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Home My WebLink About09-15-10 (3)1505610143 ~ REV-1500 EX (01-10) OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year File Number Bureau of Individual Taxes DEPARTMENT OF REVENUE Po Box.2sosol INHERITANCE TAX RETURN 21 0 9 010 7 4 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 202 32 2668 11 12 2009 11 08 1940 Decedent's Last Name Suffix Decedent's First Name MI BIXLER CAROL L (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 ^ 4. Limited Estate ^ 6 Decedent Died Testate (Attach Copy of Will) ^ 9. Litigation Proceeds Received ^ 3. Remainder Return (date of death prior to 12-13-82;) ^ 5. Federal Estate l"ax Return Required 8. Total Number of Safe Deposit Boxes ^ 11. Election to tax under Sec. 9113(A) (Attach Sch. O) THIS RETURN MUST BE FILED IN DUPLICATE VNITH THE REGISTER OF WILLS ^ 2. Supplemental Return ^ 4a. Future Interest Compromise (date of death after 12-12-82) ^ ~ Decedent Maintained a Living Trust (Attach Copy of Trust) ^ 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number DUANE P STONE 717 432 2089 First line of address 8 N BALTIMORE STREET Second line of address City or Post Office DILLSBURG State ZIP Code PA 17019 Correspondent's a-mail address: D V a n e@ S t O n e a t I a W. C O m 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 prepare~r has any knowledge. SIGNATURE OF PERSON RESPONSIB E FOR FILING RETURN DATE ~~~~~ Thomas L. Bixler, Jr. ~ - ~ •~ ADDRESS 740 Lindenwood Lane, Steelton, PA 17113 SI OF PREPARER OT AN RESENTATIVE DATE ~ Duane P Stone ~~ -- `~> -- ,,~ ~ ADDRESS 8 N. Baltimore Street, Dillsburg, PA 17019 Side 1 15D5610143 REGISTER WILLS US~LY C CJ o { ~ °~ ~::. r-- ~ t ~`t '~ t ; f,_~ ~.~ ~4 . _ ' ~w 7 C:.~ ~ ~ ... DATL~ILED ~ ~ .. c,r7 cry 1505610143 J ~~~1 J 1505610243 REV-1500 EX Decedent's Social Security Number Decedent's Name: B I X L E R, C A R O L L 2 0 2 3 2 2 6 6 8 RECAPITULATION 0 0 0 1. Real Estate (Schedule A) ........................................................................................ .. 1. 2. Stocks and Bonds (Schedule B) .............................................................................. . 2. 0 0 0 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... . 3. 0 0 0 4. Mortgages & Notes Receivable (Schedule D) ........................................................ .. 4. 0 0 0 5~ Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... . 5. 2 5 , 6 7 6 . 8 0 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ............ . 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested ............ . 7, 1 .'S 0 , 2 6 7 6 0 8. Total Gross Assets (total Lines 1-7) ...................................................................... . g. 1 '7 5 , 9 4 4 . 4 0 9. Funeral Expenses & Administrative Costs (Schedule H) ........................................ . g. .1 7 , 2 4 4 7 7 10. Debts of Decedent, Mortgage Liabilities, 8~ Liens (Schedule I) .............................. .. 10. 6 9 7 0 8 11. Total Deductions (total Lines 9 & 10) .................................................................... .. 11. .1 7 , 9 41.8 5 12. Net Value of Estate (Line 8 minus Line 11) ........................................................... .. 12. 1 .'5 8 , 0 0 2 5 5 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. 1.'5 8 , 0 0 2 5 5 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .00 15. 16. Amount of Line 14 taxable at lineal rate X .045 15 8, 0 0 2 5 5 16. 7, 110.11 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. Tax Due ................................................................................................................... .. 19. 7, 1 1 0 1 1 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAY MENT. ^ Side 2 1,505610243 1505610243 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 - 09 - 01074 DECEDENT'S NAME Bixler, Carol L STREET ADDRESS 28 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 B. Discount 3. Interest 6,186.00 325.58 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box 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. Total Credits (A + B) Make Check Payable to: REGISTER OF WILLS, AGENT. (1) 7,110.11 (2) 6,511.58 (3) 0.00 (4) (5) 598.53 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 :.................................................................................. ^ ^x b. retain the right to designate who shall use the property transferred or its income :.................................... ^ ^x c. retain a reversionary interest; or .................................................................................................................. ^ ^x d. receive the promise for life of either payments, benefits or care? .............................................................. ^ 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" or payable upon death bank account or security at his or her death'?......... ^ ^x 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ...................................................................................................................... ^ 0 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 Jul 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 is 3 percent [72 P.S. §91 ~6 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 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 refturn 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 )]. • 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)1. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, w ether by blood or adoption. SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF Bixler, Carol L 21 - 09 - 01074 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 wilting seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which 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. Include a copy of the deed showing decedent's interest if owned as tenant in common. ITEM DESCRIPTION VALUE AT DATE OF NUMBER DEATH 1 0.00 TOTAL (Also enter on Line 1, Recapitulation) ~ 0.00 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS FILE NUMBER ESTATE OF gixler, Carol L 21 - 09 - 01074 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM DESCRIPTION UNIT VALIJE I, VALUE AT DATE OF NUMBER ~ DEATH _ -- 1 ', 0.00 TOTAL (Also enter on line 2, Recapitulation) ', 0.00 SCHEDULE C ~, CLOSELY-HELD CORPORATION, COMMONWEALTH OF PENNSYLVANIA PARTNERSHIP or INHERITANCE TAX RETURN RESIDENT DECEDENT SOLE-PROPRI ETORSH I P FILE NUMBER ESTATE OF gixler, Carol L 21 - 09 - 01074 Schedule C-1 or C-2 (Including all supporting information) must be attached for each closely-held corporation/partnE~rship interest of the decedent, other than asole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships. ITEM DESCRIPTION VALUE AT DATE OF NUMBER DEATH ~ 0.00 TOTAL (Also enter on Line 3, Recapitulation) ~ 0.00 SCHEDULE D MORTGAGES & NOTES RECEIVABLE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF Bixler, Carol L 21 - 09 - 01074 All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE OF NUMBER DESCRIPTION DEATH 1 0.00 ~ TOTAL (Also enter on Line 4, Recapitulation) ~ 0.00 SCHEDULE E CASH, BANK DEPOSITS, & MISC. COMMONWEALTH OF PENNSYLVANIA PERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF gixler, Carol L 21 - 09 - 01 C174 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE OF NUMBER DESCRIPTION DEATH 1 1992 Ford F150 Super Cab short bed, fair condition, Kelley Blue Book 1,050.00 2 2011 Ford Taurus SE Sedan 4D, Good condition, Kelley Blue Book 3 M&T Bank and Sovereign Bank accounts transferred into estate bank account 4 Personal Property, Furniture, Electronics, household items, nic naks 5 Met Life dividend 6 Eire Insurance Refunds 7 Prudential Refund 8 State Employees Retirement System check 1,700.00 16,499.84 5,000.00 323.83 557.00 97.04 449.09 TOTAL (Also enter on Line 5, Recapitulation) ~ 25,676.80 ` SCHEDULE G COMMONWEALTH OF PENNSYLVANIA INTER-VIVOS TRANSFERS & INHERITANCE TAX RETURN ~+ RESIDENT DECEDENT MISC. NON-PROBATE PROPERTY ESTATE OF Bixler, Carol L FILE NUMBER 21 - 0!~ - 01074 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. - ---~- DESCRIPTION OF PROPERTY ' % OF TAXABLE VALUE ITEM Include the name of the transferee, their relationship to decedent ', DATE OF DEATH DECD'S EXCLUSION NUMBER VALUE OF ASSET INTEREST (IF APPLICAE3LE) and the date of transfer. Attach a copy of the deed for real estate. - - ---- 1 28 Palmer Drive, Camp Hill, Pa 17011, from Carol L. 150,267.60 150,267.60 Bixler to Jane L. Bixler via deed ~ TOTAL (Also enter on line 7, Recapitulation) ' 150,267.60 SCHF~ULE H ` FUNER~IL DCPOVSES & COMMONWEALTH OF PENNSYLVANIA 'C'~'p/~ n /~ INHERITANCE TAX RETURN ~~NIV 1 I~FITIY G ~~ RESIDENT DECEDENT FILE NUMBER ESTATE OF Bixler, Carol L 21 - 09 - 01074 Debts of decedent must be reported on Schedule I. ITEM NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT i A. 1 ,Dimon Funeral Home ~' 9,367.00 '~ B. I ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zip I j Year(s) Commission paid 2. ~ Attorney's Fees Stone, Duncan & Associates 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) ~ Claimant 4 5 6 7 1 Street Address City State Zip Relationship of Claimant to Decedent Probate Fees Initial probate fee, Register Register of Will, invoice Final Probate fee Accountant's Fees HB Consulting 2009 income tax Tax Return Preparer's Fees Other Administrative Costs 7,437.77 110.00 20.00 215.00 95.00 TOTAL (Also enter on line 9, Recapitulation) 17,244.77 SCHEDULE I DEBTS OF DECEDENT, MORTGAGE COMMONWEALTH OF PENNSYLVANIA LIABILITIES & LIENS INHERITANCE TAX RETURN ~ RESIDENT DECEDENT FILE NUMBER ESTATE OF BIXI@r, Carol L 21 - 09 - 01074 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM DESCRIPTION AMOUNT NUMBER 1 PPL Electric 111.18 2 UGI 8.03 3 Cumberland Law Journal 75.00 4 Comcast Cable 118.46 5 Cordia 117.87 6 Pennsylvania American Water 76.41 7 Patriot News Legal Notice 190.13 ~ TOTAL (Also enter on Line 10, Recapitulation)I ~ 697.08 REV-1513 EX+ (11-08) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Bixler, Carol L FILE NUMBEI~ _ 21 -09-01074 RELATIONSHIP TO SHARE OF ESTATE 'AMOUNT OF ESTATE NUMBER '; NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ' ($$$) RECEIVING PROPERTY Do Not List Trustee(s) I~ ', TAXABLE DISTRIBUTIONS include outright spousal distributions and transfers , ', under Sec. 9116 (a) (1.2)] ', ', 1 Thomas L. Bixler, Jr ,Son ', All cash assets 2 'Jane L. Bixler ' Daughter ~ Received Real Estate II i ',Enter dollar amounts for distributions shown above on lines 1 5 through 18 on Rev 1500 cover sheet, as appropriate. ', II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN '~ B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEE"t 0.00 scHmu~ o COMMONWEALTH OF PENNSYLVANIA ~~ ~~~ ~' ~ ~~ INHERITANCE TAX RETURN /L+pry ~C/~~ ry~-Tp~~` RESIDENT DECEDENT t~7r"~JV~F1L LJ1~7 ~ IV ) ESTATE OF FILE NUMBER Bixler, Carol L _ 21 -09-01074 Do not complete this schedule unless the estate is making the election to tax assets under Section 9113(A) of the Inheritance & Estate Tax Act. If the election applies to more than one trust or similar arrangement, a separate form must be filed for each trust. This election applies to the Trust (marital, residual A, B, By-pass, Unified Credit, etc.). If a trust or similar arrangement meets the requirements of Section 9113(A), and: a, The trust or similar arrangement is listed on Schedule O, and b. The value of the trust or similar arrangement is entered in whole or in part as an asset on Schedule O, then the transferor's personal representative may specifically identify the trust (all or a fractional portion or percentage) to be included in the election to have such trust or similar property treated as a taxable transfer in this estate. If less than the entire value of the trust or similar property is included as a taxable transfer on Schedule O, the personal representative shall be considered to have made the election only as to a fraction of the trust or similar arrangement. The numerator of this fraction is equal to the amount of the trust or similar arrangement included as a taxable asset on Schedule O. The denominator is equal to the total value of the trust or similar arrangement. Part A: Enter the description and value of all interests, both taxable and non-taxable, regardless of location, which pass to the decedent's surviving spouse under a Section 9113 (A) trust or similar arrangement. DESCRIPTION VALUE 1 0.00 Part A Total ~ 0.00 Part B: Enter the description and value of all interests included in Part A for which the Section 9113 (A) election to tax is being made. DESCRIPTION I VALUE Part B Total ~ 0.00 (If more space is needed, insert additional sheets of the same size) 1 ~a ~~- ~ ~ -~~. ~ ~~ ~: -.. ~. --~ rt' R j r cn r~ ~ , SS.~ `rrn b ~ ~ ~^ ~ ~.. `w~ o ~ r -n r ~ ~ ~~ ~~ Q Q ~ '~' ~' .. ,~~ s ~ ~~: ~. -.~z„ ~a. s ` h~ ~• D ~ ro ~ -. O "~ c. r ~n O ~ ~r 1'1J t'u I.n r r 0 :. 4 ('\_~ c~ ~ ~~.j 4 { O 'h+~ ~, N 4 W y ~~+~ ~ .o ~) {Ls.~.~r { Y.t~ ~!~ ~ j~.y~ `= V Y ~ A~. V - mo~^: n~ rro~ ~ t ~ (1~,,"~ d COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT, 280601 HARRISBURG, PA 1 7 1 28-0 601 RECEIVED FROM: STONE DUANE P 8 N BALTIMORE STREET DILLSBURG, PA 17019 -------- fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT F;EV-1162 EX(11-96) NO. CD 012348 ACN ASSESSMENT APJIOUNT CONTROL NUMBER ESTATE INFORMATION: SSN: 202-32-2668 FILE NUMBER: 2109-1074 DECEDENT NAME: BIXLER CAROL L DATE OF PAYMENT: 02/ 1 2/ 2010 POSTMARK DATE: 02/ 1 2/2010 couNTY: CUMBERLAND DATE OF DEATH: 1 1 / 1 2/2009 101 ~ 52,000.00 TOTAL AMOUNT PAID: REMARKS: RECEIPT TO ATTY SEAL CHECK# 992 $ 2, 000.00 INITIALS: CJ RECEIVED BY: GLENDA EARNER STRAE-BAUGH REGISTER OF WILLS TAXPAYER COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: BIXLER THOMAS L JR 740 LINDENWOOD LAND STEELTON, PA 17113 -------- fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ACN ASSESSMENT CONTROL NUMBER ESTATE INFORMATION: ssN: 202-s2-2x68 FILE NUMBER: 2109-1074 DECEDENT NAME: BIXLER CAROL L DATE OF PAYMENT: 02/ 1 2/2010 POSTMARK DATE: 02/ 1212010 COUNTY: CUMBERLAND DATE OF DEATH: 1 1 / 1 2/ 2009 AMOUNT 101 ~ $2,093.00 TOTAL AMOUNT PAID: REMARKS: RECEIPT TO ATTY SEAL CHECK# 1634 $ 2, 093.00 INITIALS: CJ RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REV-1162 EX(11-96) NO. CD 012346 TAXPAYER COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) NO. CD 012347 BIXLER JANE L 1380 W KING STREET YORK, PA 17404 -------- fold ESTATE INFORMATION: SSN: 202-32-2668 FILE NUMBER: 2109-1074 DECEDENT NAME: BIXLER CAROL L DATE OF PAYMENT: 02/ 1 2/201 0 POSTMARK DATE: 02/ 1 2/2010 CouNTY: CUMBERLAND DATE OF DEATH: 1 1 / 1 2/2009 REMARKS: RECEIPT TO ATTY CHECK#1589 SEAL Ah/iOUNT ACN ASSESSMENT CONTROL NUMBER 101 ~ $2,093.00 TOTAL AMOUNT PAID: $ 2,09 3.00 INITIALS: CJ RECEIVED BY: GLENDA EARNER STRAE>BAUGH REGISTER OF WILLS TAXPAYER ~}`2t Commonwealth of Pennsylvania State Employees' Retirement System 30 North Third Street, Suite 150 Harrisburg, Pennsylvania 17101-1716 www.sers.state.pa.us Telephone: 1-800-633-5461 Fax: 717-787-5866 March 12, 2010 T BIXLER JR & J BIXLER, EXECUTORS CAROL BIXLER ESTATE C/O STONE DUNCAN & ASSOC 8 N BALTIMORE ST DILLSBURG PA 17019 Dear Beneficiary: Member SSN: Beneficiary SSN/EIN ,~~ i S - E i~ ~ r k ,~ .~ XXX-XX-2668 27-6392668 A check in the amount of $449.09 will be mailed to you within two weeks. Federal withholding in the amount of $0.00 will be withheld for federal tax purposes. If you have elected to rollover your payment, the taxable portion of $0.00 will be transferred to your qualified plan. This payment representing your designated share of 100.00% in the final settlement of tl'~e account of CAROL L BIXLER, will be mailed to you within two weeks. If the individual listed above was a member of the Retirement system before January 1, -I 982, their contributions prior to that date were taxed as part of their gross income at that time. Therefore, no taxes are being withheld on that portion of their contributions. The difference between the amount of your payment and your share of the deceased member's non-taxable contributions, if an./, is taxable for federal income tax purposes. This payment will be reported to the Internal Revenue Service. You will receive a 1099R form prior to January 31 of next year along with necessary tax information regarding this payment. Under current law there are no Pennsylvania state or local taxes on any benefits paid from this system. This letter and the 1099R form that you receive should be kept in a safe place, as you will need the information when filing your Federal Income Tax Return. This is the only notice you will receive. Sincerely, Debra G. Murphy, Director Benefit Determination Division BEN3IFSL 501 Rt. 22 ATTN Billing Bridgewater, NJ 08807 ESTATE OF CAROL BZXLER 28 PALMER DR CAMP HILL, PA 17011-0000 MefLife Group No. 0095401 PRODUCT CODE LTC2 Sub/Branch 800000 CONTRACT NUMBER 001151612-003051879 UNE AI'JIOUNT 97.04 .~ Check Tmage Print 1858. PAY TO THE pR4ER OF i 3-7615/360 319 ~ $ ~/~', Ctl,~ ~~~ d `GQ DCILL.ARS ~ ~~Meia. e enn~tie~ra~ BtCll Rt~-FtATt/Rf B. Citizens Bank ~ _ ~ . Pennsylvania II'OOi~858n' ~:036026Z50~: '62003.469811' _z ~., y a~vC' ~, r.,. ~-- >031315036~ ,~~~Q ~ ~ ~ . Orrstown .Bank ~ " v`- °' ~ ^~ i- to Shippensburg, PA 17257 Phone: 717-532-6114 ~ ~ Bus Date: 11/20/2009 ~ ~' ~,~, .,~ .~ :r Branch/Teller 0008/0127 O 11/20/2009 10:36:17 { ' C105~ This is an image of an item (check, substitute check, or debit memo) which has posted to your account. Items resulting in anon-sufficient funds situation may not have been paid. Unpaid items will show as a credit item in your account history on the business date following the date the item was presented. https://www4.citizensbankonline.com/efs/servlet/efsonline/image.] sp?TransID=620034569... 12/8/2009 sTONE P.C. ~ ~ ~ ~ ~ ~~~ LAW OFFICES OF DUAN~ P , 101,TA ACCOUNT ~ • DILLSBUAG, PA.17019 /I~~~w 4 (777)432-2089 ,, - DATe ~- - - Stuart Bar Center Cumberland County Bar Association Cumberland County Bar Foundation Cumberland Law Journal Cumberland County Inn of Court 32 South Bedford Street, Carlisle, PA 17013-3302 Telephone 717-249-3166 Fax 717-249-2653 Toll Free (in PA) 1-800••990-9108 Cumberland County Bar Association Cumberland Law Journal May 14, 2010 Duane P. Stone, Esquire P. O. Box 696 Dillsburg, PA 17019 RE: PAST DUE CUMBERLAND LAW JOURNAL AD(S) Edmund G. Myers,l~resident Becky H. Mor~enthal, Executive Director Dear Attorney Stone: Our records indicate that payment has not been made for the item(s) listed below. If your ~oayment has been made, please send us a copy of your canceled check. Your prompt response would be appreciated. Very truly yours, `~~ ~.c-- Becky H. orgenthal Executive Director Date of Publication (s): 1/15, 1/22 & 1/29/2010 For your Client/Customer: Carol L. Bixler, Estate Fee: $75.00 _ -£ If any questions, call Debbie Collins at the Bar Association 249-3166 X 103 debbie@cumberlandbar.com Glenda Farner Strasbaugh Register of Wills and Clerk of Orphans' Court Marjorie A. Wevodau First Deputy Kirk S. Sohonage, f=sq So{icitor Register of Wills and Clerk of the Orphans' Court County of Cumberland One Courthouse Square Carlis{e, PA 17013 (717) 240-6345 FAX (717)240-7797 1NV41CE Bill To: InvoiceN~: 2847 Invoice Date: 1/20/201() DUANE P. STONE, ESQUIRE Estate ~f: CAROL L BIXLER P O BOA 696 Estate Nn: 21-09-1074 JN DILLSBURG, PA 17019 Qty Fee Description Fee Total 5 Short Certificates 4.00 $20.00 Total: $20.00 Checks should be made payable to the Register of Wills. Terms: Net 30. Please return one copy of this invoice with your payment. Thank you. PO Box 342 Grantham, PA 17027 Bill To: Bixler, Carol 28 Palmer Drive Camp Hill, PA 17011 Invoice Date Invoice # 03/24/2010 1901 RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17613 BIXLER CAROL L Receipt Date: 11/19/2009 Receipt Time: 09:40:03 Receipt No.: 1059009 Estate File No.: 2009- 01074 - Paid By Remarks: DUANE P STONE PC JN ------------------------ Receipt Distribution ----- -------- ------- ---- Fee/Tax Description Payment Amount Payee Name PETITION LTRS TEST 60.00 CUMBERLAND COUNTY ~SENERAL FUN WILL 15.00 CUMBERLAND COUNTY GENERAL FUN SHORT CERTIFICATE 20.00 CUMBERLAND COUNTY ~SENERAL FUN JCP FEE 10.00 BUREAU OF RECEIPTS & CNTR M.D AUTOMATION FEE 5.00 CUMBERLAND COUNTY GENERAL FUN Check# 1858 ---------------- $110.00 Total Received......... $110.00 ~~ ~~ ~ .J ~1 1~ ~ o ~~ ~ C'~ ~~ ~ ~o~ C~ ~~~~ v- Glenda Farner Strasbaugh Register of Wills and Clerk of Orphans' Court Marjorie A. Wevodau First Deputy Kirk S. Sohonage, Esq Solicitor Register of Wills and Clerk of the Orphans' Court County of Cumberland One Courthouse Square Carlisle, PA 17013 (717) 240-6345 FAX (717)240-7797 INVOICE Bill To: InvoiceNo: Invoice Date: DUANE P. STONE, ESQUIRE Estate c-~f P O BOA 696 Estate Nn: DILLSBURG, PA 17019 Qty Fee Description Fee Total 5 Short Certificates 4.00 $20.00 Total: ~, .j v ~ ~ ~ f i ~i l ~ ~. '~...„ 6 x~ ~i ~'4![ ~~ ,~ f ~~ .-" ~.. ~ a' L,~ $20.00 2847 1/20/2010 CAROL L BI~'I,ER 21-09-1.074 JN Checks should be made payable to the Register of Wills. Terms: Net 30. Please return one copy of this invoice with your payment. Thank you. s~~ "___- spa sEaric~ Billing Summary for Service to: CAROL L BIXLER 28 PALMER DR CAMP HILL PA 17011 Rate Classification: Residentia{ Heating Biliing Period: 10/27!2009 to 11f19f2009 (23 days) Final 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 $ 2.01. ~.•~, ,, Past Bill Information - UGl Utility ]StdrT'~~tl?b~r The account balance on your last bill was .................. $ 169.05 ~ ~ g'723 6616 49 Payments .............................................................................. 0.00 Adjustments ........................................................................_,. -2 3_.51 Your balance as of 12/07/2009 ..................................... -54.46 Current Bill Information - UGl Utility Customer Charge ................................................................ 6.56 Commodity Charge (42 CCF at $0.91571) ................. :38.46 Distribution Charges .......................................................... 17.64 PA State Tax 5urcharge ..................................................... Total Current Charges -UGI Utility ................................. -0.17 - 62.9 UGI Utility charges owed this bitl ................................ ...................................................... $ 8.03 ---- Total Amount Due, Please Pay by Due Date (12l28/2009~ ....................................... S.OS Meter Readin Information 5.60 5.04 4.48 3.92 3.36 2.80 2.24 1.68 1.12 0.56 0.00 Average CCF Per Day DJFMAMJJASOND 2008 Months 2009 Last This Average Year Year CCF/day 3.56 1.83 Daily temperature 34°F 50°F 9 Meter Number Previous Reading Present Reading CCF Used 1243517 7240 (remote) 7242 (final) 42 Messages from UGl ^ Your current price to compare is $ 0.854101CCF. ^ Your total annual usage is 679 CCF. Your average monthly usage is 56 CCF. ^ Help prevent pipeline damage, accidents and service disruptions. Call 811 before you dig. .. ~ .,~ _~ ~~ ~ (~ ~. ~ ~ _~ If you pay at a payment agent please take your entire bilt. Make check payable to UGI. Keep this part for your records. Important information is on the back of this bill. PPL Electric Utilities Electric Service For: CAROL L BIXLER 28 PALMER DR CAMP HILL PA 17011 Final Bill Questions about this bill? Please contact us by Dec 22 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 Meter Rea dings: Actual - Adjusted Estimated Customer Q Page 1 ,_::.: -- ---_...__..73260-81008 -------..>:... -= t~=ash ' °~vr- -.: , - - Summary Page Balance as of Dec 1, 2009 $61.71 Char es: Tota~PL ELECTRIC UTILITIES Charges $49.47 Total Charges $111.18 Account Balance $111.18 ..,:.~ ~~.~ - ~'~ ~ ~ ~' i' ~.,~ .., KWH -Average Per Day 36 30 24 18 12 6 0 rK ~cj ~i~l~' Meter Reading; Information Meter #60375636 Other important information on back ~ Dec 1 Actual 48550 Nov 6 _Actual 48130 25 Da s ~~WH Billed 420 Average -Dec 2008 2009 Tempperature 41 F 48F KWH Per Day 19 17 Yearly Use: Total Use Average Monthly Jan 2008 -Dec 2008 7008 584 Jan 2009 -Dec 2009 6917 576 DJFMAMJJASOND 2008 Months 2009 PPL Electric Utilities Electric Service For: CAROL L BD~.ER 28 PALMER DR CAMP HILL PA 17011 Page 3 p .~, Total from Last Bill .:; 73260-s 1 oos X61.71 Billing Details Amount You Still Owe as of Dec 1, 2009 $61.71 Current Charges Final siu Charges for -PPL ELECTRIC UTILITIES PPL Electric Utilities Residential Rate: RS for Nov 6 -Dec 1 Distribution Charge: Customer Service 827 Hausman Rd Customer Char e . 6.93 . Allentown PA 166 KWH at 2 9200000¢ per KWH 4.80 , 18104-9392 254 KWH at 2.63000000¢ per KWH 6.68 1-800-342-5775 (1-800-DIAL-PPL) PA Tax Adj Surcharge at -0.06400000% Transmission Char e: -0.01 www_ppleleCtric.com 420 KWH at 0. 200000¢ per KWH TranSltlOn Char e: ~ 3.16 166 KWH at .21000000¢ per KWH 2.01 254 KWH at 1.07300000¢ per KWH 2.73 Generation Chargge: d Capacity an Energy 166 KWH at S.g4900000¢ per KWH 9.88 254 KWH at 5.23100000¢ per KWH 13.29 Total PPL ELECTRIC UTILITIES Charges $49.47 ,. _ - Account Balance $111.18 General Generation prices and chargges are set by the electric generation supplier you have chosen. The Public Utility Commission re ulates distribution Information ~nces and services. The Federal Energy Regulatory~ornmission regulates ransmission pnces and services. PPL Electric Utilities uses about $0.82 of this bill Ito pay state taxes. In addition, about $6.55 of this bill pays the PA Gross Receipts Tax. For your convenience, you can now pay your bill using your Visa, MasterCard, Discover, or ATM Cara Ca11 BillMatriz at 1-800-672-2413. BillMatrtx will charge your credit and ATM card a service fee for making this payment. Before diggingg,, around your borne or properly, you. should always call the state's One Ca11 notification system to locate any uaderground utility lines. You can do this by simpl dialing 811, which vcnll connect you to the One Call system. Be safe andyca1181 I before you dig. With pa~~perless billing, you can receive and pay your PPL Electric Utilities bills onI"me. The process is free, quick, convenient and secure. To learn more or sign up, visit www.pplelectnc.com. Brighten your holidays safely. Check li t stria s before using to make sure cords and plugs are intact. Turn ofmside hgoliiday lights before you go to bed Information about appliance energy use and tips on saving energy are available through the Energy Library on our Web site, www.pplelectnc.com. PPL Electrie lJtilities Electric Service For: CAROL L BIXLER 28 PALMER DR CAMP HILL PA 17011 Questions about this bill? Please contact us by Nov 30 at 1-800-342-5775 (1-800-DIAL-PPL) or write to: Customer Service 82 7 Hausman Rd. Allentown, PA 18104-9392 www.pplelectric.com Electric Use This graph shows your electric use over the last 13 months. Types of Meter Readings: Actual - Adjusted Estimated Customer 0 pp~ Summary Page Page 1 :. ~c~1~~B~I3.A;~c~t. ~it~,b~ex :. - - - - - ... 73260-81008 :. .::: :: .::: ::: askl--' ~.~: Balance as of Nov 6, 2009 $0.00 Char es: Tota~PL ELECTRIC UTILITIES Charges $61.71 Total Charges , $61.71 .... Account Balance $61.71 ti~ _y fj ~ [ 8f/f ~ ~. ~~ KWH -Average Per Day 36 30 24 18 12 6 0 Meter Reading :information Meter #603756.36 Nov 6 Actual 48130 Oct 7 A~-tual 47612 30 Da s K'WH Billed 518 Average -Nov 2008 2009 Temperature 51 F KWH P D 16 51 F er ay 17 Yearly Use: Total Average Use Monthly Dec 2007 -Nov ;?008 7000 583 Dec 2008 -Nov ;?009 7063 589 Other important information on back ~ Return this part to address below with a check payable to PPL Electric Utilities Corporation .. 73260-81008 Nov 30, 2009 $61.71 Amount Enclosed AV 01 010406 898306 46 A**5DGT CAROL L BIXLER 28 PALMER DR , CAMP HILL PA 17011-7925 PPL ELECTRIC LTTILTTIES 2 NORTH 9TH ,STREET RPC-GENN1 ALLENTOWN :PA 18101-1175 ~~I~ii~i~~lillll~ili~,~~Ill~~l~llllilil~~iil~li~iil~ll~~l~~il~li~ 1 33000D0617130000061718 7326081008 0 NDJFMAMJJA50N 2008 Months 2009 Page 3 :.. - PP1. Electric p p = --:~~~~ A::gym _: 73260 81008 Utilities ~'" C:-. ~~ Electric Total from Last Bill $54.84 Service Payment Received Oct 23 -Thank You! $584 F°r= Billing Details CAROL L BIXLER 28 PALMER DR Balance as of Nov 6, 2009 CAMP HILL PA 17011 $~•~~ Current Charges PPL Electric Utilities Customer Service 827 Hausman Rd. Allentown, PA 1 8 1 04-9392 1-800-342-5775 (1,800-DIAI.-PPL) www.pplelectric.com Charges for -PPL ELECTRIC UTILITIES Residential Rate: RS for Oct 7 -Nov 6 Distribution Charge: Customer Charge 200 KWH at 2.89200000¢ per KWH 318 KWH at 2.63000000¢ per KWH PA Tax Adj Surcharge at -0.06400000% Transmission Char e: 518 KWH at 0.200000¢ per KWH Transition Charge: 200 KWH at 1.21000000¢ per KWH 318 KWH at 1.07300000¢ per KWH Generation Char e: Cappacittyy and ~ner y 2001~WH at 5.4900000¢ per KWH 318 KWH at 5.23100000¢ per KWH 8.32 5.78 8.36 0.01 3.90 2.42 3.41 11.90 16.63 Total PPL ELECTRIC UTILITIES Charges $60.71 Other Charges for PPL Electric Utilities Operation HELP Donation 1.00 Total of Other Charges $1.00 Account Balance $61.71 General Generation prices and chargges are set by the electric generation supplier you have chosen. The Pubric Utility Commission re Mates distribution Information prices and services. The Federal Energy Regulatory~ommission regulates transmission prices and services. Next meter reading PPL Electric Utilities uses about $0.44 of this bill. to~ ~ppay state taxes. In on or about addition, about $3.58 of this bill pays the PA Gross Keceipts Tax. Dcc 8 For your convenience, you can now pay your bill using your Visa, MasterCard, Discover or ATM Card Call BillMatriz at 1-800-672-2413. BiDMatriz will charge your credit and ATM cardl a service fee for making this payment. Before digging~ around your home or property, you should always call the state s One CaIl notification system to locate any underground utility lines. You can do this by simpl dialing 811, which willl connect you to the One Call system. Be safe andycal181I before you d-ig. With pa~perless billing, you can receive and pay your PPL Electric Utilities bills onrine. The process is free, quick, convenlenit and secure. To learn more or sign up, visit www.pplelectric.com. Heating your home is the biggest part of your winter ener y needs. Check your heating system filters} monfhlyy. Clean or change filers as needed. You can save money since your system will use less energy. Save postage and late charges -sign up for Autorniated Bill Payment. ~e C~~C~~t {( Account nber 0954'T 220933-01-8 Billing Date 12/07/09 Unpaid Balance $59.23 -Due Now j New Charges $59.23 -Due 01/01/10 Total Amount Due $118.46 Page 1 of 2 Contact us: ~www.comcast.com 717-540-8900 `~~..__-_.-_..-----.._____._._---.-----.-.-----_----------___--..__.__._--.------_--.-___.____.._r CAROL L. BIXLER Previous Balance 59.23 For service at: Payments -received by 12/07/09 0.00 28 PALMER DR CAMP HILL PA 17011-7925 Unpaid Balance -Due Now ~ 59.23 New Charges -Due by 01/01/10 59.23 NeWS f C'OCYI COt1'1CaSt see below for more information Our records indicate your account is past due. If your Total Amount Due $118.46 account is not paid in the next seven (7) days, a $6.95 late fee will be assessed. If payment has already been made, please disregard this notice. Late Fee Change Effective January 10, 2010, the Late Payment Administration charge will be increased from $6.95 to $7.95, excluding applicable taxes and fees. Comcast Cable. Television 55.95 N Taxes, Surcharges & Fees 3.28 0 Total' New' Charges $59.23' &~7. ~ s~`, µ `I ~ u P i- G ~ ~., S li+ j (i .A i ~' k. ~ ~p ~l k -v c j ~ ~ ~ _ an .._ .'f'si lF,t.. ~.~ X. "' D..:.~ ~ : ~Y ~ ~~-Si. ~7.}~:> .~~r rk yr „ . ,t`'~~` ~ ;~X% r k , u... ;~%3~ ~ ~~ ~ r ~_ r Detach and enclose this coupon with your payment. Please write your account number on your check or money order. Do nat send cash. Account Number 0954T 220933-01-8 Comcast~ Payment Due by Due Now 1555 SUZY STREET LEBANON PA 17046-8317 AV 01 005329 912428 14 A**5DGT II~1~11~11~1~~~~1111111~~1~1~~111~1~~11'I~'I~"I~11~1111~1~111~~1 CAROL L. BIXLER 28 PALMER DR Total Amount Due $118.~4fi Amount Enclosed $ Make checks payable to Comcast CAMP HILL PA 1 701 1-7925 ~~, r ~1~1~111~111~~~~1111~~1111~111~~~1~~111111~I~I~IJI~~~1~~~~1"I" COMCAST CABLE ~ ~ P O BOX 3006 SOUTHEASTERN PA 19398-3006 e ~N ~ (~ I-~ ~ ~~rS ~~ 09547 220933 D1 8 5 D118116 m ~,~ ~~ ., 6 ~~ ,E,',~ . .~ t ~. ~~, _. i=,,_ Account Summary Account No. 35127061 Customer Name CARROL BIXLER Due Date 1/12/2010 ..~ ~" .~ Perhaps there was an oversight; payment of your telephone bill is now past due. If you have not already sent payment, please do so immediately to avoid interruption of your service. If your service is interrupted there will be a charge to restore your service and a deposit may be required. If termination of your account becomes necessary, a re-connection fee will be required. Masrertard !~: iTi `:~ i'~.34r i€ ~, ~~l~~ i'~~~~4i~r~~i"~, L:.__ ~~t' ~?1C.`a1 ia',1.'.t '-;,'3~.r t~4{~3, J~E?~i?r,~;. ~?i~,~c~ Y r ~;l ~tl~~r~l~~sr ~~tlfis;t~ r ,.. ~~ uid2109521-job670346 seq~428-1et~ For Pere _ ..alized Customer Service (800) 916-9950 or www~.cordia.us Cordia Communications Transaction Summary Previous Balance 59.08 Balance Forward 59.08 Finance Charge 0.74 Local Recurring Charges 51.68 Taxes and Surcharges 6.37 Current Charges 58.05 ,~-.t;~o+..~lt ~,I' 11.x7 Location Summary Loc# Location Totaf 1 THOS L BIXLER 58.05 Monthly Recurring .Charges Local Recurring Charges For: 717-761-1097 MAIN BTN Description Date Range Charges Basic Residential Service 12/18/09 to 01/17110 28.95 Cordia Unlimited Residential P 12!18109 to 01/17/10 16.00 FCC Line Charge 12/18/09 to 01117110 6.50 Local Number Portability 12!18109 to 01117;10 0.23 Anonymous Call Rejection 12/18/09 to 01/17/10 0.00 Call Waiting 12/18109 to 01!17!10 0.00 Call Waiting ID with Name 12/18/09 to 01/17!10 0.00 Caller ID with Name 12/18/09 to 01/17/10 0.00 Speed Calling 8 12118!09 to 01!17110 0.00 Three Way Calling 12118/09 to 01/17110 0.00 Taxes. ~ Surcharges FCC Regulatory Fee (Wireline) 0.03 Fed USF Highcost B 1.17 Federal Excise Tax 0.87 PA Sales Tax 0.20 PUCIPSC Fee 0.13 Res Telecomm Relay Service Surcharge 0.08 Statutory Gross Receipts 2.64 E911 Tax 1.25 ~== ~~~> TOTAL DUE: 117.87 - - - - - - - - - - - - - - Please detach and return this portion with your payment to Cordia Communications. Please put your account number on your payment. ~ Monthly Statement 0 Ti1L ~.~~mc3 ici' 'o~t,i .;;IF~r1e. a.onztlra?;y PO Box 784206 Winter Garden, FL 34778-4206 ^ Check here to change address and make changes on back of this page. Q, aP ~- ,~c~ ~ ~ . b~ re, Iv Account No. 35127061 Invoice Date 12/18/2009 Due Date 1/12/2010 Total AlT~C}Lt1'tt Due 1 `17.8 r Amount Paid ~ ~ ~ ~ - This bill was mailed on 12/18/2009. A late payment charge of 1.25% will apply to any amounts noi: received by 01/12/10. uid2109521 job670346 CARROL BIXLER seg1428-9ot1 Cordia Communications THOS L BIXLER PO Box 1763 28 PALMER DR White Plains, NY 10602-1763 CAMP HILL, PA 17011-7925 I~~~IIII~~~~II~~II~~~~~I~I~~~III~~~I~II~~~~I!I~~II~~~~IL~I~I~I I~~~III~~~III~~~„~Il~~~lll~~~llrl~~~~l~l~l~l~~~l~ll~~l~l~~~ll 001, 00035],27061,5000011,7870D ~~ Pennsylvania American Water AME ~ICAI`~ ~~TE R ~.o. Bo. s~~. aic,,~, ri. ~~~m~ ~, NMW003 POK8HY 00004014 0l /06/2010 Bixlcr, Carol L 28 Palmer Dr Account Number: 24-U~~401.50-1 Camp Hill PA 1701 1-7925 Premise Number: 240378468 28 Palmer Dr Dear Customer: -~- Our records show an unpaid balance of $74.10 This amount is for service provided to the pl-operty -= located at 28 Palmer Dr in which you were noted as the responsible account holder. Please check your records and notify our Customer Service at 1-800-_565-7292 if you have any questions concerning your account balance. If payment has already been sent, please disregard this notice. If you have not made payment and do not respond to this notice by Friday, January 15, 2010, we will be forced io turn over the unpaid balance to a collection agency or a magistrate. We value you as a customer and would like io resolve this matter as soon as possible. ~~our prompt attention to this notice is appreciated. Please be sure to mail your payment io the address noted below. To ensure proper posting of your payment, we ask that you include the above account number on your remittance. To pay by credit card call 1-866-271-5522. Sincerely, Customer Service QIC45P COLLECTI Pennsylvania American Water PO Box 371412 Pittsburgh, Pa. 15250-7412 004014 004015 ;850892 ASE I~IC~C~ v'~ ~ ~ =~~ AMW003 POK9FU 00003252 Bixler, Carol L 28 Palmer Dr Camp Hill PA 17011-7925 Dear Customer, Pennsylvania American Water Y.O. Box 57$, Alton IL 62(?02 1-800-SCS-7'?9~ 01/08/2010 Account Number: 24-0640150-1 Prenuse Number: 24037846$ 28 Palmer Dr This letter confirms that you have authorized payment through an automated debit entry frol~l your financial institution account for the total amount of $ 76.41 on the date shown above. Provided this payment clear; $ 74.16 (payment less fee) will be forwarded to the American Water account. number shown above. _,,,.r _ ,...- -- The confirmation number for this authorization is X2B7689290 . Your account statement will report the transaction in the name of American Water. Your statement will report the PayMyBill service fee as a separate transaction under the name of Payment Fee. It may take up to 3 banking days from the date of this letter to fully process your payment. If you have any additional questions, please call Customer Service at 1-$00-565-7292. V~Je are available to assist you 24 hours per day, 7 days a week for your convenience. Sincerely, ~'~~' f~- ~"t ~ t~~., Customer Service ----~~-- C~IC45P ITSPNiBCNF 003252 003253 ,, „,,, , „ , 000240640150100000000'"t007379018 Pennsylvania American Water PO Box 371412 Pittsburgh, Pa. 15250-7412 For Service To: 28 Palmer Dr 012147 1 AV 0.335 0147/ 121471000147 050 1 PCK2GK l~~~lll~~,III~~~~,~II~~~III,..II,I~~„I~I~I~I~~~I,11~~1~{...H CARL L BIXLER 28 PALMER DR CAMP HILL PA 17011-7925 Pennsylvania American Water PO Box 371412 Pittsburgh, Pa. 15250-7412 I~~~Il~l~l~~~l~l~l~l~ll~~~l~~~l~l~~l~~~lt„t~l~~ll,l Closing Bill Please check here to add H2O-Help to Others contribution to your monthly bil! or to change your address or telephone number, and print information on reverse side. Customer Account Information Billing Summary For Service To: Carol L Bixler ----------Prior Balance------------------------ 1 2S Palmer Dr Prior Water Balance $24.97 Account Number: 24-0640150-1 Prior Balance Other $14.00 Premise Number: 24-0378468 Payments prior to Dec 09, 2009. Thanks! . 00 Total prior balance, Dec 09, 2009 38.97 Billing Period & Meter Information ----------Current Water Charges---------- Billing Date: Dec 09, 2009 Service Charge 12.97 Billing Period: Nov 05 to Dec 07 (32 days) Water Volume ($.000210 x 1,000) . 21 Next reading onlabout: Jan 11, 2010 Water Volume ($.007640 x 1,000) 7 .64 Rate Type: Residential Total Usage Billed o 20.82 ----------Other Current Charges---------- Meter readings in current billing period: Customer Protection Sewer Line 9.00 Meter Number N041828293 is a 5/8-inch meter. Customer Protection Water Line 5.00 Present-actual 551700 Tota{ other charges, Dec 09, 2009 14.00 Last-actual 550700 Gallons used 1000 ----------AMOUNT DUE --------------------- 573.79 1.992 Ford FI50 -Trade In Value, blue br,ir value -Kelley Blue Book __1~ ~(~~~~~ Blue Bao~ THE TRI;STEU RESOURCE ~.,; .. _ , ~.. 3a~, .., _.. ~:~._ _ s tl9 ~-. ~',..; r..~:_ ru:_>~2 '_ .=.e~a.~~w~ f'r,_31.~r~•, ~. rr,~:°~;' ~,~~ s~_~,,s~€! ,;~~:.s v~ ~..: s.a .;.e_„ s~~a "' i ,_. :_ Welcome Back ~ ~ ~ ZIP Code: Latest Car News Home > Usetl Cars > 1992 > Fortl > F350 > Super Cab Short Bed 1992 Ford FiSO Super Cab Short Bed r-~ -, ___ ~x~-~~~titl~ ~~~ Fair Local Listings: View Ford F350 Search all Classifieds in 170 11 On Biu~e~BookClassitiedsTM Ford F150 50 Miles ZIP Code 17011 To View Ads, Click Compare Used vs. New Under $5,000 - Both New and Used Pickup To View list, Click ~;'~ itt :.F .CIE ~~. ~... Select Year... .. 4.5 out of 5 Mileage: 150,000 Engine: V8 5.0 Liter Transmission: Automatic Drivetrain: 4 W D Standard Custom Power Steering Optional Power Windows Power DoorLOCks .~_._ •_ ,~'~? :.~fc AM/FM Stereo Tilt Wheel Kelley Blue Book Trade-In Value is the amount consumers can expect to receive from a dealer for atrade-in vehicle, assuming an accurate appraisal of the vehicle's condition, mileage and features. This value will likely be less than the Private Party Value because the reselling dealer incurs the cost of safety inspections, reconditioning and other costs of doing business. £i;:C:eli~~t 31,. 2'a i ~~,i:s ~ ~i. i~ in .~_elle+it i _4,a~;[=.a! n;~dit~ati 3. ~ i_e:is nn Page 1 of 2 http://www.kbb. com/KBB/UsedCars/PricingReport.aspx?Yearld=1992&Mileat~e=150000&VehicleClass=UsedCar&Ma~~uf... 11/ 13/2009 2001 Ford Taurus -Trade ~n Value, blue tT' ~k value -Kelley Blue Book #f; ~-' ~e~ley Blue Bo~~C THE iRUSTEU RESOURCE . ~ _. .. '' ~ r „C„ ,.; s-:W f -. y., ;. _~ '. _,` _`' ..~< :L~', i.~ ._? 3_Ir f'~1r,,,. ~. :~£Vit- ~ ~~_-..~~8~ ~. ~_..ir°i'S~3t u ;..i~~ 96fs ~~,~.: ~..*~'8 , ~'-~ aFaSt. 3". '.-..W ..~d_ 4 .-,,.r .: -... ,.., .:r Welcome Back ~ ~ ~ I ZIP Code: Latest Car News Home > Used Cars > 2001 > Ford > Taurus > SE Sedan 40 2001 Ford Taurus SE Sedan 4D ~~wr~ ~Xw4"I~:II°a: 4. .« _ _~_...- Good ~a~l• __ { _._ ~ ~~~ ~~~ ~+ Prue i'~ ~r~-, Local Listings; a View Ford Taurus Search all Classifieds in 17011 i'-, On Blue-Book Classlfieds'^ Ford Taurus 50 Miles - ZIP Code 17011 To View Ads, CNck Compare Used vs. New Under 55,000 - Bath New and Used - Sedan To View List, Click E'er S.+trw:~k+ ., ,.. Select Year... - -;, 4.2 outof5 i'AT'r 9liaf ~10~v",~ jda?,31:.1a` Mileage: 66,000 Engine; V6 3.0 Liter Transmission: Automatic Drivetrain: FWD ~ t _~ee Standard Air Conditioning Power Door Locks Power Steering Tilt Wheel Power Windows Cruise Control Optional Single Compact Disc AM/FM Stereo Cassette Dual Front Air Bags BOOi;rtAFi: ~` - Page 1 of 2 http://www.kbb. com/KBB/UsedCars/PricingReport.aspx?Yearld-2001 &Mileage=66000&VehicleClass=UsedCar&Manufa... 11 / 13/2009 REV-183 EX (~-08) (FI) {: `~ ~~~ Pennsylvania ~~~ DEPARTMENT OF REVENUE Bureau of Individual Taxes PO BOX 280603 Harrisburg PA 1~sz8-o6o3 Complete each section and file in duplicate with Recorder of Deeds when (1) the full value/consideration is not set forth in the deed, (2) the deed is without consideration or by gift, or (3) a tax exemption is claimed. A Statement of Value is not required if the transfer is wholly exempt from tax based on family relationship or public utility easement. If more space is needed, attach additional sheets. A. CORRESPONDENT -All inquiries may be directed to the following person: Name Telephone Number: Duane P. Stone (717) 432-2089 Street Address City State ZIP Code 8 N. Baltimore Street Dillsbur I'A 17019 B. TRANSFER DATA Date of Acce tance of Document Grantor(s)/Lessor(s) Carol L, Bixler Grantee(s)/Lessee(s) Jane L. Bixler Street Address 28 Palmer Drive Street Address 28 Palmer Drive City Cam Hill State PA ZIP Code 17011 City Cam Hill State PA ZIP Code 17011 C. REAL ESTATE LOCATION Street Address 28 Palmer Drive City, Township, Borough Cam Hill Lower Allen Townshi County Cumber{and School District Camp Hill _ Tax Parcel Number 13-25-0022-25 7 D. VALUATION DATA _ . 1. Actual Cash Consideration 2. Other Consideration 3. Total Consideration 1.00 -1- 0.00 = 1.00 4. County Assessed Value 5. Common Level Ratio Factor 6. Fair Market Value 119,260.00 X 1.26 = 150,267.60 E. EXEMPTION DATA la. Amount of Exemption Claimed lb. Percentage of Grantor`s Interest in Real Estate lc. Percentage of Grantor's Interest Conveyed 1oo.oa 100 2. Check Appropriate Box Below for Exemption Claimed ^ Will or intestate succession. (Name of Decedent) (Estate File Number) ^ Transfer to Industrial Development Agency. ^ Transfer to a trust. (Attach complete copy of trust agreement identifying all beneficiaries.) ^ Transfer between principal and agent/straw party. (Attach complete copy of agency/straw party agreement.) ^ Transfers to the Commonwealth, the United States and Instrumentalities by gift, dedication, condemnation or in lieu of condemnation. (If condemnation or in lieu of condemnation, attach copy of resolution.) ^ Transfer from mortgagor to a holder of a mortgage in default. (Attach copy of Mortgage and note/Assignment.) ^ Corrective or confirmatory deed. (Attach complete copy of the deed to be corrected or confirmed,.) ^ Statutory corporate consolidation, merger or division. (Attach copy of articles.) ® Other (Please explain exemption claimed, if other than listed above.) Mother to Daughter 72 P.S~ 81,02-C.3 ~- unaer pena~ties of law, I declare that I have examined this statement, including accompanying information, and to the best of my knowledge and belief, it is true, correct and complete. ~ignacure or cor ondent or Responsible Date 1~..`,7~'O f REALTY TRANSFER TAX STATEMENT OF VALUE See Reverse for Instructions RECORDER'S USE ONLY I State Tax Paid Book Number Page Number Date Recorded FAILURE TO COMPLETE THIS FORM PROPERLY OR ATTACH REQUESTED DOCUMENTATION MAY RESULT IN THE RECORDER'S REFUSAL TO RECORD THE DEED. Dimon Funeral Homes, Ync. 644 E. Grand Avenue 201 E. Market Street Tower City, PA 17980 Williamstown, PA 17098 Wanda L. Berger, Supv. Paul H. Dimon, Supv. 717-647-2741 Fax 717-647-2419 717-647-2422 Friday, January 8, 2010 Thomas Bixler 740 Lindenwood Lane Harrisburg, PA 17113 Dear Tom, Thank you for selecting our funeral home to provide services for your family during your time of bereavement. I hope that you found our services, so far, to be of the highest standards that we always try to achieve. The following is a summary of the service charges as previously explained and provided in written form on the services for: CAROL L. BIXLER PROFESSIONAL SERVICE, FACILITIES & AUTOMOTIVE $2,960.00 MERCHANDISE SELECTED Casket: $2,195.00 Outer Burial Container $1,395.00 Acknowledgement Cards $ 15.00 Register Book $ 20.00 Memorial Folders $ 30.00 TOTAL MERCHANDISE SELECTED $3,655.00 CASH ADVANCES Certified Copies of Death Certificate $ 90.00 Clergy Honorarium Rev. Natalya Cherry $ 100.00 Newspaper Notice $ 187.00 Newspaper Notice $ 139.00 Opening Grave $ 800.00 Vault Company Charge $ 145.00 Casket Spray $ 175.00 Grandchildren Flowers $ 48.00 Monument Cutting $ 120.00 Christ U. M. Church Donation $ 100.00 Dayton Market $ 848.00 CASH ADVANCE TOTAL $2,752.00 TOTAL OF SERVICES $9,367.00 BALANCE DUE $9,367.00 If there are any questions or concerns that remain unanswered, please call me. Sincerely, ~° Tl~e Pa#riot-News Co. 812 Market St. Harrisburg, PA 17101 Inquiries - 717-255-8213 THE LAW OFFICE OF DUANE P. STONE, P.C. P.O. BOX 696 8 N. BALTIMORE STREET DILLSBURG PA 17019 c~~~e ~latriot News Now you know THE PATRIOT NEWS THE SUNDAY PATRIOT NEWS Proof of Publication Under Act No. 587, Approved May 16, 1929 Commonwealth of Pennsylvania, County of Dauphin} ss Leslie Kramer, being duly sworn according to law, deposes and says: That she is a Staff Accountant of The Patriot News Co., a corporation organized and existing under the laws of the Commonwealth of Pennsylvania, with its principal office and place of business at 812 to 818 Market Street, in the City of Harrisburg, County of Dauphin, State of Pennsylvania, owner and publisher of The Patriot-News and The Sunday Patriot-News newspapers of general circulation, printed and published at 812 to 818 Market Street, in the City, County aind State aforesaid; that The Patriot-News and The Sunday Patriot-News were established March 4th, 1854, and September 18th, 1949, respectively, and all have been continuously published ever since; That the printed notice or publication which is securely attached hereto is exactly as printed and published in their regular daily and/or Sunday/ Metro editions which appeared on the date(s) indicated below. That neither she nor said Company is interested in the subject matter of said printed notice or advertising, and that all of the allegations of this statement as to the time, place and character of publication are true; and That she has personal knowledge of the facts aforesaid and is duly authorized and empowered to verify this statement on behalf of The Patriot-News Co. aforesaid by virtue and pursuant to a resolution unanimously passed and adopted severally by the stockholders and board of directors of the said Company and subsequently duly recorded in the office for tlhe Recording of Deeds in and for said County of Dauphin in Miscellaneous Book "M", Volume 14, Page 317. PUBLICATION COPY This ad # 0002032889 ran on the dates shown k-elow: December 17, 2009 December 24, 2009 _ NOTICE: Letters Testamentary In the Estate of Carol L. Bixler, late of the ~ ~~ , December 31, 2009 Township of Lower Alhn Cumberland County, Pennsvlvanip, d~ep~ased, have been~pranted.tothe underslsmed. All persons knowing themselves to be ~,,.-. 1 , ~ ~.' ~~ ~:~~ ~ ~ [.~ o. '~'") ~ ,(, :1:.. ~~:~. ! / . . Indebted to said Estate will make payment immediately, and those havine clalmswlllpr8sentthemtorsettlement to: Thomas L.Btxler of 740 Lindenwood • Sworn to-and subscribed before me t~iis 31 da of December, 2009 A.D. y Lane, Steelton, PA 17113 - or -Duane P. Stone, Esquire, P.O.Box 696 DIIlsbur , 9, PA 17014. {717) 432-2089. ~ 1 ;~ - Notary Public No~arlal Sep AYH ~' ~~Y public M ~~ ~~ Noy, 28 ~ 1 Nrb+«lnl~l Aeevge~Non M N{,~ The Patriot-News Co. 812 Market St. Harrisburg, PA 17101 Inquiries - 717-255-8213 THE LAW OFFICE OF DUANE P. STONE, P.C. P.O. BOX 696 8 N. BALTIMORE STREET DILLSBURG PA 17019 INVOICE ACCT # NAME ~,ile~latriot News Now you know ALL CHARGES ARE NET AD ORDER # DATE EDITION ADDTL. INFO. TYPE OF CHARGE AMOUNT 96106 THE LAW OFFICE OF DUANE P. STC 0002032889 12/17/09 REGULAR 96106 THE LAW OFFICE OF DUANE P. STC 0002032889 12/24/09 REGULAR 96106 THE LAW OFFICE OF DUANE P. STC 0002032889 12/31/09 REGULAR BASIC; AD CHARGE $61.91 BASIC; AD CHARGE $61.91 BASIC; AD CHARGE $61.91 AFFIDAVIT CHARGE $5.00 TOTAL: REMITTANCE ADDRESS The Patriot-News Co. 23794 N2~work PL Chicago, IL 60673-1237 $190.73 Please include the Account # or Ad Order # (above) with your remittance--Thank You NOTE: This Invoice replaces the Order Confirmation which we previously sent with Proofs of Publication