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Home My WebLink About09-11-07 -I 15[]5b[]41147 REV-1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes PO BOX.280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY '*' County Code Year File Number INHERITANCE TAX RETURN RESIDENT DECEDENT 2 1 0 7 0193 Date of Birth 201162212 02232007 09101926 Decedent's Last Name Suffix Decedent's First Name WISER, JR. CARL MI A (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix 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 ~ 1. Original Retum D 2. Supplemental Retum D 4. Limited Estate D 4a. Future Interest Compromise (date of death after 12-12-82) [KJ 6 Decedent Died Testate D 7. Decedent Maintained a living Trust (Attach Copy of Will) (Attach Copy of Trust) D 9 Litigation Proceeds Received D 10 Spousal Poverty Credit (date of death . between 12-31-91 and 1-1-95) -----, I ------' 3. Remainder Retum (date of death prior to 12-13-82) 5. Federal Estate Tax Retum Required D o 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number RICHARD L. WEBBER, JR. ESQUIRE 7175327388 Firm Name (If Applicable) WEIGLE & ASSOCIATES, P.C. \, .J .-.--:"' REGISTER 0F\IVI~LS USE-eNL Y .::,.., ~j':' ',J 'r First line of address 126 EAST KING STREET Second line of address City or Post Office DA 1E FILED c.) SHIPPENSBURG State PA ZIP Code 17257 Correspondent's e-mail address:weigleattywebber@earthlink.net Under penalties of perjury, I declare that I 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 infonmation of which preparer has any knowledge. SIGNATURE OF PERSON RESPO~BLE FOR Fill G RETURN DATE , , ~'- ... 'r- '- Susan L. leech "0) i\) ~Yl 303 Hammond Road, Shippensburg, PA 17257 SIGNATURE OF PREPARER OTHER THAN REPRESE A TIVE / .)~ (l C",-_ Richard L. Webber, Jr. Esquire DATE Cj(,CICf ADDRESS 126 East King Street, Shippensburg, PA 17257 Side 1 L 15[]5bD41147 15[]5b[]41147 -I . Rev-1508'EX+ ,6-98) *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RElURN RESIDENT DECEDENT ESTATE OF Wiser, Jr., Carl A. FILE NUMBER 21-07-0193 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 VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 F&M Trust Checking Account #33-64380 9.989.87 Accrued interest on Item 1 through date of death 0.57 2 F&M Trust Money Market #70-91915 116.410.80 Accrued interest on Item 2 through date of death 91.63 3 M&T Bank #9838027325 - Checking Account 688.04 Accrued interest on Item 3 through date of death 0.05 4 Mrs. Wiser - Account receivable 350.00 5 Orrstown Bank Savings Account #33874 810.72 6 Orrstown Bank Savings Account #33874 - Accrued Interest 0.54 TOTAL (Also enter on Line 5, Recapitulation) 128.342.22 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) REV-1151 EX+ 112-99) *' SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Wiser, Jr., Carl A. Debts of decedent must be reported on Schedule I. FILE NUMBER 21-07-0193 ITEM NUMBER A. FUNERAL EXPENSES: DESCRIPTION AMOUNT See continuation schedule(s) attached 1,888.32 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Susan L. leech Social Security Number{s) I EIN Number of Personal Representative(s): Street Address 303 Hammond Road City Shippensburg State Year(s) Commission paid 2007 PA Zip 17257 6,133.69 2. Attorney's Fees 6,133.69 See continuation schedule(s) attached 3. Family Exemption: (If decedent's address is not the same as daimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent State Zip 4. Probate Fees 306.00 See continuation schedule(s) attached 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 460.50 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 14,922.20 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1502 'EX+ (6-98) SCHEDULE H.A FUNERAL EXPENSES continued COMMONVVEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Wiser, Jr., Carl A. FILE NUMBER 21-07-0193 ITEM NUMBER DESCRIPTION AMOUNT 1 Hollinger Funeral Home & Crematory, Inc. 1.467.50 2 Photo Expressions by Terry L. Blain - Funeral Brochure 420.82 Subtotal 1.888.32 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 6-98) Rev-1502' EX+ (6-98) . SCHEDULE H.82 ATTORNEY'S FEES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Wiser, Jr., Carl A. FILE NUMBER 21-07-0193 ITEM NUMBER DESCRIPTION 1 Weigle & Associates, P.C. AMOUNT 6.133.69 Subtotal 6.133.69 Copyright (c) 2002 form software only The Lackner Group, Inc, Form PA-1500 Schedule H-B2 (Rev. 6-98) Rev-15m! EX+ (6-98) SCHEDULE H.B4 PROBATE FEES continued COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Wiser, Jr., Carl A. FILE NUMBER 21-07-0193 ITEM NUMBER DESCRIPTION AMOUNT 1 Cumberland County Register of Wills - Petition Letters Testamentary, Will, Short Certificate, JCP Fee, Automation Fee 306.00 Subtotal 306.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B4 (Rev. 6-98) Rev-1502 EX+ (6-98) SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Wiser, Jr., Carl A. FILE NUMBER 21-07-0193 ITEM NUMBER DESCRIPTION AMOUNT 1 Cumberland County Register of Wills - Filing fee for Inheritance Tax Return 15.00 2 Cumberland County Register of Wills - Reserve for Filing of First and Final Accounting 200.00 3 Cumberland Law Journal - Legal Advertisement 75.00 4 Magisterial District 09-3-02 - Filing fee for accounts receivable 77.00 5 The News Chronicle - Legal Advertisement 93.50 Subtotal 460.50 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Rev-1512 EX+ (6-98) . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Wiser, Jr., Carl A. FILE NUMBER 21-07-0193 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1 Baxter Drew Wellmon, DO VALUE AT DATE OF DEATH 82.23 2 Baxter Drew Wellmon, M.D. 158.60 3 Embarq 18.81 4 Embarq 21.65 5 G.H. Harris - Township and School District tax 29.00 6 Helping Hands 800.00 7 Millennium Pharmacy Systems, Inc. 34.52 8 Nursing Home 3.095.00 9 Physician Services 4.56 TOTAL (Also enter on Line 10, Recapitulation) 4,244.37 (If mDre space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) REV-1513 EX+ '(9'{)O) *' SCHEDULE .. BENEFICIARIES ESTATE OF COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT NUMBER I. 1 2 3 4 5 Wiser, Jr., Carl A. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] Calvin Eugene Wiser 402 S. Penn Street Shippensburg, PA 17257 FILE NUMBER 21-07-0193 RELATIONSHIP TO DECEDENT Do Not List TrusteeCsl SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) Son Ten Thousand Dollars 10,000.00 Conrad Allen Wiser 2606 Lynnwood Drive Bellevue, NE 68123 Son Ten Thousand Dollars 10,000.00 Daniel Curtis Wiser 1100 Green Spring Road Newville, P A 17241 Son Ten Thousand Dollars 10,000.00 Douglas Ethan Wiser 1838 Ritner Highway Shippensburg, PA 17257 Son Ten Thousand Dollars 10,000.00 Stephen Lee Wiser 516 Middle Road Newville, PA 17241 Son Ten Thousand Dollars 10,000.00 Total Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet 50,000.00 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 See continuation schedule(s) attached 59,175.65 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 59,175.65 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) Rev-1502 EX + 16-98) SCHEDULE .I-liB CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Wiser, Jr., Carl A. FILE NUMBER 21-07-0193 ITEM NUMBER DESCRIPTION AMOUNT 1 Susan L. Leech, Trustee - For Educational Trust 59.175.65 Subtotal 59.175.65 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J-IIB (Rev. 6-98) ~~. \ C) -, D\C(~ .-:---~---------'-.-,.----.--,._-~'--'~~,..~......-.~..._-_.......----.~_...-.~--....--....,.,...~.--,..-.,.,....,...,...,.......~---....~'-~._----~~-----~------_._- .-....................._~._~-- LAST WILL AND TESTAMENT OF CARL A. WISER, JR., A/KIA CARL A. WISER I, CARL A. WISER, JR., a/kla CARL A. WISER, on03 Hammond Road, Shi~nsburg, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, . do make, publish and declare this to be my Last Will and Testament, hereby revoking and making void all previous Wills and Codicils heretofore made by me. 1 I hereby direct that I be cremated at my death. My ashes shall be given to SUSAN L. LEECH. 2 I order and direct my personal representative hereinafter named to pay all of my just debts, funeral and cremation expenses and expenses involved or connected with the administration of my estate as soon after my death as is reasonably possible. However, my personal representative need not accelerate and pay those unmatured obligations which, in his, her or its opinion, it might be proper and more advantageous to retain or renew and pay as they become due and payable. 3 I direct that the rest, residue and remainder of my estate, together with all insurance proceeds thereon of whatever nature and wheresoever situate be liquidated and my personalty sold at public sale and the proceeds distributed as follows: ,~ A. The sum of Ten Thousand ($10,000.00) Dollars to my son, STEPHEN LEE WISER; 1 ----.-.,.--:'-..,.~~-~.~~~~~~.~~,.. "'. .~-;;,'~'."~:,_:':~~~~r, "';-'''''. :~.~':~_~_':~~-":";'~':-<::':.C,\ "-.' ~",;.:"""",,. LAST WILL AND TESTAMENT OF CARL A. WISER, JR., a/k/a CARL A. WISER B. The sum of Ten Thousand ($10,000.00) Dollars to my son, DOUGLAS ETHAN \VISER; C. The sum of Ten Thousand ($10,000.00) Dollars to my son, CONRill ALLEN WISER; D. The sum of Ten Thousand ($10,000.00) Dollars to my son, CALVIN EUGENE WISER; E. The sum of Ten Thousand ($10,000.00) Dollars to my son, DANIEL CURTIS WISER; F. The remainder of my estate shall be placed IN TRUST for scholarships, pursuant to the provisions set forth in Paragraph 4 below; and G. The distribution in subparagraphs A thru F above shall be on a per capita distribution basis. 4 The share of my estate that is distributed pursuant to Paragraph 3(F) above shall be placed IN TRUST with SUSANL. LEECH as TRUSTEE, upon the following terms and conditions: A. The annual interest only from the Trust shall be used for scholarships of One Thousand c ($1,000.00) Dollars per person per school year for graduates of Shippensburg Area High School, to be used for post-secondary education tuition while said graduate is enrolled in full-time studies. B. An applicant shall be eligible for a max:imum of two scholarships. C. The scholarships shall be awarded in the spring and paid directly to the post-secondary school by the TRUSTEE. D. Scholarships of Two Hundred Fifty ($250.00) Dollars or Five Hundred ($500.00) Dollars may be given by my TRUSTEE if there is remaining interest from the TRUST not already distributed. 2 r ......~~~~-,--,..~;'c'" -- . ------- ~'11~~:::, ~~-~-;'-~I- ~~_ ,,-- LAST WILL AL'ID TESTAMENT OF CARL A. WISER, JR., a/k/a CARL A. WISER E. A scholarship applicant must maintain a grade point average of 2.5 in the first year of college to be eligible for a scholarship renewal. F. If SUSAN L. LEECH is unable to serve as Trustee, I appoint FARMERS AND MERCHANTS TRUST COMPANY as substitute Trustee. G. My TRUSTEE shall have the absolute discretion in administering the TRUST. 5 I grant my personal representative the following powers in addition to and not in limitation of such powers as my personal representative shall hold by law: c: (a) To retain all property received including the stock of any corporate fiduciary acting hereunder, provided such property remains productive. To join in any corporation, partnership, recapitalization, merger, reorganization or voting trust plan; to delegate authority with respect thereto; to deposit investments under agreements and pay assessments; and generally to exercise all rights of investors, including but not limited to, the voting of shares. To manage, operate, repair, improve, mortgage or lease on any terms any real estate held or owned by my estate. To operate any business that I may own at my death. To invest any funds of my estate in any stocks, bonds, notes or other securities or property, real or personal, without regard to the principle of diversification or any other statute or general rule of law in his, her or its absolute discretion, it being my intention to give my personal representative the broadest investment powers possible, providing such investments do not unnecessarily prevent the prompt settlement of my estate. To sell or otherwise dispose of any property, real or personal, tangible or intangible, at any time forming a part of my estate in any manner and on such terms and (b) (c) (d) (e) (f) 3 h~"'~-~-""" LAST WILL AND TESTAMENT OF CARl A. WISER, JR., a/kJa CARL A. WISER 6 No interest of any beneficiary of my estate, either in income or in principal, shall be subject to anticipation or pledge, assignment, sale or transfer in any manner, nor shall any beneficiary have the power in any manner to charge or encumber his interest either in income or principal, nor shall the interest of any beneficiary be liable or subject in any manner while in the possession of my personal representative for the liability of such beneficiary. 4 -- '. ~,,:,'..,-~,~,; ~,~" LAST WILL AND TESTAMENT OF CARL A. WISER, JR., a/k/a CARL A. WISER 7 I nominate, constitute and appoint SUSAN L. LEECH, as Executrix of this my Last Will and Testament. In the event she is deceased, unable or unwilling to serve or shall cease to serve for any reason whatsoever, then I nominate, constitute and appoint FARMERS AND MERCHANTS TRUST COMPANY as personal representative ofthis my Last Will and Testament. I direct that my personal representative shall not be required to give or post bond for the faithful performance of his, her or its duties in this or any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand to this my Last Will and Testament this eX '7~ day of JhL~ r , 2001 WITNESS: v--...'J /L --..--,.vt--{ ~~f#z Carl A. Wiser, Jr. . a!kJ~~~~ trj~.G1~ 5 - ~-- LAST WILL AND TESTANIENT OF CARL A. WISER, JR, a/k/a CARL A. WISER ACKNOWLEDGMENT COMMONWEAL TH OF PENNSYL VANIA COUNTY OF CUMBERLAND SS. I, CARL A. WISER, JR., a/k/a CARL A. WISER, Testator whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly, and that I signed it as my free and voluntary act for the purposes therein expressed. ~~. Car - A~ . Iser, Jr. . g~t#.~ a/kla rl A. Wiser Sworn or affirmed and acknowledged before me by CARL A. WISER, JR, a/k/a CARL A. WISER, the Testator, this ;} 76 day of JA.<--<AA-4r ,200l. o ~ C iiJ-...AtJl_. ~c-. vy~ Notarial Seal Terry E. Walker, Notary Public South Middleton Twp., Cumbertand County My Commission Expires Mar. 31, 2003 Member, PsnnSVll/anj;:;l\ssociation of Notaries , ':1 \ It 6 r'-:-~~~;;I~~ AND TESTAMENT OF CARL A WISER, JR., alkJa CARL A WISER AFFIDA VIT ..---~~---.---~~ COMMONWEAL TH OF PENNSYL VANIA COUNTY OF CUMBERLAND WE, (1-,', L,c~/ L. G,__d..Uc:r>);-.and SS. witnesses whose names are attached to the foregoing document, being duly qualified according to /h~ fr]. Pff..LZ- I , the law, do depose and say that we were present and saw CARL A. WISER, JR., a/kla CARL A. WISER sign and execute the instrument as his Will and Testament; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the CARL A. WISER, JR., a/kla CARL A. WISER signed the Last Will and Testament as witnesses and that to the best of our knowledge the CARL A. WISER, JR., a/kla CARL A. WISER was at the time 18 br more years of age, of sound mind and under no constraint or undue influence. -'7..Y L1 <---/4 ~ tri '/tQ~ Sworn or affirmed and subscribed before me ~y J</~tVl.d /.. wL6~....h , and /YlCc/L1 In . rrl'u- this ~7!h day of Jlu('~ r- ,2001. C) sc,~ Notarial Seal Terry E. Walker, Notary Public South Middleton Twp.. Cumberland County My Commission Expires Mar. 31, 2003 Member. PennSVIV8f112 ASSociation of Notaries F:\User Folder\Firm Docs\WiIIs\1679-2caw.will.wpd 7 ~-'-'-~'~----"-'-"'.:-~"'~~~~"""'-c-:_,~~~_~,~_,~_"_,,, ORRSTOWNBANK A Tradition of Excellence March 8, 2007 To: Weigle & Associates, P.C. 126 East King Street Shippensburg Pa 17257 77 East King Street P.O. Box 250 Shippensburg, PA 17257 MAR - ,[ 2007 From: Traci Shaffer Orrstown Bank Customer Service Center PO BOX 250 Shippensburg, Pa 17257 Re: Estate of Carl A Wiser, Jr Date of death February 23, 2007 IT IS HERERBY CERTIFIED THAT THE ABOVE NAMED DECEDENT, ON THE ABOVE DATE, HAD THE FOLLOWING ACCOUNTS WITH ORRSTOWN BANK. CHECKING ACCOUNT Account # Title of Account Date opened Principle Accrued Interest SA VINGS ACCOUNT Account # Title of Account 33874 Carl A Wiser Jr Date opened Principle 7/14/95 810.72 Accrued Interest 0.54 CERTIFICATE OF DEPOSIT Account # Title of Account Date Opened Principle Accrued Interest , J Ie, '.,' , r' , " ..www.orrstown.com www.fmtrustmlHne.com Date of Death Valuations Customer Name: Carl A Wiser Jr Date of Death: 02/23/07 Acct Type Account Number aDen Date Close Date Balance Accrued Int Total Balance Account Owners checkina 33.64380 05/06/1999 still open $ 9,989.87 $ 0.57 $ 9,990.44 Carl A Wiser Jr, Individually ~_Milrket 70-91915 04/03/2006 stili ODen $ 116,410.80 $ 91.63 $ 116,502.43 Carl A Wiser Jr, Individually -- 717-264-6116 888-264-6116 P.O. Box 6010 Chambersburg, PA 17201-6010 FIN A N C I A L SOL UTI 0 N S... FRO M P EO P LEY 0 U K NOW f:! M&rBank 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 MAR 1 '~ 2001 Phone (888) 502-4349 Fax (302) 934-2955 March 16, 2007 Weigles & Associates PC Attorneys At Law 126 East King Street Shippensburg, Pennsylvania 1257-1397 Re: Estate of" Carl A Wiser Jr Social Securitv: 201-16-2212 Date of Death: February 23. 2007 Dear Sir or Madam: Per your inquiry dated March 2,2007, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Account Account Number 9838027325 Ownership (Names of) Carl A Wiser Jr * Opening Date 01/31/05 Closed 03/02/07 Balance on Date of Death $688.04 Accrued 1nterest $ 0.05 Total $688.09 Please be advised, there was no safe deposit box found for the above decedent. * For further account information, regarding ownership, closures and/or reimbursement of funds, etc., please call the Walnut Bottom Office # 717-532-2414. Sincerely, Nancy Clagett Records Management www.fmtrustonUn~.com ~ ~~Q1 \J!JlR ~. March 7,2007 Weigle & Associates PC Attorneys-at-Law 126 EKing St Shippensburg PA 17257 RE: Carl A Wiser Jr Mr. Webber: In reference to the above customer, our records show the enclosed information to be accurate as of February 23,2007. If I may be of any further assistance, please contact me. Sincerely, J((l\.QiLU S. tDClL0 Karen E Davis A VP, Deposit Operations 717-264-6116 888-264-6116 P.O. Box 6010 Chambersburg, PA 17201-6010 FINANCIAL SOLUTIONS... FROM PEOPLE YOU KNOW HoIIin~er Funeral Home & Crematory. Ine. Eric L. HoIIin~er, Supervisor March 7, 2007 Susan L. Leech 303 Hammond Drive Shippensburg, PA 17257- The Funeral Service for Carl A. Wiser Jr. 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 ITEMlZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT, AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS. 1. PROFESSIONAL SERVICES FUNERALHOMESER~CECHARGES THE COST OF OUR SER~CES, EQUIPMENT, AND MERCHANDISE THATYOUHAVESELECTED _ , , , , , , , . . . _ . 1170.00 1170.00 Cremation Package A. , . , . . . . , . . 1170.00 Cash Advances Newspaper Notices - Sentinel , . . , . Newspaper Notices - Chambersburg Public Opinion Certified Copies of the Death Certificate. . , . Coroner's Authorization: . _ .. . . . . . TOTALCASHADVANCESANDSPECIALCHARGES. 87.50 125.00 60.00 25.00 297.50 Total Total Cost TOTAL AMOUNT DUE 1467.50 1467.50 50] NORTH BALTIMORE AvENUE. MOUNT HOLLY SPRINGS. PENNSYLvANIA] 7065. (7] 7) 486-3433. FAX (7] 7) 4860<52.]5 www.hoIIinl2erfuneraIhome.com