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03-18-14 (2)
1 1505610101 —1 REV-1500 EX(01-10) OFFICIAL USE ONLY PA Department of Revenue Pennsylvania Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN Harrisburg,PA 17128-0601 RESIDENT DECEDENT a 1 F► 31 f i i Ic o ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 10/29/2013 06/01/1920 Decedent's Last Name Suffix Decedent's First Name MI E❑ (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI rN/A --- - ----- I - — --- -- - ❑ Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW (SO 1.Original Return O 2.Supplemental Return O 3. Remainder Return(date of death prior to 12-13-82) O 4.Limited Estate O 4a.Future Interest Compromise(date of O 5. Federal Estate Tax Return Required death after 12-12-82) ONO 6.Decedent Died Testate O 7.Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) O 9.Litigation Proceeds Received O 10.Spousal Poverty Credit(date of death O 11. Election to tax under Sec.9113(A) between 12-31-91 and 1-1-95) (Attach Sch.O) CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name _ _ _ _ __ Daytime Telephone_Number _ rAndrew H. Shaw, Esquire v� — y 1 (717)243-7135 l REGISTER OF WILLS USE ONLY CD, N First line of address 3: 111 r.- r 03-u 200 S. Spring Garden St a Second line of address COO Ui Suite 11 CDs r C c) _ _ _ _ _ c�0C) - City or Post Office State ZIP Code r n Carlisle I PA 1117013 D `n Correspondent's e-mail address: andrew @ashawlaw.Com Under penalties of perjury,I declare that I have examined this return,Including accompanying schedules and statements,and to the best of my knovAedge and belief, It Is true,camel and complete.DedaraUO of preparer other than the Personal repmsenlative is based on all information of which preparer has any knowledge. SIGNATURgOF PER RE 'N FOR FILING RETURN DATE ADDRESS 303 Net-- w SLN 1,04 SIGNATU E F PREP R T R AN REPRESENTATIVE DATE J _ ADDR Ss oo (J S� S' :SI 70 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610101 1505610101 1505610105 REV-1500 EX Decedent's Social Security Number Decedent's Name: Richard E. Corman RECAPITULATION 1. Real Estate(Schedule A). ............. ...... . ........................ 1. 106,900.00 2. Stocks and Bonds(Schedule B) ...... ................................. 2. 0.00 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ..... 3. 0.00 4. Mortgages and Notes Receivable Schedule D 4. 0.00 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. 30,577.82 6. Jointly Owned Property(Schedule F) O Separate Billing Requested ...... . 6. 0.00 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested........ 7. 40,540.63 8. Total Gross Assets(total Lines 1 through 7)............................. B. 178,018.45 9. Funeral Expenses and Administrative Costs(Schedule H)................... 9. 12,541.82 10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule 1) ..... ......... 10. 14,753.61 11. Total Deductions(total Lines 9 and 10).... . ........... ........... ...... 11. 27,295.43 12. Net Value of Estate(Line 8 minus Line 11) . ... ........ .. ................ 12. 150,723.02 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) ........................ 13. 0.00 14. Net Value Subject to Tax(Line 12 minus Line 13) ......... . . ............. 14. 150,723.02 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 (a)(1.2)X.0 0 0.00 15. 0.00 16. Amount of Line 14 taxable at lineal rate X.0 45 150,723.02 16. 6,782.54 17. Amount of Line 14 taxable at sibling rate X.12 0.00 17. 0.00 18. Amount of Line 14 taxable at collateral rate X.15 0.00 18 0.00 19. TAX DUE ....................... .................................. 19. 6,782.54 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT I= Side 2 L 1505610105 1505610105 J REV-1500 EX Page 3 File Number Decedent's Complete Address: DECEDENTS NAME Richard E. Corman STREETADDRESS 46 Carlton Avenue CITY STATE ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 6,782.54 2. Credits/Payments A.Prior Payments 0.00 B.Discount 0.00 Total Credits(A+B) (2) 0.00 3. Interest (3) 0.00 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. Fill In oval on Page 2,Line 20 to request a refund. (4) 0.00 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 6,782.54 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;.......................................................................................... ❑ 0 b. retain the right to designate who shall use the property transferred or its income;............................................ ❑ ❑>< c. retain a reversionary interest;or.......................................................................................................................... ❑ ❑x d, receive the promise for life of either payments,benefits or pre?...................................................................... ❑ ❑x 2. If death occurred after Dec.12,1982,did decedent transfer property within one year of death without receiving adequate consideration?.............................................................................................................. ❑ Z 3. Did decedent own an'in trust for'or payable-upon-death bank account or security at his or her death?.............. ❑ ❑>< 4. Did decedent own an individual retirement account,annuity or other non-probate property,which contains a beneficiary designation? ........................................................................................................................ ❑ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994,and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent[72 P.S.§9116(a)(1.1)(i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from lax,and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dales 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(1.2)[72 P.S.§9116(8)(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 by blood or adoption. 1 Rasit Will atib TeVament of RICHARD E. CORMAN I, RICHARD E. CORMAN, of South Middleton Township, Cumberland County, Pennsylvania, declare this instrument to be my Last Will and Testament, in manner and form following: 1. I hereby expressly revoke all Wills and Codicils heretofore made by me. 2. I hereby direct my Executors to pay all my just debts, funeral and administrative expenses out of my estate, as soon as practicable after my death. 3. I direct that all taxes which may be assessed in consequence of my death of whatever nature and by whatever jurisdiction imposed shall be paid out of my estate as a part of the administration of my estate. 4. For the information of my Executors, although I currently reside with MARY C. CORMAN, to whom I was formerly married, she and I are not married due to divorce and should not be considered as husband and wife. 5. Should MARY C. CORMAN survive me and be living on the thirty-first(31') day following my death, I devise and bequeath my real estate at 46 Carlton Avenue, Carlisle, Cumberland County, Pennsylvania, or any other home which may be our principal place of residence at my death, together with all household goods and furnishings therein, and all policies of insurance on said real and personal property to MARY C. CORMAN, without liability for waste, for her life so long as she desires to use such premises as a home and pays all costs of maintenance thereof, including taxes, assessments, insurance CADocuments and Settings\Roger M.MorgenthalWy Documents\Corman WHIARichard E.Corman Will.doc - and ordinary repairs, said property to be insured in a reasonable amount insuring the interest of the remaindermen as well as herself. Upon the death of MARY C. CORMAN or at such prior time as she no longer uses said premises as a home for herself, I devise and bequeath the said real estate and personal property with the insurance thereon,to my sons, RICHARD L. CORMAN and MICHAEL A. CORMAN, in equal shares per stirpes. MARY C. CORMAN shall not be required to give bond as life tenant under this paragraph of my Will. 6. I give, devise and bequeath the remainder of my estate to my friend and former wife, MARY C. CORMAN,provided that she is living on the thirty-first(31S)day following my death; and if she is not then living,to my sons, RICHARD L. CORMAN and MICHAEL A. CORMAN, in equal shares per stirpes 7. I nominate and appoint my sons, RICHARD L. CORMAN and MICHAEL A. CORMAN, as Executors of this my Last Will and Testament. Should either of my said sons fail to qualify or cease to serve in that capacity for any reason, the remaining son shall serve as sole Executor. I direct that my personal representatives shall not be required to file bond or security in any jurisdiction. 8. If any beneficiary of the Estate shall, in the sole opinion of my Executors, be or become mentally or physically incapacitated, by reason of illness, accident, minority or other circumstance, my Executors may apply either income or principal for the support and welfare of such beneficiary directly or to the person who has the care and control of such beneficiary, without the intervention of any Guardian and without obligation to supervise application of said amounts in any way. 2 C:\Documents and 8ettings\RogerM.Morgenthal\My Documents\Corman Wills\Richard E.Corman Will.doc 9. In addition to the powers conferred by law, I authorize my Executors, in their absolute discretion: A. To retain in the form received, and to sell either at public or private sale any real or personal property. B. To manage real estate. C. To invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principal of diversification. D. To exercise any option or rights arising from ownership of investments. E. To compromise claims without court approval, and without the consent of any beneficiary. IN WITNESS WHEREOF, I have hereunto set my hand and seal this -Nl ay of June, 2004. RICHARD 9. CORMAN SIGNED, SEALED, PUBLISHED and DECLARED in the presence of: 3 CADocuments a nd.$ettingsUtoger M.MorgenthaMy DoeumentsTorman WillsUtichard E.Corman Will.doc COMMONWEALTH OF PENNSYLVANIA SS:: COUNTY OF DAUPHIN We, RICHARD E. CORMAN, ROGER M.MORGENTHAL,ESQUIRE,and S4 r-i 4 tq• i"> the Testator and the witnesses, respectively,whose names are signed to the attached or foregoing instrument,being first duly sworn,do hereby declare to the undersigned authority that the Testator signed and executed the instrument of his Last Will,and that he signed willingly and that he executed as his free and voluntary act for the purposes therein expressed, and that each of the witnesses,in the presence and hearing of the Testator, signed the Will as witnesses, and that to the best of their knowledge,the Testator was at the time eighteen(18) years of age or older, of sound mind and under no constraint or undue influence. Sworn to and subscribed before me this 214 day of June, 2444 COMMONWEALTH OF PENNSYLVANIA Notarial5ea! Lisa M.Kett-ter,Notary PttbEic City Of Harrisburg,I auphM Courtly My CdnmLssbrt Eaplros Aug.30,2007 Member.Perms}t+tuda Aeeotletbn Of NofuAaa 4 CADocuments and Settings\Roger M.Morgenthal\My Documents\Corrnan Wills\Richard E.Comm Will.doc COMMONWEALTH OF PENNSYLVANIA ) ) SS COUNTY OF DAUPHIN ) I, ROGER M. MORGENTRAL,ESQUIRE, having been duly sworn according to law, do hereby depose and say that: (1) I was present on (0 2 Q when RICHARD E. CORMAN signed and executed the foregoing instrument as his (her last Will, that I saw him (her) sign it, that he(she)signed it willingly and executed it as his (her) free and voluntary act for the purposes expressed in it,that I signed it as a witness in his (her)presence and the presence of each other witness, and that,to the best of my knowledge, when he (she) signed and executed the instrument he (she) was age eighteen years or older and was of sound mind and under no constraint or undue influence. (2) I am a member of the bar of the Supreme Court of Pennsylvania and I was personally present when the acknowledgement and affidavit on the preceding page were signed by the Testator and each other subscribing witnesses. Sworn to or affirmed and subscribed to before me this 2�day of June, 2004. Ro r M. Morge�� qus�ire Attorney ID# 17143 Notary Public iA LX) a Ic y COMMONWEALTH OF PENNSYLVANIA Notarial Seal Lisa M.Ketterer,Notary Public City Of Harrisburg.Dauphin County My Canmisslon Expires Aug.30,2007 Marcher,Pennsytraria Association of Notaries 5 REV-IS62 EX+(11-08) W__r - pennsytvania SCHEDULE A DEPARTMENT OF REVENUE INHEATTANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF FILE NUMBER Richard E.Corman 21-13-1176 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 pmp;; 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 that 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. ITEM Include a ropy of the deed showing decedents Interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1. 46 Carlton Avenue,Carlisle,PA 17013 _ 106,900.00 NOON TOTAL(Also enter on Line 1, Recapitulation.) $ 106,900.OU If more space is needed,Insert additional sheets of the same size. ' A. Settlement Statement (HUD-1) OMB Approval No.2502-0265 F.-W.T.h.ft.-I.Q F2NS 3.Q Cam.Vnins. P.F8a Number. 7.Loan Number. $.-mortgage insurance Cass Numt?er: 74-N 4214010084 446-200606$.703 .QConv.ins. rm Is fumished to gNe you a statement settlement costs.Amounts"a to end by the settlement agents are shown Items moored}'ware paid Outside the Closing:that'are shown hem for informational purpoes and are not included In the totals. dress of Borrwmr: E.Name&Address of Seiler: F.Name&Address of Lender: Estate of Richard E Gorman New Penn Finandal,LLC ISAOAIATIMA 945 Forge Road,Carlisle,PA 17015 46 Corlett Avenue,Carlisle,PA 17013 4000 Chentuat Road,Suite 2W,Plymouth Meedng.PA 19452 G.Property LOOatiom H.Settlement Agent: I.Settlement Date:02A472014 46 Calton Avenue The law Olrxe of Andrew H.Shaw,PC Disbursement Date:02/1412014 Cadisie,PA 17013 200 S.Sping Garden SVOK Sude 11,CalisI%PA 17013 South Middleton Township Telephone:717-243.7135 Place of Settlement: TilleExpress 200 S.Sping Galen Stand.Suite 11,Cadisie,PA 17013 Printed 02/1012014 at 3:17 pm by MAC _ _oHer sales price 106,9W.W 103. SelOement�argesrobonover(I ner14W - 106i9W. 401. GPr000lmsuerg etc&.., _. A 104. 404, 105, 405. Adjustments for Items paid by seller In advance Adjustments for hems paid b seller in advance 106. Cityllown rooms to 400. GtyAown taxes to 107. County taxes to 407. Canty taxes to 108. School Taxes 021142014 to06r=14 334.59 408. Sdrod Taxes 02114120 4 4100 6!3611014 334.59 109, 409. 110. 410. 111. 411, 112. 412. 120. Gross Amount Due from$omewer 113,511.92 420. Gross Amount Due to Seller 107,23449 200. Amounts jd b or in Behalf of Borrower 500. Reductions In Amount Due to Seller 201. Deposllaeamest money 1,5W.0-0 501. Excess deposit(see lnsetocin} 201 Roosted amount of new bans) 104,963.00 502. Settlementtlrelges to se0er(6ce 1400) 8,41730 200. Efting b s taken subject to SW. Edson s taken sublialto 2114. 604. PW Of first non loan 205. 505. Payoff of second mortgage ban 206. SOWS Assist 4,773.28 500. Se0et5 Assist 4,773.28 207. 507. 208. 508. 209. SW. Ad uabnenta for Items unsold by$ailer Adlustments for Items toward by seder 210. Citynonfaxes to 510. CityAawn texas to 211. Canty taxes 011012014 to 02/1412014 33.64 511. Canty taxes 011012014 to 021142014 33.64 212. School Tares to $12. School Tares to 213. 513. 214. 514, 215, 515. 216. 516. 217, 517, 218. 518. 219. 519. 220• Total Paid b Hor Borrower 110,769.92 520. Total Reduction Amount Due Seller 13,224.22 300. Cash at Settlement fmmfta Borrower 600. Cash at Settlement tothom Seller Wi. Gross;amount due from borrows(One 120) 113,51152 601. Gross amount dumtose0elfine 424) 107.234.59 302. Loss anlound polo after bandana(line 220) 110,769.92 602, Less reductlons in anwunt due seller(Iine520) 13,224.22 303. Cseh �X From ❑ To Barroner 2,742.00 603. Cash E) To ❑ From Seller 94,010.37 a�uaan•a.bw«aasmva.nw.n.®sa,arnuve.aesxw.•an,+eaaz.maaungeem+n.nor..n:�anm...t•+�t+.nwam.e++eme. Previous editions are obsolete Page 1 of 4 HUD-1 REV-1508 EX•(6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Richard E. Corman 21-13-1176 Include the proceeds of litigation and the date the proceeds were received by the estate. All property Jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. M&T Bank Checking Account 111950227030 24,028.07 2. 2004 Dodge Grand Caravan 5,000.00 3. Refund of Auto Insurance Premium 299.74 4. Personal Effects 750.00 5. M&T Bank Savings Account#24097845 500.01 TOTAL(Also enter on line 5,Recapitulation) $ 30,577.82 (If more space is needed,Insert additional sheets of the same size) ©M&TSank. AC4`OUNT::Nb .: AGCUUNT TYFE; 3'SA't67ENT' FERYbb -:pAGL 950227030 M&T SELECT WITH INTEREST OCT.12-NOV.08,2013 1i1 OF 2 00 0 04344M,NM 017 RICHARD E CORMAN " RICHARD L CORMAN MICHAEL A CORMAN 46 CARLTON AVE ' CARLISLE PA 17013-3114 a INTEREST EARNED FOR STATEMENT PERIOD 0.10 SPRING GARDEN INTEREST PAID YEAR TO DATE 2.14 ACCOUNT SUMMARY BEGINNING IIEPOSIT3 a ,. OTHEft t. -.:.NRRENT ENDING- " ..LNTEA N0. i AM077UT I NO. I AMOUNT NO. AMOUNT 26,595.47 1 21 2,587.24 1 21 2,102.25 1 11 1 13,865.15 0.18 13,215.99 ACCOUNT ACTIVITY ,PASTING " - EPOSFTS INTEREST CHECKS £.AT7fER - - AAILY " RAN 'CT .DESCRI':,S N. :..:'i . ':OTHS ADDITIONS .. .. . 10-12-13 BEGINNING BALANCE $26,595.47 10-15-13 WEB XFER TO CHK 00009849044533 40.00 10-15-13 WEB XFER TO CHK 00009849044533 40.00 10.15-13 WEB XFER TO CHK 00009849044533 40.00 26,475.47 10-16-13 WEB XFER TO CHK 00009849044533 40.00 26,435.47 10-17-13 WEB XFER TO CHK 00009849044533 40.00 10-17-13 WEB PMT Ccocast cable 133.65 26,261.82 10-18-13 WEB XFER TO CHK 00009849044067 40.00 10-18-13 CHECK NUMBER 0716 1,772.25 24,449.57 10-21-13 WEB XFER TO CHK 00009849044087 40.00 10-21-13 WEB XFER TO CHK 00009849044087 40.00 10-21-13 HASAND ARCPAYMENT 000000000000715 11.50 24,358.07 10-24-13 CHECK NUMBER 0780 330.00 V4,8"'�28 0"7— 10.31-13 PNC BANK ACH CREDIT 1,143.04 25,171.11 11-01-13 SSA TREAS 310 XXSOC SEC 1,444.20 26,615.31 11-06-13 In Branch Transfer/Withdrawal 13,400.00 13,215.31 11-08-13 INTEREST PAYMENT 0.18 13,215.49 ENDING BALANCE $13,215.49 716 10-18-13 1,772.25 780- 10-24-13 330.00 ANNUAL PERCENTAGE YIELD EARNED 0.00 E ,gbfeaszp w+..M..en.eb.an 50.8720M 9191 "r Beverl4,Uh BraLn' k y} Ihu PA t7112 Ph. 69 -�77 .;.�% ,. .j.,✓�,�•...,,/ �� 166 MEM9ERS 1ST FEDERAL`CREDIT UNION P.O.WX 40 . . MECHANICSBUKr,?A 17655.' FM� q 9 L VPIxlE4 OM 4eCY.L°D°AeEP OSIXS VE6E�AB:E016E91XMB Celley,Blue Book http://www.kbb.com/dodge/grand-caravan-passenger/2004-dodge-gra... I Kelley Blue Book The Trusted Resource" ";n }' oo111=10 AMERICASe F ldnrtkemmt Why ads? 2004 Dodge Grand Caravan Sell To Private Party Passenger mod Pricing Report `'" C �aa. y°"`t° Ce„ditwn $2,768 coMa� $2,368 $2,893 Style:SE MlnNan 4D 1A%VATTPA4r, I CoMdi nlon Mileage:114,000 A 1$31118 ,r f Vehicle Highlights Fuel Economy: Max Seating:7 Private Party Values valid for your area through 3/2012014 City 17/Hwy 24/Comb 20 MPG Doom:4 Engine:V6,Flex Fuel,3.3 Liter Drivetrain:FWD Transmission:Automatic EPA Class:Vans,Passenger Type Body Style:Van Country of Origin:United States Country of Assembly:United States i i Your Configured Options Our pre-selected options,based on typical equipment for this car. i ✓Options that you added while configuring this car. Engine Comfort and Convenience Seats V6,Flex Fuel,3.3 Liter Air Conditioning 7-Passenger Seating ! Transmission ✓ Power Windows Wheels and Tires Automatic ✓ Power Door Locks Steel Wheels Drivetrain Cruise Control FWD Steering Braking and Traction Power Steering ABS(4wheel) Tilt Wheel Entertainment and Instrumentation AM/FM Stereo CD(Single Disc) Safety and Security Dual Air Bags I Glossary of Terms Kelley Blue f1i Trade-in Value-This Is the amount yo u can ez pest Tip: to receive when you trade in your or he a dealer.This value is determined based on the style,condition,mileage and options it's crucial to know your eats Indicated. true condition when you sell it, Trade-in Range-The Trade-In Range is Kelley Blue Book's estimate of what you on reasonably expect so that you can price it to receive this week based on the style,condition,mileage and options of your vehicle when you trade It appropriately.Consider having In he a dealer.However,every dealer Is different and values are not guaranteed. your mechanic give you an objective report. Kelley Blue Back®Private Party Value-This is the starting point for negotiation of a used-or sale 1 of 2 3/18/2014 8:49 AD {elley,Blue Book http://www.kbb.com/dodgeigrand-caravan-passenger124d4-dodge-gra... between a private buyer and peter.This is an"as a value that does not include any warrmrtem The final price depends at the cols accrued condition and Intel market factors. Private Party Range-The Private Patty Range Is Kelley Blue Book's estimate of what you on reasonably oApect to receive this week for a vehicle with stated mileage in the selected condition and configumd with your selected options,Excluding taxes,title and fees wicen sefAng to a private parry. Htcellent Condition-3%of all ors we value.This or looks new and is In excellent Mechanical condition.It has never had paint or bodywork and has an Interior and body free of wear and visible defects.The or Is rust-flea and does not need reconditioning.Its dean engne compartment Is free of ftlld acs.it also has a dean title history,has complete and ver83able service records and will pass safety and smog inspection. Very Good Condition-23%of all was we value.This or has minor want or visible defects on the body and hbw&but Is In excellent mechanical condition,requir"ory minimal recmdtbning.It has Mile to no pant and bodywork and iv Ame of rust,its dean erghv comagartment is tree of Did leaks.The tires match and have 75%a more of tread.It BBO has a clean title history,with most service records available,and will pass safety and smog Inspection. Good Condition-54%of all cars we value.This car Is free of major mechanical prWVetns but may reed some mcorrIftning.Its palm and bodywork may require minor touch-ups,with repairable cosmetic defects,and Its engine compartment may have minor leaks.There are minor body scratdm or dings and minor Interior blemishes,but no rust.The tires match and have 50%or more of bead.It also has a dean the history,with sane service records available,and will pass safety and smog Inspection. Fah Condition-18%of all tam we value.This or has same mechanical a cosmetic defects and needs servicing,but Is still In safe running condition and has a dean title history.The paint,body and/or Interior may need professional servicing.The tires may need replacing and there may be some repairable rust damage. 611995-2914 Kelley Blue Book Co.*,Inc.NI rights observed. Q 2014 Kelley Ones$Oak Co.,yno.All rights rexrved,311412 0 14aty2"014 Edition for Pennsylvania 17013.The spholek MIOfMDtlbd rebuffed to EetbMide the value for this partkukf which,was supplied by the(arson generating this report.veh/[le VaNatbns are opinions and May vary from vehkle to vMkle.Ad.1 Valuat/ono will vary based upon hiolket[Ondid-h-,spaC fto(IDnf.Yeh/[h Condition Or Other pDih soar[LCrhoud.fey pMNM(to this gaKkniv vehkle or the transaction or the parties to the transaction.This won is Intended nor the Ind0fld.41 use of the P..a generating the report only andsnatlnot be said or the smlMed to another party.Kohn,Blue Book assumes no remmonslNgty for avers or ommuons.0.14032g 2 of 2 3/18/2014 8:49 AN ACKNOWLEDGEMENT OF 18619.5-T Non Pt OState Farm Mutual Automobile Insurance Company CANCELLATION REQUEST 38 6713 "$ One State Farm Or Concordville PA 19339 DATE JAN 10 2014 POLICY NUMBER 569 1811-DO5-38P 552T- 6713 AUTO CORMAN, RICHARD E 46 CARLTON AVE 2005 DODGE CARAVAN CARLISLE PA 17013-3114 EFFECTIVE DATE OF CANCELLATION PREMIUM REFUND DEC142013 IzutA.M.STMDMI)-nE $299.74 AGENT FETTERMAN INSURANCE AGENCY INC As requested, this policy has been canceled as of the effective date shown. We thank you for having given us an opportunity to provide this insurance. If there is a premium refund and a check is not enclosed, it will be sent to you soon. 11489ar0 (otaon1e) 07-15-2008 200F50F000 m ©M&Tsank - �, ACCOUNx''afb iiC'CUUNa' TYL?E:: � �aTEM2NT P�Rioti: �t+A'�E :.'... 24097845 M&T SELECT WITH INTEREST OCT 16-NOV 15,2013 1 OF 1 00 0 04344M NM 017 - 51894 RICHARD E CORMAN RICHARD L CORMAN ' . MICHAEL A CORMAN 46 CARLTON AVE , CARLISLE PA 17013-3114 INTEREST EARNED FOR STATEMENT PERIOD _ 0.01 SPRING GARDEN INTEREST PAID YEAR TO DATE 0.41 - ACCOUNT SUMMARY BEGINNING DEPOSITS E . . - . - OTH6R -'CURRENT : ENDING ";; ' Y '..: ...: :CHE68S;PAID :i: :.:..SUSTRA .I NS :BALAi7GE :. THER>iADDI EONS :. NO. I AMOUNT NO. AMOUNT NO. I AMOUNT 3,618.53 of 0.00 1 11 3,118.53 1 1 1 500.01 1 0.01 0.00 ACCOUNT ACTIVITY .P STING . - . '- . r EPOSITS ID°P£REST CHECKS � OTHER :DAILY SAC2S N DE5CR2 . 1 N . . ?:OTHER: - D TX0N .:. SUBTRAC TJONS , ok 10-16-13 BEGINNING BALANCE - $3,618.53 10-28-13 CHECK NUMBER 0055 3,1.18.53 500.00 10-30-13 INTEREST PAYMENT 0.01 .� 10-30-13 CLOSEOUT - 500.01 0.00 + ENDING BALANCE 1 $0.00 SS 10-28-13 3,118.53 ' ANNUAL PERCENTAGE YIELD EARNED 0.00 L SAVE MONEY ON GIFTS AND MORE AT MAJOR RETAILERS THIS HOLIDAY SEASON. FIND OUT HOW TO GET ADDITIONAL SAVINGS BY USING YOUR M4T VISA DEBIT CARD OR MET VISA CREDIT CARD AT MORE THAN 50 RETAILERS WHEN YOU VISIT MTB.COM/SHOPPING. FOR CUSTOMER SERVICE QUESTIONS, PLEASE CALL 1-800-724-2440. MEMBER FDIC. REV-1510 EX+(08-09) ]pennsytvania SCHEDULE G xy� DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INNEMANCE TAY RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Richard E. Corman 21-13-1176 This schedule must be completed and filed If the answer to any of Questions I through 4 on page three of the REV-1500 is yes. ITEM ,DESCRIPTION OF PROPERTY iNa1DE THE waEan+E TRAraFS,EE.nma REUnormavrooE®ear wm DATE OF DEATH % DECD'S EXCLUSION TAXABLE NUMBER n�Dg1EOF TPNIS fr`A=5LA0DIN OFTNEDHDmmR EST�M VALUE OF ASSET INTEREST IF AVVU VALUE 1. Bankers Life and Casualty Company Annuity,#8721893 E2,ggp,3t 100 0.00' 22,842.31 Bankers Life and Casualty Company Annuity,#8858257 17,698.32 100 0.00 17,698.32 ❑ HI �J i —� TOTAL(Also enter on Line 7, Recapitulation) $ 40,540.63 If more space is needed,use additional sheets of paper of the same size. BANKERS LIFE AND CASUALTY COMPANY P.O.Boa 1937 Cannel,IN 46082-1937 (800)621.3724 December 5, 2013 For local service, contact : oO MICHAEL A CORNMAN Branch Sales Office g 46 CARLTON AVE ° CARLISLE PA 17013 , Phone: Agent : Insured: RICHARD CORMAN Contract Number : 8721893 Dear MICHAEL A CORNMAN We again wish to extend our deepest sympathy to you and your family for your recent loss. Your claim on the above mentioned contract has been approved and processed. The benefits have been calculated as follows: Commuted Value $22 ,842. 31 Your Share $11,421.16 Taxable Amount $ 84.36 Federal Tax Withholding $ 16.87 Final Benefit Amount $11,404.29 A Form 1099-R will be mailed at the end of this tax year for the taxable amount . We realize that the period following such a loss is a difficult time for individuals and families and we are committed to providing you with the best possible service. If you have any questions regarding your claim, please contact our office at the number above. Sincerely, Annuity Claims Department BLC0311 JT3 BLC2P8 (06/13) BANKERS LIFE AND CASUALTY COMPANY P.O.Box 1937 Carmcl,M 46082-1937 (800)621-3724 December 5, 2013 For local service, contact : 'O MICHAEL A CORNMAN Branch Sales Office 0 0 46 CARLTON AVE ° CARLISLE PA 17013 , Phone: Agent: Insured: RICHARD CORMAN Contract Number : 8858257 Dear MICHAEL A CORNMAN we again wish to extend our deepest sympathy to you and your family for your recent loss. Your claim on the above mentioned contract has been approved and processed. The benefits have been calculated as follows: Commuted Value $17, 698. 32 Your Share $ 8, 849.16 Taxable Amount $ 0.00 Final Benefit Amount $ 8,849.16 We realize that the period following such a loss is a difficult time for individuals and families and we are committed to providing you with the best possible service. If you have any questions regarding your claim, please contact our office at the number above. Sincerely, Annuity Claims Department BLC0311 JT3 BLC2PB 106/131 REV-1511 EX+(10-09) Pennsylvania SCHEDULE H '��--�� DEPARTMENT OF REVENUE FUNERAL EXPENSES AND RESIDENT DECEDENT ADMINISTRATIVE ADMINISTRATIVE COSTS RE51DENr DECEDENT ESTATE OF FILE NUMBER Richard E. Corman 21-13-1176 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: Hoffman-Roth Funeral Home 8 Crematory,Inc. 10,687.54 ❑ 1 ❑ — F1 I B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City State_ZIP Year(s)Commission Paid: 2. Attorney Fees: 1,200.00 3. Family Exemption: (If decedent's address Is not the same as daimant's,attach explanation.) Claimant Street Address city State_ZIP Relationship of Claimant to Decedent 4. Probate Fees: 36'8'S�0`� S. Accountant Fees: 1 6. Tax Return Preparer Fees: —1 7. Estate Advertising 285.78 ❑ El TOTAL(Also enter on Line 9, Recapitulation) $. 12,541.82 If more space is needed,use additional sheets of paper of the same size. k 219 No'*:Haro�Sreet Cartit, 17013 717243.4511 fo7 Gee 1.866.451.4511 tax?17243.3723 vwvcviofbfaorva7scorn FUNERAL- HOME & CREMAI-ORY, INC. h,foSh df s� ChmfgherH Haffiffia—()wn 3 deot Val E Ham-Vim Resident Rabe:tA.Fdb=M—Svpm i�w Adam G.Shzzf—F mlDire:twDacidEFe=tz—Fuim2lDl tr March 11, 2014 Richard L. Corman 2271 Waggoners Gap Road Carlisle, PA 17013 Statement of Funeral Expenses for. Richard Earnest Corman Date of Death: October 29, 2013 Account Id: 17015-251 PACKAGE: Traditional Funeral Service TRADITIONAL FUNERAL SERVICE PACKAGE $ 5,050.00 Sub Total: $ 5,050.00 MERCHANDISE: Casket: Atlantic $ 2,540.00 Outer Container: Monarch-Concrete Vault $ 1,620.00 Sub Total: $ 4,160.00 TOTAL FUNERAL HOME CHARGES: $ 9,210.00 CASH ADVANCES: Waggoners United Methodist Church Cemetery $ 900.00 6 Certified Death Certificates at$6.00 each $ 36.00 Newspaper Notice- Sentinel $ 282.54 Clergy $ 100.00 Flowers $ 159.00 Sub Total: $ 1,477.54 2 % Discount On Service/merch Discount Nov 13, 2013 184.20 Michael Corman Check 718 Nov 13, 2013 10,605.00 Reimb To Richard L. overpayment Nov 13, 2013 (101.66) Total Funeral Expense: $10,687.54 Total Payments Made: $ 10,687.54 Balance: $ 0.00 REV-1512 EX+(12.08) , [ E Jpennsylvania SCHEDULE I ray DEPARTMENT OFAEVENUE DEBTS OF DECEDENT, INHWEANCE TAX RETURN MORTGAGE LIABILITIES & LIENS ' RESIDENT DMVEW ESTATE OF FILE NUMBER Richard E, Corman 21-13-1176 Report debts Incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION Or DEATH {^' 1 PPL Electric Utilities 552.14 I 2.t ShipteyEnergy 1,311.8 1 Net settlement costs for sale of residence located at 46 Carlton Avenue,Cadisle,PA 12,889.63 .. o T-1 u♦ 4 ❑ Y TOTAL(Also enter on Line 10, Recapitulation) $ ?4,753.61 If more space is needed,insert additional sheets of the some size. Questions?Please Visit us online at Final Bill Page 1 1V1 contact us by Mar 14. ppielectric.com Due Date��� 1-804-DIAL-PPL (1-800-342-5775) 61401-26009 Mar 14,2014 $28 PM Ek• c U1111tl•• M-F:Barn to Spm Your Electric Usage Profile Billing Summary (Billing details on back) Service to: Balance as of Feb 21,2014 $115.90 RICHARD CORMAN Charges: 46 CARLTON AVE Total Washington Gas Energy Services $131.47 CARLISLE, PA 17013 Charges Meter:52732904 Total PPL Electric Utilities Charges $33.37 Total Charges $280 34 This section helps You understand your year-to-year „• ,;,��.,� e �, electric use by month. Meter readings are actual unless mount l)ue BY Mar'i4 2014 .y , . ;$280:34 otherwise noted. Account Balance $280.34 2013 201d PPL Electric Utilities'price to compare for your rate is$0.08754 per kWh. sa This changes the 1st of Mar,Jun,Sept,and Dec.Visit papowerswitch.com 4s or www.oca.state.pa.us for supplier offers. 36 Your Message Center v • Congratulations You've chosen clean,local 100%WGES 3E PA WindPower. q • With paperless billing,you can receive and pay your 0 PPL Electric Utilities bills online.The process is free, i t M n M i i a s o N 0 quick,convenient and secure.To learn more or sign up, visit pplelectric.com. Months • Information about appliance energy use and tips on saving energy are available through the Energy Library Monthly Days on our Web site, ppielectric.com/e-power kWh Comparison " • We appreciate the opportunity to have served you. Feb 2014 16 801 50 24F Because you have paid your bills within 34 days aver the past year,you have established an excellent Feb 2013 29 709 24 32F payment record ith PPL Electric Utilities. W Billing •• Type Reading Payment Methods = Feb 14 Actual 85741 Online at: ©By phone:1-800-342-5775 Jan 29 Actual 84940 �J ppielectric.com or call BiliMatrix(service fee applies) at 1-800.672-2413 to pay using Visa, 16 Days kWh Billed 801 MasterCard,Discover or debit card. = Yearly Comparison ,': _ Monthly ® By Mail: Correspondence should be sent to: Mar 2013-Feb 2014 8972 748 2 North 9th Street Customer Services w CPC-GENN1 827 Hausman Road Mar 2012-Feb 2013 6676 556 Allentown,PA 18101-1175 Allentown,PA 181049392 Other important information on the back of this bill 3 • ® Return this part in the envelope , , _ Due �P' provided with a check payable to PPL Electric Utilities. 61401-26009 Mar 14, 2014 $280.34 i'+PL EIKMC Utllltlw Amount Enclosed: AV 01 053665 805838192 A"SOOT ❑❑1E a[111 I'III'!ulllrl'nul11l146v111'Il!'I"s!I!d•hllll,lpu„11 RICHARD CORMAN PPL ELECTRIC UTILITIES 1303 CAR ISLE,RITNER P 170 �y 2 NORTH 9TH STREET CPC-GENN1 CARLISLE,PA 170139381 /•� n t l .S1 L.:. U ALLENTOWN, PA 18101-1175 t/d o[ f f/ II•EI,I.IIttll.tlt'illltll,tl.Il,tlltltllyl,tll.ltllttlH,fyt.t 1 7400002803440000280348 6140126004 Questions?Please /rh Visit us online at Page 1 ..!M contact us by Dec 26. U pplelectric.com '4 PIPS (1-80 -342-PPL � �} +:. {1-800-342-5775) 61401-26009 Dec 26,2013 . ��$763?77 M iW,xr+a uWnb• M-F:Sam to 5pm Your Electric Usage Profile Billing Summary (Bitting details on back) Service to: Balance as of Dec 3, 2013 $92.49 RICHARD CORMAN Charges: 46 CARLTON AVE Total Washington Gas Energy Services $43.24 CARLISLE,PA 17013 Charges Meter:52732904 Total PPL Electric Utilities Charges $28.04 Your next meter reading is on or about Dec 30,2013. This section helps you understand Your year-to-year Total Charges $163.77 By Del 26'2013 "'` "'5163:77 electric use by month. Meter readings are actual unless otherwise noted. Account Balance $163.77 02012 N 2013 PPL Electric Utilities'price to compare for your rate is$0.08754 per kWh. 54 This changes the 1st of Mar,Jun,Sept,and Dec.Visit papowerswitch.com 45 or www.oca.state.pa.us for supplier offers. 36 Your Message Center Z' • This bill includes a previous balance. if you have paid is this amount, please accept our thanks and pay only the 9 current charges. o EMMON Congratulationsi You've chosen clean,local 100%WGES PA WindPower. F M A M J 1 A s O N D . With paperless billing,you can receive and pay your Months PPL Electric Utilities bills online.The process is free, quick,convenient and secure.To learn more or sign up, visit ppielectric.com. • Information about appliance energy use and tips on Nov 2013 2g 407 15 ' 44F saving energy are available through the Energy Library on our Web site,pplelectriccom a-power Nov 2012 30 540 18 41F Payment Methods Nov 26 Actual 83622 jd, Online at: By phone:1-800-342-5775 Oct 29 Actual 83215 ppletectric.com or tali Bill Matrix(service fee applies) at 1-800.672-2413 to pay using visa, 28 Days kWh Billed 407 MasterCard, Discover or debit card. = ® By Mail: Correspondence should be sent to: rolal 1),w Dec 2012- Nov 2013 8792 733 2 North 9th Street Customer Services _ CPC-GENN1 827 Hausman Road Dec 2011-Nov 2012 6074 506 Allentown, PA 18101-1175 Allentown,PA 18104.9392 Other important information on the back of this bill 4 • : f f' ® Return this part in the envelo pe PM' f+ provided with a check payable I ' to PPL Electric Utilities. 61401-26009 Dec 26, 2413 $163.77 nnr,yuaom uw�w• Amount Enclosed: AV 41 400543 44987 B 3 A"SpGT ❑0 nn��❑❑ Illllrl�l�rlJ�nr�llllll'III'IILL,IIL�lrlrl�l��,rhllr��yl�l RICHARD CARMAN PPL ELECTRIC UTILITIES 46 CARLTON AVE 2 NORTH 9TH STREET CPC-GENN1 CARLISLE,PA 117013-3114/ O ALLENTOWN, PA 18101-1175 y� S�J �?�/'� � k„ _f 'pi'i!"•iuu4liluititilllt lidl'gri(rr(r.tltsllArllrun 6 3 it/��yy 1 -7 ?31�� � �� N 'L .1` 9200001637720000163778 6140126009 Questions?Please Visit us online at Page 1 •lts� IEn contact ppiletric.com Due Date Amount Otte •' Pa' 1-800-DIAL-PPL (1-800.342-5775) 611401-26009 tart 23,2014 .,, ' $96.14 ws.151 nc UUim.. M-F:8am to 5pm Your Electric Usage Profile Billing Summary (Billing details on back) Service to: Balance as of Jan 2,2014 $0.00 RICHARD CORMAN Charges: 46 CARLTON AVE Total PPL Electric Utilities Charges $32.67 CARLISLE, PA17013 Meter:52732904 Total Washington Gas Energy Services $63.47 Your next meter reading Is on or about Jan 29,2014. Charges This section helps you understand your year-to-year Total Charges $9614 electric use by month. Meter readings are actual unless mount Due Bylaw 23,2014; ° ;c{a *^T1 M"43'�r 41 ;14$96.14 otherwise noted. Account Balance $96.14 2012 2013 PPL Electric Utilities'price to compare for your rate is$0.08754 per kWh. 54 This changes the 1st of Mar,Jun,Sept,and Dec. Visit papowerswitch.com 45 "'—"" or www.oca.state.pa.us for supplier offers. 36 Your Message Center v • We credited your account this month for a portion of >s the System Improvement Charge that Incorrectly s appeared on your October bill. o • Congratulations( You've chosen clean,local 100%WGES PA WindPower. g F M A M J J A S 0 N D . With paperless billing,You can receive and pay Your 8 Months PPL Electric Utilities bias online.The process is free, quick,convenient and secure.To learn more or sign up,kWh Monthly • visit ppielectric.com. •• . Information about appliance energy use and tips on Dec 2013 34 596 18 33F saving energy are available throgh the Energy Library on our Web site,ppielectric.comle-power Dec 2012 1 30 1 575 19 38F — •• Type Readin ment.Methods — Dec 30 Actual 84218 j3� Online at: By phone:1-1300-342-5775 — Nov 26 Actual 83622 �0 ppietectric.com or call BillMatrix(service fee applies) Mm at 1-800.672-2413 to pay using Visa, — 34 Days kWh Billed 596 MasterCard,Discover or debit card. — _ Monthly ® By Mail: Correspondence should be sent to: Jan 2013- Dec 2013 8813 734 2 North 9th Street Customer Services CPC-GENN3 827 Hausman Road Jan 2012-Dec 2012 6226 519 Allentown,PA 18101-1175 Allentown,PA 181049392 Other important information on the back of this bill 4 ® " Return this part in the envelope _ Amount �p� provided with a check payable PPL 151 c Ut"M.. ``. - to PPL Electric Utilities. 61401-26009 Jan 23, 2014 $96.14 Amount Enclosed; AY 01 000479 58282 Il 3 A"SD @T ❑ j��"'�❑�❑ ,,,1'11�'1111��11111"I'IIII�Ill-Ill"1Il1llld,u�l„dl')II���' IL�If 11 RICHARD CORMAN PPL ELECTRIC UTILITIES 46 CARLTON AVE 2 NORTH 9tH STREET CPC-GENN1 CARLISLE.PA 17013-3114 / ALLENTOWN, PA 18101-1175 crI z 07 S / ( �� ?_ b 7200000961420000096148 6140126009 /a rJ ,1• o END ShipleyEnergy 16665487523300000434874 Customer Number: 166654 Invoice Number: 875233 Invoice Date: 1/15/14 Please pay: $434.87 PAYMENT DUE UPON RECEIPT RICHARD E CORMAN Amount Enclosed $ 46 CARLTON AVE Please Enter Your Email Address CARLISLE, PA. 17013 1111111111111111111111111111111111111111111111,1111111 Hill 11111 fill]HillHill 111111111111111111111IN11111IIII Please make check payable to SHIPLEY. Thank You for your payment. Delivered at: 46 CARLTON AVE CARLISLE, PA Total Gallons Start Meter: 0 .0 Total Gallons Delivered on 1/15/14 at 10:40 100. 0 Price per gal . 4. 2990 VOLUME DELV ADJ. 60 DEGREE F REGULATORY COMPLIANCE FEE $4.97 For Your Information Only: Record of Previous Deliveries : Heating Season 6/01/13 through 5/31/14 Total Gallons Delivered Since 6/01/13 318. 3 Product: BIO HEAT O Total Amount Due 1� VV%(iJ1—/ $434.87 CoN-F'o�A7'�orv� ✓ v_'" 111 Trk. 248 Drvr. 327 Shipley Energy Co. PO BOX 5006 YORK, PA 17405-5006 Customer# myshipley.com (800) 839-1849 717-848-4100 166654 frm 4 711082-0, _ _ . . The services and oroducts orovided are subiect to the terms and conditions noted on the back of this invoice/statemem .Ea � ShipleyEnergy 16665476536700000876978 Customer Number: 166654 Invoice Number: 765367 Invoice Date: 11/27/13 Please pay: $876.97 PAYMENT DUE UPON RECEIPT RICHARD E CORMAN Amount Enclosed $ 46 CARLTON AVE Please Enter Your Email Address CARLISLE, PA. 17013 Please make eheak payable to SHIPLEY. Thank You for your payment. Delivered at: 46 CARLTON AVE CARLISLE, PA Total Gallons Start Meter: 0.0 Total Gallons Delivered on 11/27/13 at 7: 54 218. 3 Price per gal. 3 . 9990 VOLUME DELV ADJ. 60 DEGREE F REGULATORY COMPLIANCE FEE $3 .99 For Your Information Only: Record of Previous Deliveries: Heating Season 6/01/13 through 5/31/14 Total Gallons Delivered Since 6/01/13 218. 3 Product: BIO HEAT Total Amount Due - $876.97 s`? V9 �/'q N PCIZIL, 3-i3 Trk. 248 Drvr. 327 Shipley Energy Co. PO BOX 5006 YORK, PA 17405-5006 Customer# myshipley.com (800) 839-1849 717-848-4100 166654 e¢>6o0o a a m> mi#711082-0 .. . The services and oroducts orovided are subject to the terms and conditions noted on the back of this invoice/statement REV-1513 EX+ (01-30) . ` pennsylvania SCHEDULE ] DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Richard E. Corman 21-13-1176 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(5)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS[Include outright spousal distributions and transfers under Sec.9116(a)(1.2).] 1. Richard L.Conran,2271 Waggoners Gap Road,Carlisle,PA 17013 son 50% 2. Michael A.Corman, 1303 Ritner Highway,Carlisle,PA 17013 son 50% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II — ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ If more space Is needed,use additional sheets of paper of the same size.