HomeMy WebLinkAbout05-07-12 (3) 1505610140
REV-1500 Ex t°'-'°'
PA DepaRment of Revenue OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Numher
Po sox 2aosol INHERITANCE TAX RETURN 2 1 1 2 O D 0 9
Harrisburg PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Secudty Number Date of Death MMDDYYYY Date of Birth MMDDYYYV
1 9 1 5 2 1 6 8 3 1 0 1 6 2 0 1 1 0 2 0 3 1 9 6 1
DecedenYS Last Name Suffix Decedent's First Name MI
O Y L E R A N N E T T E L
(If Appilwble) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Secudty Number
FILL IN APPROPRIATE OVALS BELOW
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Retum (date of death
poor to 12-13-82)
4. Limhed Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required
death after 12-12-82)
^x 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 Credit (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 CONFDENTUU. TAX INFORMATION SHOULD SE DIRECTED T0:
Name Daytime Tetep~ojte Number
c:;
R O G E R B I R W I N E S Q U I R E 7 1 7 ~~ 9 _
c3~ 5r~
ca m ~ ~~~
REGIST@ S USEIONLY ~_,,
rt
r_ Cf) ~
~!
!-7
~
First line of address C"; O
~ ~ _ ;,
I R W I N & M c K N I G H T P C B -+
a 4:p ~~+
Second line of address ~
c,~
6 0 W E S T P O M F R E T S T R E E T
City or Post Office State ZIP Code L DATE FILED
C A R L I S L E P A 1 7 0 1 3
Correspondents a-mail address:
Under penalties of perjury, I declare that I have examined this realm, inclutling accompanying schedules and atatemems, and M the beat of my knowledge ano belie)
i[ is true, correU and complete. Dedaretion of preperer other Man the pereonal representeUve is based on ell information of which preparer has any knowledge.
nnnacca
Side 1
L 150561D140
1505610140
huJ
PLEASE USE ORIGINAL FORM ONLY
1505610240
REV-1500 EX Deaident's Social Security Number
Decedanre Name: ANNETTE L• OYLER
RECAPITULATION
1. Real Estate (Schedule A) ...................................... .... . 1.
2. Stocks and Bonds (Schedule B) ................................. .... . 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .... . 3.
4. Mortgages and Notes Receivable (Schedule D) ..................... .... . 4.
1 `I 2 2 5 . 8 4
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E).. .... . 5.
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested . ..... . 6.
7. Inter-Vivos Transfers & Miscellaneous N-Probate Property
~ 2 8 2 5 7 0 3
Separate Billing Requested .
(Schedule G) ..... . 7. ,
8. Total Gross Assets (total Lines 1 through 7) ..................... ..... . 9. 4 7 4 8 2 . 8 7
9.
............
Funeral Expenses and Administrative Costs (Schedule H)
..... 9.
. 1 3 3 4 4 . 9 0
10. Debts of Decedent, Mortgage Liabilfties, and Liens (Schedule I) ....... .... .. 10. 1 9 7 3 2 . 3 6
11. Total Deductions (total Lines 9 and 10) ......................... .... .. 11. 3 3 0 7 7 . 2 6
12. Net Value of Estate (Line 8 minus Line 11) ...................... .... .. 12. 1 4 4 0 5 . 6 1
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ................ .... .. 13.
14. Net Value Subject to lax (Line 12 minus Line 13) ................ .... .. 14. 1 4 4 0 5 . 6 1
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
~
0
O
15
O
0
0
.
(a)(1.2) X.0 _ . .
i6. Amount of Line 14 taxable
8
1 2 4 3 2
1
1s
5
5
9.
4
8
.
at lineal rate x .045 .
17. Amount of Line 14 taxable 0 0 0 17 0 . 0 0
at sibling rate X .12 .
18. Amount of Line 14 taxable 1 9 7 2. 8 0 1s 2 9 5. 9 2
at wllateral rate X .15 .
19. TAX DUE ................................................ .... ..19. 8 5 5. 4 0
20 . FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^
1505610240
Side 2
1505610240
' Continuation of REV-1500 Inheritance Tax Return Resident Decedent
AI~NETTE L. OYLER 21 12 0009
Decedent's Name Page 1 File Number
Correspondents
Name
R O G E R B
I R W I N
E S O U I R E
Daytime Telephone Number
7 1 7 2 4 9 2 3 5 3
First line of address
I R W I N &
Second line of address
6 0 W E S T
City or Post Office
C A R L I S L E
M c K N I G H T
P C .
P O M F R E T S T R E E T
State ZIP Code
P A 1 7 0 1 3
Correspondent's a-mail address:
Under penalties of perjury, I declare that I have examined Mis return, including accompanying schedules and statemenb, and to the best of my knowledge and belief,
it b we, correct and complete. Dedaretion of preparer otlrer than the personal representative rs based on all information of which preparer has anv knowledge.
SIGNATURE OF~PBftSON RESPOy$IBLE yDR FILING RETURN DATE
ADDRESS
54 PINE SCHOOL ROAD GARDNERS PA 17324
REV-1500 F,X Page 3
Decedent's Complete Address:
File Numher
21 12 0009
DECEDENT'S NAME
ANNETTE L. OYLER
STREET ADDRESS
1092 MYERSTOWN ROAD
CITY STATE ZIP
GARDNERS PA 17324
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19) (1) 855.40
2. Credits/Payments
A. Prior Payments
B. Discount
Total Credits (A +g) (2) 0.00
3. Interest
4. If Line 2 is greater than Line 1 +Line 3, enter the difference. This is the OVERPAYMENT. (3)
Fill in oval on Page 2, Llne 20 to request a refund. (4) 0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 855.40
Make check payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred : ................................................................. ^ ^X
b. retain the right to designate who shall use the property transferred or its income : ........................ .....
..... ^ X^
c. retain a reversionary interest or .......................................................................................
. ^
.
..
d. receive the promise for life of either payments, benefits or rise? ............................... .....
2. If death occurred after December 12,1962, did decedent transfer property within one year of death
without receiving adequate consideration? .................................................................................. ..... ^ 0
3. Did decedent own an'in trust for' or payable-upondeath bank account or secudty at his or her death? .... ..... ^ ^X
4. Did decedent own an individual retirement count, annuity or other non-probate property, which
contains a beneficiary designation? ............................................................................................. ..... ® ( ,
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is
3 percent [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
p2 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an
adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in
72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(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-1508 EX+(11-10)
pennsylvania
~ DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, 8r MISC.
PERSONAL PROPERTY
ESTATE OF: FILE NUMBER:
ANNETTE L. OYLER 21 12 0009
Indude the proceeds of litigation and the date the proceeds were received by the estate.
All property JoiMty owned with rlgM of survivorship must be disclosed on ScheduN F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. CORNERSTONE FEDERAL CREDIT UNION 2,419.04
SAVINGS ACCOUNT
2. CORNERSTONE FEDERAL CREDIT UNION 189.67
CHECKING ACCOUNT
3 CORNERSTONE FEDERAL CREDIT UNION 2,148.99
CERTIFICATE OF DEPOSIT
4. VEHICLE - 2007 FORD FIVE HUNDRED 9,960.00
5. ACNB BANK -CHRISTMAS CLUB ACCOUNT 3,900.00
6. ACNB BANK -CHECKING ACCOUNT 108.14
7. PERSONAL PROPERTY 500.00
TOTAL (Also enter on Line 5, Recapitulation) I f
more space is needed, insert additional sheets of paper of the same size
REV-1510 EX+ (Da-09)
pennsylvania I SCHEDULE G
DEPARTMENTOF REVENUE INTER-VIVOS TRANSFERS AND
INHERITANCE TAX RETURN MISC. NON-PROBATE.PROPERTY
ESTATE OF FILE NUMBER
ANNETTE L. OYLER 21 12 0009
This schedule must be completed and filed'rf the answer to any of questlons 1 through 4 on page three Df the REV-1500 rs yes.
ITEM
NUMBER DESCRIPTION OF PROPERTY
INCLUDE THE NPAIE OFTHETRANSFEREE, THEIR REWTIONSMIPTO DECEDENT AND
THE DATE OFTRANSFER. ATfACHACOPY OFTHE DEED FOR REAL ESTATE
DATE OF DEATH
VALUE OF ASSET
%OF DECD'S
INTEREST
EXCLUSION
nrnsvDCraEI
TAXABLE
VALUE
1. PROCEEDS FROM SALE OF REAL ESTATE LOCATED AT 8,818.29 100.00 8,818.29
1092 MYERSTOWN ROAD, GARDNERS, PA 17324
2. PROCEEDS FROM SALE OF REAL ESTATE LOCATED AT 19,438.74 100.00 19,438.74
62 BROAD STREET, NEWVILLE, PA 17241
TOTAL (Also enter on Line 7 Recapitulation) I S 28 257 03
If more space is needed, use additional sheets of paper of the same size.
REV-1511 FX+ (10-09)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
-- •-• • - -• rac nvmocrt
ANNETTE L. OYLER 21 12 0009
Decedent's debts must be reported on &heduk 1.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. HOLLINGER FUNERAL HOME & CREMATORY 10,829.24
B.
State ZIP
p, AttomeyFees: IRWIN & McKNIGHT, P.C.
3. Fatuity Exemption: (If decedenCs address is not the same as daimanCs, attach explanation.)
Claimant
Street Address
City State
Relationship of Claimant to Decedent
4. Probate Fees: REGISTER OF WILLS
6, I Accountant Fees:
6. TaxRetumPreparerFees: PATRICIAA. ROSENDALE, CPA
INCOME TAX RETURN & FIDUCIARY TAX RETURN
7. REGISTER OF WILLS -FILING FEE
8. CUMBERLAND LAW JOURNAL -ESTATE NOTICE
9. THE SENTINEL -ESTATE NOTICE
10. REGISTER OF WILLS -SHORT CERTIFICATE
1,600.00
ZIP
96.50
510.00
30.00
75.00
200.16
4.00
TOTAL (Also enter on Line 9, Recapitulation) I S 13 344 90
If more space is needed, use additional sheets of paper of the same size.
ADMINISTRATIVE COSTS:
Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Address
City
Year(s) Commission Paid:
REV-1512 EX+ (12-08)
Pennsylvania
~ DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULEI
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
C51 A I G UY fILE NUMBER
ANNETTE L. OYLER 21 12 0009
Report debts incurred by the decedent prior to death that remained unpaid at fhe date of death, Including unreimbureed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. CORNERSTONE FEDERAL CREDIT UNION -VISA 5,719.20
2. SOVEREIGN BANK - SANTANDER CONSUMER -OUTSTANDING LOAN
3. PENN NATIONAL INSURANCE CO. -INSURANCE
4. CARLISLE REGIONAL MEDICAL CENTER -MEDICAL
5. IDIRECTV -CABLE
6. ~LOWE'S -CREDIT CARD
7. ~DCM SERVICES FOR KOHL'S -CREDIT CARD
7,917.77
10.00
100.00
13.48
5,397.92
573.99
TOTAL (Also enter on Line 1U, Recapitulation) I E
If more space h needed, insert additional sheeLa of the same size.
REV-1513 EX+(01-10)
Pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
BENEFICIARIES
INHERITANCE TA%RETURN
RESIDENT DECEDENT
ANNETT E L. OYLER 21 12 0009
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Llst Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [Indude oubiphtspousal dishibutbns and transfers under
Sec. 91 6 (a) (1.2).I
1. ANTOINETTE L. ROBINSON Lineal 12,432.81
18 RAYS DRIVE CAR, PERSONAL PROP
NEWVILLE, PA 17241 1/2 REMAINDER
2. KEVIN L. HURLEY Collateral 1,972.80
1092 MYERSTOWN ROAD 1/2 REMAINDER
GARDNERS, PA 17324
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE.
II. NON-TAXABLE DISTRIBUTIONS:
1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
i.
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $
tt more space is needed, use addttlonal sheets of paper of the same size.
LAST WILL AND TESTAMENT
of
Annette L. Oyler
I, ANNETTE L. OYLER, of Dickinson Township, Cbmberland County, Pennsylvania,
being of sound mind, disposing memory and full legal age, do hereby make, publish and declaze
this to be my Last Will and Testament, hereby revoking all Wills and Codicils heretofore made
by me.
1. I direct my ExecutorBxecutrix to pay all of my debts, funeral and administrative
expenses as soon as convenient after my decease. Furthermore, I duect that all state, inheritance,
succession and other death taxes imposed or payable by reason of my death and interest and
penalties thereon with respect to all property composing of my gross estate for death tax
purposes, whether or not such property passes under this Will, shall be paid by the Executors of
my estate and that none of the aforesaid taxes shall be prorated among those persons or entities
named herein or otherwise beneficiaries hereunder.
2. My Executor/Executrix may, at his/her discrefion, compromise claims, borrow money,
retain property for such length of time as he/she may deem proper; lease and sell property for
such prices, on such terms, at public or private sales, as he/she may deem proper; and invest
estate property and income without restriction to legal investments unless otherwise provided
hereunder.
3. I authorize and empower my ExecutorBxecutrix to sell any realty and/or personalty
owned by me at my death and not specifically devised or bequeathed herein, at public or private
sale or sales and to give good and sufficient deeds and/or bills of sale therefore, in fee simple, as
I could do if living. My Executor/Executrix is authorized and empowered to engage in any
business in which I may be engaged at my death, for such period of time after my death as seems
expedient to said Executor/Executrix.
4. I give and devise as follows: SoL~
a. My property at 62 Bmad Street, Newville, Pennsylvania to HARRY VANCE
subject to his paying offthe existing mortgage; + ~, J~~t'~
b. I give and devise my property at 1092 Myerstown Road, Gardners,
Pennsylvania to KEVIN~L. HURLEY subject to his paying off the existing
mortgage; ~~ '~
c. I give and bequeath my car and personal belongings to ANTOINETTE L.
ROBINSON, my daughter; and
d. All the rest residue and remainder to KEVIN L. HURLEY and
ANTOINETTE L. ROBINSON, share and share alike.
~~
5. I nominate and appoint ROGER VANCE and DORIS VANCE and KEVIN L.
~--~.
HURLEY to be the Executors/Executrix of this my Last Will and Testament.
6. No person(s) shall benefit hereunder unless such beneficiary shall survive me by sixty
(60) days.
2
7. No Executor/Executrix acting hereunder shall be required to post bond or enter
security in this or any other jurisdiction.
8. No beneficiary may assign, anticipate or pledge his or her interest in any income or
principal held or distributable hereunder, and no beneficiary's creditors may levy, attach or
otherwise reach any such interest.
9. I hereby suggest that my personal representatives retain the services of Irwin &
McKnight as attorneys in the settlement of my estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this 3~"r day of
December, 2007.
EAL)
ANNETTE L. OYLER
Signed, sealed, published and declared by the above-named Testatrix as and for her Last
Will and Testament, in our presence, who, at her request, in her presence and in the presence of
each other have hereunto set our names as subscribing witnesses.
~ ~
,~ ,
~~
3
ACKNOWLEDGMENT AND AFFIDAVIT
WE, ANNETTE L. OYLER, CHERYL L. CLELAND and KAREN S. NOEL, the
Testatrix and witnesses respectively, whose names are signed to the foregoing instrument, being
first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and
executed the instrument as her Last Will, and that she had signed willingly, and that she executed
it as her free and voluntary act for the purpose herein expressed, and that each of the witnesses,
in the presence and hearing of the Testatrix, signed the Will as a witness and that to the best of
their knowledge the Testatrix was, at that time, eighteen years of age or older, of sound mind and
under no constraint or undue influence.
~ ETTE L. OYLER ~
COMMONWEALTH OF PENNSYLVANIA
. SS:
COUNTY OF CUMBERLAND
Subscribed, sworn to and acknowledged before me by ANNETTE L. OYLER, the
Testatrix herein, and subscribed and sworn to before me by CHERYL L. CLELAND and
KAREN S. NOEL, witnesses, this 31"-` day of December, 2007.
~,~
Ndarial Seal
Royer B. Irwin, Nolary Public
Carlisle Boro, CumbcalaM County
My Commission Expires OcL 3, 2008
~~~,.,,,,,.,~~.,r,trw~~~.:,.~~~a„~.,~,~u~a,rnces-neueylsfa.. nt[p:nwww.xnn.comitonvnve-hunareai~ou/-Toro-nve-nimareaiset-se...
® ~8
a 2Ip CODE: 17324 I Sgn in (or Sign up)
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CORNERSTONE
® F e d e r a l Credit U n i o n
P.O. Box 1181, 5 East Gate Drive, Carlisle, PA 17015
Telephone (717) 249-1661 FAX (71~ 249-8208
Member founded -Service based www.cornerstonefcu.cooa
November 7, 2011
Roger B. Irwin
Irwin & McKnight, P.C.
West Pomfret Street Professional Building
60 West Pomfret Street
Carlisle, PA 17013-3222
Re: Estate of Annette L. Oyler
Roger,
Please see below for the requested information with regard to Annette Oyler's
account at Cornerstone Federal Credit Union.
Ownership of account:
Annette L. Oyler
Date Account was Established:
November 8, 2002
Ownership of the Account:
The account was always in the name Annette L. Oyler
Account Closures:
No accounts have been closed in Annette's name one year prior to the date
of her death.
Year-to-Date Interest Earned:
Savings Account - $19.23
Checking Account- .44
C/D 10 - 72.13
Total Dividends YTD $91.80
Date of Death Balance:
Savings Account - $2,419.04
Checking Account - 189.67
C/D 10 - 2,148.99
Since ely,
~~-~
K thy Keiser
Financial Service Representative
MEMBER SAVINGS ACCOUNTS FEDERALLY INSURED TO $2$O,OOO BY THE NATIONAL CREDIT UNION ADMINISTRATION
B~~
November 4, 2011
Irwin & McKnight PC
Attn: Roger B Irwin
60 W Pomfret St
Carlisle PA 17013
RE: Estate of Annette L Oyler
Dear Mr. Irwin:
The following information is being provided as per your request:
Acct. Type Account No. Balance at Accrued Ownership Date
D.O.D. Interest to Opened/Joint
D.O.D.
Christmas 5511429 $3,900.00 $2.61 Individual 6/2/99
Club Account
Relationship 1967959 $108.14 $0.00 Individual 6/4/99
Checking
Account
Inquiries concerning ACNB Corporation stock information should be directed to the Registrar and Transfer Company
at 1-500-368-5948. If you need any additional information, please contact me at (717)339-5122.
Sincerely,
Barbara J er
ACNB Ba
Deposit Services Representative II
acnb.com • acnbbusiness.com • P.O. Box 3129, Gettysburg, PA 17325 • Phone 717.334.3161 • Toll Free 1.888.334.ACN6 (2262)
U. S. DEPARTMENT OF XOUSINO erb URBAN DEVELOPMENT MB No. 2502-0285
SETTLEMENT STATEMENT TITLEPRO
LIBERTY LAND TRANSFER, INC.
B. TYPE OF LOAN
4860 Trindle Road, Suite 201 7. FHq z. RNS s. CONV.UNINS.
Camp Hill, PA 17011 4. VA fi. CONV. INS.
e, FILE NUMBER: 7. LOAN NUMBER:
Phone: 717-975-9915 FAX: 717-7837480 ~~ 1873
MORT. INS. CASE NO.:
C. NOTE:7NS folrn k amleMtl m Bkm you a aMbmeMOf BcaM eaNenNrs cosh. AnblaM pall m entl by the seaenare .Bell m alarm.
roan. maketl ryp.o.u)" rlae pall aMeIM the tloetp; tlNy ere ehaAn Mrs fw htmrrllaMn purpose. ell aro not hmlutln h tlm 68W.
O. NAME AND ADDRESS OF BORROWER:
KeNn L. FhaNy E. NAME AND ADDRESS OF SELLER:
Mnatle L Oybr F. NAME AND ADDRESS OF LENDER
Comersbrle FetleM Cretlk Urtlon
5 Eaelpab DMe
GOSb PA 17019
G. PROPERTY LOCATION:
1082 Myenbxn Rwtl
OaNaro. PA 1732. H. SETTLEMENT AGENT : Lally Lent Tmafer I. SETTLEMENT DATE:
Dee 302010
Thummy
pfAYNOn Twnelep
Cumbetlrtl Counly, PA PLACE OF SETTLEMENT: 5 ~~ Orne
GOeM. PA 77013
1 WNMIRYOF BORROWER'S TNANSAO K.8Ur1ARY OF SBLL81f87RA1g11CT10N
00. Orwa Anwurtlpr From BOnewr
01. Centred nlw prba 88.000.00
02. PataaM PropetlY 400. Draw AmwntOwwlNroar
401. Contract eaM ql®
402. Panaml Prepaty
88,000.
09. 9akkawrit Ckeryw into 110% 4.718.87 403.
or. 104.
os. 4os.
A0Jue8rNnN for Mms pall h nvsnce by aebr(s) Atljwbwnts lOr Mma peitl h a0wnce by eatler(a)
O8. C8y/Tawnmz m 408. CkyRewnW b
07. CaulBylCiryma 12!302010 m 72/172010 4W. Coulb/gytalt 12I3N2010 m VA72070
O8. Awewnalb m 409. AaeeaanxmN m
OB. Sdmal Tea 1220/1010 m 81302011 408. Sgmd Tez 12ON2010 m 820/L011
10. b 110. m
it. m 477. m
12. b 412. b
~. Oros Amww Ow tram Berrorrm 88,718A7 420. Draw Amount OwmBallx w,
. Anbmrb PaM ly Orw BalraN0lBOrrotrer 500. Ratluetltrw In AmtrunlOw Ta BaBrt
01. DapwkarwwnwtmwlaY W7. EagwOeposit (tee hatructlne)
. PrbINpM Nnaaeolnw ban(e) 81.30000 802. BstlbmsM CMrysemaeb(Ire 11W) 7.181.
E~tlWO bnU)wkn aWpdb 809. ENatlnB barl(a)Nkn abJeclm
fill. PayoROf Feq Mayape Lan
AOeme Cwrlb Natlorltl Bank
78.02021
SOS. PeyoBofSemntl MOtlgBBe Lan
508.
507.
505.
SOB.
AtlJuabnaM for Mme npeM by solar Atl}rtrneMa mrMme untmb by Wkx
10. Gp2awntar m 510. CtlyRwntu b
11. CounlylCily taz m 611. Courlty/Cly tea b
12. ANwanwks b 572. AewsawnN m
13. Sdwd Tar b 519. BawW Tax b
7{. m 574. m
15. m 675. b
18. b 518. b
17. 617.
18. 515.
18. 578.
. Tewl PaM byKOr BOrroawr 84,W0.00 520. TBW RWUetlan In Amouw Ow Bahr 80.187.71
. CMX ATSETTLEMfiNf PromlTo BORROWER 80D. CMX AT BETTLEYBNf TolFmm SELLER
1. Grew arrlovatlw iorrl bonmver Ohs l2% 83.718.87 Wt. Grow Amount tlne SSlbr ltlne l2% BB,OOD.
. Law amwwpeM bySOr borranwr(Rr R20) 84,650.00 W2. lAai retluctln ham!. tllN aatlar pine 52% 80.787.71
. Cwh®FROM ~TO Barroaar 8,188.87 pFROM 9sMr 8,87
Buyer m BortavroM SiBnemre
1
Sstler's SIBnMUro
HUD-1
L. BETREIENT CX11RDE8 Cewt9N62
700. TqI RIMI Eerb Bmher FeN i MWFrom Pets Fmm
IDINrbn acommwan (Wle T00) a9 falowa:
BowoYrefe
aNINa
701. b Fundeu Funtlau
702. b 8e7tlAmMt BMtlemea
709. Corlerystlan paltlNSetl4menl
7a. a
800. IWne Pw7eMe b CPnneetlrn IMSI Lan
~/. Ou arlOAlatlon drrBe 7,905.60 (ham (OFE t1)
BOP. VawaetlAmmaOe (poinb)fartlw mrwlnna maemi (27798) (from (OFE t2)
803. Vowetl(uMM arlBfruAbn aherpas b Canambne FaOeN Cml1 UNOn (guru (GFE to 7,091.12 0.
804. Rpparal FM b CalMllone FaOwl (PwA UMw1 prom (GFE t9) 350.00
806. CmtlB Report b CarrlBlelalw Fatleral Cletlh Unbn (raln (GFE t3) 78.00
808. Tax 3ervka bCamambne Fatlwl CmaA UMan
(f~n(GFE Xi)
86.00
807. Fbm plM2Wn bCamenroro FetlwalCmm UaOn (~ (~ t9) 78.90
808. MERS gyp. Fee b Cmwmbrw FeOwN CmtlA llnbn 7.00
808. b
870. b
871. b
812. b
873. b
81/. b
800. IAenw RpuhM BY l~nMrAO M PeM In ulvenu
901. aBY frllelal llelteshml 12I,11pT070 b 7 219 7 /20 7 0 ®E 71.7800 Nay (hart (GFE 770) 22.3E
002. Mmpsps Ynlaarlu Dranllun Am OmaOhsb prmn(GFE t3)
803. lbnwmwlxs aNUmrxs PmmrmMOyam b (horn (GFE 177)
901. b
7000. ResewM DePeeIAAtl wMr Lantlsr
1001. INtll tlepaatl for yavaeaow ecmuM CarrlwebM FaOeml Crell UMOn (from lOFE tB) 1,205.46 0.
1002. Iforrlsornwrk YNWance 6 MoIMC®S 67.3/ /Mpl7 788.38
1003. Mabepe Inwnnce 0 Moahs ®E 98.75 Mtantll
f 006. PrapeM law 73 Maahe®S M.10 /61gm 477.20
10D5. SUlom 9 Marla@E 771.89 84omh 7,614.87
t00fi. 0 MoMw ®E /Marts
1007. PSyepar ntl8rrma -%5.78
1100. TNN CRerges
1101. TYb wrNws sntl lsltleya tltlelmumncs (ham (GFEi4) 887.28 D.00
1102. SalwraamdoeYlt re bUawry LmtlTmnefer
1709. ClmWStl8a 61warrm bUaeny Lentl Tnnabr (frorrl (GFE tS) 18.2D
7704. LeMSya 61b 4111serroe 847.28
1706. LBMKStltle polq NrlA E 80.550.00
1108. Ownall tltla pdiq lYnA E 89.000.00
1107. PywMa palm athamm BEalmumrKe paMlm 758.48
7708. IlntlelrxiMys poNwtam. brl7Ar reumnn prwnrm 107.02
1108. OaeA PreD!A18Y Fees binMnBMWIgM 2~,
1170. Norry Facts bHNN KMbr 10.
1111. Tax A:m,Ex. MBA b L1AerN LBfI Tfwafer 17.
7200. OoeerrerrarR W rolUlllp entl Tnnerr Chryee
1201. GmammeM mwllrlp Clrpea (from (GFE t7) 148.00
7202. Daeai 82.00 MarlppeE R7leOrSlDYlo
7203. Tmnsrr taxes (frwn (GFE tB) BB0.00
1201. CMOCDInOr Nxllwnps Deetli 890.00 MoryepeE Rewroera Dwas
7205. lRslA rxleMrr4s DeeeS BB0.00 MMgapeS RecadwaDeetls BBO.U
1208. MoReleBre b RamNwaDeaas 50.
1300. MOMDllel BeWlrrrentCMryse
1307. Raquhtlvervkea mayau un ahap for (from (GFE t6) 0.00
1302. b
1903. b
7304. b
7305. b
1306. b
1307. b
14m. Tabl BeUllrrlertl Chegn (enbr m Anps 103, lledlaru J aM 502, Sectiorw K) 4,718.8] 1,181.5
Patin apw mer no IlaMlb h aawmea aY 9eNwnen[A9embr my smumy d bbmwtlon Nm4Ma ay omen n Moen on tln HIID-1 Betllamam 944meM.
NUD CERTIFICATK)N OF BUYERS u1D BFJJ_ER8
I halm wreaty reNawetl Vw HIID-1 Setllemmt 9emnerB aM b Bw bal amy MmwbtlBe entl OeMe(8 is a tms as eDmmle sblemenl a aA rxlpr arl
tlrbwaerrlerM Ilmtl! m mY aowml DY ms r mr tlrel l hale recelwtl a mDY atlw HUD-1 9etlbmeR Sbrmea.
2
BuywwBwroweM1 SiAnewn 9 bnaun
Buyeh Manw a Phone: BeI4M1 Neiv Aaawe a PMIw:
/1-30 . /J
WMNIKG: nbaoameb bawhgy wYa iax ebbnwbbtla Unlbtl SWU an mle orem elmlleriwm. PenYtl»upon mnWCtlon unlnmAeanne enO Mp4eorvnent Fa
OMB Approval No. 2502-02&5
A. Settlement Statement (HUD-1)
1. ®FHA 2. ^ RHS 3. ^ Conv. Unina. 8. File Number: 7. Loan Number: 8. Mortgage Insurance Caea Number:
GAYMANJI-11
4. ^ VA 5. ^ Conv. Ins.
C. Nob: Thh yrm is Nmished b give you a ebbment of adual aetllement ttab. Ampunb paid b and by the sattlemem eganb are sham kerry madytl
"(p.o.c)"were paB ouWde me dosing; they are shown here (or intamatlonal purposes and are nd Induded in me totals.
D. Name 8 Address of Borrower: E. Neme & AEdrese of Seller: F. Neme 8 Atltlress of Lentler:
JORDAN M. CAYMAN ANNETTE L OYLER MEMBERS 1ST FEDERAL CREDIT UNION
62 BROAD STREET, NEWVILLE, PA 17211 11192 MYERSTOWN ROAD, GARDNERS, PA 17324 5000 LOUISE DRIVE, MECHANICSBURG,
PA 17055
G. Property LacaBom H. Setllement Agent: 1. Settlement Date: OY3Y2011
82 BROAD STREET IOM REAL ESTATE SERVICES, LLC Diabureemem Date: OY3Y2011
Newville, PA 17241 Weal Pomfet Prohresbnal Bldg, 80 Went Pamhel Saeel,
Newville Borough CaNSIe, PA 17013
Telephone: 717-249-2353 Fax: 717-2496354
Place of Setllemard: TitleExpress
Wes[ Pomfret ProNeaional Bldg, BO West Pomfret StNei Pdnhad 041182012 et 10:06 em
Cantata, PA 17013 by JMR
t. v, .ki
1 1. aaNe price ~ .. 7 a <}r,,ra n«.
t. nhact sales price - -.7pppp ,t,
102. PeymN 402. Pereonal ro arty
103. Settlrcenl chagesyhonpxer (IIne 1400) 3,805.77 403.
104. 404.
105. 405.
for Orns ty0r'in dyurtt abryn6 for 0ema aaMrln advrwre
106. Ciryftgm IaNS y 408. Gtylmwn taxes ro
107. County taxes ro 407. Cartylays b
108. Sdad Taws 01/31/2011 b0613012011 807.35 408. Schad Taxes 01131/2011 roO6ld0Yt011 807.35
109. 408.
110. 410.
111. aedO hx trrlster tax 700.00 471. aedllfatrenNer tar 7gp,gp
112.
120. fYOxAmount Duat'mmt9ormwr
-R.~i
75,177.72
XuYApt :r.:.. S~'uG'?1. 412.
420. GrttOAnyuMDwbBdler
SY ~I{'..
71,387.39
1 F ycMn,,
ar cerrleal moray t. Ezceas (seelnetnwtigN)
202. Pdndpal amounldnew ban(s) 87.900.00 502. Set2rrent chargesm ae2er (IIne 1400) 700.00
203. Fxistl s taken s y 503. 5dsOn s taken au ro
204. aedll for amount paid 375.00 504, PayaOdflnt modgage banyADAMS COUNTY
NATIONAL BANK 51,168.61
205. 505. Pa daecmtl ban
206. Keyelay Cbskg cent assistance 3,000.00 508.
207. 507.
208. SOB.
209. 509.
for Arne un aNNr shttnb for xama un sNkx
COy/bxm tales b 51 . Cry taNS to
271. Canty tares tc 511. Canty lays ro
212. School Taxes b 512. Schal Taxes to
213. 513.
214. 514.
215. 515.
216. 516.
217. 517.
278. 516.
219.
220. Tod P4M Benmwr
17,279.00 519.
920. Tobl Reduetlorr Nryunt pry BelMr
c.
91,BBB.H
vt ;.
301. Gras amount due ham bortower (IMe 120)
302, Less anaunb Paid byMar borrower (kne 220) 7511312
71,275.00 Sgt, Gross amm,m due Naeller (IIne 420)
802. Less redudiarre in errant due srbr(line 520) 71,30735
51,888.81
301. Cash 0 Frorrr ^ 7o BOmower
w.mm.mr .>.,.wwnaeww,ww..ma.-w.x., 3,939.12
wwmw~i...u.... i
w ea. Cab ^% To ^ From sNNr
ue..n..,sa.,,..,.....,..,.........~..,.._..~.........-_~-._._ 19,420.74
.__
Previous edkions are obsolete Page 1 of HUPl
m#. TdilBi#iOEsY+CMBrdItwMF,i
Otvbbn',o$COmmra`ei'm Ikre. ~e:fdgavYe; ~. ~
701 E9.o6 to " I~Otli From
~E4~o#iil;ifs`.:..
Fa1a1tlsTat,. ~Paitl7frrc4rn =
S~'fPf
F.Imtlt
702. EO.o0 to ,5ettlecn~u~t~ Sefdai~uent.-
703. Canmissian paid at sedlement
i$Ot. :NIIIMl•:. l~9 '~I"al ..~ ~ ~ t ,15 ~: ~. ~' .
B01. Our origination charge(Indudes OdgMaBOn Point 0.000%x$0.00) 375.00 (from GFE#1)
802. Your detlit or charge(poims)tor the spedfic imerest rate dwsen (from GFE #2)
803. Yaratllusted odgina8on charges (tram GFE A) 375.00
804. Appreisal fee to MEMBERS IST FEDERAL CREDIT UNION (from GFE #3) 300.00
805. CredB report to MEMBERS 1ST FEDERAL CREDIT UNION (from GFE #3) 15.00
8ofi. Tine service in from GFE #3
807. Flood certi8ca8on to fran GFE#3
808.
to
,y
AY'I h 7 e("';
;~. ~ a t~
~~~ '
901. Daily interest charges tram from 0l 1 11 in02N112011~56.97601day
(han GFE #10) 6.98
902. Mortgage Ins. Premium fa madha N (tram G E )
903. Homeowners insurence fat monthsin NATIONWIDE INSURANCE $60.00 P.O.C.B (iron GFE fNi) 598.00
904. monNS N frsn GFE #11
1001. Initlal aepos8 fe your esaow aaroum ~~(from GFE fl9) 583.23
1002. Homeowners insurance 2 maN1s $ 54.83MionN 5109.86
1003. MMgage Insurance monMa E O.OOlmonth $
1004. Ciry Property Tax 12 medha $ 29.691montll $356.28
1005. Cwmy Property Tax nxsdha E O.OOImonN $
1006. Sdulol Takes 6 madhs $ 122.34Imonlh 5976.72
10W. Aggregate Atlluslment 5861.43
a i
`,,. ., ,: ~. ~, :,;. "`'„'' .~~-"'i '..
1101, rata services and lenders 8tle
insurance frarn GFE #4 954.6
1102. Seltlementscbsing fee to $
1103. Owners tltle insurance ham GFE #5 9.00
110x. t.erMers Ole insurance $725.06
1105. Lentlers tltle poky IhMI $87,900.00 Lenders Polley
1106. Owners Btle policy limit $70,000.00 Owners Pdicy
1107. Aged's par8on dthe fatal Otle insurance premium $580.20
1106. Undenvdters potion dMetalal Hlle irwurake premium 8173.66
1109. Deed Prep ro IRWIN 6 MCKNIGHT P.C $175.00
~_
~
1201. Govemmed receding charges $
(from GFE#7) 214.00
1202. Deed 582.00 M E9o.oo Releaee8
1203. Trenafertaxes $ (from GFE #8) 700.00
1204. ClrylCounry taxMamps Deetl $700,00 M e $ _
1205. Seale TaxlsWmps Deed E700.00 M $ 700.00
1208. Deed $ M $
1207. PHFA SUBORDINATE MORTGAGE $82.00
1206. Asaign~ntd Mortgage 50.50
.. . _,,... ..... -~-°.. ".:. .... .. ~:: .,_ .~~.~ r nr•., .rte;r,~-
1301. ulretl services atya cart slwpfar ( GFE #6) ~~
1302. Survey ro $
1303. re
1304. to
1305. to
3, .77 700.00
'Paitl adaide d dosing by (B)omaxer, (S)e9ar, (L)ender, (I)nvests, Bro(KJer. "Credit by Imder down on page 1. "'Credit by seller sham on page 1.
Previous edl[lons are obwlete Page o 4 MUD-1
525.06 23
11 . 6.98
45 .0 858.00
Yes
.07 includes
Principal
Interea
Mor~age lnsuralce
No. ^Yes,flcallHebamaxMUmd X. Thefkat change
re on l I and can chan9a again way years wryer I 1 .Every
ige dote, your lntereat reN Can inaeaeeadecr~ee by %. OverMalked
J811, y0Ur lnterBN retB l9 gaaanlWdl0 rI8VBr EB IOWBf th31 Yo aI11QhR
X.
No. UVes, It can tlseroa madmumd$
U No. U Yes, the flrsl Increase can be on I I and 8re monthly
amount owed can dsero$
Tae maximum krarl war daebb$
0 No. ^ Yea your maxknum prepaymed penalty is $
^X No. ^ Yes, you have a balloon payment d$ tlue in
years on I
^X Yau do nd have a monhly escrow paymemfa items, such as pmpary races
and homeownefs insurence. You must Day tlxrse items directly yoursett.
^ Yau have an additlonal monthly escrow paymad d;
Ihat results in a total initlel monhly amoum axed d $ . This intlutlas pdrlcipa~
any mortgage Insurence old any items chedad below
^ Properly taxes ^ Homeownets Insuranrs
n Flood Insurellte n
Nora: It you have any quasflons about me SeMement Charges and Loan Terms listed on tllls form, please contact your lender.
Previous editlon5 are obsolete aqe 0 4 HUD-1
375.00 375.00
0.00 0.00
375.00 375.00
700.00 700.00
HUD CERTIFICATION OF BUYER AND SELLER
I have carefully reviewed tna HU0.1 Satlkment SrotertleM arM to the best o(my knowledge end 6eliaf, it is a we end accurate aroroment of all receipt and
r d'nbureemems matle on my aoceunt or by me in Nia wnaactlort I further certify that I have received a copy W the HUP7 SettlemantSroromeM.
JORDAN M. GAYMAN
ANNETTE L OYLER
The HU0.1 Setdemem Statemsrn whkh I have prepared b a tnrs end eccuMro axouM of Nia danaadbrt I hew caused or wIA ceuw tlls NMe ro be
diawrsad in xcereence with this etalamem.
SETTLEMENT AGENT
DATE
WARNING IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON TNIS OR ANY SIMIUR FORM PENALTIES UPON
CONVICTION CAN INCLUDE A TINE AND IMPRISONMENT. FOR DETAILS SEE TITLE 13: U.S. CODE SECTION 1001 AND 3ECTION 1010.
Previous etlitlons are obsolete Page 4 0 4 HUD-1
rr
Name of Bonower: Name of Seller File Number:
Prepared 041262012 at 10:06 am
Note: This page displays an itemia0on of the eredils shown in seetlon 200 of the HUD-1 SatlMmaM:Sta4meM-This page
accompanies but is not a part of the HU0.1 Settlement Statement If a discropancy exists, the iMOrm~ation on the HU0.1 Settlement
Statement applies.
~~ Credk
Name of Bonoxer: Name of Seller: File Number:
JORDAN M. GAYMAN ANNETTE L OYLER GAYMANJi-11
Prepaed OM26;2012 at 10:06 am
Note: This page displays an ilemizatlon of the adJwted origination charges shown in aeWon 800 of the HU0.1 Settlement Shbman
This page aaompanlas but Is not a part of Me HU0.7 SetWment Statement If a dlscropaney exists, the Infomratlon on the HU0.1
SeHlameM Statement applies
Your Loan Odphukon Chsrgas Bonovar Seller
1. Our odgine8gi charge (Includes ginaBOn PdM O. ar .00)
odgina8an tee to MEMBERS 1ST FEDERAL CRE$ 375.00
802. Yaur aed0 or chage(poina)(a the apedOc interest rate chosen
b 0.00
803. Your atljusted aiginatlcn diarges
375.00 0.00
Name of Bonower: Name of 5ellw: File Number:
JORDAN M. GAYMAN ANNETTE L OYLER GAYMANJ7-11
P 04282012 at 10:05 arri
Note: Thle papa dbplaye an kamlaatlon o! the charges shown on Tine 11010! the HU0.1 9attlament Sta4marrt Thia page
accompanies but Is mt a part of the HU0.1 SetlkmaM Statement. tl a discropaney exleh, the informatlon on the HU0.1 Battlement
Statement applies
,
~)' , . ;~: i
s7 0~
`'t ~ [ i
F
"
end lenders Otle Imuranre
1101 ro - , -
TA 1o E 30.00
WIRE FEE to ORRSTOWN BANK E 24.00 24.00
1102. SeMariaitadosing fee m E 0.00
1104. Cantata tlb inwraice to STGCI18MREAL ESTATE $ 725.05 725.08
1109. Deed Prep b IRWIN S MCKNIGHT P.C. $ 175.00 175.00
Touts: 854. 0.00 941.08 0.
Ba.raerldaaaranaktren: 1 eoD•pra$mhM.tDloe IBR RLelidu pedll
Previous editlons are obsolete Page I of 1 HUD-1
„~
•...
n eta
,a
Hollinger Funeral Home & Crematory, Inc,
Eric L. Hollinger, Supervisor
Oct. 16,2011
Kevin Hurley
11092 Myerstown Rd.
Gardners, PA 17324
The Funeral Service for Annette L. Oyler:
We sincerety appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please
feel free to contact us if you have any questions in regard to this statement.
THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT, AND
MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS.
PfefeS5lpnal $elVlte
Traditional Services $ 5150.00
Merchandise
Oversize 18ga silver 1895.00
Sentinel Eagle 1595.00
Memorial Package -Register Book, Memorial Folders,
Acknowledgement Cards, Bookmarks Na Charge
AT THE TIME FUNERAL ARRANGEMENTS WERE MADE, WE ADVANCED CERTAIN PAYMENTS TO OTHERS AS AN
ACCOMMODATION. THE FOLLOWING IS AN ACCOUNTING FOR THOSE CHARGES.
Cash Advance
Grave Opening
Certified Copies of Death Certificate (12tad $6)
Flowers
Sentinel Newspaper
Cemetery Equipment
1 Grave Lot & Deed
Minister
Patriot
700.00
70.00
295.00
145.02
325.00
250.00
125.00
239.22
$ 10829.24
BALANCE $ 10829.24
sol NORTH 6ALiIMORE AVENUE • MOllNT HOLLYSPRINGS, PENNSYLVANIA 17065 • (7l7) a86-3a9s • FAX (~i~) ass-sots
www. hoilingerfuneralhome.com
Q
V
CORNERSTONE
F e d e r a l Credit U n i o n
Member founded -Service based www.cornerstonefcu.cooa
P.O. Box 1181, 5 East Gate Drive, Carlisle, PA 17015
Telephone (717) 249-1661 FAX (717) 249-8208
November 8, 2011
Roger B. Irwin
Irwin & McKnight, P.C.
West Pomfret Street Professional Building
60 West Pomfret Street
Cazlisle, PA 17013-3222
Re: Estate of Annette L. Oyler
Visa Credit Cazd
~~~~~~~
NOEI 0 g 201
dRWIN & McKNIGH(
~W OFFICES
4
Roger,
You had requested information regarding the Estate of Annette 1.Oyler.
However, you did not request loan information.
Annette had a Visa Credit Card with Cornerstone. The current balance and payoff
on this credit card is $5,719.20. This cazd has been cancelled, member deceased.
Finance charges will be stopped.
Please don't hesitate to contact me with any questions.
Sincerely,
C/`~
Ka y Keiser
Financial Service Representative
MEMBER SAVINGS ACCOUNTS FEDERALLY INSURED TO $2SO,OOO BY THE NATIONAL CREDIT UNION ADMINISTRATION
,, 412937674
77 Hartland Street, Suite 401
- P.O. Box 280431
East Hartford CT 06128-0431
R•M•S
Recdvahle Management Services
^033m130100162401s~
OYLER ANNETTE L
1092 MYERSTOWN RD
GARDNERS PA 17324-8926
~ru~~~u~~n~~ru~~~~~u~~u~~~r~mr~~~~~~n~r~uu~i~~u~~~
Collection Notice
~- ~ Phone: 888-545-4170
Toil Free: 888-545-4170
February 02, 2012
Re: Penn National insurance Co.PiL
Claim amt: 510.00
Claim No: 412937674-AA
Raf. No: 3729020219
LDGO
Penn National insurance Co.P~L has reviewed their policy records which
indicates that an outstanding amount is still owed to them. PSease
follow the listed instructions:
1) if your records agree, send your payment to the above address.
2) If you have ppaid this balance, forward a copy of Your cancelled check
3) if You wish to make payment on this account, You ma contact ua tali
free at 1-888-545-4170 during our business hours of 8:30 AM-9:00 PN EST
MondeY through Friday and Saturday tram 9:00 AN-4:00 PN EST, or, by
vissyiting apiocai WYe~tern Union Agent nearest you for Quick Collect
calling 1pp00t325tY000Westsrn Union location informatiion is available by
You wiii need to include the following information on the @uick Collect
form:
Pay to: Receivable Management Servicing
Coda City: DUNSPAY
State: CT
Senders Account N: RM3 Nine Digit Claim Number
if we can be of assistance, please contact us at the above pphone number,
however, if you wish to dispute this account, please refer to the notice
on the reverse side of this letter.
Sincerely,
Receivable Management Services
Pieasa consider this as notice that if payment is made by
consumer eheck we wiii convert this check to an electronic
debit to Your account via ACH and if the check is returned
NSF, we wiii represent the check via ACH debit.
w^* To view & pay Online: WWW.RECEiVABLESONLiNE.COM~A000UNTViEW
USERID = 412937674 & PASSWORD = 00608496
IMPORTANT: REFER TO CLAIM NUMBER IN ALL COMMUNICATIONS
NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION
WE ARE ACTING AS A DEBT COLLECTOR. THIS LETTER IS AN ATTEMPT TO COLLECT
THIS DEBT AND ANY INFORMATION OBTAINED WILL BE USED FOR THAT PURPOSE.
ti, k:
ANNETTE L OYLER
1092 MYERSTOWN RD
GARDNERS, PA 173248926
IlmlrurrihrlrlrrlllhPPIwPIPhrlirhlrlllr111rr1h
Past Due Amount
Unpaid Fees.&{harges
TOTAL. AMOUNT DUE
$960.76
Your account number with Sovereign was 8737362569
Your account is 15 days delinquent
No valid work phone number, please update online
ACCOUNT ACTIVITY SINCE LAST STATEMENT c
Date ~ Amount ®Pay Online at MyAutoAccount.com.
f[~ Pay by Phone at 1-888-222.4227. ,
«~ MoneyGram or Western Union.
See reverse for additional payment options.
Questions? Go to MyAutoAccount.com or call Toll-Free 1-888-222-4227.
MoneyGram services' are at 35,000 agent locations nationwide including all Walmart and CVS/pharmary
stores nationwide. Click www.moneygram.wm/SantanderUSA or call 1-800-926-9400 to find a location
near you. And be sure to use Receive Coda 1544.
.®
AUWNCE AMEWfir
e.:„ •bV,„~, ~ Walmart
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" • ~ 1 W O1 Vl1L 45 SprIM Ddve
--" MEDICAL CENTER CBrllele PA 17013
ADDRESS SERVICE R~C'UESTED
•, ~ UPON RECEIPT
Annette L Oyler
1092 Myeratown Rd
o Gardners PA 17324
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IF PAYIND BV CREDIT CARD, FlLL OUT BELOW AND BEE REVERSE SIDE
CHECK CMD USING FOR PAVMENr
^ ^ ^ I° x ^
MASTERCARD DIBCDVER VISq pAf~ICAN FXPRE86
ACCOUNTNO. BTATEMENTAATE BALANCEOUE
9508682 11/30/2011 $100.00
MAKE CHECKS PAYABLE TO:
CARLISLE REGIONAL MEDICAL CENTER
P.O. BOX 281442
ATLANTA GA 30384-1442
Irrlldh,,rJid,rLJ,rLLdLLdJLLIrd,Ll„Irr6Ll.LI
00000950868200000010000ANNETTE L OYLER 8
^ Please check If above address is incorrect antl indicate change on reverse side. TO INSURE PROPER CREDIT, DETgCH AND RETURN THIS PORTION IN THE ENCLOSED ENVELOPE.
Annetta L Oyler 9508682 ~ 10/16/2011 EMERGENCY ROOM
DATE OESCBIPTION Davuewnnmetueure:
11/02/11 BLUE CROSS CONTRACTUAL DISCOUNT 1,132.26
11/02/11 BLUE CROSS CONTRACTUAL DISCOUNT 2;115.96-
11/02/11 BLUE CROSS PAYMENT 873.11
11/02/11 BLUE CROSS PAYMENT 1,718.52-
11/02/11 BLUE CROSS PAYMENT .00
PAITAENT8 ANO CIUROE8 RFCENED AFTER THE STATEMENT GATE WILL BE REFLECTED ON THE NE%r STATEMENT. r ; r ~ $100.00
AS of today, we have not received payment in full on FOR BILLING QUESTIONS, PLEASE CALL:
your accalnt. immediate payment is required, please (7t 7) 960-ts80
contact our business office today.
Bills can be paid online st our hospital internal web site
www.caNisiermc.com
; UPON RECEIPT
d
ACCOUNT NUMBER DATE DUE AMOUNT DUE
58567557 Due Upon Receipt $13.48
Pay online today at direcri.com/myaccount
Summary
Statement Data: 12/03/11
Page 1 of 1 for.
ANNETTE OYLER
For Service at:
1092 MYERSTOWN RD
GARDNERS, PA 17324.6928
Activity
Start End Description
Previous Balance
Payment
Amount
12.84
0.00
OET OVER ~
When you order any
4 movies in December
Fees
12!03 Late Fee 0.64
AMOUNT E 13.43
26
MBWNHPWR
lPEHEFGEEGZM
AT 01 061706985168209 A"3DGT
ANNETTE OYLER
1082 MYERSTOWN RD
GAflDNERS PA 17324A928
DATE DUE ACCOUNT NUMBER
Due Upon Receipt 585(17557
bollrlh^nr~Prl~llr~~hIII~P~IIII~IIPdhII~Pr~id~lll
Previous Balance 72,84
Payments 0,00
Current Charges&Fees 0,84
Adjustments & Credits 0.00
Taxes 0.00
Amount Due 73.48
AMOUNT DUE
$13.48
PAYMENT ENCLOSED
Please do trot send cash. Make check or money order payable ~:
DIBECTY
PO BOX 11732
NEWARK NJ 07101732
n"Nrll~d116Phh~INrIthPllh~llPl~ll~llllldlll~lhll
8
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0000000000000000058567557 2 0028 00000064 00001348 1
To contact ue ca-1-800531-5000
p Note myclre'ga of address on revenm side. 1717)486.4026
DO NOTYgarE 011181 COMMENTS ONTMS FONA To sign up for Auto Bill Pay, See Reverse.
Lvwe's® Credit
~° `~Cs~rl Arrnun4
NI~
Visit us a<www.lowes.com/credit
Customer Service: t-800.4441409
8239 090999 3
nimum Payment This Period $769.00
nount Past Due $148.00
~tel Minimum Payment Due $317.00
ryment Due Date 11/02/2017
to Payment Warning: If we do not receive your
nimum payment by the date listed above, you may have
pay a late fee up t0 $35.00.
nimum Payment blaming: If you make only the minimum
yment each periotl, you will pay more In interest and it will
ce you bnger to pay off your balance. For example:
r
add~dnt~t~w ,"~ ~
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Only the minimum
payment y
aY ~ f
24 ~A 6,851.00
years
If you would like informedon about credit wunsaling
services, call 1-877-302-8775.
HAVE A DEFERRED INTEREST PROMOTION(S) EXPIRING ON 02/07/13 YOU MUST PAY EACH DEFERRED
REST PROMOTIONAL BALANCE IN FULL BY ITS EXPIRATION DATE TO AVOID PAYING ACCRUED INTEREST
RGES. PLEASE SEE THE PROMOTIONAL PURCHASE SUMMARY SECTION ON THIS STATEMENT FOR FURTHER
\ \~~
PA NT Y P.M N T U
NOTICE: We may convert your payment into an onic debit. Sea reverse For details, Billing Rights Infamadon and other
important informe0on.
7009 0007 %50 1 7 7 111°10 O PAC of 3 9294 0012 3002 Olt%7009 30157
Detach and mail this portion with your c k. Do not include any correspondence with your check.
LOWE'S
Number:
Payment Enclosed: ~ ^ ~ ^ ^ ^ a ^ ^
Please use blue or black Ink. J
New address or small? Print changes on hack.
KEVIN L HURLEY 1°157 1'11111111111"111"111111'1111"'lll'll'11111"11'lllllllll'I'I'
ANNETTE L OYLER olse
1082 MYERSTOWN RD Make Payment to: LOWE'S/GECRB
GARDNERS PA 173248926 P.O. BOX 530914
ATLANTA, GA 30353.0914
prnlllnl'nl'IhI11111P'1iI'lhll'Ilhuugplp"'dllllrl
00169000030000 003170000539792 000798256 2390009 98303
KEVIN L HURLEY
ANNETTE L OYLER
.{
4150 OLSON MEMORIAL HIGMWAYr SUITE 2O0
MINNEAPOLIS, MINNESOTA $5422-4811
TELEPHONE 763-852-8620
Fax 877-326-8784
TOLL-FREE 877-210-9145
services
Hours (CT): 7:00 am - 9:00 pm M - TH
7:OOam-S:OOpmF
S:OO am-12:00 pmS
~~~~~~~~
November 23, 2011
Account No
******3349
Unpaid Balance
$573.99
NOV 3 0 2Q9i
Reference No
7753677 lRWIN k. McItN1GH"q
~W OFFICEW
Dear Sir or Madam:
Our company represents Capital One N.A. Re Kohl's Department Stores Inc. We have learned that ANNETTE OYLER, who
was a valued customer, has passed away. Please accept condolences from our client and our company.
As Indicated above, there is an 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 solely in your capacity as personal representative of the Estate of ANNETTE OYLER. Please call our
office toll free at 1-877-210-9145 to discuss resolution of this matter and payment on this account. If you are not the
personal representative, 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 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 Gf the debt or a copy of a
judgment 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 company is a debt collector. We are attempting to collect a debt and any information obtained will be used for that
purpose. Calls may be monitored or recorded for quality assurance purposes.
NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION -Side 1 of 2-
I~IIa~~~ °'Deteoh Lower Portion and Return wdh Payment"'
DCM Services, LLC
4150 OLSON MEMORIAL HWY STE 200 Reference #: 7753677 Client ID: KOHL35
o MINNEAPOLIS MN 55422-4811 Unpaid Balance: $573.99
ADDRESS SERVICE REQUESTED Checks Payable to: DCM Services LLC
I~~~INMg~I~A~dI~~1~MI~~~~IINI~II~vII~II~~IIIQ
November 23, 2011
#BWNJGZF
#1851732718811716#
The Estate of ANNETTE OYLER
ROGER IRWIN
60 W POMFRET ST
CARLISLE PA 17013-3243
Amount Enclosed: $
DCM Services - Payment Processing
PO Box 9317
Minneapolis MN 55440-9317
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1851 ] - 388
7753677 3349
tesn-TOOK-aee