HomeMy WebLinkAbout10-19-07 (2)
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15056041125
REV-1500 EX (06-05)
PA Department of Revenue '*
Bureau of Individual Taxes INHERITANCE TAX RETURN
PO BOX 280601
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
OFFICIAL USE ONLY
County Code Year
2 1 0 7
File Number
o 2 5 2
Date of Birth
204016166
03112007
11161921
Decedent's Last Name
Suffix
Decedent's First Name
S T R I N G F ELL 0 W
P A U L
MI
F
(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
[X] 1. Original Return
o 4. Limited Estate
[X]
o
4a. Future Interest Compromise (date of
death after 12-12-82)
7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
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 SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
o
o
o
o
8. Total Number of Safe Deposit Boxes
2. Supplemental Return
o
o
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
W ILL I A M
A .
DUN CAN
7172497780
Firm Name (If Applicable)
c,
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DUN CAN &
HARTMAN,
P . C .
REGISTER 9~, WILLS USE O!"l~ Y
First line of address
1 IRVINE
ROW
Second line of address
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City or Post Office
State
ZIP Code
: "'. '. . i
.OAT~ FILED r..; ~ .
....;> ..
CARLISLE
P A
17013
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Correspondent's e-mail address:billduncan@planetcable.net
Under penalties of pe~ury, I declare that I have examined this retum, including accompany~ng schedules and stateme.nts, 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 alllnfonnalion of which preparer has any knowledge.
SIGf'iATYfE OF ~ERSON RE PONSIBL F FILING RETURN DATE
/11~' " , 6, 0-
ADDRESS
1017 SANDY SPRINGS ROAD HUNTSVILLE AL 35806
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
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15056041125
15056041125
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15056042126
REV-1500 EX
Decedent's Social Security Number
204016166
Decedent's Name PAUL F. STRINGFELLOW
RECAPITULATION
1. Real estate (Schedule A)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1.
2. Stocks and Bonds (Schedule B)
...... ............... . . .. .... ..... 2.
105855.38
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) D Separate Billing Requested . . . . . .. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) D Separate Billing Requested. . . . . .. 7.
34654.77
8. Total Gross Assets (total Lines 1-7)
......... ... .. .... ... .... .. 8.
1 4 0 5 1 O. 1 5
9 3 1 O. 0 2
2 9 3 3. 6 4
1 2 2 4 3. 6 6
1 2 8 2 6 6. 4 9
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 Governmental 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. 1 2 8 2 6 6 . 4 9
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 _ o . 0 0 15. O. 0 0
16. Amount of Line 14 taxable 1 2 8 2 6 6 . 4 9
at lineal rate X .042- 16. 5 7 7 1 . 9 9
17. Amount of Line 14 taxable o . 0 0
at sibling rate X .12 17. O. 0 0
18. Amount of Line 14 taxable o . 0 0
at collateral rate X .15 18. O. 0 0
19. Tax Due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 5 7 7 1 . 9 9
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
D
Side 2
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15056042126
15056042126
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REV-1500 EX Page 3
Decedent's Complete Address:
File Number
21 07 0252
DECEDENTS NAME
PAUL F. STRINGFELLOW
STREET ADDRESS --
551 "F" STREET
CITY [ STATE I ZIP
CARLISLE PA 17013
Tax Payments and Credits:
1. T ax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1 )
5,771.99
5,000.00
263.16
Total Credits (A + 8 + C) (2)
5,263.16
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (0 + 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)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
0.00
0.00
508.83
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(5A)
(58)
A. Enter the interest on the tax due.
508.83
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; ................ ...................................................... D 00
b. retain the right to designate who shall use the property transferred or its income; ............................... D 00
c. retain a reversionary interest; or .......................................... ...................................................... D 00
d. receive the promise for life of either payments, benefits or care? . ...................................................... D 00
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ................................. ...................................................... D 00
3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ......... D 00
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .......................... ....... ........... ....... ........ ........... ........... ................. 00 D
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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. 99116 (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. 99116 (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 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 (0) percent [72 P.S. 99116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in
72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. 99116(a)(1.3)]. A sibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1503 EX + (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
PAUL F. STRINGFELLOW
FILE NUMBER
21 07 0252
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
PAUL F. STRINGFELLOW RAYMOND JAMES FINANCIAL SERVICES
ACCOUNT # 48913620
[SEE ATTACHED RAYMOND JAMES 0.0.0. LISTING]
VALUE AT DATE
OF DEATH
105,855.38
TOTAL (Also enter on line 2, Recapitulation) $
105,855.38
{If mnrp ~n~("'p i~ npprlp.rl inc::prt ~r1rlitinn~1 c:hppt<: nf thp. ct~mp c::i7P. \
REV-1508 EX + (6-98)
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
PAUL F. STRINGFELLOW
ITEM
NUMBER
1.
2.
3.
4.
5.
6.
7.
8.
FILE NUMBER
21 07 0252
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
DESCRIPTION
M & T BANK ACCOUNT # 000000082543488
[SEE ATTACHED M&T 0.0.0.]
VALUE AT DATE
OF DEATH
6,592.76
MEMBERS FIRST CERTIFICATE OF DEPOSIT
[SEE ATTACHED MEMBERS FIRST INFORMATION]
US TREASURY CHECK PROCEEDS
7,319.68
713.00
2006 HONDA CIVIC
[SEE ATTACHED VEHICLE BILL OF SALE]
COMCAST REFUND
14,800.00
8.75
ERB AUCTIONS - PROCEEDS OF SALE OF PERSONAL PROPERTY
[SEE ATTACHED FINAL AUCTIONEER'S REPORT]
5,110.58
PENN NATIONAL INSURANCE REFUND
10.00
HOFFMAN ROTH FUNERAL HOME & CREMATORY, INC - VA BENEFIT REFUND
100.00
TOTAL (Also enter on line 5, Recapitulation) $
(If more soace is needed. insert additional sheets of the same size)
34654.77
REV-1511 EX+ (12-99)
.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
PAUL F. STRINGFELLOW
FILE NUMBER
21 07 0252
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1- HOFFMAN ROTH FUNERAL HOME & CREMATORY, INC 1,219.75
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees DUNCAN & HARTMAN, PC 7,025.50
3. Family Exemption: (If decedenfs address is not the same as ctaimanfs, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Ciaimant to Decedent
4. Probate Fees REGISTER OF WILLS 330.00
5. Accountanfs Fees
6. Tax Retum Preparers Fees BOYER & RITTER 230.00
7. THE SENTINEL LEGAL AD 129.77
8. CUMBERLAND LAW JOURNAL LEGAL AD 75.00
9 RESERVED FOR FILINGS 300.00
TOTAL (Also enter on line 9, Recapitulation) $ 9310.02
(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
PAUL F. STRINGFELLOW
FILE NUMBER
21 07 0252
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1. BOROUGH OF CARLISLE - WATER & SEWER BILL
VALUE AT DATE
OF DEATH
18.86
2. BOROUGH OF CARLISLE - FINAL WATER & SEWER BILL
37.72
3. PPL - ELECTRIC BILL
620.81
4. PPL - FINAL ELECTRIC BILL
245.99
5. COMCAST - CABLE BILL
53.91
6. EMBARQ - PHONE BILL
31.15
7. EMBARQ - PHONE BILL
143.61
8. EMBARQ - FINAL PHONE BILL
3.62
9. SEARS GOLD MASTERCARD
256.06
10. M& T BANK FIA CARD # 5490998785880734
212.55
11. M& T BANK FIA CARD # 42642297168072093
73.50
12. U.S. TREASURY INCOME TAX DUE
1 , 171 .00
13. ALABAMA CARDIOLOGY
64.86
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
2 933.64
",'v-"" '" "*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
PAUL F. STRINGFELLOW
SCHEDULE J
BENEFICIARIES
FILE NUMBER
21 07 0252
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 [include outright spousal distributions, and transfers under
Sec. 9116 (al (1.2)]
1. MICHAEL F. STRINGFELLOW Lineal
1017 SANDY SPRINGS ROAD 100%
HUNTSVILLE, AL 35806
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
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
11ast lIill aub ID.esfumtut
of
I, PAUL F. STRINGFELLOW, of 551 "F" Street, Carlisle, Cumberland County,
Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make,
publish and declare this as and for my Last Will and Testament, hereby revoking any and all
other wills and codicils heretofore made by me.
FIRST. I direct that all my just debts and funeral expenses be paid from my estate as
soon after my death as practically and conveniently may be done.
SECOND. I direct that my remains be interred within my family's burial plot at Mt. Zion
Cemetery .
THIRD. I authorize my personal representative to expend funds from my estate, in such
amounts as my personal representative shall consider necessary and desirable for the purchase,
erection and inscription of a suitable marker for my grave.
FOURTH. I give, devise and bequeath any and all tangible personal property owned by
me at the time of my death unto my wife, BETTY M. STRINGFELLOW, provided she
survives me by thirty (30) days. In the event she fails to survive me by thirty (30) days, I give,
devise and bequeath all said tangible personal property unto my son, Michael F. Stringfellow,
of Huntsville, Alabama.
FIFTH. I give, devise and bequeath any and all real estate owned by me at the time of
my death, unto my wife, BETTY M. STRINGFELLOW, provided she survives me by thirty
days. In the event she fails to survive me by thirty (30) days, I give, devise and bequeath all
said real estate unto my son, Michael F. Stringfellow, of Huntsville, Alabama.
SIXTH. I give, devise and bequeath all the rest, residue and remainder of my estate
unto my wife, BETTY M. STRINGFELLOW, provided she survives me by thirty (30) days.
In the event she fails to survive me by thirty (30) days, I give, devise and bequeath all the rest,
residue and remainder of my estate unto my son, Michael F. Stringfellow, of Huntsville,
Alabama.
SEVENTH. I direct that any and all Inheritance, Estate and Transfer taxes imposed
upon my estate passing under my will or otherwise, shall be paid out of the principal of my
residuary estate
EIGHTH. I hereby nominate, constitute and appoint my wife, BETTY M.
STRINGFELLOW, as Executrix of this my Last Will and Testament. In the event of
renunciation, death, resignation or inability to act for any reason whatsoever of BETTY M
STRINGFELLOW, I nominate, constitute and appoint my son, Michael F. Stringfellow, as
Executor of this my Last Will and Testament. I hereby relieve my Executrix from the necessity
of posting security in connection with her duties, as such, in any jurisdiction in which she may
be called upon to act insofar as I am able by law to do so. In addition to the powers conferred
by law, I authorize my Executrix, in her absolute discretion, to retain in the form received, and
to sell either at public or private sale any real or personal property owned by me at the time of
my death.
NINTH. I have made, or may from time to time make, a written memorandum
expressing my desire to give certain items of personal property to specific persons. I urge my
Executrix and beneficiaries to respect these wishes. Such a memorandum, if made, shall be
stored in conjunction with this Will.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will
and Testament, consisting of two typewritten pages this day of October, 1996.
Signed, sealed published and declared by the above named Testator Paul F. Stringfellow as and
for his Last Will and Testament, in the presence of us, who, at his request, in his sight and
presence and in the sight and presence of each other, have hereunto subscribed our names as
witnesses.
W~\A~
~'M.~~
COMMONWEALTH OF PENNSYLVANIA
SS.
COUNTY OF CUMBERLAND
I, Paul F. Stringfellow, 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; that I signed it willingly; and that I signed it as
my free and voluntary act for the purposes therein expressed,..."
( ; ). ~ ~ II '
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PAULF. S GFE( W
Sworn or affirmed to and
acknowledged before me, by; g
Paul F. Stringfellow this / 8~ay
o tober, 1996.
. Y-L,~
N ary Public
Notarial Seal .
Cynthia l. Darr, Notary Pubh~
South Middleton Twp., ~umberland County
My Commission Expires Aug. 14, 2000,.
COMMONWEALTH OF PENNSYLVANIA
:S8.
COUNTY OF CUMBERLAND \
We, ifJU-ltaf'L.J;j)tMf"cZ1^- and 6-4 rn'~5 t~witnesses whose names are
signed to the attached or foregoing instrument, being d~;qualified according to law, do
depose and say that we were present and saw Paul F. Stringfellow sign and execute the
instrument as his Last Will; that Paul F. Stringfellow signed willingly and that Paul F.
Stringfellow executed as his free and voluntary act for the purposes therein expressed; that
each of us in the hearing and sight of the Testator signed the will as witnesses; and that to the
best of our knowledge, the Testator was at that time eighteen (18) or more years of age, of
sound mind and under no constraint or undue influence.
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Sworn or affirmed to and
subscribed before me by
ki I II (Q~ /l:l)UP14W-!~nd
/3a't! 1}19/f1.-h-iJ !-dlt;y..J , witnesses,
this .~ day of October, l~.
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CUP1 1
96 OP EBRN
CUST NO.
COlD 96 SSN/TID:
N PAUL F STRINGFELLOW
A 551 F ST
C CARLISLE PA 17013-1350
CIS
INDIVIDUAL CUSTOMER PROFILE 07/03/08 14.51.51
MS 64282 INDIVIDUAL CUSTOMER DISPLAYED
CUST SEG STATUS--
CD 0 COST CENTR 4319 BRN-- 4319
TIE 1 OPENED 710528 OFF01
CLOSED OFF02
LST MAIN 1041110 MAR STATS
BRTHDATE 211115 SEX------ M
DECEASED ADVERTIS?
BANKRUPT EMPLOYEE? N
OCCUP CD HH# 0
CUST TYPE T3 SENS CODE 0
LANGUAGE REFER? N
NATIONALITY NEXT: 3
RPT OF 06/06/03 00001000487
CULO
CO
NO 204016166
EMPLOYER
BK REL
BK SVC ALL P3
HOME PHONE
BUS. PHONE
REMARKS
0001 PLACED 1030609 EXP. DATE 9999999 CLSD SDB PER
0002 PLACED 1030609 EXP. DATE 9999999 100002930
LIST HIST ACCTS? N LIST CLOSED ACCTS? Y
ACTN: ACPR ACDT A C C 0 U, NT ", R E L A T I 0
SEQ- COID- PRDSP A9COUNT- - - - - - - - - - _\- - - - - OPEN ST
0001 96 DDAH2 ,(000000082543488 L 7105 99
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N S HIP S NEXT:
CURR ------BALANCE------
6,592.76
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5000 Louise Drive, P.O. Box 40
@ Mechanicsburg, PA 17055-0040
MEMBERS 1st
FEDERAL CREDIT UNION
717-795-6049 Long Distance 1-800-237-7288 Hearing Impaired 717-697-5312
www.Members1st.org
Certificate Maturity Notice
PAUL F STRINGFELLOW
551 F STREET
CARLISLE PA 17013
Please call or check our
website to obtain
information on
our current rates and
Certificate specials
CERTIFICATE NO. TYPE OF CERTIFICATE NOTICE DATE
254087 -46 11 MONTH CERT 02/02/07
MATURITY DATE RENEWAL TERM IF NOT REDEEMED ANTICIPATED MATURITY BALANCE
03/03/07 12 MONTH CERT MONTHLY $7,319.68
-(it
THE DIVIDEND RATE AND ANNUAL PERCENTAGE YIELD THAT WILL APPLY TO THIS CERTIFICATE, IF RENEWED, HAVE NOT BEEN
DETERMINED.
This rate information will be available from Members 1 st FeU on the maturity date. You may call the credit union using the telephone numbers
listed above or refer to Members 1st website for current rate information, or if you have any questions related to your account.
ACCOUNT RENEWAL. Unless you withdraw or transfer the account funds at maturity or within the grace period, if applicable, your account will
automatically renew for an additional term. The terms and conditions applicable to your renewal account (except Dividend Rate and Annual
Percentage Yield) will be the account terms and conditions listed above.
Your certificate will automatically renew at maturity. You will have a grace period of seven (7) calendar days after the maturity date to withdraw
the funds in the account without being charged an early withdrawal penalty. Unless this is an Add-On certificate, you may also add to this
certificate during the grace period only.
j VEHICLE BILL OF SALE
On this date, 7-16-2007
1/ we, PAUL STRINGFEllOW / ;?1';.k.J ~ S~
/ I
Do hereby sell to DEBRA SKVORZ BURROUGHS
The following motor vehicle:
Year: 2006 Make: HONDA
Model: CIVIC
Body Style:
4D
Vehicle Identification Number: 2HGFA16506H521502
For the amount of: $14!800.00
As of this date, 7-16-2007
the odometer reading is: 5307
Signatures:
- ~
/Il~r . ~
Seller's Signature ~ h /J
/0/7 S~~IYf,
. 551 r STREET f;
Address I-I.a~ _ ilL 358'tJ6
/
LCARLISLD, r/.. 17013 /y!, ~ <.C;?
City, State Zip
(2,5"6) ~37~ 15/ A
Phone -
121 LONG BOW DR
Address
MADISON, AL 35758-7866
City, State Zip
256772-3545
Phone
ERB AUCTION CO.
620 North Hanover St.
Carlisle, Pa. 17013
FINAL SETTLEMENT
SELLER NAME Mike Stringfellow
ADDRESS 551 F Street
CITY Carlisle State Pa. Zip
PHONE
LOCATION OF SALE 551 F Street Carlise Pa. 17013
AUCTIONEER Tammy Erb (Erb Auction Co.)
DATE OF SALE
May 05 2007
17013
DESCRIPTION EXPENSES RECEIPTS
Total receipts (checks & cash) $6,956.50
Auctioneer fee all 20% $1,391.30
AdvertisinQ (Fry Communications) $260.40
Portable Toilet (Associated Products) $99.22
Waste Container (York Waste) $95.00
TOTAL EXPENSES $1,845.92
TOTAL RECEIPTS $6,956.50
LESS TOTAL EXPENSES $1,845.92
NET PROCEEDS PAYABLE TO SELLER $5,110.58
I (or we), the seller, . cept this settlement and acknowledge receipt of the above specified net proceeds
from the auction 0 y goods and property sold on the above date. I accept all responsibility for
oviding mercha t ~Ie title to all goods, and prope sol, nd r delive of title to the purchaser.
Date
Date