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02-10-14
. $... . r J 1505610101 REV-1 soo IX�o�_�o, �, PA Department of Revenue P�yLvania OFFICIAL USE ONLY Bureau of Individuat Taxes �`""�"T°`"�"°E County Code Year File Number Po Box 2so6c,i INHERITANCE TAX RfTURN - Harrisbu ,PA i�t28-o60� RESIDENT DECEDENT ENTER DEC�DENT IMFOIZMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY ��� �� � O � � � f � � ���i.�i�ii� `'� �eoederrt's Last Name Suffix Decedent's First Name MI � � � (If Applicablej Errter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name M� , � Spouse s Sociai Secunty Number ' """ ' �' ' " '° THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW � 1.Original Retum p 2.Supplemental Return p 3. Remainder Retum(date of death Q 4.Limited Estate prior to 42-13-!!2) O 4a.Future Interest Compromise(date of p 5. Federai Estate Tax Retum Required death after 12-12-82) O 6.Decedent Died Testate p 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 Q 10.Spousal Poverty Credit(date of death O 11. Election to tax under Sec.9113(A) �i between 12-31-91 and 1-1-95) (Attach Sch.0) CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number �' 1 �is�reR oF w�us��t � � � � � c� First line of address � � n�i ,�.,,. C3 1M► � � � � � � � � � � Q, i.�f � Second line of address � � � � � � � -� '��.�„ '� .»� � C � »-, City or Post Of�ce State ZIP Code *� � DAT6�F�ED `""" �' � l � t'a► � � Gorceapondent's e-mail address: �r���/���� �'���� Under of peryury, a�I have examined this retum,induding accompanying sehedules and statements,and to the best of my knowledge and belief, it is , and co t aration of preparer other than the personal representative is based on all information of which preparer has any knowledge. S U P E NSIBLE FOR FILING RETURN ne��� �G � A��. k���sT C,A- c� � SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 � 1505610101 1505610101 � � 15�5610105 REV-1500 EX Decedent's Sociai Security Number /� �� a �,i� �. Z � �� � `� �` � DecedenYs Name: ������/ . ���1`�" RECAPITULATION 1. Real Estate(Schedule A). .. .. . .. ... .... . . . ... . . ... . . .. . .. . .. .. . . .. . . . 1. ��• p 0 2. Stocks and Bonds(Schedule B) . . ... .. .. ... .... . ... . ... . . . . .. . . . .. . . .. 2. � �� � el Held Cor oration,Partnership or Sole-Proprietorship(Schedule C) ... . . 3. G7'� t-� t/ ' 3. Clos y p 4. Mort a es and Notes Receivable(Schedule D) . .. . . . . . . . . . . . . . . . . . .. . ... . 4. �"`� � ' 9 9 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E). . .. . .. 5. �� V � �' � � 6. Jointly Owned Property(Schedule F) p Separate Billing Requested . . . .. . . 6. �/ ' � V ` 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property �} � Schedule G) p Separate Billing Requested.. . . . . . . 7. �•a V '� 8. Total Gross Assets{total Lines 1 through 7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. � �..:� � � �� . . . . . . . . . . . . . 9. � •� Q 9. Funeral Expenses and Administrative Costs(Schedule H). . . . . . � .J"� 10. Debts of Decedent, Mortgage Liabilities,and Liens(Schedule I) . . . . . . . . . . . . . . 10. . .���� q � 11. Total Deductions(total Lines 9 and 10). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 1 I q�'� � , • 12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 � Q Q ''7� �j' � ; 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which /� an election to tax has nat been made(Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. ��(1 � 14. Net Value Subject to Tax(Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . . . 14. ' � (.f � l *��7 TAX CALCULATIOW-SEE INSTRUCTIONS FOF2 APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 �a)�1.2)X.0- � . �� 15. ��� �.������ 16. Amount of Line 14 taxable i at lineal rate X.0.� � � "�j.�� , 16. � t ��"'.�,A� ' 17. Amount of Line 14 taxable at sibling rate X.12 a 17. � ���� 18. Amount af Line 14 taxable H at collateral rate X.15 s �8� � ��� , . ,. . � �� , ' ��: 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . 19. � � � :� �,, 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 � 1,5056101,05 150561,�1,05 � �� � REV 1500 EX Page 3 Fi�NumbQr Det�eden�'s �omplet�Address: oFC�rs� L �� , I �� W ��V ' S -�i��4 ` ��� /l��/r!�l�- ��/rl� �DD u/ .� �T �,eU�.� P� � ���3 ��n ����� ��- � o ���� ,� ' �' �'�- 17D/� Ta�c Paym��s a�d �r+�aits; . �: �����,���� c�� �1�, ��� �� �.�� �y�� �� �� $.� . T�Cr�dils{A+8) �2) _! �� �� 3. ir�st �3� Z,�07 _ 4. 1#��iS�1'�'�i�1 L�1+��y�t�i�1�i0@. �#115�SS����� �N10V�O�!�@�.���b 1�@Qtl�31�. �,�� �. I#L�e 1+Line 3�s t,�a�tfi�Line?,e�#er the di�ere�ce.This is the T1�(DUE. (5� / / ,�fD 9 �lake check�ay�b��to: REGISTER t�F 1�lL�.S,AGE�IT. PL�►Sf�4N$IA�fR TH�FtN.LflWlNG t�lES���1S BY Pl.�CING A�i"�(�1N TWE APPR{}PRI�►TE BLOCKS 1. Did dec�r#m�ce a t�sfer and: Yes No a. reta�the use+x�of the prc�per�ty�sferred:.......................................................................................... ❑ � b. r�ain#he�gh##o tiies�gr�a#e who sfi�use t#�e pmQer#y#rar�sferred or its incar�:............................................ [� � c. re#ai�a rev�ers�nary�te�t;or..................... ..................................................................................................... ❑ � d. r�oeirre th��ro�+s+e fi�r#ifiee of�ither�t�,benef�ts or care?...................................................................... � �' 2. ]f deat�+�aarred after O+�c.12,i�82,did�iec�dera##rrnsfer ProPert�+rw�thin rn�e ye�of dea#� w�thout r�eceiv�uug adequate ccx��rati�n?...........................................................................................:.................. ❑ � 3. t)id c�c:e�dent own�"in t{us#��"cu payabie-t�t�rt-death bar�c ar�nt ur�ri#y at his t�r her�ea#h?.............. � � 4. Did t�eden#own an ind'nridual r�tiretr�#aaoount,anr�uify or o�her r►on-prvbate properlY,wh+ch cattairts a berref�aary desig�atir�? ........................................................................................................................ [] � IF THE ANS�R 7��1NY+0��F1E AB�3Vf�E�T�IS�S YES,YOU�S�Ct?1�PLETE SCH�D1��G A�1D f1LE�J�S PART�THf RE?URN. Fw dafie�of daa�h+c�cx af�er Juty i,1�,amf�Ore Jan. 1, 1995,the#�r�te imposed or��e net v�ue of trans�ers to or fior the use�#the s�anriving spouse is 3 per+aer�t j72 P.S.§9i16{aj{1.1)(i)]• for dat� �o# death +c� ��r Ja�:. 1, 199�, #he #ax �e �mposed on t#�e r�t val� of trar�sfers t� a� for the � �f #� surviving s�ptw�e is 0 percent (72 P.S,§9'�i£�aj�a,�){'a)�.T�e s�a�se does�t e�c�t a tr�sfi�r�a sur►r�n��ous+ee f�n tax,�d�e sta�tory req�ir�men�s for disc:�me ofi asseis and fit�+g a fiax�eh��st��ic�1e�eve��#�e surviw�s�se�tt��ee�ly t�ene�aary. F�r dat�s�fi dea�t t�or a�J�y�,2�: . The tax ra�e�d�n�net vai�e c�#transf�rs�om a c�eceased d�d �� years o�age ar youn�at c�ea� to w for#�use �#a r�atural parent, an adoptive�en#tx�a�Parer�c�#ii�e ci��s�D pet�en��72 P.S.�91�fi(a�1.�)]. • T#�e t�x ra�e i�ed a� � net value of #ra�sfers t� or #cxx #�e u� of t�e de�d�t's lit�al be�fic�ar�es is 4.5 pen�nt, exc�p# as no#ed in 72 P.S.§911fi��.2)�P.S.§9"!'I��a�{i)j• • 7'he tax ra��pased�#�net va�ue tt�f#rar►sf�rs tc�or�Or the use�f the dec�nt's si�l�s is 1��erc�n#{�2 P.S.§9��6(a)(1.3)].��g is defi�ed,under Sec�ion 91�2,as�irni'ivit�al who has�#least or�paren#i�commor�with tfi�e decedent,whet�er by t�or adoptic�n. • REV-1508IX+(1-9� SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS� a MISC. IN R S DENT D EDENTRN PERSONAL PROPERTY ESTATE OF FILE NUMBER �i� L, l,�EL.�'D z 1 �z D3�� Indude the proc;eeds of litigation and the date the proceeds were received by the estate.Ail property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ,. ���` ��-- g; �D� , �� TOTAL(Also enter on line 5,Recapitulation) ;��� (If more space is needed,insert additional sheets of the same size) � � • REV-1�11 EX+(10-06) SCNEpVLE 1�i COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF . FILE NUMBER ���. � �. , z / ��. � . o ts of decedent must be reported on Schedule L ITEM ' NUMBER � DESCRIPTION AMOUNT A. 1 FUNERi4L EXPENSES: ���� ,�� .B. ADMINISTRATIVE COSTS: ' 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address ���Y State Zip Year(s)Commission Paid: 2. Attorney Fees � 3• Family Exemption:(If decedent's address is not the same as claimanYs,attach explanation) Claimant Street Address Ci#y State Zip Relationship of Claimant to Decedent 4• Probate Fees 5. AccountanYs Fees 6. Tax Return Preparer's Fees � 7. TOTAL(Also enter on line 9,Recapitulation) $�� ` � (If more space is needed,insert additional sheets of the same size) �����✓ , � , �� _ � � � � COMMONWEALTH OF PENNSYLVANIA �"' . � REV-1162 EXf11-96) y^E DE�ARTMENT OF REVENUE ,�� ; . ` `HUREAU OF INDIVIDUA!TAXES ����x�� ° � DEPT.380601 . " z . $ `HARRISBURG�PA 17128-0801 �� ; PENNSYl.VANIA : � �':. ; RECEIVED FR4M: 1NHERlTANCE AND ESTATE T�C � OFFICIAL RECEIPT � � - _ : i: , NQ. CD 016045 , � : ; FREEMAN L�4RRY L , 829'N WE�T ST :CARL#SL'�, PA 17413 . : AGN ASSESSMENT AMOUNT CONTROL NUMBER -'`fold __��__ -- - 12120688 � $145.71 ESTATE INFQRMATION: SsN: 27�t-24�-0983 �; ��LE htUMBER: 2112-0391 � DECE�E(�T N/�►ME: WELTON MARY LOU � DATE OF PAYMENT: 05/31/`2Q12 _� POSTMARK C3ATEc Q5/31/2012 � CQUNTI�': CUMBERLAND � QAfiE O� DEATH: 03/11/2012 I : � . TOTAL AMOUNT PAID: S 145.71 RfM�►RKS: . � cwECK#�oo� � INITIALS: DMB s�� RECEIVED BY: GtENDA F�kRNER STRASBr4UGH REGISTER OF 1NILLS TAXPAYER a , _ �� � °'� �� �'° � � � ��� ��� . , ,: ,� , � _ ,,. � �.�� . . . .. i. .� . �,f� E�'�'�� � . . s��� �, . _ :��-��� :�# p�enn�yt�an�a � $UREA� D� INDIVIDUAL TAXES NOTICE 4F iNHERYTANC� '[" �. �,��,�'��a - pEPARTMENTaFREVENUE INNBtITANCE fi117C DIVISION APPRAiSEMENT, ALLOWAflCE OR III REY-1548 IX AFP C12-11) PO i0X 2a0601 OF'DEDUCTIONS, AHD ASSESSNEN�'�, QN`' ' HARRISEUR6 PA 17128-0601 JOINTLY HELD OR TRUST A�� �°�� =�,�s�f � DATE � � �1,6-25-20i2 EST�TE ; � �° : .N�EtTON MARY L �/►TE E�'•'. : � - :0`��3 I;=2012 FtLE 1�t!#, � ,��� , '�1� 12;-.0391 CO,If;��1F � �,e ; �t1M�ERLAND SSNl11�=.; ��+�*2�-`0483 GAY D FREEMAN AEN. � 1;2I��06"8$ 829 N WEST ST � ' �1P�!EAL �Y ��k�E;�8-24-20�.� CARL�I SL E PA 17 013-1435 ,;."'��e�rer�t�� ��ii�e Yi���ir'�bjec�o»;�') , ' A�aunt Rer.itt.ed'' MAKE CHECK PAYABLE AND REMIT P�YMENT TOs REGISTER OF: 1+�SLLS ` 1 CDURTHOOSE SQUARE CARLISLE PA 17013` CUT ALON6 THIS LI:HE � RETAIN LOwER PORTION FOR YOUR' RECORDS E"� �p��a���s��.r�i�.r�������������������� . . . . � . . . �lE�� �..,q��,��__ ... w�..����a�..�������.����a���������rr.�� i . ��� � . � . � �� ����� . � . .. f f.—ar�.i�..__-_.._... �. � �� -,�..._- w �. NQTICE OF INHERITAMCE TAIE APPRAISEMENT, ALLOW�iNGE I]R DISALI.OWANCE �F DEDUCTI:ONS,, AND:IRSSESSMENT QF TAX ON J�INTLY HELD OR TRUST ASSETS= DATE: Db-25-2012 - --�� ._.. ESTATE OFrwELTON MARY L DATE OF DEATH:03-11-2012" COUNTY:CUMBERLAND FILE NO. : 21 12-0391 S.S/D.C. NO. : 274-24-Q983 ACN': 12120688 y �. , _. r TAX RETU,RI�"�WAS,: CX) ACCERTED AS f ILE;D C � ,GHANGED � :tOINT .�t� 1'R�ST: l4SS�.T,.F,�1�l�01�I�tATION `� . . ,. .:. �� ;.. , . �:� . � : , _, �- : � . FINANCIAI�'.�N�TITl1TIQN:.ME.MBERS�1�ST.. FGU E': ., ACCOU�IT N„U-. : �26503-1� � T�'P� �'� ACCE}UNT:' • C )SAYINGS CX) CHECKIhIG t ):�fRUST �:C 3TIFIE CERTIFICATE ` nf4TE ESTABLISHED 03-28-2008 ' � >, _ r ,. . . . � v � . � . .. . ., -- . ; - �- ,: , ' l4ccount Balance 8,203.33 NOTE: '� TO ENStIRE PROPER CREDIT TO �. P'orcent T�xabla X : 0.500 ` Yt3UR ACCOUNT, SUBMIT THE A�au�t Subject to'Tax 4,101.67 UPPER PORTIOM OF THIS NOTICE Aab#s and"Decluctions _5-_ WITH YOUR TAx PAYMENT TO THE � Taxab'1� Ascunt 3:'O�Ob.21 REGISTER OF WILLS I�T THf Tax Rat� �r , , _,�_ AB01fE ADIIRESS. MAKE CHECK Tax Bue 135.°00 aR `MONE'Y URDER PAYABLE TQ: "REGISTER OF WILLS, AGENT." TAX CREDITSs v ' p..T. -- ---:._..4LS.G:�u1�T._Ct� `_-...�_.._�..�:_ ' DATE �lUM3ER _ INTfRES7'/PEN PAID (-} m...'^_ A1NDtiNT^"PirY17 __. _ ... 05-31-2D'12 CD016045 6.75 }�45.-71 TOTAl TAX :PA1tMENT 152.4b B�LANCE OF TAX dUE 17.46CR ' INTEREST AND PEN. - .Q0 TOTAt DUE 17.46GR * IF PAID:aFTER �HiS DATE, SEE REVERSE FOR CALCULATIOM OF ADDITIQHAL INTEREST. * IF TOTAL DUE IS REFLEGTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. { , S�� REY�RSE SIDE OF THIS FORM fOR INSTRU�TIONS. °�"��"� $ � ' I � _ - �,�� - + ' s � !i ��' <��- �� ,;�� + � ? �����L����� tiu �N'�I � a ... s � N �t����r��': � _ - i . ;.�►��1= e�ut�►U o���rr� " �.Y,�� ' j' � ��, � FTLE l�0. 2� �:- po so���a� � � lk�� - �wut��s���� at��. � � .,.�.,�.- - - `�v�=� ' �� .=T/�C��! �� d�� �� � �� 1���Q588 ��� � _ ��j�'�'E� t��=2���.�1� � � � - � : �- ���ias-iss u� ����� _ 4 � � �� � TYPE.;��� . ���t' -. �������� �F� �� �-�`�. , EST. �# .,:, � ��faN: ' � `� s�r����� ;; SSI�_ ��ry � 4 ���9�3 ��Gl�i�Er��w�:. :�.�i�t ..�r - I��`"1'�` �''� ��� �`I�-20:3�=2 �`����X , � � ;.. ;���, °� C�I��N��. `b�� ����R3����. '��CEtt�IF. .z � p� :,� ` ,�a� u��� � ��E f �� , t�3�! � it6�4f�' P��,�1��.� F���FIS. TO.: . � y''•!'� ' ° Cs�41fF �� *b,��;FR�E�l�k1�1 R�G�����Y'��S � ���;� �t�ST_ St � � ��' � .� c�a�����t����-�,��k,l�� . �� GARLZSL,E �. � � � PA 17013-1435 .: �� �.:�/�#�I�l�,�...,�'A. ..1;�'�;Y�3�_: �� . �� ` . � , NEMBE�2S I.ST�FC�, '.. � provtded.the departnent rith the inia�atfOrr�elar,,,�hich.was u,sed fn calc�]�t1ng the inhlritance��x tlue. ,, Reet►��dsk,:.i dtc,#� �iat�at the deatf►,c�,the abave-n�ineG.tlecedent,,you�ere a �a1,r�t a�.gr/benel4ciaty of thfs;��Caunt. If oi1 dPe tfie s ouse�.of the .Y. A . ,d,+���aa����,a ����trt cit�itr:tha��era ts reflected 6eloi+ on,the':�Q�en�tml 7�x;Duie '�:ine. note t�o tax , be!�ue but au iwst , ' ,�o����li'�',�� ��ea�r�t�►our �elatfanship to th�'cCeceased.by ��ier'kt�4��x�C i-rt P�C�tT°� l�eiow;and-.�r�i��n9x��s ouse'�` it� P�R'�2�. .'` If you:l�'1�ew�E�e tnitir�rtaL#on is incot�rect; p]ease obtain written cerrectian �Frw�,the �inanciai instituti,ont-att�ch a tapy to thts fot�r ahd return ft C�,th�a}u�r�e a"ddress. :Please catl 7T7-78T-.8327'with questtons. � „ ; ;E FaR"f`�'1.`�'N .��������, � ` , � .�.�� � ��.��..�..��r.�� � � � �.���..�„ �_ ��� - X��e����,�o. �326-�03{1�,1 ° �.bato � � � t�3°-�2$ �l�tl$- '� 7o-,insa�"dro�ar�crodi't;'�o tt+s account. twb.� Es#sblistl�d, ' eovi�s.o#: tASs noti,c� �ust �coMp� $ 8,20:3.33 wipo►w�nt t,�'#i» Ra�ist�r<at Ye31is. �. cn.�c , � ACCOURt.$a�at1CA aaorabi� to:"It��istrr of'M311�. A��nt". P��`C1l�t`-<,�sawt6=7��� X 'S'�.��!'�;D . , ,x AMOt��t.SuD���t to Ts�t �` ,4�Y�:1:�7; •MIOTE� If tax�aonsnts ac� �ael�xithfn t!►roo -: �onths Qf tM doc�d�et�= dat� of d�ath, Tak ��ta . ';j( :�}4�,c ' +��duet a 5!wrc�nt disc+ouht on tM taoc du�'. , llrib► #nti�ritanci tax dw xi�1 baco�i tl�linau�nt PQ#�irtt�al.Tax Dus ; � I84��$, nir►�`�onths aft�r thi_+di�tf of`dialh.` ��1��'�I�1�011 I�iY�I�1�1�1w��rrMIY1 I�I�Ir�Y�� '� i�����l�f��i���i�i i��i I�I iur�r �� " �"-�P� Elt ��_ 'S� ' � �x � v �..� x. : _.. ; �-�-�� ,� :� , �. .� .. . �l.{�The abov� infonstion and taz dua'is carrsct '; ' ' � : `Raitit t��n# ta ths Rapist�r o#Nill;.xith trta cop3�s.of. this notfcs.to obtain ���C� a disCOUnt o� avaid int�ns�t. or rytucn�this:natfe�-#a th� Ragistar of-W��xls'ahd� � an officfal assosrnnt will ba isswd by th�r'PA D�vsrt�ant af Ravonua. 0;��- ����� E. _�Tha abova ass�t has ba�n ar will ba r�port�d and taoc paid wit#� tha Fannsylvania inhtriiane� tsx raturn flN,�� v fil��.b�r tA� astat• roorasontativo. : ,>,, : . C. �'TM abo�*iinfona ion is 3�cornc# snd/or debts and d�ductions warr�paid. E Co�pl�tr PART �snd/or PART 3�balow.; 'pp�7 ; �� inQicatin�-a.difforent tax rate, pleasa stata` - , : rs-�;��3�bt��h��'�''to d`acadsnt:' - � t` : � � _. T�C t�ETt�RN �-.CAL�ULfiTION OF T/kX.QN 'JQINTlTRUS� ACCOUNTS�z' �II�E 1:.; D�rt�:Ea�sb�,Sshsd, , l ��,a�` ,�i=�;a �.:At�t�uh# Ba1a'�ta 2 � _ _ � i. a::'; P•r�.�,;t rax�b�o 3 � . .�r�EJ 4.;:Ar�o�nt S�b��c#.'to Tax 4 $ �,> 5,: Dob.ts��and'.bdtlu�tiaris. 5' '�' ' - :r,_M1. S':: A�o��t"taxabla .., � � _ ;���-. �'�,,: 'f`�w R�ta 7 Xi - � �iX I1�iY $� � �r ; pi►R�'r," DEBTS AKD ;1'��D1�;4'�I'�H$j�t��"tw��1 °��� ,. ��F.�:-_ ;.r.: D. DA�`� PI�ID ' : PdYEE DESCRIPTxDR AMQUN'F PAID „ . . �. , r. �...; __ ... .. _ : _ ;. �._,�. w�._ , �_ � ... :_ ..�.,_:�: :�,�..� � � � _ , .. � , .. _ , � ..__ _. w � ,' . ., ; ,�- . � . _ � - �� - - �n ��� �. ,: _, _ - ���r.,,.�; ,: .._ , �.-,-;:, . . . : _ . � . :.. ;,._ { ,. Y y� .: :...r.�., .�.. . _ .. ..:,.. - .... rv i:. ,� ...C�y �. 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DATE PAID PAYEE DES��`rva.1�': : AMOUNT PAID 04/01/2�12 PPL Che����°��� $3�.42 Etectric,t�� : 04/04/2012 Century link Checlt�1��I $9:44 Telephon+��e�vice 04/11/2�12 Sarah Todd Nursing Home Check#31�8 $42,92 Medical o'rntr�ents& rnedicatians 04/11/2012 PPL Che�k#i169 $7.08 Electric utifity TOTAL= $1195.96 f ♦