HomeMy WebLinkAbout03-20-09 (3)15056051058
REV-1500 Ex c08-05) OFFICUIL USE ONLY
PA Deper6rlerlt of Revenue
Bureau of Individual Taxes County Code Yea File Numbs
POBOx280601 INHERITANCE TAX RETURN ~l ®q O ~~5
liarrisbug, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of BiAh
165-20-5111 07/03/2008 09/22/1911
Decedent's Last Name Suffx Decedent's First Name MI
Hamer Hilda M
(If Applicable) Entar Surviving Spouse's Inforrnatlon Bslow
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
• 1. Original Retum 2. Supplemental Retum
3. Remainder Retum (date of death
prior to 12-13.82)
4. Limited Estate 4a. Future Interest Compromise (date of 5. Federal Estate Tax Retum Required
death after 12-12-82)
• 6. Decedent Died Testate 7. Deced®nt Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of death 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRE8PONDENCE AND CONFlDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
Ronald B. Bames (717) 774-2770
Finn Name (If Applicable) tV
REGISTER
~
~ S USE O~
_
C.-._
' ~ ~
First line of address ~ ~ C-~ ~ - `
117 Pin Oak Drive s
--
~
o - =-
~
-
;
Second line of address 1--.~ ~7 ~."'~ -p ~ _
~(7--~ ~ _
~
.
~> C _:
~l N ' "
City Or Post Office State ZIP Code DAT~FI~D _...
New Cumberland
~ PA 17070-2343 W
Cortespondent's e-mail address: r.b.bamesfa~COmcast.net
Under penalties of perjury, I declare that t have examined this return, indudhg accompanying acfredules and statements, and to the best of m
it is true. cored and complete. Declaration of preparer oCier thag fhe sentaUve is based II information of which re star and belief,
P P any kmawllerlge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RErTURN ~ DATE
/~ /J03l18/09
ADDRESS/ ~? ~ /N ~~~ ~2 /C~~iIJ~ !J~'y1J~/=fJL~4NU . ~H ~ ~~ 7/~
SIGNATURE OF PREPARER OTHER THAN REPRESENTATII'/E DATE
ADDRESS
r~e~se use olwc~NA~. Fo~all oN~r
Side 1
15056051058 15056051058
REV-1500 EX
15056052059
Decedents Name: Hilda M Hamer
RECAPITULATION
1. Real estate (Schedule A) ............................................. 1.
2. Stocks and Bonds (Schedule B) ....................................... 2.
3. Ckxely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3.
4. Mortgages 8 Notes Receivable (Schedule D) ............................. 4.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ........ 5.
6. Jointly Owned Property (Schedule F) Separate Billing Requested ....... 6.
7. Inter-Vrvos Transfers 8 Miscellaneous Non-Probate Properly
(Schedule G) Separate Billing Requested........ 7.
8. Total Gross Assets (total Lines 1-7) .................................... 8.
9. Funeral Expenses & Administrative Costs (Schedule H) ..................... 9.
10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule 1) ................ 10.
11. Total Deductions (total Lines 9 8~ 10) ................................... 11.
12. Net Value of Estate (Line 8 minus Line 11) .............................. 12.
13. Charitable and Governmental BequestslSec 9113 Tnists for which
an election to tax has not been made (Schedule J) ........................ 13.
14. Net Value Subject fA Tax (Line 12 minus Line 13) ........................ 14.
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(ax1.2) X .0_ 15.
16. Amount of Line 14 taxable
at lineal rate X .0 _ 3,067.31 16.
17. Amount of Line 14 taxable
at sibling rate X .12 77.
18. Amount of Line 14 taxable
at cdlateral rate X .15 1 g.
19. TAX DUE ......................................................... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
15056052059 Side 2
Decedent's Social Security Number
165-20-5111
6,106.34
7,843.67
0.00
13,950.01
10,882.70
10,882.70
3,067.31
3,067.31
138.03
138.03
15056052059
REY-1500 EX Page 3
Decedent's Complete Address:
Flle Number
DECEDENTS NAME DECEDENTS SOCIAL SECURrrY NUMBER
Hilda M Hamer 165-20-5111
STREET ADDRESS
325 Wesley Drive
CRY STATE ZIP
Mechanicsburg PA 17055
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19) (1) 138.03
2. CreditslPayments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
3. Interest/Pena rf a icable Total Credits (A + B + C) (2)
nY ~ PPI
D. Interest
E. Penalty
Total InteresUPenalty (D + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the diffference. This is the OVERPAYMENT.
Fitt in oval on Page 2, Line 20 to rr3quest a refund. (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 138.03
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 138.03
Make Check Payable to: REGISTER OF W1LLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred :.......................................................................................... ^
b. retain the right to designate who shah use the property transferred or its income :............................................ ^
c. retain a reversionary interest; or .......................................................................................................................... ^
d. receive the promise for life of either payments, benefits or care? .................
2. If death oaxured after December 12,1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. ^
3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? .............. Q ^
4. Did decedent own an Individual Retirement Account, annuity, or other rwn-probate property which
contains a beneficiary designation? ............................................. ^
...........................................................................
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is three (3) percent [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent
(72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-0ne years of age or younger at death to or for the use of a natural parent, an
adoptive parent, or a stepparent of the child is zero (0) percent [i'2 P.S. §9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in
72 P.S. §9116(1.2) p2 P.S. §9116(a)(1)).
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by bklod or adoption.
REV-1508 EX+ (5-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSRS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE t~1MBER
Hilda M. Hamer ~Gt 0 f! D 4 /¢ S
Include the proceeds of litigation and the dale the proceeds were received by the estate.
All properly jofMly.owrred with right of survivorship must be dbdosed on Schedule F.
pt more space is needed, insert additional sheets of the same s¢e)
REV-1509 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCNEDI~LE F
JOINTLY OWNED PROPERTY
ESTATE OF __ FILE NUMBER
Hilda M. Hamer 2LS~~.. Of> /¢s
tf an asset was made joint within one year of the decedsnNs dais of death, H must be reported on SChsdule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A• Jane M. Bames 117 Pin Oak Drive, New Cumberland, PA 17070-2343 Daughter
B.
C.
JOINTLY-OWNED PROPERTY:
ITEM
NUMBER LETTER
FOR JOINT
TENANT DATE
MADE
JOINT DESCRIPTION OF PROPERTY
INCLUDE NAME OF FINANGAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR
IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET %oF
DECdS
INTEREST pATt=pF pE,gni
VALUE OF
DECEDENTS INTEREST
t' A• 1yp~04 PNC Bank Account ~i5004415329
7,843.67 100 7,843.67
TOTAL (Also enter on line 6, Recapitulation) I = 7,843.67
(If more space Ls rN?eded, insert addRional sheets of the same size)
REV-1510 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCNEDIILE 6
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF FILE NUMBER
Hilda M. Hamer ~~Oc~_ ~~ ~4S-
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
fTEM
NUMBE DESCRIPTION OF PROPERTY
uxxuoe nfr wv~ of rre tRArs~, n~a RaATaes-~ ro oECEOarrAwo
TFfDATEOFTRA1~tATfACHACOPYOFTFiED®FORREALESTATE
DATE OF DEATH
VALUE OF ASSET
% OF DECD'S
INTEREST
EXCLUSION
t~Arvu~~
TAXABLE
VALUE
~~ International Ladies Garment Workers Union Death Benefit Fund
y,500,00 100 2,500.00 0.00
730 Broadway, New York, NY 10003 (212) 539-5800
Member ID: 870050360
TOTAL (Also enter on line 7 Recapitulation) S I 0.00
(If more space is needed, insert additional shcels of the same size)
REV-1511 EX+ (12-99)
scNEOU~ N
COMMONWEALTH of PENNSYLVANIA FUNERAL EXPENSES ~
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FlLE NUMBER
Hilda M. Hamer 2®0~1- ~l.~/¢S
Debts of decedent must be reported on Sctrertule l:
rrEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1' Minnig-Berger Funeral Home, 120 W. Main St., Tremont, PA 17981 8 945.82
Flowers 255.00
Service at St. Andrews UM Church, Valley View, PA (church use, prep and serve meal) 521.74
Update Grave Marker (add death date to headstone) 85.00
Grave Preparation and Closing (marking, opening and dosing) 375.00
Rev. Jim Browning Honorarium 300.00
St. Andrews UM Churoh Cemetary Assodation 150.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Connrrssfons
Name of Personal Representative(s)
Social Security Number(s)/EIN Number of Personal Represertatve(s)
Street Address
Cih' State Zrp
Year(s) Commission Paid:
2. Attorney Fees
3. Family Exemption: (tf decedent's address is not the same as daimaM's, attach explanation)
Claimant
Street Address
City State Iap
Relationship of Ctairrrarrt to Decedent
4. Probate Foes 245.59
5. Accountants Fees
6. Tax Return Preparer's Fees
~. Misc.
Postage 4.55
TOTAL (Also enter on line 9, Recapitulation) = 10,882.70
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX+ (11-08)
Pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE ~
BENEFICIARIES
FILE NUMBER
Hilda M. Hamer 2009-00145
NUMBER
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT
Do Not List Trustee(s) AMOUNT OR SHARE
OF ESTATE
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec. 2116 (a) (1.2).]
1. Jane M. Bames,117 Pin Oak Drive, New Cumberland, PA 17070-2343 Daughter 1533.66
2 Janice E. Wolfe, 703 Trent avenue, Wyomissing, PA 19610 Daughter 1533.65
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, A S APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 2113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. ~
Ir more space is neetletl, insert atltlitional sheets of the same size.
LAST WILL AND TESTAMENT
OF
HILDA H. HARNER
I, HILDA H. HARNER, of the Borough of Pine Grove,
Schuylkill County, Pennsylvania, being of sound mind, memory
and understanding and considering the un cgertainty of lif eye
do hereby make, publish snb declsre~~thie~to~~brs~r'~~i~Mill ;~`~~` ~ ~~~~ _ ;~
. .,
and Testament, hereby revoking and making void all prior Nills
and Codicils thereto by me at any time heretofore made.
FIRST: I direct my Executor/Executrix to pay all my
debts, the expenses of my last illness and funeral expenses
as soon after my death as may conveniently be done. I direct
my funeral to be conducted in a manner corresponding with
my estate and situation in life.
SECOND: All the rest, residue and remainder of my estate
and property, whether real, personal or otherwise, I give,
devise and bequeath to my husband, LESLIE E. HARNER„ In the
event my husband Leslie E. Harner shall predecease me, I give,
devise and bequeath all the rest, residue and remainder of~~
my estate equally to my two daughters, JANICE E. WOLFE and ;~'
.% ~~ ~~ ~ `
::; c,
' -r) fV _ ~ ~'i
7 --~ ~ .
.~
JANE P1ARY BARNES, or their issue, per stirpes.
THIRD: ,'I nominate, constitute and appoint my husband,
LESLIE E. HARNER, as Executor of this my Last Will and Testament.
In the event my husband should predecease me or should he
resign, renounce or otherwise be unable to act as Executor,
I nominate, constitute and appoint my two daughters, JANICE
E. WOLFE and JANE MARY BARNES, as succeeding joint Executrices.
I hereby relieve my appointed Executor/Executrices from
the necessity of posting bond in connection with their duties
as such in any jurisdiction in which they may be called upon
to act insofar as I am able to do so by law.
IN WITNESS WHEREOF, I, HILDA H. HARNER, have hereunto
set my hand and seal to this my Last Will and Testament, this
~~'~ day of ~a.r:~„~~~`~- 1995.
~.1~~t_~l~w~-~`%. ~~~-r.'c_-~z~~~ (SEAL)
HILDA H. HA NER
Signed,~sealed, published and declared by the above named
Testatrix, HILDA H. HARNER, as and for her Last Will and
- 2 -
i - -. _.. _ __ _ _ _ _ _ __. _ _ ..
r
Testament, in the presence of us, who at her request, in her
presence and in the presence of each other, all being present
at the same time, have hereunto subscribed our names as
witnesses.
WITN
~.. W T N E S .~ ~ ~~._
~7~~~~ -~
DD
~~
~~ _
ADDR
- 3 -
~~~ ~;y~ 1057 0000 163 Y
LISTENING. JUNE 30, 2008
I -~ Oa ~ ~B ~ B ~'~' ACCOUNT NUMBER
406-0043042
HILDA H HARNER
BURIAL RESERVE ACCOUNT
117 PIN OAK DR
NEW CUMBERLND PA 17070-2343
RATE CONFIRMATION NOTICE
12 MONTH CD
AS OF JUNE 30 2008 YOUR ACCOUNT NUMBER 406-0043042 HAS RENEWED FOR A VALUE OF
WILLOBE4EARNED AT THE RATEWOF 1A73~09;HETHERNEXT MATURITYIDATE O~NYOURAACCOUNTRWILL
BE JUNE 30, 2009. IF YOU HAVE MADE OTHER ARRANGEMENTS PERTAINING TO THIS ACCOUNT,
PLEASE DISREGARD THIS NOTICE.
Senior Checking Plan Account Statement PNCBANK
PNC 13.urk
For tl>Ie period 05/29/2008 to 06/26/2008
~ HILDA H HARNER
JANE M BARNES
117 PIN OAK DR
NEW CUMBERLAND PA 17070-2343
Primary account number: 50-0441-5329
Page 1 of 1
Number of enclosures: 0
[~ For 24-hour banking, and transaction or
~ interest rate information, sign on to
'B' PNC Bank Online Banking at pnr,.corn.
For customer service call 1-888-PNC-BANK
between the hours of 6 AM and Midnight ET.
Para servicio en espar~ol, 1-866-HOLA-PNC
Moving? Please contact rrs at 1-888-PNC-BANK
® Write to: Customer Service
PO Box 609
Pittsburgh PA 15230-9738
Visit us at pnc.com
TDD terminal: 1-600-531-1648
For hearing unpaired rlienrs only
lI~iPOR"I-AN"1' WFOI~9A"TION A130U"I' A1T~I TIUINSAC"PIONS ANll I'LIRCIIASL'S
For your convenience, under certain conditions we may allow you to overdraft your checking or money nru•ket account when using your 1'NC
Rank Visa Check Carl or PNC Bank Ranking Catd at PNC Bank ATMs, non-PNC ATMs, and for merchant purchases. At PNC 13ank A"f~-(s
we can give you the choice to cancel the transaction if it would cause an overdraft. VVe are not able to provide you this choice ~~•hen using a
non-1'NC Rank A'IT'1 or when maknrg purchases. y
Ia7ective June 22, 2008, if you would prefer not to have overdraftl access, call our Telephone Banking service at I -877-222-5401 between
6 am - 12 midnight, Lantern 'T'une, seven days a week.
If }'ou have called previously to opt-out of overdraft access at non-1'NC ATI~'is, yott are automatically excluded li•om overdraft access for all
A-1')\[ transactions and pur•vhases and do not need to call agaur.
For more inlonnation, please see our Consumer Schedule of Service Charges and Fees, Other Account Charges and Services andlor Account
Agreement for Personal Checking and Savutgs Accowrts, Withdrawals section.
Senior Checking Plan
Regular Checking Account Summary
Account number: 50-0441-5329
Balance Summary
Beginning
balance
7,8-f3.t~7
Deposits snd
other additions
00
ChecF;s and other
deductions
.oo
Average monthly
balance
7,843.7
Ending
balance
7,Sh3.(i7
Charges
and fees
.oo
Hilda H Harner
Jane M Barnes
FORM953R-1005
UNITE! Certi ' ate o ~,etiree Covera e
.f
[Effective January 1, 2000] , , ~ ~,~~ t ~'
This certificate ILGWU DEATH BENEFIT FUND
is issued to
Fund No. Local No. Ledger No. Social Security Number
f 52 351 0000259 -l 165-20-5111
HILDA HARNER 33'
124 SCHOOL ST
PINE GROVE PA 17963-1611
L ~~~III~~~II~I~~~II~~~~II~~~~II~II~~~~~II~~~II~~I~I~I~~II~I~~I J
to provide a summary of the death benefit coverage available to each retiree eligible under the Plan & Rules and Regulations of
the ILGWU Death Benefit Fund (FUND) and the applicable provisions of the Union Constitution. Additional detail is provided in the
FUND'S Rules and Regulations.
A member in good standing who has 10 years of membership during the last 15 years of which the last 2 years are continuous,
and who is granted regular or disability retirement from a retirement plan sponsored or negotiated by the former ILGWU shall, upon
withdrawal from union membership, be eligible for the benefits described herein.
I. TABLE OF RETIREE DEATH BENEFITS
a) Regular Benefit
$2,5oo.oa
b) Additional Benefit -Surviving Children
Each unmarried child under age 18 or, if a full time student,
any child under age 22
c) Additional Benefit -Accidental Death
If death occurs within 90 days due directly to an accident AND
retiree is survived by spouse, children or parents
$1,250.00 for each eligible child
to a maximum for $3,750.00
$2, 500.00
d) Maximum Benefit
The maximum retiree benefit payable in cases involving additional benefits shall be not more than tVvice the regular death benefit,
EXCEPT in cases involving three (3) or more surviving eligible children, in which case the maximum benefit shall be not more than
two and one half times the regular benefit.
II. WORKING RETIREES - An eligible retiree who returns to union employment and to regular union membership shall be covered
by the FUND for the same death benefit amounts as active members, until 30 days after the last day of work, provided such
working retiree meets all of the eligibility requirements applicable to active members. After 30 days of nonwork or if a working
retiree does ret meet the active member eligibility requirements- the retiree wi!! be eligible for the berafits described in t he above
Table of Retiree Death Benefits.
III. BENEFICIARY -means any person(s) or entity named by the retiree on the designation form issued by the FUND or, in the
absence of a valid designation, the following survivors in the order listed: 1 }spouse 2} children 3) parents 4} brothers & sisters 5)
estate. An organization or institution in which a retiree is, was or becomes a resident"may be designated to receive not more than
50% of the benefit payable, Beneficiary designations may be changed at any time solely by executing a FUND designation form.
Only the last valid designation form on file at the FUND office prior to death shall be effective.
IV. LIMITATIONS - a retiree participating in the FUND shall be deemed to have given up all rights and privileges in or to the
FUND if such retiree is found to have: become an employer or a representative of employers in any industry; or engaged in any
occupation in which she has the right to hire or fire workers or to recommend hiring or firing; or engaged in any occupation which
involves business dealings with employers in the industry or their representatives.
V. CLAIMS - a retiree's beneficiary must notify the Local or the FUND of a retiree's death and complete and file an application
within two years after the date of death. If a claim is not made within 90 days after date of death, the FUND, in its discretion, may
make payment to anon-beneficiary or to a person, local or union who has paid or contracted responsibility for the retiree's funeral
expenses.
IMPORTANT - This Certificate of Coverage is for informational purposes only. In all disputes and interpretations, it is the
provisions of the FUND'S formal Plan and Rules and Regulations, as amended from time to time, and the Union Constitution which
solely control and govern benefit eligibility and coverage. Benefits may be modified, reduced, or discontinued at any time in the
sole discretion of the Death Benefit Committee.
f~ittnig-verger ~'utterai ~ouYe
R~Inrt ~. ri~rN~. ~In~Ur
120 West Main Street
Tremont, Pennsylvania 17981-1710
Phone (570) 695-3153
Fax (570) 695-3822
E-mail: mbth@ptd.net
Ronald Barnes
117 Pin Oak Drive
New Cumberland, PA 17070
~;: BLLNG [X+TEt;; 711912008
tx~ '"` Due Dad; upon receipt
,~.
PREVIOUS BALANCE:
When sending payment, include the Deceased Name. Thank-you.
~- ~ • gi-~--~
Wednesday, July 23, 2008