HomeMy WebLinkAbout09-03-13 � REV-1500 EX`°z_,,,
1505610143
�% OFFICIAL USE ONLY
PA Department of Revenue pennsylvania County Code Year File Number
Bureau of Individual Taxes DEPARTMENTOFREVENUE
Po Box.2soso� INHERITANCE TAX RETURN 21 13 0 0 3 71
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW Date of Birth
Social Security Number Date of Death
204 26 7946 12 23 2012 12 19 1932
DecedenYs Last Name Suffix DecedenYs First Name MI
SYDNOR EDITH R
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW g Remainder Return(Date of Death
� 1. Original Retum ❑ 2. Supplemental Return ❑ Prior to 12-13-82)
4. Limited Estate � 4a,Future interest Compromise � 5. Federal Estate Tax Retum Required
❑ (date of death after 12-1282)
Decedent Died Testale � Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
� 6. ❑ (Attach Copy of Trust)
(Attach Copy of Wlq
� 9. Litigation Proceeds Received � 10.Spousal Poverty Credit(Date of Death ❑ �� Attach Sched le Or Sec.9113(A)
between 12-31-91 and 1-1-95) � �
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
DUANE P STONE 717 432 2089
REGISTER�WILLzS l�E ONLY
C7 ''� �
,� 7 rf� .� l-1
C � , , ""J
First Line of Address rc; � �> T' � E•.,.
_. .
� T,, �-_ . ,,i
8 N B A I�T I M O R E S T R E E T r"" ��' c.,.� �::�
c;,, .,-;, c:, c�:_.,
. �;
Second Line ofAddress � �-� 4- -'-; , -`�
, r..., _ _� "�1
- � DA-�E FIL:ED`-'
City or Post Office State ZiP Code • r"
� �-i �
DILLSBURG PA 17019 :: � v' "T�
� ��
CorrespondenYs e-maii address: D u a n e@ S t o n e D u n c a n.c o m ��
Under penalties of perjury,I declare that I have examined this retum,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true,correct and complete.Declaration of p parer other than the personal representative is based on all information of which preparer has any knowledge.
DATE
SIGN E OF PERS N RESP SIBLE FO FIL G ETURN
Lyndon I. Lickel
ADDRESS
1800 Orrs Bridge Road, E la, A 17025
SIGNAT F P EP ER OTHER T R NTATIVE DATE
Duane P Stone
ADDRES
Stone, Duncan 8� Linsenbach
8 N. Baltimore Street, Dillsburg, PA 17019
Side 1
� 15�5610143 15�5610143 J
�
� 1505610243
REV-1500 EX DecedenYs Social Security Number
oe�ae�c�s Name: S Y D N O R, E D I T H R 2 0 4 2 6 7 9 4 6
RECAPITULATION
1. Real Estate(Schedule A).......................................................................................... 1.
156 , 000 . 00
2. Stocks and Bonds(Schedule B)............................................................................... 2.
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C).......... 3.
4. Mortgages&Notes Receivable(Schedule D).......................................................... 4.
5. Cash, Bank Deposits&Miscellaneous Personal Property(Schedule E)................ 5.
10 , 430 . 00
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............. 6.
7. Inter-Vivos Transfers 8�Miscellaneous Non-Probate Property
(Schedule G) ❑ Separate Billing Requested............. 7.
g. Total Gross Assets(total Lines 1 through 7)..................................
........................ a. 166 , 430 . 00
9. Funeral Expenses and Administrative Costs(Schedule H)..................................... 9.
12 , 658 . 06
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................. 10.
34 , 714 . 35
11. Total Deductions(total Lines 9 and 10)..................................................................
11. 47 , 372 . 41
12• Net Value of Estate(Line 8 mmus Line 11)............................................................. 12.
119 , 057 . 59
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J)................................................. 13.
14. Net Value Subject to Tax(Line 12 minus Line 13).........................
........................ 14. 1 1 9 , 0 5 7 . 5 9
TAX COMPUTATtON-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 15
(a)(1.2)X .00
16. Amount of Line 14 taxable 119 0 5 7 . 5 9 16� 5 , 3 5 7 . 5 9
at lineal rate X 045 r
17. Amount of Line 14 taxable ��
at sibling rate X .12
1 S. Amount of Line 14 taxable �8
at collateral rate X .15
19. TAX DUE................................................................................................................... 19. 5 , 3 5 7 . 5 9
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. �
Side 2
� 1505610243 1505610243 �
REV-1500 EX Page 3 File Number 21 - 13 - 00371
Decedent's Complete Address:
DE E ' NAME
Sydnor, Edith R
STREET ADDRESS
1800 Orrs Bridge Road
CITY STATE ZIP
Enola PA 17025
Tax Payments and Credits:
1. Tax Due(Page 2, �ine�9) (�) 5,357.59
2. Credits/Payments
A. Prior Payments
B. Discount
Total Credits(A +g) (2) 0.00
3. I nterest (3) 0.0 0
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4)
Check box on Page 2,Line 20 to request a refund
5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) rJ,3 5 7.rJ 9
Make Check Payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred:.................................................................................. � ❑x
b. retain the right to designate who shall use the property transferred or its income:.................................... � �x
c. retain a reversionary interest;or.................................................................................................................. ❑ ❑x
d. receive the promise for life of either payments,benefits or care?.............................................................. � �x
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?....................................................................................................................... ❑ ❑x
3. Did decedent own an"in trust fo�' or payable upon death bank account or security at his or her death?......... � �x
4. Did decedent own an individual retirement account,annuity,or other non-probate property which
containsa beneficiary designation?...................................................................................................................... ❑ ❑x
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994 and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving
spouse is 3 percent[72 P.S.§9116(a)(1.1)(i)].
For dates of death on or after January 1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
p2 P.S.§9116(a)(1.1)(ii)]. The stafute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of
assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000:
•The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an
adoptive parent,or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)].
•The tax rate imposed on the net value of transfers to or for the use of the decedenYs 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 decedenYs siblings is 12 percent[72 P.S.§9116(a)(1.3)1. A
sibling is defined under Section 9102,as an individual who has at least one parent in common with the decedent,wfiether by blood or adoption.
INVENTORY
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA } SS File Number 21 -13 -00371
couN�rr oF Cumberland
Lyndon I. Lickel
Personal Representative(s)of the Estate of Syd110�, Edith R
deceased, depose(s)and say(s)that the items appearing in the following inventory include all of the personal assets wherever situate
and all of the real estate in the Commonwealth of Pennsylvania of said Decedent,that the valuation placed opposite each item of said
inventory represents its fair value as of the date of the decedenYs death, and that Decedent owned no real estate outside of the
Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory.
I verify that the statements made in this Inven-
tory are true and correct. I understand that false state- � Lyndon I. LiCkel
ments herein are made subject to the penalties of �
18 Pa.C.S. §4904 relating to unsworn falsification to
authorities.
Attomey-- (Name) Duane P Stone (Supreme Court I.D.No.) 85715
(Firm) Stone, Duncan 8� Linsenbach
(Address) 8 N. Baltimore Street
Dillsburg, PA 17019
(Telephone) 717/432-2089
LAST RESIDENCE g DECEDENT'S SOC.SEC.NO.
DATE OF DEATH 1800 Orrs Brid e Road 204-26-7946
12/23/2012 � Enola, PA 17025
FIGURES MUST BE TOTALED
Personal PropertY
Personal Property 9,630.00
Lincoln Mk 81997 800.00
Total Personal Property 10,430.00
Real Estate
1800 Orrsbridge Road, Enola, PA 17025 (from assessment x 1.0 for the common 156,000.00
level ration for Cumberland County)
Total Real Estate 156,000.00
(Attach additional sheets if necessary) Total Personal Property and Real Estate $166,430.00
.:'�}'� „ �
�ast �ilCand�I"estament
of�Edith 1�,. Sy�Cnor
I, Edith R. Sydnor, of 1800 Orrs Bridge Road, Hampden Township,
Cumberland County, Enola, Pennsylvania,.declare this to be my last will and revoke
any will previously made by me.
;
� I. I direct that the executor of my estate satisfy all o£my Iegally enforceable
i
' debts and funeral expensea as eoon as may be conveniently done after my death.
!
II. I bequeath to my grandson, David Austin Leafinan Lickel, the property
located at 1800 Orre Bridge Road, Hampden Townahip, Cumberland County,
Pennsylvania.
y
III. I hereby give, devise and bequeath the rest, residue and remainder of my
estate of every nature and wherever situate to be split among my two sons, Kevin
Leafman Lickel and Lyndon Lickel, provided that they shall survive me by thirty
(30) days.
N. 'Should my sons, Kevin Leafman Lickel or Lyndon Lickel, predecease me or
di�on or before the thirtieth day following my death,I deviee and bequeath the rest,
reaidue and remainder of my estate to my grandson,David Auatin Leafman Lickel. - ,
V. I direct that my executor, truatee, and their aucceasora ahall not be required
to give bond for the faithful performance of their duties in any juriediction.
i
{ � VI. I appoint my son, K,evin Leafman Lickel, executor of this, my last will.
� Should my son, Kevin Leafman Lickel, fail to qualify or cease to act as executor, I
�
! appoint my son, Lyndon Lickel,executor of this, my last will. '
,
i
� VII. No intereat of any beneficiary under this will or any codicil hereto shall be
subject to anticipation or voluntary or involuntaxy alienation and shall not be
1
� subject to any execution, attachment, levy or sequeatration or other claim of the
� creditors of said beneficiaries or any of them.
i
'1
�
�
�
�.��. � . . - � �.
I
G
� I
VIII. I direct that all taxes that may be assessed in consequence of my death, of �
k
I
whatever nature and by whatever 3urisdiction imposed, shall be paid from my k
residuary esta.te as a part of the e�cpense of the administration of my esta.te.
� -
r.
�
� IX. I direct that my executor shall have the power to make distribution in cash or �
in kind, or partly in cash or partly in kind, and in such manner as he may determi�ne �
and at valuations to be finally fixed by him. �
t
IN WITNESS WHEREOF, I,Edith R. Sydnor, the above-named Testatrix, have .
hereunto set my hand this�day of���i��/ ,1996. _
.
, �
Edith R. Sydnor
� This instrument, consisting of two pages, was on the date thereof signed,
published and declared by Edith R. Sydnor, the testatrix thereirx named, as and for
. her last will in the presence of us, who, at her request,in her presence, and in the
presence of each other,have subscribed our names as witnesses hereto.
Witness
• a � s
1
� Witnes�
�
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COMMONWEALTH OF PENNSYLVANIA :
. SS
COUNTY OF .
We, Edith R. Sydnor, �a N���-f4 .�. ��� and
,��,�-� L.,C��� , the Testatrix and witnesses, espeetively,
whose names are signed to the foregoing instrument, being first duly sworn, do
hereby declare to the undersigned authority that the Testatrix signed and executed
the instrument as her last will and that she had signed willingly, and that she �
� executed it as a free and valtantary act for the purpoaes therein expressed, and that
each of the witnesses, in the presence and heaxing of the Testatrix, signed the will as
witness, and that, to the best of witness' knowledge, the Testatrix was at the time
eighteen (19j years of age or older, of sound rnind and under no constraint or undue
� influence.
�
,
Edith R.Sydnor
itness
�- ��a�e�
.�,�,-�- �L �
Witness
Subscribed and sworn to and acknowledged before me by Edith R. Syndor,the
Testatrix, and subscribed and sworn to before me by� a Q.7�Y�
and •� Q,�,3� , witnesses, this /3°�'day of �.�,, ,
1996. _ ..� ',•.,
�\,{.` -�� :�.. �r��•�• . � .
" ,y�t� r��`. � ^ �� �D��_
1 r` y ,
� : cSe�,'1�: y o. :. -�•�
��� ,z; �,�;v� y � :� Notary Pub1iC
����'i.S:- `E�. '
1�'.,f..y . ':y:� :._ . .
'. I� . t.:i,� ' �. •�.
" .� .<:;,,�.�� : p�.::��:-r , My commission ex ires:
�,. � '` - ��O . Notaria!Seal
� �M:; � Mary Ellen Lickel,Notary Public
' •<,���••' �� Mechanicsbur�Boro,CumberlandCounty
My Commission Expires Feb•22�199�
���?�:�;;�r,°ennssdva�ia Association of Nota�ies
� ��� � � �� ������������� �� ��
iNAR�d9�3�: I� is illeya9 #� �3��li��t� �hi� �,���� �� �h������t �F° �h����r�p�a.
Fee Toa•this certif.icate, $6.00 ,r���°°�°�•--.P, 'i'his is tc� certify that the informa[io�� here given
.,,'d't�,R������c;�i��;\ correctly copied from an o�i�inal Certificate of De�
e,+'a���\�4'-� rluly iile�3 with me as Loctil I2egisirar. 'The origii
�� � =-; ��; certificate vri1P be farwarded to the 5tate Vi
;�� ;�� ��as.� Records 1�ffice for permanPnt filing.
'�'� -�-�t"',i�;` `
�} � ///(��(� I �/ +��+
' � . '��C'����,�$y���\ ./ � • �/�������1��Vr�./`� '� {X�.d� '�Le
� -_: � ,. \� � C17i i,��, \.t�. � � _ .
C'ertification Numbvr
�����-���i�°'���� Local ecistrar Datz. Issu�cl
Type/Prinf In COMMONWEALTH OF PENNSYLVANIA•DEPARTMENT OF HEALTH�VITAL RECORDS
P�,ma„e.,t CERTIFICATE OF DEATH s�az<F��eNvmber:
Black Ink 2,5ex 3.SodalSecuNiy Number 4.OaCe of Oeaih(Mo/DaV/Y)15pe11 Mo)
1.Oecedent's Legal Name(First,Middle,Last,Sufflx) g 2 0 4-2 6-7 9 4 6 De c 2 3, 2 O l 2
Edith R_ Sydnor
Sa.Ago-LasY Birthday(Yrs) 56.Untler 1 Vear Sc.Under 1 Oa fi.Oa(e of Blrth(Mo/Day/Year7(Spell Monlh) 7a.BirtMpl�rioYla;"`�a orelgn Co�n[ry)
�� 80 Mo�sns oavs Ho��• M���c=� DOCember l 9. � 932 7b.Birthplace(COUnty) Cumbex'land
6a.Residence(State or Forelgn Couniry) 86.Residence(Street antl Number-Include Apf No.) 8c.�Id Decedene LWe In a TownshlP7 H ampden i"�P-
pa �Ves,tleced<nC lived in
8d.ftesidence(County) �8 O O Orr s Br i dge Rd_ �iiY/bo.o.
Cumber 1 and ee.Residence(Zip Cotle) '� 7�rj� ONO,decedeni iived wlthin ilmits of
Marrled Witlawed il.Survlving Spouse's Name(If wife,give name prlor to first marriage)
- 9.Ever in US Atmed Fofcesi 10.Marital Status at Time of Death � � n
Q Ves �No �Unknown �OWOrced �Neve�Marrled ��lnknowl3.Mother's Name P�ICr to Flrst Ma��lage(First,Mlddle,Lazt)
12.Father's Name(Flrst,Mitldle,last.SuTflx) E151e Br'0t2
Ira RicScard
14a.InformanYs Name 14b.Relatianzhip to Oecedent 14c.Informant's Malling Address(Streec and Num Eno ltae�Z�PPae� ���2 5
Kevin Lic3cel Son 2045 Good Aope Rd. , .
p 15a. ace o oeat ec on one . ..... .. ...... ^ «��� •'^•-•" ece ens s Home ����
..."""'""'"'........... ....................................."""�.._....."""........................... .....
. ........Y.........
... ...
.................................. wt ' pif peath OcWrred Somewhere OtherThan a Hospibl: �Hosplre F
__ _ ........... w
� In tlent a V �J D d
If Death Occu�rctl In a Hospltal: u Pa peaA on Arrival �N�rsl�g Home/LOn6-Term Care Facillry 0 Othar(Speclfy)
Q Emergenry Room/OUtpaSlent � 35d.Co�anty of Oeach
c6t 15�.FaN11cY H�rt's(�f^�t�^'��T"41on,a"'��"`°c...a numbs�; •15c City orTOwry State,and Zip Cad� P a 1 7 l 1 O Dauphi n
� Carol n Croxton Slane Hospi a Harrisburg,
16a.Method of OispoziHOn Q Burial � Crematlon 36b.Date of DlsposlNOn 16c.Place of DlsOOSlcion(Name of cemefery,cremarory,or other place)
� pemavalfrom5tac� Oo��a���^ Dec 26, 20 2 Evans Cremation Service
� O Other(Specify) f Funer I Servic Ltcensee orRerson In Charge of Interment l�b.License Numbef
9 i6d.location of Oisposition(Gity o�Town,State,and ZipJ 1']a.Sig
� FDO11897-L
.. � Leola, Pa -
0 1]e.Name antl Complete Atldress of Funeral Facllity ri 1 Dr EnOla Pa 1 7 O 2 5
� h gh st d g�ee o�r Ievei of schoolkmmpleted atthettl�me olf dea h. boxDChat best tleFC'ribesiwhOeHii<r Me de edent th decedeni m slde ed h mOSelf o hersON/to be.t�t�dicate what
is Spanish/Hispanic/Latlno. Check the"NO" j7S White �Korean
� Bth grade or less vlexnamese
� No dipioma,9ch-12in grade bax If decedent is nat Spanlsh/Hlspanic/latMo. �American In'dlan orr Alaska Native 0�ther Asian
�Hlgh school graduate ar GED compleYed QI�.No,not Spanish/Hispanic/Latino �Aslan Intlian O Na[IVe Hawailan
�Yes,Mexlcan,Mexican Ame�lcan,Chicano 0 �Guamanian or Chamorro
� Some college credii,but no degree �yes,Puerto Rican �Chinese
�Assoclace degree(e.¢.�.P.,a+) ��b�� �FIIlpino 0 Samoan
0 Bachelor's degree(e.g.BA,AB,BS) �Yez, 0 Other Paciflc islanCer
� Master'z degree(e.g.MA,M5,MEng.MEd,MSW,M6A) �Yes,other Spanish/Hlspanic/Latino O�apanese
g gree O Other(Spetlfy)
O Ooetorate(e. PhO,EtlD)or Professional de (SpeclN) �
.MO,�05,DVM,LLB JD pa ype o
21.Decedent's Single Race Self-Designatlon-Check ONLY ONEto IndicateO SamhQe d,ecedent cansidered hlmself orherselito be. done during^most of�working Ilfe^�O N+OT USE RETIRE�.
Qq wniie 0�'°'^"` 0 Other FaciFlc islander Boo]c Keeper
0 Black or AfMCan Amerlwn Q Korean Don't Know/NOt Sure
0 American Indla�ar Alaska Naiive 0 Vietnamese �Refusetl 22b.Kind of Buslnezs/industry
0 Asian Indlan �Other Asian pther(SpeclN)
W p cni�es� O Na�weHa`"'a'i'^ 0 Distribution
� 0 FIIlpino �Guamanbn or Chamorro
�
ITEMS 23a-23d MUST BE COMPLETED 23a.Date Pronouncetl Oead(Ma Oay r 23b.Signatu�e o Person Pronouncing Death(Only when appli<abie� 23c.Llcetise Num er
BY PERSOIV WHD PRONOUNCES OR
CERTIFIES DEATH
23d.Date Signed(Mo Day/Yr) 24.Tlme of�each C Ves No
O 1 25.Was MediCal ExaminerarCOroner Contacte47 ❑
� CAUSE OP DEATH . aaaroximate
mxerv.i:
26.PaK 1.Enter the h In of events-dlseaaes,in)urles,or campllcatlon9-that directly causad the death. DO N�one causeronna Ilne Add sdditlonaldllnesrlf ne<essary Onset to Oea[h
resplratory arrest,ar vantricula�fibrlllatlon without S�s�1o1pN• DO NOT ABBREVIATE.E te�onl� -
� d.�.-c.�n �e r�..�i--
IMMEDIATE CAUSE ---------� a• Due to(or 5 a cens<quent n
(ilnal tlisease or condit�on
resulNng in death)
b� Oue co(or as a consequence of):
SequenHally Ilsi eontlitlans.
If any,leading to the cause ?
Ilsted on Ilne a. Enter che Due to(or as a consequence o(l: ?
UNDERLVING CAVSE 3
¢W (tflsease or Injury thai
� inlHated the events rezulUnB d- Due to(or as a consequence o�: i
,v_z In death)IAST.
� 27.Was an autepsy performed7
ontrl u to de t but not resulting in the underlyin6 cause given In Part I O ye5 No
� 26.Part 11. Enter otha� i nificant co diSi n Zg,Were avCapsy flnd�gs availabie
/ to complete the cause of deaCh7
m 1� ` �Yec Q No
30.Did Tabacco V s Contrlbute to DeachT 31.Manner of Death
� 29.IfF ale: �Ves � Prohably gNatunl �Homlcide
E Not pregnant wlShin paSY year �No Q Unk�own O Accident Q Pending InvesHgaHOn
s �Pregnant ai time oi death �Sufcide �Could no[be determ�ned
0 Not pregnant,but pregnani wlthin 42 days of death 32.Dace of Injury(MO/�ey/'�r)(Spell Month)
0 No[pregnant,but pregnant 43 day5 to 1 year before death 33.Time of lnjury
0 Unknown If pragnant wichin the past year
�farm:schao�) 35.Locatlnn of In�ury(5[reet a�d Number,Ci[y,State.21p Code)
34.Vlace af Injury(e.g.home;constructlon site,
36.Injury ai Work 37.ItTransportatian InJury,Speclry:
38.Oescribe How In)ury OcWrred:
4 0 Yes 0 Driver/Operator O Other(Specify)
p No O Passenger O �
39a.Certlfier(Check only one): ur2d due to the cauze(s)and manner statetl
� �CertlfyinQ physieian-TO the best of my knowledge,d occ tlaie,and place�and due to ihe cause(s)and manner stated
0 Pronouncing&Certifying phy '1'�the b st knowledge,deaCh occurred af the time, Q due ta the cause(s)and manner Siated
___ S���H �.r�f aa n tlo nd/or InvesHgaNOn,in my oplMon,dealh occurretl at the tfine,da[e,and pla�e,an
Q Medical Examiner/COro11C. ��'9AA��- � a �� �icense Number:AtLIL�IOQ 2"��
4, ���y;� ��� Tiele of certifle�� �
sia�at�r�o+«rt�re�: �""� 39c.Dale Signetl(MO/Oay/Vt)
39/b.'Name,AddIress antl Zip Code of Person Gompleting C!au�se�Of Death(Item Z67 / O�U 2 yI�4 �.to�2-
lI L/L2�•�E fJ- 1c 7 {YS�.+C nr✓L � �CC 1�'K ( O i
AK��� f1(_ � 42.Regfsirar Fi e Date(MO Day r)
40.Registrar's Dlstrict Number 41.ReglsYrar s S�gnature , � /ti //' , `n'`� p �� �1/ ' .���;�
� ��`i L��{:l.wZ_ia. 1 d(.P
° 43.Amendments
O
f
Q
Z H105-143
`7 r�f_-��^-•�'7 REV 07/2011
COMMONWEALTH OF PENNSYLVANIA SHORT CERTIFICATE
COUNTY OF CUMBERLAND
,
�`' �„
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' I, GLENDA FARNER STRASBAUGH
Register for the Probate of Wills and Granting
Letters of Administration in and for
CUMBERLAND County, do hereby certify that on
the 2nd day of April, Two Thousand and Thirteen
Letters TESTAMENTARY
in common form were granted by the Register of
said County, on the
estate of ED/TH R SYDNOR , late of HAMPDEN TOWNSH/P
(First Middle,Last)
in said county, deceased, to LYNDON l LICKEL
(First,Middle,Lastl
and that same has not since been revoked.
IN TESTIMONY WHEREOF, I have hereunto set rny hand and affixed the
seal of said office at CARLISLE, PENNSYLVANIA, this 2nd day of April
Two Thousand and Thirteen.
File No. 2013- 00371
PA File No. 2�- 13- 0371
Da te of Dea th 12/23/2012
S. S. # 204-26-7946
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NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL
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DEPARTMENTOFREVENUE SCHEDULE A
RESI�ENT DECE ENT URN REAL ESTATE
ESTATE OF FILE NUMBER
Sydnor, Edith R 21 - 13 -00371 -
All real property owned soleiy 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 wiliing buyer and a wilfing seller, neither being compelled to buy or sell, both having
reasonable knowledge of the relevant facts. Real property which 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.
Include a copy of the deed showing decedent's interest if owned as tenant in common.
ITEM DESCRIPTfON VALUE AT DATE OF
NUMBER DEATH
1 1800 Orrsbridge Road, Enola, PA 17025 (from assessment x 1.0 for the common level ration 156,000.00
for Cumberland County)
TOTAL(Also enter on Line 1, Recapitulation) 156,000.00
. i
u.o.uCrrirt�m�iv i ur nvv�uvu ana vrto�,iv ucv��urrn�i�i UMC IVO.'LbU'L-UGtib
SETTLEMENT STATEMENT TITLEPRO I
Brian C. Linsenbach, Esq.
B.TYPE OF LOAN
8 North Baltimore Street ❑1.FHA ❑2.FMHA �3.CONV.UNINS.
Dillsburg, PA 17019 ❑q.VA ❑5.CONV.INS.
6.FILE NUMBER: 7:LOAN NUMBER:
Phone t717)432-2089 Fax(717)432-0158 3�57 6BD0707657
MORT.INS.CASE NO.:
IOTE:This form is furnished to give you a statement of actual settlement costs.Amounts paid to and by the settlement age�t are shown.
Items marked"(p.o.c.)"were paid outside the closing;they are shown here for information purposes and are not included in the totais.
4t�tE AND ADDRESS OF BORROWER: E.NAME AND ADDRESS OF SELLER: F.NAME AND ADDRESS OF LENDER
ID A.LICKEL MEMBERS 1 ST FEDERAL CREDIT UNION
ORRS BRIDGE ROAD 5000 LOUISE DRIVE
�LA,P,4 17025 MECHANICSBURG,PA 77055
ROPERIY LOCATION: H.SETTLEMENTAGENT: BRIAN C.LINSENBACH.ESQ. I.SETTLEMENT DATE:
i ORRS BRIDGE ROAD PHONE: (717)432-2089 Jun 27 2013
iLA,PA 7 7025
Thursday
1PDEN TWP.,CUMBERLAND COUNTY PLACE OF SE?TLEMENT: 8 N.BALTIMORE STREET 04:00 PM
PARCEL#10-14-0837-010 DILLSBURG,PA 17019
l.SUMMARY OF BORROWER'S TRANSACTION K.SUMMARY OF SELLER'S TRANSACTION
Gross Amount Due From Borrower 4U0, Gross Amount Due to Seller
Contract sales price 401. Contract sales price
Personai Property 40Z. Personal Property
Settiement Charges(line 1400) 5,575.51 403.
PROBATE ESTATE FEES 15,082.36 404.
PAYOFF FIFTH THIRD . 29,385.20 405. �
Adjustments for items paid in advance 6y seller(s) Adjustments for items paid in advance by selier(s)
City/Town tax to 406. Ciy/Town tex to -
Counry/Citytex to 4D7. Couniy/Citytax to
Assessments to 408. Assessments to
School Tax to 4D9. School Tax to
to 410. to
to 411. to
to 412. to
Gross Amount Due from Borrower 50,043.07 420. Gross Amount Due to Seller 0.00
Amounts Paid By Or In Behalf Of Borrower 500. Reductions In Amount Due To Seiler
Deposit or earnest maney 501. Excess deposit(see instructions)
Principal Amount of new loan(s) BO,D00.0� 502. Settlement charges to seller(line 1400) 0.00
Existing loan(s)taken subject to 5Q3. Existing loan(s)taken subjedto
504. Payoff of Frst Mortgage Loan
CREDIT FORAPPRAISAL FEE(POC)(B) * 425.00
505. Payoff of Second Mortgage Loan
506.
507.
508.
509.
Adjustments for items unpaid 6y seller Acljustments for items unpaid by seller
Cit�r/Town tax to 510. City/Town tax to
Couniy/Citytax to 511. CountyJCitytax to
Assessmenis to 512. Assessments to
5chool Tex to 513. School Tax to
to 514. to
ta 515. to
to s�s.
co
517.
518.
519.
-otal Paid byJfor Borrower 80.425.Q0 520. Total Redudion in Amount Due Seller D.UO
;ASH AT SETTLEMEIVT FromjTo BORROWER 600. CASH AT SETTLEMENTToJFrom SELLER
aross amount due from borrower(line 120) 50,043.07 601. Gross Amount due Seller(line 420) 0.�0
ess amounts paid by/for borrower(line 220) 80,425.00 602. Less reduction in amt due seller(line 520) 0.00
:ash C1 FROM �TO Borrawer 30,381.93 603. Cash�TO ❑FROM Se'ller D.00
r or Borrower's Signeture Seller's Slgnalure
HUD-1
'ETTLEMENT CHARGES Case#3157
Total Reai Estate Broker Fees $ Paid From Paid From
Division of commission(line 700)as follows: 8orrower's Seller's
to Funds At Funds At
to Settlement Settlement
Commission paid at 5ettlement
to
�tems Payable in Connection With Loan
Our origination charge MEMBERS 1 ST FCU 455.00 (from(GFE#1)
. Your credit or charge(points)forthe interest rate chosen$ (from(GFE#2)
. Your adjusted originaUon charges to Members 1 st FCU (from(GFE A) • 455.00 0.00
Appraisal Fee to MEMBERS 1 ST FCU (from�GFE#3) 425.00
Credit Report to (from(GFE#3)
Tax Seniice ta (from(GFE#3)
Fiood certification to (from(GFE#3)
� to
to
to
. t0
t0
t0
t0
Items Required by Lender to Be Paid in Advance
Daily interest charges from 7/2/2013 to 8/1/2013 @ $ 7.6712 /dey (trom(GFE#10) 230.14
Mortgage insurance premiurrfor 0 months to (from(GFE#3)
. Hameowner's insurance premium foil years to GEICO INSURAhIGE (from(GFE#11} 713.00
. to
0. Reserves Deposited with Lender
1. Initial depositforyour escrow account (from(GFE#9) 447.86 0.00
2. Homeowner's insurance 4 Months @ S 59.42 /Month 237.68
3. Mortgage Insurance 0 Months @$ /Manth
4. Propertytexes 7 Months @$ 35.34 jManth 247.3B
5. SCHOOL TAXES 2 Months @$ 129.17 JMonth 258:34
6. 0 Months @$ JMonth
7. Aggregate Adjustment 1 295.54
0. Title Charges
1. Title services and lender's title insurance (from(GFE#4) 1,090.�0
2. Settlement or closing fee to Stone,DuncanBLinsenbach 75,00
3. Owner's titie insurance to Stone,Duncan&Linsenbach (from(GFE#�
4. Lender'stitleinsurance to FIRSTAMERICANTITLE 1,015.00
5. Lender's title policy limit $ B0,0�0.00
6. Owner's title policy limit $ 80,OOO.DO
7. Agent's portion of the total title insurance premium 752.00
B. Undervvriter's portion of the total title insurance premium 263,00
9. OVERNIGHT MAIL to UPS -� 50.00
0. DEED PREP. to Stone,DuncanBLinsenbach � 7 D0.00
1. to
J. Government Recording and Transfer Gharges
1. Government recording charges Recorder of Deeds (from(GFE#7) 168.OD
?. Deed $ 67.D0 Mortgage$ 107.00 Release$
3. Transfertaxes (from(GFE#8) 0.00
a. City/Couniytex/stamps Deed$ Mortgage$
5. State tax/stamps Deed$ Mortgage$ Recorder of Deeds
i. to
l. Additional Settlement Charges '
. Required services thatyou can shop for (from(GFE#6) 0.�0
'-. to
I. to
I. to
�. tD
�. 2013 Co./Twp.Taxes($424.03)813-14 Schoolto ,MICHAEL LANGAN,TA7C COLLECTOR 1.886.51
'. TAX CERTIFICATION to MICHAEL LANGAN,TAX COLLECTOR 10.00
i. Total Settlement Charges (enter on lines 103,Sections J and 502,Sections KJ 5,575.51 0.00
Parties agree that no liabiffty Is assumed by Settlement Ayent for the accurecy of information fw nished by others as shown on the HUD-1 Settlement StatemEnt.
ave carefully reviewed the HUD-1 Settlement Statemen d t the best of my knowledge and belief, it is a true and accurate statement of ail receipts and
bursements de on my a ount by me in this ns tion. I further certify that I have received a copy of the HUD-1 Settiement Statement.
� ` �"G � �..a...,/
�er orrower's Sig ature 5eller's Signature
�er's Address&Phone: Seller's New Address&Phone:
HUD-1 Settlement Statement which I have prepared is a true and accurate account of th' t ansa tion. f have caused or wili cause the funds to be disbursed in accordance with this
.ment. ,..-- �' ����
,�r'''..c�=..---�---
tiement Agent � Dat
RNING: It is a Crime to knowingly make false statements to the United 5tates on this or any similar form. Penaities upon conviction can include a fine and imprisonment For detalls
see Title 18:U.S.Code Section 1001 and Section 1 D10.
. �
Comperison of Good Faith Estimate(GFE)and HUD-1 charges Good Faith Estimate HUD-1
" Charges that Cannot Increase HUD-1 Line Number Loan# Title# 3157
Our origination charge #8U1 $ 455.D0 $ 455.00
Your crediycharge(points)forthe rate chosen #802 $ .00 $ .00
Your adjusted origination charges #803 $ 455.00 $ 455.00
Transfertaxes #12�3 $ .U� $ .00
Charges that cannot increase more than 10% Good Faith Estimate HUD-7
Government recording charges #1201 $ 238.00 $ 168.00
Appraisal Fee # 804 - $ 425.00 $ 425.00
# 0 $ .00 $ .00
# 0 $ .00 $ .00
# 0 $ .OD $ .00
# 0 $ .OU $ .�0
# 0 $ .OU $ .00
# p $ .00 $ .DO
Total $ 663.00 $ 593.�0
Increase betvdeen GFE and HUD-1 charges g -70.U0 QR n/a %
Charges that can change Good Faith Estimate HUD-1
Initial depositforyour escrow account #1001 $ 1.754.17 $ 447.B6
Daily interest charges # 901 $ 7.6712i $ 73.84 $ 230.14
Homeowner's insurance # 903 $ 450.00 $ 773.00
Title services and lender's titie insurance 11 D1 $ 1,110.88 $ 1,090.00
# 0 $ .0� $ .00
# 0 $ .DO $ .00
Loan Terms
Your initiel loan amount is $ 80,000.00
Your loan term is 30 years
Your initiel interest rete is 3.5 %
Your initiel monthly amount owed for $ 359.24 includes
principal,interest and any mortgage � Principal
insurance is:
� Interest
Mortgage Insurance
Can your interest rate rise 7 LX]No�Yes,it can rise to a maximum of 0 %.The first change
will be on and can change again every
after .Every change date,your interest rate can increase
or decrease by 0 io.Overthe life ofthe loan,your interest rate is
guaranteed to never be lower than 0 %or higher then 0 0.
Even paying on time,can your balance rise? [X�No�Yes,it can rise to a maximum of$ .00
Even if you make payments on time, �NoDYes,the first increase can be on and the
can your monthly amount owed for principal, monthly amount owed can rise to$ .00
interest and mortgage insurance rise?
The meximum it can ever rise to is$ .�0
Does your loan have a prepayment penalty? �NoDYes,your meximum prepayment penalty is$ .pp
Does your loan have a balloon payment 7 �No�Yes,you will have a balloon payment of$ .0�
due in 0 years on
Total monthiy amount owed,including escrow �You do not have a monthly escrow paymentfor items such as
taxes and homeowner's insurance.You must paythese items yourself.
�You have an additional monthly escrow payment of$ 223.93
That results in atotal initiai monthly amount of$ 583.17.This includes
principal,interest any martgage insurance,and items checked below.
LX]Propertytaxes �Homeowners Insurance
�Flood insurance �
a
Note: If you have any questions aboutthe Settlement Charges and Loan Terms on this form,please contadyour lender
Previous editions are ohsolete Page 3 of 3 HUD-1
REV•1517 EX+(10-09)
� pennsylvania SCI-EpULE H
�� DEPARTMENT OF REVENUE L7 11�CpA� CypC�k.C�. w.,D
ra���rV�1L v�—�IV�c�714n
INHERITANCE TAX RETURN
RESIDENT DECEDENT �q��'1�T�/'+IY�T+L+
VW la7
ESTATE OF Sydnor, Edith R FILE NUMBER
21 - 13-00371
DecedenYs debts must be reported on Schedule I.
ITEM
NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT
A• 1 Suifivan Funera� Home 2,689.51
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
C��' State Zip
Year(s)Commission Paid
2. Attorney's Fees Stone, Duncan & Linsenbach, PC 5,825.05
3. Family Exemption: (if decedenYs address is not the same as claimanYs,attach explanation)
Claimant Lyndon LiCkel 3,500.00
StreetAddress 1800 Orrs Bridge Road
City Enola State PA Zip 17025
Relationship of Claimant to Decedent SOfI
4. Probate Fees Register of Wilis 133.50
Register of Wills 210.00
5. AccountanYs Fees
6. Tax Return Preparer's Fees
� 7. OtherAdministrative Costs
1 Administrative Reserve 300.00
TOTAL(Also enter on line 9, Recapitulation) 12,658.06
'
�� �LTLLIVAN FUNE RAL HOME John C. Sullivan, Director
51 N. Enola Drive
Enola, PA 17025
�` `'l; g. h t 'l j2 g ,y O I,G � w a y phone: (717 732-5400
)
Fax: (717) 732-2162
STATEMENT OF FUNERAL C',OODS AND SERVICES SELECTED
Charges are only for those icems that are used.If we are required by law to use any icems,we will explain in wriHng below.
If you selected a funeral which required embalming,such as a funeral with viewing,you may have co pay for embaiming.You do not have to
pay for embalming you did not approve if�.you selected arrangemenes such as a direct ccemation or immediate burial.If we chazged for
enbalming,we wtll exglai�,why below:,-°' -, -
� : ,,, � �;': , � '� , �
For the Service of ''` '`` ' ' " Date of Death °
.
, ,,._
Charge to: .. , ., . . , ;,.,. .
Name Address City State
A.CHARGE FOR SERVICES SELECTED: Other clothing
1. Professional services � �
ServiceS of Funeral Director/Staff � $
Embalming $ Cremadon um.. $
Olher preparation of body :...................
Cosmetology, dressing and casketing $ ���+ptton)
Sanitary care when embalming is not elected— $
Dressing and placing in cesket ar $ �T�R $
altemative cotttainer only $
SU&TOTAL OF PROFESSIONAL SERVICES .. $ $
2. Faciltaes and equipment TOTAL MERCHANDISE SELEGTED...,....., $ " ''
Use of fadlities for viewing G 3PECIAI.CFiARGFS:
(Visitation/Weke).................. $ Forwarding of remains to
Use of faciliries for funeral ceremony .... $ $
Use of administrarive areas,reception (Funeral Home}
areas and arrangement rooms......... $ Receiving of remains from
Use of Preparatton room.............. $ $
Other use of facilides (Funeral Home)
Immediate Burial:............... .. $
DirectCremaaon ................... $ "
............................. ... $ $
, :'
SU&TOTAL OF FACIL.IZTFSIEQUIPMENT ... $ SUB TOTAL OP SPECIAL CHARGES ...,..... $ : '
3. AUTOMOTiVE EQUIPMENT D.CASH ADVANCED
Vehide to transfer remains to Funeral Home. ,.,n ,,. Opening Grave ..................... $
Local.............................. $ Cemetery Equipment ..............,, $
Hearae(Casket Coach) Lot and Deed....................... $
Local.............................. $ Newspaper NoHces-Local ............. $
Limousine N�wspaper Norices-Out-of-Town......, $
L.acal...... ..................... $ Telephone 6L Telegrams ...,.......... $
Familycar Airfare ............................ $
Local.............................. $ Clergy/Mass Offering..............,. $
Flower caz or floral disposition Pallbearers ..•.....................::... $
-�TT
��,,,,,,,,,,,,,,,,,,,,,,,,, ,, � Cerrified Copies of the Death Certificate. $ '
Lead car/ciergy car Police Escort........................ $
Local... .......................... $ Flowers............,.............., $
Car for pallbeazers VaultServiceCharge ................ $
I..ocal.............................. $ $
Out of town transportarion ........... $ $
$ $
$ $
SUB-TOTAL OF AUTOMOTIVE EQUIPMENT $ - �
$
TOTAL OF PROFESSIONAL SER'VICES� SUSTOTAL OF ADVANCES ................. $
FACILITtES AND AUTOMOTIVE
EQUIPMENT................................ $ SUMMARY OF CHARGlS
A.Professional 5ervices,Facilities and
B.CHARGE FOR MERCHANDISE SELECI�D: Equipment,and Automodve Equipment ... $
Casket ............................ $ B: Merchandise ............,...... .... $
(Description) C.Special Charges........................ $
� ` :.,-r
Ocher Receptac�e..... .... ..... $ D. ..................... �
Cash Advances.. $
TOTAL OF ALL SELECTiONS . ......,..... $
, �:
, ...
(����A�n? PAID AT TIME OF OR PRIOR TO
, . ,. •
` � '� ,` , ARRANGEMENTS...... $
Ou�er burial container ............... $ BALANCE DUE ..,....... .................. $
(Description) . ...............
REASON EO�,t EMBALMING
Acknowledgement cards.............. $
;#,...�m..� ,.��a�,.
Register book(s) ...................... $ +'' If any law,cemetery,or crematory requirements have required the
- � nurchase of any of the items listed above the law or retXuirem�nt is
lvtemory folders . ••• $ ocplained below.
Prayer cards .. .... .... .,.... $
Temporary grave marker.............. $
Burial clothing...................... $
I hereby agree that I have examined the abave stated items and found them to be correct and according to the arrangements requested and I
hereby acknowledge receipt of a copy of this memorandum and agreement. I hereby represent that I have sufficient assets legally available for
payment of the cash price and hereby agree and covenant jolntly and severally ro make payment of$ within days.
A late charge of per month amounting to per year is applied to the unpaid balance beginning deys from the
date of thia agreement Any additional services or merchandise ardered or requested after the date of this agreement will be,considtr�d part of
this agrecment and:the cost theceof will,.br`reflected on the final statement.
,.
,: ., .
(Seal)
, . .,. . .
, � ,,,...
(Purchastc) - (Dace)
, ,. ,.
(Seal) ., ,,., ,._,. .
(Pucchaser) (Licensed Funeral Director)
0 Pmcuylv�ni�Funm'I Diracon Au«i�tion �
I
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=�f.: pennsylvania SCHEDULE I
�= DEPARTMENT OF REVENUE -
INHERITANCETAXRETURN DEBTS OF DECEDENT, MORTGAGE
RESIDENTDECE�ENT LIABILITIES � LIENS
FILE NUMBER
ESTATE OF Sydnor, Edith R 21 - 13-00371
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ITEM DESCRIPTION AMOUNT
NUMBER
1 Michael Langan, Treasurer(county and township tax) 424.03
2 Fifth Third HELOC Loan Payoff#858958556 29,385.20
3 Fifth Third payment 100.00
4 Fifth Third payment 200.00
5 West Shore EMS 1,022.66
6 Lower Allen EMS 150.00
7 Pinnacle Health Med Svcs 581.00
8 Pinnacle Health Hospital 400.00
9 Pinnacle Health Med Svcs 281.00
10 Special Event Emergency Medical Services 257.46
11 Pinnacle Health Med Svcs 862.00
12 Michael Langan (per capita) 11.00
13 Appraisal fee Members 1 st 425.00
14 Members 1st origination fee 455.00
15 UPS 50.00
16 Stone, Duncan & Linsenbach deed prep 100.00
TOTAL(Also enter on Line 10,Recapitulation) 34,714.35
RECEIPT FOR PAYMENT
GLENDA FARNER STRASBAUGH Receipt Date : 4/02/2013
Cumberland County - Register Of Wills Receipt Time : 11 :15 :45
One Courthouse S quare Receipt No. : 1073638
Carlisle, PA 17013
SYDNOR EDITH R
Estate File No. : 2013-00371
Paid By Remarks : DAVID A LICKEL
CJ
------------------------ Receipt Distribution ------------------------
Fee/Tax Description Payment Amount Payee Name
PETITION LTRS TEST 30 . 00 CUMBERLAND COUNTY GENERAL FUN
WILL 15 . 00 CUMBERLAND COUNTY GENERAL FUN
SHORT CERTIFICATE 25 . 00 CUMBERLAND COUNTY GENERAL FUN
JCS FEE 23 . 50 BUREAU OF RECEIPTS & CNTR M.D
AUTOMATION FEE 5 . 00 CUMBERLAND COUNTY GENERAL FUN
INH TAX RETURN 15 . 00 CUMBERLAND COUNTY GENERAL FUN
INVENTORY 15 . 00 CUMBERLAND COUNTY GENERAL FUN
RENUNCIATION 5 . 00 CUMBERLAND COUNTY GENERAL FUN
----------------
Check# 493 $133 . 50
Total Received. . . . . . . . . $133 . 50
WEST SHORE EMS - ALS —
205 GRANDVIEW AVE � �f� �°������ �Se
CAMP HILL, PA 17011-1708
�,�VEST SH�RE E���
Phone #: (800) 367-0512 Federal Tax ID: 23-2463002 ON REVERSE SIDE
OHOLY SPIRIT HEALTH SYSTEM �
PATIENT NAME: EDITH SYDNOR INSURANCE: PALMETTO GBA REJ
TODAYS OPTIONS/AMERICi g
CALL NUMBER: �ZZO�T92A DATE OF CALL: �2�02/2012
HEALTH SOUTH REHAB
FROM:
To: HARRISBURG HOSPITAL
ACCOUNT SUMMARY
EDITH SYDNOR
1022.66
1800 ORRS BRIDGE RD TOTAL CHARGES: 0.00
ENOLA, PA 17025 PAYMENTS/ADJUSTMENTS: �'"
PLEASE PAY THIS AMOUNT: 1022.66 ,�-,
�r
{�
DETACH ALONG PERFORATION AND RETURN STUB WITH PAYMENT
RETAIN THIS PORTION FOR YOUR RECORDS
t.. Ca7lt'fE1U�NT-'Q�TE:;.'. PAYJUENT DRl'�;. _ ' . .fi12EL�1T�,�NE ,.,. ;°"` .:A1��t�f.A�L£=�REC31T'" IVpNINIIlI�PAYNENT`.t3UE_:
01J29/13 02I25t13 30,000.00 670.87 93.45
_. _ . _
SUMMARY
HISTORY SUMMARY
DATE DESCRIPTION OF TRANSACTIONS,ADVANCES,PAYMENTS,AND CREDITS AMOUNT
01123113 PAYMENT 700.00 CR
INTEREST RATE SUNMARY
ANNUAL PERCENTAGE DA�LY AVERAGE DAYS FINANCE
ACCOUNT RATE PERIODIC RATE DAILY BALANCE IN CYCLE CHARGE
LINE OF CREDIT 3.750000 0.0102739 29,346.82 31 93.45
ACCOUNT SUMMARY
PREVIOUS ADVANCES PAYMENTS NEW NANIMUM
ACCOUNT BALANCE AND DEBITS FINANCE CHARGE AND CREDITS BALANCE PAYMENT DUE
LINE OF CREDIT 29,429:13 0.00 93.45 100.00 29,422.58 93.45
C��3�I��" Ri� �t1�fl�M�E� Ft�II���� �?A�'Nl��+I'C� `l�lEl�l � �l�i�il[ArJI�
;
� ��LA�iG� �id►l�1������ �i �€�11�C3� :�td�f�R�tal�°� �iAi�i4�IC� A'l�l4i�#�,T�UE
� .�„ < - � ; � �� 4 � _ �
f �. � ��
0085895$556 29,429.13 0.00 93.45 100.00 29,422.58 93.45
TRACK YOUR EQUITY LINE REWARDS POINTS AT WWW.FIFTHTHIRDREWARDS.COM OR CALL 1-800-972-3030 FOA�INFORMATION.
NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION.PAYMENTS OF AMOUNTS DISPUTED IN WRIT�G ARE NOT
REQUIRED PENDING BANK'S COMPLIANCE WITH THE PROVISIONS OF REG.Z-226.13 AS AMENDEO.
EQUITY LINE STATEMENT CUSTOMER SERVICE: 1-800-973-3030
BILLING INQUIRY ADDRESS: 5050 KINGSLEY 1MOC2J,CINCINNATI OHIO 45263
Fifth Third Equity FlexlinesM 'O`��
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� ��
RETAIN THiS PORTION FOR YOUR RECORDS
_; "'� ATENIENT:;[iA .�: : ;;F'AYNEN�`�3tTE: `��tBF�IT`Lil��. - ; :AVAIL.ABC�;�ttEfiil'�` ,.IVN�Illfllll[iNP�kYMEN Ot1�
02/2617 3 03125l13 30,000.00 670.87 ��7•$2
5UMMARY
HISTORY SUMMARY
DATE DESCRIPTION OF TRANSACTIONS,ADVANCES, PAYMENTS,AND CREDITS AMOUNT
02/26/13 NO ACTIVITY
INTEREST RATE SUNMARY
ANNUAL PERCENTAGE DAILY AVERAGE DAYS FINANCE
ACCOUNT RATE PERIODIC RATE DAILY BALANCE IN CYCLE CHARGE
LINE OF CREDIT 3.750000 0.0102739 29,329.13 28 84.37
ACCOUNT SUMMARY
PREVIOUS ADVANCES PAYMENTS NEW 111�NIMUM
ACCOUNT BALANCE AND DEBITS FINANCE CHARGE AND CREDITS BALANCE PAYMENT DUE
LINE OF CREDIT 29,422.58 0.00 84.37 0.00 29,506.95 84.37
**PAST DUE*" 93.45
TOTAL DUE 177•82
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TRACK YOUR EQUITY LINE REWARDS POINTS AT WWW.FIFTHTHIRDREWARDS.COM OR CALL 1-800-972-3030 FOR INFORMATIO
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�' NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION.PAYN�NTS OF AMOUNTS DISPUTED IN WRITING ARE NOT
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° EQUITY LINE STATEMENT CUSTOM1f�R SERVICE: 1-800-972-3030
N BILLING INQUIRY ADDRESS: 5050 KINGSLEY 1MOC2J,CINCINNATI OH10 45263
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TAX PAYER'S "OPY- KEEP THIS PORTION FOR "'�UR RECORDS
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Payable To: MICHAEL LANGAN,TREASURER Office Hours:MAR-OCT: M,T,TH 9�t:30PM Bill No: 16496
MAR-APR:THURS 6-8PM Bill Date: 3/1/13
230 SOUTH SPORTING HILL ROAD CLOSED WED,FRI 8 HOLIDAYS Control No:10-013844
MECHANICSBURG,PA 17050 EXCEPT FRI JUNE 28 OPEN 9�:30PM
PHONE(717}737-4822 OCC
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIII IIIII�II Discount Face Penalty
COUNTY PC $4.90 $5.00 $5.50
MUN PC $4.90 $5.00 $5.50
Tax Payer:
EDITH SYDNOR TAX AMOUNT DUE $9.80 $10.00 $11.00
1800 ORRS BRIDGE RD If Date of Payment is on 3/1l13 thru 4130/13 5/1113 thru 6/30/13 7l1113 or Later
ENOLA PA 17025-1422
TAX INSTRUCTIONS - READ CAREFULLY
If you require an official receipt,send your check,two copies and a self-addressed stamped envelope.
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If not paid by 12/17/2013 this bill will be submitted to a coliection agency for delinquent collection. �'�
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Failure to receive a bili does not relieve you from liability for prompt payment.
No partial payments or postdated checks will be accepted and payment must be received or U.S.post marked by the due date.
7�os��ou/
MICHAEL LANGAN,TREASURER T�C PAY E R'S G�PY
230 SOUTH SPORTING HIIL ROAD
MECHANICSBURG,PA 17050 KEEP THIS PORTiON FOR YOUR RECORDS
TEMP -RETURN SERVICE REQUESTED
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039422"'""*""'*""'"=""AUTO""5-DIGIT 17025
LICKEL,DAVID L�EDITH R i IIIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII IIII
GIO EDITH R SYDNOR
1800 ORRS BRIDGE RD
ENOL.A PA 17025-1422
Ta review the assessment data for this property, go to:
www.courthouseontine.com>AssessmentOffice>Cumberland>PropertyRecords.
Then enter control# 10000292 and password CUHBAZEB
_...................._......................................._............................................................ ........._......................_......__...._.................................................._...........__.... ....___.......................... .......
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Payable To: MICHAEL LANGAN,TREASURER Office Hours: MAR-OCT:M,T,TH 9-+4:30PM
230 SOUTH SPORTING HILL ROAD MAR-APR:THURS 6-8PM
MECHANICSBURG,PA 17050 CLOSED WED,FRI 8 HOLIDAYS
EXCEPT FRI JUNE 28 OPEN 9�:30PM Bill No: 6120
PHONE(717)737�t822 Biil Date: 3/1113
Control No: 10000292
MAP NO: 10-14-0837-010.
Desc: �g00 ORRS BRIDGE ROAD Assessed Value: Land:64,000 Improvement:110,500 Totai: 174.500
8 LULA LANE Discount Face ena ty
LAND APPROX 1 ACRE CountV RE 2.131 $364.42 371.86 409.05
Acres 0.7fi Deed 0095T00357 County Lib 0.743 $24.45 $24.95 $27.45
' Munic.R/E 0.156 $26.68 $27.22 $29.94
$1.00 FEE FOR ADDITIONAL RECEIPTS
Tax Payer: _„_.�
LICKEL,DAVID L 8 EDITH R TAX AMOUNT DUE
C/O EDITH R SYDNOR $415.55 $424.03 �; $466.44
1800 ORRS BRI�GE RD If Date Of Pa ment is on 3l1N3 thru 4/30/13 5/1/1�thr /30113-``7/1113 or Later
ENOLA PA 17025-1422
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Piease R�rnit Paymenf To:
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Special Event Emergency Medical Services Ir
Billing Office 12-230045 4/25/2013 $257.46
PO Box 726
New Cumberland, PA 17070-0726
QUESTIONS ABOUT THIS BILL? Phone: 877-214-6018 Espanol: 866-724-4114 Fax: 717-214-6020 Email: info@ambulancebillingoffice.com
Date of Service: 12/1'V2012 17:26 Please visit our website to provide insurance or make payment, and
Patient Name: SYDNOR, EDITH E. for additional payment options and frequently asked questions:
From: PinnacleHealth Hospitals www.ambulancebillingoffice.com
To: HOSPICE HOUSE
• • .
******* This account es Past I3ue ******* I'our account remains unpaid despite o�r previous l5rlling requests. Your >
account is r�ow under coZlectzon Yeview and:may be forwarder�to our cotlection ager�cy if this bitl remains unresolved.
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12/11/12 Mileage A0425 7.4 7.50 55.50
12/11/12 Adjustment-Insurance -260.56
3/04/13 Adjustment- Insurance 1.61
Total 516.41 -258.95 0.�
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DETACH AND RETURN BOTTOM PORTION WITH YOUR PAYMENT.
PINNACLE HEALTH MED SVCS
PQ BDX 1286 05/07l13
HARRISBURG PA I?�08-1286
RE:PINNACLE HEALTH MEDICAL SERVICES OUTSTANDING BALANCE
ACCOUNT NUMBER: 13162197
TOTAL AMOUNT OUE: 5862.00
EDITH SVDNOR
1800 ORRS BRIbGE RD
ENOLA PA 1?025
DEAR EDITH SYDNOR GUID: 13162197
ACCORDIMG TO DUR RECDRDS, YOUR ACCOUNT IS PAST DUE. TO AVOID
FURTHER COL�ECTIOM EFFORTS, PAYMENT IN FULL MUST BE RECEIVED
IMMEDIATELY. IF YOU CHOQSE TO PAY BY' CREDIT CARD, COMPLETE THE
CREDIT CARD SECTION BELOW.
IF YOU HAVE AMY CONCERNS REGARDING THIS ACCOUNT BALAMGE, IT IS
IMPDRTANT YOU CONTACT OUR BUSINESS OFFICE AT 717-231-8960 OR
1-800-565-6229.
SINCERELY,
PINNACLE HEALTH MEDICAL SERVICES
CIRCLE ONE: VISA MASTERCARD DISGOVER
ACCOUNT�:---------------------CVV:-----EXP.DATE:-------------- 1,
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CARDHOLDER NAME CPLEASE PRINT) :----------------- > ,
SIGMATURE: �
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AMOUNT PAID:-------------------------------------------------- �°�
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STATEI►��'N�' 4F MEDICAL SER YICE,
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LAST StATEMENT DATE: 04/09/13
?�a� NEi! GHAR6ES: 50.00
��;��.;�.��°�'L��i.��3 NEM P�YNENTS: 50.00
������` NEM AD,JUSTMENTS; 90,00
IMlSt1RANCE BALANCE: S2115.00
YOUR BALANCE: 4281,00
If MY Qusstions, Pleaso Contact: PFMS AT 71T-231-8960 OR 1-SDO-565-6229
�- ED�T"It ��'�lNO�t AGCG��NT: 1'.E1di�'14'7; Q�l���I,3 • :
. FED TAX ID • 2517D9054
INSURAI�E YOUR
CNAR6E PAYMENfS AD.1L�Si?IENTS BAL/U�CE BALpNCE
y» PATIENT: EDITH SYUNOR
iP 120212 121112 12l0?l12 'ID 12/11/12
PERF�Iil�D AT: HARRISBUI�6 HD6pITAL
PERFQpMED BY: 1�6PITALiST AT C60H
12102f12 IMITIAL f�PITAL CAR LVL2 262.00 262.00
Pi�GEOURE: 99222.6C DIA6�SIS: T80.47
PERFORMED BY: NEUROLOG}f AS,SOC ptl1S
12/D2l12 INITIAL INPT CONSULT LYL2 144.00 1,�.�
PROCEOURE: 94252 DIA6MD6IS: 348.30
PERFORMED BY: FpSPITALIST AT C60H
12lD3✓12 SIAsEQUENT 1qSp GARE LVL3 147.00 14�.00
PROCEOURE: 99F33 DIA6NOeIS: 780.97
PERFOI�D BY: PH SR6 ASSOG FIEST
12/03/12 INlTxAL FqSPITAt CAR LVLl lg,qi,_Qp ����a
PROGEDURE: 992F1.6C OIA�6FIDSIS: 922.0 .�.
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PERFORMED BY: PALLYATIVE GARE '
12/�3J12 IHITIAL INPT CON5l1LT LVL3 �'��.
219.00 219.OD �.,�fj
� PROGEDURE: 99253 DIA6Np�IS: 783.7 .
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Please detach a�return with your peyme�rt
• . _ • -
PI lV�'�IAC i.E H EALTH YOUR ACCOUNT IS CURRENTLY DUE.
H�SPI 1 AL�7 GRATEFULL�Y APPRECIATED. �ULD BE
Financial assistance is available for the uninsured
or underinsured who apply and qualify. For more
information,please catl or see our website at
www.pinnaclehealth.org/6illpay.
EDITH SYDNOR
1800 ORRS BRIDGE RD For Account Information,
ENOLA PA 17Q25-1422 Please Call Customer Service (71�230-3717 or
1-800-603-6064 for Out of Area Calls.
See details on the back of this statement.
If payment has been serrt, please disregard.
Pay online at:
https:llbillpay.pinnaciehealth.org
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Patient Name: Sydnor,Edith Total Charges; 538,397.40
Statement Date: 03/06/13 Payments/Adjustments: 537,947.40-
Service Date(s): 12/02/12-12/11/12 Account Balance: 5400.00
Account Num6er: 130180456 Patient Balance: 5400.o0
Primary Diagnosis Code: 434.91 Please Pay TMis Amt: �400.00
. . �
Ins. 1:T�DAYS OPTION .00 For questions, call our Billing Help line at:
Ins. 2: MEDICARE A .00 717-230-3717 for local calls or
Ins. 3: 1-800-603-6064 for Out of Area.
Ins. 4:
Customer Service Hours:
o Mon-Wed-Fri 7:00 AM to 4:00 PM
� Tues-Thurs 7:00 AM to 6:00 PM
T
Please Note: Your physician wil!bil/separately for prof+essiona/senrices.
_--------------_________--------__---------___------------------..�_____----------
Make Checks Payable To: PinnacleHealth Hospitals AccauM NumAer: Pleaee Pay This AmnwR:
1301804.56 ��� �}
atis�n Name: Ye :
I 18111INII Ulll lpll Ilpl Illn Illll llle 111111111 Ifll S dnor,Edith U on Recei t
PinnacleHealth Hospitals .s..
� PO Box 2353 � � ❑ ❑ ��` ❑
H8T1'isburg PA 17105 Card Num6er cwz NoR E�.Data:
Signature: Amowrt Paid:
❑ Check 6ox it your addresc nr insurance information
has changed. P16ace make changes on Oacic. "T�e CW2 Number is the last S digrte on the 6ack of our eredit caM,
Y by Your signature
DODD2888 001 0.53
EDiTH SYDNOR
1800 ORRS BRIDGE RD
ENOLA PA 17025-1422 PINNAGLE HEALTH HOSPITALS
P.O. BOX 2353
HARRISBURG, PA 17105-2353
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O�OOU1301804560000004�0�000�04�008 � t `�
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Lower Allen Township '�����E
Eanergency 1Viedical Service
'233 Gettysburg Road•Camp Hill, PA 17011
Phone (717)975-7575 INVOICE#: 121114 6
Tax#23-6005253
DATE: Ol/28/13
BILLTO: PATIENT: EDITH R SYDNOR
EDITH R SYDNOR
1800 ORRS BRIDGE RD
ENOLA, PA 17025
ACCOUNT#,: 060052733 TRIP#: 1211146 DATE OF SERVICE: 12/02/12
PATIENT PICKED UP: 175 LANCASTER BLVD (17055)
PATIENTTAKENTO: HARRISBURG HOSPITAL
DESCRIPTION OF ILLNESS/INJURY:
PATIENT TRANSPORTED FOR (255. 41) , (959. 01) , (7$7,p3) , (7g6.05)
DESCRIPTION UNIT COST QTY. AMOUNT DUE
A0429 600 . 00 1. 0 600. 00
A0425 14 . 00 8. 1 113.40
All Delinquent Accounts Will Be Re orted To Th �redit Bu aus.
Collection Costs Will Be Added To Afl Delinq ent Invoic s.
COMMENTS: BALANCE DUE AFTER INSURANCE PAYMENT SUBTOTAL
713.40
PAYMENT FOR SERVICE IS DUE BY 02-28-13 AMOUNT
PAID 563. 40
PLEASE RETURN SECOND COPY WITH YOUR PAYMENT 7'HA1VI� I'OU TOTAL 150.00
(Checks may be made payable to Lower Allen EMS)
Terms: Net 30 ;�;'`,�
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►STATEh2LNfi OF MEDICAL SERYICES
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LAST STATENENT Wl'tE:
NEN Gt1AR6E5: 52977.00
���'�'�`'���-�������' NEM PAYMENTS: 50.00
�����°� NEN AD.JUSTMENiS: #0.00
INSURANCE BALAl10E: 52396.00
YOUR BALANCE: 5581.D0
If Any Quastfons, Pleas� Contact: PFMS AT 717-231-8460 OR 1-8D0-565-6229
-� �EO�T� ��ort �x�cc�t��t'�: �:�1�,��9'� ._v�r��,r�,:
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FED TAX ID i 25170
It�lSIJRAP�E Y01
CHARi6E PAYMEM"S AD.A�.S'If�IENTS BALAI�E BI�IJ
y» PATIENT: EDITH SYDI+qR
IP 120212 121112 12/02J12 TD I2/lIl12
PERFOISIED AT: 11RRRI5BUR6 HOSPTTAL
PERFORMED BY: FqSPITALIST AT C60H
*12/07J12 INIT'IAL HDSPITAL CJIR LYL2 F62.00 2b2.00
PRDGEOURE: 49222.6C DIA61�6IS: 780.47
PERFORMED BY: I�URDLOGY AS.SOC PFMS
*12lt12/12 INITIIIL INPT CONStJLT LVL2 144.00 144.00
PROCEOURE: 49252 DIA6N4SIS: 348.30
PERFORMED BY: H06PITALIST AT C60H
*12/03f12 SL�SEQUEFR H06P CARE LVL3 147.00 147.OD
PROCEUURE: 99233 DIA6PD,SIS: 780.97
PERFORMED BY: PH Si� AS.SOC I+IEST
*12ld3I'12 INTTIAL FiQSPITAL CAR LVLl 144.00 194r.00
PitDGEDURE: 99221.6C DIAGNOSIS: 422.Q
PERFORMED BY: PALLIA7IVE CARE
*12lD3/'12 IFIITIAL INPT CONS[JLT LVL3 219.00 219.00
�, PROCEUURE: 99253 DIA6MDSI5: 783.7
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-' PAGE l OF
Pleasa detaeh and return with yvur paymetrt
REV•1513 EX+�p�_�0)
� pennsylvania
�� ` SCHEDULE J
' DEPARTMENT OF REVENLJE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT �
ESTATE OF FiLE NUMBER
Sydnor, Edith R I
21 - 13-00371
NUMBER NAME AND ADDRESS OF PERSON(S) RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF EST�
RECEIVING PROPERTY DECEDENT (Words) ($$$�
Do Not List Trustee(s)
I, TAXABLE DISTRIBUTIONS[include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2)]
1 David Austin L. Lickel Grandson 100% of Real Estate
1800 Orrs Bridge Road
Enola, PA 17025
2 Kevin L. Lickei Son 50%of Residue
2045 Good Hope Road Estate
Enola, PA 17025
3 Lyndon I. Lickel Son 50%of Residue
1800 Orrs Bridge Road Estate
Enola, PA 17025
Enter dollar amounts for distributions shown above on lines 15 through 18 on 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
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET O.)
� pennsylvania
-��� SCHEDULE E
DEPARTMENT OF REVENUE CASH
. INHERITANCETAXRETURN , BANK DEPOSITS AND MISC.
RESIDENTDECEDENT . PERSONAL PROPERI 1
FILE NUMBER
ESTATE OF Sydnor, Edith R 21 - 13-00371
Inciude the proceeds of litigation and the date the proceeds were received by the estate.All property jointly-owned with the right of
survivorship must be disclosed on schedule F.
ITEM DESCRIPTION VALUE AT DATE 01
NUMBER DEATH
1 Personal Prope�ty 9,630.00
2 Lincoln Mk 8 1997 800.00
TOTAL(Also enter on Line 5,Recapitulation) 10,430.Oa
�� ��� � Customer Receipt Please be sure to enter this
transaction in your records.
Transaction Date Amount
Description Account Number
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Funds from your deposit may not be available for immediate withdrawal.All transactions are subject to
2zoes-BUNKER s/os 1M/PK verification as outtined in the rules and regulations of the Bank.
Member FDIC
REV-1649 EX+(09-12)
��.:� pennsylvania SCI-EDULEO
` DEPARTMENT OF REVENUE �T�un�t 'JGC.9113(A)
illli�l
INHERITANCE TAX RETURN �c��w, ����
RESIDENT DECEDENT ��r���rar��
ESTATE OF FILE NUMBER
Sydnor, Edith R 21 - 13-00371
PART A - DEFERRING STATEMENT
For all trust assets reportable for Pennsylvania inheritance tax purposes for which a deferral of tax is being elected under
Section 9113{a),the personal representative responsible for filing the return and the trustee(s)of the trust in question hereby
acknowledge the departmenYs Statement of Policy set forth at 61 Pa. Code§94.3 concerning any potential termination of the
trust under 20 Pa.C.S. §7710.1 that occurs after the return was filed. Specificaliy,the signatories recognize each individual's
assumption of liability for inheritance tax consequences that result from any termination of the trust under 20 Pa.C.S. §7710.1
that occurs after a return has been filed.
Signature of Person Responsible for Filing Return Signature(s)of Trustee(s)
PART B - ELECTION TO TAX AMOUNTS
Complete this section only if making the election to tax available under Section 9113(a) of the Inheritance 8�
Estate Tax Act.
If the election applies to more than one trust or similar arrangement,a separate form must be filed for each trust. This election
applies to the Trust(marital,residual A,B,bypass,unified credit,etc.).
Enter the description and value of all interests for which the Section 9113 (A) election to tax is made.
DESCRIPTION VALUE
Total 0.00
(If more space is needed, insert additional sheets of the same size)
, STONE, DUNCAN,
&LINSENBACH, PC
Attorneys and Counselors The Key to Great Legal Services sM
www.StoneDuncan.com
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August 30, 2013 � �t ��� n-- �
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Re ister of Wills `^' �' i�'= � �.i �-�
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Cumberland County Judicial Center ` ...�'.i r�, r�=•� ``:�
1 N Courthouse Ave a cn G, c:.,
Carlisle, PA 17013 �� T�
RE: ESTATE OF EDITH R. SYDNOR
D/D: DECEMBER 23, 2012
ESTATE FILE # 21-13-00371
Dear Register:
Enclosed please find the following:
- Original Inheritance Tax Return with the attached checks;
1 check in the amount of$230.00 representing the additional probate fees
1 check in the amount of$5,357.59 representing the taxes due
- 2 Copies of the Same;
- Pre-stamped envelope
Please file the original, time-stamp the copy, and return it to me in the enclosed self-addressed,
pre-stamped envelope. If you have any questions or concerns, please feel free to contact my
office. Thank you for your time and consideration.
Thank you for your attention to this request.
Very truly your
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Duane P. Stone, squire
DPS/aaz
Main OfficeEnclosures
8 N. Baltimore Street Duane P. Stone Alina M. Dusharm 5441 )onestown Road
Dilisburg, PA 17019 Jason B. Duncan' Michael A.Trimmer" Harrisburg, PA 17112
oFF�cE 7U-432-2089 Brian C. Linsenbach Lam D.Truong" oFFicE 7U-412-7787
FAX 717-432-0158 `Also licensed in New lersey "`Harrisburg Office FAX 7U-432-0158
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