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Home My WebLink About05-06-10" 1505607121 REV-1500 EX (06-05) A Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number Po Box 2sosol INHERITANCE TAX RETURN Harrisbu , PA 17128-0601 RESIDENT DECEDENT 2 1 0 9 0 9 2 4 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 1 6 6 2 6 5 2 0 2 0 9 2 5 2 0 0 9 0 8 0 5 1 9 3 1 Decedent's Last Name Suffix Decedent's First Name S N Y D E R MI M A R Y L (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 FILL INAPPROPRIATE OVALS BELOW REGISTER OF WILLS 1. Original Retum ~ 2. Supplemental Return 3. Remainder Return (date of death 4. Limited Estate ~ prior to 12-13-82) 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) ^X 6. Decedent Died Testate ~ 7. Decedent Maintained a Livin Trust (Attach Copy of Will) (Attach Copy of Trust) g 8: Total Number of Safe Deposit Boxes 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under between 12-31-91 and 1-1-95 Sec. 9113(A) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDEN (Attach Sch. O) Name TIAL TAX INFORMATION SHOULD BE DIRECTED T0: Daytime Telephone Number R M A R K T H O M A S E S Q U I R E 7 1 7 7 9 6 2 1 Firm Name (If Applicable) 0 0 First line of address 1 01 S O U T H Second line of address City or Post Office REGISTER OF WILLS USE ONLY Q •.. ~ ~,;~ ~ ~. M A R K E T S T R E E T ~ yr~J'~ _~ F" ~ '~ M E C H A N I C S B U R G Correspondent's e-mail address: rmarkthomasCci74mail.com State ZIP Code ~ P A 1 7 0 5 5 E FILED - " • ~ ~w -• y` --- ~~-~ fl ¢ , 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 knowled e. SIGNATU REF~SO ESP ISLE FO ING RETURN g ' DATE ADDRESS iC . Z, ~. ~ ~ ~ 1600 CgRLIN LA REPRESENTATIVE MCLEAN VA 221,01 ATE .Z ~ d 101 SOUTH MARKET STREET MECHANICSBURG PLEASE USE ORIGINAL FORM ONLY P A 17 ~ 5 5 Side 1 1505607121 1505607121 J J r RECAPITULATION 1. Real estate (Schedule A) ........................................ 1. 2. Stocks and Bonds (Schedule B) , . , , .. , , , . ....................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 1 5 3 0 0 0. 0 0 0. 0 0 4. Mortgages & Notes Receivable (Schedule D) .. , , , , .... . ............. 4. • 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ....... 5. 4 5 ? 4 3 3. 7 7 6. Jointly Owned Property (Schedule F) ^ Separate Billing Re uest d 6 q e . ....... 7. Inter-Vivos Transfers & Miscellaneous N n-Probate Property (Schedule G) ~ Se t B • para e illing Requested ....... 7. 1 2 4 2 • 0 3 8. Total Gross Assets (total Lines 1-7) ... , , , , .................... 8. 6 1 1 6 7 5 . 8 0 9. Funeral Expenses 8 Administrative Costs (Schedule H) .... . . . .. . ... . g_ 4 4 5 1 4 . 1 3 10. Debts of Decedent, Mortgage Liabilities, 8~ Liens (Schedule I) ............ 10. 3 3 0 5 6 11. Total Deductions (total Lines 9 ~ 10) . . . ......... . . 11 4 4 8 4 4. 6 9 12. Net Value of Estate (Line 8 minus Line 11) .. , , , , . _ , , .. 12 5 6 6 8 3 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which ], , ], ], an election to tax has not been made (Schedule J) ........ 13 .......... . 14. Net Value Subject to Tax (Line 12 minus Line 13) , , , , . , , , , ~........ 14 5 6 6 8 3 1 1 1 . 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 . 0 0 15. 16. Amount of Line 14 taxable 0 • 0 0 at lineal rate X .045 5 6 6 8 3 1. 1 1 16. 17. Amount of Line 14 taxable 2 5 5 0 7. 3 9 at sibling rate X .12 ~ 0 0 18. Amount of Line 14 taxable 17. 0 • 0 ~ at collateral rate X .15 • 18. 0 0 ~ 19. Tax Due REV-1500 EX Decedent's Social Security Number 1 6 6 2 6 5 2 n a ................................................19 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505607221 MARY L• SNYDER 1505607221 2 5 5 0 7. 3 9 1505607221 J REV-1500 EX Page 3 Decedent'$ Complete Address: File Number 21 09 0924 ECED~ NT'S NAME MARY L. SNYDER STREET ADDRESS 514 EAST COOVER STREET CITY MECHANICSBURG STATE PA Tax Payments and Credits: 1 • Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 22 000.00 1 100.00 3. Interest/Penalty if applicable Total Credits (A + B + C ) D. Interest E. Penalty 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.Total Interest/Penalty (D + E ) Fill in oval on Page 2, Line 20 to request a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. ZIP 17055 (1) 25 507.39 (2) 23 100.00 (3) 0.00 (4) 0.00 (5) 2 407.39 (5A) (5B) 2 407.39 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" I N THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred; b. retain the right to designate who shall use th '"~~~~~~"~~~~""""'~""" Yes ^ No e roe c. retain a reversionary interest; or p p rty transferred or its income; .......................... . ^ X ..................................... d. receive the r .......................................................... p omise for life of either payments, benefits or care. ~ ^ ^ 2. If death occurred after December 12, 1982 '~~~~~""~~~~~~~'~"~"""""" did decedent transfer property within one ear f d ^ X y o eath 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 Individu l R ti ^ ^ 0 a e rement Account, annuity or other non- robat p e property which contains a beneficiary designation? .................................................................................................. D 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 is three (3) percent [72 P.S. §9116 (a) (1.1) (i)], of transfers to or for the use of the surviving spouse 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 survivin s use is z [72 P.S. §9116 (a) (1.1) (ii)). The statute does not e_ xemot a transfer to a surviving spouse from tax, and the statutory requireme ns o disclo ero (0) percent filing a tax return are still applicable even if the surviving spouse is the only beneficiary. sure of assets and For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-0ne years of age or younger at death to or for the use of a nat adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116(a)(1.2)j. ural parent, an 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 exce # 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. pas noted in The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a 1.3 . A siblin ' Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. )( )] 9 is defined, under REV-1502 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE A REAL ESTATE FILE NUMBER All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price t which props would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant fats. Real roe which is 'oint -owned with ri ht of survivorshi must be disclosed on Schedule F. ITEM NUMBER VALUE AT DATE DESCRIPTION OF DEATH 1 • 14 E. Coover Street echanicsburg, PA 17055 153,000.00 TOTAL (Also enter on line 1, Recapitulation) ~ $ (If more space is needed, insert additional sheets of the same size) REV-1508 EX + (6-98) ~ r COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MARY L. SNYDER SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER ^~ - - ci uy UyL4 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION ~ • ersonal Property 2• embers 1st Federal Credit Union, Savings Account No. 200849-00 000 Louise Drive, P. O. Box 40 echanicsburg, PA 17055 3• embers 1st Federal Credit Union, Investment Savings Account No. 200849-05 000 Louise Drive, P. O. Box 40 echanicsburg, PA 17055 4• embers 1st Federal Credit Union, Certificate of Deposit No. 200849-45 000 Louise Drive, P. O. Box 40 echanicsburg, PA 17055 5• itizens Bank, Money Market Account No. 6203122088 25 William Penn Place, Suite 153-2618 ittsburgh, PA 15219 6• itizens Bank, Checking Account No. 6203122088 25 William Penn Place, Suite 153-2618 ittsburgh, PA 15219 7• NC Bank, Account No.50-0088-6721 00 Grant Street, 36th Floor ittsburgh, PA 15219 8• NC Bank, Account No. 50-0197-0845 00 Grant Street, 36th Floor ittsburgh, PA 15219 9• ulton Bank, Checking Account No. 3622-99966 423 South Market Street echanicsburg, PA 17055 10. ulton Bank, CD No. 328-0294117 423 South Market Street echanicsburg, PA 17055 11 • ash and insurance refunds 12. 000 Honda Civic Sedan 4 Door 13. terling silver flatware and jewelry 14. 009 tax refund TOTAL (Also enter on line 5, Recapitulation) I S (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH 785.00 193.77 5,384.20 100,299.18 54,372.12 0.01 1, 794.65 240, 353.26 1,371.57 45,731.14 678.14 4,820.00 1,207.73 443.00 457,433.77 REV-1510 EX + (g_98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FCTATG nc SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY LSNYDER FILE NUMBER 71 na nnn. ITEM NUMBER - .,~~ This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH % OF DECD'S EXCLUSION merican Funds, Account No. 60489190 .O. Box 2560 orfolk, VA 23501 VALUE OF ASSET INTEREST (IF APPLICABLE) 1,242.03 00. TAXABLE VALUE 1,242.03 TOTAL (Also enter on line 7 Recapitulation) I $ (If more space (s needed, insert add(ttonal sheets of the same size) 1 REV-1511 EX + (10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESTATE OF ER SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER ~]A nn ww... . Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION A• FUNERAL EXPENSES: ~ • Malpezzi Funeral Home 2• Garden Bouquet (funeral flowers) 3• LKoste Villa Cafe (funeral dinner) B. ADMINISTRATIVE COSTS: ~ • Personal Representative's Commissions Name of Personal Representative (s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees R. Mark Thomas, Esquire 3. Family Exemption: (If decedents address is not the same as claimants, attach explanation) Claimant Street Address City State ------ZiP Relationship of Claimant to Decedent 4' Probate Fees 5, I Accountants Fees 6• I Tax Return Preparers Fees ~• Chuck Bricker Auctioneer (personal property appraisal) 8• The Patriot News (publication) 9• Cumberland County Law Journal (publication) 10. UGI (gas bill) 11. PP&L (electric bill) 12. Zimmerman Plumbing (house repairs) 13. Housekeeping 14. United Water (water bill) 15. Packing boxes, trash bags, and lock for moving truck 16. Repairs to home to get ready for sale 17. Closing costs on sale of home 18. Jewelry aooraisal TOTAL (Also enter on line 9, Recapitulation) ~ $ (If more space is needed, insert additional sheets of the same size) AMOUNT 10,067.80 588.30 1,133.00 18,100.00 591.00 248.00 90.00 148.17 75.00 173.56 75.74 145.00 50.00 18.13 104.08 2,060.35 10,478.00 212.00 44,514.13 Continuation of REV-1500 Inheritance Tax Return Resident D ecedent MARY L. ,SNYbER Decedent's Name, 21 09 0924 Page 1 .-.. ~~~~ wumoer. Schedule H -Funeral Expenses ~ Administrative Costs - B7. ITEM NUMBER DESCRIPTION AMOUNT 19. 1-800-Got-Junk (disposal) 156.00 SUBTOTAL SCHEDULE H-B7 I 156.00 REV-1512 EX + (12-03) ~~ ~ SCHEDULE 1 COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN Fcrerc ~~ RESIDENT DECEDENT MORTGAGE LIABILITIES, & LIENS FILE NUMBER MARY L. SNYDER 21 09 0924 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical ex enses. ITEM p NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 • entral Medical Equipment Company 2• ~loly Spirit Hospital 3• pP & L (electric bill) 4• f.1Gl Gas (gas bill) 5• ~Jnited Water (water bill) 6. 7• ~erminex 7.80 50.00 57.61 83.78 34.34 7.99 89.04 TOTAL (Also enter on line 10, Recapitulation) I $ (If more space is needed, insert addii~onal sheets of the same size) REV-1513 IX + ~g.pQl C~MONWE~gLTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY j, TAXABLE DISTRIBUTIONS [indude ou ' ht spousal distributions, and transfers under Sec. 9116 (a (1.2)) 1 • ~Iliam Roy Snyder, Jr. 1600 Carlin Lane McLean, VA 22101 2• Linda Kirlin 1784 North Meadow Drive Mechanicsburg, PA '17055 3• Cindy Hendricks 919 Highland Way Bowling Green, KY 42104 FILE NUMBER 21 09 0924 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) son: daughter. daughter ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T I II• NON-TAXABLE DISTRIBUTIONS: HROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SH A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION T EET 1 ~ 0 TAX IS NOT BEING MADE I B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF (If more space is needed, insert additional sheets of the same00 COVER SHEET ~ size) AMOUNT OR-- SHq E _ OF ESTATE. 0.33 0.33 0.33 A COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INQIVIDUAL TAXES ' DEPT.2S0601 HARR~BURG, PA 07128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 012120 THOMAS R MARK 101 S MARKET ST MECHANICSBURG, PA 17055 ~ -------- fold ACN ASSESSMENT CONTROL NUMBER REV-1162 EX(11-96) AMOUNT 101 ~ $ 22, 000.00 ESTATE INFORMATION: ssN: 166-26-5202 FILE NUMBER: 2109-0924 DECEDENT NAME: SNYDER MARY LOU DATE OF PAYMENT: 1 2/ 1 7/2009 POSTMARK DATE: 12/ 17/2009 COUNTY: CUMBERLAND DATE OF DEATH: 09/25/2009 REMARKS: CHECK# 3063 TOTAL AMOUNT PAID: $ 22, 000.00 INITIALS: DM SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS TAXPAYER ~ I . A OMH N0.2502-0265 ' U.S. DEPARTMENT OF HOUSING 8 URBAN DEVELOPMEN ~ 2• FmHA B' NPE OF LOAN: 1. X FHA ~ 3. ~CONV UNINS SETTLEMENT STATEMEN . . O9 ER: 4• ^VA 5. QCONV. INS. T 6 DI 7 RA356- . LOAN NUMBER: Y ~ 8. MORTGAGE INS CASE NUMBER: 104300825 C. NOTE: 441.9637148-703 This form is famished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are Items marked '(POCJ" were paid outside the closing; they are shown hero for inf sh o D. NAME AND ADDRESS OF BORROWER: . wn. ormational purposes and are not included in the totals . E. NAME AND ADDRESS OF SELLER: ~ ~ 3ree (°~33e-OO.FFD/DRA336-09/'x1 JOANNE M.DRABENSTADT F. NAME AND ADDRESS OF LENDER: 57 DREXEL PLACE ESTATE OF MARY LOU C. SNYDER NEW CUMBERLAND, PA 17070 PRIMARY RESIDENTIAL MORTGAGE 514 EAST COOVER STREET . MECHANICSBURG, PA 17055 INC. 4750 WEST WILEY POST WAY SUITE 200 G. PROPERTY LOCATION: SALT LAKE CITY, UT 84116 514 EAST COOVER STREET H• SETTLEMENT AGENT: 25-1619811 MECHANICSBURG, PA 17055 CUMBERLAND County Pen l TRI-COUNTY ABSTRACT SERVICE I. SF_TTLEMENT DATE: , nsy vania PLACE OF SETTLEMENT December 17, 2009 48 CENTRAL BLVD. CAMP HILL, PA 17011 J. SUMMARY OF BORROWER'S TRANSACTION 100. GROSS AMOUNT DU E FROM BORROWER: 101. Contract Sales Price 102 K: SUMMARY OF SELLER'S TRANSACTION 400. GROSS AMOU . Personal Pro ert 103. Settlement Char es to B NT DUE TO SELLER: 153,000.00 401. Contrail Sales price 4 orrower Line 1400 104. 02• Personal Pro e 153,000.00 8,785.28 403 105. . 404. Ad ~ustments For Items Paid B Seller in advance 405. 106. Cit /Town Taxes 12/17/09 to 01/01/10 107. Coun Taxes 1 to Ad'ustments Forltems Paid B SeNerin advance 24.90 406. Ci !Town Ta 08. SCHOOL TAX 109. SEWER/TRASFi OCT 7 0 1 xes 12/17/09 to 01/01/10 407. Count Taxes 24.90 757 79 t -DEC. 12/1 /09 to 01 0 1/ p 110. 111 . 408. SCHOOL TAX 0 ~ ~ 18.48 409. SEWER/T 12/17/09 to 07/01/10 RASH OC 757 . .79 T-DEC. 12/17/09 to 01/01/10 410 112. . 18.48 411. 120. GROSS AMOUNT DUE FROM BORROWER 412. 162,586.45 420. GROSS AMOUNT DUE TO SELLER- 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER; 201. De osit or earnest i 1 mone 202. Princi al Amount of New Loans 203 E i 53,801.17 500. REDUCTIONS IN AMOUNT DUE TO SELLER: ~ 2.000.00 501. Excess De osit S . x stin loans taken sub ect to 204. ee Instructions 150,228.00 502. Settlement Cha es to Seller Line 1400 205. 206 503. Existin loans taken sub'ect to 10,128.00 504. Payoff of first Mort . 207. gage ~ 505. Pa off of second Mort a e ~ 208. 506. 209. SEI I FR ri nc~.~.. ,.___ i 507. De oslt disb. as orornoric, i ~• wit i I own Taxes - - - .,°"" --°" ""'°"vu !:UST ASSIST -------.- 211. Count Taxes to ~ Ad'ustments Forltems Un aid B Seller -"'~=t to 510. Ci !Town Taxes 212. SCHOOL TAX 511. Count Taxes to ----. 213. t0 to ------ 512. SCHOOL TAX 214. 215. 513. to -'------ 216. i 514. ~---- 515. --'---~- 217. 218. 516. 219. 517. i 518. '------ 220. TOTAL PA/D BY/FOR BORROWER i 519. ------_ 152,578.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 300. CASH AT SETTLEMENT FROM/TO BORROWER: 301. Gross Amount Due From Borrower Line 120 800. CASH ATSETTLEMENT TO/FROM SELLER: 10,478.00 302. Less Amount Paid By/For Borrower (Line 220) 162,586.45 303. CASH (X FROM) ( TO) BORROWER 15 ( 152,578.00) 602. Less ReduilionDs Due Selelee(L nle 520) ---~----_, 10,008.45 603. CASH (X TO ( 10,478.00 The undersigned hereby acknowledge receipt of a completed co ) ~ FROM) SELLER I HAVE CAREFULLY REVIEWED THE HUD-1 SETTLEMENT STATEMENT AND TO THE BEST OF MY KN 143,323.17 ACCURATE STATE py of pages 1&2 of this statement 8 any attachments referred to herein. THAT I HAVE REC VED A~COPY OF TEI $ A DISBURSEMENTS OWLEDGE AND BELIEF, IT IS A TRUE AND Borrower EMENT STATEMENT. - SE MADE ON MY ACCOUNT OR BY ME IN THIS TRANSACTION. f FURTHER CERTIF J N .DRAB A ~ ~ Seller / r-. TO THE BEST OF' M KN ~~!~~~~G ~~'~l-~- i~ . ~ / ~ t,~,~ r FUNDS WHICH WER R~.i;F D E. THE HUD-1 SETTLEM ESTATE OF MARY. "OU'C 'SNYDE TRANSACTION. ___ I ; AND H VE BEE ST T MENT WHICH I HAVE PREPARED IS A TRUE AND ACCURATE ACCOUNT OF TH R/~ L a'-T~i6-.UNDERSIGNED AS PART. OF - - TTLEMENT OFFICER ~ i---- .THE SETTLEMENT OF THIS - ettlement Agent ~ ` - ___,._. WARNING: IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEAQE TO THE UNITE .. _. -- NVICTION CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE: TITLE 18 U.S. CODE SECTI - D STATES ON THIS OR ANY Sf14Tft:;gR'FORM PENAL'fiIES UPO ~~ ~ ON.1001 8 SECTION 1010. L. SETTLEMENT CHARGES • 700. TOTAL COMMISSION Bas d P~aZ e on.Price Division of Commission line 700 as Follows: $ 153,000.00 5.5000 % 8,415.00 ' 701 S 4 615 00 PAID FROMPAID ROM ' , . to ERA-NRT, LLC 702. S 3,800.00 to TAMANINI •REALN , 90RR~DWER'S SELLERS 's ~' 703• ommisslon a at Settlement FUNDS AT FUNOS A7 704. TRAN ACTION/ADD'L BROKER FEE SETTLEMENT SETTLEMENT TAMANINI REALTY/ERA-NRT LLC 800. ITEMS PAYABLE IN CONNECTION 8,415.00 WITH LOAN 801. Loan Ori ination Fee °/ 125.00 165.00 a to 802. Loan Discount % to 803. Appraisal Fee to MICHAEL HENNIGAN APPRAISALS 804. Credit Report to 805. Lender's Inspection Fee 375.00 Fee to 806. Mort a e Ins. A . 807. Assumption Fee to 808. PROCESSING FEE to 809. FL000 CERTIFICATION FEE to PRIMARY RESIDENTIAL MORTGAGE INC , . 810. UNDERWRITING FEE to FAFDS 595.00 811 to PRIMARY RESIDENTIAL MORTGAGE, INC, 10.00 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 295.00 901. Interest From 12/17/09 to 01/01/10 21'608100/day ( 15 da 902. Mort a e Insurance Premiu s f ~ y %~ m or months to HUD 903. Hazard Insurance Premium for 1 0 324.12 . 904. ears to ERIE INSURANCE EXCHANGE 2,583.79 905. 366.00 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard Insurance 1002. Mort a e Insurance 2.000 months $ 30.50 er month 1003. Ci !Town Taxes 0.000 months $ 67 24 61 00 . er month 1004. Count Taxes months . $ er month 1005. SCHOOL TAX 8.000 months $ 50 49 . . er month 1006. 5.000 months (~ $ 117.60 per month 403.92 1007. months $ er month months 1008. AGGREGATE ESCROW 588.00 er month ADJUSTMEI 1100. TITLE CHARGES months $ er month 1101. Settlement or Closin Fee -28.80 1102. CLOSING PROTECTION LETTER to 1103. Title Examination to FIRST AMERICAN TITLE INSURANCE COMPANY 1104. Title Insurance Binder to 75.00 1 f 05. Document Pre aration to 1106. Nota Fees to 1107. Attorney's Fees to CASH includes above item numbers: to 1108. Title Insurance 15.00 8.00 includes above item numbers: to TRI-COUNTY ABSTRACT SERVICE/AGENT FOR 1 ST AMERICA 1109. Lender's Covera e 1 1 g 1110. Owner's Coverage $ 150,228.00 23.75 1 $ 153,000.00 107081066PAL 1111. ENDORSEMENTS 100 300 8 . 1112. to TRI-COUNTY ABSTRACT SERVICE 1'123'75 107115520PA0 1113. 150.00 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording Fees: Deed $ 62.00; Mortgage $ 92.00; 1202. Ci /Coun Tax/Stam s: Deed Releases $ 1203. State TaxiStam s: Revenue Stam s 1,530.00• Mort a e 154.00 1204. ELECTRONIC DOCUMENT RETRIEVAL to 1.530.00; Mort a e 1205. OVERNIGHT/COURIER FE TRI-000NTY ABSTRACT SERVI 1 530 00 1,530.OC ES CE 1.300. ADDITIONAL SETTLEMENT CHARGES to TRI-COUNTY ABSTRACT SERVICE , . 25.00 1301. Surve 14.50 1302. Pest Ins action to 1303. TAX CERTIFICATION FEE to 1304. to TRI-COUNTY ABSTRACT SERVICE 1305. RE-IMBURSEMEN 1400. TOTAL SETTLEMENT CHARGES Enter on Lines 103, Section J and 502, Section K ey signing Page 1 of this statement, the ~ignatortes apm°wledga racsi t 10.OC p or a plated copy °/ page 2 W tMs Iwo page at t, 8,785.28 10,128.OC ~~~ ~~ ;•1' ETTLEMENT OFFICER Certified to be a true copy . Settlement Agent _ C a z f i< DRA3tSt1-0g / DRA156.Og / g ) .: _ . APPRAI SAL _. ,, . ,,,~ . ~. Persor~ral Property of p v N d ~l ~ ~, ~ om V E,2 S T l'~EC~ /J Appraised by Chuck E. Bricker AU094-L Date ~ ~ ~ ~,~- U Q ITEM VALUE ITEM VALUE /°~ ,C3~c~ ~(, v, ~' ~ ~, D Tl~i/~/ d s U,~p /T~ T ~ U. OD ~G~-I1U~ S 0 G ~~Q6 5 ~ ~1Ps , 0 I'` L-/~- sc~~ -7J 0.Oa ~T~wct ~p,ao ~. ~w~ r ~.a oa C d d ~~ / va ~ L~9- ~ia 5' T~4- ~d -S' ~yra uJ,~s~r~,~ .- ~~~E /~ - S.ST, IJ~~SI~c~s, f !-~~ ~-S5~ f ~ T~' -- ~.A-NS .ASST Tv v ~.s ~ ~ P, (~dw ER M ocv~~ G 4. o0 X00 ,UO IDD, An " L s /-~- L ~~LU 2U0 S 3D. PG l IU ~11.~ (ZM ~ S U r T~ (~ j} p P6 r2.T~ 5 ;~ a 20,0 o p.p ~ C-~3 -lR 5 / ~ !~c- ~.0 . ~c~ + ,. 2000 Honda Civic -Private Party Pricing Report -Kelley Blue Book .,,• ~, ~~~ ~ THIS TAt~7'ED- ~ovRC~ > r~~1~~S~~~f ~~ ~ ifN77 ~. 2000 Honda Civic. DX Sedan 4D Bi.~tE B~Q~ P~1~!~Tf ~~~ ~~ ehicie Highlights ileage: 26,100 ~gine: 4-Cyi. 1.6 Liter ~ansmission: Automatic rivetrain: FWD Condition Excellent Good (Selected) Fair advertisement Hey [+~ok* a b~t~ tricked-out price tai r Value $5,245 $4,820 $4,320 :Selected Equipment Standard €Air Conditioning Tilt Wheel Dual Front Air Bags :Power Steering AM/FM Stereo _......__..,_~..~,..~.._..~..,w.~.,M..m..:~.,.,.,.,.,...~...~ a vertisement „ `~`~ _~~~~~: Honda Civic Learn More Dealer Locator Inventory Extended Special Offers Warranty ~, ~Z~3~. Presented by: Blue Book Private Party Value Kelley Blue Book Private Party Value is the amount a buyer can expect to pay when buying a used car from a private party. The Private Party Value assumes the vehicle is sold "As Is" and carries no warranty (other than any remaining factory warranty). The final sale price may vary depending on the vehicle's actual condition and Iota) market conditions. This value may also be used to derive Fair Market Value for insurance and vehicle donation ur oses. Vehicle Condition Ratings Excellent $5,245 Page ~1 of 2 ` Send to Printer i:nfier ~P cadet http://www.kbb.tom/kbb/UsedCars/PricingReport.aspx?Yearld=2000&Mileage=26100&VehicleClass=UsedCaz&Manufactu... 4/15/2010 Close Window 2000 Honda Civic -Private Party Pricing Report -Kelley Blue Book ~ ~ ~ Page 2 of 2 .~ • Looks new, is in excellent mechanical condition and needs no reconditioning. • Never had any paint or body work and is free of rust. • Clean title history and will pass a smog and safety inspection. Engine compartment is clean, with no fluid leaks and is free of any wear or visible defects. • Complete and verifiable service records.' Less than 5% of all used vehicles fall into this category. *~' Good (selected) $4,820 Free of any major defects. • Clean title history, the paints, body, and interior have only minor (if any) blemishes, and there are no major mechanical problems. • Little or no rust on this vehicle. • Tires match and have substantial tread wear left. A "good" vehicle will need some reconditioning to be sold at retail. Most consumer owned vehicles fall into this category. Fair ~~`'~ $4,320 • Some mechanical or cosmetic defects and needs servicing but is still in reasonable running condition. • Clean title history, the paint, body and/or interior need work performed by a professional. Tires may need to be replaced. • There may be some repairable rust damage. Poor ~ _ N/A • Severe mechanical and/or cosmetic defects and is in poor running condition. • May have problems that cannot be readily fixed such as a damaged frame or arusted-through body. • Branded title (salvage, flood, etc.) or unsubstantiated mileage. Kelley Blue Book does not attempt to report a value on a "poor" vehicle because the value of these vehicles varies greatly. A vehicle in poor condition may require an independent appraisal to determine its value. * Pennsylvania 4/15/2010 http://www.kbb.com/kbb/UsedCars/PricingReport aspx?yea~.Id=20008cMileage=26100&VehicleClass=UsedCar&Manufactu.,, 4/15/2010 ~~ ~OSEPI~i JAMES JEWELERS TO WHOM IT MAY CONCERN: This is to e«tity that we are ettgaged in the jewelry business, appraising diamonds, watches, jewelry and precious stones of all descriptions. We herewith certify that we have this day arefully examined the folbwing listed and described articles, the property of: NAME: Estate of Mary Lou Snyder ADDRESS: c% William Snyder 1600 Carlin Lane McLean, VA 22101 We estimate the value Y listed for insurance or other tntroosq at the current ret>,il r,h~~ •url~vline F..t...l e...1 ...1... •~.. _-. --_ ..._._ ..o .... ,.,,,,.-.~...` .,v ..v ~ agrtx u7 pwcnase Or replace the I The following items were evaluated for estate purposes: DESCRIPTION State House sterling silver flatware. The set consists of the nine full settings: dinner forks, salad.forks, and knives with 17 teaspoons and additional miscellaneous serving utensils. The manufacturer is State House with the pattern being Formality. The entire set weighs approximately 45.8ozt. Value: $779.73 State House was a line of three patterns Oneida made for private distribution. The three patterns under the State House name were Formality, Inaugural and Stately. The patterns were not distributed through department stores nor jewelry stores, the conventional distribution channels of this time (1942-1960's). )ilrrl l~Yl~tVll .pl /.VV ~JGI uVy Vuut,:G iiJ UI VGLOUCrL, LUUJ. ~~~~~~ October 2, 2009 . DAMS P.G. The foregoing Appraisal is made with the understanding that the Appraiser atnumes no liability with respect to any anion that may be taken on the basis of this Appraisal. 301 East Main Street • Mechanicsburg, PA 17055 ~ (717) 795-922.4 ~~ ~~~ ~~~ ~OSEPIi JAMES JEWELERS TO WHOM IT MAY CONCERN: This is to certify that we arc engaged in the jewelry business, appraising diamonds, watches, jewelry and precious stones of all descriptions. We herewith certify that we have this day carefully examined the following listed and described articles, the property of. NAME: Estate of Mary Lou Snyder ADDRESS: c% William Snyder 1600 Carlin Lane McLean, VA 22101 We estimate the value as listed for insurance or other arrmses u the n,rrarnt ..r.~i ...i,....,.i.s.... r...r..._~ __., _.~.__ .____ ,_ -_._• ... _ _ _. _- o _ ______ _.__ _____..~.__. .............1, ....a r.yy.a.a.~ ..c uv t.v ^ agree W purchase Of replace the The following items were evaluated for estate purposes: DESCRIPTION Lady's 14K yellow gold sapphire and- diamond neckpiece. The three stone, l = 4.9mm genuine sapphire and two approximately 3.6mm round brilliant cut diamonds, approximately .32ctw. ~ The snake chain measures approximately l.Smm in diameter by i7 inches long. Value: $180.00 1 --- - - - a_____- ~--~°~"~ October 1, 2009 JAM D. DAVIS P.G. The foregoing Appraisal is made with the understanding that the Appraiser aswmes no liability with respect to any action that may be taken on the basis of this Appraisal. 301 East Main Street • Mechanicsburg, PA 17055 • (717) 795-9224 UPi~I~P ~OSEPIi JAMES JEWELERS TO WHOM IT MAY CONCERN: This is to certify that we are engaged in the jewelry busineu, appraising diamonds, watches, jewelry and precious stones of all descriptions. We herewith certify that we have this day carefully examined the following listed and dest:ribed articles, the property of NAME: Estate of Mary Lou Snyder ADDRESS: c% William Snyder 1600 Carlin Lane McLean, VA 22101 We estimate the value as listed for inwrance or other purposes at the current retail value. excludine FMtM,t and rvhwr rs,v... ~„ ....4:_...~:_ . ______. _.._ .... _...... v ----- -rr -•--• --- ~~ • v . oyca au taww~rax Vr fCplaC.e cnc I The following items were evaluated for estate purposes: DESCRIPTIO\ Lady's 14K yellow gold diamond heart pendant. Each of the six round brilliant cut diamonds approximately 2mm in diameter These diamonds weigh approximately .18ctw. Each is prong set within an asymmetrical wire design. This heart measures 29mm x 24mm. Value: $128.00 _ __- - October 1.2009 JAM . DAVIS P.G. The foregoing Appniul is made with the understanding that the Appraiser aswmes no liability with respect to any action that may be taken on the basis of this Appraisal. 301 East Main Street • Mechanicsburg, PA 17055 • (717) 795-9224 ~~~ ~ ~ i ~ ~ i i ~ , ~ -t. ;~ r ~:~ :a z= ~=_ _ ~OSEPIi DAMES JEWELERS TO WHOM IT MAY CONCERN: This is to certify thu we sre engaged in the jewelry busineu, apprising diamonds, watches, jewelry and precious stones of all descriptions. We herewith certify that we have this day carefully examined the following listed snd described articles, the property of: NAME: Estate of Mary Lou Snyder ADDRESS: c/o William Snyder 1600 Carlin Lane MclJean, VA 22101 We estimate the value as listed for insurance or other purposes at the cttrrrnt retail value, excluding federal and other taxes. In making this Appraiul we DO NOT agree to purchase or replace the The following items were evaluated for estate purposes: DF,SCRIPTIO\ Lady's 14K yellow gold sapphire and diamond cluster pendant. The custom pentagonal pendant contains six round brilliant cut diamonds, approximately .16ctw. and five round sapphires, approximately .20ctw. The pendant measures approximately l Omm in diameter. The rope chain measures approximately .70mm x 18 inches long. Value: $120.00 - - .-.-October 1, 2009 AM D. DAVIS P.G. The foregoing Appraiul is made with the understanding that the Appraiser auumes no liability with respect to any action that may be taken on the basis of this Appraiul. 301 East Main Street • Mechanicsburg, PA 17055 • (717) 795-9224 8 Market Plaza Way _ (717) 697-4696 Mechanicsburg, PA 17055 www.malpezzifuneralhome.com Jeremy J. Shartzer, FD Michael J. Malpezzi, Owner, FD Kyle C. Knipe, FD October 21, 2009 William R. Snyder 1600 Carlin Lane McLean, VA 22101 The Funeral Service for Mrs. Mary Lou Snyder We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please feel free to contact us if you have any questions in regard to this statement. THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT', AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS. 1. PROFESSIONAL SERVICES Services of Funeral Director/Staff $4275.00 FUNERAL HOME SERVICE CHARGES $4275.00 SELECTED MERCHANDISE: Solid Oak Casket $3095.00 Butterfly Register Package $85.00 Laminated Obituazies $24.00 DVD Memory Slideshow $30.00 THE COST OF OUR SERVICES EQUIPMENT AND MERCHANDISE THAT YOU H , , AVE SELECTED $7509.00 AT THE TIME FUNERAL ARRANGEMENTS WERE MADE, WE ADVANCED CERTAIN PAYMENTS TO OTHERS AS AN ACCOMMODATION. THE FOLLOWING IS AN ACCOUNTING FOR THOSE CHARGES. CASH ADVANCES Opening Grave Cemetery Equipment $112.00 Certified Death Certificates $275.00 Newspaper Notices -Patriot $150.00 Newspaper Notices -Lansdale r $238.32 Clergy/Mass Offering $29.48 Organist $250.00 Deacon Jack Paruso $125.00 $100.00 TOTAL CASH ADVANCES AND SPECIAL CHARGES $2558.80 SUB-TOTAI, $10067.80 INITIAL PAYMENT /DISCOUNT /CREDITS --- ------------ TOTAL AMOUNT DUE $10067.80 1' ~ w I„i°~ P~` Malpezzi Funeral Home ~ V N E~A~. ~~~,~c2 LKOSTE VILLA CAFE 2151 FISHER RO I~CHAHISCBUR6~ PA 11855 TERMINAL Id. 8818$8236 MERCHANT #: 316218859998 VISA #R ?xxxx xxxxxx6595 . SALE BATCH: 888397 IHUQICE: 891359 SQTE~ 2CT 83: 09 I 8 pUTN NO: 83515C PRE-TIP AMT ~ 1133.00 TIP TOTAL CUSTOMER COPY The- Patriot-News Co. 812 Market St. 'H~ rri$ b u rg, PA 17101 Inquiries - 717-255-8213 R. MARK THOMAS ATTN: JOETTE L. MCGOWEN 101 SOUTH MARKET STREET MECHANICSBURG c~he ~1a~iot News NOw you know PA 17055 INVOICE ALL CHARGES ARE NET ACCT # NAME AD ORDER # DATE EDITION ADDTL. INFO. TYPE OF CHARGE AMOUNT 35242 R. MARK THOMAS 35242 R. MARK THOMAS 35242 R. MARK THOMAS 35242 R. MARK THOMAS 0002026372 11/20/09 METRO WEST 0002026372 11/20/09 METRO WEST 0002026372 11/27/09 METRO WEST 0002026372 12/04/09 METRO WEST BOLD TEXT CHARGE BASIC AD CHARGE BASIC AD CHARGE BASIC AD CHARGE AFFIDAVIT CHARGE TOTAL: REMITTANCE ADDRESS The Patriot-News Co. 23794 Network PL Chicago, IL 60673-1237 t Please include the Account # or Ad Order # (above) with your remittance--Thank You NOTE: This Invoice replaces the Order Confirmation which we previously sent with Proofs of Publication $4.00 $46.39 $46.39 $46.39 $5.00 $148.17 ~~ ~ ~s~ CUMBERLAND LAW JOURNAL 32 SOUTH BEDFORD STREET CARLISLE, PA 17013 Tele: (717) 249166 Fax: (T17) 249-2683 . December 4, 2009 Cumberland Law Journal is published every Friday by the Cumberland Coun Bar Association and is designated by the Court of Common Pleas as the official le al publication for Cumberland County and the legal newspaper for publication of legal notices. TO: R. Mark Thomas Esquire Mary Lou Snyder Estate RE: Legal advertisements must be received by Friday Noon. All legal advertising must be paid in advance. Make all checks payable to: Cumberland Law Journal. Advertisement inserted on following dates: November 20, November 27, and December 4, 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 I x ~~~~ Page No. of Pages •` Commonwealth Chimney Sweeps Harrisbur Main Office:. g (717) 541-8473 Chimney and Air Duct Cleaning Lancaster (717) 393-6777 Palmyra (717) 838-6699 6059 Allentown Boulevard • Harrisburg, PA 17112 York 717) 852-4488 PROPOSAL SUBMITTED TO ~ PHO NE (^ ~` DATE 7 1p ) (/_/~ ~~ JOB NAME 1 _ r- CITY, STATE. AND ZIP CODE JOB LOCATION ..~ ARCHRECT DATE OF PLANS JOB PHONE We hereby submit specifications and:estimates for:. r~ r i~/~.J ~. ~ .rte ~ s% ~ e~ ~r f ~.ars !~~ .~ ~ •?^~ E ~r>Or~ge h ,reby to furnish~rlateri I and labor -complete in ac~ance with above specifications, for the sum of: ~~ ~ G~/~r ~~` t~ w /'~ /C~ F ~~ .~ ~.~----mod ~ ry-~ L ~-• / (~ dollars ($ f26~ . ~ ~ ) . 'aym to be made as follows: All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Arty alteration or deviation from above specfica- Authorized _ lions involving extra costs wilt be executed • only upon written orders, and will become an Signature • extra charge.over and above the estimate. All agreements contingent upon strikes, accidents or delays b~yQnd our control. Owner to. carry fire, tornado, and other necessary insurance. Note: This proposal may be Our workersare fuly covered by Workmen's Compensation Insurance. withdrawn by us if not accepted within days. ~~~~~~ ~~ ~X~~$~~ -The above prices, specfications and conditions are satisfactory and are hereby accepted. You are authorized to Signature do the work as specfied. Payment wilt be made as outlined above. Date of Acceptance: Signature .. NDYMAN MA~TERS}.A 1860 MO~O1N ~` [hTMC ; REG~ PA000032 Huitrnelslown, P11 t7Q36 BILL TD Linda ~ George Karlin 1784 N Meadow Drive Mechanicsburg, PA 17055 WORK LOCATION Mother's House 514 E. Coover 3tr~ee! Mechanicsburg, PA 17056 INVOICE INVOICE DATE INVOICE # 1?111/2009 10'172 Customer Phone (717 610.3173 P A I D DEC 4~ _~._ P.O. NO. TERMS CRAFTSMAN Due Upon Receipt RAMO DATE ITEM DESCRIPTION REP QTY RATE AMOUNT 2/11 Trip Charge Service charge RM 30,00 30.00 1218/2009 Labor Removed and replaced 12 sq ft of shower floor file RM 72.00 432.00 1?J912~09 Labor cleaned and grouted. file RM 7Z.00 216.00 2111 Labor sealed grout RM 72.00 72.00 2/11 Materials thinset, grout, file RM 119.75 119.75 2/11/2 Discount ... Coupons and Printed Offers-10°~O off TY coupon RM -72.00 72.00 Thank you for lour business. Sub~tai ;797.75 PA Sales Tax {6.0°i6j ~~ 1Ne acce t checks Dlsco~rer mod d V[ Pl p , , , an sa. ease call in your card number. As P~ !/~ si9nsd PEA ~ due on completion of work. Any unpaid balance i Totai accn,.s arthe rate of 1.5% psr month {tax APR). of isgal action is n3quir+sd m X797.75 co1Nd unpaid funds, you art resporedble for all coilectlon c~sts _ ' EFFECTIVE.glL.Y 1, 2009 tlorE BIIPROVEMENT CONTRACTORS tN PA MUST BE Paym@nis~Credifis ~~ REGISTERED VYtTH THE ATTOf~EY GENERAL'S OFFlCE. CONSUMERS MAY CALL THE CONS PROTECTION OFFICE AT 1-S88-SZO-6880 {TOLL FREE) TO OBTAIN II~ORMATION ABO T BaranCe Dt1@ U CONTR/1CTOR REGISTRATION tN PQr1~YLVANUI ~797.T5 TEL (717j 566-$604 FAX {717j 566-6778 a ,, , 10;"4:'iO~i 13:54 #UG16298 HAMMY c-USt~rr~er:SNl"f)ER/jvll.L:IAM --- ~ k of 2 - --~ - _-Ltrm ~~cY _ ..- - -- . _ ___ - -- Prue mounT. -1-~-- 4ZS7II TV ~G~.-I- 4~;~,ar 1~RA~N Ea 17.9 ~ 17 9~- ~ ~.4~)()fs 1 j . 8i_tJFT SFFtA ' tl. ~)9 11. 9c~ c; F t=R i h1 ~A :~~rbtc~ta ! 4 ~ 9c sa lei r:,x . 1. 8U Total Cdr-rN ~ ~ ~a r _ ~ ear~lc car•~t ~t. ~8 yard Ac~-i rX ~:kxx~;x;;xxxxxG59S Ar,tf~ori 4atiorr OS5-14~~ THANK YaU FdR SHdPPING AT BITTERS MONDAY - FFi1aAY B:OOAN1 TO 6:OOPM SE1TU,~pAY g;00AM TO S:OOPM fit' JGAY ~10.OOAM TO 3:OOPM THE HOMF_ DEPOT 4120 6000 CARLISLE PIKE, MECH PA 17055 STORE MANAGER CHET KEELEY (717}795-9602 41X1 00009 96348 10/30/09 SALE 11 KAM5485 08:08 AM __ _ _ F --- ~--- isoe . a4~,~~ ~> ~ ~{~ ~~~~ 043168718455 40W GLOBE <A> 4.77 076607026460 3X VF 220 <A> 3.97 051131642041 PACK TAPE <A> 2.97 077089217049 2 1/2"BRUSH <A> 8.97 ~. 020066163150 PAINT <A> 8.39 --~~ SUBTOTAL 29.07 SALES TAX 1.75 - TOTAL $30.82 XXXXXXXXXXXX6595 VISA 30.82 -~ AUTH CODE 00585C/2097182 TA r iii I i 4120 09 96348 10/30/2009 1508 ~: --- POLICYUID~PODAYS DEPOLICYOEXPIRES ON A 1 90 01/28/2010 THE HOME DEPOT RESERVES THE~RIGHT TO ~: LIMIT /DENY RETURNS. PLEASE SEE THE RETURN POLICY SIGN IN STORES FOR _ DETAILS. GUARANTEED LOW PRICES LOOK FOR THOUSANDS OF LOWER PRICES STOREWIDE ~r~r~r~r~c~r~r~r~c~r~c~c~c~cx~~r~r~r~r~r~r~r~c~r~rx~r~r~rx~~r~r~r~r~rx~r ENTER FOR A CHANCE TO WIN A $5,000 HOME DEPOT G2FT CARDi Share Your Opinion With Ust Complete the brief survey about your store visit - and enter for a chance to win at: www.homedepot.com/opinion TPARTICIPE EN UNA OPORTUNIDAD OE GANAR UNA TARJETA DE REGAL.O DE THD DE $5,000! ~Cornparta Su Opinibnt Complete la breve encuesta sobre su visits a la tienda y tenga la oportunidad de ganar en: www.hornedepot.com/opinion Usor ID: 1.97105 192994 Password: 9530 192985 - ._. :. Entries must be entered by 11/29/2009. Entrants must be 18 or 01 der to enter. .; ~` ~~ `' ~ See complete rules on website. No ._ w~T - ~+ +~•"+ /~ Q 7~ ~~ ~' 1I~11K REMOVi4L SERViCE~ ~ ~ ~ T V ~~ P,Q Bax 4706 Lancaster, PA 17604 ~~~t~ ~ ~ ~ ~ ivloving; [~ G~ !~ r~:n~-saz.~ ~st5-572-5'396 Dail: 1 Z Driver: , C Name: _._.~ _ ~~~...._ Route;r<: Company Name: __._____. ._._ .__._..~ Start Time: tw~uing ~~~: `' 1 ~ ~d run8: -____ ----~ .................~ wwa~conr vetaur ccar~,ea Home. ~Q ~~ - P/Postal:- .~~~~~7 ~~ _ _ Dif~ce......_..... _._ -._ ______...._.__._..._ --~ Job ID: %~~01 ~~(p d _ Pidc~gr Airire~ ....._._.~......~... _ City:._..._..._._.......__._..._._._...~_ Load description t~Aa .n dw wwn wcwta~ac w.dict~s bMa tMw acaa~e an dw ~ 30 2!G ~lK~ lK%p~raomwR Asaiww~~al~antof~e ~. 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