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03-0692
Register of Wills CumberlandCounty, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of William D. Becknell No. also known as. , Deceased Social Security No. 251-76-6388 David D. Becknell and Charles H. Becknell, (COMPLETE "A" OR "B" BELOW:) [~ A. Probate and Grant of Letters and aver that Petitionerls) is/are the execut Decedent, dated and codicil(s) dated named in the Last Will of the Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered for probate; wac not the victim of a killing and wes never adjudi(mted incompetent: B. Grant of Letters of Administration Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: I Name Relationship Residence I David D. Becknell Charles H. Becknell (COMPLETE IN ALL CASES:) Attach additional Son Son heats if necessary. 11238 Garners Ferry Road Eastover, SC 29044 1001 Piney Branch Road Eastover, SC 29044 Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence at 185 Woods Drive, Mechanicsburg, Silver Spring Twsp., Cumberland County, PA 17055 Decedent, then 56 years of age, died' August 19 ,20 03, at Lebanon VA Medical Center, Lebanon, PA 17402 Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property ........................... :... s 12,500.00 (if not domiciled in PA) Personal property in Pennsylvania ...................... $ (If not domiciled in PA) Personal property in County .......................... $ Value of real estate in Pennsylvania ............................................... $ 87,200.00 Total . $ 99 700 00 Real Estate situated as follows: 185 Woods Drive, Uechan csbur.q, S ver Spnn,q Twsp., Cumberland (Jounty, I~A Wherefore, Petitioner(s) respectfullv request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: Signature Typed or printed name and residence David D. Becknell 11238 Garners Fer, ry Road, Eastover, SC 29044 'Charles H. Becknell 1001 Piney Branch Road, Eastover, SC 29044 Oath of Personal Representative Commonwealth of Pennsylvania County of The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true and (Jorrect to the best ofthe knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to and affirmed and subscribed before me this ~./.~.~, , d;y of ' :.~/-~Da~/id D. 'Bedknell :/. ~., / -Ch-aries H."Beck'hell DECREE OF REGISTER Estate of William D. Becknell Deceased No. also known as Social Security No: 251-76-6388 Date of Death: 08/19/2003 AND NOW, , 20 , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters [] Testamentary [] of Administration are hereby granted to David D. Becknell and Charles H. Becknell in the above estate and that the instrument(s), if any, dated n/a described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters ........................... $ c~.Oo, ~ Short Certificate(s)...8. ...... Renunciation .................. Affidavit ( ) ................. Extra Pages ( ) ............ Codicil....' ...................... JCP Fee ........................ Inventory & Tax Forms... 0ther.:~ ............... $ TOTAL ............ :... $ o~, xz*z~. ~ Rhl-Ta Attorney: Mark E. Halbruner, Esquire I.D. No: 66737 · Address: Gates, Halbruner & Hatch, P.C. 1013 Mumma Rd., Suite 100, Lemoyne, PA 17043 Telephone: 717-731-9600 DATE FILED: Bond # R-25385640 BOND REGISTER OF WILLS OF Cumberland COUNTY BOND AND SURETY FOR PERSONAL REPRESENTATIVE KNOW ALL BY THESE PRESENTS, That Charles h. Becknell Company David D. Becknell &' as principal(s) and Western Surety as surety (sureties) are held and firmly bound unto the Commonwealth of Pennsylvania in the sum of Two Hundred Thous,~nd~ ao.ars ~200,000) to be paid to thc Commonwealth, for which payment we do bind ourselves, jointly and severally, our heirs, executors, administrators and successors, thc condition of this obligation being that if David D. Becknell & Charles H. Becknell as (state fiduciary capacity) C o - Adm in i s t r a t o r s oftheestateof William D. Becknell , deceased, or any of them, shall well and truly administer the estate according to law, then this obligation shall be void as to the personal representative or representatives who shall so administer the estate and his or their surety or sureties; but otherwise it shall remain in full force. Signed and sealed this 21 s t intending to be legally bound hereby. dayof August ,~ 2003,each Western Surety Company (Seal) (Seal) POWER OF ATTORNEY ~now All Men by These Presents: (Irrevocable) BOND No. R- 75185~60 That this Power of Attorney is not valid or in effect unless attached to the bond which it authorizes executed, but may be detached by the approving officer if desired. That Western Surety Company, a corporation, does hereby make, constitute and appoint the following ~q authorized individuals: AUTHORIZED INDIVIDUALS DAVID t~ HOPCRAFT :: JEFFREY PATRICIA K ARBEGAST AUTHORIZED INDIVIDUALS L ScoTT in the City of CARLISLE State of PENNSYLVANIA , with limited authority, its true and lawful Attorney(s) in fact with full power and authority hereby conferred, to sign, execute, acknowledge and deliver for and on its behalf as Surety, one of the following bonds. An ORIGINA~L bond required by Statute, Decree of Court or Ordinance for: MAXIMUM PENALTY (A) ADMINISTRATOR REFEREE IN PARTITION EXECUTOR COMMISSIONER TO SELL REAL ESTATE PERSONAL REPRESENTATIVE TRUSTEE OR RECEIVER - In Bankruptcy (Excluding Chapter 11) GUARDIAN OF INCOMPETENT CURATOR CONSERVATOR OF 1NCOMPETENT/CONSERVATEE COMMITTEE OF INCOMPETENT .: SALE OF REAL OR PERSONAL PROPERTY ' When this c°mpany has qualifying b°nd °r when it is a separatebond for accounting of proceeds of sale only. :. : (B) GUARDIAN OF MINOR OR CONSERVATOR OF MINOR ! $ i 10~00 : : (C) NOTARY PUBLIC RECEIVER - (In State Court Only) PUBLIC OFFICIAL AND DEPUTIES TRUSTEE - (Testamentary Only) (D) PLAINTIFF'S COURT BOND - Banks, Savings & Loan, and Trust Companies $ 100~000 (Except Restraining Order and In. junction) - All Others, except bonds prohibited by "NOTE" below (E) COST ON APPEAL (EXCLUDING OPEN PENALTY, STAY, SUPERSEDEAS OR GUARANTEE OF A JUDGMENT) (F) LICENSE AND PERMIT EXCEPT BONDS WHERE THE UNITED STATES OF AMERICA, A FEDERAL AGENCY, OR A STATE IS THE OBLIGEE: $ 2~,000 :, :: (G) STATE LICENSE AND PERMIT - Thc followingaw - bonds are authorized where thc state of PENNSYLVANIA ~s the obligee (other state required bonds not authorized). A~TIONEER AND APPRENTICE AUCTIONEER A~TION COMPANY A~ AUCTION HOUSE *************** $ 2s,0oo PRIVATE DETECTIVE ******************************* ************************************************ : : : SPECIAL FUEL USERS :?:2,000: (H) ANY BOND OR INDEMNITY provided there is attached to this Power of Attorney, wriuen authority in the form of an endorsement, letter or telegram, signed by the Senior Underwriting Officer, Underwriting Officer, President, Vice President, Assistant Vice President, Secretary, Treasurer or Assistant Secretary of Western Surety Company specifically authorizing its execution. For confirmation of the necessary written authority, please contact our Underwriting Department at 1-800-331-6053 .... ¢ ~dn South Dakota). NOTE: ~g~E,,~'~pEN PENAI.TY OR STAY BONDS ON APPEAL OR GUARANTEE OF JUDGMENT OR BAIL BONDS OR CONSTRUCTION BID OR CONTRACT :;i ~ ~B'~i~::B:0N~!~ DEFENDANTS OR UTILITY DEPOSIT BONDS OR SITE IMPROVEMENT ~ON~S ARE NOT AUTHORIZED BY THIS COWER O~ ATTORNEY, ~ ~ :~Y h~er ceffifies ~at the following is a ~e ~d exact copy of Section 7 of ~e By-Laws of Western Su~ty Comply, duly ~f~W~Sfi ~, ~:~g~: "Section 7, All bonds, ~licies, unden~ngs, Powers of Attorney, or omer obligations of the co.ration shMl ~ ex~u~ in ~e ~97~e of ~e C¢~Y~Dy the ~esident, Secre~ ~y Assistant Secret~ Treasu~r or any Vice ~esident or by such o~er officers as ~e Bo~d of ~ay authohze. ':~; ~ent, ~y Vice ~esident, Secret~, ~y Assismt S~ret~, or the Treasurer may ap~int Attomeys in Fact or Agents who shall ~thofity to issue honda; ~:'~cies, or unden~ngs in the name of the Comply. The co.rate seal is not necess~ for ~e validity of ~y bonds, ~licies, ~n~o~ers~o[~A[to~:o~er obligations of ~e co~oration. The signature of ~y such officer ~d me co.rate seal may ~ printed by hcsimile." ~:;::;~¢::'~. : ....... ?;;~:;;~::;:?/ J I I , WESTERN ~URETY COMPANY .... A~nt Secre~ By ~/ / STATE OF SOUTH DAKOTA a / ~ . ~' COUNTY OF MINNE~HA ~ SS Seffior Vice Pr~ident~ ~ ~is 1st day of Ap~), 2~2, befo~ mc, D. ~11, thc undcrsign~ officer, ~monally aphid PAUL T. BRU~AT ~d A. VIETOR who ac~ow]edged ~cm~lvcs to ~ ~c Senior Vice ~si~nt Assis~nt Secret~, rcs~ctivcly, of Westin Surety Comply, a co.ration, ~d ~at they, as such officers ~ing au~od~d to do so, cxccut~ ~c foregoing ins~mcnt for ~e pu~s ~in confined, by signing ~e nme of thc co.ration by ~emsclvcs ~ such officc~. In witp~~}o set my hand and official m~. ~ O. KaELL ~.~n~,~,~ No~ ~blic, Sou~ Dako~ 1, the undc~ign~ officer of Western Surety Company, a st~k co~oration of ~c State of Sou~ D~ot~ do he.by ce~ify ~at ~c at~ched Power of Anomey is in ~11 fo~ ~d eff~t ana i~ i .... u .... a fu.h ...... ~a~ S~edon * of ~ ~y-[ .... f th .... p~ny ....fo~ i. ~ ~ .....f ~o~cy, i~ ~*~o ..... Aug u s ~ 2 0 0 3 In testimony whereof, 1 have he.unto set my hand and thc seal of thc Western Surety Comply this * ~ S E day of WES~N SURETY COMPANY · IMeOaTANT: Thi mn t fill a ia it I to ~e ~nd and it must be the same date as the bond. By · S~ENT ~o~ 99-A-4-2~2 NOIIC[: This Doffier must be BLDE. If it is not BLUE, this is not a cedffi~ copy. POWER OF ATTORNEY 'Know All Men by These Presents: arrevo~able) BOND No. R- That this Power of Attorney is not valid or in effect unless attached to the bond which it authorizes executed, but may be detached by the approving officer if desired. That Western Surety Company, a corporation, does hereby make. constitute and appoint the following - _ - _ ~ authorized individuals: AUTHORIZED INDIVIDUALS ~ -- DAY! D '4 HOPCRAFT AUTHORIZEO INOIVIDUAL--~L'~---_ PATRICIA K AR~EGAST JEFFREY L SCOTT in the City of ~ State of __ PFNN_qy[ VAN! a. lawful Attorney(s) in fact with full power and authority hereby conferred, to sign, execute, acknowledge __, with limited authority, its true and one of the followin bonds, and deliver for and on its behalf as Surety, An ORIGINAL bond Decree of Court or Ordinance for: (A) ADMINISTRATOR EXECUTOR REFEREE IN PARTITION MAXIMUM PENALTY PERSONAL REPRESENTATIVE COMMISSIONER TO SELL REAL ESTATE ~G_UARDIAN OF INCOMPETENT TRUSTEE OR RECEIVER . In Bankruptcy (Excluding Chapter 11) cONSERVATOR OF INCOMPETENT/CONSERVATEE CURATOR COMMITTEE OF INCOMPETENT SALE OF REAL OR PERSONAL PROPERTY.- W?en this cOmpany has qualifying bond or when it is $ 1~00~000 uonu for accOunting of proceeds of sale only. a separate (B) GUARDIAN OF MINOR OR CONSERVATOR OF MINOR : :: : (C) NOTARY PUBLIC '-'-'-'-'-'-'-'- RECEIVER ~rt Only) (D) (Except Restraining Banks, Savings & Loan, and Trust Companies ::i.$::i 50~000' ~ow $ 100,000 (E) COST ON APPEAL (EXCLUDING OPEN PENALTY, STAY, SUPERSEDEAS (F) OR GUARANTEE OF A JUDGMENT) LICENSE AND PERMIT EXCEPT BONDS $ 2~,000 . : WHERE THE UNITED STATES OF AMERICA, A FEDERAL AGENCY, OR A STATE IS THE (G) STATE LICENSE AND PERMIT. The following~rized where the state of is thc obligee (other state required bonds not authorized). PR $ 25,000 SPECIAL FUEL USERS (H) ANY ', ~written $ :2,,000: : Vice °%~sue~drorsem.ent, letter or t;legram, s gned execution. For necessary written authority, · .. ,*. or ~.ss~stant Secretary of Weo~ our underwrit' mg Department at 1-800-331-6053 NOTE PENALTy OR STAy BONDS ON APPEAl. OR GUARANTEE OF JUDGMENT OR BAll. BONDS OR CONSTRUCTION BID OR CONTRACT DEFENDANTS OR UTILITY DEPOSIT BONDS OR SITE IMPROVEMENT BONDS ARE NOT AUTHORIZED BY THIS POWER OF ATTORNEY, (H). further certifies that thc following is a hue and exact copy of "Section 7. All bonds, policies, undertakings, Powers of Attorney, Section 7 of the By-Laws of Western Surety Company, duly authoriz, the President, Secretary, any Assistant Secret , T or other obligations of thc corporation shall be executed in the to issue oa? Vice President, Secret . ary reasurer, or any Vice President, or b su ary, any Assistant Secretary, or thc Treasurer m ~, a-~:-- ~Y ch ot.her officers as the Board a,, t-,p~,mt attorneys tn Fact or Agents who sha~[ undertakinys in the name of thc Company. The corporate seal is not necessary for thc validity of any bends, policies, of thc corporation. Thc signaturc of any such officer and thc corporate seal may be printed by facsimile." WESTERN /~.~)URETY COMPANY STATE OF SOUTH DAKOTA By COUNTY OF MINNEHAHA } sS Senior Vice P~'esident~ On this 1st day of April, 2002, before mc, D. Krell, the undersigned officer, personally appeared PAUL T. BRUFLAT and A. VIETOR who acknowledged themselves to be thc Senior Vice President Assistant Secretary, respectively, of Western Surety Company, a corporation, and that they, as such officers being authorized to do so, executed thc foregoing instrument for the purposes therein contained, by signing thc name of thc corporation by themselves as such officers. In witll, ess wh.e~upi° set my hand and official seal. and 1. thc undersigned officer of Western Surety Company a stock co rat and is irrevocable; and furthermore, that Section 7 of thc B ' -- ~ fpo 'on of thc State of South D-'- ' - ~_ , ,. y-t~aws o~ the company as set fo~, :- *~ ~ a~o[a, uo hereby certify that th aUacho~ ~ ~o~l'y l~IlOlle, ~ollth D .......... y '~"ereof, ~ h~¢ h ..... to set .............. '"' ........... f Attorney ..... ' o;ce. e ............ f Attorocy .... full fo.:e O~}k~°~ect ANT: This date must be filled in before it is attached st be the same date as the bond. ~E~OR VIC Form 99-~-4-2002 By . This bordor E PRESIDENT NOTICE: must be BLUE. If it is not BLOE, this is'n-ot a certified copy. CERTIFICATION OF NOTICE UNDER RU~.~. 5.6 (a) Name of Decedent: Date of Death: File No.: William D. Beckne11 August 19, 2003 21-03-0692 To the Register: I certify that notice of 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 August C~7 2003. ' Name Address David D. Becknell 11238 Garners Ferry Road Eastover, SC 29044 Charles H. Becknell 1001 Piney Branch Road Eastover, SC 29044 Notice has now been given to all persons entitled thereto under Rule 5.6(a). Dated: August ~7, 2003 Mark E. halbru~er, ~sq~-f-re Counsel for Personal Representative GATES, HALBRUNER & HATCH, P.C. 1013 Mumma Road, Suite 100 Lemoyne, PA 17043 (717) 731-9600 PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE FORM 6.12 YEARLY UNTIL COMPLETION. Name of Decedent: Date of Death: Will No.: STATUS REPORT UNDER RULE 6.12 William D. Becknell August 19, 2003 21-03-0692 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: No Date: If the answer is No, state when the personal representative reasonably believes that the administration will be complete: September 2004 3. If the answer to No. 1 is yes, state the following: A. Did the personal representative file a final account with the court? N/A Bo The separate Orphans' Court No. (if any) for the personal representative's account is: N/A Co Did the personal representative state an account informally to the parties in interest? N/A Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphans' Court and may be attached to this report. May ~--2004 Mark E. Halbruner, Esquire PA I.D. # 66737 GATES, HALBRUNER & HATCH, P.C. 1013 Mumma Road, Suite 100 Lemoyne, PA 17043 (717) 731-9600 Capacity: Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ~J~U OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 0O3915 HALBRUNER MARK E 1013 MUMMA ROAD SUITE 100 LEMOYNE, PA 17043-1144 ........ fold ESTATE INFORMATION: SSN: 251-76-6388 FILE NUMBER: 2103-0692 DECEDENT NAME: BECKNELL WILLIAM D DATE OF PAYMENT: 05/07/2004 POSTMARK DATE: 05/07/2004 COUNTY: CUMBERLAND DATE OF DEATH: 08/19/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $1,147.72 REMARKS: TOTAL AMOUNT PAID: $1,147.72 SEAL CHECK# 1035 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS LOWELL R. GATES Also Admitted to Massachusetts Bar MARK E. HALBRUNER Also Admitted to New Jersey Bar CRAIG A. HATCH CORY J. SNOOK ALBERT N. PETERUN Also Admitted to Maryland Bar STACEY L. NACE Paralegal/Office Manager TRACI L SEPKOVIC Paralegal VALERIE LONG Paralegal LAW OFFICES OF HALBRUN ER t-HATCH, P.C. 1013 MUMMA ROAD · SUITE 100 · LEMOYNE, PENNSYLVANIA 17043 (717) 731-9600 · FAX: (717) 731-9627 Cumberland County Courthouse Office of the Register of Wills One Courthouse Square Carlisle, PA 17013 RE: Estate of William D. Becknell Estate No. 21-03-0692 Dear Sir or Madam: May 6, 2004 BRANCH OFFICES: 3 WEST MONUMENT SQUARE, SUITE 304 LEWISTOWN, PA 17044 (717) 248-6909 2917 NORTH FRONT STREET, SUITE 302 HARRISBURG, PA 17110 (717) 731-9600 WEB SITE: www. GatesLawFirm.corn CORRESPONDENCE ADDRESS: Lemoyne Office Enclosed for filing are the Pennsylvania inheritance tax return (in duplicate~inveniory and Status Report for the Estate of William D. Becknell. A check in the amount o1~1,147.72 is also enclosed as payment of the inheritance tax. Please time-stamp the additional photocopy of each document and return them to our office in the enclosed envelope. Thank you for your assistance in this matter. Sincerely, Traci L. Sepkovic Paralegal Enclosures cc: David D. Becknell, Co-Executor Charles H. Becknell, Co-Executor r~ST CLASS MAIL OFFICES OF IRUNER &-HATCH, P.C. MMA ROAD, SUITE 100 ii, PENNSYLVANIA 17043 !COUNTY COURTHOUSE iHE REGISTER OF WILLS i~USE SQUARE i'A 17013 REV-1500 EX (6-OO) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128'0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 21 COUNt' CODE -- 2003 0692 ; YEAR NUMBER DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER ~' Beckne11, W£ZZiam D. 251-76-6388 U,I DATE OF DEATH (MM-DO-YEAR) I DATE OF BIRTH (MM-DO-YEAR} THIS RE'I1JRN MUST BE FILED IN DUPLICATE WITH THE tU 08/19/2003 J 1/30/1947 REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER ~ i L~ 1. Original Retum I I 2. Supplemental Retum ,,~mlr-~ O Sv I I I 4. Limited Estate r'--] 4a. Future Interest Compromise (dale of death after 12-12-82) ,,,a.o I ~ ~O~ J[~ 6. Decedent Died Testate (Attach copy of Will) ~ 7. Decedent Maintained a Living Trust (Attach copy of Trust) ~ r-~ 9. Litigation Proceeds Received r'--] 3. Remainder Return (date of death pdor to 12-13-82) [~5. Federal Estate Tax Return Required -- 8. Total Number of Safe Deposit Boxes [--"] 10. Spousal Poverty Credit (~late of death between 12-31-91 anti 1-1-s5) r~ 11. Election to tax under Sec. 9113(A) (Attach Sch O) THIS SECTION MUST BE COMPLETED, ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION sHOULD BE DIRECTED TOi uJ Z ul COMPLETE MAILING ADDRESS 1013 Mtaaata Road, Suite 100 Lemoyne, PA 17043 Z O X I- NAME Mark E. Halbruner, Esquire FIRM NAME (If Applicable) Gates, Halbruner & Hatch, P.C. TELEPHONE NUMBER (717) 731-9600 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 6. J~.L~Y Owned Property (Schedule F) (6) ~ Separate Billing Requested 7.Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 1 1. Total Deductions (total Lines 9 & 10) 12. Net Value of E~tata (Line 8 minus Line 11 ) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 3,882~- o~oo 0.00 0.00 13,233.87 0.00 35,214.25 OFFI~ ~ ONLY (8) 52,330.98 17,588.85 9,237.24 (11) 26,826.09 25,504.89 0.00 25,504.89 (12) (13) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) SEE INSTRUCTIONS ON REVERSE BIDE FOR APPUCABLE RATES 15. Amount of Line 14 taxable at the spouseltax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate. 19. Tax Due 20. 0.00 x.o0 (15) 25,504.89 x.o45 (16) 0.00 x .12 (17) 0.00 x.15 (18) (19) 0.00 1,147.72 0.00 0.00 1,147.72 > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 1~W4645 1.000 Decedent's Complete Address: I$~RE.~ ADDRESS 5 Woods Drive Mechanic sbur~ I STATE I ZIP PA 17 0 5 5 Tax Payments and Credits: 1. Tax Due (Page I Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Interest/Penalty if applicable D. Interest E. Penalty 0.00 0.00 0.00 0.00 0.00 (1) Total Credits (A + B + C) (2) Total Interest/Penalty (D + E) (3) 1,147.72 0.00 0.00 1,147.72 4. If Line 2 is greater than Line I + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page I Line 20 to request a refund (4) 5. If Line I + 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). 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 1~ 147 o 72 · ~ ~ Make Check Payable to: REGISTER OF WlLLS~ AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE .I~PROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the properly transferred; ....................... ~ r~ b. retain the right to designate who shall use the property transferred or its income; ......... r~ ~ c. retain a reversionary interest; or ................................ r~ r~ d. receive the promise for life of either payments, benefits or care? ................. ~ r~ 2. if death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ............................ [--'] ~ 3. Did decedent own an 'in trust for' or payable upon death bank account or secudty at his or her death? ~ r~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................................ r~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE rr AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct end complete. Declaration of preparer other than the personal reRresantaUve is based on all information o~ which preparer has any knowledge SIGNATURE 0B, PEP-,E~N '-~'---' - -~FILING RETURN .,, - ~ DATE A~ESS ZZ23S Garners Ferry Road _ ,r ~ ~ Eastover, SC 29044 SIGNATURE OF ~P~EPARER OTHER TI-I~N-REPHr-~cNTATIVE ADDRESS 1013 ~ Road, Sts. 100 Lemo~ne, PA 17043 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.§ 9916 (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 exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return ara 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 decedenrs siblings is 12% (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. 2W4646 1,000 Estate o£: William D. Be=kne~.. 251-76-6388 1001 Piney Branch Road Co-Administrator REV-1502EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Beckne11, Wi11iam D. 21-2003-0692 All real property owned solely or es a tenant In common must be reported at fair market value. Fair market value is defined a.s the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which Is jointly-owned with dgh~ of survivorship must be disclosed on Schedule F. ITEM DESCRIPTION VALUE AT DATE NUMBER OF DEATH 1. 3,882.86 One-story, single family dwelling; located at 185 Woods Drive, Mechanicsburg, Cumberland County, Pennsylvania; being Tax Parcel No. 38-20-1831-057; transferred to decedent by Hiram C. Lerew, widower, on February 28, 2000, by deed recorded in the Office of the Recorder of Deeds of Cumberland County, Pennsylvania, on February 29, 2000, at Book 216, Page 949. Value is net sales price. See attached Settlement Statement. TOTAL (Aisc enter on line 1, Recapitulation) $ 3, 8 8 2.8 6 2w4695 2.000 (If more space is needed, insert additional sheets of the same size) REV-1508 EX + ('1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS,& MISC. PERSONAL PROPERTY ~$¥ATE OF FILE NUMBER ~ec~mell, Nilliam D. 21-2003-0692 Include the ~roceeds of litigation and the date the proceeds were received by the estate. NI property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 568.09 7 8 Members 1st Federal Credit ~nion Savings Account No. A4462-00 Miscellaneous personal property Allstate automobile insurance refund 1995 Chevrolet S10 Truck YIN 1GCCS19Z3SK16&641 Worldcom manual account refund Co~=ast Cable subscriber refund 1999 ~C YIN 1G~CDT13W1X2551863 Capital Self Storage refund of security deposit TOTAL (Also enter on line 5, Recapitulation) $ 500.00 80.57 2,045.00 79.98 10.23 9,925.00 25.00 13,233.87 2W46AD 2.000 (If more space is needed, insert additional sheets of the same size) REV-1509 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY E,~¥ATE OF FILE NUMBER Beckne11, Wi11~am D. 21-2003-0692 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. JOINTLY-OWNED PROPERTY: ~ DATE DESCRIF~'ION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank account number er DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT similar identif~in~ number. Ntach deed fer jeintl¥-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. TOTAL (Also enter on line 6, Recapitulation) $ 0 o 0 0 2W46AE 2.000 (If more space is needed, insert additional sheets of same size) REV-1510 EX+ (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ..~iATE OF FILE NUMBER BeckneZ1, WilZia.~ D. 21-2003-0692 This schedule must be completed and filed if the answer to any of questions I through 4 on the revers side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PRC~-'~H i ~' %OF ITEM INCLUCE THE NAIVE OF THE 'PRANSFEREE, THEIR RELATIONSHIP TO DATE OF DEATH DECD'S EXCLUSION DECEDENTAND'R-E DA3E OF TRANSFER. A'FFACH A COPY OF THE TAXABLE VALUE NUMBER DEED FOR RE~ ESTATE. VALUE OF ASSET INTEREST (IF APPUCABLE) 1. Meml:~ers let'. Feder&l Credit: 19,14,3.9'7 100.00 6,000.00 13,14,3o9'7 Union Checking Xcel:. No. 4'44'62-11 Trans£erred to sons, David D. Becknell and Charles H. Becknell, on August 15, 2003. 2 Thri£t Savings Plan 22,0'70.28 100.00 0.00 22,0'70.28 Federal e~q~loyee retirement savings plan O~ner: William D. Becknell Bene£iciaries: David D. Becknell and Charles H. Becknell, in equal shares TOTAl. (AJso e~te~ on Ji~e ?, Reca~it,,latJon) $ 35,214.25 (If more space is needed, insert additional sheets of same size.) 2W46^F 2.000 REV-1511 EX + (1-97) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ~.~¥ATE OF FILE NUMBER BeckneZ1, Hill£arm D. 21-2003-0692 Debts of decedent muat be reported on Schedule I. ~EM NUMBER 5. 6. 7. 9 10 Tot~ DESCRIP~ON FUNEP~LEXPENSES: Myers Funeral Ho~e, Inc. funeral goods and services ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State __ Zip Year(s) Commission Paid: AttorneyFeesNaUne.' Gates, Halhru. ner& Hatch, P.C. Family Exemption: (If decedent's address is not the same es claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent Probate Fees Accountant's Fees T~ Raturn Pre~rer's Fees Federal Express express mail charge Capital Self Storage storage of Dersonal property for 09/30/2003 Silver SDr~ng Township Authority trash removal PPL Electric Utilit~es i £romcontlnuation pages .... Deriod 08/23/2003 - TOTAL (Also enter on line 9. Recapitulation) AMOUNT 0.00 9,000.00 0.00 249.00 0.00 0.00 16.46 200.00 57.60 6.76 5,614.13 17,588.85 2W46AG 2.000 (If more space is needed, insert additional sheets of same size) Estate of: Becknell, William D. Schedule H, Part B -- Administrative Costs Item Description 10 electric service for December 2003 11 Wal-Mart film processing for photos of real estate for sale (listed on Schedule A) 12 13 Principal Residential Mortgage, Inc. October 2003 mortgage payment paid on real estate llsted on Schedule A pending sale of property Eshenaurs Fuels, Inc. heating system service 14 U.S. Post Office stamps 15 Eshenaurs Fuels, Inc. heating oil 16 17 U-Haul transport portion of personal property J. Thcanas Landscape lawn maintenance for October 2003 18 19 Principal Residential ~rtgage, Inc. November 2003 mortgage payment paid on real estate listed on Schedule A pending sale of property. The Patriot-News Co. estate notice publication 2O Ditmar's Texaco gas - travel expense 21 O,m~erland Law Journal estate notice publication 22 J. Thomas Landscape lawn maintenance for August - September 2003 Page 2 21-2003-0692 Amount 7.23 988.98 136.95 74,.00 152.17 85.93 75.00 955.51 182.05 11.98 75.00 130.00 TOTAL. (Carry forward to main schedule) ...... 2,87A.80 Estate of: Beckne11, WilliamD. Schedule H, Part B -- A~mlnistrative Costs Item Description Page 3 21-2003-0692 Amount 23 24 25 26 27 28 29 3O Mark E. Rilbert & Associates real estate appraisal Duty's Lock & Key new door locks on real estate listed on Schedule A Principal Residentlal M~rtgage, Inc. September 2003 mortgage payment paid on real estate listed on Schedule A, pending sale of property. Capital Self Storage storage of personal property for 10/2003. PPL Electric Utilities electric service for September 2003 Executors travel expenses for October 2003 trip fr~ South Carolina to Pennsylvania to handle real estate matters. See attached receipts. trash removal (October - December 2003) PPL Electric Utilities electric service for October 2003 300.00 74,.20 955.51 128.26 92.72 1,101.9A 36.70 50.00 TOTAL. (Carry forward to main schedule) ...... 2,739.33 REV-1512 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE UABILITIES, & LIENS ,-$iATE OF FILE NUMBER Beck. nell, William D. 21-2003-0692 Include unrelmbursed med~,al expenses. ITEM NUMBER 2 7 8 10 11 12 13 lA DESCRIPTION Internal Revenue Service Decedent's 2003 £ederal income tax liability PA Department of Revenue Decedent's 2003 state income tax liability Silver Spring Ambulance & Rescue Assoc. emergency transport PPL Electric Utilities electric service (July 2003 service) PPL Electric Utilities electric service (August 2003 service) West Shore EMS emergency medical transport West Shore EMS emergency medical transport Internists of Central PA medical bill Silver Spring Township Authority trash removal Holy Spirit Hospital medical bill Spirit Physician Services medical bill Allstate autoa~mbile insurance Bates Pum~ Service repair pum~ at 185 Woods Drive property Penske Truck Rental removal of personal items frc~a real estate prior to sale of Total f~ continuation pages .... TOTAL (Also enter on line 10, Recapitulation) AMOUNT 4,666.00 1.00 276.37 98.07 92.72 A1.70 507.07 6.50 68.57 73.43 7.20 55.49 500.00 999.68 1,843.44 9,237.24 2W46AH 2.000 (If more space is needed, insert additional sheets of the same size) Estate of= Becknell, William D. Schedule I -- Debts of Decedent, Mortgage Liabilities & Liens Page 2 21-2003-0692 Item Value at No. Description Date of Death real estate 15 Co~m~nity Life Team, Inc. medical bill 188.50 16 Riverside Anesthesia Associates. medical bill 121.00 17 ~ates, Halbruner & Hatch, P.C. legal fees incurred for estate planning services, but not pai~ until after death 1,533.94 TOTAL. (Carry forward to main schedule) ...... 1,843.44 REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER Beck. n~ NUMBER II. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLEDISTRIBUTIONS[inclu~ ~tri~tspous~distributions, andtransfers underSec. 9116(~(l.2)] Becknell, David D. 11238 Garners Ferry Road Eastover, SC 29044 Becknell, Charles H. 1001 Piney Branch Road Eastover, SC 29044 21-2003-069; RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Son Son AMOUNT OR SHARE OF ESTATE 12,752.45 12,752.44 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON 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 $ 0.00 2W46AI 1.000 (If more space is needed, insert additional sheets of the same size) DEATH CERTIFICATE PA REV-1500 SCHEDULE A REAL ESTATE ' EEDS :.,U, ~ B,.P,L.,-,, ~ COUNI'¥- PA '00 FEB Pti 2 15 TAX PARCEL NO. 38-20-1831-057 MADE THE ~ ~'day of in the year two thousand (2000) BETWEEN HIRAM C. LEREW, widower, by his Attorney-in-Fact, GLEN W. LEREW, Grantor, AND WILLIAM D. BECKNELL, single man, of Mechanicsburg, Pennsylvania, Grantee, WITNE$$ETH, that in consideration of EIGHTY-NINE THOUSAND NINE HUNDRED ................... ................ ($89,900 00) Do ............................... · ................................................... liars, in hand paid, the receipt whereof is hereby acknowledged, the said grantor does hereby grant and convey to the said grantee, his heirs and assigns, ALL THAT CERTAIN lot of ground, improved with a one-story masonry bungalow, situate in the Township of Silver Springs, Cumberland County, Pennsylvania, bounded and described as follows: BEGINNING at a concrete monument at the intersection of the land now or formerly of Herbert W. Quick, and Mae Clepper Wolf, which monument is 540 feet 11 inches easterly from a concrete monument on the eastern side of the Mechanicsburg-Hogestown Road; thence North along said land now or formerly of the said Quick land, 200 feet to a concrete monument on the southern side of a public road running East and West; thence in an easterly direction along the southern side of said road, 200 feet to a stake; thence South along other land now or formerly of Carl A. Wentz and Margaret B. Wentz, his wife, and Robert H. Wentz and Hilda O. Wentz, his wife, 200 feet, more or less, to a stake on the line of land now or formerly of the said Mae Clepper Wolf; thence in a westerly direction along said Wolf land, 200 feet to the place of BEGINNING. BEING known and numbered as 185 Woods Drive, Mechanicsburg, Pennsylvania. BEING THE SAME PREMISES which Carl A. Wentz and Margaret B. Wentz, his wife, and Robert H. Wentz and Hilda O. Wentz, his wife, by Deed dated and recorded March 29, 1947 in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in Deed Book K, Volume 13, Page 477, granted and conveyed unto Hiram C. Lerew and Lillian M. Lerew, his wife. The said Lillian M. Lerew died February 25, 1990 thereby vesting sole title unto Hiram C. Lerew, widower, Grantor herein. The said Hiram C. Lerew, by a Power of Attorney dated March 29, 1990, did appoint Glen W. Lerew as his Attorney-in-Fact. Said Power of Attorney is intended to be recorded contemporaneously herewith. And the said grantor dc hereby Warrant Specially the pre rty hereby conveyed. IN' WITNESS WHEREOF, said grantor has hereunto set his hand and seal the day and year first above written. HIRAM C. LEREW, by'his A~to,~ney-j/~-...~ Fact, GLEN W. LEREW ~ ~. ~'/~~ STATE OF i~-12 ' 2 5")it ~ /~ ,;~ tf 2' On this, the ~,~'~'/t day of officer, personally appeared GLEN W. LEREW, ,2000, before me, the undersigned known to me (or satisfactorily proven) to be the person whose name is subscribed to the instrument, and acknowledged that he executed same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. ,/ Notary Public SusannP. K. Sa.,~er Na*ary Pub,ic Camp Hill Boro Cun')ber~'~nd Cour~y My Commission Expires Aug. 25, I~h~nber, Psonsylvania Association of Notaries (S CERTIFICATE OF RESIDENCE ! do hereby certify that the precise residence and complete post office address of the ~rantees ~-~- Attorney/Agent for ~ COMMONTVEA~TH OF PENI~YLVANIA ' SS County of x.~ m~_ ~.-hC~ & RECORDED on this day of A.D. 2000, in the Recorder's office of the said County, in Deed Book ~'~/~ Vol. ~""' , Page [~ 'C G~ven under my h~d ~e s~ of the s~d office, the date above ~itten. I I'E]FHA 2'E]FmHA 3.[--~CONV. UNINS. 4. C~VA 5.~--]CONV. INS. U.S. DEPARTMENT OF HOUSING & URBAN D" -:LOPMENT ~ 6. FILE NUMBER: ' 7. LOAN NUMBER: SETTLEMENT STATEMENT ~ HOKE470-03 I 8. MORTGAGE INS CASE NUMBER: C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "[POC]" were paid outside the closing; they are shown here for informational purposes and are not included in the totals. · 1.0 3/98 (HOKE470-03,PFD/HOKE470-03/12) D. NAME AND ADDRESS OF BORROWER: DENNIS HOKE and LINDA L. HOKE 501 HOLLY LANE MECHANICSBURG, PA 17055 G. PROPERTY LOCATION: 185 WOODS DRIVE ' MECHANICSBURG, PA 17050 CUMBERLAND County, Pennsylvania E. NAME AND ADDRESS OF SELLER: THE ESTATE OF WILLIAM D. BECKNELL 185 WOODS DRIVE MECHANICSBURG, PA 17050 H. SETTLEMENT AGENT: CHARLES E. SHIELDS, Ill, ESQ. F. NAME AND ADDRESS OF LENDER: PLACE OF SETTLEMENT 3414 CHESTNUT STREET CAMP HILL, PA 17011 PRIVATE FINANCING I. SETTLEMENT DATE: December 19, 2003 J. SUMMARY OF BORROWER'S TRANSACTION 100. GROSS AMOUNT DUE FROM BORROWER: 101. Contract Sales Price I 98,000.00 ,969.25 102. Personal Property 103. Settlement Char~les to Borrower (Line 1400) 104. I 105. 'r Adjustments For Items Paid By Seller in advance 106. City/Town Taxes 12/19/03 to 01/01/04 107. County Taxes to 108. SCHOOL TAX 12/19/03 to 07/01/04 406.45 109~ SEWER BILL 4TH QUARTER 12/19/03 to 01/01/04 14.05 110. 111. .112. 120. GROss AMOUNT DUE FROM BORROWER 100,398.05 200, AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 201. Deposit or earnest money 1,000.00 202. Principal Amount of New Loan(s) 203. Existin9 loan(s) taken subject to 204. 205. 206. 207. 208. SELLER CREDIT 600.00 209. Adjustments For Items Unpaid By Seller 210. City/Town Taxes to 211. County Taxes to 212. SCHOOL TAX to 213. 214. 215. 216. ~'217. 218. 219. 220. TOTAL PAID BY/FOR BORROWER 1,600.00 300, CASH AT SETTLEMENT FROM/TO BORROWER: 301. Gross Amount Due From Borrower (Line 120) I 100,398.05 302. Less Amount Paid By/For Borrower (Line 220) I( 1,600.00 K. SUMMARY OF SELLER'S TRANSACTION 400. GROSS AMOUNT DUE TO SELLER: 401. Contract Sales Price 98,000.00 402. Personal Properb/ 403. 404. 405. Adjustments For Items Paid By Seller in advance Taxes 12/19/03 to 01/01/04 8.30 407. County Taxes to 408. SCHOOLTAX 12/19/03 to 07/01/04 406.4! 409. SEWER BILL 4TH QUARTER 12/19/03 to 01/01/04 14.05 410. 411. 412. 420. GROSS AMOUNT DUE TO SELLER 98,428.80 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 501. Excess Deposit (See Instructions) 502. Settlement Char(~es to Seller (Line 1400) 503. Existing loan(s) taken subject to 504. Payoff of first Mortgage to PRINCIPAL RESIDENTIAL 506. Mortgage as proceeds) SELLER CREDIT 7,066.49 86,879.45 508. 600.00 509. Adjustments Forltems Unpaid By Seller Taxes to 511. County Taxes to 512. SCHOOL TAX to 513. 514. 515. 516. 517. 518. 519. 520. TOTAL REDUCTION AMOUNT DUE SELLER 94,545.94 600. CASH AT SETTLEMENT TO/FROM SELLER: 601. Gross Amount Due To Seller (Line 420) ( 98,428.80 602. Less Reductions Due Seller (Line 520) 94,545.94 303. CASH( X FROM)( TO)BORROWER 98,798.05 603. CASH( X TO)( FROM)SELLER 3,882.86 The undersigned hereby acknowledge receipt of a completed copy of pages 1&2 of this statement & any attachments referred to herein. I HAVE CAREFULLY REVIEWED THE HUD-/~SETTLEMENT STATEMENT AND TO THE BEST OF MY KNOWLEDGE AND BELIEF, IT IS A TRUE AND ACCURATE STAT~E]~EN'T.,OF ALL RECEIP'~S AN, J] DISBURSEMENTS MADE ON MY ACCOUNT OR BY ME IN THIS TRANSACTION. I FURTHER CERTIFY THAT I HAVE REC..EIVED ~,.,~PY OF THI~'~IUD#I SETTLEMENT STATEMENT. /.. . .... ~ .: Borrower ~ ~/J. ~, ~/I Y Seller ~')'? ] ' /J --') / '.-..z'_,~ ._ ~,~ ~:---~ { :' /.. .,~ , ;'i, ~ ~., ~ ..... DENNIS IdlE ~ t.l/¥/ / / ~ THE ESTATE bF WILLIAM O. 700. TOTAL COMMISSION Based on Price Division of Commission (line 700) as Follows: 701. $ 5,880.00 to ERA-NRT, INC. 702. $ to L. SETTLEMENT CHARGES $ 98,000.00 (~ 6.0000 % 5,880.00 703. Commission Paid at Settlement 704, TRANSACTION FEE to ERA-NRT, INC, 800. ITEMS PAYABLE IN CONNECTION WITH LOAN PAID FROM BORROWER'S FUNDS AT SETTLEMENT 100.00 ~age z PAID FROM SELLER'S FUNDS AT SETTLEMENT 5,880.0C 100.00 801. Loan Orit ination Fee % to :~02. Loan Discount % to 803. Appraisal Fee to 804. Credit Report to 805. Lender's Inspection Fee to ). Fee to 807. Assumption Fee to 808. 809. 810. 811. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From to @ $ /day ( days 902. MIP Totlns. for LifeOfLoan for months to %) 903. Hazard Insurance Premium for 1.0 years to 904. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard Insurance months (~ $ per month 1002. Insurance months (~ $ per month Taxes months ~ $ per month 1004. County Taxes months ~ $ per month 1005. SCHOOL TAX months @ $ per month 1006. months (~ $ per month 1007. months @ $ per month 1008. 1100. TITLE CHARGES months ~ $ per month Settlement or Closin9 Fee CLOSING PROTECTION L~- ~ I ER to 1102. to FIRST AMERICAN TITLE INSURANCE COMPANY SEARCH/HUD PREP to TRI-COUNTY ABSTRACT SERVICE POC: 150.00 1104. Title Insurance Binder to 1105. Document Preparation to 1106. Notary Fees to CASH 4.00 1107. Attorney's Fees to CHARLES E. SHIELDS, III, ESQ. (includes above item numbers: 1108. Title Insurance to TRI-COUNTY ABSTRACT SERVICE~ AGENT (includes above item numbers: 1109. Lender's Coverage 4.00 500.75 346.00 $ 1110. Owner's Coverage $ 98,000.00 346.00 102123862 1111. ENDORSEMENTS 112. .1113. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording Fees: Deed $ 38.50; Mortgage $ ; Releases $ 3s: Deed 980.00; Mortgage 980.00 1203. State Tax/Stamps: Revenue Stamps 980.00; Mortgage to BIECHLER & TILLERY 1204. 1205. OVERNIGHT/COURIER FEES to TRI-COUNTY ABSTRACT SERVICE 14.50 1300. ADDITIONAL S~-i m LEMENT CHARGES 1301. Survey to POC: 35.00 I 1302. Pest Inspection 1303. SEWER BILL 4TH QUARTER to SILVER SPRING TOWNSHIP ACCOUNT 83-841 I 87.99 1304. HOME INSPECTION BIECHLER & TILLERY POC: 275.00I 1305. WATER INSPECTION BIECHLER & TILLERY POC: 55.00l 1400. TOTAL S~-m m LEMENT CHARGES {Enter on Lines 103, Section J and 502, Section K) I 1,969.25 7,066.49 By signing page 1 of this statement, the signalories acknowledge receipt of a completed copy ol' page 2 of this two page statement. SETTLEMENT OFFICER Certified to be a true copy. Settlement Agent PA REV-1500 SCHEDULE E CASH, BANK DEPOSITS & MISCELLANEOUS PERSONAL PROPERTY MEMBERS 1 REGULAR SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest to Date of Death Name of Joint Owner 44462 -00 10/25/1985 $563.46 $4.63 $568.09 None CHECKING ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest to Date of Death Name of Joint Owner 44462 -11 10/25/1985 $19,141.34 $2.63 $19,143.97 None LOAN ACCOUNT: Account Number Date Loan Established Principal Balance at Date of Death Loan Type 44462 -12 08/15/2002 $2,163.62'* · Signature **Loan paid in full by credit life insurance MEj~,,~ERS 1sT FEDERAL CREDIT UNION Insurance Supervisor September 5, 2003 Estate of: WILLIAM D. BECKNELL Date of Death: August 19, 2003 Social Security Number: 251-76-6388 5000 Louise Drive, P.O. Box 40, Mechanicsburg, PA 17055 www.memberslst.org Automobile Insurance Refund Policy Number: 0 01 442674 01/08 10815 DA VID TAYLOR DRIVE CHARLOTTE NC 28262-1045 Type of Policy AUTOMOBILE AIIstate. You're in good hands. ESTATE OF WILLIAM BECKNELL 11238 GARNERS FERRY EASTOVER SC 29044-9110 Loan Number NONE Policy Issued To ESTATE OF WILLIAM BECKNELL 11238 GARNERS FERRY EASTOVER SC 29044-9110 Policy Number Description 0 01 442674 01/08 99 GMC JIMMY Agent And Telephone Number MARK R PEIPER (717) 795-9808 Important Information As you requested, we have terminated your policy effective September 5, 2003. Attached is your refund check. We thank you for the opportunity to serve you and hope we can provide your insurance protection in the future. If you have any questions, please contact your agent or producer of record. This statement as of September 5, 2003. ( OVER ) Please detach the check below before depositing. 030905000035C Vendor No. 1RFCBMSC Vendor Name WILLIAM BECKNELL Our Account With You Payment Doc, No. 2006340887 Check No, 1001444550 Check Date 11/25/2003 Date Invoice No, Doc No. Gross Discount Net 11/24/2003 Check Total 2CK3497900001974 1904073721 MANUAL ACCOUNT REFUND 79,98 0.00 79.98 PAGE 1 / 1 Kelley Blue Book Used Car Vak Page 1 of 2 Kelley Blue Book THE TRUSTED RESOURCE kbb.com New Car Pricing: ~xmd~ ¢,r, Blue Book Trade-In Report 2,tce.ti~ i Pennsylvania · October 23, 2003 Blue Book ~-ear,, mo MAIIKETWATCIL [Enter email address j _Sign,,p! Z~ur~n~ ii L~mm~ Check. 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A "good" vehicle will need some reconditioning to be sold at retail; however major reconditioning should be deducted from the value. Most recent model cars owned by consumers fall into this category. Trade-In Value $2,045 Trade-in value represents what you might expect to receive from a dealer for this consumer owned vehicle. Keep in mind that the dealer must then absorb the cost of making the vehicle ready for sale, advertising, sales commissions, arranging financing and insurance and standing behind the vehicle for any mechanical or safety problems. Oet the latest Blue Book Get a Private Party Value http://www.kbb.com/kb/ki.dll/kw.kc.ur?kbb. PA;690434;PA041 & 17050;pic+t;&278;Chevrolet; 19... 10/23/2003 COMCAST CABLE COMMUNICATIONS 4008 N. DUPONT HIGHW ATTN: SUPPORT SERVIC,~S NEW CASTLE, DE 19720 O~OCBDT-OOOOOO~8~2Z5 ( C 'omcost WILLIAM BECKNELL 185 WOODS DR MECHANICSBURG, PA 17050 Dear William Becknell, The attac_h~k represents a subscriber refund for account number 09547-206416 in the amount of~10.23//If you have any questions or concerns regarding the refund check you can write us at t'h"e-a'ddress above. ~'~__..-~(,~ ~--~ Check Date: 10/08/03 Check Number: 155643782 O~IOD7 CHPI7665 I)FTI'^Cll ANI)RETAIN Tills IF NOT ,'UORR F'¢ Page 1 of 2 Traci Sepkovic From: To: Sent: Subject: <BecknellD @ usa.redcross.org> <wooodchuc@aol.com>; <dawaau@bellsouth.net>; <m.halbruner@gateslawfirm.com>; <t.sepkovic @ gateslawfirm.com> Wednesday, August 27, 2003 7:47 AM 1999 GMC Jimmy Value Traci, Here are the two options for the 1999 GMC Jimmy's value. The first one is for it as a trade in and the second is as a direct sale to another party. : :lSwww:l~b .co~.~w.~ .~r?. l~b .PA ;707101 ;PA 041 &17050 ;s~-'v~° $:723 ~GMC Power Windows Power Door Locks Cassette Alloy Wheels Dual Front Air Bags Consumer Rated Condition: Excellent "Excellent" condition means that the vehicle looks great, is in excellent mechanical condition and needs no. reconditioning, It should pass a smog inspection, The 'engine compartment should be clean, with no fluid leaks, The paint is glossy and the body and interior are free of any wear or visible defects. There is no rust. The tires are the proper size and match and are new or nearly new, A clean title history is assumed, This is an exceptional vehicle, Private Party Value $9,925 Private Party value represents what you might expect to pay for a used car when purchasing from a private party. It may also represent the value you might expect to receive when selling your own used car to another private party. Your Oat the late~ BI ue Book Get a Used Car Trade-In Value Get Invoice ~ MSRP on Hew Cars Thank you, 9/22/2003 10/27/2003 David Becknell 11238 Garners Ferry Rd. Eastover, SC 29044 Unit No.: 0H012 Size: 10X20 Dear David Becknell: We at Capital Self Storage Mech. sincerely appreciate your choosing our facility for your storage needs and we hope your stay with us was satisfactory. If you are ever in need of storage services in the future, we hope that you will contact us. Again, thank you. If you have any questions, please call 717-691-8800. Very trt)ly yours, Karen Schorr Site Manager PA REV-1500 SCHEDULE G INTER-VIVOS TRANSFERS and MISCELLANEOUS NON-PROBATE PROPERTY st MEMBERS 1st FEDERAL CREDIT UNION REGULAR SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest to Date of Death Name of Joint Owner 44462 -00 10/25/1985 $563.46 $4.63 $568.09 None CHECKING ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest to Date of Death Name of Joint Owner 44462 -11 10/25/1985 $19,141.34 $2.63 $19,143.97 None LOAN ACCOUNT: Account Number Date Loan Established Principal Balance at Date of Death Loan Type 44462 -12 08/15/2002 $2,163.62** Signature **Loan paid in full bY credit life insuranCe ME~/It~ERS IsT FEDERAL CREDIT UNION Denise A. Wolfe /'Y'- -- Insurance Supervisor September 5, 2003 Estate of: WILLIAM D. BECKNELL Date of Death: August 19, 2003 Social Security Number: 251-76-6388 5000 Louise Drive, P.O. Box 40, Mechanicsburg, PA 17055 www.memberslst.org THRIFT SAVINGS PLAN September 15, 2003 Fhrift Savings Plm National Finance Center P.O. Box 61500, New Orleans, LA 70161-1500 Law Offices of Gates, Halbruner & Hatch, P.C. Suite 100 1013 Mumma Road Lemoyne, PA 17043 Re: TSP account of William D. Becknell, Deceased Dear Ms. Sepkovic: This is in response to your letter to this office dated August 28, 2003, requesting information about the Thrift Savings Plan (TSP) account of William D. Becknell. The TSP is one part of the retirement system created for Federal employees in the Federal Employees' Retirement Savings Act of 1986. (See 5 U.S.C. §§ 8351, 8401-79.) The TSP is a tax-deferred retirement savings plan similar to those authorized under section 401(k) of the Internal Revenue Code for private sector employees. The TSP began accepting contributions from Federal employees in April 1987 and from members of the Uniformed Services in January 2002. Mr. Becknell's first contribution was accepted in April 1987. Mr. Becknell's TSP account number is his Social Security number and the account is held solely in his name. As of the date of death, Mr. Becknell's TSP account balance was $22,070.28 and there were no outstanding loans. The disposition of a TSP account is a matter of Federal law. The account balance of a deceased participant is distributed according to the order of precedence found at 5 U.S.C. § 8424(d) . First in the order of precedence is the beneficiary or beneficiaries designated by the participant in a properly executed and filed Form TSP-3, Designation of Beneficiary. If there is no designated beneficiary, the account is paid to the participant's surviving spouse. If there is' no surviving spouse, the account is paid to the children of the participant, and descendants of deceased children by representation. If there is no child of the participant (or descendants of deceased children), the account is paid in equal shares to the parents of the participant, or entirely to the survivor of them. In the absence of these enumerated beneficiaries, the account is paid to the executor or administrator of the deceased participant's estate (including one authorized to dispose of the estate under small estate procedures). If no estate is administered, the account is paid to the participant's next of kin under the laws of the state of the participant's legal residence at death. To liquidate this account we must receive a completed Form TSP-17, Information Relating to Deceased participant, along with a copy of the certified death certificate. We have enclosed a blank Form TSP-17 for you to complete. Additionally, we are returning the enclosed death certificate for your convenience. We are providing the most recent participant statement regarding Mr. Becknell's TSP account. Participant statements are detailed statements which contain a Complete record of all the transactions in an account. However, this process often takes four to five working days. We will forward all TSP participant statements to you upon receipt. In your letter, you ask for the names of the deceased participant's beneficiaries. We are unable to provide this information; a final beneficiary determination cannot be made until a Form TSP-17 is received and reviewed. (Each individual who files a Form TSP-17 will be notified of this determination.) We hope this information has been helpful. Sincerely, REGINALD G. HARGETT, Chief Thrift Savings Plan Operations Branch Enclosure (s) PA REV-1500 SCHEDULE H FUNERAL EXPENSES and ADMINISTRATIVE COSTS Myers Funeral Home, Ir , ) 37 East Main Street Mechanicsburg, Pa. 17055 Boyd L. Myers Jr., Supervisor | (717) 766-3421 STATEMENT OF FUNERAL GooDs AND SERVICES SELECTED Cha~es are only for those items that you selected or that are required. If we are required by law or by a cemetery or crematory to use any items, we will e. xplain, in writing b~ iow. !f~ou selected, a. funeral that ~ay requ.]re e. mbaiming, such ~ a fu.n. eral with viewing, you m..ay have to pay tbr embalming. Yo aD not have to pay rot emoamming you (rio not approve iryou setectea arrangements such as airect cremation or immediate burial. If we charge you tbr a embalming, we will explain why below. For Services of __ William D. Bm:knell Date Of Death August 19, 2003 Date of Contract August 19, 2003 Charge to David D. Beckncll ! 1238 Garners Ferry Road Eastovcr, S.C. 29044 .... N~- Address C~ty S~tE Zip A. CHARGE FOR SERVICES SELECTED: !. PROFESSIONAL SERVICES Services of Funeral Director and Staff $ 1795.00 Embalming $ Casketing, dressing, cosmetology $ Other Preparation of body $ 95.00 Hairdresser / Barber $ Autopsy Remains $ SUB-TOTAL PROFESSIONAL SERVICES A1 $ 1,890.00 2. USE OF FACILITIES AND SERVICES For visitation / wake service $ For funeral ceremony $ For memorial service $ Equipment & services for graveside service $ $ SUB-TOTAL FACILITIES AND EQUIPMENT 3. AUTOMOTIVE EQUIPMENT Vehicle to transfer remains to Funeral Home Hearse (Casket Coach) Flower Car / Floral Distribution Family Car Lead Car / Clergy Car Utility Car Out of town transportation SUB-TOTAL AUTOMOTIVE EQUIPMENT TOTAL SERVICES, FACILITIES, AUTOMOBILE B. CHARGES FOR MERCHANDISE SELECTED Casket $ Other Receptacle Cardboard Cremation $ Outer Burial Contalilontainer $ Ac 'knowledgment Cards $ Register Book "$ Memorial Folders $ Prayer Cards $ Temporary Grave Markers $ Burial Clothing $ Other Clothing $ 450.00 395.00 A2 $ 350.00 lncl A3 $ AS Incl Incl 75.00 lncl 845.00 350.00 3,085.00 C. SPECIAL CHARGES Forwarding Remains to other Funeral Home $ Receiving Remains form other Funeral Home $ Immediate Burial $ -- Direct Cremation $ SUB-TOTAL OF SPECIAL CHARGES C $ D. CASH ADVANCED Opening Grave/Crypt $ Newspaper Local $ 108.40 Newspaper State Paper $ 96.50 Clergy / Mass Offering $ i 00.00 ' Certified Copies of Death Certificate 15 $ 30.00 Family Flowers $ Crematory Charge $ 200.00 Cremation Authorization $ 25.00 Shipping SUB-TOTAL OFCASH ADVANCED Wcchargcyou~rourse~icesinobtainingthe NONE DS following: 599.90 SUMMARY OF CHARGES TOTAL ABOVE ITEMS (A,B.C.D) $ 3,759.90 Sales Tax (ifApp) ~ % $ 0.00 TOTAL OF ALL SECTIONS $ 3,759.90 LESS: Payment Made $ LESS: Credits Pending $ LESS: Credits granted Package Price Discount $ 1.315.00 BALANCE DUE by Sep 18, 2003 $ 2,444.90 A late charge of i.5% per month on the outstanding balance (annual rate of 18%) will be added to the balance. REASON FOR REQUIRED SER¥1CES OR MERCHANDISE DISCLAIMER OF WARRANTIES _ Our funeral home makes no representations or warranties regarding caskets Cremation urn $ or outer burial containers. The only warranties expressed or imp ed granted Temporary C(~ntainer for Cremains $- Incl in connectio_n with goods sold with the funeral 'sen/ice are the express wr~tteq .................. -: -- warranties, it any, extended by the manufacturer thereof. No other warrantie~ .................. ~ __ including the implied warranties of merchantability or fitness for particula~ TOTAL MERCHANDISE SELECTED B $ 75.00 purpose are extended by the seller. / I agree that I have examined the items of goods and services selected above and found them to be correct and according to the arrangements I hav~ requested. I acknowledge receipt of a copy of this Statement of Funeral Goods and Sen/ices Selected. I represent that I have sufficient funds available fd p. ay.men..t, of the cash. pric9 for_ the g .opds a_nd. s.e_~.~i_c~.s.s~_ke(~t_ ed..- I__also agree .to .m..aokze payment o.f $ 2444.90 within 30 days. I agree to be jointly and several [~l~w._ltn_~a~_on_e__e.l_.~__?~o _.s,~_n,s_ DelOW;~A ~L~ m ~ ~ ~-~6~,. ~ o[.1 .~% per. .rnonm .{1 u ~p?r a..nnu._m) will,b~, ap .pT~. to t.h.e unpaid balance beginning 30 days affe Th__U_-? u_m.½.,?_uH.?[[a~. , ..w,. mso. pay [ne run?am .uire. ctor..all reasonao.le .co.sm .p. mo .O~f tne..I-.uneral u,rector.to collect amounts I owe under this agreemen be~:~e~[Is~n~nfl~l~i~lyOmey trees and court costs. Any items reques[eo alter tne Date of mis agreement will be considered part of this agreement and w (Seal) t~eal~ Purchaser August 19, 2003 Contract Date RECEIPT FOR PAYMENT Cumberland_County - Register Of Wills Hanover and Hiqh Street Carlisle, PA I7013 eceipt Date eceipt Time Receipt No. : :24 1033802 BECKNELL WILLIAM D File Number Remarks 2003-00692 DAVID D BECKNELL AC Transaction Description PETITION LTRS kDM BOND SHORT CERTIFICATE JCP FEE Check# 1942 Total Received ......... Distribution Of Receipt ......... Payment Amount Payee Name 200.00 CUMBERLAND COUNTY GENERAL FUN 15.00 CUMBERLAND COUNTY GENERAL FUN 24.00 CUMBERLAND COUNTY GENERAL FUN 10.00 BUREAU OF RECEIPTS & CNTR M.D 249.00 249 00 USA Airbill ~xpl'ess 542262896504 "'200 From ~.~.~,.~,~ 4a Express Package Sewice Packa~esupto1~Ol~s, Oa,e 0 8,~ ~00 ~ Sa.,e.'aFad~, Account Number ~ FedEx Priority Ovemight [--'] FedEx Standard Overnight [] FedEx First Overnight Name dC~U, ~'d~// Phone ( ~ ~3 3 ~'"'3-- / 0 ~'Y D FedEx2Day [] FodF. x Express Saver 4b Express Freight Service .. PsckagesoverlSg~w. // ~ ~d [-'~ FedEx, Day Freight* [--~ FedEx 2Day Freight~-] FedEx 3Day Freight 5. Packaging City ~J' -~ F~ &/g'~?~-" bgete ~r~ ~ ZIP ~5~)/'~/*'/ ~.~ExEnvelope* [--] FedExPak'~.d.. ~s.~ ,.,,,Ex [] Other Your Internal Billing Reference P~..,,,,.0. ~ ,~., o. ~0~,. 6 Special Handling To Name 4¢,'', ~&'pA.~~'~ Phone( 7~ / ~ L-'] SATURDAYDeFwmY HOLD-W'es~ r'-'l HOLD SaturdaY By u~ing this J~Cmllyou egme to dm ~ice co~li6mm on lira back of ~is AJrbiU an~ in our cmmm Sec&ce 6ulde, incluo"mg tmm~ ~ Iknit our I~bility. Questions? Visit our Web site at fedex.corn or cell l~O0.Go. FedEx~ 8~0.463~33~. L~No r~] Yes Yes [] Dry Ice Dr/Ice. 9. U N lg45 .-------~--' x [] Cargo Akcra~t Payment BilI~: Sender [] Recipient EJThird Party [] Credit Card ~8s Tolal P~ Tml WeigM Total Deda~'~l VeMet $ .00 8 Release Signature By si~ltng yml authorize L~ 1o deliver thi~ sldlmlmTt without o/~lain[mg a signature ~-~ and agree to indemnify and hold us harmless Imm any resulting claims, oo Sil" .r Spring Township Auth"rity Silver Spring Township Authority 6415-Rear Cadisle Pike Mechanicsburg, Pa 17050 717-591-1370 Account Number: 83-84 Service Address: 185 Woods Dr Statement of Account for Sewer Services Due Date Before Due Date 10/31/03 $114.70 After Due Date $126.17 Office will be closed: November 27, 2003, November 28, 2003, December 24, 2003 (noon) and December 25, 2003 07/01/2003 Billing Period From To: $0.00 ] $114.70] Previous Balance: Current Charge: Other Charges: Meter Credits: Pay this amount before due date: Pay this amount after due date: 09/30/2003 Hours: Normal business hours are from 8:00 AM until 4:00 PM, Monday through Fdday, except holidays and special occasions. An answering machine is available for after hour questions regarding billing. Payments: Payments are due at the Silver Spring Township Authority office on the due date pdnted on the bill and are subject to the 10% penalty. Payments can be made by check or money order. Customers may pay in the following ways: * Mail payment along with the return stub to the Silver Spring Township Authority, 6415-Rear CarliSle Pike, Mechanicsburg, Pa 17050 * Bring your payment along with the return stub to the Silver Spring Township Authority Offices during normal business hours (8AM to 4PM, Monday thru Friday). * Payments will no longer be accepted at the Township office, please remit all payments, questions and concerns to the Authroity Office located at 6415-Rear Carlisle Pike behind the All-State Insurance Office (near the old Kams store). Rates: The rate schedule for Silver Spring Township Authority is as follows: * Commercial -Flat Charge of $164.00 (per unit). * Residential -Flat Charge of $114.70 (per unit). PPL Electric Utilities PP, Page I 0t~660-75014 J Electric Service For' WILLIAM BECKNELL 185 WOODS DR MEC1L~kNICSBURG PA 17050 Questions abont this bill? Please contac! us by Sep 29 al 1-800~4,-57759 or 484-634-4900 or write to: Customer Service 827 I lausman Rd. Allenlown, PA 181 O4-9392 www.ppKveb.com Summary Page BMance as o1' Sep 8, 2003 Charees: qk)taFPPL ELECII~IC UTII.,ITII-';S Charges Tottfl Charges :t!'~ ~P 29, 2003 Account Balance $ 0.00 $ 92.72 $ 92.72 .Electric Use qqfis graph shows your eleclric use over lhe last 13 monlhs. ePeS of ter Readings: Aclual l Estimated ~ Customer ['--] KWH- Average Per Day Meier Reading Inlbrmation 42 ~l[eler ~24229447 35 [Sep 8 Xciual 3350 /Aug 7 Acluai "'~49 28 /32 Days KWtl Billed ~1- 21 AveraRe - Sep 20022003 'l'empe~ature - 75I: 74f: 14 KWH Per Day 21 34 Yearly Use: Total Average 7 Ilse Monflfly ()ct 200l - Sep 2002 5946 496 0 Oct 2002 - Sep 2003 7582 632 SONDJ I:MAMJ JAS 2(102 Months 2003 Other important inlbrmation on back PPL Electric Utilities Page I Electric Service For' WILLIAM BECKNELL 185 WOOI)S DR MECHANICSBURG PA 17050 Summary Page Balance as of Oct 8, 2003 Char~es: TotaVPPL El ECTRIC UTI[ I'IIES Char es Total Charges $ 0.00 $18.62 $18.62 Questions about this bill? Please contact us by Oct 29 at 1-800-342-5775 or 484-634-4900 or write to: Customer Service 827 Hausman Rd. Allentown, PA 18104-9392 www.pplweb.com Account Balance $18.62 Electric Use This graph shows your electric use over the last 13 months. Readings: Actual l Estimated ~ CUslomer ~ KWH - Average Per Day Meter Reading Information 42 [Meter 024229447 ] 35 lOci 8' Aclual 348'7 ISev 8 Actual 3350 28 [ 30'Days ~ --i3-7 Average - ()ct 20112 2003 21 Temperalure 66F 625F 14 KWH Per Day 14 Yearly Use: Total Average 7 Use Monthly Nov 2001 - Oct 2002 5887 491 0 Nov 2002 - Oct 2003 7298 608 ONDJ FMAMJ JASO 2002 Months 2003 Other important information on back PPL Electricppi Utilities Page I Electric Service For: WILLIAM BECKNEIA. 185 WOODS DR MECHANICSBUR(; PA 17o5o Questions al)out lhis bill'? Please conlact us by Dec 29 at 1-800-342-5775 or 484-634-4900 Summary Page Balance as o1' Dec 8, 2003 $ 0.00 Char~zes: TotaFPPl. I~,LECII~IC UTItXIIES Charges $ 0.67 Total Charges $ 0.67 Account Balance ~ / Il/ 827 llausman Rd. Allentown, PA 18104-9392 ~.pplweb.com Electric Kw}~- Average Per Day Meter Reading Information Use 42 Mete]' #24229447 This graph sho~vs 35 Dec 8 Actual 3702 Nov 6 Actual 3594 your eleclric use 28 32 Days KWH Billed 108 over the last 13 - months.. 21 Average- Dec 20t}2 2003 Temperalure 36F 42F ~T~ypes of , KWH Per Day 14 3 wieter Readings: 14 Yearly Use: Total Average Actual / 7 Use Monthly Jan 2002 - Dec 2002 5894 491 Estimated ~ () Jau 2003 - Dec 2003 6671 556 Customer ~ DJ I:MAMJ JASOND 2002 Months 2003 ~ ~ ~ Other important infornmtion on back '~ WAL :MART· Al_WAYS LOW PRICES. HI~NRGER RO]~i.:R'r FRflNK ,: 717 ;, 6'~'1 .- 3150 ST~ 1886 OPI 01}003~:~,t 'r(~d:t 05 TRt 04655 · ~ ITEIq .P~;KFiBE 48560:~10070 ~a FZLH DEVEL X' ~.96060623 6.21 d DEVELOP PRIdO 02049~08011 ~1 1.19 J ~NDEX PR~N'r 0;?.0~99:~5009,1 0.94 d ~ PRCKRI]ED PR:ICE 8,34 ~ FZLH DEVEL X 02049606062~ ~~~ DEVELOP PRNO 020~,98030'10;~ ~ /NDEX PRZNr 020~9~:~5009,1 ~d i# PRCKA6Erl PR/CE 8.17 t# POOH LUN KIT 0707'22,!;18310 5.50 $1.J]tTO Il:IL 22.01 TRX 1 6.000 ~ 1.32 Te filL 23,33 CRSI.~ 'rEH:0 25.00 CHRIdGE BIlE 1.67 # ITEflS SOLD 3 TCII 8955 1~8E, 5'i"16 9!129 8392 "LORD I]F THE RINGS 2" ON VHS/DVD TLJE$, 8/26! 09/10/03 09 ', 50: 59 ,, idential Mortg? , Inc. ~et Ahead. s~? Eesi#entia/ Mortgage,/nc. A member ~f ~e Pnnc~pal F~hanc~a! Group Loan Number H1564933-8 Listed below is a history of the payments credited to this loan in 2003. This also shows the amounts deducted from the escrow account for the items shown in the transaction description column. Retain this statement for use in filing your income tax return. Paid Due Transaction Late Date Date Description Principal Interest Charge 01-03-03 01-03 Payment 02-03-03 02-03 Payment 02-03-03 Insurance Premium 03-03-03 03-03 Payment 03-19-03 Annual 04-01-03 04-03 Payment 05-05-03 05-03 Payment 06-03-03 06-03 Payment 07-01-03 07-03 Payment 07-29-03 08-03 Payment 08-13-03 Annual 09-15-03 09-03 Payment ~10-21-03 10-03 Payment 10-21-03 11-03 Payment 12-22-03 12-03 Payment in Full Interest Paid During 2003 349.52 487.18 351.41 485.29 353.31 Township or Borough Tax 355.23 357.15 359.09 361.03 362.99 School Tax 483.39 481.47 479.55 477.61 475.67 473.71 $6,040.52 , 364.95 471.75 366.93 469.77 33.47 368.92 467.78 85,991.07 787.35 33.47 * The monthly payment transactions shown above reflect the total amount of interest applied to your loan each month, including the monthly buydown contributions. We have deducted the monthly buydown contribution from the total interest paid figure so this figure reflects the actual amount of interest paid by you during this year. Escrow 120.55 120.55 268.00- 120.55 228.25- 120.55 120.55 120.55 118.81 118.81 747.62- 118.81~- 118.81~ 118.81 30.56 *** See important information on next page P.O. Box 711, Des Moines, Iowa 50303-0711 F291 IV 1564933800098898000955512 Mortgage Loan Payment 1564933-8 Late fee ifaftem 09-01-2003 09-16-2003 ~ Payment Amount: WILLIAM D BECKNELL 185 WOODS DRIVE MECHANICSBURG PA 17050 $955.51 $33.47 $988.98 D Change of address? Check here, see reverse. Make extra prh~cipal payments? See reverse for details. Call 1-800-367-6448 (7 a.m.-7 p]m. CT M-F), or visit www. principal.congmortgage t DAVID D SECKNELL EXECUTOR CHARLES H BECKNELL EXECUT ; PAy TO ~E ~ ~ ~ - - _ - -_ -_-_ I~ Wacho~a ~nk, Nv v ~ ~ ~o ACH R~Oa~oooso~ * INVOICE NO. 44742 JIAURS FUEL;S,. INC. 2900 HERR ST · 227 SOUTH 17th ST · P.O. BOX 2112 · HARRISBURG, PA 17105 DATE ACCOUNT NO. 04431 0 WILLIAM D BECKNELL 185 WOODS DRIVE MECHANICSBURG PA 17050 JOB - PHONE 236-5031 SALES & SERVICF Plumbing Heating Air Conditioning Fuel Oil Water Treatment Bathrooms Welding 1V4% FINANCE CHARGE ADDED AFTER 30 DAYS. ANNUAL RATE 15%. DESCRIPTION PRICE AMOUNT NOV 1 CONTRACT 2(')(]3 NOV 2004 136 · 95 '- ' '7 "(HEATING OIL/DYED DIESEL FUEL, NON-TAXABLE USE ONLY, PENALTY FOR TAXABLE u-~Ei T~is invoice haS.~eer~ accurately'comput "' " ,~;m:l automatically prated by the- t ~): COM 650:1 E!,~tronlc Co{'nPuter Re )Uter Register. ........... 18 5 ~OoD$ DRIVE ~_ co ~ MECHANICSBURG PA 17050 D~ ~ ~ ** ~TU~N COPY *, 044319 HU NO ESHENAURS FUELS INC. 2900 HERR ST., P.O. BOX 2112, HARRISBURG, PA 17105 ' PHONE: 717-236-5031 VOLUME COMPENSATED AT 60o FAHRENHEIT WILLIA. D' BECKNELL ESTATE C/O DAVID D BECKNELL 03 5 iii38 GARNERS FERRY ROAD/ 780 sc ............................................................................................................................... >:,:.:-:-:.:-:-:-:.x,.-:-.-.:..--:,:,.-:.:-:.:.:.:-:.:.:.:...-:-.- ii.".:ii:',::'..~i~!iY.':'i~-:~i~i:'.'4:':'.:.~;":~:'.~i,",'~ ~:'i~i!i:'.:-"i:'.::'.;~i:'~.".::':Yi!i."..!i~!i~i-',,Y:'~i~i:':';? :::::::::::::::::::::::::::::::::::::::::::::::::::: ~.~'~:~::;~:::?.~:.~¥~:.:<4: ~.'.+:,~:~>¥:.:.:.<::::,2:.~:.~>:.~! .....:: ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::<: ~:~:{:~.~.~: :~:~::~:~:!;? ..... Member Number: 1418813 Member Name: DAVID DOUGLAS BECKNELL Account #9987876 Detail o~ Account Title FREEDOM CHECKING Account Balance $2,319.35 Account Number 9987876 Available Balance $2,319.35 Account Type Shara Draft 2003 Dividends $0.00 2002 Dividends $0.00 Account #9987876 History 08-27-2003 to 08-27-2003 Date ":3' 08-27- 2003 08-27- 2003 08-27- 2003 08-27- 2003 08-27- 2003 08-27- 2003 ~ 08-27- 2003 08-27- 2003 08-27- 2003 08-27- 2003 Check # '.i~' 0000001941 0000001943 0000001946 Transaction ~} Description *~ Withdrawal CLEARED CHECK Withdrawal CLEARED CHECK Withdrawal CLEARED CHECK Withdrawal VERIZON WIRELESS Withdrawal DAYS INN OF STAUNTON STAUNTON VA Withdrawal CRACKER BARREL # 128 STAUNTON VA Withdrawal UHAUL MECHANIC00811554 M~ECHAN~GPA Withdrawal - f~ EXXONMOBIL91 04716718 FORT MIL SC Withdrawal EXXONMOBIL91 04716718 FORT MIL SC Withdrawal EXXONMOBIL75 04203873 STAUNTON VA Amount .~:~ Balance -860.00 2,593.33 -360.00 3,453.33 -200.00 3,813.33 -200.00 4,013.33 -135.58 4,213.33 -39.62 4,348.91 -85.93 4,388.53--~-.--- -7.79 4,474.46 -21.81 4,482.25 -19.47 4,504.06 https://www.fj fcuhb~~rg/~n~ineserv/HB/Summary~cgi?nextStartM~nth=~8&nextStartDay=27&nextStartY.~. 8/28/2Q( / Account HlStOry Export Au[ ; 27, 2003 to August 27, 2003 Please choose an export format i ....................................................................... [ Download Data Next History Date Range: (same account) 071 27'2003i[] to 08 ~26 !2003 [] [ More History I View A Different Account: (08-27-2003 to 08-27-2003) 9987876; FREEDOM CHECKING [ View Different Account [ Account Summary I Account Transfer I Export ] [ Account Access I Bill Payment I Stock Quotes I User Options I Help I Email I Sign Off ] Change Current Member: Member Number: i Password: ~ lB V4.0.2 https://www.fj fcuhb~~rg/~n~ineserv/HB/Summary.cgi?nextStartM~nth=~8&nextStartDay=27&nextStartY... 8/28/20C , outh Carolina 292092601 45:[8030209-0098 09/09/2003 (803) 776-6 ! 78 08: 32: 20 AI~ 'Product Description 37c F~ag PSA Coil/lO0 Total: Paid by: Personal Check Sale t Final Oty Price Price 1 $37.00 $37.00 $37.00 $37.00 Please cai/ 1-800-ASK-USPS (1-800-275-8777) for USPS information or visit us on the web at www.usps com To order stamps by phone, cal] ' ' 1-800-Stamp24. Bill#: 1000200580941 Clerk: 21 Refunds only per DNN PO14 ------ Thank you for your business Customer Copy --"'-- J. Thomas Landscape Providing all your landscaping needs at a fair price Invoice Date: Invoice Number: 10/12/2003 03-1014 302 North Arch Street Mechanicsburg, PA 17055 Tel: (717) 796-7738 Sold To: David Becknell 185 Wood Drive Mechanicsburg, PA 17055 Item Number 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Description Lawn Mowing on 10-4-2003. Taxable Subtotal PA State Tax Non-taxable Subtotal Total Qty. Price Extended Price I $75.00 $75.00 Terms: Due Upon Receipt $75.00 $75.00 CLASSIFIED ADVERTISING INVOICE Questions ~,; ~rding this invoice call (717) 255-8138 INVOICE NO. CLASS .' '~TART DATE STOP DATE TIMES BILLING DATE {.-,,~c,,,/:[ .q./'O;".-~ To Place your ad Call Classified (717) 255-8121 Tearsheet Request call (717) 255-8417 SIZE I Is BOX CHARGE AFFIDAVIT CHARGE BOLD PRINT AD AMOUNT 1.75 3. O0 ACCOUNT NO. I"- i '"i,~ ~!'., (} C'.{;;'.A'T' D :-:?CRIPTION OR TAG LINE II# J I J#:! 'J:t'l,l:l I I III ACdOI~ITING DEp~h~MENT P.O. BOX 60367 HARR~SBUR, FEE'. ]',)#: 23-1304402 :" ..' ·ACCOUNT NAME' [t~",. '!" E:!:~,, k(AL. )':~ Fl UN E;~, CREDT MEMO DISCOUNTS ADVANCE PAYMENT 11,. 82- ~"-~ 05 TERMS[ DUE UPON RECEIPT INVOICE NO; ACCOUNTI MENT - DO NOT SEND CASH .... ~?'""~:"": .... " ! f~-;;2. 05 MONEY ORDER V SA MASTEROARD AMER OAN EXPRESS AND D SCOVER , ACCOUNT NUMBER EXP. DATE ' ~"J J ~"' ~"~" ~" AMOUNT PAID ~ 14 151 221650 DITHERS TEXACO 4840 OLD GETTYSBURG MECH PA Invoice # 0988816 Date 08x23~O3PM Time 07:29PM Auth # 00023118 VISA Acct# XXXX XXXX XXXX 2328 Pump Gallons Price 07 7.134 $1.679 Product Amount UNLEADED $11.9B Total Sale $11.95 CUMBERLAND LAW JOURNAL 32 SOUTH BEDFORD STREET CARLISLE, PA 17013 SEPTEMBER 19, 2003 Cumberland Law Journal is published every Friday by the Cumberland County Bar Association and is designated by the Court of Common Pleas as the official legal publication for Cumberland County and the legal newspaper for publication of legal notices. TO: Mark E. Halbruner, ESQUIRE RE: William D. Becknell. ESTATE Legal advertisements must be received by Friday Noon. All legal advertising must be paid in advance. Make all checks payable to: Cumberland Law Journal. Advertisement inserted on following dates: SEPTEMBER 5, 12, 19, 2003 Advertising Cost $ 75.00 Proof of Publication $ 0.00 Second Proof Request $ 0.00 Payment Received $ 75.00 Total Amount Due $ 0.00 Payment received _ September 3, 2003 by Becky H. Morgenthal/Executive Director Invoice Date: Invoice Number: 302 North Arch Street Mechanicsburg, PA 17055 Tel: (717) 697-7145 Fax: (717) 697-7146 Item Number 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 3. Thomas Landscape Providing all your landscaping needs at a fair price Description Lawn Mowing on 9-15-2003. Taxable Subtotal PA State Tax Non-taxable Subtotal Total 9/16/2003 03-1013 Sold To: David Becknell 185 Wood Drive Mechanicsburg, PA 17055 Qty. Price $65.00 Terms: Due Upon Receipt Extended Price $65.00 $65.00 $65.00 PAY TO THE ORDER OF ESTATE OF WILLIAM D BECKNELL DAVID D BECKNELL EXECUTOR CHARLES H BECKNELL EXECUTOR 11238 GARNERS FERRY RD EASTOVER, SC 29044 (80~353,~ 094 /j ~ W~Om Wachovia Bank, N.A. ACH R/-r 031000503 MEMO ~ 3-- / 0 / 3 ~"0 t ]'OOO 50 ~"-' i~OOO0 ], i~ ~. E E r= 5 q,' J. Thomas Landscape Providing all your landscaping needs at a fair price Invoice Date: Invoice Number: 9/6/2003 03--1012 302 North Arch Street Mechanicsburg, PA 17055 Tel: (717) 697-7145 - Fax: (717) 697-7146 Sold To: David Becknell 185 Wood Drive Mechanicsburg, PA 17055 Item Number 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Description Lawn Mowing on 8-31-2003. Taxable Subtotal PA State Tax Non-taxable Subtotal Total Qty. Price I $65.00 Extended Price $65.oo $65.00 $65.00 Terms: Due Upon Receipt NAM E ADDRESS Camp Hill, PA 17011 (717) 761-6337 (717) 657-9545 · (717) 258-9797 Fax (717) 975-0411 LOCK & KEY. This is an original invoice #2s- 6s0s39 NO 073276 LPHONE WORK COMPLETED AT ~ [~ '~BT'.:, ,~,,-, CKSMI H TE .~ PO# ~ AMOU.¢-- __~ SERVICE CHARGE & ~BOR DEADBOLTS (~P E~ KEY & KNOBS (TYPE) CUSTOMER'S TOTAL / ~ TO 1~ SERVICE C GE MONTHLY. M/N/MUM CHARGE $.50. ~~ SIGNATURE ABOVE AUTHORIZES SECURITY/EMERGENCY SERVICE. I hereby ce~i~ / that I have the authority to order the lock, key or security work designate~ above. Fu~her, YOU I agree to absolve the locksmith who bears this authorization from any and all claims · arising from the pedormance of such work. ~ 03-631M1S File No. 03-631 M1S ********* INVOICE********* File Number: 03-631M1S Summay Appraisal Report Mark E. Halbruner Esq. 1013 Muma Road, Suite 100 Lemoyne, PA 17043 Borrower: Invoice #: Order Date: Reference/C ase #: PO Number: William D. Becknell Estate 03-631 M 1S September 30, 2003 03-631M1S 185 Woods Road Mechanicsburg, PA 17050 Appraisal Invoice Total State Sales Tax @ Deposit Deposit Amount Due 300.00 $ 300.00 $ o.oo ($ ($ $ 300.00 Terms: Balance due upon receiptof invoice add15% fee if paid 30 Days past receipt. Please Make Check Payable To: Mark E. Hilbert & Associates 14 North Walnut Street Mechanicsburg, PA 17055 Fed. I.D,#: 23-2391423 TO INSURE PRPOER CREDIT PLEASE RETURN A COPY OFTHISINVOICE WITH YOUR PAYMENT. CAPITAL 7 CAPITAL SELF STORAGE 5;160 E. TRINDLE ROAD, ME.CHANICSBURG, PA I?0S0 (?17) 691-8800 Name SELF STORAGE Date --" :-' '--- - Unit # Address City. Email Phone Driver's License# -, State .Zip_ Bus./Cell Phone State · -~. - Fax # .? , SS# Pin # PRO RATE Days , Month(s).__ ADVANCE PAYMENT AND SECURITY DEPOSIT Tax Misc Discount Security Deposit : ,:'.._,5 ,' Total Amount LEASE AGREEMENT-THIS IS A LEGALLY BINDING CONTRACT . ;. "': -2~ - <::--' -- It is between CAPITAL SELF STORAGE - MECHANICSBURG, THIS LEASE is made on ': ---- -' · 5160 E. Trindle Road, Mechanicsburg, PA 17050 referred to as "OWNER" and ~i:~7 ~! i.~//~? C' , ': ~: ';~ ,L A~ _ ' ~- referred to as "OCCUPANT:' OCCUPANT's address and identification is listed above. 1. LEASE. OCCUPANT agrees to rent from OWNER a storage space designated as UNIT ,..9~/ ~. (referred to as the "UNIT") at the Capital Self Storage - Mechanicsburg facility at 5160 E. Trindle Road, Mechanicsbu.rg, PA 17050. This Lease begins today. OCCUPANT agrees to pay $ <v< ~x ~ as rent and sales tax for the UNIT from today through ~'? ~' ']~r~ ~:" ' :' ~ . This Lease automatically renews on ' -.: ...... ~.*" for an additional period of one mo,nth, and,s° on from MONTH to MONTH. Each renewal is subject to the terms of this Lease. OCCUPANT agrees to pay rent for the month of !, L; '- / c-, ' t:7'~"' today. 2. RENT AMOUNT. OCCUPANT agrees to pay rent for the UNIT as follows: MONTHLY RENT $ / z2- ' . ................... -" ~ L5 / '""t,, 6% SALES TAX $ / TOTAL COST PER MONTH $ {' ~, ~.: NEXTDUEDATE: -/ C" - , .; "';' ! ' / ? , 2.5 OWNER can change the amount of rent 15y~givirrg OCCUPANT thirty (30) days notice. 3. DUE DATE & LATE CHARGES. The monthly rent and tax are due ON OR BEFORE THE FIRST DAY OF EACH MONTH. OWNER does not have to ask OCCUPANT to pay the rent. OCCUPANT will pay LATE CHARGES if the rent payments are late. The LATE CHARGES are as follows: Rent Received After The 5th day of the month 12th day of the month 20th day of the month Late Charge $7.00 $14.00 $21.00 All rents are payable to'C-APITAL-SEL_~F STORAGE - MECHANICSBURG, at 5160 E. Tfindle Road, Mechanicsburg, PA 17050. Rent paylnents are not refun'd'able. : 4. MOVING OUT. OCCUPANT can move out of the UNIT and end this Lease at the end of any month as long as OCCUPANT gives OWNER W[!t~¢n._/i~fic~.~-lfihst ~en (10) days before the end of the month. If OCCUPANT moves out without giving the ten (10) day notice, OCCUPANT will pay a $25.00 CHARGE. If OCCUPANT does not remove the lock and all property from the UNIT before the first day of the month, then OCCUPANT owes rent for the entire month. OCCUPANT will not move out without paying all rent and other charges due OWNER. OWNER can end this Lease and require OCCUPANT to move out at the end of any month by giving OCCUPANT ten (I 0) days notice. 5. SECURITY DEPOSIT. OCCUPANT has paid $ }~'f ~7 "' ' to OWNER as a security deposit. OWNER does not have to keep this deposit separate from OWNER's other funds. OWNER can take money from the deposit to pay any damages caused by OCCUPANT and to pay any rent, late charges or any other charges or fees owed by OCCUPANT to OWNER. If after taking ont for damages, ('LASSIFIED A[)VERTISING INVOICE Questions .~q,rding this invoice call [717) 255-8138 BILLING DATE To Place your ad Call Classified (717) 255-8121 Tearsheet Request call (717) 255-8417 INVOICE NO. cLAss START DATE ' STOP DATE TIMES SIZE I i ,,:,b ,,J,,:, ' I 301N C,[3./ 3,;.i;./':-'.) 3 ,'h'":'~' z .... ' ....... ' BOX CHARGE AFFIDAVIT CHARGE BOLD PRINT A'FrENTION GETrER DEBIT MEMO CREDIT MEMO AD AMOUNT I'$ DISCOUNTS 1.75 3; O0 ACCOUNT NO. D :::,CRIPTION OR TAG LINE ADVANCE PAYMENT 1 ~:: ..... TERMSI DUE L,~PON RECEIPT I ACdC UI~ITING DEP/~hTMENT P.O. BOX 60367 HARRISBURG, PA 17106;0367 FEE. 1, if. 23-1304402 ! ~. ~. 0.5 MONEY ORDER, VISA, MASTERCARD, AMERICAN EXPRESS AND DISCOVER. g ~h"}" E. 5-~ :. · .~, ', .... Iii!' ACCOUNT NUMBER EXP. DATE 14 151 221650 DITMER$ TEXACO 4540 OLD OETTYSBURG MECH PA Invoice # 0988816 Dote 05~23~03PM Time 07~29PM Au~h # 00023118 VISA A¢¢~ # XXXX XXXX XXXX 2328 Pump Gallons Price 07 7.134 $1.679 Product Amoun~ UNLEADED $11.98 Totol Sole $11.98 CUMBERLAND LAW JOURNAL 32 SOUTH BEDFORD STREET CARLISLE, PA 17013 SEPTEMBER 19, 2003 Cumberland Law Journal is published every Friday by the Cumberland County Bar Association and is designated by the Court of Common Pleas as the official legal publication for Cumberland County and the legal newspaper for publication of legal notices. TO: Mark E. Halbruner, ESQUIRE RE: William D: Becknell. ESTATE Legal advertisements must be received by Friday Noon. All legal advertising must be paid in advance. Make all checks payable to: Cumberland Law Journal. Advertisement inserted on following dates: SEPTEMBER 5, 12, 19, 2003 Advertising Cost $ 75.00 Proof of Publication $ 0.00 Second Proof Request $ 0.00 Payment Received $ 75.00 Total Amount Due $ 0.00 Payment received _ September 3, 2003 __ by Becky_ H. Morgenthal/Executive Director Invoice Date: Invoice Number: 3. Thomas Landscape Providing all your landscaping needs at a fair price 9/16/2003 03-1013 302 NoFLh Arch Street Mechanicsburg, PA 17055 Tel: (717) 697-7145 Fax: (717) 697-7146 Sold To: David Becknell 185 Wood Drive Mechanicsburg, PA 17055 Ire m Number 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Terms: Description Lawn Mowing on 9-15-2003. Taxable Subtotal PA State Tax Non-taxable Subtotal Total Due Upon Receipt Qty. Price Extended Price ! $65.00 $65.00 $65.00 $65.00 ESTATE OF WILLIAM D BECKNELL 3-so-3~o 1012 DAVID D BECKNELL EXECUTOR CHARLES H BECKNELL EXECUTOR 11238 GARNERS FERRY RD EASTOVER, SC 29044 ! PAY TO'~-IE ~ (80~'~3532 094 ~ ORDEROF /. /~~ Waoho~a Bank, N.A. ACH R/T 031000503 ~:O 5 ~OOO 50 5~: 80DOD ~ ~ 5~g& 5q,' ~O~ Invoice Date: Invoice Number: 302 North Arch Street Mechanicsburg, PA 17055 Tel: (717) 697-7145 Fax: (717) 697-7146 Item Number 1 2 3 4 5 6 7 8 9 10 11 12 13 15 16 17 18 19 20 ]. Thomas Landscape Providing all yOur landscaping needs at a fair price Description Lawn Mowing on 8-31-2003. Taxable Subtotal PA State Tax Non-taxable Subtotal Total 9/6/2003 03-1012 Sold To: David Becknell 185 Wood Drive Mechanicsburg, PA 17055 Qty. Price 1 $65.00 Extended Price $65.00 $65.00 $65.00 Terms: Due Upon Receipt Pilot #e55 Dunn NC Invoice # 88S3244 Date 18/27/83 Time 12:83PM Auth # 8863244 VI Acct# 4XXXXXXXXXXXS~38 Exp. Date 89/05 Pump Gal lons Pr ice 87 43.414 $! .449 Pro4uct Amtount Unleaded $62.91 T°tal Sale $62.91 SALE - Card S~iped APPRVD # 824223 Refer # 8863244 Unit #88817474 Su bwa y FLYING J TRAVEL PLAZA 1-95 Exit 184 Crml Chrch, VA 22546 18/26/2883 21:22:49 Invoice # 118N5658 BECKNELL DAVID Payment: VISA XXXXXXXXXXXS6939 Auth # 834556 Pump: 81 UNLEADED Quantity 48.8?9 Price 1.349 Amount 54.87 Total Amt. 54.87 Great Deals On Line IJNl~. FLY INGJESTORE · CO Et/ANt:; t~02 530? Ca~i'~'~'' Pike Mechan~c,~burg, PA ViSA XXX××XXXX×XX6s39 !SSU~i) lO: BECKNEii DAVID EXP. PARE: 09/05 AUI'H, ~: 014909 :i !HANK YOU FOR VISii[NG , BOB EVANS * , Mechanicsburg, FA , ~,try Market ; 95 Exit 104 Car,'~e! : ,u'-ch. VA 22546 ~ x.,j4 ) 448 -98 t5 10-26--2003 1,.~:b5:55 ir,voice ~: 41048744 RESTALIR¢,N i Table: 5 ,:stomer COUr~t: 3 Set vet: T i sf':a ,.:.¢st~i er': [ aL;Fen baser ~1)~ i ,.,;, 1.29 Iced Tea .......... 1.49 Sub-T c, tai I9.56 I. 66 SBI es Tax 2~. 22 lot. al Re. -taura~ ,~. Total Pu' z,~ 21.22 ADOtJrlt ~.;xlel-e: V~S~ ~',~,.', ,- ~',,~.X-~o~ 2~.22 Change O. O0 ~tFreque ~ Fue;~, Ea~'t", Points on Rest aOramt pur'ct-as~s :,.,, er' how, DOB EVANS ,,-x~~, cs[~l AVl5 ,Avis System Licensee ;',:;2f, .: ? :. "' ,. & Trip Details Page 1 of 3 Trovelocitq' Home Flights Hotels Cars/Rail Vacations Cruises Last Minute Deals Guides & Advice ', ._M_y_~tu_ff_ Help {~ Hotels I Deals Tools for your Trip ~ _.D_e. stin ati_p_n_ G u_!~_e (~ Maps _~_~__a..th e_r _C_qn__cjerge__.~__e_~[C__es_. ~ Tours & Activities Restaurant ~e_ ~_e_. _ry. _a_t_ig. n _s Trip Details search select purchase Please print this page for your records. This itinerary has been e-mailed to you at: DAWAAU@BELLSOUTH.NET Your Travelocity Trip ID is: 746776666779 Itinerary for: DAVID BECKNELL CHARLES BECKNELL Please reference the Trip ID 746776666779 anytime you contact the Customer Service Center. 'r may be a penalty and/or an additional charge for changing a reservation, if your ticket is eligible fc changes. Customer Service Center: In the United States call 888-709-5983 (En Espafiol 7am-11pm: 866-8: 3933, TDD/Hearing Impaired: 800-555-7585). Outside the United States call 210-521-5871. Your Trip Details Flight(s): Fri, October 24, 2003 V].j/ Flight: United Airlines flight 7342 operated by UNITED ...... EXPRESS/ATLANTIC COAST (Non-Stop) Depart: Columbia, SC (CAE) - Terminal Information Unavailable Fri, Oct 24 at 6:25am Arrive: Washington DC-Dulles (lAD) - Terminal Information Unavailable Fri, Oct 24 at 7:46am Seats: 9B, 9C (Canadair Regional Jet) Freq. Flyer: UA 03118567489 Meal: No Meal Served Status: Confirmation Code ID SHJHZ0 ~ Flight: United Airlines flight 7435 operated by UNITED ...... EXPRESS/ATLANTIC COAST (Non-Stop) Depart: Washington DC-Dulles (lAD) - Terminal Information Unavailable Fri, Oct 24 at 8:40am Arrive: Harrisburg INTL, PA (MDT) - Terminal Information Unavailable Fri, Oct 24 at 9:30am Seats: 10B, 10C (Canadair Regional Jet) Freq. Flyer: UA 03118567489 Meal: No Meal Served Status: Confirmation Code ID SHJHZ0 Car: Fri, Oct 24 - Sun, Oct 26 Car Company: Avis Rent A Car Car Provider: AVIS RENT A CAR Car Type: Compact Car Automatic with Air Conditioning Mileage: Unlimited Pick-up: Harrisburg INTL, PA - Fri, Oct. 24 at 10:00am FlighJ _F!~hJ https://dps 1 .travelocity. com/hotsreview.ctl?SEQ= 106684381833471010222003 &LANG=EN 10/22/2003 Trip Details Page 2 of 3 8 Brands. Over 3,500 Locations. One Click. Drop-off: HarrisbUrg INTL, PA - Sun, Oct. 26 at 5:00pm Status: Confirmation Code O 15089614US1 Hotel: Fri, October 24, 2003 Hotel: Check-in: Check-out: Room: Policy: ~OW ~ATES GUA~ COMFORT INN WEST Comfort Inns 6325 CARLISLE PIKE US 11 MECHANICSBURG PA 17050 Fri, Oct 24 Sun, Oct 26 1 room, 2 nights ~)~ This hotel has been prepaid. Please print this page if you require a receipt. The rate below is based on double occupancy unless otherwise noted. Charges for extra persons and I or children may apply and will be due directly to the hotel. Guaranteed Late Arrival Any incidental charges such as extra person fees, parking, phone calls, room service or energy surcharges will be handled directly between you and the property. Cancellation Policy Status: · Bookings are subject to a $25.00 USD fee for any cancellation or change. · If cancellation occurs within 24 hours of check-in, 1 night charge will be assessed. · Any changes made within 24 hours of check-in, 1 night charge may be assessed. · For cancellation and change purposes, check in date is considered to be 12:01am Central Standard Time of the day on which you are scheduled to check in to your hotel. · For questions regarding your hotel reservation, pleaSe contact Travelocity Customer Service at 888-709-5983 Confirmation Code O 56732274 Questions about this reservation? Call 888-709-5983 (210-521-5871 if( the U.S. or Canada). Hotel Price Summary Hotel Guests ~ 2 adults Night Rate Per Night Fri, Oct 24 78.99 Sat, Oct 25 78.99 /9[~ ~"C-/ ~ ~;~ ,.~ 157.98 Car Price Summary - Prices shown in USD Drivers Rental Charges I~ 1 adult over 25 74.94 Total: USD Taxes/Fees Tot; 20.72 Taxes & Fees Drop Charge Totall 19.49 0.00 USD *TotalPriceTM is based on information available at the time of booking. Charges for optional services, fuel, insurance waivers, etc included. Charges for additional or underage drivers may be levied if applicable. These additional fees or surcharges may apply. Rental Policies for additional information and restrictions. Any currency conversion for the above rates are based on today's excl- The actual price may be different. Airfare Summary - Prices shown in U.S. dollars Total: USI' Travelers Price per person Taxes & Fees Total Price https://dps I .travelocity.com/hotsreview.ctl?SEQ= 106684381833471010222003 &LANG=EN 10/22/2003 Trip Details Page 3 of 3 E3 2 adults Service Fee F!jg b t_ P rp_te.c_tj q~. 169.30 32.70 404.00 10.00 10.00 2@14.95 29.90 Total of non-air charges: 39.90 F~//~_ ~/~_~Trip Total: 443.90 Flight Protection Information You have added the _FJ_ig.h__t_P_r_o_t_.e_cti_o_..n__~J_an_ to your arrangements for the following passengers: Name 1: DAVID BECKNELL Name 2: CHARLES BECKNELL The flight protection plan includes reimbursement up to your total flight cost should you need to c; your flight or interrupt your trip for covered reasons. It also includes up to USD 100,000 of flight insurance. The protection plan cost is non-refundable. Please be sure to print out the full Descript Coverage to take it with you when you travel. Questions about your coverage? Contact us in one of the following ways and reference policy 9500394: · Call us at 800-453-4031 · Complete the online inqgi_ryform · Or e-mail us at Lr_ayelo_cj_ty~_._berJ~__eJy..;c_o__m_ Conqratulations! Click here to claim vour Special Reward from Connections for vour bookinq today. Home Flights Hotels Cars/Rail Vacations Cruises Last MinuteDeals Guides&Advice Customer Care © 2002 - 2003 Travelocity.com LP. All rights reserved. Travelocity~, Traveiocity.com® and the Travelocity skyline logo are trademarks and/or service marks of Travelocity.com LP. Use of this Web site constitutes acceptance of the Travelocity ~_ser _A_g.[_e_e_~_e.[/! and https://dp s 1 .travelocity.com/hotsreview.ctl?SEQ= 106684381833471010222003 &LANG=EN 10/22/2003 Penn Waste, Inc. P.O. Box 3066 York, PA 17402 Phone (717) 767-4456 Fax (717) 767-4285 RESIDENTIAL Invoice I' ,ber: 150131 Page Number: 1 Date: Sep-01-03 Customer Number: 016198 Site Number: 0000 BECKNELL, WILLIAM D 185 WOODS DRIVE MECHANICSBURG, PA 17050- Remittance Amount: 36.70 Check Number: l O~q Code Description PLEASE DETACH AND RETURN WITH PAYMENT Date Reference Quantity Amount 15 32.00 (0001) BECKNELL, WILLIAM D 185 WOODS DRIVE Curbside Trash & Recycling 01 Oct03-31 Dec03 31 Dec ESTATE OF WILLIAM D BECKNELL 3-s~3~o 10 0 9 DAVID D BECKNELL EXECUTOR CHARLES H BECKNELL EXECUTOR 11238 GARNERS FERRY RD DATE EASTOVER, SC 290~ (803) 353-1094 PAY TO ~E ~ WAC~Om 36.70 0.00 0.00 0.00 ~ Total Due: A LATE FEE WILL BE CHARGED TO ALL PAST DUE ACCOUNTS Invoice Number: Page Number: Date: Customer Number: Site Number: Reference: 36.70 150131 1 Sep-01-03 016198 0000 Notes: PLEASE PAY BY OCTOBER 6, 2003 TO AVOID $10.00 LATE FEE EFFECTIVE 10/1/03 - YOU MAY SIT OUT 1 LARGE ITEM PER WEEK 1.00 36.70 36.70 Penn Waste, Inc. * P.O. Box 3066 * York, PA 17402 Penn Waste, Inc. Telephone: (717) 767-4456 * EIN#: 23-3030774 PA REV-1500 SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES and LIENS ,O-V of the Treasuny .evenue Service (99) Your social security number (SSN) 251-76-6388 4 Your first name, initial, and last name Wittiam D Becknelt OMB No. 1545-0074 2003 Payment Voucher "Do not staple or attach this voucher to your payment or return. 2 If a joint return, SSN shown second on your return 3 Amount you are. paying by ch.ecK or money oraer 4,666. If a joint return, spouse's first name, initial, and last name Home address (number and street) 185 Woods Drive Apt no. City, town or post office Mechanicsbur§ State ZIP code PA 17055 BAA FDIA8601 08/28103 ........ -~-Detach Her~ a-~ I~ai-'J ~'Vit-h-Y;u~ ~a~ment and-R~t~r~ ~ .... Mail Form 1040-V (federal tax payment voucher) to the address listed below. Internal Revenue Service Center P.O. Box 80101 Cincinnati, OH 45280-0001 PA-40 - 2005 Social Security Number 0300217106 251766388 Name(s):William D Beckne~l L_ 12 Pennsylvania Tax Liability. Multiply Line 11 by the rate shown on the Form PA-V instructions. 13 Total Pennsylvania Tax Withheld. See the instructions. 14 Credit from your 2002 Pennsylvania Income Tax Return. 15 2003 Estimated Installment Payments. 16 2003 Extension Payment. 17 Nonresident Tax Withheld from your PA Schedule(s) NRK-1. (Nonresidents only) 18 Total Estimated Payments and Credits. Add Lines 14, 15, 16, and ]7. TAX BACK/Tax Forgiveness Credit. 19a Filing Status: 01 Unmarried or Separated 02 Married 03 Deceased 19b Dependents, Part B, Line 2, PA Schedule SP 20 Total Eligibility Income from Part C, Line 11, PA Schedule SP. 21 TAX BACK/Tax Forgiveness Credit from Part D, Line 16, PA Schedule SP. 22 Resident Credit. Submit your PA Schedule(s) G and/or RK-1. 23 Total Other Credits. Submit your PA Schedule OC. 24 TOTAL PAYMENTS and CREDITS. Add Lines 13 and 18, 21, 22, and 23. - 25 TAX DUE. If Line 12 is more than Line 24, enter the difference here. 26 Penalties and Interest. See the instructions. 27 TOTAL PAYMENT. Add Lines 25 and 26. 28 OVERPAYMENT. If Line 24 is more than the total of Line 12 and Line 26, enter the difference here. The total of Lines 29 through 35 must equal Line 28. 2.9 Refund - Amount of Line 28 you want as a check mailed to you. Refund 30 Credit - Amount of Line 28 you want as a credit to your 2004 estimated account. 31 Amount of Line 28 you want to donate to the Wild Resource Conservation Fund. 32 Amount of Line 28 you want to donate to the United States Olympic Committee. 33 Amount of Line 28 you want to donate to the Governor Robert P. Casey Memorial Organ and Tissue Donation Awareness Trust Fund. 34 Amount of Line 28 you want to donate to the Korea/Vietnam Memorial, Inc. 35 Amount of Line 28 you want to donate to Breast and Cervical Cancer Research Fund. 12 13 14 15 16 17 18 19a 19b 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 00 00 922 921 0 0 0 0 0 0 0 0 0 921 1 0 0 0 0 0 0 0 0 Your Signature Date Spouse's Signature, if filing jointly Date Preparer or Company Name, o~er than ~xpayer(~, ~sed on all in~rmati~ of which the preparer has any knowledge, ~lease Prin0 Gates, Halbruner & Hatch, PC Date 1013 Mumma Rd. Suite 100 Lemoyne PA 17043 04/08/04 IPreparer telephone number (717) 731-9600 PAIA0412 01/07104 0300217106 0300217106 0300117108 251766388 BECKNELL WILLIAM 185 WOODS DRIVE MECHANICSBURG PA-40 - 2003 Pennsylvania Income Tax Return ENTER ONE LETTER OR NUMBER IN EACH BOX Do Not Use Your Preprinted Label D Occupation E Q U I P M E N T Occupation PA 17055 21160 D N Extension. Amended Return. Residency Status. PA Resident/Nonresident/Part-Year Resident: from to Single/Married, Filing Jointly/Married, Filing Separately Final Return/Deceased Date of Death 0 819 0 3 Farmers, 1 a Gross Compensation. Do not include exempt income, such as combat zone pay and qualifying retirement benefits. See the instructions. Unreimbursed Employee Business Expenses. Net Compensation. Subtract Line ] b from Line Interest Income. Complete and submit PA Schedule A, if over $2,500. Dividend Income. Complete and submit PA Schedule B, if over $2,500. Net Income or Loss from the Operation of a Business, Profession, or Farm. LOSS 10 5 Net Gain or Loss from the Sale, Exchange, or Disposition of Property. LOSS 6 Net Income or Loss from Rents, Royalties, Patents, or Copyrights. LOSS 7 Estate or Trust Income. Complete and submit PA Schedule J. 8 Gambling and Lottery Winnings. 9 Total Pennsylvania Taxable Income. Add only the positive income amounts from Lines ]c, 2, 3, 4, 5, 6, 7, and 8. DO NOT ADD any losses reported on Lines 4, 5, or 6. Medical Savings Account. CAUTION. Do not deduct medical expenses or insurance. See the instructions. 11 Adjusted Pennsylvania Taxable Income. Subtract Line 10 from Line 9, PAIA0412 01/07/04 0300117108 FC la 32909 lb 0 lc 32909 2 20 3 0 4 0 5 0 6 0 7 0 8 0 9 32929 10 0 11 32929 0300117108 Silver S~,, ~ng Ambulance & Rescue A~oociation P.O. Box 726, New Cumberland, PA 17070-0726 717 214-6018 Toll Free 877 214-6018 Patient name: BECKNELL, WILLIAM D. WILLIAM D. BECKNELL 185 WOODS DRIVE MECHANICSBURG, PA 17055 Patient SSN: 251-76-6388 Run number: 03-5749 Date of call: 6/29/2003 Time of call: 17:50 Caller: From: RESIDENCE To: Holy Spirit Hospital Primary payor: PA Federal Blue Cross R58732338 Secondary payor: Bill Patient Description Basic Life Support Emergency Mileage Oxygen Payment - Check Check# Quantity Unit price Payment date Amount 1 390.00 9 7.50 1 45.00 1 9/17/2003 390.00 67.50 45.00 -226.13 PLEASE PAY THIS AMOUNT: $276.37 PPL Electric Utilities Electric Service For: WII. LIAM BI,.'('K NEI.I. 185 W(I(')IX'; I)R MECHAN1CSBURG I'A 17i}5L1 Questions al)out this bill'! l'lcase contact us by Aug 28 at 1-800-34~-5775'~ or 484-634-49t)0 or write Cuslomcr Service 827 Iiausman Rd. Allenlown, PA 18104-9392 www.pplweb.eom Summary Page Balance t~ of Aug 7, 2003 $ 0.00 (.har~es. TotaFPPL EI,E(?II~IC I JTILI'IIES Charges $ 98.07 Tottfl Charges $ 98.07 -: :[ :::;: :]( .; .: :::: .:.: '::: - : . : ; : . :: · .::: :':-.:../: : ~ ': Account Bahmce Electric Use This graph shows your ~zleclric use over lhc ktsl 13 tllOlllh$. VeP e s of ler Readings: Aclual l Estimated ~ Customer [---] KWH - Average Per Day Meter Reading lnl'ormation 42 [Meter #242Z9447 1 I Augc 7 Actual ~49 35 l Jul 9 Aclual ~74 28 [29 Days KWH Billed ~ Average - Aug 20t}2 2003 21 Temperalure 781: 74F KWH Per Day 24 41 14 Yearly Use: Total Average Usc'Monthly 7 Sop 200l - Aug 2002 5810 484 0 Sep 20(12 - Au~ 2003 "7171 598 ASONi) J FMAMJ JA 20(}2 Months 2(1(13 Olhcr important inlbrmation on back PPL Electr,. pPI I Utilities '" Page I 60 60 75 !4 .... Electric Service For: WILLIAM BECKNELL 185 WOODS DR MECHANICSBURG PA 17050 Summary Page B',dance as of Sep 8, 2003 $ 0.00 Char~es: Total-PPL ELECIRIC UTILI'I1ES Charges $ 92.72 Total Charges $ 92.72 Account Balance $ 92.72 Questions about this bill? Please contacl us by Sep 29 at 1-800-342-5775 or 484-634-4900 or write to: Customer Service 827 Hausman Rd. Allentown, PA 18104-9392 www.ppiweb.com Electric KWH- Average Per Day Mete,' Reading Inl'ormation ESTATE OF WILLIAM D BECKNELL DAVID D BECKNELL EXECUTOR 3-50-310 1011 CHARLES H BECKNELL EXECUTOR 11238 GARNERS FERRY RD DATE EASTOVER, SC 290~ __(803) 353-1094~ ~ / - DOLLARS ~ WAC~O~ o Wachovia Bank, N.A. AGH ~ 031000503 IlO t fOOD SD t~: ~OO00 [ ~ thBh Sg,, Return this part to addre~ below wilh a check payable to PPL Elecldc Ulilities Corporation 6o66o_ o 4I I,,,111,,,111,,,,I,1,11,,,,,I,I1,,,I,1,1,11,,,I,,I,,I,1,11,,,I WILLIAM BECKNELL 185 WOODS DR MECHANICSBURG PA 17050 -Z750 3350 2249 1101 2003 74F 34 A verag4 Monthl3 49( 63: Sep 29, 2003 ] $ 92.72 Amount Enclosed PPI. EI.ECTRIC UTII,1TIF. S 2 NORTH 9TIt STREET RPC-GENNI AI,LENTOWN PA 18101-1175 i 8100000927210000092725 6066075014 PATIENT NAME: INSURANCE: Phone #: WEST SHORE EMS - EIVtS 205 GRANDVIEW AVE CAMP HILL., PA 170I 1 (800) 367-0512 Federal Tax ID:,23-2463002 INVOICE i SHORE YMLLIAM BECKNELL FEP R58732338 107025E WILLIAM BECKNELL 1~5 WOODS DR MECHANICSBURG. PA 17055 PATIENT NUMBER: 1 t 884 CALL NUMBER: !07825E DATE OF CALL: 08[30/2003 TIME OF CALL: t2:FJ0 AM CALLER: HO[_'",/ SPIRIT HOSPITAL FROM: HOLY SPIRIT HOSPITA. L TO: H.ARR, c, BUR~ HOSPITAL REASON(S) FOR TRANSPORT Seizure5 IBAL D DESCRIPTION OF CHARGE QUANTITY UNIT PRICE AMOUNT BASE RATE-NON TRANSPORTING t A0427 t.O 442.70 442.70 AMBULANCE B.,,.~E C:HARGE - BLS "f: ...... ~ .~ 34 :o 1.0 387.50 o8~ .50 ALS MILEAGE A- ..,5 . · .b~.=~ 4.0 8 t4 32.58 Oxygen Adh-migration A0422 t .0 48.50 48.50 lDtal Charges 891.26 DESCRIPTION OF PAYMENT RECEIPT PAYMENT DATE AMOUNT DISCOUNT HiGHMARK BLUE SHIELD 08/07/2003 474,28 Insurance Payment- FEP (CONTRAC~ i52181 '144 08i07/2003 375.30 Total Credits PLEASE PAY THIS AMOUNT ~ / 'V PATIENT NAME: INSURANCE: WEST -SHORE Ei¥~ - ALS CAMP H~LL... PA 17011 INVOICE WEST SHORE R587:--;233S 30085@5A BECKNELL FERRY 2ff~344 PATIENT NUMBER: 'i i 884 CALL NUMBER: 3~08505A DATE OF CALL: ,0~':"":"-".":'F'f'i°,_-'., .~ ~., .c,~,., TIME OF CALL: CALLER: FROM: -! ::-I§ '%,/OOF:,S Ei~..~ TO: HOLY SPIRIT HOSFiTA. L REASON(S) FOR TRANSPORT D.APH.DRES, E .' REJ DESCRIPTION OF CHARGE QUANTITY UNIT PRICE AMOUNT BASE RATE-HOi',': TRA['JSPOR'.TI[qG., A0427 1.0 442.70 442.76 Ei<G ELECTRODES A0396 i ?3 4.82 4.02 OP SiTE A0394 f .0 4.47 4.47 ANGiOCATH (14-24) A0394 3.0 4.75 14.25 GLUCOSE BLOOD A0394 20 5.54 1 ! .08 iNFECTiON CON~:OL SUPPLIES A0382 2.0 3.0Q 6.00 ~ ~ ,_4 f.., ~ A03Y4 i .O 7.58 ~ ~'-' NORMAL SAL![',JE 5OOOC A0394 'i.0 22.4 2.84 DEXTROSE 25GM A0394 i .0 8.1§ 8.i9 VALIUM i O!'...4G A0;:~4 ! ri ...... u ..~ iet~.~ Charges 507.07 DESCRIPTION OF PAYMENT RECEIPT PAYMENT DATE /~)~/~ AMOUNT ToKai Credits 0.0,'3. PLEASE PAY THIS AMOUNT --~ PLEASE MAKE CHECK PAYABLE INTERNISTS of Central Pa. -'~ LTD. IRS~23-2146427 Peter M. Brier, M.D. Michael L. Gluck, M.D. James A. Tyndall, M.D. Ira ]. Packman, M.D. Richard Schreiber, M.D., EA.C.E L. Lynne Britton, M.D. Lawrence B. Zimmerman, M.D. Michael A. DeMichele, M.D. Carla J. Dente, M.D. Dominic Mirarchi, D.O. Wendy Schaenen, M.D. Patrick Ratnasamy, M.D. Andrzej R. Walker, M.D. V. Martha Kapoor, M.D. Victoriya K. Abramova, M.D. Dean L. Lehman, PA-C Beth M. Rabedeau, PA-C Michelle L. Latsha, PA-C HARRISVIEW PROFESSIONAL CENTER · 108 LOWTHER ST. · P.O. BOX 107 · LEMOYNE, PA 17043-0107 · (717) 774-I366 FAX (717) 774-4232 10/23/03 25711 6.50 6.50 WILLIAM D BECKNELL C/OESTATE OF WM. D BECKNELL 11238 GARNERS FERRY RD EASTOVER SC 29044 E~PLEASECHANGEADDRESSIFINCORRECT DETACH THIS STUB AND RETURN WITH PAYMENT CHARGES OR PAYMENTS MADE AFTER CLOSING DATE WILL APPEAR ON NEXT STATEMENT ** STATEMENT DUE UPON RECEIPT * THANK YOU ** * Insurance Pending CLOSING ACCOUNT DATE: NUMBER 10/23/03 DAYS :{ 90 DAYS DAYS : ~: TOTAL BALANCE :00 .00 25711 INTERNISTS OF CENTRAL PA. · ]08 LOWTHER ST. · P.O. BOX 107 · LEMOYNE, PA ]7043-0]07 · (7]7) 774-1366 FAX (7]7) 774-4232 HOLY Holy Spirit Hospital 503 N 21ST STREET CAMP HILL PA 17011 717-763-2141 For Account Information, Please Call 717-763-2141 Statement of/ICc°unt 09/04/03 Trnnsa~ion D~e Descri~ion PREVIOUS BALANCE 05/01/05 PERIPH DUPLEX DOP 05/16/05 BC C/A HOSP OP B09 $6! 05/16/03 BC PYNT 0P B09 S61 ....... = TRZCARE Z55 CHAHPVA CENTE B DAVID D BECKNELL EXECUTOR 3-50-3,0 ~J CHARLES H BECKNELL EXECUTOR la 11238 GARNERS FERRY RD D^TE ~'~ ~ ~ - ~ --~_,~ .~, EASTOVER. SC 29044 j~' .^~TOT.~ / /, (~0~) ~S~-~09~ [~ Wacbov~a Sank, N.A. ~ ~ _ ACHR~031000503 ~ ~ ~ YOUR INSU~NCE HAS BEEN BILLED.THIS IS YOUR CURRENT BA~NCE. YOUR PAYME~ IS DUE UPON RECEI~, THANK YOU, B09 361 ,00 ZS3 CHAMPVA CENTE .00 PLEASE DISREGARD THIS STATEMENT IF YOU HAVE PAID. Amount .00 562.00 167.58- 56.qS- qq.Sq- Account Balance: 73.43 Piease detach end return with your HOLY SPIRIT HOSPITAL 503 N 21ST STREET CAMP HILL PA 17011 For Hospital Use Only ADM DT: 050103 DSH DT: *NONE* SB: 21020 717-796-3608 HR: HSG 729.5 Account Number:. Patient Name: Due B~ BECKNELL ,WILLIAM D 09119103 [] Visa [] Mastercard [] D, .... Card Number. F~p. Date: Signature: Amount Paid: Make Check Payable To HOLY SPIRIT HOSPITAL ADDRESS SERVICE REQUESTED I,,,111,,,111,,,,I,1,11,,,,,I,I1,,,I,1,1,11,,,I,,I,,I,1,11,,,I 00007898 I AT 0.292 01 20900221 NILLZAM D BECKNELL 185 NOODS DR MECHANICSBUR6 PA 170S0-2750 I,,,111,,,111,,,,,,11,,,11,,I,1,,I,II1,,,,I,,111,,,,,11,1,1,,I HOLY SPTRZT HOSPZTAL 505 N ZIST STREET CAHP HILL, PA 17011 II '..,I <: :Z "' ortl J..-,m ~- -13 m z--i =:;o:;o-~ m o~ Om 12> RIIstate Wu're in good hands. PAYHENT RECEIPT Allstate Insurance Company Agent Name Northbrook, I]linois Receipt No. · 89932 · Mark Peiper Agent Number · 076106 Agent Address · 5205-F Simpson Ferry Mechanicsburg, PA17050 Bus'i-ness Phone: Bus (717) 795-9808 Payment Date: 8 / 21Z,..29~3~ ....... Payment Time: 08 ,~,..38': 22 Amount Received< 55.49 CHECK Total Received · $ 55:49 · *The above amounts were applied to-the following policy(ies)** Policy/App Number Elf. Date Policy Type Line Amount Applied 000000001442674 01/08 AUTO-VOL 010 $ 55.49 Customer Name/Address WILLIAM D BECKNELL 185 WOODS DRIVE MECHANICSBURG, PA 17055 v-- - ~g¢t Signature ~ To fit 771 DU-O-VUE'~' Envelope, Iold along bottom ol shaded stdp ~ TO Reorder:. 1-800-e.25-6380 or www.nebs.com PRODU~ 107 BATES PUMP SERVICE 3900 Durham Road HARRISBURG, PENNSYLVANIA 17110 [_DUE UPON RECEIPT[ 3 0 3 8 TO Phone 238-5868, TERMS: QUANTITY 1%% per month after 30 days. DESCRIPTI°N ~DATE SALESPERSON VIA · PRICE AMOUNT Tt"uo&' l~en~'al CONFIRMED RESERVATION Confirmation Number WWW 1012 037 DAVID BECKNELL 11238 GARNERS FERRY ROAD EASTOVER, SC 29044 October 12, 2003 Dear DAVID BECKNELL, Thank v,-u for c. boosing Penske Truck Renm~ O,~tlined below are the details of your move. In addition we have noted on the back important information for your rental, to ensure your move is hassle free. o Pick Up On: 10/25/03 10:00 At: CAMP HILL STORAGE (717)975-8808 Hours: SAT 9:00-12 NOON 3960 INDUSTRIAL PARK RD Loc # 4517-33 CAMP HILL, PA 17011 o"Drop Off:On: i0/29/03 At: WESTSIDE SALES (803}49~-'7368 Hours: WED 9:00- 5:00 PM 1430 HWY 441 Loc # 0098-27 SUMTER, SC 29154 Rental Rate (25 Ft Truck with 4 days Travel) $ 769.00 Tow Device None Smart Kart (Quantity = 1) $ 20.00 Furniture Pads (Quantity = 2 dz @ $15.00) $ 30.00 LDW (Optional) $ 72.00 PAl/Cargo (Optional) $ 24.00 Environmental Recovery Fee $ 5.00 Estimated Sales Tax 8.000% $ 79.68 Total Charge (Pay Mthd VISA) $ 999.68 if you are paying by' cash or money. order mn additional. $ !00 d~osi.t.is r~uired by 10/15/03 at your pick up location to guarantee your truck arid the'rate 'quOted. If Payingby credit card, the cardholder must be present for an imprint and signature. If you need to change your rental, please contact us at 1-800-664-1761. It is our pleasure assisting you with your upcoming move. Sincerely, INTERNET RESERVATI Moving Specialist We require 3 forms of identification in order to rent a truck. Acceptable forms of identification include: Driver's License, State Issued ID, Passport, Social Security Card, :)]Vehicle Registration, Phone Bill, Military ID and Credit Cards. Under no circumstances will a truck be released without this identification. Penske Truck Rental is a service of Penske Truck Leasing Co. PENSKE TRUCK LEASING CO. / ROUTE 10 GREEN HILLS / P.O. BOX 391 / READING, PA 19603-0391 TELEPHONE: (800) 664-1761 · www.pensketruckrental.com I Ill II1 IIIII Blilllllll Ill PO Do~ 455 IVlanhcim PA 17.545~0455 RETURN SERVICE REQUESTED Credi' Olus Collection Services 2491 Paxton ~t · Harrlaburg PA 17110-1010 (717) 61M-7742 or (800) 814-6546 Phone Hfs: Mon Bam- gpm, Tues. Barn - 5pm, We~ earn - 9pm, Thur ~nd Friday 8am - Spin, Sat Barn - 12pm ESP Office Houm: 8;30am - 5pm ESP Moa - Fri, December 16, 2003 285213-1 272469 34790 h,l,lhl,,Ih,,,h,hl,,Ihh .... II,.llll ..... I!,1,,I,1,1,,I William B~ckncll ! 123g Garners Ferry Rd Eastover SC 29044-9110 -I Re: Accoun! #: Client ID #: For: Total Balance: Credit Plus Collection Services PO 8ox 458 Manheim PA 17545-0458 I,,,lll,,,I,l,l,,I,,I,Id,lh,,,h,hhhl,,l',hhh,hh'hl Re: Community Life 3'cam lac Account #: 285213 365887 Client ID #: 4118 For: William Beekncll Total Balance: $188.50 **'PIcaS¢ Dctach Aqd Return The Top Portion O£Th¢ Notice With Your PBymcnt. Community Life Team inc 2852 i 3 365887 4118 William Becknell $188.50 The account listed abovc has been referred to this office for collection. II is to your benefit to pay this claim. Do not neglect your obligation. Ali payments must bc madc directly to this office for prompt credit to your account or call (800) 814-6546 to make arrangements. Unless you notify this office within thirty-days after receiving this noticc that you dispute thc validity of the debt or any portion thereof, this office will assume this debt is valid. If you notify this office in writing within thirty-days from receiving this notice, 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 thirty-days after receiving this notice, this office will provide you with the name and address or the original creditor, if different from the current creditor. This is an attempt to collect a debt and any information obtained will be used for that purpose. This communication is from a debt collector. If requesting a receipt, please enclose a self addressed stamped envelope. All payments must be made directly to the address above. If your check is returned for insufficient funds or closed account, a $25.00 charge will be added to your account. (__) Enclosed is payment in full, ( ) Enclosed is my El VISA or [] MasterCard number: If you wish to pa), by VISA or MasterCard, fill in thc information bclow and return thc entire I~ter to us. Account Number .... Payment Amount Expiration Datc /__ Card Holder Name ' Signature of Card Holdcr Date IDNPLUSDI I _! Credit Plus Collection Services · 2491 Paxton St Harrisburg PA 1711 I - l 010 · Telephone: (717) 664-7742 or (800) $14-6546 PEERL _,SS CREDIT SERx, ICES, INC. P.O. Box 518 * Middletown, PA. 17057 * ph. 717-702-2000 * fax 717-702-2007 Dec 29, 2003 WILLIAM BECKNELL 11238 GARNERS FERRY RD EASTOVER, SC 29044 OU~ ACCOUNT# 177564-1A SEND PAYM~,NT TO: PO BOX 518 MIDDLETOWN PA 17057 AMOUNT ENCLOSED $ cut ~nd retur~ t0~ portion Dec 29, 2003 DEAR WILLIAM BECKNELL, OUR CLIENT INSTRUCTS THIS OFFICE TO RELEASE UNPAID ACCOUNTS TO THEIR ATTORNEY AT THE GUIDA LAW OFFICES. HELP US AVOID THAT FROM HAPPENING BY RESOLVING THIS ACCOUNT TODAY. YOU CAN AVOID YOUR ACCOUNT FROM BEING RELEASED BY SENDING IMMEDIATE PAYMENT OF YOUR BALANCE DUE. IF THAT IS NOT POSSIBLE, WE URGE YOU TO CALL TO DISCUSS A PAYMENT ARRANGEMENT THAT WILL HOLD YOUR ACCOUNT IN OUR OFFICE. THANK YOU, MS. WELLS >>CALL OUR OFFICE IF YOU WOULD LIKE TO PAY BY MC/VISA OR CHECK BY PHONE. >>THIS LETTER IS FROM A DEBT COLLECTOR AND IS AN ATTEMPT TO COLLECT A DEBT. ANY INFORMATION OBTAINED WILL BE USED FOR THIS PURPOSE. YOUR ACCOUNT (S) DUE: Creditor Account # RIVERSIDE ANESTHESIA A$$0 119112 TOTAL ALL YOUR &CCDUNTS ~ITH THIS OFFICE; 0 $ 121.00 INCLUDING THE ABOVE. Regarding Amt Owed Serv Date 1~1.oo o7/16/o~ >>PAY TO: PEERLESS CREDIT SERVICES, INC. * PO BOX 518 * MIDDLETOWN, PA. 17057 >>QUESTIONS TO: 717-702-2000 OUR ACCT~ 177564-1A 90 William D. Beckneli, Estate of c/o David D. Becknell 11238 Garners Feny Road Eastover, SC 29044 Estate Planning Gates, Halbruner & Hatch, P.C. 1013 Mumma Road Suite #100 Lemoyne, PA 17043 (717) 248-6909 Federal I.D. #03-0379998 INVOICE Invoice Date September 12, 2003 Period Ending August 31, 2003 Invoice No. 26074 PAYMENT DUE UPON RECEIPT OF STATEMENT All overdue accounts will be assessed finance charges of 1.5% per month. We now accept the following credit cards for payment: Discover, Mastercard & Visa. Professional Fees 8/8/2003 MEH 8/8/2003 MEH 8/11/2003 MEH 8/12/2003 MEH 8/i4/2003 MEI-I 8/14/2003 TLS 8/15/2003 MEH OFFICE CONFERElqCE WITH MARGARET FITZPATRICK, DAVID BF_L-KN~ I, AND CHARLES BF_CKNE[ I ~, DRAFTED POWER OF ATTORNEY FOR Wn I,IAM BECKN~ l ~. MET WITH BECKNVI I, FAMILY AND MARGARET FITZPATRICK AT ! EI~ANON VA MEDICAL CENTER (INCLUDES TRAVEL TIME). INTER-OFFICE CONFERENCE WITH TLW. CORRESPONDENCE TO MARGARET FITZPATRICK AND DAVID BF_L-KN~ I ~ LEFT VOICE MAIL FOR MARGARET FITZPATRICK. TEl JEPHONE CALL FROM MARGARET FITZPATRICK. DRAFTED WILL AND LETTER OF INSTRUCTION. RECEIVED VOICE MAIL FROM MARGARET FITZPATRICK, LEFT VOICE MAlL FOR MARGARET FITZPATRICK. TH.~HONE CALL FROM MARGARET FITZPATRICK. TH EPHONE CALL FROM MARGARET FITZPATRICK. OFFICE CONFEREnCE WITH MARGARET FITZPATRICK. RECEIVED FED EX FROM SOUTH CAROLINA. OFFICE CONFERENCE WITH DAVID BECKNEI,I ~ CHARLES BECKNEI I, AND MARGARET FITZPATRICK. CONFERENCE WITH TLS. PREPARED FAX; PREPARED AUTHORIZATIONS FOR RFI EASE OF FINANCIAL INFORMATION. O~ SEARCH FOR ADDRESS AND FAX NUMBER OF ! FBANON VA MEDICAL CElqTER. CORRESPONDENCE TO ! EF~ANON VA MEDICAL CENTER WITH COPIES TO ELAINE 1.60 ~ 160.00/hr 2.50 ~ 160.00/hr 1.50 ~ 160.00/hr 0.50 @ 160.00/hr 1.50 ~ 160.00/hr 0.60 ~ 98.00/hr 0.80 ~ 160.00/hr 256.00 400.00 240.00 80.00 240.00 58.80 128.00 Estate Planning 8/18/2003 MEH ~18/2003 TLS Gates, tial~uner & Hatch, P.C. BECKN~ I, AND DAVID BECKN~ I ~. MEMO TO TLS RE: RECORDING POWER OF ATTORNEY. REVIEWED E-MAIL FROM DAVID B~ I, AND RESPONSE FROM TLS. CONFERE2qCE WITH TLS RE: INFORMATION REQUESTED BY DAVID BECKNE[ I ,~ PREPARED POWER OF ATTORNEY FOR RECORDING;, CORRESPONDENCE TO RECORDER OF DEEDS FOR RECORDING OF POWER OF ATTORNEY. 0.20 @ 160.O0/hr 0.70 ~ 98.00/hr Sub-total Fees: Page: 2 32.00 68.60 1,503.40 Expenses 8/8/2003 8/15/2003 Mil' FAGE TO AND FROM VA MEDICAL CENTER POSTAGE. Sub-total Expenses: 29.34 1.20 30.54 Payments 9/12/2003 Payment Trust application. 925.00 Sub-total Payments: 925.00 Trust Account 8/18/2003 8/18/2003 8/19/2003 8/27/2003 9/12/2003 *VOID* William Becknell Reverse Check No. 1290 William D. Beckneil Estate Trust application. Beginning Balance: Ending Balance: 0.00 1,000.00 -31.00 31.00 -75.00 -925.00 Estate Planning Gates, I-Ialbruner & Hatch, P.C. Total Current Billing: Previous Balance Due: Total Now Due: Page: 3 1,533.94 0.00 608.94 Current Over 30 Over 60 Over 90 1,533.94 0.00 0.00 0.00 PLEASE VISIT OUR WEBSITE AT WWW.GATESLAWFIRM.COM Register of Wills Pennsylvania Estate of also known as William D. Becknell Cumberland. County, INVENTORY ., Deceased No. 21-2003-0692 Date of Death 08/19/2003 Social Security No. 251-76-6388 RW-8 Personal Representative(e) of the above Estate, deceased, verify that the items appearing in the following inventory include ail of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. IhNe verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Personal presen~ Attorney: Mark E. Halbruner, Esquire kD. No.: 66737 . _ Address: Gates, Halbruner & Hatch, P.C. 1013 Mumma Rd., Ste. 100, Lemoyne, ~PA 17043 Telephone: (717) 731-9600 Description Real estate located at 185 Woods Drive, Mechanicsburg, PA Members 1st Federal Credit Union; Savings Acct. 44462-00 Miscellaneous personal property Allstate - automobile insurance refund 1995 Chevrolet S10 Truck; VIN1GCCS19Z3SK164641 Worldcom - refund Comcast Cable - refund 1999 GMC Jimmy; VIN GKDT13QlX2551863 Capital self Storage - refund (Attach AdditionalSheetsifnecessary) $ 3,882.86 568.09 500 00 80 57 2,045 00 79 98 10 23 9,925 00 ¥ot81~17' 25 O0 116.73 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DTVTSZON DEPT. 280601 HARR/SBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLO#ANCE OR DZSALLOHANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-16q7 EX AFP (01-05} MARK E HALBRUNER ESQ GATES ETAL 1015 MUMMA RD STE 100 LEMOYNE PA 170~ DATE ESTATE OF DATE OF DEATH FILE NUMBER :i~!COUNTY ACN 07-05-200q BECKNELL 08-19-Z005 21 05-0692 CUMBERLAND 101 Amount: Remi~ad WILLIAM D MAKE CHECK PAYABLE AND REMTT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LTNE ~ RETAIN LOWER PORTTON FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRATSEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BECKNELL WILLIAM D FILE NO. 21 05-0692 ACM 101 DATE 07-05-200q TAX RETURN #AS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATTON CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es~a~a (Schedule A) (1) 2. S~ocks and Bonds (Schedule B) (2) 3. Closely Held S~ock/Par~narship In~aras~ (Schedule C) (3) q. Mortgages~No,es Receivable (Schedule D) (q) $. Cash/Bank Deposits~Misc. Personal Propar~y (Schedule E) ($) 6. Jointly Owned Proper~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To,al AssaYs APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expensas/Adm. Cos~s/M/sc. Expanses (Schedule H) (9) 10. Debts/Mortgage Liab/1/~ies/L/ans (Schedule 1) (10) 11. To,al Daduc~/ons 12. Ne~ Value of Tax Ra~urn 3~882.86 .00 .00 .00 15~235.87 .00 NOTE: To insure proper cradi~ ~o your account, submi~ ~ha upper portion of ~h/s form wi~h your tax payeen~. 35121q.25 (8) 52,550.98 17,588.85 13. lq. NOTE: ASSESSMENT OF TAX-' 1_~. Amoun~ of L/ne lq a~ Spouse1 ra~e 16. Amoun~ of Line Zq ~axable a~ Lineal/Class A ra~e 17. Amoun~ of Line lq a~ Sibling ra~e 18. Amoun~ of L/ne lq ~axable a~ Collateral/Class B ra~e 19. Principal Tax Due TAX CREDITS: PAYMENT RECE/PT DISCOUNT DATE NUMBER INTEREST/PEN PAID (- 05-07-200q CD005915 .00 9,257.2q (ll) 2&.82~.09 (12) 25,50q.89 Chari~:able/Governmen:kal Bequests; Non-elected 9113 Trusts (Schedule J) (13) Ne~ Value of Es~a~e Subjec~ ~o Tax (1~) ~f an assess.ent Has issued previously, 11nes 14, 15 and/or 16, 17, reflect f&gures that /nclude the total of ALL returns assessed to date. .00 25,50q.89 18 and 19 w&11 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL TAX CREDIT 1,1q7.72 BALANCE OF TAX DUEI .00 INTEREST AND PEN. .00 TOTAL DUE . O0 ( ZF TOTAL DUE TS LESS THAN $1, NO PAYMENT ZS REQUIRED. ZF TOTAL DUE IS REFLECTED AS A "CRED/T" (CR), YOU MAY BE DUE ~ A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ~ 1,1~7.72 AMOUNT PAID (1~) .00 X O0 = .00 (16) 25,50q.89 x Oq5= 1,1q7.72 (17) .00 x 12 = .00 (ia) .00 x 15 : .00 (1;)= 1,1~7.72 RESERVATION: Estates of decedents dying on or before December 1Z, 198Z -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the tawful Class S (collateral) rate on any such future interest. PURPOSE OF NOTICE: PAYMENT: REFUND (CA): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section Zl~O of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (7Z P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side. --Make check or money order payable to: REGISTER OF NILLS, AGENT A refund of a tax credit, which was not requested on the Tax Return, may bm requested by completing an "'Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications are available at the Office of the Register of Nills, any of the Z3 Revenue District Offices, or by calling the special Zq-hour answering service for forms ordering: 1-800-36Z-ZO50; services for taxpayers with special hearing and / or speaking needs: i-aOO-qq7-30ZO (TT only). Any party in interest not satisfied with the appraisement, alloaancs, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (603 days of receipt of this Notice by: --written protest to the PA Oapartmant of Revenue, Board of Appeals, Dept. zalogl, Harrisburg, PA 17lza-lozl, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered an this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. ZB0601, Harrisburg, PA 171Z8-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the dscadent's death, a five percent (SZ) discount of the tax paid is alloaad. The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 16, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one fl) day from the date of death, to the date of payment. Taxes ahich became delinquent before January 1, 1982 bear interest at the rate of six (6Z) percent par annum calculated at a daily rate of .00016q. All taxes which became delinquent on and after January 1, 19DZ mill bear interest at a rate which mill vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 19az through 200q ara: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor ~ ZOZ .O005~B 1988-1991 XXZ .OOO3Ol ~ 9X .OOOZq7 1983 16Z .000q38 1992 91 .0002q7 ZOOZ 6X .O0016q 198q 112 .000301 199~-199~ 7Z .000192 2003 51 .0001~7 1985 132 .000356 1995-1998 92 .0002q7 ZOOq qX .000110 1986 101 .O00Z7q 1999 7Z .00019Z 1987 lOX .O00Z7q ZOO0 7Z .O00Zez --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBBR OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. Xf payment is made after the interest computation date shown on the Notice, additional interest must be calculated. PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE FORM 6.12 YEARLY UNTIL COMPLETION. STATUS REPORT UNDER RULE 6.12 Name of Decedent: Date of Death: Will No.: William D. Becknell August 19, 2003 21-03-0692 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: o State whether administration of the estate is complete: Yes If the answer is No, state when the personal representative reasonably believes that the administration will be complete: N/A If the answer to No. 1 is yes, state the following: A. Did the personal representative file a final account with the court? No B. The separate Orphans' Court No. (if any) for the personal representative's account is: N/A C. Did the personal representative state an account informally to the parties in interest? Yes D. Copies of receipts, releases, j oinders and approvals of formal or informal accounts may be filed with the Clerk of Orphans' Court and may be attached to this report. Date: Mark E. Halbmner, Esquire PA I.D. # 66737 GATES, HALBRUNER & HATCH, P.C. 1013 Mumma Road, Suite 100 Lemoyne, PA 17043 (717) 731-9600 Capacity: Counsel for Personal Representative LOWELL R GATES Also Admitted to Massachusetts Bar MARK E. HALBRUNER Also Admitted to New Jersey Bar CRAIG A. HATCH CORY J. SNOOK ALBERT N. PETERLIN Also Admitted to Maryland Bar STACEY L. NACE Paralegal/Office Manager TRACl L SEPKOVIC Paralegal VALERIE LONG Paralegal LAW OFFICES OF GATES HALBRUNER -HATCH P.C. 1013 MUMMA ROAD · SUITE 100 ° LEMOYNE, PENNSYLVANIA 17043 (717) 731-9600 · FAX: (717) 731-9627 August 2, 2004 BRANCH OFFICES: 3 WEST MONUMENT SQUARE, SUITE 304 LEWlSTOWN, PA 17044 (717) 248-6909 2917 NORTH FRONT STREET, SUITE 302 HARRISBURG, PA 17110 (717) 731-9600 WEB SITE: www. GatesLawFirm.com CORRESPONDENCE ADDRESS: Lemoyne Office Cumberland County Courthouse Office of the Register of Wills One Courthouse Square Carlisle, PA 17013 RE: Estate of William D. Becknell Estate No. 21-03-0692 Dear Jackie: Enclosed is the final Status Report for the Estate of William D. Becknell. Please time- stamp the photocopy and return it to our office in the enclosed evenlope. Thank you for your assistance in this matter. Sincerely, Traci L. Sepkovic Paralegal Enclosures cc: David D. Becknell Charles H. Becknell