Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
08-18-11
1505610140 REV-1500 ~ (01-10) PA Department of Revenue OFFICIAL USE ONLY ~ ~ Bureau of Individual Taxes County Code Year File Number Po Box z8osol INHERITANCE TAX RETURN 2 1 1 0 0 5 9 9 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 2 0 4 5 2 9 6 9 5 0 5 2 1 2 0 1 0 1 0 2 8 1 9 6 1 Decedent's Last Name Suffix Decedent's First Name MI D A N N E R R O B E R T K (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 FILL IN APPROPRIATE OVALS BELOW ^X 1. Original Return ~ 4. Limited Estate ~ 6. Decedent Died Testate ~ (Attach Copy of Will) 9. Litigation Proceeds Received ~ 2. Supplemental Return 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) ~ 3. Remainder Return (date of death prior to 12-13-~82) ~ 5. Federal Estate' Tax Return Required 8. Total Number of Safe Deposit Boxes ~ 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 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 REGISTER ¢F~IVILLS USE CIN Y ~i '.1'7 ~'"1 - - First line of address - ~ ~ ; ',.-~ ~. 1 0 1 S O U T H M A R K E T S T R E E T ' _~ ` .; ! _ ; , p <: Second line of address , ; - _~ , - ` -, ~ - City or Post Office State ZIP Code L _~7E FiILED - - r~ 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: rmarkthomasCc~gmail.com Under pen Ities 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,~ rrect and com411ete. Declaration of preparer other than the personal representative is based on all i nformation of which preparer has any knowledge. SIG9IA~U)'~F, C3F P,J;R~ON.S~, PQNSIBLE FOR F141t~/`,, RETURN .naTF NE H~~L ROAD DOVER IpREP _ E _ ER THAN REPRESENTATIVE PA 1731 DATE 101 SOUTH MARKET STREET MECHANICSBURG PA 17055 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610140 1505610140 h~' 1505610240 , , REV-1500 EX Decedent's Social Security Number ~ecedent'sName: ROBERT K- DANNER 2 0 4 5 2 9 6 9 5 RECAPITULATION 1. Real Estate (Schedule A) ......................................... .. 1. 5 5 0 0 0. 0 0 2. Stocks and Bonds (Schedule B) ..... ............................... .. 2. 2 9 8 • 6 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. 8 3 1 5 . 0 3 6. Jointl Owned Pro ert Schedule F y p y ( ) ^ Separate Billing Requested ..... .. 6. ~ • ~ ~ 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested ..... .. 7. 8. Total Gross Assets total Lines 1 throw h 7 ( 9 ) ......................... g, .. 6 3 6 1 3. 6 5 9. Funeral Expenses and Administrative Costs (Schedule H) ................ .. 9. 1 ~ 1 4 0 . 7 3 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ........... .. 10. 7 7 9 9 9 . 7 D 11. Total Deductions (total Lines 9 and 10) ............................. .. 11. 9 5 1 4 0 . 4 3 12. Net Value of Estate (Line 8 minus Line 11) .......................... .. 12. - 3 1 5 2 6 . 7 8 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) .................... .. 13. 0 . 0 0 14. Net Value Subject to Tax (Line 12 minus Line 13) .................... .. 14. - 3 1 5 2 6 . 7 8 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 D 0 0 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate X .0 _ 16. 0 . 0 0 17. Amount of Line 14 taxable at sibling rate x .12 0. 0 0 17. D. 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0 0 0 1g, 0. 0 0 19. TAX DUE .................................................... ..19. 0 • 0 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ Side 2 1505610240 1505610240 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 10 0599 DECEDENT'S NAME ROBERT K. DANNER _ STREET ADDRESS P. O. ErOX 1534' CITY j STATE T ZIP MECHANICSBURG j PA i 17055 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 0.00 2. Credits/Payments A. Prior Payments B. Discount Total Credits (A + B) (2) 0.00 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (3) Fill in oval on Page 2, Line 20 to request a refund. (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 Make check 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: Yes No a. retain the use or income of the property transferred : ...................................................................... ^ X^ b. retain the right to designate who shall use the property transferred or its income; ............................... ^ ^X c. retain a reversionary interest; or ................................................................................................ ^ X^ d. receive the promise for life of either payments, benefits or care? ....................................................... ^ 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... ^ Q 3. Did decedent own an "intrust for" or payable-upon~ieath 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 u:>e 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;l(1.3)]. Asibling is defined, undi Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX+ (01-10) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF: FILE NUMBER: ROBERT K. DANNER 21 10 0599 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1. 14 West Allen Street echanicsburg, PA 17055 The estate attempted to sell the house, but had no reasonable offers. Meanwhile, the mortgage lender as not being paid due to insufficient funds in the estate. As of now, the property has either been oreclosed upon or is in the process of foreclosure. The County's assessed value of the property was 116,600.00, but that assessment is twice the fair market value of the property. The mortgage payoff was 66,552.29, which exceeded the fair market value of the property.) TOTAL (Also enter on Line 1, Recapitulation.) If more space is needed, use additional sheets of paper of the same size. 55,000.00 REV-1503 EX + (6-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER ROBERT K. DANNER 21 10 0599 All property jointlyowned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. ucent Technologies, Inc. (3 shares x $2.46) ~ 38 2. ~ederal Express (.510231 share x $83.06) I 42.38 3. ~f'he Hershey Company (5.3092 shares x $46.56) ~ 248.86 TOTAL (Also enter on line 2, Recapitulation) L (If more space is needed, insert additional sheets of the same size) REV-1508 EX + (6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. IN R SIIdENT DECEDENTRN PERSONAL PROPERTY ESTATE OF FILE NUMBER ROBERT K. DANNER 21 10 0599 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointty•owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 004 Ford Ranger Pickup Truck 5,410.00 2, 0130 Winchester Model 94 with scope 37~ nn 3. 15tevens 25 4. 2 Savage Model 93 bolt action 5. 2 gage shotgun Modee 37 with extra barrel 6. ittle Scout 22 7. 2 gage shotgun capital ejector steel choke board single barrel) 8. ousehold furnishings 9. etro Bank, account no. 536040942 801 Paxton Street arrisburg, PA 17111 10. embers 1st Federal Credit Union, account no. 268477-00 000 Louise Drive, P. O. Box 40 echanicsburg, PA 17055 11. embers 1st Federal Credit Union, account no. 268477-11 000 Louise Drive, P. O. Box 40 echanicsburg, PA 17055 12. tate Farm Insurance (refund) . O. Box 830854 irmingham, AL 35283 13. entral Pennsylvania Auto Club (refund) 14. ighmark Blue Shield (refund) . O. Box 890171 amp Hill, PA 17089 TOTAL (Also enter on line 5, Recapitulation) L$ (If more space is needed, insert additional sheets of the same size) REV-1511 EX+(10-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESII;ENT DECEDENT ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address Ciry State ZIP Year(s) Commission Paid: ESTATE OF FILE NUMBER ROBERT K. DANNER 21 10 0599 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Musselman Funeral Home, Inc. 5,684.27 2. Rolling Green Cemetery Company 1,730.00 B 2, Attorney Fees: R. Mark Thomas, Esquire 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant 4. 5. 6. SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS 1,560.00 Street Address City State ZIP Relationship of Claimant to Decedent Probate Fees: Accountant Fees: Tax Return Preparer Fees: 211.50 7• State Farm Insurance 467.95 8. Ford Credit 6,328.35 9. United Water 167.50 10. UGI 329.17 11. PPL 608.40 12. First Premier Bank 22 97 13. Vascular Associates 4.06 14. Wilteck (truck oil change) 26.56 TOTAL (Also enter on Line 9, Recapitulation) I $ 17,1 If more space is needed, use additional sheets of paper of the same size. REV-1512 EX+ (12-08) pennsylvania DEPARTMENT OFREVENUE INHERITANCE TAX RETURN RESIpENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8~ LIENS ESTATE OF FILE NUMBER ROBERT K. DANNER 21 10 0599 Report debts incurred by 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. innacle Health Hospitals, Account No. 100286787 1,100.00 . O. Box 2353 arrisburg, PA 17105 2. omputer Credit, Inc. (Pinnacle Health Hospitals #100023242A) 1,068.00 . O. Box 5238 inston-Salem, NC 27113-5238 3. ureau of Account Management, Account No. 27090733 3,387.03 . O. Box 8875 amp Hill, PA 17001-8875 4, ccounts Recovery Bureau, Inc. (Pinnacle Health Hospitals #101232103) 1,024.00 . O. Box 6768 yomissing, PA 19610-0768 5. innacle Health Hospitals, Account No. 100038018 31.75 . O. Box 2353 arrisburg, PA 17105 6. innacle Health Medical Services, Account No. 252718 33.89 . O. Box 1286 arrisburg, PA 17108 7. nternists of Central PA 114.14 08 Lowther Street emoyne, PA 17043 8. iberty Medical Supply Pharmacy 1,138.05 . O. Box 198057 tlanta, GA 30384 9. rchard Bank Gold Mastercard c/o HSBC Card Services 143.92 . O. Box 17051 altimore, MD 21297 10. orough of Mechanicsburg 860.94 6 West Allen Street echanicsburg, PA 17055 11. ellCare 47.30 . O. Box 69328 arrisburg, PA 17106 12. hase, mortgage loan number 1213526196 (see note on Schedule A) 66,552.29 . O. Box 78420 hoenix, AZ 85062 13. A Medical Center 211.11 ebanon, PA 17042 14. ureau of Account Management, Account No. 26998368 2 287 28 . O. Box 8875 amp Hill, PA 17001-8875 TOTAL (Also enter on Line 10, Recapitulation) I S 77,999.70 If 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 RESIgENT DECEDENT ESTATE OF: ROBERT K. DANNER FILE NUMBER: 21 10 0599 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1. Darla Moyer Lineal 100.00 5211 Pine Hill Road Dover, PA 17315 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT TAKEN: 1. 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET If more space is needed, use additional sheets of paper of the same size. Cumberland Count/ t3oard or Assessment Appeals Old Courthouse, First Floor One Courthouse Square Carlisle, PA 17013 19000277-2A-19054 In~II1n~IIlunl~L~l~l~l~lnllun~llnlulnllnlnllilnl DANNER, ROBERT R PO BOX 1534 MECHANICSBURG, PA 22973 T66 P1 17055-9034 Deadline for Scheduling an Informal Review Appointment: June 19, 2010 For details, please see the reverse side. The Cumberland County Board of Assessment Appeals is providing you with notice of the value on this property, determined as a result of the Cumberland County countywide reassessment completed this year. The countywide reassessment values each property at current Fair Market Value, as of January 1, 2010, equalizing and establishing a uniform tax base so that properties of like characteristics and the same actual Fair Market Value will be taxed the same. FORMAL APPS.AL DEADLINE: _ _June 14 , 2 010 MAILING DATE: May 3, 2010 Muaic.: 19 - MECHANZCSBURG 4TH WRD School: 6 - MECHANICSBURG SD Location: 214 W ALLEN STREET LAND LESS THAN 1 ACRE Taxable Property Land Size: .03 acres Property Type: R Residential (Under 10 Acres) Homestead Approved Parcel Identifier: 19-23-0567-127. 2010 Base Year Assessed Value Old Assessed Value Fair Market Value (2010 Market x 100%) (2004 Market) Land 30, 000 30, 000 19, 000 Buildings 86, 600 86, 600 70, 280 TOTAL 116,600 116,600 89,280 2010 Clean and Green Values Land NOT NOT NOT Buildings APPLICABLE APPLICABLE APPLICABLE TOTAL Clean and Green values apply to qualified farm and forest land and become effective only upon application and approval. Clean and Green applications must be received by the i-assessment Ofiice no later than 4:30 p.m. cn Qctober 15, 2010. Those previously approved for Clean and Green do not need to re.-apply. The ESTIMATED impact statement printed below is our best estimate of change, based on 2010 COUNTY tax figures. THIS ESTIMATE DOES NOT INCLUDE ANY BOROUGH, TOWNSHIP, OR SCHOOL DISTRICT IMPACT. Current 2010 County mills = 2.579 Adjusted 2010 County mi:11s = 2.074 $ 230 2010 COUNTY Tax BEFORE Reassessment. $ 242 2010 COUNTY Tax AFTER Reassessment. (see reverse side) Historical ~i~ctes: Charting Tools fcr Looking Up a Security's Exact Closing Price - Bi ~C'... Fage 1 of 1 More IF..nterKe~vordls} _ s SEARCH .~ Cf1~8~ .. (we~+wsxaoirsc`ew, ,~I'" R) L ~-~I ~~~ ~ ~ - . <. T~I~ 1+fY)~O;~fl' Ffll<RSF._~S(~h~ RE:~Sf3RT s . ,... . r r ~t.uA,rS A'aynrordY. .--. _. _._. HoR,o ru:rtrs Nswy tndnrtriss MarkiHa ' NYstoricolQuotes ~.-fitipRepdrta ~AtiwnesdTOOiE PrsrriurttProdueta' This I-,uwr~.:al Quotes tool allows you to look up a security's exact cbsing puce. Simply type in the symbol ono a historical date to view a quote and mni chart br that security. 'Enter Symbol: ALU Alcatel Lucent SA Jlosing Pace: ~. CHt: Hiyh: Vafums Enter Date: 05/21/2010 2.46 2.38 2.51 2.37 24,957,071 Go To Charting ~~ L No Splits jt! 2-MCner vatly C ar, of Acate ucen; SA Sponsored Links Mortgage Rates Hit 2.99% If you owe less than $729k you probably qualify for govt Refi Programs www.5ec R eFn a nceRace<. cum Trader Makes $87 Million California Option Trader Makes $87 Million in a Single Year! See How w1rv: ThelnvestorCrty.cam Our last pick rose 1550% We provide our newsletter with the best stock picks. Join Free Today! wtw+. Per: ny,^•,iccisU niverse.co m Market Crash 1131!11? Technical indicators suggest market collapse may begin by Jan. 31st W Ww.StefllGisb?rk5oninr..ccm Find a broker SACTttsrriatMdiO~f[;~T~ ~.w'~y,...,~_,a.~N.A~t~ wr~.MSrva Septtrade: $7 Trades. 30.Day Guarantee. 30.Day Guarantee. Why Pay Morel Switch Trade Currencies ONne Fast Execudons Code Here. Click Here. to OptlonsHouse. Home I About I Job Oooortunities I n ad Us I Feetlb c l Helo Copyright®2011 MarketWatch, Inc. NI ngh~ reserved. By using this site, you agree b the Tenns of Use and Pnvaw Palicv(updated M3/03). Intraday Data pmvided by Ttanson Reuters and subject 1o terms of use. Historical and currem end-of-day data provided by Ttgmson Rasters. Intraday data delayed per exchange requirements. Dow Jones Indexes (SM) from Dow Jones 8 Company, Inc. All quotes are in local exchange tlme. Real tlme last sale data provided by NASDAQ. More klfonnatlon on NASDAQ tratled symbols and their current financial status. Intraday data delayetl 15 minutes for Nasdaq, and 20 minutes for other exchange. Dow Jones IndexesSM from Dow Jones & Udmpeny, Inc. SEHK intraday data is provided by Cortstock and is at least 60.minutes delayed. All quotes are in local exchange 6me http://bigcharts.marketwatch.com/historical/default.asp?detect=l&symbol=ALU&close d... 1/24/2011 _ __. Historical. Quotes: charting Tools for Looking Up a Security's Exact dosing Price - LilzC... page 1 of i. More Fnter Keyword(s) SEARCH t 4ll'i it I,i,~;l rI "c (1 ~~cl ~ ~'r t ~4- vs ~. ~ ~'~ r _ - Charts• 1YaltskS klaas6erg The iPad No_Ca r Take Com d of Corrysuters _ _ v1.c ~ if ~Tt$r~a i Y t i1~~3. John_PaczkcwskF An "A ppta Invn sion`rn Korea. Tvro Fd~pFon ~Ptanes So:d ,1 ~t t ? cJn !'I t,cx~ Ir , ~ ~.~~ 1_ ,3~ Ciz Gantaa Oo You.Cli>~FacebookaErrxad Fi ct Each Ray?.. ~?1,~1 t,t3am PT ~.}'~ "S~ ':+1 r y+r~r~a nix. ..,-, _ __. _ b l _Homa Quotes News [ndustnn hluketr ? HEstoriuir7uotea BFpReportr ®AdwneedTaols PrerNumProduets'.. This H~stoncal Quotes tool allows you fo look up a security's exact cbsing pace. Simdy type in the symbd and a historical tlate to view a quote and mini chart 6r that security. Enter Symbol: FDX ', Enter Date: 05/21/2010 FedEx Corp Frinry. Flay 27, 26:0 .; ~~sine Pace: s3.as Cpen: 80.14 filth: $3.35 :~J'N. 79.41 V-,;ume: 4,243,926 Go Ta Chaning ~~ Sponsored Links Mortgage Rates Hit 2.99% If you owe less than $729k you probably qualify for govt Refi Programs ww•w. SeaRC•fma n cc Ra ies. can Learn to Trade Options This Idaho Fann-boy did and fumed $1,000 into $16,940 in 30 Days! ViN^h' III!;IgVV.SivfCity.iA1D Market Crash 1131/11? Technical indicators suggest market collapse may begin by Jan. 31st Yi\•n..,S:!'H1na1n;;kSJnilrif.. f:firn 1 Stock to Watch Tomorrow Don't miss out on tomorrow's big winner -Join our Free Newsletter! www. Pe rn ySECCksExpe rt:^o m Find a broker Sealfrarl~ °~°7 re~Team~~il~ ~,~,,,,,~,,,~ No Splits 2--Viontn DzfEy Chart of Feder C.;rp Tnaae ~- c~a~ffENCY n~trE;s Scottrade: S7 Trades, 3aDay Guarantee. 3ODay Guarantee. Wh Pa More? Swish Fast Executions Click Here. Click Here. to OptionsHOUSe. Trade Cumendes Onine Home I About I Job Oooortunities I Contact Us I Feedback ~ HeID Copyright ©2011 MarketWatch, Inc. NI rights reserved. By using this site, you agree to the Tenns of Use and Privacy Policv(updated 413103). Intraday Data provided by Thortson Reuters and subject m terms of use Historical and cumerC end-o(•day data provided by Ttomson RaRers. Intraday data delayed per exchange requirements. Dow Jones Indexes (SM) from Dow Jones & Company, Inc. All quotes are in local exchange time. Real time last sale data provided by NASDAQ. More infonnaton on NASDAQ tratled symbols and tlteir current financial status. Intraday data delayed 15 minutes for Nasdaq, and 20 minutes for other exchanges. Dow Jones IndexesSM from Dow Jones & Company, Inc. SEHK intraday data is provided by Comstock and is at least 66minutes delayed. All quotes are in local exchange time. http://bigcharts.marketwatch.com/historical/default.asp?detect=l&symbol=FDX&close da... 1/24/2011 Historical Quotes: Charting Tools for Looking Up a Security's Exac~ Closing Price - B~.gC... Wage 1 of Fntar Keyword{s) !, SEARCH More _ • r ~ _ Chalrt~ k y~-..-,.<,:: iM1e~LlryJVdt r r s, a rn~ ar _ __ __ _ Home t}uoiu News industri:s -lYlerket^ Historicd Quoles BipNeports ~Ad+nneedTools Premum ProdactY Ths Hskirical Quotes tool albws you fo look up a security's exact cbsirg price. Simply type in the symbd and a historical date to view a quote and mall chart for that securiy. `, Enter Symhol: HSY. 'Enter Date: 05/21/2010 _.. The Hershey Company ~riray.:f::ry 21. ^ry.0 Clsmg P~~ice: 46.56 Open: 46.44 "'at'~ 46.63 Lcw. 45.59 vcwme: 3,236,350 Go To Charting ~ L Sponsored Links Trader Makes $87 Million California Option Trader Makes $87 Million in a Single Year! See How vnrn. FhelnvG~stoK;ity.can Mortgage Rates Hit 2.99% If you owe less than $729k you probably qualify for govt Refi Programs w.rr: SaeRef+nancx Ratan„a:rn 1 Stock to Watch Tomorrow Don't miss out on tomorrow's big winner -Join our Free Newsletter! www. Penn y6:rc;csExpzrt.^.mr~ Our last pick rose 1550% We provide our newsletter with the best stock picks. Join Free Today! wvrvr.PernySiecks W,iversz. corn Get started with a broker Scxirade ~tUiico~r, ~-ttt:a~rt(artlt~tiittl~. ~, ~,,:ns t__~ °~*^~*` $malt8tssinass. Scottrade: 57 Trades. 30.Day Guarantee. Visd Why Pay Morel Switch Trade Currencies ONne Fast Execufiore Click Here. WSJ.coMsmallbusiness to OptionsHOUSe. Home j About I Joh Oooonundies I Contatl Us ! Feedback I Helo Copyright©2011 MarketWatch, Inc. Pll rights reserved. By using this site, you agree to the Terms of Use and Privacy Policy (updated 4!3/03). Intraday Data provided by Tt»nson Reuters and subject to terms of use. Hisioncal and curteM endoF-day data provitled by Thomson Reuters. Intratlay data delayed per exchange requvements. Dow Jones Indexes (SM) from Dow Jones 8 Company, Inc. All quotes are in local exchange time. Real Ume lazt sale data provided by NASDAQ. More intonnation on NASDAQ traded symbols and their current financial status. Intraday data tlelayed 15 minutes for Nasdaq, and 20 minutes far other exchanges. Dow Jones IndexesSM from Dow Jones & Company, Inc. SEHK intraday data is provided by Constock and is at least 6aminu[es delayed. All quotes are in local exchange tlme http://bigcharts.marketwatch.com/historical/default.asp?detect=l &symbol=HSY&close_ des... 1/24/2011 No Splits 2-r~,enth Daily Chat of The Hershey Comoar:: 2004 Ford Ran`er T_egu~[ar gab -Private Party Pricing F,eport -Kelley Flue Book Page 1 of ~~ U^r s%a R/~/~ ` * w Kelly Blue BOOk f SEARCtI ~~~~= TNF TRUSTED RFSOURfii ......_... ... .._._... .-__..._~.__._-..._~. Heme New Cars Ceairied Ere-Dwrled Used Cars Research Reviews & News Dealers & Inventory Cars ror Sale Loans & Ensurance Used Car Values ~ Sear<n UseC Cars fer Sale ~ Certified Pre-Owned ~ Compare Venicles ~ Perfect Car Finder I 'a ost Researcned Vehicles Cr,RFAX Venicie History Welrnme Back ~ Sign Ir, ~ Q°are 0.cc ~.,n[ (My KBB 21P Code: 17055 Home > Useo Cars > 2'~M > ~_ er Renular Can > %LT PkYUp 1D 6 R 2004 Ford Ranger Regular Cab XLT Pickup 2D 6 ft Trade-in Value _... __.. ____ Private ?artyvalue BLUE $~l©iC'~ PR1YAtE PARFf YbEUE ~~`~'" 5 gaescee Retail ?raise pn Value a Condition - .- .,u._ Value phOCO Cialf?ry ~ Cats For Sale ~~°~ Excet-ent $5,960 CDmpare VehlCee GOOd $5,410 E!ue 3cok Reveal Pair $4,810 Consumef Ratings Mom Photos Find Ycur Nexi Car Speaficaticns tt tttlll l~ ~~~~ ~~~~: SEARCH L6CAL LISTINGS R;fY ~ i SE? GR On Biua Book ClasaiFieds'^ Free CARFAX Record Check Powered by 11 Ford VIN: RangerRegular Cab No VIIJt NO problem! 75 Miles ;. ....... __. .... ...... .... Near ZIP 17055 ----- Avera e: Consumer Ratin 9 9 (751 Reviews) Read Review's To Vfew Ads, Click . .. 4.5 out of 5 Review this Veh,c:e ~: Shopping Tools Similar New Vehicie5 Free UkFAx Fecerd Check 2010 Ford Ranger Regular 2009 Macd'd B-Series Roq ular Auto Loan Rom 3.85".t APR Cab Cab Ge[F'our Gedit'rore' .: .nw ~~ w, cos rnotos Cumnare Insurance Rates Re_ew R . ,•: w to Prcyr ess,ve p.+:cn~ .n~ Payment Calcula [or Eztznded :'~arranty ;quote ' More Results Prin: For Sale Sign ..._.__... .............. . __.... ......__. ......__._ ._..__.. f -.- i;:(,i![ 1R Vehicle Highlights ~~ Compare Used vs, New 55,000 [0 510,000 Mileage: 87,000 - Engine: 4-Cyl, 2.3 Liter Both New and Vsed Transmission: Manual, 5-Spd Drivetrain: 2WD Pickup _...._ _. _...... To Vlew List, Click Selected Equipment Change Equipment YIFW ?atFQiHFR VEtItLEE standare Select Vear... Air Conditioning AM/FM Stereo Dual Air Bags --- Power Steering CD (Single Disc) ABS (a-Wheel) - latest Car News [~ Save Vehicle paint 2ez Email ri, 600Knw[7c : .' [!-.. Gr Search by Category Or Change Z_P Coce i Estimated Payments S 103 /mo rm 4.19°b APR Get aPre-ilwnzi Loan from a.za~t:, APR fiet Yn:Ir CredlC iCOfe fJJ'.+ bet a Free tnrerance .^,uote cve~tir. rrn _.:: http://www.kbb.cow/kbb/LJsedCars/PricingReport.aspx?Yearld=2004&Mileage=87000&;Ve... 6/ 1 /20I 0 'METRO BANK 3801 Paxton Street Harrisburg • PA • 17111 mymetrobank.com 888.937.0004 July 26, 2010 R. MarkThoma<_ 101 South Market St Mechanicsburg PA 17055 RE: Estate of: Robert K. Danner Tax Identification Number: Date of Death: May 21, 2010 To Whom It May Concern: This letter is in reference to decedent account information you requested for the individual listed above. We are able to provide the following: Account Type: Checking Account Number: 536040942 Date Opened: 04/17/2002 Primary Owner: Robert K. Danner Date of Death Balance: $621.79 Please feel free to contact me at (717) 412-6127 if I may be of further assistance. Sincerely, Diana Reynolds Metro Bank Research Associate/Deposit Services St 0 MEMBERS 1St FEDERAL CREDIT UNION REGULAR SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner CHECKING ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Estate of: ROBERT K. DANNER Date of Death: May 21, 2010 Social Security Number: 204-52-9695 268477-00 07/25/2005 $114.88 $.02 $114.90 None 268477-11 07/25/2005 $22.36 $.00 $22.36 None E BERS 1ST FEDER L CREDI UNION . ~ ~ ~~' Danielle A. Kline Lending Insurance Support Specialist July 23, 2010 5000 Louise Drive PO. Bos 40 Mechanicsburg, Penns}~Ivania 1705 (800) 233-?328 wv~~~.memberslst.org ._, .:s ~`'~ ~~ .,, . tip; ,,. ~,~t ~.~... 1`~'llllll~ll II1CIl~lIl11 ~IlIl]I11~IC"~1ll 11.1®1rIItIl~, ~IIll~. Established 1895 Brian C. Musse!man, F.D. Supervisor William G. Pegan, F.D. P.O. Box 137 324 Hummel Avenue Lemoyne, PA 17043-0137 (717) 763-7440 To Funeral Expenses of ROBERT K~. DANNER Darla Maurer 5211 Pine Hill Rd. Dover,PA 17315 2010 May 25 PROF.SERVICES,FACILITIES,AUTOS "Bradford" Metal Casket Cash Advance Items:. Flowers Copies of death certificate Newspaper death notice Minister's gratuity Tip for honor guard TOTAL (Cumberland Co. veteran allowance) SUB-TOTAL June 8,2010 $4,090.00 1,125.00 $5,215.00 $185.50 18.00 240.77 100.00 25.00 $569.27 $5,784.27 -$1 00.00 $5,684.27 FOR APPOINTMENT PHONE 111-763-440 ___ _ U PRENEED COUNSELOR SALES RECEIPT ROLLING G~EE~ J CEMETER`( CO~v~PAh~Y 62~ Nc.OC079~7 1811 CARLISLE to CAN1P HILL, PA ~'~81' '(i /`-,oi-~lC~~ ` DATES- aZ~-~O RECEIVED FROM~(l~ `d ~S~~Lr Na a of haler THE AMOUNT O -., ~ -- ~e.( COLLARS ($ ~ LqS. ~) AS: DOWN PAYMENT ^ REGULAR PAYMENT ~t`'C~` CREDIT CARD CHARGE ^ CASH ^ CHECI(~`~5( ~„~ CARD TYPE ^ FOR THE PURCHASE OF INTERMENT RIGHTS AND/OR MERCHANDIS ANDS V CE OM HE ABOVE NAMED CEMETERY. RECEIVED BY CEMETERY SALE OU E OR DATE BY NAM GEN 8002 (6/02) PRENEED COUNSELOR SALES RECEIPT P.OLLi~•SG GREEN CEMETERY COMP,~N`( 62~ C~~~~.GG08138 "811 C,',;=~L.SL DATE - - RECEIVED FROM _11_~,,[_~ ~' ~ /~~,~~( ~~~~TT ( Name o haler CO C THE AMOUNT OF}-.~c,~ ~,~,~~~~~ ^~~ T-~-•..(- ~~~5~ DOLLARS (~J 'jr~ . ~ ) AS: DOWN PAYMENT ^ REGULAR PAYMENT ~~~~\l CREDIT CARD CHARGE ^ CASH ^ CHECK X5331..1 CARDTYPE ^ FOR THE PURCHASE OF INTERMENT RIGHTS AND/OR MERCHANDISE A SE ICES FR MTHE VE NAMED CEi41ETERY. RECEIVED BY CEMETERY SALES N EL R DATE BY NAM GEN 8002 (6i02) RECEIPT FOR PAYMENT ------------------- ------------------- GL~NDA F'ARNER STRASBAUGH Receipt Date: 6/10/2010 Cumberland County - Register Of Wills Receipt Time: 09:51:00 One Courthouse Square Receipt No.: 1061452 Carlisle, PA 17613 DANNER ROBERT K Estate File No.: 2010- 00599 Paid By Remarks: R MARK THOMAS wz ------------------------ Receipt Distrib ution ----- -------- ------- ---- Fee/Tax Description Payment Amount Payee Name PETITION LTRS ADM 135.00 CUMBERLAND COUNTY GENERAL FUN RENUNCIATION 5.00 CUMBERLAND COUNTY GENERAL FUN SHORT CERTIFICATE 24.00 CUMBERLAND COUNTY GENERAL FUN JCS FEE 23.50 BUREAU OF RECEIPT~~ & CNTR M.D AUTOMATION FEE 5.00 ---------------- CUMBERLAND COUNTY GENERAL FUN Check# 2810 $192.50 Total Received......... $192.50 ~~~~~~ RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA`FARNER STRASBAUGH Cumberland County - Register Of Wills One Courthouse Sgware Carlisle, PA 17613 DAI~TNER ROBERT K Receipt Date: 2/10/2011 Receipt Time: 09:29:32 Receipt No.: 1064367 Estate File No.: 2010-00599 Paid By Remarks: R MARK THOMAS SAP ------------------------ Receipt Distribution ------------------------ Fee/Tax Description Payment Amount Payee Name SHORT CERTIFICATE 4.00 CUMBERLAND COUNTY GENERAL FUN ---------------- Cash $4.00 Total Receives......... $4.00 FordCredit 7[INT INF(IRMATIC Account Number 41621053 Vehide Description 2004 FORD RANGR VIN 1FTYR10D44PA43877 Statement Date 07/05/2010 Payoff Amt Good Thru $ 27.53 07/25/2010 Customer Service Cellar i-800-727-7000 Hours of Operation Mon-Fri lam - Bpm CST Sat lam - 5pm CST Website Address www.fordcraditcom Refer to back of statement for additional contact information. DATE DESCRIPTION AMOUNT 07/02/2010 Payment Received -Thank you! $ 6,328.35 Payments received after statement date are not reflected. 1 1 GATE DESCRIPTION AMOUNT 07/25/2010 Payment Due $ 0.00 TOTAL AMOUNT DUE ; o_oo Your account is prepaid, but you can continue to pay the regularly scheduled monthly payment and reduce your overall interest obligations. 1 ~~~~ ~~ v~ III bzN O S~ Important Customer Information. We're always looking for ways to help make your ownership experience more enjoyable and convenient. To help you're holding one of the most consumer-friendly invoice statements in the industry. At left, you'd see the manyways to contact us should you ever have a question or concern. For added convenience, answers to frequently asked questions are always listed on the back of your statement each month. Thankyou for choosing to finance with us, and enjoyyour vehicle. m 0 Is it time for your scheduled maintenance visit? Keep it genuine by bringing it to = your local dealership today for an oil change and zire rotation. Ourfactory trained technicians know your vehicle best and will use pares designed and engineered = specifically for your vehicle. DETACH AND RETURN REMITTANCE COUPON BELOW FOR EACH ACCOUNT PAID ~. FordCredit Customer Service Center P.O. Box 542000 Omaha, NE 68154-8000 #BWNKPYC #000000416210538# AB 01 044844 32487 B 181 A Lln~rllll~llll~rl~~~~llll„Il~nlll,lll~l,llll,lll,~lllrll~~~ ROBERT K DANNER 5211 PINE HILL RD DOVER PA 17315-4927 6 Account Number 41621053 Payment Due Date 07/25!2010 TOTAL AMOUNT DUE S 0.00 r ENTER TOTAL AMOUNT PAID ABOVE SEND PAYMENT TO: Ford Credit Box 220564 Pittsburgh, PA 15257-2500"4 Illllrllnlllllnlllrrlllnntlrlll~ll~rllllllllllrllllrrlllll 14806300000000000004Z62105300026463006 ~1 P[NNACLEHEALTH HOSPITALS ROBERT K DANNER PO BOX 1534 MECHANICSBURG PA 17055-9034 Patient Name: Danner ,Robert Statement Date: 09/16/10 Service Date(s): 04/25/10-05/21/10 Account Number: 100286787 Primary Diagnosis Code: 008.8 insurance Information Ins. 1: MEDICARE A .00 Ins. 2: PBSHM .00 Ins. 3: Ins. 4: Financial Aid Is Available For Those Who Apply And Qualify. Customer Service Can Assist You With This Process. For Account Information, Please Call (717} 230-3717 or 1-800-603-6064 for Out of Area Calls. If payment has been sent, please disregard. Pay online at: http:/lwww.pinnaclehealth.org/billpay/ Total Charges: Payments/Adjustments: Account Balance: Patient Balance: Please Pay This Amt: 5244,617.29 5243,517.29- 51,100.00 SI,100.00 $1,100.00 For questions, call our Billing Help line at: 717-230-3717 for local calls or 1-800-603-6064 for Out of Area. Customer Service Hours: Mon-Wed-Fri 7:00 AM to 4:00 PM Tues-Thurs 7:00 AM to 6:00 PM Please Note: Your physician will bill separately for professional services. Make Checks Payable To: PinnacleHealth Hospitals I mm mll mll iau urn i~ai ~Ilu ui~ um un lul PinnacleHealth Hospitals PO Box 2353 Harrisburg PA 17105 ^ Check box if your address or insurance information has changed. Please make changes on hack. 00012398 002 0.72 ROBERT K DANNER PO BOX 1534 MECHANICSBURG PA 17055-9034 Accaum Number: 100286787 Please Pay This Amcum: 1 1C0 0 Pa[iem Name: Danner ,Robert Due ey: Due Now Cara Number: CW2 No:' Exp. Date: Signature: Amoum Paid: -- i ne wvz numoer is me iaa ~ a~gns on the hacx or your cremt card, by your signature I.t~lllt~~lt>,~Nll~~t~l~lt~ll>,~I PINNACLE HEALTH HOSPITALS P.O. BOX 2353 HARRISBURG, PA 17105-2353 OOOD010028678700000110000000000003 ~~OIVIPJTER CREDIT, INC. CLAIM DEPT 083301 640 Vilest Fourth Street . Post Office Box 5238. Winston-Salem, NC . 271 13-5238 .336-761-1538 January 11, 2010 021 SH7 4>26 0559037348 Robert K Danner For: Danner, Robert PO Box 1534 Mechanicsburg, PA 17055-9034 I~~I,III...III....I.I..I~I~III~~iII~I~~iI~I,I~~II~II~~I~Ill~l~~l Pinnacle Health Hospitals Attention: Karen Telephone: (717) 230-3421 or 1-800-603-6064 Acct. No. 100023242 A Date of Service: 07-31-09 AMOUNT DUE: $1,068.00 Dear Robert K Danner: ACA INT 88NATIONAL the Anociatlon of Credis and Collettion Pcofeatma6 Despite our previous communication to encourage you to pay your delinquent account with Pinnacle Health Hospitals, you still have an outstanding balance. This is our FINAL NOTICE and you must take action to resolve this overdue account. Pay the amount due to discharge your debt owed to the hospital. This letter is sent as a final demand for payment in the amount of $1,068.00. Computer Credit, Inc. is a debt collector and a member of ACA International, the Association of Credit and Collection Professionals. Be advised this is our LAST ATTEMPT to collect this debt and any information obtained will be used for that purpose. We expect you to resolve your financial obligation. C Payment in full is expected. Partial payments will not :;top the collection process. If C. JOrdan you have recently paid your balance in full, thank you. Director of Operations You maybe eligible for assistance through a financial support care program. You may call the number above if you have questions or if you think you maybe eligible. To Team more about why you received this letter, you may contact CCI: wr~^tr.infom:ationcci.cem login cede: 0559037343 DI~~II' ~ ~-~ ~ • • ^ VISA ~ -~.I Imo: ~ arccav~a ^ CARD NUMBER EXP DATE SECURITY COCE AMOUNT SIGNATURE PRINT CARDHOLDER'S NAfo1E BILLING ADDRESS BILLING Z!P CGDE Computer Credit, Inc. "' z=<5:6 "s'6 CCI KEY: 0559037348 Returr, this portion with your payment GUAR NAME Robert K Danner ACCOUNT NO 100023242 A 'AMOUNT DUE `'$1,Q6800 You may make check payable to: Pinnacle Health Hospitals PO Box 2353 Harrisburg, PA 17105-2353 I..,IIII,~II~~IIII~I„I,I~~~IIIIIIIIJII~IIIL~I~I~~JI,~I~I~I BUREAU OF ACCOUNT MANAGEMENT ~~ 3607 Rosemont Avenue, Suite 502 PO BOX 8875 Camp Hill, PA 17001-8875 Telephone: 1-717-214-3017 Toll free: 1-800-599-0423 ' Monday -Thursday 8:30 - 8:30 (EST) Friday 8:30 - 5:00 (EST) March 16, 2010 Robert K Danner PO Box 1534 Mechanicsburg, PA 17055-9034 Robert K Danner In Re: YOUR CREDITORS Amount Due : $3387.03 Account # :27090733 Client Ref. # :100038018 Date of Service : OS-08-09 Your account has been placed with this office for collection. This notice has been sent to you by a debt collection agency. Payment in full is being requested to resolve this past-due account. If you have any questions call our office using the account # as a reference to your file. Unless you notify this office within 30 days after receiving this notice that you dispute the validity of this debt or any portion thereof, this office will assume this debt is valid. If you notify this office to writing within 30 days from receiving this notice, this office will: obtain verification of the debt or obtain a copy of a judgment and mail you a copy of such judgment or verification. If you request this office in writing within 30 days after receiving this notice, this office will provide you with the name and address of the original creditor, if different from the current creditor. This is an attempt to collect a debt by a debt collector and any information obtained will be used for that purpose. Your payment should be made directly to this office for prompt credit to your account. Atwenty-dollar service charge will be added to all checks returned to us by our bank. Should you desire areceipt, aself-addressed, stamped envelope is required. Bureau Of Account Management ------------------------------------------------------Detach and Return with Payment------------------------------------------------------ PO Box 8875 Camp Hill, PA 17001-8875 Return Service Requested To pay by credit card, please complete the information below: Check one: ^ Visa ^ MasterCard Card Number: _______ ________ Expiration Date: / / Payment Amount: Signature: Amount Due : $3387.03 Account # :27090733 Client Ref. # :100038018 Date of Service : 08-08-09 PERSONAL & CONFIDENTIAL Robert K Danner 27090733 PO Box 1534 Mechanicsburg, PA 17055-9034 I~~~III~~JII~~~~I~I~~I~LI~I~JI~~~~~II~~I~~I~~II~~I~~II~L~I Amount Enclosed $ Bureau of Account Management PO Box 8875 Camp Hill, PA 17001-8875 I~~~III~~~III~~~II~~~~~~III~~IJ~JJ~~J~1JJ~~~IJ~1~~~~111 D01 000051 P 1 159 000020 75 076808 Z-CRE :n•I~ ACCOUNTS RECOVERS BUREAU, INC. P.O. Box 6768 • Wyomissing, Pa. 19610-0768 August 03, 2010 Account #: 101232103 Creditor: PINNACLE HEALTH HOSPITALS L, 024.00 TOTAL DUE: $:1,024.00 OUR RECORDS INDICATE THAT YOU REFUSE TO PAY THE ABOVE REFERENCED BALANCE. PLEASE NOTIFY THIS OFFICE IF YOU CAN NOT PAY THIS BALANCE. YOU MAY QUALIFY FOR RELIEF FROM THIS DEBT. WE WILL BE HAPPY 'PO ADVISE YOU OF THE ELIGIBILITY REQUIREMENTS. TELEPHONE: (800) 220-1622 or (610) 750-8450 THIS COMMUNICATION IS FROM A DEBT COLLECTOR AND IS AN P_TTEMPT TO COLLECT A DEBT. ANY INFORMATION GBTAINED WILL BE USED FOR THAT PURPOSE. PLEASE DETACH AND RETURN BOTTOM PORTION WITH YOUR PAYMENT lNOUIRIES TO: PO BOX 3495 TOLEDO. OH 43607 IF PAYING BY MASTERCARD, VISA OR AMERICAN EXPRESS. FILL OU7 BELOW. i G FOR PAYMENT CHECK ARD U IN S-' I ~ U W .. ® ^ ~ ^ i ~ ~~ v1ASTERCARD DISCOVER VISA ~~:~ AMERICAN EXPRESS CARD NUM6ER SIGNATURE CODE SIGNATURE EXP. DATE I NOTICE DATE ~ BALANCE ~ ARB ACCT. ;* 08/03/2010 j $1,024.00 01-101232103- 11I PAGE: 1 of 1 AMOUNT ENCLOSED ~ 30724-Q462 U F!ease checK bor f .eow addrass is Incorrer,!. am inaica~s chann~~, s! en reverse side. oioi ~lill~llllrlllnrl~lliilil~li~liliil~l~~iili~~i~l„Illln~iinl ROBERT K DANNER 5211 PINE HILL RD DOVER, PA 17315-4927 0.^.LbU~t PAYMENTS ACCEPTED ONLINE AT www.payarb.com 30724-Q 462'TZXOQ ES M N009514 i,Il~~n~lllili~ll.linl~lilin„rl~~lill~lililn~~ni~~~~niin ACCOUNTS RECOVERY BUREAU, INC. PO BOX 70256 PHILADELPHIA, PA 19176-0256 01107,232103080320101100001024008 P'J. 3ox 2353 Harrisburg, PA ? 7105-2353 PINNACLE HEALTH 12/31/09 ROBERT K DANKER PO BOX 1534 MECHANICSBURG PA 17055 Patient Name: ROBERT DANKER Account Number: 100038018 iatE' Of ucr'viC2: Ocg/vt^i/v9 Account Balance: $ 31.75 FINAL NOTICE Dear ROBERT K DANKER Your Pinnacle Health Hospital account balance of $ 31.75 remains unpaid to date despite previous requests for payment. Please send payment in full to: Pinnacle Health Hospital PO Box 2353 Harrisburg, PA 17105-2353 If the full payment is not received within 15 days of receipt of this letter I will be obligated to refer your account to a collection agency. To avoid this action remit your payment of $ 31.75 today using the enclosed envelope, or call me to use your VISP_, MASTERCARD, DISCOVER, or AMERICAN EXPRESS. If you have any questions regarding this account, please contact me at (717) 230-3717 or 1-800-603-6064. Thank you in advance for your cooperation. Sincerely, Financial Counselor Patient Accounts Department I authorize you to charge VISA MASTERCARD Account Number CW2 No Effective Thru / Authorized Signature Prir_t Name DISCOVER AMERICAN EXPRESS * The CW2 number is the last three digits on the back of your credit card by your signature. STATEMENT' OF MEDICAL SERVICES LAST STATEMENT DATE: 03/03/10 NEW CHARGES: 50.00 ~il'~i;~1ACLEHc:~LT'ti Pz>~rv>;ya NEW PAYMENTS: NEW ADJUSTMENTS: INSURANCE BALANCE: 50.00 50.00 50.00 YOUR BALANCE: 533.89 If Any Questions, Please Contact: PHMS AT 717-231-8960 OR 1-800-565-6224 ~ ROSERT K DANNER >ACCOUNT::, 252116 'II4/28~Y0 FED TAX ID •251709054 INSURANCE YOUR CHARGE PAYMENTS AD.RJSTMENTS BALANCE BALANCE »> PATIENT: ROBERT K DANKER IP 072809 073109 PERFORMED AT: HARRIS8~JR6 HOSPITAL PERFORMED BY: NEUROLOGY ASSOC PHMS 07/29!09 INITIAL IJVPT CONSULT LVL4 PROCEDURE: 99254 DIA6WDSIS: 780.2 07/30/D9 SUBSEQUENT HDSP CARE LVL1 PROCEDURE: 99231 DIAGNOSIS: 780.2 07/28/09 TO 07/31/04 218.00 56.00 110.68- 79.65- 27.67 24.88- 24.90- 6.22 BALANCE: ROBERT K DAMIER 533.89 UNLESS PAYMENT IN FULL IS RECEIVED WITHIN TEN (107 DAYS OF RECEIPT OF THIS BILL, YOUR ACCOl1~7T WILL BE REFERRED TO A COLLECTION AGENCY. IF PAYING BY CHARGE CARD PLEASE INCLUDE THE THREE DIGIT SECURITY CODE LOCATED ON THE BACK OF YOUR CARD. THANK YOU FOR USING PINtrACLE HEALTH MEDICAL SERVICES. OUR OFFICE HOURS ARE 8:30AM TO 4:OOPM, MONDAY, WEDNESDAY, FRIDAY AND 8:30AM TO 6:OOPM TUESDAY AND THURSDAY N Q1 iP N PAGE l OF 2 ~- Please detach and return with your paytrerrt HI2 PP.V1tiACLE HEALTH MED SVCS PO BOX 1286 HARRISBURG PA 17108-1286 ADDRESS SERVICE REQUESTED Check box and enter any address or ^ insurance corrections on back 00004537 01 1...111-..I~,.1111...1~.1..2.11~~1.11~.1.~11..1..1„11..,,1.1! ROBERT K DANKER PINNACLE HEALTH MED SVCS 214 W ALLEN ST PO BOX 1286 PO BOX 1534 HARRISBURG PA 17108-1286 MECHANICSBURG PA 17055-9034 Make Check Payable To PINNACLE HEALTH MED SVCS INTERNISTS OF CENTRAL PA 108 ~QpTf~R STREET LEMOYNE, PA 17043 Forwarding Service Requested - 11231 ESTATE OF ROBERT K DANNER 5211 PINE HILL ROAD DOVER PA 17315-4927 12/15/10 46188 •, ~ 114.14''` _MC _VISA Disc Security Card~~ __ Code _ Sign Exp _/_ INTERNISTS OF CENTRAL PA 108 LOWTHER STREET LEMOYNE, PA 17043 RETURN TOP PORTION • RETAIN LOWER MESSAGES EXPLAINED BELOW *** PLEASE PAY UPON RECEIPT. FOR BILLING QUESTIONS CALL 774-1366 BETWEEN 10 ~''`" CTIVE 3/1/10 THERE WILL BE A ''`^''` 'ti*^ AM AND 4 PM AND CHOOSE BILLING. EFFE ~~::~~ :tit ~~ ~::'c~c LATE FEE ADDED , TO BALANCES OVER 60 DAYS OLDS ~.~ ~, ~~ ,,,. ckic~c;.,,;c;c,c..,,;.:,...c„~";,.,.~'c,.~c:c:k4c~'c.,..~'c,.~'c'c~'c~'c~'c ~'c~:~t,,;.:c..~l;c...,,.~Yi:~'c~'c~'r~:...,;Y,.,. . ,,,~~,, ,. ,.4;:c;:.:;'c9:.,,...,.;'cr.~:~Y,.~'r,. 01/25/10 1 12 E OFFICE VISIT EST LEVEL 4 99214 250.01 124.00 00 0 01/29/10 Medic DEDUCT Payment . 75 _28 01/29/10 Accept Assign Adj. t DUCT P . 0.00 02/12/10 aymen BS 65 DE 01/25/10 1 12 E ELECTROCARDIOGRAM COMPLET 93000 250.01 55.00 00 0 02/16/10 Medic DEDUCT Payment . 11 -36 02/16/10 Accept Assign Adj. t . 0.00 03/31/10 BS 65 SPECIA Paymen E-This bill applied against your deductible. You are responsible to pay us. 95.25'` 18.89* DATE LAST PAID AMOUNT • - ~ • ~ ~ • ' ' "' • ' ' ' 00/00/00 0.00 114.14 0.00 0.00 0.00 0.00 0.00 0.00 114.14 ,~~AKE INTERNISTS OF CENTRAL PA ~t1ECK 108 LOWTHER STREET ~avaeLETO: LEMOYNE, PA 17043 PAT~r 1-ROBERT K DANNER PRV~~ 12-RATNASAMY, PATRICK, M.D. • ~ •~ ~ 1 114. 14''~ Ph: (717)-774-1366 Acct~~: 46188 Date: 12/15/10 Page 1 of 1 e INe Deliver Better Kealth® Toll Free 1-888-840-3844 Date 07/14/2010 Account Number HX123 Valued Patient Since 07/08/2009 Statement Important Notice Please review the reverse side of this statement for your rights and privileges. Order Date Invoice Number 0511712010 543083 30 BD SYR UFII SHRT.SCC 31G5/16 1S 1 LANTUS INSULIN 1000 VIAL 1000 Pendin;D Insurance Claims Total Amount of Order $94.24 Deductible Charge $0.00 Less Payments from Medicare and/or Insurance $0.00 Less Patient Payments $0.00 Less Adjustments $0.00 Due From Insurance $0.00 Estimated Due from Patient $94.24 "'Effective August 10, 2009, our new billing department hours of operation will change to 8:30 AM to 7:00 PM Eastern, Monday through Friday."" Previous Balance uue rrom the rauent a~,u4s.a~~ Total Amount Due $1,138.05 The amount noted as "Due from Patient" will not be a final total until all insurers have processed your claim and made a conclusive determination. Therefore, your balance may fluctuate between statements. TO ENSURE PROPER CREDIT, DETACH AND RETURN THIS PORTION IN THE ENCLOSED ENVELOPE ~ tF PAYING BY CREDIT CARD, PLEASE FILL OUT BELOW ~ CHECK CARD USING FOR PAYMENT ^ MASTERCARD ^ DISCOVER ^ VISA ^ AMERICAN EXPRESS CARD NUMBER AMOUNT SIGNATURE EXP. DATE PLEASE CHECK, if you have indicated change(s) on reverse side. BWNHFPK 72'~AUTO"MIXED AADC 334 #CHX123074# I~~~III~~~I~~II~~~~II~I~I~~I~~II~I~~~~I~II~~~I~~~II~~~III~I~~I ROBERT K DANNER 5211 Pine Hill Rd Dover, PA 17315-4927 Account #: HX123 Due Date: 08/13/2010 700200 Source: $1,138.05 Amount Du e: Amount Remitted: $ ~ ~ LIBERTY MEDICAL SUPPLY PHARMACY PO BOX 198057 ATLANTA GA 30384-8057 L~II~II~~~~~ILL~LJ~JLJ~II~~~~l~l~lw~,IJ~I~I~~~IIL~~I HX12308132~1070020~01138052 t„1I"CI~hNKU bHtVn Vvt_U IV1/1J I C('~V/"~RU ROBERT K DANNER Orchard Bank Gold MasterCard Account Statement Account Number 5120-2550-0327-2980 Page 1 of 2 From April 22, 2010 to May 23, 2010 Summary of Account Acttvtty ~ Previous Balance • $141.63 00 ~ - $0 Payments . 00 $0 - Other Credits . _ Purchases/Debits + $0.00 I Balance Transfers + $0.00 + $0 00 Cash Advances . Past Due Amount $10.00 + $1 20 ~i Fees Charged . + $1 09 Interest Charged . New Balance $143.92 I, ~~ Credit Limit $300.00 ,Credit Available $0.00 ° Statement Closing Date May 23, 2010 'Days in Billing Cycfe 31 11 ., r, z~ ZI Z Z ~' N ' Questions? 24Hour Automated Account Information 1-503-293-4037 Espanol 1-503-293-4834 Lost or Stolen Card 1-800-366-7817 Outside USA Collect 1-503-245-9280 TDDlHearing Impaired 1-800-655-9392 ', Payment Information ' New Balance ~ Minimum Payment Due Payment Due Date $143.y[ $20.00 June 17, 2010 Late Payment Warning: If we do not receive your minimum payment by the date listed above, you may have to pay a $0.00 late fee and your APRs may be increased to the Penalty APR of 29.49°k. Minimum Payment Warning:lf you make only the minimum payment each period, you v~ill pay more in interest and it will take you longer to pay off your balance. For example: If you make no additional You will pay off the ' And you will end up paying charges using this card balance shown on ~ an estimated total of... and each month you pay... this statement in ' about... Only the minimum 14 Months $152 Payment I If you would like information about credit counseling services call in ~'~1-866-569-2227. Payment Address: HSBC Card Services, PO Box 17051, Baltimore, MD 21297-1051 Billing Inquiries: HSBC Card Services, PO Box 80084, Salinas, CA 93912-0084 Manage Your account online at www.orchardbank.com Important information As a reminder, you may pay your credit card bill online or through our automated phone system for no fee. - - Transactions '~ ' Fees Trans Date Post Date Description of Fees Reference Number Amount 05!22/10 05/23/10 P~r'nUNTSECURE PLUS 800-690-1532 $1.20 «_ I Total Fees For This Period $1.20 Interest. Charged' ' _ Amount.. Description of Interest Charge INTEREST CHARGE ON CASH ADVANCES $0.00 INTEREST CHARGE ON PURCHASES $1.09 iNTEREST CHARGE ON BALANCE $0.00 TRANSFERS Total Interest For This Period $1.09 2010 Totats Year to' Date Total fees char ed in 2010 $5.32 ' ' Total interest charged in 2010 $5.31 Detach and return bottom portion with your payment 110501 5 G 22 OOOOOOOSOS G STMT07 D L 17563 ODS1 See reverse side for important information ------------------------------------------------------------------------------------------------------------------------------------------ Account Number: 5120-2550-0327-2980 New Balance $143.92 BOROUGH OF MECHANICSBURG 36 West Allen St. MECHANICSBURG, PA 17055-6257 Telephone 717-691-3310 • Fax 717-691-3312 PDenn`is@MeChanicsburgBorough.org December 23, 2010 Estate of Robert Danner P.O. Box 1534 Mechanicsburg, Pa 17055 RE: 214 WEST ALLEN STREET ACCOUNT #: 4188-0 Dear Executor: Patrick Dennis Borough Manager On December 14, 2010, the Borough of Mechanicsburg liened the above-referenced property for delinquent sewer and refuse rents. A copy of this lien is enclosed for your records. These liened amounts will be transferred from your sewer and refuse account to an account bearing the lien reference number. The quarterly bill that you receive for service in January will no longer reflect these past due amounts. Below is a statement of the lien and fees due. Partial payments will be accepted, but the lien will not be removed until rents, fees and interest are paid in full. Tian ~ nr•rnmt fE• 1 (1_7~ihR ITEM COST Lien Amount $860.94 Attorney Fee for Filing $75.00 Court filing Fee $19.00 Attorney Satisfaction Fee $50.00 County Satisfaction Fee $8.00 Interest Rate 6% annually (available u on request) If you wish to have this lien removed, please call the Borough Office for a closeout figure, which will include accumulated interest. If you have any questions or concerns regarding this information, please feel free to contact the Borough Office at 691.-3310. Office hours are Monday through Friday from 8:30 a.m. to 4:30 p'.m. Sincerely. l~ ~°~ Glenda Boyer Office Manager GJB/tsh Enc. Certified Mail # 7010-1870-0001-6870-7739 First Class Mail "fie ~oYOu.gh o-f Mechav~%csbu.rg - ~4 good place ~o lwe" ~~WellCare~ PO Box 69328 Harrisburg, PA 17106-9328 02/24/2010 PRM STMT 82223016 a ~ 54573 """""""3-DIGIT 170 T163 P1 7018060682 i Premium Notice for Signature (PDP) Plan Send Payment To: P.O. Box 78230 Phoenix, AZ 85062-8230 Member Number: 3665881 Coverage Month: March 2010 Payment Due Date: 04/15/2010 ROBERT DANNER Please direct billing inquiries, including PO BOX 1534 questions about adjustments to MECHANICSBURG, PA 17055-9034 1-888-550-5252 I~~~III~~~III~~~~I~I~~I~I~1~1~~11~~~~~11~~1~~1~~11~~1~~11~1~~1 (TTY/TD D: 1-888-816- ~25~J Monday -Sunday lam to Zam Eastern. Thank you for allowing WellCare Health Plan to serve your healthcare needs. ACTIVITY DESCRIPTION AMOUNTS Previous Balance $9.00 Payments Received since last Billing Cycle $0.00 Monthly Member Premium for March 2010 $38.30 Adjustments Amount $0.00 Amount Due -Please Pay This Amount $47.30 Note: Payments received after 02/15/2010 will be reflected on your next statement. To have your monthly charge automatically deducted trom your bank account or ~oaai ~ecunty cnecK please cvniaci ~uawi ~ lei Service. To ensure that your payment is posted correctly to your account please remember to mail the payment stub with your check. Please fold and tear at perforation. Make check payable to WellCare and include payment stub. DO NOT SEND CASH. --------------------------------------------------------------------------------------------------------------------------- PAYMENT COUPON ~~We11Care° Account Number Payment Due Date Amount Now Due' l 3665881 04/15/2010 $47.30 Check here and please print change of address and phone on back. ~N ~~ II~~I~~I~I~II~~~~II~~~~I~II~~I~~~I~I~~II~II~~~~~II~II~~~~~II~I ~-r WellCare P.O. Box 78230 Phoenix AZ 85062-8230 ROBERT DANNER PO BOX 1534 MECHANICSBURG PA 17055-9034 208390210041014822000000383000000047307 CHASE ! i Customer Care Phone: 1-800-848-9380 Please send payments only to: PO BOX 78420 PHOENIX, AZ 85062-8420 Hearing Impaired (TDD): 1-800-582-0542 ..,IIL~~IIL,~JJ~~LIJJr,II,~~~JLJ~J„II„L~ILL~ 68352 MSD Z 23510 C - BRE ROBERT K DANNER P O BOX 1534 MECHANICSBURG PA 17055-9034 MORTGAGE LOAN STATEMENT Loan Number: 1213526196 Statement Date: 08/23/10 Payment Due Date: 05/01/10 Property Address: 214 W Allen St Mechanicsburg, PA 17055 Loan Information: Balances: Principal Balance $66,552.29 Escrow Balance $494.56 __- Payment Factors: Interest Rate 5.87500% Principal & Interest $434.18 Escrow Payment $177.59 Optional Products $0.00 --_o Past Due Payment $2,447.08 Unpaid Late Charges $97.88 Miscellaneous Fees $0.00 Total Payment $3,156.73 N Year-to-Date: Interest $1,308.66 Taxes $510.01 Principal $432.51 Visit our website at chase.com to team about offers for Chase mortgage customers. Activity Since Your Last Statement TRANSACTION TRANSACTION TOTAL OPTIONAL MISCELLANEOUS DESCRIPTION DATE RECEIVED PRINCIPAL INTEREST ESCROW PRODUCTS OR FEES LT CHARGE ASSESSMENT 08/16/10 $24.47 Important Messages About Your Account Please designate how you want to apply any additional funds. When sent with this coupon, undesignated funds first pay outstanding late charges and fees, then principal, provided your loan is current. Undesignated funds sent without this coupon may be placed in suspense rather than applied to your loan as principal until Chase determines how you want to apply those funds. Once paid, additional funds cannot be returned. ' Your account is past due. If you have not already contacted our Collections Department, please do so immediatEaly at 1-800-848-9380, Monday through Friday, 8:30 a.m. to 5:00 p.m. Eastern Time. Chase Home Finance is attempting to collect a debt and any information obtained will be used for that purpose. If you receive or expect to receive an insurance settlement check for damages to your home, please access www.mylossdraft.corn for information on the claim process. When prompted, enter the PIN Number CH001 to access the Web site. You may also call the Loss Draft Department at 1-866-742-1461 from 8 a.m. to 8 p.m., Eastern Time, with any additional questions. ATTENTION PENNSYLVANIA HOMEOWNERS: As you are aware, many taxing authorities in your state will only provide the original I current tax bill to you. If you have a tax agency installment due in the near future, you should have recently received a letter requesting that you provide the original current tax bill to Chase for payment. Please forward this bill as soon as possible to ensure prompt payment. Chase FasiPay is a quick and convenient payment option. Make sure your mortgage payment is made on time, and avoid late fees witf-r one simple phone call. Your mortgage payment will be processed as early as the same day. To use this service, call Chase FastPay at fhe number fisted in the upper left hand corner of this statement. When you use our automated system, you'll save 25°0 on the fee for this service, and pay just $15.00. Please refer to the back of this statement for important information about your account. Please detach and return the bottom portion of this statement with your payment using the enclosed envelope ~, M W ~D 0 a 0 0 0 w x G O O 0 0 0 00012135261961 313D00 DDD61177 00063624 00315673 00001 AGREEMENT TO PAY INDEBTEDNESS VA PILP. NU. lLrt'h~dr Gorr prrfi.n (nnrl PAYEE NQ Il~binu~/ PERSON ENTITLED RECEIV.\131.P, CODIf. ' VA MEDICAL CENTER, LEBANON, PA 17042 1. I, Robert Danner, (Name of Debtor), hereby acknowledge my Medical (Type of Debt) indebtedness to the Veterans Administration in the amount of $211.11, which consists of principal, interest and other costs accrued as of this date, as a result of my participation in a benefits program administered by the Veterans Administration. -. i promise to repay the Veterans Administration by paying minimum monthly payments of not less t}lan $ 50.00 on or before the 28th day of each month beginningJune 2010. I agree to snail monthly payments to the DEPARTMENT OF VETERANS AFFAIRS PO BOX 530269 ATLANTA, GA 30353-0269 to arrive no later than the due date specified above, or mail with monthly bill statement. (Repayment plans will only consider the charges that bare been incurred as of the date of the signed agreement. New charges incurred after the signed agreement date will not be included and payment on both the repayment plan ~ and the current charges need to be paid, in order to avoid Treasury Offset). I ~ 2. I understand that, at the option of the Veterans Administration, any future benefit payments due to me maybe withheld in lieu of this repayment agreement until the indebtedness is liquidated. This amount represents the current charges billed as of Mav 25. 2010. These charges represent billable charges as outlined in Public Law 99-272 and Public Law 101-508. A check equal to the first monthly payment must accompany this form for the repayment plan to beLin. This will be the only notice you receive. vnr,Rl s~ 3~E INDIv~iDl';vI. 1~3 ~Mri.l-Tmz; n nti PORM r v'o ~~.,d Sneer ~,~ ~~~„~l R~„~P. c ;rr. SlaiP. zIH c~>d~~~ su~N,cn ~Rr an1 r. VA PURM ~-~ ~~~ SUPERSEDES VA FORM 4-I 10. APR 1979, L\N 19YJ WHI('H WILL NOT BF USED BUREAU OF ACCOUNT MANAGEMENT 3607 Rosemont Avenue, Suite 502 PO Box 8875 Camp Hill, PA 17001-8875 Telephone: 1-717-214-3017 Toll free: 1-800-599-0423 Monday -Thursday 8:30 - 8:30 (EST) Friday 8:30 - 5:00 (EST) January 19, 2010 Robert K Danner PO Box 1534 Mechanicsburg, PA 1705-9034 Robert K Danner In Re: Your Creditors Amount Due : $2287.28 Account # :26998368 Client Ref. # :290274918 Date of Service : 04-24-09 Your account has been placed with this office for collection. This notice has been sent to you by a debt collection agency. Payment in full is being requested to resolve this past-due account. If payment in full is not received, this account maybe reported as "placed for collection" with the credit bureaus. This "unpaid account" information and your payment htstory on this account will then be available for review by the business community. If you have any questions call our office using the account # as a reference to your file. Unless you notify this office within 30 days after receiving this notice that you dispute the validity of this debt or any portton thereof, this office will assume this debt is valid. If you notify this office in writing wtthin 30 days from receiving this notice, this office will: obtain verification of the debt or obtain a copy of a judgment and mail you a copy of such judgment or verification. If you request this office in writing within 30 days after receiving this notice, this office will provide you with the name and address of the original creditor, if different from the current creditor. This is an attempt to collect a debt by a debt collector and any information obtained will be used for that purpose. Your payment should be made directly to this office for prompt credit to your account. Atwenty-dollar service charge will be added to all checks returned to us by our bank. Should you desire areceipt, aself-addressed, stamped envelope is required. Bureau Of Account Management ------------------------------------------------------Detach and Return ~~ith Payment------------------------------------------------------ PO Box 8875 Camp Hill, PA 17001-8875 Return Service Requested To pay by credit card, please complete the information below: Check one: ^ Visa ^ MasterCard Card Number: Expiration Date: / Payment Amount: Signature: Amount Due : $2287.28 Account # :26998368 Client Ref. # :290274918 Date of Service : 04-24-09 PERSONAL & CONFIDENTIAL Robert K Danner 26998364 PO Box 134 Mechanicsburg, PA 1705-9034 L~~III~~JIL~~~1~LJ~IJJ~~II~~~~~ILJ~~1~~11~~1~~11~1~~1 Amount Enclosed $ Bureau of Account Management PO Box 8875 Camp Hill, PA 17001-8875 L~JII~~JIL~~II~~~~~~III~~I~I~~I~I~~~IJ~IJ~~~I~LI~~~~III DCB01 000359P 1 097 000133 19 076808 Z-CRE