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07-07-10 (2)
' 1505610140 Y REV-1500 ~` ~°'-'°' PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year Fi{e Number PO BOX 280601 INHERITANCE TAX RETURN 2 1 1 D 0 4 5 3 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 1 6 1 3 2 3 9 6 5 0 4 0 8 2 0 1 0 0 2 2 2 1 9 4 0 Decedent's Last Name Suffix Decedent's First Name MI B E R N A R D J O H N A (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number 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) []X 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) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number R M A R K T H O M A S E S Q U I R E 7 1 7 9 6 ~ 0 0 -.~~ ; irst line of address REGISTE ~ ILLS US dLY I ~ -~-~ , ~".: t,.~ '~ .,.: r~, i - ` ' " -•~-~' 1 0 1 S O Second line of address U T H M A R K E T S T R E E T ~ ~~~ ~ ~ ~~ .C' (~ i , t. _, ~~"~ _, ,. ,:°~ ,. _~ ,~' * ~'~} ."± i City or Post Office State ZIP Code DATE FILED M E C R A N I C S B U R G P A 1 7 0 5 5 Correspondent's a-mail address: rmarkthomast~4mail.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 kno ledge. SIGN E OF PERSO R ON~S'~LE FOR FILING RETURN DATES , „ ., ,,. _ 14 PALMER DR VE CAMP HILL PA 1,7011 SI REP O ER THAN REPRESENTATIVE D TE :s'~~~ ADDR SS 1,01 SOUTH MARKET STREET MECHANICSBURG PA 17055 PLEASE USE ORIGINAL FORM ONLY 15D5610140 Side 1 1505610140 J ~~ ~~ J 1505610240 REV-1500 EX Decedent's Social Security Number ~ecedenYs Name: JOHN A• BERNARD 1 6 1 3 2 3 9 6 5 RECAPITULATION 1. Real Estate (Schedule A} ........................................... 1. 1 3 6 0 0 0. 0 0 2. Stocks and Bonds (Schedule B) ...................................... 2. 4 8 6 1 9 • 5 5 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. • 4. Mortgages and Notes Receivable (Schedule D) .......................... 4. • 5. Cash, Bank De osits and Miscellaneous Personal Pro a p p rty (Schedule E)....... 5. 1 8 9 7 6 8. 5 1 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. • 7. Inter-Vivos Transfers & Miscellaneous N n-Probate Property ~ 1 7 0 5 1 1 9 4 (Schedule G) Separate Billing Requested ....... 7. . 8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 5 4 4 9 0 0 . 0 0 9. Funeral Expenses and Administrative Costs (Schedule H) .................. 9• 3 1 1 8 5 . 1 2 10. Debts of Decedent, Mort a e Liabilities, and Liens Schedule I 9 9 ( ) .... ...... 10. ... 7 9 9 . 2 1 11. Total Deductions (total Lines 9 and 10) ...................... ...... ... 11. 3 1 9 8 4 . 3 3 12. Net Value of Estate (Line 8 minus Line 11) ................... ...... ... 12. 5 1 2 9 1 5 . 6 7 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 1 2 9 1 5 . 6 7 TAX CALCULATION -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.o 0 0 0 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate X .045 5 1 2 9 1 5. 6 7 1 s. 2 3 0 8 1. 2 0 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17. 0. 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0. 0 0 18. 0. 0 0 19. TAX DUE ............................................. .........19. 2 3 0 8 1• 2 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ Side 2 1505610240 1505610240 REV-1500 EX Page 3 Decedent's Complete Address; File Number 21 10 0453 DECEDENT'S NAME JOHN A. BERNARD ___ __ ___ _ _ STREET ADbRESS 14 Palmer Drive CITY Camp Hill STATE PA ZIP 17011 Tax Payments and Credits: 1 ~ Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments 21,980.00 B. Discount 1,099.00 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. 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. (1) 23,081.20 Total Credits (A + B) (2) 23,079.00 (3) (4) 0.00 (5) 2.20 Make check payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred : ...................................................................... ^ Q b. retain the right to designate who shall use the property transferred or its income; ............................... ^ c. retain a reversionary interest; or ................................................................................................ ^ d. receive the promise for life of either payments, benefits or care? ....................................................... ^ Q 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... ^ X^ 3. Did decedent own an "in trust for" orpayable-upon-death bank account or security at his or her death? ......... ^ Q 4. Did decedent own an individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? .................................................................................................. ~ ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse 3 percent [72 P.S. §9116 (a) (1.1) (i)J. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 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 21 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 0 percent [72 P.S. §9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 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 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, undo Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX+ (01-10) pennsylvania SCHEDULE A DEPARTMENT OF REVENUE ;~ INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF: FILE NUMBER: JOHN A. BERNARD 21 10 0453 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 at which property 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 facts. Real properly that is jointly-owned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 4 Palmer Drive ~ 136,000.00 ;amp Hill, PA 17011 TOTAL (Also enter on Line 1, Recapitulation.) ~ $ 136.000.00 If more space is needed, use additional sheets of paper of the same size. REV-1503 EX + (6-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS Il~f-IERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER JOHN A. BERNARD 21 10 0453 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 1.225 shares of Artisan Mid-Cap Value Fund @ $18.75 per share 1,522.97 2. 92.530 shares of Blackrock Municipal Money Market Portfolio @ $1.00 per share 492.53 3. 5.352 shares of Blackrock International Opportunity Service @ $31.25 per share 479.75 4. 26.929 shares of Eaton Vance Large-Cap Value Fund Class A @ $18.03 per share 11,202.63 5. 15.330 shares of Federated Equity Kaufmann Fund Class A @$4.98 per share 1,570.34 6. 4.806 shares of Federated Equity Kaufmann Small Cap Fund Class A @ $21.92 per share 543.75 7. 3.478 shares of Franklin Small Cap Value Fund Class A @ $39.42 per share 531.30 8. 6.648 shares of JP Morgan Emerging Markets Equity Fund @ $22.24 per share 1,037.45 9. 760.575 shares of Mainstay Large Cap Growth Fund Class A @ $6.40 per share 11,267.68 10. 63.627 shares of Mainstay International Equity Fund Class A @ $28.17 per share 4,609.37 11. 431.666 shares of Oppenheimer PA Municipal Fund Class A @ $10.73 per share 15,361.78 TOTAL (Also enter on line 2, Recapitulation) I $ 48,61 (If more space is needed, insert additional sheets of the same size) REV-1508 EX + (6-98) SCHEDULE E COMM®NWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, ~ M~~7C. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER JOHN A. BERNARD 21 10 0453 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 VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. ersonal Property 1,770.00 2. NC Bank, Checking Account No. 5140004196 111,929.14 SX Tower, 600 Grant Street, 36th Floor ittsburgh, PA 15219 3. NC Bank, Savings Account No. 5003503458 29,102.06 SX Tower, 600 Grant Street, 36th Floor ittsburgh, PA 15219 4. eritage Investment Services Fund, Account No. 1006764 12,699.33 651 Westport Drive echanicsburg, PA 17055 5. eritage Investment Services Fund, Account No. 1006765 23,166.39 651 Westport Drive echanicsburg, PA 17055 6. aterpillar Retirement Income Plan (Medicare reimbursement) 385.60 7. ash 10,341.00 8. isability payment from Met-Life 374.99 TOTAL (Also enter on line 5, Recapitulation) I $ 189,768.51 (If more space is needed, insert additional sheets of the same size) REV-1510 EX+ (08-09) pennsylvania DEPARTMENT OF REVENUE ~' INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE G INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY FILE NUMBER JOHN A. BERNARD 21 10 0453 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM NUMBER 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 VALUE OF ASSET °fo OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1. 97.115 shares of American Balanced Fund Class C @ $16.84 per share 15,107.42 00.00 15,107.42 2. 12.288 shares of American Balanced Fund Class B @ $16.86 per share 15,381.17 00.00 15,381.17 3. ransamerica Fix Annuity #02CBT082476 140,023.35 00.00 140,023.35 TOTAL (Also enter on Line 7, Recapitulation) ~ $ 170 511 94 If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+ (10-09) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND r 'INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER JOHN A. BERNARD 21 10 0453 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Conklin Funeral Home, Inc. 12,055.15 2. Burial Clothing (suit) 179.97 3. Dinner at Christian Life Assembly 500.00 4. Minister fee at funeral 150.00 5. Pianist fee at funeral 100.00 B. ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City State ZIP Year(s) Commission Paid: 2, Attorney Fees: R. Mark Thomas, Esquire 13,622.00 3. Family Exemption: {If decedents address is not the same as claimants, attach explanation.) 3,500.00 Claimant Sharon L. Bargo Street Address 14 Palmer Drive City Camp Hill State PA ZlP 17011 Relationship of Claimant to Decedent Daughter 4• Probate Fees: 434.50 5 Accountant Fees: 6. Tax Retum Preparer Fees: 7. Clauser Real Estate Appraisals, Inc. (real estate appraisal) 350.00 8. Chuck Bricker Auctioneer (personal property appraisal) 100.00 9. Sewer line repair at 14 Palmer Drive, Camp Hill, Pennsylvania 193.50 TOTAL (Also enter on Line 9, Recapitulation) I $ 31,185.12 If more space is needed, use additional sheets of paper of the same size. REV-1512 EX+ (12-08) pennsylvania DEPARTMENT OF REVENUE ~' INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF F1LE NUMBER JOHN A. BERNARD 21 10 0453 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1, ennsylvania Water Company (April, May and June, 2010) 135.05 2. P & L Electric (April, May and June, 2010) 234.27 3. erizon (April, May and June, 2010) 375.29 4. GI Gas 54.60 TOTAL (Also enter an Line 10, Recapitulation) I $ 799.21 If more space is needed, insert additional sheets of the same size. REV-1513 EX+ (01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES ~' INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: inu-.i o RFRPIARrI FILE NUMBER: 21 10 0453 - - - -- - - -- - -- -- -- -- -- RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).J 1. Sharon L. Bargo Lineal 100.00 14 Palmer Drive Camp Hill, PA 17011 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: 1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ If more space is needed, use additional sheets of paper of the same size. ~ ~. LAST WILL AND TESTAMENT BE IT REMEMBERED THAT I, JOHN A. BERNARD, a resident of Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this to be my LAST WILL and TESTAMENT, hereby revoking any and all Wills and Codicils previously made by me. 1 I declare that I airs married to IIILDA B. BERNARD, and that I have two (2) children, CATHY A. BERNIllZI>, I:~c~rri January 5, 1963 and SHARON L. BARGO, born August 8, 1971. II I direct that all my just debts arrd funeral expenses shall be paid from my residuary estate as soon as practicable after my decease. III I direct that all taxes that ir~ay be assessed in consequence of my death, of whatever nature and by wl~iatever jurisdiction unposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. IV I hereby specifically bequest and devise to my daugt^iter, CATHY A. BERNARD, ttie 1948 Chrysler `T'own ~~rid Co~:u~t~r-y Danbury Mint Car. I hereby specifically bequest and ~lev_ise to irry daughter, SHARON L. BARGO, the 1953 Chevrolet Pick U~> Danbury Mint Car. I hereby specifically bequest and devise to my son-in-law, VINCENT BARGO, my Benjamin Sheridan .22 calik~er air rifle, provided he is sti1.1 married to my daughter, `~~Ij.ARUI~1, l~i~>on the date of my decease. v I give, devise and bequeattr all my reln~~iriing property, whether real or .per. sonal, wherever situate, inc.lucli_1~~~ any property over which I may have a power of appointment to my wife, HILDA B. BERNARD, provided that she survives me by thirty (30) days. VI If my wife, HILDA B. BERNARD, shall predecease or fail to survive me by thirty (30) days, I give, devise and bequeath all of my property, whether real or personal, wherever situate, including any property over which I may have a power of appointment, to my children, CATHY A. BERNARD and SHARON L. BARGO, in equal shares, per stirpes. VII If my wife, HILDA B. BERNARD, and all of my children shall predecease or fail to survive me by thirty (30) days and if I have grandchildren living on my date of death who inherit property, pursuant to this Will then their property is to be distributed to them pursuant to the terms of the hereinafter included Trust., VIII TRUST If my wife and children shall fail to survive me by thirty {30) days and I have any grandcl~lildren w~zo are under the age of eighteen (18 ) years who survive me, I appoilzt tYly wife' s brother, DALE E. BUBB, as Trustee of the property that I Dave given to my grandchildren. If DALE E. BUBB is unable or unwilling to act as Trustee, then I appoint my nephew, MARK CURTIS, as Trustee. A. The assets that are transferred to the Trust shall be divided into approximately equal stlares for each of my grandchildren under the age of eighteen (18) years of age. B. The Trust estate shall be administered until each grandchild reaches the age of eighteen (18) years. tJnt_Ll that time,~the Trustee shall apply all net incoir1e and principal of the Trust estate as follows: 1) So long. as my grandchild is under tie age of eighteen (18 ) years of age, the riet income of the Trust shall be paid to, or applied for the benefit of my yrar7dchild at such times and in such amounts as the Trustee shall in his discretion deem necessary for his support, welfare, mainterzarlce and education. Education shall be defined broadly to include not only that available in college, but also trade school and other similar training. In the event that the income shall be insufficient to provide my grandchild with adequate maintenance, support, welfare or education, the Trustee may invade the principal of this Trust for this purpose. 2) The Trustee in exercising his discretionary authority with respect to the payrrlent of income or principal of t~-ie Trust Estate to my beneficiary, shall. take into consideration any iricorne or_ other resources available to my grandchild from sources outside of this Trust that may be )'mown to the Trustee . The determinatioz~i of tale Trustee with respect to tt~~e necessity of making payments out of income or principal to my beneficiary shall be conclusive on all persons howsoever interested in the Trust. 3) The Trustee shall accumulate and add to principal any net incortle of tt-ie Trust not paid out in accordance with the discretion hereinabove conferred or-~ the Trustee. 4) In the event my grandchild predeceases me or dies prior to the termination of this `Trust, the interest of my grandchild in the Trust shall cease, except that, if he is survived by any children, then the Trustee shall pay net income of the Trust to or apply the same for the benefits of such children of my deceased grandchild, ire sucl~~ amount or amounts as the Trustee in 1-iis sole discretion may determine for support, welfare and maintenance. C. When my grandchild reaches the age of eighteen (18) years, a calculation of the property remaining in tl-~e Trust shall be made and the total thereof shall be distributed to him or her. D. My grandchild, as beneficiary of this Trust, shall not have any right to alienate, encumber, or hypothecate his ,interest in the principal or income of the Trust iri any manner, nor shall any interest be subject to claims of his creditors or liable to attachment, execution or other process of law. E. In order to carry out the purposes of this Trust established by this Will, the Trustee, in addition to al]_ other powers granted by this Will, or by law, stall Y~ave the following powers over the Trust estate, subject to any limitation specified elsewhere in this Will: 1) To retain any property receive<_~ by the Trust estate for as long as t7le `T'rustee considers it advisak~le. 2) To spend funds for the maintenance and repair of real property. 3) To sell at public or private sale, exchange or lease for a period of time, any real or personal proper_~ty acid give options for sale of the lease. 4} To execute and deliver any deeds, leases, assignments or other instrulr~ents as may be necessary to carry out the provisions of tl~iis Trust . 5) To borrow money and to mortgage or pledge any real or personal property. 6) The Trustee st~iall irlaintain accurate records and accounts and sha1.1 render statements to my beneficiary hereunder showing receipts and disburseit~ents of principal and income no less frequently than annually. The `T'rust,ee st~~all serve without bond and shall receive fair and reasonable comb>erlsation for administration of this `T'rust, not to exceed five (5'') percent of annual income. 7} To distribute property in T~i.nd. 8) To do all other acts t~lat are irl his judgment necessary or desirable for tt~e proper management, hives ttzlent and distribution of the `T'rust estate. I ~; I nominate, constitute and appoint i~~y ~~~rif_e, HILDA B. BERNARD, as Executrix of this LAST WILL, to serve without bond. If my .wife is unable or unwilling to act irz tl-gat capacity, then I nominate, constitute and appoint i~ly children, CATHY A. F3ERNARD and S~TARON L . BARGO, as Co-Executrixes of this LAST WILL, to serve witT-lout bond. If either is unable or unwilling to act i_n that capacity, then the other alone may act as Executrix of tl-iis LAST WILL, to serve without bond. IN WITNESS WHEREOF, I, JOHN A. BERM-~ZU, nave set my hand to this LAST WILL this C~ day of ~~/-`f"~ ~ 199'7. ~` ..~ -~ .,- Jp A. BERNARD Signed, sealed, published and declared l.~y the above-reamed JOHN A. BERNARD, as and for his Last Will and `I'estan~ent, in tl~e presence of us, who, at his request and in his presence, and in tt-~e presence of each other, have hereunto subscribed otzr nazr~es as witnesses . ACKNOWLEDGEMENT Notary Public -~~-- Notarial Seal Luanne M. Heikes, Notary Pubiic Mechanicsburg Boro, Cumberland County My Commission Expires Dec. 6, 1999 AFFTDAVTT ~~ '~, _ ~ ~ _ otarf~ Puk;lic Notarial Seal Luanne M. Heikes, Notary Public Mechanicsburg Boro, Cumberland County My Commission Expires Dec. 6, 1999 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss. I, JOHN A. BERNARD, Testator, whose name is signed to the attached or foregoing instrument, >~laving been duly qualified according to ]_aw, do hereby acknowledge tt-rat I signed ar-id executed the instrument as my LAST WILL; that .I siyried it as my free and voluntary act. for the purposes therein expressed. ' /,. ' ~L~~ ~~- 7 h'/ ~ L -- ,~J H A . ~ERNARU Sworn or affirmed. to and acknowledged before me by JO~~N A. BERNARD, Testator, this - ~_ ~~ ~'~ day of -j.) ~' c ,, .,.,... `~ -. 199 . COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND , ss. We ~ (~' . v i 1~~~~:' ~ " I ~ (~~:~~, r ~ ~,a,o`_; drld ~ ~- ~ ~,, l~'_it' t:~ i,. t~-' 1~. ~~~~,1 f-_-~ t_ I~';`> ;1 ~__ the witnesses whose names are signed to tyre attached or foregoing instrument being duly qualified according to law, do depose and say that we were present and saw Testator sign and execute the instrument as his LAST WILL; that Jc~?I]I~1 A. L~F~RNAflU signed willingly and that he executed it as 1-ris free arld voluntary act for t:he purposes therein expressed; that eacl~l of us in the hearing and sight of the Testator signed tyre Will as witnesses; and ttrat to the best of our knowledge, the Testator was at t1~e tune 18 years of age or more, of sound mind and under no constraint or undue influence. Sworn or affirmed to and act>r~owledged before me this ~~ ~~~--~~__ day of ,, ( 1~~9 1 . Main_File No._10-0518 R-1_[Page #1 ~, APPRAISAL OF REAL PROPERTY LOCATED AT: 14 Palmer Dr Deed Book 21X Page 1052 Camp Hill, PA 17011-7921 FOR: R. Mark Thomas 101 S. Market St. Mechanicsburg, PA 17055 AS OF: 4/8/10 BY: Dennis L. Stover PA Certified Residential Real Estate Appraiser Certification Number RL 138906 Clauser Real Estate Appraisals PO Box 777 Camp Hill, PA 17001-0777 Form GA1 - "WinTOTAL" appraisal software by a la mode, inc. -1-800-ALAMODE Main File PJo. 10-0518 R-1 Pale #4~ SUMMARY OF SALIENT FEATURES Subject Address 14 Palmer Dr Legal Description Deed Book 21 X Page 1052 City Camp Hill County Cumberland State PA . . Zip Code 17011-7921 Census Tract 42041-0111.00 Map Reference 25420 Sale Price $ NA Date of Sale NA Client R. Mark Thomas Owner The Estate of John A. Bernard Size (Square Feet) 1,260 Price per Square Foot $ Location Suburban Age 51 Condition Avg ' Total Rooms 5 Bedrooms 3 Baths 1.5 ' Appraiser Dennis L. Stover Date of Appraised Value 4/8/10 Final Estimate of Value $ 136,000 Form SSD - "WinTOTAL" appraisal software by a la mode, inc. -1-800-ALAMODE B PN C 11~JVESTMENTS Member F~NRA and SIFC May 10, 2010 Sharon L BarQo 14 Palmer Drive Camp Hill, PA 17011-7921 RE: Estate of John A Bernard Date of Death Valuation Date of Death: April 8, 2010 Social Security Number: 161-32-396 Dear Mrs. Barao: The Date of Death Value for securities held by John A Bernard and Sharon L Bargo in PNCI Account X2780-4892 is as follows: _" 81.22 shares Artisan Mid-Cap Value Fund @ $18.7 per share 492.30 shares Blackrock IVlunicipal Nloney Market Portfolio @ $1.00 per share 1~.3~2 shares Blackrock International Opportunity Service a~ $31.2 per share 626.929 shares Eaton Vance Large-Cap Value Fund Class ~. @ $18.03 per share 31.330 shares Federated Equity Kaufmann Fund Class A @ $4.98 per share 24.806 shares Federated Equity Kaufmann Small Cap Fund Class A @ $21.92 per share 13.478 shams Franklin Small Cap Value Fund Class A @. $39.42 per share 46.648 shares JP Morgan Emerging Markets Equity Fund @. $22.24 per share 1760.~7~ shares Mainstay Larne Cap Growth Fund Class A @. $6.40 per share 163.627 shares Mainstay International Equity Fund Class A @. $28.17 per share 1431.666 shares Oppenheimer PA Municipal Fund Class A @. $10.73 per share The Date of Death Value for securities held by John A Bernard in his PNC IRA Account ~130~-3309 is as fol':ovvs: 897.11 shares American Balanced Fund Class C @ $16.84 per share 912.288 shares American Balanced Fund Class B @ $16.86 per share PNC Investment Account X4389-399 contains a Transamerica Fix ~='innuitv~. You will receive a Date Of Death Value directly from Transamerica. Please feel free to contact me if I can be of further service. Sincerely, e Charles E Little, CFP, VP Financial Advisor The izzformation contained herein has been obtained from sources we believe to be reliable but do not guarantee it to be accurate, correct, complete or timely, and shall not be responsible for the results obtained from it's use. PNC Investments LLC Member of The PNC Financial Services Group ~ ~ I ~GC1 Two East Main Street Mechanicsburg Pennsylvania 17055 www.pnc.com :\lac Lose Value ~ \o BankGu<u-wuee importantlnvestorlnformation: Securities and brokerage services are provided by PNC Investments LLC, member FINRA and SIPC. Annuities and other insurance products are offered by PNC Insurance Services LLC, a licensed insurance agency. APPRAISAL ,~.... . Personal Property of ~ Q ~-{ ~ L° ~ R J~,~~d ~ST~-T~ / ~ ~'~~-~/~R p h~, ~.}~l''d ~' t--! ~ ~~ J~~ Appraised by Chuck E. Bricker AU094-L Date ,j - %~--,/v ITEM VALUE ITEM VALUE 2 Pc ~/U~ ~~''I, ~"v~T~ ~o, ~o ~ ~c~ti~~ ~7 j , ov ~ ~ti~ T e.~s l ~', u~ a2 ~ ~ . ,2~~ o ~ jZ~c~~tiE,~ :5t~,~o ~D~K~~~~~ ~D,bd S S I7 d ~ l~ U 1~ L l 7-`/ $~ ~ULz ~v, f~ d ~PtZi.S~T" ~-~~ ~o,bo I ! I C/Z 6 L.= .~ !/~ ~ S T N c~ ~{~: D t~ 1~l li-1T-y C ~~ti~~,' 2©,~0 C TJi~'~ TTF SET ,3`G, vO Uti1 i~~ ~~,C~LZ KN'~~ i-/U~~ ~ ,l.»"sr~ ~Z~~~o .S % ~ ~."c~ / L , ~~~ ~ i~i~u~ ~~~c= ~ ~ ~ s ~-' ~ i~ 1 ~~, ~~ c'H~.S I 'G~ - I~rZ c%-,Z S ~',GG C ~~~~ c ~ s - .~~ . ~ ~. ~~,~ ~~ G;~,~~~ ~~ `h`~~L l3, =~ ~ cz% ~--~, ~ ~ L,~~G(,'N S't'y/ZF_ ~(~ Z ,L~, L~(3 TL'r~ d S ~ d c~',~~.d w~ t2 ;Z.G, d ~ c5~ ' LL, r~~' L~~.i.'~~ ~~Gd ~~~~~ S~'-,, L~ ~L_S ~~~d~~7ZCLS_ l.,Zc.~, ~~ 7d r G`~ll _-. L ~ ~ /~~ S J~ ~ iJ " C..~/~ ~~ r ~~ `~i~-VC~'1~Q11 Jun, 29. 2010 1:2'~PM PNC BRNK 412-70~-214i +~P1VC ~aeromrH~rr~v June 29, 2010 R Max'k Thomas Attorney At Law 101 South Market Street Mechanicsburg, PA 17055 RE: Name: John A Bernard SSN: 326-I 1-$039 DOD: 04-08~Z010 Dear Mr. Thomas: J ~ i In response to your request for Date of Death (DOD} balaaces far the custatx~ex Hated above, our records show the following: Checking Account Account # 5140004196 Established: OS-O1-1966 JOAN A BERNARD 1~Ola balance: ~ 1 l 1,925.68 + 0.46 accrued interest Savings Account Account # 5003503458 Established: 03-07-2001 JOHN A BERNARD DOD balance: ~ 29,095.95 + 3.11 accrued interest Investment Account The decedent maix~taived Investment Account # 13053309. For further infarmatiun, you may call the Brokerage Department at 1-500-762-6111, Please note that this office provides date afdeath baaaz~aes for deposit accounts (IRAs, CDs, Checking and Savings). Vie do not process any financial transactions or provide statements. if you need assistance with any of these items, please call 1-$8S-PNC-BANK (1-8SS-762,2265) or stop by your local PNC Sank branch ot~ce. Sincerely, National Financial Services Center PNC Bank, N.A. Member F]~7C Page 1 of 1 4G51 Westport Dr Mechanicsburg PA 17055 (717) 796-9784 Mr John A Bernard 14 Palmer Dr Camp Hill PA 17011-7921 Account Rate Matures 1006764 3.25% N/A 1006765 5.75% 10/31 /2010 Deposits $0.00 $0.00 SEICES FUND An r~n~t>w~~f fiat wor~Cs Apr 08, 2010 Interest Withdraws Penalties Balance $100.87 $0.00 $0.00 $12,699.33 $323.43 $0.00 $0.00 $23,166.39 '^ ^ Page 1 $35,865.72 Jun. 24 201 ~~ i ; ~4FM 'I~;AN~SA,IV~ERI~A ® i.IF~ INSURANCE GOMPANY May 18 , 2 01.0 Shaz'c~n L Bargo c/o 1'NC Investments 91 Cumberland Parkway Mechanicsburg PA 17055 RE: Yann~i~y Number oaCaT08a~76 Dear client: ~10.31~2 ~. i Traueamcrica Lifc Insurance Company 4333 Edgcwovd Road N~ PO Bax 3153 Cedar ltapide, Iowa 524~~6-3183 Thank you for the recent inquiry on tk~e above listed tax deferred. annuity for the decedent, John A Bernard. On April 8, 2010, the date of death of the annuitant, John A Bernard, the full--acGUmu~.ated value was $140,023.35. The taxable amount on April $, 2010 was $25,558,57. . Our records indicate that this annuity was processed as a death claim on May 10, 2010 in the amount of $140,564,75, The taxable amount on May 10, 2010 was $26,099.97. Please note : '?'his annu~.ty is no longer act1.V~ with our Cgmpany, It you ha~re any questions cal"1 us at 1--800-553-5957 Manday -Thursday, 7:00 a.m. - 5:30 p.m. or Friday, 7:pp a.,m, -- 4;30 p.m. Central t~..me. Sincerely, Kathalena Raposa Contract Services Member of the ~EC70N. Group _. _. 'r' 1. ~ C, N .'' ~ '1 t+ Cocklin Funeral Home, Inc. 30 N. Chestnut St. Dillsburg, PA 17019 (717)432-5312 May 10, 2010 Mrs. Sharon L. Bargo 14 Palmer Drive Camp Hill, PA 17011 The Funeral Service for John A. Bernard 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. Professional Services Funeral Director & Staff 3,725.00 Total Professional Services --"----"-------"- 3;T~~.~ia "- Merchandise Lexington Maple 4,740.00 Monticello 1,270.CI0 b-a is pia ___ Total Merchandise Selected ----'-"--"-------- , ; 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 Cemetery Charges 750.00 Newspaper Notice Harrisburg 533.27 Newspaper Notice York 391.20 Death Certificates 60.00 Death Certificates (Cathy) 72.00 Flowers 188.68 Cutting date on stone 170.1)0 Tent Rental 155.1)0 ota as Advances ~,3zu. ~~ SALES TAX 0.00 SUB-TOTAL 12,OSS.1S INITIAL PAYMENT /DISCOUNT /CREDITS 11,807.08 TOTAL AMOUNT DUE 248.07 The unpaid balance over 1 days is subjected to a 0 % service charge per month - 0 °J° per annum. Page V RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Cumberland County - Register Of Wills One Courthouse Sgware Carlisle, PA 17613 Receipt Date: 4/30/2010 Receipt Time: 10:14:27 Receipt No.: 1060934 BERNARD JOHN A Estate File No.: 2010-00453 Paid By Remarks: R MARK THOMAS WZ ------------------------ Receipt Distribution ----- Fee/Tax Description Payment Amount Payee Name PETITION LTRS TEST 360.00 CUMBERLAND COUNTY GENERAL FUN WILL 15.00 CUMBERLAND COUNTY GENERAL FUN SHORT CERTIFICATE 16.00 CUMBERLAND COUNTY GENERAL FUN JCS FEE 23.50 BUREAU OF RECEIPTS & CNTR M D AUTOMATION FEE 5.00 CUMBERLAND COUNTY GENERAL . FUN --- Check# 2757 ------------- $419.50 Total Received......... $419.50 X~S~~~ GEOfiGE CLAl1SElt (Mani File No._10 8518 n 1(__!?aye_~21 FROM: Clausen Real Estate Appraisals, LLC George C. Clausen, SRA P.O. Box 777 Camp Hill, PA 17001 Telephone Number: 717-737-7300 Fax Number: 717-730-0922 T0: R. Mark Thomas 101 S. Market St. Mechanicsburg, PA 17055 E-Mall: Telephone Number: Fax Number: Alternate Number: INVOICE r", °~ ,~ . INV;O~C ~ M~ ~ 10-0518 R-1 Invoice Date: 5/31,1 U Due pate: Internal Order #: 10-0518 R-1 Lender Case #: Client File #: FHA/VA Case #: Main File # on form: 10-0518 R-1 Other File # on form: Summary F;eport Federal Tax fD: 26-164706Ei Employer ID: ~~!{i x ~~ ~~~~~~~~~~~~i~ ~.r fir r r v - ~ s i. : i SaS kF "~ .t~~~x ~~;~rw ~ ~ ~ y !a r , a, ..ra ~~ . .~~ rM ~.r. Lender: R. Mark Thomas Client: R. Mark Thomas Purchaser/Borrower: R. Mark Thomas Property Address: 14 Palmer Dr City: Carnp Hill County: Cumberland State: PA Zip: 17011-7921 Legal Description: Deed Book 21 X Page 1052 r; 1 ~.~~W ~ ~~~, p -~ ~ f~ ° y ;: ^ ' ; ~ 5, t ~~ ~~ p r !.~ I u:, ~ i~h i ~ ~ kR ~l ~yY~+k~ L' AI .t . . .. .. ~: . ... r. ... ... ~ ,: . 1++ -rr..r. Residential 1004 Please make check payable to: Clausen Real Estate Appraisals and mail to: Clausen Real Estate Appraisals P. O. Box 777 Camp Hill, PA 17001-0777 Payable Upon Receipt ~OUNr g+ky 350.00 A 1.5 % service charge will be added to all balances over 30 days. SUBTOTAL ~ 350.00 ~~ . •G~r~: ayx .~ ~_,pF i ,w ~~ ', ~~JI; .a.~ ai, ~' a .I `~.N~+. + wa ~y ~~!!~~{{ jj~~ , ~M, 4`1Q1. 4 M ,l a. N. ~ ~~CF; r ° , ~. ~ ~' ~.F~ . rv~ i . L , 3 ,+~, ~ ~ ,I'pG~N~~ . f y,,~~~I!~ ~ ,~ .F„,+ ~~H~w,~r, M,I~, ~t ~ 31'~ ~ Ej: d F ~ ~~ 1 ~ ~ ',r ~ ~ , ~~ ,,r k `t ~ ''w ~~ +"~ ~~ ~~ ~ ' ~ ~ ~ ~ y~!,~~`1~ {.. ~ ~~~~~ i~lr ~1. ~ r ~ ~ r + ,aka + ~ ~ , -. r _ ~ .(, h ~ , r ~ "4. r 'gel rl ~~ ~.. ' . ~ r i° r 9 ~'~i d "~ p ~ +~ r ~ c.•, tie 111*, ~ u §~ _.. I j ~ Pp ~~ L «.p. 71: 73µ utl4 y!'i N9~ ~ A... ~iF~i~ ~ ~~`_F';' tkrvak; .., ,, .~'a n°.i tlt~, . rxq r 4 9'6" -Kt r1r i~ .'.~F~'c+. . .ir .:L k ~'.mj, + "~Id~`.~ ~~ ~~ 4 ~ §5 1 I' i ~'~ + y ~!l. iE 1~0...~~'+~ q Ib ~'~' h~6,'~~ n+ iii Check #: . ' Date: Description: ! Check #: Date: Description: Check #: Date: Description: SUBTOTAL TOTAL DUE 350.00 Form NIVSD - "WinTOTAL" appraisal software by a la mode, inc. -1-800-ALAMODE t._ J K*1. i~a A S'~'AT~~~ ~1..E~- From-~ v~~ ~o ~~ ' ct 3 T~ ~~ ~7U5v To ` ~ ~ .S Address _ ~- ~,~~ ~ t ~T~/__~~ --~ 20~ ~ ~E ~=~ ~~_ i~~~ ~~~5 ~ ~~~, r ~~j ~ ~~~ J Drain Cleaning Specialists "Family owned and operated" 30 Years Experience i ~ -;~/; Mileage j~~'/~'-' D (1 I~In Dan/Josh Meyer 486 Lewisberry Road New t:umberland, PA 17070 West: 717-7'74-4571 -East: 717-232-7290 Carl isle: 717-245-9879 Fax: 717-774-7861 email: info@freeflowpa.com web: www.freeflowpa.com - _ _ ...,-.~~r, ... ~ ~ ~' ~ ! ' ~i ~ ~ Job /iT ~,f~ ~~ ~ M ~/ ~G=' ~'~'J Eiill ' ~ ` 1 ~ ~ ' ~ fi ~ i j - .~ , r ~ , , _- ~~ PHONE ~ : ~ J -='' ~ ~~ --/~~ LENGTH OF,-- LENGTH OF ~.1NE; DIAMETER .- BLOCKAGE, : LINE ~; `~,` CLEANED f;-~ !.% ~ _ 4'' ~ a AREA ~-' r_% CAUSE OF ROOT~_..' SLUDGE GREASE POSS. DIP RAGS OTHER: BLOCKAGE `~- M.S. ~~ H.S.,' K.S. B.T. B.S. L.D. L.T. T.A. U.R. F.D. D.S. OTHER: ~~ BLADES _,_, ~, ,- CLEANOUT:"~ `~..~ ~'-~- MACHINE S.J. "S..-' MR ROOT CUTTER USED ~ `~~~' !,~+.~~ LOCATION: ,,, ."-?r,.rt PP GPP PB CAMERA LOCATOR CONDITIONAL/UNCONDITIONAL ~ FOLLOW UP ^ SERVICE CONTRACT ......MONTHS GUARANTEE COMMENTS ~ `1' ~ r. ~ i ~~ - ~ _... ;t .ey ` Ns, p _ TIME ^ AM , , „~- ; 1 TIME ^AM '"~ ~ ;~ ! ~' ""` ' ~ SERVICE ",.~ -~ '' -~ ' ` •' ' ~ ;r, ~ IN ~ PM" , ' f OUT ~ PM MAN ; , . . ~ ; CUSTOMER'S SIGNATURE ~ PRICE r~.., ;' -~,,-r; ~ PAYMENT TERMS: ^ DUE UPON RECEIPTS NET 30 •~ ~ ; ~~%:,_~ ~-• ~ Administrative fee 1.5%~per month for past due balances ,t f , ~-.=' 1'' . ~~ 1 ,.,-~ PAYMENT • ~ l _ -' _ _ .- ~ ,. ~ _ ^ PAY ONLINE SOURCE TOTAL -~ .~ = ,,'"~.~~ ~,.~ ~~ ~ ~' --f' FOR PROPER CREDIT PLEASE WRITE INVOICE NUMBER ON CHECK *$35 Charge on All Returned Checks , ~ ~ ~,r , ~ ~/; Customer Account Information For Service To: J A Bernard 14 Palmer Dr Account Number: 24-0640076-8 Premise Number: 24-0378420 Billing Period & Meter Information Billing Date: Apr 13, 2010 Billing Period: Mar 05 to Apr 08 (34 days) Next reading on/about: May 06, 2010 Rate Type: Residential Meter readings in current billing period: Meter Number N041267704 is a 5/8-inch meter Present-actual 650200 Last-actual 647400 Gallons used 2800 Billing Summary ______prior Balance-------------~.._~__~_ Prior Water Balance Prior Balance Other Payments prior to Apr 13, 2010. Thanks! Total prior balance, Apr 13, 2t)1A ____w_Current Water Charges-~•--____ Service Charge Water Volume ($ .007890 x 2800) STAS PAWC Water 0.45% DSI -PAWC Charge 0.40% Total Usage Billed 2so0 ---------Other Current Charges---------- Customer Protection In Home Customer Protection Sewer Line Customer Protection Water Line Tota! other charges, Apr 13, 201 ~~ ___~____AMOUNT DUE -----•---------____ Water Usage Comparison Monthly usage in hundred gallons. ~~ -- -~ a~ ~ ~~ ~y _-; ~; tip., :~.~, ~ ,~ ;, •1 ~ , 1. Y y ~ . tit. ~4~ ti~ ..~~ ~^,. ~ • -. 1. ~. h 4.. ~. '? !\.a ~ , 1l Y it A M J J A S O N D J F M A 2 p a u u u e c o e a e a p 4 r y n i g p t v c n b r r 0 $34.45 $15.99 -50.44 .00 13.00 22.09 .16 . 14 35.39 3.99 7.00 5.00 15.99 $51.38 ~ Messages to you from Pennsylvania American Water Any portion of the water charges which is not paid as of 5/10/10 will be subject to a 1.50°o penalty. * Approximately 3.90 percent or $1.38, of State taxes are included in your current bill. 'Effective January 1, 2010, the State Tax Adjustment Surcharge (STAS) increased from 0% to 0.45%. 'Effective April 1, 2010, the Distribution System Improvement Charge (DSlC) increased from 0% to 0.4°l°. The DSIC funds the replacement of water distribution facilities. * Follow us on Twitter for real-time updates on Pennsylvania American Water news, activities and water-related alerts in your area at Twitter.com/paamwater. Customer Service & Emergencies 1-800-565-7292 (24 Hours) For Hearing Impaired Customers TDD 1-800-300-6202 (24 Hours) Visit us on the INTERNET: www.pennsyivaniaamwater.com RAW t00 001 1 04/00 1 1 04 PCKWMJ TAV04 1 AIM 6411 Ct,~stomer Account information Fcr Service To: J A Bernard 14 Palmer Dr Account Number: 24-0640076-8 Premise Number: 24-0378420 Billing Period & Meter Information Billing Date: May 11, 2010 Bitting Period: Apr 08 to May 06 (28 days) Next reading on/about: Jun 08, 2010 Rate Type: Residential Meter readings in current billing period: Meter Number N041267704 is a 5/8-inch meter. Present-actual 651700 Last-actual 650200 Gallons used 1500 Billing Summary __~__._~prior Balance---__~___~___~_ Prior Water Balance Prior Balance Other Payments prior to May 11, 2010. Thanksl Total prior balance, May 11, 2010 ---------Current Water Charges---------- Service Charge Water Volume ($.007890 x 1,500) STAS PAWL Water 0.45% DSI - PAWC Charge 0.40% Totai Usage Bi{led o _~_____Other Current Charges---------- Customer Protection In Home Customer Protection Sewer Line Customer Protection Water Line Total other charges, May 11, 20110 ~_~~__AMOUNT DUE -----------_.~____ Water ~Jsage Comparison Monthly usage in hundred gallons. J~ ~3 i L / p a u 9 y n i . '+T •~ "iii : ! i ~~ Yl -1 ~.~ ~ ~tl 5`}~~ 1~f ~`~ ;~• ~ K ^ ~~?" ^i '4{ J A S O N D J F M A M 2 I u e t v c n b a p a 0 9 P y 0 $35.39 $15.99 -51.38 .00 13.00 11.84 .11 .10 25.05 3.99 7.00 5.00 15.99 $41.04 ~~ Messages to you from Pennsylvania American Water Any portion of the water charges which is not paid as of 6/07/10 will be subject to a 1.50°o penalty. * Approximately 3.90 percent or $.97, of State taxes are included in your current bill. * Effective January 1, 2010, the State Tax Adjustment Surcharge (STAS} increased from 0% to 0.45%. * Effective April 1, 2010, the Distribution System Improvement Charge (DS1C} increased from 0% to 0.4%. I The DSIC funds the replacement of water d~str-bution facilities. * Follow us on Twitter for real-time updates on Pennsylvania American Water news, activities and water-related ~ alerts in your area at Twitter.com/paamwater. ~c1 CC-~ ~ , 00202i/00202i PCL2YK TAV07 t3 Customer Service & Emergencies 1-800-565-7292 (24 Hours} For Hearing Impaired Customers TDD 1-800-300-6202 (24 Hours} Visit us on the INTERNET: www.pennsylvaniaamwater.com RAW100AM3081 A1M 262 ~C~n.,stomer Account Information For Service To: J A Bernard 14 Palmer Dr Account Number: 24-0640076-8 Premise Number: 24-0378420 Billing Period & Meter Information Billing Date: Jun 11, 2010 Billing Period: May 06 to Jun 08 (33 days) Next reading on/about: Jul 08, 2010 Rate Type: Residential Meter readings in current billing period: Meter Number N041267704 is a 5/8-inch meter. Present-actual 653400 Last-actual 651700 Gallons used 1700 Water Usage Comparison Monthly usage in hundred ga{{ans. 3 .; r_ Pc~,~- $25.05 $15.99 -41.04 .00 13.00 13.41 .12 .11 26.64 3.99 7.00 5.00 15.99 $42.63 Messages to you from Pennsylvania American Water Any portion of the water charges which is not paid as of 7/06/10 will be subject to a 1.50% penalty. * Approximately 3.90 percent or $1.03, of State taxes are included in your current bill. * Effective January 1, 2010, the State Tax Adjustment Surcharge {STAS) increased from 0% to 0.45%. * Pennsylvania American Water will be changing its treatment process from chlorine to cl'~loramine the week of July 1 For more information, visit www.PAChloramineFacts.ca * Effective April 1, 2010, the Distribution System Improvement Charge (DSIC) increased from 0% to 0.4%. The DSIC funds the replacement of water distribution facilities. 003448/003448 PCL9S2 TAV06 123 Customer Service & Emergencies 1-800-565-7292 (24 Hours) For Hearing Impaired Customers TDD 1-800-300-fi242 (24 Hours} Visit us on the INTERNET: www.pennsylvaniaamwater.com RAW {OOAM315tAM3121 A1M 5609 Billing Summary -------Prior Balance----------~-__~ Prior Water Balance Prior Balance Other Payments prior to Jun l 1, 2010. Thanks! Total prior balance, Jun 11, 2010 --------Current Water Charges-------- Service Charge. Water Volume ($ 007890 x 1, 700) STAS PAWC Water 0.45% DSI -PAWC Charge 0.40% Total Usage Billed o ------Other Current: Charges-------- Customer Protection. In Home Customer Protection Sewer Line Customer Protection Water Line Total other charges, Jun 11, 2010 -------AMOUNT DUE ------------- 2 ~~ J J A S O N D J F M A M J 2 0 u u u e c o e a e a p a u p 9 n I g •p Y v c n b r r y n ~ ~ I ~ ~ ~ ~ .- ` Page 3 PPL Electric p p ; :;: _ :::,:_~:$~~~~~:::~ :::.::..:::.: 80260-81003 Utilities '~ '" Electric Total from Last Bil! ~6L3I SerViee Payment Received Mar I7-Thank You! $6I.3I For: B g Details JOHN A BERNARD 14 PALMER DR Balance as of Apr 12, 2010 $0.00 CAI~iP HILL PA 17011 Current Charges DOMINION ENERGY Charges for -DOMINION ENERGY SOLUTIONS SOLUTIONS General Service Rate: DOMPPL for Mar 10 -Apr 9 Customer Service Electric Chg - 680 Kwhna, $.09403 63.94 120 TREDEGAR STREET Gross Receipts Tax $3.5~ RICHMOND, VA Estimated Pa State Tax $0.00 23219 1-88&-216•-3721 Total DOMINION ENERGY SOLUTIONS Char€;es $63.94 PPL Electric Utilities Customer Service Current Charges 827 Hausman Rd_ Allentown, PA _ Charges for -PPL ELECTRIC UTILITIES 18104-9392 - Residential Rate: RS for Mar 10 -Apr 9 1-800-342-5775 Distribution Charge: (1-800-DIAL-PPL) Customer Charge 8.44 www.pplelectric.com 200 KWH at 2.90600000¢ per KWH 5.81 480 KWH at 2.64000000¢ per KWH 12.67 PA Tax Adj Surcharge at 0.10300000% 0.03 Transition Charge: 200 KWH at -0.25200000 per KWH -0.50 480 KWH at -0.22300000¢ per KWH -1.07 Total PPL ELECTRIC UTILITIES Charges $25.38 Account Balance $89.32 General Generation prices and charges are set by the electric generation supplier you have chosen. The Public Utility Commission re elates distribution Information rices and services. The Federal Energy Regulatory~ommission regulates transmission prices and services. Next mggeter ppL Electric Utilities uses about $0.11 of this bill to~ av state taxes. In on oar about addition, about $1.49 of this bill pays the PA Gross receipts Tax. May 10 For your convenience, you can now pay your bill using your Visa, MasterCard, Discover, or ATM Card Call BillMatrix at 1-800-672-2413. BillMatrix will charge your credit and ATM card a service fee for making this payment. Before diggin around your home or property, you ;,hould always call the state's One Ca~ notification system to locate any underground utility lines. You can do this by simpl diahn 81 1, which will connect you to the One Call system. Be safe andycall 81~ before you dig. With pa~perless billing, you can receive and pay your PPL Electric Utilities bills onrine. The process is free, quick, convenient amd secure. To learn more or sign up, visit www.pplelecinc.com. Clean the lint filter on your dryer between loads. A clogged filter cuts air flow and wastes energy. A clean filter shortens drying time and saves money. Save postage and late charges -sign up for Automated Bill Payment. PPL Electric Utilities Electric Service For: JOHN A BERNARD 14 PALMER DR CAMP HILL PA 17011 Questions about this bill? Please contact us by Jun 1 at 1-800-342-5775 (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. Types of IVl~eter Readings: Actual - Adjusted Estimated Customer ,, ~; ~~1 4 J 6 ?.'r.•` pp ~~~ o~y it .~ Summary Page Balance as of May 11, 2010 Page 1 $0.00 Charges: Total: DOMINION ENERGY SOLUTIONS Charges$40.53 Total PPL ELECTRIC UTILITIES Charges $19.35 Total Charges $59.gg ::... .:.~yl~is: A~~a~ 1~ ~~ter n Asa ~.,. ~€Fl~ ...:::::.......:.:.:.: ... . Account Balance ~~g.gg ~~I~~~~~U~~ ~~ 36 30 24 18 12 6 0 Meter #63107435 May 10 Actual 35665 Apr 9 Actual 35234 31 Davs K`iuH Billed 431 Average -May 2009 2010 Te~mpperature 54F 57F KWH Per Day 10 14 Yearly Use: Jun 2008 - Mav 2009 Jun 2009 -May 2'010 Total Average Use Monthly 4737 34~ 5159 430 ©ther important informat:ioa oa back ~ ~, Meter Reading :[aformafion KWH -Average Per Day 80260-81003 ........ ........::.... MJJASONDJFMAM 2009 Months 2010 n 'i y .~,• `•, ~,,`_~ &'* ,~' Page 3 ~_ pp ... .. .... PPL Electric '~__ :_::~~~::$~~:_:::::::::. i~~ i~'°, 80260 81003 Utilities ~ rM E leCtrlC Total from Last Bill X89.32 Service Payment Received Apr 21' -Thank You! X89.32 For: ~~ ~ g Details 30HN A BERNARD 14 PALMER DR Balance as of May 11, 2010 $0.00 CAMP H1L.L PA 17011 Current Charges DOMINION ENERGY Charges for -DOMINION ENERGY SOLUTIONS SOLUTIONS General Service Rate: DOMPPL for Apr 9 -May 10 Customer Service Electric Chg - 431 Kwh ~a $.09403 40.53 120 TREDEGAR STREET Gross Receipts Tax X2.2 RICHMOND, VA Estimated Pa State Tax $0.00 23219 1-888-216-3721 Total DOMINION ENERGY SOLUTIONS Charges $40.53 PPL Electric Utilities Customer Service Current Charges 827 Hausman Rd_ Allentown, PA Charges. for -PPL ELECTRIC UTILITIES 18104-9392 - Residential Rate: RS for Apr 9 -May 10 1-800-342-5775 Distribution Charge: (1-800-DIAL-PPL) Customer Charge 8.44 www.pplelectric.com 200 KWH at 2.90600000¢ per KWH 5.81 231 KWH at 2.64000000¢ per KWH 6.10 PA Tax Adj Surcharge at 0.10300000% 0.02 Transition Charge: 200 KWH at -0.25200000¢ per KWH -0.50 231 KWH at -0.22300000¢ per KWH -0.52 Total PPL ELECTRIC UTILITIES Charges $19.35 Account Balance $59.88 General Generation prices and chargges are set by the.electric generation supplier you have chosen. The Public Utility Commission re elates distribution Information nces and services. The Federal Energy Regulatory~ommission regulates transmission prices and services. _ Next mgeter ppL Electric Utilities uses about $0.09 of this bi111:o pay state taxes. In on or about addition, about $1.14 of this bill pays the PA Gross Keceipts Tax. Jun 4 For your convenience, you can now pay your bill using your Visa, MasterCard, Discover, or ATM Card Call Bi1lMatrix at 1-800-672-2413. BillMatrig will charge your credit and ATM card .a service fee for making this payment. Before diggin around your home or property, you should always call the state's One Call notification system to locate any wsderground utility lines. You can do this by simply diahn 811, which will connect you to the One Call system. Be safe and call 81~ before you dig. With paperless billing, you can receive and pay your PPL Electric Utilities bills online. The process is free, quick, convenient ,and secure. To learn more or sign up, visit www.pplelectnc.com. New refrigerators use about half the energy as models made before 1979. If you buy a new refrigerator, get rid of tfie old one. It's costly to keep two llI11tS nlIlning. Save postage and late charges -sign up for Automated Bill Payment. PPL Electric Utilities Electric Service For: JOHN A BERNARD 14 PALMER DR CAMP HII.L PA 17011 Questions about this bill? Please contact us by Jul 1 at 1-8U0-342-5775 (1-S00-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. Tvpes of 1Vleter Readings: Actual - Adjusted Estimated Customer ~', '. ,,, , '•;--^•~,~~,- Page 1 ;,.- =-_:=~a~~.Bil#~~cci_iii~=_ tiib~r>::.:.:::~::.:_ ,'•.' - ., 80260-81003 .. .. Summary Page Balance as of Jun 10, 2010 $0.00 Chargges: TotarPPL ELECTRIC UTILITIES Char es 24.51 Total DOMINION ENERGY SOLUTIO~S Charg;es~60.56 Total Charges $85.07 + '~bEis ~~ ~ ~~t~~. man: ~s~ :_ ~~~~ . ..:::..::..::..:..:.::.....: ..: . Account Balance $85.07 ~c11~= oo KWH -Average Per Day 36 30 24 18 12 6 0 Meter Reading Information Meter #63107435 Jun 9 Actual 36309 May 10 Actual 35665 30 Davs KWH Billed 644 Average -Jun 2009 2010 Tempperature 63F 9 66F 21 KWH Per Dav Yearly Use: Total Average Use Monthly Ju12008 -Jun 2009 4719 393 Jul 2009 -Jun 20:10 5511 459 Other important information on back ~ J J A S O N D J F M A M J 2009 Months 2010 ,~ ~ C' ~ ~ ' ,~. `. ;. ~:,.; ,~ Page 3 PPL El t i ' '~~I - :;~:_:5~b.~lf::$ilk'i~Gb~t'lf~.~l3f~1~3CT::i;:~'~::• ;,~ ..::_.. 1 pp r c ec . . 80260-81003 Utilities ~' '" Electric Total from Last Bill $59.88 S erViee Payment Received May 18 -Thank You! $5'9.88 For_ Billing Details JOHN A BERNARD 14 PALMER DR Balance as of Jun 10, 2010 $0.00 CAMP HILL PA 17011 Current Charges DOMINION ENERGY Charges for -DOMINION ENERGY SOLUTIONS SOLUTIONS t r Service m C General Service Rate: DOMPPL for May 10 -Jun 9 us o e 120 TREDEGAR STREET Electric Chg - 644 Kwh (cry, $.09403 60.56 Gross Receipts Tax $3.3'f RICHMOND, VA Estimated Pa State Tax $0.00 23219 1-888-216-3721 Total DOMIlVION ENERGY SOLUTIONS Charges $60.56 PPL Electric Utilities Customer Service Current Charges 827 Hausman Rd_ Allentown, PA Charges for -PPL ELECTRIC UTILITIES 18104-9392 Residential Rate: RS for May 10 -Jun 9 1-800-342-5775 (1-800-DIAL-PPL) Distribution Charge: Customer Char e 8.44 . www.pplelectric.com 0600000¢ per KWH 5.81 200 KWH at 2 444 KWH at 2.64000000¢ per KWH 11.72 PA Tax Adj Surcharge at 0.10300000% 0.03 Transition Charge: 200 KWH at -0.25200000¢ per KWH -0.50 444 KWH at -0.22300000¢ per KWH -0.99 Total PPL ELECTRIC UTILITIES Charges $24.51 Account Balance $85.07 General Generation prices and charges are set by the electric generation supplier Information you have chosen. The Public Utility Commission re mates distribution ricer and services. The Federal Energy Regulatory~ommission regulates t ransmission prices and services. N~xt~mgeter t b ppL Electric Utilities uses about $0.11 of this bill to ppay state taxes. Ili about $1.4.4 of this bill pays the PA Gross :Keceipts Tax. addition ou on or a , Jul 9 For your convenience, you can now pay your bill using your Visaa,, MasterCard, Discover, or ATM Card. Call Bi1lMatrix at 1-800-b72-2413. BillMatrix will charge your credit and ATM card a service fee for making this payment. Before diggin around your home or property, you should always call the t C f i l ' d d l l all noti ity state icat on system o ocate any un uti s One ergroun ines. You can do this by simply dialing 811, which will connect you to the One t d ll 81 I b f f di ll B C e sa e an ca e ore you em. g. a sys With paperless billing, you can receive and pay your PPL Electric Utilities bills online. The process is free, quick, convenient and secure. To learn more or sign up, visit www.pplelectnc.com. Air conditioning is probably the biggest part of your stunner energy il e keeping cool. Check air conditioner needs. You can save money wh filters monthly. Clean or change filters as needed. You'll stay cool and your system will use less energy. Manage Your Account Pho~ie ~`J ~rnb~~~- ~~,r, ;;cur I~ ii~~~:~„ ~ Billlr~c i:~:~re very n My Account atverizon.cam/billview. 717-7:'.'~;'-.3E~~t+ ~~ , ' ~';3 .. i~3C~ !i~l', '; ;Y 6/4l2(11L~ Verizon News ,Enjoy Your Triple Play! ~ Your plan includes Verizon Freedom Essentials, FiOS Internet 15/5 and FiOS TV Essentials for $109.99 a month. This price excludes taxes, fees and charges for any products outside the bundle such as set-top box rentals, video-on-demand, premium channels, security and gaming services. Entertainment - On Your Time The FiOS DVR records your favorite shows and allows you to watch them on your schedule. Record up to two shows at the same time, pause & rewind live TV, or schedule recordings from any web enabled PC/cell for just $15.99/mo Call 1-800-671-1227 today & receive 3 months FREE. Offer ends s-21-10. Check Out Our New Bundles! Call 1-888-226-8139 to find out about new bundles and features for Verizon customers. Make sure you are getting the best value for your TV, Internet and Phone services. We can 1 help you choose the combination of services ~hat'~ riyl~t for your needs. Quick Bill S~ami~~~cu-~~~ fc~~ .JOHN A BERNARD Previous Balance Payments Received May 1!1 Balance Forward $716.42 -$1' 16.42 $.Op New Charges FiOS Triple Freedom ~Sr+ ~ a 3 i Voice Additional Services TV Additional Services Internet Additional Service: Taxes, Fees & Other Verizo ~ Cha.~~,les __ Total New Charges Due tr~,luna 3(1, 7['11!l Total Amount Due key J~~ui~e~ 3(~,, ;~!p'I ~ ~ ~ ~ -~~' J ... _~ _ .. -- $99.99 ;7.25 $13.97 `,66.99 $'16.22 ~;i 44.42 $141.42 ~,~!i ------- Direct Payment Enrollment Online Billing & Payment Ouestiors abort your ai I ~' verizon.com/billpay verizon.com/billview verizon.c om or 1-80 ~ ~- II:RI ~') ~;1 -~~i0[ -•3 37- E966}' Manage Your Account Phone Number Account Nurnber Billing Date ~,~ My Account at verizon.com/billview 717-737-3680 717 737-3680 51.9 i 92Y 5!4/2010 Verizon News Triple Freedom ~ Your plan includes Verizon Freedom ~ Essentials, FiOS Internet 15/5 and FiOS TV Essentials for $109.99 a month. This price excludes taxes, fees and charges for any products outside the bundle such as set-top box rentals, video-on-demand, premium channels, security and gaming services. We Want You to Stay With Us ~ You are a valued customer & we want to deliver the very best service & value to you. Call us at 1-888-226-0799 to find out about ~ the new ways Verizon can save you more money. We appreciate being your provider, and we would like to keep you with us longer by improving your Verizon experience. I Are You Enjoying Your FiOS? We hope you've been enjoying your FiOS TV, Internet & Home Phone for the price of two. Please note, your promotional price ends ~ soon. Your bill will now reflect regular charges', for your three services. If you love what FiOS has to offer, there's no action required. Just enjoy! Quick Bill Summary for JOHN A BERNARD Previous Balance Payments Received Apr 22 Balance Forward New Charges FiOS Triple Freedom (See pg 3} Voice Additional Services TV Additional Services Internet Additional Services Specials and Promotions Taxes, Fees & Other Charges Total New Charges Due by June 1, 2010 Total Amount Due by June 1, 2010 ~~~ ,rg s,.- ;.. . !uoy ~~3r._: ~,~ li~i $1 4:45 -$114.45 $.00 $99.99 $7.25 $13.97 $6.99 -$28.00 $16.22 $116.42 $716.42 Direct Payment Enrollment Online Billing & Payment ~ Questions about your biil? ___..-- --.r__. _~_.___-- _.______._.._____ _ ___-- _-__ - _ -~ ______~_~_ ___ ~_.___-_ _. __- verizon.com/billpay verizon.comfbillview ! verizon.com ar 1-800-VER120N ~~1-800-837-4966). very, Manage Your Account Phone Number Account Number Billing Date My Account at verizon.com/billview 717-737-3680 717 737-3fi801519192Y 4/4/2010 Verizon News Triple Freedom Your plan includes Verizon Freedom Essentials, FiOS Internet 15/5 and FiOS TV Essentials for $109.99 a month. This price excludes taxes, fees and charges for any products outside the bundle such as set-top box rentals, video-on-demand, premium channels, security and gaming services. Entertainment - On Your Time The FiOS DVR records your favorite shows and allows you to watch them on your schedule. Record up to two shows at the same time, pause & rewind live TV, schedule recordings from any web enabled PC/cell, & view photos or listen to tunes from your TV for just $15.99/mo. Call 1-800-584-1091 today! Moving? Let Verizon Heip Call 1-866-UZ-MOVES to bring the power of the Network to your new home. We can connect your TV, Internet ~ phone quickly-maybe before you're finished unpacking. Plus, we have Bundles to fit your needs and your budget. Service availability varies. Direct Payment Enrollment Online Billing & Payment Questions about your bill? venzon.com/biilpay _ verizon.com/bsllview i verizon com or 1-800-VERiZON (1-800-837-4966) Quick Bill Summary for r' ~~~~~~ ~ . Jq..t'.. .:I •I JOHN A BERNARD i ~uU~~ , ~~~ Previous Balance -'.1 .1~~'.. $114.24 Payments Received Mar 17 __ - - - -$114.24 Balance Forward $.00 New Charges FiOS Triple Freedom (See pq 3} $109.99 Voice Additional Services $7.25 TV Additional Services $3.97 ___ __ _ __ Internet Additional Services -$23.01 Taxes, Fees 8~ Other Verizon Charges _ __ $16.25 Total New Charges Due by May 3, 2010 $114.45 Total Amount Due by May 3, 2010 $114.45 ;: BE IT REMEMBERED THAT LAST WILL AND TESTAMENT Y, JOHN A. BERNARD, a resident of Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this to be my LAST WILL and TESTAMENT, hereby revoking any and all Wills and Codicils previously made by me. I T r1Pr1 arP that I aICI married to ~IILDA B. BERNARD, and that I -~. ~. `'~~ BAS SE11Y1CE Billin Summary for Service to: JOHN ~ BERNARD 14 PALMER DR CAMP HILL PA 17011 Rate Classification: Residential Heating Billing Period: 03/30!2010 to 04/28/2010 (29 days} Remote Device Read Questions? Call 800-276-2722 or write to UGI at PD BOX 13009 Reading, PA 19612-3009 `Your current UGI charges include State taxes totaling about $ 1.11. ._ .,, ~ -,_ y,~,.. ~, Past BIII Information -UGI Utility GuStomer Numf~el~ The account balance on our last bill was $~ 89.27 ~° ~ - s~, ~,r4w~; y ................. Thank you for your payment of ...................................... -89.27 219 723 $344 11 Your balance as of 05/03/2010 .................................... ~E . ~ Current Bill Information -UGI Utility Customer Charge ............................................................... 8.55 Commodity Charge (20 CCF at $0.85400} ............... 17.08 Distribution Charges (First 20 CCF at $0.44450) .... 8.89 PA State Tax Surcharge ................................................... -0.10 Total Current Charges -UGI Utility ................................ 34.42 UGI Utility charges owed this bill ..................................................................................... Total Amount Due, Pleaae Pay by Due Date (05/2412010') ....................................... .~:/ ~~ ~~~ ~o 4.80 4.32 3.84 3.36 2.88 2.40 1.92 1.44 0.96 0.48 0.00 Average CCF Per Day AMJJASONDJFMA 2009 Months 2010 Meter Information -Next Read Date May 28, 2010 Meter Number Previous Reading Present Reading CCF Used 1250133 4456 (remote) 4476 (remote} 20 Messages from UGt ^Your current price to compare is $ 0.85410 /CCF. ^Your total annual usage is 551 CCF. Your average monthly usage is 45 CCF. • We can make your energy costs easier on your budget with our 12 month Budget Billing plan. Your monthly payment would be approximately $ 77...00. For more information about this plan call UGi. • Help prevent pipeline damage, accidents and service disruptions. Call 811 before you dig • Sign up to view and pay your future UGI bills on{ine at www.ugi.com. Last This Average Year Year CGF/day 2.04 0.69 If you pay at a payment agent please take your entire bill. 141ake check payable to UGI. Daily temperature 52°F 56°F Keep this part for your records. Important information is on the back of this bill. .. ~. ~~~~ sus saevicE Billingg Summary for Service to: JOHN A BERNARD 14 PALMER DR CAMP HILL PA 17011 Rate Classification: Residential Heating Billing Period: 04/28/2010 to 05!2712010 (29 days} Remote Device Read Questions? Call 800-276-2722 or write to UGI at PO BOX 13009 Reading, PA 19612-3009 * Your current UGI charges include State taxes totaling about $ 0.65. ty ~~ ~ v Past Bill Information -UGI Utili StQ~ ~ f ~t~rtl~teT The account balance on our last bill was $~ 34.42 ~ ~° ~ ' ~°~~~~ ~~~~ y ~ ................. Thank you for your payment of ...................................... -34.42 219 723 8344 11 Your balance as of Ofi/02/2010 .................................... ~r~ Current Bill Information -UGI Utility Customer Charge ............................................................... 8.55 Commodity Charge { 9 CCF at $0.85444) .................. 7.69 Distribution Charges {First 9 CCF at $0.44444) ....... 4.00 PA State Tax Surcharge ................................................... -0.06 Total Current Charges - UGl Utility ................................ 20.18 UGI Utility charges owed this bill ..................................................................................... $ 20.18 Total Amount Due, Please Pay by Due Date (06/23/2010') ....................................... S 20.18 c~ ~~~ 4.80 4.32 3.84 3.36 2.88 2.40 1.92 1.44 0.96 0.48 0.00 Average CCF Per Day MJ J AS ONDJ FMAM 2009 Months 2010 Meter Information -Next Read Date June 29, 2010 Meter Number Previous Reading Present IReading CCF Used 1250133 4476 {remote} 4485 {remote} 9 Messages from UGI 'Your current price to compare is $ 0.81380 /CCF. 'Your total annual usage is 535 CCF. Your average monthly usage is 44 CCF. ^ We can make your energy costs easier on your budget with our 12 month Budget Billing plan. Your monthly payment would be approximately $ 72.00. For more information about this plan call UG{. 'Help prevent pipeline damage, accidents and service disruptions. Call 811 before you dig 'Sign up to view and pay your future UGI bills online at www.ugi.com. Last This Average Year Year CCF/day 0.83 0.31 If you pay at a payment agent please take your entire bill. Intake check payable to UG{. Daily temperature 62°F 64°F Keep this part for your records. Important information is on the back of this bill.