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HomeMy WebLinkAbout07-02-09 (2)1505607120 ---~ REV-1 SOO Ex (05-05) OFFICIAL USE ONLY PA Department of Revenue c Buroau of Individual Tazae aumr cods vs•r Fib Numtxr PD eox.zaosot +* INHERITANCE TAX RETURN Harrisburg, PA 17128.0601 RESIDENT DECEDENT 21 0 8 110 7 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 223 04 5610 O1 07 2007 07 15 1967 Deoadent's Last Name Suffix Decedent's First Name MI STEELE RODNEY L (If Applicable) Enbr Surviving Spouse's Informatlon Below Spouse's Lest Name Suffix Spouse's First Name Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW 1. Original Retum ni 4. Llmitetl Estate ~' 9. DeodMlDbd Teatela -- (Atlechcopya7n7n) MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 2. Supplemental Retum ~ 3. Remainder Retum (date of death pnor to 12.13.82) {a, FNW InlxaN Compromiw ~ 5. Federal Estate Tax Retum ReQUired (dab or d••Ui sax 12-72-02) T Dand•nl M•inlinW •LNinp Trust Q B. Total Number of Safe Deposit BOxaB tanacn copy or rrwp r-~. 9. Litigation Proceeds Received 10. spouu7 POVS•ddv~. CrWattdab or d••7n 7t,Elecdon to 4z under See a713(A) i_._1 Mavs•n 124791 •M 1-1-BS) ~ (AaaG7 Soh. O) CORRESPONDENT • THIS SECTION MUST BE COMPLETED. ALL CORRE PONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Noma Daytime Telephone Number BRUCE J. 7>PARSHA'ftSRY 717 238 6570 Firm Nams (If Appllubls) CUNNINGHAM 6 CHERNICOFF, P.C. REGISTER OF WILLS USE ONLY rU First Ilne of address o 2320 NORTH SECOND STREET ~ u= =: Seeond Ilse of address ~~R r cs '`U City or Post Offlca HARRISBURG D 2e• State ZIP Coda PA 17110 -: .7, 3 c11 o+ 23187 BayWOOd Court, Apartment 2-C, Chestertown, MD 21620 alb RE OF PREPAR OTHE 7f7AN REP ENT THE DATE e J. Warshawaky _Cj 2320 North Second St t, Harrisburg, PA 17110 L___ Side 1 1505607120 15D5607120 J Corroapondent's e-mail address:. bJw~CCIawpC.COm PA Inheritance Tax Return Signature of Additional Fiduciaries (ESTATE OF 127-08 1qp BER Steele, Rodney Lee Under penaNiea of perjury, I dedaro that I have examined this return, Including accompanying achedubs and statements, and to the beat of my knowedge and belief, d is true, wrroct and wmpbte. Declaretion of preparer other than the personal ropresentativa is based on all information of which properor has any knowledge. Signature #2 Name Addresal Address2 City, State, Zip Brucs JNMy Warohawsky 2J20 N. 2nd St HaMsburg, PA 17110 Date 1505607220 REV-1500 EX o.aa.n•sn.ms: Rodney L@@ St@ele Decedent's Social Security Number 223 04 5610 RECAPITULATION 1. Real Estate (Schedule A) ................................................................................... ....... 1. 2. Stocks and Bonds (Schedule B) ......................................................................... ...... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorehip (Schedule C)....... ... 3. 4. Mortgages 8 Notes Receivable (Schedub D) ..................................................... ..... 4. 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ............ .... 5. 5 9 , 8 8 8 . 2 9 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ........... .. 6. 7. Inter-Vivos Trensfere 8 Miatellaneoua Non-Probate Pro~erty (Schedule G) ~ Separate B Iling Requested ........... .. 7, 8. Tohl Gross Assets (total Linea 1-7) ................................................................. ...... 8. 5 9, 8 8 8. 2 9 9. Funerel 6rpenaes 8 Administrative Costa (Schedub H) .................................... ..... 9. 9 , 817.5 3 10. Debts of Decedent, Mortgage Llabililiea, 8 Liens (Schedule I) ........................... ..... 70. 11. Tofal Deduetlons (total Linea 9 8 10) ............................................................... .......t t. 9, 8 1 7. 5 3 12. Net Value of Estate (Line 8 minus Line 11) ....................................................... ......12. 5 0 , 0 7 0 . 7 6 13. Chedtebb and Governmental BequesWSec 9113 Truata for which an election to tax has not been made (Schedule J) ............................................ ..... 13. 14. Net Value SubJect to Tax (Line 12 minus Line 13) ........................................... ...... 14. 5 0 , 0 7 0 . 7 6 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax refs, or transfers under Sec. 9118 (a)(1.2)X.00 0.00 15• 16. Amount of Line 74 taxable at lineal rate X .045 5 0, 0 7 0. 7 6 t6. 17. Amount of Line 14 taxable at sibling refs X .72 0 . 0 0 17~ 18. Amount of Line 74 taxable at collaterel reteX .i5 0.00 t9. 19. Tex Dus ................................................. ............................................................. .... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 0.00 2,253.18 0.00 0.00 2,253.18 ^X Side 2 1505607220 1505607220 REV-1500 EX Page 3 Decedent's Complete Address: Flle Number 21-08-1107 DECEDENTS NAME Rodney Lee Steele STREET ADDRESS 4341 Carlisle Pike Apt B-11 _ CITY STATE 'i ZIP Camp HIII PA 17011 Tax Payments and Credits: i. Tax Due (Page 1 Line 19) 2. Credlts/Paymenta A. Spousal Poverty Crodit B. Pdor Payments C. Dlswunt 2,300.00 0.00 (1> 2,253.18 3. Intereat/Penalty if applcable TotalCrodita (A +B+C) (2) _ 2,300.00 D. Interost E. PenaKy Total Intereat/Penalty (D + E) (3) 4. If Line 2 is groater than Line 1 + Line 3, enter the difference. This Is the OVERPAYMENT. (4) 46.82 Cheek lwx on Page 2 Line 20 to roqusst a rotund 5. If Llne 1 + Line 3 is groater than Line 2, enter the dHferonee. This Ia the TAX DUE. (5) A, Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a tansfer and: Yes No a. retain the use or inwme of the property transferred :.................................................................................[] x b. retain the right to designate who shall use the properly tansferred or its inwme :.................................... [] c. retain a reversionary interest; ac ..............................................................................................................~] L><~~ d. receWe the promise for life of either payments, beneMs or care7 .............................................................{ ] [x] 2. If death occurred after December 12, 1982, did decedent tronafer property within one year of death without _ roceiving adequate wnsideration2 ....................................................................................................................t~ U 3. Did decedent own an "in trust for" or payable upon death bank awount or security at his or her death......... [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate properly which wnlains a beneficiary dealgnation7 ...................................................................................................................~] U IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE O AND FILE IT AS PART OF THE RETURN For dates of death on or after July 1, 1994 and before January 1, 1995, the taz rete imposed on the net value of trenafere to or for the use of the survNing spouse is throe (3) parceM [72 P.3. §9118 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rote Imposed on the net value of tranafero to or for the use of the surviving sDOUSe is zero (0) percent [72 P.S. §9118 (a) (1.1) (Iq]. The statute does not exemoe transfer to a survNing spouse from taz, and the statutory roquirements for dlsdosuro of easels and flling a tax rotum aro still applicable even if the surviving spouse Is the only beneficiary. For dates of death on or after July 1, 2000: The tau rate Imposed on the net value of trensfen from a deceased child lvronty~one years of age or younger at death to or for the use of a natural paronL an adoptive parent, or a atepparont of the child Ia zero (D) percent [72 P.S. §9118 (a) (1.2)]. The tax rete Imposed on the net value of trenafero to or for the use of the decedents lineal baneflciadea is four end ono-haH (4.5) percent, except es noted in 72 P.S. §9116 1.2) [72 P.S. §9118 (a) (1)]. The tax rate imposed on the net value of tranafere to or for the use of the decedents siblings Is twelve (12) percent [72 P.S. §9118 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has et least one Daront In wmmon with the decedent, whether by blood or adoption. Rw-7606 EX+ (6-M) SCHEDULE E CASH, BANK DEPOSITS, 86 MISC. PERSONAL PROPERTY cawOwxeuTH of rtwuttvv~w MMERRNlCl TA%RETURN RleOenT OEt;EOEM ESTATE OF (FILE NUMBER Steele, Rodney Lee 27-05-1707 InGuM iM prorwed~ of RI6HM rtid bra ato tM gouetl~ waro raceivaE by an astNS. All prap~Ry JeIMlYOwnW wIM tlt~ tleM of nurvlvanMp mint M M~eloxe on ~e~WUN F. (h moro apace b needed, adtlitbn6l pape6 of the same alza) Copyright (c) 2002 form soflwaro only The Lackner Group, Ina. Form PA-1600 Schedub E (Rev. 8.98) REV-0161 E%+113Aa) COMMONWEALTH OF PENNSYLVANIA IN RESIDEM ~CEDRErT''l1TRN SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Steele, Rodney Lee 21-08-1107 Debts of decedent must Lx reported on Schedule 1. ITEM DESCRIPTION AMOUNT NUMBER p, FUNERAL EXPENSES: See continuation schedule(s) attached B. I ADMINISTRATIVE COSTS: 1. Pereonal ReproaentatNe'a Commissions 8,597.13 Stroet Addroas City State Zip Year(s) Commission paid z. Attorney's Fees Cunningham & Chemicoft, P.C. 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Stroet Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 307.00 5. Accountant's Fees 6. Tax Retum Proparer's Fees 7. Other Adminlatrative Costs 913.40 See continuation schedule(s) attached TOTAL (Also enter on Ilne 9, Recapitulation) 9,817.53 Copyright (c) 2002 form eotlwere only Tha Laekner Group, Inc. Form PA-7800 Schedule H (Rev. 8-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Steele, Rodney Lee 21-08-1107 ITEM NUMBER DESCRIPTION AMOUNT Funerel Expenses 1 Bennie Smith Funeral Home 8,597.13 H-A Subtotal $,587.13 Other Administrative Costs 2 Greve Marker-Kirby Memorials 481.40 3 Legal Advertising-Cumb. L. J. 75.00 4 Legal Advertising-Journal Pub. 87.00 5 Misc. Law Office expenses for postage, overnight delivery, copies, courier service 250.00 and reserve for future expected similar expenses H-87 Subtotal 913.40 Copyright (e) 2002 form soRwaro only The Laekner Group, Ine. Form PA-1600 Schedule H (Rev. 6-96) RFVdN] FYI IY.INI SCHEDULE J COM INHER~ITµCE~ ~ RENRNANw BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Steele, Rodney Lee 21-08-1107 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) (aaa) Do Not LI.171u• I TAXABLE DISTRIBUTIONS pnclude outright spousal distributions and Pranafero under Sec. ~116(a)(1.2)] Tavonya Steele Daughter All 50,070.78 23167 Baywood Court Apartment C Chestertown, MD 21820 Total 50,070.78 Enter dollar amounts for distrlbutiona shown above on lines 5 throw h 16, es a ro H ate, on Rev 1500 cove r sheet II. 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 SHEE 0.00 Copyright (c) 2002 forth sofN/ero only The Laekner Group, Ina. Form PA-1tr00 Schedule J (Rev. 6-98) "+ ~~~~(~ BRUCE J. WARSHAWSKY, ESQUIRE and TAVONYA STEELE, Co-Adminiatrators of the Estate of Rodney L. Stale, Plaintiffs v. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO: 08-7518 Civil Action -Law BONG J. CHOI and RICHARD T. CHOI Jury Trial Demanded Defendants RD AND NOW this day of 2009, upon consideration of the attached Petition for Apgroval of Decedent's ompromiae Settlement end Distribution of Pmcada, IT I3 HEREBY ORDERED THAT: 1. Settlement of the abovo-captioned action by Bn~ce J. Watshaw9ky, Esquire and Tavonya Stale, as Co-Adminiatratore of the Estate of Rodney L. Stale and Tsvonya Stale, individually and in her own right, in accordance with the terms of the Petition, is hereby ratified and approved. Brace J. Warahawsky, Esquire and Tavonya Steela, as CaAdminiatratora of the Eabte of Rodney L. Stale and Tavonys Steele, individually and in her own right, are authorized to mark the above-captioned action, sealed, discontinued and ended as to Defendant. 2. All proceeds will be agocated as set forth in Paragraph 17 of Phtintiffi Petition for Approval of DccedenYa Compmmise Settlanent ark Distribution of Prnceeda. BY THE~OURT J. I ,r Bruns J. Warehawaky, Saquite - Gtimninshaoo R Chenilco>i" P.C., 2320 Nalh Second Street, Hsrriaburs, PA 171 !0 Donald. Saiontr. Baquie • Saicntz Kirk dt Milee, P.A., Three South Frederick Street, Suite 900, Bahhnors, HID 21202 Sons J. Choi, 3521 Louisa Lane, ~. PA 17030 Rictiat+d T. Choi, 3321 Louise Laos, hfachmicaMrq, PA 11030 Mr. Krlatopl-er N. Chmey, Nsfbnwide Insurance Company oiAmarica, 1001 Hector Streaf, Suite 300, Coasda~ckae, PA 19426 Mr. Dave Korins6ock, CLim Repres~ve, State Farm Maloof Autcarobila hrsnsance Comp~y, Concordvile Opartfoaa Center, One State Farm Drive, P.O. Hox 142, Concordville, PA 19331.0412 F. i „{ .~ '3 ~ r, -~ .. i ~ ~ y~` ~ :'i :9 .t ~ ~ ..' :.." 1 e '. JJ~ ~ .1 . ~ R A v ' -~ ry .~ rt t ~M1 F ~ 1C. ~ ~~ . y G y ~! _ ~ ~_ ....... .. ... .. y, ...,. . ~... _,.,..._ ,..:.~. _ . .w, ., ,..,.,., . , ..,. , e ~ _ 9 .. ~~ },.: -: ~ c ... ,~ i BRUCE. J. WARSHAWSKY, ESQUIRE IN THE COURT OF COMMON PLEAS and TAVONI'A STF.~t.E, CUMB$RLAND COUNTY, Co-Adminiatratora ofthe Estate of PENNSYLVANIA Rodney L. Stale, ~ ^, Plaintil$ ' ~~ NO: 08-7518' ~ ~; ~ ~ "~ v. Civil Action -Law ~ ~ _ ` , ~ , ~ ~ BONG J. CHOI end RICHARD T. CHOI ~ Jury Trial. Demanded o Ikfendaats PLAINTIFFS' AMENDED PETITIONi FOR APPROVAL OF DECEDENT'S COMPROMISE SETTLEMENT AND DISTRIBUTION OF PROCEEDS PURSUANT TO PA A.C.P. X2106 Petitioneks, Bruce J. Warshawslty, Esquire and Tavonya Steele, as Co-Administrators of the Estate of Rodney L. Stale sad Tavonya Stale, individually and in har own right, by and through her attorneys, Cunningham & Clternicoff, P.C., hereby aver as follows: Decedent, Rodney L. Steele, was 39 years old when he died on January 7, 2007 as a result of complications fi~om a motor vehicle accident which occurred on January 3, 2007 (the "Accident"). 2. This litigation was instituted against Defendants as the owners and driver of the vehicle at fault in the Accident and initiated by Writ of Summons on December 30, 2008. 3. A copy of Mr. Steele's death carHficate is attached as Exhibit "A" to Plaintiffs' Petition for Apptoval of Deced'ent's Compromise Settleme~ and Disttibution of Proceeds Pursuant to PaRC.P. §2206 Sled on April 16, 2009 (tha "Original Petition") 4. Petitioner, Tavonya Steele, is the sole child a~ surviving heir of the Decedent who was unmarried at the time of his death.. 5. Decedent died intestate. b. Petitioners, Bruce J. Wandutwalry, Esquim and Tavorrya Steele, are the Co- Administratom of the Estate of Rodney L. Steele by virtue of Letters of Administration duly granted by the Register of Willa of Cumberland County, Pennsylvania oa December 9, 2008. A copy of the Short Certificate - Letters of Adminiatiratton is attached to the Original Petition as Exhibit "B" 7. Decedent is survived only by Potitioner, Tavonya Steele. S. Defendants, Bong J. Choi etxl Richard T. Choi, through their insurance carrier, State Farm Mutual Auto Insurance Company ("State Farm"), have provided Petitioners with a Release which, in exchange for payment of 5100,000.00 by State Farm incorporates the ternys of the settlement with State Fan~n, a copy of" which is attached to the Original Petition as Exhibit "C". Additionally, Mr. 3taale's own insurance cagier, Nationwide Insolence Company of America ("Nationwide"), has provided Petitioners with a Release which, in exchange for payment of 5100,000.00 (Nationwide's limits oa its underinsured policy) incorporates the tenors of the settlement with Nationwide, a copy of which is attached to the Original Petition as Exhibit "D", for a total settlement of 5200,000.00 (collectively the "Settlem~t"). 4: lit view of the disputed nature of this clsint, Petitioners consider the Settlement to be a fair, just and equitable settlement and to be in the best interest of the Estate and Tavonya Steele as the sole beneficiary. 10. Your Petitioners retained the law offices of Saio~z Kirk tlt Miles, P.A. and Cunningham Bt Chernicoff, P.C. to prosecute this action and entered into Power of Attorney and Contingent Fee Agreements for professional services, plus expenses. Copies of the Powet of Attorney and Cotriingency Fee Agrxmenta are attached to the Original Petition as Exhibit "E". 11. Putsyant to the Power of Attorney and Contingency Fee Agreements, Saiontz Kirk 8t Miles. P.A. and Cunningham 8t Chernicoily P.C. are entitled to a collective fen' of forty percent (40°i6) of Petitioners' claims for the amount recoveted plus 12. 9aiontz Kirk Bt Miles, P.A. and Cunningham tit Chernicoi~ P.C., on behalf of Petitioners and the Estate, spell considerable lima and effort itt the investigation- andpreparation ofthis case. Saio~z Kirk tit Milos, P.A. and Cunningham & Chernicofi; P.C. have incurred expenses for the investigation, medical records and litigation coats, totaling 5372.35. Aa itemization of tlu expenses is attached to the Original Petition as Exhibit "F" 13. No liens have been asserted in this matter. 14. By reason of the death of the Decedent two (2) causes of action anise against the Defendants, one (1) under the WmngiW Death Act fot the benefit of Petitioner, Tavo~+a Steals, and one (1) under the Survival Act for the benefit of the Decedent`s Estate. IS: Undetslgnedcoadael hasreceived-approval f om the Department of Revetrue to allocate Stl°y6 of the proceeds to the Wrongful Death Act given Tavonya Steele's j~ .. ... - financial dependence upon Decedent while he was alive. A copy of the approval letter from the Depacttnent of Revenue is attached to the Original Petition as Exhibit "(}". 16. There are sufficient assets is Decedent's Estate to satisfy any outstanding debti of which them an none. 17. Petitioners believe that, in accordance with the terms of the Power of Attorney and Contingent Fee ABreen-enta, and the Department of Revenue aclmowledgmeat letter approving. the allocation of the Settlement proceeds claim,... a fair, just and equitable distribution of aU settlement proceeds would be as follows: a Tavoaya Steele will receive 539,888.29 in wrongful death proceeds; b. Bruce J. Wsrshawsky, Esquire and Tavoaya Steele es Co-Adminishntora of the Estate of Rodney L. Steele will receive 559,888.29 in survival action proceeds; c. 3siontz Kirk & Miles, P.A. and Cunningham dt Chernicoff, P.C. legal fees of 579,851.06; and d, Saiontz Kirk dt Miles, P.A. and Cunningham & Chernicoff, P.C. reimbursement of expenses of 5372.35. TOTAL SETTLEMENT: 5200,000.00 18. No Judge has been asaigaed to any prior proceeding in this matter. 19. Defendants are not represented by counsel in this matter, however, State Farm (IIehndaafs' iosiuance carrier} has agreed to settlf this math as evidencxd by Exhibit "C" to the Original Petition, thus Defendants, by and through State Farm, ,r: concur hereto. . 20. An Affidavit signed by the Petitioners requesting Court approval in accordance with the terms of this Petition is attached to the Original Petition as Exhibit "H". R-t1EREFOItI?, your Petitioners, lituce J. warshawaky, Esquire, and Tavonya Steele, as Co-Administrators of the Estate of Rodney L. Steele and Tavo~+a Steele, individually and in her own right, pray that this Honorable Court enter an Order approving said Compromise Settlement, dlrccting dialribution of the proceeds in accordance with the ternoa of this Petition, the sealing of the record in the Court's discretion and to mark the above-captioned action settled and discontinued. B Bruce 7. warahawaky, Esquire I.D.#58794 2320 North Second Street P.O. Boys 60457 Harrisburg, PA 17106-0457 Telephone: (717) 23$-6570 Attor-~ys for Plo!»ti„83 Date: Apri124, 2004 p; PMWs M App'eW dD,e,drb Cmipeeiw 9wtl,m~t d DhtlihuUm.wpa ,~ _ .., , BRUCE J. WARSHAWSKY, ESQUIRE IN THE COURT OF COMMON PLEAS and TAVONYA STEF,LE, CUMBERLAND COUNTY, Co-Administrators of the Estate of PENNSYLVANIA Rodney L. Steele, Plaintiffs NO: O$-7518 v. Civil Action -Law BONO J. CHOI and RICHARD T. CHOI Jury Trial Demanded Defendants I, Juliesnna Ametrano, Legal Assistant, with the law Brat of Cunningham Ft Charniooff, P.C., hereby that I setvui a true and correct copy of the attached PLAINTIFFS AMENDED PETI'T'ION FOR APPROVAL OF DECEDENT'S COMPROMISE SEITLEMEI~IT AND DISTRIBUTION OF PROCEEDS PURSUANT TO PA R.C.P.. f?x6d war Sled with the Cumberland County Prothonotary on April Ib, 2009, upon tlu following via Srst Chun Mail, postage prepaid. Donald 3aiontz, Esquire Saiontz Kick dt Miles, P.A. Three South Frederick Street Suite 900 Baltlmorq MD 21202 Richm~d T. Choi 3521 Louise Lana Mechanicsburg, PA 17050 Bong J. Choi 3321 Louise Laae Mechanicsburg, PA 17050 Mr. Kriatophet N. Cheney Nationwide Insurance Company of America 1001 Hector Street Suite 300 Conshohocken, PA 19428 Mr. Dave Korinshock Claim Representativo State Farm Mutual Automobile Insurance Company Concordville Operations Center One State Farm Drive P.O. Box 142 Coneoidvil(e, FA 19331-0412-- CUNNINOHAM & C1iE1tNICOFF, P.C. Date: April 24, 2009 13Y! Julieaane Ametrano 2320 North Second Street Harrisburg, PA 17110 Telephone: (71?) 238-6571 p; lASmdd RHtlw AcAyµwrdDiade4 Conpadw 9dMmiet~ad Ofgilbtllm.wpd ,. = ' *,~ BRUCE 7. WAR3HAWSKY, ESQUIRE and TAVONYA 3TEELE, Co-Admiaiahators of tha Estate of Rodney L. Steele,. . Plaintiffs v. BONG J. CHOI and RICHARD T. CHOI Defendants 1N THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA o ~ 0 ~~ n ri • ~:~~ s ~ N0: 08-0SI8 ~ _ `~ ~~; rn Civil Action -Law ~ c~ ~, "q D~ Jury. Trial Demeatded °'' PLAIIVTIFF3 PETITION FOR APPROVAL OF DECEDENf'3 COMPROl4II3E 3>w"1'I'I.EMEIVTRND DISTR®UTIOIV OF PROCEEDS PURSUANT TO PA R.C.P. X2206 <~ Petitioners, Bruce J. Warshawalcy, Esquire sad Tavotrya Steele, as CaAdministratora of the Estate of Rodney L. Steele and Tavonya Steele, individusUy and is het own right, by and through her attorneys, Cunningham Bt Chernicoff, F.C., hereby aver as follows: 1. Decedent, Rodney L. Steele, was 39 years old when he died oa January 7, 2007 es a result of complications from a motor vehicle accident which occurred on January 3, 200' (tha "Accident"). 2. This litigation was instituted against Defendants as the owners and driver of the vehicle at fault is the Accident and initiated by Writ of Summons on December 30, 2008. 3. A copy of Mr. Steele's death certiScate is attached hereto as Exhibit "A". 4. Petitioner, Tavonya Steele, is the sole child and surviving heir of the Decedent wlro was unmarried at the time of his death. ~ ~ a. S. Decedent died intestate. 6. Petitioners, Bruce J. Warshawaky, Esquire and Tavonya Steele, are the Co• Adnninishstora of the Estate of Rodnry L. Steele by virtue of Letters of Administration duly granted by the Register of Wills of Cumberland County, Pennsylvmia on December 4, 2008. A copy of the Short Certifibate -Letters of Administration is attached hereto as Exhibit "B". ?. Decedent is survived only by Pedtloner, Tavorrya Steele. 8. Defendapta, Bong. J. Choi and Richard T. Choi, thmugh their insurance carrier, Stets Farm Mutual Auto Insurance Coarpeay ("State Farm"), have provided Petitioners with a Release which, in exchange for payme~ of 5100,000.00 by State Farm incorporates the terms of the settlement with State Farm, a copy of which is attached hereto as Exhibit "C": Additionally, Mr. Steele's own insurance carrier, Nationwide Insurance Compa~+ of America ("Nationwide"), has provided Petitioners with a Release whicly is exchange for payment of S 100,000,00 (Nationwide's limits on its underinsured policy) incorporates the tenors of the seWement with Nationwide, a copy of which is attached ae Exhibit "II", for a total settlement of 5200,000.00 (collectively the "Settlement"). 9. In view of the disputed nature of this claim, Petitioners consider the Settlement to be a fav, just and equitable settlement and to be in the best interest of the Estate and Tavonya Steele as the sole beneSciary. 10. Your Petitioners retained the law offices of Saiontz Kirk ~ Milas, P.A. and Cunningham & Chernicoff, P.C. to pmsccute this action and entered into Power of Attorney and Contingent Fee Agreements for professional services, plus ~ ~ ~ expenses. Copies of the Power of Attorney and Contingency Fee Agreements are attached hereto as Exhibit "E". 1 I. Pursuant to the Power of Attornay and Contingency Fee Agreements, Saiorrtz Kirk. Bt Miles, P.A. and Cunningham & Chemicot~ P.C. are entitled to a collective fee of forty percent (40°!0) of Petitioners' claims for the amount recovered plus 12. 3aiontz Kirk & Miles, P.A. and Cunningham do Chernicoff, P.C., on behalf of Petitioners and the Estate, spent considetabie time and effort in the investigation and preparation of this case. Saioatz Kitk dt Miles, P.A. and Cunningham & Chernicoff, P.C. have incurred expenxs for the investigation, medical records and litigation costa, totaling S3T2.35. An itemi7stion of the expenses is attached hereto as Exhibit "F". 13. No liens have been asserted in this matter. 14. By reason of the death of the Decedent, two (2) causes of action arose against the Defendants, ono (1) under the Wrongful Death Act for the benefit of Petitioner, Tavonya Steele, and ono (1) undat the Survival Act for the benefit of tho Decedent's Estate. 15. Undersigned counsel has raxived approval fi+om the Department of Revenue to allocate SOyb of the proceeds to the Wrongful Death Act given Tavom+a Steele's financial dependence upon Decedent while he was alive. A copy of the approval letter from the Department of Revemu is attached hereto as Exhibit "C3". 16. Tyre are sufficient assets is Decedent's Estate to satisfy any outstanding debts of which there are none. 17. Petitioners believe that, in accordance. with the terms of the Power of Attorney and Contingent Fa Agreement, and the Department of Revenue acknowledgmart letter approving the allocation of the Settlemart procads claim, a fair, just and equitable distribution of all aettlemeut proceeds would be as follows: a. Tavonya Steele will receive. 559,888.29 in wrongfirl death proceeds; b. Bruce J. Watshawaky, Enquire and Tavonya Steele as Co-Administrators of the Estate of Rodney L. Steele will receive 539,888.29 in survival action proceeds; c. Saioatz Kirk & Miles, P.A. and Cunningham do Chernicofi; P.C. legal foes of 579,851.06; and d, 3aiontz Kirk dt Miles, P.A. and Cunningham dt Chemicoff, P.C. reimbursement o€expenaes of 5372.33. TOTAL 3ETTLEMEIVT: 5200,000.00 18. An Affidavit signed by the Petidorteta requesting Court approval in accordance with the terms of this Petition is attached hereto as Exhibit "H". WI~REFORE, your Petitioners, Bruce J. Warshawsky, Esquire and Tavonya Steele, as Co-Adwiniahators of t>m Estate of Rodney L. Steele and Tavonya Stale, i~ividually and in her own right, pray that this Honorable Court arts an Order approving said Compromise SeWement, directing distribution of the proceeds in accordance with the terms of this Petition, ffie sealing of the record in the Court's discretion sad to mark the abovo-capHoned action settled and discontinued ~ a Icy #s~~ 20 North Second Street ~+ 4. Box 6045?" Harrisburg, PA 17106-0457 Telephone: (717) 238-6570 Attorneys for Plai»ti,,$a Data Apri116,2009 gAna~~an~aa.rcm~+o.i.s.«aow~+~u~.wna F. EXHIBIT `A' t6a Pd,niylvani. DlvLion of V,ni Rmcrd. in aooordan~s ehe Gara.t AremblF. June 29, t953. s' WIIi1Np13: k N kMq~i bo dupMaN 11fN ooPlf by P ~ ~~' ~~` GMa & jobo~ao. M.l)„ M.P.H. Fnmk YeegwH ~9 of Haleh $010t Re~env .4102173 Na ~u~ ~s zoos t~ s3 yeG~-- rlss as. a.si ~. C» ..""."' d..~ a... ~~ ~~ Ofrr ~~'r N o ...~.....+ ~. CI~~l~ M s •, E~IIBIT `B' ~, _. [~ COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SHORT CERTIFICATE I Register for the Probate of wi11s and Granting Letters of Administration in and for G'tA~IDERLAND County, do hereby certify that on the 9th day of December, Taro Thousand and Sight Letters of ADM/N/STRATION in common foaa were granted by the Register of said County, on the estate of RODNEYLEESTEELE late of HAMPDENTOWNSH/P ass uw in said county, deceased, to TAVONYA STEELS and a+rt urw u.r BRUCE JEFFREY WARSHAWSKY nss wn and that same has not since been revoked. IN T88TI1~NY WHEREOF, I have hereunto set my hand and affixed the seal of said oftice at CARLIBLS, PENNSYLVANIA, this 9th day of December Taro Thousand and Sight. File No. PA File No. Date of Death 3.3. #~ 2008- O1 107 2 f- 08- f 107 f/n7/2007 223-04-6810 NOT VALID PTITHOi1T ORIGINAL BIGNATURS AND IMPRSSSSD SEAL ' R • , Release ~~~~ ~~~~~ HOO~dO~.Ot3 daNna 1h. raaai~t and MAnoNnq- wnM.or b hMaby aoggwladOsd, pn undnragnad hanfby ~d...w and fbirvar dbd,a,~. ^oMa aro ~aweo attar trr~~ rMrt thai h.rR Ntaa+ltra, , aoarq~ snd ~ aM other lkms a plan, wbla ar, wNo mtyht ba olatiiad b ba MaWw naM awtiom admM any b the w~.a~'e e.r.,~wh- abr ,nr n,p~-, +~„ any .ne ali dst+nr. daair,d~ danupN, .aBon. aauaNr or adiolt a «rr of ar~y wnd or nabs what.oarar, ,,,a parpouln~r an aoooune of a~ W~+•. Iu~oaM and unNnowti bash b oarwn and piopary, ~ haw ~.nrt.d a may t~ the A+lun dawlop Aom an soete~nt MAdoh ooaumad on or about tlw Snd day a .hnuary ' ~ 2001 type at ar naa- aAAA1- NN.4 ~A. Tfis nNnu ah~oa~r nNSrv~M a1 rtyMi of d» parMN IslsNSd b pufw N1ak Nprl nnwdiM, d any, +pak~k the undangnK, ~ halA, sowouto~o, ~+ta and nNOrr, " daabrM tlrt Ufs tNms a tiYa sslrNrwK haw basis oompNOMy nrr! and dna hyly undNMaod and fb- /fa pepo.. a ewdr~ a fl,At and anal aornpromha and saltlMnant at argr and aN alaana, a orMxwUa, on aemurd a the tghrlaa and daarpM aboMS mstila+ad, and fbr tha.oipnw pupoaa a prroMttinO bfawp antr Aatlnr or sddtilorNl dins arlN~q out dths daarMd aoolddf! UndMSlplad Aanby aooapa+ dnwt or dnM1 M tidal psyAwk ath. oorrldwaYl~n sw 1brM~ show. r to YYNnMa MIINraoF. '~.~`~L.. haw hNaurAo pc- harldfa) pd aad(a) uwa...~.-L__drt~ of ~ ~g to ana d. V d r ,~ 'R /E & Mann ~.~.. . /K ~ ~< tigflad X roan.+a +a,~-:eoa r~nrywr~r Release aW.1q~a Ra u^ sob CnrMon~ d Il+o oooolpC end s-dAdwio!- rNiMrol M Iw~Ngl ~okawbdp~lf,lh~ aol~gnM AMOOq nlrrM snd OONO 1V~ ItlpWO CIiCIIAis) sTA7sllMIl sINM1AN6~ .~ fllNr halrR ~, sOM* Irw nN1q-N1 and oil oMw' P~~. ~ ~ ao~pontlorNl.bbb a. vrho mpk ba a4Miod b M none din ~ III ~sW to s+t bat o1 dMrj- nnY b~, Aen~ a~ w~ d dnMnw dnnw~- dnnp~- dare eouNO d ~n wiu ~d wqr Idnd a noMod wfN4oMr anf! an aooou+t das M~irlwr, 6t~wn oM uduiow~~, 6alh b paoon a~ PnP~ rdflaB hrN nrWYd or mfr ~ Mw ~dowbp saM fn ~eeldMrt wihlah aoounod an a oDaw tlwt 7rf drr d Jwwnry .2007 h~ ~ornw~'~~ 1'N2 robwo NgMMr~ n~dt +~ ~ d MN ndwMd tb puratN tlMk 1gtl rwrndton, M rq-. prMMt tlw udorripwd ~' ~~ alaub~r, p~Mf nlid w~rportlor ddlrw fAo! Mia tiny d tli NMl~nwrK Mvo boon aon~plMr~t nod and on Ail vi0noleed and br iM Nrpeos d no~Mr r NM n1M itiN aanpomlN oe~usfn+d snd NtlIrnMlt d argt wd M drnM, ar arlMMibr` an noaeud d b It~uelM and d~11MOM ob01w mM~/awd, Md br dN orpnw pvpo~o d pndudMg faoro- Mqr wMIMr Ot nddwawl qd~ ^INq oul dNo ~~wld oeddr~E lAid~lw}Nd hMr6~ ooonPl~ dlrR Of IYtlI~ r11kiM prYRwK dwo aonMd~lolbn N11b01 obew~ --- ___-.~_ ~_a-r.rr~. -' -.~.war.r.~rrr+~rr~M~/YMtl1M~MMM~~r~- •R M~~ ~rN hM~uMO ~ ~~ ~ oMl(w ~ ~L.i~....~~. ~ Of • Q~1 ~l w _ f)A !1~/i~I I~lli/l~ ~x p~ •I ~~ gl'KL J' ~~~i ~I -~~iiyl ~Jl eprW X +a~en.to to,tsaow rwrrrrMY I ^ ~` ~ii~i i ~~ ~. r r. t ~~Y~ ~-A IOwar aN man by t1+w pnasrMk fiat. for tlta soh aonsldt+rdlon al tiN; rum a1 Cn. Hundred Ttiounrb oollM. choao0ok,11-. noaq d whlah trap tM Natlanwida hwNanaa canwrq- of MNrka p~+MwMN- a~ad •N.donwld.~ N IIN undsMpnad hsrabr nha.as, and for hYllls/ ssll,lNslhar aaraaulora, aniaaoavar Idnd ra pr~r to and t~toNrdwto ata dw M~aal ~rawlnq out a tha ux~aa.d MolorNt Cow'apa of an ~nolnab>Aa knuraanoa Po~ox mrnbK OA 37 D M`7T7f IMwd by IW~ManwWir ip Pa1~ Waodo, and rarulOnp a /o raauN h01b arl aootd~M wfdaA oeoumad on f!f-00•i0D7 al or MMr MARItl~1` 8TH CM~AP HILL. PJ~ 1701 i M r~~ IYM A/Yf, MlMllt ThN nNaM oonatlwtN pMmMltrt from NMlonwld0 b dts Insured to sadla wNh tlN ltndsrNatnd MotorM, and oontalna tln ENt1R11 AARIEt?#1t3M' d fn pardsa hstab, and do Corms aI U1N ratans an oattraohW and not many a noMM. na aoa for payma~d d any nndioal ttana and wIM kfdsmndy and Hold Nrdtonarlda harrntan from any wolf INtr WVa furflutr agds tawl fAw htiva awA+ly nMd the tarapotg ntsasa and Iaww tfta oontsnM tlnna/, snd INw slp~ dtr was n mylar oa~n tnM aot. WlrNi9M F+y^~si Hand ~ aaat mN_~_ day of tto.Qg. to dr ~ t~R. cnurk~wl ialJ1D t a~Ia--~' YqM ~. - ~J tll.m. at ~p ~- - Co~n~ d ~!'~1~ On this ~ day of _.~iRhn . ~ ~ . BNbra ma PsnonMY appw'ad "T~~. 1.0.ao~iri!~" L!„u-,~ - b ma Nnr~wn b ba 1IN psnott...dssarbsd hantrl, and who axawbd iM iaapaYMl imtrunsrd and NsAttw .oknoadsdpsd t at hdY1M volunlarl ~ oulad the sama M,,e.rm.orplra. b~ iIa 1(~ . ~-~ . _ ~, gJUM fiUM~ Mt S7 D tl4"f7tl/010tl~00701 ~ Osnsn who Is~cMdnpy and wNh Meld fo dsiraud am Mntsarrea ostnPary of otfr.r parson flas an apploMlon for tnsuranoa a aadMwN of alaYM aentHdrq any mslsrWlr fa1N MormaMOn or oonaaU fb- Mn psp~ess d ~ • Infonnarion Bone any 11bt mdsrW 11wab aommis a tnodulad inw+rana aet, whkh Ia • a~MM and PMaaa b q'Y11trn1 OivN pwaNlM. ~~ • R ~wfWM~ r M n-an by 1haM pnwe~ "~R for flr aaY ~ d Iha auu d Ona FMxM~edlThouw+d Down 0._DOab~_ dwl~nhhanUf~Nrlo~_wld_o__t_~M_r~raa_C_o_m_Or__n~-_dAmM_I_a_It_(wr~YW~-arrdTagonald~I~ wharta~rar NMM anfl npp~e M ~ M drb firrei pfgM~M~ aut d fha lAfdNYfNaad Saari co,~r~, d afll~mnaellrliwranoa w~nhlr!!/DYltriit~Mrdlrid~elwdil~rrpdddrWeeAr_rn1...~mr....~ ~ O~J1~11Y OoOtM~Md a110i7 of al!rNat MAPMRT' iT'llltl' CAMP Fi~J., ~A 17d1' B~ IIAgEIIY lT d prtlra ANOIe, n1d IAa Utma d MiM1 nMM~ aorMrra~al and y trawl. 11d undarl~ndl aw wpp~M for paymad d anir awllnwq nladoel ~ and wIN lndenaNy and held NMlenwlda hanllMeefroia aay-woh Wie. W W iudfer MGM rit YYrr heoe aenluy retl Ih~ Ilo~po4~ r~YeM rid loaw 11M aonbnM MnoR and tAwr NQI Ma cams eifn~pror~ll horaef: wrrf~ r+.nd.naMwu~ l~ dtq-w ~o,~, 1ntMpna~no~ c/Wfl01NNEAD !)IQN~ .whnaea~~ '~`°~`! ~ct1•urvr4w.1~"1,a-~s~..~.ra wlrrue elawwn rar flbnaeKe fllaa of Cawgr d ~ ,_,_. rrr ~'` aq d so~_. Aawr. aN f~+Mt apParafF t~.7weshts~skc. _ ~ n~ te+awn to ea rie varaan...da.oiwd h.nK, .;d aAw aueaouMr 1ha feraooM+~ YMMianant and ha+rha aa~oiowle~l~helrMe.MO~i~M~p~r~xeo~Aed fn eNne, 1Wt~rlnn,.omlra !ap _ ^~-d ih+010 a~ e~ sr c erns, aoamoos a+ ` JWE~ ~ t+r11e . ., .. ~, J • .. , palaal Mlhe giowM~r an0 rr/I Mlpt to dNnMa an~r Mte4e'anos e~npery a aww penan Irn an anpNaMl~ for Marries ar alalan~wt o?_aYla aenl~liM~ anY ~- faMa Hamadan or aaiaaaia far ear of mYwadYw Nlenaaean am 4nf maNeW lhaale aenanlls a tnriduMM liawanaa ao; adlkh M a aloe and aul~ada auaf- • pawen is aMntiMl anioM ~iMMw A 1 o- ~ EXHIBIT `E' t'+ ¢ f /, • ~ ~. , Y as4rLb~CaslriauaalNor>~1hdd11tAMy/0 a'Y~,~ ! ~adaq n311diq dunyN ardinaf on nr +AOrt IbhM+bP+Q~fa M ~~aa•aidaMOdedT+~Ot (9S 1M~~3toNwlla~etdpNatlelp~/I~eemoloflon b7 Hof • afdMWo~.lCadl a ~b~td~ tt Nei ~rlt d. ~ ~ iM atlrb yaroait 0011) o! ~Y far adll~arMpMMp) sM otMp11 rMOwri Dear a x ~ ~ l~~J ~a onset a ab~a Ia~daWorm~lywa~im~dtMee9'~goea~l~+trlihodwdlowt4 d~~a~wdnadra6~Irifd~ antatap~pow aKd~rM.t • Tn OoaldnMl011 dMir ~ae~ wdo0aw eldw a ~ aanM~ buM. I bw0y a~w sy MId +et m arlM ~ ralr)Mwet udwr 1hry rn'wd wt eaedw 1lb~dr was ht aMaeiowiiYywm~et Io ilrew- aaulOwaNai of 1Mr ~NrugM eikb3lMr aw ak Nd11o~t~trpN~~rarP4awela~~dwNe~de~Ir+~•o~bq~arw~nd iwwt~0 hwt~N~rApldanl~ -~ on~g6nae~eattlnot~ q....ao~,atw~a+r~, lodvi; 45k A.ti13?!¢f~QAl~eiftl~Gled~aEViyhiill~p~p~a~1hY~ , ~fi~ntar~errr. RlMlMeia~d~eMrtd~tageolt+waN~aal~mpfhNpaw~ewd ~Y IIMI m Mllet Or aat4n/lrimlil r ~~Mam~r ~ Au than ad /~ wdde0ld~~ ila~.rple.ir+rauaeirwa •awq~rmlNiwr ii~r1U/Yarv4o~ati MM~IIaN~hM~~MM~t~~1111rfIMa~,~~~a~• ~~~+bw•.~~oad rora4>•te6Y~uwau~ ~riryniwt nY wR T ey.lpdn~ b!r leawt Nemnw ra+o awuo~ d~ w1lAeee er e.ro. d~ a~awrM~p+a . tao~e ~. ~4s.are~Iraetaenr0eiw~tM~eniar«tArunai fWel~r M~M~lIIldwywrto~M4~Y n.rKiY.ra.rnpbvit t.na~i.nd fi ~*~~N f~i ~I div t~Caurd yr l~.r ltn~r wlN salt arAl red ~~MreM~Ytt+AeriMrbllrM+~au~llonefa0e a4Nia I Arew atinrn/ ~ deR di. ~9 lYs M IbiMi alsrr wlil M end b'~IK +"d~~+~regsr l~ fi~.w/ ~Mt rs .~iI11MrrT i.+ra M.Mr*d a ~ ba~wrleri.dwalld 16s e~syppodtesd wa! aMiR dne~ Mi 6ann lu ~q1-~ a +~tasaetat llom 1b. IaMrN~m~aq~ AZ 1'!d: ~.'t.AL1~ 7'~Rf IYIIL R 1T0 >~ Ol A C ~ 1'U R ~ 1~ t A ~'rR,Tl11 Q lP3'~ yoomm~raRis~T'iltA iw , rrTTA'YZ>IZiA~AT 1I+OIJ.YUl~'ATm 17~A10V~ . ~F ~ ~ w~^~ /rTEiL~ JTAtaA~i (drM 10~/7lN.Oi ~ l~Oi~?1971 ~A~Ar r 14R~+I f Abp ,~° n ~ ~ ~ ti. lOW~ 0~'A~'fO~Y ~~~~~ y M.t~~oMie~dit Alr' - d 7 SI{~!~' r a Ai~Wrl ~ a! YL BIwM (,d~ow.dy+ l~dli 1EAMalI~ ~A~Ms ~ 0?!?611~01(ligl/J0071 ~eMJrPb,NwW (,G~ ~, ..•+ On behalf of ~ ~ CJ~rntco,$, F. G, let me thank you for asl~ine ~ to t+epiesent your lateeeab in cxumectian with matteea relaxed m the death of your father. Rodney L. Steele, ~~~~~~ 1. All maneas relaood m of the Rsteae of Rodney L. Steele; 2. 3etvin8 as Co-Adtgiaietratar ofthe F.mte of Rodney L. Steele; 3. Fi+asecunn~ an acnan eadlor of a settlement for any claims in oonnectiaa with the daW of 3teela Ruls 1.5(b) of fhs Pennsylvania Rulagt ofPro_ 1 Ca~uct ~ovmnitt~ a laayefs April 1, l~amendai S'am time m tlm0apecial ordet~6,1987, "When the Iaveyet hse not ~ the Cliamr, the basin of rate of the fai ~~"the 3n wring. within a za~eonablo time otter Ruls 1.S(c) of the Pemisyivania Rule of Pmibseional Catduct eovemin a lawyer's e es~of~Apr~ll 1~19smaad~ed fYo~ndpna~tim ~ ~ ~ber~i6,1987 whioh is todeoarmined,inoludias ~ p a pee+centaea shall acaw to the lawyer in the event of sattlememot- trW a appal. lineation and other to bs deducted 8+oa4 file rocowxy~ and whether wch axpenaa are to be d wted baPara ar sRar the a~daeent fns is calou>abed. Upon concluaioa of s condneaad fee matter the lawyer sha4 provide the Client wilt a written staoen>mnt some the ovooome of the matter and, >f tha:e is a tecovary, showlne the remithwos to tim Client and the method of ib deoecminanon." L Tavonya Steels, indi and a 9duoiaeY of the Estaoe of Rodney L. Steele, the uodersiSned, herd appoiao C~an~ ~t CltaMco,~` P.G to be our attorneys for ua and in our aamea, place and ated. toe~s~esseotaopr h~oereaq sod, ~f deemed gec~ary,b9 CwaiG~ne dt Chendco,~' P.C. to insntuoe and no~dtdain an acnan at law, e~ity or othawin nsp~ relaxed scnom, and nary and sU pmsona. indivi~st imd ooeporros, to rawver dameeea by ms, with iW1 powro~ m sme~los my iogidrles, to neeoti+de ar seals, brine. prosecute sue a in :...~~ ehand taF earaoupr a+s! ettdotse as0' papsnx checlrs or ordaa on my 1.~. I. I heroby firil power aad avthorlty to the aR~r+easid attomeya to appear on behalf' of the undeeai~ged ~otlrtlon pWemerk, peasenc~utlca4 trhd and depod~aa m aay Court of the ~yaU~bv~~aot ao¢~th ~m~ayregt>;sibe~ ' shall the course of our you be with offer which moat be accepted of ce acted byyou in wrlt in the Form at he~eata..4ny ai~rny to thin Fee Agieeme~ L authoe~zed to accept or reject aqy such offer presented,. Fat theirr sesvioes, said attorneys shall ba aoNtled do a fbs, calculated a.,tio lap flan a Rio iloas the ~r psoceede of arq rscoveey mods a secured oithiriy-throe and one• third percent (33-Y3lij if the ceK is seated the fUind of a suit or llxty percaU (q~aib) of a m~of 3 ~ dt Milo. PA of B~more, MarY>and, afaremendomed Roe vnth I hmeby assiyp to >~1' said attorneys the afa~..id peeceata~e of said amouaE whicII may be rooovaeed, ab security for his Rae and autharlae psymaot dhectiy to him by sn ob)iQar. I hereby empower my attorney m ream such aasociats a subatttua attomeys in my as he sea 8t, provided the smouni of their fba shall rat eacceed iht toW attorney foe autLoriasd heroin, It b uaderatuod sad agreed that c~ mall promptly~p~ al~l Court coca in the ne~atior and ion ottide adicn and cldm- bat act g~mited to dling Reba: sltsrig'or mersll aoaa„ wi~u t6ms and miiea~ ~teba leer or chsraes, ~ Rees, bond feed. moeaudaa fees and costa, and any other cab flak mtUr be rwswati y impeded In thirclaim and scfiap and I Roedter Ler~eby ogles to reimlaase aad psgr to sdd attorneys any and all photocap~+ chepes sod lone dlaaaoe a1 ~ that nvq+ bs ineuerad by the aforesad attorneys in tb~e perfoimemce of their ropeeematlaa, boa, and prusecudon of the clsim end sctbn. C1iep heroby lrtthar a~reea that C d< Chsrnko,,~ P.C. is hereby sutharized to brim suit, deRead a to setW and eompeordssi~elaim to eececuts all docwmenb thereto, and to do all lawRoi aeb reepona'bie far etlbcdn~ the claim ~ deferme oa y~f. phase of thisthis Rx which C been ao Suartartaa mach s. to the dispositiwo of auy tae~gllap ~ CArrnfco„p'; P.C. hoe been reaiaed. It b imdeatood aad sdteed that ~ at aqy titgs;, in the eok,~ud of Cruadaghaer dk Cltenrfco,,~ P.C, the Delietdaat shall become exegtHaa ~ or rf it no likelihood of; recovery on say veedid which am bs obtained, Cwadt CAitrntco„fl; P.C. shall have the right to withdtsw seen the case upon tea (10) days< writaa mice to fhb uodersi Ia the event otsuch withdrawal, I ages fo prompter pq to said attorneys all coats and rpwr eosa which have beaapairl ar edyaQoed _bYead l~eaay~: w remahm >n s .,. , Darin fl the cow~ss of on, Cwyrfngfia+~ ~ Cllsn~ico„Q; P.~ will kap time. rccords which are always a le tQ Client... Yo the event Client terminecea this Rx a~reemmt far a~+ reason or in soy event. C ¢ Cikrafco,¢; P. G tenninaoes thin and Chart is suocasth! in the pueauit ofa@d~~ matter th[o~u flh othdr crnmeet or widwut couaeei, Client shall pay ~ Asnd¢o,Q;_P.G Reee~ Further, Client and Ciaaiinghwn ~ Cha~rico„~; P.C. may ~e~ b amend tmhlisa A~+eane~F, in rvridnR to te8act a !be based solely upon. hourly chsrQes or a hybrid of Res. and hourly chat:, Yon slwnld 4e awaea of our Sie r will bs oSi~y closed. Once tb flie fit be aorta associated with reMevt<i of L1Ror retain shred and closed flla for a rad~w mm d tyo obtain~t6 m at the a okay. Once your cees is concluded; the flla may W cant tooff-silo atora~s, sad throe may an the. ~ v t~ di CAnrrdco,,~; P.C y~need from the docum~~ve possess, we of your case. Client hereby ~s to the f~oh~ and aclmowledfloa receipt of a copy of this A~teaaa-t. hand and a ~ s~,,~V~REOF, sad i w~dit ~b be le~Uy bound, I have ha^e~mb set my 1 ar~a to e; ~iw~~yy~a capaoHy m fl of the Earate of Rodney L. 3teela The above appointment and aareanart is hereby approved and scceptod this ~~ day of rnA2rh , 2009 A C>~RMCOFF, P.C. wro P. O. Box 6M37 Hanisbuq, PA 17106-MST (717) 23d-6310....... 3 :,::, , .. E7~.HIBIT `F' ~• V I. FIMIt1 UN1~ NOtBS D~ ~X=00• 1~epQl~ ~rrt~. ~+a~ 1au~M Lid Forma ~~ ~'' '~ D11s TNrN Cody- aMR ' DMO< MEt Raf Mgt lie BrM+r a~o2rlooa tasuw ~4rNm M errR ~+as t~.awai E~pn 8Y!l1.5. RODNEY L 0712514.0 t~ol2o0o aeo~11 E~.u w~w.n M enae ~Slsn f.ewat Ewn 8TlELi. Row1EY c 0712514.01 1n217oo5 5'.SLPM 6glwws ItMM~n M 1lnflt ` '511.45 F~dual Et~18TEElE, ROOMY L o712s14.o7 110Ar100E 11:OOAM EIOMrM4 KMNMi M C~rN '510.77 t?plMrl Ewpn 8'tflLE. ROON@Y L Or12044.01 12I22I1005 2c41Md fiOMrM Iw1Mn M BnM ' '511.5? f4A1rM Ern BTIRE, ROOKY L 0712014.07 1?H7/~OOE t:a1PAt ~Mws K~M~n M MAM '{tE.71 FwlMat l~n BTEELE, ROpNEY L 07116M.01 1yt7/~00/ 11:65AM ~MMM KrNin M BYM 'S1ZA7 f4d~rM Ewe BTrlL[, ROOr1EY L 0711A44.01 12/OSrl005 t2."11iAf EgrM1Ma KYWn M wN '570.02 F4dMNl~ iTEELE, ROONEY L 0712614.01 11f10/1005 t2/!II{ fapwrN KafN~n M MfYF "524.e2 harts ~~ BTEILI, RODNEY L 0772M4A7 10/222005 72"12PM Ems IOYNr1 M Ou1N 'S1i.01 F~d~nl E~qn STEELE, RODNlY L 0772!14.01 10/t0/400E 1:04PM Mpw>•N ItrMO M BMIk 't10.A1 f~~l Bpn BTld.e, ROONEY L 0772Mi.01 6!182005 s:07PM E1pMrN KMNMn M Srllr 'S~.76 NdMrl Egan fTlELE. RODI~Y L 07125M.01 lAOIl006 11:21A11 Erhnw K1rMn M Brlk 'S28.2i f~dMY Eapn 51'ElLE. ROO14lY L 0712514.01 01052005 6:67AM iR KrINn M SMrIM '517.50 f~Qr~l tfpr i'r!!~, ROONEY L 0712514.01 Ei012005 1;I2pM gN~Na Krlwn M MIM 'pl.BD P~dirM 52pw E'rEB.t, ROONtY L 0712544.01 421/J00~ 11!1MIIM E~n1N lradwn M SWw 'i22.Q2 F~d~n4 E~ i7EELE. ROOKY L 07U514.01 l2V2005 8~7PM EIgNNN KrWn M Mtw 'n2.02 F«Iri E~p1 67EELE. RODNlY L 07125M.01 1H7/1005 103d1M Estprnw Kr1Mn M CwIY '522.40 F~drM ~1 IYTEELE, ROOrlY L 07170MA7 1!??/JOOf 1:15PM KMMn M S,.nr `510.24 f~e~rn E~pn BTEELE. RODNEY L 07126/4.01 t P y k FIIINt UNd; TNn~ , Cody WIM Prlnbd: aNLfON TIrtM PAnad: 10:]0118 Printed Br JLC X41 W~ r. • :. fM f f:26A1Y- ~~ KMNNi M Ortlt 'if 0.00 CMnq F~ Pd ~Ll, RODNEYL W12044.pi ~~ ~ 3'l~ 3s d EXHIBLT ' G' _ _ ~:, r ~, q .4 COMMt)NWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BuREluu of IrtowtouA` TAXES: PO 80x280801- FIARRI38UR0, PA 17128-0601 April 2, 2009 snja J. Warshewsky, Esq. C~o>tdnphom S Chemiadl, P.C: PO Sax ®0467 HartieDurp, PR 17106.0467 Ra: Estab d Rodney Lea Steele Flk Number 21061101 Court d Gammon PMe~ Cumt-arland Count' Dear Mr. Werehawskyc TtN Dsparbnent d RawmN hN nealved your oontaepaasnoe doled Mesh 18,1009. Attached wee Ure psgMon b approve o oompromMe selearnent b be f8ed on behoM d tM atxrw- rofennoad Ntate h ropard b a wlanphe death and eurvlval actlon. K vrae sent to thle oAlp for the CarlrnonwaMBfe approval d 1M aNOCalbn 60 8re procsede paid to eeltla 8ia actlonar ,• .. . 'Acca~dkp b tAa PalMlort, the 3o year old decedent dNd a a rostilt of a motor vehicle '. . arxldent. Decadent to survived by ha aduk dngh~bf. Pursuant to 8~e Supnma Court d Penneyh~nta, damapp ncavarable under a suMval action Induda 1hoN liar t1Alerf eamkge, awn where Blow eamkge may ba dttlloult b quanlHy, Kieerv. 8eirrlte. 636 Pa. 219, 844 A.2d' 1(1994p Thk M eupporl~d by the CammarnudelM-,6ourt:. 674 A.2d 1198 (CnrwMh. C! 1990 A potion d the subJaot recovery, ibeerrt any facie b lire contrary. therefore must ba aNocwd b iM surNval sctlon w oompeneatlon for the deosdanb lot aamirgi: PNow bra advhed flat booed upon thsM fools and aw law, the Dsportrrarrt dfeaproae b the propaed allocailon d an 80/20 spNt helwean wrorrpltd death and turvfval ocean. Horrawr. for IMadWrca tau purpose any, thM Departrrant would rrat abJeot b tfre aMoratlorr d lfre rret prooesde d this actlan, s69,888.29 b lire wronpllrt dMtlt detm era Si69,868.29 b the survival claim. This h egwi b o 60/60 split Procaade d a survival ac8on are art owet krchrded ifr ttre decsderrl's aetaoe and era subf aCt b the Impoel8on d PanMyfvarrN IrMarifarloe lore 42 Pa GS.A. §8302, 72 P.B. $9108, 9107. I iruat Bat thN latter' N a sullklerK represenWlon dtlra DeparbrarM'a poeltlon on 1hN molter. Plaaw oonbd ma N you or U1e Court 11oe any qusMfaro or rsgtrl~ae any8rirrp addMlonol from thN erxeau. '~ls`~h ~ . i 4 ~ :J J~J .~ ~ 1 i ~ U JI .iv f l.9 .3 ~ .:V ~ +.^ ~~; C I i 1 ~ .;: r .. ) ,~~' 1 I ,:~' 349 jp~ ... ...• ~ S .ylL?!14Lljyr)jF~'j a`;lllltc.'.. •}lil.!_;~.~bL!`?21~N18UIf71 (. , M:4M::~ E. Sakar . er!!~na11.' n.... ..i - ~ Tnr~Vat~n 8perl' alt . Brseeu d Indivldrral TaraN •• .t Rrorc 717.7!3-5!24 • FNC 717.7e3.3'NT • alwa; ,p~,y~ .,;e-.gip .r .. _ .{ .. ... ~. M -F E~IIB~T `I~' ,, , .~ w r AFFIDAVIT We, Bruce t, Wacehawalcy, Esquire and Tawmya Stale, as Co-Administrators of the Estate of ltodaey L. Stale and Tavouya Steele, individually, hereby approve the Petition for Approval of D~eadeat's Compromise Settlement and l~ibutioa of Pmcade Pursuant to Pe RC.P: $2206, to which this Affidavit is attached a Exhibit. "H". Dateo- Z ~ ~ _ waky, CaAdministcator ofthe of Rodney L. Steele COMMONWEALTH OF PENNSYLVANIA . SS. COUNTY OF DAUPHIN On this, the o1 fob day. of n"1a~eF~ . 2008, before me, a Notary Public, the uadersiQned officer, personally appeared Brace J. Warshaw~siq, Eagnire, lmown to me (or ssxtstactorily proven) to be the person described in the within instrument, and aclmowledged that he executed the same in the capacity therein stated sad for the purposes therein contained, IN WITNESS WfIEREOF, I hereunto set my hand and official seal. r:, .,, ', ., `~' .~ _ ~ ::' '' : ~ a ~.. ,.. w. V .k. AFFIDAVIT We, Hruce J. Warahawsky, E~quite and Tavoaya Steele, as Co-Administrators of the Estate of Rodney L. Steele and Tavonya Steele, individually, hereby approve the Petition for Approval of Decedent's Compromise Battlement and Distribution of Proceeds Pursuant to Pa RC.P. §2204, to which this Affidavit is attached as Exhibit "H". Date: c > ~- a / STATE OF MARYLAND COUNTY OF_ ~~ Tavo~a Steel vidually SS. Oa this, tha ~_ day of ~.ce h . 200 j, before me, a Notary Public, the undersigned officer, porsoaally appeared Tavonya 9teela,lmowa to me (or satisfactorily proven) to be tha person described in the within instmm~ent, and aclmowlodged that he executed the same in the capacity therein stated and for the purposes therein contained. 1N WITNESS WHEREOF, I hereunto sot my bend and official seal. Notary Public i (J 'B ~-5 (r o1 S~torrrz K~x~ 3 S. Frederldt Street Stdle 900 Beldmere, blarylend 21202 May 22, 2009 Bruce Warshawsky, Esquire. Cunningham & Chemicoff, P.C. PO Box b0457 Harrisburg, PA 17106-0457 RE: Our Client: Rodney L. Steele (Deceased)*, Our File No.: 0712644.01 D1Incident: 1/03/2007 Dear Bruce: (410)539-6339 Toa Free (800) 492-5872 Local Fax (410) 539.7088 Tag Free Fax (900) 308.3848 wwwlbttFiINEALItWY>~t.ca Per the Order that was issued, enclosed herewith please find our escrow check, number 117504, made payable to yourself and Tavonya Steele, Co-Representatives of the Estate of Rodney Steele. Also, enclosed please find a copy of the funeral bill from Bennie Smith Funeral Home is the amount of $8,547.13 which needs to be paid. If these is anything further that you need from me, please contact me. Once again, thank you for your help in bringing this matter to a conclusion. Very truly yours, 17onald S; Saiontz DSSf lc Enclosure --{---` a~ ~~ 9,, vm ~ O r to ~~ ~ t Q 3- m ~ ~ C O 9 W r ru Q 0 0 c 'd~ l' Qe '~ ~ ~ ~ J O ~c~' ~~ ~ a m ~~~ ~~~ ~~ ~ ! y nY ~ "' m sW 6 rw ~; ~. ~~ p~1sw~ ~ r'"'~r r r r Al O A ' . )N~ ` OtClf3 ~hC. ~WOII'tOIIr /~ ., P.O. Box 691 ~ T 1~-~ Dover, DE 19903- ,~ Phone: (302)678-8747 Fax: (302)736-6410 -r STATEMENT Dnre: Ahri130: _'007 f« Ms.1AC'taUELW~ fiLACK 423 hIGH sT aPT _' Chestertown, MD 21620- Services for. MR Rodney Lea Steele. Service id: W 07001 Due Date: 05/31/2007 Please return stub with your remittance to mailing address abovr. Amount S ~.= Date Deacrtpttoa Arooant 03l17/~007 Funeral Sale Obituary fee Account Balance NO11C~ f011 NpIN1ANf~ CLAr OILY Ybur+orlttt V In prneMS ._ . . snd rrallip far pignl trams Unurano~ ooio~gr 93.13 ~~~ 8597.13 ~I ~~ ., -~" ~~~; ~~~ ~~ ~ ~~! ~~ ~~ i c o~; ~~ w~ ~ ~ ~ ~ - ~~i ~~ ~' ~~~~ .. ~ ~ ~; + } ~ . ~ ~ ~~ I ~ c wM~wi. .ww www~- iwwMr.-r ~'illllll~ t a ~,~ ~i i~ I I ~ ~ ~I I! II ORIWNAI - i3.0. d h 1N! ~~ r J ~~~~ (~ ~~~~ °. L.. ~ M~ORD TOLL FREE ~ 1-800-673-9041 ~~ --{~-aO ~. A Division of Wm. V. Simile f3 Son www. sipplenronumerw. cor» 7206 Church Hill Road, Chestertown, MD 21620 4iasia-290I ~~ MEMORIALS FAX: 410-SIO-9144 Date: January 3t, 2007 Purchaser: Address: PHONE 410-810.1072 Material: ~ Medium Southern l.lbertnn Stock #, Display: Design; Cemetery: LOCATION IN LOT: t Will be marked by aflag. - Time: Approx. 8 - Tablet Base Sizc ~~ Markers 1-8 x 0.70 x Cornemosta ADDITIONAL INFORMATION. INSCRIPTIONS: ; 520 leas t0% Winter Sale discount= i 468.00 h ~j,~,~,( (~~~ 1~1 ~ "_ ~ ODNEY L~ J sTEEI.ir tJLY 15,1967 I( 3l~ 0'~ JANUARY 7, 200'I MllfJ;r Buyct: -..~ Buyer. 468.00 Monutnenc lettered ac installed 23.40 Maryland Saks Tax i 49L40 TOTAL f y Memorials _,~,_ SUBJRCT'i'O Y4 S~\l.&4 TAX tF 1NST~II.HD [N MARYLANQ PRICE DOPS NOT INCLUDE I.H'ITHRMC OR O]NER WORK AFI'kiR ORIGINAL IN.SfALLA770N. _~_'lERM4 'A deport WeOO O1t° P~ Net bhnm Lilled upon oompkaon. Belws due b drys fmm date of imoies. 1'A'. nwnthfy sepia cM,~ye aC,er n. Customer ee}een efut dtb to nwnumeot and/ex mvke,s witl remain wid, V(Tr. v, 5tPPI.H A SON ants paid tor, with eight to rnno~<seo~w. ,~_[r aoco,mt hunrnee ddi,apent, Burs+`~ rr nS maeeelae, Dorn cued euoeners fns signed under,rry sn4 (3) OrlRlosl Copies: Wm. V. Sipple Order Copy Blrby Memotiab Fik Copy Buyer Copy RECEIPT FOR PAYMENT vsaeev.soxoaeasvv~3. GLENDA FARNER STRASSAUGH Receipt Date:. it//10 2008 Cumberland County - Register Of Wi11a Receipt Time: 5.2 :1:02 One Courthouse S4quuare Receipt No.: 1054669 Carlisle, PA 17Q13 STEELE RODNEY LEE. - Estate File No.: 2008-01107 Paid Hy Remarks: CIINNINGHAM & CHERNICOFF PC A ------------------- ----- Receipt Distribution ------------------__ -___ Fee/Tax Description Payment Amount Payee Name PETITION LTR3 ADM 260.00 CUMBERLAND COUNTY GENERAL FUN SHORT CERTIFICATE 12.00 CUMBERLAND COUNTY GENERAL FUN JCP FEE AUTOMATION FEE 10.00. 5.00 BUREAU OF RECEIPTS & CNTR CUMBERLAND COUNTY GENERAL M.D FUN Check# 045512 $287.00 Total Received..... .... 5287.00 ,. ~„~ RECEIPT FOR PAYMENT osaasaaoa aesxbaa=aa GLENDA FARNER STRASSAUGH' Cumberland County - Register Of Willa One Courthouse Sqquuare. Carlisle; PA 17013 STEELFs RODNEY LEE Receipt Date: 12/08/2008 Receipt Time: 09:53:02 Receipt No.: 1054987 Estate File No.: 2008-01107 Paid By Remarks: wtZJNNINGHAM & CHERNICOFF ------------------------ Receipt Distribution. ----------------------_~ Fee/Tax Description Payment Amount Payee Name PETITION LTRB ADM 20.D0 CUMBERLAND COUNTY GENERAL PUN Check# 012382 $20.00 Total Received......... $20.00 N V O I C E ,500 Pmritllr Sheei ~ ~ourna~ ,q~~,r,a: nr-s~oo ~gC~~~3~~ PUBLICATl4NS'r~.jebam nEC i 5 zoos. INVOICE TO Cunningham 8 Chemkoff, P.C. BY ................. Acccunta Payabls ~-- P. O. Box 8046t Harrisburg, PA 17108 1?HYl2008 ORDER A: 81396 TERMS: Net 30 Oryr ADVERTI8ER Cunningham & Chemkoff, P.C. INVOICING: Adwktleer OLICRIPTWIk OF t:}IARGEi' C~'P .~ CREDR IALANCE PUBLICATION: CLASSIFIEDiCENTRAL PENN BUS. JRNL COVER DATE: 1?/6/2008 TFIEME: CLASSIFIED ADlCENTFiAL PENN SUSINE88 JOUR RATE CARD: DI.aCRIPTION OF AD: Lsgd lung: Stwle Estme REPis>: :-CWsiMd AxouM E~naNw 84iE: LEGAL LISTtNO, PAGE: 97.00 COLOR: SSW 0.00 PROOF OF PUBLICATION OF NOTICE IN CUMBERLAND LAW JOURNAL (Under Act No. 38?, approved May 16, 1929), P. L.1784 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND e!. Lisa Marie Coyne, Esquire, Editor of the Cumberland Law Journal, of the County and state aforesaid, being duly sworn, according to law, deposes sad says that the Cumberland Law Journal, a legal periodical published in the Borough of Carlisle in the County end State aforesaid, was established January 2, 1932, and designated by the local courts as the official legal periodical for the publication of all legal notices, and has, since January 2, 1932, been regularly issued weekly in the said County, and that the printed notice or publication attached hereto is exactly the same. as was printed in the regular editions and issues of the said Cumberland Law Journal on the following dates, AtTiant further deposes that he is authorized to verify this statement by the Cumberland Law Journal, a legal periodical of general circulation, and that he is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statements as to time, place and character of publication are true. Marie Btesb, 1!o/aq Lae, decd. Late of Camp Hill. Administrator. Tavonya Steele. Attorneys:l3rucx J. warahawsky, qu , Gtiuaningham & Cherni- cEoB, P C., 2340 North Second Street, Haaisbur*, PA 1711P. SWO1tN TO AND 3UBSCRIB$D before me this day of December. 2008 Notary WOtNINL SEN. oewaw ~ cottons rainy R,enc c~atmte wan, cun~tt~ao cournr ray eonrdwon o~ Apr Zs. 2oio COAWcICNWiIALTN OF PENN8YLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIV10UAl TAXER DEPT. 28000'1 NARRISBURO~ PA 171 YBL801 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT WARSHAWSKY BRUCE J CUNNIGHAM &CHERNICOFF PC 2320 N SECOND STREET HARRISBURG, PA 17110 ----~ ESTATE INFORMATION: SSN: 223-o4-68to FILE NUMBER:. 2108-1107 DECEDENT NAIVE: STEELE RODNEY LEE DATE OF PAYMENT: 06/03/2009 POSTMARK DATE: 06!0212009 COUNTY: CUMBERLAND DATE OF DEATH: Ol /07/2007 REV-1184 EXi11-9E1 NO. CD 011310 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ $2,300.00 TOTAL AMOUNT PAID: REMARKS: CUNNINGHAM & CHERNICOFF CHECK#012823 sEA~ INITIALS: W2 $2,300.00 GLENDA EARNER STRASBAUGH REGISTER OE WILLS - RECEIVED BY: TAXPAYER