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Home My WebLink About01-17-12 (2) 1505610140 REW-1500 ~` ~°'-'°' PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year FNe Number PO BOX 280801 INHERITANCE TAX RETURN HarrisburD, PA 17128-0601 RESIDENT DECEDENT 2 1 1 1 0 4 0 6 ENTER DECEDENT INFO~iMAT10N BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 2 D 3 3 4 2 0 8 2 0 3 1 8 2 0 1 1 1 2 2 4 1 9 4 5 Decedent's Last Name Suffix Decedents First Name MI D A L W A Y B R U C E C (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OwAL3 BELOW THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 1.Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death pnor to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) © 6. Decedent Died T9state ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Urlilq (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty CredB (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS, SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX NiFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number D O U G L A S G M I L L E R 7 1 7 2 4 9 2 3 5 3 First line of address 6 0 W E S '~ Second line of address City or Post Office C A R L I S L E State ZIP Code REGISTEI+f F,YI~Il.L3 USE ONLY :'. ~~ ; ~ .... , ., ,_ , -, ;-~ .- , - .T., _ r. . , DATE FILED P A 1 7 D 1 3 :.~~ .~r .-, a Correspondents e-mail address: Under penalties of perjury, I d are that I have examined this return, including accompanying schedules and StatelTlerlte, and to the best Of rtry knowledge and belief, it is true and complete. aratbn of preperer other than the personal representative is based on all information of which preparer Flea any knowledge, SI TU PEON RE PONE FOR FILING RETURN DATE 1212 FLEETWOOD DRIVE CARLISLE PA 17013 SIGNA~T'tfF~F Pf~PARER~' THEFj~HAN~PRESENTATIVE DATE 60 WEST POMFRET STREET CARLISLE PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610140 1505610140 P O M F R E T S T R E E T 1505610240 REV-1500 EX Decedent's Social Security Num ber Decedent's Name: BRUCE C• D A L W A Y 2 0 3 3 4 2 0 8 2 RECAPITULATION 1. Real Estate (Schedule A) ........................................ ... 1. 2 2 5 0 0 0. 0 0 2. Stocks and Bonds (Schedule B) ................................... ... 2. 2 7 2 0 0 3, 6 6 3. Closely Held Corporatibn, Partnership or Sole-Proprietorship (Schedule C) .. ... 3. 4. Mortgages and Notes It?eceivable (Schedule D) ....................... ... 4. • 5. Cash, Bank Deposits i~nd Miscellaneous Personal Property (Schedule E).... ... 5. 1 8 0 5 8 , 0 0 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested .... ... 6. 7 2 0 2 . 3 6 7. Inter-Vivos Transfers & Miscellaneous N n-Probate Property (Schedule G) ~ Separate Billing Requested .... ... 7. 0 , 0 0 8. Total Gross Assets (tptal Lines 1 through 7) ........................ ... 8. $ 2 2 2 6 4 , 0 2 9. Funeral Expenses and'Administrative Costs (Schedule H) ............... ... 9. 6 0 3 4 7 . 8 8 10. Debts of Decedent, Mmrtgage Liabilities, and Liens (Schedule I) .......... ... 10. 1 5 1 2 2. 5 1 11. Total Deductions (total Lines 9 and 10) ............................ ... 11. 7 5 4 7 0 . 3 9 12. Net Value of Estate (dine 8 minus Line 11) ......................... ... 12. 4 4 6 7 9 3 . 6 3 13. Charitable and Governimental BequestslSec 9113 Trusts for which an election to taz has mot been made (Schedule J) ................... ... 13. 2 0 0 7 6 6. 6 4 14. Net Value Subject to flax (Line 12 minus Line 13) ................... ... 14. 2 4 6 0 2 6 . 9 9 TAX CALCULATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,. or transfers under Sec. 9i 16 (a)(1.2) X .0 16. Amount of Line 14 taxable at lineal rate X .045 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 0 . 0 0 15. 2 2 2 9 0 1. 9 9 1s. 0 . 0 0 17. 2 3 1 2 5. 0 0 18. 19. TAX DUE ...................................................... 19. 20. FILL IN THE OVAL IF hr•OU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0. D 0 1 D 0 3 0. 5 9 0. D 0 3 4 6 8. 7 5 1 3 4 9 9. 3 4 Side 2 L 15056101240 1505610240 REV-1500 EX Page 3 Decedent's Complete Address: Ffle Number 21 11 0406 DECEDENTS NAME BRUCE C. DALWAY STREET ADDRESS 1212 FLEETWOOD DRIVE CITY CARLISLE STATE PA Zip 17013 Tax Payments and Credits: ~ • Tax Due (Page 2, Line 19) 2. CreditslPayments A. Prior Payments 12,500.00 B. Discount ~ 657.88 3. Interest 4. If Line 2 is greater than Line 1 + Line $, enter the difference. This is the OVERPAYMENT. Fill in oval on Page ~, Line 20 to request a refund. 5. If Line 1 + Line 3 is greater than Line ~, enter the difference. This is the TAX DUE. (1) 13,499.34 Total Credits (A + B) (2) 13,157.88 (3) (4) 0.00 (5) 341.46 Make check payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER T~iE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make ~ transfer and: Yes No a. retain the use or income of the property transferred : ...................................................................... ^ Q b. retain the right to,designate who shall use the property transferred or its income; ............................... ^ ^X c. retain a reversionary interest; or ................................................................................................ ^ X^ d. receive the promise for life of either payments, benefits or care? ....................................................... ^ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving ad~quate consideration? ....................................................................................... ^ ^X 3. Did decedent own a~ "in trust for" orpayable-upon-death bank account or security at his or her death? ......... ^ X^ 4. Did decedent own arh individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? .................................................................................................. ^ X^ For dates of death on or after July 1,1 3 percent [72 P.S. §9116 (a) (1.1) (i)]. 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is For dates of death on or after Jan. 1,1 95, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)]. The statut 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 ev n if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2x00: • The tax rate imposed on the net val~e 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 thle child is 0 percent [72 P.S. §9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116(1.2) p2 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 hlas at least one parent in common with the decedent, whether by blood or adoption. QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. REV-1502 EX+ (01-10) pennsylvania ~ SCHEDULE A DEPARTMENT OF REVENUE I REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: BRUCE C. DALWAY 21 11 0406 All real property owned solely or as ~ tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a drilling buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property that hz jointly-owned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1. 1212 FLEETWO~'OD DRIVE, CARLISLE, PA 17013 225,000.00 SOLD - SETTLgMENT SHEET ATTACHED TOTAL (Also enter on Line 1, Recapitulation.) ~ $ If more space is needed, use additional sheets of paper of the same size. REV-1503 EX + (B-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER BRUCE C. DALWAY 21 11 0406 All properly jofMlyowned with right of survhrorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 26 SHARES OF IGENESCO STOCK @ $36.95 PER SHARE _ $960.70 960.70 2. 8 SHARES OF ~;HE FINISH LINE INC. CLASS A COMMON STOCK 144.88 @ $18.11 PER SHARE _ $144.88 3. MORGAN STA LEY SMITH BARNEY ~ 1,099.45 ACCOUNT NU BER 48J-04164 (CASH BALANCE) 4. MORGAN STA~LEY SMITH BARNEY 66,305.07 ACCOUNT NU BER 48J-04762 5. MORGAN STA LEY SMITH BARNEY ~ 203,493.56 ACCOUNT NU BER 48J-61009 BENEFICIARY: THE ESTATE OF BRUCE C. DALWAY TOTAL (Also enter on line 2, Recapitulation) I S 272, 003.66 (If more space is needed, insert additional sheets of the same size) REV-1508 EX + (8-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, ~ MISC. IN RES DENT DECEDENTRN PERSONAL PROPERTY ESTATE OF FILE NUMBER BRUCE C. DALWAY 21 11 0406 Include the roceeds of litigation and the date the proceeds were received by the estate. All properly ~ointlyowrred with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. PERSONAL PR PERTY -APPRAISAL ATTACHED 1,875.00 2. 1999 JEEP GRAND CHEROKEE 2,525.00 3. 2000 DODGE DAKOTA 2,325.00 4. WEDDING RINCu 600.00 5. CEMETERY PLOTS 500.00 6. 2004 TOYOTA CAMRY 10,233.00 TOTAL (Also enter on line 5, Recapitulation) I S 18 058.00 (If more space is needed, insert additional sheets of the same size) REV-1509 EX+ (01-10) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF: FILE NUMBER: BRUCE C. DALWAY 21 11 0406 Nan asset was made jointly owned within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME(S) I ADDRESS (RELATIONSHIP TO DECEDENT A. TERRY OVER 100 BIG SPRING AVENUE NEWVILLE, PA 17241 DAUGHTER B. C. JOINTLY-OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR I NTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET 96 OF DECEDENTS INTEREST DATE OF DEATH VALUE OF DECEDENTS INTEREST 1. A. M8T B,~4NK -CHECKING ACCOUNT #700187545 14,404.72 50. 7,202.36 TOTAL (Also enter on Line 6, Recapitulation) I S 7 202 36 If more space is needed, use additanal sheets of paper of the same size. REV-1511 EX+ (10-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER BRUCE C. DALWAY 21 11 0406 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSE 1. EWING BROTH RS FUNERAL HOME 11,132.08 2. SECOND PRES YTERIAN CHURCH 186.53 3. CUMBERLAND ALLEY MEMORIAL GARDENS -BRONZE SCROLL 685.00 B. ADMINISTRATIVE CASTS: 1. Personal Represen>Gative Commissions: Name(s) of ~'ersonal Representative(s) ROBERT S. OVER StreetAddr$ss 100 BIG SPRING AVENUE City NEV1~/ILLE State PA ZIP 17241 18,500.00 Year(s) Connmission Paid: 2. AtromeyFees: A64M 8~ KUTULAKIS 2,069.00 3, Fatuity Exemption: (If decedents address is not the same as claimant's, attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees: RE~uISTER OF WILLS 393.50 5 AcoountantFees: ~AROLYN SCHLUSSER 50.00 6. Tax Retum Preparer Fees: PATRICIA A. ROSENDALE, CPA 375.00 7. REGISTER O~ WILLS -FILING FEE 30.00 8. REGISTER O~ WILLS -SHORT CERTIFICATES 16.00 9. REGISTER O~ WILLS -RELEASE (2) 20.00 10. NOTARY FEES 35.00 11. ROY D. GOTtSHALL -APPRAISAL ON PERSONAL PROPERTY 60.00 12. CUMBERLANID LAW JOURNAL -ESTATE NOTICE 75.00 13. THE SENTINEL -ESTATE NOTICE 187.54 14. REGISTER OIF WILLS -SHORT CERTIFICATES 20.00 15. CLOSING COISTS ON SALE OF REAL ESTATE 16,531.22 16. POSTAGE 21.38 17. HOME DEPOT -REPAIRS TO FLOOR 35.33 18. CARLISLE S ALL ANIMAL VETERINARY CLINIC 9.14 TOTAL (Also enter on Line 9, Recapitulation) S 60.347.88 If more space is needed, use additional sheets of paper of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent BRUCE C. DALWAY 21 11 0406 Decedent's Name Page 1 File Number Schedule H -Funeral Eacpensles & Administrative Costs - B2. Attorney Fees ITEM NUMBER DESCRIPTION AMOUNT 2. IRWIN & McKNIGHT, P.C. 7,000.00 SUBTOTAL SCHEDULE H~B2 ~ 7,000.00 Continuation of REV-1500 Inheritance Tax Return Resident Decedent BRUCE C. DALWAY 21 11 0406 Decedent's Name Page 2 File Number Schedule H -Funeral Expenses 8~ Administrative Costs - B7. ITEM NUMBER DESCRIPTION AMOUNT 19. REGISTER OF rIVILLS -RELEASE OF CLAIM 10.00 20. ROBERT OVER! -REIMBURSEMENT OF EXPENSES (RECEIPTS ATTACHED) 468.65 21. RONALD G. BAKER -MASONRY REPAIRS 296.00 22. HAWKINS' CONSTRUCTION COMPANY -ROOF/CHIMNEY REPAIRS 150.00 23. LOWE'S - VINYL/BATHROOM REPAIRS 363.25 24. LOWE'S - CARNET 1,043.26 585.00 SUBTOTAL SCHEDULE H•B7 ~ 2,916.16 REV-1512 EX+ (12-08) Pennsylvania SCHEDULE DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES, & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER BRUCE C. DALWAY 21 11 0406 Report debts incurred by thte decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. CITI CARDS -CREDIT CARD 9,222.00 2. WELLS FARGp BANK, N.A. -CREDIT CARD 90.53 3. CUMBERLAND~GOODWILL FIRE RESCUE EMS -AMBULANCE 96.43 4. ALEXANDER SPRING EMER PHYS -MEDICAL 33.80 5. GUARDIAN LOING-TERM CARE PHARMACY -MEDICAL 6.21 6. JOHNS HOPKI~JS UNIVERSITY CLINICAL PRACTICE ASSOC -MEDICAL 4.31 7. CARLISLE REQIONAL MEDICAL CENTER -MEDICAL 226.40 8. MASLAND ASSpCIATES, INC. -MEDICAL 108.00 9. ENCOMPASS -MEDICAL 29.34 10. PP&L -ELECTRIC 1,244.22 11. BOROUGH OF CARLISLE - WATER/SEWER 218.70 12. KEYSTONE INSURANCE COMPANY -INSURANCE 218.00 13. COMCAST - CABLE 139.05 14. LOWE'S - CREDIT CARD 1,680.35 15. VERIZON WIRELESS -TELEPHONE 60.74 TOTAL (Also enter on Line 10, Recapitulation) ~ s If more space is needed, insert additional sheets of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent BRUCE C. DALWAY 21 11 0406 Decedent's Name Page 3 File Number Schedule I -Debts of Decedent, Mortgage Liabilities, ~ Liens ITEM NUMBER DESCRIPTION AMOUNT 16. CENTURYLINK-'TELEPHONE 19.33 17. PINNACLE FINANCIAL GROUP -MEDICAL 74.12 18. CAROLYN R. Mc~QUILLEN, TAX COLLECTOR -REAL ESTATE TAXES 1,001.52 19. MOUNT ROCK IMPATIENT SERVICES -MEDICAL 15.94 20. MILLVILLE MUTWAL INSURANCE COMPANY -HOMEOWNERS INSURANCE 392.00 21. MITCHELL D. B4UHM & ASSOCIATES, LLC FOR CARLISLE REGIONAL MEDICAL CTR 223.78 22. GRAHAM MEDICAL CLINIC, PC -MEDICAL 17.74 SUBTOTAL SCHEDULE I 1,744.43 GRAND TOTAL SCHEDULE 1 E 15,122.51 REV-1513 EX+ (01-10) pennsylvania ~ SCHEDULE J DEPARTMENT OF REVENUE I BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: BRUCE_C. DALWAY 21 11 0406 NUMBER NAME AND ADDR SS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE I TAXABLE DISTRIBUTION [Indude oufi' ht spousal distributions and transfers under Sec. 91 f6 (a) (1.2).] 1. MARGO MACREA ', Collateral 20,000.00 831 NEWVILLE ROAD CARLISLE, PA 17013 2. TERRY A. OVER ' Lineal 124,916.64 100 BIG SPRING A ENUE NEWVILLE, PA 172 1 1/2 REAL PROPER ($105,106.28) PERS. PROP ($1875.00) Lineal 95,660.35 TOYOTA CAMRY $ ,0,233, C PLOTS $500 JT ACCT 7202.36 1/2 REMAINDER TOTAL $124,916.64AND 1/2 REMAINDER - $95,660.35 3. DENNY COX Collateral 2,525.00 60 DERBYSHIRE D~tIVE JEEP GRAND CHEROK CARLISLE, PA 170115 4. ROBERT S. OVER Lineal 2,325.00 100 BIG SPRING A~ENUE DODGE DAKOTA NEWVILLE, PA 172 1 5. BENJAMIN ELDRID~E Collateral 600.00 3279 CILLY AVE WEDDING RING SPRING HILL, FL 3#609 ENTER DOLLAR AMOUNT FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE. II. NON-TAXABLE DISTRIBU IONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: L B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. SECOND PRESBYTERIAN CHURCH 1/2 REAL PROPERTY PROCEEDS & 112 RESIDUE 200,766.64 528 GARLAND DRI E $105,106.28 $95,660.36 CARLISLE, PA 1701 ~i TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 200.766.64 If more space is needed, use additional sheets of paper of the same size. y Last Will and Testament of BRUCE C. DALWAY I, BI~,UCE C. DALWAY, of Cazlisle, Cumberland County, Pennsylvania., being of sound aid disposing mind, memory, and understanding, do hereby make, publish, and declare (this to be my Last Will and Testament and hereby revoke all other Wills and Codicils6 if any, that I have made. F1ts~: I direct that all my just debts and the expenses of my last illness and funeral shah be paid from the assets of my estate as soon as practicable after my decease. I authorize my Executor to expend funds from my estate, in such amounts, as my Executor shall consider necessary and desirable, for the disposition of my remains as follows: ' I wish to be buried and have the same or similaz funeral and burial arrangements as my wife, CHARMAINE C. DALWAY, who has predeceased me, and was accorded a stainless steel coffin and buried in Cumberland Memorial Gardens. I ask my Executor to make these burial arrangements through the Stephen Ewing Fune~kal Home, if practicable. t Second: I direct that my dog, ROCKY, shall be given to MARGO MACREA of The Animal Inn, located at 831 Newville Road, Carlisle, PA 17013, who has promised tol provide and care for ROCKY for the rest of his natural life, or to a person designated t#y the Executor, as of the date of signing of this Will. I bequeath X20,000 from my Estate to MARGO MACREA to provide for the care and maintenance of ROCKY. I~h the event the Executor chooses to designate a caretaker of ROCKY other than MARCO MACREA, the funds shall remain with her. At the end of ROCKY's natural life, I it is my wish and desire that ROCKY be cremated and his remains be scattered ufon the graves of myself and my wife, CHARMAINE C. DALWAY, in Cumberland Memorial Gardens. I direct that JEFF GTBELIUS, Pastor of Second Presbyterian Church, handle the spreading of ROCKY's ashes. ~"huf 'd: I direct that my real property be sold and the proceeds divided equally between m~ step-daughter, TERRY A. OVER, and SECOND PRESBYTERIAN CHURCH,1528 Garland Drive, Carlisle, Pennsylvania. I suggest that my Executor use my realtor, ~Vlarylou Comune, to handle any real estate transaction necessary to transfer this interest Fourth: I give, devise, and bequeath my personal property as follows: 1. The entire contents of my house to my step-daughter, TERRY A. OVER; / ~i?:~j . 2. 2. Toyota Camry to my step-daughter, TERRY A. OVER; 3. Jeep Girard Cherokee to DENNY COX; 4. Dodged Dakota to my step-daughter's spouse, ROBERT S. OVER; 5. Weddi~ig ring to my nephew, BENJAMIN ELDRIDGE; 6. The R~amaining cemetery plots in Cumberland Memorial Gardens to my step- daugh~er, TERRY A. ~ OVER, to manage and distribute in accordance with my wishes!r Fffth~ I give, devise, and bequeath the rest and residue of my Estate equally divided be~ween my step-daughter, TERRY A. OVER, and SECOND PRESBYTE~v CHURCH, 528 Garland Drive, Carlisle, Pennsylvania. Srxt~: All interests of any beneficiary in the income or principal of this Estate, while undistributed and in the possession of my Executor or Executrix, even though vested and distributable, shall not be subject to attachment, execution or sequestration for any debts contract, obligation or liability of any beneficiary and, furthermore, shall not be subject to pledge, assignment, conveyance, or anticipation. Seventh: All inheritance, estate and succession taxes, including interest and any penaltie~ thereon, payable by reason of my death shall be paid out of and be charged generally against the principal of my residuary estate without reimbursement ~~ `r 3 from any person. E1gl~th: I nominate, constitute, and appoint my step-daughter's spouse, ROBERT S. OVER, as Executor of this, my Last Will and Testament. I direst that no Executor named above shall be required to post secwity for the faithful performance of his duties in any jurisdiction insofar as I am able by law to relieve him ~, of such obligation. My Executor shall be entitled to reasonable compensatign for the performance of the duties set forth herein. In ~ltttess Wh~teof, I have hereunto set my hand and seal this 15``' day of February, 211. ;~ - J, g BRUCE C. DALWAY 4 Signed, Published, acid Declared by the Testator, BRUCE C. DALWAY, a~ his Last Will and Testament, in the presence of us, who at his request, in his presence,'~nd in the presence of each other, have hereunto subscribed our names as Residence ~,Q~I c.z_P ,, ~'~~ls~~ ~~, ~~ I Residence ~~~ ~- /~~~ /olr,S', LL f 2 ~~~ N~~I„ s-~,-~~, ~t,l~:~,, p,~ ~~o~ s witnesses. Acknowledgement Commonwe th of Pennsylvania County of C berland : SS I, BRUCE C. DALWAY, Testator, whose name is signed to the attached instrument, h~.ving been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; andl that I signed it as my free and voluntary act for the purposes therein expressed. ,~ ~ ~ {~ ~- BRUCE C. DALWAY ~ !, Sworn o~r affirmed to and subscribed before me by BRUCE C. DALWAY, the Testator, this j15`" day of February, 2011. ~~ TARY PUBLIC COMMONWEALTH F PENNSYLVANIA Ndad~l Seat Sh p~ My Commletbn 78018 Member, Pennsylvania ssoCistlon of Notaries G .Affidavit Commonwealth of Pennsylvania County of C~.unberland : SS . . We. I~rc~niCt,~-~C-r,S___ and ~C~G~ C.i'1 the witnesse~ v~hose names are signed to the attached instrument, being duly qualified according to law, depose and say that we were present and saw the Testator sign and execute the ' strument as his Last Will and Testament; that BRUCE C. DALWAY executed it a his free and voluntary act for the purposes therein expressed; that each of us in the he and sight of the Testator signed the Will as witnesses; and that, to the best of our owledge, the Testator was at that time 18 years of age or older, of sound mind, under no constraint or undue influence. II J Sworn I r of ed to and subscribed before me by C ~~ ' h I Gr- ~~ and ~ witnesses, this 15`'' day o ebniary, 2011. 2G~ NOTARY PUBLIC COMMONWEALTH OF PENNSYLVANIA Nota~hl s~ Shannon L. Freeman, Notary PubMc CadiNe earo, Cun~sthnd County My Commlaebn Exphaa AprN 7.2013 ~~^+~^~ Pennsylvania AasoclaUon of Notaries A. SETTLEMENT STATEMENT (HUD-1) °"`"~°`~~ Select Platinum Settlement Services, LLP ~G ~„ ~ 3912 Market Street ''4vowe~ Camp Hill, PA 17011 (717)737-0884 FINAL B. TYPE 0 1• FHA 2. RHS 4. ^ VA 5. ^ CONV. INS. 8. ESCROW FILE NUMBER: 00112305-001 MAW 7. LOAN NUMBE 7123141165 8. MORTGAGE INSURANCE CASE NUMBER: C. iNOTE: this form is tuprished fo gwe you a statement of acNal setfhuneM oosfs Amounts geld b and by the seklemenf agent are shown. !tams marked I,'~P.O.G)' were paid ou(slde the closing; a,ey are shown here for lnbmratiortaf purposes and are rat Included in the trials. o. NAME of BoaROwER: Dean B. Hull and Denise E. Hull ADDRESS OF BORROWER: 4152 Kittatlnny Drive Mechanicsburg PA 17050 e. NAME of sELLER: Estate of Bruce C. Dalway ADDRESS OF SELLER: F. NAME OF LENDER: '~, ERA Home Loans ADDRESS OF LENDER: ~'~, 1 Mortgage Way Mount Laurel, NJ 08054 G. PROPERTY LOCATION: ', 1212 FleetWOOd Drive ', Carlisle, PA 17013 ' Cumberland County 04-22-0479-052 Parcel #04-22-0479-052 H. sErrLEMENr AGENT: ~, Select Platinum Settlement Services, LLP (717) 737-0884 Puce of SETTLEME 3912 Market Street, Camp Hill, PA 17011 1. SETTLEMENT DATE: 1 122/2011 PRORATION DATE: 1 1 12 2 /201 1 DISBURSEMENT DATE: 11/22/2011 J. S Y OF ORROWFJt'S TRANSACTION K SUMMARY OF SELLERS TRANSACTION ~iiri=nonric,~un'il"ir-ni' imriu erioowieo.~. ' '.'~.., .,. - ~ ;':.: -".erin~~lr'e}~acawiuniiZ-i~n~i2!Pn.~ci L;2n.: 101. Contract Sales P ce 225,000.00 401. Confrad Sales Price 225,000.00 10'2. Personal Props 402. Personal Property 103. Settlement charg s to Borcower (line 1400) 8,878.35 403. 104. 404. 105. ' 405. _ ADJUSTMENTS FOR IT S PAID BY SELLER IN ADVANCE: ADJUSTMENTS FOR REMS PAID BY SELLER IN ADVANCE: 106. Ci /Town Taxes 408. C frown Taxes 107. Coun Taxes 11!22111 to 12131!11 124.65 407. Coun Taxes 11122!11 to 12131!11 124.65 108. Assessments 408. Assessments 109. School Tax ~ 11!22111 to 06130!12 1,619.13 409. School Tex 11!22/11 to 06!30!12 1 619.13 110. 410. 111. ' 411. 112. 412. 113. ' 413. 114. i 414. 115. 415. 120. GROSS AMOUNT UE FROM BORROWER: 235,622.13 420. GROSS AMOUNT DUE TO SELLER: 228,743.78 ~Z00: AAIO, I,iNT$ R . HY" _ :IM`FQF`.B.QRL~OYY.gt: ' ' 400 I?I~'IN AMQUNF?DIIE+TO,; ., ER: 201. DeposO or same t money 2,500.00 501. Excess de osit see lnstrudions 202. Prtndpal amount f new loan(s) 180,000.00 502. Settlement cha to Seller (line 1400) 14,281.22 203. Existing loan(s) t ken subject to 503. Exoti loan(s) taken sub act to 204. ' 504. Pa off of Bret m age ban 205. 505. Pa ff of second mort loan 206. Seller portion of rensfer Tax 2,250.00 508. Seller portion of Transfer Tax 2,250.00 207. 507. 208. 508. 209. 509. _ ADJUSTMENTS FOR EMS UNPAID BY SELLER: ADJUSTMENTS FOR REMS UNPAID BY SELLER: 210. Citylrown Taxes ~ 510. Ci /Town Taxes 211. County Taxes ' 511. Count Taxes 212. Assessments 512. Assessments 213. 513. 214. ' 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 2i!0. TOTAL PAID BY/F R BORROWER: 184,750.00 520. TOTAL REDUCflON3 W AMOUNT DUE SELLER: 16,531.22 1300:ICASHAT.SHLrIJ~1TFRONYfDi60RROYIIER:'--: ~ .':.' tf00:;GASP1~1Ta8ETJ1iE1~1T:;.IOIFRD[IE8ELtiEft f 3(11. Gross amount du from Borrower (line 120) 235,822.13 601. Gross amount due to Seller (line 4201 226,743.78 3(12. Less amount poi tty/for Borrower (line 220) 184,750.00 602. Less reduction in amount due Seller !line 5201 18,531.22 3(13. CASH (®FROM) ( O TO) BORROWER: 50,872.13 603. CASH (~ FROM) (®TO I SELLER: 210,2i2.b6 Tlhe Public Reporting B den for this collection of informaton is estimated at 35 minutes per response for collecting, reviewing, and repor8ng the data. This ayen~y may not collect his information, end you are not required to compote this form, unless It displays a currently val'x1 OMB contrd number. No confidentiality is assure this disclosure is mandatory. This Is designed to provide the parties to a RESPAcovered transacl'an with information during the s~sttlement process. 3. brJ CONV. UNINS. are obadlle Paae 1 of 4 HUD-( L. SETTLEMENT CHARGES W FILE NUMBER: 00712305.001 MAW ~00:!TOTALREAL;~3 kTB;:8R0iEBR:FEES:-., , .. s:`.. : -; EsCRO- . . urvwrvn yr wmmrSSron (urvE 700) AS FOLLOWS: i'01. 38,945.a0 to Prudential Homesale Servces PAID FROM BORROWERS FUNDS AT SETTLEMENT PAID FROM SELLER'S 7'02. 58,750.00 to ERA NRT LLC FUNDSAT SETTLEMENT T03. Commission paW at aelUement 13,695.00 7'04. Additlonal Commission bERA-NRT LLC 195.00 7'05. 800.>1TEN;S PAYABLE:; r .-; GQNN~CTION WITCi.LOAN: , > -, -::. a .. - P.o.c1 801. Our origNatkxt a 5555.00 (from GFE at) H02. Your aedil or d7arg (poktts) for the spedOc Interest rate dtosan (57,125.00) (tram GFE arJ) Et03. Your adjusted ongi Uon charpea b ERA Hama Loans (hen GFE AI -540.00 E104. Apprahal tae b ST S (horn GFE a3) 410.00 805. Credit report b CB InnoWs (Van GFE M3) 6.20 E{O6. Tax servks (from GFE rq) E107. Flood certl5cetlan i (from GFE a3) 1108. Scoring Fee to FN 15.95 ft09. 1110. 0800. ITEMS.REREliRED YLEN[)E:RTQBfi~PNDINADVkN.CE;:- e.o.c. . _901 Daily Interest dla (trap GFE a1o) 205.20 from 11/221'2017 to 211)2011 ®522.80001 day % (9 days) 902. Mortgage inS premium for 0 month(s) (from GFE a3) 903. Homeowner's Insu nce for 1 year(s) b AIIStale (from GFE a11) 605.44 904. 905. [aE1a RESERVE~nEPO 'E~H eENOER: , . ,, 1)101. InttlaldeposUtor reacrowaxount (framGFEaa) 1,617.68 1(X)2. Hortteowrtar's b nce 3 months ®S 50.45 per math 5151.35 11X)3- Mortgage insure months ~ S per month 1(X14. City property taxes months ~ S per month 1005. County property tax s 10 months ®5 97.21 per month 5972.70 11X16. Annual asaesamen monUts ®S per month 1007. School fazes 8 months ®S 222.84 per month 51,337.04 1008. monUu ®S per month 11X)9. Aggregate Acct. Ad . nwntlts ®S per month -584281 100. -TITLE CHARGES: - Pb.c. - 1101. Title services and nder's dUe insurance (trap GFE a4) 1,487.38 1102. Settlement or dos tee 1103. Ovmofs Ude Insure to Select Platlrtum Settlement Services, LLP (ham GFE a5) 198.00 1104. Lender's UUe Insu • to Seled Platinum Settlement Services, LLP 51,137.35 1105. Lender's Ude pdky limit 511X1,000.00 1106. Ownefs title pdicy mil 5225,000.00 1107- Agenth prxtbn of a total tltla insrcance prerttium 51,282.57 b Salad Platinum Settlement Servces, LLP 11 OB. Underwrtters poN d Ute total title insurance premium 5297.81 to Old Rtlpub5c Natlonal Title ins. Co. 1109. ErMS. 100, 300, 8. • b Sebd Platinum Settlement Services, LLP 5750.00 1110. Insured Cbaing Le • !o Old Repubtlc Natlonal Tltle~ Ins. Co. 575.00 1111. Notary Fees • b tlklmenl Oftlcer 545.00 10.00 1112. ^See attadted for reakdavn 580.00 1;EO0.`r~r. coR01.NG;a TRANSFER CHARGES: 1.'- . _, --`R.O.C. '.~ ' 1201. Government recd g charges (from GFE a7) 158.00 1202. Deed E82.00 age 598.00 Release 10.00 1;103. Transfer taxes (horn GFE a8) 4,500.00 12oa. c5yicoanty taxes ps Deed sz,25o.a9 Mortgage so.DO 1:205. Stale tax/stamps 52,250.00 Mortgage 50.00 1;zpg. Recerd Satlafaclio Pbce to Recorder d Deeds 50.50 1207. '1;t00.`ADDITIONAL _. CHARGES: ~ ~ P:D.C, - . 1301. RegWred services _ you can shop for pram GFE rl6) 1950_ .. 1302. Flood CeNfrcaUon to STARS 579.50 1303. Home Wartanty l0 erican Home Shield 435.00 1304. Water 7!27!1 t-1111 !71 to Carlisle Borough 90.72 1:305. 1306. 1 X400. TOTAL SETTLEM NT CHARGES (Enter on line 103,St7cUon J -and -line 502, Sedbn X) 8,878.35 14,281.22 1 haw cerafuAy ravbwed the U0.1 Setllarrem Statement and b the best d my krlowkdge and bNlef, Il la a Vua and accurate statement d aA recefgs and dlabursentenb made on my acoounl or try me In Ihls tran tlon. 1 NrNe oeNty I nave received a copy of Ute HU0.1 Settlement Statement Dean B. Hull / E ate Bru C. D )way '~ ~fj.rt-G2-Q 5 ~-~.I-(' r ~~ DeAree E. Hull Borravers Sellers The HU0.1 Setikmenl StaterhreM which I_heve prep is a a~ amtaate account d Nis trenaadion. I hew ceueed or wlA cause the lands m be dislwrsed n aaordance aiN this S. -l, ~ ~~" ~ ~.l ~~ `•I ~- / ~. r '" ~ Settlement Agent ) ~ / ~ c~ / Select latinum Settlem nt Services, LLP Date WARNING: It is a crime b singly melee fabe statements b the United Stales on Nis or any skntler form. Penaltlea upon cawbtlon can include a free and 6npnsonmenl For degas see: Title 1 e u.s. coda Sectlon 1401 and sedbn 7d7o. Esrxow Number 00112305-001 MAW Cornparisori of Good Faith EaUmate~(G<tE) and HU0.1 Charpss Good?~rtlfh,F~tt .mate ~ 1 HUD-1 Charges That Cannot Increase HU0.1 Line Number Our origination charge #801 585.00 585.00 four credit or charge (points) for the spedfic interest rate chosen #802 -1,125.00 -1,125.00 ti'our adjusted origination charges #803 -540.00 -540.00 Transfer taxes #1203 4,510.00 4,500.00 Charges That~ln T.otaf CannoUncreaaeyMore Than id ~ ; "• Good'~'a(tlisF_fifimate HU.D-1 Ciovemment retarding s #1201 279.00 158.00 Prppreisal fee #804 410.00 410.00 Credit report ~ #BO5 6.20 6.20 Scering Fee #808 15.95 15.95 Flood Certification #1302 19.50 19.50 Total E 730.65 809.65 i Increase between GFE and HU0.1 Charges ~-121,00 or -16.5606% -Charges That GanC ~ ~nge. ,;.: ~ ,' , t Good'F~ith F~Uma~.. HU0.1 Ini0al deposit for your screw account #1001 621.84 1,617.68 Dairy interest charges ' #901 $ 22.8000 /day 205.20 205.20 Homeowner's insuran #903 505.32 605.44 lltle services and lend rs title Insurance #1101 365.00 1,487.38 <hvner's Otle insurance'., #1103 1,558.75 198.00 Loan Terrns 'four initial ban amounk is $18D,000.00 `four loan term is 30 years 'four initial interest re is 4.5600% `four initial monthly a nt owed for principal, interest, and any mortgage insurance is ~ $ 918.47 includes ^X Principal ', Qx Interest Mortgage Insurence Ivan your interest refs 'se? ^X No. ~ Yes, it can rise to a maximum ~ O.OODO%. The first change will be on and can change again every after .Every change date, your ingest rate can increase or decrease by 0.0000%. Over the life of the ben, your interest rate is guaranteed to never be lower then 0.0000% or higher Ihan 0.0000%. Even if you make your payments on Ome, can your loan balance rise? x0 No. ~ Yes, it can dse to a maximum of $ 0.00. Even ff you make your ayments on time, can your monthly amount X^ No. ~ Yes, the first increase can be on and the monthty amount owed can rwved for principal, lots sl, and mortgage insurence rise? dse to $ 0.00. The ma>omum it can ever dse to is $ 0.00. Does your loan have a prepayment penetty7 X^ No. ~ Yes, your maximum prepayment penalty is $ 0.00. Does your loan have a balloon payment? X^ No. ^ Yes, you have a balloon payment of $ 0.00 due in 0 years on . 'total monthly amount owed including escrow account payments ^ You do not have a monthly escrow payment for items, such as property faxes and homeowner's insurance. You must pay these Items direc0y yourself. x^ You have an addi0onal monthly escrow payment of $ 370.50 Ihat results in a total inital mouthy amount owed of $ 1,288.97. This inGUdes prndpal, ingest, any mortgage insurance and any Items checked below. X^ Property taxes ^X Homeowner's insurance ^ Flood insurance ^ ^ Note: If you have any questions about the Set0ement Charges and Loan Terms listed on this form, please contact your lender. PIPV IRIIA RIer11V1A RM rR PAfIR :~ n(d Hr m-~ Es~crtiw IVUmbef. 00112305001 MAW HUD 1112 DETAILED BREAKDOWN OF ADDITIONAL TITLE CHARGES Description Detail Amount 1'i 13. Doc Trans/VUlre Fees • to Select Platinum Settlement Services, LLI$50.o0 1114. Overnight Fees • to Select Platinum Settlement Services, LLP $30.00 Total as shown on HUD page 2 Line #1112 HUD 1200 DETAILED BREAKDOWN OF GOVERNMENT RECORDING AND TRANSFER FEES Buyer Amount City $ County Ta>~Stamps City Tax/Sta ps: Deed $2,250.00 Total as shown on HUD page 2 Line #1204 2,250.00 Seller Amount Buyer Seller Amount Amour State TaxlStamps State Tax/Stamps: Deed $2,250.00 Total as shown on HUD page 2 Line #1205 2,250.00 etlitla~s are obaobN an,.e a .,r e GENE SCO X00279 Ill~hllrll'I~~'Ihll~~aMl~Ialnllua~uuall6~a~llrl~~1~1111111 BRUCE C DALWAY 1212 FLEETWOOD I~R CARLISLE PA 1701$-3571 ~mputershare Computershare PO Box 43076 Providence, RI 02940-3D78 Within USA, US territories & Canada 877 224 0366 Outside USA, US territories & Canada 781 575 2819 www.computershare.co~nvestor The t12S nquMee that we report tln coat baab of eertafn aharu acquired after January t, 2011 and thw wld. Shares tnrnferred out of an etxrount wkl be done uting our default coat baab glwlatton of flat In, flaat out (FIFO) urdeae otlrerwiee InsWcted. Please vbk our webake, review the encbead FAQ, or corauk yyoour tax advisor If you need addklonal bdormatlon about coat besets. Dear Holder: Re: BRUCE C DALWAY Company Name: Gene Inc. Account Number. 0000118125 DRS book-entry shares: 0 Certificated Shares: 26 As requested, enclosed are the in sand instrucctions needed to transfer the decedent's stock to a new account oranother hoder. We have also enclosed answers to Frequently Asked Ques ions (FAQs) to assist you with completing the form and to answer transfer related questions you may have. You an find additional helpful information in the Frequently Asked Questions" section of our website, wwH-.compubershare.comlinvestor. To request the transfer, you will net~d to complete the following steps: Step 1: Transfer Request form Complete the enclosed form. All surviving registered holders (if applicable) or a legally authorized repl+eserttativernust sign the "Authorized Signatu s" section (section 7), with a Medallion Signature Guarantee for each signature. An individual signing on behalf of the current registered holder must in irate his or her cepacliy next to the signature on the form (e.g. John Smith, Executor or John Smith, Custodian). See the enclosed FAQ document r additional information. If the decedent held any I rtificeted shares, you must include the original stock certficate(s) along with the Transfer Request form. If a certificate is lost, please contact us at the customer service number listed on the top right corner of this letter to find out the cost and process for requesting a certificate replacement. L st certificates must be replaced prior to transferring the shares. Step 2: Form W-9, tax certificat on -The new holder should sign and date set~ion 9 of the enclosed Transfer Request form. ff the new holder is unable to provide tax certification a this time, we will send him or her a Fonn W-9 (Request for Taxpayer Identification Number and Certification) once the transfer request is proce sed. Computershare will be required to withhold taxes on any dividends or other cash distributions until tax certification is received by us. Step 3: Additional tax documentation -Obtain either (a) or (b), as applicable: (a) If the decedent resi~ed in a state in which an inheritance tax waiver is required, an Inheritance Tax Waiver form. (b) If the decedent did of reside in a state in which an inheritance tax waiver is required, either (i) a Notar¢ed Affidavit of Domidle (blank form enclosed), or {ii) an~nheritance Tax Waiver stamp affixed next to the signature on the Transfer Request form. See the last page of the ~ndosed FAQ document for additional information on these items and how to obtain them. Step 4: Send all required documents outlined above to: Regular mail: Ovemightlcertifiedlregistered delivery: Computershare Computershare PO Box 43078 250 Royall Street Providence, RI 02940-378 Canton, MA 02021 OOICS0003.D.F.MIX_3 2 34/0002 79/00139 1 2NG (Rev. 1111) "~""~^ 07655 9000008924 309409920 OF: >``~ BRUCE C DpLWAY 1212 FLEETWOOD DR Jp , CARLISLE P 17013-3571 ''~ ' ' .' $ ' s _ d. ~. ~ j. ,, s _. a:4.4 > a ^• it :i ~. S' ~~'309409920~~' ~:03L10026?~: 630~52i674 509~i' Detach Here ~~ p~ ~~~w°.~ ~~ ~~~ ~~ 1 INFORMATION STUB Detach Here Operations Center 6201 15th Avenue Brooklyn, NY 11219 Telephone: 800-937-5449 Web: wrvw amstock com Record Date Payable Date 05,/28/2010 06/14/2010 Record Date Position Distribution Rate 8.000 0.040000 Account Number 9000008924 Check Number Check Amount 309409920 0.32 07655 TIRE FINISH LI E INC CLASS A COMMON Detach Here ~~~ Current Distribution Year`to-Date Gross Amount Gross Amount 0•~ 0.64 Tax Withhek! Tax Withheld 0.00 0,00 BRUCE C DALWAY ADDRESS CHANGE FORM 548 Detach Here --- g you wish to change the rasa on your account, please complete the address drange form below. Pbase nose that Changes to the registered name(s) on the amount may not be submitted via fhb method. For trMormadon regarding changes to the n~rJ lease consult our Website at http://i~ww.amstockcondshansho/dsNshar~ehohh3r services. registe name(s)r ~ bebw. asp, or contact us using the contact w- °- I~IIIII^NI^IINIIIII s~"°~' o.le: 07655 9000008924 Note: Ploae fiyn fxaogy of your nanr or n~ss appar an koowil. Whin ohfraf w hNd loirgy faoh holder mwt dyn When afynirq as atfoutor, admMdatratar, attorney, hulas or n, nab fill tM(o a loch. if the figMar h f corponUo~pbfff lion fill oarporde nano 6y d~djr fulhorind ofikfr, g-{„iny tub tglo ff loch. M nor b o rhwfhl dyn In paelno p perwn. ~ W P. 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' -~ ._r ~//~-_ l/ ~~ 0 o a~ go~~ ~. _ ..__ -_ -. ~~ ~. o,-.. ~_ ~~ ~ -" 1 ~'~~~~`.vv aaav" vvaaulaVaa ,J tV VaI VtV Va\ - 1 GLL1VVi l a1atLLL1VV 1 tL~V 1 va Hi, Karen ;Sign Out ;Help Trending: Lady Gaga Yahool Mail YAH~re Fi1NANCE search r._webSearch ~ pow ? 0.0196 Nasdaq t 0,04 HOME INVESTING NEWS PERSONAL FINANCE MY PORTFOLIOS EXCL StIVES -1 OET QUOTES Flnance Search Mon, Jun 13, 2011,1:54pm EDT - US MarkMS close In 2 hrs and 6 mina Genlssco Inc. (GCO) i At 1:3aPM EDT: 42.26 10.$3 {2,00°/s) ~~ ~ "-" 4., ~ Historical Prices r fiat HbMrlul Prices for.) ; G0 Set Date Range ®Dauy Skirt Date Mar ~ 18 2011 Eg. Jan 1,2010 ~~ Weeldy End bete Mar 18 ! ,2011. _ f)Mofdhly Q Dividends Oniy Get Pntcea , Prices First ~ Previous ~ Next ~ Last Date Open High Low Close Volume Adj Close' Mar 18, 2011 38.31 38.45 36.55 36.95 1,044,800 38.95 ' Ckue price adjusted for dividends and splits. First ~ Previous ~ Ntott ~ Last Download to Spreadsheet Currency in USD. Copyright O 2017 Yatwol Inc. All rfgMs reserved. Privacy Pagq -About Our Ads -Terms of Service - CopyrlghtAP Pdky -Send Feedback - Yah001 News Netwofk Quotac are real-rims for NASDAQ NYSE, and Amex.Sea also delay Wines for other exchanges. AY information provided "aa is" for Infameaonal purposes only, not intended fa tredh9 pwposaa or advice. Nedher Yahool nor any of indspendant pfovidere is dsbb for any informWOnW srrore, Incompleteness, or delays, or for any aeaons taken in rNisnce on inromislipn contakrM heroin. SY accsaNng ms Yehool site, you agree not ro redistnlwte the infomnhon found Herein. ReabTima caMinuous streaming quotes are available Nrough our premium servke. You may Wm streaming quotes on or ofl. Fundamental company date provided by Capita IC. H4roncal than data antl daily updates provitlad by Commodiy Systems, Ina (CSp. Intamakonal hisrorical than dale, dally updates. fund summary, Wnd Ixrtormance, dividend data and Momingsrer Index data provided by Mominpstar, Inc. http://finance.yahoo.tom/q/hp?s=GCO&a=02&b=18&c=2011&d=028ce=18&i=2011&g=d 6/13/2011 --- ----~ ---_. _._....__ ~..,.....,. ~ ............ . ",b.. - - Hi, Karen Sign Out Help Trending: Ricki Lake Yahool Mail Y~HOp!o FINANCE ,_.........._.._...._ Search Web Search ,, Dow ?" 0.16% Nasdaq ? 0.16% I'-~HO~M" E~tNVE~STI~NG NEWS PERSONAL FINANCE MY PORTFOLIOS EXCLUSIVES 1 I OET QUOTiE3 Finance Search Mon, Jun 13, 2011.3:OBPM EDT - U.S. Mefkets Gose in 52 rains. Finish Line Inc. (FINE) At2:52PM EDT: 21.44 10.37 (1.76%i ~: weuix mtaaora ue :Historical Prices -- f3et Hhtorlcal Prbas 1or:) 00 'Set Date Range ~ Daily Start Data ;Mar ~ 13 2011,..,........ Eg. Jan 1, 2010 (~7 Wtaekiy End woe: ;Mar ;. 13 :2011 Li Monthly _..... Q Dividends Only Get,Prces,,, Prices Rrst ~ Previous ~ Next ~ Last Date Open High Low Close Volume Add Cbse• Mar 11,2011 17.68 18.24 17.49 16.15 776,300 18.11 ' Cbae price equated for dividends and epifta. First ~ Previous ~ Nefd ~ Last Download to Spreadsheet Currency in USD. Copyright O 2011 Yahool Inc. All rights reserved. Privacy Pdky • About Our Ads • Terms di Servlee - CopyrlghVtP Pokey -Send Feedback. Yah001 News Network Ouotea are real-time For NASDAO, NYSE, and Arrtex.See also delay lirrtes for other exchanges. AU information provided "as ic" for infrxmational purpwea only, not Intended for vading purposes or advice NeNher Yahool nor any of IrWSparulsnt providers is Bads for arty nformaaonal errors, incomplstenesa, or delays, or for any aetiom taken in raNanee on inbrtnatan rnnlained heroin. By accessing the Yatwol sale, you ages not to redistrdrlrte the informabon found tharoin. Real-Time congnuous sUeaming quotas are wailade ihreugh our premium service. You may wm straamng quotes on or oV. Fundamental comperry data provided by Capital 10. Hlatoncel than data and daily updates providetl by Commodity Systama, Inc. (CSI). Intemalronal hialorical chart dale, daily updates, fund sumnvry, fund patforrrrenee, dividend date end Mamirtgstar Index da4 provided try Morningstar, Inc. http://finance.yahoo.torn/q/hp?s=FINE&a=02&b=13&c=2011&d=02&e=13&2011&g=d 6/13/2011 "' "' """r "-"'• ~"~~ UL Ural ~ ~ t111ty ~+,., ~ rauC In v Blues, xevlews - lteuey tSlue tfoox rage 1 of ~ R~G9'~y Mtfa~ R7RAlR Tlit; TRUSTED REf011RC~" Rndrar values cv features __.___J ,. ___ car,_va..lues._....__(_ cars._for a.le. j ...car reviews,.,,.,,.,,),,. top stories )_ research tools ! Popular at KBB.com 10 Coolest Cars Under adverusemaa #18,000 .._ _ _. _.. _..... ......._... wAy ads Home > Car Values > Jeep > Cherokee > 1999 > Sryle > Optlons > SE Sport Utlllty 4D 1999 ~ ]eeP'Cherokee ,r go !3°~ rPur. ~~~~ ... 1999 Jeep Cherokee SE Sport Utility 4D Mik~ge: 55,000 change edit opdans change style ..............._._ .._..... _........ _ _ ._...._...... 1 Select Yvur Car 2 Tell Us Style I Options 3 See Blue Book Value L~ price your next car ___.. __ . __ .. . _ ................................._....... . .........._.. _. .... 1.._..._ ............._..EI ! values ii specs ii new car finder ~i used cars for sale i _ .. _. Trade-I n/Sell Values ~e ~ Car Prkes _.. _ . _ Trade-In Private Party Excellent Good Fair S3,325 53,025 '' $2,CJ2CJ Change conditlon Get a CARFAX Get your Record Check New Car Price admit whyad6t Enter VIN (ophonal) 90 price your next car ' ~~ No VIN? No problems ~ Seller's Resources _. -.... __ __ _ _ _ _ ; How much can I afford? _ _....... _._ Use our monthly paYmetit olculator Search Used Cars for Sale near CarUsle What if my credit's not perfect? Apply with a spe[ialist now View actual photos, compare prices, and buy your next car. I want to Ost my car for sale Get your free Seller's'roolkit _....... _ _ _ _..._.. r. __ _.. _ Jeep Cherokee _ - _ _.. up to 75 Miles °: away ~,,, aP 17013 I want help selling my car Search Read 30 tlps m sell your car ................. . '~ Top 10s b News Stwre Print My Recently Viewed My Saved Cars save My KKK 7[P C:cx1e: 170.13 Sign In http://www.kbb.com/jeep/cherokee/1999 jeep-cherokee/se-sport-utility-4d/?vehicleid=568... 6/14/2011 """~ ""-'b" -~~-~~~~ -~-'(jam+... ~..uv 1v 1 Ullul~ you 11ZtUG 111 V [UUGJ, 1LGVICWJ - 11G11Gy D1UG ... ra~G 1 vi ~ •~+'~~ ~~. ~{rA1 7NETRUtiEDRE50lIRC~' Flnd.edrvaluasorfaahres---Cj car values_._ ,.~.._. cars._for sate.. __ [ __ ca...r reviews _,~,_ ..top sto, ries __._~ research tools _..._ ___ i Popular at KBB.com 10 Cadest Cars Under ~~~~ X18,000 _. wny aas~ R/T Short ged aloes > Dodge > Dakota Regular Cab > 2000 > Style > Opdons > 2000 Dodge DakOtd Regular Cab ;"' go ~r~~.°°. 2000 Dodge Dakota Regular Cab '"~ "''' ~ R/T Short Bed ...................... M ge: 85,000 change !edit options diange style uke _._ _. 1 Select Your (:ar 2 Tell Us Style / Optio~ts 3 See Blue Book Value 4 price your next car ................ . values specs ~I new car finder ( used cars for sate I ~; Trade-In/Sell Vatues Trade in private Party Exceilent Good $3,150 $2,825 See Used Car Prkes , . ', Fair $2,325 Change conditWn Get a CARFAX Get your Record Check New Car Price ~ ~ wnrads7 Enter VIN (options!) go price your next car _ .... _ No VIN? No Probk:m~ Seller's Resources _ _ _ _..__ _ _. How much can I afford? Use our monthly payment calculator _ _. Search Used Cars for Sale near Carlisle what if my credits not perfect View actual photos, compare prices, and buy your next car. Dodge ~ Dakota Regular Cab UP ~ 75 Miles i away from Z[P 17013 Apply with a speciatlst now I want to list my car for sale Get your free Seller's Toolkk I wank help selling my car search Read 10 tlps to sell your car _ _... _ _ _ Share Print f4y Recently Viewed My Saved Cars save My K88 "LIP Cie: 17013 Sign In http://www.kbb.com/dodge/dakota-regular-cab/2000-dodge-dakota-regular-cab/r-t-short-b... 6/14/2011 ~ ~ _ ___~._ .~ ~„„~ vw i aavvo - l~VllV~ L1U\. 1JVVl~ rC1b'G 1 vi ., 7t Print ZIP CODE:17013 ~ Sign In -home-- -1- car values ~ ~~- cars for sale- -~- car reviews 1_ kl5ti fop picks 1.. research a"ools ~' i Q ~ b100~ ~ Popular at KBB.com ~ _ 1Ne don'EteU-you wFtatyourbudget is. Io Besc used cars under sa,ooo advMfsement .. _.. _-..-------~ wyaOS? Home > Car Values > Toyota > Camry > 2004 > Style > OpOOns > Condltbn > TO oW Cmry ~ 2004 Sedan 4D go 2004 Toyota Camry Sedan 4D R. -_.-.__-_ ~;`~ View all 5 photos ~ Mileage: 45,000 change ~ ~ lJke ! this or edit optbns ~ dtange style pricing photos specs kbb expert review consumer reviews ratings compare Used Car Prices j Suggested Retail ~ Private Party i ~- Y !Excellent 1 ~-------- See Trade-In/Sell Values $10,833- Verify Condition ~ F;nd Deals Near You see local deals i i ---- I Very Good $10,483 ___ _ I - Good Free VIN Check j ~~ Enter VIN (optional) go X AutoChedt No VIN? No Problem! $10,233 ------------ -- i ! Fair -I I i ~ ~ $9 283 ~ , j Know Your Credit Score? get yours now I I i I_--..._-__-__- x FrgPC:ranitSr.~r .____.-_____..._-.:._._.__.___.._. ~~. We make it easy ' to compare ~ y y --• `rates and save. N;7pdgy~j~. ,' Enter ' ZIP Codc: ~~ 4' """°"'~„'°"` why aas~ advertisementwhy aes~ Used Cars for Sale near Carlisle ' 2004 Toyota Camry 17 for Sale Near You 14 Below Blue Book Value' view all 1 _ _ ----- - •Based wthe Su99ested Retail Value Fxcelkn[coneRpn ano [he base w~itk confguraGOn. - - - - ----~------__-- - ------- --- -- ~ - - _ _ - --- _. ~ Buyer's Resources Compare This Car cwal~W~ n I afford? ~ Your npnfhlY PaYmem ~ I _ i ~ ----...--- - - __-~_ -_ 2004 Toyota Camry I want extended vehKle protection Get a free wanan ~ ~ exterxkd ty quote Engine: 4-Cyl, 2.4 Liter Recently Viewed Cars I !~y Sa~ars-- _-caveFar-_~ _.___. _ _ .___- __ (~ n n X Pnnt http://www.kbb.com/toyota/camry/2004-toyota-camiy/sedan-4d/?vehicleid=3465&intent=... 1 / 11 /2012 p~~x 499 Mitchell Road, Millsboro, DE 19966 Adjustment Services Irwin and McKnight PC 60 West Pomfret Street Carlisle, PA 17013-2222 Re: Estate of Bruce C Dalwav Social Security: 203-34-2082 Date of Death: March 18.2011 ~~~~~ SAY' 2 8 X011 GI~WIN & I+fICKIViGHs l.aW ~~Plione 888-502-4349 Fax (302) 934-2955 May 26, 2011 Deaz Sir or Madam: Per your inquiry on May 20, 2011, please be advised that at the time of death, the above-narked decedent had on deposit with this bank the following: 1. Type of Account Checking Account Account Number 700187545 ~~ Ownership (Names ofJ Terry A Over ~~"" ,, Opening Date 0225/2 Balance on Date of Death $14,404.70 Accrued Interest $ .02 Total $14,404.72 For any additional informatlon on the above accounts, inclndbig ownership and any changes, closuresand/or reimbursement of funds, p~ese ca0 the CarNele West Of6ae at #717-2MFb717. We were unable to locate any safe deposit box for the above-mentioned decedent. This letter does not indude any aaoounts is which the deceased may have bem listed as Power of Attorney, (,~Sfodian of Uniform Treaders, Representative Payee, or Trustee user a Writb~ Ags+eement Sincerely, Tammy Spencer Adjustment Services .. - r Ewing Brothers Funeral Home, Inc. 630 South Hanover Street ~' Carlisle, PA 17013- (717)243-2421 March 31, 2011 Robert Sharpe Over 100 Big Spring Ave. Newville, PA 17241 The Funeral Service for Bruce C. Dalway 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 FOLLOWMG IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOM07'IVE EQUIPMENT , AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS. 1. PROFESSIONAL SERVICES Services of Funeral Director/Staff , $1840.00 Embalming, $875.00 Dressing, Casketing, Cosmo etc. _ $290.00 2. FACILITIES AND SERVICES Family Viewing (Discounted) $250.00 3. AUTOMOTIVE EQUIPMENT Vehicle to transfer remains to Funeral Home, _ $275.00 Hearse (Casket Coach) $250.00 Utility Vehicle for DC retrieval/filing , $125.00 FUNERAL HOME SERVICE CHARGES $3905.00 SELECTED MERCHANDISE: Dark Brushed SS from Aurora , $2950.00 Guardian Burial Vault (Silver) , $1295.00 Acknowledgement cards, _ $10.00 Register Book(s) _ $40.00 Memorial folders , $75.00 THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE THAT YOU HAVE SELECTED $8275.00 Cash Advances Opening Grave, . Clergy/Mass Offering (2) . Certified Copies of the Death Certificate , , Flowers . Organist (Andy Hoke) , Church Custodian (Deb Brandenburg), . The Sentinel Obituary w/pic, John Larson . TOTAL CASH ADVANCES AND SPECIAL CHARGES . . Total Total Cost , . $1720.00 $300.00 $90.00 $159.00 $125.00 $80.00 $283.08 $100.00 $2857.08 $11132.08 ~~e~ ~e~ r ~ y SUB-TOTAL $11132.08 • INITIAL PAYMENT /DISCOUNT /CREDITS 11132.08 TOTAL AMOUNT DUE $0.00 The unpaid balance over 30 days is subjected to a 1.50 % service charge per month - 15.0000 % per annum. 2°~~ 3I3~' -a~ ,Ql n ~,~.~ ~J/ T A '/ ua,~~ il~ LUIL iU,17hiVl ~UIYIDCRLF11rv VnLLLt InLlnvnlnL uvlv~ tOZ1 RITNER NIDFIWAY • CARLISLl, PA 17013 717-2A8•ss41 r'AX: 7 f 7•~A8.44~6 ~~~, Do~ /n,//~,e. ~17~. /?a6Pef ~~i«, wa~.P~ ~clSt t~~u~c~ae a `l20~ 2 e f (~2G+~ J,Ov ~~UC~y ~ T.~G ~ 0~ t,~ .,~~C G' ~j;, y ~u~a.~o2o l~c~ P N ~~ ~„ ~. ,tee ~ ~'(~soo. V ~A~s ~~~ S'roNeMOR PwRTreeRS, L. P. ~, c a~ a ~o 7~~ ~ l w~ " 4..Y ~~ ~`, a ~, y~~ ~ ~} Y~ '~`'4 ~ ~n% ~4 ty ~ +1 ~ ~ r~ e` ~° 8 a ~ OM ~' LITLILAKIS AnOU+EVS Ai Iww May 12, 2011 ~~ GRLBLE OFFICE (717) 249-0900 (-j~R~~~, ~FFLCE (717) 232-9511 C~B~pR(, OFFICE (717) 267-0900 YORK OFFICE (717) 8'16-0900 1 Douglas G. Miller, Esquire Itwin & McKnight, P.C. 60 W. Pomfret Street Carlisle, PA 17013-3222 Re: Eetxt~e ofBtuce C. Dalwsp Dear Attorney Miller: ~'~pY ~`~ ~NFO~~ r ~QUR ~Q~ Please be advised that our firm bas not been paid is hill and as such, please find copies of invoices for our legal services. Invoice No. 39578 is for the Will update for Bruce Dalway before his death totaling X555.00. The other two invoices are for work on the Estate,_oae.is_..for $1,045.50 and the other is for $468.50. The total for all three invoices come to:~2,069:00. ~We kindly ask that you please pay this immediately upon receipt. Also enclosed is the Praecipe to Withdraw Appearance which I have signed Please foravard to my office atime-stamped copy of the Yraecipe to Withdraw/Praecipe to Enter Appearance Dace filed with the Court. Very txlily yours, ABOM & gUTULA~S, L.L.P. Michelle L. So ei, Esquire ESTATE OF BRUCE DALWAY ~ 119 ROBERT S OVER, EXEC 100 BIG SPRING AVE pA,I,E ~.. ~ A '7 A NEUWILLE, PA 17241 1~}'-~ PAY TO THE (~, f ~'(.tTi1.Lf~-l~ ~ ~ j~ ~~,' ~ ORDER OF I ~ ~~W ~ i•_ /(~, ~ a ~~.~.~1n' S / ~t l~fiawlo~_lbcr.~4~?SL 'i .J'~aQi,LARS ~ ~ .,. /iillrid[i D~111~ -sow.n.aaano. ,~~39s~~ ~ ~g~~~~ t:0 3 L 30 29 5 5~: 984089696411.0 L L9 Fnx (717) 249-3344 Bruce C Dalway 1212 Fleeiurood Drive Cariisle, PA 17013 Irrvoice Date: April 15, 2011 Carolyn Schlusser 4707 Enola Road Newville, PA 17241 (717) 776-6151 Invoice 50.00 TOTAL 5p,00 ESTATE OF BRUCE DALWAY - 10 9 ROBERT 8 OVER, EXEC _ 100 BICi 9PRWp AVE NEYYVILLE: PA t124t arts ?.ql revtorxe >....... ~. . ~ ~^LLARS m ~irJiOLi ~lic +r.rMaro r MEA4D .. // Q .vim ~ ~ r ;~~:0 3130 29 5 5~: 9840896964u'0 LO4 ~' - ?-:. _ .. . ,... :. r ;., . u.'. . x .~ 0:` oU `'~ in `r Y m}` - _4 a::, t~ ~ n F; V ~ ~ y . ~:. _ ~~ .. t,.,:. k. ~~• ~, ~~~ ., ~ ~'~~ OD P...G ~~ ~ ~ i J t, ;'-+ . _~ . p z ~`r ~ti ~ u f"z .~ 'id ) !et htJ~i~.~. ~ .a$ .'m ~ i..~ •Y, Ci `In~. . " ^N I ,_ ~~ 1 of 1 ~S . ~~ ~" c .. AL USE ~m ~ cerunea Fee _.....~ _~~`~ p~ ~w~) 0 p ~) - ..... ~ '~ v .1 ,r' ::ABP 0 p M1 ~~~~ ~- .. ~~~``~~ ---- Certllled Fee comae ~~ 0 p (REndoreenrent ~uin~ ~ T~a1 Postage & Fees r-~ 0 p G 3beet Apt 7Ga; ....-°-- ~, aPOBautNa ~0 ~ .T X1.1 ~ _ ~ ~ '~ .~ ~ .fie ~ Qe-dfled Fee Q «M Required) Restrictedp~y~ p ~EYRequbed) l~- ~ T &F rl p o p bY-ee4 Apt 7Qo.; °------° `, or POBoxl4o. y~~ ~ a,~ ~~~ ~~ Z ~,,,,,~,q-ss ~ ~~ ~' ~~ o•,c b,~,+tsr, >~S~~s~ NEWVILLE POST OFFICE • NEWVILLE, Pennsylvania 172419998 04/04/2011 4t 00)2751877098 04:29:08 PM Sales Receipt Product p le Final a Description Price y Price READING PA 19612 Zone-1 Priority Mail Window $q,95 Flat Rate Env 1.50 oz. Expected Delivery: Tue 04/05/11 Delivery Confirmation $0.70 Label #: 03102640000026042701 Issue PVI: $5 65 Total: $5.65 Paid by: Cash $20.00 Change Due: -$14.35 Order stamps at USPS.com/shop or call 1-800-Stamp24. Go to USPS.com/clicknship to print shipping labels with postage. For other information call 1-800-ASK-LISPS. X'1k'K7t7CYf 7tX 7(ltkkX XX7C 7f 7r*1k 7t7t7tlt7t7l7M IC %'7C7k 7f 7Y7C 1k 1kJC 7C 7C 7K ~x~,~~~*~~~x~*~~*~*~~x~xxx~~~~x~~r*:r,~~r~r~~r~r Get your mail when and where you want it with a secure Post Office Box. Sign up for a box online at usps.com/poboxes. ~e~t~cx*~txxxxxxrcxxxxxrr~e~rxxxxs~t*xxx~rx * *,r,r~rx* 8111#: 1000202500897 Clerk: 08 All sales final on stamps and postage Refunds for guaranteed services only Thank you for your business '~**************x~**~r~xxxx********xrcx~r~r,r,r *'~*****************~c~r~r~~rrc*********~~c~x~rx HELP US SERVE YOU BETTER Go to: https://postalaxperience.com/Pos TELL US ABOUT YOUR RECENT POSTAL EXPERIENCE YOUR OPINION COUNTS 7t:txxtx*~k%x~r~r~kat~rcX~t~k~r~~Xx~r~rx~rxx**7t~c~rx~r~t~cx ~r~r~rxx~r~r~rx~c~r~crc~r~n~cx~r~rx~r~rrxxxx~t~r~rxzrr~r~r~r~r~r~r NEWVILLE, Pennsylvania 172419998 •4134870241 -0099 ~~-t /2011 (800)275-8777 12:32:56 PM ~ Sales nacei~pt . Product Sale Unit Final Descri Price Price _____ __________ K PA 17401 Zone-1 _ $4.95 iorlt Mail Small Flat a e nv 1.20 oz. Expected Delivery: Wed 04/06/ 11 Delivery Confirmation $0.70 Label #: 03102640000026041339 Issue PVI: ---- $5.65 Total: $5.65 Paid by: Cash $10.00 Change Due: -$4.35 Order stamps at USPS.corn,~shop or call 1-800-Stamp24. Go to LISP°;.com/clicknship to print shipping labels with postage. For other informatton call 1-800-ASK-LISPS. ~c~c,~rcx~cxrcrcr~x,~v~rc~c,r~~r~r~rcx~rrvcW~rxrc~rrc~rrcrcx~~xxx x~c~cx~cxx~crc*x~rx~rxrc~rxxx~rrcxxxxxr~xx~rzxx~rxxxzx Get your mail when and where you want it with a secure Post Office Box. Sign up fur a box online at usps.com/poboxes. ~c~t~rrx~cx~tr~x~rcrc~rxrc,~~xr~~~~cxrcr~~r~~rxxx~tw~trcrer~~rx ~~~~~~~~~~~~*,~,~*,~*~~*~s~rx~xx~rxx~txx*~**~ Bill#: 1000100555308 Clerk: 04 All sales final on stamps and postage Refunds for guaranteed services only Thank you for your.business 7t Yf*71f YC7f Yt7C X1t 7C 7t Yl7t YI7KY(flXlt'X iC YC 7Y X YlX Y(711c7K 7C k7CX 7liY7CYf 7C ~~~xx~~~~*x~r~xxr~~rxr~xx~rzx**~xxx~r~exzx~~rxxx HELP US SERVE YOU BETTER Go to: https://postalexperience.com/Pos TELL US ABOUT YOUR RECENT POSTAL EXPERIENCE YOUR OPINION COUNTS 7KYl Yf iC Yf 7K 7C 1tK AYi is X7CX:C:t 1Crt R;t%7C %7t Yt YI XY(Yf 1t IC It Yt Yl yf X7C 7C7t 7C Yf t~k7C~7CXX ri"R:tX'7t%7C yC7tIC]C7C%YCYf Yl7[X1~k*7CXX7t lt)C 7k 7C 1t 7t ~:IISt(1fl1g1' rIlI1V _Q~~ ESROB ~~ F BRUCE WAY 1 W B-~ s OVER, EC N~/-LLE~ PA G 724 PAY'['O17~E Ny ORDER OF ~ ~ - J ~ H u ~ 3-~~ 11.3 ~~ h DATg ~ a ~ C M MMDDTr~ _, ., ~~ a~~ ~ DOLLARS a ~~ ~~:03t3029 ~; '~ 9840896964i-~0 3 j 3 .~ I 0 ~~ ~ mac°~ ~~~~~~mm~~~ _ ~ Q N m' m ~ •+ Q m m ~F„~a0 m~ ~~4f,C ~ID~jCy~ ~t ~'~~3 ~~~~OQ~n~a1fD cDN~,y? ~^m"`~ ~N~~~~n` v ~~ ~'-tic~-o ~~~ -n.+ y ~ c ~,.. m o m~- O µnl~i G~~ oo~ ~y H H ~X(~ i~ .y z° .; ~;~_ nk O1 ~~ ~ H W m ~ia ~ C~ poo$ ZN Q ~ N y2 < p v„ (~ ancr ~~ N a a ~~ -1yy ~~r~ ~ _y ~ ~7 -i -i k V ~ a v w ~ ~ m ~ a ~a ~ ¢- tri ww ~71.U1NCwj wtNp o c v Zv ~~ n wwow w ~~ ~~ ~.yo ~ ww m a 3 i Carlisle Small Animal Veterinary Clinic 25 Shady Lane Carlisle, PA 17013 717-243-2717 "Our Goal Is To Keep Your Pets Healthy and Treat Them Like Our Own" FOR: Bruce Dalway Printed: 03-18-11 at 1:57p 1212 Fleetwood Dr. Date: 03-18-11 Carlisle, PA 17013 Account: 5896 Invoice: 388549 Date For Qty Description Price Discount Price 03-18-11 Rocky 14 Doxycycline 100 mg 9.14 Old balance Charges Payments 0.00 9.14 0,00 New balance 9.14 Reminders for: Rocky (Weight: 33 0 Ibs -12 . y) Last done 05-07-12 Rabies, Canine 3 Year 05-08-09 02-22-12 DHP-P 2 Year Vaccination 02-22-10 01-31-12 Office Visit 04-28-11 Lyme Vaccination Annual Booste 01-31-11 11-02-10 Potassium Bromide (blood Sampl 04-28-10 1 11-02-10 Health Check Profile (Idexx) 1-02-08 11-02-08 10-27-10 Kennel Cough Vacc. Injectable 0428-10 EMERGENCY CALL POLICY CHANGES- If you are an established client and have an emergency before 10 pm, please call to leave a message for the on call Doctor. ALL EMERGENCIES after 10 pm must contact either the Animal Emergency Clinic of Mechanicsburg or the Animal Emergency Clinic of York. The most common zoonotic parasites are roundworms andrhookworms. In fact, in the U.S. alone, nearly 20% of children contract roundworms from their pets each year. MORE THAN 700 CHILDREN YEARLY HAVE BLINDNESS RELATED TO ANIMAL PARASITES. The Companion Animal Parasite Center (CAPC), recommends continuous, year round protection for your pet as the best way to reduce the risk of infection. Yearly fecal sample analysis is also recommended. WELLNESS EXAMS- A dog or cat getting a wellness exam once a year is equivalent to a person getting a physical exam every 5 to 7 years. Routine wellness exams are an important part of helping pets live longer, healthier lives. ATTENTION: Due to the increased volume of prescriptions, we are encouraging owners to provide 24 hours notice for refills. PRESCRIPTION RETURN POLICY- In compliance with state and risk management guidelines, all Pharmacy items, including drugs, fluid therapy, nutritional products and food are non-returnable. This policy is to protect your pet from receiving items that may have been tampered with or improperly stored or used. The exception to this policy is pet ;~ ~~ Carlisle Small Animal Veterinary Clinic 25 Shady Lane Carlisle, PA 17013 717-243-2717 "Our Goal Is To Keep Your Pets Healthy and Treat Them Like Our Own" FOR: Bruce Dalway 1212 Fleetwood Dr. Carlisle, PA 17013 Printed: Date: Account: Invoice: 03-18-11 at 1:57p 03-18-11 5896 388549 Date For Qty Description Price Discount Price 03-18-11 Rocky 14 Doxycycline 100 mg 9.14 Old balance Charges 0.00 9.14 Payments 0.00 New balance 9.14 Reminders for: Rocky (Weight: 33.0 Ibs -12y) Last done 05-07-12 Rabies, Canine 3~Year 05-08-09 02-22-12 DHP-P 2 Year Vaccination 02-22-10 01-31-12 Office Visit 01-31-11 04-28-11 Lyme Vaccination Annual Booste 04-28-10 11-02-10 Potassium Bromide (blood Sampl 11-02-09 11-02-10 Health Check Profile (Idexx) 11-02-09 10-27-10 Kennel Cough Vacc. Injectable 0428-10 EMERGENCY CALL POLICY CHANGES- If you are an established dient and have an emergency before 10 pm, please call to leave a message for the on call Doctor. ALL EMERGENCIES after 10 pm must contact either the Animal Emergency Clinic of Mechanicsburg or the Animal Emergency Clinic of York. The most common zoonotic parasites are roundworms and hookworms. In fact, in the U.S. alone, nearly 20% of children contract roundworms fromaheir pets eac~-wr~~ 11A^or_ THAN 700 CHILDREN YFaar v u~.R-.•~~ •••-~ •-- 1 F a ESTATE_OF BRUCE DALWAY H0s~~a3cs 1 ROBERT S OVER, EXEC _ ~ 1.00 BIO SPRINt~ AVE DA.~ 011 pi ~ NE//WV--IL,,~LE, PA ~1~7,2~41~, ~// ~` f j + In ~ PAY TO THE ~1.•iG.~+'^I 4i~i'f"6/ , ~ ,V:../~I 1.//_... ,_. ORDER OF ~•!/ ( T A- ~ ~ pp t0 DOLLARS L~J ' ~.. e PF ~ MST D~1111~ 9u ~ '~ .o~. p/ f foc ,~~ / to `~` „r ha~ ticEiK ~:0 3 i 30 29 5 5~: 984089696411'0 LO L __ . __.. _ __ ~ ~ ..~ r ~~ .~2 Ia • ~~ ~t2 ~o ,o~ 19.3 g' ~ 3 6 31 . y3 1.90 I~~,sY ~1~8, ~s f i ~ ... - 48 _- .. tiley Steemer ilnv~, ~ `.' ,.F `, ~ 0 E. College Ave.. 1'984~~ ~ "- ~ ~ -}- lefonte, PA iG823 -~~- 0)445-7741 Date::, '" a6~-~2~ k 1 W 3 ~ '"' t ~ " ~.' ;, nymt : ~ I } ,~< ~ `.~ ='_' ~ ~ s ~ ~ ~~a ~.- ~~~~ ~ , $#8 t V Iv1C D , , ~ ,.. ~' ~ G ~ota1 ~d~, '` ~~~~ ; r~ , 't u it .~' . ~ ~ ~ x x~j ~+ M v Cr~'; +'` ~ ~~) ~~ a.} Y ~ ~~ Yea.? } .' ... ., .. r ,« ..- ..... ,.. a_~~pec~aa ~ . 1_~-~~0' -5~ _`_~ . _ fi 13.9:.,0.0 ~ j I~ .. ,~,; r ~ ~ t ,, ~ ~ ~~ a ~ 3 r3. ~.~ ~ ~t~ i _. ~~ d ~Y~,. i~' ~~ li ~ ~. :~, , r ~ t ~ 4~ ~y,r i ~ ~ J~fI R F L rY S bJ 'i. ;. ~ Y.d ~ ~iP f 1t8laIIla ~Or alOrtg waU6~ 0r COIICLlt! flOOd~~Ot.thatligYl.been, ~ ~• ~~ defeedvely instilled, ace cleaned af;cu~tome[e dsk: Caepeb: that . ; : '~ Decd to pets may sometime aot be;;able to deododze:sffecHvely: '", , ooncemiag:ouc rvoel~uhip mnt be repoeted wittiin 30. dirys ~ =::..~~ j rn a~f work or will'be eabjed b a;savice charge at.our,o~losL 3usbomer aclrnowdedges being informed and undeuhndb flat- d' and after cleaning arul that I~ne slwald 6s iwken:fn ~,~" / ,;,, rfwces tv avoid slippGe& and 1~teliy releases gtanleY, fJ ~7 ~ , j i l ]iabUity foe injuries ~ be snstair-ed as a ~ ~` '~ `- I D LY BRST TIi6 ABUVB. ,~ ~ .~...-... Jr ~~'~ ~;`~ ' ~~ :III ':~ ~. t ~`~ ~~ PREVIOUS GUSTO. . ~+~~'• Tax. Rate 6:00 leaning is due tm: That. date has been: O' Scheduled, ^ Not Scheduled - ~~; ~ 1MER COPY ~o ~,r~-s More saving. More doing: 1013 S. HANOVER ST, CARLISLE PA 17013 WE NOW INSTALL HOME SOLAR POWER UNITS 4149 00059 02465 06/04/11 08:25 PM CASHIER SELF CHECK OUT - SCOT59 080776118697 SHOWERHEAD <A> 12.75 028905846301 SHOWERHEAD <A> 24.98 SUBTOTAL 37.73 SALES TAX 2.27 TOTAL $40.00 XXXXXXXXXXXX4376 DEBIT 40.00 AUTH~CODE 030686 iiuiiwiHii~uiwmiiwiHiiii .~ ~,;,~a~~ P~it~ ~'~ -~' -r lr Mar~:sawin~. M+or~ ~doinc~.a'" 1013 Sl. HANOVER ST, CAI~~ ,r :~ t= F.,~N 17013 WE NOW INSTALL HOME. S~~ i;. ~ ~t(~ITS 4149 '000'06' 4928 05; 1 ~ t ~ ~'~ ~~ PM CASHIER ~HEA1'.HER -. HML16E ' 078477800737 10PK OUT I~ 3.57 078477839737 6PK,3W IV ^^ 07847795588.8,.WALLPLATE 5A> 2 Q9 078477955772 2G W~, IV <A> . 2v1.31~ 2.62 078477459010 WALLPLATE <A> .3.60 .SUBTOTAL 18.26 SALES TAX. 1.10 TOTAL $19.36 XXXXXXXXXXXX4376 DEBIT 19.36 AUTH CODE 162232 RETURN POLICY DEFINITIONS POLICY ID DAYS POLICY EXPIRES ON A 1 90 09/02/2011 THE HOME DEPOT RESERVES THE RIGHT TO LIMIT /DENY RETURNS. PLEASE SEE THE RETURN~POLICY SIGN IN STORES FOR DETAILS. GUARANTEED LOW PRICES LOOK FOR HUNDREDS OF L - --- ~ ~Tnnr.~rTnC >r>rx>rft~r>rtf: ~ *XYCYC>r~t u~ E a ) IINNIIIIII I ~ III~II~II~Nllblll 4149 0 49 85 /19/2011 2493 RETURN POLICY DEFINITIONS ^~~.TCY 3D` DAYS POLICY EXPIRES ON a .90 08/17/2011 . '~ ' ^ r !4~ N ~ MN E ¢ ~~ OOD I~IOQQ .~ ==W=W=.. . / O ~ +1 ~ ~e ~ ~ ~ 1 V ~ ly,l p . -a _ v Jd \ ~ ` v , ~ ~~ ~ ~~ O G ¢ ~~-~ ..fA ~ y~ ~r CCJ7 j"'~ ~~ ~ ~, ~77d.. r~+ C7~ ~ ~ ~~~~ ~i ~ ~ ~Xf _ H pp 4 ';~ CVr +~ODONO ~O XUJ OF -- O - , ~ ~ S ~.. Nomo ~, - ^ rn.O o +OS®f~ '+ X MZ r~ •. ~l. O 1 i~ Oft 1 T Q"C~~CCC777V XS _~ -- - ~ ~~ 000 O X¢ O ~O t-~ i N' O H f- a H LL C F C C F t l d O,n, „m. u ,.-. -. .. ~~ ~N Mar+~ saving. Mire d+aing 1013 S. HANOVER SST, CARLISLE PA 17013 WE NOW INSTALL';HbME SOLAR POWER UNITS 4149 00006 47164 05/18/11 03:14 PM CASHIER NICHOLAS - NJH0652 020066779283 RSTOGLSWISPR <A> 3D3.98 11.94 SUBTOTAL 11.94 SALES TAX' 0.72 TOTAL $12.66 XXXXXXXXXXXX4376 DEBIT 12.66 AUTH CODE 762763 Il~~llli) ~ III ~ I ~INl~~li I~~I 4149 O6 4 1 405/18/ 011.8062 RETURN POLICY DEFINITIONS POLICY ID DAYS POLICY EXPIRES ON ~ A 90 08/16/2011 LIMIF R3FFTTHF { --,cxxx '~ P-:~7~ lam' OD ~T N N C~ O~ O~ O~ OD ~O W ILA >~ ~ ~O~l7OWPNPP I ~ „ ~ C~ .~ ~ ~ Z P O At O WIDQ!l11~1-;Itl-W ~ ~S' I ~F-~. ~tiO Oi- J •-+67 Z N M ~O Irf M ~O -~+ n ~ W N ~ N N !~ 7C~y d~N1ANN C NO. 0000 . ~ CC t9~1-100000 ~ G ZvyC Q 0 F ~ ao to ~ ~ ~ M N ¢ H ~ Z N = J } \ iRHJHJ j ~ L~/76¢.YdC ~~ ~v~~ ~~'` ~~. Mire saving. Mire d+aing;" 103 S. HANOVER ST, CARLISLE PA 17013 WE NOW INSTALL. HOME SOLAR POWER UNITS 4149 00002 68623 05/21/11 06:58 AM CASHIER TAMMY - TMR701 078477211847 1G WP, IV <A> 9®0.46 4.14 078877211724 iG WP IV <A> 20.46 0.92 078877955833 3G WP;IV <A> 1.98 078477018101 KNOB: IVORY <A> 078477509661 SWITCH <A> 5.25 X9.99 19.98 078477775226 JUMBO IV <A> 1.18 SUBTOTAL 33.45 SALES TAX 2.01 .TOTAL $35.46 XXXXXHXXXXXX4376 DEBIT 35.46 RUTH CODE 660576 ~~maq~~II~NN~II~I~II O ~ O ~ ~ M 4 L O~ V L P r.. Q ~~ d 7^ C N O ' 4 `DOLL700 i IB LWD //~~ , V/ O~DTO~ CNQ W Q ~O ~ l I V ~ ~ L¢ M ~m N O ~ W ~ N ~ \ .1 D 6 ~ ~ W OI O n a ss~` 1 oy H 1 i u~o ' JOO1-1 ^'~ 0~0~21Oi~ 77~ ~ 71V0 Vp~ W ~~ Q J O ¢¢Ct~?a ~ e~ Arytf @, fl ~, t y ~~ ~,~ ~a ~( ~~~ OUIE LONE'S HOME CENTERS, INC. 250 SOUTH CONESi08A DAIUE SHIPPE~ISBURO, PA 17257 (717) 530-3701 - SALE - SALES' t: S2B16AL2 1566905 07-28-11 1613 DRP 2LT BRSNDNICKL SENIFL 29.65 SUBTOTAL: 29.65 TAX: 1.78 INl~OICE 23614 TOTAL: 31.43 DEBIT: 31.43 DEBIT: XXXXXXXXXXXXd376 ANOUNi:31.43 AUTHCD: SYIPED REFID:B03910157 07/28/11 20:01:22 iRACE:00286040 PURCHASE CASH BACK TOTAL DEBIT 31.43 0.00 31.43 ~' 2816 TERMINAL: 23 07/28/11 20;01:25 # r ...~,.,~aCFp _ ~ ___ -C& '~ IROFJ7RLTFiLC_ ___ .. .. ~= D gram ~ r• ~ _. is o r a ~.-....... . ~ 7p l .3 n~ m .,...< ~ . . ~ vz ~ ' 0 p ~~ ~ '.T1 1091--~1 y O ~~ N< ~ "O ~ rr~~ = z i ~ O :") ~~ ` N Z ' 7 I'1'i ~ WXCn • O 7j ~ -r u ~ ... m mo `+~ 2 ~~~ 2~ Ma~r$ saving. M+~re d+aing;" J. 1013 S. HANOVER ST CARLISLE PA 17013 WE MOW INSTALL HOME SOLAR POWER UNITS 4149 00002 37594 06/25/11 04:20 PM CASHIER BRANDI - BLC3351 043168493437.60W 2f(~. gp <q, 785247122370 2L FM AN KA> 3.47 2ri39.00 78.00 NLP Savings $11.92 SUBTOTAL 81.47 SALES TAX q,gg XXXXXXXXXXXXg376 pEBIT $86.36 RUTH CODE 261487 86.36 NEW LOWER PRICE (NLP)SAVINGS $11.92 IIIIII ~IIII ISM II ,, . _ I I .~ MNI ~~ 4 n. 14 ;~4 / / 1 29 RET " : lCY DEFINITIONS A POLICY ~ ~~A.VS POLICY EXPIRES ON + ~ "" '"3/2011 -- TI ,._.. - ~GHT TO X C W • - -I N~ ~O X O ~ p O M ZW 1~1 X 00 ~ p 1-{ ~~~ OO1X d D ~ U.~ oa CJ v ZZ CJfIV ~O ~N FICi~ N ~ '~ ~ 7p . v ~ ~ ' 2 ~ f 7 9 G "' ~ ~ 3-i .. W~ i ` p ~ --I - -I - -~ rn ~ ~ ' ~. ~ '~ s X A ~ N . sr- ~ H ~ ~ ~ g a '~. ~ c m ~ ~ f~ yp ~ \ ° ~D ~ r ~ ~ ~ .c o c ~• ' ~ ~~ Ql 0 1 G Sl ( C31 H O f~ = ! _ \ 00~ ~ D NW AAA ~ S~\1 3 i,. N \LL 3 ~ _ ~ ~~ Lou~E~ 1 LOYE'S HOME CENTERS,. INC. 250 SOUTH CONESTOGA DRIVE SNIPPEItiSBURB. PA 17257 (717) 530-3701 *s•uss:t:~»*caus#a*t•sr~:-tar.x:ta:~:a::x PICK UP INFORMATION TO OBTAIN STOCK MERCHANDISE DESIGNATED AS [PICK UP LRipi] ON THIS RECEIPT. YOU MUST COME TO THE CUSTOMER SERVICE DESK. PICK UP DRTE 08/09/11 f~l INVOICE 17723 stttsa#rtsse~taa+rsstsa+tast+k+aa*~W*~+ra~~a~*s*t*+**+* - INSTALLED SOS SALE SALES is S2B16RN1 140%05 OB-OB-11 17740 lAB INSi VINYL-SNAIL JOB [DIRECT DELIVERY] 163979 LAB INST VINYL-REMU/REPLC [DIRECT DELIVERY] 275601 LAB INST VINYL FLOOR UNDE 64 0 [DIRECT DELIVERY] 163973 BASIC LABOR VINYL -FULL 6o B [DIRECT DELIVERY] PO is 113290665 INVOICE 77122 SUBTOTAL: 259.61 'I INSTALLED SALE - SALES r: 52816RM1 1409605 08-OB-11 87556 46.80 12' EPIO SOHO PAVER NUTRL 5 4 9.36 - [PICK UP LATER] --41222- 11.90 GAL 356PRM FLTBCK SHT/CRP [PICK UP LRTERI 80246 39.% 1/4IN4FT%8F7 PREMIIRI UNDE 2 0 19.98 [PICK UP LATER] 61155 4.98 JUNE YAX RINfi YITN BATS [PICK UP LATER] INVOICE 77723 SIMTOTRL: 103.64 I~~ '~ INVOICE 17722 SUBTOTAL: 259.61 INVOICE 77723 SUBTOTAL: 103.64 SUBTOTAL: 363.25 TAX: 0.00 BALANCE DUE: 363.25 CHECK: 363.25 STORE: 2816 TERMIIWL: 14 OB/01/it 21:90:34 4t OF ITEMS PURCHASED: 5 crri ix~cc cccs ScpliTfFS ANA SVFfigl IIRIIER ITEMS •~ ~~~ ce ~a,r ~e ~t ~OW~S LOYE'S NOME CENTERS. INC. 150 SOUTH CONESiOBA DAIUE SNIPPENSBURB, PA 17257 (717) 530-3701 PICK UP INFORMATION TO OBTAIII STOCK MERCHANDISE OESIBNATED AS [PICK UP LATER] ON iNIS AECEIPi, YOU MUST COME i0 THE CUSiONER SERVICE DESK, PICK UP DRTE OB/09/11 FBI INVOICE 77725 ###t######t##i###i########tR##R##i###+F#########t#### - INSTALLED SOS SALE - SALES t: 52816RM1 1409605 08-OB-11 191848 LAB INSTL CARPET -PRICE [DIRECT DELIVERY) 111645 LAB IMSi CARPET-STAND NO Tzo e [DIRECT DELIVERY] PO -: 113190666 INVOICE 77114 SUBi0iAL: 104.20 I - INSTALLED SALE - SAIES 1: S2B16RM1 1409605 08-OA-11 256619 12' SENECA (141779) % 148.20 19 8 7.80 [PICK IW LATER] 256619 12' SEIECA (141779) 117.00 15 ® 7.80 [PICK UP LRTERI 256619 12' SENECA (U1779) 93.60 12 B 7.80 [PICK UP LATER] 256619 12' SENECA (141779) 109.20 - 14.8 7.80 [PICK UP LAiERI -" ' 17122 6' ODOR BAN II CARPET CUS 453.60 120 8 3,78 [PICK UP LATER) 16280 1.5"X6'80LD BINDER BAA 7.54 [PICK UP LATER] 139117 60LD LINE NOi MELT SEAM i 9 92 [PICK UP LATER] INVOICE 77725 ~i0iAl: I 939.06 ~~ INVOICE 77724 SUBTOTAL; 104.20 INVOICE 77715 SUBiOTAL: 939.06 SUBi0iAL: 1,043.26 TAX: 0.00 BALANCE DUE; 1,043.26 CHECK: 1.043.26 Sf011E:2816 TERMINAL: 14 OB/8Y/1121:32:41 ~ OF ITEMS PURCHASED: EXCLUDES FEES. SERVICES App SpECIAI ORDER ITENS 7 C~~`~ ~'~% ESTATE '..OF .BRUCE DALWAY ~-~sas 14 S ROBERT S OVER, EXEC 10U 810 SPRINQ AVE hh ,`., ~NEVWILLE, PA 17241 DATE iii/ ~ ~ PAYTOTHE I ~ ORDEROF _ , ~y ~~ i LARS 8 -~ •~M~~l. aa.n.y.aew r ~~~:03130295~~: -~9840896-~64i~'0i48 Ronald G. Baker Masonry Contractor 8,56 Cater Road Newvllle, Permsyhr~ia 17241 TELEPHONE: 717-77603 PA028362 ~ `~ Date 1-y rs~ i ~ ~., ~~' ~~ o vJ. ~ (~. Hawkins' CAnstruCdon Company ]aeon A. Hawkins 320 Rr~e House Road Shippensburg, Pa. 17257 Phony Number: Ol~iae 717-776:6908 Fax: 717-776-5037 Regis6ered Pa. Home Improvement Contractor # PA060638 Desakplion of Work Completed: Replace n~of boots . Check flashing around chimney; flashing okay added more bkadc jack as needed. Installed c:a~hinous bradng anwr~ chimney in attk Installed metal tr~ ) ~ ridge board Amount Due: $150.00 .. nk ,;: :., F ~ ~r .~ ~~ ; , ,iii PO BOX 660370 DALLAS, TX 75266 June 4, 2011 s~eaez2s~.oooosos-0o~ ~ aao-0oo~ooo-0oo ,, BRUCE C DALWAY 1212 FLEETWOOD DR CARLISLE PA 17013-3571 I~~~III~~~III~~~~~~II~~II~~~II~~I~I~I~~~I~~~II~~~II~~I~II~I..I Dear BRUCE C DALWAY: Cltl 1f. Account Ending I :3199 i{0 ~i ") / 2 BALANCE: $ 1.00 ~ ~/ ~C 1 Your account is two payments past due and at risk of being negatively reported to the national credit reporting agencies. Avoid letting your past due account damage your credit record by making your minimum payment due of $1,065.79 today. To make an immediate payment, simply call 1-800-447-8144* with your checkbook available for reference. It is a fast, secure, and easy payment method without the delays associated with mailing your payment. We will ask you to authorize the checking account number and check number that you would like to use for payment.. It will take only minutes and it will save you postage, time and money! If you prefer, you can mail your payment to the address below. Citibank/Choice P.O.Box 688901 Des Moines, IA 50368-8901 LL Qi O M If you are mailing your payment, be sure to send it at least seven days before the due date on each statement. If you are unable to make your payment today or are experiencing financial difficulty, please call us toll free at the number shown below. Let's work together to keep this matter from becoming more serious for you. Sincerely, G. Stevens Vice President Citicorp Credit Services, Inc. (USA) PLEASE SEE REVERSE SIDE FOR IMPORTANT INFORMATION VISIt uS at: www.D9vsolutions_ritirardc rnm Toll-free Telephone Number: 1-800-447-8144* TDD Number: 1-800-926-5818 (Hearing Impaired Only) Any representative can assist you. Office Hours (Central Time) Send Correspondence To: Monday -Thursday 6:30 am to 11:00 pm Citibank Friday 6:30 am to 9:00 pm P.O. Box 6077 Saturday 7:00 am to 7:00 pm Sioux Falls, SD 57117-6077 Sunday 8:00 am to 7:00 pm *Calls are randomly monitored and recorded to ensure quality service. ~;~s P.S. If your Minimum Payment Due has already been sent, thank you. Estate Information Services, LLC . 2323 Lake Club Drive Suite 300 esraco informarion scrviccs, llc. Columbus, OH 43232 Hours: M~-Thu Sam-9pm and Fri Sam-Spm EST Toll Free: (877) 347-2484 Phone: (614) 322-2758 Fax: 614 322-2761 ( ) www.probate-care.com ~L~~~~~ 09/26/2011 DOUGLAS G MILLER, ESQUIRE ~~~ ~ ,~ 191;1 60 W Pomfret St Carlisle, PA 17013-3243 sRw11V & V1cKNiGH E 4 I~~~III~~~III~~~~~~II~~II~~~II~~~I~I~I~~I~~II~I~I~~I~I~~I~~I~i 3 aw o~>=1cEs RE Estate Of: BRUCE C DALWAY Creditor Name:Citibank NA ~ ~. Account Type: CITI MASTERC Amount of Debt:$10,552.27 ~ ` Account Number.*********** 199 Reference #:2959466 ~~ Dear Attorney DOUGLAS G MILLER, ESQUIRE: ~ \ - c~ As attorney for the estate, you are aware that an estate claim was filed on behalf of Citibank NA in the above- referenced estate. We are requesting that the estate provide to us a copy of the estate's inventory that was filed with the probate court. It is imperative that we inform Citibank NA if the estate has recognized the estate claim as valid. In matters such as these, the executor or executrix has access to supporting documentation such as cancelled checks, statements or check registers indicating past payments made by the late BRUCE DALWAY without dispute. We can provide this information if absolutely necessary. We would appreciate the estate requesting the above information before issuing a disallowance if all that is needed is supporting documentation to determine the validity of the claim. If you wish to discuss an early settlement of the estate claim, please feel free to call our office at the toll free number listed above and ask to be connected to the proper legal assistant handling the claim. Thank you for your assistance toward a prompt resolution of this matter. Estate Information Services, LLC is a debt collection company. This is an attempt to collect a debt from the assets of the estate of BRUCE DALWAY and any information obtained will be used for that puf pose. Calls may be monitored or recorded for quality assurance purposes. Very Truly Yours, ~~ Andrew C. Hall, Esq. Estate Information Services, LLC } ROBERT S From: eisi aQprobate-services.com Sent: Thursday, September 29, 2011 4:20 PM To: OVER, ROBERT S Subject: Payment Confirmation Dear ESTATE OF BRUCE C DALWAY, Thank you for using the ESTATE INFO SERVICES PROBATE CARE DIVISION payment service. This is to confirm your authorization, on Sep 29,2011 at 16:19, for electronic debit from your funding account payable to ESTATE INFO SERVICES PROBATE CARE DIVISION. The following account(s) will be paid, in the total amount of $7,400.00. Account Number: 2959466 Confirmation Number: 71613014 Effective Date: Sep 29,2011 Payment Amount: $5,000.80 Account Number: 2959466 Confirmation Number: 71613015 Effective Date: Sep 29,2011 Payment Amount: $2,400.00 If you have any questions, concerns or require clarification regarding this correspondence, please call . G ~~ ~~ ~~ ~~ ~ ~2~ ~~' 1 .. Enhanced Recovery ,,~-. ~ Company, LLC ~. Easy, Simple, Secure ... www.payerc.com • View your account(s) • Manage your account(s) • Save time Dear Bruce Dalway, REPAYMENT OPPORTUNITY Statement Date: May 24, 2011 Creditor: WELLS FARGO BANK NA Original Creditor: WELLS FARGO BANK, N.A. Account Number: XXXXXXXXXXXXXX5893 Amount of Debt: $452.64 Reference Number: 51799138 We recognize that you may have gone through some financial difficulty and have been unable to repay your I#ccount. We would like to offer you a few positive and flexible options to satisfy your account. Option 1: Settl :90.53 ease remit by 06108111. Option 2: Settlemenrt: .16, payable over the next 3 months. Option 3: Settlement: x135.79, payable over the next 6 months. 8 View statements, pay your balance, and manage your account online at www.paverc.com Telephone: (800) 565-0164 Toll Free; Fax: (904) 645-3009 ® Send correspondence to: Enhanced Recovery Company, LLC, 8014 Bayberry Rd, Jacksonville, FL 32256-7412 © Office Hours (Eastern Time): Mon -Thur, 8:00 am -11:00 pm; Fri: 8:00 am -10:00 pm; Sat: 8:00 am - 8:00 pm Visit us on Facebook at Enhanced Recovery Company, LLC Sincerely, ~l. r~e~y N. Akley, Recovery Specialist P.S. We are very interested in helping you resolve this debt. If one of the above options does not suit your financial situation, please contact one of our recovery specialists to assist you in settling up a repayment plan that will. _~ This is an attempt to collect a debt. Any information obtained will be used for that purpose. BBB _~_ NOTICE -SEE REVERSE SIDE FOR IMPOftTAN7 N071CES AND CONSUMER. RIGH.T5 ""°""""'-'°' Please do not send correspondence to this address. I~~~~®~~~~~~~~I PO BOX 1967 Southgate, MI 48195-0967 May 24, 2011 ` ~"~- WFWITNVS06! 1 / 202281403602 000586510027 <~.~._ ~Ih~I~~~~L~~~I~~~II~~~~~d"'~I'I~'I~'~~'11~111'I~"I'~~'1111~1 ''` ` Bruce Dalway 1212 Fleetwood Dr Carlisle, PA 17013-3571 IF PAYING BY CREDIT CARD, FILL OUT BELOW. ^ ..,. .. ^~ ^I ~ a N R SIGNATURE .DATE REFERENCE NUAABER 51799138 A 10 ~ Make Payment To: Enhanced Recovery Company, LLC 8014 Bayberry Rd. Jacksonville, FL 32256-7412 1~~11~~~1~1~~1~111~1~~11~11~~~1~11~1~~~11~~1~11~~1~1 ,Jmberland Goodwill Fire Rescue EMS Billing Office P.O. Box 726 New Cumberland, PA 17070 ~ QUESTIONS ABOUT THIS BILL? Phone: 877-214-6018 Espanol: 866-724-4114 Fax: 717-214-6020 Email: info~ambulaneebillingoHlee.eom Date of Service: 2/17/2011 13:57 Patient Name: DALWAY, BRUCE C. Please visit our website to provide insurance or make payment, and for additional payment options and frequently asked questions: From: Carlisle Regional Medical Center To: FOREST PARK HEALTH CENTER www.ambulancebillingoffice.com ~. "'~'fll~-JS:4N t'1NRES~L ~EDr~B~*'.'`~'aur` count,-has~no-~ beert'tra~ed'ta out'+1~~+~'4'fo"~'z~dl~Jle,~cir~fett "#flEDI~ITEA~TIOIVISN~~ES~R~**'` ~ ..~~ -~,~ ~, '^ , s S r. ~. , . V y _ 2/17/11 Stretcher Van One-Way Trans A0130 2/17/11 Mileage S0209 Total PAY TO THE ESTATE OF BRUCE DALWAY ROBERT S OVER, EXEC 100 BICi 3PRINCi AVE NEVWILLE, PA 17241 0.00 0.00 319 ~ 1 1 6 ~ ~ DATE ll ~ _ ~ as- _ ~ ~ DOLLARS I ~ I .~~..~ Ic~~'I~M&TBanic ~. ~~~:03 X30 2955: 9840B96964u'0 i i6 DETACH AND RETURN BOTTOM PORTION WITH YOUR PAYMENT. ti > r r.. ~at~c~6el~.w~" .ywacrf~.9R11'vr~e~.FGTO r~pl~'.,~i/} gti+. deductlon Plead tndi~bli.`y+aurt~ 4IIQ1 r and?f1111hregUfretl:information:; IF cther~ar`re~emeiatsa'fe CumberiBrldGbodwllf~l~~; ~, necessary, please cau us at B77Lz14=sois, Reseue EMS ® y ~ ascmvEa ~- a o Credit Card: ^ MASTERCARD ^ VISA ^ AMERICAN EXPRESS ^ DISCOVER -..~-- _ . ov,rt un Electronic Check Deduction ~~ !'lease send a vo/ded check OR provide information below: L..-%=- - Eck ng : ~tco~nc ';~,mi:?r 1.0 80.00 80.00 1.3 1.75 2.28 82.28 11-94763 ~ $ 82.28 Amount Paid: Please make any corrections to address below. BRUCE C. DALWAY 1212 FLEETWOOD DRIVE CARLISLE, PA 17013 `Returned checks -you will be responsible for all incurred bank fees permissible under state law. Bi1lirlg>ce ~ `- 11-93563 7/6/2011 $14.15 P `f?. t3ox' 726 New Cumberland PA 17070 ~srioNS Asour nits sn.i.~ Phone: s»-Zaa-soar r~a~oi: a6s-~s~a-~aaa max: ~a~-Za~o=o c-~i: ~„o.muMgo~nnoeoon, 2113!11 BLS Emergency Transport A0429 1.0 600.00 600.00 2113/11 Mileage A0425 1.8 11.50 20.70 2/13/11 Adjustment -Insurance _ - . ,_~ •,. .. 5/31/11 - 5r~u11 ~ ESTA~:fifl1~;-~ D~1AlA'Y 133 s -1x.98 5/31/11 7/06J11 ~~~.:~ - 1 ~~s~!S9;r~'-'~- f241 RA 1 •sx~ .: ~ air -268.01 -56.58 .~ ; ~ ~ ~ -3:58 ~° ~ _ M,~."`~. ~ _ °~'~~ ~~ ~~ :~ ~ ~~ a ~~ _ o { 11-93563 Coedit Grd: ^ MASI'ERCARD O VISA Ci AMERICAN EXPRESS ^ DISCOVER $ ~a.~s Amount Paid: i Y ;#y 7 i E ~ f ~ f S f ~ 1 E ~ 1 ~ Cartl N16kIbCr Nerve kM CaM Expiration Beetnonie G~ee.:k Deduction Atease serve a wldee kYeealr ox vwrap Irklbrrn~on below: Bank Routlrg Number Checking Account Number Pi2852 kriake ekly COREftiOr15 lb address beiOYY. To the Fr:st~te of BRUCE C. pALWAY 1212 FLEETWOOD DRIVE CARLISLE, PA 17013 Date of Service: 2/13/2011 18:37 Please visit our wet>fssite to provide insurance or make payment, and Patient Name: DALWAY, BRUCE C. for additional payment options and frequently asked questions: From: RESIDENCE To: Carlisle Regional Medical Center ~W' 'COIif1 r ~' "~11"~~'~I'1~"11111.q1'I'I~Lb.~d'~"I~~IIII~III~.~~I~U~~II 031212-0000094849379-04 #BWNJFDB #OOOOOOCLL1762249# BRUCE C DALWAY 1212 fLEETWOOD DR CARLISLE PA 17013-3571 biN securely online Mmown renaurg Insurance: 50.00 Amount Due From Patient (Current): 533.80 Amount Due -From Patient Past Due): 30.00 Pay This Amount: 133.80 PLEASE REMIT PAYMENT BY "PAYMENT DUE BY" DATE. THANK YOI Please refer to coupon below for payme tnstruQions. 01A1/11 1 965 EMERGENCY EVAL 8 MGMT 51,037.00 ll~ ~ DX:553.9 DR. RANKINfCARLISLEREGlONAL MEDICAL ENTER 001'1&11 .BLUE SHIELD CWMDENIED -COB S•O.OD OIA8I11 MEDICARE CONTRACTUAL ALLOWANCE S•888.02 04108H 1 11~QICARE PAYMENT 5-135.18 S33 8C i ,1 110 ; :ESTATE OF :BRUCE DALWAY -913 ~, ROBERT S OVER, EXEC " Ze .71~J 1 -100 BIG SPRING AVE DATE ~NEWVILLE, PA 17241 ~~ -,~ s $ 3~ ~a PAY TO Tt0/ - _ .ORDER OF ~Q OLLARS U +~~+ b ~ _ - /U s33.eo s '~MO[JL 17~+~ torlhis q - I~t-omine $, aeo.w.ee•oelw sr ~,~ t• 9840896964n'0 i L0 ~~1.03L30~955. -,......,y~~uestlo~nE~emca Cnr orn~~u~n~setld ~inaii to ~.~. ~ ~ Please detach and return bottom portion with your remittance. y BRUCE C DALWAY STATEMENT OF ACCOUNT 1212 FLEETWOOD DR Statement Date: April 15, 2011 CARLISLE PA 170133571 ACCOUNT NUMBER:CLL94849379 YOU MAY PAY THIS BILL WITH YOUR CREDIT CARD Patient Name: BRUCE C DALWAY PLEASE SEE REVERSE SIDE. Payment Due By 06/06/11 Make CtrecklMoney Order payable to: Amount Due: 133.80 Amount Enclosed: ~~ Go Green -pay online at ~nr~~~r~uur~~~~orm~~~ur~~ur~n~r~~~urn~r~) www•MyMedk:alPayments.com ALEXANDER SPRINGS EMER PHYS Tue rnsursnoe ,r~,mmo„ n arc h1e appears e.low gorse m~e any PO BOX 37720 mn«uons arwra saaoons on nre reverse srde d and tam and ream t m PHILADELPHIA, PA 19101-7720 "~ T"iNtyO" ^ If your address has changed, check this box and complete the reverse side of this form meu rxis AUWN MEDICARE PART 8 209392082A PBS PENNSYLVANIA BLUE SHIELD ZAK1138348020p103999892 54771 0312120000094849379000033800000000000008 :.-..;..._. __..............,.~ rte: PAGE 1 123 BRUBAKSR ROAD HROCRWAY, PA 15824 814-503-7400 STATEMENT OF ACCOUNT PLHASB coaracT c~awRDIAW PWARluc~r ,n17 ,~ QvssTloWS Rsc~RDl~o Y~R HILL. A SBAVICB CHARGB WILL BB.ADDSD TO YOUR ACCO[A1T IF PAYl~T IS ~T RHCSIVgp WITHIN 30 DAYS. STATEMENT DATE ; 03/25/11 TERRY OVER 100 W. HIG SPRING AVBNUS NSNVILLg, PA 17241 AMOUNT DUE: 6.21 - PLEASE DETACH HERE AND RETURNTOP PORTION WITFIYDUR PAYMENT Invoice#:PH77863 Account#:147 :::,PAID x7' 1 r ~~. y i{.. ~, /fig... :~ R ~~: ~ ;';,~/ML ~ ~` 'x/11 ~j5rd n ~ „ ~~ ., R6~~476 ~ v ' " .., .. .' SL lZ,FATL ' ~ snti ~$, S/F R~~~SON ~ ` 30 :Tt'tC' -27. 31 ~`~ 50LUi`ION ~~ f!'~y/25/11 F1~T RTU0~427 ~ ~ ,,~. 'SULFA'TE Eit lOOMG RCSarS,ON 45 - R~ - 73..80 4 :~ ~~T SA 0,~ ~ ~ 890-01 ~QZ'f25/11 ~:.. • ~;CR~D3T R~'-00359 SULFATE 1$ DROPS a ~ ROpISQN 15 -38 85 ~0 06 , :. U~~25/11 ; h F ° ; ,,r ,{~ZS~T9IT` R`10035'1 , ~~LY?A~E A/F S/F r r• 1~t~UZSON 60 .~ -51 83 . i .2.: ~4 ~t ~. ~~:/25 / 11 x ` ~ ~l :DST Imp 0339 ~ ~ TABLET j ,> R C!$ISON ` " 25 ~ 4: ~ 69304`,~077~3-~TO y , - 90 ,~ ,~ .....a::.n.; ~ '5Y . ' .. ~ ~~~ of e~cE u:~~~r C 1.Q goo ~I~ §P~ao~.nvE NEYWILLE,. Pd• ?241 _ ~ . Dw7s ~, PAY1+01HE ~ .'~~ ;; _ _ ~. ± u~ } " ^ -r- ., ` ' ~ ° ~ ~,LARS; iJ ~'~ ' ~ +'~ ,,. i o ~ ' rr.4 ~ INB1N0 ~~ ,~ ~'~r0.3 ~-3C3 2955: _ ,_ -197.29 203.50 0.00 _ ._ ~ 0.00 ~ p,00 7. 203.50 + ~ ;BNYIB .,q,~, -197.29 + 0.00 a 6.21 0.00 0.00 `AMOUNT DUE 6.21 THE JOHNS HOPKINS UNIVERSITY CLI~)ICAL PRACTICE ASSOCIATION BiQinglnquiries: Call (410) 933-1200 or 1-800-657-0066 or rnntact us via a-mail at jhupbs~jbmi.edu (please include account numher, patrent name, address, and phone numher) DISCOVER CARD USERS: INClUOE IAST 3-DI6IT5 011 SIWIATURE STRiP EXP DATE: SIGNATURE: Once Hours: Monday-Friday, gam-4pm PATIENT: BRUCE DALWAY PAYM06/22/11~TE I30-3247567 I PAY THS14.AMOUNTI $ UNT ENCLOSED !u~!~~u~~~~nun~~u~~u~~~n~~~~~u~~m~~n~~~u~~~~~~u~ MAIL PAYMENT T0: BRUCE DALWAY THE JOHNS HOPKIN5 UNIVERSITY 1212 FLEETWOOD DR 14314 1 AB 0.368 AMECH CLINICAL PRACTICE ASSOCIATtflN CARLISLE, PA 17013-3511 PO BOX 64896 BALTIMORE, MD 21264-4896 ^ CHECK BOX IF YOUR ADDRESS/INSURANCE HAS CHANGED (SEE REVERSE SIDE). 301989400060120110000043148960 PLEASE DETACH AND RETURN THE TOP PORTION WITH YOUR PAYMENT. STATEMENT OF PHYSICIAN SERVICES (AS OF JUNE 1, 2011) ACCOUNT NUMBER: 30-3247567 PATIENT NAME: BRUCE DALWAY PAGE 1 THE FOLLOWING INVOICES DESCRIBE OUTSTANDING CHARGES FOR SERVICES PINIYIDED BY PHYSICIANS AT THE JOHNS HOPKINS UNIVERSITY. THE LEFT SIDE DESCRIBES THE SERVICES PROVIDED AND THE CHARGES FOR EACH SERVICE. THE RIGHT SIDE DESCRIBES ACCOUNT ACTIVITY AND THE AMOUNT YOU OWE. PLEASE NOTE THAT THIS IS A PHYSICIAN BILL AND NOT A HOSPITAL BILL. CALL (443) 997-0100 OR 1-800-757-1700. FOR QUESTIONS CONCERNING YOUR JOHNS NOPKINS HOSPITAL BILL. CALL (443) 997-0100 OR 1-800-757-1700 FOR QUESTIONS CONCERNING YOUR BAYYIEW HOSPITAL BILL. CALL (443) 997-0200 OR 1-877-361-8702 FOR QUESTIONS CONCERNING YOUR JOHNS NOPKINS BAYYIEW MEDICAL CENTER BILL. GAIL (443) 997-0300 OR 1-866-323-4615 FOR QUESTIONS CONCERNING YOUR HOWARD COUNTY GENERAL HOSPITAL BILL. INVOICE NUMBER: 30-54393921 CHARGES PROVIDER: CHARLES G DRAKE MD JHU DEPT OF ONCOLOGY 02/11/11 99214/QI-OFFICE/OUTPATIENT VISIT, EST ............... 5238.25 TOTAL: $238.25 PAYMENT ACiIYITY:` 03 25 11- INSURANCE CLAIM: FILED 04/11'/li MEDICARE PAYMENT. MEDICARE PAYMENT.............. $86.21. CONTRACTUAL ADJUSTMENT...... E130.49 04/12/11. BLUE SHIELD CLAIM FILED 05/25/11. BLUE SHIELD PAYMENT PAYMENT ..................... 517.24 ADJUSTMENT .................. 0.00 AMOUNT DUE NOW ............................ $4.31 YOUR CUIM NAS BEEN PROCESSED BY YOUR INSURANCE COMPANY. PLEASE REFER TO YOUR EXPLANATION OF BENEFITS FROM THE INSURANCE COMPANY. .-.~ 12 6 ESTATE OF BRUCE DALWAY 31s """ ROBERT S OVER, EXEC 100 BIG SPRING AVE DATE ~O( ¢ NEVWILLE, PA 17241 1' .~/ PAY TOTH ~~'("~-~ ~P ~NJ ~v C~11~i~G~ 1 l I ~ ~i ~ 1 ORDER OP J L p ~~i ~ ~ net[ j 1LLQ ~L, -~"~ ---rroLLARS Ll ..~~.~.~ I~1M&T'Bank ,_ ~ 5,a,~,.~,.~. i 2 y , MEM ~ J C~ "- ~ Z~ ~~~~ / ~:0 3 L 30 29 5 5~: 98408969641'0 L 26 PLEASE MAKE CHECK PAYABLE T0: THE JOHNS HOPKINS UNIVERSITY STATEMENT DATE: 06/01/11 CHECK NUMBER: ^ VISA ^ MASTERCARD ^ AMERICAN EXPRESS ^ DISCOVER CARD NUMBER: EIVED SINCE 05/02/11... 50.00 cCEIVED SINCE 05/02/11. $57.58 [NSURANCE PENDING $o.o0 54.31 ~ ~CTICE ASSOCIATION! Tur ,o~c unnvtuc urrvroctTV riTWTrn1 nRal'TTrF sctllcrsTTnw PII 6oX 6489b. BALTIMORE. MD 21264-4896 (410) 933-1200 1-800-657-006 QN/~, 45 Sprlnt Drive MEDICAL CENTER CatIISIe,PA17013 ADDRESS SERVICE REQUESTED •~ UPON RECEIPT I IF PAYING BY CREDR CARD, FILL OUT BELOW AND SEE REVERSE 810E MASTERCARO ~ DISCOVER ACCOUNT NO. STATEMENT DATE ^ .AM ^ VISA AMERICAN EXPRE98 BALANCE DUE 4488180 105/16/2011 5226.40 MAKE CHECKS PAYABLE TO: Bruce C Dalway 1212 Fleetwood Dr Carlisle PA 17013 ~u~'~~u~~~~ouu~~n~~u~~~n~~~~~us~u~~~~n~~n~l~~s~n~ CARLISLE REGIONAL iNEDICAL CENTER P.O. BOX 281442 ATLANTA GA 30384-1442 =,. n~~~~~nu~~~~~n~u~n~m~~~~u~~~u~u~~~~~u~to~~~~~i~~ OOD00948818000000022640BRUCE C DALWAY 5 Please check if above address is incorrect and indicate change on reverse side. TO INSURE PROPER CREDIT, DETACH AND RETURN THI5 PORTION IN THE ENCLOSED ENVELOPE. Bruco C Dalway: 03!04/11`. MEDICARE. DISCOUNT- 03/09/11 MEDICARE PAYMENT 04/08/11 BLUE CROSS::. PAYMENT 05/11/11 BIDE CROSS PAYMENT 05/11/11 BLUE CROSS PAYMENT 9488180- 102/14/2011 I INPATIENT PAYMENTS ANTI. CNARBEE NFCFIYSII eFTSa TMs AT~TSUew nix wu.i ~.. ,..~. ~.............~ .....- ...._---'-- ESTATE OF BRUCE DALWAY ~~~ 121 ROBERT S OVER, EXEC 100 BIG SPRING AVE DA,~ ZC~I ~ NEWVILLE, PA 17241 • PAS G _ ' ... ~^ [ ~ DOLLARS 8 ~ Iii1M&T Bai1k r~ ~ ~ _ . r, . ~o~9~QQi~~ --t:0 3 L 30 29 5 5t: 98408969641N0 L 2 L 4,617.18- 4,327.33- .00 .00 905.60- 5226.40 ASE CALL: ital Internet web site '~~onu ocrrror I MIAKE CHECK8 PAYABLE TO: MBlsland Associates Inc 220 Wilson Street Suite 109 Carlisle, PA 1701 STATEMENT ADDRESSEE: ~u~~~~u~~~~nuu~~n~~~~n~F~ DaMray, Bruce C 1212 Fleetwood Drive Carlisle, PA 17013 _ F PAYING BY CREORCARD, FlLL OIR BELOW cr~ICCARD usING wRPAYrlerr ® ~v~isA CARD NU16ER MDIRQT sICNATUr~ ow. DATE STATB'~T DATE 03!29!11 PAY TENS /WOIN~Ir $108.00 ACCOUNT NBR 6641 SHOW AMIOUNT PAID HERE REMR TO: . `` Masland Associates inc 220 Wilson Street Suite 109 Carlisle, PA 17013 PLEASE DETACH AND RETURN TOP PORTION WO'F! YOUR PAYMENT Phase pay P~PIh~~ tlank you.249~71 DATE DESCR~TION OF SERVICE I AMIOUNT I I CE i PB InAN~CTE I BALANCE ... - A000UNT NBI~ CURRENT 30 DAYS 60 DAYS ~ 90 DAYS. 1Z0 DAYS TOTAL ACCOUNT BALANCE 6641 $0.00 $0.00 $0.00 - $0.00 $108.00 $108.00 MIESSAOE: PLEASE PAY THIS AMOUNT ssss $108.00 elite policy collection notice Aoo Southern PA Trave161ns Agy !n 2840 Eastern Blvd. Yak, PA 17402 1iII'1iI'II'II'11'llllllllllli6""'1'1'111'11"'I'lllllllllll' BRUCE DALWAY 1212 FLEETWOOD DR CARLISLE PA 17013-3571 Amount due X29,34 Payment due upon receipt Important inform; Your insurance has been terns $29.34 is due for coverage pr terminated. If you obtained ir% were changes to your policy p please send proof of new insu the tear off portion of this noi; if any will be applied. ESTATE OF .BRUCE DALWAY ROBERT S .OVER, .EXEC .100 Bld SPRINt3 AVE NEVWIL.LE, PA 17241 ~~ Encompasses ~` Creating protection around you Information as of May 31, 2011 Policyholder Page 1 of 2 Bruce Dalway Cancelled olic number 260 612 358 Your Encompass agency is Aga Southern PA Travel &Ins Agy In (800) 222-1469 Segments for which premium is due Motor Vehicle 1999 Jeep Grad Cheroke 2004 Toyota t:amry 2000 Dodge Truck Dakota ~ 12 7 V DA7T I PAY TO ~ CO~t P~~ *J, ~J ORDER OF q v 7 Please remit your payment fo s ~._ envelope. It is our practice to Collection Agency. ~ ,~*~QTa~~'_ ~ t~16[i a>~i1K Terms of agreement for One ~ ~ r~ If you choose to make a payrr MEMO ~~~`t°Z~~~ information, you may be asks ` using this code you au#horize ~-1:0 3 i 3 0 2 9.5 51: one-time electronic withdraw amount you specify. Future payments you initiate using the same checking account will be sent to your bank as an electronic withdrawal /continued) DOLLARS L+1 0 1 en 984089696411'0 i 27 Detach bottom portion here • Return this portion with your payment 06/10 Amount due $29.34 Payment due upon receipt Amount anebsed X1111111111"I'I'11111'I~1111111i'III'1'1iII'Illl'IIIIIIIIIIII'I Make check or money ader rw-bwetaErr~ompa:s ENCOMPASS INDEMNITY COMPANY Inswonce. Please include your p0 BOX 3589 polic y number. Allow (ive days AKRON OH 44309-3589 for delivery. Encompass~~ ~ Creahnfl protectrnrr around yuu Policyholder Bruce Dalway Cancelled policy number 260 612 358 Do not write address or policy change requests on this return portion, contact your aggency. /2700000371000000260612358061D8000293480000000000D29348/ /i~!!~tfl/1@ Insurance CO/1'1~t1 y INSUr~-NCE BI~~ - Nor1EOr11ERs PO Box 41745 Philadelphia, PA 19162-0313 111St811fY1@11t PAGE; 1 OF 1 Policy Number: ZOZ3 9225 1 SSUE DATE; 06/ZS/?Ai 1 ~t11CE C DALMAY 1212 FLEE?YOOD DR CARLISLE. PA 17013 I current Activity I 06/?3/=Oll PROCESSING FEE ~ I 6.00 ~`~ ~ ~' t<t 1{ l f t ~ - ~ ~ {: ~,2 5:~ a 4t is , ?: ~ ~ r ~ f '~ _ ;'S Y. ~ j . ~ ~ r. F ;e a . ,. +''5.~ " t ' ~ , k91; i f t ~, ~~++. . ~ ...:. w Q ~> . ~ ~ ; INETAI~NT PAYMENT 9CH®ULE Date Dwe . . _.. I , P~oc~ngr-I,.~n..~..+ _ Fee .~. Toby 09ft3f20Yt--- 531~-:00-~-- X6:69--~~3~Zl~d-~AQ _ 08/29/2011 $212.00 $6.00 5218.00 10/13/2011 $212.00 56.00 $$18.00 If s c,LanBa has boen -made to 7aar pp , and 7~` ara P~ ~' Pe+emimQ the bosts~llnnent your remainin= insWimesoe been adjasted to re[lect flee increme, ar decraue, in your Premium. Amount Enclosed: Pie do not seed cosh. ~ AscensionPoint Recovery Services, LLC 200 Coon Rappids Blvd..$uite 200 ASCE11SI011~®~i1~ Coon Rapids, MN 55433-5876 RECOVERY SERVICES, LLC (888) 806-9073 Phone - (763) 235-4055 Fa% Hours: Monday -Friday 8: OAM to S:OOPM CST Creditor: GE Consumer Finance - LOWE'S CONSUMER Account No.: 7528 Reference No.: 452319 Balance: $1,680.35 Apri19, 2011 Dear estate of BRUCE DALWAY, We would like to offer our deepest condolences during this time of loss for you and your family. Thank you for promptly attending to this important matter in the life of BRUCE DALWAY. The GE Consumer Finance - LOWE'S CONSUMER account in the amount of $1,680.35 for BRUCE DALWAY has been placed with our office for collection. Please contact our office toll-free at (888) 806-9073 to discuss your options. Payments and/or the estate information coupon on the reverse side can be mailed to the address listed above. All payments should be made payable to the creditor listed above. Please remember that only the estate of the deceased is liable for the debt owed and family members are not personally responsible for payment of this debt. Very truly yours, Christina Mallen AscensionPoint Recovery Services, LLC Federal law requires that we give the following disclosure: Unless you notify this office within 30 days after receiving this notice that you dispute the validity of this debt or any portion thereof, this office will assume .this debt is valid. If you notify this office in writing within 30 days after receiving this notice that you dispute the validity of this debt or any portion thereof, this office will obtain verification of the debt or obtain a copy of a jud ent and mail you a copy of such judgment or verification. If you request of this office in writing within 30 days after receiving this notice this office will provide you with the name and address of the original creditor, if different from the current creditor. This communication is from a debt collector. This is an attempt to collect a debt and any information obtained will be used for that purpose. * * * PLEASE SEE REVERSE SIDE FOR IMPORTANT INFORMATION ABOUT YOUR RIGHTS AND THE PROBATE COUPON. * * * ACA INTERNATIONAL The Association ~' C:cdit PLEASE DETACH AND RETURN BOTTOM PORTION WITH YOUR PAYMENT and Collection Pmfraiosuls r DEPT 303 3147192411048 PO BOX 4115 CONCORD CA 94524 Amount Enclosed: Creditor. GE Consumer Finance - LOWE'S CONSUMER Account No.: XXXXXXXXXXXXX7528 Reference No.: 452319 Balance: $1,680.35 ADDRESS SERVICE REQUESTED #BWNFTZF #TAM3147192411048# t~t~~~~tttt~iiul~i~titntllllinli~i~t~t~ttiiltl~iti~i~tiinii~t 452319 ESTATE OF BRUCE DALWAY 1212 FLEETWOOD DR CARLISLE, PA 17013-3571 PLEASE SEND PAYMENTS & CORRESPONDENCE TO: ASCENSIONPOINT RECOVERY SERVICES, LLC 200 COON RAPIDS BLVD. SUITE 200 COON RAPIDS, MN 55433-5876 TAMNLB-0408-142996247-00169-i69 .:AFa.rST.t'60HOUCaHTAX ACOOUPIT ~O BOX 100.53 YYEST SOUTH STREET :ARlJSLE PA 17013 na+ 433'~.NO - 04001192 NAP NO: 04 22.0479062 1212 FLEETNKXm DRIVE 4CRES .3iW GEED 00222 !00408 .or4eSEC2P828PG2 ~ae~ 1o acres ~ESe~lRAL nnc~-rei WAY, BRUCE C B~FWRMAe4E C 1212 FLEEIVMOOD DRIVE :ARIJSI.E PA 17013.3671 ~R6AY-FRIDAY 7:30AM-4:30PM PHONE (71784®-4422 CLOS®SA . SUN ~ HOLIDAYS CASH ONLY AFTER 12h5/11 TAX A~AOUNT DUE -~ On or Your encbeed fax l1W tndudes a tax reductlon for your homestead arldlor tarrrlst~d property. Ae an tlomeatead and/or tarmsfl9ad property owrlar, you have received tax relef lhrnuph ahomeelead anNor famrebad ezcNmion whk~r hae trees provided Assembly dasigrl~foed reTducer property ~teXea ~~ ~ ~ ~~ ~e~ NOTICE OF f TAX REtJEF ~ Con6d No: 004 -001192 Bid Date: 7/01/20'11 '1+ota1 28 600 10 492- FiDe 1014 l~4.~a ~ iasst.s~ ~ NOTRAD sY ~~n~ TwB ^Iltwtu. ee IIrRt~o To TAx CI.Al11 BIJIIEAU FOR DBJOiIENT COLL~i10l1L >)y.OD DUPL~ATE TAX 8RL FEE ~/J~ /w ~® i~n/~ //! ~©b/ . - ~l~ 19, /3 ~- l1JD/ ~~ pryYg ti wa fhe oarpans 6.ta. m avhrolt,gyaaMllsR X paylrq Iri tali ua OIi.Y f,1.7ST oanport b.IeMrfra slrbren pyrrlNlt s1n~a 2011 ou-TE 7/012011 eats 1272 TNCtrr~w.2011 w~T~ 7/01/2011 era: 1272 TNrr~ln 2011 w-1E 7ro1/2011 eats 1272 AYAaLE70 I~~UGH TAX AOOOIAYT O BOX 100. 63 VYE$T SOUTH STREET ARt18LE PA 17013 dilllOti ~~ ~$-0479-Oa2 pgOL ~E AREA SD. AX F'AYErI ~LWA4; BRUCE C 8~ CW1FAtAINE C Laud Rates 12.26060 12.260601 12.26060 PAYAeLeTO TAX AMOUNT PO BOAC 100.69 ViIEST SOUTHBTREEI' CAFY.ISLE PA 17013 CONiROLB ~$-04•J9-052 . >3p100L lE AREA S.D. TA7[ Mll~i BRUCE C 8c CHARMAINE C nArAnETo CARLISIF BOROII(iFl TAX ACCOUNT PO BOX 100.68 WEST SOUTH STREET CARLISLE PA 17013 ;~1~2 ~~ SCil00L ~~SI.E AREA S.D. :'fAXPJ11r0i ~LWA4; BRUCE C & CHARMAINE C PLEABE iETiJlMI COUPON WiiN P/1`T OR FULL PAYII~f T PLEABE RET1lfiN OOUPON ZND WITH PAYIENT PLFA9E REI'1!N OOUNON ~D 1MitFi TIC PA1f I@fT $891.29 Q140R BEfgiE 8/31/2011 ~ $891.29 ON OR BEFORE 9/30/20].1 $891.55 CN OR ~ 10/31/2011 ieTAr.u~11SCA1e107'snenrllF7et 8/31/2011 ~ $980.42 AFIBf 9/30/2011 $980.71 AFTER 10/31/2011 OR uuA1- lrsr E 74.13 10 31 2 1 ESTATE OF BRUCE DALWAY , s 13 5 ROBERT S OVER, EXEC 100 BIG SPRING AVE NEVYVILLE, PA 17241 DAZE ~+~ ~F! PAY10 .~ Lsl~ l~~~. ~~. ,~ee~c~~ 2, 6 20. ~5 ~~ ~1VI8+T B8t11C '~°~° ~7 ~ r C? /~'I 1YIVUly ~ RVVr~ Ilvrh 1 IGIV I StKVIGtS alalanuln..l.w/..Iwy cc, al 1 PO BOX 3780? ACCOUNT NUMBER: CLE8~8ata0Z LPHIA, PA 19101-7807 PaUerrt Nanr~ BRACE C DiA1.YW1Y Taos ID 11: 27-2Eidi2136 ~-ccouM~ealarocs: sto.~a Amorurt Pandkg lasurarroe: Zt7.s0 141•IIIIIIIIIIIIIII~11111~1111111111.111111.161..IIII~IIyn11. Moo~rot Due From Peuerd (Currant): st0.4a 031205-0000094881802-08 nnwut Due From pB Patient (~ Due): sooo ~OOOOOnOCLE1339B3as My TMs Amowol: sto.K ~~: Y ~~#~ bR PLF,l~S~ ~!1 9Y "PAY~I' E:J~RLi . ~'l~ T~1~3571 dttE BY" C~ erilrer ~::+crauponpit . ~r.;yowb~N:, lil~yq~,>~www,.. s ., .. oan,n~ ' , esn~at anon, w~c 04ffYt11 IaP 'a~115/11_ ~:: t 0211II111 II :: s 05~12t11 ~' ... `.~611i~11; . _.. _ .... ;at~nena s ; ~~~ : ~ ., . ,. ~C7~14:~.E 'a~~1f11 Ui1011 .1y~ T amrrm~ ~ ap(peer ~.. ~. r~~ s: 7~154 i4 e'~iIONM. 14GE '. ~ . ~W' ~711C` ~fx.hT.l. ~ ~ ' - -' ~ ~' R1A1. J1L1+~WMICE . .. "Payment Plans" Accepted 1-187 S13:i sae? N4~ t > k you. !R~F~E%L~..:: L.e.:w /in-lt;aa.r~ 1:~u:i~:1' ~nM 1 `rnr.f'i3we...'1 '.:1:. .. ~. ^^"~~NT ROt~K INPATIENT SERVICES PO BOX 3 i o07 PHILADELPHIA, PA 19101-7807 llllll~llllllll\llllllplllll\lillyllllll~nld~llll,llllllllul 0 031205-0000094881802-08 ~~ #BWNJFDB #OOOOOOOCLE133963# ° BRUCE C DALWAY 1212 FLEETWOOD DR CARLISLE PA 17013-3571 v.i-l~rm\..\~\ V\ AVVVVIYI ~1~ Statement Date: September 25, 2011 ACCOUNT NUMBER: CLE94881802 Patient Name: BRUCE C DALWAY Tax ID #: 27-2992136 Account Balance: $5.50 Amount Pending Insurance: $0.00 Amount Due From Patient (Current): $5.50 Amount Due From Patient (Past Due): x0.00 Pay This Amount: $6.50 PLEASE REMIT PAYMENT BY "PAYMENT DUE BY" DATE. THANK YOU. Please refer to coupon below for payment instructions. Pay your bill securely online anytime at www. Date x Description Charge Paid By First Ins. MyMedicalPayments.com Paid BY paid By Amount Due From PATEN Other Ins. Patient Adjusted Irreurance BAI.AWC 02/14/11 1 9827,; INITIAL HO~ITAL CARE LVL 3 5838 ' DX:724.5 DR. GABASAN JRICARLISLE REGIONAL ME . CAL CENT 041191 11 MEDICARE CONTRACTUAL ALLOWANCE 04M9/11 MEDICARE PAYMENT S•154 s~45.23 07HSN1 BLUE.SHIQDPAYMENT. . 08009111 PERSONAL PAYMENT 3-30.84 02M SN 1 \ 2 98232 SUB-O HOSPITAL CARE LVL 2 5236 00 5-7.71 50. DX:724.5 DR. MITTAL/CARLN9t.E REGN~NAL MEDICAL . ENTER 05M2111 MEDN.'.ARE CONTRACTUAL ALLOWANCE 05112/11 MEDN:ARE PAYMENT ~ 5-~ 5-187.23 09122H 1 02118111 3 BLUE SHIELD PAYMENT 982;12 SUBA HOSPITAL CARE LVL 2 , 5-11.00 52 DX:724.6 DR. MrTT'AUCARLISLE REGIONAL MEDICAL 5238. ENTER . OSH2M1 MEDICARE CONTRACTUAL.ALLOWANCE 05M2A1 MEDICARE PAYMENT 5-55 02 5-187.23 09N 5H 1 BLUE SHIELD PAYMENT . 02/17/11 4 89298 FIOSP DISC DAY MGMT;LT 30MINS X8 00 S•11.00 S2. DX:724.5 DR. PINTOR/CARLISLER5GIONAL MEDICA . CENTER 04/19111 MEDICARE CONTRACTUAL ALLOWANCE 04/19111 MEDICARE PAYMENT 5-54 59 5-157.78 07M5M 1 BLUE SHIELD PAYMENT . 08A8/11 PERSONAL PAYMENT 5-10.92 5-2.73 sn ~ / V /ALS: 151,336.00 I 6316.85 I 663.76 I 510.44 5937.45 so.oo ss.so Important Messages: This staletfleM is for the diroct treatrrlsnt andldr au of care you recently received as a rerun of ur Inpatient Hospital Vick a! Carlisle Regional Medical.Center. The foes for this private physician are Wlbd sepsraEsly from any trospital charges or other onal fees for wAieh The a triN from the hospital or other physicians for eharyes in txmnectlon with this viak, k wilinGude the kerns Iisted~ o thls~statemere~sible. refore, should you receive "Payment Plans" Accepted Questions about this statement?/Llama de Lunes a Viernes? Call 1-800,522-3998 Monday through Friday 9:OOAM - 3:OOPM. Your automated system access code is 1072-94881802, or you can send email to statement questions~emcare.com. 9,9e4.01•e63o ~~ Please detach and return bottom portion with your remittance. ~~ ~N~1'~. I ~ ~{ r c O~~ r ~ I~ ^ a c N ~ ~ ~ mma m m >~a ~ ~ m-t ~~~ . ~ ~ ~ ~o~ _ ~~ - ~~ ~~ ~ m ~ _ o` s O m v D v ~e~ n~~ ~~ d n A ~I ~iC 1 -'t J Z ~J Z 3 m~ ~ ~. n ~ ~' m ~'9 -~ 0 a o '~ C a ~~ (r.tIAZ ill~.•~'~,~..,y .7~vu\YJV iu ~r1W ter, -, -...~ ~. •. _ _ _ . a ~ 6 4p0-.Lj4 3 MILLVILLEM UTUAL Po sos 170 I N S U R A N C E C O M P A N Y Millville PA 17846-0170 13illiag Name & Addt+e>as ESTATE OF BRUCE DALWAY C/O ROBERT S OVER 100 BIG SPRING AVE NEWVILLE PA 1~~"' - ~ ppL CpY ESTpSE OF g OyER, ~ R~B~ 810 ~p~ '1724 . NEV'Nl~, t $~ 3~q~-- 8 ~"~ RS ~ `~ ~{..A ~` t O ~~ ~ _ wv 1v ' r 5 ~~ 1 ~ }~- 8g6g641i~0 L4 2 gg40 Ito 9 5.5t: ~,•t;0 3 ~ 3~ 2 Current Amount $ 392.00 - _ .,...:y Number 1117668 FF DUE DATE 10/13/11 Coverage Period Fmm; 9/15/11 To: 3/15/12 DWELLING FIRE SEMI-ANNUAL (See payment options on reverse side) IhMach at pcrtoration and return lower portion in enclosed envelope M/~L.VILLEM UTUAL PO soX 170 I N S U R A N C E C O M P A N Y Millville PA 17846-0170 Policy Number Effective Date 1117668 FF 9/15/11 DUE DATE PREMIUM NOTICE 1289558 1289558 10/13/11 Pl2ENIIUM ESTATE OF BRUCE DALWAY C/O ROBERT S OVER 100 BIG SPRING AVE NEWVILLE PA 17241 1289558 0039200 Ageat J P WnT "" CNSURANCE INC 'GH STREET 142 ~.. 17241 ~1 is to-~ 31-~` 1~~ Z(o ~~~ `213 DATg . W $ 392.00 DWELLING FIRB SEMI-ANNUAL Make check payable to Millville Mutual DEPT 322 1040440211103 PO BOX 4115 CONCORD CA 84524 RETURN SERVICE RE(al~STED BRUCE G DALWAY 1212 FLEETVYOOD DR CARLISLE, PA 17013-3571 Account ~: 3513954 Settlement Aunt Due: X223.78 PLEASE SEND PAYMENTS d~ CORRESI°ONOFNCE TO: Law Offroes of pli~ctrell Dy Bluhm 8 Assoaates P. O. Bwt 3269 Sherman, TX 75091 Me~,a,oo~s~uoc~e~-0oae~.e GRAHAM MEDICAL CLINIC, PC Statement 100 S. HIGH STREET NEWVILLE PA 17241 Tax ID : 232173798 Phone # : (717)776-3114 Date : 09/01/2011 Page : 1 BRUCE C DALWAY 100 WEST BIG SPRING AVENUE NEWVILLE, PA 17241 Patient : BRUCE C DALWAY Account # : 24338 ;.. Please pay this amount : $17.74 Insuranoa Patkrrt Dab Coda Deacriptlon Provider Diagnosis Locatlon Amount Balarros Balanoa Balance Forward: o.oo o.oo 02/18/11 99305 INITIAL NH VISIT, COMPREHENSIV CKR 185 FP 150.00 4.91 04127!11 MCCK Medicare Check -98.24 04/27/11 MCDD Medicare Deductible 24.56" 04/27h 1 MCDS Medicare Disallowance -27.20 08/10/11 BSDD BSJBC Deductible 24.56• 08/25f11 BSCK BC/BS Check -19.65 03/11/11 99308 SUB NH VISIT,EXPANDED CKR 185 FP 75.00 12.83 OSH 2h 1 MCCK Medicare Check -51.33 05!12111 MCDD Medkare Deductible 12.83` 05!12111 MCDS Medicare Disallowance _10,84 08h0/11 BSDD BS/BC Deductible 12.83` so-ss.".~ 191 ESTATE OF BRUCE DALWAY sus "''" ROBERT S OVER, EXEC 100 BI(i SPRING AVE T Sri DAZE L NEWVILLE, PA 17241 _,"^ PAY TO THE ~~~ 'L~ 1 T i~ p .~ l {+f N f ~ ~ ~ , " / •_.~"'~.... ` ~. r~ ( ORDER OP- _~- e DOLLARS ~ ~= .a Cr.... ~~~ ~ I~1M&TBank "" " sm,,,,.uo. ol~e.. ~:0 3 i 30 29 5 5~: 984089696411'0 1.9 i Current : $17.74 Past Due : $0.00 ~ Total amount : $0.00 $17.74 Please pay this amount : $17.74 Your insurance carrier has processed this claim and the balance is now vour responsibility. Please remit promptly or contact our office to make payment arrangements. -- ~Mameem ary (oeeucmia a pelves)