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Home My WebLink About04-05-10L1 •~'' ~ Y 15056051058 REV-1500 EX 06 05 PA Department of Revenue ( - ) OFFICIAL USE ONLY Bureau of Individual Taxes PO BOX 280601 County Code Year File Number INHERITANCE TAX RETURN ~l ~~ Q~~~~ Harrisburg, PA 17128-0601 RESIDENT DECEDENT `~T ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 184-26-3039 12/07/2008 09/24/1934 Decedent's Last Name Suffix Decedent's First Name MI Peterman Nancy T (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW • 1. Original Return 2. Supplemental Return 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate 4a. Future Interest Compromise (date of 5. Federal Estate Tax Return Required death after 12-12-82) 6. Decedent Died Testate 7. Decedent Maintained a Living Trust _ _ 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of death 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULb BE DIRECTED TO: Name Daytime Telephone Number Peter J. Russo (717) 591-1755 era Firm Name (If Applicable) - _ ® ~~ REGISTER 1~F-S USE O~y r-r: _ ? Law Ofc Peter Russo ~ r~~-~7 -v ~ ~ ? ' First line of address 5006 E. Trindle Road ~~=,~ %~ ~ ~ , ^, , Second line of address (~> ~.~ ~ 3 ;~ -~= . `~~ ~ . Y ire r Suite 100 V _ 4•~ City or Post Office ~~~ State ZIP Code DA~FILED tV Mechanicsburg PA 17050 Correspondent's a-mail address: 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, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATUR ~F~PERSON RE ONSIBLE FOR FILING RETURN r.--- 3 ~~ 4~/a Izc~.~~s-~y r« N a SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ADDRESS y DATE PLEA8E U8E ORIGINAL FORM ONLY 15056051058 Side 1 15056051058 "'J 1 5056052059 REV 1500 EX Decedent's Social Security Number _, Decedent's Name: ancY T Peterman 184-26-3039 RECAPITULATION _. .,.,.,.~....~. ,,a.,M. ............._...~ 1. Real estate (Schedule A) ............ ................................. 1. 93,000.00 2. Stocks and Bonds (Schedule B) .... ~._ _... ___.. ................................... 2. 3,115.95 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages 8~ Notes Receivable (Schedule D) .. .......... . . . . • , 4 .._ 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ........ 5. _.- _. _....v . _•~ ._... 16,241.49 ~r., ~~ 6. Jointly Owned Property (Schedule F) C,} Separate Billing Requested ....... 6. , _~. 7 211 47 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property , . ° ° w.., ....., (Schedule G) ~ Separate Billing Requested........ 7. 8. Total Gross Assets (total Lines 1-7)... _,..u,~r . M _...,...._ ,.. , .~...A .......... 8. 139 568:91 , 9. Funeral Expenses & Administrative Costs (Schedule H) ; ..................... 9. 21,254.95 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) .... 10 ............ . ~~, 8,109.94 Total Deductions (total Lines 9 & 10) ... ~_ .,~ ~ n, . ...._. ................................ 11. 29,364.89 12. Net Value of Estate (Line 8 minus Line 11) .................... 12 .......... . 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 110,204.02 an election to tax has not been made (Schedule J) ........................ 13. 14. Net Value SubJect to Tax (Line 12 minus Line 13) ....... .. 14 2 ...... ........ . _. -~___....,~..-~ 110 204 0 '' .. _.____..__...,..___.__._..~.......Y..._ _~_~......,~ 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 .0~ 4,959.19. 15. 4 959 19 ... 16. Amount of Line 14 taxable ''"" " ""' , . „ . ,. at lineal rate X .0 _. 16. 17. Amount of Line 14 taxable ~" " ~ ` " _. . at sibling rate X .12 17 s ,. 18. Amount of Line 14 taxable _" .. u~. .,, .. at collateral rate X .15 18 19. TAX DUE ......................................................... 19. 4,959.19 ____ 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 L ~°":~°s 15056052059 REV-1500 EX Page 3 Decedent's Complete Address: Fri N~mb~r , DECEDENTS NAME ~,~.°-°° ..e.a..-.,~ ~..,.... Nanc DECEDENTS SOCIAL SECURITr' NUMBER Y T Peterman STREET ADDRESS 184-26-3039 32 East Green Greet cITY Mechanicsburg, STATE ZIp PA 17055 Tax Payments and Credits: 1. Taz Due (Page 2 Line 19) 2. Credits/Payments (1) 4,959.19 A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penal if a livable Total Credits (A + B + C) ty ~ PP (2) D. Interest E. Penalty 181.20 tal InteresUPenalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT (3) 181.20 . Fill in oval on Page 2, Line 20 to request a refund . (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference, .This is the TAX DUE. 5 ( ) 5,140.39 A. Enter the interest on the tax due. (5A) 181.20 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE . (5B) 5,140.39 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPR OPF~IATE BLOCKS 1. Did decedent make a transfer and: . a. retain the use or income of the property transferred :..................................................................... Yes ^ No ..................... b, retain the right to designate who shall use the properly transferred or its income :............................................ ^ c. retain a reversionary interest; or ........................ d. receive the promise for life of either payments, benefits or care? ...........................................:. 2. If death occurred aRer December 12,1982, did decedent transfer property wi~in one year of death without receiving adequate consideration? .................. ........................................ .......... ^ .......................................... 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ............................................................................................................ - n n IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS .YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT aS PART OF THE RETURN For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent 172 P.S. §9116 (a) (1.1) (i)). For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent (72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: - The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent p2 P.S. §9116(a)(1.2)j. 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) [72 P.S. §9116(a)(1)j. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent (72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an. individual who has at least one parent in common with the decedent, whether by blood or adoption. • ' ~i` Pennsylvania SCHEDULE A OE-~gTMEVt 0-NEVENU! INNBarTANCErA~caETUaN REAL ESTATE RESIDENT DECEDENT ESTATE OF Nancy T. Petetman FILE NuMSER 21-08-1250 All real property owned soiNy or ae a tenant b7 oonaaon aunt be reported st hU ngrltet slue. Falr market value is defined as the price at which would be exchanged between a wilting buyer and a wiping Seger, neither being compelled to buy or seN, both havin reasonable! knowk ~oDenY (teal P-ol~ that Is ioindy-owned wltll ~~ ~ survlvorehip must ~ ~ 9 ~ ~ F, dge of the relevant taus. ITEM Attach a copy of the settlement sheet it the property has Gear sold. NU+18ER Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE DESdtIPTiQN OF DEATM 1' 32 E Gtesrt Street, Mectlenicabtrg, PA 17055 93,000.00 TOTAL (Also enter on Une 1, Recapitulation.] ; 93,000.00 If more space is needed, insert additional sheets of the same site. IWAR ----- '". .~. 2 AOdrpri Oonpmbtq I~i '-"- »._._. 3 s>~ Plao, --~ a ~IICIPI~otMRalar.._.,__,,.,_,,,,,_ ~i --•.... ... 10 , SYE)111PIIOMtdwl101 ~.~w "-•.•. -._._._..""'"'_ ••..•..••••.»»•,•-.....~....__..._ It ...."'" .-.... suci~ava~xor~aar ».~. ....._.._ _ 1r 510AdPIImDt I~dar 13' 511WR1Rg1p1 Ylel~ 14 III Pllalot 1,~ ...._..-.~-.~.....----..........._....... ._....._..._.._.» _» 18 ' fbnWnhleRgYi4~i._....... ~_._.._.._...._.._ .._....... ...-........._..........~._ 1T lxdon Mho -------~'.-.-" - - ---_--- 16 Swnwy of Scent Faiup ~ ~ ._"'""""'_""^'--`----------- _...__.......___..._..,».. ...~...............,._.....»....._»...~_ »....~..._..,....»............... 22 knaTGCp-'TOTAL Mtr WMdo~'>~ 1oingrt h atd woaRlue.-1 TABLE OF CONTENTS Gary G. Troup 1000 Good ttapa Rand AAaehanipburp, PA 17050 (7/7)761.2724 Fax p17~0~0815 Law 081oas d Paler J tiusao, A.C. 5008 East Tdndp Reed. SuMa 100 MaohaNpbufg, PA 17080 Ra: P~avnlY. 22 Ead Gran Sheet ANehaNesb~ap, PA 17066,'L176 Barowar. trlA Fha No.: 8807274 e~~ ^a ~ Y~+eWwt w• hMw aOP~Mod 1be above rderenoed proPMlfti The spat a tifM epOraleN 4 ~ PuPoee d this appedsd Y b aslYaafa the madnt wWa d the pnparly dnceRsd b lhfs appnMl nporl, as tniporad, En unanpmiband fis slmpb uha d owiwaltp. Thin neat b besad an a pMakal anayals d the she and tswovamanb, a batlontl aisYyda d lha nabhbodgod end ~9. and an eoabnNe andp~y d tha awlat torpnpaYas such as tha e~mjael The apptalad rrea dwebpad and tlw upon wee pnpoad b aooadanca wAh h» uNtoim Standards d Prdatfond Appalad Praatloa. Tha wYw oondlusbna rapatad an as d 8a ethetira daN embd b the body d un sport and aid upon the arltlia8on and Prnitln8 axationa atunried. h tnW Man a plggae b aaht you, Plaasa do not trahda b amtact ma ar eny d my std! 8 vw am M d addhlaW saMca b you. ,;~.~. ~ ~ fiery G. Troup RL-001t198~1 ~oap~ry Apnud luput Gary Troop • w. ~ w v F8na10 Mh! FOt1111004' Alq-Ch 2005 fain ~aa-•roT~rawwo~r,en~,n ~, ~rmea~,r~e.- ~ Fone low -'fOtAl br Ygndowr ~ppr~p~i soltwrr by i b mods, irc. - I~OMLA4gpE ~'~°"'^ v Filllll! Mir+Fam 1001 AAaCf12OO FOm~ 1001-'TOTAL for IMtOors' tolnrm qr ~ d ~ irc. -1OE Tide report form is degprled to roport an appraisd of a aie-unk propery or a oae~e~b Pn~ wNh m ~s bcbrdklp a uak b a phoned Isdt da+retoprrraM (PUD). This sport brm b not dealaned to report an >q>~ ~ unb; rrlarsnc~baed home or a usit h a Irorrdombirsa a cocpaNMe project. lhh apprdael report k ar~Ct to the bpowirp scope of wont, blended user blended aer, statement at asumpdons sad pmigrp cartdltlona, end aAAeadals, tAorxlcadptls, addMtoa, a b~tlre Imt~erld'ed ~ tlro scope of tiq~ ~. or asarprrpdo~ sad Ilmgln0 corrdtlores aro not perrNlbd. 71ro appragter asp addlUanai research ro araysis acawy based on the campkodty ~ thib apprI ~proneM. tlAodlScapoaa ro dehtloa to the certlRcaUoa are also sot trtxrnNMd. HoweYer, addlllonal aurltcatlorn prat do corMkalbrp educatlon or membership bean eppre~~~ ~ bw or tlrose related 1o the appraiser's SCOPE OFYVORK: The scope of work for this appraisal h detbred by tfre , of tlrh apprelset essipnrrlwrt and the ~ ~n ~meab of this appraisal reDOrt torn, 6tdudln0 tfa toNowhg aeMltlmr of market wdw, sruanerR qt MmMInO ct-ndltlans. and ~, ~ appti~ ~. at a nartbnunr It) PeMorm a canpNpe ~Wawl comparable tiles from brat the1M s1~ (4 hrt seu~, y~ ~ a) ~P~1 tlN nelphborhood, (3} Ins00ct OaCh df the and {S) ropoR hh a her aralysb, apWorls, and I:arrtdrrtlaa b trite app~rahal ~e Pabpc anNor private solrces. INT9~ID~ USE: The bterlded up d this appraisal roport h for the lendeddlent to evsbate the proparly that h the subject a ihh sppnhal for a nwrtpepe Marlce trarlaectlon, INTENDED USER: The brtended user of fhb appraisal report h the hnder/clhrrt. DEFINITION OF MARKET YALUE; the nwit probabN prig whhb s property should bhp h a ~ ;~ market under al candbbns raquitbe 1D a fair sale. Ure uyer and seller, each pru the prke h not aNecgd by undue itharlut. h h this deMilolr b the consrua~rr~lon aN as~ ~'~umbW tlro 0 of 1110 from seller Oo b wheroby: (tj buyer and aUer an ~ ~~ earldbhra bDhafhr rtroWated~ ~ and rpsoruble Ibae h al~bwed ~ advised. end each actlnp b whet he ar she considers hb a her own best bKaest; (3) a ergroslse h dw open marker (~) paf~l h ramie h terns of cab b U. S. douan ar b terms rsleffetdedNby~~ tbereto•, eM (~ the price ropro:errb the namU coalderatlcn for 1M chp or axles oora;essbna• txented by anyale aaochted wpb pro sale. ProP~ sold 'Adjustments to the comperapl0t must be node for > a cntllve MerrcYrp ar sofa corweasbrla, t+la ~ tlrose ~ ~~ aro y DHd by aNero a a rauR of tradltlon or Itw b a merlrN a~sibnerbs roe tderplNeDle sbce >tle sNer peps dleee cops b vlrWely eN sahe trentectfcns. SPachi a rYUWi ~ these oogs are a~ can be coeds to 1M comparable property by ~a4artsone b lender tlW b not abeedy bnob-ed h tla property or trarlsecden. Asy >irwlcbq oa a~m~~ dower tar doaar ewM a the flaack-p ar conaaion blrt the dolhr a any adjrubrlerlt ahoukl apprordnWe ihe'merkeCs ractlon to the Mandnp ar carceplona based an die apprahers STATEMENT OFA88UMP~IONB AND UMITINB CONOftaNS: The sppraser's t.ertlacetloa h dds repot b subject to the lobwbp asatrnrptlorrs and corld(Uons: t. The appraiser wlN sot be roeponshle for ngpers of a kpel rlatse tlrat affect eAber the to b, euxept for bfornladon Chet he or stir became awero of dwhp tla research YnroMd ~ ~ T~he~ apl>reher asauma that the tale h good and rnartretebh arrd wil not render shy opblioa abort the iNh. The sketchk bldshqudued ~ to ~ s ~ ~ to show tlu apprsaMaete dimenelons of the hrprovMnenb. a tls size. the Property end underitadbp the appraiser's detemhb~bal 3. The appraiser has wrabed the avalleble hood naps that aro proNded by the Feder (or other dNa soa-rca) and ha holed h tlrh eppradsai repot whetlrer Emerperlcy Ngnepemerlt AQeaY ~ Because ure appraiser b not a spa ~l oar ~ r r~ b ~sro or I+r1leThsse ~1ic ~ ~ !lM Y ~ aPPaar In cast because be at she made an appraisal of the properly h grre:tbn, to do so Inve been made beforohand, a a adrelwise roqulrod by law. S. The apprsar hoe noted b fhb apprehal report any adveroe conditlona (loch a needed ropain, detedarallort, pro became i~ dolrolt • t0odc wbanrrces, etc.) observed durbq the ~pectlon a the eubJect properly or that' he cr report. the sppreher ha~larowfedpe cl an ~ ~ormbr0 ~ aDPraisel. lhdeaa alhawtae st>ted fn thk appr~bal poPwb (such as, but not Ihrbed is needed «peka, detedorMloaIheWrY~a delwderlcta or adverse corrdgiorrs of the ~'0ne envkonmengl condiront, e1c.) that would rrralle tfre a °f freurdaus , imdc talbstaaces, coaQltlone and cooks ra Oropalp Iea valuable, and ha ataumed if W there aro na wcb carrditfona tbet do exbt or~por tesWq drat be ~dkuov~er whethercondilfons~l~t ~l auahmre~m act d~ro b the Geld of ~ hazard:, tole appraisal ropon revert not be considered a p-oparly &. roPaMs °f ~ hem~r~tlata the c~alon br an apPrabal tlnt Is subject b setbtacrory be performed b e protesttanal nlarrle< ~adon• ropebs, w' alteradona of the subject property v+N Fieddle ee~C form 70 ~terelr 2005 . ~.' ..• ~ FertrYtt tNe Pone 1004 Ngrch 2006 tam 1001-'TOTAL (~ warearrl' stdA~ir1 brr t Y moor, arc -1.ti00.A{AA{ODE APPRAIS3LR'8 Cl~ITIFICATIOIfe The Jkprolaer certgles and aproea that - - s davebped and repotted tlda apprabal b acoordarae with the scope of work nprUemenh stated trt 2 I ptdomted a ca~pb0e vbwl ktspedon a the frrterlor and erdedor aroaa a the properly. !reported the corrddlort a the lmProramerNNa fn tacbpl. tpeeiRo temai. I Idenplbd and ropoAed 11ro phystcd~dencba Hutt could effect the lhrabilbY. aowtdness, a strtrchrrat btleprpy a ore property. 3. Ipe donned fhb approbal b accordance with the requkemena a uro tNdtortn Sandards a Profeaatatal i~prabM Practice that were adopad sad prerratlpated by ~ ~{ppro~ y~,,,d,~ g~ a ~ ItPPabal Faatdauon and tltat wero In place u the unae uda approbal roport rns proparad. 4. I devebped rrry ophtlort a ua market yalw of ~ roil p~ b the augect a fhb report based on tla oaks comparison apprach to vibe. I have sdequaa comparable r~t doh to develop a rolbbb sales eomparlaon, approach utem, udo fadicaad k, p~ ~t~ 1 ~ the coat and tnoome approaches t0 vagre but rid Aot develop 5. I retearclted, verMbd, analyzed, and reported an any tatrteM aproemalt br sale for the aka PmPw4-. any a~terhtp for sob a the srblecf properly h ua twelve mamba pda ro the efhcure dale a fhb aPPr+b>d. and ua prla asks of the wbJeq properly fa a nrn6rurrta of pose Yana far to the eUeetlw doh a 1Ns apprabai, urdesa apNrwbe Ybbakd b tltis ropon. W zeta d~of h a~ reported on the price sales a the compeapb oaks fa a minkrarn a one ypr gior coetparaWe sale, unless otherwbe Indicaad in udt ropoR 7. I aebcad and used comparobb nabs tlrot aro IocagorgNY. PhY~y, and hncuona0y the toast sknlar to the subject property. 8. 1 have rte used comparobk sales that wero the result a combbbp a lend site wqh the contract purelaee price or a home that has been hula a will be built an the land. $~~ s~ curable salmi Ihat ropes the market's aactipt to the dpferertces belwept the supjeq 10. I wrgbd, trortt a dbbrterestb earrra, aN ktramtdton br fhb report Zhu eras provided by parltea who have a tbtartchl ktterost b zeta sale a dtandap a use wbiecl property. 11. I have btowbdge and egarlprw b apprabinp thta type of property la fhb marital aroa. 12 I am swan ot, and have accent to, use necessary and pub and prlraa dace sowaa, such as nudpph payrtp services, ~ ~ recadt. pubs knd reeor~ art0 o~dah :aloes: for the aroa in which the proprly- ks bcasb. 13. I aMabed the bdorrrtation, esllmaas, and opirdona hartblted by other. partka and etgsesaed b fhb apprabal report tram reliable sourtxs that I bepaw b be tote and correct. 14. I haw talrert Irtlo corptderatbn uts fat:tors prat have a trtrpect an vaMro wqh respect to zeta wbjeq ProPwty, and use proairrdty a pre auDjeet proPedY to advera bdkrateea In tM dewlopntent a rely opinioe cf mule v~ I have noted b fhb approbal roPmt arty adveae condNbna (suck ace, but rat pmbd to, needed abs, ,the Prosence a h wastes, teodc substances. adverse ~ oatdhbns, eb.) ~ the of the subject properly a zest I becanw swan a durhp use research ktrolwd in perromt6p fhb apprakal. I ltaw pbm~d these adverse condidana N my analyst a pu property wilts, and hpro nporad an rite effect a tla catdttlons on zeta valor Wtd ntarkatabshy a the :object propetp,, 15 ~ arq- aeQrYpeaM kdortnatlon frart orb epprabar uod and,.b rie best a my IoawMdge. cep apprabal sport are trw and carted. t6. I shad trt zeds apprabal report my own pasortal, t-nbbsed, and Professional analyst, oPktlons, and canclusbna, which aro subject only to the assumpupts and ffmdktg eandAbns In fhb apprabal report 17. I haw ro protein a presPecure Inarest b the property that b pre subject a zeds report and t have no present a prospective personal hderest a boa wpb rust to the parudltatta in IM bansactlat. l did not bete, attar permlly oQ wmpbtey. my aealy:ls artdla opnbn a market value n fhb appralal eeport an zeta rase. cobr, roupion, sett ape. rpeAat stahu, handicap, farttllsl :attn. a rtauona< orb a anther uu prospecthrt owners a occuperth a the subject properly ar a da Presarrt owrten or oawPata a the prat in the viturtky a the wbject property a on any other boob problbited bylaw. eorWNlorta ~ ~~a0reem~ a ur~iderotarttor pertortrttrtp thta apprabal a any futon a erttlc a~ywy w~ ~ Pr'edearrtdrted specMc valve. a predehrrrtkad~mbinpen ovafueaparwbe, Drat I waukl report (a preset7< anayai: suppa~tlnp) a arty party, a zeta eaakurant a a tpecfllc rosrdl a ocarteax a raertpe a dkecuon to vote, s value that favors the !cwse of rnapape ban ~) specpk: went swot (such as approval a a'p~Mq tp. I person~lepwd ail cwcbrsbas and opktbrts about the root esha ihN wero :M brth b ihb approbal report, M 1 ~ uaiba a urtpfe°~ aPP~ asabtartee kom any ktdtvfdual a krdhdduab to tM paformanee of utb a~pr~a~ aPPraisal report I ~ tkrmv~iduail ~iwne~d b ~wpped') and dbcbsed the ~Cgfc hsb prtonrred In tkk a~ ~ ~ rn b fhb appabal retort; uterofore. a Y etuutpe rrae u~ila aPProbal~h unaa andal wpnj ntakem~e ~ardered and wq receire prabal ~ who b ~ ~. or~atbn. a agent for IM a~tlort oral Fredme fast Form 7e ru...s Moe ~~., u10 Fanltle l~taa FOIrtt tal4 Mrctl 2005 Faint 10Dr-'tOTAl.lor NtIIdeM'f' apprald eOaMlat by a 4 soda. src. -1•a0eueatoot: 21. The brnier/Cgpit may dlacioae ar dbtrtbub fhb appraisal roporl tor: tla barrorver, arlolller brtder u the request of the Dorrorrer; tla ntorl0apee ar 4s secoeasors and assigns; hwroa; povemnent spoaaorod des; attar secondary narlal patlclparNs: data la0ecgon a mpoA6io s~ agency, or itslnsrlenbgty of fhe Urdbd States; and ~' ~ ~~ ; ~ dL alrWn qa l'a or aupervbory approber's (q ap~pgpble) coaas~h consent m be efb°tb ~ h~ a report may be disclosed or dbMibubd b erns other gasps (blch~rlp. but not Artdled a. the publb lhravob advertbbp, pl roWlaa, news. sobs, or other rrarda). 22. 1 am aware that any disdoauro or dlstrlbugorl at qds roiaal report by nN a the IendedeNent tbu per4M~ ar ~ ldNbNud~ by~ir~ a ~ Dons of the Uniform Slandands d Protea:Wral Appra~l Practlce 23. The borrower. another bodes u the request of tla barrows. qa mort0a0ss or ~ aucceasors and asatpna, mortgage Mssuront, poverrsrarK sponsored erltxprhas, and ogler secondary market parlbiparda may rely on itds approlaal report as part any mortgage tbnrlce trargactlon tint Involves any arse a mare of these pestles. 24. K tlda apprabai roport was transrldtled as an •NactroNc rocard' contalnkq my "ebctrordo alprluu%" a tlrose temp aro defined in appBgble tederol and/or stab bws (exckldrl0 aedlo and video ), or a factlmMe trarnmbsion af'Ws map tlralsal8re~pat contaiatnp a copy or r~reseabtlon of my sipnattrre. tfq app ~ be as eBectlve, eNotceable and paper vasbn of flds appndsal report were deYverod cordahbrp my ortpbud hand wrlbbn sip~rro. 25. My iMerdlonal or ne00pent mlareproaematlon(s) Mined In this appraisal ropoR may rosult b cire tlabAipr aod/ar rahrThnl PenUtles indudkq, but nu Nndted a, floe or Imprisonment or both. under qa Drovbbns of iltle 18. Urdted States Cade. Secgoq 1001. et seq.. of skn8u Wb larva. SUPERVISORY APPRAISER'S C9iTIFICATiON: The Supervbory Approber certltbs and a0reea ihaC t. 1 dkecgy supervbed qua approiaer far q~is approbsl asstp~rnsni, have read tla apprasal report, and aproe with the apprabet's aplnions. sabmerKS, loondwtons, and tla appraisers certlecatlon. 2. I axept tuN rosparaibdlpr for pa conterlta of fhb appraisal ropoR bdudlnp, brit not Nndbd a. the apP~ers arlalysla, opiMons. stabmal~, oorldualana, and the appraiser's certlAcatlon, ~ ~ ~~ ~ report is eNher a ~ a ~ empbyN or the aupervbory appraber (or qle approbal, arW hj acceptable a perform thb approlad under tla appNcabb stole Iaw. 4. 7hb appraisal roport complbs with the untlonn standards of Professional Apprabal PraWe;s flat war adopte0 and D ADprabal~~ Sta+uards Board of the MProNd Faurbation and flat were N place u the tlme bN appraisal 5. h fhb appraisal report was transm4led as an "Msctrorlic rocord" coemlinp "electroaic tdpabue," as prose temp an defined M apptlrybb hderol and/or state lava (slxlydlap audio and video recarps), or s facskrlAe bansrrdsslsn of 'ihk appraisal report rrorrlahbq a copy or rgpesa~gwl of my ~ the appralsd repel ahd be as elfeWve. enlacegbie and vaNd as M a paper veratorl of q~is approtsal report were dcontaklirq my ~~ head y sbpmtturo. APPRAISER S~nadrro Herne Tian Company Name Company Addross +~- PA 17050 TObphalle Nurlser 7t7-781,2744 EnnY Addross Dab Of Si0rlatrre and Reporl JJv 4D_ 4eoa Etlectlvs Dale d Appnatsal ,t;dr ts. 2ooe State CertlBcagon #- B~0018eat. Or Stab Ltcease N or Other (deslnibe) State ~~._____ State PA Explrulat Dab ad Certlibagal or Ucense Jnn• 30. ~t t' ADDRESS OF PROPERiYAppRAlg~ 32 Earl 13~n ~~ _ PA 1 ~214c aPPwusED vaulE ot=sue~ECr PRDPEIms loo LENDER/CLIENT flame ~atssv ereo Campargr Name 1~O0bes a Ptlcr J ra,s a r. SUPERVISORY APPRAISER (Ol~Y IF REOU~) Narl10 ~n4-ar-Y Name Compmly Address ~e~epnara numaer Emal Adders Due of SlQnatree Stab CertlAcubn Or StitO L1Ce0ae ~ Stile E>gsiratlon Date of CertlBcaian or Ucense SUBIECTPROPERiY O Old not kapact subject properly ^ Old knpect oderior of subject properly frarn street Dab Of ingleagOri ^ Did Inspect bRartor and exterbr of subect property Date of hapectbn COMPARABLE SALES Enai Address Fgdab Mac Form 70 Mann 2085 ~ Old not Inspect e,dertor of comparable aabs born street p Did Napect exbrbr d comparabb cabs from street Oab at Inspection . -"- ~ ~ - fwre sar Form 1004 Mandl 2005 ism tOSr -'TOTAL kr VYltloes• rOprYw s5lweie lr a b mods, iit - t.e0oM1ANOpE -- ---- Farod. wq. wnn Boa r~mncn zoos Fina~ 1001(AC)-'fOTAI to 1RAado~s~ ~pyty py ~ 11 node, ix. -1i0D~ALAI~OE Subject Pbcto PaSe Subject Frost 3Z Eat Gwen Soiwt Select qfa WA G1A 1,158 Topl 5 Tohl Bedr~s 2 Tofy BadMmc 7 W11 Avusp~ SIIe .21 Adn ~ AAoninun Ago 109 Subjsdss Rear Subject Sheet Fann RG46SR -'TOTAL Ax YMOdiK ep~dal uMMrno by a d mode, he. - t.Spp,AU1Al00f Su6)eot Interior Photo Paea suWsot InNrior 32 F.Mt ©n.n str..t 8W PAa NfA G!A 1,136 ToblRooml 3 2 911h0om1 t 1AIN Avg ~ .2/ App ~b Aganinum ~ 10i Su~jsot Innerior 8ub)eM Inbrior rma r+c~aa - Moro ~ wrdo.r ~r,-w salmon ~ ~ r moeR arc. - t ~eoaaurta~ ~..~IHLl4 PlM N74 8ublect IMeNor Photo Psaee Sub]ect Inbrlor ~ Eaa ciw.n so..t Sdo Adq WA 9U 7,ISB TaWNaome S Bedtoonr 2 9eJhe0eR 1 IAMOa StdpdbWl VYN llvwape ~ .24 A¢r~ Ovslgi AAanYwm Aqe 109 Sub~eet IMsrlor Sul~sct leterlo~r --- - -.- o~ wn ~- caner ca..tirhnd Ser pa neoeo ~ P.C. - Fore PNA~6.SI -'TOTAL for YYMdowo' eppadod eaQvnre by e k amde, Me. -1~809d111M00E Subject Interior Photo Paee Suaeet Interior rt E~ co..n sa..i SsIrPAa wA su ~.~se ToW Rooms S BtUroowtc 1 Nn1 Awtap~ sw .u ~-a. ur,~ Aw.ninam Ape goo Sabjeot Interior Sabjeot Interior fam PIC~B.SI - ~tOTA! for Wheorr u~w soa~m ey, Y moes.sae. - s~lpp,µAMppE SubJeot Interior Pboto P~ae SebJeat Interbr 32 EaR Gram 80osat SdeP~foe 1r/A 61A 1,168 7oWRooes 6 Bediooes 2 BeNranr 1 Nnr AWarapa ~1 .24 ACra ~M Nunbpmr Are 108 Su~ect intartlor Sabjsct Inbrior Fam 11C48S1-'DOTAL for YYY~dorrr atprdsd eonwue by a 4 enOb ine. -1 RE1/•15prdEX+16.98j C~MMONWEALTN OF PENNSYWANIA rNHERI,TANCE TAX RETURN RESIDENT DECEDENT ESTA OF Nancy T. Petertnan scN~ou~ e STOCKS & BONDS FlL~ NUMBER 2108-1250 -~ ~ ~ M'oVa~h Jai~Y~owmd wpk rl~ht of wnNaaMp muu ba dlidoad oa 3daduN F. ATBT Stodr •00011097472 Conu~st Stock - 03013888956 Vernon Stock -00013188955 Qwest Stock -125068870111 Fairpoint Stock -125248546346 TOTIU_ (Rho erNer on line 2. Reapigdetlon) I i pf rtare ~ h n..o.a, loan addirbond ~lNeh a tl,e cart. ~) 12,188.95 1,066.56 9,824.24 20.0 15.50 23,115.95 7 ..._ BNY ellon Sharoowner Services P.O. ox 358333 Pittsb gh, PA 15252.8333 Mara 16, 2009 AS R SIDE 5006 TRIlJDLE ROAD SUITE 100 ME CSBURG PA 17055 RE: ANCY T PET7~;RMAN & LOIS r0~ JT TEN BNY 11~BLLON aw-RCOvrNes s Company FAIItPOINT ame OMMUI~ICATIONS, C. , AL~ATEL- UCENT & QWEST CO~CATIONS A ONAL INC. Account Ke ETERM -NANCTO100 Control 2009031601001342 umber elephone 877-295.8$08 umber Dear it or Madam: you for your inquiry requesting information for this account. Pleas be informed that the closing prices for the dates referenced below: The cl sing price as on December 07, 2008, was $3.1000 per share for FAIRPOINT CO CATIONS, INC. The cl sing price as on December 07, 2008, was $23200 per share for ALCATEL-LUCENT. The c sing price as on December 07, 2008, was $3.4500 per share for QWEST CO~CATIONS ATIONAL INC. We h e that this information has been helpful. If you have additional questions, please call our Custo er Service Center at the number listed above. BNY l~ylellon Shareowner Services Histotical Quotes: Charting Tools for Looking Up a Security's Exact Closing Price - BigC... Page 1 of 1 Man Enter Keywo/A(sl SEARt:N w"~.. ~•+~ Cil a.w. ; w.o 1 wow. I t.ww. ~ ataswo naar ae.a. ~ lyatp.ra i BMreordrets t~leat.wttleaeetr tlw ClnIr INltlMryarr Mtera•rerysewalrrrp Nq, 6YNM MOr•r•+aarelYMOIkrNMMtlwr~tlwNadNraaeMOw~+b. ', ;' rater symbol: VZ Enter Oele: 121OSI06 vo Comnwokatloln Ine F~oa~ Dwlnp~r0S.70W Gos. -lu. 33.19 ~~~~ 31.97 ~~ 33.346 t..., 30.96 vu.. 20.039.600 Go To Charting ~~ ~I Fbt S~oelt Fick • EV80 lsaMr EaerEy Invseblulp, EvWlAion 8dv Gnsn tanryy Sopitlone. .w.E.eunalca.rcmn Fna Forut t#srkat News NteraaYns dlab. IAtrkst Nswe, and nxlpe MAN1 s hse dMno aooount +.wsoseualy Mska Easy Moaay In 1 How SNgr i Noer 1Fadbp PNNorln - P1roA Ilp to 9 t!i RipM Now _. tae+~WO~r.Ebluar.cem 6% pslr motMh MAtll ETFs: 6mh a NDIO, b leads tAle i-ovsn sygertl -Get Isele, Ilo hypeMhAf. it ETFwslrnl aura YK to IhtA1+It Nwl N lortnanont tpoorM ~~~ ~ ~ 4f T/Ma, TwM Nw r fray TO AYgmuos. fen RrN~. IN Cww IM Teter 17e t0, m Y!'a. FM. tlttrt 1 mnl I rrlpootaletw I Comrlatlb I [et01t~ I ttlra '~. lrerw nr ~tM ttwr, alrlrlt hrtaM Ntb tN err tnlw , eropilnlo ala wwtMraa, IIIG /u rps nrrens. b a~w w rM, t+ll tprt r ox LoWSI~! rIr t~Ipl Ia~wO uLw1. alwrtwpewMb •artpreatatnaweotaea~.ttawgwl.tam~eu. lerlalta w atnlt tt6tFp/ tilt peMbe W rta. tMrlwwrn w w srr tttrr IanlrM aart. traetpom eagM tseraeuw Nlrere.ettmawtrrtralrraWgo. 1#Jtntt rwetotr pwo aw~tort a ~r.Ite aartt atw.ro.u a /tNtrt bc«latw ora a wa ~Ootttrrs aaytt. N~tan to a rwt.ewgr w.. II • httpJ/bigcharts,marketwatch.com/historicaVdefault.asp?detec~l8csymbol=VZBcclose_da.., i 1/13/2009 No Spllle '. Vr,n91L~n 11 Clan t/Va~'..~GwrggoY.Oh`^.• t.•, ~pmputershare Computarshsre Irnestor Services Z50 RoyaN Street Canton Massachusetts 02021 www.computershare.com L S M NEWMAN C/ LAW OFFICES OF PETER J RUSSO E TRINDALE RD STE 100 CHANICSBURG PA 17050 7ur~le 12, 2009 G~rlpany: COMCAST CORPORATION Re~fstradon: NANCY T PETERMAN & LOIS M NEINMAN JT TEN Ho~d~' Account Number: 03013888956 Ouk Reference: CMCS/0002812297/24/HM6b631 Deer Ms. Newman: Think you for your inquiry regarding the above referenced aooour>t. We appreciate the oppbrtunihr to be of ser~r~e bo you. Oe~ember 7, 2005 was not a trading date. On December 5, 2006, this account held a total of 66 shares. Thy closing price on that date was X16.16 per share. Sh~uld you have other account related questlorts, please tali us at 888-883,8903 during regiWar business hours. You may wride to us at Compubershare, P.O. Box 43078, Providence, RI 02940-3078. ~ ~Y, Ser~iae Representative Endlosure: None Historical Quotes: Charting Tools for Looking Up a Security's Exact Closing Price - BigC... Page 1 of 1 . Mao Enter Keyword(s1 JEgtttN ~ zr- ao' ~, ... _. Ilu~r : ~ t>r.rr. ; itra.wtr. ~ snY.b j ttirtarlrrlarrbr ~y1l.pra 9A~wtrrtiTiNr ~ h«drras+sdn.b Trq OurwNMrrewr yMlMMrLrOrrrerMlraW wrrs rttrr. fY+11' t MMrirstMre01N10rkrl~bNw/Mt~M1/r611fMRNnllqup7h. '•.~', E~etar Symbol: T EntsT Datr. 1?/06lOS ATi Inc pro,. r os. coos c'"•'rt vnu' 28.16 err. 27.67 ~e 28.84 ~... 28.97 v'~~ 51.101 r400 t3o To Cnartng ~~ ~t Sprr+rora0 Utgtr ItOt stock PIOk - Evso 8alar EnarOy ln-aabtlsnt. Erobteotl SaW Qrasn Ettar6y Solutions. ^..r Fwr4,pnlietx tan. Fon>< Gob Teada Mdrl Za1'o Spnasda and Coasltbsion RMuttds. + 5100 bones. ...rw ta•trbtan Praetino Faint Tt'Witlp Sfarl Tta~rtp 11YMh A Fns 560 000 Ostno Atxottttl. Play 8alara Payl +rn+rr.scr+own AAUP 60~ A1MO Itssuwl>ra Owr 609 Saw 501 On At,MO Inwrarw. Slam SavYgl Fros Quotas tVOVN A+NP Tnrrun~rom.+ tYaAJRrfO rtNM,IMJgrt. Nrp, rrTrrr.stwral IuMs a ~•~. ~ ~ . ~ *~rr. f~ Tns. trr. u twan To rutstanuoe. Pert ttwa rtecrnuaa TaM Err hr>0 utr. ~. 1la0t1loaNI+IS3,lSIWdYSlld1 faoba.lh 1 tea I firm uer+rr ab alrPrtr++.rrr. r+nWa brnelrt MrM rnrlrr rent ~ 200 MrrrraAatr+4 tre N+Y+ro wwr.rr. ay my trk rra t++r prrr M M Ter.. r u.. rp OOii72W0! lroae.e rnosl tarwga.r r+rMUS y . arrrrerr tmrrrtrw t>.tr crs• w rrpret a lamutau. ItiMrrMr/~ ~.rwt+grawr•wwy brMyarr NYyN t w taw awrnt a+rnew wtw. oo. Jurr trrreraY brave ~w i ., t~ ~~. stoat rmrortrsr~ r trrrrtrr b cerraeo roe r wtrrN anranrr wrsre. N Ontrr Yr YI tOrrt riRMrr IYrr. http:Nbigcharts.marketwatch.com/historicaUdefault.asp?detect 18csymbol=T&close_date... 11 /13/2009 do Sp6b ~MOM4 G.•r •a.nrt M aTiT r;.< REV-1508 EXa (G-98) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PER50NAL PROPERTY ESTATE OF FILE NUMBER Nancy T. Peterman 21-08-1250 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointty•owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Sale Of Car 1,500.00 2.' MetLife 7,637.91 3.' ForeThought 301.84 4. Patriot News 24.50 5. Donegal I' 491.00 6. AAA 48.64 7. Lee Procurement (The Sentinel) 31.09 8. Furniture 40.00 9 Concrete Sold 120.00 10. Personal Items -Donated 300.00 11 Washington national Insurance Co. 16.00 12' Qwest Communications International -Dividend 2 gg 13 Fairpoint -Dividend 1 29 14. AT&T -Dividend 710.12 15 Comcast -Dividend 13.05 16. Verizon -Dividend 408.48 17. Verizon Benefits Center 450.00 18 Federal Tax Return 2,482.00 19 PA 1000 250.00 20 Citizens Bank 1,278.38 21. ' Travelers 105.30 22 Owest Communications 29.01 TOTAL (Also enter on line 5, Recapitulation) $ I 16,241.49 (If more space is needed, insert additional sheets of the same size) BILL OF SALE SELLER: Lois Newman BUYER: Gail Jones 2001 Saturn wagon TOTAL COST: $1500.00 P «~ ~-~ _3~ao~a q ' TRAVELERS~~ 301 P~AXTCNIJRCH ~011D RISlUR6, ~A 17110 STATE OF NANCY T PETERMAN AW OFFICES OF PETER J RUSSO OOb E TRINDLE RD SUITE 100 CHANICSBURG PA 17050 -- Account No.~~~Z11 NARA! 1Z, Z009 For pelioy olw~aa or gwstiana . cell: i-800h842-5075 For alaies ell: 1-800-CLAIM-33 IMPORTANT BILLING NOTICE Dae reoeat nativity, there is a refund of 010x.80 oa your aaoount, which we have depos tsd to yoar beetle aaaouat XXXXI~%800a . tbnnk''you for insnria eeith us. Please aontaat your inseersnas represeeitative if you have aeq~ gdestions oonaern~e this letter. oa03sa/o03sa F3116A40 6813 03/12/09 • A Community Service ofd Volunteers of America 675 Sliver Spring Rd • Mechanicsburg, PA 17058 PHONE 717-766-2999 • FAX 717-766-7505 W W W.VOAPA.ORG Name: Lois Newman ~ Addross9: 32 East Green Street Add»ss2: City: MECHANICSBURG State: PA I Postal Code: 17050 Special instructions (if applicable}: Category Clothing --- ~- No: I! Donation Date: i' Pickup Date: ~ Pickup Phone: Picked Up By Delivery of items: Dsscriptlon of items Donate 35 Boxes FOR INCOME TAX PURPOSES. This slip will serve as your roceipt, in case you wish to use your contribution for purposes of income tax deductions. The Internal Revenue Department advises us that it is up to the contributor to estimate the fair market value of his contribution. Volunteers of America has provided no good* or services in donsideration of this donation. Estimated Value of Donation I $ NO ONE AT HOME ~ _~ A.M. P.M. C'oa~s -asp sW~-~~,~~s~ ~ Ly ~o~es Sh~~~s- I~a~- CAS`s- ~ ~.~' ~,5kt ~~ S~;i~ 7137 3/2012009' 3123/2009' (797),557-3482 Pickup Thank You! ~~~ cn ~ l F'ish,nS Ao~, ~sh,nS l,ks-~s h eor~ pie Q `~.~t. 91ass ~c1~ sh d-s-. 5~, ng s fi~~e., +Me~0.~ cashb~ s~ , 9 c~ <<,~,~~- ~ ~ lao {~~, crMo~ W tn.da.~ ~11a~t. ~e~') ~~~~ ~o~ ~r fihe~, ,~~~1 ~~ce~n~al~,~ r 'Ilte Sahration Army: Dottatitm Recxi~s - Valuation Guide dlpJ/www.Sal'vatt0~[myuB8.0i~StVWww ti4n '1.OSt/vw-dylmmtC•... wMwtiert stela. ter sMwtiett Mwry oen.lions Yoar aanltnura support ttrthas air oosd watt parlbb. tour vu•~o me dedtrWbla otontnonr an mold fhnmpb aw Sslrafan Araly 7hr9t Storas and sdratton Army >~may atoms tlroa9l+fha ooanfry and sma to tad as IWult aa11r~Uoa aooram. Tlla Velw thddr tlrlow wl0 salt Y~ b drtrrtrlhlmp ttlr telo-drdlrolhlr vslw d aabttms tau ari OoiiMlnO to lti~ SaMefarl Mrry.11b11 wMl sN tlpt ~ trMlr bldlyda low end Mqh atin~trs d aloe.' t~frrre dloors a valor rrpllb tha ranpr tllet a a bNpYq wtJh goer Itrta"a rrkflva apt and gerltY. U You Mew 4uaganr, Yar Mld Salvagorl Ilnnll, llMlR Stop and donstla~ anllrr wSl Or aha to aetlt Yaw i A reoslpt ter year Ifdarrts slaw bw obea~d in anw d lAr~as wawa: ' t. tf you ~ olf a donrffrrr et a locsl sdwtlea ArarY 1bnMM Tlaet Stara ar ~brps (rronhip and awnmunltY arlfa`), tht rJerk a' IPwpuorrrt wO a b1ppY m ptoelae Yal wtah a renYpt. 2. if yatr eaaissra dapprd df at as antrtrdsd taMaUon Army droP~, an ftsmard art b taquMad lr ~wlve a noNpt.llola' Ird fdrrllon May Core a' iwa0y lhrat Sfae an have a realpt niid'e aiE Ib-.~ anai `ydit Mrip fhb Ikt to t11im. Plrrra ttaala. yar ~otMlloltr wah the vahrs not to thra to WMa tlam Ibr your tawrr. Ybar toot mlrn/tarrt wul ba tbs bat roalrar fbr adNat an how to lrunar aad subaa ihb hdbrmsuon. 3. 1f y0Y!ttara Y~ drnrllrrrl pkkad up fhr tradt drfvar w19 prmude you wab a raoMpt. Art txtrtlerratlolrs Apgenes tow Miolt Alt Oerbftlanr 20.09 90.00 ttryar ~s.ao 9aoc as stove so.ao 12s.oe tts.ara 7.10 22.00 RadW 7.50 50.00 11rh1geralor (YVorkhq) 15.00 250.00 T.V. (4MlYAxldiq) 25.60 60.00 T.V. (tetor YYbtkll4) 75.00 225.00 YIIrtl111q rreohMN 27.50 150.00 CbaOnM'e =loots tow Mipb elcydas Stsoo ibs.~ ela.a Sx.oo Se.oo Boas Ss.oo ~o.ao oo.fs Ss.so 52aao otaaa s3.so 512.ao >.a~ i3.oo i2.s.o ~ala< ~.so 512.ao hats 52.50 512.00 SMrb 52.00 16.00 Shres 12.50 i6.7S swro Si.so 56.00 saga 52.0o Se.oo sawrsts Sl.oo 519.00 soaa SO.so Si.so swaaea sz.so saoo usderwar Si.oo 53.So orr wbers Low IpOb ~a+~ :gym 5.00 tllelllats 52.so Sa.ao aawroovas Sts.oo 535.ao atrrarrs p.s0 512.00 crapes 56.so sw.oo vwlows Sz.oo Sa.oo shsaa 52.0o Se.oo llaew wqs Si.so u2.oo leweb Soso i~.ao RrrrnRYro Low Iflah aed CefnpaEr (douba) i5o.o0 1170.00 Oed Complelr (elapla) 535.00 1100.00 esdreonl Set (maplsty 5250.00 x,000.00 CaRlrpb x.00 5100.00 G1Nd 525.00 595.00 Cllhla Ca0111et ~~ 5300.00 GoltNS Chat Sis.00 550.00 amtee ~aeb Sis.oo Sbs.oo t]orwertlblr Sob (wlpl nnltrars) Sa5.00 ;300.00 t~rlb (w/mred~as) 125.00 iloo.00 oak i2s.oo ueo.oo ~0~ ~ csntrat teattory 5stsm 1'srrRarv Soutbam TerrlrorM watem 70rtltOry 1 of 2 4/2/2009 8:30 PM 3 0 m z~^ o~~ F~ ~g~ ~ z ~~ il~oad • 8, IL 60173-2096 000ooooos ooomzs:so > > oase o~' I...III...111....I.I..I.I...lI...II...11..1.1...11...1.1..11.1 SST. OF UANCY T PSTSRlIA 32 8 QIiBBN 8T l[SCHA>hiICSHUA(i, PA 17055-3335 pA~;08/18/09 CHECK NO.: 0002025290 TINI8SN: DESCRIPTION POUCY/CERTIFICATE ACCOUNT NETAMOUNT POLICY TSfiiiliidTiOIi AZ250415Z6 1005V000 16.OU B0000026 10000060 ~~STSTSK 91881701 DETACH AND RETAIN THIS STATEMENT THE ATTACHED CHECK IS IN PAYAAENT OF THE ITEMS DESCRIBED A80VE tsw...w s+w ~:' Washington ga~onal T11s Co. ~ ` <' f ,; :, 200 Hortti llartiagale : Road ~> + .. 8Chauabltt'q, iL: 60173-2096 :> PAY: 8~ >31D 00/100 DO[.ti98 TO THE ORDER OF EST. OF NANCY T 32 E GREEN ST MECHANICSBURG, PETERMA PA 17055-3335 Irmo: ladcdMnne..NJI ArMN.. O.kab C.unty. OA. vo~o ovER;~e.oo CHECK UNT t~ ~ II'000 20 2 5 290u• 1:06 i i i 2 7881: ~ 29 9~ 5 3 68 3u' MetLife NetrapolitanLitelnfx~-~neeCompany ' '500 SCHOOLHOUSE ROAD JOHNSTOWN, PA. 15915 Notice of Clalm Pay.*t~nt &JDist. A~enryt Date of Notice NAME OF DECEASED DATE OF DEATH DIST PHDNE NUMBER (717) 724-97~ LAW OFFICES OF PETER J RUSSO PC 500 E TRINDLE ROAD, SUITE 100 Please See Important Notiee on Reverse Side MECHANICSBURG PA 17050 Palley Number Ca~sReferto 11 Bdow. 6D0666a93 MS a.B 640345178 MS A.B Items Payable Amount 1000.00 1000.00 Une• ear Terminwranoe Additionallnsurance 3166.75 2274.37 Dividends With Interest Dividerd to Policyholder 14 . eo 22 . t e Termhal Dividend 50.00 50.00 Premium in Advance I1ltereSt011 Cli ainl 33.39 26.41 Dednatiens Premium in Arrears Loan Loan Ixterest TOTAL PER POLICY 4264.94 3372.97 A. Nh haw compbted a sw-oh of ow rsioords, but woo unable to idantNy any additbnN In ioroa~ polkNs d. Our chsadc for the bahxsp duo Is attached bNow. Detach stab before caabiag Ibis claim bas been a roved for the total ~ the amounts appearing in the boxes below. Items determining these amounts are listed to ' the left. Aw~wl&IltrDaf~nelp~nt l 4r-t~wibalwe.rfs.lerGnler 1 ~r~susatq~e-a1 4467516 Lois M Newman 1223 Mill Creek Rd Hampstead, NC 28443 Re: Coverage for Nancy T. Peterman Coverage number : 00109065? On behalf of the Forethought Life Insurance Company, please accept our deepest sympathy on the death of Nancy T. Petarman. Proceeds were designated for payment to the Funeral Home. Accordingly, 4467516 we have paid the proceeds of the ooverage to Michael J. Malpezzi Funeral Home for their goods and services rendered. The amount of a9,9~'2..42 was paid to them. Attached is a oheck !or X301.84 which represents your excess proceeds. If you should have any questions or need further assistance, please contact your Forethought Counselor at Michael J. Malpezzi Funeral Home or our office at 1-800-331-8853. /SC1 SAfE(iUARO 937f439-0197 UCSN83WAe ~ ~ ~ --~ ~ ~ ~ ~ H ~ '• . e ~ ~~ r ' ~~ ._ ~~a ' -~ ~ ~ ~ ,, ~~~ ~~~ >;;<.. :~<< ,-~ ::~:: ~5 ~ <: ~' . 0 ~, 0 .u '~-A ~, 0 :~ . H ;~y:~ M '~~h.- ~~ f:: 0 ~~ ' o ~ °` <~ N Q' N N .S v~~.,: ~'~$~ ~ '' 0 ~~ o+ao4+ VSRISOli' 8 BSITSBITS C~NTBR ~ 10o e11I.p ~l-7[ ~ ' L'INCOLNa9IR8, ii. 60069 ~ ~~ Return Service Requested 0037 RKDK5TIA ESTATE OF NANCY T PETERMAN CIO PETER J RUSSO OR LOTS M. N 5006 E. TRINDLE ROAD SUITE~'100 -~ MECHANICSBURG PA 17050 01L020222T Pace 1 d 1 7,595 Fos pension papswat queatioas, oall 1-877-x{89-2367. Oatside t2ta II.s. call 1-85~-883-1Ob9. !t-F B:OO1H[ to 6:O~PM 88T It pour Address is not correct, loq oa to waw.verl.soa.co~/benetits, Your seaefits Resbnraes, and update Address ia~o. Incorrect addsesaes will is~act pear end ta:/IR8 sepostiaq. PAY ON: 041r11Z00Y CHECK DpJM6ER: g4tGlOZ~T sssoc=~-ls Rscs rsasioe~ rza+ vsA:zox ~ ssrwrs or xx~c~c r psrsmWt~ C ~ 8 ~ 8w ozeszseoowi ~ _~, u a c as ;s ooPOO 9089T 01 np~t, II1C !~C - W X50.00 Ili! YIIYIRIT! 1111DtlliT / X450.00 ~a ~~ ~_ J ~' 1~ ~ ~~ ~~ m gl d~ ~ o ~~ od ~r~ V ~ N ~~~ i '`i ~ i i t s ~~ l J-, i ~ c ' ~~ ~ 0 ; o- a ~ .a t m ~ ~ i .a } ru .. .~~ ~ l } ~ ti ~~ L ~ ~ ~ ~ .., ~~~' _{ Y~fN M ~Y" MW ~ - _ __ • •' ~ • ~ . s PAYABLE ONTE CH®pt NUMEER QO-1f0 Odl1?12010 T78~l636 ~-- CIWEST COIYIMUI~aCAT10N8 d~TEttNAT10NAL INC... s.O~ NJ o~eoaeQOS ~ PAYABLE AT . THE BATIK OF NEW YORK N,EtLON 8l !! 8.OCLLARS 001460 74O1Z110 PETERiW1N-NANCT0000 PAY TO Tla: 00040603 01 AT 0.357 01 TR 00140 SOVDBA02 000000 ,. ~~ ~' LOIS M NEWMAM ADM EST NANCY T LPAY••'•"••••'•'•••••••••••••••»•:0.~ PETERMAN __,. CIO PETER J RUSSO - 5008 E TRINDLE ROAD STE 100 ~ MECHANICSBURG PA 17050 ~ ' ~I~II~I"~I~~I'1111'11~1~'~~I~I~II'llly,~il„~Il~lldy,~hll„I .``.• '' AUl!FiORIZED SIGNATURE 6'?7948536E' 1:04330i60i1: i23 01401' THE CHECK BELOW REPRESENTS A ONIDEND PAYMENT GWEBT COMMUNICATIONB INTERNATIONAL INC. To Inqulnt shout your account, contact 8NY Mellon 8haroovrner Ssrvka:s Toll Free Number 877 288-7Zg3 Outside the U.S. (Collect) 201~80~578 Hearirl~ Impaired 800-231-5489 "" "r'r G"' ~" ~~ ~ Logtn setvlce program by using the option below. Investor ServiceDirect®m ~bnmellon.cocolshareowner/isd Have one of your chucks handy. You will need to rater to the bank infamatton planted across the bottom of your check. RETAIN FOR YOUR RECOROa __ -..._.,....v..n.,.aw~o mICRIwT~OI'WL II~IC. •----.~..~....W.n..n YrYEE10RID ^_ ~AOCO1N~IfKEY --•--. _.. 18~11OFaTCGc -_ ...1>!60ftf701lt.._- ... _. OOf dQ07~a12110 _ _ RATE PER SNARE - •- - ~- -- - ~ - --- - ._ . _- COAiMON SPOCK i0Al00000 CER1fIC~TEO MARES - eDOK.ENrRY MARES ~pgg µp~r _._.. - ---- •------ - ---......~_.~...--- acooo OMDENDPAQYEART~ TE ... - .-._..-....-------- TgX~7gNNUAE I TAXNRfIpIELDYEARTOOATE _ CM1IDENO DATE _ 0?11A!2010 TAXMIIRRELp _ _ ~~ _ Plsess dehch sIu ^... _ PAYAeLEOATE - . - - _.. .. _ _ 03/1?12010 CuRRENr DIVIDEND --- i E11rs form for yolr roads. THE CHECK BELCWV REPRESENTS A DIVIDEND PAYMENT QIAIE8T COMMtNVICATIONS MITlDiNAT10NAL INC. To inquiro about your account. contact 8NY AAegon Shanawner Services Toll Free Number 877-268-2283 Outside the U.S. (Cdlect) 201.880.8578 Hearing Impaired 800-231-5489 .. .. ... .. ..i.. ;.: :. .. .~...~ .:.. ., y.. .w u .. ...t.... .::.:,. -. ...: ..:'... ... r:... K .. :.. .r• .3., :. ay: ;::. ::::::+::{.. "5":: :-.'tip:?::.T .,,.. .> w. .Ali;.. ..... ,~..k... ~.f. ... .,..... .. .:;..::. .:.:<'i. ~'~' %.~i:~':-;•' k. ',.^~..t .. ~$•' +.a.:: .~..: ~;:: v{~:';~v .N;,:i.Y4-• .s?i:~.:.. ~iY;3;`q:hti.'/~F`.. iyv .,, .. t... ... f. ;n< Aidf f; i.:~...~r: ••::d:rif '..:..'+:o-:r::,, ;;; :::.:}• a.. ~'~ - 'a^ i ~~4 ~ •i:L • ~~~~ i`a~` your bank"accounf ~ ~:~Y~'~~J~ ~' cea~~ by ~~~1~ Simply enroll in our self-service program by using the option below. Login ~o Investor ServiceDirect~ ar www.bnvmel lon.com/shareowner/isd Have one of your checks handy. You will need to refer to the bank Information printed across the bottom of your check. 3 ~. :: ~ .. .. . . % ': ~.. • < ~ ~ . G~ ~ 5 ~ ~, -rT. O4VEaT OOAMMtJr'MCATKNr3 INTERNATIONAL INC. 7RAWSAC110N OE ~ DNIDEND MY!l10RA ' ! CWIP AOCONNr KEY ! 00 : ISSt1E+L'IASSOR STOCK RECORp GATE ~ PAYAiIE OATS 7 450 7~YT2110 GOMMOM STOCK 1 U201200e 1b11/lOOP RATE PER ewwE CERTMsICATEp a-uREa e00K•EIrtRY SF1AgE S ` OROSe IW01PR TAX VNnslEtp CURRENT OAI10@N sa~aooooo o e.oooo soa D 'o~oo So +e PAID YE~~ OATE AX 1NRi0iEtD YEAR TO DA : TAX X7EWTIFICJ1710N NiJMBEA . 50.00 r PIMtf detach erld ~n this lOrin ~Or IIOUr raCOfda. QWEST COMMUMCATIONS INTERNATIONAL g1tC. P O aOX 7625 S NACKEMMSACK.NJ0700642~5 PAYAaLB OATa CNBCK NYMa!!t 12/11/Z009 77730945 PAYABLE AT THE BANK OF NEW YORK tYIELLON W U.S. DOLLARS 001450 74912110 PETERMAN-NANC'f0000 50tT57/N01 ATa3S7 IWTO T925~ 17p60,T5172S0 OOM00000150 6~,III...iiiu~~l~i,l1~~~„11~~16~,;1,~fi,~~l~~i~l,i~l~ll~~~i PAY TO Tltg ~~~ LOIS M NEWMAN ADM EST NANCY T • PETERMAN C/0 PETER J RUSSO 5006 E TRINDLE ROAD STE 100 MECHANICSBURG PA 17050-3647 PAY' ' • ' ' ' ' ' • ' "' ' " • ' " ~ ~ 0.4 8 ~ ~ ~_ AuTrlole¢EO s TURF n'???309451N r:04330 A60 iI: 123 01,40tN itETAIN FoR roWt R®t~11pi PNap d~taafl and 1al~fn tl11t btm far your noords. RE~E ~~ f1~OW G1Ep(NIIYtSER: 771?1313 THE CHECK BELOW REPRE3ENT8 A DIVIDEND PAYMENT INTERNATIONAL tl~tC. To inquire staut your account. oontad BNY Mellon Sbanownrr Servloea Toll Free Numbw 877-268-2283 Outside the U.8. (Cogect} 201-88Q~578 Hearing Impaired 800-231-b16A e:• ~• a •+x~• < .: , .~ • • ..R. ., .: ~ , your ban~C• account ~ ~ Simply enroll in our self-service program by using the option below. Login ro Investor ServiceDirect'~ ar Have one of your checks handy. You will need to refer to the bank information pTiltted across the bottom of your check. ~~ ti01t lroult i~ i i w.+e w.oo so.~e ~ TAX ICAO NUM96R PI~Ne d~taoh aM,gtaln MIh Qofn kr yntM,loO,de. THE CHECK BELOW REPRESENT:; A DIVIDEND PAYMENT DYYE3T COMMtlIipCA?IONe N~rTEIWA?10NAL MIC. your To Inqulro about yrwr aQOOw~tt, oortaa BNY MNlon tiharro+tnrar 8arviou Toll Free Number 977 2E8-22ai Outside the U.8. (Collect) 201-080-0.578 Hearir>p Impaked 800-231-5 ~. aCCOUl1t~ ~ Simply enroll in ourself-service program by using the op~on below. Login ro Investor ServiceDirect~ ar www.bnymellon.com/shareotlvnetNisd Have one of your checks handy. You will need to refer' to the bank Mformation printed aa+oss the bottom of your check. arNw rat rows ltl~atos PMseo dNSOh ere r~1.in IMs pion br your roads. '~ tti Its i ~omcast. IMPORTANT TAX RETURN DOCUMENT ENCLOSED ~AUro~otaT t7o 6ootstao16143 0 4 814 3 elldllitelllliitl11i1e11iitltillillilltlllitliie1ltiiiii11lietll t LOTS M I~YVMAN ADM EST NANCY T PETERMAN 010 PETER J RUSSO 5006 E TRINDIE RD STE 100 MECHANICSBURG PA 17050 'Uegttlead s0001Nae ara a1~JaC1 fa releA101dMIg taxaa on ethlldarld pafyraara0 arld glad piro0oeda. kntructbrls for Redpbnte AeaaalrwaMr. NerracaaaooounladMrseepwwwdeo0rpetereeebudbAeMgidrlYavaooov~a. sea 1r. shows IoM adYwY dhldeed 0ul w bsrde. ildade ede awawta see M d Foes 1010 a IoloA era ~ r on Sdudar a ~ toal ar arleare ~ ~ 1010A), rwai.d. 7rw awecsa r1ow11 erpM drketsl- a ooipoldoa paid diulY b y0a a a peOcEant fr wlrideryda pufdpen0 h en wybyeagldcawlNppsnpSOP-. 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See M SdrduN 0 pale 1010) iseb11c0ecr. 188UDR ooRTw Ccomcast. PAY9t'6 Fadaral IdealMea6atl nlentl0r: Z7.0000796 PAVBt'8 sawt, atraat eddFass, dry, 01af0, and 2tP 0oda COMC,AST CORPORA110N C!O COAIPUTERBHARE P.O. BODt 43010 PROVIDENCE RI 021w0.3010 IlBCIP~tfT'a IdrnYAoepon nlreber. 286765319 Aaowlt eeuebar (r00 NtpruOtlons$ 03017909766 RiT'S eear0. dfNt addleae. dy-, ehUc ZIP 00110 11016 M NEWMAN ADY E3T NANCY T PETERWWJ C!0 PETER J RUSSO 5008 E TR810LE RO STE 100 MECHAMC88URGPA 1T050 Form 1089-DIV (keep for yow records) ~omputershare ComputeFShare Tnut Company, N.A. PO Box 13078 Provideltce, 8102910.3078 • Within USA, US terruories 5 Canada 888883 8903 Outside USA, US territories 5 Calla~i 781575 4730 www.computerf~are.coMcancast Holder Account Nulttlar Ca10 03017909788 CMCS RedplOrR'i ID Na 28.6705711 Psyars Fadard ID Na 27.0000791 OOICae006_ItIe.D 0101.CMCS.07e)f0,=lOelD~R1~YWI111y e~x~~.~xrwaa,ro.fean«~a~eamMe~u«. r~.e,v,.rr~aaowrwna- aapteen0 rr sex (teb OeieyeeieMaF Life to to /M iwwSar a 8dledeN o ~ >oai, eea fd Shah M p>fr dM 0W Y ealscehle lceoenea r s M visa drew ooa(a ewer rwrl. lbo ewa eedcoe ra. oor pr eaex hap rY es awaed br 0pwio,10rh a ba~cAee ya,W yor abd. earyoueureera~ourooett«or~re.wl.~vonw.arbueawaavrro~. ee•w~r.sso hnarnad rAOen and ~ Oa14: Slasa redwP we0~erdr0. fa secede. a payer as1e1 ia~weddd ae salve el h arWuw aib r Yon ae wa9M Yourwoleyer tlaisreroe wnerer b Iha ONE Sa Fans nM, Regwr w Teeyeya IdeNAaoree Menberandpl9beroa br rraarral oa bedeepwsid0ig. breae ree naval oe year raww Luc wbw n b+c wsiwld sea r: Slaws you rw. dnapclen d s naipnbrdy domed fearrrd INceebMal oanpa0r, OuwaBy e lfoiqubrdr domed molar Mcd. rya a Foae 1010. y'a wl' eeAal tae egwiwn a M tires eapcan' ree a+SdwdJs A (face 101q esblor b M 7x ta1t. This wsat N 6111adad b bat te. sec k eMOws er weipc w yen wqa rbls bdeiwo eQeduaYawa •adlonFanc 1010. Sse M Fa1w 101e reerlfaaw. Sac 1: 7lie Oo><lcad/ be rahwik r a wOnMsO iaabnenl aapenF npar~ b laet0e rc Yara a Ook /. sea k Shows talh fgoi0etoadrr6fAeee. Naaiwee: r01e beurlydnamoesle iMrMPV roenoelrpewoe, pnw odlefldna0a naaiiee weg4nt lbu e>twl~e Fore tefa~olvwla M rte bradld M erworaere Ibra.wrehaa d MiwrM, sae yaa7oabmrA•Faw101i0elbwh AhrlbwliawreYrotwMBNbMseanreerarlcbraw arwars ewwr dy Or orrr. See M rafeal lea YwQafad brnlroMle w Fewu tON,100e. 7rZ1, 3022 SqO. an01Y-21i. CORRECTi:D (it checked) Dividends and Distributions 1a Tow a~Y artaMae is ouareae dhidrl0a f 4.48 f 1.46 z. Tow a0a Orr1 aea. sr unnpp. sae. Ism Stln f OAO !i OAO to Section 1 Z02 0aN ~ Celecfmha (~) 0~ f ow s coo ~ lsndhidnd delnbu0aa 4 Fedwl ine0ab Ya f 0.00 f 0.00 S ilreslwenl eapwwee f fwipl tatic paid : o.oo f 7 FerNpn aacnrir a 11.5. pweeren a kawh lo}deeron dM~uOaee ~ 0.00 Tlw nportabir erlouab above weplde e-e loMwrle aldleawl Nlaowe: C9alpllly Pad Has CanpLy Paid SuNoO Q~ t 0.00 f 0.00 OsoouMan Reelreawlal f 0.00 Oepelbnerd d 0fa Tlefwry - WAenM ne1e1d1e Selvia cila Ito. tslsotto 2009 raw 1099-0N Copy B For Recipient Trs s bipoAUr Ira I+koefefon aM s heiq fisnhlled b M Mlanr Reacw Secvloe. rya w repole0 b Ne a rwr~ a ne0101noe pingraa0rr eencdal navy b ~d on yes r fde beoaw s taahle ar M rIS detenrrn 0W aMe nr hen lapard. THE CHECK BELOW REPRE8ENT8 A DNIOENO PAYMENT To Inquire about your acgount. oontad BNY Mellon 8hareownler Servk~s FAIRPOINT COMMlMI1CAT1ONS. INC. Ton Fres Number 877 295.8808 Outside the U.8. (Coned) 201.880-0578 Hearing Impein~d 800-231.646A BNY Nepal ~t>Ireo~lmer Services b dediC~ed to ~+oviding you the best s1l~arrtowt!lel~ expeniencel Did You know that you Could manage your portfopo online 24 hours a day, seven days a creek? Slrl~ply log hl to Investor servicaDirsct~ (ISO) at ~ -vnour m+~raa nor opsnO oy oil fawn. • OUta'100Y 0 ~pmpu~ershare ~ at&t ~~ ~ : P ~ Ro~dence, o29e0.3o78 ® IMPORTANT TAX RETURN DOCUMENT ENCLOSED Witllin USA, US temtaries & Canada 800 3511Y21 0u~~ ~ ~ ~ S Calted~ 781575 4M9 ® ».»........AUro~o~ciT ~ 0ooo75ao24oe7 0 2 4 0 9 7 www.c0lllputarahare.corNalt i® 'i"I'i"'I'ih'1°~i"'li'li'II"ili"I'I~'II(li"'~~Iliiillurl ® Redpienl ~ NANCY T PETi:RMAN ~ L06S M NEWM~W JT TEN Holder Accotalt NumMr ~ ~~ ~• cREec RD 00011097472 J N T IiAr~sT~-o Nc zea4~-~e~a Rraoord o.a a Oat 2000 c~.ar Number 0007N0906 eawnN CerlMed Yes a~tSD07S110~1tJr0E0s_POr.Ati.rai a~nuo~~oviwi~ovr~ AT~T inc. -Combined Dividend Payment 12009 Tax Form 1099-DN ^ ~di Form 1098 • DN • Olvidends and Dl:dributbru 2009 Copy B • F~ Redpient 1MU M t~Kporlwl li:iikmraen a110 t; ~ anJrird k 11w 61MrraY I6MrnM SMrIO/. •ror an rpYlnO m ak ~ rNurt~ a rNaAywlo~ NKYgraallrrnnden ~a repaNan rut{a~lxoom.rmuhl.ane aM aea AeMnarie~ snkho net tu.s wponrAL a~dObnt NANCY T PETERMAN 31:013 M NfiWMAN JT TEN 1223 MILL CREfK RD tUlA1PSTEAD NC 264432810 Aecoant NurrrbK Coo110174n RealplerR's ~ OMo. 11/•t0a03! Payers Federal NI Na 43.1301iq OtAd No. 1545-0110 DCpMhINI[afrM Tw~ary • 6~enW aweia~ 6rria olNdende ~ ~ ~) ~ olsabuao~ (s~ TAx wlraNSO Is;) PaiO {5) ~ a us. ~ orex tsl ~ Payars Del>ab 710.12 710.12 0.00 0.00 OAO AT3T INC. C10 COMPUTERSFiARE P.O.80X+3010 PROV1t1ENCE R102a~0~3010 Form 1098-DN (Keep ror your recoMs) Conftnnatfon of Dh-idends Paid in Cash Payment DaM I Chas Descri tion I Partk;ipati I Divir~ I I a ~ p ~ M Dividend(;) Am ouM~ I lype I Dividend (5) ~ Feb 2000 Oi May 2009 03 Mp 2006 ~ N~ 2009 COMMON COMMON COMMON COMMON 433 433 433 433 10.41000 10.41000 10.41000 50.41000 177.53 177.53 177.53 177.53 0.00 0.00 OAO 0.00 WA NfA WA NUI 171.53 171.53 t77.53 177.33 YarTo-0aM Pall 710.12 0.00 710.11 ® 46UTX A T T '~' ~PP'NnI'K1) PIEASE CASWOEP09f11MSC?IECK PKQI~riY. _ _ ~ 1MPORTgNT TAX RETURN DOCUMENT ENC103ED ~ "'"""'"'AUro'~DICR 1Ta oooaTmo16643 0186 4 3 ~ r11IIlllttAgliiltlitftfitil~llll~lltliltli~liiftt~tiliiffl~t~il ® LOI.S MNEWMAN ADM PETER J RUSSO ADM EST NANCY T ~ PETERMAN ® C/0 LAW OFFlCES OF PETER J RUSSO 5006 E TRINOLE RD SURE 100 MECWWICSBURG PA 17050 'UnouMsd frooolfnb sn fpb~set to fnttldfolalrfy taws on elrldsnd psyanab sfd sdss proossds. Irtsiructions for Redpienb AawKNuwIK: feefelaaM.emi.r«owrM4wn~M-wyry«.f/~•ebfw+piYhrei..ooew. aM /r chew bweeiaryeletl.ede w1 en fMfOb. MfteOe tAle Mlaenl M Ilse ei d Fam fae « iofoi- A11e,eeoeetsa-aebeeeb a1Fam/eat«attaAeb I {FM. 81011}, rwauwe, leeeaeaetlawn ~rwelraaeN.oava~ua~erbraraao~Mae N-barAalapasortdo~f~gann fiAeofw Modt amaebp pw 1Ea0Pl. Report a f~• s deldad aoyas Fam t01orf01611 ad mete at e pbndM~ellon, oats IMgatlbmmf, brgraMrpnpoM. treelk S~sMratiwdw•~o~•dbta:Ut~at~rlea~~l•(«w1S1t«a%ca~plYaaYrwn see w Fans tagil0laRtrlheedant W Isar b dMemiae sit asaae. RepeA reeapeb eaeaeq M rw eb. Fam>taN« fae0. aM?t claw bfdeaplMeoeeeMWfbeeontfawaeepeebereeaaeeerteam~ery«reetomOaneMrona tret IbeafwaneailtMoanlnt~hMErJadd•DtFaa~faW.iali art rep araaei e~oeeeb beros7lWdaMfe«eeer ayssflyolne Md toeew wuplryNneWibeeaa, fMmN a a. aaperre eereemr el~wr+e M ee. bM IYa u arum f010 ~. fo a raw fMOA) are, rM eebelrb a flee w ram faerroas inweelfar. aM 7k slaw sr peNMd w aaanf b bar Ia fbM N weeopeeee Melon t250 fpie eem uorlete 1opWaMa rat perMfe RepoA SieanowtMSa UreeaybM tieeron f~aoanWMaMet• Line fa ie w sdaaef o hrbearoee 1r«m fao1. aMt~ssen.aroeaanan..e,aeaeo.saawba~nen tsot~,a,moawe.wte•reme aod~ eeetnaf aeeiteq b. eox.rr~dan adarbirappneMetmM bMla. aodc oatmpe.weiaa b e 1011 mdulo~f SM M Sdrdnb 0 ~ 10101 Mftnrdae. 188UDR ooara PAYER'S Fsdreal IdsfHMlf~Uaf ffwabsr. ?3.ZZ~4 PAYER'S ffafRSe tx•rt addFfrsse dg-. faMa,,ffd 2p txds vEr+lmalco~wnn~cAno~ls a+c. c~oooMPI~NARE P.O.OOIt1.1010 PROMOENt3z Ri 0Q91G3010 RECIPIENT'S idoadllatloft atflubsr. 26.8766319 Aeeowftfwal6sr(ses Mspaf4bfls~: 00013168155 RECIPIBlT'S atala ttfsst ftddnss, eRye stats~ ZIP Cods 1015 AI NtaNMAN AOM PETER J RUSSO ADM EST NANCY T ca0 uw oR~s ol= PiRet J Russo 5006 E TRIIOIE RD SUITE 100 MECWWICSBIStG PA 1TOSD Form 1089-0N (kup for your records) ~olrl~tershar~e Computorahare Trust Company, NA. PO Box 43018 Praridence, RI 02940-3018 Within USA, US tenEtories & Canada 8006312355 Outside USA, US t«ritories 8 Canada 781 575 3994 www.carnpltershare.com/Irefiton HoldarActoutrt Nun~lsr Cad 00013188955 VZN RsefplsflNs tD Na 286765311 Paysf's Fsdsnl R) Na 23.2251164 wfcslooo~Jt-a.u~_rof.vtH.isna~sawfsci~aucu, aer re: scow ssx role oae Irene Mba «aetaegMaatee~4a a the, ae eef aeaent rlMaen ea sex ~• tleb waf.eee~ tl~a fa bfee aMatbMbr o Irani feat. aoe 3: llaae w PM a w dNRueM Iiq b eaebeNle taceree e Y ~ eehrn a foeoeeM(orewar teriq. vMaaotnAue yoaemt (oreMa bells} h gee anoeeltaiperM~ a bM MiM fM eeefaaebde. emfr~9wacr,oyewooap~ow-wa,~.ve~fw~.arresufano•apa~,. s..P.r.sso. brteleMM6ioaee a,e ErpalfM. lee k Slaert bedwp wiMalina. F« uMple, a MMfnaY b•dub M prlaa pefneaea • tlr aMe~dM~.beyora~rotylwyawM~porNarr~wtM.w~M.b payer. fwFMewA,Nspwliar lawraaMw~o•~.•ecwfeoaraxta-aTonnae•Mn•ay+.~aaa aew.ai.n,o~fM faro inaanee br Mme ee be affeald. sM x sbaw ya. srn a eepeeMe a • oreeed na„bre i~reeneea aaroMx f1~eMa nagbtdyeebroe mrlalbree. a yos fia lame 1eY. fan mar eeerrq wp a4o•wn M w ~Oear ppaa•C ine M 8dadeee AlFerm 1a~ eeOMp b w 2x rad lble amaoe bteelde0 b tar ta. aM t< snow w feaipNee fM mef a,bb b deYe M, eMlllee «b e:ell en Form ,ota. sM ea Fow Iola Ititeaeaa. aM r.1w bar olarle a bs bbrb l e noose bnebrae ~ eepabd ea biape ~ elaeee r eo. e aM x saew ari rgrweaM dloftbular. goenbree: l art ben awAed•• aroeoef 6Ma~q b awtha paaar, fee' en eorstlaed • nombw fcdybnt 1Arr mmt ~ Fan foesDnr eeA w its br.ede a w oewoaeae b ~lierr trwr ebeoe a w boors, ab foe oral badele • Foes fedFON b eed~ Aleabarearele b oat e.~.e b 1N a noeieee rrlne betar emaee,mmletywa~ef. aMwanaenrywo..arMnlabeibrFMwfadM.faea.aal.soas, SWi.a+dW~f3. '~' CORRECTED (If Checked} Dividends and Distribertbns 7a Tatl ordMry elvWende ib tteeYed dMdneds f 136.16 1 138.16 b IoW ~ een dstr. >M Uanop. Est iZSOpdn s aoo :0.11 za saSore 1202 ptin 2e ceot~• pe'y 0•bl s oao s o.oo 7 Naldnldred dbabu6ona 1 tisdatl Meals Me : oao s ooo s ar,erear ezpaffee 6 Fonlpl tat paid s o.oo s< 7 Fa'elpreeamby«U.S.pafMedarl a plhEquldsaondebbufap f 0.00 the reportable arauels ebaee b>ebde MN NaoaUg adep«rl MoOeefw P~~ CafprgPs+dderrbspwgn 1 0•~ = 0.00 ObooaM M RMmralnwd : 0.00 DeoerelNrlt d w Tferlw • Mtan11 RswMfe $avtea OIrB N0.15RF0110 2009 Faee 1099-0N Copy B For Recipient illb b apabet m abmerion end b twier taeidbd b en MtarW Beeson Savbe. ryM on rpJnd b lie arebeq • eprOeeoe psiaq,aralrr aaeason mrahnyofee M foe r ado sass. Ie twEle ad w IRS debnelree ew p Ira eatteeoneeparbd t~ ~ ,~„lei,,,1,~II,I„IIu,1~'I~'ll"III"I'I~'llli~"'~~II~~IIN„I ~ NANCY T PETERMAN ® ~ LOIS M NEWMAN JT TEN ~ 1223 MILL CREEK RD HAMPSTEAD NC 28443-2810 ~ompu~t'shar+e Carlputerahara Tntst Canpany, NA. PO Box 43078 Pravidance, RI 029403078 Within USA, US territories b Canada 800 631 2355 Outside USA, US tetrritafes b Cannde 181 575 3994 www.computershare.corrVveriton Holder Account Number Co.10 00012249853 VZN ReapieM':ID No. ta.26~39 Payalr's Fadaal ID No. 2~.2251t14 IMPORTANT TAX RETURN DOCUMENT ENCLOSED """"""'AUro"3otc~r 284 00030310109856 10 9 6 5 6 ~tntenea.a aeoolebe aFa aubJaat to ~ lautq on dhddend payalertb and pbs progede. Instructions for Recipients AaattarMtnnber. M,y,lawssanmuMadletMlpwnmaerhOSys~Y~CdbEbtgwAfau+aanl. as: ts: Shows rtst aatary dhbabs eat eta ba01e. esdeds sde anaml on eene>l d fan telp a to10A Also. wpata at adre„r a IFOwn,o,g a sdrdub t iFain +0/0111. enptid. 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BOXg010 Pao~not.tdcs m a~to,~oto tIT'BIdaM(BaYmf nuat6ar: 181.28.303e A~ a,at~ar (~ tlleb,IWalrk 00012210853 ,ranee. sfraN addnas, cillr, ebb, ZNe Dods 81,018 bl NE1NbAADI JT,lT TEP- 12231t1U. CREO(RD HAAO?STEAp NC 28N3.28t0 Forrrb 109B.D1V (kblen fe- veta~ -wanrrl,el ~ , ooicsnooi.~t-s.pplot.~~a,.uraa~,~..ruto~ttnas.~ ~. !~ 'a .. aos sl: Slaw, ~Ix rNe yeNlion tsra a esdiMgn d eslsalblw. a pvu-sd. ass edt snasd turn oorolwq ar 1e1c Rsb Qsb YMalglrsb tit N M h Yrbateoss by eonsdrAs D iFastt 101q. as k Slaws h aMd h dhetbueat ewr nampOE, besawse k s rsbmdfowaestpr aewesw). lbu sstq ndua yea and la sew best by ads saruslbr SpM4io~ein a bw trlwi pe tN pa gods a" s soar earl. Roes seas ar~r3~+. a aro~l o„r. sa w. s~o. eat k Shows baetAip ttildrtdiq, For waror. a epa roR beabl~paitth,td an eatWt orR~+b m h sDDeuide Rb a you dhl ad plre t'aa eta IOtn,Ylslteos twrbsr bi h psyo. eN Form YF-!. Reprt br TaspayabdsnOtialeoal4rttbsrsadCal6u6sataLdoierfonaaOeahtotdldtotOGq, baldeea,ssgNltan your boons ese Rllttl ai bR wtddtdd. tea k snows -na snot d e+panse d • natpAldrdrwd tpuUMd beseMrtll ooeeenK prwslp a naioubadtoeaedttadualbad, ayoa sr foss 1010. yoe taepdedaq!ewa.syeaw,m er'Oewet'enas' it on StMdur A (Fan 1010) tstbJ,p b h 2~ Inde. Thb stuoua r 1nCu0e0 b boo te. ass k Slaws h btei0t W you my M sbr b ebiat e• s dedugrs a s sad! oa Fan 1010. SN h Fan 1010 iatnresar. sea t: Thr eto: sltadd b, las 64tdt e s ntpurbd bweNntltll noorbd h bntipn Oc drwa b halt Hat k 8Mws cash h0urdsdett dsbibttbas. Metnbres: a ass boa itchtdes aatetads ~q b sttoaw prso4 ~ sR aetrldetel s roeWw,eagisa. flw ttstY f1e Faint t09l~Oltltte-ets Ols br etch d h sew aairR p ahew enr Bata d er InoeRa. sod feu ttttgl bwni,h a fans t0Yiti0N b etch Ahttsbaftd attlM r twl apshad b ea s aaRYrs Hera b slrw anaw+b oatrd bt h sew. See h eunam m year tlpta,I ttrbneeotn br Fonas ip){e. 1010.3!21. ~, s1ee. andw.2c '~' CORRECTED pt chee*edi Dividends and Distributions >a Tom adnery aNideaOe tr owe>wd ahlaMtee : n2.32 :712.32 b Tout apiW yen d'ab. =b tNaeeep. Bea 12b0 gate = a•~ s o.ao zc Section 12a2 yon td CeOUbtawa ~ 0w t 0.00 f 0.00 3 Nortdtidertd drlnbttear 4 federal bteear bs ttllAlbld = o.oo s a.oo 5 NveeNrM espendes a Forriprl me paid : o.oo : T Foreipa ttotstltp a U.S. pasneseton >! Cseh Iplidaaon disebuUOns f 0.00 able No. ts<sotto 2009 Fan 11191MD1V Copy B For Recipient Thb b YnOorWrt 1a bdotarYmt end r bebg hanileed b the baurrl Bettor 8osea. eyou The repoAabN aeaaaq show bttdah tlr b0atbtt eddNletw Mroale: w Rauad b ne a tebalt, e Company Pall Fese ne9~ P~tf a Deis COa~' Pall eaNn ' auKtlon atry be bpoeed m s o.oo : ono yal r ode batonte a 1staMe nla arottrtl an RentwbnsM ere stS Oebaltble art M Its i 0.00 rrl been teforisd ILnrhn~nl d lho Ttwwna . hdnwal R~r S~wity A~owrr oR c~c • s~~~~~~~48. ', ,,.- _ _ . ,- -, ~ ~- ~. • . . FORTY-EIGHT DOI:LARS ~S~IXTY-FOUR CENTS ~ V~ : t f :~•..A~ER00 ~ ~ ` :OAY8 "` ~~ ' ~~ ..;.....•r;. NANCY T PETERMAN _ ~' ~ ~,{r. ~ PAY 1223 MILL. CREEK RD ~ ~ ,~ ,!~ ~ .~ -:--.~,, ~ , ; ` o o~ of HAMF'8TEAD, NC `284.43-8010 ~•~.- w `" ~%` ' 'fi. ~ ~+~,;f .~'~L .~: ~ ,~ ;%E. , . .:'.. - ...: .. - ~ J t ~.~.., lit • ~~ I/-+, ~ ~wJJ• p' 2? 5 5 i 9p' b0 3 1000 50 3~: 20006 i i 128 5 5 ~N BWNYMELLONCATIONS INTERNATIONAL. INC. SHAREOWNER SERVICES P.O. BOX 3525 SOUTH HACKENSACK. NJ 07606-9225 Cash proceeds on sale of shares of Qwest Communications International, Inc. small shareholder program. 001-450-74912110 LOIS M NEWMAN ADM EST NANCY T PETERMAN C/0 PETER J RUSSO 5006 E TRINDLE ROAD STE 100 MECHANICSBURG PA 17050 ACCOUNT KEY PETERMAN-NANCT0000 RECAP NUMBER 0013 STATEMENT OF SHARES EXCHANGED LOST RATE SHARES SECURITY PROCESSING PER BLOCK ITEM LT# JOB# TENDERED FEE FE!E SHARE M 0305 0488 223624658 251900 6.0000 .00 .00 4.8352 CHECK NUMBER GROSS AMOUNT WITHHELD AMOUNT CHECK AMOUNT CHECK DATE 55007843 29.01 .00 29.01 03/24/2010 PLEASE KEEP THIS STATEMENT FOR YOUR RECORDS PLEASE DETACH THE CHECK BELOW _ _. QWEST COMMU1vICATIONS INTERNATIONAL' 60 -160 /433 ,INC. DATE 03/24/2.010 CHECK N0.550Q7843 PAYABLE AT The Bank of New York Mellon. Pittsburgh, PA. PAY TO THE LOIS M NEWMAN ADM EST NANCY T ORDER OF PETERMAN C/0 PETER J RUSSO 5006 E TRINDLE ROAD STE 1.00 MECHANICSBURG PA 17050 ;PAY $***********29.01 ~~ ~, ~~' S 500 784 3~~' x:04 3 30 L60 L~: i84~N 2496~~' Pennsylvania DEMIITMENT OF REVENUE INNERRAN~ TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMIMt Nancy T. Peterman 21-08-1250 This sdleduhl nwst be completed and flkd H the answer to any of questtolls 1 through 4 on page three of the REV-15001 is yes. ITEM NINA DESCRIPTION OF PROPERTY alauoE nt RNQ or AiE TRAI6EEREE, TMIR RIIAfIORIIp 10 aD:oelT Ni0 TIQ EWE Or flA16fER. ATIApI A D71r a TIE aEO RXI R81L ESTATE. PATE OF DEATH VALUE OF ASSET Xi OF DECDS INTEREST E)4CLU5[ON aNICAEIE TAXABLE VALUE 1. Pruoo Life Company 28.105.13 100.00 2 PnEdetdial Lid ~~ 11.000.00 100.00 TOTAL (Also enter on Line 7, Recapitulation) # I 0.00 If rare space is needed, use addRiollal sheers of papa of the saflle sue. ., ~1 • ~~f' 5006 E Trlndle Rd Ste 100 Mechanicsburg, PA 17050 (~ Prop Life lna~oanoe l:ompany POBoac 7~i0 ~~ P~ldl ~~PA 18176 www.pn~dediaLcom Contract Number: E0216~12 March 3, 2009 Dear Ms. Sops: 'thank you for the opportuNty to be of service to you. The contract value as of December 5.2008 (1217/08 was anon-business day) was 528105.13. If you have any questions, please contact the Prudential Annuity Service Center at (88$) 778-2~8. Tlu Service Center is open Monday thmu$h Thursday between 8:00 a.m. tb 7:00 pm. aad Friday 8:00 a.tn. through 6:00 p.m„ Eastern time, thk of our Customer Service Associates will be glad to help you. Thank yon for choosL~g Prudential for your insurance and tlnancial services. Sincerely, ~s~ ~wy~~ Precious Harper Annuity Service Center AID 6r1Ytlt ~r.+.oeoc~s~ Moasreu.x~wutDlr aiazsm v Ths Prudential tnsurance Company of America Explanation of Benefits (1 OF 1) ~- Prudential If you have 8ny GROUP LIFE CLALM DIVISION questions about P , O . 808 8 517 this claim, please PHI LADELPHI A, PA 19176 pie °°°"`t ~~' 800-524-0542 JANUARY 8,2009 ALLIANCE PAYMENT NOTIFlCATION LOIS M. NEWMAN 1223 MILL CREEK RD. HAMPSTEAD, NC 28443 CNTRLN 13935 p~l~ 10933265 INSUftEO: NANCY T PETERMAN DEATH BENEFIT PAY To: LOI S M . NEWMAN 110 O O, O O I eENEFR AMOUNT PLUS INTf1iEST 11000.00 a.oo 0.00 LESS DEDUCTIONS DEPOSITED AMOUNT EXPLANATION OF BENEFlTS: We have approved your group life insurance claim and haw settled your baneftt through Prudemial's Alliance Accounts settbmsnt interest-bearing account has been estabkshed in your name.' You wip receive a starter kit and draftbook (•chadcbook'1 soon. opaon. An Whh the AlNartoe Account, you can acw:s your money immediately by writing a check for the amount you'd like to whhdrsw . You can withdraw the entire smotutt immadiauy, which will close the account, or you can vtrite checks ae needed. Any bslsrtce you rnaimtsin wi0 earn continuous interest. There sro no monthly service charges, per.check charges, or fees to re•ordar checks.: If you already hsve an IUlliancs Account, this benefit wiM be shown on your next monthly statement. If you have any questi~ne about the Alliance Account Please call ANiance Services toll free at 1.877•ALLIANCE (1-877-25.4282). THIS PAYMENT REPRESENTS THE PROCEEDS FROM THE VERIZON GROUP LIFE INSURANCE PROGRAM. ' You may wish to oonsutt your tax sdrisor re0arderq interest earned on the sooount. r Thera are fees for specisl prwpa sudl a• stop Payment nquests. Prudendays ANianw Account is a nyistered trademsrk of The Pnrdential Insurance Company of America ~n Sokrtions BIS, Inc is tM Administrator of tM Prudential AOiana Ateount Settlement Oppon, a cornraetrral oWryapon o! TM Prudent}at Insurance Company of Amsriea locagd at 761 &oed Street Newark, NJ 07102.3777. Check elearirr0 is provided by JPMorgan Chap Bank, NA and proassirq suppoR is provided by Integrated Payment Inca ~"ahs d p ~k~ Aot~unt balanps ars not in:txad by the Federal Deposit Mwranw Corporation IFOICI. Open Solutions BIS. fnc,. JPMorpan pup Bank, N.A., and !K ayment Systems. Me. are not Prudanliat Finandal compenies. ~_ v. ~,: Faun 712 I ~"'• "~" ~~ Llfe Insurance Statement Opa~MiMM dt e. Tnswry T 8 Type t GROUP wcadaM-Ir~swed (To he Aed by 9a exsar0or with Form 7U6, UniMd Sales EaWe (snd GenoralonSldppup Tranak T08.NA, Urlilsd Sfa~s Estate (pnd Gsrleretiar-,Sldppirg Trarhtsr) Tax Realm. t.sSsq of rtoraesiderq rlol a d9zen of the United Ks first name and nlEdme eidisl Z Deosdertt's lest Hams 3 Decedent's social seasity e ~ Pebmwn Insrsartoe oomperty pre _ Group P.O. Box 8817 Plfe e owners name. s deoederM fs not owner, aisach copy of application. Nancy Palarnaan ' Value of the poky at the 13 Amount of prorNtrrt (see irubuctiorrs time of assignment Group Rafe varies by age and coverage ~ nsaprrors narrre. AUSCh copy of 111 astigmrlent. Name of TJ race amount of PoBcy .................................................................. ................................................. Ili irtderlrraty benefils .....» ........................................................»................................ ........................ 17 I°lddlffonal insurance .........................................».................................... ................................. ...... 18 Otlter berte6ts .........................................................................»....... ............................................. 19 Primal of any indsbtedrless to the company 9trlt is dedudibb in detenNnirlg net prcoeeds ... 20 Interest on irtdebledness (Iirle 19) aoaued to date of desttl .»........».».... . 22 Mlotrlt of post-mortem d .....................................».........»............................................. 24 Amount of Proceeds H p~aYabie in one sum ..................................»»:.......................................»... ............................................. z5 value of proceeds as at date of death (if na payable in one stunk ........................... ~ PoFicy Provisions ooncaNrq deferred payments or irxdspnbrtls. Nola. K other than lump•stsn settlement fa authorized icr a aunrivirg spouse. attach a Dopy of the i1t8WanCe policy. ......r...w ....................................................................... 27 Amotrrtt Of Inatalilrlerlta ...»...»..»...».......» ................................................................... .. •_ ~. .» ..........................................»..........................»......... '~- S . 28 Dale of bGtll, sex, and rtartte of any person fire duration of whose 6te may measure the rasttber d S- Y S .............................................................................._...................._.............. PaYn-en<s . ~ Amotelt applied by the insurance oo ............................•----.......................... , mPeny as a aingie promium , . `-' represetWng the purchase of instaYrrlent beneMs .:...........................».». ... . _~:_ r ~.. , _ ...... ~ S 30 Bash (mortardy table and rate of interest) used by irlsttner in valuing irletallmeM beneMs. .. 31 Wens Qtsre transfers of the ................................................................... any poky wlfltkt the thr+es years prior to the death of die decedent? ......... ......... 32 Gate of assignment or transfer: ~ 1 ~ Yes ~~No Month Dray Yea 33 Was the insured the amuilanl or beneficiary of any annuity contract issued by the compan~/1 Yes 34 Did the decedent have any Irlddertts of ownership on any pofiCies an hislher Nfe, but not owned by him/her at g Yes ^^ No the date of death? ~ N of companies with which decedent carried oNeer palicfea and anwrxrt of such pdides ff this in6ormation is disdoaed by your ................................................. ~ ~ ~ aonKtinlormsroon~~ ~~ far appropri,te bd~rd eea>nty ex nrMement gaMm al~ry INnpy eus seatement sets -~ rwrlrbsr (If known) 184-26-3038 kleurarree rhie, PA 19176 15450022 Rekrm, or Form Tiee- SENIOR VICE PRESIDENT see Page 3. Cet. No. Dale or CerMiestlon - 03/05/lOpe faml 712 (Rev, 4,T008) REV•1509 EXa (6.98- f COb1610NWEAL'T`N~~~`'~PENNSY WANIA INHERITANCE TAx RETURN RESIDENT DECEDENT SCMEpt1LE F JOINTLY-OWNED PROPERTY Nancy T. Peterman M an aseN wa msds)olnt wNhin om yee- of the deaderlt~ ~ of dWA h rmrsl be SURVMFiG JOINT TENANT(S) NAME ADpgEgg a Lois M. Newman 1223 Mtll Creek Road Hampstead, NC 28443 B. C. JOINTIY-0WI~D PiIOPERTY: RLE NWMBER 21-08.1250 on !ielledrde G . RELAI~IONSFpP TO DECEDENT ~+ehter ITEU tAJYeER IErTER FOR.IOtlIT TERANT OAIE WOE T DESCRIPTION OP PROPERTY It~tUDE RAPE OF FINARCIAL WSTITUTIOR ANO eAtK ACLgJNT tAAtBER OR SYUW IOENTfritKi . ATf F Yd1ELD REAL ESGTE OATS Of OEATR VALUE Of ASSEt bC1F OEC~'S HT R T OATEOFOEATN YALUE Of 0 V7TEREST '. a eELCO - AooouM No.115800 14.422.93 50 7,211.47 TO?AL (Alw enUr Online 6, RecapiNrlslion~ I = 7,211.47 pt more spa is R~eded. insert aAditlalel slleeb et tale same site) MAR-27-2009 FR1 08:01 A(1 FAX NO P. 02/02 . ~_ 1. Name(s) in which tha account was hold: T. Aexount number: 11ba00 3. Balance as of dsta of daafh: i 12 710.!!3 ealsnoe Accrued Div~ends YTD Dividends For Rw~ a ! 1.73 .7a sat 1 ~z s a237 ~ Whatever Club: ; a sa5b s ---~- a ~- M~on~t~~aritet: ~ a is 27l. Q i 871 0 S x3.85"` a 1. ; 1A! s a „ .ls Certi~ee: Bad Fa Acatied Dhridends Yib Dividends Certificate Number a a s s s - ., a _ a s ,~.~.,~ : ~ a -.. s ~ s ~ 4. Date tho aoccrrnt was lnitlAMd: 3N/11~82 6. Name(s) in whkdl Sato Deposit Box waa held: NIA 8. Date the toot wu lnitlaNy rooted: 7• t3~cdl sddrese at which the bcoc is located: 6. t.oan Information: Balance Aoauad interest Per Diem tot IINE OF CREDIT Unsscurod Lonna: vlsA ala4,oo ' a 1.76 ,pat off 1/2 9 B. Secured Loans: ~~. s s C. Mortgage loans: a ~ ., a 8ELC0 t,.Opp~Ty t:I~ClT uNtON DEC~iOBNT ESTATE INFORIYIATION a v a~ ~Q z 0 0' o •+ .~ ~ ~ ti = ~m ~ N .r P N N ~ 'N p N ~D N °. ~ ~ '" oG ~: ~ G N ~ 3 ~ ~ ~s w ~~ ~~ c rn ~ H M a ~ O y p f N N pN qA f0 rf O O O Z' Y p W V O N a~ v ~WZ ~~ O~ aid W ~~ REV=1511 EX~ (tZ-pp) scNSOU~~ N coatutoNwEA~TH of P~svtvAeaA FUNERAL EXPENSES $ INHERITANCE TAX RETURN A~~N~STRAmE COSTS RESIDENT DECEOEPIT Nancy T. P'etertnan 21-OS-1250 tkbts of deCedNll must be nporfJad eal aeMaduN L A FINVERAL EXPENSES: ~. M~pt~ 8. ADMINISTRATIVE COSTS: ~. Penorod Reprosenb~tiw's Comei::iorls t~bnle d Personal RaprasuMativels) Bois Newman Sodel ~ih t~A~mbMsI1EIN Number d Pslsenal Rglrasantetire(s} _ SbeslAddross 1223 Mill Creek Road City Hampstead yyne NC ~v 28443 Year(s) Conanb:ioe Paid: 2. Atbmey Foes 3. Faeiy E~amption: (Il dacadant's addross b nol the scale as deblent's, aned- explanrsbn} COimaM Sheet Address ~ StaM Reblbnship d Clebsard b Decedent 4. Probate Fees 5. AoooieManl'a Fea 6. Ts>< Retun Preperer's Fees ~. Prepare and Fib Revenue 1500 ~P 9,946.00 5,144.51 5,394.51 619.93 150.00 - TOTAL (Also ert0er on Nne 8. Recapiluidion)' i 21,254.95 lM more speoe b needed, inteA adddbnal chests of Ule asele :f:e) _ - _ ,_ l -frdr~f rfrir N~ ..Ifte-rriet-r P 7 Ma~ e r -R, A f IsS ~ ,+iFcaerrJ. AliPr,~. o~lee. Pfrrre: if7-Iffb FUNERAL HOME lenmy ~. skorrer FrrerailNrnvo, STA7 EMFM' OF FtTNERAL GOODS AND SERVICES SELECTED Clnrpea are ads fa three ilesm tlnt }vu sdeQad a Ilut are required. U we arr nquind ly !aw a try a celaelery m to tas any ~ wx w'il efphal Ihr Raxtll a Ntalllg h~iow•. U yvu selecud a firaral dut any R'4uie eolbalmilrg, such ss a BrNT~1 vn~wuyl. fru nay IuYr to pay ear m6a4ron(t. Yw d~ oat kaYx p pay for emlatYr- inlt you did oat appnnx it you seiectnl auarylemws noch as diram attiroliun w imnlcr4atr tw:ial. If we aI~NrJ fa ernlupnina, re writ etpltia wfiy below. Far the Serxlae of Dane of Death ~~ ~auurr Address Cr- Seale A. CBARfiE FOR SERMCES SELTICIt9: ~t IMnllrle 1 f'll0ttS5WYALSFJlgGES 4Taa+ d Fullrral Dilrttar.•3ta1f .. ... f ~n+Vl .... ... ... ......... S Odltt {nelonliael d laxfl. _...__ ............f SU67>tFl'AL OF PROFlSeIONAL SlheViCES ....... _ .Alf . 1 fAC[llTiFS M'1) SERY'IUS the u(fullnitll and arsYica fur YfeNnyll~aitaliut~e).......... f Itie Irf taoiWks WWII seNkts tm lonetal cnelralF ........... . f the d fat>Yirll and un;am4 tat Mean„ial &rsir+r ..... .......... ! the d erNpnlnn are:erYices N. RtaYewde amax .......... 1 Odlrr ux d faci4ipl ......... ........... ..... 1 EU&T+OTALOIFFAWILfICS/EQIIGMIENI' ...........A2 f !• At771W1O711R LQURIENI' ~ehck so aaafer lalnn. a Flnoal Haee final . .......... ............ f Hesse ICif-ts fussall) heal .. ..........f Linwwlt bal . .. .... _..... ....... f Farnih ear roue .. .. .................... s florler cat a Waal twl . .... ............ f Lad asvkryq ar Lural . ... .. ... S fir ke PdRlolen twl .. ... .. .. ... ...... f f11u of hn+n trarnrysuli4rl .......... f S SU6TOTAI.OF AVIn-1071TE EQUQMFNF .. .. A3 s Ta7AL OF PIROFES610NAL SEt17CES1 EACDJfSS AND AUiO71tOTIVE A S E CHARGE FOR -ffR~1ANINJE SELEC7EQ 1'a..L,ti S ItkvnlahrU~ .. .. _-~ 1-4114:1 P\1•~M.h 14' ... \ I IM.\Igrrrll 14.n4, halal 4g0.nIM j 411:w11~r1.n4 ~.-~.~~ _ ••I 'L.n. I ~ .. r, ~ . .. , 1• t,.i-• •~ ~ .....I - - fierntsioN um ............. . S IOesciiplilnl OTHER t 3 TIORALANDt3EiFJ8i ...............b f C. SlECJAL CItAROESr Faw'alr-ryl d rera~irs b (FIp1lpl Hone) t Raekiryr d rendlu from s lPurlenl mane) aunmlute irrlal .. ........... . .. f Dpca Oerlwlon ................ .. f s SUbTO'[AL oP:ilEaAt CHARGES .................c s D. CAST! ADVANCED Opts G:are ................. .. f la~nek+ll Fqugnterr ............. .. t Lq arilkad ................... ..f `~+rei1e* Molioer.0utd+oww .. .. S Tekldlare # Tdeprans ........... .. f Arfare _ ............. ...... .. f Paden ........... f fandred eagles d dle Deah ..... . .. S Cendrme ................:.... .. t R>acc Esnn ........... .....: .. f .. ....... _ .... . s ally kn ilx Omer .... ,. .. s s s s S 1 StATOTAL OF ADVANCES .. .... .... ......O s 14e eh:rrr uw fw Iltlr eeniarl a . I~t ciri8 rdrorna tlrf a1R ralalr+tar~) SU-DIARY OF CHARGES A. Allharuul Frnxew Facdnw~ anll Faplyhnrle. arW AalnrUr tipryaruall .. ~ II lka/fur6~r S /: yh~ad 1'I-Irlt+ 3 11.U.h.'khalllr\ ... c' TOTAL OF AIL SECflON4 . . l!11D AT TI-IE OF ~ FWOA TfJ ARRANGE-{EN1S .. .. .. - c RALII~CE DUE REA50\ FOR t?NllUa1L~G 11 r~44-.. ..'.1' !~'I. • .[l'I41.i:~a'. ~i~~:l t':114'll.. IL.t4 --11. .rrV Il.i IY'1. 1!:~_. _ . • ..11. .. I~~\ 4'. 4.~. Il~y ~: .41\r\ ..i4 ..14. .. ,\'141114'll'~I:: 1. 4'.1'~.l:li.u 1... 4• • ~ ~ 1 ' .. ~ ~..~ h`L~.. ... ~ ... 1 _, .. X11 .. .. . I~.. .. I.+r1l• /. n4 ail' . ~= '..J CUMBERLAND LAW JOURNAL 32 80UTH BEDFORD STREET CARLISLE PA 17018 .Tale: (71 ~ ?.~0.~1a6 F~ (71 ~ 2~{Y-Zdbs May 22, 2009 Cumberland Law Joumal is published every Friday by the Cumberland County Bar Association and is designated by the Court of Common Pleas as the offieial legal publication for Cumberland County and the legal newspaper for publication df legal notices. T0: Attn: Ashley P. Sipe Law Offices of Peter J. Russo, P.C. Nancy T. Petertnan Estate RE: Legal advertisements must be received by Friday Noon. All legal advertising must be paid in advance. Make alt checks payable to: Cumberland Law Joumal. a~saa====~a~ao=a.~..a=°====~========~--- --_~ao.-:ooa==.==oae:====sue Advertisement inserted on following dates: May 8, May 15, and May 22, 2009 Advertising Cost $ 75.00 Proof of Publication $ 0.00' Second Proof Request $ 0.00 Payment received $ 75.00 Total Amount Due $ 0.00 Becky H. Morgenthal, Executive Director 17iE SFlYPINLL - LEGAL 7-d4 365304 girst taken Soy italic 02/27/2009 17:34 Print7ed ou 03/25/2010 at 13:31 by r+olEc Last changed by wolfc 0:/27/2009 13:41 1717) 597-1755 ACCtO 29309 Given by ASHLEY SIPS POA 8st.N.Patos~tiaa P8Y'ER J. ItVS80, ESQUIRE Start 03/05/2009 Stop 03/19/1069 SOOG B~SP 7RINULE AOAD 7'ransiont Sill Expir. SUITE 100 Class i0 PUBLIC NOTICES NECIIANICSBURG. PA 17x50-4327 Index: Y>LECOTRIX~ S N07"!CE LETPBRS T8STAI+B: Subscr? M Cols ~ Lines 18 lnchea 1.69 itMrds 91 Box? N Nxil Tnfo: Typ@ Mnil SChed Copies Sunday Comment AEfid N L 1 Estate of Nancy Peteraien PW Codo Rate Base-Charge Addl-Charge Total-Cost Ins Start step S~p~g O1PRF 7.00 Applied 03/19/2009 LtiL 141.16 7.00 198.16 3 03/OS/20D9 03/19/2609 0000100 ~T~' ~ ros't' 198.16 PaymOnta: Date Chackt Aawttot Cz it-Card-4 Exp-Date Auth-Code D4/01/2009 3157 -198.16 NRT DilEl 0.00 EXf~lTBIX~tl0I1~ Leaett testa at M Lspte o1NANCY T. PBTiR1U1N, pm of b~M~~Coueh. Pennsylvanb. deaw4herk+Q Ati pe:eoaa hsriq dapu er dsinaods spinet sold wpm are n4wW.dm a:eke torss:n e:easste.aaddpe~q hrdebNd b sateewe s» ngwspd m a:aka paya:eat, wiO:o:A dWy. m q:e eseauma a odndn W npoa or m tlMY eiismey mm ed bNow; Lek ~i. Nwwaen 1?Z! UIh Cnek Rued tmatpatwd. NC 4841D Law OAwa of PemrJ. Rrwe. P.C. 8000 E~wlTdndle Pad, Sups 100 Megranlalw-0, PA 17050 _ _ RECEIPT FOR PAYMENT ' =moo:=oaxz==ssaaasx GLE~3DA FARMER STRASBAUGH Rece' t D te: 6 08/2009 Cum~beerland County - Register Of Wills Recei~t Time:3:35:40 One Courthouse Square Receipt No.: 1057053 Carlisle, PA 170"13 PETERMAN NANCY T Estate File No.: 2008-01250 Paid By Remarks: CSJ'TER RUSSO ------------------------ Receipt Distribution -------_____-_________-- Fee/Tax Description Payment Amount Payee Name SHORT CBRTIFICATE 12.00__ CUMBBRLAND COUNTY GENERAL FUN Check# 3219 --------$12.00 Total Received......... $12.00 RECEIPT FOR PAYMENT GLENDA FARNER STRASBAUGH Cumberland County Register Of Wills One Courthouse Sqquuare Carlisle, PA 17Q13 PETERMAN NANCY T _. _. I._ Receipt Date: 12/122008 Receipt Time: 16: 9:18 Rece~pt No.: 1085070 Estate File No.: 2008-01250 --- Paid By Remarks: TER RUSSO/LOIS NEWMAN ------------------------ Receipt Distribution ----- -------- -----__ __-- Fee/Tax Description Payment Amount Payee Name PETITION LTRS ADM WILL 260.00 CUMBERLAND COUNTY GENERAL FUN Ai7TOMATION FEB SHORT CERTIFICATE 15.00 5.00 CUMBERLAND CUMBERLAND COUNTY! COUNTY! GENERAL GENERAL FUN FUN RENTINCIATION JCP FEE 20.00 5.00 CUMBERLAND CUMBERLAND COUNTY~i COUNTY., GENERAL GENERAL FUN FUN _ __ 10.00 BUREAU OF RECEIPTI3 & CNTR M.D Check# 3048 Cash $295.00 Total Received......... 20.00 $15.00 R:V~15:2 E~:- ;1J-iiNj Pennsylvania OENUTMENT Of REVENUE INNERR~ TA1I RCrIRW RestorNT oecenewr SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF FILE NUMBER Nancy T. Petemnan 21-08-125q Rport dehb IRCwnd by tla deadend prbr bo death flat nnadned unOeid a>t tM daht of dsath, Mdudh~g era~eNnburad medid ~xpenees. t. UGI 117.04 2. PPL 342.16 3. UnEed Water 95.92 4. Black's Detachable Trtx;k Syst 461.35 5. IDT 27.38 6. Belo visa Loan 197.94 7. Verizon 34.59 8• Cort~t 62.74 9. Barty Fkckard - Courtiyr 504.70 10 CapSal CNy ON 601.90 11. Borough ~ Medlanicsbrag WaNr and Sewer 227.47 12 Dan While Phxnbing 166.50 13 Roy h{iNer -Neighbor 300.00 14 Soon Love 400.00 15. Pig Pam Hau6rq 210.00 16. Donegal 245.50 17. Ibis appraisal 360.00 18 Foremost Insurance 1,910.00 t9 Gary Troup -Appraiser 350.00 ~ Recorder ~ Deeds 48.50 21 BanyHedcard 1,296.25 22 GiR and Assoaates 150.00 TOTAL (Also ester an Une 10, Retapitulatlai) ; 8,109.94 lr more spROe K needed, h>krt additional sheets or the fame siEe. FAlLl1RETn RECEIVE BILjI, DOES NOT EN7ITYE C~~3IER 1G NET RATE 3145-0 04/15/09 32 E GREEN ST ---~-_.~ 04/01/09 06'30/09 0.00 1.00 65.00 1.00 0.00 3000 .' 43.32 108.32 "'~ +'~ "7 119 15 INSUREDS.COPY INSi~ANCEGROUP A1IANt1C SrAiE$ M15tIpA}ICE OOwIPANY • OONFOAL wUtttAL MbUg11NCE 0011PANY ~ ~ O~unAMCS oohlPAnr - P~lwauu y ooMPArn rNH Pifp15(A,A NiSUpAlK,`E CGYPANY • BCgJTF1ERM MiBtIgANC~ COMPANY OP YIRGOlb1 P.O.SAX 900 • MAtiIETTA, PA 1751x0000 • 1-500.577.0500 • www.dab5~lpioup,~ DONEGAL MUTUAL INSURANCE COMPANY BILLING INQUIRIES CALL: 1-800-877-0600 03/16/09 PREMIUM INVOICE 0004255 I N PBTERMAN NANCY T. S 32 8. GREEN STREET ' U MECHANICSBURG, PA. 17055-3335 R E D 1~~~111~~~111~1~~1~1~~1~1~~~11~~511~~~11~~1~1~~~11~~~1~1~~11~1 G 0943563. 2405 HOMEOWNERS D A C C O U N T S T A T E M E N T TOTAL PREMIUM 491.00 AMOUNT RECEIVED 245.50 ACCOUNT BALANCE .245.50 * AMOUNT DUE 04/17/09 245.50 CURRENT INSTALLMENT INCLUDES $7.00 SERVICE CHARGE. A D N C ~`~ , ~ ~ AMOUNT DUE $i 24 5.50 * , T. T E A WELLS FARGO INS SERV OF PA INC I R G 4900 RITTER RD SUITE ''250 O E E MECHANICSBURG PA 170!55-4807 NS N AT T ~ TELEPHONE (717) 506- 3049 )M-1 prop r z 7 ~ ~ p ~ .~.. ~ ~ ~ m ,5.... b c ~ ~ m C O C7 p. ~N 1 V toL ~:J ~~ id m o~ D ^~ t .. ~ v O ~~ a~ s g a ~~ IRTAXES ARE 5Y ESCROW, FORWARD TO MOAT(3AGE OO =1 FEE FOR AOOn aB~ASH OI~ Y . AFTER 12/t8g0 TAXPAYER COPY ~ 3~ rnr~eu ntrol 018 - ~a BARRY L HECKARD SR TAX COLLECTOR a. Improvaaaat E~ ~ o s sa pl lbta 31101 ~ ~MERSET DRNE MECHANNC88URO. PA 17086 ' ~ Ratea .0o2399ao .00239900 92 310 OeJL. ~E88.N0.18000$04 ? .9? 14 0 2 sates . 00 0000 .0001 00 17 21.4 0 243 60 MAP NO: 18- 32 E (#1EEN 18 ' 2 ! u. 16 2 s.sx to le 2e ACRE8 240 pip 00~~~1 sata• $ .0030000 0 .ooi~ oo a = . Bu~ng ~ 0 27 '3 TAX A100l~IT DUE --+s ~ 2? to t 30 .62 L RES ~„ ~~ u >l~s ~ air ~~ 3 Ol 2 5 Ol 2009 7 012 r~x n~rs~ 32aREBBT' EE'r U1NlCSBl1fIG PA 17065 2 s 0 2009 ~~1A Y!°01100{J,~'11011 Alb fElN9 Of UB~I A4iA~f f "~ VIDE OF BILL ROR A BAEAKpp~N OP ~llt TAX O OLL,AR9 « 10.4' AAA~Y ~ -0~ ~~ ~~ ` ~ (~ ~ , B EPT TUEB 1a4,~A~B , v . DAY A ~~ 5 717-788.8806 Y( Z Relum BNI wllh Payment For a Re~lpt E b . nc ss Sell Addrseeed ig~ POd Envelope. ^ E RTY ~ %°~~ • ~~ oor ~,. ... i :~ Oi l~c~.a:,l..o. ~~.~M VING GRDUP ~~~ :~ r,~ . ~ Addrou• ! Cam.. . ~ 81ib: ..., ..:; ~''~ . / • ,.. APk ~ fond Addnee. • Cl~-!~ ~%~• ~ 1i1. (t): 7i1. (2) Atldltbnel Addrou• A~1 rrr: bse N~ OII tlMen ~M a 70 peloeld 1~/i etestalaslda eeaA r nalat M 11Nd b ale ~ 01141P e0 Oalsele d !#e tsaeeee r10 M ells b dle bne dof pN~~ r'+n•~r . ~ ~araaad aleeM. M!' 0 t+alellee re3 a dsa d dYalsy, pyrto ~` ~"~~ i ., ~~ sleaeds4 b the /1nn N eeeh ar PON t)lape rwil A1ij •• oall.llbCorMf1~11~~y~beoGeGapb~O$NbMn4d~wpllprb Mme ~ ee ~ b ~AOlly~ b~Nbl~ 11s' b NdMd bwr, ~11~~ N F~.1, N ~ swrM~ 110% bny N e00aeebb. AO deUrry osd Ater b "M w dwpN eo eeaad m ~q~ b ~ rr ~ :~ ~': _.. - -• • .. Dole . Vrn _~M~n~~-h,el~~PO.W. S i 1e1L11M1pN OR t~11Ji11Apb ~~ Plolldaa Mo relydell oPdofN: Uniked tir ~. w° ~ w°i"Iwl.°°""~ "'°m.el. *I~Il.vabnal ~ 'l rb.~r. ®s?. ~ s/..7 b poNa }ellr °°°'°"''• °~"'~ `°""°"" nadat alelol.t; --__ • s t+er alp ~ , wr wxc i ~ ally t»dnd ~ ale ollller n wea ~ntod ~~ awl.: tably ~_ abee load.) S I+epalable br 0~ a bllbm~wgl b!' I~w CrrNr N ~Ao nel ~ ~N: (OAOIn) `_ ~ ~ ~~) : ~~ aaarred e!' IM". The oelrler ha elo rib hn~at andropNr ~ ~ ~rbrw ono PaddnO (w eaoeMd ada«pe.CanNrltnol0opl~ornopfppKbr~y~~b~iobllor ~~r s ably, ~b ~. aooh. apnpt, ~ ~0 QOrNcw s ~ora.p ~: fr,eaae t b~ir:.llw.b trorwo tl N ° eorred arlyr ~ ro ul: ~wr vkiw ar aabrMy eareraae el no Essa 1A0i""d"""n ~h y aedbe b aap doltieey. s ,u,~.°aa"' Ilasouwaly b W alpn;nt ~ ~ alao~ boa fow lanmg S ~ ~- - ~ - ~ - ~ ~-~.~ eeae. ~ ban! +a: a w~lvEtt: trr alallaq thy boll. `-_ Ndrwon oedVeieO Values s ~ olsbre< yer o~v.nr.eew e~ c,«x. al.eey bMare ~o t~oll- sabason, s ewe ~' "'~ Repleanlalll vim. aovae~ l~ rlel olo• o~ndwa a0NlD VON ~v: P+w'Onbwwaldlleorenllaildlldad +relYelrs daabiisla a a~ b IM w~wq a~ «l~a 71b Twd ~OMI Pa-Mna anbw0 an0 4petl m als patllba ~bAeb bt Onlae ale card tow s ulldar thla apyrl b aaooo a feoo alela~ an fwd ee we card waylld d y,~ +roMAt fb Paelda) N dle ~- t+~Pe1lY eal+lad.111o aoaoe Isaneaosopaoll, N d Tlla epplaablNp oat br><VV y aeao br aadl x1000 a da ywwFyp' ~ ^10l' ee wed by rb arllx b dye gy~oet. em a y a0and wn . aZQQ fa00 ar rd01 m dedrafbla. the eelolre a tMe dadua. 0enbo°~"a'~wlw doounwd, lOurAe a IbWyd N aad alroae o~llor ro ely,lm oaaet tlla Best at yerr fVP , aarntl thels s dabalq end wldl. h traeap. A0 ehalpaa MrhIdY10 addrolld aalNaa vrel to ebrnr.: ~: ~ aai0 ~ hood ~ ~4Per a• Doan! Iw ~Ybw Aa+reaaeew, w ll ~ "ai"d a«, end Vda~e. ~ tlall~plllsta Raady b IllbMr ~a N elaleb; Gldel ahe0 nol be Ieplr for the ba a daeeeaon N ar dr11a0a d ~ 9eeda blldaled lleeawdar or r+1r Yell 1Aalsof unya obYs y d` ~'b MoreoNr~ ~ PloadNM~ W oudlydyp ebnyr Irwl be veld b nle betoq alq aeeo all t» edrnleae a ehe _y.~_aad~ ~ Iaa1 edeAln • eallehs N daaary ar daerlld nelad an ale enalalrnellyryy~, Arlyyea°od~OlblwdllluM fb4nlold N delao0a boa. A yerloral IaaenoMon N rlplb or aellNy ~ et ar weo a d°~"edw.ly.' °~"~,„ N ~ ~ y ees: nle lAd db bmeaad ea ere~e br ~Yryat the ..~nl.+a~w ~a °~Iwd °uw'~' deb. qac ,1~ ,,,d eawry r0e1' ewre,y; Ebel dulaee wwrb~Mede~tl w"1"Iw'°'°""t +w woowq ens aalrloa p,Mdea Nbalrrll e,„~„ l «euby bd of a~ aretq,10^~~a ~aw'd°yal~et~~~.;.~,°0%„~xn0w. ~ ~TOe »nl°o~M b«a0 • y a or 7 eaMdaaorla br ale trw a,.b.. alwroTarrp,; s/:lr; PMRTMI PRE•PNYIENT,: . r .. ~ ~• ~ "•/ . ~1~,~.s,,r s .. . w-vldp~rrcol.~crtcar. a~~:;'-~ i s -~ ~D:RJSTMEh1T ort oEU~r: S . nEw ewwcE out:: s DELIVERYACKNOYW,Epp~IEM; ~ ar ee neled an Iho~M ~ ~W h apper. ealtwwbdpas toot oa the eaMaa the ward~inid ~ o~ ha ANS yR E ~qM~ eewerd. olld 1Ae trud~ else InrPeged eltl ddpnenland enyr I ha eye aWlerey b e~ drodro t.r.Oefew d4iAM Ow4 O tole M~yhY 1e~nKL A comcast® ~°~ DATE TOTAL ~, ~ NUMBER OUE AMOUNT DUE Volt us ort tlfo t~trob at o9sa7r~aeos.ot•t t2-zsioe 65721 J lndiooa: fio Commit teryint you tub~etib~ to NANCY T. PETERMAN How to rertoh us... For aetvks at How N t~aeoh w: 32 E GREEN 8T 4830 Carpal Pllaa, Saito D; 14 MECH/WIC38URC3 PA 170563336 Mecherticatxap,Pa 170b6 (71740.8900 TNsphot» Cuatomar 9srvice 24 hour a day, aa+ven Jaya a week News from comcast Effective January 1, 2009, or with your first bluing Statement thereafter, the monthly pace fa Limited Basic Service will decrease from 69.10 b 68.70 and the monthly prk~e for Expanded Basic Service will irxroass from 544.85 to 545.25. If you are a Standard Cable customer, these changes will not Impact your total monthly bill. Thank you br your prompt payment. For your convenience, we now socxpt regular and automatic rnontlrly credit card Payments and direct debit Hearing / Spssah Impaired CaU 711 On 12/6 at 9pm, Olyrr~ic gold medalist and 10-time world champion 'The Golden Boy' Oscar Oe La Floya and fk1-ranked Pound for pound drarnpion Manny'Pacman' Paoquiao will collide. Order with your remote! Summary of Charges stn«n«rt Plrep.red t t/zdoa Bp'Nd from i?ABIOBto 01/07/09 Prwioua Balance 57.21 Paymsnta (received by 11/28108) 57 21 cr Corncast Cable Televisbn 53.95 Taxes. Surcharges 8 Fsee 3 2B Total Due 55721 l~tall of Charges on back ~~ --_. o ~ ~D '~ ~o ^` J \v atae iiada t~ PPL Electric Utilities Electric Service For. NANCY T PETERM/W 32 E GREEN ST MECiIANICSBtJRG PA 17053 ~ ~ •, ;,~• I Page 3 ' ~ t :::: ?~ :,~>.:.:;: •~• I pp•: ~ :. c07io-~7o06 T°rd fi~rr lam Bill 537.95 Paysrafr Reaelred Mar 2 - TlYark YoW! 537, 95 Billing Details Balance ss of Mar l6, 2009 x0.00 Current Charges PPL Electric UWtia C~ for -PPL ELECTRIC UTILITIES Castoa~er Service R tial Rate: RS for Feb l2 - Mar I6 827 yam ~ Dishibutioa Charge: Customer Chacge~ 18104-9~39~2PA 200 KWH at 2.89200000¢ per KWH 5.78 1-80i.•34~STI5 102 KWH at 2.63000000¢ r KWfI 2,68 •• (1~OA-DUG-PPL PA Tax At~urcharge at 6400000% -0.O1 warw.pplelectric.cwn Traasrnission ar e: 302 KWH at 0.~20000U¢ per KWH 2,27 T 200 KWH at 21000000¢ per KWH 2.42 102 KWH at 1.07300000¢ per KWEI 1,09 r .:,~ rw_~__ zuu KwH at 5.94900000¢ per KWH 11.90 102 KWH at 3.23100000¢ per KWH 5.34 Total PPL ELECTRIC UTILITIES Charges 539.79 •KM1tit} i •• Accoual Balaacc :.. ~y.~ ~ .. General Information Next meter readingg on o[ atx~W Apr 1 S Generation prices d charges are set by the elc~clric g etat' suicr you bave chosen. T~e Public Utility Comrnissian >re ales ~ n on ~ • ~nces and setvicxs. The Federal Energy RegulatoryiQUrtissian regulates :' ~•~ ranslnissiart prices and services. , =:,r~r; ~F; ~. PPL Electric Utilities uus~e ~about 60.29 of this bill tod~aay start taxes. In addition, about x2.39 ol'this bill pays the PA Grass Kecc:ipts Tax. For your convenience, you can now pa your bill using your Vises • MasterCard, Discover, or ATM Card. all BWMatrfic al 1-800-672-2413. BIOMatriz will dtarge your credit and ATM card a service fee for matting this paymcat. Before digg~n~ around your home or property, you should always call the state s One~all notification systcart to locate any, underground utility lines. You can do this by simpl dialin 811, which writ conned you to the One Call system. Be safe andyc;a1181 ~ before you dig. Wish gaped billing, ycnt can receive and pay your PPL E1ec:Idc Utilities bills otilme. "lire process is free, quick, convetuent and secut+e. To learn more or sign up, visit www.pplelcctac.com. Clean the coils on the bade or bottom of your rcfrigeratar every 3 months. Dust covered coils waste energy. Save postage and late charges -sign up for Automated Bitl Payment. Informatiat about appliance energy use and ti on saving energy arc available t~oiigh the Energy Library on our Web site, www.pple ectnc.cotn. . ~~;; , . ~„ . . ''~ '~' :':-' Page 1 PPL Electric ~ : = Uhl~ttes ~~ ~~~~ Electric Summary Page Service B'u~o~ ~ orris iz, zoos saao ror: NANCY T PETEttMAN 'tote AL ELECTRIC UfILIT[ES Charges $7G.43 3z c cREt:N sr MF.CHANICSDUR!} PA 17055 Tot,d Cla,rgca $76.43 :;.. Account Balance $76.43 estlaas about bill? Please matacl us Jan 2 at 1,800-31 5 (1-800-D[AIrPPL) or w~'Ik to: Customer Service 827 Hausman Rd. Allentown. PA 18104-9392 www.pplclcctric.com Electric Use 'fhisgra~ shows your electric use over the last 13 months. Types of Meter Read3n=s: Actual . Adjusted - Eshimatcd Custom~v 0 KWH -Average Pa Day 36 30 24 18 12 G 0 DJfMAMJJASOND 2007 M~mths 2008 Mcler Rcadiug Information Meter #79236073 Dcc 12 Actual 35906 Nov 12 Actual 35215 30 Da s K~II 1 B~igai 691 erage - v 2007 2008 ~np~a D 38~ 36 I ' KWH Per ay 2 3 Yearly Use: 'Total Use Avers c Mon Jan 2007 -Doc 2007 633[ 52 Jan 2008 -Dec 2008 6824 569 Other ltnportanr iafortnut~on un buck ~ ', ~~d^p'EB le/p/t~9p~a'oa` ~0/~Yl~tvS Electric Service I~or: NANCY 7' 1'17G1th1AN i2 E GREEN S'f MECHANICtinURG 1'A 17055 1'PL Electric Utiliti~~c C'uslnmer Service tt27 I-lausma„ Rd. AIlcntown.l'A 18104-I.3c)2 11110-:I42-S77S www.pplc.'lcxtric.a,m I'agc 3 ... ::;~::: ~: ~ 1F.d~ic/~-t~~ilNiil/e~eoilipt/t~~/~u/ri6~er:::: •<:<~:>~; a tJl)7 1 \/-V7V~N T~rjlaa, last BiU S74.Z4 Po)c,rreat Rraelve+d Nov 21-Thank Yorr: S7.~Z4 Boling Details B„bnce ».c of llcr 12, IU08 $U.00 Current Charges Charrms~ for - PPI, ELECI'R1G UT'1LITIES Rcsidcotia! Ratc: IiS for Nov 12 - llec t 2 U KWI~I at 2.1!5800000 1 KWI I at 2.51800000 Tax AdL' Surcltargc at emission Char'c: 1 KWH at O.~U00000 ;Tax Adj Surcfiargc' at ,lion c: ~ KWIi at .213U0000~ I KWII at 1.U7500000~ Tax Ac~j' Surc5tarlc at K r KWI~I 00()V00`/o r KWI I KWI-I OOOOW% 8.21 5.72 12.76 0.0) 0.0 2.43 5.28 0.02 Ztx1 KWH at 5.8T90UU(H)!t per KWI•[ 11.64 49I KWH at S. 11400000¢ per KWIi 25.11 PA 'fax Adj Surcharge at 0.31000000% 0.11 'fc><al PPL ELECTRIC UTILI'1'lCS Charges ~- $7C.43 ................ ... =Alin~ti ~~l~d~i-ter`~~IiraJ~u:;.:;:3~9:::1~ >;<:`•>:';. Account Balance $76.43 General • Information Cic~neration prices and char~t.~ arc set by the clec:tric gcmeralinn supplier yew have chosen. fhc Public Utility Curntnissicxt rc mates distributicxt ~~nrtces and services The l~cdcral E R ~ l . nergy egu atury otnrnission regulates [ransmissiun prices and services Neat m~ycx . ,cuding un c-r alxwt 1'I'L Electiric tJlililic's uses abewt $5.35 of this bill to day state taxes. [n addition, abcwt $4.50 of this bib pays the PA Grass Kccc:,pts fax. tan 1 S 'Iltc Transiticxl C31arlc incluck's an Inlangible'1'ralt.~ition Chargc {1'1'(') and the applicable g~lross receipts Il~X which tc ~cther atncwnl to $h31. '1'hc ITC _ IS 8 pef USagC Cllargr allpfQV~Kt b the j'u~j I Ulllll ( y C y :OtY1mISSlO[I WhICh I PL Elextnc Utilities collects as agent far PPL Glrctnc Utihhes 'transition [3ottcl Company LLC and which that comppan uses to service debt incurred to recovrr a pcxtion of PPL El~~cttic Utilities' st l d h ran a costs. T e 'rcus receipts tax, which is collecKed tilt the Commonwcatth of ~ cnrLCylvania, is cyual to 5'I%ofthc 1'1'C'. I~or your ccx,venicnce, yew can now pay yextr bill using yc>tlr V,s~ MasictC'ard, Uisc:ovcr, or A'I'M C'arcL L.'all BiliMatrix at 1-80t>-G72-2413 . Bi111Vfalria will charge your credit and ATM card a servirc fee for making this payment. . 13cfare di "'ng arewnd ynur hcxnc or property, you should always call the state's One C:ail nI11111Callon Syslchrt 1U 1(,(:atC any UndCigr(Nlnd Ulillly lines , . Yuu c~,n do this by simpi dtahn' 81 1, which will connect you to the One Call syslcan. lie safe andycal181 ~ beli,re you dig. ~ ~ I ~'~•'°°'•' - Page 1 PPL Electric pp~ °~-- ''rr'++' ~3~i i~;~- Utilities ~''~ ~~ I o-67006 3T?f:7 .{ SF. Electric Summary Page Service Bslana sa of May 14, 20@9 50,80 For. C ~: NANCY T PETERMAN TPL ELECTRIC UTILITIES Charges $29.04 32 E GREEN ST MECHANICSBIAtG PA 17055 Tpbl Chst~ca $29.04 Account Balance 529.04 Qaatiana a6ant 1 'a bill? Please conlecl ua~ 4 at i~8i0- 5 (l-gAO•DIAIrPPL) or wrke to: Cwtoeoer Servke 8ZT Hewn Rd. Apanwwn. PA 18104-9392 www.ppldxtric.cam Electric Use your de~ctric taicws over the last 13 InOAll14. Meter Radiaga: Actual Adjusted - Es6mated o Meter Reading i'ilformstion KWH -Average Per Day 36 Meter A~79236tr73 yl3 ~ Apr Actual 37119' 29 Da KVYH Billed 192 ' 24 . T ~ ro ny I8 an petst~ 3~ KWH Per Day IS 7 12 Yearly Use: Total Avers 6 6 M~t ~ Juo 2007 -May 2008 1 ~ S I 0 lua 2008 -May 2009 5936 4 MJIASOND7FMAM zoos MomM 2009 Other important Intormatioa on back ~ .. ~~ f s ., ~~. !~@ctric t~hlitles Electric S@rV1Ce For: NANCY T PETERMAN 32 E GREEN Sr MECHArIICSBURG PA 17035 PPL F.kctric Ulilitiq Cwtaner Service 827 Nsua~aan Rd. 18192PA i,goas4z-sns •• (1-800-DIAL-PPL) wwM+.ppldecdic.com ;~; e;:. Page 3 pp~ .._. :..:.~~:y.. .~~r.. . •. ',• ~' W! i~7~/~/V ;:'si:;:i:17f11i~Yhlittal ri;~: 1 Turd j~,n lest Bt-! S29 p4 Peywrenrt Jtexdv~M Juu I - TkenX You! t29.0I Billing Details Bslsaice sa of Jun ls, 2009 50.00 Current Charges C elr ! PPL ELECTRIC LTfILITIES ltesi hate:ltS fcx May 14 • Jun 1 S n:~~--~-- ^'----- at per KWH 8.32 5.78 1.29 -0.01 1.87 1 2.42 0.53 ,' 1 uc- tcwH at 5.94900000¢ per KWH 11.90 9 KWH at 5.23100000¢ per KWH 2.56 Total PPL ELECTRIC LTfILITIES Charges 534.66 rr:... a A~connt Bslaace 534.66 General ca«I prices Tara es set b the electric g statist su ter you ve chosen a b~ie tI 't Cbymmi i t ~ Information . y ss on ma es distcil on oas and services. The Federal nagy Regulatory~anmission regulates ~ astnission rices and servic s Nett meter rea~ng w p e . PPL Electric Ui~des uuttee~~ ~about a0.2S of this bill to,~p~y state taxes. In addition about 2.04 ofthis bill ra s the PA t r i t T Midis , p y .,ross ece p s ax, For yyour cculverlience, you can now peY~r bill using your Vi MasterCard,l3~ver, err ATM Card ~allgBYla~ttix at 1-800-672-2413. ~i~strix ~ it charge your credit and ATM card a service fee for making paynien Before dip~n~ amend your home or p~operty, you should alwayg cal the state's One- CaD notification s~tem to orat d ~ e anx un erground utilittyy ines. Y 4 can do this by si~~ siting 811, which wtn connect you to tfie One Call s st B f ed~ y em. e sa e a 181 i before you dig. With ~~ess billing, you can receive and pay your PPL Elechic Utilities bills da~liae. The process Is tYee, quick, convenient and secure. To learn m i ore or s gn upy resit wwvr electric.coni. Air conditimiing is bably a biggggest part o s~l~~ner needs. You can save~mon while k- g ~ k air con 'ti Her ~ filters monthly; Cle or c ange Tilt needed You'll stay cool and your system will use~ess energy. Save postage and late charges -sign up for Automated Bill Payment. Information about appliance energy use and t~i~pa on saving energy are available through the Energy Library on our web site, www.pptelecfiacom. ~~: .',~,,:. ~. i"'Qi i Page l ~ • ~, ° ~• PPL Electric ° ~== pp Utilities .• 60~~0-6006 :~ ~ ~~,~ Electric Summary Page Service Batsace a8 0[ Apr 15, 2009 50.00 roc NANCYT PETERMAN Char es: ~ Tota> PL ELECTRIC UTILITIES Charges $35.34 32 r GREEN ST MECHANICSBURG PA 17oSS Totsl Charges $35.34 ~... µ;~IY~~~~• ~:7:ii1t~ .;~ :ill. ::"Srif.`•+?;~:?Y':•.•~S``•: Account Balance 535.34 estia~s shout t 's biq? Please contact us May 6 et 1~00.3~t 5775 (1-800-DIAL-PPL) or wzite to: Cwtomer Service 827 Hautanen Rd 181 PA www.ppldectric.oom EIectrlc Use This graph.shows your dectnc use over the last 13 rrrunths. Typa of Meter Readings: Acluel Adjusted Esbmeted Customer Meter Readin8 Information KWH -Average Per Day 36 30 24 18 l2 6 0 et M er tl7923;6073 Ap r Mar 16 Actual 30I) KWH B i l 36863 - * a l ed 23( Avenge-Apr K 2008 41 2009 4 W Per Day 3 9 Yearly Use: May 2007 -Apr 2008 ToW Use 6238 Average Monthl 52~ May 2008 -Apr 2009 6193 S 16 AMJJASONDJFMA 2008 Moaths 2009 Other important information on back ~ _:,t ~ ., ~P~ Elet,:tl'IC utilities Electric Service For: NANCY T PETERMAN 32 E GREEN ST MECHAMC3BURG PA t70S3 PPL Electric UtNities Caatomer San ice 827 Hausman Rd. Allentown, PA 18144-9392 ~-8oa3a2-sns (1-S00-DIAL-PPL) www.ppldectric.com ~~ i r ,'~~"°~ ', Pagc 3 •~::__ :ifbiii>Bia~ile~eoiii~N~iinT~a>' ~~ ~- "; 60710-67006 :::....::::u.G~ri~:n .....«~s...:~::~..... To-rrl jroar Last Bill x39.74 Playwrprt Rescdrrd Apr 6 -Thank J'orr! t39 74 Billing Details Bshnce tts of Apr 1S, 2009 x0.00 Current Charges Chs ea for -PPL ELECTRIC UTIL[TIE3 Rcsid~ential Rate: RS for Mar 16 -Apr l5 a 2.89200000 per KWH 578 t 2.63000000¢ per KWH 1.47 Surcharge at -0.06400000% -0.01 at 0. 200000¢ per KWH 1.93 t1e21000000¢ perKWH 2.42 t 1.07300000¢ per KWH -- 0.60 Z00 t:WH at S.rI4900000¢ per KWH 11.90 56 KWH at S.Z3100000¢ per KWH 2.93 Total PPL ELECTRIC UTILITIES Charges $35.34 iSC.:::C~: ••~~.. :• Accottat Brah+nce S3S34 General Information Generation paces and charges set by the electric generation sup rer you have chosen. The Public L~t'ty Commiss'on re~Mates dtstribu~on paces and services. The Federal ~ner Re u~atory~om i i t l gy g m ss on regu a es transmission prices and services. Next meter rmdi on or a~out PPL Elechic Utilities uses about 50.26 of this bill to y state taxes. In addition, about 2.12 of this bill pays the PA Gross Receipts Tax. May 14 For our convenience, you can now pa y~olur bill using your~Vi~sa, ~ ~ ~ C ~ >,~ x 'will c6a ge y w c red ii a~itd ATM ca rd~ a ~servaice femme f 7~Iug this payment. Before diggpp~~ng around your home ar p~operry, you Quid always call the state's OtK`~a71 notification systam to orate any, ound utilrry lines. Yo can do this b simply diatin 811 which wtl connect you to the One ~ , Cal system. Be a anddca1181 ~ before you dig. With paperless billing, you can receive and pay your PPL Elect 'c Utilities bills online. The process is free, uick, convenient and secure. '~o learn more or sign up, visa www.pplel~ctric.carn. Clean the lint filter on your dryer between loads. A clogged filter cuts air slow and wastes energy. A clean Flter shortens drying trne and saves money. Save postage and late charges -sign up for Automated Bill Payment. Information about appliance energy use and ti on saving energy are available throu h the Ener Lib Web it g gy rary on our s e, www.pplelecmc.corn. • r Bfu~ls~6a~t~6ervlce to: Go ~au~s 32 E rMiEEN ST MECNAMECSEKIRG PA 170SS Rab Clas:i8eatioa: Residentbl Genera! N81q Perbld: 11/20/2006 b 12/23/2006(33 days) p~Rem~ob device Read NC`s B00.27t;-2722 or vrrib b IIGI at PO 60D(13009 Reediq, PA -19612-3009 ' Yow current UGI charyes include Stab taxes totaling S 0.57. Past 81p hNermatlai - liGl Utll . _-- Tbeaccount balance on yow hst bill rr~s t 20.58 'C~atO~14F.~ltllhbl~: p~~ 0.00 N 219 729 8~~04 isle CAarps -..-----__......._ 0 Yonrbabnce as of 1v29/200e {due now) ~ ~1~4 Current 8111 lafoneadon ' tlGl UUllly Customer Charge 6,5g Canmodily Cbarye { 6 CCF at 11.09633)) 6.59 Oistribntion Char~ggeess (First B CCF at SQf3000) ..... 2.56 PA Sbb Tsx Sun:harge •...._...__.. ~~.q~ Total Carrot Charges - IIGI UtNity ._.........,..... ~T.b7 U81 UIIMh cbeeges owed tbb bill .~. _ Total Amoerd One, Place Pay by Due Deb (01/>A/2806) -- ...._,. _ tiilabr lahtaratloe • Nad Read hate Janary 26.2009 tilsbr Ra/lag latonastbe NNer Nnssber Prsvions Radbrg Praeat Radteg CCF thed 1264979 367 (remob) 393 (nmob) 6 titessges irony 1161 • Yow anent price b compare is E 1.03266 /CCF. •Yow total annual usge is 76 CCF. Yow average mouthy usage is 6 CCF. • iblP Pmt Pipsline ~~6a accidents and service disruptions. CaN 611 before you dip. •Yow bib does not display a usage graph because your average daily usgs is too low. ~ ~ ~ 1 ~ ~'z ~`~I ~~ ~ .r _ A -- r~r racier ~1=M~N~~'T~rvioa to: C10 LOINS NEINMAN 3Z E CI~EN ST MECMANICS•IIIiG PA 17055 Rats ClaselRatiar: Residential General MRIap Perlad: 04/27/2009 b 05127/2D09 (30 days} Remob Device Rend Gp 900-2276-2722 oa wrib b IIGI at PO ttOD(13009 Reading, PA 19612-3009 ' Yoar current IIGI charges include Sbb texas bblirrg abed 5 0.45. Past eta lataraatioa - uw uu Ths aamronnt babrrce oa your bet biN was _ S 16.55 Yuri bai~anq~aa ~ 9/2009 .....~ Cancel RIN latarlastloa • liw litlllty Customer Cbarpe 8.55 Comrnodily Charge (4 CCF at 50.91750 3.67 Distribution C~ (First 4 CCF at =0.2500) ._. 1.70 PA Stab Tax Surma _ ~Q~ Tobl Curnlrt Charpf~-NCI Why ~3:N0. U01 IlNlill ebaswse awed tide bat ._ O 219 729 8~7VY'^2" •^ '104 , t Ow, Places Pay by Ow Del 7 ~~~~ ~ l~ MNsr Infonaatloa - Merd Rand Ogle Jans ~, 2009 Ms1er Radlap la(<ornatloa Meter Naraber Ptevlsus Radiap Present Readlap CCF Used - 1284979 _ 41 S (remote} 419 (remote) 4 /rswl ~ ^ Your wrrer-t price b compare is 50.91570 /CCF. ^Your bbl snnual ussgs is 62 CCF. Your avenge montAly ussgs is 5 CCF. •Help prevent pipeNne dsmage, accidents and service disruptions. Call 611 t+Ofore you dig. ^ Sign np b view and pay your future UGI trills online at www:ugi.com. ^Yaur laN does rrM dispby a usage graph trecauae your average daily usage is tco bw. i ,;~ ' ~ . • ~ rat tttriet eta a~mary 1t~:erYlCe te: CIO LOINS NEYYAAIArI 72 E 6NEH1 ST ~ PA 17055 Rate CIas:Mlcatloa: Residential General eralaa Perled: 03124!2009 b 04/27/2009 (34 days) Renlob Devics tied ~CaN 600-276.2722 orwrib to UGI at PO 80Dt 13009 Radrrrp, PA 19612-3009 ' Your clwront aGl charges include Sbb taxes totaling S 0.53. O Psst toll bdorNatiell - t161 UWlty ~# ~~ ... ..i . The acoolNlt aI your lest bib was _ =15.29 ., ^::• -~-~ Tlank you foryour of _.... -15 219 729 83O2µ 4 r•.. YOllf belrlnco as of D4 2/ 9/2009 ._.....«..-._.........„„.. O,pp CemaM 9Nl labrnratioa - ltW INRNy Commodity Charge t B CCF at 10.91667) M 5.50 OistritwtieoN CM {Fiat 6 CCF et 10.42500).... 2.55 PA Sbb TaxSu Tobl _Cumeat Clmraes - gGl Ubliiy ~~"~~ Monet Due. Ptaa hhVt IetormNioe -Neat Rgd Date My Y7, 200! McSer Reeding IeltsrNUNlea Meier Number Prwiow Radirrg Present ReadlNg lxF Ibed 1284979 Naeeges tram ltfil •Yoer crNrent price b comparo is = 0.91570 /CCF. •Your total annual usage is 65 CCF. Your average monthly usage is 5 CCF. .3 • help prevent pipeNne damage, accidents and service disrlrptiorls. Call 811 tretore you dig. • Sign up b view sad pay your futuro UGI tltlls Doti ne at www ugi.oom. ^Your bib does not display a usage graph because your average daily usage is too bw ? , ~~~ ' . - .. ~.~_'.+Kn' .. .:.,Q~ > . YV' .,:: 6iN>~r t~BeNke te: cro iou>s M ~2 E fiNEEN ST MEpNIHCS~URG PA 17055 Rde Wassllkatlon: Residential Geneal 811Np Perbd: 02/23/2009 b 03/24/2009 (29 days) Remote Device Rsad 11800-276-2722 or vWite b UGI at PO B01t 13009 Reeding, PA 19612-3009 ' You t UGI charyos induds Stab taxes totaNrg S 0.49. of Past8111 Intermatloe - UG! WR : ~ ~up~m~ paoynny~ou ~:t bill wa: ____~ s 16.1 a 219 728 8~2 b4 Your babas as of 03x30/2009 _ '-'1'~ . t:uMnt Blil In/oraratton • UG1 IJUIUy Customs Clarge g,~ Dra~lro~a Cl~arp~se (Fr~t 5 tC~ at:0 4)2200)..» X16 PA Stab Tax Surcharge _.. .„.•.__.~ Total Cnment Clayes • UGI I~ity................._..•.. --~ • 4 Meier labrnrstlen - Ilad Read l4te April 27.1018 Meter Reedln8 Intorraatlen Meter Nundter P Reading PraeM Reading CCF Used 1284979 404 (emote) 409 (remote) 5 Mesagee irow UGI •Youraxmrrt price to compare is:0.91570 /CCF. •Your tool annual usage is 66 CCF. Your average montbly usage is 5 CCF. • Help prorsnt pipslise damage, accidents and service disruptions. Call 811 bstore you d'g. •Your bib does not display a usage graph becaese yow average daily usage is too low . •.; . i~.'tyy;tdir'~ ~ • . :r ..tip--"•`'' ~~ ..comcasts N~ EA o~E ~~ ~,E ~ ~, Malt t~s on fhe t4wb at oasa7r~eaoe•o1-1 oN RECPT ~,~ J IndiwNt the Comust ~erviea~ you tutaaib~ o0 NANCY T. PETERAAAN How to rach ue... fror service at: Hoar to reeah ue: 32 E GREEN ST 4830 Carlhls Pike, Suite 0.14 MECHIWICSBUR(iPA 17055.3335 Meduurfpbury,Pa 17055 p17~540~8500 Telepitara Custaner Service 24 hours a day. swan days a week News from Comcast were ret bsi Summary of Chat~pes steterrrent prepared 12121/08 g ng .you as one of our cable subscribers. Our BNled trorrM /2/07J081o 12/31/08 records indicate that the Bnai balance shown above is now due. Your prompt payment is appreciated. Any outstanding equipment nx~st be returned b our oNics within T days. Please catl us at any time should you wish to reconnect your service, Previous Balance 57.21 Comcast Cable Televisan 48.73 cr Taxsa. Sureharees d~ Fees 2 95 cr Hearing / Speech knpaired Ca11711 Total Oue S5.Si3 detail of Charges on back Ny2S T PETERAAAN Aocoutrt Summary Previous Charges s 35.44 No Payment Received .00 Past Due Charges (please pay now) $36,4{ New Charges Mov~ag~ MovinpT !-~q.YZ.A~OVFS One caN pets goer erp 6 ~vnnirW.+ Count on the Verizon neh~rork to make at Nast one part of your move easier. Across the street or across the nation aq yver reaad is one call ro verizon to set up yourlnleriret, phone 6 e?ip>tai TV IR your new home in no tune. Service availabvfity valves. Total Duo $34.59 r Please pay upon receipt vertron FoerreeNtton Vlsd flevnk~iiury.orp for thousands of F13EE educational resouroes for - FINAL BILL - teachers, students, par~fs and This Final t~N may have already been n:ferred to an outside casleclion the after-school community. Y• Pay your btll online at verizon.conVpayfinalb~l Verizon (page 3) s .62 Verizon Online(pape 5) -1.47 total N.w Charles oue -~ - s .85 .1~5,t~ooa N T PETERMAN 32 E GREEN ST MECHANICSBURG, PA 17055-3335 ~ BELCO COMMUNfIY CREDIT UNION FRIENDLY REMINDER RE: Account /Loan ~: 115800 / L14 Past Due Amount: $10.00 Current Loan Balance: $197.94 Dear N: The payment on your above-referencxd VISA loan is currently past due. Please note that when the pa~-nlent bacomea 30 or more days past due, your credit raring may be affected. If you have aklrady sent the payment, please disregard this letter. Otherwise, please proNct your futuri borrowing ability and send your payment Today in the enclosed envelope. We understand our members experience financial dii'ficultiers at times. if this is the case, pl~se contact us immediately to defennine how we might be able to assist. In addition, we are now offering s free financial counseling progn~nl available from Acoel. The As:cel IlAembers Financial Management pn~gram cart provide you with unlimited access to a variety of 3erv&xs as described in the attached pamphlet. If you are having difficulty paying bills or staying current on your credit cards, a Debt Management Plan may be right for you. An Accel fnanaal counselor can provide you with more information on this valuable service. An Accel financial counselor Is available to assist you Monday thnwgh Thursday, Sam to 10pm E3T, Flhday, Sam to 7pm, and Saturday, gam to 1 pm by calNng (877) 33ACCEL (332-2235). . If you would Ilke to discuss this loan with someone from Belco, or if we can be of any further assistance, pisses contact Beloo at (717) 232-3526 or toll free at (800) 642-4482 ext. 6428. Sincerely, Loss Prevention Department Belco Communfty Credit Union 449 Eiseohovrer Blvd. Flertisbug PA 17111 800~642~44i2 www.6doo:or~ INVOICE • n , BLACK'S DETACHABLE TRUCK SYST. 300 MULBERRY DRIVE ,YIECHANICSBURG, PA 17050 7,7.7e~-3~ 1~ Lois Newman 32 E. Green St. Mechanicsburg, PA 17055 PAID* 1 Box Delivery and Pull Fee $350 00 his amount will be Charged to your card ending in 0558. Thank You. ;,. t ~ CS,J acre ,wrn+ort~raM sue y~7 c,5 No TOT/LL ~' ~~ ~ ~' ~R T/1X .~~.:, ; ~ «~ TiP X ~--~_. iO~w••.r.. r _".~."°`""~"'' ~.w,~„"`"~ ~ ~«w»1p~;: CUSTOMER: REraNTH~s S`S`A `'u .-~ ~~M~"~ `°' COPY fOR YOlAi REC RDS a """ ------_._.__ e~: f1'V-PC71t.~c-'---- --- -- - N~o. 5582 iNVOice o~TE 4/4/09 CusTOMEas ORDER NO. . a H ~~ INVOKE •. dIACK'S DETACHABLE TRUCK SYST. N~ 558 7. ACC MULBERRY ORI`JE . ,~1EChAIVIC98URG, ~A i705G INVOICE DATE CUSTOMER'S ORDER NO. SOLO TO: SHIP TO: Mrs. Lois Newman 1223 Mill Creek 8d. Hampstead, NC 28443 SALESPERSON o•. . Servi SHIPPED VIA TERMS f.O.B. PAI~a;: Visa • • ~ a To: 32 E. Green St. Mechanicsburg, PA 17055 1.31 Disposal Fee per Ton ~ $85.00 $11135 THis amount charged to your Card ending c: 055 . Thank you. t TIa~ ~p~~p 171~ T AI81tAl l01 U~t1z~11~ ilaralT r: sA ~~cxxxxxxxxxASSB MTpfiEEMilll IItI~LE~ 1 OITE~ AN 17, N Tt t ~t Nl All: f1- ANN I e TOTAL *111.SS CUSTOlIER COPY s ..~ al: !1V VVI~.t • .. r United Wad :PbNt:ylvartia , .:. Customer Sarvict~ Cittber - O. ~ •' " 8189 Adams ~Hummelstoltm, PA 17086 ~~,~ Ur~~ted 1Nater Telephone• 717.564-3662 ; ; - S~.IC~Z '.'www.unitadwater.com .. USAGE HISTORY Monthly usage in thousand gallons 0 Billing Date: 03/16/09 Account Number: 00200999543331 Previous Balance 3.52 Payments Through 03/16/09 r~rsn~r rou 3.52CI Balance Forward 0.00 Current Charges Due 04/05/2009 8.81 . TOTAL AMOUNT.DUE $8.81 •PAY BY 04/10/09 TO AVOID A T.596 LATE PAYMENT CHARGI SERVICE T0: NANCY T PETERMIAN SERVICE ADDRESSs 32 E GREEN ST MECHAINICSBURG PA Meter Number Service ~ ;Days of Meter Reading Usage Unit of Readin T S YPe From To Service Previous Present Measure 053766689 02/13/09 03/13/09 28 0256 0256 0 MGL ACTUAL EOIJIVALfNT TO OGALLONS SERVICE CHARGES $8.50 W-DSIC SURCHARGE $0.33 W-STAB SURCHARGE $0.02 CR TOTAL CURRENT CHARGES $8.81 SEE REVERSE SIDE FOR IMPORTANT ACCOUNT INFORMATION IMPORTANT MESSAGES If you would like to pay your bill online, please visit our website at www.unitedwater.com and click on the Western Union's Speedpay icon. WATER PRESSURE. FOR HYDRANT FLUSHING Approximate state tax included on this bill $0.42. DISTRIBUTION SYSTEM IN YOUR AREA FROM APRIL 1ST )ISCOLORATION OF WATER AND TEM RARY DECREASED PLEASE CALL 717-564-3662. ff l~ '~ c 1~ feb Mar Ap May Jun Jul Aug Sep Oct Nov Dec Feb Mat Next meter reading date: on ar about 04!14/2009 • ~, Istown, PA 17036 USAGE HISTORY Monthly usage in thousand Eallons m N r~9 0 ~rs° United later sve~_ __ Billing Date: 12/12/08 Account Number: 00200999543331 Previous Balance $14.10 Payments Through 12/121x8 rnanr rot- Balance For d 14.1OC war Current Charges Due 01101/2009 $0.00 $14.10 TOTAL AMOUNT DUE 514.10 SERVICE TO: NANCY T PtTERMAN •PAY 8Y 01/06/09 TO AVOID A 1.596 LATE PAYMENT CHARGI SERVICE ADDRESS: 92 E GREEN ST MECHANICSBURG PA -Meter Number _ Service ~~- -"- Days of Meter Reading ~ ; Unit of .From . To Service :~ Previous Present Usage Mea;Etue Reading Type' ,, 053766689 11/13/08 12/11/08 28 0254 0255 1 MGL . ACTUAL SERVICE CHARGES eourv~teNrro ~.t~cnccavs $8.50 WATER CHARGES $5.14 W-DSIC SURCHARGE $0.49 W-STAB SURCHARGE 0.03 CR TOTAL CURRENT CHARGES :14.10 SEE REVERSE SIDE FOR IMPORTANT ACCOUNT INFORMATION IMPORTANT MESSAGES Bpeeldpa~j- icon e ~ ~ y°~ a!I otdine, please visit our erebaite at www.unitedwater.com and click on the Westsrn Union`s Approximate state tax included on this bill 50.68. uec ran rep Mat wp Map Jun Jul Auk Sep lkt Nov Uec Next meter reading date: on a atwut 01/10/2009 .. , 8189Adatns Drirs •:Hummelstowlt, PA 17036 ~ ~~ ,~~,~ UN~rxedWater ;Telephofita:~17-343662 ~ '. ~d A~~~~jj www:utiitedwatarroin.. ;. ~ ;; :. < ru rl 0 Next meter reading date: on a about 05!14/2009 Billing Date: 04/15/09 Account Number: 00200999543331 Previous Balance Payments Through 04/15IOJ rna~,r r«, Balance Forward Current Charges Due 05/05/2009 8.81 8.81CI 0.00 8.84 :TOTALAII,AAOUNT t~UE'{:...... ~ $8.84 'PAY BY 05/10/09 TO AVOID A 1.5°6 LATE PAYMENT CHARGI SERYICE TO: NANCY T PETERMAN SERVICE ADDRESS: 32 E GREEN ST MECHNNICSBURG PA Meter Number 5ennce Gays of :Meter Reading ~ .Unit of -- Frain . To. '.... . . Service . P-evious Presenf Usage Mtaasuie R13sding Type 053766689 03/13/09 04/14/09 32 0256 0256 0 MGL ACTUAL SERVICE CHARGES EOU/VifLEMTO OG+ILLOWS $8.50 W-DSIC SURCHARGE $0.36 ~Lf/ W-STAB SURCHARGE .02 CR TOTAL CURRENT CHARGES ;8.84 ~ ~ SEE REVERSE SIDE FOR IMPORTANT ACDOUNT INFORMATION -IMPORTANT MESSAGES If you would like to pay your bill online, please visit our website at www.unitedwater.com snd click on fire Western Union's Speedpay icon. Save a stamp and go paperless today! Log on to www.unitedwater.com or call Customer Service to find! out Wrote information and to enroll in eBlliirlg. UWPA WILL CONDUCT ASEMI-ANNUAL FLUSHING OF THE DISTRIBUTION SYSTEM IN YOUR AR FROM APRIL 1ST THROUGH END OF JUNE. THIS MAY CAUSE TEMPORARY DISCOLORATION OF WATER AND TEM~RARY DECREASED WATER. PRESSURE. FOR HYDRANT FLUSHING UPDATES, PLEASE CALL 717.564-3662. Approximate state tax included on this bill X0.43. USAGE HISTORY Monthly usage in Thousand gallons ~ w, UNITED WATER USAGE HISTORY Monthly usage in thousand gallons s H l7 0 SERVICE TO: NANCY T PETERMAN United Water Pennsyluanio CustomerSenrice Center 8189 Adaies:Drit-e, Huegmelsto~un, PA 1703ti Teiephorie:717.564-3662~~ . uninu.tmitedwatercom~ ~~ . . ~. Billing Dote: 06/15/09 Account Number. 00200999543331 Previous Balance $8,81 Payments Through 06/15/09 $0.00 Balance forward $8.81 CR Current Charges Due 07/05/!2009 ~_$&:87-. T(~TAI AMOUNT' DUB .. ' $406 , .,` -~'~ . •PAY 8Y 07/10/09 TO AVOID A 1.546 LATE PAYMENT CHARGE SERVICE ADDRESS: 32 E GREEN 5T MECNANIC58URG PA Meter Number Service : -_ Days of Meter Reading Unit of Uso9e ... Reading Type From 70 : .. Se[VicE Previous ,; <Present, Measure: 053766689 05/13/09 06/12/09 30 0256 0256 0 MGl TUAL SERVICE CHARGES tarTm orrueor~s S8.50 W-OSIC SURCHARGE $0.39 ~~ W- AS SURCHARGE 0.02 CR ~~(,~ i / TOTAL CURRENT CHARGES 8.87 t ~ `( Q J SEE REVERSE SIDE fOR IMPORTANT ACCOUNT INFORMATWN ( ++ ww ~~ .! W ,IMPORTANT MESSAGES If you would like to pay your bill online. please visit our website at www.unitedwater.com and click on the Western Union's Speedpay icon. Saue a stamp and go paperless today! Log on to www.unitedwater.com or call Customer Service to find' out more information and to enroll in e8illing. UWPA WILLCONDUCT ASEMI-ANNUAL FLUSHING OF THE DISTRIBUTION SYSTEM IN YOUR AREA FROhh~~ APRIL 1 ST THROUGH ENO OF TUNE. TH15 MAY CAUSE TEMPORARY DISCOLORATION OF WATER AND TEMPORARY DECREASEp WATER PRESSURE. fOR HYDRANT FLUSHING UPDATES, PLEASE CALL 717-564-3662. Approximate state tax included on this bill $0.43. wiay gun Dui ~ Sep Oct Nov Dsc Feb Mar Apr Mali Jaa Next meter reading date: on or atwut 07/14/2009 K s ~ . r M V! ~ o ~~n~ $~~ <~ ~~$~ ~~~ ., ~. ~o~ g e _ M~~ as Q~ QQ~ ~Yr ~ ~ o u NN ~~ .. 5~~ ~~ ~ a o z CO 0 H 2 ~ -~. ~~ n ~~i N ~ «~.. ~ O N r, ~ ~ '±' v >~#~ ~! 00 ~ r<•c: ~ U ~: ~ ~ ~ C~ d. U a~ ~ i i ~r ~ ~ M f ~`~~s'sia~~i ' ~ ~S w Y #' ~. • C w op l . o_ ~ ~ a ~ m ---• '~ A Q ~ ~:. v.~ m"u~F' Q r pNp 1~ a •V ~ < ~m v v ~ ~m W ~ ~ ~ H~ ~~ d wtn ~~~ w rya ~ ~ •• ~~p" ~ ~a e~ ~ ~^ ~~ , ~ 0 0 ~~,~~ o~ ~ ~ '8 ~ ~ ~~ ~ A ~ M ~' ~ ~ Vl O N~1 ~~~ ~ g~ ~ y . ~ ~ ~ .~ ~ ~ 8 ~c ou~a~° ~ W ~ ~ ~o~ F~ a ~ -~ ~ tl w, ~ •~~ •ssrist ~w-wc~r'v~T'~°tt~ii~hrviee to: E ~N~ST~N MH;IMNICSBIIRG PA 17055 Rah ClaseHkatba: Residential General Bllllag Perbd: 01/26/2009 b 02/23/2009 (28 days) Rsmob Device Read Ca1~1800~276-2722 or vrrite to UGI at PO BOD(13009 Reding, PA 19612-3009 'Your current UGI clargs: inclede Stab faze: bbling t 0.55. Pad Bfp Nr/orwetlon - It61 , `~ "'~". The auount babrres oa your bd bill rras __._.._ S 16.63 ~~~E'~.4~~t ~~ !~ Part of -16.63 219 729 8302 04 Your balance as of 02/27/2009._.._.._.....,_____-""'~;g~ CuredBID krtorragen - IIW ttUllly . CustomerCbarge_ 8.55 Commodity Cheap (6 CCF at :1.03333) _..,~,,,_ OisMbution Cln~rgssss (First 8 CCF at t0.40b00) ,._, X43 PA Stab Tax Surcharge __-__„~, -0.05 Total Current Charges - UGI Utilit~yy ...._,..-..,,,.,,,,,,,,,, -'"~'j`~ UfN eM ewN tlrb tdll _.._.........~._.r.._+.-..»-.._._-_w._._._..._, i 1i: Tebl Anioed Dee, PINae Pay by Dee Dab (M/20/ i 16: Mebr Irrlorrrrotlse -Meat Read ~b Nar+cb 26, 2008 ftlebr Rnding IMsreatlen ARNer Number Prevloee Rgding Prae Radleg CCF Il~d 1284979 39B {remob) 4041 bl s MassOp tiara UW lour current price b comparo is S 1.03266 /CCF. ^ Your tobi snnual usage is 70 CCF. Your average monthly wage is 5 CCF. 'Help Provent pipeline damage, aaidents and service disruptions. CaR 811 before you dig. • Your biN doss not dispby a urge graph bepuse your sVerage daily usage is bo low. OL9 ~~~~~~~~ oorsa~~ O R you pay at a payment agent prase take year eMke billy Make cMck payable b UGL I(eeP Ih1e Pad lor>~ records. Importarrt intormn/lan to on the back of fhb blll. • K . 2009/2010 Mechanicsburg School District flake cheeks Barry Neckard payable to: 605 Somerset Drive Mechanicsburg, PA 17055-6603 Phones (717) 766-6205 Hours: Tue - 1Os00am to~pOpm~ 3009 Bill Number: 2273 Account Numbers 18-Z3-0565-018 My records indicate that your School Real Estate Please be advised that $1,296.25 is due b bill has not yet been paid. paid by that date, the bill will be turned overeto~the county0tax claim bureau,iwitht additional charges assessed. Thank you for your prompt attention to this matter. NEWMAN, LOIS M 33 EhST GREEN STREET IKECHANICSBURG, PA 17055 Property Description 32 GREEN STREET LOT Residential Building ' " REO 1509 E%a (898 COMMONWEALTH Of PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT OECEOENT scNSOU~E F JOINTLY-01NNED PROPERTY ESTATE OF l~ NuMt~eR Nancy T. Petennsn 21-08-1250 K es meet ens made JoiIM erlglM aae year d qle decedent S T6M of deMk R moat be ngabd en tiolwlule . SURVIVINta JOMiT TENANT(S) NAME ADDRESS REUITIONSHIP TO DECEDENT ~ Lois M. Newman 1223 Mifl Croak Road DauplhMr Hampstead, NC 28443 e. C. JgNTLY-O~YVNED PROPERTY: ITEM URTER FOq.lOeiT T DATE MADE DESCRE'TION OF PROPERTY Oe0.WE RA1Q:Oi i111A11C1AL WSTIlUT10R ARID BANK ACCp1MT NUMBER OR a014M R ATr Y R AT OATS OF DEATH OEICO'S M ~TVIIWE OF TN plTERESI ~• ~ ~ CO - Acoourd No 115800 . . 14,422.93 50 7,211.47 TONAL (Also enter on Nne 6, Recap4ulatioR) I i 7,211.47 (M mops epeoe ie needed. insert additlolld stfleete d the wile aloe) TLR BRN TER TlC AMOUR . TRAM / ACCOUN7i Qf _~ SEQ D6 r 3 515 W 7,211.47 260 115800 0 DIRECT GATE TRANSACTION TELLER 032309 WITHDRAWAL NICHOLAS C BAt.ANCE TYPE OLD BALANCE AMOUNT NEW BALANCE Si -SAVINGS 14,422.93 7,211.97 7,211.46 ESTATE vF NANCY PETERMAN 1223 MILL CREEK RD HAMPSTEAD NC 28443 2810 oErACH Hire naanoN BEFORE oEPOaRwo CHECK NO: 00383992 DATE: 03/23/09 B~ ® BELCO COMMUNITY CREDIT UNION SATE tbfficiastl Check No. °i~"~" P.O. Box 8't • Hanlatwry, PA 17108 03123/09 2313 00363992 1.800842.4482 www.b•lOO.ory AMOUNT i"""7,211.47 PAY SEVEN THOUSAND TWO HUNDRED ELEVEN AND votD AtRER 9o DAYs 47!100 DOLLARS TO THE ESTATE OF NANCY PETERMAN ORDER 1223 MILL CREEK RD of HAMPSTEAD NC 28443.2810 aoNntun` u'00363992~ x:23 i3809971:a'90030006tt'~8 r Gift & Associates, LLC 1205 Manor Drive, Suite 100 Mechanicsburg, PA 17055 717-766-3555 January 27, zo io CONFIDENTIAL Nancy T. Petemtan 32 East Green St Mechanicsburg. PA 17055 For professional services rendered in connection with the preparation of your 2008 individual tax r+etum: Form 1040 pndividual Income Tax Return) PA Form PA-40 (lncome Tax Return} PA Schoduk W2S (Wage Statement Summary) PA Schodule SP (Spatial Tax Forgiveness) PA Form PA-1000 (Properly Tax and Renters Claim) Amount due $ .150.00 __ ___, ~ 1.. ~ Pennsylvania SCHEDULE ~ DEHIRTMENT Of REVENUE gENEFIGIARIES INNERRARCE TA% RETURN RESIDENT pECEDENT EST® ZLE NUI-I6ER Nancy T. Peterman c Iwv- ~ cav REUTIONSFiIP TO DECEpENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Oo Not Lkt Tswtae =) OF ESTATE I TAXABLE OISTRItriiT10N5 pndude outright spousal ~ributions and transiels under Sec. 9116 (a) (1.2).J 1. Lois M. fyewrllan 1223 MIN Croak Road, Halltpstead, NC 28443 Datghter 100 ENTER DOW1R AFWUNIS FOR DISTRIBUTIONS SHOWN A80VE ON LINES 15 TFIROUG H 18 OF REV-1500 DOVER SHEET, A S APwROPR1ATE. II NON TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WH1CH AN ELECITON 1T) TAX IS NOT TAKEN 1. B. CItARTTABIE AND GOVERNMENTAL O15TiUBUTI0N5 1. TOTAL OF PART II -ENTER TOTAL NONTAXABLE DISTR18UTlONS ON LINE 13 OF REV-1500 COVER SHEET. ~ II RRII'e spas is needed, insert additional sheets of the same sae.