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HomeMy WebLinkAbout11-03-09 1505607120 ~~~ ~oo ~ (~5) OFFICIAL USE ONLY PA Department of Revenue county coos veer Fie Nunber Bureau of Individual Taxes INHERITANCE TAX RETURN PO 80X.280601 21 0 8 0 614 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death 208 24 2145 05 03 2008 Decedent's Last Name MELLINGER (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Date of Birth 06 28 1929 Suffix Decedent's First Name MI JR. IRA C Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICJ4TE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW X^ 1. Original Retum ~ 2. Supplemental Retum ~ 3. Remainder Retum (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. F"i"re Interest Compromise ~ 5. Federal lstake Tax Retum Required (date of death after 12-12-82) g. Decedent Died Testate ~ ~ D men ~ ~t Teed; Living Trust 8, Total Number of Safe DeposR Boxes (Attach Copy of Nraq ( 9. Litigation Proceeds Received ~ t p, Spousal r~wenr credit (date of desa, ~ t ~. Election to tax under Sec. g113(A) heMroen 12-31- 1 end i-1-g5) (Attach $ch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFOR ON SHOULD BE DIRECTED TO: Name Daytime Tel~phlone Number EARL RICHARD ETZWEILER (717)'234 5600 Firm Name (if Applicable) ETZWEILER AND ASSOCIATES First line of address 105 NORTH FRONT STREET Second line of address City or Post Office HARRISBURG State ZIP Code PA 17101 REGISTER OF WILLS~E ONLY , .o Z `a> r-: _• , ~ s~~ ~,. L i W ~. ~_. c. `~~ r FILED ~ , i,,._ ~ - t' .. ~•-~-.. Correspondent's e-mail address: REtZWeilert~COmCast.net Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, k is true, correct and complete. DeGaretion of preparer other than the personal representative IS based on all information of which reparer has any knowledge. ADDRESS Lou Brandt 10130 to 337 Maple Lane, Carlisle, PA 17015 SIGNATURE OF PREP ER OTHE THAN REPRESENTATIVE Earl Richard Etzweiler ~ l~~ Q ~ ADDRESS . 105 North Front Street, Harrisburg, PA 17101 Side 1 1505607120 15056[17120 J 1505607220 REV-1500 EX • Decedent's Social Security Number o~SN~: Ira C Mellinger Jr. 208 24 2145 RECAPITULATION 1. Real Estate (Schedule A) .......................................................................................... 1. 1 3 7, 0 0 0. 0 0 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 6, 1 0 4. 8 0 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3. 4. Mortgages & Notes Receivable (Schedule D) .......................................................... 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ................ 5. 1 6 , 4 7 8 . 6 0 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ............. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ............. 7. 8. Total Gross Assets (total Lines 1-7) ....................................................................... 8. 1 5 9, 5 8 3. 4 0 9. Funeral Expenses 8 Administrative Costs (Schedule H) ......................................... 9. 1 7, 3 2 5. 6 8 10. Debts of Decedent, Mortgage Liabilities, ~ Liens (Schedule I) ................................ 10. 2 9 , 8 4 7 9 9 11. Total Deductions (total lines 9 8~ 10) ...................................................................... 11. 4 7 , 17 3 . 6 7 12. Net Value of Estate (Line 8 minus Line 11) ............................................................. 12. 1 12 , 4 0 9 . 7 3 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ................................................. 13. 1 0 2 , 4 0 9 . 7 3 14. Net Value Subject to Tax (Line 12 minus Line 13) ................................................. 14. 1 0 , 0 0 0 . 0 0 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x .o0 0. 0 0 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate X .045 0. 0 0 16• 0. 0 0 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17• 0. 0 0 18. Amount of Line 14 taxable at collateral rate x .15 10 , 0 0 0. 0 0 18• 1, 5 0 0. 0 0 19. Tax Due ..................................................................................................................... 1s. 1, 5 0 0. 0 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 1505607220 1505647220 REV-1500 EX Page 3 File Number 21-08-0614 Decedent's Complete Address: DECEDENTS NAME Ira C Mellinger Jr. STREET ADDRESS 409 S. Enola Drive CITY Enola STATE PA ZIP 17025 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditslPaymeMs A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty'rf applicable p. Interest E. Penalty 1,500.00 0.00 0.00 Total Credits (A + B + C) (1) 1,500.00 (2) 1,500.00 Total Interest/Penalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT (3) 0.00 (4) (5) 0.00 (5A) (5B) 0 , 0 Q 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 :.................................................................................. x b. retain the right to designate who shall use the property transferred or its income :.................................... x c. retain a reversionary interest; or .................................................................................................................. x d. receive the promise for life of either payments, benefits or can:? .............................................................. x 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................................................... ^ ^x 3. Did decedent own an 'in trust for" or payable upon death bank account or security at his or her death?......... ^ ^x 4. Did decedent own an Individual Retirement Account, annuity, or other non-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 transferts to or for the use of the surviving spouse is three (3) percent p2 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 exemot 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 Juy 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 tp or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [T2 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)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whetfjer by blood or adoption. Rev-1602 p(+ (6-98) SCHEDULE A REAL ESTATE COMdONNIFALTH OF PENNSYIVANW pJFiERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NWMBER Mellinger, Ira C Jr. 21-108-0614 All reel properly owned solely or u e [anent In common must bs roportad a< hir market value. Fair market value fs defined as the price at Wlrch property would be exchanged between a waling txryer end a wAGng se9er, netlher being compeAed to buy or seA, both having reasonable knueAedge of the rleleveM facts. Real property which is Jointlyowned wMh rtght of suMvorship must be disGosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Real Estate known as 30 South Front Street, Wormleysburg, situate in 62,000.00 Wormleysburg Borough, Cumberland County, Pennsylvania, identified as Cumberland County Tax Parcel No. 47-20-1858-094, with the Deed being recorded in Cumberland County in Deed Book "X", Vol. 33, Page 166, sold at private sale for $62,000.00. 2 Real Estate known as 409 S. Enola Drive, Enola, situate in East Pennsboro 75.000.00 Township, Cumberland County, Pennsylvania, identified as Cumberland County Tax Parcel No. 09-16-1050-029, with the Deed for the property being recorded) in Cumberland County in Deed Book "Z", Vol. 22, Page 714, sold by private sale for $75,000.00 TOTAL (Also enter on Line 1, Recapitulatign) 137,000.00 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form' PA-1500 Schedule A (Rev. 6-98) rtew~soa oct (o-ss) SCHEDULE B STOCKS ~ BONDS ca.410NNIFxrr+ of PENNSV~vAN1A I I eYrERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE (NUMBER Mellinger, Ira C Jr. 21-p8-0614 Ail property joirdiyowned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 735.518 shares of Thrivent Income Fund - A Shares @ 6,104.80 $8.30 per share TOTAL (Also enter on Line 2, Recapitulation) 6,104.80 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) Rev-1601 t7(+ (6-96) cor+NtoNwFxTti of PErtNSV~vANIA e1NERITANCE TAX RETURN Rl:9DEM DECEDENT ESTATE OF (FILE NUMBER Mellinger, Ira C Jr. 21»08-0614 Indude the proceeds of ktipation and the date the proceeds were received by the estate. All propsRy Joirrtlyowned wNh the rlQht of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Anthony W. Frey and Constance A. Frey, reimburse Estate for portion of 200a?ti 31.18 County/Borough tax 2 Anthony W. Frey and Constance A. Frey, reimburse Estate for portion of 200$-09 641.59 School tax 3 Internal Revenue Service, 2008 Federal Income Tax Refund 1,092.00 4 Internal Revenue Service, 2008 Stimulus Payment 600.00 5 M & T Bank -Checking Account #76871746 10,228.87 6 PNC Bank -Checking Account 5140112605 2,395.62 7 Stephen B. Diller, reimburse Estate for portion of 2009-2010 School taxes fori409 S. 840.14 Enola Drive property 8 Stephen B. Diller, reimburse Estate for portion of 2009 County/Township taxes for 74.58 409 S. Enola Drive property 9 Stephen B. Diller, reimburse Estate for portion of sewer bill for 409 S. Enola Drive 51.37 property 10 Stephen B. Diller, reimburse Estate for portion of trash bill for 409 S. Enola Dive 23.25 property 11 1988 Cadillac in very poor condition, sold for $500.00. Buyer had to pay to have it 500.00 towed. TOTAL (Also enter on Line 5, Recapitulation) I 16,478.60 SCHEDULE E CASH, BANK DEPOSITS, ~ MISC. PERSONAL PROPERTY (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) REV-1161 EX+ (12-98) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & ~" E8IDENED EoE~NrR" ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Mellinger, Ira C Jr. 21-08-0614 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER q, FUNERAL EXPENSES: See continuation schedule(s) attached 1,668.00 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Mary Lou Brandt Social Security Number(s) / EIN Number of Personal Representative(s): Street Address 337 Maple Lane ~;ty Carlisle state PA zip 17015 Year(s) Commission paid 7,363.34 2, Attorney's Fees Earl Richard Etzweiler 7,363.34 3, Family Exemption: (If decedent's address is not the same as Gaimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 295.00 5. Accountant's Fees 6. Tax Return Preparers Fees 7. Other Administrative Costs 636.00 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 17,325.68 Copyright (c) 2002 form software ony The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE'INUMBER Mellinger, Ira C Jr. I 21-08-0614 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Rolling Green, grave marker 1,668.00 H-A Subtotal 1,668.00 Other Administrative Costs 2 Bureau of Public Debt, savings bond search 18.00 3 Cumberland County Legal Journal, advertise estate 75.00 4 Etzweiler 8~ Associates, photocopies, postage, notary fees, etc. 400.00 5 Heather A. Heisey, witness will 15.00 6 Mary Jane Herr, witness will 15.00 7 Paxton Herald, advertise estate 38.00 8 Register of Wills, additional probate fees 55.00 9 Register of Wills, file Renunciation 5.00 10 Register of Wills, three Short Certificates 15.00 H-B7 subtotal 636.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form IPA-1500 Schedule H (Rev. 6-98) Rev-1b12 p(+ (b-96) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES,~8~ LIENS CDAMO~NVEALTH of PENNSrivANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE' NUMBER Mellinger, Ira C Jr. 21.08-0614 Include unreimbuneed medlcsl expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Black's Trash Service, dumpster - pd.1/6/09 663.55 2 Black's Trash Service, dumpster - pd.10/14/08 350.00 3 Black's Trash Service, dumpster - pd. 4113/09 350.00 4 Black's Trash Service, dumpster - pd. 6122/09 170.85 5 Debbie Lupold, 2008-09 School taxes for 409 S. Enola Drive, Enola, Pennsylv~lnia 1,249.30 6 Debbie Lupold, Tax Collector, 2009-2010 School Taxes for 409 S. Enala Drive` 1,226.60 Enola, Pennsylvania 7 Debbie Lupold, Tax Collector - 2009 CountylTownship taxes for 409 S. Enola'Drive, 394.52 Enola, Pennsylvania 8 East Pennsboro Township, final trash bill 31.00 9 East Pennsboro Township, water, sewer and trash charges - pd.1/6/09 115.00 10 East Pennsboro Township, water, sewer and trash charges - pd.10/14/09 68.50 11 East Pennsboro Township, water, sewer and trash charges - pd. 10/3108 115.00 12 East Pennsboro Township, water, sewer and trash charges - pd. 4/13/09 115.00 13 East Pennsboro Township, water, sewer and trash charges - pd. 7!8/09 115.00 14 Etzweiler & Associates, statement for services rendered to Decedent, prior to' 1.113.04 Decedent's death 15 Golden Living Center of Camp Hill, outstanding nursing home bill 9.103.94 I Total of Continuation Schedules See attached pages TOTAL (Also enter on Line 10, Recapitulation) 29,847.99 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Forrh PA-1500 Schedule t (Rev. 6-98) Rev-1512 E7(+ (5-8E) scNe~u~E ~ DEBTS OF DECEDENT, MORTGAGE LIABILITIES, ~ LIENS ~E°~~'s~;""" continued ~~~~ ESTATE OF IFILE'NUMBER Mellinger, Ira C Jr. 21-08-0614 ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 16 Holy Spirit Hospital, outstanding medical bill 131.95 17 Jeff Brandt, clean out junk from real estate 728.83 18 Jeff Brandt, clean out real estate -4119/09 200.00 19 Jeff Brandt, maintenance of real estate -10/10109 100.00 20 Jeff Brandt, maintenance of real estate -12/24/08 324.00 21 Jeff Brandt, maintenance of real estate - 5/3109 140.00 22 Jeff Brandt, maintenance of real estate - 611/09 190.00 23 Jeff Brandt, maintenance of real estate - 6115109 150.00 24 Jeff Brandt, maintenance of real estate - 719/09 125.00 25 Jeff Brandt, maintenance of real estate - 819109 75.00 26 Jeff Brandt, maintenance of real estate - 9/14/09 150.00 27 Leffler Energy Co., fuel oil bill - pd. 1120/09 488.30 28 Leffler Energy Co., fuel oil bill - pd. 12/24/08 589.19 29 Leffler Energy Co., fuel oil bill - pd. 2125/09 314.24 30 Leffler Energy Co., fuel oil bill - pd. 3123109 257.55 31 Leffler Energy Co., fuel oil bill - pd. 9/10108 899.66 32 M ~ T Bank, charge for checks 19.75 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule 1(Rev. 6-98) Rev-1512 p(+ (6-98) ca~oNUVEUni of e~r~Nmvnaw e+~RrrurcE rrx r~vru+ ResnFxr oece~rrt SCHEDULE 1 DEBTS OF DECEDENT, M012TGAGE LIABILITIES, & LIENS continued ESTATE OF FILE'NUMBER Mellinger, Ira C Jr. 2108-0614 ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 33 Marcus Brandt, maintenance of real estate -10/10109 50.00 34 Marcus Brandt, maintenance of real estate -12124108 216.00 35 Marcus Brandt, maintenance of real estate -4/13109 100.00 36 Marcus Brandt, maintenance of real estate - 513109 140.00 37 Marcus Brandt, maintenance of real estate - 611109 190.00 38 Marcus Brandt, maintenance of real estate - 719109 40.00 39 Marcus Brandt, maintenance of real estate - 8/9109 50.00 40 Michael Brandt, maintenance of real estate -4113/09 100.00 41 National Motor Museum, outstanding bill 25.00 42 Nationwide Insurance Company - pd. 10/16/08 51.42 43 Nationwide Insurance Company - pd. 3112!09 107.46 44 Nationwide Insurance Company - pd. 3129109 55.73 45 Nationwide Insurance Company - pd. 4129/09 55.73 46 Nationwide Insurance Company - pd. 6/29/09 55.73 47 Nationwide Insurance Company - pd. 613/109 55.72 48 Nationwide Insurance Company - pd. 8126109 107.45 49 Nationwide Insurance Company - pd. 9127109 55.72 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) Rev-1512 p(+ t6-88) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, ~ LIENS ~ ~ - ~ ~ - CO"'~AON"~"~TM °F ~""S'""A"" continued INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Mellinger, Ira C Jr. 21-p8~+0614 ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 50 PA American Water, water bill - pd.1/26/09 29.97 51 PA American Water, water bill - pd.10/16/08 6.06 52 PA American Water, water bill - pd.10/29/08 30.48 53 PA American Water, water bill - pd.10/3/08 20.06 54 PA American Water, water bill - pd. 11/24/08 31.88 55 PA American Water, water bill - pd. 12/30/08 32.57 56 PA American Water, water bill - pd. 2125!09 29.27 57 PA American Water, water bill - pd. 3!23/09 27.15 58 PA American Water, water bill - pd. 4122109 27.22 59 PA American Water, water bill - pd. 5126109 26.51 60 PA American Water, water bill - pd. 6/22109 27.22 61 PA American Water, water bill - pd. 7/23109 28.68 62 PA American Water, water bill - pd. 8126/09 26.54 63 PA American Water, water bill - pd. 9110108 488.01 64 PA American Water, water bill - pd. 9!24108 123.86 65 PA American Water, water bill - pd. 9/24109 26.54 66 PCS, outstanding bill 33.90 Copyright (c) 2002 form software only The Lackner Group, Inc. Fomn PA-1500 Schedule I (Rev. 6-98) Rev-1512 E7(+ (6-98) SCHEDULE 1 DEBTS OF DECEDENT, - - - WIORTGAGE LIABILITIES, 8~ LIENS ~TM~P~""~"""'" INHERRANCE TAX RETURN continued RESIDENT DECEDENT ESTATE OF FILE (NUMBER Mellinger, Ira C Jr. 21-08-0614 ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 67 Pharmerica, outstanding prescription bill - pd. 9127108 198.80 68 PPL Electric Utilities - 30 S. Front Street, Wormleysburg - pd.10/29/08 45.02 69 PPL Electric Utilities - 30 S. Front Street, Wormleysburg - pd.1.1/26/08 60.85 70 PPL Electric Utilities - 30 S. Front Street, Wormleysburg - pd. 12/30/08 71.07 71 PPL Electric Utilities - 30 S. Front Street, Wormleysburg - pd. 9110108 83.67 72 PPL Electric Utilities - 409 S. Enola Drive, Enola - pd.11/03/08 22.18 73 PPL Electric Utilities - 409 S. Enola Drive, Enola - pd. 12/2108 26.45 74 PPL Electric Utilities - 409 S. Enola Drive, Enola - pd. 12/31108 23.25 75 PPL Electric Utilities - 409 S. Enola Drive, Enola - pd. 213109 27.91 76 PPL Electric Utilities - 409 S. Enola Drive, Enola - pd. 312/09 18.41 77 PPL Electric Utilities - 409 S. Enola Drive, Enola - pd. 4/3109 17.97 78 PPL Electric Utilities - 409 S. Enola Drive, Enola - pd. 5130109 16.58 79 PPL Electric Utilities - 409 S. Enola Drive, Enola - pd. 515109 17.01 80 PPL Electric Utilities - 409 S. Enola Drive, Enola - pd. 6/29109 24.47 81 PPL Electric Utilities - 409 S. Enola Drive, Enola - pd. 8/1109 18.63 82 PPL Electric Utilities - 409 S. Enola Drive, Enola - pd. 9/30108 12.50 83 PPL Electric Utilities - 409 S. Enola Drive, Enola - pd. 9/30109 18.52 Copyright (c) 2002 form software only The Lackner Group, Inc. Form) PA-1500 Schedule I (Rev. 6-98) Rev1672 IX+ (6-981 C.OAMIONVVEALTIi of PENNSnvANw INHERITANCE TAX RETURN RESN)ENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES~,~ ~ LIENS continued ESTATE OF FILE'NUMBER Mellinger, Ira C Jr. 2108-0614 ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 84 PPL Electric Utilities - 409 S. Enola Drive, Enola - pd. 914109 19.27 85 Recorder of Deeds,1%Realty Transfer Taxes for sale of 30 South Front Street, 620.00 Wormleysburg 86 Recorder of Deeds, /% Realty Transfer Taxes for sale of property at 409 S. Eriola 750.00 Drive, Enola 87 Robert Emsinger, Auctioneer -remove junk - pd. 10/20/08 953.68 88 Robert Emsinger, Auctioneer -remove junk - pd. 11/08/08 475.81 89 Robert Emsinger, Auctioneer -remove junk - pd. 11/25/08 390.00 90 Storage fee - pd. 412/09 232.76 91 Storage fee - pd. 4129109 103.88 92 Storage fee - pd. 611109 103.88 93 Storage fee - pd. 6126/09 103.88 94 Storage fee - pd. 7/29/09 103.88 95 Storage fee - pd. 9130/09 103.88 96 Storage fee - pd. 914109 103.88 97 U-Haul, expense to move personal property into storage 200.00 98 UGI, fee to turn on gas service and pay balance owed 500.00 99 UGI, gas bill - pd. 1120109 20.01 Copyright (c) 2002 form software only The Lackner Group, Inc. Forrh PA-1500 Schedule I (Rev. 6-98) Rev-1612 p(+ (6-96) SCHEDULE 1 DEBTS OF DECEDENT, - - -NfORT~AGE LIABILITIES, ~ LIENS - ~ - - -- . _ _ col.~.loNwFxTM of aENNSnvANU continued teiERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE' NUMBER Mellinger, Ira C Jr. 21±08-0614 ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 100 UGI, gas bill - pd. 1018109 17.87 101 UGI, gas bill - pd. 1218/08 27.28 102 UGI, gas bill - pd. 2/12109 21.44 103 UGI, gas bill - pd. 3113109 21.35 104 UGI, gas bill - pd. 4113109 16.55 105 UGI, gas bill - pd. 5126109 19.21 106 UGI, gas bill - pd. 6/15109 17.87 107 UGI, gas bill - pd. 7111109 19.85 108 UGI, gas bill - pd. 9111109 17.87 109 UGI, gas bill - pd. 9/18!08 77.45 110 Verizon, telephone bill 26.89 111 Verizon, telephone bill - pd.1/19/09 30.10 112 William A. O'Donnell, Tax Certification fee 10.00 113 William O'Donnell, Tax Collector - 2008 County/Borough taxes for 30 South Flront 1,083.31 Street, Wormleysburg 114 Wormleysburg Borough, water and sewer charges for 30 South Front Street, 266.20 Wormleysburg - pd. 9125108 Copyright (c) 2002 form software only The Lackner Group, Inc. Fomh PA-1500 Schedule 1(Rev. 6-98) Rev-1612 EX+ (&98) SCHEDULE 1 DEBTS OF DECEDENT, ._ ._ MOFZTGAGE LIABILITIES, & LIENS ~- - ~ ~ ~ -~ coMMONwEALTN of PENNSYWANw continued MIHFRRANCE TAX RETURN RESIDFM DECEDENT ESTATE OF IFILE'NUMBER Mellinger, Ira C Jr. 21»08-0614 Copyright (c) 2002 form software only The Lackner Group, Inc. Forrih PA-1500 Schedule I (Rev. 6-98) REV-1bt3 EX+ (9-0D) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA -INHERITANCETAX RETURN - "- ~ ~ ' - ~lil/~p'cc BENE C C l~ M[\ G 7l _. ... RESIDENT DECEDENT - r f - ~ aa .- .._ - ESTATE OF FILE NUMBER Mellinger, Ira C Jr. 21-08-06 14 NUMBER NAME AND ADDRESS OF RELATIONSHIP TO DECEDENT SHARE OF EStATE AMOUNT OF ESTATE PERSON(S) RECEIVING PROPERTY Do Not List Trust s (Words) ($$$) I. TAXABLE DISTRIBUTIONS [nclude outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] Mary Lou Brandt First Cousin Specific 10,000.00 337 Maple Lane bequest of Carlisle, PA 17013 $10,000.00 Total 10,000.00 Enter dollar amounts for distributions shown above on lines 1 5 through 18, as appropr iate, on Rev 150 cove r sheet III NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO tAX IS NOT'' BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 Zion Evangelical Lutheran Church 50,000.00 2 Bethesda Mission 17,469.91 3 The Salvation Army 17,469.91 4 Knights of Pythias 17,469.91 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER! SHEET L 102,409.73 Copyright (c) 2002 form software only The Lackner Group, Inc. Fonn'~,PA-1500 Schedule J (Rev. 6-98) LAST WILL AND TESTAMENT OF IRA C. MELLINGER, JR. I, IItA C. MELLINGER, JR., a resident of Wormleysbl~rg Borough, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this instrument to be my Last Will and Testament, hereby revoking any and all wills by me at any time heretofore made. ITEM I: I direct my hereinafter named Executor to pay all my just debts, funeral expenses, administration expenses and inheritance, estate, succession or excise taxes, which I owe or may become due on account of my death, as soon as may be convenient after my decease. ITEM II: I give, devise and bequeath the sum of Fifty Thousand Dollars ($50,000.00) to Zion Evangelical Lutheran Church, of 265 North Enola Drive, Enola, PA 17025. A. If said church should not be in existence at the time of my decease, then said share shall lapse and be included in the residue of my estate. ITEM III: I give, devise and bequeath the sum of Ten Thousand Dollars ($10,000.00) to my cousin, Mary Louise Brandt, of 337 Maple Lane, Cdrlisle, PA 17013. ,. A. If my said cousin should predecease me or die simultaneously with me, then said share shall lapse and be included in the residue of my estate. ITEM IV: All the rest, residue and remainder of my estate, be it real, personal or mixed, of whatever nature and wheresoever situate which I may own ar have the right to dispose of at the time of my decease I give, devise and bequeath to be divided equally among the following: L~ ~ J EAL) Ira C. Mellinger, .Ir. A. Bethesda Mission, of 611 Reny Street, Harrisburg, PA - - - ._ - - B. The Salvation Army, of ll22 Green Street, Harrisburg, PA C. Knights of Pythias, Buehler Lodge, Marysville, PA D. Pythias Sisters, Buehler Lodge, Marysville, PA ITEM V: If any of the above-named charities should not be in existence at the time of my decease, then said share shall lapse and the residue shall be divided squally among those charities in existence at the time of my decease. ITEM VI: I hereby nominate, constitute and appoint Mid 'Penn Bank, of 349 Union Street, Millersburg, PA 17061, its successors or assigns, Executor of this my Last Wi11 and Testament, with full power in its discretion to do any and all things necessary for the complete administration of my estate, without being required to file bond for the performance of its duties, with full power to sell at public or private sale and without order of court any real or personal property belonging to my estate, and to compound, compromise or otherwise settle or adjust any and all claims, charges, debts and demands whatsoever against or in favor of my estate as fully as I could if living. IN WITNESS WHEREOF, I have hereunto set my hand and' seal to this my Last Will and Testament this day of September, 2000. ,. /~ ' C ~~ _/ ~~~~~ ~ _J-~ ~ . SEAL) Ira C. Mellinger„ Jr. ~~' Signed, sealed, published and ~ ~ - ~ - ~ - declared by the above-named Ira C. Mellinger, Jr. as and for his Last Will and Testament, in the presence of us, who at his request, in his presence and in the presence of each other, we believing him to be of sound and disposing mind, memory and understanding, have hereunto subscribed our names as witnesses this day of September, 2000. C~i~ ~ "fit-~ ,, AMR NA 95M119RS A B. TYPE OF LOAN: DEPARTMENT OF HOUSING S URBAN DEVELOPMENT U S 1.~FHA 2.QFmHA 3. CONY. UNINS. 4. QVA 5. ~CONV. INS. . . 6. FILE NUMBER: 7. LOAN NUMBER: SETTLEMENT STATEMENT 8, MORTGAGE INS CASE NUMBER: C. NOTE: This fiwm is famished to give you a statement of actual settlement costs. Amounts paid to ar-d by the settlement agent are shown. Items marked (POC]' were paid outside the closing; they an: shown hen: for informational pu-poses and are not inGuded rn the totals. 7.0 3198 (2008-0070.PFDR008.OD7013) D. NAME AND ADDRESS OF BORROWER: Anthony W. Frey and Constance A. Frey his wife 66 Sherwood Circle Enola, PA 17025 E. NAME AND ADDRESS OF SELLER: Estate of Ira C. Mellinger, Jr F. NAME ANA ADDRESS OF LENDER: G. PROPERTY LOCATION: 30 South Front Street PA 17043 Wormleystwrg H. SETTLEMENT AGENT: 23-1677682 Christian S. Daghir 1. SETTLEMENT DATE: December 11 2008 , Cumberland County, Pennsylvania 47-20-1858-094 Wonnlesyburg Borough PLACE OF SETTLEMENT 105 North Front Street Harrisburg, PA 17101 , J. Y R'S TRAN CT N K. SUM Y OF SE E TRA NSACTION 101. Contrail Sales Price 62,000.00 401. Contrail Sales Price 62,000.00 102. Personal Pro 402. Personal Pro 103. Settlement Cha s to Borrower Line 1400 1,128.50 403. 104. 404. 105. 405. 106. 2008 School Taxes 12!12/08 to 07/01/09 641.59 406. 2008 School Taxes 12!1210 to 07/01/09 641.59 107. 2008 Coun Taxes 12/12/08 to 01/01/09 31.18 407. 2008 Coun Taxes 12/12/0 to 01/01/09 31.18 108. Assessments to 408. Assessments to 109. 409. 110. 410. 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 63,801.27 420. GROSS AMOUNT DUE TO SE R 6?~,672.77 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE O ELLER: 201. De sit or earnest move 1,000.00 501. Excess De osit See Instructions 202. Princi al Amount of New Loans 502. Settlement Cha es to Seller Linei 1400 630.00 203. Existin loans taken sub'ed to 503. Existin loans taken sub'ect to 204, 504. Payoff of first Mortgage 205. 505. Pa ff of second Mort a e 206, 506. De sit retained b seller 1,000.00 207. 507. 208. 508. 209. 509. u n tams n a a er us en ms n r a er 210. 2008 School Taxes to 510. 2008 School Taxes to 211. 2008 Coun Taxes to 511. 2008 Coun Taxes to 212. Assessments to 512. Assessments to 213. 513. 214. 514. 215. 515. 21fi. 516. 217. 517. 218. 518. 219. 519. 220. TOTAL PAID BY/FOR BORROWER 1,000.00 520. TOTAL REDUCTION AMOUNT D E SELLER 1,630.00 300. CASH AT SETTLEMENT FROMITO BORROWER: 600. CASH AT SETTLEMENT TO/FR M ELLER: 301. Gross Amount Due From Borrower Line 120 63,801.27 601. Gross Amount Due To Seller Line' 42D 62,672.77 302. Less Amount Paid B/For Borrower Line 220 ( 1,000.00 602. Less Reductions Due Seller Line 2p) ( 1,630.00 303. CASH (X FRO TO BORROWER 62 801.27 603. CASH (X TO ( FROM SEL R 61,042.77 The ands pages i az of tnrs statement a any attachments reterre4 to nerem. Seller ~? ~~`.,, Estat of Nr Mellinger, Jr ~ HU0.7 (3A6) RESPA, H84305.2 Pare. 7 L. SETTLEMENT CHARGES 700. TOTAL COMMISSION Based on Price ° PAID FROM PAID FROM Division of Commission line 700 aS FOIIOWS: BORROWER'S SELLER'S 701. $ t0 FUNDS AT FUNDS AT 702' $ t0 SETTLEMENT SETTLEMENT 703. Commission Paid at Settlement 704. to 0. ITEMS P CONN CTIO TH LOAN 801. Loan O ' ination Fee % to 802. Loan Discount % to 803. Appraisal Fee to 804. Credit Report to 805. Lender's Inspection Fee to 806• Mo a e Ins. A .Fee to 807. Assumption Fee to 808. 809. 810. 811. V 901. Interest From to ~ $ /day ( days °k) 902. Mo a e Insurance Premiumfor months to 903. Hazard Insurance Premium for 1.0 ars to 904. 905. 100 E E DEPOSITED WITH LENDE 1001. Hazard Insurance $ r 1002. Mort a e Insurance $ r 1003. 2008 School Taxes $ er 1004. 2008 Coun Taxes $ r 1005. Assessments @ $ per 1006. $ er 1007. @ $ Per 1008• $ er 1100 ITL C A E 1101. Settlement or Closin Fee to Etzweiler 8 Associates 75.00 1102. Abstract or Idle Search to Etzweiler 8 Associates 385.00 1103. Tdle Examination to 1104. Title Insurance Binder to 1105. Document Pre aration to 1106. Nota Fees to 1107. Attorney's Fees to includes above item numbers: 1108. Title Insurance to includes above item numbers: 1109. Lenders Coverage $ 1110.Owners Coverage $ 1111. 1112. 1113. 12 VE M NT ECORDI T N C S 1201. Recording Fees: Deed $ 38.50; Mortgage $ Releases $ 38.50 1202. C' /Coun Tax/Stam s: Deed 620.00 Mort a e 620.00 1203. State Tax/Stam s: Revenue Stam s 620.00; Mort a e 620.00 1204. Tax Parcert Certfication Fee to Cumberland Coun Recorder of heeds 10.00 1205. 1300 D A EMEN CH R E 1301. Surve to 1302. Pest Ins action to 1303. Tax Certification Fee to William A. O'Donnell 1000 1304. 1305. 1400. TOTAL SETTLEMENT CHARGES Enter on Lines 103, Section J and 502, Section K 1,128.50 630.00 _~ _.~....~ ~_~_ . ......... .............. , .... .,.y. o•..nw o..nrwmca~yc ~oa.ciNi v~ a wmp~e - yr pa G' L OT [ IS O~pag siaiemeni. 7/I Cert~ed to be a true copy. hristian S. Da it Settlement Agent (2008.0070 / 2008.007D ! 3 ) nlrlrR un 7cn~s~cc '~ A, B. TYPE OF LOAN: U.S. DEPARTMENT OF HOUSING LG. URBAN DEVELOPMENT 1.QFHA 2.QFmHA 3.^CONV. UNINS. 4.QVA 5.QCONV. INS. SETTLEMENT STATEMENT 6. FILE NUMBER: 7. LOAN NUMBER: g. MORTGAGE INS CASE NUMBER: C. NOTE: 7iiisk)rrn is fuurtfshed in give yiou-a sfatemenf of actual settlement costs. Amounts paid to and by the settlement agent are shown. - hems marked 'ZPOC)" we-e paid outside the dosing; They are shown here for informational purposes and are not inducted rn the totals. 1.0 3198 rdoos+ooea.PFOrmos-0oaare) D. NAME AND ADDRESS OF BORROWER: Stephen B. Diller 7 West Locust Street Enola, PA 17025 E. NAME AND ADDRESS OF SELLER: Estate of Ira C. Mellinger, Jr 409 S. Enola Drive Enola, PA 17025 F. NAME AND ADDRESS OF LENDER: G. PROPERTY LOCATION: 409 S. Enola Drive Enota, PA 17025 H. SETTLEMENT AGENT: 23-1677682 Earl Richard Etzweiler I. SETTLEMENT DATE: October 23 2009 Cumberland County, Pennsylvania 09-16-1050-029 East Pennsboro Township PLACE OF SETTLEMENT 105 North Front Street Harrisburg, PA 17101 , J. SUMMARY OF BORROWER'S TRANSACTION K: SUMMARY OF SEL 'S TRA NSACTION 1 D1. Contract Sales Price 75,000.00 401. Contrail Sales Price 75,000,00 102. Personal P 402. Personal Pro 103. Settlement Cha es to Borrower Line 1400 898.50 403. 144. 404. 1 D5. 405. 106. 2009 School Taxes 1024!09 to 07/01/10 840.14 406. 2009 School Taxes 10/24/05 to 07101/10 840.14 107. 2009 Coun Taxes 1024/09 to 01/01/10 74.58 407. 2009 Coun Taxes 1024/09 to 01/01!10 74.58 108. Sewer 1024!09 to 01/01/10 51.37 408. Sewer 1424/05 to 01/01/10 51.37 109. Trash Billi 1024109 to 01/01/10 23.25 409. Trash Billing 1024/09 to 01/0'1/10 23.25 110. 410. 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 76,887.84 420. GROSS AMOUNT DUE' TO SE R 75,989.34 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE O SELLER: 201. De sit or earnest mone 12,000.00 501. Excess De sit See Instructions 202. Pri al Amount of New Loans 502. Settlement Cha es to Seller Line! 1400 781,00 203. Existin loans taken sub'ect to 503. Existin loans taken sub'ect to 204. 504. Payoff of first Mortgage 205. 505. Pa ff of second Mort a e 206. 506. De sit retained b seller 12,000.00 207. 507. 208. 508. 209. ustmen terns n a a er 509. ustments r ems n a a er 210. 2009 School Taxes to 510. 2009 School Taxes to 211. 2009 Coun Taxes to 511. 2009 Coun Taxes to 212. Sewer to 512. Sewer to 213. 513. 214. 514. , 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. 7DTAL PAID BY/FOR BORROWER 12,000.00 520. TOTAL REDUCTION AMOUNT D E SELLER 12,781.00 300. CASH AT SETTLEMENT FROMlfO BORROWER: 600. CASH AT SETTLEME TOIFRO SELLER: 301. Gross Amount Due From Borrower Line 120 76,887.84 601. Gross Amount Due To Seller Line 420 75,888,34 302. Less Amount Paid By/For Borrower (Line 220) ( 12,000.00 602. Less Reductions Due Seller (Line $ 20) ( 12,781.00 303. CASH (X FROM) ( TO) 80RROWER 64 887,84 603. CASH (X TO) ( FROM) SEL R 63,208.34 ~c unuc~~~yucu ~~_~ u~.n~iv_ n~=a~yc ~=~.c pc~j~~yajn ~Ni=l=u wpy u~ pdyes lac or mrs stetemenr rx any atracnmenrs rerem~ea ro Herein. Borrower l/j~_~3 `ljL)S[}CiJ(J~~` Seller ~ ~~~~` ~ ~ ~l~ Ste en B. Diller Estate of Ira Mellinlger, Jr HU0.1 (3-86) RESP/~ HB43052 I'a e 2 L. ac 1 1 LCMtN 1 l.F1AK(itb 700. TOTAL COMMISSION Based on Price PAID FROM Division of Commission line 700 as Fogows: eoRR PAID FROM ' 701. $ to OwErrs FU SELLER S 702. $ to 703. Commission Paid at Settlement NDS AT SETTLEMENT FUNDS AT SETTLEMENT 704• to 800. !TENS PAYABLE IN CONNECTION WITH LOAN 801. Loan O ' ination Fee 9/° to 802. Loan Discount °k to 803. Appraisal Fee to 804. Credit Report to 805. Lenders Inspection Fee to ~• Mort a Ins. .Fee to 807. Assumption Fee to 808. 809. 810. 811. I E BY ND T I I C 901. Interest Fmm to @ $ !day ( days °r6) 902. Mo Insurance Premium for months to 903. Hazard Insurance Premium for 1.0 ears to 904. 905. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard Insurance $ r 1002. Mort a e Insurance $ r 1003. 2009 School Taxes $ r 1004. 2009 Coun Taxes $ r 1005. Sewer ~ $ per 1006. $ r 1007. ~ $ per 1008. $ er 1100. TITLE CHARGES 1101. Settlement or Closin Fee to .Earl Richard Etzvreiler 1102. Abstract or True Search to 1 ~ ~ 1103. Title Examination to 1104. Title Insurance Binder to 1105. Document Pre aration to 1106. Nota Fees to 1107. Attorneys Fees to includes above item numbers: 1108. Idle Insurance to includes above item numbers: 1109. Lenders Coverage $ 1110. Owners Coverage $ 1111. 1112. 1113. 1200. GOVERNMENT RECORDING AND TRANSFER C GE S 1201. Recording Fees: Deed $ 38.50; Mortgage $ Releases $ 1202. C' /Coun TaxlStam s: Deed 750 00• M 38.50 . o a 1203. State TaxlStam s: Revenue Stam s 750.00; Mort a e 750 ~ 1204. UPI Certfigtion Fee to C b l 750 ~ um er and Coun Recorder of Deeds 1205. 10 00 1300. ADDI770NAL SETTLEMENT CHARGES 1301 Sun/e . to 1302. Pest Ins 'on to 1303. Final Trash Blllin to E t P b as enns oro Townshi 1304. 31 00 1305. 1400. TOTAL SETTLEMENT CHARGES Enter on Lines 103 S i , ect on J and 502, Section K By signing Daoe 1 of this statement Ihp ernnalnriec ~..I,......A...L._ ~~:_. _~ _ __ _- ) 898.50 781.00 - - - • - - ----------~-• -~- -•a••--•-••--~ oM...+...~.+yc ~aa.c~Nl vl a wmplelea Copy OT page Z of this t1A10 pa a statement. Cert~ed to be a true copy. Earl Richard Etzweiler Settlement Agent (20030043/2009-0043/4) ~Thrivent Investment Management Confirmation of Activity May 5, 2008 Page 1 0 1 - IRA C MELLINGER JR POA 409 S ENOLA DR ENOLA PA 17025-3010 Registered Represe>titative FREDERICK NEVERM,AN 151 GETTYSBURG PIKE MECHANICSBURG, PEA 17055-5605 PHONE: (717) 730-9611 OD0697 I11111111111L~inLI,LI1111LIlii~i~~IllliillLiiLLillLll Do you want to consolidate your reMrement assets and simplify your life? A rollover IRA from 'Iluivent Financial for Lutherans makes it easy to roll over your eligible traditional, SEP, SIMPLE and Roth IRAs, and 403(b) accounts. Enjoy low minimum requirements and having one source for statements, tax fo.*ms and distributions. You'll also receive guidance from a financial professional who'll help ensure your assets are properly allocated. Open a Thrivent Financial Rollover IRA today and enjoy tax-deferred growth potential, continued accumulation and a wide range of options. Simplify your retirement investments. Call your Thtivent Financial representative today to take advantage of a special; limited-time offer. Financial Activity IRA C 1VIEI.I.INGER JR 1'OA Thrivent Income Fund-A Shares Fund/Account55-7398005 Trade Description Dollar Amount Share Price Shares Beginning Balance 05/05 Shs Purchased -Good Funds $25.20 $8.300 3.036 OS/OS Shs Purchased -Good Funds $20.20 $8.300 2.434 05/05 Shs Purchased -Good Funds $27.55 $8.300 3..319 OS/OS Shs Purchased -Good Funds $27.77 $8.300 3'.346 Total Shares 735.518 738.554 740.988 744.307 747.653 Total Value: $6, 205.52 IRA C MELLIN ER JR A Thrive t Income Fund-A 409 S ENOLA DR ~Thrlvent lnvestment Fund/A~et Number: 55-7398005 ENOLA PA 17025-3010 Monagement- Thrivent Investment Management Inc. PO BOX 219334 Kansas City, MO. 64121-7251 To>~oe~sy~ I~II~~~liil~~ill~~lil~~~lllii~li~lil~l~liii~ll~~~lll Total lnvestment For purchases into this account, return this stub and your check in the enclosed envelope. ~n~~ to Account X thisbox if you have made any ~ changes or rnrrecrtions including an address change on the back. ($ 50.00 IDltllnium) _~-~- _ _~ __,~„--_ {} OOOD OOOOD000 00007398005p 00001055 p ~~ 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 Etzweiler and Associates Attorneys At Law 105 North Front Street Harrisburg, Pennsylvania 17101-1436 Phone (888) 502-4349 Fax (302)934-2955 September 3, 2008 Re: Estate of Ira C Mellin e Social Security.• 208-24-2145 Date of Death: May 03, 2008 Deaz Sir or Madam: Per your inquiry dated August 18, 2008, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Account Number Checking Account 76871746 Ownership (Names of} Opening Date Balance on Date of Death Accrued Interest Total Ira C Mellinger Jr 04/28/73 Closed 09/02/08 $10,228.58 $ 0.29 $10,228.87 2. Type of Account Certificate of Deposit Account Number 031003913821277 Ownership (Names of} IRA C Mellinger Jr Opening Date 11/15/99 Closed 02/21/08 Balance on Date of Death $ 0.00 * * Closed prior to the date of death Please be advised, there was no safe deposit box found for the above decedent. ** Please contact the West Shore Plaza Branch for all additional information on accounts closed prier to the date of death. * If upon reviewing the information above, you believe there are additional accounts not referenced, please provide us with an account number and/or name of any possible joint account holder. For any additional information on the above accounts, including ownership and any changes, closures and/or reimbursement of funcjs, etc., please contact our West Shore Plaza Branch at 1200 Market Street, Lemoyne, PA 17043, or # 717-2_55-2271. Sincerely, 1~Z~ Nancy Clagett Records Management __ _. Sep. 12. 2008 l0:OlAM PNC BANK 412-705-2747 No. 0635 P. 1/1 ~~~ iEADlN6 THE MIRY September 12, 2008 ' Earl Richard Etzweiler Attorney at Law 105 N Front St Harrisburg, PA 17101-1436 RE: Ira C Mellinger SSN: 208-24-2145 DOD: OS-03-2008 Dear Mr. Etzweiler: In response to your request for Date of Death (DOD) balances for the customer noted above, our records show the following: Checlang Account Account # 5140112605 Established: 02-01-1970 IRA C MELLINGER DOD balance: S 2,395.62 zton interest bearing Please note that this office provides date of death balances for deposit accounts (IRAs, Cis, Checking and Savings). We do sot process any financial transactions or provide statements. If you need assistance with any of these items, please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch office. Sincerely, National Financial Services Center PNC Bank, NA. Member FDIC Received Time Sep, 12. 2008 10:13AM No. 2782 Pagelofl ~ 15-51 A 581 , 566, 435 .~!~ ago t a s ~ ~ Check No. :,. _.~, 05 15 09 23 AUSTIN, TEXAS 23p9'87632891 ,, ~~,,. r:~_ = b 2309 87632891 20090700 I30 OME4.L ATLANTATAX REFUND '; Par co I~~~III~~~III~~~~~~ILLI~L~~IL~L~~I~LJ~I~~ILI~~JL~~II `"' rthieoraeaof MARY LOU BRANDY ADM 12/08 :~* `~~ IRA C MELLINGER JR DECD 91 -~~ .,;; 337 MAPLE LN ~***.1092*00 CARLISLE PA 17015-7822 ~~ Rwnx.LL ~a+oomcu VOID AFTER ONE YEAR c'_, i #'!;, "_. ;,,, ~~ i T ~. k 'f ~~~~~ '~~m~~' _` ~:~D0000 5 LBO: 8 7 6 3 28 9 L 5n^ p 40 5019 .lei ~f, ~. M tiV 1 t f ETZWEILER AND ASSOCIATES ATTORNEYS-AT-LAW " 105 NORTH FRONT STREET 1=iARRISBURG, PA 17101-1436 Office hours: Mon.-Fri. 8:00 a.m.-5:00 p.m. (717)234-5600 Earl Richard Etzweiler, Esquire _____ Christian S. Daghir, Esquire HALIFAX LINE (717) 896-3737 225 Market Street Fax Line: (717) 234-5610 2 West Main Street Millersburg, PA 17061 Email Address: retzweilerCa~comcast.net Elizabethville, PA 17023 (717)692-2519 (717)362-8395 Office hours: Tues. and Fri. 4:00 p.m.-8:00 p.m. Office hours: Thurs. 7:00 p.m.-9:00 p.rn. Sat 10:00 a.m.-12:00 noon May 12, 2008 Ira Mellinger, Jr. c/o Mary Lou Brandt 337 Maple Lane Carlisle, PA 17015 RE: Landlord/Tenant Matter Medical Assistance Eligibility Dear Mr. Mellinger: Following are the costs and fees incurred in the above-referenced matters: ATTORNEY TIME: DATE DESCRIPTION MINUTES 04/0.8/08 District Justice Hearing - 4~Vormleysburg 90 04/16/08 Telephone conversation with Cumberland County Assistance Office; draft correspondence 40 05/06/08 Telephone conversation with constable; discuss with ERE; telephone conversation with Mary Lou Brandt 25 05/07/08 Telephone conversation with constable and Jeff Brandt regarding eviction 20 05/08/08 Review file 15 05/08/08 Draft correspondence 10 05/09/08 Eviction from 30 S. Front Street Wormleysburg 60 260 260 minutes = 4.34 hours @ $200.00 per hour = $868.00 G:\ WRDOC~BI LLINGSFI.EMurrn\bills\i~llingcr Page 2 Ira Mellinger, Jr. c/o Mary Lou Brandt May 12, 2008 ASSISTANT TIME: DATE DESCRIPTION MINUTES 04/21/08 File request for Order for Possession 20 20 minutes .34 hours @ $60.00 per hour = $20.00 COSTS: DATE DESCRIPTION AMOUNT 03/14/08 District Justice Filing Fee $113.00 04/21/08 Order for Possession 112.04 $225.04 Total Due: $1,113.04 It was a pleasure to represent you in this matter and I trust that you found everything satisfactory. Very truly yours, ~.C%~,~~ Christian S. Daghir CSD:kr G:\WP1D0(1BILLINGS.Fl.Elamanbills~Mlingv DODSONCHASE Christian Daghir, Esquire Etzweiler & Associates 105 North front Street Harrisburg, PA 17101 In Re: Estate of Ira C. Mellinger, Deceased Orpbans' Court of Cumberland County, No. 21-05-0614 Claim of Golden LivingCenter-Camp Hill August 28, 2008 Dear Mr. Daghir: This is to notify you of the claim of GGNSC Camp Hill III LP d/b/a Golden Living~Center-Camp Hill in the amount of $9,103.94 against the above mentioned estate for nursing care and meldical services. D. e for Golden LivingCenter-Camp Hill ATTORNEYS AT LAW North Park Office • 9800 McKnight Rd. • Building A • Suite 332 • Pittsburgh, PA 15237 Phone: (412) 635-9314 • Fax: (412) 635-9358 • ww~vDodsonChase.com t? 13at.~N DoourN, F_x>. Crrr-.rsr=.n U. CH;\S ; Fa). N:\TI1AN T. CHASft, Esci. FiI)OD~N@rX)Di(1NCHA5L'.CO\[ Cl.HAtiG 1~7,t)UDtiONCF1.iS~ CObr NCHASC ¢,1)ODSONl:HASG.COM Enclosure cc: Paul Clougherty, via email