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HomeMy WebLinkAbout02-11-091505607121 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN Po6ox2eosot 2 1 0 8 0 5 1 3 Hamsbu , PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 1 7 7 2 4 7 3 5 5 0 4 2 6 2 0 0 8 0 1 1 9 1 9 3 1 Decedent's Last Name Suffx Decedent's First Name MI N E A L I D A M (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffx Spouse's First Name Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Requiretl death aker 12.12-82) B ^X 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust ~ oxes 8. Total Number of Safe Deposit (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) O between 12-31-91 and 1-1-95) ) (Attach Sch. CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number A S G M I L L E R 7 1 7 2 4 9 2 3 5 3 D O U G L Firm Name (If Applicable) I R W I N & M c K N I G H T First line of address 6 0 W E S T Second line of address City or Post Office C A R L I S L E State ZIP Code rV REGISTER~~LS USE Y i ~ -Tl i m r ;-,-~ rn .: {-- .rn _. -,~~ ` , u ., z ~- ~ `--- -v~ ~ fV ~' DATE FILED ~' MI t=' ~~ C ;; ~._ i -> 4 ';~ P A 1 7 0 1 3 Correspondent's a-mail address:DMILLERna IRWINMCKNIGHT COM Jnder penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my kr t is true, coned and complete. 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(y alnPa4oS)alelsa lean 'L - NOlltllfllldtl032! 5 5 E L h 2 L L '[ l V 3 N • W tl Q I :aweN s,luapaoad ~agwnN R1Pnoeg l e!oog s,luapaoap X3 004L-A32i `C22L09505'C REV-150 Decedent's Complete Address: File Number 21 08 0513 DECEDENT'S NAME IDA M. NEAL STREET ADDRESS 502 N. BEDFORD STREET CITY CARLISLE STATE PA ZIP 17013 Tax Payments and Credits: 1. Tax Due(Page2Line19) (1) 1,018.00 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + B +C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total InteresUPenalty (D+E ) 4. If Line 2 is greater than Line i +Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund.t, 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) 0.00 (4) 0.00 (5) 1,018.00 (5A) (5B) 1,018.00 Make Check Payable to: REGISTER OF WILLS, AGENT . ,w.i;'•'~ vfa~r dry .. ,M1{ w~,~7 .~ ~~,~ ,~°, ~ '~y,ry9 i.~.XM ~, ~ s,~t .a".m 6~*2,= w1rJ° ~~#i, ~. s ..3,, ~~ t . ]t ~ M' I : ~ ar ~ . l~ ..k'.' ;r;5' 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 transfened : ................................................................. ... . ^ 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 considerafion? ................................................................................. ...... ^ 3. Did decedent own an "intrust for" or payable upon death bank account or secudty al his or her death? ... ...... ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which crontains a beneficiary designation? ............................................................................................ ...... ^ ^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) (t.t) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and fhe statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only benefciary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased childtwenty-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 (O) 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 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER IDA M. NEAL 21 08 0513 All real properly ovmed solely or as a tenant in common must be reported at falr market value. Fair market value is defined as the pdce al which property would be exchanged between a willing buyer and a willing seller, nefiher being wmpelhsf to buy orsell, both having reasonable knowledge of the relevant facts. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 502 N. BEDFORD STREET, CARLISLE, PA 17013 40,000.00 (If more space is needed, Insert additional sheets of the same size) REV-1500 All SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY were received by the estate. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. COMMERCE BANK -CHECKING ACCOUNT #536708472 105.81 2. PERSONAL PROPERTY 150.00 TOTAL (Also enter on line 5, needed, insert additional sheets of the same size) REV-1511 EX+(10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE H FUNERAL EXPENSES 8 ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER IDA M. NEAL 21 08 0513 Dells of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: t. HOFFMAN-ROTH FUNERAL HOME 5,823.88 2. CUMBERLAND VALLEY MEMORIAL GARDENS -OPENING AND CLOSING 412.00 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representatlva (s) Street Address City State Zip Year(s) Commission Paid: p, AnomeyFees IRWIN & MCKNIGHT 3, Family Exemptlon: (If decedents address is not the same as claimants, attach explanation) (:laimant Street Address City State Relationship of Claimant to Decedent 7. REGISTER OF WILLS -FILING FEE 8. STEVEN W. BARRETT REAL ESTATE -APPRAISAL 9. BRETHREN MUTUAL INSURANCE COMPANY 10. CLOSING COSTS FROM SALE OF REAL ESTATE 11. PATRICIA BAUMGARDT -HOUSE CLEANING TOTAL (Also enter on line 9, Recapitulation) I $ 4. I Probate Fees REGISTER OF WILLS 5 AxounUnYs Fees 6. TaxRetumPrepamfsFees PATRICIAA. ROSENDALE, CPA Zip 2,650.00 124.00 350.00 30.00 325.00 220.00 3, 322.81 600.00 (If more space is needed, Insert additional sheets of the same size) REV-1512 EX+(12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUmt7ER IDA M. HEAL 21 08 0513 Report debts incurred by the decedent priorto death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. SEARS -CREDIT CARD #5049 9480 8154 3755 1,877.86 2. (AMERICAN GENERAL FINANCE -ACCOUNT #149813498205 3. (THREE SPRINGS FAMILY PRACTICE -MEDICAL 4. (CARLISLE REGIONAL MEDICAL CENTER -MEDICAL 5. (FOOT LOCKER -REIMBURSEMENT OF PENSION TOTAL (Also enter on line 10, Recapitulation) ~ S (If more space is 631.00 141.61 1,024.00 101.35 REV-1513 EX+(g-p01 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT Oft SHAHt OF ESTATE I TAXABLE DISTRIBUTIONS [InGude outriyyhtsppousal disUibutions, and Vansfers under Sec. 9116 (a) (12)j 1. BRIAN L. BAUMGARDT Lineal 11,311.15 502 NORTH BEDORD STREET REAL ESTATE & CARLISLE, PA 17013 1/3 REMAINDER 2. TAMMY LYNN NEAL WILLHIDE Lineal 11,311.15 1155 GREENSPRING ROAD REAL ESTATE & NEWVILLE, PA 17241 1/3 REMAINDER 3. PATRICIA ANN NEAL BAUMGARDT Lineal 244 W. NORTH STREET 1/3 REMAINDER 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: 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 $ more space Is neeoeo, msen addmonai sneers onne same SCHEDULE) BENEFICIARIES WILL OF IDA M. NEAL LAW OFFICES OF STEPFIEN J. HOGG 401 E. LOUTHER STREET CARLISLE, PA 17013 I, IDA M. NEAL, of Carlisle, Cumberland County, Pennsylvania, declare this to be my last Will and hereby revoke all prior wills and codicils. 1. I direct that all my just debts, funeral expenses, gravemarker and administrative expenses shall be paid from my residuary estate as soon as practicable after my death. 2. I direct that 'all inheritance, estate, transfer, succession and death taxes of any kind whatsoever which may be payable by reason of my death shall be paid out of my residuary estate. 3. I direct that my entire estate be distributed as follows: A. T_ leave to my grardchildrer., Tammy Lynn Neal and Bryan L. Baumgaret, my house located at 502 North Bedford Street, Carlisle, Pennsylvania. B. Should a grandchildren predecease me, then that share shall go directly to the other grandchild. Should both grandchildren predecease me, I leave the house to my daughter, Patricia Ann Neal. C. I leave the remainder of my estate of whatev- er nature and wherever situate to be divided equally among my grandchildren and daughter: Tammy Lynn Neal, Bryan L. Baumgaret and Patricia Ann Neal. 4. I appoint my daughter Patricia Ann Neal, as Executrix of this my last Will.- If she should prede- cease me or cease to act in such capacity, I name my son, Robert Neal, Jr., to so serve. ~~ ~ 't ~~~C~ ~i ~ /r f ~j 5. The Executrix of this Will shall have the power to distribute my estate in kind or in gash, or partly in either. 6. I direct that no Executrix acting under this Will shall be required to enter bond. in any jurisdiction. IN WITNESS WHEREOF, I have hereunto het my hand this~~~ day of ~(.- ~~ (~ 19% . i IDA M. NEAL ~._~ ~ ~~~11 ~~~~ ~~ v LAW OFFICES OF szEr~x J. xocG 401 E. LOUTHER STREET CARLISLE, PA 17013 The preceding instrument consisting of this and two other pages was on the day and date hereof signed, published and declared by IDA M. HEAL, as and for her last Will in the presence of us, who at her request, in her presence and in the presence of each other. have subscri$ed our names as witnesses hereto. L1 ', ' ~~ ~ '' 1' , .~. V~ LAW OFFICES OF STEPHEN J. HO(~G 401 E. LOUTHER STREET CARLISLE, PA 17013 ACKNOWLEDGMENT LAW OFFICES OF sTEr~N J. xoc,G 401 E. LOUTHER STREET CARLISLE, PA 17013 Commonwealth of Pennylvania County of Cumberland ss I, IDA M. NEAL, the testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby, acknowledge that I signed and executed the instrument as my last Will; that I signed it willingly and as my free and voluntary act for the purposes therein expressed. IDA M. NEAL Sworn to or affirmed and ackno~~~ic~ed befl by IDA M. NEAL, the testatrix, this -~ /~f~`~day of 199. i% % / ~~ ~~'. County of Cumberland _,--t ' , r y~~,rnal ,m! ~,~ ~~ £, a; ~ 'ti`' ,'hk Cr ,ref N to a ~.~ t t C 'X'x+ .._. _._- --- AFFIDAVIT ,, 4 ~' Commonwealth of Pennsylvania ss Swor to or affirmed and su~ c b -_ to before me by witnesses, this ~, ;day of ~ ~Z .,-, 1993 . We, Fi~Dt-K~c K ~. ~F15 5 and ~ c-r~~.. 1~ .14 ~a\-~.,r the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified accord- ing to law, do depose and say that we were present and saw the testatrix sign and execute the instrument as her last Will; that the testatrix signed willingly and' executed it as her free and voluntary act for the pur- poses therein expressed; that each subscribing witness in the hearing and sight of the testatrix signed the Will as a witness; and that to the best of our knowl- edge the testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. ` ) ~:,;I, w i LAW OFFICES IR WIN ~ McIQVIGIIT A. Settlement Statement U.S. Department of Housing and Urban Development OMB No. 2502-0285 ex fires 11/30/2009 B. TYPE OF LOAN WEST POA9FRET PROFESSIONAL BUILDING 60 W 1. ^FHA 2. ^FmHA 3. l7Conv. Unins. 4. OVA 5. Conv. Ins. EST POMFRET STREET CARL/SLE, PENNSYLVANIA 17013-3222 (717) 249 2353 6. FILE NUMBER STONER81.09 7. LOAN NUMBER - mm rn a youaa man • eu Darr a C. Note: Inma marketl'1p.o.ar' waw wa auu1C• tM clwme: ttlMwyy w slwwn run br IMOnutlon wm WMNING: Itbaerlmamknow hmaln feuaaWm•~sbtlu UMnd BtWaan tk4 oram/ o comktlon can InUUtl• a M• oral mwm. For AMaIN tae:7nu 70 U.B. CPE• BaQlon'1007 8, MORTGAGE INSURANCE CASE NUMBER a ama apa ana own. o.u aM are not InoWMtl M the tauu. Titlelxpress Settlement System tlwr slmtlar/onn. PSUltlu upon ana 8ectlon mto. Printed 01/3012009 at 09:29 JMR D. NAME OF BORROWER: BLAINE H. STONER ADDRESS: 549 N BEDFORD STREET CARLISLE PA 17013 E. NAME OF SELLER: IDA MAY NEAL ESTATE ADDRESS: BO WEST POMFRET STREET CARLISLE PA 17013 F. NAME OF LENDER: ADDRESS: G. PROPERTY ADDRESS: 502 N BEDFORD STREET, Carlisle, PA 17013 Carlisle Borou h H. SETTLEMENT AGENT: i&M REAL ESTATE SERVICES, LLC, Telephone: 717.249.2353 Fax: 717-249.6354 PLACE OF SETTLEMENT: West Pomfret Professional Bid 80 West Pomfret Street Carlisle PA 17013 I, SETTLEMENT DATE: 01/3012009 J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION: 100. GROSS AMOUNT DUE FROM BORROWER 400. GROSS AMOUNT DUE TO SELLER 101. Contract sales rice 40 000.00 401. Contract sales rice 40 000.00 102. Personal Pro rt 402. Personal Pro 103. Settlement cha es to borrower line 1400 708.50 403. 104• 404. 105. 405. Ad ustments for Items aid b seller in advance Ad ustments for Items aid b seller In advance 108. SchcolTax 01130109to06130109 365.55 408. School Tax 01130109to06/30109 385.55 109. 409. 110. 410. 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 41074.05 420. GROSS AMOUNT DUE TO SELLER 40 365.55 200. AMOUNTS PAID BY OR ON BEHALF OF BOR ROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER 201. De sit or earnest mone 501. FJCCeS3 De osit see instructions 202. Print al amount of new loans 502. Settlement cha es to seller line 1400 3 296.16 203. Exislin loan s taken sub'ed to 503. Existin loan s taken sub ed to 204• 504. Pa off of First Mart a e Laan 205. 505. 206. 506. 207. 507. 208. 508. 209. 509. Ad'ustmerds for items un aid b seller Ad ustments for items un aid b seller 211. Count taxes 01101109to01130/09 26.65 511. Coun taxes 01101109to01130109 28.65 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. TOTAL PAID BYIFOR BORROWER 26.85 520. TOTAL REDUCTION AMOUNT DUE SELLER 3 322.81 300. CASH AT SETTLEMENT FROM OR TO BORR OWER 600. CASH AT SETTLEMENT TO OR FROM SELLE R 301. Gross amount due from borrower line 120 41 074.05 601. Gross amount due to seller line 420 40 365.55 302. Less amounts aid b/For borrower line 220 28.65 602. Less reduction amount due seller line 520 3 322.81 303. CASH FROM BORROWER 41047.40 603. CASH TO SELLER 37 042.74 ., w nrneeT.~CtIT nc uro IsINt, AND URBAN DEVELOPMENT File Number. STONERBI.08 PAGE 2 UA.,VU"nw mu., v. .~ ... .. ._ _. SETTLEMENT STATEMENT Tkle ss settlement S L. SETTLEMENT CHARGES 700. TOTAL SALES/BROKER'S COMMISSION based on dce $40 000.00 = Division of commission Ilne 700 as follows: 701. to 702. to 703. Commission ald at Settlement tem not a PAID FROM BORROWER'S FUNDS AT SETTLBMENT PAID FROM SELLER'S FUNDS AT SETTLEMENT 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Od ina8on Fee % 802. Loan Dlscounl °/. 603. A raisal Fee 604. Credit Re rt 805. Lender's Ins 'on Fee 806. Mo a e A Ilcetlon Fee 807. Assum on Fee 808. 809. 810. 811. 900. REMS REQUIRED BY LENDERTO BE PAID IN ADVANCE 901. Interest Fran to Ida 902. Mo a Insurance Premium to to 903. Hazard Insurance Premium for to 904. 905. 1000. RESERVES DEPOSITED WITH LENDER FOR 1001. Hazard Insurance mo• hnD 1002. Mc a Insurance mo. Imo 1003. CI Pro Tax mo. Imo 1004. Coun P Tax mo. 27.96 Imo 1005. School Tax mo. 73.15 Imo 0.00 0.00 1009. A re ate Anal sis Ad'uslment 1100. TITLE CHARGES 1101. Settlement or closl fee 1102. Abshact or title search 1103. Title examination 1104. Title insurance binder 1105. Document ration 10.00 1106. Note Fees 25000 1107. Attome s fees includes above items No: 1101.1102 11031907 1108. Title Insurance includes above keins No: 1109. Lender's Covera NONE 1110. Owner's Cove a 40 000.00 - 1111, 1112. 1113. ,. ,,, GOVERNMENT RECORDING AND TRANSFER CHARGES.. 1200 . 1201. Recordin Fees Deed 48.50 M' ' 'Release ~ ~ 400 00 1202. Ci ICoun taxlstam s Deed 400.00 • Mat a e 400.00 1203. State Tax/stam s Deed 0.00 • M 1204. 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Surve 1302. Pest In coon 1303. 2007 COINIP/SCHOOL TAXESto TAX CLAIM BUREAU 1304 1 2.35 . 2008 CO/TWPISCHOOL TAXESto TAX CLAIM BUREAU 1305 1355.22 . 1306. Flnal WU-Swr # 006749 to BOROUGH OF CARLISLE 105.59 1307. 1308. ..r•.r. nuenn_ec ra.ae...e aaaa Ana Rnrllnn J antl 502. SeCtlan KI _ 708.50 3296.16 Wa and xwnte eletarnerrt of all rewipta and dbburesmeMa made an my awoum or b IDA NAY NEAL ESTA7E ~~, Y: !, ~ `\ WARNIND: RIB ACRINE 70 NNOYNNGLY NA%E FALSE STA7ENENrE TD 7N TM HUD+I Sartlamem etmamamwhkhl haw yynpand ba Waaml aearetsaxoum of Mh tramaclli UNR~ STATES ON TNIS OR ANY SIMSAR FDRN.PENALTIES UPON CONw ON 1 have uauwd or wxl rtewe MSfuMa Nf be dlaburead In aecertlaxe wllh M4 abtamant ~S ICODE SEECTION 1001AND SECTION 010 ~~~ 8EE TITLE 78. / 3~ O Sy: ~ 74UU. I U I NL JC I I LGmGn ~ vru+nvr.. ..~ ~...~ .... ....__ . __ ______ - - HUD CERTInCAT10N OFBUYERAND SEDER July 19, 2008 Commerce CBank Douglas G. Miller Law offices of Irwin & McKnight 60 West Pomfret St Carlisle, PA 17013-3222 RE: Estate of: Ida Mae Neal Tax Identification Number: 177-247355 Date of Death: April 26, 2008 To Whom It May Concern: Jt4i~ < ~ 2'~~ fRWIIV & VJIcKItiIGH'i -AN! i}FFICE This letter is in reference to decedent account information you requested for the individual listed above. We are able to provide the following: Account Type: Checking Account Number: 536708472 Date Opened: July 3, 2004 Primary Owner: Ida Mae Neal Date of Death Balance: $105.81 Accrued Interest: $.02 Principal Balance: $105.79 YTD Interest: $.22 Please feel free to contact me at (717) 412-6127 if I may be of further assistance. Sincerely, CindL y Shultz Support Associate/Deposit Services Commerce Bank Commerce Bank /Harrisburg, N.A. PO Box 4999 3801 Paxton Street Harrisburg, PA 17111-0999 commercepc.com Hoffman-Roth Funeral Home & Crematory, Inc. 219 North Hanover Street Carlisle, PA 17013 (717)243-4511 May 12, 2008 Robert E. Neal 15 McBride Avenue Carlisle, PA 17013 The Funeral Service for Ida Mae Neal 15319-107 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. OUR SERVICE: Traditional Funeral Service Package $4150.00 FUNERAL HOME SERVICE CHARGES $4150.00 SELECTED MERCHANDISE: Viceroy Casket $1260.00 THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE THAT YOU HAVE SELECTED $5410.00 Cash Advances Newspaper Obituary Notice- Sentinel , $79.92 Newspaper Obituary Notice -Sentinel 2nd run $39.96 Clergy Offering $75.00 Certified Copies of Death Certificates, $60.00 Flowers. $159.00 TOTAL CASH ADVANCES AND SPECL4L CHARGES . $413.88 Total Total Cost , $5823.88 TOTAL AMOUNT DUE $5823.88 This statement is net and payable in full within 30 days of receipt. Please return this portion with your Remittance $ Amount Enclosed Service ID # 15319-107 Ida Mae Neal ( ~ S l~® r C ., ~- Call usatt-80D91777x0 111t a ea ~.- Go to wlywseaVscard:com , Wnte to us at PO Box 6283 Sioux Falls, SD 57117 6283 IDA M HEAL ~ paymaM Oue Date Account Number: 5049 9480 $154 3755 i Page 1 bf 1 ~ 05/14/08, Your Account Summary Billing Cycle Closing Date 04/16/08 Amount:Over Credit-Line $I)'.00 Amount:Past Due $0.00 Total Minimum Due' $81..98 Previous Balance- $1;900:08 Payments & Credits $6520 Plarehases & Debits " $D.00 OtherGharges $0.00 TotafFINANCECHARGES $42.98 Account Balance $1,877.86 z z z Zo Zo Z ~' 2 ro Z O Z Zp Z N Z~ zo z° Your Credit Sumrnary Total Credit Lirie $1,980:00 Total Credit Available $0.00 ACtlVlty Sale Dete Poet Date Deacdption Amount 04/11/08 04/11/08 PAYMENT-THANK YOU -65.20 Avenge Daily Rates 'Rate Varies Balance Balance Pedodic Rate Periodic D=Day FINANCE M=Month CHARGE SEARS REGUUIR EXTERNAL REGULAR CASH ACCESS REGULAR Days in Billing Pedod: 30 $1,877.86 $1,907.85 27.40%' .0751%(D)' $42.98 $0.00 $0.00 27.40%' .0751 %(D)" $0.00 $0.00 $0.00 27.40%" .0751 %(D)" $0.00 Effective ANNUAL PERCENTAGE RATE: 27A0% Minimum FINANCE CHARGE: $0.00 Please }ollow payment instructions on reverse side. Payment must be received by 5:00 p.m. local time on Payment Due Date. Sears Card® II I I"I IIII II I'II'll"II I II'I'I I I I III Account Number: 5049 9480 8154 3755 II I Payment Total Account Balance Due Data Minimum Due 86 05/14/08 $61.98 $1 877 Amount Enclosetl , . 0061019E 11 A 08107 1 TRS000 FXG 001 7 N ml~ ~u~~~~u r~~~ruur~~u~~uu~~~r~uur~~u~~r~~nur~r~n~r~) °~ c~- IDA M NEAL °~ 502 N BEDFORD ST -_ CARLISLE PA 17013-1913 Please make address changes on reverse side. IIII II II'~IIIII'111I'~IIII IIIII'II III II~II VIII II I1111"IIIII~ Make check payable to SEARS CREDIT CARDS PO BOX 183081 COLUMBUS, OH 43218-3081 200 5049948081543755 0187786 D006198 D006520 1110 ~ IIIIIIII Ilh IIIII Illla II ~ ~~ III IIIII ~~~~~ IIIII Alll IIIII IIIII IIIII ~~~~ ~ ~~ ~~~ IIIII IIIII IIII IIII P.O. Box 48458 Oak Park, MI 48237 Return Service Requested 05/13/08 IDA NEAL 502 N BEDFORD ST CARLISLE PA 17013-1913 I~11111~1~111~~~~~~11~~1111~1111~111~~111~111~11~~~~~1~1~~1~11 Phillips & Cohen Associates, Ltd. Ph 800-259-6991 Fx 302-368-0970 Office Hours: M - Th: 8am - 9pm Fri: Sam - 6pm Sat: 8am-12pm 258 Chapman Rd Suite 205 Newark, DE 19702 Account#: 5049948081543755 Balance: $1877.86 --------------------------------------------------------- *** PLEASE DETACH ANU RETURN IN THE ENCLOSEll ENVELOPE WITH 1"OUR PAYMENT *** Client: Client Account#: Our Account#: Balance: Citibank 5049948081543755 12174482 $1877.86 To The Estate of IDA NEAL: Our company represents Citibank in reference to an account in the name of IDA NEAL. We have teamed that IDA NEAL, who was a valued customer, has passed away. Please accept condolences from our client and our company. There is an unpaid balance on this account. Please accept this letter as a Notice of Claim on behalf of our client. This letter is sent to you solely in your capacity as a personal representative of the Estate of IDA NEAL, please call our office toll free at 800-259-6991 to discuss resolution of this matter and payment on this account. If you are not the personal representative, please contact us with the name and address of the personal representative or attorney who is handling the estate. Cordially, 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 notice, 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 any information obtained will be used for that purpose. Phillips & Cohen Associates, Ltd. • 258 Chapman Rd, Suite 205 • Newark, DE 19702 • 800-259-6991 ,ncco..n.Tnc cnn~ c, cnm n nnn.ne ~ a n.o, m ~ ~n~ n t nn i .n ~ ~ PC Ai f141 AV\rV Mtla Vap aa.rttaerta IDA M NEAL AMERICAN Please re/er questions or requests br money to the address bebw. Please include your name antl account number on any correspondence. AMERICAN GENERAL FINANCE 6 S HANOVER ST CARLISLE, PA 17013-3306 Phone: (717)243-6055 Retain dlla portion IDr your records t st Due P Past Due Total Payment Additional Past Due Charges Accrue Account Curren Amount Due a Amount Char es Amount Due Due Date if Pa ment is Received After Number 13498205 90.00 181.00 4.05 275.05 Jul 06, 2008 Jul 16, 2008 Previous Balance .......... Pg 1 0l 1 CALL THE AMERICAN GENERAL INSURANCE HOTLINE AT 1-804325-2147 EXT 5232 WITH ANY QUESTIONS YOU MAY HAVE ABOUT INSURANCE OR OTHER NON-CREDIT PRODUCTS. ~ YOUR ACCOUNT IS PAST DUE. IF THERE IS A PROBLEM, PLEASE CALL (717) 243-6055 . WE MAY BE ABLE TO HELP. IF YOU HAVE ALREADY SENT YOUR PAST DUE AMOUNT, THANK ~/~ YOU. Contact us on the internal at www.bansfasl.com T y 0192854 0000131]0 OAGD13 JULOB (03) Please tlerech and return rhla poMon with your payment Puase smp er eu. ems a use nN, .,mlesse.everoPS m nmm rms. wrmPaN m we aeemas 5.mw. CHEGH HERE FOfl SPECIAL PAYMENT MPLICATION ANO/OR ADDRESS CORRECTION ON aAGN. AMERICAN GENERAL FINANCE 6 S HANOVER ST CARLISLE, PA 1]013-3306 or ~iENERAL FINANCIAL SERVICES A Member of American International G,OUP. Inc. www.loansfast.com Statement Date: June 21, 2006 Regular Payment: $90.00 631.00 All loans are sublecl to normal credfl poACy. SLP16 '040AS2' 149813498205 a $ 275.05 Ju106,2008 $ 278.14 Jul 16, 2008 AMEItIC4N (GENERAL FINANCIAL SERVICBS ®n Mw.e., o, nma.men ima...nenN mo.o. mo. Yes, l would like additional cash. • 0192854 000013170 OAGDE3 JOLOB (03) IDA M NEAL 502 NORTH BEDFORD ST CARLISLE, PA 17013-1913 ul))~ul)~)uuuOn~)uu~))I~uul)~u~)I))wu)I~u)I AMERICAN GENERAL FINANCE P.O. BOX 742536 CINCINNATI, OH 45274-2536 )I~u~l~l~u l)II)IU)r)u(n)I(I~I~n I)~u ))nu)~u~~nu))I) 149813498205000009D0000002750500002781400D063100000D09D00 /REGIONAL MEDICAL CENTER Po aox aloo Carlisle, PA.17013-4100 July 03, 2008 zsatnz~ IDA M NEAL 502 N BEDFORD ST CARLISLE PA 17013 DEAR IDA M NEAL STATEMENT 005761595 PATIENT: IDA M NEAL PATIENT #: 9399998 BALANCE: $1,029.00 ADM.. DATE:-09/19/08 Thank you for choosing Carlisle Regional Medical Center for your healthcare needs. We value your use of our facilities. Your insurance company was billed and has paid according to the benefits of your policy. However, there is a patient balance due which is indicated above. Your payment is important to the efficiency of the hospital and our attempts to hold down costs. Please mail your check or money order today. For your convenience, we accept Visa, MasterCard, Discover and American Express(see below). If you have additional insurance information which you have not previously provided, please notify us immediately. Furthermore, if you are not able to pay this account in full at once, please contact us for payment arrangements. If you have questions regarding the balance of this account, please do not hesitate to call us at the number shown below. Thank you for your prompt attention to this matter. If you have already made payment, please disregard....and thank you. PLEASE RETURN LOWER PORTION WITH YOUR PAYMENT CARLISLE REGIONAL MEDICAL CENTER PATIENT: IDA M NEAL PATIENT REPRESENTATIVE PATIENT #: 9399498 800 361-9160 BALANCE: $1,029.00 8:30 A.M. TO 5:00 P.M. ADM. DATE: 04/19/08 PIA 03 ** CREDIT AUTHORIZATION ** CARLISLE REGIONAL MEDICAL CENTER VISA(_)MC(_)DISC(_)AMX(_) P.O. BOX 4100 EXP DATE ( ) VIN# ( ) CARLISLE PA 17013-4100 CARD # ( ) PMT AMT ( ) SIGN ( ) 03 *CALLS/INQUIRIES MAY BE MONITORED FOR QUALITY CONTROL* 127