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HomeMy WebLinkAbout07-01-1015056051058 REV-1500 EX (06-05) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 10 0596 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 193-24-0647 03/05/2010 06/30/1932 Decedent's Last Name Cree Suffix Decedent's First Name Mary (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number MI A MI 198-30-2056 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGiS~'~R ©F WILLS FILL IN APPROPRIATE OVALS BELOW `• 1. Original Return _., 2. Supplemental Return 3. Remainder Return (date of death 4. Limited Estate 4a. Future Interest Compromise (date of d h pnorto 12-13-82) 5. Federal Estate Tax Return Re uir d eat after 12-12-82) q e 6. Decedent Died Testate (Attach Copy of Will) 7. Decedent Maintained a Livin Trust g (Attach Copy of Trust) 0 8. Total Number of Safe Deposit Boxes 9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of death b t 11. Election to tax under Sec 9113(A) e ween 12-31-91 and 1-1-95) . (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST B E COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORM Name ATION SHOULD BE DIRECTED TO: Daytime Telephone Number Michael A. Scherer, Esq (717) 249-68~ '`' c~ Firm Name (If Applicable) --, ' -, ~ t ...Q ~ Barlc Scherer REGISTER ~~ LS USE ~y r;``' First line of address - 19West South Street ~ ' %~ ~ -, Second line of address ~ ; ~ ,~ C_ - City or Post Office A: ,7 ~~ -o~ State ZIP COde _ DATE FILED Carlisle PA 17013 Correspondent's a-mail address: mscherer@baricscherer.com 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. SIGNATU PERSO PONSI FOR NG RETURN ~ ~~ DATE ADDRESS 409 Holly Drive, Dauphin, PA 17018 SIGNA~wE r~F PREPAR~R OTHER THAN REPRESENTATIVE DATE 6/r> /iv 19 West South Street, Carlisle, Pennsylvania 17013 PLEASE USE ORIGINAL FORM ONLY L_ 15056051058 Side 1 15056051058 REV-1500 EX 15056052059 Decedent's Social Security Number _.._. Decedents Name: ary A Cree 193 24 0647 RECAPITULATION - - ~-~--'-µ----- ••---.-....,. _._ 1. Real estate (Schedule A) .......... ....... ................ ......___.... .................. . ........... ..... 1. 2. Stocks and Bonds (Schedule B) ....... ........................... .... . 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages & Notes Receivable (Schedule D) .. ....................... .... 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) .... .... 5. 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ... 7 .... 6, 18 723 34 . Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property , . (Schedule G) ~ Separate Billing Requested.... .... 7. 8. Total Gross Assets (total Lines 1-7).. . ... ................... 18,723.34 9. Funeral Expenses & Administrative Costs (Schedule H) ................. .... 9. 7,889.87 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............ .... 10. 4,286.82 11. Total Deductions (total Lines 9 & 10) ...... _.. ..................... . ... .... 11. 12,176.69 12. Net Value of Estate (Line 8 minus Line 11) .. ....... . ................ 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which .... 12. 6,546.65 an election to tax has not been made (Schedule J) .................... 13 . ... . 0.00 14. Net Value SubJect to Tax (Line 12 minus Line 13) _,. ..... . ............... ~._ ~._.._.~._._,._.._~.____wW_____~-~---- TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABL S - ... 14. _........ 6,546.65 ~.rya.e. E RATE 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0_ 16. Amount of Line 14 taxable """"""'""'"""" 15. at lineal rate x .0 45 6,546.65 16 17. Amount of Line 14 taxable "`""""°'"'"'" • ~._ 294.59 , at sibling rate X .12 18. Amount of Line 14 taxable ~ ~ ~ `` _,. at collateral rate X .15 ' 18 .,.... 19. TAX DUE .......... , ............................................ ... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~; 15056052059 Side 2 15056052059 C,ERTtFICATE OF TCT F VEHICLE - V .n '''~ ~ J .~./ F~~ I 1EHICC~"tt3iFlC~r MU § \ 1~ .' 114 V~'i~rl I~ oasarl~l~~r yy~„{ IN dl ~ d I UM ~~' Y ~ ~ of:9 ~~~~Y~k ~ a Y.k9.~ ~~ ~r-a4 a v BOD 7'~PE ~c& ~ r t ' _ ~ ~ ~~J1P ~ II~~IO~tfITL~9TATE ~ '~ ~ P t~~ ~~ ILE` ~~,i ~,...~.,; y~1 ~~J r1y~ N 1~11~16II ~I I~~IIIIr I!' k II ~ D Tk~TY .~. LT~,pI. j--LJ-y. y ;.~;t :;: .::;PP:C;:4BPJ:ao":Y::6,.~,,, .; , "'.~ ,,,.~„ :f"~, ,.. ~.,,..~..,.. vo .~ .... ...... ...... . ..; • DAT .. ,,,,,, o, ~ , A EOFISSUE UNLADEN WEIGHT ,e,...,, ~ , , oo .,,e .~.., ..., ,.,. .,..<..~.,.,,.oa,.,,.e , E P .. TIT ` ~.. A LED ~D T , GVWR ,,..,,,.r,°eb.A.~,ti..,o .,, ,,.~..,o.~.. ,,.....,J . 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BY AUTHORIZED REPRESENTATIVE CITI.Z'E1~5 AUTO ~I~IANCE CO PO BOX X555$? SACRA~IEIUTO CA 95$b5 I certify es of the date of issue, the official records of the Pennsylvania Department A~ ~ ~~ ~ ~ ~ ~~~ of Transportation repeat that thepersoh;s) or company ,~~ad herein isNe lawfulovmar ~ • of the said vehicle. ._ '~ Secretary of Transporfatioa ~ '' 1 1• . 1 1• , 1 iuescRleED ANC swORN 1f a co-purchaser other than your spouse is listed and you want the title to qn&EFORE,~ME N ~;Iru, u,l- -. be li tad. as " 'nt Tenants tth Ri ht of S , ~ orship" ~ ri deatft one i 4'G971Itr~ ~VIi411tilWllydma ~ ,,....~,. _.. -.~ . __~.. ~. ..,a i PFPS^rr a_~ILIISI ~. ~'NG U~'- I ~ ~ .- _. - ? \\ .. ~. T~ ~~.~. ~ ~t . m~ -. ati - ~ r , ~ t me ~~ ~.r,; ~re ~Leyey ~ n.,.n.itve,. ~~ „~v,~.,, I ic. Mere. ~,.^F'f .`IGMAiUgE OF§AP~L7CAt~~' IZED SIGNE~+ „~ ii 1STLl~NHOLD~~1 ~~ 31RELT ~_ TY ' FIN~NCPAL Ih;STfT'JT ~survrvt~~~wnFr r ~"H~,G;1~kiE ~. ~` rwls~, t~~~tte ants N~mmon (O'n°N~e~fh o~`'ona own r, interest cM, -to hr h Irs m estate). - • IF no ESE 1 r ~ ~~. ~,.a 'V1\\1h\1\1t" ''1,,,,,, t tr 11V1 INSTITUTION NUMBER iF NO LIEN.,CHECK i STATE ZiP M.~y 26 2010 4:42PM HP LRSERJET FRX 717 795 8870 p,2 PENNSYLVANIA INHERITANCE TAX INFpRMATION NOTICE BUREAU of INDIVIDUAL rAxES AND FILE N0. 21 Po Box 2BO6a1 TAXPAYER RESPONSE ACN 10125534 HARRISBUR;6 PA 1T12B-0601 DATE 05-06-2D10 AN-lsaa EII RrP <W-~~~ RAY F CREE JR 409 HOLLY DR DAUPHIN PA 17018 EST. OF MARY A CREE SSN 193-24-0647 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND. FORMS TD: REGISTER OF WILLS 1 COURTHOUSE SpUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. SUSQUEHANNA BANK Drovided the Departnent with the information below, which has boon used in caleuletinp the potential tax due. Records indicate that at the death of the abnve•nansd decedent. you ware a joint owner/ban°ficiary of this account. If you foal th• informati0n is incorrect, please obtain written correction frog the financial institution, attach a copv to this form and return it to the abare add rasa. This account is taxable in accordance with the inheritance Tax laws of the Cofmaonwsalth of Pennsylvania. Pleess calY (71%) 7BT-6377 withtluestians. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 115D01353 Dat• 08-22-2006 To ensure proper credit to the account, two Established copies of this notice must accoapanir 16 D74 77 pay'"°nt to the Resister of Wills. Mak• check Account Balance $ , . vavsble to "Resistor of Mills, Asent^~ Percent Taxable X 50.000 Amount Subject to Tax y~ 8,D37.39 NOTE, If tax payeents ors ^ede within three nonths of the decedent's date of death, Tax Rate X , 1 5 deduct a 5 percent discount an the tact due. Arnr Inheritance Tax duo will become delinquent Potential Tax Duo $ 1,205.61 nine nonths after the date of do at h. PART TAXPAYER RE PONSE a A. ~ The above inf ornetion end tax duo is correct. Remit payaent to the Register of Wills with two copies of thif notice to obtain CHECK a discount or avoid interest, or check box "A" end return this notice to the Register of Mills and an official assessnent will be issued by the PA Devartaent of Ravenuo. C ONE BLOCK B. ~ The above asset has been or will 6o reverted and tax paid with the Pennsylvania Inheritance Tex return O N L Y to be filed by the estate representative. C. ~ The sbeve info ation is incorr ct and/or debts and deductions wars paid. Cotavlete PART ~ and/or PART ~ below. PART If indieatinp a different tax rate, Dlease state relationship to decedent: TAX RE TURN - CO!NPUTATION DF TAX ON JOINT/TRUST ACCOUNTS. ~~ LINE 1. Date Established ~ L ~~ _ ~ 2. Account Balance 2 $ 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 $ 5. Debts and Deductions 5 6. Amount Taxable 6 $ 7. Tax Rate 7 X 8. Tax Dua B $ PART DEBTS AND DEDUCTIONS CLAIMED a DATE P AID -PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare chat the facts [ have reported above are true, correct and complete to the best of ey knoMledge and belief. HOME C ~ WORK C TAXPAYER SIGNATURE TELEPHONE NUMBER DATE May 26 2010 4:42PM HP LRSERJET FRX GENERAL INFORMATION 717 795 8870 p,3 ). FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based on information submitted by tM financial institution. 2. Inharitanca Tau beeoro: delinquent nine months attar the decedent's deto of death: 3. A joint account is taxable ^von when tM decedent's name was added vs a matter of eonvenienee. 4. Accounts (including those hold between husband and wife) the docadant put in joint mamas within ono year prior to death are fully taxably. 5. Accounts establishotl iointly batwamn husband and wife more than one rear prior to death era net taxable. 6. Accounts field by a decadent "in trust for° another or others are fully taxable. REPORTING INSTRUCTIONS - PART. 1 - TAXPAYER RESPONSE 1. BLDCK A - If tM information and eomputetign !n the notleo era correct and deductions era not being elaiaod, place an =X" in Blodk A of Part ] of tM "Ta~rpayer Response" section. Sion tuo copies and submit thaw with a check for the amount of tax to tM register of wills of the county indicated. The PA Oopartaant of Revenue will issue an official assosameat (Form REV-1546 EX) upon receipt of the return from the register of wills. 2. BLOCK B If the asset spaeiflad on this notleo has been or wail be reported end tax Dafd with the PonnsYlvania ~nhsritsnea Tax Return fi]ad by the estate's raprasentetiva, place sn "X" in Block B of Part 1 of the "Taxpayer Response" section. Sisn one copy end return to the rvgistor of wills of the tounty indicated, 3. BLOCK C - If the Holies lnformatien is incorrect and/or doductiens era being claiaed, chock Black C and cemplote Parts 2 and S according to the instructions Dolew. Sian two copies end submit than with your check Far the amount of tax payable to the ragiator of walla of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-1540 EX) upon receipt of the return frog Oho register of wills. LIME TAX RETURN - PART 2 - TAX COMPUTATION 1. Enter the date the account originally was established or titled to the manner existing at date of death. ROTE, for • decedent who died aftarl2/12/82, accounts the decedent put in joint naaes within ono year of death era fully taxable. However, tharo is an exclusion not to exceed e3,000 par transferee. raoardloss of the value of tM weount or the nuwbar of accounts held. If a doubl^ asterisk Csa) appears before your first newe in the address portion of this notice, the 63,000 exclusion vas deducted from the account balance es reported by the financial institution. 2. Enter the fetal balance of the account including interest accrued to the data of death. 3. The pereentago of tM account that is taxable to each survivor is determined as foilewss A. the percentage tastable of joint assets established Sara than ono year prior to the decedent's depth: 1 DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL HUMBER OF MULTIPLIED $Y 100 = PERCENT TAXABLE JOINT OWNERS SURYIVINI: JDINT OWNERS Exaap]e: A joint asset registered in the Hams of the dacadsnt and two other persons: 1 DIVIDED BY 3 CJOINF ONRIERS) D]Y1DED BY ? (SURVIVORS) .167 X lBa 16.7 percent (TAXABLE TO EACH SURI/IVOR) H. iha percentage taxable for assets croetad within one yoar of the decedent's death or aceeunts owned Oy the docadant but held in trust for another individual(s) [trust bonefieiaries7: l OIYIDED BY TOTAL NUMBER OF SURYIVTNC JOINT HULTIPLIEO BY 16p PERCENT TAXABLE OWNERS OR TRUST BENEFICIARIES Exarple: Ja1nt account registered in the memo of the decedent and #wo other Parsons and establiahad within orta yoar of death by the decadent. i DIYIDEO BY 2 (SURVIVORS) _ .50 X 100 = 50 percent (TAXABLE FDR EACH SUpVIVOR) 4. The mount subject to tax (Line 4) is detorminad by multiplying the account balance (Line 2) by the percent taxable (Lino 3). 5. Enter the total of the debts and deductions Iistod in Part 3. L. Tho amount taxable (Lino 67 !s deteralnad by subtracting the debts and deductions (Line 5> from the amount subioet to tax [Lino 4). 7. Enter the approariata tax rate (Line 7> as detarmined below. ,,, A.p1,k,~.,,,gf Death $POUSO Lineal Siblin , $ Collgtera 1 07/01/94 to 32/31!94 3 percent 6 portent __ 15 porcont _ _ _ f15 pgreeht ~~ D1/O3/45 to 06/30/00 0 percent 6 porcont 15 percent 15 percent 07/O1/00 to preseht e • ax ra a imposed on • 0 portent na value of tran 4.5 percent +: s era raw . . 12 percent ,,. 1S porcont ----•• - ~ - an. use or a naeural parent, an adoptive parent or a stanpannt of tM•child SswOgar at Tho lineal class of hairs includes grandparents, parents, children and other ltnoal descendents. "Children" includes natural children whether or not they hara boon adopted by othors, adopted children and step children. "Lineal descendents" includes all children of the natural aaronts and their descendents, whether or not that' hays bean adopted by others; adopted descendants and their descendants; and step-dascendanta. "Siblings" are defined as individuals who hara et least one parent in common with tM dacadsnt, whether by blood or adoation. Tha Leilatoral class of hairs includes ell other bonefieiaries. CLAIMED DEDUCTIONS - PART 3 - DEBTS AND DEDUCTIONS CLAIMED Allowable debts and deductions are determined as follows: A, You era legally roaponsible for aayaent, er the estate subject to administration by a pmrsonal representative is insufficient to pay the deductible liars. B. Yau actually paid the debt: of for the tlaath of iha decedent and can furnish aroof of pay cont. C, Debts being elaised must ba itaniied fully in Part 3. If additional space is needed, use B I/2" x 11" shoat of papa r. Proof of payment may be roquastod by the PA Department of Revonw, May 26 2010 4:42PM HP LRSERJET FRX 717 795 8870 p 1 F~vc covE~ sH~~Y CREE'S WLLDlNG $ FABR/CATl4N, lAIC. ~aECrr~a~4`iwc eu~, P ~ mso PHONE TtT-T9S-8Tt t FAX 777-T9~S-887p TO: Y Y1 .~ ~n ere COMPANY NAME: ~ (~ ~ ~ ~ ` Da ~l G ~" ~ ~ ~-~r' FAX N1JM8ER: "1 f "'~ _ ~ 1.-~ FROM,: ~ a, ~ ~~ ~~ _,.___ ~if" . DISCRIPTIaN: ~ S S ~ S `~-~} C 1 h ~' 1 P,.~i ~ (/1 C~ ~~ ~ .. j 1 n`~r~~r.~`~ ~,.~ V~o`h c~ tc~. ~.~i c~ Ca ~ j ~ Lts , NtJ1YtsER ~ PAQES SENT (lnctuding Cover Shset): OATS SENT: N than is a ro m recelving tNs trsryrnissian please contact; Check Us Orrt... On The WFB! www. creeswef ding.com ~,~~iedeman FUN Dennis L. Wiedeman, F.D.-Supervisor Jomes W. Taljan, F.D. William A. Sibert, F.D. Lisa M. l4'iedeman-Krasnar, F.C. March 24, 2010 Mr. Ray F. Cree, Jr. 409 Holly Drive Dauphin, PA 17018 ERAL HOME STATEMENT O F The Funeral Service of: Mrs. Mary A. Cree A. CHARGE FOR SERVICES SELECTED: 1. PROFESSIONAL SERVICES $ 293:;.00 2. FACILITIES/SERVICES/EQUIPMENT:$ 670.00 3. AUTOMOTIVE EQUIPMENT: $ 695.00 (A) TOTAL OF PROFESSIONAL SERVICES, $ 4300.00 FACILITIES AND AUTOMOTIVE B. CHARGE FOR MERCHANDISE SELECTED: Casket .............................. $ -0- (Description) Outer Receptacle • • • • • • • • • ............. $ -0- (Description) Outer burial container • ~ • • • ~ • • • • • • .... ... $ -0- (Description) Acknowledgement Cards .......... . .. .. $ -0- Register Book(s) .................... ... $ 48.00 Memory Folders .................... ... $ 50.00 Prayer Cards .... .................. ... $ _0_ Temporary grave marker .............. .. $ _0_ Burial Clothing ..................... ... $ -0- Other Clothing ...................... ... $ _0_ Custom Graphic Design & Printing ...... , . $ _0_ Flowers .Casieei S~ray•r Ta~• .. • • . • • • • • • • $ 371.uv" $ -0- Cremation Urn ...................... ... $ _p_ Interior & Exterior Crucifixes ........... .. $ _0_ Refrigeration ........................ .. $ 0_ (B) TOTAL MERCHANDISE SELECTED $ 469.00 PAID, IN FULL RECEIVED 04/08/2010 „~ ECi~ NO. 1068 \, . ~ t ~,.~ ~, :' ` ~~ 1 ~ o ~y ~~i~+ , ,' Fa ly Owned and O A C C O U N T 357 South Second Street Steelton. PA. 171 13 Phone: 717.939.2344 Fax: 717.939.1999 email: wiedemanfh~comcast.net www.wiedemanfuneralhome.com C. SPECIAL CHARGES: Fon,~4rding of remains to $ -0- (Funeral Home) Receiving of remains from $ -0- (Funeral Home) Immediate Burial $ _0_ Direct Cremation $ _0_ $ -o- SUB-TOTAL OF SPECIAL CHARGES . ...... ... C $ D. CASH ADVANCES: Opening Grave ............... .... $ . _0_ Cemetery Equipment .............. .. $ 0_ Newspaper Notices -Local .......... $ 174.34 Newspaper Notices -Out-of-town . ... $ 69.53 Telephone & Telegrams ............ . $ 0_ Airfare ......................... . $ -0- Clergy Honorarium ................ . $ 150.00 Pallbearers ...................... . $ -0- Certified Copies of Death Certificate .. . $ 72.00 Crematory Charges ......:......... . $ -0- Organist ........................ . ~ -0- Soloist .......................... . $ -0- Other -- _ - $ -0- Other $ _ 0 Other $ -0- -0- SUB-TOTAL OF CASH ADVANCES • , , , • ... D $ 465.81 SUMMARY OF CHARGES: A. Professional Services, Facilities and Equipment and Automotive Equipment ....................... $ 4300.00 B. Merchandise ..................... $ 469.00 C. Special Charges .................. S _0_ D. Cash Advances ................. $ 465.87 TOTAL OF ALL SELECTIONS ................. $ 5234.87 LESS PAYMENTS.RECE1VEt] ................. $ ..0.00 BALANCE DUE ............................. $ 5234.87 MARY A. CREE RAY F. CREE, JR. 119 REGENCY WOODS NORTH CARLISLE, PA 17015 60-880/313 8012957 3726 Dnre A ~ ~ ~~ ~ 10 rr,F cxzi)i K oF: - ___ ------ lad CANS ~~~1_D__F'a~~_ ~~,, `~'/rr~ _ _~~A~S 8 ~~ M1p PENN BANK 1001 !l~OY YOIIMAM R ~YIIIIRIIIp~iYICnk',c~qu MEMO__~]QjN~._..~~ ~Y IS ~..~~~ . ~:0 3 1 30880 7~: 80 L 29 5~~~ 71i' 3 ? 26 BARK Attorneys-at-Law David A. Baric SCHERER Michael A. Scherer Tricia D. Naylor Of Cousel Estate of Mary A. Cree c/o Ray Cree 409 Holly Drive Dauphin, PA 17018 DATE DESCRIPTION Mar-19-10 Office conference with Ray and Pam. Draft correspondence to Ray. Obtain d.o.d. balances for accounts. Totals 19 West South Street Carlisle, Pennsylvania 17013 (717)249-6873 (717) 249-5755 -Fax admire®baricschererlaw.com Apri121, 2010 File #: 8893 Inv #: 26335 HOURS AMOUNT LAWYER. 1.50 $277.50 MAS 1.50 $277.50 Total Fees & Disbursements $277.50 Previous Balance $0.00 Previous Payments $0.00 Interest Due $0.00 Balance Due Now $277.50 NOTICE: OUR NEW FEDERAL TAX I.D. NO. IS 27-1363964 Administrative charge of 1 % per month (12% per annum) will be added to arry outstanding balance over 30 days. Payment due within 20 days of invoice date. :. 0 w r w O O :. O r -v `~ W -+] rv ~;~ ,~ ,= r ~ ~~ v . , ~ xio -~ r ~ ~ ~ ~~ ~ a~~n 3Z ~ O ~ C17 ~:~ ~ ° o ~ tri N o ~ ~ x y `j ~~ i ~ I ~' v i r t ~ O ~ ~ ~~ ~ ~ ~~ O ~ `• "e y o o ~ c~ i o~ w Q ~ zZ~ ~ r W ~ o ~ D ~~~f1 ~ O ~ O ~~ r w ~.^ ~ ~ i• o ~ loo L ~ S r Ul O O r W lJl W i r ~ O Q' ~ ~ n ~ O 3 c ~ ~ ~ ~ u~ s ~ ~ m ~ Q~ ~ ~ _~ Ray F. Cree, Jr. 409 Holly Drive Dauphin, PA 17018 Apri18, 2010 TO: Regency Parks FROM: Ray F. Cree, Jr. RE: Property of Mary A. Cree at Regency Woods This is to notify you that on March 5, 2010, my mother Mary A. Cree, who resided at 119 Regency Woods North, Carlisle, PA 17015, passed away. I will be putting her mobile home up for sale soon. I will maintain the property, lawn, and continue to make the lot payments until the home can be sold. I have also notified Lynn, the park manager, of this situation. Please direct any questions or concerns to my attention. Thank you for your understanding in this matter. Sincerely, C `~„\~ ~U"` , Ray F. Cree, Jr. Home Phone 717-921-8497 Office/Business 717-795-8711 Cell Phone 717-773-6381 :. O W r W 0 -,, ~_~ 0 r ti lJl -,] w ti r I= [Z s~ .~. e ~ ~' ~> ~:.~ J 'J ~'~ M z~ O ~, ~~ I ~I S, ~ 4 n~ ~~~ lr~;'~~ 9~~n Gp~~r1 °o~~r~ z 0 ~~ ~; w Q w N Cm d ~~, \~ ~3 Cardmember Service P.O. Box 15298 Wilmington, DE 19850-5298 (800) 436-7937 Visit us online at www.chase.com/creditcards CHASE Q Apri! 09, 2010 Irr~lll,r~lll~r~~~~ll~lrlrlrl~~ll~r~~l~lrl~~l~rr~lll~l~~~lr~ll 41961 RCS 001 003 09910 - NNNNNNNNNNNN Est Of Mary A Cree 119 Regency Woods N Carlisle PA 17015-9058 Important information is provided below regarding your account. RE: Your account ending in 8724 Dear Est Of Mary A Cree: We appreciate your willingness tbeen uaid n full and't'he ac oaunrt snclosed aslpreeously bequest d. V'~e would like to inform you that the balance has p We want to ensure that we have fully addressed your concerns to call us at 1-866-926-6909. Sincerely, Customer Support Division It you have additions! gt,itstir.=r~s, please don't hesitate Account is owned by Chase Bank USA, N.A ,._~~_ M~.. ti~ ..,,,.,ir.,~art and/or recorded to ensure the highest level of Duality service. ~aa w W °~ ~ ~ ~ © ~ a A ~ O . \ V !nl cD e~ rrt IY1 .-~ ui ..a .-. O :• fTt .-~ J .-~ ~~ ~~ a ~~, V ~ v _ U a 0 a ~ o Qa y qq C°C N a~c~ C Y r ~ m L N ~ N > 7 E m g ~U3~ ~ ~~z ~ ~ N a a ~ 8 ~ m ~ N ~ 1N m Z ~ ~ C1 G ~ `~' ~o o ~ C C O {TG~r M C ° a _.__..._ Q ti O 0 0 0 0 0 0 O 0 O O O O fl.l O 0 0 ti ti ti 0 0 0 S f1J S S O f1J m ~' W ~ - U ~ ~ W ~ Q _ ~ - wu"',z - m^o - w~~ ~oz - °m - ~ - Ua?s o$ 8~ _ O ~i ~ - °W}Q WUa ~Uw~ waWfn `~~~~Q ~S~~U - J ru Ca l J RJ L!l fL .-~ J .. ru O 0 0 .. ;.:. , '• :••~: % - Page 1 e~.~ p p' ::.. : _: Yauf:lll AL~r PPL Electric ~;=: - is92o-72017 Utilities ~' ~ ~ _,~ •=:~;~ ~~~ Electric Summary Page Service Balance as of May 4, 2010 $(1.00 For: Char es: MARY A CREE Tota~PL ELECTRIC UTILITIES Charges $10.39 119 REGENCY WOODS N $10.39 CARLISLE PA 17015 Total Charges Final Bill ..... :~..~"-1~ltt111~E~.t~$ ~at~r.~L~~ .....:: ~~, ~~#.~[~ .. ~~~::.:: Account Balance $10.39 Questions about this bill? Please contact us b Ma 25 t 1-800-342-5775 ~,, ~ -"! a (1-800-DIAL-PPL) or write to: Customer Service 827 Hausman Rd. PA town All ~ ~'i~~J (( , en 18104-9392 ~ www.pplelecUric.com Electric Use 24 20 16 12 8 4 0 KWH -Average Per Day Meter Reading Information This graph shows your electric use over the last 13 months. Types of Meter Readings: Actual - Adjusted Estimated Customer Meter #84512144 May 4 Actual 37565 Apr 19 Actual 37518 15 Da s KWH Billed 47 Average-May 2009 2010 Temperature 59F 58F KWH Per Day 12 3 Yearly Use: Total Average Use MontWy Jun 2008 -May 2009 5384 449 Jun 2009 -May 2010 4666 389 MJJASONDJFMAM 2009 Months 2010 Other important information on back ~ PPL Electric Utilities Electric Service For: MARY A CREE 119 REGENCY WOODS N CARLISLE PA 17015 Questions about this bill? Please contact us by Ma 10 at 1-800-34Z-5775 (1-800-DIAL-PPL) or write to: Customer Service 827 Hausman Rd. Allentown, PA 18104-9392 www_pplelectric.com Electric Use This graph shows your electric use over the last 13 months. T es of Meter Readings: Actual - Adjusted Estimated Customer [~ ~~;;~ '.: p:: •; ' Page 1 ~•~ I ~°:•;. - - > 5~ctnc Bili~cnu~;~l'tttabtx == 18920 72017 -, pp ~:~ Summary Page $o.oo Balance as of Apr 19, 2010 Char es: Tota~PL ELECTRIC iJT'ILITIES Charges $35.69 $35.69 Total Charges Account Balance KWH -Average Per Day 24 20 16 12 8 4 0 $35.69 3,16 ~~ ~ ~ ~~ ~ ,~~ ,~cE ~- o I~~ G~~ ~I~~ti ,~ G ,~ ~ o h6 C~ L~; it ,rd's -I Meter Reading Information Meter #84512144 37518 Apr 19 Actual Mar 18 Actual 37310 _- 32 Da s KWH Billed 208 Average -Apr 2009 46F 2010 54 Temperature K P Per Day 12 ~ Yearly Use: ~ Total Averagge Use ly h Mont May 2008 -Apr 2009 5440 4 s 3 415 May 2009 -Apr 2010 4974 Other important information on back "~ AMJ JASONDJ FM~10 2009 Months palyable To: ~P~ FIELDSTONE DRIVE ELECTOR CARLISLE, PA 17015 Phone: (717) 697-5740 MAP NO: 21-04-0371-046-TR04480 per: 119 REGENCY NORTH Acres .000 Deed: REGENCY NORTH MOBILE HOME P LOT 119 Mobile Home - No Land II Eu~ $1.00 FEE FOR ADDITIONAL RECEIPTS Tax Payer: CREE, MARY & RAY CREE JR 119 REGENCY WOODS NORTH MHP CARLISLE, PA 17015 Bill No: 483 Office Houro: MARCH-JUNE MON 10-1; THUR 47 SEE JULY BILL FOR HOURS JULY-DEC Bill Date: 3/1/10 EXTRA HRS APRIL 21&3010-12; CLOSED 6/10 Control No: 21000108 PHONE (717) 697-5740 Assessed Value: Land: 0 Improvement: 13,650 Tota1:13,650 Face Penalty Discount COUNTY R/E 2.39900 $32.09 $32.75 $~•~ COUNTY LIB .18000 $2.41 $2.46 $2.71 - -..-.._ .,,~ ~ moo $16.05 $16.38 $18.02 If Date Of $51.59 5/1 /10 thru 6/30!10 $56.76 7/1110 or Later Is On 3/1 /10 thru 4/30/10 TAXPAYER'S COPY -KEEP THIS PORTION FOR YOUR RECORDS PENNY G DAVIS, TAX COLLECTOR 158 FIELDSTONE DRIVE CARLISLE, PA 17015 RETURN SERVICE REQUESTED ADDRESS C;-iAiJ _FS Cy'd BE f:~AUc C'+ E~`,Ch JF BILL OFFICIAL COUNTY MUNICIPAL TAX BILL 87110 - 44423 CREE, MARY 8 RAY CREE JR ~~ 119 REGENCY WOODS NORTH MHP CARLISLE, PA 17015 i~iml~nm s c MID PE~NN~BANK - _ ~ M8M0 /YJ/.d~'r1~ _ .. MARY A. CREE so-880/313 3 7 21 8012957 RAY F. CREE, JR. 119 REGENCY WOODS NORTH D~~t'e NT~t''i__~ ~Ta~ CARLISLE, PA 17015 87110-R-44423 ~:0 3 L 30880 ?~: 80 L 29 5~~~ ?II' 3 7 2 E Payable To: P~ FIELDSTONE DRIVE ELECTOR CARLISLE, PA 17015 Phone: (717) 697,5740 I 51.00 FEE FOR ADDITIONAL RECEIPTS Tax Payer: MARY CREE 119 REGENCY WOODS N CARLISLE, PA 17015-9058 BIII No: 800 Off~e Hours: MARCH-JUNE MON 10-1; THUR 47 SEE JULY BILL FOR HOURS JULY-DEC Bill Date: 3N/10 EXTRA HRS APRIL 2183010-12; CLOSED 8110 Control No: 21-008148 PHONE (717) 697-5740 OCC COUNTY OF CUMBERLAND Discount Face PenaftY 54.90 $5.00 5550 COUNTY PC TWP OF MIDDLESEX 55 ~ 55 50 MUN PC ~'~ ~'~ 50 ~ ~ ~ MUN OCC $9.80 510.00 511.00 TAX AMOUNT DUE 311 /10 thru 4130/10 511 /10 thru 6/30110 7/1 /10 or Later If Date Of Payment Is On ~ . TAXPAYER'S COPY KEEP THIS PORTION FOR YOUR RECORDS PENNY G DAVIS, TAX COLLECTOR 158 FIELDSTONE DRIVE CARLISLE, PA 17015 RETURN SERVICE REQUESTED MARY CREE ~~~; 119 REGENCY WOODS N :~,~~~ CARLISLE, PA 17015-9058 87110 -22743 ~nmr~nm MARY A. CREE RAY~F. CREE, JR. 119 REGENCY WOODS NORTH CARLISLE, PA 17015 TO ~ •~ ~ ~ ~ 60-880/313 3 ~ 2 2 80,2957 Tr?~ --.. J ~ 9 • 00 ,•M •^ rvvlw ~~~ .. LJ p•..+..y nn. MID pE~NN~BANK .~ ,~~ ~:0 3 ~ 30880 ~~: 80 i 29 5~~~ ?II' _. 3 7 2 2 ........, .u. 87110-P-22743 :• O I ~ G a 0 r ~ !'0 ~ ~ ~ ~ = z p •a~ r .. ~ 0 r r+.r , to W ~ i ~ w r ~i s `~ -~ b ~;:~ N ~ L V 7 i > W ~~~ ~ i~ a ~~~ r ~ '~ ~ 9~z~ ~~ ip~~ ~~~~ z 0 c ~ Y ~~ ~, D w C W N cc~ O ..0 In .C W W ti -.1 -J -J 0 N W -~] D W W G1~ ~ ~--_ ~~ - n _ ~ A ~ - o mmm zm = ° - rn m~ a D ~ cWO D can ~ .~ ~ Z rn ^ N o °o . ~ Z ~ ~1 3 v v ~ i cn rn .~ ~ ~ ~ f A ~ CO Z o CA r ~ r'T' C cn ~ ~ ~ g ~ i ~ ~, -n o d w J ~ ~ _ ~ ~ ~ ~' = ~ _ ~ . c m g c ~ ~ 3 ° ~ ~ _ C C n ? ~ '~"~ 3 ~ ~ •~~- g t. mou nx-+-- y m ~ ~ ~ ~ m0a~ ~ n ~ ~ 3 c ~ ~c z ° c r~m= Q N D a ~ $ _ .~ .~ ~ K ~ .... n O O ° ~ f W ~ ~ ~ c n , ~1 0 ~ y ~ c W m ,_ ~ ~ ~~ W N y a m a W ^ • 0 w r w Q •r [~ O rr ru uy w r W W ~z~ 9~ ~'n ~o~ ~ z t~~ ~~ d ~~ l ~w W ~ n ~ C •:•: :; ~ + = ~ ~ ~ ' O ~ z ~ ' : ~', ~~. ~ t _ ff ~ e f~ ~ o a ~~ N ~ ~.+ ~ N ~ ~' o _ pp rd ~ ~ N o w °o = ~ z ~ o O -_ V' ~ _ N ~ 'rti m ~ o ~; o o =_ o ~ ~ ~ ~ = o . ~ o = ~' = ~ O - o Dc` ~ ~ p~ 0 o .D "' ~ 9 ~ r C'~ N " N '0 b ~zr ~ ;; ~ ~~r a~ ~ ~ ~ ~:: x ° o c~~. ~~~ ~ ~. ~ ~ ~ ~ ja d o t ? 1 °o ~ a O V~ ~ :: ~ :. . ~ p O a ~" jo g n u.,~.. Snirjt Hos jtal ~ ~V~7 vN 503 North 21g` Street • Camp Hill, PA 17011 • (800) 596-9997 April l3, 2010 Your Account With: 61501 g3 it Hospital Account #: For: Mary A Cree Admission Date: 12/20/09 Total Due: $1068.00 Dear Mary A Cree: This letter is to follow up the above referenced visit to I Iol'tS a~rment in full upon receipt~of this letterthere is an outstanding balance remaining on this account. Please rem p y It has always been the continuing goal of Holy Spirit Hospitacount s fithe community as a full service health care .. mal resolution. If you have any questions facility from the time of a patient's initial care through the ac regarding this account, please feel free to call this office at 1-800-596-9997 and speak with one of our representatives. Thank ou for choosing Holy Spirit Hospital for your family's health care and for resolving this outstanding y balance promptly. To assure proper application of your payment, please attac nton the rerverse side of th slletter.olf you have ish to pay by credit card, please complete the required mformat~o a alt or a portion of this debt, please complete the information on the reverse side of this insurance that may p y letter and return the entire letter. Sincerely, Holy Spirit Hospital !oNFttuie~9; .._~ o_...... VV:rh Pavments-s o ~ - a o °; ~o d = 'b O ~,' ,-p `~ ~ ~ O ~ ~ a . -f w w ~ ~ - cn n - o" a~~=° o ~.. ~ `~ ~ _ w _ - ----.._ _-.- -_.._.. ~ a Q ~ D~~ w °z -~ ~~°z ~ O ~~ ~ ~ oy v~ 00 x_ ~ V.,I 0 ~ x O ~ ~ ~ ~ r ~ ~ ?Z~ D -+ 3co W o CO ~ ~ D (~ ~ ~ ~mm o _ ~ i ~ N O - A ° r ~ L ~ g O .~ N W w ~^ o~ - •' N o - O 00 _ ,... ~ c1~- o = ~ ~. ~ i~ 0 o N w ~ r o ~ t!ti G ~ - O W O ~i o - s~o o ~ f ~ - ~ W v' ~ ~ ~ (` _ x9 0~ r W ?Nw. N ~ Oi l ~ 'o ~ aww r ~ 3 ~_° ( ~ 0o y W N ~ O w ~ C ~ C = ow ~ ~ ~ a ~ ~ ~ _ Z ~ ~~ ~ ~ c t ~ t~A ~ _ ~ ~ ~ ~srrr''` HOSPITAL TELEPHONE AND TELCOM, LTD. P.O. Box 39127 Cleveland, OH 44139 MARY CREE 119 REGENCY WOODS N CARLISLE , PA 17015 Patient Name: MARY CREE INVOICE Invoice #: PH10 03-35328 Date: 3/15/2010 Balance Due: $16.00 Admission Date Discharge Date Service Days Description of Service Balance Due: 2 / 8 / 2010 2 / 12 / 2010 4 TV/PHONE $16.00 These charges are for the convenience of having use of telephone and / or television services during your hospital stay at PINNACLE. These services are not covered by any insurance plan. contact us with any questions at our toll free number,1-866-362-3880, 'n the hours of 8:00 AM and 5:00 PM, Monday through Friday. Thank you. MARY A. CREE so-880/313 3 7 2 3 RAY F. CREE, JR. ~~~~ 119 REGENCY WOODS NORTH 7,~D/U~ CARLISLE, PA 17015 '" Dn rs i PAY TO 1~._ s__! ---..-------------------------~ ~ / ~ ~ ~~ Pf IE ORDF~ .r ~ w- _- 6 ~ ~.,,.- . /~'~'~ MID PENN BANK ~~ ~~ ~~~ MEMO~/~`j~~M~/M/ _ ~:0 3 L 30880 7~: 80 L 29 5~~~ 71l' ~. C~~- 37 23 Customer Service: 866-362-3880 8AM-SPM, M-F WILLOW MILL VETERINARY HOSPITAL 11 WILLOW MILL PARK ROAD MECHANICSBURG, PA 17050 (717) 766-7981 Kellie Peterson 45 Partridge Circle Carlisle, PA 17013 Page 1 / 1 Client ID: 16419 Invoice #: 222990 Date: 4/14/2010 Patient ID: 6302-4 Species: CANINE Weight: 18.90 pounds Patient Name: TOBY Breed: POMERANIAN Birthday: 09/15/2002 Sex: Neuter Description 4/14/2010 OFFICE VISIT- PROFESSIONAL FEE HEARTWORM/TICK TEST (4DX) BILE ACIDS TEST 4/12/2010 Phenobarbital 1/4gr (15mg) Tablet 4/14/2010 A/D Canine/Feline 5.5oz Can Thank you, Colleen) Staff Name Quanti Total Dr. Thomas W. Munkittrick, [ 1.00 $51.00 1.00 $59.00 1.00 $138.00 Dr. Renee D. Richards, V.M. 90.00 $17.00 Dr. Thomas W. Munkittrick, [ 1.00 $0.00 1.00 $0.00 Patient Subtotal: $265.00 Instructions For the safety of all our patients, prescription items cannot be returned once it has been dispensed. Far your convenience, please call 24 hours ahead far medication and diet refills. Reminder 02119!2010 URINALYSIS QUEST Chemistry Profile 06/08/2010 QUEST CBC w/Dill 10/13/2010 QUEST Phenobarbitol Level 11/18/2010 RABIES CANINE 2 YEAR VACCINATION 12/08/2010 QUEST T4 Thyroid Profile BORDETELLA BOOSTER BORRELIA BOOSTER 04/14/2011 HEARTWORM/TICK TEST (4DX) OFFICE VISIT- PROFESSIONAL FEE 12/08/2011 DISTEMPER VANGUARD+5 (2 YEAR) Invoice Total: Default Tax Rate Total: Balance Due: Previous Balance: Balance Due: Check Check No. 3725: Less Payment: Balance Due: $265.00 $0.00 $265.00 $265.00 $0.00 $265.00 {$265.00} {5265.00 j $0.00 If your pet needs after hours care, please call Animal Emergency Medical Center at (717)796-2334 or The Animal Emergency Clinic of York at (717)767-5355. G~w~ .,~ au,' ,~-y INVOICE NO. ~ ~ t _ ^ 1N~CE SOLD TO c~ e SHIPPED TO VIA ADDRESS ADDRESS CITY, STATE, ZIP CITY, STATE, ZIP CUSTOMER'S ORDER SALESPERSON TERMS F0.8. DATE L - l G-~ ~ '~ ~f ~ ~ ~~ ~(_ ~ `-l `_ l ~ 3~ z~ `~ ~~ ~ ~ ~el~ ~.~ 8740 :. O w r W r O r w O r r l11 O O r W L!1 W i r O / ~~ ~ / ~ O ~ O 3 3 c 3 ~ S ~ ~ ~ ~' z t ~ ~::: t- ~ ~ N - 8 $~ c~ ~o~ ZZA D~ ran ~ 0 mx 0 0 ~~"hi la .~ P~~~~yt~. The energy to help G~ save. 16973100000000000490006 Cnstomer Namber: 169731 Statemeat Date: 3/25/10 Do you have an e-mail address? MARY A CREE 119 REGENCY PARK NORTH CARLISLE, PA 17015 Total Amount Enclosed: $ -- ._. . ~~'.~ ,T.PiNSTATEMEIVT: `,_ Sun-09 Monthly Budget P~ytner+t: $245:00 Customer #: 16973] bct ofM~F~ 12 Statement Date: 3125/10 Delivery Looatiarfs: ~ "d1" 1 t 9 ~)~CY PARK I~IORTI'i~ CARLISLE, PA Cr+e~ ~ ~=ituci~tde~<tu battdg~t: tsince last statement) l~-voice Date Posh ~ete Traa>, ctlon 1~Scr1 'on Aanqunt 2125/10 Previous Balance: $919.51 3/23/10 3/25/10 Propane Delivery.-"01"(see details next page) $21b.20 BALANCE CURRENT HEATING SEASON BUDGET: $1,135.71 APRIL BUDGET PAYIl~1gT DUE 04!l0~1°0 ' ..Your account currently shows a balance. You may want to increase your monthly payment to, avoid owing a large balance at .the-end of the heating season. 5490.00 Shipley Energy (717}848-4100. or 1-800-834-1849 SSU,st 1C.i~tg'~eet or Pp lldx St10~6 ~ Visit our website Yvr1c; PA 17405Y5006 myShpley.com page: / fl~~~1~Y0H00~21310525 THE SERVICES AND PRODUCTS PR~ViDEU AfiE ~UBJFC;T TCl I!i t-~ lE~r; 1~ AC3~> LG~1[. ~ •. r; G '.-)^1 iF .:.AS.;u, iA r~~;l ~ C~li.E-i;?T ,~~,1 f. Pd