HomeMy WebLinkAbout07-25-2005
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[urrl\In 'Eafn OOffires
1711 HAMILTON STREET
ALLENTOWN, PA 18104-5697
(610) 432-7600
THOMAS J. TURC2YN
July 21, 2005
Fax: (610) 432-7390
Glenda F. Strausbaug
Register of Wills, Cumberland County
One Courthouse Square
Carlisle, PA 17013-3387
Re: Anna A. Brown
Date of Death: December 3, 2004
Dear Ms. Strausbaug:
Relative to this Estate, enclosed please find the following docUDlents:
1. Original Inventory;
2. Original Inheritance Tax Return with one additional copy;
3. Check No. 16312 in the amount of $4,972.94, the inheritance tax due;
4. Status Report; and
4. Our check in the amount of$30.00 covering the cost to record the above
documents. i .-j
I will anticipate receiving two receipts. Thank you very much.
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en
THOMAS J. TURCZYN
TJT:mk
Enclosures
cc: Patricia Hallock (without enclosures)
Register of Wills of Cumberland County, Pennsylvania
INVENTORY
Estate of ANNA A. BROWN
File No. 2005-00325
also known as
Date of Death: 12-03-04
Deceased
Social Security No. 185-01-0536
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the
following Inventory include all of the personal assets wherever situate and all of the real estate
in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item
of said Inventory represents its fair value as of the date of the Decedent's death, and that
Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears
in a memorandum at the end. of this Inventory. I/We verify that the statements made in this
Inventory are true and r. r ct. I nderstand that false statements herein are made subject to
the penalties of I e 4904, relating to unsworn falsification to authorities.
Attorney:
(~~'-/oJfl r€ IitILR L
~ersonal Rep. (signature)
Date:
fJtt:; /~ Z()()5
Phone:
Turczyn Law Offices
1711 Hamilton St.
Allentown, PA 18104
(610) 432-7600
Address:
Item # Description
Value
l. Real Estate: 43.54 Acres on York Road, Monaghan
Pa
2. PNC Bank - Checking Account 51-4000-7653
3. PNC Bank - Checking Account 51-3010-4724
4. Personal Property
Township,
175,000.00
588.00
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(Attach additional sheets if necessary)
TOTAL:
$ 175,936.83
:EV.1500'EX(6"OO)
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
D EPT. 280601
HARRISBURG, PA 17128-0601
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
BROWN, ANNA A.
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
12/03/2004 10/20/1913
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
REV..1500
OFHCIAI. ImE OI'JI.Y
FILE NUMBER
2 1 - 0 5
-- --
COUNTY CODE YEAR
_i!...2-.22
NUMBER
SOCIAL SECURITY NUMBER
185
- 01
- 0536
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WIllS
SOCIAL SECURITY NUMBER
[Xl 1, Original Return
o 4, Lirnited Estate
D 6. Decedent Died Testate (Attach copy of Willi
D 9. litigation Proceeds Received
o 2. Supplernental Relurn
o 4a. Futllre Interest Compromise (dat. of death after 12-12.82)
D 7, Decedent Maintained a living Trust (Attach copy ofTrust)
o 10. Spousal Poverty Credit (dal. 01 dealh b.tw,," 12-31.91 BOd 1.1-95)
D 3. Remainder Return (dale of dealh pr'lor 10 12-13.82)
o 5. Federal Estate Tax Return Required
8. Total Number Qf Safe DepQsit BQxes
o 11. ElectiQn to tax under See, 9113(A) (AllachSch0)
THIS SECTION MU$TBECOMPLETEO.ALlcORRESPONOENCE'AND.CONFn:jENTIALTAX INFORMATIONSHOlll:.D'BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
Thomas J. Turczyn, Esquire
8. Total Gross Assets (tolal Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts Qf Decedent, MQrtgage Liabilities, & Liens (Schedule I)
11. Tolal Deductions (total Lines 9 & 10)
12. Nel Vatue of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to lax has not been
made (Scheduie J)
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FiRM NAME (If Applicable)
Turczyn Law Offices
TELEPHONE NUMBER
610-432-7600
1711 Hamilton Street
Allentown, PA 18104
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held CQrporation, Partnership or SQle-PrQprietorship
4. Mortgages & NQtes Receivable (Schedule D)
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5. Cash, Bank DepQsits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-PrQbate PrQperty
(Schedule G or L)
(1)
(2)
(3)
(4)
(5)
175,000.00
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14. Net Value Subject to Tax (Line 12 minus Line 13)
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936.83
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(6)
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(7)
(8)
175,936.83
(9)
(10)
16,782.88
48.644.17
(11)
(12)
(13)
65,427.05
110,509.78
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
(14)
110,509.78
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15. Amount of Line 14 taxable at the spousal tax
rate, or Iransfers under See, 9116 (a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rale
18. Amount of Line 14 taxable at cQllateral rate
19. Tax Due
110,509.78
x.O_ (15)
x.O li (16)
x .12 (17)
x .15 (18)
(19)
4,972.94
CH!:CK HERE IF YOU I\RE REQUEl:\TING A R!:FUNDioF AN OVERPAYMENT
200
> >BE SORE TO ANSWER ALL QUESTIOIllS ON REVERSE SiDE AND RECHECt<.MATH<';.:{:', !I.. . .
Decedent's Complete Address:
STREET AGORESS
4905 East Trindle Road
CITY
I STATE
PA
17055
Mechanicsburg "
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2, Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
4,972.94
Total Credits (A + B + C ) (2)
3. InteresUPenalty if applicable
D. Interest
E. Penalty
TotallnteresUPenalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
I ZIP
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is tlle TAX DUE. (5)
A. Enter the interest on the tax due.
(5A)
B. Enter the \otal of Line 5 + 5A. This is the BALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
4,972.94
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes
a. retain the use or income of the property transferred;.......................................................................................... 0
b. retain the right to designate who shall use the property transferred or its income; ............................................ 0
c. retain a reversionary interest; or..................................................................................,.,."...............'.................. 0
d. receive the promise for life of either payments, benefits or care? ............................................................,......... 0
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ................................................,...................... ....................................... 0
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0
4, Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ............,., ........... ......................................................................................... ..... 0
No
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IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, t declare that I have examined this return, Including accompanying schedules and statements, and to the best of my knowledge and beliel, 11 IS true, correct and complete.
Declaration of preparer other than the personal representative is based on all informa . which preparer has any knowledge,
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RE
Patricia B. Hallock
ADDRESS
3763 Preston Lane,
SIGNATURE OF PREPARER OTHER THAN REPRESENll\'l1llE /
Thomas J. Turczyn, Esquire ~
ADDRESS
DATE ,;z 11 ;1----
DATE
~J;7/J--
For dates of death on or after July 1, 1994 and before January 1, 1995. the tax rate imposed on the net value of transfers to - - ,.. 'h~ . '00 "I thR survivinq spouse is 3%
[72 P.S. ~9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of tl
The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of
the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death
or a stepparent of the child is 0% [72 P.S. ~9116(a)(I.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except a
The tax rate imposed on the net value of transfers 10 or for the use of the decedent's siblings is 12% [72 P.S. !j9116(a){1.3}]. A slDnng " u,,",~~, _..__
individual who has atleasl one parent in common with the decedent, whether by blood or adoption.
NA?b
(1.1) (ii)
Jle even
tive paren
.)(1)].
9102, as a
REV-1502 EX+ (6-98)
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SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
BROWN, ANNA A.
FILE NUMBER
21-05-0325
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 properly 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 factse
Real property which Is jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
43.54 Acres on York Road, District 38, Map OD
Parcel 92A, Monaghan Township, PA 17019
~ I:: IG It rl VI- Q.t~ (\ (l '(' tt-..t\1 ~ rlt-
175,000.00
TOTAL (Also enter on line 1, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
175,000.00
II
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APPRAISAL OF REAL PROPERTY
LOCATED AT:
43.~4 Acres on York Road
District 38, Map OD, Parcel 92A
Monaghan Twp., PA 17019
FOR:
Attorney Tom Turczyn
1711 West Hamilton Street
Allentown, PA 18104
AS OF:
April 25, 2005
BY:
Gerald AustinfIbomas Meagher
Form GA1-'TOTAl fcrWmdows' appraisal software by alamcrle, inc, -l-8OQ.AlAMODE
IFlle No. L05-05371 Paoe #31
Remace, Ltd.
439 West Market Street
York, PA 17404
(717) 841-5104
May 3. 2005
Attorney Tom TurctYn
1711 West Hamilton Street
Allentown, PA 18104
Re: Property; 43.54 Acres on York Road
Monaghan Twp., PA 17019
Borrower: Estate of Anna A. Brown
File No.: LOS-OS37
In accordance with your request, we have appraised the: above referenced property. The report afthat appraisal is attached.
The purpose of this appraisal is to estimate the market value or the property described in this appraisal report, as improved, in
unencumbered fee simple title of ownership.
This report is based on a physical analysis of the site and improvements, a loeational analysis of the neiRhborhood and city, and an
economic analysis orthe market for properties such as the subject. The appraisal was developed and the report was prepared in
accordance with the Unifonn Standards of Professional Appraisal Practice.
The value conclusions reported are as of the effective date stated in the body of the report and contingent upon the certification and
limiting conditions attached.
It has been a pleasure to assist you. Please do not hesitate to contact me or any of my staff if we can be of additional service to you.
~.
Gerald AustinfThomas Meagher
LAND APPRAISAL REPORT
IHle No. L05-05371 Paoe #41
Borrower Estate of Anna A. Brown
Property Addr&ss 41.54 Acres on York Road
City MonalZ.han Twt>.
legal Descrlption District 38 Ma OD Parcel 92A
Sale prt.. $ NI A Date of Sale N/ A Loan Term ~ yes. Property Rights Appraised ~ Fee L I Leasehold r J De Minimis PU
Aclual Real Estate lam $ $72 (yr) loan charges 10 be paid by seller $ N/A Other sales concessions N/A
lender/Client AtlomevTomTurczvn AtIdress 1711 West Hamilton Street Allentown PA 18104
Occupant N/A Appraiser Gerald Austinrrhomas MeaRher Instructions to Appraiser As r raiser is to estimate
resent market value of the sub'cet's unencumbered fee sim le estate fOT estate settlement u
Location Urban SUbm"an Rurai
Built Up 0 O,er 75% 0 25% 10 75% ~ Under 25%
Growth Rate 0 Fuily De<. 0 Rapid ~ Sleady 0 Siow
Property Values ~ Incleasing LJ Stable 0 Declining
Demand/Supply 0 Shortage ~ In Balance 0 Oversupply
Marketing Time [1 Under 3 Mos. ~ 4-6 Mos. [I aver 6 Mos.
Present Land Use --1Q.% 1 family _% 2-4 family _% Apts. _% Condo _% Commercial
% industrial % Vacant 70% Vacan'
Change in Present Land Use 0 Not likely -0 likely (*) ~ Taking Place (*)
(*) From Vacant To Residential
~ Owner 0 Tenant --.!tL% Vacant
$ 1O0,OOO to $ GOO,OOO Pre<lomlnant Value $ 250,000
New yrs. to...JQQ:t.. yrs. Predominant Age 50 yrs.
Census Tract 101.20
File No. L05-0537
Map Reference Atlas: 15-Bl3
County York
Stale PA
Zip Code 17019
Predominant Occupancy
Single family Poco Range
Single famJiy Age
Employment Stability
Con"nlence to Employment
Convenience to Shopping
Convenience to Schools
Adequacy 01 Public lransportatlon
Recreational Facilities
Adequacy of Utilities
Property Compatibility
Protection from Detrimental Conditions
Police and Fire Protection
General Appearance of Prop,rtles
Appeal to Malkel
Good A,g. fair Poor
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43.54 SQ. R. or Acres Corner Lot
Present improyem,nts IX! do 0 liD not conform 10 zoning regulations
Elec.
Gas
Water
San. Sewer
~NoOY..
The undersigned has recited tt1ree recerrt sales m propmties most sImilar and proximate to subject and has considered these in the market analysis. The desGliption Includes a dollar
adjustment reflr.c!fng market reactlon to those Items of signIficant variation between the sublect and comparable properties. If a significant Item [n the comparable pmperty Is SUperiOf
to Of more favorable than thfI SUbject property, a mms (-) adjustment Is made thus reducing the indicated value of subject; If a sIgnificant Item In the comparable is in1eflor to Of IBSS
lavorable than Ihe SUbject property, a plus (+) adjustment is made thus increasing the Indicated value 01 the subject.
ITEM SUBJECT PROPERiY COMPARABLE NO.1 CoMPARABL NO.2
Address 30.00 Acres offPinetown Road 31.02 Acres on Salem Church Rd.
Wellsville Wanin ton T Dover DoveJ Townshi
+27600
27600
177 600
April 25, 2005 to be $ 175000
~ Did 0 Did Not Physicaily Inspect Property
EMACE, no.
Form LNO - "101 AL 1m Windows' apprals~ software by a la mode, Inc. - 1.aOO-ALAMoDE
PHOTOGRAPH ADDENDUM
"........._.....-...".,.~
State _ PA
lio Colle 17019
IlomlYfflrlCli8nt Estate of Anna A. Brown
I.......... Mdmss 43.54 Acres 00 York Road
CIIv MODBl<Ium TW!>. County Yark
Lemler AltomevTomTurczvn
Northwest Elevation
Street Vicwine; East
Street ViewidR West
Fann GPICPIX - 'TOTAl for WllIdo,"s' appraisalsottw... by a Ia mode. inc. -1-801l-AlAMODE
[File No. L05-0537lPiUie#61
DEFINITION OF MARKET VALUE: The must plObable price which a property should Mng In a competitiva and op", market under ail conditions
requisite to a fair sale, the buyer and seiler, each actlll\l prudently, knOWledgeably and assuming the price is not affected by undue stimulus. Impilcil in this
definition is the consummatlon of a sale as of a specllled date anil the passing of titie from seller to buyer under condillons whereby: (1) buyer and seller are
fypicaily motivated; (2) bolh parties are well infonned or weil advised, and each acting in what he considers his own best Interest; (3) a reasonable time is allowed
for exposure in the open market; (4) payment Is made in terms of cash in U.S. dollars or in terms of financial arr'llllell\l!nts comparable therelo; 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.
ft Adjustments to the comparables must be made for special or creative financing or sales concessions. No adjustments are necessary
for those costs which are normally paid by selle" as a resuil of tradition or law In a market area; these costs are readily identitlable
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 finenclng terms offered by a third party Institutional lender fhat is not already involved in the
property or transaction. Any adjustment should not be calculated on a mechanical doilar for doilar cost of the financlll\l or concession
but the doilar amount ot any adjustment should appro~mate the market's reaction to the financing or concessions based on the
appraiser's iudgement.
STATEMENT OF LIMITING CONDITIONS AND APPRAISER'S CERTIFICATION
CONTINGENT AND UMITING CONDITIONS: The appraiser's certification that appears In the appraisal report Is subject to the following
conditions:
1. The appraiser wili not be responsible for matters of a l<gal nalure that affect eilher the property being appraised or the title 10 It. The appraiser assumes that
the title is good and marketable and, theretore, will not render any opinions about the title. The property is appraised on the basis of II being under responsible
ownership.
2. lhe appraiser has provided a sketch in the appraisai report to show approximate dimensions ot the Improvements and the sketch is Included only to assist
the reader of the report In visualizing the property and understanding the appraiser's delerminailon of Its s~e.
3. The appraiser has examined the available flood maps that are provided by the Federal Emery'ncy Manayement Agency (or other data sources) and has noted
in the appraisal report whether the subject slie is located In an identified Speciai Flood Hazard Area. Bacanse the appraiser is not a surveyor, he or she makes
no gUarantees, express or implied, regarding this determination.
4. The appraiser wiil not give lestimony 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.
5. The appraiser has estimated the vaiue of the land in the cost approach at its highest and best use and the improvements at tilek corrtrll>ulory vaiue. lhese
separate valuations of the land and improvements must not be used in conjunction witlt any otiler appraisal and are Invaild n tiley are so used.
6. lhe appraiser has noted in the appraisal report any adverse condllions (such as, needed repairs, depreciation, the presence of hazardous wastes, toxic
substances, etc.) observed during the inspection of the subject property or thaI he or she became aware of during the normai research Involved in pelforming
the appraisal. Unless olherwise stated in the appraisal report, the appraiser has no knowtedge of any hidden or unapparent conditions of the property or
adverse envlronmentai conditions (including the presence of hazardous wastes, toxic substances, etc.) that would make the property mure or less valuable, and
has assumed that there are no such conditions and makes no guarantees or wananties, express or implied, regarding the condition of the property. The
appraiser will not be responsible for any such conditions Ihal do e~st or for any engineering or testing that might be required 10 discover whether such
conditions exist. Because the appraiser ;s not an expert in the field of environmental hazards, the appraisal report must not be considered as an
environmental assessment of the property.
7. 1he appraiser obtained the information, estlmates, and opinions that were expressed in the 3Pflraisal report from sources that he or she considers to be
reliable and believes them fo be true and conect. The appraiser does nol assume responsibillly for the accuracy of such lIems thaI were furnished by other
parties.
II The appraiser wiil not disclose the contents of the appraisal report except as provided tor in Ih. Unilorm Standards of Professional Appraisal Practice.
9. The appraiser has based his or her appraisal report and valuation conciusion for an appraisal thai Is subject 10 salisfactory completion, repairs, or
alterations on the assumption that completion 01 the Improvements wili be pertormed In , wcrkmanlike manner.
10. The appraiser must provide his or her prior writi", consent betore the lender/client specified in the appraisal report can distribute the appraisal report
(including conciusions about the property value, the appraiser's identity and professional designations, and references to any professlonai appralsai
organizations or the finn willi which tile appraiser is associated) to anyone other than the borrower; the mortgagee or ifs successors and assigns; the mortgage
insurer; consunants; professional appraisal organizations; any state or federally approved financial institution; Of any departrrumt, agency! or instrumentality
of the Unlied Slales or any state or the District of Columbia; except that the lender/client may dislTibut, the property description section ot the report only to data
collection or reporting service(s} without having to obtain the appraiser's prior written consent. The appraiser's written consent and approval must also
be obtained before the appraisal can be conveyed by anyone to the pUblic through advertising, publk: relations, news, sales, or other media.
Freddie Mac Form 439 6-93
Page 1 of 2
Fannie Mae Form 1004B fi-93
REMACE, L TO.
Form ACR - "TD1AL for Windows" appralsai soffware by a la mode, inc. -f-BOO-At.AMODE
IFile No. L05.0537! P.oe #71
APPRAISER'S CERTIFICATION: The Appraiser certilies and agrees that:
1. I have research,,1 the subject market area and have selected a minimum of three recent sales of properties most similar and proximate to the subjecl property
to< consideration in the sales comparison .naly,is .nd have made a dollar adjustment when approprtate to reflect the market reaction to those Ilems ot slgnmcant
variallon. It a slgnilicant Item in a comparabl. property is supertor fo, or more favorable than, the subject pro",rty, I have made a negallve adjustment to reduce
the adjusted sales price of the comparable and, iI a ,ignillcant item in a comparable property is infertur to, 0< less lavorable than the subjecl property, I have made
a posillve adjustment to Increase the .d/usted sales price of the comparable.
2. I have laken into considerallon the facfors that have an impact on vaiue in my developmenl of the esllmate of market value in the appraisal report. I have not
knowingly withheld any signillcant information from the appraisal report and I believe, to the best ot my knowledge, that all slatements and infonnallon in the
appraisal report are true and correct.
3. I stated In the appraisal report only my own person.l, unbiased, and professional analysis, opinions, and conclusions, which are SUbject only to the continyent
and limiting conditions specilled in this tmm.
4. I have no present or pro,,,,,tive Inleresl in the property thaI Is lhe subject to this report, and I have no present or prospective personai interest or bias with
respect to the participants In the transaction. I did not base, eilher partially or completely, my analysis and/or the estimate of market value in the appraisal report
on the race, color, religion, sex, handicap, familiai slalus, or national origin of either the prospective owners or occupants of the subject property or of the present
owners or occupanls of 1I1a proparties in 1I1e viCinity of tha subject property.
5. I hava 110 presant or conlemplated fulure inlerest in the subject property, and neither my current or future employment nor my compensallon for periorming 1I1is
appraisal is contingent on the appraised value of the property.
6. I was not required to report a predetermined value or direction in vaiue that tavors the cause 011l1e client or any related party, the amount of the value estimate,
the adainment of a specific result, or 1I1e occurrence of a subsequent event in order to recelve my compensallon and/or employment for pertorming the appraisal. i
did not base 1I1e appraisal report on a requested minimum vaiuation, a specilic vaiuation, or the need to approve a specitic mortgage loan.
7. I pertormed this appraisal In contormity with the Uniform Slandards of Pro1",lonal Appralsai Practice that ware adopted and promulgated by the Appraisal
Standards Board of The Appraisai Foundation and that wera in place as 01 the elIecllve date of this appraisal, with the excepliOfl of the departure provision of those
Standards, which does not appiy. I acknowledge that an estimate of a reasonable lime for exposure in the open market is a condition In the definlllon of market value
and the eslimate I davel"",d is consislent with the marketing lime nuted In the neighborhood section of this report, unl", I have otheMlse stated in the
reconciliation section.
8. I have personaily inspected 1I1e Interior and exierlor araas of the subject property and the exterior of all properties Iistad as comparabies In 1I1e appraisal raport.
I lurther certily that I have noted any apparent or known adverse condillons in 1I1e subiect improvements, on the subject sile, or on any sile wilbin the immediate
Vicinity ot 1I1e subject property of which I am aware and have made adjustments for these adverse conditions in my analysis of the property value 10 the extent that
i had market evidence 10 support them. I have also commented about the effect of the adverse condilions on 1I1a marketabiiity of 1I1a subject property.
9. I personally prepared all conclusions and opinions about 1I1e reai estate that were set lorih in the appraisai report. It I railed on signillcanl professional
assistance from any indi~dual or Individuals in the pertonnanca of the appraisai or the preparallOfl of the appraisal report, I have namad such individual(s) and
disclosed the specmc tasks pertormed by them In the reconciliation saction 01 this appraisal report. I certJly that any individual so named is qualilied to pertorm
the tasks. I have not authorized anyone to make a change to any Ilem in the report; 1I1erefore, It an unauthonzed change Is made to the appraisal report, I will lake
no responsibility for if.
SUPERVISORY APPRAISER'S CERTIFICATION: If a supervisory appraiser signed the appraisal report, he or she certilles and agrees that:
I dlreclly supervise the appraiser who prepared the appraisal report, have reviewed 1I1e appraisal raport, eyrea with the statements and conclusions of the appraiser,
agree 10 be bound by the appraiser's certillcallons numbered 4 through 7 above, and am taking tull responsibility for the appraisal and the appraisal report.
ADDRESS OF PROPERTY APPRAISED:
APPRAISER: ~~-
Signature: ~CVL-J
Name: Gerald Austin
Date Signed: May 3, 2005
State Certification #: Assistant to Pennsvlvania Certified General Appraiser
or Slale License #:
Slate:
Expiralion Date of Certilication or License:
[5<l Did
o Did Not Inspect Proparty
Freddla Mac Form 439 6-93
Page 2 of 2
Fannie Mae Fonn 1oo4B 6-93
Form ACR - ''TOTAL for Windows" appraisal software by a lamode, inc. -t-BOO-ALAMODE
11l..lVI/'\ul-, LtU.
tFlle No. L05-05371 Paoe #BI
PRIVACY NOTICE
Pur.uant 10 Ihe Gramm-Leach-Bllley Acl of 1999, eIIecllYe July 1, 2001, Appral.ers. along with all
providers 01 personal IInanclal service. are now required by lederal law to Inlorm their clients 01
the pollcle. of Ihe IIrm with regard 10 lhe privacy 01 client non public per.onal Inlormatlon. A.
profe88lonal.. we understand thai your privacy I. very Important to you and are plea.ed 10 provide
you with thl. Inlormatlon.
Type. of Nonpubllc Peraonal Information We Collecl
In the course ofperfonning appraisals, we may collect what is known as "nonpublic personal infonnation" about you. This information is
used to focilitate the services that we provide to you and may include the information provided to us by you directly or received by us from
others with your authorization.
Partie. 10 Whom We Olsclo.e Inlormetlon
We do not disclose any nunpublic personal infcrmation obtained in the course of our engagement with our clients to nonaffiliated third
parties, except as necessary or as required by law. By way of example, a necessary disclosure would be to our employees, and in certain
situations, to unrelated third party consultants who need to know that information to assist us in providing appraisal services to you. All of
our employees and any third party ~onsuhants we employ are infonned that any infonnation they see as part of an appraisal assignment is to
be maintained in strict confidence within 1he firm.
A di~cLosure required by law would be a disclosure by us that is ordered by a court of competent jurisdiction with regard to a legal action to
which you are a party.
ConlldenUal1ty and Security
We will retain records relatin~ to professional services that we have provided to you for a reasonable time so that WI: are
better able to assist you with your needs. In order 10 protect your nonpubIic personal infomlation from unauthorized access by third parties.
we maintain physical, electronic and procedural safeguards that comply with our professional standards to insure the security and integrity of
your information.
Please feci free to call us an any time if you have any Questions about the confidentiaHty of the infonnation that you provide to us.
tEV.15Q8 EX + {1.97j
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
BROWN, ANNA A.
21-05-0325
Include the proceeds of litigation and the date the proceeds were received by the estate. All propelty Jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. PNC Bank - Checking Account 51-4000-7653 588.00
2.
PNC Bank - Checking Account 51-3010-4724
41. 03
3.
Miscellaneous Personal Property - sold at auction by
Haar's Auction - See attached summary sheet.
307.80
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed,. insert additional sheets of the same size)
936.83
,~'?- ~~) .
'/'
. " .''"t'' . ro-
D;', "",~ l--"'~'t...... ,.",,~--,
_. _. 1.(..1 '(.1 1.."lV\L'\_
~'~ww. hi':\i:\r'~:;. COlli
Hni~R' ~3 AUCTION
~:;(,'ti; I t~llI~:!nt
8(011 et"':: 376~3
PATTY H{'~l_LOCV,
3763 PRESTON LANE
CENTER VAU_EYPA 18034
Item
DeSCt'iption
Pt'ice
Oty
l_ i Uht
Chest of dt'awet's
Mit'Tot.,
Dt'e sse l"'-m i 1"1"0 t'
Chest of di'i:lWel'S
Tv
Hide-.a--.bed
2: single beds
BOK spring and mattress
BOK spring and mattress
Float" cleanet'
S~<Jivel t'oCI~ei"
Sweep~}t'
Oa~( i'OC~(el"
Stool
Li:.\fflp i;a.ble
Tv .:tnd !5t;:'\l1d
B. tZI0
-:>
'-'
1
1
1
1
1
1
'f. 00
17.00
8.00
.:::.
c
.::.
L...
Items:
17
nmount:
Commission at 40.000%
132.3121
Less adjustments:
Net due to seller:
717 -A-3;:::-Cl,:;:/t\S
PafJe:
1.
Tot a I
2'1.00
5~5. 121121
0. ~5000
~~5. 01Z1
1
1
1.
1.
1.
1.
1.
6121.0121
218. \ZIIZI
3.00
8. iZlI2I
3'1.00
1 G. 1211Z!
l1ZI. 1110
1,0.010
co:. 1210
35. illiZi
0. ;:::500
3.00
25.QIIZI
330.75
'''''13i::;1I 31Z1
1. 9B. '1::5
I Dcr 3~
717''''i.3i~."aZ~LfG __
-;"/j-;;7 #7; 0
V'H<J\<J. ha.::1l"s. com
HnnR'S AUCTIONN
7~
i~J3' '
'~:5~' '\)
/' L-
~' SO
~'
"t~\'"" "f\ \ \ '
($~~ A
. .
... .~ ..... ,-
1)<\; (': ~I".t-:::llI0"h
WW~^J. haEti'''~j... com
H{il:ll~' G 14LJCTI DI\I
Hutt lE!lIIent
BE~ll€';r": ~3763
Pr-iTTY H(4L.U)CI-~
3763 PRESTON LANE
CENTER VAU_EY PR 18034
It E'm
Ih!SCr'iption
PI"ice
Qt,;,
IVlill( 1;\1;;\5'.0', set
J €!v;(~ 1.",;,
.T €~It;e 11"'";,
Bui t C~~St~:;j.
J€!vH! 11"'";,
J ew(~ 1 r"y'
Si. ~lns
Hii'll]
Gter"l pin
NC'H::I( lace
Pi.tch(?r'
JeltJl-o 1 r'y
Jewelr'";'
Gloves
Dog
SnOI"lIll(':!n
Tr'ef~
E.\f-1i.:l.Y'S
T,,"ee
Music bo;-(
DOH lot
Bc)}( lot
Music box
Do}( lot
1,,.Jase
C;at
Music box
Lot
L.inht
Mus ic l:Jo;.(
Bcn( lot
Lot
Br'ushes
1
1
1
1
1
1
1
1.
1
1.
1
1
1
1
1
1
1
1
1
1.
1
1
1
1
1
1.
1
1
1
1
1
1
1
Itelll~;:
~.~
'_I,_}
Amount:
Commission at 40.000~
72. ':,!l21
Less adjustments:
Net due to seller:
VoJwv;. hdi,n's. com
HllAR' E; ALH::;TIONN
717-..1.1.32--8;:::'1-6
717-1.1.32.....EI2A.E,
Pa~}t? :
1
Tot a 1
1. i.~~5
IB.0iZl
G. e"Z!
Lt.. 1')4)
;;::~::'j. ~~121
1 ill. 1i)1Z!
3.50
3. 12HZ!
1.1.1210
0. ~':;0IZ";;
3.. ~;(~
;::::;~:~. 01zr
3;:::. (?10
1.5121
;::'::.12"21
0. ;;::5(~1Z1
1. (10
0. ~3 iZIIZII;'
0. ;:::~jiZle1
1 . ~51Z1
0. ~:jiZI0~D
0. 750121
0. ~50ellZ1
1.12)0
1:5.1210
lei. 0121
3" ~;0
9. VIIZI
1.1210
0. ;::cSIZllZi
121. '::i QI G, Ql
121. ;;::50121
0. ;:':'500
1. cl1::. ;;::~S
--72. ':30
1.0':3.35
REV.1511 ~X+ (7.991
ESTATE OF
ITF.M
NUMBER
A.
B.
4.
C.
1.
2.
3.
4.
5.
6.
7.
B.
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
Please Print or Type
FILE NUMBER
21-05-0325
COMMONWEALTH OF PENNSYLVANIA
I~IHERITANCE TAX RETURN
RESIDENT DECEDENT
BROWN, ANNA A.
DESCRIPTION
AMOUNT
Funeral. Expenses:
1.
Myers-Harner Funeral Home, Inc.
7,102.00
Administrative Costs:
1.
Personal Representative Commissions
Social Security Number of Personal Representative:
Year Commissions paid
2.
Attorney Fees Turczyn Law Offices
8,700.00
3. Family Exemption
Claimant
Address of Claimant at decedent's death
Streel Address
City
Relationship
Slate
Zip Code
Probate Fees Register of Wills - Cumberland County
295.00
Miscellaneous Expenses:
Real Estate Appraisal - Remace, 439 W. Market Street, York, PA
300.00
Estate Ad - The Patriot News
310.88
Estate Ad - Cumberland Law Journal
75.00
TOTAL (Also enter on line 9, Recapitulation)
(If more space is needed, insert additional sheets of same size.)
S 16,782.88
REV.l.512 EX+ fl-Q3)
'*'
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES AND LIENS
Please Print or Type
FILE NUMBER
21-05-0325
COMMONWEALTH Of PENNSYLVANIA
INHERITANCE TA.X RETURN
RESIOENT DECEDENT
ESTATE OF
BROWN, ANNA A.
ITEM
NUMBER
DESCRIPTION
AMOUNT
1.
Obligation to Patricia B. Hallock under terms of Agreement
(see attached copy marked as Exhibit A, a schedule of all
payments made by Patricia B. Ha11ock.iis attached hereto as
Exhibit B.
48,641.17
TOTAL (Also enter on line 10, Recapitulation)
(If more space is needed, insert additional sheets of same size.)
S 48,641.17
LAW OFFICES OF
THOMAS J. TURCZYN
ATTORNEY AT LAW
:1 Tj.j. HAMILTON STREET
ALJ.ENTOWN. PA IBI04.-1569T
AGREEMENT
NOW, this {~ day of ~ U U.kr ,2003, ANNA
ALICE BROWN of Mechancisburg, Cumberland County, Pennsylvania, by and through her
Attorney-in-Fact, Patricia B. Hallock, and PATRICIA B. HALLOCK of Allentown, Lehigh
County, Pennsylvania,
WHEREAS, Anna Alice Brown is the mother of Patricia B. Hallock; and
WHEREAS, Anna Alice Brown appointed Patricia"B. Hallock as her Attorney-in-Fact,
pursuant to a Durable Power of Attorney executed on February 2, 2000, a true and correct copy
which is attached hereto as Exhibit A; and
WHEREAS, the said Anna Alice Brown is, at the present time, incapacitated, and has
funding requirements that she is unable to meet at this time; and
WHEREAS, Patricia B. Hallock has agreed to provide funds to Anna Alice Brdwn as the
said Anna Alice Brown may, from time to time, require; and
WHEREAS, it is the desire of both parties that the funds provided by Patricia B. Hallock
,
shall remain an obligation of Anna Alice Brown to Patricia B. Hallock.
NOW, THEREFORE, in consideration of the mutual promises set forth herein and the
intent of both parties bound hereby,
1. The above recitals do form a part of this Agreement and are incorporated herein
by reference thereto.
2. Patricia B. Hallock agrees to make payments on behalf of and for the benefit of
I
Anna Alice Brown for as long as the payments shall be required and to the extent that such
payments shall be required, it is agreed that an account will be maintained to reflect the total
amount expended as such expenditures occur:'
3. All such payments made by Patricia B. Hallock on behal(of Anna Alice Brown
i
shall be documented by a receipt for cash payments and copies of any checks, money qrders or
drafts utilized to make such payments provided that a copy of any invoice or receipt evidencing
and justifying such payment shall be attached to such payment.
4. All such payments may be made on an ongoing basis and any such payments shall
reduce the amount available for future payments and advances to be made by Patricia B. Hallock
on behalf of Anna Alice Brown.
S. It is agreed that Anna Alice Brown shall remain obligated to repay to Patricia B.
Hallock any payments or advances made by Patricia B. Hallock on behalf of Anna Alice Brown
as shall be documented, there being no specific time period for the repayment, however, it is
agreed that claim and demand for the repayment shall be made within four (4) years of the last
payment made pursuant to this Agreement.
6. In event such payment is not made, the said Patricia B. Hallock may make a
demand thereafter for the payment of the same and any delay or passage of time until such time
that Patricia B. Hallock shall make such demand, shall not be perceived in any manner to be a
waiver of the requirement for such advance funds to be repaid by Anna Alice Brown.
7. The obligation of Anna Alice Brown to repay all sums advanced by Patricia B.
Hallock pursuant to this Agreement shall remain the responsibility of Anna Alice Brown and her
Estate if the same shall not be paid in her lifetime.
IN WITNESS WHEREOF, the parties aforesaid, i.e., Anna Alice Brown by and through
her Attorney-in-Fact, Patricia B. Hallock, and Patricia B. Hallock do hereby enter this
Agreement and intend to be bound legally thereby.
By:
ANNA ALICE B~OWNO l
~~J~
- . ' ~. ~1 (iLL 9.DFt.
PATRICIA B. HALLOCK
Power of Attorney
~~~B. ~
PATRICIA B. HALLOCK
KNOW ALL MEN BY THESE PRESENTS THAT:
I, Anna Alice Brown, Social Security Number 185-01-0536, of West Shore II, 355
South Sporting Hill Road, Mechanicsburg, County of Cumberland and Commonwealth of
Pelmsylvania 17055, do hereby nominate, constitute and appoint, Patricia B. Halloel"
Social Security Number 202-36-7086, of 3763 Preston Lane, Centervalley, Conullonwealth
of Pelmsylvania 18034, my Attorney-in-fact, for me and in my name, place and stead, and
for my use ami benefit. In the event Patricia B. Hallock is unable or unwilling to serve, 1
then appoint Geoffrey Ross Hallock, Social Security Number 168-64-2074 of 3763 Preston
Lane, Centervalley, Commonwealth of Pennsylvania 18034 in her place and stead.
To ask, demand, sue for, recover, collect and receive all sums of money, debts,
dues, accounts, legacies, bequests, interests, dividends, alUlUities and demands whatsoever
as are now or shall hereafter become due, owing, payable or belonging to me, and to use all
lawful ways and means in my name or otherwise for the recover thereof, and to compromise
and agree to the same and give acquittances or other sufficient discharges for the same at
PNC Bani,. N.A., where 1 maintain accounls and all other financial institutions with which I
do business, fo make deposits and withdraw funds;
To entei. any safe deposit box of which 1 may be renter;
To sell, transfer or assign any stock of which I am now the owner, or any cel"lificates
of ownership or any bonds, and to this end, to have full power and authority to execute any
and all instruments necessary to make such sale, transfer or assiglUllent;
For me and in my name, to make, seal and deliver, bargain, contract, agree for,
purchase, receive and take any interest in any real property which I own or to which I
acquire title to or accept the possession of, and all deeds and other assurances for any
interest in said real property; and to lease, let, demise, bargain, sell, remise, release,
,
convey, mortgage and hypothecate any interest in real property more particularly the tract or
wood land partially in the Township in Monaghan and partially in the Township of
Warrington upon such terms and conditions and under such covenants as she/he shall think
fit;
And generally, in the absolnte discretion of my said Attorneys-in-fact, to appl~ any
funds in her/his hands or coming into her/his hands from time to time on my account, to the
payment of maintenance in any hospital, nursing home, public or private institulion, or at
my residence, and also to the payment of any medical, surgical, dental or nursing, care .
which inay be or is required for me and to exeCute all documents relating to the providing of
such care;
'.
~\A/I
Also to bargain and agree to buy, sell, mortgage, hypothecate an1 in any ami every
way and matmer deal in and with goods, wares and merchandise, choose,s in action, and
other property in possession or in action, and to make, do and transact a~1 and every kind of
I
husiness of any nature and kind; i
And also for me and in my name, and as my act and deed, to sigk seal, execute,
deliver and acknowledge such deeds, leases, mortgages, judgments and bther debts, and
other instruments, in writing or any kind as may be necessary or proper in the premises;
Should I at any time become incapacitated, either mentally Or physically, the
authority given under this Power of Attorney shall not lapse.
GIVING AND GRANTING unto my Attprney-in-fact, full power and authority to do
and perform every act necessary, requisite, or proper to be done in exercising this Power of
Attorney a~ fully as I might or could do if personally present, with full power of substitution
and revocation, hereby ratifying and confirming all that my attorney shall lawfully do or
cause to be done by virtue hereof.
IN]WITNESS WHEREOF, I have hereunto signed my name and seal this J-<1~
day of ! T ~~ dL--7'd -- ,2000. '
I '
SIGNED,ISEALED and DELIVERED
in lhe presence of
!
---tffrv
~~~
~'--~
Anna Alice Brown
OMMONWEALTH OF PENNSYLVANIA
ss
COUNTY OF YORK
On this, the ;J.,.vP{ay of
appeared before me, a Notary Public, the above-named Anna A: Ice Brown and "
2000, personally
acknowledged the foregoing Power of Attorney to be her act and deed, and desired the same
might be recorded as such, according to law.
IN WITNESS WHEREOF, I have hereunto set my hand and notarial seal the day
and year aforesaid.
A4d/ tlf/.~L
My Commission Expires:
NotBlla1 Seal
Halvard E. Alexander, Notary Publlo
DlUsburg Boro. York County
My Commlssron Expires April 23, 2001
Member, PennsylvanIa Association of olaries
PAYMENTS ~E BY PATRICIA B. HALLOCK
PURSUANT TO AGREEMENT FOR REIMBURSEMENT
WITH ANNA A. BROWN
DATE CHECK
PURPOSE
AMOUNT
03-1996 DEPOSIT 4,764.00
06-2003 1488 CABLE 11. 94
06-2003 1489 RENT 3,065.40
07-2003 1501 CABLE 11. 94
07-2003 1504 RENT 3,048.93
08-2003 1524 RENT 3,056.42
08-2003 1530 CABLE 11. 94
10-2003 1553 RENT 2,999.08
09-2003 1557 CABLE 11. 94
11-2003 1571 RENT 3,147.53
12-2003 1588 RENT 3,090.12
01-2004 1604 CABLE 11. 94
01-2004 1607 RENT 3,028.08
03-2004 1632 RENT 3,080.94
04-2004 1643 RENT 3,104.50
06-2004 1665 RENT 3,215.37
11-2003 1674 CABLE 11.94
07-2004 1683 RENT 3,254.01
08-2004 1684 RENT 3,215.00
11-2004 1718 RENT 3,218.44
12-2004 1728 CABLE 11.94
12-2003 1735 TELEPHONE 20.84
01-2004 1744 TELEPHONE 5.23
08-2004 1774 RENT 3,219.82
02-2004 1781 CABLE 11. 94
11-2004 1781 CABLE 11. 94
TOTAL 48,641.17
REV-IS13,EX+ (2-87)
*'
COMMONWEALTH OF P~NNSYlVANtA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHED'ULE J
BENEFICIARIES
ESTATE OF
FilE NUMBER
BROWN. ANNA A.
21-05-0325
ITEM RELATiONSHIP AMOUNT OR
NUMBER NAME AND ADDRESS OF BENEFICIARY SHARE OF ESTATE
A_ Taxable Bequesls:
1. Batricia B. Hallock Daughter 100%
3763 Preston Lane
Center Valley, PA 18034
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
.
AMOUNT OR
SHARE OF ESTATE
B. Charitable and Governmental Bequests:
1.
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13, Recapitulation) S
(If more space is needed. insert additional sheets of same size)
r
REV-1512 EX+ P_93)
'*
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES AND LIENS
Please Print or Type
FILE NUMBER
21-05-0325
COMMONWEALTH Of PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
BROWN, ANNA A.
ITEM
NUMBER
DESCRIPTION
AMOUNT
1.
Obligation to Patricia B. Hallock under terms of Agreement
(see attached copy marked as Exhibit A, a schedule of all
payments made by Patricia B. Hallock is attached hereto as
Exhibit B.
48,641.17
TOTAL (Also enter on line 10, Recapitulation)
$ 48,641.17
(If more space is needed, insert additional sheets of same size.)
LAW OFFICES OF
THOMAS J. TURCZYN
~~
ATTORNEY AT I-AW
~ TH. HAMILTON STREET
PA ~8104-1'S6PT
AGREEMENT
NOW, this ltr day of ~ U tJ.0 ,2003, ANNA
ALICE BROWN ofMechancisburg, Cumberland County, Pennsylvania, by and through her
Attorney-in-Fact, Patricia B. Hallock, and PATRICIA B. HALLOCK of Allentown, Lehigh
County, Pennsylvania,
WHEREAS, Anna Alice Brown is the mother of Patricia B. Hallock; and
WHEREAS, Anna Alice Brown appointed Patricia B. Hallock as her Attorney-in-Fact,
pursuant to a Durable Power of Attorney executed on February 2,2000, a true and correct copy
which is attached hereto as Exhibit A; and
WHEREAS, the said Anna Alice Brown is, at the present time, incapacitated, and has
funding requirements that she is unable to meet at this time; and
WHEREAS, Patricia B. Hallock has agreed to provide funds to Anna Alice Brown as the
said Anna Alice Brown may, from time to time, require; and
WHEREAS, it is the desire of both parties that the funds provided by Patricia B. Hallock
shall remain an obligation of Anna Alice Brown to Patricia B. Hallock.
NOW, THEREFORE, in consideration ofthe mutual promises set forth herein and the
intent of both parties bound hereby,
1. The above recitals do form a part of this Agreement and are incorporated herein
by reference thereto.
2. Patricia B. Hallock agrees to make payments on behalf of and for the b~nefit of
Anna Alice Brown for as long as the payments shall be required and to the extent that such
payments shall be required, it is agreed that an account will be maintained to reflect the total
amount expended as such expenditures occur..
3. All such payments made by Patricia B. Hallock on behalf of Anna Alice Brown
shall be documented by a receipt for cash payments and copies of any checks, money orders or
drafts utilized to make such payments provided that a copy of any invoice or receipt evidencing
and justifying such payment shall be attached to such payment.
~:X H\~I-f A-
~-'
i
f
4. All such payments may be made on an ongoing basis and any such payments shall
reduce the amount available for future payments and advances to be made by Patricia B. Hallock
on behalf of Anna Alice Brown.
S. It is agreed that Anna Alice Brown shall remain obligated to repay to Patricia B.
Hallock any payments or advances made by Patricia B. Hallock on behalf of Anna Alice Brown
as shall be documented, there being no specific time period for the repayment, however, it is
agreed that claim and demand for the repayment shall be made within four (4) years ofthe last
payment made pursuant to this Agreement.
6. In event such payment is not made, the said Patricia B. Hallock may make a
demand thereafter for the payment of the same and any delay or passage of time until such time
that Patricia B. Hallock shall make such demand, shall not be perceived in any manner to be a
waiver ofthe requirement for such advance funds to be repaid by Anna Alice Brown.
7. The obligation of Anna Alice Brown to repay all sums advanced by Patricia B.
Hallock pursuant to this Agreement shall remain the responsibility of Anna Alice Brown and her
Estate if the same shall not be paid in her lifetime.
IN WITNESS WHEREOF, the parties aforesaid, i.e., Anna Alice Brown by and through
her Attorney-in-Fact, Patricia B. Hallock, and Patricia B. Hallock do hereby enter this
Agreement and intend to be bound legally thereby.
By:
ANNA ALICE BJ3.0WN'O ,
~Gl.LLti,,~-
--.' &X. ~J~ 9.014-
PATRICIA B. HALLOCK
Power of Attorney
~B.~
P A TRlCIA B. HALLOCK
KNOW ALL MEN BY THESE PRESENTS THAT:
I, Anna Alice Brown, SoCial Security Number 185-01-0536, of.West Shore II, 355
South Sporting Hill Road, Mechanicsburg, County of Cumberland and Cununonwealth of
PelUlsylvania 17055, do hereby nominate, constitute and appoint, Patricia B. Halloc1l,
Social Security Number 202-36-7086, of 3763 Preston Lane, Centervalley, Commonwealth
of PelUlsylvania 18034, my Attorney-in-fact, for me and in my name, place and stead, and
for my use and benefit. In the 'event PatriCia B. Hallock is unable or unwilling to serve, I
then appoint Geoffrey Ross Hallock, Social Security Number 168-64-2074 of 3763 Preston
Lane, Cenlervalley, Commonwealth of Pennsylvania 18034 in her place and stead,
To ask, demand, sue fort recover I collect and receive all sUlns of money, debts,
dues, accounts, legacies, bequests, interests, dividends, annuities and demands whatsoever
as are now or shall hereafter become due, owing, payable or belonging to me, and to use all
lawful ways and means in my name or otherwise for the recover Ihereof, and to compromise
and agree to the same and give acquittances or other sufficient discharges for the same at
PNC Bank, N.A., where I maintain accounts and all other finanCial institutions with which I
do business, to make deposits and withdraw funds;
To entei. any safe deposit box of which I may be renter;
To sell, transfer or assign any stock of which I am now the owner, or any certificates
of ownership or any bonds, and to this end, to have full power and authority to execute any
and all instruments necessary to make such sale, transfer or assigrunent;
For me and in my name, to make, seal and deliver, bargain, contract, agree for,
purchase, receive and take any interest in any real property which I own or to which I
acquire title to or accept the possession of, and all deeds and other assurances for any
interest in said real property; and to lease, let, demise, bargain, sell, remise, release,
convey, mortgage and hypothecate any interest in real property more particularly the tract or
wood land partially in the Township in Monaghan and partially in the Township of
Warrington upon such terms and conditions and under such covenants as she/he shall think
fit;
And generally, in the absolute discretion of my said Attorneys-in-fact, to apply ,Iny
funds in her/his hands or coming into her/his hands from time to time on my account, to the
payment of maintenance in any hospital, nursing home, public or private institution, or at
my residence, and also to the payment of any medical, surgical, dental or nursing, care .
which inay be or is required for me and to execute all documents relating to the providing of
such care;
~\A"
I
I
Also to bargain and agree to buy, sell, mortgage, hypothecate and in any ami every
I
way and manner deal in and with goods, wares and merchandise, choos~s in action, and
I
other property in possession or in action, and to make, do and transact "11 and every kind of
business of any nature and kind;
And also for me and in my name, and as my act and deed, to sign, seal, execute,
deliver and acknowledge such deeds, leases, mortgages, judgments and other debts, and
other instruments, in writing or any kind as may be necessary or proper in the premises;
Should I at any time become incapacitated, either mentally or physically, the
authority given under this Power of Attorney shall not lapse.
GIVING AND GRANTING unto my Attprney-in-fact, full power and authority to do
and perform every act necessary, requisite, or proper to be done in exercising this Power of
Attorney as fully as I might or could do if personally present, with full power of substitution
and revocation, hereby ratifying and confirming all that my attorney shall lawfully do or
cause to be done by virtue hereof.
IN WITNESS WHEREOF, I have hereunto signed my name and seal this J ?(
day of : ~--<~ ....4- ,2000. .
SIGNED, 'SEALED and DELIVERED
in lhe presence of
I
~c/
~~~'-'~
Am." Alice Brown
OMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF YORK :
On this, the ;7/1""l~ay of ~~./A.rrA'4t.~'/2000. personally
appeared before me, a Notary Public, the above-named Anna A: Ice Brown and
acknowledged the foregoing Power of Attorney to be her act and deed, and desired the same
might be recorded as such, according to law.
IN WITNESS WHEREOF, I have hereunto set my hand and notarial seal the day
and year aforesaid.
)L)/ Il~L
otary Public .
Notarial Seal
Halvard E. Alexander, Notary Publlo
0I115OOrg Bora. York County
My Commlssfon Expires April 23. 2001
annsy vania Assm:ialion of Nolaries
My Commission Expires:
PAYMENTS MADE BY PATRICIA B. HALLOCK
PURSUANT TO AGREEMENT FOR REIMBURSEMENT
WITH ANNA A. BROWN
DATE CHECK
PURPOSE
AMOUNT
03-1996 DEPOSIT 4,764.00
06-2003 1488 CABLE 11. 94
06-2003 1489 RENT 3,065.40
07-2003 1501 CABLE 11.94
07-2003 1504 RENT 3,048.93
08-2003 1524 RENT 3,056.42
08-2003 1530 CABLE 11. 94
10-2003 1553 RENT 2,999.08
09-2003 1557 CABLE 11. 94
11-2003 1571 RENT 3,147.53
12-2003 1588 RENT 3,090.12
01-2004 1604 CABLE 11.94
01-2004 1607 RENT 3,028.08
03-2004 1632 RENT 3,080.94
04-2004 1643 RENT 3,104.50
06-2004 1665 RENT 3,215.37
11-2003 1674 CABLE 11.94
07-2004 1683 RENT 3,254.01
08-2004 1684 RENT 3,215.00
11-2004 1718 RENT 3,218.44
12-2004 1728 CABLE 11.94
12-2003 1735 TELEPHONE 20.84
01-2004 1744 TELEPHONE 5.23
08-2004 1774 RENT 3,219.82
02-2004 1781 CABLE 11. 94
11-2004 1781 CABLE 11. 94
TOTAL 48,641.17
t:~H lelT ~
REV.1513 EX+ (2.871
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PtNNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT D'ECEDENl
ESTATE OF
FILE NUMBER
BROWN, ANNA A.
21-05-0325
ITEM NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR
NUMBER SHARE OF ESTATE
A. Taxable Bequests:
1. Fatricia B. Hallock Daughter 100%
3763 Preston Lane
Center Valley, PA 18034
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
AMOUNT OR
SHARE OF ESTATE
B. Charitable and Governmental Bequests:
1.
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13, Recapitulation) S
(If more space is needed, insert additional sheets of same size)
MYERS-HARNER FUNERAL HOME, INC.
1903 MARKET STREET
ROBERT H. HARNER
SUPERVISOR
CAMP HILL, PENNSYLVANIA 1701 I
LOCALLY OWNED AND
OPERATED
TELEPHONE
717.737.9961
December 8, 2004
I
Mrs. Patricia B. Hallock
3763 Preston Lane
Center Valley PA 18034
Services for Anna A. Brown
December 8, 2004
. ~.M
~ /73&
Charges for Services Selected
Professional Services
Use of Facilities
Automotive Equipment
$ 3,775.00
$ 3,775.00
Charges for Merchandise Selected
Casket
Vault
Gown
$ 1,650.00
980.00
150.00
$ 2,780.00
Cash Advanced
Opening Grave
Newspaper Notice/Local
Certified Copies
$ 450.00
77 .00
20.00
Balance Due:
$ 547.00
$ 7,102.00
- 5,958.,,9.
------.....-......--....-..;
$'1,143.01
Total:
Received PNC Bank Check (12/09/2004)
([be patriot-News
Now you know
Order Confirmation
Customer
TURCZYN LAW OF FICES
Orderer Acc.ount Number
83414
Ad Order
0001296254
Order Source
rhollon
rl1ollon
Fax
Payer
payer Account Number
83414
Sales
Order Taker
Special Pricinq None
Allentown PA 18104-5697 USA
PO Number
Ordered By
Customer Fax
Customer EM ail
ESTATE OF BROWN
THOMAS TURCZYN
TURCZYN LAW OF FICES
1711 HAMILTON STREET
Customer Phone 610-432-7600
Payer Phone 610-432-7600
Tear Sheets
o
Proofs
o
Affidavits
1
Blind Box
Promo Type
<NONE>
Invoice Text
Materials
Total Ad Cost
$310.88
Payment Amount
$0.00
Payment Method
Amount Due
$310.88
Ad Number Ad TYDe
0001296254-0' Legal Liners
Ad Size
:1.0X18Li
Color
<NONE>
Production Method Production Notes
Ad Booker
Product Information
Classification
11 Inserts
Run Dates
PNCO: :Full Run
806-Estate Notices
3
412212005, 4/29/2005, 516/2005
Run Schedule Invoice Text
ESTATE NOTICEEstate of Anna A. Brown, deceased, late of Hampden
5/612005 9:00:05AM
1
Anna A. Brown, Estate
RE:
Legal advertisements must be received by Friday Noon. All legal advertising must be
paid in advance. Make all checks payable to: Cumberland Law Journal.
======~-=~=========================================================
Advertisement inserted on following dates:
April 22,29, May 6, 2005
Payment received
$ 75.00
$ 0.00
$ 0.00
$ 0.00
-------------
Advertising Cost
Proof of Publication
Second Proof Request
Total Amount Due
$ 75.00
--------
-----------
Payment received
by
lol,
DATE (dr.Jq ~3
PAYTOTHE C~~/J rj /71 \/1-1- $
ORDER OF (I) I Y I LA:-r ./V. 1 _ I II, 9' "l-
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~=~'8036
PATRICIA B. HALLOCK
., 3763 PRESTON LN.
CENTER VALLEY, PA 16034-9453
55-33/212
4439014039
1501
Page 2
ount
MEMO
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t1.94cr
11.94 cr
I. ... 0 :1 9 II" I. 50 I.
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11.26
11.26
Taxes & Fees
07111 -08/10
07/11 -08/10
StatelLocal Tax
FCC Reg Fee
Total Taxes & Fee!1
0.63
0.05
$0.68
""'--- PATRICIA B. HALLOCK
..~ 3763 PReSTON LN.
CENTER VAllEY, PA 18034'9</53
55-33/212
4439014Q39
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Total Due
~
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=---- 11.26
0.68
$11.94
Detail of Charges on back
~-,---..... -'---- .-.-
-
PATRICIA B. HALLOCK
3763 PRESTON IN.
CENTER VALLEY, PA 18034-9453
55-33/212
4439014039
1557
!?-ATE 4t'?Jft ~ ..?lO 3-
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-
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~
11.94 9:...
11.26
0.68
$11.94
Detail of Charges on back
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NUMBER
DATE
DUE
TOTAL
AMOUNT DUE
I Fleet
Visit us on the web at www.comcast.com
09547203775.01.5
01/23/04
$11.94
For service at:
355 S SPORTING HL RD APT 35
MECHANICSBURG PA 17050-7702
How to reach us...
How to roach us:
3800 Trindle Rd, Suite B
Camp Hill, PA 17011
(717)540-8900
Telephone Customer Service
24 hours a day, seven days a week
ANNA BROW
<'J
~
Summary of Charges
Billed from 01/11/04 to 02/10/04
Previous Balance
Payments (includes payments received by 12124/03)
Monthly Services
Taxes & Fees
1 1.94
11.94 cr
11.26
0.68
$119.00
Total Due
$11.94
Detail of Charges on back
$22.63
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AMO,UNT: $27.55
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REF. NO.: 0106000403187930
AMOUNT: $50.00
REf. NO.: 0122001303866722
AMOUNT: $93.25
039564414
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[:CCOUNT
NUMBER
09547 203775-01-5
DATE
DUE
TOTAL
AMOUNT DUE
eet
12/23/04
$11.95
For service at:
355 S SPORTING HL RD APT 35
MECHANICSBURG PA 17050-7702
How to reach us..,
How to reach us:
3600 Trindle Rd, Suite B
Camp Hill, PA 17011
(717)540-8900
Telephone Customer Service
24 hours a day, seven days a week
-
ANNA BROW
Summary ot Charges
Billed from 12/11/04 to 01/10/05
!
Previous Balance
Pavment~(inc'udes payments received by 11/26/04)
Monthl~ Services
Ia~~~Surc~~ges, & Fees
11,94
11.94 cr
11.26
0.69
!.98
")
Total Due
$11.95
Detail of Charges on back
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This bill reflects a change in the FCC Regulatory Fee from $0.05 to $0.06.
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REF. NO.: 1228000380410307
AMOUNT: $44.22
REF. NO.: 1202001080089745
AMOUNT: :$620.19
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REF. NO.: 1203000980840656
AMOUNT: $27.37
REF. NO,: 1201000480732934
AMOUNT: I $50.00
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Page 6 of 8
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AMOUNT: $27.31
REF. NO.: 1110001080589839
AMOUNT: $71.00
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REF. NO.: 1110001180903630
AMOUNT: $11.94 '
REF. NO.: 1108000780014325
AMOUNT: $945.01
pA.UUClAa.KAlJJ)CK =: 1783
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REF. NO.: 1109000480502674
AMOUNT: $36.89
REF. NO.: 1116000680857383
AMOUNT: $39.95
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REF. NO.: 1110001080507207
AMOUNT: $50.00
REF. NO.: 1117001080462796
AMOUNT: $12.75
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AMOUNT: $78.00
REF. NO.: 1116001180655440
AMOUNT: $59.54
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Page 5 of 6
PATRICIA.. tW.LOCK
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REF. NO.: 1104001203020764
AMOUNT: $195.70
. PATRICIA II. tW..L.OCIl
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REF. NO.: 1103001203232205
AMOUNT: $16.52
PATfUCiA .. tw.1.OCK
...............
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REF. NO.: 1114l)o0604&9 55
AMOUNT:
PATRlCtA .. HAlLOCII.
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REF. NO.: 1124001003602337
AMOUNT: $47.22
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.. 0 Fleet --_.
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.....,(dl )'RI'.41il.f'--.
.':Dil~Oa3.3.ql: ....)tiQ
:;:~
1573
PAlftl~1A .. HAllOCK
wnJ':J&~~1~ -l~;~-':',.-..,. IUL 'l.",~
\ m'i.w.~ ......I..Ah/'t1A;{:A. JnjA...(Jh~JA'U. I $ Olo~0
I -
'()('h"rJ--' -"'_JlXllllUI5lil u.=
Fleet
-'er__ ~ _' rfuAA_.
*-l'fll>tl(!'~~
':0 B ~OOB'l': ~~~'l0 l~O~'l"- lSB 0"000000.000..'
REF. NO.: 1125000903555148
AMOUNT: $20.00
PATR1C1A II. HAUOCK
:AU PflaIOH lH.
~tlRIIAIJ..I:'t,Nt. IIl1M-IMN
~nr 1615
--
,.~ It It AlA JQ3
C'm1ll"Snl""" (it1"A,ulA. _ 1$/;:>'1.36'
i ~ Au., /ll>e.~ ,/",.Af,ssJfco OOUAlU 6l 50-:-
~ Fleet .
- S:r=-_ ~-. fhPkvL .
':OBI00H~t: ~~~'1O l~O)~." l515 "OOOOOU~15"
-
REF. NO.: 1119000403577098
AMOUNT: $134.35
~~
1.677
PATRlCLl IL KAU.OCK
3Ja .w;IIOH LIt
QH1UlIIAla'f,M I~ llilrl/7 Jltfl", ~3
b-~ii::~'~~ l ;;~~-",~;r6-"'~,~,IiJ-liU
. r::;;r.m' tllJrH~j IS fCJ.7'1
~rt....,"".....J 7~Lt')~,,,.........&E:a::'
el~~l.-- -.. ~.
-==-- . /A..JfA
Mtwa . ~."".~X1'~~
,:01l1ll0nq.: ~~~~o l~O~'l" l571 0"000000'1.1'1"
REF. NO.: 1121000603425895
AMOUNT: $92.79
-
~,c~~~~.~_
VeriZ!!O:tt is'.;>, "i
,~ //~
Page 2 of 10
717 763-8955-886 60Y
----
I'
lN, InformatIon I, requIred by the Publ;c Uti I; ty Comml..lon. . "B..k"
'Or v ke I ncl ude, the I;ne charge. local ca" I ng and TOUCH ToNE 'erv I ce
(if app I kab I e). "Non- Ba, Ie" 'erv ke Include, optional 'erv ICe,. other
than Touch Tone. 'uch a, MaIntenance agreement for In'lde wIre and
Guardian and does not include tol I services.
-
December 29, 2004
Non-payment of any Past duo basIc charges could result in suspensIon
of YOUr local serv;c. aft.r YOU receIve a s.parate written statamont.
BASIC
TOll
NON-BASIC
TOTALS
Past Due
Ba lances
$20.84
$.00
$.00
$20.84
Current
Charges
$ -15.61
$.00*
$.00*
$ -15.61
Totals
The fol/owing pages provide additional details.
· (lnclude, Ver;zon and other service provider(,) charges.)
$5.23
$.00
$.00
$5.23
.-- -. --------
_____ _.w.'
~
verizoJ:l
We never stop working for you.
Billing Date 12/10/04 Page 1 of 4
Telephone Number: 717 763 8955
Account 717 763 8955 886 60 Y
How to Reach Us: See page 2
Previous Charges
Payments Received thru Dec 13
Past Due Charges
~)v;7
~~~$VI7?S-
ANNA A BROWN
Account Summary
$20.84
-20.84
$.00
Total Due (pa'l Due + New)
$20.84
~nage Your Verizon Account Online!
~~IM & pay bills, request repairs, place orders,
It's ,quick and easy:
Go 'to verizon.cblTl
Click 'Sign in' under 'Manage My Accounf'.
First time user? Gel started with...
User 10: 7177638955$
Password: K9R2CR
... and customize your 10 as you register.
Then follow the step-by-step instructions.
New Charges
Verizon (page 3)
Total New Charges due Jan 5
$20.84
$20.84
DATE <f' ~ ;::)-(Jt) ~
PAY TO THE III "---_ . _ ~A /. I " -L ('I. _ . .-::2 $
ORDER OF ('JOn ,IIJJJ. ~ , tJ lUAJ Jlx...(()11 b!1 fA/. JUJ ,~O"->- I .s3 C (Q S 46
( <' . -'P . .
t:lJ.h 1 " TI (')J I -() (f.u.-cl ~ Ljj J J l.. e ~ J.. / I (JC) DOLLARS tn e;=
. C) Fleet
04039 ~~I"'f)J' ~ '-1- /I n _ .
MEM~Ai=t;J UA,u{ ff11rliht, _ ~dJ;1 eJ 'D_lSJ~
I I: 0 2 ~ 20 0 J J 9 I: L, ItJ 9 0 ~ L, 0 J 9 III ~ L, 8 9 ... 0 0 0 0 JOb 5 L, 0--
PATRICIA B. HALLOCK
3763 PRESTON LN.
CENTER VALLEY, PA 18034-9453
55-33'212
4439014039
1489
;.31
..00
3,077.3
(11.9
3,065.4
Previous Balance Char es this month
\
i 105.31
AMOUNT DUE
____ ~_ ] [_~______~=:J
105.31
l=nRI\III=)(
717_"~~_1?":m
,.".n" f......r.......ovin.... ...............
PATRICIA B. HALLOCK
3763 PRESTON LN
CENTER VALLEY, PA 18034.9453
55-33/212
4439014039
3,065.4
(3,065.4
f
3,048.9
84
.00
;.---
::/:t--
/G'01:-
3,060.8
(11.9
MEMO
ou for choosin Count
~._ ._:'" ",: :':.<' ~ ,.+;\~: ~'!'~ ::>fi_}~_V;~?:;l>\~_~t;\~:':1,:-:,-"p;ll' }',k-:!;-:'.'!_ir<~}\\~;Ji'i
please :inqiude :j:b;e;t'0J1;!~P)9i~:io,
15th usinglthe'enclosed,enve
Meadows. Associates >"/,\r~i: ,::~::': . '
For pharma~Y qUestions!:.plel1se'i,<?
.. . ...~: :~J!
. ....~1s;!'n;;;
\.
-l~--
II
85~ II .............."3.471
LEGElNON LEGEND
FOR MONTH FOR MONTH
AMOUNT DUE
, 88.84
I=()RlI..4r::V
7-17,1::'1":1 ",,)":In
u...~.. .r~r_~..:__ __~
DATE It') O.lwif'-Gcd ~3
b1iDl~b~E &u1";;iL'Il/~~~. 1$ ?,oE;'(Q ,1-~
tAA.-u -:t~n){]ruJx..'-djJ;/;r, ,,; 9k 12//()~OLLARS In !!i$':.'::"
~ !..t:,=.t I
.rno~t-JiJ~;b\ ~J-uJU~ /Jall6<-!:
I:02L200:l:l91: L,L,:l90 j.L,O:l911" j.S2L, ,"OOo'030SbL,U
PATRICIA B. HALLOCK
3763 PRESTON LN.
CENTER VALLEY, PA 18034-9453
55-33/212
4439014039
1524
3,048.9
.33
.00
(3,048.9
3,068.3
(1]...9
3,056.4
J
Thank you for choosing
, 'please;':, include ::t);ie,:A,to
, i;-" oj " ,
'15th' using, the i'enclOs
;'-:. ~\< /,:"-"~
.-,-,', ""'"
c" . ~ ','~; ~~...
~,,";!~: .~: ,--:.;
.' n':", ",' ;~':':_\':'>':! ,_;
, ;' ;:\). ~" ,-,
,,:.'~ :i:~ jl\.
l---=_~ I
\\1
---0 I
AMOUNT Dl
, 96.3
D!\fE (f) (I 'f. eX C:M7l3
J
, PAYTOTHE filM ; A '\ A ,A AI1. .1 /iI1. J. I ........ $
i ORDER OF l'wl1 uJ/Jl.1 , r j( .1.(iltl'X IX..Lf JL ~ ( JOlJI JIJ.fL,. I B q Cfq. Of?
· (. .' d/
!1:lii1J~-'~(I e9. /lW6 ~oJ hLli~l1hLLltut!I /I/l:.IDOLLARS l'il !E:::-
! C) Fleet .
"'""1ket.~)'I\~
04039 ~= ~ 10036 rrlV vt"
MEMO fll.LT -d! lO (' - ro (L ..
I: 0 n 20 0 II 91: l. L,j 90 L l. 0 l 9 II" L 5 5 l
PATRIOiAltJ:rALLOCK
3763 PRESTON LN.
CENTER VALLEY, PA 18034-9453
55-33/212
4439014039
1553
3/~61.8
(3,~61.8
.99
.00
3,0~O.9
(11. 9
2,999.0
vs0
l.~
\fr'(\~ 'l'l"i ,0 i
I
\
\
....",,-
.~
ResidentName:AnnaBrC;~/
;>';:::,:,'
. i' : ,~ c. ., ,,'
. /. .:<?~q..:t~::\-;,,; "".,
;-.-"
~' < ~', ':; .;:; :,',
,. "..-\:',_, :.'.: '.<~_i' -.
o ,>; '1-;';' '~1
:;~,' ~ )" -,;,:;',
s~cur~ty epos~t:
- ~-
....-.........-...
2,382.00
-
2,999.0
DATE
BALANCE FORWARD
10/03/2003
10/21/2003
10/22/2003
11/01/2003
10/31/2003
PAYMENT
Pharmacy Charges
Beauty Shop Bldg.3
Room, Board and Services
CURRENT MONTH CHARGES
Interest on Security @ 6%
(2,999.0
162.44
25.00
2,972.00
3,159.4
(11.9
CURRENT BALANCE DUE
3,147.5
Interest Earned Year-to-Date:
r-----\ r
LEGEND
FOR MONTH
[0r~~HARG~S\
. =<,16t.~~..-
AMOUNT DUI
.00 +
162.44
Previous Balance
DATE
~
11/07/2003
11/20/2003
11/21/2003
12/01/2003
11/30/2003
BALANCE ~
3,147.5
PAYMENT
Beauty Shop Bldg.3
Pharmacy Charges
Room, Board and Services
CURRENT MONTH CHARGES
Interest on security @ 6%
(3,147.5
4.3.00
87.03
2,972.00
CURRENT BALANCE DUE
Interest Earned Year-to~Date:
Thank you
;:'~?
',.;c.:,
:J ." ,<
"";,"' {";
";;,
:'~::r J~ .
c:-
II
~1
2JJ I
AMOUNT DU
Previous Balance
.00 +
87.0::
DATE
_' _ B.ALANCE FORWARD
3,090.1
(3,090.1
12/12/2003
12/05/2003
12/19/2003
12/21/2003
12/22/2003
01/01/2004
12/31/2003
PAYMENT
Beauty Shop Bldg.3
Beauty Shop Bldg.3
Pharmacy Charges
Beauty Shop Bldg.3
Room, Board and services
CURRENT MONTH CHARGES
Interest on Security @ 6%
, .,,,
",:'" i ' .;::;,if,j,,:
18.00
15.00
19.99
15.00
2,972.00
CURRENT BALANCE DUE
Interest Earned Year-to-Date:
Thank you for choosing
pleas e I; inc lj.iQe;i(;thei':~i.t()j;if":po,re:ibiE,~
, '15 th'us irig ;the':'enciXosedJt~nve ",' I"~
", Meadow,s ::~s s~<? iat~ 'Elj 2Q/~r;:;:I~;i,\:',~i)t~;J~:!
For pharmacy,~.ques~i9ri~:p1e~~
N"I"e. ,;~~;~~,~i~~~t
:-; ':',-t~:' ;." ;(';;<'~;,,~~:~:":
:l'~,;r~
:" ;l} ':;:<>h:': j
";':-:~f<,~- "
\f,'."...;",,'
1:.!
1 '
l
i
I
i
I
!
i
i
\-----------\ \--
\ \_-
1\ \~UL9 9 \ \1
\
:'~! (~', ;- " ~~y)
Previous Baiance
AMOUNT DUI
19.99
FORMI=X
717A:n.1?'10
'^nAI\A' fnrmpvinr I"'nm
. -
~'
02/12/2004
02/04/2004
02/18/2004
02/21/2004
03/01/2004
02/29/2004
PAYMENT
Beauty Shop Bldg.3
Beauty Shop Bldg.3
Pharmacy Charges
Room, Board and Services
CURRENT MONTH CHARGES
Interest on Security @6%
3,157.98
(3,157.98
DATE
BALANCE FORWARD
15.00
15.00
90.85
2,972.00
3,092.85
(11.91
CURRENT BALANCE DUE
3,080;94
nterest Earned Year-to-Date:
~ \I?}~
Thank you for choosing Country
"~le~se :j~ri~1:Sd~~:',th~~~:t;;~:,~6~tig" "
15th: fusing';~~e\e.D,C:l()f3e~:lt~rt,y~~'C) .
,Meadqws "AE\S',?ciates;,},",,'i :i:! i;U, "i~:i:,;~.:}'l.,
For pharmacy:qu$'~t':!-6I1s'pl.e_asei',"
ReSident'" ,. '" ~ri~;,~~J~i":t,.,,;j.,':
. - -" .", '.' \:j :~... - - - ~ .. "
. , , '; -' .:::~;: :'~
,';":'\;'.::.!-:,,:~I','.;:;,::,'" .... -
" :--_:"'''::.:~';_:,:/,
.-,':\; "-,:"-.-,,..".-.;-;
,;-,-<>:;_":-":
.. --..--..-..1---.-.-..-.-....-'
, i" " : ' , ',: l, ( ,< ~i':' ~
i' _'. ,II I" {,' J I ... "~' t 11 i .'
I '
I
1
L.=--=]\-~-I L
I
:=JJ L._ 90.85 II
lJJulJJflJ
.oo-r--
TOTAL TAK~
Prei'iiou..'Balanc'e Chaiges this month
.00 + 90.85 +
FOR MONTH
: \ TOTAL CHARGES\
= 90.85.
AMOUNT DUE
~ talPByment & Credits
j .00
J
90.85
---~~~~~ ~-~-~~~.
4.0, JU.&I.V,V
=-
DATE
--B:~CE FORWARD
3,080.94
03/08/2004
03/03/2004
03/17/2004
03/21/2004
04/01/2004
03/31/2004
PAYMENT
Beauty Shop Bldg.3
Beauty Shop Bldg.3
Pharmacy Charges
Room, Board and Services
CURRENT MONTH CHARGES
Interest on Security @ 6%
(3,080.94)
15.00
43.00
86.41
2,972.00
3,116.41
(11.91)
CURRENT BALANCE DUE
3,104.50
nterest Earned Year-to-Date:
35.73
QJ(.J/ /~ r3
Thank you for choosing Country Meadows of West Shore 31
Please ~ncl ude the top portion o,fi~hhiS;bi.iJ.\>li~h,iC>~l:"~ayrti~n~'~y ,the
15th us~ng the enclosed !envelope,'<M:ak~y()u8,h~pkpa,ya]j].t:i'.tb.Cbun1:.ry
Meadows Associates.. i."". ..'i',,'.'>
For pharmacy questions please contact ;I'Alert'.'direct.at'f-'.800,... 66"'9954
:':'
Resident Name: Anna Brown
,'.Acbotint#: '
,"Statement.
. '-"r~""'~'.~I'1"'ff""'l....,.,""'.".r
~r;/:,.:r .,,' ~: I}';:', '
\;':li:; Iii f,j (: I '
r>:('IT; I:!' : "
j 'I' ' 1
I--.---=J I
II
~ r----- 86.41 II !,.
I ~EGEIID . ,
~1~~\()\l~ ~i\al\ce~ J~"a'9".-\"\S mQu\"1 \ "\nance Cbalge \ \ ~~~ :~:~$' \ Total Payment & Credits \
.uO l:Sb.4.l I. .:OU1 I B''6.'ij:'1 ,11 /1/1
J.. ,
tl..lI\O\l~"'t 1
l
~e~UL.LLY UC~U~~~;
./!.,..::Jo.e..vv
~~
BALANCE FORWARD
3,229.30
05/12/2004
04/28/2004
05/12/2004
OS/21/2004
06/01/2004
05/31/2004
PAYMENT
Beauty Shep Bldg.3
Beauty Shep Bldg.3
Pharmacy Charges
Reem, Beard and Services
CURRENT MONTH CHARGES
Interest en Security @ 6%
(3,229.30
15.00
15.00
91. 28
3,106.00
3,227.28
(11.91
CURRENT BALANCE DUE
3,215.37
nterest Earned Year-te-Date:
59.55
/
-"
Thank yau far chaasing Cauntry Meadaws .of West
, PleaseCinqlude.'the'.'Bo~: ..portibril. ~:fC>~his.biJ.t~itliyouri paymen
15 thusing . the' enclosed' . envelop~.Mfl-k,e' you9heckpayable to
Meadows Associates. I:! .... ..... . ..' ! . :
For pharmacy questions please cOIltact'''Alertli
~~0Lo~
Shore 3! ~.
j':.:.:',.'.,'
'i':';" ....
Resident Name: Anna Brown
"'.;'"
:le:
i.'...:
"'::'.J:'
;:i.',,"
"
'if:!
:";::',',-:".:
:::','"
,'" :",;,<:.) ."ii..'
"
.'.-1':"
\."";;>
....... '1
i
I
1
PreWoUSB' j--
i a anee rCIJ~thl
~ S tnn...~
[===--~li Q-:2il I rr----
~ . ~LL f
,,~
y aepos1t:.: :.::,
DATE
BALANCE FORWARD
3,215.37
06/04/2004
OS/24/2004
06/09/2004
06/18/2004
06/21/2004
07/01/2004
06/30/2004
PAYMENT
Beauty Shop Bldg.3
Beauty Shop Bldg.3
Beauty Shop Bldg.3
Pharmacy Charges
Room, Board and Services
CURRENT MONTH CHARGES
Interest on Security @ 6%
(3,215.37)
15.00
15.00
43.00
86.92
3,106.00
3,265.92
(11.91)
CURRENT BALANCE DUE
3,254.01
nterest Earned Year-to-Date:
71. 46
C~-Jt /6 g~
Thank you for choosing Countr Meadows of West Shore 3!
~~~~S~si~~'~~: ;~:,~~Ut. ~;~~~. p~1. :~~."~..'...~'.'.'..~~.t.:~.;.'~."~.'~;.'..;'...~,".k',;,f~C..,.~,'~,.;"a,:,~,:~',','.,r:,",',..,:,e;,~'."',t~~,I'~~.,'."~',.~.,,..","".' ,.
Meadows Assoc1ates. ' l " ,",",' ,.', , ,'i'e' ,"",c","'"" ,'"
For pharmacy questions please contact.IIAlertll,,<H~ect>a~',1"~p:O~2\~6".9954
Resident Name: Anna BrownACC911J:1t~Y.107 , \.: ,.," ,,'.,..
Statement Date: 07/0~12004
I
I
I
I
!
i
I
II
~J I
o ~-86.92 III
~GEND
FOR MONTH
~ I TOTAL ~'t~R9G:.fSI ~
.00
TOTAL TAX
AMOUNT DUE
86.92
PAYMENT
PAYMENT
PAYMENT
PAYMENT
Beauty Shop Bldg.3
Beauty Shop Bldg.3
Pharmacy Charges
Beauty Shop Bldg.3
Room, Board and Services
CURRENT MONTH CHARGES
Interest on Security @ 6%
FORWARD
___ ~ JANf VJ;1lt!,
~r- vtdE-
3,254.01
DATE -
BALANCE
07/08/2004
07/08/2004
07/27/2004
07/27/2004
06/23/2004
07/07/2004
07/21/2004
07/28/2004
08/01/2004
07/31/2004
3,254.01
(3,254.01
(3,254.01
(3,215.00
15.00
15.00
94.45
15.00
3,106.00
3,245.45
(11.91)
CURRENT BALANCE DUE
18.54
nterest Earned Year-to-Date:
83.37
t-\~
Thank you for choosing Country Meadows of West Shore 3!
Please ~nclude the top ~.()rtion""Ot'~h~~);~~1-i;C~~#h;.,ygll.#P~~~#t:~Y';tlle<"
15th uSl.ng the enclosedenvelope"""'~C:l.k.r:Y"()'U<C:l1~CKPC:l.Yc:l.P~e.,t:o.CCI)'UntJy .
Meadows Associates. .. " . ....,. """/;.'",','" .....\.,. ...... '.".' .
For pharmacy questions please corttactl.A.1.~rt" i~i~ei~".~~':~--~OO~T66~9954
Resident Name: Anna Brown'AOCOUtlt,#::.107 \
,statementPi3.te: .'. 08/01/2004
..' .... I
. !
i
I
i
i
l""&~~~;- ~
':OBlOOB~I: ~~~~o I~Oi'~" 1'87 ...00000 10~i~1
1 () C)FlHl-'
...; Eii"=-_
-;;OBlOOH~I: ~~~~o I~Oi'~"
REF. NO.: 0713001103226555 AMOUNT: $106.39
REF. NO.: 0723001080428993 AMOUNT: $8.00
1110
DATE
BALANCE FORWARD
18.54
...--. -- .
08/23/2004
08/11/2004
08/20/2004
08/24/2004
09/01/2004
08/31/2004
PAYMENT
Beauty Shop Bldg.3
Pharmacy Bldg.3
Beauty Shop Bldg.3
Room, Board and Services
CURRENT MONTH CHARGES
Interest on Security @ 6%
(18.54
15.00
85.73
25.00
3,106.00
3,231.73
(11.91)
CURRENT BALANCE DUE
nterest Earned Year-to-Date:
95.28
eJ4/[ltr
3,219.82
Thank you for choosing Country Meadows of West Shore 3!
Resident Name: Anna Brown
.0
I: I 85. 73 II
LEGEND
FOR MONTH
I TOTAL CHARGESj
= . 85.73 -
.00
TOTAL TAX
\--~---~-ll----=J L__
AMOUNT DUE
Previous Balance
T~ta' Payment & Credit.
I .00
85.73
10/08/2004
10/06/2004
10/20/2004
10/21/2004
11/01/2004
10/31/2004
PAYMENT
Haircut, Wash Set & Conditione
Wash Set & Conditioner
Pharmacy Charges
Room, Board and Services
CURRENT MONTH CHARGES
Interest on Security @ 6%
3,254.26
(3,254.26)
DATE ..-=== B~RWARD
25.00
15.00
'84.35
3,106.00
3,230.35
(11.91)
CURRENT BALANCE DUE 3,218.44
Interest Earned Year-to-Date: 119.10
G }A? ,+
'17 fB
Thank you for choosing Country Meadows of West Shore 3!
I
Please include the top portion
15th using the enclosed envelope
Meadows Associates. ".'
For pharmacy questions please,
Resident Name: Anna Brown
039564414
4 - 5
Country Meadows West Shore 3
4905 East Trindle Road
Mechanicsburg, PA 17050
Telephone: (717) 761-8880
Resident Statement
~ K.-. : (TO" 10 1'\Il.:& Ii
Date: 01/01/2005
Re: Anna Brown
Account#: 10
Balance Due
patricia Hallock
3763 Preston Lane
Center Valley, PA
18034
DATE
BALANCE FORWARD
3,158.44
12/06/2004
01/03/2005
12/01/2004
12/01/2004
12/01/2004
12/28/2004
12/31/2004
PAYMENT
PAYMENT
Room, Board and Services
Room, Board and Services
Room, Board and Services
Meal Credit Bldg.3
CURRENT MONTH CHARGES
Interest on Security @ 6%
012/6'- .
102.12
796.67
(3,106.00)
(75.00)
(3,158.44)
...seC.. 'J>e;p. ( 2 , 3 82 . 0 0 )
(2,282.21)
(11.91)
CREDIT BALANCE - DO NOT PAY
(4,676.12)
Interest Earned Year-to-Date:
11.91
Thank you for choosing Country Meadows of West Shore 3!
Please include the top portion of this bill with your payment by the
15th using the enclosed envelope. Make you check payable to Country
Meadows Associates.
For pharmacy questions please contact "Alert" direct at 1-800-266-9954
Resident Name: Anna Brown
Account#: 107
Statement Date: 01/01/2005
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 005610
TURCZYN THOMAS J
1711 HAMILTON STREET
ALLENTOWN, PA 18104
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
nUhd fold
101
$4,972.94
ESTATE INFORMATION: SSN: 185-01-0536
FILE NUMBER: 2105-0325
DECEDENT NAME: BROWN ANNA A
DATE OF PAYMENT: 07/25/2005
POSTMARK DATE: 07/22/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 12/03/2004
TOTAL AMOUNT PAID:
$4,972.94
REMARKS:
CHECK# 16312
SEAL
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS