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HomeMy WebLinkAbout03-12-12 1505610140 OFFICIAL USE ONLY REV-1500 ~` (°'~'°' PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN Po Box 2sosol 2 1 1 0 0 0 3 7 Harrisburg PA 17128-O60t RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death tdMDDYYYY Date of Birth MMDDYYYY 1 6 2 2 2 2 3 5 2 1 2 2 7 2 0 D 9 0 7 2 7 1 9 2 7 Decedent's Last Name Suffix Decedent's First Name MI E C K R I C H S R H A R R Y C (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS MI D 1. Original Return ~ 2. Supplemental Return ~ 3.. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) Q 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credk (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SE(~TK)N MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTUIL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number S U S A N J H A R T M A N 7 1 7 2 4 9 ? 7 8 0 First line of address 1 I R V I N iE R 0 W Second line of address City or Post Office C A R L I S L E State ZIP Code REGISTE~R„'OF WILLS US~QNLY n r ~ -?" _., ~ te-- r r,:- !Tl - !"- .," r r `~ ~" CJ'3 ~ ~~ ~ -'- ~_~ ~ ~.-,~j,.17 -`.7 ~~.. , G ~ ~ _~., - FILED ~::~ ~-- ,- P A 1 7 0 1 3 .~- 'x'1l ;-r~ t t.:_:7 ?"?' 3 _. ~ _.; ~:,_.! ^t ~,: ~~ correspondenrse-mailaddre:ss: susanaduncanhartmanlaw.corn Under penalties of perjury, l that I have examined this return, inducting accompanying schedules and statements, and to the best of my knowledge and belief, it is true. correct and canplete. ration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESP NSIBL~FOR_ FILING RETURN DATE ADDRESS' 503 NORTH WEST T CARLISLE PA 17013 SiG E OF PREPARER E~FIAN REPRE ENTATIVE DATE z- ADDRESS ~) 1505611140 PLEASE USE ORIGINAL FORM ONLY Side 7 1505610140 J~ 1505610240 REV-1500 EX Decedents Social Security Number Oeoedenrs Name: HARRY C• E C K R I C H, S R 1 6 2 2 2 2 3 5 2 RECAPITULATION 1. Real Estate (Schedule A~ ........................................... 1. 0 . 0 0 2. Stocks and Bonds (Schedule B) ...................................... 2. 0 . 0 0 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages and Notes Relceivable (Schedule D) .......................... 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)...... . 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ...... . 6. 1 0 2 1 9 8 , 3 1 7. Inter-Vivos Transfers & Miscellaneous N~Probate Property (Schedule G) S eparate Billing Requested ....... 7. 8. Total Gross Assets (total Lines 1 through 7) • • • • • • ..................... 8. 1 O 2 1 9 8 , 3 1 9. Funeral Expenses and Administrative Costs (Schedule H) .................. 9. 3 4 0 3. 2 6 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ............. 10. 3 0 6 2 . 9 6 11. Total Deductions (total Lines 9 and 10) ............................... 11. 6 4 6 6 . 2 2 12. Net Value of Estate (Lind 8 minus Line 11) ............................ 12. 9 5 ? 3 2 , 0 9 13. Charitable and Govemmdntal 13equests/Sec 9113 Trusts for which an election to tax has nof~ been made (Schedule J) ...................... 13. , 14. Net Value Subject to Ta}C (Line 12 minus Line 13) ...................... 14 9 5 7 3 2. 0 9 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2)x.oa5 9 5 7 3 2. 0 9 15. 4 3 0 7. 9 4 1ti. Amount of Line 14 taxable at lineal rate X .0 _ 0. 0 0 16, 0. 0 0 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17. 0. 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0. 0 0 18, 0. 0 0 19. TAX DUE ...................................................... 19. 4 3 0 7. 9 4 20. FILL IN THE OVAL IF YOIU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 1505610240 1505610240 J REV-1500 EX Page 3 Decedent's Complete Address: Flle Number 21 10 0037 DECEDENTS NAME HARRY C• ECKRICH, SR STREET ADDRESS 503 NORTH WEST STREET CITY CARLISLE STATE PA Zip 17013 Tax Payments and Credit: 1. Tax Due (Page 2, Line 19) (1) 4 , 3 0 7 • 9 4 2. CreditslPayments 2 0.12 A. Prior Payments B. Discount Total Credits (A + B) (2) 2 0.12 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (3) Fill in oval on Page 2, ~.ine 20 to request a refund. (4) 0 • 0 0 5. If Une 1 + Line 3 is greater than Line 2, Tenter the difference. This is the TAX DUE. (5) _ 4 , 2 8 7 • 8 2 Make check payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred : ...................................................................... ^ b. retain the right to designate who shall use the properly transferred or its incxxne; ................................ ^ ~ interest; or ................................................................................................. re e n ^ d. ece ve the xnis p for I'rfe of either payments, benefits or cue? ............................................ ........... 0 2. If death oaurred after (December 12,1982, did decedent transfer property within one year of death without receivin juste consideration? ....................................................................................... 9~ 3. Did decedent own an •Fn trust for' or payable-upon~death bank account or security at his or her death? ......... ^ ^ 0 X^ 4. Did decedent own an individual retirement account, annuity or other non-probate property, which contains a benefiaary designation? ........................................................... ....................................... ^ 0 IF THE ANSWER TO ANY OF THE ABbYE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN For dates of death on or after July 1,1994, and before Jan.1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent ]72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 199 ,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even ~f the surviving spouse is the only beneficlary. For dates of death on or after July 1, 200: • The tax rate imposed on the net value {if transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a stepparent of the ~hild is 0 percent (72 P.S. §9116(a)(1.2)]. • The tax rate imposed on the net value pf transfers to or for the use of the decedent's lineal beneficlaries is 4.5 percent, except as noted in 72 P.S. §9116(1.2) (72 P.S. §9116(a)('))]. • The tax rate imposed on the net value bf transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1509 EX+ (Ot-10) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY EaTATE OF .FILE NUMBER: HARRY C. ECKRICH, S'R 21 10 0037 Man asset was made jointly owned within one year of the decedents date of death, it must be reported on Schedule G. SURVNING JOINT TENANT(S) NAMIE(S) ADDRESS RELATIONSHIP TO DECEDENT A. STEPHEN R. ECKRIC 503 NORTH WEST STREET SON CARLISLE, PA 17013 E). CASSANDRA ECKRICH' c. 5304 OXFORD DRIVE #90 MECHANICSBURG, PA 17055 JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY ITEM FOR JOINT MADE INCLUDE E OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR NUMBER TENANT JOINT IDE TIFYING NUMBER ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. 1. A. 10/96 503 N- WEST ST•,CARLISLE, PA MAP NO: 06-20-1798-077 96380' x 1.26 clr 2. A. 10/96 137 E!• PENN ST., CARLISLE, PA MAP: 102-20-1800-204 64850 x 1.26 clr 3. A•B• 11/74 MEMBERS FIRST SAVINGS ACCT. #51134-00 4. A•B• 09/83 MEMBERS FIRST CHECKING ACCT. # 5114-11 5. A. 07/07 MEMBERS FIRST C.D.s 51134-40 DAUGHTER DATE OF DEATH DECEDENTS DAVALUE OAF TH VALUE OF ASSET INTEREST DECEDENTS INTEREST 121,438.00 50. 60,719.00 81,711.00 50• 40,855.50 579.41 33.3 192.94 48W•08~ 33.3 539.34 50• TOTAL (Also enter on Line 6, Recapitulation) ~ s 161.20 269.6? 02 1 If more space is needed, use additlonal sheets of y ~ 9 8 • 3 Ja I 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 HARRY C• ECKRICH, SR 21 10 0037 Decadence detr'ts must be reported on Schedule L ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~. HOFFMAN RO'~H FUNERAL HOME 2,693.76 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representatlve(s) STEPHEN R• E C K R I C H streetAddregs 503 NORTH WEST STREET Cary CAR41SLE state PA zlP 17013 Year(s) Comrhissbn Paid: 2, AttomeyFees: DUNCAN 8 HARTMAN, PC 3, Famiy Exemptan: (if d~cedenCs address La not the same as daimanPs, attach explanatan.) Claimant STEPHEN R • ECKRICH StreetAddresp 503 NORTH WEST STREET Cary CARL'hISLE state PA zlP 17013 Relationship ~f Claimant to Decedent a. Probate Fees: REGISTER OF WILLS 5 Acxountant Fees: 6. Tax Retum Prepar~er Fges: ~. REGISTER OF WILLS - FILING FEES 500.00 194.50 15.00 TOTAL (Also enter on Line 9, Recapitulation) I S ~ ~ ~ n > > r If more space is needed. use additlonal streets of paper of Ure same sae. REV-1512 EX~ (12-08) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8~ LIENS ESTATE OF FILE NUMBER HARRY C• ECKRICH, SR 21 10 0037 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ~. DISCOVER BANK REF # 6022447 1,088.38 2• ~GE MONEY BANK LOWErS CONSUMER # 6247475 I 1,974.58 TOTAL (Also enter on Line 10, Recapitulation) I S 3 , 0 6 2 - If more space is needed, insert additional sheets of the same size. REV-1513 EX+(01-10) ~ • pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE) BENEFICIARIES ESTATE OF: FILE NUMBER: HARRY ~. Er=KRIr=H, SR al. i.n nna~ RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include might s I dbtributans and transfers under Sec. 91'T6 {a (t.2).] 1. STEPHEN R• EC~RICH Lineal 503 N • WEST S~' • 1/3 SHARE CARLISLE, PA ~L7013 2• CASSANDRA ECK~ICH Lineal 5403 OXFORD D~i• X90 1/3 SHARE MECHANICSBUR6b PA 17055 3• HARRY C• ECKR~[CH, JR• Lineal 63 SHERIDAN S1f 1/3 SHARE WILKES BARRE, PA 18702 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTI NS: A. SPOUSAL DISTRIBUTIONIS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT TAKEN: L 8. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: L TOTAL OF PART II -ENT R TOTAL NON-TAXABLE DISTRIBUTIONS ON UNE 13 OF REV-150t} COVER SHEET. : Ir more space Is neeaea, use aaaltlonal sheets of paper of the same size. 3 a l~ W I L L I, HARRY CONRAD ECKRICH, SR. of 503 North West Street, Carlisle, Cumberland County, Pennsylvania, declare this to be my last will and revoke any wi'11 previously made by me. ITEM ONE: I dire' t that all my debts and funeral expenses, including my gray marker shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administratioln of my estate. ITEM TWO: I give ECKRICH a life es Street, Carlisle, therein, maintair resident. My sor maintenance and c utilities and upk like condition as excepted. In the reside permanent) direct that the b private sale. Af administration, t equally among my reside therein ur remainder interes share alike, per R. ECKRICH. devise and bequeath to my son STEPHEN R. ate in the property located at 503 North West Pennsylvania, so long as he shall reside ng a residence permanently as a full time STEPHEN R. ECKRICH shall pay the costs of re, taxes, assessments, insurance, and general ep, maintaining the premises in good repair, in of the time of my death, natural wear and tear event that my son STEPHEN R. ECKRICH does not as a full time resident at the premises, then I operty be sold by my executor at public or er payment of costs of the sale and e balance of the proceeds shall be distributed hildren, per stirpes. In the event that he does it his death, i give, devise, and bequeath the therein to my children, equally, share and tirpes, including the children of my son STEPHEN B. The rest, resijdue and remainder of my estate, I give, devise and bequeath tom children, share and share alike, per stirpes. ITEM THREE: I aplpoint my son STEPHEN R. ECKRICH Executor of this my last will. Shpuld he fail to qualify or cease to act as Executor, I appoi!~t my son HARRY CONRAD ECKRICH, JR. to act as Executor with thei same rights, powers and duties. ITEM FOUR: I app the death of any passes to any per which I am author specifically done income from time and welfare witho provide for such for these purpose beneficiary or to taking care of th the separate and becomes 21 years beneficiary remai said beneficiary beneficiary after years, his or her surviving childre this guardianship int the oldest of my children remaining after hild or children guardian of any property which on under the age of 21 years and with respect to zed to appoint a guardian and have not otherwise so. Said guardian shall have the power to use o time for the beneficiary's education, suppart t regard to his or her parent's ability to ducation, support or welfare, or to make payment without further responsibility, to the the beneficiary's parents or to any person beneficiary. Said guardian shall administer qua) share of each beneficiary until he or she f age, at which time the share of each inq in the guardianship account shall be paid to n full. in the event of the death of any my decease and prior to reaching the age of 2.1 share shall be distxi~uted equally to the or child to be administered in accordance with provision. ITEM FIVE: All estate, inheritance, succession and other taxes, imposed or'~payable by reason of my death, and interest and penalties thereon, with respect to all property comprising my gross estate fbr tax purposes, whether or not such property passes under this will, shall be paid out of the principal of my residuary estatte, without apportionment or right of reimbursement. PAGE ONE OF THREE PAGES ITEM 5IX: I direct that my personal representative or guardian shall not be required to give bond for the faithful performance of their duties in any jurisdiction. ITEM SEVEN: In addition to the rights and powers given to the fiduciaries by lalw or elsewhere in this will, I give to my Executor during the full time necessary and for the administration of! my estate the following rights and powers to be exercised in his sole discretion. A. To retain any real or personal property which may at any time form a part ''of my estate so long as he or she deems it advisable. B. To invest in~any real or personal property without restrictions to llegal investments. C. Ta repair, allter, improve or lease for any period of time any real or personal property and to give options for leases. D. Tc sell at pwblic or private sale, for cash or credit, with or without securilty, to exchange or to partition real or personal property', and to give options for leases. E. To make distribution in kind. F. To compromise' claims. IN WITNESS WHEREgF, I have hereunto set my hand this ~'7'day of /1/~v~iSit6r' /G ~ 1989. SIGNE ~~~ Y ONRAD EC ICH, SR. The preceding insltrument, consisting of this and two other typewritten pagesi each identified by the signature of the Testator was on the day anki date thereof signed, published and declared by the Testator therein named as and for his last will, in the presence of us, who at his request, in his presence and in the presence of each other have subsc bed r names ~\ ~ COMMONWEALTH OF PENNSYLVANIA SS COUNTY1Y OF CUMBERLAND We Jo~.,~ ~ • ~ "e^S and C' V-Y~•~`t+cc~' C witnesses whose names~are~signed to the attached or foregoin instrument being jduly qualJified aacGZ~din~to law, do depose and say that we were resent and saw the Testator sign and execute the instrument as his last will; that he signed willingly and executed it as his free anjd voluntary act for the purposes therein expressed; that e~ch of us in the hearing and sight of the Testator signed t e will as witnesses; and that to the best of our knowledge, the Telstator was at the time 18 o more years of age, of sound mind and under no const a r u ue nfluence. ~-~ ~~ PAGE TWO OF THREE PAGES sworn and subscribed to before me this / ~~ day of /VD lrl`rn b-Gr- 1989. t,GT.15c41 SEAL KAREN ~. L'YE'?S. NL'1ARY PU9UC. 8080 OF CaPLISLE. CUN!BER! ANO COUNTY Notary Publ 1C MV COMMISS!ON CXPIRES MARCH 18, 1991 COIrII~fONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERIADTD I, HARRY CONRAD E~CKRICH, SR., whose name is signed to the attached instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my last will; that I sighed it as my free and voluntary act for the purposes therein 'expressed. a Y NRAD ECFCRICH, SR. Sworn and affirmed to and acknowledged before me this / 'day of /~/G/6~~1b~ /Q 1989. Notary Publi NOTARIAL SEAL ', KAREN F, BVERS. NOTARViPUBLIC 8080 OF CARLISLE. CUMBERL D COUNTY MY COMMISSION EXPIRES MAR~H 18. 1991 PAGE THREE OF THREE PAGES BUREAU OF INDIVIDUAL TAXES f+D soot zesssl NARRISiURC PA 17121-iLil ,~, . ,~:, ~-'- .. a[v-tsa a wo cw•w- PENNSYLVANIA INHERITANCE; TAX INFORMATION NOTICE AND TAXPAYER RESPONSE FILE N0. 21 ACN 10102345 DATE 01-18-2010 STEPHEN EGKRICN 503 N WEST STt~EET CARLISLE PA 17013 EST. OF HARRY ECKRICH SSN 162-22-2352 DATE OF DEATK 22-27-2009 COUNTY CUMBERLAND REMIT PAYMENT ANO FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT ® SAVING: CNECK II [] TRUST CERTIF M~NlERS 1ST FCU arovlded the Departaent with the inforwation below, which hss boon used fn calculstin9 the potential tax duo. Records indicate that at the death of the abova•naaad decadent, you ware a joint owner/beneficiary of this account. It'you fool the )nforaat)on is lncorract, vleaa• obtain written correction free the financial institution, attach a copy to this fors anVd return i! to tM above addhess. This account is taxable in seeordsneo with the Inharitane• Tax laws of the Coatisonwealth of Penns--lvanla. Plan aall (7171) 757-!1127 with uuaations: . CONPLETE PART 1 E-ELOW r SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 51134.00 Aocount )alone. Percent Tsxabl• Amount Subject to Tsx Tax Rat• PoNntial Tax Du• Dst• 11-06-1974 Establiahad g 579.41 X 16.667 ~ 96.57 )( . 045 ~ 4.35 To ensure proper credit to the account, two coplaa of this notice lust aceosparo payaent to the Raeister of Wills. Nak• chock payable to "Railster of Wills, Ayent". NOTES if tax payaents are ssde within three swntha of the decadont': data of doath. deduct ^ 5 percent discount on tM tax duo. Any Inharitane• Tax due will becoa• dallnquent nine aenths after the date of death. A. ~ TM abeva inforaation and tax duo is correct. React payMnt to the Raalstar of Wills with two npia• of this notice to obtain C HECK a discount or avoid interest, or cheek box "A" and return this notice to the Raaistar of ' ONE Wills and an official asaassaant will ba issued by the PA Dapsrtaent of Ravanw . BLOCK ~. ~ TM absw easel hss boon or will be reported and tax paid with tM Pennsylvania Inharitane• Tax return 01111 Y is M ttiad sr tA+ .:late rdpraa.,.att... C. ~ TM abovs infor~lon is incorr~ and/or debts and deductions wore paid. PART ; below PART 2 a d/ C l t osp e • . n or PART If indieatino a differen! tax rate, pleas. stet. ~~CYAL USE ONt,Y ~ AAF tiff L~J relationship to decedent: . , ~~` TMk~NT OF REVENUE TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS ~`" " gait t. uac. flstaettsnee - i _ 2. Acoount !slant. 2 # ...-. 3. Percent Taxable 3 X 4. A:sount tub~aot tp Tax 4 ; ~`"``° , 5. Debts and Deduotions ! - ~"+` 6. Aslount Tsxabl• 6 7. Tax Rat• 7 _ X-. . _ - - .___ _ 8. Tax Du• i ~ PART DENS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of pt~riury. I dealer. that the facts I have roportad above are true. correct and co~plet• to the best 'of ~y knowledy and belief. HOME C ) WORK ( ) TAYPAVFQ CTP aTItD~ Tel eounue e---uaeo nsre 1~ ' BUREAU OF INDIYIDIIAI TAXES Po ~ pmt aaasa~ IM~tISSUIEC PA lnn-••u aav-tau a ~ case«: PENNSYLVANIA INHERITANCE T INFORMATION NOTICE AND TAXPAYER RESPONSE FILE N0. 21 ACN 10102347 DATE 01-18-2010 EST. OF HARRY ECKRICH SSN 162-22-2352 DATE OF DEATH 12-Z7`-2d0li TYPE OF ACCOUNT ^ SAVINGS ® CHECKING ^ rRUSr COUNTY CUMBERLAND ^ CERTIF. REMIT PAYMENT AND FORMS T0: ~ STEPHEN ECK~ICH REGISTER OF WILLS 503 N WEST STRE T 1 COURTHOUSE SQUARE CARLISLE PA 17013 CARLISLE PA 17013 i NE N iRS 1ST FCU provided the Dapartaant with the in/oreation bales, which has boon used in calculating the veto fal tax des . Raeerds indioat• that at the Math of the apove-reseed decedent, yen xar• a Joint owner/beneficiary of this account. If Y fool tM intonation is irjcorreet, pleap obtain written eorreetfon frog tM flnanefal institution. at hah a copy to this fora and tYM it to the above address. This aeeeunt is taxable in aceerdance with the [nheritanca Tax Lars of tAe Coasetwaalth of Penn lvania: Plano ewll 0717) 'Tf7+t3,'1~'f wlth mtostlane. „ CONPLETB PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 51134.11 Dat• 09-09-1983 To •nswr• prover credit to the account, twe rstsbilsAad cevir, of tH~r rr.cie..e/1It eee:.,.~r wnraent to the Register of Willa. Nak• cheek Account ~alanc• $ 484 08 • payable to "Register of Willa, Agent". L Poraant Taxable X 16.667 NOTEt It tax payaenta era aada within three Arount Subject to Tax ~ 80 + 68 aronlhs of !M di•etidant's date of death. Tax Rat• X , OfiB Mduct • 5 percent discount en tM tax dta. 63 Aror Inheritance Tao: dtle will beeore Mlimtwn! Potential Tax Du• 3 . nits eenths after tM data of MatA. P,~ u A A. ^ TNa abew intonation and tax des is correot. RiiiE iiwiii.i~t !e kh• Rei•ialrr of Wills witA twe cePies of this notion to obtain NECK a diseeunt or avoid interest. or cheek beat "A" and return this notice to tM Register of C ONE ~ Mills aM .n effiafal aaaeaasent will be isswd by the PA D.partaen! of Roremn. LOCK ~. ^ The above asset has boon or will M reverted and tax paid with the Pennsylvania inMritanea Tact return Nl Y !0 6e flied 0!- tM aataN rapresentatiw. C. ^ TMe abew infor~ien is incorr~ and/or debts and deduationa ware paid. CaiMlet• PAM 2 and/or PART Z below. PART If indiaat of a diTlerent tax rata, piuse state ,,: ~~; ® relationaAip to debadant: . . TAX , RETURN - COMPUTATUON OF TAX ON JOINT/TRUST ACCOUNTS t~~ t. set: ese•sitsn:d 1 . . 2. Aaoount ~alanaa 2 f µ~'~ ' 3. Percent Taxabi• 3 X i4. Arount suYiaet to Tax S S. Debts and Daduattona 5 i i 6. Aowunt Taxable 6 ~7. Tax Rat• 7 X ~•. Tax Duo 0 PART DEfTS AND DEDUCTIONS CLAIMED DAT PAID PAYEE DESCRIPTION AMOUNT PAID i ta+traa. aanzar on wn• a •r rax ueNatation) • under panaltiea of p•riltry, I declare that the facts i here raportad above are true, correct and 4onoplat• to the bast of ooy knowledo• and belief. HOME ~ WORK ( ) TAXPAYE SI6 A URE Tit t: unuo: untraco nwrr ^igtF/IU OF INDIVIDUAL TAXES Po aooc xsua wuaalsauRG PA 1T1za-os~l PENNSYLVANIA INHERITANCE INFORMATION NOTICE AND TAXPAYER RESPONSE ~.._.... er .e. ,r.r, TAX FILE N0. 21 ACN 10102349 DATE 01-18-2010 STEPHEN ECKRICH 503 N WEST STREET CARLISLE PA 17013 £ST. OF HARRY ECKRICH SSN 162-22-2352 DATE OF DEATH 12-•27-2009 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 170.13 TYPE OF ACCOUNT SAVINGS CHECKING TRUST ® CERTIF. NE Nl~RS 1ST FCU provided the Departrent with the lnforaation below, which has bean used in calculat ne e peten,ial tae due. Raeerda indicate that at the death of the about naaed decedent, You ware a iolnt owm r/benefieiery of this account. If ye4 foal the tnforaation is incorrect, please obtain written correction frog the financial institution, attach a copy to this fort and r~aturn !t to tM above address. This sceount is taxable in accordance with the Inheritance Tax laws of the Corroawealth of pane lvanla. Pleew eeil (71T) 7kT-ab2T-with queallens. ~OMPLETE PART 1 BEI.ON r SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS .Account No. 51134-40 Date 07-05-2007 7o ensure proper credit to the account, two EatabliaAad cosies at this notice rust aeeorpany pareent to the Resister of Wills. Nske cheek 'Account lalance ~ 539.34 payable to "Register of will a, Asent". Percent Taxable X 50 • 000 NOTEe If tax payaents era aade within three Awount subject to Tax f 269.67 apntha of the decedent's data of death. ,Tax Rate ~( . 045 deduct s 5 parent discount on tM tax dw. AM, Inheritsne• Tax dw will beeoae delinquent Potential Tax Due 7~ 12 • 14 nine ronths after the data of death. PAR TAXPAYER R PONSH 1~ _~~ .TAX AS„' A. ~ ThM above intoraation and tax dw is cornet. Rerit peawent to the Register of Mills with twa coplee of this notice to obtain CHECK • discount or avoid interest, or check box "A" and return this notice to the Register of Mille and an official assessrent will be issued by the PA Departrent of Reveeue. C .ONE fL ~C K 6. ~ The above asset has bean or will be reported and tae paid with the Pennsylvania Inharitsnea Tax rat urn ONL Y to be filed by tM estate reoroaentativa. C. ~ The above info ion is incorre and/or debts and deductions ware paid. Cdrplate PART r Z and/or PART ~ bales . PAR If indlcatlny a di fannt tsx rata, please stole ,'~` ~"~~~AL USE ONLY [] AAF relationship to dseadant: r J~ © ! R '~.. ~ ~~ , T OF . REVENUE ., ... TA~Q RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS . _ _- _ _. -. LBlIq 1. Date EstabllsMd 1 .; ~ t -.>•.. . 2. Aecoun! science 2 = ~:. z T ~k 3. Percent Taxable 3 X re •~ - 4. Awount Subject to Tax 4 ~ ~- y~-,r, ~.-,. 5. Debts and Deductions 5 6. Awount Taxabl• 6 ~ 7. tax Rate 7 X 0. Tax Dua d PART DEBTS AND DEDUCTIONS CLAIMED ® DESCRIPTION AMOUNT PAID DATE PAID PAYEE TOTAL (Enter on line 5 of Tax Cowputation) • Under penalties of Per~ury, I declare that tA• facts I have reported above era trw, correct and cowplete to the beat of wy knowled{1e and belief. HOME C WORK C ] ~-- _,~,,,,,,,.,, „~„~„~„~~ rce cpunNC WIIMR q (1ATF ~ ve PO Box 40 Mechanicsburg, PA 17055 www.membersi st.org Main Switchboard: (800) 283-2328 F1 Call: (717) 697-4372 or (800) 283-4372 TDD: (717) 697-5312 or (800) 283-2328 ext. 5312 ® TeleBranch: (800) 237-7288 MEMBERS 1St FEDERAL CREDIT UNION 1514 1 AV 0.335 5371-1514 * = I~~~III~~~III~~~~~~II~~II~~~~III~I~~~II~~~I~I~II~~~~~II~~I~~II HARRY C ECKRICH ~ ~ STEPHEN R ECKRICH U~ 503 N WEST ST "~ CARLISLE PA 17013-1965 r~ ~~ *= Statement of Accounts Nov 25, 2009 thru Dec 24, 2009 Account Number: 51134 Balances at a Glance Checking : 484.08 Savings : 579.26 Certificates : 538.84 Loans: 0.00 Money Management : 0.00 Swipe 5 YTD Reward : 2.15 Page : 1 of 3 Your current Member Loyalty Rewards level is Silver. Your aggregate balance as of December 1st is $3,385.99. An aggregate balance of $15,000 and having 3 products will move you to the Gold level. 1099-INT s are not included in this statement. If you earned at least $10 in dividends on'your account for 2009 you will receive your 1099-INT in a separate mailing in early January 2010. 1099-INT information will also be available on Members 1st Online early in January. CHECKING ACCbUNTS OOt1 -CHECKING to T Additions /ldvv 25 bfa~ixae 392.38. Nov 25 Check 007408 racer OQ96098625 96.26- 296.42. Poirrt of urchase Check • NELL'S SPRING R0 Terminal City..6 State -CARL PA TYPE: URCHASE ID: 9038103027 DATA: TELECHK 800-89T-9263 Nov 25 Check 007404 Tracer 0001508897 15.28- 280.84 Nov 25 Check 007409 Tracer 0001481611 '~.'~- 264.87 Nov 27 Check 007410 Tracer 0001216099 91'.96- 172.72 Nov 3fJ Check. 007411 Tracer 0096486758` 43.36- '129.31 i Point of Purchase Check - NE 'S SPRING R0 i Terminal City $ State - CARL A ~ ~ -9263 6 TYPE: PURCHASE lD: 90381 DATA: TELECHK 800 Dec. 01 DeBosit Transfer From Share 0000 799.79 889•'18 Dec 01 Withdrawal ACH TRAVELF_RS IN R 70.67- 796.49 ..'TYPE: INSURANCE ID: 9 CO RAVELER IN3UFT Dec Ot, Check 007412 Tracec 0001360465 $.00- 793.48 Dec 02 Check 007413 Tracer 0097328796 93.41- 704.09 Point of ~Chese Check - ELL' S S INC3 RO Terminal City & State - CA PA TYPE: PURCHASE iD: 103027 DATA: TELECHK -697-928:3 Dec 03 Depostt-Transfer From Share, 0000 914.00 1.614.OQ Dec 03 Withdravteyl ACH ADdi)800- TYPE`: I PREM I ~: ~~t1ST FEDERAL 30 ~ 1`384 ~ CO: 860 71 Dec 04 WithdraweMl A. TRAVELEi~'.1hlL-~:R~t?I`I' TJ~It)N` 44.87-. 1,1x.41 TYPE: 1hkSURANCE ID: 9130208001. CO: TRAVELERB~ INSUR Dec O7 Withdravl~l' A THE SENTINEL _ 12.92- 1.528.48 TYPE: ENEWAL ID: JS10891888 CO: THE SENTINEL Dec 07 Check 007414 racer 0011809164 78.46- 1.460.03 Prouesse~ Check - TNbbile TYPE: Payment ID: (3911983800' DATA: l///!/////OOOOOOQ596' Dec 07 Check 007415 Tracer OIxi0053Z84 97.77.- 1,362.26 Point of iurchase Chec[c - NELL'S SPRING RO - - - Continued on following page - - - St Send Inquires to 5000 Louise Dri Send Inquires to: AAefn Switchboard: (800) 283-2328 ~~ 5000 Louisa Drive ~ Call: (717) 697-4372 or (800) 283-4372 Po Box 4o Nov 25, 2009 thru Dec 24, 2009 TDD: (717) 697-5312 or (800) 283-2328 exl. 5312 ~~z-ieaa ~~~ tiMchanfcsburg, PA 17055 TeleBranch: (800) 237-7288 Account Number: 51134 www.memberslst.org Pa 201 3 ge: Date Transaction Descxiation Additions Subtractions Balance TerminaE City & State -CARL PA TYPE: PURCHASE ID: 9038103027 DATA: TELECHK 800-697-9263 '~ Dec 08 Check 007416 Tracer 0096500918 92.66- 1,259.60 _ Point of Purchase Check - NELL'S SPRING RO Terminai City 8 State -CARL PA ,~ TYPE: PURCHASE ID: 9038103027 DATA: TELECHK 800-697-9263 * ~ Dec OS Check 000004 Tracer 0001215070 50.00- 1,209.60 N ~ Dec 09 Check 007417 Tracer 0091372247 63.47- 1,146.13 ^' .. Point of Purchase Check - NELL' S WALNUT BO TerminaM City $ State -CARL PA TYPE: PURCHASE ID: 9038103026 DATA: TELECHK 800-697-9263 Dec 11 Check 007418 Tracer OOA9608883 82.29- 1,063.84 * ~ Point of Purchase Check - NELL'S SPRING RO Terminal City & State - CARL- PA TYPE: PURCHASE. ID: 903$103027 DATA: TELECHK 800-697-9263 Dec 15 Check 007419 Tracer 0099880872 62.60- 1,001.24 Point of Purchase Check - NELL'S SPRING RO Terminal! CitX 8 State -CARL, PA TYPE: F~URCHASE ID: 9038103027 DATA: TELECHK 800-697-9263 Dec 16 Check 00742Q ITrecer OO9b~65841:: 30.91- 976.33 Point of I Purchaser Check -NELL `S WALNUT EO TerrrlinalI Gity ~ State -CARE. PA' TYPE` F~URCHA3~ IQ: 90081038 DAYA: TELECHK 808-8A~I-9263 ' Dec 22 Check 007421 'racer 009t36f~791 56.02- $16af1 Point: of Purchase 4`raack - NELL'S.3PRIPK3 RC? _ Termnai~ City ~ Sta?tt4 -CARL PA TYPE: RCHASi`c iD: 9038103027 DAtA: TELECHK 8110-8~T'-9Q83 Dec 22 Check 007422 racer 0001238233 ` ~ 69.96?- 8411.Os Dec 23 Withdrav~nN A~,H PP .. 12,24- 83!!`.80:- TYPE: F~t~E; EIt.L I~'3: 12,'1Q96966Q DATA: 22 CO: PP' Aid , ,> oec: 23 withdravvai r~ cHASfB z~. oa , ate 7YP@: ~pAY IL1: 57d0039bt24 CQ: CHASE Dad 23 Withdrewak AGH CHASE 30.OQ- 78Q.>31't_ TYPL: EWAY Il?: 5780039174 CO: CHASL is: ~;: , Doc 23 WitfMravrat ACFl, P~". ° ., 20ri.18- !' 6A :" TYPE3~. Ei.!`~. $~ ~ It?~, 11~ " t)A7,~~ 22. CO: PP ~ ~ s~~ Dace 24 Withdravv~ Aft ~QAACAST:' ~ ~ ~ 87.54~*, ~ , ~ ~ TYple:_ F'AYAA~NT IiJi; 0000006lS~Kf COQ, E;CyMCASX ~ r F' ~ '' y. r r~ Courtesy Pair, ~ ;, ear-tp-Date - ~ ~ • . ~ 30.OQ : ~ ~ ~-,+ t 1, SUAIIMp-RY ~ rw .. to Ort 08 1l~- ~. ~ Of~/4tf4' 1s11~ IVpv 25 p0ii1 ~ 9R.l4f# at>~4o8~ 9~. 25 arta~~ 63.4T ~~` ~~'~~~~ Ni~v z5 oay'4t4~ ~ ~. _ D Ot1~'a1Q 9t.9$ N~ 27 00?41$ 82. t~ E 1 otn411 4~.3lt = N 30 - ~Qp7ta~ 3a~.~ ~ ~ r~r ~ ..:. 00'l4'12 5. 01 '~'t4 56.3't D~a,~ .. . _ , 413 r ,. ., Od7414 :~. ~s~ ~ ~ . - ' Aellriat next b nlrn ~ ` n c~inrt~ ,tl~ ~. , A L C~ UIT` UNION: ,._ wrtHO~-w~ ~d c ~. . .. ,. - Dec 01 70.67 ACH ~ Deo ZS : ' ,00; ~ ACkt •: Dec o3 3o.oa A~~ - D~1 23 " 3.00- w~ ACM Dec 04 44.67 VI/ehdrawll)t ACH Del,23 2~:1$ Witlid~l ACFE . Dec O7 12.92 J~ ACH Dec 24 87.58 Wittidravwl ACFt' Dec 23 12.24 V~I~I ACH 9 N~-iral"snlaflr arhd t~--er CAaryw 16i- Si??.24 - - - Continued on reverse side - - - st Send Inquires to: Main Switchboard: (81X1) 283-2328 5000 Louise Drive ~ Call: (717) 697-4372 or (800) 283-4372 NOV 25, 2009 thru DeC 24, 2009 PO Box 40 TDD: (717) 697-5312 or (800) 283-2328 ext. 5312 53'13-u3a MEhIBERS 1•~ Mechanicsburg, PA 17055 TeleBranch: (800) 237-7288 Account Number: 51134 www.memberstst.org Page: 3 of 3 DEPOSITS AND OTHER CREDITS Date Amount Description Date Amount Description Dec 01 739.79 Deposit Transfer Dec 03 914.00 Deposit Transfer 2 Deposits and Other' Credits Irn 1,653.79 SAVINGS ACCOUNTS 0000 -REGULAR SAVINGS Date Transaction Det~Cxiption Additions Subtractions Balance Mvv 25 BaAsnae For-va~t1 214.02 Nov 30 Deposit Dividend 0.350% 0.12 214.14 Annua/ Perlaenis#g~e Y~ek1 Eanhad 0.36PJI6 fna-n 11/01/ZtJ1019 throtrglh 11/30/2n1t19 Dec 01 Deposit ACH CIVIL SERV 1,139.79 1,353.93 ID: 3121736156 CO: CIVtL SERV Dec 01 Withdrawal Tr~lnsfer To Share 0011 739.79- 814.14 Dec 03 Deposit ACH $OC SEC 914.00. 1,528.14 ID: 3031{36030 CO: SOC SEC. Dec 03 Withdrawatl Transfer To Share 0011 914.00- 614.14 Dec 24 Withdrawal ACH Centuryt_ink 34.$8- 579.26 TYPE: Telecom iD: 928250.~i000 DATA: 1'~-888-723-80••10 CO:' CenturyLink, Lae+t; 24 ErMs~g ~irae! 579.26 CERTIFICATE ACCOUNTS 0040 - 6 MONTH CERT I~laturity Date.. -Jan 30, 2010 Date Tra tibv 25 ~sAsirce f 53$:27 Nov 30 Deposit Divide~ ld 1.290% 0.57 538.$4 Annna/ Perae»laytg Y,a,(d 1.3AdX lito~m ll/01/Z~L9 dhrot~J 11/3~-f2gOC9 Dlslc 24 En~g Batarx~el ; 838.84 . LOAN ACCOUNT S 0005 -PERSONAL SERY~CE LOAN Credit Limit 6,000.00 Credit Available 6r0000~' to T ~ F ~ ~ a.oaE. Dlelc 24 Ena9hg Bsifariicel 0.00 P Ra 1 R t 0301 Annual ercentage M 1 Dot a e "Periodic Rate.. May Vary On Thin Low *' YTD SUMMARIES TOTAL DNIDENDS PAIQ TOTAL L INTEREST PAID 0000 REGULAF2 SAVINfSS 4.04 0006 PER SERVICE LOAN 0011 CHECKING ~~~~•,~ 0040 6 MONTH CERT -'IMJIi ~~ ;,,,. i=~DE~~I, GI21~D[T UN[C)N Total Ye~rr To Date Dividends Paid 13.43 NOTE: Toth includes closed shares Dona forget about our new Member Loyalty Rewards pro~ra m. The mode products yyou have with us* the more benefits you'll receive. Ask an associate for details or visit our website at www.members1 st.arg for. details. -.0.00 J ~~ ~n m ~ ~ ~ r> ~ ~~~ ~ ~ ~a D$=~ _I ~~0 O ~ ~RN+Nm~ °cn~ `~ w~~ W~c ~ ~~ ~m ~ s ~ ~~ .~ ~ ~ F ~ :. ~~~ a .,. I. a a ~ ~:~ ~ _ C I ~, II i $ ~ oo~ ~~ ~ 3 .. ~ ~o p ~ y o ~ ~ Z e~ ~^ C '~ o s ~~ °~ 0 0^ A fl1 m ~ '~~ ~ II ~ ~ p (~ ^ ~ _ o .~- ~~ ~ O Y M O r ' ~ b b ~ i ~_ N S m n O ,+ 8 a O v ~ ~ S T c)~ ~ n ~ ~n ~ ~~ a a ~ ~ ~~~ J a~ ~ ~ a ~ ~ ~ ~ ~ ~~ ~, ~ ~ ~ ~ ,~ ,~ C &~ ~~ ~A s 7r1 a ,~ ~f~ . ~~rr ~~i cx~ C; D ~~ J~ r~~. • 9 ~ ~nr D~~A x D ~ ~,,~ to x ~ Z ~~ m~v.DE ~ i~ ~{ ~~t~x A D ~~ D ~ y ~ ~~~D o~~~ ~ ~N~n i~D mx J ~~~ ~ Q A J 0 r,`' t ~i ~~ 6 ~ -~ i ~ ~ ~, o i mi, '~QQ D ~~5 >~~fDA DpD i v~° ~Z~m ~~~ ~~i m~ ~~.7c~. ~ rnxm my ~ ~~~ ~Z ~~~~ ~ o ~ ~~ N~ {o i m ~ a~ cccDDD ~ ~ ~ ~ n ~~ $ T m~ ~~ ~ ~~, ~~ D m ~' J DQix ~~N ~ m ~ c>i8~ ~ '< x~A~ ~~r~r ~ mC yzZ ~m ~g .~ Dr1-~~ ~tlm~ ~S~ N~ b8~ 1CAD o1~~ ~ o~+ ~ ~~~ 31 n '~ v W ~z ~ W~~~ > ~ ~ ~~ ~~~~ ~~ ~ ~ ~ ~ ~ c~~S~ ~~ 3 g 3 ~~ ) ~° ~ ~ ~~ O ~` ~ ~, ~ . .gym ~ ~~ 0 ~ o ~' O. ~ ~~ ~ ~~ m ~~ a0 ~~ ~a ~~~ ~~ .~ ~~ g~ ~ ~ ~y~ ' ~~~~ ~~~ ~ t~ a Q U t ~~ ~ . _~~~ b ~.. W ~~ ~. ~ vii ~ P" ~ ~ tf M W ~ p`~' °n ~ w ~+ m m a Fi' R ~ ~~r rw ~r ~ w w ~,, r o $r MM ~ AO O~ F,, ~'' a. e o r ~,, R A ~O OR w o ~~ S w ~ 0 O o ~' a v ~,' rr • y~j yWjN N ~ rW O O W O b b ~ o ~o r ~~ S rw ~no~iy O O ~~ ~ r W R O O ~ J O tO ~O 07N InO~O ~ ~ fl r r N ~ w r or N 1-~ b O O V ~ N b a ~ W D ~i €~ b Dec 21 10 12:40p Hc,ffman-Roth F.H. 7172433723 p•i ~ ~ , ~ - ;.rl .. ~~',~ r ~• ~~ .>"r FUNER-IL ~-(C7Mt ~ GREi~'I~`.T'QRY, I~1C s'~' Karen Eckrich 503 North West Street Cariisie, PA 17b13 214 NCrTh Nano~er S're~t Carlisle. Pennsyvan'c I IU 13 i 7,2~t3.4G ; I tol, I~ee !.866.a51.as I i fax 7' :.243.3723 www.raffrrcnrom.;.CT info st~affmcn•oth.;:oT December 21, 2010 Statement of Funeral Expenses for: Harry Conrad Eckrich, Sr. Date of Death. (December 27, 2009 Account Id' 15812-288 immediate C emation OPTION 5 - ~remation MERCHANDISE: $ 1,690.00 Sub Total: S 1,590.00 Urn; tlllahoga~ny Urn $ .325.00 2 Keepsake I,1rns (~ 125/ea $ 250.00 Sliver Necklalce $ 116.00 Sub Total: S 691.00 TOTAL FUNE L HOME CHARGES: 5 2,381.00 CASH ADVANCES: 15 Certfied Bath Certificates at $ 6.00 each $ 90.00 Newspaper ~ otice -Sentinel $ 197.76 Coroner's Fie $ 25.00 Sub Total• S 312.76 Total Funeni Expense: S 2,683.76 Total Payments Made: S 2,693.76 Payments Matle: Stephen Eckrich Check 0092 Jun B, 2010 2,693.76 Balance: A.AO Please return (this portion with your Remittance. S Amount Enclosed Harry Conrad IEckrich, Sr. Service ID~t: 198.12-288 ERV~NG OUR COMMUrrITY SINCC ~ 9Q7 • ~~ services 4150 OLSON MEMORIAL HIGHWAY, SUITE ZOO MINNEAPOLIS MINNESOTA 55422-4811 TELEPHONE 763-852-8620 HOUrS (CT): Fax 877-326-8784 To-.~-FREE 877-326-1536 January 03, 2011 JOHN BROUJOS 78 E RI DG E ST CARLISLE PA 1'7013-3925 RE: Estate of: Our Client: Account No: Unpaid Balance: Reference No: Probate Case Number? Dear Sir or Madam HARRY ECKRICH DFS Services LLC ************4602 $1088.38 6022447 21 2010-0037 7:OOam-9:OOpmM-TH 7:OOam-S:OOpmF 8:OOam- 12:OOpmS This letter is sent pursuant to 20 Pa.C.S.A. 3501.1. A significant amount of time has passed since the Personal Representative was appointe .Our client wishes to minimize the burden to the Personal Representative of responding to repeated requests for inform tion regarding the Estate. For this reason, we have attached a Declaration which allows the Personal Representative to c mply with the duties prescribed by the code with minimal intrusion. We will accept the completed Declaration in lieu of a Formal Accounting or Inventory, provided that the Estate complies with its duty to supplement such information if additional assets are discovered. DFS Services LLC requests a description of the status of the Estate and the payment fits claim. Please complete the attached Declaration and return it promptly by facsimile or mail at the address or facsim le number listed above. Please consider that this request is made pursuant to the probate code under which the Person I Representative has a duty to manage the affairs of the Estate with the ordinary care and dilligence of a fiduciary and ust pay all claims in order of priority to the extent that the Estate contains sufficient assets to do so. Please Hate that the p obate code does not exempt personal representatives of independent or unsupervised estates from the duties to properly manage the affairs of the estate and to pay claims. As an alternative to completi g the Declaration or serving a copy of a Formal Accounting or Inventory, we will accept ~ ~ $925.12 as a resolution of th~ full amount owed, provided payment is received in our office on or before 01/28/11. Please call one of our account representatives toll free at 1-877-326-1536 to confirm this arrangement or to make payment by telephone. ', Cordially, DCM Services, L.LC ', This communication is from a debt collector. We are attempting to collect a debt and any information obtained will be used for that purpose. Calls may b~ monitored or recorded for quality assurance purposes. NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION -Side 1 of 2- ~~~ II 1781&7778-1854 ~~ ~ ~ ~ sere ces 4150 OLSON MEMORUL HIGHWAY, SUITE 200 MINNEAPOLIS, MINNESOTA 55422-4$11 TELEPHONE 763-852-8620 Hours (CST): 7:00 am - 9:00 pm M - TH Fax 877-326-8784 7:00 am - 5:00 pm F TOLL-FREE 877-210-9145 8:00 am - 12:00 pm S May 17, 2010 Account No Unpaid Balance Reference No ***********~`4937 $1974.58 6247475 Dear Sir or Madam: Our company represents GE ~oney Bank Lowe's Consumer. We have learned that HARRY ECKRICH SR, who was a valued customer, has passed away. ,lease accept condolences from our client and our company. As indicated abave, there is a~ unpaid balance on this account. Please accept this letter as a Notice of Claim on behalf of our client. This letter is sent to you sole) in your capacity as personal representative of the Estate of HARRY ECKRICH SR. It is our client's policy that anon-acco nthoider has no personal legal obligation to pay the debt of the deceased accountholder. Please call our office toll free t i-877-210-9145 to discuss resolution of this matter and payment on this account. If you are not the personaN representati e, please contact us with the name and address of the personal representative or attorney who is handling the estate. Cordially, DCM Services, LLC *IMPORTANT NOTICE* 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 assum this debt is valid. If you notify this office in writing within 30 days after receiving this notice that you dispute the validity f this debt or any portion thereof, this office will obtain verification of the debt or a copy of a judgment and mail you a cop of such judgment or verification. If you request of this office in writing within 30 days after receiving this natice this offic will provide you with the name and address of the original creditor, if different from the current creditor. This company is a debt colle or. We are attempting to collect a debt and any information obtained will be used for that purpose. Calls may be monit red or recorded for quality assurance purposes. NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION -Side i of 2- imn~Ilnm ~..~_..~._.,~..- DCM Services,'LLC 4150 OLSON EMORIAL HWY STE 200 • MINNEAPOLIS MN 55422-4811 ADDRESS SER ICE REQUESTED (~~~~~~~1~~~~~~~~~~~~~~~ Reference #: 6247475 Client ID: GECF31 Unpaid Balance: $1974.58 Checks Payable to: DCM SERVICES LLC Amount Enclosed: $ May 17, 2010 18s17.248 82474757033 N~1~17 31~7057564s2k DCM Services - Payment Processing $ t: ~ The Estate off' HARRY ECKRICH SR p0 Box 9317 ~~ JOHN BROUJOS Minneapolis MN 55440-9317 78 E RIDGE S1' CARLISLE PA ' 17013-3925 ~,~~~„~~~u~n~~~~~~~~n~~i~nu~~uu~~~m~n~~~~u~~~~~~~~ 6 2 4 7 4 7 5 4 9 7 +rts+~_~ma_~er+