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HomeMy WebLinkAbout10-15-12 1505610140 REV-1500 Ex (°'-'°' PA Department of Revenue Bureau of Individual Taxes PO BOX 280601 INHERITANCE TAX RETURN County Code Year File Number ~ _ -~, - . ~ r Harrisburg, PA 17128-0601 RESIDENT DECEDENT , ! ~ ~~ ~~' ~ ~~~-- ~/ L~ ;~ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 1 8 1 4 2 7 8 2 9 0 1 2 6 2 0 1 2 0 1 2 3 1 9 5 1 Decedent's Last Name Suffix Decedent's First Name MI COR N MAN ROD N EY L (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI C OR N MA N SAND RA L Spouse's Social Security Number 1 2 7 3 4 2 0 4 2 THIS RETURN MUST BE FILED I N DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW a 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ prior to 12-13-82) 5. Federal Estate Tax Return Required 6 D d t Di death after 12-12-82) . ece en ed Testate ~ (Attach Copy of Will) 7. Decedent Maintained a Living Trust A 8. Total Number of Safe Deposit Boxes ( ttach 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 T0: Name Daytime Telephone Number R MARK THOMAS, ESQUI RE First line of address 1 0 1 SOUTH MARKET Second line of address S T R E E T City or Post Office State M E C H A N I C S B U R G P A Correspondent's a-mail address: RMARKTHOMAS GMAIL.COM REGISTE~pF WILLS USE'®NLY -- ~ ~ e_ - ~.3 ~` _ ~.. 1 ~ r- - ._ `Y_ ~~_- { c~ `_z - -. ~ ~ i t ~-~F.• 1 ' AT~ FILED ,'*' ~ ~' ZIP Code L 1 7 0 5 5 cx~ ._~~~ ~. ~~ C~~ .~~:~ r- -=.; ~:~~ ~"~ ~ - .~..~ '_ . -~ ~ ~~ r~'1 2 unaer 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, correc nd complete. Declarati of pre arer other than the personal representative is based on all information of which preparer has any knowledge. S NATO PERS N RES LE ILING RETURN DATE ADDRESS ' ', 357 R SROA OOL ROAD NEWVILLE PA 17241 SIGNA OF RE HE R PR T TIVE A DRESS ~OAI~ ~ .Z 101 S. MARKET STREET MECHANICSBURG PA 17055 PLEASE USE ORIGINAL FORM ONLY L 1505610190 Side 1 1505610140 J`4 J 1505610240 REV-1500 EX Decedent's Social Security Number Decedents Name: RODNEY L. CORNMAN 1 8 1 4 2 7 8 2 9 RECAPITULATION 1. Real Estate (Schedule A) ........................................... 1. 2 O 1 2 ~ ~ • 2. Stocks and Bonds (Schedule B) ...................................... 2. 0 • ~ 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. 1 1 6 8 1 3 3 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. • 7. Inter-Vivos Transfers & Miscellaneous Nan-Probate Property (Schedule G) S 0 ~ U eparate Billing Requested ....... 7. . 8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 2 1 2 $ $ ~ 3 3 9. Funeral Expenses and Administrative Costs (Schedule H) ................ .. 9. 9 7 7 1 2 0 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ...... ..... .. 10. 5 6 7 2 3 . 9 3 11. Total Deductions (total Lines 9 and 10) ........................ ..... .. 11. 6 6 4 9 5 . ~ 3 12. Net Value of Estate (Line 8 minus Line 11) ..................... ..... .. 12. ~ 4 6 3 8 6. 2 ~ 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ............... ...... . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ............... ...... . 14. 1 4 6 3 8 6. 2 ~ 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 .0000 1 0 ~ ~ O 15. Q• Q Q 16. Amount of Line 14 taxable at lineal rate X .0 ~ ~ ~ 16. 0. ~ 0 17. Amount of Line 14 taxable at sibling rate X .12 ~ ~ ~ 17. ~. ~ ~ 18. Amount of Line 14 taxable at collateral rate X .15 0 0 0 1 g. ~. ~ ~ 19. TAX DUE ............................................... ...... .19. 0 . 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ Side 2 1505610240 1505610240 J RE`J-1500 EX Page 3 Decedent's Complete Address: File Number 0 0 DECEDENT'S NAME RODNEY L. CORNMAN STREET ADDRESS CITY STATE Zlp Tax Payments and Credits: ~ ~ Tax Due (Page 2, Line 19) 2. CreditslPayments A. Prior Payments B. Discount 3. Interest 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) Total Credits (A + B) (2) (3) (4) (5) 0.00 0.00 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 income of the property transferred : ...................................................................... ^ b. retain the right to designate who shall use the property transferred or its income; ............................... ^ Q c. retain a reversionary interest; or ................................................................................................ ^ 0 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 "in trust 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? .................................................................................................. 0 ^ 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) (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. REJ-1502 EX+ (01-10) Pennsylvania SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF: FILE NUMBER: RODNEY L. CORNMAN 0 0 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1. HOUSE AND PROPERTY 4.5 ACRE -LOT 26 PB 56 PG 17- ASSESSED VALUE 201,200.00 357 CROSSROAD SCHOOL ROAD NEWVILLE PA 17241 TOTAL (Also enter on Line 1, Recapitulation.) I $ 201,200 00 If more space is needed, use additional sheets of paper of the same size. RFV-1508 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY r~Lt numrstrt RODNEY L. CORNMAN 0 0 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 NUMBER VALUE AT DATE DESCRIPTION OF DEATH 1. PRUDENTIAL-UNION PENSION PAYMENT 428.33 2. PRUDENTIAL- UNION PENSION PAYMENT 428.75 3. M&T BANK ACCOUNT#871346 1,98521 4. (SOVEREIGN BANK ACCOUNT#2591005605 I 2,006.74 5. 1993 BUICK CENTURY -142,000 MILES 1,275.00 6. 1984 FORD RANGER - 77,000 MILES 300.00 7. (FIDELITY 401(K)- (PAYOUT CK RECEIVED 3/23/2012- $4205.84- after federal taxes) I 5,257.30 TOTAL (Also enter on line 5, Recapitulation) I $ 1.1,681 33 (If more space is needed, insert additional sheets of the same size) - REV-1511 EX+ (10-09) Pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER RODNEY L. CORNMAN 0 0 ITEM NUMBER A. 1. 2. B. 1 Decedent's debts must be reported on Schedule I. DESCRIPTION FUNERAL EXPENSES: Hoffman-Roth Funeral Home George's Flowers City State ZIP ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address Year(s) Commission Paid: 2. Attorney Fees: R. MARK THOMAS, ESQUIRE 3. Family Exemption: (If decedents address is not the same as claimant's, attach explanation.) Claimant 4. 5. 6. 7. 8. 9. 10. 11. 12. 13 Street Address City State ZIP Relationship of Claimant to Decedent Probate Fees: Accountant Fees: Tax Return Preparer Fees: HERSHEY MEDICAL CENTER CK#102 BANK FEES- SOVEREIGN- OVER DRAWN- AUTOMATIC DEDUCTION MORTGAGE PAYMENT UNION PENSION- RECLAIMED UNION PENSION RECLAIMED CHECK BOOK FEE SOVEREIGN BANK FEE- REQUEST DOD VALUES 2, 312.50 323.50 100.89 70.00 163.17 428.33 428.75 9.80 20.00 TOTAL (Also enter on Line 9, Recapitulation) $ 9 771.20 If more space is needed, use additional sheets of paper of the same size. AMOUNT 5,751.02 163.24 RSV-1512 EX+ (12-08) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER RODNEY L. CORNMAN _ 0 0 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. FIA CARD SERVICES - 5,382.00 BANK OF AMERICA CASE NUMBER 11414961 ORIGINAL DEBT- (5979.99- REDUCED BY 10%) 2. FIDELITY 401(K)- FEDERAL TAX WITHHELD AT DISTRIBUTION 1,051.46 (REPORTED ON SCHEDULE E) 3. Sovereign Bank Line of Credit Acct# 4539470264 16,748.85 4. Sovereign Bank Acct #2596000348 33,541.62 450 Penn St Reading, PA 19601 TOTAL (Also enter on Line 10, Recapitulation) I $ 56,723.93 If more space is needed, insert additional sheets of the same size. REi~-1513 EX+ (01-10) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: RODNEY L. CORNMAN n 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. SANDRA L. CORNMAN Spousal 100.00 357 CROSSROAD SCHOOL ROAD NEVWILLE, PA 17241 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: 1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN; 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ It more space is needed, use additional sheets of paper of the same size. M&T Bank 499 Mitchel Road, Millsboro, DE 19966 Adjustment Services Phone 8~3-502-~ X49 F ax (~02; 934-295 June 13, 2012 R. Mark Thomas Attorney At Law 101 South Market Street Mechanicsburg, PA 17055-3851 Re: Estate of Rodney L. Cornman Social Security: 181-42-7829 Date of Death: January 26, 2012 Dear Sir ~r Madam: Per your inquiry on June 5, 2012, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Accoicnt Account Number Oti~~ners{tip (Names o~ Opening Date Balance on Date of Deatla Accrued Interest Total Clzeckina Account 871346 Rodney L. Corrtrnan 1021/1988 $1,985.21 $ .00 ------ _ _ $1,985.21 For any additional information ~n the above accounts, including ownership and any changes, closures and/or reimbursement of funds, please call the High Street at 717-1A0~3536. We were unable to locate any safe deposit bos for the above-mentioned decedent. This letter does not include any accounts in which the dece~~.5ed ma~~ have been listed as Power of Attorney, Custodian of Uniform Transfers. RepruSentative Payee, or Trustee under a Written Agreement. Sincerely, Valarie Mercer Adjustment Services So~~ereigr~ Bank ESTATE OF Rodney L. Cornman SOCIAL SECURITY #: 181-42-7829 DATE OF DEATH: January 26, 2012 Account #: 2591005605 Type: Checking Open date: 12/9/1998 In the name of: Rodney L Cornman Date of Death Balance: $2,006.73 Int.(YTD) from 1 / 1 /2012 to 1 /26/2012 $0.00 Accrued interest to date of death: $0.01 Other Info: Account #: 4539470264 Type: T_.ine of Credit Open date: 6/2/2010 In the name of: Rodney L Cornman Date of Death Balance: $16,678.77 Int.(YTD) from to . Accrued interest to date of death: $70.08 Other Info: Day-of--death payoff amount: $16,748.85 ($16,678.77 balance + $70.08 interest) Page 1 of 1 .. K ~, j.: ~~t ~ .~.. es ~4- r~;'t 3 h~ °n. n r~ ~ r ~ ery - {• ~i. F, 'v i n _ ~ _ -~~~. 'sa..~ ti+i~a.,J~~ ~i i f +.~I ~I~i I I~ `il GIU LPL? t ~f (iJG>V `t'LW .. ~ r; ~ z Date: d~/a~/2oza SOV~~EIGN SANK 450 ~RNN sT R~p,DING, PA 19 ~ Q 1 RE: SANDRA L. CORND~AN ACCT#: 2596004348 pear Sir/Madam: Enclosed please find my check in the amount of ~ 3 ~ , s~1.. 62 for the payoff of the above account. For Revolving Line of Credit Qnly: (Cheek Qne} l~iease leave this Revolving Llna of Credit open. Please clo$e this E~evolving Une of Credit. (Customers signature Is required below.} If the Revolving Line of Credit is secured by a mortgage or other lien on my hams, please satisfy the mortgage or other lion of record. If for any reason you do not satisfy the mortgage, please advise me and Sovereign Bank, Mail Step RIB-EPV-02-15, One Sovereign Way, Riverside, Ri 42915, as promptly as passible, as t have obtained a home equity loan ar line of credit from Sovereign Bank 4n the condition that the mortgage you hold be satisfied. ~-~'~' ~ ,~ ~ ~ { 1 _ (Customer signature (Customer signeture) - (Customer signature) (Customer signature) Please forward any paid documents directly to the customer. Pamela ~Cu~nzi~ (717) 243-29,5 ,... ,, .:. Sovere_gn Bank l+IA Attn: 10-421-t~2 a5o Ponn stroot R,oading, PA 19602 **Reaidential Mortgages Payoff Quota** 06/9/12 Loan Number: 2596A00348 Sent To: Fax x}877-391-6367 APPLICATION #~ 110725a Borrower (s ) Name (s) RODNEY Z CQN Property Address: 357 CROSSROADS SCHOOL Rl~ NEWV II,LL PA 17241 As of 06/29/12 the status of this loan i~ ~~ follow: '~itxvs Y'1'D Escrow Bs-lariae Interest Paid To Dsr Diam Iatirest .00 .00 06/20/12 5.6912 Iatere~t F~tQ GalCUlated Tc~ Intexe~t Due -------------- ------------- ------------- 6.~5000 o~/cs/12 loa.~a *** Payoff Amount Calculation *** --------------------------------- Prinoipal Balaaco ~ 33320.18 Intorost Caloulatod to 07/09/12 108.3a D~i'err~d Amount (a) . 00 Accumulated Late Charge Balance 0.00 Lifo/AH Inauranao CalouYatod to 07/09/12 0.00 Escrow Shortag~(~)fEacrow Netted(-) 0.00 Other Fees 0,00 Recording Fee 5p,50 Prepal+ment Penalty Fee 0.04 Leis U'napp~.i.ed Fuad~ 0.00 .04 ~'AX E'EE 0. 0 G ** TQta~. Recuired to Pmu Lacer. Off** - 3?479.02 PMZ/sHA to be doduat.d Pram Becrow Balance G,QO Payoff Prepares,' By: T~llar# 00326 ©r. 06/29/12 Py~ Feac; 0 ~.-~-~ cr..~st'ar.~, ~ oaso ccntac~ L~ at ~~gOC-r..~~:-r~.~.y I .~ ____. s= " -~ ; f ~. la ZWN ~ ~ ~.i Z -~ O HC)A ~ r A A ro rnNo v -p OZ ~' z O ~~ ro N = F~ O r A 0 v d f ,A) V C ~~ ~ ~°--~ r -G - = C7 ""~ == ..~ .,i ~~ ~----- ~~ Z ~.~----~ ___--- 7J r_ T •+~- ~•. ~'i'1 __-- rn .. i z O 'Z -i -~ -~ ' w ~~~ u, ~- r n z ~~ ~' ~ .._i _. ~~_. ~ . ,.~ m x o N co cv '~ i11 ~ O ~ X -; ~..Y.: tD p1 r r. :+~ O 3. ca; O ~' N ~. o ~'~:. ~ W W CJl o `., z cv cn ~ E v Z -A 'C d O E-~+ t7 70 F-+ r~1,, r- O rn~n NO ~~ rte. n z d~ z ~-' N o N = b -~ O ~o ~- 0 n d C '' '`! -----_ A --= ----._ _ ---- rn ao == ~~' rn z -~- .~ --- D ""_" -- __ _~ ---_ -.._. Z -- ~ -'~=: fn -,._ 't7 r D Z gin.: m ~ ~ D~ ~~. ~~ro .... p Z ~ ~ ~ ~ ~~ X m can .. v ro ~: 0 ~ a O i'C~Ef~ Efl {ry ~' N ,~,r '~' O N N n W cp ~ E°s UOi ~ Cn Vi ~ ~ N 'V ~ OOw D '~~ACJCJS '~:QlOO„~,~ N O~ O ~, _~_' ~-._. °' --~_ -.. e / N S T M E N T S Supply Ch '~ Retirement Savings Plan Retirement Savings Statement October 1, 2011 -December 31, 2011 ENV#OP042852 OP 74401 T RODNEY CORNMAN 357 CROSSROAD SCHOOL RD NEWVILLE, PA 17241 ~$ Customer Service Number: 1-800-835-5095 Internet Address: www.401 k.com You can get information 24 hours a day by calling tl~e customer service number or accessing your account online. Get Your Statements Online Online statements offer many advantages over paper statements. For instance, you can view and print up-to-date statements whenever you like, and you can retrieve statements for any date, month, quarter, or custom date range within tl~e previous 24 months. To sign up for online statements, please visit us online, go to Mail Preferences under the Your Profile tab, and update your delivery preference for savings statements and other notices. Yau must also provide us with a valid a-mail address so that we can periodically remind you to view your statements and other notices online. Your Account Summary Beginning Balance $4,912.26 Fees -7.00 Change in Market Value 151.46 Ending Balance $5,056.72 Additional Information • Dividends 8 Interest $98.74 Your Personal Rate of Return This Period 3.1 Year to Date 0.3% Your Personal Rate of Return is calculated with atime-weighted formula, widely used by financial analysts to calculate investment earnings. It reflects the results of your investment selections as well as any activity in the plan account{s) shown. There are other Personal Rate of Return formulas used that may yield different results. Remember that past performance is no guarantee of future results. Your Asset Allocation Stocks 35% . Bond/Mangd Inc 60% Short-Terra 5% Your investments are currently allocated among the displayed asset classes. Percentages and totals may not be exact due to rounding. The Additional Fund Information section lists the allocation of your blended funds. ,~, Please read this statement carefully. Any error must be reported to Fidelity Investments within 90 days. 42852 OP042852 0001 20120110 OP4K Fidelity Investments, PO Box 673008, Dallas, TX 75267-3008 ~ Page 1 of 6 Kelley Blue Book ~~ ~~ ~. ~~ 1,.---~-~ ~3`'~"~~ R~~~ #;]!~~ B~ rift ra~st€c~ r~rac>u~c: t. ,~ i', r ~9g~:~ un~~ ~' ~~ _ "f?~e i~};~rai~ i`c3~~r f'r cE itzol. ~r~ly f~ ~;~~ l~rc~~ir,: ss±va .- _~ .. ~..._~.. =~ .. - awemsemen[ why ads? Your Blue Book®Value ~~ ~~' 1993 Buick Century Style: Special Sedan 4D „~ ' Mileage: 142000 -.. .~ ^~ ~~~ Private Party Value Vehicle Highlights Excellent $1,425 MPG: Cit 17/H 24 y ~ Max seating: 6 Doors: 4 Engine: V6, 3.3 Liter Very Good $1,325 Drivetrain: FWD Transmission: Automatic Good EPA Class: Midsize Cars Body Style: Sedan $1,275 ,' Country of Origin: United States Country of Assembly: United States Fair ~8~~ Your Configured Options Our pre-selected options, based on typical equipment for this car. / Options that you added while configuring this car. Engine Comfort and Convenience Wheels and Tires Vti, 3.3 Liter Air Conditioning Steel Wheels Transmission Power Windows Automatic Power Door Locks Drivetrain Cruise Control FWD Steering Power Steering Tilt Wheel Entertainment and Instrumentation AM/FM Stereo .., Cassette Page 1 of 2 http://www.kbb.com/buick/century/1993-buick-century/special-sedan-4d/?vehicleid=9935... 6/26/2012 ~.... ,y --~ . ~"_ -~ ~i'~ -- __ 1, - I~UNLI'AL I-IOML & CREMA~'ORY, INC. Mrs. Sandra Lee Cornman 357 Crossroad School Rd. Newville, PA 17241 Statement of Funeral Expenses for: Rodney Cornman Date of Death: January 26, 2012 Account Id: 16457-028 PACKAGE: Traditional Funeral Service at Funeral Home Embalming, Other Prep of Body, Public Viewing and Cremation nPTIONA 1A -Cremation $ 4,100.00 'otal: SANDRA LEE CLARKSON G% ~Q,G~jri/~j~~j„~ 825 ~' ~~~ .00 122 N PITT STREET ~ARLISLE PA 17013 60-8762/2313 '17-776-3580 a~ ..~...u, ~,~,.,~ „>>,>,~>,>, f'.c7, $ox 1181, Carlisle. PA 17013 ~: ~ 3 L 38 ?6 28~: 06 2 L008 5 _letr~rv . ~ ~~.; ense: Balance: ~~,~^~42 Please return this portion with your Remittance. $,~~'~~~~-- Amount Enclosed Rodney Cornman Service ID#: 16457-028 219 Norfh Hanover Sfc~ Carlisle, Pennsylvania 17c! 717.243.4 `> I toll free 1.866.451.4.`_~~ I ! fax 717.243.31 :' , v~~.hoffmarroth.c , a info@hoffmanroth.r. ~ ~ ~ February 8, 2012 $ 4,100.00 'otal: $ 1,195.00 ~ _ DATE ~~ ~~>~ ~RS Fe.,~,., 1.90 Detailed on Ba[k. x.12 ` ).00 1.00 . ~/~~.,•.~~ _ Total. SERVING OUR COMMUNITY SINCE 1 9 0 7 z... . ~ , v ,u .3~ GEORGES' FLOWERS 101-199 G STREET CARLISLG, PA 17013 ~ ~~ , - - ~~ ~~~~~~ ~. ~~ SALESPERSON ., FILLED BY DELIVERED BY _ -- ~ `^ FLORIST # DATE ORDERED FTD TF PHONE M.C. VISA A DISC. EXP. TIME & DATE SENT # ;u-~C..~%l ~C~°L.tis~~~ SOLD M d,., ~ TO ~~ ~ ~ ADDRE r, CITY: STATE: ORDERED: BY: PHONES HOME: BUSINESS: DELIVER j TO I ADDRESS: ZIP: CUSTOMER.ACCT.'.# c o ~~~ /'".. .Y n ~-y1 CIlY: PHONE DELIVERY CARD- ATTACHED, SYMPATHY SPEED REC. - BIRTHDAY MATERNITY ANNIV. PLAIN FiOLlf3AY ~ ~ ~~~E ~'~~~ i _- 1 A ~~~~ DELIVERY DATE: g ~ 0 R BASKET - PRAY MACHE EMBLEM iNREATH ARRANGE p' CENTERPIECE ALTAR VASES BOXED CONT. PLANTS BL. PLANTS ARTI. ARRANGE CORSAGE , IN CUST. CONT.. ~ PICKED OUT CONT. SELECTED.. ~~ ~~ ' (~zJ ./ ~,~`~ f~~ O ~~ CX-` ~~~ ~ v ` ~~ ~/~'t'~i ELIVER L (-~ ~' RELAY ay~,~ '~ `\ UB TOT, ~ ~~` ~,,~~r ~ ,- ~ TAx . ~ ~ ~ ~~~ TOTAL U PRESS ~-~ARD eARABIN ASSUC'IATES M7) 773-9327 GF-04 3 ~~ i ,_ ~a3nn3o 3NOMd W ? 14Z.! ~t I ZU : ~,~~'~ ~~ +`' ~~ rL~^ C~ (,e'k1l.V U a.~ ~ ~h~ VI ~ ujsn~ a-~~1~ -~c'~ n°~, ~1~.-e al. ~s3a . ~~ ~~ ~ ` : anp af~ueyQ _ .# ~~.oov a3wolsno - p0' Q $ ; pa.aapua 1 dui ~ou~d ~diz v' r', 00 Q I i ~ _ i ~ ~ e~atd NOIldUd SIFT N~1(11~~1 aNt1 I-i~dl~Cl ~~' er~p a,>'_Ip[~~] g :(ZtOZIrtIZ) OQ' ~) $ :~~mrnud ~uaui(~ 2d`p as ~el~,4t tiZ' ~;9t 1N3Wl~dd HlIM lIW3a dN`d H~d134 3Sd3ld ;~j~uE'N ~'-jj1°~'`~ ~~dH ~ d~dl ~ M pln~p : a~,~ ~~~~~t~ ~~~~r~~~~~~:, ~,~Qtzoo t $ aldd iNnowd ~r1~~IaNI ~Sd3ld £60 ~ Z00 Z ~ OZ/ L O/ZO 1N3W~d `~ ~ON 1N~10~0`d 31`dd 1N3W~lt/1S uaoo~do~~sao 109-~;t%~-LLL ~Xt1~ 9Z9~-', :UOtss~'S GZtZ alp °eao~~a~al ,~~ eGO~~ b~ `~-~si-i~d~'l~_ ? ;~eut~uaal {~~ ~ ~ ~. C 'Z,t :~~ui. ~~(1Z1.~t 5213Mt11 ~ .S~`Ji147`J RECEIPT FOR PAYMENT -------------------- GLENDA FARNER STRASBAUGH Receipt Date: 2/22/2012 Cumberland County - Register Of Wills Receipt Time: 11:31:00 One Courthouse Square Receipt No.: 1068848 Carlisle, PA 17613 CORNMAN RODNEY L Estate File No.: 2012-00233 Paid By Remarks: R MARK THOMAS HEA ------------------------ Receipt Distribution ----- Fee/Tax Description Payment Amount Payee Name PETITION LTRS TEST 260.00 CUMBERLAND COUNTY GENERAL FUN WILL 15.00 CUMBERLAND COUNTY GENERAL FUN SHORT CERTIFICATE 20.00 CUMBERLAND COUNTY GENERAL FUN JCS FEE 23.50 BUREAU OF RECEIPTS & CNTR M.D AUTOMATION FEE 5.00 CUMBERLAND COUNTY GENERAL FUN --- Check# 3550 ------------- $323.50 Total Received......... $323.50 rzr ~ .? .w-~ ~~ -~ w w~ O -ti7 °^~ p rL ~ i ti ~ v' D ~ r ^: z ~ v m Gl ., °a rr ~ ru r ~~ ~ ~~ Z ~'' (!) f71 l8 rn~D~ ~oo~ m~DR7 nom 1 ~ ~ T ~ ~ n 0 ~ v --., o° 70 rn ~, ' r' Z -G 'oDr.. Zn rn~ ~n': ~ m~ D Z, ,. t': N w w .i /~ V 1 0 N ~. Previous account number: FIA CARD SERVICES"" 4313077214430110 New account number: _ LL 0530 H 245 000 00022 #~Ol SP 0.000 4313077999000047 ESTATE OF RODNEY L CORNMAN J C/0 R MARK THOMAS 101 SOUTH MARKET STREET MECHANICSBURG PA 17055 May 25, 2012 Dear R Mark Thomas: Please accept our condolences on the loss of Rodney L Cornman. As we discussed, the current balance on the above referenced account is $5,979.99. If a payment of $5,382.00 is received by June 25, 2012, our claim against the Estate will be settled. Please use one of these convenient payment; options available to you: .k Overnight your payment by express delivery to FIA Card Services Visa Signature, Retail Payment Services, MS: DE5-023-03-02, 900 Samoset Drive, Newark, DE 19713. Please write the full new account number on the front of the payment. * Mail your payment to FIA Card Services Visa Signature, PO Box 15019, Wilmington, DE 19850-5019. Please write the full new account number on the front of the payment. * Make your payment over the phone by calling 1.888.339.6262,`24 hours a day, seven days a week. Please have your checkbook available. Be advised, that you, in your capacity as the personal representative, executor or attorney handling the affairs of the decedent, are not personally responsible for this debt. We are seeking payment from the assets of the decedent's Estate from the person authorized to pay the decedent's bills. In this capacity, you are not required to use your assets or any asset you own jointly with the decedent to pay the decedent's debts. _~ MBM ES16 1-1 US-EN / .._ __ U1 of U2 ~~. National Integrated Group Pension Plan NIGPP EXECUTOR OF THE ESTA'T'E OF RODNEY CORNMAN 357 CROSSROAD SCHOOL ROAD NEWVILLE PA 17241 Dear Executor: April 3, 2012 PO Box 5315 Scranton, PA 18505-5315 Phone: (8001321-2393 Fax: (8881499-4315 www.nigpp.org Employer Number: 00730 Name oi' Deceased: Rod~~ey Cornman Customer ID Number: A00301544 Date of Death: January 26, 2012 Please accept our sincere condolences on the death o1~ Kodney Cornruan. Mr. Cornman was receiving payments during his lifetime. These payments ceased with the payment due hefore death, therefore, no further payments or benefits are due. Please note, if applicahle, we have attempted to recover any outstanding checks and/or electronic del~x~sits that were either dated after the decedent's death yr not due the decedent. We will contact you if we are unsuccessful in our attempt to recover these funds. If you have any questions or concerns, please dv not hesitate to call us toll free at (800) 321-2393 between the hours of 8 a.m. and 9 p.m., Eastern Time, Monday through Friday. One of our Customer Service Representatives will he happy to assist you. Again, please allow us to express our deepest sympathy for your loss. Sincerely, NIGPP Administrative Agency Prudential Financial is a service mark of The Prudential Insurance Company of America, Newark, NJ and its affiliates. Prudential Retirement Insurance and Annuity Company, Hatrtford, CT, a Prudential Financial Company, is acting as the administrative agent for the National Integrated Group Pension Plan (NIGPP), Scranton, PA. Jun, ia, 1i~?1 ?0:~4A~i Sovereign ~~ ~~~ , 1 ~ ~~ ~ ~, 1 Court ordered Processing 1 TSecedents - MA1-M83-02-10 - P. O. Bo:~ 841045 -Boston, ~lA 02284 June 18, 2012 I~. IVlark Thomas Attorney at Law 101 South N[arket St. Mechanicsbur0, PA 17055-3851 VIA FACSIMILE 717-796-3600 Re: Estate of Rodney Gammon Date of Death: 01/2612012 Dear Mr. Thomas: 1Ne have received your request for date of death balances on the accounts of fhe above-named decedent. Please refer to the additional item(s) indicated below that are required to complete your request; same of which are required in order to comply with privacy laws affecting bank accounts. V11e need to ensure that we provide account informafion only tc those individuals authorized to receive it. Please send the documentation checked off below to my attention at the address listed above. _X $20.00 Date of Death Balance Fee payable to: Sovereign Bank (effective Gl1/09) Death Certificate Court Appointment of Executor(trix) or Administrator(trix) ("Certificate of Appointment") Authorization from Execrator/AdministraforlJoint OwnerlBenefciary to release information Other: If you would like to liquidate the accounts, please return certified copies of the Death Certificate, Certificate of Appointment, if applicable, and a notarized letter of instruction from the executor, ca-holder, or beneficiary, as appropriate_ Very truly yours, S L` r ~ c r ` Ed Stevens GOP Specialist G17-514-5189 phone 617-533-1931 fax U /'V LP~~II ~- 4 J T 1