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Home My WebLink About09-27-11.....1 15D561D105 REV_ i ~oo Ex ioz-ii) tF1, ~~ ~i~~~ PA department of Revenue pennsy~(vania Bureau of Individual Taxes - °"' ' " ' ' ~ OFFICIAL USE ONLY PO BDx z8osoi INHERITANCE TAX RETURN C°unry Code Year Harrisbur , PA 1 128-06oi File Number ENTER DECEDENT INFORMATION BELOW RESIDENT DECEDENT ~ 1 I ~ /~OG~6 Social Securrty Number v I _ Date of Death MMDDYYYY Date of Birth 204-28-0817 MMDDYYYY 12/29/2010 09/22/1937 Decedent's Last Name Nichols Suffix Decedent's First N<3me Patsie Mi (If Applicable) Enter Surviving Spouse's Information Beiow Spouse's Last Name - A Suffix......... Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE FILL IN APPROPRIATE OVALS BELOW REGISTER OF WILLS ~ 1. Original Return O 2. Supplemental Return O 4. Limited Estate O 3. Remainder Return O 4a. Future Interest Compromise (date of Prior to 12-13.82) (Date of Death ~ 6, Decedent Died Testate death after 12-12-82) O 5. Federal Estate Tax (Attach Copy of Will) O 7. Decedent Maintained a Living Trust U Return Required O 9. Litigation Proceeds Received (Attach Copy of Trust.) ------- B. Total Number of Safe Deposit Boxes O 1 Q. Spousal Pove Between 12-31 91 add jDatgeSjf Death O 11. Election to Tax under Sec. CORRESPONDENT- THIS SECTION MUST BE COMPLETED. 9113(A) Name ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMAT ON SHOULD 8E DIRECTED T0: Gary B• Quigley Daytime Telephone Number (717) 443-2676 REG{STER O~~ U O First Line of Address ~ ~ _ . ---. 428 Woodruff Way _ _ - =zc'~ : ; , , , _, Second Line of Address '~ `'= ~l ~•.., ~.r-_ ~~ -•.J -~. -_., r-~ City or Post Office -~ -; 7 ~.. Harrisburg State ~ 'f ZIP Code DATE FILED PA ;17112 ---- l-~-_- ~ C~; Correspondent's a-mail address: ui s comcast.net Under pen ies of perjury, I declare that t have examined this return, including accom an in it is true, rect and complete. Declaration of preparer other than the personal representative is based on all information of NAT OF PERSO p Y g schedules and statements, and to the best of m ', 1!fNSI FOR FILING RETURN Y knowledge and belief, which preparer has any knowledge. ADDRESS DAT SIGNATUR pR ` ~~, R ER THAN EPR ~ NTATfVE ~ ~'~ ~ ~ ~~ Z...- ADDRESS n// ~ ~ ~- ~.~` ~ ^ nnT~ f ~~ .Y L Side 1 15D56101D5 ~ ~~~ 15D561D1D5 / .......1 REV-1500 EX {FI) 250561,0205 Decedent's Marne: PBtSIe A. Nichols Decedent's Social Security Number RECAPITULATION .204-28-0817 1. Real Estate (Schedule A).... . 1. 2. Stocks and Bonds {Schedule 8} .. , , .... . 85,000.00 ......... ........ 2. 3. Closel he! Y d Corporation, Partnership or Sole-Proprietorship (Schedule C) 6,803.51 . . 4. Mortgages and Notes Receivable {Schedule D} ...... 3 4 5 Cash, Bank Deposits and Miscellaneous Personal P ro ert P y (Schedule E). , , . 5 6. Jointly Owned Property (Schedule F $6 360 10 g Requested .. , 7 Inter-Vivos Transfers & Miscellaneous NoOn_pprobate Pr (Schedule G) 6. ~ , . p eri O Separate Billing Requested .... , . . 8. Total Gross Assets (total Lines 1 throu h 7 7 9 )...... .... 100,922.32 ........... 9 Funeral Ex 8 penses and Administrative Costs (Schedule H) .. _ 279,085.93 9 10 Debts of Decedent, Mortgage Liabilities and Liens (Sch d 3,179.13 e ule Ij. , 11. Total Deductions (total Lines 9 and 10} ..... 10 1, 919.28 11. 12. Net Value of Estate (Line 8 minus Line 11) i 3 32,098.41 .. 12. . Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J} .. , . 246'9$7.52 13. 14 Net Value Subject to Tax (Line 12 minus Line 13) 1,000.00 TAX CALCULATION -SEE INSTRUCTIONS FOR AppLICABLE RATES 14. 15 Amount or Line 14 ta bl 245,9$7,52 xa e at the spousal tax rate. or transfers under Sec. ,9116 16 Amount of Line 14 taxable 0'0p 15 . at lineal rate X .0 _ 0 00 17. Amount of Line 14 taxable 0.0p ig . at sibling rate X 12 0.0~ 18. Amount of Line 14 taxable 0.00 1 ~ at collateral rate X .15 0 00 245, 987.52 . 19 TAx DuE _ 1s 36,898.13 19. 36,898.13 20 FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O L Side 2 250561,0205 1,50561,0205 REV-';SOU EX (rlj Page 3 Decedent's Complete Address: DECEDENT'S NAME Patsie A. Nichols STREET ADDRESS 615 Southview Drive CiTV Mechanicsburg Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2 Credits;Payments A. Prior Payments ___ 34,803.00 B. Discoun± _ _ _ 1,740.15 ........__......._...._.. 3 Interest ?. 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 request a refund, 5. if Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. File Number j STATE ZiP -- PA 17055 (1) 36,898.13 Total Credits (A + g } ,2} 36, 543.15 (3} 0.00 (4} (5J _ 354.98 Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCK 1. Did decedent make a transfer and: S a. retain the use or income of the property transferred ............. ..... No b. retain the right to designate who shag use the properly transferred or its income ........................................... c. retain a reversionary interest ................. . --~ d. receive the promise for life of either payments, benefits or care? ................................................... 2. If death occurred after Dec. 12, 1982. did decedent transfer property within one year of death ^ without receiving adequate consideration? ............ 3. Did decedent own an "in trust for" orpayable-upon-death bank account or security at .his or her death?........ _... ^ 4. Did decedent own an individual retirement account. annuity or other non-probate property, which ^ contains a beneficiary designation? ................ __ ...................................... ~ ~i 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 ar 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 survivin s o is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. g p use 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 4 percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent ar a stepparent of the child is 0 percent [72 P.S. §9116(a1(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{a)(1)J. • 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.;i. §9116{a)j 1.3)]. A sibling is defined, under Section 9102; as an individual who has at least one parent in common with the decedent; whether by blood or adoption. REV-1502 EX+ (01-10) ~ pennsy(vania DEPq R7MENT OF REVENUE INHERfT/WCE Tqx RETURN RESIDENT DECEDENT ESTATE OF: Patsie A. Nichols SCHEDULE Q REAL ESTATE FILE NUMBER: -~-• •~ ~~•~~~~ solery or as a tenant in common must 6e reported at fair market value, fair market value is defined as the price at which propert would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both havin Real property that is JointlY~owned with ri ht of survivorshf must be di g p g reasonable knowledge of the relevant facts, y ITEM Attach a copy of the settlement sheet if the property has been soldu'~ on Schedak f. NUMBER Include a copy of the deed showing decedent's interest if owned as tenant in common. DESCRIPTION VALUE AT DATE 1. OF DEATk 615 Southview Drive, Mechanicsburg, PA 17055 (settlement sheet attached) 85,000.00 TOTAL (Also enter on Line 1, Recapitulation,) ~ 85,000.00 If more space is needed, use additional sheets of paper of the same size. Calcula.te~l Value of r'aur ~?aper Savings Bond(s) Ca[CUtated Vatue of YQUr RaRer Savin 9S Bar~d(S~ Ca[cu[ator Resutts for RedemR'~ion Date 02/2011 page 1 of Total Price Total Vatue $650.00 $1 919,44 Total Interest $1,269.44 YTD Interest X13.12 Bands: 1-26 of 26 Seriat ~ Series Denam Issue Next Date Finaf Issue 1426564998 EE Accrual Maturity Price Interest Interest 1426550468 EE $50 12/1989 06/2011 12/2019 Pate Value t~~ote - - $50. 1.2/1989. 06/2011 1.2/2019 $25.00 $47.50 4.00% 1426557737 EE $50 12/1989 06/201.1 12/2019 $25.00 $72.60 1426535973 EE - $47,E~0 4.00% $72.60 $50 11/1989 05/2011 11/2019 $25.00 $47.Ei0 4.00% I 1426543255 EE X25.00 $72.60 1426528607 EE _ $50 1.1/1989 05/2011 11/2019 --- ~47,Ei0 4.00% $72.60 $50 10/1989: 04/2011 10/2019 ~ $25.00 _ $47.60 4.00% 1426518524 EE $50 09/1989 03 2011 09 2019 $25.00 $72.60 1404737090 EE / / $47,60_ 4.C0% $72.60 $50 _.09/1989. 03/2011 _ 09/2019 $25.00 $47.60 4.00% $72.60 1404714716 EE $50 08/1989 08/2011 _ 08 2019 $25.00 1404729791 EE / $47.60.. 4.00% $72.60 - $50_..08/1989 08/2011 _ 08/2019 $25.00 $49.04 4.00% 1404722174 EE $50_ 08/1989 08/2011_ 08/2019 $25.00 $74.04 1404702103 EE $49.04.. 4.00% $74.04 $50 ._07/1989_:_ 07/2011 _ 07/2019 ~ 00 $49,04 4.00% $74.04 1404707256 EE _ , . $25.00 ~50. 07/1989 07/2011 _ 07/2019 -$!-19'04_: 4.00% 1404684551 EE _ _ `25.00 $74.04 1404692219 EE $50 - _0.6/1989. 06/2011 06/2019 - $49.04 4, 00% $74.04 $50 06/1989. 06/2011.__...06/201.9 ` ._ $25.00 ' $49.04 4.00% 1404668776 EE $25.00 $74.04 1404675492 EE $50 05/1989 05/2011 .05/2019 49'04 _ 4.00% $74.04 $50 05/1989 05/2011 05/2019 $25.00 $49.04. 4.00% 1404652861 EE $50 04/1989 04 2011 04 2019 $25.00 $74.04 1404661128 EE / / $49.04 4.00% $74.04 $50 04/1989: 04/2011 _ 04/2019 $25.00 $49.04 4.00% $74.04 1404629512 EE _ $25.00 1404636474 EE $50__03/.1989. 03/2011 03/2019 - $49.04..__ 4.00% _ $74.04 - -- $50 03/1989_..03/2011 03/2019 25.00 $49.04 4.00% 1404645485 EE $74.04 - $25.00 $49.04 4.00% 1404621193 EE $50 03/1.989. 03/2011 03/2019 - $74.04 - $50 - 02/1989. 08/2011 __ 02/2019 $25'00 .,$_49.04 4.00% 13798860863 EE $50 02/1989. 08 2011 02 2019 $25.00 $74.04 1378852784 EE / / - $50.52., 4.00% $75.52 $50 01/1989 07/2011 01/2019 $25.00 $50.52 4.00% $75.52 11378844202 EE $50 01/1989 07/2011 01 2019 / $50.52 4.00% $75.52 Totals for 26 Bonds $25.00 $50.52 4.00% 650.00 1 269.44 $75.52 -~otes 1 919.44 NI Not Issued NE Not eligible for payment P5 Includes 3 month interest penalty MA Matured and not earnin interest tp ~ ~~~~~. treasurydirect. gov~B C/SB CPri ce Mini-,„, Ca1c~:ly+e~1 - ~'c.Lae or i'our Paper Savings Bond(s) Page 1 of 1 Calculated Value of Your Paper Savin s Bo 9 nd(s~ CaEcutator ResuEts for RedemptEOn Efate 02/201 ~ 'eEaE Trice Totat Vatue X25.00 Total Interest $77.04 YTQ Interest $52.04 $0.00 Bands: 1-1 of 1 Se-ia( ~: Series C}enom Issue htext Finat Issue Interest L351668561EE EE Qate Accrual maturity Price I,=terest _ __ X50.05 1988.05 2011.05 2018__ X25,00 ~ Rete Vai~e C~otE _ _ _ _.. ~. . - -. ---- -$5:_.04: _ 4 00% $77.04 TotaEs for 1 Bonds $25.00 X52.04 lei~tes $ 77.04 NI Not Issued __- -. E Not eligible for a ment ___ - P Y- P5 Includes 3 month interest _... .. penalty ._..._... _ MA Matured and not earnin interest http://~,-~,-~,.treasurydirect. QovB C/SBCPrice 2'9/2 (11 ~ Ca. cuhated Value of Your Paper savings Bonds j CaleuEated V'atue of Yaur Raper SavEngs Bond s (~ Calculator Results for Redemption Date 02/2011 Page 1 of TotaE Price Totai Value $100.00 Totai Interest YTD Interest $327.04 $227.04 $6.40 Bonds: 1-4 of 4 Seria! ~ Series [Oenam Issue Next Final Issue 1291563999 EE $50 €3ate 02/1987 Aceruai Maturit Y Price Interest Interest Rate Value ~,!©te 1284858108 EE $50 1 01/1987 08/2011 07/2011 02/2017 Oi/2017 $25.00 $56.76 4.00% $81.76 291573039 EE X50 1261555781 _ 02/1987 __ - 08/2011. 02/2017 $25.00 00 $25 $56,76 4.00% $81.76 EE__ _ _ $50 _ 01/19.87 .07/2011__- 0.1/2017 . $25.00 $56.76. $5Ei 76 4.00% $81.76 Totals for 4 Bonds __ ~ 100.00 . 227.04 4.00% $81.76 Notes 327.04 fYI Not Issued NE .Not eligible for payment P5 Includes 3 month interest penalty MA Matured and not earnin interest http:; /~~~.treasurydireet.gov/BC/SBCPrice 2/9/~n> > calculated ~'a~ue ~,~' yo ~. Paper Swings Bond(s) Calculated V'a(ue of Your Paper Sa - vrngs B©nd~s Cafcutatar Results for Redemption pate 02/~Q1 1 i of-~ Priee 5550.00 Totaf Va(~` 51 997.04 TotµE interest 51,347.04 Bonds: 1-26 of 26 Y3D ~rterect 513.76 Page 1 of 1 3Cer~~~ = `°+err=~ ~ ISS€!8 F ..... ... eai~?.'~ ~eXt i-:cEa~ L351696188EE EE Date Accrual Maturity pr ~q st 550 06/1988.06/2011 06 2018 1'`lets ~ Rarest L351630376EE EE - t~ ~=fue ~ L351640066EE --550 03/1988 03/20__11. 03/_ 2018 X25.00_ 552 04 4 0 y mil` EE - _ o -- -- 525.00 X77.04 ~~ X50 03/1988 03 ~ /~ L351649330EE EE - - /2011:03/2018__ 525.00 -- _550 04/1988 04/2011 04 2018 552 04 4.00% L351658393EE EE _ $52.04 4 ppojo " -- - -- _ _ / - $77.04 _-~50_04/1988.04/2011.04/2018- 525.00 L351668561EE EE --- ___ - -- ___ 525.00 -_ $ 77.04 550 05/1988 05/2011.05/2018 2 04 4.00% - - - L351677524EE EE - - --~52 04 ojo - --- ___ X50 05/1988 _05/2011 05/2018 525.00 $52 04 4.00% L351687124EE EE $77 D4 7.04 ... L351619628EE_ , ..EE 550 06/1988 06/2011 06/2018 525._ Op - '52.04 4.00°j ~ -- - - . 550 03/1988 03 -- _ 552 G4 ° ° L378811384EE EE ~°` " _..= 4 00 /o $77 04 --~ __.. /2011 03/2018_ 525 00 L378801622EE .~50 11/1988 05_/2011: 11~ ~ 55 .04 `~ - .. ~ ......._.., ._ .. /2018... EE 00% .... .... . _ . _$77 04 550 09 1988 03 525 00 "2"""` ~ 4 . L378786460EE EE ~~~ .50.52 4 00% ...._ _. /2011 09/2018 ~ 550 52 4 0 -` ,$75 52 .. .- - -- ~ --...- .._ X50 10/1988.04/2011. 10/?018 _...,525 00 ... ' . L378793467EE ... ..............._ ..... $50.52 4 00% _ .. EE.... 550 10/1988 04 ......525 00 00 / $75 52 L378733429EE EE ._..../2011. 10/?018 ~ ` - - - __... 5 75 52 ..... X25.00 -_.550 07/1988 07/2011 07 2018 -- ~. L378742293EE EE - - 5 ._- -~5 __ -~- /... 4:. _ ,75 .. _.550 07 1988 07 -...... 525.00 ;_50.04 ~~% .52 ~ - L378750960EE EE ~ -.__._./2011: 07/2.018- X25 00 _ ,$77.04 _ / -- _ ___.~52 04, 4.00% L378759636EE EE 550 08/1988 08/2011.08,2018 X25.00 7, 04 °- -~-- .. 550 08/1988 08/2011 08/2018 5 4 00 ° $7 L378768357EE ~ 55 $77,04 ._... L378776831EE ~ - .550 08/1988 08/2011 08/2018 ~~ - 552 04 4 00°/0 7 04 L378819630EE~ ~E 550 09 1988 03 525 00 552 04 0/ _ ~ /2011:09/?018- ._._.. __ ...._ .._ 25 00 _ . 4 00 ° _ . EE . _ .. $77 04 - _. _ - 550 11/1988 05/2011 11/2018 L378827853EE S50 52 4 00% _..... 525 0C ~~5.52 E 550 12 1988 __ __._ ~- _ 06/2011 12/2018 550 52 - 4 00% _ L378836061EE- EE _ ~- _ _. 550 12 Io --~ - 5.25 00 X75 52 L336831505EE_ EE - ~ _88 06/2011. 12/2018 _.~50 52 _._._4.00% - - $75 52 550 01/1988 07/2011__01/2018 525.00__ L336841265EE - 55.0 52 4 00% -~ _ 550 01/1988 07/2011.01/2018 ~-25 00 - - 4 00 o S75 52 L351601157EE EE 553 58 0/ EE $78 58 550 0.2/1988 08 _- $_25 00 L35161092gE~ 553 58 of _ - 4 _ _/2011. _02/2018 - EE 5 / 525.00 00 __ __ 50 02 1988 08/2011 ' 02/20. 18 _ _78.58 _ $53 58 4 00% -_ Totals for 26 Bonds - 5-25 00_ 553 58 - o $78 58 5650.00 __$78 58 S1 347.04 - !~`vtes S 1 99 7.04 NI _ Not Issued NE Not eligible for a- -- - p _.yment . - - -- P5 Includes 3 month interest penelty - - P9Q Matured and not earnin inter ,.rest http ~~ ~w~'w.treasurvdirect. gov/B C/SB CPrice ,,, ,.. Calculated Value n_.f Your Pager Savings Bond(s) Calculated ~/afue of Your Paper Savf n9s Bond(s) Calculator Results for RedemptEOn Date 02/2QZ1 Tatat Price Total Value $475.00 $1 355.30 Total Inte $880,30 Bands: Y-I9 of 19 Seriat ~ Series Denom Issue Next Date t<inal 1456229909 EE Accrual Maturity 1456223604 EE $50 09/1990 03/2011 09/2020 1456218133 _: EE - $50 09/1990 ; 03/2011 ; 09/2020 1456211078 EE $50 08/1990 08/2011 08/2020 1456204640 EE -$5~ 08/1990_, 08/2011. 08/2020 1456198953 EE $50-- 07/1990 07/2011 07/2020 1436090089_- EE $50. 07/1990 07/2011. 07/2020 1436096995 EE $50 06/1990 06/2011_. 06/2020 1456191535 EE $50 06/1990. 06/2011 06/2020 1436076300 EE $50 06/1990 06/2011 06/2020 1436083212 EE $50 05/1990 05/2011 05/2p20: 1436070366 EE $50 05/1990 05/2011 05/2020: 1436062713 EE $50 .04/1990 04/2011 04/2020 1436055615 EE - $50 04/1990; 04/2011 04/2020 _ $50 03/1990: _ 03/2011.^ 03/2020.,... 1436048573 _ EE $50 _.0.3/1990 03/2011: 03/2020. 1436034495 EE 1436041522 EE $50 02/1990.: 08/2011 02/2020 1436027339 EE $50-_02/1990:__08/2011 02/2020 1426572132 EE $50-- 01/1990 07/2011: 01/2020 _ _ -_ _ $50_ 01/1990 07/2011.. 01/2020 Totals for 19 Bonds ., _ . NI -Not Issued VJ NE Not eligible for payment P5 Includes 3 month interest penalty MA Matured and not earnin interest ttp ~!%~~~.treasurydirect.gov/BC/SBCPrice Issue Price Interest $25.00. $44.7 8 _ $25.00 $44.78 $25.00 $46.18 $25,00 $46.18 $25_.00 $46.18 $25.00 $46.18 $25.00 $46.18 _.$25.00_ $46.18 $25.00 $46.18 $25.00 __ $46.18 $25.00 $46.18 _$25.00___.$46.18 $25.00 $46.18 $25.00 $46.18 $25.00 $46.18 $25.00 $47.60 $25.00._ $47.60 $25.00 $47.60 $25.00 $47.60 475.00. $880.30 Int Rate 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4,00% 4.00% 4, 00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% ~. YT® Interest _ $11.28 Value $69.78 $69.78 $71.18 ...$71.18 $71.18 $71.18 $71.18 $71.18 $71.18 $71.18 $71.18 $71.18 _.$71.18 $71.18 $71.18 $ 72.60 $72.60 $72.60 $72.60 1,355.30 Page 1 of Mate ^~ in r, ., Investor Relations -Prudential Financial -Historical Price L,ooku P Page 1 of 1 ~~ im~estor Relations > Historical Price Lookup Historical Price Lookup Pruir This Paae I - _ rteceive ~-n'ia;: A;ertc,~'/ StocK Quote ~ Stoci: Chart I Historical Price Lookup ~ Investment Calculator Symbol PRU (Common Stock) Lookup Date December 29 2010 Lo UkoLo Uko p Results Date Requested 12/29/10 Closing Price ;58.950 Volume 2,024,804 Split Adjustment Factor 1.0000:1 Open $59.660 Day's High $59.750 Day's Low $58.950 NAT Cics nc : rice, D -~c i, y -~9h, a 's Low since ne date s~eva~i Y and Day's'JOiume ~av2 been aa)wtE...o account e ShDw( a DVe aDO e TRe ACCL Grp!' ~: n t ad]US'.ed for np6 Cc Or di yipene r n4 'CJCk S(ili n ~Or aiviDengs which ~Pnt ~ ~t~tr ,tint . a ~cr s ray nave Dccu rreG for this seNri[y o t imwanve acwr ~xhich encapsu~aieS all Splits since the dale Ths Josirg price above ~, n:,t necessariry ~ndcative Dt rut~re prce perrcr-mance_ INVESTOR RELATIONS I PRIVACY I BUSINESS INTEGRITY TERMS AND CONDTIONS anaal, Inc. and its related entities. http://www,investor.prudential.com/phoenix.zhtml?c=129695&p=irol-stockLoo - kup&t-Hi... 9/22_~~n> > Prudential IMPORTANT TAX RETURN DOCUMENT ENCLOSED _® R AUTO 5 DIGIT 17055 000648/0224108 IIIir1111111i1r11 r t hr Irl rl r IlrirILIIIIrrL7iII ' (IOB IIII I III II I I I v Recipient PATSIE A NICHOLS 615 SOUTHVIEW DR MECHANICSBURG PA 17055-5750 s ~.ompute s are Computershare PO Box 43033 INithin USA, iJS territories & Canadace, RI 02940-3033 Outside USA, US territories b Canada 800 305 9404 732 512 3782 vwvw.computershare.com/investor Holder Account Number 00002012774 I N D Record Date Check Number Now 23 2010 . SSN/TiN Certified 0010081119 Prudenfia! Financial, lnc. -Combined Dividend P Yes OOI CS0107.D0 \1LNGEQS_PG I.PRL.01aF-2 107!?2J I OR;__'4I OR%i (~ ayment 12010 Tax Form 1pgg.plV Corrected (if checked) ---- -- ___- Form 1099 -DIV -Dividends and Distributions 2010 This is important tax information and is being famished to the Intemal Revenue Service, If you are regCOd to B a returna neg Bence penalty or other sanction may be imposed on yourf this income is taxable and the IRS determines that it has not been reported. Recipient PATSIE A NICHOLS 615 SOUTHVIEW DR tvIECHANICSBURG PA 17055-5750 JloialOrtlinary ibi Qualified~l Nondividend d! Dividends ($) Dividends {$) Distributions ~$ FEDERAL INCOME s iForeign Tax (; I Foreign Coun t) TAX WITHHELD I~"-' ~ 33.35 33.35 (Sl Paid (S) or U.S. Possession 0.00 0.00 Form 1099-DIV Dividend Confirmation I Payment Date 17 Dec 2010 (Keep for your records) Class Description j Participating I Dividend Shares/Units Gross Rate Dividend ($j COMMON 29 - 51.15000 33.35 Year-To•Date Paid 33.35 ;5?GO~q OORX6A-PP-(F2) 46UTX Account Number Recipient's ID No e di 00002012774 . n ng in Payer's FederallD N ...., -0817 o. 22.3703799 OMB No. De~artrraol of the 7rea,~r ~ . 1545-0110 r Intemal Revenue Service ~qu~aation I Distri. ($) 0.00 Deduction Amo- ant ($~ 0.00 0.00 Payer's Details PRUDENTIAL FINANCI ILA NC CIO COiJIPUTERSHARE P.O. BOX 43010 PP,OVIDENCE RI 02940-3010 Deduction I ---~ TYPe Dividend ($) N/A 33.35 33.35 P R U ..~. ranter friendly Page 1 of 1 Today is: 01/10,2011 User: nsmith5 Name: Nicholas Smith . Branch: 0168 , L ~, ~ ~. 'v.. G .~i C. `v ~..'.' N CGNTACT INF ORf~;ATION F lid nt'anti~ ~"~ PATSIE A NICHOLS CLOSE A^ COUNT -CLOSING 5A! A SSN/'IN: 204-28-0817 Email: NCE r-vlev ,h - Close Ac.:o!in~ , J .~ r - I ' ' " ~~tions." ~ S leer S p ii " ~ Home Phone: (717) 697-9700 . Work Phone: Czli Phone: _ ~ = Log A Customer P Fax Phone: roblem HOME EQUITY - PRE- ISELECT-D -TAKE App -~-% ~QC ';:5'0!57@' CnC510n F- I •,-.~cuntNu;~~~er 057?1^0~a5 Close Account Wrap-up Instructions: V 1. Confirm that you have delinked this account from an 2. Notify the customer tc cancel an ~ p 1 external re-authorized debit or credit transactions assoc,ated with this acc BiIIPay transactions. 3 Confirm with the customer that all transactions againstbh skac o(unt ha Pe cleared; includin punt. g all outstanding checks, bankcard transactions and/or ! o co'Tp1ete the clesing of this account, fill out the Checkin Savines of: and Mone Market Close-Gut Withdrawal ticket with the Gosin balance a ~~ The closing balance was derived from: w26,Ei '{,j$ g mount Ledger Balance 5 26, 571.58 50.00 (51.;q gccrued Interest was forteited) 50.00 (Memo Credits) 50.00 (Mutual Funds) 50.00 (Temporary Holds) 50.00 (Fed Tax Withheld) Closing Balance 526.571.58 h~p:,'imiddle«-are.sovereignbank,com/printFriendIy. jsp?needS'a= iy no renter Friendl~~ Today is: Oi/10/2011 ...Lt..v~ n",~CGuN i CONTACT INFGRMATIGN PATSIE A NICHOLS SSN/TIN: 204-28-0817 Email: Home Phone: (717) 697-97D0 Work Phone: Cell Phone: Fax Phone: HOME EQUITY - PRE- SELECTED -TAKE APP --' User: nsmith5 Name: Nicholas Smith Branch: 0168 CLOSc ACCOUNT -CLOSING BALANCE revia4h ,h r.., 5,:1...,. ...,bmi,, ~.._,,~r'pU^,+dJ' -.^;i„c'.i. ~~CiO~^,5. r Log A Customer Problem Pale 1 of 1 "~^""'~ S~~sior, CL 31NC BALANCE - a-cculi Nur,1.~,er D57113g7-a Ciose Account Wrap-up Instructions: 1. Confirm that you have delinked thi_c account from any bankcard(s), if a 2 Notify the customer to cancel any external pre-authorized debit or credit transactions associated with this account 3. Confirm with the customer that all transactions a PPlicable. BiIIPay transactions. gainst this account have cleared, including all outstanding checks, bankcard tra Tc complete the closin of this nsactions andlor ef: 9 account. rill out the Checkin Savines and Mone Market Close-Ou' VY--~wai ticke, with the ciesin r _ g balance amount he closing balance was derived from: ~3E, i '~ 3.2~ Ledger Balance 5 35, 713.26 50.00 (84.78 Accrued Interest was forfeited) SC.00 (tNemo Crediis) 50.00 (Mutual Funds) 50.00 (Temporary Holds) 50.00 (Fed Tax wthheid) Closing Balance 536, 713.26 hrip://middl eware. sovereignbatilc. com/printFriendly, j sp?needSig=no 1/10/201 ~ Balances its/Credits x14,484.36 Current.Balance + 32,4 i 1.25 Avera e J 32fi Rca~ a, 9 ails Balance Interest -Paid this Period * Earned this Period 3 0.00 ,4nnual Percentage Yield Earned Paid' Year-To-Date 8 0 00 Paid Last Year *The interest earned and the interest paid may differ depe dung on when interest is credited to Checks Posted your account. Check # Date Paid Amount Reference 3871: 12!22 $36.D0 97464D38D 2 Check(s) Posted = $124.03 .An asterisk (*) indicates a skip in sequential check numbers. Account Activity Date Description 12-22 Beginning Balance 12-22 ATM CASH VI/!D 003852 SOVEREIGN 990LDYORKR __ _ NEW CUMBERLANPA 12-22 CHECK --- 3871 ------- CHECK---- --- ---------- _ _ 3872 _ 12-30 PA TREASURY DEPT ANNUIT,~;NT 101230 ----- - 036047 -------- - , v v~uStNG 7'RAN -23 Ending Balance PQOe 2 of3 Check # Date Paid x.00 3?~ 251-43 O.DO% 322.39 Amount R f 3872 ---- 12/27 e erence $88.03 975353775 An (E) indicates check was convert d e to an electronic item. Additions Subtractions Balance '$100 00 $24,484.36 . .324.384.36 - ---- - -------836.00 - -- - - ~__-- --- 324,348.36 - ------$2,411.25 -- - $88.03 - -- $24.260.33 - -----___ ---- ~~b,671.58 $25:;671.58 30.00 ~'I130925 ~c:count # 579 93pg25 Your account is currently at a zero balance. If your account remains at a zer statement periods with no activity, your account may be closed. Please de osi quickly to prevent it from closing. If this account is not meetin ° balance for two entire discuss other options with you. P t funds into this account g your needs, it would be our pleasure to Balances Beginning Balance Deposits/Credits Withdrawals/Debits ` Checks Posted Check # Date Paid Amount Reference _ 101 01/13 102 01/13 5323.50 971053420 -?~' E103 0111$ 31.395 00 971053415 i 04 01/18 344.82, _ .Allied Was _ 105. 01/'14 539.71 982_577120 K-- 10_ 01__ ------ 01125 --39.24.94 ~'---- 971---- 338700_ 1002 01125 336- 745 984451950 :c- 1004' 01/26 89.04 973027245: 37,495.12 993697550 i5 Check(s) Posted = 311,628.99 An asterisk (') indicates a skip in sequenti l Account Activity a check n umbers. Date Description 01-10 Beginning Balan ce -iii. i~r'V.~iT 01-13 CHEC 2 01-13 CHECK 101 _ O1-i4 CHECK 105 ----- - :.01-1.8: CHECK __ 1 D4 ---- ---------. 01-18 Allied Waste Sv E K PYMT 011711 ____ ~---- ~ 0103 01-25 CHECK - - - ~ ( 01-2 CK 1010 _ „-_ 1001 --~ -- ----- --- i" .._.,".,,~~,c~zc:HECKPAYMT-`110125---------- - 101 ; ---- -- ~o3y.T1 --------____-- - ------- 380,417.16- - C1-%5 - :~1 ~ - -- DiSGO'JER ARC P -- AYME S 101241 --- -------- 3367.45 ---- - 3246.83 ----~ --- 360.049.71 359 ~~ - 5 008 -- ----- -- ---- C!-iECK 1009, ,802.88 01-25 CFiECK 1002 --- ----- 3118 01 - C1-25' _ ---- ZEV PIPI ON.P,P,G CHECK PY ----- ' - MT 11 . -- ---- S93.03 - --- - 559.684.87 _ -- _ 0124 1006 -- ------ -- -- 389 04 - - 359 591.84 - -- 01-26 CHECK 1004 --- - - - -- 569 56 -- 559,502.80 _ - 01-27 ---- -- AT~T SERVICES C ----- HECKPAYMT 012611 ---- - . -- _--- - 359,433.24 01-31 1007 ----- CHECK ~-_ 67 495 '~ 2 - ----- ---- _ _ --- ---- 851.938.12 0202-06 -- 1005 --~__ EEnding Balance ----- -- _ 391.40 __ __ 351,846.72 ~_'_ 3 8 351,755.85 ~cr°e? r7/3 30.00 Current Balance `- + $63,384 84 Average Daily Balance 311;628.99: ~-+~c,vunt ~# 1401445764 351 755.85 357 3- 47- g~ Check # Date Paid 't` 1005_ Amount Reference E1_Opg __01131 01!25 $90.87 994314675` '~ E'i- 007 ; __ 01/27 ' 369.56 VERfZON AR E 1008 ~ 01/25 391:40 AT&T SERVi '1009 __~ - 01,25 3118.01 DISCOVER A 3` 1010 ---- -- _ 01!25 393.03 _- 9846 - ~ E1011 __ 01/25 3539.71 973005465 3246.83 RETAIL SER` An (E) indicates check was converted to an electronic item. Additions Subtractions Balance a~o3,384.8; 30.00 ~------- _ 363,384.84 -----_- 31,395.00 ---~ ---~_ __ 361,989.84 - -- -- -- 3323 50 - -~~_ -- ---- --- _ _ 3fi 1, 666.34 - -- $124.94 361,54140 -- -- 9 71 _- 361,00 61 g - 344.82 -86r-856.87 140144 764 ~~wunt # 1409445764 Balances Beginning Balance Deposits/Credits $51;,755.85 - Curr~nf Balance ` Wrthd~awals/Debits + $7,189.86 Average Daily Balanc ' $56 692 74 Checks Posted $2.;252.97 e , . . $55,733.71 Check # Date Paid Amount Reference ?:003 02/15 $798.80 E1013' 02/07 9Z7594D10 Check # Date Paid Amount Reference iD14 543.52 02/11 X68.13 1015 ATB,T SERVI --- 9 1076 -.- ~2~14 1018' 02/16 $14.4,28 98076970Q 02/15 $79.50 __ 8D~6510 981114510 1:019 ~ ----- X2/24 $450.00 977702780 8 Check(s) Posted = $2,175.93 1020 02/24 $141:70 $450 00 971246895 An asterisk (`) indic t . 97124&900 a es a skip in sequential check ACCOUnt ACtlVit numbers. An (E) i d y n icates check was convert Date Description ed to a n electronic item. 02-07 Beginning Balance ~ Additions Subtractio 02-07 AT8,T SERVICES CHECKPAY ns Balance MT 02D511 ..1013.:. 02-09 DEPOSIT - -- $43 52 $51,755.85 02-1"1 CHECK - 1014 _ , . ' $51,712.33 02-14 C~EPOSIT--------- --- --- $1,190.00 02-14 CHECK -- 1016 -- -------- ------- $68 13 " $52 902.33 _ 02-15 E ----~--_-_ 1003 ----- - -- ---- - $5- 6__75.66 . -__ ~52,834:2D _ 02-15 CHECK 1015 ___--___-_---- _ - -~--- $144 28 $58,510.06 02-15 SOVEREIGN ADJ SVCS 02152p - . ~- ~- . $798.80 X58,365.78 201102150830 - - $57,566.98 02-16 CHECK 1018 $i7 04 --- $57,487:48': ~~-- 02-24 CHECK 1020 --- - ---- . $57,410.44 -02 24; ;CHECK _: 1019 03-03 DEPOSIT --~_ $450.00 $6;960.44 03-06 Ending Balance ----___ ~_ _ $450.00 _$141 7D $56,510.44 __ $324.00 . $56,368:74 -- $56, 692.74 $56,692.74 page l o~ 3 14014.15?6-/ ESTATE OF PATSIE A Q /~l Balances redits ~5ti,692.74 Checks Posted Date Description Check # Date Paid Amount Reference 9021 __ _-_ 03/11 1022 ----- 03.18 $40_90 98593_ 7 g70, 1023 03130 --- - 3400.00 - --- ~ -987815$5 1026` --- --- 03/24 210.89 __ 534,803 00 97_ 0216860 . 977061920 8 Check(s) Posted = 539,454.79 An asterisk (`) indicates a skip in se Account Activity quential check numbers. t Balance e Dailye DB1iy ga an elan el Account # 1401445764 825,7pg 76 844.759.83 Check # Date Paid 1027 Amount Reference _ _---- 1028 - --_ 03;29 - u4~O ----81~~uD.OD 981669335 _ _..1029 -- ~- q 04/04 - S~ OOO.OG -___-'_-_---- 622177 p 1030 04/04 --51'Q00,00- ~7758~ 31,000.00 622177560 An (E) indicates check was converted to an electronic item. 03-07 03 Beginning Balance Additions Subtracti -11 --- CHECK 1021 - ons ~ Batance 03-18 _ CHECK ---1022 - -- 03-Z3 DEPOSIT --~ - - --~- --- ---------- 540 90 556,692.74 03-24 _ _ CHECK - --1026 -- ~------ -- . ~---~ -- ---- 8400 00 356,659.84 - 03-29 - CHECK---- -- 1027 - . ------------ 58,470.81 --- ~ - ----- ---- 856,251.84 _ _03-30 _ --F ------------ H_CK 1023 --------- --------------- - - ----- --- - -~-- ----- 534.803 00 8 65 -- _ -- - _ D4-04 _ _ CHECK -- _ 1030 - . ___------------.- - _ ------- 81,n00:n0 529.919.65 -- 04-C4 _ CHECK -- - , 029------ -_ _ ----- _-- -- ~10 89 - ~~R caio { - _'.. _ ..,.6_ 8 04-04 CHECK - --- 1028 - ----`-------- _ -- ------- 51,000 00 52 708.76 04-05 Ending Balance ---_-- . - _ ~ 81,000 00 -- - 527,708.76: - --- _ . 51,000 00 62 6.708.76 . $25, 708.78 I1V CASE OF ERRORS OR QUESTIONS r s v • ~~ C-`~-L YOUR CliSTOMER SERVICE CENTER AT THE NUMBER SHOWN p YOLi FOR DEBIT CARD IssuES: R ELECTRONIC TRANSFERS T~ TOP OF YOUR STATEMENT OR yt'RITE TO THE BANK Sovereign Bank FOR ALL OTHER ISSCIES Attn: Card Disputes Team MA 1 MB3 02 OS Sovereign Bank P.O. Box 831002 Attn: Client Relations Boston MA 02283.1002 10-421-CRI P.O. BOX 12646 Please contact us ifyou think your statement or receipt is wTOn READING, PA 196]2.2646 «'e must hear front you no later than 60 days after we sent you the FIRST • Tell us your name and account number. g or if you need additional information about a transfer on the statement or receipt. • Tell us the dollar amount of the suspected error. statement on which the error appeared. • Describe the error or the transfer that you are unsure about and explain as clearly as you If you tell us orally, we ma , can why you believe there is an error or why you need further info }require you to send your com laint or }fie will promptly investigate the matter and call or write to you with an answer within ] 0 basin budav~ sl0 cs rmation. need more time, we may take up to 45 days to investigate your com taint or put }our complaint or~questi~one nou~ritirig and~uhe do not recei~e Revithin 10 busm _ P question. If we do we will cTeditalourdaccdount~within this 10-day money during the time it takes us to complete our investigatton aIf ueeask you to For errors im~olving neu' accounts, ess days, we may choose not to credit your account. Period question. For neu- accounts, we maptake of sale purchases or forei y p to 20 business days t gored t } out°accoun for tt~e a nount you think is in error. ~~e will tell you the results of our im~estio p P to 90 days to investigate your c send you a aTitten explanation. I'ou ma .°ation within 3 business days after com letin our investigation. If we decide there u, °mplamt or y ask for copies of the documents we used in our im~estigation. Important information about your Sovereign Debit Card ~ °o error, we will The networks through which some of your Sovereign Debit Card without either a signature or a PIN. If`you are not required to enterurchases are processed have begun allowin through the Visa network or throw h the ST g AR or NYCE networks. Ifyour You make a purchase, ou gppmuuerchants to process your and you will not be eligible for the rights and protections available th ough ~ isahePlease see your Personal De osit information. purchase is processed through STARrchase may be processed e the ases or NYCE. different terms apply Pale Z of ~ P Account Agreement for more 1401445764 cSTATE OF PATSIE A Q N/CHOLS GARY B QUIGLEY Balances Beginning Balance Deposits/Credits lNithdrawalslDebits Ghecks Posted Check # Date Paid $25,708.76 Curreh# Balance + $0.00 Average Daily Balance `- 5452.39 Amount Reference 1D31 04108.._ 1032 6145.00 98425937ti` 04/15 623.84 986265360 4 Check(s) Posted = 6452.39 An asterisk (') indicates a skip in sequential check numbers. Account Activity Date Description Check # Date Paid Amount Reference 103_ 3 ______- 04/20 1034 X155.49 :975069940 05/04 6128.06 997489595 An (E) indicates check was converted to an electronic item. 04-06 Beginning Balance Additions Subtractions D4-08. - ~ '-CHECK 1031 Balance 04-1 S CHEC!'--- 1032 --- ---- - -- -- 625,708.76 04-2D _ ___ CHECK 1033 - ------ ----- - -- 6145.00 ---- X25,563.76 05-04 ----~_ CHECK 1034 ------------ ----- __ 623.84 - ---_-__ ~ --- ----625,5 g 05-05 Ending Balance -----_-- --- -- X155.49 ' $25, 83 q 4343 51 6 - - ~2 6 CALL YOUR CUSTOMER BEI~VI E C~EN~7E R ~R ~E NUMB~R SHOB~ ON Tl~ TOP pp CTRONIC T t FOR DEBIT CARD ISSUES: RAI\SFERS ~ OLR STA7'EI\TE?~,rT OR WRITE TO THE BANK Sovereign Bank FOR AL Attn: Card Disputes Team MAI MB3 02 OS P.O. Boa 831002 Boston MA 02283.1002 L OTHER ISSUES: Sovereign Bank Attn: Client Relations 10-421-CR I p O. BOa 12646 Please contact us ifyou think your statement or recei t is wrong READING, 1'A [9612-2646 ~~'e must hear from you no later than 60 da ~ P or ifvou need additional information about a transfer on the statement or receipt. 1s after we sent you the FIRST statement on which the error a • Tell us vour name and account number. • Tell us the dollar amount of the suspected error. • pPeared. Describe the error or the transfer [hat you are unsure about and explain as clearh~ as you . can why you believe there is an error or ~~-1»~ you need fuRher information. If you tell us oralh~_ we ma} require you to send your complaint or question in writing within 10 business days. «'e will promptly im-estigate the matter and call or write to you with an answer within 10 business days (10 calendar days in Massacl need more time, we may take up to 45 days to investigate your complaint or question. If we do, we will credit your account within this 10-d nrsetts). If we put vourrcomplaint orrque tion rnowrrtlrig andrwetdoenort recei~etit wrthnn 10 business days. we m a~ period the time it takes us to complete our investigation. if we ask you to question. For new accounts, we may take u a} choose not ro credit vour account. - For errors im~olvine new accowrts, point of sale purchases or foreign transactions. we may take up to 90 days to investigate pour com I p to 20 husiness days to credit vour account for the amount you think is in error. ~>.'e wrll tell you the results of our investig P p amt or send you a ~+ritten explanation. Y'ou may ask for copies of the documents we used in our investigation. anon ~iithin 3 husiness days after com letine our investigation. ff we decide there ~+as no error, «e N ill Important information about your Sovereia The nehvorks through which some of vour Sovereign Debit Card purchases are processed have beeunarll~ dine merchants to process vo^ without either a signature or a PIN. If you are not required to enter your PIN ~~-hen you make a purchase, your purchase may be rocessed through the Visa network or through the STAR or NyCE netw ~ p inforntation. ` and you will not he eligihle for the rights and protections aaailable through y isa. Please see your Personal Deposit Account Agrepement fr purchases orks. lfvour urchase is ro~essed through STAF; or Nl'CE. different termsrapph- or more P~°e ? oft Account # 1401445764 525,256.37 625,465.2 1401445764 ESTATE OF PATSIE A Q N/CHOLS GARYB QUIGLEY Balances Begtnnng Balance Deposits/Credits $25.256.37 WithdrawalslDebits + $10,214.49 - $28.;49 Checks Posted Check # Date Paid Amount Reference 1035 06/02 $28.49 97619129D" 1 Check(s) Posted = $28.49 An asterisk (') indicates a skip in sequential check numbers. Account Activity Date Description 05-06 Beginning Balance 05-12 DEPOSIT 05-24 DEPOSIT-------------- ______ :06-02 >CHECK ~n~~ -- ------ g Ba Currenf Balance Average Daily Balance Check # Date Paid Account # 1401445764 535 442.37 52,926.43 Amount Reference An (E) indicates check was converted to an electronic item. Additions Subtractions Balance 51,008.12 $25,256.37 S9,206.37 -------__ $26,264.49- -- -------------- $3 6 c:=,I.L YOLrR CUSi o C ~S E OF I~RROR ~ OR,QE ESTEONSI CBO ~T T[OURP LECTRONIC TRANSFERS FOR DEBIT CARD ISSUES: ~~ r T ' yOL...,TA.._11L-NT OP, l~',^,IT E TO T1iE D ;_*:v Sovereign Bank FOR .ALL OTHER ISSLJES: Attn: Card Disputes Team Sovereign Bank MAl MB3 02 OS Attn: Client Relations P.O. Box 831002 ) 0-421-CR 1 Boston MA 02283-1002 P.O. BOX 12646 READ[NG. PA 1 96 1 2-2646 Please contact us if you think your statement or receipt is ~+~ong or if you need additional inforntation about a transfer on the statement or recei t. ~'e must hear from you no later than 60 days after we sent you the FIRST statement on which the error appeared. • Tell us your name and account number. P • Tell us the dollar amount of the suspected error. • Describe the error nr the transfer that you are unsure about and explain as clearh~ as you } you believe there is an error or why you need further information. If you tell us orally, we may require you to send your complaint or question in tiTiting within ] 0 business days. w'e ~~-ill promptly im'estieate the matter and call or write to you u°ith an answer within 10 business days (] 0 calendar days in Massachuse - need more time, we may take up to 45 days to investisate your complaint or question. If we do. we ~i tll credit your account within this 10-da for the amount you thinl: is in error, so you will have the use of the money dunng the time it takes us to complete our investieation_ If we ask _~'ou put your complaint or question in writing and we do not receive it within 10 business days, we rna + tta1. If u~e } period For errors involvine new accounts, point of sale purchases or foreign transactions, we may take u }to 19 ose not to credit your account. to question. For neu accounts, we may take up to 20 business days to credit your account for the amount you think rs in error. P 0 days to investigate your complaint or V~`e will tell you the results of our investieation ~s~ithin 3 business days after completing our im~estigation. If we decide there Sias no error, we ~~ ill send you a ~tiTitten explanation. 1'ou may ask for copies of the documents we used in our investigation. Important information about your Sovereign Debit Card The networks through which some ofvour Sovereign Debit Card purchases are processed have be un allowino p ~i ithout either a signature or a PIN. ]f~you are not required to enter your PIN when you make a purchase, your urchase mar b through the Visa network or through the STAR or NYCE networks. IfyourPurchase is processedghrough ST~ merchants to rocess vrnrr purchases information. - e pprocessed either and you ~~ ill not be eligible for the rights and protections available tfvough ~ isa. Please see your Personal Deposit Account Agreement for more R or NYCE, different terms apply page 1 of ~ 1401 d-15,'64 account # 1409445764 Balances uance .~;+~ C~Iecks Rusted ;759.72 ,Current Balance + 80.00 Average Daily Balance ,000.00.:... Check # Date Paid Amount Reference 1039 D7/06 55,000.00 995551615 1 Check(s) Posted = $5,000.00 An asterisk (*) indicates a skip in sequential check numbers. ACCOIint ACttVlt)/ Date Description Check # Date Paid $103,759.72 5103,759.72 -__ , Amount Reference An {E) indicates check was converted to an electronic item. 07-06 Beginning Balance 07-06 CHECK ' _ 1039 OS-07 Ending Balance Additions Subtractions Balance 5108.759.72 55;000.00 X103,759.72 $103,759.72 IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR ELECTRONIC TRANSFERS CALL 1"OL`R CUSTOMER SER~7CE CENTER AT THE N1~ FOR DEBIT CARP ISSUES: UMBER .SHOV,'N ON THE TOP OF Y UPs7~ ~TEMENT OR ~rRITE T "'~ O Ti-IE BANk Soy ereign Bank FOR ALL OTHER IS .Attn: Card Disputes Team ~~:`ES: MA 1 IviB3 02 Oj Siii~~reien Bank p-O. [3ox 831002 Attn: Client Relations Boston MA 022 ) Ci-421-GR I 83-]002 P_O. BOA 12646 Ple;ice contact us if you think your statement ar recei t is ia~TOna READING. PA 19F, I2_L6.}6 ~~ e must hear from you no later than 60 days after t+~e sent you the FIRST statement on which the error appeared. P or if you need additional information about a trznsfer on the statement or receipt. • Tell us ~-our name and account number. • Tell us The dollar amount of the suspected error. ~ Lleseribe the error or the transfer that you are mrsure about and explain as clearly as ~~ou if vrni tell us oralh. we may require you to send your complaint~or question n Iwritinle u~thint~l Orbusinress~da~su need further infom~ation_ ~~1`e N-ill prompilv investigate the matter and call or r~~rite toy • need more time. we may take up to 4j days to im~estieate your complaint or question. If we do, we ~s;ll credit your accou ou ~+~ith an ans~i-er ~~ ithin ] 0 business days (10 calendar days in tvlassachusettsl. if ~ti-e put }ouatcomiplaintt ur~questinneiii tirihna and~werdo not receivetite~ithiu `10 business days...+e may the time it takes us to cum lete our im~estigalion~lf gee •d~ Penod choose not to credit your account. ~ ou to For errors nvoh ine net. accounts. point of sale purchases or liireign transactions, .+e may tape up to 90 day pki investio question. For ne~~~ accounts. we may tale up to 20 husiness days to credit your account for the amount you think is ir, error. ~~e N-ill tell ~-ou the results of our im~esti~ation within 3 business da}'s after completing our investieation. If we deride there ~ ur complaint or send you a written ecplanation. 1'ou mac~ask for copies of the documents we ,-iced in our investigation_ as ^o error, ~~e will Important information about your Socerei« The neta~orls through ~~~hich some ofvour Sovereien Debit Card purchases are processed hate he ~n a~lln ~ing merchants to process vo through the Visa neh~ork or through the S' , ~+ithout either a signature or a PIN. (f~.ou are not required to enter your PIN w-hen you make a purchase. your purchase may be rocesse information. - p d either FaR or N1'CE neh~~orks. If your purchase is processed through STAR or N)'CF: different terms apply and you ~+°ill not be eligible for the rights and rotections available through \ isa. Please see your Personal De osit Account A~~ ur purchases p ~reement for more paor ? o/~ ~ ,~„~, Balances redits ~1o3,7ss.~z + Sd.00 - 50. $ t03.75g, 72 103.]59.72 IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR ELECTRONIC TRANSFE CALL 1'OLrR CUSTOMER SERI'1CE CENTER AT THE NUMBER SHOV,'N FOR DEBIT G4}ZD 1SSUES: ON THE TOP OF YOUR STATEMENT OR WRS E TO THE BANK Sovereign Bank FOR Attn: Card Disputes Team MAI MB3 02 OS P.O. Box 831002 Boston MA 02283-1002 ALL OTHER ISSUES: Sovereign Bank Attn: Gent Relations 10-421-CR I P.O. BOX 12646 READING, PA 1 96 1 2-2646 Please contact us if you think your statement or receipt is HTOng or if you need additional information about a transfer on the statement or recei t. ~%e must hear from you no later than 60 days after we sent you the FI(~ST statement on which the error appeared. • Tell us vour name and account number. p • Tell us the dollar amount of the suspected error. • Describe the error or the transfer that you are unsure about and explain as clearly as you If you tell us orally, we may require you to send your complaint or question m writing withinnl0 bus Hess days. } you need further information. }~'e will promptly investigate the matter and call or write to you with an answer within 10 business da3~s (10 calendar days in Massachusetts . If w need more time, we may take up to 4S days to investigate your complaint or question. If we do, we will credit your account within this 10-dav eri put your canplaint or question in writino ~ e for the amount you think is in error, so you will have the use of the monev dunne the time it takes us to complete our im~estigation. If we ask v ~ and we do not receive it within y10 business days, we may choose not to credit your account. P od For errors involving new accounts.. point of sale purchases or foreign transactions, we may urke up to 90 days to investigate your complaint or ou to question. For new accounts, we may take up to 20 business da}~s to credit your account for the amount you think is in error. We will tell you the results of our im~estigation wrthin 3 business daps after completing our investigation. If we decide there w send you a written explanation. You may ask for copies of the documents we used in our investigatron. as no error, we will Important information about pour Sovereign Debit Card The networks through which some of your Sovereign Debit Card purchases are processed have begun allowing merchants to process your urc without either a signature or a PIN. Ifyvou are not required to enter your PLN when you make a purchase, your urchase may be rocessed erthe through the Visa network or through the STAR or NYCE networks. If vour purchase is processed throu~ and you will not be eligible for the rights and protections available through Visa. Please see your Personal Depopsit Accomrt~Agreement fop hales information. ~h STAR or NYCE different terms a r PPIY more P°SP ~ oft Current 6a(ance Average Daily Balance 1T0144576~ Hccount # 1401445764 ROWELS A,U- -- CTION S.~RVI R CE ( H 79L) Bill Rowe (AU 1538L) 2505 Ritner Highway Carlisle, PA 17015 249-1978 697-4 i94 Dave 249-2677 Rowe (AjJ 2295L) Auction Is Action CaLI "R,~ywe» For Satisfaction SELLERS NAME ~ -f -s~~-~- a~ ~ ~~tC ~. ~ I c~ ~~S ~` ~----- DATE v2 ~t C (, (, ADDRESS , c~. ~ t-,.S~o~r~,~• ~ 4lJ/•~ E-f~rrr~ 5 (~ ~,r P~ OTHER - ~ - ~, r,-., ~:. -- , 6"L t t ~- PHONE `~` ~ ~ `~L'~ ~ ---__ AUCTIONEER ~~. -~!~-~_ AUCTION DATE;LOCATION ! 11~~~ -------_ CLERK ~~ ~_ DESCRIPTION OF MERCHANDISE '`" / l GGr~ !1 r. S r ~ < f afo ~S ~ ~.. ,. l 1 / • / 7~ :mss ~ r o ctd` ~ /1U/6t!'C5 ~s ~ /~e~T~(S 1~ Ys ~ c ~ ~ -~~~.~ ~oX Cpc~ r /v~~'` ~~ f'~ y l ~ is ~i ~ ice.; ~ v // ur s ~~~ ~ l~~ ~rc,~ ~ ~' (/ G,S' ~ ~!t •CI ~.5~ .) C /^ (~,^. p~C S/Cy /S 4 / pal J/ / /j l~Ij c--. ~ ~ ~cuS Yla~ ~a~,~..;, ~~v 1 ~ ~s I Commission the Auctioneers to sell the merchandise to the highest bidder b to be sold as is & grouped as necessary to obtain bids. I certify that I am the owner or tative of the merchandise, o y Public Auction. llgerchandise from all incumbrances. I a g ods and or property and have good title and the right to sell and that they are fr e title to the purchaser. I a gree to accept all responsibility for providing merchantable title and for delivery of ~'e~t. ' f / this a ~'e~to hold harmless the Auctioneers against ~i~~ claims of the nat re referred to in /i ~~ I % '~\ AUCTION SIG. TATURE Total Sales (Clerking Tickets Attached) ~ SELLE S S~Gp qT E _1__s~. ~ ~' ~ s~ _ Less Sale Expense: -----~_ °%o Commission Auctioneer g ~ ~ ~~~~ _ -------__ ~%'o Commission I r C e ks g _ OTHEP~; - -- ~~- ~ TOTAL SALE EXPENSE DEDUCTED ~ _ ~, i~' SELLERS NET $ ~ ~-t `f ~ ~ ``` ~~'~'~_ COMCAST 1555 SUZY STREET ATTN; LEBANON SUPPORT SERVICES LEBANON, PA 170d_6 ~~~5~'~. _ 428SWOODRUFFLSAy 22381 0975-40-68-ppgC HARRISBURG, PA 17112-8958 f~~~l[f ~~~[„~(i„.[l~~I~f[~~i~l~[~,~I~[~l~~t~<<I~f[~~I~I~~l~I CHECK Nn~ ~'-q Y~tTEN7' S L~ ~ L ACCOUNT NO: ""vo1auSb3 09547 23748101 r CHECK DATE: 02 ~ ~ T ~ .~ ~ near PATSIE NICHOLS, The attached check re resents the amount of $14.15 , a subscriber refund for account number 09547- 'you can write us at thefaddressvabove Qrestions or concerns regardin at 1-888-COMCAST. 23748101 in call Comcast's toll free customerrservidcehnu~er DETACH ANG RETAIN THIS STATEIv1EN7 THE ATTACHED CHECK IS IfJ PAYfdEh'T OF ITEMS DESCRIBED HonVE IF IVOT CORRECT, PLEASE NGTI;~1' US PROMPTLY. IVC RFCFior r,~~,.,.-. --...~., Here) ~ ~ ~ V ~ ~ z ~ ~ N =~ Z V ~ o m IT1 N 3 ~ ff ~ rTl "~ I~ ~N p z0 Z mz CA n I ~ ~ 0 r I ~ m I a °n I o r N I~ r m ~ a o ~ ~. I .i ~ m o m °~ vrn I „~ W W O O O O~ 10 ~ m ~sv ~ O - r N O ~Z ~ ~ ~ C I n W C~ I ~ W Z ~ "~ n m ~ ~ ~ I V O r Z ~ i N I D I ~ z m ~ I m m z O ~ I I o a I ~ ~ o o° I ~ V N O O O U7 Q~ N N y ~-(o ~ a1 _ ~ ~ _ccou:;t 8200kXXXXX NICHOLS,PATSIg A Docent Number: 2583692 Effect: 04/12/11 post: 04/12/11 Tlr: 0306 .D DUE DATE PRINCIPAL Yy _____________ INTEREST -FEES- NEW BALANCE -------------------- ,'~thdrawal from REGULAR SHARE TRAN AMOUNT 5EQ --------------- 1 ------------------- -44_12- 0.00 Prev-Bal: 44.12 ----------------- 0.00 --------_-- __ 0'00 44.12 #621273 C'~eck Disbursed --- ESTATE OF PATSIE P_ Q NICHOLS ----------------- 44.12- PATSIE A Q NICHOLS " C/0 GARY B QUIGLEY EXEC _ 428 WOODRUFF WAY ?iARRISBURG FA 17112 Account 8200XXXXXX NICHOLS,PATSIE D°cument Number; 2583692 A Effect.: 04/12/li Post: 04/12/11 Tlr: 0306 ID DUE DATE PRINCIPAL ---______ _ _ INTEREST FEES NEW BALANCE Withdrawal from REGULAR. SHARE ---- I'~N AMOUNT SEQ 01 44.12- Prev:Bal: -- --------------------- D.00 0.00: 44.:12 -- -------------------- ---- .0.00 44.1.2 #621273 Check Disbursed _ - -------------- ESTATE OF PATSIE A Q NICHOLS - ----- 44.12- NO :STOP PAYMENT PERMITTED PSECU is obligated to pay this Cashier`s Ch wa s issued. If the check is lost, stolen o rde troy d~ please cont ct usha time it 237 7328 nationwide or (7 1 71 234-8484. t (800:) ~~ DECEASED PATSIE A NICHOLS 12/29/2010 Department of the Treasury -Internal Revenue Service Form ~ (~~Q/Q! U.S. Endiv~eiua( ~n~ome Tax Fdefurrt (99) 2®1© Name, Your first name and initial Address, Last name and SSN PATs j E If a joini return, s ous=_' ~ A NICHOLS P s first name and initial _ast name See separate instructions Presidential Election Campaign Filing statUS Ohe-k only One bOX. ----_ Exemptions I` more than six dependents, see instructions. Income Attach Form(s) W-2 here. Also attach Forms} 1099-R if tax was withheld. f VOL' did nOt eet a w'-2, see instructions. Enclose, but do not attach, any payment. .Also, please use Bonn 1040-V. Adjusted gross income 7 Wages, salaries, bps, etc. Attach Form(s) W-2 .. , . , 8a Taxable interest. Attach Schedule B if required 7 ......... . b Tax-exempt interest. Do not include on line 8a 8 b 8a . , .... , 9a Ordinary dividends. Attach Schedule B if required ~- ......... b Qualified dividends (see instructions) .... 9a 10 Capital gain distributions (see instructions ) 9b 11 a IRA distributions . .......... , 11a ..... .... 10 12a Pensions and annuities ...... 12a 11 b Taxable amount .. .... 11 b 12bTaxable amount .. 13 Unemployment compensation and Alaska Permanent F .... 12b und d (see instructions) . ividends ............ 4a Social secun±y ... 13 benefits . .... 14a 15 Add lines 7 through 14b (far right column). This is your total income Taxable amount . 16 Educator expenses .... 14b- ~ (see instructions) ... 17 1RA deduction (see instructions) 15 18 Student Ican interest deduction (see instructions) 17 _ 19 Tuition and fees. Attach Form 8917 18 _ . .. .............. Add lines 16 through 19. These are your total adjustments .. 19 . .. . 20 .. 21 Subtract line 20 from line 15 Thi Home address (number and sheet). If you have a P.O. box, see instructions, 428 Woodru~r Wa City, town or pc, offioe, It you have a foreign address, see instructions. HarrislDUrQ ~oY IRS Use Only - Do not v.~rite or staple in this space. OMB No. 1545-0074 Your social security number _ 204-28-0817 Spouse's social security number Apartment no. Make Sure the SSN(S) above and on line 5c State ZIP Opel--- are correct. PA 171 1 2 Checking a box below will not change your ~ Check here if you, or your spouse if filing jointly, want $3 to go fo this fund see ; tax or refund 1 IX I Single ( nstructiors) .... ~ ~ ~ You h Spouse 2 ~ ~ -r P~ -' ~ ~ y ( 4 ^ Heatl of household (wl~h pual!rymo person). (See instructions.) h a. I,,,, nli~,g cintl ever if oniy one had in~ome) 3 ~ f~^arried tiling separately. Enter spouse's SSIJ above and I; the qualifying person is a child but not your dependeni, full name here - en±er this child's name here ~ 5 ^ Qualifying widow(er) with dependent child Ea IX Yourself. If someone can claim ~ p (see instructions) } ou as a de endent, do not check box 6a - b ~ SpOUSe " ~~~~ ~ Bones checked on I 6a and 6b c dependents: ....... ... . (2) Dependent's I (3) Dependent's (4) ;f No. of children (1) First name Last nam SOCIaI SeCUI"It Y number chile undar °n 6c who: relatlonshi p q as fo • lived e I to you child tax cr with you ~__ (see instrs) (~ • did not - ---- I I live with ~ you due to ~ - ----- droorce or separation (see ~ - ------ instructions) . Dependents - -~,_ on 6c not - entered above ----_-- d Total number of ~ 21 ~ For Disclosure, Privacy Act, and Paperwork Reduction Act Noticetsee separate nstructions. ons claimed ......... , Add numbers on lines above 159. 3--, _625 32,716. 36, 500. 36,500. Form 1040A (2010) FDIA1312 01/08/11 Prudential °rudertial Financial °remium Accounting Division 3AS -'l01 Weish Road, Dresher, Pq 79025 000000745 I INSURED NAME: PATSIE A NICHOLS POLICY NUMBER : 0000003474 REASON: INDIVIDUAL LTC REFUNC CHECK DATE: MAY 07 201 ~ CHECK NUMBER: 3420033322 CHECK AMOUNT: 3668.58 CLAIM NUMBER: 0000003474 CHECK STATE~E~T THE ESTATE OF PATSIE A NICHOI_S 615 SOUTHUIEW DR MECHANICSBURG PA 17055 This check represents a Long Term Care refund payment. . f~ .Ql~ ~'v ~ ` ~ ~~`~`~ ~~ Should you have any questions, Customer Service Representatives are available to assist you, toll free at 1-800-732-0416. Detach before cashing or depositing ch eck. Please retain this chec=statement for future reference. ~ -/I Manheim Market R eport Year: 1989 ~9/2~/20 ~ '~ Make: HONDA Selected Region: Model: ACCORD National Style: 4D SEDAN LX Seasonal Adjustment: No Mileage: 155314 Auction Averages --- For Month Of Week Ending Sep 4 Above Average Below Sale Price $807 $538 Ju12011 Mar 2011 SeP 2010 $269 Mileage 120,478 172,960 $1,050 $0 $450 225,442 Total Sold All 106 634 2 , 0 133,230 This Week's MMR P i 1 0 -- --- 1 r ces -_ Sep 9 -Sep 16 2011 Above Average Below Auction $875 Oct-Nov 2011 $575 $275 Est. Retail $4 000 Sep 2012 $575 , $2,625 $1,250 $450 $2,600 $2,100 Summary --- Counts Date Range ------ Total MMR H~ghS & LOWS Transactions 2 Earliest Sale 09/07/2011 Highest Lowest Average Transactions Price $600 $475 $538 for this Region 2 Latest Sale 09/07/2011 Mileage 187 133 , 158,787 172,960 i REV-?503 EX+(6-96) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TFJC RETURN RESIDENT CECECENT ESTATE OF Patsie A. Nichols FILE NUMBER All DfODeRv iointlv.nwnerl w~~ti .i..1s ,.~ _.. _.:..___~:_ .. .. . - ----- ~ .--" ~~~"~~~~a~ ~nccia ui uie same SIZE) REV-iyo8 EX+ (ii-io) pennsytvania SCHEDULE E ~FFARTPI F.N' pF {~FVF.. N~IF INr+EarrA:vcE TAX keruH~; CASH, BANK DEPOSITS & MISC . KesieENr cecece.tir PERSONAL PROPERTY ESTATE OF: Patsie A. Nichols FILE NUMBER: Include the proceeds of litigation and the date the proceeds wer by the estate All property jointly owned with right of su ITEM i . rv vorship must be disclosed on Schedule NUMBER F. 1. Sovereign Bank Checking Account #0571130925ESCRIPTIOIV ~- VALUE AT DATE Of DEATH 2. Sovereign Bank Checking Account #0571139779 26,671.58 3. Gem Jewelry (estate did not receive receipt) 36,713.26 4. Rowe's Auction -Auction of Houshold Items 1,190.00 5. Comcast Refund 12:998.00 6. Verizon Refund 14.15 7. PSECU Savings Account (closed) 7.62 8. IRS Refund for 2010 Federal Income Tax 44.12 9. Long Term Care Insurance Refund from Prudential 964.00 10. refund of Credit Balance from Macy's Credit Account 668.58 11. 1989 Honda Accord LX Sedan w/ 173,000 miles -good condition 37.79 12. Willow Ware Dish Collection 538.00 13. Wedding Ring 6,000.00 14. I Erie Insurance Refund 1 50.00 15. Erie Insurance Refund 39.00 324.00 TOTAL (Also enter on Line 5, Recapitulation) $ If more space is needed, use additional sheets of paper or the same size. 86 360 10 ~ Pennsylvania SCHEDULE G OF'r,4R7y? p;T pE RE VEPJI;= tratiEatra~cE rqx kEruati INTER-VIVOS TRANSFERS AND RE;mENT vECEO:r•;r MISC. NON-PROBATE PROPERTY ESTATE OF Patsie A. Nichols FILE NUMBER This schedule must be completed and filed i` the anstiNer to any of questions 'through q=n page three of the REV- -' ~ ="1 DESCRIPTION OF PROPERTY 1500 is yes. iUMgER ~"%'-L'JCE THE Nq:^iE OE THE TRANSFEREE, THEIk RELATfONSN!P Tp DECE THE DATE pF TfW.PJSFEk. ATTACH A COPT pF TFE CEED FpR REAL E DEPT A(1D DATE OF DE. u- Curian Capital Traditional IRA Account #A2321500V srgTE Art; '° or DECO's ExcLUSION VALUE OF ASSET INTEREST F APFL,'%ABLE; 2 ~ American Equity Annuity Contract #609529 I 69, 785.38 I 100 31,136.94 ~ 100 TAX,AB_E 09,%85 ~8 x1.135.94 TOTAL (Also enter on Line 7, Recapitulation ~~- [ more space is needed use additior'.al sheets a a er o, ~ ~ 100,922,32 r P P `the same size. ---------___ #~J, # J Pennsylvania nFr ~u- ~ ~ Mr~:-oF~~rvrr~u.c iNHE(2fiANCE lkx RETURPi RESIDENT DEiEDENi ESTATE OF Patsie A. Nichols SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS FILE NUMBER ITEM Vl)MjF,~ F1. 1. 2. 3. Decedent's debts must be reported on Schedu a lie II FUNERAL EXPENSES: ~ Rolling Green Cemetary Parthemore Funeral Services Parthemore Funeral Home -initial payment B + ADMINISTRATIVE COSTS: '• + Persona! Representative Ccmmissior,s: I ~'Vame{s) of Persona! Representative(s) Gary Qui le street Address _428 Woodruff Way g__..Y ____ _._ I _ __ Gty Harrisburg _ I _ Year(s) Comm~rion Fad: 2011 _ State PA ZIP 17112 _ _. __ _ _._. 2. Attorney Fees: -__ ____ 3. ~ Family Exemption: ;i` decedent's address is not the same as claimant's, attach explanatior:.; Claimant _.._. __ Street Address _...__-- __.__ City __ __._ _._. __._. Reiatienship of Claimanttc Decedent ----- State Zip _._... a. ____ ...._.......... Probate F Accountant Fees: 5. i lax Return Preparer Fees: Auctineer comission paid for sale of 615 Southview Drive (see settlement sheet) 8. Advertising cost paid to Rowe's Auction Service for sale of 615 Southview Drive (see settlemen s. Notary fees related to sale of 615 Southview Drive (see settlement sheet) t sheet) ~ o Tranfer Taxes for sale of 615 Southview Drive (see settlement sheet) ~ ~ I Tax Certification for 615 Southview Drive (see settlement sheet) ~ 2. Owens, Barcavage and Mclnroy Attorney fee related to sale of 615 Southview Drive -~__~_ If more space is needed, use additional sh~~~~ pope of the same s e Recapitulation) ~ aMOu 1, 395.00 7, 495.12 798.80 5,000.00 3, 500.00 323.50 145.00 1, 700.00 457.00 10.00 850.00 10.00 1,280.00 30,179.13 R~~-1513 EX+ (O1-iC; ~' ~ pennsy(vania ~~~AH-~~=~:T~FRE.~F~~:~F SCHEDULE INHERITANCE TqX RETURN RESIDENT DECEDENT BENEFICIARIES ESTATE OF: Patsie A. Nichols NUMBER FILE NUMBER: NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT i TAXABLE DISTRIBUTIONS [Include outright spousal di Do Not List T AMOUNT OR SHARE s Sec. 9116 (a) (1.2).) rustee(s) tributions and transfers under OF ESTATE 1• James A. Roccasecca Angel I. Roccasecca 2 Step-Grandchild 1000.00 3. Evan A. Roccasecca Step-Grandchild 1000.00 4. Karen J. Nichols Step-Grandchild 1000.00 5. Gary B. Quigley Stepdaughter 6,150.00 g Terry M. Quigley Nephew 58959.38 ~ Cynthia Quigley Nephew 58959.3$ 8 Lori A. Quigley Niece 58959.38 Niece 58959.38 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUG 118 OF REV-1500 COV I II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN; ER SHEET, AS APPROPRIATE. 1. B• CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. St. Mark's Evangelical Luthern Church 1000.00 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVE If more s~~ce is needed, use additional sheets of paper of the same size. R SHEET. ~ 1000.00 _~ - _ _ ~, LAST WII.L AND TESTAMENT OF PATSIE A, QUIGLEY NICHOLS I, PATSIE A. QUIGLEY NICHOLS, of Mechanicsbur Pennsylvania, do make 8 ,Cumberland County, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils by me at any time made. ITEM ~. I direct that all inheritance and estate taxes becoming due b re death, whether such saxes may be payable by my estate or by any reel sent y ason of my p of any property, shall be paid by the Executor out of the property passing under ITEM III of this Will a and cost of administration of my estate. The Executor shall have no dut or s an expense reimbursement for any such tax so paid, even though on ro y obligation to obtain p ceeds of insurance or other property not passing under this Will. I-T-E~. T direct the Executor to pay my just debts and the expenses of m la illness and funeral expenses from the ro ert Y st p P Y passing under this Will as an expense and cost of administration of my estate. I E H: I hereby devise and bequeath the following special bequests; (a) ONE THOUSAND DOLLARS ($1,000.00 to ST. LUTHERAN CHURCH, whose office is located at 117 W~ I{ Eer S~ ee LICA,L Mechanicsburg, Pennsylvania 17055; ,~~~ (b) ONE THOUSAND DOLLARS ($ l , 000, 00) to each of my step-grandchild JAMES A. ROCCASECCA; ANGELA I. ROCCASECCA~ ren: ROCCASECCA, as may be surviving at the time of my death EVgN A. (c) I hereby give and bequeath unto my stepdaughter, KAREN J, NICHOLS ROCCASECCA, the following items, if she survives me: m weddin rin my antique Willow Ware dishes and other Willow Ware ite s. g g; all of ITS whatsoever nature and wherever situate as follows: (a) Twenty-five percent (25%), to my nephew, GARY B. QUIGLEY, or, in the event he predeceases me, his share shall be paid to his issue, per stirpes; (b) Twenty-five percent (25%), to my nephew, TERRY M, QUIGLEY, or, in the event he predeceases me, his share shall be paid to his issue, per stirpes; (c) Twenty-five percent (25%), to my niece, CYNTHIA QUIGLEY, or, in the event she predeceases me, her share shall be paid to leer issue, per stirpes; and {d) Twenty-five percent (25%), to my niece, LORI A. QUIGLEY, or, in the event she predeceases me, her share shall be paid to her issue, per stirpes. In the event any of these beneficiaries predecease me and leave no surviving issue, his or her share shall be divided equally to the remaining beneficiaries set forth in ITEM IV. hereof, ITF~I Yi In the settlement of my estate, my Executor shall possess, among others, the following powers: (a) To retain any investments I may have at my death, as long as the Executor may deem it advisable to my estate to do so; I devise and bequeath the rest, residue and remainder of my estate of 2~/ (b) To sell either at private or public sale and upon such terms and conditions as the Executor may deem advantageous to the estate, any or all real or personal property or interest therein owned by the estate; (c) To pay all costs, taxes, expenses and charges in connection with the administration of my estate; (d) To compromise controversies; and (e) To do aIi other acts in the Executor's judgment deemed necessary or desirable for the proper and advantageous management, investment and distribution of the estate. ITEM VI• Any person who shall have died at the same time as I shall have, or in a common disaster with me, or under circucnstarice that the ordet• of deaths cannot be established by proof, or within thirty (30) days of my death, shall be deemed to have predeceased me. 1<TEM Vn~ I appoint my nephew, GARY B. QUIGLEY, to be Executar of my Estate. In the event my nephew, GARY B, QUIGLEY, cannot act or refuses to act as Executor for any reason, I nominate, constitute and appoint my nephew, TERRY iVI. QUIGLEY, as alternate Executor. Any Executor is specifically relieved from the duty or obligation of filing any bond or other security, ~~,~~ IN WITNESS WHE~pF~ I have hereunto set my hand and seal to this, my Last W' and Testament, consisting of this and the preceding three 3 111 ( }pages, at the end of each page of which I have also set my initials for greater security and better identification this -.~ day of October, 1999. PATSIE A. QUI NICHOLS (SEAL} We, the undersigned, hereby certify that the foregoing Will was signed, sealed, published and declared by the above-named Testatrix as and for her Last Will and Testament, in the presence of each other, have hereunto set our hands and seals the day and year first above written, and we certify that at the time of the execution thereof, the said Testatrix was of sound mind and memory. Lin Stirlin i Laura J. ug e -Doyle Residing at: 1013 S. Waterford Way Mechanicsburg, PA 17055 Residing at; 2670 Conewago Road Dover, PA 17315 4 ~.~NOWL~nC~ , um COMMONWEALTH OF PENNSYLVANIA , COUNTY OF CUMBERLAND ~ SS. I, PATSIE A, QUIGLEY NICHOLS, Testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to taw, da hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly, and that I signed it as my free and voluntary act foi• the purposes therein expressed. ~" ~ ~. -may`. ~~~~-~~, YATSLE A. - j~~,~,~ {SEAL) Q Y NICHOLS Sworn to and sub~c~ribed before me this~~`-~-_ day of Octo , 1999. NOTARY PUBLIC ~ ~ SEA~r -~-- My Commission Expires: g„,.g~it~„rm, edotary Puhito~ (SEAL) gam, p~,~4and'9an+~, ~ pRy pifln-fE,xpMSe (fro. ~ 8. J FFIDA VIT COMMONWEALTH OF PENNSYLVANIA , COUNTY OF CUMBEKLAND ` SS° We, Linda Stirling and Laura J. Hughes-Doyle, the witnesses whose names are si to the attached or fore oin instrument, bein dul gned g g g y qualified according to law, do depose and say that we were present and saw Testatrix, PATSIE A, QUIGLEY NICHOI,S, sign and ex ecute the Instrument as her Last Will and Testament; that Testatrix signed willingly and she executed said Will as her free and voluntary act for the purposes therein expressed; that each of us in th e hearing and sight of the Testatrix signed the Will as Witnesses; and that to the best of our knowledge the Testatrix was at that time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. ITNE S I SS Sworn to and subscribed before me this ~~ day of Octobe 9 NOTARY PUBLIC - . ---------~----~-~-- My Commission Expires: M ~~~ ~~ ~rtto ~~. ~ .. (SEAL} ~„ (~,abe~nnd:~. O+x ~ i)oairN~do,rr.E.waa, rt?, i~ 6 ~ l~ - a. - ~ oMB NO. 2502-0265 ~- B. Tl'PE OF LOAN: U.S. DEPARTMIENT OF HOUSING 8 IJRBAN DEVELOPMENT 1.^FHA 2.QFmHA 3. QX CONV. UNINS. 4. QVA 5. QCONV. INS. 6. FILE NUMBER: 7. LOAN NUMBER: SETTLEMENT STATEMENT L M YN - 1 - THVI 8. MORTGAGE INS CASE NUMBER: C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. (terns marked "(POCJ" were yard outsrde the closing; they are shown here for informations! purposes and are not included in fhe totals. D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER:ILEMOVNE-sis-sFuTNAME AND ADDRESS OFvLE'NDER: Lemoyne Land Corp., Inc. Patsie A. Q. Nichols Estate Integrity Bank 319 South Third Street, P.O. Box 31 by Gary B. Quigley, Executor 3345 Market Street Lemoyne, PA 17043 Camp Hill, PA 17011 G. PROPERTY LOCATION: 615 Southview Drive Mechanicsburg, PA 17055 Tax Parcel No. 42-28-2417-012 H. SETTLEMENT AGENT: 23-2083639 Kerwin & Kerwin, LLP PLACE OF SETTLEMENT Integrity Bank - 3345 Market Street Camp Hill, PA 17011 ~ 101 . Contract Sales Price 102 . Personal Property 85,C 1103 . Settlement Charges to Borrower (Line 1400) I 104. 2 3 105. stments or terns ar e lean a vance 106. Ci /Town Taxes to 107. Coun Taxes 06/14/11 to 01/01/12 2 108. School Taxes 06/14/11 to 07/01/11 ' 109. i 110. 111. 112. 120. GROSS AMOUNT DUE FROM BORROWER 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: ' 87,7 201. De osit or earnest mone 202. Princi al Amount of New Loan(s) 8,5 203. Existin loans taken sub ect to 85,0 204. 205. I 206. 207. 208. 209. Ad'ustments For Items Un aid B Seller ~ 210. Ci !Town Taxes to 211. Coun Taxes to 212. School Taxes to 213. 214. 215. 216. 217. 218. 219. , 220. TOTAL PAID BY/FOR BORROWER 00.00 401. Contract Sales Price 402. Personal Property 88.75 403. - 404. - d ustments or items ar eller rn a var, 406 . City/Town Taxes to 83.08 407 . Count Taxes 06/14/11 to 01/01/12 64.21 408 409 . School Taxes 06/14/11 to 07/01/11 . 410. 411. 412. 36.04 420. GROSS AMOUNT DUE TO SELLER 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 00.00 501. Excess De osit (See Instructions) 00.00 502. Settlement Char es to S ll Li e er ( ne 1400) 503. Existin loan s) taken sub ect to 504. Payoff of first Mortgage 505. Pa off of second Mort a e 506. De osit retained b seller 507. 508. 509. Adjustments For Items Unoard ev eller 510. Ci /Town Taxes to 511. Coun Taxes to 512. Schcol Taxes to 513. 514. 515. 516. 517. 518. 519. 93,500.00 300. CASH AT SETTLEMENT FROM/TO BORROWER: 301. Gross Amount Due From Borrower (Line 120) I 87,736.04 302. Less Amount Paid By/For Borrower (Line 220) ',( 93,500.00) 303. CASH ( FROM) (X TO) BORROWER The undersigned hereby acknowledge receipt of a completed copy of pages96& Borrower Lemo ne Land-Corp.. In Y c. Michael L. Coons, President I 520. TOTAL REDUCTION AMOUNT DUE SELLER 600. CASH AT SETTLEMENT TO/FROM SELLER: 601. Gross Amount Due To Seller (Line 420) 602. Less Reductions Due Seller (Line 520) 603. CASH (X TO J ( FROM) SELLER 2 of this statement & any attachments referred to herein. Seller Patsie ~~Q. Ni . -€stat BY: c Gary'B. Quigl , Eke~c tqr I. SETTLEMENT DATE: June 13, 2011 283.08 64.21 85,347.29 3, 027.00 8,500.00 11,527.00 85,347.29 11, 527.00 73,820.29 HUD-1 (3-86) RESPA. HB4305.2 uivision of Commissio 701. $ 1,700.00 to R 702. $ to 703. Commission Paid at Se 704. Advertising Costs 800. ITEMS PAYABLE IN C~ 801. Loan Ori ination Fee 802. Loan Discount 803. Appraisal Fee 804. Document Preparation 805. Flood Cert. 806. Mortgage Ins. App. Fee as Follows: ' ~ Drl SefVICe PAID FROM BORROWER'S FUNDS AT SETTLEMENT PAID FROM SELLER'S FUNDS AT SETTLEMENT to Rowe's Auction Servic 1,700.0 e N WITH LOAN 457. 01 to _ to to Integrit Bank y to Integrit Bank 50.00 y to Integrity Bank to 300.00 15.00 807. Assumption Fee to 808. Flood Certificate 809. 810. 811. 900. ITEMS RE UIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From 06/13/11 to 07/01/11 $ ~ /day ( 18 days %) 902 . Mortgage Insurance Premium for months to 903. Hazard Insurance Premium for 1.0 ears to 904. 905. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard Insurance months $ per month 1002. Mortgage Insurance months $ 1003. Ci !Town Taxes per month months $ per month 1004. Coun Taxes months $ 1005. School Taxes per month 1006. months @ $ per month 1007. months $ per month 1008. months @ $ per month months $ er month 1100. TITLE CHARGES 1101. Settlement or Closin Fee to 1102. Abstract or Title Search to 1103. Title Examination to 1104. Attorne 's Fees to 1105. Document Pre aration (Deed) to 1106. Nota Fees to Kerwin & Kerwin LLP , 1107. Attorneys Fees to 20.00 (includes above item numbers: 1108. Title Insurance to Stewart Title Guaran Com an includes above item numbers: ------- 768.75 1109. Lender's Coverage $ 85 000 00 , . 1110. Owner's Coverage 768.75 $ 85,000.00 1111. Endorsements 100, 300 and 8.1 to Stewart Title Guaranty Company 11 12. 150.00 1113. Closing Service Letter to Stewart Title Guaranty Company 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 75.00 1201. Recording Fees: Deed $ 62.00; Mortgage $ 78.00; d Releases $ 1202. City/County Tax/Stam s: D p ee 1203 State Tax/Stam s. Deed 850 00 Mortgage ~ 140.00 850 00 850.00; Mort a e - 1204. . 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Survey to 1302 PestlnspecLon to 1303. Overnight Fees/Postage Fees to U.S. Postmaster 1304. Tax Certification to Dennis Zerbe Tax Collector 20.00 , 1305. 2011 CountylTwp Taxes to Dennis Zerbe, Tax Collector (Reimburse K & K) POC:S514.05 1400. TOTAL SETTLEMENT CHARGES (Enter on Lines 103 Section J and 502 S , , ection K) By signing page 1 of this statement, the signatories acknowledge receipt of a completed copy of pa e 2 f thi 2388.75 g o s two page statement. Certified to be a true copy. ~ K in 8 in Settlemen Agent 10.00 I 850.00 ~a 10.00 '~ 027.00 ( L'cMOYNE-615-SOUTHVIE / LEMOYNE-615-SOUTHVIE / 19 ) ~~ Sa~erei n R PZ # 00168-0214-110541 Branch# 168 Processed Gloria Booz TRANSACTION DISBURSEMENT ^ Cash TYPE(S) NUMBER OF #76 BONDS ~~ SAVINGS BOND REDEMPTION' INTEREST REPORTING FORM Date Redeemed 02/14/2011 Te(ler # 001 i ^ Check ^ Sovereign Acct Credited Account #: TOTAL REDEEMED $5,675.86 Ensure that the following information applies to the NAME on BOND!BOND OWNER. TOTAL 1099 INTEREST TO BE REPORTED IS $3,775.86 SOCIAL SECURITY NUMBER OR EIN NAME on BOND/BOND OWNER DATE OF BIRTH STREET ADDRESS of NAME ON BOND/BOND OWNER CITY STATE & ZIP CODE 326-15-1770 nary qui le /patsie nichols 01/10/11 _ 428 woodru.f way harrisbur a 17112 COUNTRY OF CITIZENSHIP United States Complete the information below about the person cashing the bond{s) ONLY if NOT the .NAME on BOND/BOND OWNER named above.. NAME OF PERSON CASHING BOND(S) RELATIONSHIP TO NAME on BOND/BOND ^ Parent/Guardian ^ Trustee OWNER: ^ Conservator ^ Executor/Administrator Certifications Instructions: You must cross out item 2 below if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. I certify under penalties of perjury, that (1) that the number shown above is my Taxpayer Identification Number and is my correct TIN; (2) I am not subject to backup withholding either because I have not been notified that I am subject to backup withholding as a result of a failure to report all interest or dividends, or the Internal Revenue Service has notified me that I am no longer subject to backup withholding; and (3) I am a U.S. person (including U.S. resident alien). signature Legal Representative Title (if any) Date Important! By signing above, you certify that either 1) Your TIN is being used to report the interest earned on the savings bond(s) OR 2) You are authorized to sign on behalf of the registered holder/TIN reporter whose TIN is being used to report the interest earned on the savin s bond(s) (i.e., you are the parenUquardian trustee executor/administrafor or conservator) Refer below for additional Federal Reserve Bank redemption resource information. ~ Via telephone: 1-800-245-2804 ~ Via the lnternet.~ http:/lwww.savingsbonds.govl BRANCH USE ONLY Provide copy to customer. Retain copy in branch fetes. Forward original in Savin s Bond Redemption Forms special use envelope the same procession rlav 1059 PROCESSING TEAM USE ONLY UTJ SBR001 REPORT DATE PZ 250 REPORT DATE Effective 12/10/2008 Revised 07/15/2009 s - -3 ERIE INSURANCE EXCHANGE Erie° Insurance P.O. BOX 1699 ERIE, PA 16530 ~~ Exchange CANCELLATION NOTICE Mem6_r Erie Inswan~e Group 100 Ene Ins. P!. Erie, PA 1 E530 j fJIAIL DATE 06/16/11 BAL: $39.00 CR ~ POLICY NUMBER Q55 1500635 H j POLICY EFFECTIVE DATE 07/15/10 ' -J HOMEPROTECTOR POLICY NAMED INSURED PATSIE A Q NICHOLS C/0 GARY QUIGLEY AA7546 428 WOODRUFF WA.Y HARRISBURG PA 17112 .~ ~I NAMED SURED COPY CANCELLATION EFFECTIVE 06/15/11 12.01 AM STANDARD TIME WE ARE NOTIFYING YOU THAT THE ABOVE POLICY IS CANCELLED AS OF THE CANCELLATION EFFECTIVE HOUR AND DATE SHOWN ABOVE. IF 1NE HAVE 13EEN ASKED TO PROTECT OTHER INTERESTS, WE ARE REQUIRED TO ADVISE THEM OF THIS CANCELLATION. THE REASON FOR THIS ACTION INSURED DECEASED PREVIOUS BALANCE UNUSED PREMIUM: PRESENT BALANCE 00505 AA7646 FETR FETROW INS ASSOC LLC $.00 $39.00 CR $39.00 CR REFUND CHECK ENCLOSED 532EX~ 6i 00 ,~ ERIE fNSURANCE EXCHANGE ~ Erie Insurance P.O. BOX 1699 ERIE, PA 16530 Exchange CgE1(CELLATfON NOT[CE Member Brie Insurance Group 100 Erie ins. pl. Erie. ?A 15:.30 NAM INSURED COPY MAIL DATE 02/15/It~ CANCELLATION EFFECTIVE BAL: $324.00 CR POLICY NUMBER Q09 2501$09 H 02/09/11 12.01 AM POLICY EFFECTIVE DATE 09/25/10 ~ ~ PIONEER FAMILY AUTO POLICY STANDARD TIME j NAMED INSURED PATSIE A NICHOLS C/0 GARY QUIGLEY AA7646 428 WOODRUFF WAY HARRISBURG PA 17112 WE ARE NOTIFYING YOU THAT THE ABOVE POLICY IS CANCELLED AS OF THE CANCELLATION EFFECTIVE HOUR AND DATE SHOWN ABOVE. IF WE HAVE BEEN ASKED TO PROTECT OTHER INTERESTS, WE ARE REQUIRED TO ADVISE THEM OF THIS CANCELLATION. THE REASON FOR THIS ACTION REQUEST OF NAMED INSURED - SOLD PREVIOUS BALANCE UNUSED PREMIUM PRESENT BALANCE 00200 AA7646 FETR FETROW INS ASSOC LLC $.00 $324.00 CR $324.00 CR REFUND CI3ECK ENCLOSED P/ ~ r1' ,~ ~~; ~ ssz5xc s;oc 11/18/2010 $68,192.68 11/19/2010 $68,331.58 11/22/2010 $68,350.31 11/23/2010 $67,493.60 11/24/2010 $68,144.02 11/26/2010 $67,748.75 11/29/2010 $67,630.:14 11/30/2010 $67,290.93 12/1/2010 $68,197.47 12/2/2010 $68,807.91 12/3/2010 $69,079.78 12/6/2010 $69,077.48 12/7/2010 $68,990.10 12/8/2010 $68,996.23 12/9/2010 $69,093.72 12/10/2010 $69,311.84 12/13/2010 $69,450.75 12/14/2010 $69,329.54 12/15/2010 $68,914.77 12/16/2010 $69,025.89 12/17/2010 $69,109.81 12/20/2010 $69,251.60 12/21/2010 $69,581.62 12/22/2010 $69,665.38 12/23/2010 $69,550.24 12/27/2010 $69,616.84 12/28/2010 $69,447.38 12/29/2010 $69,785.38 12/30/2010 $69,887.77 12/31/2010 $70,005.93 1/3/2011 $70,534.74 1/4/2011 $70,461.56 1/5/2011 $70,551.67 1/6/2011 $70,406.53 1/7/2011 $70,337.92. 1/10/2011 $70,288.05 1/11/2011 $70,476.31 1/12/2011 $71,090.91 1/13/2011 $71,181.22 1/14/2011 $71,513.64 1/18/2011 $71,546.15 1/19/2011 $70,968.96 1/20/2011 $70,544.37 1/21/2011 $70,662.04 1/24/2011 $70,971.81 1/25/2011 $71,022.44 1/26/2011 $71,294.37 _~ L ~ ~ ~. ~''~~ ~ ~~ ~~.` ~~ ~~ '~~ i ~ v ~~~ ~. ~i ~ ~~~ ~~ ~ ~,r' ~ ,~.. ~,~ ~~~~ ,~" t Lr"`~ ~ ~~.Y -°~ ~~ ! ~ , ~`~~ ~I ~~~, ~T T ~T ~ ~T Quarterly Summary ~® v 1 1. ~I Patsie A Nichols c ,a, ~ r -,- .n ~ Account # RA232i 500V Statement Date: December 31, 2010 Initial Investment Date: 11,'10/2046 The following is a Quarterly Summary of your Account Activity and Performance, Specific holdings and transactional information may be found in your respective monthly statements. US Bank N.A. C!F Curian Clearing F80 Patsie A NicholsTraditionai IRA 615 Southview Drive Mechanicsburg, PA 17055 Your Referring Financial Professional is: Anthony Conte Cambriclge Investment Research Advisors, Inc. 2009 Market Street Camp Hill, PA 17011 Tel: (717) 975-8800 e-mail: 'Tbny.conteC~3contebrawne.com Your Account Summary of Activity for the Quarter Ended -December 31, 2010 ' Yr0 values are no! displayed ku accounts opened aher January 7 of (he current calendar year. 2 Re/fecfs a!! client ronldbulions and wifhdmwals as well as certain adjuslmenfs refefed fo the cash movements and acbNnlsnatien of your accnunf. s Ne! Gal; dLnss & Income includes accw~nl aoprecialion/deprecw-tion, a!,' gadns arrd lasses from account securftfes sales, plus aft dividends arrd interest, less lees. _ __ _ ~...~i..o -zJp% NIA -0.43 Returns !or periods beyond one year are annualized. s Pedormance is presented net of atf lees 'Taal returns" pedorrnance : elfacis fhe assumed reinVestmer7l of dividends and interest wrfh the "firne•weghfed" calcutatiwr semng to neutralize the eNecf o7 other cash, flows, tike aokiitiona! conMbutlons fo or wifbdrawafs from your aacvunf. Time-we+gMed performance provides 3 mere appropriate comparison fo index perfonnar6ces, which are alsounallecred by arty c9n7ributions or wifhdraw2ls ~ r Curian Capital, LLC,ARegsrered investment Advsor 7607 Technolpgy Way ~ Oenver, CO 80237 877.847.4192 Beginning Market Value $66,19fi.52 $63,187.65 $63,187.65 $79,132.42 NiA $77,171.82 Additions I Withdrawals 2 $0.00 $2.41 $2.41 {$3,597.59) NrA ($5, 540.07) Net Gain/Loss & Income 3 $3,809.41 $6,815.87 $6,815.87 {$5,528.90; NIA Endin Market Value ($1,625.82) 9 $70,005.93 $70,405.93 $70,005.93 $70,D05.93 N!A $70,005.93 Your Pertormance Report for the Quarter Ended -December 31, 2010 ivu. X1=1 W~~? C~-Z Septembez 14, 2011 GARY QUIGLE~' Re: Patsie A Nichols- Deceased Annuity Contract No 609529 Deaz Gary: The date of death value for the above named annuity contract was $31,136.94. If you have any questions regarding this contract, feel free to contact our office at 1-888-221- 1234. Sincerely, Ci~/ t u( - John Lickteig Claim Service Specialist ~..,,~ - ~"" ~~"'"°° 1° ~n~~S • ~-RRfi-221-1234 • 515-221-0002 • 515221-9947(Fax) • www_american-equity,com 'T _~f~i~ ~.=€~_i! ~~~FiC i ~t~. ~' ~~~~='iF`; .t~ti' .µ i~"~.:tJ l~~t.~t ~-`i ~.:,=;,:'_;SL~ rim . E. ~- ~ -. -;~-,.~ F - - -,: ~ _ - ----- ~~TgI~r~LJ~I,CAS~~ECE~t BATE t _ ~=~ ,-~ t1`\~ 4ccoL-~T *.o. ~ ~CCTICO'\TR.?~4?~IE~'-~'~~ `~ ~"-~,~1 ~ ~~~ ~- 4CC'C/CO'~TR. tiO. ~~ `'~ f f ~ ~ ~ ~ ~,~'~ ~ ~ /'=• ~ , RECEI~ EB FRE3'_i1 _ ;ICK ~1C.C. APPRO~4 L # ~ ~ ~ :~/ . . ~` r ' ~ ' C.C. "CI"PE ~ DESCRLPTIO'5 ~~.~ E ~ •~ \ ~~' ~ `~ '~ ` TRUST ?! O. ~ ' G2 3-CCT. ~ ~ ~ ,ter i 7 ~ / ~ ~ Cf~ECIi CREBT CARD G"'~ 500; i3/08; R`hice -Customer Cop. Fellow - Coocract File U CASH ` ~ ~ ~~ DE3IT TOi4L 4 , /, ~ ~ ; Pinl: Control Cope ~~~`~~ ~'(3I7 ~A~ .o. v 9vss:Jr 1t ~'ti it. ~ - Li ...4. b F~ r ~~ Contract ~'= ~ ~ -t .. ~~ ` z File Folder Name/Nuit~ber _ CEMETERY INTERMENT RIGHTS, MERCHANDISE, AND SI;RVICES PURCHASE/SECURITY AGREEMENT THIS AGREEMENT PROVIDES FOR PERPETUAL/ENDOWMENT CARE. -• --------- -- --- ---.-..--- ..-.-..,, •.e.«, .., r,,.,,..,.,~~ ,..~ .,,,,.,~„o,~r ~•~gms, icrercnanurse ana ~ervlees nescrrbetl herein, subject to acceptance an[I approval of the above named cemetery, hereafter referred to as `Seller'. Purchaser: List Name rI~ ;. J. I~ i:~~. I~~ 1~" i n I I I 4 I I I I I I I I First !I~r b", Iv. IE? I I I I I I I I I I t`4'ddle~ h~ I I I I I 'telephone :- ~ -, ( r ~i: . s .. SISN'"` ~ ~~~) / _. I ,~t ,~, t" C t t c-d'"~ c-" DOB: ~. ~ / / Email: ~- -- { Address: I ~ I~-`.F ? I ' l ~ l~ ~ f_ -i~~ IF I~n~l't tl~l I-Ix ~~~~6 l s l I I I I I I I I I City: ~ ~ l~; l~ K ~ I I ~I'> L..~li Ic° I I ., I State. ~ t~'~~ Lip- T j ~ ~ ~ ~ !~`~-•, ~ _ Gr-Purchaser: Last Name: I I I I I I I I Fin[ . . ~ I I I I Middle: I I I I 'Telephone SSN: O - _ llOB: _ _ / / Email- Addres`~ I I I I c'ty~ I I I I I I I I St`1e~ I ~'I'~ Uecease[I: Last Name f~k ~ i i '41,~ F r°~ I t I~ I` ; I DOB: ~ }) a UOI`: "} '. F /:- /T, r"3 ~ :°~,d ~~_. t i ~ I I I I I I I I I I t "sr I~ I I~'~ I' I h I+" I I I I I I {.r r' [3urialDale: /: ~ r. / E { ~ / ~ /~ Veteran: ~~ Middle: ~ - I I ~ lld l l lI I I __ Dcscription of Interment Rights to be used: -~ - _ - ~ ~, [ ~ ~I _„ t.~.~ ~lemorialization Rights: Issue Certificate of lntermeot Rights to~ Address: Cit>': Stale: Lip: IN'fERI\1ENT MERCHANDISE & SERVICES • nlenncnt Rights `F_~--'"` Urn __ ~_- __ (includes Perpetual/Endowment Care of $_°~~- ) Supplier _ • Interment and 12ecording fees t 1 i~~~', ~ ~ T ~/Color i oT- Yp' - • Outer Burial Container _ ~~~-" Desi;*_n/Size Supplier _ -_ Admin/Processing Fee _ Model/Design Other Material/Color Other ~- • Outer Burial Container installation Other _ D4EMORIALIZATION Other ~~ • Memorial - -- _ Other Supplier Other ' Type/Color -_ 'f0'fALS, ALLOWANCES &'1'AXES Design/Size Interment Rights .................................._. ......................... ( ~ • iA4enua-ial Base ~ ~~ Reason _ - Merchandise/Service ..................._......._. ......................... ( ) Type/Color Reason Design/Size _ ApP1Y to - • Memorial Perpetual/Endowment Care Merchandise/Service ............................... ........................ ( _. ) • Memorial Installation Fee ~ Reason • Memorial Lispection Fee _-' Apply to • Nameplate{Scroll ;?~':, C te.~ Sub Total {,...,'\."i. t.. 4 • Lettering °'~"~" Total Taxable -'~ ~~'~ ~ ~ • R • ~ ower Vase Sales Tax (iF applicable) .............. „_ ..,... Supplier TO`fAI. CASK PRICE $ t.~`~ i''~~ (~~:~_wi Type/Color Less: Down Payment ~ ~~~} , ~: '~ .. Design/Size Other . °°^°~ ~!I/~ ~~ /, ~A~~ .._~ Mr. Gary B. Quigley 428 Woodruff Way Harrisburg, PA 17112 i303 Bride Street P.O. Boy 431 \ew~ Cut~berland. ?~_ 1"0-0 ~~17i %'?-%%~1 FaXl -?4-tip?6 ~~ +~~~-.partiler~lore.con~ Gilbert ~V. Pathemore, Founder Gilbert J. Parhemore_. Super~~isor Stepheal K Parthemore, CFSP Bruce R. Parthemore. Pre-Need Coordinator, CPC Professional ~'Iemberships: NFDA • PFDA DCFDA • CCFDA Intema w.' Cher of(l~ ~~«?~LDEN ULE The Rule I'ou Knox; 77ie People }'ou Trust ~-~ ~~~ For the Service of Patsie A. Q. I~Tichols 1/3/2011 We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please feel free to contact us if you have any questions in regard to this statement. The following is an itemized statement of the services, facilities, automotive equipment and merchandise that you selected when making the funeral arrangements. Terms Due Date Account # Net 30 2/2/2011 2010096.0 Description Amount SERVICES & MERCHANDISE I Traditional Funeral Service Reflections Stationery Set 20 Gauge Steel Casket, Copper Shaded Total Services and Merchandise CASH ADVANCE ITEMS Death Notice, Harrisburg Patriot 20 Certified Copies of Death Certificate Hairdresser Clergy Honorarium Flowers, Casket Spray Total Cash Advances T-~.-~~~ yon N~~. Q~~gl~yl ~ ~ a5~ c.~ ~ ~ 1' ~ U.1 a ~4 ~ ~c ~ ~ ~ ~c-v ~ ce.. Z A F~~~il Trac~s,t~ar~ Qf ~a ~~ Y 5,990.00 135.00 1,395.00 7,520.00 220.12 120.00 40.00 150.00 243.so 773.42 ~~~ ~ . - ( ~ZE~~ `~ Total ~ $8,293.92 Payments/Credits ~-798.80 Balance Due ~7-- 49 ~~~~~~ Parthemore Funeral Home & Cremation Services, Inc. P.O. sox 43.1 ~~~ 1303 Bridge Street New Cumberland, PA 17070-0431 ~ ~~ (717) 77~-7721 Mr. Gary B. Quigley 428 Woodruff way Harrisburg. PA 17112 For the Ser~~ice ofPatsie A. Q. Nichols S~a~errlent DATE 2/312011 DATE TRANSACTION 11i30r2010 Balance forward O ll0312011 INV #2268. O1/0~/2011 PMT X1672. rec from Lori Crider Ol ~25i2011 PMT .`1004. Estate AMOUNT DUE AMOUNT ENC $0.00 AMOUNT BALANCE 0.00 8,293.92 8.293.92 -798.80 7,49.12 - i ,491.12 0.00 .~ ' { 3 t ,, \ ~. J CURRENT 1-30 DAYS PAST DUE 31-60 DAYS PAST DUE 61-90 DAYS PAST DUE OVER 90 DAYS PAST DUE AMOUNT DUE 0.00 0.00 0.00 0.00 0.00 $0.00 Please don't hesitate to Gail our office if we may be of assistance. Thank you. r~$- The La~~ Offices of Da~~id L. Anderson 816 Rud~~o~~~i Road New Cumberland, Penns,~lvania 17070 telephone 717.554.4736 facsimile 888.871.0367 INVOICE September 14, 2011 Gary B. Quigley 428 Woodruff Way Harrisburg, PA 1.7112 Nichols Estate Administration Total Amount Due $3,500.00 $3,500.00 RECEIPT FOR PAYMENT GLENDA FARMER STR_ASBAUGH Cunberiand County - Register Of Wills Or_e Courthouse Square Carlisle, PA 17613 NICHOLS PATSIE A Q Estate File No. 2011-00040 Pa;d By Remarks: GP_RY B QUIGLEY SAP ________________________ Receipt Distri~,ution Receipt Date: 1/10/2011 Receipt Time: 12:06:56 Receipt No. 1063966 F'ee/Tax Description Payment Amount Payee N-me a PETITION LTRS TEST WILL 260.00 CUMBERLAND COUNTY GENERAL FUN SNORT CERTIFICP_TE 15.00 20.00 CUMBERLAND CUMBERLAND COUNTY COUNTY GENERAL FLT?~7 JCS FEE AUTONLATICN FEE 23.50 BUREAU OF RECEIPTS GENERAL ~ CNTR FUN M D 5.00 CUMBERLAND COUNTY GENERAL . F~~?~j ~"neck# 203 $323 50 Total Received......... $ . 323.50 G ~-y ~- Lari B. Shoop cPa - ~~SSOCiate~ ~'.` . 711 STATE STREET • LEMOYNE. p.A 1704 PHONE: ;717) 76~-771 OR 7EF-7'~'' Fax: (717j 7E~-i~h6 r ~- _ u .` u efy ~.. ~ =. c. _ a FOR PROFESSIONAL SERG'ICES IZEI~~ERED Ail In~-oices Are Due And Pa~~abie Qn Receipt. THERE RILL BE A $15.00 RE.BILLING CHARGE FOR ALL ACCOliNTS OVER 30 DAPS • A. B. TYPE OF LOAN: U.S. DEPARTMENT OF HOUSING 8 'URBAN DEVELOPMENT 1 ~^ FHA 2.QFmHA 3. ^X CONV. UNINS. 4. ~VA 5. QCOt~ 6. FILE NUMBER: 7. LOAN NUMBER: SETTLEMENT STATEMENT - - I 8. MORTGAGE INS CASE NUMBER: C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. . Items marked '(POCJ" were paid outside the closing; they are shown here for informational purposes and are not included in the totals. D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SEI; LER(LEMOrNE-sis•sFurNv4ME AND ADDRESS OFvLENDER: Lemoyne Land Corp., Inc. Patsie A. O. Nichols Estate Integrity Bank 319 South Third Street, P.O. Box 31 by Gary B. Quigley, Executor 3345 Market Street Lemoyne, PA 17043 Camp Hill, PA 17011 G. PROPERTY LOCATION: 615 Southview Drive Mechanicsburg, PA 17055 Tax Parcel No. 42-28-2417-012 101. Contract Sales Price 102. Personal Property 103. Settlement Char es to Borrower (Line 1400 104. 105. iu6. Gi !Town Taxes 107. Coun Taxes 108. School Taxes 109. 110. 111. to 06/14/11 to 01/01/12 06/14/11 to 07/01 /11 to i. 5t I I CEMENT DATE: June 13, 2011 UEi/14!11 to 01/01/12 283.08 U(i/14/11 t0 07/01/11 112. `` " • 120. GROSS AMOUNT DUE FROM BORROWER 412 . 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 87,736.04 420. GROSS AMOUNT DUE TO SELLER 85 347 29 201. De osit or earnest mone 500 . REDUCTIONS IN AMOUNT DUE TO SELLER: 202. Princi al Amount of New Loans 8,500.00 501 . Exe:ess De osit See Instructions 203. Existin loans taken sub~ect to 85,000.00 502. Settlement Char es to Seller Line 1400 3 027 00 204. 503. Existin loans taken sub ect to , . 205. 504. Payoff of first Mortgage 206. 505. Pa 'off of second Mort a e 207. 506. De osit retained b seller 8 500 00 208. 507. , . 209. 508. ustments or terns n aid a er 210. Ci !Town Taxes to I 509. ustments or terns n a) a er 211. Coun Taxes to 510. Ci !Town Taxes to 212. School Taxes to 511. Coun Taxes to 213. 512. School Taxes to 214. 513. ~ 215. 514. 216. 515. 217, 516. 218. 517. 219. 518. 220. TOTAL PAID BY/FOR BORROWER 519. 300. CASH AT SETTLEMENT FROM/TO BORROW 93,500.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 11 ER: 301. Gross Amount Due From Borrower Line 120 ( ) 600. CASH AT SETTLEMENT TO/FROM SELLER: ,527.00 i 302. Less Amount Paid By/For Borrower (Line 220) '( 87,736.04 601. Gross Amount Due To Seller (Line 420) 85 347 29 , 303. CASH ( FROM) (X TO) BORROWER I 93,500.00) 602. Less Reductions Due Seller (Line 520) ~( , . 11 527 00 The undersigned hereby acknowledge receipt of a completed cop 5,763.96 603. CASH (X TO) ( FROM J SELLER y of pages 1&2 of this statement & ' , . 73,820.29 Borrower _..a __._. Lemoyne Land-Corp Inc .~~ any attachments referred to herein. Seller _, --~ _. ""~ - ~.. . Patsie .~. Ni stat -~ Michael L Coons, President BY: •,`;-~ Garyi3. Quigl , Ekec Qr H. SETTLEMENT AGENT: 23-2083639 Kerwin & Kerwin, LLP PLACE OF SETTLEMENT Integrity Bank - 3345 Market Street Camp Hill, PA 17011 5,U~ 401. Contract Sales 402. Personal Prope 2,388.75 403 INS. 'iU4, 405. m n 406. Cit /Town Tai 283.08 407. Coun Taxes 64.21 408. School Taxes 409. 410. HUO-t (3-86) RESPA, HB4305.2 700. TOTAL COMMISSION Based on Price 5 8 000 ~ C d Division of Commission (line 700 1 as Follows a 2 D000 % 1.7 OO.OO : PAID FROM PAID FROM , .01. $ 1,700.00 to Rowe's Auction Service BORROWER'S SELLER'S 702. $ tC~ FUNDS AT FUNDS AT 703. Commission Paid at Settlement SETTLE T SETTLEMENT 104. Advertisin Costs to Rowe's Auction Service 1,700.Oi 800. ITEM PAYABLE IN CONNE TI N WITH L AN _ 457.Oc 801. Loan Origination Fee % io 802. Loan Discount % to _ 803. Appraisal Fee to Inlegnty Bank 804. Document Pre aration P to Integrity Bank 50.00 805. Flood Cert. to Inlegnty Bank 300.00 806. Mortgage Ins. App. Fee to 15.00 807. Assumption Fee f~ 809. 810. 81L 900. ITEM RE IR D BY LENDER T BE PAID IN ADVANCE 901. Interest From 06/13/11 to 07/01/11 @ $ /day ( 18 days %) 902. Mortgage Insurance Premium for months to 903. Hazard Insurance Premium for 1.0 ears to 904. 905. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard Insurance months $ 1002. Mort a e Insurance per month months $ per month 1003. Ci /Town Taxes months $ 1004. Coun Taxes per month months $ per month 1005. School Taxes months @ $ 1006. per month - months $ per month 1007. 1008. months @ $ per month months $ er month 1100. TITLE CHARGE 1101. Settlement or Closin Fee to 1102. Abstract or Title Search to 1103. Title Examination to 1104. Attorne s Fees to 1105. Document Pre aration Deed to 1106. Nota Fees to Kerwin & Kerwin LLP , 1107. Attorney's Fees to 20.00 10.00 includes above item numbers: 1108. Title Insurance to Stewart Title Guaran Cam an includes above item numbers: 768.75 1109. Lender's Coverage $ 85,000.00 1110. Owner's Coverage 768.75 $ 85,000.00 1111. Endorsements 100 300 and 8 1 , . to Stewart Title Guaranty Company 1112 . 150.00 1113. Closing Service Letter to Stewart Title Guaranty Company 120. V N NT RE RDIN AND TRAN FE HAR E 75.00 1201. Recording Fees: Deed $ 62.00; Mortgage $ 78.00; d Releases $ 1202. Cit /Coun Tax/Stam s: D ee 1203. State Tax/Stam s: Deed 850.00 • Mort a e 140.00 850 00 1204. 850.00 ~ Mort a e . 1205. 850.00 1 . AD ITI N L TT EMENT HAR E 1301. Surve to 1302. Pest Ins ection to 1303. Overni ht Fees/Posta a Fees to U.S. Postmaster 1304. Tax Certification to Dennis Zerbe, Tax Collector 1305. 2011 CountylTwp Taxes t Reimburse K & K) 20.00 o Dennis Zerbe, Tax Collector 10.00 POC:S514.05 1400. TOTAL SETTLEMENT CHARGES (Enter on Lines 103, Section J and 502 S ti , ec on M() By signing page 1 of this statement, the signatories acknowledge recei t of 2'388.75 3,027.00 p a completed copy of page 2 of this two page statement. . Certified to be a true copy. Kerwin & in Settlemen Agent (LEMOVNE-615-SOUTHVIE / LEMOYNE-615-SOUTHVIE! 19 ) Owens Barcavage c~ ltifclnroy, LLC 2595 Interstate Drive Suite 101 Harrisburg, PA 171 l 0 USA Ph:717-909-2500 F<rx:717-909-2604 Dave Anderson 816 Rudyto«~ Road New Cumberland. PA 17070 U SA Attention: Dave Anderson RE: Dave Anderson/Quigley Estate DATE DESCRIPTION Jun- l 0-11 Correspondence to ?vlr. Anderson regarding bill for Estate work and summary of sale. Totals Total Fee & Disbursements Previous Balance Balance Now Due TAX ID Number 90-0429867 ~~ June 30, 2011 File ~: FL-100-2011 Inv ~: 2466 HOURS A'~ZOUNT LAWYER 0.20 40.00 ATK 0.20 $40.00 X40.00 1,240.00 S 1,280.00 ~; `~. ""`• `` , Page 1 PPL E ectric ~~=_ d t. ~~f e~~~ ~~ectric ~~rvice For= P ATSIE A Q 2~TICHOLS S 1 ~ SOi TTINIEVY' DR rf~.c~.a.~~cs$uxG P A i7~ss ~uesEions about this bill? Please contact us by Feb 22 at 1-Spp-342-5775 (1-8pp-D7Ai~-PPL) or R-rite to: Customer SerF•ice 827 Hausman Rd. Allento~°n, P A 18164-4392 ~~~~~_ppleIectric. cones TIec~~°~~ V ~Iv This graph shame's ~~our electric use over the last I3 months. Tvges of >~feter Readings: Act'.~al Adjusted Estimated Customer ~~~~~r~„ ~ag~ Balance as of Jan 31, 2d~1 Char es: Tota~PL Electric Utilities Charges Total IDT Energ~~ Charges Total Cltar~es ~o 30 24 IS 12 6 0 K~~~H -Average P~ Dad F lvf A M J J A 5 0 I~? D J F 2010 Monts 2011 ~f}.ap $20.24 X47 R4 'Meter Reading Information I~feter X31155551 - Jan 28 Actual 43661 Det, 29 Actual 43141 3G Davs KV~~I Billed 460 Average -.Tag 201© 2011 T empperar~tre 31 F 2 K`P'H Per Dad- 12 1; ~'earl~~ L?se: Total Averagge fTse Alontbly Feb 2GJ9 -Jan 201 G >068 42' 7 Feb 201 G -Jan 2611 ;276 _ 446 (}tier ~~par~~nt i~.for~ati~a on hae~ •$ ~~ Z~slj~ i 5040 LOUISE DRIVE SUITE 108 MECHANICSBURG PA 17055 ACGQtlNT INQUIRIES ~ Local Office: (717)796-171 D I Toll Free: 1:800.TERMINIX 1oz air ise Rwa -se ~~ G;,GO KR RP 24 C1?42Gi1 YYN'fNYNN 0031431 S1 T103 PAT NICHOLS 615 SOUTHVIEIN DR MECHANICSBURG PA 17055-5750 ~Illn~lll~lllllrl.Illlll~lilu~l~llllul~rllllll~llrlll,llrlllll ~ ]ATE j 01;2112011 12'20/2010 11/18/2010 DESCRIPTION OF SERVICES SERVICE ADDRESS General Pest Control Location: 615 SOUTHVIEW DR, MECHANICSBURG PA 17055 General Pest Control Location: 615 SOUTHVIEW DR, IvtECHANICSBURG PA 17055 General Pest Control Location: 615 SOUTHVIEW DR, MECHANICSBURG PA 17055 STATEI~IIENT O~~ A-GGO~~lVT THE PESTS YOU DON'T SEE QRE EVEN SGA,RIEFt. Every year, termites infest 1 in 30 U.S. homes and do more than $5 billion in damage. Guaranteed protection starts for under $35 per month.* Call 1.80Q.Terminix now for a Flo-Obligation Termite Inspection. ' Home must quality for the Terminix R~ Termite Inspection & Protection Plan ~J ~ My Customer Number: 2592036 Use this number to manage your account online. INVOICE # CHARGES PAYMENTS/ NET CREDITS I AMOUNT 301704204 $79.50 ~~ ~~~' i $79.50 30D839475 $44.52 ri`1 $44.52 ~~ 300085360 $44,52 1 ~ $44.52 ~ ~ ,! SUMMARY Total Due: $168.54 Past Due: $44.52 j Your account is still past due. P/ease give this matter your prompt attention and remit the past due amount in the enclosed envelope. Easy pay automated payments sign up at Terminix.com » Due date: Upon Receipt Important Message: Please retain the top portion o* the statement for your records. f _'~ `_.r. . J J. i u . ~ h J~`~TU w L r . 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From: Belinda Brady Pages: Dates: r:~,~-'~""~' '` 'O for Review ^ Invoices Requested ^ Please Reply ^ Send Payment ASAP***We Accept vsa, MC, AEXP or Check By Phone FAX # 717-764-1944 PHONE 717-779-2527 PLEASE SEND PAYMENT YORK WASTE DISPOSAL INC. 3730 SANDHURST DRIVE YORK, PA 17406 09-22-2011 04:05Pf~ FROE,A- Payment Details ReferencelD: 93650774052 Status: Paid Payment Transaction Information Payment Qate: 02114/2011 Creation Date: 02/14/2011 15:18:34 (CST) Submitted By: bradybe: Belinda Grady Authorization Number: 016173 Payment Enformation Account Number: 308119999991 {Utility) Customer Type: Consumer Payment Amount $347,gg Payment Method: Credit Card CSR Enformation CSR Name: Belinda Srady CSR Phone Number: (717) 779-2527 CSR Memo: FOR ACCT 107378 Contact Information First Name: GARY MEddle Initial: Last Name: QUIGLEY Address: g15 SOUTHVIEW DR City: MECHAlV1CSBURG State/Province: Pennsylvania ZIPIPostal Code; 17055 Country: United States Daytime Phone Number: (717} 779-2527 T-585 P.002 F-229 _. hops J/secure3. billerweb.com/alwlBillerConsole/inetSrv?sessionHandle=zwrXdV tN8QdF... 9122!2011 09-22-2011 04:05PM FRON- E-maif Address: Payment Method -Credit Card Card Type: VISA Card Number: *'`*"*"*"*"*4159 Expiration Date: 0312012 Name on Card: GARY QUfGLEY Credit Card Billing Information First Name: GARY Middle Initiat: Last Name: QUIGLEY Address: 615 SOUTHVIEW QR Clty: MECHANICSBURG StateJProvince: Pennsylvania ZIPJPostai Code: 17055 Country: United States >~~ T-585 P.003 F-229 https://secure3.billerweb.comlalwB i1lerConsole/inetSrv?sessionHandle=zwrXdV#N8QdF... 9/22!2011 09-22-2011 04:05PM FROM-- .-~--~Y A .,__. t~-.~ re }ls~s,s~ R~P,i"a'° 3730 Sandhurst Drive York, PA '174!18 Account Number 3-0611-01 0 73 7 8 Invoice Date February 15, 2011 lnvolce Number _ 0611_-000.5.33661 Previous Balance f0,0~ PaymentslAdJustments •5347.68 Unpatd Balance -5347.68 Current Invoice Charges 50.00 -$347.68 Due By: 03107!11 Customer Service {717} 845.1557 Customer Service (800} 210-9675 rs • • FOR YOUR CONVENIENCE 71NOALTERNATIVE ME7HODSTOPAY: WWW.DISPOSAI..COMOR PAY eY PHONE ®877.892-4728 80TH METHODS MAVH NO PROGESSING FEE _ To pay 'on-line or sign up far convenient auto pay, go to: , Visit us at www.dls oeaF.com T-585 P.004 F-229 GARY t3 (~UtGLEY Invoice Page 1 of 2 PaymentslAdjustments ~_ -__ Dascriotlon f;;eferenco - - _ _,- - 02l15 02/15/11 Unreterenced Memo -$347.68 Re: Payment In (credit) --Current•lnvolce Charges Current lnvolce Charges $0.00 ~ - - -- - o.oa -. - ~ •347.66 ~ o.oo ~ o.oo S Z • Vlsll our website, www.dlapoeal.com to make your payment electronically or tc sign up for our convenient automatic payment plan. • Please see reverse aide for terms and eonditione Please Return Thls t~'C~O Portion Wlth Payment 3730 Sandhurst Drive York, PA 17406 Total Enclosed Return Service Requested GARY B QUIGLEY 615 SOllTHVlEW DR MECHANICSBURG PA 17055-5750 Pay This Amount ,$347,68 Account Number 3-0611-0107378 {nvoice Date Febntary 15 2011 Inyalce Number 0611A00533681 Payment Due date March 7 2011 For Billing Address Changes, Check Box and Complete Reverse. Make Checks payable 70: YORK WASTE DISPOSAL #611 PO BOX 9001099 LOUISVILLE, KY 40290-1099 30611010737800000005336810000000000000347f87 09-22-2011 04:06PM FR06(- 'i1:•tSC~ Dt5P0$AL rircro 3730 Sandhurst Drive York, PA 17406 Account Number 3-0611.0107378 tnvoice Dale February 28, 2011 Invoice Number ,- 0611-000540545 Previous 9aiance -5347,68 PaymentslAdJustments 50.00 Unpaid Balancs -E347.68 Current tnvoice Charges 5347.88 CPU. L U Due By; 031201A 1 Customer Service (717) 845.1557 Customer Service (800) 210-9675 ~• • FOR YOUR CONVENIENCE TWO ALTERNATIVE METHODS TO PAY: WWW.DISPOSAL.COM OR PAY BY PHONE ~ 8T7-892-9729 BOTH METHODS HAVE NO PROCESSING FEE To pay on-line or sign up"for _ convenient auto pay, go to: Visit us at www.dls osal.com GARY B QUtGt.EY T-585 P.005 F-229 Page 1 of 2 Current Involce Charges Qery B Quigley 615 Scuthvlew.Rr (L1) ~~-~_ .__=__ __- Mechanicsburg, PA -- -'~'` 1 - Rotloff (10 Yd) On Calf Service (S1) Date ,gQscriotlon Re(Orence 9uantity SJnit Price ~Qyp~ 02128 Basic Service Gary/Pm 1.0000 5347;68 $347.68 Receipt Number 66478 Currant Invoice Charges $347.88 `--------347.88 , -347.68 i 0.00 -. I 0.00 I S Z • Visit our wabslte, www.dispoeat.com to make your payment slectronicalfy or Ia sign up for cur canvsnlent automatle payment plan. -' - - = --_ - ~---_- • Please see reverse side for terms and conditions ~uura 3730 Sandhurst Drive York, PA 17406 Pay Thls Amount $0.00 - Account Number 3.0611-0107378 Please Return This Invoice Rate February 28, 2011 Portion With Payment Involce Number 0811.000540545 Payment Due Date March 20, 2011 Total Enclosed For Billing Address Changes, Check Box and Complete Reverse. Return Service Requested GARY B QUIGLEY Make Checks Payable To: - 61 S SOUTHVIEW dR MECHAtV1C$BURG ~PA 17055-5750 YORK WASTE DISPOSAL #611 PO BOX 9001099 - LOUIS'J{LLE, KY 40290-1099 30fi11010737800000005405450000347680000000009 09-22-2011 04:07PM FROM- T-585 P.006/009 F-229 Payment Details ReferencelR: 93876244052 Status: Paid Payment Transaction Information Payment Date: 02!23!2011 Creation Date: 02!2312011 08:23:47 {CST) ` - Submitted By: bradybe: Belinda Brady Authorization Number: 009224 - -_ --_-- _. -_ Payment Information =- - -=__.-- Account Number. 306119999891 (Utility} ` ••--••- Customer Type: Consumer Payment Amount $437.68 Payment Method: Credit Card ~`~ "° ~ "'~- --~ - CSR information CSR Name: Belinda Brady CSR Phone Number: (717} 779-2527 CSR Memo: for 107494 Contact Information First Name: Gary Middle Initial: Last Name: Quigley Address: 615 southview dre City: Mechanicsburg State/Province: Pennsylvania ZIPIPostal Code: 17055 Country: United States Daytime Phone Number: - _ (717} 779-2527 hops://secure3.billetwveb.com/alw/Bi1lerCansole/inetSrv?sessionHandle°zwrXdV fN8QdF... 9/22/2011 09-22-2011 04:07PM FROkI- T-585 P.007/009 F-229 E-mail Address: Payment Method -Credit Card Card Type: VISA Card Number '`*"""""*""4159 Expiration Date: 0312012 Name on Gard: Gary Quigley Credit Card Billing Information First Name: Gary Middle Initial: Last Name: Quigley - _~_ - ,__.. Address: 615 southview dre City: Mechanicsburg StatelProvince: Pennsylvania ZIP1Pastal Code: 17055 Country: United States https://secure3. billerweb.com/alw/BillerConsole/inetS rv?sessionHandle=zwrXd V fN8QdF... 9/22/2011 09-22-2011 04:08Ptv1 FROM- ~~~.tisre'Q s~o~~~ r~trtltm 3730 9andlturat Drive York, PA 17408 • Account Number 3-0611-0107494 Invoice Date February 28, 2011 InvoiceNum7~er "•--`~ Ofi11-00054057 Previous Balance $0,00 Payments/AdJustments -5437.88 Unpaid Balance -5437.fiB Current Invoice Charges 50.00 _~ ~ s -$437.68 Due By: 03!20141 Customer Servica (717) 845-1557 Customer Service (800) 270-9675 ~~ ~ • FOR YOUR CONVEN[ENCE TWO ALTERNATIVE METHODSTOPAY: WwW.DISPOSAL.COMOR PAY BY PHONE (5j B77•B92.9729 BOTH METHODS HAVE NO PROCESSING FEE ---_ __--•_ _'- tea-- _____._ =.:s~.f j To pay on-line or sgn~up for i "convef~ient-auto pay,~o to:""--- - V{slt us at www.dfs osal.eom - T-585 P•008/009 F-229 GARY B QUIGLEY tnvolce Page 1 of 2 PaymentslAdjustments ~~g Descrintton ~ -- _ °_ _-- Refs 02124 02!24!11 Unreferenced Memo - -$437 68 Re; Payment In (credit) . Current tnvolce Charges _ . Currant Invoice Charges SO 00 _ __ 0.00 ~ -437.86 I 0.00 I 0.00 5 Z • Vlslt ourwehsite, www.diaposal.com to make your payment eleclranlcaliy or to elan up for our convenient autamatlc payment plan. • Pieaea sae reverse s3tle for terms and ccndltlans - ti~~asr~~'s~s~'l~st~t..__ .~ . ~..____ _____ _ - Jtua Please Return This - Pardon With Payment 3730 Sandhurst Drive York, PA 17406 Tots! Enclosed Return Service Requested GARY B QU IGLEY 615 SOUTHVIEW DR MECHANICSBURG PA 17055-5750 Pay This Amount -5437 68 Account Number 3-0811-0107494 Invoice Date Februa 28 2011 Invoice Number Ofi11.060540879 Payment Due Date March 20 2011 ^ For Billing Address Changes, Check Box and Compiete Reverse. Make Checks Payable To: YORK WA5TE OISPflSAL #611 PO BOX 9001099 LOUISVILLE, KY 40290-1499 30611010749400000005405790000000000000437683 09-22-2011 04:08PM FROId- QQ`` ~~ ~... 1': 51'~ !) ISFflSrlt r.,~~ 3730 Sandhurst Drive '-YC rIrPA-17408 ~- Account Number 3-Ofi11.0107494 lnvolca Date March 15, 2011 Invoice Number . ___ 0611-00.056!3305 Previous Balance '" ~ ~~` `-X437:68 PaymentslAdJustments SD.DD Unpaid Balance -5437.88 Current Invoice Charges 5437.58 ~UaVU ova By: aaioail1 Customer Service {717) 645-1557 Customer Service {800) 210.9875 r~ • ~ To pay on~line_or sign up for _ ~_ ~convenient auto pay, go to: -- Vistl us at www.dia osaLcom T-585 P.009/009 F-229 GARY B QUIGi.EY ~~ lnvaice ?age 1 of 2 Current Invoice Charges - -Gary B Qutgley 615 5outhvlew Dr ,L1) ~_=_ s___ - Mechanicsburg, PA 1 -Rolloff {30 Yd) On Call Servlce ~;31J Date '"°]Zascrlotlon Reference_ ritity ~ n1t Price - --~Qgpt, 03107 Basic Servlce Gary/Pm 1:0000 - $437.68 $437.68 Receipt t~tumber &8859 Current invoice Charges - - -- $437.68 ~_ __~ -_ - 437:88 I -437.86 1--- ' ~ 0.00- f 0 00 - S Z r Visit our wehalte, www.d(aposal.com to make your payment electronically ,; __ -_ _,_ _ or to sign up for our convenlant automatic payment plan. , _.-- _ -_ ___ • Please see reverse side for terms end coadHlana ~~ppJ~t# -~ -- --- -- ---~~ ___ ___ _ ..,_ __ __.._.. Piease Return This ~ustw_ portion Wlth Payment 3730 Sandhurst D_r_lye __- York, PA 17408 Total Enciosed Return Service Requested GARY B QU IGLEY 615 SOUTMVIEW DR - h71ECHA~I~SBURG PA 17055-5750 Pay This Amount 50.00 Account Number 3-0811-0107494 Invoice Date March 15, 2011 Invoice Number 0511-000588308 Payment Due Date April 4, 2011 ^ For Billing Address Changes, Check Box and Complete Reverse. -- ..._._ Make Checks Payable To: YORK WASTE DISPOSAL #611 PO BOX 9001093 - - --_. _- ~- - - LOUI5VILLE, KY 40290-1099 30611010749400000005883080000437680000000009 h+iore saving. o More cioirg;': 5101 1~J(vESTUWhI C;0 UWER FRrTO ,~ WE ~ ~' .: _ ISTA~L r?~FS,~ID!NG r~_~JUt'W~ ~r~'t li ~~ `~1 ~- ~ I )ti-. _ ~.,z2,3 02~,' 'll n_5a Pr± ~ A ~ ~~r -,~ch o~~~T _ ~oT~r _' i~ )5,Y,5 SPONGE M':;P =A> , .; i ~"' iG7(i, s~ ~ PLDGWDTFIG <A= ~ , t~titi. 04650U71687=; GLADE '' ~;~- ;,, 9.36 iJ 'os?75921gy? WOOLY GUS r_i .,= C .~- rER <.~= r ao suBTOrAL ss.4 SRLES TAX ~ XXXXY,XKKXD;kY,=1159 CyEBIT X35. q AUTH CODE 93039``+"- _ 's5. =;9 ff" ~ lil!IIIIIIli111111 i IIII~IIIIIIIIIII ~IIIIIIIII~II~III 9138 58 28223 G2/11/20i1 1?vS ~ ~~ RETURN POLICY DEFIrJITIOr~JS POLICY ID DAYS P~~LICY E>tPIRES OIV R 1 90 U5,%i2./2~~11 THE HGME DEPOT RESERVES THE RIGHT TO LIMIT % DE(VY RETURNS. PLEASE SEt THE RETURN POLICY SIGN IN STORES FOR DETRILS. GUARANTEEG LUW PRICES LOOK FUR HUNDREDS OF LOWER PRICES STUREWIDE Xxx'XX'x1."AXXkxXxxaxXxY;XXkXYCY:Y:xXXxx"x"XTkX: X ENTER FOR A CNANCE_ TO WIN A $5,000 HOME DEPOT GIFT C~RDt Share Your Opinion With Usl Complete the briefi survey about your store visit and enter for a chance to wir, at: www.hamedepct.com/apiriion iPARTICIPE EN UNA OPORTUNIppp DE C~r~C~lf3R UNA T'aRJETA pE ~PEGA~LO GE THD DE :$5 . 0300 s iComparta Su Opinion) Complete la breve encuesta sabre su visita a la Benda y tenga la apartunidau de yanar en: www.homedepot.aam;opir~ion User-- ID 6Oc`373 56783 Password. 11111 5E735 Entries must be entered by 03%13!2011. Entrants must be 18 or alder to enter. See complete rules on website. No purchase necessary. '' i - _ c' 4.a ~;~~ -. i i~ ~i Ii ~~. ~ !; '~ lil I~~, ii! ~' I ~I~,~ ?+ `_ 0 . t Share Your 0pinion With Usl Complete he brief survey about Your store visit and enter for a chance to win at: www.homedepot.rom;opirn on s PARTIC_=pE Ef~! U-~,q C)PORTUNIDAD DE rAf~tAF: UNA TARJETA DE REGALO DE THD DE $5,000: i;omparta Su Opinion? Camp;ete 1a bre~~e ancuesta sabre su visita a la tien;,+a ~;~ tenga la oportunidad da gan..;r enn: www. homedepot . Komi opi ni ~~+ User- I[j X3775 3964 P~sswr~rd 11118.39637 entries must be entered by 03;20%1011. entrants must be 18 or older to enter. - See complete rules on'website. PJo purchase necessary. Sovereign ESTATE OF PATSIE A Q NICHOLS GARY B QU IGLEY 428 WOODRUFF WAY HARRISBURG; PA 17112-8958 Date: 02-1 ~-1 1 Reference Number: 201102150830 Account I~Tumber : ~~XX~iX~~O~XX~764 Serial Number: Dear Sovereign Bank Customer, ~~~` ~N Your account is being charged 577.04. Savings bond redemption error in your deposit of 2/14/1 a for 5~,67~.86. Teller redeemed bond#L351668561EE valued at $77.04 twice in error. Tlus entry to adjust. f/-zo If you have any questions or «~ould like more information, please call the Customer Contact Center at 1-877-SOV-BANK (1-877-768-2260, between 7:00 a.m. and 8:00 p.m. EST, 7 days a week. Hearing impaired customers may call 1-800-428-9121 (TTY/TDD). A customer service representative will be pleased to assist you. Thank you Linda Scarborough Adjustment Services D'IA1 MB3-O1-06 2 Morrissey Blvd. Dorchester, >\ZA 02125 PPL Electric Utilities ~>C~ For: PATSIE ~ Q I~'ICHOLS 613 SOITIHVIE~' DR Iv1EC1iA1~IICSt~URG PA 1705 Questions about this bill? Please contact us by Mar 23 atl-8dd-342-577 (1-80d-BLaiL-PPL) or R~a-ite to: Customer Seri-ice 827 I~ausman Rd_ Allentov~>n, PA 18104-9392 Rwc~~.ppl el ectrie. cony ~~ec~r~~ ~T~~ This ~aph shoR~s vaur electric use over the Iast 13 months. T~-pes of 141_eter Readings: Actual Adjusted Estimated Customer ` ~i ` ` <`_ `~~~~"<<~`; Faoe I .` ..-- E~~_ ~~~ ".. <,•E~ ~...~ ~1~~~~>l~~ ~~~~ Ba~a~ce as of l~~ar 2, 2€111< Chargges: TotaI~PPL Eiect~ic utilities Chafes Total IDT Energy Charges Total Charges Account Balance K~~i`H -Average Per Day 36 30 24 ig 12 i 6 0 M A M I J A S O N D J F M 2010 Months 2011 64801 30001 ~€}.l}0 $14.6 X25.34 ~. $40.90 i ~4C.9q r r; ': ~~~ ~ ~ ~ ~ ,'`. ~ ` [ ~ '~~ ~ r ~~Ieter Reading Informatit~n 'deter =31255551 Mar I Actual 43883 Jan 28 Actual 43601 32 Davs KVJH Billed 282 AE-erage -1~'1=ar 2410 21111 Tempperahrre 30F 32F K~rH Per Dav 12 9 `r'earl~~ Use: Total Aj-erag I/TSe >4fanthl~ Apr 2009 -Mar 2010 X063 42: Apr 2010 - ?.gar 201 I ~ 18I 43, Qth~r i~2p4rtaiat iaf€~a-l~atict~ ~a ltaek ~ /~'2/ Z'Z- ihNOtCE Date: MARCH 12, 2011 Prepared ?or. NICHOLS, PATSIE A.O. (ESTATE) 615 SOUTHViEVV DR. lVIECHANICSBURG, PA. 17055 Property Appraised: PATSIE A. Q. NICHOLS 615 SOL'THVIEW QR. MECI•iANICSBURG, PA. 17055 File No. NICHOLS Case No. 615 SOUTHV{EtrV APPRAISAL FEE _ $ 400.00 £ _ 5 Toth! Amount Due: ~ 44o,aa Piease make checks payable to: P. SCOTT ARCHIBALD 4454 DUNMORE DR. HARRISBURG, PA 17112 717 - 541 - 5005 -OFFICE 717 -541 - 5051 -FAX scottarchibald~ver¢on. net Produced by ClickFORMS Software 800.622-8727 ~e d~lOt~ .fie N o ~~ w You know Ad Order Number 0002132886 Customer DAVID ANDERSON,. ESQ. Sale~Re~ Customer Account durie 224759 Orde- rTaker Customer Address durie 816 Rudytown Rd Orde_,r~Ce New Cumberland PA 17070 USA Customer Phone 717-554-4736 PO_ Number Orde- red By David Anderson Customer Fax Custo~me- EMail Tear Sheets ~-~--_ Proofs Affida=its 0 0 1 Invoi~Xt Matte Net Amount $135.89 Pavme`hod payment Amount $0.00 AdAd Number Ad Ty,L 0002132886-01 Ad SSize Legal Liners 1.0 X 9 Li Production Method Production Notes Ad Booker External Ad Number Ad Attrib_tes 3/18/2011 5:26:59PM ~-z Order Confirmation Blin~gox Tax~~t $0.00 Amo~Ue $135.89 Color <NONE> Pavo` r Cu=tr~~er DAVID ANDERSON, ESQ. Pavo-`punt 224759 Pavo`d=ess 816 Rudytown Rd New Cumberland PA 17070 USA Pavo_ r 717-554-4736 Soecia~c~n~~ None P rom~Tv De Total Amount $135.89 Ad R~Sed No Pick 1 Ad Preview Nkhols, Fatsie A.Q„ aec~a, Late of Mechdn lcsburg; Executor: Gary g, Quigley, C/0 David C, Anderson, Esq„ DC Anderson $ Associates, 816 Rudviown Roaa, New Cumberland, Pq 17070. Attorney: Davla C. Anderson, DC Anderson 8 Associates, 816 Rvdytown Roaa, New Cumberlond, Pq 17070. Product Information Run Schedule Invoice Text PlacemendClassification PNCO: Full Run Sort Text 800P -Main Legals ESTATE NOTICE Nichols, Patsie A.Q. ESTATENOTICENICHOLSPATSIEAQDECDL! # Inserts C_ ost PNCO::Full Run 800P -Main Legals ESTATE NOTICE Nichols, Patsie A.Q. ESTATENOTICENICHOLSPATSIEAQDECDLf # Inserts Cost PNCO::Full Run 800P -Main Legals ESTATE NOTICE Nichols, Patsie A.Q. ESTATENOTICENICHOLSPATSIEAQDECDL! ## Inserts Cost Online::Full Run 800P -Main Legals Nichols, Patsie A.Q., decd, Late of Mechanicst NICHOLSPATSIEAQDECDLATEOFMECHANI # In- s-e-rts Cost Online::Full Ru-~- 800P -Main Legals Nichols, Patsie A.Q., dec'~d, Late of Mechanicsk NICHOLSPATSIEAQDECDLATEOFMECHANI # Inserts Cost Online::Full Run Nichols, Patsie A.Q., decd, Late of Mechanicsk N CHOLSPATSIEAQDECDL # In_ smarts ATEOFMECHANI Cost 3/18/2011 5:26:59PM Rues }/-s 3 2 ~/z3 CUMBERLAND LAW JOURNAL 32 SOUTH BEDFORD STREET CARLISLE, PA 17013 Tele: (717) 249_3166 Fax: (717) 249-2663 April 22, 2011 Cumberland Law Journal is published every Frida b Bar Association and is designated by the Court of Common publication for Cumberland County and the le y y thE'' Cumberland County notices. gal newspaperf oecpublication of le legal gal TO: David C. Anderson, Esquire Patsie A.Q, Nichols Estate RE: Legal advertisements must be received by Friday Noon. All I must be paid in advance. Make all checks payable to: Cumberlan egal advertising _______________________________________ d Law Journal. Advertisement inserted on following dates: April 8, April 15, and April 22, 2011 Advertising Cost $ 75.00 Proof of Publication $ 0.00 Second Proof Request $ 0.00 Payment received $ 75.00 Total Amount Due $ 0.00 Becky H. Morgenthal, Executive Director .~ovv~=S AUC~r ,~. ON SER,~~~ ~R~. ~ ty 9~) Bill Roc~-e (_aU 1538L) 25Ei5 Ritner Highway Carlisle, PA I'7015 249-1978 597-4 ~ 94 Dave Row 249-267'7 e (AU 2295L) Auction Is Action Call "REiwe's ~'or Satisfaciion SELLERS NAME ~ -~°~.~~' ~-~ ~~G~ ~, `~ ~e ~t c.G. ~..,~~ -DATE aZ ~ ~ ~ ~ A DDRESS , ~ ~ t~~cC~r~,, E t utJ'~- E~THER ~-,~ R ~4r~t 5 ~ wry ~~- RHONE ~~ ~ ~ `~ f AUCTION D.4TE,'LOCATION ~"` [ff~' -- AUCTIONEER ~ -~!-~__ l - CLERii ~,~ ~_.~ ~} I~~SCRIPTION Q~ I~ERC~IAIVBFS~ -2a. ~-~ ~-fifi x~a~~ ~ CF ~~.s~ ~`- ~ / ~'~ ~` •• ~` ~/ ~.f S err F ifs' ~G/7~!/` `~ ~s ~ p~ ~~ ,~tf ~ ~ ~ ~` `~~ ''~'~ ~ Gnaw. !d?S °'~ ~~ `G~ ~~ ~ ~C G,~ ~ s , ~ ~.e. ~ ~E. L`~i ~ ,( ,~^ r n if r ~ I Commission the Auctioneers to seIl the merchandise to the highest bidder b - t.~ be sold as is & grouped as necessary to obtain bids. I certif t tative of the merchandise, goods and or property and have good title and the ri h Ptublzc suction. Merchandise Y hat I am Lhe owner or authorized represen- from all incumbraaces. I agree to accept all responsibility for providing merchant title to the purchaser. I afire to hold harmless the Auctione g o sell and that they are free this afire t, ers a ainst ,h , able title and for delivery of + g ~ ~ clairr~s of the na~re r ,- ~~ ~ ~ f ~ _ efe_red to in AUCTION SIG; iATURE Total Sales Clerking Tickets Attached) ~ 1 ~ t SELLE S SI'G~,ATL E L ,ess Sale E~:pense: --~=- °%~ Commission Auctioneer ~ 4 ~'~-`~;,~ ~ ~ -----_ `"o Co~m1ssion Clerks OTHER: ~~~~~~~ TOTAL SALE EXPENSE DEDUCTED ~ -~, SELLERS NET ~ ~ ~ ~ ~r ~ ~/""'~~ ~~ PPL Electric t~tili~i@5 ~~~ctr~c ~er~~ice For_ PATS%c. A Q ?~TICi3OLS 615 SOL`I'I7~'~R'DR biECiL~?~iCSBL'RG PA 1?p55 Questions about this bill? Please contact us by Appr ? 1 art-840-342-57i5 {1-800-I}L4L-PPL) or write to- C'ustamer Service 827 F,ausman Rd. Alieutown, pA I8I04-s39% a ~'w-Ppleleetiie.com ~~~E~C~~`IC ~J ~~ Iltis ~aph shoR-s dour electric use o~ er the Iast 13 months. Tt~pes of Meter Read~gs: .~ct<,ial ~;djusted Estimated C~stOliler ~5 3G ,~ I8 12 6 0 ~ 4 ~ ~ ~~ F F E ~ ~ ~ . e.~ ~~ :.- e~~ '•`'et • , ~ 4 ~ *u ~~~~~~T ~~~e La~a~ee as €~f _ltfar 31, 2QI1 Charges: TotaT"IDT Ener~v Charges Total PPL Elec~rie Utilities Charges T'erfa~ Clzarbes Account~~alance ~O.ItO $13.70 $10.14 X23.84 X23.84 i `~~ ~`` ~ 1 K~fiH -Average Per j?av /-, ~~~"`~ I~~eteF Pteadigb ~nfC3rn1ati4II Paleter #3125x531 Mar 30 Actual ]1~tar I Actual 4403I :?9 Dais K«'H t edB 1Ii edB II X3883 148 A~'eraee - R~r 2010 Ten~lpperature K~~'1I P 4j i 2011 4IF er Dad. I'earlt~ IIse: _~ Total LTSe Apr 2009 - R'Iar 20I 0 Avers~ ge >~foIItl~`~ ~ Ap~,_ 20I 0 -Mar 2011 ~~~~ 4I'i 4I9 Qt~er ~mpor~a~t icrfar~ati€t~ err baclti rilvt i JASOND 7 FMA 2010 Months 20I1 "~ ~ (' ~.~ More saving, o :More do~ngC" ~'"E MANAUEr? C HET t . f, F_,n ~ r N ,r' Vet E ~Y ~ 7 `u 9 - 'IE;; SELF Coil 6 til)T I:ul,~~ ,1' C, ~ ail` ii ~U, , ~ ~. ' '~' ~ ~ ~ rigs ~ 5 ~ ;-_ _ .~7 ~, r,~y1 ~~~ ~ ,, 'J P ~av ti ,_-~ r -~ ~ S ~ , . 1',1 ~!~ ~ tQ4rl 1 AI ~ M ~ .,- k ~:,., 6443._ ~00~36 L'ryTf ",NFi D ~- , JLr S~vlilgs ~ 0~~ r 51689 PFf T~ -,fACT ~ = . . :~~.~r, ~V ')f {~ 'E5 IAA: .XXh~k~~XV~~r~,yr~, Ilt[IT ~:;i 11~~~~ ;UTh' ~ ODE 8;;196! ~ ~,-~ PJtW ~UYIEh2 i'i'i([ fJ' f' ~'%''a J i, . JU ~II I~~E~~~~~~1 ~~~~~~~~'~i'~~~!~I~~I~~i~I~~II~~~tD~~ ~~ 41 ,_ F~ .1.040, ,ia,_,E,~~i7~ ~?yq7 I POL r.l,~ !Rfd P~,iL1C:';` Cicf-iNITIOIV'S A ~1 aD ~~~~i~)~ ~'~~LIC!' E~:FIF:~_: r!f,! 07'15/2C'i1 _ THE HOME DEPOT i'E ~?1%LS THE P,I:;,;-T T(~ ~''t~r~ 5~~1~1~. 5101 JONESTOWN RD :LOWER PAXTON PA. 17112 WE INSTALL RDOFS,SIDING;WINDOWS,FENCES 4138 OODOZ 80387 04; 30/11 08:40 ,AM C.gSHIEP, JANAE - JBR4311 ` 032247249843 5MTRFBLDPLS2 <A> 16.44 046462007140gMAILBOXSPOST cA> 44.97 NLP Savings $O.OD 053923975336 1 GAL GAS CA <A> 8.48 039645124048920#QUIK~ETNG SA> NLP Savings $0.00 10.80 045899358054 5 BLK $ SILV' <A> 0.58 NLP Savings $0:00 045899358016.1 BLK & SLUR <A> 0.58 045462002725gMAILBOXu~A> NLP Savings $0.00 17. a7 045899358061 6 ELKB:SIL KA> 0.58 NLP Savings $0.00 ---Free Round-Up w/ Turf Builder------ 070183500314_RUP 1%2 RTU <A> g.gg NLP Savings $0.00 MAX REFUND VALUE $5.81 032247249843 5MTRFBLDPLS2 <A> 15.44 R- ~ ~, ~v ~'~~ ~~~` ~~~~~z~~ ~r~'~~~~r~~. 6000 CARLISLE FIE(E, MECH Pn 170;5 STORE MANAGER CHET KEEI_EY t 717) 7,yG :~6C)2 4120 00010 41 X32 Ci4;'i6i 1l 11:19 AM C~+SHIER AMAnIDA - A.)Wa719 022367568467 GL EX,' ,,AT q> 077089209006 WDGRPR9"RLri :r,., luil.~iu ., ~- 5 u7 suaroTAL 1~i5, G7 SALES TAX ~-~ ~ ~,- XX;a'Xf XXXXXXkE759 V(SgL /"'11' `~ AU?H CODE 011184i9:L01221 t' 712.33 TA i a I ~ ~ iI ~ iI ~, I, ,~,, ~ i ; ~' ~ ~ ~ f . € ~~ -~ ~ ~ ~~ I=1iiI~C~I~I' ~ ; ~' 41 ; G I~II~~I~~:~ 10 1c 41,, ~I-III 32 04/16%2011 1938 P,EIURt~1 POLICY DEr"INITIOIJS POLICY ID DA`/S POLICY EXPIRES OfJ A 1 90 07%15/2011 ...r ... ,..r r-nn T_ u-c~n?rrc _n_i~.. r, r:zur Tn More saving, ~ o More doing: 5101 ,JUNE3TOWTJ RD LOWEP, PAXTUN FA, 17112 WE INSTALL R00FS,SIDING,WIIVDOWS,FENCES 4138 00057 52621 04/30/11 08:5D AM CASHIEP, SELF CHECK OU7 - SCOT57 015812587243 TORP LEVEL KA> ~ 3.9, SALES 1'AX TUTAL< ` CASH 2~-- ~ OY- p ~ CHANGE DUE 15.79 IIIII'Illlllll IIIIIIIIIIIIIIIII IIIIIIIIiIIIIINIII lillll 41~:~ 57 52621 04/30/2011 0754 POLI(VT IO PAYS ~ POLI Y EXPIP,ES ON A ~~ 90 ' ' ' 07/29!2011 THE HOhIE DEPOT RESERUE5 THE RIGHT TO LIMIT /DENY RETURNS. PLEASE SEE THE RETURI+I POLICY SIGN IN STORES FOR DETAILS. APL E~ec~r~c .~~f'C~~'~C ~ ~~~~ C' For: Parsr~ .~ Q ~~cxo~.s 6t5 SOUTi3~'IEW DR I~CH4IVICSBURG PA 17055 Questlous about this bill? Please contact us by IVIav 23 at I-&OQ-342->775 (1-80Q-I~L4L~PPE.) or Write to: Customer Ser~-ice 82 7 Hausman Rd. AllentoRJn, PA 18104--992 ~~~ ~'~•. ppl e1 ec t~ c. com V S E' This graph shoes=s your electric use over the last 13 months. T~'pes of 1~'Ieter Rea€lic~gs: Actual ~~ djusted Estimated CF1StOmei 3c 30 24 i8 12 5 0 1 ~ ~ .t i F f ` ~ ..-- ~~ .. , ;.. ~r ``,' t ` ,,, ~EI~~c`II~r ~~E' balance as of~ga~= 2, ~.Q~I1 ~=ha~ges: Toiaj PPL Electre L~tjlities Chat-~,es Total IDT Enero-~~ Ch~ges Total Cl~arbes Account Balance ~~~ R«x -Average Per 7a~- ~.(IEi $1 7.~Q $15.99 ~28.~49 X2$.49 ~~~` .-~~ 1,, c. F ~~ ~ \ ~.) '~ r~feter Readigb I~'o rmatioII r~feter #312~j~;~I Appr 29 q~ h'I:r 30 .4chial 44220 10 Davs g~ •H ~ 44031 189 ~~vera6e _ :Lpr Tee~lp nature K` T ` 2010 ~6F 2~tt ~ + H Per Bav >2F - 9 6 I'earlti~ Lase: l~~y 2009 -Apr 2010 Total ~~6 AE'erage ~fontlal~- n~y2010-Apr2o11 4 R -93~ 41~ 411 E}tl~er ic~~artaat ~tt~'ar~atictt7 a~ l~ael£ ~ ivl~ iASOND iFMAA7 201 ~ Months ~r ~~J11 PPL Efecfiric ~ft~i'~ie5 ~IecL~-ic Service hor: PAI SIE A Q NICHOLS 61~ SOUTI~'gW DR ~'~CK~~TICSBLTRu PA 17pjj Questions aho~t this bill? Please contact us by Jun 22 at1-800-342-5775 (1-800-VIAL-PPL) or Write to: Custocuer Sers-ice 82' Hausman Rd. AlIento~~, pA 18104-9392 ~'u~'-ppI el ectti c. cam ~~TIe~Lr~~ U$~ This graph shows Jour electric use Deer the last 13 months. ~T~'pes of 1~ieter Readings: Actual .~~djusteri F',stimated CUStOmer t ~ e ~~ 64801-30001 ~~ t E ! • ~ ~~ PaQe i~~~ b !~-_ !~~ ' • ~~'~~ I3ala~ce as of.iu!r~ ~ 2Q11 r ` t ~ ~Q.4Ei Charges: '~ t ll `` Total pPL Electric utilities Ch yeS Total IDT Energy C'h~-~eS ~ ~ 16.76 Total Charges ~ $30.6 Account Balance X47.72 36 30 24 18 12 0 I;~~rH - A~-eraQe Per Dz~: >~'.Ceter Readi~sg l~€traaatian l~feter X312555=1 l`Zay > 1 Actual Apr 29 Actual ~}69 ~2 Davs KVvT~i edB lI ~72Q 349 AE ecage - Itia~~ Ter~ip erature K~vH P ZOIp 6iF 2011 63F er Da} 10 lI Ye:~rle' Lase: Tc~tat At'era6e Jun 2009 - ~F'lav 2010 Use g IGfonth~~, Jun 2010-Ma}~201I gi `' 415 950 413 Other imgarta~it ~ufarmagian o~ hack ~- '•'ASONDJFMAMJ 201 J Months 2011 PPL Electric ~tiiitie~ ~~e~tr~c Ser~~ce Fdr: P ~TST~ A Q 1~TICHOLS EI5 SOLTTH~rIEw DR MECFLAI~rICSBL~RG PA I7055 Ffital B~II Questions about this bill? Please contact us big Jul 7 atl-80~-342-3775 (1-80U-I~L~L.-PPL) or q-rite to: ~ust~mer Sen-iee 827 Hausu~an Rd_ ~.Ilentoa.~n, P_~ I8i04-9382 ~~ ~'-pplelectric.cdn~ ~~ee~~~ use ~E This €'zaph shows yo~zr el~teic use ova- the Iast 13 m~nths- T`'pes of >E~eter Readings; actual ~~~justed l=sti~~ated Custdn~er r~ 30 24 18 12 6 0 4 { < < ! ~ ~ ~[tt1 1~/ •' 1 - ,,._ ..__ ~~ .1- •.. `° ... Su~~~r~T gage Balance as afJul~ 16, 2Q)I Charge,: Total PpL Elec~c L~ l~~~s Char:~es I'cetal C~tar-hes rxGG©.Int ~alaIICc 1i~1'~l - fivera¢ e Per I~~<. SQ.~PO $4. ?0 -1=~. i ~ -`~. ~ J ~-9.35 PF~eter Rea€i~g 'dr~a~©1$ ~M1Leter X31255551 Jau I , Actual A'Iay 3l Acts 44622 I ~ Davs K~1 Btll - ~6g AF-erage -Jun ~3 T~~~pzrature K ~`H Per D `~lU 7 2Q11 7 ai. ~~ 3F 4 ~'earlt' Lase: Ju12009 -Jun 2Q10 TdtaI Lase Aeera e >~Lont~~> .I~ ZOI O - Juu 20I I ?088 ,~ 4372 364 ~3'tber F~parta~t 1~f€~r~atl~c~ taa back ~ ~1~F 69801-3 0001 ~V t~1 Q05449 2Te11B 42 ~"5DG? ?aTSIE a Q I~'ICHOLS 5I ~ SOLTIT+TEw DR ~CHA?~TCSBLrRG P~ 170;5-5,50 ~Z~35„ P-di_ ~5:~ - ~zs_~u~ ~van~ PPL ELECTP,IC UTILITIES ~~E°~r~~rflt~l[rel~f~~E~~~I![P Iffy ~~ ~I~FI - r E I(~ r ~i Ii 2~voxTxyTHST1~FT~pC-cEn~~l ~ i ! E~ f e (~ a << ~ ALi.ENTO~~fii PA 1 81 01-1 1 75 Z 9QQQQpQQQQQQQ©QQQQQQQ2 6~BQZ3000Z '``~SUT•'DJFMAMJ J 2010 Mc?nt~s 2011 RECEIPT_FOR_PAyMENT ~ ~ GLENDA FARMER STRASBAUGH OneCourthousenSqy Register Of Wills Receipt Date: 7/08/2011 Carlisle, pA 17613re Receipt Time: Receipt No.: 13:50:54 1066232 NICHOLS PATSIE A Q Estate Fi.1e No.: 2011-00040 Paid By Re=marks: GARY QUIGLEY DB ------- Receipt Distribution Fee/Tax Description --------------------- Payment Amount Payee N,~.me INVENTORY Cash -____-- 15.00_ CUMBERL~~ND COUNTY Total Received.... GENERAL FUN 15.00 "" 15.00 'sfr~5it 's'~~.<ii; -- ~ PATSIE NICHOLS J/1•~ a 3~ Z., />t -` REPUBLIC i.~'~`.~ t~ J 3730 Sandhurst Drive ~ { - // InVO1Ce 1'ork,PA t74D6 ~~~ ~,~ [~~ (~ -- ~~„ Page 1 of 2 PaymentslAdjustments r~s r 4 Date De Account Number !. Invoice Date 3-0611-1229693 sc--r-tot1On t, l~ 10/05 Payment -Thank You ~~ Reference - December 15, 2010 !nvoice Number 0611-000480568 previ B Current Il1VOICe Char es 3 - Amount ggg -$44.82 ous aiance $44 82 g ,'ayments/Adjustments Unpaid Balance . -'p4,a 82 Patsie Nichols 615 Southvievv Dr (L1) Mechanicsbur pq - [ } ` ~ Q Current Invoice Charges 50.00 544.82 g, - Contract: 9611028 (C2) ,~ . _ tJu ~~~ ~~ 1 -Trash Cart (85/96 Gallon) Scheduled Service (S1 Dat I ~~ '~ r _ • ' ~ ` e Description r i _ 12/15 Residential Service 01!01/11-03/31/11 Reference Quanti t Unit P__ice Amount S>44.82 Current Invoice Charges $44.82 $44.82 Gue i3y; 01/04/11 544.82 Customer Service (717} 845-1557 Customer Service (800) 210-9675 { f ~~~~ ~ i / FOF2 `.!OUR CONVENIENCE TVJO ALTERNATIVE ~ y~ S LG ME HODS TO PAY: WIMN.DISPOSALCOM OR ~~/f`` PAl 6Y PHONE ~ 877-692-9729 BOTH METHODS I 4 ~ ~ ` HAVE NO PROCESSINGrEE ~ ~ ~° ~~ - ~., To pay on-(ine or sign up for ~~~~~ -- ----~~' --- - - --- --- c3 DAY5 - ` -- _6b DAYS T- convenient auto a 44.82 O.oo --- -- --nD~.D~ p Y, go to: o.oo ~ a oo - --- ` = `° B A Visit our website, F isit us at ww~.d;sp~saLcom or to sign up for ouWr convenient automat c payment pia ent electronically ' Please see reverse side for terms and conditions r- i i C. V UU I J 4 UU,^, UUUUUUVLbL f1Ek` ~~~f °"P~ ~ K E 1. /r`abody serves you better Send all inquiries to: 40 West IVlanoa Road Havertown, PA 19083 www irskelton com 000000p0262 IILlIIllltllltttfilltlltlRllFll PATSIE NICHOLS RD #9 615 SOUTHVIEW DRIVE MECHANICSBURG PA 17055 STA TEMENT T!i ~ _ ~~ _- ~ ~. ~~ For questions on your account, please call us: 610-525-3600 '' ! k, ~~ Account Number Previous Balance 5216, Current Charges 5539.7 Statement Date 01/03/11 Payment Due Date ceipt AL ANtOUN tipvE $539.71 /' ~e~~veryiaervlce Address: 615 SOUTHVIEW DR 17055 Current Dollar 31-60 Days 61-90 Days 50.00 5539.71 50.00 INVOICE # DATE DESCRIPTION 147194 08;31/10 SERVICE CONTRACT 0 09/15/10 PAYMENT-LOCKBOX 718553 12/03/10 #2 HEATING OIL 91-120 Days Over 120 days Past Due Gprrent Balance so.oo so.oo 5539.71 GALLONS ~ PRICE CHARGE 3299.95 I 150.8 3299.95 CR 53.5790 3539.71 Current Finance Charge: $0.00 i^'~ortertt Notice: CALL TODAY TO SCHEDULE ATUNE-UP FOR YOUR HEAT.tNC AND OR AIR CONDITIONING UNIT. REFER AN AUTOfv1ATIC DELIVERY ACCOUNT TO SKELTON APJD RECEIVE 550.00 PLEASE PUT YOUR ACCOUNT NUMBER ON ALL CORRESPONDENCE TO INSURcPR ~.°rff CREDIT 7EAR DFFAND R i!,~t: 7HI5 PDRTJON WITH YD'JR REMfTTANCE aooooaoz6z Ittllilttt1111tttIILILLttLll PATSIE NICHOLS RD #9 6I5 SOUTHVIEW DRIVE MECHANICSBURG PA 17055 Account Number -~-- 29356 Amourn Due ~"-'-"- 5539.71 Payment Due Date 10 da s from I Erner Amount Paid wlake checks Payable to: III~~II[Itttll[II IIIlttttlLlLtittltti(Ltttlttll P.O. Box 32840 Hartford, CT 06150-2840 0506D29356 OODD00 2 000053977,OOOODOOOOOOD0000000 ~--, . -- ____ ~p Account Number 09547 237481-01-8 _ Billing Date 12/14/10 Unpaid BaEance $62.47 -Due Now --~;~-~--~ i /~~ P,lew Gha'g~ X2.47 -Due 0 ~ ~ Total Fimount Due 1/07,11 Go~~ct us t_ ~~: www.camcast.ccrrra '~~" 1-800-XFft~IETY $124.94 ~$ Page 1 of 2 F~TS[~ N~Gf~QLS t _._ Far service at: Previous 8aiance 1015 SOtJTF;VIEIVV DR Pa 133.29 I+~EGN/~NICSBURG Fri 17055-5750 yment- 11/22/1fl-thank you -70.&2 Unpaid 8afance -Due Nauv 62.47 C~~~~S from ~aC~1C~S~ Ne~v Charges - Due. hy01/fl7/11 see below for more irfor,~natior. 82.47 Qur re~rds indicai:e your account is past due. !f your ~~ta1 Arna~rft ~c:e ^_ account is not paid in the next seven {7~ days, a $7.95 _ ~~~4.~4`'' late fee will be assessed. If payment has already been - made, please disregard this notice. ~ _. _-., XF!NITY TV 59.45 For your convenience; vee na~~ accept regular and automatic manth!y credit card a ~ + ~± Taxes, Surcha~ es ~ Fees debit. p } men;s an~ direct ~ 3.02 q Total New Chi s E#e®ring/speech Impaired Cai! 711 _ ~ $62:47 Have you had your ~FiNfTI` On Demand toda~ ~ a huge selection of movies, TV shoves; kids y. V~%atch ~ programming and music, many at no additional charge! ~~ - Just click On Demand on ya;.~r remote and choose fro ~ e thousands of programs! ~~ l G.%°~ r.~ ` ( ~ ~, F ( ~ i;L, ~ 1 a ! ~, t ~ ~ ~ t ~~ Jam. - ~". ~ ~ t -~ p - ~ ,~ ~ ~' ~ 'v~ ~ E-~A ~ ~ ~~6~~ Vt7 :~~" v ~, r v -- I- 3 ~`a °' P0. Boz 67013 (117) 234-8484 (Harrisburg) Harrisburg, PA 17106-7013 (800) 237-7328 (Nationwide) 0202 000 700 4 r r r r r • r ~ ~ 002864 2008606 - ~~~~ PAGE 2 1/EMoER NiJM9ER ~~ t PAYP.~ENT DUE DATE _° _ -- - - - { N -~~37 ip ~ ,AMOUNT-~q~T DUE } - CURRENT Afd ;UHT DUE c MINiMUfvf PAYMENT 8200XXXXXX 0112511 .- _~- 1 ~'J -- 3 6 7 . 4 ° _ - ---- - - 20. ao - - __ - - - --__ ~- .. _.~ ~.~ __ 2 0 . o 0 - a - - ~a.vo> ~~~` ~ PSECU AMOUNT OF PAYMENT INCLOSED PO BOX 67010 ~.~v PATSIE A Q NICHOLS 1000982005002025353 ry ~-~~; ~ ~`~ - sTaTiE~Er~T ~~ ~c~c~c~~T 5040 LOUISE DRIVE SUITE 108 `~~ ~~ ~ , N ~ ~ ~~~~- MECHANICSBURG PA 17055 {\~~ ~~~ ~~ ! ~~,~~ ~ v GET ~fC~1~iE [[rtSt~LATlC~N~ ACCOUNT iNQE)I ` 44 `~ Local Office: (717 -1710 ~ ~y ~. ~ LPS CC>NTE~C~L PEST , ~ Toll Free: 1.80D.TER I~ X j '~ -~ Terms 'xs"" Insulation Service saves you u to i - ---- _ ~`ti ~~ energy while w~ Ito kee ests eke s y~Z aR_ :sa Ewa Tse p p 'r 35 O1Cv KR RP =!7 12272010 YYNYNYNN 0027042 S1 T52 ' c aches nd ~~ verfish out of your omY~.r ~t L ~~ ifalify or up,$'i,500 in tax creditsrt.;' PAT NICHOLS ~ ~-~`° ~° ~' ~ ~~~` f Call 1.8 rmir-Ix or visit ~` 61 5 SOUTH'V I EW DR ~~ ~ lvIECHANICSBURG PA 170355-5750 l 1,= ,.,~," Te .~ .com/InsuiationService to learn m Ilrlllrllllllllirrllllill~~nllillllllll~rll~'{~rllllrlll~lllllllr ~ 4~~' ~ ~~ y Customer Number: 2532036 ~~Q~ ~ ~ ~tal~ ncsC~ ~ ~ i ~'; Use this number to manage your account online. DATE DESCRIPTION OF SERVICES INVOICE # CHARGES PAYMENTS/ NET SERVICE ADDRESS I CREDITS AMOUNT I i i2~20/2D70 General Pest Control 300839475 $44.52 Location: 615 SOUTHVIEW DR, MECHANICSBURG PA 17055 $44 52 11118,'2010 General Pest Control 300085360 544.52 it Location: 615 SOUTHVIEW DR, MECHANICSBURG PA 17055 544.52 i } ~ ~~~ ~ ~~ SUM ARYL i Total ue: $89.04 This statement ref/ects payments received by 12/27/10. !f you have not paid your previous balance, please mail your payment today. Easy pay automated payc~ents sign u at Terminix m » Due date: 01/10/2011 Important Message: Please retain the top portion of the statement for your records. t-S COMMONWEALTH OF PENNSYLVANIA STATE EMPLOYEES' RETIREMENT S :i'STEM HARRISBURG REGIOl~'AL COUNSELING CENTER 30 NORTH THIRD STREET; ROOM 319 HARRISBURG. PA 17101 TELEPHONE: (717) 783-9065 FAX: (717) 783-9599 TOLLFREE: 1-800-633 -5461 ~'~~~. s ers. state. p a. u s January 13, 2011 Estate of Patsie I~Tichols C/O Andrea Quigley 428 Woodruff Way Harrisburg PA 17112 Dear 1\~is. Quigley: T- 4 Invoice rt 23664 }ZE: Patsie Nichols SS#: 204-28-0817 We have recently been informed of the death of Patsie Nichols, a retired member of this System. We wish to extend our condolences to you at this time. Since Ms. Nichols died 12/29/10 and the December check was not returned to our office, this account has been overpaid in the amount of $90.87 for the period fron ~ ~ 12/30/10. It will therefore be necessary for our office to be reimbursed r 90.87 to liquidate this overpayment. ~ ~ ~ ~ ~~~~ The reimbursement should be made payable to The State Employees' Retirement System, and mailed Frith the enclosed copy of this letter to the aa.dress shown above. Upon receipt of the reimbursement, this account will be closed. ^Chere are no further benefits to be paid from this System. Should you have any questions concerning this matter, please do not hesitate to contact me at the above address or by telephone at (717) 783-906 or 1-800-633-461. Tha~~k you for your cooperation. Sincerely, Linda Dolan, Administrative Assistant Harrisburg Regional Counseling Center Enclosure - _ -- -_ v_ _ ' r. .~a- _ - . - s~..~, Aa;ouN Number Due Date Amounl Due '~~ 'i7697-9700 419 32`r 1/17/11 z 69.56 , ~~~~~~ ~4 a y" Account Information " ~-`` n„j`~~ ~ ~~'`r ~ t, ~- ~-. ~ uer~~arl.corF1 ~' ~ ~'r1 Statement Date: 12/19/10 ~ _ ~!J L Shop '' 8ii1 Pay ' Acrortttt Changes , ,,Y' / ~, lv1RS PATSIE A ldICHOLS fiut~pay "PaverJessBt/l°Pepair ~'° . Phone: 717-697-9700 ~ ~ u Go green today Go papettess Q' ~~ 1_ i~ 1 '~ ~, E:~~ ~~erizon.com,rnyvenzon ~ - \ Account Summ~iry , r~ ; ,' Verizon News No Term Contract with FiQS lsk. about ou; FIOS specials. Call 1-888-692-5118 and fake advantage of this month's hot offers. FiOS available in select areas only. PerFect Time To Get FiOS Gei FiCS 1V Prime HD, Internet speeds up to 15/5 Mbps & home phone for 599.99/mo. for a year with NO TERf/ CONTRACT REQUIRED. Plus, you can get 12 months FREE of the multi-room DVR. Call 1--888-692-5122 io order by 1/15/11. Availability varies. Taxes, terms & fees apply. FiOS O13L Play - NO CONTRACT Sign up now for Verizon FiOS TU Prime HD & Home Phone for 569.99/mo. for 6 mos. (579.99/mo. for mos. 7-12j. There's NO TERM CONTRACT REO'D & enjoy HBO©& CinemaxC,~ FREE for 3 months when you sign up by 1/15 & install by 3/15. Call 1-888-692-5126 to order. Avail. varies. Taxes, terms & lees apply. Want Automatic Payment? Enroll below or a1 Verizon.com to authorize your financial institution to deduct the amount of your monthly bill from the account associated with your enclosed check and send payment directly to Verizon. To discontinue Automatic Payment, call Verizon. Please keep a copy of this authorization. PIE Previous Balance tVo Payment Received Balance Forward New Charges Current Activity Specials and Promotions Taxes, Fees and Other Ct Total New Charges due Amount Due ~'~ ~~~ `~ January 17, 2011 \' f, ,( / i " ~cc 534.56 5.00 S34JiS 526.01 -5.95 S9.94 $69.56 Questions about your bill or service? View your bills in delail at verizon.com or call 1-800-VERIZOtd (1-800-837-4966) Enter your ten digit number 717-697-9700. Use 419 if asked for the three digits following your account number. Use Quidc Codes! -Enter 4PAY (4729) to pay bill, Enter 4BAL (4225) for balance. Customers with disabilities can reach us by TTY at 1-800-974-6006. ase return remit slip with payment. i -~ at&t Page: 1 of 5 Billing Cpcle Date: 11/14/10 - 12/]3!10 Account Number: 464007108312 Ho« To Contact Us: . 1-800-,31-000 or 61 1 from your cell phone . For Deaf/Hard of Hearing Customers (TT~'/TDD) 1-866-241-6667 rre~ tous tsatance 85,g: Pa~~ment Posted -QO,~ P.-~ST Dt;E B~I._~'~'C'E 45.7t Pa~ableimmediarel~ . Alonthh° Ser~~ice Charges 32,g~ Usa«e Charges 0 Ot t, a «'ireless Number ~~~ / Credits/Adjustments/Other Charges 9.3~= 717-877-~66~ `r~'~-' Goy ernment Fees S Taxes 3.3f ~ ~ TOTAL CURREI~iT CI~aRC~ES ;/-~'~~45.7i- ~ ,,, 1 ~ ~ Due Jan 08, 017 ~, "~ ~'"'~~ ~ ~ i 3 ~ ~ ~ ~~~ Lare fees assessed ai'rer Ja~ , F a ~ ~` ~ ; °'.~v.~-- '`~.r..s ~ ~~ ~-..•~--~ i Total :~inoun e ~91,~0 ~~ YY*This Bil nc u e ~ s ue a anceu If payment has already been made, thank you, please disregard. If not, payment must be made inm~edtately. Please send }rour payment, including current charges, in the enclosed em-elope. You may also pay 24 hours a day, by mater credit card or electronic check at 1-800-331-0500, or att.com/1~9yWireless.~~F your service is suspended, a reconnection fee will appply. ~f you have que ions regardine your account. contact us at I-800-947-5096. ^~ Return the portion below ~~ith pad ment onlc to AT~T ~lobilit~. ~. T- 8 Opening Date: November 28, 2010 - Cl~sino Date December ~'7, 'LO i Q page I of 3 Payment Information New Ba once $1 18.0 Minimum Payment Due` $80.0c Payment Due Date January 22, 201 1 'Includes past due amount of $40.00 Late Payment Warning: If we do not receive your minimum payment 6y the date iisteo' above, you may have to pay a late fee of uF to $35.00 and your purchase and balance transfer APPS for new transactions may be increased up to the ?malty APR of 12.24°o variable. Minimum Payment Warning: If you make only the minimum payment each period, you will pay more in interest and it will take you longer to pay off your balance. For example: I; you rrciri=_ :o !'ou ~~aill pay off the =,~;~d vo°~ ~~.ill and oda,,ion~ai cha~-ge~ balar°,c~ sh;>, n on parmc Y r, using Yht card an9 i. arementin estimufeo ot~ai c,f. each mo rtn you pav._~a~ou` ._ Only the minimum I 2 months I $1 19 payment ~QSISEJaC{C BoilU$' Anniversary 1/tonth September Opening Cashback Bonus Balance $ 2.82 New Cashback Bonus This Period + 0.00 ~! Cashback Bonus Balance $ 2.82 'o team more, loo in at www.Discover.com ° 3 Easy Ways to Contact Us 1 . Access your account securely at www.Discover.com 2. Call 1-800-DISCOVER (1-800-347-2683 Pease have your Discovero card availab e. J. \V~YI IIC tV U~ lJl VIJI.VyCI, PV UVh .IV743, Salt Lake City, UT 84130 For TDD (Telecommunications Device for the Deaf) assistance, please call 1-800-347-7449. If you would like information about credit counseling services, call 1-800-347-1 121 . ~ f_ ~ ~.. Manage Yom atco~nf line at www.Discover.cot • Acces free online tools like P down Planner to create a play to a ~ down your balance, secuur~ely access statements, pay bills dnline and easily track all trcnsactions • Make your money worth moreSN~~ find easy ways to earn and rE~deem cash rewards • NEW! Access your account sec ely through your mobile phone ~ Tra~sactior~s F'~ ~~ ~~; Trans. Post ty ~-~•~~'"`'~ ~~ Daie Date ,~ _ ~i~~~ r Fees Dec 22 Dec 22 LATE FEE " ~;C.'%`~ ~$ 19.00 E- . TOTAL FEES FOR THIS PEP.IOD 19.00 interest Charged INTEREST CHAP.GE ON PJRCHASES $ 0.59 INTEREST CHAP,GE ON CASH ADVANCES 0.00 INTEREST CHARGE ON B4LANCE TRANSFEP.S 0.00 TOTAL INTEREST FOR THIS PERIOD 0.59 Continued on revers=_ side. !! ~[ ~l~~ V ~~ t9 ,~, ~ .~~ . `..`"` f .fi . .=-~ PPL Electric ' ~~ `_ ! ~~ f«E ~ ~tE~itie5 ,° E~ectr~c Se>~ice Far: PA TSB. A Q rrlcxoLs b 1 ~ SOUTx~'IE~'v DR h'~FCH.4hZCSBURG PA 17055 Qoestioms about this bill? Please contact us by Jan 20 at 1-800-342-5775 (1-S00-I}~IrPPL) or R-rite to: Customer Sen-ice 827 Hausman Rd. AllentaR~n, PA 18104-9392 u~~ ~-. ppl el ectri c. cony ~~eCtr>Ec ~~e This graph shows your electric use over the last li manths. Tees of '~'leter I2eadiags: Actual Adjusted Estimated Customer S~».>€>~ary ~'~~~ Page 1 ~: F Q~f. ~133:-~ItHt)1iT~-~n~L :~. .. 68801 30001 _ 1~~~g~tt~~~~~~~ <: )3aia>aee as of I3ee 30, 2[110 ~Jr.Sb Char es: Tota~PL Electric Utilities Charges Total IDT Energy Charges $15.2.5 ~35.~1 Tatal Charges X93.03 Accalrht Balance 36 30 ?~ 18 12 6 0 ~~ K~~- H -Average Per Da}r ~~~~~ 1~'Feter IZeadigb Information 93.031 Deter it31Z55551 Dec 29 Actual 43141 Nov 29 Actual 42?9I 30 Davs K~~'H Billed 350 A`~erage -Dec 2009 2010 Tem~~pperatu.~e 34F 30F K~~e'H Per Day 11 12 Pearl}- Ilse: T€~tal Averagge Lase >~Io>~tbl~- Tan 2009 -Dec 2009 ~ 108 426 Tan 20I0 - De` 2010 ,172 431 JFMAM7JASONDJ 2009 Months 2010 E?11~er ~partaat l~~c~rmatial~ o~ ~a~c~ y:io ~ ~~~~~~~ r ~. 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Tr~zs e ~cst ~~e .. : ~°<< _ _ ~ c :~:`cl~~~e ~F~~e ~e€erc~,ce f~:€{rber ~ma;~, .. .~ ?00~~ 'v _----~------ ~°~- ~ !F ~- -~ --____-- _- ._._ ~~F~'Ct~s'~ctFffrF Tctef ...--- - _~ 6. ~--~.. ~ i ~ f ,, ~L e`U"C'1 _ r L[CcIESE,4fODEF,.~'_ RR _ p:.rvh vPRTSti4~ ~~ f(Fr, f "~..i~v~l~.~C Grit t!~~~I I ~~: C=E[~PO~Of~ES Trere~ctacac~ Tat~E _ cr a.,_ ^uT a~~m Cortia~: vrr~ L. p=_ymerr`. 3~~30~ 25 ~~?g D-!... ~yE~~~y ~~,~..,~? , ~.0 Sze -vz _ si;i= ~r i:near~nt i:tr"o-'mz:ion at8(t Page: 1 oT4 "~a.:-~ ~'' Billing C~-cle Date: 12/14/10 - 01/13/11 Accou nt '~ u m bcr: 46=1007108312 Ho~+ To Contact Us: 1 800 3 31 0>00 6 Pre~rious Balance ~ ~p ~}!~ ~~ ` . - - - or 11 from your cell phone Pa~~ment Posted 0.0 . For Deaf'Hard of Hearing Customers (TTY;TDD) 1-866-241-667 \\'ireless slumber 717-877-~66~ PA~;T DGE BAL.4!s`CE ~,g Payable Immediatek Alonthlp Sen~ice Charges 32,g: Usage Charges 0.0~ Credits/Adjustments/Other Charles 8.2: Government Fees & Taxes 2,2~ T'O"['aL CL'f~RE?~ITCIi_4RGES _ ` 43.5' Dtk Feb 1)S, 2f111 Latcfees assessed after Feb 13 Total Amount Due ~13~.92 C ~ _ This bill reflects charges that du not appear on the prey ous statement. ~~~~ ~~~This Bii1 Includes A Past Bue SalanceY*~ ~~ , ~ if payment has already been made, thank you, please disregard. if not, payment must be made immediately. Please send your payment, includin= current charees, in the enclosed envelope. You may also pay 24 hours a day, by major credit card or electronic check at 1-800-331-000, or att.comiA9yVJireless. If your service is suspended, a reconnection fee will appply. If you have questions re~~arding your account, contact us at 1-800-947-096. Return the portion below Frith pad ment onlq to ATST A7obility. ~rz