceding two sentences shall not apply to the presence,use,or storage on the Property of small quantities of Hazardous Substances that are generally recognized to be appropriate to normal residential uses and to maintenance of the Property(including,but not limited to,hazardous substances in consumer products). Borrower shall promptly give Lender written notice of(a) any investigation,claim,demand, lawsuit or other action by any governmental or regulatory agency or private party involving the Property and any Hazardous Substance or Environmental Law of which Borrower has actual knowledge,(b)any Environmental Condition, including but not limited to,any spilling,leaking,discharge,release or threat of release of any Hazardous Substance,and (c)any condition caused by the presence,use or release of a Hazardous Substance which adversely affects the value of the Property.If Borrower learns,or is notified by any governmental or regulatory authority,or any private party,that any removal or other remediation of any Hazardous Substance affecting the Property is necessary,Borrower shall promptly take all necessary remedial actions in accordance with Environmental Law. Nothing herein shall create any obligation on Lender for an Environmental Cleanup. Non-Uniform Covenants.Borrower and Lender fiurther covenant and agree as follows: 1547160666 PENNSYLVANIA-Single Family-Fannie Mae/Freddie Mac UNIFORM INSTRUMENT Form 30391/01 VMP® Walters Kluwer Financial Services 201008123.5.0.0.40022010031 BY Initials: Page 16 of 20 1 � 3 � 22.Acceleration;Remedies.Lender shall give notice to Borrower prior to acceleration. following Borrower's breach of any covenant or agreement in this Security Instrument (but not prior to acceleration under Section 18 unless Applicable Law provides otherwise). Lender shall notify Borrower of, among other things: (a) the default; (b) the action required to cure the default; (c) when the default must be cured; and (d) that failure to cure the default as specified may result in acceleration of the sums secured by this Security Instrument, foreclosure by judicial proceeding and sale of the Property. Lender shall further inform Borrower of the right to reinstate after acceleration and the right to assert in the foreclosure proceeding the non-existence of a default or any other defense of Borrower to acceleration and foreclosure. If the default is not cured as specified, Lender at its option may require immediate payment in full of all sums secured by this Security Instrument without further demand and may foreclose this Security Instrument by judicial proceeding. Lender shall be entitled to collect all expenses incurred in pursuing the remedies provided in this Section 22, including, but not limited to, attorneys' fees and costs of title evidence to the extent permitted by Applicable Law. 23. Release.Upon payment of all sums secured by this Security Instrument, this Security Instrument and the estate conveyed shall terminate and become void.After such occurrence,Lender shall discharge and satisfy this Security Instrument. Borrower shall pay any recordation costs. Lender may charge Borrower a fee for releasing this Security Instrument,but only if the fee is paid to a third party for services rendered and the charging of the fee is permitted under Applicable Law. 24.Waivers. Borrower,to the extent permitted by Applicable Law,waives and releases any error or defects in proceedings to enforce this Security Instrument,and hereby waives the benefit of any present or future laws providing for stay of execution,extension of time,exemption from attachment, levy and sale,and homestead exemption. 25. Reinstatement Period.Borrower's time to reinstate provided in Section 19 shall extend to one hour prior to the commencement of bidding at a sheriffs sale or other sale pursuant to this Security Instrument. 26.Purchase Money Mortgage.If any of the debt secured by this Security Instrument is lent to Borrower to acquire title to the Property, this Security Instrument shall be a purchase money mortgage. 27. Interest Rate After Judgment.Borrower agrees that the interest rate payable after a judgment is entered on the Note or in an action of mortgage foreclosure shall be the rate payable from time to time under the Note. 1547180688 PENNSYLVANIA-Single Family-Fannie Mae/Freddie Mac UNIFORM INSTRUMENT /' Form 3039 VO1 VMP® Wafters Kluwer Financial Services 201008123.5.0.0.400220100318Y Initials Page 17 0120 J C-- BY SIGNING BELOW,Borrower accepts and agrees to the terms and covenants contained in this Security Instrument and in any Rider executed by Borrower and recorded with it. Borrower +*k/ � ZZ IC> AlA CHEN mate Seal ONG J+ HEN * Date K 3 G Seal Date Witness Date Witness 1547180666 PENNSYLVANIA-Single Family-Fannie Mae/Freddie Mac UNIFORM INSTRUMENT // Form 3038 1101 Wolters Kluwer Financial Services 201008123.5.0.0.400220100318Y Indlals Page 18 of 20 'H Acknowledgment State of Pennsylvania County of Cumberland �j Ley On Ll q US f 13, 241 d ,before me " c' �`'' ,the undersigned officer,personally appeared fi/. k"lvG JI' ch m known to me(or satisfactorily proven)to be the person(s) whose name(s)is/are subscribed to the within instrument and acknowledged that he/she(they)executed the same for the purposes therein contained. In witness whereof 1 hereunto set my hand and official seal. tztkf� My c Public p tjC( f� ��/ Z M commission expires: �I ` NOTARIAL SEAL BETH C LAWSON Notary Public LOWER SWATARA TWP,DAUPHIN COUNTY My Commission Expires Mar 18,2013 . 1547180666 PENNSYLVANIA-Single Family-Fannie Mae/Freddie Mac UNIFORM INSTRUMENT �' Form 30391/01 VMP® Wolters Kluwer Financial Services 201008123.5.0.0.4002201003'18Y Inilia Page 19 of 20 Certificate of Residence 1, .` Y v1, �,do hereby certify that the correct address'of the within-named Mortgagee is 1111 Polaris Parkway,Columbus,OH 43240 Witness my hand this August 13,2010 r Agen ol t Aee Space below notary acknowledgment(s) and information regarding the loan, lender, document preparer, or property tax is intentionally left blank 1547180666 PENNSYLVANIA-Single Family-Fannie Mae/Freddie Mae UNIFORM INSTRUMENT /r Form 3039 1101 Wolters Kluwer Financial Services 201008123.5.0.0.40022010031 BY Initia Page 20 of 20 1 .....,.....,...... . . .:�-.ar..v......n,w.w- Nations Lending Service Ohio—Chase Division 3700 Corporate Dr. Suite 200 Columbus,OH 43231 Telephone: 614-890-5950 Fax:614-890-6490 Toll Free Telephone: 1-866-334-7198 Toll Free Fax 1-866-825-6348 By:Nations Title Agency,Inc.,dba Nations Lending Service Ohio herein after referred to as NLS OH Chase Division EXHIBIT A LEGAL DESCRIPTION 1 OCM09621 ALL THIS TRACT OF LAND SITUATED IN SOUTH MIDDLETON TOWNSHIP, CUMBERLAND COUNTY, PENNSYLVANIA, BOUNDED AND DESCRIBED AS FOLLOWS: BEGINNING AT A POINT ON EASTERN SIDE OF HEDGE ROW LANE ON THE DIVIDING LINE BETWEEN LOTS NOS. 1 AND 2 ON THE HEREINAFTER MENTIONED PLAN OF LOTS;THENCE BY SAID DIVIDING LINE, NORTH 88 DEGREES 35 MINUTES EAST 150.02 FEET TO A POINT; THENCE BY LAND NOW OR.FORMERLY OF IVO OTTO, SOUTH I DEGREE 25 MINUTES EAST 119.32 FEET TO A POINT; THENCE BY THE NORTHERN SIDE OF A PROPOSED STREET, SOUTH 88 DEGREES 35 MINUTES WEST 54.7 FEET TO A POINT; THENCE BY THE SAME ON A CURVE TO THE LEFT HAVING A RADIUS OF 325 FEET,AN ARC DISTANCE OF 74.16 FEET TO A POINT;THENCE BY THE SAME, ON A CURVE TO THE RIGHT HAVING A RADIUS OF 30 FEET, AN ARC DISTANCE OF 47.12 FEET TO A POINT ON THE EAST SIDE OF HEDGE ROW LANE; THENCE BY THE EAST SIDE OF HEDGE ROW LANE, ON A CURVE TO THE LEFT HAVING A RADIUS OF 325 FEET, AN ARC DISTANCE OF 88.27 FEET TO THE PLACE OF BEGINNING. BEING LOT NO. 1 OF SECTION J-I OF THE PLAN OF LOTS KNOWN AS FORGE ROAD ACRES AS RECORDED IN THE OFFICE OF THE RECORDER OF DEEDS FOR CUMBERLAND COUNTY IN PLAN BOOK 23, PAGE 28. BEING THE SAME PREMISES AS CONVEYED IN DEED FROM KURT SCHUTZ AND INGEBORG SCHUTZ, HUSBAND AND WIFE RECORDED 06/18/2002 IN DOCUMENT NUMBER 2002-024754, BOOK 252, PAGE 1168 IN SAID COUNTY AND STATE. COMMONLY KNOWN AS: 7 HEDGE ROW LN CARLISLE PA ROBERT P. ZIEGLER RECORDER OF DEEDS CUMBERLAND COUNTY 1 COURTHOUSE SQUARE ==' CARLISLE, PA 17013 - 717-240-6370 Instrument Number-201023425 Recorded On 8/24/2010 At 11:17:42 AM *Total Pages-22 *Instrument Type-MORTGAGE Invoice Number-71390 User ID-AF *Mortgagor-CHEN,Al HUA *Mortgagee-JPMORGAN CHASE BANK N A *Customer-NATIONS LENDING SERVICE *FEES STATE WRIT TAX $0.50 Certification Page STATE JCS/ACCESS TO $23.50 JUSTICE DO NOT DETACH RECORDING FEES - $45.50 RECORDER OF DEEDS PARCEL CERTIFICATION $10.00 This page is now part FEES of this legal document. AFFORDABLE HOUSING $11.50 COUNTY ARCHIVES FEE $2.00 ROD ARCHIVES FEE $3.00 TOTAL PAID $96.00 I Certify this to be recorded in Cumberland County PA �y VC vs� a: /o RECORDER O D EDS F *-Information denoted by an asterisk may change during the verification process and may not be reflected on this page. f`IOOOG`R6 IIIII�I�ilillllllll�llllllll REV-1513 EX+(01-10) pennsytvania SCHELE 3 ti DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEF-VICAFRIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Ai Hua Chen RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS(Include outright spousal distributions and transfers under Sec.9116(a)(1,2),] I. Kong J.Chen,7 Hedge Row Lane,Carlisle,PA 17015 Son 0 2. Ricky K.Chen,6809 Clubhourse Dr.#G8,Harrisburg,PA Son 0 3. Jin K.Chen,80 Bowery Suite 403,New York,NY 10013 Son 0 4 Jin E.Zhang,7 Hedge Row Lane,Carlisle,PA 17015 Wife 0 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE, II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: TOTAL OF PART II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ If more space is needed,use additional sheets of paper of the same size.