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Home My WebLink About07-08-11 (2)J 1505610101 REV-150Q ~`~O1-°°' ~ PA Department of Re~Venue Pennsylvania OFFICIAL USE ONLY OEMEiXEA Df PEVEXUE /~°Un Bureau of Individual axes E/ ly Code Year File Numb'~yer~y~_ PO BOX28o6oi INHERITANCE TAX RETURN !~ ~ ~1.7171z _ Hamsbura, PA i7iz8 o6oi RESIDENT DECEDENT ( ~ ~ ~ ~ Social Security Number ~ 6 ~~g~ Date of Death MMDDYYW Date of Birth MMDDYYYY 0 6 30,0 3/ ~ lTZTE~ Decedent's Last Name Suffix Decedent's First Name MI E Li L S ® ~_~,y~(' y a (N Applicable) Enter Surviving Spouale's Information Below ~'_-~~'+' Spouse's Last Name Suffix Spouse's First Name MI II~~ ® ~111~111~1~11~~ ' Spouse s Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL INAPPROPRIATE OVALS BELO~IV i 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death O 4. Limited Estate prior to 12-13$2) O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-62) ~ 6. Decedent Died Testate (Attach Copy of WIII) O 7. Decedent Maintained a Living Trust © 8. Total Number of Safe Deposit Boxes (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTX)N MUST COMPLETED. ALL CORRESPONDENCE AND CONFIDENTUIL TAX INFORMATX)N SHOULD BE DHU:CTED TO: Name Dayflme Telephone Number First line of address Second line of address c'~O~i O $~ City or Post Office State ZIP Code ~ DATE CHA~ / C S uRG ~ 17o Sg~7 C cxesh'e/d ~ t f t _, E7D ~~T7 r` ~ r -_, ~' ;= ~n r- v..ESepvEEUem rt a-mau seeress: ! S (..Q'1CQ$ . qG Under penalties of perjury, I declare that I have it is true, correct and complete. Declaration of xamined this return, Including accompanying schedules and statements, and to the best d my knowledge and belief, parer other than fhe personal representative is based on all information of hi h SIGNA URE ~PF~SON RESPON~ (,/'•~/• w c preparer has any knowledge. R FILI RETU DATE 4 ADDRESS L yN ~¢. EE ~ ' /079 (.~pp~r ~ ras `rg l ~t ' b ' i r as r /P / 7 Z S SIGNAT F P PAR OTME N ESENTA IVE DATE ADDRESS CH~QL~ ~- SH/ S ~rrr" ~,ct / ~OUSP~/' LCD W ~ 5 / / , Q ICS / OS PLEASE USE ORIGINAL FORM ONL Side 1 1505610101 1505610101 a"~~ J REV-1500 EX Decedent's Neme: ~Dt"OI Y1 Y =- 1 eebles 1505610105 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, 6. Jointly Owned Properly (Schedule F) O Separete &wn9 Requested ....... 6 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested........ 7 8. Total Gross Assets (total Lines 1 through 7) ............................. 8 9. Funeral Expenses and Administrative Costs (S~hedule H) ................... 9 10. Debts of Decedent, Mortgage Liabilities, and Liens {Schedule I) .............. 10 11. Total Deductiona (total Lines 9 and 10) ................................. 11 12. Net Value of Estate (Line 8 minus Line 11) .............................. 1 c 13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been made (Schedule J) ........................ 1: 14. Net Value Subiect to Tax (Line 12 minus Line 13) ........................ 14 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 .OQ 16. Amount of Line 14 taxable at lineal rate X .0 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 Decedent's Social Security Number 11 ~ I^YI 3 ^ Y o YIII eo 1111E o ~ ~ ~ 4 1 7 (o r 2 ~ 9 o 9 ~ Q g ~ ~ 7 i zs ~ 3 9 ~ S 9 6 y 9 9 z 3 3 0 9 4 8 3 3 y ~ 15. 16. 17. 18. 19. TAX DUE ......................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 1505610105 1505610105 O COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280801 HARRISBURG, PA 17128-0801 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX~11-96) N0. CD 013272 PEEBLES LYNN A 10791 UPPER STRASBURG FAD UPPER STRASBURG, PA 17265 ACN ASSESSMENT AMOUNT CONTROL NUMBER lak ESTATE INFORMATION: A SSN: iss-is-aasi FILE NUMBER: 2110-05 2 DECEDENT NAME: PEEBLES OROTHY I DATE OF PAYMENT: 08/27/24 10 POSTMARK DATE: 08/26/201 0 COUNTY: CUMBERL ND DATE OF DEATH: 06/03/2 ,10 REMARKS: RECEIPT TO ATTY SEAL CHECK#106 101 ~ 54,750.00 TOTAL AMOUNT PAID: INITIALS: HMW RECEIVED BY: 54,750.00 GLENDA EARNER STRASBAUGH REGISTER OF WILLS TAXPAYER REV-1500 EX Page 3 Decedent's Complete Address: File Number a~-io- syz, DECEDENTS NAME ~orn f'Ity Z. +~e21oj~S STREET ADDRESS 309 N. ~aee f - CITY rneChan fcsb u STATE ~'~- 21P ~ ~ o ss Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments ! eo A. Prior Payments ~ 750. B. Discount ~SD• o0 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to r(iquest a refund. (3) 5~, 9Y (q) O 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) ~ ~f8 23 Make chuck payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the properly transferted :.......................................................................................... b. retain the right to designate who shall use the property transferred or its income : ............................................ c. retain a reversionary interest; or ...................................... d. receive the promise for I'rfe of either payments, benefits or care? ......................................... 2. If death occurred after Dec. 12, 19$2, did decedent transfer property within one year of death Yes No without receiving adequate considgration? .............................................................................................................. ^ 3. Did decedent own an "in trust for" qr payable-upon-death bank account or security at his or her death? .............. ^ 4. Did decedent own an individual re$ement aarount, 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 is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the fax 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 exCmpt 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 transf rs 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 rcent p2 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value oft nsfers 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 transfe to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least a parent in common with the decedent, whether by blood or adoption. (t) /o~ y~9..~~ Total Credits (A + B) (2) fS, 000• o0 REV•1502 EX+ (6-98) , SCNEpULE A COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF PGGIp~t$, DoroEP, FlLE NUMBER T, 2/- /o- s7z All real property owned solely ar e a talent In exchanged between a wflNng buys and must be sported at fair makst value. Fair market value is defined as the price at which property would be wiNing seller, neither being compelled to buy or sell, txNh tlavirlg reasonable knowledge of the relevant facts. RBI property ich b JofMgr-owned with rfgM of wrvlvorship must bs diedosed an Scflsduk F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH t' ~'"L /~// .nor CCIf~I /' ~O~ Or Qroand a~fd fide ~n,•pro~ur~enTs ererftd ~t n havrn~ an ctdcfress in ~ Rnr»rs•~l~ of /-1crl~an-~sbu , Cu-v+.btr~oM.d Cou.nry, ~nns~!/a,~+c4~ pF' 309 N. Racc ~Sffcrf and 73e.;n Lof No..Z as ~oWn it~t P Bce1C No, alb, ~a~ ~G can ~ Ot7,i.~ t7l' ~tt R6Ca dcr o~ dlC~S %n a~'rnr ~$7IiC~ ~Olt>.~. far• ~// des riplSon see ~y of derma ~iy tKnJr 17. ~eC• /~ ~ y~'6 , r•e C° rr/ec/ h1 ~%ea~ ~o,L "i ,r vo% 32, 61~ ~ c/~ he.t~a. ova:~/ p .'see wore So/a~ ~ /S'e//yh L..1s~-ah DH •Ticne /S, ZD!( ~vr- ~//3,~500, °O See !~ o~ ~//3,.SaD•D° ~'efHcnxa f S of 2na~ D~ E~L'ufirs de tu/ 41~a c~iq/ herd . TOTAL (Also enter on line 1. Recapitulation) S // 3 S"n~ DO (N more space is needed, insert adddionel sheets of the same size) ~.4~rr•"4 ~ ~ ~ ~ ~ ~ ~ OMB Approval No. 2502-026E ~'"~"I(hF A. Settlement Statement (HUD-1) ~4q eNt`"'.. B. Tvoe of Login 6. Fib Number. 7. Loan Number: 5. Mortyaps Inwrona Cana Number. 7.~ FHA .~ RHS 3. QConv. Unira. 2071050014H5 8015564008 4. Q VA . ~ Com. Ins. C. Nob: bmr 1s kwrNslrod to Ohro you a statement oiacluM aWamsnE cosh. Amourrb pakl b and bylM sat8iment eyed aro shown. ms marked "(p.o.a)"awe Paid txuslda tM tYONrrp; OreY sro slroan Mro krrlnlorrnsObnal Duiposss and en rxN kxyudsd M Uw 6otala D. Name end rase N Borrower: E. Name and Address N 6elbr. F. Name and Address of LaMar. KNNn L. Ishm n Lynn A Paabbs, Exacutrbt NTM Estate Navy Fsdarol Credk Union, 309 N. Race N DaoNy I. Pasbbs and/or k's Sucwssors Mechanbebu , PA 17055 and AalOns 12861 Worldpab Drive, Sutra 600 Hamdon, VA 20170 G. Properly L Bon: H. Sslkemant ApeM: 20-0144871 1. 3skbmanl Data: 309 N. Rasa Homstwm Sattlalenls, LLC Machankabu , PA 17055 3800 MsrkN Street June 15, 2011 Cumberland nry, Psnnsyhenia Camp HM, PA 17011 Ph. p17)781~4170 Plaoe N SNtbmeM: 3800 MsrkN Street MIN PA 77011 J. Summa of eortovwrs iroraac8orr K Summa of Setters treraeedon 100. Gross M Dw from Borrover: 400. Gress Amount Due 10 Ss9sr. 101. Control ale 1 t3 500.00 401. Contract aala 113800.7 102. Personal 402. PmsarN 703. Satlleme CM to Bonowsr Lkra 1400 8 983.74 403. 104. 404. 705. P 405, bnarNa ksms b Salbr in advance Ad wbnaMS fw Moms k7 SNNr in advarru 108. /town Taxes 08/16/11 b 01/01/12 305. 408, txan Taxes 0&16/11 to OtN1M2 r 107. S T 08/16M1 to 07101/71 48.15 407. SdaNTaxa OB/1&11 to 07A1/11 48.' 106. Seward rash 08/18111 ro 07A)1/11 79.50 408. Sower d Tmh 06118/11 to 07N7/11 19.! 108. 409. . 110. 4 171. 411. 112. 412. 120. Grow cunt Des Trom Borroarar 120,857.32 420. Gross Amount Dw to 8albr 113,873. 200. Amoums Paid or In Bahatf o/ Borrower 600. in Amount Ow SNNr: 201. N ameN mo 1000.00 501. Excess sea bttnx:Nor7s 202. N new bans 113600.00 502. SNdsmam to SNler L{na 1400 8689! 2(73. Exk s taken to 503. s Wan to 204. 504. P FirN 20b. . P 2 ~ ~ 508. 207. 607. dbb. as s 206. SNbr nce 2500.00 508. 3easr Asebbncs 2500. 209. 509. Ad ustrneMs r Hems un b Salbr ustmaMs for Moms SNbr 210. C awn Texas b 510. !town Tallas to 271. Sdwol T a to 511. SMOOI Taxes W 212. Sawar d rash a 612. Sswar d Trash to 213. 513. 274. 674. 275. 515. 218. 518. 217. 517. 218• 518. 219. 519. 220. Total Ifor Borrower 117,000.00 620. Total Radrrctbn Amount Dw Salbr 77089. Soo. Cant at ant tmmlto Bortowsr h at aattlanarrt tolfrom SNbr 301. Gross arrr unt des from Bortower Ins 120 120 857.32 801. Grose amount des b Ss9er Nrre 420 ~ 713 873 302. Less am m /for Borrower ire 220 ( 117000.00 602. Las roductlons due SNler line 520 11 088 30.1. Cah X From ~ To Borrower 3,857.32 603. Cah ~X To ~ From SNler 102,764. TM undemip rsby nowbdps roeelp a c bled copy of thh salamsnt 8 arty akechmanh rotor d b heroin Bo r S°I CC ~ - n L. k an Lynr Pa ~b~a, xecul of fM Esbb N Dorothy L • Pesbbs aC$ PsOa 1 of 3 HUP (2011050014HS.PFWM71(W0014HSJ4 L. Settl mo t Cha es 700. Total Real Esfatr Broker Fen i 8,880.00 v.u ran v.n ryam commr 7 as wa: ~~• s.uw. 71 RFJNIAX Flrgrr vwne.a 7 . r WI a Central PA ~nwv saumrM f 704. Tronsadk Fes to KeOer WUlbms of Centel PA 295.00 ]05. Comm Fee to RFJMAK 385.0 BOO. kema Pa bb M Connxtlon wkh Loan SOt. Our in Ion pre S 1988.00 from GFE N1 802. Your cred8 or charya (ppMS) for ttro specHk inbroat rote chosen S 283.75 (from GFE A2) our ad u ed atbn a s from GFE #tP, 2268.75 804. rebel to Austlerman rebel from GFE /3 POC:8350. 805. CrodO R to E uitax from GFE IC7 POC:611. 808. Tax ro roL k ( FE 1l'7 46.00 807. Flood m floe to Data ,Inc. rom 808. Tax ss to L k 5.00 808. from E t3 810. 811. 900. Ibms irad Candor to es Paid In Advance 901. Da I st cha s from 08/15/11 to 07101/11 18 575.938844Po ham GFE 110 254.98 902. M i surence ium fa months ro from GFE +K7 s uronce r 1. are to Insurence a . 904. Pest In n 1.0 ro ro Sudtlen DsaN TermOs 8 Pest Conlrc hom GFE /t 1 309 N. Race St 40.00 905. (from GFE tK11) 1000. fbd vv8h Lander 1001. Inhfal for your escrow account ~ (from GFE S9) s wrenee mon per m 1 nsunnoe mon r month S 1004. Property a S 284.89 axes mon r month uMy T months ~ S per month drool 1.000 months S 97.85 r month 4005. S 1006. Ma months •g S per monN S 1007. Pest In pion months ~ S per monN S 1908. i 4009, rop Atl)wtmsnt ~ i -3511.115 1100. TRb CM 1101. TBb and bndars ti8e ksurance rom 1,253.75 1102. a poN las B 1103. s ro rt uaron a hOm GFE s surancero bwart uaro n ~ 1,078.75 8.1/1 7105. Condors Am8 113500.00 Bask 1108. Owmsl's Bm8 113500.00 Bask 1107. fs d iM trial t81e imurance romium ro Flomstown SeBlements LLC 918.94 1108. U rs of 91s trial tlib insurance remium to Stewart TOb Gua C 181.81 1109. CPL to Staaart TlW Gum Com 75.00 1111. 1. 13. 7200.Oow ant Rasordinp and Tnnabr Charpas 1201. Gtwem t rooord pw to Recorders Oflfce from GFE !f7 163.00 1202. Deed S 82.00 e i 101.00 Rsbaaas i Ottror i 1203.Trensbr w to Recorders Office IromGFESB 7,135.00 1204. C lCou tazhbm S 1,135.00 S 1205. Stab tam S 1 135.00 S 7 135 a 1207. 1500. Add 19aaNnrarrt Cha ]301. R uked servkss that cen ah for from GFE lM8 1302. 2011 od Taxp Comi Due ro Hometown Settbmenls LLC 1303. Hans W m ro Flrol Amerlcen Home B Proteplon Ordani 10315085201 389 1304. Peal W Preformed to Know Swell Temrke d Pat Services POC:S795. 7305. Ebpdca Work Dons ro R.L. SnNbedtor, Inc. POC:S685. 1100. Tool ent CM error on Imes 703 Sectlon J and 602 Sidon K 8983.74 858£ a~apwowr+ ma.amee~,n.~v.ab..cww.UOf•.naa a.oanp.Na ayrap.s.x aaaw. srw WS.~ n \ ~~ ' Florti Se LLC, mart Apart Csridbd to fro a hue copy. Papa 2 of 3 HU0.1 (2011060014HS.PFD12011050014H3/45f ....,ny.nevn v, vw.., .,w, r.,.no,. w. ~~,.,,. ..~~ ~.~.e~~ _ ........._ _.... _..... Char ea That Cannot Increase HUD-1 Llne Number Our origina8on cha e # 807 1,g8g,pp 1,ggg.gl Your credk or eha e ( oinls for the specffic interest rate chosen # 602 283.75 283.7: Your ed usted o ' inatbn charges #803 - 2,269.75 2,289.7: Transfartaxes #1203 2,270.00 1,135.01 Cha q That In Totai Cannot Incnaw More than 1 oX Good Fekh Estlmab HU0.1 Gowmment cord' char es #1201 400.00 183.01 Appraisal foe #804 425.00 350.IX Credk report #505 11.00 11.IX Tax service #808 45.00 45.IX Fbod ceAificadon #807 7.00 7.IX Tex Set-Up Fse N 8014 5.00 5.d Tobl _ 893.00 581 Ot Increase behreen GFE and HU0.1 Charges S ~ -312.00 or -34.& Charges That~~Can Change Good Fakh Esthnab HU0.1 Inttlal depwk r your escrow accarM #1001 Daly interosl dtarges #801 6 16.936844lday 239.05 254.9! liomeownefa urencs #903 445.00 445.p Pest Inapedba #904 100.00 40.p 7itb servbes and kndeh tkN insunnca #7101 1,885.25 7,253.7: pvmefs tttk I urence ro Stewart Tito Guareny Comparry #1103 926.25 Loan Tarrna Your Inklal loan amount b S 113,500.110 Your loan bmlr Is 30 yeana . Your Inkbl IMerot me b 5.1260 % Your Inklal monthy amount owed for principal, Inbrest and S B17.99 Includes arty mortgagrinsurenca b Prindpal ^ IMerost ^ Mor~aga Insurance Can your inbrest oats Au7 ^X No ^ Yea, tt can rise to a mardrr7um of %. Ths flnt charge w81 W on and nn change Spain wary _ months afler . Every change dsb, your httorosl reb an krdseae or decrease by %. Cover the pb of the ban, your hderaal rab k gwrenbed ro nswr be borer then % or higher tMn %. Ewn N you mrlM payment on time, can your loan balance rhe9 ^X No ^ Yea, h can Aw to a maximum of S Ewn H you male paymems on dme, an you monthly 0 No ^ Yes, the first irrasate can De on and the monthy amount owed for principal, Interest, and mortgage Inaunncs Ass? amount owed can rise l0 6 - Ths maxvnum k an ever rise ro is S Does your Iwo haw • IuepaymeM penahy'J ^X No ^ Yes, your maximum prepayment penally b = -~Dioes your ban haw a balloon paymenYl ® No ^- Yss, you haw a battoon payment of S due In _ yeah on Total mouthy Mmount owed including escrow account payments ^ You do nd have a mouthy sacrow payment for ttems, such as preperly taxes and homaownsfs insurance. You must pay these ksms direly youreek. © You haw en adtlttional monMy escrow payment 015181.49 that resutta in a total Initlal mouthy amount owed of 1799.48. Thb indudsa pdndpal, Interest, arty mortgage Insurance end any ksma chadced bebw: ^X Property taxes X^ Homeownefs insurance ^ Flood insurona ^ ^ ^ note: n you new arty questbns about iM Settlement Charges and Loan Terma listed on Mia form, pNass conbd your tinder. Pape 3 of 3 HU0.1 (2011050014H8.PFDI2011050014HS/45) HUD-1 Attachment Bo~ rower(s): Kellyn L. Ishmi~n Selleds): Lynn.A. Peebles,:Executrix of The Estate of Dorothy I. Peebles 309 N. Race Street Mechanicsburg, PA 17055 Lender. Navy Federal Credit Union, andlor It's Sucxessors and Assigns setae entApent:Hometown Settlements, LLC ' (717)761-4170 , Place of ettNmerrt: 3800 Market Street Camp Hill, PA 17011 ment Dat.: June 15, 2011 Props Lowtlon: 309 N. Race Street ' Mechanicsburg, PA 17055 Know ett Terrnit~~r>~~rp~nty, Pennsylvania Pest ervices Done POC:S795.00 Adjus Origination Charge Details Odgina on Charge ' 1.7596 F nding 1,986.00 t Navy Federal Credit Union, andlor It's Successors ~ Totai : 1,986.00 Origins on CrediUCharge (points) for the specific Interest rate chosen CrediUC ergs 283.75 t Navy Federal Credit Union, and/or it's Successors Total S 283.75 Adjusted Origination Charges i 2,269.75 TIUe Se Ices and Lender's Title Insurance Details BORROWER SELLEF Express emight Fee 20.00 Hometown Settlements, LLC Wire Fe 20.00 Hometown Settlements, LLC Email F 35.00 Hometown Settlements, LLC BK/PaU omestic 15.00 t Hometown Settlements, LLC Tax Cert Fee 10.00 t Hometown Settlements, LLC Lenders tide insurance 8.1!1001300 1,078.75 Stewart Title Guaranty Company CPL 75.00 Stewart Title Guaranty Company Total E 1.253.75 S 0.00 WARNING a b • crime to knowitgy make hies stetemeMS to tl» Unlbd States on NM~or am sknaar form. Penaahs upon wmktlon un InduM a and NnprYomreM. Fw defalb see: TMN 18 U.S. Code Sectlar 1001 and 8eetlon 1010. (2011050014HS.PFLY20110500UFiS/4b: 1 HUD-1 Attachment - Lendet':# T1tle Insurance BORROWER SELLER Ora Llu. ai..r.....w....~ L. ~x~~ c~~n~r -.r i -~~~~- wu_ .__..~___ .._~.._ Lender'a olicy Premium 928.75 t Stewart Title Guaranty Company Lender's ndorsement Charges 150.00 Endo ement Endorsement Charge ALTA ndon;ement Form 100 50.00 ALTA ndorsement Form 300 50.00 ALTA ndonement Form 8.1 (Environmental Protection Lien) 50.00 Total S 1,078.78 i 0.00 WARNING: M • oAm~ W knoiMnpyr make faN~ st~bmMts to tM Unlbd 81abs on this or arty slm0ar roan. P~IWS upon wnvktlon un Inclutl~ a fl an0 Imprhomn~M. For MWIs sN: TkN 10 U.S. CoM SMlon 1001 and 3~caon 7010. (2011050014HS.PFDR011050014FIS/46) Tax Parcel Number: THIS INDENTURE MADE THE / ~//day of , in the year of our Lord thousand and eleven (2011). BETWEEN LYNN A. PEEBLES, as Executor of the Estate of DOROTHY I. PEEBLES, deceased, late of the Borough of Mechanicsburg, Cumberland County, Pennsylvania, Grantor, and ICELLYN I. ISHMAN, a single individual, currently of the Borough of Mechanicsburg, Cumberland County, Pennsylvania, Grantee. WHEREAS, the said Dorothy I. Peebles, was vested in her lifetime with title to the :s hereinafter described, in the Borough of Mechanicsburg, County of Cumberland and mwealth of Pennsylvania; and WHEREAS, the said Dorothy I. Peebles, departed this earthly life, testate, on the 3rd day June, 2010, and Letters Testamentary were duly issued to the said Lyon A. Peebles, by the gister of Wills of said Cumberland County; docketed to No. 21-10-0592; and WHEREAS, the lands herein-mentioned were not specifically devised: NOW, THEREFORE, THIS INDENTURE WITNESSETH, that the said Lynn A. bles, Executor, as aforesaid, for and in consideration of the sum of ONE HUNDRED IRTEEN THOUSAND FIVE HUNDRED and No/IOOtha (5113,500.00) DOLLARS, and ;r good and valuable considerations, to him in hand paid by the said Grantce, at and before ensealing and delivery hereof, the receipt whereof is hereby acknowledged, has graated, 3ained, sold, aliened, released, and confirmed, and by these presents, by virtue of the power authority in him vested by the Fiduciaries Act of the Commonwealth of Pennsylvania, does at, bargain, sell, alien, release, and confirm unto the said Grantee, her heirs and assigns: ALL THAT CERTAIN lot of ground together with the improvements thereon erected uate in the Borough of Mechanicsburg, County of Cumberland and Commonwealth of nnsylvania, more particularly bounded and described is accordance with a survey by Michael D'Angelo, R.S., dated September 22, 1982, as follows: BEGINNING at a point mazked by an iron pin in the western line of Race Street (60 feet ), which said pin is the division line between Lots Nos. 1 and 2 on the hereinafter mentioned of Lots; thence extending along the western line of Race Street, South 09 degrees 30 des East, a distance of 80.00 feet to a monument in the northern line of Long Alley (20 feet ); thence extending along the northern line of Long Alley, South 81 degrees 52 minutes a distance of 60.00 feet to a monument at comer of land now or formerly of Robert C. cer and Randall C. Hassinger; thence extending along the line of said land now or formerly Ebert C. Bricker and Randall C. Hassinger, North 09 degrees 30 minutes West, a distance of feet to an iron pin in the division line between Lots Nos. l and 2 on said Plan; thence h 81 degrees 52 minutes East, a distance of 60.00 feet to an iron pin in the western line of Street, aforesaid, at the point and place of BEGINNING. BEING Lot No. 2 on a certain Subdivision Plan for Kirk Hassinger, which said Plan is d in the Cumberland County Recorder's Office in Plan Book No. 40, Page 16. TOGETHER with the right and privileges in Grantee, her heirs, and assigns, to use a fain sanitary sewer line in common now or formerly of Roy D. Hicks and Jeannie L. Hicks, wife, their successors in title, their heirs, and assigns, which extends from the premises einabove described along and adjacent to the western line of Lot No. 1 on the above recited xiivision Plan being now or formerly retained by the said Hickses, their successors in title, it heirs, and assigns, in a northerly dvection to its point of connection to the main municipal rer line located in the bed of East Portland Street. BEING the same premises which Roy D. Hicks and Jeannie L. Hicks, his wife, by their d dated December 1, 1986 and recorded in the Recorder's Office aforesaid in Deed Book "I", ume 32, Page 674, granted and conveyed to Dorothy I. Pcebles, Widow. Her said Estate is Grantor herein. TO HAVE AND TO HOLD the said messuage or tenement and tract of land, :ditaments and premises hereby granted and released, or mentioned and intended so to be, ~ the appurtenances, unto the said Grantee, her heirs and assigns, to and for the only proper and behoof of the said Grantee, her heirs and assigns, forever. AND THE SAID GRANTOR, Executor, as aforesaid, his successors and assigns does enant, promise and agrce to and with the said Grantee, her heirs and assigns, by these seats, that the Grantor has not done, committed any act, matter or thing whatsoever whereby premises hereby granted, or any part thereof, is, are, shall or may be impeached, charged or umbered in title, or otherwise howsoever. IN WITNESS WHEREOF, the said Executor of the Estate of Dorothy I. Peebles, :d, Grantor herein, has hereunto set his hand and seal the day and year fast above written. fined, Sealed and Delivered the Presence of: ~22a~ ~~1~:E°,~.~i~~/~~y~"~~~X~ (SEAL) L'~i A. PEEBLES, Ezecutor of the ~~ ~' ~r Estate of DOROTHY I. PEEBLES, Deceased ~,rrtl~~ ~ P-P~h1PS~ Dc c eAs`Pc0 OF PENNSYLVANIA OF CUMBERLAND SS: On this, the ~ S~day of A.D. 2011, before me a notary in and for the Commonwealth o Pennsylvania, personally appeared LYNN A. JES, known to me (or satisfactorily proven) to be the person whose name is subscribed as ar of the Last Will and Testament of Dorothy I. Peebles, and acknowledged that he :d the same in such capacity. IN WITNESS WHEREOF, I hereunto set my hand an official seal. Notary Public My commission expires: (SEAL) CERTIFICATE OF RESIDENCE I do hereby certify that the precise and exact post office address of the within Grantee is: Attorney for Grantee REV-1500 EX+ (6-BB) SCHEbUDL^Ew,B COMMONWEALTH OF PENNSYLVANIA STGCK5 & BONDS . INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FlLE NUMBER /~teb/es, abrot~y .I. 2/-/0- S62 Ad jolntlyownsd wNh rlyht of wnrlvonhip mwt bs dfedopd on Schsduk F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ~~ ~iyJer~i~ah den ~y =n/esl'ment ~~ Ne 9z/-oo4o5/~f7 ~{S, ~f'f/. 76D ski ~'s q(~ f/. oo ~ $~f5 '/~I.76 TOTAL (Also enter on line 2, Recapitulation) I ~ ~{5, ycj/ 76 more space ~ needed, in6ert additlor~el any a use scone arms) /`+~~ •~~/~//Iv November 23, 2010 ~, American Century Charles E. Shields III Investments Attorney at Law 6 Clouser Rd Mechanicsburg PA Re: Dorothy I. Peebles Dear Mr. Shields: We have noted the dea of Dorothy I. Peebles in our records. Please express our sincere condolences to Ms. Peeb es' family. The Short Certificate is enclosed for your records. Ms. Peebles owned an ' dividual account registered in her name under her Social Security number. We understand that Ms. Peebles' estate was probated and the personal representative of her estate will redeem the assets. do so, the following documents are required: • A completed Account Distribution Form, signed in capacity by the personal representative with his si~na notarized. The value of Ms. Peebles account as of June 3, 2010, is provided below. Account Shares Net Asset Value Value 921-009051493 45,441.760 $1.00 $45,441.76 Ms. Peebles was a value 'investor with us, and we appreciate the trust she placed in us. Please be assured we will do our t to make the process of handling the account as convenient as possible. If you have any questio or if I may be of further assistance, please call me at 1-800-422-3301, Ext. 48117, weekdays from 8 .m to 5 p.m. Central time. Sincerely, ~..~ Cale Brewster Estate Transfer Document No. 0100671 Enclosure: ORIGIN. Estate Tr Account Business American Century Investments P.O. Box 419200, Kansas City, M Short Certificate (112010/9002467/1754) ;fer Kit iution Form Envelope 1-800.34`x2021 americancatturymm CLS7A OBOt REV-15uB IX. (7~ coMrwtoNwi:ntri+ of PEttrtsnvn-iw eatEraru~ rnx tsErtxa~t SCHEDULE E CASH, BANK DEPOSITS, 8 MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Irtdude the prtxeeds d I'ih'pation and the dale the srere received by the estate. Approperty joYitly-owned wNh tM ripUt of suMvonAip nwst be discbsed on ScMduN F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ~• Pro-rtx•h'ons retlnbtttr'Sernen'C's per S~~Hement 51,ee.~- tsrt ~ ~' ~ '~tafe cttfacl~eol ~o Sch.~! A-.' ~. 4'ht 4~1/v -- Clfy~rsua TxaS ¢305 93 $ Lint ~~- Sr-/cool T~s ~ ~18./S L'. L.;ne S/o8- t4~ec~!•r ~ T~sti r l9, Sb a? 1=: n.e/ /~•out ~:hc; pa/ f Want: a/ soup f+~ Eevt p/ogees of Chun;cal 1. carp. r G Sf, 7S' 3, J~~R/ ~ivkt ~enJy"k/ ~erinD, Titmsfzrs ~um~/ f~nntcify f a 33.oD 'f IY11~KtaQ/ of O/n ba ~isur. loo. ~arfid! refwtd of prtent~tv-~, ~~~y.9o 5 1 A. ~t. ~d tlt. - l~c}~a~c. - ~SDO.oO ~ . C: ti zeq s J3 nK (sce v~/u~/foitS q~ucltt~/~ f~ ~~ ecK: Nv. tb /O!J 70o yob "~ r 8, ii6. Ss ~. Tom. ~: ffa"cr. fd c(v. q! o~ i4-. .6~ e. e~~~ . ~! 6 a/s 3~ s3a (Me~.~ mn~~tt) ~ /D 7/9.09 F: ?.'mt vs~t ~/fFp 86S a~7 x/.69 F. ~f Arc . 1~ d ad. oq ~ ~/o, zy~. F6 G. T.i~t d st 6 /Yo 70o so ~ ~/o, sa fi!. Sat .4•ee . ~v d.o.y% on G ~/9, 566.9! 7• Mofnrsfa /!!w/~r / ..T,s~rr. (a. ooir,~,~,'a ~ ~~,,u/ of rent. uM ~{ ~, ZZ ~ lS6.03 g ~itx4ut~ ~, /NarKe% Ft~td .#~ oo/!_D987o5915f36 l / 7y~ 701. ~f 9 /}cam': d ~ /ia/tads ~' dv a~ i~ Lfcirt 8. Csu va/cto>~on ti«f A/facha~/) - ~l ~O- Motorists /hu ~ I»sur. (,b. ~xrf;r~/ red of ~Kmiurr~ y~//8. g/ /l, 1n rcato~y ~{ 1~erso~Q//y .Z'/r~ris ~s~ /.;,¢ ~~ls~/rtw~) ~/ DSF7, Do CSw t onl~~ n un.1i • n She.~.t TOTAL (Also enter on line 5, Recaptulation) S ~ a 6 r 902, 99 (If rare space is nestled, insert additional sheets d the same size) ~-Z --- /2. _._--_ I I scyE7J. ~, _.~g . ~~ ~- {~~/~ __ 1835 Z/8 D T y -1 ~ 'f2~oea m~1t--- ---- scra ~ t eels oi/ ~lr ~i~c~r does a®~lvvrk_ an.~ •'f L / _ _ _ ~ -- - -- ___. - ----- ~. September 1, 2010 Charles E Shields, III Attorney At Law 6 Clouser Road mechanicsburg PA 17055 Estate of Dorothy I Pe Date of Death: Jun 03, SSN: 195-16-4481 Dear Sir/Madam: h1 accordance with your n name as of his/her date of The above decedent did For Installment Loans or all other inquiries, please Sincerely, Kelli-Jean aiva Decedent Account P~ REF#: 460584 One Citizens Drive ROP112 Riverside, RI 02915 the attached information sheet has been provided in the above decedent's own an active safe deposit box at the time of death. of Credit accounts, contact our Loan Department at 1-800-708-6680. For 1-877-579-2667 Account Number 6100700402 Account Title Doroth I Peebles Date ed 6/6/1 g~ Account T ~~~ Princi al Balance as of D $8116.55 Interest from Last Postin to DOD $ ,64 Account Balance as of D D $8117.19 YTD Interest to DOD $4.09 Account Number 6215380532 Account Title Doroth I Peebles Date ed 2/2/2007 Account T ~~~ Princi Balance as of OD $10719.09 Interest from Last Po to DOD $1.69 Acxount Balance as of D D $10720.78 YTD Interest to DOD $12.75 ~~~' j '~` ~ ' Account Number 6140865247 Account Title Doroth I Peebles Date ed 4/6/1992 Account T Time sits Princi al Balance as of D $10296.86 Interest from Last Postin to DOD $10.50 Account Balance as of D D $10307.36 YTD Interest to DOD $52.65 .$ ' •'~4 i4.~t;. .: ..; M 5 t I Account Number 6140700507 Account Title Doroth I Peebles Date ed ' 10/2/1995 Account T ! Time sits Princi al Balance as of D D $19566.41 Interest from Last Postin to DOD $4.22 Account Balance as of D D $19570.63 YTD Interest to DOD $379.08 ~~~: ,~Of'1S1S ~rJhk31 '~ Check No.: 0000097243 , ~ ~^' ~'r Check Amount: $ls6.03 xrdiheMotadsKmwmnor~wnrp ~Of: 7676 7152293600 DOROTHYIPEEBLES 309 N RACE ST MECHANICSBURG PA 117055 Date ISSUed: 06/22/2011 ~'000009 7 24 3~' ~:04 1 20 389 5~: 4 2 39 7069 5L~ " 'f"lil[.llY 711E'A~filremu neTeite~f it:~ .:, Dorothy I. Peebles 10791 Upper Strastwrg Rd Upperstrasbrg, PA 17265-9701 Page > 1 of 1 ` Vanguard' Voyager Services:800-284-7245 ,Total report value: 574,708.86 (Total report vakre includes any accrued dividends.) Neale '.' 4Ftrgd &Acequnt' Date ;, ', ~., .~` 'Puce Per: %i;~jj Wombat c0peried ' Shares ShaP6 ' , Va[ire• ..: ` Divideilr~r.: Admiral TrsY ~~Y Mkt Op11-09870591436 08N012009 74,708.750 $1.00 $74,708.75 $0.11 TdtYitlr 051680242810/18!201010:22:44 StS Muh.lal neti+otorlsarnsurona~7~'~ ~~ DOROTHYIPEEBLES 309 N RACE ST MECHANICSBURG PA 17055 Check No.: 0000030790 Date Issued: 07/o6/zoio Check Amount: $11a . 91 For: 7676 0505230337 ~r0000030790~' ~:04i203895~: Oi62L65~' Dorothy I. Peebles Estate -Inventory -Schedule E LIVING ROOM Small end table & lamp $ 4.00 LYNN Old couch $ 15.00 LYNN Old recliner chair $ 10.00 LYNN Old upholstered rocking chair $ 10.00 LYNN Old color TV $ 20.00 CHURCH Small round stool $ 1.25 CHURCH Assorted knick-knacks $ 9.50 CHURCH Electric clock $ 2.00 LYNN CD player (hand carry style) 4.25 $ 76.00 UPSTAIRS LYNN Old wooden dresser (scratched up) $ 45.00 CHURCH Neck lamp-electric $ 1.50 LYNN Old bed detached & frame $ 18.00 LYNN Old cedar chest $ 65.00 LYNN Old 2 door clothes closet $ 55.00 CHURCH Old metal wardrobe $ 22.00 LYNN Old chiffarobe (wooden-scratched) $ 48.00 LYNN Old window air conditioner -junk value - 0 - LYNN Newer window air conditioner 40.00 $ 294.50 DOWNSTAIRS BEDROOM LYNN Bed with wooden head board $ 25.00 LYNN Short dresser $ 30.00 LYNN Chest of drawers $ 42.50 LYNN Padded stool $ 1.75 CHURCH Table lamp $ 2,25 CHURCH Small round table & lamp $ 6.00 CHURCH small end table & lamp $ 6.00 CHURCH Electric clock $ 1.50 LYNN Small nightstand $ 4.50 CHURCH Assorted small flower pictures $ 5.00 2 card tables 5.00 $ 129.00 SPARE ROOM LYNN Small desk $ 18.00 LYNN Foldable bookcase $ 3.00 CHURCH Assorted small lamps $ 8.00 SPARE ROOM (continued CHURCH Assorted fake flowers $ 4.00 CHURCH Assorted small appliances $ 5.00 LYNN Chest of drawers & small table lamp $ 42.00 LYNN Small vanity and mirror $ 65.00 CHURCH Small wooden table $ 2.00 CHURCH Small end table $ 3.25 LYNN Two chairs $ g.00 CHURCH Old luggage $ 2.50 CHURCH Costume jewelry 8c plastic beads 5.50 $ 166.25 BATHROOM CHURCH Plastic waste can 0.50 $ 0.50 KITCHEN CHURCH Assorted pots & pans $ 17.00 CHURCH Assorted kitchen utensils $ 6.00 CHURCH Assorted flatwaze $ 6.50 CHURCH Assorted small appliances $ 12.00 LYNN Kitchen table with 2 benches $ 28.50 LYNN Wooden chair $ 3.50 CHURCH Floor fan 2.50 $ 76.00 CHURCH Assorted books 10.00 $ 10.00 UTILITY ROOM LYNN White metal cabinet $ 15.00 CHURCH Assorted fake flowers $ 2.50 LYNN /LEE Refrigerator, washer, dryer $ 110.00 CHURCH Assorted rooms, vacuum, cleaning items 40.00 $ 167.50 PORCH LYNN Old wooden glider $ 18.50 CHURCH Assorted folding chairs 15.00 $ 33.50 GARAGE CHURCH Lawn tools, rakes (no lawn mower) $ 15.00 CHURCH Assorted hand tools $ 5.00 GARAGE (continued LYNN Plastic garbage cans $ 5.00 LYNN 2 small ladders $ 10.00 LYNN 4 plastic patio chairs $ 10.00 LYNN Folding round patio table $ 10.00 LYNN Oval folding patio table $ 15.00 STAYED Set of wooden shelving $ 2,25 CHURCH Plastic cabinet 5.00 $ 77.25 BACK PATIO LYNN Plastic gazbage can $ 2.00 LYNN Wooden swing $ 10.00 LYNN Plastic table and chair 4.50 $ 16.50 $1,047.00 H165-99 Principal l.ffe Insurance Company Des tiAoines, lA •50392-0001 REgP1ENT NAME DO)~D'1'HY I PEEBLES - gtEgC NUMBER AA15876350 ~ RPS Nlll~iti of ~ OATE.OfrO1-10~ REFER TO YOUR RPS NUMBER IN ALL CORRESPONDENCE - 011662 H You Have Any Questions Contact PRINCIPAL FINANCIAL.GROUP DO1tOTBY I PEBBLES REPETITIVE PAY!lSNT SERVICES 309 N RACE STRBET P.O.BOH 492b GRAND ISLAND, NE 68802-4926 NECHAI(ICSBURG, •PA 17055 PHONE 1-800-247-7011 DES MOINES AREA AND FOREIGN COUNTRIES CALL 1-515-247-7820 F114AG7 AA1S878350 08/01/2010 Benefits Provided By Account Number Description Amount Net Payment . -. ~ , 4:4fii :,. ~'•r'F~a}i.». its->F:: ..i}:i;:w ... »;:~,:A::.:.. ; ~i• ... ni . „C , :. ... 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PAYEE NAME I CHECK AMOUNT 0012290594 08/10/2010 0000000009 DOROTHY PEEBLES EST $484 9C DESCRIPTION VOUCHER AMOUNT 282041-99 DOROTHY PEEBLES EST DECEASED REFUND 04008738 484.90 PSMF s e. °-~-- ~ ~ . ` , -~ ~ .i ,$ ~ >. ~ ~. n t ., ~ ~ r r ;.. ~~' ° ° ro rHe DOROTHY PEEBLES EST ° ~ ORDER ' m of M1 A O x•00 1 2 290 594x' ~: i049000ti8~:09 10406 2n• i~~~ 3 DOROTHYIPEEBLES 309 N RACE $T MECHANICSBURG PA 17055-3381 DOROTHY I PEEt3LES ~oocr~oc-~.fa~ oiro~rm~o o2oeeees s233.oo s.oo s.oo s.oo s233.o0 DETACH AND RETAIN THIS STATEMENT The attadred check is in pevmeM of iterr-s deactbed above. If not correct, please notify us frnmediately. PLEASE NOTIFY US PROMPLY OF ANY CHANGE OF ADDRESS JOINT & SURVIVOR 50~ ANNUITY XXX-XX-4481 IMPORTANT TAX NOTICE CONTACT THE FUND OFFICE AND REQUEST A W-4P FORM IF YOU WISH TO MAKE A CHANGE TO YOUR FEDERAL WIT1iHOLDING ACCOUNT 1-800-3430136 (in PA) t-800-331-0420 (Nationwide) Social Security Number must appear on an oonesporrderroesubrmtted to the Fund This chedr may only be cashed N the payee is living on the date the benefit check is issued DETACH HERE p'000 20 6868 5N' ~:0 3 1000 50 3~: 2000 506 26 1 i 34w' REV-1511 EX+(10-06) SCHEDULE N COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES ~C - INHERITANCE TAX RETURN ADMINISTRATNE COSTS RESIDENT DECEDENT w lwl a ur FlLE NUMBER I~eGbles, ~ero~iy ~• a/_ /o _ S9 2 Debts of decedent must be reported on Shcsduk L ITEM A. FUNERAL EXPENSES: 1. /h y~rs Fw-rentl +lemc o~ meclwn ics bw-~ ~. Csi/I ~pi(,It Mc/horia.~t B. ADMINISTRATIVE COSTS: t - Personal Representative's Commissions Name of Personal Representative(s) Lunn ,r_ PlG6/Gs ~~ stieetAddress /079/ ujajocr aSfras6ur4 Rd city ~pQ/' ~ ur+~ Oi~d v state t~A~ Z'ip i 7 z bS Year(s) Commission Paid: 2. AttomeyFees Cl,d;.--~t.~ ~• ~tir~dS 'ItI'~ ~~. 3- Famiy Exemption: (If decedenCs address is not the same as daimanCs, attach explanation) Claimant ND C,YYE' ~"L,/G/,BL E street Address Cdy State ~ Zip Relationship of Claimant to Decedent 1 4• Probate Fees AMCI OtlC3-n~ ,l5$1eQ o~ ~${~torf CP.I"li~[a-~S, 5• Accountant's Fees "1 (~-K ~ndntia~ for ARP c.(oSGow1' to {~o~ PA-yp ~,~( 6• Tax Return Preparer's Fees ~ ~ Z ~ ~ ~b4ls *" P/F ~/s ~~/;,„•) ~d/'cffisr,Jr %h ~ar/.:se° ~if~ix/ /1ct~~apcr 9- ~4ddi /i os~.~/ p.,o6a~ >~~ ~{v iPc j - sf 6•~i//s //, Re:~~Krscatenfi~~ C//farl~s E' os~lic/a/s 1L {r naa~/.irjs, C-CrJfi ~ /lla~~~"7 ~ P/1 o~G~JiPS~ ~~~D~sf a~•sf P~s .r,..,,C;. c%,c 1 ~ io, /97.00 ~/ 60, oa ~/1, S7s, o0 ~~~, 325. oD NoN~ 157.50 7.$~• B1J X7,5, oD ~135/.yy ~~o.oo ~/S Ao ISTJ• Oo TOTAL (Also enter on line 9, Recapitulation) 15 S.'l, S7~ 96 (H more space is needed, insert additional sheets of the same size) z se~F~, y, ~~t~% ------ ~ Gf' ~¢c6~s, ~'o~ix ~, -------- F%LE/~D_--- 2/-ID-,S'g2 -__- /2. 7fcros 6l~__--4a~/ ~ s~~_ cSe/PYCAJL~/!f s6e~,~'`oa ~Salc d' ---- --- ---_---- ~ -- L%ne 7a.3 f~c~c/{ars~i,~,o,-%ss%oa ---- --------_ -------------- -- - ~`L 660. ~' ---1-- -------- ~ L'il~ . 70S ---C~!1~%SS%Oq Fae J/o RF~'~JYifX - ---------- - --- ---- - ~3 S D -------- --- D-~1:n~__lzos - - a5fttt --- ~3~~-~'------------ -- - -------- - -- r ---- /3s °° _----- -- _-- E. Ln~ / ~3 _ - /~on1t 6tlat~an _ - X 3 t9. ot~ • _ L ~ ~r r~pa:rs nr~eri4/s_ ci.~ul_~,a /_IC ---------- _____ --~-,L~~4/~ ~0~/t~---~s ~rt.~ ~~ .- See 6/'eakdoati~ aslpr /~e~.~ ____-- _ ~.73.?.08 - - ------ -~~c/w1,~--------------------------- -__--- ,tS: ---- -- --- -- ~ 6~rrsemt~ fo' _~ri-,~s --E: ~iie/~s~ ,{ter __--_.-- ----------- BD - ~ ---------- ~ ~ ------ Le~~~a er era.~sa/ ~khons ~ :s~/ ~''~ ~ - pI - f ~ -- --- __-- /qtr _ i -.- O -_ _ ~a ~; fiuns ~aMK ~.l~ar~e - S~v~~ed s~ ~ns;o C'-h.~.k ~nr 7~a.1v --- - c_a.oo_ . ---~/o. 00 --------- / 1/eri zoo ------ -- ---- -- ----- --- - - Sao. ~o --------~• -Zee-- - ---_- =1?to7 --- a PPG ------------------ _ ray, ~3. ~H _ - -- - ------ - q ---- `~ ----- -/C r - f//3 3z -- --0~ ----------- - - . %7. iS ----------- --------~ pPC ~/tGfri~ ___------ ---------------------- --- ~~-- ---- 2S, ~f hra er ----- ----- - --------- ---------------. --- . zs f/° - - -- -- 30. -- -- I~e~iu.~;cs6K ~oro ~wtr• eluse_--___- --------- ~- -- +- - 1 //~ 32 ~,, / ------------ _ J~ ----- --- - ------ - -- 33--a- _ _ - ~- f r (~~ _ s ~~_r~r ale o fra/ ~------- ~S/8~ ss ------ _ 1~or! _[nlo~u--- ----------- _ ~ ---- - -----__-------- ----- -------- f 70,SL 36. -- -- - --~-------- --------- /hofar;sJ"s l}1tr,~ual~isur ~!~pki7eC~ sur - ----------- ----- - -- o0 ~35~/ ._- (~ ~~shrr~-- --- , ----- -- ~o.~° ~ Sl.HED. ~l, Cad ~l 0~ ~GI~PS~~D .Z_ >`/LE ND .Z./-/D-S9z ------ 3 Z ` /71 ~Z~e~s~ ~as/ G1~r,~n~, ~'r sa/G ~ ¢ ass s= -~~------ --~ __ ----__ - -~ ------- - ~~L " iss 6Z . - ------ ---- 39. - _ l.Gxtiltd l~'er ---- '~lo. ------------- -- ---- 3Y ---- ---------- -------- /o. YS - --- - ~ ~--- -------- --._. ------- ---------- j--t~s ~ u iq 13~vi,~~ ~w .rr~c{usG - - - _ ~ll ~~ --- 7~ - - - ------- -------- -- - - ----- ~ ---!°PC _ ~/ccfr:~------.__ ~~33. SAS f __ ~ ~` .---- ---------------- ------------------------------- - - --- -- __~- PPL t'eciSti~ ` ---------------------_-------- 8F'L --- - ~ un~ f llla~cr s' _ __ s ~ Sr. [ . fle~fr:,. i.. ~ _ sb~ ~2 ~---~.-.:- --- - Q ~~ ,~ , Q ,/~~ -- --- --s`/. Gcriil`~ ~ifcftr -- ---------------- --- io, Yy ----__-- Ss', ------- _ /~iiorJ p&uC71` Ter~nfe_~tunor~/ l~srnw 79S,no -- -----_---- ~` ~ - R. L, oS/~ef6eeker--f- ~1ec ~~S•xc~i?~~,e,E ~b~ sa/e /r..~<,fa ~' ----- SIaS. 96 --- __ st. -! - PPL ~'/ec~;~ ------- -------------- ------- --- ¢is~ ~r ------- GLENDA M. WETHINGTON TRI-COUNTY ABSTRACT SERVICE 48 Central Blvd. CAMP HILL, PA 17011 &LL TO SHIELDS, CHARLES E. !U, ESQ. 6 CLOUSF.R ROAD MFCHANICSDURG, PA 17055 Invoice DATE INVOICE # ~nsnolo lalo9z ..-~... ..o... ...ww Wluar,~ au aarwun[y AC3Q'ti C[ JCNICC - EXPENDITURES - 309 NORTH RACE STREET DATE MERCHANT 8/4/2010 Stauffers of Kissel Hill 08/1410 The Home Depot ITEM PURCHASED Mulch, weed killer Mulch front flower beds, weed killer fence perimeter Mulch Mulch-I bag not used AMOUNT $29.64 $8.00 -$4.00 1/2/2011 Lowes Vinyl baseboard and adhesive $22.17 For lanudry area 1 tube adhesive returned _$2.94 Utility kniefe -$4 22 1/2/2011 Lowes Glass light shade $5.43 Sunroom 1/23/2011 Lowes 4 X 8 Plywood $21.17 Replaced pantry shelves TOTAL EXPENDITURES $232.08 LEE W. PEEBLES 9/3/2010 Lowes House for Sale sign $25.36 ni„ ice..,., ,~_ .~----- ^--- - - EXPENDITURES - 309 NORTH RACE STREET DATE MERCHANT ITEM PURCHASED AMOUNT 8/4/2010 Stauffers of Kissel Hill Mulch, weed killer $29,64 Mulch front flower beds, weed killer fence perimeter 08/1410 The Home Depot Mulch $g,00 Mulch-I bag not used -$4..00 9/3/2010 Lowes House for Sale sign $25.36 9/11/2010 The Home Depot Front door mat, toilet seat $12.32 10/22/2010 The Home Depot Paint, rollers, brushes $59.94 Paint both bedrooms 11/27/2010 Sears Paint $19.07 Paint sun room 12/2/2010 The Home Depot Vinyl floor adhesive, paint $41.97 For sunroom Vinyl floor adhesive returned -$13.41 12/24/2010 Lowes Shelf liner $23.17 For pantry shelves 1 Roll shelf liner returned -$11.59 1/2/2011 Lowes Vinyl baseboard and adhesive $22.17 For lanudry area 1 tube adhesive returned -$2.gq Utility kniefe -$4.22 1/2/2011 Lowes Glass light shade $5.43 sunroom 1/23/2011 Lowes 4 X 8 Plywood $21.17 Replaced pantry shelves TOTAL EXPENDITURES $232.08 LEE W. PEEBLES ~. STAUFFERS OFIQSSEL HILL 3949 CARLISLE ROAD DOVER PA 17315 DATE: 08J14J10 MERCHANT ID: CARD# EXPIRATION DATE SEQ: APPROVAL CODE: ENTRY METHOD: AMOUNT: TIME: 09:45 ]1142821065003 CREDIT CARD VISA SALE **ss~r~e~****5827 »~~ 611003 000318 SWIPED $29.64 $29.64 TOTAL AMOUNT: APPROVED 000316 THANKS FORYpUR BUSINESS CUSTOMER COPY ',: Mare saving. ~. • l~loi=e long; ~ `: h~~ ,» STO~M,~~~ PA :17055 i~~f.7.17)195-9602 4 ~.Y`y~~gg~(i6~1~10 01:20 PM 742786912039 REQ I'irJL4~1 <A> ~. ~ 7.54 AL '7s 54 X 70~IAx 38.00 XxKKKxXX)01X5827 VISA 8.00 AUTN CODE 030306/4240427. TA i .~ ;! i ~~ 24.. , 1 !14 10 4 RETURN POLICY DEFINITIONS POLICY ID DAYS POLICY EXPIRES ON A 1 .. . ~ ...._ ..at/t2/2010 LIB 7HE FIO TA~SE SffTTi{E ~~ORES "FOR >]f y 1'.: Share Your 0,pinion. Mith Usl ConiPlete the brief eIiout Yax`'star`e visit and enter~::a a to win at: t ~inion ,_` ~'rc iCa~parta Su Opinl3rjl Ga~ji) ' 1~a breve ~ues~e':sobre su vl~ita a Benda y t~`"i8 nP~rtunitlad de ganar`en: www.honedePot.~opinion -...~.1J max- .ID.: 18~~31 3.0235 t's~as~srd . ,11~'. 111 :ntrans ~Miet ~ `~~~ ~/13/2010. tsrt ~_~~ Xir'>'bicier to enter. ~ ~'. eke _~ui eB 'on .wiebsi te: No Purt~lgoe nece~p~-y, doing:" ~' ~ ,~~ STO~MN R 17 -9602 4120 00007 02704 '~~ 09/11/315 CASHIER SONORA~ - 'SU14'fG7 Q1:47 PM X ~ 5 86 7839 TO SEAT A> . 5.74 SlA3TOTAL 11.62 ~~ ~ ~TAK 0.70 512.32 AIRH CADS a - 12.TA ,, YE`' RE7lJF214- {~IGY'':06~IN1~IS. A F'OLICi ID DAYS ~-I1~1~0~30 ~ LI~MRp~~y Iy°~~V~S T ~~~RIGHTTTEO RETURN P'OL`72M~1~O~S~OR ';OETAII:S: . . GUARMITEm LOM PRICES LOWOER CES TS OREIiIDE YYYYYYIYYYYYYYYYYY7afYYYYY1tiYYYYYYYYYYYYY ~~ TZD{~~,, - i ~' F ~ . Share Your Op~, Wt~11~1 CalPlete the br1e1 stYatr store visit arld entei" , o rri n =at ~f 4 iMrlw. iloneq~upbx . C~lj/r' yi`pp ____ L o u~.F'~' LOYE'S I~IIE.CEN>'ER$, INC. 1115 CARLISLE ROAD . YORK. PA 17404 (717) 676-4050 - SALE - SALES r: 52409NY1 1484541 09-09-10 64052 HOUSE FOR SALE BY OIRBt 16 B.94 ~ 236804 18X24 FOR RENT Y/FRANE SI 14.E SUBTOTAL: 23.92 TAX: 1.44 INVOICE 09606 iO~AL r15.36 VI 25:36 VISA:65827 AMOUNT:25. NCD:02697B REFID:B01007229 09 10 11:17:56 240! iERMINRL: 0 14:18:16 • OF ITEMS PURCHASED: EXClUDEB FEES. SERVICES AND SPECIAL ORDER Ii TNANK YOU FOR SNOPPINB LOYE'S. SEE REIN:RSE SIDE FOR RETURN POLICY. SiORE INd1AfiER: BRIlYI LINBENFELTER HAVE A COlAIENi OA FEEDBACK2 LET US KNOY Ai: llgM. LOMES..COl1/FE®BACK STORE (~: 2A090-90310-.09908 YE NAVE THE LOYESi PRICES, BUARRNTEED! IF YbU FIyO A LOYER'PRICE. YE YILL PEAT IT BY 101. SFE.STORE.FOR.DETAAS. NOTICE: Dry14a11 Settle. Read Bela4. ~^ Tv ~ VVV j iConparte 6u.. inidril-BoiRpfete-1e breve erxxrestg _ su vi si to a 1 a tle-ida y tel'lya .1 a ' ~xli d~kde panar 'earl rw~w ~iti~/+~Inion' ~~: . ,~ ~ _~ .. :t , w g~ Entrieg rust be~ `b L~fi%11/20 Entrants.nusx..Fae.1,8r"or~oa- io;erlt See ~P~a"chas~eles on irebsite. No necessary. Low's heq settled a laesuit e}}eying that certain drraall purchased froe.love s res'defectiue end eased property deea9e and/or persona} iniurY., Love's denies all of these clatas. You are included in the Clew if you have or had allegedly defective drrwil that wa purchased froe Low's emt1K before 7/27/10. Gass Meebers ear receive fror 550 to 54.500 in Low's gift cards and crib. To vet a paraent. YDII east subatt e claie fon ear 5/18/11. Unless you exclude Yourself #roe the Class br 11/9/10. YOe give uD the right to war Sue Low's about tM 1ega1 clela6 this settleealt resolves. If You star in the Cisss, you say oblect to the settleaent by 11/9/10. The Court viii hold a hearirg m 11/19/10. to caltider *'Y. • V 4 1 .; Y 1 '~~ ~•: x ~ ~101fTig. 6000 CARLISLE PIKE, PECH PA 17055 STORE MANAGER CHET KEELEY 1717>795-9602 4120 00058 64087 10/22/10 12:42 PM CASHIER Sf3F. NECK (A1T - SC0758 077089101337 ~ <A> .:. 7.97 0466772a;1~368 ~ ~~. ' 7.49 077 Tip. i'~Q€4~2 tA> 2.57 077~~~ ~" ~'FQI~` gR6`l'1 <A> 0.57 02236784269 f~V_IlilT., $~ y1y,• 2918.97 ~'~ 37.94 NLP Savings `$4,00 . SUB70Tal 5b.54 SALES TAX 3.40 rorA~. s59.94 XXXXK)(XX)00(X5827 VISA" 59.94 AUTH CODS 098436/5580996 TA NEw-LOWER Pit[CE cr~P)saviNGS s4.0o F'uf_1S9f lU '09YS_ , :1'(ICICY E3(PIRES ON A '~ ~ ~ 90` , 01/20/2011 THE HOME D~br: fi~E~,'rf£, (I[(~iT 70 LIMIt /DENY`'-i~'(URNS,y~1R~-$EE THE RE~2N POLICY = INg., . FOR .. ._. DfiPAii..S... GUARANTEED Low PRICES LOOK FOR tiUNOREDS OF Lfi~2 PRFtES °3'f6RENIDE *xtxzxax*xtrrr~a~rxxxxxxxxxxxx*xxtxxxrcxx: ENT~t ,3C3R' A.. CHANCE TO ~~ ~l ~;~~ O~OO HGi1i~AE . P~~'' ~=FT ~A ! ,. Share Your •AiS i fS~ yh•~YI1 th ilds t ~ Cpmpl ete the brief surve;!•-eb®ut-~u^ stY>re visit and enter for 8,c+ki'~nce•$b'win at: www.Fwnedepot.coalopinion iPARTIC=PE EN UNA OPORTIJ#V2D/aCL7 ""L7E C.ANAR UNIT TAFZJETA DE `iF2E~3.rA1~,:C~ C~,E THD bE , ~5 . -0200 ! +Conparta Su Opinidn{-~Gwtilplete la breve encuesta sobre su vlsita a la Yienda y tenBa la apurtunidad de ganar en: ........ ~.,_..,~..~.,....,.....,,.,...x.... _. aANit •Rfr/STORE.: REGI AS60Cit !52 99 01244 209 ,4119 •.., SALE i445 INT PAINT, SAL 17.997 UPC: 035777562215 SUBTOTAL•~ " `#x.99 ,.~: TAX• `1.08 4::VISA ..,.; 15B27~IH ` ".: ,, ~u -VISA TtNAL ;, a~~.07 •>3860 2769 3919=0619 ` .'. •.; .. '~DHDLDERACItlJ1~115' I~CEIpT , 60®BS' ~iND/UR SERVI•CES N THE ; "A~lO11NT .,OF S19,U? ~ . wlall ANOUN,TS AS 5110NN CHAR~~D T`D rai:ii fzRE9i~: CARD I®ENTIFTEfl HEREON;.. ANilg~~ ~ Bl: 89kpRl,BY XHE `t`ERifS •tiNT FORTH I41 THE CARDHOLDER'S Auiti~Q~~:(~~) 11TH ,TNE 1SS~IERI~I,,bF THOSE CRET3~£T°CARDS., r ~d~~i;154kt~1tolKr~lo~RYsalcaN+la7Rq~+sh+~k~mk i t i L Us~.= h `'A`Rt1'Yal~.. LUUf.U •IFIti A...34~~, 1 Q~~~~~T BARD. NttpS>~~1Td'~"'Y ~T3IM =OF~•F?1lASEt ~ ,,;r, .. ~„u r Y~Wfi.$E~R$KE~OBACK CaN ~~r ~,~>N+'l€fE THE SURVEY Y(lU TFItt AEU iii). , ~ 2 QTG~'I:: ~ NlA1~ER' DM . ,YOk1R RECEIPT r~s: ~=AVOR TflNAT6: Et _TIENRI); PARA ,_ i~~ct~~URCIflNARNOS ~U' T41FflRNACION Y ' t'iu;T'I~P1I 1*N UN SURT,E4 ~llN 'LA : Ut'Uk f11NI0Afl~ OE GANAR -UNA TARJETA •' : ftEGALfl S€ARS,RE ~4~Olb:`;. , , . ~ri'.[TA LA PAGINA DE INTERNET h More saving. ~MQre doing: STO~MAN~R~CFET~K~ELEY~<717>796-9602 4120 00020 480F~ ~ 01/02/11 12:56 PM ~ ~ 0 ~ 38 12/02/10 TA 9 RE 05 77 *ORIG 075378000235 FLR LEVEL -12.65 SALES TA% -0.76 4 -613 XXMXXXXXXXXX5827 PISA . 1 INVOICE 3201961 TA REFUND-CUSTOMER COPY GUARANTEED LOM PRICES LOOK FOR FAi~iEDS OF LOiiER PRICES STOREfiIDE *x*****rc*::a*r*:x**x*******xx:*xx**x**x ENTER FOR A CHANCE TO y~IN A 5 000 HOME CARD ! t'=FT Share Your Oplnfan Mith Ust Cosplete tlis brief survey about your store visit and enter for a dunce to win at: www.twmedetwt.coa/opinion iPARTICIPE EN UNA OPORTUNID D DE GANAR UNA TA JETA DE REGALO DE THD DE ffi°5 , 000 ! iComparta Su Opinibnt Complete la breve erxuesta sobre su visits a la tlenda y tango l a aportuii dad de penar' en: www.honedspot.c~n/opinion Us~ar I D 100605 96505 Password- 110'.52 964E35 Entries moat bs entered by 02/01/2011. Entrants east be 18 or older to enter. See complete rotas on website. No purchase necessary. . ~~ More saving. Mona doing" 6000 CARLISLE PIKE. MECH PA 17055 STORE MANAGER C•fT KEELEY <717>795-9602 4120 00059 77038 12/02/10 02:59 PM Cp~{IER SELF CHECK OUT - SCOT59 075378000235 FLR LEVEL <A> 12.65 073502031353 AH30160 <p> 17.96 082474105047 PPINFLULMh1OT <A> 8.98 SUBTOTAL 39.59 SALES TAX 2.38 TOTAL $41.97 )(X)0(XXl(X)p0(x5827 VISA 41.97 AUTH CODE 0828'x/4590134 TA ri ii~~arruu~~iriruriir r 4120 59 77038 12/02/2010 9739 RETURN pOUCY pEFINITIONS A pOLICi ID ~ X03/02/2011 ~ TiE FIOIE DEPOT RESERVES TFE RIGHT TO LIMIT / DENY RETURNS. PLEASE SEE THE RETURN POLICY SIGN IN STORES FOR DETAILS. GUARAM® LOM PRICES LOOK FOR FIUrDREDS OF LOWER PRICES STOREitIDE **::**xx*xxxx**:*xx*tt*****xx:**xx***xs* ENTER FOR A CHANCE HOME DEP0~5GIFT0 CARD! Share Your Opinion kith Us! Complete the brief survey about Your store visit and enter for a dunce to win at: www.homedepot.com/opinion iPARTICIPE EN UNA OPORTUNIDAD DE GANAR UNA TARJETA DE REGAL_O DE THD DE $5,000! iConparta Su OpiniGnt Complete la breve encxaesta soore su visits a - i a t1 er-da Y tea la oportunidad o1e goner en: www.honedepot.c~n/opinion User ID: 15$485 154424 Password: 10602 154365 Entries must be entered by 01/01/2011. Entrants east be 18 or older to enter. See coaplete rules on website. No purchase necessary. M _, - RETURN 19092 - SALES t:R 52409,1,11 1031211 01-09-11 REi 47550 24"X16' BLACK SBI+RENE $1M. 10.93- ORIB. STORE: 2409 ~ITE:122410 INV: 9527 SU1i0TAl: 10.99- rAX: - o.6s- TOiAL RETURII: it 59- VISA: 11.59- VISA: X~8271rIBIAli:11.59- REFID:809910253 01/09/11 15:41:44 A~:2401 TERNAIK: 18 !1/13V1115:41:M STORE MA11A8ER: BRIAN LAIBENFELTER HAVE A COIRIENi VA FEEDBACI(? LET US K1NIr Ai: ~~E (~E: 2090-10911-18082 r-h ...~.....~.-..-........rn......«..a.....-„.a..v..«-.~+.. L~i~E'~ LOVE'S NDNE CENTERS. AIC. 1175 CAAI.ISLE RDAD YORK. PA 17404 017) 676-4050 - SALE - SALES 1: S2409CN1 1473611 12-24-10 47550 24'X10' BLACK SUPREME SHL 21.66 2 @ 16.93 SUBTOTNL: 21.86 TAX: 1.31 IIMNIICE 05127 TOTIr_: p3,p ' VISA: 23.17 VISA:XXI!X%lU0!IOUIX5827 AMOUNi:29.17 RUTNCD:046598 REFID:809999181 12!24/10 11:48:24 C~~ iT1RE: 241! TERNINRL: 09 12/~!I! 11:41:3! s OF ZTEMS PURCHASEDc 2 EXCLUDES FEES. SERVICES RgD,SPEC7RL ORDER ITENS I~ 11 ~ ~; LOME's. .SEE REVERSE $IBE ~ RETURN:POLICY. .STORE NAINM)ER: iNtIAN LDNIEIFELTER NAVE A COMIENi OR ? LET US IUI011 AT: IIMIl. LOpES.COM/FE®BACK STORE CODE: 2091-22410-027 YE INRff THE LOIR:Si PRICES. BUARRNTEED! IF YOU FIND A LOVER PRICE. rE YAL BEAT If BY tOt. SEE STORE FOR DETRILS. YOIA1 OPINIgIS COUNT! REGISTER TO rIN A 12500 LOVE'S GIFT CARD iREBISTRESE PARR BANAA UNR TRRJETA DE AE8AL0 LOVE'S REGISTER ONLINE OR BY PNONE BY COMPLETING A ~Si SATISFACTION SURVEY RNYiINE DURA~ THE IIEI!T 9 DAYS: http://wDviar4.lsecorp, coUl mes OR 1-8-362-~77 YOUR I D B 09527 2409 358 NO PURCNR~ NECESSARY TO ENTER OR MIN. NRIL-111 ENTRY IS RVAILRBLE., SEE OFFICIRL RULES Ri: http: //isurverwb.ca/loree/rule/ SIFT cRRO rINNER rnL BE NorIFIEO rlTxnl t2o oAYa. ~~ •s ~ CENTERS. rMC. 1175 CARLISLE Rpq ~. PA 11404 (717) 676-4050 .._____..____.~,.._.._.__^..._..___....,._~____...~._ .._Y~._.._.~ ~.~ ., . , ... r, -. Lou LOVE'S NOME CENTERS. INC..... 5500 CARLISLE pA(E MECHANTCS~, PA 17050 ~ 017) 810-9190 - RETURN 18556 - SALES I:R 5222~i2 1980000 01-02-11 REi 141978 11 OZ YALL OASE ADHESIVE 2.77- ORIB. STORE; 2229 DRTE:014111 IMY: 9504 ~orE'sa±d~ CENTERS, Inc. 5500 CRRLISLE PIKE MECMIMIICSBUI~, pR 17050 0117) 610-9230 - SALE - SALES t: 32229EA1 1475947 Oi-02-it 141378 11 OZ YALL BRSE RDNESNE 5.54 2 1 2.n 167755 PERSO111A RETRRCi uinm 3.~ 60700 4"X48" TPR CnOCOLNTE PALL 11.40 4 / 2.85 SUOTOiRI: 20.92 TRX: 1.25 INVOICE 09504 TOTAL: 22.17 VIER: 22.17 SUBiOTAL: 2.71- TAX: 0.17- iOiAl RETURN: 2.94- ViSR: 2.94- UISA:XXXXXXX1tl00CC5827 ANOIAli:2.94- REFID:8099109/9 01/02/11 15:05:48 STORE: 2129 TERNDYIL: iB 01/12/11 15:x:4/ STORE MANAGER: JIM DUNKELBERBER NAVE A COMMENT OR FEEDBRCIC? LEi OS KNOY Ai: IIIIM. LOMES.CO»/FE®9ACK STORE CODE: 22230-10¢11-1B5b6 VISA:XXX>v00!XX)QDI5827 AN0UMT:22.17 RUTIK:D:0690TB REFID:809999149 01/02/11 13:26:94 1226 TERMIINIL: 09 01/02/11 19:20:4! • OF ITEMS-PURCHASED: i EX0.UDES FEES, SERVICES RND SPECIAL ORDER ITENS ~~~~ TIHINK YDU FOR SipPPING LOVE'S. SEE REVERSE SIB FOR RETURN POLICY. STORE IHInRBEA: JIN DUM(EL~RBER HRUE R COMNENi OR FEEDBIK:K2 LET US KN011 RT: IAiM . LOUES . COM/FEEDBACI( STORE-CODE: 22230-10211-09504 YE NAVE THE COYEST PRICES. GUARANTEED! ff YOU FIIA1 R LOVER PRICE. YE YILL BERT 11 BY 10i. SEE STORE FOR DETRAS. - _~~ . ~~ LDUlE LOYE'8 ROTE CENTEAS. INC. LOYE"8 NOME CENTERS. INC. 5500 CARLISLE PIKE :`5500 CINILI~.E PIKE NECIIANICSBNRB, PA 17050 017) 810-9290 IECItlINICS~AIB, PA 17050 017) 610-9230 - SALE - - SALE - BALES t: 52229AR1 1205184 Oi-02-11 SALES t; 52223EY1 664472 01-29-11 220234 12" SBUARE ~DR0011 BLABS 5.12 12244 23/32"II4X6 RRTED SNEATNAI 19.97 SUBTOTAL: 5.12 TRK: 0.31 ~~~~ 19.97 INVOICE os435 TOTAL: 5.49 rAK: 1.20 VISA: 5.43 INVOICE 02611 TOrRI: 21.17 `•. - DISC: 21.17 UISA:IApAUOOOODUO15827 ANOUNT:5.43 AUTIICD:066138 p~;!OO~O.AIIDIAIT:21.17 AUTNCD:02371A REFID:8099l929.9 01/02/11 15:12026 SYIPED BEFID:607996221 01/23/11 15:46:26 227! TERNINRL: O6 01/62/11 15:12:37 4~ ~~ tTBBE: ?227 iERMINAL: 02 01/7!/11 15:40:7! N OF ITEMS PURCHASE_D:. 1 E%CLIIDES.iEES, SERVICES AND SPECIIIL.OADER ITEMS ~ OF ITEMS PURCHASED : tl E)ICI.UDES FEES. SERVICES AND SPACIAL ORDER ITFNS TIAIIA(. YOU FOR SNOPPINB LOYE'S. SEE REVERSE BIDE FOR RETURN POLICY. ! YOU FOR SNOPPINB LOME'S. SEf REVERSE SIDE FOR RETURN POLICY. STORE MANAGER: JIN DIRRO:L~ER STORE.MANABER: JIN BINIKEL~ER NRVE A COMMENi 011 FEEDBRCK? LEi US KROY RT: IIAIIE A COINM71i Op FEE09ACK2 LEi US NNOY Ai: MM . lalES .CON/FE®BM'J( STORE CODE: 22290-10211-E16~35 ~••CI~/FE®BACK STORE CODE: 22230-8311-02677 YE HAVE iNE LWIEST PRICES. BURApIITEED! , ~ NAME LDYEIST PRICES. GUARANTEED! ff YOU FIND A LOYER PRICE. YE YILL BERT IT BY 10t. SEE STOIE FOR DETAILS. ff YOU~FDID R LOITER PAIGE. YE Yltl BEAT IT BY 10=. SEE STORE FOA DETAAS. YOUR OPDIIONS COUNT! REGISTER TO YIN R 12500 LOYE'S GIFT CIYID SREBISTRESE PAAA BANAA UIUI iRR.ETR DE REBRLO LOYE'S REGISTER OMLIIff OR DY PNONE BY COMPLETIIIB A BUESi SRTISFRCTIDN SIIRYEY RNYTIIE DURA16 THE NEXT 3 DAYS:. htty: //YtDui ~r4.1 secoro. cw/1 owc OR 1-666-382-3677 YOUR I D t 06435 2229 002 NO PURCIIRSE NECESSARY TO ENTER OR YIN. NRIL-IN ENTRY IS RVRILRBLE. SEE OFFiCIAI. RULES AT: httD: //iaurwrrtl.t~/lora/rul ec/ GIFT CARD YDNER YILL BE NDiffIED YITNIN 120 DRYS. STORE: 7123 TERNIIIRL: 06 01/02/11 15:12:31 ~i»iEpi~BeS*ht*i~#f- TIYIIIK YOU FBR SHOPPAAI Ai LOYE'S iRKE i1O OFF YOUR IE1Ii S50 PURCHASE (E111XIAIINi .TAKES) 01/21/11 - 01/26/11 COIWON CA18pT BE USED IM CONJUNCTION YITR ANY BTNER COUPON OR DISCDIMi. 5500 CBBIIELE PiKf MEC111YIICSBIRIB. PA 17050 Otn 610-9230 RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Cumberland County - Register Of Wills One Courthouse Sqquuare Carlisle, PA 1713 PEEBLES DOROTHY I Estate File No.: 2010-00592 Paid By Remarks: CHARLES E SHIELDS III HMW Receipt Distribution Receipt Date: 11/09/2010 Receipt Time: 15:42:01 Receipt No.: 1063279 Fee/Tax Description Payment Amount Payee Name SHORT CERTIFICATE 8.00 CUMBERLAND COUNTY GENERAL FUN Check# 1910 $8.00 Total Received......... $8.00 GLENDA EARNER STRASBAUGH REGISTER OF WILLS AND CLERK OF ORPHANS' COURT MARJORIE A. WEVODAU FIRST DEPUTY KIRK S. SOHONAGE. ESO SOLICfiOR REC3ISTER OF WILLS AND CLERK OF THE ORPHA-I`1S' COURT COUNTY OF CUMBERLAND ONE COURTHOUSE SQUARE CARLJSLE, PA 17013 0717) 24P6345 FAX (717)2407797 INVOICE Bill To: InvoiceNo: 3183 Invoice Date: 11/2/2010 CHARLES E SHIELDS III Estate ofi DOROTHY PEEBLES 6 CLOUSER RD Estate No: 21-10-0592 os MECHANICSBURG, PA 17055 Qty Fee Description Fee Total 2 Short Certificates 4.00 $8.00 Total: $8.00 [7 6 p I• ~ - ~ a O ~ -: =7 - n n C ~ c,~, r r m G" , .`7 ~ 7"~ ~7 L7 , •J O .O'i7 ~ / _ \_ ~. ~~ 'T' c; c a F _ -; ; _ ~ _ ~- "~ G "~~ 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. GLENDA EARNER STRASBAUGH REGISTER OF WILLS AND CLERK OF ORPHANS' COURT MARJORIE A. WEVODAU FIRST DEPUTY KIRK 5. SOHONAGE. ESQ SOLICITOR REGISTER OF WILLS AND CLERK OF THE ORPHANS' COURT COUNTY OF CUMBERLAND ONE COURTHOUSE SQUARE CARLISLE, PA 17013 f717) 240.6345 FAX (717)240.7797 INVOICE Bill To: CH T.FS E SHIELDS III 6 CLOUSER RD MECHANICSBURG, PA 17055 Im~oiceNo: Invoice Date: Estate ofi Estate No: Qty Fee Description Fee Total 2 Short Certificates 4.00 $8.00 TotaL• X8.00 Checks should be made payable to the Register of Wills. Temms: Net 30. 3183 11/2/2010 DOROTHY PEEBLES 21-10-0592 os Please return one copy of this invoice with your payment. Thank you. RECEIPT FOR PAYMENT GLENDA FARNER STRASBAUGH Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 PEEBLES DOROTHY I Receipt Date: 12/20/2010 Receipt Time: 12:13:51 Receipt No.: 1063736 Estate File No.: 2010-00592 Paid By Remarks: CHARLES E SHIELDS III ESQUIRE WZ Receipt Distribution Fee/Tax Description Payment Amount Payee Name SHORT CERTIFICATE 8.00 CUMBERLAND COUNTY GENERAL FUN ---------------- Check# 1975 $8.00 Total Received......... $8.00 GLENDA EARNER STRASBAUGH REGISTER OF WILLS AND CLERK OF ORPHANS' COURT MARJORIE A. WEVODAU FIRST DEPUTY KIRK $. SOHONAGE, ESQ SOLICITOR REGISTER OF WILLS AND CLERK OF THE ORPHANS' COURT COUNTY OF CUMBFn.:...~ ~D ONE COURTHOU8E SQUARE CARLISLE, PA 17013 (7179 2406345 'FAX (717)240.7797 INVOICE Bill To: InvoiceNo: 3237 CHARLES E SHIELDS III Invoice Date: 12/15/2010 Estate of: DOROTHY I. PEEBLES 6 CLOUSER RD Estate No: 21-10-0592 CJ MECHANICSBURG, PA 17055 Qty Fee Description Fee Total 2 Short Certificates 400 ;g ~ Total: X8.00 IMdrrie~6up, PA 17066 ~ ' AMp~~M~E~r.717-Q67-1826 inNy~1K:717-007-0Q20 T0: 71N E~W d DooYy I P~~DMs oro cnsM. St,w 6 Cloirr Rose M~WNraEuip, PA 17066 TMpsNOM~r. ia6u.ic ~wrM,rr. E-Wt ,1~ IMdIG~Trr E~W~dDao/q~PeaON~ C6r~t `J.l-l~lri .~`/ ~`/a~.~It`~~1t'-!t . f~~~t/ ~ / ~~+i% '~/ ` '~tx '1`I L fit /il$/~' ~ 1` 1 \' \' 1 l ~ 1' 1~ l 4 ~i~~/~I~~ f.,I~I~I,ti f~ f~I~ f\J~I~; j'~ f~~ ~~.~ItiI ~r,tij~ °~~j~I~r'~I~I.1r~j~~~fti1 ~jti/~./~I~l~j~l~l~f~.>~: r~l\~~I~~~ f~~tiJ~l~ f 1~~'1rti ~~~1 ~ jti f`; j~~~J~ j ~~~~ `,l, 1 tip`/.1%.~`/~~`/.~fLi r~va~~E B127l1Ot0 YMnYOdr/: trdrCw-. cwR.r. rr.w.~a.a.r ~o~P..er. O/rrR~IaMa~ F~OrYTn~c , ~Q SUBTOTAL soooo anrar: Dec DMerpbc n~~: orK ~4~ air. or.c D~ww~r SUBTOTAL TOTAL OUE ; aoooo Fam-NS-'wr76rx ~ppr~r+o~wuyr.rwoe~ lne.-i-6oo,iu kor,rrsawar m7leAaaas ~~ (717)766-3421 A standard of excellence in Central Pennsylvania since 1910 Thursday, June 10, 2010 Charles E. Shields, III 6 Clouser Road Mechanicsburg, PA 17055 Dear Charles, Thank you for selecting our funeral home to provide services for your family during your bereavement. I hope that you found our services to be of the highest standards and that they met your needs and those of your family and friends. The following is a summary of the service charges as previously explained and provided in written form on the services for: Myers Funeral Home, Inc. Boyd L. Myers Jr., Supervisor 37 East Main Sheet Mechanicsburg, Pennsylvania 17055 Fax (717) 795-7291 Dorothy 1. Peebl SUMMARY OF EXPENSES TOTAL OF SERVICE RENDERED - :11,627.00 LESS: Credits granted 1.430.00 LESS: Total Payments 8,000,00 CURRENT BAL/WCE 52,187.00 Credits Granted: 51,430.00 Package Price Discount Interest at the rate of 1.5 % per mor-th (18 % per annum) will be added to balance after 30 days. If there are any questions or concerns that remain unanswered, please call me. Sincerely, Boyd L. Myers, Jr. Su ' or Myers Funeral Home, Inc. Boyd L. Myers Jr., Supervisor 37 East Main Street Mechanicsburg, Pennsylvania 17055 (7l7) 766-3421 Fax (717) 795-7291 A standard of excellence in Central Pennsylvania since 1910 Thursday, June 10, 2010 Charles E. Shields, III 6 Clouser Road Mechanicsburg, PA 17055 Dear Charles, Thank you for selecting our funeral home to provide services for your family during your bereavement. I hope that you found our services to be of the highest standards and that they met your needs and those of your family and friends. The following is a summary of the service charges as previously explained and provided in written form on the services for: Dorothy I. Peebles SUMMARY OF EXPENSES TOTAL OF SERVICE RENDERED :11,827.00 LESS: Credits granted 1,430.00 LESS: Total Payments 8,000.00 CURRENT BALANCE 52,197.00 Credits Granted: $1,430.00 Package Price Discount Interest at the rate of 1.5 % per month (18 % per annum) will be added to balanos after 30 days. if there are any questions or concerns that remain unanswered, please call me. Sincerely, Boyd L. Myers, Jr. Su or ~. RETURNED DEPOSITED ITEM NOTICE DATE 08-30-10 AMOUNT 64.75 --------------- 64 75 REASON REFER TO ITEM TOTAL FOR MAKER 1 ITEMS TOTAL FEE 10E00 OS/25/2010TE 00004242623 10.00 THE ITEMCS) SHOWN ABOVE WAS.DEPOSITED TO YOUR BANK ACCOUNT, BUT IT HAS BEEN RETURNED UNPAID BALANCE.RASSWEILNASCCHAR6EDWY0URVA000UNTSTHETITEMTFEEAND PLEASECUPDATEETHE BALANCEMINOYOURCCOUf' ACCOUNT. IF YOU HAVE ANY QUESTIONS OR CONCERNS, PLEASE CONTACT U5 AT THE NUMBER LISTED BELOW. THANK YOU. ESTATE OF DOROTHY I PEEBLES LYNN A PEEBLES EXEC 10791 UPPER STRASBUR6 RD UPPERSTRASBUR6 PA 17265-9701 DEPOSITING ACCOUNT NUMBER 622261-288-! CHARGE ACCOUNT NUMBER 622261-288-! CITIZENS BANK - 060 CUSTOMER SERVICE 1-800-922-9999 s011500120* --- ~ --- ~-- ~~- -~ - - - 08/30/2010 000000024002102 0 *07~~` ~ Qa~27~201D ~ •._ .v-~x~+.~•~a~....s-~+ra•M~aw s ~~ c .~w-~+ec+s+~+~wae~8,c;u~s.~ This is a LEGAL COPY of your h it fi c Y N ti h L lf w M ~ N ~`' ~,,,~,,~.~ ~~ ~~, le same c e k. ou can USQ th i i l ld ~ O e e ar ean a ~wa~ew.Madn.i " ~ C..S'~~.°5..~~' e or g na use ~Y YoU wou ~ tlwd~. Che .~'i~. I N tT R M ~Ot il®Mi err tw.w~w.~W.iM 03607615008301D328 0o Jo ~..,.,,. ~~ pN ~ m 0 011500120 0 0 ! 0 O /~ .:taws .ccx miav zsszse ow~sszoo. z o _ I r w~i.aMweyM~r.~auaavewwwwr. wrw~r.MrMw...+~~..w.~ww.rwww I'~ O 0 r2?>,5934664r r.4O7i923828. 030 LS6200r2t000000 6 4 4 5t I V 5~:0360Z6L50r. 100000064451 ~' 2 7 i 59 34664n' ti~:0 7 19 2 38 28~: u• 0 30 L 56 200iM 2~~'00000064 7 5~~' REV-1512 EX~ (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE UABIUTIES, 8~ UENS ESTATE OF FILE NUMBER /gee tiles, D~olfy r 2~- io -s9z Report debts Incurred try the decedent prior to death whkh remained unpaid as of the date of deaffi, including unrelmbursad medical expenses. (Ii more space is needed, insert additional sheets of the same size) REV-1513 EX+ (9.00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FlLE NUMBER J~eCb/es, 1~s~+v/fiy Z oZ/-/O-S9.Z RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not LlstTmstss(s) OF ESTATE I TAXABLE DISTRIBUTIONS [induds outright spousal dishitwtions, and transfers under Sec. 9116 (a) (1.~) '' Lynn /9-. pee6/Gs son y3 /0?9/ Gtppd~ sfrAs6k,~ l1~d ~lp~Ot/' oSfras~a~, f~ /7zlvS ~. Let W, f~eed/es son y3 3s~6/ Ho//y ~o~d Dvver', P.4 / 73 /S 3. ~%cKcy L , i~ee6/es ~., y 3 3ov ~ ~,raK%n ~fve. cSl~/te~wltftr, ~iV 37875 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 TH ROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART U -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Z (H more space is needed. insert additional sheets of Ole same size) LAST WILL ~1ND TESTAMENT OF DOROTHY I. PEEBLES I, DOROTHY I. PEEBLES, unremarried widow, currently of 309 North Race Street, Borough of Mechanicsburg, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this ray Last. Will and Testament, hereby revoking and making void any and all prior Wills and Codicils by me at any time heretofore made. 1. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can conveniently be done. 2. All the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situate, I give, devise, and bequeath to be divided equally and distributed amongst my three (3) sons, to wit: RICKEY L. PEEBLES, LEE WILLIAM PEEBLES and LYNN ALAN PEEBLES. In the event any of my said sons predecease me, his share shall go to his issue, ~ stimes. In the event any of my said sons predecease me and has no surviving issue, his share shall be distributed to his surviving siblings or sibling's issue, as the case may be. 3. It is my intention that beneficiaries Warned before or after the date of this Will on my life insurance, annuities, individual retirement accounts (IRAs), in Trust for or joint bank accounts and any other assets for which I may designate beneficiaries will receive such investments and that my Will provisions shall not control such investments. 5. I nominate, constitute and appoint my son, LYhiN ALAN PEEBLES, to be the Executor of this my Last Will and Testament. In the event that he is unable or unwilling to act as Executor, I appoint my son, LEE WILLIAM PEEBLES, to be Executor in his place and stead. I further direct that they shall not be required to file bond or other security in the Office of the Register of Wills for the purpose of administering my Estate. IIN ~ S-WHEREOF, I have hereunto set my hand and seal this ~ day of ~ A.D.2010. ULRiL~~' ~ ~~i~ I~~E~~.f~~~~ '3~~~ (SEAL) DORO I. PEEBLES L. ,Le.,. JL~I .~~ i i w n.r h~vtll~+v ~° t J Signed, sealed,rpublished and declared by the above-named DOROTHY I. PEEBLES, as and for her Last Will and Testament, in the presence of us, who at her request and in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses. C~~~ `- ` ~ ~~~ ,- .~~ Ve.na ~';sur/fau~cr Mti^lu~cicsla~, ~ i7ars P.Qe z YN' a' ~°~ ~~~ 1i ti~c~ ~'~y~ ~~ R^)!