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HomeMy WebLinkAbout10-02-12 (3) 1505610140 REV-1500 EX (01-10) PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN _ Harrisbur , PA 17128-0601 RESIDENT DECEDENT 2 1 1 2 0 7 8 1 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Deat h MMDDYYYY Date of Birth MMDDYYYY 2 0 4 0 3 7 0 6 9 0 7 0 5 2 0 1 3 0 8 1 7 1 9 2 0 Decedent's Last Name Suffix Decedent's First Name MI G I B N E Y M A R T H A M (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 0 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) ^X 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 1 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number R O G E R B I R W I N E S Q U I R E 7 1 7 ~4 9 2~-~ 5 3 ~ ~ ,~~, ~~ REGISTE~ ILLS US LY ~ . ~' '.~: -- ~ ~ :: First line of address ` I R W I N 8 M c K N I G H T P C ~ ~-_=' _. ~`'- - }. Second line of address ~ ~ ~ ," _ :: - • i= ; 6 0 W E S T P O M F R E T S T R E E T City or Post Office State ZIP Code DATE FILED C A R L I S L E P A 1 7 0 1 3 Correspondent's a-mail address: Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE~j /P~R~S~ON RESPONSIBLE R FILING RETURN DATE ADDRESS ` 60 WEST - FRET BEET CARLISLE PA 17013 $ ~ F PREPA ROTE fiHAN REPRESENTATIVE DATE l`_ AD E - , 60 "EST POMFRET STREET CARLISLE PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610140 1505610140 ~ j~(~ J 1505610240 REV-1500 EX Decedent's Social Security Number Decedent's Name: MARTHA M- G I B N E Y 2 D 4 0 3 7 0 6 9 RECAPITULATION 1. Real Estate (Schedule A) ........................................... 1. • 2. Stocks and Bonds (Schedule B) ...................................... 2. 1 6 6 8 1 • 6 8 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. • 4. Mortgages and Notes Receivable (Schedule D) .......................... 4. • 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. 3 5 0 7 8 • 2 8 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. • 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested ....... 7. 8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 5 1 ? 5 9 • 9 6 9. Funeral Expenses and Administrative Costs (Schedule H) .................. 9. 1 7 6 4 8 . 7 8 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ... .......... 10. 1 6 9 6 . 3 4 11. Total Deductions (total Lines 9 and 10) ..................... .......... 11. 1 9 3 4 5. 1 2 12. Net Value of Estate (Line 8 minus Line 11) .................. .......... 12. 3 2 4 1 4 . 8 4 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ............ .......... 13. 3 2 4 1 . 4 8 14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... 14. 2 9 1 7 3 . 3 6 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x.o 0. 0 0 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate X .045 0. D O 16. D. 0 0 17. Amount of Line 14 taxable at sibling rate X .12 O D 0 17. 0. 0 0 18. Amount of Line 14 taxable at collateral rate X .15 2 9 1 7 3. 3 6 18. 4 3 ? 6. 0 0 19. TAX DUE ............................................ .......... 19. 4 3 7 6• 0 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ Side 2 1505610240 1505610240 J REV-1500 EX Page 3 :,,Decedent's Complete Address: File Number 21 12 0781 DECEDENT'S NAME MARTHA M. GIBNEY STREET ADDRESS 870 OVAL OAK CIRCLE CITY MECHANICSBURG STATE PA ZIP 17055 Tax Payments and Credits: ~ • Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest 218.80 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (1) 4,376.00 _2.1.8.80 (3) (4) 0.00 (5) 4,157.20 Make check payable to: REGISTER OF WILLS, AGENT ?k- 3 sdt Z ,, t #- PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred : ...................................................................... ^ Q b. retain the right to designate who shall use the property transferred or its income; ............................... ^ Q c. retain a reversionary interest; or ................................................................................................ ^ d. receive the promise for life of either payments, benefits or care? ....................................................... ^ Q 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... ^ Q 3. Did decedent own an "intrust for" or payable-upon-death bank account or security at his or her death? ......... ^ Q 4. Did decedent own an individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? .................................................................................................. ® ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. - ~ 1~ For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Total Credits (A + B) (2) REV-1503 EX + (6-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER MARTHA M. GIBNEY 21 12 0781 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 228 SHARES OF DEVON ENERGY CORPORATION 13,009.68 228 @ $57.06 = $13, 009.68 2. 40 SHARES OF NEWMONT MINING CORPORATION 1,903.20 40 @ $47.58 = $1, 903.20 3. 48 SHARES OF EXELON 1,768.80 48 @ $36.85 = $1, 768.80 TOTAL (Also enter on line 2, Recapitulation) I $ 16,681.68 (If more space is needed, insert additional sheets of the same size) REV-1508 EX+ (11-10) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, ~ MISC. PERSONAL PROPERTY ESTATE OF: FILE NUMBER: MARTHA M. GIBNEY 21 12 0781 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. PERSONAL PROPERTY 2,151.00 2. PNC BANK -CERTIFICATE OF DEPOSIT #31100233508 5,650.62 3. M&T BANK -CERTIFICATE OF DEPOSIT #31800331971 5,000.04 4. PNC BANK -CHECKING ACCOUNT #5070074358 1,357.32 5. PNC BANK -SAVINGS ACCOUNT #5030072155 13,519.92 6. PNC INVESTMENTS #4335096 5,568.43 ALLSTATE LIFE INSURANCE COMPANY CONTRACT #GA16878502 7. 1993 BUICK LASABRE -SOLD 1,600.00 8. CASH ON HAND 130.95 9. PASTEL MINK & KNIT JACKET -SOLD 100.00 TOTAL (Also enter on Line 5, Recapitulation) I $ 35,078.28 If more space is needed, insert additional sheets of paper of the same size REV-1511 EX+ (10-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MARTHA M. GIBNEY City CARLISLE State PA ZIP 17013 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. MALPEZZI FUNERAL HOME 10,584.49 B. Year(s) Commission Paid: 2, AttomeyFees: IRWIN & McKNIGHT, P.C. 3. Family Exemption: (If decedents address is not the same as claimants, attach explanation.) Claimant 4. 5. 6. 7. 8. 9. 10 11 12 ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) ROGER B. IRWIN Street Address 60 WEST POMFRET STREET SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS FILE NUMBER 21 12 0781 Street Address City State ZIP Relationship of Claimant to Decedent Probate Fees: REGISTER OF WILLS Accountant Fees: Tax Retum Preparer Fees: PATRICIA A. ROSENDALE, CPA FINAL FIDUCIARY RETURN REGISTER OF WILLS -FILING FEE ROY D. GOTTSHALL -APPRAISAL ON PERSONAL PROPERTY CUMBERLAND LAW JOURNAL -ESTATE NOTICE THE SENTINEL -ESTATE NOTICE REGISTER OF WILLS -SHORT CERTIFICATES RUMBERGER'S -AUTOMOBILE REPAIRS (1993 BUICK LASABRE) 2,600.00 3,300.00 115.50 375.00 30.00 60.00 75.00 178.92 8.00 321.87 TOTAL (Also enter on Line 9, Recapitulation) $ 17,648.78 If more space is needed, use additional sheets of paper of the same size. REV-1512 EX+ (12-08) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER MARTHA M. GIBNEY 21 12 0781 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. FC&A -OUTSTANDING INVOICE 37.96 2. MESSIAH LIFEWAYS -NURSING 1,475.06 3. ALERT PHARMACY SERVICES, INC. -MEDICAL gs.gg 4. PPBL -ELECTRIC 4$ 2~ 5. CONSUMER CELLULAR -TELEPHONE ~g ~p 6. VERIZON -TELEPHONE 29 4~ TOTAL (Also enter on Line 10, Recapitulation) I $ 1,696 34 If more space is needed, insert additional sheets of the same size. REV-1513 EX+ (01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: MARTHA M. GIBNEY ~~ ~~ mQ~ RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1. GARY L. NOBLER Collateral 7,293.34 913 HERMAN DRIVE 1/4TH REMAINDER MECHANICSBURG, PA 17055 2. CURTIS D. NOBLER, SR. Collateral 7,293.34 107 N. WALNUT STREET 1/4TH REMAINDER HUMMELSTOWN, PA 17036 3. MARY JANE WEAVER BLAZER Collateral 7,293.34 4600 CREEKVIEW ROAD 1/4TH REMAINDER MECHANICSBURG, PA 17050 4. JACK DENNIS Collateral 7,293.34 1922 RESEVOIR DRIVE 1/4TH REMAINDER CARLISLE, PA 17013 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. MESSIAH VILLAGE 3,241.48 100 MOUNT ALLEN DRIVE MECHANICSBURG PA 17055 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ 3 241.48 If more space is needed, use additional sheets of paper of the same size. e LAST WILL AND TESTAMENT I, MARTHA M. GIBNEY, of Upper Allen Township, Cumberland County, Pennsylvania, being of sound mind, disposing memory and full legal age, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils heretofore mad;, by me. 1. I direct my Executor or Substitute Executor, as the case maybe, to pay all of my debts, funeral and administrative expenses as soon as convenient after my decease. Furthermore, I direct that all state, inheritance, succession and other death taxes imposed or payable by reason of my death and interest and penalties thereon with respect to all property composing of my gross estate for death tax purposes, whether or not such property passes under this Will, shall be paid by the Executor or Substitute Executor from my estate, and that none of the aforesaid taxes shall be prorated among those persons named herein or are otherwise beneficiaries hereunder. 2. My Executor or Substitute Executor may, at his discretion, compromise claims, borrow money, retain property for such length of time as he may deem proper; lease and sell property for such prices, on such terms. at public or private sales, as he may deem proper; and invest estate property and income without restriction to legal investments unless otherwise provided hereunder. I authorize and empower my Executor or Substitute Executor to sell any realty and/or personalty owned by me at my death and not specifically devised or bequeathed herein, at public or private sale or sales and to give good and sufficient deeds and/or bills of sale therefor, in fee simple, as I could do if living. My Executor or Substitute Executor is authorized and empowered to engage in any business in which I may be engaged at my death, for such period of time after my death as seems expedient to said Executor or Substitute Executor. /~~ 3. I give and bequeath certain items of personal property according to a list left with my Executor or Substitute Executor. 4. I give, devise and bequeath ali. the rest, residue and remainder of my estate of whatever nature and wherever situate as follows: a. Ten Percent (10%) to MESSIAH VILLAGE, Mechanicsburg, Pennsylvania; and b. Ninety Percent (90%) to be divided in four equal shares as follows: (1) One-Fourth (1 /4) to GARRY HOSLER, and if he is not living at the time of my death, his share shall go to his wife, NANCY HOSLER; (2) One-Fourth (1/4) to CURTIS HOSLER, and if he is not living at the time of my death, his share shall go to his wife, DECOKES HOSLER; (3) One-Fourth (1 /4) to MARY JANE WEAVER BLAZER, and if she is not living at the time of my death, her share shall be divided in equal shares among the surviving beneficiaries named in Paragraph 4(b} herein; and (4) One-Fourth (1 /4) to JACK DENNIS, and if he is not living at the time of my death, his share shall go to his wife, EMMA DENNIS. 2 5. I nominate and appoint ROGER B. IRWIN to be the Executor of this my Last Will and Testament. In the event he has predeceased me, failed to qualify or is not able or does not serve for whatever reason, I then appoint DOUGLAS G. MILLER as Substitute Executor of this my Last Will and Testament with the same powers as are given to the original Executor hereunder. 6. No person(s) shall benefit hereunder unless such beneficiary shall survive me by sixty (60) days. 7. No Executor or Substitute Executor acting hereunder shall be required to post bond or enter security in this or any other jurisdiction. 8. No beneficiary may assign, anticipate or pledge his or her interest in any income or principal held or distributable hereunder, and no beneficiary's creditors may levy, attach or otherwise reach any such interest. 9. If any person entitled to share in any distribution under the terms of this my Last Will and Testament becomes an adverse party in any proceeding to contest the probate of this Last Will and Testament, such person shall forfeit his or her entire interest inherited hereunder and all provisions in favor of such person shall be declared void and of no effect. The share of such person so forfeited shall be distributed as part of the residue pursuant to Paragraph No. 4 hereof, 3 except that if such person is entitled to share in the said residue, that interest shall be distributed proportionately to the other residuary beneficiaries. 10. I hereby suggest that my personal representative retain the services of Irwin & McKnight, P.C. as attorneys in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 22°d day of June 2011. MARTHA M. GIBNEY Signed, sealed, published and declared by the above-named Testatrix, as and for her Last Will and Testament, in our presence, who, at her request, in her presence and in the presence of each other have hereunto set our names as subscribing witnesses. ~I ~~ ~~ ~.-G<%C.. ~` - °~; .r CMG%cr-(~~~- 4 ACKNOWLEDGMENT AND AFFIDAVIT WE, MARTHA M. GIBNEY, I~:AREN S. NOEL and SHARON L. SCHWALM, the Testatrix and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and that she had signed willingly, and that she executed it as her free, and voluntary act for the purpose her-ein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the will as a witness and that to the best of their knowledge the Testatrix was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. MARTHA .GIBNEY 1 KAREN S. NOE SHARON L. SCHWALM COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND Subscribed, sworn to and acknowledged before me by MARTHA M. GIBNEY, the Testatrix herein, and subscribed and sworn to before me by KAREN S. NOEL and SHARON L. SCHWALM, witnesses, this 22nd day of June 2011. nJ . C~S~tft.,,~.~ otary Public COMM(~NNVf~-L~'!~ Qt= PENNSYLVANIA Notarial Seal Roger B. Irwin, Notary Public Carlisle Boro, Cumberland County My Commission Expires Oct. 3, 2012 Member, Pennsylvania Aasoclation of Notaries 0 0 A v ~ o ~ ° w ~ ~D ~ ~ N a v N rt N 0 2 x D n d ~ N N 1p °' v O A v o _, ~ ~ ~ d ~ o' c: z ~ ~ ~ ~ . ~ ~ C _ H A~ 0 C m N ~- ~ m v cfl v 0 _ , ~ o ° ~ Q o D . v <' ~: ~ G7 j ~ ~ 0 ~ ~ N ~ ~ v N D~ ~ _ ~. ~; 0 0 ~ O 0 0 ~. ~ v v ~ ~ / \ ? ~ ~ .~ D Z Q. ~D w ~ ~ ~ Q p p ~ ~ v ~ ~ ~ o ~ C~ ~ C ~D ~ < ~ ~ 'a p ~ n ~ ~ o m ~ ~ ~ ~; ~. ~.. ~ ~ ~ ~ ~..- d ~ ~' ~ o ~ ~ ~ 3 ~ CD ~ .-~ o -., . ~ v ~ < a ~ ~ 7 .~~. _. ~. ~D 3 ~i tD' rt I I IIIIIII II I VIII VIII VIII (IIII (I III IIIIIII III V III IIII IIII D~o~ D "'~ .~ _ r Oy m ~ ~ ~~ D ~ G1 ~ oo o ~ - o ~ W - W _ . ,A ~ ® : ~ O O -~ ~ ~ ~ - ~? ~ ® _ LJ c~ ~ ~ ~~ ~ cn ~ z N , ~~ .. P~ ~ LA S lC ~ (^' _ C) o Z {D CI ~ ~ ~ ~ ` ' ~ O C ~ v ~ ° ~ ~~ a ~ ~ ~' . O V1 .. b < N ~ z N W ~ U _ ~ ~ ~ ~ , O O 0 ~ to ~ O A ~ o o 0 .tea N 't7 ~ lA ~ ~ J N W N ~ ~~ ~ ~ ~ O C .-+ V7 ,_+ Q ? CD ~ C C D D ~ ~ coo c,~o o. o~ 1 ~ ~' N' 0 oc+ a~ ~ ~~o O ~~~a `~ ~aa~ ~ y ~ ~ ~ S ~ N CD v ao ?~ ~ o o ~°~°~~ ~ N W 'D C.rt O O ~ ~ (D J~ CTi W W ~ ~ ~I OD O O ~ p O N V ~I ~ V O OD 00 CD LY1V 1uJW11V0.11-11\.GJ I,-.cvvll,/!!cl-gy~,urp~ratwn~;ommonJtocK-... http://hnance.yarioo.com/q/rip'!s=UVN~ia=Ub~ib=6~ic=~u~~6cu-vo... Hi, Karen Sign Out Help Mail 2 My Y! Yahoo! Search ~ sSAearch tiVetr„ HOME INVESTING NEWS PERSONAL FINANCE MY PORTFOLIOS EXCLUSNES i $~ytset t~t~flte5 Finance Search Mon, Oct 1, 2012, 11:44AM EDT- US Markets close in 4 hrs and 16 mins Dow 11.19% Nasdaq •0.63% Im1t1 SIi}}SCf1Qti0f1 f8$.5. , t GET MOBS` C1N ~~~; - ,"~" DVN t~ Aaw~tradra o ~'rcattfar-css'iF ~ ................:~ E+kiRNDE S[CURIiIES L1C Devon Energy Corporation (DVN) -NYSE 61.45 • 0.95 (1.57%} 11:43AM EDT -Nasdaq Reat Time Price Add to Portfolio Like 41 Historical Prices __ Set Date Range Get Historical Prices for: t• Daily Start Date: JUI ~ 2012 ; Eg. Jan 1, 2010 ~ Weekly End Date: JUI ~ 012 C~ Monthly Dividends Only ' $'tbp mK#'+ ,a First ~ Previous ~ Next ~ Last i Prices Date Open High Low Close Volume Adj Close• Jui 6, 2012 57.15 57.60 56.66 57.25 2,239,800 57.06 • Close price adjusted for dividends and splits. I~Download to Spreadsheet Currency in USD. First ~ Previous ~ Next ~ Last Copyright V 2012 Yahoo! Inc. All rights reserved. Privacy Policy -About OurAds - Terms of Service - CopyrlghUlP Policy -Send Feedback - Yah001 -ABC NEWS NetWOrk Quotes are real-time for NASDAQ, NYSE, and NYSE MKT. See also delay times for other exchanges. All information provided "as is" for informational purposes only, not intended for lading purposes or advice. Neither Yahoo! nor any of independent providers is liable for any informational errors, incompleteness, or delays, or for any actions taken in reliance on information contained herein. By accessing the Yahool site, you agree not to redislritwte the information found therein. Real-Time continuous streaming quotes are available through our premium service. You may tum streaming quotes on or off. , Fundamental company data provided by Capital IQ. Historical chart data and daily updates provided by Comrnodity~Systems, Inc. (CSI). IntemaGonal historical chart data, dairy updates, fund summary. fund performance, dividend data and Morningstar Index data provided by Morningstar, Inc. 1 of 1 10/ 1 /2012 11:44 AM r m v m a x o~ m O n m n z c W rn V W V a z O 0 c m n O v ~o~H~n~n ~ rn ~ ~ ~ rn n _ ~ ~ ~ ~ v -• ~ ~ . o a~ ~ rn O ° ~ ~ c O c~ o ~ rn ~ ~ ~ ~ ~ ~ N ~~ rn ~ ~ ~ ~ ~ ~ D w ~ ~ v o ay _ <_ to 3 N rn ~ ~ ~, z o ~~ c ~ -- ~° c~ v on 3 ~ rn ~ Q p '~ N ~, O p o < v ~ ~ ~ . 3 ~ ~ N O ~ '~_ o ~ =0-~ m c ° c ~ - r,. _ =. ~' ~ ~ ~ c° c~ ~ O ~ n~ `~ ~ z ~ a. ~ 3 ~ O ~ ~. Qom ~ ~D _ y ~ ? o -~ ~ O ~ Q ~ n N ~ ~ C `¢ O ~ 3 ~ Cp ~ ~ ~ ni 3 n ~ k ' N a ~~ ~ c ~ ~. p' oo ~ ~ n o a • N 3 !'~ N 01 N ~ '- w ao ~ morn n ,~ ina~oo ~cn~ rn~o cfl oo .A ivLivi iu~wiifrai rtt~w I ivcwt11V111.lvutllit~' I,vTPordnOTl JiOCK- YSh00... http://t1T;lance.ylil100.COIYUCI/hP'!S=NI/McSGa=UblKLb=b~LC=LVt[,o[.u-uv... FG, Karen Sign Out Help Mail 3 My Y! Yahoo! Search ~ Search Weh ------ HOME INVESTING NEWS PERSONAL FINANCE MY PORTFOLIOS EXCLUSNES C:et~Q~totes :<~ Finance Search Mon, Oct 1, 2012, 11:47AM EDT- US Markets close in 4 hrs and 13 mins ~~•;. Dow 'r 1.18% Nasdaq 't'O.fi4% ~• No Subst~ti0n ~. .M.,.~,.~:...,.~...,..,.~.: wnartaa. a -NEM~ oN AT EiPTRADE x '''' [~krRhDC TECURRIES LlC Newmont Mining Corp. (NEM) -NYSE 56.09 • o.os (0.13%~ 11:46AM EDT -Nasdaq Real Time Price Add to Portfolio ' Like 88 Historical Prices Set Date Range (~ Daily Start Date: Jul 1 ~ 012 , Eg. Jan 1, 2010 (,t, Weekly End Date: Jul (V i; 0.12 C~ Monthly C`a Dividends Only First I Previous ~ Next ~ Last Prices Date Open High Low Close Volume Adj Close` Ju16, 2012 48.39 48.66 47.56 47.91 3,458,400 47.58 `Close price adjusted for dividends and splits. r"'I DOWnIOad to Spreadsheet Currency in USD. First ~ Previous ~ Next ~ Last Copyright (~J 2012 Yahoo! Inc. All rights reserved. Privacy Policy -About Our Ads • Terms of Service - CopyrighU~ Policy- Send Feedback - Yah00! -ABC NeW S NetWOrk ~~d r Quotes are real-time for NASDAQ, NYSE, and NYSE MKT. See also delay times for other exchanges. All information provided "as is" for informational purposes only, not intended for trading purposes or advice. Neither Yahoo! nor any of independent providers is liable for any informational errors, incompleteness, or delays, or for any actions taken in reliance on information contained herein. E3y accessing the Yahool site. you agree not to redistribute the information found therein. Real-Time continuous streaming quotes are available through our premium service. You may turn streaming quotes on or off. Fundamental company data provided by Capital IQ. Historical chart data and daily updates provided by Commodity Systems, Inc. (CSI). International historical chart data, daily updates, fund summary, fund performance, dividend data and Morningstar Index data provided by Morningstar, Inc. Get Historical Prices for: _ _..__ __ 1 of 1 10/ 1 /2012 11:47 AM 0 _~ N ~~~ ~. ~~ ~~ .~ ~~ ~~ .~. ~~ ~~ =_ ~~ ~. ~~ --' v ~. p ~~ ~~^ ~~ ~~ ~~ ~. ~~ ~~ N `~ m 1 (7 0 cn 0 ao pv --~ ~~ ao ~~ a, a ~~ m`'~ n ~-~ O O ~ ~~D ~ crt ~ 3Z ~ Q ~ n ° ~ ~ ~ ~ m °' y ~ n o ~ Q ~ V y ~ fD fA ~ m ~ m ai n N X X TA98 C ~ °• .<_ 7 p: p 7 3 a 7 N C ^" N d A .Q C a 0 d a ~~ N p1 o s 3 d m ~ _~ ~. o Z N ~ p 3 ~ Q ._~ p a m ~ N ~~ ~~~ o~~~ ~~ O1 ~ ~ N- ,o '~. Ul O ~. .~~ ~. ~ N ~ o cc' ~~. mna + Q ~ ~~ ~° o ~ ~7 ~ ~ ~ ~ ~ N- ~ _ ,~.'pC O ~ p =. C a~ a o ~~ ~ X N - fD _. ~~ = N ?, m~~ m o~ o = ~ p ~ "~ ~~o ~~ ~~' __ p "p" N .. ~ a g~ ~~ ccma - o ~ ~ co e~ ~ ~~a ~o'~' 1 ~_ N p 'N 7 ~, c~0 ~ °, n n _Q ~~< =~ ~ ~ Q ~ 7 ~~.. Q' Q 70~1N ~ ~ O O N t3D n ~~'a ~, Q ~~ m ~a ~~ ~ rn ~Q3~ ~ ou~i~ p ~ ?; ~' 3 3 n ~o~ c 0 ~~ 3'0 ~~~ ~ ~ p _ O .~ - ~~ ~ ~ ~ ~ fD N f~D N N W ~ ~: 0 k a y Q ~ p ~~ ~; ~ C ~~ ~ `•°' < ~o~° oi~ 0 O i V, ~ o ~.o ~ y p ~o 7 H 'O S 1 2 N ~I`:~ r~q p z S2~ ~ ~; p ~ "r'I f'~ n ~ ~ Via. ~ i i:7 ~ q ~ a _. a. ~F :fl~'U~D n 'p'~ `c A n m ~ -p a. ° 'c a c. ~ v`~ ov" ~ m ~ ~ ~ = n ~ O ~ ~ c 1 N r- N ~O ~ $ ~- O CTI O O N ~ ,p N ~0 0D V 7 00 ~ j .`.1 (r^~ O ~ ~ ~ f,71 O O N N N Z ~ Z ~ y/ v~ v~ N C1 Q~~~~ ?, 7 ~~_~-G n- a' m a a a c 3 3 NEAEAb9N '~+ C11000U1 K NGOOIV O O O O O ~ ~ Z ~ ~ ~ N D ~ N ~ o;~~ °1v a ~ ~ ~ _<• ~~?~~ ~~3N a fD ~- °- ~ ~ Q H f~D 0 v V EA EA ffl V ~ fJ1 O O O N (p ~ O O O ~ O O O O O h, ~~ 0 rn k fD O ~ 3 c o~ ~ O ~~ O '= Ti 'J Y.i i iaucauvv.yuuvv.vvuy yi ur : u L~wwu vvwv vwv .~~ ----- - •- Hi, Karen Sign Out Help Mail My Y! Yahoo! ?._€ Search ( Search Web j _ ._._._...-.a...__.~... _ . HOME INVESTING NEWS PERSONAL FINANCE MY PORTFOLIOS DCCLUSNES - ---- GQt QUOt ;,~, Finance Search Mon, Oct 1, 2012, 1:14pm EDT- US Markets close in 2 hrs and 46 mins ,.r~s~ Dow 'x0.87% Nasdaq X0.21% r Ma ~tis>nn feet. ~ ~~ i ~~~ '~~t~~»~ ~r~.~t ~» accou~r t~ wentt~. o ~ ~~~ >•_ tempoe seouwnes ue Exelon Corporation (EXC) -NYSE 35. ~ ~ • x.07 ~0.~ 8%~ 1:14PM EDT -Nasdaq Real Time~Price Add to Portfolio Like : 83 Historical Prices . ................................................. Set Date Range Get Historical Prices for: ~ AdChoices !~~ Daily Start Date: JUI I" J 2012 Eg: Jan 1, 2010 G Weekly End Date: Jul ~ 012 I C: Monthly C~ Dividends Only First ~ Previous ~ Next ~ Last Prices i Date Open High Low Close Volume Adj Close' Jul 6, 2012 37.17 37.36 37.03 37.35 3,921,400 36.85 ' Close price adjusted for dividends and splits. ~1 Download to Spreadsheet Currency in USD. First ~ Previous ~ Next ~ Last Copyright ~~ 2012 Yahoo! Inc. All rights reserved. Privacy Policy-About Our Ads • Terms of Service - Copyrighf/IP Policy- Send Feedback- Yah001 -ABC NeWS NetWOrk Quotes are real-lima for NASDAQ NYSE, and NYSE MKT. See also delay times for. other exchanges. All information provided "as is" for informational purposes only, not intended for trading purposes or advice. Neither Yahoo! nor any of independent providers is liable far any informational errors, incompleteness, or delays, or for any actions taken in reliance on information contained herein. By accessing the Yahoo! site, you agree not to redistribute the information found therein. Real-Time continuous streaming quotes are available through our premium service. You may turn streanng quotes on or off. Fundamental company data provided by Capital IQ. Historical chart data and daily updates provided by Commodity Systems, Inc. (CSI). International historical chart data, dairy updates, fund summary fund pertormance, dividend data and Morningstar Index data provided by Morningstar, Inc. 1 of 1 10/ 1 /2012 1:14 PM .h [~ .~-ti:~i ~. ~ ~ / l G ~ .~i ~-~ .<- ~ G~i' > __... ,_~' a _i _ ~ ~, ._ _.... .. ~~~ 4 _ . . s`~ ~~ ~ ,Q~ ~ r Ary --~_ .__---.,_._ f / rr!~ _ I ^T ^~ n r /~ ~ gyp ~ 'r ! f ~~~.r.~ % +''j~~~ ~ ice'" ~ ~" ~~` ~`"'° ~` ~~ : ~ .~ E ----'---'-'---'------- //. 9 ~ / ---.. . ~ ~ r. ,, ~ ~ ter,. ...~ `" -~-z'~~ _ - - - --- -------_.---- --------'-------- ` ~ ~ ~ _4.~.r~F ~ /s~ivra' '" a++s.*rI ~~..rc-T'"°~y t _ ~~"~~..- (~' '6J _ ~'--J~T//~ /~' ~f •~~ ~L~-.~.____ -ter ~ V ~°"~• ------'-- /1 r ° ",~ • ...ten,: ;a.• v... ,y / _,~ .~,: ~ j U -- ~.. . ~ ~ ~ 4c _Y ._.....______-_.____ _____.-_.__ .- _._ _.__ __.__..~__._._. _-- ~~ t ~,~ ~ - ..!~~- - -- ' ' u - ___~ ~ ,. ... .r ~ .• - ~/ -- - ~ Ci ~ ~, ,~ ~- i ~ s ~~ .~. - . ~- -~`- - D __~ __ ,~.~_ t ~._ ,. f~ ! A - w ~ . -yam t •• ~/ ----- ---- - - - - ~- --~- ~ ,,~ij _~ /J ~ ~"T . _ - ~' i ~ n ~~ /!^ ,_,, .. r.1~ ~ ` . _~ y~Aw f ~~-~~,r~,/- o o ~ ------- - - -- -- - -~_--.----- -- --- ~~~ ~~ o a * r-------- fY .---- - ----______-~pa.~--- __ . - ------------ ---- -- -- _ . ~ ~ ~~~; , ~-- _ 292 ~ 00 + ~ ~~ SQ~,~G~` `, - / __ _~N~,_..___. _ _ _. - -~ -._. -- ---__ - ------- - _ _ - .-. ~= 2 9151 ~ ~ ~®~~°' % 0~ __- - - : ~~,~ ire. 'f'TJ I I li ~ .-r+ } ~~ ~~~ August 2, 2012 roger B Irvviri. Esq. Irwin ~ Mc~night P.C. 60 'VV Pomfret St Carlisle, PA 17013-3222 RE. Martha M Gibney' SSN:204-03-70b9 DOD: 07-052012 Dear Mr. Irvin: In. respozzse to Four req~xest for Date of Death (DOD) balances for the customer noted abo~cre, oYxr records show the ~ollowi.ng: Certificate of Deposit Account # 3110023 3 508 Established: 11-0 l -2002 11/IARTHA M CrIBNEY D4D balance: $ 5;650.00 + 0.62 accrued interest Interest paid O l -01-2012 tbru 07-05-2012 ~ 32.12 ~'"TD Account # 3 ] 800331971 Established: 0902-2008 MARTHA IWI G~lv-EY DQD balance: ~ 5,000.00 + 0.04 accrued interest Interest paid 01-01-2012 thru 07-052012 ~ 6.45 'Y'TD Checiring Account Account # 5070074358 Established: 05-07-I993 MARTHA Ivl G~3I~TEY DOD balance: $ 1,357.32 + 0.00 accrued interest Interest paid 01-01-2012 rhnz 07-05-2012 ~ 0.00 YTD Savings Account Account # 50300721 ~ ~ Established: 06-05~ 1989 MARTHA M GIB~IEY DQTJ balance: ~ 13,519.01 + 0.91 accrued interest Ynterest paid 01-0 l -201 Z thru 07-05 -2012 ~ 5.51 'Y'TD ~X1~~eStment ACCO Wit The decedent maintained Investment Account # 4335096 _ For further information, you mad call the Brokerage Dapartrnent at I-800-762-6111. Page 1 ~f 2 Please note that this office provides date of. death balances for deposit accortnrs (IR,As, g CDs, Cbeckin and Savings). We do not process any financial transaefioas ax p~-ovYde statements. Yf yov need assistance ~ilh any oi'these items, please call 1-88S-PNC~~,ANK (1-888-762-~26~) or stop by your local PNC Barak 1~ranch office. Siancerel3~, National ~7naueial Services Ce~~cer FNC Bank, N.A. Me~aber FDYC 'his message is intended for the use of the individual or ent~ity~ to which it is addressed and may contain information thQr. is privileged, con, fidenfial and exempt from disclosure under applicable law, 1f the reader of this message is not the intended recipient or the employee or agent responsible for delivering this message to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communications is stprctly prohibited. 1f you have received this communication iri error, please notify me immediately by reply or• by telephone at 800~762~1775 and immediately destroy this fazed document. Pa ore ~. ~f 7. ~~ A I I state You're in good hands. July 31, 2012 Roger B. Irwin Irwin & McKnight, P.C. 60 West Pomfret Street West Pomfret professional Building Carlisle, PA 17013-3222 Re: Martha M. Gibney Contract No: GA16878502 Dear Mr. Irwin: We received a request to complete IRS Form 712 for the above referenced contract. The purpose of Form 712 is to provide an estate or donor with the value of a life insurance contract or its proceeds as of a certain date (usually the owner's date of death or date of transfer of the contract). Because this contract is an annuity, it is not reportable on IRS Forrn 712. I can, however, provide the following information for estate purposes: Date of Death: Annuity Value as of Date of Death Cost Basis: Value as of July 31,2012: Ownerlannuitant: Contract date: Named Beneficiary: July 5, 2012 $ 5,560.60* $ 5,000.00 $ 5,568.43 Martha M. Gibney January 29, 2004 Estate of Martha M. Gibney *The actual amount paid may differ due to Market Value Adjustments and/or any applicable Surrender Charges. If you have any questions, please contact me at 1-877-499-6418 Ext. 24794. Sincerely, Bobbi Jo Seveska Sr. Claim Examiner Allstate Life Insurance Company Life and Annuity Claims P.O. Box 94212, Palatine, IL 60094-4212 Phone 877-499-6418 Fax 866-635-4523 ~ 'v z Z n V ~ N ~ r r n I~ bid N O N 0 N z~ o o; ~ ~~ ~ ~, ram ~ ~ O ~ c ~ ~~ S. ~ ~ ~• ~ H ~ ~ ~. p, ] n . e. ~ ~ ~ ~ Sp7 ~~ a ~ ~ _~ E O l" c ~n ~ ~ n o w ~' i Z ^^ 4J ~ ~ ~ ~ f ° f P17 ~ ' + n z y• ~ 0 t C. ~ n ~ ~r1 ~ ~ ~e ~ o o ~ L]. S. H ~ n n ~ w ~ H a a. ~ ~ o ~z~ ~~ ~~ a- C ~ ~.Q' `~ ~ ~ z~ ~~~ ... H r a ~ a ~ ~ ~ ~ 3 O'er ~i A 1~. y~~, ? _ ~. ~ O N ~ '. A Ol OD y Z e o 0 0 ~ 0 0 o qm ~ , Z' ~ r~~~ ~ ~ ~ ~ c ', 0 ~ m; `~ ° ~ ~~ ~ . o ~ a. c ~~ J z o a ~. ~. ~ ~ ~; ~ ~? ~ n ~ ~ N p J ~ ~~ ~~ r ~ ^ / yI O 7 ~ i ~ ~ ~ O f~ i ti i ~ ~ N y Q ~ ~ I ti o ~ ` O ~ d 10 N ~ ~ N O O1 °~~ y ~~~ ~ ~ h ~ ~~ ~ ~ ~ . ~ ~°o ~~ N ~ O O ~ V C `C o J ~`~ '~ o' Q ~ o -~ w o ~ a < ~~ ~ < ~ ~ a ~' '` r ~, ~ c o g ~ m ~ w ~~ O w n `~ C m ~ ~ ~ a ~~ b O y ~. o ~ ~ ~~ o ~~ O N A Y O ~. C• ~ ~. A O A ~' Q ^. 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N O N N Y c ~ ~ ~;~ ~ . ~. ~. ~ii ~ ~ ~ ;.U:~w:a ~~~U L..~'m. ~' ~ ~~W'~Q.~ m ti.m ~ ~C- ~ ~' 2'cp Q ~ ~.. ~ e a:N = ~: oo c .~ ..,, e~lO P~PeH : ;; :a -- A Friendly Reminder -- FC~ 103 Clover Green, Peachtree City, GA 30269 (800)226-8024 on-Fri 9-5 EST ~~ #BWNNMRK #21 12 8346 0# MARTHA M GIBNEY 870 OAK OVAL MECHANICSBURG, PA 17055-8409 Q ECR2 ~' Statement Date 07/09/12 h Order No. 21-128346-0 Please include Order No. - in all correspondence Order Total : $ 37.96 Amount Paid: $ . 00 BALANCE: $37.96 PAYMENT DUE: $25.30 Pay Before: 07/29/12 FcIt2 INST-R2 10854 Statement Date Qty Item(s) THE KITCHEN TABLE BOOK ~. Return your payment by 07/29/12 to avoid $3.00 late fee Amount TOTAL I (Amount Paid: $.00) To pay in 3 monthly payments, amount now due for 1st and 2nd payment is: Or, to pay full amount due, return: $37.96 Sas so $37.96 Note: A Late fee of $3.00 will be added to past To Pay in Full, due balances to cover postage & handling, and other Pay Last Amount expenses. (This is not a finance charge.) in This Column Order # : 21-128346-0 I-2U-HIO Please Detach and Return Bottom Part with your Payment by 07/29/12 --_.__-_,_-__ ~"~r'JQ'1-"L-ZC.roTtr---r-rsus~.oro--w~- l~•~•:-_r.•!-•• 1 _~---------------------- Don't worry if your recent payment is not reflected in the current bill, it is not necessary to call or write us. Note: A $3 late fee will be added to past due balances. 0 0 0 N C7 a 0 0 a U O N N F~- 0 ,~ p ~ ~~~. ~ IVI~S~~T1fl FormPB-01 SN, ~t l~~S5iAH Vi~.LA;G~ 100 MT. ALLEN DRIVE, MECHANICSBURG, PA 17055 ROGER B IRWIN 60 W. POMFRET STREET CARLISLE, PA 17013 RESIDENT # 'UNIT STMT.DATE 49713 870 07/31/2012 RESIDENTS Mrs. MARTHA M. GIBNEY TOTAL AMOUNT DUE $1 475.06 DATE DUE 08/31/2012 DATE DESCRIPTION RATE Days Units- CHARGES CREDITS ' BALANCE Balance Forward 817.00 *** Residential Living *** 07/01/2012 MNTHLY CHG TIOGA 07/01-07/24 658.06 1.00 658.06 1,475.06 ClV AUG 14 2Q1~ IRWIN ~ ~cKNIGNT ~W OFFICES _` ~ ~ //~ • \~ P ( , \ V RESIDENT # CURRENT OVER 30 OVER 60 OVER 90 OVER 120 TOTAL AMOUNT DUE 49713 658.06 817.00 0.00 0.00 0.00 $1,475.06 RESIDENT NAME Mrs. MARTHA M. GIBNEY Form PB-01 Please make check payable to Messiah Lifeways at Messiah Village. A 1 % finance charge may be assessed on accounts for which payment has not been received by the due date. Thank you! If you have any questions or concerns about your bill, please address them directly to Fiscal Services at 790-8220. Thank You! "0, O , hD: <. ;. ~. p p x, ~ D' ~ ~ ~ - . ~~ o o ~" ~Nn ~ ~~y j` N N D ~: H '~ m: ~--~ N H D rn rn ~C ,n "~ + n: , o o N w• ~T1 ~ _ . ~ ~, O _ 'm° ~ ,o. . ~ . ao ao ~. '~ ;' ~ --i . o , H ~ mp ~ ~ _. _ _ H u; w . ~ o ~ A 3 Z v,` o' C i] rt /~ '~~:. - _ .. . ~ .. `~ ~ + '; '' - ro -rri o a:. ~, ~+ ~ . ~ 7> ro H H : ' o r2 `" ~ N ` Z ':y . ~ a: U ~ __ - C o G} ~ - N 3 Or a ~. ~ , rn n ~' ~~~ ~ 0: o 0 ~ z a z ~ ~ ~ _ . ~, .. ~ ~ H o D ~' ~ ~ ~ Q ~; ~ ,, m c ~ , ~. o ~ `~ o ~ ~~ o ' ~ ~ . m ~ (/, ~ O ~ o 0 rn co o "~ ~° ~ co. ~ m ~ d ~~ ~ ~ ~ O W J F--1 -~ D n ~ ~ a ~ ~ m o 0 0 a o ~~ 3 N O ~- C o Z w ~ ~ ~ O ~ o C o 0 m ~~ D H ro n *K VJ C H C] N N to O H x E~ H 0 r~ H O r ro ro J 0 m '0 _ o o' o 0 0 0 0 o x~ - ~ rnrnrnrnrnrnrn.rn, + p ~ ' t~ N N 1-' N '~ O C t- ~ n ~ W N N N N Ol p0 _ H N ~ r ~ W N N N N N N N ~ lfl 01 H D F-3 ~ ~ j ,z A ~ rn ~ ~ ~ ~ ~ + - W N ~ _ ., "'~ n _ ~ n ~ ~ o OD 00 u, m ~ ~ , m J s o o Z a ~o ~, ~ z o ~ p ~, ~ ~ ~ ~, ~- ~ ro ro , d.-o `~ b ro ~ ro ,x H ,~. r, ~ _ H fd cr ~ 1i c-r O x ~o D ` _ _ ;ti ~ p cn H ~ ~ ~ x ~' .~ m o ~ p o o ro o m' D ~ ~ ~ (1 N~oo 30;x. . `m .D ~ . ~ - ~ ~ W- W W i ., . (,Z , O U1 U~ N ,, _ 3 a, II 1 w N ~ 4 - ~ -~ ~ or ; ~ ~ ~ ~ .~ z. ~ 7o y ~7 0 - ' - ~, ~ m x , H. ~ ~ ~ - -~ ~ n ~ ~ - w o s ~ ~ ~ ~ _ Qo ,ai ao to ~ '~ o - O ~. o ~ -oo, t-~ ao ~o ~ 00 0o m ~ - i o o ' i~ a ~ W o rN , N 00 m ~,~ N o C4 lfl ~ Z ~ co ~ H '7~. I- ' - v" ~ ~ ~. , u .x H H F--1 , tl 1 . _ ;; ,, , _. O _._ -1 a :, . r o O N a ~ 3 rn ,~ ~ '--' C W o ~ ~~aow J Z l0 "I O J ~ ~ N D ~n~o~ ~ C 11t H ro n K H n N N ~o 0 H x ., H 1H ~O ~~ ~~ ~H ~x °r K ro N 0 ~, U7 '. ;: a~ % - Questions? Please Visit us online at Page 1 ~'~'°°°°~o~;:_ ©contact us by Sep 4. `~ pplelectric.com ~ ~ ~ , ~ . ~ °,, 1-800-DIAL-PPL • , . 4 , •:'~ (1-800-342-5775) 205.00-75004 Sep 4 2012 ~~dd ~•,. ~~~ ' 1 ~ ~~~ ~'~~;~;`'~'~`' ~. ~ ~~ M-F: Sam to Spm •„rr~Y.;,~r,;,..., ~ .~ ~_:: ~ ~•v..H~~:;+1, . , Your Electric Usage Profile Service to: MARTHA M GIBNEY 870 OAK OVAL MECHANICSBURG, PA 17055 Meter: 84532681 Your next meter reading is on or about Sep 12, 2012. This section helps you understand your year-to-year electric use by month. Meter readings are actual unless otherwise noted. ® 2011 ~ 2012 12 ~ 10 Y g v ~ 6 v a 4 ao Q ' Months • s ~ • • ~. Aug 2012 31 - . 78 3 - . 76F Aug 2011 29 158 5 79F °. .. -- Aug 13 Actual 18620 Jul 13 Actual 18542 31 Days kWh Billed 78 - . . . .. • Sep 2011-Aug 2012 1818 152 Sep 2010 -Aug 2011 2191 183 Billing Summary (Billing details on back) Balance as of Aug 14, 2012 $0.00 Charges: Total PPL Electric Utilities Charges $11.33 Total Dominion Energy Solutions Charges $5.37 Total Account Balance $16.70 X16.70 PPL Electric Utilities' price to compare for your rate is 7.993 cents per kWh effective 6/1/2012 to 8/31/2012. For a list of supplier offers, visit papowerswitch.com or www.oca.state.pa.us. Your Message Center • With paperless billing, you can receive and pay your PPL Electric Utilities bills online. The process is free, quick, convenient and secure. To learn more or sign up, visit pplelectric.com. • Information about appliance energy use and tips on saving energy are available through the Energy Library o on our Web site, pplelectric.com. • Before digging around your home or property, you should always call the state's One Call notifi system to locate any underground utility lin do this by simply dialing 811, which will connect you to d g One Call system. Be-safe and call 811 be~fQrg y2uo 20~~ cRWiN ~ Mcl~f~~G~{~ Payment Methods Iu~.~Plc~l:.~ ~. Online at: `~ ®By phone:1-800-342-5775 pplelectric.com or call BiIlMatrix (service fee applies) at 1-800-672-2413 to pay using Visa, _ MasterCard, Discover or debit card. ®By Mail: Correspondence should be sent to: 2 North 9th Street Customer Services .°. CPC-GENN1 827 Hausman Road Allentown, PA 18101-1175 Allentown, PA 18104-9392 _ Other importa nt information on the back of this •bill -~ J F M A M J J A S O N D 1 1 1 I . , °~seeuoQ+~o±. •r-.- i ~~~ ••« -- •.°~. PPL ~tootrlc UNtitio~ ` .. © Questions? Please Visit us online at Page 1 contact us by Oct 4. `~ ppielectric.com _ ~ 1-800-DIAL-PPL • a s (1-800-342-5775) ~ .:~, ~ „ 20500-75004 Oct 4, 2012 ~~::,~~~5:~.,~,~: f~,~~,a~~s+"' M-F: Sam to 5pm Your Electric Usage Profile Service to: MARTHA M GIBNEY 870 OAK OVAL MECHANICSBURG, PA 17055 Meter: 84532681 Your next meter reading is on or about Oct 12, 2012 Billing Summary (Billing details on back) Balance as of Sep 13, 2012 $0.00 Charges: _ Total PPL Electric Utilities Charges $9.96 Total Dominion Energy Solutions Charges $2.55 Total Charges $12.51 This section hel s ou understand ~~~ 1 i. ~~ ;. ~.,. r, ,; ~( , ~ ~~„ ~,rzk ~~~~~`~.,~~r ~~~~~~~~E+~~ ~~~~;~3~ ,,~ ,v, f~x~ ~,F~;a~ ~~~;~~ ~~~,;,1,~~;~, , - ;~ ~~ .~~: P Y your year-to-year ,.~. ~~. ,.,~ , -sw..lr~ts~' , J<c ;~ ,,:I~r;+•~:.;~~.~.«~r5r~,~,<<~~.~~t~~,~~,~~,.~'~~ r 3~,"~<<r ~~„~;~~r.~c~~i~~~.;,,~h~~„~~;r~~~~~ „~:,~yK ~.° electric use by month. Meter readings are actual unless Account Balance otherwise noted. $12.51 2011 ~ 2012 PPL Electric Utilities' price to compare for your rate is 7.907 cents per kWh 12 effective 9/1/2012 to 11/30/2012. For a list of supplier offers, visit r so papowerswitch.com or www.oca.state.pa.us. Y $ Your Message Center 0 6_- -- -- 1- ~ ; . :+e.~~' of pp PPL. ElecMc Uttltuea, Page 1 Questions? Please f~ Visit us online at 0 6. PPlelectiic.com . • . • ' _ U :~.-~ contact us by Aug ,. sl. T. .V ~ ~, ~ >>~,;•rr • ° DIAL-PPL ;t7' ;o=- 1-800- 20500-75004 Aug ~~~ ~~` " ~ ~;~~s`'„ `''i~~ •. (1-800-342-5775) 6, 2012 ,,,,~„5~,~;~c~::,,,,~ ~„ , ,,,~;~r,~~~tr e~ , ~- M-F: Sam to 5pm Your Electric Usage ~rofil~ Service to: MARTHA M GIBNEY 870 OAK OVAL MECHANICSBURG, PA 17055 Meter: 84532681 Your next meter reading is on or about Aug 13, 2012. This section helps you understand your year-to-year electric use by month. Meter readings are actual unless otherwise noted. ®2011 ^ 2012 12 Billin .Summa (Billing details on back) Balance as of Jui 16, 2012 $0.00 Charges: $12.10 Total PPL Electric Utilities Charges Total Dominion Energy Solutions Charges $6.96 $19.06 Total Charges ,-~ ,, _. ........ .........:.1. ...,.i.,1:~..,art,~i:„rftYat~n..,i??.~_,W~'wl!Ii4it.I~t~i,:'I~. 1 '.1~lYt;('E;~ ~'~~1~11y Account Balance $19.06 PPL Electric Utilities' price to compares fist of supplier offersCevis'tper kWh effective 6/1/2012 to 8/31/2012. Fo papowerswitch.com or www.oca.state.pa.us. Your Messa a Center • With paperless billing, you can receive and pay your PPL k convenie t ands securle To earnr more or s gri up, qu~c , visit pplelectric.com. r Y 10 8 0 6 4 2 0 1 F M A M J J A S O P1 v Months ~ . y ~ :. -: ~ • • Ju12012 30 101 3 77F Ju12011 30 164 5 74F :.. Jul 13 Actual .. 18542 Jun 13 Actual 18441 30 Days kWh Billed 101 .. . Aug 2011-1u12012 . . 1898 158 Aug 2010 -Jul 2011 2196 183 • Information about appliance energy use and tips on saving energy are available through the Energy Library on our Web site, pplelectric.com. • Before digging around your home or property, you should always call the state's One Cali notification system to locate any underground utility lines. You can do this by simply dialing 811, which will connect you to the One Call system. Be safe and call 811 before you dig. Pa ment Methods Online at: ©By phone: i-800-342-5775 lies `~ pplelectric.com or call BiIlMatrix (service fee app. ) at 1-800-672-2413 to pay using Visa, MasterCard, Discover or debit card. ® By Mail: 2 North 9th Street CPC-GENN1 Allentown, PA 18101-1175 Correspondence should be sent to: Customer Services 827 Hausman Road Allentown, PA 18104-9392 Other important information on the back of-this bill -~ • - - • Co G ll l ~umer e ~ ar Account Number 7404643 • • Invoice Number Bill Close Date F081328871 Due Date 08/17/2012 o9/os/2o12 ~~~~ FINAL INVOICE - This account is closed. Thank you for your past business; ifi is greatly appreciated. There are two Balance Information things we would like to point out as you review this Previous Balance $14.00 final invoice: Payments -$14.00- Adjustments $0.00 ~ Consumer Cellular bills airtime & monthly Past Due Balance $0.0o fees in arrears ~ after they have been used. Usage $0 75 This invoice is for services used during Monthly Access Fee $2 26 your final billing period up until the day Surcharge & Other Charges $1 21 service was canceled. Please reference the Government Taxes & Fees $1,48 Monthly Summary section on page 2 to verify Current Charges the days you are being billed for on this $5.70 invoice. The Billing End Date is the last Total Amount Due $5.70 day of service. _ _ Pa.~.rrrent:.Due._091.OS/201;2,_ v . We only hill vn~ ~ for tt,o_r~a.,~ "~~ ~ ,,,,oro „-, Please detach and return above portion with your payment . _ . ~ . consumer ~ell~lar~ . Account Nucm ~e,~ Invoice Number Bill. Close Date Due Date 7404643 F071320971 07/17/2012 08/08/2012 3RD ANNUAL GRANDPARENT'S DAY CONTEST BEGINS Balance Information Previous Balance Payments ~ Adjustments Past Due Balance Usa ge Monthly Access Fee Surcharge & Other Charges ~ Government Taxes & Fees Current Charges Total Amount Due Payment Due 08/08/2012 sf r {'~ ~ .i ^ '. Consumer Cellular GRANDPARENTS DAY 2012 It's that time of year again! We've launched our 3rd annual Grandparent's Day Contest! Submit your super grandparent story for a chance to win one of the grand prizes - a European River Cruise or an Orlando Vacation Package! Plus, we have lots of special category prizes like "most humorous story" and "best travel-related story" as well. Whether you want to enter or just view all the touching stories about the joys of grandparenting, be sure to visit the contest web site: www.ConsumerCellular.com/Grandparents. $13.68 -$13.68 $0.00 $0.00 $0.25 $10.00 $1.43 $2.32 $14.00 $14.00 ......... n..........,._....n..~~..~.... ,....,.,. I /QQQ\ 4AG_~Gi~l I Cor~ii~o(c~~`nnc~~marC_~all~~lar ~nm veri~n V+~Irzon ~~lrs Don't Move Without Verizon! Call 1-888-416-9691 before you move. We'll help set up your Internet, TV and Phone for your new address. You can be up and running in no time! DON'T WAIT! And be sure to ask if FiOS is available in your area. Service availability varies. We Want You to Stay With Us You are a valued customer & we want to deliver the very best service & value to you. Call us at 1-888-882-4397 to find out about the new ways Verizon can save you money. We appreciate being your provider, and we would like to keep you with us longer by improving your Verizon experience. FiOS Network Upgrade Call 1-888-882-4394 or visit verizon.com/supreme to learn more about our network upgrade to deliver better services at the best value. From phone, Internet & TV bundles, to international plans and fun add-ons, together we'll find ways to save you more on Verizon's superior services. Account Number 717 796-1220 1314 I43Y Due Date Amount Due Upon Receipt $29.47 _Account Information Statement Date: 8/6/12 MARTHA M GIBNEY Phone: 717-796-1220 Account Summary Previous Balance No Payment Received Balance Forward $45.02 $.00 $45.02 New Charges Current Activity -$8.78 Taxes, Fees and Other Charges _ -$6.77 Total New Charges -515.55 Amount Due -Please Pay Now $29.47 Final Bill Pay your bill online at Verizon.com/payfinalbill To avoid referral to an outside collection agency, the full amount is due upon receipt. 6 ~~~~~ `~ ~ AUG 1 1 2012' ~,' ~,. Want Automatic Payment? ~ ~ Questio s about your bill or service? ~RW~IIV ~ iNCKIVIGFITView your bills in detail at verizon.com or call 1-800-VERIZON (1-800-837-4966). Enroll below or at Verizon.com to authorize your fina OFFICES Enter your ten digit number 717-796-1220. Use 314 if asked for your customer institution to deduct the amount of your monthly bill rt om identification code. Reach us by TTY at 1-800-974-6006. the account associated with your enclosed check and send payment directly to Verizon. To discontinue Automatic Payment, call Verizon. Please keep a copy of this authorization. Please return remit slip with payment. -~_..u ___ ........................ OC = ~ _ _ Z ~~ O ..._ ~ ~ J ~ v W W ~ ~ ~ W _Z ~' I- °4 W ~ W Z ~ ~ °L 3 w 0 a 0 a c 0 «. ;~ 0 a 0 u 0 N N m 0 o: 2 ~ a a. ~~ RUMBERGER'S AUTOMOTNE SERVICE CENTER 4840 OLD GETTYSBURG ROAD MECHANICSBURG, PA 97055 (717) 73?-4099 ~ V .. NAMEIADDRESS TODAY'S PHONE MILEAGE Work Order Number 83,354 45093 GARRY NOBLER HOME PHONE COLOR Work Order Date 913 HERMAN DR (717) 766-9407 WHITE 07!2612012 MECHANiCBURG, PA. 17055 WORK PHONE LICENSE NO. SOLD BY DCP5134 JASON ACCOUNT NO. CELL PHONE VIN PURCHASE ORDER NO. HOSL001 (797) 991-3436 1G4HR53L5PH471841 7993 BUICK LESABRE LIMITED 237cid 3.8l. V6 GAS Fl N ViN:L (9099630) Completed Da#e: 07/24!2012 QTY. PART NO. DESCRIPTION OTHER PRICE DISC TOTAL 1.00 IM PA EMISSIONS INSPECTION ~ $19.95 $19.95 PRICE INCLUDES $2.40 TELE-COMMUNICATION FEE STICKER # IM2-5596204 1.00 PS1 PA SAFETY INSPECTION $18.00 $18.00 INCLUDES: $2.00 STICKER FEE BRAKES: LF: 7/328 RR: 4/32R TIRES: 7LF 6RF 6LR 6RR STICKER # AI2-7521359 ~Q 1 ~" F' 17v ~ ~ 14.00 3116 METAL BRAKE LINE $2.95 Y $41.30 2.00 BF BRAKE FLUID $2.25 $4.50 2.00 P FITTINGS $4.95 $9.90 3.00 L LABOR $70.00 <<~~7~f ~' $210.00 RU~1U~Ru~Rt TTYSBUI~G RO Q84q t~LD t~ECHANICSBUR PA 1~t~1a5 L3428761470U1 U7/`16/2012 #.1~D~D Op ID: 91 Register : 1 Trans ~ Your Cashier: Area $321.gj ~~ ~~ORK __._-----._ . _ r~.~.... _. _ `,,, 5uhtntal = ~3~1.U7 a ~.~_...~... ~U.~~ ~o ooeeosoeooeaoooooeao0o.+ Tax = U Total = X521.87 + hereby £ Cfi811ge Due = $() ~ 00 ~' Total Jobs $37.95 Subtotal $303.65 sutorze the ie+s and hereby gran Total Parts $55.70 Disc $0.00 on stres3s. t ~~~ 1 , ~~ _ aedesalbed o ._~ ~ '_ . vehicle at lh C red i t ~_ ._.., +. ~ TOtal Labor $210.00 Sales Tax /0 6.000 _ .____.___-._ _ .- -- .... _ __._ _ _ _- .._. - He~a~ Total Other $0.00 Sales Tax $18.22 reFairs. Yo;. _. ` pit in vehdGe in IIa59 011Ere i~~~~I ~X ~y X~~~ g~,(~Q , Visa sge~ e~cn Shop Supplies $0.00 Total $321.87 i9 rieCteSSaf; X HQSLERIGARRY i- ~NVQICE A3g333 A~ ~i'u Ilf1Qi ~i~i _ _. _: .