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HomeMy WebLinkAbout11-17-11 (2)J 1505610105 REV-1500 EX (oz-u) (FI) nns lvania OFFICIAL USE ONLY PA Department of Revenue Pe Y County Code Year File Number Bureau of Individual Taxes " ""'"`""` "`~`"~` PO BOX 28D6oi INHERITANCE TAX RETURN Harrisburg PA i~f28-o60i RESIDENT DECEDENT p~ ~ r ~ d ~ `~ ENTER DECEDENT INFORMATION BELOW /19/2011 07/24/1955 Decedent's Last Name Suffix Decedent's First Name MI Swavola JoY~ (If Applicable) Enter Surviving Spouse's Information Below Spouse's last Name Suffix Spouse's First Name MI Swavola Robert spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW rOp 1. Original Retum O 2. Supplemental Return O 3. Remainder Retum (Date of Death Prior to 12-13-82) O 4. limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Retum Required death after 12-12-82) ~ 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Boxes (Attach Copy of'Wili) (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (Date of Death O 11. Election to Tax under Sec. 9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT - THIS (SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number ,.. Jacqueline M. Verrhey, Esq (717) 243-9190 n e _.. ~n REGISTER OF WIt~.S USE ONLY C`7 _1 First Line of Address ~ ~. ~ j ` t C„) ~ - 44 S. Hanover Street ~~ ` ' ` ? [_ J :.-- Second Line of Addres& ~ _;~ r .~ DATE~FILED ~' City or Post Office State ZIP Code Carlisle PA 17013 Correspondent's e-mail address: Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complgte. DeclareUon sparer other than the personal representative is information of which preparer has any knowledge. O ON NS FILING RETURN DA ADD S ATURE OF PJ~EPAR R OTI-JFR THPtN~REP~ NTATIVE DATE O /Vi /,/l /~ -~y-~( ~, ~-! y S. ~-,4N o J ~ 5 i ~, ~ "'L- ~r S L z: , /UA- l 7 D PLEA8E USE ORIGINAL FORM ONLY Side 1 L 1505610105 1505610105 (;_~;-j i ~ r.__~ c ' c. ~~ -~ i r" s ~... ;~'1 L ~.) (~ ~~1 1505610205 REV-1500 EX (FI) Decedent's Social Security Number 164-38-9023 Decedent's Name: RECAPITULATION 1. Real Estate (Schedule A) ............................................ . 1. 0.00 2. Stocks and Bonds (Schedule B) ...................................... . 2. 0.00 3. Closely Held Corporation, ParMership or Sole-Proprietorship (Schedule C) .... . 3. 0.00 4. 9 9 ( ) .......................... Mort a es and Motes Receivable Schedule D 4. . 0.00 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)...... . 5. 1,865.17 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ...... . 6. 0.00 7. Inter-Vivos Taan$fers 8 Miscellaneous Non-Probate Property 00 0 (Schedule G) O Separate Billing Requested....... . 7. . 8. Total Gross Assets (total Lines 1 through 7) ............................ . 8. 1,865.17 9. Funeral Expenses and Administrative Costs (Schedule H) ................. .. 9. 21,698.98 10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ............. .. 10. 51,146.82 11. Total Deductions (total Lines 9 and 10) ............................... .. it 72,845.80 12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. -70,980.63 13. Charitable and tdovernmental Bequests/Sec 9113 Trusts for which 00 0 an election to tax has not been made (Schedule J) ...................... .. 13. . 14. Net Valua Subjt:ct to Tax (Line 12 minus Line 13) ...................... .. 14. 0.00 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under l5ec. 9116 (a)(1.2) X .0_ 15. 16. Amount of Line 14 taxable at lineal rate X .0 _ 16. 17. Amount of Line 14 taxable at sibling rate k .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. TAX DUE ...................................................... ...19. 0.00 20. FILL IN THE OWAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 1505610205 1505610205 J RE'V-1500 EX (FI) Page 3 nar~orlpnt'c Cc~mnlete Address: Flle Number Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 2. Credits/Payments A. Prior Payments __ B. Discount Total Credits (A + B) (2) 3. Interest (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 210 to request a refund. (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 0.00 Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWEtR THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain thee. use or income of the property transferred .......................................................................................... ^ b. retain the right to designate who shall use the property 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" or payable-upon-death bank account or security at his or her death? .............. ^ t own an individual retirement account, annuity or other non-probate property, which 4. col nta ncs a bieneficiary designation? ........................................................................................................................ ~ ^ IF THE ANSWER TO ANY OF! THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1,1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)]. Thestatute 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 applicalble even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the met 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)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. ,REV-isD8'EX+ (11do) ~ Pennsylvania DEPARTMENT OF REVENUE INHERLrANCE TAX RETURN RESIDENT DECEDENT SCNEOULE E CASH, BANK DEPOSITS & MISC. PERSONAL PROPERTY ESTATE OF: FILE NUMBER: JOYCE SWAVOLA 21-11-0145 Indude the proceeds of litigation and the date the proceeds were received by the estate. s11 eroeerN ioirrtly owned with right of survivorship must be disclosed on Schedule F. If more space is needed, use additional sheets or paper of the same size. REV-i5o9 EX+ (oi-io) ~ Pennsylvania DEPARTMENT OF REVENUE INHERTiANCE TAX RETURN RESIDENT DECEDENT SCNEpuLE F 70INTLY-OWNED PROPERTY ESTATE OF: FILE NUMBER: JOYCE SWAVOI.A 21-11-0145 If an asset beca a jointly owned within one year of the decederrt's date of death, k must be reported on Schedule G. SURVMNG JOINT TENAINT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A• Robert E. Swavola 2 Johns Drive Mechanicsburg, PA 17050 Husband B. C. ]OINTLY OWNED TTEM NUMBER LETIHt FOR TENANT DATE MADE ]O1NT DESCRIPTION OF aROVER7Y INCLUDE NAME OF FINAN(]Al INSTTTUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER ATTACH DEED FOR lO1NTLY HELD REAL ESTATE. DATE OF DEATH VALUE f ASSET '!~ of DECEDENTS INTEREST DATE OF DEATN VALUE OF DECEDENT'S INTEREST i. A: 01115!92 18 Jane Lane, Carlisle, PA 17013 186,400.00 50% 0.00 TOTAL (Also enter on Une 6, Recapitulation) I # 0'00 If more space is needed, use additional sheets of paper of the same size. ,REV-1510 EX+ {08-09) ~ ~ Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER JOYCE SWAVOLA 21=11=0145 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM NUMBER DESCRIPTION OF PROPERTY IN0.lAE 1~ NAME aF THE TRANSFEREe, TNEIR RELATIONSHIP TO DECEDENT AND THE TE OF TRANSFER. ATTACH A COPY OF THE DES FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION IF ADPLICABLE TAXABLE VALUE 1. Thrift Savings PIan~Beneficiary Jill Beam-daughter 44,332.19 100 44,332.19 0.00 2 CSRSAnnu1ty-Beneficiary Robert E. Swavola-husband 41,329.66 100 41,332.19 0.00 TOTAL (Also enter on Line 7, Recapitulation) ; 0.00 If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+ (10-09) ~ ` Pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERIfANCETAxRETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER JOYCE SWAVOLA 21-11-0145 Decedent's debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPE SES: I. WestministerlCemetery 1159 Newville Road Carlisle, PA 17013 8,667.80 2. Hoffman-Rotfh Funeral Home North Hanover Street Carlisle 17013 7,450.50 B. ADMINISTRATIVE COSTS: 1, Personal Reptesentative Commissions: NameO of Personal Representative(s) ____ _____ _ ____._.__- _-_____-- Street Address - -- ---- - _ _ _ --- --__------__-- -- City -. - State Z:IP Years} Commission Paid: 5, 000.00 2. Attorney Fees: 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant - ..............._..---.... Street Address _ - _ __- __ - _ -. City _., __ State _ ZIP _ __ _ _ _ Relationship of Claimant to Decedent _ _ __ - _ _ 350.00 4. Probate Fees: 5. Accountant Eees: 6. Tax Return Rreparer Fees: ~• Advertise letters Sentinel 155.68 a. Advertise letters Cumberland Law Journal 75.00 TOTAL (Also enter on Line 9, Recapitulation} I ; 21,698.98 If more space is needed, use additional sheets of paper of the same size. I _ -- _ __LL_ _ _ _ REV-1512 EX+ (12-08) ~i ,~ Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF FILE NUMBER JOYCE SWAVOLA 21-11-0145 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unretmbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1• Members 1st FCU mortgage on 18 Jane lane, Carlisle, PA $176,793.41 in foreclosure 2. Kohl's credit card #4601 366.29 3. Chase credit card #1341 6,989.99 4. Camp Hill Emergency Physicians P.O. Box 13693 Phila PA 689.00 5. Wst Shore EMS-Carlisle-205 grandview Ave Suite 211 Camp Hill, PA 179.81 6. .Quantum Imaggng 8~ Theraputic Assoc. P.O. Box 62165 Balt MD 8.85 7. Ascension Point Recovery Services, LLC 200 coon Rapids Blvd Suite 200 Conn Rapids MN 228.52 8. Cumberland Goodwill fire BLS emergency transport 826.55 9. Members 1st FCU personal loan #0000373028 6,857.81 10. Deficiency judgment on repossed motor home 35,000.00 TOTAL (Also enter on Line 10, Recapitulation) I; 51,146.82 If more space is needed, insert additional sheets of the same size. REV-1513 EX+ (O1-10) s ~~~ Pennsylvania DEPARTMENT OF REVENUE SCHEDULE ~ BENEFICIARIES ESTATE OF: FILE NUMBER: JOYCE SWAVOLA 21-11-0145 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME FIND ADDRESS OF PERSON(S) RECENING PROPERTY Do Not Llst Trustee(s) OF ESTATE I TAXABLE DISTRIBU ONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2),] 1. Jill Beam, 8 Jeffrey Road Mechanicsburg, PA 17050 daughter 50% 2. Katherine Swavala, 115 Tower Circle Carlisle, PA 17013 daughter 50% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. II NON TAXABLE DIS'n'RIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN; 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COWER SHEET. I ~ If more space is needed, use additional sheets of paper of the same size. LAST WILL AND TESTAMENT OF 4,~ , , JOYCE SWAVOLA rt I, JOYCE SWAVOLA, 105 Pearl Drive, Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all former Wily, Codicils, or writings in the nature thereof, by me at any time heretofore made. FIRST:'I hereby direct my Personal Representative, Jill Elizabeth Beam or Katherine Lynne Swavola Ito pay all my just debts and the expenses of my last illness, funeral and administrative expenses out of my estate, as soon as practicable after my death. It is my desire to be buried (not cremated). SECOND: I direct that all taxes which may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid out of my estate as a part of the administration of my estate. THIRD: I hereby give, devise and bequeath my entire estate, of whatever nature, to the following individuals, in equal shazes, provided they survive me by thirty days: Page 1 of 6 A. Jill Elizabeth Beam, currently residing at 8 Jeffrey Road, Mechanicsburg, PA 17050; and B. Katherine Lynne Swavola, currently residing at 18 Jane Lane, Cazlisle, PA 17013. In the event that Ji1T Elizabeth Beam does not survive me by thirty days, her shaze shall be divested andl shall pass to my grandson Zachary Kay Beam, currently residing at 8 Jeffrey Road, Mechanicsburg, PA 17450. In the event that Katherine Lynne Swavola does not survive me by thirty days, her shaze shall be divested and shall .pass to my grandson Joaquin Reed Swavola, currently residing at 18 Jane Lane, Cazlisle, PA 17013. FOURTH: I nominate and appoint Jill Elizabeth Beam as Executrix of this my Last Will and Testament. In the event that she is deceased, unable or unwilling to serve in said capacity, then I jnominate, constitute, and appoint Katherine Lynne Swavola as alternate executor. I direst that my personal representative(s) shall not be required to give bond or security for the performance of their duties in any jurisdiction. FIFTH: In addition to the powers conferred by case law, by statute and by other provisions of thils Last Will and Testament, my personal representative, Jill Elizabeth Beam or Katherine Lynn$ Swavola and any successors in that capacity shall have the following discretionary powers applicable to all real estate and personal property held by them, which powers shall be effective without Order of any Court and which shall exist and continue until the time of actual distribution: Page 2 of 6 A. To retain any property of any nature received by them for whatever period it shall be deemed advisable; B. To invest and reinvest all or any part of the assets of my Estate in certificates of deposit in a financial institution, wither bank or federal credit union that pays the highest interest ~ ate; C. To sell, (transfer, exchange or otherwise dispose of, any part of the assets of my Estate, for cash or on terms, publicly or privately, or to lease, without liability on the purchases to see td the application of the proceeds, and to give options for these purchases; D. To execute and deliver any deeds, leases, assignments or other instruments as may be necessarty to carry out the provisions of this Will; E. To borrow money, if necessary~to facilitate the administration and closing of my Estate, including the right to borrow money from any financial institution, and to mortgage or pledge amy asset of the estate as security; F. To loan to, and to purchase assets from, my Estate, even if also acting as Executor thereof;. G. To assume continuance of the status of any beneficiary with regard to death, marriage, divorce,''illness, incapacity and similaz incidents or matters in the absence of information deemed reliable without liability for disbursements made on such assumption; H. To makq any distribution hereunder either in kind or in money, or partially in kind or partially'in money, considering of course the reasonable wishes of the beneficiary. Distribution in kind.shall be made at the appraised value of the property distributed, as it is set forth in the Inheritance Tax Return filed in my Estate; I. To exercise any subscription right in connection with any security held hereunder, to consent ~o or participate in any. recapitalization, reorganization, consolidation or merger of any corporation, company or association, the securities of which may be held hereunder; and to delegate authority with respect thereto, to deposit investments under agreements, to pay assessments, and generally to exercise all rights of investors; J. To comppromise claims; K. To continue for whatever period of time my personal representative shall deem necessary any ownership as a tenant in common or as a partner, in real estate or other property and to act as I would have done had I been living; L. To do a1L other acts in their,~udgment necessary or desirable for the proper management, investment and distribution of the assets of my Estate; Page 3 of 6 M. I direct that my personal representative may be compensated for the services they render as Executor under this my Last Will and Testament at a reasonable rate not to exceed one percent of the gross amount of my estate. N. ~ Should any changes occur in the Internal Revenue Code or Pennsylvania statutes after the date of the execution of this Will which affect the tax liability of my estate, then to the extent possible and as may be permitted by law, my persanal representative shall have the power and discretion to interpret this Will and to administer my Estate in a manner'which results in the lowest tax liability possible; IN WITNESS'WHEREOF, Ihereunto set my hand and seal this ~~ ~ da of Y ~~ ~J2mj~.~ , 2010 , ~" JO A OLA SIGNED, SEALED, PUBLISHED and DECLARED in the presence of: !J n ._,~_ Page 4 of 6 ACKNOWLEDGEMENT I, JOYCE SWAVOLA, the Testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to the law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly, and t$at I signed it as my free and voluntary act for the purposes therein expressed. -~f~" J ~ E SWAVOLA Sworn o1r affirmed and acknowledged before me by JOYCE SWAVOLA the Testatrix, this ___j~~tay of /Vcr,~w,~_, 2010. ~._~ `, ~~. Notary Public COMMONWEALTH OF PENNSYLVANIA Nolaiial SeN Valerie F. C~II, Notary Ft~bpc Carlisle eoro, pm~berlend ~Y 1'fi~ ~urNS>>on 6~kea Oct 9 I01~ Member. PerrnsMarrla Aisodatlgr d Navrles Page 5 of 6 AFFIDAVIT We, JOYCE SWAVOLA, JacG-u t.4.vr 1~/~ . ~,ca c~ 1/r ~d J ,e~-- ~ e ~e (~ ,the Testatrix and the witnesses, respectively, whose names aze signed to the attached or foregoing instrument, beinjg first duly sworn, do hereby declaze to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and Testament and that she had signed willinglyi, and that she executed it as her free and voluntary act for the purposes therein expressed, and t,~iat each of the witnesses, in the presence and hearing of the Testatrix signed the Last Will and Testament as witness and that to the best of their knowledge the Testatrix was at that time eighlteen (18) years of age or older, of sound mind and under no constraint or undue influence. TESTATRIX, 3 rte" esiding ~~{ r 1 i b) ~ /'l'~ J 7r~ ~~ WITNESS, ~K ~ V residing at ~ S ~ ~~ 1 X00 ~' Jr p WITNESS, IJy.~c~fl~" I~~.o,Q . ,residing at ~ ah~, ~ (~ ~ ~ D j ~ Subscribed, sworn to and acknowledged before me by Joyce Swavola, Testatrix, and subscribed and sworn to before me byf~ ~a u ~. L nrs ~!q . V £ ie,~ £u , and V ~ o ~~,:~ ~-z.ec~.. ,the witnesses, this ~ day of ~~/!,l.J , 2010. ' lt~,P~.f,C- ~~ 'wEU~r+ ~ Pe~arsnv~wu Notary Public Noar~al seal Valle F. GseM, Notary Ribac BOf'0~ ~ 4 Mdeb~:r. 1lssodslfoo d Nohrks Page 6 of 6 P ~ ~ ~ o r' ^' ;~ A a ~ 5 ~' ~' ~ 5' ~ CAA p~ v P ~5 w ~ ~ r o ~~ ~ ~. o~. 7 'O C') C1 ~ N C C ~ p A A ~' ~ ~~ O "~ • "" ;, o~ ~• •- a 2 a A a .~ .~ n ti 0 a 0 n 0 .~ ~ H ~6 A A' N d 0 0 z n ~~ ~~ °' ~ o b y ~~~~ ~~ °e9 5 .. 1 -.. ~ ~ .: I_.~ z ~ ~ ~ ^ .~ ~ ~ y ~ ~ v; ~ ~ ~ ~ ~, z ;; ~. C. p ~p II. O ~p C. 7 ~' St ~~~~ y ~ v r H h f'1 O :Z 'v ~a •o .. v v ~ v ~ ~~c~ ~ay~ ~~~5°~s~+~o ~~o~~ ~R~ ., ~~ o ~. v ~~,.~ ~ ~ ~ R ~: ~~ ~: v H H H H H H H ~J { -+'~... 1 .,~ J •~ v ~. <.,, 0 v 'o-7 CJ w ~o~~° A N Q• Q 00 ~~ c~~P~~~~ ~,~ r~a~~ a n M v N ~~ ~. sd z ~~ ~ ~~ o ~-~ ~ ~ ~ ;. R .. 6. ~~- ,i ~, ~ . __ ~~ _y ~ ~.. R b H H H H H H H H H ;. c' ~~ ~. H~ d! H H H H H H H H ~~ A ~~ i ` ~ (~ r ~; ,~ c { ~~ C '~ G ., ' ;, ._- ir-- ~ w ~? r ~'° ~ ~ J .,=~ c, ''/j ~ C .x1 ~l .:r.- ~_ ~. Z ,.:_.. ~z ~ 0 "~" v O' O O Oo d ~ ~p ~C C ~ ! 1 ~~ ~ ~~ ~~ ~s ~~ ~ OD`°' ~~ i 5~ ~~ ~ ~ ~, D ~" ; ~, 8 a I A ~~ 0 c ~ ~ S. ~~ ~'g / H ~~ a 1 ~~ ..s ~ ~ ~. ~ .~. ~~ ~~ ~~ ^i ((.~ ~. 00 ~ ~` •• ~• ~ + 0^ • ~ ~ ~ `,~+ ~. o^ ~~ o~ ~~ .~ ^ R n ~. ~ ~ ,_ ~ ~,^ ~~~ ~~.~~~( ~ ~~ ~ ~ ~ $' tiQ°~~ ~ N y 5' ~ ~o ~~~.~~ ~~. ~: ~ ~ _~° ~`~ ~ f~~ h g. ~. ~• •~ ~. 7 a CUMBERLAND LAW JOURNAL 32 SOUTH BEDFORD STREET CARLISLE, PA 17013 • Tele: (71 Ti 249-3168 Fax: (7177 249-2869 March 4, 2011 Cumberland Law Joumal is published every Friday by the Cumberland County Bar Association and is designated by the Court of Common Pleas as the official legal publication for Cumberland County and the legal newspaper for publication of legal notices. TO: Jacqueline M. Verney, Esquire Joyce Swavola Estate RE: - Legal advertisements must be received by Friday Noon. All legal advertising must be paid inl, advance. Make all checks payable to: Cumberland Law Journal. Advertisement inserted on following dates: February 184, February 24, and March 4, 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. Mor~enthal, Executive Director PROOF OF PUBLICATION OF NOTICE IN CUMBERLAND LAW JOURNAL (Under Act No. 587, approved May 16, 1929), P. L.1784 COMMONWEALTH OF PENNSYLVANIA ss. COUNTY OF (CUMBERLAND Lisa Maid; ie Coyne, Esquire, Editor of the Cumberland Law Journal, of the County and State aforesaid, eing duly sworn, according to law, deposes and says that the Cumberland Law Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid, was established ~`anuary 2, 1952, and designated by the local courts as the official legal periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly issued weekly inlthe said County, and that the printed notice or publication attached hereto is exactly the samelas was printed in the regular editions and issues of the said Cumberland Law Journal on the folllowing dates, Affiant fl~rther deposes that he is authorized to verify this statement by the Cumberland Law Journal, a 1$gal periodical of general circulation, and that he is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statements as to time, place and character of publication are true. 8wavolt, Joyce, dec7d. Late of North Middleton Town- ship. Executrix: Jill Beam c/o Jacque- line M. Verney, Es~uire, 44 South Hanover Street,, Carlisle, PA 17013. Attorney: Jacquel~e M. Verney, Esquire, 44 South anover Street, Carlisle, PA 1701. lsa Marie Coyne, Ed~tor SWORN TO AND SUBSCRIBED before me this 4 of March. 2011 Notary NOTARIAL SEAL DEBORAH A COLLINS Notary Public CARLISLE BOROUGH, CUMBERLAND COUNTY My Commission Expires Apr 28, 2014 The Sentinel www.cumberlink.eom V~~/"+~~ CARilSE StRPENSBURC PER'h' CWN?Y JACQUELINE M. VERNEY 44 SOUTH HANOVER STREET CARLISLE, PA 17013 717-243-9190 AD NUMBER PAGE NO. 394138 1 of 1 BILL DATE SALESPERSON 02/25/11 wolfs START DATE STOP DATE 02/11/11 OZ/25/11 ~ 394138 ~ EXECUTRIX NOTICE LETTERS TESTAMENT ~ 10 PUBLIC NOTICES ~ 28 * 2 cols ~ Publication Insertions Rate Net Amount Gross Amount 3 THE SENTINEL -LEGAL 3 LGL $148.68 TOTAL AD CHARGE $148.68 3 PROOF OF PUBLICATION 01PRF $7.00 Purchase order Est. J.Swavola PAY THIS AMOUNT $155.68 $186.82* *AFTER 03122H 1 Than you for advertising with The Sentinel! Deadline for in-col mn legal ads is 4:00 p.m. two business days prior to da a of insertion. For questions, call (717) 240-7130. THE SENTINEL c/o LEE NEWSPAPE~2S PO BOX 540 WATERLOO IA 507014-0540 JACQUELINE M. VERNEY 44 SOUTH HANQVER STREET CARLISLE, PA 17013 THE SENTINEL c/o LEE NEWSPAPERS PO BOX 540 WATERLOO IA 50704-0540 Legal Ad Number 394138 Billing Date 02/25H1 Amount Due $ 155.68 a ~.~;,~ Ea1C~D ., ~.:= ,+~;: -~ THE SENTINEL c/o LEE NEWSPAPERS PO BOX 742548 CINCINNATI OH -45274-2548 (r~u~r~~~u~~~~~n~~~~n~u~~~~~r~n~n~~n~n~n~~n~~~n~~~ 2154020000000394138000DOODOOOOODD01868200000155684 icsram mrs PAR amm Ya+~PaY~~ ^ Check # ^ Credit Card ^®^~^®^~ Acd #: Ems. Date: ^ ^ Name on credit card Signature Please make dbcka oevable to: THE PROOF OF PUBLICATION State of Pennsylvania, County of Cumberland Tackie Cox, Rgtail Sales Manager, of The Sentinel, of the County and State aforesaid, being duly swtorn, deposes and says that THE SEIV'I'INEL, a newspaper of general circulation in ,'the Borough of Carlisle, County and State aforesaid, was established December 13 ,1881, since which date THE SENITNEL has been regulazly issued in said County, and t the printed notice or publication attached hereto is exactly the same as was printed d published in the regular editions and issues of THE S Lon the following day(s): February 11, ~eb~ry, 18 and FebruarX,25, 2011 COPY OF NOTICE OF PUBLICATION Affiant further deposes that he/she is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statement as to time, place and chazacter of publication ' e. Sworn to and subscribed before me this a~ZDo Notary Public My commission expires: NOTARIAL SEAL BAMBI ANN HECKENDORN Notary Public CARLISLE BOROUGH, CUMBERLAND CNN My Commission Expires Jan 27. 2014 ~ m .~ m O O N = W ~ o I n ,-i ~ - a }S _ - - N > ~ _~ N a ~n J N ~ - W ~' _ V O ~~' LA ~ rl of o I ~ m J ~ Z = V- O _ ~,y .J U Q ~ C N O 41 > G' = NQAQ O 4 UI ~'+' ~ ~ N 41NJ = W O z U~ ~ ~ j Q<J _ ~y~N W(n a o s -I ~~~ ~_ 1r O , ~ .+v ~ = Z~ ~ ~ ~~OO[7a - m ~ L /^ ~. Y - Y 000318 L ° ~ ~ ° C) ° Vl U L ~~ oc~3c ~La ° a~ ~o ~~ mya ~ ~o? 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We are offering the estate a: 85°~ Settlement Offer TOTAL AMOUNT OWED: $6,989.99 '~~ SETTLEMENT OFFER: $5,941.50. It's easy to resolve this account: 1. Call us at 877 486-4998 to further discuss the bill or provide paymentinformation over thephone. Our office hours are' MO DAY-TUESDAY 7:OOAM - 8:OOPM, WEDNESDAY-FRIDAY,7:OOAM - 5:OOPM, .SATURDAY 7:OOAM - 11: OAM CST/CDT; or 2. Log online vi our secure web site www.Easydebtpav.com; or 3. Call our auto ated payment service at 886-269-2879: to .pay this account oNer the phone; or 4. Enclose chec or money. order for payment in the provided envelope and nhail the .payment to the address provided. thFs matter. Sincerely, WEST ASSET MAN GEMENT, INC. *Notice -See Reverse For Important Information PLEASE ENiCL03 THIS PORTION WITH YOUR. PAYMENT'I'O ENSURI•: YROY>K Cl~lll l "1'U Y uUK AI;CC)uN l 191 -11680 - DSIF85 :JOYCE SWAVO Statement Date: 08-02-2011 105 PEARL DR The Estate of: JOYCE SWAVOLA CARLISLE, PA 17 13-1045 Account Number: 202800465 Account Balance: $6,989.89 Amount Enclosed $ Please note your account number on your check or money order to ensure proper credit to your account i~~u~~~,wuen~ Make Payment To: 1111+III+11111111111111+111+1111++1111+1111+111111111111111111+1111 WEST ASSET MANAGEMENT, INC. P.O. BOX 956842 ST. LOUIS; MO 63195 III II II 111111 AIII1111IIIIIIIIII IIIIIIIII IIIIIIIIIIIIIIIIIIII II 01 000000000202800465 9 001)00698999 .132818150805 4 Statement Date: 08-02-2011 Account Number: 202800465 Creditor Account Number: 4417122622131341 Creditor(s): CHASE BANK USA, N.A. Account Balance: $6,989.99 - _ r /~ 03/12/11 I I $6,989.99 L $190.00 $380.00 ~ /~ Account number: 44-17 1226 2213 1341 • Make your check payable to: Chase Card Services. Please write amount enclosed. New address or a-mail? Print on back. 441712262213134100038DDDDD69899900000000DDODD05 15154 BEX Z 04611 D EST OF JOYCE A SWAVOLA 105 PEARL DR CARLISLE PA 17013-1045 LIJILIIIIIIIII~IIIIIILIIIIIIIIIIILILIJJLIIJJ1111111 III III II III II IIIIi IIIIIIII II III IIIIIIIIII:IIII II IIIIIIIIIIIIII CARDMEMBER SERV{CE PO BOX 15153 WILMINGTON DE 19886-5153 ~:500016028~: 22L2622L3L34L81I• s I a tew t~ Manage your account online: Additional contact information from CHASE Q www.chase.com/creditcards convenientty boated on reverse side AC OUNT SUMMARY Agcount Number: 44171 226 22131341 Previpus Balance $6,954.46 Inter$st Charged +$35.53 New ~alance $6,989.99 Oper•inglClosing Date 01/16/11 - 02/15/11 TotallCredi# Line $10,200 Availaible Credit $3,210 Cashj Access Line $2,040 Avail~ble fchr Cash $0 PAYMENT INFORMATION New Balance $6,989.99 Payment Due Uate 03/12/11 Minimum Payment Due $380.00 Late Payment Warning: If we do not receive your minimum payment by the date listed above, your APR's will be subject to increase to a maximum Penalty APR of 29.99%. 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: If you make no You will pay off the And you will end up additional charges balance shown on paying an estimated using this card and this statement in total of... each month you about... pay... Only the minimum 30 years $16,590 payment $213 3 years $7,657 (Savings=$8,933) If you would like information about credit counseling services, call 1-866-797-2885. Your account is on a payment program. The Minimum Payment Warning disclosures may not match your payment program terms. This ccount is closed and no longer available for use. If you have a balance remaining on the account, please continue to make mont~ily pa~rments by the due date. Thank yora. ~AC~OUNT ACTIVITY _. m ~ .._,._~ -. _~ (,9 Fhl(:F-119 H9!If 19(1(79111)'1(1'11 /f1f19'I!'F' CAMP HILL EMERGENCY PHYSICIANS PO BOX 13693 PHILADELPHIA, PA 19101-3693 I~'I~~~~1~1~~'I~I~'~'II~II'1'~~'~~rrrLtrlllrl~IJrlrrl'lll'LII~ 082516-0000038821963-06 ~~ #BWNJFDB #OOOOOOHYP4494104# JOYCE A SWAVOLA 105 PEARL DR CARLISLE PA 17013-1045 STATEMENT OF ACCOUNT (4) Statement Date: July 17, 2011 ~ ACCOUNT NUMBER: HYP3882196~ Patient Name: JOYCE A SWAVOLA Tax ID #: 20-4667340 Account Balance: $20.25 Amount Pending Insurance: $0.00 Amount Due From Patient (Current): $0.00 Amount Due From Patient (Past Due): $20.25 Pay This Amount: $20.25 YOUR ACCOUNT IS NOW SERIOUSLY PAST DUE, AND A DELINQUENCY REVIEW IS BEING CONDUCTED. Please refer to coupon below for payment instructions. bill securely online Da ~ Descri lion Char a Paid B Paid B Paid B Amount. Due From PATIENT i p 9 First Ins. Clther Ins. Patient Adjusted Insurance BALANCE 1 99284 EMERGENCY EVAL & MGMT (LVL 4) .0X:459.9 DR. ALFANOIHOLY SPIRIT HOSPITAL BLUE SHIELD CONTRACTUAL ALLOWANCE BLUE SHIELD PAYMENT BLUE SHIELD CLAIM DENIED -DEDUCTIBLE $-114. TOTALS: ~ $~~ ~, -s„a:7s I so.oo I so.oo ~ -ss54.oo I ao.oo I szo.zs Messages: :ement is for the direct Vestment and/or supervision of care you recently received from an Emergency Physician at Holy Spirit Hospital. The fees for this private n are billed separately from any hospital charges or other professional fees for which you may also be responsible. Therefore, should you receive a bill from the or other physicians for charges Ih connection with this visit, R will not include the items listed on this statement. !~ "Payment Plans" Accepted Questions about this statement?/Llame de' Lunes a Vernes? j Call 9-800-355-2470 Monday through Friday 9:30AM - 4:OOPM. ~~ Your automated system access code is 0801-38821963, or you can send email to billing_q uestions~emcare.com. 9sz,s}R,-zsz,o ~~ Please detach and return bottom portion with your remittance. ~~ STATEMENT OF ACCOUNT JOY E A SWAVOLA 105 EARL DR Statement Date. July 17, 2011 CAR ISLE PA 17013-1045 ___ ACCOUNT NUMBER HYP38821963 YOU' MAY PAY THIS BILL WITH YOUR CREDIT CARD PLE/~SE SEE REVERSE SIDE Patient Name. JOYCE A SWAVOL_A . Payment Due By PAST DUE Makin ChecklMoney Order payable to: Amount Due: $20.2b Amount Enclosed: CAMP HILL EMERGENCY PHYSICIANS PO BOX 13693 PHILADELPHIA, PA 19101-3693 ~rrr(~~r~nur~~~~nun~~n~~n~~u~r~nn~~r~r~nn~~u~r~t~ Go Green -pay online at www.MyMedicalPayments.com The insurance information in our file appears below. Please make any corrections and/or additions on the reverse side of this form and return it to us. Thank you. FEP PA B/S FEDERAL 823614705 104 54771 PBS10 CAPITAL BLUE CROSS YWP80007153001005042070000 23045 [] If your address has changed, check this box. and complete the reverse side of this form 08~5160000038821963000020250000000000003 • CONSOLIDATED COLLECTION SERVICE, INC. PO BOX 60550, HARRISBURG, PA 17106 800-521-7559 Jul 26. 2011. #853298#1~~0 + JJOYCE A S~WAUOLA C/0 JILL BEAM 2 JEFFREY' RD MECHANICS~BURG PA 17050 CONSOLIDATED COLLECTION SERVICE, INC. STATEMENT Creditor Account # Regarding Amt Owed WEST SHORE EMERGENCY W1ED 212594W HOLY SPIRIT TO HOME 179.81 PLEASE BE AD ISED THAT THE ABOVE CLAIM HAS BEEN REFERRED TO US FOR COLLECTI N IN FULL. THE DELINQUENT BALANCE APPEARS AGAINST YOU WHICH YOUR CREDITOR STATES IS DUE. THIS NOTICE IS A FORMAL DEMAND UPON `SOU FOR PROMPT PAYMENT OF THIS CLAIM IN FULL. CALL 800-5217559 IF YOU HAVE ANY QUESTIONS. WE CAN ACCEPT CHECK BY PHO~JE, DEBIT CARD, VISA, AND MASTERCARD. PURSUAivT TO ~.5 U.S.C. SEC:1b92G, UNLESS WITHIN 3C DAYS AFTER RECEIPT OF THIS LETTER YOU DISPUTE THE VALIDITY OF THE DEBT OR ANY PORTI~N THEREOF THIS OFFICE WILL ASSUME THIS DEBT I~ VALID. IF Y U NOTIFY fiHIS OFFICE IN WRITING WITHIN THE 30 DAY PERIOD THAT THE DEBT, OR ANY PORTION THEREOF, IS DISPUTED, THIS OFFICE ILL OBTAIN VERIFICATION OF THE DEBT OR IF APPLICABLE ~ COPY OF A JUDGMENT AGAINST YOU AND MAtL YOU A COPY OF SUGH'UERIFICATION OR JUDGMENT. UPON YOUR WRITTEN REQUEST WITHIN THE 30 DAY PERIOD, THIS OFFICE WILL PROVIDE YOU WITH THE NAME AND ADDRESS OF THE ORIGINAL CREDITOR, IF DIFFERENT FROM THE CURRENT CREDITOR. THIS IS AN ATTEMPT TO COLLECT A DEBT AND ANY INFORMATION OBTAINED WILL BE USED FOR THAT PURPOSE. THIS COMMUNICATION IS FROM A DEBT COLLECTION AGENCY. OFFICE HOURS MONDAY-THURSDAY 8:OOAM-9:OOPM * FRIDAY 8:OOAM-5:OOPM EASTERN STANDARD TIME • ~ f" ~` WEST SHORE EMS -CARLISLE DISCOVER 205 GRANDVIEW AVE SUITE 211 ~ ' ~~~ CAMP HILL, PA 17011 ON REVERSE SIDE ,~~~ H~ ,~ Phone #: (800) 367-0512 Federal Tax ID: 23-2463002 PATIENT NAME: JOYCE SWAVOLA CALL NUMBER: 212rj94W JOYCE SW~VOLA CIO JILL B AM 8 JEFFREY] RD MECHANICEBURG, PA 17050 INSURANCE: FEP REJ CAPITAL BLUE CROSS g DATE OF CALL: 01 /06/2011 FROM: HOLY SPIRIT HOSPITAL To: 105 PEARL DR ACCOUNT SUI111MARY TOTAL CHARGES: 179.81 PAYMENTS/ADJUSTMENTS: 0.00 PLEASE PAY THIS AMOUNT: 179.81 nFrar_H ALONG PERFORATION AND RETURN STUB WITH PAYMENT .DESCRIPTION OF CHARGE QUANTITY UNR PRICE AMOUNT STRETCHER One Wad Transport T2005 1.0 108.75 108.75 Transport Van Mileage S0209 19.0 3.74 71.06 Total Charges 179.81 DESCRIPTION OF PAYMENT RECEIPT' PAYMENT DATE AMOUNT Denied by Insurances-FEP (electronic) 03/15/2011 0.00 Total Credits 0.00 PLEASE F!AY THIS AMOUNT -INVOICE DUE UPON RECEIPT -> $179.81. n~T~ ~Q~~~n r uGr~ cGG _ @~i nn PATIENT NAME: SWAVO , JOYCE A CALL NUMBER: 2'I 2594W AMOUNT PAID: 05/09/2011 - -- - IMPORTANT MESSAGES:, This account is now PAST DUEL! Payment must be received WITHIN 10 DAYS. Collection process will begin. WEST SFjIORE EMS -CARLISLE 205, GRANDVIEW AVE SUITE 211 CAMP HILL, PA 17011 i_ -_ _ - - - _ __ - Financial system s "Your Accounts Receivable Management Company" 800-521-7559 Jul 7, 2011 #BWNBZNZ #853298/0# JOYCE A SWAVOLA C/O JILL BEAM 2 JEFFREY RD MECHANICSBURG PA 17050 Creditor Account # WEST SHOR$ HMfiRGHNCY MED 212594W Regarding Amt Owed HOLY SPIRIT TO HOM& 179.81 DEAR JOYCE A SWAVOLA WE UNDERSTAND THAT ON OCCASION CIRCUMSTANCES PREVENT PAYMENT OF DUE OBLIGATIONS. HOWEVER, WE FIND IT UNACCEPTABLE TO DISREGARD THESE DEBTS. TO DATE YOU HAVE NOT PROVIDED A VALID REASON FOR NON-PAYMENT OF THIS BILL. THEREFORE, PAYMENT IS EXPECTED IMMEDIATELY. PLEASE REFER ALL PAYMENTS AND CORRESPONDENCE TO: WEST SHORE EMERGENCY MED SVC 205 GRANDVIEW AVE STE 211 CAMP HILL, PA 17011 (717) 763-2108 THIS IS AN ATTEMPT TO COLLECT A DEBT. ANY I:[VFORMATION OBTAINED WILL BE USED FOR THAT PURPOSE. THIS COMMUNICATION IS FROM A DEBT COLLECTOR. 2213 Forest Hills Dr. Suite #2 • Harrisburg, PA 17112 • P.O. Box 60550 • Harrisburg, PA 17106 Financial system s "Your Accounts Receivable Management Company" 800-521-7559 Jun 2, 2011 #BWNBZN~ #853298/0# JOYCE A SWAVOLA C/0 JILL BEAM 2 JEFFREY RD MECHANICSBURG PA 17050 Creditor Account # WEST SHOR~ SMSRGSNCY MSD 212594W Regarding Amt Owed HOLY SPIRIT TO HOME 179.81 DEAR JOYCE A SWAVOLA WE HAVE'BEEN RETAINED BY WEST SHORE EMERGENCY MED SVC IN AN EFFORT TO RESO]~VE YOUR DELINQUENT ACCOUNT BEFORE IT REACHES THE NEED TO BE P]~ACED WITH AN OUTSIDE COLLECTION SERVICE. YOUR PATRONAGE IS VALUED AND WE ARE CERTAIN THIS CAN BE RESOLVED IN A MUTUALLY ACCEPTABLE MANNER. PLEASE REFER ALL PAYMENTS AND CORRESPONDENCE TO: WEST SHORE EMERGENCY MED SVC 205 GRANDVIEW AVE STE 211 CAMP HILL, PA 17011 (717) 763-2'1013 IF YOU %ELIEVE THE AMOUNT SHOWN ABOVE IS NOT CORRECT OR THAT YOU DO 1~OT OWE THIS BILL, SEND US A WRITTEN NOTICE OF THESE FACTS WITHIN 30 DAYS. WE WILL OBTAIN VERIFICATION OF THE DEBT AND MAIL, IT TO YOU. IF YOU DO NOT PROVIDE WRITTEN NOTIFICATION WITHIN 30 DAYS, WE WILL ASSUME THE AMOUNT DUE SHOWN ABOVE IS CORRECT. THIS IS AN ATTEMPT TO COLLECT A DEBT. ANY INFORMATION OBTAINEIb WILL BE USED FOR THAT PURPOSE. THIS COMMUNICATION IS FROM A DEBT COLLECTOR. 2213 Forest Hills Dr. Suite #2 • Harrisburg, PA 17112 • P.O. Box 60550 • Harrisburg, PA 17106 ,~ - . ORIGINAL 2861 ACCT. NO. ,.,.. ~ 5 ~ LAST BALANCE $ ~ f i c j C~ / , ,, ~ ^ INTEREST ~. ~ -~'"'_~- LATE PAYMENT ^ CHARGE , f J D~~ SUB TOTAL --__ cam= Funeral Services , -- - ~ "~' Name of Deceased CREDITS ^ CK # ~ _ ~~ LESS PAYMENT '`~ ~~Q ~ ~~ I ^ CREDIT CARD Flweral Home & Crematory. Inc. ', ^ OTHER i / NEW BALANCE ~~ $ '~^~ =~>l !J 1 f -=-- -°- -- - I - 4 1503 I _ m..~-_ _..-._ ... __,..._T __ I l ~~ ~} ~_ ~~~~~1 _._ !ii /,;` FUNERAL. HOME ~ CREMATORY, INC Jill E. Beam 8 Jeffrey Roa Mechanicsburg, PA 17050 Statement of F Date of Death: ria.nq(7E: Traditional TRADITI~I Casket: TOTAL FUNI CASH ADVA 12 Certified Newspaper Newspaper Clergy Flowers Expenses for: Joyce Anna Swavola y 19, 2011 219 North Hanover Street Carlisle, Pennsylvania 17013 717.243.4511 toll free 1.866.451.4511 fax 717.243.3723 ~^Nw.hoffrrx7nroth.com info@hoffmanroth.com February 28, 2011 Account Id: 16140-019 oral Service FUNERAL SERVICE PACKAGE ---- unur --~•••~ vnr~Rl7t.1-: Certificates at $ 6.00 each - Sentinel - Patriot $ 4, 550.00 Sub.Total: $ 4,550.00 $ 2,150.00 $ Sub Total: $ 2,150.00 $ 6,700.00 72.00 138.88 280.62 100.00 159.00 sub Total: Expense: Total 750.50 7 Balance: $$~ -------------------- fi------------------------- Please return this portion with your Remittance. ---• $ I' Amount Enclosed Joyce Anna Swav~la Service ID#: 1614 -019 - ..n.^~ -_ SER~ING OUR COMMIINITV c,:,_- - - ' DO NOT SEND PAYMENTS TO THIS ADDRESS Dept. 19fi8 7 IF PAYIWO BY VISA, IIIASTERCARD OR aSCOVER, ~y ~. BELOW P O Box 1259 OwsA [~ Oaks, PA 194.56 `""°"`"~" ~"'A~RC'4F1D ~'~- ^ ~I ~,pfl ~'IfpII I ~'fI 1 0~. DArE Awo1n III~iIIII.IIIIIII.II~IIIIIII~It IIII~III~I.III~~IIIIIII~II~IIIIII PRIN7 CARDHOLDER NAME MUST INCLUDE 3 DIGR SECURITY CODE FgOM BACK OF C,ggp STATEMENT DATE PAY TMIffi AMOUNT' For billing questions call: (717)932-5955 - ~_ Aet.' or: (877)932-5955 3/18/2011 $8,85 ~~ Fax: (717)932-4856. 16681 CHARGES AND CREDITS MADE AFl'ER STATEMENT SHOW AMOUNT ffice Hours: 8:00 AM - 4:30 PM DATE WILL APPEAR ON NEXT STATEMENT. ADDRESSEE: PAID HERE ~~ MAKE CHECKS PAYABLE / REMIT TO: ~B ' '1'1111 "'•1111111'I1111~11'11111"'1'111111111i1~~~1111"'1'I tss~a2~ ~ ~ JOYCE A SWAVOLA 1 D 5 PEARL D R Quantum Imaging Ind Therapeutic Associates ~ CARLISLE PA 17D13-1045 P ~ B°x 62165 Baltimore, MD 2 1 264-2 1 65 I..ICI„~II~~I~I~II~~~I„I..I.I.,~II~II~~~I~I~~II~~~I~I~II~~~I information has changedeand ind'cate change(s) on eve se side. ;, Patient; JbY'~E A S'WAV(~LA ~ PLEASE DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT IN ENCLOSED ENVELOPE ,~ AaaountlgBS~.1 Date rcac Ser1!ii;t~f~rf~i~~~1 At: HOLY SPIRIT H~q$PtTAL 1/6/2071 ~ -~~iption 98971 U$ Dl1PLEX ~F`~TREM; fNS IJNIChat a ~Y-~e . ~ '~: 2/3/20.11 ~ ~ '~ Ad ~stit8 .' 2/3%2011 PIV17~ HI f~,I~R#C 1?i;O~l'L BLI~~~HI1~L~ 101.00 1/6/2011 CR`Adjustr`t~t I~iIF~HIU3~R~ PEi3ERA'L`E3L'11~5'F~tELD 93926 US Dt1pJ~,EK LgiiR:E~(T:+aRTERY iyNl 26.35- 2/3/2011 PIWT HtGHMARK FEDF{~q~ BLtIESHIl~l.D 70.40 2/3/2011 CR Adjustment Hfr;HMRRK FEpI=RAL BLUESHIELD 82.00 23. $0 64.00 Current 31 - 60 61 - 90 91 -120 0.00 8.85 00 r 120 BALANCE DUE 58.85 0.00 0.00 PAY BY ACCOUNT BALANCE IS YOUR RE$P©N~t~I~ITY, April 17, 2011 =~4SE REMIT PAYMENT IN FULL OR CALF. IJUFt' For billin ~_ CE IF PAYMENT ARI2ANpEMENTS AND/OR 9 questions rail: (717)932-5955 .arRANCE INFORMATION IS NECESSARY. or: (877)932-5955 Office Hours: 8:00 AM X4(30 pM 2-4856 ~- _ STATEMENT Tax ID: 251792806 ~~~IIII SEE REVERSE SIDE FOR IMPORTANT BILLING INFORMATION 19670 - 27 • ~, ~ AscensionPoint Recove . ry Services, LI,C 200 Coon Rapids Blvd. Suite 200 14SC@~ p~ ~~~ Coon Rapids, MN 55433-5876 Reco~ =iavices LLC (888) 420-2510 Phone - (763) 235-4055 Fax Hours: Monday -Friday 8:OOAM to S:OOPM CST Creditor: Alliance Data Assignee of HSN Account No.: ~'~KXX2693 Reference No.: 463028 Balance: X228.52 Apri127, 2011 Dear estate of JOYCE SV~AVOLA, We would like to offer o ~~ deepest condolences during this time of to advance for attending to t~is Important matter in the life of JOYCE SWA r you and your family. Thank you in VOLA.. The Alliance Data Assign a of HSN account in the amount of $228.52 for JOYCE SW with our office for collects n. Please contact our office toll-free at 1-888-420-2510 to ' Payments and/or the estate, information coupon on the reverse side can be mailed to AVOLA has been placed discuss your options. Very truly yours, the address listed above. Christina Mallen AscensionPoint Recovery ~ervices, LLC Unless you notify this offic within 30 days after receiving this notice that you dis ute or any portion thereof, this ffice will assume this debt is valid. If you notify this office in writs days from receiving this no ice that you dispute the validity of this debt or an ortio the validity of this debt obtain verification of the de t or obtain a co g n~ within 30 verification. If you request f this office in wntin~ wathin 30 day after receiv1n ~. n thereof, this office will provide you with the name d address of the ongmal creditor, if different from y of such judgment or g is notice this office will This communication is fro a debt collector. This is an attempt to collect a de cturent creditor. obtained will be used for t~t purpose. bt and an ' y information * * *PLE SE SEE REVERSE SIDE FOR IMPORTANT INFO ABO~TT YOUR RIGHT RMATI S AND THE PROBATE COUPON. * * * ON PLE INTE~)ZNCTIONAL ~1SE DETACH AND RETURN BOTTOM PORTION WITH YOUR PAYMENT The Association of Credit - - - -- - --- - and Collection Professionals ---- -- - ~Nerxbe~ - ---------------------- DEPT 303 4836376411043 PO BOX 4115 CONCORD CA 94524 ~I Amount Enclosed: IHIIIIIIIIIMIIIIIpI~IIIryIIIIINgIIIIINIIIIIIINIIIIIIIINIIIlllllllllllllll Creditor: Alliance Data Assiggnee of HSN ` Account No.: XXXXXXXXXXXXX2693 1 Reference No.: 463028 Balance: $228.52 ADDRESS SERVICE REQUESTEDII #BWNFTZF #TAM4836376411043# ~~ ~~~t~iiiti~t~iii~i~~iiit~nt~in~titlnlt~~~~t~ii~~~~n~~~~~n~tl 463028 ESTATE OF JOYCE SVrIAVOLA .. ~ 105 PEARL DR CARLISLE, PA 17013-145 ills PLEASE SEND PAYMENTS & CORRESPONDENCE TO: ASCENSIONPOINT RECOVERY SERVICES, LLC 200 COON RAPIDS BLVD. SUITE 200 COON RAPIDS, MN 55433-5876 TAMIST-0426-148904723.00021-21 P.O. Box 3268 ` Shiremanstown, PA 17011 July 26, 2011 0000000514 ~~Iil~~illl~~lill~lll~~~ll~~~i~l~~ilil~~l~lil~ll~i~~I~lnil~~l~ll JOYCE SWAVOLA 105 PEARL DR ', CARLISLE, PA 170131045 ~I You may now pay your bill onlinel'I at our secure site, www.paycac.com. You will need to For security reasons, credit card payments will not be processed without the securi codnter your agency number, 710575. ty a from the back of the card. ~- --~; SIGNATURE ~~ "" `^"~~ I ACCOUNT NUM $826.55 710575 REGARDING JOYCE SWAVOLA Commercial Acceptance Company Debt Recovery Consultants Phone: (717) 901-4557 (800) 690-3857 Extension: 211-- ~d/SA` ~.~~ Remit payment to: ,...._....._......_ V(uA EXP. DATE BILL DATE 7/26/11 --~~ P.O. Box 3268 Shiremanstown, PA 17011 A01 _. ' ,; Cumberland Goodwill Fire Rescue EMS 'Billing Office P.O. Box 726 11-82281 6/16/2011 New Cumberland, PA 17070 ~® $826.55 _ QUESTIONS ABOUT THYS BILL? Phone: 877-214_6018 Espanol: 866_724-4114 Fax: 717-214-6020 Email: info@ambulancebillin Date of Service: 1/6/2011 10:11 9office.com Patient Name: SWAVOLA, JOYCE A. Please visit our website to provide insurance or make payment, and From: RESIDENCE for additional payment options and frequently asked questions: - To: Holy Spirit Hospital WWW.ambUlanCebillingOfflCe.COm •***h'OUR14C'CQU.~VTI~S'7"AST Z?C~'**~ This claim ivl{l `$~ s~uhllutlcr~'t~ c °reeeived within I (~ days: you wi~1 he responsibly fQr alT et~jJectic~ll fees Inca CREDIT ~-.. 1/06/11 BLS Emergency Transport 1/06/11 Mileage Total A0429 1.0 A0425 19.7 I~ ~~i:l~r'i'h( ~.>:: , t -.- -- ___ - - DE~~CH AND RETURN BOTTOM PORTION WITH YOUR PAYMENT. -._.- - ~' 1^+l ~lii!'It to Ulf ~ 4~i1~C ~k ~ ~ „~` "''!' ~ 4 i is q,' r~ S ~~~ka~i '~~,~ ~ - - - - thetfu d~daction. PF~ase' /ndi¢ate o ~ - '~~e~trr7r4iri. ~~~, ~ ~! •~ and fall in requtred info~matiorr. If otner~f c~~c+3,be#ow '~ U necessary, please calf us at 877-z14-6018 ~e~nts are Cuf'nfaetiand CObdw~lt ~lr-e Rescue EMS l ~^~" 1 y ~0 11-8 l ~!. 1 a ~ olsca~vEir Credit Card: ^ MASTERCA a RD ^ VISA ^AMERICAN EXPRESS ^ DISCOVER Amn„n+ Card Number Name nn Card Expiration Electronic Check Deduction ~_ Please send a voided check OR provide information below I JOYCE A. SWAVOLA - 105 PEARL DRIVE °ank Routing Nuns-bar --~-------____- CARLISLE, PA 17013 Checking Account Number -- ~i~?n..ri r~ ----- ------.__--_----------------__----- _ _ *Return~=_d checks -You will be responsible for all incurred bank fees permissible under state law, t?~2~'~F~,~~ ~~nt rs at¢f r Yo~R 600.00 600.00 11.50 226.55 ~~ ~ ~ Please make any corrections to address below. Share and Loan IListl .~~' ~ ~~~~~ 1$t3i ~ "~~r'f k~~-c'~E,t~rrtdNtilt~t }~w~ ~ 4~ ~r~~ ,, , ~~' ~~ ~ c ,~ ,~' ~h ~~~ k:o apt: ~~ ~ ~ ~. -___. - .~c~ f- ~$ c. .fit 1="pr A cw unt ~}rui-rt~ `°~` ~: . l~iccalJpt Typ@: ~ It1 Page 1 of 1 ~~~ ~{f .~ ;::: . ~..: ~ - Q f F `~ )' :t: ~. :f 1. 7 , '(~ _ ' • s t ~ ~ ~ ~~~~ ~~~- ~ ~" j`, ~ , .rr~+.4aaa VCi ~ JOYCE A SUVA~/OL~ ~~~. Frlm2r~'_~ W'aI.74t8 -. , •~ SSA '. Home Nitmlrer : 0?I24l1955 - fi64<38-9D,23~ 717-240-1430 105 PEARL DR CARLISLE, PA 1 701 3-1 04 5 Shame De4ci•iption` S 0 Rate ~`~turity Date 000 REGULAR SAViN(3S Available . $~~~$ S 00.11 CHECKING $ S.OD'. $ 5.01 $ 0.00 $ 85:1'6.: QEpOSIT Tt3TAL $ rJp;9~ Lout Desci• il~ h on Rate ~'~ P ayrr- ent I):~te S DD01 PERSONAL SE VICE LOAN 11.DD96 03114!2011 Avai]1D{~ ~ Balance $ 81.00 T $ 6, 85 7.81. $ 6, 85 7.81 LG1AN T©TAL $ ~,a57.8'1 I~, file://C:\Documents and S~ttingslAll UserslApplication DatalJack Henry and AssociateslEpi... 3/1/2011 Current Loan Information . . Current Loan Information Loan Number:0006156059 Property Address:l8 JANE LN Borrower Name:ROBERT E SWAVOLA 0000 Co-Borrower Name:JOYCE A SWAVOLA Please us~ the IeR navigational bar to return to the previous screen. General Loan Infot~ Current Principal Balan~ Loan Origination Date First Payment Due Date Maturity Date $176,793.41 Current Interest Rate 04/23/2009 Original Loan Amount 06/01/2009 Loan Type 05/2039 Payment Method Scheduled payment Breakdown: Next Payment Due' Principal 8 Interest 07/01/2011 Homeowner's Insurance s) $966.83 Q $27.58 MIP Mortgage Insurances, City Tax $74.30 Other Tax ', $45.35 07/01/2011 Scheduled P yment $151.27 $1,265.33 Payments received more than 15 days after the payment due date may rewire a late charge of $50.6 L ' If Next Payment Due dat is in the past, additional payments, charges and/or~fees may be required to bring your loan current. Outstanding Fees; Late Charges Other Fees ' $101.22 $45.00 Last Payment Breakdown 4.875% $182,692.00 FHA residential Coupons Principal Received Interest Received $494.20 Escrow Received $1,439.46 $597.00 For more detailed information, lick here Year-To-Date Totals Principal Interest $1,470.66 Property Taxes $4,330.32 Hazard Insurance $2,867.67 $772.00 Copyright ©2000 - 2011. Lender Processing Services, Inc. All Rights Reserved. i Page 1 of 1 hops://carenet.fnfismd.co Ipnc/MenuServl ~ - et. MenuID CNAV311 %2C2%2C0%2C+%2C... 11 /3/2011