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HomeMy WebLinkAbout01-0743 Estate of Paul R. Durf also known as PETITION FOR GRANT OF LETTERS OF ADMINISTRATION 152' - 0\ - ,4- '3 No. To: Deceased. Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania Social Security No. 204-30-6857 The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older, appl ies for letters of administration on the estate of (d.b.n.; pendente lite; durante absentia; durante minoritate) the above decedent. Decedent was domiciled at death in Cumberland County, Pennsylvania, with h is last family or principal residence at 5 East Main Street Walnut Bottom Pa. (list street, number, Twp. or Bora.) Decedent, then 66 years of age, died 12/11/00 at Sarah A. Todd Memorial Home Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: $ $ $ $ 0.00 0.00 0.00 0.00 Petitioner after a proper search ha ~ ascertained that decedent left no will and was survived by the following spouse (if any) and heirs: Name Relationship Residence 5 East Main Street Lvdia B. Durf soouse Walnut Bottom Pa. 17266 THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the appropriate form to the undersigned. >?J4~ 5 East Main Street Walnut Bottom Pa 17266 "....., '" Qj" u C <1) "0 . v; --. <1) '" cGl:' <1) "0 C C 0 ~:E 'tr~ ........ ~ 0 C OJ) i:i5 1'1- \~-q (:}l~ ~e~ \\O-:24q-IO OATH OF PERSONAL REPRESENTATIVE COMMONWEAL TH OF PENNSYL VANIA } ss COUNTY OF Cumberland The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief ofpetitioner(s) and that as personal representative(s) ofthe above decedent petitioner(s) will well and truly administer the estate according to law. if~1:rJ8&AAhr 3: ~ ;::: ~ s:: .~ c;:j No. 21 - 01 - 743 Estate of Paul R. Durf , Deceased GRANT OF LETTERS OF ADMINISTRATION AND NOW October 92001 , in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that Lvdia B. Durf is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration are hereby granted to Lydia B. Durf LYDIA B DURF in the estate of Paul R. Durf ~@JJ2'~F~. Register of WIlls MARY CLEWIS FEES Letters of Administration. . . Short Certificates ( 1 ),. ~je~ciation. . , $ 18 . 00 $ $ $ TOTAL _ $ 26.00 PCTo.B~~ .9,,- . . ,. A.D. 2001 H. Anthony Adams 25502 1 nn ATTORNEY (Sup. Ct. 1.D. No.) 128 East King Street Shiooensburg Pa 17257 ADDRESS 5.00 Filed . 717-532-3270 PHONE Letters put in attorneys file in prothy. on 10-9-01 1105.80'; RF\' 9/8(, This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. No. Fee for this certificate, $2.00 p 7060002 fl,/c$ Date ~CP-D R.. 2111 COMMONWEALTH OF PENNSVLVANIA . DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH _ OF Ol!CEDENT,F..... _.l_1 SEX SWI'I\.E_1l SOCIAl. SECUR'T'V NUMBER t. PAUL R. DURF AGE ct- ~ UNDER I YEN! - 0.,. .. 12-11-2000 Y... ~o COUNTY OF 0ERl4 ... White SUl'VIYlNG SPOUSE 1"......t;JM'm"Ir1IW\~~ DECEDENT'S USUAl OCCUPllllf1ON ~-=:_:'''=':::zt;.j'j' - ~ I'I1UlT .: 0dW 1ignifteMl_ c:anInbuIing 10 _"'.llul .... -*in9...... ~ .,....ll"*l.. ""'"" I -.CMIIlIlF_ _......-, ...anu"~- ~..- .--...- _._-- CMIIlI ~or ..,ry ..~.... '-.v..~LMT [ : DUE 10 tOR AS A CONSEQUENCE Of): DUE 10 tOR AS A CONSEOUE NCE Of), - ~. o o DATE OF INJURY ,_. DI't-1 TIME OF INJURY INJURY /If \NOAI(? DESCRIBE HOW INJURY OCCURRED VMS AN AU1CPSY PERFORMED? WERE AU1CPSY FINDINGS --.E PRIOR 10 COMI'lETlON OF CAUSE OF 0ERl4? MANNER OF DEATH __ 0 lID _0 - IID~- -- .......... "-,,,",Ion 12, ~I :>1 Co.AId.... be_onect -. -- CIM_o.- ""'" onel 'CIM...,... PMYIICIAtl (PIIyu:.... corlllyonQ ~ rJ _ _ _ Dh_.... heo Ilfonauncetl_... aNI comlllo4<<l ""'" 2:l1 ,...._..."'Y'..............___lD......UM(.I_...._H..._....................,.......... . "-*CIllO IWO CERTIF'f1NO ""SlClAN~.... ""'" "''''''''''''''''0 '*"" ancI certlfyonglOt.luse of ""."', To.... bNI or..., IIl'lOwtecI9ft. ..... occurrwd.' ........ da'., and piece, and d.... to the UUM(a) and manne,.. .tated "WDlCAL EXAMlNEAlCORONER On the .eM of ..am.Mllon end/or investig..ton, In my opinion, de.'h occurred .. the lime. date, and ptac., and due to the cau..(.) and 3'.~.. ......... . . . .. . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . ... , .. . .. . ... .... .. . ., . . . . .. . .. ...... . .. . .. . . . . . .... .. . .. ~GISTRI\A.S SIGNATURE AND NUMBER >> j;- CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Paul E. Durf Date of Death: 12/11/00 Will No. Admin. No. 2001-00743 To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on 1/3/02 Name Add ress P.O. Box 98 Walnut Bottom Pa 17266 Lydia B. Durf Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None Date: 1/3/02 -~~~ Signature Name: H. Anthony Adams Address: 128 East Kina Street Shiooensbura Pa. 17257 - o f"\ ~ 4'( Ii. Telephone(717) <~ ~ 3::) 70 ....- a: x Personal Representative Counsel for Personal Representative ..q I z c::c: ......, "11 Capacity: ;~) +~': ~- ......... 8 ~}! mCl: CI: ',') ~ jj 'J ..0 ~E 11>- Go COURT OF COMMON PLEAS CUMBERLAND COUNTY ORPHAN'S COURT DIVISION In Re: THE ESTATE OF PAUL R. DURF DOCKET NO.: 21-01-743 PROOF OF CLAIM To the Clerk of Orphan's Court: Attached hereto is documentation evidencing a debt by Paul R. Durf prior to his death as owed to the Sarah A. Todd Memorial Home. Please index this claim against the Estate of Paul R. Durf in the amount of Twenty Eight Thousand Fifty Six and 73/100 Dollars ($28,056.73), together with interest at a rate of 1.25%) per month on all outstanding amounts since the debt was incurred. Respectfully submitted, McKissock & Hoffman, P.C. ~~ '-. .. .' /--/-- By: . ..... ./ Edwin A.D. ~I~~ Esquire Supreme Court I.D. #75902 2040 Linglestown Road Suite 302 Harrisburg, PA 17110 (717) 540-3400 Date: ~</oz n' .~ . ,,) ~;z -lnr 2~O. . .. (it. Chri ~~:i t. HOff!{i:~~:.~~ ['1 Elrfl 0 r-;:; i.;~ J. 0;. ., -'~~{~ J. -7 ().1. <~~: Statement Date: 05/10/200: Lye! :L3. Du r"'f P " 0.. Hr'}x 9B Walnut Bottoms PA 17266 Due Date~ 05/25/2002 R.E~: Paul R Du (f Account Nr'~ .1.01.041 ;~-~-------~~-~-~--~-~~~~~~~~~--~~-~------~-~--------~--~---------~-~---~~-~~~~~~~-- D;;:-~tA Desc r':l.pt.ian D~:~ys Quant R.::~ tE?- Ch~;.J. !"'98S P&.yrnents e.:;~l.~~nc:~ ~~~~--~_._---~----~---~~~---~------~-----------_._-~-----_._--------~-----~~;~,~~~~~~~~ r~Pl'-. A~JC F FOR~~ARf) 28.. 0.56" 7;'?, 2B ~ 0.56" '7. () n :::', t.. ::) t. e i'n c:, n t ~ ;.J nd ["ern'i t thE?: rn.-a \, :..'1~) \1 (:~ rn .::i (~E~': NOTE .~ P 1 ea~:.8 s t .;.:~ t E~ rn E~ n t. " \1 () l. J r' c:= t"\! 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':::. :.i: ...! ..... l'1.;';-;. l..../ (.~:.: iT~ .:'::. .j (.:.:: .::\r.~ (,! t,,, (-::~~Tf:1. \'. 't (f(.::: f).:':'t. J .::\;--1 (:~{':.: ,."(':':'fi"L:':'i. :i. {"i :t r.j (J :i '1- t~) .:':f," COf ~.,:. --( C) !..!. H ::::. t. ,;';i. t C:' fn (.:.,; n t tJn :i. t(,,::'d C hU,l'" C h o'f Chi'" :i, ':::. t. HOinl'::':":::, b (';l.!'" .:;1. h ti.. T ciI::i d iT\ (.::- men" :i. ':" 1 !,'kHl'lI::-:- 1000 West South Street (~::/:... t... :t. :t ":::-:L (-:!:I i::t(=t :i..~l() 1. ~':') Statement Date: 10/09/200 L yd :i, ,::t Du j"'f PIIU.. Box ?B Walnut Bottom, PA 17266 I. ,.. t )U~:~ 1)~:'~' E':: :i. 0 /:;~ :)/~':':OO:l. r~f~ :: P i:i.u:I. F< DtU""f Account Nr:: 101041 D '::1. -1:. (-:! 1)(7:-:::' C 1-- :i, p t :i. on D i:'!. >...~::. GU<:l.n t, F~ <:'1. t E' C h <:1. ('" I] f!! '::~ P ';;1. ymi::'! n t ':::. 1.J '::1. 1 '::1. n c BtiLI~~!'.ICE FC:I~i,.l.!(iF~D ~:: ~:~ :1 () ~5 {~ .. ::~-; :::; ~~:: ~:5 :1 () ~.:\ {::. .. *;.~: !.,It:rn:: :: Please remit by October 25, 2001, the Last amount printed on the ';:;. t..::'. t.l:::-fnf:,:n t n P:I. (~7.::'I, ':::(';;' :i. n c: 1 l..I.clf::..' PI c cC)un t. 1'41..... 'f r'om 'os t..:':\. 'b:.:~'m(.~n t on j"lEI'\'lD i... I j"'iE O'/" >'''C u ".. c: h f::'! c: k .. (:'j 1". .~...., {) ,'Ei. '/.r.'(n f'::'" r1 t. :::. to" i::.:: C: i::.:' :L \.l t:"::: <:1 .::1. uf: t. (:::t t... () (/ ....... ~.:.:' () ....... ~.;.:.: () () :1. .t:'i. tr f:"::t r't () t. I..' (.:.:: .or ]. f:.:: c: t. (.:.:' (I () j"'j '::~. t. .::.i, t. r:-::y. In (.:~, r"j t. ;~ 1] ]. (.:~ ";':". ':~:. (.,":! ij f:::'" cj tt c:.t .::'. r.t ">/ .:':\ () (t :i. t.:L C) r., -:.;'1.1 F) .:';t ,/""jTi (.:-:,!") t. ~;:' '>/C) tt fn ':-:.'. ......... f'j .:;~i. \/ 1:.:.:1 in .::'t c~ f:':.:~ .:':\ n ci I" (.:.:, in :i. t. t hi::! b ':":'. 1-:':'~ n c i:~.' \." !::.' m .:':\ :1. n :1. n IJ .. "!' h {:'t. n i<. '..( D U. .. .' ~:> t. .::'. t. (.:.:, ifH::' n -1:. Un:i. tt;-:.~d CI'H.t1"ch C)'f Chl":i.st I"iom(~'~-:::, ~:3 ,:;\ I'" ;":\ h l~).. T C) d d I"l E' friO 1'" :i. .:Ff.1 H 0 m (.:.~ 1000 West South Street Carlisle, PA 17013 Statement Date: 09/14/20 L yc! l.:..~. Du f.'t': P.. 0.. Box 9B Walnut Bottom, PA 17266 Due Date: 09/26/2001 I:;':(.?:: Paul 1:< Dul.....f Account Nr~ 101041 D ~:i. t. f:~ D(-?~::. c: I~' i, P t:i. on I) <"it ;_l~::. Rc:l. t ~:~ C 1"1-:':\ I"g l:':~~r:. 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Z.o 1 :":) Statement Date: 08/15/200] L yd :i. CI. Du I"'f P.ON Box 98 Walnut Bottom, PA 17266 Due Date: 08/28/2001 I:~e: Paul I=\: DlU....f Account Nr: 101041 .__._-_.__.._.__._._-_.__._-_..~.~_._-------_.__.-._.-_._._._~_.~-----~_.-._--~---------------------_.~~_._-~" Date D€~scri ption D c~ y-s; Quant Rate Chi~t"ges F'aymE!n ts B,?I. 1 an C:f:: -_.~-_.__.-----_.__._._--_._-_._--_._-------_.._._------------.-------------_____._________.._____.___e- BALAI'-ICE FOI:~W~,HD 2B, 056 u 7:.3 ~~B , 0 !56 .. '7:: 1'-101'1::: Please remit by August 28, 2001, the Last amount printed on the statement. Please include Account Nr. from statement on MEMO LINE of your check.. Any payments received after 07/3:\./200:\. are not reflected on ~;;.t.:":\t*?ment.; pl.?~a~H'? c!.:?duc'i:. ~:..ny' .;":\dd:i.t:i.c)Il.;:1.1 paY.fIH'?!lt.::i. }J'QU may hi:\v€~ (n~':H:IE' and remit the balance remaining. Thank You. : . ... .. .1. .._ .., ...... .'. :::: i.. .::t t.. :::.:! ~! i:.:~ ~; ;.. ~..)l"i :L 't. 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United Church of Christ Homes B {:l.I'" .i:"t h f:~.. T D cI d 'Y!I:.::sfIKH" :i. -:.,":t. :I. H CHlH':~ 1000 West South Street c; .::-1. I." :1. :l "::> :1. (.:.: !t r:' (::, :1. ~:' () :t :":) Statement Date~ 05/10/200 L.yd:i. a Du r"f P..D.. Box <"is Walnut Bottom, PA 17266 Due Date: OS/25/2001 F~e:: Paul I~ Dur..t:: Account Nr: 101041 _._._.'_'_.'~'_._."___'~'_'_____.__'___'.'_..M._'_.'____._.__._.__.______.__........____......__._._..__..__.~_..___.____..______.._._____.._.__....._.._ DatE' Desc:ri pt.:i.orl Days I]uant ,"'- t ' ",.::t f:! Char<;'I€-!S; Pi'tym€-:an t~; Ba], (itn c: ._. -eo- .... ._. ._. .._ .... .... .... ...... .... _... ._. .... .... ._ .... .._ ..... __ .... _.. 'O... .... ..... ..... ..... .... .... ...... _. ._ ._.. .._.. .._. ._. ._ .... _. .... 'O_. ._ __ .... .... .... .... ..... _.. _.. ._. .._ _.. .... _.. _. ...... _... ......... .... ._. ._.. _ .... .... ..... .... ..... .... ...... _... __ ._. ...... ..... .... _ .... ._. Bf~l...f~~'ICE FOI~lJjf-'1HD :::) 9 , :.::;.7 c; II ::> ~:~ :':') 9 :' :,:') 7 ',~ . :.:') i',IOTE:: P ], E'~:\. -;::. f?' 1'- E:' m j, t b)'" 1"1 f.'I.Y ;.:: ~:I , 2 () ():l., t h (.:: L. {;'I. r:d. ;:H1H) l.t n t 1::t1.- :i. n t f:'! d C) nth f..:, statement. Please include AccDunt Nr.. from statement on MEMO LINE of '/oux c i'H:-:a c: k .. f.m >." p 6'~ ;/11H7:' n t, So 1'- E: c: E: :i. v ~::! d <,:\"1: t <-:-:a ,.- 0 l.L/ ::J 0../ :~:~ 00 1 ",ll'- I::';' not I" E,'f ]. (-:~. c: t f:'! ci Dn ':::. t,{':'l 't..?I'IH~-:n t ;; p:l. E'.,::'v::;(-:? d (,;,:'d u c t .::"n Y' {":'t.d d :i. t:L on (:,..:1. p,::'!:~/(IH':':n t ':::. .}....Ol..!. m{;",:'/ 1'1.;';1.\/(-:-: m{;I.cl (-:.:. and remit the balance remaining. Thank You.. .~ .' ~::; -t, ~t:'t '1:. (.:~, rn (:;:1 r'f t. tJ n :i. t (.:.: d C h u 1'" C h <:) "f; ChI" :i. ~:; t H Ct ilH:.: ':::. E:.:",l. 1'" (':\ h I~i.. T CH:! c! !TIE':-,TI(:) v':i. ,:\1 HCH/"iC' j.()O() We~;;t Ei(:ll.t.tt'l S.tl'.ee.t c:: ,';\ v~:L :L ':::. :L (:..:.-!! F:I f~:l :L ..;: <) :L :.::; Statement Date~ 04/09/200 L >,"d :i. .::t DI..I.,"'f P.. 0.. 1-:.0:>=: ':7'B Walnut Bottom~ PA 17266 Due Date~ 04/25/2001 ~~(-? :: P ift.U:I. F~ Dl.I.l""f Account Nr~ 101041 D ~:"I. t i:":: .... -. .... .u. .... .... .-. ..... _.. ._. ..... ..... .... ._. .... .... ..... ._. .... .... ..... _u .... _....... ._. .... ..... .... ..... ..... .... _.. .... ._. ._. ._. _. ..u .... _.. ..n .... .... .... ..... .... ._. .... ..... .._.. ..... ._. .... ._. ..... ....o. ._. .... ._. ._. .... ._. .... __. .... ...._ .... .... .... ..... .... ..... .... ..... .n. .... .... ...... ~ X::: ,::f. :1. ~':.\ r, c: I D0:~:; C I"':i. q t :i. on D a ~/~:; Ouc-..n t F~ (:1. t €.~ C h (~. I" (~! E: ~::. P<:tymE:.n t.:;; .... .... .-. .....- .... .-. ...... ..- .-. -... - .-. ..... .... .- -.- ..... .-....... .... .-..- ".... 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It (~~; i::~ () ~l :::> :.::; (.y' II :~.)~ :::> I:";':' ~! ::, .;' ~~ II :::); .... .1. (.:.:, .~. ':::. ':::' 1" f? in:i. t l:) >-., €=:', F' F;~ I 1... ::;:: !::' l' ';:'~ 0 ():L:I t hi:',:' L. -i';'t ~::. t .:':'t m <:) u. n t pI'" :i. n t. {:::. c:l (:1 n :::.-l:..:":"t, '1:.(~~'mF'n t " !::O:L E'i:'. S(.? :i. n c], uci (.:" i; C C:CHJ.n t. ".., v'.. 'h'''CH!"l 1::. t~':t t.(~~'iIH.~n t on lylEITiC! L. I",IE C)'f '>.... C) U. 1" c: j") I::: c: k'. .. ?:i n y p .::1. '~/m f.': n t ':::. I" f..:" c: t::! :1. v E: cl ~:I. "f t (:::. 1'" 0 (::f ./ :::1 / :? 0 () :t .~i. 1" (.:.:. not ,... f:::"f' :L (.::., c: t i::.~ ci (:) ~"J ':::. t. .~.{. t. (.:.:. rn €.:- r'f t. !~ ~:) 1 (:.~ ~':'t. ~::. (.:=: c! f::'~' ci 1..1. c: .t <:.. r-, .;..... .:?I. Ct ci :i. .j:. :i. C) r) .:~ ~L 1:) .::... ~.....fn r:.:.. rOt t. ':::_ ."......C) 1..1. tTi '::.'. ......... ~..i ':'";.'. \} !:.:.:- iT~ .;.;.'. :::t (.::.' .~':';. n d I" (.:.: (1"\ :i. -i:. t h !?::. i:) ~:f.l ~:I. n c: f::.:' !J' (:::' in Ct_ :i. n :i. n q .. T h .,:1. n k Y C) u .. ,. " S t.~... t. (-::'11H~.m t United Church of Christ Homes S-:.":I.r..ah A. Todd 1\1f~mor:ial HOir,,:? 1000 West South Street Carlisle, PA 17013 Statement Date: 03/13/20( L yd i. <.":1. Du ,'"'1: P.D.. Box 98 Walnut Bottom, PA 17266 'Due Date: 03/28/2001 I~e:: Paul I~ Dur.f Account Nr: 101041 ------------------------.--------------------------------------------------------- Date Description Days Gluan t Rate Charge~=) P 2\ ymE-~n t s B2d. -::\ rH .------------------.-----------.--------------------------------------------------= BALANCE F()I~WARD 41 ,076.4~:) 41,07f.).l NOTE: Please remit by MARCH 28, 2001, the Last amount printed on statement. Please include Account Nr.. from statement on MEMO LINE of your check.. Any P2\Y(I"tf?nt~; t'.€.~c<-:~ivE:~d crft<-?Ir O~~/28/2001 i:\r(-:~ not t'.e.flE.~ctE:~d on ~5tat(o:unf.~mt;: pl(-?i:\-::i.~~ d(o?d.....ct -::tl1Y i-\dditicm~:\l p..;.ymen1:.s you m~.f.Y h.:;\v(~~ m..":H:IE-? i:\nct remit the bali:\nce remi:\ining. Thank You. ,It. . ' ~3 t~. i:.i-?fIH'?11 t United Church of Christ Homes Sarah Aft Todd Memorial Home lOOO WE~S.t S.ou.th Str€~€:~t C.0.''"1 :1. ~:; 1 (~, PA 1]01:::") Statement Date: 02/12/20( Lyd ia Dur-f P..O.. Box 9B Walnut Bottom, PA 17266 Due Date~ 02/26/2001 Re:: Paul R Durf Account Nr: 101041 ---.--------------------------------------------------~---------------~-------------". Date Deseri ptie)n Days Quant Rel te ChargE:-s Payments B<i.\lanc ~.~---~._------------~---_._---_.._----------------_.-------------_._--~._-------_._-_._---- BALANCE F'OI~WARD 41!1076..43 41,076..4 r.fOTE :: Please remit by FEBRUARY 26!1 2001, the Last amount printed on statement. Please include Account Nr. from statement on MEMO LINE of your ch€:~c"':... Flny pel.ym€:~nts ,,'ecE?ivecl a1;tEH'- 01/3:l/~::OO:t a,'-€::- not l"'e'flec:t.f:~c1 on statement; please deduct any additional payments you may have made and remit the balance remaining" Thank You. . \ .' ~::; t, -::'!. t. ~:.:.:~ rn (::.f r't t. tJ n :i. t E' ci C hu, f' C j"1 cd: c:: h r' ]. ':::. 'I:. I"\(:HI"I'::':' ';;;. ~:::;.:':\ t..~ ,:.:\ t~ (:'1 u .r ()(j c~ i":"h:':-:~fn() V. :i. .;:;. :1. !"~C:qTp:.:.:t :1. () () () i..tJ (.:.! :::,.1:. ~:~; C) (.f. .~~. ~"i :::~; t. ;.,. f::~: {.:.~: ~t C~: -:':'!. v.} :L ~::. 1 C.:1~! r:' (~~ :L '.)~() :L :::':~ E t .:;~ t E' en r,:,' n t :0 .::i, t f::'::: () :t ,,/ :\. () ..f 2 () (> : L.. ,;./c~ :i. .::i. I) tt i....f F: It (J" I{())( (;}~:::~ t.J.) ~":'f. ]. r.i t.I. t. I{ () .i:r 1:. C) in ~l F' f~'1 1. ::} ~;=: (S 1~':' I)t.l8 I)ate: O:i/26/200:L J:;~ ~:-::1 ~~ i::1 '::1.1..1. :t F:.~ I) t.i. j....f (.~l c: c: (;) u, n t 1',.11"':: :1. () :t () l.i :1. .... .__. .... .... .... ..~. ._. ...._ .... .... .... ._. .... 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() () C) }:: '::/f] (:;"t r'i :L ::;'::,/1 O/()(} In con t:l, nE'n eE' ~:)U pp l:i. :1.2/3:l/0() i"~(:)c)rn & Bc)a(~.c~ Semj, :L .. 00 t~.:1 (.;.1 u ::::; ~5 {:) (.;' I. :.':.~ ~5 ,..:1 :t :::) ~::~ u () () :l :1. at i..:)() l.} :i. 1':'.\ " ()() t.} l..} u ~::l ~.;r .~) $I l,~ ~ - - :L II ()() :L 1 II 60 12/31/00 Room & Board - bem1 ::~..~ t{. :L ;:t !,:.:, I: () () :.:.:: !I ,:ll.:) () II (") () l~.:L :l () ';ll:J If ~..t. ~~ ('-,iDTE;: I..I .L (.:.:. .:.:.{. .:~:. €.:1t i". f::.:: (n:1. .;,~_ tJ '>.: ,:3 f~:'! f~"~ t.J {:! F.~ ..{ ~:':.: t::):l :~;:'~ () () 1 ~t ..t inl (-! ~... .::1" ~::. t. ,~:i. in C:- i..l. r', 4t, ~:j ~... i r-1 .t €~I (t C) r) ':::. "r:. .:~:\ t. ~::-!iTi (.:.:. r-~ t. It F~ :L (.:.:~ .~.!I. ':::. (~:.! i r'~ c: 1 f..t c~ (.::, f:~'! c: (::(] l..lr', t. t'..t f. u ~r f' (:~ en .:::..t:. .~.;\. ~i:. (:'~fn ::'::'s !"l t. ()r.~ 1\'\ i~: t~.t() L.. ~[ l"'11::. C) 'T~ ';...:. C) L i. i.'. C: ~"i {~~I C: ;..... H r:.:'i l'~ ..>.., ~) .::'( .>."(1"1 t":.:: r'i .t. '::~ V'I::,:I c: (~.:: :i. \/ r::':;::1 .::i. "f: .t (:.~& ~.,. :1.. ~.~:~ /.,~? t:~.:t ..f :;=~ () () () .:"~'i. v' ('"::: ~'l C) 't. (:Ir.~ .:::. .t..::!. 't:.t"::.:.(ni:::;in; t. ;l \]:L (~~'_:=:t.~:::.i::! c~ (_;'1(:\ i..i. c: t, .:';i.!"l'>'" .:.;\c\ c~ :i. .t:L ()r'j .:':'~ 1 1)-:::. '>"'fn(.:-::r~ .~:..:::. }_..()t!, in.:.:"!...../ .... . . r." f:"::!"( J. r:..~:: c: .t (~,:t c; t~'f .:.:"!. \/ (.:;.:. fr'~ .::\ (:.i (,:.:! .~:\r"~ (] !-"f;:rfr~:i. .t:. t. ~'.~i:::' i).:;\:l. .;:\r", C:l:::: ~'''f.:.ifn..:';\'i ri:1. r', I;J " "r \....i .:,.:'t r~t ~.,:. ....{ C) tJ. " E" f2-&~ci }::1../ Ji J ;woD ,.. n t. .::\ t (.:.:, in if.:" n t. Un:i. '\:.I::.!d C: hU.I." c: h o''f Chl"':i. ~::. t. \"\(:HnE":::, :::) .::\ I'" ,;t. h (:1" T c)(:\ d 1'11:-::;' inn I" :i. .:';<1. H 0 i1H-:,:' loob West South Street C~ .~~~.\ ro:L :i. 0;:;. :1. ('~I~! F> f~:) 1 -..:? () :1. :..:~:: L ycl :i. ,:t DI..\ I"'f F' .. 0 .. Bo x 9:::3 i},i.::',.:!. nut Be) t tCHn:1 Pf.'t :1. "7~:~66 Statement D~te= 12/15/200( Due Date~ 12/28/2000 F;~.?' :: P ,;.. u ]. F: D l..I. I'''f f.'1 c: c: 0 1..1, n t "..llr:: 1 ():l. Ot.i :1. D~."ti::~ 1)€:.,'::; C I'-:i. pt.:i. cln .U. .... .... .... .... .... ..... .... ..... .... ..u .... .... ..... .... ..... .... _., ..... _... .... 0... _0. .... ...... .... .... ..... _. ...., _.. n.. .... .... ..... .... on. .... un .... .... ..... .... .... .on ..... .... ..... n.. .... ...., ..... ..... .... ..... ..... ........ .... .... .... ..... ..u.... .... .... _... .... .... ..... ..... ..... _Ou ...... nO' .... .... .... .... u. C h,!~ lr q i::~~; D c\ 'i~:~ OtU:H) t f, '::". -i:. f:~ P r.~ '';l'm I:',:' n t ~:;. 13'::1.1 ~:tn C:{-:; .... ...... ...... ._. .... ...._ .... ..... .... .... .... ._.. .......... .... .... 0<0-4. --... .... __. _" .... ...._ _0. .... ..... ..... ..... .... ..... .... .... .... .... on.. .... .... ...,. ..... ._.. .... .... ..... ..... .... _-... ..... ..... ..... n.. ...._ ..... ..... ._.. ._. ..... ......... ...... ..... ..__.... .... '.no .... ..... ..... ..... _".. .~_ ...... ..... .... u._ ..... .... un .U" -...... E{ i~i L. f::j t',1 C E F CII:;': \JJ f~) F;~ D 11/07/00 Beauty & Barber 11/27/00 Oral Function Thera 11/27/00 Oral Function Evalu :l. :L/~::B,..lOO Ch",::\l Fun ct.:i.on TI"I€'~I""',:,. :I. :1. /~'::':? /00 n 1'- a:l. Fun c: t :i. on ThE' t.. ~~ 11/30/00 Incontinence Suppli 11/30/00 Medical Supplies :L :L /::')0./00 0,.".:\], Fun c t:t on T hi;-:! t" i:.. 12/01/00 koom & Board Semi 12/01/00 Room & Board Semi :\.2./01/0() 1:;.:oOITi 8.: BO;:t !"'ci S(':!ITI j, !'..\UTE:: :!... ()O 1 .t ()() :1...00 1..00 :L..OO 1..00 :l...OO :tIlOO ~:4 :1. P ], (i::' '::', ':::, i:.:" t" E.:' in :i. t '::; t. ,;:\ 'I:, i::.'tTf ~.:.:' n t. " by DECEMBER 28, 2000~ P ], 1":'::' ~'~ ~:; (.::,. :i. Ii C 1 u cl (.:~ i::', C c: CH.t n t Any payments received .}.... C) t.r~ t.... c: f-j r:::,' c: t..:. I~ :.:::<.1 !.l~.06.. :I. 4 :.:;;9:< '(.l06 .. :i.lj ~:.; ';) ,_ z~:~ 1 :::; at llj :..:) .:;' , i~ ~;.:: ~.:: $I .:;} l. ?..OO ~5:1... 00 7..00 ':?..BO :I. 1 r:+ .. 00 ~,:L .. 00 l <7' \t tif:;? ::::: &:,:} !l ,:\ l.i ::;:~ 11 E~ :::.. ~:I:I. .. 00 9"BO 0::/..00 :..::: (.~} , l+ !::t :::':~ U J::) :':" ~:~)~.:; :1 t.} <'::r ~:~ a l.i:: :.3 '~~ ~I ~~:f 2~+ :::") II (~) :': :...:") l.? :1 <:, () ::;") n {-3}~ :::') 1:.:;- !i !'~.. :1. :::") .. (~)~: .q :::"> !' 0 <? :::) .. I~ f l..} :.) !l ~.:~ :.:;; ~:l u .~:' ::: ...~ t4 'l () ~:; rf.:. II t:t ~~ 01 .. ~b) B:l. .. :;;:~() (:,0.. :;;:: ~:I l.t () .. :;:: ~,l 6 ~:.:,:t .. 00 :I.t~::I.. 00 ll+!:.).. 00 1. :~')~':) .. 00 9..BO ::') !11.:lBO .. 00 :l.45..\)() :.19::::.. 00 t. h f.':- to, ci. -s; 't .~~Ht'I CH.l. n t, p t" i n t €':> d on Nr.. from statement on MEMO LINE of .:;\..r: t.\::.- \~. J~ :~::/.'!~).~~I./~;:~()()() .:if.I--t?..:; r"j C) t. r-c::?-i~:t F:! c: t.i::.:r~ () n .:"..t ,';i, t. i:'J IT! i::.:' n t. ;; P 1 (,::., .::i. ~;; f:~ d !::.' d u c: t .:':\ n '/ .:~. d d :i. t :i. 0 n .;;1. :I. p .:':\ }'m i':~ n t. ~::. .~/O u. '::\ n c! 1'" i::! in :i. t thE' h <:1. ::. <:1. n C F.. I" (.?.' m _::1. :!. n i n q .. T h ,::1. n I..... ,.{ c:. u .. , . . . (1'1 i:\ .>.... n .::'f. \/ E' (n .:',\ Cl (.:! t l . .. E; t .::1. t (~~!"Ii (.:~. n 'j:. United Church of Christ Homes ~::; .::~ ,... c\ h t't ,. T (:) d d ITi(o~ ilK}!" :i. -::t:!. H CHIH-::C 1000 lj.J(i:! ':::. t ~:kH.l. t h ~:::; t \'" I'::-:'i::-:' t C~ .:':\ i'" :L :1. '::; :t )::'~!i j::' i~=t :1. .-l: () :1. :.:.) Statement Date: 11/13/200 L >"d :i. i:\. Du. r"f P..O.. Box 9B Walnut Bottom, PA 17266 Due Date: 11/28/2000 F~(.:! :: P ,,,:\U 1 I:~ Du Ir-f: Account Nr: 101041 --_._.._~.._._.__.__._.-...~._._._._.._....~._.-._...-.._..~_...._._....._.._-_.._.._-_.._-_._......_........_._.~-_..~._.."....-.._._..~._..~~--~.~.~._.__.~._"...-....-........-......-.. 1) .::'~ t E~ D€-:a~;cl":i. pi: j. on D~~ )/':::. I]u~tn t I~~ .::t t €-~ C h a I'" c;.1 E~ '5:. P<i'tymr:.-:an ts :f.':i:t J. an C:j ....... .... _.. _. _... ._.._ ..... ...... _.. .... ...... .._ ..... _. _.. .... .... .... ._. _. _"_ __~ _.. .... .... ..... .... ...... _.. .... .... _u .._ __ .... _ .... .... .... ..... .... .... ..... .... _.. ..... .... .... u_ .... _.. .... ..... .... _. ._. .... -- -..-.- .... .... ..... -. ..- .... .... .... .... ..... ..... ............ ..... .... ....... E{f-~LAI'-lCE FOI:~Wf~t=:~D 10/31/00 Incontinence Suppli 10/31/00 Medical Supplies :1. :l./O:l./OO F~r.::'f.)m &: BOE,xd .... S~:-:m:i. 1"00 46..40 1..00 60"BO ::') () :t ,q ~.) .. () 0 :.::;q , 9(:~B.. 91.i- I..lf.:. .. .qO 60..BO .q ~I ::> ~.)O .. 00 ::}4 , (?4B .. 9j ::;.q , 99~} " ::). ::::: ~5 ~I () 5t.) .. :I. :::) -:;- ~l l..~. () eJ " :l- j-'.JOTE:: t..' .U:.~{:l. '::;'02 t"€-~m:L t b'~/ t,jOV€:!ITI t:lI~! \'" ~:~B~, ;::O()O ~I thE' L..::l.':::. t .6\f1KH.I.n t p f' i n "t.f!.'c\ on '::;. t..;;;. tt;;--:'fn€:>n t. .. P 1 !~~-::-\ .::,; I......~ :i. n c 1 ud (~~ i:~f c coun t 1'-1 V' It 'f !"CHn '=:; t-::\ tE'ITIl-:~n t on IvIEr-IO L. I I'~E cd: .::-.... C) U I'" C 1"1 e c: k. .. (.:'t n y p ';:1. }'fn '=::! n t ':::. v- (!..:. c: i!:~ :i. v r::~ d _:!. -f: t fi!! ,.-. :I. O/:.!' :i. /:? () 0 0 -::1. t" €-'! n c:s i:. !~ Ed: 1 E' C 1:. IZ:! c! on ';:;, t.:;.. 'i:,(':'~I'IH:::'n t';l plc',::",'::;(~-:' dt?duc:t -:';\IY;.-' .~:~cid 1. tion.::d. p.::t>"iIH.~n t.-;::. }'O\..l. lTI(:t)" h.::~'v'{:::! in.:'H:iE:' and remit the balance remaining.. Thank You.. .. . Statement United Church of Christ Homes Sarah A. Todd Memorial Home 1000 West Sc,uth Stt-eet Carlisle~ PA 1~013 Sta temen t Date: 10/12/200' Lydia Durf P..O. Box 98 Walnut Bottom, PA 17266 Due Date: 10/26/2000 I~e:: Paul R Durf Account Nr: 101041 ------------------.--------.--------------------------------------------.---------- Date Description Days Quant Rate Chalrges Payments Bc\la.n c -------------------------------------------------------------------------------- BALANCE FORWARD 30,359.69 30,359 116 09/20/00 Beauty & Barber 1.00 7.00 7.00 30~366.6 09/30/00 Medical Supplies 1..00 64..05 64.05 ~30 !' 430 .. 7 09/30/00 Incontinence Suppli 1.00 23.20 23.20 30,453.9 10/01/00 Room & Board - Semi 3:1. 145.00 4,495.00 34,948.9 NOTE: Please remit by OCTOBER 26, 2000, the Last amount printed on statement. Please include Account Nr". from statement on ITIEMO LINE of your check. Any payments received after 9/30/2000 are not reflectE~cI on statement; please deduct any additional payments you may have made and remit the balance remaining. Thank You. .} .' S-I:.a temen -/:. United Church of Christ Homes Sarah An Todd Memorial Home 1000 West South Street Carlisle~ PA 11013 Lydia Durf P.O.. Box 98 Walnut Bottom~ PA 17266 Statement Date: 09/15/200i Due Date: 09/29/2000 Re: Paul R DUt"T Account Nr: 101041 Date -------_.__._-_.__._-----_._~.._---------_._-~.__._------~-""-----------_._--_._-_._----_._--~.: :Balancf, Des~cri. pti.on Days tluan t Ra te..~ Charges Payments .... -. .-.-.-----..---- --.-.-. - ~_._--_.- ---...----..--.-.-.---.------------.---..-..----..--..--.---.--....--..---.-.-.-----...--....-.- 08/18/00 08/0~~/OO 08/31/00 08/31/00 09/01/00 BAL.ANCE FOI=\:WAF(D PAYMENT -- f~ (3 C-I , NO". O€L III qq P€ ~V\'\..C4.( tie.. (), 51 tl Beauty & Barber Incontinence Suppli Medical Supplies Room & Board - Semi ~A 45~903.94 .. cr'-) ft.bj ~~nrt1<A..~ 1.00 7.00 7"00 1.00 34"80 34.80 1.00 63.95 63..95 30 145.00 4,350.00 ~~o ,000.00 NOTE: Please remit by SEPTEMBER 29, 2000, the Last amount printed on the statement. 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'." i' .... ...~ 't'" .... -.... n..'$ "~. + ~..~ ''..":, ..i. .:. ,':i.: ; ;... !;:: ;." ~:::: fr~ .'":\ :1. (1 :L c: (.:3 :: .. ,. .... .... : ~:::\ ~_.! !..!. ;'...;.. . J. . ...... . . :'.\ C~ C~ :~ 'E:.:L (::-, !"t .:';\ .f ~ ,~;.! ! ;'-. .; r::~ ;.. i. " ... ....'.. - {";':L II .,::~ ,,:,;.":,;. u ~-;.~. z ". ." '" .... . ..: " . ~ :..' . ~~; ... :~ ..... . z ... H .h . .., ,.:+ 1 ., ~::: (:: ~~. u t:; l.;. :i. :' ~;':~ ..:.....: () : z ~.:~:~ . ..' ... ........ ... :~ {-:L :; ~.::~ ,,/ 1../ ~ :.::> ... ... .... .,. .... . .'" ....l:. '.... ...; _i. ;! ..:.~ :...' ..' u .'- ~ :.:'.~.:L :* :::':~ (.:} i:':') I~ (.)! l.~:L u ~::; () ~::l If :::). I':"~" ~L ~f :::.;::L /+ u (>: .' ~ .. ... ." ."- ..... ," " :"'!.L t, '.::: ~'..; t:i n l:::i .. ., ....' ... J.':.~.l u ;-:.;. () t~ u :'./. l.~ :5 :i ,:.:;. () :::; " (? tt'j .::! (': o'~.:. " &' Statement United Church of Christ Homes Sarah A. Todd Memori~l Home 1000 West South Street Carlisle, PA 17013 Statement Date: 07/07/2000 Lydia Durf P.O. Box 98 Walnut Bottom, PA 17266 Due Date: 07/25/2000 Re: Paul R Dur.f Account Nr: 101041 Date Description Days Quant Rate Charges Payments Balance BALANCE FORWARD 36,601.13 36,601.13 06/27/00 Speech & Hearing Ev 1.00 66.00 12.16 36,613.29 06/27/00 Speech/Hearing Ther 1.00 44.00 8.70 36,621.99 06/28/00 Speech/Hearing Ther 1.00 44.00 8.70 36,630.69 06/30/00 Incontinence Suppli 1.00 58.00 58.00 36,688.69 06/30/00 Medical Supplies 1.00 60.75 60.75 36,749.44 07/01/00 Room & Board - Semi 31 145.00 4,495.00 41,244.44 NOTE: Please remit by FEBRUARY 26, 2001, the Last amount printed on statement. Please include Account Nr. from statement on MEMO LINE of your check. Any payments received after 01/31/2001 are not reflected on statement; please deduct any additional payments you may have made and remit the balance remaining. Thank You. . ' ~::) t ~:'I. t E' en i::.! n t Sarah A. Todd Memorial Home :!. 000 llJ ,:-:~' ~;;. t ~::) () u. t. h :::) t 1"" (~:< i,:~' t Carlisle, PA 17013 T if_':'} i,:~ p h C) n !:-::- :: ( "? :I. '7) . ~::? l~. ~) ---::;:: :!. :;;{.? Statement Date~ 06/13/20C L. ycl :i. .::"t. Du 1'"" 'f: P.. C) II Box 9B Walnut Bottom, PA 17266 Due Date: 06/28/2000 l::':(~~:: P au]. i:~ Dt.u-"f Account Nr: 101041 ..... _. __ ..u .... .... ._. ..... .... .... ..... ..... .... ...... _. .... ..._ ..... .... .n' ..... .... .... ..eo .... ..... .... ..... ._.. ..u. .... .... ..._ .... __ ..... ......... .... .... ...... ....... ..... .._ ._. .... .... ....... .... ........ .... _. _.._ ....__ .... ..- .... ..... .-. .... .... .... .... .... .... ..-..- -.. .... _.0 ..... ...- u_ ..... ..........-. D -:'..-i. t. i:':'! De'!::. Ct.. :i. p t:i. on 1) ,cl. '::/~; Cluan t R ~:l. t E.! C hE~ t-9 f::'S Pa~/m(I.:'n ts I: ,::'t :l. .iit n c .... ..... .... .... ...... _.. .... .... __ ...._ ._. ._. _. _. _._ .... _.. u.. .... ..... u.. .... _.. ...._ _.. ._. __ ...... _. ...... ._. ._. _. ...... ..... _. ...... ..._ .... .._ ..... .... .... .... _.. ...... .... .... _. _... ..... _... ...... _.. _.. _.. _.. -.. _... _.. ._. ...... ..... ..- ...... .... ...- .- ..- -... -... -.- ..... .... -.. ...... u... -.. ..... ~:.:IB II 00 j,!5..00 ~::, ;::~ n () (.1 3~':: , 1. OB .. :i. 2');;:': !' :l. :l.. ~) .. :I. :.:') ~:: !! :1. '.? i3 n :t :~.) ;:": ~, ~:: ~..:.; t.> n :t :.'":; ~..:: ~t ~:~~) 1. sa :1 ::;>6:; (:,0:1. .. j JJ ,-:'1 1... f~ 1--1 C E F 0 F;~ l}.J i:~1 F;~ D OS/23/00 Beauty & Barber 05/31/00 Medical Supplies 05/31/00 Incontinence Suppli O~.7'/::'):i./OO OXY(]E\n ()f.;./O 1 /00 F~C)C)m ;~ Bo..3.I"c! .... BE'!ff1:i. j,,,()() :1.... 00 :1..00 :1...00 ~:')() '7.00 ::::;2!1 lOB.. lB 7..00 6:::~ .. 9::1 62.. ':';-'!j :i.L~5.. 00 1 ~5 .. 00 1.1 , ~:) ~-:IO .. 00 j....IOTE:: Please remit by JUNE 28, 2000, the Last amount printed on the statement.. F'lease include Account Nr.. from statement on MEMO LINE o~ ;./;::H.I.I~' c: rH':-:- c: k... tH'!'/ p.;:....~/ilH:::.n t -:::- t..€.! c:(.:-:' :i. 'v'E'd ~:.d: tE'I". !:.:'f"::::; :l./::~OOO .~t.l"'I?:~ nc) t t-';-:,"f]' f:- ci:.0~d on statement; please deduct any additional payments you may have made and remit the balance remaining.. Thank You. .' ::::; tat. (~fIi t:-:-:. n t. Sarah A Todd Memorial Home 1000 West South Street Carlisle, PA 17013 Telephone~ (717) 2SS-2187 Statement Date~ 05/12/2000 L ycl :i. -iiI. Du ,"'i: P.. 0.. Bc))( 98 Walnut Bottom~ PA 17266 Due Date: 05/30/2000 F~e:: Pi:H.d I::': Du,"'f Account Nr: 101041 D~,,:\ t.e l)€.~~; C I'" :i. p t i on P2l,>'m€:~n t~:; _....._..~_....._.-.----~.~._.~._.~_._._.._._._--.~-_.....~."......_.._._..-._.._..~........._...---_.~.._.._.._.._.._..~....~..~._._._...~._.._.~-~......~._-_......_.__......-...-.~.._..._........ Balan C:f:~ Da}/s Gluan t F~.i:\ .t.2 Lhe"I'-9E'~; -- .... ..... - .--..- -.._ .-. .-. ..- -.. .... ..... .... .... -- .....- e_ .... .... _._ .... .... .... ..... ..... I_a ._. "We .... .... 'M' .... ..... .... ..... ._. ._.. ..... .._....h ..... ._. ._. ..... .... _... ..... ~.... _... _... ._.. .._ ._.. ......._ _... ..._ ..... ........_.._ ..... ._. __ .... ._. .......... ..... ._. _. _.._._ .._._._ B~ILf~I"ICE FOF~WlqF..:D 04/30/00 Incontinence Suppli 04/30/00 Medical Supplies 05/01/00 Room & Board - Semi ;:::':1 h ~~O ~:~'7 !1 ~.=' ~:: 9 II ~::~:) ~:~::> at ~:: 0 1..00 1..00 ~:)l ~.)o.. 7!5 :f.l+~I.. 00 60.. 7~.\ I..} , I..J 9 ~.:I .. () 0 I'IOTE :: Please remit by MAY 30, 2000, the Last amount printed on the statement.. Please include Account Nr.. from statement on MEMO LINE of your check. Any payments received after 4/30/2000 are not reflected on =:.t..i.~,t(-?flH~:znt.~ pl(-:.:.-:,,:'~':;;,(-:-:- cleduc:1:. ,:I,rl>.' ,,,cid:i.t:i.on.:;..l p.::i../.'mf.:\I"lt~5 'y'CH.t frI.::",}" h,':\v(-? flj.:':I.df.:o and remit the balance remaining.. 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I el S tc\ -b.?mE-?n t Sarah A. Todd Memorial Home 1000 West South Street Carlisle, PA 17013-2798 (717) 245-2187 Statement Date: 01/05/2000 Lydia Dur'f P..O.. Box 98 Walnut Bottom, PA 17266 Due Date: 01/19/2000 Re: Paul R DUFf Account Nr: 101041 ------------------------.~_._-----------------------------~---------_._------------ Date Descri, pti.on Days Quant r-\:ate Chal"ges Payments Bal~ln ce --------------~---_._--_.._------_._-----------------------.-------------------------- BALAt-lCE F(JI~WAI~D 111376..:1.4 :l ,3"71.>.. :I. 4 :1.1/01/99 Room 8: Boa r'cJ - Semi 30 133..00 311990..00 51'366..1.4 11/:1.0/99 Bei:\L\ t y & Barbe,'" 1..00 7..00 7..00 5 , 37:3 .. 14 11/30/99 In con tinenc:~~ Suppli. :I, ..00 34..80 34..80 5,407..9t4 11/30/99 Medical Supplies 1..00 112.25 1j.2.25 :3 , 5~~O .. :1. 9 12/01/99 Room 8: Board - Semi 31 1::;3.. 00 4 !t 1 ~~3 .. 00 9, c)43 .. j,9 Please I"emi. t paymen t i.n 15 Days.. Please pay last amount printed on statement. T'f: you ill<:..de <:\ p.;~Yil\ent in Dee.. t9O:i9, pleasi-fi' deduct amount paid from the last line and remit the balance remaining. SARAH A..'T()~D.MEMORlALHOME 1000 WEST. SOUTH. STREET .CARUSLE,PA 17013 PH{)NE (717)245~2187 I PAGE~ :!. ol '.' AMOUNT OF PAYMENT 1$ RESIDENT NAME RESIDENT NUMBER SEX AGE ADMISSION DATE DISCHARGE DATE STATEMENT DATE :() ~. J F:.~ r:~ F:tf::'tI.JL.. () () () .1. () .i. ()l~l 4t.. l"~ I:':') .... .") \:::~ f".'.;....t ().../::::; :l. ,,".":.~) ::.) t't.. .. .. 1... Y J) If:, DljF;~F F' " D.. 'BD>< ':;.:'B E W.. i'ltf:) I I'.j STF~EET 1},If:'tL.I'..IUT BC)TTOjv\ ****************************** H?)F'P\' ::{{ >:{ ::t~ ){-:: :;{< >~{ >?;: :+=: F'(', :i. '7~?66 T H I{~! t..! I{ ~3 Ci I \.1 I j',) c:; ::t:::*:* :* *: ***************~************** F'L.E{',GE r;~Ejv! I T D"'r' :l.:L /?I..} /':?~":> :I. O/()6/9<.'(J BI{:'IF~BEF~../DEf:1i...iT I C: I (~:I!',i ~:)EF:':'V' I CE: :I. O/~'::B/?':;;' CO'''+'{:YYIT1EHT Dl..JE FF~Or{1 F~Et) I DE}.rr :l. O,,/:::):!. /':?~.Y' :::; LEVEL :':') I'H:: F {ie T I... I TY D(..iYB (~! :J. :.::;:::5" 00 l ()/....:.:~:L /9? I"IED I C:{:)L.. SUPPL. I FE; :1. ()./ ::::; 1 / .:;;- <.:.:- P E F:': E; 0 I'.! (:j L L t'\ U j',,( D F;~ y 1..00 4.? II () I:) (.~} <:.) () II () () :~.:.~ (; <;.j .. () () :L .. 0 () ::~:~ .: (~':, l~~ :I. () /.:":.:(;'.... :i. O/::::::i. J. It ~.)() 11/():I./>:?9 :.:~() "I...E\./EL. :.:;; 1'.\(:: F:-t'tCIL..I'"j""{ I) (~1 Y ~~ (~! 1 :~.) ~::';: n () () -.. ... f.... ....I -.::' ',:/ ...:/ () it () () STA'TEMENTOATE :1. O/':::;:l. /"?9 t. ()O CURAENtACCT.~aAlANCE ADVA~CECijARGES,/,;j n () () :L :::\ .)t (~.) It :L '-:l ~::) $=-;) S:;'J () tl (~~() PREVIOuS BALANCE ~URRENtCtlAAGF$; .. 00 1 :::';:"7 (::' .. :1. If , 'PAYi-'ENrs ~l~!~.~.imif~~~~~~;~iiki"'" PLEASE PAY ~ THIS AMOUNT " $ !.:1 ::> Co) (!). it 1-4 4 .JUk-17-02 WED 07:49 AM MCKISSaCK HOFFMAN FAX:7175403434 PAGE 17 VERIFICATION I. Mary Jane Walker, hereby verifies that the statements in Answer and New Matter to Plaintiffs Complaint together with New Matter Counterclaim Pursuant to Pa.R.C.P. 2256, are true and correct to the best of my information, knowledge and belief. I understand that the statements are made subject to the penalties of PA.C.S. Section 4904, relating to the unsworn falsification to authorities. ~-J( ~~rf ))~JJ(~) Mary Jane Walker, Administrator for United Church of Christ Homes t/a Sarah A. Todd Memorial Home Dated: /( . )'( . J) /'L- .. ... CERTIFICATE OF SERVICE I hereby certify that on the date set forth below, I am serving a copy of the foregoing Answer and New Matter to Plaintiffs Complaint and New Matter Counterclaim pursuant to Pa.R.C.P. 2256 upon the person(s) and in the manner indicated below, which service satisfies the requirements of the Pennsylvania Rules of Civil Procedure, by depositing a copy of the same in the United States Mail, first-class, postage prepaid, addressed as follows: Anthony Adams, Esquire 128 West King Street Shippensburg, PA 17257 (Counsel for Plaintiff) McKISSaCK & HOFFMAN, P.C. Date: 7h9~ 2 ., -,. BY:~ Edwin A.D. Schwartz, 1.0. #: 75902 2040 Linglestown Road Suite 302 Harrisburg, PA 17110 (717) 540-3400 Attorneys for Defendant, United Church of Christ Homes, Inc., t1a Sarah Todd Memorial Home BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA If; .r;41"1" *C:;JL DEPARTMENT OF REVENUE A \f,o ~~ ~ NOTICE OF INHERITANCE TAX \'- ,~-1 ~ APPRAISEKENT~ ALLOMANCE OR DISALLOMANCE OF DEDUCTION~, AND ASSESSKENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-iS"8 EX AFP <12-00> LYDIA B DURF BOX 98 WALNUT BOTTOM DATE ESTATE OF DATE OF DEATH FILE NUMBER lei, COUNTY .SSN/DC ACN 08-13-2001 DURF 12-11-2000 CUiiER~'~"f"Y 3 204-30-6857 01125813 Allount R...itted PAUL R PA 17266 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ iifv:is~i-E)f-AFii-(i1f:ooi------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 08-13-2001 ESTATE OF DURF PAUL R DATE OF DEATH 12-11-2000 COUNTY CUMBERLAND FILE NO. S.S/D.C. NO. 204-30-6857 TAX RETURN WAS: (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 01125813 FINANCIAL INSTITUTION: ALLFIRST BANK ACCOUNT NO. 0097214078 TYPE OF ACCOUNT: () SAVINGS (>0 CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 01-28-1980 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 26,400.20 0.500 13,200.10 .00 13,200.10 .00 .00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE . ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. . ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A ..CREDIT" ( CR), YOU I1A Y BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE / t:-e2S19 - /W~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG# PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEKENTL ALLOHANCE OR DISALLOHANCE OF DEDUCTION~, AND ASSESSKENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-l&48 EX AFP (12-11> lYDIA B DURF BOX 98 WALNUT BOTTOM DATE ESTATE OF DA TE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 08-13-2001 DURF 12-11-2000 ~-OI"'OlLfa CUMBERLAND 204-30-6857 01125812 PAUL R Allount Rellitted PA 17266 :. ._r.... MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WIllS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REfv:is~8-E)f-AFi>>-(i1f:ool------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 08-13-2001 ESTATE OF DURF PAUL R DATE OF DEATH 12-11-2000 COUNTY CUMBERLAND FILE NO. S.S/D.C. NO. 204-30-6857 TAX RETURN WAS: (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 01125812 FINANCIAL INSTITUTION: AllFIRST BANK ACCOUNT NO. 87004938900599 TYPE OF ACCOUNT: (x> SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 11-06-1989 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 1,544.60 0.500 772.30 .00 772.30 .00 .00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WIllS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WIllS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. . ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. . IF TOTAL DUE IS REFLECTED AS A ..CREDIT" ( CR), YOU "AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS. ) . 0'(... (J/ ;" STATUS REPORT UNDER RULE 6.12 Name of Decedent: ~ 'h u \~ Date of Death: Will No. Admin. NO.;;t!f:J ( -- (j() 7Cf-S Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1 . State whether ~inistration of the estate is complete: Yes NO~ 2. If the answer is No, state when the personal representative reasonably ~eli~ves that the administration will be complete: -, n ?'O~) ~ \ l ~(tl~'T.N-- ~\~. 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. Date: JJ Jp/O;r- / f s~~~ \-\. ~-\9~---~ mNV'-S Name (Please type .. r p~in~ lj q 'r\>:l '. CN"~ .s. ~ ~'^\~.~ c \'0-,,)" \("'" (1'7~57 Address \ r)/'7) S ?/ d ~"3>/"70 Tel. No. (MAH:rmf/AM3) Capacity: Personal Representative .~ Counsel for personal ~epresentative - cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 ,- Date: 11/05/2002 DURF LYDIA B 5 EAST MAIN STREET BOX 98 WALNUT BOTTOM, PA 17266 RE: Estate of DURF PAUL R File Number: 2001-00743 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 12/11/2002 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, MARY C. LEWIS REGISTER OF WILLS cc: JFile Counsel Judge JRD/June 30, 1992/17858 JAN 1 2 200~~ Estate No.: 21-01-0743 ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA In Re: Estate of Paul R. Durf Late of South Newton Township NO. 21-01-0743 NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE Personal Representative: Lydia Durf Counsel for Personal Representative: Anthony Adams, Esquire Date of Decedent's Death: 12/11/2000 Date of Delinquency Notice: 01/10/2005 The undersigned, Glenda Farner-Strasbaugh, Clerk of Orphans' Court, in accordance with Rule 6.12, Supreme Court Orphans' Court Rilles, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cwnberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, was given by the Clerk of the Orphans' Court on November 10, 2004, and that the ten (10) day notice to file the Status Report has expired. Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Date: 01/13/2005 ~~~~7r Clerk ofthe Orphans' Court Distribution: Personal Representative Counsel for Personal Representative Estate File "v't\a.xc1. '\- '100 S- <J : 3 () -A \VI A hearing is scheduled for atl in Courtroom No.3. If the Status Report is filed prior to the hearing date, the hearing will automatically be cancelled. j) VV" Geor Name of Decedent: STATUS REPORT UNDER RULE 6.12 ?~u\ ~, b\Jr+ \~~ dOOO Date of Death: Will No.: Admin. No.: 'd (-0(- o7l/3 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State~ether administration of the estate is complete: Yes J2S.l No 0 2. If the answer is No, state when the personal representative reasonably believes that the administration will,be complete: 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No 0 b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personalwesentative s, tate an account informally to the parties in interest? Yes J2Sl. No 0 c. Copies of receipts, releases, joinders and approval of formal or informal accounts maybe filed with the Clerk of the Orphans' Court and may be attached to this r~rt. ~ Date:~CoIOS "~ ' SIgnature \-i Name ~~~~ AO-~ ~ ~.. O{'~e &~~* AddressS; '~""$\1v-i~1 <::\. I (d'S 7 ') /1- <;; ~~ ~ 3;) 7() Telephone No. c:> r.-..... '.,'d Capacity: n Personal ReDresentative I)itCounsel for 'personal representative vA