HomeMy WebLinkAbout11-16-10],505610143
REV-1500 Ex (01-10,
OFFICIAL USE ONLY
PA Department of Revenue pennsylvania County Code Year Fife Number
Bureau of Individual Taxes DEPARTMENT OF REVENUE
PO 60X.280601 INHERITANCE TAX RETURN 21 10 0 7 2 4
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
__
ENTER DECEDENT INFOR~AATION BELOW
Social Security Number Date of Death
165 38 1569 06 23 2010
Decedent's Last Name Suffix
COLEMAN
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Date of Birth
10 11 1922
Decedent's First Name MI
MARILIA B
Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OV+~-LS 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 death after 12-12-82) ~] 5. Federal Estate Tax Return Required
6 Decedent Died Testate
(Attach Copy of Will) ~ ~• AttacdheCo aof Trust a Living Trust
pY ) g. Total Number of Sate Deposit Boxes
9. Litigation Proceeds Received ~ 10. between 12 31 ~Crae ditl(dat~e5~ f death ~ 11, Election to tax under Sec. 9113(A)
(Attach Sch. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
JOHN E SLIKE ESQ 717 737 3405
First line of address
210 9 NiARKE T S TREE T
Second line of address
City or Post Office
CAMP HILL
Correspondent's a-mail address:
State ZIP Code
PA 17011
REGISTER OF WILLS USE ONLY
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Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
S TURE OF PERSON ON5 E F R FILING RETURN DATE
(' ,~,~~ _ Dennis R. Coleman 1' ~~~ ®~ p
ADDRESS `"" - ~ `
5211 Ismere Avenue Bethesda MD 20814
SIGNAT OF PREPAR(~HER TH REP ESENTATIVE DATE
John E. Slike
Camp Hill, PA 17011
L 1505610143
Side 1
1505610],43
J ~~
J
1505610243
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: Coleman, Marilia B. 165 3 8 15 6 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 & Notes Receivable (Schedule D) ........................................................ 4.
104,060.04
5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 5.
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers & Miscellaneous t~Qq Probate Property
Requested
arate Billin
Se
7 18 , 0 0 0 . 0 0
............
g
p
(Schedule G) ^ .
g.
.........................
Total Gross Assets (total Lines 1-7) ............................. ............... g, 12 2 , 0 6 0 . 0 4
12,989.45
9. Funeral Expenses & Administrative Costs (Schedule H) ....................................... 9.
1,693.35
10. Debts of Decedent, IJlortgage Liabilities, & Liens (Schedule I) .............................. 10.
14,682.80
11. Total Deductions (total Lines 9 8~ 10) ................................................................... 11.
107,377.24
12. Net Value of Estate (Line 8 minus Line 11) .......................................................... 12.
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ............................................... 13.
107,377.24
14. Net Value Subject to Tax (Line 12 minus Line 13) ............................................... 14.
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
15
0 . 0 0
(a)(1.2) X .00 .
16. Amount of Line 14 t~ xable 10 7 3 7 7 .2 4
j 16. 4 , 8 31.9 8
at lines{ rate X .04F
17. Amount of Line 14 taxable
0 0
0
17
0' 0 0
'
at sibling rate X .12 .
18. Amount of Line 14 taxable
0
0 0
18
0. 0 0
.
at collateral rate X .15 .
19. Tax Due .................................................................................................................. 19. 4 , 8 31.9 8
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^^
Side 2
L 1505610243 150561243 J
REV-1500 EX Page 3
l~Pr_PriPnt's Complete Address:
File Number 21-10-0724
DECEDENT'S NAME
Coleman, Marilia B.
STREET ADDRESS
1100 Crandon Way _ _ _,
CITY
Mechanicsbur
9 STATE
PA ZI P
~ 17050
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments
B. Discount
3. Interest
3,500.00
184.21
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.
(1)
Total Credits (A + B) (2)
~`3)
(4)
(5)
4,831.98
3,684.21
1,147.77
Make Check Payable to: REGISTER OF WILLS, AGENT.
~..
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PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent n-:ake a transfer and: Yes No
a. retain the~use or income of the property transferred :............................................................................... ^ [x]
b. retain the right to designate who shalt use the property transferred or its income :.................................. ^ [xJ
c. retain a reversionary interest; or .............................................................................................................. ^ ~~
d. receive the promise for fife 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? .................................................................................................................... ~ ^
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? .................................................................................................................. x
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS lS YES, YOU MU5T COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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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 is 3 percent [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after Jana!ary 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)J. 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 ir!
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 (aj (1.3)]. A
sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Rev-1508 EX+ (6-98)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Coleman, Marilia B. 21-10-0724
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
NUMBER DESCRIPTION OF DEATH
1 Cash on Hand 5,000.00
2 PNC Bank Checking -Account No. 51-4001-2305 91,694.99
Accrued interest on Item 2 through date of death 2.55
3 PNC Certificate of Deposit -Account #31300309022 3,099.95
Accrued income on Item 3 through date of death 0.49
4 PNC Money Mairket -Account No. 50-0471-5225 1,795,71
Accrued income on Item 4 through date of death 0.10
5 Personal property - (See listing attached) 1,770.00
6 Resurrection Cemetery 2 Plots -Value of $200 per plot 400.00
7 Verizon -Refund 14.46
8 Highmark Retirement 281.79
TOTAL (Also enter on Line 5, Recapitulation) ~ 104,060.04
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E i Rev. 6-98)
Rev-1510 EX+ (6-98)
SCHEDULE G
i , ~ ~ INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF ~ FfLE NUMBER
Coleman, Marilia B. 21-10-0724
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
ITEM
NUMBER DESCRIPTION OF PROPERTY
THE DATE OF TRANSFERSATTACFITA CO Y OF THE DEED OR REAEESTATE. DATE OF DEATH
VALUE OF ASSET °i° OF DECD'S
INTEREST EXCLl1SI0N
(IF APPLICABLE) TAXABLE
VALUE
1 Gift of Real Estate - A recognized gift was awarded 21,000.00 100.000% 3,000.00 18,000.00
David Coleman, son, on April 5, 2010 when he
purchased the real estate from his mother prior to her
death.
TOTAL (Also enter on Line 7, Recapitulation) I 18,000.00
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-150U Schedule G (Rev. 6-98)
REV-1151 EX+ (10-06)
.,
~ ,
COM IN~ ERITANCE TAX RET~RN ANIA
RESIDENT DECEDEN
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Coleman, Marilia B. 21-10-0724
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
A, ~ FUNERAL EXPENSES:
See continuation schedule(s) attached ~ 6,155.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Persona` Representative(s)
Street Address
City State Zin
Yearls) Commission Daid
2, Attorney's Fees Saidis Sullivan Law 6,290.00
3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zin
Relationship of Claimant to Decedent
4. I Probate Fees
273.50
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrat;ve Costs 270.95
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) ~ 2,989.45
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Coleman, Marilia B. 21-10-0724
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Ex e~ rases
1 Anna Marie Basom Cool -Reimbursement for funeral flowers 276.00
2 David Coleman -Myers Funeral Home $5,264.00; Resurrection Cemetery $615.00 5,879.00
H-A 6,155.00
Other Administrative Costs
3 Cumberland Law Journal -Estate Notice Advertisement 75.00
4 PNC Estate Checking -Check Charge 11.99
5 Register of Wills -File the Inheritance Tax Return 15.00
6 The Patriot News 168.96
H-B7 270.95
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98)
Rev-1512 EX+ (12-08)
SCHEDULE 1
i ~ ~ DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF I FILE NUMBER
Coleman, Marilia B. 21-10-0724
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
REV-1513 EX+ {11-08)
SCHEDULE J
COMINHR~D NTED CEp~ TRNANIA BENEFICIARIES
ESTATE OF I FILE NUMBER
Coleman. Marilia B. 21-10-0724
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSONISI RECEIVING PROPERTY DECEDENT
o Not 'st r ste s (Words) ($$$)
I TAXABLE DISTRIBUTIONS [include outright spousal
• distributions, and transfers
under Sec. 9116 a 1.2
Britt L. Coleman Grandchild Five Thousand 5,000.00
1755 South Ba.~eler Street Dollars ($5,000)
Apt 6R
Denver, CO 80247
David A. Coleman Son Twenty-five 25,594.31
4701 Maple Avenue percent (25%)
Mechanicsburg, PA 17055
Dennis R. Coleman Son Twenty-five 25,594.31
5211 Elsmere Avenue percent (25%)
Bethesda, MD 20814
Fernando A. Coleman Son Twenty-five 25,594.31
1550 Rimpau Avenue percent (25%} of
#104 the residue.
Corona, CA Q2881
Anna Maria Bcisom Cool Daughter Twenty-five 25,594.31
PO Box 157 percent (25%)
Garfield, KS 67529
Total 107,377.24
Enter dollar amounts for distributions shown above on lines 1 5 throu h 18 on Rev 150 0 cover sheet, as a r o riate.
NON-TAXABLE DISTRIBUTIONS:
II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FO R 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 SHEET
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08)
LAST WILL AND TESTAMENT
' OF
MAKILIA B. COLEMAN
I, MA~tILIA B. COLEMAN of Mechanicsburg, Cumberland County,.
Pennsylvania, declare this to be my Last Will and Te;~tament,
hereby revoking any will and• associated codicil or statement:
previously made by me.
I - S direct the payment of all my just debts and
funeral. ex~~enses out of. the cash assets of my estate as soon as
practical lifter my death.
II - I bequeath the sum of $5, 000 to each of my two
granddaughters, Aliree S. Coleman and Britt L. Coleman, payable
out of the cash. assets of my estate as soon as practical after my
death.
III - Unless prior to my death, I have sold certain
named item~~ of tangible personal property, not including cash,
securities and real estate, or gifted such items to my children. or
others, I bequeath them in accordance with the Attached List,
which is hereby incorporated into my Last Will and Testament . The
remainder of my tangible personal property, not so designated on
the Attached List, including jewelry, household goods, vehicle and
personal effects, together with the proceeds of publicly selling
any such property that my children (Fernando A. Coleman, Dennis R.
Coleman, David A. Coleman and Anna Maria B. Cool) may not want,
shall be d~.vided among them by my Executor based on indepE:rident
professional valuation and in as equal shares as possible,
~~, ~, C, Page l o f 4
adjusted ir_ accor_dance with paragraph VI below.
~V - I devise and bequeath all of the rest, residue, and
remainder of my estate of whatever nature and situate, iricludinc~,
cash, securities and real estate, to my children in as equal
shares as possible, based on independent professional valuation
and adjusted in accordance with paragraph VI below.
V - Should any of my children predecease me, their share
of my estate shall either be paid to his or her issue if any, per
stirpes, or else divided among my surviving children in a;~ equal
shares as possible, based on independent professional valuation
and adjusted in accordance with paragraph VI below.
VI - My son Fernando's share of my estate shall be
reduced by $5250. This amount is the negative impact that his
loan balance of $7000, if it continues to be unpaid, will have had
on the estate shares of my other 3 children, and it shall be
distributes to them in equal shares of $1750.
~"II - I appoint my son, Dennis R. Coleman, Executor of
my Last WiJ_1 and Testament . Should he fail to qualify, cease to
act, or become unable to act in this capacity, I appoint another
son, David A. Coleman, to .act as Executor. No personal
representative in settling my estate shall be required to post
bond in this or any other jurisdiction. I desire that my Executor
engage the services of John E. Slike of the law. firm Saidis,
Guido Shuff ~ Masland to assist in settlin m ,estate
g Y
X77, l3, L , Page 2 of 4
ZN WITNESS THEREOF, I have hereunto set my hand and seal on .
this, the ~ ~~day o~f /1.~..~ 2006.
GinS,' ~ a. ~ ~~-~ ~~,-~ ( S ESL )
y ~_
Marilia B. Coleman
Signed, sealed, published and declared by MARILIA B. COLEMAN,
Testatrix therein named, on this and three (3) other sheets of
paper as and for her Last Will and Testament, in our presence,
who, in her presence, at her request, and in the presence of each
other, have hereunto subscribed our names as attesting witnesses.
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Page 3 of 4
LIST OF NAMED PERSONAL PROPERTY BEQUESTS INCORPORATED INTO
THE LAST WILL AND TESTAMENT
OF
MARILIA B. COLEMAN
ITEM
(1) Aquamarine Ring
(platinum w/small diamonds)
(2) Toreador Ring
(3) Grandfather's Gold Pocket Watch
(4) Gold Snake Bracelet
(5) "Ecce Homo" Oil Painting
~,
RECIPIENT OF BEpCJES~I'
Anna Maria
.Anna Maria
David
Aliree
Good Shepherd. Church
Page 9 of 4
COMMONWEALTH OF PENNSYLVANIA)
SS.
COUNTY OF CUMBERLAND)
WE, the undersigned testatrix and witnesses,
respectively, whose names are signed on the foregoing instrument,
being first duly sworn, do hereby declare to the undersigned
authority that the Testatrix signed and executed the instrument as
her Last Will and Testament and that she signed willingly, and
that she executed it as her free will and voluntary act :for the
purposes therein expressed, and that each of the witnesses, in the
presence of hearing of the Testatrix, signed the will as witnesses
and that to the best of their knowledge, the Testatrix was at. that
time eighteen years of age or older, of sound .mind, and under no
constraint or undue influence.
7'7 one-~4, ~~~im ~
Testatrix
Witness
~~~ ~~
Witness
. Subscribed, sworn to and acknowledged before me oy the
Testatrix, and subscribed an sworn to before me by both
witnesses, this ~ 7~-~day of ~ 2006.
Notary Public
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Iz~ z~esporlsc to your r::yuest f~~r I)~t~° f~f I~)ef~th (?~)~)L)} hal<~~7~;~>s f~~~ tale cust~'un~~~ ;~4~r_~~~ ~_~~~ ~•~, -,---
recaras shc~~~ the f ~~llowin~;:
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flccc~unt # "3? 300"~U~O'?_? I;:~iri~"!#1`~h~_`F ~~~~ 'r Jl;
MARILII~ ~ C~'C)I :~~'~~ ~ >~;
I)tJI) halax~ce: ~ 3,099.95 + 0.49 ~3~.~~r"uec~ interest
Ch~c-king ~.cc«unt
Accc~tar~? ## ~ l 41)()12305 ~::;4= f ~ ~.. `~~
I)(~)I) balance: `~ 91,b94.99 + 2.55 u~,~,rued interest
~Sxvin~s Acc«u~t
Acu>unt #f 500~~; .522; ~;st~tri; ~:~;~~~-.: ,";'~~ ~ ~,
r)C)r) h~il~nt;e: .°r' 1,795.71 + 0.10 ~~;~:;~•ut;ti ir~Yc;~es`
Yletis~ r~oie that i~ie office ~r~vides d~~t: ~~f clean: hs~l~~nce~; ft~~ ~.i~;~vsit ~i~;~:ounts {IIZf1~~-. r;'~:.:., ~~ _ .:•s.:~~a~ ~._:`
Sfi~~in~7s). Way du not process any fnaneial tran~acdions or €Y~d-vic~•, ~tateme~nts, If. w~~, z~::':` •.'-~ ~~i:~=-,'~c-
any c>f~tl~ese ~ti;lr.~- ~>Icase call 1 RRK-I'\!"' 1~A~IK ('-~BK-?(~~ ?~'.~~s' «r stogy h~~ yt~ zr ~,~-,: ;,~' ~,~ ,.
cuff ~c~:.
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Sint:er:;l ,
I~Tatioitr~l l~iriar~ci~xl Serviee~ C;e;ntc,r
I'`N~~ 13nnk, I~.1";. Mernher'(~r)IC'
I~~~c~~' 1 ~ ~
~,
Coleman Estate
August 4, 2010
Small Bedroo~n
Small Bed
Dresser
Lamps (3 )
Rugs
Chest of Drawers
Total Value $40.00
Small Bedroom
Mattress
Folding Bed
Chest ~~f Drawers
Lamp,
Total Value $ 3 0.00
Living_Room
Sofa
Rug
2 Chairs
Book Case (2)
Clock-Pendulum Wall
Lamp
Coffee Table (2)
Small ~~3racket Clock
TV
Wall decorations
Total Value $550.00
Kitchen
Refrigerator
Coffee Maker
Cabinet
Total Value $50.00
Rec Room
Chair
Tables
Hide ~`~way Bed
Coffee Table
Armoires-Brazilian
Book Case
Total Value $500.00
Hall
Wall Decorations
Marble Top Table
Total Value $100.00
Dining Room
Table
Benches
Hutch Cabinet
Total Value $500.00
Grand Total $1,770.00
DEPOSIT TICKET tau-1273i.~t
1lIG
ESTATE OF MARILIA Q COLEMAN casFl -
DENNtS R COLEBIIARI, ExECUTOR . ~- ,
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CFIECKS
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ITEM` SUE} TOTAL - ~ ~
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SIGN HEHE IF CASH RECEIVED FnOM OEVOSIT ~
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_ LESS GASH -
1'NC Isanl., N.A. 1140
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r THIS:DOC.UMENT,.CONTAINSMU~TtP.LE FRAU.D`_LDETERRENT SEGURIT.~' FEATURES -`SEE'REVEP.SE GHEGK'NO. ~~
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^~~"' +V~B~RI.ZON GB:O voID.AFTER O~OQ5433$fi~BL
~V:ERIZON :PA .DATE 0~8 /`0 6 / 10 1BODAYS ;G
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ebb-.156k531 ~
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~F'Al' FOURTEEN .and 46/100 DOLLARS
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TO THE MARILIA B COLEMAN
OP,DEP, OF ''~/I~~~~i nn Il (t~.l~~(~I111~11=11
:U ~u'v~vuu U.~ vu~uU
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WACHOVlA BANK'NATIONALASSO.C. a.
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/- VERIZON CBO VERIZON PA 0005433$6$
verJ,~on 350 GRANITE ST 2ND FLOOR BRAINTREE, MA 02184-9000
Telephone Number Description
717/737-5548 CREDIT BALANCE REFUND
DATE TELEPHONE NUMBER TOTAL REFUND ~~.
08/06/10 7177375548 $14.46 '~
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FOR ANY QUESTIONS, PLEASE CALL 800!483-3000 ~4, 46