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Home My WebLink About06-29-07 ...J . 15056041114 REV-1500 EX (06-05) OFFICIAL USE ONLY CountyCode Year FIle Number PA Department of Revenue Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 1712~1 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death INHERITANCE TAX RETURN RESIDENT DECEDENT f)-I 07 041 ~ Date of Birth 172-01-4213 Decedenfs Last Name 04062007 Suffix 01011916 Decedenfs First Name MI WAMPLER (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix WYANEMA E Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WItH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW m 1. OrIginal Return D 4. Umlted Estate D 6. Decedent Died Testate (Attach Copy of Will) D 9. Utigation Proceeds Received D 2. Supplemental Return D 3. Remainder Return (date of death pliOl'to 12-13-82) D 48. Fut\.I'e Interest Compromise (date of D 5. Federal Estate Tax Return RequIred death after 12-12-82) D 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Trust) D 10. Spousal Poverty Credit (date of death D 11. ElectIon to tax under Sec. 9113(A) belween 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number 717-541-1626 I"-.) HARRISBURG City or Post Office PA State 17111 ZIP Code Y -.. .~2f~ c..- 1'"1'1 C"") ~ ~~23 N r'" (T' \.0 :..n CJ Firm Name (If Applicable) ROBERT K. WAMPLER First line of address 1071 COUNTRY HILL DRIVE Second line of address D HARRISBURG, PA 17111 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056041114 15056041114 ---.J ~ --I' 15[]5b[]42115 REV-1500 EX Decedent's Name: WYANEMA E WAMPLER RECAPITULATION 1. Real estate (Schedule A) . . . . . . . . . . . . '.' . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1. 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . .. 3. 4. Mortgages & Notes Receivable (Schedule D) . . . . . . .. . . . . . . . . . . . . . . . . . . .. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5. 6. Jointly Owned Property (Schedule F) DSeparate Billing Requested . . . . . . .. 6. 7. Inter-VIVOs Transfers & Miscellaneous Non-Probate Property (Schedule G) DSeparate Billing Requested. . . . . . .. 7. 8. Total Gross Assets (total Unes 1-7) . . . . . . .. . . . .. . . .. . .. . . . . .. . . . . . . .. 8. 172-01-4213 Decedenfs Social Security Number 0.00 298.00 0.00 0.00 148666.00 0.00 0.00 148964.00 9. Funeral Expenses & Administrative Costs (Schedule H) . . . . . . . . . . . . . . . . . . .. 9. 1769.00 10. Debts of Decedent, Mortgage Uabilities, & Uens (Schedule I). . . . . . . . . . . . . .. 10. 11. Total Deductions(totaIUnes9& 10).................................11. 12. Net Value of Estate (Line 8 minus Une 11). .. . . . . . . .. . . . . . . . . . . . . . . . . . . 12. 13. Charitable and Governmental Bequests/See 9113 Trusts for vvhich an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . .. 13. 14. Net Value Subject to Tax (Line 12 minus Line 13). . . . . . . . . . . . . . . . . . . . . .. 14. TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under See. 9116 (a)(1.2) X.O L 16. Amount of Line 14 taxable at lineal rate X .0 ~ 17. Amount of Line 14 taxable at sibling rate X . 12 18. Amount of Line 14 taxable at collateral rate X . 15 15. 133377.00 16. 17. 18. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15[]5b[]42115 15[]5b[]42115 8818.00 10587.00 138377.00 5000.00 133377.00 0.00 6002.00 0.00 0.00 6002.00 D ~ REV-1500EX Page3 172-01-4213 Decedent's Complete Address: File Number DECEDENrs NAME DECEDENrS SOCIAL SECURITY NUMBER IwVANEMA E WAMPLER 172-01-4213 STREET ADDRESS 100 MOUNT ALLEN ROAD CITY II STATE I ZIP MECHANICSBURG PA 17055 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 6002.00 300.10 Total Credits ( A + B + C) (2) 300.10 3. InterestIPenalty if applicable D. Interest E. Penalty TotallnterestlPenalty ( D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill In oval on Page 2, Line 20 to request a refund. (4) A. Enter the interest on the tax due. (5) (5A) 0.00 0.00 5701.90 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58) . Make Check Payable to: REGISTER OF WILLS, AGENT 5701.90 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS No 00 00 00 00 00 00 D 00 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transferred; . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. D b. retain the right to designate who shall use the property transferred or its income; . . . . . . . . . . . . . . .. D D D 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. D 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [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 zero (O) percent [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child 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 zero (O) percent [72 P.S. ~9116{aX1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. ~9116{1.2) [72 P.S. ~9116{aX1 )]. The tax rate imposed on the net value of transfers to or for the use of the decedenfs siblings is twelve (12) percent [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. 217 . . REV.1.502 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Wyanema E. Wampler 2007-00414 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 JolntJy-owned with right of survivorship must be disclosed on Schedule F. SCHEDULE A REAL ESTATE ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH None None TOTAL (Also enter on line 1 Recaoitulation) $ (If more space is needed, insert additional sheets of the same size) o 217 REV-1s03'EX+ (6-98) . . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Wyanema E. Wampler FILE NUMBER 2007-00414 All property Jolntly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION Royalty - Gas Well- Energy Corporation of America - 501 56th Street, SE Charleston, West Virginia 25304 Market Value per Energy Corporation of America - last 2 years of income $ 264.00 Royalty - Gas Well- Chesapeake Appalachia LLC - P.O. Box 6070 Charleston, WV 25362-6070 Market Value -last 2 years of income $ 34.00 VALUE AT DATE OF DEATH 264 2. 34 TOTAL (Also enter on line 2 Recapitulation 11$ (If more space is needed, insert additional sheets of the same size) 298 REV-1504 EX+.(6-98) AT SCHEDULE C COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Wvanema E. Wampler 2007-00414 Schedule C-1 or C-2 (Including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than a sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. None None CLOSELY-HELD CORPORATION, PARTNERSHIP OR SOLE-PROPRIETORSHIP TOTAL (Also enter on line 3. RecaDitulation) $ (If more space is needed, Insert additional sheets of the same size) o 217 . . R~:1507 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE D MORTGAGES & NOTES RECEIVABLE ESTATE OF FILE NUMBER Wvanema E. Wampler 2007-00414 All property Jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. None None TOTAL (Also enter on line 4, Recapitulation) $ (If more space is needed, Insert additional sheets of the same size) o 217 . R~:1508 EX+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Wvanema E. Wampler Include the proceeds of litigation and the date the proceeds were received by the estate. All DrOnArtv lolntlv-owned with rlaht of survlVOl:Shln must be disclosed on Schedule F. FILE NUMBER 2007-00414 ITEM NUMBER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 DESCRIPTION Checking Account at M&T Bank Account # 88734749 Certificate of Deposit - Fulton Bank # 3280178192 Certificate of Deposit - Fulton Bank # 3280203412 Certificate of Deposit - Fulton Bank # 3280227125 Certificate of Deposit - M& T Bank # 31003915885916 Certificate of Deposit - M& T Bank #31003915885924 Certificate of Deposit - M& T Bank #31003915885932 Certificate of Deposit - M& T Bank # 31003915886568 Certificate of Deposit - M & T Bank # 31003916967094 Certificate of Deposit - M & TBank # 31003916967078 Certificate of Deposit - M& T Bank # 31003916967086 Certificate of Deposit - M& T Bank #31003915885891 Certificate of Deposit -M& T Bank # 31003915885908 Certificate of Deposit - PNC Bank # 3200081719 Interest Check Received After Death: Fulton Bank Interest Check Received After Death: PNC Bank Interest Check Received After Death: Fulton Bank Interest Check Received After Death From CD John Hancock Reimbursement from Long-term Care Policy Royalty Check from Chesapeake Appalachia Received after Death Refund Check from Messiah Village received after death VALUE AT DATE OF DEATH 31,513 10,009 12,035 20,014 5,119 5,119 5,119 5,127 9,992 4,996 4,996 10,264 10,264 10,000 218 35 42 82 3,600 34 88 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets ofthe same size) 148,666 r f (7'7 i7tJnf _ Page: 1 Document Name: untitled * 04/03 * 04/06 * 04/06 * 04/06 * 04/06 * 04/10 * 04/13 co STFD 1 96 OP EBRN COlD ACCT THF TRANSACTION STMT FORMAT 07/04/30 10.08.08 MS 50852 ACTION COMPLETE 88734749 SHORT NAME WAMPLER WYANEMA E PAGE 3 SEARCH FROM 107/02/20 THRU 107/04/13 CHECK NUMBER TRAN AMOUNT D/ C BALANCE DESCRIPTION' 153.00 C 020070874090582 US TREASURY 312 CIVIL SERV 1,101.00 C 020070884816051 US TREASURY 303 SOC SEC 42.30 C 020070926045277 TRANSFER FROM ACCT 031003916967094 21.15 C 020070926045275 TRANSFER FROM ACCT 031003916967086 21.15 C 020070926045285 TRANSFER FROM ACCT 03+003916967078 73..70, D 020070961886838 P&A GROUP P&A ADMIN ", 2,840.02 C 6104416108 DEPOSIT 020071024439440 VERIZON PaymentREC PF: 1-HELP 3-PLVL 6-INQ 7-SB 8-SF 9-ASUM 11-CUTO -STSM 26.03 D STMT ACTION PROD CODE DDA CURR CODE ACTN POST EFFECTIVE TRACE ID * 04/02 27, 586..~1 28,687.~1 28,729."91 .... 28, 75i. 06 28,772.2J:' 28,698.S'I 31,538.53 31,512.50 Fulton Bank 58119 1057 LISTENING. FEDERAL ID NUMBER: 23-1928421 DIRECT INQUIRIES TO: 800-385-8664 P.O. Box 4887, Lancaster, PA 17604-4887 1 WYANEMA E WAMPLER 179 SPRINGHOUSE DR LEWISBURG PA 17837-9418 YOUR TAXPAYER I.D. NUMBER: 172-01-4213 TAX YEAR 2006 1099-1NT (OMB NO. 1545-Q112) INTEREST INCOME STATEMENT 1099-010 (OMB NO. 1545-Q117) ORIGINAL ISSUE DISCOUNT 1099-DIV (OMB NO. 1545-Q110) DIVIDENDS AND DISTRIBUTIONS This Is Important tax Information and Is being furnished to the Internal Revenue Service. If you are required to file a return, a negligence penalty or other sanction may be Imposed on you If this Income's taxable and the IRS determines that " hIS not been reported. Ii) ~ il II: ~ g rl:1~~ P.O. Box 767, BuffalO, NY 14240-0767 1099-INT (OMB No. 1545-0112) 1099-DIV (OMB No. 1545-0110) 1099-010 (OMB No. 1545-0117) 1099 Mise (OMB No. 1545-0115) 00466988L 1099-A (OMB No. 1545-0877) 1099-B (OMB No. 1545.0715) 1099-e (OMB No. 1545-1424) 1099-S (OMB No. 1545-0997) 1098 (OMB No. 1545.0901) E.I.N. 16-0538020 1-800-724-2440 FOR TAX YEAR WYANEMA E WAMPLER GAYLE W POLLOCK C/O GAYLE W POLLOCK 179 SPRINGHOUSE DR LEWISBURG PA 17837 466988 4514 2006 TAXPAYER ID NUMBER 172-01-4213 2006 - 1099-INT, INTEREST INCOME ACCOUNT NUMBER SAVINGS INT 015004214334233 BOX 1 INTEREST INCOME 125.58 CERT OF DEPOSIT 031003915885891 BOX 1 INTEREST INCOME 102.12 CERT OF DEPOSIT 031003915885908 BOX 1 INTEREST INCOME 102.12 CERT OF DEPOSIT 031003915885916. BOX 1 INTEREST INCOME 46.01 CERT OF DEPOSIT 031003915885924 BOX 1 INTEREST INCOME 46.01 CERT OF DEPOSIT 031003915885932 BOX 1 INTEREST INCOME 46.01 CERT OF DEPOSIT 031003915886568. BOX 1 INTEREST INCOME 42.25 TOTAL INTEREST 510.10 (}rIJfir& .:t! ~/tJ~:?P/~?"'%Jf~ LI 3/~p~f/~J'p$ .# 3'1t'/~fAt~~ 4'/P~ /7/ AR#f' //1%1/ /); ~~~ SRYihf' 1It?/!lJPl'APlp~fW "Form 1099.0ID: This may not be the correct figure to report on your Income tax return. See Instructions on back. ~ 5 ~ 1011-INT 1011- DIV LOOM (11/011 1011-0lD 1011-MISC 1011-B 1011-A 1011-C Thia ia Irnport.nttllllnlorlNltion.nd Ie IIelne furnl......to the I_rllll Re..nue Servlc.. If you .re requlrecl to file . return,. .1"I.nc.plIll1l1yor other unctlon"",y lie irnpo..d on you if II..ble inco"", reouMI lrornthia trono. Ictionond the IRSd.torrninoothot It hel not lIeon roportod. 1011-MORTGAGE The InIorlNltion noli! to boIooo 1,2, .nd 3 Ie Irnportonttox Inlo,. motion.nd Ie IIelne lurniahedto the Intornol RewnueServlc.. If you .ro ..qulrod to file I return,. nol"llne. plllIlty.or other .lnction""'Y lie impolloton you If the IR$ dot.rrninolthoton undorpoymotntof w....u"" lIee.UII you __ed I deduction for thll mortg... Intoreot or for thel. polnto or lIeel... you did not roport thia rofund 01 Intoroot on your return. Thlo II Irnportonttox irtorlNltionlnd 10 lIeine lurnllhedto the Int.r.1 RI..n.. Servico. II you.ro roqulrod to file. return, I no,lie.ne. plllIlly or other unction ""'Y lie irnpouot on you If thi. incol'l'll II to_blo IncllRS dotorminolthot it hn not....n reportod. 217 . REV-1509 EX+ (6-98) COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER Wvanema E. Wampler 2007-00414 If an asset was made Joint within one year of the decedent's date of death, It must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. B. C. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY "10 OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAt.E OF FINANCIAL INSTIlVTION AND BANK ACCOUNT NUMBER DR SIMILAR DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTL Y-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENrSINTEREST 1. A. None 0 0.00% 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 TOTAL (Also enter on line 6. Recaoitulation\ S 0 (If more space is needed, insert additional sheets of the same size) 217 . REV-1S1~ EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER 2007-00414 Wyanema E. Wampler DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RElATIONSHIP TO DECEDENT AND THE DATE OF DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE NUMBER TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (FAl'PI.JCAIl.E) VALUE 1. None None 0.00% 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 TOTAL (Also enter on line 7 Recaoitulation\ $ 0 This schedule must be completed and flied If the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET Is yes. (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (10;O~) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Wyanema E. Wampler FILE NUMBER 2007-00414 e tso ece ent must feDO e on c e ue . ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Auer Memorial Home and Cremation Services, Inc. 1,447 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representatlve(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If clecedent's address Is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 322 5. Accountanfs Fees 6. Tax Retum Prepare!'s Fees 7. TOTAL (Also enter on line 9 Recapitulation) $ 1769 D b fd d be rtd Shdll (If more space is needed, insert additional sheets of the same size) ~ ~~-~~~.~~~...~.~~,<l!,~~~~~;, ~. STATEMENT OF FUNBRAL GOODS AND SBRVICBS SELECTED .~ /1'1", Charges are ;n1ylor items 1bll)'Oll selected orthtt.... required. 1f.......l!ljIdred by law or by ac:eneteryor cremolorflo use 1II)'_,..1me n<<aeIected, wewlll explIin the reIIOIl! In writing below. If)'Ou h... selected senIces thtt may roquire emboImiog, ,.. may Jme 10 pay for embllaq. Yoa do nollme III pay lor embIImInc 1haI)'OlI did not apprllft. Pn1l>aiJUIs ~ nol required for direct cremttlon or immedltte buriall!mbalmlog ~ noIl!lj1dred by law, eueplln cenaIo spedaI cases. 1f)'OU.... dwged lor embalmIn& we will 0IpIaIn Mlr below. Dote .r Death Lewisbur- C. AUTOMOTIVE EQUIPMENT: Rem.n! Vehicle .................................... _ Cl\k~ Gotdl",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, _ Family Car (eg. IJm.) .......................... _ SUBTOTAL ........................................................................$.;l~ 00 FI.wer Car or non] Delivery .............. _ DISCOUNT .............................................................................. ----40.. 00 Leai! Car/Clergy Car..........;..................... _ TOTAL DUll ......................................................................$.;l~ 00 Service Vehicle ...................................... _ PAID.................................................................................~$.3.~ 00 TOTAL OF AUI'OMOTIVB IQUIPMINT ................................ $0.00 BALANCE DUE........................................................................ ---lll'il.. 00 If..y lopl, cem,,"Y, or """"'" requt_ hu reqvi.... tile p_ 01 lily oIohe _liIIed -. we olD expItl. ohe .....Iretoeol below: RIASON POR BMIALMING f v'o C' l'V\. ~ l~ I",v ~ I _ tIw I b", .....,.... ohe _ 01 plOds .od _ oeieaed aboftllld 'DlIlI _ 10 .. comet lid occordlIt 10 lb. ._.. I b", reqaaoed. I acbowIedse raceIpt 01. "'PJ oIlbb Stllem..tol....n1GoodaIld_"'_ I_I""" Jme_lr..cIamll.bltfor_oIlh.cubprt..forlhe......lldaenlCla1'<'! J~_IO- paymeot 01 $ 1;'1,1 1 _ 'I days. 1_ to be lolady IlId -ur hhle wtIb ..,... .... who ..... below. A ilia ...... 01 per IlOOIb ......UnIIO '1 R lk pe"ear will.. 'l'lIUed" 'b. ullplld bIIuce bepd"l~ ...,.Iro..lbecl... 0I1biJ _L I wtU.... pi)' III lit........ D1rectortU __"hie co.. pIId by th. Pb..n1_ to collect ........,... tmder Ibb _em. TIlooe COllI may IncIode ._.,.' feea, CODrt COllI lid ocher COllI. "'" _d ami", or_ oro..... or req,,"ed alter lb. dIIe oflbla.......... will be COIIIidered part 0I1bIa ...-enlllld ohe COlI_olD be _.. lb. 8u1 WJJ or_. 4-7-2007 L/- ~ZM ") <>>-0) A. SPECIAL CHARGES: Direct Cremation .................................... $895 . 00 Fonvardlng Remains 10 ........."............. _ (Funeral Home) Receiving Remains lrom ...................... _ (Funeral Home) Immediate Burial .................................. _ Natio.wlde Gu.rantee Prosnm............ _ Worldwide m..1 ProtecJIon ................ _ Pre-,lrrangement ReglsJrtJlon .............. _ TOTAL SPECIAL CHARGBS ...............................................s.8~ B. CHARGE FOR SERVlCB SELECTED: PROFBSSIONAL SERVICBS Services of Funeral DirectorlSttf ........ _ Embalming ............................................ _ Otber Preparation of Body.................... _ Other- FAClLlTIES, STAPP AND EQUIPMENT U.. of the Pacilities and Sttf r.r VIOwtnBMsllatlon .................................. _ u.. of the Facilities and Sttf for Funeral Ceremony .................................. _ U.. of the PacillUes and Sttf for Memorial Service .................................. _ Vae of ,he SlldIand EquJpmenl for V1ewlnWVIalIaUo. IIUOlber location.... _ Use of Ibe Sta1Iud lqulpmenl for Funenl Service lIuollter locaUon ........ _ Use of the SlldIud Equipment for Memorial SonIce lIuother IocllIon .... _ PrlYate Famlly Vlewlng .......................... _ Wltneasing Crellllllon............................ _ Pacbglng and Forwarding Cremlletl Remanl (RegIstered Mall) .................. ~. 00 Pmona1 DeIiYery olCremlleclRenlalns.. _ DeIl..ry of Cremlled RenIalns.................._ DeIiYery and CoordJnaJion of Cremlled Remains 10 a Pmlle or Nll!onal Cemelery _ Scall.rlng of Cremated Remlbut o.er Land or Sea ............................................ _ TOTAL OP PROnSSIONAL BBRVlCBS ..............................~ (Sea}J-= (S~ ~'I~( IlA(~:2tJfP /30'lrt7 / ~ Dh:lar) ,/ 4-6-2007 PA 17857 City D. MERCHANDISE RegIster Book........................................ _ Memorial PolderslPrayer Cards............ _ Thank You Cards .................................. _ Remembrance Package ........................ _ Um(s).................................................... _ (DescrtptIoo) Car-dboar-d Contalner- A1temaUYe Contalner ............................ _ (Descrlptioo) Um 0UJer Burial Contalner .................. _ (~U,ial Vault Veteran PIa& CUe' .............................. _ CUket .................................................... _ (DescrtptIoo) Casket Oulet BurIal COnlllller......................... _ Gra.. MarkerlMem.rlal........................ _ OtItePther OthePther Dal. of Arnn.....nll 4 - 7 .. 200? 570 524..0246 Phooe No. SIalrIl.Ip TOTAL MBRCHANDISI ..............................................,......... -$4.. 00 E. CASH ADVANCE mMS: Gme Openlns ...................................... _ CemeteJy BquJpment ............................ _ Newspaper Notices ................................ _ Newspaper Notices ................................ _ AIrfare .................................................... _ Clergy/Mass OfJerJng ............................ _ Pa1Ihearers.............................................. _ CalIfted CopIes of the Dealh CenI8cale.. ....!U.2.. 00 1'Iowers.....................,............................._ Vauk SerlIce CwJe ................................_ CountyCOmnerPee ................................ ~. 00 0rpn!sI.................................................. - SoloJst .................................................... _ Honor Guard ......................................... _ Crematory Clarge................................... ~. 100 Other TOTAL OF CASH ADVANCES .................................................. ~ 00 ,...",.",. ,.. for...r __ In obltdnlng' (lpIC/h ""-nt ClUb iIIIrItmce 1mIu) SUMMARY OP CRARGBS A. Speda1 Charps ......................................~0 B. Profeaslooal SonIces, Pacilltlea ............ ~ 0 C. AutODlou.. lqulpment............................ .....sa...00 D. Merchandlse .......................................... ....$J,).....QJ 0 E. CUb Ad...ce ltema ................................$~00 . RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17G13 Rece~pt Date: Rece~pt Time: Receipt No.: 4/30/2007 09:30:32 1048259 WAMPLER WYANEMA Estate File No. : Paid By Remarks: 2007-00414 B & L TAX AND ACCOUNTING SVCS CJ Fee/Tax Description PETITION LTRS TEST WILL SHORT CERTIFICATE JCP FEE AUTOMATION FEE Check# 6116 Total Received.. ....... Receipt Distribution ------------------------ PaYment Amount Payee Name 260.00 CUMBERLAND COUNTY GENERAL FUN 15.00 CUMBERLAND COUNTY GENERAL FUN 32.00 CUMBERLAND COUNTY GENERAL FUN 10.00 BUREAU OF RECEIPTS & CNTR M.D 5 . 00 CUMBERLAND COUNTY GENERAL FUN ---------------- $322.00 $322.00 REV-1512 EX+ (101-ll3) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER Wyanema E. Wampler 2007-00414 Report debts Incurred by the decedent prior to death which remained unpaid as of the date of death, Including unrelmbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Messiah Village -Nursing Care for March and April 2007 8,284 2. Capital Area Health Associates -Nursing Care January and February 2007 110 3. Alert Pharmacy -Pharmacy Services for March and April 2007 424 TOTAL (Also enter on line 10, Recapitulation) $ (If more space Is needed. Insert additional sheets of the same size) 8,818 ~~~~ah 100 MOUNT ALLEN DRIVE, MECHANICSBURG, PA 170~ rTl LEWISBURG, P A 17837 QUESTIONS: CALL: (717) 697-4666 RESIDENT # I UNIT I STMT. DATE 120001 I 001 D I 4/30/2007 RESIDENT(S) Mrs. WYANEMA WAMPLER TOTAL AMOUNT DUE $8,284.15 DATE DUE 5/31/2007 $ ___ ___ J)A TE DESCRIPTION RATE DAYS! CHARGES CREDITS _ H__!3ALANCE - -- --' . - - UNITS .,-- . ----....~. Balance Forward 7,035.00 ***Nursing Care*** 04101/07 MOTION MONITOR 04/01-04/05 0.17 5.00 0.85 7,035.85 04102107 PREVAIL BRIEFS MED/12 13.60 3.00 40.80 7,076.65 04I0~/07 RMlBRD - NURSING - SEMI-PVT 224.00 5.00 1,120.00 8,196.65 04105/07 OXYGEN 04/01-04/05 17.50 5.00 87.50 8,284.15 RESIDENT # CURRENT OVER 30 OVER 60 OVER 90 OVER 120 TOTAL AMOUNT DUE 120001 1,249.15 7,035.00 $8,284.15 RESIDENT NAME Mrs. WYANEMA E. WAMPLER A 1 % finance charge may be assessed on accounts for which payment has not been received by the due date. Thank youl If you have any questions or concerns about your bill, please address them directly to Fiacal Services at 790-8220. Thank You! Date MI!:_Aat:1S~y."."'"~"UW . ImIImlImJ Service Description Cpt Dx Line Balanc -_BmmI ,'o'c* P1'ease Pay upon Receipt, If billing questions call (717) 591-7200 ext H-Ic ***. 6423. *** *** Your Account Balance Is Overdue. Please Make Pavment *** *********************************************************************************** Insurance Charges pending to Prv: 2254.00 Ins Pay/ Adj against Ins pending 1162.21 -540.09 551. 70 01/09/07 1 1 E 01/22/07 01/29/07 01/29/07 02/16/07 01/19/07 1 1 E 02/06/07 02/26/07 02/26/07 03/14/07 01/29/07 1 1 02/16]07 03/14/07 03/14/07 03/30/07 OZ/frtfo7" 03/14/07 03/30/07 03/30/07 04/16/07 NURSING FACILITY CARE SUB Medicare Payment Medic DEDUCT Pa~ent Accept Assign Adj. CAPIT DEDUCT Payment NURSING FACILITY CARE SUB Medicare Payment Medicare Payment Accept Assign Adj. CAPITAL BC S Payment NURSING FACILITY CARE SUB Medicare Payment Medicare Payment Accept Assign Adj. CAPITAL BC S Payment -"NURSING FACl1:TTYC~E-cSmt--9~'0~'h-l05. 00- Medicare Payment . Medi car.e Payment Accept Assign Adj. CAPITAL BC S Payment 99308 250.02 78.00 0.00 0.00 0.00 -27.27 50.73* 99308564.00 78. 00 0.00 5.79 0.00 -27.27 44.94* 99308 78.0.6 78.00 0.00 40.58 0.00 -27.27 10.15* 0.00 56.97 10.18 -33.79 4.06* E-Thisbill apPlied.against your ded.uctibh. You are responsible to pay us. DATE LAST PAID A-,' 00/00/00 .0.00 ..CAPi'rALAREA HEALTHASSO~l:ATES '1 OOl'fOuttTALLEN DRIVE MECHANICSBuRG, flA 17055-6100 MA!(:E ctECK PAVABLET . PATti l-WYAN,BMAE W:AMPLER PRvtl '- R~9\~\~~ Ph: (717)-790-8232 Acet//: 144 Date: 04/23/07' Page 1 of 1 1-NOORBAKSH, SARAH Y, M.D~ TO ~L .00 AMOUNT DUE 348.10 217 REV-1513 EX+ (9-00) COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER Wvanema E. Wamoler 2007 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND AOORESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS pnclude outright spousal distributions. and transfers under Sec. 9116 (a) (1.2)] 1 Robert K. Wampler 1071 Country Hill Dr. Hbg PA 17111 Son 50% 2 Gayle W. Pollock 179 Spring House Drive Lewisburg, PA 17857 Daughter 50% 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 1 Messiah Village EIN # 23-1458000 -100 Mount Allen Drive Mechanicsburg, PA 17055 5,000 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 5000 -00414 (If more space is needed. Insert additional sheets of the same size) Ms. Sharon Engle Development Office Messiah Village 100 Mt. Allen Drive Mechanicsburg, P A 17955 Dear Me. Engle, Enclosed is a check in memory of our mother, Wyanema Wampler. She had placed Messiah Village in her will for this amount. My brother and I want to thank everyone at Messiah for the wonderful and thoughtful care our mother received during her time with you. Sincerely, Gayle W. Pollock and Robert K. Wampler " o :n II , 1 II~ II O"tl :0)> . c< \m-t :00 .~;! m m tJ) ~ I, -f ,,' :tl m ~g~o r;cjm<"T1 ~(J)::!;;== 1ii ;g ?'~ -< ~z~;,. ~ ~ ~l2 z . o'U,.. m -0 c: "'0 3l: >~!B~. ~.o:" in m ~ ~~ >< . -..j<><mc mm ~ c::; ~ . 3: "'D r- m :D . g ~. ~ ~\.J\' ~ .~ ED :~ IIJ ~ if ~ ~ 01 01 H 105 .R05 REV ] 105 This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It Is Illegal to duplicate this copy by photostat or photograph. No. I~/J;~. Local Registrar Fee for this certificate, $6.00 p 13353018 APR 0 9 2007 Date 'lEVl1_ PIWIT .. IAHENT lKlNK COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CEImFlCATE OF DEATH (See Inatructlone lIlCIexamplea on _I 7. ..._.. t._"'_(Anl,_....ouIxl 5.IqI(lM111itld1y) 91 VII. Ht. oOOll.-'Sl>odIY: 10._:____,& (Si>dIl ... CounIy"'DoIIll eu.berlaDd Id. Fdy _ (If "'" -..... gill _........., 11.--'~ _'" "'00""'_ KlndC!!- KInd"'_'--, Bank Tel.ler Boonking 11l-.ra-._(9noI, clyl_,_.cD! 100 Mount Allen lload Pennsylvania DId DocodonI Uwoln. -.oIlIpl 17e. 0 YoI, _LMdIn 17d.DNo,_LMd_ "X AcUllnlllol M~~h.ftf pa'hllTg Top. III "-'-(Anl,-,laI. 17b. CounIy l!w~"Tl.nd Clyl- t8.\Iolhor'I_(FIIII,___1 Charles Peter Eater 2Or. 1nIomWlI'I_ (1ipo II'IInIl 21.._",~ o - 0 _1nIm_ oOhr. 22lI. '" ~ 21d.I.DcIlon(CllyI-'_.._1 Cr_tion Society of PA rrisburg. PA 17109 22c._"'_"'Fdy Aller HeIIorial IIC*e & Cr_tion Services. Inc. (MonIh, -" """ 2lI. _eo. _ID_ _,Coronorfor._OIhato.> c...- "_1 oYol oNo AppoolIInloIa_ PaIIR:EnIor_____.._ 2IlDid_Uoa~IDDaalh1 0rwaI1D1lao8I ""''''''.......In..ordoIIjIng_glllnInPartl 0 YoI 01'1dlolltt ~o~ ~-==~.. .kt/Ulli+,'otJ Oua"(ar.._oI): b. "DUD elLvr ~ OuaID(...._ol): ~~(LA.. 3 r 28.~~: [d1ioI pIIpI1l-. "'" ol'lliPWllatllma"'_ o Not.pIIpI1l, but pIIpI1l_ ~ daya ol- D Not. pIIpI1l, ""'_ 43 daya ID 1 "'" -- o ~W__"."", 32c.PIaca"'''*''''Homa,F...._~. t*a IkiIIIng, lie. /Sl>dl') ==IIII_W.." . to ...lIMdonlrwa. EnIor __CAllIE =-~~ c. Dwto(oru.~or): 301. WIll.. "-I -- d. 3l1li. -"-I FhIngo __ID~ '" Cauoa '" DaoIll oYol l;Joflo 31._"'1lao8I ~ D- O -- 0 -.e1l.-galOn 0- oCoulllNot.bo_ 32d._"'lI$.ry ~p_No. 3Il.n__lI$.ry~ oDrilllrIOpnor 0-.. D- Ollar. --* 33b. SipOlII"'. '" CoItIar. _1.DcIlon"'II$lly~cllyl_._1 oYol ~ II. IlL ColIIor ~...,....I . CIItIIllnt~~...,...-"'---~ha___................23) Yo.._II.., .........__ ..to".-a(o) and _. -. _ _ _ _ u _ _ _ _ __ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ 0 . -............... ~ ~""" IllOIwD1G _ ...CIltIyIngID_"'_1 Yo .._11..,........._ _ ..._ _ and.... and ..to.........1 and _. -. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ '__1- On"_II_and/"~ .."".......-_.....__and....and......cauaa(aland _.-. 0 36. RagiaIrIr'a ~ .~ II e1 /J 11 STATE OF PENNSYLVANIA COUNTY OF CUMBERLAND SHORT CERTIFICATE I, GLENDA FARNER STRASBAUGH Register for the Probate of Wills and Granting Letters of Administration in and for CUMBERLAND County, do hereby certify that on the 30th day of April, Two Thousand and Seven, Letters TESTAMENTARY in common form were granted by the Register of said County, on the estate of WYANEMA E WAMPLER , late of UPPER ALLEN TOWNSHIP (First, Middle, Last) in said county, deceased, to ROBERT K WAMPLER and (First, Middle, Last) GA YLE W POLLOCK (First, Middle, Last) and that same has not since been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of said office at CARLISLE, PENNSYLVANIA, this 30th day of April Two Thousand and Seven. File No. PA File No. Date of Death S.S. # 2007-00414 21- 07- 0414 4/06/2007 172-01-4213 ~~~ QWdu - (t~ ~epu y NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL LAST WILL AND TESTAMENT of Wyanema E. Wampler I, Wyanema E. Wampler, of Apartment 732, Messiah Village, Mechanicsburg, Cumberland County, Pennsylvania, 17055, declare this to be my Last Will and Testament and do hereby revoke all wills and codicils previously made by me. ITEM 1. Cremation. I direct my hereinafter named Executors, or the survivor thereof, to pay all my just debts and memorial service expenses. I direct that as soon as practicable after my death, my body be cremated and my ashes interred at the Rolling Green Cemetery, located at 1811 Carlisle Road, Camp Hill, Pennsylvania, 17011. I would like my son, Robert K. Wampler, and my daughter, Gayle W. Pollock, to be present at my interment. ITEM 2. Identity of Beneficiaries. I am a widow. r have two (2) children - a daughter, Gayle W. Pollock (008: 06/26/1946); and a son, Robert K. Wampler (008: 10/22/1953). I have no deceased children. All references in this Will to my . children include the above referenced children. ITEM 3. Property Being Disposed. It is my intention to dispose of all my property. However, I do not intend to exercise any power of appointment which I now possess or which may hereafter be conferred on me, unless such power is specifically referred to herein or in any Codicil hereto. IT~M 4. 4.1 Specific Bequest. I give and bequeath the sum of Five Thousand Dollars ($5,000.00) to Messiah Village, of 100 Mt. Allen Drive, PO Box 2015, Mechanicsburg, Pennsylvania, 17055, to be used by the trustees at their generous discretion. ITEM 5. Gifts of Residue. I give, devise and bequeath all of the rest, residue and remainder of my estate, both real, personal and mixed, of whatsoever kind and wheresoever situate as follows: 5.1 One-half (1/2) thereof unto my daughter, Gayle W. Pollock, of 179 Springhouse Drive, Lewisburg, Pennsylvania, 17837. Should my daughter, Gayle W. Pollock, predecease me, then I direct that her share shall pass to my son, Robert K. Wampler, of 1071 Country Hills Drive, Harrisburg, Pennsylvania, 17111. Should both my daughter, Gayle W. Pollock, and my son, Robert K. Wampler, predecease me, then I direct that this share of my estate shall pass to Messiah Village, of 100 Mt. Allen Drive, PO Box 2015, -2- Mechanicsburg, Pennsylvania, 17055, to be used by the trustees at their generous discretion. . . 5.2 One-half (1/2) thereof unto my son, Robert K. Wampler, of 1071 Country Hills Drive, Harrisburg, Pennsylvania, 17111. Should my son, RobertK. Wampler, predecease me, then I direct that his share shall pass to my daughter, Gayle W. Pollock, of 179 Springhouse Drive, Lewisburg, Pennsylvania, 17837. Should both my son, Robert K. Wampler, and my daughter, Gayle W. Pollock, predecease me, then I direct that this share of my estate shall pass to Messiah Village, of. 100 Mt. Allen Drive, PO Box 2015, Mechanicsburg, Pennsylvania, 17055, to be used by the trustees at their generous discretion. ITEM 6. Executors Right to Dispose of Real Estate. I hereby authorize and direct my Executrices, or the survivor thereof, without being required to furnish bond, to sell and dispose of all or any part of my real estate, in whatsoever state situate, at private sale or sales, for such prices or considerations and upon such terms and conditions as my said Executrices, or the survivor thereof, may deem best, and by proper deed or deeds, conveyances in law, to be duly executed, acknowledged al)d -3- perfected, togrant and convey the same to the purchaser or purchasers thereof, her, his or their heirs and assigns, free from all liability for or on account of the application of the purchase. money. ITEM 7. Survivorship Clause. No person named as a beneficiary in this my Will shall be regarded as "surviving" me if such beneficiary dies within thirty (30) days of the date of my death. ITEM 8. Executors. 8.1 Appointment. I appoint my daughter, Gayle W. Pollock, of 179 Springhouse Drive, Lewisburg, Pennsylvania, 17837, and my son, Robert K. Wampler, of 1071 Country Hills Drive, Harrisburg, Pennsylvania, 17111, or the survivor thereof, as Executors this my Will. ITEM 9. No Bond Required. No bond or other security shall be required of any Executor appointed in this Will. ITEM 10. Headings. The headings above the various provisions of this Will have been included only to make it easier to locate the subject covered by each provision and are not to be used in construing this Will or in ascertaining my intentions. -4- IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my last will and testament typewritten on <-~i~ ( J.L. ) sheets of paper this 18{D day of . Ap-i1 ,2003. WITNESS: v?la...J ~jJ!_~" ) ~pr.j)W~ 1J1/iu',.ed!a C' 'jJ~. (SEAL) W~nema E. Wampler / . . SIGNED, SEALED, PUBLISHED and DECLARED by the above named Testatrix, Wyanema E. Wampler, as and for her last will and testament, in our presence, who, at her request, in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses in attestation thereof. wL]. j d ~/ residing at ~.JJ (j~ ~ 171$. ~ }J\p('\r-o {\f(SbJrq,. PA Ie 05S residing at ~ i~ N\t~\(~hl(~1 ?A 17055 -5- . ACKNOWLEDGMENT AND AFFIDAVIT COMMONWEALTH OF PENN5YLV ANIA COUNTY OF CUMBERLAND ) ( 55: ) We, Wyanema E. Wampler, f-leJ.C!.f'\}(is-\ fer , and LD~'S. to. D. l)cd lo..c.e... , Testatrix and the witnesses, respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and that she had signed willingly, and that she executed it as her free ~nd voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best of their knowledge the Testatrix was at that time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. ~w~~ ~'.-J .~ Wit,pS A/i. b{f). ~/- Witness . (SEAL) (SEAL) (SEAL) Subscribed, sworn to and acknowledged before me by Wyanema E. Wampler, the Testatrix, and subscribed and sworn to before me by , and ~. , witnesses, this I \3f!l. day of ~ ~~ , 2003. My Commission Expires: tK. 13/ a.(X4 Notarial Seal Jennifer R. Freeland, Notary Public Upper Allen Twp., Cumberland County My Commission Expires Dec. 13, 2004 Member. Pennsvlvanla Association of Notaries !!:\u~erldWloloc'wii!....] -6.- ~ ~-.,.,\.-,- ........... ....U\:.'.,."'.....'.............:.\II,,i. - -~p~- rl.'_-.'.--..!\:.",,:..I..-C.:,.,.....-......'....,.. N. . '1d,''''I.'''''"",..,." i\:,)\,',\';,' '\'('}\ ' ':':',':',i : .. _,:"i,\'j':': \':'W.. . , .. \'(\\, '.':".",> .. . .'.,'...:.... " ...'.......... '. .. .. .. ~ .. ',.' -,'.. .. ..: ,.." ',', .. ,,' .,' ,.,".. ... \\1.'- ,~". , [',tate Notices BSTATI NOTICI LETTERS TESTAMENTARY In the estate of Wyantmal. Wampler, late of Mechanlaburg, CumlMrland County, Penn'Ylvanla having beln granted to .the under.lgned, all PlrJOns Indebted to the .ald estate are required to make 1m _ 'mediate payment and those hCIVlng claim. ur ~mand. to Pl'lsent the same without delay tor settlement to: Robert K. Wampler Ixecutor 1011 Country Hili Drive Harrl.burg, PA '"" ~1('ctlnlJ fJC){,C I'S A worker.' comPlnsatlon hearing will be held In the case of Eric Benda v. Wal- Mart A.soclate. and Spherlon of Lan- ta.ter. The hearing I. lChIduled to oc- cur on JUly 31, 2007 at 3:00 p.m. at the Lancaster ,Jud\lI'. OffIce Hearlll\l Room A. 315 WHt JamHStreet, Suite 206, Lan- caster,PA. 17603. TheClalmant's foil- ure to appear will rHult In dl.mlssal of the claim wIth preludlce. MHtIII\l Notice There will be a mlltlng of the Worm. IlYIburg Borough Council.. CommIttee on Parks. PUblic Land. and Recreation on July 12, 2007, commencing at 6:00 p.m. In the Council Chambers of the Bor. ough Hall, 20 Market Street, WOrmley.. burg, PA. The pU/'llOll of the mllttng I. to dlscuu park and recreation Item. and any other bu.lneu that may come' bI- fore the committee. Gart W. ...,.....rd, .onun MallCl\llr NOTICI OF CANCILLID MIITING OFTHI HARRIS.URG PARKING AUTHORITY The Regular Meltlll\l of the Board of the Harrl.burg Parking Authority which was scheduled for Thursday, June 28. 2007 at 5:30 p.m. at the office of the Har. rlsburg ParkIng Authority located at the McCormick Public Servlcn CIIltIr, 123 Walnut Street, Suite 317, Harrl.burg, PA has been cancelled. Kathl_ C. McMullin Cllalr NOTICI OF PU.L1C MIITING PUblic notice I. herebY given of a meet _ III\l of the Lobbying DISCIOlUrt Rl\lUla . tlun Committee Hfabllshed unclltr Act lU of 2006. The mlltlng will be held on Thursday, June 28, 2001 at 9:00 AM In Hearing Room 3, North Offlce BuildIng, Harrl.burg, PA. The purpose ,of the mlltlng will be for the Committee to con'lder regulation. pur.uant to Act lU of 2006 alld to receive Public comments. Please vl.lt www.attorneY\llneral.\lCIVfor mort In - formation and to view a COPY of the com _ plete agenda. The FacllltlH Committee of the South Mlddhtton School DistrIct'. Board of Dlre<:tors will milt on WedllHclay, June 71, 2001 at 7 pm In the Board Room at. the Iron Forve Elementary C..,Ier, 4 FCII'\lt Road, Boiling Springs, PA. 17007. IIIl 'i~ _ M _ PUBLIC NOTICE DEADLI~ES Daily Editions j\- AIl notices must be received 2 working days prior to For additional infon Contact: Rosalyn Holton (717) Legal Advertising \1cetiIlLj N()(ices PUBLIC NOTICI SPICIAL BOARD MIETING The Lower DauphIn School Board here _ by give. notice that a Special Board Meeting will be held on Wednesday, June 26 blllnnlng at 7:30 a.m. at the Lower DauphIn District Administration Center, 291 E. Main Strllt, Hummel. . town, PA 17036. The pur_ of the meetIng Is to act on a resolution InvolvIng an agreement with Honevwe.ll International, Inc. and the Dauphin County Area Vocational- Technical School Authority. Sharon K. Hagy Board Secretary WIIST HANOVER TOWNSHIP NOTICE OF PUBLIC HIARING AND NOTICE OF PROPOSED ENACTMENT Oil ZONING ORDINANCI AMINDMIINT NOTICE IS HEREBY GIVEN by the Board of SUIllrVI.or. of We.t Hanover Township that It will conduct a pUblic hearing upon a proPllIId amendment to the Zoning Ordinance of WHt Hanaver Township. The public hearing I. to be helcl on Monday, July 2, 2007, at 7: 15 p.m;, at the West Hanover Town.hlp Mu- nicipal BuildIng, 7171 Allentown Boule- vard, Harrl.burg, Penl1lYlvanlci, 17112. FURTHER, NOTICE IS HEREBY GIVEN by the Board of Supervisor.. of WHt Hanover TownshIp that It will con. .Ider the enactment of a prol'Olld amendment to the Zoning Ordinance of WHt Hanover Town.hlp MOnday, Julv 2, 2007, during It. regular mlltlng at the West Hanover TownshIp Municipal Building. CoPlH of the prOllOsld ZonIng Ordl. nance . amendment mClY be examIned, without charge, at the WHt Hanover Township Municipal Building, 7171. AI. lentown Boulevard, Harrisburg,' Penn. .ylvanla, 17112, durlna regUlar bu.lneu hour., MOnday thrOugh Frlday,from 8:00 a.m. to 4:00 p.m. CoPI.. of the pro- POHd Zoning Ordinance may be 0b- tained for a charge, which I. nof greater than the co.t _sary to. produce. the COPIH. The propo'eclamendment to the Zoning Map, ArtiCle 3, Sectlan 195-12 Zoning boundary dncrlptlons. I. a. fol. lows: Rezone from BE (Bu.ln_ Enter- prill) to CH (Commerc;lal Highway) the tracts of land located at 7OoC5 .Blue Ridge AYlliue, Tax Parcel .a.o28-0&4, & 085 Jeffrey & Sandra FltHr/ownlr, and 7050 Allentown Boulevard, tax parcel .68- 028-125, Barry & Sandra Marlin/owner.. .OARD OIlSUPIRVISORS Oil WIST HANOVIRTOWNSHIP Sportslans speak upl Fan comments published in The Patriot News Sports Fan Une Every day in Sportsl 232-5~78 G:bt Patriot-Nrws Mlscell"nco S tlet> II II . ~ II, '/1 L DAUPHIN COUNTY INDUSTRIAL I CONCISE FINANCIAL STAT EM CONSIDE BALAI SEPTEMBEI ASSE1 CASH AND CASH EQUIVALENTS ACCOUNTS RECEIVAILE RENT RECEIVABLE LOANS RECEIVABLE PREPAID EXPENSES PROPERTY AND EQUIPMENT BOND ISSUANCE COSTS TOTAL . LIABILITIESANO ACCOUNTS PAYABLE NOTES PAYABLE ' DEFERRED REVENUE SECURITY DEPOSITS NET ASSETS INVESTMENT IN GENERAL FIXED ASSE NET ASSETS TOTAL CONCISE STATEMENT OF REV! YEAR ENDED SEPTE REVENUES: PROJECT FEES ANNUAL ADMINISTRATION FEES CLOSI.NG FEES , TERMINATION FIES RENTAL INCOME INTEREST INCOME -CASH AND CASH EQ INTEREST INCOME - LOANS PASS THROUGH G~NT INCOME EXPENSES: PROFESSIONAL FEES IUILD1NGMAINTENANCI! ADVERTISING INSURANCE MEMBERSHIP DUES OFFICESUPPLIES SPONSORSHIPS SEMINARS AND MEETINGS OTHER EXPENSES INTEREST EXPENSE DEPREC.IATtON AMORT'IZATION PASS THROUGH GRANT EXPENSES EXC.ESS OF REVENUES OVER IEXPIONSES NET ASSETS- BEGINNING OF YEAR, RESTI NET ASSETS - END OF YEAR INTHE COURT OF COMMON PLEAS Harr OF DAUPHIN COUNTY said I CIVILACTION.LAW 12,21 ACTION OF Adm MORTGAGE FORECLOSURE ers ~ NO.2007-CV-G26I1-MF Sfret DEUTSCHE BANK NATIDNAL the a TRUST COMPANY, AS TRUSTEE FOR taInt LONG BEACH MORTGAGll.OAN AL T TRUST 2006-Wu, N51 Corbin Avenue, FOR Northrldge, CA 91324. PlaIntiff VI. LOAI DAVID LANDAU, MOrf\lagar' and Re . cord OWner, 4493 LakHldI'Drlve, Har _ YI rl.burg, PA 17110, D THIS LAW FIRM ISA EaT COLLEC TOI TOR AND WE ARE AlTlPrING TO, take' -COLLECT A DEBT. THIS N.OTJCE IS 1. 1 SENT TO YOU IN AN ATT'MPTTO to DE COLLECT A DEBT. ANY INFORMA -TRUS TIONOBTAINED FROM Y()U WIL-L LON( BE USED FOR THAT PURPOSE. \ TRUS '" NOTIC~ F SHERIF~. SALE" lattc! OF EAL PROPE, " neY!I' TO: LAN ~1iI, DAVID,. LakHldIt mU'~1 Drive, Harr urg, PA lnt~~l 1~ Your house at 4493 LakHIllI' Drive, 2. 'V / J'" r L1 d 'i. C> t:i a: I'""-~ <I. O;~;; ~~ tr,_ c..:J=' .~ .eg C.~~~_I""'::J 1'""-0 a."UDC::''J~ -f:A-g V;Cl_~ ;Z'~ --'; ~ ,~ - a: :I: 2001 -...}....: , __\ i yJl .. .....J '1111~~1 ERK OC Cl ~ ,,(\ ry'; !qT 0(')1""-11. . I , curv' --- --- ---- ===M ~=== ~ --=-1"- ~~-== - ---- ---- -=== ==== -- ~rll ~ ..,,~ - - - - -. - -. - o U"tf ICe..... "Ii: . r-. <<; :E~:I: ., . ~ ~ ~ ~ ~~ ~ '-.I &.> ~ ~ ~~~. ~ ~ ~ "3" '" ~ ~ ~ ~ ~~ ~ ~ ~~" ~ ~~ ~,~ ~~~~ ~~~ '" ~ I , l I