Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
02-21-14
Ex oz-itl 1505610143 REV-1500 OFFICIAL USE ONLY PA Department of Revenue penrrsylvania cw*code Year Fea N nftr Bureau of Individual Taxes o®rms¢Trarrs�wa PO BOX.2E0601 INHERITANCE TAX RETURN 21 13 00288 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Dale of Birth 03 04 2013 12 08 1929 Decedent's Last Name Suffix Decedent's First Name MI MILLER JO ANNE Q (it Applicable)Enter Surviving Spouse's Information Below Spouse.a 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 ❑ 2. Supplemental Return ❑ S.Rem index Re 2r(Date of Death ❑ A. Limited Estate ❑ 41.FO Intmet Cempombe ❑ 5. Federal Estate Tax Return Required . (48%.f death after 12A2.-" ® e. O rd Clod Testate ❑ 7. Dewderd Mdntalncd a INFq TW9 (Anacheopyofwn)) (AnachcapyorTUS�) 9. Total Number of Safe Deposit Boxes ❑ B. Litigation Proceeds Received ❑ 10.between P12a1 911 andt .1a 5�f Death ❑ 11.Elttahn to ax under See,0113(A) CORRESPONDENT•THIS SECTION MUST BE COMPLETED.ALL CORRESPONffDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number DUANE P STONE 717 432 2089 REGISTER OF WILLS USE ONLY First Line of Address —) °— 77 8 N BALTIMORE STREET �Lp m-i� m _'. TJ Second Line of Address �'i CNJ' =�rT r. O City or Post Office Sfato ZIP Code DATE''FILED DILLSBURG PA 17019 0 Correspondent's e-mail address: Duane @StoneDunean.com Under Pena( perjury,I declare that I have examined this return,Including accompam)mg schedules and statements,and to the best Of my knowledge and belief, it Is true,oo rM complete.Della Lion of preparsr other than the personal represenlatNa Is based on all information of which preparer has any kn9wiedge. SIGNAN ERSONNRONSIB IDN _ qN TE Jon E. Miller ADDRESS 124 nal Street,Santa Rosa Beach, FL 32459 S10NATVe6F PPgOM OTHER TINNREP A DATE Duane P Stone ADDRESS Stone, Duncan &Linsenbach 8 N. Baltimore Street, Dillsburg, PA 17019 Side 1 L 1505610143 1505610143 J 1505610243 REV-1500 EX Decedent's Social Security Number Decedent's Name: MILLER, JO ANNE Q RECAPITULATION _ 1. Real Estate(Schedule A).______..................................-......... ............................. 1. 173 , 445 . 24 2. Stocks and Bonds(Schedule B)............................................................................... 2. 12 , 366 . 00 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C).......... 3. 0 . 00 4. Mortgages&Notes Receivable(Schedule D).......................................................... 4. 0 . 00 5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)................ 5. 271 , 824 . 77 6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............. 6. 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) ❑ Separate Billing Requested............. 7, 8. Total Gross Assets(total Lines 1 through 7)................................._.................... 8. 457 , 6 3 6 . 01 9. Funeral Expenses and Administrative Costs(Schedule H)..................................... 9. 41 , 063 . 55 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................. 10. 383 , 947 . 03 11, Total Deductions(total Lines 9 and 10).................................................................. 11. 425 , 010 . 58 12, Net Value of Estate(Line 8 minus Line 11)............................................................. 12. 32 , 625 . 43 11 Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J)................................................. 13. 680 0 0 14. Net Value Subject to Tax(Line 12 minus Line 13)................................................. 14. 31 , 9 4 5 . 43 TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal lax rate,or transfers under Sec.9116 (a)(1.2)X.00 15. 16. Amount of Line 14 taxable at lineal rate X .045 31 , 945 . 4 3 16. 1 , 437 . 5 4 17. Amount of Line 14 taxable at sibling rate .12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. TAX DUE................................................................................................................... 19. 1 , 437 . 5 4 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 L 1505610243 1505610243 J REV-1500 EX Page File Number 21 - 13 - 00288 Decedent's Complete Address: DECEDENT'S NAME Miller, Jo Anne Q STREET ADDRESS 26 Forest Drive CITY STATE ZIP Mechanicsburg pa 17055 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 1,437.54 2. Credits/Payments A. Prior Payments 17,865.43 B. Discount 71.88 Total Credits(A +B) (2) 17,937.31 3. Interest (3) 0.00 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) 16,499.77 Check box on Page 2,Line 20 to request a refund 5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) Make Check Payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X' IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;................................................................ x b. retain the right to designate who shall use the property transferred or its income;.................. x c. retain a reversionary interest;or.................................................................................................................. x d. receive the promise for life of either payments,benefits or care?.............................................................. x 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?....................................................................................................................... ❑ 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 January 1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [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 lax reitum are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: •The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an adoptive parent,or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)]. •The tax rate imposed on the net value of transfers to or for the use of the 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 decedent's 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 f y bloor)or adoption. S�';T pennsylvania I, � DEPARTMENT 01 REVENUE SCHEDULE A _ INHERITANCE TAX RESIDENT DECEDENT RETURN REAL ESTATE _ ESTATE OF Miller, Jo Anne Q FILE NUMBER 21 - 13-00288 All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. •- Attach a copy of the settlement sheet if the property has been sold. Include a copy of the deed showing decedent's interest if owned as tenant in common' ITEM DESCRIPTION VALUE AT DATE OF NUMBER DEATH 1 26 Forest Drive, Mechanicsburg, PA 17055(per sales agreement at fair market value plus 173,445.24 reimbursements for taxes per HUD) TOTAL(Also enter on Line 1,Recapitulation) 173,445.24 REV4600 EX-(6-96) SCHEDULE B _ COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERTMCETAXRMRN RESIDENTOECEOENT FILE NUMBER ESTATE OF Miller, Jo Anne Q 21 - 13 -00288 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM DESCRIPTION UNIT VALUE VALUE AT DATE OF ^ NUMBER DEATH 1 Pennsylvania Power& Light Company(number NU64273 and CL177459 30.915 12,366.00 TOTAL(Also enter on line 2, Recapitulation) 12,366.00 pennsylvania SCHEDULE C DEPARTMENT OF REVENUE INHERITANCE TAX RETURN CLOSELY-HELD CORPORATION, RESIDENT DECEDENT PARTNERSHIP or _ SOLE-PROPRIETORSHIP FILE NUMBER _ ESTATE OF Miller, Jo Anne Q 21 - 13 -00288 Schedule C-1 or C-2(Including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent,other than a sole-proprietorship.See instructions for the supporting information to be submitted for sole-proprietorships. ITEM VALUE AT DATE OF NUMBER DESCRIPTION DEATH 1 TOTAL(Also enter on Line 3, Recapitulation) vA5h pennsylvania f.1.1 DEPARTMENT OF REVENUE SCHEDULE D RESIDENT DECEDENT RN R ESIDENT CE TAX RE MORTGAGES & NOTES RECEIVABLE R _ ESTATE OF Miller, Jo Anne Q FILE NUMBER 21 - 13-00288 All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE OF NUMBER DESCRIPTION DEATH 1 TOTAL(Also enter on Line 4,Recapitulation) pennsylvania SCHEDULE E DEPARTMENT R REVENUE INHERITANCE ANCE TAX RETURN f CASH BANK DEPOSITS AND MISC. RESIDENT DECEDENT PERSONAL PROPERTY FILE NUMBER ESTATE OF Miller, JO Anne Q 21 - 13 -00288 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE OF NUMBER DESCRIPTION DEATH 1 PNC Bank Acct#5006198743 12,078.46 2 PNC Bank Acct#5070076134 46,929.01 3 PNC Bank Acct#1020019422 79,150.36 4 Members 1st FCU 61,300.00 5 Sovereign Bank 68,213.95 6 Met Life dividend on common stock 4.81 7 cash 5.00 8 PPL dividend 294.00 9 EZ Pass refund 42.47 10 Capitol One refund 232.69 11 Personal household items 680.00 12 Insurance Premium return 318.00 13 Refund of county taxes (collected on HUD1 but already paid) 646.55 14 PPL refund and Capital One refund 569.16 15 check deposit(PPL Dividend and Donegal Insurance refund) 612.00 16 check deposit(Pyramid refund and Metlife) 653.70 TOTAL(Also enter on Line 5, Recapitulation) 271,824.77 SCHEDULE E CASH, BANK DEPOSITS AND MISC. COMONWEALTH OF PENNSYLVANIA PERSONAL PROPERTY INHERRANCE TAX RENRN RESIDENT DECEDENT continued FILE NUMBER ESTATE OF Miller, Jo Anne Q 21 - 13-00288 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointlyowned with the right of survivorship must be disclosed on schedule F. ITEM DESCRIPTION VALUE AT DATE OF NUMBER DEATH 17 check deposit(Donegal Insurance) 63.00 18 PPL Dividend check 7.15 19 Pinnacle Health refund (overpayment) 24.46 20 Page 2 of Schedule E REV-1511 EX-(10-09) pennsylvania SCFEWLE H �.1. DEPARTMENT OF REVENUE FUNERLBIGINSMAND INHERITANCE TAX R RESIDENT DECEDENT URN /YMAII� '1VMIPw1 TWE COM FILE NUMBER ESTATE OF Miller, Jo Anne Q 21 - 13-00288 Decedent's debts must be reported on Schedule I. ITEM NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT A. 1 Neil Funeral Home 5,840.00 2 Gingrich Memorials 390.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zip Year(s)Commission Paid 2. Attorneys Fees Stone, Duncan & Linsenbach, PC 16,567.77 3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Register of Wills, Probate fees, filing fees, Short Certs. 17,865.43 5. Accountant's Fees 6. Tax Return Preparers Fees 7. Other Administrative Costs 1 Administrative Reserve 250.00 TOTAL(Also enter on line 9, Recapitulation) 41,063.55 .•.,,Scchedule H y _ COMMONWEALTH OF PENNSYLVANIA F��® R INHERITANCE TAX RETURN Adn inMatw COS1.Sconfintled RESIDENT DECEDENT FILE NUMBER ESTATE OF Miller, Jo Anne Q 21 - 13-d0288 - 2 UPS overnight delivery fees reimburse Stone, Duncan& Linsenbach 150.35 3 Puplication Costs? Page 2 of Schedule H pennsylvania SCHEDULE I DEPARTMENT OF URN DEBTS OF DECEDENT MORTGAGE INHERITANCE TAX RETURN f RESIDENT DECEDENT LIABILITIES & LIENS FILE NUMBER _ ESTATE OF Miller, Jo Anne Q 21 - 13 -00288 Report debts incurred by the decedent prior to death that remained unpaid at the dale of death, including unreimbursed medical expenses. -- ITEM NUMBER DESCRIPTION AMOUNT 1 Deluxe Check for estate account 14.25 2 Home Instead Senior Care, Feb 2013 1,933.00 3 Home Instead Senior Care, Mar. 2013 1,010.75 4 Dennis Zerbe-Tax collector 633.62 5 Dennis Zerbe-Tax Collector per capita 4.90 6 PPL Electric 620.09 7 PPL Electric 154.65 8 York Waste Disposal 39.03 9 United Water 53.20 10 Verizon 156.22 11 Verizorr 48.17 12 Sleep Inn (Executor stay open probate) 67.15 13 Meanness (Executor gas for travel) 6413 14 Oasis at Amelia (Executor gas for travel) 60.39 15 U-Haul to move deceased personal property 382.32 16 St George(fuel for travel for Executor) 56.72 TOTAL(Also enter on Line 10, Recapitulation) 383,947.03 SCHEDULEI Imp DEBTS OF DECEDENT, MORTGAGE COMMONW LT OF PENNSYLVANIA LIABILITIES & LIENS INHERITANCE TAX RETURN RESIDENT DECEDENT continued ESTATE OF Miller, Jo Anne Q FILE NUMBER 21 - 13 -00288 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 17 Office Max(Executor admin supplies) 11.65 18 Sheetr(Executor travel gas) 35.15 19 Michael's (supplies to show house for sale) 6.35 20 Michael's(fake flowers for showing home for sale) 38.12 21 AJ Truck and Trailer(trailer hitch to transport car) 432.75 22 Giant(Wake supplies) 68.24 23 Giant(Wake supplies) 55.51 24 Delta Airline ticket for family to attend funeral 603.80 25 Delta Airline extra bag fee 25.00 26 Delta Airline ticket for Executor to attend funeral 737.60 27 Delta Airline extra bag fee 25.00 28 Delta Air ticket for family to attend funeral 707.60 29 T Mobile 119 84 30 United Water 11.32 31 PPL 174.12 32 T Mobile 60.24 Page 2 of Schedule I SCHEDULEI DEBTS OF DECEDENT, MORTGAGE COMMONW LTHOEPENNSYLVANIA LIABILITIES & LIENS INHERFMCETMRETORN REEIOENT DECEDEM continued 1. Y ESTATE OF Miller, Jo Anne Q FILE NUMBER 21 - 13-00288 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 33 The Mitigator(mold remediation) 650.00 34 Pinnacle Health 24.46 35 West Shore EMS 134.96 36 Murphs Landscaping 190.81 37 Enviroquest, Inc 760.00 38 Elrich (pest control) 163.95 39 Green Mechanicals(Fix AC) 425.00 40 United Water 11.32 41 PPL 45.15 42 Credit to Seller per HUD-1 2,000.00 43 MC Walker Realty per HUD-1 5,187.00 44 ERA-NRT per HUD-1 5,187.00 45 Realty Transfer Tax per HUD-1 1,729.00 46 Saidis, Sullivan & Rogers Tax Cert per HUD-1 10.00 47 Upper Allen Township Sewer per HUD-1 112.00 48 Dennis Zerbe, County Tax 2013 per HUD-1 646.55 Page 3 of Schedule I SCHEDULEI DEBTS OF DECEDENT, MORTGAGE CDNNIONWEA THDEPENNSYLVANIA LIABILITIES & LIENS INHERITANCETAEREJRN RESIDENT DECEDENT continued ESTATE OF Miller, Jo Anne Q FILE NUMBER 21 - 13-00288 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 49 PPL 66.13 50 Overdrawn check fee 35.00 51 Hershey Door Service 135.00 52 T Mobile 19.48 53 Cardiology Diagnostic, LLC 3.34 54 Jon Miller 358,000.00 Page 4 of Schedule I REV-1513 EX-(01.10) penns Ivania DE OF REVENUE SC HEDULE J — INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Miller, Jo Anne Q 21 - 13-00288 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$) RECEIVING PROPERTY Do Not ur Tmstee(s) I, TAXABLE DISTRIBUTIONS[include outright spousal - distributions,and transfers under Sec.9116(a)(1.2)] - 1 Jon E. Miller son one hundred percent 124 Canal Street Santa Rosa Beach, FL 32459 Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate. NON-TAXABLE DISTRIBUTIONS: A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 HoseHold items to Salvation Army 680.00 TOTAL OF PART 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 680.00 REV-1649 Ex.(09.12) 1. 1, pennsylvania SCHEDULE DEPARTMENT OF REVENUE SLLiii�r MECTIIONUNDER SEC.9113R INHERITANCE RN RESIDENT DEC ENT (SKXlsALWT RM0Ns) ESTATE OF FILE NUMBER Miller, JoAnne Q 21 - 13-00288 PART A - DEFERRING STATEMENT For all trust assets reportable for Pennsylvania inheritance tax purposes for which a deferral of tax is being elected under _ Section 9113(a),the personal representative responsible for filing the return and the trustee(s)of the trust in question hereby acknowledge the department's Statement of Policy set forth at 61 Pa. Code§94.3 concerning any potential termination of the trust under 20 Pa.C.S. §7710.1 that occurs after the return was filed. Specifically,the signatories recognize each individual's assumption of liability for inheritance lax consequences that result from any termination of the trust under 20 Pa.C.S. §7710.1 that occurs after a return has been filed. Signature of Person Responsible for Filing Return Signature(s)of Trustee(s) PART B— ELECTION TO TAX AMOUNTS Complete this section only if making the election to tax available under Section 9113(a) of the Inheritance& Estate Tax Act. If the election applies to more than one trust or similar arrangement,a separate forth must be filed for each trust. This election applies to the Trust(marital,residual A,B,bypass,unified credit,etc.). Enter the description and value of all interests for which the Section 9113(A)election to tax is made. DESCRIPTION VALUE Total 0.00 (If more space is needed, insert additional sheets of the same size) LAST WILL AND TESTAMENT OF JO ANNE Q MILLER I, JO ANNE Q. MILLER, of Upper Allen Township, County Of Cumberland and State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all prior Wills by me at any time heretofore made. 1. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can con- veniently be done. 2. All the rest, residue and remainder of my estate, real, personal and mixed, of whatever nature and wheresoever situate, I give, devise and bequeath to my son, JON E. MILLER, absolutely and in fee simple. 3. 4 � mrn o � Lastly, I nominate, constitute and appoint myrnsr_P1, .--tea �, n r r:i ° D C•.) N 6 - 1 - JON E. MILLER, to be the Executor of this my Last Will and Testament. I direct that no bond be required of my personal representative to guarantee satisfactory performance of his duties. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 11th day of August, 1992. (SEAL) Jo Anne Q. miller - signed, sealed, published and declared by the above named JO ANNE Q. MILLER as and for her Last Will and Testament, in the presence of us who have subscribed our names hereto as witnesses, at her request, in her presence and in the presence of each other. 2 - COMMONWEALTH OF PENNSYLVANIA SHORT CERTIFICATE COUNTY OF CUMBERLAND I, GLENDA FARNER STRASBAUGH Register for the Probate of Wills and Granting Letters of Administration in and for CUMBERLAND County, do hereby certify that on the 11th day of March, Two Thousand and 0 Thirteen, Letters TESTAMENTARY in common form were granted by the Register of said County, on the estate of JO ANNE Q MILLER late of UPPER ALLEN TOWNSHIP (First,Middle,Last) in said county, deceased, to JON MILLER (First,Middle,Last) and that same has not since been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of said office at CARLISLE, PENNSYLVANIA, this 11th day of March Two Thousand and Thirteen. File No. 2013- 00288 PA Fi 1 e No. 01- 13- 0288 Date of Death 310412013 S. S. # �1 Register Of Vyilis v NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL I 1 ..a<s'.,w,..n•mdn• mlm HUo-1 ryASlb wnasRR.aos2 Settlement Statement ' A U.S.DeDc.anent of Housing and Urban Development B.Type of Lean OMB A pproval No.2502-0265 1. OFHA 2. ❑FmHA 3. MCM,.Unins. 6.FOe Number 7.Loan Number 8.Mortgage Insurance Case Number a. V 5 on C ,,.Ins. PY013-47RCS C.NOte: n.m.nn'n'tvc.crw.o�wnle•Ie.ae.Nro:aer�..sRuNsWV Nxmm.�uen�m.Nmrn°•ro.nmww.tlnox uu`. TlbeFxprew Setilement System wAamRO:nu•wmmN,wxyy m.N.tw•n•wnmaron•ul+m sm.meev am>•Yn•R lmn.n«M•ia vean �+mmwr,wa.•rm..ml umw,cF>a.,w.n:TR.le u.s.cetl•semm i�ol.m susvlolo D.NAME OF BORROWER: Frederick R.Pracht,Jr.and Hope M.Pracht ADDRESS: 315 E.Main Street Mechanics bur PA 17055 E.NAME OF SELLER Estate of JoAnne Q.Miller ADDRESS: F.NAME OF LENDER ADDRESS: G.PROPERTY ADDRESS: 26 Forest Drive,Mechanicsburg,PA 17055 Parcel lDq 42.25-0030-021 Upper Allen Township H.SETTLEMENT AGENT: Pyramid Land Transfer,LLC PLACE OF SETTLEMENT• 26 West High Street Carlisle PA 17013 I.SETTLEMENT DATE, 0610312013 I SUMMARY OF BORROWER'S TRANSACTION: K.SUMMARY OF SELLER'S TRANSACTION: 100.GROSS AMOUNT DUE FROM BORROWER 400.GROSS AMOUNT DUE TO SELLER 101. Contrast sales price 172 900.00 401. Contrast sales price 172 900.00 102. Personal Property 402. Personal PmpdM 103. Settlement chames to borawerline 14001 3737.50 403. 1D4. 404. . 405. Adustmenls for Items cold by seller in advance Adlustments for Items oald bv seller In advance 107 County taxes 061031131012131113 368.01 407, Counn,laws 061031131012131113 368.01 108. School Two 06103113to06130113 142.77 408. School Taxes 061031131o06130113 142.77 109. Final Seaver Reading 06103113toOS130113 34.46 409. Final Sewer Reading 061031131o06130113 34.46 110. 410. 111. 411. 112. 412. 120.GROSS AMOUNT DUE FROM BORROWER 177182.74 420.GROSS AMOUNT DUE TO SELLER 173445.24 200.AMOUNTS PAID BY OR ON BEHALF OF BORROWER 500.REDUCTIONS IN AMOUNT DUE TO SELLER 201. Deccasit or earnest money 5,000.00 501. Excess Deposit see InstnaUons 202. principal amount of nea loans 502. Seillemen ch es to selar line 14001 12 871.55 203. Exisft bans taken sublect lo 503. Edstin loans taken sullied to 204. 504. Pavall of Rmt Morigaae Loan 205. 505. 206. Credo from Seller for Repair 2,000.00 506. Credit from Seller for Repair 2 000.00 207. 507. 208. 209. 509. Ad'ustments for Items un aid b seller Ad'ustments for items unpaid b seller 213. 513. 214, 514. 215. 515 216. 516. 217. 517. 218. 516. 219. 519. 220.TOTAL PAID BYIFOR BORROWER 7,000.00 520.TOTAL REDUCTION AMOUNT DUE SELLER 14 871.55 300.CASH AT SETTLEMENT FROM OR TO BORROWER 600.CASH AT SETTLEMENT TO OR FROM SELLER 301. Gross amount due from borrower Ims,120 177182.74 601. Gross amant due to serer line 420 173 445.24 302. Less amounts id b Ifo borrower line 220 7 000.00 602. Less reduction amount due seler line 520 14 871.55 303.CASH FROM BORROWER 1 170182.74 603.CASH TO SELLER 158 573.69 SIUMS�Tp•MUrG MIVA IM SELLER STATEMEM:Ili.Mwm.ientaXW trw b.npwltMW Mwm•'bi•MM0•Yq Nm4MCbIM M.emn Row.a•rN[•.II p,.n r.N,Y�11•W.rMUn, ixdl 20wwu�'.']9n R'atntl.l M�trpmylyp�l 1.N,WUN.01e4.n0.'Mtlm]tl,•IR9 tlY.n,nnnININMm1le•n,WUI•tl.T,.CUn,M etla Rl[•tl..aD.Gm tmW1.N.M1VIVM.taro MFwmn iTp)�Fwm CD2 tMblStl,•d1•D Fam 1 W04•SM W bca.M•M RM1dGR RRbM.IV•AY C.%Mn W.NCPn•1v t•OVM1 b WY tM..dMS. YPIMrp,YM l>)'IMbWOMO•P•i•NGmN•OM. lO.T41a N0: IMA qpu,I MRpI•f tlYIfM16dIM1AiMf.n'Hltlolgl P'oM]•Y.@M.WWN/MCMMIWI evr,ea.)wm•Y tr•auN•tlmew vew,nn wn.n... .aMw. ,�MaRry.saN•4•Y.IMNy NnaM n,me..M1w..,mlNS.wmu,Nn mywn.auxp.)•r p•n6bYmnunGer. 11R- / SELLEWe)SIWUTUREtSk / SauEtysl REw MAR/rva ADDRESS: r -..10, a+l0pn5¢¢¢55olele fmm HUD-1(Y66)of Handbwk 4305.2 U.S.DEPARTMENT OF HOUSING AND 1N DEVELOPMENT File Number: 113-47 PAGE 2 SETTLEMENT STATEMENT TitleE Tess bP,.lement s stem L, SETTLEMENT CHARGES PAID FROM PAID FROM 700. TOTAL SALES/BROKER'S COMMISSION based on prce$172900.00 0 6.000=10 374.00 BORROWER'S SELLER'S Division Of commission line 700 as follows: FUNDS AT FUNDS AT 701. 5187.00 to M.C.Walker Realty SETTLEMENT SETTLEMENT 702. 5187.00 to ERA-NRT 703. Commission paid at Settlement 10374.00 704. Broker Transaction Fee to ERA•NRT 195.00 800.ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Origination Fee % 802. Loan Discount % 803, Appraisal Fee 804. Credit Report 805. Lenders Ins eclion Fee 806. Mort a e Application Fee 807. Assumption Fee 808. 809. 810, 811. 900.ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From to /day 902. MortgaSe Insurance Premium for to 903. Hazard Insurance Premium for to 904. 905. 1000.RESERVES DEPOSITED WITH LENDER FOR 1001,Hazard Insurance mo. Imo 1002.Mon a eInsurance me. /mo 1003.City Propel Propely Tax mo. ITO 1004.County Propel Pmpely Tex mo. 52.80 Imo 1005,School Taxes mo. 155.10/mo 1009..A r ate Analysis Adjustment 1100.TITLE CHARGES 1101.Settlement Or closing fee 1102.Abstract Or title search 1103.Title examination 1104.Title insurance binder 1105.Document Preparation 1106.Notary Fees to Pyramid Land Transfer LLC 22.00 1107,Attorney's fees includes above ilems Na 1108.Title Insurance to Pyramid Land Transfer LLC 1265.00 includes above Items NO: 1109,Lender's Policy 1110.Owner's Policy 172 900.00 -1,265.00 1111. 1112. 1113. 1200.GOVERNMENT RECORDING AND TRANSFER CHARGES 1201.Recording Fees Deed$52.00 Moe a e �Release 52.00 1202.City/County tax/stamps Deed$1,729.00 Mortgage 11729.00 1203.State Tax/stam s Deed$1,729.00 ,Mort a e 1729.00 1204,Parcel ID Fee to ACCP Electronic Filing 10.00 1205.Electronic Filing Fee to ACCP Electronic Filing 4.50 1300.ADDITIONAL SETTLEMENT CHARGES 1301.Surve 1302.PesURadonMome Ins eclion to Inspection Center by Mike Beichler,INC. P.O.C. 415.00 Buyer 1303.Home Warranty to American Home Shield 460.00 1304.Tax Certification to Saidis Sullivan 8 Rogers 10.00 1305.Final Sewer Reading toUpper Allen Township 112.00 1306.2013Co.nN Taxes to Dennis Zerbe Tax Collector 646.55 1307. 1308, 1400.TOTAL SETTLEMENT CHARGES enter on lines 103 Section J and 502 Section K 3,737.50 12 871.55 HUD CERTIFICATION OF 6UYER AND SELLER IM1a rerully reNeweGypHUO-15¢tll¢m?nle�enla O101M1e treslINmy knoM7etlBea-tlelief,it ise WaenO,a�ural¢sla/emmtatpllTemi� IS meEe onmyacmunlm5yme Hill -L /F2NXy 1M1511 M1ev¢rttHVetlafupYIN IM1e HU0.t eeWemem Slalanenl. ,('/UL//al/ 77 Freaul FTTP�]r. V Op¢ ' J � N WARNING:IT IS A CRIME TO KNOWINGLY MARE FALSE STATEMENTS TO THE TNO HUMI 14 N.h',e Prapare015atme antl accurele e¢ountar Nis transaction. UNITED STATES ON THIS OR ANY SIMIWi FORM.PENALTIES UPON CONVICTION IM1ave11E Orwilil Oave11E Orwill ra Se tlisSarsee lna¢oNance w Se tlisEUrsetl lna¢oNance wlN Otis slalem¢nt. CAN INCLUDE A FINE AND IMPRISONMENT FOR DETAILS SEE TITLE 16: ITS.CODE SECTION 1001 AND SECTION 1010. ? A , k mo . } [ ° / ) � �� i ( � ) ® 2 wE : \ \ § § m . \ § ; r pct ( c(h i o � ° § | /§(\ :rii ; ; m / } ( /LM \ C5 (D , E rt \ ] § e 2 ( \ ft } ( \ \ 7 / j j)\\ ; / N f ; : § Ear / e } 9 ` / ) 2 / � 4 3 m � \ ^ ® ok § * rt / to � ( � m � ; k ! . m / ; (En Ln / c" V .mom CA 2 � `x �\\� - , \ \ o/0 . ( \ D \ ' PV % § w �« Its 60412731313 PN C BANK. Vk,k �,t -10, PNC Bank,N816nal'A�Qiidi'iO4n 11 ,�X , 10 ki"zv 1-w Q'f ` t Cashier's'Check No. 10485371 �TCW� 201,j� io; Date Nd -7 Pay to the Order of JO ANNE Q MILLER :12,078.46 0 T w e I v�,i h 0�6s Ah*T.'S e 4 k t = 6t,Dollars And Fortv-six:.Centsa PN Z( A 5006198743 Signewre 11' 1048537111' 1:03 L3 127381: 5000L0064511' .4 ' "K 0, PNCBA-.":N -, Oki, J. , Bank Ntihoa*" k 1 4) PNC Ban at AstociatioA gi, q S-Ch60k N!O. 10485331 Cashier' 9- 1 -4 j N�;&- ( Pay to the Order of JO ANNE Q MILLER 46,929.01 0' Forty-sN�;,Th<'6691 N1n6� 146ZINid Twenty-nine DollarsoAndvone.Gen v�,11-4 4 ki on S 0 a on A 5070076134 Remltror lgnature 104853 3 Lill 1:03L3L2731311: 5000 L0064511' /3t3 PN C BAN 1(� alAssotAb6n ��O kV t 6�;,F PNC Bank NA('�n < Cashier MU&k No. 10485231 n spate-Mdrch-,7,`.'20h31. 4 Pay to the Cider of JOANNE Q MILLER 79,150.36 Seventy-rune/ '�Thousand a n' 6C dndred Fifty Dollars'And T in -six Cents 149 1? 1 -,1 1, ` 3 11 1 M. , I �k W6'b44 J 1020019422 • Remitter Slpneture 115L048 5 23'LIII 1:03L3L273811: 5000 LOOGL. SIII i� ..nk of America .° Al 641278 AtlV 1 ' Atlanta,Dekalb Count Georgia 611 GA PLEASE DEPOSIT THIS CHECK PROMPTLY.VOID SIX MONTHS FROM CHECK DATE. Pay $****FOUR DOLLARS AND EIGHTY ONE CENTS' Check Number:0002155076 Pay to the JOANNE Q MILLER 05 Mar 2013 order of 26 FOREST DR MECHANICSBURG PA 17055-4705 Authorized Officer Senior Vice President 6 Treasurer Dividends on MelLife,Inc.common stock w1X Computershare Shareowner Services LLC Authorized Signatures) 480 Washington Blvd,Jersey City,NJ 07310 n1000 2 15 50 76u■ e:0611 -L2788': • 335 987 09311' No. 0000795879 MEMBERS 161 Issued By:Moneygram Payment Systems,Inc. P.O.Box 9476,Minneapolis MN 55480 'FEDERAL CREDIT UNION Drawee: Boston Safe Deposit&Trust Company P.O.Box 40 Boston,MA = Mechanicsburg,Pennsylvania 17055 „�;� 5-7 0 9/110 'N' 09 _ DATE 03/11/13 *** SIXTY-ONE THOUSAND THREE HUNDRED DOLLARS AND 00 *** *** CENTS *** $61, 300 . 00 PAY EXACTLY'61 3 O O Dollars 0 Q Cents OFFICIAL CHECK Drawer• S 1S ERAL CREDIT UNIO TO THE ORDER OF ESTATE OF JOANNE Q MILLER OSIGNATURESRE mR FoR ER$2,500.00 TR� 11.000079587911' 1:0 1 100 709 2111:Oi6001i30478211' [PAYTO HE AUTHENTICITY OF THIS MULTI-TONE SECURITY,DOCUMENT. CHECK BACKGROUND AREA CHANGES COLOR GRADUALLY FROM TOP TO BOTTOM ” Wax 22136:1. . ere ii Bank:N.A. fi6yZ5 € g. "or cr'AL CHECK F THE SAN'TAN�DER'GROUP K'k8 * ^Y^ G r ;k _ - - ,'i Oa;I-;,i lei i I ;>i Drawer Sovereign Bank, N.A. IMP EIGN BANK,N.A. ISSUED BY.. SOVEREIGN BANK,N.A. ED SIGNATURE 11. 227136111' r: 23 137 269 0: 12001'2455311' -I'—IlKmltAUWftu WIN" ,IV re ry ui fu'U cl b,mz re tu M u Lm :::q,-Ap On, tg j 44-w mw,*0 ft-?, Donations of Moms Furniture Value Bedroom 1 Bed 35 Dresser 20 TV 20 2 lamps 12 Bedroom 2 Bed 35 Dresser 20 2 lamps 12 Bedroom 3 Desk 25 Desk chair 5 2 lamps 12 Chair 25 Living Room Couch 35 3 tables 30 2 chairs 50 tv 10 4 lamps 24 Dining room Dining room set 150 Kitchen Utensils/small applianes 80 Wall Art 80 Total Value $680 w o 7 r A N i w m C) o f0 m° 0 o o r C\1 a m w � � H N a � U Q N O LL K > O N ; � J q a g m � q C m E f o 2 U W N f Ln Y E` O m S t N u m O Ln q o O y O W U w W U w Z W w z Z a n w v _ O rn C13 m O v = m x U c = O ¢ = O O N w W O t a I O � � m 0 W O O U z b a r LU = 2 N U F- w 0�le LU _ ° O 5 ° ax z c _ �W r QO¢ z 2 7 od a S SO U a N F rG U,- Ln - w LL = WX= A zom W Gl J MZmJ� U F, op0� LL _ v i U. = 0�ao z M mw ._. 0 > .•� ^��� r •T THE BANK OF NEW PITTSBURGH, MELLON 80180 1{fh(J/t�t f/�JJ,//'�'f /l1 if BANK NEROH, K 433 INSLIItANCEGROUP ISSUED BY: DONEGAL MUTUAL INS. CO. FOR RETURNED PREMIUM DATE: JULY 08, 2013 PAE 0361509 INSURED: MILLER ESTATE JO ANNE CHECK NO. 2224473 PAY TO MILLER ESTATE JO ANNE PAY $ ty*** **t THE ORDER C/O JON,MILLER, -EXECUTOR 318.00 OP 124. CANAL ST CHECK IS VOID OVER(5,000.00 WITHOUT TWO SIGNATURES I SANTA ROSA BEACH FL 32459 VOID IF NOT PRESENTED WITHIN 6 MONTHS FROM ISSUE DATE 4 . IP 11. 222447311• t:04 3 30 160 11: 0 141110 7 9 11" _ I e :I,s: �7 4]3B71U)ePUIbeINN�:r IA10luClyl�TptTycla'Ana•a:m,c,:, olw.w..rw..,..w..�+...,.�� _ _tee..._...........`. PPL Corporation •`.T::,%;; Two North Ninth Street PP 1, •:� Date JULY 1,2013 Void after 180 days Allentown,PA 18101-1179 S •�;" �~ $*******'****294.00 ""TWO HUNDRED NINETY FOUR AND 00/100" PAY TO THE MRS JOANNE Q MILLER ORDER OF.: 26 FOREST DR SUNNYLAND MECHANICSBURG PA 17055 . 4705 The Bv*of New York Mallet Au0lprlxatl Blpnelure PNI.4•Iphl•,PA 3057748975 82439000839 - -- 111000 3 20 9 5 3 211• 1:0 3 1 10004 71: 2111967 19811' S MEMBERS 111 :PU rE RALCREOIT-bNlt)ai Dill.sburg 5 Tristan Drive Dillsburg PA 17019 Inquiries Call: 717-502-9992 Acct XXXXXXX473 JOANNE Q 14ILLER Eff: 03/12/13 Date: 03/12/13 Tlr: 1653 Time: 11:06am Deposit to REGULAR SAVINGS 0000 Prev Sal: 0.00 Amount: 5.00 New Sal: 5.00 Sag: #308842 Cash Received 5.00 Fives Received 5.00 Authorized by ID Scurce: - ❑ Dry Lic ❑ SigCard ❑ Known ❑ Other VISA Balance 'Transfer 1.909, APR NO balance transfer fees. AO an associate for more details. JOANNE Q MILLER ESTATE 9l m � C t+ C 0 0 O d 2 E c `. LU co au, N l6 N N x d N g iuor $ > z 2cp 4) v m cq m a1 � v N r OM T c o 0 ' v 7 cD cc a 3 . . >` J `� O U '° ° 0 L: �•' a m 5", T E 0 o 0 Z O u' m '0 8 m w Ea, _ ,� � Tm Ir U a00 y a ❑ ❑ m Z o w � - o Q o a co nj ¢ O , .°> - = m 3 = .a Z = ruu _ Ln = a Ir _ N y - ru V °1 m _ a SVI w o N _ O /�� w N T ( 1 Y. a h �s `N LO O m m — FD } Sm i i The Mitigator Invoice 198 Rose Hill Drive New Cumberland, PA 17070 Date invoice # Office 717-576-9589 5/9/2013 1061 Fax 717-770-0226 Bill To 26 Forest Drive,Mechancisburg i P.O. No. Terms Project - Quantity Description Rate Amount Mold Rcmediation:Microbial growth was observed as follows:Condition#3/Level 3. 650.00 650.00 Implement three stage mold treatment:Clean,Kill,Seal with inhibitor. 1.Contain the impacted areas(with double 6 mill FR polymer plastic)from the rest of the residence and implement high-speed negative airflow Hepa filtration unit to decontaminate air while work is in progress. 2.Remove aprox 6 sheets of paneling and dispose.(does not include replacement) 3.Clean,treat and seal:Remove all fungal colonization by Hepa vacuuming contaminated surfaces behind removed paneling and chemically remedime structural material.Seal with white,mold resistant sealant. 4.Dispose of Infected Material in accordance with Toxic Mold Guidelines. 5.Fog entire basement with anti-microbial solution. Treatment to be done by Seymour Levine CRMUCMR#008463. PA Contractors 0.00 license#PA056451 C) Please forward to settlement department. Total $650.00 Murphs Landscaping Invoice Precision lawn care 260 Reeser Dr. York Haven, Pa 17370 Phone(717)433-6430 DATE:0511812013 - To:John Miller M C Walker Realty 14 North Walnut St. Mechanicsburg PA, 17055 .. DESCRIPTION AMOUNT 4(30 26 Forest Dr. Mechanicsburg $45.00 ' $45.00 5%3 26 Forest Dr.-Mechanicsburg 5(23 26 Forest Dr, Mechanicsburg - : $45.00 - 5(31 26 Forest Dr.Mechan!cburg - $45.00 i j Subtotal $180.00 Tax $10.80 I Total $190.80 f c r i G � X90 q0 ]take all checks payable to Murphs Landscaping Payment is due within 30 days. If you have any questions concerning this invoice, contact Garrett Murphy 717-433-6430 Thank you for your business! invoice E N V r R O Q U E S T DATE INVOICE# www.evgharrisburg.com 5/30/2013 12923 1738 N. Third Street, Suite A Harrisburg, PA 17102 BILL TO Estate of Joanne Miller 26 Forest Drive Mechanicsburg,PA 17055 TERMS DUE DATE PROJECT Settlement 6/3/2013 26 Forest Drive QUANTITY DESCRIPTION RATE SERVICED AMOUNT Install Radon Mitigation System:26 760.00 5/24/2013 760.00 Forest Drive,Mechanicsburg,PA 17055 GP501 Fan Sales Tax 6.00% 0.00 V Thank you! We appreciate your business very much! TOTAL $760.00 A FINANCE CHARGE of 1.5%per month,which is equivalent to an annual percentage rate of 18%will be applied to all accounts past due.Past due customers are responsible for all collection costs We accent Visa/Mastercard for Your convenience. Phone# Fax# E-mail 717.233.6144 717.233.2699 evq @comcast.net t3ank of Amenca I UnlmeSank�ng I Accounts I Account-Details I Accou*' 'try f ity Page I o 2 . BankofAmerica'O�b " y� •Available Credit In0ude5 purthaM that have Deen authorize but have trot yet posted to your account. /�/ rj//v P��� ///��•'f f�f) Go to: Cunem veru0bns - --- - FXf3P.U5� /NCvN•���/ Date I DOSCrlpdon Amount ealarim P fny NE1IFM.COM $21.20 $14,652.82 PmJhro TOM THUMB*86 $1.00 $14,631.62 PenOVro MOM.153 $83.07 $14,630.62 ftmhg EX%ONMOBIL POS $1.00 $14,547.55 Pendln9 PAYROLL $28.00 $14,546.55 PaWhp SMep inn .%AJe/ $67.15 $14,518.55 03/15/2013 BENTLEYS AND MADOOG53 $76.11 $14.451.40 ` 03115/2013 MEEMEES,INC ('A 3 'Af�1✓A I $64 31 A $14.375.29 0311512013 THE OASIS AT AMMA -i, 7.ZAJ6I $60.39., 514,310.98 0., C 03/14/2013 U-HAUL-MECHANICSB salt IAPU/�j $382.12 1 $14.250.59 ON14/2013 GINGRICH MEMORUIS C.,C`•f✓e-, 1�✓^-)� $390.00 $13468.27 03114/2013 ST GEORGE CAS .TZA✓1 I $56.72. $13,4)8.2) 67"15 + 03/1312013 OMCE MAX S-,,4,,/, -T $11.65, $13,421.55 64`31 + 03113/2013 SHEER 00002014 641 T0,%Ue I $35.15, $13.409.90 60 39 + 03/13/2013 ROO(BASS GRILL $46.21 $13,3)4.)5 382 JL + �. 03/12/2013 MICHAELS.2)S4 $6.35. $13,328.54 _ 03/12/2013 MICHAE .2754 llo• ji! /'J G$-(- $38.12 $13,322.19 J9O-OO + 03/12/2013 APS MUCK A TRAILER C $432.75 . $13.284.07 56-72 + 03/1220/3 ROCKBASS GRILL $160.00 $12,851.32 11 65 + 031u2013 GUM 6331 JPlA/ $68.24. $12.691.32 35,15 + 03/11/2013 GIANT 6331 5 $55.511. 5121623.08 6.35 + 03111/2013 GIANT 6331 $13.45 $12,56).5) 38 'L + 03109/2011 GLINT 6311 $46.0 $121554.12 03/0912013 GIANT 6331 $7BJ4 $12,507.95 432.75 + 031082013 GIANT6331 $6.35 $12,429.21 66 24 + ON08/2013 WINE A SPIRrTS.2105 $78.39 $12,422.86 55'51 + 031082013 7HEOLLVEGARD0001011 $85.02 $12,344.47 53840.00 + 03107/2013 GIANT 6331 $75.81 $12,258.65 L5°i.O + 031062013 NEILL FlINERAL HOME d74 424 f $5,840.00 $12,182.84 603°80 + 031OW2013 RTA AIR 0B21030 TXA✓e sxs.o w.34z.e4 03/062 737 $C +013 VISUALTOVRCOM $29.95 f6.317.84 nn 03106/2013 001 MUS NLD*349 $729.21 $6.207.89 25 00 + ON062013 SNAPPERS MR a GRILL $91.89 $61058.18 707 GO + �• 03/052013 DELTA AIR 0062325620 FA/M•r.J j�( l $603.80 r $5.966.29 9,G07 65 * 03105/2013 D&TA AIR 006232580 A ,7A/J 'r�AJe I $737.601 $5,362.49 03105/2013 08 %x153 $16.39 14.624.89 03/05/2013 WINE a SPIRITS x2105 / ,I $31.78 P.608.50 .. 03/04/2013 DELTA AIR 00592101952 Y,IMr/,/ iGIJ2 $25.00 • 14,576.72 03104n013 DELTAAIR 0,1167176077 �,M,(/ .lt)CI $707.60 • $4,551.72 0310412013 REALTOR ASSOCIATION/ML $90.00 $3,844.12 0310412013 TOM TMUMB x86 $74.23 13,754.12 03/04/2013 TARGET 00022020 $10.08 $3.679.89 0310142013 PAYMENT-THANK YOU -$7.339.35 $3,669.61 03/0112013 PUBLI%a 153 $147.93 $111009.16 02/28/2013 BENIIF/S AND MADDOGS 3 $61.75 $10,861.23 02/28/2013 HILLSIDE SOFIWARE,INC $9.95 $10,799.48 01420/2013 VOCALOCTTY INC $149.92 $10,789.53 Be9innin9 b.1.nm as Of 02/16/2013 $7,339.35 hops://secure.bankofamerica-com/myaccounts/brain/redirect.go?source=overview&target=... 3/16/2013 Fage I of I Haig I LgqM I Exi on Deluxe Od,,Pm4D NEW' Order Branch SU[i ................... ................................. -------------- Order Search Order Confirmation The order has been submitted.You may_ppnt Phis screen for yoy!jscords then either place another o derfortihisaccomt access another account or_Exit. Order Contents Account Conn"'adon 1 7161695390 R-mll 0 23138224 2184984736 ord. Ober $14.25 Order Date: 03/12113 Item I: Product Description Specialty Blue Checks-Single/wallet tropirlint: JOANNE Q MILLER ESTATE 8 N BALTIMORE ST DILLSBURG.PA 17019 Shipping Method: Standard Delivery-14 Days Shipping Addrugs: JOANNE 0 MILLER ESTATE 8 N BALTIMORE ST DILLSBURG,PA 17019 Important. Did you Fiat Packaging for Personal Chocks Know 70 Mee offorl U.B.Postal Scivics redittionchichrol in.Col. 82%of 22-32 year Olds write R.,gsR.f:1,eRkbgxhqomRc;ftRRrRg, checks.Be sure they know ZZ7, c,•flidler..e trocriggerIL cite eck� g 11ch -R"- about Leluxe_qoml—i ogentong,C411DOU" for easy orderingi toll free titc lncr.981,1.414 orchoets—cess- Wnq-t NW—Ac- --dj EPrnt:j—hjsT Screen] [-aWhCurCenfAcc—o:u:rE1Ra.ijd likilt .. ............... ...... ...... ........... ------------- Privacy Security and Reliability Terms and Conditions All dosi,ils shown Ithe subject to ll.1111.1.t notol., All lrodersolks sh,file r.'eh,of their ros,,unve owners.e;2012 Dole Enterprise operstirc,Inc.All Rights Reserved Bkllld Version:810.15 3/12/2013 Account Number Due Date Amount Due 799000 I8503013157I09 4/15/13 5204.39 very on Account Information 1 .Y'I,lisRi/erit61Y+C4m�inytl�►izofiiY}ask � state entDate: WV13 JOANNE DMILLER Phone: 717-766-0196 �-.sh""� Sl:}1D�rYaluwyV—fit f7f4. Y4,F� i u•v 'F fi s� V.>.vES .X � oP� t�j`( 5�4�. Account Summary .- Pmvious Balance /� -..5156.2 ' KQ<f ro4� — . 0 tiwr'.:y:,ff:c6:.✓.^n;r' _ No Payment Received ,__.. .! j,"j}r;j;��,ti•i VefIZ00 News'i:rhll;���;n:aj.i;i� Bdanee Foreard . . ... -- 56 Get 3%Speeds With ROS Now is the perfect time to upgrade to ROS Ouantum New Charges ._- Internet.Even with multiple devices oNim,you Mn Current Aclivily $35.91 triple your download speed and get 5x the upload _.. _ .... .... ._- _._ . .. _._. speed for only$to mom a month.Call Taxes,Governmental Surcharges and Fees _ $4.74 1-888-456-4481 to loam mom.Speeds riot Verizon Surcharges and Other Charges&Credits available in all areas.Taxes and terms apply. -- - --- - ------ Toad New Charges due by April 15,2013 77 �A 546.17 Experience F0S Quantum A revolution in Internal has arrived.Step up to 100% Amount Due libel-optic speeds and enjoy the Internet better than ever.faster streaming,downloading,Deming& to$65 return iL Bon-owned equipment immediatdY a Prevent is Des or up surfing Call 1-888-367-4023 and ask about our to S6r+0 per unit.find out more in Need-to-Know at the and of this 6111. new bundle deals with ROS Quantum. ` Get More,Save More � 7 .Call 1-888-301-7244 to ensure you're getting the best Vemon services at a great value-from phone. Internet and TV,to money saving burde%irderre8oral plans,arid tun add-ons Together we'll find ways to save you own mom. Questions about your bill or service? Want Automatic Payment? View your bills in detail at vedzoncom or call 1-800-VEIBZON(1-800-837-4966). Enroll below or at Verizon.com to authorize your financial When asked for your amount number,please enter 8503013157.Customers with imtitution to deduct the amount of your monthly bill from disabilities call 1-800-974-6006 TTY. the account associated with your enclosed check and send payment directly to Verizon.To discontinue Automatic Payment,call Verizon Please keep a copy of thisaulhorbalion, Please return remit slip with payment. To enroll inAutomalic Payment(Sign and date below) Account Nut t 0 New"C ■ ourd2213 B,yr4 abmI emyeeh i are rnle+eaem Make Check gaeatw.= valrm.eoeJauwP=Ne�beutonOtic Ea FaY'em� 00087915 Ol MO 0.405 VY032211 389 XX / JOANNE 0 MILLER C 124 CANAL ST II'IIII"'I'Itllll"'i'IIIIhI'IIIIII' SANTA RSA BCH FL 32459-6332 VERIZON IIIIIII'II'IIII'II'IIIiI'IIIII'II'III'IIII'III' ' 1 — PO BOX 920041 DALLAS Tx 75392-0041 79 9000 8503013157 09N00000015622 00000020439 00 I j Ehrlich FRIENDLY Your Local Peso Control Experts R REMINDER REEADING ADING PA A l 19612-3848 ADDRESS SERVICE REQUESTED liillRlllitliililililili3illiiiiliilllllllliltilililiill�ill "`*—"MIXED AADC 442 !„11 166,iI1.1a1 1 liil I'll l,6,liili,Ili,[fill,Ili,Ii,iliil o6TN: ATTN:JON MILLER J.C. EHRLICH CO., INC. JOANNE MILLER PO BOX 13848 ,... 124 CANAL ST READING PA 19612-3848 SANTA ROSA BEACH FL 32459-6332 10.11 HARRISBURG 1539 SOBALl DRIVE ' R "��_ r HARRISBURG PA 17104-3208 (717)238-9590 FAX#(717)966.0397 5/10/13 This is just a friendly reminder that your account is now past due. Perhaps the original invoice was overlooked, or you may have made payment and it is in the mail. In any event, we appreciate the prompt reply we know you will give this reminder. Simply check the proper block below and return this form to us in the envelope provided today. Thank you! ACCOUNT#: 720639 AMOUNT DUE: 163.95 YOUR REPLY: ❑ C� I am enclosing payment. E made payment on My check numberwas ❑ I want to register to pay this and all future invoices by credit/debit card. My Card Number is Please circle card type. Expiration Date is i VISA Mastercard Discover American Express SIGNATURE DATE REMARKS: 680 EHR 720&39 t, GREEN MECHANICALS LLC invoice 5231 Simpson Ferry Rd Suite 150 Date Invoice# Mechanicsburg,PA 17055 5/2212013 2316 Bill To Ship To Walker property rentals 14 N.Walnut St Mechanicsburg Pa 17055 P.O. Number Terns Rep Ship Via F.O.B. Project 5/22/2013 Quantity Item Code Description Price Each Amount IS HVAC 26 Forest Dr.Sunnyland development.Unit very low on R-22. 425.00 425.00 Added 5lbs R-22.check operations,unit running ok at this time. � lY r- +3 sz4 2 Phone# Total 8425.00 1-877-266-9199 r + QuestiG. Please Visit us online at 1 Page 1 W. contact us by Jun 12. pplelectric.com P' --_ 1-800-DIAL-PPL bill - o Due Date A ' (1-800-342-5775) 77960-68004 Jun PPL eacMO 16nNSs M-F:Sam to Spm � 12, 2013 *":Q453Sii Your Electric Usage Profile Billing Summary (Billing details on back) Service to: Balance as of May 22,2013 $0.00 JON MILLER Charges: 26 FOREST DR Total PPL Electric Utilities Charges $45.15 MECHANICSBURG,PA 17055 Meter:98853881 Total Charges $45.15 Your next meter reading is on or about Jun 21,2013. _• ^ 'o" fDfi ..BTirn, 2;201_3, '�s� �':^ ' .roi?tt;;�sr. `'-'�'. S This section helps you understand your electric use by Account Balance $45.15 month. Meter readings are actual unless otherwise noted. PPL Electric Utilities'prlceto compare for your rate is$0.07237 per kWh. This raph shows the average number of kWh you used This changes the 1st of Mar,Jun,Sept,and Dec.Visit papowerswitch.com 8 Y or www.Oca.state.pa.us forsupplier offers. each day. You used 274 kWh in 30 days,or an average of 9 kWh a day. Your Message Centel` The average dally temperature for your area last month s With paperless billing,you can receive and pay your was 58F. PPL Electric Utilities bills online.The process is free, 02013 quick,convenient and secure.To learn more or sign up, 90 visit pplelectric.com. 75 s Information about appliance energy use and tips on saving energy are available through the Energy Library 60 on our Web site,pplelectric.com. ° 45 s Before digging around your home or property,you 30 should always call the state's One Call notification system to locate any underground utility lines. You can 15 do this by simply dialing 811,which will connect you t0 o the One Call system. Be safe and call 811 before you J F M A M J -J A S O N D dig. Months 730Days Actual 56603 Payment Methods c Actual 56329 Online at: By phone:1-800-342-5775 pplelectric.com or call BIIIMatrlx(service fee applies) kWh Billed 2 74 at 1-800-672-2413 to pay using Visa, MasterCard,Discover or debit card. _= ® By Mali: Correspondence should be sent to: 2 North 9th Street Customer Services — CPC-GENNI 827 Hausman Road Allentown,PA 18101-1175 Allentown,PA 181049392 = Other Important information on the back of this bill 4 >_ ® Return this part in the envelope ; Date Amount Due pp1 provided with a check payable to PPL Electric Utilities. 77960-68004 Jun 12, 2013 $45.15 an.d.mne unrur.s Amount Enclosed: MB 01 064813 59639 B 233 A �� 4\ _ []n[In REM 1,166�6 1111 1111 6 11t'11111'II' Ili,6�I,6i,iI11'Iillll�'�'It1II111I r JON MILLER PPL ELECTRIC UTILITIES 124 CANAL ST 2 NORTH 9TH STREET CPC-GENN1 SANTA ROSA BEACH,FL 32459-6332 / ALLENTOWN. PA 18101-1175 / /' � II'ICI"I��t,1..�I'll��ll'I'll"II'I�I'I�IIII'I�16116611�11�1�116 1 6400000451540000045155 7796068004 k 0hjted W atiY � ' e r S lvdMo l ' i 9 F,`, � . .� + �`w_i�i. �t-fe'�i9 5 ��+ a c-'y.'' afa*i ' N'Clfftomf.��fVic.F. �ir }.h f v 't. '��'+,+,•4`�.t�� ,,, v��r: .1 ,m nW`':t'L s t xL'K'� - •"n Y'1 �- '7'U_ ;sK°N c�r��T-u.-'`'�D1e.-1� s -, f..r�T rffta,,;, tit FelOyyhafie.',r 1D() 1°3� �E � .t r g C A, 'c£ ,.:.a*, +dr- a-',� „t iTN^".T..S�S.q�i+�..�;rK .t- -...1`�',�ii l�v�w si,l• h'. �i,7.� .LLtUV)`tUia n"iYeBw�t'§r'�c"orri,:; �nl�f2-i"b}''X'� tr" ."�:het.15'1..+.:%i; .fi USAGE HISTORY Billing Date: 05/21/13 Usage in Thousands of Gallons Account Number: 00200147820000 4 3 ' Previous Balance $11.32 Payments Through 05/21/13nwwa $11.32CR e Bala nce Forward $0.00 Current Char es Due 06/10/2013 $11.32 V 4 4 fl. c. 0 M Yn H M W M Nau o¢ 1m h! Mr M bf Next meter reading date:on or about 06/19/2013 'PAY BY 06/17/2013 TO AVOID A 1.5%LATE PAYMENT CHARGE SERVICETO: IDANNE,Q MILLER SERVICE ADDRESS: 26 FOREST DR MECHANICSBURG.PA 9s-n y,-4i'ff t,�MF 'NO�d¢G e r i. N dam Seyilnce A4 rG rE ° r= U 9 4- os u'JYe-'a I e „ y .l. yRFram.l Tawt a 3PeUSgGs Yie3ngt, d rn ifs w a w r ; 68594208 04/19/13 05/21/13 32 0070 0070 0 MGL ACTUAL W07 EQUNALENT TO . O GALLONS SERVICE CHARGES $11.00 DISTRIBUTION SYSTEM IMPROVEMEN $0.31 STATE TAX ADJUSTMENT SURCHARGE $0.01 TOTAL CURRENT CHARGES $11.32 SEE REVERSE SIDE FOR IMPORTANT ACCOUNT INFORMATION ME Rix P —.ra—�e'ar. , �v :.lc 1< IORT(�N > SSA Your consumpption is based on an actual readirig of your water meter. Effective Aph 1.2013 the Distribution System Improvement Charge(DSIC)increased from 2.45%to 2.81%.This charge funds the replacement of water distribution facilities in Pennsylvania. Save a stamp and go paperless today! _og on to www.unitedwoter.com or call Customer Service to find out more information and to enroll in e8illing. Approximate state tax included on this bill $0.44. � r ..._._.. . .a.e_a,ae.....IMP?....... PlEASE.gETACH HEREANDRETYnH THEBOTTOM PDRTION VJRH YOUNVAYMENTINTHERENFIN ENVELOPE PROVIDED, ,,,,,,,,,,,,,,,,,,,,,➢Ot. om s% UNITED WATER Account Number: 00200147820000 Customer'Service Center 8189 Adams D,PA 17036 Balance Forward $0.00 Temp-Return Service Requested Current Charges Due 06/10/2013 $11.32 SERVICE ADDRESS: 26 FOREST DR i �W" MECHANICSBURG PA klmse` �r e6fetb"UNIYFD� }I7FijYgfNNSyIV „ El Payment Amount Enclosed $ Please check this box if you have made any changes to the Information on the reverse side. 001725 uuIIIIIIn,Iud�IIIId��,�I�II�JJIInIIIIIrIIIIuIIIJnIII� 'll"�Illlll'I"III"IrIIII�,��III'llll�llllrlll'lll�ll"'ll'lll' UNITED WATER PENNSYLVANIA '•**AUTO•"MIXED AADC 2801725 T7:14 1725 1 MB 0.405 PAYMENTCENTER UJOANNE Q MILLER PO BOX 371804 C/O JON MILLER PITTSBURGH PA 15250-7804 124.CANALST SANTA ROSA BEACH FL 32459-6332 0020014782000000000001132000000004 +3 iO ; Oi pp d .i O i0 ; 0 ; O ; O' i W , LC N i v ei i¢r - i o � — V ti y p+ At C ` .................................................... ............y o � V d A ............................................... a+ a . . _ _. . . . _ ) ) , 6 co \ to i � $\ � ƒ \ . \ \ � • % � \ 4& , � ! \ � i •��; �,-,. Ques..,ns2 Please Visit us online at .,nal Bill _ Pag:.r PPS�- O contact us by Jun 25. pplelectric.com =y (1 800 942-5775) M-F:Sam to Spm 77960-68004 Jun 25,2013 cp��oummee Your Electric Usage Profile Billing Summary (Billing details on ba• Service to: Balance as of Jun 4,2013 $45.15 JON MILLER Charges: 26 FOREST DR Total PPL Electric Utilities Charges $20.98 MECHANICSBURG, PA17055 Meter:98853881 Total Charges $66.13 `t'�io .;.•., , '9,. Y " rr'" - tip ♦.a(t IiZ This section helps you understand your electric use by Account Balance $66. noted. Meter readings are actual unless otherwise PPL Electric Utilities'priceto compare for your rate is$0.08227 per kWh. This changesthe 1st of Mar,Jun,Sept,and Dec.Visit papowerswitch.com This graph shows the average number of kWh you used or www.ocastate.pa.us for supplier offers. each day. You used 129 kWh In 13 days,or an average of 9 kWh a day. Your Message Center The average daily temperature for your area last month • With paperless billing,you can receive and pay your — was 68 F. PPL Electric Utilities..bills online.The process.is free, 2r t3 quick,convenient and secure.To learn more or slgn up, 90 visit pplelectric.com. • information about appliance energy use and tips on x 60 - saving energy are available through the Energy Library on our Web site,pplelectric.com. 45 • Before digging around your home or property,you 30 should always call the state's One Call notification > a system to locate any underground utility lines. You can 15 do this by simply dialing 811,which will connect you to o the One Call system. Be safe and call 811 before you J F M A M 1 J A S O N n dig' Months Billin�g Period Type Reading Jun a Actu=j 56732 Payment Methods May 22 Actual 56603 Online at: ®By phone:1-80D-342-5775 13 Days kWh Billed 129 pplelectric.com or call BIIIMatrix(service fee applle Y at 1-800-672-2413 to pay using Vls: MasterCard,Discover or debit card ® By Mail: Correspondence should be sent to: 2 North 9th Street Customer Services CPC-GENN1 827 Hausman Road Allentown, PA 18101-1175 Allentown, PA 181049392 Other important information on the back of this bill -- £ali4.i rz iil E: Vh^Y y� +Si h to jr "Cl to cr co 4` + L C f OPO iM 6) ryr0' 4 n.p Miv+.914 tMit++ � 1`R STATEMENT OF MEDICAL SERVICES 7 LAST STATEMENT DATE: 09/10/12 MEN CHARGES: 0914.00 PINNACLEHtALIH MEN PAYMENTS: 0384.34 _ Proven MEN ADJUSTMENTS: $492.18 INSURANCE BALANCE: $1458.02 YOUR BALANCE: $26.46 _ If Any Questions, Please Contact: PHNS AT 717-231-8960 OR 1-800-565-6229 E JOANNE Q MILLER _ ACCOUNT: 175886 4 04/26/1 FED TAR ID 6 2511 INSURANCE Y CHARGE PAYMENTS AWIbTMENNS BALANCE BA >>> PATIENT: JOANNE Q MILLER IP 022613 D22713 02/26/13 TO 02/27/13 PERFORMED AT: HARRISBURG HOSPITAL PERFORMED BY: HOSPITALIST AT CGOH *02/26/13 INITIAL HOSPITAL CAR LVL2 262.00 105.85- 129.69- PROCEDURE: 99222.AI DIAGNOSIS: 599.0 ■02/27/13 HOSP OSCH DAY MGMT >30MIN 202.00 102.08- 99.92- PROCEDURE: 99239 DIAGNOSIS: 599.0 PERFORMED BY: NEUROLOGY ASSOC PHMS ■02/27/13 EEG; AWAKE 8 DRONSY-PROF 135.00 44.10- 79.88- 11.02 PROCEDURE: 9581626 DIAGNOSIS; 781.0 7;02/27/13 INITIAL INPT CONSULT LVL4 315.00 132.31- 182.69- PROCEDURE: 99254 DIAGNOSIS: 294.20 BALANCE: JOANNE Q MILLER 5 It INDICATES MEN FINANCIAL ACTIVITY SINCE LAST BILL. OTHER CHARGES BILLED TO INSURANCE 1447.00 518 O 4-0 ems; PAGE 1 O Plc s detachaM mtom with your pwma WEST SHORE EMS - BLS v® DISCOVER M&se Eps 205 GRANDVIEW AVE SUITE 211 77 CAMP HILL, PA 17011-1708 ON REVERSE SIDE WEST SHORE EMS Phone#: (800) 367-0512 Federal Tax ID: 23-2463002 OHOLY SPIRIT HEALTH Sys PATIENT NAME: JO ANNE MILLER INSURANCE: MEDICARE B WCS FEPI HIGHMARK W1 CALL NUMBER: 238819W DATE OF CALL: 02127/2013 FROM: HARRISBURG HOSPITAL TO: 26 FOREST DR ACCOUNT SUMMARY JO ANNE MILLER 124 CANAL ST TOTAL CHARGES: 0.00 SANTA RSA BEACH, FL 32459-6332 PAYMENTS/ADJUSTMENTS: PLEASE PAY THIS AMOUNT: 134.96 DETACH ALONG PERFORATION AND RETURN STUB WITH PAYMENT DESCRIPTION OF CHARGE QUANTITY UNIT PRICE AMOUNT Stretcher One Way Trans Member T2005 1.0 96.06 96.06 Transport Van Mileage 50209 10.4 3.74 38.90 C Total Charges 134.96 DESCRIPTION OF PAYMENT RECEIPT PAYMENT DATE AMOUNT Questions?Please Visit us online at Page 1 ® contact us by May 13. pplelectric.com Due Date Amount Due „„ 1-800-DIAL-PPL M�I (1-800-342-5775) 77960-68004 May 13,2013 5174.12 wi,ewmne umnw. M-F:Sam to 5pm Your Electric Usage Profile Billing Summary (Billing details on back) Service to: Balance as of Apr 22,2013 $0.00 JON MILLER Charges: 26 FOREST DR Total PPL Electric Utilities Charges $174.12 MECHANICSBURG, PA 17055 Meter:98853881 Total Charges $174.12 Your next meter reading is on or about May 22,2013. mount Due ey May 13,2013 $172 This section helps you understand your electric use by Account Balance $174.12 ith. Meter readings are actual unless otherwise PPL Electric Utilities'price to compare for your rate Is$0.07237 per kWh. ,—ed. This changes the 1st of Mar,Jun,Sept,and Dec.Visit papowerswitch.com This graph shows the average number of kWh you used or www.oca.state.pa.us for supplier offers. each day. You used 1446 kWh in 32 days,or an average of 45 kWh a day. Your Message Center The average dally temperature for your area last month • With paperless billing,you can receive and pay your was 47F. PPL Electric Utilities bills online.The process is free, 2013 quick,convenient and secure.To learn more or sign up, visit pplelectric.com. 90 • Information about appliance energy use and tips on 7s saving energy are available through the Energy Library 60 on our Web site, pplelectric.com. 9 45 • Before digging around your home or property,you o should always call the state's One Call notification 30 system to locate any underground utility lines. You can is do this by simply dialing 811,which will connect you to o the One Call system. Be safe and call 811 before you J F M A M J J A 5 O N D dig. Months Period Type Reading Apr 22 Actual 56329 Payment Methods Mar 21 Actual 54883 nr a Online at: O By phone:1-MG-342-5775 �J pplelectric.com or call BIIIMatrix(service fee applies) 32 Days I kWh Billed_L 1446 at 1-800-672-2413 to pay using Visa, MasterCard, Discover or debit card. ® By Mall: Correspondence should be sent to: 2 North 9th Street Customer Services CPC-GENN3 827 Hausman Road Allentown, PA 18101-1175 Allentown, PA 18104-9392 Other important information on the back of this bill 4 aim murr un aan 0 0 0 r United Water Pennsylvania Customer Service Center J�cy UNITED WATER 8189Adamwn,PA H Telephone: PA 17036 Telephone:717-564-3662 www,unitedwater.com USAGE HISTORY Billing Date: 04/19/13 Monthly usage in Thousands of Gallons Account Number: 00200147820000 3 3 Previous Balance $53.20 3 Payments Through 04/19/13 rNANxrou $53.20CR 2 2 Balance Forward $0.00 Current Charges Due 05/09/2013 $11.32 1 t t TOTAL AMOUNT DUE $11.32 a 0 0 0 0 0 0 .q ray Nn NI kp Sep M Na dp Zvi ht Mn M Next meter reading date:on or about 05/21/2013 "PAY BY 05/15/2013 TO AVOID A 1.5%LATE PAYMENT CHARGE SERVICE TO: JOANNE Q MILLER SERVICE ADDRESS: 26 FOREST DR MECHANICSBURG PA Meter Number Service Days of Meter Reading Unit of from To SerWCe Previous Present Osage Measure Reading Type Rate 68594208 03/19/13 04/19/13 31 0070 0070 0 MGL ACTUAL W07 EQUIVALENT TO 0GALLONS SERVICE CHARGES $11.00 DISTRIBUTION SYSTEM IMPROVEMEN $0.31 STATE TAX ADJUSTMENT SURCHARGE $0.01 TOTAL CURRENT CHARGES $1132 SEE REVERSE SIDE FOR IMPORTANT ACCOUNT INFORMATION IMPORTANT MESSAGES Your consumption is based on an actual reading of your water meter. Effective April 1, 2013 the Distribution System Improvement Charge(DSIC)increased from 2.45%to 2.81%.This charge funds the replacer b of water distribution facilities in Pennsylvania. Save a stamp and go paperless today! Log onto www.unitedwater.com or call Customer Service to find out more information and to enroll in eBilling. Approximate state tax included on this bill$0.44. X1 .32 '5.1 .3 0 0 o ne ,semr PLEASE DETACH HERE AND RETURN THE BOTTOM PORTION WITH YOUR PAYMENT IN THE RETURN ENVELOPE PROVIDED. ao, DETAILED INVOICE Service For : Joanne Miller(1) Billed To : Mrs. Joanne Miller(1) Invoice#: 1746-0213-2 5002 Invoice Date : 2/28/2013 Mechanicsburg,PA 17050 Lenker Street (717)731-9984 Service Period : Feb 16,2013 -Feb 28,2013 w .Homelnstead.com Date From To Type CAREGiver Miles Service Qty. Rate SubTotal 2/16 7:00am 9:00pm Weekend Taylor,Glenda Hourly Service, Level 1 14.00 $21.95 $307.30 9:00pm 7:00am Sleepover,Level 1 1.00 $175.95 $175.95 2/17 7:00am 1:00pm Weekend Genet,Deborah Hourly Service,Level 1 6.00 $21.95 $131.70 1:00pm 9:00pm Dougherty,Ashley Hourly Service,Level 1 8.00 $21.95 $175.60 9:00pm 7:00am Taylor,Glenda Sleepover,Level 1 1.00 $175.95 $175.95 2/22 9:00pm 7:00am Weekend Ross,Juliette(Jill) Sleepover,Level 1 1.00 $175.95 $175.95 2/23 7:00am 3:00pm Weekend Ross,Juliette(Jill) Hourly Service,Level 1 8.00 $21.95 $175.60 3:00pm 9:00pm Genet,Deborah Hourly Service,Level 1 6.00 $21.95 $131.70 9:00pm 8:00am Ross,Juliette(Jill) Hourly Service,Level 1 1.00 $21.95 $21.95 Sleepover,Level 1.00 $175.95 $175.95 2/24 8:00am 9:00pm Weekend Dougherty,Ashley Hourly Service,Level 1 13.00 $21.95 $285.35 Total 60.00,--------$1,933.001 Miles: 0.00 @ $0.59 - $0.00 Miscellaneous Charges: - $0.00 Additional Charg&Crcdits: - $0.00 Service Deposit'Applied: - $0.00 Current Invoice Total: - $1,933.00 Vt I Total Amount Due: $1,933.00 Due Date: Due upon Receipt *All Overdue Invoices art Subject to an 18%Annual Service Charge Plem Retain For 1'aur Records DETAILED INVOICE AomeThstead® Service For : Joanne Miller(1) r zowf iLf�ertos2al Billed To : Mrs. Joanne Miller(1) Street Invoice#: 1746-0313-1 5002 Mechanicsburg,rg,P Mechanicsburg,PA 17050 Invoice Date 3/15/2013 (717)731-9984 Service Period : Mar 01,2013 -Mar 15,2013 w .Homelnstead.com Date From To Type CAREGiver Miles Service Qty. Rate SubTotal 3/1 9:00pm 7:00am Weekend Taylor,Glenda Sleepover,Level 1 1.00 $175.95 $175.95 3/2 7:00am 9:00pm Weekend Taylor,Glenda Hourly Service, Level 1 14.00 $21.95 $307.30 9:00pm 7:00am Sleepover,Level 1 1.00 $175.95 $175.95 3/3 7:00am 3:00pm Weekend Dougherty,Ashley Hourly Service,Level 1 8.00 $21.95 $175.60 9:00pm 7:00am Taylor,Glenda Sleepover,Level 1 1.00 $175.95 $175.95 'i. Total - 25.00 51,010_.75_) Miles: 0.00 @ $0.59 - $0.00 Miscellaneous Charges: - $0.00 Additional ChnrgWCrcditc: - $0.00 Service Deposit Applied: -=,O$00..00Current Invoice Total: Total Amount Due: $15010.75 Due Date: Due upon Receipt -All overdue Invoices ate Subject to an 18::Anat al Service Charge Please Retain Par four RKOrds i t DENNIS ZERBE,TAX COLLECTOR TAXPAYER'S COPY 275 CUMBERLAND PARKWAY#325 MECHANICSBURG,PA 17055 [KEEP THIS PORTION FOR YOUR RECORDS TEMP - RETURN SERVICE REQUESTED ulllllll�)IrI�I�hIiI�IPmllll�um4lihllllll�l�lh�nhl�l 065358^--''-'-^""AUTO-'6-DIGIT 17055 MILLER.KENNETH C&JOANNE Q I IIIIII VIII VIII VIII VIII VIII VIII VIII Iill IIII 26 MI FOREST DR } MECHANICSBURG PA 17055-4705 pd 410D I (D To review the assessment data for this propert y 90 to: www.courthouseoniine.com>AssessmentOffice>Cumbei,and>PropertyRecords. Then enter control# 42001069 andpassword CUXXKTWT ... .....................................................................................................................................................................................................................................--............................................ ... Payable To: DENNIS ZERBE,TAX COLLECTOR Cltice Hours: WED.THURS 9AM-11AM& 12-2PM 275 CUMBERLAND PARKWAY#325 EVENING HOURS MECHANICSBURG.PA 17055 CONSULT UPPERALLENTWP.ORG OFFICE AT 100 GETTYSBURG PIKE Rill No: 4185 PHONE(717)766 4238 Bill Date: 3/1113 Control No: 42001069 MAP NO: 42-25-0030-021. Desc: 26 FOREST DRIVE Assessed Value: Land:53,600 Improvement: 10,800 Total: 164,400 Discount Face ena y SUNNYLAND LOT 32 PB 17 PG 48 County RE 2.131 $343.33 $350.34 $385.37 Acres 0.34 Deed 0025GO0955 County Lib 0.143 $23.04 $23.51 $25.86 I Munic.R/E _ 1.5 $241.67 $271.26' �uuui I II'tl)II II I Fire Protc 0.1 $16.11 $16.44 $18.08 $1.00 FEE FOR ADDITIONAL RECEIPTS Tax Payer: Fire Hydrt 0.05873 $9.47 $9.66 $10.63 MILLER.KENNETH C&JOANNE Q TAX AMOUNT DUE $633.62 $646.55 $711.20 26 FOREST DP. MECHANICSBURG PA 17055-4705 If Date Of Payment is on 311113 thru 400113 511113 thru 6130/13 13 r.• r DENNIS ZERBE.TAX COLLECTOR T� ,,PAYER'S COPY 275 CUMBERLAND PARKWAY#326 KEEP THIS PORTION FOR YOUR RECORDS MECHANICSBURG,PA 17055 TEMP - RETURN SERVICE REQUESTED IIIIIIIIIdIrIJrIIIII'Illll'Illl'Illl'Ill'Illlllll'I'Ill'Illll'I 110401"""-"' ....AUTO"5-DIGIT 17055 JOANNE MILLER 26 FOREST DR 1 111111 VIII/III Iillll VIII VIII VIII VIII VIII/III/III MECHANICSBURG PA 170554705 ..................... ....................................................... . ....... . .. . . Payable To: Office Hours: WED,TOURS 9AM-11AM& 12-2PM Bill No: 6880 DENNIS ZERBE,TAX COLLECTOR EVENING HOURS Bill Date: 311113 275 CUMBERLAND PARKWAY#325 CONSULT UPPERALLENTWP.ORG Control No;42-003556 MECHANICSBURG.PA 17055 OFFICE AT 100 GETTYSBURG PIKE PHONE(717)7664238 OCC IIII�illllllllllllllllllllllllllllllllllllllllllllllll Discount Face Penalty COUNTY PC $4.90 $5.00 $5.50 57.00 FEE FOR ADDITIONAL RECEI?TS Tax Payer: JOANNE MILLER TAX AMOUNT DUE $4.90 $5.00 $5.50 26 FOREST DR If Date of Payment Is on 3/1113 thru 4130113 5/1113 thru 6130113 7/1/13 or Late MECHANICSBURG PA 170554705 •�• r r Questions ase Visit us online at Fi ll Page 1 contact us pplelectric.com I 1-800 DIAL-PPL P Bill Acct.No. Due Date Amount Due PS :; (1-800-342-5775) 20955-24406 Mar 28, 2013 $620.09 PPL thect umme• M-F:Sam to Spm Your Electric Usage Profile Billing Summary (Billing details on back) Service to: Balance as of Mar 7,2013 $439.60 JOANNE Q MILLER Charges: 26 FOREST DR Total Dominion Energy Solutions Charges $127.20 MECHANICSBURG, PA 17055 Total PPL Electric Utilities Charges $53.29 Meter:98853881 Total Charges $620.09 This section helps you understand your year-to-year mount Due By Mar 28,2013 5620.09 electric use by month. Meter readings are actual unless Account Balance $620.09 otherwise noted. 2012 2013 PPL Electric Utilities'price to compare for your rate Is$0.07237 per kWh. This changes the 1st of Mar,Jun,Sept,and Dec. Visit papowerswitch.com 150 or www.oca.state.pa.us for supplier offers. izs 100 Your Message Center g' 75 • With paperless billing,you can receive and pay your PPL Electric Utilities bills online. The process is free, a so quick,convenient and secure.To learn more or sign up, a ss visit pplelectric.com. • Information about appliance energy use and tips on ° saving energy are available through the Energy Library F M A M 1 A S 0 N D on our Web site, pplelectric.com. o Months • Before digging around your home or property,you should always call the state's One Call notification Average Monthly Days Average system to locate any underground utility lines. You can kWh Comparison Billed do this by simply dialing 811,which will connect you to Mar 2013 13 1500 115 1 34F the One Call system. Be safe and call 811 before you dig. Mar 2012 29 2441 84 47F 1pd Billing Period • Payment Methods 11 -xi J o,4 Mar 6 Actual 53546 Online at: O By phone: 1-800-342-5775 Feb 21 Actual 52046 pplelectric.com or call BillMatrix(service fee applies) at 1-800-672-2413 to pay using Visa, 13 Days kWh Billed 1500 MasterCard, Discover or debit card. Yearly Comparison Total Use Avg. Monthl ® By Mail: Correspondence should be sent to: Apr 2012-Mar 2013 22397 1866 2 North 9th Street Customer Services CPC-GENN1 827 Hausman Road Apr 2011-Mar 2012 21475 1790 Allentown, PA 18101-1175 Allentown,PA 18104-9392 Other important information on the back of this bill—3 © Questions, ase Visit us online at Page 1 contact IA by Apr 11. U pplelectric.com (1-800-342-5775)0 -PPL Due to 5p 77960-68004 Apr 11, 2023 IM 54 65 „, PPL 6lectrlrs Utltnke• M-F;Sam to Spm Your Electric Usage Profile Billing Summary (Billing details on back) Service to: Balance as of Mar 21,2013 $0.00 JON MILLER Charges: 26 FOREST DR Total PPL Electric Utilities Charges $154.65 MECHANICSBURG, PA 17055 Meter:98853881 Total Charges $154.65 Your next meter reading is on or about Apr 22,2013. t � 65 p , This section helps you understand your electric use by Account Balance $154.65 month. Meter readings are actual unless otherwise PPL Electric Utilities' price to compare for your rate is$0.07237 per kWh. noted. This changes the 1st of Mar,Jun,Sept,and Dec.Visit papowerswitch.com This graph shows the average number of kWh you used or www.oca.state.pa.us for supplier offers. each day. You used 1337 kWh in 15 days,or an average of 89 kWh a day. Your Message Center The average daily temperature for your area last month • This bill covers a shorter period than usual. was 39F. • With paperless billing,you can receive and pay your zot3 PPL Electric Utilities bills online.The process is free, 90 quick,convenient and secure.To learn more or sign up, 75 visit pplelectric.com. • Information about appliance energy use and tips on saving energy are available through the Energy Library n 45 on our Web site, pplelectric.com. a 30 -- • Before digging around your home or property,you should always call the state's One Call notification a is system to locate any underground utility lines. You can D do this by simply dialing 811,which will connect you to I F M A M i J A s o N D the One Call system. Be safe and call 811 before you Months dig. Billing Period Type Readil g Mar 21 Actual 54$83 Payment Methods Mar 6 Actual 53546 Online at: By phone:1-800-342-5775 `10 pplelectric.com or tali BiilMatrix(service fee applies) 15 Days kWh Billed 1337 at 1-800.672-2413 to pay using Visa, MasterCard, Discover or debit card. = ® By Mail: Correspondence should be sent to: � 9thD cy -4/31/3 2 North Street Customer Services CPC-GENN1 827 Hausman Road = Allentown, PA 18101-1175 Allentown,PA 18104-9392 = Other important information on the back of this bill 4 YORF- R TEDINSAL JOANNE MILLER Invoice ��y.asPUauc 3730 Sandhurst Drive Page 1'0(2 York,PA 17406 Payments/Adjustments Date Description Reference Amount 01/04 Payment-Thank You 1 -$39.03 Account Number . 3-0611-1227299 Current Invoice Charges Invoice Date March 15,2013 Invoice Number 0611-001207998 Joanne Mailer 26 Forest or (L1) Previous Balance $39.03 Mechanicsburg,PA Payments/Adjustments -$39.03 Contract:9611028(C2) Unpaid Balance $0.00 1 -Trash Cart(95/96 Gallon Scheduled Si S1 Current Invoice Charges $39.03 ) Service ( ) Date Description Reference Quantity Unit Price Amount 03/15 Residential Service 04/01/13-06/30/13 $39.03 $39.03 Current Invoice Charges $39.03 $39.03 Due By: 04/04/13 Customer Service (717)845-1557 Customer Service (800)210-9676 • • • • FOR YOUR CONVENIENCE 2 ALTERNATIVE METHODS TO PAYAepuNkseMoes.com OR PAY BY PHONE®677692-9729 BOTH METHODS HAVE PROCESSING FEE.PAYMENTS ! �� POSTED D ONLINE OR THRU THE PAY BY PHONE SYSTEM WILL APPEAR ON YOUR BAN WCREDIT CARD STATEMENT AS:REPUBLIC SERVICES/ALLIED WASTE PHOENIX AZ ✓V� Iiiiiiiiiiiiiii[CURRENT 30 DAYS SO DAYSIIIIIIIIIIIIIIIIIIIii 39.03 0.00 0.00 0.00 To pay on-line or sign up for convenient auto pay, go to: 8A • Visit our vebshe,w .dispos al.comto make your payment electronically www.disposal.com or to sign up for our convenient automatic payment plan. Please see reverse side for terms and conditions 0n o0imr mr i ous0 r o 0 0 1 United Water Pe gluania a Customer 1 ams Service .-'.:er UNITEDWATER Hummelstown,PA 17036 Telephone:717-564-3662 www.unitedwater.com USAGE HISTORY Billing Date: 03/19/13 Monthly usage in Thousands of Gallons Account Number: 00200147820000 4 3 3 3 Previous Balance $23.40 Payments Through 03/19/13 $0.00 z = 3 Balance Forward - PAST DUE $23.40 Current Charges Due 04/0.8/2013 $29.80 S TOTAL AMOUNT DUE $53.20 a 0 0 0 0 01 1 . M M, fe4 . Past Due Balance may be subject to late charges,collection and/or Next meter reading date:on or about 04/19/2013 s termination. PAY BY 04/15/2013 TO AVOID A 1.5%LATE PAYMENT CHARGE SERVICE TO: JOANNE Q MILLER SERVICE ADDRESS: 26 FOREST DR MECHANICSBURG PA Meter Number Service pays of Meter Reading Unit of _ From To service Previous Present Usage Measure Reading Type Rate 68594208 02/19/13 03/19/13 28 0067 0070 3 MGL ACTUAL W07 EQUIVALENFTO 3,OOa GALLONS SERVICE CHARGES $11.00 STATE TAX ADJUSTMENT SURCHARGE $0.02 WATER CHARGES $17.73 WATER LATE PENALTY CHARGE $0.35 DISTRIBUTION SYSTEM IMPROVEMEN $0.70 TOTAL CURRENT CHARGES $29.80 SEE REVERSE SIDE FOR IMPORTANT ACCOUNT INFORMATION IMPORTANT MESSAGES Your consumption is based on an actual reading of your water meter. Effective January 1,2013 the Distribution System Improvement Charges(DSIC)increased from 1.52%to 2.45%.This charge funds the replacement of water distribution facilities in Pennsylvania. Save a stamp and go paperless today!Log on to www.unitedwater.com or call Customer Service to find out more information and to enroll in e8illing. Approximate state tax included on this bill$1.16. pa 4W13 5b�1 0 0 0 0e 0um PLEASE DETACH HERE.AND RETURN THE BOTTOM PORTION WITH YOUR PAYMENT IN THE RETURN ENVELOPE PROVIDFD. 0m [myverIzon.com ge ;our Account Phone Number Acw�nt Number Notice Date verizon 717.766.0196 799000®09 03/26/2013 MILLER,JOANNE 0 124 CANAL ST SANTA RSA BCHFL 32459 S l Notice of Suspension Save Timel Manage your account online at verizon.com Dear MILLER,JOANNE 0, Verizon Plus Stores. We appreciate your business and nted to le ou that your C211 1.800.483.6697 fora location nearyou. account is overdue in the amount f$156.22. To retain all of your Verizon Services,which Include your FIOS TV, Payyour bill quickly byphone Verizon Internet Access,please pay the total overdue amount. Call 1.800.345.6563 anytime day or night. If you have made a payment,please accept our thanks and disregard this letter. It Is not too late to avoid suspension if payment is received by 04/05/13.If suspension occurs then:will be a charge of$29.99 to billfloat. restore your service. Need more Gme to pay? If your service Is terminated,you may be subject to the applicable NeyioatcomNerizan service or bundle agreement termination fee. Billfioat Is not affiliated with Verizon This following payment op2lens are available 24 hours per day,7 days a week.Your account Is noted Immediately so that you If payment has been made don't have to contact us: please disregard this notice and accept our thanks. If you have questions regarding this matter please call us toll free at 1.888.338.9333 �. (x-113 (Continued an Page 2.) � Jl/V Direct Payment Enrollment _ Online Billing d Payment Questions about your bill? vedzon.coiri/b(Ilpay Verizoncom/blllview I vedzon.com or 1.800 VERIZON(1 800 637 4966j ` Your Statement Page 1 of 4 Statement For: JO ANNE MILLER Mobile Number: (717)802-0586 Account Number: 321077169 important Information Your past due balance is due AB 01050645 22819 B 188 B immediately and may be subject to a late payment charge. Please see page I��II'�'��II�'IFI III1 -1I'1�I��'�IIIII�IIII'I�II'll 2 for details. H you have recently paid this amount, please disregard this message.Thank you. JO ANNE MILLER 124 CANAL ST SANTA ROSA BEACH FL 32459-6332 erg QSummary Previous Balance $ 60.37 - Total Past Due $ _.60.37 ■ (Due Immediately) Monthly Recurring Chgs $ 49.99 t s Other Charges $ 1.61 Taxes&Surcharges $ 7.87 4122113 Total Current Charges $ 59.47 r r� Current Charges Due ey 4127113 C�.ecv *L 5I L Grand Total $ 119.84 l Q � �f 54 b St Members 1st Federal Credit Union Non-Sufficient Account Number Notice Date 5000 Louise Drive P.o.Box 40 Funds Fee Notice I XXXXXXX473-0011 06/26/13 AV 1 Mechanicsburg PA 17055-0040 ® (800)237-7288 The items below were presented for payment but returned unpaid due to exceeding the balance in MEMBERS 1r` (717)697-5312(Hearing Impaired) your account.Please deduct$35.00 for NSF fees and make a deposit or transfer funds immediately HDERA�cReorr ON www.inemberslst.org to bring your account to a positive balance. Item Description* Amount Returned Fee(s) 000530 $385,000.00 $35.00 Total: $385,000.00 $35.00 1 JOANNE Q MILLER ESTATE Members 1st Federal Credit Union's current non-sufficient 8 N BALTIMORE ST funds(NSF)fee is charged to your account for each NSF DILLSBURG PA 17019 72 transaction whether paid or returned. (ur)OurO)nuuO)r)u n rO u r r 151111 n 1 1 111(11)11111 1 Form 300-201 Rev.2113 CHECK CARD USING FOR PAYMENT CARDIOLOGY DIAGNOSTIC, LLC U4STERCARD M VVISA 659 SPRING GARDEN DR CARD NUMBEa _ 9iCNAivaE CODE(cw1 MIDDLETOWN PA 17057-3033 SIGNATURE - EXP.DATE STATEMENT DATE ACCT.# PAYTHISAMOUNT (717)702-5500 07/17/2013 MILJ0003 3.34 08219 0101 - CHECK# AMOUNT PAID DUE DATE: 08/01/2013 j 51101 MAKE CHECK PAYABLE TO: JOANNE Q MILLER CARDIOLOGY DIAGNOSTIC, LLC 26 FOREST DR 659 SPRING GARDEN DR MECHANICSBURG, PA 17055 MIDDLETOWN, PA 17057-3033 I�D1�11��I1��1�NI11�11�11�1�IIq�1'll��lll91'lll��l�llnlllll� . Plm.diork box K above address or Insuisnce Inlam,a0on PLEASE DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT has changed.and indicate change(s)an reverse sWe. o(� Statement Date: 07/1712013 Account Number: MILJ0003 ALL CHARGES HAVE BEEN PROCESSED BY YOUR INSURANCE AND THE BALANCE IS NOW DUE. PROMPT PAYMENT IS GREATLY APPRECIATED! >BILLING.QUESTIONS CALL 1-800-29072528. CREDIT CARD PAYMENTS CALL 800 290-2528. Insurance . Insurance Applied Patient Date Piroc Code Services Charges Payments Adjustments Deductible Payments Balance JOANNE 11114/2012 93010 EKG INTERPRETATION&'REPORT 35.00 -6.67 -26.66 0.00 0.00 1.67 ,11/15/2012." " 93010 : 'EKG INTERPRETATION&REPORT , ' 35.00 " . .'=6.67,: " ' : -26.66..`. . - 0.00; 0.00 - 1.67' JOANNE Q MILLER ESTATE 6D-8224/7313 561 8 N BALTIMORE ST. - DILLSBURG,PA 17019 DATE .. .. PAY TO THE TO F LC- - e awl l� DOLLARS e N�MEMBERS 10 TPO¢RALQi®rr umGN _ _ . emnq MEMO 119 +1: 23 138 2 214 0: . 2 184984 7 3618 0'56 1 � S�w. `�^ ' . . .:.'70.00 -13.34 -53.32 0.00 0.00 3.34 c A ra. s° ....ax: N s" yep E...,. ts :sae �.,"..vu .. . +. in S[ .�•.a.T£�.a. H. .. ... ..HT3t..y 3.34 0.00 0.00 0:00 0.00 11" III"'^'6 !!n RR0.19RRR9t_1 ACCA7A 7i 9.D 'Ia•IRRn9_1_Fd•a']A a4AOO 1.1