HomeMy WebLinkAbout01-17-14 (2) 1 1505610105
-� REV-1500 EX���_��>�F�>��
PA Department of Revenue pennsylvania OFFICIAL USE oNLY
E�•a»E� F aE�E��E Counry Code Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURN
PO BOX 28o6oi /�) �� %����
Harrisburg,PA 1�128-o6oi RESIDENT DECEDENT ��
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
' 04/25/2013 ' 03/27/1926
DecedenYs Last Name Suffix Decedent's First Name MI
Delasin Dorothy H
(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
� 1.Original Return O 2.Supplemental Return O 3. Remainder Return(Date of Death
Prior to 12-13-82)
O 4. Limited Estate O 4a. Future Interest Compromise(date of p 5. Federai Estate Tax Return Required
death after 12-12-82)
� 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust _ 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
O 9. Litigation Proceeds Received O 10.Spousai Poverty Credit(Date of Death O 11. Election to Tax under Sec.9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAI TAX INFORMATION SHOULD B�,,DIRECTED T0:
Name Daytirr�Telephone N�Imtier � �
ft1
Philip Delasin ' � a C_ � �
m � � -- �
Gf�E F WILLS USC-4iNE�
D F—� g a� t'�i
� � � � � �
� � ?C G'y `'-;,
First Line of Address �
C;:7 � Cy � -„� �ce'i
1318 Kingsley Road � <:� --t� -r- �
� f._., �
Second Line ofAddress _._ : � � �...- r'�-¢
fi
r� _,�-- r!� C:�
r � `R
City or Post Office State ZIP Code DATE FILED
Camp Hill PA '17011
CorrespondenYs e-mail address: �V �)���LQ ��,2r Z��,Lj , N�j
�
Under penaities of perjury,I deciare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true,correct and comp lar ' preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE. P SP IBLE R 1NG$�TURN DATE
/ ' �' � -��
ADDRESS '
/�3%�' �S`i�1G S c..�y �'o ���rs'Ir� ��-r �� � ��l�
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
� 1505610105 15�5610105 �
�
� 1505610205
REV-1500 EX(FI)
DecedenYs Social Security Number
DecedenYs Name: '
RECAPITULATION
1. Real Estate(Schedule A). .. ...... ........ .............. ... ......... . . L
2. Stocks and Bonds(Schedule B) .. ... . ... .............. ... ........... .. 2. ' 713.83 ,
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) ... . . 3. '
4. Mortgages and Notes Receivable(Schedule D) ... ... ...... ... ..... ...... . 4.
5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E).. . .. .. 5. 110,399.05
6. Jointly Owned Property(Schedule F) O Separate Billing Requested . . ..... 6. 2,714.21
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property ,
(Schedule G) O Separate Billing Requested.. ..... . 7. '
8. Total Gross Assets total Lines 1 throu h 7 g, 113,827.09 '
� 9 )... ..... ......... ........... .
9. Funeral Expenses and Administrative Costs(Schedule H).. ... ..... ... . .... . 9. ', 16,218.20
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)... ... ..... . .. . 10. ' 16,325.95
11. Totai Deductions(total Lines 9 and 10). . . . .... .... .. . .. . ..... ... ... ... . 11. 32,544.15
12. Net Value of Estate(Line 8 minus Line 11) ...... . .. ... . . ... ..... ... . . ... 12. 81,282.94
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which '
an election to tax has not been made(Schedule J) ... . . . .... . ... . .. ... ... . 13. 8,128.30
14. Net Value Subject to Tax(Line 12 minus Line 13) ... ...... ... ... ..... ... . 14. ' 73,154.64 ,
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116
(a)(1.2)X A_ 15. , '
16. Amount of Line 14 taxable .
at�inea�rate X.0 45 ' 70,440.43 , �g. 3,169.82
17. Amount of Line 14 taxable __ _ _ _
at sibling rate X.12 , , 17. '
18. Amount of Line 14 taxable 2,714.21 407.13
at collateral rate X.15 18.
19. TAX DUE .. .............. ... .. . ... ... ..... .... ... .... . . .. . . ... . .. . 19. S57B.95 '
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Side 2
� 1505610205 1505610205 �
Decedent's Cornplete Address:
DECEDENT'S NAME
Dorothy H Delasin
. - . _
__ __ _ __ ___. _ ___ _ . __ _
STREETADDRESS
Country Meadows
_ __ .. _ _ _. _ _. __
_ __ .
4905 East Trindle Road
__ _ __
CITY __ _ _ _ _ STATE ', ZIP
Mechanicsburg ', PA ' 17050
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 3596.14
2. CreditslPayments
A.Prior Payments
B.Discount
_ __ _ Total Credits(A+B) (2)
3. Interest
(3) 0
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2,Line 20 to request a refund. (4)
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 3596.14
Make check payable to: REGISTER OF WILLS, AGENT.
a . ro.s , ua. �� , �" . �
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.......................................................................................... ❑ �
b. retain the right to designate who shali use the property transferred or its income ............................................ ❑ �
c. retain a reversionary interest .............................................................................................................................. ❑ �
d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ �
2. If death occurred after Dec.12,1982,did decedent transfer property within one year of death
without receiving adequate consideration?.............................................................................................................. ❑ �
3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?.............. ❑ �
4. Did decedent own an individual retirement account,annuity or other non-probate property,which
contains a beneficiary designation? ........................................................................................................................ ❑ �
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN,
For dates of death on or after July 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 Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000:
. The tax rate imposed on the net value of transfers from a deceased chiltl 21 years of age or younger at tleath to or for the use of a natural parent, an
adoptive parent or a stepparent of the child is 0 percent[72 P,S.§9116(a)(1.2)].
. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)].
. The tax rate imposed on the net value of transfers to or for the use of the decedenYs siblings is 12 percent[72 P.S.§9116(a)(1.3)].A sibling is defined,
under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
� pennsylvania SCHEDULE B
DEPARTMENT OF REVENUE
INHERITANCETAXREfURN STOCKS & BONDS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Dorothy H. Delasin
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1• MetLife stock-19 shares 713.83
TOTAL(Also enter on Line 2, Recapitulation) $ 713.83
� pennsylvania ��n�vv�� �
DEPARTMENTOFREVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX REfURN pERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Dorothy H. Delasin
Include the proceeds of litigation and the date the proceeds were received by the estate,
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION Of DEATH
� Metrobank-checking account 1,473.95
2 Sovereign Bank-checking account 94,205.93
3 Inheritance check from sister's estate 13,354.77
4 retirement account death benefit 1,364.40
TOTAL(Also enter on Line 5, Recapitulation) $ 110,399.05
��.:`_��� s pennsylvania SCHEDIJLE F
DEPAR?MENT OF REVENUE
INHERITANCE TAX RETURN 70I NTLY-OWN ED PRO PE RTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
If an asset became jointly owned within one year of the decedent's date of death,it must be reported on Schedule G.
SURVIVING]OINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
q, Ross Gibson son's partner
B.
C.
JOINTLY OWNED PROPERTY:
�ErreR onh DESCRIPTION OF PROPERTY �io oF DATE OF DEATH
I'fEM FOR 101NT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT'S VALUE OF
NUMBER TENANT )OINT IDENTIFYING NUMBER.ATTACH DEED FORlOINTLY HELD REAL ESTATE. VALUE OF ASSEi 1NTEREST DECEDENT'SINTERESf
1, A. Santander Bank est.12/1912006 acct:1055541633 1140.49 100 1,140.49
2 Santander Bank est.12/19I2006 acct:1055459489 1573.72 100 1,573.72
TOTAL(Also enter on Line 6, Recapitulation) $ 2,714.21
� pennsylvania '�•n�vu�� n
DEPARTMENTOFREVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RENRN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Dorothy H. Delasin
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1' funeral,casket,burial.etc 14,681.86
2. flowers 235.84
s. tombstonelfooter 200.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s) __ __ _ __ _ .__
Street Address
City _ _ . _ __ __ _ State __ ZIP _ .
Year(s)Commission Paid, __ __ __ __ __ __ __ _
�. Attorney Fees:
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation.)
692.00
Claimant
Street Address
_ _. __ _ _ _ . _
City __ _ ___ _ _ _ State _ ZIP _ __
Relationship of Claimant to Decedent __ __ __ __ ___ _
4. Probate fees: 408.50
5. Accountant Fees:
6. Tax Return Preparer Fees:
7.
TOTAL(Aiso enter on Line 9, Recapitulation) $ 16,218.20
� pennsylvania ��ncvu�� �
DEPARTMENTOFREVENUE DEBTS OF DECEDENT,
lNHERITANCE TAX RETURN MORTGAGE�LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OP FILE NUMBER
Dorothy H. Delasin
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,inciuding unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1� LL Bean 784.11
2. Sallie Mae 10,983.74
3. Sallie Mae 4,390.09
4. Diamond Pharmacy 83.01
5. Travelers Insurance 85.00
TOTAL(Also enter on Line 10, Recapitulation) $ 16,325.95
� � ��pennsylvania SCHEDULE �
: DEPARTMENT OFREVENUE
INHERIfANCE TAX RETURN B E N E FICIARI ES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Dorothy H. Delasin
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS[Include outright spousal distributions and transfers under
Sec.9116(a)(1.2).]
i. Phil Delasin son 45%
2. Elaine Kennedy daughter 45%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
Silver Bay Association 2%
2. American Academy in Rome 2%
3. Camp Hill Presbyterian Church 5%
4. Penn State University 1%
TOTAL OF PART II—ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ 10%
0
�
LAST WILL AND TESTAMENT a ° -� � �
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DOROTHY H. DELASIN `-� �::.' - =�� _
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d> C..� t;t; �?
�i "�3
I, DOROTHY H. DELASIN, of Cumberland County, Pennsylvania, do make,
publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils
by me at any time made.
ITEM I: I direct that all inheritance and estate taxes becoming due by reason of my
death, whether such taxes may be payable by my estate or by any recipient of any property, shall
be paid by the Executor out of the property passing under ITEM IV of this Will, as an expense
and cost of administration of my estate. The Executor shall have no duty or obligation to obtain
reimbursement for any such t� so paid, even though on proceeds of insurance or other property
not passing under this Will.
ITEM II: I direct the Executor to pay the expenses of my last illness and funeral
expenses from the property passing under this Will as an expense and cost of administration of my
estate.
ITEM III: I hereby devised and bequeath to my son,Philip Joseph Delasin, the sum of
Sixty-Eight Thousand Dollars ($68,000.00) provided he survives me. This bequest shall lapse
1 �� ��J
however, if, during my lifetime, I have allowed my son to purchase my home at 1318 Kingsley
Road, Camp Hill, Cumberland County, Pennsylvania 17011 with a reduction in its then current
fair market value by the sum of Sixty-Eight Thousand Dollars($68,000.00) or I have otherwise
made a direct payment of Sixty-Eight Thousand Dollars ($68,000,00)to my son, Philip Joseph
Delasin.
ITEM IV: I devise and bequeath the rest, residue and remainder of my estate as
follows:
(a) Forty-five percent (45%)to my daughter, ELAINE JOYCE KENNEDY.
In the event my daughter predeceases me, this share shall be paid to her
issue, per stirpes. If my daughter predeceases me and leaves no issue, I
direct this share be paid to the beneficiary set forth in subparagraph (b) of
this Item;
(b) Forty-five percent (45%) to my son, PHILIP JOSEPH DELASIN. In the
event my son predeceases me, this share shall be paid to his issue, per
stirpes. If my son predeceases me and leaves no issue, I direct this share be
paid to the beneficiary set forth in subparagraph (a) of this Item;
(c) Two percent (2%) to SILVER BAY ASSOCIATION, a YMCA
Conference Center in Silver Bay, New York 12874;
(d) Two percent (2%) to the AMERICAN ACADEMY in Rome, whose office
is located at 7 East 60``' Street, New York, New York 10126-1334;
(e) Five percent(5%) to CAMP HILL�'RESnYTERIAN CHURCH ORGAN
FUND. If the Organ Fur.d is non-existent, this amount may be spent at the
discretion of session with preference given to musical or Christian Education
programs; and �
(� One percent(1%) to PENN STATE UNIVERSITY, Main Campus, University
Park, Pennsylvania 16802, to be used for the acquisition of library materials or
books.
2 ;���i
ITEM V: In the settlement of my estate, my Executor shall possess, among others,
the following powers:
(a) To retain any investments I may have at my death, as long as the Executor
may deem it advisable to my estate to do so;
(b) To sell either at private or public sale and upon such terms and conditions
as the Executor may deem advantageous to the estate, any or all real or personal property or
interest therein owned by the estate;
(c) To pay all costs, taxes, expenses and charges in connection with the
administration of my estate;
(d) To compromise controversies; and
(e) To do all other acts in the Executor's judgment deemed necessary or
desirable for the proper and advantageous management, investment and distribution of the estate.
ITEM VI: Any person who shall have died at the same time as I shall have, or in a
common disaster with me, or under circumstance that the order of deaths cannot be established by
proof, or within thirty(30) days of my death, shall be deemed to have predeceased me.
ITEM VII: I appoint my son, PHILIP JOSEPH DELASIN, to be the Executor of my
Estate. In the event he should predecease me or be unable to serve, I appoint my daughter,
ELAINE JOYCE KENNEDY, as alternate Executrix. Any Executor is specifically relieved
from the duty or obligation of filing any bond or other security.
3 ���
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last
Will and Testament, consisting of this and the preceding three (3) pages, at the end of each page
of which I have also set my initials for greater security and better identification this /��-•day of
July, 2005.
C 1 ._
�/ 1.�� �.,� �sE�,�
DOROTHY . ELASIN
We, the undersigned, hereby certify that the foregoing Will was signed, sealed,
published and declared by the above-named Testatrix as and for her Last Will and Testament, in
the presence of each other, have hereunto set our hands and seals the day and year first above
written, and we certify that at the time of the execution thereof,the said Testatrix was of sound
mind and memory.
/,i� �
UIi�`1��(��'�-��� ����' Residing at: 129 Herman Drive
Amanda L. Baker Lemoyne, PA 17043
^ � .l J�?��L�r���. � � Residing at: 123 Seventh Street
Laura J. I�u es , New Cumberland, PA 17070
�
4
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVAI�TIA :
: SS
COUNTY OF CUMBERLAND :
I, DOROTHY H. DELASIN, Testatrix, whose name is signed to the attached or
foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I
signed and executed the instrument as my Last Will and Testament;that I signed it willingly, and
that I signed it as my free will and voluntary act for the purposes therein expressed.
� �u�ti�� (SEAL)
DOROTH . DELASIN
Sworn to and sub ribed
before me thi �day
of 7uly .
�
� NOT PUBLIC -
My Commission Expires: (SEAL)
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��eoaour�
cu�rtw�o��s.zoo�
comn�«�
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA .
: SS
COUNTY OF CUMBERLAND •
We, Amanda L. Baker and Laura J. Hughes, the Witnesses whose names are signed to the
attached or foregoing instrument, being duly qualified according to law, do depose and say that
we were present and saw Testatrix, DOROTHY H. DELASIN, sign and execute the instrument
as her Last Will and Testament; that Testatrix signed willingly and she executed said Will as her
free and voluntary act for the purposes therein expressed; t�at each of us in the hearing and sight
of the Testatrix signed the Will as Witnesses; and that to the best of our knowledge the Testatrix
was at that time eighteen(18) or more years of age, of sound mind and under no constraint or
undue influence.
.%
����fi �+'{+/�V`. �� J ` `����.-. 1/ .✓ ' L�. �
WITNESS W N S �
Sworn to and subscribed
before me t ' �day
of July,
, NOTARY PUBLIC _
My Commission Expires: (SEAL)
NornRUU s�u
ea�enw►su�-suwviw
N����H
�� Nov 15,2007
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- Christopher M. Swart
Attorney at Law
Christopher M. Swart 1151 Old Freeport Road Bridgevilte Office
Member of Pennsylvania Pittsburgh, Pennnsylvania 15238-3108 445 Washington Ave. Suite 106
and Florida Bar Bridgeville, PA 15017-2337
Telephone: (412) 782-5498 (412)257-2266
FAX:(4]2)782-5297
October 17, 2013
Philip J. Delasin,
Executor of the Estate of Dorothy Delasin, Deceased
1318 Kingsley Road
Camp Hill, PA 17011-6116
Re: Estate of Drusilla M. Hoke, Deceased
Dear Mr. Delasin:
I have received from all of the Heirs their respective signed and notarized signature
page of the Family Settlement Agreement for the Estate of Drusilla M. Hoke, Deceased.
Therefore, I may now, as Executor of the Estate, issue a check to each of the Heirs.
Enclosed please find a check in the amount of$13,354.77, which represents the share
that your mother's Estate should receive of the Estate of Drusilla M. Hoke, Deceased. I
will now file the Family Settlement Agreement and a Status Report with the Orphans'
Court of Allegheny County and the Estate will be considered closed.
If you have any questions or concerns, please do not hesitate to contact me at my
Pittsburgh office address and/or telephone number.
Very truly yours,
Christopher M. Swart
CMS/pgr
Enclosures
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= �i��ill�liii�i����i���illi����i��ii�i�ll��ll�il�i����i�i��i�iil�i
= DOR„OTHY;.H DELASIN,._; _ � � � � �
=_ . � �1318 KINGSLEY=RD �� a , �.. � _ . . � � �<;. .. ��_� � , .��;� �°�.
— CAMP HILL PA 17011-6116 �Holder Account Number � ' "
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Record Date 09 Aug 2013
, Check Number . Q007518918
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Attached is your Third Quarter Dividend Summary and check.You can now elect to have your dividends depositetl directly into your bank
accoun,t.To participate,-please complete the enrollment form on the back of this statement and retum it in the enclosed postage paid env,elope.
You may also enroll by calling 1•800-649-3593,and at the main menu say"Direct DeposiY'or Press 5.Please refer to the ehclosed,instructions ,
before enrolling. :
[?IVId2nd SUrYllriar�l �,- HolderAccount Number.00012987731
Record Payable Security Total Trust Dividend Curreni Tax Net Total Stock Price as of
Date 'Date Descri tion Interests Rate Distribution Deduction Dividend Market Value Record Date
I I p I I I I Amount($) I (a)I I
O6 feb 2013 13 Mar 2013 TRUST INTERESTS 19 $0.18500 3.52 0.00 3.52 713.83 37.57000
09 May 2013 13 Jun 2013 TRUST INTERESTS 19 $0.27500 5.23 0.00 5.23 771.21 40.59000
09 Aug 2013 13 Sep 2013 TRUST INTERESTS 19 $0.27500 5.23 0.00 5.23 945.63 49.77000
Year-To-Date Paid 13.98 0.00
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DOROTHY H DELAS/N Account#1051139600
PHILIP J DEL,4S/N ATTY lFF
Balances
De sits/Credits +$�20,371.19 Avera eDail Balance $33,226.68
Interest
Earned this Period $0.23 Paid last Year $0.42
*The interest eamed and the interest paid may diffe�depending on when interest is credited to your account.
Checks Posted
Check# Date Paid Amount Reference Check# Date Paid Amount Reference
1043 04/24 $13.000.00 984697200
0 3 Check(s)Posted=E29,626.00
o An asterisk(')indicates a skip in sequential check numbers. An(E)indicates check was converted to an electronic item.
� Account Activity
N
'oo Date Description Additions Subtractions Balance
W 04-10 Beginning Balance $5,329.30
N
N
°0 04-17 PERSHING BROKERAGE 130416 $26,000.00
o $31,229.30
n� 33W-093217-1 PCD
0
0
c°n 04-19 CHECK 000000001044 $13,000.00 $14,603.30
�
�
� 04 25 PERSHING BROKERAGE 130424 $9,000.00 $10,603.30
w 33W-093217-1 PCD
V
�
O
� 04-29 CASH WITHDRAWAL FEE MEMBERS 1ST FCU $3.00 $10,098.30
°� W430128 LEMOYNE/PA US
�
�
D
� 05-01 YMCA Retire Fund ANNUIT'Y_PYMAY 13 �$1,263.56` $50,118.45
64878
05-03 MISCELLANEOUS CREDIT $2,U00,00 r ;` $95,469.35
05-09 YMCA Retire Fund REVERSAL MAY 13 ' $1,263.56 $94,205.93
64878
� ,��
page 2 of S I051139600
- Phillips & Cohen Associates, Ltd.
II���III��III�I�III�I'II'IIIIII"IIII�I'�IIIIIIII"II'll Ph866-268-1666 • Fx302-368-0970
y Office Hours: M-Th: 8am-9pm, Fri: 8am-6pm
. �C�Box 5790 Sat: 8am-12pm
Hauppauge,NY 11788-0164
RETURN SERVICE REQUESTED
June 7,2013
Phillips&Cohen Associates,Ltd.
Mail Stop:655
1002 Justison Street
19290309-105 68803957 Wilmington, DE 19801-5148
���I�111�"I��II�I�II'lll"'ll���lll�lll�l�l�l�I�l�l"��'I��1111� I III I 1 I II II I I II I II I II 1 I III
��� � �� �� � ������ � � ���� � �� �� � ����� � ���
The Estate of:
DOROTHY H DELASIN
1318 Kingsley Rd
Camp Hill PA 17011-6116 Reference#: 19290309
Balance:$784.11
....................................................................................................................................................................................................................................................................................................................:...........
*'*PLEASE DETACH AND RETURN IN THE ENCLOSED ENVELOPE WITH YOUR PAYMENT**'
Re: Client: Barclays Bank Delaware .
Client Acct#: "**'''"'''3284
Reference#: 19290309
Balance: $784.11
To the Estate of DOROTHY H DELASIN:
Our client Barclays Bank Delaware recently received notification that DOROTHY H DELASIN passed away. Initially,on behalf
of our client and our office,please accept our condolences.
This account was referred to our office because we are specialists in the area of deceased account care,and because
DOROTHY H DELASIN was a valued account holder. As it is our goa�to assist family members/loved ones through this
process,enclosed is an informational leaflet providing helpful tips,guidance and support during this difficult time of managing
the final affairs of DOROTHY H DELASIN.
At this time,we are seeking information regarding the Estate of DOROTHY H DELASIN, including information about who is
administrating the final affairs,if there is not an estate. While family members and/or loved ones are not personally liable for
this account,we are trying to contact the party handling the final affairs to ensure the proper resolution of the account.
Please contact our office at 866-268-1666 to provide information about the estate,and to speak with our specially trained
deceased care agents.
Sincerely,
Phillips&Cohen Associates,Ltd.
Though our goal is to assist family members/loved ones during this difficult time,we are required by law to provide you with the
information below.
"*IMPORTANT CONSUMER INFORMATION''"
Unless you notify this office within thirty(30)days after receiving this notice that you dispute the validity of this debt or any
portion thereof,this office will assume this debt is valid. If you notify this office in writing within thirty(30)days from receiving
this notice,this office will:obtain verification of the debt or obtain a copy of a judgment and mail you a copy of such verification
or judgment. If you request this o�ce in writing within thirty(30)days of receiving this notice,this office will provide you with
the name and address of the original creditor,if different from the current creditor. This communication is from a debt collector.
This is an attempt to collect a debt and any information obtained will be used for that purpose.
Phillips&Cohen Associates,Ltd. . 1002 Justison Street.Wilmington, DE 19801 •866-268-1666
292CSPCAL03105
. L.L.B►ean V�isa C'ard , --- ----_'
,�__ ____ ---------- ,
, Payment Due Date July 14,2013 �
P� � I��F`��� ���• �=,r���y(���_1��,`� �I Minimum Payment Due $57.98 'i
y Previous Balance $827.73 �
Statement Balance $784,11 '
`�---- -------- -- J
Visa� Card Statement
Page 1 of 4
Primary Account Number Ending in:3284 Questions�Call 1-866-484-2614
Statement Billing Period;OS/18/13-06/17/13 Ilbeanvisa.com
Account Summary Activity Summary
Minimum Payment Due �57.98 Previous Balance $827J3
Payment Due Date 47/14/13 - Payments ' �d.00
Statement End Date 06/17/13 + Purchases $0.00
Credit Line �0.00 - Other Credits $43.62
Credit Available $0.00 + Balance Transfers $0.00
Cash Cretlit Line $0.00 + Cash Advances $0:00
Cash Gedit Available �0.00 + Fees Charged $0.00
Past Due Amount' $32:98 + Interest Cliar ed '50:00
Overlimit Amount $0.00 tatemenf Balance $784.11
Payment Information
�
--- ---- --------- -- --_ _ ______------ --i
Statement Balance $784.11
Minimum Payment Due $57.98 j �
Payment Due Date 7/14/2013 j
� Late Payment Warning: If we do not receive your minimum payment by the date ;
listed above,you may have to pay a late fee of up to $35.00 and your APRs may be �
increased up to the Penalty APR of 29.99%.
;
� Minimum Payment Warning: If you make only the minimum payment each period,
� you will pay more in interest and it will take you longer to pay off your balance. For
example: �
i
� � � 'If�r k �`r� �oi�a 1 ,�f ��- _ �
� �� �3° 1T IS�� 4
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� Only the minimum payment 3 years . $874.00 �
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� If you would like information about credit counseling services,please call 1-800-570-1392. �.,,•,
. ;
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*Repayment ir�ormation is based on your account activity and the APRs on your account as of the closing date of this 3?::::�:::
statement,Account activity after the closing date is not reflected.To view your most recent transadion adivity online,go
to Ilbeanvisa.com.
_ �, Detach here.Pleate make thetks payable to"Cerd Servltes"and Include thls payment coupon In the encbsed envelope. Please allow 7-70 days for U.S.Postal Service dellvery. .,...�p
Payment Coupon ������
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Ilbeanvisa.com Card Services
P.O. Box 13337
Philadelphia, PA 19101-3337
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''� Check for address change.
- Complete forrn on the back. AT 01 020223 70939B 84 A**3DGT
DOROTHY H DELASIN
- 1318 KINGSLEY RD
` — — - - � CAMP HILL PA 17011-6116
` Amount Enclosed; I� �
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Account Number 486&9600-2443-3284
' -----------
MinimumPaymentDue _ ________ �57.98 I�I����1�11�11�"��11���111��1���1�1���11�1111111�1������������11
Statement Balance 5784.11
Payment Due Date July 14,2013
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*323RB30100050102*
11i19i2013
TRAVELERS DOROTHY DELASIN
CLAIM NO: 436525844-TR AMOUNT DUE: $85. 00
POLICY NUMBER POLICY DATE AMOUNT
81$ ABS9786538886341ABS 10-13-2012 $85. 00
SIMM ASSOGIATES, INC.
Ootober 07 2013 800 PENCADER DRIVE
NEWARK DE 19702
(866)572-9374
CLIENT: SALLIEMAE
BALANCE: $10,983.74
ACCOUNT#: 9965349988
ORIGINAL CREDITOR: SallieMae
Estate of DOROTHY DELASIN,
On behalf of SALLIEMAE we extend our condolences on your recent loss. This account has been referred to SIMM
Associates to resolve the outstanding balance.
If an estate has been probated please provide our office with the estafe information or a copy of the Notice fo Creditor's so
we may properly file a creditor's claim in the estate. You may not be personally liable for this debt; however, we ask that
you advise as to what the intentions are of the estate with regard to the outstanding debt.
Please`contact SIMM Associates at (866)572-9374 to discuss this matter. We are here to work with you during a difficult
time and to help find an am'icable resolution to this matter.
This is an attempt to collect a debt by a debt collector. Any information obtained will be used fo�that purpose.
Unless you notify this office within 30 days after receiving this notice that you dispute the validity of this debt or any portion
thereof, this office will assume the debt is valid. If you notify this office in writing within 30 days from receiving this notice,
this office will: obtain verification of the debt or obtain a copy of a judgment and mail you a copy of such judgment or
verification: If you request this office in writing within 30 days after receiving this notice, this office will provide you.with the
name and address of the original creditor, if different from the current creditor.
Please review the Privacy Notice contained on the second page of this letter for an explanation of the Account Owners
policies and procedures regarding the use of non-public personal information. All inquiries regarding this account should
be addressed to our office and not to creditor as noted above.
Sincerely,
Jeffrey S. Simendinger
SIMM Associates
(866)572-9374
PLEASE: To ensure proper credit remit payment directly to our office only.
Remit to :
SIMM Associates, Inc.
P.O Box 7526
Newark, DE 19714-7526
Payments can be made via credit card or bankdraft at:
1NWW.SIM MASSOCIATES.COM/PAYMENT.HTM
**Please 3ee Reverse Side for Important Information**
Department 4121 Detach Bottom Portion And Return With Payment
PO Box 1259
Oaks PA 19456
IIIIIuIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Account#: Balance:
7520446 $10,983.74
Client: SALLIEMAE
_Opt-Out Notice(See back for details)
��I��li�����ll�i�����lli�l�llllllil�i�iluli��l�li�lil��nlli�i��
DOROTHY DELASIN 4603'26 SIMM ASSOCIATES, WC.
� � P.O. BOX 7526
N 1318 KINGSLEY RD NEWARK DE 19714-7526
CAMP HILL PA 17011-6116
I���III�I��I���I���IIJ��II��J�I�I„�LIJI����1�1�11��11���1
IIIIIINiIIIN�IIIIIIIIIIII�I�IIIIIIIIIINIIIIIIIIIIIIIIII 4603-11-26
►Jil�il�1 !lV V V V IJ R 1 l.�V� �14 V.
October 07 2013 800 PENCADER DRIYE
NEWARK DE 79702
(8fi8)572�9374
CLIENT: SALLIEMAE
$AL.ANCE: $4,390.09
ACCOUNT#: 9855348988
ORIGINAL CREDI7QR: SallieMae
Estate of DOROTHY DELASIN,
On behalf of SALLIEMAE we extend our condolences on your recent loss. This account has been referred to SIMM
Associa#es to resolve the outstanding balance.
If an estate has been probated please provide our office with the estate information or a copy of the Natice to Creditor's so
we may properly file a creditor's claim in the estate. You may not be personally liable for this debt; however, vve ask that
you advise as to what the intentions are of the estate with regard to the outstanding debt.
Please contact SiMM Associates at (866)572-9374 to discuss this matter. We are here to work with you during a difficult
time and to help find an amicabEe resolution to this matter. .
This is an a#tempt to collect a debt by a debt colleckor.Any information obtained will be used for that purpose.
Unless you notify this office within 30 days after receiving this notice that you dispute tha vafidity of this debt or any portion
thereof, this o�ce will assume the debt is valid. ff you notify this office in writing within 3Q days from receiving this notice,
this office wili: obtain verification of the debt or obtain a copy of a judgment and mail you a copy of such judgment or
verificatian. �f you request this office in writing within 30 days after receiving this notice, this office will provide you with the
name and address of the original creditar, if different from the current creditor.
Plsase review the Privacy Notice contained an the second page af this Istter for an explanation of the Account Owners
policies and procedures regarding the use of non-public pe�sonal information. All inquiries regarding this account should
be addressed to our office and not to creditor as noted above.
Sincerely,
Jeffrey S. Simendinger
SIMM Associates
{866)572-5374
PLEASE: To ensure proper credit remit payment dfrectly to our office only.
Remit to:
SIMM Associates, Inc.
P.O Bax 7528
Newark, DE 19714-7526
Payments can be made via credit card or bankd�aft at:
WINW.SIM MASSOClATES,COM/PAYM ENT.HTM
�'�Please See Reverse Side For Important Information*"
Department 4121 Detach Bottom Portion And Return With Payment
PO Box 1259
Oaks PA 19456
I(I��(II�I IIIII IIII[III�IIII)�IIIII��W�III�iIll�llll IIII
Account#: Balance:
7520447 $4,390.09
CI ient: 5ALUE MAE
_Opt-Out Notice(See back for details)
iri�E�ii.ifi,u�„i,il�Illi�In�i�IFi�t�iu11�+II�iIIN�iil���i��
� DOROTHY QELASIN 4�oa'2' SIMM ASSOCIATES, INC.
� � 1318 KINGSLEY RD P.O. BOX 7526
CAMP Hll.l.PA 17011-6116 1NEWARK DE 19714-7526
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