HomeMy WebLinkAbout09-18-13 (2) � 1505610105
REV-1500°`{�-",�"�f
PA�epartment of Revenue � �F���USE ONLY
Bureau af Individuat Taxes �+��/Code Year F�e Numhar
po Box aeo6o3 �NHERITANCS TAX RETt1RN 2� �� / j �j
HaMSbura PA i i'�28-o6oi RESIQE#tT RECEDEAIT �/ °
ENTER DECEDENT INFORMATION BELOW
Sodai Security Nur� Date of Death MMH7DYYYY pate uf BiNr MMDDYYYY
� 01/27J2013 08/d3N927
DecedenYS Last Name Suffix decederrt's Firsf Na� Mi
RoupM Harold A
{if Appik�j Eerter Survivu�g 8parse's kdomyatian 8elwv
5pousds tast Name 3uffix Spouse's Pirst Name Mi
Spousc's Social Securiry Number THl3 R�TURN MUST BE FILEp IN DUPL.NCA7E WITH THE
REGISTER OF WI�LS
F141 IFt AP�OPRtATE OVAi.S BE40W
� 1. Originat Return O 2.Suppfemantal ftetum p 3. Remaintler Retum(DaM of Deeth
Priorto 12-13-82)
O 4. Limttetl Estate p 4a. Future fnterest Compromise(date af p 5. Fetlerai Eatate Tax Retum Required
. deeiti efter t2-12-82}
� 8.Decedent Died TBSfate p 7.Decedent Ma�tained a Living Trust � B. Total Number at Safe paQosit Boxes
(Attach Copy of Will) �Attach Copy of Trust.)
Ci 9.L@igstion Proceeds Recelved p 10.Spousal Poverty Credft(Date of Oeath Q 11.Eiectioo ta 7a�c under Sem 9'113(Ay
Beiwean T2-31-91 and t-t-9fi) (AUach Schedule O)
CORREEPONDEMT- THIS 38CTpN MUST BE COMPLETED.AlL CORRESPOpDENCE AN�CONFl6ENTULL TA%&�IFDRMATqN 3HOULg�D�tECTEQ T0:
Name Qaytlme Talaphone Number
Jaseph E. Fink Jr. 717-018{�80
x
R80HC'J' '�}F WIL.L$4tR'N.:'.�
R7 _
� _:� r_
First Line of Address � `� - � !-..a
r—
Sa. i:sJ
_",. i;.� � . .
27 McNaughtOn driVe " `
SeeondUneofAddress ,._�, ,^.� : =�,:j� �-�
CitY ol'P88t t?ffic4 S�tB Z!P COd6 m`j �'+�UATE FI������ ',., �.....
..f _�Y
Duncannon Pa 17020
CarrespondanCs e�mail address:„,,,,,,,,,,,,,u,m,.,�,,
J'I�.r��
Under penpldes of parjury,l tlsdere tfret I Mve examinW Ws retum,indutling accurt�arryinp ar.Mduba end sm9pmerrts,and dhe best nf my knowbdpe and heliN,
it is true. rtea a carnpb�.D re' n M preparer oMer tlwn Me pareorrel npreeertlatbs islmsed on atl i�fomre6an aiuMtli propqrx hae srcy knoxrktlga.
S�GNA RE Q ERSO �S 81E FOR FtLiN6 RENRN �d��
�.v.-{-�?� /yiU�cYt.l,r`•� G�^-r.e , �/-.�- ,�r�nd-,$, da f7�aD
SIGNATURE OF PREPARE OTHER THAN REPRESENT14TI DATE
ADMtESS
PLEA�E IISE ORIOINAL FORM ONI.Y
Side 1
� 1505fiid4d5 15p5610105 � � �
�
J i�ass�ozos
REV-154Q EX(Flj DececknYS Sociai Security Number
oso.a.nr.N.me:
RECAMTtlCATION
t. Reat Estate(Schadute A}. .. ....... ...... .... ......_................. i. 467�7.73
2. Stocks and 8onds{Sche�le B) ....................................... 2. Nf)NE
3. Closey Held Corporation,Parfnership or Soio-Proprietorahip(SCheduie Cj ... .. 3. ���E
a. Martoeqes�a rtot��ecea�e(s�,�o}..... ...................... 4. NONE
5. Cash,Bank Deposits end Miscelleneous Personal PropeKy(Schedule E)... ..., 5. 7002.22
6. Jointly Owne6 Property(SchadWe� O Separete Hiking�tequested ....... 8. NONE
7. terter-Vivas Fransters 8 Mieceflaneare Npn-Prabate Raperty
(3chedWe G) O Separete Bilkng Requested.... .... 7.
6. ToLI 4ross Assats{M�I lines 1 6vough 7j............ ... .............. 8. 53729."�
9. funer�E�cpensex and Administrative Costs(Schetk�fe H)................... 9. " 7049.38
10. Debis of Decedeot,Mortgage LiabNiBes end Lierre(5cheriuie t).. ... .. ... ..... 10. �$�8�
». Tara oaducuons{m�w�s s a�a so>.........................._..... n. 4d,647.82
72. Net Value of Estate(Line 8 Mnus Line it) .. ... .. ... ..... .... .... .... ... 12. 40969.64
73, Charitable end GovemmenW Boquasta/Sec 9113 Truste fa which - � " �
en eiectiotf to�c hac not been made(ScheduFe J} .......... .............. 13. ��
74. Net Yalue Subject tn Tast(Une 12 minus Lfine 13) ................... ..... 14. ,�QO$2 13
TAX GALCiiLA?'fON-SEE iNSiRUCTIQN$F4R APPUCA64E RATES
15. AmouM of Line t4 taxabk
et the appusal tax rote,or
trarrah�a under Sec.9t96
(ext.2}X.4._ 15.
Y6. Ar�wunt of line 14 tau�able �
ffi Ifneal rete X.Oqg_ 39082.13 t6� � 1758.70
17. Amount nf tine 14 ta�cabie
ffiBibNnBroee x.�2 �7.
t&. Amam#of Line 14 traabie
at cdleterel rate X.15 1 g,
78. TAX DUE ... ..... .. . .. ... .. ... .. .. .... .... ......... ........... .. .. 18. 1T�5$.7i1
2t}. FIL!_IN THE OYAL iF YOU ARE REQUESflNO A REFUND OP AN OVERPAYMEM p
Side 2
� 15d56i02Q5 15Q5810205 �
, A US Depertment of Housing&Urban Deveiapment T���F�rsota coen,vr�eo iN a�ocKS e.fl,H,i nrra ur�e aoa is
IMPORTANT TAX INFORMAT ON AND I$BEING FURNISNE�TO TME
� tRS. 4F YpU qRE REQUIREQ TO PIiE A RETURN,A N�C�L�GE(�Il:f
' SETTLEMENT STATEMENT PENAITY OR OTHER SANCTION WILL BE IMPOSED ON YOU IF TMIS
iTE:M IS REQUIRE6 TO BE REP4RFEQ A74P THE tRS D�7�RMINES
TH AT IT HAS NOT BEEN REPORT�b.
6,T •of Loen
1.FHA 2.FmHA 3.Conv.Unlns. 8.FIIa Na: 7.,Loan No: 8.Mo a e ins Gase No:
4.VA 5.Conv.ins, x
(�'.Nd'{�: '{ryk fortn{a fwniMetl 9}�.'e ycu e aietamttd�ac416�seUlemant WSCs, Mnain�peid to antl Dy the soWemant agent are shown.
��yl�9A{!d 'p4C' wq! eW oulslde Me dosln ' are alwwn here M1x Infmmgtlosial U Se8 and 8re Y�ol Ii1CIutlBtl In�Ae t8f9is��
���/�SP �'9°�' � D.Name and Addreas of Buyer: E.Name and Add�BSS o#Selter. F.Name and Address af Lender:
� r �,^� ' ,�,rts'�' Merrell I.Wheeier Est.oE Haroid Rougbt.cfeNd
!� �ef en[eS I �ti Joyce A Wheeisr do JosePh Fink,Jr.,Ercee
b u�fr r�s�jte�' � fF�ort Wa nehlN t BNd. 27 McNapgMon Gtr.
�,rrm f} -y- y Duncannon,PA 17026
'�i iS ire C u"w P�"T�A �m j
q �/r. c�ST�J�e 4 �e<r.� 7rs G.Propsrty Locat{on: M.SattiemeM ABsnt; 1.SettlemeM Date:
� �} WOLF 8 WOLF
rR�.�y ASha�'r7-�,-rri 140PennaylvanieAve PlaceoiSatttemenl: July3,26f3
� CARLIBLE,PA i70i3 10 WEST HIGH STREE7
rn o^��5 t ;., Th e c�r,r"� CARLIS�E PA 17013
/� ��.T. SP�� ��S J.SUMMARY OF BUYER'3 TRAN8ACTIpN: K.SUMMARY OF SE4LER'3 TRANSACTIpN:
b u��r �f''.� 100. 6R088 OUNY DUE FROY BORROYJER: 100. OR 88 OUNT OUE TO ELLEft:
,,,r r t nT tI m C' • �v J e' S01. Contrad SeMs Price 88 006.CA -061. Conkact Ssies Pdod �p�p.W
C o tia2. Pei9on41 Pr 902.
103. SelUanent mBofrowe� IIna14W 2858.71 Aq$. itrtereston 773t3(113H�7137/2013 -0S.yt
$el�Q h ;s homc un ,aa, ao+.
!Ja',l� �T�le �alant'� o-� to6. fa.Nms a.ar4twvanw eos. bn�t+ iMm. souxM.dv«w+
C � (�J �r �j�G Ti� t0i. Cqun�� �i3 012/37/2018 185.� �. �Rawn� 1/12013TO 1PI3t/2018 198.06
�t� yOC J -� n 40@. Srhbol7a�ces 0.00 408. School78�ms 0.00
`n"�P,aS7� LtGCr�Pi' . ioe. aas-
� »o. aro.
7�e .sdy�v� >�T�rr�$'r „z ;,z:
S 12U, O ANOUNT DU F BORRONiER E2 M3.TT 120. OR488 AMOUNT TO EIIER d0$83AT
� �:�„p y0'�` w& 2pA. AMOUNT9 PAiD BY OR ROR It l00. REDUC970N61N AMOUNT 4UE�LLER:
(_t,7`v/✓1�"d" r'b ..h✓��,/ AS 202. Ph emo�new s ' ICOOO.pO 502. Sedlertent b50iier Ins�dW
„ , ./ 203, f ba s Lkan ffi �3. s Wcerta M
j,,��{��1G/� �"` 204. 504. P flretmo ban
/� { 2YS. 505.
`jL�}F'u �e L 206. 508. LeeBMo 440U0.00
207. 56T.
208, 508.
208. 508.
iarlMmsu flaN�r M forkwnsun tl 9NNr
210. am Te�ron 810, q ?aM Tams
2t1. Tsx9s 6it Tazee
212. 9tlaCi Tmms 717tR013 b Tl3I2013 B.B4 872. Sdrod Taxee 7/iM2013 to 7/3I2013 .e.64
213. Water3avar St3. NtatrJ3ewer .ip3.
244. 5t4.
215. Sti.
21b. 518.
217. 577.
2t8. 538
278, 518.
2M. 1'OTAL PP/D BYIFOR 60RR R 15006.61 b20. FOTAC REOUC7t PAOY BEIL@R IItD93,25
790. CA4N AT 8£TRfltENT'[�fll OOU. CA6X AT T TOIFM SELLER
301. 6mae amwM due finm Boimwx e 720 82 843.T/ BOt, f3�aas pnount dum m ler 80 233.47
302. 4eas anwunb C 8omnwr W» A4�.84 S�. Lees (rom SWer S?6 57,3@3.25
70.4. CP9H ,�,_fROM ^ 84RR 77.835.13 003. CA9H ,,,,_ FROY �jf,_TO 9ElLEN 3,840.22
1 heve caretulry rb.lmreE dfla 3btlbmaM$lelement End W tlre Eesl Mmy knnMe�e sM bNb4 ft b a bue aeM eqv�Me atetempM aiall recaipts and
disbutswnams mede on my acmunt a 4y ma M�#da tensac�Wn. !fiutlrlr wWy ihet I hew rxtivetl e mpy of tlUS HU0.1 SMtlemont 3tafxnent I
diracl an0 autlwrize ths SeMem6nt Apmt b meRe the tl4cMbutloruB Intliqe(ed (pr my eapunt recbpnttlng dat Me SatllemeM Rgent h irot recponai6te
forNeacairecYawNtlttYOftl�ediWuaemeirtemountsartlammWetpnessotd�ar9eometleMo�hera. Myhrterecteeme4onfuMSdepoal4dwith
Settlamen�Agmt hertuntler mnY bd remind 6y Seltlament Apent. �
_. • /
�'�- ;��t �
jj � (� . ,-
/�/ .� .]�/ ,�
BUYER M�LL I.WH :LER 3EC4 SUSEPH E.Ft ,JR.EXEC.
/; �
p.i
BUYER OYCE . HE LER SELLER
Ta Ne of m pe.M 07:eNanent SmOemaN whltli i hem P�nd ie a Uue&ecafaie eaaunt M iha NrMS w�tc�wme receM1etl arM
havMvN{ diaWtaetJDS asR�tMktteettlsmmtdNhtr6nmLtlan.
P .......� -'�_,y�� �r ?T . 1
.. �f.".,,. l r�
�u��EN GE NATHAN G.WOLF DAT ����
' !
REV4513 EX+ (01-10)
�'penr�sylvarria SCHEDULE 3
oetamue�rt ov nEVenue
ixneumxce T�z nerunx BENEFICIAELIES
RESIDENT DECEDENT
ESTATE�: FILE NUMBER:
REtATtONSNIY TO DfCEDENT AMOUNT Oii SffARE
NUMBER NAME ANp ADDRESS OF PERSON(S)ItECE(NING PROPERiY DO ti�t�t T s} OP£STATE
I TA%ABLE DISTR18UT10NS[Indude ou4ight spousal diskriDutlons xnd transiers under
Sec.9ll6(a}(1.2},j
i. Elesa Q.Krei�r 1949 S�irg Road,C�Iisle,Pa 17013 Daught�st' 39d82.i 3
ENTEN DOLI.AR AMOUNTS fOR DISTRIBU7IpN5 SHOWN ABOVE ON LINES I5 THROUGH 18 Of REV-i5p8 COVER SHEET,AS ApPROPRLITE.
� RON-TAXABtE plSiRiBURONS
A SP011SAL DISTRIAUTIONS UNt1ER SECiiON 93f3 fOR.WHICH AN E[ECTTON TO TAX tS N4T TkKEN:
1.
B. CHARIfABI.E AND GqVERtiMEMTAL 6tSTRIBUT30NS:
i.
TOTAI QF PART II-fNTER TOTAL NONdAXABLE SISTRIBU7IONS ON LINE 13 OF REV-1500 COVER SHEEL �
If more space is needc6,use additionai sfieets of pape af Mie s�re size.
REV-1508 EX+(0842)
�pennsytvarria ffiCN�1'iUl�i �
oEwwrr�roFaEV�ue CA$H„ BANK DEPOSTiS 8� MISC.
'""E""'`"cE T'"°R�""" pERSONAL PROpERTY
0.ESIDENT DECEDENT
£STATE OF: FILE NUMBEB:
HarolA A Rtw,qht
Iraclude the proceeds of btigadon and the dMe the proceeds were received by the estate.
All proparty joinHy owneKi with ripM of surviwrihip must b!dircbsed on Schedule F
ITEM . VALUE AT DATE
NUP79ER DESCRIPTION pF pEATii
}.
Autonwbile 1996 Ford Corrtour 4�sadan En paa condition. Sold ta t�ruly member for$900.OD afier
5378.00 in repairs. 900.00
Fumikme ar�d ca�r�ts af house that was salaageaele were sak!�r Marow's tlsed fumitwe in Landisburg
2 Pa for$A00.00 400.1�
Cash in Mc RoiphYs chedcing acoaum at tir�of d�itt was S4$47.d2 wY�ch was tr�rsierted to an Est�
3 CheckinpAccou�t 4847.42
Mr RougM h�no jewelry,cans pr tirollect�dWes.IW dWhing and househdd items that remaned were thrown
awaY acaw�o#a setbus irdestaGOn�t�as irom fee�g and housi�9�raY t�rral cats fo�many ye2rs.
4
John Hancock Wtutuai Fum1,Incortre A,Aat#91-4068279
29Q.�Q
This fund has not yet been liqudated to the astate,haNever,ft�in tl�e pracess.the amaurrt sta9ad is�+
estimate aM1 is must tikelY a little hi9h,Thfs fi9ure was detemtined bY Bview of sever�Y rece�rt rrardhiv
st�nettls.I feel this to be very ci0se to accurate.
The address is:M�Fund Oper2Gons,,lahn H�codc Sfgnahue Sflrvices,fnc,PO Box 55913,
Boston,MA 02205-5913
Addtior�deposits ta the Esta�e Checking Acct indude variaus�rpaymetits�td iefunds;
5
03/13l13 50.15 Various refunds udlfies efis
Q4103113 254.90 Various refunds utiii6es etc
564.80
Q9l09f t3 259.75 Varaus retunds utiliUes dc
TOTAL(Nso enter on Line 5, Recapitulation) $ 7qQ2 22
if more space is�eeded, use addmonai sheMS of paper af the same size.
REV4512 EX+ (12d2)
�pennsytvarria SCHEDULE I
DQMWTMR(fOF1�VENUE DEBTS OF DECEDENT,
�r+NewrnxcenixnErunx MORTGAGE LIAlBIL1TIE$ $i LIENS
RESIDENT DECEDENT
£STATE OF RLE NUMBER
Repork d inarred by the decedent pr�or to tlesth tl+at temtlned unpaid at tlrc datm of de�th,inchMN�g unrolmbumd madlcN expertaa,
ttEM ViU.UE kT 6ATE
NUMBER DESCRiP'f10N OF DEATki
1.
Fia�ne Equiry tine Ot(xed+t with M�T Bank,Cartisfe Pa. acc�k 120-444-50193fit-4998 Paymerds rr�arle
fram the Estaie Checking,4cct irom d2111/73 to 06J06/13 totaied 5505.51. 5Q5.51
2 o Suburban Proaane for hane heatir�i di.Mr Roupht w�ai a budq�tdan of$2�.00 per manih.At
time of Yds death the balmace was 31833.96.Fve fdiowing moMhiY Paymertls were made irom the
Est�e Acct.and a finffi payttier�t i�full made shortly a�tet seUleanent of the home. 1833.98
3 $377.20 was Daid ta 8i�'s G�.�auphin,Pa�9�h�RoughPs C�rep�red and staGa insP�d in
order to sell it tt had set negieched for arer a ye�: 877.20
4 CostofchecksforlheEstateChedcingAcctwas375.74 15.74
5 Ta Didc Coan Re�v�Or Iwme market v�t�evalu�n;75.00 75.p0
s PPt Etectris utilities u�s�e ot hmse�aled 5548.31 548.31
7 Reai estatelSchooi T�es paid to Robin K.SoNeaberger,T�CoNeCtor an 03t29t13 w�$371.14.
A partion of tlus was retumed as indkated on scl�duie A and ihe�etlkmer�attached to Schedute A
371.14
s York W�Disposa{5198.92. Had ta caminus trash r�wv�service aa;oum deani�g out the house
s�i. isa.sz
s North Middfeton Autlwritv for watedsewer undl saie of tame.The firc�d paymeM,no#irwttrcied in this�. 253.37
was made e2 settlemenk as indicated on schedule A
10 Cart�c�t 5187.i5 Service was tNsconb�ued as soon as possible�er dffis flP tle�h 197.15
11 Ouistand+ng bi�for arnu{am�service from Cumber�dlGaodwiN FaefRescue tar tr�sportabon�r Mr
Rought from Moiy SpiR Hospit��his hurtie and Hospice.Date of sBnriCe Ot116t13 112.20
12 Ce�tury Li�k for pMyne seivlce.53279.Service was c6soartinued ASAP after death 32.79
TOTAL(Aiso eMer on 17ne 10, RecapiWlation) # �, ��y P,,�
if mare space is rieeded,fisert addtt+ooai sfieea of th8 same site.
IiEV-1512 EX+(12-12)
�penrysytya�i� SCHEDUi.E I
f„�J o�*+���+� DEBTS OF DECEDENT,
�nn�eRnnc.�rac x�runr+ MlpRTGAGE LIABILITIES $LIENS
RESIDENT DECEDENI'
E57ATE 6F FILE NUMBER
Repor!d incurred by the decedent priur to deaih tl�at remained unpaW st the date o#dNth,Mdu6Hy wrcdm6waed metliu4 axpertees.
lTEM VRtUE AT 4ATE
NUMBER DESCRIPTI4N Af DEATH
1.
Woif 8 WoiF Aitomeys 6ees for consWG�an pria to�err�ot of real est�e Q5l02l13&05f28113 250.00
14 Carlisle SeMinai Newspaper for Leg�hktce 3 wks 85128/13 147.06 �
�5 Reirr�urseme�to Executor Joseph E Fi�k Jr.(expense paid out of own podcet}for repair�d parts�r
He�inp/AC sys�m. Primary control Module d Transfomrer for fumace, 07f021t3 366.00
16 Refund inkerest cdlected at hame sediemeM as Der apreemeM ta Merreil Wheeter t boYev}09tt 7t13 48.41
�7 medtc�W�S ur�p�d by Mediare arM Blue Shield over the periad fram 0810d120i2 ta dake of deafh 2265.66
Mr Rought was hospit2lized several times during this period and wa5 i�2 nursing homes Tur the purpose
�rehab from d surgeries orrer tt�e per{od.Mot everythin9 was covered by kYs insur�ce and medicaze.
his azrauM covers what h�been P�d bY��io de6e,however,unpaid�tis�II arriue on
occasion.
TOTAL(Aiso enter pn Line iq,Aecapituiation} ; ?598.44
it more space fe needed,tnsert additfqnat sheMS af the same slze.
aev-zsii ex+�os-i3a
�pennsytvania SCHEDU�E H
o�annr�MO�n�uE FUNERAI EXPENSES AND
mnenRnncE r�ac neruv� ppMINISTRA7IVE COSTS
RES[OENT DECEDEN7
£5TATE 6F FILE NUMBER
�pf^I� Rn: ^h}
OetedeM's debb mutt be reportad on ScheduM i.
iTEM
NUM9ER DESCRIP'fION AMOUNT
a. FUNERAtEXPENSES:
j Paid bY dauphker,Elesa D.Kre.iQer to Miche�J Shaionis Fut�rai Norrre,206 MaDie Ave.M�5^svitie,Pa
17053.Reimbussd Elesa from the Estate�6ar Sale af horrse 6870.88
z R'ice Memaiai Waks,424 W.Main St,New BbarAfeld,Pa Inscribe d�es ir�Gravestone 200.00
8. ADMINISTRATIVE Cp5T5:
i. Persona�Representative Camm�sslons:
Name(s)of Personal RepresentatNe(s)�,g�.,�Fjnk Jf . —.-- �--
Street pddreas�������Fly�__, ___�___ �__
��v-Aurscanaon---�.�.—________�_�_,SWte__pg_ZIP 1Zl�20-.._--
Year{s}Cammission Paid:��_,._._,� _----l----�___. ._.
2. nttamev�e�� None
3. Family Exemptian: (If decedent's address is nat tha same as ciaimanYs,attach expianadan.j
Ctaimant
N9Fl�------------------------- T_
Street AdGress.---- T^. ___.i------
CItY_.�.r._.._.—_..�__ ._ StaM_.___ZiP_,._._.,..,_
Relationshtp af Cia�mam to Decedent--,--_-----�_.-----J---------------,---
a• Probate Fees: 178.50
5. Acmuntant Fees: N�e
6, Taz Return Preparer Fees: Npna
J, ThCIB ffi@ Ib 6XCCUfd#'BS tp bC ChN'9�OR UNS SSl2�C
70TA1{Aiw enter on tine 9,Recapituiatlon} # 7� ��
if mdre space is needed,uSe additionai sheets�paper of the Same stze.
Michael J. Shalonis Funeral Hame
246 Maple Avenue
Marysv�ile, Pennsyivania i7053
Fax(717}-957-2077 Michael J. Shalonis. Owner Phone(�1?)857-3451
We Care Abau!Service To You
Wednesday,Pebruary 6,20(3
Mr. Joseph E.Fink,7r.
27 McNaughion Drive
I)utscannon,RA 17020 �
i�ear 3ce,
Thank you For selecting our funerat home to provide services frn your family d�ring yav iime of 6ereavement. I hope that you found
our services,so far,ta be af the highest s[andards that we always try W achieve. 1fie fof3o�+•ing is a summary oYthe szrvice chargas as
previous3y exp{ai�red and pmvided in uritten foms an the serYsces for:
HAItf3LD tl. ItOUG$T
PRClFESSIdNAL SERYICES
Basic setrice af funers!director and stafi' S 1$OO.p6
Embahniirg S 625.60
Dressing,Casketing,and Cosrnetology $385.{N3
Tornl Punerat Service Selecud
TQTAL PROFESSIONAL SEBVICES $2,8I0.00
FAC(LiTiES,S?AFF AND EQt31PMENT
Use of Facilities&Staff for Visitarion $N!C
Use of Facilities&Staff for Ceremony at Punerei Home 5 450.Q0
FACtLtTiES,STAFF A1VD EQUIPMENT $.ygp,p¢
AUTQMQTIYE EQ(JIPMENT
Transfer o£Remains to Funeral Home $200.00
Heazse!Fur�eral Coach S 250.00
TOTAI.AUTOM017YE EQUIPMENT 5450.00
OTRER M�RCHANUIBE S�LECTEU
Casket: Gemi Series Biue $1,195.00
Outer Huriat Comainar Gravc Li�rer $875.4Q
Acknowlecigement Cards S included
RegisCer Book S included
Memorial Folders 150 $ittctuded
TOTAL OTHER MEi2CHANDiSE SEL�C7'ED $2,OY0.40
CASH AAVANCES
Grave 4pening 7 Closing Char�e $S 10.06
Certified Copies of Deat3s Cert�ficate $30.00
Ciargy Honorarium $75.04
NewspaperNotice CarlisteSentsnel S 193.88
Cen�eteq�equipmem $2lQ.OQ
Ftowers $ 15Q.00
CASii ADYANCE T{7TAL S1,46$.8$
LE55: Crediugranted $598.06
34 L1ap Payment discount 557$.00
TdTAL OF$ERViCES 56,674.88
BALANCE DUE $4,670.8$
If Nrare are any qucstions or concerns that remain unanswered,ptease call me.
S'sncerely, �'
, ,
y�;� � :i.��t .� r r.a: {, f.�'jf �
�/�c6.�P"L'� �� � � ;i t)i "-
Mrchae(3. Shalonis i. ,
Owner ;*,t : './_..l �� ,/4��<;.,. r��. _�--------""�.
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$ ,
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Rice Memarial Works
421 W. Main Street
New Biaomfieid, PA 17Q6$
(717) 582-2512
Joseph Fink, Jr ,,�/IVOJL"e 6I7/2013
27 McNaughton Or
Duncannon, PA 17024
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18-31442 5l6124i3 Harold Rought Lynne Traae
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1 Cemetery Inscription
2�an(�r�ou, yaur rrzemorial`or eemetery Order Totef: $20d.00
insct�iptiort zs finisfi.ed. Payments: $O.Of}
Ba�ance oue: s2ao.00
Pia�ase inciuds contraet # with vour ua}�enent
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A jinaxea eha�r of l�%per month p8%annuaUy}wr7t be added aJter 3U Aays
RECEIPT POR PAYMENT
�LE1aDA FARNER STRASBAIIGH Receipt Date: 1/31/2013
Cumberland County - Register �f �ills Receipt Time: 11 :15 :3�
�ne Conrthouse 5quare Receipt No. : 16?2$96
Car2isle, PA 17613
ROUGHT HAROLD A
Estate File No. : 2013-0011$
Paid By Remarksr HJO�wSEPH E FSNK JR
------ ------------------ Receipt Distributian —__---_.__
FeeJTax Descrip�ion Payment Amount Payee Name
PETITION LTRS TEST 90 . 00 CUMBERT.�AND COUNTY GENERAL FUN
WILL 15. 00 CCJMBERI,.�+,ND COUNTY GENERAT.� FUN
SHORT C$RTIFICATE 25 . 4Q CUMBER.LAZ3D COUNTY GENFsRAL FUN
JCS FEE 23 .50 BUREAU pF RECEIFTS Sc CN3'R M.D
AUTCIMATION FEE 5 . 00 CUMBERT,AND COUNTY C,ENER.AI� PUN
INV�NTORY 15 . 00 CLIMBERLAND CCIUNTY C,ENERAL FUN
INH TAX RETiTitN 15. fl0 CUMBERi,ANLI CCIUNTY GEZ3ERAL FUN
--------�-- —---
Check# 5083 $1?8 . 50
Tota], Received. . , . . . . . . $778 . 50