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02-0416
PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Estate of l'Y)o......~ Lee \..-Q~-h-f"'I<(f-r also known as No. To: :J../-fJ J.. - tf I' Register of Wills for the County of (' A.l1Y"I nev' ~ C in the Commonwealth of Pennsylvania Deceased. Social Security No. r:9 ~ &- - 5 d - "-/ '/ 3 I The petition of the undersigned respectfully represents that: Your petitioner(s), who is/ftf'e 18 years of age or older, appl If> <... for letters of administration on the estate of (d.b.n.; pendente lite; durante absentia; durante minoritate) the above decedent. Decendent was domiciled at death in C' _\.1 (Y'\ lot> v \ Cv--\ C . County, Pennsylvania, with her last family or principal residence at C) J.-j~ We.6tD,'i' ( Jh<~ J ~'.\ i!J ~ Cu.mbe( IClr\C -e,1) I. (list street, number and municipllity) ,~dOO~, Decendent at death owned property with estimated values as folllows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: $ ~ I 0 DD $ -0- $ .- 0- $ /,p . 00 () -+o+J Petitioner_ after a proper search haS....- ascertained that decedent left no will and was survived by the following spouse (if any) and heirs: Name () Relationship (', 'r\\c...s\-:l\.,,/~ I P/\ l/()~ THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the appropriate form to;e ~ '\ IE~~ tx ~ g /6 r;jrr~" c' f. c::.= / / ~ "'.= ,/:t/~ChC_ /-,... r 'J~::5 ".~, /?os-r 3~ ' OJ '- :::;0 ~ c:: "" r;j /j-S9-/eJ OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland } ss The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal ~ representative(s) of the above decedent petitioner(s) will well and -L ' tmly administ" the estate accmding tn law. ~. U - . ~-l)Z Sworn to or affirmed and subscribed f .. ___ before me this 25th day of _) ~"?'= r L. /20 KO';t/sk r' 'tr ~ 002 5 Register ~ J No. 21-2002-416 o -- =' ci 1'..1 Estate of Mary L. Lastinger , De~sed 1'---) GRANT OF LETTERS OF ADMINISTRATION Vl .' . C;') \,]1 AND NOW April 25th ~ 200~ in consideration of ~~ petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that Mary r.. Lastinger is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration are hereby granted to James L. Rakowski in the estate of Mary To Toa!=:tingp.r IEG~ $ $ $ $ TOTAL _ $ Filed .~p~j).. ;2.5.1;:1). . . . . . .. A.D. FEES Letters of Administration Short Certificates(5) . . . . . . . . . . Renunciation ................ JCP ATTORNEY (Sup. Ct. 1.0. No.) 40.00 15.00 5.00 60.00 }9{~002 ADDRESS PHONE CALL ADMINISTRATOR AT (717) 648-2452 Cellphane JRD/June 30, 1992/17858 APR 3 0 2004 In Re: Estate of Mary L. Lastinger Late of New Cumberland Borough Estate No.: 21-2002-0416 ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 21-2002-0416 NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE Personal Representative: James L. Rokowski Counsel for Personal Representative: Date of Decedent's Death: 04-20-2002 Date of Delinquency Notice: 03-25-2004 The undersigned, Glenda Famer-Strasbaugh, Clerk of Orphans' Court, in accordance with Rule 6.12, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, was given by the Clerk of the Orphans' Court on 03-25, 2004, and that the ten (10) day notice to file the Status Report has expired. Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Date: 04-30-2004 Clerk of the Orphans' Court Distribution: Personal Representative Counsel for Personal Representative Estate File A hearing is scheduled at QJ'~ in Courtroom No. 3. If the Status Report is filed prior to the hearing date, the hearing will automatically Geor 12431305072004 ROW621 Cumberland County - Register Of Wills Pa~e 1 5/~7/2004 File No 2002-00416 PA File No 2102-00416 Decedent LASTINGER MARY L Docket Entries D/E Date No. Filed 001 04/25/02 PETITION FOR GRANT OF LETTERS OF ADMINISTRATION OATH OF PERSONAL REPRESENTATIVE DEATH CERTIFICATE 002 04/25/02 GRANT OF LETTERS OF ADMINISTRATION 003 06/10/02 INSOLVENT INHERITANCE TAX RETURN DKT 17 PAGE 59 LINE 10 004 07/23/02 REV 1547 NOTICE INH TAX APPRAISEMENT - ACN 101 Docket: 17 Book: Page: 59.00 005 08/08/02 CERTIFICATION OF NOTICE UNDER RULE 5.6(A) 006 10/17/02 CLAIM AGAINST ESTATE - AMERICAN EXPRESS 007 11/05/02 CLAIM AGAINST ESTATE BOSCOV'S · Complete Items 1, 2, and 3. Also complete ~m 4 B ~ D~h~efy b de, red. · Print your name and address on the mveme so that we can return the card to you. · .Attach this card to the back of the mallplece, [] Addressee B. Received by (PrfntedName) 'it. Date of Delivery . If YES, enter 3. Type [] Insured Mail [] Return Receipt for Merchand~e [] C.O.D. 4. Restricted Deliver? ~.xtra Fee) r-I Yes 7~03 1010 0001 i ~o~st~ Return Receipt 1204 0529 Postage Certified Fee Return Reciept Fee (Endorsement Required) Restricted Delivery Fee (Endorsement Required) Postmark Here r"R Total Postage & Fees F-t [Sent · ED . [ '~'Fe'&~ .,. ......~ .................. o..;v ............. · ~ items 1, 2, and 3. Also complete item 4 If Restricted Delivery is desired. · Prflltyc:~ir'na!7~ and address on the reverse so that we oan return the card to you. · .Attach ~ card to the beck of the mailpiece, oro~ the front if spece permits. II B. Received by(Pr/ntedName) lC. DeteofDe~ Type -, 3. ~--ertl~ Mail [] Registered [] Return Receipt for MerchandiSe [] Insured Mall [] C.O.D. 7003 1010 0001 1204 0529 Domestic Retum Receipt 1~2595'02-M'154~! JRD/June 30, 1992/17858 APR 3 0 2004 In Re: Estate of Mary L. Lastinger Late of New Cumberland Borough Estate No.: 21-2002-0416 ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 21-2002-0416 NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE Personal Representative: James L. Rokowski Counsel for Personal Representative: Date of Decedent's Death: 04-20-2002 Date of Delinquency Notice: 03-25-2004 The undersigned, Glenda Famer-Strasbaugh, Clerk of Orphans' Court, in accordance with Rule 6.12, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, was given by the Clerk of the Orphans' Court on 03-25, 2004, and that the ten (10) day notice to file the Status Report has expired. Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Date: 04-30-2004 Distribution: Clerk of the Orphans' Court Personal Representative Counsel for Personal Representative Estate File A hearing is scheduled at in Courtroom No. 3. If the Status Report is filed prior to the hearing date, the hearing will automatically be Georg~ E ~(o~fe~, p.l~ '' ~ 12431305072004 ROW621 Cumberland County - File No 2002-00416 Decedent LASTINGER MARY L Register Of Wills Pa~e 1 5/~7/2004 PA File No 2102-00416 Docket Entries D/E Date No. Filed 001 04/25/02 PETITION FOR GRANT OF LETTERS OF ADMINISTPJtTION OATH OF PERSONAL REPRESENTATIVE DEATH CERTIFICATE 002 04/25/02 GRANT OF LETTERS OF ADMINISTRATION 003 06/10/02 INSOLVENT INHERITANCE TAX RETURN DKT 17 PAGE 59 LINE 10 004 07/23/02 REV 1547 NOTICE INH TAX APPRAISEMENT - ACN 101 Docket: 17 Book: Page: 59.00 005 08/08/02 CERTIFICATION OF NOTICE UNDER RULE 5.6(A) 006 10/17/02 CLAIM AGAINST ESTATE - AMERICAN EXPRESS 007 11/05/02 CLAIM AGAINST ESTATE BOSCOV'S STATUS REPORT UNDER RULE 6.12 NameofDecedent: ~T~fl ff'u ~. ate o e th: 0 aO - OO& Will No.: Adrnin. No.: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes~ NoD uoa noe c/-e. 2. I/the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the an,qwer to No. 1 is Yes, state the following: ao Did the personal representative file a final account with the Court? Yes _ No n'] b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to thc parties in interest? Yes 1--] No Fl c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. b]gnature Name Address t Telephone No. Capacity:~ersonal Representative Fl Counsel for personal representative r CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: (Y\().fd ~ e e ko...s.+-l' CIOje (' Date of Death: C)4 - ~O - d- 0 0 d...... Will No. No. dOO(}..- Oo"i 1\0 Admin. No. pC\.. tVo c9-l ~ 0 J - 04 I t.o To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on Name Address ::}GrY\f5J L9)() \~ d\VS K ~ (sol Q ~fL4 ~) 110 G. \con c;f- /hecAGJ1l LSb0fj PA 170SS- Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: t-...)IA 8-(t?-o~ ~j~ Name :::Ta..rneS L, ~6~ owsLt Signature Address ~~lCO^ Cou..f+- mechan\'(~b~1 PA \lOSS Telephone ( ) r') \ t) - If q S - I 0 <+0 Capacity: E- Personal Representative _Counsel for personal representative '0 .. c:...;..rH FOR."!. MARY LEE LASTINGER ORPF..ANS' COURT DIVISION O~ cUMR~~ca~~ OF 1-02- 1 NO. ESTATE OF N'oc.:..ce or cla.im by BOSCOV'S ~n che .a.mounc or S 135.35 t~~ed pursuanc co 8ac~~on ]384, Probata, Escates and F~duc~aries C~de Laws or 1972, A~ No. 104 effec~~ve July I, 1972 as amended. Date Ente: t~e cla.im at BOSCOV'S 9441 LBJ FREEWAY Lock Box 30 Dallas, TX 75243 '!.'O THE~RK OF THE ORPHANS' COURT aNISIaN: (Cl~anc and Aadress) in Che amounc at S 135.35 agaLnsc the above ent~tled Estate. The deeedenc \.Iho r-esided at: NEW CUMBERLAND, PA (Address) ~/20/02 d.i.ed on (Dace) Wr~!:~en not:~ce of said claim \.Ias malled to see attached (Personal Represencac.:..ve or C~unsel) ac an (Adores s ) (Dat:e ) The basis of aIoresa.i.d claim is as tallows: (Ita~~=e fully to enable personal representa.tive co make prope: ~nvesc~gat:ion). Acct.#106829446 (Name) ~441LBJ FREEwAY Lock Box 30 Dallas. TX 75243 (Address) Q72-644-6360 C~a..:..manc's C~unsel (Address) "__I PROBATE COURT Cumberland County, State of pennsylvania Mary lee Lastinger, Deceased Case #21-02-416 Proof of Mailinq I mailed the creditors claim to the fiducia:ry (and attomey, if applicable) as follows: I deIX>sited a copy/copies of the claim with the United States Postal Service in a sealed envelope with the IX>stage fully pre-paid. I used first-class mail. I am employed in the county where the mailing occurred. The envelope (s) was/were addressed and mailed as follCMs: Mr. James Rakowski 16 Falcon Ct. Mechanicsburg, PA 17055 Date of Mailing: County of Mailing: I/~~J- Dallas, Texas I decla:re UIl"')lenalty of perjury that the foregoing is true and =ect:. Date: ,///~ ~~ -=> . ~son,: Agent f= Boscov's P.O. Box 741026 Dallas, 'IX 75374 , ') Page: 1 Document Name: BARBARA BOSCOV'S CREDIT DIVISION ACCOUNT INQUIRY ORGANIZATION 100 LOGO 110 ACCT 0000000000106829446 SHORT NAME LASTINGER ESTAT STATE PA HOME PHONE TOT CR LMT 0 EMPL CD 00 STATUS Z CA CR LMT 0 CSH AUTH .00 CASH BAL .00 TOT DISP 0 .00 CASH AVAL .00 CASH DSP 0 .00 O-T-B **********0 CYCLE DB 0 .00 PCT LEVEL 1 10 S PAl CYCLE CR 0 .00 CURR BAL 135.35 CYCLE PMTS .00 \RIQ ( [' I 1, PAGE 01 REL 7177300729 BLOCK NBR PLANS CARD USAGE BILLING CYCLE nn DATE OPENED CARD FEE DATE DTE LST BILL n'T'~ PM'T' nrJF. 08/30/2002 15:03:43 CODES H o 2 4 9 08/01/1993 08/09/2002 OC)/09/2002 1,,}-l6'1- /6 ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISE"ENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESS"ENT OF TAX JAMES L ROKOWSKI 16 FALCON CT MECHANICSBURG 'OZ ,JiL:n :: 7 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 07-15-2002 LASTINGER 04-20-2002 21 02-0416 CUMBERLAND 101 *' REV-1541 EX iFP (01-021 MARY L Allount Rellitted PA_' 17055 "', \ .' t MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS -- REV=is4j-Ex-AFp-('oY':o'2Y-No,.-icE--oF-YNHER-iTAi.fcrTAx-A"PPRA-isEifENT~--ALl-oWANCE-(fi-------------- --- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF LASTINGER MARY L FILE NO. 21 02-0416 ACN 101 DATE 07-15-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. "ortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/"isc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) .00 382.80 .00 .00 5,220.72 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/"isc. Expenses (Schedule H) 10. Debts/"ortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 9,846.39 9.440.70 (11) (12) (13) (14) NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 5,603.52 19.287 09 13,683.57- .00 13,683.57- 14, 15 and/or 16, 17, 18 and 19 will returns assessed to date. NOTE: I~ an assessment was issued previously, lines re~lect ~igures that include the total o~ ALL ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due .00 X 00 = .00 X 045 = .00 X 12 = .00 X 15 = (19)= .00 .00 .00 .00 .00 TAX CREDITS: ""._n. .-, l+J A"OUNT PAID DATE NU"BER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL D~E IS LESS THAN $1, NO PAY"ENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU "AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS.) Estate Recoveries, Inc. Over 15 Years of Service to the Financial Industry October 15, 2002 Registei" Of Wills Cunrberland County Courthouse j Courthouse Square Carlisle, PA 17013-3387 RE: Estate Of Mary Lastlflgcr, uecc:::::.cu. ;:::~ Our Fi1e#: LAR-1001S' Estate #: 2102416 -'~J Dear SirlMadam: Enclosed please find our claim regarding the above captioned estate which is being filed on behalf of American Express, creditor. A copy (lfthis claim is being forwarded to James L. Rokowski, Representative for the estate. If you have any questions concerning the attached claim, please do not hesitate to contact this office. Sincerely, d.~ RJH Enclosure See Reverse Side For Special State Disclosures. This communication is from a debt collector. This is an attempt to collect a debt and any information obtained will be used for that purpose. P.O. Box 24566, Baltimore, Maryland 21214 · 5543 Harford Road, Baltimore, Maryland 21214 Monday - Friday 8:00 am - 6:00 pm Eastern Time · Telephone: 410-444-8022 . 800-229-8472 · Fax: 410-426-4051 STATE OF PENNSYL VANIA IN THE MATTER OF ESTATE OF: MARY LASTINGER IN THE ORPHAN'S COURT OF CUMBERLAND COUNTY ESTATE#: 2102416 STATEMENT OF CLAIM 1. The creditor, American Express, certifies that there is due and owing by MARY LASTINGER, deceased, the sum of FOUR THOUSAND TWO HUNDRED SEVENTY EIGHT DOLLARS AND EIGHTY ONE CENTS ($ 4,278.81). 2. The nature of the claim is a OPTIMA CARD account 372527313831002. 3. The name and address of the claimant is: American Express, 200 Vesey Street, New Yor~NY 10285-3830. 4. The name and address of the claimant's agent is: Jennifer L. Streh1ein, Estate Recoveries, Inc., P. O. Box 24566, Baltimore, Maryland 21214. ""...,; 5. This claim is not contingent and is not secured by any liens or judgments. 6. This claim is not based on anyone instrument. Said balance has accrued since the account-was established. On behalf of American Express, creditor, I do solemnly declare and affirm under the penalties of perjury that the information in the foregoing claim is true and correct to the best of my knowledge, information and belief. I have made diligent inquiry and examination, and I believe the claim is just and all legal offsets, payments, and credits made known to the affiant have been allowed. st te Recoveries, Inc; P.O. Box 24566 Baltimore, Maryland 21214 (410) 444-8022 County of Baltimore, Maryland: IN WITNESS WHEREOF, I hereunto set my hand and Notarial Seal this My Commission Expires: IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DNISION I I I File No. 2102416 Estate of Mary I.astinger , Deceased NOTICE OF CLAIM by .JF,NNTFRR T, STRRm ,RTN, A~F,NT FOR A MF,RTCA N F,XPRRSS Filed Pursuant to Section 3532 (b) (2) of the Probate, Estate, and Fiduciary Code, 20 Pa. C. S. A ~ 3 5 3 2 (b) (2) To the Clerk of the Orphans' Court Division: Enter the claim 0 .JF,NNTFRR T, STRRm ,F,TN, A~F,NT FOR A MRRTCA N F,XPRF,SS (Claimant) in the amount of $4,278.81 against the above entitled estate. The Decedent, who resided at 244 Wedover Drive, # R " (Street Address) , Cumherland -.J County , New Cumberland~ PA 17070 (City) Pennsylvania, died on A. prH 20) 2002 Written notice of said claim was given to .Iames I,. Rokowski (Personal Representative, or . If known to claimant, at 16 Falcon Court his Counsel) ( Address) ,on October 15T 2002 (Date) Mechanicsbur~. P A 17055 , Claimant Post Office Box 24566. Baltimore. Maryland 21214 ( Address) Claimant's Counsel: ( Address) V ~'-'~~'~°' ' COMMONWEALTH OF PENNSYLVANIA REV-1500 q ~ ~ 5 !. ~~ .. .. DEPARD PT ~OF~REVENUE INHERITANCE TAX RETURN FI NUMBER ` ~ / a ~ ~ ~ ~ HARRISBURG, PA 17128-0601 R E S (DENT DECEDENT ( - COUNN CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER f' Z Lastinger, Mary L. 228-52-4731 W DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE W 04/20/02 09/10/40 REGISTER OF WILLS (Vj,J (IF APPLICABLE) SURVNING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER ~ N/A w ~ 1.Original Retum ~ 2. Supplemental Retum ~~ 3. Remainder Retum idea of deem pda a iz-~s-ezl ~ ~ ~ ~ 4. Limited Estate ~ 4a. Future Interest Compromise /date m deem aver iz-is-szl ~~ 5. Federal Estate Tax Retum Required ~ a m ~ 6. Decedent Died Testate lanam copy or waq ~ 7. Decedent Maintained a Living Trust IAnacn copy or trust) 0 8. Total Number of Safe Deposit Boxes a ~ 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date ~ deem between ~z-a~-si and ~-~•ssl ~~ 11. Election to tax under Sec. 9113(A) IAmm scn of r THIS SECTION MUST 6E G0 ETED. ALL C(?RRESPONDENCEALAD CONF TIALTAX INFOR ATION SHOULD BE DIRECTED TO: w NAME COMPLETE MAILING ADDRESS Z James L. Rokowski 16 Falcon Court y FIRM NAME (IfApp~icable) Mechanicsburg, PA 1'7055 ~ N/A o TELEPHONE NUMBER ~ (717) 795-1040 Z ~Q J H a Q V W 1. Real Estate (Schedule A) (1) O~QO- "' ' 2. Stocks and Bonds (Schedule B) (2) 382r-$0 ~' 3. Closely Held Corporation, Partnership or Sole-Propdetorship (3) 0:00 ~. ~, 4. Mortgages & Notes Receivable (Schedule D) (4) 0.00 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (5) 5,220.72 ' ~' (Schedule E) :. 6. Jointly Owned Property (Schedule F) (6) 0.00 Separate Billing Requested iS 7. Inter-Vrvos Transfers & Miscellaneous Non-Probate Property (7) 0.00 (Schedule G or L) tal Gross Assets (total Lines t-7) 8 T (8) 5,603.52 . o _ 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 9,846.39 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) (10) 9,440.70 Total Deductions (total Lines 9 & 10) 11 (11) 19,287.09 . _ lue of Estate (Line 8 minus Line 11) t V N 12 (12) -13,683.57 e a . _ uestslSec 9113 Trusts for which an election to tax has not been mental Be d G it bl (13) 0.00 q overn e an a 13. Char s made (Schedule J) Net Value Subject to Tax (Line 12 minus Line 13) 14 (14) 0.00 . _ SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES Z 15. Amount of Line 14 taxable at the spousal tax 0.00 rate, or transfers under Sec. 9116 (a)(1.2) ~ H __ x .0 l t t li bl _.... (16) _ 0.00 ra e nea e a 16. Amount of Line 14 taxa C 12 x (17) 0.00 . . 17. Amount of Line 14 taxable at sibling rate _ ~ Amount of line 14 taxable at collateral rate x .15 18 (18) v 0.00 V . D (19) _ 0.00 ue 19. Tax I- » 3lfFtE Td /1 E ALL QUE NS ON REV RSE' 51D AND RP,CHF~CK MATH < < Decedent's Complete Address: STREETADDRESS 244 Westover Drive, Apt #B ~InNew Cumberland srarEPA zIP17070 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) Total InteresUPenalty (D + E) {3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) Make Check Payable to: REGISTER OF WILLS, AGENT (1) 0.00 0.00 0.00 0.00 0.00 0.00 0.00 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :.......................................................................................... ^ ^Q b. retain the right to designate who shall use the property transferred or its income : ............................................ ^ ^X c. retain a reversionary interest; or .......................................................................................................................... ^ ^x d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. ^ 3. Did decedenf own an "in trust far" or payable upon death bank account or security at his or her death? .............. ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a 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. Under penalties of perjury, I dedare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is hue, correct and complete. Decoration of preparer other than the personal representative is based on all information of which preparer has any knowledge. DATE ~ r ~p ~ ~ C o n C~ /'~ 1~2.-C..D. t^ti~ ~ C~ ~J r-z. SIGNAT'UrRE` OF PREPARER OTHER THAN REPRESENTATIVE ADDRESS S3'^ DATE 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 3% [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 0% [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exemR 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 0% [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 4.5%, 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 12% [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-1503 EX+ (6-98) SCHEDI~ILE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Lastinger, Mary L. ~ ~ _ ~a - (~ ~[ ~ (P All property jointly-owned with right of survivorship must be disclosed on Schedule F. (If more space is needed, insert additional sheets of the same size) REV-1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Lastinger, Mary L. p? ~ , O ~ ^ O y Include the proceeds of IitigaGon and the date the proceeds were received by the estate. All property Jointly-owned with right of survivorship must be disclosed on Schedule F. /(o (If more space is needed, insert additional sheets of the same size) PSEC ~0. ~oz 67013 (717) 234-8484 (Harrisburg) Harrisburg, PA 17106-7013 (800) 231-7328 (Nationwide) website - http»//www.psecu.com GET YOUR FREE CREDIT REPORT! SEE YOUR CREDIT RATING AND LEARN" HOW YOU CAN IMPROVE IT. VISIT WWW.PSECU.COM FOR DETAILS. ~n~~~~u~~~~n~~n~~~~nun~~n~~~~i~~u~~~~~~u~~~n~~n~~~ MARY L LASTINGER APT B 244 WESTOVER DR NEW CUMBERLAND PA 17070-1152 JOINT OWNER I 0228XXXXXX I PAGE 1 040102043002 ac~e~ ~ , FNANCE F@68OR '~. ~ 0~>E P'fi01wE CHARGE . ,'l1AG'[1C1N.p89~R1 ;,5~!Mf101B8 ;:< .:JIII4lUlFl' .:. ~:AN~ 04/01 ID O1 REGULAR SNARE BEGINNING BALANCE 90.85 04/05 PAYMENT: KEYSTONE HLTH PL 25.00 115.85 TYPE..e DSPOSIT ID: 1232399845. 04/19 FPtYME~I': KEYSTONE h1.TH Pk 2~r 00 ' ~4fl &5 '. 'CYPEs i 11Bi'fiSxT ~ID: 1ZS239984b ::.. ;; 04J'30 :ip!AYME~'~ D.~~TID~HB 2;.2~O.C ,, ,1 ...:...... O«Z~ . ..:::14~..:.rtrT!> ANNUAL PERCENTAGE YIELD EARNED 2.21% FROM 04/01/02 THROUGH 04/30/02 BASED ON AVERAGE DAILY BALANCE OF 122.52 04/30 ENDING BALANCE 141.07 AIVIDEND YTA= YEAR TD 'DATE .; ... ;: - ~k,~ 71 _. _. . R7 R # Ri 3i # Ri Si # Ri Si # fA ~i~iLpi 7i iiiii;alF, 3FfiLR # Rf # # ip R # Ri ii.# R!'iit.iFiii 3i #. R: SS SL#I pi:iL$R iSi # R7:7i # R7:R # Rini # Ri3i.# Ri # # iA 3i # ip ii ii 1Cpi iiiiiR ii=iipi SLiR Ti ipi;I 3i # Ra Xi # Gk/tfl r.n:::>t#4 CHECKll~i4.:<~~terl~lTt~o 8A1CE ....:: '' .. ..........~3..0~1.:'. 04/30 ENDING BALANCE 0.00 DIVIDEND YTD: YEAR TO DATE 0.00 .:.. TDTAI. #1IVID~HD YTA: YEAR TO: DATE, ' ":<": . ; W oint ® ~~BANK LOOK FOR U5. WE'll GET YOU THERE. P.O. Box 1711, Harrisburg, Pennsylvania 17105-1711 - MemberFDIC MARY L LASTINGER DECO C/0 JAMES L. ROKOWSKI-EXCT STATEMENT DATE 16 FALCON CRT 5/10/02 MECHANICSBURG PA 17055-1152 2631 PAGE 1 FOCUS **TRANSACTION ACCOUNT SUMMAR Y** ACCOUNT TYPE OF ACCOUNT: INTEREST PAID ANNUAL PERCENTAGE YIELD DAYS IW CYCLE AVERAGE BALANCE YEAR TO DATE EARNED (APYE) 1000011821 FOCUS 50 FREE INTEREST 1.84 .55 ~ 32 830.51 1060004212 SAVER'S ADVANTAGE .00 .55 X 32 831.00 TYPE OF ACCOUNT: FOCUS 50 FREE INTEREST ACCOUNT 1000011821 ENCLOSURES 10 PREVIOUS BALANCE DEPOSITS WITHDRAWALS CHARGES INTE REST ENDING BALANCE 841.61 1,050.04 1.112.53 .00 .40 119.58 GATE ACTIVITY DESCRIPTIuN DEPOSITS WITHDRAWALS ~'~' BALANCE 4/11/02 CHECK #1688 20.00 821.61 4/11/02 CHECK 11690 10.00 811.61 4/12/OZ POS PURCHASE CHKIEFT TRANS 016216 21.95 789.72 THE HEALTHY GROCER CAMP HILL PA 4/12/02 POS PURCHASE CHK/EFT TRANS 099011 15.98 113.14 12TH ~ MACNS530690 LEMOYNE622992 PA 4/12/02 CHECK #1681 32.02 141.12 4/15/02 POS PURCHASE CHK/EFT TRANS 000056 22.02 119.10 130 OLD YORK ROAD NEW CUMBERLA PA 4/15/02 POS PURCHASE CHK/EFT TRANS 000056 20.52 699.18 130 OLD YORK ROAD NEW CUMBERLA PA 4/15/02 POS PURCHASE CHK/EFT TRANS 063101 16.58 682.60 HUNAN EXPRESS MECHANICSBURG PA 4/15/02 POS PURCHASE CHK/EFT TRANS 081003 12.13 669.81 AVATAR'S NATURAL G NEW CUMBERLAN PA 4/11/02 CHECK #1692 9.82 660.05 4/19/02 KEYSTONE HLTH PL/DEPOSIT 695.31 1,355.42 4/19/02 AMERICAN EXPRESS/ELEC REMIT 100.00 1,255.42 4/19/02 CHECK #1698 8.50 1,246.92 4/24102 CHECK 111691 400.00 846.92 4/29!02 CHECK 111696 21.45 825.41 4/29/02 CHECK #1693 16.81 808.66 5/02/02 CHECK #1697 24.00 784.66 5/03/02 KEYSTONE HLTH PL/DEPOSIT 354.61 1.139.33 5/03/02 CHECK X1694 419.15 120.18 S/10/OZ INTEREST EARNED .40 120.58 5/10/02 DEBIT CARDHOLDER FEE 1.00 719.58 Customer Service Toll-Free I-866-WAYPOINT (I-866-929-7646) In York Area 717/815-4500 POD-502 (2/02) www.waypointbank.com RfrV-1511 EX+ (12-99) SCNEDI~LE N COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATNE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Lastinger, Mary L. a~ ' ~ a ~~~ Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1 ~ Parthmore Funeral Home and Cremation Services 6621.39 2. Rolling Green Cemetary 1765.00 3. Gingrich Memorials 1400.00 B. 1 2. 3. 4. 5. s. 7. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) N/A Soaal Security Number(s)/EIN Number of Personal Representative(s) Street Address City State _ Zip Year(s) Commission Paid: Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant NIA Street Address City State Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees Cumberland County Courthouse Petition Letters Ad Short Certificate JCP Fee Zip 0.00 0.00 0.00 0.00 40.00 15.00 5.00 TOTAL (Also enter on line 9, Recapitulation) I $ 9,846.39 (If more space is needed, insert additional sheets of the same size) REV-1512 EX+ (g.g8) SCNEDI~LE 1 DEBTS OF DECEDENT, COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT , ESTATE OF FILE NUMBER Lastinger, Mary L. a ~ - Qp? - O ~/fo Include unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH t. Bon Ton -Acct. #065502429 10.62 2. J. C. Penney -Acct #071-793-274-3 13.99 3. Hecht's -Acct #529-643-37 11.99 4. American Express -Acct #3737-329973-73003 4278.81 5. Boscov's -Acct #106829446 135.35 6. Mobile Exxon -Acct #822-880-119-0 41.57 7. Verizon -Acct #717-770-1634-837 48Y 8.27 8. AT&T -Acct #717-770-1634 3.77 g. Comcast Cable -Acct #0502048293902 8.16 10. PP&L -Acct #75040-78010 24.57 ~ ~, Honda Financial Services -Acct #001-108-4042980-0001 4367.39 12, Nester and Mathias Dental Association -Acct #1512 496.20 13, Sollenberger Colon and Rectal Surgery, Ltd. -Acct #12802 10.00 14. Oakwood Center Radiation Oncology -Acct #5393 10.00 15, Andrews and Patel Associates 10.00 16. Fisher, Steven DDS 10.00 TOTAL (Also enter on line 10, Recapitulation) S I 9,440.70 (If more space is needed, insert additional sheets of the same size) __ ii i i i i ii ii i iiii ACCOUNT NUMBER iiiiiii i ii iii PAYMENT DUE DATE ~+ '+ ~~~' ~~~~~~'~,~~~ 065502429 I MAY 6, 2002 %a,GZ 03 21182 NEW BALANCE MINIMUM DUE ~ INDICATEA~1t0UiJiE"iCLOSED io.12 io.oo ; /p, ~~ ADDRESS CHANGE? CHECK HERE Pa''""~ ~`~~ ~ ~ .AND COMPLE?E?HE REVERSE SIDE ,_ I LISTED MY E- MAIL ADDRESS ON TI1E REV RSE SIDE. CHE ri HERE _ (111'III11"'111111'~~IIIIIII'lll"I~tI1111111'tlll'II "11'II MARY L LASTIN(TER 244 WESTOVER DR PO BOR 17598 NEAP CUMBERLAND PA 17070-1152 BALTIMORE MD 21297-1598 ~II~II1111'II~1~~1'11~111~111'~1'I~I~I~IIIIt~I'1'II~11~1'1~11' 065502429 0001012D001000 PLEASE DE?HCH HERE ,AND ~+1AIL WITH PAYMENT?O ?HE ADDRESS ABOVE • MAKE CHKKS PAYABLE iN U.S. GOLL;iRS SEND ME A FREE NONE VALUES CATALOG KITH BEDDING, BATH 6 NINDON. MIX S MATCH COORDINATES AND MUCH MORE. t ) (3411) CHECK BOX ABOVE OR CALL TOLL-FREE 1-800-222-6161 ASK FOR TA003-41I6A Remit to MCCBG - JCPENNEY a CHECK HERE IF ADORESSIPHONE NUMBER MAS CHANGED. SEE REVERSE SIDE. MARY L LASTINGER 30x494 244 WESTOVER DR B NEW CUMBERLND PA f 7070-1 f 52 0305494 364 vtEtsE cr:'ntat ~n+v raarvw+r nss snrs rnrt~ rouR p~ nuevr JCPENNEYACCOUNfNUMBER: Q71`Z93-ZT4-31 PAYMENT SHOULD AEACH US BY : OB-O 1-02 2T0TAL > MIf1IMUA1 - 8At/tNGE .PAYMENT 13.99 13.99 r ALL IN TOTAL BELOW t (,{~, „ „~ ~ („~,~ ~ ~~ ~ ^oao~ . ao P.O. BOX 32D00 ORLANDO, FL 32890-0002 0717932743 20 00013990001399 5433 0002 T90 I 7 4 020503 D Paso 1 Of 1 9119 0700 R061 305494 _ F H _ __. .~.., ~i~~• •~ ~ AREA HOME TEL: AnEA BUSINESS: . „~ _ . A DIVISION OF THE MAV DEPARTMENT STORES COMPANY ~ • • ~ FLEX I 529-643-37 11.99 11.99 05/16/02 MARY L LASTINGER PO BOX 94872 244 WESTOVER DR ~ B CLEVELIWD OH NEW CUMBERLND PA 17070-1152 44101-4872 ~u~~~~m~~~n~~ni~~~uuu~~u~~~~~~~u~~~~~~u~~~u~~u~i~ N~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1400529643372000011990000000000001199 8 ~ Please detach here and return the upper portion with your check or money order. Th~nlr vn~i fnr chnnnine at Hecht's .- . .. MAR 30 064-0076 029 376 LADIES BETTER KNITS 11.99 *********** THE B ST THIN S COME IN SMALL PACKAGES. ALWAYS T E PERFE T GIFT - HECHT'S GIFT CARDS. ORDER Y URS TOD Y BY CALLING 1-800-424-9205 R VISIT US AT WWW.HECHTS.COM. C-U7`1~U~ ~ Hecht's Account Summary ACCOUNT INQUIRY CALL (800) 567-7067 To avoid incurring additional finance charges you may remit your new balance in full within 25 days of the billing date shown below • r .DO 11.99 .00 .00 .00 11.99 .... .. 21.60 ~ 1.800 __ 11.99 Refer to your account number when makin in uiries. This bill contains transactions throw h • • ~. I FLEX 529-643-37 04/21/02 05/16/02 NOTICE: See reverse side for important information. The American Express Credit Card ' ~~~~~~~~~~ ~~'~ rep°a~~eh ~o ~o ° ape Statement S5 MINIMUM PAYMENT" DUE BY PAYMENT DUE DATE. Monthly •~• ~ - . ~ ~ ~ '~~-nt 'New ~ ACCOJ it Please write in ACtlVlty ~ - --- -~ ~ ~ ° ~_.ie ~ Balance ~~~ ~~IumEer amount of payment Summary 86.00 .00 05/ 17/02 ~ 4, 278.81 ,, <_. _ ~ ~ ,enclosed 3725•-273138-31002 IS C a , _. _ ... - _ , :: P~lake rhecx payable to: MARY L LASTINGER AMERICAN EXPRESS CENTURION BANK 244 WESTOVER DR #B .SUITE 0002 NEW CUMBERLAND PA 17070 CHICAGO IL b0679-0002 ~~~~n~~nn~~u~u~~~i~n~~iu~~ni~~uu~+~~~~~n~~~nn~i~~ 00003725272'_3831002 000427881000008600 28rir~ Cardmember Why write a check for routine expenses like your phone bill, gym membership or commuter pass? Make your life simple and News just sign up for easy automatic billing on your Platinum Optima Card(R) from American Express for free. To find out how, simply visit americanexpress.com/automaticbill. Cartlmz:r.i;zr ?~~^•= Account Number Page MARY L LASTINGER 3725-273138-31002 2 1 of Amex ~ Da: a u _ ra~~sacf,on ~ Charges R f ^d ~ T ~~ ~ ~ Credits ~,,. e erenca ~. ray .,,.~,:~~,~, ~~;.r Des~~u.~un 831107-0 04/17 04/17. PHONE PAYMENT RECEIVED - THANK YOU DATE OF ABOVE 04/17 I 100.00 ACCOUNT TOTAL ~ .0 100.00 i AS NOTIFIED, THE APR FOR PURCHASES IS I THE APR ON THE "NEW RATE - PURCHASES" LINE OF THE FINANCE CHARGE SECTION, NOT i i THE APR FOR "PURCHASES" IN THAT SECTION j ~ OR ELSEWHERE ON THIS STATEMENT. j I ! ~ YOUR CASH ADVANCE LIMIT IS $1500 AVAILABLE BALANCE FOR NEW CASH ADVANCE TRANSACTION IS $221, ACCOUNT GRACE PERIOD=STANDARD GRACE l ~ (SEE STATEMENT BACK FOR DETAILS). I Account , :--e:•ic~~s - ~;~~.~: j -Payment Credits I+FINANCE + Debit =New Summary 15;:.a^c:: ;- : ~ ~ CHARGE ~ Adjustments Balance 4,313.20. .00 100.00 .OOi 65.611 .0 i 4,278.81 ~' ~'^ - ! ^ ea.t fAvailable hmount C)ver Past Due `' ~~ - , !e Minimum ; - . ~ mit I Credit credit ~irnit Amount Payment Due 04/27/02 05/17/02 4,500] 221 .O ', 1 ' 86.00 1 i ~ FINANCE CHARGE ~ vs ' x Daily +x Average FINANCE CHARGE' CURRENT' ANNUAL ~ - _ I _ :.. Periodic Rate I Daiiy Baiance PERCENTAGE RATE NEW RATE-PURCHASES 30 .0513%' 3,452.441 53.13 18.740% CASH ADVANCES 30 .0486% 855.90! 12.48 17.740 INTRO. RATE 30 .0107% .OOI .00 3.900% PURCHASES 30' .0295%~ .00~ .OQ 10.750 i ~" t t ~ ~ ~~ ~ ..:: m • ~,t ~ u ~ ve tt nt er girest n ~ ,.t ~r ,~ .. n xuress (,r. drt Crrd - i the it free -'*' Fr ~ -- ~ - rntl us on tie nternet ae xtiww americarexpress.com r ~ e•. to ' men.an txore_a ~2drt _ a _ v _, -, .Y Skate t K ~.-, ; r _ .:.,avve ..inor. _ _„ir ,rn e_. C:3IY~S cr= ; c -csw=d af?er cicsinq c~ .~ _ _ _ter=~ s ae `c~ ~~eertanc infortnar.on ...,, __:. :.< a...u: a Sa1P,-,~onr. V V n n n n i J I H I C171CIV 1 LH I C: U7/ Uy/ UL 1'HUt 1 ACCOUNT NUMBER 106829446 PAYMENT DUE DATE 06/06/02 NEW BALANCE 135.35 MINIMUM DUE 30.00 AMOUNT, ENCLOSED S ~~~'~' e~. CHECK HERE IF ADDRESS / PHONE IS INCORRECT. MAKE CHANGES ON REVERSE SIDE. 'IIIII'IIIIIIIIIIIII~II111111"III~~IIIIIIIIIIIIIIIIIII'~11'II MARY L LASTINGER 244 WESTOVER DR # B NEW CUMBERLAND PA 17070-1152 1068294461 0013535 0003D00 DETACH AND RETURN THE ABOVE PORTION WITH YOUR REMITTANCE - MAKE CHECKS PAYABLE TD BOSCOV'S CREDIT CARD RASTER TRUST PLAN -01 C107 REGULAR CREDIT.. PLAN DATE STORE REFERENCE M DESCRIPTION AMOUNT NO PURCHASE ACTIVITY THIS PERIOD PLAN 02 _ (20) MAJOR: PURCHASE PLAN I' DATE STORE REFERENCE N DESCRIPTION AMOUNT NO PURCHASE ACTIVITY THIS PERIOD CPAYMEN75' GATE STORE REFERENCE # DESCRIPTION AMOUNT 04/IO/02 O1 20009769 PAYMENT - THANK YOU -20.00 TO YOUR LAST ''WE ADD WE SUBTRACT TO ARRIVE AT :YOUR. MONTH'S BALANCE PURCHASES FINANCE CHARGE CREDITS/RETNS '>PAYMENTS NEW°BALANCE PLAN O1 50.13 .00 .70 .00 10.00 40.83 .PLAN 02 102.90 .00 1.62 .00 10.00 94.52 TOTAL 153.03 .00 2.32 .00 20.00 135.35 AVERAGE DAILY BALANCE PERIODIC RATE FINANCE CHARGE ?ANNUAL:! PERCENTAGEiRATE' -PAST DUE-PAY INMEDIATEIY ~°PAYMENT' IDUE GATE `MINIMUM AMDUNT-DUE 133.03 X 1.75% ~ 2.32 21.0% 10.00 06/06/02 30.00 THANK YOU FOR TAKING ADVANTAGE OF OUR MAJOR PURCHASE PLAN. WE HAVE TEMPORARILY EXTENDED YOUR AVAILABLE CREDIT TO S.00. STATEMENT DATE 05/09/02 PAGE 1 FOR ACCOUNT NUMBER 106829446 NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION, PAY SAIANCE BY DUE DATE TO AVOID ADDITIONAL FINANCE CHARGES. REV. 12100 - _-_. - _.. _. s-awvwaaa a~w...vc... _ vcr. vvw aa~ Y- - F ' Payment Due Date: 06-03-02 E~~ Mobil Minimum Payment: ~ ~S~ New Balance: -4~9--~_J We're drivers too. Indicate Amount Enclosed: (--~ Make your check payable to ExxonMobil/MCCBG. PLEASE INDICATE ADDRESS CHANGE BELOW. New Street New City New State Zip New Home Telephone 07070073609 MARY L LASTINGER 244 WESTOVER DR # B PO BOX 4555 NEW CUMBERLND PA 17070-1152 CRLSTRM IL 60197-4555 ~ne~~~ne~~~ne~na~~~nnn~~ne~~e~e~ne~i~~~n~e~e~~~ee~e~ ~e~~n~~tenn~~~e~n~ne~e~n~a~t~n~i~n~t~n~t~n~a~e~n~t~ f 0001000000130101000020000000495709200822800008011909002 Detach and mail this portion with your check to the address above. 822 880 11 . . 9 0 05-08-02 06-03-02 30 ~ 05;06 ;LATE CHARGE ON PAYMENT DUE 05/ 8.00 0001 ~ 04 15 P7H0356 ~ O1 10TH 8 LOWTHER LEMOYNE PA 10.00 t CARD SUBTOTAL 10.00 t ~ 'PLEASE ACCEPT THIS NOTICE AS A FRIENDLY REMINDER ~ THAT YOUR PAYMENT HAS NOT BEEN RECEIVED FOR THIS MONTH'S BILLING PERIOD. IF YOUR PAYMENT HAS ;ALREADY BEEN MADE, PLEASE ACCEPT OUR THANKS. NE , ;LOOK FORWARD TO YOUR CONTINUED PATRONAGE. t t .THE PERIODIC RATE SHOWN ON THIS STATEMENT MAY VA t t t t . t t t t t t t t r t t t t t t t t t t t ~ ~ + FlNANCE e . CHARGE REG 30.07 .00 1.50 10.00 8.00 49.57 20.00 TOTAL 30.07 .00 1.50 10.00 8.00 49.57 20.00 Plan TM finance cherg~ Which is an ANnUAL To aiat oen d the eemrrce ~ friaf~e dye t And a W1YCh a en AIaMlAL To tlmt pan of thn beler~ca n access a If pan inmo`es a M1nanro charge aawce s to M f hi tul~ Stch tralence was determkred las l n a is determined by PEACENTAt~ uP o ~ n io t~E ance merge ~e ~ or t s e~ e e on b a ~~) by ^PPh^n9 + IUTE of r ib ol RATE d A REG .05754% DAILY 21.00 . ENTIRE BAL 38.38 2D Purcnaaes, ren:ma, end peytttatta mane lun poor to onnng crate may nm appear umn nen monm a sotematt. Utdest promotions call ror spetdel terms. additlonal finance ehargea can be atroided if we retxiw the new Wkrtce hY the due date. THE FINANCE CHARGE ON THIS STATEMENT IS A MINIMUM f ~R PERMITTED BV STATE LAW WHICH RESULTS IN AN ANNUAL PERCENTAGE RATE of 9 / . ~~f%N THIS BILLING INQUIRIES: Send inquiries (not payment) and your account number to: PO BOX 103031 ROSWELL, GA 30076 NOTICE: See reverse side for important Billing Rights and other information. CUSTOMER SERVICE: For account fnformaHon call toll free: 800-344-4355 Telephoning about billing errors will not preserve your rights under federal law. To preserve your nghts. please wnte to the Billing Rights Summary Address on reverse side. PO BOX 4555 CRLSTRM IL 60197-4555 b Page 2 of 11 . . ~~~ veri~n 717 770-1634-837 48Y May 20, 2002 This information is required by the Public Utility Commission. "Basic" service includes the I ine charge, local cal I ing and TOUCH TONE service (if applicable). "Non-Basic" service includes optional services, other than TOUCH TONE, such as Maintenance agreement for inside wire and Guardian and does not include toll services. Past Due Current Totals Balances Charges BASIC $16.27 $ -8.48 $7.79 TOLL $. 48 $. 00* $. 48 NON- BASIC $. 00 $. 00* $. 00 ._----- TOTALS $16.75 $ -8.48 $8.27 ~ 07 The following pages provide additional bi I I ing detai Is. * (Includes Verizon and other service provider(s) charges.) ~ ~~ Please write your account number on your check or money order made payable to AT&T. Qo not send cash. Do not staple this portion to your payment. Thank you. Total amount due ~j. 'l1 ~$4A.88~- Date due May 15, 2002 Amount enclosed: $1...~..~ -r ,, = ~1T~T ._.... MARY L LASTINGER Mar 21-Apr 20, 2002 Customer ID: 717 770-1634 D ~~ Moving'? Check the box and print new address on back. I~II~~II~~~~I~I~I~«I..l~ll~~l~~~I~I~,ill-~I~I~-,II~~I~I~I~~II AT&T PO BOX 8212 ~ ~~" ~ AURORA IL 60572-8212 ~ © ~~ a O912o84154501OO6OOOOODOOO1oO9OOOOOO1OO9OOOOOO1OG91 (comcast PiRW~N - LiIG i V{4~ Number Due Amount Due 0502048293902 5/05/02 $34.99 MARY L LASTIN(;<1:R 1~or service at: 244 Westover Dr -- Apt B New Cumb. Pa 17070-1152 How to reach us... - - You can reach. our Customer Service Delrartment at: (717) 540-890() 24 hours a day, seven days a week ® WW W.COIUC2.Yl.Wlil Otlice Location: 3800 Trindle Rd., Suite B Camp Hilt, PA 17011 Summary of Charges Previous Balance_-.--- -- ---___-_ __ Payments !includes payments received by / /0~ - _ Monthly Services --- - _-_-- Ins'~T:atior. C:.az'gs~s _- _ _ Taxes & Fees __ __ Billed from 04/18/02 to 05/17/02 _ - --- - - --- 32.02 _ - - -- --- ---- --- -- 32.02 cr - - - -- - ------- 34.95 _ 0.00 Total Due $34.99 Detail of charges on back News from Comcast 'IITANK YOU FOR PAYING YOIJR Bll.l. ON 'l'IMT;. Your proutpt attention is appreciated. A $2.00 late chazge will be applied only when a payment is received S days past your Payment Due Date. For your convenience, we now acxept regulaz and automatic monthly credit card payments, direct debit (ZipCheck) and MAC for payments. BARRIJRA VS MURAI.ES "I~OR I TONOR 8c 1'RIllE" HAS BEEN RESCIiEDtJLED 1~'OR SATURDAY JUNE 22, 2002 AT 8:30 EASTERN STANDARD 'T'IME, LIVE ON. ON PAY-PER-VIEW. CALL TODAY L-800-COMCASTTO GET DETAILS ON HOW 1'O ORDER. DON'T MISS THIS LIVE EVENT ON PAY-PLR-VIL'W! WWF P!2):SENl'S BA(:K LASH SUNDAY APRIL 21, 2002 AT 8:00 P.M. EASTERN STANDARD TIME. CALL NOW 1-800-CUMCAS'1' TO GET MORE INFORMATION ON HOW TO ORDER TI IIS LIVE EVENT ON PAY-PER-VIEW. COMCAST TNDEMAND BRINGS MLB ksXTRA INNINGS BACK FOR 2002! S'1'AR'1'IN(i APRIL Ol, 2002 YOU CAN GET UP TO 35 OUT-OF-MARKET GAMES A WEEK THROUGHTOUT THE REGULAR SEASON. I~OR MORE DETAILS & PRICING CON(TA('1' 1-800-('OMCAST TOllAY! sss~~~iat~~~e~~~~~~~~~~~~~~~~~~~~~a~~~~~~s~~~~~~~~~s~~~~~~~~~~~~~~~~~~~~~~~~~~~ss~~~~~a~~~~• Plem~r detucrh and enclose this coupon with puur pul~neent. Do not send cwh. ~Lluke checkr payable to: Comcast COMCAST ~' .ux12c N. Dupcnlt Highway New ('astle. DE 19720-b328 .~UURFSS SERVICE REQUb:S'1'lSU #BWNFKDB MARY l LASTINGER wroiasssi i•ra ~r,~ 244 WESTOVER DR • APT B NEW COMB PA 17070-1152 ~ul~~~nl~~~ln~~n~~~unu~~ui~~l~i~ul~~~~~n~l~u~~u~~~ Date Total Amount Due Amount llue Enclosed Account Number: 0502048293902 g ~~ COMCAST CABLE ~, ~~~,< PO BOX 3007 SOUTHEASTERN PA 19398-3007 ~lu~~~l~nn~~l~l~n~u~ul~~i~~nl~~~u~ul~~~ln~lu~u~~l~ 050200100],048293902520003499 __ _ _ _j: , ~, Page 3 9 '',~,. - >, ~'owBkkl Acoowit Nutiiter PPL Electric ppI ~'~- 7so4o-78010 rw Utlllties '"w ei ra ' w" . Electric Total front LastBill ~ 2;.83 Service Billing Details For: Amount You Still Owe as of May S, 2002 $23.83 MARY LASfINGER 244 WESTOVER DR ~HL NEW CUMBERED PA 17070 Current Charges for -PPL ELECTRIC UTILITIES Charges • Residential Rate: RS for May 6 -May 7 Adjusted Final Bill Distribution Charge: Customer Chargge~_ 0.21 6 KWH at 1.79b()0000¢ per KWH 0.11 PPL Electric i.Jtililies Customer Service Transmission Char e: 6 KWH at 0.370000¢ per KWH 0.02 827 Hausman Rd. Allentown, PA Transition Charge: 6 KWH at 1.588()0000¢ per KWH 0.10 18104-9393 Generation Char e: d ~ 1-1300-342-5775 b iler Cappacity an er KWH 920()()000¢ b KWH at 4 0.30 .coiu www.pplwe p . Total PPL ELECTRIC UTILITIES Chazg;es $ 0.74 Pay This Amau><at Na Later Than ]1~1uy:29,'002 $ 2#.57 Account Balance ~ 24.57 ~ ~G ~ ~ cE,~-cs' ~ U~ General Generation prices and chargges are set by the electric generation supplier Information you have chosen. The Public Utility Commission re ulates distribution prices and services. The Federal Energy Regulatory~ommissioil regulates transmission prices and services. PPL Electric Utilities uses about $2.43 of this bill to ay state taxes. In addition, about $1.08 of this bill pays the PA Gross receipts Tax. The Transition Charge includes an Intangible Transition Chargge (ITC) and the applicable ggross receipts tax which together amount to $0.08. The ITC is a per usage c-hazge approved by the Public Utility Commission which PPL Electric Utilities collects as agent for PPL Electric Utilities Transition Bond Company LLC and which that company uses to service debt incurred to recrner a portiogof PPL Electric Utilities' stranded costs. The gross receipts tax, which is collected for the Commonwealth of Pennsylvania, is equal to 4.4% of the ITC. For your convenience, you can now pay vour bill usin yyour Visa MasterCard, or Discover Card. Call BitlMatrix at 1-~0-672-243. BIIIMatrix will charge your credit card a service fee for making this payment. We appreciate the op ortunity to have served you. Because you have paid your bills within 30 dpays over thepast year, you have established an excellent payment record with PPL Electric Utilities. Air conditioning is probably the biggest I-azt of your summer energy needs. You can save money whilelceeping cool. Check air conditioner filters nlonthly..Clean or change filters as needed. You'll stay cool and your system will use less energy. PPL Electric Utilities' new, free on-line F~.nergy Audit shows how your. heating system, water heater, refrigerator, lighting, and level of insulation add to your home s energy bills. g e where your energy dollar is going - and how you can save energy. For a free report, go to http://audit. pplweb.conl/energyaud it. May 8, 2002 Honda Financial Services P. O. Box 6034 Newark, DE 19714-6034 A~'TN: Jennifer D. RE: 001-108-4042980-001 Mary L. Lastinger Jennifer: This is in regards to our telephone conversation of OS-07-02 regarding the payoff of the vehicle owned by Mary Lastinger. I understand the payoffto be $4,367.39 and this is good unti105-17-02. Mary Lastinger passed away on 04-20-02. We wish to pay offthe vehicle and have the title changed over to James L. Rokowski, her son. Please forward any paperwork that we need to sign to: James Rokowski 16 Falcon Court Mechanicsburg, PA 17055 Also enclosed is the Death Certificate and Short Certificate from the Cumberland County Courthouse, Pennsylvania, giving James authorization to title the vehicle in his name. If you have any questions, please feel free to contact me via email at srokowski~hotmail.com or by phone at work-717-975-6871 or home-717-795-1040. Thanks again for your help in this. Also should we pay offthe vehicle before we receive the title paperwork. Sincerely, 7 ~cL~, ~. ; Stacy Rokowski ~©NDA t>.~~.13~,X 6034 Newark, Dl?. 10714-6034 Financial Ser~•ices Use the address above fnr correspondence onl~~. AfII~C's Customer Service is available at 1-80(1-91G-9939 weekdays from 9:111) AM to 5:11(1 YM EST. Up-to-date payoff information is available at this number 24 hours a day. ~BWNGKLH ~HRT 1084042980041 ~~oos535 MARY L LASTINGER 244 WESTOVER DR APT-B NEW CUMBERLAND PA ]7070-1152 ~in~~~in~~~in~in~~~i~iui~~ni~~i~i~in~i~i~n~i~n~~i~~i~ MONTHLY STATEMENT ACCOUNT SUMMARY Hate April 4. 2002 Account # 001-108-4042980-0001 Vehicle: 95 HONDA AC RD ID # 1HGCD5642SA 058313 Scheduled Payment $419.15 due 04/24/02 Total Amount Due $419.15 Orig. Maturit~~ March 24. 2003 Estimated Payoff $4,745.99 Good Through Aril 24. 2002 'Tj?, A 1\TC ~ CTiQI~T C)j,T1VjM s RI' DATE DESCRIPTION AMOUNT Principal Interest Misc. Total 03/25/02 Payment Received -Thank You $365.22 $3.93 $0.00 $419.15 As a reminder, a late fee may be assessed if your payment is not received Ley the due date. Please refer to your contract for details. Statement Nester and Mathias Dental Assoc. 1851 Center St. Camp Hill, PA 17011 (717) 761-0325 (717) 761-5477 fax Mary Lastinger 244 Westover Dr. #B New Cumberland, PA 17070 .... .. .. .. ..... v:::.-:::.v:: : ..n:• r.. ....x:: w. • y{~ • ~ ....:•.:..•.......... ..... ;••,~. ............. .:. ..... ... n. ....:::.:•x: n:: :n:.v.M ( . \ •\ •. v.{ w::.v3.v.::..n..v v ....:: ....... .::: .:......\\:::... .r:: ti}!\ \.. .. :..:: vv•.v::::.v£ .: {::.:}:?•: ;..:...:::: v:: •:.•..}: :•: L:i•}'.~:.. .: ' ' ~+:v: {': •::.'~r}:\w.~.~.;~'~.: •.: - ... :. ' '•:v-A vv~.~•~.~R: ~ C{ ~ i ' { ~ ~~f~~~ { ~ ..: ...x:; ••: .. rv\4. .:..'k ..::.:. ..: :... .: {C.. .}n . •- }:'n•: •: •`•. •h h4 :: \•.......... n`nv+~.x v'iiQ:y^l Li :.?i$•:. ':i:. •: :v}.J x : ~ ~ ~~ ~ ~ ~• ,hy~.{...•....,.; r.~• i.:.. •. h. ?. ... w::n...- , - v: v.}x\. i%:.» ;.•;,,, },,.,.,,~?:tiiix?i:{' ::.... : t •. f.4::?:.: v v.4.• F :: • vv:vy.... :.v::: n .:TT ;: •:::::: ^: hh :•::::::::::: i.:?}?::ry::::+•::: •f•}r.: 4'h`:•}}?};h::-}..}:}'ri•?}1::.::•:::-:::::::...ti:.;•:: ....... n.....:::. ....... :.. .. .. ., .f .},. y{.. •n:. :•?.,. :{ .,.,.,:. .. ., •ry• , . ..:.:. .. w..iv.. n\ - v.. .. ............ iii^i.: . 03/13/2002 Previous Balance 520.20 04/29/2002 Payment-Check Mailed In Mary 24.00 Estimated Ins. Portion Due 0.00 Estimated Pat Portion Due 496.20 Balance 496.20 urrent < <'<> ..... :,::•• ~>>. .:........:..:::.~.::~.;:.::.?..t.:>??'::.. 0 496.2 496.20 Pay this Amount Please pay the amount listed above. Due by 05-27-oZ Thank You. Please Return Bottom Portion with Payment Mary Lastinger 244 Westover Dr. #B New Cumberland, PA 17070 Nester and Mathias Dental Assoc. 1851 Center St. Camp Hill, PA 17011 Account: 1512 Balance: 496.20 Pay This Amt: 496.20 Bill Date: 05/08/2002 . T'-.. 4T ?1iVl~,iuG'^, [~ C`c"+4.^/:~gYLT~:4j#:'~IPYtj _ .. .. .. .-r -_ ~; RR .. ' s ~ ~ ~ ~tt '~ S ..` -. i' .. .. i ! ~ i~} r* t i t'E.f i 'S~ i ,~ 1 ~ ;~ 1 ~ .S S f f , . ~ y L74E~ ~ U~ C.''4 3} w Y!M ~% t ~ !~- "` s.. 1 •t .. ~ r :~ E _: :,`3 I ; ~~, t~ . ti ~ , ;~ ~ W t ~+ y .~ 2 1 0~ "~7 ~ { ~ ~ ~~ ~ ~. ~. fti' TZI . ~ ~ ~ ~ ~~'. ~ i ~ n ~:_ W ~ • ~,~r I Viii LZ~ ~: ~ ~~ aarr {{tt '.~ Yw (.Ri WW•rl r^ /~ a ~ 4 :f3c . `~~ i ~+e,~.a - ~. EJ.~4 ~ I ~ i- Q. . , ~u ~ t ~~ a ~~ "~~ti 1 t-t1R~r :. ~ r. ~ W t W ~ f ^ { , ~ µ { ~ ~ ''~ ~ /~( ~{ ~j, ~ ~ (~ ~ a ~~ J} • ~/~ F V J iu ! . .r. . N ~ ~ TT ./~ r f r'? 1 ~} V J ( I { t"' iM i ~ - ~ nn i ~.\\ Y e ~ Q J I l~7lL LSI g i u ~ U %: ~ ~U7L7 - ~ ~.. ~~. ~ .:r~ a. ~~~'. - i. ~ EJ Lr6 - .' -,w -. <'X ; ~~ Z .. n C W L 1 i ~+ } a LU O Z H ~r.n. UJ ~.i Q r! j.. ~. . Statement of Account Oakwood Center Radiation Oncology _ . 880 Century Drived Mechanicsburg, PA 17055 <,,A000Unt No.~ ~ ~'~l (717) 691-3235 5393 1 Marv L. Lastinger ~---~-~~T~--^ 244 Westover Dr B Date New Cumberland, PA 17070 05/02/2002 Date For Description Ref Charges Credits Notes 03/22/200? ! I Mary Comprehensive Consult -Mod. Coml I ! 7341 190.00 I 04/11/200? 04/11/200? ;Mary Insurance Payment ~ Mary ~ WRITE OFF INSURANCE I 7341 7341 -151.00 -29.00 ~~ ~j ~0 Da s y ...,Current _ ~i31 - ~0 Da s y ~ Past Due 81 - 90 Da s y Past Due 91 - 'k~20 < " ~" ~ Past - `' ~ ~ Da s .~ ~,:~~ y~ J ~~stDue . '~~ •~ t ~;~~ ~ ~` ~ F $10.00 $o.oo $o.oo $o.oo $o.oo ~ $10.00 ANDREWS &PATEL ASSOCIATES, P.C. 3912 TRINDLE RD. ' ~ CAMP HILL, PA 17011 PHONE: (717) 761-8740 MARY L. LASTINGER 244 WESTOVER DRIVE #B NEW CUMBERLAND PA 17070 .. 04/26/02 16786 ~;1) ANDREWS &PATEL ASSOCIATES, P.C. 3912 TRINDLE RD. CAMP HILL, PA 17011 04/26/02 16786 Detach this stub and return with payment. 16786.0) 0.00 03/26/02 10.00 04/08/02 10.00 TOTAL DUE CURRENT 31 - 60 DAYS 61 - 90 DAYS 91 -120 DAYS OVER 120 DAYS ,,__, t_..., ___,.. 10.00 10.00 0.00 0.00 0.00 0.00 :; s • ~ 10.0 0 Please pay this amount! REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA SCHEDULE J BENEFICIARIES ESTATE OF Lastinger, Mary L. NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS [ndude outright spousal distributions, and transf Sec. 9116 (a) (1.2)] 1. James L. Rokowski 16 Falcon Court Mechanicsburg, PA 17055 FILE NUMBER a/, pa --oy/~ ATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not Llst Trustee(s) OF ESTATE Son ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE N/A B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 100% TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I; 0.00 (If more space is needed, insert additional sheets of the same size)