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HomeMy WebLinkAbout05-16-06 I ~. .~ COMMONWEAlTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA .17126-0601 ()FF~Ctt\L USE Ot~L-{ REV - 1500 EX + (6-001 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER C"'{.... 21 = COUNTY CODE .. YEAR SOCIAL SECURITY NUMBER 00023 NUMBE.R DECEDENT'S NAME (LAST. FIRST, AND MIDDLE INITIAL) Fuller, Ten)' E. 168-48-2967 ~ z W o w (.) w o DATE OF BIRTH (MM-OO-YEAR) DATE OF DEATH (MM-DD- YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE 02/04/1955 11114/2005 REGISTER OF WILLS SOCIAL SECURITY NUMBER (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST AND MIDDLE INITIAL) o o o 181 1. Original Return 0 2. Supplemental Return o 4. Limited Estate 0 4a. Future Interest Compromise (date of death after 12-12-82) ~ 6. Decedent Died Testate (Attach copy 0 7. Decedent Maintained a Living Trust (Allach of Will) copy of Trust) o 9. Litigation Proceeds Received 0 10. Spousal Poverty Credit (date of death between 0 11. Ejection to tax under Sec. 9113(A) (Allach Sch 0) :~~~..~g~11.Q~~Mt:L~!l~~i~QM~~g~P}..~.~~coa@~~~~~~W~j~~~g'~->C>.Nf~j~~#.~~iWfg!\Mj:@"qtf~aQU~Jlig~~~@~~mpj!Q.t... NAME COMPLETE MAILING ADDRESS Dale F Shughart, Jr. Esquire 3. Remainder Return (date of death prior to 12-13-82) W ~ ~:!(/) ur:r:~ wll.U :cOO (.)r:r:...J Il.al Il. oct 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes '1- (/)z WUJ r:r:o r:r:z 00 Oil. FIRM NAME (If applicable) 10 West High Street Carlisle, PAl 70 13 (1 ) 35,500.00 (2) None (3) None (4) None (5) 6,125.75 (6) None (7) -0- (8) (9) 10,611.55 (10) 9,329.70 TELEPHONE NUMBER 71 7/241-43 11 --~l I I ! I I i i ! I J OFFICiM.. ';&~Cf'L'" ,--- ") , 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) '_' 'i z o i= ~ ~ ~ ii: oct o UJ a: (.n,,: '.0 41,625.75 10. Debts of Decedent. Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) (11 ) 19,941.25 21,684.50 (12) 12. Net Value of Estate (Line 8 minus Line 11) (13) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 21,684.50 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate. x .00 (15) or transfers under Sec. 9116(a)(1.2) z .045 (16) 0 16. Amount of Line 14 taxable at lineal rate x i= oct ~ ~ Il. 17. Amount of Line 14 taxable at sibling rate 21,684.50 x .12 (17) :! 0 (.) >< 18. Amount of Line 14 taxable at collateral rate oct x .15 (18) ~ 19. Tax Due (19) 2,602.14 2,602.14 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 20. D Form REV-1500 EX (Rev. 6-00) Copyright 2000 form software only The Lackner Group, Inc. Decedent's Complete Address: . STREEtI' ADDRESS ManorCare Nursing Home 940 Walnut Bottom Road CITY Carlisle STATE PA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) 2,602.14 Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) 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 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) 0.00 (4) (5) 2,602.14 (5A) (58) 2,602.14 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;................................................................................ ~ I b. retain the right to designate who shall use the property transferred or its income;.................................... c. retain a reversionary interest; or........ ............ ..................................... ............................................. ......... d. receive the promise for life of either payments, benefits or care? ............................................................. 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.............. ........... ....... .......... ......................... ....................... ............................ 0 ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... D ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .............. ................................... ................ .......... ...... ............................. ........ ~ D 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 01 perjury, I declare that J have examined this retum. including accompanying schedules and statements. and to the best of my knowledge and belief, it is true. correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS Ted Fuller -d ~ // SIGtATURE OF P~~IBLE FOR FlUNG RETURN DATE 430 Fairground Avenue Carlisle, -p A 17013 :.)- /6-:.06 ADDRESS DATE SIGNATURE OF PRE PARER OT~ER T~~~'EPR ENTATIVE Dale Shu~r~ J, ~u, Ir ~.{/, / ADDRESS DATE 10 West High Street Carlisle, P A 17013 5//~ 1{;J6 For dates of death on or aft July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. ~9116 (a) (1.1) (i)}. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P .S. ~9116 (a) (1.1) (ii)]. The statute does not exemDt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: The tax rate imposed on the net value of transfers from a deceased child twenty.one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. ~9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P .S. 99116 1.2) [72 P.S. 99116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 99116 (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. ,~ ~ SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Fuller, Terry E. FILE NUMBER 21 - 05 - 00023 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 which is jointly-owned with right of survivorship must be disclosed on schedule F. ITEM NUMBER 1 DESCRIPTION VALUE AT DATE OF DEATH 34,000.00 Lot and dwelling house @ 430 Fairground Avenue, Borough of Carlisle, Cumberland County, PA. Tax Parcel #06-20-1798-318. Value based upon attached appraisal of Susan B. Burkholder. 2 Vacant lot, 30 feet by 37 feet in dimension, located at rear of 421 North Pitt Street, Borough of Carlisle, Cumberland County, P A. Tax Parcel #06-20-1798-305A. Value based upon actual sale price. Copies of Deed and HUD 1 Settlement Statenlent attached. 1,500.00 TOTAL (Also enter on Line 1, Recapitulation) 35,500.00 .~ ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Fuller, Terry E. FILE NUMBER 21 - 05 - 00023 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER 1 Clothing and personal effects. DESCRIPTION VALUE AT DATE OF DEATH 0.00 2 Sovereign Bank, checking account # 16020057 Principal 51.98 Interest 0 51.98 .... .) HeR ManorCare, resident's personal trust fund Principal 3,824.69 Acclued interest .24 3,824.93 4 Carlisle Tire & Wheel, final paycheck 350.64 5 HCR ManorCare, refund of overpayment. 1,850.57 6 Tax proration on sale of 122 N0l1h Pitt Street, rear. 47.63 TOTAL (Also enter on Line 5, Recapitulation) 6,125.75 ESTATE OF ITEM NUMBER '* SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDEfIIL_ _ __.~______ --- Fuller, Terry E. FILE NUMBER 21 - 05 - 00023 .Thi~~~~_~.!;Iul~._f!l_~~~~~~_-:a!~~~ecL~Bd filed if the a_llswe~J~jl!!y~Lq~e_sti~n~_1 thro~gh 4 Ol!P~.9~ll~_Y!~~__ DESCRIPTION OF PROPERTY : ' % OF : ; Include the name of the transferee, their relationship to decedent and the date of transfer. ; DATE OF DEATH: DECO'S ! EXCLUSION ) TAXABLE V ALU E Attach a copy of the deed for real estate. : V ALU E OF ASSET: ; (IF APPLICABLE) ! i : INTEREST ; I .._ .___.__._______.____.___________________._________~- ---+-_____+-_._._____ _____________ .___..n_'_,,_' _ _... Carlisle Companies 40 1 (K) Plan, statement attached. ! 54,762.331 100% 54,762.33[ 0.00 Beneficiary: Ted Fuller, brother. This Qualified Retirement i Plan is not subject to inheritance tax under P A Regulations i because decedent was an employee of the Company which - owned the Plan, 50 years of age, and unable to withdraw the funds . i ' : ____.+~___._._._._____.,___.________.J____._______.____"___~_____~..........__,_________ TOTAL (Also enter on line 7, Recapitulation) '. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF F 11 T E u er, eny . Debts of decedent must be reported on Schedule I. AMOUNT ITEM NUMBER A. FUNERAL EXPENSES: Ewing Brothers, funeral bill B. ADMINISTRATIVE COSTS: Personal Representative's Commissions 1. SCHEDULE H FUNERAL EXPENSES & AIlVIINSTRA11VE COSTS FILE NUMBER 21 - 05 - 00023 DESCRIPTION Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City Year(s) Commission paid Attorney's Fees Dale F. Shughart, Jr. (estimated) State Zip 2. 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address State Zip City Relationship of Claimant to Decedent Probate Fees Register of Wills, paid 90 - owe 30 4. 5. Accountant's Fees 6. Tax Return Preparer's Fees (estimated) 7. 1 Other Administrative Costs Register of Wills, Short Certificates 2 Cumberland Law Journal, advertising Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation) 1,492.00 7,500.00 120.00 250.00 8.00 75.00 1,166.55 10,611.55 .w SchecUe H FuleraI Expenses & Acministrative Costs contil'l.ECl COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENTDECEDENT __ ESTATE OF Fuller, Teny E. 10 11 12 " .) The Sentinel, advertising 4 Sovereign Bank, checks 5 Diversified Appraisals, real estate appraisal 6 Recorder of Deeds, photocopies, Deed recording and Mortgage Satisfaction. 7 Carlisle Borough Tax Account, 2006 countylborough real estate taxes on 421 North Pitt S treet, Rear, Carlisle, P A 170 13 8 Recorder of Deeds, realty transfer taxes 9 Carlisle Borough Tax Account, 2006 countylborough real estate taxes on 430 Fairground Avenue, Carlisle, P A 17013 BOIUlie L. Coyle, notary fees Register of Wills, filing Inheritance Tax Return and Inventory Postmaster, certified mail 13 Reserve for filing Account Page 2 of Schedule H 122.51 25.35 225.00 99.50 45.74 15.00 222.45 25.00 30.00 6.00 350.00 'W SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS CO~ONWEAl TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Fuller, Terry E. Include unreimbursed medical expenses. ITEM NUMBER 1 DESCRIPTION HCR ManorCare, final balance due for nursing care 2 Carlisle Regional Medical Center, hospital bill FILE NUMBER 21 - 05 - 00023 3 Cumberland County Tax Claim Bureau, past due real estate taxes on 421 North Pitt Street, Rear, Carlisle, PA 4 Cumberland County Tax Claim Bureau, past due real estate taxes on 430 Fairground Avenue, Carlisle, P A 5 Healing Arts Surgical Assoc., medical bill 6 Neighborcare Pharmacy, prescription bill 7 PennCredit Corp, unpaid personal tax bill 8 Great Seneca Financial Corp, settlement of claim for balance of loan past due TOTAL (Also enter on Line 10, Recapitulation) AMOUNT 4,175.57 597.72 332.90 1,731.29 138.20 25.52 28.50 2,300.00 9,329.70 REV-1513 EX+ (9-00) .w SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESlDENI.DECEDENL-_ - -___ i _~_______________.________________L-____, FilE NUMBER 21 - 05 - 00023 ESTATE OF Fuller, Teny E. I. RELATIONSHIP TO AMOUNT OR SHARE NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY , DECEDENT . OF ESTATE _ _____________m__U ___un__ _. _______ _______.___ --.------------------r-'-----Do..Not-USt-l'r.ustee(s)-- .n_' _____u,__ I I NUMBER TAXABLE DISTRIBUTIONS (include outright spousal distributions) Ted Fuller 430 F airground Avenue Carlisle, P A 17013 I : Brother ! 1000/0 Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PARTII- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET~ -- j '<Ii" APPRAISAL Of REAL PROPERTY LOCATED AT: 430 Fairground Avenue Deed Book 251 Page 1153 Carlisle, PA 17013 fOR: Estate of Terry Fuller AS OF: November 14, 2005 ThiS Indented use Is \0 establish velue for PA Inheritance Tex Re\Um. summary Format complete APpraisal BY: Susan B. Burkholder. RL_000659-L State certified Residential APpraiser fann GA \ _ "TOTAL 101 Windows' awasal so\IW"e by · \. mode. inC. - \ -llOIl-/d.AIAOOE ~ FannieMae D kt U' Diversified Appraisal Services es aD nderwrlter uantltative Analysis Appraisa Report File No. 020905Ftaxappeal rHIS SUMMARY APPRAISAL REPORT IS IflTENDED FOR USE BY THE LENDER/CLIENT FOR A MORTGAGE FINANCE TRANSACTION ONLY. PronP.rlv Address 430 Fairaround Avenue Citv Carlisle State PA Tin Code 17013 Lenal Descrintion Deed Book 135 Paae 924 Countv Cumberland Assessor's Parcel No. 06-20-1798-318 Tax Year 2005-06 R.E. Taxes S 752.10 "_.._1_' ._uu_-~s t 0.00 Borrower n.a. Current Owner Estate of Tenv Fuller OccuDant !Xl Owner r 1 Tenant n Vacant Neinhborf1ood or Proiect Name n.a. Proiect TVDe rlPUD r 1 Condominium HOAf /Mo. Sales Prtce-S n.a. Date of Sale n.a. Descrintion / S amount of loan charaesJconcesslons to be naid bv sellAr Pronertv rfr;hts :mnraised IX1 Fee Simnle r 1 Leasehold I Man Reference 20-1798 Census Tract 0124.00 NotA: - Location [8J Urban 0 Suburban 0 Rural Property values I:8J Increasing o Stable o Declining Single family ~ CondomInium ~ Built up ~ Over 75% 025-75% 0 Under 25% Demand/supply 0 Shortage IZJ In balance 0 Over supply ~RICE AG PRICE r appHc.) AG (000) (yrs) $(000 (yrs) Growth rate Ranid fXi Stable Fi Slow Marf<etino time Fi Under 3 mos. rx; 3-6 mos. n Over 6 mos. 25 Low 75 Low_ Neighborf100d boundartes The subiect neiahborhood is bordered bv Hanover Street Sorina Road E Street and 80 Hiah 200 Hiah Pitt Street. 1 Predominant T Iprerlom1n:lnt I 45 100 Dimensions 14' X 138' Site area .04 acre Shape RectangUlar Specific zoning classification and descrtption R-2 Zoning compliance cgj Legal o Legal nonconforming (Grandfathered use) o Illegal, attach description o No zoning Highest and best use at subject property as Improved (or as proposed per plans and specifications): i:2J Present use o Other use, attach description. UUIIU.. Public Other Public Other I Off-sIte Improvements Type Public Private Electricity ~ Water ~ Street Macadam ~ R Gas SanitaN sewer I Allev None Are there :1m :mnarent adverse site conditions (easements encroachments soecial assessments slide areas etc.)? nYes rXI No If Yes attach descrintion. SOne(S) useug physical characterlstics of property: ~ Interior and exterior inspection Werior inspection from street TI Previous appraisal files MLS Assessment and tax records n Prior insnection n PronArtv owner Other lDescribe); No. of Stories 2 Tvoe lOet/Att.) Attchd Exterior Walls Brick Roof Surface Metal Manufactured Hnusinn n Yes 1Xf No Does the nronertv neneralh;" conform to the nelahborhood In terms of sIvle condition and constructlon materials? IX1 Yes r 1 No If No attach descrlntifln. A~ere any ~arent physical deficiencies or conditions that would affect the soundness or structural integrity of the improvements or the livability of the property? Yes No n Yes attach descrintion. Are there any apparent adverse environmental conditions (hazardous wastes, toxic substances, etc.) present in the improvements, on the site, or in the Immediate vicinity of the subject property? DYes IZI No If Yes, attach description. I researched the subject market area for comparable listings and sales that are the most similar and proximate to the subject property. My research revealed a total of 4 sales ranging In sales price from $ 27,000 to$ 38,000 My research revealed a total of 0 listings ranging In list price from $ 0 to$ 0 The analYsis of the comocrable sales below reflects market reaction to sianiticant variations between the sales and the sublect orooertv. FEATIJRE SUBJECT SAlE 1 SAlE 2 SAlE 3 430 Fairground Avenue 169 E. North Street 442 Fairground Avenue 428 Fairground Avenue Address Carlisle Carlisle Carlisle Carlisle Proximitv to Subiect 0.31 miles 0.03 miles Beside subiect Sales Price S Is 38 000 Is 27 000 Is 36 500 Price/Gross Uvinn Area $ rj:J $ 36.19ctJ I 1$ 25.71 r:tJ I $ 36.50 rj:J I .. Data & Verlftcatlon Sources --- Courthouse Courthouse/Aooraiser's flies Courthouse/aDDraiser's flies VALUE ADJUSTMENTS DESCRIPTION DESCRIPTION I +( -1$ Adlust. DESCRIPTION I +( -)$ Adlust. DESCRIPTION 1 +( -)$ Adiust. Sales or Ananclng None known None known None known Concessions ..... Conventional Conventional Conventional Date of SalAfTime , 5-20-05 : 10-10-05 : 1-24-06 : Location Averaae Suoerior : -3 800 Similar : Similar : Site .04 acre .04 acre : .05 acre : .04 acre : -1 000 View Averaae Similar : Similar : Similar : Desinn fStvle) Attached Semi-attchd : -2 000 Attached : Attached : Actual AnA Nrs.) 105 years 135 vears : 105 vears : 105 vears , , Condition Fair Suoerior : -5.000 Fair : Suoerior -5 000 Above Grade Total : Bdrms: Baths Total: Bdrms : Baths I Total: Bdrms : Baths I T ntlll : Rrlrm~: Rath~ T ... Room Count 6 3 1 5 2 1 : +1,000 4 1 : 1.5 : +1,500 6 : 3 : 1 : Gros!! Uvlnn Area 1 000 Sn. Ft 1 050 So. Ft. : 1 050 Sa. Ft. : 1 000 So. Ft : Basement & Anished Full bsmt Full bsmt Full bsmt Full basement +1,000 Rooms Below Grade None None None None Garanf!/C:lmort None None : None : None : No heat Heat : -3 000 No heat : Heat : +3 000 Scmd DOrch Porch : +1 000 Porch : +1 000 Porch : +1 000 Net Adi. (total) .... f1+ IX'I-:S 8800 1X1+ fl-:$ 7500 n+ rxT-:~ 1000 Adjusted Sales Price Net23,2>~1 Net 27;8 %1 Net 2.7% of Comparables Gross 49,5% I s 29 200 Gross. 27.8%1 $ 34 500 Gross 30,1 % . $ 35 500 Date of prtor Sale 10-12-00 12-16-94 12-3-98 10-21-00 Price of Prior Sale S 211s 25 000 S 1.00 1$ 21 Analysis of any current agreement of sale, option, or listing of the subject property and analysis of the prior sales of subject and comparables: Summary of sales comparison and value conclusion: See Addendum. A S2 000 adiustment was made for the total number of rooms. A location adiustment was made for comoarable sale1 since is It not located beside industrial use. This appraisal is made ~ "as-is", D SUbject to completion per plans and specifications on the basis of a hypothetical condition that the improvements have been completed, or o subject to the following repairs, alterations or conditions Appraised in current condition. BASED ON AN D EXTERIOR INSPECTION FROM THE STREET OR AN C8J INTERIOR AND EXTERIOR INSPECTION ,I ESnMATE THE MARKET VALUE, AS DEFINED, OF THE REAL PROPERlY THAT IS THE SUBJECT OF THIS REPORTTO BE $ 34.000 ,ASOF November 14. 2005 Q PAGE 1 OF 3 Form 205 - ''TOTAL for Windows. appraisal software by a la mode, inc. -1-800-ALAMOOE Fannie Mae Form 2055 9-96 Desktop Underwriter Quantitative Analvsls Appraisal Report file No. 020906F Project Infatmltion for PUDs (If applicable) - - Is the developerlbuilder In control of the Home Owners' Association (HOA)? 0 Yes 0 No Provide the following information for PUDs only if the developerlbuilder is in control of the HOA and the subject property is an attached dwelling unit Total number of phases Total number of units Total number of units sold Total number of units rente<! Total number of units for sale Data Source(s) Was the project created by the conversion of existing buildings Into a PUD? 0 Yes 0 No If yes, date of conversion: Does the project contain any ITlIIti-dwelling units? 0 Yes 0 No Data Source: Are the common elements completed? 0 Yes 0 No If No, describe status of completion: Are any common elements leased to or by the Home Owners' Association? Describe common elements and recreational facilities: DYes DNa If yes, attach addendum describing rental terms and options. Project Information for Condominiums (If applicable) - - Is the developerlbuilder In control of the Home Owners' Association (HOA)? 0 Yes D No Provide the following Information for all Condominium ProJects: Total number of phases Total number of units Total number of units sold Total number of units rented Total number of units for sale Data Source(s) Was the project created by the conversion of existing buildings Into a condominium? 0 Yes 0 No If yes, date of conversion: Project Type: 0 Primary Residence D Second Home or Recreational 0 Row or Townhouse 0 Garden 0 Midrise 0 Highrise 0 Condition of the project, Quality of construction. unit mix, etc.: Are the common elements completed? DYes 0 No If No, describe status of completion: Are aIr'f common elements leased to or by the Home Owners' Association? Desctibe common elements and recreational facilities: DYes 0 No If yes, attach addendum describing rental terms and options. PURPOSE OF APPRAISAL: The purpose of this appraisal is to estimate the market value of the real property that Is the subject of this report based on a quantitative sales comparison analysiS for use In a mortgage finance transaction. DEFINITION OF MARKET VALUE: The most probable price which a property should bring in a competitive and open market under all condltlons 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 definltlon 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 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 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 com parables must be made for special or creative financing or sales concessions. No adjustments are necessalY for those costs which are normally paid by sellers as a 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 UMITING CONDITIONS AND APPRAISER'S CERTIFICA nON CONTINGENT AND LIMITING CONDITIONS: The appraiser's certifICation that appears in the appraisal report Is subject to the following 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. The appraiser assumes that the title is good and marketable and, therefore, wHI not render any opinions about the title. The property is appraised on the basis of it being under responsible ownership. 2. The appraiser has provided any required sketch In the appraisal report to show approximate dimensions of the improvements and the sketch is included only to assist the reader of the report in visualizing the property and understanding the appraiser's determination of its size. 3. 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. 4. The appraiser has noted in the appraisal report any adverse conditions (such as, but not limited to, needed repairs, 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 nonnal research involved in performing the appraisal. Unless otherwise stated in the appraisal report, the appraiser has no knowledge of any hidden or unapparent conditions of the property or adverse environmental conditions (including the presence of hazardous wastes, toxic substances, etc.) that would make the property more or less valuable, and has assumed that there are no such conditions and makes no guarantees or warranties, expressed or Implied, regarding the condition of the property. The appraiser wHI 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 of environmental hazards, the appraisal report must not be considered as an environmental assessment of the property. 5. The appraiser obtained the Information, estimates, and opinions that were expressed in the appraisal report from sources that he or she considers to be reliable and believes them to be true and correct. The appraiser does not assume responsibility for the accuracy of such items that were furnished by other parties. 6. The appraiser will not disclose the contents of the appraisal report except as provided for in the Uniform Standards of Professional Appraisal Practice. 7. The appraiser must provide his or her prior written consent before the lender/client specified in the appraisal report can distribute the appraisal report (Including conclusions about the property value, the appraiser's identity and professional designations, and references to any professional appraisal organizations or the finn with which the appraiser is associated) to anyone other than the borrower; the mortgagee or Its successors and assigns; the mortgage insurer; consultants; professional appraisal organizations; any state or federally approved financial institution; or any department, agency, or Instrumentality of the United States or any state or the District of Columbia; except that the lender/client may distribute the report to data collection or reporting servlce(s) without having to obtain the appraiser's prior written consent. The appraiser's written consent and approval must also be obtained before the appraisal can be conveyed by anyone to the public through advertising, public relations, news, sales, or other media. 8. The appraiser has based his or her appraisal report and valuation conclusion for an appraisal that is SUbject to completion per plans and specifications on on the basis of a hypothetical condition that the improvements have been completed. 9. The appraiser has based his or her appraisal report and valuation conclusion for an appraisal that is subject to completion, repairs, or alterations on the assumption that completion of the improvements will be pelfonned in a workmanlike manner. PAGE 2 OF 3 Form 205 - "TOTAL for Windows. appraisal software by a la mode, inc. -1.800-ALAMODE Fannie Mae Form 2055 9-96 Supplemental Addendum Rle No. 020905Ftaxa eal Cumberland State PA Zi Code 17013 Additional Comments The interior of the home is in poor condition. There are cracks in the plaster walls, water damage in the ceilings and around the windows. The bathroom is in in poor condition and the kitchen has damaged and missing doors. The soffit and facia on the home is rotten, there is peeling on all of the exterior trim. There is not a working furnace in this home. The subject is older than five years old. All mechanical systems including heating, electrical and plumbing systems appear to be working adequately. No warranties are implied in this statement. One or more of the comparable sales are older than six months old. Although there are comparable properties in the subject's area, none have sold recently, therefore, sales in excess of six months old have to be used. All three comparables used were the best available. Gross adjustments exceed 25% and net adjustments exceed 15% for one or more of the comparable sales. Although there are other similar homes in the area, none have sold recently. The sales used are the best available. The scope of the assignment included an analysis of the subject's area, an inspection of the subject property, an estimation of the property's highest and best use and the consideration of all three approaches to value and the application of those relevant to the valuation of the subject property. The Intended User of this appraisal report is the Lender/Client. The Intended Use is to evaluate the property that is the subject of this appraisal for a mortgage finance transaction, subject to the stated Scope of Work, purpose of the appraisal. reporting requirements of this appraisal report form, and Definition of Market Value. No additional Intended Users are identified by the appraiser. Privacy Notice Pursuant to the Gramm-Leach-Billey Act of 1999, effective July 1, 2001, appraisers, along with all providers of personal financial services are now required by federal law to inform their clients of the policies of the firm with regard to the privacy of the client non public personal information. As professionals, we understand that your privacy is very important to you and are pleased to provide you with this information. In the course of performing appraisal, we may collect what is known as "nonpublic personal information" about you. This information is used to facilitate 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. We do not disclose any nonpublic personal information 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 independent contractors, 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 independent contractors and any third party consultants we engage are informed that any information they see as part of an appraisal is to be maintained in strict confidence within the firm. A disclosure 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 party. We will retain records relating to professional services that we have provided to you for a reasonable time so that we are better able to assist you with your needs. In order to protect your nonpublic personal information for unauthorized access by third parties, we maintain physical, electronic and procedural safeguards that comply with our professional standards insure the security and integrity of your information. Fonn TAOO - "TOTAL for Windows" appraisal softWare by a la mode, inc. -1-80o-ALAMOOE Subject Photos round Avenue Co Cumber1and State PA Zl Code 17013 tI, Subject Front 430 Fairground Avenue Subject Rear Subject Street Fonn PICPIX TR - ''TOTAL for Windows" appraisal software by a la mode, inc. -1-800-ALAMODE ----------- PHOTOGRAPH ADDENDUM cumberland State PA Ii Code 17013 Foon GPICl'lX _ 'TOTAL tor 'Mnd..... ~ so\IWIR bY a \a mode. 1nC, _1-8\lll4IlAM01)l; PHOTOGRAPH ADDENDUM Cumberland State P A Fonn GPICPIX - "TOTAL for Windows" appraisal software by a la mode, inc. -1-80O-ALAMODE Zi Code 17013 PHOTOGRAPH ADDENDUM Cumberland State PA Fonn GPICPIX -''TOTAL for Windows" appraisal software by a la mode, inc. -1-800-ALAMOOE Zi Code 17013 Comparable Photo Page Co Cumberland State P A Zi Code 17013 Comparable 1 169 E. North Street Comparable 2 442 Fairground Avenue Comparable 3 428 Fairground Avenue Form P/CPIX.SR - "TOTAL for Windows" appraisal software by a la mode, inc. -1-800-ALAMODE A. Settlement Statement U.S. Department of Housing and Urban Development ~ 1r OMB No. 2502-0265 (Page I) B. Type of Loan 1. FHA 2. 4. VA 5. FmHA 3. Conv.}l)~. Cony. Unins. 6. File Number 7. Loan Number 8. Mortgage Insurance-Case Number C. Note: This form Is fumlsbed to pve yoa a stat_ent of actaal.ettlement cost.. Amounts paid to and by the Htdement alent aft .hOW1lo Item. marked "(poo.e-)" weft paid oatslde the dosln&; they are shown heft for Informational purpo.es aud ~r~ u~tl~~~~_~~~_t~t~~_ _ __.-_ ___ _____ _ __ _.____ ____________________________________ _ . ____ D. Name and Address of Borr~;;~~-... - - - E. Name, Address, and Taxpayer identification # of Seller F. Name and Address of Lender Shirley M. Hockenberry Estate of Terry E. Fuller, deceased 420 Fairground Avenue 430 Fairground Avenue Carlisle,PA 17013 Cartis1e,PA 17013 G. Property Location H. Settlement Agent Name, Address and Taxpayer Identification Number Dale F. Shughart, Jr., Esq.- 35 East High Street, Suite 203 ___ _S~_r~i~~.!Y-~_O.!~_ _'.. _____.__ ___ .__ ___25-18~:~_5} 5 Place of Settlement 35 East High Street, Carlis]e, P A J.~ummary_~f !I~r.~o~~'~l'.~~~!~.ct~_~________. _._ ______.__________,!\-- Summary of Seller's Transaction 100. Gr~ss_t\mountI?~eXr~m}lo.!'t:.'!.~~r _..____.____._.._._n______' 400. Gross Amount Due To Seller 101. Contrac! sales.price . 1,500.00 401. Contract 'sai~s p~-------------------' 102. Personal Prop~rty . . ."_ .__. ._--'~ .~:- _~_-=_~~__-=-==_.------ -. - ~~_=~:~9_n~~__~~~~rtY.====____-=__~~=__==_~~~~. ] 03. Settlem~nt charges to borrower(l!.':1e 14~2 403.50 403. I~. 4~. 105. 405. . ____~___.__..._._.______ .._._,____....... ,,__ __.... ~_ _._ ___ h_.__..___ Adjustments for itel1l.~ P'.a!<:IEy__s~II~~ni~. ~dv.~~~ Adjustments for items paid by seller in advance 106. City/town taxes to------- -406:---CitYlt~wntaxes -----.to-.----.-------n 107. County ta~es_ _. _Q4~~~o.~_~?~~I~~().~~_~_~~~.~~~~-_==___-i~If: -467~ouniytaxes- ----..(54/17 ~()6~~Jp31(~='.~=__=,'-~' - . 108. Assessments to 408. Assessments to , 109. School Tax ..n ---04/1"7/66-1O'-06/3.oiO'6--------------.-i5."4-7" 409~---School Tax----04/17/06 to 06/30/06------- 110. Garbage Fee .----~~~.~=_=__:~_=:-~~~='_=_~-~~_~ 410.' Garbage F~----------.-n--_._---..-- III. 411".-------....----- .m________._______ ." ~.'__.___,,__.___ ____.._.________ __._..~_.____n_ ___.__.__...__..,~_________. ____.___. _..____~ _ ______.. __ ._.. ._ 112. 412. 421 North Pitt Street, Rear Carlisle, PA 17013 I. Settlement Date 4/1 7/2006 1...500.00 32.16 15.47 120. Gross Amount Due From Borrower 1,951.13 420. Gross Amount Due To Seller 1,547.63 200. 201. 202. 203. 204. 205. 206. 207. 208. 209. Adjustments.for i~t:ms unpa.i~ by se.lI~r 210. City/town taxes to 211. County taxes to 212. Assessments to 213. School Tax to 114. 215. 216. 217. 218. 219. Amounts Pa!d B}'_()~i~ ~ei!.~~!<?_t:.~~~~'!~r.......____H_.____.. _. __ _5,!)~._.~t!~~~.!!~~~_!!!_~!n.!'!~~_~~_~_!~S~II~_~_ Deposits or earnest money 0.00 501. Excess deposit (see instructions) Principal amount o{ne~ 108n(5)-- --- ---"" ,__.______H._ '502.-S~tt1~~t charges to seller Oi~~ 1400) -.---.-- ---.--- Existing loan(s) ta.ke~. su~f~ct.to ------ -'-'- ---.... --- .. ---- .---- 503:--ExiStiil""iioan(s)t~en subject to ---------- __________u - - 504:---Payotf~ffirst mortgagel~an------.-- - . .._~_.. _. ~--_.._-_.._------- -.- -. 50S~-P8yoff of second mortgage 1~------_.-._--_._.._------.-. --. . - ..-.. ...----- n_ ." ----.... _._h' -- -506: ---, .---. .-......-.-------.--.-- ---- - -. --.---,--- -- - .-"-.- .,-- -.--.-..--- -----. ~5.oi:-.---.--~-.._.~. -- .-... ----.------.. --.----.--- -----.----- __u.___.____ .-- _ ..__.__.___._____.._.__________ 4__._~_...__.___~.~____._____.._.___.._.. ~ _.______.._. _ ___._ 508. -5~----.-_.----.--.--....-------...-----_.-._-...-----..--- .- .__ _....__ __4_._____~_..._.___. __..__w_. ______.___..___._._____.._.. ,.~_._..._ ___ __.._ Adjustments for items unpaid by seller .' .- ~=:...:~~.-~~..~'--~----~~~~~~~.--. }fF1~;~~~~=~=~-..~==~=~~,-_~-==~-=-=:-.~--- . 512. Assessments to' .- . 5-13~--'-' S.choo(Tax ~ ---- -.--.---..... -- .. ----.--to. --~.---. ~ ----. .--- -.....--.... -.-.----. 514. -- -5] s~ --'--'~._.--- .. - ---~--- --.-.------.-- ________._._..__._____..~_._____._n____ __'_" .__.__.__._...__.___._____.________. ._.________ 516. 517. .- ._- ----.---..---.--.-~- -------..--..-.- -51~8~-.---._-------.-.-.----. --.-----.----.--..----.-.-----. --- --~.--....- ._+_._- -.--~..----------_...._._..--.-- .-~-. ..-- -- '5'i~--- --_.._._~.- --------..----------.---------.--------\." ."'--- 0.00 15.00 220. Total Paid BylFor Borrower 300. Cash At Settlement Fromffo Borrower 30 I. Gross Amount d~efrom borro;er (I.ine !20) . 302. Less amounts paid by/for borr?we~.<Jin_~ 220) 0.00 520. Total Reduction Amount Due Seller 600. Cash At Settlement To/From Seller ) ,95 J .1360'i:--Gioss-Amo~nt due--to'seller(li~e420-)--- 0.00 602.. ._~.i~s_r.c:_~~~~~sJ!ia~~:-~.~~-.~IT~Q{~~_5_~OC~- -.. . <. ]5.00 303. Cash .X From To Borrower $ 1,951.l3 603. Cash X. To __ From Seller 1,547.63 -- 15.00) $ 1,532.63 I have carefully reviewed the HUD-I Settlement Statement and to the best of my knowledge and belief. it is a lrUe and accurate statement of all receipts and disbursements made on my account or b)\ me in this transaction. I furth.er certify that I have received a completed copy of pages I and 2 of thiS~UD-1 Settle ent Statement. ~ -----.J..._~ B or Shi~l~ ...: ;;;1!{4~._.._------ SOli., s~.. OfT.;:fF~~ed E FUU';--.- SETTLEMENT AGENT CERTIFICATION The:' Hl'D-1 SelllemeOl SI8lemeOl \.~:.!'....lr.h8\'e . and accurate accounl of this trallSaction. I have caused Ihe fll~be dn i: ~"ce . ~ t .. .9Pl/!)iLH Settlement Agent ~~ ~1:t~~~ ~~\~~t?~ ~~=~~ ~:ea~~m~t Seller Seller's Taxpayer Identification Number Solicitation and Certification ~~::. Wfd,.,%b~':o~~~~~~~I~'~I =~:xwi~~r:n~~!:-=~:~~~::i~ ~~bl~~ ~~~~i;n~i~~~~~=tiW~~~ ~~nalties o~ury. I certify that lbe number shown Borrower HUD - I 3/91 Seller's S ijtllature Date RESPA, HB 4305.2 L. Settlement Charges 700. Page 2 ----PaId From Seller's Funds at Settlement Total Sales/Broker'~ ComJllissio"-_ ~!l~~~. ~__~_ __ Division of Commission (li!le!O_Ol~s !oll?~~:.___._ $ ro $ ro Commission paid at Settlement _~==~~__-.:--=._~_@~_:-:. _:::O(~~~=:~::~-=--===---_. ;~:~:~--- ______.___ _______________ Funds at Settlement 701. 702. 703. 704. 800. 801. 802. 803. 804. 805. 806. 807. 808. 809. 810. 8t!. 900. 901. 902. 903. 904. 905. 1000. 100 I. 1002. 1003. 1004. 1005. 1006. 1007. 1008. 1100. 1\01. 1102. 1103. 1104. 1105. 1106. 1107. 1 terns Payable in Co~n~_tion~_I_~~_ !:-_o~!I_ _.._ . ___" __ __. .. ____ ..___ _ _ __ ..' _. __h_ "'__' _________________ ___'_.. _.____._.___ . Loan Origination Fe.e. . '_' . ___ ____ _' ___ !'o_____ ._______.._______ ___ .____ _ _____._.__________.___.._. _____ ___ Loan Dis~ount _0.._. _~o._ _ ______________._ . ._______.._ __h..___________._._____.._ __________ _ _ ______________ ..._ Appraisal Fee ....___ ._..._~c:>____..__.. _. ...._.________.______.._.__________.___..____.________..._._____._.___._.... -. --------- Credit Report ....._.. .... ............__..__......._ ~~___ ____.._.__n.___._.___..._ __.______ ________._____._._______________...__________ Lender' S InsPection-Fee _. __"_ ____________~~_____.. _ '___'__ __._.___...________._.____._ __. u_ _ _...___ _____________.___ ____._..... ___ _ Mortgage Insuranc_e_.~~p.!i~~~~_~~.c:...___._ ....!~_.___ _ __.________.______ .___._ .______ ..___._____---"--____________ _ __ __________. Assumption_ Fee _ _ ._..____. ___ _ __ ...____.__ ____h.._ __.. __.___ _. __. __ ____..._ _ ______. ._______ _.._. Flood Certitication Fee to: Items Required By Lender To Be Paid In Advance _____....___ .__...__________... Interest trom' _ .' - -'-'_ ..to - -:: -_~_ __:~~-_~@:s.- _.__ __!~!I_____ _____________ __ _________._________...__ ._ Mortgage Insurance Pre1l1i':l:~f~~._____ _'___ ___________._______ mo~.!~~..!.'?___.__ ___ ___.____._____________.__.____ Hazard Ins~~anc~' PT~nium for _________________ ___._._______ .___X~~_~~__.. _____.______._________________.__.___ . ::i:~~-~:~~;~~~ ~!!~.~~n~~_H_ . -5..@---$-----...-.--...--------.. -.-per.----- ...-.------.--------.--...---------- _n. --- -.---' Mortgage Insurance - ------8 @- $ . _hu_'__ per -------- ---.--.--- ..-------.-.--- -.-.------ ------ City property taxes . s ~f "-if--"- 'pe-i--n----- -. -.----.-----.----------.- -- - ------. -----. County property taxes S@. -$- - - -..- -. uper- - - --- -~: =_~~~_.~~-_~-.. ~-:_=~~_~.-.~_-_.~-.... __ ____ _____ __ Annual assessments "'s-@' $ per School Taxes s"O - --$.-" .-.. ._._.~. ..---. per- .-- ._._0_--"._.. .- ~---- -- ... __.~u_.__. . ____ - '_- ~=__'~..__-_::_~ ---- - --~-~~~.~_-~_~:=~_=__=~=-==_~y~i"~~:=.===_____________~==_=-=-.____=~~~-~------ --. Aggregate Reserve Adjustment Title Charges Settleme;t~r--ci?~i~g_r.~__ . Abstract or title search Title examination Title insurance binder Document prepa~~tion Notary"s fees. Attorney's fees {includes above jtems~~.l~b~rs: Title insurance (includes a~ove-j~~s-~~mbei~: Lender's cov~ge Owner's.coverage. to.-oai~-F~-Shughart:"jr. Sclfe~POC-1OO)------.---loo.00----. --- -- ---_ -_--~-~~~__ !?~le_ ~~_ ~~u~_~~r.s J!..~ .~~~!~~~~C.~!?!"!~8:~~_~ !J.!~___==_==-=-=~~~i.~_=_----.-. to to - - - .--. . ... to Dale~. S~ug.~art, Jr.: (p()C. IO~) to to ..__ __ ___ _.._._.________...___......2__--____ _.._____..___.~-.-. 1108. to _______._._.___. __.._.__._2___ ________._______.__ $ $ 1109. 1110. 1111. 1112. 1113. 1200. 1201. 1202. 1203. 1204. 1205. 1300. 1301. 1302. 1303. 1304. 1305. 1306. 1307. 1308. 1309. 1400. Total Settlement Charges (enter on lines 103, Section J and 502, Section K) 403.50 15.00 IlIltlal Escrow Account Statement Required by Sectlon 10 (c) (1) of the Real Estate Settlement Procedures Act (RESPA) If checked,. the tenns of your loan require you to have an escrow account to assure that the certain obligations relating to the mortgaged property. such as taxes, insurance premiums and other charges are paid. The amount specified below will be collected, along with your mortgage principal and interest payments. during the flJ'St 12 months after your account is opened to pay these anticipated expenses: Fscrow Account Government Recordi~~ a~d_ Tran~.!e!. .~~a.:ri~__ . _____.___m_ _____....____.._.___. .. 'n __ ___ ___... ..___ Recording fees: Deed $ 38.50; Mortgage $ ___L~~~se~_$__. ______ ______n_._..:..._ _.____..}~~~.P____ City/county tax/stamps: DeedS 15.00---------- ; Mortgagei 15.00 State taxlstalllPs':- De~. ~. .. ----.- - i5~~~-_:=_-_=:_ .~:~~_~--i-~o.~~~i~ -~~-: __-~_._~_-_.- ---=~~~==--=-=--=._=~~==~==_=~~~~~Q~O='~--_ 0.00 15.00 Additional Settlement Chal'2es Survey to: . Pest Inspection to: Beginning Date: Your escrow account payment will be S Po rpose Estimated Amount ______ per Anticipated Due Date Payee HUD - I 3:91 RESPA, HB 4305.2 I...., r- ..~. ..- ~ . ~.. '0 ..~ :\..' L, .-- ---...", 20Gb RPR 1 7 Pr1 :3 Ll6 I ;)375.- Shujhrf ,', , ; i.' . .. Tax Parcel No. 06-20-1798-30SA TIllS DEED, . ;-ell. MADE THE 17 day of April in the year of our Lord two thousand six (2006). BETWEEN TED FULLER, Executor of the ESTATE OF TERRY E. FULLER, Deceased, late of the Borough of Carlisle, Cumberland County, Pennsylvania party of the first part, hereinafter Grantor and SHIRLEY M. HOCKENBERRY, FORMERLY SHIRLEY M. MORTON, married woman, of the same place, party of the second part, hereinafter Grantee WHEREAS, the said Terry E. Fuller became in his lifetime, seised, in fee, of a certain tract of land, situate in the Fifth Ward of the Borough of Carlisle, Cumberland County, Pennsylvania, and more particularly described hereafter; and WHEREAS, the said Terry E. Fuller died on November 14, 2005, having made his Last will and Testament in writing dated October 7, 2005, duly probated and filed in the Office of the Register of wills in and for Cumberland County, Pennsylvania, on January 9, 2006, to Estate No. 21-06-0023, in which he appointed as Executor, his brother, Ted Fuller; and WHEREAS, Letters Testamentary in the Estate of Terry E. Fuller were issued by the Cumberland County Register of Wills on January 9, 2006 to Ted Fuller, without the requirement that any Bond be posted, which Letters Testamentary remain in full force and effect; and WHEREAS, Section 3351 of the Probate, Estate and Fiduciaries Code (20 Pa.C.S. 3351) gives the personal representative the power to sell at public or private sale any real property not specifically devised; and WHEREAS, the herein described real property was not specifically devised; and NOW THIS INDENTURE WITNESSETH, that the Grantor, for and in consideration of the sum of One Thousand Five Hundred ($1,500.00) Dollar, to him in hand paid by the said Grantee at or before the sealing and delivering hereof, receipt whereof is hereby acknowledged, has granted, bargained, sold, aliened, released, confirmed and conveyed and by these presents does grant, bargain, sell, alien, release, confirm and convey unto the said Grantee, her heirs and assigns; eoo~ 274 PAGe 187 ALL THAT CERTAIN lot of ground, situate on the West side of an alley running North and South between the 400 block of North pitt Street and Fairground Avenue, in the Fifth Ward of the Borough of Carlisle, Cumberland County, Pennsylvania, bounded and described as follows: ON the North by lot now or formerly of the Heirs-at-Law of Benjamin Lackey, deceased; on the East by lot now or formerly of Mrs. Annie Ebersole; on the South by lot of ground now or formerly of Charles T. Rinesrnith; and on the West by lots now or formerly of John H. Casey and Laura Casey, his wife. BEING thirty (3D) feet in width on the side adjoining land now or formerly of the Benjamin F. Lackey's heirs; thirty-seven (37) feet in length on the side adjoining land now or formerly of Mrs. Annie Ebersole; thirty (30) feet in width on the side adjoining land now or formerly of Charles T. Rinesmith; and thirty-seven {37} feet in length on the side adjoining land now or formerly of John H. Casey and Laura Casey, his wife. BEING the same premises which Cletus A. Kipps and Shirley J. Kipps, husband and wife, by their deed dated July 25, 1974 and recorded in the Office of the Recorder of Deeds in and for cumberland County in Deed Book "S", Vol. 25, Page 264 granted and conveyed unto Terry E. Fuller. AND the said Grantor, for himself and his heirs and assigns, does for his own act only, covenants, promises and agrees to and with the said Grantee, her heirs and assigns, that they, the said Grantor, has.not heretofore done or committed any act, matter or thing whereby the premises hereby granted, or any part thereof, is, are, shall or may be impeached, charged or encumbered in title, charge, estate or otherwise howsoever. IN WITNESS WHEREOF, the said Grantor has caused this Indenture to be duly executed and his seal to be hereunto affixed the day and year first above written. SIGNED, SEALED and DELIVERED ~;~~~~f \ r / 1 '/ . G ' ESTATE OF TERRY E. FULLER By: -;;;; JJr ~ CyA( [SEAL] Ted Fuller, Executor COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND " h /~I!i-. d f"l b f h On thlS, t e /- ay 0 Aprl ,2006, e ore me, t e undersigned officer, personally appeared Ted Fuller, Executor of the Estate of Terry E. Fuller, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have set my hand and official seal. NOTARIAl SEAL BONNIE L. COYLE, NOTARY PUBliC BORO OF CARLISLE, CUMBERLAND co. pf\ MY COMMSSION EXPIRES OCTOBER 17, 2ii.cf . ~X~~ [SEAL] NOTARIAl SEAL BONNIE L. COYLE, NOTARY PUBLIC BORO OF CARlISLE, CUMBERLAND CO. PA MY COMMISSION EXPIRES OCTOBER 17, 2006 "",lCIV~. I do hereby certify that the precise residence and complete post office address of the within named grantee(s) is 420 Fairground Avenue, Carlisle, PA 17013. April /7 , 2006 :ti Sovereign Bank" STATEMENT OF ACCOUNTS 1.,877-S~\t-,~,ANK (1-877-768~226S~ ,\I\f\IIAV.~()v.erelgnbanl<~com , TO"fi~~~FREEP~EMIER CHECKIr,lG TOTAlL V FREE PREMIER CHECKINC Staten1ent Period 10/24/05 - 11/22/05 7"E8~YEFl1biJER, : ,lJ.~~Q}Jflt:' #' .1671 02{)JJ)57 Ro.t;mer'Account, 100667-922 ) " ) page 3 of3 1671020057 The Managing Trustees HeR ManorCare Resident Personal Trust Fund 5th floor Resident Trust Statement 01/03/2006 04:50 PM 10/01/2005 Through 12/31/2005 Page 1 Legal RCI> rescntativc Resident # 25251 FulIer~ Terry E 430 Fairground Ave CarlislePA 17013 Banl{: M & T Bank Acct #: 3740881531 Admit: 7/20/2005 4:00:00 AM Disch: 11114/2005 6:00:00 A Fuller, Terry E Beginning Balancc $0.00 Datc Descrilltion Check# 10/25/2005 DEPOSIT 10/25/2005 DEPOSIT 10/25/2005 DEPOSIT 10/25/2005 DEPOSIT 10/27/2005 pension 10/31/2005 Interest 11/04/2005 carlislr tire and whe 11/10/2005 deposi t 11/10/2005 deposit 11/17/2005 deposit 11/30/2005 Interest Earned 12/20/2005 deposit 12/20/2005 deposit 12/30/2005 past due balance 1975 Withdrawals Deposits Balance Trans ID $350.65 $350.65 15688 $350.66 $701.31 15689 $350.65 $1,051.96 15690 $350.64 $1,402.60 15691 $350.64 $1,753.24 15696 $0.14 $1.753.38 15889 $350.66 $2,104.04 15916 $350.65 $2,454.69 15908 $1,370.00 $3,824.69 15911 $350.64 $4,175.33 16101 $0.24 $4,175.57 16188 $350.64 $4,526.21 16099 ($350.64) $4,175.57 16100 $4,175.57 $0.00 16246 Ending Balance $0.00 This is not a bill M & T Bank 3740881531 ~.e.= W~CHOVIA Wachovia Bank, National Association Retirement Services Charlotte, North Carolina 28288-1155 CARLI SLE COMPAN I ES 401(K) PLAN 10: SSN: OOOOOCSP XXX-XX-5140 OOOOOCSP 000110 TED FULLER B 430 FAIRGROUNDS AVE. CARLISLE PA 17013-1922 PAYMENT DATE: 12/21/2005 CHECK II: 0004430178 NET AMOUNT: S 49,322 . 28 FOR INQUIRIES, CALL OR WRITE 1-800-3n-9188 WACHOVIA BANK, N.. A. WACHOVIA RETIRBtENT SERVICES 1525 W WT HARRIS BLVD NC-1155 CHARLOTTE, NC 28288-1155 Payment Amounts Deduction Amounts Current Y ear- T a-Date Current Year-la-Date GROSS S 54,762.33 S 54,762.33 TOTAL DEDUCTIONS $ 5,440.05 TAXABLE S 54,400.53 ; S4,400.53 FEDTX $ 5,440.05 S 5,440.05 NONT AXABLE S 361.80 S 361.80 I THIS DISTRIBUTION MAY BE ELIGIBLE FOR ROLLOVER TO A WACHOVIA IRA. IF YOU WOULD LIKE MORE INFORMATION, PLEASE CONTACT PARTICIPANT ACCOUNT SERV I CES AT 800.377.9188, WEEKDAYS FROM 7 AM . 10 PM, EST. THIS IS A STATEMENT OF YOUR BENEFIT PAYMENTS AND DEDUCTIONS. PLEASE DETACH AND RETAIN FOR YOUR PERSONAL RECORDS. DALE F. SHUGHART, JR. ATTORNEY AT LAW 35 EAST HIGH STREET SUITE 203 CARLISLE, PENNSYLVANIA 17013 Telephone (717) 241-4311 Facsimile (717) 241-4021 OF COUNSEL HAMILTON C. DAVIS May 1, 2006 Terry Fuller Estate c/o Ted Fuller, Executor TO: Dale F. Shughart, Jr., Esquire EIN: 25-1802515 LEGAL ASSISTANT BONNIE L. COYLE Professional services rendered as follows: Cash Advance: , 04/17/06 - Certified mail to Beneficial. Fees: 04/10/06 - Preparation of Deed for settlement of 421 North Pitt Street, Rear. 04/17/06 - Attend real estate closing. 04/04/06 - Office conference with Ted; review of Lumenos statements; letter to Lumenosi letter to Shirley Hockenberry; letter to client. 1.0 04/05/06 - Reconciling ManorCare and letter to ManorCare. .5 04/06/06 - Telephone conference with Shirley Hockenberry. .3 04/10/06 - Letter to ManorCare and client; correspondence with Shirley Hockenberry. .3 04/11/06 - Letter to client; letter to client and Shirley Hockenberry. .4 04/17/06 - Research on Beneficial Mortgages; prepare two Satisfaction Pieces; letter to Beneficial. 1.0 04/21/06 - Review information from Wachoviai letter to client. ~ Total hours - 3.7 Total fee at $175/hr. Total fees Total fees and cash advances - Fees to date: 02/01/06 - 03/01/06 - 04/01/06 - 05/01/06 - Total - $ 2,852.50 $ 1,242.50 $ 542.50 $ 847.50 $ 5,485.00 $ 6.00 $ 100.00 $ 100.00 $ 647.50 $ 847.50 $ 853.50 DALE F. SHUGHART, JR. ATTORNEY AT LAW 35 EAST HIGH STREET SUITE 203 CARLISLE, PENNSYLVANIA 17013 Telephone (717) 241-4311 Facsimile (717) 241-4021 OF COUNSEL HAMILTON C. DAVIS April 1, 2006 Terry Fuller Estate c/o Ted Fuller, Executor TO: Dale F. Shughart, Jr., Esquire EIN: 25-1802515 LEGAL ASSISTANT BONNIE L. COYLE Professional services rendered as follows: 03/01/06 - Letter from Ted; telephone conference with Sovereign Bank. .6 03/06/06 - Brief office conference with client; filing information. .2 03/14/06 - Review Tax Returns; fax from and to Doug Heineman; office conference with client. 1.0 03/24/06 - Telephone conference with Nancy Jaffe at Lumenos. . 3 03/30/06 - Prepare for and office conference with client; pay taxes; complete form and letter to Attorney for Lumenos. 1.0 Total hours - 3.1 Total fee at $175/hr. Fees to date: 02/01/06 - 03/01/06 - 04/01/06 - Total - $ 2,852.50 $ 1,242.50 $ 542.50 $ 4,637.50 $ 542.50 DALE F. SHUGHART, JR. ATTORNEY AT LAW 35 EAST HIGH STREET SUITE 203 CARLISLE, PENNSYLVANIA 17013 Telephone (717) 241-4311 Facsimile (717) 241-4021 OF COUNSEL HAMILTON C. DAVIS March 1, 2006 Terry Fuller Estate c/o Ted Fuller, Executor TO: Dale F. Shughart, Jr., Esquire EIN: 25-1802515 LEGAL ASSISTANT BONNIE L. COYLE Professional services rendered as follows: Cash Advances: 02/02/06 - The Sentinel, advertise 02/15/06 - Cumberland Law Journal, advertise Total - 02/02/06 - Meeting with ManorCare; office conference with client; telephone conference with Douglas Heineman, B-H Agency; and fax to B-H. 2.5 02/14/06 - Review appraisals and information from Lumenos. .3 02/15/06 - Telephone conference with Jodi at Lumenos Compliance Center; telephone conference with Julia at Wolpoff & Abramson; fax to Julia and telephone conference with Andrew Spears. 1.5 02/16/06 - Telephone conference with Andrew Spears and letter to Lumenos and ManorCare. 1.0 02/20/06 - Review file; letter to client and Andrew Spears; office conference with client; pay bills; letter to Brad Mentzer. 1.8 Total hours - 7.1 $ 122.51 $ 75.00 $ 197.51 Total fee at $175/hr. $1,242.50 Total fees and cash advances - $1,440.01 Fees to date: 02/01/06 - 03/01/06 - Total - $ 2,852.50 $ 1,242.50 $ 4,095.00 DALE F. SHUGHART, JR. ATTORNEY AT LAW 35 EAST HIGH STREET SUITE 203 CARLISLE, PENNSYLVANIA 17013 Telephone (717) 241-4311 Facsimile (717) 241-4021 OF COUNSEL HAMILTON C. DA VIS February 1, 2006 Terry Fuller Estate c/o Ted Fuller, Executor TO: Dale F. Shughart, Jr., Esquire EIN: 25-1802515 LEGAL ASSISTANT BONNIE L. COYLE Professional services rendered as follows: Cash Advances: 01/06/06 - Copying Deeds. 01/09/06 - Register of Wills, probate 01/27/06 - Cumberland-Perry Abstract, bring down Total - 01/04/06 01/05/06 01/06/06 01/09/06 - Review file; office conference with client; prepare forms. - Preparing probate papers. - Locating deeds and copying. - Preparing Petition for Probate and EIN; office conference with client; probate willi go to Bank. 3.0 1.5 1.0 2.0 01/11 and 01/12/06 - Compiling information; various correspondence; Notice of Beneficial Interest; legal Notices; letter to and office conference with client. 3.0 01/13/06 - Letter to Ted Fuller. 1.0 01/16/06 - Review Medical Insurance information and letter to client. 1.0 01/18/06 - Review file; letter to Nicole Baird; telephone call to Carlisle Regional Medical Center. 1.0 01/20/06 - Telephone conference with ManorCare and Aetnaj prepare insurance papers; various correspondence and telephone conferences; office conference with client; pay bills. 1.5 $ 5.00 $ 98.00 $ 25.00 $ 128.00 Dale F. Shughart, Jr. February I, 2006 Page 2 01/23/06 - Receive information on medical bills;; pay bill; letter to client. 01/27/06 - Review bring down and letter to client; obtaining tax lien information. 01/31/06 - Pay tax lien at Tax Claim. Total hours - Total fee at $175/hr. Total fees and cash advances - .6 .5 ~ 16.3 $2,852.50 $21980.50 LAST WILL AND TESTAMENT OF TERRY E. FULLER I, Terry E. Fuller, of the Borough of Carlisle, Cumberland County, Pennsylvania, declare this to be my Last will and Testament and revoke all Wills and Codicils previously made by me. ITEM I: I direct that my legally enforceable debts and funeral expenses, together with the expenses of the administration of my estate shall be paid from my residuary estate as soon as practicable after my decease, as a part of the expense of the administration of my estate. ITEM II: I devise and bequeath all of my estate of every nature and wherever situate unto my brother, Ted Fuller, provided he shall survive me by thirty (30) days. ITEM III: All Federal, State and other death taxes payable because of my death, with respect to the property forming my gross Estate for tax purposes, whether passing under this will or otherwise, including any interest or penalty imposed in connection with such taxes, such be considered a part of the expense of the administration of my Estate and shall be paid out of the principal of my residuary estate without apportionment or right of reimbursement. ITEM IV: I appoint my said brother, Ted Fuller, Executor of this my last will. ITEM V: I direct that my personal representative shall not be required to give bond for the faithful performance of this duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal, this "'7-11--day of October, 2005. ~~c~ Terry E. Fuller [ SEAL] it '. ;. The preceding instrument, consisting of one (1) other typewritten page, identified by the signature of the Testator, was on the date thereof, signed, published and declared Terry E. Fuller, the Testator therein named, as and for his last Will, in the presence of us, who, at his request, in his presence and in the presence of each other, have subscribed witnesses hereto. ~~~ -2- . {. , .. COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF CUMBERLAND We, Terry E. Fuller, Dale F. Shughart I Jr., and R U /:; V G!J1 a r 1/ J1 . / , the Testator and the wltnesses, respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his last Will and that he had signed willingly, and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as witness and that to the best of his/her knowledge t~e Testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. rI~A~~' . . Test~ -iJ~, y) Witnes \ ~~~~ /" Witness Subscribed, sworn to and acknowledged before me by Terry E. Fuller, the Testator, and subscribed and sworn to before me by Dale F. Shughart, Jr. and witnesses, this 1iL day of October, 2005. NOTARIAl SEAL BONNIE L. COYLE. NOTARY PUBLIC BORO OF CARLISLE. CUMBERLAND co. PA MYCOPJMISSION EXPIRES OCTOBER 17. 2006 ~X~&- Notary bI1C -3- ~ j 'Du-<=- ("i () - ()0 "Pd " toO.. (i:', y ~ v - .::So .cv (s 'l,'" eL) N l-\~ D 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 SHUGHART DALE F JR ESQUIRE SUITE 203 35 E HIGH STREET CARLISLE, PA 17013 -------- fold ESTATE INFORMATION: SSN: 168-48-2967 FILE NUMBER: 2106-0023 DECEDENT NAME: FULLER TERRY E DATE OF PAYMENT: 05/16/2006 POSTMARK DATE: 05/16/2006 COUNTY: CUMBERLAND DATE OF DEATH: 11/14/2005 NO. CD 006703 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $2,602.14 I I I I I I I I TOTAL AMOUNT PAID: $2,602.14 REMARKS: CHECK# 1016 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS ~ Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of Fuller, Terry E. Cxo No. 21 - (l' - 00023 Date of Death 11/ 14/2005 also known as , Deceased Social Security No. 168-48-2967 Ted Fuller The 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 located 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 the 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 correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904 relating to unsworn falsification to authorities. Attorney: Dale F Shughart, }r'}~~9~~~ _ Personal Representative 7 I ..., -;-- /~ Signature: ____~r---_--~~p-_- Ted Fuller I.D. No.: 19373 Signature: Signature: Address: 10 West High Street Carlisle, P A 17013 Address: 430 Fairground Avenue Carlisle, PAl 70 13 Telephone: 717/241-4311 Telephone: 717-448-5692 Dated:_1!l-tJ!-O( Personal PrODertv Clothing and personal effects. 0.00 Sovereign Bank, checking account # 16020057 Principal 51.98 Interest 0 51.98 HCR ManorCare, resident's personal trust fund Principal 3,824.69 Accrued interest .24 3;824.95-' , (..... ~~ -'-.' Carlisle Tire & Wheel, final paycheck -::.~ 350.64 HCR ManorCare, refund of overpayment. (~- ,.., uj,850.57 ' Tax proration on sale of 122 North Pitt Street, rear. 47.63 Total Personal Property $6,125.75 (Attach additional sheets if necessary) Total Personal Property and Real Estate $41,625.75 . Register of Wills of Cumberland County, Pennsylvania INVENTORY continued Estate of Fuller, Terry E. No. 21 - 05 - 00023 also known as Date of Death 11/14/2005 Social Security No. 168-48-2967 , Deceased Real Estate Lot and dwelling house @ 430 Fairground Avenue, Borough of Carlisle, Cumberland County, PA. Tax Parcel #06-20-1798-318. Value based upon attached appraisal of Susan B. Burkholder. Vacant lot, 30 feet by 37 feet in dimension, located at rear of 421 North Pitt Street, Borough of Carlisle, Cumberland County, P A. Tax Parcel #06-20-1798-305A. Value based upon actual sale price. Copies of Deed and HUD 1 Settlement Statement attached. 34,000.00 1,500.00 Total Real Estate $35,500.00 2