HomeMy WebLinkAbout09-13-07
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15056041125
REV-1500 EX (06-05)
PA Department of Revenue ..
BUl98uoflndividualTaxes INHERITANCE TAX RETURN
PO BOX 280601
Harrisbuta, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
OFFICIAL USE ONLY
County Code Year
2 1 0 6
File Number
110 8
Date of Birth
195 - 3 8 - 7 9
1 1 1 7 2 0 0 6
o 3 1 0 1 9 4 8
Decedent's Last Name
Suffix
Decedent's First Name
L U S H
TIM 0 THY
MI
o
(If Applicable) Enter Surviving Spouse's Infonnation Below
Spouse's Last Name Suffix
L U S H
J A NET
MI
K
Spouse's First Name
Spouse's Social Security Number
187 - 4 4 - 7 5
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
00 1. Original Retum
o 4. Limited Estate
o
o
o 2. Supplemental Return
o 4a. Future Interest Compromise (date of
death after 12-12-82)
o 7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
o 10. Spousal Poverty Credit (date of death 0 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. 0)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULq ~ DIRECTED TO:
Name Daytime Tel~l)one Numbet' .,;
.,--- ....-.1
7172;='49 QJ780
:' 1 I
\J .
o
o
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
8. Total Number of Safe Deposit Boxes
S USA N
J .
HARTMAN
Firm Name (If Applicable)
-r;
DUNCAN
&
HARTMAN,
P . C .
REGISTER oF WILLS URONL Y
",' .:-: --_:} c....)
(._' ,--,,'-
First line of address
"-..-'
. I-I
1
I R V I N E
ROW
,
=.:':j
f....:)
Second line of address
l")
<:..n
City or Post Office
State
ZIP Code
DATE FILED
CARLISLE
P A
17013
Correspondent's e-mail address:susanhartman@planetcable.net
Under penalties of perjury, I declare that I have examined this return, induding accompanying schedules and statemenls, 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 F PERSON RESPONSIBLE FOR FILING RETU N DATE
CARLISLE
PA 17013
DATE
(1LuJJ.J~~O. tJA. 110/3
PLEASE USE ORIGINAL FORM ONLY
Side 1
L
15056041125
15056041125
--.J
c;
--.J
15056042126
REV-1500 EX
DecedenfsName: TIMOTHY D. LUSH
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) 0 Separate Billing Requested . . . . . .. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) 0 Separate Billing Requested. . . . . .. 7.
8. Total Gross Assets (total Lines 1-7)
........................... 8.
9. Funeral Expenses & Administrative Costs (Schedule H) . . . . . . . . . . . . . . .. 9.
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . 10.
11. Total Deductions (total Lines 9 & 10)
. . . . . . . . . . . . . . . . . . . . . . . . . . . 11.
12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . 12.
13. Charitable and Govemmental Bequests/See 9113 Trusts for which
an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . 13.
14. Net Value Subject to Tax (Line 12 minus Line 13)
. ..... . . . .... . . . . . 14.
-44998.55
TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X.O _
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
-44998.55
15.
o . 0 0
16.
o . 0 0
17.
o . 0 0
18.
19. Tax Due
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
L
15056042126
Decedent's Social Security Number
195 -3 8-79
3831.12
3 8 3 1 . 1 2
4 0 5 9. 0 0
4 4 7 7 O. 6 7
4 8 8 2 9. 6 7
- 4 4 9 9 8. 5 5
o. 0 0
O. 0 0
O. 0 0
O. 0 0
O. 0 0
o
15056042126
--.J
REV-1500 EX Page 3
Decedent's Complete Address:
File Number
21 06 1108
DECEDENrs NAME
TIMOTHY D. LUSH
STREET ADDRESS
75 RUSSELL DRIVE
CITY I STATE I ZIP
CARLISLE PA 17013
Tax Payments and Credits:
1. Tax Due (Page 2 Une 19) (1)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
0.00
Total Credits (A + 8 + C) (2)
0.00
3. InterestIPenalty it applicable
D. Interest
E. Penalty
TotallnterestlPenalty ( D + E) (3)
4. If Une 2 is greater than Line 1 + Une 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Une 20 to request a refund. (4)
5. If Une 1 + Une 3 is greater than Une 2, enter the difference. This is the TAX DUE. (5)
0.00
0.00
0.00
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(5A)
(58)
A. Enter the interest on the tax due.
0.00
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ...................................................................... 0 00
b. retain the right to designate who shall use the property transferred or its income; ............................... 0 00
c. retain a reversionary interest; or ................................................................................................ 0 00
d. receive the promise for lite of either payments, benefits or care? ....................................................... 0 00
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... 0 00
3. Did decedent own an 'in trust for" or payable upon death bank account or security at his or her death? ......... 0 00
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .................................................................................................. 0 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.
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 (0) 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 retum are still applicable even it 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~ 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 (0) percent [72 P.S. ~9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedenfs lineal beneficiaries is four and one-half (4.5) percent, except as noted in
72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1 )].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 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.
REV-1508 EX + (6-98)
'W
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
TIMOTHY D. LUSH
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
21 06 1108
Include the proceeds of litigation and the date the proceeds were received by the estate,
AR property jolnIIy-owned with right of survlvOl'Ship must be disc:losed on Sc:hedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. PROCEEDS OF CITIZENS BANK ACCOUNT 871.51
2. PROCEEDS OF BENEFICIAL ACCOUNT 648.00
3. PROCEEDS OF M&T ACCOUNT 1,561.61
4. SALE OF 1979 CHEVROLET TRUCK 250.00
5. SALE OF 1989 FORD TRUCK 500.00
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheels of the same size)
3831.12
REV-1511 EX + (12-99)
'w
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
TIMOTHY D. LUSH
FILE NUMBER
21 06 1108
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. HOFFMAN-ROTH FUNERAL HOME 2,199.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of PeISOnal Representative (s)
Social Security Numbe!(s)/EIN Number of PeISOnal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. AtlDmeyFees DUNCAN & HARTMAN, P.C. 1,500.00
3. Family Exemption: (If decedenfs address is not the same as claimants, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. ProbateFees REGISTER OF WILLS FILING FEE 63.00
5. Accountants Fees
6. Tax Return Preparel's Fees
7. CUMBERLAND LAW JOURNAL LEGAL AD 75.00
8. THE NEWS-CHRONICLE CO. LEGAL AD 77.00
9. FILING FEES ORPHANS COURT 145.00
TOTAL (Also enter on line 9, Recapitulation) $ 4 059.00
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX + (12-03)
*'
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
TIMOTHY D. LUSH
FILE NUMBER
21 06 1108
Report debts Incurred by the decedent prior to death which remained unpaid as of the date of death, Including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. CITIZENS BANK - COMMERCIAL LOAN 32,491.29
2. CITIZENS BANK - LINE OF CREDIT 3,685.39
3. CITIZENS BANK - LINE OF CREDIT 3,952.55
4. SPRINT TELEPHONE BILL 276.11
5. RBS CREDIT CARD SERVICE 3,865.33
6. HOLY SPIRIT HOSPITAL BILL 500.00
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
44 770.67
"'-'~,,<X.*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
TIMOTHY D. LUSH
SCHEDULE J
BENEFICIARIES
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS pnclude outright spousal distributions, and transfers under
See. 9116 (a) (1.2)]
1. JANET K. LUSH Spousal
75 RUSSELL ROAD 100% SHARE
CARLISLE, PA 17013
ENTER DOLlAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
n. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART n - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
FILE NUMBER
21 06 1108
(If more space is needed, insert additional sheets of the same size)
00 0 04319H NH 017
14120
TIMOTHY D LUSH
75 RUSSELL RD
CARLISLE PA 17013-9534
INTEREST PA~D YEAR TO DATE
0.63
HIGH STREET-CARLISLE
...... . BEGINNING... .. ..... ....... DEPOSITS.,.,...,.
../......&~LAllleE<>....... .. ..............:'oTHERADDITIONS.
NO. AMOUNT
2 IJ486.75
473.89
ACCOUNT SUMMARY
...:,..,..'ITHDRAWALS,.....OTHfR.... . .............CURRENr>.. .......... .
....,..... .....,...<suatltACTIONS,.,: .:.....,<IJiitEREsT....PAm:....<.'.
NO . AI10UNT
2 400.00
0.29
ACCOUNT ACTIVITY
... POST. ... ..... . ..... .. .. .............. .......................:.........,.. .......... ..:........::.,...........:.........: DEPOSIT$~'INTEResT.
'..)DAtE> .......: .......:.,.,.........'..<fR.N:SActION1)E:StRlpHOif ,.:.<.:::<":COTHEil:ADnnloNS
09-30-06 BEGINNING BALANCE
10-02-06 DEPOSIT
10-02-06 I1&T ATH CASH WITHDRAWAL ON 09/29
SPRING GARDJI00 S SPRING GARDEN STJCARLISLEJPA
10-10-06 DEPOSIT
10-10-06 I1&T ATH CASH WITHDRAWAL ON 10/06
SPRING GARDJI00 S SPRING GARDEN ST,CARLISLE,PA
10-30-06 INTEREST PAYI1ENT
917.54
200.00
569.21
200.00
0.29
ENDING BALANCE
ANNUAL PERCENTAGE YI~LD EARNED = 0.24 %
ENJOY THE FLEXIBILITY OF LOCKING IN FIXED-RATE LOANS WITHIN A LINE OF .
WITH I1&T CHOICEQUITYJ YOU GET THE ABILITY TO LOCK IN A LOAN WITH A G~E
RATEJ AS WELL AS A LINE OF CREDIT - ALL IN ONE ACCOUNT. HOW'S THAT
FLEXIBILITY? BEST OF ALLJ YOU DECIDE THE REPAYI1ENT SCHEDULE THAT F
BUDGET. SO WHY WAIT? START ENJOYING THE FLEXIBILITY OF H&T CHOICE
TO APPLYJ STOP BY ANY H&T BRANCHJ VISIT WWW.I1ANDTBANK.COI1J OR CAL~
TELEPHONE BANKING CENTER AT 1-866-236-1219.
L008A (1/03)
IIHi8 28 ~ 2... b? ~1I11:0 2 ~OO ~0881: 11100 ~8 L. b ~ ~ bill
(;----------------.-----.------------.------___-c.________________,..___.._________.___________________._-'___...;..,..__________
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I ^ Beneficiar P.O. Box 8639 I
I _1ISBC~&ooup Elmhurst,lL 60126 I
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02/28/07
Dear Customer:
(~ .
)
Attached is your loan proceeds cl,teck. Thank you for choosing HFC.
Ifwe can be of further assistance, ple~"se contact us at 1-(800)365-8389.
~p.:
l
S-S H t20 C/w LJ r
Hoffman-Roth Funeral Home & Crematory, Inc.
219 North Hanover Street
Carlisle, PA 17013
(717)243-4511
December 20, 2006
Janet Lush
75 Russell Rd.
Carlisle, P A 17015
The Funeral Service for Timothy Dale Lush
14899-218
We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please
feel free to contact us if you have any questions in regard to this statement.
THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT,
AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS.
(A) OUR SERVICE:
CREMATION PACKAGE #5. . . . . . . .
FUNERAL HOME SERVICE CHARGES
$1490.00
$1490.00
THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE
THAT YOU HAVE SELECTED . . . . . . . . . . . . .
$1490.00
Cash Advances
Newpaper Obituary Notice-Patriot News.
Newspaper Obituary Notice-Sentinel .
Certified Copies of Death Certificates. .
Coroner Authorization Cremation Fee. .
TOTAL CASH ADVANCES AND SPECIAL CHARGES.
$383.80
$240.20
$60.00
$25.00
$709.00
~...
Total
Total Cost .
$2199.00
TOTAL AMOUNT DUE
$2199.00 )
1>" AJ I 0 1
is statement is net and payable in full within 30 days of receipt.
~- - - - -. ... _........ - _.. - - _.... -.".i"':- _",,,,,,, ___ - -....- - - -....,,,,,,,,, -", - - II""' - -.
~~ Citizens Bank
PO BOX 18204
BRIDGEPORT, CT 06601-3204
111'11I.1.11.1...1..111...1.1...11...11'111.1.11...11...1.1..1
Account Number
Payment Due Date
4798153251028655
DEe 17,2006
$73.71
$3,685.39
Amount Due
It
PO BOX 9665
PROVIDENCE, RI 02940-9665
New Balance
Amount Enclosed 1$
111.111"1111""1111.1.1.1.111.1.111111..1..1111.1.1.1...11.1
TIMOTHY D LUSH
LIBERTY MILLWORKS
75 RUSSELL RD
CARLISLE PA 17015-9534
For proper credil, please mail payments to address at Jeft.
Payments received at any other location may delay crediting
your account up to five days.
P000181
4798153251028655
000007371
000368539
-...---...---....--....-....--.-.-.--..-....--..--..-...--...--.-....--.-.............-...-.......--....-------....-....----..-...---..
Please detach and return with your payment
~~ Citizens Bank
Account Summary For:
TIMOTHY D LUSH
LIBERTY MILLWORKS
75 RUSSELL RD
CARLISLE PA 17015-9534
Account Information:
Account Number: 4798153251028655
Total Credit Line: $5,000
Available Credit: $1,315
Days In Billing Cycle: 31
Billing Information:
Statement Date:
Payment Due date:
Amount Due:
Past Due Amount:
Disputed amount:
NOV 22, 2006
DEC 17, 2006
$73.71
$0.00
$0.00
To report card lost or stolen, call 1-877 -593-3878
For 24-hour customer service, call 1-800-862-6200
Send billing inquiries to: COMMERCIAL CARD PO BOX 18290 BRIDGEPORT, CT 06601-8290
Average Daily Monthly Corresponding Annual Periodic
Balance Periodic Rate Percentage Rate Finance Charge
PURCHASES $3,837.23 0.9583% 1 1.50% $36.77
CASH $0.00 0.9583% 1 1.50% $0.00
FEES $0.00 0.0000% 0.00% $0.00
PERIODIC RATE MAY VARY
PLEASE REFER TO YOUR CARDHOLDER AGREEMENT
Post Tran
Date Date Reference Number Transaction Description Amount
11-08 11-06 74864646312000369470029 Payment Received Thankyou 500.00 CR
11-16 11-15 24692166319000072970476 TWX'AOL SERVICE 1106 800-827-6364 NY 25.90
11-22 11-22 PURCHASE 'FINANCE CHARGE' 36.77
Member FDIC
Page 1 of 2
419 VILLAGE DRIVE
CARLISLE PA 17013
ft Beneficiar
Member HSBC ID Group
Statement of Your Account
Payment
Coupon
711715-20-508733-4
1;3,818;41
09/20/06
10/14/06
649.00
1.111111111111111111111.1.1.111.1.11..11111111..11111.1.111.11
TI MOTHY D LUSH
75 RUSSELL RD
CARLISLE PA 17015-9534
Mail Payment To:
111.1.111..11111111.1.11.11.1.1111111111.11111.111111111111111
BENEFICIAL FINANCE
POST OFFICE BOX 4153-K
CAROL STREAM IL 60197-4153
1.1111111.1111111.111111111111111.1111.1...111111111
0920011632
o
3000649007117152050873340013818412
For Assistance:
419 VILLAGE DRIVE
CARLISLE PA 17013
717-249-1515
Your Credit Line is $ 14,750.00
Your Available Credit is $ 931.00
\
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\, !,t;;',
Account Summary
v')
!
Life Insurance
,00
Tolal'lnsurance
.00
If HN/AH appears, N/A means not applicable
Account Detail Since Last Statement
Transaction Date
09/20/06
09/20/06
09/20/06
Posting Date
09/20/06
09/20/06
09/20/06
Transaction Description
LIFE INSURANCE CHARGE
A & H INSURANCE CHARGE
ANNUAL FEE
Transaction Amount
9.68
21.75
50.00
To evaluate and maintain the quality of our service to you, you
permit us to listen to and/or record telephone calls between you
and our representative.
You may request a credit line reduction or cancellation at any
time during the life of this loan. Contact us at 1-800-564-779"1
or visit our website at www.Beneficial.com/creditline for
additional information.
YOUR MINIMUM PAYMENT INCLUDES A $321.00 PAST DUE AMOUNT
WHICH WE REQUEST YOU PAY PROMPTLY. IF YOU ARE UNABLE TO MAKE
YOUR PAYMENT, PLEASE CONTACT A SERVICE REPRESENTATIVE AT THE
NUMBER LISTED ON YOUR STATEMENT.
Want a convenient way to make your payment? Just call
1-866-PAY-2DAY (1-866-729-2329) or pay online at
Average
Daily
Balance
$ 13.175,10
Monthly
Periodic Rate
2,000%
ANNUAL
PERCENTAGE RATE
24000%
CURRENT
FINANCE CHARGE
$ 263,50
Page 1 of 2
'New Balance mayor may not include interest accrued since the billing date, If you have questions on this billing, please call Customer
Service at 717-249.1515, Written inquiries about billing errors or questions a~d any nonpayment correspondence, including instructions on
how to request a credit line reduclion, cancellation. or reinstatement, should be addressed to Beneficial Cuslomer Service, 419 VILLAGE
DRIVE. CARLISLE PA 17013, Please include your name, address. and aCClJur t number on all correspondence, Mail payment to:
BENEFICIAL FINANCE, POST OFFICE BOX 41 53-K, CAROL STREAM IL 60197,
NOTE: PLEASE SEE REVERSE SIDE FOR IMPORTANT INFORMATION
DATE
"",.
~
LOAN STATEMENT
11-17-06
Page 1
$256.41
TOTAL AMOUNT DUE
Int Charged To Acct
$256.41
$256.41
9.25000
BALANCE FORWARD
32,491.29
2001 HARKEr ST
PHILAnELPHIA PA 19103
COMMERCIAL LOAN
Account 060-0001-8146225-0101
TIMOTHY LUSH DBA
LIBERTY MILL WORKS
t5RUSSELL RD
CARLISLE PA 17015
Interest
$0.00
DUE DATE 11-28-~6
MATURITY DATE -DEMAND-
Balance
TOTAL AMOUNT DUE
$32,491. 29
$256.41
Re~ittance Amount
RATE
11-28-06
Account Nunber 6100086577
Will Be Charged
$256.41 On 11-28-06
PAYMENTS AND ADVAN~ES MADE AFTER YOUR STATEMENT DATE WILL APPEAR ON
NEXT I1ONTH'SSTATEHENT. IF YOU HAVE ANY QUESTIONS PLEASE CALL YOUR
RELATIONSHIP MANAGER, OR 1-800-403-2736 WEEKDAYS FROM 8 AM TO 5 PM
AND A CUSTOMER SERVICE REPRESENTATIVE WILL BE HAPPY TO ASSIST YOU.
COMMERCIAL LOAN
Account 060-0001-8146225-0101
Payment Address:
P.O. Box 9799
Providence RI 02940-9799
Amount Due
Late Charge
TOTAL AMOUNT DUE
TIMOTHY LUSH DBA
LIBERTY MILL WORKS
75 RUSSELL RD
CARLISLE PA 17015
Additional Principal $
Additional Escrow $
Late Charges $
Other Amount Enclosed $
TOTAL AMOUNT ENCLOSED $
24 001060 0001 8146225 0101 0000000 0000000000 0000000000 0000
DUE DATE 11-28-06
$256.41
$0.00
$256.41
LINE OF CREDIT
STATEMENT
Page 1
Closing Date
NOVEMBER 27, 2006
060-00006007408675
5,000.00
1 , 047 .45
30
3,974.76
.03493150%
12.75%
41.65
3,952.55
79.88
0.00
0.00
79.88
Finance + Insurance +
Charge
41.65 0.00
Other
Charges
0.00
New Total
Balance
3,994.20
Check No.
Amount
100.00
Principal Balance
3,952.55
IF YOVHAVE ANY QUESTIONS ABOUT YOUR STATEMENT, PLEASE CALL OUR 24-HOUR
PHONEBANK AT 1-800-708-6680. THANK YOU FOR BANKING WITH CITIZENS.
NOT YOUR TYPICAL BANK.
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LINE OF CREDIT
Payment Address:
PO Box 42008
Providence RI 02940-2008
Account Number
Payment Due Date
Minimum Payment
060-00006007408675
12/17 /06
79.88
TIMOTHY D LUSH
75 RUSSELL ROAD
CARLISLE, PA 17013
Amount Enclosed
1$
01 060 00006007408675 000000000007988