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Home My WebLink About06-19-121505610101 REV-1500 ~"°'-'°' ~'' PA Department of Revenue Pennsylvania OFFICIAL USE ONLY Bureau of Individual Taxes "~`""" Counry Code Year File Number PO BOXZBO6ot INHERITANCE TAX RETURN ~) I ' ~~ Harrisburg„PA t9tz8-o6ot RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMODYYYY 207-34-7099 03/03/2011 11/15/1945 Decedent's Last Name Suffix Decedent's First Name MI WERT WILLIAM G (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name WERT JACQUELYN MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW Ob 1. Original Return O 2. Supplemental Retum O 3. Remainder Return (date of death prior to 12-13-ffi) O 4. Limited Es[ate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) ~ 6. Decedent Died Testate O 7. Decedent Maintained a living Trust S. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT- THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone mbar rr`'o-~ Andrew H. Shaw (717) 243-713, ~ First line of address 200 S. Spring Garden St Second line of address Suite 11 City or Post Office Carlisle Correspondent's e-mail address: State ZIP Code PA 17013 REGISTER OFjI@ USE ONLY ~ G''S ~~ ~D ~~ r - A• __, C.rl c.> DATE FILED rn G~GJ `--~~ ~'.LJ ~ ~ .~, ~--; r* S7 __ -r~ ~~~ ~~ iFd 1^7 Under Denalties of perjury, I tledare that I have examined this return, inclutling accompanying schedules and statements, and to me best of my knowledge and belief, it is true, coned and complete. Ddclaration of preparer other than the Dersonal representative is DaseO on all information of which preparer has any knowledge. SIG TURE OF PERSON R SPON6IBLE FOR FILING RETURN nATF 725 lie, PA 17013 THAN REPRESENTATIVE 200 S. Spring Garden Street, Carlisle, PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505610101 1~i0561g1U1 J C~ 1505610105 REV-1500 EX Decedent's Social Security Number Decedent's Name: Wllllam G. Wert 207-34-7099 RECAPRULATION i. Real Estate (Schedule A) ........................................... .. 1. 0.00 2. Stocks and Bonds (Schedule B) ..................................... .. 2. 0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. 0.00 4. 9 9 ( ) ......................... Mort a es and Notes Receivable Schedule D .. 4. 0.00 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)..... .. 5. 27,498.93 6. Jointly Owned Propefty (Schedule F) O Separate Billing Requested ..... .. 6. 0.00 7. Inter-Vivos Transfers'8 Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested..... ... 7. 0.00 8. Total Gross Assets (total Lines 1 through 7) .......................... ... 8. 27,498.93 9. Funeral Expenses and Administrative Costs (Schedule H) ................ ... 9. 19,827.45 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ............ .. 10. 39,910.29 11. Total Deductions (total Lines 9 and 10) .............................. ... 11. 59,537.74 12. Net Value of Estate (Line 6 minus Line 11) ........................... ... 12. -32,038.81 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ..................... ... 13. 0.00 14. Net Value Subject t0 Tax (Line 12 minus Line 13) ..................... ... 14. -32,038.81 - - TAX CALCULATION - SSE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taDCable at the spousal tax ratle, or transfers under Sec. 9116 (a)(1.2) X .0_ 15. 0.00 i6. Amount of Line 14 taxable at lineal rate X .0 _ 16. 0.00 17. Amount of Line 14 taxable 0 00 at sibling rate X .12 17. . 18. Amount of Line 14 tapcable 0 00 at collateral rate X .15 18. . 19. TAX DUE ...................................................... ... 19. 0.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 150561015 1!i05610105 J REV-1500 EX Page 3 Decedent's Complete Address: 0.00 DECEDENT'S NAME William G. Wert STREET ADDRESS 75 Fickes Road CITY Newville STATE PA 21P 17241 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. CreditslPaymenls A. Pdor Payments B. Discount 3. Interest 0.00 4. If Line 2 is greater than Line 1 + Line..3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page k, Line 20 to request a refund. 5. If Line 1 + Line 3 is greater than Linen, enter the difference. This is the TAX DUE. File Number (1) Total Credits (A+ B I (2) (5) (4) 0.00 0.00 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,inceme of the property transferred :.................................................................................... ...... ^ x^ b. retain the dght td designate who shall use the property transfered or its income :...................................... ...... ^ ^x c. retain a reversionary interest; or .................................................................................................................... ...... ^ ^x d. receive the promise for life of either payments, benefits or care? ................................................................ ...... ^ Q 2. If death occuned afper Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ........................................................................................................ ...... ^ X^ 3. Did decedent own an "intrust for" or payable•upon-0eath bank account or security at his or her death? ........ ...... ^ ><^ 4. Did decedent own ah individual retirement account, annuity or other non-probate property, which contains a benefciary designation? .................................................................................................................. ...... ^ Q IF THE ANSWER TO ANY OF THE'ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN, For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (t.t) (ii)]. The statute does no[ 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 v lue 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 t e child is 0 percent [72 P.S. §9116(a)(1.2)]. • The tax rate imposed on the neY value of transfers to or for the use of the decedent's lineal benefciaries is 4.5 percent, except as noted in 72 P.S. §9116(1.21 [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. 0.00 0.00 (3) 0.00 LAST WILL AND TESTAl-~NT OF WILLIAM G. WERT I, WILLIAII~I G. WERT, of Ne~wille, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my List Will and Testament, hereby revoking and making void any and all former Wills, Codicils, or writings in the nature thereof, by me at any time heretofore made. FIRST: I hereby ditect my Personal Representative to pay all my just debts, funeral and administrative expenses out of my estate, as soon as practicable after my death. SECOND: I duect that all taxes which may be assessed in consequence of my death, of whatever nature and Iby whatever jurisdiction imposed, shall be paid out oI'my estate as a part of the administration of my estate. THIRD: I give devise and bequeath my entire estate, be it real, personal or mixed to my children, DENISE ELLEN MORRISON (daughter) and DONALD GEORGE WERT (son) or their heirs with the exception of the following personal and real property: 1. My ownQrship interest in my retirement plan that I have with ilnited Pazcel Services ~s bequeathed to my deaz friend Sheila Ann Miller; 2. My 1972 ~D-35 Martin Guitaz and my country and rock and roll music is bequeathed to my dear friend,Sheila Ann Miller; ta:cotax?D orrl(:r. or 2011 MAR 14 (:3.tat1: or ORPI IANS CUUIi'I' CUh[RIiR3..\NU COURT, P:\ 3. My 2002 Terry RV Camper is bequeathed to my dear friend Sheila Ann Miller; 4. My tool shed and all of my tools is bequeathed to my son, Donald George Wert; 5. My Rifle 30/30 Bolt Action Clip-Feed Gun and 12-gauge shotgun is bequeathed to my son, Donald George Wert. FOURTH: I nominate and appoint my sister, Sheila Ann Miller to serve as the Executrix of this my Last Will end Testament. In the event my sister is unable to serve as my Executrix, for whatever reason, I;name my deaz friend, Sheila Ann Miller as Executrix of this my Last Will and Testament. I direct that my personal representative(s) shall not be required to give bond or security for the peiFFormance of their dufies in any jurisdiction. FIFTH: In addition to the powers conferred by case law, by statute and by other provisions of this Last Will and testament, my personal representative, and any successors in that capacity shall have the folldwing discretionary powers applicable to all real estatE: and personal property held by them, which powers shall be effective without Order of any Court and which shall exist and continue until ithe time of actual distribution: A. To ret~n any property of any nature received by them for whatever period it shall be dee ed advisable; B. To inv~st and reinvest all or any part of the assets of my Estate without regazd to statutes limiting the property which a fiduciary may purchase.; C. To sell, transfer, exchange or otherwise dispose of, any part of the assets of my Estate, for cash or on terms, publicly or privately, or to lease, without liability on the purcha$ers to see to the application of the proceeds, and to give options for these purchases without the obligation to repudiate them in favor of a higher offer; D. To execute and deliver any deeds, leases, assignments or other instruments as may be necessary to carry out the provisions of this Will; E. To borrow money, if necessary to facilitate the administration and closing of my Estate, including the right to borrow money from any bank, and to mortgage or pledge any asset of the estate as security; F. To loan to, and to purchase assets from, my Estate, even if also acting as Executor thereof; G. To assume wntinuance of the status of any beneficiary with regazd to death, marriage, divorce, illness, incapacity and similaz incidents or matters in the absence of infor~ation deemed reliable without liability for disbursements made on such assumption; H. To mak~ any distribution hereunder either in kind or in money, or partially in kind or parti~lly in money, considering of course the reasonable wishes of the beneficirary. Distribution in kind shall be made at the appraised value of the propert}h distributed, as it is set forth is the Inheritance Tax R<:tum filed in my Estate; I. To exer~ise any subscription right in connection with any security held hereunder, to consent to or participate in any recapitalization, reorganization, consolidation or merger ¢f any corporation, company or association, the securities of which may be held hereunder; and to delegate authority with respect thereto,. to deposit investntents under agreements, to pay assessments, and gener~illy to exercise all rights o~investors; J. To continue in any partnership, joint venture, joint ownership or other business enterprise of which I am a part at the time of my death; K. To compromise claims; L. To continue for whatever period of tone my personal representative shall deem necessary any ownership as a tenant in common or as a partner, in real estate or other prloperty and to act as I would have done had I been living; M. To do all other acts in their judgment necessary or desirable for the proper management, investment and distribution of the assets of my Estate; N. I direct khat my personal representative shall be compensated for the services they render as Trustee and Executor under this my Last Will and'Cestament; O. Should lany changes occur in the Intemat Revenue Code or Pennsylvania statutes after the date of the execufion of this Will which affect the tax liability of my estate, then to the extent possible and as may be permitted by law, my personal representative shall have the power and discretion to interpret. this Will and to administer my Estate in a manner which results in the lowest tax liability possible; P. Should the principal of any Trust herein provided for be or become too small, in the TRUSTEE'S discretion, so as to make establishment or continuance of the Trust inadvisable, my TRUSTEE or my Executrix may make immediate distribution of the then remaining principal and any accumulated or undistributed income outright to the pt:rson or persons and in proportions they are entitled to income. Upon such termination, the rights of all persons who might otherwise have an interest as succeeding income beneficiary or in remainder shall cease. IN WITNESS WI~EI2EOF, I hereunto set my hand and seal this ~~'}r~ day of ~~b~~, zol 1. SIGNED, SEALE)~, PUBLISHED and GLARED in th pr a ce of: 0. ~ C' ~~,,~.r~ `~ ~~ ~• fYC~x~-~ G. WE1t.T Y ACKNOWLEDGEMENT I, WILLIAM G. WERT, the TestatOR whose name is signed to the attached or foregoing instn}~nent, having been duly qualified according to the law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it awillingly, and that I signed it as my free and voluntary act for the purposes therein expressed. WILLLM G. ~ RT Sworn or affi ed and ac owledged before me by WILLIAM G. this ~`~ 11day of 2011. ~j~/ r COMMONWEALTH OFPENNSYLVANiA Moailal seal Valerie F. Gs II, Notary PuWk UdWe 6oro, ~ mberla~ CaimV ~ ~~~ rea O[i. 9, 2014 Member. Pennsvlvan paodatlon of Notaries WERT the Testator, AFFIDAVIT T We, WILLAIM G. WERT, SI1T/y~ ,~ • ~y/~~.,`'>/'_ t"~c~~ 1-1,,1,~'r_]~~ • the\e\~Testator~and t~h~.e~{`j/w^,~litnesses, respectively, whose names aze signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as her Last Will and'1'estament and that she had signed willingly, and that she executed it as her free and volun~ary act for the purposes therein expressed, and that t;ach of the witnesses, in the presences and hearing of the Testator signed the Last Will and Testament as witness and that to the best of their knowledge the Testator was at that time eighteen (18) yeazs of age or older, of sound mind and under no constraint or undue influence. TESTATOR, ~~~ y '~k siding ~C~u.'u,1~IC t" WITNE55,.~~b ~ P; /A- A ~, l,~i; residing at i U p~h/~(~.~j ~'~`t" ~I r ' I ~ WIT1~iESS,~u~ct~~~ F-FP_C•Kri~W'~asiding at flit ~i S ~ P: 1'71-3 Subscribed, sworn to and acknowledged before me by WILLIAM G. WERT, Testator, and stpbscribed and sworn to before me by j /~ ,~-. /~/ ~.~',r , and ~ C~unlti~ ,the witnesses, this 14~~ day of ~'r 2011. ~ - ~_, ~~BL7e. ~-~~2enn Notary Public COMMONWEALTH OF PENNSYLVANIA Notarial Seal Valerie F. Gsell, Notary Public CaAlsle Born, Cumberland County My COItrml55lon Expires Oct 9, 2014 Member. Pennsvlvanlx AssoGatlon Of Notaries REV-1508 EX+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. coMMONwEn~TR of RENNSVwnNln INHEiRITANce rnx RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER William G. Wert 21-11-0336 Include the proceeds of Ikigation and the date the proceeds were received by the estate. All property lolntly~owned with right of survivorship must bs disclosed on Schedub F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. GheckingAccount 2,134.67 2. Final Social Secud~y Payment 1,889.11 3. Teamsters Local l~nion Death Benefit 800.00 4. Auction Proceeds from repossession of Ford truck 4,772.03 5. Credit on account f rom Lite Insurance 659.89 6. Personal Assets sold at auction 17,204.20 7. Verizon refund 39.03 TOTAL (Also enter on line 5, Recapitulation) $ 27,498.93 (It more space is needed, insert addklonal sheets of the same size) _. ... ....... .. ..'. f..: t ., ' C . .. _ I, i, .. _. 1 .. _ I ~.! ~ .. ~.. i .. li -I .. ~i I ... -_ ~~ II .. ~~ . - i ~~. i '. .. it _. . ,.. .. .,, ... . (.. _.. .. __ _. ._ :. ... - .. _... . . - .. '. ~ ~ ',, , ., ,. .__ . _ ., uFVasil ex+ila-oei Pennsylvania SCHEDULE H `+1 o~=eaR1nENTOrREVENUE FUNERAL EXPENSES AND IAMERITHNCE TA%RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE Of FILE NUMBER William G. Wert 21-11-0336 Decedent's debts must be reported an Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: t' Fogelsanger Bricker Funeral Home 8,463.96 z. Westminster Cerhetery, LLC (grave opening and headstone) 4,760.00 B. ADMINISTRATIVE ~OSTS: 1. Personal Representative Commissions: 750.00 Name(s) of (Personal Representative(s) Paula V. Heckman street Addr ss 725 Yorkshire Drive city Carl~sle state PA ZIp '17013 Year(s) Commission Paid: 2011 4,000.00 2. Attorney Fees: 3. Family Exemptions (If decedent's address is not the same as claimant's, attach explanation.) 0.00 Claimant ~~ Street Addr~ss City ~I State ZIP _ Relationshipli of Claimant to Decedent 4• Probate Fees: ' 178.50 5. Accountant Fees: 6. Tax Return Prepar§r Fees: 200.00 Y DeHart's Auction ~& Surplus for property appraisal 450.00 a. George Gutshall dlawn care and maintenance) 825.00 ~~ TOTAL (Also enter on Line 9, Recapitulation) I $ 19,627.45 '~i If more space Is needed, use additional sheets of paper of the same size. FI'`dIs'RAl, [-I<kNLES, ti'!C. June 22, 2011 Mrs. Paula Heckmap 725 Yorkshire Drive Carlisle, PA 17013 ', Deaz Mrs. Heckman, ~~ ~r ~ r ~ ,~~1 (fir We are writing this ~etter to call your attention to the funeral bill of your father, William G. Wert. A balance o $8,463.96 remains. We realize it sometimes takes a while to settle an estate, and we aze unders ding of this. If you could please call the office to let us know when we could expect payme t, we would appreciate it. (717) 532-2211. Otherwise, please remit payment in full to: Fogelsanger-Bricker Funeral Home, Inc., P. O. Box :336, Shippensburg, PA 17257. Sincerely, ~~ ~-~ William S. Herb, Jr1 SELECTED Independent _FUNERAL HOMES NORMAN H. BRICKER, ED. 112 West KingStreet • P.O. Box 336 • Shippensburg, Pennsylvania 17257 • Phone (717) 532-2211 I Cumberland'(~aCCey.9KemoriaCGardens Invoice No. 5341 `Westminster Cemetery A DIVISIONOF STONEMOR PARTNERS, L.P. 1921 Ritner Highway Carlisle, PA 17013 ' Phone:717-243-3541 Fax:717-243-4495 /NVO/CE - Customer Name ESTATE rAf WILLIAM G. WERT Address; c/o ATTY. ANDREW H. SHAW City CARLISL~ State PA ZIP 17013 Phone 717-243- 135 Qty Description 1 At-Need Grave Opening/Closing William G. Wert Tuesday March 8, 2011 ', Fogelsanger-Bricker Funeral Home Garden of Christus, Lot 29B, Space #1 NOTE Opening/Closing check was written by Sheila A. Mille on 3/4/11 on the account of William G. Wert. This c eck was returned to our company on 3/31/11 as unpaid for'unauthorized signer'. i Payment Dekails O Cash ~ O Check/Money Order O Other Date 5/20/2011 Order No. Rep FOB Unit Price TOTAL $1,720.00 _ $1,720.00 SubTotal $1,720.00 Shipping & Handling $0.00 Taxes PA - 6% - TOTAL $1, 720.00 PAST DUE OSIRIS HOLDING OF PENNSYLVANIA, INC. aEV-islz Ex+ (IZ-as) pennsylvania SCHEDULE I `y oEaaaTnENTOEacveNUE DEBTS OF DECEDENT, IN,iER>rnNCETnx REruRN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER William G. Wart 21-11-0336 Report debtr incurred by the decedent prior to death that remained unpaid at the date of death, Including unrelmbursed medical expenses. ITEM VALUE AT DATE 1 Internal Revenue Service, past due taxes 335.33 2. Nlationwide Insurance 108.66 3. Pf;nnsylvania Power and Light 494.17 4. Ttix Claim Bureau dt Cumberland County 833.33 5. Deborah Piper, TaxjCollector 59.69 6. Foremost Insuranc9 36.12 7. Apria Healthcare 201.94 8. Associated Cardiolq'gists 25.00 9. Biotech Research 178.00 10. Casses ChiropractiQ Clinic 133.00 11. Carlisle HNA Physician Management 31.23 12. Carlisle Regional Medical Center (toal of all accounts) 2,175.14 13. Century Link 200.50 1a. Columbus Bank anc Tmst 1,548.08 15. Direct TV 161.63 16. EdenPURE 88.00 17. Citibank 660.91 18. Applied Bank 2,266.10 19. First Premier Bank Qtotal of all accounts) 1,082.68 20. Forest Park Health tenter 800.00 21. Household Recovery Services 7,109.80 22. JC Christensen andAssociates, Inc. 963.35 23. Kinetic Imaging 13.25 24. Moffitt Heart & Vascular Group 30.00 25. Remainder of Schedule I continued from attached page 20,374.38 TOTAL (Also enter on Line 10, Recapitulation) § 39,910.29 If more space is needed, insert additional sheets of the same size Schedule I continued 26 Midland Credit Management $1,517.27 26 National Recovery Agency $106.48 27 NCB Management Services $288.94 28 NCO Financial Systiems $1,071.93 29 Pathology Associated of Central PA $91.00 30 Phillips & Cohen Associates, Ltd. $14,387.70 31 Pinnacle Health Hospitals $150.00 32 Praxair Healthcare Service $30.28 33 Praxiis Financial Services $645.91 34 Preciision Revy An$lytics $1,415.57 35 Radiology Diagnostics, LLC $18.16 36 Sovereign Bank ', $479.61 37 Ultrasound Servic s $30.00 38 Walnut Bottom R~diology $30.00 39 West Shore EMS- LS $111.53 Total $20,374.38 ~~~"-' Department of the Treasury 7 j~}]1 ~~NN Internal Revenue Service 1 j`~ ~,, Cincinnati, OH 45999-0030 369697.882002.1413.030 1 AT 0.365 702 "II'Idl'llllllll'LnI~I~Llllll~l"II1111'I'IIII'I'1lllh~lhl WILLIAM G WERT 725 YORKSHIRE DR CARLISLE PA 17013-3$53255 69697 Your installment agree ent Monthly payment due Your monthly payment of $100.Op is due on June 24, 201 L If you can't pay your monthly billy this date, call us at 1-800-829-8374 to dis uss your situation. Notlce CP521 Tax Year 2008 Notice date June t 5, 2011 Social Security number 207-34-7099 To cantact us Phone 1 800-829-8374 Your Caller ID 736948 Page 1 of 4 IIII~ IIIN II I IIIII I ~ IIIN IIN III I II N ICI I IN IIIII ~ Ilu *207347099101* Billing Summary Tax you owe _ _ $167.99 Failure-to-pay penalty 68.17 ___ Interest charges 98.00 ......... _ ............................... Remaining balance $334.16 __ _ Monthly payment due by June 24, 2011 $100.00 If we don't hear from yq'u If you don't pay $100.00 by June 24, 2011, you may default on your agreement, interest will increase, and additional penalties may apply. Continued on back... wuunm~weer Notlce CP521 ~,zr.•~nirss.ur Notlcedaie J ne15 eMt cnnu ie vn vm3ass3zs5 Social Security nnmber 207-34 7099 IRS Payment INTERNAL REVENUE SERVICE P.O. ROX £304527 CINCINNATI, OH 45280-4527 I'll' 111111"N' l l"111111' 11' I I I I I I l l l' 1' 1 1 1 1 l' l l" I l l l l' I' 1 1 1 1 1 1 $100.00 • Make your check or money order payable to the United States Treasury. • Write your Social Security number (207-34-7099), the tax year (2008), and the form number (1040) on your payment and any correspondence. Monthly payment due by $100.00 June 24, 2011 207347099 SP WERT~ 30 0 200812 670 00000010000 ® Nationwide On Your Side 00086 Nationwide Insurance 4407 CreedmoorRoad Raleigh, NC 27612-3914 May 09, 2011 Paid By: Paula Heckman 725 Yorkshire Dr Carlisle PA 17013 Thank you for choosin~ Nationwide Insurance as your insurance rovider 0 ~o ~ ° his written notice co p . firms your verbal authorization obtained on May 09, 2011 for the payment of your o Account/Policy, in the mount of $4933. Per your authorization, Natiohwide Insurance will debit a single o transaction from your ank account on or after May 09, 2011. a ,~ Policyholder's Name: ~ William G Wert ~ Account/Policy: ReceiptlD: ' S837MH269989 000000039295739 Bank Name: ! Woodforest National BK Bank Account Type: j Checking Please retain this notic ~ for your records. If you have any questions, please contact Nationwide Insurance at 1-800-421-i 444 . Thank you for your pa~ment. We value your business. Please visit us online at Nationwide.com for your insurance needs. PPL, Electric Utilities Electric Service For: WILLIAM G WER7 7S FICKES RD NEWV'ILLE PA 17241 PPL Electric UtilitiCs Customer Service '.. 827 Flausnran Rd Allentown, PA ]8104-9392 1-800.342-5775 (1-800-DIAL-PPL) www.pplelectric.cony General Informatiojn Next meter reading on or about May 24 ,~:;, ;. .,~ _... Page 3 pp~ ; - Total from Last BiU ~~,>~ ~; 81370-70018 I~sc'gpSr{,ncatli~°ir«Ed 11372.38 Billing Details Amouut You Still Owe as of Apr 25, 2011 $372.38 Current Charges Utilities 24 -Apr 25 pper KWH (J.27600000% per KWH Cienerarion Chaz e: Capacity and ~ner 143 KWH at 9.20500000¢ per KWH PA Tax Adj Surcharge at -0.28600000% 8.75 4.72 -0.04 0.13 13.16 -0.04 Total PPL Electric Utilities Charges $26.68 Other Char~es for PPL Electric Utilities Late Payment Chazge 4.65 Total of Other Charges $4.65 !`I~,~,1~-eu~lplo L~k~~ 1'14~i~€r~.~~1 ! .. '" Account Balance $403.71 The $372.38 balance includes $8.35 in prior late; payment chazges. Creneration prices and Chaz es aze set by the electric generation supplier you have chosen. The Pub~c U61ity Cornrrrission re ates distribution pnces and services. The Federal Energy Regulatory~ommission regulates Transmission prices and services. PPL Electric Utilities uses about $0.48 of this bill to pay state taxes. In addifion, about $23.81 of this bill pays the PA Ciross ecerpts Tax For our convenience, you can now pa your bill using your Visa, Mas~etCazd, Discover, or ATM Card all BillMatria at 1-800-672-2413. BiIlMatrix will chazge your credit and ATM card a service fee for making this payment. Before diggin azound your home or property, you should always call the state's Chre Call notification system to locate any underground ufility lines. You can do this by simpl dialing 811, which will conned you to the One Call system. Be safe andycall 81I before you dig. With pa~perless billing, you can receive and pay your PPL Electric Utilities bills onfine. The process Is free, quick, convemc:nt and secure. To learn more or sign up, visit www.pplelectric.com. Save postage and late charges -sign up for Autcmlated Bill Payment. Clean the lint filter on your dryer between loads. A clo ed filter cuts air flow and wastes energy. A clean filter shortens drying ~me and saves money. GARY EICHELBERGER CHAIRMAN RICHARD ROVEGNO VICE CHAIRMAN BARBARA B.CR05s TAX CLAIM BUREAU OF CUMBERLAND COUNTY SECRETARY One Courthouse Square, Room 106, Carlisle, PA 1 701 3-3 389 (717)240-6366 DENNIS MARION CHIEF OPERATIONS OFFICER EDWARD SCHORPP SOLICITOR STEPHEN D.TILEY ASSISTANT SOLICITOR Printed: 5/12/11 C Receipt No.: 81605 15:36:31 Receipt Date: 5/12/2011 Control Number: 4'6-502783 **** RECEIPT **** F?age: 1 Property Description: WERT,, WILLIA G ~ 75 FICKES RO NEWV:CLLE PA 1,7241 Mobile Home - No Land Situs Information: 75 FICKES ROAD Map No: 46-09-05171-018A I TR10123 WEST PENNSBORO TOWNSHIP Tax Penalty & Year Description'. Face Interest Costs Total 2009 CTY-WEST PE SBORO 59.35 13.14 72.49 2009 CLB-WEST PEN~ISBORO 4.45 .93 5.38 2009 MUN-WEST PE SBORO 5.28 1.17 6.45 2009 SCH-BIG SPRI G 248.71 54.79 14.15 303.50 2009 BUREAU COSTS'. 7.55 7.55 Received For :tear Of 2009 $409.52 2010 CTY-WEST PE SBORO 59.35 7.74 67. 09 2010 CLB-WEST PE SBORO ~ 4.45 .57 , 5.'02 2010 MUN-WEST PEN NSBORO 8.66 1.11 9.77 2010 SCH-BIG SPRI G 265.38 34.50 16.00 299.88 2010 BUREAU COSTS 26.05 26.05 Received For `tear Of 2010 $423..81 Total Received $833.33 Tendered :> CHF~CK Received 13y > MM Paid By > WE12~T, WILLIAM G ESTATE Remarks > CK#~ 50890392 * Conti nued YnBLE DEBORAH W. PIPER, TAX COLLECTOR P O BOX 157 PLAINFIELD, PA 17081 TEMPORARY RETURN SERVICE REQUESTED sc. ASSESS.NO -005(12783 MAP NO: 46-09-0!i17-018A TR10123 75 FICKES ROAD MOBILEE HOME -LEASED LAND .Ea EWVI LE RQAD N L P 17241 r:OE TUESDAY AND TFIURSDAY 8AM-4~PM u6s: AT WPT BLDG 21;i0 NEWVILLE R DEC,JAN,FEB BY APT PH(717)44 - 6680 FAX(717)243-9268 IF TAXES ARE ESCROWED PLEASE FORWARD A COPY 70 MORTGAGE cV. CASH OR MONEY ORDER AFTER 12/24/11. RETURN BOTH COPIES OF BILL AND POSTAGE PAID ENVELOPE IF YOU REQUIRE A RECEIPT. NOTICE OF PROPERTY TAX RELIEF Your enclosed tax bill includes a tax reduction for your homestead and/or farmstead properly. As an eligible homestead and/or farmstead property. owner, you have received tax relief through a homestead and/or farmstead exclusion which has been provided under the Pennsylvania Taxpayer Fjelief Act, a taw passed by the Pennsylvania General Assembly designed to reduce your property taxes. ~~_ $ Return Bill with Payment. For a Receipt, Tax Collector Signature Date Paid Amount Paid Enclose aself-addressed stamped envelop6 It paying installments, u~e the coupons below to submit payments. If paying in full, submit the remittance copy above. TAX YEAR 2011 BILL DATE 7/1/2011 BILL # 2268 PAYABLE TO DEBORAH W. PIPEp, TAX COLLECTOR P O BOX 157 - PLAINFIELD, PA 17Q/81 = CONTROL # 046 -502783 MAP #. 46-G9-0517-O18A TF~10123 SCHOOL BIG SPRING S.D. '. ~_ TAX PAYER WERT, WILLIAM G ~~ 75 FICKES ROAD NEWVILLE PA 17241 3rd Please return coupo~l with third payment. $47.44 ON OR BEFO E OCTOBER 31, 2011 $52.18 AFTER OCTO ER 31, 2011 10 °k _l~- $ Tax Collector Signature '., Date Paid Amount Paid TAX YEAR 2011 BILL DATE 7/1/2011 BILL # 2268 TAX YEAR 2011 BILL DATE 7/01/2011 BILL # PAYABLE TO DEBORAH W. PIPEF~, TAX COLLECTOR ~ PAYABLE TO DEBORAH W. PIPER, TAX COLLECTOR P O BOX 157 P O BOX 157 PLAINFIELD, PA 17b81 =_ PLAINFIELD, PA 17081 CONTROL# 046 -502783 ~ CONTROL# 046 -502783 MAP# 46-G9-0517-018A TF~10123 ~ MAP# 46-09-0517-018A TR10123 SCHOOL BIG SPRING S. D. ~_ SCHOOL BIG SPRING S.D. TAX PAYER WERT, WILLIAM G ', TAX PAYER WERT, WILLIAM G 75 FICKES ROAD 75 FICKES ROAD NEWVILLE PA 17241 ~ NEWVILLE PA 17241 INSTALLMENTS CANNOT START AFTER OCTOBER 31, 2011 $t Please return coupoh with first payment. $a7.a4 ON OR BEFOFI E AUGUST 31, 2011 $52.ta AFTER AUGU T 31, 2011 10 °k ~~- $ 2011 Statement of Real Estate Taxes Control No: Bill Dale: 046- 502783 7/01/2011 nseeeeed Land I rovement Minezal Total Values 0 Homestead Exclusion 2a, 600 0 22,600 10,636- BIG SPRING S.D. Discount Face Penal Rates SCHOOL R E .01209600 2 9 273.41 10 b Homestead Czedit 131.09- TAX AMOUNT DUE -----> $139.47 $1az.3z $156.55 If If Paid On or After Paid On or Before 7/01/2011 B 31 x011 9/Ol/a011 10 31 2011 11/01/2011 12 31 2011 2268 2nd Please return coupon with second payment. $a7.44 ON OR BEFORE SEPTEMBER 30, 2011 $52.18 AFTER OCTOBER 31, 2011 10 °k _J~- $ r..., r..u,...«.. m...,.,....,, n.,.,, o..~.Y n..,,., ~.d o.,:.~ 1'VKICMVlT Pay your bills online at www.ForemostPayOnline.com. INSURAN(:E COMPANY GRAND RAPIDS, MICHIGAN Represented By BLASCO.KINGSLEY J C/O KINGSLEY OLASCO 8 ASSOCIAT PREMIUM PAYMENT NOTICE 15 SUBDIVISON RD NEN/VILLE PA 1 724 1-0602 POUCVHOLDER LOAN NUMBER PAYMENT DUE BY CURRENT.AMOUNT DUE WILLIAM WERT SEF' 29, 2011 S 36.12 POLICY NUMBER DESCRIPTION POLICY COVERAGE PERIOD 381-0068816045-01 BASICS ONE DWELLING AUG 10, 2011 TO AUG 10, 2012 TO: POLICYHOLDER YOUR REPRESENTATIVE WILL1[AM WERT ~~ A BLASCO,KINGSLEY J 725 1fORKSHIRE DR '~ /~~~ ,l- C/0 KINGSLEY BLASCO & ASSOCIAT CARL][SLE PA '17013 ~~„' `\\~~ v,\D 15 SUBDIVISON RD I 3~ NEWVILLE PA 17241-8602 (717) 776-7138 PAYMENT INFORMATION ~~ C~~~`~a, ~ ~ ~~ ~ r ~ OR, TO PAY IN FULL, THIS IS YOUR SECOND FOR-THE SCHEDULE OF SEE REVERSE SIDE. PAYS 293.0$ OF TEN PAYMENTS. FUTURE BILLS, VACATIONING THIS SUMMER? REDUCE THE CHANCE OF A BREAK-IN! DON'T ANNOUNCE YOUR PLANS ON FACEBgOK. USE TIMED SWITCHES ON LIGHTS. STOP DELIVERY OF MAIL & NEWSPAPERS. HAVE YOUR LAWN MOWED. *** MAKE SURE YOUR INSURANCE KEEPS UP WITH YOUR LIFE. CONTACT YOUR AGENT TODAY FOR A REVIEW. Have a question? Want to make a policy change? Just call your representative. `°'"~0°"~08 For billing questions c~tl our automated phone service, et 1-81)0-532-4221 available until midnight EST. We are available during normal business hours to assist you with questions or to discuss your payment options. l - PLEASE RETURN THE CARD BEI OW NNTU YOI In pREMR nn ogYp4Ft,rT qp aAN nun INE t APxrA frr:nL rrlcAxe 1328 S. ri1GII1,ANll AVE JACKSON TN 38301-7369 :~1~1', I'r:'.;7iiul~:. ](address or other intbrmatinn has changed, check ofTbox and complete reverse side. 8 907 I WILLIAM WERT 75 FICKE51 RD NEWVILLE, PA 17241 t t4e~outit Number 2 pattent Nam+; - 3 "3tarmanM #hita !'age ~: O17047,T9g3 WP;RT, WILLIAM 07/20/2011 1 of 1 41}na tslhe current insui ante infom7atmt nn file S rlttruunt f}uc IIIG[IMARK DS/C1,ASIgPP(I,DI ~ $20[94 6 ][paying by Credit Card, Please complete this section 7 CHF.CK/M.O. Cud Type ^~--(rl ply"'~~ll O ~ '1l lauthorizc automated payment to AMOUNT L(~ `~J I my noted credit card fur all patient EN(7LOSED charger nol covered 1,y insurance. Cardq $ Exp. Date AM'r. AUTH $ Si azure `l APRIA HEALTHCARE P.O. BOX 536841 ATLANTA GA 30353-6841 Il~llrllrllrlllrllrirlrll~~lllrl~rllrllrlr~lllllllll DDDDDDDD243134~9999100DDDDDDDDDDDDDDD10000002D1944 To ensure proper credi~ to your account, detach top section and return with your payment Please keep this portion for your records. ifl Aunt~ivmbet 1i F~tirrt9l ~I i~ St~lett~ent3(3aaln Pic 0370AZT983 WERT, WILLIAM 07/20/2011 I of 1 17 For Insurance relatetl 18 For service or questions about your 19 For questions about your questions call: 1-(866) 505-6365 equipment call: 1-(717) 761-4630 statement call: 1-(866) 505-6365 See reverse side for instruction and explanation of statement A1~RIA HEALTHCARE • P.O. BOX 536841 • ATLANTA GA 30353-6841 907 I Statement Date Page 8/31/2011 ~ 1 Cases Chiropractic Clinic, P.C. I 313 South Hanover Street Tax ID #260002844 Carlisle, PA 17013-3954 (717) 249-0055 - -Make Checks Payable To Cases Chiropractic Clinic, P.C. William G Wart 725 Yorkshire Dr Amount Due: $ 133.00 Carlisle, PA ,17013 Amount Paid: Pat No. 5966 ' PLEASE DETACH AND REiTURN TOP PORTION WITH YOUR PAYMENT Patient: Wert, William 'Bill' Number: 5966 Diagnosis:... i _ __ - - __ _ __-_ Insurance i Patient - i Date Transaction ! Amount Est. Paid Adjust Amnt Paid Due r - - __ _ _ _ _ _ __ Balance For~lterd 133.00 133.00 -.- 133.00 Last Payment: 1/31!2011 Statement Dates: 7!28/2011 - 8/3/2011 AMOUNT-DUE l $ 133.00 ~ ex - ASSET MANAGEMENTt~c 1891 Santa Barbara Orive, 8204 Lancaster, PA 17001 717.519-1770 ar 888592.2144 ' " ~fi Dear WILLIAM 5 WERT, ~ ~~~ ~~SIC~t ~~ `~~~~ ~~;r1~S We thank you for choosing CARLISLE ONCOLOGY for your health care needs. You should have received a hill for services provided by CARLISLE ONCOLOGY. Th~ balance in Full of 531.23 is now due for payment in full. We realize this could be an oversight and not a deliberate attempt to dis egard your obligation. You may take care of this obligation today by returning a check, money order, or charge card information with this letter. Please mail your payment in the enclo$ed envelope. VISA and Mastercard are also ilccepted over the phone by calling 717-519-0753 or toll free at 871.2053879. If you need to make other payment arrangements, please call 717-519.0753 or toll free at 877.205-3879. If full payment is not received in thirty days your ac~ount may be considered for collection activity. In the event full payment has been made or payment arrangement has keen established, please accept our thanks and disregard this notice, This is an attempt to collect a ~ebt. Any information obtained will be used for that purpose. 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 i~ writing within 30 days after receiving this notice this office will obtain verification of the debt and mail you a copy of such verific lion. If you request from this office in writing within 30 days after receiving this notice, we will provide you with the name and laddress of the original creditor if different from the current creditor. This communication is from a debt collector. APEX ASSET MANAGEMENT IILC Please tear off and return lower portion with payment. PD Box 7D44 Lancaster PA 17604-7D44 nlal ~ ~p up w ~pY rga gg ay rpla ra ~~~I 00 3 61 111111'11'I~Ildl,m,Ir„,IIh~~~I~{Il~ulll~l~lllllfl~r6p61~ CARL70 16779536 105 LAN MSP WILLIAM S WERT z96aa-oa 2 75 FICKES RO NEWVILLE PA 17241.9461 CARLISLE ONCOLOGY ..eusDx-asB-- f U ~'K a~~I (oot9 820257 531.23 May 05, 2011 Undeliverable Mail Only: P.O. Box 1954 Southgate, MI 48195-0954 ~~~II ~~~~~ ~~~~ I~~II ~~II~ ~~~~~ ~~~~~ ~I~~~ II~~I ~~I~I ~I~~~ ~~~~I ~~~~ ~~I MM1036428758I105 008 44128125 000749810034 ~~ml~l'III'I~'~II~I~mII1rdJlr~umlr~lIIII1d~IrlllnrJll William G Wert 725 Yorkshire Dr Carllisle, PA 17013-3553 Date of Service: Balance: Account Number: Client Ref Number: January 27, 2011 $189.53 86428758 1085020 Date: June 27, 2011 Dear William G Wert: We hoe that youread our prior letter to you. Your delinquent.debt remains unpaid and,we intend to continue our co ecfion actiyrity on be alf of our client. We urge you to glue this matter your attention. Please contact oulr office at the telephone number listed below should you wish to initiate a payment by telephone. Please' have this letter available when you call. We are a debt co lector attempting to collect a debt and any information obtained will be used for that purpose. Please note chat i your financial institution rejects and returns your payments for any reason, a service fee -the maximum permittled by applicable law -may be added to your balance. Sincerely, Account Representative 800-966-0755 Allied Interstate uLC SEE REVERSE SIDE FOR OTHER IMPORTANT INFORMATION Detach and return with payment A//ied/nters-t~-t~ Healthcare Division P.O. Box 361596 Columbus, OH 43236-1596 Toll Free:800-966A755 Mon-Fri Sam to 10pm EST Date: June 27, 2011 Client Ref Number: 1085020 Client: CARLISLE REGIONAL MEDICAL CTR Amount Due: $189.53 Amount Remitted: $ Payment and Correspondence Address MM1/86428758I858 Allied Interstate LLC Healthcare Division P.O. Box 361596 Columbus, OH 43236-1596 I~Irrlrrll~rrl~lrrllrrll~rr,rllrlrlrlrlrrrllrrrrrlll 105 Carlisle Regional Medical Center P.O. Box 15618 Wilmington DE 1)850 I'~~'~ ~I~~~ I~'I' ~~I~I ~~I~I I~I~~ I~'~' ~I~~~ "II~ I~~I I~~I 82.6581209.8802 FOR RETURN MAIL ONLY JUN 21 2011 '~~.~~5~ MEDICAL CENTER Phone:800-381-9160 Statement: 658 ] 209 PO Box 4100 Carlisle, PA, 17011-3661 Account#:1095275 utIIIIIII~I~u~III~IIhduIII~IIIh~d~h~Pll~lhllll~lgllpl zsoo~-ae Patient Name: W [LLIAIVi G WIiRT 65812119 Service Date: 03/15/1 1 WILLIAM G WERT Balance: $100.00 t~ 725 YORKSHIRE UR CARLISLE PA 17013-3553 Deaz WILLIAM G WERT, You have ignored our previdus requests for payment of your past due account. Your account is seriously D)~LINQUENT! If we do not receive the balance in full within ten (10) days, we will recommend that your account be referred to a professional collection agency. This a FINAL NOTICE. The only way to avoid this a~tion is to pay in full or contact our office at the number above. You may pay with Mastercard, Visa, Discover r American Express by filling out and signing the form below. PAY ONLINE 7 DAYS Ai WEEK 24 HRS/DAS' AT www.carlislermc.com PLEASE RET'tIItN LOWER I'OR'TTON WITH YOUR PAYMENT IF YI BY REDIT ARD MPLETE BEL W [mil ~ ~1 CARDHOLDER'S NUMBER _ VIN# EXPIRATION DATE CARDHOLDER'S NAME AMOUNT CARDHOLDER ADDRESS ~'. LP CDDE SIGNATURE OE CARUhIOL[XdH WILLIAM (i WE:RT 72S YORKSEi]RI?. DR CARLISLE PA 17013-3553 Account: 1095275 Patient Name: WILLIAM G WERT Service Date: 03/1.5/11 Balance: $100.00 PLEASE UPDATE CHANGE OF ADDRESS OR INSURANCE INFORMATION ON REVERSE SIDE PLEASE MA[L PAYMENT TO Carlisle Regional Medical Cen[er P.O. Box 281442 Atlanta GA 30384-1442 eaoz-saoor-ae OOOO1710952751]O0~~010000WILLIAM G WERT Carlisle Regional Medical Center P.o. Box ]s61k WihningtanDE 1)850 ~"I'~ ~I~~' II~~I ~~~~' ~~~'I ~~I~~ ~~'I~ I~I~' ~~I~~ III ~'ll 82.5980969.8883 FOR RETURN MAIL ONLY MAY 19 2011 ~~... J F~~CIONAL MEpiCAI, CENTER Phone: 801)-381-9160 St~tc;ment: 5980969 PO 13ux 4100 Carlisle, PA, 17015-3661. Account#: I Ok543~1 I'hl^1.IILI^~•I'll'Iddlhlll'I'It'191tthllmnrllllul111 ssoozea Patient Name: WILLIAM G N-'ERT 59817969 Service Date: 11210 1 /1 1 WILLIAM G WERT Balance: $1235.61 725 YORKSHIRE DR CARLISLE PA '17013-3553 Dear WILLIAM G WERT, Thank you for choosing Carlisle Regional Medical Cenier for your healthcare needs. We value your use of our facilities. It is unfortunate that we have to inform you that your account is now past due! Please help us keep the healthcare costs down by pa~ing your balance in full, promptly within the next ten (10) days. To ensure proper cr~diting of your account, p ease return your payment m the envelope enclosed along with the lower portion oft is letter. For your convenience, we also accept Mastercard, Visa., Discover and American Express. If you have any questions regarding your bill or you have additional insurance informa~ion, which ryas nat previously provided, pleasie contact us at the telephone number listed above. if you have paid this account in fill within five (5) clays of the date of this letter, please disregard this request....and thank you. PAY ONLINE 7 DAYS A WEEK 24 HRS/DAY AT www.carlislermc.com PLF;ASE RE'PUIiN LOWI':R POR'T1UN WITH YOl7R PAYMt}iN'f IF PAYIN BY CRE 1 A D MPLETE BEL W CARDHOLDER'S NUMRF_R VINN E%PIRATtON PATE CARDHOLDER"S NAME AMOUNT CARDHOLDER ADDRE:iS ZIP GODS SIGNATURE OF GAHOFIOLDER WII.LLIM G WERT 725 YORKSHIRE DR CARLISLE PA 17013-3553 Account#: 1085434 Patient Name: WILLIAM G WERT Service Date: 02,/01/1 I Balance: $1235.61 PLEASE 1JPDAT'E CHANGE OF ADDRESS OR INSURANCE INFORMATION ON REVERSE SIDE PLEASE MAIL PAYMENT TO Carlisle Regional Mcdieal Center P.G. Box 281442 Atlanta GA 303k4-1442 eea3-zsoo~-eel OO17001~85434001J00123561W:[LLIAM G WERT Carlisle Ke4;ional Medical Center P.O. Box 15618 Wilmington DE 19850 I IIIIII VIII VIII VIII VIII VIII VIII VIII VIII IIII illl 82.6301364.8802 FOR RETURN MAIL ONLY JUN 12 201 I ~~rius~ fZf~IONAL MEDICAL CENTER Phone:800-381-9160 Statement: 6301364 PO Box 4100 Carlisle, PA, 17015-3661 Account#: 9488(162 yulllh„hull,qp,lpgl,l.plld~u.l~ll,l,lll~gl~.l~~llu 2,~,-~ Patient Nance: WILLIAM G WERT Service Date: 02,22/11 630:L364 Balance: $400.00 WILLIAM 6 WERT 725 YORKSHIRE DR CARLISLE PA ]y 71713-3553 Dear WILLIAM G WERT, You have ignored our previous requests for payment of your past due account Your account is seriously DELINQUENT! If we do not receive the balance in full within ten (10) days, we will recommend that your account be referred to a professional collection agency. This a FINAL NOTICE. The only way to avoid this ajction is to pay in full or contact our office at the number above. You may pay with Mastercard, Vtsa, Discover pr Amencan Express by filling out and signing the form below. PAY ONLINE 7 DAYS A WEEK 24 HRS/DAY AT www.carlislermc.com PLEASE RETURN LOWER PORTION WITH YOUR PAYMEN"C IF PAYIN BY REDIT ARD MPLETE BEL W [mil ~J ' I CARDHOLDER'S NUMBER VIN# EXPIRATION DATE CARDHOLDERS NAME AMOUNT CARDHOLDER ADDRESS ZIP CODE SIGNATURE OF CARDHOLDER Account#: 9488062 Patient Name: WILLIAM G WERT Service Date: 02/22/1 I. Balance: $400.00 PLEASE UPDATE CHANGE OF ADDRESS OR INSURANCE INFORMATION ON REVERSE SIDE wII.LIAM G WeRT 725 YORKSItII{}i DR CARLISLE PA 17013-3553 PLEASE MAIL PAYMENT TO Carlisle Regional Medical Center P.O. Box 281442 Atlanta GA 30384-14.42 seas-Zaoor-aee 0001709488176200000t740OWOWII_LIAM G WERT Carlisle Rcl;ional Medical Center PLO. Box liril8 Wilmington DE 19850 1111111 IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII IIII 82.6160225.8802 FOR RETURN MAIL ONLY JUN 12 2011 ~nl~dd~ugllp.lllt..1.1111y1..ll.l..qul.g6ugq611... zsoo~-aez III!!!~~~::: 6161]225 p;~;~ WILLIAM G WERT I~ 725 YORKSHIRE DR CARLISLE PA ]i7013-3553 Dear WILLIAM G WERT, 'CV ~''~~N/A1~. MEDICAL CENTER Phone:800-381-9160 Statement: 6160225 Account#:1087484 PO Box 4100 Carlisle, PA, 17015-3661 Patient Name: WILLIAM G WERT Service Date: 02/15/1 1 Balance: $50.00 You have ignored our previbus requests for payment ofyour past due account. Your account is seriously DELINQUENT! If we do not receive the balance in full within ten (] 0) days, we will recommend that your accounnt be referred to a professional collection agency. This a FINAL NOTICE. The only wav ~o avoid this action is to pay in full or contact our office at the number above. You may pay with Mastercard, ~tsa, Discover or American Express by filling out and signing the form below. PAY ONLINE 7 DAYS A WEEK 24 HRS/DAY AT www.carlislermc.com PLEASE RE"T"URN LOWER POR'T'ION WITH YOUR PAYMPNT I PAYIN BY REDIT. ARD MPLETE BEL W (® CARDHOLDER'S NUMBER VIN# EXPIRATION GATE CARDHOLDER"9 NAME AMOUNT CARDHOLDER ADDRESS ZIP CODE SIGNATURE OF CARDHOLDER WILLIAM G W13R1' 72i YORKSIIIF'.E DR CARLISLE PA 17013-3553 Account#:1087484 Patient Name: WILLIAM G WERT Service Date: 02/15/11 Balance: $50.00 PLEASE UPDATE CHANGE OF ADDRESSOR INSURANCE INFORMATION ON REVERSE SIDE PLEASE MAIL PAYMENT TO Cartisle Regional Medical Center P.O. Box 281442 Atlanta GA 30384-1442 aeos•Zaoor,as2 0000010874840000BOO50DOWI1_LIAM G WERT t,arns~e reeg;wnal mcwcal v.enLer P.o. Box Ise;ls Wilmington DE 19850 ~'~~~~ ~~~~~ ~~~~~ ~II~' I~~~~ ~~~~~ ~I~~~ ~I~~~ ~I'I~ I~~I I~~I 82.6345172.8802 FOR RETURN MA[L ONLY JUN 122011 nlll....Ip.1.1.!.II.Illlull.l..pnllllllhlhrlhlunl.lnl asooT-3sa 6345172 v' WILLIAM G WERT 725 YORKSHIRE DR CARLISLE PA L70L3-3553 Deaz WILLIAM G WERT, ~pp ,,~ruast.~ IV~i~~N/`~. MEDICAL CENTER Phone:800-381-9160 Statement: 6345.172 YO Box 4100 Carlisle, PA, 17015-3661 Account#: 1093474 Patient Name: WILLIAM G WERT Service Date: 02,28/11 Balance: $200.00 You have ifmored our previous requests for payment ofyour past due account. Your account us seriously DELINQUENT! If we do not receive the balance in full within ten (10) days, we will recommend that your account be referred to a professional collection agency. This a FINAL NOTICE. The only way to avoid this action is to pay in full or contact our office at the number above. You may pay with Mastercard, Visa, D[scover or American Express by filling out and signing the form below. PAY ONLINE 7 DAYS A WEEK 24 HRS/DAY AT www.carlislermc.com PLEASE RETURN LOWER PORTION WITH YOUR PAYMENT IF PAYIN 8 R DI ~~ AR MPL TE B L W ~~ CARDHOLDER'S NUMBEFI VINk EXPIRATION DATE CARDHOLDER'S NAME AMOUNT CARDHOLDER ADDRESS ZIP CODE SIGNATURE OF CARDHOIDEH Account#:1093474 Patient Name: WILLIAM G WERT Service Date: 02/28/11 Balance: $200.00 PLEASE UPDATE CHANGE OF ADDRESS OR INSURANCE INFORMATION ON REVERSE SIDE WI1,I,IAM G WIR'C 725 YORKSHIRE DR CARLISLE PA 17013-3553 PLEASE MAIL PAYMENT TO Carlisle Regional Medical Center P.O. Box 281442 Atlanta GA 30384-1442 8802-23007-389 00000109347400000020000WI1_LIAM G WERT ~,1 CenturyLink° Page 1 of 3 Monthly Statement Account Number July 4, 2011 7n-775-o27a-3as Payment Options & Contact Info Current Charges At-A-Glance Retail Store in Your Area B CARLISLE 202 Westminster Drive in The Carlisle Crossings Center Pay Online CENTURYLI N K.com/myaccount Pay by Phone 1-877-813-7804 Customer Service 1-800-829-8009 Repair Service 1-800-788-3800 Internet Address CENTURYLIN K.com/residenkial CeMuryLink Services Total Previous Balance PaymerFts & Adjustments Past Due, Please Pay Now Total Current Charges Total Amount Due 200.50 I .00 I 200.50 I .00 I 5200..r1~ Current Charges Due By: 07/28/11 fi `1 r~ ~I ,~ CenturyLinkry Please return this portion wkh payment Customer Service Internet Address ', U900.929-E009 CENTURYLINK.com/residential Please pay past due amount of 5200.50 immediately Total Amount Due: AV 01 000194 14827 B ~ A~k5DGT Ipl,Irgll,liltlurgll,rllhlrl~llrlulrhllllhlllllu~llllr WILLIAM G WERT ESTATE CIP WILLIAM G'iWERT C O PAULA HECKMAN 725 YORKSHIRE DR CARSILE PA 17013-3553 12 717776027434919 ® Please Recycle Account Number ~n-ne-0z7a•sa9 n P 5200.50 Amount Enclosed: Write your 13-digit account. number on check Make checks payable to: CenturyLink P.O. Box 1319 Charlotte NC 28201-1319 Ilhlllld„Illl'llllllllllllll~Jllr~hllllllllllll"IIIIIIIIIII 000200509 1121400 RNorn MWf Only - No ('arreepondence ~m~ Dept. 12421 I,C~ PO Box bu3 Oaks, PA 19456 IIIIIIIIIIIIIIINUNIUUiININNINIININININIIIINNNNINIIIINNNI{IIN IN o7-oa-zg7 7 !tlr•41LI•Ph'^Illnb•lmi'Ihb'•'ppp,'q'llr'I'rri aBWNHLTH Boost -ease xaoaa 0853 2141 7496>t WILL IAn WERT a" 725 YORKSHIRE DR CARLISLE, PA 17813-3553 Dear WILLIAM, 852141749 COLUMBUS BANK AND TRUST Hours of Operalion~. M-Th Bam - 7pm; Fri Gam - Spm; Sat Gam -Noon PST Congratulations! You have been oreaooroved Fur a discount program designed to save you money. Ap now to maximize your savings and put this tlt:bt behintl you. ;option t:. 40% OFF You Pay Only -Payment Due Date: OB-07-2017 $928.85 Option 2: 20% OFF 6 Monhly Payments of Only " 'First Payment Due Date: 08-07-2011 $206.41 Option 3: Monthly Payments As Low As: 8.50 per months t, Call today to tlisbuss your options and get more details. If these options don9 work for you, call one of our Account Managers to help you set rip a payment plan that does. Sincerely, D. Manning, Senior Group Manager (800) 282-2644 For ease and convenience, make payments online and view additional otters at: www.mitllandcretlitonline.com $1,548.08 We witl stop applying interest to your account! Your credit report wN bs updated with the payments madel" Once you make your agreed-upon payments to settle your account, your credit report will be updated as'Paid in Full't" US TODAY! (800}282-2644 " Your credit repod will not be updatetl if the federal reporting period has expired. PLEASE SEE REVERSE SIDE FOR IMPORTANT INFORMATION Pease lent offend return lower portion with payment irc the envelope provided •( ~ • Pa me t Optons~ MCM Account No.: 8532141749 Original Account No.: 4106360015785002 Current Balance: 81,548.08 Payment Due Date: 08-0T-2011 Amount Enclosed: y n i 1) Mail in this coupon with your payment 2) Pay by phone (800) 282-2644 Make Check Payable to: Midland Credit Management, Inc. IitCill Mitllantl Credit Management, Inc. P.O. Box 60578 Los Angeles, CA 900600578 I I, I,.I I...I I, ~,.I I..I I.,, i I„ ~, I , I ~ I„.11., i ~ 1, ..11. ~ I, I I ,,, I 12 8532141749 6 0092885 080711 3 00031. DOE]. MSt 5375951 .20110fi U03J `lltl. ~UV_tl 06/01 /2011 NATIONWIDE CREDIT, INC. 2002 SUMMIT BLVD, STE 600, ATLANTA GA 30319-1559 1-800-564-2395 RE:~J$1=_f',~L, 63031246 BAL: $161.63 This is to advise you that your delinquent debt with the above creditor has been placed with us for collection. Your account is now p st due and due in full. To settle the matter, you should send your payment for the above amount by heck or money order directly to DIRECTV in the enclosed envelope. The total account bal~nce as of the date of this letter is shown above. Your account balance may increase because of in Brest or other charges, if so provided in your agreement with your creditor. Unless you notify th s office within 30 days after receiving this notice that you dispute the validity of the debt o~ any portion thereof, this office will assume this debt is valid. If you notify this office in writing within 30 days from receiving this notice, that the debt, or any portion thereof is disputed, t is office will obtain verification of the debt or obtain a copy of a judgment and mail you a copy f such judgment or verification. If you request this office in writing within 30 days after receivi g this notice, this office will provide you with the name and address of the original creditor, if di Brent from the current creditor. PERSONAL AND CO~JFIDENTIAL PO BOX 26314 LEHIGH VALLEY PA 18002.614 I~I~I~~I~~,~~~uIIV FOR PROPER CREDIT TO YOUR CCOUNT RETURN THIS STUB IN THE ENCLOSED ENVELOPE W ITH YOU CHECK OR MONEY ORDER. BE SURE THAT OUR NAME AND ADDRESS A PEARS IN THE W INDOW. 014/D01 /7)CL/06/01 /201 aooie 'llllllllllllVlllVllllullllllllll *11152170004* WILLIAM G WERT Doi 725 YORKSHIRE DR CARLISLE PA 17013-3$53 PLEASE SEE REVERSE SIDE FOR IMPORTANT INFORMATION RE: DIRECTV 013354018 ID NUMBER: 11152170004 ACCOUNT NO: 63031246 BALANCE DUE: $161.63 AMOUNT ENCLOSED: $ O Change of address: Print New Address on Back ~~ DIRECTV PQ.80X. 6 PHOENIX AZ 85062-8626 II~~I~~I~I~II~~~~II~~~~I~II~~1~~11~~~~1~1~11~~~~1~1~11~~1~1~~1 01 11152170004 1 ,,..~„ EdenPURE® 7800 Whipple Ave. N.W., Canton, OH 44767 COLLECTION STATUS NOTIFICATION William Wert 725 Yorkshire Dr Carlisle, PA 17013-3553 5/18/2011 ~~~~~~~ /~ - y~v-~ 144292205/EHCL421/EHT5037/EPG4IDP Dear William Weft, Ycur insta, purchase of yo' we do not hear 6/07/2011, you: not affiliated credit. request neglect this m ment agreement you entered into on 10/13/2010 for the EdenPURE Infrared Heater is now in past due status. If rom you regarding the $$88.00 past due amount by account will be sent to an independent collection agency ith EdenPURE. This action could negatively affect future from other institutions. You can no longer afford to Please call', our special Customer Service Department today at 1-800- 811-32:37. Again!i, the final date for you to take action on this situation is 6/07/2011. ~~ Michael R. Puterbaugh Corporate Counsel ~~`x 3~~-y~~ ~ ~~~ ~~ 1 ~~` (4~ ~~- < PO BOX 1259, Dept #25271. OAppKS,gpPA 1945tltl6 qq ~~~~II~I~NI~~~~II ~~~I~~I RETURN SERVICE REQUESTED Date: Fehmary 04, 2012 Personad & ConfidenPiu[ ^IIIIIdIIIIIIIIPII^hudlllll'ulllllullllllPlnllhhllpll &513-339 w,,,., William Wert 72'.5 YORKSHIRE DR CARLISLE PA;17013-3553 Dear William Wert: ~~~ ~ ACA PO Box 7S Archbald PA 184113 ' `~`°;` ^^'"'~" "'° *Calls to or from this comoam may be monitored or recorded for uuulily assurance. Phone #:(570)R76-(1309 Fas #:(57(1)87G-8179 OFFICE FIOURS (Eastern Time) Monday - Thursdsly 9AM - 9PM Friday 9AM - SPM Saturday 9AM - 1PM Original Creditor: Citibaulc -1'he Home Depot Current Creditor: Jumpstarl Fund I LP Original Account #: 6(135320307296838 Reference #: JMP0001578 Curren) Balance Due: $962.91 Discounted Amt Due: $481.46 This account has been listed with our office for collection. It is our intention to work with you to resolve this collection account. We may report U is account to all national credit bureacs. You can enclose your payment in the envelope provided and make your check or m~ney order pa able to USCB Coloration. All payments and correspondence should be sent to our mailing address at PO Box 75, Archbald PA 18403. Shout you wish to speak to a rcpresentattve concerning your account you may contact this office at (570)876-6309. Please refer to the account number indicated above. Subject to your right to val'date as described below, at this time we are offering a 50°iu discount on the amount you owe. This opption evil] be availab a through 03/20/2012. After that date USCB reserves its right to close this offer or not to renew this offer. If we receive th~ discounted amount by 03/20/2012, you will have no further obligatton to our client regarding this delinquent account. This is an attempt to collect a debt, and any information obtained will be used for that purpose. This communication is from a debt collecl:or. Unless you notify this offi i; within 30 days after receiving this notice that you dispute the validity of this debt or any portion thereof, this office will ass ime this debt is valid. If you notify this office in writing vvrthm 30 days from receiving tliis notice that you dispute the validit of this debt this office will obtain verification of the debt or obtain a co y of a judgment and mail you a copy of such ju ment or verification. If you request of this office in writing within 30 days after rcceivmg this notice this office will provi c you with the name and address of the original creditor, if different from the current creditor. Sincerely, James Francis USCB Corporation A Professional Debt Recoviery Agency «<To pay online visit www.uscbcorp.com or to pay using our 24/7 automated system call (570)876-6309»> DETACH AND RETURN THIS PORTION WITH YOUR PAYMENT Original Creditor: Current Creditor: Original Account #: Reference #: Current Balance Due: Discounted Amt Due: CitiHank -The Home Depot Jum~pstart Fund 1 LP 6039320307296838 JMPp001578 $96.91 $481.46 R PAYrrIr~NG~BY W811, N/ISiBICMU~~[~O~IIB~C,O~~YEII CR AYENCAN E~~1I~i~I~RESB, FlLL CUr BELOW Ovlsn L~ ^M~BIERCAIIO C~ ^wecovEn ~rr`i1MJ OMIEN. FJP® cuoxuem m.urz nuwxr wIMTK MUST INCLU(IF 9 nlfll sn~,nnr rmt Frr>M HM.N IN CgND ^. ~ ~ .. ~ William 'Wert 725 YORKSHIRE DR CARLISLE PA t7013~3553 PLG9SE SEND.9L/. CQRRESPONDENCE T'O ~f/E /3E/.ON'ADURESS: U S C B CORPORA'110N P.O. BOX 75 ARCHBALD, PA 18403 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII11111,1 339 - CLV50.1 111111111111111111111111II Illllllllalllulll IIIIIIINIIII Dep't• >< 21377 PO Oox 1259 Oak~s• PA L9456 ADDRESS SERVICE REQUESTED First National Collection Bureau, Inc. 610 Waltham Way • Sparks, NV 89434 (800) 824-6191 June 03, 2011 Office Hours: Mon. - Fri. 6 a.m. - 6 p.m., Sat. 6 a.m. - 12 noon Pacific Standard Time '*Please remit all correspondence to the above address** jII111111'I'Il Pllil l'1'1111'+ lll^illll~dll~llllll~l"hl"i'i' 21 z88-seas #BW + #212 JGZF 815493723046# WILL AM G WERT 725 ORKSHIRE DR CARL SLE PA 17013-3553 Creditor: APPLIED 6ANK .~- Account #: AIX-1339257 Ref #: 034325778 Total Due: $2,266.10 This is to advise you that your delinquent account has been assigned to our office for collection by the above mentioned client. Unless you notify this office wi hin 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 ebt or any portion of it, this office well obtain verification of the debt or obtain 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 In order to aid your financial sikuation, as may be necessary, we could set up your account on a monthly payment plan. We would like to extend the following offer: A 40% discount payable in 3 payments of $453.22. Each payment within 30 days of the previous payment. We are not obligated to renewlthis offer. For your convenience you may pay via a check over the phone or credit card. You have our word that your a count executive will treat you fairly and with respect Sincerely, First National Collection Bure~u, Inc. This is an attempt to collect a ebt. Any information obtained will be used for that purpose. This is a communication from a debt collector. IF PAYYlO BY YUTAOR BTERCMD. FI.L OUT BEIDY/ f~iyi~. _ _ly ]H~ I_~ ~ ^ W,BTEI~IRD Isis UIO MAlMI ', oP.wrz MIDIYVr PMYT YAMF MIIt APPFAP51)Y CMD YIDIMTU! ' MUFT IYCLUDE LP<ODF PEOM BTRTEMFFi $50 minimum is requi}ed for credit card payments. 1 OF 3 Ref #: 034325778 MAIL PAYMENT" TO: FNCB INC. PO BOX 51660 SPARKS, NV 89435 PAYMENT AMT - $453.22 DETACH COUPONS AND MAIL PAYMENT" 20F3 Payment by Credit Cards -Transaction Fees MasterCard and Visa: $5.00 per $150.00 Ref #: 034325778 I MAIL PAYMENT TO: I FNCB INC. I PO BOX 51660 I SPARKS, NV 89435 I I PAYMENT AMT - $453.22 I DUE: 30 DAYS AFTER 1ST PAYMENT ~ DETACH COUPONS AND I MAIL PAYMENT I 2128&8838808 30F3 Ref #: 034325778 MAIL PAYMENT TO: FNCB INC. PO BOX 51660 SPARKS, NV 89435 PAYMENT AMT - $453.22 DUE: 30 DAYS AFTER 2ND PAYMENT DETACH COUPONS AND MAIL PAYMENT First PPREM/ER ® Ba nk t~ , June 14, 201 I TO 1-HE ESTATE OF WILLIAM G WERT 75 FICKES R© NEWIIILLE PA 17241-9461 To the Estate of WILliIAM WERT: First PREMIER© Bank N.O. Box 5524 3820 N. Louise Ave. Sioux Palls, SD 57117-5524 First PREMIER Bank recently received notitcation regarding the death of WILI_.IAM WERT. Please accept our sincere condolences_ To protect your familyli from unauthorized use of this account and to assist you during this time. we have outlined below ahe steps that need to be taken on your behalf. Account Management -The Firs[ PREMIER Bank credit card account ending in 0401 has been closed. The current balance is $524.38. If ~ou have not done so already, please cut in half and discard all credit cards associated with this account. ~. Automatic Billing -1#lease notify any merchants who automatically bill charges to this account of the account closure. This should prevent charges received after the date of closure to delay any refund that may be due on this account Such chargesmay include insurance premiums, magazine subscriptions or online services. Credit Protection- I~ credit life insurance was purchased in connection with this account, a claim will need to be submitted by calling central States Insurance of Omaha at 1-800-445-6500. If the account was enrolled in PREMIER Credit Protection, contact [he Benetit Administrator at 1-866-332-8226 regarding beneti[ activation. Estate Processing -The person(s) responsible for handling the estate of WILLIAM WERT is required by law to contact. creditors in writing of the financial status of [he estate and whether or not [here will be any estate. trust or other proceeding fi]edJ This should include instructions on where a claim is to be submitted or notification that no proceedings will occuti. Please notify us at the following address: ' First PREMIER Bank Deceased Claims Processing P.O. BOX 5524 Sioux Falls, SD 57 1 17-55 24 Fax:]-605-357-3438 If we do not receive n~tice that such a proceeding has been commenced. we reserve our rights as a creditor of the decedent to commenc an estate administration. Questions can he diredled to the Customer Service Department at 1-800-987-5521. Business hours are Monday- Friday t}om 7:00 a.mJto 9:00 p.m. and Saturday 8:00 a.m. [0 4:30 p.m. Central Time. Sincerely, M. Wilson Customer Service Department First PREMIER Bank 84 00073 0014147865-:1076 The federal Equal Credio Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race. color. n;ligion, national origin. sex. marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or pan of thNapplicant's income derives from any public assistance program; or bemuse the applicant has in good faith exercised any right ~nder the Consumer Credit Proration Act. The federal agency that administers compliance with this law concerning this creditor is the Federal Reserve Bank of Minneapolis. You may contact them at Federal Reserve Consumer Help, P.O. Box I?00. Minneapolis. MN 55480. Toll-fra: (888) 851-190. Fax: (877) 88R-?520. TUD: t877) 766-8533 First PREMIER ® Bank Member FDIC ~:>- ', June 14, 2011 TO THE ESTATE OF WILLIAM G WERT 75 FICKES RD NEWVILLE PA 17241-9461 To the. Estate of WILLIAM WERT: First PREM[ER®Bank P.O. Box 5524 3820 N. Louise Ave. Sioux Falls. SD 57117-5524 First PREMIER Banl~ recently received notitication regardio~ the death of WILLIAM WERT. Phase accept our sincere condolences. ', To protect your famiuy from unauthorized use of this account and to assist you during this time, we have outlined below the steps that creed to be taken on your behalf. Account Management-The First PREMIER Bank credit card account ending in 5571 has been closed. The current balance is $558.30. If you have not done so already, please cut in half and discard all credit cards associated with this account. ~. Automatic Billing -'IPlease notify any merchants who automatically bill charges [o this account of [he account closure. This should ~trevent charges received after the date of closure to delay any refund that may be due on this account Such charoep may include insurance premiums, magazine subscriptions or online services. Credit Protection - f credit life insurance was purchased in connection with this account, a claim will need to be submitted by calling ~entral States Insurance of Omaha at 1-800-445-65W. If the account was enrolled in PREMIER Credit Protection, contact the Benefit Administrator at 1-866-332-8226 regarding benefit activation. Estate Processing -The person(s) responsible for handling the estate of WILLIAM WERT is required by law to contact creditors in v~riting of the financial status of the estate and whether or not therr, will be any estate, trust or other proceeding Yile~. This should include instructions on where a claim is to be submitted or notification that no proceedings will occ r. Please notify us at [he following address: Firs[ PREMIER Bank Deceased Claims Processing P.O. BOX 5524 Sioux Falls, SD 57117-5524 Fax:l-605-357-3438 if we do not receive ~to[ice [ha[ such a proceeding has been commenced, we reserve our rights as a creditor of the decedent to commende an estate administration. Questions can he dirt}cted ut the Customer Service Department at 1-800-987-5521. Business hours are Monday- Friday from 7:00 a.n1. ro 9:00 p.m. and Saturday 8:O0 a. m. to 4:30 p.m. Central Time. Sincerely, M. Wilson Customer Service Department First PREMIER Ban: 83 00073 (X14440 34 8 6-7 5 3 9 The federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race. color, religion, nationallorigin. sex. marital status. age (provided the applicant has the capacity to enter intoa binding conlrnctl: because all or part of th applicani s income derives from any public assistance program: or because the applicant has in good faith exercised any righ~under the Consumer Credit Protection Act The federal agency [hat administers compliance with this law concerning this crtditar is the Federal Reserve Bank of Minneapolis. You may contact them at Federal 12eserve Consumer Help. P.Q_ Box 1200, Minne:~polis, MN 55480. Toll-Gee: (888) 851-1920, Fax: (8771 888-2520. TDD: (877) 766-8533 STATEMENT Forest Park Health Center Resident: Wert, William (23196) 700 Walnut Bottom Road Location: - Carlisle, PA 17013 Statement Date: 911/2011 (888) 880-7090 ALL TRANSACTIONS PROCESSED AFTER Aug 31, 2011 WILL APPEAR ON YOUR NEXT STATEMENT Paula Heckman 725 Yorkshire Drive Carlisle, PA 17013 Amount Due $800.00 PLEASE DETACH AND RETI~RN WITk~YOUR PAYMENT Amount Enclosed $ _. Forest Park Health Center Resident: Wert, William (23196) 700 Walnut Bottom Road ' Location: - Cariisle, PA 170'13 ', Statement Date: 911/2011 (888) 880-7090 Effective Date Description Units Unit Amount Amount BALANCE F~RWARD $400.00 2/2812011 Date of Servic 2/28/2011 BCBS Copay 1 $400.00 $400.00 BALANCE DIjE $800.00 Please call 888-880-7090 Ext. 872 if you have any questions. I Julie Please note, your account i PAST DUE. This amount is YOUR Copay from BCBS. You have received letters regarding your balance due Please submit payment in full as soon as possible or we will be forced to pursue further legal action. IN THE COURT OF COMMON PLEAS OF Cumberland COUNTY, PENNSYLVANIA ORPHANS' COURT DMSION IN RE: ESTATE OF No.: 2011-00336 WILLIAM'I G WERT (Dweaaed) CLAIM To the Cleric of Orpha~os' Court Division: Index and mdke proper entry in }roar ofncial record of claim of HOUSEHOLD RECOVERY SERVICES c/o Weltmag. Weiabeta & Reis Co.. L.P.A.. 323 W. Lakeside Avenue Cleveland. OH 44113-1009. Account No.: xxxxxxxxxx1870 / Lr$tallment Loan account unsecured in the amount of $7.109.80. against the estate of the above named decedent This claim is filed under section 3532 (b) (2) of the Probate, Estates and Fiduciaries Code. The said decedent, who resided at 725 YORKSHIRE DR CARLISLE. PA 17,QL'I, died on March 3.2011. Written notice of this Maim was given to PAULA HECKMAN. Fiduciarvl c% ANDREW SHAW. Esquire at 200 S SPRING GARDEN S!f. CARLISLE. PA 17013 oa y~iav 26.2011. ~~~. Susan Takata Authorized Agent for Claimant Weltmm, Weinberg & Reis Co., L.P.A 323 W. Lakeside Avemre Cleveland, OH 44113-1009 Telephwa 1-800-807-7796 W WR# 9120407 J.C. Christensen ~., & Associates, Inc. P.O. BOX 519, SAUK RAPIDS, MN 56379 TOLL FREE#: 1-866-768-5813 06/23/11 FILE #: 11572787 ORIGINAL CREDITOR(S) GE Capital CLIENT RESURGENT CAPITAL SERVICES LP CURRENTCREDITC~R(S) LVNVFUndingLLC REGARDING 6032203133661230 AMOUNT OWED $963.35 MERCHANT: Wal-Mart TOTAL DUE: $963.35 Dear Executor: We understand thej person listed below has passed away. On behalf of our client, RESURGENT CAPITAL SERVICES LP we Avould like to extend our condolences for your loss. We realize that this is a trying time however there is an outstanding amount due of $963.35 to our client. To finalize and clo a the account related to the estate, we are extending a settlement offer of 70% of the total amount due. A on~ time payment of $674.35 will clear the matter up. The opportunities listed above do not alter or amend your valuation rights described below. We are not obligated to renew this offer. To take advantageof this opportunity or to discuss other options, the Executor or Personal Representative will need to establish c ntact with our office representative at 1-866-768-5813. This offer will expire 40 days after the receipt of this notice. Sincerely Joe Mathis Probate Departure t Unless you notify t is 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 from receiving this notic that you dispute the validity of this debt or any portion thereof, this office will obtain verification of the d bt or obtain a copy of a judgment and mail you a copy of such judgment or verification. If you request this office i 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 communicatioh is from a debt collector. This is an attempt to collect a debt and any information obtained will be used for that purpose. JCC receives incoming calls Central Time Monday-Tuesday Sam-9pm, Wednesday-Friday Sam-5pm, Saturday Sam-noon PLEASE DETACH AND RETURN THIS PORTION WITH YOUR PAYMENT RPt PG Box 1952 I authorize the following amount to be charged tom credit Southgate, MI 4 195-0952 card shown ~ ~ ~ ® ~ ® ~ IIIIIII'IIIIIIIIIIIIIIIIIIIIIIIII Cardholder name: _ Exp. Date: IIIIIIIIIHIIII~IIIIIIIIIIIIIII .Account#: -~~- ~~- ~ -~~- ~ ~~;~~- 06/23/11 Amount $: _ Signature: File Number: 11572787 Balance Due: $963.35 Client Account: 6032203133661230 224073132777 448110002149/0009 IJI'~'II'~I~I~~'~'~I"~,I'III~~~~IIIII~I.,IIIIIII'I"~~I'lll~~d The Executor of: William Wert 72;5 Yorkshire Dr Carlisle, PA 17013-3553 PLEASE SEND ALL CORRESPONDENCE TO: J.C. CHRISTENSEN AND ASSOCIATES, INC. P.O. BOX 519 SAUK RAPIDS, MN 56379 I~I~I~~II~~~~II~I~~~II~i,~II~~~~I~I~~~~III~I~~~I~I~I Toll Free#: 1-866-768-5813 MOFFITT HEART & VASCULAR GROUP 06/24/11 198891 1000 NORTH FRONT STREET ~ WORMLEYSBUFIG, PA 17043 30.00* Forwarding Service Requested _MC -VISA -Disc Security Card~~ Code _ Sign Exp _/_ .~-- ,,,,,_ 35738 WILLIAM WERT MOFFITT HEART & VASCULAR GROUP 75 FICKES RD 1000 NORTH FRONT STREET NEWVILLE E'A 17241-461 WORMLEYSBURG, PA 17043 •• ••• • • MESSAGES EXPLAINED ~ BEL W *** Pay Account Ba~ance Immediately to Avoid Collection Agency!!!!!! *** *** Thankk you for your prompt payment. Please call 717-731-8315 with any *** *****~~~~~fr~~~.~****~*************************************************************** Ins~rance Charges pending to Prv: 160.00 Ins ,Pay/Adj against Ins pending 72.00 -88.00 0.00 07/27/10 1 ].2 L ECHQ,(2D) W/DOPPLER/COLOR 93306 429.3 650.00 08/11/10 C BS OUT OF Payment 274.00 08/11/10 ccept Assign Adl. -346.00 30.00* L-The 'PLEASE PAY' includes unpaid co-pay or co-ins. Please make payment. DATE LAST PAID AMDUNT ~ • - ~ • - . ~ • - • ~ • • : , . 00/00/00 0.00 0.00 0.00 0.00 0.00 30.00 0.00 0.•00 •30.00 TAKE MOFF'ITT HEART ~.& VASCULAR GROUP :HECK 1000 NORTH FRONT STREET AvASLETO: WORMLEYSBURG, PA 17043 PAT/~ 1-WILLIAM WART PRV~~ 12-MANDAK, JEFFREY, MD, FAC ~ ., , ~ 30.00* Ph:(717)-731-0101 Accts/: 198891 Date: 06/24/11 Page 1 of 1 P.O. BOX 15270, DEPT 55 WILMINGTON, DE 19850 ~IIIIII IIIIIIIIIIIIIIIIIIII"IIIVIIIIIIIIIIIIIVIIIIIIIIIII 58071294/8 111111'1"illllllilll'lll'II'111'll"tll'I'll'I'lll'lll'lll'lll~ rtes&235 WILLIAM G WERT 725YORKSH[RE!DR CARLISLE PA 171113-3553 NCO FINANCIAL SYSTEMS, INC. 306(1(1 TELEGRAPHI RD SUITE 4235 BINGHAM FARMS. Ml 48025 November 27, 2011 OFFICE HOURS: MON: I I:OIIAM - B:OOPM ET TUES - FRI: B:OOAM - S:Ol1PM ET PHONE: R00-7R5-U26 CARLISLE REGIONAL MEDICAL CENTER RE: WILLIAM G WERT RE: 1087484 DATE OF SERVICE:: 02/15/1 I BALANCE: $ 50.00 Tour Account May be Credit Reportc-d! Our records indicate that your 1}alance of $50.00 is due in full. ll is our intention to work with you [o resolve this collection account. However, subject to your dispui'H and validation rights provided on the reverse side of this letter, if you fail to resolve this collection account we may report the account to all national credit bureaus. To assure propelr credit, please put our reference mm~ber 580712')4 on your check or money order. Calls to or from this company :hay be monitored or recorded for quality assurance You may also make payment dry visiting us on-line ut www.ncofinanciaLcom. Your uniyue registration code is f25.23471R22.SR1171294.1112R. o receive fidure notices for the ac;count(s) by a-mail, visit www.ncoGmmciaLcom lbr details. This is an aitenipl to collect a debt. Any information obtained will be used for that purpose. This is a communication from a debt col lector. Notice: Se Reverse Side For Important Information. See Reverse Side fur Federal Validation Notice. PLEASE RETURN HIS PORTION WITH YOUR PAYMENT (MAKE SURE ADDRESS SHOWS THROUGH WINDOI Creditor Reference R: 1087484, WILLIAM G WERT NCO Financizil Systems, Inc; 30600 TELEGRAPH RD SiJITE 4235 BINGHAM FARMS, MI 48025 PHONE: 800-785-1426 0255580712947000~005500000000000050003 Our Reference # Total Balance 58071294 $ 50.(111 Payment Amount i Make PeymeM To: NCO FINANCIAL SYST'EMS,INC. P.O. BOX 1521'0 WILMING"CON, DE 19850 I...Illrl..l..l,.lrlrllrr~lrr.ll Nco a P 235 P.O. BOX 15.?70, DEPT 55 WILMINGTON, DE 19850 ~~'~~I'~1'~ ~If~~ ~~~~~ I'~t~ illl) I~I~t ~t'~~ ~"~~ ~~~" ~~~~ ~"~ 58214743/8 I~IIltlilll~~'~ixx,1x11,xl'ill'l~l'~~'~•Itllllll~l~llll'~"~'lll 11959-93a ,Ky,.~ WILLIAM G WERT IJ.~°`~ 725 YORKSHIRE DR CARLISLE PA 17013-3553 NCO F1'NANC'LAL SYSTEIVIS, INC. 30600 TELEGRAPH[ RD SU[TE 4235 P.IN(iHAM FARMS, NII 48025 llc'cember 1I, 2011 OFFICE IiOURS MODl: l I :OOAM - B:OOPM ET TUES - FRL: B:OOAP~I - S:OOPM E'C PHONE: 800-785-] 426 CARLISLE REGIONAL MEDICAL CENTER RE: WILLIAM G WERT RE: 1095275 DATE OF SERVICE; 03/15/1 ] BALANCE: $ 100.(10 Your Account May be Credit Reported! Our records indicate [hat your~balance of $100.00 is due in full. Il is onr intention to work with you to resolve this collation account. However, subject to your disp to and validation rights provided on the reverse side of this letter, if you fait to resolve this collection account, we may report the ac~ount to all national credit bureaus. To assure proper credit, pleas put our reference number .'.8214743 on your ch~k or money order. Calls to or from this company may be monitored or recorded for quality assurance. You may also make payment by visiting us nn-line at www.ncofinancial.crnn. Your uuiyue registration code is f25.23471822.582I4743.I02('. To receive future notices for the account(s) by a-mail, visit ~titivw.ncofinancial.wm Cor details. This is an attempt to collect a debt. Any information obtained will be used for that purpose. This is a canmunication from a debt collector. Notice: $ee Reverse Side For Important information. Sec Reverse Side for Federal Validation Notice. PLEASE RETURN THIS PORTION WITH YOUR PAYMENT (MAKE? SURE ADDRESS SHOWS THROUGH WINDO' Creditor Refrrena t!: ]0952T5, WILLIAM G WERT NCO Financiai Systems, Iytc. 30600 TELEGRAPH RD ~UITE 4235 BINGHAM FARMS, MI 48025 PHONE: 800-785-1426 0255582147430000^[JSSOC1l7l7Qdf1(lOfl01000f14 Our Reference # Total Balance 58214743 $ 100.00 1'aytnent Amount l Meka Poymx>nl To: Nt.'.O FINANCIAL SYSTEIVIS,INC. P.U. BOX 15270 WILMINC,TON, DE 19850 Ixxxlll11,111x1x11xlx111111x~xll NCO 8 P 834 P.O. BOX 1.5270, DEPT 55 WILMINGTON, DE 19850 57470730/8' 1'llllll~l~'I'~~IIII"'I'1111111'~'t~11111~~1~1,~,1~~'I~~I.~~~II. i~asasaoa ..t WILLIAM G WFRT 725 YORKSHIRE DR CARLISLE PA '.17013-3553 NCO FINANCIAL SYSTEMS, INC. 30600 TELEGRAPH RD SUITE 4235 BINGHAM FARMS, MI 48025 September 25, 2011 OFFICE HOURS: MON: 11:OOAM - 8:OOPM ET TUES - FRI: 8:OOFtIvf - S:WPM ET PHONE: 800-785-1426 CARLISLE REGIONAL MEDICAL CENTER RE: WILLIAM G WERT RE: 1085020 DATE OF SERVICE: 01/27/11 BALANCE: $ 189.53 Your Account May be Credit Reported! Our records indicate that yo~r balance of $189.53 is due in full I[ is our intention to work with you to resolve this collection account. However, subjjecl to your dis u[e and validation rights provided on the reverse side of this letter, if you fail to resolve this collection account, we may report the a count to all national credit bureaus. To assure proper credit, plea~e put our reference number 57470730 on your check or money order. Calls to or from this compan~ maybe monitored or recorded for quality assurance. You may also make payme~rt by visiting us on-line at www.ncofinancial.com. Your unique registration code is (25.23471822.57470730.1025. To receive future notices for the acconnl(s) by a-mail, visit www.ncofinancial.com For details. This is an attempt [o wllect ~ debt. Any information obtained will be used for that purpose. This is a communication from a debt collector. Notice: ee Reverse Side For Important Information. Sec Reverse Side for Federal Validation Notice. PLEASE RETUR~ THIS PORTION WITH YOUR PAYMENT (MAKE SURE ADDRESS SHOWS THROUGH WINDOW Creditor Reference #: 10850 Q WILLIAM U WERT NCO Financial Systems, nc. 30600 TELEGRAPH RD~UITE 4235 BINGHAbf FARMS, MI 18025 PHONE: 800-785-1426 Credit Card Number (VISA ana Mas~erGaN only) Our Reference # Total Balance 57470730 $ 189.53 Payment Amount i Make PeymeM To: NCO FINANCIAL SYSTEMS,INC. P.O. BOX 1 `i270 WILMINGTON, DE 19850 I~~~III,I~~I~~I~~1~1~11~~~1~~~11 NCO 8 P 025557471773~40m000055001701I170~000189533 34os P.O. BOX 1527Q, DEPT 55 WILMINGTON, DE 19850 I Illlll Illll VIII lllll VIII VIII I'll) "III ~"" VIII Ilil IIII 57470734/8 NCO FINANCIAL SYSTEMS, INC. 30600 TELEGRAPH RD SUITE 4235 BINGHAM FARMS, MI 48025 September 25, 2011 OFFICE HOURS: MON: 11:OOAM - 8:OOPM ET TUES - FRI: S:OOAM - S:OOPM ET PHONE: 800-785-1'126 I,t.,1.ulllrr•IlPulhlthuhdl,lllr~ll~lrul,~luPlidl „asesnor WILLIAM G WERT 725 YORKSHD3EI DR CARLISLE PA 1/013-3553 CARLISLE REGIONAL MEDICAL CENTER RE: WILLIAM G WERT RE: 1086813 DATE OF SERVICE: 02/01/11 i BALANCE: $ 50.00 ' Your Account May be Credit Reporied! Our records indicate that your ~alance of $50.00 is due In full. It is our intention [o work with you to resolve this collection account. However, subject to yow dispu a and validation rights provided on the reverse side of this let[e;r, if you fail to resolve [his collection account, we may report the a ount to all national credit bureaus. To assure proper credit, please put our reference number 57470734 on your check or money order. Calls to or from this company nay be monitored or recorded for quality asswance. You may also make payment by visiting us on-line at www.ncofinancial.com. Your unique registration code is f25.23471822.57470734.]029. To receive future notices for the account(s) by a-mail, visit www.ncofinancial.com for details. This is an attempt to collect a debt.. Any information obtained will be used for [hat purpose. This is a cormnunica[ion from a deb[ collector. I Notice: S e Reverse Side For Important Information. See Reverse Side for Federal Validation Notice. _:__ _ _ PLEASE RETURN HIS PORTION WITH YOUR PAYMENT (MAKE SURE ADDRESS SHOWS THROUGH WINDOW Creditor Reference k: 1086813 WILLIAM G WERT Our Reference # Total Balance NCO Financial Systems, In . 57470734 $ 50.00 30600 TELEGRAPH RD SI~JITE 4235 BINGHAM FARMS, MI 4025 Payment Atnount ^ PHONE: 800-785-1426 I i Credit Card Number (VISA end MasierC'artl only'i Make PoymeM To: NCO FINANCIAL SYSTEMS,INC. P.O. BOX 15270 WILMINGTON, DE 19850 I,,,I I I,I„I„I„I,I,II,,,I,~, II NCO 8 P 025557470734111]Og00055001]001100000U50000 3ao7 PATHOLOGY ASSOCIATES OF CENTRAL PA 9520 UNION DEPOSIT RD. HARRISBURG, PA 17111 (717) 652-6105 ~t~o ~S ~ , ~(L;-5 Patient Acct #: 139399 WERT, WILLIAM G 75 FICKES RD NEWVILLE, P.A 17291 Responsible party: WERT, ESTATE OF WILLIAM G 75 FICKES RD NEWVILLE, PA 17241 Srvc. Date Proc. Code' Proc. Description Charge Balance Physician 08/17/2010 88392 IMMUNOCYTOCHEMISTRY $605.00 $80.02 Bentz, Michael S Insurance Payment : 09X09/2010 of $953.98 Adjustment: $71.50 08/17/2010 88307 Insurance Payment: 09 Patient Payment: 02/0 PLEASE SEND US A COPY OF THANK YOU. SURGICAL PATH LEVEL 5 $220.00 $10.98 Bentz, Michael S 17/2010 of $79.90 Adjustment: $126.00 /2011 of $3.12 TOTAL BALANCE: $91.00 Print Date: 09/19/2011 ~'HE DEATH CERTIFICATE AND LETTER STATING NO ESTATE IS THERE IS NONE. ', This report has been Reproduced from the. Original ~teproduced Tuesday, April 19, 2011 03:51:96 PM (mgallo) Page 1 of 1 I VIII I I I II I VIII III I I VIII IIII I VII I VI I I VII I PO Box 5790 Hauppauge. NY 11788-0164 RETURN SEF2VICE REQUESTED May 4, 2011 17912095-105 540109133 r~rrhh~IrIhIIIIlrrrhlrrllPl~ilPduPlrrlrlrrrllll4ggl The Estate of: William Wert 725 Yorkshire Dr Carlisle PA 17013-3553 Re: Client: P 'rtfollo Recovery Associates- LLC Original Creditor: Or hard/Sub Prime Client Acd#: ""'""'2878 Reference: 17 12095 Balance: S6 7.12 To the Estate of William W~rt Phillips 8r Cohen Associates, Ltd. Ph 800-477 6441 • Fx 302-368-0970 Office Hours: M•Th: Sam-9pm, Fri: Sam-6pm ;Sat: Sam-12pm Phillips & Cohen Associates, Ltd. Mail Stop: 789 1002 Justison Street Wilmington, DE 19801-5148 I~~~Ill~l~~l~~l~ll~~~~~~ll~l~l~~~~ll~l~~ll~~l~ll~r~~~l~l~~~lll Reference #: 17912095 Balance: $627.12 ENVELOPE WI7H YOUR PAYMENT"' Our client Portfolio Recove Associates- LLC recently received notification that William Wert passed away. Initially, on behalf of our client and our office, lease accept our condolences. This account was referred t our office because we are specialists in the area of deceased account care, and because William Wert was a valued account holder. As it is our goal to assist family members/loved ones through this process, enclosed is an informational leaflet providi g helpful tips, guidance and support during this difficult time of managing the final affairs of William Wert. At this time, we are seekin information regarding the Estate of William Wert, including information about who is administrating the final affairs, if there is n tan estate. While family members and /or loved ones are not personally liable for this account, we are trying to contact the pa handling the final affairs to ensure the proper resolution of the account. Please contact our office at 800-477-6441 to provide information about the estate, and to speak with our specially trained deceased care agents. Sincerely, I Phillips 8 G~hen Associate ,Ltd. Though our goal is to assis family members/loved ones during this difficult time, we are required by law to provide you with the information below. "'IMPORTANT CONSUMER INFORMATION" Unless you notify this offic within thirty (30) days after receiving this notice that you dispute the validity of this debt or any portion thereof, this office ill assume this debt is valid. If you notify this office in writing within thirty (30) days from receiving this notice, this office will: o fain verification of the debt or obtain a copy of a judgment and mail you a copy of such verification or judgment.. If you reques this office in writing within thirty (30) days of receiving this notice, this office will provide you with the name and address oft a original creditor, if different from the current creditor. This communication is from a debt collector. This is an aftempt to collet a debt and any information obtained will be used for that purpose. Phillips & Chen Associates, Ltd. • 1002 Justison Street • Wilmington, DE 19801 .800-477-6441 292CSPCAL03105 ill IIIII II I III IIIII IIIII IIIII IIIII IIIII VIII NII VIII IIII IIII PO Box 5790 Hauppauge, NK 11788-0164 RETURN SER`JICE REQUESTED April 28, 2011 17822238-592 53Q233042 dlpnFgFIFtFFFglllhurllhtllll~InyIIPI~IIIdFIFIIIFIpI William Wert 725 Yorkshireo Dr Cadisle PA 17013-3553 Reference #: 17822238 Ralance:$13,760.58 DETACH AND RETURN IN THE Re: Cllent: S ntander Cllent Acct #: * '»"»""1000 Reference #: 1 822238 Balance: $ 3,780.58 Dear William Wert: Phillips 8 Cohen Associates, Ltd. Ph 888-344-0900 • Fx 302-368-0970 Office Hours: M-Th: 8am-9pm, Fri: Sam-6pm Sat: 8am-12pm Phillips & Cohen Associates, Ltd. Mail Stop: 2000 1002 Justison Street Wilmington, DE 19801-5148 IFFFIIIIIFFIIIIFIIaFFIIaIIFIINIIFFIIIIaFIIIFIlI1FFlllIIIFFFll1 O O CHECK GRD UGING FOR PAYMENT ^ ® CARD NUMBER PLU5301GIT BECURITV C OE (an back of mM) E%P. DATE I CARDHOLDER NAME AMOUNT f CARDHOLDER GIGNATURE We had hoped that you woul resolve your financial obligation with Santander prior to initiating further collection activity to recover the amount owed to hem. Apparently that is not the case. In an effort to reach a mutua~y acceptable remedy to this matter, our client has agreed to offer you the opportunity to settle this indebtedness for 60°/D of the amount owed or $8,256.35. If this matter remains unresolved, we will have no other alternative but to evalual:e your credit hi tory and present financial ciroumstances, then proceed accordingly. You now have an extremely mportant decision to make. The wrong choice could ultimately be more costly to you in the future, as this offer b~ set0e at a red ced rate may not be available. If you are unable to pay in fu I or settle at the reduced rate, contact our office today. You may qualify for our hardship program. However, please be advised that your failure to respond will leave us with no option but to use the resources of this agency to explore all means of recove ng the total amount due to our client. Time is of the essence. We genuinely hope that you resolve this obligation without the need for further collection activity. Should you have any questi ns regarding this matter please call at the above referenced number. Sincerely, Phillips 8 Cohen Associates Ltd. Payment by credit card transaction fees: MasterCard, Visa and Discover $5 per $150. ', ""IMPORTANT CONSUMER INFORMATION "" This communication is from ~ debt collector. This is an attempt to collect a debt and any information obtained will be used for that purpose. Phillips & Cofhen Associates, Ltd. • 1002 JusOson Street • Wilmington, DE 19801 •888-344-0900 1CSPCALO&592 BUREAU OF ACCOUNT MANAGEMENT 3607 Rosemont Avenue, Suite 502 PO Box 8875 Camp Hill, PA 17001-8875 Telephone:l-717-214-3017 Toll free: 1-800-599-0423 Monday -Thursday 8:30 - 8:30 (EST) Friday 8:30 - 5:00 (EST) March 1, 2012 In Re: Pinnacle Health Hospital Amount Due : $].50.00 William G Wert Account # :28037969 725 Yorkshire Dr Client Ref. # :1].0037925 Carlisle, PA 17013-3553 Date of Service : OE.-17-10 William G Wert Your account has been placed with this office for collection. This notice has been sent to you by a debt collection agency. Payment in full is being re'p~1uested to resolve this fast-due account. If payment in full is not received, this account maybe reported ~S "placed for collection' with the credit bureaus. If you have any questions all our office using the account # as a reference to your file. Unless you notify this offi a within 30 days after receiving this notice [hat you dispute the validity of this debt or any portion thereof, this o~fice will assume this debt is valid. If you notify this office in writing within 30 days from receiving this notice, this office will: obtain verification of the debt or obtain a copy of a judgment and mail you a co y o1` such judgm nt or verification. If you request this office in writing within 0 days after receiving this notice, this office will pro ide you with the name and address of the original creditor, if different from the current creditor. This is an attemjtt to collect a debt by a debt collector and any information obtained will be used for that purpose. Your payment should be ade directly to this office for prompt credit to your account. Atwenty-dollar service charge will be added to al~checks returned to us by our bank. Should you desire a receipt, a self addressed, stamped envelope is requi ed. Bureau Of Account Management ------------------~--------Detach and Return with Payment--------------------------- PO Box 8875 Camp Hill, PA 17001-875 Return Service Requested'. PERSONAL & CONFIDENTIAL William G'Wert 28037969 725 Yorkshire Dr Carlisle, PA 17013-3553 L~JIh~dI1~~~~iJInI1~~Jh~Lh~IId~olh~d~LIJ~~LLI To pay by credit card, please complete the information below: Check one: ^ Visa ^ MasterCard Card Number: _____________ Expiration Date: ~~_ Payment Amount: Signature: Amount Due : $150.00 Account # :28037969 Client Ref. # :110037925 Date of Service : 08-17-10 Amount Enclosed $ Bureau of Account Management PO Box 8875 Camp Hill, PA 17001-8875 t~~~II1~~~111~~~I1~~~~~~IIh~hL~LL~ddd~L~~hLh~~dl1 DCB01 001273P 1 0'13 000162 61 078808 Z-CRE BUREAU OF ACCOUNT MANAGEMENT 3607 Rosemont Avenue, Suite 502 PO Box 5875 Camp Hill, PA 17001-8875 Y .. _ .. .... w.. . ~'AIf~RITY NOTICE Telephone: 1-717-21.4-3017 Toll free: 1-800-599-0423 Monday -Thursday 8:3U - 8:30 (LS"h) Friday 5:30 - 5:00 (EST) August 2, 2,011 Estate Of G William Wert 725 Yorkshire Dr Carlisle, PA, 17013-3553 Estate Of Ci William Wert ,. In Re: Your Crediitors 1 ~y• rf`~ ~'1~1 ~~ f -1~~~ " .~ Amount Duc : $129.35 Account # : '1,7739918 Client Ref. # : JI34394 ('lease see reverse side for important account information. We sent you a first notic~, which included your rights under the Fair Debt Collection Practices Act. Your account remains unpaid and we have not heard from you concerning your rights. This past-due account n~eds to be paid in full. If you have any questions call our office using the account # as a reference to your file. Remember that your account may be reported to the credit bureaus Your payments should a made directly to this office for prompt credit to your account. Atwenty-dollar service charge will be added to II checks returned to us by our bank. Should you desire areceipt, aself-addressed, stamped envelope is required. This is an attempt to col~ect a debt by a debt collector and any information obtained will be used for that purpose. Bureau Of Account Management PO Box 8875 Camp Hill, PA 170018875 Return Service Request~d To pay by credit card, please complete the information below: Check one: ^ Visa ^ MasterCard Card Number: _ _ _ _ _ _ _ _ _ _ _ Expiration Date: ~_~ Payment Amount: Signature: Amount Due : $129.35 Account # Client Ref. # :134394 Detach and Return with Payment----- PERSONAL & CONFIDENTIAL Estate Of G William Wert 27739916 725 Yorkshire Dr Carlisle, PA 17013-35'53 Iud16~dlLoudlnlLuFhd~LJJmIL~d~LL1~JJd Amount Enclosed $ Bureau of Account Management PO Box 8875 Camp Hill, PA 17001-8875 h~dlh~~Ilh~dL~~~~Jlhdd~~LI,~~LIdJ~~d~Lh~~Jll 27739918 PKTC802 000073P 1 716 000068 $13 076808 Z-CRE BUREAU OF ACCOUNT MANAGEMENT 3607 Rosemont Avenue, Suite 502 PO Box 8875 Camp Hill, PA 17001-8875 Telephone: 1-717-214-3017 Toll free: i-800-599-0423 Monday -Thursday 8:30 - 8:30 (EST) Friday 8:30 - 5:00 (EST) September 12, 2011 William G Wert 725 Yorkshire Dr Carlisle, PA 17013-3553 Wilfiari O vJart In Re: Pinnacle Health Hospital Amount Due : $603.00 Account # :27833749 Client Ref. # : 10 7 6 Date of Service : 08-03-09 Your accowtt has been paced with this office for collection. This notice has been sent to you by a debt collection agency. Payment in full is being r quested to resolve this fast-due account. If payment in full is not received, this account maybe reported~as "placed for collection' with the credit bureaus. If you have arty Unless you notify this off any portton thereof, this from receiving this notic< you a coppy of such judgm notice, thts office will prc creditor. This is an atten that purpose. Your payment should be charge will be added to a stamped envelope is regt Bureau Of Account call our office using the account # as a reference to your file. within 30 days after receiving this notice that you dispute the validity of this debt or ce will assume this debt is valid. If ou notify this office in writing wtthin 30 days tis office will: obtain verification ofYthe debt or obtain a copy of a judgment and mail or verification. If you request this office in writing within 0 days after receiving this e you with the name and address of the original creditor, if different from the current to collect a debt by a debt collector and any information obtained will be used for tade directly to this office for prompt credit to your account. Atwenty-dollar service checks returned to us by our bank. Should you desire areceipt, a sel -addressed, -----------------------------------1----~ PO Box 8875 Camp Hill, PA 17001->~875 Return Service Requested Card Number: ___________ Expiration Date: ~ L-Payment Amount: Signature: Amount Due : $603.00 Account # :27833749 Client Ref. # :100027736 Date of Service : OS-03-09 Detach and Return with Payment------------------------------------------------------ To pay by credit card, please complete the information below: Check one: ^ Visa ^ MasterCard PERSONAL & CONFkDENTIAL William G Wert 27833749 725 Yorkshire Dr Carlisle, PA 17013-3553 h~JIh~~IIL~x~~JLdL~~Ih~LI~d~L~~IL~~IJJd~d~Ll DC601 000112P 1 '777 000042 254 76808 Z-CRE Amount Enclosed : $ Bureau of Account Management PO Box 8875 Camp Hill, PA 17001-8875 h~Jlh~dlh~JL~~~~~IILJJ~d~L~dddd~~ddd~~~~lll PINNACLEHE.ALTH CARDIOVASCULAR INST, INC 1000 NORTH FRONT STREET WORMLEYSBU:RG, PA 17043 Address Service Requested 30.00* 04/22/11 ~ 198891 _MC _VISA _Disc Security Card/ Code _ Sign Exp _/_ 26264 WILLIAM WERT 75 FICKES RD NEWVZLLE PA 17241-9461 PINNACLEHEALTH CARDIOVASCULAR INST, INC 1000 NORTH FRONT STREET WORMLEYSBURG, PA 17043 MESSAGES EXPLAINED *** Pay Account Bajlance Immediately to Avoid Collection Agencp!!1!!! *** *** Thank you for your prompt payment. Please call 717-731-8315 with any *** *** questions. >k>k* >k ir>k>4*:, :c >k ., skit>'c 9r is ski is ~4 i<liric'.c ~k ic:c3c it 4r***:k ~YaYir is ~k irir4r it ik*4cir4c4r>k>Yit,k~4 it is ic',r~k iciriric is iritir ~'r~k*ir>k irir ~k is is A'.'r ~k Yr9r is irak Insurance Charges pending to Prv: 160.00 Ins Pay/Adj against Ins pending 72.00 -88.00 0.00 07/27/10 1 12 L ECH,b,((2D) W/DOPPLER/COLOR 93306 429.3 650.00 08/11/10 BC/BS OUT OF Payment 274.00 08/11/10 Accept Assign AdI. -346.00 30.00'k L-The 'PLEASE PAY' inclludes unpaid co-pay or co-ins. Please make payment. DATE LAST PAID AMOUNT • - ~ • - . ~ • - • ~ • - ~ . . . :.. - 00/00/00 0.00 I.00 0.00 0.00 0.00 30.00 0.00 0.00 30.00 PINNACLEHEALTH CARDIOVASCULAR INST, INC HECK 1000 NORTH FRONT STREET nvaeLEro: WORMLEYSBURG,. PA 17043 PAT/ 1-WILLIAM Wi,ERT PRV~~ 12-MANDAK, 7EFFREY, MD, FAC; 30.00'k Ph:(717)-731-0101 Acct~~: 198891 Date: 04/22/11 Page 1 of 1 r Praxair Healthcare Service 120 Marc Drive Cuyahoga 1=alls, OH 44223 866-775-3099 MONTHLY STATEMENT L.,IIIfrflllrrr~~rrlLJlffJLJ,IrJrlrrJhf,LIrIrLrlfLl "AUTO"A,LL FOR AADC 170 10 - 2317 1102 WILLIAM WERT 725 Yorkshire Dr Carlisle PA 17013-3553 AXG08 000 X0000032289 PLEASE CHECK BOX IF ABOVE ADDR 55 IS INCORRECT OR INSURANCE INFORMATION HA:i CHANGED, AND INO~ICATE CHANGE(S) ON REVEP.SE SIDE i,_~',s M ~. i .: IiL „7..;i ~ "'al a IiM V, i}'i , s, ~~1: Nanie WILLIAM WERT AXGOS 1 of 1 `.ale eti Vie'- ~i= v, Do aCaY~ ot~ r. '~a•+: Ai$o4 [ se r Saturday, AprO 30, 2011 05/28/2011 $32.28 I, a v rocnrr rewn ni i ni it Tuc cnwM wwi nw __,,,__. Code on beck of card CARD TYPE ^ .... ^ L____~ ~ ~ .'. ` . +a CARD NUMBER AMOUNT SIGNATURE EXP. DATE y NG4~i,'PAYf~~~T.Tb '.. „` , ' "'' `, `, ~. Praxair Healthcare Service P.O. Box 121183 Dallas, TX 75312-1'183 8C PLEASE DETACH AND RETURN THE TOP PORTION OF THIS STATEMENT WITH ~C YOUR PAYMENT. RETAIN THE BOTTOM PORTION FOR YOUR RECORDS. '~, WILLIAM WERT ' _ ~turday, April 30, 2ott ~ 1 of 1 _ Date of Invoice Item Item Description Customer Service Number '. Balance 01/21/2011 00783573 ' CHARGE MEMO - REFER TO INV# 8534608 RENT PORTABLE GAS SYS W/0 OC $4.31 01/21!2011 1)0783573 CHARGE MEMO - REFER TO INV# 8534608 RENT CONCENTRATOR aisas098-10 $25.97 03/25/2011 08888815 '. FINANCE CHARGE $1.00 04/29/2011 08937716 FINANCE CHARGE $1.00 $1.00 $7.00 t~.. f, Radiology Diagnostics, LLC ~, Date: 9/1/2011 WILLIAM WERT 725 YORKSHIRE DR CARLI'iLE, PA 17813 Referring Doctor DR. CHASTITY KELLER Dateol'Service 2/10/2011 Type of Service I Specialist X-Ray Interpretation P.O. Box 130 North Easton, MA 02356 Telephone:800-642-2596 Fax:508-238-3379 xray@radiologyd iagnostics.com www. radiologydiag nostics. com Acconnt# 638657 BillCode: C2 Deaz Patient: We have written to ,you many times regarding your outstanding balance. We are; consideringlrefen•al of your account to our attorney. Unless we receive }our immediate payment, we may instruct our attorney to pursue a small claims action/judgement a~ainst you. This could leave you with a poor credit rating for the next seven years. The ONLY way to stop this action is to send your payment immediately! Total Amount Due ~~ g, ~ g ', Please Return This Portion With Your Payment 1VL~KE CHEC~{ PAYABLE TO RADIOLOGY DIAGNOSTICS ^ Check Amount Paid ^ Money Order 638657' ^ Visa/Mastercard WILLIAM WERT $18.16 Card Expiration Date:_ ~-Sovereign Bank osro:;izol l Overdrnfl CollaMiom Mail Code: 1Ofi438-CC7 601 Pem Btraet Reading, PA 19601 PHONE 877-391-6371 ~„ FAX 610-378-6660 WILLIAM G WERT 75 FICKES RD NEW'VILLE PA 17241-9461 ILI•II.1P^Illlllld~drlddlu~Pullhl.lhl~111111••ll•lll Re: FINAL NOVICE Account Nu~ber 2891106032 Amount Due 479.61 Dear WILLIAM ~ WERT: Your account hasl been closed, effective March 30, 2011, due to non-payment of the overdraft on your account. Tlt'e amount due as of the date closed is listed above. Please contact uq immediately at our toll free number 1-877-677-9130 in order to obtain the exact amount dl>re. We have told a cr dit bureau about a late payment, missed payment or other default on your account. This information ~ilay be reflected in your credit report. It is not too late ko resolve this matter, it you act quickly. Sincerely, Sovereign Bank Collections Department Membm FDIC. Hovereigaj Hnek and ib logo me rogiebrad tradomerke of 8ovmeip Beak m ib alLliabe m nubeidiarim in We Uaitad 8btee and other comtriae. rrornlwal.-o. ULTRASOUNI) SERVICES, INC 27 BLACKSIITH RD SUITE 200 NEWTOWN, 1?A 18940 FORWARDING SERVICE REQNESTED SUPPLIER: ULTRASOUND SERVICE NEWTOWN PATIENT WERT, WILLIAM 08/05/11 I 30.00 ~ 487543 Any questions, please gall Alla at 215-497-1001 ext 127 (Mon-Fri B:OOam - 3:OOpm) SHOW AMOUNT PAID HERE ..,. .~ WERT, WILLIAM 725 YORKSHIRE RD CARLISLE, PA 170133553 IIIIIdJIJell911111illllll'I'I'I'1~'Illlelel6Llll"'Il9gl' ooteo ULTRASOUND SERVICES, INC 27 BLACKSMITH RD SUITE 200 NEWTOWN, PA 18940 IIII"Illldl'1111"111111'1111'1111'lll'lllllllllll'llllllllllll PLEASE DETACF AND RETURN TOP PORTION WITH YOUR PAYMENT . ~ :a 3 ": i q t ~ ~ , f. ..lt ~ sj X) ~ ~ ~ ~ i ~.t rFhi ~g~~ ~ '~ of ~: i i ~ ~ '~' _i n l ~I `~ iij - . -, n , c i ~! " ~~ ~ N ~~ "' ~ k~E a ~ tl I Y ~ i v° t"~r l ' i~ `13 ~ :df E I m. ...... v ~+- „p _ .,i ::. . ^i ~ ~ ~ I~~A. x oI w'~.:. h 3 ~ i`t'e ..,a w. .~~ ~ 4 v~. e a ~HY..i is , iv ~}d . f . %'in§ } .{i, . r .:i ... t a ~ni,... "e{i. 02/26/11 729.5 9397 DUP-SCAN XTR VEINS CO 100.00 11)98394 30.00 The glance due is your co-pay. Please remit pay ent. 03/2 /11 CHECK # ,0012748985 -8.50 03/24/11 WRITE OFF -61.50 CURRENT OVER 30 DAYS OV R 60 DAYS OVER 90 DAYS OVER 120 DAYS TOTAL 0.00 0.00 0.00 0.00 30.00 30.00 30.00 STATEMENT DATE: 0$/05/11 RECENT PAYMEKfTS NOT SHOWN WILL APPEAR ON YOUR NEXT BILL. PAYMENT DUE DATE: 0$/25/11 ua opm esse-au c eoo moss ~I slots . v~s: ' -~ ~iiL ~)~ WF;ST SHf()RE WEST SHORE EMS -BLS vl~'I ~oiscovea l~ ~Mes~erCard 205 GRANDVIEW AVE SUITE 211 ~ww~l CAMP HILL, PA 17011 ON REVERSE SIDE Phone #: (800) 367-0512 Federal Tax ID: 23-2463002 PATIENT NAME: WILLIAM WERT CALL NUMBER: j1144Q4W WILLIAM WERT 725 YORKSHIRE DR CARLISLE, PA 11701 3-3 5 53 INSURANCE: HIGHMARK WCS B DATE OF CALL: 02/22/2011 FROM: CARLISLF_ REGIONAL MEDICAL CTR TO: FOREST PARK HEALTH CENTER ACCOUNT SUMMARY -1 TOTAL CHARGES: 111.53 PAYMENTS/ADJUSTMENTS: 0.00 PLEASE PAY THIS AMOUNT: 111.53 ncrnru d~ nur RERCnaennN dN!) RETURN STUB WITH PAYMENT _______ DESCRIPTION OF1 CHARGE QUANTITY UNIT PRICE AMOUNT Wheelchair One Way - Menhber A0130 1.0 46.52 46.52 OXYGEN ADMINSTRATIOt~ A0422 1.0 65.01 .65.01 Total Charges 111.53 DESCRIPTION T}F PAYMENT RECEIPT PAYMENT DATE AMOUNT Total Credits 0.00 PLEASE PAY'ttHIS AMOUNT -INVOICE DUE UPON RECEIPT -- mrrr rnucn nucnv CcC @Qi nn $111.53 _- PATIENT NAME: WERT, WILLIAM G CALL NUMBER: 2144O4W AMOUNT PAID: 05/09/2011 IMPORTANT ME;iSAGES: This account is now PAST DUEII Payment must be received WITHIN 10 DAYS. Collection process will begin. WEST SH~RE EMS -BLS 205 GRANDVIEW AVE SUITE 211 CAMP HILL, PA 17011