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J 1505611185
REV-1500 EX(02-11)(FI)
OFFICIAL U3E ONLY
PA Department of Revenue Counry Code Year File Number
Bureau of Individual Taxes
PO BOX 280601 INHERITANCE TAX RETURN 21 12 0320
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDVVVV Date of Birth MnnDDVwv
03112012 11061935
Decedent's Last Name Suffix DecedenYs First Name M I
ROSS CLAIRE C
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name M I
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
- - REGISTER OF WILLS
FILL IN APPROPRIATE BOXES BELOW
� 1. Original Return � 2. Supplemental Return � 3. Remainder Return(Date of Death
Priorto 12-13-82)
❑ 4. Limited Estate ❑ 4a. Future Interest Compromise(date of ❑ 5. Federal Estate Tax Return Required
death after 12-12-82)
� 6. Decedent Died Testate � 7. Decedent Maintained a Living Trust _ 8. Total Number of Safe Deposit Boxes
(Attach Copy of WiIQ (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 Schedule O)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: '',
Name Daytime Telephone Number
CRAIG A • HATCH, ESQUIRE 717-731-9600
REGISTER OF WILl3 USE ONLY
First Line of Address n w � �
C � '-r� �.,,
1013 MUMMA RD, STE • 100 � � �_ �' �=M
� � c.� %=�
Second Line of Address � A � � � �=�
y � f�` --- ... c;•
C/'y
�` ��DAT ED� �''
City or Post Office State ZIP Code :
G� =::3 -'-,
� c:, _wy _. .
LEMOYNE PA 17043 � � -- <::�
. �� ►—• ° ;c,
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D �� � '�*i
corresPo�dent'se-mailaddress: C • HATCHo�GATESLAWFIRM • COM � '-
Under penalties of perjury, I declare that I have examined this retum,inGuding aecompanying schedulea statemeMS,and to the best of my knowledge and belief, I
it is true,correct and complete. Deelaration oi preparer other than the personal re ae ive is based II infortnation of which preparer has any knowledge.
SIGNAIURE OF PERSON RESPONSIBLE FOR FILING RETURN D TE
KENNETH E - ROSS, EXECUTOR /� T �
ADDRESS '
417 HUMMEL AVENUE LE OYNE, PA 17043
SiGNATURE OF PREPARER OTHER 1NAN REPRESENTATI DA E '
CRAIG A • HATCH, ESQUIRE 6
ADDRESS
1013 MUMMA RD • , STE • 100 LEMOYNE, PA 17043
PLE USE ORIGINAL FORM ONLY
Side 1
� 1505611185 OM46473.000 1505611185 �'
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� 1505611285
REV-1500 EX(FI)
Decedent's Social Security Number
oecede�t�s Name: R 0 S S C L A I R E C
RECAPITULATION
1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . � $O • ��I
2. Stocks and Bonds(Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . 2, $12,578 • 5.�1
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C), , , , , 3. $� • ��I
4. Mortgages and Notes Receivable(Schedule D) , , , , , , , , , , , , , , , , , q. �� � �a
5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E) , , , , , 5, $],5],,7 6 7 • 2 4�
6. Jointly Owned Property(Schedule F) � Separate Billing Requested , , , , g. $Q • �q
7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property '
(Schedule G) � Separate Billing Requested . . . . �. $4 3 5,6 5 7 • 9�
8. Total Gross Assets(total Lines 1 through 7) , , , , , , , , , , , , , , , , , , 8 $6 Q Q��0 3 • 7� ;
9. Funeral Expenses and Administrative Costs(Schedule H). . . . . . . . . . . . . g. $5 6,],l{], • ],�
10. Debts of Decedent, Mortgage Liabilities,and Liens(Schedule I) , , , , , , , , , �0. �21 O,6 8 9 •1�
11. Total Deductions(total Lines 9 and 10), , , , , , , , , , , , , , , , , , , , , ��. $2 6 6,8 3 0 • 2�r
12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . �2 $3 3 3,17 3 • 4�i
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which ,
an election to tax has not been made(Schedule J), , , , , , , , , , , , , , , , �3, $� • �p
14. Net Value Subject to Tax(Line 12 minus Line 13) , , , , , , , , , �4. $3 3 3�1�3 • 4�i
TAX CALCULATION -SEE INSTRUCTIONS FOR APP�ICABLE RATES '
15. Amount of Line 14 taxable '
at the spousal tax rate,or
transfers un�er Sec.9116
�a)�1.2)X.0_ $� • �� 15. $� • ��'
16. Amount of Line 14 xable '
atlinealrateX.04� $333�173 • 47 �s. $14 ,992 • 8�
17. Amount of Line 14 taxable
at sibling rate X.12 $� • Q Q 17. $� • ��i
18. Amount of Line 14 taxable '
at collateral rate X.15 $0 • 0 D 18. $0 • 0(�
19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �s. $14,9 9 2 • 8�
20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT X❑
Side 2
� 1505611285 1505611285 �
OM4648 3.000
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REV-1500 EX(FI) Page 3 File Number
Decedent's Com lete Address: 21 12 0 3 2 0
DECEDENTS NAME
RO A R
STREETADDRESS
R N
C�T�' STATE ZIP
L MOYNE PA 7 -
Tax Payments and Credits:
1. Tax Due(Page 2,�ine 19) (�) $14 ,9 9 2 • 81 I
2. Credits/Payments
A. Prior Payments $2 6�5 0 0 • 0 0
a. oiscount $7 4 9 • 6 4
Total Credits(A+g� �Z� $2?,2 4 9 • 6 4
3. Interest
(3) $� • ��'
4. If Line 2 is greater than Line 1+Line 3,enter the difference.This is the OVERPAYMENT.
Fill in box on Page 2, Line 20 to requeat a refund. (4) $12,2 5 6 •8 3'
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) $� •0�.
Make check payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X"IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred . . . . . . . . . . . . . . . . . . . . . . . . X❑ ❑
b. retain the right to designate who shall use the property transferred or its income . . . . . . . . . . ❑ �
c. retain a reversionary interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ❑ �
d. receive the promise for life of either payments,benefits or care? . . . . . . . . . . . . . . . . . . ❑ �
2. If death occurred after Dec. 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? ❑ �
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.
For dates of death on or after July t, 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 ta 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 retum 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(a)(1)J."
• The tax rate imposed on the net value of transfers to or for the use of the decedenYs siblings is 12 percent [72 P.S.�9116(a)(1.3)]. A sibling is defined,'
under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
OM4671 2.000
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REV-1502EX+�o,_,o> SCHEDULE A
pennsylvania
OEPPRTN�NTOF REVENUE
INHERITANCE TAX RETURN REAL ESTATE
RESIDENTOECEDENT
ESTATE OF: FILE NUMBER:
Claire C. Ross 21 12 0320
All real propeRy owned solely or as a tenaM in common must be reported at falr market value.Fair market value is deflned as the price at which property
would be exchanged between a willing buyer and a willing seller,neither being compelled to buy w sell,both having reasonable knowledge of the relevant facts.
Real propeRy that is Jointlyowoed wkh rlght of survivorship must ba disclosed on Schedula F.
Attach a copy of the settlement sheel if the propeAy has been sdd.
ITEM Include a copy of the decd showing decedenYs interest if owned as tenant in common. VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. None
TOTAL (Also enter on Line 1,Recapitulation.) i $0.0
swaess z.000 If more space is needed,use additional sheets of paper of the same size.
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REV-1503 EX�(&12)
pennsylvania SCHEDULE B
DEPARTMENT OF REVENUE
INHERITANCETAX RETURN STOCKS 8� BONDS
RESDENT DECEDENT
ESTATE OF FILE NUMBER
Claire C. Ross 21 12 0320
All property jointly owned with right of survivorship muat be diaclosed on Schedule F.
ITEM VA�UE AT DATE
NUMBER DESCRIPTION OF DE4TH
1. Edward Jones Brokerage Acct. '
288 Shares
Oracle Corp. , common stock; DOD High $29. 92
per share; DOD Low $29.20 per share; DOD
Average $29.56 per share. $8,513.2�
2 127 Shares
Microsoft Corp. , common stock; DOD High
$32.20 per share; DOD Low $31.82 per share;
DOD Average $32.01 per share. $4,065.2'�'
TOTAL (Also enter on Line 2,Recapitulation) S $12,578.5
zwasss z.000 If more space is needed,insert additional sheets of the same size
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REV-1508 EX+(pg.t2)
pennsylvania SCHEDULE E
DEPPRTMENTOF REVENUE CASH, BANK DEPOSITS 8 MISC.
RESIDENTDEC ENTTURN PERSONAL PROPERTY
ESTATE OF: FILE NUMBER:
Claire C. Ross 21 12 0320
Include the proceeds of litigation and the date the proceeda were received by the estate.
All ro ert 'ointl owned with ri ht of aurvivorahi must be discloaed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
�. Comcast
refund $48.14
2 Hartford Leaders Variable Annuity No.
711348501
Owner/Annuitant: Claire C. Ross
Beneficiaries: Estate of Claire C. Ross $85,644.5�
3 Verizon
refund $23.3�'
4 Chase
refund $6.11
5 Navy Federal Credit Union
Savings Acet. X6282 $2,015.0'�
6 2005 Buick LeSabre
VIN 1G4HR54K55U123399
(Vehicle sold back to Frysinger
dealership. ) $5,500.0(�
7 NIDVIP
member refund $750.OQ
8 PNC Bank
Checking Acct. No. 51-4042-4342 $849.3$
9 USAA
insurance refund $60.0�
10 USAA
insurance refund $222,8�
11 Navy Federal Credit Union '
Money Market Savings Account $56,647.9�
TOTAL(Also enter on line 5,Recapitulation) S $151,767.241,
2W4sAD 2.00o If more space is needed,use additional sheets oi paper of the same size.
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REV-1510EX+(OS-09) SCHEDULE G
pennsylvania
DEPARTMENTOFREVENUE INTER-VIVOS TRANSFERS AND
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
f�SIDENT DECEDENT
ESTATE OF FILE NUMBER
Claire C. Ross 21 12 0320
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
DESCRIP110N OF PROPERTY
ITEM INCLLOETFE WJAE OFTIE 7RANSFEREE,THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE
NUMBE T�E P41E OF 1RNSFER ATfACH A CqPV OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST IF APPLJCABLE VALUE
�• Ohio National
Annuity No. E1243742
Owner/Annuitant: Claire
C. Ross
Beneficiaries: children
Kenneth E. Ross, Shari
Ross Lahlou and Russel
Ross $70,157.95 100.0000 $0.00 $70,157.9�!
Ross Family Trust dtd.
6/30/04
Total from continuation sched les . . . . . . . . $365,500.00'
TOTAI(Also enter on line 7,Recapitulation)S 435 657. 951 !
I(more space is needed,use additional sheets of paper oi the same size.
9W48AF 2.000
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Estate of: Claire C. Ross 21 12 0320
Schedule G (Page 2)
Item DOD Value Taxab�le
No. Description of Asset � Interest Exclusion Value
2 Two-story, single-family
condominium located at 24
Crain Circle, Lemoyne,
Borough of Lemoyne,
Cumberland County,
Pennsylvania; being Tax
Parcel No.
12-20-1858-003B-U16B; $365,500.00 100.0000 $0.00 $365,500.Od'
transferred to Claire C.
Ross, individually and as
Trustee of the Ross Family
Trust, by Jeffrey R. Dietz,
et al. , by their Deed dated
November 14, 2006, and
recorded on November 21,
2006, in the Cumberland
County Recorder of Deeds
Office at Book 277, Page
3363. The value reported is
county assessed value.
Total (Carry forward to main schedule) $365,500.00
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REV-1511EX+(10-Og) SCHEDULE H
pennsylvania
pEPPRTMENTOF REVENUE FUNERAL EXPENSES AND
INHERITANCETN(RETURN ADMINISTRATIVE COSTS
RESIDEIJT DECEDENT
ESTATE OF FILE NUMBER
Claire C. Ross 21 12 0320
DecedenYs debts must be repoRed on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
� Blooms by Vickery
flowers for funeral $378.37
Total from continuation schedules . . . . . . . . . $592.OQ
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s)
Street Address
City State ZIP
Year(s)Commission Paid:
2. Attorney Fees: $5,750.0�
3. Family Exemption: (If decedenYs address is not the same as claimanYs,attach e�lanation.) $7,000.Op
Claimant Russel C. Ross and Cindv L. Ross
Street Address 24 Crain Circle
City Lemoyne State PA ZIP 17043
Relationship of Claimant to Decedent CHILDREN
4. Probate Fees: $14 0.5 m
5. Accountant Fees:
6. Tau Return Preparer Fees:
7.
1 UGI
gas utility $457. 91
2 Penn Waste
trash removal $177.04
Total from continuation schedules . . . . . . . . . $41,645.3�
TOTAL(Also enter on Line 9,Recapitulation) $ $56 141.1
9W46AG 2.000 If more space is needed,use additional sheets of paper of the same size.
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Estate of: Claire C. Ross 21 12 0320
Schedule H Part 1 (Page 2)
Item
No. Description Amount
2 Auer Cremation Servicea
funeral expense $115.00',
3 Premier Caterers
funeral luncheon $477.OQ
Total (Carry forward to main schedule) $592.0(3
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Estate of: Claire C. Ross 21 12 0320
Schedule H Part 7 (Page 2)
3 Repairs to property to prepare for sale. $623.84!.
4 PA American Water Company
water bills $505.88`�,
5 PennLive.com
ad for sale of personal property $15.04
6 PPL Electric Utilities
electric bills $603.2�
7 Mid-State Cleaning 6 Restoration
carpet cleaning $502.83'
8 Verizon
phone service $18.37!
9 Triple P
house painting $2,750.OQ'�
10 Nature Guard
deck refinishing $509.0�
11 House Cleaning $550.04
12 Woods at Bridgeport
homeowner's association fee $3,520.0�
13 PNC Bank
account / wire fees $15.OQ'
14 USAA
insurance premium $142.8$'
15 Edward Jones
processing fee $100.OQi
16 US Postal Service
postage $19.30';
17 Lemoyne Borough
sewer bill $191.9�;
18 Faith A. Nicola, Tax Collector for West
Shore School Districe
real estate taxes
$4,619.04i
Total (Carry forward to main schedule)
$14,686.38
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Estate of: Claire C. Ross 21 12 0320
Schedule H Part 7 (Page 3)
19 PA Basement Waterproofing, Inc.
basement repair $3,760.0�
20 Chris Cowoski
basement paint and repair $675.Od
21 Register of Wills
short certificates & filing fees $24.Od
22 Executor and Trustee's Commissions $22,500.00
Total (Carry forward to main schedule)
$26,959.04
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REV-7512 EX+(72-08)
pennsylvania SCHEDULE I
DEPPRTMENTOF REVENUE DEBTS OF DECEDENT,
INHERITANCETAXRETURN MORTGAGE LIABILITIES 8� LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Claire C. Ross 21 12 0320
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
�• Visiting Angels
home health care $793.0�
2 Penn Waste
trash removal $45.0(�
3 Maid to Perfection
cleaning service $265.0�
4 PA American Water Company '
water bills $274.7�
5 Liberty Life
return of overpayment $344.2�
6 PPL Electric Utilities
electric bills $114.7�
7 James Rich, M.D.
medical bill $20.0�
6 Verizon
phone service $195.1'Y
9 Highlights Puzzle Club
final bill $2g,g�,
10 Chase Card Services
credit card bill $67.8�'
11 Hazel Clarke
home health care $660.0�'
12 Sonya Dawson
home health care $308.0�':
13 Djenabou Diallo
home health care $374.0�'
14 Acacia Federal Savings Bank
Mortgage No. 1418542682 $207,073.3�i1
Total from continuation schedules . . . . . . . . . $124.0�',
TOTAL(Also enter on Line 10,Reca itulation E 210 689.1 � :
ewasnH z.000 If more space is needed,insert additional sheets of the same size.
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Estate of: Claire C. Ross 21 12 0320
Schedule I (Page 2)
I tem
No. Description Amount
15 Faith A. Nicola, Tax Collector for West
Shore School District
per capita tax $9,gQ'
16 Comcast
cable bill $114.21'
Total (Carry forward to main schedule) $124.01
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REV-1513 EX+(01-10) SCHEDULE J
pennsylvania
DEPPRTMENT OF REVENUE BEN EFI C IARI ES
INHERITANCE TAX RETURN
RESIDENT OECEDENT
ESTATE OF: FILE NUMBER:
Claire C. Ross 21 12 0320
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECENING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS[Indude outright spousal distributions and transfers under
Sec.9116(a)(1.2).]
�, Kenneth E. Ross
417 Hummel Avenue
Lemoyne, PA 17043
Ohio National
Annuity No. E1243742
Owner/Annuitant: Claire C.
Ross
Beneficiaries: children
Kenneth E. Ross, Shari Ross
Lahlou and Russel Ross
Inventory Value: $23,386.03
25� of Residue: $65,753.88 Son $69,139. 91
ENTER DOILAR AMOUNTS FOR DISTRIBU110NS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
�� NOt�TAXABLE DISTRIBUTIONS
A.SPOUSAL DISIRIBU710NS UNOER SEC110N 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
L
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
L
TOTAL OF PAR7 II-ENTER TOTAL NON-TAX/1BLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. S $0.OOI '
swaeAi z.000 If more space is needed,use additional sheets of paper of the same size.
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Estate of: Claire C. Ross 21 12 0320
Schedule J Part 1 (Page 2)
Item
No. Description Relation Amount
2 Shari Ross Lahlou
5526 MacArthur Blvd. NW
Washington, DC 20016
Ohio National
Annuity No. E1243742
Owner/Annuitant: Claire C.
Ross
Beneficiaries: children
Kenneth E. Ross, Shari Ross
Lahlou and Russel Ross
Inventory Value: $23,385.96
25� of Residue: $65,753.88 Daughter $89,139.84'
3 Ross Eamily Trust f/b/o
Cindy L. Ross Under
Agreeement dtd. 06/30/2004
c/o Kenneth E. Ross, Ttee.
417 Hummel Avenue
Lemoyne, PA 17043
25� of Residue: $65,753.88 Daughter $65,753.8$'
4 Russel C. Ross
24 Crain Circle
Lemoyne, PA 17043
Ohio National
Annuity No. E1243742
Owner/Annuitant: Claire C.
Ross
Beneficiaries: children
Kenneth E. Ross, Shari Ross
Lahlou and Russel Ross
Inventory Value: $23,385.96
25� of Residue: $65,753.88 Son $89,139.841',
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LAST WILL AND TESTAMENT '
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I�A�
LAST WILL AND TESTAMENT
OF
CLAIRE C. ROSS
I, CLAIRE C. ROSS, now of 133 Yellow Breeches Drive, Camp Hill, York County,
Pennsylvania 17011,do publish and declare this to be my Last Will and Testament,hereby revoking '
all other prior wills and codicils made by me.
FIRST: Familv Background and Appointment of Executor. '
(A) Familv and Background Information. I am not currently married. My children are
CINDY L. ROSS, RUSSEL C. ROSS, KENNETH E. ROSS and SHARI L. LAHLOU. '
Throughout this Will,CINDY L.ROSS,RUSSEL C.ROSS,KENNETH E.ROSS and SHARI
L. LAHLOU, will be referred to as "my children". The word "issue" will include my children as
well as my other descendants. '
(B) Appointment of Executor. I appoint as my Co-Executors(a11 hereinafter referred
to as Executor or Executors throughout this Will), the following named persons without being
required to account to any Court:
Co-Executors: My son, KENNETH E. ROSS and my daughter, SHARI L.
LAHLOU,or the survivor of them, to act jointly. '
(C) Inter Vivos Trust. The inter vivos trust agreement referred to in this Will is entitled '
"THE ROSS FAMILY TRUST",by and between myself as Settlor and myself as Trustee,as now
in effect or as may hereafter be amended.
SECOND: Funeral and Last Illness Expenses• Taxes.
(A) Ezaenses of Funeral and Last Illness. I direct my Executor to pay my funeral
expenses and the expenses of my last illness from my estate.
(B) Taxes. I direct my Executor to pay any and all estate,inheritance,succession,legacy,
transfer and other death taxes or duties,by whatever name called,including any and all interest and '
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LAST WILL AND TESTAMENT
OF
CLAIRE C. ROSS
PAGE 2
penalties thereon, imposed under the laws of any jurisdiction by reason of my death upon or with
respect to any and all propecty included in my gross estate for the purpose of such taxes, whether
such property passes under or outside of this Will. Without any apportionment otherwise required
by law and without being prorated or apportioned among or charged against the respective devises,
legatees,beneficiaries,transferees, or other recipients of any such property or charged against any
property passing or which may have passed to any of them, I direct that any taxes so paid shall be
charged against my residuary estate. My Executor shall not be enritled to reimbursement for any
portion of any such t�es from any such person. The foregoing provisions of this Article SECOND
shall not apply to such portion or portions of said taxes,interest and penalties which may be required �
to be paid, or are actually paid or reimbursed, by the Trustee of the Trust described in Paragraph
FIRST(C), above.
THIRD: Tangible Personal Propertv. Except for those items excluded below and those
items enumerated in the Letter of Instruction,I bequeath all my tangible personal property,including
but not limited to clothing,jewelry, heirlooms, furniture, household furnishings, personal effects,
motor vehicles,and all other similar articles,which I own,and the insurance thereon,to my children,
CINDY L. ROSS, RUSSEL C. ROSS, KENNETH E. ROSS and SHARI L. LAHLOU, per '
stirpes, living at the time of my death.
Notwithstanding any other provisions in this Article THIRD, I may leave a separate, dated
and unsigned Letter of Instruction,which I shall place with my Will,containing directions as to the
ultimate disposition of certain of the property bequeathed under this Article THIRD,and such Letter
of Instruction shall determine the distribution of such items.
FOURTH: Residuary Estate. I devise and bequeath all of the rest,residue and remainder
of my estate, real, personal and mixed, of whatever nature and wherever situated to which I am
legally or equitably entitled, to the then-acting Trustee of the Trust described in Paragraph FIRST
(C)of this Will, to be held, administered and distributed pursuant to the terms thereof, as the same
may be amended from time to time. By this devise and bequest of my residuary estate I hereby '
exercise all Powers of Appointment I possess at the time of my death except any power of
appointment which I possess under the Trust described in Paragraph FIIZST(C) of this Wi1L
FIFTH: Powers of Executor. In addidon to the powers and duties as may have been
granted elsewhere in this Will, but subject to any limitations stated elsewhere in this Will, the
Executor shall have and exercise exclusive management and control of the Estate and shall be vested
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LA5T WILL AND TESTAMENT
OF
CLAIRE C.ROSS
PAGE 3
with the following specific powers and discretion, in addition to the powers as may be generally
conferred from time to time upon the Executor by law:
(A) In the management, care and disposidon of the Estate, the Executor shall have the
power to do a11 things and to execute such instruments,deeds,or other documents as may be deemed
necessary or proper, including the following powers, all of which may be exercised without order
of or report to any Court:
(1) To sell, exchange or otherwise dispose of any property at any time held or
acquired hereunder, at public or private sa1e, for cash or on terms, without advertisement,
including the right to lease for any term notwithstanding the period of the Estate,and to grant
options, including any option for a period beyond the duration of the Estate.
(2) To invest all monies in such stocks,bonds, securities,mortgages, notes, choses
in action, real estate or improvements thereon, and any other property as the Executor may
deem best, without regard to any law now or hereafter enforced limiting investments of
fiduciaries.
(3) To retain for investment any properiy deposited with the Executor hereunder.
(4) To vote in person or by proxy any corporate stock or other security and to agree
to or take any other action in regard to any reorganization,merger,consolidation,liquidation,
bankruptcy or other procedure or proceedings affecting any stock, bond, note or other
security.
(5) To use attomeys, real estate brokers, accountants and other agents, if such
employment is deemed necessary or desirable,and to pay reasonable compensation for their '
services.
(6) To compromise,settle or adjust any claim or demand by or against the Estate and
to agree to any rescission or modification of any contract or agreement affecting the Estate.
(� To renew any indebtedness, as well as to borrow money,and to secure the same
by mortgaging,pledging or conveying any property of the Estate.
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LAST WILL AND TESTAMENT
OF
CLAIRE C.ROSS
PAGE 4 '
(S) To retain and carry on any business in which the Estate may acquire an interest,
to acquire additional interest in any such business,to agree to the liquidation in kind of any
corporation in which the Estate may have an interest and to carry on the business thereof,to '
join with other owners in adopting any form of management for any business or property in
which the Estate may have an interest,to become or remain a partner,general or limited, in
regard to any such business or property and to hold the stock or other securities as an
investment, and to employ agents and confer on them authority to manage and operate the
business,property or corporation,without liability for the acts of such agent or for any loss,
liability or indebtedness of such business if the management is selected or retained with
reasonable care.
(9) To register any stock, bond or other security in the name of a nominee, without
the addition of words indicating that such security is held in a fiduciary capacity,but accurate
records shall be mainta.ined showing that such security is a Estate asset and the Executor
shall be responsible for the acts of such nominee. '
(B) Whenever the Executor is directed to distribute any Estate assets in fee simple to a
person who is then under twenty-one(21)years of age,the Executor sha11 be authorized to hold such
property in Trust for such person until he/she becomes twenty-one (21) years of age, and in the
meantime shall use such part of the income and the principal of the Estate as the Executor may deem
necessary to provide for the proper support and education of such person. If such person should die
before becoming twenty-one (21) years of age, the property then remaining in trust sha11 be
distributed to the personal representative of such person's estate.
(C) In making distributions from the Estate to or for the benefit of any minor or other
person under a legal disability,the Executor need not require the appointment of a guardian,but shall
be authorized to pay or deliver the same to the custodian of such person,to pay or deliver the same
to such person without the intervention of a guardian,to pay or deliver the same to a legal guardian
of such person if one has already been appointed, or to use the same for the benefit of such person. '
(D) In the disbursement of the Estate and any division into separate trusts or shares,the
Executor sha11 be authorized to make the distribution and division in money or in kind, or both,
regardless of the basis for income tax purposes of any property distributed or divided in kind, and
the distribution and division made and the values established by the Executor shall be binding and
conclusive on all persons taking hereunder. The Executor may in making such distribution or
.�?��Y�-
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LAST WILL AND TESTAMENT
OF
CLAIRE C. ROSS
PAGE 5
division allot undivided interests in the same property to several trusts or shares.
(E) The Executor sha11 be authorized to lend or borrow, including the right to lend to or
borrow from any trusts which I may have established during life or by will at an adequate rate of
interest and with adequate security,and upon such terms and conditions as the Executor shall deem
fair and equitable.
(F) The Executor shall be authorized to sell or purchase at the fair market value as
deternuned by the Executor, any properiy to or from any trust created by me during life or by Will,
even though the same person or corporation may be acting as Executor of my estate or as Trustee
of any of my other trusts.
(G) The Executor shall have discretion to determine whether items should be charged or
credited to income or principal or allocated between income and principal as the Executor may deem
equitable and fair under all the circumstances, including the power to amortize or fail to amortize
any part or all of any premium or discount, to treat any part or all of the profit resulting from the
maturity or sale of any asset,whether purchased at a premium or at a discount,as income or principal
or apportion the same between income and principal, to apportion the sales price of any asset
between income and principal, to treat any dividend or other distribution of any investment as
income or principal, or apportion the same between income and principal, to chazge any expense
against income or principal or apportion the same, and to provide or fail to provide a reasonable
reserve against depreciation or obsolescence on any assets subject to depreciation or obsolescence,
all as the Executor may reasonably deem equitable and just under all the circumstances. If the
Executor does not exercise the above discretionary power,the cash or accrual allocation shall be in
accordance with Chapter 81 of Title 20 of the Pennsylvania Consolidated Statutes, or the
corresponding provisions of subsequent state law. '
(I� If at any time the total fair market value of the assets of any trust established or to be
established hereunder is so small that the corporate Trustee's annual fee for administering the trust
would be the minimum annual fee set forth in the Trustee's regulazly published fee schedule then,
in effect, the Trustee in its discretion shall be authorized to terminate such trust or to decide not to
establish such trust,and in such event the property then held in or to be distributed to such trust shall
be distributed to the persons who are then or would be entitled to the income of such trust. If the
amount of income to be received by such persons is to be determined in the discretion of the Trustee,
then the Trustee shall distribute the property among such of the persons to whom the Trustee is
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LAST WILL AND TESTAMENT
OF "
CLAIRE C. ROSS
PAGE 6
authorized to distribute income, and in such proportions, as the Trustee in its discretion shall
determine.
(n Except as otherwise provided in this Will,when the authority and power under this
Will is vested in two (2) or more Executors or Trustees, the authority and powers are to be held
jointly by the Executors or Trustees, respectively. A majority of the Executors or Trustees may
exercise any authority or power granted under this Will or granted by law, and may act under this
Will. Any attempt by one such Executor or Trustee to act under this Will on other than ministerial
acts shall be void. The action of one such Executor or Trustee under this Will may be validated by
a subsequent ratification of the act by a majority of the Executors or Trustees.
SIXTH: Rights and Liabilities of Executor and Trustee. .
(A) No bond or other security shall be required of any Executor.
(B) This instrument always shall be construed in favor of the validity of any act or
omission by any Executor, and any Executor shall not be liable for any act or omission except in the
case of gross negligence, bad faith or fraud. Specifically, in assessing the propriety of any
investment, the overall performance of the entire Estate shall be taken into account.
(C) Each Executor shall be entitled to receive reasonable compensation for services
actually rendered to my estate, in an amount the Executor normally and customarily charges for
performing similar services during the time which he/she performs the services.
SEVENTH: Tax Elections.
(A) In determuung the estate,inheritance and income tax liability relating to my Estate,
the Executor's decision as to all available tax elections shall be conclusive on all concerned. In
accordance with IRC Section 2632(a) and without regard to whether a Federal estate tax return is
actually filed, my Executor shall allocate so much of the Federal Generation Skipping Transfer
(GST) exemption amount as will fully exempt any generation skipping transfer which may occur
under this Wi1L
(B) The Executor may, in its discretion, determine the date as of which my gross estate '
shall be valued for the puipose of determining the applicable tau payable by reason of my dea .
�
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LAST WILL AND TESTAMENT
OF
CLAIRE C.ROSS
PAGE 7
(C) The Executor may, in its discretion, decide whether all or any part of certain
deductions shall be taken as income tax deductions (even though they may equal or exceed the
taxable income of my estate and whether or not claimed or of benefit on my estate's income tax
return)or as estate tax deductions when a choice is available; and in the event that all or any part of
such deductions are taken as income tax deductions,no adjustment of income and principal accounts
in my estate sha11 be made as a result of such decisions.
EIGHTH: Spendthrift Provision. No beneficiary shall have the power to anticipate,
encumber or transfer his or her interest in the estate in any manner other than by the valid exercise
of a power of appointment. No part of the estate shall be liable for or charged with any debts,
contracts,liabilities or torts of a beneficiary or subject to seizure or other process by any creditor of
a beneficiary.
NINTH: Defmitions and General Provisions.
(A) Survival. Any beneficiary who dies within sixty(60)days after my death shall be
considered not to have survived me.
(B) Captions. The captions set forth in this Will at the beginning of the various articles
hereof are for convenience of reference only and shall not be deemed to define or limit the provisions
hereof or to affect in any way their construction and application.
(C) Children. As used in this Will, the words "child" and "children" shall include ' ;
persons who are legally adopted and the issue of said persons,whether born in or out of wedlock, ' �
so long as any person born out of wedlock is acknowledged in a written instrument executed by the ' �
one of their natural parents who is a descendant of mine to be the child of said descendant. The word '
"issue"shall include descendants of all generations including adopted persons. A posthumous child
shall be considered as living at the death of his parent. T'he birth to me or the adoption by me of a
child or children subsequent to the execution of this Will shall not operate to revoke this Will.
(D) Code. Unless otherwise stated, all references in my Will to section and chapter �
numbers are to those of the Internal Revenue Code of 1986, as amended, or the corresponding
provisions of any subsequent federal tax laws applicable to my estate.
(E) Other terms. The use of any gender includes the other genders,and the use of either '
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_ _ _ �A 1�
LAST WILL AND TESTAMENT
OF
CLAIRE C.ROSS
PAGE 8
the singular or the plural includes the other.
(� Powers of Appointment are Exercised. By this Will I exercise any and all Powers
of Appointment which I possess at the time of my death except any power of appointment which I
possess under the Trust described in Paragraph FIRST(C), above.
IN WITNESS WHEREOF,I,CLAIRE C.ROSS,the Testatrix,have to this my Last Will
and Testament,typewritten on nine(9)pages,including the Acknowledgment and Affidavit,set my
hand and seal this 30`�day of June, 2004.
- �-
CLAIRE C. ROSS .
Signed, sealed,published and declared by the above-named Testatrix, as and for her Last Will and
Testament, in the presence of us, who have hereunto subscribed our names at her request, as
witnesses hereto,in the presence of the said Testatrix, and in the presence of each other. Each of us
further declares that he or she believes the Testatrix to be of sound mind and memory. The
preceding instrument consists of this and eight(8)other consecutively numbered typewritten pages
including the Acknowledgment and Affidavit.
residing at ��
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�#o:^i eL �. yu�
(print name)
, � � ��
�_ residing at �o i u,UC� S�Ri►J�S ��
�a� � � - r=�.��I�-�0
(print name) '
,
_ __
_ ___
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� _
ACKNOWLEDGMENT AND AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA :
. SS:
COUNTY OF CUMBERLAND : '
The Testatrix and the witnesses whose names are signed and subscribed to the attached or
foregoing instrument,being first duly sworn and qualified according to law,do hereby acknowledge, '
depose and say to the undersigned authority, that the Testatrix signed and executed the instrument
as her Last Will in the presence of the witnesses; that she signed it willingly or willingly directed '
another to sign it for her; that she executed it as her free and voluntary act for the purposes therein '
expressed; that each of the witnesses were present and saw the Testatrix sign and execute the
instrument as her Last Will; that each subscribing witness in the hearing and sight of the Testatrix '
signed the will as witnesses; 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. '
Testatrix
G�Ga�!�� ��
Wl CSS
��-��.-�.� � �_�ti
Witness
Sworn to or affirmed, subscribed to, and acknowledged, before me by the above-named
Testatrix and witnesses, this 30`''day of June, 2004. ',
Notary Public '
My Commission Expires:
nia�se�
Teri L WaMcer.NOtery P1�Ic
�ernayne Boro,G�nbed�nd CotrMy
My Cortrrussion Expires Jen.20.2007
Member,PennsvNarna Asaoaation Of Nolaries
_ _-- LL_� -
_ _ _ _ __ _. A11�
CERTIFICATE of
GRANT of LETTERS
,
_ _ _ _ __ - - - ��
_____ 1�A1�
REGISTER OF W1LLS CERTIFtCATE OF
CJN;E����.�PJQ COU�lTY G�A�lT O� LETT��i�
P�!'�!�i 5`�'�,.�.%�N!A
c
.: h,i
Vo. 20?2• 170320 �A 1�1.n. . 21- 12- f)3'LG
Es�a te Of: CLA/RE C ROSS
fFirSf.MrJd1e,!asti ��
a/k/a.: CLAIRE WINIFRED CLOUSER ROSS
La t e Of: LEMOYNE BOROUGH
CUMBERLAND COUNTY
Deceased
Sc�ci a.L Securz t y No:
WHEREAS, on the 16th day r�f Mazch 2Q12 �n :instrument ��'ateci
June 30th 2004 was adm.itted to proba�e as th� 1as� wil2 nf
CLAIRE C R�SS
---- �_.._.__�.__.___..�.__
(tNSr MirWlo,las�! . .
�/k/a CLAlRE WIItIIFRED CLOUSER ROSS
.I a te of LEMOYNE BORDUGH, CUMBERLAND Caunty,
wha d�ed on thE 11th day of March 2017. and,
WHF.REAS, a true capy of the will as probated is anr�exed hereto.
THFREFORE, .T, GLENDA FARNER STRASBAUGH_�_ , Regi s ter c�f Wi 11 s ir. r�nqC
for CUMBERI��.*J� !"ounty, zl� the C�mmonweal th �f Pennsy.lvan?�, hf�reby '
ce.rt.i.fy that I� have this day granted LeLt��rs TESTAMENTARY to:
KENNETH E ROSS
wh� has Clill�� qualifi��? as EXECUT4R(RIX)
�nd h�s ��g:�e�d tc� �cImi.nisL�r t�e �st�t�� arc;�rc.�.?ng t�c.� Ia�, zJ,_l or °,�h.ic}2
:v??y app��r� of rc�c:c�rd in my ot�1`ic� �� CUMBERLAND CCIUNTY COURT HOUSE,
CARLISLE, PENNSYL VANIA.
TiJ TrST'.I�,��NY ��HFREnF, T h�-�.ve hereunL.o set� my hand and atf�xed thr�� 5�,:�:i
of my office on L-he 16th day of March 2012.
� ' � -�-�--�-- � �
---___�__ _._.�__ ;.:,-_. __�___ ._ __
Kegrsrr�ol bvrus
t . ' ,
-- �. t;7Ef�uiy" --_..._____.___.�_.__..___.
**NOTE** ALL NAMES ABnVE A�'PFAR (F.Z'RST, NI.TI7DLF, Lr.AST)
�--� ---- —_.. �1..��
_ . . _ �fA1� _
THE ROSS FAMILY TRUST
DATED JUNE 30, 2004
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_ _ _ _ __ �A1�
THE
ROSS FAMILY
TRUST
THIS TRUST AGREEMENT is executed in triplicate on this 30t''day of June, 2004, by
and between CLAIRE C. ROSS, now of 133 Yellow Breeches Drive, Camp Hill, York County,
Pennsylvania 17011,(hereinafter called "Settlor") and CLAIRE C. ROSS, now of 133 Yellow
Breeches Drive, Camp Hill, York County, Pennsylvania 17011 (hereinafter called "Trustee").
ARTICLE I. TRUST ESTATE
1.01. Initial Principal. Settlor, desiring to establish an irrevocable trust, does hereby
irrevocably transfer, assign and deliver to the Trustee and its successors, and assigns the assets
listed on Schedule A, attached hereto and made a part hereof. As further evidence of such
assignment, the Settlor has executed or will execute or cause to be executed such other
instruments as may be required for the purposes of completing the assignment or transfer of title
to such property to the Trustee. The Trustee accepts such transfer and assigrunent to itself as
Trustee, and undertakes to hold, manage, invest and reinvest the assets of this Trust, and to
distribute the income and principal of the Trust in accordance with the provisions of this
Agreement.
1.02. Additional Principal. The Settlor and any other person or persons, with the
consent of the Trustee, shall have the right at any time to make additions to the corpus of this
Trust or any share thereof hereby established. All such additions shall be held, governed, and
distributed by the Trustee in accordance with the terms and conditions of this Agreement. The '
Trustee, in its sole discretion, may require, as a prerequisite to accepting property, that the
transferring party provide evidence satisfactory to the Trustee that (i)the property is not _
contaminated by any hazardous or toxic materials or substances; and(ii)the property is not being
used and has never been used for any activities directly or indirectly involving the generation,
use, treatment, storage, disposal, release or discharge of any hazardous or toxic materials or '
substances.
1.03 Disclaimer. The Trustee shall have the right to disclaim,�in whole or in part, prior
to its acceptance by the Trustee, any interests in property for any reason, including but not limited
to a concern that such property could cause potentialliability under any federal, state, or local
environmental law.
ARTICLE II. IRREVOCABILITY OF TRUST
2.01. Irrevocabilitv. Settlor has been advised of the consequences of an irrevocable
trust and hereby declares that this Trust shall be irrevocable and shall not be altered, amended, :
_. -_ -.... _... _-. . _-. .. .. - .. _._.. . 3..__��...
_ 1�1�
revoked, or terminated by Settlor or any other person or persons.
ARTICLE III. LIFE INSURANCE POLICIES
3.01. General Provisions. If any insurance policies are transferred into this Trust, the '
Trustee shall be vested with all right,title, and interest in and to the transferred policies of
insurance, and is authorized and empowered to exercise and enjoy, for the purposes of the Trust
herein created and as absolute owner of such policies of insurance, all the options,benefits, rights
and privileges under such policies, including the right to borrow upon and to pledge them for a
loan or loans. The Trustee takes all rights, title, and interest in and to the above stated insurance
policies subject to any prior split-dollar life insurance agreement and assignments, which may be
in effect at the rime of transfer. The insurance companies which have issued policies are hereby
authorized and directed to recognize the Trustee as absolute owner of such policies of insurance
and as fully entitled to all options,rights,privileges, and interests under such policies, and any
receipts, releases, and other instruments executed by the Trustee in connection with such policies '
shall be binding upon all persons interested in this Trust. The Settlor hereby relinquishes all
rights, title, interest and powers in such policies of insurance which Settlor may own and which
rights, title, interest and powers are not assignable, and will, at the request of the Trustee, execute
all other instruments reasonably required to effectuate this relinquishment.
3.02. Payment of Premiums. The Trustee shall be under no obligation to pay the
premiums which may become due and payable under the provisions of any policy of insurance '
which may be transferred or assigned to this Trust, or to make certain that such premiums are
paid by the transferor of such policy, or to notify any persons of the nonpayment of such
premiums, and the Trustee shall be under no responsibility or liability of any kind in case such
premiums are not paid, except the Trustee shall apply any dividends received on such policies to
the payment of premiuxns thereon. Upon notice at any time during the continuance of this Trust '
that the premiums due upon such policies are in default, or that premiums which will become due
will not be paid, either by the transferor or by any other person, the Trustee, within its sole
discretion, may apply any cash values attributable to such policy to the purchase of paid-up
insurance or of extended insurance, or may borrow upon such policy for the payment of
premiums due thereon, or may accept the cash values of such policy upon the policy's forfeiture.
In the event that the Trustee receives the cash value of such policy upon its forfeiture for
nonpayment of premiums, the amount received sha11 be added to the corpus of this Trust, and
shall be administered according to the terms of this Agreement. If the insured under such
policies of insurance,becomes totally and permanently disabled within the meaning of any
policies and because thereof the payment of premiums, or any of them, shall during the pendency
of such disability,be waived, the Trustee, upon receipt of such knowledge, shall promptly notify
the insurance company which has issued such policies, and shall take any and all steps necessary
to make such waiver of premium provision effective.
3.03. Duties of Trustee With Regard to Life Insurance Policies. The Trustee shall
be under no obligation or duty whatever except with respect to the safekeeping of such policies
of insurance and the duty to receive such sums as may be paid to them, in accordance with the
requirements of this Trust,by the companies issuing such policies, and to hold,manage and
-- _ ___ �; ,
_ _ ___ _ _____ _ _
disburse such proceeds subject to the terms of this Agreement. Upon the death of the insured,
the Trustee shall make reasonable efforts to carry out the provisions of this Agreement, including
the maintenance or defense of any suit,provided,however, the Trustee shall be under no duty to
maintain or enter into any litigation unless its expenses, including counsel fees and costs,have
been advanced or guaranteed in an amount and in a manner reasonably satisfactory to the
Trustee. The Trustee may repay any advances made by it or reimburse itself for any such fees
and costs from any corpus or income of this Trust. '
ARTICLE IV. TRU5T DISTRIBUTIONS
4.01. Trust Principal. The entire corpus of this Trust, including the assets initially
transferred to this Trust, subsequent additions to this Trust, and the proceeds of any sale, ;
exchange or investment of such Trust assets, shall be used for the purposes herein contained.
4.02. Income Distribution. During the Settlor's lifetime, the Trustee shall distribute all
of the net income of the trust to, or for the benefit of the Settlor, CLAIRE C. ROSS. The
Trustee shall make no distributions of principal to CLAIRE C. ROSS. In the event that
CLAIRE C. ROSS is admitted to a long term care facility for a period of time in excess of '
ninety(90) days, the Trustee shall cease the distribution of income from the Trust and such
income shall be accumulated to the principal of the Trust.
4.03. Principal Distributions. Upon the death of the Settlor, CLAIRE C. ROSS, the
Trust shall terminate. Upon termination of the Trust, the remaining Trust estate shall be
distributed as follows:
(A) ONE-QUARTER(1/4) of the Trust estate shall be distributed, absolutely, to the ;
Settlor's son, RUSSEL C. ROSS.
(B) ONE-QUARTER(1/4) of the Trust estate shall be distributed, absolutely, to the
Settlor's son, KENNETH E. ROSS.
(C) ONE-QUARTER(1/4) of the Trust estate shall be distributed, absolutely, to the
Settlor's daughter, SHARI L.LAHLOU.
(D) ONE-QUARTER(1/4) of the Trust estate shall be distributed to the Trustees ', ;
herein named for the use and benefit of the Settlor's daughter, CINDY L. ROSS, '
(hereunder"the Beneficiary") according to the following terms and conditions:
i
(1) Intent of the Settlor. This Trust is established for the benefit of CINDY
L. ROSS as well as to preserve assets for distribution to the remaindermen ;
hereunder. It is not the purpose of this Trust that it serve as a primary or
main source of income, support or maintenance for CINDY L.ROSS. '
Anything to the contrary herein notwithstanding, no trust income or
principal sha11 be paid to or expended for the benefit of CINDY L. ROSS
so long as there are sufficient monies available to her for care, comfort,
_ _ __ �i
_ __ _ _ �1�
and welfare from federal, state, and local government agencies and
departments. The Trustees shall consider such governmental funds in
determining whether there are funds available to the Beneficiaries from
sources other than the Trust estate and shall use Trust assets only to
supplement and never to substitute for such funds. In no event may Trust
income or principal be paid to or for the benefit of a governmental agency
or department, and the Trust estate shall at all times be free of the claims
of such governmental bodies.
(2) Conditions of Use and Benefit of Trust. Subject to the termination of
this Trust,the trust estate shall be held for the benefit of the Beneficiary,
CINDY L. ROSS , for her lifetime, together with any other assets
received by the Trustees, for the following uses and purposes:
(a) This Trust is established for the purpose of improving the
quality of life of the Beneficiary, CINDY L. ROSS, for and
during all the term of her natural life. As the result of
current or future physical and mental deteriorations of her
age and infirmities, the Beneficiary, CINDY L. ROSS,
suffers or may suffer from substantial mental and physical
disabilities and may require additional medical care. She
may be entitled to benefit from various governmental '
programs which provides for her basic or supplemental
care. It is the purpose of this Trust to provide the
Beneficiary, CINDY L. ROSS, with a higher quality of life
beyond that which would be provided by these public
entitlement programs and to provide her each with a proper
funeral and burial.
(b) Settlor's intent in creating this Trust is that the Trustees use
the Trust created herein to promote the happiness, welfare
and benefit of the Beneficiary, CINDY L.ROSS, through
income and principal distributions, without in any way
reducing the services or financial assistance and basic
maintenance, support,medical or dental care which the
Beneficiary may receive without charge from any local,
state or federal government agency or department thereof,
and without using any portion of the Trust income ar
principal to reimburse any local, state or federal
government agency or department thereof for basic
maintenance, support,medical or dental care received by
the Beneficiary. Settlor's intent is that the Trust income and
principal is not to be considered income, assets, nor
resources of the Beneficiary, for any purpose, including but
not limited to, the determination of income, assets or
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resources as stated in any rules or regulations set forth in
any local, state or federal government agency or department
thereof. In the event the Trustees are requested by any
department or agency to release principal or income of the
Trust to or on behalf of the Beneficiary to pay for
equipment,medication or service which other organizations
or agencies are authorized to provide, or in the event the
Trustees are requested by any department ar agency
administering such benefits to petition the Court or any
other administrative agency for the release of Trust '
principal or income for this purpose, the Trustees shall deny '
such request and are directed to defend at the expense of '
the Trust estate, any contest or other attack of any nature. '
(c) The Trustees shall distribute to the Beneficiary, CINDY L.
ROSS, or expend and apply for her benefit, so much of or
all of the income and principal of this Trust, as the
Trustees, in their sole and absolute discretion, determine to '
be advisable for the Beneficiary's special needs far '
happiness and comfort to achieve the purpose of the Trust
herein set forth. The "special needs" which the Trustees
may provide to the Beneficiary, CINDY L. ROSS, include
but are not limited to spending money, additional food, '
clothing, gifts on her birthdays and major holidays, small '
appliances that would provide the Beneficiary with
entertainment or amusement, computer equipment, '
vacations, athletic contests, movies, trips,money to '
purchase appropriate gifts for relatives and friends, any '
recreational items that would be of use to her and other
monetary requirements to enhance her self-esteem or
situation. "Special needs" shall also include medical and '
dental expenses, annual independent check-ups,
rehabilitation and physical therapy equipment,programs of
training, education, treatment, physical therapy and
rehabilitation,private residential care, eye glasses,
transportation(including vehicle purchase), maintenance, '
and insurance(including payment of premiums of insurance
on the life of the beneficiary) and other requisites far
maintaining the good health, safety, and welfare of the '
Beneficiary when, in the discretion of the Trustees, such
requisites are not being provided by any public agency,
office, or department of any state or of the United States.
Nothing herein sha11 preclude the Trustees from purchasing
those services and items which promote the Beneficiary's
happiness, comfort and welfare. The Trustees shall also
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have authority in their absolute and sole discretion to make
gifts to any community residence in which the Beneficiary
may be residing.
(d) Any net income not expended for or applied to the special
needs of the Beneficiary, CINDY L.ROSS, shall be
accumulated and added to the Trust principal.
(e) The Trustees sha11 have no obligation to expend Trust
assets for the Beneficiary's special needs,but if the
Trustees, in their sole discretion, decide to expend Trust
assets, under no circumstances should any amounts be paid
to, or reimbursed to, the federal government, any state, or
any governmental agency for any purpose, including for the
care, support, and maintenance of the Beneficiary. T'his
Trust is created expressly for the Beneficiary's extra and
supplemental care,maintenance, support and education in
addition to, and over and above the benefits they otherwise
receive or may receive as a result of handicap or disability,
from any local, state or federal government, or from any
other private agency, any of which provides service or
benefits to persons with disabilities. It is Settlor's express
purpose that this Trust be used only to supplement other
benefits that the Beneficiary may receive.
(fl Because the Beneficiary may be dependent on the support
and aid of others, the Trustees shall, in the exercise of their
best judgement and fiduciary duty, seek support and
maintenance for her, or request her or her guardian ar
agent(s)to seek support and maintenance for her, from all
available public resources, including, but not limited to,
Social Security Administration benefits, the Supplemental
Security Income Program(SSn, any such supplemental
income program offered by or through the Commonwealth
of Pennsylvania, the Old Age Survivors and Disability
Insurance or successor programs, U.S. Civil Service
Commission benefits, Medicaid, and Federal Social
Security Disability Insurance(SSDn, and any other
comparable programs, state, federal, or local. The Trustees
sha11 take into consideration applicable resource and
income limitations of any public assistance programs for
which the Beneficiary is eligible when determining whether
or not to make any discretionary distributions. In cariying
out the provisions of this Article, the Trustees shall be
mindful of the probable future needs of the remaindermen
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of this Trust. If necessary, the Trustees may seek
appropriate authority to collect, expend, and account for
sepazately all such governmental assistance benefits,but
shall not commingle them with these Trust assets. In
addition, in making distributions for the special needs of
the Beneficiary, the Trustees shall take into consideration
the applicable resource limitations of the public assistance
programs for which they are or may become eligible.
(g) The Trustees shall regard this Trust as existing for the
welfare and benefit of the Beneficiary, CINDY L. ROSS.
Accordingly, the Trustees shall exercise their discretion as
to disbursements and investments with this standard in
mind. Consistent with the purpose of this Trust, the Settlar
may establish a life plan to be periodically updated, signed
and dated. It is intended that the Trustees read the life plan
and use it as guidance in administering this Trust according
to the terms set forth herein. In no event shall the life plan
be binding upon the Trustees or otherwise diminish the
Trustees'discretion as described herein.
(h) The Trustees shall exercise reasonable diligence. However,
the Trustees shall not be liable for any acts or omissions
done or performed in good faith.
(i) The Trustees shall not be required to make an accounting to
any public official except to the extent otherwise required
by law. The Trustees shall,however, keep and maintain
complete and open accounts of the Trust principal and
income and any expenditures from the Trust. Anyone
having an interest in the Trust shall have a right to inspect
the accounts at reasonable times and with reasonable notice
to the Trustees. All discretion conferred on the Trustees
shall be absolute and unlimited, and its exercise by the
Trustees shall be conclusive and binding on all persons.
(j) The Trustees shall pay reasonable burial expenses including '
a suitable and proper grave marker for the Beneficiary,
CINDY L. ROSS.
(k) Distributions Upon Termination of Trust. The Trust shall
terminate upon the death of the Beneficiary, CINDY L.ROSS.
Upon termination, the then-remaining trust estate shall distributed
to RUSSEL C. ROSS, KENNETH E. ROSS and SHARI L. '
LAHLOU, in equal shares, per stirpes. If and in the event that any
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of these individuals predeceases their distribution without
surviving issue, then their share shall be distributed, equally,
among the remaining named individuals, per stirpes.
(E) If any of the named individuals predecease the termination of this Trust, the
predeceased individual's share shall be distributed, unless otherwise stated,
equally to the predeceased individual's issue,per stirpes,provided that if any '
named individual predeceases the termination of this Trust without leaving issue,
then such predeceased individual's share shall be distributed equally to the '
surviving named individuals,per stirpes. If a beneficiary receives their distribution '
in Trust, then their receipt of a predeceased sibling's share shall also be held in
Trust, according to the same terms of distribution as their direct distribution. '
4.04. General Power of Anpointment. Settlor's children, KENNETH E. ROSS and
SHARI L. LAHLOU, are hereby granted the general power to appoint some or all of the
principal of this Trust to themselves or to any individual or Trust as they jointly or individually '
deem advisable during the lifetime of the Settlor. Upon the death of the Settlor or the incapacity
of the Settlor, this power shall terminate. This power shall not be exercisable under his Will and
may only be exercised by written request to the Trustee. Upon receipt of the notice of the
proposed power of appointrnent, the Trustee shall inform the Settlor of the proposed exercise.
The Settlor shall have ten(10) days from the date of receipt of the proposed exercise to accept or
veto the proposed exercise. If the Settlor accepts the proposed exercise or fails to veto the
proposed exercise within the ten(10)days,then the proposed exercise is accepted and the
Trustee shall proceed with the terms of distribution of the proposed exercise.
ARTICLE V. POWERS OF TRUSTEE
5.01. General Powers. In addition to such other powers and duties as may have been !
granted elsewhere in this Trust,but subject to any limitations contained elsewhere in this Trust,
the Trustee shall have the following powers and duties:
A. In the management, caze and disposition of this Trust, the Trustee shall have the
power to do all things and to execute such deeds, instruments, and other documents as may be
deemed necessary and proper, including the following powers, all of which may be exercised
without order of or report to any court:
(1) To sell, exchange, or otherwise dispose of any property, real,personal
or mixed, wheresoever located, at any time held or acquired hereunder, at public
or private sale, for cash or on terms as may be determined by the Trustee, without '
advertisement, including the right to lease for any term notwithstanding the period '
of the Trust, and to grant options, including an option for a period beyond the
duration of the Trust.
(2) To invest and reinvest all or any part of the Trust Estate in any
common or preferred stocks, shares of investment trusts and investment
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companies, bonds, debentures,mortgages, deeds of trust,mortgage participations,
notes, real estate, or other property the Trustee, in the Trustee's discretion, selects
in the manner that, under the circumstances then prevailing(specifically
including,but not limited to, the general economic conditions and the anticipated
needs of the Trust and its beneficiaries),persons of skill,prudence, and diligence,
acting in a similar capacity and familiar with those matters would use in the
conduct of an enterprise of similar character and similar aims, to attain the ''
Settlor's goals under this trust agreement.
(3) To retain for investment any property deposited with the Trustee '
hereunder.
(4) To vote in person or by proxy any corporate stock or other security
and to agree to or take any other action in regard to any reorganization,merger,
consolidation, liquidation, bankruptcy or other procedure or proceedings affecting
any stock,bond, note or other security held by this Trust. ,
(5) To use lawyers, real estate brokers, accountants and any other agents,
if such employment is deemed necessary or desirable, a.nd to pay reasonable
compensation for their services. '
(6) To compromise, settle or adjust any claim or demand by or against the
Trust and to agree to any rescission or modification of any contact or agreement
affecting the Trust.
(7) To renew any indebtedness, as well as to borrow money, and to secure
the same by mortgaging,pledging or conveying any property of the Trust, ;
including the power to borrow from the Trustee(in the Trustee's individual
capacity) at a reasonable rate of interest.
(8) To retain any business interest transferred to the trustee, as
shareholder, security holder, creditor,partner or otherwise, for any period of time
whatsoever, even though the interest may constitute all or a large portion of the
trust principal; to comply with the provisions of any agreement restricting transfer
of the interest; to participate in the conduct of the related business or rely upon
others to do so, and to take or delegate to others discretionary power to take any
action with respect to its management and affairs which an individual could take
as outright owner of the business or the business interest, including the voting of
stock(by separate trust or otherwise regardless of whether that separate trust will
extend for a term within or beyond the teim of the trust) and the determination of
all questions of policy; to execute and amend partnership agreements; to
participate in any incorporation, reorganization, merger, consolidation, sale of '
assets, recapitalization, liquidation or dissolution of the business, or any change in
its nature, or in any buy-sell, stock restriction, or stock redemption agreements; to
invest in additional stock or securities of, or make secured, unsecured, or
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subordinated loans to, the business with txust funds; to take all appropriate actions
to prevent, identify, or respond to actual or threatened violations of any
environmental law or regulation thereunder; to elect or employ with
compensation, as directors, officers, employees, or agents of the business, any
persons, including a trustee of any trust held under this instrument, or any director,
officer, employee, or agent of a corporate trustee of any trust held under this
insm�ment, without adversely affecting the compensation to which that trustee
would otherwise be entitled; to rely upon reports of certified public accountants as
to the operations and financial condition of the business,without independent
investigation; to deal with and act for the business in any capacity(including in
the case of a corporate trustee any banking or trust capacity and the loaning of
money out of the trustee's own funds) and to be compensated therefor; and to sell
or liquidate the business or any interest in the business.
(9) To register any stock,bond or other security in the name of a nominee,
without the addition of words indicating that such security is held in a fiduciary
capacity,but accurate records shall be maintained showing that the stock,bond or
other security is a trust asset and the Trustee shall be responsible for the acts of
the nominee.
(10) To set aside as a separate trust, to be held and administered upon the
same terms as those governing the remaining trust property, any interests in
property, for any reason, including but not limited to a concern that such property
could cause potential liability under any federal, state, or local environmental law.
B. Whenever the Trustee is directed to distribute any trust principal in fee simple to a
person who is then under twenty-one(21)years of age, the Trustee shall be authorized to hold
such property in trust for such person until he becomes twenty-one(21)years of age, and in the
meantime shall use such part of the income and the principal of the trust as the Trustee may deem
necessary to provide for the proper support and education of such person in the standard of living
to which he has become accustomed. If such person should die before becoming twenty-one (21}
years of age, the property then remaining in trust shall be distributed to the personal
representative of such person's estate.
C. In making distributions from the Trust to or for the benefit of any minor or other '
person under a legal disability,the Trustee need not require the appointment of a guardian, but
shall be authorized to pay or deliver the distribution to the custodian of such person, to pay or
deliver the distribution to such person without the intervention of a guardian, to pay or deliver the
distribution to the legal guardian of such person if a guardian has already been appointed, or to
use the distribution for the benefit of such person.
D. In the distribution of the Trust and any division into separate trusts and shares, the
Trustee shall be authorized to make the distribution and division in money or in kind or in both,
regardless of the basis for income tax purposes of any property distributed or divided in kind, and
the distribution and division made and the values established by the Trustee shall be binding and
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conclusive on all persons taking hereunder. The Trustee may in making such distribution or
division allot undivided interests in the same property to several trusts or shares.
E. If at any time after Settlor's death the total fair market value of the assets of any trust
established or to be established hereunder is so small that the corporate Trustee's annual fee for
administering the trust would be equal to or less that the minimum annual fee set forth in the
Trustee's regularly published fee schedule, then the Trustee in its discretion shall be authorized to :
terminate such trust or to decide not to establish such trust, and in such event the property then
held in or to be distributed to such trust shall be distributed to the persons who are then or would
be entitled to the income of such trust. If the amount of income to be received by such persons is
to be determined in the discretion of the Trustee, then the Trustee shall distribute the property
among such of the persons to whom the Trustee is authorized to distribute income, and in such
proportions, as the Trustee in its discretion shall determine.
F. 'The Trustee shall be authorized to lend or borrow, including the right to lend to or
borrow from the Settlor's estate, at an adequate rate of interest and with adequate security and
upon such terms and conditions as the Trustee shall deem fair and equitable.
G. The Trustee shall be authorized to sell or purchase, at the fair market value as
determined by the Trustee, any property to or from Settlor's estate, the estate of Settlor's spouse,
or any trust created by Settlor or Settlor's spouse during life or by will, even though the same
person or corporation may be acting as executor of Settlor's estate or the estate of Settlor's spouse
or as trustee of any other such trusts and as the Trustee of this Trust.
H. The Trustee shall have discretion to determine whether items should be charged or
credited to income or principal or allocated between income and principal as the Trustee may
deem equitable and fair under all the circumstances, including the power to amortize or fail to
amortize any part or all of any premium or discount, to treat any part or all of the profit resulting
from the maturity or sale of any asset, whether purchased at a premium or at a discount, as
income or principal or apportion the same between income and principal, to apportion the sales
price of any asset between income and principal,to treat any dividend or other distribution on
any investment as income or principal or to apportion the same between income or principal, to
charge any expense against income or principal or apportion the same, and to provide or fail to
provide a reasonable reserve against depreciation or obsolescence on any asset subject to
depreciation or obsolescence, all as the Trustee may reasonably deem equitable and just under all
of the circumstances.
5.02. Actions and Voting by Trustee. When the authority and power under this Trust
is vested in two (2) or more Trustees or Co-Trustees, the authority and powers are to be held
jointly by the Trustees or Co-Trustees. A majority of the Trustees or Co-Trustees may exercise
any authority or power granted under this Trust Agreement or granted by law, and may act on
behalf of the Trust. Any attempt by one such Trustee to act for the Trust on other than
ministerial acts shall be void. The action of one such Trustee on behalf of the Trust may be(but
need not be) validated by a subsequent ratification of the act by a majority of the Trustees or Co-
Trustees.
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5.03 Trustees Power to Deal with Environmental Iiazards. The Trustee shall have
the power to use and expend the trust income and principal to (i) conduct environmental
assessments, audits, and site monitoring to determine compliance with any environmental law or
regulation thereunder; (ii) take all appropriate remedial action to contain, clean up or remove any
environmental hazard including a spill, release, discharge or contamination, either on its own
accord or in response to an actual or threatened violation of any environmental law or regulation
thereunder; (iii) institute legal proceedings concerning envirorunental hazards or contest or settle
legal proceedings brought by any local, state, or federal agency concerned with environmental '
compliance, or by a private litigant; (iv) comply with any local, state or federal agency order or
court order directing an assessment, abatement or cleanup of any environmental hazards; and(v) ,
employ agents, consultants and legal counsel to assist or perform the above undertakings or
actions. Any expenses incurred by the trustee under this paragraph may be charged against
income or principal as the trustee shall determine.
ARTICLE VI. SPENDTHRIFT PROVISION
6.01. General Provision. No beneficiary shall have the power to anticipate, encumber
or transfer his interest in the Trust Estate in any manner other than by the valid exercise of a '
Power of Appointment. No part of the Trust Estate shall be liable for or charged with any debts,
contracts, liabilities or torts of a beneficiary or subject to seizure or other process by any creditor
of a beneficiary.
ARTICLE VII. CONSTRUCTION OF TRUST
7.01. Choice of Law. This Trust shall be administered and interpreted in accordance
with the laws of the Commonwealth of Pennsylvania.
7.02. Code. Unless otherwise stated, all references in this Trust to section and chapter
numbers are to those of the Internal Revenue Code of 1986, as amended, or corresponding
provisions of any subsequent federal tax laws applicable to this Trust.
7.03. Other Terms. Unless the context otherwise requires, the use of one or more �
genders in the text includes all other genders, and the use of either the singular or the plural in the
text includes both the singular and the plural.
7.04. Captions. The capdons set forth in this Agreement at the beginning of the '
various divisions hereof are for convenience of reference only and shall not be deemed to define
or limit the provisions hereof or to affect in any way their construction and application.
7.05. Situs of Trust. The Trust shall have its legal situs in York County, Pennsylvania.
ARTICLE VIIL
COMPENSATION OF TRUSTEE AND
APPOINTMENT OF SUCCESSOR TRUSTEE
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8.01. Compensation. The Trustee shall receive as its compensation for the services
performed hereunder that sum of money,based on an hourly charge or percentage rate, which the
Trustee normally and customarily charges for performing similar services during the time which
it performs these services.
8.02. Removal of Trustee. Settlor may remove the Trustee, at any time or times,with
or without cause, upon thirty(30) days written notice given to the current Trustee. Upon the
death of the Settlor, a majority of the current beneficiaries may remove the Trustee, at any time
or times, with or without cause,upon thirty(30) days written notice given to the Trustee. Upon
the removal of the Trustee, a successor Trustee shall be appointed in accordance with the terms
set forth in Pazagraph 8.03.
8.03. A�pointment of Successor Trustee. The Trustee may resign at any time upon '
thirty(30) days written notice given to the Settlor if Settlor is living, or in the event of Settlor's
death, upon thirty(30) days written notice given to the current beneficiary or beneficiaries
(including a beneficiary's natural or legal guardian or legal representative), hereunder. Upon the
death, resignation, removal or incapacity of the Trustee, a successor trustee may be appointed by
the Settlor during Settlor's lifetime, or, after Settlor's death,by a majority of the current income
beneficiaries. Any successor hustee thus appointed, or, if the Trustee shall merge with or be
consolidated with another corporate fiduciary,then such corporate fiduciary, shall succeed to all
the duties and to all the powers, including discretionary powers,herein granted to the Trustee. In
the absence of any other Trustee being appointed by the Settlor during the Settlor's lifetime, the
Settlor's children, KENNETH E.ROSS and SHARI L. LAHLOU, shall serve as the successor
Trustees.
8.04 Exoneration of Trustee. No Trustee shall be liable for any loss or depreciation
in value sustained by the Trust as a result of the Trustee retaining any property upon which there
is later discovered to by hazazdous materials or substances requiring remedial action pursuant to
any federal, state, or local environmental law, unless the Trustee contributed to the loss ar
depreciation in value through willful default, willful misconduct, or gross negligence.
8.05 Indemnification of Trustee Upon Distribution. Notwithstanding any contrary
provision in this Trust Agreement,the Trustee may withhold a distribution to a beneficiary until
receiving from the beneficiary an indemnification an agreement in which the beneficiary agrees
to indemnify the Trustee against any claims filed against the Trustee as an "owner" or "operator"
under the Comprehensive Environmental Response, Compensation and Liability Act of 1980, as
from time to time amended, or any regulation thereunder.
ARTICLE IX. PERPETUITIES CLAUSE
9.01. General Provision. Notwithstanding anything to the contrary in this Trust, each
disposition I have made here, legal or equitable, to the extent it can be referred in its
postponement of becoming a vested interest to a duration measured by some life or lives in being
at the time of my death is definitely to vest in interest, although not necessarily in possession, not
later that twenty-one(21)years after such lives (and any period of gestation involved); or, to the
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extent it cannot be referred in any such postponement to such lives, is to so vest not later than
twenty-one (21) years from the time of my death.
ARTICLE X.
ACQUISITION OF UNITED STATES TREASURY BONDS
ELIGIBLE FOR TAX PAYMENT; PAYMENT OF TAXES, FUNERAL
EXPENSES,AND EXPENSES OF ADMINISTRATION
10.01. Acquisition of Bonds. The Trustee may, at any time, without the prior approval
or direction of the Settlor and whether or not the Settlor is able to manage Settlor's own affairs,
acquire United States Treasury Bonds selling at a discount, which bonds are redeemable at their
par value plus accrued interest thereon for the purposes of applying the proceeds to the payrnent
of the United States estate tax on the Settlor's estate; and the Trustee may borrow from any
lender, including itself, with or without security, to so acquire these bonds.
10.02. Pa�ment of United States Estate Tax bv Bond Redemption. The Settlor
directs that any United States Treasury Bonds which may be redeemed at their par value plus
accrued interest thereon for the purpose of applying the proceeds to the payment of the United
States estate tax imposed on the Settlor's estate, and which are held by the Trustee, shall,to the
extent of the amount determined to be required for payrnent of the estate tax,be distributed to the
legal representative of the Settlor's estate to be used by the legal representative ahead of any other
assets and to the fullest extent possible to pay the estate tax.
10.03. Payment of Death Taaces and Other Estate Settlement Costs. After the Trustee
has complied with paragraph 10.02, above, and ascertained from the legal representative that all
such bonds have been redeemed in payment of the United States estate tax, the Trustee shall also
ascertain from the legal representative whether the legal representative has sufficient assets to
pay the remaining legacy, succession, inheritance,transfer, estate and other death taxes or duties
(except the additional estate tax imposed by Section 2032(c), or corresponding provisions of the
Internal Revenue Code of 1986 applicable to the Settlor's estate and imposing the tax) levied or
assessed against the Settlor's estate(including all interest and penalties thereon), all of which
taxes, interest and penalties are hereafter referred to as the death taxes, interest and penalties. If
the legal representative advises the Trustee that insufficient funds exist to pay all the death t�es,
interest and penalties, the Trustee shall then pay to the legal representative from the trust
property, an amount equal to all the death taxes, interest and penalties in excess of the funds
available to the legal representative for this purposes, which payments are to be made without
apportionment. In making the payments, the Trustee shall use only those assets ar their proceeds
which are includable in the Settlor's gross estate for purposes of the United States estate tax and
shall not impair the marital portion without first exhausting the entire non-marital portion.
If the Executor of the Settlor's estate, in such Executor's sole discretion, shall determine '
that appropriate assets of Settlor's estate are not available in sufficient amount to pay(1)the
Settlor's funeral expenses, and (2) expenses of administering the Settlor's estate, the Trustee
shall,upon the request of the Executor of the Settlor's estate, contribute from the principal of the
trust estate the amount of such deficiency; and in connection with any such action the Trustee
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shall rely upon the written statement of the Executor of the Settlor's estate as to the validity and
correctness of the amounts of any such expenses, and shall furnish funds to such Executor so as
to enable such Executor to discharge the same, or to discharge any part of all thereof itself by
making payment directly to the person entitled or claiming to be entitled to receive payment
thereof. No consideration need be required by the Trustee from the Executor of Settlor's estate
for any disbursement made by the Trustee pursuant hereto, nor shall there be any obligation upon
such Executor to repay to the Trustee any of the funds disbursed by it hereunder, and all amounts
disbursed by the Trustee pursuant to the authoriry hereby conferred upon it shall be disbursed
without any right in or duty upon the Trustee to seek or obtain contribution or reimbursement
from any person or property on account of such payment. The Trustee shall not be responsible
for the application of any funds delivered by it to the Executor of the Settlor's estate pursuant to
the authority herein granted, nor shall the Trustee be subject to liability to any beneficiary
hereunder on account of any payment made by it pursuant to the provisions hereof.
IN WITNESS WHEREOF,the Settlor and Trustee have hereunto set their hands and
seals as of the day and yeaz first above written.
WI ESS:
/ (SEAL)
CLAIRE C. ROSS, SETTLOR
,_�_,e..,�.s.�.,<�- ��,
COMMONWEALTH OF PENNSYLVANIA .
. SS:
COUNTY OF CUMBERLAND . !
On this, the 30`�day of June, 2004,before me, a Notary Public, the undersigned officer, ,
personally appeared CLAIRE C.ROSS,known to me(or satisfactorily proven)to be the person
whose name is subscribed to the within Trust Agreement, and acknowledged that she executed
the same for the purposes therein contained.
IN WITNESS WHEREOF, I have set my hand and official SeaL
�-ClL.I l�,C,�
Notarial Seal Not Public
Teri L.l�Nalker,Notary Public �'
Lemoyne Boro,Cumbedand County My Commission Expires:
My Comrnission Fxpires Jan.20,2007
I�EfI'1�T r�,�,. , ,., .��,,n.:cr^ia1i:,^f�ff.Vnta�P.� �.
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_ ___ ___ �If�
The foregoing Trust Agreement was delivered, and is hereby accepted, at Lemoyne,
Pennsylvania, on June 30, 2004.
—.. ' �y
� C �-�� (SEAL)
WITNESS CLAIRE C.ROSS, TRUSTEE
_,,,� �\ 7`;/l,dt-.�-��..�
WITNESS '
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1�A�
SCHEDULE "A"
SCHEDULE
REFERRED TO IN THE ANNEXED
TRUST AGREEMENT
DATED: JUNE 30,2004
FROM CLAIRE C. ROSS, SETTLOR
TO CLAIRE C. ROSS, TRUSTEE '
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PROPERTY DESCRIPTION:
ALL THAT CERTAIN piece or parcel of land situate in Fairview Township,York County,Pennsylvania,bounded
and described as follows,to wit:
BEGINNING at a point on the eastem side of Yellow Breeches Drive which point measured along the eastern side
of Yellow Breeches Drive,is 1580.70 feet South of the southeast corner of Yellow Breeches Drive and Green Lane
Drive and which point is also at the Southwest corner of Lot No. 151A,general plan, Section 4,Green Lane Farms,
recorded in the Office of the Recorder of Deeds in and for York County,Pennsylvania in Plan Book K,Page 21;
thence along the Southem line of Lot No. 151 A aforesaid North 78 degrees 15 minutes 00 seconds East 156 feet
more or less to the Western bank of the Yellow Breeches Creek;thence Southwardly along the Western bank of the
Yellow Breeches Creek by its several courses a distance of 102.66(eironeously described in prior Deed as 101.00)
feet,more or less to the Northern line of Lot No. 153A on the plan of Lots hereinafter referred to;thence along the
Northern line of Lot No. 153A aforesaid South 79 degrees 00 minutes 00 seconds West 173 feet more or less to the
Eastem side of Yellow Breeches Drive;thence Northwardly along the Eastern side of Yellow Breeches Drive;by an
arc curving to the left and having a radius of 802.72 feet a distance of 99 feet to a point,being the place of
BEGINNING.
BEING Lot No. 152A on plan of Green Lane Farms,Secrion 4-A,Cedar Cliff,which plan was approved by the
Planning Commission of Fairview Township,York County,on May 4, 1965 and was approved by ihe Supervisors of
Fairview Township,York County on May 14, 1965 and which Plan was recorded on May 20, 1965 in Plan Book O,
Page 132 in the Office of the Recorder of Deeds in and for York County,Pennsylvania.
BEING known and numbered as 133 Yellow Breeches Drive,Camp Hill,Pennsylvania.
BEING the same premises which Robert E.Pellxnan and Eleanor S.Pellman,his wife,by their Deed dated June 29,
1979 and recorded in the Recorder of Deeds Office in and for York County,Pennsylvania,in Deed Book 79T,Page
090,granted and conveyed unto George C.Ross and Claire C.Ross
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PA REV-1500
SCHEDULE B
STOCKS and BONDS
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Oracle Corp., ORCL Historical Quote - (NASDAQ) ORCL, Oracle Corp. Stock Price - BigCharts.com Page 1 of 2
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Microsoft Corp., MSFT Historical Quote - (NASDAQ) MSFT, Microsoft Corp. Stock Price - BigCharts.... Page 1 of 2
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Microsoft Corp.
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PA REV-1500
SCHEDULE E
CASH, BANK DEPOSITS &
MISCELLANEOUS PERSONAL
PROPERTY
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comcast� ' - 1
; Account Numbe� 09547 252947-02-9
Billing Date O6/14/12
; Totai Amount Due �48.14
' Payment Due by No Payment Due i
! P�e 1 of 2
Contact us: •� www.comcast.com " 717-540-8900 �`,. ��
__------------- ---------------�.__..
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MS CLA.IRE ROSS � ?�
Previous Balance 234 gi
For service at: Payment- 05/24/12-thank you -234 9i
24 CRAIN CIR
LEMOYNE PA 1704�1381 New Charges -see below -48 4
Totat Amount pue -$48. q�
News from Comcast Payment Due by No Payment �
You have a credit balance of-48,14. Make no payment! � _
Our records indicate that you have a credit balance. All � Partial Month Charges &Credits -52 �t
credit balances o#$1.00 ar more will automatically be � " Effective 06/06J12, ou made d►anges to your ,
refunded to you. If your credit balance is tess then$1.00 account. See the f�owing pages far ma�e detafis. �
and you would like us to send you a refund, piease Other Charges&Credits 7. ' �
corrtact our office by mail or phone with your forwarding °
address. However, if you are still a customer,this Taxes, Surchanges& Fees -4. 5'
balance will be transferred to your new account. To�al New Charges -$48, 4
Hearing/Speech impaired Cali 711 =
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Detach and enciose this coupcx�with your payment.Please write your a�nt number on your check or maney order.Do not send cash.
C���ast5 Account Number 09547 252947-02-9
Payment Dus by No Payment Due
1555 SUZY STREET
LEBANON PA 17046-8317 Total Amount Due -$�8.�4
AV 01 018370 084278 49 A**5DGT Amount Enciosed $ ;
��II't'��I������'���t'1��'lll��'��I�i'll�'���"��'I�"��1'I�'��1' Make checks payable to Comcast
MS CLAIRE ROSS
24 CRAIN CIR
LEMOYNE PA 17043-1381 �,���I��I�I���I����Iii1������II�I�II��1���I��IJl��1�1�1'I„Il�ll
COMCAST CABL�
P 0 BOX 3005
SOUTHEASTERN PA 19398-3005
09547 252947 D2 9 1 OQ4814
- - --- - - __ __ �, . -
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May B3 2813 15:14:16 EDT FROM: F2M/17838458884 M5G# 31679814-886-1 PAGE 882 OF B82
THE
HARTFCfRD
May 3, 2013
Traci Sepkovie
717-731-9627
Reference: The Hartford Annuity 711348501
CLAIRE ROSS,Decedent
Dear Traci Sepkovie,
Thank you for your cotreepondence regarding the above annuity contract.
The death benefit payable undcr this contract is not considered"life insurance"roportable on IRS Form 712, (life
ineurance statement).Please find the below information in reeponae to yotu requeat.
Contract Number 711348501
Owner Claire Ross
Decedent Claire Ross
Social Security Number
Date of Death ueed for values March 11, 2013
Cash Value on tho datc of dcath $79,232.17
Death Benefit Value on the date of death $85,644.49
The Death Benefit Value on the dete of deeth dieplayed ebove may include a Death Benefit Adjustment es outlined in the Annuity Contract.This figure is being
providod for illustration puryoses and ia not equivalent to thc final death benefit.Thc death beno�t will be calcutated on all co�scts associatod with thia client
the day we rcceive due proof of death.Once the deeih beneSt is calculeted,the benefit amount romaine invested and is subject to market fluctuation uMil
complete setUement inawctions are received.
Please contact your Inveetment Profeseional or one of our Annuity Specialieta with any questione or conceme. You
may reach The Hartford by calling 1-800-862-6668, Monday through Thureday from S a.m.to 7 p.m. and Friday
from 9:15 a.m. to 6 p.m., Eastern Time.
Thank you for the opportunity to help provide for your finaneial needs,
Sinceroly,
Inveetmellt PTOduct Service� Tho Hartford Woslth Management-Citobal Annuities
ICS Annuity Bene�it Services Team 7as wes�xew circie xnaa
Hartford Life and Annuity ineurance Company Le ingcon,��a s i 1 r
Mailing Adcfrasa:
PO Box 14293
Lexington,KY 40511•4293
onlinc.hartfordlifc,com
;�
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NAVY •
FEDERAL�
Credit Union
9 May 2013
Law Offices of
Gates, Halbruner, Hatch and Guise, P.C.
1013 Mumma Road, Suite 100
Lemoyne, PA 17043-1144
ATTN: Craig A. Hatch, Esq. '
or
Traci L. Sepkovic,Paralegal
RE: Claire C. Ross(Deceased on 1 i March 2012)
Social Security No.
Navy Federal Access No. 2349028
Dear NIr. Hatch or Ms. Sepkovic:
This letter is in response to your letter dated 29 April 2013 concerning the Navy Federal accounts of our
above-referenced member, Claire C. Ross. I also acknowledge receipt of the accompanying Short
Certificate and Authorization for Release of Financial Information.
Our records indicate that Mrs. Ross's accounts were titled in the natne of"Claire C. Ross." Her savings
and checking accounts were opened on 24 January 2003; her Money Market Savings Account(MMSA)
was opened on 12 March 2003. There was no joint owner or designated beneficiary listed on her
accounts; therefore,the funds were payable to her estate. In addition,there was no change in the
ownership of the accounts.
As of 11 March 2012,the balances of Mrs.Ross's savings account and MMSA were$2,015.07 and
$56,647.90, respectively. Her checking account did not reflect a balance on that date.
During the period of 1 January 2012 to 11 March 2012,the savings account and MMSA earned interest in
the respective amounts of$.99 and $64.95. No interest was earned on the checking account during that
time period.
If you have any questions or need additional assistance,please do not hesitate to call me toll-free at
1-800-883-3323, extension 48028. You may also reach me by faac at 1-703-255-7963.
Sincerely
/ �.,,�� `
r--�� ' �" ; , j�
� �,�,, :J, _;��� ,
RT:tr Tandra H er �
�
cc: Mr. Kenneth E. Ross
PO Box 3000 Merrifie!d Vn 221?9-3000
,
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PA REV-1500
SCHEDULE G
INTER-VIVOS TRANSFERS and
MISCELLANEOUS NON-PROBATE
PROPERTY
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s �, C)wi�ership change ane vear prior cv da��of ilearh: iviA
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S:�DeedslDietz.Cherevka Deed.doc
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RECORDATION REQUESTED BY: ���� NO� 2� ��1 12 18
WHEN RECORDED MAIL TO:
SEND TAX NOTICES TO:
SPACE ABOVE TffiS LINE IS FOR RECORDER'S USE ONLY
THIS DEED,
THIS INDENTURE MADE THE r�t� day of �n��r»�7 2.� ,2006,
BETWEEN JEFFREY R DIETZ, COURTNEY B. CHEREVKA, and ROBERT A.
DIET a$ 'oi�t t ts ith e ri ht s�,� ina e de ' ��a �},�Grantors,
�il�cipa��y �iis �gerl� .������:—f7� a�c�a .����REY-"�IETZ.
AND
CLAIRE C. ROSS, T�rus e oal1 and as .
�e � th�Ross Family Trust, hereinafter designated as
the Grantees.
WITNESSETH, that the Grantors for and in consideration of Four Hundred Thousand and
00/100 ($400,000.00) Dollars ($400,000.00), lawful money of the United States of America, to the
Grantors in hand well and truly paid by the Grantees, at or before the sealing and delivery of these
presents, the receipt whereof is hereby acknowledged and the Grantors being therewith fully satisfied,
does by these presents grant, bargain, sell and convey unto the Grantees forever.
ALL THAT CERTAIN condominium unit, situate, lying and being in the Borough of
Lemoyne, Cumberland County, Pennsylvania, described as Unit No. 16-B, the Woods at Bridgeport, A
Condominium, a flexible condominium, (LTnit 16-B) in a Declaration of Bridgeport Associates, Inc.
("Declarant") and Michael L. Martin, Inc. dated December 14, 1992, which, has heretofore been
submitted to the provisions of the Uniform Condominium Act, Act of July 2, 1980, P.L. 286,No. 82 (68
Pa. C.S.A. Section 3101 et seq.)by the recording of the said Declaration in the Office of the Recorder of '
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�.�ta Deed.doc
4
Deeds, in and for Cumberland County, Pennsylvania, in Misc. Book 433, Page 719, as amended by First
Amendment to Declaration of Condominium for The Woods at Bridgeport, A Condominium, recorded
in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in Misc. Book 460,
Page 838, as amended by the Second Amendment to Declaration of Condominium for The Woods at
Bridgeport, A Condominium, dated February 17, 1995, and recorded in the Office of the Recorder of
Deeds in and for Cumberland County, Pennsylvania, in Misc. Book 491, Page 413, (see also revised
plan recorded in Plan Book 69, Page 97), �nd as amended by the Third Amendment to Declaration of
Condominium recorded in Misc. Book 528, Page 386, and the Declaration Plat Building Ten, The
Woods at Bridgeport, A Condominium, by Hartrnan and Associates, dated August 20, 1996, and
recorded in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in Plan
Book 72, Page 134, as amended by the Fourth Amendment to Declaration of Condominium for The
Woods at Bridgeport, a Condominium, dated September 13, I996, recorded in Misc. Book 530, Page
988, to convert Phase 3 in its entirety to the Condominium, consisting of Phase 3 in its entirety as set
forth in the Declaration Plat Building Ten, The Woods at Bridgeport, a Condominium, dated August 20,
1996, and recorded in Plan Book 72, Page 134, as amended by the Fifth Amendment to Declaration of
Condominium for The Woods at Bridgeport,A Condominium, dated February 25, 1997,and recorded in
the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in Misc. Book 541,
Page 981, and the Declaration Plat Building Nine, T'he Woods at Bridgeport, A Condominium, dated
February 24, 1997, and recorded in the O�ce of the Recorder of Deeds in and for Cumberland County,
Pennsylvania, in Plan Book 74, Page 34, as amended by the Sixth Amendment to Declaration of
Condominium for T'he Woods at Bridgeport, A Condominium, dated May 1, 1998, and recorded in the
Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in Misc. Book 576, Page
1076, and the Declaration Plat Building Eight, The Woods at Bridgeport, A Condominium, dated April
10, 1998, and recorded in the Office of the Recorder of Deeds in and for Cumberland County,
Pennsylvania, in Right-of-Way Plan Book 11, Page 147, as amended by the Seventh Amendment to
Declaration of Condominium for The Woods at Bridgeport, A Condominium, dated August 25, 1999,
and recorded in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in
Misc. Book 623, Page 935, and the Declaration Plat Building Four, The Woods at Bridgeport, A
Condominium, dated August 25, 1999, and recorded in the Office of the Recorder of Deeds in and for
Cumberland County, Pennsylvania, in Right-of-Way Plan Book 12, Page 76, as amended by the Eighth
Amendment to Declaration of Condominium for The Woods at Bridgeport, A Condominium, dated
December 7, 1999, and recorded in the Office of the Recorder of Deeds in and for Cumberland County,
Pennsylvania, in Misc. Book 633, Page 34, as amended by the Ninth Amendment to Declaration of
Condominium for The Woods at Bridgeport, A Condominium, dated October 30, 2000, and recorded in
the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in Misc. Book 659,
Page 274, and the Declaration Plat Building Twelve, The Woods at Bridgeport, A Condominium, dated
October 27, 2000, and recorded in the Office of the Recorder of Deeds in and for Cumberland County,
Pennsylvania, in Right-of-Way Plan Book 12, Page 117, as amended by the Tenth Amendment to
Declaration of Condominium for The Woods at Bridgeport, A Condominium, dated February 14, 2001,
and recorded in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in
Misc. Book 667, Page 330, and the Declaration Plat Building Eleven, The Woods at Bridgeport, A
condominium, dated February 15, 2001, and recorded in the Office of the Recorder of Deeds in and for
Cumberland County, Pennsylvania, in Right-of-Way Plan Book 12, Page 126, as amended by the
,
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Eleventh Amendrnent to Declararion of Condominium for The Woods at Bridgeport, A Condominium,
. dated May 18, 2001, and recorded in the Office of the Recorder of Deeds in and for Cumberland
County, Pennsylvania, in Misc. Book 676, Page 1075, and the Declaration Plat Building Thirteen, The
Woods at Bridgeport, A Condominium, dated May 16, 2001, and recorded in the Office of the Recorder ' .
of Deeds in and for Cumberland County, Pennsylvania, in Right-of-Way Plan Book 12, Page 134, as
amended by the Twelfth Amendment to Declaration of Condominium for The Woods at Bridgeport, A
Condominium, dated December 4, 2001, and recorded in the Office of the Recorder of Deeds in and for '
Cumberland County, Pennsylvania, in Misc. Book 682, Page 4165, and the Declaration Plat Building
Fourteen The Woods at Bridgeport, A Condominium, dated November 28, 2001, and recorded in the
Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in Plan Book 84, Page ,
67, as amended by the Thirteenth Amendment to Declaration of Condominium The Woods at
Bridgeport, A Condominium, dated Mazch 1, 2002, and recorded in the Office of the Recorded of Deeds
in and for Cumberland County, Pennsylvania, in Miscellaneous Book 685, Page 736, and the
Declaration Plat Building Fifteen Unit A The Woods at Bridgeport, A Condominium, dated February
26, 2002, and recorded in the Office of the Recorder of Deeds in and for Cumberland County,
Pennsylvania, in Right-of-Way Plan Book 13, Page 4, as amended by the Fourteenth Amendment to
Declaration of Condominium for The Woods at Bridgeport, A Condominium, dated October 15, 2002,
and recorded in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in
Misc. Book 691, Page 750 and the Declaration Plat Building Fifteen Unit B, The Woods at Bridgeport,
A Condominium, dated October 15, 2002, and recorded in the Office of the Recorder of Deeds in and
for Cumberland County, Pennsylvania, in Right-of-Way Plan Book 13, Page 21, as amended by the
Fifteenth Amendment to Declaration of Condominium for The Woods at Bridgeport, A Condominium,
dated August 27, 2004, and recorded in the Office of the Recorder of Deeds in and for Cumberland
County, Pennsylvania, in Misc. Book 711, Page 1085, and the Declararion Plat Building Five, The
Woods at Bridgeport, A Condominium, dated August 10, 2004, and recorded in the Office of the
Recorder of Deeds in and for Cumberland County, Pennsylvania, in Right-of-Way Plan Book 13, Page '
65, as amended by the Sixteenth Amendment to Declaration of Condominium for The Woods at
Bridgeport, a Condominium,dated October 6,2004,and recorded in the Office of the Recorder of Deeds
in and for Cumberland County, Pennsylvania, in Misc. Book 712, Page 2093 and the Declaration Plat
Building Six, The Woods at Bridgeport, A Condominium, dated October 6, 2004, and recorded in the
O�ce of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in Right-of-Way Plan
Book 13, Page 71, as amended by the Seventeenth Amendment to Declaration of Condominium for The
Woods at Bridgeport, A Condominium, dated December 15, 2004, and recorded in the Office of the
Recorder of Deeds in and for Cumberland County, Pennsylvania, in Misc. Book 714, Page 678 and the
Declaration Plat Building Seven, T'he Woods at Bridgeport, A Condominium, dated December 15, 2004,
and recorded in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in
Right-of-Way Plan Book 13, Page 78, as amended by the Eighteenth Amendment to Declaration of
Condominium for The Woods at Bridgeport, A Condominium, dated September 1, 2005, and recorded
in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in Misc. Book 720,
Page 2605 and the Declaration Plat Building Sixteen, The Woods at Bridgeport, A Condominium, dated
August 31, 2005, and recorded in the Office of the Recorder of Deeds in and for Cumberland County,
Pennsylvania,in Right-of-Way Plan Book 13, Page 115,together with a proportionate undivided interest
in the common elements (as defined in subject declaration)of 2.65%.
:=1
BG�K �`,�� P�1GE�;���
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,
UNDER AND SUBJECT to restrictions,rights-of-way, easements and agreement of record.
Said property being known as 24 Crain Circle,Lemoyne, Pennsylvania 17043.
BEING THE SAME PREMISES which Jeffrey R. Dietz and Courtney B. Cherevka, as joint
tenants with the right of survivorship and not as tenants in common, by their deed dated May 10, 2006,
and recorded in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in
Record Book 274, Page 3295, granted and conveyed unto Jeffrey R. Dietz, Courtney B. Cherevka, and
Robert A. Dietz, as joint tenants with the right of survivorship,the Grantors herein.
FLJRTHER BEING a unit subject to special declarant rights of Classic Communities
Corporation, a Pennsylvania Corporation as set forth in the Partial Assignment of Special Declarant
Rights recorded March 30, 2004 in the Office of the Recorder of Deeds in and for Cumberland County '
in Misc. Book 707, Page 377.
TOGETHER with the benefits of and under and subject to the terms,covenants and conditions
contained in the Declaration for The Woods at Bridgeport,A Condominium,and Declaration Plats and
Plans for The Woods at Bridgeport, A Condominium, as aforesaid.
TOGETHER with the right of ingress to and egress from said property and the right to use, for
all proper purposes, in common with the Declarant and the Grantors their successors and assigns, and all
other occupants from time to time any and all portions of the project designated as Common Elements
by the Declaration or by statute.
THE GRANTEES, for and on behalf of the Grantees and the Grantees'heirs,personal
representatives, successors and assigns,by the acceptance of this deed, covenant and agree to pay such
charges for the maintenance of, repairs to,replacement of and expenses in connection with the Common
Elements as may be assessed from time to time by the Executive Board in accordance with the Uniform
Condominium Act, and further covenant and agree that the Unit conveyed by this deed shall be subject
to a charge for all amounts so assessed and that, except insofar as the provisions of said Uniform
Condominium Act may relieve a subsequent Unit Owner of Liability for prior unpaid assessments, this
covenant shall run with and bind the land or Unit hereby conveyed and all subsequent owners thereof.
TOGETHER with all and singular the buildings, improvements, ways, woods, waters, watercourses,
rights, liberties, privileges, hereditaments and appurtenances to the same belonging or in anywise
appertaining; and the reversio� and reversions, remainder and remainders, rents, issues and profits '
thereof, and of every part and parcel thereof; AND ALSO all the estate, right, title, interest, use,
possession, property, claim and demand whatsoever of the Grantors both in law and in equity, of, in and
to the premises herein described and every part and parcel thereof with the appurtenances.
TO HAVE AND TO HOLD all and singular the premises herein described together with the
hereditaments and appurtenances unto the Grantees and to the Grantees'proper use and benefit forever.
800K ?�''� PAGE���
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_�ica Deed.doc
UNDER AND SUBJECT, nevertheless, to certain conditions and restrictions of record as
aforesaid.
AND the Grantors covenant that, except as may be herein set forth, they do and will forever
specially warrant and defend the lands and premises, hereditaments and appurtenances hereby
conveyed, against the Grantors and all other persons lawfully claiming the same or to clairn the same or
any part thereof,by, from or under it, them or any of them.
In all references herein to any parties, persons, entities or corporations, the use of any particular
gender or plural or singular number is intended to include the appropriate gender or number as the text
of the within instrument may require.
Wherever in this instrument any party shall be designated or referred to by name or general
reference, such designation is intended to and shall have the same effect as if the words "heirs, executors
administrators, personal or legal representatives, successors and assigns" had been inserted after each
and every such designation.
IN WITNESS WHEREOF,the Grantors have hereunto set their hands and seals. Dated the day
and year first above written.
Signed, Sealed and Delivered
in the presence of
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COURT Y B. CHEREVKA
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OBER A.D T7i P I C�PAL by JEF'FREY R.� D n m� ���
C�,�'�,�,1 �i�;� ,��.�.i�' a/k/a JEFFR�E�Y @��.
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COMMONWEALTH OF PE1vNSYLVANIA ) ' :+" .,"
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BE IT REMEMBERED, that on /�D V P•I'l�J� [ � , 2006, before me the subscriber personally ,�
appeared JEFFREY R DIETZ,lrnown to me(or satisfactorily proven)to be the person whose name is subscribed to the
within instrument and aclrnowledged that he executed the same far the purposes therein contained.
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IN WITNESS WHEREOF,I hereunto set my hand and official seal.
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Copyright 2011 Esri. Ali nghts �served. Fn May SO 2013 01:37:32 PM. '
24 CRAIN CIRCLE
PIN: 12-20-1858-003B '
Deedbook: 00277-03363
Owner: ROSS, CIAIRE C
Land Use Code: 107
Property Type: R
Acreage: '
Square Feet: 2380 '
Taxable Status: T
Clean & Green Status: '
Land Assessed Value $: \
Buiiding Assessed Value $: 356500 ( C � � ,. �J ,
Total Assessed Value $: 356500
Sa�e Price $: 400000
Sale Date: Mon Nov 20 2006 07:00:00 PM
Year Built: 2005
Municipality: LEMOYNE BOROUGH
Height in Stories
Type of Dwelling: TOWN
Pnmary Exterior: Vinyl '
Basement Percentage: 100 '
Air Conditioning: AC
Total Rooms: 7 '
Bedrooms: 3
Full Bath: 2
Half Bath: 1
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PA REV-1500
SCHEDULE H
FUNERAL EXPENSES and
ADMINISTRATIVE COSTS
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►� INVOICE
P R E M I E R Thursday,March 1 S,�012
E11750
cate re rs $0.00 Balance Due
This is the Only Invoice you will recieve
If Balance Due pdease su6mit for paym.ent
Credit Card
ClienUOrganization Account# Booking Tel Fax Event#
Shari Lahlou A05404 (202)352-2096 ( } - E11750
Address Booking Contact Site Contact Guests
Private Party Shari Latilour 40(Act)
City,SUProv Postal Sales Rep Theme Category —� '
Jenn Funerat Lunch
Shari Lahlour
Private Party
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Site Name Site Address Site Telephone
Private Residence 417 Hummel Ave,Lemoyne Q-
Foad�Bwerage Eautom�rklMkwllaneous
Food&Beverage Price �ty Total EquipmenUMist�ellaneous Price Qty Total
Luncheon Choice 10.00 40 400.00 Delivery Fee 50.00 1 50.00
Menu• Includes Black Plastic
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Assorted Wrap ao Buffet Linens,Set up, '
Sandwichs Clean up.
* (Tipping is not expected,
Italian Meatballs ao but appreciated)
(in Marinara Sauce)
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Our Famous
Cookies and Brownies ao
Sodas served from 2 40
3/15/2012 09:32 am Premier Caterers �of 2
FEDERAL TAX I.D 25 ]686749
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E11750-Shari Lahlou
Liter Bottles
Includes Plastic Cups
and Ice
Coffee&Tea ao
Service
Food Beverage Liquor Equipment Labor Room Other Total
Subtotal 400.00 0.00 0.00 0.00 50.00 0.00 0.00 450.00
Ty� 24.00 0.00 0.00 0.00 3.00 0.00 0.00 27.00
Total 424.00 0.00 0.00 0.00 53.00 0.00 0.00 477.00
Paid 477.00
Balance 0.00
PaVatlnls AAade
Method Card Type Expires Card Number
Credit Cazd American Fxpress 04-2015 ""•""-000
PREMIER CATERERS
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7l7 761 2700 WWW.PREIvIlER-CATERERS.COM
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FEDERAL TAX I.D 25 16&6749
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The Patriot-News Co. � ��.• �
2020 Technology Pkwy �� � a rio � ���
Suite 300 �'
Mechanicsburg, PA 17050 Now you know
Inquiries - 717-255-8213
GATES, HALBRUNER & HATCH, P.C.
ATTN: TRACI HILFERDING
1013 MUMMA ROAD
SUITE 100
LEMOYNE PA 17043
STAT E M E N T ALL CHARGES AR�,,VET
ACCT# NAME AD ORDER# DATE EDITION ADDTL. INFO. TYPE OF CHARGE UNT
41052 GATES.HALBRUNER&HATCH, P.C. 0002208089 OS/11l12 METRO WEST Ross BASIC AD CHARGE $39.46
41052 GATES, HALBRUNER 8 HATCH, P.C. 0002208089 05/18/12 METRO WEST Ross BASIC AD CHARGE , $39.46
41052 GATES, HALBRUNER 8 HATCH,P.C. 0002208089 OS/25l12 METRO WEST Ross BASIC AD CHARGE ' '$39.46
AFFIDAVIT CHARGE I $5.00
TOTAL: $�123.38
This is not an invoice. Please do not remit payment from this Statement.
An invoice will be generated at the end of the month. --Thank you. '
NOTE: This Statement replaces the Order Confirmation which we previously sent with Proofs of Publication
_ _ - ---
---_ ___ _ ___ ___
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CUMBERLAND LAW JOURNAL
32 SOUTH BEDFORD STREET
CARLISLE, PA 17013 '
Tele: (717)249-3166 Fax:(717)249-2663
May 18, 2012
Cumberland Law Journal is published every Friday by the Cumberland County
Bar Association and is designated by the Court of Common Pleas as the official legal
publication for Cumberland County and the legal newspaper for publication of legal
notices.
TO: Craig A. Hatch, Esquire '
RE: Claire C. Ross Estate
Legal advertisements must be received by Friday Noon. All legal advertising
must be paid in advance. Make all checks payable to: Cumberland Law JournaL
------------------------------------------------------------------ '
------------------------------------------------------------------
Advertisement inserted on following dates:
May 4, May 11, and May 18, 2012 ,
Advertising Cost $ 75.00
Proof of Publication $ 0.00
Second Proof Request $ 0.00
Payment received $ 75.00
Total Amount Due $ 0.00
Becky H. Morgenthal, Executive Director ;
_ - _
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_- _ __-- -- -
---- I i . __
_. _ _ ��1�
RECEIPT FOR PAYMENT
-------------------
-------------------
GLENDA FARNER STRASBAUGH Receipt Date : 10/25/2012
Cumberland County - Register Of Wills Receipt Time : 12 : 07 : 16
One Courthouse S quare Receipt No. : 1071863
Carlisle, PA 17613
ROSS CLAIRE C
Estate File No. : 2012-00320
Paid By Remarks : GATES HALBRUNER ET AL
WZ
------------------------ Receipt Distribution -----------------------�
Fee/Tax Description Payment Amount Payee Name
SHORT CERTIFICATE 24 . 00 CUMBERLAND COUNTY GENERAL FiJNf'
----------------
Check# 16364 $24 . 00
Total Received. . . . . . . . . $24 . 00
_ Ii�.___
___ __ �A�
P.EC�:T�T Ft�R PA�€MENT
___=�»_���_=�_���_
GLENDA FARNER STRASBAL'GH }2eceipt Dat� : 3/16�2012
Cumberlan.d CounCy - Register Of Wills Receipt Time : 12 : 1. : 27
Or�e Cour�nouse S quare Receipt No. : 1Q69159
�arlisl�, PI`> 170"13
RO�� CLAI�E C
+ Egtate File No. : 2012-00320
Paid By Remarks : KENNETH ROSS
CJ
_ __.. __.. _ __ __..-- --------- Receipt Distribution _______ _ ___ _ ___ .. __, - --- - '
Fee/Tax Descriptioz� Payment Amount Payee Name
PETITION LTRS TEST 60 . 00 CUMBERLAND COUNTY GENET2AL P'UIv' ' i
WILL 15 . 00 CUMSERLAND COUNTY GENERAL FiRti ' ;
SHORT CERTIFICATE 32 . Q0 CUMBERLAND COUNTY GENERAL FUN ' i
JCS FEE 23 . 50 BUREAU OF RECEIPTS & CNTR M.D ' i
AUTOMATION FEE 5 . Q0 CUMBERLAND COUNTY GENERAL FUN ' '
RENUNCIATIOI�T 5 . 00 CUMBER'LAND COtTNTY GENERAL FUN !
Check�� 2817 !$140 . 50�
Total REC�ived. . . . . . . . . $140 . 50
—— _ ��_,__
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� Past Biil Information-UGI Utility :���j`��'�
o�s rfr r�c� The account balance on your iast bill was................. $49 01 " 4 �-� ' •°°�
Bi1Hnp 8umma for Service to: Thank you for your payment of...................................... -49.01 216556120724
CLAIREC RoSS ry Your balance as of 06/01/2012....................................-�6
24 CRAIN CIR
LEMOYNE PA 17043
Rate Classification:
Residential Heating Current Biil InMrmation-UGI Utllity
Billinp Period: CustomerCharge............................................................... 8.55
04/2712012 to 05/30/2012(33 days) Commodity Charge(23 CCF at 50.58826) ............... 13.53
Remote Device Read Distribution Char�s(First 23 CCF at$0.40304) .... 9.27 "
PA 5tate Tax 5uroharge..................................................�
QuesUons? Total Current Char es-UGI U61ity . . 3 . '
Ca11800-276-2722 or write to UGI at °"'°°°"°°�°�°°•°°
PO BOX 13009 UGI Utility charpes owed thls btll..................................................................................... '' S 81.23
Reading,PA]9612-3009 Total Amount Due,Please Pay by Due Oate(06/22/2012) ....................................... . =81.23
'Your current UGI charges include � �� !"�
5tate taxes totaling about$1.01. � �n � �f�
'b
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I
Averape CCF Per Day Meter Informatlon-Next Read Date June 28,2012
5.00 Meter Number Prerious Re�ing Preaent Reading CC �ed
4.50 1356939 4753(remote) 4776(remofe)
4.00
3.50 Mess�ss from UGI
3.00 •Your current price to compare is$0.60244/CCF.
2.50 ■Your total annual usage is 666 CCF. Your average monthly usage is 55 CCF.
Z.00
1.50 'We can make your energy costs easier on your budget with our 12 month Budget Iling
1.00 plan. Your monthly payment would be approximately S 69.00. For more inform�ion
about this plan call UGI.
0.50
0.00 'Help prevent pipeline damage,accidents and service disruptions.Call 811 befor��ou dig.
M J J A S 0 N D J F M A M •5ave time.5ave the pianet Sign up to view and pay your UGI bills online at www.��i.com.
2011 Months 2012
Last This
Average Year Year
CCF/day 1.07 0,70 �f you pay at a payment agent please take your entire 6i11. Make check payable tn GI.
Daily temperature 63°F 66°F Keep this part for your records. Important information is on the back ot tl is bill.
UGI Utilities,tnc. Customer Number P��se pay by ►o�due da
� PO Box 15523 216556120724 to avoid the I Gharge.
wlmington,DE 19886-5523 Ptease return t is portion
� s�s rrrriee VYith youf pa nt
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June 22, 12
AV 01 U03739 84080B i4 A**SpGT
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CLAIRE C ROSS $31.23
24 CR�1IN CIR �
LEMOYNE F'A 17043-1381 `���� '
� $31.62
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2165561207240622D1000031230�0039�0000000OOO�QOOOOOO�Q9
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s The account balance on ur last bill was................ $ 134.19 �"�-•Y�'• �"5 {`"` `�`
— a�r rE�ricr Thankyouforyourpayme tof..................................... -134.19 2�6556�aa724
Billinp Summary ior Service to: Your balance as of 03/02/2012...................................i�d6
CLAIREC ROSS
24 CRAIN CIR
LEMOYNE PA 17043
tiate Classiflcation: CurroM Bill lnformation-UGI Utllity
Residen6al Heating Customer Charge........................................................._... 8.55
8flling Period: Commodity Charpe( 109 CCF at 50.63541�..... ., 69.26
01/30/2012 fo 02/29/2012(30 days) Oistribution Charges First 50 CCF at s0.4 480) ... 20.24
Remote Device Read ��stribution Charpes�Next 59 CCF at 50.34034).... 20.08
Qusdlon:? PA 5tate Tax Surcharge.................................................. -0 43
Call 800-276-2722 or write to UGI at ��UUlity chahr�owed thi�'�WII ...........................
PO80X 13009 ..........................................._........ ' '=117.70
Reading.PA 19612-3009 Tatal Amount bue,Plsase Pay hy Due Data(09/29/2012)..................................... ; 117.70
'Your current UGI cbarges inciude
5tate taxes totaling about$3.79.
�
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Past Bill inbrmatlon-UGl Utility `
The aaount balance on ur last bill was._............. $58 83 ""°'F `°
- OAi fFIY/C[ � �
— Thank you for your payment of...................................:: - 8;83 2165561 T24
Bi�liln���ary ior Service to: Your balance as of 05/02/2012................................. '
24 CRAIN CIR
LEMOYNE PA 17043
Rate GasslflcaUon:
Residential Heating Curront Bill Infnrmatlon-UGI UtlIHy g,55
8iliinp Perfod: Customer Charge............._...................._................ '
03/27/2012 to 04l27/2012{31 days) D stribution Char�s(Firat 41 CCF a8SO4�0293) ... 16.52
Remote Oevice Read PA State Tax Surcharge... . . ___�,Z ' '
......».....................................
QusdlonsY Total Current Cha a-UGI Util tv . .. ���f ` ' '
...._.._..............._. .
(�II 800-276-2722 ot write to UGI at Uq Utll ch
PO BOX 13009 ity arpes owed this bill .........._....__.................._.................._...................... , i �49.01
Reading,PA 19612-3009 Total Amount Dus,Plea�e Pay by Due Date(OSl29/2012�..................................... ��S 49 01
'Your current U61 charges include
State taxes totaling about S 1.58.
Mater IniormaUon-Next Rsad Dafe May 90,2012
5.00 ��°�F P°��Y Msfsr Number Provioua Reading Prossnt Reading CCFI !sed
4.50 1356939 4712�remote) 4753(remote)
4.00
3.50 Maaapes irom UGI
3.00 •Your current price to compare is S 0.60244/CCF.
2.50 ■Your total annual usage is 674 CCF. Your average monthly usage is 56 CCF. j
2.00
1.50 'We can maka your energy costs easier on your budget with our 12 month Budget�lling
1.D0 plan. Your monthly payment would be approximately S 69.00. For more inform on
about this plan call UGL
0.50
0.00 •Help prevent pipeline damage,accidents and service disruptions.Call 811 beforej�ou dig.
A M J J A S 0 N D J F M A 'New�ook.Easier to find what you need.Vsit the new www.ugi.com!Be sure to cli�l�on
2011 Months 2012 'Energy Savers'for more ways to save energy and money.
•5ave time.Save the planet Sign up to view and pay your UGi bills online at www.t�i.COm.
Last This
— - - ___
Average Year Year
_ � _. .
_ _ _ __ _ ___ _ ___ 1A�
INVOICE
Invoice Number: 0002068723
^ Penn Waste, �I1C. � � Page Number: 1 of 1
PO Box 3066
� Date: 05/31/2012
� York,PA 17402 Customer Number: RS736956
� � � � www.pennwaste.com � `� Site Number: 0000
Phone(717)767-4456 } Reference:
� � ToilFree 1-(866)575-8720 1�y
Fax(717)767-4285 �» Invoice Total: $45.00
� Total Due: $45.00
�
� http:llpennwaste.bil t st.com
PSL VPP M
7095 1 AV 0.350 E0158X 10166 D484638484 P1012505 0001:0001 H12 , �
I�I������������������������I��������I���������'���������'�������� Online Billing Now Available!
��'� CLAIRE ROSS ��p��/} ��° L�(./ c'� � ♦ / Receive your invoices faster '
24 CRAIN CIR -�'JW''"" � " ' ` �'� �f°�� � '. � '. and help save the environment by '�'I ;
LEMOYNE PA 17043-1381 (, enrolling in our free online service.
n�,I ; ���.-��� See enrollment details above!
�� •
Code Description Date Reference Quantity Am nt
(0001)
CLAIRE ROSS
24 CRAIN CIR LEMOYNE,PA
01 Curbside Trash&Rec 05/31/12 1.00 45.00
32.00GA
07/01/2012-09/30/2012
Please visit our website at www.pennwaste.com Current 30-so oays st-so nays ove o��ays
for holiday schedules and collection information. $45.00 $0.00 $0.00 .00
PLEASE DETACH AND RETURN HOTTOM PORTION WITH PAYMENT
'»-'--------------------------------------------"'--------"""""----------'--------------"-"'--"-------------------""'-'------------"---------------------"'---------'--"�"'^"'---
PAYMENT COUPON
Make Checks Payable To:Penn Waste,Inc. Invoice Number: 0002068723
Page Number: 1 of 1
Payment For Curreat Charges is due by 06/30/2012 Date: 05/31/2012
All past due balances are due im�ediately. CustomerNumber: RS736956
AFTBR THIS DATS A LATS F88 OF $10.00 AIILL BE A338338D Site Number: 0000 '
Any check returned for inauf£icient fuads will be Reference:
asaesaed up to a $50.00 service charge Remittance Amount: 45.00 '
Pleaee no xoe sacioee Check Number:
l�ay lirittan Co�unication
Nith Your Hill I
Pleaee Contact Ci�etomar Sarvica 11t (717) 767-4456 '
REMITTANCE ADDRESS
��������i����������u�������n����nin����n��������n�������
Penn Waste Inc. ,
c/o M&T Bank
P.O. Box 64910
Baltimore, MD 21264-4910
736956000000020687230000004500
- �,,.�„ ___
__ — — _ _ ii -- __ .
___ _ _ _____ AA�
INVOICE
Invoice Number: 0002159053
^ Penn Waste, �I1C. Page Number: 1 of 1
PO Box 3066 Date: 08/31/2012
_ � York,PA 17402 Customer Number: RS736956
/ � � www.pennwaste.com Site Number: 0000
� Phone(717)767-4456 Reference:
� v.� ToIlFree 1-(866)575-8720
Fax(717)767-4285 Invoice Total: $45.00
Total Due: $45.00
�
� http:l/penrnvaste.bil ;t.com
PSL VPP M
11727 2 AV 0.350 E0168X 10178 D539537662 P1167026 0001:0001 Ht 13 i
���I���I��I��II���I���ll�l�l������l�l����l��l�ll�������i�����ll�� Online Billing NowAvailablel
�� ` CLAIRE ROSS ♦ / Receive your invoices faster I ,
24 CRAIN CIR � '. �� ', and help save the environment by '
LEMOYNE PA 17043-1381 enrolling m our free online service.�I �.
� See enrollment details above!
�f �
� �
Code Description Date Reference Quantity Am nt
(0001)
CLAIRE ROSS
24 CRAIN CIR LEMOYNE,PA
01 Curbside Trash&Rec 08l31/12 1.00 j 45.00
32.00GA
10/01/2012-12/31/2012
Please visit our website at www.pennwaste.com Current 30-60 Days 61-90 Daya Ove 0 Days
for holiday schedules and colledion infor►nation. $45.00 $0.00 $0.00 .QO
PLEASE DETACH AND RETURN BOTTOM PORTION WITH PAYMENT
-"""""'----'------'---------'-----'--'--------------------------------------'---------'--------'-------------------------------------------"-'---'------------------------------"�-t"----"•
PAYMENT COUPON
Make Checks Payable To:Penn Waste,Inc. Invoice Number: 0002159053
Page Number: 1 of 1
Payment For Current Charges is due by 09/30/2012 Date: 08/31/2012
All past due balances are due ia�ediately. Customer Number: RS736956
AFTBR TBIS DATB A LATS Fi38 OF $10.00 9PILL 88 ASSESSBD Site Number: 0000
Aay check returned for iasufficient fuada will be Reference:
asaessed up to a $50.00 service charge Remittance Amount: 45.00 '
Pleaee Do Not 8acloae Ch@Ck NUlltb@f" ' i
]►ay rritten Co�unicatioa '
Nith Your eill '
Pleaee Contact Cuatomer S�rvice 1►t (717) 767-4456
REMITTANCE ADDRESS
�n�����������i��������n���n�����nn�����nn�����u���in� �
Penn Waste Inc.,
c/o M&T Bank
P.O. Box 64910
Baltimore, MD 21264-4910 '
736956000000021590530000004500 '
�,�,�•�, - _
__ _ __ ------- ��__.__ __
__ _ _
LATE NOTICE
Invoice Number: 0002200780
z Penn Waste, �t1C. Page Number: 1 of 1
PO Box 3066 Date: 10/15/2012
� York,PA 17402 Account Number: RS736956
� � � www.pennwaste.com Site Number: 0000
� Phone(717)767-4456 Reference:
: TolfFree 1-(866)575-8720
� Fax(717)767-4285 Invoice Totai: $10.00
� Total Due: $55.00
�
� http:!/pennwaste.bil at.com
PSL VPP M
13931 AV 0.350 E0020X 10021 D566397943 Pt215662 0001:0001
I��'�11'll�l�il�l��y�liln�l�����Il�i�����'ll�l"I��I'I�I�'�I"� Online Billi�g NowAvailablel
�N = CLAIRE ROSS ' A,� / Receive your invoices faster
24 CRAIN CIR V � ', and help save the environment by '
LEMOYNE PA 17043-1381 � l erK011ing in our free online service. '' I
• �1� ' �_ See enrdlment details above!
� � �
Code nnRCriptia� �ate Re!erence Quantfii Am •h.
10 Late Fee 10h 5/12 1.00 10.00
Please visit our website at www.penrnnraste.com Current 30-60 Da s 61-90 Days Ower C�a s
for holiday schedules and coliection information. $10.00 $45.00 $0.00 $ 00
PLEASS DBTACH AND R&TURN BOTTOM PORTION WITH PAYMENT
"""-------'-"'------------"""""'--'----"'-------"-'---"-'-"-'------'-°-----'-"'--------"""-"--------'-'---------""--------------------'°---
"""""""_"'�"'a.4""'..�'
PAYMENT COUPON
Make Chedcs Payable To:Penn Waste,Inc. Invoice Number: 0002200780
Page Number: 1 of 1 i
Payment is due immediately. Date: 10/15/2012
Account Number: RS736956
Site Number: 0000
A service charge up to $50.00 will be aseessed on all Reference:
returaed checks. Remittance Amount: 55.00 '
Pleaaa no pot sncios• Check Number. '
Any Nrittea Co�uaication
xith Your Sill
i
Pleas• Contact Cuatomer 9ervice At (717) 767-4456
REMITTANCE ADDRESS
I��I�I���II��I�I�II���1��1�1��11�1�����1111������1111���11���1
Penn Waste Inc.,
c/o M&T Bank I
P.O. Box 64910 f
Baltimore, MD 21264-4910 �
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736956000000022007800000005500
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TI�ANKS FOf2 SHOPPING WEI5 MARKETS #125
119'.i lawther Road
CamF� Hill, PA, 17011
TELE=PHC�NE: 717-73'T-7091
YUUk CASH:[ER 70DAY WAS Michelle
CHK WINGS 5.08 F
BABY BELLA PC 2.49 F
SC BABY BELLA 0,99-F
BAKEF'Y ITEM 2.50 F
SC 50� OFF BAKRY T7M 1 ,25-F
WE.I LEM OIL 16 PC 4,59 T
SC WE:I LEM OIL 16 0,60-T
MR CLN ERSR EX2 2,99 T
MR CLEAN ERASER 3,99 T
MC MHGIC ERASER 3.99 T
TAX 0,81
�**+� BALANCE 22.60
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� WNis Club Savinss Total 2.34
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0!3/03/12 t)4:GOPm 125 114 139 130
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WE:IS GAS REWARDS
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Earn Gas f�ewards thru 10/Oo/2012
Redeem I:,as Rewards thru 10/13/2012
�f:E iE it**ff�f�t�:�k if IF9t�f 1f iE iF if�f 3f 3f�E if�k 1f if it if iE it i�3t i�it iE iE if
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CAMP HILL POST OFFICE
CAMP FIILL, Pennsylvania
CAMP HILL POST OFFICE 170119998
CAMP HILL, Pennsylvania 4i.34870011 -0096
170119998 06/18/2012 t717)737-1461 04:34:21' M'
4134870011 -0097
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Sales Recei t _. Product Sale Unit Fin
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to pri nt shi ppi ng 1 abel s wi th postage. x�r,rx�r�rx�r,rx�rrrrc�xx�rr�rr�rrcx�t�rx�r�r*�c,r�t�r�r�yc���*��, ;
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� 5500 CAF�LISLE PIN:E
MEfNRNICSBURG, PR 17050 (717) 610-9230
L041E'S HONE CENTERS, INC.
5500 CAFILISLE PIKE — SIaLE —
MECHANICSBUA6, PA 17050 (717) 610-9230 SRLESt: S2223JS7 872483 TRANSA: 7961890 09-06-1'I�2i
— SNLE — 194574 SS 22%28 BEVEt OUAL MIF;RO 96.97
SALES#: S2223JS7 872083 iRANSN: 7961899 09-06-12 43676 HB 52" CROSSYINDS BRSHD N 88.89
18400 NONCONTRCT PKT VOLi DETt1 12.47 SUB1'OTAL: 135.86
�A%: 8.15
SU8i0iAl: 12.47 INVOICE 07069 1OTAL: 144.01
TAX: 0.75 VISA: 144.01
INVOICE 07077 TOTAI: 13.22
VISA: 13.22 UISA:%XIfX%K%XXX%X7707 AMOUNT:144.01 AUIHCD:680055I ;
SUIPED REFID:961411222307 09/O6/12 15:56:51 �
VISp:1(KXIU(XXXJI%Xffi707 pMOUNT:13.2`[ AUTHC0:578380 �
SMIPEO REfI0:9619072i:2307 09/Q6/12 16:05:07 ��
STONE: ?223 TERMINAL: 07 09/06/12 16:05:09 �'�'"��,� ��� I ;
� O F I TE M S P URCH A S E D: 1 ��: � TERbINAI: 07 09/06/12 15:57:04 �, !
El(CLUDES fEES, SERVICES pND SPECIAL ORDER Iic'MS � OF :C T E MS PIJ R C H A S E D:
I����������������� EXCLUDES FEES, SERVICES AND SPECIBL ORDER ITEMS "
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THANK VOU FOR SHOPPINB LOME'S.
SEE REVEASE SIDE FOR AEiURN POLICY. THANK YOU FOR SHOPPIN6 LOYE'S.
STORE NANA6EA: JIM DUNIfEt8ER6ER SEE REVERSE SIDE FOR REiURN POLICY.
SiORE NANA6ER: JIM DUNKELBERBEA
11E HAUE iHE L0YES1� PRICES, GUARANTEED!
IF YOU fIND A LOYER PRIf:E, WE WILL BEAi IT BY 10$. VIE HAUE iHE LOYESI PRICES, BUAAANTEED!
SEE STORE FOR DETAILS. If YOU FIND A LOYEA PRICE, YE YILL BEAT IT BY 10$� I�II
SEE STORE fOR DEiAILS.
**«*r�***►���************r��*r��r*��*****�*��******�*�**
* YOUR OPIMIOHS COUNi! � �**********��**����*�s*����:**��****�:���*�**��*��*��..,��s��
* REYISTER TO YIN A i`.i.000 LOYE'S SIFT (�! * * YOUR OPI�IIONS COUNi! ' ' �
* iRE6ISTRESE PAAA GANAR UNA TARJETA DE RE6AL0 LOYE'S! * * 116GISiER TO YIN A t5.000 LOYF.'S 6ffT 6.RAD! -I� I +
* � * iREGISTRESE PARA BANAR U"'� TARJETA DE REGALO LOYE'S�!!�
* REfiISTER BY COMPLETIN6 Fl fiUESi SAiISFACTION SURVEY � * ' #
* aITHiN C!:E �iEEK Ai: uww.loaes.caolsurueY * * REGISTER BY COMPLEiING fi 6UEST SATISFACTION SURUE ;� �
� ,
* Y 0 U R I u t 07077 2223 250 � * NITHIN ONE IdEEK AT: wwu.laaes.con/suruer , �
* * * 4 0 U R I D w 07069 2223 250 , �
* NO PURCHASE NECESSARY i0 EMTER OR WIN. � * ' *
* vOTD bHERE PROHIBITED. MUST BE 1B OR OLDER TO ENTER. * * NO PURCHASE NECESSApY i0 ENTER OR 4iIN. ' I�
* OFFICIAL AULES E MINNERS AT: aww.lowes.coA/SUrueY � * UOID WHERE PROHIBITED. Ml!ST BE 1B OR OLDER 10 EHiEA.��
********�**r�r******�*���t*�:*s�****���********���*��*�*�* * OFFICIAL PULES S YINNERS Ai: uwu.lowes.coe/suruer '��
STORE: T223 TEAMINAL: O7 05/06/12 16•05•09 ************�*******#*****�*****�**�#�********r***�** !�*
. � SiORE: 7223 iERMINAL: 01 09/06/12 15:57:04 I ;
THE FOLLOWING ITEMS HAUE E�.TENDED PROTECiION PLANS '
AUAILABLE FOA PURCHASE. YOU NAUE 30 DAYS FAOM THE DAT��
Of iHIS SALE TO PURCHASE A PLAN. TO MAKE A DURCHASE, I '!
. CONTACT R LOYE'S SALESPERSON.
43676 HB 52" CROSSWINDS BF;SHD NIKL FAN I�
_ _ �A� _ _
ateway Square
99 Gateway Sq/Gatewav Dr
Mechanicsburg, PA 17055
JCF'ENNEY 2712 717-691-7601
CAPITAL CITY MALL
3501 CAPIIAL MALL DR 83 - SEASONAL DEC 348369 4.9�;T
CAMP HIL.L PA 17011 83 - SEASONAL DEC 414704 4.9 ;T
�'� 71.7-730-6064
� I��� � 83 - SEASONAL DEC 414704 4.9 ;T
83 - SEASONAL DEC 414582 3.9�iT
__ _ �_ 63 - SEASONAL DEC 394055 4.9� T
83 - SEASONAL DEC 414473 6.9�'T
i�xi3 QUICK DR=: � 40/].727/040101 83 - SEASONAL DEC 414456 5.9��T
3.00T1 83 - SEASONAL DEC 390134 5.9�iT
13K13 �UICK DR=: 740/1727/040101 83 - SEASONAL DEC 388443 7.9��T
3.00T1 83 - SEASONAL DEC 388457 7.9�iT
��x��, QUICK DR:: 740/i.727/040101 83 - SEASONAL DEC 359971 7.9 iT
3.00T1 83 - SEASONAL DEC 414456 5.9�!;T
83 - SEASONAL DEC 414487 6.9�!T
1�xi�, OUICK OR:: 740/]J27i030201 83 - SEASONAL uEC 389686 3.9 'T
3.00T1 g3 - SEASONAL DEC 414442 5.9�;T
1�xi3 OUICK DR:: 740/1727/030201 83 - SEASONAL DEC 414442 5,9�'T
3.00T1 83 - SEASONAL DEC �14579 3.9�'�i7
16x28 OUICK DR:: 740/i726/040201 61 - KITCHEN ACC 311388 4.9�I�iT
4.00T1 61 - KITCHEN ACC 311374 6.9�'�T
16112E OUICK DR_: 740/1726/030301 SUBTOTAL $���•��
4.00T1 pp 6.0009� Sales Tax $6.�1
30X54 QUICK OR:: 740/i.725/030401 T O T A L $��8•��
5.00T1 V I S A �118��
************6928
3QK54 QUICK UR:: 740/7.725/030401 PURCHASE
5.00T1
EXPIRES: **/�* SWIPED
Subtc�tal 33.00 AUTH# 03420A
Ss�tes, Tax 6.o0o0X 17011 1.98 09/06/12 15:24:47
REFERENCE #: 19340559
Tcatal 34.9$
� � * * * � * � * * � � � � * * �
� -- - - T.J.MAXX VALL'ES YOUR FEEDBACK!
VISA 34.98 Tell us what you thir�k about
KXXXXXXXXXXX�►707/XXXX/4934130C1 M your store visit todaY and
Curdholder acknowledges receipt of enter a monthly drawiny to win a
goods/services in the amount shc,wn and $500 T.�1.Maxx Gift Card.
aGree�s to pay ��or them accordinc� to credit
contract with r,ard issuer. Visit www.TJMAXXFEEDBAGK.com
Respond by 09/20/12
You t�ili need to reference
-�- - - your receipt
Store: 2712 Term: 09U Tran: 3516 Survey number: �i2Gu6r.s72
Date: 09/30/12 Time: 02:45 PM kssoc: 0749 SEE WEBSITE FOR COMPLETE RULES
* � * * � * * * * * � * * � � � *
Thank you for rounding up! In SE�ptember we I j
Foe roope�infog vesit jcp.com/jcpcares IIIIIIIIII�IIIIIIIIIIIII�III�IIII��IIII�I��IIIII�II��I���II�;
Your feedback matters. Give us your 9 0 7 2 0 0 6 7 3 7 2 1 5 5 $ 9 3
thou�hts and enter to win a $50U gift card
Survey and sweepstakes rules at: ITEMS 19
www.jc;penney.com/survey
- - ---_ _ _ _Mrocc s�ncic vn1 i d_foc 7 .1�....___ - _- Ofil�l_ - --- ___ _ _ _�i_
f�,ittcr5 Lemr��ne Tru� Value Flardware
1'!u0 Market Street
Lemoyne, PA 170h3
?�-717-731-1 C�70
Trursa�;tion#: A�0121? �
�,ssociat�: Sharon
Gaie: U�i/26!201� 'ime: c?h:38:31 PM
*�� SAL[ ��»
!
'1 BiI1 ln: '
;i�Y6YC L.�.�I11�'i?� I I��iiP `%8iU8 IICf r'riJi'_ U ..1(II� '.
� f't.;�tc,ir,.r.� # T R387��,,=J.341
;2C�U Market Stree±
L�mioyne, NP. 17043 ������!:�i-I fiO;;S
1-�li-;sl-10�0 417 I�UMMEL pVE
LEMIi1'NE> PA 17043 1':1�:;5
'iu�',�: kl`;[1tS7J
,re: ._!ii, i� �r�.ii> Vali�e R�w�rrJs # ;�P75li0i1541
,� _ Ti�ie: — � �
�ALE x�, / _ ._ _ __--- ------ #y�� _
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- �: i4':<:ir�;�;0U0�.14� 20x20x1Pleat Fur Fi?ter ,( _�L
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�i!;MiA�� ;�•� �.G CN @ $4.79 T $9.58
il_i'"11'Pd! . i� . ,:i,;�_
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VISA: �10 .,�
_ ;� $,4.9.i I" GHkNGE: �O.iiu
;;., ;
ti`� - ;t�
,.,:; , 6UYEk AGREES Til PAY TOTAt_ AMOUNT AEOVE
�. , . : �=: ' ' ACCURDING 7U ,:ARUHOL�Ek'S AGREEMENT
WI7H ISSUER
���,,�
Approva1:874592
CNUM:VISA--�****M�****�7707
�:%'r:k#��# �
N;si�it:kt:NNETf', � ROSS
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R.itte��, l_emoyne Trua Value Hardware Ritters Lemc,yr�e True Value Hardware
1200 Mar�ket Str�et 1200 Market Street
Lemoyne, P� 17043 Lemoyne, PA 17043
1-717-731-1070 1-717-731-1C�70
Transactinn#: A198E16 Transaction#: A19�OU1
Associate: JULIE Assuciate: Kelly
. Date� U9/14/2012 Time: 03::'0:39 PM Date: 09/06/2012 Time; 02:51:24 PM
�*� SALE �*� *** SALE �.�*
8i;1 To: Bill To:
Customer # TVR3875000941 Customer # 1'VR3815000941
K[NNETN R05S KENNETH kUSS
41? HUMMEL AVE 417 HUMMEL AVE
LEMD'fNE, PA 17043-1955 LF.MCYNE, PA 17043-1955
True Value Rewards # 3875000941 True Value kewards # 38i'5000941
WHT 1G ��PLY, Urea Plate EC (]T FLT Pastel. Base
12�3918 670067
3.U0 EACH @ $0.49 "f $i.47 1.00 EACH @ $10.99 T $10.99
15A WHT 25P UL Switches
367t154 Subtotal: $1C.99
3.00 tACH @ $9.49 T $28.47 6% - 5tate Tax: $0.66
TOTAL: $11.65
Subtotal: $29.84
6� - State Tax: $1.80 VISA: $11.65
TOTAL: $.31.'r'4 �HANGE: $0.00
4[SA: $31.74
CHANGE: $0.00
6UYER AGREES T� PAY TUTAL AMCIUNT ABQVE
ACCURUING 'f0 CARDHGLOER'S AGREEMENT
WI7H ISSUER
BUYER AGREES TU PAY TOTAL AMOUNI ABOVE
AL'CGRbING TO CARDNOLDER'S AGREEMENT Appr'ara1:160853
h'ITH ISSUER CNJM:�,`I�A-«********�**7707
� EXP:**/*�
Apprnva1:004011 NAMF:KENNErH E ROSS
CNUM:VISA-�*��+�**�****7707 AMT:11.65
EXP:**;+*
NAME:KENNETH E ROSS j ,� J
AMT:31.74 �� + f 1 ,��'.�:�,,
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4f�j l,{ 1 f . �:�'`��,''� pu�hor i zed�igria�ure -
`�f� .k', } `�r � � ..�._..____
� '-' ______________=________=____=-___---
(X) __--Aiitliorize�_Signa�ure`----- . ,
_..--�----___-------�--------------
- -.--_----_--- Thank You! �
.-----------------�-----------------
Thank You!
i
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kitter�s Lemoyne TruE Value Har�ware
,; .�i. ;.;,e Vai�_�� �i;u'dwa�`e 1200 Market 5treet
•..�:t �;t ret r L.emoyne, PA 17043
, :: ',lil4? 1-717-731-107U
I-7i�-i; I�:J?il
Transaction#: R1y7204
Trar�sac'ti:�,�#: A19671fi Assucinte: JACKIE
Associate: ,�l'U E Date: 09/07/2012 'fime: 01:16:52 PM
r',at�:�: 09/U5/2012. Time: 11:�3:i)`; �;M
� *�.* SALE ***
�*» SALE ***
Bill To:
BiIJ T�a: Customer� # TVR3875UU0941
Custon�er # ?'1R3�7500:1,�"t KkNNE7H kOSS
KtNN�fH 4ClSS 417 NUMMEL AVE
; AVF LEM01'NE, PA 17U43-1955
17043-1955
True Value Rewards # 387500Uy4?
,;��e Rewards # 387500i,�;41
__ _.._____.___.._._ _—
BP CHR Harid SNWR Head
'..GT NI Cei1_ Fixt��re 138312
!;."1�736 1.00 EACN @ $1?.99 T �17.99
2.00 EACN @ $24.99 T $4y•�� gP CHR Hand SfiWR Head
i -3,�4"Cob Ceil Fixture 138316
�ua6�� 1.oU EACH @ $20,99 T $20.99
:.'.i�U �A�,l; @ $25.99 7 $51.c,� Ny l F iber Sp��ut Brush
�.'�w ,I � G�ii�� Light 565836
, $3.79 T $7.5�3 1.U0 EACH � $3.29 T $3.29
12PK 3/4" WHT SO Bumper
538324
Subtotal: $1''Q !`-' 1.00 EACH C� $3,79 T $3.79
fS,�?�^ G�.- State Tnx: �f ` ��
`2�,J���, , TGTAL: �; � Sa4U96 HingePin DR Stop
4'
�'�� VitiA: �116.:� ?.00 EACH @ $3.79 T $3.79
CHANGE: $d.Ot' 15A WHT SP TOG SwitCh
583187
1.00 EACH @ $0.79 T $U.79
Subtotal: $50.64
8UY"tR A�REE`� T4 ''AY TCiTAL AM����N( ,�;�, 6� - State Tax: $3.174
� '��Ci;OR[`l N;; �.� � Ahl �i0f 1',4 R'S AGhI `'�'����i TO f At.: $53.68
'�TH : ;;�.}F':,
VI:;A: �53.68
QP� CHANuE: $O.UiJ
CN:.;M :• «�:��+...+ . ��ti;
.;+:P:>,,;*»
NAMI_�KkNNFTN E ROSS
AM1;116.iZ BLJYtR AGREES TO PAY T07AL. AM�!�!Mf h6114'E
kCCURDTNG TO CAR6NU�DER'S AGkFEMENT ,
~ ���� �—'t I�r:�� r WI-TH ISSUER
�IJ,lrY��++�r���E^�,,'�r' ` a�' �,.7•1 �— APPYOVaI:b35262
�f, ,+v 4 � � CNUM:VISA-********�***?7U7
!:X} ' ------- - EXP,»*/�.►
� "�u�FiorizecTS`ig'nature NAME:KENNETH E RO�S
__...:_��;:-____�__________________� _-_ AM i:53.68
----...----------
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A.it*.ers I._emoyr,r Ti°u� Va'ue Narclware
12�G M�rket Street
i.amuyne, PA 17043
1-717-731-10?0
Transacti�ri#: A19fiG98
�� Assiiciate: Kell;
Date: U9/06/2C12 Time: G2:39:�8 PM
r Y
. i�.� !��1UF{�� �1��A*
Ritters Lemoyne True Value Har�:�ware
��'OU Market Street biil fo:
?moyne, PA 17G43 Cust:o�ner # TbR38'75G(�U941
"!��-731-1G70
KENNETN RU�S
4;? NUMMEL AVE
��`�5Z48 l_EMOYNE, f'A 17043-1955
.E
_�:;� Tir,i;�: 1i;::�!.__;,;� nM
Ti��ie Val�e Rewards k 3875 ��+i
+�*M SAIE **�
Bi l l To: --_._--.-- --_.____.._--- -._.4_�.----.--
Customer # TVR3°. ��!i�y41
KENNETH ROSS 11-3/4"�'ob Ceil Fixture
417 HUMMEL AV�
LEMGYNE, PA t"1u4;�-1�55 3C�4656
-I.JU EACH @ $25.99 T -225.��9
7rue Value Reward5 # 3675000941
Suk,total: -�25.99
� 6� - State Tax: -$1.56
LGTD WHT/GLD GhimButton TUTAL: -$27.55
529584 '
1.00 EACH @ $4.792 T $4.79
(Reg Price $5.99) VISA: -$27.55
lY GRN Reuse Shop Bag ;;NANGE: $0.00
Z90726 '
1.00 EACH @ $0.99 T $U.99
GREEN BAG SALE
U00000
1.00 EACH @ -$0.99 7 -$U.99 BUYtN A�;REES TO PAY 70TAL AMQUNT ABOVE
Subtotal: $4,79 ACCOkUING TO t:ARDHOLDER'S AG�2EEhfENT
6% - State Tax: $0.29 WITH iSSUER '
TOTAL: $5.08
CASH: $5.08 Appravsl:
CHANGE: $0.00 CNUM:VISA--****+�*�*�»**7707
EXP:**/k«
As a valued custamer, you have NAME:KENNETH E ROS5
' savad $1.20 on this purchase AMT:(27.55)
__.__. _-- --_---_____._------------
� Thank You! � ,, _ -� '
� 4� f�"��
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1 IIII II lIII Ilif 1111111lII Illi Illll I 11 llil ________________�____.___��_________
1 5 4
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THANK YDU FOR SHOPPING AT THANK YDU FOR SHOPPING AT
HEPFERS ACE HOMECENTER I-IEFFtRS Al:t 1-IUMtI;tl41 tti
(717) 761-7722 (717) 761-7722
SPEC.ORDER/SOME OTHER NO RETURNS t=LiJI�U J I-IIJKtt1l;ANt MISI�E NU ittiii�i6S
� SEE STORE SIGNS FOR DETAILS SEE STORE SIGNS FOR DETAILS
9(03J12 3:36PM IK 553 SALE i ijG4%12 iz:zi�i�i Ci+i 553 SAi.�'
---------------------------------- �«
------ ------------------------------------ ,
17319 1 EA 3.79 EA i0b5�0� i EA 5.y9 EAii
CLEANR G00 GONE 80Z 3.79 ACE MARINE EPDXY .850Z "�9�
1361013 1 EA 3.99 EA
WD-40 8 OZ. SMART STftA�! 3.99 siiB-iuTAL: 5.yy iA�t: ' .;�b
3991007 1 EA 5.99 EA TOTAL: �t35
BULB 3WAY30-70-100REVEAL 5.99 B� AMT: ����5
3407020 1 EA 21.99 EA
BULB 16/25/32N! CFL RVL 21.99 tiK L'AIiD#: XXxxR](nl(nXxl('(f U l
42821 3 EA 7.�9 EA ID: 670121225899
SEAT TOILET WOOD WHT 22.47 AuTFi: 32122G AMT: �:35
Host reference #:1127 Bat#0276 ',
SUB-TOTAL: 58.23 TAX: 3.49 SwINtG
TOTAL: 61 .72 CARD TYPE:VISA EXPR: XXXX!
BC AMT: $61.72
BK �ARD#: XXXXXXXXXXXX7707
ID: 670121225899 ��Il���I�����,i�i��4��������l��'! '
AUTH: 523512 AMT: 61.72
Host reference #:984898 Bat#0214 _-)> JtiNL#AO11Lf �k�=
SWIPED CUST # *2064
CARD TYPE:VISA EXPR: XXXX p�E RtWAt�uS Iu � i�t723i6y586
7FiANK i'Uli KtnNt I ti E Ftt7S�
+ FOR YOUR PATRONAGE
�I i��l������i����������1���������
I agree 2o pay aDOVe totai amouni
• __» JRNL#J84898 «_= according to card issuer agreement '
CUST # *2064 �mercnant agreement ir credit vouchelrj
ACE REWARDS ID # 19023169586 Acct: KENNETH ROSS
THANK YOU KENNETH E ROSS '
FOR YOUR PATRONAGE SEASONAL MSDE MUST BE RETURNED IN �AY
- pLL OTHE�t�-3GuAv�,iN F'Fil( IMlIH httC !��'I
Acct: KENNETH ROSS
C;ustomer C:opy
I agree to pay above total amount '
according to card issuer agreement
(merchant agreement if credit voucher) -
SEASONAL MSDE MUST BE RETURNED IN 3DAY
ALL OTHERS-30DAYS,IN PAK WITH RECEIPT
Customer Copy
__ _- - -
_--- __ _ ��.:__ ___
__ _ _ _ _ _ _ ____ _ __ �rA�
THANK YOU FOR SHOPPING AT
HEPFERS ACE HOMECENTER
(717) 761-7722
. SPEC.DRDERJSOME OTHER NO RETURNS
SEE STORE SIGNS FOR DETAILS
9/09/12 8:57AM IK 553 SALE
5027123 1 EA 2.99 EA
SHIELD DOOR&KNOB 3.25"WH 2.99 ' �
3235199 1 EA 8.49 EA
SWTTCH COMBO QT DPLX VdHT 8.49
3202504 1 EA 1 .09 EA
DUPLEX RECP 4VALPLT 1G WH 1.09
SUB-TOTAL: 12.57 TAX: .75 ' '
TOTAL: 13.32 '' '
BC AMT: $13.32 ''
BK CARD#: XXXXXXXXXXXX7707
ID: 670121225899
AUTH: 631580 AMT: 13.32 "
Nost reference #:986093 Bat#0220
SVlIPED
CARD TYPE:VISA EXPR: XXXX
III IIIIII IIIIIIIIIIIIHIIIII ll l lli
__» JRNL#J86093 «__
CUST # *2064
ACE REWARDS ID # 19023169586
THANK YOU KENNETH E ROSS
FOR YOUR PATRONAGE
Acct: KENNETH ROSS
I agree to pay above totai amount
according to card issuer agreement
(merchant agreement if credit voucher)
SEASONAL MSDE MUST gE RETURNED IN 3DAY
AtL OTHERS-30DAYS,IN PAK WITH ftECEIPT '
Customer Copy
i�__
__ _ _ _ ___ ��� _
I 00024181435050000000000002239018
� Pennsylvania American Water � r � r - 24- 1814350- i
P O B o x 3 7 1 4 1 2 AMOUNT DUE �22,
Pittsburgh, Pa. 15250-7412 3
For Service TQ: 24 Crain Cir
DUE DATE OCt 31, 201 ;
AMOUNT PA{D E�ECTRONIC
PAYMENT
�,i�iufli�li�i�rvll�ull.i„u�i�i,��,�,,,�i,i����pi�,,.ilil�� ', i,
. .
022911 1 AV 0.347 2911!22911/002911 092 7 NCE2P3
CLAIRE C ROSS , � •
24 CRAIN CI PENNSYLVANIA AMERICAN W�TEI
LEMOYNE, PA 17043-1381 PO BOX 371412 '
PITTSBURGH, PA. �5250-7412 I!
� 1 II ���� I �� � � � � 1� 1 ��I � i�l L� '
II I ini i li III I ill I I lilllli li III ill I ii
n Pfease check here!o add H20-Help to Ofhers contribution to your monthly bill
l�l or to change your address or telephone number,and print information on reverse side.
---------- ------------ ----- ------------------------------------------------------ --- ---------- --- -- - - -- -- --- ---- -- - ------- -----�-'� ---
Cusfomer Account Informatlon Bllling Summary
For Service To: Claire C Ross ------Prior Balance---------..—_—._—.
24 Crain Cir Prior Water Balanoe $19.3 �
Account Number:24-1814350-5 Prior Was[ewaterBalanae $40.0��
Premise Number: 24-0607844 Payments prfor to O�ct 11,2012 Thanks! 59.3 i
Total prior balance,Oct 11,2012 = ,0�!
B/N/ng Period& Meter Information --...--Current Water Charges------
. Biiling Date: Oct 11,2012 Service Charge 13.7 ,
Biliing Period: Sep 07 to Oct 08 (31 days) Water Volume($.009101 x 900) 8.1�!
Next reading on/about: Nov 06,2012 DSI-PAWC Charge 2.05% 4 i
Rate Type: Residar�tial Total water charges,Oct 11,2012 22.3 I
�;
Meter readings in current bitling period: ----_---AMOUNT DUE-------_---.___ $22,3
Meter Number N080625690 is a 5/8-inch meter.
Present-actual 422900 Do not send payment.Total Amount Du will be deducted I ;
Last-actual 422000 trom your bank account oo Oct 31,2012
Gallons used 900
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---�---------------------------------------------- - ---------------------------------------------------------------�---------------------------------------- --- -�------- ---�-----
Customer Account Informatlon Bllling Summary
For Service To: Claire C Ross _-----prior Balance--------------____
24 Crain Cir Prior Water Balance $61.28
Account Number:24-1814350-5 Prior Wastewater Ba/ance $65.45
Premise Number: 24-0607844 Payments prior to May 10,2012. Thanks! -126.73
Total prior balance,May 10,2012 .00
8/lling Perlod& Mefer lnformatfon --------Current Water Charges-------
Billing Date: May 10,2012 Service Charge 13.75
Billing Period: Apr 04 to May 07(33 days) Water Volume($.009101 x 4,900) 44.59
Next reading onlabout: Jun 07,2012 DSI-PAWC Charge 0.32% . 19
Rate Type: Residential Total water charges,May 10,2012 58.53
.._------Current Wastewater Charges----- - '
Meter readings in current billing period: Lemoyne Swr Svc 40.00
Meter Number N080625690 is a 5/8-inch meter. Lemoyne Swr ($ .00000o x 2100) .00 '
Present-actual 418000 ($ .00950o x 1500) 14.25
Last-actual 413100 ($ .00700o x 1300) 9.10
Gallons used 4900 Total Usage Billed 4900 63.35
_---.---AMOUNT DUE-------_------- $121.88
Water Usage Comparison
>�;
Monthly usage in hundred gallons.
62
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�
2 M J J A S O N 0 J F M A M 2
0 a u u u e c o e a e a p a 0
; y n I g p t v c n b r r y 2
Messages to you from Pennsylvanfa American Water '
'Any portion of the water charges which is not paid as of 6/04/12 will be subject fo a 1.50%pena/ry.
�Approximately 4.57 peraent,or$2.67, of State taxes are inc/uded in your current bill.
Elfective April i,2012, fhe Disbibu6on System/mprovement Charge(DSIC)increased from 0.00%to 0.32/.
This charge funds the rep/acement of water distribution faalifies.
'Have you recent!y changed your primary phone numbe�?!f you have,please update your account informadon online
using My H20 Online a[www.amwater.com/myh2o or caU us at the number below so that we can update our records.
003943/003913 NCDRaN TAV05 13
Customer Service& Emergencies 1-800-565-7292 (24 Hours)
For Hearing Impaired Customers TDD 1-800-300-6202 (24 Hours)
Visit us on the INTERNET:www.pennsylvaniaamwater.com
--_ _ RAW 144AAA2671 - _ --- _ - -_ . _ __ A1 M oar,a_ _ _ 11_ _ _
__._
--------------------------------------------�------ ---------�-------------------9-----------------y._--- - --- -------------------- --- ------- --_ --- - -
Customer Account lnformation Billln Summar
For Service To: Claire C Ross ---------Prior Balance-----------.___.__
24 Crain Cir Prior Water 8alance $7 7.46
Account Number:24-18i 4350-5 Prior Wastewater Balance $75.45
Premise Number: 24-0607844 Payments prior to Apr 09,2012. Thanks! -152.91
Total prior balance,Apr 09,2012 .00
Bflling Perlod& Meter Informatlon -------Current Water Charges---..-___
Billing Date: Apr 09, 2012 Servrce Charge 13.75
8illing Period: Mar 06 to Apr 04(29 days) Water Volume($.009101 x 5,200) 47.33
Next reading on/about: May 07,2012 DSI-PAWC Charge 0.32% .20
Rate Type: Residential Total water charges,Apr 09,2012 61.28
---------Current Wastewater Charges----- ---
Meter readings in current billing period: Lemoyne Swr Svc 40.00
Meter Number N080625690 is a 5/8-inch meter. Lemoyne Swr ($ .000000 x 2100) .00
Present-actual 413100 ($ .00950o x i5oo) 14.25
Last-actual 407900 ($ .00700o x 1600) 11.20
Gallons used 5200�]�s,�`� Total Usage Billed 5200 65.45
� � J � _____ _-----_..__.._
' �� �`����� —AMOUNT DUE- $126.73
{
Water Usage Comparison
Monthly usage in hundred gallons.
,:i
�� � �:
4j � �
��
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a�
2 A M J J A S O N a J F M A 2
; p a u u u e c o e a e a � 2
1 r y n I g p 1 v c n b r
, Messages fo you from Pennsy/van/a AmeNcan Water
*Any portion of the water charges which is not paid as ol 5/07/12 wi!l be subject to a 1.50%penalry.
�Approx�mately 4.57 percent,or$2.80, of State taxes are included in your current bill.
Etfective April 1, 2012, the Disbibubon System/mprovement Charge(DSIC)increased from 0.00%to 0.32%.
This charge funds the rep/acement of water distribu6on faalifies.
"Have you recently changed your primary phone number?If you have,please update your accounf informa6on onlin
using My H20 Online at www.amwafer.coMmyh2o or call us at the number below so that we can update oui records
000572/000572 NCDNYM TAV04 12
Customer Service& Emergencies 1-800-565-7292 (24 Hours)
For Hearing Impaired Customers TDD 1-800-300-6202 (24 Hours)
Visit us an the INTERNET:www.pennsylvaniaamwater.com
RAW100AM7091 A1M 23743 '
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HARRISBURG YORK LANCASTER
�17-732-7626 717-845-3432 717-290-1494 INVOICE 3��'� �
(F)717-732-7941
(Emergency) 717-576-5898' Appt. Date/Time q�2g�2oi2 i:oo:oo I?h1
mro-sTArE aEarun�a �sTO�non VISIT US ONLINE AT <-�eW :'�'�����.
�7 R�ilrc�;��3 r4�e Ist Fir
5l2zrer��aasst€�t��., 9'a I7(l�� WWw•midstatecleaning.CORI SalesRep. J.A.tiIIESNY-DER
BILL TO• Source �i\'T'ER?`tFT
' JOB SITE:
KEN ROS56 � i
2�CItAIN CBR KEN ROSS �
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I.F.Mf�YNE PA 17�43 24 CRA�N CIR ', �
385-1�74 LEMOYNE�'A fl�o43 I i
Comments:
RESIDENTI L
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mro-npTe«farun�e aesroAmion
Water Restoration • Leather Restorat r�
Oriental Rug Cleaning • Tile&Grout CI Y�ing
Carpet Cleaning • Upholstery Clean g
Service/Product Description Qty. Unit Price Ta �
���� 31�
so.�s s, .��a
�.Ibl(UG R�f�B 2� Sd.36
S't .�8
STIEPS W/F'6�TECTBOGV �y,� 5�.5� .�D
LANDBIVC3 �
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FBALLW�IY '�63 SQ.36
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BEDR0061IV 197 Sp.3g ; :�,�
BED� 203 5�.36 S7 d�
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Job Descri tion:
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CALY.ON t�41.4�'30 1V��1�S-E��tNILL B�1VIEET'ING U THERE TO PAY AI��TI��N Discounts
i.RAVING
Subtotal ` �.3
, Tax $ .�
PAID: _CASH _CHECK# _CREDIT CARD-EXP TOTAL $ �,.63
ADDENDUM TO OUR CONTRACT: In the event of default, I (we) promise to pay any legal interests on the
indebtedness,togetherwifh collection cos}s in the omount of noT less than 33 33%nor more ihon 50°/a of ihe principol Mid-State C/eaning & Restoratio
balonce due,reosonable attorneys'fees and court costs,as moy be reqwred to,e$ed collection of this note.
Registered Home Improvement �
AUTHORIZED ACCEPTANCE BY: X_ ' ` ' -�
" Contractor ID# PA048177
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. _ _ _ . _ _ r��A
AccourA Number Due Date Amount Due
� 717 763-4999 ',824142Y Upon Receipt $18.37
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, �� `'�'�"�� Stabmant Date: 8l19/12
�}�i�`_��� CWRE C ROSS
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.�►���,�`i�:�;':`::?:>::';.; Phone: 717-763-4999
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Previous Balance $92.381, ;
V�I)�9�5 Paymem Received May 21 -- —-- - - - -$92.38I '
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Don't Move Without Verizon! 8a1anos F0""'"� S'0� �
Call t-888-416-9691 beiore you move.We'll help
set up yoix IMemet,TV an�l Phone tor your new N�q����
address.You can be up and mm�ing in no time!DON'T - _----------_. -- ,
WAIT!And be sure to ask'rf FiOS is available in your CuRerri Activiry _ _ __ _ __ S�9•�
area.Service availability vanes. Taxes,fees and Other Charges -$1.62� '
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We Want You to Stay With Us Tot�New Charses S�a.s�j
You are a valued cuu411omer&we warrt to deliver the
very best service 8 value to yoa Call us at M Due s18.37� %
1-877-875-849010 tird out about the new ways
Verizon can save you money.We appreciate being Hnal Bd
your provider,and we would like to keep you with us ,/j �
longer by improving yoix Verizon experier�ce. � / !.
� � Ibl�
Better Bundles That Save
Call 1-888-363-3644 or visit verizon.comisupreme
to make sure that you're getting the bes[Verizon
services at ihe best value.From phone,Intemet and
TV bw�dles,to iMernatior�al plans and tun add-au,
together we'll find vrays to save you more on Verizon's
sueerior�r:rvices.
Questlons about your blll or service?
W811t Aut�118tk Pey1118n1? View your bills in detail at verizon.com or call 1-800-VERIZON(1-800-837-4966),I !
Enroll below or at Verizon.com to authorize your tir�ancial Fnter your ten digit number 717-763-4999.Use 824 it asked tor your customer
institulion io deduci the amouM of yau moMhly bill trom ideMification number.Reach us by T1Y at 1-800-974-6006.
the accouM associated with your enclosed check and
send payment directly to Verizon.To dixominue
Automatic Paymerrt,call Verizon.Please keep a copy ot
this auttarization.
� Please retwn remit slip wAh paymeM.
_ �
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. _ _ __ _ _ _ *�� _
� �
905 Hidden Hollov� �rive
Gap, PA �1�7���;27
-�� `°"� � ��� Phone: (717) 442-r)�105
i
\ � � 1-866-TRY-g'�'P1
r Fax: (717) 442-4F�47
.
Painting, Power Washing, Papering Co. -- ---- ----- —
lndustrial • Commercial • Residential
�nVO�ce
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t„n.�..�.,.�.�, �,.,� .m, ,a.�.t�.�.�.��.,�..�. _�... �
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Ken Ross � 'nvoice# 87
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� �..�_--YDate_—`_�
1 , �_________ __.:._ �__�
� 9/26/2012
( ' ----.._.._,_ ._._---�
Work order#
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Description � Amount �
_�_...�--. ------�_�.__.._.__.___�_.__�_____.�_.----__,_.___�_._-----.--__. ._.-----_
24 Crane Circle Lemo e,PA 7----^----�--��—��T�
Yn ; 2,750.00 �
;
��Apply two coats of paint on kitchen wails only. ' f
Apply one coat of paint,flat finish on walls in the following rooms:dining room,hallway,foyer,den I �
(3 walls),master bedroom,master bath(walls and ceiling),two bedrooms,one bedroom(walls and ( ,
ceiling)and loft area �
Closets not included. ;
�Two bathrooms and]aundry room not included. i i
Touch up dings on trim only. � �
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Date Dascription Amaun# Account
09/2412012 Check 1021 $509.00 5114119862
This is an image of a check, substitute check, or deposit ticket. Refer to your posted transactions to verify
the status of the item. For more information about image delivery click here or to speak with a
representative call: 1-888-PNC-BANK(1-888-762-2265) Monday- Friday: 7 a.m. - 10 p.m. ET, Saturday
&Sunday: 8 a.m. -5 p.m. ET.
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TAXING AUTHORITY:WEST SHORE SCHOOL DISTRICT WEST SHORE SCHOOL DISTRICT
TAX YEAR:2012-13 REAL ESTATE TAX NOTICE LEMOYNE BOROUGH PAIO 70: REAL ESTATE TAX NOTICE
FAITH A.NICOLA,T/C (717)761-7785
PAYABLE FAITH A.NICOLA,T!C (717�761-7785 PROPERTY ID 570 HERMAN AVENUE Sl11TE 4
70: 610 HERMAN AVENUE SUITE 4 122018580038U168 LEMOYNE,PA 1704J-1856
LEMOYNE,PA'1�013-7866 ASSESSED VALUE LOCATION OF TAXED PROPERTY PROPERTY I '..
356,500 24 CRAIN CIRCLE 12201858003 '16B
TAX SCHOOL hiOMES7EAD ExCLUS10N SCHOOL TAXES PAID AT ASSESS356 pq E
9.30 ON Oq O A ATE 8'S85 g gp � � � HOMES7EAD �LGSION
RATE ONORBEFOREFACEDA7E . FARMSTEADEXCLUSION REBATE FACE PENALTY �$a
AFTERPENALTYOA7E
REBATE 3,170.90 BY 09/01/2012 3,170.90
0 BY 09/01/201 3,170.90 REBATE FARMSTEAD EX �.U�SION
FACE 3,235.61 BY ��/�l/2��2 $,235.61 NETASSESSMENT BY 11/01/207 3,235.61 FACE
AFTER 11l01l201 3,559.17 pENALTY NE7 A33ES ENT
PENALTY 3,559.17 AFTER'I'I/O'IIZO'IZ 3,559.17 sa�,s�s aa� �
WEST SHORE SCNOOL DISTRICT
TO: ROSS,CLAIRE C ROSS,CLAIRE C
24 CRAIN DRIVE 24 CRAIN DRNE
LEMOYNE PA 17043 LEMOYNE PA 17043
BILL DATE-07/01l2012 BILL#040�89
FOR: 24 CRAIN CIRCLE REBATE•09/07/2012 FACE-11I01l2012 TAX YEAp:�2p12-73
BILL DATE-07/07l2012 BILL#040689
DELINQUENT BILLS ARE TURNED OVER TO TAX CLAIM ON 14/31/2012 TAXPAYER'S COPY TAX COLLECTOR�S COPY ��.
TAX YEAR:2012-13 REAL ESTATE TAX NOTICE REAL ESTATE TAX NOTICE
INSTALLMENT PAYMENT 3 PAIDTO:
LEMOYNE BOROUGH FAITH A.NICOLq T/C p����s�a�es
PAYABLE FAITH A.NICOLA,T!C (717)�61-7785 � 570 NERMAN AVENUE SUITE 4
TO: 610 HERMAN AVENUE SUITE 4 PROPERTY ID LEMOYNE,PA 77043-7e56 �
LEMOYNE,PA 17043-1856 122018580038U16B LOCATION OF TAl(ED PROPERTY PROPERTY ID' '�
TAX SCHOOL-INSTALLMENT PAYMENT 3
24 CRAIN CIRCLE 122018580038 6B
SCHOOL-INSTAILMENT PAYMENT 3 TAXES PAID AT ';
RATE 9.30 ON OR BEFORE FACE DATE � � I
AFTERPENALTYDATE 9.30 FACE PENALT���i
FACE 1,078.55 BY 10/31/2012 1,078.55 t,078.55 Onoreetore �0/3��2��2 1,078.65 Ff1�4"E
PENALTY �,�$6.41 AFTER lO/3'I/2O'IZ �,�86.4� 1,186.41 Atter 10/31/2012 1,186.41 PEN,}1LTY
rAxING yyEST SHORE SCHOOL DISTRICT NET ASSESSMENT WEST SHORE SCHOOL DI3TRICT
AUTHORITY NET ASSES �AENT
FOR: 24 CRAIN CIRCLE 347,915 y�CRAIN DRIVE 3 '�,915
Tp; ROSS,CLAIRE C LEMOYNE PA 17043
24 CRAIN DRIVE
LEMOYNE PA 17043
BILL#040�9
IF DUE DATE IS MISSED,INSTALLMENT MUST BE PAID AT PENALTY. : BILL DATE-o7/ov2ot2 OUE DA7E-ton !o�z
BILL DATE•07/Otl2012 DUE DATE-10131l2012 BILL#040689
DELINQUENT BILlS ARE TURNED OVER TO TAX CLAIM ON 7L31/2012 TAXPAYER'S COPY TAX COLLECTOR'S COPY �
TAX YEAR:2012-13 REAL ESTATE TAX NOTICE REAL ESTATE TAX NOTICE
INSTA�LMENT PAYMENT 2 PAIO 70:
LEMOYNE BOROUGH FAITH A.NICOIA,T!C (717)761-7786
PAYABLE PAITH A.NICOLA,UC (717)761-7785 610 HERMAN AVENUE SUITE 4 � �
TO: 510 HERMAN AVENUE SUITE 4 PROPERTY ID LEMOYNE,PA 77D4]-1D66
LEMOYNE,PA 77013•1668 122078580038U16B LOCATION OF TAXED PROPERTY PROPERTY ID !
TAX SCHOOL-INSTALIMENT PAYMENT 2 24 CRAIN CIRCLE 1220186s003B 168
SCHOOL-INSTALLMENT PAYMENT TAXES PAID A
RATE 9•3� ONORBEFOREFACEDATE � � 'i
� � AFTERPENALTYDATE 9.30 FACE PENAL �
FACE 1,078.53 BY 09/30/2012 1,078.53 1,078.53 onoreetore os�3o�2ott 1,078.53 pq�qE
PENALTY 1,186.38 AFTERO9/3O/YO12 �,786.$8 Atter PEN�I�TY
1,186.38 os�sasoiz 1,186.38 �-
7AXING yyEST SHORE SCHOOL DISTRICT
AU7HORITY NET ASSESSMENT WEST SHORE SCHOOL DISTRICT NET ASSESSI�NT
FOR: 24 CRAIN CIRCLE 347,915 ROSS,CIAIRE C 34I�915
TO: ROSS,CLAIRE C 24 CRAIN DRNE
24 CRAIN DRIVE LEMOYNE PA 17043
LEMOYNE PA 17043
BILL#0406$�
IF OUE DATE 13 MISSED,INSTALLMENT MUST BE PAID AT PENALTY. BILL Da7E- onov2ot2 DuE DA7E-os�3oi#q12
BILL DATE- 07l01l2072 DUE DATE-09130/2012 BILL#040689
DELINQUENT BIlLS ARE 7URNE0 OVER TO TAX CLAIM ON 72/31l2012 TAXPAYER'S COPY TAX COLLECTOR'S COPY
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PA REV-1500
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES
and LIENS
_
_ _ �,
— -- _ _ ._ _ __ __ . _
_ __ _ _ _ eR
In vo i ce �m�rica's Ctioice in 3fometah
, � �
�l�U _ 4 Aii�'415;
Visiting Angels Phone:(717)652-8899 ��,.�w,��:
9 A N.Progress Avenue Fax: (717)909-3185
Hamsburg,PA 17109
Invoice To DATE II�NOICE NO: . PAGE '!
Ken Ross Mar 16 2012 891 Page 2 of,a
417 Hummel Ave
Lemoyne, Pa 17043 Terms: DUE UPON RECEIPT
Client Date Start-End Time Description/Care Giver Unit QTY Rate / Per Amp' t
��
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�
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�� ��
TOTAL: 122.00(Hours) `$�9�,
DUE UPON RECEII'T "
F.;.
--- ----- --- -- -------- -- - -- -- --- - - - ------ - -- �. ---
-�� ._
_ _ _— _ __ _ "�� _
INVOICE
Mvoice Number. 0002022641
� Penn Waste, �f1C. Page Number: 1 of 1
PO Box 3066 Date: 02/29/2012
■ York,PA 17402 Customer Number: RS736956
� � � � www.pennwaste.com Site Number: 0000
� Phone(717)767-4456 Reference:
� � ToiiFree 1-(866)575-8720
� Fax(717)767-4285 Invoice Total: $45.00
� Total Due: $45.00
�
'� Mtp:!lpennwaste.bil bit.com
PSL VPP M
122251 AV 0.350 E0154X 10159 D442117698 P999142 0001:0001 H1
�I�1��1��11�����1"I�li�l��l�l�ll��lll�����l�ll�'�Illl�����f���I� Online Billing NowAvailablel
�� ` CLAIRE ROSS I Receive your invoices faster
24 Cf2AIN CIR ', � ', and help save the environment by '�I
LEMOYNE PA 17043-1381 enrolling in our free online service. ,
See enrollment detaiis above!
Code Description Date Reference Quantity Amo f,
(0001)
CLAIRE ROSS
24 CRAIN CIR LEMOYNE,PA
01 Curbside Trash&Rec 02J29/12 1.00 ' ' 45.00
32.00GA
04/01/2012-06/30/2012
�
� �� �S�
1� �
Please visit our website at www.pennwaste.com CurreM 30-60 Da 61-90 Da s Over 9 Days
for holiday schedules and coilection ir�formffiion. $45.00 $0.00 $0.00 $0 0
nrL�TC�` TL`TT/`LT TTTTI DF�'TiDlT A/1TTl1M Dl1DTT(1TT LTTTN DDVMRTTT � '
_. _�.�..�—_
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wR�
Maid to Perfection Invoice
2929 Gettysburg Road DATE INVOICE'�
Suite 9 —
Camp Hi[l,PA 170I1 3/9/2012 23825
717-730.6243
BILL TO
Ross, Claire
24 Crain Circle
Lemoyne, PA 17043
TERMS DUE DAT�I
Net Due 3/9/201?�;
DESCRIPTION AMOUNT
Cleaning on 3/7, 3/14, 3/21, 3/2$/12 200.0
Sales T�
12.0f�;
Thank you for your business. Please include the invoice number Total '
with your payment. $212.00''� (
Maid to Perfection reserves the right to charge a finance fee of 1.5%
or $25.00, which ever is greater, on all invoices 30 days or more
j,
- - __ - �i_�-
_ _ _ _
„�,� -
Maid to Perfection Invoice
2929 Gettysburg Road DATE INVOICE�
Suite 9 4/10/2012 23903
Camp Hill,PA 170II
717-730-6243
BILL TO '� ' �
� �� � ;
� ,, �,��
Ross, Ken j~� `�(•�'�
24 Crain Circle
Lemoyne, PA 17043
TERMS DUE DAT�'j
Net Due 4/10/201�;
DESCRIPTION AMOUNT
Cleaning on 4/4/12 SO.Oq'�'
Sales Tax 3.00I i
_ ;,.
Thank you for your business. Please include the invoice number �r
with your payment. Total � $53.00 ,'
Maid to Perfection reserves the right to charge a finance fee of 1.5% ��---.------�'f
or $25.00, which ever is greater, on all invoices 30 days or more
_ - -- _ - - �;
. _ __ . .�� _
._..-------�---------------------------------_.-----•---------._...-------------------------------------------------------------------------------------------------------�------- - -� --------
Customer Account Informatfon Billing Summary
For 5ervice To: Claire C Ross ---..---prior Balance------_..__.....___
24 Crain Cir Piior Water Balance $70.18
Account Number:24-1814350-5 Prior Wastewater Balanoe $71.45
Premise Number: 24-0607844 Payments prior to Mar 09,2012. Thanksl -141.63
Totaf prior baiance,Mar 09,2012 .00
BlUtng Perlod& Meter Informatfon -----.--CurreM Water Charges----------
Billing Date: Mar 09,2012 Senrice Charge 1.'�'.75
Billing Period: Feb 03 to Mar 06(32 days) Water Volume($.009101 x 7,000) 6 � a 1
Next reading on/about: Apr 04,2012 Total water charges,Mar 09,2012 7�;46
Rate Type: Residentiai -----»--Current Wastewater Charges----- ---
Lemoyne Swr 5vc 44 E 00
Meter readings in current billing period: Lemoyne Swr {$ .o0000o x 2100) ;00
Meter Number N080625690 is a 5/8-inch meter. ($ .00950o x 1500) 14;25
Present-actual 407900 ($ .00700o x 2100) 14��70
Last-actual 400900 ($ .005000 x 1300) __6i�__SO
Gallons used 7000 � Total Usage Billed 7000 75'�45
'�� ��• (�� ` � ---------AMOUNT DUE------_---.___.._ $1521,.�91
�
! f�
Water Usage Comparison
Monthly usage in hundred gallorts.
7�� '
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7� � i: '� ;; � .��:
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2 M A M J J A S O N D J F M 2
0 a a u u u e c o e a e a 0
; r � y n I g p t v c n b r 2
Messages to you from Pennsyivanla Amerlcan Water
'Any portron ot the water charges which is not paid as of 4103/12 will be sabject to a 1.50%penalty.
'Approximate/y 4.57 percent, or$3.53, of State taxes are included in your current bi1L
"Effeciive November 11,2011, the Distribution System Improvement Charge(DSlC)decreased from 5.44%to
0.00�. This charge funds the replacement of water disfributron facilities.
"Have you recenily changed your primary phone number?If you have,please update your acr,ount informa6on o,�in
using My H20 Online at www.amwater.com/myh2o or call us at the number be%w so that we can update our recoj.�/s.
�
002634l002634 NCDLK6 7AV07 1�
Customer Service&Emergencies 1-800-565-7292 (24 Hours)
For Hearing tmpaired Customers TDD 1-800-300-6202 (24 Hours)
Visit us on the INTERNET:www.pennsyNaniaamwater.com
RAW100AW4861 A1M 254�76
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MORTGAGE SERVICES
1 CORPORATE DRIVE
LAKE ZURICH IL 60047
CUSTOMER ACCOUNT ACTIVITY STATEMENT DATE 10/10/12
REQ BY CBS PAG�i 2
CLAIRE ROSS
LOAN NUMBER: 1418542682
ACTIVITY FOR PERIOD 10/09/10 - 10/09/12
PROCESS DUE TRANSACTION TRANSACTION EFFECTIVE ��ATE
DATE DATE CODE DESCRIPTION OF TRANSAC$'�'ION
---------------------------------------------------------------------------�---
TRANSACTION PRIN. PAID/ ESCROW PAIDj ------------OTHER--------� '�---
AMOUNT BALANCE INTEREST BALANCE AMOUNT CODE/DESCRIPTION !
--------------------------------------------------------------------------��---
07-03-12 07-12 173 PAYMENT
1, 354 . 91 231. 71 747 . 01 376 . 19
204, 662 .44 3442 . 31 NEW PRINCIPAL/ESCROW BALANC,+�S
06-04-12 07-12 175 PRINCIPAL PAYMENT . '
500 . 00 500 . 00 0 . 00 0 . 00
204 , 894 . 15 NEi� PRINCIPA�/�ESCRE�+T� B�f�AI�C}�'9
06-04-12 06-12 173 PAYMENT
1, 354 . 91 229. 05 749 . 67 376 . 19
205, 394 . 15 3066 . 12 NEW PRINCIPAL/ESCROW BALANG'{,�S
05-03-12 06-12 175 PRINCIPAL PAYMENT "
500 . 00 500 . 00 0 . 00 0 . 00
205, 623 . 20 NEW PRINCIPAL/ESCROW BAI,�INC!�S
05-03-12 05-12 173 PAYMENT
1, 354 . 91 226 .40 752 .32 376. 19
206, 123 .20 2689 . 93 NEW PRINCIPAL/ESCROW BALANCI�S
04-04-12 04-12 313 CITY TAX
1, 448 . 14- 0 . 00 0 . 00 1448 . 14-
2313 . 74 NEW PRINCIPAL/ESCROW BAL;AI�TC��
04-03-12 05-12 175 PRINCIPAL PAYMENT
500 . 00 500 . 00 0 . 00 0 . 00
206, 349. 60 NEW PRINCIPAL/ESCROW BALANC�S
04-03-12 04-12 173 PAYMENT
1, 354 . 91 223 . 77 754 . 95 376 . 19
206, 849 . 60 3761. 88 NEW PRINCIPAL/ESCROW BALANC�S
03-05-12 04-12 175 PRINCIPAL PAYMENT
500 . 00 500 . 00 0 . 00 0 . 00
207, 073 . 37 .r� �a�� �„� ��fu�`1 BGU,� .NEW PRINCIPAL/ESCROW BALANC�S
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1, 354 . 91 221 . 14 757 . 58 376 . 19 '
207, 573 . 37 3385 . 69 NEW PRINCIPAL/ESCROW BALANC�IS
02-03-12 03-12 175 PRINCIPAL PAYMENT
500 . 00 500 . 00 0 . 00 0 . 00 � '
207, 794 . 51 NEW PRINCIPAL/ESCROW BALANC��S
02-03-12 02-12 173 PAYMENT
1, 354 . 91 218 . 52 760 . 20 376 . 19 '
208, 294 . 51 3009 . 50 NEW PRINCIPAL/ESCROW BALANC��
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�omca�tm � Account Number 09547 252947-02-9
Biiling Date 02/14/12 �
� Unpaid Balance $114.21 -Due Now i
New Charges $114.21 -Due 03/07/�2
� Total Amount Due $228.42 �
ContaCt us: �%''www.comcast.com � `.717-540-8900 � Pa9e 1 of 2 �
�,.._� �� �` �,�� ,�:- � r.
MS CLAIRE ROSS ����� :: ��t. �.��`°:,����. ;. � _. ...
Previous Balance 11�4.21
For service at: Paymerrts- received by 02/14/12 I 0.00
24 CRAIN CIR '
LEMOYNE PA 17043--1381 Unpaid Baiance -Due Now '1�44.Z1
New Changes-Due by03/07/12 ',114.21
News from Comcast see below formore infomiarion
Totai,Amou�t due $��8.42
Gomcast has al!the speed you need to do everything you
want on the Internet--faster, including our Performance � �- ����. : z
Starter tier,with speeds up to 6 Mbps,for$49.95 per month. � : ` . �y� - � �� . �.
5.� ,:
— Our records indicate your account is past due. if your ,�_� XFINITY 1V 05.55
account is not paid in the next seven (7)days, a$7.95 Taxes, Surcharges&Fees ' 8.fi6
late fee will be assessed. if payment has already been '
made, please disregard this notice. Total�tew Charges $�9'14.21
For your c�nvenience, we now accept reguiar and
automatic mor�thly credit carcf payments and direct '� ° ' • • :
debit. - . � a � :.� �,.
>�. , _ _
Hearing/Speech Impaired Cali 711
On February 29th, the"Preferred Collection"On Demand
folder will no longer be available.
IMPORTANT INFORMATION: On April 3, 2012, Disney
Junior will replace SOAPnet on Digital Preferred channel 120.
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�** END OF ATTACHMENTS **�
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