Loading...
HomeMy WebLinkAbout08-02-10IN RE: AMANDA MCKEE : IN THE COURT OF COMMON PLEAS An Incapacitated Person :CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION No.: 21-05-463 REPORT OF THE GUARDIAN OF THE ESTATE AND PERSON OF AMANDA MCKEE, AN INCAPACITATED PERSON AND NOW, this ~ day of U ~ _, 2010, comes Elizabeth Reinecker, Guardian of the Estate and Person of Amanda McKee, an adjudicated incapacitated person, and files the following Report pursuant to the Probate Estate and Fiduciaries Code (20 Pa.C.S. §5521(c)(1)(i)(ii)): 1. The Reporter is Elizabeth Reinecker, whose address is 9 Mayfield Road, Mechanicsburg, Pennsylvania 17055. 2. The Reporter was appointed plenary guardian of the person and estate of Amanda McKee by Order of this court dated June, 20, 2005. 3. Amanda McKee currently receives the following monthly income; copies of the most recent checks for Chevron and John Hancock are attached hereto as Exhibit "A"; Social Security is automatically deposited into Mrs. McKee's resident account at Claremont Nursing and Rehabilitation Center. a. Chevron Retirement Plan $267.90 ~z.;: ~ ~,--~ w ._ 4 JT ~.. ~.7 ~._. \_ ! 1 f...~ i ~ ~I.'. ~.~ .~ b. John Hancock Financial Services $29.65 ii --- ~`. c. Social Security $1,513.00 L~ ~l C, C~ Y V,~'` w ~ •~; J ~~ U~~, ~~ U 4. As of the time of this report, Amanda McKee has the following accounts through Susquehanna Valley Federal Credit Union, a copy of the statements from May 31, 2008 to May 31, 2010 are attached hereto as Exhibit "B": a. A checking account with a balance of $1,248.04 as of June 30, 2010. b. A savings account with a balance of $2,598.48 as of June 30, 2010. 5. Amanda McKee has an account held through Claremont Nursing & Rehabilitation Center with a balance of $2,375.98 as of June 30, 2010. A copy of the most recent statement is attached hereto as Exhibit "C". 6. The majority of expenditures made on behalf of Amanda McKee have been made from her Susquehanna checking account for Claremont Nursing & Rehabilitation Center and other miscellaneous necessities. Copies of the Claremont statements are attached hereto as Exhibit "D." 7. Amanda McKee has continued to reside at Claremont Nursing & Rehabilitation Center, 1000 Claremont Road, Carlisle, Pennsylvania 17013, since the inception of the guardianship. 8. Amanda McKee suffers from Alizhimers, which makes her unable to make and communicate knowledgeable decisions. Due to her incapacity, Amanda McKee is in need of daily care. 9. Amanda McKee is currently receiving medications. A list of said medications are attached hereto as Exhibit "E." 10. In the opinion of the guardian, the guardianship should continue due to the fact that the conditions that lead to the guardianship have not ceased. 11. Throughout the term of the guardianship, the guardian has exercised her guardianship rights by visiting Amanda McKee at Claremont Nursing & Rehabilitation Center. Respectfully Submitted, Wendy Weikal-Beauchat Beauchat &Beauchat 63 West High Street Gettysburg, PA 17325 Phone: (717) 334-4515 Facsimile: (717) 337-2010 Supreme Court Id. #71930 Our Address for Coneapwrdenoe The Human Resources Service Center For Information Cell Post Office Box 438 The Human Resources service Center 1-806-TALK2HR Ltttie Falis, NJ 07424 a AMANDA MCKEE CIO ELIZABETH REINECKER 9 HAYFIELD RD MECHANiC3BURG PA 17055 goo ooo~o I~aooroo^ Rw o» sy On: Dac~lptton TNs Pay • ~~ 7' 7000A13322 ~ ~ Check Number: Las Deposits To: Bank Routk~ Number Account Number ~ Amount coon oomeo hooo~ao~ w« 0~1 _ 0000 ooo~so l~ oooew. n.r oi) Pey.~.~~ 12/1012009 Account 028835100 Pay m nr order of ~ AMANDA MCKEE ~~ CIO EIIZ~BETH REINECKER 9 HAYFIELD RD '"3257.90" MECHANICSBURG PA 17055 _ RlDWYS i FOR: 1 i/3012008 BENEFIT CHECK w.a~ew.e.+,r+.w _ _ _... 1 1 ,•a .•n c a Lf1 Oi262r -. \DDRESS CHANGE RORM CI~~D~ DIRECT DEPOSIT ENROLLMENT FORM please ptiot cleariy) (please print clzady) SAME iTREET ApTq :II'Y ST ZIP CODE CE[.EPHONEN ( ~ ~fY LEGAL RESIDENT STATE IS: ;SIGNATURE) 3ROSS AMOUNT (DATE) 7076 10001 XXXXX8165 201 101 ~muc: nuNS~cREDiTs FEDERAL W/H 29.65 AMOUNT 0.00 ~'~~ ~ ~ul a ~~~ `~ N BANK NAME B.aNK MAILING ADDRESS CITti• ST ZIP CODE please make an X for one type of account CHECKING or []SAVINGS ACCOUNT N (please enclose a VOIDED check) ABA~oaac~ooooc~ (SIGNATURE) (JOINT SIGNATURE iF APPLICABLE) sI hereby authorize John Hancock IJfz It~nntax Company (U.SA.) b iniUace credit entries my aocoimt indicated abwe_ If an amount abauld be ctYdiced b my account, in e~tur, or atLtr my ~kath, I authorize the apprupriace debit adjusonent.+ DUE DATE 06/30/2010 . C.HECKNUb1BER GB7-001327688 II?NO. 7076 10001 XXXXX8165 201 101 FOR QUESTIONS PLEASE CALL• 1-800-624-5155 SEND REQUESTS TO: JOHN HANCOCK LIFE INSURANCE CO. (U.S.A.) IY)TAL DIDIJCTIONS VET Ah10UNT TAX REPORTING TAXABLE AMT 0.00 29.65 AhfOUNT 24.65 PO BOX 9512 PORTSMOUTH, NH 03802-9512 JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) C~~~n,~,~ 62 20 ('HECK NIIMAIR G67-001327688 317 G$7-OD1327688 03 N ID NO. 7076 10001 XXXXX8i:b5-201 101 0477' Mautb I7n ~ Y'ear' la the Atnottttt of 0 ':21110 ssstssstssssssrsssss-sssss•*ssssssssE~AC~Ir ~~ NINE DOLLARS AND 65CIIYTSsssssssssssr:-ssss•isssswsssssssss ~y ~ mt: orderuf auc valid after Iso says AMANDA MCKEE I¢tbeAmo Eof 9 HAYFIELD RD #?~****~t~I+r9:65~~E MECHANICSBURG PA 17055-5628 Cltibauk, N.A. ~/'17..,I ~ ' ~'""t One Pem'a Way _ - t/"~. New Caatce, DE 19720 e~ w 1~ 2 7 ~RAtt• I_fl ~ i iflfl 2f191: 3R 7 5 4 5 3 7ua SUSQUEHANNA ALLEY F E D E R A L C R E D I T U N I O N 3850 HARTZDALE DRIVE CAMP HILL, PA 17011-7809 LOCAL: (717) 737-4152 TOLL FREE: (800) 948-1454 FAX: (717) 737-0589 ~u~~~~m~~~nn~~~u~~~~~~~~u~~un~~~~n~~~~n~~~~nu~~~~ 00001277 1 AV 0.335 ELIZABETH REINEKER FOR AMANDA MCK 9 MAYFIELD ROAD MECHANICSBURG, PA 17055-5628 Meaberl~ : 14698 Social Security #: X-XXXX Statement Date: 06/30/2009 PageM: 1 Mail .Code: Web Code: YTD TAXABLE DIV: $7.99 YTD TAXABLE INT: $.00 YTD FINANCE CHG: 5.00 OVERDRAFT FEES THIS PERIOD: $.00 RETURNED ITEMOFEESRTHISEPERIOD: 5.00 RETURNED ITEM FEES YTD: S.00 TRAM DATE POST DATE TRANSACTION DESCRIPTION TRAN FEE FINANCE LOAN- ------ - AMOUNT AMOUNT CHARGE PRINCIPAL 06/01 - Type:'-00 - REGULAR SHARES - 00 --------- -------- - ------ Joint with ELIZABETH A. REINECYER PREVIOUS BALANCE 06/30 06/30 Dividend Posting 3 22 06/30 . *~ ANNUAL PERCENTAGE YIELD EARNED: 0.50 X FOR A PERIOD OF 91 DAYS ~* NEW BALANCE 06/01 06/30 Type 06/30 : 40 - SHARE DRAFT - 40 ,,~°"" ACH Credit ' JH GBSA """ """°~^~.., ~ °~ ~~EN I PREVIOUS BALANCE 06/30 06/30 PACE ACH - 1041414 60 P S ON~ ACH Credit 267 90 06/30 BENEFITS - 1056023351 PP S . NEW BALANCE Descri tion S ______p ~ C y Debits Credits Share Draft Iteas ~+ ATM Transactions ~ -- - p ~ '00 ----------- .00 , EFT Transactions "'~ 2 ~„~°'/ :00 Electronic Checks .00 297.55 Voice Transactions 0 .00 00 .00 Other Withdrawals • 00 .00 Dther Deposits U . .00 Balance Forward: 3,293.81 Net Change: 297 55 New 8aiance: . 3,591.36 BALANCE 2586 49 2589.71 2589.71 3293.81 3323.46 3591.36 3591.36 We've added a new branch to better se at 339 East Park Drive, off of Derry ~H~ R i~ SVFCU's new Harrisburg branch g• 6401277 SUSQUEHANNA ALLEY FEDERAL CREDIT UNION 3&50 HARTZDALE DRIVE CAMP HILL, PA 17011-7809 LOCAL: (717) 737-4152 TOLL FREE: C800) 948-1454 FAX: (717) 737-0589 ~m~~~~n~~~uu~~~u~~~u~~~u~~nn~~~~u~~~~u~~~~nn~~~~ 00000363 1 AV 0.335 ' ELIZABETH REINEKER FOR AMANDA MCK 9 HAYFIELD ROAD MECHANICSBURG, PA 17055-5628 Meaber8: 14698 Social Security 8: X-XXXX Stateaent Date: 07/31/2009 Page#: 1 Mail Code: Web Code: YTD TAXABLE DIV: 57.99 YTD TAXABLE INT: $.00 YTD FINANCE CHG: 5.00 OVERDRAFT FEES THIS PERIOD: 5.00 OVERDRAT FEES YTD: 5.00 RETURNED ITEM FEES THIS PERIOD: 5.00 RETURNED ITEM FEES YTD: S.00 TRAN POgT TRANSACTION HATE DATE DESCRIPTION TRAM FEE FINANCE _ LOAN _____ _____-__ ANOUNT ANOUNT CHARGE PRIM-CIPAL Joint With ELIZABETHGA`AREINECKER- 00 PREVIOUS BALANCE 07/31 NEW BALANCE 07/01 Type: 40 - SHARE DRAFT - 40 07/31 07/31 ACH Credit JH GBSA PACE ACH - 1041414660 07/31 07/31 ,ACH Credit BENEFITS - 1056023351 PPD 07/31 PREVIOUS BALANCE 65 7. NEW BALANCE Description Share Draft Iteas ATM Transactions EFT Transactions Electronic Checks Voice Transactions Other Withdrawals Other Deposits Balance Forward: Net Change: New 8aiance: bits _-___Credits 00 .00 0 0 297.55 .00 .00 .00 .00 .00 .00 0 3,591.36 297.55 3,888.91 (~~~~ t! . ~Y ~~ a ~~~e~ BALANCE 2589.71 2589.71 3591.36 3621.01 3888.91 3888.91 havepansppecificnvehiclecin~PinditletFus,knowtandrEnterpriseewilletryptoahave2it26orIa you eoaparable one, available for you! 6400362 SUSQUEHANNA ALLEY E D E R A L C R E D I T U N I O N 850 HARTZDALE DRIVE CAMP HILL, PA 17011-7809 LOCAL: (717) 737-4152 TOLL FREE: C800) 948-1454 FAX: (717) 737-0589 ~u~~~~m~~~un~~~n~~~u~~~u~~~m~i~~n~~~~u~~~~un~~~~ 00000424 1 AV 0.335 ELIZABETH REINEKER FOR AMANDA MCK 9 MAYFIELD ROAD MECHANICSBURG, PA 17055-5628 Social Securityr~c 14698X-XXXX Statewent Date: 08/31/2009 Pagelk : 1 Mail Code: Web Code: YTD TAXABLE DIV: 57.99 YTD TAXABLE INT: 5.00 YTD FINANCE CHG: 5.00 OVERDRAFT FEES THIS PERIOD: $.00 RETURNED ITEMOFEESRTHISEPERIOD: $.00 RETURNED ITEM FEES YTD: 5.00 TRA7i POST TRANSACTION DATE DATE DESCRIPTION TRAM FEE FINANCE LOAN _____ ~____ _________~___----______ __ _. AMOUNT ANOlJNT CHARGE -PRINCIPAL_ _-- EALANC€ OS/O1 T ------ ----------- -------- -------~-- ype: 00 - REGULAR SHARES - 00 -°°°° - ----------- Joint witch ELIZABETH A. REINECYER PREVIOUS BALANCE 2589.71 08/31 08/01 Type: 40 - SHARE DRAFT - 40 08/31 08/31 ACH Credit Jtt GBSA PACE ACH - 1041414660 08/31 08/31 ASH Credit 08/31 BENEFITS - 1056023351 PPD Description ~ Share Draft Itews~ ATM Transactions EFT'Transactions Electronic Checks Voice Transactions Other-Withdrawals Other Deposits Balance Forwarq: Net Change: New Balance: NEW BALANCE 2589.71 9.65 PREVIOUS BALANCE 3888.91 N 3918.56 7.90 ! 4186.46 NEW BALANCE 4186.46 Debits Cregits .00 .00 0 .00 2 •00 297.55 0 .00 .00 0 .00 .00 .00 0 .00 3,888.91 297.55 4,186.46 havepa sppecificnvehiclecin7ainditlatFus~j:nowtandrEnterpriseewilletryptowhaveZit26orIa you cowparable one, available for you! 6400423 SUSQUEHANNA ALLEY F E D E R A L C R E D I T U N I O N 3850 HARTZDALE DRIVE CAMP HILL, PA 17011-7809 LOCAL: (717) 737-4152 TOLL FREE: (800) 948-1454 FAX: (717) 737-0589 ~n~~~~ui~~~un~i~n~~~n~~~u~~nn~~~~~~~~~~u~~~~uu~~~~ 00001284 1 AV 0.335 ELIZABETH REINEKER FOR AMANDA MCK 9 MAYFIELD ROAD MECHANICSBURG, PA 17055-5628 MeaberiF : 14698 Social Security #: X-XXXX Stateaent Date: 09/30/2009 Pagel: 1 Mail Code: Web Code: YTD TAXABLE DIV: 511.25 YTD TAXABLE INT: 5.00 YTD FINANCE CHG: 5.00 OVERDRAFT FEES THIS PERIOD: 5.00 RETURNED ITEMOFEESRTHISEPERIOD: S.00 RETURNED ITEM FEES YTD: S.00 TRAN POST TRANSACTION TRAN FEE FINANCE LOAN_ DATE DATE DESCRIPTION _ AMOUNT AMOUNT CHARGE PRINCIPAL BALANCE 09/01 Type: 00 - REGULAR SHARES - 00 - ------- ---------- ----------- Joint with ELIZABETH A. REINECKER PREVIOUS BALANCE 2589.71 09/30 09/30 Dividend Posting 3.26 ** ANNUAL PERCENTAGE YIELD EARNED: 0.50 % FOR A PERIOD OF 92 DAYS >K* 2592.97 09/30 NEW BALANCE 2592.97 09/01 Type: 40 - SHARE DRAFT - 40 PREVIOUS BALANCE 4186.46 09/30 09/30 ACH Credit. 9.65 JH GBSA PACE ACH - 1041414 60 P ENSION 4216.11 09/30 09/30 ACH Credit 67.90 BENEFITS - 1056023351 PP NS 4484.01 09/30 NEW BALANCE 4484.01 Description -Sum r ° C Debits Credits ----------------- - - - °---.00 ---------oo- Share Draft Itews 0 .00 .00 ATM Transactions p EFT Tran:actions .00 297.55 Electronic Checks 0 .00 .00 Voice Transactions 0 .00 .00 Other Withdrawals 0 .00 Other Deposits 0 .00 Balance Forward: 4,186.46 Net Change: 297.55 New Balance: 4,484.01 The Credit Union's Supervisory Co~aittee has controlled the distribution of this statewent. If you feel it is not correct, pplease su~ply details in writing to: Supervisory Co~wittee SVFCU, PO Box 3233, Shireaans own, PA 17011. 6401283 SUSQUEHANNA ALLEY FEDERAL CREDIT UNION 3850 HARTZDALE DRIVE CAMP HILL, PA 17011-7809 LOCAL: (717) 737-4152 TOLL FREE: (800) 948-1454 FAX: (717) 737-0589 L~~II6nIII~ndJ~~LIn66dInul~IlulJln~LLmLII 00000411 1 AV 0.335 ELIZABETH REINEKER FOR AMANDA MCK 9 MAYFIELD ROAD MECHANIC58URG, PA 17055-5628 Member#: Social Security #: Statesent Date: Page#: Mail Codo: Web Code: 14698 X-XXXX 10/31/2009 1 ~r~~~~~ lJ YTD TAXABLE DIV: 511.25 YTD TAXABLE INT: 5.00 YTD FINANCE CHG: 5.00 OVERDRAFT FEES THIS PERIOD: 5.00 RETURNED ITEM FEES THTIS PERIOD: 5.00 RETURNED ITEM FEES YTD: 5.00 TRAN POST TRANSACTION - __ _ - TRAN FEE FINANCE LOAN ATE DATE DESCRIPTION -AMO(JNT AMOUNT CHARGE PRINCIPAL BALANCE ----- ----- ---------------------- -------- ---- ---- -------- --------- 10101 Type: 00 - REGULAR SHARES - 00 °°------ --°------- Joint with ELIZABETH A. REINECKER PREVIOUS BALANCE 2592.97 10/31 10101 Type: 40 - SHARE DRAFT - 40 10/09 10/09 Ite^#- 528 10/30 10/30 ACH Crsdit JH GBSA PACE ACH - 104141 10130 10/30 ACH Credit BENEFITS - 1056023351 PPD 10/31 C e ed I ItemN NOTE: An -----Amount Itam# -------- -------- 528 3235.97 NEW BALANCE 2592.97 PREVIOUS BALANCE 4484.01 5.97- 1248.04 NSI 1277.69 7'90 1545.59 „~„~ NEW BALANCE 1545.59 sKip in sequence. -----Amount Item7F Amount Description Co-~un"~' Share Draft Items 1 ATM Transactions p EFT Transactions 2 Electronic Checks 0 Voice Transactions 0 Other Withdrawals _.p Other Deposits p Salance Forward: Not Change: New Balance: Debits Credits 3235.97 .00 .00 .00 .00 297.55 .00 .00 .00 .00 .00 .00 4,484.01 2,938.42- 1,545.59 Bring thq,kids to SVFCU qn Saturday, Deceober 5 for FREE photos with Santa! Kids can also enter our Christwas coloring contest. Visit SVFCU.org for the drawing rules and to print the coloring .sheets! 6400410 SUSQUEHANNA ALLEY FEDERAL CREDIT UNION 3850 HARTZDALE DRIVE CAMP HILL, PA 17011-7809 LOCAL: (717) 737-4152 TOLL FREE: C800) 948-1454 FAX: C717) 737-0589 ~m~~~m~~~uu~~~n~~~n~~~u~~nn~l~~u~~~~n~~~~nn~i~~ 00000427 1 AV 0.335 ELIZABETH REINEKER FOR AMANDA MCK 9 MAYFIELD ROAD MECHANICSBURG, PA 17055-5628 MeaberlF: 14698 Social Security •: X-XXXX Stateaent Data: 11/30/2009 Pagel: 1 Mail Code: Wab Code: YTD TAXABLE DIV: 511.25 YTD TAXABLE INT: $.00 YTD FINANCE CHG: 5.00 OVERDRAFT FEES THIS PERIOD: S.00 RETURNED ITEM FEESRTHISEPERIOD: 5.00 RETURNED ITEM FEES YTD: 5.00 TRAM DATE POST DATE TRANSACTION DESCRIPTION - IRAN- ....FEE FINANCE LOAN._ _____ AMOUNT AMOUNT CHARGE PRINCIPAL BALANCE 11/O1 T the -------- - G ~ A - 00 -------- -- -------- - ------- Joint wi ELIZABETH A . REINECKER PREVIOUS BALANCE 2592.97 11/30 NEW BALANCE 2592.97 11/Ol Type: 40 - SHARE DRAFT - 40 11/30 11/30 ACH Credit 65 PREVIOUS BALANCE 1545.59 JH GBSA PACE ACH - 104141466 P NS 1575.24 11/30 , NEW BALANCE 1575.24 - ----- ,P'-,mow Description Cou its Credits Thankppyoufor your businesll this year. We know that you sake a choice to bank with us and friendseataSVFCUe trust that you place in us. Thank you and Happy Holidays frog your Share Draft Ite 00 .00 ATM. Transactions ~ .00 .00 EFT Transactions 0 29.65 ' Electronic Checks 0 .00 .00 Voice Transactions 0 .00 .00 Other Withdrawals 0 .00 Other Deposits .00 Balance Forward: 1,545.59 /~ Net Change: 29.65 New Balance: 1,575.24 __ ~ _ ~~ r ~ 5~ ~ ~ ~~ ~ ~~ '~ c~ 6400426 SUSQUEHANNA ALLEY F E D E R A L C R E D I T U N I O N 3850 HARTZDALE DRIVE CAMP HILL, PA 17011-7809 LOCAL: (717) 737-4152 TOLL FREE: C800) 948-1454 FAX: (717) 737-0589 ~u~~~~m~~~nn~i~n~~~n~i~u~~nn~~~~u~~~~u~~~~nn~~~~ 00001232 1 AV 0.335 ELIZABETH REINEKER FOR AMANDA MCK 9 MAYFIELD ROAD MECHANICSBURG, PA 17055-5628 Meaberi: 14698 Social Security lf: X-XXXX Stateaent Date: 12/31/2009 Pagelk : 1 Mail Code: Web Code:. YTD TAXABLE DIV: 613.54 YTD TAXABLE INT: 5.00 YTD FINANCE CHG: 5.00 OVERDRAFT FEES THIS PERIOD: 5.00 RETURNED ITEM FEESRTHISEPERIOD: 5..00 RETURNED ITEM FEES YTD: 5.00 TRAN DATE POST DATE TRANSACTION DESCRIPTION TRAN -- _ _... . FEE FINANCE LOAN _____ _____ ___ ANOUNT AMOUNT Cl1ARGE PRINCIPAL BALANCE 12/01 T th 6 LAR E - - pp ------- --------- ---------- - ------- Joint A ~I~CX ER wi ELIZABETH PREVIOUS BALANCE 2592.97 12/31 12/31 Dividend Posting 2 29 12/31 ** ANNUAL PERCENTAGE . YIELD EARNED: 0.35 X FOR A PERIOD OF 92 DAYS 7KIK 2595.26 ~--- NEW BALANCE 2595.26 12/01 12/31 12/31 Type: 12/31 40 - SHARE DRAFT - 40 ACH Credit JH GBSA PACE ACH - 104 ,. ~^"~,,..w 141,,l6'6~0 PENSION ]' __._ , PREVIOUS BALANCE 1575.24 1604.89 NEW BALANCE 1604.89 Description Share Draft Item 9 ATM Transactions , 0 ~ EFT Transactions ' ~~ 1 Electronic Checks ` ~ 0 Voiee Transactions '""^~..0 Other Withdrawals 0 Other Deposits 0 grits Credits y00 .00 .00 .00 .00 29.65 .00 .00 .00 .00 .00 .00 Balance Forward: Net Change; New 8aiance: 1,575.24 29.65 1,604.89 Thank you for your business this year. We know that you sake a choice to bank with us and we appreciate th~ trust that you place in us. Thank you and Happy Holidays frog your friends at SVFCU. 6401231 SUSQUEHANNA ALLEY F E D E R A L C R E D I T U N I O N 3850 HARTZDALE DRIVE CAMP HILL, PA 17011-7809 LOCAL: (717) 737-4152 TOLL FREE: (800) 948-1454 FAX: (717) 737-0589 . Social Securityr8c 14698X-XXXX Stateaent Date: 01/31/2010 Pagei: 1 Mail Code: Web Codo: ~u~~~~m~~~uu~~~n~~~u~~~n~~~m~i~~n~~~~n~~~~ u~ ~~ n ~ YTD TAXABLE DIV: 5.00 00000389 7 AV 0.335 YTD TAXABLE INT: 6 00 ELIZABETH REINEKER FOR AMANDA MCK YTD. FINANCE CHG: . 5.00 MECH NiCSBURGADPA 17055-5628 OVERDRAFTOVERDRATI R FEES YTD: RETURNED ITEM FEES THIS PERIOD: 5.00 5 00 RETURNED ITEM FEES YTD: . 5.00 TRAN POST TRANSACTION DATE GATE DESCRIPTION TRAN FEE FINANCE LOAN O1/Ol __z~~ _-- TYPe: 00 - AMOUNT AMOUNT CHARGE PRINCIPAL ~~-~~~--~ ---~y-4- --`-"' BALANCE Joint 01/31 REGULAR SHARES - 00 with ELIZABETH A. REINECKER °" " PREVIOUS BALANCE _ ~2595.26W NEW BALANCE 2595.26 O1/O1 Type: 40 - SHARE DRAFT - 40 01/31 PREVIOUS BALANCE 1604.89 '"`"""`;~,"""'°a.,4 NEW BALANCE 1604.89 Description ~ ~~ ~' ________________ -- - ~'~ Debits - Credits Share Draft Itaws -- ------ -- ~ ~: a ------- - ATN Transaction 0 EFT T n "~'" ~~,. ~,j~~,,,~.xt00 ' 00 00 0 ~ #~ ransactio ~ ~ ~ ~ ~~,t, 00 ~" 0 . Elsctronia Check ' Voice Transatctio s "~. , X "`"~~ ' 00 ~ .00 .00 Other Withdrawals '~ ~;, X00 .00 Other Dsposits '+o 0 ; ~ , 8aiance Foirwa • f, ~""'~ .00 _~.,-.,. Nat Change:' ~ 1,604.89 New Balance: .00 1,604.89 Thank you for. your business this year, We know that you wake a choice to bank with us and we appreciate the trust that you placo in ua. Thank you and Happy Holidays frow your friends at SVFCU! 6400388 SUSQUEHANNA ALLEY FEDERAL CREDIT UNION 3850 HARTZDALE DRIVE CAMP HILL, PA 17011-7809 LOCAL: (717) 737-4152 TOLL FREE: C800) 948-1454 FAX: C717) 737-0589 ~~n~~~m~~~nn~~~u~~~n~~~u~~un~~~~u~~~~~ul~~nn~~~~ 00000415 1 AV 0.335 ELIZABETH REINEKER FOR AMANDA MCK 9 MAYFIELD ROAD MECHANICSBURG, PA 17Q55-5628 Mewber#: 14698 Social Security #: X-XXXX Statewent Date: 02/28/20.10 Page#: 1 Mail Code: Web Code: YTD TAXABLE DIV: 5.00 YTD TAXABLE INT: $.00 YTD FINANCE CHG: S.00 OVERDRAFT FEES THIS PERIOD: S.00 RETURNED ITEMOFEESRTHISEPERIOD: 5.00 RETURNED ITEM FEES., YTD: S.00 _ _ ._ - TRAN POST TRANSACTION --- -- DATE DATE DESCRIPTION _ TRAN FEE FINANCE LOAN -_-__ ANOUNT AMOUNT CHARGE- PRINCIPAL BALANCE 02/01 Type: 00 - REGULAR SHARES - 00 -'--°'--- ----'° ---- Joint with ELIZABETH A. REINECKER PREVIOUS BALANCE 2595.26 02/28 NEW BALANCE 2595.26 02/01 Type: 40 - SHARE DRAFT - 40 PREVIOUS BALANCE 1604.89 02/02 02/02 Ttew#- 530 95_ 02/02 02/02 Ite^#- 529 7 1515.94 02/28 - 1248.04 NEW 8ALANCE 1248.04 C ar s This Pe iod Iteml! NDTE: An * in a skip in sequence. __ Amount It9mS Amou Amount itemi~ Amount -----529 ----267 90 -----530 -- --8 - -------"----------- -------- ----------- s ry Description unt Debits Credits -------------------- ----o - ---------- ---------oo- Share Draft Itews 356.85 .00 ATM Transactions .00 EFT Transactions 0 .00 Electronic Checks 0 .00 .00 Voice Transactions 0 .00 .00 Other Withdrawals 0 .00 Other Deposits 0 .00 Balance Forward: 1,604.89 Net C}inge : 356.85- _ _ New Balance: 1,248.04 Do we have your ,current a-wail address? We've switched to an electronic newsletter and we sand pperiodic a-wails with special events, prowotions and wore. Don't wise out on valuable inforwation! Call and update your a-wail address with SVFCU today. 6400414 SUSQUEHANNA ALLEY FEDERAL CREDIT UNION 3850 HARTZDALE DRIVE CAMP HILL, PA 17011-7809 LOCAL: (717) 737-4152 TOLL FREE: (800) 948-1454 FAX: C717) 737-0589 ~u~~~~u~~~~un~~~ll~i~u~l~n~~un~~~~u~~~~ln~~~nn~i~~ 00001237 1 AV 0.335 ELIZABETH REINEKER FOR AMANDA MCK 9 MAYFIELD ROAD MECHANICSBURG, PA 77055-5628 Mewber~k : 14698 Social Security •: X-XXXX State®ent Date: 03/31/2010 Page1F : 1 Mail Code: Web Code: YTD TAXABLE DIV: 51.60 YTD TAXABLE INT: 5.00 YTD FINANCE CHG: 5.00 OVERDRAFT FEES THIS PERIOD: S.00 RETURNED ITEMOFEESRTHISEPERIOD: 5.00 RETURNED ITEM FEES YTD: 5.00 TRAN DATE _POST DATE _ _- 1•RANSACTION DESCRIPTION T.RAN _ - - ._ FEE FINANCE _ LOAN -_____ ___- -AMOUNT AMOUNT CHARGE PRINCIPAL BALANCE O1/O1 Type: 00 - REGULAR SHARES - 00 Joint with ELIZABETH A. REINECICER PREVIOUS BALANCE 2595 26 03/31 03/31 Dividend Posting 1 60 03/31 ** ANNUAL PERCENTAGE YIELD EARNED: . 0.25 :! 2596.86 FOR A PERIOD OF 90 DAYS >Ks 03/01 Type: 40 - SHARE DRAFT - 40 03/31 Description Share Draft Ites~ ATM Transactions EFT Transactions Electronic Checks Voice Transactions Other Withdrawals Other Deposits Balance Forward: Net Change: New 8aiance: You're on the g your accounts, Visit SVFCU.org I~- ~1' ~ ~ Z W Z O O ~' W m J = v w Z N Z 0~ N ~~ W ~~ bits ------------ -- Credits ----- Br00 ----- .00 /.00 .00 .00 ° .00 ,,;,_ .00 .00 .00 .00 1,248.04 .00 1,248.04 ~ • ~ tp ,V O ~ ^ g ~ ~ ~ = Y = _ V ~ V V ~ 2 ~ ~ ~ _ ~ $ $ ~ ~ ~ ~ o ~ ~ o ~ C ~ o ~ ~ o NEW BALANCE PREVIOUS BALANCE NEW BALANCE D 2596.86 1248.04 1248.04 view hone. 6401236 SUSQUEHANNA ALLEY F E D E R A L C R E D I T U N I O N 3850 HARTZDALE DRIVE CAMP HILL, PA 17011-7809 LOCAL: (717) 737-4152 TOLL FREE: (800) 948-1454 FAX: (717) 737-0589 ~u~~~~~m~~~nn~i~u~~~n~~~u~~nn~~~~u~~~~ui~i~uu~~~~ 00000382 1 AV 0.335 ELIZABETH IIttEINEKER FOR AMANDA MCK 9 MAYFIELD ROAD MECHANICSBURG, PA 17055-5628 TRAN POST T~tANSACTION GATE DATE DESCRIPTION -~ ----- ----- ------------------------------ -- 04/01 Type: 00 - REGULAR SHARES - 00 Joint with ELIZABETH A. REINEC[ER 04/30 04/01 Type: 40 - SHARE DRAFT - 40 04/30 _.,.~ Description - Share Draft Ito a ATM Transaction EFT Transaction Electronic Chec Voice Transactio s Other Withdrawal sib Other Deyosits ~..,~ a° Balance Forwa'r~d~: Net Change: Nsw Balance: You're on the gR your accounts, i Visit SVFCU.org © O N Q v ~ W c O Z ~ ~ W ~. V Z O ~ a~ o ~ ~ J ~ m F J = W ~ ~I ~ ~ ~~ +' f (~ s's3 Z (5 Z 'yam •~ W ~~ Meaberi• 14698 Social Security #: X-XXXX Stateaent Date: 04/30/2010 Pages: 1 Hail Code: Web Codo: YTD TAXABLE DIV: 51.60 YTD TAXABLE INT: 5.00 YTD FINANCE CHG: 5.00 OVERDRAFT FEES THIS PERIOD: 5.00 OVERDRAT FEES YTD: 5.00 RETURNED ITEM FEES THIS PERIOD: 5.00 RETURNED ITEM FEES YTD: 5.00 TRAN FEE FINANCE LOAM AMOUNT AMOUNT CHARGE PRINCIPAL BALANCE PREVIOUS BALANCE 2596.86 NEW BALANCE 2596.86 PREVIOUS BALANCE 1248.04 """"" ° •< g,, NEW BALANCE 1248.04 _'+~Debits Credits .giNdt'ay.__' A o0 00 ~ .00 ~,` -x`.00 0 .00 =~m« 1, 248.04 .00 1,248.04 ~ ~ ~ N Or ~ 0 b ,~ a DSO ~ O Z p Z p Z pp Z Y ~ ~ V V V W V V O _ ~' i i O W O ~ W O W ~ H O ` ~ H D ~~ view hone. 6400381 Jul 19 10 10:29p Greg & Liz Reinecker I SUSQUEHANNA ALLEY FEDERAL CREDIT UNION 3850 HARTZDALE DRIVE CAMP HILL, PA 17011-7809 LOCAL: (717) 737-4152 TOLL FREE: (8D0) 948-1454 FAX: (717) 737-0589 6uiII~~~II1~~~~LI~~h6~h1~~16~~~L16d,IL„Id~~~~LlI 00000420 1 AV 0.335 ELItABE7N REINEKER FOR AMANDA MCK 9 HAYFIELD ROAD MECHANICSBURG, pA 17055-5628 5551212 Mesber#: 14b98 Social Security #: g-~~ Stateaent Date: 05/31/2010 Page#: 1 Mail Code: UTeb Code p.2 YTD TAXABLE DIV: 51.60 XTD TAMABLE INT: $.00 YTD FINANCE CHl3: 5.00 OVERDRAFT FEES THIS PERIOD: $.00 RETURNED ITEM FEESRTHISEPERI00: $.00 RETURNED ITEM FEES YTD: $.00 TRAN' DATE POST DATE TRANSACTION DESCRIPTION TAAN' 'FEE FINANCE LOAN -- -AMOUNT --- ---- -- AMOUNT CHARGE PRINCIPAL BALANCE OS/O1 Type: 00 - REGULAR SNARES - 00 --- -------- ---- ---------- - - ---'------ Joint with E LIZABETH A. REINECKER PREVIOUS BALANCE 2596.86 05/31 NEW BALANCE 25% .86 05/01 Type: 40 - SNARE DRAFT - 40 05/31 PREVIOUS BALANCE 1248.04 NEW BALANCE 1248.04 Description ------------------- uleaary Count - -- -- Debits Cretlits Share Draft Iteas ATM Transactions o --- 0 ----oo- - .00 --------oo- .00 EFT Transnctions 0 00 Electronic Cheeks 0 . 00 .00 Voice Transactions . 00 .00 Other Nithdrawals 0 . 00 .DO Other Deposits 0 . .00 Balance Forward: Net Change: New Balance: 1,248.04 1,248.04 You're on the go. So are we! SVFCU is proud to introduce Mobile $anking. Now you can view your accounts, transfer funds and sore all froo your web-enabled or text- capable phone. Visit SVFCU.org to barn Bore and to s~gn up for this service! 6400419 SUSQUEHANNA ALLEY FEDERAL CREDIT l1NION 3850 HARTZDALE DRIVE CAMP HILL, PA 17011-7809 LOCAL: C717) 737-4152 TOLL FREE: C800) 948-1454 FAX: (717) 737-0589 ~n~~~~n~~~~uu~~~u~~~u~i~n~~un~i~~u~~~~ul~l~nn~~~~ 00001289 1 AV 0.335 ELIZABETH REINEKER FOR AMANDA MCK YTD TAXABLE DIV: 53.22 YTD TAXABLE INT: 5.00 YTD FINANCE CHG: S.00 9 MAYPIELD ROAD OVERDRAFT FEES THIS PERIOD: 5.00 MECHANICSBURG, PA 17055-5628 OVERDRAT FEES YTD: 5.00 RETURNED ITEM FEES THIS PERIOD: 5.00 RETURNED ITEM FEES YTD: 5.00 TRAN DATE POST DATE TRANSACTION _ - DESCRIPTION TRAN - FEE FINANCE LOAN ----- ----- ------------------------------ ---- ANOUNT --- AMOUNT -CHARGE PRINCIPAL- BALANCE 06/01 Type: 00 - REGULAR SHARES - 00 ---- -------- --------- ---------- - ---------- Joint with ELIZABETH A. REINECICER PREVIOUS BALANCE 2596.86 06/30 06/30 Dividend Posting 1 62 06/30 xa ANNUAL PERCENTAGE YIELD EARNED: . 0.25 X FOR A PERIOD OF 91 DAYS ss 2598.48 06/01 Type: 40 - SHARE DRAFT - 40 06/30 Description Share Draft Ite ATM Transactions EFT Transactions Electronic Checks Voice Transactions Other Withdrawals Other Deposits Meabert: 14698 Social Security •: X-XXXX • Stateaent Date: 06/30/2010 Page: 1 Mail Code: Web Code: NEW BALANCE 2598.48 PREVIOUS BALANCE 1248.04 NEW BALANCE 1248.04 its ----- -- Credits ----- :,AO *~'". 00 --oo- .00 . 0 .00 .00 .00 .00 .00 .00 .00 Saiance Forward: ~ 1,248.04 Net Change: .00 New Balance: 1,248.04 Transfer your qualified loan from another financial institution to SVFCU and we'll let you skipp your first two pay~ents. Plus, we'll Beet or beat your rate! Soae restrictions aPP1Y• Learn amore and apply online at svfcu.org! 6401288 Jul 19 10 1O:29p Greg & Liz Reinecker 5551212 p.3 CLAREMONT NURSING & REHAB CTR 1000 CLAREMONT ROAD S A- V I N G S S T A T E M E N T CARLISLE, PA 17013 ~ '~ ___________________ ___ i~ Statement Number ^330+ Page 1 Date From 04/01/10 I,~ .f n ~ ~ ~ ~ Date Thru 06/30/10 ~" /~Ama da McKee ~i~r- ~ 1 Elizabeth Reinecker f" ! 9 Mayfield Road J~Y" Mechanicsburg, PA 17055 ~ - L~/ Admission Date 03/24/05 Resident ID Nr 4562 Ty Iran Date Ck D Refer Fn Code Description Deposits Disbursed Balance ate Ck # Payee ------ 04/03/10 472307 G DP ----------- Balance Forward APR SS ----------- ------------ ---------- 507.76 04/28/10 958421 G DP APR CHEVRON PENS 1,513.00 267 90 2,020.76 04/30/10 259189 G DP APR JOHN HANCOCK . 29 65 2,288.66 05/03/10 520746 G DP MAY SS . 1 513 00 2,318.31 05/31/10 40953 G DISB MAY NET INC DUE , . 1,767.27 3,831.31 2 064 04 05/31/10 966086 G DP MAY CHEVRON PENS 267.90 , . 2 331 99 06/03/10 581921 G DP JUN SS 1,513.00 , . 3 844 99 06/03/10 293492 G DP MAY JOHN HANCOCK 29.65 , . 3 874 59 06/30/10 06/30/10 41030 973750 G G DISB JUN NET INC DUE 1,767.27 , . 2,107.32 06/30/10 DP JUN CHEVRON PENS 267.90 2,375.22 G INTER INTEREST INC TO RES .76 2,375.98 Totals 507.76 5,402.76 3,534.54 2,375.98 EXHIBIT GLAREMON'~ NURSING & REHAB CTR 1000 CLAREMONT ROAD CARLISLE, PA 17013 Telephone: (717) 243-2031 Elizabeth Reinecker 9 Mayfield Road Mechanicsburg, PA 17055 Please detach and retumtop portion with payment: STATEN ENT ~f",/`"tatement Date:07/17/2009 Due Date: 08/01/2009 Amount Enclosed $ Account #: 4562 RE: Amanda McKee a\6°` o~ ~~~ ~1 ~~~ ~ I e / F 06/30/09 06/25/09 R R , EI 77ARE7}{ EI NE q~ 6,070.4 6,070.48 ~ 08/01/09 MEDICARE B PREMIUM CREDIT -1 ESIDENT INCOME 96.40 -96.4 0 1,767.27 4, 06.81 ~ 1,863.6 7 6,070.48 7 YOUR ACCOUNT IS OVERDUE PLEASE PAY IIvIlvIEDIATLEY Currant 1-30 Days 31-60 Days 61-90 Da Ys Ove r 90 Days Amount Due ~,,,.,.,.v, i,tws.bi .00 297.61 2,045.53 Payment Is due~by the 1st of the month. Please send paKments to the Attention of the Business Office Include the Resident's number in the Memo Section of the check. Statement Date: 07/17/2009 For questbns please contact Denise Lehman at 717.240.1908 Due Date: 08/01/2009 Amanda McKee -Account #: 4562 C4AREMONT NURSING & REHAB CTR 1000 CLAREMONT Rt~nn STATEMENT CLAREMONT NURSING & REHAB CTR 1000 CLAREMONT ROAD Statement Date: 09/18/2009 ~ ~ CARLISLE, PA 17013 Due Date: 10/01/2009 Telephone: (717) 243-2031 ~~S ~~ Amount Enclosed $ ~1 \~ Account #: 4562 I1~ (~ RE: Amanda McKee . o "~ Elizabeth Reinedcer ~\ ~'~ 9 Mayfield Road ~ ~ • Mechanicsburg, PA 17055 Please detach and return top portion with payment. 08/31/09 REINECKER, ELIZABETH •^"'~-~ ~ ~~ 08/31/09 MEDICARE B PREMIUM CREDIT _1 10/01/09 RESIDENT INCOME YOUR ACCOUNT IS OVERDUE PLEASE PAY IMMEDIATLEY Current I 1-30 Days I 31-60 Days I. 61-90 Days i i,ooo.yi I l,tfb3.67 ~ 299 27 Payment is due by the 1st of tfie month. Please send payments to the Attentlon of the Business Office Indude the Resident's number in the. Memo Sectlon of the check. For questlons Please contact Denise Lehman at 717.240.1908 299.27 Amanda McKee -Account #: 4562 CLAREMONT NURSING & REHAB CTR 1000 CLAREMONT ROAD CARLISLE, PA 17013 Telephone: (717) 243-2031 Over 90 Days ~ Amount Due 2,343.14 Statement Date:09/18/2009 Due-Date: 10/01/2009 STATEMENT CLAREMONT NURSING 8c REHAB CTR 1000 CLAREMONT ROAD Statement Date: 10/20/2009 CARLISLE, PA 17013 Telephone: (717) 243-2031 Due Date: ii/01/2009 Amount Enclosed $ Account #: 4562 RE: Amanda McKee Elizabeth Relnecker 9 MayFleld Road Mechanicsburg, PA 17055 Please detach and return top portion with payment. Balance B/F 6,669.02 09/30/09 REINECKER, ELIZABETH 6,669.02 10/15/09 NECKER, ELIZABETH 1,468,00 5,201.02 09/30/09 MEDICARE B PREMIUM CREDIT 3,240,95 1,960.07 11/01/09 RESIDENT' INCOME -1 96.40 -96,40 1,863.67 1,863.67 3,727.34 --~a~~ ~' ~`°~ Current 1-30 Da s Y 31-60 Days 61-90 Days Over 90 Days Amount Due 1,863.67 1,863.67 ,00 .00 .00 Payment Is due by the 1st of the month, Please send payments to the Attention of the Business Office Include the Resident's number in the Memo Section of the check. - For questions please contact Denise Lehman at 717.240.1906 Statement Date: 10/20/2009 Due Date:il/01/2009 Amanda McKee -Account #: 4562 CLAREMONT NURSING & REHAB CTR 1000 CLAREMONT ROAD . CARLISLE, PA 17013 Telephone: (717) 243-2031 STATEMENT CLAREMONT NURSING & REHAB CTR 1000 CLAREMONT ROAD Statement Date: 11/19/2009 CARLISLE, PA 17013 Due Date: 12/01/2009 Telephone: (717) 243-2031 C1 O~~ ~`b~ Amount Enclosed $ \ ~ `~ 1 Account #: 4562 A ~ ,~~ RE: Amanda McKee Elizabeth Reinecker 9 Mayfield Road Mechanicsburg, PA 17055 Please detach and return top portion with payment. Please send payments to the Attention of the Business Office Indude the Residents number in the Memo Sectlan of the check. For questions please contact Denise Lehman at 717.240.1908 Amanda McKee -Account #: 4562 CLAREMONT NURSING 8i REHAB CTR 1000 CLAREMOI~T ROAD CARLISLE, PA' 17013 Telephone: (717) 243-2031 Statement Date: 11/19/2009 Due Date: 12/01/2009 CLAREMONT NURSING 8c REHAB CTR 1000 CLAREMONT ROAD CARLISLE, PA 17013 Telephone: (717) 243-2031 STATEMENT Statement Date: 12/18/2009 Due Date: 01/01/2010 Amount Endosed $ ~ A '~~~ Account #: 4562 - RE: Amanda McKee Elizabeth Reinedcer ~ ~ f 9 Mayfield Road Mechanicsburg, PA 17055 Please detach and return top portion with payment. CLAREMONT NURSING & REHAB CTR 1000 CLAREMONT ROAD CARLISLE, PA 17013 Telephone: (717) 243-2031 Elizabeth Reinecker 9 Mayfield Road Mechanicsburg, PA 17055 Please detach and return top portion with payment. 12%31%09 RMEEI ICARERB PR MIUM CREDIT 02/01/10 ; RESIDENT IN[YfMF f ~ as ~.co V ~, X53 Uo ~55 ~ ~~,v I''' ~ a q, cam c~ a 1~~ ~,~ ?~ Current i-30 Days I 31-60 Days I 61-90 Dayc -~--_.,,, i,aos.ui .00 299.27 Payment is due by the 1st of the month. Please send payments to the Attention of the Business Ofl9ce Indude the Resident's number fn the Memo Section of the check, For questions please contact penile Lehman at 717.240.1908 Amanda McKee -Account #: 4562 CWREMONT NURSING 8r REHAB CTR 1000 CLAREMONT ROAD CARLISLE, PA 17013 Telephone: (717) 243-2031 STATEMENT Statement Date: 01/19/2010 Due Date: 02/01/2010 Amount Enclosed $ Account #: 4562 RE: Amanda McKee 1,767 Over 90 Dayc I Amount Due 51.3 Statement Date: 01/19/2010 Due Date: 02/01 2010 ,i ..._~..~ .-._ _ ~~ STATEMENT _. CLAREMONT NURSING & REHAB CTR l` 1000 CLAREMONT ROAD ~ ~ (,~ 1 Statement Date: 02/18/2010 ` CARLISLE, PA 17013 ~ Telephone: (717) 243-2031 Due Date: 03/01/2010 Amount Enclosed $ (~ Account #: 4562 1~~ i RE~ Amanda McKee Elizabeth Reinecker ab \ 9 Mayfield Road Mechanicsburg, PA 17055 ~( i. . f Please detach and return top portion with payment. Balance B/F 01/31/10 REINECKER, ELIZABETH 4,077.98 ~ 4,077.98 01/31/10 REINECKER, ELIZABETH 1,767.27 2,310.71 Ol/31/10 . REINECKER ELIZABETH 01/28/10 MEDICARE ~ PREMIUM CREDIT 51.37 2,259.34 299.27 1,960.07 -1 03/01/10 RESIDENT INCOME 96.40 -96.40 1,863.67 1,863.67 3,727.34 Currant 1-30 Days 31-60 Days 61-90 Days l Over 90 Days Amount Due 1,863.67 1,863.67 .00 :00 Pa ment I d .00 ~ y s ue by.the 1st of the month. -. ~~ ^ . Please send paymgntsto the Attention of the Business Office Indude the Resident's number in the Memo Section of the check. ! For questions please contact Denise Lehman at 717.240.1908 Statement Date: 02/18/2010 Due Date: 03/01/2010 Amanda McKee -Account #: 456 ' CLAREMONT NURSING 8c REHAB C'TR /~~ 1000 CLAREMONT ROAD ~ la // CARLISLE, PA 17013 `s Telephone: (717) 243-2031 CWREMONT NURSING & REHAB CTR 1000 CLAREMIONT ROAD CARLISLE, PA 17013 Telephone: (717) 243-2031 Elizabeth Relnecker 9 Mayfield. Road Mechanicsburg, PA 17055 1 ~' ~~'~ ~~' ,~, V ~ ~~ ~~~ ~\ ~l Please detach and return top portion with payment. STATEMENT Statement Date: 03/18/2010 Due Date: 04/01/2010 Amount Enclosed $ Acwunt #: 4562 RE: Amanda McKee ~~ STATEMENT CLAREMONT NURSING & REHAB CTR y 1000 CLAREMONT ROAD ~~~' `n'~ Statement Date: 04/20/2010 CARLISLE, PA 17013 d Due Date:05/O1/ZO30 Telephone: (717) 243-2031 Amount Enclosed $ Account #: 4562 RE; Amanda McKee Elizabeth Relnecker 9 Mayfield Road Mechanicsburg, PA 17055 Please detach and return top portion with payment. ___ ~~ ~'° \~° a~ `~ ~~, STATEMENT CLAREMONT NURSING 8~ REHAB CTR 1000 CLAREMONT ROAD ~ ~ ~ ~ Statement Date: 05/24/2010 CARLISLE, PA 17013 Due Date: 06/01/2010 Telephone: (717)243-2031 / / Amount Enclosed $ Account ~: 4562 RE: '. Amanda MCKee Elizabeth Relnecker 9 Mayfield Road Mechanicsburg, PA 17055 Please detach ar~d return top portion with payment. l~~~ s ~1~r~,~ /tee L~ ~r ~ ~2:~crC~' 1 C~ibo,,,~Pm~u, 'tas ~ 3y ~n~.c~ ~~ 1~- ~ v ~ ec,~ ~ ~ s~c~',~a..~ t ~- se~~a ~-~ ~v.~'r: v~~czrn„c~5 ~~~~~ ax tX EXHIBR VERIFICATION I, the undersigned guardian of the person and the estate of Amanda McKee, hereby verify that the foregoing report and account is true and correct, to the best of my knowledge, information, and belief. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S.A. §4904 relating to unsworn falsifications to authorities. Elizab Reinecker