HomeMy WebLinkAbout10-15-101,50561,0140
REV-1500 ~` ~°'-'°'
PA Department of Revenue OFFICIAL USE ONLY
Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year File Number
PO BOX 280601 2 1 1 0 0 1 3 8
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
1 7 3 1 4 0 1 8 9 D 1 2 3 2 D I D 1 2 1 2 1 9 2 1
Decedent's Last Name Suffix Decedent's First Name MI
K Y L O R J A C K p
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
N / A
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FELL 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. 0)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SFIOULD BE DIRECTED T0:
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 7 9 6 2 1 0 0
f~- 3
REGISTER 0 F ILLS USE ON~Y --,
First line of address _ r_ ...~
-.. ~ ~"~1 [`~. ~ ~
], 0 1 S O U T H ~1 A R K E T S T R E E T ~ ~~- ~~-', ~'~ ~
Second line of address I ~-~ -r r .~ i ` --.
Ci or Post Office DAB FIILED ~"~~' z__~>
ty State ZIP Code i _ --- ~ ~ ,
C
M E C H A N I C S B U R G P A 1 7 0 5 5
Correspondent's a-mail address: rmarkthomas~g_mail.com
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of may knowledge and belief,
it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNAT RE OF PE SON RESPONSIB(. FOR FILING RETURN DAME
~ ~/ /' (7
ADDRESS '7'"'-
1111, FLORIBU D LANE MECHANICSBURG PA ]7055
SIGN P H HAN REPRESENTATIVE p -,rE'/.
ADDR S 7`'" ---
1,01 SOUTH MARKET STREET ~1ECHANICSBURG PA 17055
PLEASE USE ORIGINAL FORM ONLY
Side 1
150561,01,40 150561,01,40 J
J
15D5610240
REV-1500 EX
Decedent's Social Security Number
Decedents tvame: JACK P• K Y L O R 1 7 3 1 4 0 1 8 9
RECAPITULATION
1. Real Estate (Schedule A) ........................................... 1. •
2. Stocks and Bonds (Schedule B) ...................................... 2. •
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. •
4. Mortgages and Notes Receivable (Schedule D) .......................... 4. •
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. 1 7 7 0 6 • 9 1
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 5 5 0 5. 9 1
8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 3 3 2 1 2 . 8 2
9. Funeral Expenses and Administrative Costs (Schedule H) ................ .. 9. 6 8 3 1 . 8 3
10. Debts of Decedent, Mort a e Liabilities, and Liens Schedule I 10.
9 9 ( ) ............. 5 6 7 • 7 6
11. Total Deductions (total Lines 9 and 10) ............................... 11. ~ 3 9 9 . 5 9
12. Net Value of Estate (Line 8 minus Line 11) .......................... .. 12. 2 5 8 1 3 . 2 3
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) .................... .. 13. / O 3 D • 73
14. Net Value Subject to Tax (Line 12 minus Line 13) .................... .. 14. Z. ~'~ 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 D 15. 0. 0 0
16. Amount of Line 14 taxable ~!
~ $ ~ , ~,O
at lineal rate X .045 2 7
16
! ~~-
~ ~` ~ .~' t
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 1 g. D. 0 0
19. TAX DUE .................................................... ..19. I
~~ o~
r 5
~ ,
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^
Side 2
15056],0240 1,505610240
REV-1500 EX Page 3
Decedent's Complete Address:
File Number
21 10 013$
DECEDENT'S NAME
JACK P. KYLOR ______
__
STREET ADDRESS
1111 Floribunda Lane
CITY
Mechanicsburg S TAT E
PA ZIP
17055
Tax Payments and Credits:
~. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments
B. Discount
3. Interest
4.
5.
If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Filt in oval on Page 2, Line 20 to request a refund.
If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
Make check payable to: REGISTER OF WILLS, AGENT
(1) ! ! l..S.~ j
0.00
(3)
(4) 0.00
(5) 11/S, ~1
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 ................................................................................................ ^
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? ....................................................................................... ^ 0
3. Did decedent own an "intrust for" orpayable-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? .................................................................................................. ~ ^
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)].
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)].
• 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, undf
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Total Credits (A + B) (2)
REV-150$ EX + (6-98}
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEflIlLE E
CASK, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF 1=1LE Numt~tK
JACK P. KYLOR 21 10 0138
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 DE4TH
1. etro Banlc 2,039.83
801 Paxton Street
arrisburg, PA 17111
2. 000 Buicic LeSabre 3,500.00
3, eritage Investment Services Fund, CD #1008851 6,144.56
651 Westport Drive
echanicsburg, PA 17055
4. ationwide Life Insurance Company -cash divident (0345116) 543.90
. O. Box 182928 '
olumbus, OH 43218
5. ounty of Cumberland -military burial fund ~ 100.00
6. rudentia4 Life Insurance (policy for Dorothy Kylor) ~ 5,209.07
7. ationwide Life Insurance Company -cash dividend t#0324522} 169.5x"
. O. Box 182928
oiumbus, OH 43218
.~ r r ~-he wr 7"~ ~~ ~'a~k P ~ ~a~-. ~ otr~{
r~9roTt1 ~ Sir Hl~ `~
~ ~ P X ~^. ~a~~ P ~ I~ filled
A -~ w tNe~~ b~~`*1e ~0c c ~ ~ ,`1'
~-1 1~fe ~n sccra~c~' ~viceQafs vn
P ~r e *' ~O I'L°4°~ ~/Ih~o ~
TOTAL (A{so enter on line 5, Recapitulation) (~ 17.706.91
(If more space is needed, insert additional sheets of the same size)
REV-1510 EX+ SOS-091
pennsyivania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE ~
INTER-VlVOS TRANSFERS AND
MISC. NON-PROBATE PROPERTY
ESTATE OF
FILE NUMBER
JACK P. KYLOR 21 10 0138
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
DUMBER DESCRIPTION OF PROPERTY
INCLUDE THE NAME `JF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENTAND
THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE
DATE OF DEATH
VALUE OF ASSET
% OF DECD'S
INTEREST
EXCLUSION
(IF APot.1CA8LE1
TAXABLE
VALUE
1. ationwide Annuity #0603251420 3,213.29 00.00 0.00 3,213.29
2. eritage lnvestment Services Fund, CD #1008852 6,146.31 00.00 6,146.31
651 Westport Drive
echanicsburg, PA 17055
3. eritage Investment Services Fund, CD ##1008853 6,146.31 00.00 6,146.31
651 Westport Drive
echanicsburg, PA 17055
TOTAL (Also enter on Line 7, Recapitulation) ~ ~ 15.505.91
!f more space is needed, use additional sheets of paper of the same size.
REV-1511 EX+ (10-09)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
JACK P. KYLOR 21 10 0138
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Cocklin Funeral Home (cremation) 250.00
2. Funeral dinner 100.00
3. Rev. Bob Steele (pastor fee) 100.00
4. Obituaries 501.98
8
ADMINISTRATIVE COSTS:
Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Address
City
Year(s) Commission Paid:
2 Attorney Fees: R. Mark Thomas, Esquire 750.00
3, Family Exemption: (If decedents address is not the same as claimants, attach explanation.) 3,500.00
Claimant Sharon L. Smith
Street Address 1111 Floribunda lane
City Mechanicsburg State PA ZIP 17055
Relationship of Claimant to Decedent
4. Probate Fees: 105.50
5 Accountant Fees:
6. Tax Return Preparer Fees: John C. Shaw 100.00
7. UPS Store (shipped family mementoes to sister) 113.82
8. Gayfene Coover (reimburse for airline ticket to attend funeral) 308.00
9. Lindsay Coover (reimburse for airline ticket to attend funeral) 370.00
10. U. S. Postal Service (postage) 44.00
11. Pennsylvania Department of Revenue (2009 taxes) 588.53
State Z1P
TOTAL (Also enter on Line 9, Recapitulation} I $ 6,831.
If more space is needed, use additional sheets of paper of the same size.
REl!-1512 EX+ (12-08)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCc TAX RETURN
RESIDENT DE~:,cDENT
SCf-fEDULE f
DE$TS OF DECEDENT,
MORTGAGE LlABILlTIES, & LIENS
ESTATE OF FILE NUMBER
JACK P. KYLOR 21 10 0138
Report debts incurred 6y 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. T & T (cell phone bill) 48.43
2. est Shore EMS 75.00
3. oly Spirit Hospital 250.00
4, icnael J. Lawler, NP 20.00
5. obiie X-Ray imaging 104.3.3
B, uil Gospel Churc;~ of Gad (mcm's funeral dinner) 45.00
7. ;~ristian broadcasting Netwcri< (donation) 25.00
r ,~j .'~' ~~"~ .
5o~c,~c P. I~r- ~ as ~s~~r.~-,~~e ~ his w~
r
" - ~± w r,~e~ ~~~Z~ 1te -~i~
~t~° G~s~ t~ a
J
TOTAL (Also enter on Line 10, Recapitulation) ~ ~ 567.76
1f 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
ESTATE OF: FILE NUMBER:
JACK P. KYLOR 21 10 0138
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSONS} RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec. 9116 (a) (1,2).]
1. Sharon L. Smith
1111 Floribunda Lane
Mechanicsburg, PA 17055
2. Gaylene Dawn Coover
110 Wood Ridge Trial
Sanford, FI 32771
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF 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:
1,
0.50
0.50
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1. Fulf Gospel Church of God /03(, ~ 7 3
220 St. John's Church Road
Camp Hill, PA
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ ~ ~ ~~~ ~`~
1f more space is needed, use additional sheets of paper of the same size,
LAST WILL AND TESTAMENT
• OF
JACK P. KYLOR
I, JACK P. KYLOR, residing at 1111 Floribunda Lane, Mechanicsburg,
Cumberland County, Pennsylvania 17055, being of sound and disposing minci, memory
and understanding, do make, publish and declare this to be my Last Will and Testament,
hereby revoking any or all Last Wills or Codicils heretofore, if any, by me at any time
made, to wit:
FIRST: I direct that all my just debts and funeral expenses be paid as soon
after my death as possible.
SECOND: I give, devise and bequeath forty-five percent (45%) of my said
estate unto my daughter, SHARON LYNN (KYI,OR) SMITH. Should she predecease
me, her forty-five percent (45%) of the estate shall go to her husband, JAMES RONALD
SMITH. I give, devise and bequeath forty-five percent (45%) of my said estate: unto my
daughter, GAYLENE DAWN {KYLOR} COOVER DUNK. Should she predecease me,
her forty-five percent (45%) of the estate shall go to her daughter, LINDSAY
MEREDITI-I (COOVER) FCTSCO. The remaining ten percent (IO%) of my said estate
shall be given to FULL GOSPEL CHURCH OF GOD, 220 St. John's Church Road,
- Camp Hill, Cumberland County, Pennsylvania 17011.
THIRD: In the event that my said wife and my said children predecease me
or shall die at the same time as my death, then in such event I give, devise and bequeath
eighty percent (80%) of my said estate unto my grandchildren, to be theirs in equal
shares, share and share alike, in fee simple and forever. The remaining twenty percent
{20%) of my said estate is to be given to FULL GOSPEL CHURCH OF GOD, 220 St.
John's Church Road, Camp Hill, Cumberland County, Pennsylvania 17011.
FOURTH: I nominate, constitute and appoint my daughters, SHARON LYNN
(KYLOR) SMITH and GAYLENE DAWN (KYLOR) COOVER DUNK, co-executrixes
of this my Last Will and Testament. In the event that both of my said daughters shall
~~~
predecease me, or if after qualifying shall be unable to continue to serve, then in such
event I nominate, constitute and appoint ROBERT S. MARSH, as executor in their place
and stead. I further direct that no bond shall be required of any of them.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this ~y Last
~11 and Testament consisting of two Z t ewritten a es, on this 4 ~i~ day of
~a ~, ~) YP P g
/' '~ ~ ~ A. D., 2008.
4,,
Jack P. ylor
STATE OF PENNSYLVANIA )
COUNTY OF CUMBERLAND }
I, Jack P. Kylor, the testator to the foregoing instrument, having been sworn,
declare to the undersigned officer that I am the testator and I have signed the instrument
as my Last WiII.
I/11 4 M
Jack P. K r
SWORN TO~ UBSCRIBED BEFORE ME b Jack P. Kylor, the testator,
on the c~~.y of '~ A.D. zoos.
Notes ~'ic,~5tate of Pennsylvania
My Commission Expires:
- ~
' ' ~
1 ~ f
~0~y~"N~:s~<° a~:~4L
.'?~1~...r~,v~:`:s. :,~. _rs„.r~:._~'?, ~.~:c~~,}~forp~.C`7t~;ryziC
~~~:ar fr :~; ~j .'F., ., ~,.. ..,i•(arl.. H ~.•ii S.tll~~r
z
J. Larry Cocklin F.D., Pres.
Scott D. Brenneman F.D., Supv.
Becky J. Cocklin F.D.
March 2, 2010
Mrs. Sharon L. Smith
1111 Floribunda Lane
Mechanicsburg, PA 17055
RE: Death Notices
~ ~ .~-.
FUNERAL HOME, INC.
P.O. Box 424, 30 N. Chestnut St.
Dillsburg, PA 17019
Obituary for Dorothy M. Kylor in the Harrisburg paper----------------------------$159.01
Obituary for Jack P. Kylor in the Harrisburg paper----------------------------------$342.97
TOTAL---------------------$ 501.98
Make check payable to Cocklin Funeral Home, Inc.
~o
~c~. ~g ~q
~•
RE
T UGHT
FUNERAL PLANNING
Tel: (717) 432-5312
Fax: (717) 432-5711
In PA: (800) 780-5312
1~~~
~~
RECEIPT FOR PAYMENT
-------------------
-------------------
GLENDA FARNER STRASBAUGH
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17613
KYLOR JACK PHILIP
Estate File No.: 2010-00138
Paid By Remarks: SHARON L SMITH
SAP
-------------------
Fee/Tax Description
PETITION LTRS TEST
WILL
RENUNCIATION
SHORT CERTIFICATE
JCS FEE
AUTOMATION FEE
Check# 906
Total Received.........
Receipt Date: 2/16/2010
Receipt Time: 12:15:14
Receipt No.: 1059995
Receipt Distribution ------ ------- ------- ----
Payment Amount Payee Name
30.00 CUMBERLAND COUNTY GENERAL FUN
15.00 CUMBERLAND COUNTY GENERAL FUN
5.00 CUMBERLAND COUNTY GENERAL FUN
12.00 CUMBERLAND COUNTY GENERAL FUN
23.50 BUREAU OF RECEIPTS & CNTR M.D
5.00
---------------- CUMBERLAND COUNTY GENERAL FUN
90.50
90.50
John C. Shaw
1844 Lilac Road
fork, PA 17448
717-764-8469
March 9, 2010
CUNFIDEIVTIAL
JACK P. ~ DORO'T'HY M. KYLOR
1111 FLORIBUNDA LANE
MECF[ANICSBURG, PA 17055
5
~~~
~' ~ ~~
~~
~~ ~ ,~i
~'
For professional services rendered in connection with the preparation of your 2009 individual tax
return:
Amount due
$ 100.00
FJIOEST SHORE EMS -BLS r
205 GRANDVIEW AVE _ ~~
SUITE 211 ~_
CAMP HILL, PA 17011
Phone #: (800 367-0512 Federal Tax ID: 23-2463002 ~+~~~~ ~HO
PATIENT NAME: .JACK KYLOR PATIENT NUMBER: 88232 IBAL
CALL NUMBER: 10009878 NONE
DATE OF CALL: 01/16/2010
INSURANCE:
TIME OF CALL:
CALLER:
10009878 FROM: 1111 FLORIBUNDA, LANE
TO: HOLY SPIRIT HOSPITAL
JACK KYLOR
1111 FLORIBUNDA LANE REASON(S) Generalized Weakness
MECHANICSBURG, PA 17055 FOR PAIN GENERALIZED
TRANSPORT
INVOICE
DESCRIPTION OF CHARGE QUANTITY UNIT PRICE AMOUNT
BLS EMERGENCY BASE RATE A0429 1.0 824.74 824.74
BLS MILEAGE A0425 9.0 13.73 123.57
INF CONTROL GLOVES {PR) A0382 2.0 3.83 7.66
OXYGEN ADMINSTRATION A0422 1.0 65.01 65.01
Total Charges 1020.98
DESCRIPTION OF PAYMENT RECEIPT PAYMENT DATE AMOUNT
Medicare Assignment Adjustment 01 /28/2010 642.49
Insurance Payment - HIGHMARK -FREEDOM B1 10759989 01i28I2010 303.49
~ ~~~~
• ~n
Total Credits 945.98
P!_EASE PAY THIS AMOUNT -INVOICE DUE UPON RECEIPT -~- $75.00
RETURNED CHECK FEE -- X31.00
.~._ } D~}
,~~ Pa e: 3 of 4
~ ~ ~ `OC ` g
f~„`~;. Billing Cycle Date: 12/14/09 - 01/13/10
Account Narnber: 464007b19S31
Prior Activity
Previous Balance 4640
07619531
Detail of Payments Posted 48. ~ 6
Payment by Visa posted on Jan 06, 2010
TOT_~I. BA~:ANC~ -48.16
~}~QQ
Wireless Line Summary For:
User Name: JACK KYLOR 717-364-2744
Monthly Service Charges Period Monthly Total
Rate Plan Charge Charge
NATP450RUMMSKVW
Includes: O1i14-02/13
39.99 -
39 gg
- 450 Anytime Mins
- Anytime Min Rollover
- Basic Voice Mai]
- Call Forward Conditional
- Call Forward Immediate
- Call Hold
- Call Waitins
V
- Caller ID
- Direct Bill Detail
-'.Message Waiting Ind
- NATION GAITiGSM
- Three Way Calling
- Unlimited M2M Expnd ~ ~~ `"'r
«(JJ°""'~~~, c~.~,~' ~
,~ ~--
11
- Other Services
`' .,~ ~>
.E
x.79 Roam Rate
AT&T Direct Bill 01/14-0213
O li 14-0?f 13
0.00
0 ~
ATBT Domestic i,D
OU14-02%13 0.00
0.00
AT~T Roam LD O1i14-0213 0.00 0.00
Includes: 0.00 0.00
- Toll Domestic
- Toll International
EXPANDEDIIv TLROA~~i
GSM Coverage Area 0 L' i 4-OZr' 13
01,'14-02%13
0.00
0 00
IntlDialingAlio~~ed
O l% 14-02/ 13 0.00
0.00
IntlRoamAllowed
01!14-02/ 13 0.00 0.00
IntlRoamTollN~ C
01!14-02/13 0.00
0.00
Includes: 0,00 0.40
- Toll Domestic
- Toll International
NIGHTS & WEEKENDS SK
01/14-02113
Unlimited Expd VI2M
01114-02/I3 0.00
0.00
Wireless Data o.oo o.oo
PIC;'VIDEO PayPerli se
Text Msg Pay Per lise 01 ~' 14-02/ 13
01:' 14-0~ 13
0.00
0 00
0.00
0.00
a' `&~ Page: 4 of 4
Bluing Cycle Date; 12/14/09 - 01/13/10
Account Number: 464(107614531
.. a~ ~i~a.~ ~lu~ „ululu~.j y r ur: ~~onrmuea~ 717-364-2744
User Name: JACK KYLOR
Monthly Service Charges Period Monthly Total
Wireless Data Charge Charge
Includes:
- Int't Text Messaging
- Text Messaging
TQT~ MONTHt.v S~RVIC~ CHANGES
Usage Charges ~39g0
(See Usa e Cha e Details)
`~`E)TAI_; iJSAGE CHARGE
Credits, Adjustments & Other Char $~`~t~
ges
Regulatory Cost Recovery Charge
Federal Universal Service Charge 0'~
State Gross Receipts Surcharge 1'65
TEQ'~ CR~I3I1'~, _
JUS~MrTS ~ oTx~R c~x~R~~s 2.23
Government Fees & Taxes ~~*~&
911 Service Fee
PA State Telecom Tax 1.00
TQTAG: G~?v~~R1~I~-NT` F~E~ c4~ ~ t~Xl~+ ~ 2.68
TQ'~''A~~~f.?~~ D~ ,~~
t.
_ r.
~"
Usage Charge Details
-
-
~~,
User Name: JACK KYLOR ,/~~ ~ 71 -
~~ 7
Minutes
Summary of
Included Minutes
Usage Charges I Billed Stilled Total
n Plan Used Minutes ][fate Charge
NATP450RUIVIlVI5I~1W
450 Rollover Mins 450 455
[Inlimited Expd M2M
726 0.00
NIGHTS & WEEKENDS SK
5,000 198 0.00
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Summary of Rollover Minutes
User Name: JACK KYLOR
Previous Rollover Balance 1,712
Rollover Minutes Used _5
Rollover Minutes Expired (* j _~0~
Current Rollover Balance 1,505
(*} finused Package Minutes Expire After 12 Billie:g Periods
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DAWN
CONVERSIONS
INC.
1445 Holly Pike Carlisle, PA 17015
Telephone (71~ 243-5550 Fax (717) 2,43-6542
July 22, 2010
James R. Smith
1111 Floribunda Lane
Mechanicsburg, Pa. 17055
RE: 2000 Buick LeSabre
Vin# 1G4HR54K04U183174
Dear Ron:
Please be advised we sold the above noted vehicle, by means of Consignment, for a net
amount to you and your wife for $3,500.00 .
The amount we sold the vehicle for was at "Fair Market Value" less the cost of Penna.
Safety Inspection and Advertising Fee which totaled approximately $300.00.
We are hopeful this information is beneficial to you in your attempts to settle your
Father-In-Law's estate. Should there be any questions or additional information needed
please feel free to contact us.
Best regards,
%~~~
Bruce Ruth
President