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HomeMy WebLinkAbout10-31-08J 1.5056041125 R~~~~ ~~~ EX (06-05) PA Department of Revenue OFFICIAL USE ONLY - Bureau of Individual Taxes County Code Year File Plumber Po Box 280601 Harrisburg, PA 17128-0601 INHERITANCE TAX RETURN RESIDENT DECEDENT ~~ ~'~7 __11 ~~ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 1 8 6 3 4 2 0 5 3 1 0 2 5 2 0 0 7 0 8 0 2 1 9 4 4 Decedent's Last Name N E L S O N Suffix Decedent's First Name D A V I D AQ I ~_ (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WIILLS MI FILL IN APPROPRIATE OVALS BELOW Q 1. Original Return ~ 2. Supplemental Return ~ :I Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ .~. Federal Estate Tax Return Required death after 12-12-82) 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust f~ Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ t0. 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 TA}; INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number P A U L B R A D F O R D O R R E S Q 7 1 f' ~~ ~ _' Firm Name (If Applicable) = °° ~-~ C? REGISTER OTi`~ILLS USE"iJNLY L A W O F F I C E O F P A U L O R R --- r-~ ._...( - ~~ First line of address ,,; ,:,, 5 0 E A S T H I G H S I R E E T -~ Second line of address ~_~ °; -,-, - f~ i City or Post Office State ZIP Code DATE FILED C A R L I S L E P A 1 7 0 1 3 Corresp nd is e- ai addre PAUL R EMBARQMAIL.COM Under pe ies f perlu declar th 1 I have e e this return, including accompanying schedules and statements. and to the best of my kro~~iledge and behaf it is true. o ec nd co ete De ar on of pr ar r her than the personal representative is based on all inform ation of which preparer has amp :Howled e SIGNAT F PERS N RESP NSI LE F R IN R TURN i !~~ ` 1 ADDRESS - 50 EAST HIGH STREET CARLISLE PA _1701 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE _ DATE ADDRESS ~ ~"~-~~~`-~'-' PLEASE USE ORIGINAL FORM ONLY Side 1 15056041125 1 ~= O~i_~04 i_1 2.5 15056042126 REV-1500 EX Decedent's Social Security Number David G. Nelson -- ~ `~' - `~ - i' r' ' Decedent's Name: - RECAPITULATION 1. Real estate (Schedule A) 1. 2. Stocks and Bonds (Schedule B) 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) 3. 4. Mortgages & Notes Receivable (Schedule D) 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested 7. 8. Total Gross Assets (total Lines 1-7) 8. -, ~, (_l (1 ~ ~~ 9. Funeral Expenses & Administrative Costs (Schedule H) ~' r, 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 10. 11. Total Deductions (total Lines 9 & 10) 11. 0 ~; <~ 7 ~>~ c 12. Net Value of Estate (Line 8 minus Line 11) 12. ~ r' % ~a :~ `" 13. Charitable and Governmental BequestsiSec 9113 Trusts for which an election to tax has not been made (Schedule J) 13. - 1 %~ ~ y 3 3 14. Net Value Subject to Tax (Line 12 minus Line 13) 14 - TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES " 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0 i ~ ~j 0 15. 16. Amount of Line 14 taxable at lineal rate X .0 _ 0 0 0 16. 17. Amount of Line 14 taxable at sibling rate X .12 0 0 0 1 7 18. Amount of Line 14 taxable at collateral rate X 15 0 0 0 1 g, 19. Tax Due 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505604212r 1`:.0~6ii~2:i :'. F, t_l ij ( ; I) : ( 1 (1 ~`1 (1 (~ !J !:~ Ct ~ REV-1500 EX Page 3 Decedent's Complete Address: File Number DECEDEfJT'S NAME David G. Nelson --_ ___ STREET ADDRESS 13 LARKEN LANE - -- -- - CITY MT. HOLLY SPRINGS STATE 71P PA 17065 Tax Payments and Credits: 1 Tax Due (Page 2 Line 19) (1) 0.00 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C Discount Total Credits (A + B + C) (2) 0.0Q 3. Interest/Penalty if applicable ~- D. Interest E. Penalty Total InteresbPenalty (D + E:) (3) 0.00 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) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 0.00 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN 1"HE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :.................................................. ^ [~ b. retain the right to designate who shall use the property transferred or its income; ...... ^ X^ c. retain a reversionary interest; or ............................................................... .... ^ C~ d. receive the promise for life of either payments, benefits or care? ............................... ^ [X] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ........................................................... ^ [X] 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 containsabeneficiarydesignation?......_...._ ............................._................_..... ^ ^X 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)] 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. OCAL REGISTRAR'S CERTIFICATION ~OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograpFl. ~ Fee tix lhi< re~riificate. tib.Ofl P 1~~~79g2 ~;;rrr%~ ~-~ This is to certify the( the inf~onnation here gi~~en is It,~~p,~ZH OFpfy~~ correctly copied from an original Ccrtificatc of Death "to~~ ~ ~ duly filed with ore as Local Registrar. 1'he orr~*inal o`~,I' 1;z certificate will he forwarded to the State Vital ~~ y i~ a Records Office li)r permanent filing. ---- MINT Ur ;II~~ ~..a....~ ..- . ~,~..~ ~CI'UIkCa[Il)I? ~Ulllhk'r - .ura//,tl Local Rc~~istrar v rn a .~ a 0 U D, 0 R105.144 REV 1t/2ad6 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS TYPE / PRIIJf IN BLACNNNK CORONER'S CERTIFICATE OF DEATH >r~31-124 (See instructions and examples on reversal Date [slued 1. Name d Decedent (Fxsl, midde, baL sureal David G N l 2. Sax 3. Sadal Security Number V 1 ^' L r"c "V 1n 4. Dale of Death (Month, daY, year) e son Male 186 - 34 - 2053 October 25, 2007 5. Age (last BidMay) Undsr 1 year Under 1 day 6. Date d Birth (MOnm, day, year) 7. Binnplaca ( end state or for ' n country) Ba. Place of Deem (Che k mty ar.) 63 Maww oBn ~° µ""B8 NospilaC aher yrs Aug. 2, 1944 Mt. Holly Spgs. Pa.^ mpatiem^ER/oatpeuent^DOA ^Narsi Nnma rg Residence ^aher-Spedry: Sb Co d D m . ny ea &. C , of Death Bd. Facility Name (If not imlAUtiw, gNe sheet end number) 9. Was Decedent d Hispank Origin? ®No ^ Yes 10. Race: Ameacan Indsn, BbQ Wnib ek , , . Cumberland Mt. Holly Springs 13 Larken Lane nfYee.aPedtyadan, tsPaaM Maxkan, Pusdo Rian, etc.) Whit e 11. Deatlen's Usual lkc don Nird d work Oona mod d tile. Do not smh mlire0 12. Was Deaxm ever in the 13. Deadem'e Edualion (Sped y Dory highest grade completed) 16. Madlal Sbtus: Merited, Never Mameq 75. SurvNirg Spouse (If wile give maiden name) Ki , nd d Wak Kktl d Busk.sa / Indlsby U.S. Armed Faces? Ebmenhry /Secondary (412) College I1< or S+) Wxbwed Divorced (Span/)? Laborer St New M l er ore C orrie erk ^Y~ ~No 12 rsB - 16. DeatlenYS Meairg Atl6ess (Street, dy /town, able, zip coda) Decedents D ~~ ~e~t Actual Resbwa 17a. Slate • lJve in 17c. ^ YBS, Deatlent Lnred m Twp. 13 Larken Lane ,,,~,,,,y Cumberland T°w'""'p? nd.C~NO,Decedwllivaawahk Mt. Holly Spg Onhs of $ - P d ' Ac1ue11 . ~! Bom 18. Fathefs Name (Flrsl natltlle, bsl suRxj 19. Mome(s Name (First, middle, maitlen surname) Carl Nelson Sara Kohr 2a. InlwmenYS Name (Type /Print) 2W. InlOmmm's Maihng Awress (Street, chy /town, wale, W wde) Martha Stum 153 Southampton Dr-- Harrisonbur Va 22801 21a. Memod d Disposition; ~[] Cmmalion ^ Donetbn 21b. Dale of Dlapailion 1Mpnm, day, Year) ^ &rdel ^ Removal Iron Slate ~ . 21c. Place of Dispoition (Name of caatery, cremahry a omnr Plea) 21tl. lmatbn (City I town, sole, zip care) Wu Cremation or DarUw Authorized Oe t . 31 2 0 0 7 ^omer-sPetry_ ibykkdk.lEx.mirnrlcawrrl glvea^Nn ~ ~ Ho 11 i n e r FH g /Crematory Inc Mt.Holly Spgs-Pa.17065 72e. Sigretae d Fwnal (a pawn eclbg m such( - ~ ~ 221,. License Number 22c. Name entl Address d Facilay 5p 1 N BB 1 t 'more A V - .,.~ FD-011589-L Hollinger FH/Crematory lnc:B Mt. Aol~y ~prings,~a.17065 Canplate hems 23et Doty vArw anilying physidan'e rid avaaabb al erne d deem l0 2 . To a,e bell d my krgMetlge, Oeem occurred at the Hme, Ooh end plate elated. (Sigralwe and line) 23b. License Nunber 23c. Dare Signed (MOmh, tlay, year) array aaa. a deem. - aema 26.26 rtxrn ba axnpletetl by person wro pranaartee aatn 24. Time of Death prX . 8 00 A 25. Data Prwwacal Dead (MOmh, day, year) O t b 27 2 26. Was Case Referred to Medxxl Examiner / Coroner iw a Reason oher than Cremation a Donation? . : . M. c o er , 007 ~(vaa ^No CAUSE OF DEATH (See Inatruetlona and esamplee) , Approximate bmrval: Item 27. Part I: Eller me dshl of evems - K eases, inrydes, a conplkaliau- mar directly ausetl me deem, DO NOT solar lamkal evan6 swh as caNiec arr ! Pad II. Enlw dhw ~r d wndtiws d anB,1 •m, 28. DM Tobeca Use Cwiddde h Dmm? as , Omel to DBam respratay arrest, a ventrindar PoONeaon without sfawkrg the eddogy. Usl wry are ease w each Ibe. bur 11d resullirg in the urltledying aua given in Pan L ^ Vas ^ Probagy WMEDIATE CAUSE Flnal tlksease w ta,dlbnrea~dfin in~eami ^ No ^ Unkmwn g a. ~ _Occlusive Coronary Arter Disease zs.rcFemab: Due la (w as a consequence off: ~ ^ Nd pregnant within past year let canditiore, R wry, bedalP to cause Ydetl w Ane a. h' ^ Pregnant al time d seam Emer Brs UNDERIYMG CAl15E Da to (w as a conssquerlce op. (deease a kNal' mat iwietad me ^ Not preg;teM, bW pegnam wahin 42 tleys .gene rasuNng .n deaml usT, c. Due to for as a wnsequerxw oh. w d earn ^ Nat IxaAran6 bM Pregnam a3 days to 1 year e. ~ beNre death ^ Unknown it preyrranl wimb the pall ybr 3Da. Wee en ANatssy 3gb. Warn Aukpry FiMkga 31. Mamer d Deem Pedormed? Avaaede Prbr m Conpbam }y~ 320. Dale d Injury (Month, day, yeaq 32b. Destrme Now Inlary Occared 32c. Plea 1 bury: Hasa, Farm, areal Faday, d Caum of Deem? IC6Natural ^ Hanidde Olfia BuNd"ag, ak. (gpeLrly) ^ Yes ~NO ^ Vas ^ No ^ AwideM ^ PBMkg Investigation 32tl. Tma d Inury 32e. Injury et WaM7 321. If Tremponetiw Injury ($pedFyJ 32g. Laaaw al Injury (Street, dry /lam, state) ^ Sukide ^ Cauk Nd W Determined ^ Yes ^ No ^ Dnvar/ Opemta ^ Passenger ^Peasabn M aMr' Spealy: 33e. Cedifier (dleck say war • caaMrlg DeWd.n (Phyalaan amlying aaa at deem when anana physidan has pmrolmad mem one cwwbtea ham 231 33b. Sigralae and T Co r one r To tl1e heal of my bnwdedga, death occurre0 due M tM auae(a) uM manner u sbbd_ _ _ _ _ _ _ _ _ _ ^ _______________________ • Prwoullcglg sad certXying phyaklen (Phyzdan both PrawurKing death and arM ir h d d m - y g ease ee ) To the heat of my kttowhdge, dead) otptrrted ei the ems, deb, and place,enaduelomeaase(e)argmawaruabted_____________ __ ^ _ _ _ 33c License NaMer 33tl. Doh Signed (Monm, Oat. Year) McOlpl Exsmker /Coroner • O October 29 2007 n tae basis d examlru0on and / a IrnMlgaaon, In my oplnbn, dam oaaretl rM Ma tlme, Oats, all plea, entl due to the auaMa) and menror as sbletl ~ s _ 34. N M u P w 1 Caused m Ite ~~ "~ ~ ~ ( m 271 Type I Print 35 R t natureantlUSirid c tae ~ oL r .s, ~or oner . - I ~I l I cdl ~ I~ I .DeteFaeO(Mwm,dey,yeeN 6375 Basehore Road Suite 4f1 ~ 3C ~ ~ Mechanicsburg, PA 7050 Olspasilion Parma Nn. UOt i~ ~tv<s REGISTER OF WILLS CUMBERLAND COUNTY PENNSYLVANIA No . 2007- 01 150 Estate Of: DAVID G NELSON (First, Middle, Last) CERTIFICATE OF GRANT OF LETTERS F'A No . 21- 07- 1 150 Late Of : MT HOLL Y SPRINGS E30ROUGH CUMBERLAND COUNTY Deceased Social Security No: 186-34-2053 WHEREAS, on the 19th day of December 2007 an instrument dated February 18th 1999 was admitted to probate as the last will of DA VlD G NEL SON (First, Middle, Lastl Late of MT HOLLY SPRINGS BOROUGH, CUMBERLAND County, who died on the 25th day of October 2007 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, GLENDA EARNER STRASBAUGH Register of Wills in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAIIAENTARY to: BRIAN NELSON who has duly qualified as EXECUTOR(R/X) and has agreed to administer the estate according to Iaw, all of which fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYL VANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 19th day of December 2007. r ~ ~ .. ~ c.- } ~p egiste~ of it C!•/ ' %" !~"~ i Deputy **NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) LA~~T W~1L,1L. AI~YIID 71'lE~'}i"Al~lll+ll`l'll' X11'' ~A~li~ ~e I~YIELS®lY I, ll~~yu~l ~o ~1e9~®~, a legal resident of South 1Vliddleton Towns~iip, Cumberland County, I~ennsylvania, being of sound and disposing mind, memory, and understanding, do hereby make, publish, and declare this as and for my Last Mill and Testament, hereby revoking all other wills and codicils heretofore made by me. FtlifR~'~'~ I direct that all my just debts and funeral expenses, including my grave marker, shall be paid from the assets of my estate as soon as practicable after my decease. ~ll;~~l~~o I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as apart of the expense of the administration of my estate. '1['~I1~IE8IDo I give, devise and bequeath the residue of my estate, of every nature and wherever situate, to my mother, Sara A. Nelson, provided she shall survive me by thirty (30) days. Should she fail to survive me by thirty (30) days, I devise and bequeath said residue to my nephew, Erian Nelson. ~~gTll~T1111o I nominate, constitute and appoint my mother, Sara A. Nelson, Executrix, of this, my Last Will and Testament. In the event of the renunciation, death, resignation, or inability to act for any reason whatsoever of the said Sara A. Nelson, I nominate, constitute, and appoint Arian Nelson, Executor, of this, my Last Will and Testament. I hereby relieve my Executrix or her successor from the necessity of posting security in connection with their duties as such in any jurisdiction in which they may be called upon to act, insofar as I am able by law so to do. '~?~? WITNESS ~?~l-IEIZE~1~', I have hereunto set r y l~wnd a::d sea;! to t?:is, n:,~ Last I~~ill and Testament, consisting of two typewritten pages, each of which bear:; my initials, this /' 8''~ day of r~~~Pc,~.q~rr , 1999. (SEAL) Signed, sealed, published, and declared by the above-named Testator, i)avid G. Nelson, 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. ,~~~ - r r ~~~1 V ® V V ~li%11Y~~llJ~T ~'lJ'lYY1WA®N WL[`yLTIlA ®ly H LNNIJ'~L~l2NI~ `l~`V '1J19T~ ®Y ~~lJ 1V&Ill'JLiI~v.BNI~ ~~. I, David ~. Nelson, Testatrix, whose name is signed to the attacl~ed or foregoing instrument, having been duly qualified according to law, do hereby acky>owledge 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. ~ySworn or ar ed to and acknowledged before me by David G. Nelson, the Testator, this ~_ day o , 1989. Notary Public IVotari,E Seal 9 SL'Satl K. Gu~c•, Notary Public Carlisle Co•o, ~Uu~;%st~erland County Poly Con~;issiar. ~xr;i,-es; Sept. 4, 1999 ~i~l n.~er. l~'F~ni~~:lti~t,~ .'~i~i~IFifICif10!(VUtarl~5 Ally ~°~g-A~11'~' ~~MM®NWEAT.TT-T ®1~ PENNS~'I,~IANTA ~®TJNT`1' ®P ~T1M~EI~L,ANI~ SS. We, Edward L. Schorpp and ~~ "'- t, ~ J "~ % ,the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testator sign anal execute the instrument as his bast Will; that David ((~. Nelson signed willingly and that he executed it as his free and vol;,.nt~nf x~.t for the purpose therein expressed; that each of;~s in thQ'~carir~.g ~~nd s?ght of tl,e `T'estator signed the Will as witnesses; and that to the best of our knowledge the Testator was at that time eighteen or more years of age, of sound mind, and under no constraint or undue influence. Sworn or aff rmed and subscribed to before me by Edward chorpp and ' ^ •' ,witnesses, this ~~-day of , 1999. (SEAT,) Witness, Edward I,. SchorT~p ,~;. < ~'= /~1 ~~ (SEAL) Witness Notary Pablic a ~r.t~.~i-a.? lea! ~I~~:?n Ff. ~u err. Notary Public ~~~ ~ ~~ ~ ~ ,~ ~r „uarland County Y ~" Irir I .'.~ Y - lli Fri )~~~t. 4r 999 ,:+,s~; ~ u ~ ~ ; ~~~ccialic~h of hataries RIEV-1508 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERfTANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY I ESTATE OF David G. Nelson FILE: NUMBER Include {he proceeds of litigation and the date the proceeds were received by the esfaie - All property jointlyowned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. PNC BANK __ 2.04 PO BOX 609 PITTSBURGH, PA 15230-9738 2. WAYNE MYERS AUCTION SERVICE 330.00 92 GREENS VALLEY RD. LANDISBURG, PA 17040 3. WAYNE MYERS AUCTION SERCIVE 134.57 92 GREENS VALLEY RD. LANDISBURG, PA 17040 4. COMMERCE BANK 481.41 ACCT NUMBER 0537397580 5. MOBILE HOME SALE- Gross Sale (Buyer also Paid Debt on Mobile Home) 5,000.00 13 LARKEN LANE MT. HOLLY SPRINGS, PA 17065 6. Receipt # 535752 (Dated January 12, 2008) Individualized below 6a. Lawn Tractor 75.00 6b. Snow Blower 100.00 6c. Leaf Blower 20.00 6d. Blue Recliner 25.00 7. 1996 Jeep Grand Cherokee (Poor Condition) 1,000.00 8. 2007 IRS Tax Stimulus Check 300.00 TOTAL (Also enter on line 5, Recapitulation} I $ 7,468.02 (If more space is needed- insert additional sheets of the same size) Free Checking Account Statement PNC: Bauk For the period 03/27/2008 to 06/19/2008 DAVID G NELSON 35 ELM DR CARLISLE PA 17013-8804 II\IPORTANT INFORMATION ABOi?T ~"f1~1 'IRANSACI'IONS ANll PURCIIASFS PNCBANK Primary account number. 50-0447-4839 Page 1 of 1 Number of enclosures: 0 (~ For 24-hour banking, and transaction or /=='' interest rate information, sign on to a' PNC Bank Online Banking at pnc.com. For custormer service call 1-888-PNC-BANK between the hours of 6 AM and Midnight ET. Para servicio en espanol, 1-866-HOLA-PNC Movingl' Please contact us at 1-888-PNC-BANK ® Write to: Customer Service PO Box 609 Pittsburgh PA 15230-9738 J~4 Visit us at pnc.com •'~ TCID terminal: 1-800-531-1648 Fo~, hearni,~ impaired clients onh~ For your convenience, under certain conditions we may allow you to overdraft your checking or money market account when using your PNC Bank Visa Check Card or PNC Bank 13ankina Card at PNC Bank ATI~Is, non-PNC A"1~1~~Is. and for merchant purchases. At PNC. Bank AT~'Is we can give you the choice to cancel the transaction if it would cause an overdraft. lVe are not able to provide you this choice ~~-hen using a non-PNC' Bank A'Ih1 or when making purchases. Efleclive .tune 22, 2008, ifyou would ptmfernot to have overdraft access, call our'felephone Banking service at 1-477-222-5101 hetu~ecn 6 am - 12 midnight, l~astern Time, seven days a week. If you have called previously to opt-out of overdraftt access at non-PNC A1'1~'Is, you are automatically excluded liom overdraft access iin all ATn~I transactions and purchases and do not need to call want. Forntot~e infotntation, please see our Consumer Schedule of Set~~ice ('barges and Fees, Other Account Charges and Sets-ices and/or Account Agreement for Personal Checking and Savings Accounts, Withdrawals section. .~.~~~ Free Checking Account Summary David G Nelson Account number 50-0447-4839 Balance Summary Beginning Deposits and Checks and other balance other additions deductions 2.01 .00 .00 Average monthly balance 2.0~( Ending balance x.04 Charges and fees 00 FORM953R-1005 L.OT # ~ '~ RECEIVED' DATE CONSIGNOR'S NAME ADDRESS _ CON~I__GNIUIEI~IT CONTIR~CI~ /'AND SETTLEMENT .~?~ -- ' ." PI-IONE ZIP CODE ~ ' ~~~ ~° h a i. .. Arn ~~~~~ s~a-~...-tr ~~ W»' f. • ~ .3~~. ~:~. f:=~ s Joao - +" S ti . ~~~ - ,.f . - ;< -- : ,:. ... !~:' ~..F ... - 't ~ '..,1-A /' -- .r' - ~ - .,- ~ ,~ 1 ~ ..°C I' Ar f,. ~ l~ e ~ .t p ~ - .. ~_~' ~`F I .r ~. ~ el 1'( i' ~ _ R /y ~! .( __ .. ~. .. - ..f.. _... __.:.. _..... - f+I /ef~.__.,r • .rte ~ • _ ! l ' ~ , -- ~~ ~' T { ( ~ SHEET # OF TOTAL SHEETS I (consignor) hereby commission you to sell the items listed above & on the attached sheets to the highest bidder by public auction. I certify that I am the owner of the above listed items and have good title and the right to sell them. I certify that the items listed are free from all encumbrances. I agree to accept all responsibility for providing good title and for delivery of title, the purchaser. It is agreed that the consignee is not responsible for th of any item due to fire, theft, damage, etc. l understand thatany item due to fire, theft, damage, etc. I understand that a --_ % commission will be deducted from the gross sales of my items. "No Bid" items will be disposed of at the discretion of the Aue~tioneeNAuction House. Payment will be made to the consi~hor v~ifhin days from date of sal 1 - ,.,~..•; r ,r,~/:~ _... Date j...' : f _ ,~. ~ -- /' Consignor Signature f f ;' i . ) 4 ~~ ~ 1, -"` Date . ~ ~, .'~,•5 r~, ' Auctioneer/Auction Staff Signature ~ ;,~ CONSIGNOR'S SETTLEMENT COPY EXPENSES: SET'TL.EM NT TOTAL CONSIGNOR SALES ~ ~r~~ s r" ~..''~ % COMMISSION $ ~~.~.:~ ° ~ $ -- $ - ~ ~ ..a $ _ >'~ A ~-- i ~ ~s TOTAL EXPENSES $ = Try ~ r ~ ,f ~ ~-~' CHECKAUO. "fir i'~~ NET PAYABLE TO CONSIGNOR ~~ ~' L.OT # .~ _ DATE CONSIGNOR'S NAME ADDRESS PHONE :~ . -7d < ZIP CODE Y ~ It • • • ~ . ~ • • • ~ _ 2 ~_ ~...; -~ _. .: -?' ~ ~ r'_ ~. ~ ,, SHEET # OF TOTAL SHEETS l (consignor) hereby commission you to sell the items listed above & on 1:he attached sheets to the highest bidder by public auction. I certify that I am the owner of the above listed items and have good title and the right 1'o sell them. I certify that the items listed are free from all incumbrances. I agree to accept all responsibility for providing good title and for delivery of title to the purchaser. It is agreed that the consignee is not responsible Tor the loss of any item due to fire, theft, damage, etc. I understand that a % commission will be deducted from the gross sales of my items. "No Bid" items will be disposed of at the discretion of the ,4uctioneer/Auction House. Payment will be made to the consignor within days from date of sale. Date Consignor Signature Date Auctioneer/Auction Staff Signature CONSIGNOR'S SETTLEMENT COPY til ~ \4 CC-N~~uN~PIENT CIONTIR~,CT ~1'~D SETTLEMENT )EXPENSES: .. _ SETTLEMENT ~~TOTAL CONSIGNOR SALES "~ ~ , f!~ ~;_, .., ,.~~`" °!a COMMISSION $ ~' $ ~ ~• vC.. $_ $ $ W _ ,/" rK t TOTAL EXPENSES $ a~ t ctiecK No ~ NET PAYABLE TO CONSIGNOR r •--~ .~` °' Commerce CBank 0184021NY2NOD003713 DAVID G NELSON 13 LARKEN LANE MT HOLLY SPRINGS PA 17065 Commerce Bank/Harrisburg N.A. P.O BOX 4999 Harrisburg, Pennsylvania 17111-0999 1-888-937-0004 We're here 7 days a week, 24 hours a day at 1-888-937-Oa04. 50 PLIJS CHECKING 0537397580 Statement Balance as of 10/12/07 Plus 3 Deposits and Other Credits Less 13 Checks and Other Debits Statement Balance as of 11113!07 Transactions By Date Date Description 10/15/07 WTHDRL DDA 6802 10/15 10:52 413 FORGE RD BOILING SPRIN PA 10/15/07 CKCD DEBIT `10114 KARNS QUALITY FOODBOILING SPRINPA 10/15107 CKCD DEBIT 10/72 KARNS QUALITY FOODBOILING SPRINPA 10/15/07 CKCD DEBIT 10/14 SHEETZ OOOOMT HOLLY SPRGPA 10i16l07 CKCD DEBIT 10114 CCBill.com * fxper888-5969279 AZ 10117/07 CKCD DEBIT 10116 SHEETZ OOOOMT HOLLY SPRGPA 10/17107 CKCD DEBIT 10116 SHEETZ OOOOMT HOLLY SPRGPA 10118/07 WTHDRL DDA 3908 10118 12:08 413 FORGE RD BOILING SPRIN PA 10/22107 WTHDRL DDA 0031 ?0/22 10:55 413 FORGE RD BOILING' SPRIN PA 10122/07 CKCD DEBIT 10120 DOLLAR- GENERAL #88MOUNT HOLLY SPA 1Q/22)Q7 .CKCD DEBIT 10/20'SHEfTZ OOOOMT HOLLY SPRGPA 10/24/07 CKCD DEBIT 10123 SHEETZ OOOOMT HOLLY SPRGPA $767.65 $401..85 $286.24 $883.26 Debit . Credit $41A0 $11.02 $15.12 $24.65 $29:95 $19.72 $20.01. $41.00 $41.00 $5.62 Balance $726.65 $715.63 $700.51 $675.86 $645.91 $626.19 $6as.18 $565.18 $524.18 $518.56 $19.72 - $4913.84 $16.43 $482.41 1Q/25l07 CKCD DEBIT 10134 AP9* $1.00 SAViNGSMART.CO800-316877A CT 11/01/07 AC-JH USA PACE ACH -PENSION 11!01!07 AC-BENEFIT PAYMENTS-PENSIONS.. $84.72 $317.04 '$481.41 $566.13 $883.17 003 Cycle Page 1 of 2 NOTE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION Member FDIC Commerce CBank Transactions By Date Date Description Debit Credit Balance 11113!07 INTEREST PAYMENT $0.09 $883.26 Interest Summary Beginning Interest Rate 0.15% Number of Days in this Statement Period 3Z Interest £arned this Statement Period $0.09 Annual Percentage Yield. £arned this Statement Period (APY) 0.15°f° Interest Paid Year to Date.. $0.58 EFFECTIVE JANUARY 1, 2008 RESULTS OF AN ELECTRONIC TRANSFER INVESTIGATION WILL BE PROVIDED WITHIN THREE BUSINESS DAYS. 537397580 0784021NY2N00003713 Page 2 of 2 NOTE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION Member FDIC U~/ ~~ / ~~ ~~ ~~ r Q~ '1 ~~ G~ ~~ _ 6i -~~ ~ ~~ i~ -`~~ ~ ~ °~ ~~ ~ ~`, ~ ~~ ~~ s ~~ ruNr F°N}He cuFlE \ ~- ~F rJ ~''~ ~ ~ m W ~~ N 3 ~ ~i C~ NON ~ ~p~ N O~ ~ ~ o ~ t ~~m oX ~ r ~~ ~A~ °~ y ', u' ~ r ~~ °~ r A ~ ~ ~' a v N -d O Z '~ Z ~~ ~ -J ~, u, _ o r'`. ~ a ~, ~ ~c-~--~. ~~ !~ {~.i ~ w ~ ~' Estate of David G. Nelson 13 Larken Lane Mt. Holly Springs, Pa. 17065 To whom it concerns: This letter is to advise that Larry L. Warner and Kenneth S. Hollinger, owners of Mt View II agree that all unpaid fees have been paid in full as of Friday February 22, 2008 for the address of 13 Larken Lane, Mt. Holly Springs, Pa. 17065. As of February 16, 2008 the total cost of lot rent and late charges owed are $1,895 alon€; with additional $6.00/ day in late charges until paid in full. As of February 16, 2008 the water, sewer and trash total was $206.00. These fees are from the dates of September 2007 through February 2008. Thank you Brian L. Nelson LX ztil Larry arner and / or Kenne~h S. Hollinger ~., Brian L~. Nelson ,~~ ~ )~ G`Ji~itrl(~ive.-..~ ..__ ; ~ ~,~ -~:~roYi..VAIViA NOTARIAL SEAL DAWN M. CAREY, Notary Public `~n, a of Carffsle, Cumberland Gaup it N 9wom8~Sub~d~~_ ,, ~~ ~e~ ~~ ~m= 535752 ~~~ t~ r e il,< © ~ I { I ~ fl I 1 1 b F [ 1 1 (•!;1 n! t ~- / ~ S' it ~..y w~..~ i'rGT .Tl. "... S~A3~i6a'a ~c Tw^G>^.I~Ta.. ~ p I it \ ~ ` CERT'iFiCATE OF TET'LE FE>R L ~ Er}ICE Y r ~ ~ t I ~. ~ ' / r ~•'"~~ ~ ;~ , 261 ~" ..~' ^8^31Q272^^D22^-^^1 ~ l~ ~~ ~ rx ~ t , ~„ ~ ~ ~ 1J4~Z78S5TC29y642 1996 I JEEP I ~ 506199^91^1 NE ~a ~I, ~.'~!~ VEHICLE IDENTI FIGATION NUMBER YEAR MAKE OF VEHICLE ~ TITLE NUMBER ° j°~, ~~~ SW 1 1/37,1^8I, ^^^^39~ ^ .~ f E30D`' TYPE DUP SEAT CAr~ PRIOR TITLE STATL OfJOM. PROCG. DnTE ~ ODOt,~~. M'I_EC. ~ ODOM. STHTU„ t !. 3f21l97 F 1l3L1D8 ~ `' , m~i i~ DATE PA TR LEG DATE OF ISSUE UNLADEN WEIGHT GVWR GCWF ~ 4t TITLE BRANDS i~-,-''~;~-~' W !~ v W W O REGISTERED OWNER(S~ DAVID G NELSON ', 13 LARKEN LN MT HOLLY SPGS PA 17^65 FIRST LIEN FAVOR OP. FIRST LIEN RELEASED DATE BY AUTHORIZED REPRESENTATIVE MAILING AD DRES"- ^39^36 DAVID G NELSON 13 LARKEN LN MT HOLLY SPGS PA 17^65 SECOND LIEN FAVOF OF: ODOMETEFI STATUS U =ACTUAL MILEAGE . = A1ILEAGE E%GFEDS THE MECHANICAL LIMITS - =MOT THE ACTUAL MILEAGC .. - NOT 7HE ACTUAL MILEAGE-ODOMETER TAMPERING VERIFIED < = E%EMPT FROM ODOMETEP I1ISCLOSl1RE I:I LE BRANDS .- _. ANTIGUc VEHICLE =CLASSIC VEHICLE E~ = COLLECTIRLF. VEHICLE - CUT CI= COUNTRY ~. = ORIGINALLY MFGD_ FOR NON-U.S DISTRIBUTIOf: = AGRICULTURA•_ VEHICLE _ =LOGGING VEHICLE - ISANAS A POLICE VEHICLE = RECONSTRUCTED = STREET ROG T =RECOVERED THEFT VEHICLE = VEHICLE' CONTAINS REISSUED VIN w =FLOOD VEHICLE Y, I5,'WAS k TAXI II a second lienholtle~ is Ilsted upor. safisfacfion of the firs) lien. the firs'. Ilenholder must (orwarc ihi~ Title Io ;ne Bureau of Motor Vehicles with the appropriate form and fee. SECOND LIEN RELEASED DATE B': _ AUTHORIZED REPRESENTATIVE I certil, as eI Ine darn el IS6lle. the oillaal renord~ nI the Pennsylvania Daparin,ent ALLEN D BI E H L E R el Transporldilon reflect inat the person) sr or company named herein Is the lawlul owner ~ • of the said vehiae. tiecret:rn of 7l~anspurlaliml a.° . 4. . 1 1 la 'I:• B fi ° sueseRIRED AND SwoRN '-'~ ~ ~ ~ ~ II a co-purchaser other than your spouse is listed and you want the tlfle to TO BEFORE ME: ~_ ~~ be listed as "Joint Tenants Wlth RigYd of SUNIVCBhip' (On death Oi one ei~•. onv YEAH owner, title goes to surviving owner.) CHECK HERE ~. Otherwise, the title _ \ will be issued as "Tenants in Common" (On death of one owner, interest of ~~~_ deceased owner goes to his/her heirs or estate). r SIGl~~ATURE Cif SON AnMIN!STERIN{, pAll~ I- i 1ST LIEN DATE' • IF NO LIEN, CHECK I ` COMMONWEALTH OF PENNSYLVANIA ,ST LIENHOLDEF NOTARIAL SEAL JUDITH D. KAUFFMAN, NOTARY PUBLIC CARLISLE BOROUGH, CUMBERLAND COUNT' MY COMMISSION EXPIRES MARCH 10 2011 , M1rztOt~~ applicalo~ Cenilica~c Tnl ~, Ihr va~icc- a_,cnlioo a i £nnl i !. [P. ~ 1 o111a ~ [ 3 . col nrt^ 1-cr~_ STATE ZIP IIS IS AN ELT. CHECK HERE ^ F'NANCIAL -'. FIN REOUIREU INSTITUTION NO. LIEN DATE. ~- IF NO LIEN, CHECK 2ND LIENHOLDEH ~G'~l/1C//'f~UH-. OLD Pf'f~l.l :i O/AVTHORIZEI~ SIGNFr~ '-~Y'~~~t~ `tIG'tJ.~T~~. Or : (~~~;HtJN~ii'c C1~A±~YRShI!EOLi1ENEr STREET CITY 6TATE ZIP IF THIS IS AN ELT. C'.HECK RERE ^ FIN ANCtAL NOTE FIN REQUIRED INSTITUTION) NO. .. ~ N O ~ O~ J O ~ z r" ~ ~ O H ~ U1 f-- O~ ~- O cJ M ti N V~ O z ~ ~ N N N J N W N z N O N .p Q O ~ X M ~ w H - F- ~- ~0= ~ ~ Z ~ = O H O ~ ~ H F- O~ .~ ~ N O ~ O M Q N _= r, ~~o N . O o z `- Mp~_~t ~t O J Q ~- ~ W ~ ~o'-z~ O aw C7 J ~ ~ ~h N O ~ CJH N M ~ HWJ O (V '~ ~ ~ r Q~Q = ~Mt~ ... O _ ,IL~_9 O a •~ ~ O O ~!c O O M ~J2 ~k is ~k W z o. W a; o: >u 0 0 7 ~, a z W i d w F N v 0 O v W 0 N zzo6o~os bscooo .-~ S D [~ ru RJ Q' O ..a O ~~ r. L11 • Q' [O er1 n,, E.V-1511 EX+(12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ~~,~~ ~ ~~ David G. Nelson FILE NUMBER Debts of decedent must be reported on Schedule 1. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. HOLLINGER FUNERAL HOME & CREMATORY, INC. 2,486.50 B. 1 ADMINISTRATIVE COSTS: Personal Representative's Commissions t~lame of Personal Representative (s) Brlan L. NeISOn Social Security Plumber(s)/EIPJ r~lumber of Personal Representative(s) 166-66-0547 _ StrPPt A~~rP~s 35 Elm Drive city Carlisle state PA z,p 17C113 Year(s) Commission Paid 2 Attorney Fees LAW OFFICES OF PAUL ORR 900.00 3, Family Exemption (If decedent's address is not the same as claimant's. attach explanation) Claimant Street Address 4 5. 6. 7. 8 City State Zip __ Relationship of Claimant to Decedenl _ Probate Fees CUMBERLAND COUNTY REGISTER OF WILLS Accountant's Fees MARSTON'S TAX SERVICE 817 FACTORY STREET, CARLISLE, PA 17013 Tax Retum Preparer's Fees THE SENTINEL -LEGAL, PO BOX 130, CARLISLE, PA 17013 THE PATRIOT NEWS, 812 MARKET STREET, HARRISBURG, PA 17101 ss.oa 35.00 118.72 194.73 TOTAL (Also enter on line ~I, Recapitulation) I $ 3,800.95 SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS (If more space is needed. insert additional sheets of the same size) Hollinger Funeral Home & Crematory, Inc. Eric L. Hollinger, Supernisor 2ND NOTICE March 11, 2008 Brian Nelson 35 Elm Drive Cariisie, 1'ia 1Ui3 The Funeral Service for David G. Nelson; We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please feel free to contact us if you have any questions in regard to this statement. THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT, AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS. Professional Service Cremation Package D $ 1995.00 AT THE TIME FUNERAL ARRANGEMENTS WERE MADE, WE ADVANCED CERTAIN PAYMENTS TO OTHERS AS AN ACCOMMODATION. THE FOLLOWING IS AN ACCOUNTING FOR THOSE CHARGES. Cash Advances Newspaper Notices -Sentinel Newspaper Notices -Patriot LCi 1111C1.t LVF/le? UI lJCOt~i ~.~.~ t~t:t,.s t.. , `, r ~~, Cumberland County Coroners Authorization Clergy Current Balance: $ 103.60 96.90 60.00 25.00 100.00 2/ 4g6.5U ~ ~ o5~al~o8 501 NORTH BALTIMORE A'~ENUE • MOUNT HOLLY SPRINGS, PENNSYL\7ANIA 17065 • (717) 486-3433 • FAX (717) 486-3215 www.hollingerfuneralhome.com Check Image Page 1 of 1 HOME 480UT US CONTACT US NEWS S E1[.N ~`S PUF3LI ?,TIONS R~SOURC ES Account Summary Transfers eSfatements Bill Payer Services vsa Loan Applipfions My Profile Messages Check Image Ciose Front of Check: ~_... ' ~s.'~ SOVERE1GN ~ ~ ~' f ~IMI' L NELSON ~ NELSON SAY ~ ~ 28~ eo-az+2n9 iYu 110 i nutsa~ GtitSlE PA t~~~ ` ?JI9-~1LrE~'1R'i~t ~ I _ - -~ - ---~kG. v 1:23~38224L~. 2L83240262~' iL0 •''0 0248650f' Back of Check: w LL O., ;- ~? ~_,.o--O V., .._rZ p ~':/'n m ¢u~~~~~ ~wawp~ ~apW~~ _... ~ I ¢oa ~. - ... '33=Rd L~9s]=:1'L± Lr73+)-.Lb;3 ~~ ~1Li43Zi.^'c4c•E3C•iEi'"i'`3'~~i~ ~~%%r~]L7~lJs 4~5 l Close Window 02008 h^ -nt i FE .. r Urra~~; M .. F~. i. .~~a https://ml online.members 1st.org/OnlineBanking/AccountSummary/CheckImage.px?accou... 10/3/2008 RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Cumberland County - Register Of Wills One Courthouse S uare Carlisle, PA 1713 NELSON DAVID G Estate File No.: 2007-01150 Paid By Remarks: BRIAN L NELSON JA ------------------- Fee/Tax Description PETITION LTRS TEST WILL AUTOMATION FEE SHORT CERTIFICATE JCP FEE Check# 370 Total Received......... Receipt Date: 12/19/2007 Receipt Time: 14:15:32 Receipt No.: 1050964 Receipt Distribution ----- -------- ------- ---- Payment Amount Payee Name 20.00 CUMBERLAND COUNTY GENERAL FUN 15.00 CUMBERLAND COUNTY GENERAL FUN 5.00 CUMBERLAND COUNTY GENERAL FUN 16.00 CUMBERLAND COUNTY GENERAL FUN" 10.00 ---------------- BUREAU OF RECEIPTS & CNTR M.D $66.00 $66.00 ~d o 7 ~~~~ 4 MARSTON'S TAX SERVICE 817 FACTORY STREET CARLISLE, PA 170131352 ctmarston03@aol.com April 11, 2008 DAVID G. NELSON 35 ELM DRIVE CARLISLE, PA 17013 Statement of Charges for Services Rendered: Per Form Charges: See forms listed below -Federal Total fee $ Summary of Federal Form Charges: Description Charge per Form Count Form 1040 Individual Income Tax 35.00 1 Summary of Pennsylvania Form Charges: Description Charge per Form Count / v ~, y,/f ~ v~ l 35.00 35.00 Charge 35.00 Charge Check Image Page 1 of 1 HOME ABOU'C llS CC NTAC I~ U5 NEWS & EVEN 7S PJBLIC ATIONS RESOURCES Account Summary Transfers eStatements Bill Payer Services Vsa Loan Applications My Profile Messages Check Image nose Front of Check: ES1tATE OF W1MD c NELSON «, ~ 108 lINML L NELlON +~ ~" wo~nou+~ ~ Ll'r{ 1s ' ~ ciwus~E ra t~ota STDIW~ TAX SE°~! Z 35' Ckj °~ ~~:23i3822~.i~: 2~832L,0262r 008 Back of Check: ~ _. . c- tt ~~ ~ F =- ~ • ~ ~~ g g ~i .+ ~ ~~ g - .~ a Close Window n2008 MLf.~eER~ isi P - - ~ Usi r, ~F M ~ a~. c~~n h P_ - _~,. I' "Y ~!El f h11, I ..._ i 'R. J{„ ~ ~i~-A~1C `a l 'i ~.. i I~ ~-. < https://m 1 online.members 1st.org/OnlineBanking/AccountSummary/CheckImage.px?accou... 10/3/2008 20 ~~ Received from: The Sentinel Box 130, Carlisle, Pa. 17013 For: Class. Circ. Retail Lega Other 84791 ~~ %~~~ Invoice No. ~_~/ /~~~ Initialed by JAI'/~ RETAIN THIS PORTION FOR YOUR RECORDS THE SENTINEL - LEGAL V v P.O. BOX 130, CARLISLE, PA 17013 BRIAN NELSON AD NUMBER CLASS SALESPERSON BILLING DATE LINES 344231 10 PUBLIC NOTICES carss 03/10/08 28 * 2 AD DESCRIPTION START DATE STOP DATE EXECUTOR NOTICE LETTERS TESTAMENTA 02/23/08 03/08/08 PUBLICATION INSERTIONS RATE NET AMOUNT GROSS AMOUNT 3 THE SENTINEL - LEGAL 3 LGL 111.72 TOTAL AD CHARGE 111.72 3 PROOF OF PUBLICATION OlPRF 7.00 PREVIOUSLY PAID -118.72 YS RUN PURL"ASE ORDER _ PAY THIS AMOUNT . 00 David G. Nelson .oo* MESSAGE: Thank you for advertising with The Sentinel. Deadlines for in-column legal advertisements: Monday is Friday at 11 a.m.; Tuesday is Friday at 4 p.m.; Wednesday is Monday at 12 Noon; Thursday is Tuesday at 12 Noon; Friday is Wednesday at 12 Noon; Sunday is Thursday at 12 Noon. If you have any questions regarding your Legal bill please call Tammy Shoemaker 717-240-7176 Fax your legals to 717-243-3754 attention Tammy Shoemaker You can also EMAIL your legal to Classified ads: classified@cumberlink.com Please send a cover letter including your name and address as an attachment DETACH AND RETURN THIS PORTION WITH YOUR PAYMENT THE SENTINEL -LEGAL David G. Nelson P.O. BOX 130 CARLISLE PA 17013 AD NUMBER CLASSO START DATE STOP DATE 344231 PUBLIC NOTICES 02/23/08 03/08/08 AD DESCRIPTION BILLING DATE TELEPHONE NUMBER EXECUTOR NOTICE LETTERS TESTAMENTA 03/10/08 717-422-5207 BRIAN NELSON 35 ELM DRIVE CARLISLE, PA 17013 I..,III~~~111~~~~~~11~~11~1~~1~1 GROSS AMOUNT OF .00 DUE AFTER 04/09/08 TOTAL AMOUNT DUE .00 ENTER AMOUNT ENCLOSED 20200000003442310000000000000000000000000000002 PROOF OF PUBLICATION State of Pennsylvania, County of Cumberland Troy 4Vhitesel, Classified Advertisin Manager of The Sentinel, of the County and State aforesaid, being duly sworn, deposes and says that THE SENTINEL, a newspaper of general circulation in the Borough of Carlisle, County and State aforesaid, was established December 13th, 1881, since which date THE SENTINEL has been regularly issued in said County, and that the printed notice or publication attached hereto is exactly the same as was printed and published in the regular editions and issues of THE SENTINEL on the following day(s): February 23, March 1, 8 2008 COPY OF NOTICE OF PUBLICATION ~„ ,ru , EXECUTOR NOTICE Letters Testamentary on the Estate of DAVID G. NELSON, late of Mount Holly Springs, Cumberland County, Pennsylvania, deceased, have been granted to the undersigned. All persons knowing themselves to be indebted to said Estate will make payment immediately, and those having claims will present them for settlement. Brian Nelson, Executor 35 Elm Drive Carlisle, PA 17013 Affiant further deposes that he/she is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statement as to time, place and character of publication are true. Sworn to and subscribed before me this 10th day of March 2008. i Notary Pu is My commission expires: c~/~/~'O COMMONWEALTH OF PENNSYLVANIA Notarial Seal Christina L. Wotfe, Notary Pudic Carlisle Boro, Cumberland County My Commission Expires Sept 1,2008 Member. Pennsylvania Association Of Notaries The Patriot-News Co. 812 Market St. Harrisburg, PA 17101 Inquiries - 717-255-8292 NELSON 35 ELM DRIVE CARLISLE PA 17013 Ile ~lahiot News NOw you know THE PATRIOT NEWS THE SUNDAY PATRIOT NEWS Proof of Publication Under Act No. 587, Approved May 16, 1929 Commonwealth of Pennsylvania, County of Dauphin} ss Joseph A. Dennison, being duly sworn according to law, deposes and says: That he is the Assistant Controller of The Patriot News Co., a corporation organized and existing under the laws of the Commonwealth of Pennsylvania, with its principal office and place of business at 812 to 818 Market Street, in the City of Harrisburg, County of Dauphin, State of Pennsylvania, owner and publisher of The Patriot-News and The Sunday Patriot-News newspapers of general circulation, printed and published at 812 to 818 Market Street, in the City, County and State aforesaid; that The Patriot-News and The Sunday Patriot-News were established March 4th, 1854, and September 18th, 1949, respectively, and all have been continuously published ever since; That the printed notice or publication which is securely attached hereto is exactly as printed and published in their regular daily and/or Sunday/ Metro editions which appeared on the date(s) indicated below. That neither he nor said Company is interested in the subject matter of said printed notice or advertising, and that all of the allegations of this statement as to the time, place and character of publication are true; and That he has personal knowledge of the facts aforesaid and is duly authorized and empowered to verify this statement on behalf of The Patriot-News Co. aforesaid by virtue and pursuant to a resolution unanimously passed and adopted severally by the stockholders and board of directors of the said Company and subsequently duly recorded in the office for the Recording of Deeds in and for said County of Dauphin in Miscellaneous Book "M", Volume 14, Page 317. PUBLICATION COPY This ad # 0001813269 ran on the dates shown below: February 14, 2008 February 21, 2008 February 28, 2008 i3TAT6 NOTICi1 i~ Letters Of TestameMcrv on the EstWe .... .. ........ . } pavld G. Nelson, late of Mt. Holly rlnps, Cumberland County. Pennsvl - nla, deceased, twvln0 been Orantsd to _ eundenl0ned,allpersonslndebted Id estate ore requested to make Imm - S ` to ar-d subscribed before me,this 2 d~.y of February, 2008 A. D. ` dlah aayment and those havlnp claims will present them for settlement to: I ~ ~ ,, ~•~` Brlaa Nelson 95 tilrll Drive PA 17019 Carllsb ~~_ ~ ' .`~~ ~ ~'~~ ~ ~, ~, '~ , g~11f0r - ~ Notary Public ~ COMMONWEALTH OF PENNSYLVA~ a Notalia! Sea! ~~~ Shortie L. Kisner, Notary Public CrtY Of Hartisburg, f~auphin Courltl. My fiat Expires Nov. 26, 2G ( I Member, Pennsylvania Association of iNo~ ~S .. . The Patriot-News Co. 812 Market St. Harrisburg, PA 17101 Inquiries - 717-255-8292 NELSON 35 ELM DRIVE CARLISLE INVOICE ALL CHARGES ARE NET ACCT # NAME 178318 NELSON 178318 NELSON 178318 NELSON 178318 NELSON c~he ~latriot News NOw you know PA 17013 AD ORDER # DATE EDITION ADDTL. INFO. 0001813269 02/14/08 REGULAR 0001813269 02!14/08 REGULAR 0001813269 02!21/08 REGULAR 0001813269 02/28/08 REGULAR TOTAL: REMITTANCE ADDRESS The Patriot-News Co. 23794 Network PL Chicago, IL 60673-1237 TYPE OF CHARGE AMOUNT BOLD TEXT CHARGE $4.00 BASIC AD CHARGE $61.91 BASIC AD CHARGE $61.91 BASIC AD CHARGE $61.91 AFFIDAVIT CHARGE $5.00 $194.73 ~3l i~ I Please include the Account # or Ad Order # (above) with your remittance--Thank You NOTE: This Invoice replaces the Order Confirmation which we previously sent with Proofs of Publication Check Image Page 1 of 1 HUMt ~&C)UT US COPJTACT US NEWS 8 EVEN `$ Fi_BLIC ATIONS RESOURCES Account Summary Transfers eStatements Bill Payer Services Vsa Loan Applications My Profile Messages Check Ymage nose Front of Check: ~ Estate a~ oano G ~saN -- - - f 9 i~- 106 ~ ' eauw ~ ~tsoH pE$1'f71tS181E1f~ptilDllAl ~' (~-o3-0i8 ~ aa~ orawE tJlr~lSlE. PYI t7SY:3 ]~'~~:- _(~ile. hw~e~d n -~ ~~~ .:. a =.. a ~ . :u wa..~.an 4~s ~ I$ 1;23L38224~t: 2~832~U262~' 01 6 ~'00000~94?ir' of Check: > ~96506bZ9< QAS~ Sly l'1~ X88 ~ 0~.8~58 i3ii ~i3 ~aM:~ia~- ~.'iria~d ur~i Nitiii~ a Qi2i~ iI1J3 ~0 R~ ~5R~9 FEZ. HQQ 88R8b8 SBR~~tt £- ~i~36Qb0~ i8 ~c.£Z60 L L'.. r.... . i~ic46il4 ~ ~ i~1 Close Window ©2~J08 Mir.^~.i ~ FC~~er:.n, C~L~ir U^ncN ME ~ ~~ir. Pr^. .,.. i_. raF https://ml online.members 1st.org/OnlineBanking/AccoiutSummary/CheckImage.px?accou... 10/3/2008 REV-1512 EX + (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER David G. Nelson Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. MOUNTIAN VIEW TERRACE 2 137 60 250 BEETEM HOLLOW RD. NEWVILLE, PA 17241 2. CUMBERLAND COUNTY RECORDER OF DEEDS 1.50 1 COURTHOUSE SQUARE CARLISLE, PA 17013 3. SOLLENBERGER'S MESSENGER SERVICE 39.50 29 WESTMINISTER DRIVE CARLISLE, PA 17013 4. SOLLENBERGER'S MESSENGER SERVICE 5.00 29 WESTMINISTER DRIVE CARLISLE, PA 17013 5. PENN CREDIT CORPORATION 36.00 PO BOX 988 HARRISBURG, PA 17108-0988 6. PENN CREDIT CORPORATION 72.00 PO BOX 988 HARRISBURG, PA 17108-0988 7. AT&T MOBILITY: ACCT NUMBER 34695453-001-40 128,74 PO BOX 537113 ATLANTA, GA 30353-7113 8. EASTERN ACCOUNT SYSTEMS OF CONNECTICUT, INC. 131.47 PO BOX 837 NEWTOWN, CT 06470 9. AFNI, INC. 98.01 PO BOX 3427 BLOOMINGTON, IL 61702-3427 10. KOUGH'S OIL SERVICE 327.42 PO BOX 116 NEWVILLE, PA 17241 11. CREDIT BUREAU CENTRE 288.85 PO BOX 273 MONROE, WI 53566 12. MET-ED 393.03 PO BOX 16001 READING, PA 19612-6001 13. MERCANTILE INNOVATIVE SOLUTIONS 58.87 PO BOX 9016 WILLIAMSVILLE, NY 14231-9016 14. PHILLIPS & COHEN ASSOCIATES, LTD 806.07 PO BOX 48458 OAK PARK. MI 48237 15. BOROUGH OF MT. HOLLY SPRINGS 98.58 200 HARMAN STREET MT. HOLLY SPRINGS, PA 17065 TOTAL (Also enter on line 10, Recapitulation) $ 5,496.40 (If more space is needed. insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent David G. Nelson Decedent's Name Page 1 Schedule I -Debts of Decedent, Mortgage Liabilities, 8~ Liens File Number ITEM NUMBER DESCRIPTION AMOUNT 16. MERCHANT'S CREDIT GUIDE CO. 419.91 PO BOX 18053 HAUPPAUGE, NY 11788-8853 17. THE HARTFORD 171.62 PO BOX 5025 HARTFORD, CT 06102-5025 18. CUMBERLAND COUNTY TAX CLAIM BUREAU 202.77 ONE COURTHOUSE SQUARE CARLISLE, PA 17013 19. MIDAS AUTO SERVICE EXPERTS 79.45 740 EAST HIGH STREET CARLISLE, PA 17013 20. M&T BANK-SAFE DEPOSIT BOX (no monetary value) 0.00 PO BOX 4223 BUFFALO, NY 14240-4223 SUBTOTALSCHEDULEI 873.75 GRAND TOTAL SCHEDULE I $ 5,496.40 MOUNTAIN VIEW TERRACE 250 BEETEM HOLLOW RD NEWVILLE , PA. 17241 02/22/08 BRIAN NELSON 35 ELM DRIVE CARLISLE, PA. 17013 717-226-2982 EXECUTOR FOR THE LATE DAVID NELSON ESTATE: THIS IS CONCERNING LOT RENTS AND LATE CHARGES ALONG WITH WATER, SEWER AND TRASH OWED FOR THE LATE DAVID NELSON MOBILE HOME LOCATED AT 13 LARKEN LANE. MT. HOLLY SPRINGS, PA. 17065. LOT RENT AND LATE CHARGES ARE AS FOLLOWS BEGINNING WITH FIRST MONTH OF UNPAID LOT RENTS. SEPT. 2007 LOT RENT AND LATE CHARGES TO 02/22/08 ARE $398.00 OCT . 2007 LOT RENT AND LATE CHARGES TO 02/22/08 ARE $368.00 NOV. 2007 LOT RENT AND LATE CHARGES TO 02/22/08 ARE $337.00 DEC. 2007 LOT RENT AND LATE CHARGES TO 02/22/08 ARE $307.00 JAN. 2008 LOT RENT AND LATE CHARGES TO 02/22/08 ARE $276.00 FEB. 2008 LOT RENT AND LATE CHARGES TO 02/22/08 ARE $245.00 TOTAL LOT RENT AND LATE CHARGES TO 02/22/08 IS $1931.00 WATER , SEWER AND TRASH BILLS OWED FOR DAVID NELSON HOME IS $206.60 THE TOTAL OWED ON THE NELSON HOME TO 02/22/08 IS $2,137.60 r AS OF 02/22/08 THIS BILL HAS BEEN PAID IN FULL, CHECK # a ~ _ IN THE AMOUNT OF $2,137.60, NO OTHER BILLS ARE FORTH COMING PERTAINING TO THE DAVID NELSON ESTATE. .WARNER 717-258-6396 P RK OWNERS MV 11 KENNETH S. HOLLINGER U 7-486-4497 ~~~ ~ vT/ LA Y L CUMBERLAND COUNTY RECORDER OF DEEDS RECEIPT Inv Number: 23295 Invoice Date: 06/18/2008 1:15:29 PM RECEIPT Reg/Drw ID: 0201 Customer: Last Change: Receipt By: COUNTER By: MSW COUNTER Chg # Charge /Payment /Fee Description _ Amount Inst # / Inst Date Municipality 1 COPIES $1.50 Fee Detail: COPY FEE $1.50 Comment: copies TOTAL CHARGES $1.50 PAYMENTS CASH $5.00 TOTAL PAYMENTS $5.00 AMOUNT DUE $1.50 PAYMENT ON INVOICE ($1.50) BALANCE DUE $0.00 REFUND DUE $3.50 CASH REFUND ($3.50) Date: Jun 18, 2008 1:16:24 PM Page - Messenger Service Receipt SOLLENBERGERS MESSENGER SERV. 29 WESTMINSTER DRIVE CARLISLE, PA 17013 717-249-8149 Invoice #: 28365 Date: 01/31/08 Time: 11:25 AM For: DAVID G NELSON 13 LARKEN LN MT. HOLLY SPRINGS, PA 17065 000-000-0000 Clerks Initials: DS File Name: CARL08 Title # or Date of Birth: 50619909101 VIN or Driver's Number Tag Number or Eye Color Year-Make or Soc. Sec.# Transaction MV38 O Odometer 0 Comments: ONLINE This item will be Mailed to you. WARNING: Bureau regulation require that any item left in our office for 60 days be returned to the Bureau of Motor Vehicles as unclaimed. I/We swear that I/we have applied for the above item(s) . Sworn & subscribed to before me on 01/31/08 Notary Seal State Fees Title Fee ............. 22.50 Encumbrance Fee....... 0.00 Tag Transfer.......... 0.00 Registration.......... 0.00 Dup. Fee .............. 0.00 Increase Fee.......... 0.00 Replacement Fee....... 0.00 Tax-On $0.00.... 0.00 .. 0.00 .. 0.00 Total State Fee....... 22.50 Check # ............... Service Fees Messenger Fee......... 12.00 Temp Tag Fee.......... 0.00 Notary Fee............ 5.00 Copy/Fax Fee.......... 0.00 Document Fee.......... 0.00 Check or M.O. Fee..... 0.00 .. 0.00 .. 0.00 Total Service Fee..... 17.00 Service Fee Check #... 377 SOLLENBERGERS MESSENGER SERV Grand Total........... 39.50 Total Due. .......... 39.50 Amount Paid........... 39.50 Paid in Full No Refunds on Service or Notary fees. We are not responsible for work the State fails to process. Messenger Service Receipt SOLLENBERGERS MESSENGER SERV 29 WESTMINSTER DRIVE CARLISLE, PA 17013 717-249-8149 Invoice #: 29189 Date: 02/22/08 Time: 11:03 AM For: BRIAN NELSON 35 ELM DR CARLISLE, PA 17013 000-000-0000 Title # or Date of Birth: VIN or Driver's Number Tag Number or Eye Color Year-Make or Soc. Sec.# Transaction NOTARY Odometer 0 Comments: AGREEMENT This item will be Mailed to you. WARNING: Bureau regulation require that any item left in our office for 60 days be returned to the Bureau of Motor Vehicles as unclaimed. I/We swear that I/we have applied for the above item(s). Sworn & subscribed to before me on 02/22/08. Notary Seal Clerks Initials: DMC File Name: CARL08 State Fees Title Fee ............. 0.00 Encumbrance Fee....... 0.00 Tag Transfer.......... 0.00 Registration.......... 0.00 Dup. Fee .............. 0.00 Increase Fee.......... 0.00 Replacement Fee....... 0.00 Tax-On $0.00.... 0.00 .. 0.00 .. 0.00 Total State Fee....... 0.00 Check # ............... Service Fees Messenger Fee......... 0.00 Temp Tag Fee.......... 0.00 Notary Fee............ 5.00 Copy/Fax Fee.......... 0.00 Document Fee.......... 0.00 Check or M.O. Fee..... 0.00 .. 0.00 .. 0.00 Total Service Fee..... 5.00 Service Fee Check #... Cash Grand Total........... 5.00 Total Due. .......... 5.00 Amount Paid........... 5.00 Paid in Full No Refunds on Service or Notary fees. We are not responsible for work the State fails to process. PO BOX 988 HARRISBURG, PA 17108-0988 800 900-1372 Hours: Mon-Fri Sam-10pm, Sat Sam-2pm ~_ (Eastern Standard Time) 2008/09/21 `E~TOrts °sa y o°~ \°~~ ~' 1~1~ #BWNMZSX ~ ~ = #801100420003# ; ~r~~~o DAVID G. NELSON •. \\% 35 ELM DR , r°Rwsr~o`'P® CARLISLE, PA 17013-8804 CLIENT: Cumber land County TOTAL BALANCE DUE: $36.00 REOUE~T FOR PAYMENT Failure to contact our office leads us to believe that you do not have intentions of resolving your just debt. If you are unable to pay in full, settlements and/or payment arrangements may be available. We will do our best to work with you. Please contact our office today or send payment in full in the enclosed envelope. SERVICE RENDERED 2006 CNTY & TWP PER CAPITA 'TAX SERVICE GATE ACCOUNT NUMBER 2006/00/00 738617006 9ALANCE $36.00 This letter is from a debt collection agency. This is an attempt to collect a-debt: Any information obtained will be used for that purpose. If you have filed bankruptcy, please furnish us with your bankruptcy case number. If you wish to have us communicate with your attorney regarding this debt, please furnish us with their name and address so that we may contact them. Detach and return with payment to expedite credit to your account 2008/09/21 DAVID G. NELSON 35 ELM DR CARLISLE, PA 17013-8804 ID NUMBER: 80110042 BALANCE DUE: $36.00 Call our toll free number and pay using check by phone If you wish to pay by credit card, please enter the requested information in the spaces provided. Check one: ^ Visa ^ Mastercard Card#: _________ Expiration Date: _/_/ Signature: B01100420003 PENN CREOIT CORPORATION AD2PC PO BOX 988 HARRISBURG, PA 17108-0988 2008/05/22 #BWNMZSX #800744040003# DAVID G. NELSON 35 ELM DR CARLISLE, PA 17013-8804 800 900-1380 Hours: Mon-Thur Sam-10pm, Fri Sam-5pm, Sat Sam-12pm (Eastern Standard Time) ACA NOTICE OF COLLECTION ~~TF:R~.~r~o~.~~, 7Te Asaocl~tlon of CreNt and CoDectlon Professlonols Manber CLIENT: Cumbe r I and County TOTAL BALANCE DUE: $72.00 Our client has referred your delinquent account(s) referenced below for collection. Our client is serious about collecting all monies owed them and I am sure your intentions are to honor your debt. Send payment using the enclosed envelope or you may go online to make payment or contact our office to pay over the phone. Contact our office if you are unable to pay the amount due. Unless you notify this office within 30 days after receiving this notice that you dispute the validity of this debt or any portion thereof, this office will assume this debt is valid. If you notify this office in writing within 30 days from receiving this notice that you dispute the validity of this debt or any portion thereof, this office will obtain verification of the debt or obtain a copy of a judgment and mail you a copy of such judgment or verification. If you request this office in writing within 30 days after receiving this notice this office will provide you with the name and address of the original creditor, if different from the current creditor. This is an attempt to collect a debt by a debt collector and any information obtained will be used for that purpose. The important rights included above apply to each account individually and you have the right to dispute any or all of the accounts included in this notice. In the event you choose to exercise your important rights included above please indicate which accounts(s) you are disputing. SERVICE RENDERED SERVICE DATE ACCOUNT NUM6ER BALANCE 2004 CNTY & TWP PER CAPITA TAX .SOUTH MIDDLETON TOWNSHIP 2004/00/00 738609904 $36.00 2005 COUNTY & TWP PER CAPITA 2005/00/00 738612605 $36.00 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Detach and return the bottom portion with your payment for account identification. 2008/05/22 DAVID G. NELSON 35 ELM DR CARLISLE, PA 17013-8804 ID NUMBER: 80074404 BALANCE: $72.00 We accept Visa, MasterCard and check by phone Please include a check or fill out the information below if you wish to pay by credit card. Check one: ^ Visa ^ MasterCard Card #: ---------------- Expiration Date: _/ / Signature: s,„ -~ at&t How To Contact Us: • 1-800-331-0500 or 61 "t from your wireless phone • For Deaf / Hard of Hearing Customers (TTY/TDD) 1-8 C,6-241-6567 Page: 1 oi' 3 Billing Cycle Date: 34695453 001-40 7 Account Number: ***This Bill Includes A Past Due Balance*** If payment has already been made, thank you, please disregard, If not, payment must be made immediately. Please send your payment, including current charges, in the enclosed envelope. You may also pay 24 hours a day, by major credit card or electronic check at 1-R00-331-0500, or att.com/mywireless. If your service is suspended, a reconnection fee will apply, If you have questions regarding your account, contact us at 1-800-947-5096. Return the portion below with payment _ _ _ _ _ _ _ only to AT&T Mobility.. _ , _ 15901 E. SKELLYDR - (PHILA) 'Account Number: 34695453-U01-40 TULSA, OK 74116 Total Amount Due: $128.74 Amount Paid: #BWNHHBD #34695453400019# I a AV 01 003726 50581H 15 A**5DGT DAVID NELSON '" Please do not send correspondence with payment. 13 LARKEN LN MOUNT HOLLY SPRIN, PA 17065-1734 ^ yes, enroll mein AutoPay. 5ignatare required on reverse. „i~~~u~~~~nn~~n~~~~nn~~~n~~n~~n~u~~~~~~~~~~~~~~~~~ Please Mail Check Payable to: AT&T Mobility P.O. Box 537113 Atlanta, GA 30353-7113 ~n~~~~~un~~~u~~~ui~~i~u~~u~~~ui~~n~~un~~u~~i~~n~~ 4003469545390010200712D8O00OOO128745D2 ~. ~. t ~ ~ ~ `~` Billing Cycle Date: 11/09/07 -12/08/07 ~ -- Account Number: 34695453-OO1-40 Prior Activity 34695453-001-40 Previous Balance ~ 2a , ~ s 1'O't'AI_ PAST UilE BALANCE $123.16 Account Charges 34695453-001-40 Credits, Adjustments & Other Charges Late Payment Fee STATE GROSS RECEIPTS SURCHARGE 5.00 0.26 A('C(aUNT CRElli'1'S Ai,?.JUSTIVIEN'I'S & OTHER CHARGES 5.26' Government Fees and Taxes STATE SAI:ES TAX 0 , 32 ACCOUN:1' GOVERNMENT FEES ANU TAXES 0.32 Get your billing details at att.com/mywireless In the coming months you may notice our new bill format. We are simplifying your paper bill by removing the itemized call and data details. All the important information you need is still available and now easier to read on fewer pages. As always, all your account details including call and data usage details are available online. Just login to att.com/mywireless it's safe, secure and easy! Thank you for supporting us in our ongoing commitment to the environment. Online Banking Goes Mobile! Easily pay bills, transfer funds and check account balances safely and securely right on your wireless phone. See att.com/mobilebanking for a list of participating bank partners and more information. Auto Pay Authorization Agreement If I enroll in AutoPay by phone, I authorize AT'&T to pay my bill monthly by electronically deducting money from my bank account. I can cancel authorization by notifying AT&T at att.com/mywireless, calling ]-80U-331-0500, or dialing 611 from my cellphone. If my bank rejects a payment, I may be charged a return fee up to $30. Add a line with Family Talk from AT&T. Available with 2-line FamilyTalk® Nation plans starting at $69.99, new 2 year wireless service agreement required. To sign up call 800-909-7011. P.O. Box 837 Newtown, CT 06470 Change Service Requested June 17, 2008 PERSONAL & CONFIDENTIAL #BWNLPGJ #0654 2700 0808 0374# I~nllln~lllnnnl~nll~lnl~l~~l~llnnlnlnllnlililln~l m Nelson, David 13267030 0 35 Elm Dr Carlisle, PA 17013-8804 P.O. Box 837 Newtown, CT 06470 (800) 750-6343 Fax (203) 426-9630 ACCOUNT IDENTIFICATION EAS Account Number: 13267030 Creditor #: 371114- 2 Creditor: Comcast Harrisburg Service Notice Date: June 17, 2008 Service Balance Due: $ 131.47 Equipment Balance (if not returned): $ 0.00 Total Balance Due: $ 131.47 * * * FINAL NOTICE * * * Our records indicate that you owe $131.47 which is long past due. Pay this account immediately. This is absolutely final. * * IMPORTANT To be sure of proper credit and to stop further procedure make your payment in full. This is an attempt to collect a debt. Any information obtained from you or anyone else will be used for that purpose. This communication has been sent by a debt collector. ------------------------------------------------------Detach and Return with Payment ------------------------------------------------------ Enter the requested information in the spaces provided below: Change of Address: For: David Nelson Street Address: Ciry, State, Zip: _ Telephone: Eastern Account System of Connecticut, Inc. P.O. Box 837 Newtown, CT 06470-0837 IIInnIImInII~n111n~11mh~In~II~In~~n~~~~nJ~l~l~l EASTERN ACCOUNT SYSTEM OF CONNECTICUT, INC. New York License #1244261 Creditor #: 371114- 2 Creditor: Comcast Harrisburg Service Notice Date: June 17, 2008 EAS Account Number: ; 3267030 Service Balance Due: $ 131.47 Equipment Balance (if not returned): $ 0.00 Total Balance Due: $ 131.47 Amount Enclosed: $ Please Charge to my []Visa []MasterCard []American Express []Discover Card Number Expiration Date Name of Cardholder Signature Enclosing t is nottce wit your payment w~ expe ite ere rt to your account. FINALCBL 000495P 1 068 000048 169 065427 S-CRE Afni, Inc. PO Box 3427 Bloomington, IL 61702-3427 (866)308-9119 www.afniicollections.lcom This account has been acquired by our agency for collection. We believe it is in your best interest to resolve this account. We may report information about your account to credit bureaus. If you have any questions, please contact our office toll free at (866)308-9119 Monday through Friday lam-9pm CST. For proper credit on your account, please write thls number 024900242-02 on your payment. Unless you notify this office within 30 days after receiving this notice that you dispute the validity of the debt or any portion thereof, this office will assume this debt is valid. If you notify this office in writing within 30 days from receiving this notice that you dispute the validity of the debt or any portion there of, this office will: obtain verification of the debt or obtain a copy of a judgement and mail you a copy of such judgement or verification. If you request this office in writing within 30 days after receiving this notice, this office will provide you with the name and address of the original creditor, if different from the current creditor. This is an attempt to collect a debt. Any information obtained will be used for the purpose. You have the right to inspect your credit. This letter is from a debt collector. Please see reverse side of this notice for our Privacy Statement and credit card payment options. To manage your account online, visit us at : www.ainicollections.com Please retain this information for your records O_ For proper credit, please include your Afni account # listed below on your check AFNF7-1120F202582-~ WSP-2 2582 ADDRESS SERVICE REQUESTED Department 555 PO BOX 4115 CONCORD CA 94524 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII IIII Afni, Inc. Account # Original Creditor: Client Account #: Original Balance: Collection Fee: Balance Due: Date: Toll Free: 024900242-02 EMBARQ 7174869945120 $98.01 $0.00 $98.01 11 /20/2007 (866)308-9119 981 #BWNFTZF #AFN3162031 1 071 1 9# In~lll~nlll~n~l~n~~~l~n~lll~nlnll~~ln~~~~l~~~l~~~~l~ll DAVID NELSON 13 LARKEN LN MOUNT HOLLY SPRING PA 17065-1734 020249~~242 9922~~ PO Box 3427 Bloomington, IL 61702-3427 I~Iln~nlll~nlll~n~~l~lnll~~lnlnl~ll~~~l~~l~ll~nll~l~~l Detach along pertoration and return bottom portion along with payment in the enclosed envelope. Credit card payment options are on the back of notice. K0111GN'S OIL SERVICE P.O. BOX 116 NEWVILLE, PA. 17241 PHONE: 776-3533 or 776-5685 n~~~~~ DATE _ ~ ~,. i r ~^,,: , ~., SOLD TO ` ~"' ADDRESS ~ t.'t~.f: .~~'.~~.~ F~ /' - .. s:- ..~+rJ,~"cam TERMS: NET ~ rJ DAYS. INTEREST OF ~ ~/a% PER MONTH ADDED •TO ALL ACCOUNTS OVER 3O DAYS, OR ~ S% ANNUALLY. PAYMENT ^ CHECK ^ CASH ^ THIS DELIVERY ^ C.U.D. ^ CHARGE RECEIVED ^ A/C OLD BALANCE FULL ^ NOT FULL THIS INVOICE HAS BEEN ACCURATELY COMPUTED i AND AUTOMATICALLY PRINTED. ', ^ FUEL OIL ,d KEROSENE REMARKS i CUSTOMER SIGN HERE :.. _ .. .. . 1. I' Gals. Reading -Start Gals. Reading -Finish - Sales Sequence Number _..... Price per Gallon -Cents Product Cost Tax Total Price ,, F P.O. BOX 273 MONROE, WI 53566 RETURN SERVICE REQUESTED (608)325-5121 (800)538-4658 Fax: (608)325-4738 ***************AUTO**MIXED AADC 535 CREDIT BUREAU CENTRE REDIT _= UREAU __ = ENTRE A QUANTUM FINANCIAL GROUP DAVID NELSON CBC-542657 (3-69-614) May 27, 2008 35 ELM DR CARLISLE, PA 17013-8804 I~~~III~~~III~~~~~~II~~II~I~~I~I~~I~II~~~~I~~I~~II~~I~I~II~~~I Account # CBC-HELP-542657 Amount Due: $288.85 Creditor: MASON SHOES If paid in full to this office, all collection activity will be stopped. CALL US to work out a solution. WE CANNOT HELP YOU UNLESS YOU CALL Phone: 1-800-538-4658 Federal law requires that we inform you that this is an attempt to collect a debt and any information obtained may be used for that purpose. This communication is from a debt collector. Enclosing this notice with your payment will expedite credit to your account. We Accept Credit Cards! VISA Mastercard Discover Credit Card #: Expiration Date: ___ _ CW #: ___ ~a~c s di~n6 following card # AmOUnt: _ _ _ on back Signature: __ __ Credit Bureau Centre P.O. Box 273 Monroe, WI 53566 I~I~I~~~II~~I~l~~ll~~~llf~ll~~~~~lfllf~~l~~ll~l~~~l~~ll~~~ll~l If any of the following has changed, please indicate: New Name: Street: City: State: Zip: Home Phone: Employer: Employer Address: City: State: Zip: Business Phone: C:CBC L:HELP A:542657 D:05/27/08 Name: DAVID NELSON Amount Due: $288.85 DAVID G NELSON 02/20/2008 13 LARKEN LN Met-Ed MOUNT HOLLY SPRINGS PA 17065 PO Box 16001 Reading, PA 19612-6001 1-800-962-4848 10 00 55 9371 0 4 10 DAY SHUT-OFF NOTICE AVISO DE SUSPENCION DE SERVICIO Your Electric Service May Be Shut Off ! Because your bill is past due, we will shut off the service to: 13 LARKEN LN MOUNT HOLLY SPRINGS PA 17065 on or after 8:00 a.m. on 03/05/2008. We may act on this notice for up to 60 days. We will NOT Shut off your electric service if you do ONE of the folloa.+ing: • Call us at 1-800-962-4848 to arrange to pay your past due bill of $393.03. • Pay the amount you owe on your payment agreement. Call us at1-800-962-4848 for this amount. • Show us a paid receipt for the past due amount. • Call 1-800-962-4848 right away if you dispute this bill or to provide us with household income and occupant information. You may be eligible for a payment agreement or special assistance programs. If we shut off your electric service, you may have to pay all of the following before we can turn your service on: Past Due Bill $393.03 Turn-on Charge $36.00 Security Deposit $196.00_ Total 62 .0 To talk about your bill, please call our office at 1-800-962-4848. MEDICAL EMERGENCY NOTICE Let us know if someone living in your home is seriously ill or has a medical condition. WE WILL NOT SHUT OFF YOUR SERVICE provided you: 1. Have your licensed physician or nurse practitioner certify by phone or in writing that such an illness exists and that it may be aggravated if your service is shut off. Written certification is needed within 7 days: AND 2. Make arrangements to pay this bill. You must provide us with household income and occupant information to determine your payment terms while protected under the medical certification. IMPORTANT TO KNOW: Before we shut off your utility service please read the back of this notice. You may be eligible for certain protections from shut-off. Attention ! Este es en mensaje muy importante. Si usted no to entiende, favor de llama a ? -840-982-4848 TERM10 ^vl~y a~ ArMS^tEVi~ry_ ry- c~~„-~,_~ ~M Return this part with a check or money order Payable to Met-Ed. SERVICE TERMINATION NOTICE Changes to your name or address? Write them on the bat`` ecJ ~~~ DAVID G NELSON 13 LARKEN LN MOUNT HOLLY SPRINGS PA 17065 oa ~~ ~~,,4,~ Account Number: 100055937104 ~~ Amount Paid Please Pay $393.03 Due By 03/05/2008 MET-ED PO BOX 3687 AKRON OH 44309-3687 I~I~~I~I~~I~~Il~ll~nl~ln~~~lnllulnl~ln~ll~~l~lu~l~nlll ^21D00559371040000000000D000000000000393030000393033 P.O. Box 9016 Williamsville, DIY 14231-9016 9297141 Fol-~~ arding and adch-ess connection requested. `~ ~D ~~~~ ~. ,~ 6 ~ ~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ` 10884 ~n~~~~n~~~~nu~~n~~~~un~~~n~~u~~n~n~ni~~n~~n~~~~~ DAVID G NELSON 13 LARKEN LN MT HOLLY SPGS. PA 17065-1734 REFERENCE NUMBER 9297141 AMOUNT ENCLOSED ~ MAKE CHECK PAYABLE TO: ~ MERCANTILE ADJUSTMENT' BUREAU PO BOX 9016 WILLIAMSVILLE, NY 14231-9016 OR Secure online payment can be made at http://v~~ww.mercantilewebpymt. com Pass Phrase: M&T B&T BA PLEASE DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT Mercantile Adjustment Bureau, LLC P.O. Bos 9315A Rochester. Nei+~ York 14604 ACCOUNT NO. 0000003740942804 REFERENCE NO. 9297141 DAVID G NELSON 13 LARKEN LN MT HOLLY SPGS. PA 17065-1734 ~~~ 11-09-07 Your account with M&T BANK-OVERDRAFT2, has been listed with our office for collection. The balance due is $58.87. Please be advised that our client has authorized us to offer you substantial savings to settle this account. We are authorized to settle this account for reduced amount. This offer is good for a limited time only. Full payment of $36.49 must be received on or befare 11-23-07. Contact our ofEce or send payment immediately to take advantage of this limited time offer! Respectfully, ~Qe JIe,~E Lee Kent Mercantile Adjustment Bureau, LLC P.O. Box 9315A Rochester, NY 14604 1-800-834-7516 _~ i MERCANTILE Innovative Solutions, Exceptional Results ACCOUNT NUMBER 0000003740942804 THIS COMMUNICATION IS FROMA DEBT COLLECTOR THIS IS AN ATTEMPT TO COLLECT A DEBT. ANY INFORMATION OBTAINED WILL BE i1SED FOR THAT PURPOSE. IIIIIIII IIM IIIII IIIIN II I II III IIII IIIII IIIII IIIII IIIII IIIII IIII I II III IIIII IIIII IIII IIII P.O. Boy 45455 Oak Park, MI 48237 Return Sen•ice Requested 05/23/08 David G Nelson 35 ELM DR CARLISLE PA 17013-8804 I~~~III~~~III~~~~~~II~~II~I~~I~I~~I~II~~~~I~~I~~II~~I~I~II~~~I Phillips & Cohen Associates, Ltd. Ph 800-990-1491 Fx 702-731-9752 Office Hours: M - Th: Sam - 9pm Fri: Sam - 6pm Sat: Sam- l2pm 258 Chapman Rd Suite 205 Newark, DE 19702 Account #: 7101525 Balance: $506.07 *** PLE:~SE DETACH ANll RETURN IN'rHE ENCLOSED EN VI?LOPE WITH YO[rIt Pr1Y"hIEN1' *•* RE: Client: PORTFOLIO RECOVERY ASSOCIATES, LLC Original Creditor: MRC RECEIVABLE CORP Client Acct#: 5488975009194583 Our Acct#: 7105525 Balance: $806.07 To the Estate of David G Nelson: Our client, PORTFOLIO RECOVERY ASSOCIATES, LLC, now owns the debt previously owed to MRC RECEIVABLE CORP. PORTFOLIO RECOVERY ASSOCIATES, LLC recently received notification that David G Nelson passed away. hlitially, on behalf of our client, please accept our condolences. At the time of the passing of David G Nelson, an outstanding debt in the amount of $806.07, was owed to PORTFOLIO RECOVERY ASSOCIATES. LLC. To resolve this matter and prevent any filrther collection activity, either full payment must be sent to this office at the above address or information regarding the Estate of David G Nelson, must be received, by mail or telephone, by our office. IF YOU HAVE ANY QUESTIONS, YOU MAY CONTACT OUR OFFICE AT THE ABOVE TELEPHONE NUMBER. Sincerely, Phillips & Cohen Associates, Ltd. ** IMPORTANT CONSUMER INFORMATION ** Unless you notify this office within thirty (30) days after receiving this notice that you dispute the validity of this debt or any portion thereof, this office will assume this debt is valid. If you notify this office in writing within thirty (30) days from receiving this notice, this office will: obtain verification of the debt or obtain a copy of a judgment and mail you copy of such verification or judgment. If you request this office in writing within thirty (30) days of receiving this notlce, this office will provide you with the name and address of the original creditor, if different from the current creditor. This communication is from a debt collector. This is an attempt to collect a debt and am~ information obtained will be used for that purpose. Phillips & Cohen Associates, Ltd. • 258 Chapman Rd, Suite 205 • Newark, DE 19702 • 500-990-1495 ~~2ESr>-ui:~ruzl :oo Io6z:ool :I000:os~ aa:rr~ol :PCaLO2~:o I: Pc~LOa~ ACCOUNT NUMBER DATE BILL MAILED 98885111 9J28J2881 PRESENT READING SERVICE FROM 556989 6J11J299r PREVIOUS READING SERVICE TO 552889 9J11J299r UNITS USED DAYS USED 4116 98 DESCRIPTION AMOUN~ Prev. Balance ;8,66 Dater ;26.29 Sever ;31.66 Trash ;41.39 RETURN THIS STUB WITH PAYMENT TC. BOROUGH OF MT. -10LLY SP.RIf~GS 200 HARMAN STREET MT. HOLLY SPRIAIGS. PA 17065 PRESORTED IRST CLASS MAIL ~; ~G«ar,E PAID •.. ..R '!T »ui fr. HOLLi SPRINGS. ~~A I joss ACCOUNT NUMBER DUE DATE A~Ee ouE aiE __ ev oii- '~ ~„1F 11115171 11J9J211r -~ 1.08.45 ~ $98.59 iT paying in cash please have correct a~ount RETURN SERVICE REQUESTED CURRENT BILL DUE DATE AMOUNT Du BV DUE DATE 11 J9J2861 $98.59 ,' :, ', $108.45 sERVICE #13 LARKIN ADDRESS D p:EEP THIS STUB FOR YOUR RECORDS LARRY WARNER & K. HOLLIN6ER 414 E. OLD YQRK ROAD CARLISLE, PA 17013 PO BOX 18053 Hauppauge, NY 11788-8853 15079906997 ,III ~~,I II I ESTABLISHED 1896 Mer~h~,ts' Credit Cuid~ Co._ 00049439 247 159505042 INCORPORATED 1899 EXECUTIVE OFFICES 223 W. JACKSON BLVD CHICAGO, ILLINOIS 60606 MEMBER OF THE AMERICAN acA COLLECTORS ASSOCIATION ~~~~ ~ ~ ~-~ Office Hours: M-TH 8AM-9PM;FR 8AM-SPM;SA 8AM-l2PM Telephone: (888)249-4134 ~II~I~II~II~III~~I'III~~'II11~1~~1"I'lll'1~111'~~I~~I~III~I~II~~ DAVID NELSON 13 LARKEN LN MOUNT HOLLY SPRINGS PA 17065-1739 www.merchantscreditguide.com Our File#: Our Client: Orig #: Account Number: Original Creditor: Current Balance: 12/27/07 15-079906997 PINNACLE CREDIT SERVICES 5868940510 C V500887 BRITISH PETROLEUM $419.91 Please be advised we renr_esent the above client, PINNACLF_ CREDIT SERVICES who has purchased your defaulted account referenced above. We are able to offer you one of the THREE (3) repayment plans :Listed below to settle this balance. Please mark your choice with and forward with your payment to Merchants' Credit Guide Co. in the envelope provided. This communication is from a debt collector and is an attempt to collect a debt. Any information obtained will be used for that purpose. Sincerely, (~ !leetioe ~yercy ~e/ruaertaYue Collection Agency Representative (888) 249-4134 Unless you notify this office within 30 days after receiving this notice that you dispute the validity of the debt or any portion thereof, this office will assume this debt to be valid. If you notify this office in writing within 30 days from receiving this notice, this office will obtain verification of the debt or obtain a copy of a judgement and mail you a copy of such judgement or verification. If you request this office in writing within 30 days after receiving this notice, this office will provide you with the name and address of the original creditor, if different from the current creditor. 1 SCD0130-NOI-S-A ~A /~~n Auto & ~[-j ju' Homeowners Insurance hProgram THE HARTFORD INSURANCE BILL PERSONAL AUTOMOBILE A A R P INSURANCE PROGRAM PROPERTY AND CASUALTY INS. CO. OF HARTFORD NELSON DAVID 13 LARKEN LN MOUNT HOLLY SPRINGS PA 17065 Billing ID Customer Service Statement Date Policy Number Policy Term Balance 84479802 1-800-423-6789 11 /01 /07 55 PHJ461084 03/01 /07-03/01 /08 $171.62 Thank you for your business. Please refer to the back of the bill for additional information. tf we receive the minimum amount due by the due date, you will avoid a $12.00 late payment fee. FULL PAYMENT You may avoid future fees if we receive your balance of '~'11'''11..,~.$~''~..~.,..,~.. by ';1'~'t~1;;! Or, you may choose one of the available payment options shown below by paying one of the shaded amounts by the due date: TWO PAYMENTS DUE AMOUNT DATE DUE AT THIS TIME THREE PAYMENTS DUE AMOUNT DATE DUE '' AT THIS TIME TWELVE PAYMENTS Pay '~ by '~'~'l~& With this option you will be billed on the 1st of each month with payments of $60.54* due on the 18th. Nelson David * A service fee of $5.00 has already been included in the amount due. Bill Account # 55 84479802 DUE DATE: 11./18/07 THE HARTFORD AMOUNT ENCLOSED: P.O. BOX 5025 HARTFORD, CT 06102-5025 5584479802500000000000000000060540011608000000000D17162610D? Form PLIC-INS1 69517576 11 /01 /07 37 17065 84479802 NV5010U D 1 -~ 11 it ~ ~ ~5/, . MELISSA F. MIXELL ~~-~ ,r~~j DIRECTOR ~ , TAX CLAIM BUREAU OF CUMBERLAND COUNTY One Courthouse Square, Carlisle, PA 17013-3389 (717) 240-6366 Printed: 6/18/08 C 13:21:12 Control Number: 23-000714 STEPHEN D.TILEY ASSISTANT SOLICITOR Receipt No.: 61687 Receipt Date: 6/18/2008 **** RECEIPT **** Page: 1 Property Description: NELSON, DAVID G C/O ERIC HOLLINGER 13 LARKEN LANE MOUNT HOLLY SPRINGS PA 17065 Map No: 23-32-2338-046 MOUNTAIN VIEW II LOT 20 Mobile Home - No Land Situs Information: 13 LARKEN LANE & FRANKLIN STREET TR09667 MT. HOLLY SPRINGS BOROUGH Tax Penalty & Year Description Face Interest Costs Total 2007 SCH-CARLISLE AREA 106.90 14.69 121.59 2007 CTY-MT HOLLY SPRINGS 1.8.65 2.57 21.22 2007 CLB-MT HOLLY SPRINGS 1.47 .20 1.67 2007 MUN-MT HOLLY SPRINGS 12.65 1.72 14.37 2007 STLT MT HOLLY SPRING 2.28 .33 2.61 2007 BUREAU COSTS 41.31 41.31 Received For Year Of 2007 $202.77 Total Received $202.77 Tendered > CHECK Received By > JC Paid By > NELSON, BRIAN Remarks > 354799 Balance Due As Of 6/18/2008 Claim Balance: .00 Receipt Number: 61687 Total Received: $202.77 MIDAS AUTO SERVICE EXPERTS 740 E High St PAGE 1 ~ CARLISI_E,PA 17013 (717)243-7738 Customer ID: 8200008982 Year: 00 Date/Time: 04/15/08 15:17:51 Name: BRIAN NELSON Make: DODGE Estimate #: 173279 Address: 35 ELM DR Model: RAM 1500 PICKUP Invoice #: 160363 Address 2: Lic No: YMR4388 Key Tag: City,State,Zip/Postal Code: CARLISLE, PA, 17013 VIN: 167HF13ZSYJ181355 PO Number: Home Phone: () - Color: Email Address: Work Phone: () - Engine: Fleet/Wholesale: N Other Phone: () - Mileage In: 11111 Tax Exempt #: Mileage Out: 11111 Service comments: Qty. Part # RFR Loc Description List Labor Total TIRES FRONT BRAKES LR MISCELLANEOUS REAR BRAKES L R 1 MT34 * MEGATRON BATTERY 74.95 0.00 74.95 TOTAL MISCELLANEOUS: 74.95 *** Customer Wishes To Discard Old Parts *** PAY AMOUNT SUB TOTAL 74.95 CHECK 79.45 SALES TAX 4.50 GRAND TOTAL 79.45 TECH: 000004-0.00 M.ONDEK INVOICE INVOICE MIDAS AUTO SERVICE EXPERTS INVOICE CUSTOMER COPY Check Image Page 1 of 1 HOME ABOUT US :oNTACT US NEWS 8 EVEN75 °I,B~ICAT!ONS ftE50L'RCES Account Summary Transfers eStalements Bill Payer Services ~lisa Loan Applications MY Profile AAessages Check Image nose Front of Check: ~taN ~ G ~a.son ~~f136~ ~" 109 CARt151.E, PA t $ ~'`~5 -^ ~~~ e ~~ - ~(~/~~/////n] ~. 2 3138 2 24 i~: 1$ 3 24~ 26 2p' 0 i q Back of Chea:k: •- ~i ~ ~ - ~, ~~~ } a I 2~~ ~ ~ Ui~'~CO~t~; X ~ Gd -: -~ .. ~,o , . ~~ -y1~a~.--e) ---Jf'VL;eli~ _•~~ ' • 'a Ci~4ui - ~ ' L C aw~ e~ I`~!''f'E[N .l,Y~}!7 900Zl4i/D'0 a ~!H ~¢'W"+}:~ 3:]~Udt3'J 6d iL~ E£D~`I ~ 90'3E s OZ IEOG - 0`3L3 LESYEO '!t;! ~ Close Winsbw' ~J2008 M~~h~Se3-- '. F - C'~ it Ur: N M C~~'. A^.i~'sH Pr .. ~, n ~;w~-t r.n, ~oA,.~ . a anera~ ; -. ~. ,k riu~ https://ml online.members 1st.org/OnlineBanking/Accout~tSummary/CheckImage.px?accou... 10/3/2008 MsT Manufacturers and Traders Trust Company Member FDIC SAFE DEPOSIT BOX RENTAL INVOICE DAVID G NELSON 13 LARKEN LANE MT HOLLY SPRINGS, PA - 17065 SEND PAYMENT TO: M & T BANK P. 0. BOX 4223 BUFFALO, NEW YORK 14240-4223 RENTAL PERIOD: 12/31/07 TO 12/30/08 INVOICE DATE 12/01/07 PAYMENT TERMS: DUE UPON RECEIPT MT HOLLY SPRINGS BOX N0: 0000067 BOX RENT DUE FOR: RENTAL RATE: 25.00 PREV PAY/CR: 60.00- BALANCE DUE: 35.00- A 310.00 late charge will be assessed if the balance due (shown above) is not received on or before 1/30/08 YOUR PREPAYMENT HAS BEEN APPLIED ©M~TB~•uik Manufactu re rs and 7rarie rs Trust COmpa nY SAFE DEPOSIT BOX RENTAL INVOICE Member FDIC SEND PAYMENT TO: M & T BANK MT HOLLY SPRINGS P. 0. BOX 4223 BOX N0: 0000067 BUFFALO, NEW YORK 14240-4223 BOX RENT DUE FOR: RENTAL PERIOD: 12/31/07 TO 12/30/08 INVOICE DATE 12/01/07 RENTAL RATE: 25.00 PAYMENT TERMS: DUE UPON RECEIPT DAVID G NELSON 13 LARKEN LANE PREV PAY/CR: 60.00- MT HOLLY SPRINGS, PA - 17065 BALANCE DUE: 35.00- 0004331 0004331 103'1 (91199) L~ , COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 SAFE DEPOSIT BOX INVENTORY Please Print or Type MUST BE COMPLETED BY REPRESENTATIVE OF FINANCIAL INSTITUTION WHERE SAFE DEPOSIT BOX IS LOCATEn ANn RFT~ iRniFn -rn narniF annacee COUNTY CODE FILE NUMBER SOCUIL SECURITY (Required) OR DEATH CERTIFICATE NUMBER (only If SSN Is unknown) 186-34-2053 DECEDENT'S NAME (LAST, FIRST, MIDDLE) DATE OF DEATH Nelson, David G. 10/25!2007 ADDRESS OF DECEDENT (STREET) (CITY) (STATE) (ZIP CODE) 13 Larken Lane Mt. Holly Springs, PA 17065 NAME AND ADDRESS OF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSIT BOX (NAME) Brian L. Nelson, Executor (STREET NAME) (CITY) (STATE) (ZIP CODE) 35 Elm Dr Carlisle, PA 17013 NAME, ADDRESS AND RELATIONSHIP (IF ANY) TO DECEDENT, OF PERSON(S) PRESENT AT THE BOX OPENING a. (NAME) (RELATIONSHIP) Brian L. Nelson, Executor Nephew (STREET NAAAE) (CITY) (STATE) (ZIP CODE) 35 Elm Dr. Carlisle, PA 17013 b. (NAME) (RELATIONSHIP) (STREET NAME) (CITY) (STATE) (ZIP CODE) c. (NAME) (RELATIONSHIP) (STREET NAME) (CITY) (STATE) (ZIP CODE) • NAME AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED (NAME) M&T Bank (STREET NAME) 631 Holly Pike (CITY) (STATE) (ZIP CODE) Mt. Holly Springs, PA 17065 1 NAME OF PERSON MAKING LAST ENTRY DATE AND TIME OF LAST ENTRY DATE OF CONTRACT TO RENT BOX NUMBER OF BOX ~ TITLE UNDER WHICH BOX IS REQUESTED 12/24/2003 67 David G. Nelson NAME AND ADDRESS OF PERSON(S) HAVING ACCESS TO BOX a. (NAME) b. (NAME) David G. Nelson (STREET ADDRESS) (STREET ADDRESS) 13 Larken Lane (CITY) (STATE) (ZIP CODE) Mt. Holly Springs, PA 17065 (CITY) (STATE) (ZIP CODE) • NAME AND TITLE OF EMPLOYEE TAKING THE INVENTORY Wendy S. Snyder, Manager WAS A WILL IN THE BOX? ^ YES [~ NO If yes, a. Date of will: b. Name and address of personal representative, If named In the will (NAME) (STREET NAME) (CITY) (STATE) (ZIP CODE) c. Name and address of attorney, If any (NAME) (STREET NAME) (CITY) (STATE) (ZIP CODE) • SAFE DEPOSIT R[~X INVFNTnRV Page ~ of ~~ ~.~. INSTRUCTIONS The Department is authorized under federal law , 42 U.S.C. § 405(c), to use the decedent's Social Security number in administering this state tax law. The Department uses Social Security numbers to establish a decedent's identity and ensure proper credit for tax payments. (1) Cash: Report total only. (2) Stocks: List in detail every common or preferred certificate, warrant or other rights found in box. Stocks are to be designated by name of company, certificate number, date of certificate, name in which stock is registered, and number of shares and class of stock. (3) Obligations of U.S. Government: Number of items, date of issue, face value, names in which registered and type of ownership, i.e., jointly held, payable on death, etc. (4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds) (5) Bank and Savings and Loan Passbooks: State name of depositor, number of book, last date appearing in book, name of bank and branch, and balance. (6) Jewelry, Coins, Stamps, Manuscripts, etc: List and describe as fully as possible. (7) Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness: List and describe as fully as possible. (8) All other contents. ITEM NO. ITEM DESCRIPTION ~h ~ ~, of ~n ~~ V~ 1 CERTIFY UND PENALTY OF PERJURY THAT THE ABOVE RECORD IS CORRECT A D COMPLETE TO THE EST OF MY KNOWLEDGE AND BELIEF. PERSON RECEIVING COPY OF SAFE DEPOSIT BOX INV NTORY: SIGNATUR SIGN C PRINT``N~~A~~E PRINT NAME A C CK APPR~ ''PRPPTE BOX BELOW: PRINT TITLE ~rjt ~~~ ~~j~ ^ ~ „JJ vim( 1C~ "_. `'~, DATE I L,/1 C~~~y~ O I !!' 6 CHECK APPROPRIATE BOX: ~Executor(trix) ~Administrator(trix) ~ Estate f~epresentatlve ®Joint owner of safe deposit !wx r.~. cc r,uacn aaatuona~ o•f~ x ~~-- snee'<tsl Ir necessary or use duplicates of this page of form. RE`/-1513 EX ~ i9-00) SCHEDULE) BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER f~avitt G Nelsen RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE ~ TAXABLE DISTRIBUTIONS [include outright spousal distributions.. and transfers under Sec 9116 (a) (t2)] 1. SARA A. NELSON Lineal c/o Claremont Nursing Home Carlisle, PA 17013 2. BRIAN NELSON Collateral 35 ELM DRIVE CARLISLE. PA 17013 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, O N REV-1500 COVER SHEET ]], NON-TAXABLE DISTRIBUTIONS: 1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART Il -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)