The URL can be used to link to this page

Home My WebLink About10-14-08J 15056051058 REV-1500 EX (06-05) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number Po sox zsosol INHERITANCE TAX RETURN ~, Harrisburg, PA 17128-0601 RESIDENT DECEDENT ..., ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 202-20-2370 0;s/08/2008 06/08/1929 Decedent's Last Name Suffix Decedent's First Name MACRI _ MI NICKOLAS (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 FILL IN APPROPRIATE OVALS BELOW REGISTER OF WILLS i `+' 1. Original Return 2. Supplemental Return 3. Remainder Return (date of death 4. Limited Estate prior to 12-13-82) 4a. Future Interest Compromise (date of death after 1~-12-82) 5. Federal Estate Tax Return Required 6. Decedent Died Testate 7. Decedent Maintained a Livin Trust (Attach Copy of Will) (Attach Copy of Trust) g 8. Total Number of Safe Deposit Boxes - 9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of death --- . 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name _ Daytime ieiephone Number DEBORAH M. MACRI EX . ~., Firm Name (If Applicable) __ _ ~-, . -: ~_ ~.~ _REGISTBR ~ WILLS U~~NLY, -; e_I First line of address ~, :. __ ~~; _ - .>r- i_.. -,, - Second line of address - - - -- --: ,; _r 4137 KITTATINNY DRIVE --' i J City or Post Office ~ State ZIP Code DATE FILED MECHANICSBURG _ _ PA ;17056 Correspondent's a-mail address: Under enalties of perjury, I declare that I have examined this ro:urn, including accompanying schedules and statements, and to the best of my knowledge and belief, it is t e, corr ct and complete. Declaration of preparer other than the personal representative is based on all inf~rmatii;n v° „nigh preparer has any knowledge. SI T F PER R ONSIB OR FILING RETURN TE ADDRESS - %~ - 4137 KITTATINNY DRIVE, MECHANICSBURG, PA 17056 SIGNATURE OF PREPA ER OTHER T AN REPRESENTATIVE _ DATE ADDRESS -' ~ - ~ 1~ _ p d~ 4200 CRUMS MILL ROAD, HARRISBURG, PA 17112 PLEASE USE ORIGINAL FORM ONLY 1 505605 1 058 Side 1 L 15056051058 15056052059 REV-1500 EX Decedent's Social Security Number Decedent's Name: NICKOLAS MACRI ~..,. _ 202-20-2370 RE . .__ ~._. d..,._. CAPITULATION 1. Real estate (Schedule A) . ......................................... ... 1. 170,000.00 2. Stocks and Bonds (Schedule B) .................................... ... 2. 95,774.66 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. 10,406.61 6. Jointly Owned Property (Schedule F) Separate Billing Requested .... ... 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) :. + Separate Billing Requested..... ... 7. ! 75,156.02 8. Total Gross Assets (total Lines 1-7) ................................. ... 8. 351,337.29 9. Funeral Expenses & Administrative Costs (Schedule H) .................. ... 9. 12,088.19 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............. ... 10. 16,697.32 11. Total Deductions (total Lines 9 & 10) ................................. .. 11. 28,785.51 12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. ' 322,551.78 13. Charitable and Governmental Bequests/Sec 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. 322,551.78 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 .0_ 15. 16. Amount of line 14 taxable at lineal rate X .0 45 322,551.78 16. 14,514.83 17. Amount of Line 14 taxable at sibling rate X .12 17 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. TAX DUE ....................................................... ..19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 15056052059 REV-1500 EX Page 3 Decedent's Complete Address: File Number DECEDENT'S NAME DECEDENT S SOCIAL SECURITY NUMBER NICKOLAS MACRI 202-20-2370 STREET ADDRESS ---~- -- - - 635 GRANDVIEW AVENUE CITY STATE zip CAMP HILL PA 17011 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. InteresUPenalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) - Total InteresUPenalty (D + E ) 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. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) (4) (5) (5A) (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 14,514.83 0.00 0.00 14,514.83 14,514.83 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 :................................................................................... ....... ^ ^x b. retain the right to designate who shall use the property transferred or its income : ..................................... ....... ^ c. retain a reversionary interest; or ................................................................................................................... ....... ^ d. receive the promise for life of either payments, benefits or care? ............................................................... ....... ^ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................................... ....... ^ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ........ ...... ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a benefciary designation? .................................................................................................................. ...... ^ 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 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 (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 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(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)]. Asibling 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-1502 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NICKOLAS MACRI FILE NUMBER 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 reasnnahla k~~WiPn~o „f ,ho ~o~e,,.,..~ ~..,..,. SCHEDULE A REAL ESTATE ~~~ ~~~~~~ ~Na~~ ~~ iioouau, insert aaa¢ionai sneers or the same size) REV-1503 EX+ (6-98) _~ SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NICKOLAS MACRI All property jointly-owned with right of survivorship must 6e disclosed cn s~r,o,~~~io FILE NUMBER t~~ iiwie space is neeaea, insert adoitional sheets of the same size) REV-1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY NICKOLAS MACRI 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. ITEM NUMBER DESCRIPTION 1. CITIZENS BANK CHECKING ACCOUNT #610068-226-9 2. CITIZENS BANK SAVINGS ACCOUNT #6243-920106 3~. PRO-RATED REAL ESTATE TAXES AND SEWER/TRASH 4. ECONOMIC STIMULUS REBATE 5. WEST SHORE TAX BUREAU OVERPAYMENT OF LOCAL TAX TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) FILE NUMBER VALUE AT DATE OF DEATH 7, 382.52 1, 870.04 782.63 300.00 71.42 10,406.61 REV-1510 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY NICKOLAS MACRI FILE NUMBER This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is ITEM DESCRIPTION OF PROPERTY y es. NUMBER INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE ~ , CITIZENS BANK IRA CD ACCT #6140-708184 VALUE OF ASSET INTEREST tIFAPPUCASLEI VALUE 20,749.59 100 20,749.59 2. CITIZENS BANK IRA CD ACCT #6247-260496 28,608.63 100 28,608.63 3. SYMETRA LIFE INS. CO. IRA ACCT #V00040639 25,797.80 100 25,797.80 TOTAL (Also enter on line 7 Recapitulation) $ I 75,156.02 (If more space Is needed, Insert addltlonal sheets of the same size) REV-1511 EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NICKOLAS MACRI ITEM NUMBER A• FUNERAL EXPENSES: ~~ NEILL FUNERAL HOME 3401 MARKET STREET CAMP HILL, PA 17011 SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Debts of decedent must be reported on Schedule I. DESCRIPTInN FILE NUMBER 2. I RECEPTION FOLLOWING THE SERVICE @ OUR LADY OF LORRDES, ENOLA, PA 17025 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 3. Family Exemption: (If decedent'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 5. Accountant's Fees 6• Tax Return Preparer's Fees 7. TOTAL (Also enter on line 9 Recapitulation) I $ (If more space Is needed, insert additional sheets of the same size) 10,670.17 250.00 473.02 695.00 12,088.19 REV-1512 EX+ (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF NICKOLAS MACRI FILE NUMBER Re ort debts i d b p ncurre y the decedent prior to death which remained unpaid as of the date of death, including unreimb urse d medical ex ITEM penses. NUMBER DESCRIPTION VALUE AT DATE ~ SETTLEMENT CHARGES FOR SALE OF RESIDENCE - 635 GRANDVIEW AVE. CAMP HILL PA lCCT OF DEATH , , TI CAACt\IT C4.ICCTl1 ~ 13,04,0.00 2~ CK #993 MILLENNIUM PHARMACY 143.76 3. CK #994 BONNIE K. MILLER, TREAS. PERSONAL TAXES 9.80 4. CK #995 PAWC WATER BILL 12.68 5. CK #996 PPL 131.21 6. CK #997 WESTTAB LOCAL TAX (NO RECEIPT) 92.55 7. CK #998 BETHANY VILLAGE 1, 731.39 8. CK #999 QUANTUM IMAGING 26.36 9. CK #1001 WILLIAM O'DONNELL TREAS R. E. TAXES 746.66 10. CK #1002 BORO OF WORMLEYSBURG SEWAGE & TRASH 121.00 11. CK #1003 PPL 43.96 12. CK #1004 NICK PLANK LAWN CARE (NO RECEIPT) 120.00 13. CK #1006 PAWC WATER BILL 12.05 14. CK #1010 PAWC WATER BILL 9.24 15. CK #1011 PPL 24.34 16. CK #1012 QUANTUM IMAGING 53.10 17. CK #1014 FED RES BK OF PGH (OVERPAYMENT OF BONDS) 27.10 18. CK #1015 FED RES BK OF PGH (OVERPAYMENT OF BONDS) 27.10 19. CK #1016 CITIZENS BANK HARSCO STOCK TRANSFER 325.02 TOTAL (Also enter on line 10, Recapitulation) $ I 16,697.32 (If more space is needed, insert additional sheets of the same size) REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF NICKOLAS MACRI NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT Do Not List Trustee(s) t TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] ~ ~ NICHOLAS V. MACR1,115 BRAMBLEWOOD LN, LEWISBERRY,PA17339 SON 2~ TINA M. NAVITSKY, 1787 AUTUMNWOOD DR, MECH., PA 17055 DAUGHTER 3. DEBORAH M. MACR1,4137 KITTATINNY DR, MECH., PA 17050 DAUGHTER FILE NUMBER AMOUNT OR SHARE OF ESTATE 33% 33% 34% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I $ (If more space is needed, insert additional sheets of the same size) A OMB NO. 2502-0265 B. TYPE OF LOAN: U.S. DEPARTMENT OF HOUSING 8 URBAN DEVELOPMENT 1.^FHA 2.QFmHA 3. ~X CONV. UNINS. 4. []VA 5.QCONV. INS. 6. FILE NUMBER: 7. LOAN NUMBER: SETTLEMENT STATEMENT OB-236 I8. MORTGAGE INS CASE NUMBER: ""°f°or ro 6 125/F/826 35 MML DMORTGAGE INS CASE G NOTE Thrs )orm rs lumrshed to gyve you a statement of actual seltlemenf costs. Amounts pard to and by the setHemenf agent am shown. Items marked '(POCJ" were paid outside the closing; they are shown here /or Infomrafional purposes and are rrotlncluded in the totals. D NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: r'0 a~ee (FERGUSON.MILIER.PFD,08-7a6ft1) F. NAME AND ADDRESS OF LENDEI Anthony Ferguson and Estate of Nickolas Macri Rachel Miller WELLS FARGO BANK 635 Grandview Avenue allc/a Nicholas V. Macri 111 Continental Drive, Ste. 114 Camp Hill, PA 17011 Newmark, DE 19713 G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 68-0510988 635 Grandview Avenue I. SETTLEMENT DATE: Camp Hill, PA 17011 Community Land Transfer, LLC Cumberland County, Pennsylvania PLACE OF SETTLEMENT May 9, 2008 2331 Markel Street Camp Hill, PA 17011 J. SUMMARY OF BORROWER'S TRANSACTION 100. GROSS Aiurn rnrr n„c con.. e..~.,,,...~.. ~ K. SUMMARY OF SELLER'S TRANSArrInN 103. .+ ~wunenrs ror,rems yard By Seller in ad, 106. Cdy/TOwn Taxes to 107. County Taxes 05!09108 to 01/01 108. School Taxes 05109!08 to 07/01 109. Sewer/Trash 05/09/08 to 07101!08 110. 111. 112. 120. GROSS AMOUNT DUE FROM BORROWER '.01. Deposit or earnest money ?OZ. Principal Amount of New Loan(< ?03. Exislinq loan(s) taken subject to ?04. !08. ?11. County Taxes to '12. School Taxes fo ?13. !14. !15. '16. '17. '18. '19. ?20. TOTAL PAID BY/FOR BORROWER .00. CASH AT SFTTr t=MCr~T con..mn e, to 409. Sewer/frash 05!09/OB to 410. 411. 176,439.04 1420. GROSS AMOUNT DUE TO SELLER 170,782 51 519. 137,000.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 13,040.00 103. CASk (X FROM) ( TO J BORROWER ~~ ""° "`" t 13,040.00 39 439.04 603. CASH (X TO) ( FROM) SELLER 157,742.63 The undersigned hereby acknowledge receipt of a completed copy of pages 182 of this statement 8 any attachments referred to herein. T Borrower - Seller ~~. ny er soq~ ~ Estate f NI olas Macri a/k/a Nicholas V. Macri !!// ~ BY: ache) Miller ~ -' t .Ci~y~_ Yepe L. SETTLEMENT CHARGES Inn TnTel Cnuureetnu rs___~ __ .._,_ _ J 1/U 000.00 6.0000 % 10,200.00 Division of Commission line 700 as Follows: PAID FROM FAIO FROM 701. S 5,125.00 to RE/MAX REALTY ASSOCIATES eORROWER'a SELLER'S 702. S 5,075.00 to THE HOMESTEAD GROUP INC FuNOSAr FUNDS AT , . 703. Commission Paid at Settlement SETTLEMEM SETTIEMEN> 704. Transaction Fee to The Homestead Group Inc 10,200.~t0 , . 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 100'00 801. Loan Ori ination Fee % to 802. Loan Discount % to 803. Appraisal Fee to WELLS FARGO BANK 804. Credit Report to RELS 75.00 905. Lender's Inspection Fee tp 30.00 906. Mort a e Ins. A .Fee to 907. Assumption Fee to 908. Flood Lite of Loan to WF FLD SERVCS 909. Processing Fee to WELLS FARGO BANK 19.00 POC: $350.00 B 910. Tax Service Fee to WF RE SRVCS 45.00 911. 100.00 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 301. Interest From 05!09!08 to 06/01/08 @ b 22.820000/day ( 23 days %) 302. Mort a e Insurance Premium for monihs to 524.86 303. Hazard Insurance Premium for 1.0 ears to Erie POC:8445 00 . 304. 305. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazardlnsurance 4.000 months $ 37.06 er month 1002. Mort a e Insurance months $ er month 148.32 1003. Cit Rown Taxes months $ er month 1004. Count Taxes 5.000 months $ 62 22 r month . 1005. School Taxes 13.000 months @ $ 123.40 per month 311.10 1006. months $ er month 1,604.20 1007. months er month 100!1. A re ate Ad'ustment months $ er month 1100. TITLE CHARGES -582 82 1101. Settlement or Closing Fee to 1102. Abstract or Title Search to 1103. Title Examination to 1104. Title Insurance Binder tp 1105. Electronic Document Pre to Communi Land Transfer LLC 1106. Closin Service Lefler to Communi Land Transfer LLC 50.00 1107. Attorney's Fees to 35.00 includes above item numbers: 1108. Title Insurance to COMMUNITY LAND TRANSFER includes above item numbers.1102, 1103 8 1104 1 208.75 1109. Lenders Coverage $ 136,000.00 1110. Owners Coverage $ 170,000.00 1 208 75 , . 1111. Endorsements 100, 300, 8.1 to Community Land Transfer LLC , 1112. Notary Fee to Community land Transfer 150.00 1113. Notary Fee to Community Land Transfer 10.00 1114. Overnight Fees & Handling to Community Land Transfer, LLC 5 ~ 1115. Wire Fee to Communi Land Transfer, LLC 15.00 1116. Tax Cen. to William O'Donnell, Tax Collector 10.00 1117. 10.00 1118. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recordin Fees: Deed $ 38.50; Mortgage $ 64.50; Releases $ 1202. Ci /Coun Tax/Stam s: Deed 1 700.00• Mort a e 103.00 , 1203. Stale Tax/Stam s: Deed 1 700.00; Mort a e 1 700.00 1204. 1 700.00 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Surve to 1302. Pest Ins ection to 1303. Daed Prep. to RElMAX Real Associates Inc . 1304. Transaction Fee to RE/MAX Real Assocaites Inc 125.00 . 1305. Deed Copy to Tri-County Abstract 250.00 1400. TOTAL SETTLEMENT CHARGES Enter on Lines 103 Section J and 502 Section K 1°. :0 , 6Y >iq~q page t of Ws sletemeM, qie signatdiea acknowledge reeeiot or a m,.,nw.n..,.,,, „r .,,,,. ~ ....~..._ ____ 5,656.41 12,305.10 _ Certified to be a true copy. _._ ___..._... / - W - Community Land Transfer, LLC Settlement Agent "~ 4/23/2008 Issue Date Serial Number I - - - _ - - ssue Date -- Serial Number Issue Date Seri l N b A r-77 p 02025133398E - __ -- a um er _ _ _ - ----- ----- - Apr-85 - Rl 9665781 EE - Sep-87 --- R43001309EE - ------ Jul-77 -- K201372055E - ---- -- ----- Apr-85 --- R22008435EE _ ~ _ _ ' O ct-87 ---- - - R43028886EE - - Jul_77 Q61_65689372E - - May-85 - _ R22008505EE _ _ _ __ _ Oct-87 R43041882EE Mar-78 - - 02048278895E --- _ May-85 R22008535EE ___ Oct-87 ----- R43017774EE - Mar-78 - M 7 8201263337E ---- ---- _ _ -- Jun-85 R22008602EE --- - ov-87 -- ------ R43735813EE -- - ar- 8 ___- 02048278898E -- - un-85 - R22008642EE - - - - Nov-87 -------- --- R43717617EE -- - --- Mar-78 8201263338E -- _ Jul-85 _ R22213368EE _ __ Dec-87 -- ------ R43744476EE May _78 8201263339E ---- - - --- Jul-85 - _ _ R22213332EE -- ----- Dec-87 --------- - R45894553EE -- - - May-83 C48896047EE ___ - Au 85 --- --- 82_2213441 EE -- _ _ - Dec-87 ----- R45619096EE _ _ May_83 C48896107EE ------ -- Aug-85 - _ R22213477EE ____ - a n -88 --- R45906962EE -- - Jun-83 --- C48896180EE ----------- - Aug-85 -- R22213503EE -- _ _ Jan-88 _ --- R46050133EE Jun-83 048896261 EE - Sep-85 R24271945EE - - Feb-88 - --- -__ R46061748EE _ Jul-83 C48902454EE -- Se 85 - p- 82427191 OEE ---- ---- Feb-88 ---- -- -- _ 846099191 EE _ - - .Jul-83 C48953876EE Oct-85 __- R24272026EE --- ------ M -88 ------ --- R4 --- - A 8 3 0 - -------- ---- ---- ar 7305379EE u g=_ A 50205540EE-- Oct-85 -- R24271989EE - ----- -- Mar-88 R46106684EE u --83 048953941 EE Dec-85 -- - R027078443EE -- - Aprr=88 -------------- R47368170EE ------ Sep=83 C50205610EE ---- Feb-86 -- -- --- R028774513EE - -- - - -- A r-88 P ------ -- - R473 41 02 7EE _ -- - Sep_83 C50205680EE - Oct-86 -- -- R17615700EE ---- - --- - May-88 _ _ _ __ R47889887EE _ Sep-83 052258141 EE -- --- - _ Oct-86 --- 817615699EE - _ - May-88 -------- R47866278EE -- -- Feb-84 - R14889909EE ------- ----- ---- Oct-86 --- ----- R1 761 5698EE - --- - -- Jun-88 - ----"---- - R47915887EE - Feb-84 __ _ - R14889929EE --- - _ Oct-86 __ R17615697EE _ _ --- Jun-88 ---- R47922284EE - -- Mar-84 - --- R14889989EE -- --- -- ct-86 - ------ R1 761 5701 EE - - - Jul-88 - ----- R48374020EE -- "-- Mar-84 R14889967E - - -- _ __ - E --- --- Oct-86 Rl_7615702EE - Jul_88 _ -- R48347729EE ~ -- Mar-84 - - R14889947EE - Oct-86 - -- R027437034EE ___ ___- Ju -88 ----- R48337425EE -- - pr- 4 R14890026EE -Oct-86 -- RO_27437033EE - - Aug-88 R48 389727EE A r-84 -- p _ R14890007EE _---. _-_ -_ ___ Oct-86 -- ---- R027437032EE - - --- -- Aug-88 _ R48410867EE _ _ Y- Ma -84 R 14890066EE __-_ __ - _-___ _ __ __ -_Oct-86 _---- 8027437031 EE -- Se 88 p _ R49693568EE - Ma 84 -_ Y-- R14890043EE _ _---___ -- ---- Oct-86 -- -____ 81761 5694EE - -- - _ -- -- - Sep-88 --- - - -- 8491 72210EE - - Jun-84 R14890084EE --- --- - - - Oct-86 ------ -- -- R027437030EE - _ ___ _- Oct-88 -- ----- "-- 84970741 3EE __ _ Jun-84 -- R14890102EE -- --- - Oct-86 --- -- Rl 761 5693EE - -- ------ Oct-88 -- -- - -- 849722801 EE - -- Jul-84 R14890122EE Oct-86 R17615696EE ----- Nov-8 8 _ - R49754635EE _ Ju -84 Rl 71 1 1013EE ----- - - - _- Oct-86 ._-__.--__ R318582 46EE _ __ . Nov-88 - -- -- R49767539EE - Aug-84 R1-7111053EE ------ -_---_ Oct-86 -_ --_ _ R_31858196EE - -- ---- Dec-88 - -- - - R51277332EE __; _ Au 84 R17111040EE _- _ -____ _ ____- __- Jan-87 - 8246371 59EE - - -- Dec-88 851 305288EE Aug-84 81 71 1 1029EE -- -- -- - _ _-_ Jan-87 _ - R25205919EE _ - - - --- Dec-88 --- -- --- - - R51333952EE Se 84 p- 17615620EE ---- --- - an-87 - ----- - - - - R25205902EE _ - --- Jan-89 ----- -- - '- - 851345297EE Sep-84 - R17615608EE -- - --- - - Feb-87 - -- _ _ R24643093EE _ - Jan_ 89 --- -- - _, - -- 851 377746EE ct-84 -- 18559997EE - - - - -- eb-87 - -- - R24632568EE - eb -89 __ - ---- R51425668EE Oct 84 R18559969EE _ - - __ Mar-87 ----- - R__24646942EE - -- _ _ Feb-89 _ - --- - R51393585EE i Nov-84 - - R18560034EE - -- - - Mar-87 - --- R23796859EE _ ___ M ar-89 R51439153EE ov-84 7 8560059EE -- - -- - r-87 23884186EE _ _ _ _ _ _ _ Mar-89 - - --- - R51455644EE _ ec-84 - --- R19223947EE -- - -- - -- - Ma -87 y - R25241666EE Apr-89 ----"- R56583486EE -_----- Dec-84 _- R19223974EE --- ---- -- - - Ma -87 y - - _ ___ R25256223EE - -- Apr-89 -- ------------ 851 500087EE - - an-85 l 8886045EE - - - Jun-87 - - --- 825266281 EE -- - _ _ -- May-89 _ _ 85658081 7EE _ Jan-85 - R18886004EE ___ ___ -_-__ _ un-87 --- R252775 2 8EE un_89 -- - R56655730EE- --.-- Feb-85 -- R18886075EE --- -- - Jul-87 --- _ _ _ R25303619EE _ - Jun-89 ----- R56635596EE _ -__ Feb-85 R18886096EE - __ Ju -87 -- - R25289590EE - -- -- _ _ Jun-89 ---- 856671 129EE _- Mar-85 R18070287EE - -- -- --. Aug-87 ---___- --- R_25310688EE -- --- ul-89 - -- -- R59692140EE _- - Mar 85 - R18070264EE -- - Aug-87 --- - - -- R25311423EE ---- - -- -_ Jul-89 R59689493EE ar-85 - 18070342EE -- - - - ug-87 - --- ---- - 833118762 EE -- --- -- - - - - - -- Aug-89 - __--. -- -- R59720384EE - - - --- 4/23/2008 Issue Date Serial Number I _ - -- --- - -- ssue Date Serial Number Issue Date Serial Number A r-77 P- _ 02025133398E - --- -- - Apr-85 --- 819665781 EE _ --- Sep-87 R43001309EE - -- Jul_ 77 K201372055E --- - -- - Apr-85 - --- R22008435EE __ -------- Oct-87 R43028886EE -- - Jul_77 Q6165689372E --- - May-85 --- R22008505EE _ - - ------- Oct-87 R43041882EE ----- -- Mar-78 - -- 02048278895E --- _ May-85 _ R22008535EE - ------ - Oct-87 R43017774EE -- Mar-78 8201263337E __ ___ _"Jun-85 -- R22008602EE -- -- - - - ---- --- Nov-87 R43735813EE _ Mar-78 - 02048278898E -Jun-85 __ R22008642EE - -- _ - - - --- -- Nov-87 84371 7617EE __ Mar-78 8201 Z63338E _ u=g5 --- R22213368EE - _ -- ----- Dec-87 R43744476EE __ __ May_78 8201263339E ___ _ -- - __ _ Jul-85 _ _ R22213332EE _- - ------ ---------- Dec-87 R45894553EE --- May-83 C48896047EE Aug-85 822213441 EE -- --- - Dec-87 R45619096EE - _ - _ May-83 - C48896107EE ------ - Aug-85 R22213477EE ___ _ Jan-88 R45906962EE _ _ -_ )un-83 - - C48896180EE - -------- -- Aug-85 - -- R22213503EE __ _ ---- Jan-88 8460501 33EE -- Jun-83 - 048896261 EE -- - ___- - _ Sep-85 - R24271945EE - ----- --- ------ Feb-88 R46061748EE - -.--- Jul-83 l C48902454EE ____ _.-____-__ ep-85 2427191 OEE --- _ - -- - - ----------- Feb-88 846099191 EE -- --- - Ju -83 C48953876EE - - --------- - - Oct-85 - R24272026EE -- - ------ --- --- Mar -88 R47305379EE - - Aug-83 C50205540EE - --- ----- _ _ Oct-85 -_ __-____ R24_271989EE _ --_ _ _ ---- --- Ma r-88 R 4610 6684 E E _ __. Aug=83 - 048953941 EE ---- -- - Dec-85 -- _ _ R027078443EE __ _ _ __ _ _ _ _ _ _ _ _ Apr-88 8473681 70EE _ ep- 50205610EE -- -- - - -- Feb-86 - - -- R028774513EE --- - Apr-88 R47341027EE Sep=83 C50205680EE ---------- - - Oct-86 -- -- 81761 5700EE - - - -- ----------- - May-88 R47889887EE - -- ep_ F b 052258141 EE _ _- Oct-86 81761 5699EE _ _ ---- May -88 R47866278EE e -84 - b R14889909EE - ---- --- - -- Oct-86 _-_ R17615698EE -- _-_ __ _ ----- tun-88 84791 5887EE - - - Fe -84 --- R14889929EE --- - ----- Oct-86 R17615697EE -- __-- ----- Jun-88 R47922284EE _ ___ - Mar-84 Rl 4889989EE Oct-86 _-_-_ 81761 5701 EE -_ _ -_ J l-88 R _ Mar-84 R14889967 ---- ------- -- u 48374020EE --"----- -- EE --- ------ _ -- Oct-86 - - 817615702EE ---- ----- Jul - 8 8 R48347729EE _- - Mar-84 R14889947EE --- -- ---- - -- Oct-86 - -- ---- RO__27437034EE - - _ _ _ _ - --- Jui_b8 R48337425EE _ - A r-84 R14890026EE - t-86 - - - R 0 27437033EE __ __ --- -- Aug-88 R48389727EE A r-84 R14890007E --- _ . - - -- -- - - - E -- - -- - - ct-86 027437032EE - --- Aug-88 R48410867EE _ _ ay-84 R14890066EE Oct_86 8027437031 EE __ Se 88 R49693568EE p _ May-84 R14890043EE --- Oct-86 _..-___-__ - -- 81761 5694EE -- - -- - -- -- - --- - - --- - Sep_88 849172210EE - Jun-84 R14890084EE -- - -- _ - ct-86 - --- R027437030EE --- - - - - - - Oct-88 R49707413EE - Jun-84 R14890102EE - --- --- -- Oct-86 --- -- -- -- R17615693EE - - --- ---- - - 1 EE _ Oct-88 84972280 Juf-84 - R14890122EE - - ct-86 _ -- ----- R17615696EE - -. - . - __ - - Nov-88 R49754635EE - - Jul-84 R17111013EE _- --- -- ._ Oct-86 ------ - R31858246EE ---- --- -- -_-- Nov-88 R49767539EE ' Au 84 9- R17111053EE ___ --__ _- _ _ - Oct_86 --- - R31858196EE - - _ ----- - Dec-88 R51277332EE -- _ Aug-84 81.7111-040EE - Jan_87 R24 637159EE -- - -- --- --- --- Dec-88 R51305288EE - Aug-84 R17111029EE -- - - n- 7 - _ -- R25205919EE - - - --- -- - ----- - Dec-88 851333952EE - - Sep-84 R17615620EE- - - -- _ Jan-87 _..- R25205902EE -_ - ___ --- ----- Jan-89 R 51345297EE Sep-84 - 81761 5608EE _ __ ____- -- _- Feb-87 -_--___ _ _ R24643093EE _- -_ _ _ _ --- ----- ' Jan-89 851 377746EE - Oct-84 - -- R18559997EE - - -- - Feb-87 _ _ R24632568EE _ ___ _ _ ----------- ---` Fe -89 R51425668EE - ct 4 Nov 84 R18559969EE R18560034EE _ Mar-87 R24646942EE __ _ --- --- __ Feb_-89 R51393585EE - - - - - __ _ Mar-87 _ R23796859EE Mar-89 851439153EE I - -- v- __- l 8560059EE __ _ -- pr-87 -- R23884186EE ----- - - - -- -- 1- -- ---- M ar-89 R51455644EE i - - - ec-84 _ R19223947EE _-- ___ --- ~ - - Ma 87 Y- - ------ --- R25241666EE __ ___ _ - ---"- - "-- A r-89 R56583486EE - - Dec-84 R19223974EE ---- --- - -- -- Ma 87 -- Y- _- -- -- R25256223EE -- - - - - ----- Apr-ts9 851500087EE _ _ Jan-85 - R18886045EE - - - -- - - -- _ Jun-87 --- -- -- --_ 825266281 EE - ---- ~ -- -- -- ---- Ma 89 R56580817EE y Jan-85 R18886004EE ---- - _ __~un-87 - R252 77528EE - _ -- - -- --- Jun-89 R56655730EE - Feb-85 -- R18886075EE - - -° -- - -- )u_I-87 __ _ R_25303619EE - _ __ -- - -- Jun-89 R56635596EE _ Feb-85 R 18886096EE -- - ----- _ _ __ Jul-87 -- -- R25289590EE - - -- _ - --- --- - Jun 89 856671 1 29EE - - Mar-85 R18070287EE - ----- _ Au 87 -- R25310688EE _ --- _ _ -- --- Jul-89 R59692140EE -- Mar-85 R18070264EE - - - - - ug-87 --- - R_2_5311423EE ---- _-_ - _ - Jul-89 R59689493EE - Mar 85 R18070342EE -- ---- - Au -87 g - -- --- 833118762 EE -- _--- - - __ _ - Aug-89 R59720384EE _ ~y~ Citize a~ nsBank 1-800-773-7373 Call Citizens' PhoneBankanytime for account information, current rates and answers to your questions. US259 BR301 1 1 NICHOLAS MACRI 5225 WILSON LANE 305 MECHANICSBURG PA 17055 Circle Gold Account Statement O of 5 Beginning March 12, 2008 through Aprit 09, 2008 Contents Summary Page 1 Checking page 2 Savings Page 3 Retirement Page 3 Check Images Page 5 Circle Gold Summary Account Account Number Balance Balance NICHOLAS MACRI Last Statement This Statement uerusli BALANCE Checking Circle Gold Checking w/Interest Savings Circle Gold Savings Retirement 11 month IRA CD 13 month IRA CD 610068-226-9 6243-920106 6140-708184 6247-260496 Monthly combined balance to waive monthly fe? is Your monthly combined balance this statement period is 7,431.24 1,870.04 DOROTHY J MACRI Circle Gold Checking w/Interest .36 610068-226-9 00 20,749.59 .00 28,608.63 .00 n Total Deposit Balance .36 20, 000.00 n Total Relationship Balance 53,271.48 .36 Member FDIC Q Equal Housing lender SYMETRA LIFE INSURANCE COMPANY RETIREMENT SERVICES PO BOX 3882 -SEATTLE, WA 98124-3882 ~~27ru~c' ACCOUNT EFFECTIVE DATE: 12/30/2004 I~~~Ill~irlll~r~rl~l~~l~l~~llrr,Ilr~rrl,l~~lrll~lrrlrlrrl~~l~l AGENT NAME: NICKOLAS MACRI KLINGER, DEBRA K 5225 WILSON LANE OFC MECHANICSBURG, PA 17055-6622 Page 1 of 2 QUARTERLY STATEMENT 01/01/2008 through 03/31/2008 OWNER{S): NICKOLAS MACRI SYM `TRA. FINANCIAL ACCOUNT NUMBER: V000040639 ACCOUNT TYPE: IRA ACCOUNT SUMMARY -SYMETRA CUSTOM ANNUITY Beginning Value 01 /01 /08 - 03/31 /08 $25,657.04 01 /01 /08 - 03/31 /08 $25,657.04 Interest Ending Value $187.69 $25,844.73 $187.69 $25,844.73 There have not been any financial transactions during this statement period. ~S, GS 710../. ~`Ni T~ 2 ~S,'79'7~ ~'~ Important: Please contact our Retirement Services Department within 30 days of receipt of this statement if information or investments are not accurate.Oral communications should be re-confirmed in writing. Symetra Life Insurance Company reserves the right to limit its liability if inaccuracies are not reported promptly. HOW TO CONTACT US www.symetra.com: 24 hours a day web access to account balances, transaction history & fund information retser@symetra.com: email any account inquiries 1-800-796-3872: Client Services Mon -Fri, 7:00 AM to 4:30 PM Pacific Time Hearing Impaired - TT/TTY 1-800-833-6388 SymetraSM and Symetra Financial Logo are service marks of Symetra Life Insurance Comioany. 3~s t vos llv~i>~; NUMBE QTY. DESf_`RIPTION "'*** PREVI US BALANCE "'* ACTIV TY FOR CRI, NICKOLAS 02/13/08 6471221 15 OXYBUTYNIN CL ER 00378-6605-O1 02/13/08 6471211 0 BUPROPION HCL 100 00378-0435-01 02/13/08 6471222 15 ENALAPRIL MALEATE 63304-0836-01 02/13/08 6474213 15 AMLODIPINE 5MG 59762-1530-02 02/13/08 6471219 15 ISOSGRBIDE MN 30 58177-0222-04 02/13/08 6471210 15 METOPROLOL SUCC E 00186-7301-05 02/13/08 6471207 15 LIPITOR 20MG TABL 00071-0156-23 02/13/08 6471220 15 ARICEPT lOMG TABL 62856-0246-30 02/13/08 6550720 8 FAMCICLOVIR 500 M 00093-8119-56 02/13/08 6471208 0 NAMENDA lOMG TABL 00456-3210-60 02/13/08 6550721 15 TRICOR 145MG TABL 00074-6123-90 02/13/08 6549965 15 PANTOPRAZOLE SOD 00093-0012-98 * ACTIV TY FOR CRI, DEB 02/14/08 Payment-C'K#1143 ~~~,1~~ ~~9~ AMOUNT SALES TAX TT)iM TOTAL 165.98 - CRNICH - Ol * 8.00 .00 Ol * 8.00 .00 O1 * 7.76 ..00 O1 * 8.00 ..00 O1 * 8.00 ~ .00 O1 * 8.00 .00 O1 * 20.00 .00 O1 * 20.00 .00 O1 * 8.00 .00 O1 * 20.00 .00 O1 * 20.00 .00 O1 * 8.00 .00 - CNIC - 165.98- .00 143.76 469.11 143.76 MED DED YTD MED LEGEND FOR MONTH DEDUCTION FOR MONTH Pg$VIOU9 BRLANCE TH3SaMf3~NTN FINANCE CHARQE Tp 16 5. 9 8 + 14 3. 7 6 + . 0 0 ~ cx~&a>rs = 309.74 PLEASE REMIT PAYMENT T0: MILLENNIUM PHARMACYSYSTEMS,ZNC. 124; PAYABLE TO: DESC: BONNIE K. MILLER, TREASURER 1993 HUMMEL AVENUE CAMP HILL, PA 17011-5938 CONTROL NO: 013- 028022 JOB TITLE: FULLY RETIRED DEADLINE TO APPEAL OR CHANGE JOB TITLE IS 90 DAYS FROM BILL DATE. PH 240-6365 OR 1-888-697-0371 EXT 6365. .00 TOTAL ' 'T - 165.98 = 143.76 i0 PERRY HIGHWAY, SUITE 200 WEXFORD, PA 15090 TAXPAI"ER COPY BIII No: 5731 Assessed 2008 Statement of Personal Taxes Bill Date: 3/01/2008 Value 0 rnn~.rv ...-........__. ---- Rate CNTY TOtNIi Rate 5.00000 :R ALLEN 5.00000 TAx MACRI, NICKOLAS PAYER 5225 WILSON LANE #305 MECHANICSBURG PA 17055 4.90 2 t< TAX AMOUNT DUE -> ;9.80 ---- IL Paid Oa or ]-ftar 3/01/2008 Z! Paid Oa or Betora 4 30 2008 0 ~i 3l3'~6~ _~f ~j~~y ;10.00 10~ s.so ;11.00 i1/zooe -... ... v~~~f~flV For Service To: Nickolas V Macri 635 Grandview Ave Account Number: 24-0652707-3 Premise Number: 24-0385419 BllUng Period & Meter Information Billing Date: Mar 24, 2008 Billing Period: Feb 19 to Mar 18 (28 days) Next reading on/about: Apr 17, 2008 Rate Type: Residential ------Prior Balance------___..___.__ Prior Water Balance Payments prior to Mar 24, 2008. Thanksl $12.68 -12 68 Total prior balance, Mar 24 2008 . , ---Current Water Charges------_ . 00 Service Charge Water Volume ($.006809 x 100) 12.00 Total water charges, Mar 24 2 68 , 008 12 68 Meter readings in current billing period: Meter Number N037713800 is a 5/8-inch meter. Present-actual 746500 Last-actual 746400 Gallons used ~~' ~ ''' Water Usage Comparison M(lnthly nc~nn in 4,....d...~ __.. _ _ 7 ~. .t 2 0 7 -------AMOUNT DUE -----_~~__. $12.68 `~_~ 2 0 8 ~ ~~~~ 9~ ~q Messages to you from Pennsylvania American Water Any portion of the wafer charges which is not paid as of 4/21/08 will be subject to a 1.50 % penalty. " Customers may use their credit card, debit card or pay by electronic check only by calling toll free: 1-866-27i-5522. Customers may also pay on-line at www.water.paymybill.com. Aservice fee will apply. "Approximately 4.20 percent or $.53, of State taxes are included in your current bill. "Save time and money by signing up for Pennsylvania American Water's automatic payment program. Your bill will be paid directly from your checking or savrngs account. "Have you moved or changed your phone number? Please let us know, so that we can update our customer records. To update your information, call us toll-free, 24 hours a day at 800-565-7292. "ATTENTION LANDLORDS: Interested landlords can sign up for Pennsylvania American Water's landlord revert agreement program, whereby every time a tenant moves out of the rental property, the account aufomatica/ly reverts back into the landlord's name. To participate, the landlord only pays the $30 activation fee one time. For more information, please contact our customer call center at 800-565-7292. Customer $ervice'~,Emergencies i=800-565=7292"(24 Hours) For Hearing Impaired Customers TDD 1-800-300-6202,(24 Hours) Visit us on the INTERNET: www.pawc.com w-wlao -. 002131/002131 PCEFNI TATOC 1 alna lzeoa m n M J J A S O N D J F M a p a u u u e c o e a e a y n~ 9 p t v c n b r PPL Electric Utilities Electric Service For: rrlcx MACxI 635 GRANDVIEW AV)i CAMP HILL PA 170] I ~~~" ~: Page 1 ' ''~: = pp - ;_Yaiii}I3 ~Acciiiini:~iiibe`' . . . ,,, ., 5 1510-69005 Summary Page Balance as otMar 13, 2()08 $0.00 Char es: Tota~PL ELECTRIC LJTIi,IT'IES Charges $131.21 Total Charges .::<:.:;:.:::.::,.,..._..... $131.21 Account Balance Questions about r~ $131.21 this bill? Please \ ~ ~l ~ contact us by Apr 3 ~` at 1-800-34Z-5775 (1-800-DIAL-PPL) ~~ or write to: 1~ Customer Service ~( 827 Hausman Rd. Allentown, PA " 18104-9392 www.pplelecttic.com Electric KWH -Average Per Day Meter Reading Information Use 1 KO Meter #57018883 1 SO Mar 13 Actual 5383 This graph shows Feb 12 Actua_ 1 _ 4084 your electric use 120 30 Da s KWH Billed over the last 13 1299 months. Avera a -Mar 9o g 2007 2008 T pes of Temperature 31 F 34F Meter Readings; 60 KWH Per Day 166 43 Year Use: Actual . 30 ~' Total Average Apr 2006 -Mar 2007 22374 Monthly Estimated 0 Apr 2007 -Mar 2008 ] 0282 1865 857 Other important information on back ~ MAMJJASONDJPM 2007 Months 2008 $0.00 --- ----- Date °. 03/07/08 - 03/07/08 03/13/08 - 03/13/08 03/13/08 - 03/31/08 03/31 /08 - 03/31 /08 $1,821.39 ~ $(90.00) - -- - - --- __ _ ~ _ _ _ _ --- _ _I~ ----_ -- -- Descriptian T _ - ~ JI, Balance Forward Room Charge Decrease Phone Services Monthly Fee Phone Services TOTAL BALANCE DUE: $ --- -- o.c~ --- --- -JL $0.00 ------~-- $1,731.39 -- Days) !I Rate -~ Charges/ T`~ pa merits y -- -- Balance Units ~ (Credit) i ._ ._ _---_ $4,704.00 _._ (7) $5.00 $(35.00) 1 $8.39 $8.39 (19) $(154.00) $(2,926.00) (1) $20.00 $(20.00) $1,731.39 ~ a\~c'~ Y~ ~ a~~ FACILITY NAME RESIDENT NAME ACCOUNT NUMBER BETHANY ASSISTED LIVING NICKOLAS MACRI 2230 •••,~~ ~r~ Mau RP SERVICE ~~NSUaANCE~. LOC _ COMPANY AMOUNT ' `OPAIN BY ADJUST ;' YOU "'°:YOU CHARG S FOR PATIE ICKOLAS MACRI Pni~ 'owe (239778- OITA) -12-08 70450-26 5 CT HEAD/BRAIN W/0 DYE HOLY SPI MEDICARE 198.00 13.73 157.91 02/17/08 FILED P IMARY TO MEDICARE ART B (M 002) 03/10/08 Med'care Pay ent 03/10/08 10.98 Med'care Non Allowed 57 91 03/18/08 Blu Shield ayment 03/21/08 2.75 GUARANT R RESPON IBILITY D TE (Char eID: 984 69) ADDIT ONAL INFORMA IO CONCERNING YOUR ACCOUN PLEASE CO AC US IF YOU CANNOT PAY T IS BILL. THANK YO ~ ~'-'(~\ REFERRING RO IDER 045 IS JON DUBIN - UPIN: E9 045 ~ U v ADDIT ONAL STATEME T ESSAGE ~ ~ G 1~ =or bill ng questions, c 11 toll free 1-866-254- 629. 26.3 TOTALS: -- 13.73 157.91 0.00 26.36 STATEMENT DATE" ~ RESPAN3IBL' E PARTY .-,.rACGDUNT#,~ <. PQY,'~H~$~' N~ s': ; 03-23-2008 NICKOLAS MACRI 239778-QQITA PAYApITfiREC6VEDAFIER1H16STATFAENI'pA+lEyyd.L~ApFEAgON1'OUR~NEXT$tATEIASNT.$PAYbEN1"DUEIIPORItECE1pT,4HAN(~'pU., .,''; 26.36 DAYS 0 - 30 31 - 60 61 - 90 g1 _120 MAKE CHECK PAYABLE TO: ACCOUNT AGING Over 120 26.36 0.0 0.00 0.00 0.0 QUANTUM IMAGING & THERAPEUTIC ASSOCIA~ FOR ONLINE ACCESS TO YOUR ACCOUNT VISIT US AT: https:llwww.ezmedinfo.comllgita INVOICE#: 787335 FOR BILLING QUESTIONS CALL 1-866-822-8415. ,~t, o~~o~ 66>~-.,6 1066046 STOCk : F-AW Balance reflects current patient responsibility only and does not include charges pending with your insurance carrierw BOROUGH OF WORMLEYSBURG 20 MARKET STREET, WORMLEYS[3URG, PA 17043 PHONE: ('17) 763-4483 FAX: (717) 763-5701 ACCOUNT NO. _ BILLING DATE ~ 40728-0 04/01/08 i._ _.__._ _ ___-__ SERVICE LOCATION __ 635 GRANDVIEW AVENUE F _SEWER UNITS _ TRASH UNITS 1.00 1.00 PREVIOUS_BALANCE __ PENALTY/CHARGES - --- 0.00 0.00 *- ;----- i _ CURRENT,SEWER __CURRENT TRASH I~ 75.00 46.00 .I-- i ----- _ USAGE--- ~ ~ ~ 0 12 L___ __._._.____ BILLING PERIOD _ ___ 04/01/08 06/30 08 05/01/08 133.10 c~ ~l~~Ia ~~ ___ ~ ID~~ _ __-__ - ___ _ IF TAXES ARE ESCROWED, FORWARD TO MORTGAGE CO. SEE SCHOOL TAX BILL FOR JULY & AUG COLLECTION HRS Control No: 047 - 00051 0 i'AYABLE TO. WILLIAM A. O'DONNELL, TAX COLL PO BOX 200 WORMLEYSBURG, PA 17043-0200 oesc: ASSESS.NO-47000510 MAP NO: 47-19-1590-001A 635 GRANDVIEW AVENUE ACRES .230 DEED 0024W 00480 LOT 19 Residential Building t7FCIIlFNTIAI N V Macri 5225 Wilson Ln Mechanicsburg, PA 17Q55 OFFICE MAR: TUES ONLY 4-6PM; APR: TOES Houas: & WED 4-6PM; BOROUGH OFFICE 20 MARKET STREET; CALLS TAKEN MON - THURS 9-4PM ~ 717-737-0974 TAXPAYER COPY BIII No: - 528 ~g S;YAtAenwM eft R~1 r.Ms~~ Te..r o:u n_._- Assessed Land Improvement Mineral Total Values 22 830 125 310 0 148 140 COUNTY OF CUMBERLAND, PENNSYLV R t q~o~M Faa a es ,00228500 .00228500 2 $ 10 $ COUNTY R E 52.17 286.33 331.73 338.50 372 35 Rates .00018000 .00018000 2 $ . 10 $ COUNTY LIB 4.11 22.56 BOROUGH OF WORAIILEYSBURG , 26.14 26.67 29.34 Rates .00267800 .00267800 2 $ MUNZC. R E 61.14 335.58 $ 396.72 10 $ 436.39 TAX AMOUNT DUE -> ~~.~ ~~,~y ~_~ IL Paid Oa or 11ltar 3 O1 2008 5 O1 2008 7 O1 2008 I! Paid Oa or Belore 4 30 2008 6 30 2008 IF NOT PAID BY 1?HS1Z008 THIS BILL W ILL BE RETURN ED TA TaY cLA~wl BUREAU FOR COU~CTION AND FlUNG OF A UEN AGAWST YOUR PROPERTY. REVERSE SIDE OF BILL FOR A BREAImOWN OF YOUR COUNTY TAX DOLLARS « ~- ~~ ~ l Return Bill with Payment. For a Receipt ,Enclose Self Addressed Stamped Envelope. PPL Electric Utilities Electric Service For: NICK MACRI 635 GRANDViEW AVF, CAMP HILL, PA ~ 701 ~ Quesfions about this bill? Please contact us by May 5 at 1-800-342-5775 or write to: Customer Service 827 Hausman Rd. Allentown, PA 18104-9392 www.ppleleciric.com Electric Use This graph shows your electric use over the last 13 months. Types of ctcr Readings; Actual . I?stimated Customer ~, ~, ~ ; ., +' ~ . ~~ ••,. ..-- ••. pp '~": ~"•~ ., Page 1 Summary page 13alancc as of Apr 14, 2008 $0.00 Char >es: Tota~pL ELECTRIC UTILITIES Charges $43.96 'Cotal Charges ,; $43.96 Account Balance - .. _ ~,^~~~~,#~.>"~>` ~V `~ a~ 1 0~ ~[~~~ $43.96 t 96 80 G4 48 32 16 0 K W I I -Average Per Dav Meter Reading Informati on Meter #57018883 A r 14 Actual Ma l3 5734 r Actual 32 Da s KWH 11BI ~ 5383 351 Average -Apr 2007 Tempperature 4 2008 KWI-I P D 8f 45F er ay ll Yearly Use: Total gg e Use May 2006 -Apr 2007 227] 9 Monthl ~ May 2007 -Apr 2008 80~ 4 1 gc~ i 672 Yaifr Bill,-.tLccc~unl;:I~tuiEtb,er 5 1 5 1 0-69005 Other important information on back ~ AMJ .IASONI).i FMA 2007 Months 2008 For Service To: Nickolas V Macri 635 Grandview Ave Account Number: 24-0652707-3 Premise Number: 24-0385419 Billing Period & Meter Information Billing Date: Apr 22, 2008 Billing Period: Mar 18 to Apr 16 (29 days) Next reading on/about: May 19, 2008 Rate Type: Residential Meter readings in current billing period: Meter Number N037713800 is a 5/8-inch meter. Present-actual 746500 Last-actual 746500 Gallons used 0 ~nrormatton ng ummary ---------Prior Balance---------_________._ Prior Water Balance Payments prior to Apr 22, 2008. Thanks! Total prior balance, Apr 22,2008 -----Current Water Charges-----__ Service Charge OSI - PAWC Charge .45% Total water charges, Apr 22, 2008 ---------AMOUNT DUE -------.______. ~ ~4~ t'; Water Usage Comparison Monthly ncann in h~i...d....l __u_.__ 2 1 1 2 0 0 7 ~v~essages to you from Pennsylvania American Water Any portion of the water charges which is not paid as of 5/19/08 will be subject to a 1.50% penalty, ' Customers may use their credit card, debit card or pay by electronic check only by calling toll free: 1-866-271-5522. "Approximately 4.20 percent or $.50, of State taxes are included in your current bill. Celebrate Earth Day. We are! Everything from hosting an educational station at "Earth Day Along the Susquehanna River" event for 1,000 students (grades 4-7) at Nesbitt Park (April 18) to sponsoring a watershed cleanup in the Perkiomen watershed (April 19) to supporting the Fayette County Children's Groundwater Festival (April24). For more in/ormation on these and other activities, visit www.pawc.com. Select 'About Water", then "Commr,nirv ~~ $12.68 -12.68 .00 12.00 .05 ,12.05 $12.0 A M J J A S O N D J F M A 2 p a u u u e c o e a e a p y n ~ 9 p t v c n b r r p 8 For Service To: Nickolas V Macri 635 Grandview Ave Account Number: 24-0652707-3 Premise Number: 24-0385419 ummary Billing Period & Meter Information Billing Date: May 13, 2008 Billing Period: Apr 16 to May 09 (23 days) Next reading on/about: May 19, 2008 Rate Type: Residential ----------Prior Balance-------_______ Prior Water Balance - Payments prior to May 13, 2008. Thanksl Total prior balance, May 13, 2008 ------Current Water Charges-----__ Service Charge DSI - PAWC Charge .45% Total water charges, May 13, 2008 --------AMOUNT DUE -------__-____ Meter readings in current billing period: Meter Number N037713800 is a 5/8-inch meter. ~ ~ ~ ~ O Present-actual 746500 ~ ~( Last-actual 7465 ~~ 00 Gallons used p ~ ~'x U Water Usage Comparison Monthly usage in hundred Gallons t Messages to you from Pennsylvania American Water This is your Final Bill for service. t has been a pleasure serving you and we hope we may again have the opportunity in the future. "Approximately 4.20 percent or $.38, of State taxes are included in your current bill. "Guard against imposters posing as utiliiy workers: Do not op the door to anyone who cannot provide a photo ID badge. Check the service person's vehicle. All Pennsylvania American Water vehicles have the company's logo clearly displayed on the side. If there is any question about the person's identity, don't hesitate to call us at 1-800-565-7292 to confirm service work is scheduled in the area. " Save time and money by signing up for Pennsylvania American Water's automatic payment program. Your bill will be paid directly from your checking or savings account. 'Have you moved or changed your phone number? Please let us know, so that we can update our customer records. To update your information, call us toll-free, 24 hours a day at 800-565-7292. " Effective April 1, 2008, the Distribution System Improvement Charge (DSIC) increased from 0% to 0.45%. This charge funds the replacement of water distribution facilities. Customer Service & Emergencies 1-800-565-7292 (24 Hours) For Hearing Impaired Customers TDD 1-800-300-6202 (24 Hours) Visit us on the INTERNET: www.pawc.com aAw~oo $12.05 -12.05 .00 9.20 .04 9.24 9.24 001164/001164 PCEUKD TAT08 1 AtM 6925 2 ~~ ~ u A 5 0 N D J F M A M 2 00 a u u u e c o e a e a~ a p ~ y n ~ 9 p t v c n b r y 0 8 ., '~ ~ ~ ~ ~ ~ i '~~ `~'••~•••• '~ Page 1 .• +,,, Y.oucf3ill!AccountNiiinbcr PPL Electric p~ "'_ •+. Utilities ' ~ M 5 1 5 1 0-69005 Usc:whcn'calG vrwriUa ~____ Electric Summary Page Service Balance as of May y, 20Og $0 00 l~or: Charx cs: MCKMACRI 1'otafPPL FLEC'FRFC U7'ILFTILS Charges $24.34 63S GRANI)VIF.W AVE cnMt~ tTU,t. rn I~ol I Total Charges Final Rifl $24.34 Pay Thr~ Annount :No I;atcr than 1VIay'30 2008 - Account Ralancc -_- __--__- ~Z4,3: Questions about ~~ $24.34 ) this bill? Please -\` contact us by May 30 ~ ~ 1 ~\ at 1-800-342-5775 (1-800-DIAI,-PPL,) },~ or write lo; %~~ Customer Service 827 }Iausman Rd. .. Allentown, PA 18104-9392 www. pplelectn c.com Electric KWH -Average Per Day Meter Reading Information Use 6TH ~ __ -- _ --- ---- --- Meter #57018883 Sp --- ___ ____-_--- _ _ _ MaY y Actual 5898 'I~his graph shows _ - - - -_- A r 14 P Actual 5734 - - --- your electric use 25 Days KWI-I Rilleci - over the last 13 40 --_ -- - -.- -_-- - -- 1 fi4 months. Average -May 2007 30 --- - - -- _ _ 2008 -- - - ----- Tem eralure '1' pes of 57F' S8F Meter Readings: 20 - KW I Per Day i0 7 Yearly Use; Total Averagge Actual Ip --- - _ Use Monthly -~ lun 2006 -May 2007 22587 1882 Estimated ~ t~ _ _- _ lun 2007 -May 2008 7310 609 Other important information on back ~ M J J A S O N D J F M A M 2007 Monlhs 2008 ~••~~ ,vri-MOD RP 'SERVICE'; ~ '-~ rJNSURANcE r,P.: : , "comaANy AMOUNT iNS ADJUST you. ~ ::you CHARG S FOR PATIE ICKOLAS MACRI 1239778- pITA) PAiD owe 72-12-08 70486-26 5 CT MAXILLOFACIAL W/0 D HOLY SPI MEDICARE 236.00 02/17/08 FILED P IMARY TO MEDICARE ART B (M 002) 182 90 53. 1C 03/10/08 Med'care Non Allowed 03/23/08 82.90 FILED S CONDARY 0 HIGHMAR BLUE SH ELD-NON ND (HIO 1) 05/07/08 GUARANT R RESPON IBILITY D TE (Char eID: 984 70) ADDIT ONAL INFORMA IO CONCERNING YOUR ACCOUN PLEASE CO AC US IF YOU CANNOT PAY T IS BILL. THANK YO Q, REFERRING RO IDER 045 IS JON DUBIN - UPIN: E9 045 `J \ ADDIT ONAL STATEME T ESSAGE ~, or bill ng questions, c 11 toll free 1-866-254- 629. \D~ TOTALS: 0.00 182.90 0.00 53.10 STATEMENT DATE ~ RESPDNSIBLE PARTY< -'~ AccauNT~t . `PAY T S= MORN 05-07-2008 NICKOLAS MACRI ~`J`'- ,~ ,, ,, 239778-QQITA 53.10 PAYNENTSRECEIVED AFtER1NIS STAIENR](TpATEyyi;liplipEAR ON YpUR NEXT STAiEHDIT: PAYMENT DUE UPON RECEIPT. ~TRAk}~YOl1.~~ DAYS 0 - 30 31 - 60 61 - 90 91 -120 Over 120 MAKE CHECK PAYABLE TO: ACCOUNT AGING 53.10 0.0 0.00 0.00 O.O QUANTUM IMAGING & THERAPEUTIC ASSOCIA FOR ONLINE ACCESS TO YOUR ACCOUNT VISIT US AT: https:llwww.ezmedinfo.comllgita INVOICE#: 803744 FOR BILLING QUESTIONS CALL 1-866-822-8415. )9) 011~I RS)1-169 10])840 STOCK = F-AW Balance reflects current patient responsibility only and does not include charges pending with your insurance carrier.nw Treasury Retail Securities Federal Reserve Bank of Clevelpnd Pittsburgh Branch fisco! Agent of the United States May 29, 2008 MS DEBORAH M MACRI 4137 KITTATiNNY DR MECHANICSBURG PA 17050 Dear Ms. Mac--i: P.O. Box 299 Pittsburgh, PA 15230-0299 1-800-245-2804 A review of our records indicates that your recent savings bond redemption transaction for the Estate of Nickolas Macri was_processed incorrectly, you recently received a deposit in the amount of $71,315.28. In the pricing proc , s -t a.~ discovered that one bond was priced incorrectly, which resulted in an overpayment o~7.12, he bond in question was a $200 Series EE R318 09/ 1986. The e- rred when the bond was priced as a Series EE bond5with6anE ssu-e date-of 09/ 1984E In this regard, we are asking that you please return a check, made payable to the FEDERAL RESERVE BANK OF PITTSBURGH, as soon as possible in the amount of $27.12 in the enclosed envelope. Thank you in advance for your prompt attention to this matter, and we apologize for any inconvenience this may have caused you. If you should have any questions, please contact our Quality Assurance Area at 1-800-245-2804. When prompted, select Option 3, followed by Option 2. You may also contact me directly at 412-261- ] 293. Si- cerely, - q 1 ~, ~~~ ul a A Beall C stomer Service Representative Federal Reserve Bank of Cleveland Enc.: Copy of bond Return envelope For information about Treasury Retail Securities, go to: www.treasurydirect.gov Treasury Retail Securities federal Reserve Bonk of Cleveland Pittsburgh Branch Fisco! Agent of the United States P.O. Box 299 Pittsburgh, PA 15230-0299 1-800-245-2804 June 2, 200 MS DEBORAH M MAORI 4137 KITTATINNY DR MECHANICSBURG PA 17050 Dear Ms. Maori: A review of our records indicates that your recent savings bond redemption transaction for the Estate of Nickolas Maori was processed incorrectly, you recently received a deposit in the amount of $71,315.28. In the pricing procejss-it wa, discovered that a second bond was priced incorrectly, which resulted in an overpayment of.27.12. e bond in question was a $200 Series EE, R31858246EE 10/1986. The error occurred when the bond was priced as a Series EE bond with an issue date of 10/11984 1n this regard, we are asking that you please return a check, made payable to the FEDERAL RESERVE BANK OF PITTSBURGH, as soon as possible in the amount of $27.12 in the enclosed envelope. Thank you in advance for your prompt attention to this matter, and we apologize for any inconvenience this may have caused you. If you should have any questions, please contact our Quality Assurance Area at 1-800-245-2804. When prompted, select Option 3, followed by Option 2. You may also contact me directly at 412-261- 1293. Sin erely, 11'1 (~ ~ 4 l~`._ r r ,_ ~7 ~ '~ uli A Beall Customer Service Representative Federal Reserve Bank of Cleveland Enc.: Copy of bond Return envelope P~ ~`5~~ici5 For information about Treasury Retail Securities, go to: www.treasu rydirect.gov ~~ SNAQEON!ltER SERVICES NICHOLAS MACRI & DOROTHY J MACRI JT TEN C/O DEBORAH MACRI 4137 KITTATINNY DR MECHANICSBURG PA 17050 06-05-2008 REGISTERED OWNER: COMPANY NAME: F~ARSCO CORPORATION CLASS OF STOCK: Common ACCOUNT KEY: MACRI----NIGH-0100 Dear Shareholder: ~~~ :~~~ ~ ~ ~~~~ \~~' ;,~~~' ~lei~ LOST SECURITIES DEPARTMENT P.O. Box 358317 Pittsburgh, PA 15252-8317 Certificate Number(s) Share or Principal Amount H000083579 100.0000 H000094697 100.0000 A stop has been placed against each certificate noted above, which has been reported lost, stolen or destroyed. If the certificate has been located, please notify us so the stop can be removed. If the certificate has not been found, and you would like a replacement to be issued, a lost instrument open penalty surety bond must be obtained and filed with Bank of New York Mellon. The purpose of the bond is to protect the issuing company and Bank of New York Mellon against any responsibility to honor the original certificate in the event it is ever presented to the issuer or Bank of New York Mellon for transfer. For your convenience, Bank of New York Mellon has set up a program through which you may obtain such a bond. Alternatively, you may, if you prefer, obtain a lost instrument open penalty surety bond from an insurance company of your choice. The insurance company must be rated A+XV or better by A.M. Best & Company. If you choose to obtain a bond through Bank of New York Mellon, you will need to complete the enclosed forms and return them to us. The attached document describes certain additional requirements, which may or may not be applicable to you. Please comply with the requirements set forth under the heading that applies to your specific situation. All signatures must be notarized by a notary public or guaranteed by a financial institution that participates in a Medallion Signature Guarantee program. Upon completion of the enclosed fork,;, please return all :.opies along with a copy of this letter a^d any additional requirements, with a money order, certified check or cashiers' check made payable to Bank of New York Mellon Shareowner Services for the surety bond premium and service fee listed below. To help us identify your account, please indicate the following reference number on your check: 192687 Surety Premium: $125.02 Service Fee: $200.00 _~~' Total $325.02 Please note that Bank of New York Mellon is unable to re you any do uments that you submit in connection with this process and that additional information, signatures or documents may be requested. If you wish to obtain a lost instrument open penalty surety bond on your own rather than through Bank of New York Mellon and have any questions, please contact us at the number provided below. Please notify Bank of New York Mellon as soon as possible if your original certificate is located after you receive a replacement certificate. Depending on the timing of such notification, a partial refund of the bond premium may be available to you. Should you have any questions or need further assistance, please contact our Communication Center at (800) 270-3449. CASE NUMBER: 331031 CUSIP NUMBER: 41586410 REFERENCE NUMBER: 192687 il;s~ ~~>~~~ .-.;„d.~e E ~ . ~, '~~i` ~• nu ~ '~~ i ~y, ~~~ n~ y, . a t i4 ~.;~~ ~ "~ ~_ a o o o o ~, _~ m _~ .~ ~~ o -~- o w F--~ C~ `/ J ^~ ~ o N i J ~ T ~ U `~ ~ L ~ p ~ h('il ~°a d ~ o~ ~--1 w N ~ wm~ '~ \~ Q p ~ ~ Y~~ ~ V ~~l~ v ~ ~, ~ Cv ~ -~ ~ ~~~ _~