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HomeMy WebLinkAbout05-07-13 (4) 1505610105 REV-1500 `102-11)(H) OFFICIAL USE ONLY PA Department of Revenue Pennsylvania County Code Year File Number _ Bureau of Individual Taxes `��"`" "�`"` - um PO BOX 28o6o1 INHERITANCE TAX RETURN Harrisburg PA 17128-o6oi. RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW - Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY - __.......-... .................. ....__.........- _ . --------- ...._..-_-_- ................-. ..-...........- _..-.-. 09/0512012 110121/1934 ....... -- ........... Decedent's Last Name Suffix Decedent's First Name MI - Shiley Elwood G. .... ...-._ _.. (If Applicable)Enter Surviving Spouse's Information Below Spouses Last,Name Suffix Spouse's First Name MI NIA Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE • REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW OD 1.Original Return O 2.Supplemental Return O 3. Remainder Return(Date of Death. Prior to 12-13-82) O '4. Limited Estate O 4a. Future Interest Compromise(date of O 5. Federal Estate Tax Return Required death after 12-12-82) - Om 6. Decedent Died Testate O 7.Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) O 9.Litigation Proceeds Received O 10.Spousal Poverty Credit(Date of Death O 11. Election to Tax under Sec.9113(A) Between 12-31-91 and 1-1-95) 1(Attach Schedule O) CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number Michael Cherewka Esquire (717) 232-4701 REGISTCM OF WILLS USETLY x0 rn m � __,t m � First Line of Address roll 2 n Y n 624 North Front Street a a r n2: rn ry Second Line of Address � C(3 -.N � O � C TI City or Post Office State ZIP Code - RATE RLEDI' WOrmleysburg PA 17043 t Co o Correspondent's e-mail address: mcherewka@cherewkalaw.com Under penalties of perjury declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIG APE O SPONSIBLE FOR FILING RETURN - DATE ADDRESS s' 428 H an Avenue, Lemoyne, Pa 170423 SIGN F EP T N REPRESENTATIVE DATE ADDRESS - 624 North Front Street, Wormleysburg, PA 17043 PLEASE USE ORIGINAL FORM ONLY - Side 1 1505610105 1505610105 1505610205 REV-1500 EX(Fl) Decedent's Social Security Number Decedent's Name: Elwood G. Shiley RECAPITULATION 1. Real Estate(Schedule A). . . .. . .. ..... . . . .... . . . . .... . . ... ... . . . ..... . 1. ! - 0.00 2. Stocks and Bonds(Schedule B) ._... . . .. .. .. . .. .. . .. . .. .. . . . ..... . . . . 2. - 0.00 3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . . ,.. 3. 0.00 4. Mortgages and Notes Receivable(Schedule 0) .... . . . ..... . .... .. . . . ..... 4. 0.00 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E). .. ... . 5. 30,728.83 6. Jointly Owned Property(Schedule F) O Separate Billing Requested ... . . . . 6. 57,500.00 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property •. (Schedule G) O Separate Billing Requested... . . . .. 7. 0.00 8. Total Gross Assets(total Lines 1 through 7). . . .. ... ... .. .. . ... .. . . . .. ... 8. 88,228.83 9. Funeral Expenses and Administrative Costs(Schedule H)... . . . .. .. . . . . .... . 9. 7,011.73 10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule 1)... . . . . . ..... . . 10. !^ 51,479.35 ! 11. Total Deductions(total Lines 9 and 10). . ... ..... . .. . .... . . . ... .. . . . . .... . 11. 58,491.08 12. Net Value of Estate(Line 8 minus Line 11) . .. . . . . ..... . . . ... . . . . . .... . . . 12. 29,737.75 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which m__........_._.._._....__.,......_„_.,._...„_..._... an election to tax has not been made(Schedule J) .. ..... . . . .. . . . . . . .... . . 13. - 0.00 14. Net Value Subject to Tax(Line 12 minus Line 13) .. ... . . . .. . . . ..__. . .. . 14. 29,737.75 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 __._....__.......__._.___.._.. ..._.._...__. _._.,_.._.__._.......__m.._..___....__.__._�,_.., (a)(1.2)X.0_ 15. 16. Amount of Line 14 taxable at lineal rate x;0 45 29,737.75 : 16.i 1,338.20 17. Amount of Line 14 taxable .___....._.,.___,___.._....,._..._ _�.. __.._...._.__.__... at sibling rate X.12 ! 17. 18. Amount of Line 14 taxable ..._...._ _„...,,,_..__._.wW......_.,..:.. ,.....e..... at collateral rate X.15 ( 18. . 19. TAX DUE . . . . . . .... ... . . 19.-' 1,338.20 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 L 1505610205 1505610205 REV-1500 EX(FI) Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME Elwood G. Shiley STREETADDRESS - 637 Bosler Avenue CITY - STATE ZIP Lemoyne PA 17043_ Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 1,338.20 2. Credits/Payments A.Prior Payments 0.00 B.Discount 0.00 Total Credits(A+B) (2) 3. Interest (3) 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2,Line 20 to request a refund. (4) 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 1,338.20 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.......................................................................................... ❑ E b. retain the right to designate who shall use the property transferred or its income ............................................ ❑ 0 c. retain a reversionary interest ............................................:................................................................................. ❑ E d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ 0 2. If death occurred after Dec. 12,1982,did decedent transfer property within one year of death - without receiving adequate consideration?.............................................................................................................. ❑ N 3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?.............. ❑ 0 4. Did decedent own an individual retirement account,annuity or other non-probate property,which containsa beneficiary designation? ........................................................................................................................ ❑ 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994,and before Jan. 1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent[72 P.S.§9116(a)(1.1)(1)]: For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dales 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)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S. §9116(a)(1.3)].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. REV-1502 EX+(12-12) pennsylvania SCHEDULE A �T. DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF: FILE NUMBER:.. Elwood G. Shiley 21-12-1030 All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts. Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1 None 0.00 I t tl i ( I TOTAL(Also enter on Line 1, Recapitulation.) 0.00 If more space is needed,use additional sheets of paper of the same size. REV-1503 a) (ena) pennsylvania SCHEDULE B .•� DEPA TMENIOFREVENUE INHERITANCE TAX RETURN STOCKS & BONDS RESIDENT DECEDENT ESTATE OF FILE NUMBER Elwood G. Shiley 21-12-1030 All property jointly owned with right of survivorship must he disclosed on Schedule F. REM VALUE AT DATE NUMBER DESCRIPTION OF DEATH. 1' None 0.00 TOTAL(Also enter on Line 2, Recapitulation) $ 0.00 If more space is needed,insert additional sheets of the same size REV-1507 EX+(6-98) SCHEDULE D COMMONWEALTH OF PENNSYLVANIA MORTGAGES & NOTES INHERITANCE TAX RETURN RECEIVABLE RESIDENT DECEDENT ESTATE OF FILE NUMBER Elwood G. Shiley 21-12-1030 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. None 0.00 TOTAL(Also enter on line 4,Recapitulation) $ 0.00 (If more space is needed,insert additional sheets of the same size) REV-i5o8 IX+(o&u) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Elwood G. Shiley 21-12-1030 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1.� M&T Bank Account#9847692655 j 29,909.28 2. 1995 GMC Van,very poor condition-not able to drive ��V 250.00 IComcast,Refund —� 69.55 q. Clothing and Personal Items V 500.00 I I� I— I � I i i I i TOTAL(Also enter on Line 5, Recapitulation) $ T 30,659.28 If more space is needed,use additional sheets of paper of the same size. i i � . p ' I i I i ek- COMCAST 1555 SUZY STREET ATTN: LEBANON SUPPORT SERVICES r LEBANON, PA 17046 comcast, ELWOOD SHILEY 26167 0796-32-62-3DG 637 , BOSLER AVE - LEMOYNE, PA 17043-1817 Jill 1111IIIIII�fw�lu�ilP�I����i°fl-II 1h11rr1lll1illd1) PAYMENT SUMMARY r7CHECK NO: - 0009852977 ACCOUNTNO: 09547-17912901 CHECK DATE: 11/06/12 Dear ELWOOD SHILEY, The attached check represents a refund for account number 09547-17912901 in the amount of $69.55. If you are d Comcast RFINITY customer and have questions regarding your refund check, you can write us at the address above, call Comcast's toll free customer service number at 1-888-COMCAST (1-888-266-2278) , or chat with us at www.comcast.com/chat. Our representatives are available to assist you 24 hours a day, 7 days a week. If you are- a Comcast Spotlight client or agency, please contact your local Spotlight office. DETACH AND RETAIN THIS STATEMENT THE ATTACHED CHECK IS IN PAYMENT OF ITEMS DESCRIBED ABOVE. IF NOT CORRECT,PLEASE NOTIFY US PROMPTLY NO RECEIPT DESIRED. .........................._..__._............................................................ pM&T Bank 499 Mitchell Road,Millsbom,DE 19966 Adjustment Services Phone 888-502-4349 F az (302)934-2955 February 20,2013 _ Law Office of Michael Cherewka 624 North Front Street Wormleysburg, PA 17043 Re: Estate of Elwood G. Shiley Social Security: 210-26-9109 Date of Death: September 5, 2012 Dear Sir or Madam: Per your inquiry on February 07, 2013, please be advised that at the time of death,the above-named decedent had on deposit with this bank the following. I. Type of Account Checking Account Account Number 9847692655 Ownership(Names of) Bobbi Jo Jones(POA) Elwood G.Shiley Opening Date 0812812008 Balance on Date of Death $29,909.28 Accruedlnterest $ .12 Total $29,909.40 2. Type ofAccount Installment Loan Account Number 10000172312430001 Ownership(Names oJ) Elwood G.Shiley Opening Date 0311512004 Balance on Date of Death $8313.96**This amount is not to be used for payoff purposes. For a payoff . balance,please call 1-800-724-2440 Current Balance $ .00 ** This balance is not a payoff balance REV-LSog IX+(oi-ao) J pennsylvania SCHEDULE F p�y7 DEPARTMENT OF REVENUE INHERITANCE TAX RETURN - JOINTLY-OWNED PROPERTY - RE5IDENTDECEDENT ESTATE OF:' - - _ FILE NUMBER: Elwood G. Shiley 21-12-1030 1 If an asset became jointly owned within one year of the decedent's date of death,it must be reported on Schedule G. SURVIVING JOINT TENANT(S)NAME(S) ADDRESS - RELATIONSHIP TO DECEDENT - AS .bbi Jo Jones �` T-_Y .428 Herman Avenue T Daughter f - 'Lemoyne, PA 17043, B.. JOINTLY OWNED PROPERTY: . .A LETER DATE DESCRIPTION OF PROPERTY % DATE OF DEATH _ ITEM FOR)DINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT'S VALUE OF - NUMBER TENANT JOINT IDEN77MNG NUMBER.ATTACH DEED FOR)DIMLY HELD REAL ESTATE. q- VALUE OF ASSET -` INTEREST yD-ECEDENTS INTEREST 1. A 0211 . , 9104 �i 428 Herman Avenue,Lemoyne Borough,Cumberland County, '—; C L ! 1 ITax Parcel 12-22-0822-146A t 57,500.00 50 f°/,Ip' �'�`28�7•SOM'O'O'•�t ]2 (L AA I 16331 Bosler Avenue,Lemoyne Borough,Cumberland County, L�i jTax Parcel#12-22-0267-382 - 57,500.00 I, 50%j 'L..o.28,750-001 . - - F1 E F....L-TOTAL(Also enter on Line 6, Recapitulation) $ 57,500.00 .._... ._.—.- If more space is needed,use additional sheets of paper of the Same size. i1— Page 1 of 2 10226483 - _ 10226369 10229768 a arm Sold - Sold - Sold 330 5TH ST 606 State St 336 10th Street West Shore West Shore West Shore New Cumberland Lemoyne New Cumberland New Cumberland Lemoyne New Cumberland 17070 17043 17070 Original $59,900 Original $49,900 Original $74,90 Price 3 000 List Pric 00 List Price Sold Price 33 502�1 $49,907;1 Sold Price $57,50 Seller Help 0.00 Seller Help 0.00 Seller Help 0,00 Close Date - 12/6/2012 Close Date 8/29/2012 Close Date 2/3/2013 Yr Built 1930 DOM 113Acres 0.0700 Yr Built 1910 DOM 9 Acres 0.0600 Yr Built 1920 DOM 3E Sq Ft 1,764 $/Sq Ft $18.99 Sq Ft 1,084 $/SgFt $46.03 Sq Ft 1,689 $/SgFt BR/FB/HB/FP BR/FB/HB/FP BR/FB/HB/FP Type Semi-Detached Type Semi-Detached Type Semi-Detal Design Traditional Design Traditional Design Traditional Style 3 Story Style 2.5 Story Style 2 Story Wtr/Swr Public Sewer, Public Watel Wtr/Swr Public-Sewer, Public Watel Wtr/Swr Public Sewel Exit Vinyl Ext Vinyl Ext Vinyl Parking On Street Parking Parking Off Street Parking, On Parking 1 Car Garage Street Parkinq Heat Forced Air, Natural Gas Heat Natural Gas Heat Oil, Steam Cool None Cool None Cool None Bsment Exterior Access, Full, Bsment Full Bsment Full Const Brick Const Frame Const Frame Tax $ 1,531 2012 Tax $ 2,000 2012 Tax $ 2,100 2( DIR13s to exit 40b left onto Carlisle rd,right onto bmndt DIR:Market St in Lemoyne,R/State St across from Hess DIR: South on Bridge to W 1 ave,left onto 5th sL Station. - Check out this New Cumberland Twin. BANK OWNED........SOLD IS"....A GREAT DEAL Very nice 3 bedroom, 1.5 bat Property features 4 bedrooms and one bath. FOR INVESTORS. home on a real nice and quie Backyard offers storage shed. Full living and walking distance to Elemental dining areas. Full basement with exterior Schools. Relax on the coverer access.This home is ready for a new owner. Attic can be finished for 4th t _ Build some sweat equity in this home which room. Side driveway leads to offers tremendous potential for both investors garage.Great price. Don't rrii: and home buyers. Forced air with natural gas. _ http://cpml.paragonrels.com/publink/Report.aspx?outputtype=HTNlL&GUID=48fc781 a-71... 4/2/2013 REV-1511 EX+(10-09) pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER . Elwood G. Shiley 21-12-1030 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: )' Musselman Funeral Home 8 Cremeation Services,Inc. 3,620_0 Royers Flowers ❑ [Texas R—oaddhhou—se,Luncheon ❑ F B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City State_ZIP Years)Commission Paid: 2,600.00 2. Attorney Fees: 3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation.) Claimant Street Address city State_ZIP , Relationship of Claimant to Decedent 4. . Probate Fees: .102 5. Accountant Fees: 6. Tax Return Preparer Fees: T• Register of Wills for Photocopies -� —^, C .��2.5••271 1. aRecorder of Deeds 2.50 ❑9 ILegal Advertising-Cumberland Law Journal to. Legal Advertising-Sentinel 157.68 ❑ El E- TOTAL(Also enter on Line 9, Recapitulation) $I; 7,011.73 If more space is needed,use additional sheets of paper of the same size. I i I d. QYERS° TEXAS ROADHOUSE CAMP HILL .ftowef>E`s=frs j 1101 Lower Allen Drive 3015 GETTYS RD Camp Hill, PA 17011 CAMP HILL, PA (717)730-4090 Server: Ricky DOB: 09/06/2012 Fable 21 09/06/2012 Clerk.#: 245 HOLLY 09/07/2012 Table 2l5/1 6/60019 Transaction: 16419 REG #2 12:58am SALE Ln4 Pn Oescr Qty Amount Ext Amt VISA 1 23 FUNERAL 1 175.00 175.00 j f Card #XXXXXXXXXXXX4353 6291465 Validated Order: 83652 2 9 LOOSE 3 7.50 22.50 Magnetic card present: FOSTER CYNDILOU Validated order:: 83654 Card Entry Method: S 3 3 LOW FL 1 5.00 5.00 Approval: 028062 Validated ender: 63654 4 33 MUM PLAN 1 34.99 34.99 Validated order: 83655 Amount: $ 102,57 33 MUM PLAN 1 34.99 34.99 Validated order: 63656 + Tip: 0) Oa 6 33 MUM PLAN 1 1 .49 1 .49 Val mated order: 83658 = Total : 89 COMBO AD 1 5.25 5.25 Validated order: 83656 I agree to pay the above Tax: 16.76 tctal amount according to the Total : 295.98 card i er agreement. Check Tender: 295.98 X rhonk'You For Your Patronage mwiiz royer 3.corr GUEST COPY I Order Number: 83552 Dalivery Date: 09/08/2012 M USSELMA N FUNERAL HOME & CREMEATION SERVICES, INC. Bobbi Jo Jones 428 Herman Avenue Lemoyne, PA 17043 September 12, 2012 Funeral Expenses for Elwood Shiley. 2012 September 8, 2012 Professional Services Cremation with One Hour Visitation and Memorial Service 3495.00 Total 3495.00 Cash Items Cremation Authorization Fee 25.00 Extra Cremation Charge 200.00 Total 225.00 Credit Cumberland County Veterans- .100.00 Total Due $3620.00 Terms: Net due 30 days.A charge of 1.5%per month (18%per annum) for Unanticipated late payment will be charged on any amount unpaid after due date. P.O. Box 137 • 324 Hummel Avenue • Lemoyne, PA 17043-0137 • (717) 763-7440 • Fax: 717-730-9798 Brian C. Musselman, Supervisor• www.musselmanfuneial.com RECEIPT FOR PAYMENT GLENDA FARNER STRASBAUGH Receipt Date :- 9/20/2012 Cumberland County - Register Of Wills Receipt Time : 14 : 14 : 14 One Courthouse Square Receipt No. : 1071428 Carlisle, PA" 17TT13- SHILEY ELWOOD G Estate File No. : 2012-01030 Paid By Remarks : HMWBI JO JONES ------------------------ Receipt Distribution ------------------------ Fee/Tax Description Payment Amount Payee Name PETITION LTRS TEST 90 . 00 CUMBERLAND COUNTY GENERAL FUN WILL 15 . 00 CUMBERLAND COUNTY GENERAL FUN SHORT CERTIFICATE 12 . 00 CUMBERLAND COUNTY GENERAL FUN JCS FEE 23 . 50 BUREAU ,OF RECEIPTS & CNTR M.D AUTOMATION FEE 5. 00 CUMBERLAND COUNTY GENERAL FUN ---------------- Check# 2043 $90 . 00 Cash Total Received. . . . . . . . . $1545 . 50 RECEIPT FOR PAYMENT ------------------- GLENDA FARNER STRASBAUGH Receipt Date : 9/20/2012 Cumberland County - Register Of Wills Receipt Time : 14 : 24 : 15 One Courthouse Square Receipt No.': 1071430' Carlisle, PA 17613 SHILEY ELWOOD G Estate File No. : 2012-01030 Paid By Remarks : BOBBI JO JONES HMW ------------------------ Receipt Distribution ------------------------ Fee/Tax Description Payment Amount Payee Name PHOTOCOPIES 2 . 50 CUMBERLAND COUNTY GENERAL FUN ------------- =-- Cash $2 . 50 Total Received. . . . . . . . . $2 . 50 CUMBERLAND COUNTY RECORDER OF DEEDS RECEIPT Inv Number: 117768 Invoice Date: 09/2012012 12:43:51 PM RECEIPT Reg/Drw ID: 0101 Customer: Last Change: - Receipt By:COUNTER By: SW BOBBI JO JONES - Chg# Charge I Payment/Fee Description Amount Inst#I Inst Date Municipality 1 COPIES $2.50 Fee Detail: COPY FEE $2.50 TOTAL CHARGES $2.50 PAYMENTS CHECK:2042 $2.50 TOTAL PAYMENTS $2.50 AMOUNT DUE - $2.50. PAYMENT ON INVOICE ($2.50) BALANCE DUE $0.00 Date:Sep 20,2012 12:44:43 PM Page 1 J���,R1N`10 Co y . �hS50CNt�� CUMBERLAND LAW JOURNAL 32 SOUTH BEDFORD STREET CARLISLE, PA 17013 Tale: (717)249-3166 Fax:(717)249-2663 - _ - March 8, 2013 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: Michael Cherewka, Esquire RE: Elwood G. Shiley 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 the following dates: February 22, March 1, and March 8, 2013 Advertising Cost $ 75.00 Proof of Publication $ 0.00 Second Proof Request $ 0.00 Payment received $ 0 .00 Total Amount Due $ 75.00 Payment received by .-`like Senfinel MICHAEL CHEREWKA AD NUMBER -PAGE NO. - w w w.cum 6.r l i n k.c o m 624 NORTH FRONT STREET 418313 1 of 1 _� WORM RG,PA 17043 BILLDATE SALESPERSON ��RO1 .717-232-4701 d7D1 02127113 wolfc CJDa61f SN>BLMY.; �E£RV C(.JN.^.' ' START DATE STOP DATE 02113/13 02!27/13 AD NUMBER - AD DESCRIPTION CLASS ' LINES: 418313. NOTICE NOTICE IS HEREBY GIVEN THAT 10 PUBLIC NOTICES 28.` 2 cols Publication Insertions Rate Net Amount Gross Amount 3 THE SENTINEL-LEGAL 3 LGL $148.68 TOTAL AD CHARGE $148.68 3 MOBILE SITE MOB2 $2.00 3 PROOF OF PUBLICATION 01PRF $7.00 r Purchase,Order .Est. E.G.Shiley, . PAY THIS AMOUNT ` $157 68.. „ 1$9.22• - e .. *AFTER 173124/113 THE SENTINEL Thank you for advertising with The Sentinel! Deadline for c/o LEE NEWSPAPERS in-column legal ads is 4:00 p.m.two business days prior to PO BOX 540 date of insertion. For questions, call (717)240-7130. WATERLOO IA 50704 0$40 Return ibis portion with yourpaymenr Legal ❑ Check# ❑Credit Card' '-. - Ad Number -"'418313 THE SENTINEL Wo LEE NEWSPAPERS ❑ ❑ vrsr ❑ " ❑ oWd_.. Billing Date 02127/13- PO BOX 540. WATERLOO IA 50704-0540 Acct# Amount Due $' 157.68 E)p.Date:[I] m tz;. 1 ," i,A'If10U� Name on credit mrd I $It 1c o5- $ Signature . Please make checks payable tat THE SENTINEL r tom' . . Was � - � _THE SENTINEL, L�1c MICHAEL-CHEREWKA `- r c/o LEE NEWSPAPERS 624 NORTH FRONT STREET v - PO BOX 742548 WORMLEYSBURG,PA 17043 CINCINNATI OH 45274-2546 - 21540200DOOD0418313DODDOODOO 0000DO1692200000157681 w REV-15.12 Ex+(12-12)' - pennsylvania SCHEDULE I DEPARTMENT OF REVENUE '_ DEBTS OF DECEDENT, ' INHERITANCE TAX RETURN. MORTGAGE LIABILITIES &LIENS ' RESIDENT DECEDENT ' ESTATE OF - - FILE NUMBER - Elwood G. Shiley 21-12-1030 . 'Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ' 1 IM8T Bank,Home Equity Line of Credit,Account#1000072312430001 (428 Herman Avenue) 8,313.96 2. Divorce Settlement { 37,500.00 �' �- .,-...�T��'°•_"cam-Z��._=t�`^�__-_�_'�l ��i,�, 3. Hazen Elder Law Offices 2,137.50 , 4. ;Veterans Affairs,Pharmacy Charges . 98.00 5.� 'Verizon Telephone 32.05 6. 'Comcast - - 53.45 7. IPPL Electric r - 80.06 ` f` •8.. IUGC I Utilities - 14.74 9. ;Pennsylvania American Water Company. ` 79.69 ' 10. !Pinnacle Health 22.78 11. 'East Pennsboro Ambulance Service 1,028.80 12. 1UGI Utilities 14.74 iPPLElecbic ' 31.60 14. Pennsylvania American Water Company 32.52 15.• iPENRAC,LLC 157.51 I 16� iPPL Electric 22.77 171 . UGI Utilities 14.74 r a 1' 18. `Pennsylvania American Water Company T 32.52 LLL '19. Lreedom Systems Corp.,Sewer 42.00 2.01 Utilities 21j (Pennsylvania American Water Company - - 32.52 .11 22. jCapitol City Oil,Heating Oil t 357.00 23. !Freedom Systems Corp.,Sewer ) 42.00 24-1• ' `Penn Waste;Inc.(2 quarters) 87.00 - 20. , Fa tl Nicola,Tax Collector,2013 Real Estate Taxes 547.32 L _� TOTAL(Also enter on Line 10, Recapitulation) $ 50,790.000 - If more space is needed,insert additional sheets of the same size. ESTATE OF ELWOOD G. SHILEY 21-12-1030 DOD: 09/05/2012 SCHEDULE E. (continued) Balance forward: $50,790.00 Penn Waste 43:50. UGI Utilities 29.70 Pennsylvania Water Company 32.52 PPL Electric 23.20 Freedom Systems Corp., Sewer 15.00 UGI Utilities 29.70 Pennsylvania Water Company 32.70 Freedom Systems Corp., Sewer 40.00 -UGI Utilities 2.52. PPL Electric 26.35 UGI Utilities 15.75 Home Inspection 295.00 Termite Inspection 60.00 Pennsylvania Water Company 15.15 PPL Electric 28.26 TOTAL Schedule E 551,479.35 © M&T Bank 499 Mitchell Road,Millsboro,DE 19966 Adjustment Services Phone 888-502-4349 F a (302)934-2955 February 26,2013 Law Office of Michael Cherewka 624 North Front Street Wormleysburg, PA 17043 Re: Estate of Elwood G. Shiley Social Security: 210-26-9109 Date of Death: September 5,2012 Dear Sir or Madam: Per your inquiry on February 07, 2013, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Account Account Number 9847692655 Ownership(Names oJ) Bobbi Jo dones(POA) Elwood G.Shiley Opening Date 0812812008 Balance on Date of Death $29,909.28 Accruedlmerest $ .12 Total $29,909.40 2. Type of Account Installment Loan Account Number 10000172312430001 Ownership(Names og Elwood G.Shiley Opening Date 0311512004 Balance on Date ofDeath $8313.96**This amount is not to be used for payoff purposes. For a payoff balance,please call 1-800-724-2440 Current Balance $ .00 ** This balance is not a payoff balance V� Depattririent , 7700 S LINCOLN AVE STATEMENT OF MEDICAL CARE COST RECOVERY ACCU77NT ACTIVITY _— LEBANON PA 17042-7597 _ NAME OF FACILITY _ LEBANON VA MEDICAL CENTER (595) FOR QUESTIONS ABOUT YOUR ACCOUNT, PLEASE PHONE THE 1oz 2571553 09 9037912 0975823 BELOW NO. 1-866-408-2657 "�'1'I�I�I�I�I'I'��III'III' '�I�'II'II'�II��II�,��I„IIIIIII�III For written inquiries concerning your account please send them to the MCCR or Revenue Office at the facility address above. ELWOOD G SHILEY 637 BOSLER AVE Payments received after 09/10/2612 will be on LEMOYNE PA- 17043-1817 - your next statement. i To pay your statement online, go to www.pay.gov or call 1-888-827-4817. :lent Name ELWOOD G SHILEY Account No: 595-00000000-94920-SHILE Stmt Date: 09/14/2012 ANSACTION POSTED DESCRIPTION. AMOUNT. :BILLING REFERENCE- -08/22/2012 COPAY RX:2957872D FD:08/21/2012 24.00 595-K208NAO - DRUG:GLIPIZIDE iOMG TAB DAYS:90 QTY: 180 PHY:KARCZEWSKI,MICHELE L CHG:$24.00 ' 08/22/2012 COPAY RX:2319903L FD:08/21/2012 24.00 595-K208NAO DRUG:NITROGLYCERIN 0.2MG/HR PATCH DAYS:90 OTY:90 PHY:KARCZEWSKI,MICHELE L CHG:$24.00 08/23/2012 COPAY RX:3520087 FD:08/22/2012 24.00 595-K208NAO DRUG:FERROUS SULFATE 325MG TAB DAYS:90 OTY: 180 PHY:KARCZEWSKI,MICHELE L CHG:$24.00 08/23/2012 COPAY RX:2937417F FD;08/21/2012 - 24.00 595-K208NAO DRUG:WARFARIN NA (GOLDEN STATE) 3MG TAB DAYS:90 . OTY:90 PHY:KARCZEWSKI,MICHELE L CHG:$24.00 - - �� II2 �� l Account Number Due Date Amount Due 717763-4271 � ]55Y Upon Receipt $32.05 I,. Verizon • k � r Account Information ZO rt'Dhl ;„ statement Date: 1019/12 -t MRS CAROL R SHILEY `� *-gAfpa}[ ccplMLShar{ges '` - Phone: 717-763-4271 . ;riealtsoy'zBane7Fise8idr*8eaau' �C` N' y�g� yy �p Account Summary .'` Yp N y,Y Bread tada�t tf"e tkaper('itet."R" '� 4.4Y7kgn,ppfi�IpyatlnyAd' Previous Balance $35.15 No Payment Received - _$ Balance Forward___.___ ——__— $35.15 r*���•`;.�-s�Ytynapi:I,NBNPS,.rk �� s Don't Move Without Verizon! New Charges _ Call 1-888-416-9691 before you move.We'll help Current Activity -$6.10 set up your Internet,TV and Phone for your new - address,You can be up and running in no time!DON'T Taxes,fees and Other Charges S3-53 WAIT!And be sun;to ask 0 HOS is available in your Other Providers $6.53 area.Service availability varies. ---------- -- - -- —.- Total New Charges 43.10 We Want You to Stay With Us You are a valued customer 8 we want to deliver the Amount Due-Pleasefay NOW $32.0 very best service 8 value to You Callus at Final Bill 1-88B-615-6303 to find out about the new ways Verizon an save you money.We appreciate being Pay your bill online at Verizon.eomlpayfinalbill your provider,and we would like to keep you with us To avoid referral to an outside collection agency,the full amount is due upon longer by improving your Venzon experience. receipt i Get More,Save More Call 1-888-610-7299 to ensure you're getting the - - - best Venzon services at a great value-from phone, - Internet and TV,to money saving bundles,international plans,and fun add-ons,Together we'll find ways to .. save you even more. Questions about your bill or service? Want Automatic Payment? - View your bills in detail at verizon.com or all 1-800-VERIZON(1-800-837-4966), Enroll below or at Verizon.com to authorize your financial Enter your ten digit number 717-763-4271.Use 012 U asked for your customer institution to deduct the amount of your monthly bill from identification code.Customers with disabilities all 1-800-974-6006 TTY. the account associated with your enclosed check and / send payment directly to Verizon.To discontinue Automatic Payment,call Verizon.Please keep a copy of this authorization. Please return remit slip with payment. I Comcaste EDate 09547 179129-01-5 09/07/12 $53.45 10/01/12 . . Page 1 of 2 Contact us: www.comcast.com 717-540-8900 ELWOOD SHILEY � Previous Balance,„ , ,tip ^ a vi. For service at: Paymerrt �08/27h12 k thanlyou sr4 5S`� 637 BOSLER AVE LEMOYNE PA 17043-1817 Trotal�i4nC�Dyew, ,� �� F R r 'l i»r�i.aw ley 4;v L $s'o�'a} V�i" "Yf,N �' News from Comcast ?DA),�� z Thank you for your prompt payment. XFINITY TV For,your convenience, we now accept regular and automatic monthly credit card P Y a ments end direct wTax2sZ�5urcharges 8LFees„ ^,a ; a bark debit. ve . � � a � u o Hearing/Speech Impaired Call 711 01�� 7 Questions?Please Visit us online at Page 1 contact us by Oct 2. pplelectric.com �Pf 1-800-DIAL-PPL ► « • « �ti- {1-800-342-5775) 2066075002 Oct 2,2012 lecv�e unimee M-F:Sam to 5pm ur Electric Usage Profile Billing Summary (Billing details on back) vice to: Balance as of Sep 11, 2012 $0.00 SH I LEY Charges:, BOSLER AVE . Total Washington Gas Energy Services $48.91 9OYNE,PA 17043 Charges ter:74061796 Total PPL Electric Utilities Charges $31.15 r next meter reading is on or about Oct 8, 2012. > Total Charges Charges y $80.06 section helps you understand y our year-to-year s k Stl .. -tric use by month. Meter readings are actual unless erwise noted. Account Balance $80.06 ® 2010 ®2012 PPL Electric Utilities`price to compare for your rate is 7.907 cents per kWh 42 effective 9/1/2012 to 12/31/2012. For a list of supplier offers,visit 35 papowerswitch.com or www.oca,state.pa.us. 28 Your Message Center _ t n « Your electricity includes 5%local wind power.Add t4 more at cleansteps.com. 7 « With paperless billing,you can receive and pay your o PPL Electric Utilities bills online.The process is free, i r M A M A s a H o quick,convenient and secure.To learn more or sign up, visit pplelectric.com. S Months « Information about appliance energy use and tips on saving energy are available through the Energy Library ' IV, "' on our Web site,pplelectric.com. Dishwashers use about 13 gallons of hot water per ap 2012 30 670 22. 73F load.That's less than washing dishes by hand. Always use full loads on the shortest cycle.When washing >p 2011 1 30 659 22 71F dishes by hand,don't let the hot water run — continuously. •• IMES Payment Methods Sep 6 Actual 63365 Online at: By phone:1-800-342-5775 Aug 7 Actual 62695 pplelectric.com or call BillMatrix(service fee applies) at 1-800.672-2413 to pay using Visa, 30 Days kWh Billed 670 MasterCard, Discover or debit card. —_ By Mail: Correspondence should be sent to: =Sep 8735 728 2 North 9 th Street Customer Services CPC-GENN1 827 Hausman Road 8304 692 Allentown, PA 18101-1175 Allentown,PA 18104-9392 Other important information on the back of this hill 4 i Past Bill inforrhation-661 Utility -" Well` The account balance an your last bill was..... $ 14.44 tt „ , :F,,,t�. Thank you for your payment af---- _ .___ 216541473710 ±h Blibngg ,murnary for Service to: i� (N yo balance as of 0813012012__.:............__.._.m._.. ELWOOD SHILEY Current Bill Information-UGI Ut”, 837 BOSLER AVE Customer Cha e.__..__..__..___......_..........._____.._... 8.55 LEMOYNE PA 17043 rB " ((YVIIJJ - Supplier Commodity 6 CCF at$0.65000)_....___... 3.90 Distribution Charges First 6 CCF at$0.3$833)._.. 2:03 Rate Classification: s�� Migration Rider Surcharge........1:.........„._........___... 0.30 - Residential General-CC PA State Tax Surcharge...-......:........._....__...._....__..... -0.04 B€lling Period: Total Current Charges-UGI Ubhty _:.__.......... .._... 0712712012 to 08/2712012(31 days) UGI Utility charges owed this bill _.__..______.----......w-----—----- $14.74 , Remote Device Read Questions? Current 6111 Information-WASHINGTDN GAS Call 800-276-2722 or write to UGI at WASHINGTON GAS gas costs are shown in the PO BOX 13009 supplier charges above. ” Reading,PA 19612-3009 Total Amount Due,Please Pay by Due Date(09120/2012) $14.74 i Your current UGI charges include " State taxes totaling about$0.35. - i Meter Information-Next Read Date September 27,2012 - - Meter Reading Information Meter Number Previous Reading Present Reading CCF Used 1197884 2003(remote) -2009(remote) 6 - General Information •WASHINGTON GAS ENERGY SERVICES,INC. 13865 SUNRISE VALLEY OR SH200 ' HERNDON VA 20171 or phone 703-793-7500 " `Commodity prices and charges are set by the natural gas supplier you have chosen. The Public Utility Commission regulates distribution prices and services. Important Messages from UGI ■Your current price to compare is$0.60244/CCF. e 'Your total annual usage is 85 CCF. Your average monthly usage is 7 CCF. ■Help prevent pipeline damage,accidents and service disruptions.Call 811 before you dig. "Save time.Save the planet Sign up to view and pay your UGI bills online at www.ugi.com. If you pay at a payment agent please take your entire bill. Make clerk payable to DOE Keep th is part for your records. Important Information Is on the back of this bill. j ..................I..............._­............................--------------------_- ..........._----------------................................. ----- Customer Account Information Billing Summary For Service To: Elwood G Shiley -----prior Balance---------- 637 Bosler Ave Prior Water Bala.nce $23.04 Account Number:24-06274-41-1 Prior Wastewater Balance $40.00 premise Number: 24-0*370794 Prior Balance Other $18.49 Payments prior to Sep 11,2012. Thanks/ -81.53 Billing Period& Meter Information Total prior balance,Sep 11,2012 , .00 Billing Date: Sep 1.1, 2012 _—Current Water Ch.arges Billing Period: Aug 08 to Sep 06 (29 days) Servi ce Charge. 13.75 Next reading on/about: Oct 05, 2012 Rate Type: Residential Water Volu me($.009101 x Boo)- 7.28 DS,I-,eAWC Charge 6.0% . 17 Total.mter-charges;Sep'1.1,2012 21.20 Meter readings in current billing period: --Current Waste_water Charges--- Meter Number N084673753 is a 5/8-inch meter.: . Lemoyne swr Svc, 40.00 iJ Present-actual 79700 'Lemoyne Sw($.00OOOOx8Oq) .00 Last-actual 78900 Total wastewater charges Sep 11*,2012 40.00 Gallons used no other Current Charges--. 'Customer Protection In Home 3.99 Customer protection Sewer Line 9.00 Customer Protection WaterLine 5.50 Total other charges,Sep 11,2012,; 18.49 ----AMOUNT DUE- Water Usage'Comparison Monthly usage In hundred gallons. 2 lk 2 S 0 N D_ J F M A M J J A S 2 o e o e a e a p a u U e 0 P t c v c n b r r y n 9 p i 2 Messages to you from Pennsylvania ylvania Am erican Water 'Any po n'o n of the water charges which is not paid as o' wi �subject to 5 0* p e n a lly. 'Approximately 57 r nt'or' 6' o'Star taxes are included in yo r cu n'b' I/active Ju'y 0'2 the O stnb on System Improvement Charge(OSIC)increased Jrom 0.32%to 0 .83%.This C ha g,fund the replacement of water d sobuhon faclities Have you recently changed your primary phone number? fyo u havaple as update your account informal on n onfi n using My H2O On in at wwwamwaler com'm h2o or call us at the nu�bar I w s a tha t we update our records . ' 'ATTENTION LEMOYNE BOROUGH WASTEWATER US Me R S T h Is I 5 y 0 u r fin /bill with both water and sewe charges. F'eed om S y st e ms(for Lemoyne Borough)is now ng yo ur wastewater charges Any money received by Pennsylvania American Water aft the due date shown above will be applied to your water balance. You s h oul d make your wastewater payment directly Boroug h after the due date shown above. P03863MC38M NCEOK2 TAVW 12 Customer Service & Emergencies 1-800-565-7292 (24 Hours) For Hearing Impaired Customers TDD 1-800-300-6202 (24 Hours) Visit us on the INTERNET:ww.w.pennsylvaniaamwater.com PAWI00AMsw AIM 7264 404112: 23 MARY SONAR DO 496 - 00999 -ADMITTED TO HOSPITAL. - `.. .00 . 404112 - 23 .MARY aoNAR Do• 496 .'99284 .EMER DEPT HI SEVERITYBURG 304150:+ !09112: . :. . . - . :;' :. ,:"PY.MT,MEDICARE:ASSIGNED - _. 91.10-.' . %09!12 '. _. . _._ . . .:. ,.::. ...-..WIOFFWEDICARE A$SIGNED ,...... . _ _ •PLACE OF SERVICE 21:INPATIENT M-OWkTIENT 23.EMERGENCY ROOM «.:NOTE,.: Your-insurance has been billed as noted below..Any unpaid balance is due before 01!18%13 ; and is your responsibility. , TMT DATE 030 DAYS 3150 DAYS I -61.90 DAYS JOVER90DAYS PRIMARY INSURANC SECONDARY INSURANCE 11118112 22.78 .o6 .00 ".00 MEDiCARE-ELECTRONIC ' PATIENTS NAME LOCATION OF SERVICE ACCOUNT NUMBER NOOD G SHILEY HARRISBURG HOSPITAL PHI 1082100 - ' $22.78 JtSE VISIT US AT:mvw.MyMedAccountcom , STOMER SERVICE PHONE:1 (877)846-7929 - PERSONAL BALANCE: $22.78 STOMER SERVICE HOURS:8:00.6:00 Mon-Fri Eastern INSURANCE BALANCE: $.00 �ASE-eAYYOUR.P_ERSONAL BALANCE._—. ,�.,.,._r_ WORKERS COMP.BALANCE: $.00 PINNACLE HEALTH EMERGENCY DEPARTMENT SERVICES,LLC PO BOX 650055168 '.:-ppl- II.IImm:II II.IIIIIIII .IIIII�IIII . PHILADELPHIA,PA 19176-5168 ��IIE�IIIIII�I ��� fE(��II( ll �I� STATEMENT SEE REVERSE SIDE FOR IMPORTANT BILLING INFORMATION Page 1 of 1 94390.45 elease Rem[t.PaYmen't-So .- - •. _ . _ Eesfi4Pennslioro Ambulance<'Service..lnc . BI!llrag 01fice 12-191744 317/2013 $1,028.80 PO Box 726 New Cumberland PA 17070-0726 I QUESTIONS ABOUT THIS BILL? Phone: 877-214-6018 Espanol: 866-724-4114 .Fax: 717-214-6020 Email:info @ambulancebillingoffice-com 7 Date of Service: 91412012 23:04 Please visit our website to provide insurance or make•payment, and 1 Patient Name: SHILEY, ELWOOD for additional payment options and frequently asked questions: From: RESIDENCE www.ambutancebillingoffice.com To: PinnacleHealth Hospitals account is Past Due *-*#***'I bur account remains unpaid.despzte our previous b+flii:gr errs Tour } account rs now under collection review and may be forwarded to our cottectron agency cf this bttt remains unresolved [r 9104112 Bariatric BLS Emergency Trans A0429 1.0 1,000.00 1,000.00 ,. 9104112 Mileage A0425 3.2 9.00 28.80 Total 1,028,80 0.00 0.00 6. if i DETACH AND RETURN BOTTOM PORTION WITH YOUR PAYMENT, - ljf iI I l r g Past Hill Information-UGI Utility The account balance on your last bill was $ 14.74 UIWIA411rr C Thank you for your payment of.._ 14.74 Your balance as of 10/0112012_ .._.___. 0.00 216541473710 Billing Summary for Service to: _ ELWOOD SHIL€Y Current Bill Information-UGI Utility - 637BOSLERAVE Customer Charge..............................__--------------_-_. B.55 LEMOYNEPA 17043 - Supplier Commodity 6 CCF at$0.65000)...._......... 3.90 � Oistributien Charges SFirst 6 CCF at$0.33833)...... 2.03 - Rate Classification: Migration Rider Surcharge-- 0.30 _ Residential General-CC PA State Tax Surcharge.....___......................_.............. .0.04 Billing Period: - - Total Current Charges-UGI Ubirty_._.__....__............. 08/27/2012 to 09/26/2012(30 days) UGI Utility charges owed this bill .........................__........__...........__...._.._..___ $1.4.74 Remote Device Read - - - - - Questions? Current Bill Information-WASHINGTON GAS _ - Call BOO-276-2722 or write to UGI at WASHINGTON GAS gas costs are shown in the - PO BOX 13009 - supplier charge Reading,PA 19612-3009 Total Amount Due,Please Pay by Due Date(10/22/2012).7-7-7-7....... $14.74 'Your current UGI charges include Stale taxes totaling about$O.M. Meter Information-.Next Read Date October 26,2012 - - - Meter Reading Information - - Meter Number - Previous Reading- - - Present Reading CCF Used - 1197884. 2009(remote) 2015(remote)-- - .6 General Information •WASHINGTON GAS ENERGY SERVICES,INC. 13865 SUNRISE VALLEY OR STE200 HERNOON VA 20171 or Phone 703-7934500 •Commodity prices and charges are set by the natural gas supplieryou have chosen. The Public Utility Commission regulates distribution prices and services. SI Important Messages from UGI el •Your current price to compare is$0.60244/CCF. •Your tidal annual usage is B3 CCF. Your average monthly usage is 6 CCF. •Help prevent pipeline damage,accidents and service disruptions.Call 811 before you dig. •Save time.Save the planet Sign up to view and pay your UGI bills online at www.ugi.cem. _ If you pay at a payment agent please take your entire bill. Make check payable to UGI. j Keep this part for.your records. Important information is on the back of this bill. Questions?Please Visit us online at Pagel PIP contact us by Nov 2. a pplelectric.com 0 • . PIP 1-800-DIAL-PPL . • - , • - (1-800-342-5775) 20660 75001 Nov 2;2012 .• , �uuunes M-P: 8am to Sam i i ur Electric Usage Profile Billing Summary (Billing details on back) j i rice.to: Balance as of Oct 12,2012 SHILEY Charges: BOSLER AVE Total Washington Gas Energy Services $15.69 IOYNE, PA 17043 Charges ':er: 74061796 Total PPL Electric Utilities Charges $15.91_ r next meter reading is on or about Nov 6,2012. . , Total Charges $31 60 section helps you understand your year-to-year m — x tric use month. Meter readings are actual unless n? �rwlse noted. Account Balance $31.60 U2011 ®aofz PPL Electric Utilities'price to compare for your rate is 7.907 cents per kWh '42 effective 9/1/2012 to 11/30/2012. For a list of supplier offers,visit 35 — papowerswitch.com or www.oca.state.pa.us. - za Your Message Center - 21 + Your electricity includes 5%local wind power.Add 14 more at cleansteps.com: - 7 + With paperless billing,you can receive and pay your r a PPL Electric Utilities bills online.The process is free, - q s a lv o quick, convenient and secure. To learn more or sign up, z J F M a M i visit pplelectric.com. 8 Months . Information about appliance energy use and tips on saving energy are available through the Energy Library • • on our Web site, pplelectric.com. 3 •• '• • Keep light bulbs and fixtures clean. Dust and dirt absorb � t 2012 2 215 7- g3 light and can reduce fight output by as much as half. + Save postage and late charges-sign up for Automated t 2011 30 598 20 63F Bill Payment. —' Payment Methods Oct 8 Actual 63580 Online at: By phone:1-80D-342-5775 Sep 6 Actual 63365 pplelectric.com or call BIIIMatrix(service fee applies) at 1-800.672-2413 to pay using Visa, 32 Days kWh Billed 215 MasterCard, Discover,or debit card. —_ By Mail: Correspondence should be sent to: 2011-Oct 2012 8352 696 2 North 9th Street Customer Services =� CPC-GENNS 827 Hausman Road 12010-Oct 2011 8351 696 Allentown,PA 18101-1175 Allentown,PA 18104-9392 Other important information on the back of this bill 4 i _..._ ----------.....-------......-------------.._...--------.-._._... Customer Account Information Billing Summary . For Service To: Elwood G Shiley -----Prior Balance=- 637 Bosler Ave Prior'Water Balance $21.20 Account Number:24-0627441-1 Prior Wastewater Balance '. $40.00 Premise Number: 24-0370794 Prior Balance Other $18.49 Payments prior to Oct 10, 2012. Thankst -79.69 - Billing Period& Meter Information Total prior balance Oct 10,2012 .00 Billing,Date: Oct 10,2012 Current Water Charges=---- Billing Period: Sep 06 to Oct 05 (29 days} Sam' a ce Charge, „ 13.75 . Next reading on/about: Nov 05,2012 DSI-PA WC Charge 2.05% .28 Rate Type:. Residential_ . _ Total water charges,Oct 110,20,12 ,-, 14.03 . --Other.Current Charges= 1 -- Meter readings in current billing"period:. Customer Protection In Home - 3.99 Meter Number N084673753 is a 5/8-inch meter: Customer Protection Sewer Line- 9.00 Present-actual 79700 Customer Protection Water Line• 5.50 Last-actual 79700 Total other charges,Oct 10,2012 - 18.49 Gallons used 0 6/ n ---AMOUNT DUE— $32.52 Water usage Comparison. 1 Monthly usage in hundred gallons, _ 7I p C o a e e a A a u u u a C 20 r y n 1 ,g P t 2 Messages to you from Pennsylvania American Water 'Any portion of the water charges which is not paid as of 11105512 will be subject to a 1.50%penalty. Approximately 4.57 percent, or$.64, of State taxes are included in your current bill. 'Effective October 1, 2012, the Distribution S stem Improvement Charge(DSIC)increased from 0.83%to 2.05%. This charge funds the replacement of water o stribution facilities. `Have you recentlyy changed your primary phone number?If you have,please update your account information onion using My H2O Online at www.amwateccomlm h2o or call us at the number below so that we can update our records. 'ATTENTION LEMOYNE BOROUGH WASTEWATER CUSTOMERS: The adjustment above reflects past due wastewater charges that have been reported to Lemoyne Borough. To pay this delinquent amount, please contact Lemoyne Borough at 717-737-6843. . .. 002UMX2640 NCE2NL TAV0612 Customer Service& Emergencies 1-800-565-7292 (24 Hours) For Nearing impaired'Customers TDD 1-800-300-6202(24 Hours) Visit us on-the INTERNET:www.pennsylvaniaamwater.com. RAW10mmen _ ; AW 7365 Page 1 oft -PENRAC,LLC,46003ONESTO"RD,HARRIBBUR6,PA 171056214(717)671-5617 - - RENTAL AGREEMENT REFV SUMMARY OF CHARGES - . . 1672 3ZR14TV - ` Char9a DasatpNon Date Quantity P" Rate Total RENTER .EXCESS DISTANCE CHARGE II/10-11111 54 DISTANCE $0.49 $26.46 FOSTER,CINDY LOU TIME 6 DISTANCE 11/10-11/11 1 DAY $59.00 $59.00 DATE&TIltE OUT DW 11/10-11 111 1 DAY $28.99 $28.99 - 11./1012012 09:03 AM POOWLING CHARGE 11110-11/11 . 5 GALLON ., $6.38' $31.90 DATE R TIME IN Subtotal' $146.35 11/11/2012 07:00 AM Tax"&Sustiat9es - - PENNSYLVANIA STATE 1_1/10 Wil 6% $6. 7 BUILU40 CYCLE SALES TAX M 24-HOUR PUBLIC TRANSPORTATION 11/10-11/11 1 DAY $2.00 $2.00 ASSISTANCE VEN#12012 NITS FE2$16BX VEHICLE RENTAL TAX - 11/10-11!11 2% $2.29. VIN#JL65NGlAOCK004253 YOU)Chargm $157.51 LIC*ZCM6608 'am-To/-Deposits MILES DRIVEN 54 DEPOSITS ($157.51) Total Amount Due ".Do PAYMENT INFORMATION AMOUNT PAID TYPE CREDIT CARD NUMBER $157.51 V'sa x7532 ' i i 1 11112/2012 AN Questions?Please Visit us online at Page 1 O contact us by Dec 3. U pplelectric.com P1 1-80D-DIAL-PPL �i' (1-800-342-5775) 20660-75001 Dec 3,2012 $2 77 t N�utnmas M-F:Sam to Spm ur Electric Usage Profile Billing Summary, (Billing details on back) vice to: Balance as of Nov 12,2012 $0.00 SHILEY Charges: BOSLER AVE Total Washington Gas Energy Services $9.64 IOYNE, PA 17043 Charges ter: 74061796 Total PPL Electric Utilities Charges $13.13 r next meter reading is on or about Dec 6, 2012. Total Charges $22.77 i section helps you understand your year-to-year $22:7T tric use by month. Meter readings are actual unless ml�aptDUR Dee.3,?012 arwise noted. Account Balance $22.77 112011 ®2012 PPL Electric Utilities' price to compare for your rate is 7.907 cents per kWh 42 effective 9/1/2012 to 11/30/2012. For a list of supplier offers,visit 35 papowerswitch.com or www.oca.state.pa.us. 28 Your Message Center - u • Your electricity includes 5%wind power sourced from 14 Pennsylvania wind farms. • With paperless billing,you can receive and pay your PPL Electric Utilities bills online.The process is free, D quick,convenient and secure.To learn more or sign up, g J_ F _M A M J, J A S 0 N D visit ppielectric.com. Months . Information about appliance energy use and tips on saving energy are available through the Energy Library on our Web site, pplelectric.com. • ' • Heating your home is the biggest part of your winter )v 2012 29 132 5 51F. energy needs. Check your heating system filter(s) monthly. Clean or change filters as needed.You can )v 2011 31 623 20 S1F save money since your system will use less energy. _ M Nffi8=a -• Payment Methods Nov. 6 Actual 63712 Online at: ©By phone:1-800-342-5775 —' J pplelectric.com or call BIIIMatrix(service fee applies) Oct 8 Actual 63550 at 1-80D-672-2413 to pay using Visa, c 29 Days kWh Billed 132 MasterCard, Discover or debit card. .. _ " ® By Mail: Correspondence should be sent to: c 2011-Nov 2012 7861 655 2 North 9th Street Customer Services CPC-GENN1 827 Hausman Road — 2010- Nov 2011 8389 699 Allentown, PA 18101-1175 Allentown, PA 181049392 Other important information on the back of this bill 4 I r Past Bill Information-UGI Utility�! The account balance on your last bill was .._ $ 14.74 P216541473710M; - T UJIM BA, ,,,rreE Thankyeuforyourpaymentof _._. .... -14.74 Billing Summary for Service to: , Your balance as of 10/3012012.............._........__........ 0.00 , ELWOOD SHILEY- - Current Bill Information-UGI Utility - - 637 BOSLER AVE - - LEMOYNE PA 17043 Customer Charge...._............._..........................._...... 8.55 Supplier Commodity(6 CCF at$0.65000) ........ 3.90 Distdbution Charges First 6 CCF at$0.33833)...... 2.03 Rate Classification: Migration Rider Surcharge......................._....._.......... 0.30- Residential General-CC -PA State Tax Surcharge._........................................ -0.04 - - Billing Period: Total Current Charges-UGI Utility.._::...._.._........:.... 14.74 09126/2012 to 10/25/2012(29 days) UGI Utility charges owed this bill _............................................................. $14.74 Remote Device Read - - - - - Questions? Current Bill Information-WASHINGTON GAS - Call 800-276-2722 or write to UGI at WASHINGTON GAS gas costs are shown in the - PO BOX 13009 supplier charges above. Reading.PA 19612-3009 Total Amount Due,Please Pay by Due Date(11/20/2(112)............. ..............._... �$14.74 Your current UGI charges include State taxes totaling about$0.35. - - - - Meter Information-Next Read Date November 28,2072 - - Meter Reading Information - Meter Number "Previous Reading Present Reading - CCF Used. 1197884 - 2015(remote) 2021.(mmote) 6 - General Information 'WASHINGTON GAS ENERGY SERVICES,INC. 13865 SUNRISE VALLEY OR STE200 - HERNDON VA 20171 or Phone 703-793-7500 - - - 'Commodity prices and charges are set by the natural gas supplier you have chosen. The Public Utility Commission regulates distribution prices and services. _ Important Messages from UGI - ' Your current price to compare is$0.60244/CCF. - e 'Your total annual usage is 80 CCF. Your average monthly usage is 6 CCF. 'Help prevent pipeline damage,accidents and service disruptions.Call 811 before you dig. 'Save time.Save the planet Sign up to view and pay your UGI bills online at www.ugi.com. If you pay at a payment agent please take your entire bill. Make check payable to UGI. Keep this part for your records. Important in formation is on the back of this bill. i ........................ ---------------------- ------ .......... .......----------- IL Customer Account Information Billing ', For Service To: ELWOOD G SHILEY, -----Pr 0 r Balance 637 Rosier Ave, Prior Water �c Baia`l in Account Number:24-0627441-1 Prior Balance Other"I $18.4:9 Premise Number:.24-0370794 P -32.52 4� ayments pear to Nov 08,20 T061 prior balan6i,`Nov 0-81 .00 Billing Period& Meter Information —==Cu;irelint Waiie Chirg­es—';' Billing Date: Nov 08,2012 Service Charge,c...: 13.75 Billing Period: Oct 05 to Nov 05(31 days) PAWC Charge .28 Next reading on/about: Dec 05,2012 Total w'a-1e-'r"c'ha­rges, Nov 08,'2012: tee, —14.03 Rate Type: Residential --Other Current 666es Customer Protection In Home �4-. ~ 3.99 Meter readings In current billing period: Custo er Protection ,;a war Line 9.00 Meter Number N084673753 is a 5/8-inch meter. Customer Protection Water line 5.50 r�l Sr ;Prese;t-actual 79700 Total other charges Nov , 08,2012 r , I �,� �- -,-- "-- � �- . .-� Last-actual Gallons used 0 AMOUNT \N\J zf. A Water Usage Comparison Monthly usage in hi5ndrad gallons'^ tIIk - ;f"A st.+y< k 4X-4-� 1 `4 .'X., I I IN J 2 N 0 - F M A J J A .-$' 0 0 e a ..M:, - e a p a I V U O�.C:.,. I V C n b r y 1 •9 P, I v I :g zqw,34K�� 3= i*'U"T Messages to you from Pennsylvania American Water 'Any portion of the water charges which is not paid as of 12103112 will be subject to a 1.50%penalty.•Approximately 4.57 percent,or$.64,of State taxes are included in your current bill. 'Efective October 1,2012, the Distribution stem Improvement Charge(DSIC)increased from 0.8351.02,05%. This charge funds the replacement of water S distribution facilities. Have you recently changed your primary phone number?If you have,please update your account information online using My H2O Online e at wwwamwater.convinyh2o or call us at the number below so that we can update our records. Y. 0 01274=1274NC Customer Service & Emergencie's 1-800-565-7292 (24 H06is) For Hearing Impaired Customers TDD 1-800-300-6202 (24 Hours) IZ Visit us on the INTERNET:www,pennsytvaniaarhwater.com, RAW100AM8661 0 a". I Al. r.. 1 LEMOYNE'BOROUGH SEWER ACCOUNT SUMMARY Name: SHILEY, ELWOOD'G Invoice Date: 1012512.012 Account Number . 240370794 InvolGe Number 39424 f . Yji } I t. J 'f_ ri zi f� t tY �7 t;' n Service Lacaflari ,� 637 Bader Ave- `1 r. „, ' 4 ` a£ y ,r't PaymenE Due Date 1111512012s Q. tF'tM 17 r�.lj}. yPREV10USY.uOtt USE RATEtGODE� '•" ' }'-rr.�"�y�34��$�iT<Y'SY Icrf`h'"' 6'" � f.= y, .�y t �y , P 'i ''r BILLING'SUMMARY twm ffr RLA' NG�.!a° DATE v REAU1NG?i"i? irr'r.�y.>;; .nFr3'�.£� C• ' 7 s "l SPJ ?S6 t �SEWM '+' ;.'^�,.79'700r 9/6%20 2 79 700 'Ort` 'SN1R1 + y;=Fnor Wastewater Bala cer "0 Opp E v `!i 4V'0/5/201 v w I r r, ru£'T>^ e , „is r5 ✓''J"'r�s i- �:. q'm'«- "s <",� ' li ri fp^r` rgg�" `t 'W a' 'r rs��,.'+f{Y'Pfd'�+titentS''" Srf{,m i.k+�.t.k. t''t G+' .cr "s4+fl � p!• ` Yi.. y Yf tfr 4 -p r+i �'£ tz`rls '!6 C ,. i+ e t yh i tau x M r Nx } yt'7 t Y a I. ?3 e h t'j�+ ''t+.t`t c" „�3° rr ,%i ze y {,� r} !t5 ,nrr {I 4,4.Ad ustments/CrediWtQ�? 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M' YssxtG- r<.fts'�41 el { I i l.:4.C.�.C'..-.e�.:F 9 4 i {{4 l':s 26,'n,,`.'nts*.•+am.,.'``t••y,•;v",i=..'—ac's "•'3"-,FT«.If.M-.yx^,ri.'. z Fi$ «{?p??i""'i u'-ai:` '?� rS x,"S`-`'.:`•_ep�'`D E• iFrsCz��,Nx V{0'tmkle ny11,�J'^�`�2wtZt',�'i;'}'." . r A r Pyieasetkeepthls.porttOnTOr your reGOrds x., PAY*AFTER DUE�DATEr^ �IL ¢42.00 fep'�['�r { fertC+-1N)F. r,+vCai:.rH r f.. l:nnJ W m nJ mp 1 rfrr^e' Yh_•.k. 1 .t u� r t )lW }J J.. ,zSat4n�+Sii' 'Kf Vf. t""'{V6'`, ;F'r'?W`1!'.nt_00'i^<5'1Dd.,.'�>t 15 A-4�s.+Ela�,..J'.. ..j'+n,if^'�nx"r'�. 't4lnzu'"`t'#-=� .tu=_�.SSr�rr - it 4tt+i"k �Sa!"xFk-73't cy,•^tiu..'?.ty ry.y b`H'y.n' i t' xLy F l,rf{ `U4+f:--5 M1r^n - I4k,Y £.^'1Xt1'a- ,ib3 'TF,l.+flii'tti T.,+t Z•>"1 !rE t M fiTiFN a ^2 44 "`f m ry p R:a-t #'�'., iJi of r4q ,44 , 'A ' ... %v'{'� r '�'�;NOTESrAND-OTHEf2t'IMPORTANT,'If�VF.ORIIIIATION,ABOUT4�YOUR ACCOII�NT -' .f '�„�r^_� ,ibilEge dra idiom ,t f"T -W;,bi i g!'SyS Mr: fr ,ru¢ ,Aif '% 'rntc.:ater ,+;u u,.rL 'z't-�stt�.�'s..'•. r'- 1` 7'Y This is your first{till gener�axtedtbykour new btNingysys iem-Lor+sewer and asfewater*tre5tme 4t sdfV es ;,The Borough s ohargesn oty p r ; #}ya these services w111Eno longerAapPear i the g1IRhatlyou get trom Pennsylvama ArnencamW atbrf Companyi4(�P�AW C) Theme Borough +`�tias now confrac'ted wdti�FREEDOM SYSTEMS''zCORP to';pe%iooimzih�"sevw'e{and}awastew�ater�treatrrienfwb'ill�nga�ngd;�{CV_ "•Cs,'. 1, 5'efVrvCB 4Ft 'a." '+ +�" ''9p� SFx � � �f Trv,��� �„� Sa'.J er .r fta 441 is tai F��.T{„ }, ,� i5�'��? + 1' �7h� 1�a-Mi�r{�kA'4.1,=;• I y�f PAYMENTiOPTION$ ?`r '^7� -t�}z<•'x„'"<r>:;j,,»yi 3f.4.z�r� � At�;ly+ ..r'�`�.7m� y,'^"�t, � rr^- -N:e y y u. , ? BY MAiC Pieria note payments MUST BESMAIL-ED to Freedom Systems Corp POC Boz 440 t7ak`s PA 19d56 0440 A retu n y envelopetls enc�osed.for your cgnveCnence Be sure to;lnclude your payment stub) ..,, i.r• 1. t>it to Lr, °'yY`«` _ ' k t ''-yp }eY.ar Ya t.t. k. ,; M. IN PERSON: Walk-In'payments;w ll'beaccepted at Borough Hall however you are'encouraged to mall payments using the enclosed envelope for the quickest posting of the payment to'your account:. ELECTRONICALLY: If you have submitted a completed-Authorization Agreement for Automatic Eiectronia Payment for your account,then no payment is necessary. Payment will be deducted from your bank account ten days after the bill date listed above'.' Included on this bill may be a 'Prior Wastewater Balance'that came from information provided by PAW C. This Balance may not raf}ect payments that you may have sent to them in the last two weeks. 58434f you have any questions about your account as well as to report aiSchanges to f i . Past Bill information-U61 Utility , The account balance an your last bill was $14.74 ,rs rterraE Thank you for your payment of -14:74� - Your balance as of 11/30/2012......._....... _..„.. X10 216541473710 BRUe Summary for Service to: - ( $0.66000) - - - i IL 37V 4 - Di Current Supplier hangs(F6 CrF at 0 3833).._..... 2.03 S37V BOSLER AVE LEMOYNE PA 17043 � Rate Classification: Migration Rider Surcharge____— 0.30 Residential General-CC PA State Tax Surcharge._,...:.o__„_.__........„.._...._...._ A.05 ! Billing Period: Total Current Charges-UGI UUIitY...,_.:_.._..__„....__.. 14.73 - 'j 14.73 � 10/25/2012 to 11/28/2012(34 days) UGI Utility charges owed this bill ..............._....L _ ......... _..... .: .... ___......„._._..__ Remote Device Read Donations? Current Bill Information-WASHINGTON GAS _ s Call BOO-276-2722 or write to UGI at WASHINGTON GAS gas costs are shown in the PO BOX 13009 - supplier charges above. ' Reading,PA 19612-3009 Total Amount Doe,Please Pay by Due Date(f 2/211 2012).._.......... $14.73 'Your current UGI chargoaincluda - - - State taxes totaling about$0.35. ` I Meter Information-Next Read Date December 28,2012 Meter Reading information - Meter Number Previous Reading - Present Reading CCP Used 1197884 - - . 2021 (remote) 2027(remote) - 6' - General Information - - - 'WASHINGTON GAS ENERGY SERVICES,INC. - - - - 13865 SUNRISE VALLEY OR M200 - - HERNOON VA 20171 orphans 703-793-7500 'Commodity prices and charges are set by the natural gas supplier you have chosen. The Public Utility Commission regulates distribution prices and services. - =” Important Messages from UGI $I 'Your current price to compare is$0.60244/CCF. 'Your total annual usage is 77 CCF. Your average monthly usage is 6 CCF. 'Help prevent pipeline damage,accidents and service disruptions.Call 811 before-you dig, 'Save Limo.Save the phinat Sign up to view and pay your UGI bills online at www.ugi.cam. .� If you pay at a payment agent please take your entire bill. Make check payable to UGI. Keep this part for your records. Important information is on the bprk of fhre SIP- I. LEMOYNE BOROUGH SEWER ACCOUNT SUMMARY . _ Name: SHILEY, ELWOOD G Invoice Date: 11/26/2012 Account Number: 240370794 Invoice Number. 43156 Service Location: 637 Bosler Ave,r„ c Payment Due Date: 12/16/2012 SERVICE. CURRENT + '`w SPREVIOUS - USE RATE CODE BIL LING SUMMARY EADING DATE . -RE READING „• " -' " r z t _ _ l tfS.., .t:}5 SEWIM 11/612012- A.79 700 ;,,141512012 =79 700 0 „ SMR1 Prior Wastawater Balance .i Pavments,r" S3;•,`� ,�F. SS _ 40.Q0t" AdiuStmentsfCredits. fi - Q.QQ. + .l.y _F` :• } Penalty :... l y �i • O.QQi ,i ' ti f+"3• �" • n�°S,t a. {.,r,r,S Mn R i RateC 4 dte, C R ei ; • , Current;C,•a h rgte.i s y �� tirt,•i Y�, �OJB Q •Y ;tsfdenbat-. di �ti11 J7tjj G y SMCR Rafe Code Si .:•r .. _ :;�c= ,ac.... uwim_-.nom. w„sra;;s!R7i........+a. _.,1.4 ...1.,... ._a'fS..:.... ...a.�.L-+..-�-11.++fl1:'vF'.t.:�a.t ate, r!•- r PAY BY DUEDATEn � zf '$4QQQ a uT:l •�'�•� �� u iH^ n r sU f .�i ip fi f f Z i'4r i x �, 7 x.. .ifs A j —.*tt•--,y..+t,'..,.-.a B ." ..Q'j�4-+. -ww-1':''x4 fh ._ .=n it. : •�_r r _ -DUE DATE: December i6 2012 OR * t r<=rsYzstl Np� aSe keep h�5 ortion for y4Ur.r eCOrds r _;PAY AFTER DUE DATE :$4200 >-zirx. *a,raOM e.'MSei'_afI'Ibrr3.�'^s;�yiwrmx..uiar"'+aF- '"V r<wu�,,.. .o �:a:.. 'y --T�r r. -w t ..z• ... - ., - r. - fi OTHER I ORTANT INFORMATION ABOUT-YOUR ACCOUNT',, t W s for,(, °. ;This bill.is being generated by our,new billing system for sewer and wastewater treatment services. The Borough's charges fork r,_- these`services vnll`no`tonger appeaao`p the bill thatyou get from Ponnsylvania.American Water Company(PAWL). The Borough has now contacted with FREEDOM SYSTEMS CORP to perform the sewer and wastewater treatment billing and collection PAYMENT OPT.tONS:". BY MAIL: Please note that payments MUST BE MAILED to Freedom Systems Corp., PO Box 440,Oaks PA 19456 0440.A return envelope is enclose!!for your convemence. Be.sure to include your payment stub! IN PERSON:Walk-in payments w t!be accepted at Borough Hall however you are encouraged to mail payments using the enclosed envelope for the quickest posting of the payment to your account. ELECTRONICALLY: If you have submitted a completed'Authorization Agreement for Automatic Electronic Payment for your account,then no payment is necessary. Payment will be deducted from your bank account ten days after the bill date listed above. Please contact Lemoyne Borough at 717-737-6843 if you have any questions about your account as well as to report all changes to name,address and account status. INVOICE w tt � Invoice Number: 0002274983 - /=\ Penn Waste,Inc. ( �`} Page Number i of 1 PO Box 3066 t Date: 12/28/2012 • York,PA 17402 / Account Number: RS736760 v w .penmvaste-corn Site Number: 0000 Phone(717)767-0456 Reference: L TollFree 1-(866)575-8720 ` V Fax(717)767.4285 Invoice Total: $43.50 fii�Milli= - Total Due: $43.50 ' - • •• 1 • • • hffpa/pen...te.billtrustcom, + + PPK DPP MPT 529 1 Ay 0.350 ED012X 10012 DWS8206M P1292834 0001:0001 � - (li(�Illdr��f(�)tlliO't'(III°II{�N°II"1'i�ll)I�II)It{t�lt�l� Online Billing NowAvallablei ELWOODSHILEY - ��/ Receive your invoices faster 637 BOSLER AVE �� and help save the environment by enrolling in our free online service, LEMOYNE PA 174431817 . . See enrollment details abovel Code Description Date Reference Quantity Amount (oe91) - ELWOOD SHILEY - 637 BOSLER AVE LEMOYNE,PA 01 Curbside Trash&Rao 12/28/12 1,00 41.25 32.00GA 0110112013-03/3112013 01 Municipal Administrative Fee 12/28/12 1.Otl 2.25 0110112013-0313112013 i i Please visit our wabslfe of www.pennvrasfe.com - Current 30-60 Days fit-90 Days Oyu 9a Days for holiday schedules and collection information. $4350 $0.00 $OAO $0.00 PLEASE DETAM AND RETURN BOTTOM PORTION WITH PAYMENT INVOICE Invoice Number: 0002158900 Penn Waste, Inc. I/ Page Number: 1 of ® PO Box 3066 VI( ( - Date: RS73 08/31/2012 760 York,PA 17402 - J _ Customer Number. RS736760 www.ponnwaste.com i - Site Number: .I 0000 Phone(717)767.4456 - Reference: TollFree 1-(866)575-8720 v Fax(717)767-4285 - Invoice Total: $45.00 Total Due: $45.00 VIEW OR PAY TO • http://ponnwaste,bilitmst.com 12119 2 AV 0.350 EM96X 10098 0539537502 P7167028 0001:0007 N723 PPK DPP MPT r r l l l r l l l l l l t l(r r(r t I I I I I(t i)(I l t l l l r l t t l()I I I)(1 1 1 1 1)fill[ Online Billing Now Available) ELWOOD SHILEY �_/ - Receive your invoices faster 637 BOSLER AVE and help save the environment by LEMOYNE PA 17043-1817 enrolling in our free online service. See enrollment details aboveI Cade Description Date Reference quantity Amount (0001) ELWOOD SHILEY . 637 BOSLER AVE LEMOYNE,PA 01 Curbside Trash&Rec 32.00GA 08/31/12 1.00 45.00 10/01/2012-12/31/2012 Please visit our website at www.pennwaste.com - Current 30-60 Days 61-90 Days Over 90 Days for holiday schedules and collection information. $45.00 $0.00 $0.00 $0.00 PLEASE DETAOH AND RETURN BOTTOM.PORTION RIM PAYMENT FAITH A NICOLA,TAX COLLECTOR TAXPAYER'S COPY 510 HERMAN AVENUE,SUITE 4 LEMOYNE,PA 17043. KEEP THIS PORTION FOR YOUR RECORD - L TEMP -RETURN SERVICE REQUESTED IiIId�I;ulhlhhrvPn llll��hl�hhhulNmlhl��h�l��lh 041807*`"'°" —AUTO"5-DIGIT 17043 - SHILEY,ELWOODG&CAROLR 1110,11911 i111111Hill11 1 11111111111111 637 BOSLER AVE LEMOYNE PA 17043.1817 To review the assessment data for this property, go to: wvtw.c o u rth o u s e o n l i n e..c o m>A s s e s sm e n t Offi c e>C u m b e rl a n d>P ro pe rty R e c o rd s. TL,n e;a-r cc7r, ;* 12336976- and password_ CUASEICC ..............._.................._............._....._...._......._._..._..............................__..........................._........_...._..............._........................_....................................... /( Payable To: FAITH A NICOLA,TAX COLLECTOR Office Hours: TUBS 9AM-IIAM&WED IPM-3PM 413-31�j[,5 510 HERMAN AVENUE,SUITE 4 CLOSED ALL HOLIDAYS,MAY 28-29, LEMOYNE,PA 17043 - SEPT 17-18,DEC 17ZI Bill No 1408 PHONE(717)761-7785 Bill Date: 311113 Controt No: 12000975 MAP NO: 12-21.0267-382. r^ Desc: fi37 HOSLER AVENUE - Assessed Value: Land:22,100 Improvement: 100 000 Total: 122,100 LAND Discount Face ena y Acres 0.06 Deed 0021P00417 Count�RE - 2.131 $255_00 $260.20 $286 County Lib 0.143 $17.11 $17.46 $19.21' IMM fflAL Muni c.R/E 2.3 $275.21 $280.83 $308.9 1 CEIPTS Tax payyer. : - SHILEY,ELWOOD G&CAROL R TAX AMOUNT DUE $547.32 $558.49 $614.34 637 BOSLER AVE LEMOYNE PA 17043-1817 If Date Of Pavrreni is on 3;1113 thru 4130113 511113 thru 6!30113 711113 or La er CAPITOL CM OIL,. 3639, P.O. BOX 157 - - CAMP HILL; PENNSYLVANIA 17001 - . 1 - (717) 737-4188 - DATE A .:RECEIVED FROM DOLLARS 1 Lu FOR AMOUNT OF ACCOUNT SH THIS PAYMENT CHECK BY.. BALANCE DUE ❑ M.O. Thank You! 1 I I I INVOICE w Invoice Number: 00023187533 /=\ `Penn Waste, Inc. . Page Number: 1 of 1 PO Box 3066 Date: _ 02128/2013 York, PA 17402 Account Number: RS736760 www.pennwaste.com Site Number: _ 0000 Phone(717)767.4456 Reference: TollFree 1 {866)575-8720 s Fax(717)7674285 Invoice Total: $43.50 i= Total Due: $43.50 • trttpJfpennwasis.biiltrus�iram '• • PPK DPP'MPT J} 5177 1 AV 0.360 E8089X 10206 0630210148 P1361027 0001:0003 - II'1iI]1�( ` OI)]11'1'lEl)(1i1�'Ptltl�'116)uludi(1(Iulli(i Online Billing NowAvaitabtel ELWOOD SHILEY I �I/ Receive your invoices faster - 637 BOSLER AVE and help save the environment by LEMOYNE PA 17043-1817 enrolling in our free online service. See enrollment details above! � I Code Description - Date Reference Quantity Amount 1 (0001) _ ELWOOD SHILEY 637 BOSLER AVE LEMOYNE,PA 01 Curbside Trash 8 Rec 02128/13 1 Co 41.25 32.00GA 04/01/2013-06/30/2013 01 Municipal,Administrative Fee 02128113 1.00{ 2.25 04101/20,13-06130/2013 E -7 Please visit our website at www.pennwaste.com Current 30-60 Days 61 -90 Days Over 90 Days for holiday schedules and collection information. - 1 $43.50 $0.00 $0.0� PLEASE DETACH AND RETURN BOTTOM PORTION WITH PAYMENT --------------..------------------------------------------------------------------------------------------------.----------------_----------------------------------------------------------------------- -----------'._---------- .....---------ry.... :.... ........ ......._ . Customer Account Information Billin Summa For Service To: ELWOOD G SHILEY -----prior Balance- 637 Bosler Ave Prior Water Balance $14:03 Account Number:24-0627441-1 Prior Balance Other $18.49 Premise Number: 24-0370794 Payments prior to Dec 10,2012. Thanlcsl ' -32.52 Total prior balance, Dec 10,2012 .00 Billing Period& Meter Information —I -=Current water charges=-- Billing Date: Dec 10,2012 Service-Charge 13.75 Billing Period: Nov 05 to Dec 05(30 days) DSI-PAWC Charge 2.05% .28 Next reading on/about: Jan 07,2013 Total water charges, Dec.10,2012 14.03 Rate Type: Residential ----- Current Charges----- Customer Protection In Home. 3.99 Meter readings in current billing period: Customer Protection Sewer Line 9.00 Motor Number N084673753 is a 5/8-inch meter. Customer Protection Water Line 5.50 Present-actual 79700 Total other charges,Dec 10,2012 18.49 Last-actual 79700 Gallons used 0 AMOUNT DDE---------- •--- $32.52 Water Usage Comparison 12 Monthly usage in hundred gallons. . — g+ 2 D J F M A M J J A S O N D 2 g e a e a a u u u e c o e i c n a r y n 1 g P t v c _. Messages to you from Pennsylvania American Water `Any portion of the water charges which is not paid as of 1107113 will be subject to a 1.50%penalty. Apppproximately 4.57 percent or$.84,of State taxes are included in your current bill. Effective October 1,2012, the Distribution Syystem Improvement Charge(DSIC)increased from 0.83%to 2.05%. This charge funds the replacement of water disMbution facilities. Have you recency changed your primary phone number?If you have,please update your account information online using My H2O Online at www.amwater-com/myh2c or call us at the number below so that we can update our records. a W 175006W5 NCE70A TAV04 123 Customer Service& Emergencies 1-800-565-7292 (24 Hours) For Hearing Impaired Customers TOD 1-800-300-6202(24 Hours) Visit us on the INTERNET:www.penhsytvaniaamwater.com �' RAW10DAMUSIAMae41 - A1M. 2854 l ' LEMOYNE BOROUGH SEWER ACCOUNT SUMMARY Name: SHILEY, ELWOOD G, . Invoice Date: 12/28/2012 _ Account Number: 240370794 Invoice Number. 1001892 Service Location: 637 Bosler Ave Payment Due Date: 01/18/2013 SERVICE CURRENT PREVIOUS USE RATE CODE BILLING SUMMARY DATE READING DATE READING SEWM 1215/2012 79,700 11/5/2012 79,700 - 0 - SMRi Prior Account Balance 40.00' Payments/Adjustments -65.00 Penalty 0.00 Current.Charges Sewer Metered 40.00 . SMR1 Rate Code Residential SMC1 Rate Code_Commercial SMCR Rate Code.=Residential/Commercial Amount Due By Due Date: $15.00 26 Please kee p.this portion for your records °Payment Due Date:: 1/1812013 t; NOTES AND OTHER IMPORTANT INFORMATION ABOUT YOUR ACCOUNT. A reminder that We have impleniented.a new billing system for sewer and wastewater treatment services The Borough's charges - for-these services will no longer appear on the,bill that you get from Pennsylvania-American Water Company(PAWC), The, - Borough has now contracted with FR EE _ D.OM SYSTEMS CORP to perform the sewer and wastewater treatment billing and collection services: PAYMENT OPTIONS: BY MAIL: Please note that payments MUST BE MAILED to Freedom Systems Corp., PO Box 440;Oaks PA 19456-0440. A return envelope is enclosed for your convenience. Be sure to include your payment stub! - - IN PERSON: Walk-in payments will be accepted at Borough Hall however you are encouraged to mail payments using the enclosed envelope for the quickest posting of the payment to your account. - - ELECTRONICALLY: If you are scheduled for automatic electronic payment, the message DO NOT PAY-ELECTRONIC PAYMENT SCHEDULED will appear under the Amount Due field above along with the scheduled withdrawal date. If you would like to sign up for Automatic Electronic Payment, please contact Lemoyne Borough at 717-737-6843. Please contact Lemoyne Borough at 717-737-6843 if you have any questions about your account as well as to report all changes to name, address and account status. Questions?Please Visit us online at Page 1 contact us pplelectric.com . �] _ 1-80D-DIAL-PPL • " %�!� (1-800-342-5775) 2-Lg/I-7z 20660-75001 Jan 2, 20137©b rx d �unuo� M-F: Sam to 5pm ( Your Electric Usage Profile Billing Summary (Billing details on back) Service to: Balance as of Dec 11,2012 $0.00 E G SHILEY Charges: 637 BOSLER AVE Total PPL Electric Utilities Charges $13.27 LEMOYNE, PA 17043 Total Washington Gas Energy Services $9.93 Meter:74061796 Charges Your next meter reading is on or about Jan 8, 2013. This section helps you understand your year-to-year Total Charges $23.20 N electric use by month. Meter readings are actual unless , 10 <.. ,„ r, 12 otherwise noted. Account Balance $23.20 ®2011 02012 PPL Electric Utilities' price to compare for your rate is$0.07544 per kWh. 4z This changes the 1st of Mar,Jun,Sept,and Dec. Visit papowerswitch.com 3 as or www.oca.state.pa.us for supplier offers. x 2$ Your Message Center zi • Your electricity includes 5%wind power sourced from m 14 Pennsylvania wind farms. - - < 7 • With paperless billing,you can receive and pay your o PPL Electric Utilities bills online.The process is free, F M A M J 1 A 5 O N D quick, convenient and secure.To learn more or sign up, m visit pplelectric.com. s Months • Information about appliance energy use and tips on saving energy are available through the Energy Library Monthly ••ys ..-, kWh Average Average on our Web site, pplelectric.com. Comparison ' • Brighten your holidays safely. Check light strings before Dec 2012 30 136 5 40F using to make sure cords and plugs are intact.Turn off inside holiday lights before you go to bed. Dec 2011 1 30 828 28 46F — • y . ' a• Payment Methods Dec 6 Actual, 63848 Online at: © By phone: 1-800-342-5775 Nov 6 Actual 63712 pplelectric.com or call BillMatrix(service fee applies) at 1-800-672-2413 to pay using Visa, c 30 Days kWh Billed 136 MasterCard, Discover or debit card. _ j�YeailyCcimpadson Total Use Avg. Monthly Mall: Correspondence should be sent to: — Jan 2012- Dec 2012 7169 597 ® 2 North 9th Street Customer Services CPC-GENN3 827 Hausman Road — Jan 2011- Dec 2011 8549 712 Allentown, PA 18101-1175 Allentown, PA 18104-9392 = Other important information on the back of this bill 4 . .. Past Bill Information-UGt Utility The account balance an your last bill was __...._. $14.73 sxxsts rree Paymants....._................_'___...„...........................:......_. 0.00 Late Charge ,...._..._....._......_.._....._._....._......_....___. 0.18 216541473710 @Alinep Summary for Service to: Your balance as of 01/0212013(due now)__ .__.��d 91 ELwO{Xr SH,LEY - 80SLER AVE LE MOVNE PA,17043 Current 8111 information-U01 Utility LE . CustomarCharge;_........__.._....,......._._...................._: 8.55 Supplier Commodity 6 CCF at$0.65000)__........... -3.90 Rate classification: Distrbuhon Charges First 6 CCF at$0.33833)._... 2.03 Residential General-CC. Migration Rider Surcharge_»_.__._..___.....,...__._..r 0,36- Billing Period: PA State Tax 9urcharge.____„..,._.._....__....___.._..__ -0.05 - 11l28/2012 to 12/2812012(30 days) Total Current Charges-UGI Remote Device Read UGI Utility charges owedthis bill ........____..»».:___..______,__.._..,......___......_ $29.70 . Questions? - . . Call 800-276-2722 or write to UGI at . currant Bill Information-WASHINGTON GAS- PO BOX 13009 WASH%ON GAS gas costs are shown in the. Reading,PA 19612-3009 supplier charges shove. - - -'Your current UGI charges include Total Amount Due,Please Pay by Gus Cafe(01/23/2013).......___....»____..__.... $29.70 State taxes totaling about$035. Meter Information-Next Read Date January 29,2018- - MeterReadingInformation Meter.Number.. Previous Reading Present Reading CCF Usk 1197884. 2027(remote) 2033(remote) - -6 General information 'WASHINGTON GAS ENERGY SERVICES.INC. 13865 SUNRISE VALLEY 0R STE200 - - - HERNDON VA 20171 or Phone'703-793-7500 - 'Commodity prices and charges are set by the natural gas supplier you have chosen. The Public Utility Commission regulates distribution prices and services. Important Massages from UGI - Your current price to compare is$0.55048/CCF. 'Your total annual usage is 76 CCF. Your average monthly usage is 6 CCF: 'Help prevent pipeline damage,accidents and service disruptions.Cali 811 before you dig. 'Save time.Save the planet Sign up to view and pay your UGI bills online at www.ugi.com. - If you pay at a payment agent please take your entire bill. Make check payable to UGL Keep this part for your records. Important information Is on the back of this bill. Customer Account Information Billing Summary For Service To: ELWOOD G SHILEY -------Prior Balance --- 637 Rosier Ave Prior Water Balance $14.03 Account Number:24-0627441-1 Prior Balance Other $18.49 Premise Number: 24-0370794 Payments prior to Jan 11,2013. Thanksl -32.52 Total prior balance,Jan 11,2013 .00 Billing Period& Meter Information -----Current water Charges Billing Date: Jan 11.2018 Service Charge 13.75 Billing Period: Dec 05 to Jan 08 (34 days) STAS PAWC Water -.02 Next reading onlabout:. Feb 07,2013 DSl-PAWC Charge 3.48% .48 Rate Type: Residential Total water charges,Jan-11,2013 14.21 --Other Current Charges--=------ : . Meter readings in current billing period: Customer Protection In Home 3.99 Meter Number N084673753 is a 5/8-inch meter. Customer Protection Sewer line 9.00 Present-actual 79700 Customer Protection Water Line X5.50 Last-actual 79700 Total other charges,Jan 11,2013 18.49 Gallons used 0 AMOUNT DUE- $32.70 Water Usage Comparison 12 Monthly usage In hundred gallons, - 9 3 0 2 J F M A tut J J A S O N D J ?� 0 a a a a u u u e c b e a 2 n b r y n I g p t v c n I Messages to you from Pennsylvania American Water Any portion of the water charges which is not paid as of 2105113 will be subject to a 1.50%penalty. Apppproximately 4.57 percent, or$.64, of State taxes are included in your current bill Effactive January 1,2013, the State Tax Adjustment Surcharge(S AS)has decreased from 0%to-.15%. Effective January 1, 2013, the Distribution System Improvement Charge(DSIC)increased from 2.05%to 3.48%. This charge funds the replacement of water distribution facilities, Have you recently changed your primary phone number?if you have,please update your account information online using My H2O Online at www.amwater.com/myh2o or call us at the number below so that we can update our records. 000902MWW2 NCE9P1 TAV07 123 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.cotrl RAW100AM9031AM9D41 A1M 2339 i i LEMOYNE BOROUGH SEWER ACCOUNT SUMMARY Name: SHILEY, ELWOOD G, . Invoice Date: 02/25/2013 _ Account Number: 240370794 Invoice Number: 1025967 Service Location: 637 Bosler Ave Payment Due Date: 0 311 7/2 01 3 SERVICE CURRENT _ PREVIOUS USE RATE CODE BILLING SUMMARY DATE READING DATE READING SEWM 277/2013 79,800 1/8/2013 79,700 . . 100 . SMR1 Prior Account Balance 0.00 Current Charges Sewer Metered 40.00 3�. SMC 4>1 Rate Code= Residehtial s7� SMC1 Rate Code= Commercial SMOR Rate.Code=Residential/Commercial 1�I11�D1��1���101]��]II6N_ Amount Due By Due Date: $40.00r ?6 .`. Please.keep this.,portion for your records - payment Due Date: 3L17I2013, NOTES AND OTHER IMPORTANT INFORMATION ABOUT YOUR ACCOUNT A reminder that the Borough is now billing for sewer and wastewater treatment services.The Borough's charges for these services will no longer appear on the bill that you get from Pennsylvania American Water Company(PAWC).The Borough has now contracted with FREEDOM SYSTEMS CORP to perform the sewer and wastewater treatment billing and .collection services. - - - PAYMENT OPTIONS: BY MAIL: Please note that payments MUST BE MAILED to Freedom Systems Corp., PO Box 440, Oaks PA 19456-0440..A return envelope is enclosed.for your convenience. Be sure to include your payment stub! IN PERSON: Walk-in payments will be accepted at Borough Hall however you are encouraged to mail payments using the enclosed envelope for the quickest posting of the payment to your account. ELECTRONICALLY: If you are scheduled for automatic electronic payment, the message DO NOT PAY- ELECTRONIC PAYMENT SCHEDULED will appear under the Amount Due field above along with the scheduled withdrawal date. If you would like to sign up for Automatic Electronic Payment, please contact Lemoyne Borough at 717-737-6843. Please contact Lemoyne Borough at 717-737-6843 if you have any questions about your account as well as to report all changes to name, address and account status. --------------------:----------------------------- -- --------------- --------------- ----- ----------------------------------------------------------- Customer Account Information Billing Summary For Service To: ELWOOD G SHILEY ---Prior Balance-- ---- 637 Bosler Ave Prior Water Balance $15.15 Account Number:24-0627441-1 Prior Balance Other $18.49 Premise Number: 24-0370794 Payments prior to Feb 20,-2013. Thanks) .00 Total prior balance,Feb 20,2013 . 33.64 Billing Period& Meter Information -,---Adjustments-- Billing Date: Feb 20, 2013 CPP Adjustment-water -5.50 Water Line Protect Adj -1.67 CPP Adjustment-sewer -9.-00 Rate Type: Residential Sewer Line Protect Adj -8.38 CPP Adjustment-in home -3:99 In Home Line Protect Adj , -2.58 Total adjustments, Feb 20,2013 -31.12 U } AMOUNT DUE a�3 Water Usage Comparison 12 Monthly usage in hundred gallons,_ b 3 0 2 F M A M J J A S O N D J F 2 o e' a a u u u e c o e a a o 2 b r y n I g P I v c n b 3 Messages to you from Pennsylvania-American Water Any portion of the water charges which is not paid as of 3118113 will be subject to a 1.50%penalty. The due date pertains to current charges only. Any past due balance should be paid immediately. 2A�/pproximately 4.57 percent, or$0.00, of State taxes are included in your current bill. nCctive January 1,2013, the Distribution S stem Improvement Charge(DSIC)increased from 2.05%to 3.48%. This charge funds the replacement of water d stdbution facilities. Have you recently changed your primary phone number?If you have,please update your account information online using My H2O Online at www.amwater.com/myh2o or call us at the number below so that we can update our records. 000313:000313 NCECS6 TMe01 123 Customer Service & Emergencies 1-800-565-7292 (24 Hours) For Hearing Impaired Customers TDD 1 7800-300-6202 (24 Hours) Visit us on the INTERNET:www.pennsylvaniaamwater.com RAW 10DAM9181AM9191 24107 Page 1 Questions?Please Visit us online at "f +; O contact us by Feb 4. pplelectric.com - - 1-800-DIAL-PPL P1 (1-800-342-5775) 20660 75001 Feb 4,2013 N � , „� � ,Q PPL EJar1HC UNINa• M-F: gam to 5pm Your Electric Usage Profile Billing Summary (Billing details on back) Service to: Balance as of Jan 14,2013 $0.00 E G SHILEY Charges: 637 BOSLER AVE Total PPL Electric Utilities Charges $15.11 LEMOYNE, PA 17043 Total Washington Gas Energy Services $11.24 Meter:74061796 Charges Your next meter reading is on or about Feb 6;2013. Total Charges $26.35 This section us� iaral electric use by month. Meter readings e actual R Er +Pw2 �3 - ^ ' -`'" w rri�rtaDW. P t otherwise noted. Account Balance $26.35 B2012 S 2013 PPL Electric Utilities' price to compare for your rate is$0.07544 per kWh. 42 This changes the 1st of Mar,Jun,Sept,and Dec.Visit papowerswitch.com : 35 or www.oca.state.pa.us for supplier offers. Y za - Your Message Center 0 21 • Your electricity includes 5%wind power sourced from 14 Pennsylvania wind farms. a • With paperless billing,you can receive and pay your = PPL Electric Utilities bills online.The process is free, S o quick, convenient and secure.To learn more or sign up, o J F M A M i J A S 0 N D visit pplelectric.com. Monks • Information about appliance energy use and tips on saving energy are available through the Energy Library .. on our Web site, pplelectric.com.kWh.Comparlson Billed kWh/Day Temp A fireplace can lose more heat up the chimney than it Jan 2013_ 33 154 5 35F provides. Glass doors and tight fitting dampers help reduce heat loss when you are not using it. Jan 2012 33 3011 31 37F = Period Billing Payment Methods Jan 8 Actual 64002 /� Online at: ©By phone: 1-800.342-5775 Dec 6 Actual 63848 U pplelectric.com or call Bill Matrix(service fee applies) at 1-800-672-2413 to pay using Visa, 33 Days kWh Billed 154 MasterCard, Discover or debit card. _ ® By Mail: Correspondence should be sentto: 7Feb 012-Jan 2013 6312 526 2 North 9th Street Customer Services = CPC-GENN1 827 Hausman Road _ 011-Jan 2012 8707 726 Allentown, PA 18101-1175 Allentown, PA 181049392 Other important information on the back of this bill 4 -Past Bill Information-UGI Utilitp'.y__ The account balance an your last bill was '-44:61 2970 r reavrrc Thank you for your payment of _.. Biilin Summary for Service to. Your balance as of 01,31/2013__..__,.__._..........�'S-r . -1' P2M16541473710 6637 BOS ERIAVE Current BIN Information-UGI Utility LEMOYNE PA 17043 Customer Charge...................._........_................... 8.55 Supplier Commodity{7 CCF at$0.65000}.,___...— 4.55 Distribution Charges(First 7 CCF at$0.34000)....... 2.38 Rate Classification: Migration Rider Surcharge................. .... 0.43 Residential General-CC PA State Tax Surcharge_....__,...___.______.._...__ -0.05 Billing Period: Total Current Charges-UGI Utility.........____.......... 15.86` 12/28/2012 to 01128!2013(31 days) UGI Utility charges owed this bill__.....___»___„_„....:__.___:.,._.___.,__....._w $IL95 Remote Device Read Questions? Current Bill Information-WASHINGTON GAS - - Call 800-276-2722 or write to UGI at WASHINGTON GAS gas costs are shown in the - PO BOX 13009 supplier charges above. ," Reading.PA 191612-3009 Total Amount Due,Please Pay by Due Date{02/21/2013} ___...._............._...__. $0.95 `Your current UGI charges include State taxes totaling about$0.36. Meter information-Next Read Date February 28,2013 - Meter Reading Information- Motor Number • Provious"Reading Present Reading --- CCF Used 1197884 - 2033(remote) 2040(remote) -7. General information 'WASHINGTON GAS ENERGY SERVICES,INC. - - 13865 SUNRISE VALLEY OR STE200 HERNDON VA 20171 or Phone 703-793-7500 `Commodity prices and charges are set by the natural gas supplier you have chosen. The public Utility Commission regulates distribution prices and services, - Important Messages from UGI - 'Your current price to compare is$0.55048/CCF. I 'Your total annual usage is 75 CCF. Your average monthly usage is 6 CCF. . `Help prevent pipeline damage,accidents and service disruptions.Call 811 before you dig. 'Save time.Save the planet Sign up to view and pay your UGI bills online at www.ugi.com, If you pay at a payment agent please take your entire bill, Make check payable to UGL Keep this part for your records. important information is on the back of this bill. i Past Bill Information-UGI Utility The account balance an your last ill was ............. $0.95 .r let' - Thank you for your payment of ....... -1.00 Your balance as of 63/04/2013 ............ ___.. =0.3 216541473710 Billingg Summary for Service to: ELw06O SHILEY Current gill Information-UGI Utility 637 BOSLER AVE - Customer Charge PA 17043 - Supplier Commodity 6 CCF at$0.650(10) ........ _ 3.90- - Distribution Charges First 6 CCF at$0.3 3 833) .... 2.03 Rate Classification: - Migration Rider Surcharge ..................__.................. 0.37 Residential General-CC PA State Tax Surcharge...__....................................._ - =0:05', Billing Period: - Total Current Charges-UGI Utility........_................X4.80 01128/2013 to 02/27/2013(30 days) UGI Utility charges owed this bill ........ ....:......:...............:................__ - $14.75 Remote Device Read Questions? Current Bill Information-WASHINGTON GAS _ Call 800-276-2722 or write to UGI at WASHINGTON GAS gas costs are shown in the PO BOX 13009 supplier charges above. Reading,PA 19612-3009 - Total Amount Due,Please Pay by Due Date(03/25/2013)..........................:..... $14.75 'Your current UGI charges include State taxes totaling about$0.35, - - Meter Information-Next Read Date April 1,2013 - - Meter Reading Information - . - Meter Number Previous Reading - Present Reading- CCF Used • 1197884 2040(remote) - - 2046(remote) ..' - ... '6 .. General Information •WASHINGTON GAS ENERGY SERVICES,INC. - 13865 SUNRISE VALLEY DR STE200 HERNDON VA 20171 or Phone 703-793-7500 -•Commodity prices and charges am set by the natural gas supplier you have chosen. The Public Utility Commission regulates distribution prices and services. Important Messages from UGI •Your current price to compare is$0.55048/CCF. •Your total annual usage is 74 CCF. Your average monthly usage is 6 CCF. _ •Help prevent pipeline damage,accidents and service disruptions.Call 811 before you dig. •Save time.Save the planet Sign up to view and pay your UGI bills online at www.ugi.com. If you pay at a payment agent please take your entire bill. Make check payable to UGI. Keep this part.for your records. Important information is on the back of this bill. ------- ------ -- -------------------------... - - - --.... -------------------------------- -- ........... - Customer Account Information Billing Summary For Service To: The Estate of Elwood Shiley ---------Prior Balance—­­­­... 637 Bosler Ave Prior Balance $.00 Account Number:24-2297865-6 Payments prior to Mar 13, 2013. Thanksl .00 Premise Number: 24-0370794 Total prior balance,Mar 13,2013 .00 ------Current Water Charges---------- Billing Period& Meter Information Service Charge 13.75 Billing Date: Mar 18,2013 Water Volume($.008101 x 100il .91 Billing Period: Feb 07 to Mar 08(29 days) STAS PAWL Water - ,02 Next reading on/about: Apr 09,2013 DSI-PA WC Charge 3:48% 51 Rate Type: Residential Total water charges,Mar 13,2013 - 15.15 Meter readings in current billing period: ---------AMOUNT DUE Meter Number N084673753 is a 5f8-inch meter. - - - Present-actual 79900 Last-actual 79800 Gallons used 100 Water Usage Comparison Monthly usage in hundred gallons. 2 M A M J J A S 0 N D J F - M 2 0 a P a u u u e c 0 e a a a p 2 r r y n f g p t v c n b r I Messages to you from Pennsylvania American Water Approximately 4.57 percent, or$.68, of State taxes are included in your current bill. Effective January 1,2013, the Distribution System Improvement Charge(OSIC)increased from 2.05/a to 3.48%. This charge funds the replacement of water distribution facilities. - Pennsylvania American Water is now offering paperless billing. It's a convenient,environmentally friendly and secure way to receive your water and or wastewater bill. Users must enroll online. To get started, visit www.amwater.comlmyh2o. Go to Account Detail and click on the green line Biding button. Follow the steps,press submit and you're enrolledl Have you reoently an your p mary phase number?if you have, please update your account information online using My H2O Online of www.amwafercom/myh20 or call us at the number below so that we can update our records. "IMPORTANT WATER QUALITY INFORMATION: Your annual Water Quality Report can be viewed electronically at wwwamwater.comlccrlmechanicsburg.pdf ' - If you prefer a paper copy to be sent to you,please contact our Customer Service Center at 800-565-7292. ---------------------------------`---------------------------------` i 003112IW3112 NCEEFY TAV08 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 IMAM9321 AIM . 34188 i Questions?Please fry Visit us online at Page 1 contact u,by Mar 5. 1 pplelectric.com pl •::' ' 1- L-PPI. : ' s »» SWIDIA(1-800-342-5775) ^� 20660-75001 Mar 5, 2013 PPL Eleavla Wlilitlee M-F:Sam to 5pm Your Electric Usage Profile Billing Summary (Billing details on back) Service to: Balance as of Feb 12; 2013 $0.00 E G SHILEY Charges: 637 BORER AVE Total PPL Electric Utilities Charges, $18.41 LEMOYNE, PA 17043 Total Washington Gas Energy Services $9.85 Meter:74061796 Charges Your next meter reading is on or about Mar 7,2013. _ Total Charges $28.26, This section helps you understand your year-to-yearw Ilr �tU r t1a20 e d's uy d ir"� Q J✓ pd wov + n y+m9 electric use by month. Meter readings are actual unless n a' 7N � t + , otherwise noted. Account Balance $28.26 ®2012 ®2013 - —_ _ PPL Electric Utilities'price to compare for your rate is$0.07544 per kWh. 42 This changes the 1st of Mar,Jun, Sept,and Dec.Visit papowerswitch.com 35 --- - or www.oca.state.pa.us for supplier offers. '. za Your Message Center n e Your electricity includes 5%wind power sourced from 14 Pennsylvania wind farms. <' t e With paperless billing,you can receive and pay your o Uffll ILI PPL Electric Utilities bills online.The process is free, J F M A M i n s o N o quick, convenient and secure.To learn more or sign up, visit pplelectric.com. 8 Months . . Information about appliance energy use and tips on saving energy are available through the Energy Library ' on our Web site, pplelectric.com. kwh ' ' • Take showers instead of baths to save energy and Fe62013 29 135 5 31F water. It takes about 30 gallons of water to fill an average bathtub.A 5-minute shower uses about 20 Feb 2012 29 648 22 34F gallons. Low flow shower heads can cut your hot water ' use in half. A X4 •• Payment Methods — Feb 6 Actual 64137 Online at: By phone:1=800-342-5775 _ Jan 8 Actual 64002 pplelectric.com or call BIIIMatrix(service fee applies) at 1-800.672-2413 to pay using Visa, 29 Days kWh Billed 135 . MasterCard, Discover or debit card. - ® By Mail: Correspondence should be sent to: Mar 2012- Feb 2013 5799 483 2 North 9th Street Customer Services — CPC-GENN1 827 Hausman:Road Mar 2011-Feb 2012 5225 685 Allentown, PA 18101-1175 Allentown, PA 18104-9392 — Other important information on the back of this bill- — Z is ;abed ;uago o;Adap'Auedwoo o;ieu!6u0 49Z809#uopgagrpao-amArou6y io;dap Vd �r' -Lf - h :a;ep -==itS '//(� :aln 4eu6ls s,�aloadsut (ePop dZ`ale1S`A31o) _ ; - Oawls) IV> _ :s4aaPPV luayno slua{lo :a;ep :am;eu6'S :(luud)aweN;uapo r _ ` .a;ep 7M1 „`•?` :�`.;! 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Shiley 21-12-1030 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS(Include outright spousal distributions and transfers under Sec.9118(a)(1.2).1 _ 1. Bober bi Jo Jones,428 Herman Avenue,Lemoyne,PA 17043 - ?Daughter j0% ; E2.2.', �ICyndi Lou foster,7895 Manor Drive,Harrisburg,PA 17112 j (Daughter 50°k F-1 r _ ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS - A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: , 1.. .None - 0.00 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: Nl one t 7 _ 0.04 I t TOTAL OF PART II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ 0.00 If more space is needed,use additional sheets of paper of the same size. LAST WILL AND TESTAMENT (Pour-Over Will) °uiY,, , r, t OFz N =' ELWOOD G. SHILEY r"" ° r .. ; �c ry IDENTITY yQ Q n o 1,ELWOOD G.SHILEY,residing in the County of Cumberland,Commonwealth of Pennsylvania, being of sound mind and memory, and not acting under duress or undue influence of any person whomsoever,hereby declare this to be my Last Will and Testament,and I do hereby revoke all other former Wills and Codicils to Wills heretofore made by me. My Social Security Number is 210-26-9109. I have the following children: BOBBI JO JONES born July 22, 1961 and currently residing in Lemoyne,PA 17043 and CYNDI L.FOSTER born April 22, 1963 and currently residing in Harrisburg,PA 17112, DEBTS,TARES AND ADMINISTRATION EXPENSES I have provided for the payment of all my debts, expenses of administration of property wherever situated passing under this Will or otherwise,and estate, inheritance,transfer, and succession taxes, other than any tax on a generation-skipping transfer that is not a liability of my Estate (including interest and penalties,if any)that become due by reason of my death,under THE ELWOOD G.SHILEY REVOCABLE LIVING TRUST executed on even date herewith (the "Revocable Trust'). If the Revocable Trust assets should be insufficient for these purposes,my Executor shall pay any unpaid items from the residue of my Estate passing under this Will,without any apportionment or reimbursement. In the alternative,my Executor may demand in a writing addressed to the Trustee of the Trust an amount necessary to pay all or part of these items, plus claims, pecuniary legacies,and family allowances by court order. PERSONAL AND HOUSEHOLD EFFECTS It is my intent that all my personal and household effects were transferred to the Revocable Trust as a result of the Declaration of Intent signed this date. If there are any questions regarding the ownership or disposition of these assets,it is my desire that such assets pour into the Revocable Trust,signed by me this date in accordance with the provisions of the section titled"Residue of Estate." RESIDUE OF ESTATE I give, devise and bequeath all the rest, residue and remainder of my property of every kind and description(including lapsed legacies and devices),wherever situated and whether acquired before or after the execution of this Will, to the Trustee under that certain Trust executed by me on the same date of the execution of this Will. The Trustee shall add the property bequeathed and devised by this item to the corpus of the above described Trust and shall hold, administer and distribute said property in accordance with the provisions of the said Trust, including any amendments thereto made before my death. POUR-OVER WILLS Page 1 (Testator) If for any reason the said Trust shall not be in existence at the time of death, or if for any reason a court of competent jurisdiction shall declare the foregoing testamentary disposition to the Trustee under said Trust as it exists at the time of my death to be invalid,then I give all of my Estate including the residue and remainder thereof to that person who would have been the Trustee under the Trust,as Trustee,and to their substitutes and successors underthe Trust,described herein above,to be held,managed,invested,reinvested and distributed by the Trustee upon the terms and conditions pertaining to the period beginning with the date of my death as are constituted in the Trust as at present constituted giving effect to amendments, if any, hereafter made and for that purpose I do hereby incorporate such Trust by reference into this my Will. EXECUTOR I hereby nominate and appoint BOBBI JO JONES to serve without bond as my Executor of this my Last Will and Testament. In the event the first named Executor shall predecease me or is unable or unwilling to act as my Executor for any reasons whatsoever, then and in that event, I hereby nominate and appoint CYNDI L. FOSTER to serve without bond as my Independent Executor. Whenever the word"Executor"or any modifying or substituted pronoun therefore is used in this my Will,such words and respective pronouns shall be held and taken to include both the singular and the plural, the masculine,feminine and neuter gender thereof,and shall apply equally to the Executor named herein and to any successor to substitute Executor acting hereunder, and such successor or substitute Executor shall possess all the rights, powers, duties, authority, and responsibility conferred upon the Executor originally named herein. EXECUTOR POWERS By way of Illustration and not of limitation and in addition to any inherent, implied or statutory powers granted to executors generally,my Executor is specifically authorized and empowered with respect to any property, real or personal, at any time held under any provision of this my Will: to allot, allocate between principal and income, assign, borrow, buy, care for, collect, compromise claims, contract with respect to,continue any business of mine,convert,deal with,dispose of,enter into,exchange,hold,improve, incorporate any business of mine, invest, lease,manage, mortgage,grant and exercise options with respect to,take possession of,pledge,receive, release, repair, sell, sue for,make distributions in cash or in kind of partly in each without regard to the income tax basis of such asset and in general,exercise all of the powers in the management of my Estate which any individual could exercise in the management of similar property owned in its own right upon such terms and conditions as to my Executor may seem best, and execute and deliver any and all instruments and do all acts which my Executor may deem proper or necessary to carry out the purpose of this my Will,without being limited in any way by the specific grants or power made,and without the necessity of a court order. My Executor shall have absolute discretion, but shall not be required, to make adjustments in the rights of any Beneficiaries,or among the principal and income accounts to compensate for the consequences of any tax decision or election, or of any investment or administrative decision, that my executor believes has had the effect,directly or indirectly,of preferring one Beneficiary or group of Beneficiaries over others. In determining the Federal Estate and Income Tax liabilities of my Estate,my Executor shall have discretion POUR-OVER WILLS , � c- Page 2 (Testator) to select the valuation date and to determine whether any or all of the allowable administration expenses in my Estate shall be used as Federal Estate Tax deductions or as Federal Income Tax deductions. SPECIFIC OMISSIONS I have intentionally omitted any and all persons and entities from this,my Last Will and Testament, except those persons and entities specifically named herein. If any person or entity shall challenge any term or condition of this Will, or of the Living Trust to which I have made reference in the sections "Household and Personal Effects"and"Residue of Estate,"then,to that person or entity,I give and bequeath the sum of only one dollar($1.00) only in lieu and in place of any other benefit, grant, bequest or interest which that person or interest may have in my Estate or the Living Trust and its Estate. SIMULTANEOUS DEATH If any other Beneficiary should not survive me for sixty (60) days, then it shall be conclusively presumed for the purpose of this my Will that said Beneficiary predeceased me. ELWOOD G. SHILEY Testator This instrument consists of 5 typewritten pages, including the Attestation Clause, Self-Proving Clause,signature of Witnesses,and acknowledgment of officer. I have signed my name at the bottt 4f each of the preceding pages. instrument is being signed by me on this (.1¢ day of POUR-OVER WILLS Sz Page 3 (Testator) ATTESTATION CLAUSE The Testator whose name appears above declared to us, the undersigned, that the foregoing instrument was his Last Will and Testament,and he requested us to act as witnesses to such instrument and to his signature thereon. The Testator thereupon signed such instrument in our presence. At the Testator's request,the undersigned then subscribed our names to the instrument in our own handwriting in the presence of the Testator. The undersigned hereby declare, in the presence of each of us,that we believe the Testator to be of sound and disposing mind and memory. Signed by us on the same day and year as this Last Will and Testament was signed by the Testator. WITNE SES: 1 / ADDRESSES: l i yy6 (Printed Name of Witness) (Printed Name of Witness) POUR-OVER WILLS /t Page 4 (Testator) COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SELF-PROVING CLAUSE ,/ BEFORE ME,the undersigned authority, on this day personally appeared ELWOOD G. SHILEY, 9W 5oa/ and /,jam DRjf6 l �9Lr7RG3� ,known to me to be the Testator and the witnesses, respectively, whose names are subscribed to the foregoing instrument in their respective capacities, and all of them being by me duly sworn, ELWOOD G. SHILEY, Testator, declared to me and to the witnesses,in my presence,that the instrument is his Will and that he had willingly made and executed it as his free act and deed for the purposes therein expressed; and the Witnesses,each on his or her oath,stated to me in the presence and hearing of the Testator,that the Testator had declared to them that the instrument is his Will and that he executed the same as such and wanted each of them to sign it as a witness; and upon their oaths, each witness stated further that he did the same as a witness in the presence of the Testator,and at his request and that he was at that time eighteen (18)years of age or over and was of sound mind, and that each of the witnesses was then at least fourteen (14)years of age. ELWOOD G. SHILEY Testator Witness M.1 K (Printed Name of Witness) eld L— ha' Gold.;('_ ., (Printed Name of Witness) SUBSCRIBED AND ACKNOWLEDGED before me by ELWOOD G. SHILEY, Testator, and subscribed and sworn to be e me by and witnesses,this the / 9 day of _ /a/ _ )o Notary Pu Commonwealth nsylFania Narno�',"°n'�=y:�rr:�.a ae=oc:rccicr:u�....arras POUR-OVER WILLS Page 5 (Testator)