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Home My WebLink About09-05-14 X1505610105 REV-1500 EX(e]-11)(FI) PA Department of Revenue Pennsylvania OFFICIAL USE ONLY Bureau of Individual Taxes PC BOX 28o6m Camly INHERITANCE i —° Code Year File Numbenbe r Harrisburg PA 17128-06ot RESIDENT DECEDENT p'IJ 9T 0 ENTER ER DECEDENT INFORMATION BELOW ...w 06/28/2013 08/14/1967 Decedent's Last Name Suffix Decedent's First Name MI TREJO JR JOSE M ' (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix _ Spouse's Firs{Name b,{I _. TREJO I MONICA Spouse's Social Security Number A 564-61-8297 - THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW COD 1. Original Return C=) 2.Supplemental Return O 3. Remainder Return(Date of Death C7 4.Limited Estate Prim to 12-13-82) Cr 4a.Future Interest Compromise(date of C=:) 5. Federal Estate Tax Return Required death after 12-12.82) O 6.Decedent Died Testate C) 7.Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) C) S.Litigation Proceeds Received O 10.Spousal Poverty Credit(Date of Death d 11. Election to Tax under Sec.9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number STEVE C. NICHOLAS, ESQ. — (717) 540-7746 ry REGISTER OF%t!a USE ONL" CtY First Line of Address � Cj 2215 FOREST HILLS DRIVE Second Line of Address SUITE 37 City or Post Office State ZIP Code t)ATE_FILEO c7 HARRISBURG PA 17112 __ -- tit +7T Correspondent's e-mail address: Under penalties of perjury,I dedwe that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and be7ial, it is true,correct and complete.Declaration of preparer other than the personal representative is based on all infonnatmn of which Pmewer has any knowledge. SIG AT E OF PERSON$ESPONSIBLE FOR FtLiNO 3A Gc- , 9 �Ar ADDRESS 5538 Ge ral Knipe Cirlce, Mechanicsburg, P 7050 SIONATU THF,i}ry1AN REPRE NTATiVE I, QQTE r ADDRESS / 2215 Forest Hills Drive, Suite 37, Harrisburg, PA 17112 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610105 1505610105 J 1505610205 REV-1500 EX(FI) RECAPITULATION 1. Real Estate(Schedule A). . . . .. ....... ... ..... . .... ..... .. . .... . .. . ... 1. 211,800.00 2. Stocks and Bonds(Schedule B) . . .... .. . . ....... ..... . .... . .... . . ..... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) .. . .. 3. 1,053,883.00 4. Mortgages and Notes Receivable(Schedule D)...... ...... ..... ....... . .. 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. 18,730.80 6. Jointly Owned Property(Schedule F) O Separate Billing Requested .. . . .. . 6. 7. Inter-Vivos Transfers R Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested.. . ..... 7. 8. Total Gross Assets(total Lines 1 through 7). ....... ..... ... ..... ..... . . . 8. 1,284,413.80 9. Funeral Expenses and Administrative Costs(Schedule H).. ...... ..... . . . ... 9. 30,789.28 10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule 1). .............. 10. 442,036.28 11. Total Deductions(total Lines 9 and 10). ....... . ..... ........... . . ...... 11. 472,825.56 12. Net Value of Estate(Line 8 minus Line 11) . . . . . ......... . ............ . .. 12. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) ....... .. ... .......... . . 13. 14. Net Value Subject to Tax(Line 12 minus Line 13) ..... ..... ...... .. ... ... 14. 811,588.24 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 00 420,794.12 15 0.00 16. Amount of Line 14 taxable - - - - - at lineal rate X.0 45 390,794.12 16. 17,585.74 17. Amount of Line 14 taxable --- - ... - - at sibling rate X.12 _ 17 18. Amount of Line 14 taxable at collateral rate X.15 18 19. TAX DUE ..... . .. . .......... .... . .. . ....... ..... ........ ..... ..... 19. 17,585.74 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 1505610205 1505610205 1 REV-1500 EX(FI) Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME Jose Merced Trejo a/Wa Jose M. Trejo, Jr STREETADDRESS ------------. 5538 General Knipe Circle _" STATE �PA ZIP 17050 Mechanicsburg — Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 17,585.74 2. Credits/Payments A.Prior Payments 20,0_00.00_ B.Discount ,— 1,052.63 Interest 3. Total Credits(A+B) (2) 21 052.63 4. If Lim 2 is greater than Line 1+Line 3,enter the difference. This is the OVERPAYMENT, (3) Fill in oval on Page 2,Line 20 to request a refund. (4) 3,466.88 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......................................................................................... ❑ 0 b. retain the right to designate who shall use the property transferred or its income...........1........11...................... ❑ 0 c. retain a reversionary interest.............................................................................................................................. ❑ ■ d, receive the promise for life of either payments,benefits or care?..............................___.........................._...... ❑ ■ 2. If death occurred after Dec. 12, 1982,did decedent transfer properly within one year of death without receiving adequate consideration?....111.........1._........................11.........1... ❑ 3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?........ 1111.. ❑ 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)(1)]. 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 el transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary, For dates of death on or after July 1,2000: • The tax rate imposed on the net value of transfers from a deceased 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 far 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 by blood or adoption. REV-1502 EX+ (12-12) permsylvan9a SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX REruRN REAL ESTATE RESIDENT DECEDENT ESTATE OF: TREJO, JOSE MERCED alk7a Jose M. Trejo, Jr. FILE NUMBER: 2113-0850 All real property owned solely or as a tenant in common must be reported at fair market value.Pair mar'Ret value is defined as the price at which property would be exchanged between a willing buyer and a willing sailer,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 gf the settlement sheet if the property has been sold. ITEM include a copy of the deed showing decedent`s intarest if owneG as tenant to common. NUMBER YACUE AT GATE _. DESCRtPftON OF DEATH 1' Real estate owned decedent's individual name: A. 507 Erford Road,Camp Hill,PA 17011 -Assessed @$142,700 x 1.00 142,700.00 B. Vacant lot on Center St.,Enola,PA 17025-Assessed @$69,100 x 1.00 69,100.00 FOR INFORMATION PURPOSES: 2. Real estate owned with Monica A.Trejo,surviving spouse,as Tenants by the Entireties; C. 5538 General Knipe Circle,Mechanicsburg,PA 17050 D.75 Pine Hill Road,Enola, PA 17025 E.596 Belle Vista Drive,Enola,PA 17025 F.4703 Duke Street,Harrisburg,PA 17109 G. 125 Earl Avenue,Harrisburg,PA 17109 3. Real estate owned with surviving spouse,Monica A.Trejo,as Tenants by the Entireties as to an undivided interest;and Jesus B.Arellano as to the other undivided interest,as Tenants in Common as to the whole: H.724 Loucks Road,York,PA 17404(DecedentfSpouse-50%/Arellano-50%) 1.6417 Carlisle Pike,Mechanicsburg,PA 17050(DecedentfSpouse-30%/Arellano-70%) 4. Real estate owned by decedent as a partner in a PA General Partnership- See Schedule C-2s J.Arellano,Bravo,Trejo&Trejo-218 N.East St.,Carlisle,PA 17013 K.Arellano,Trejo&Bravo-6588 Carlisle Pike, Mechanicsburg, PA 17050 L.Arellano,Trejo,Bravo&Arelllano-1130 S.Carlisle St.,Hanover,PA 17331 TOTAL(Also enter on Line 1, Recapitulation.) $ 211,800.00 If more space Is needed, use additional sheets of paper of the same size. Gw J4it 11 fl� 8 57 THIS DEED TAX PARCEL x'09-71-0020-24 Made this day of D tx°7rt R in the year my thousand,ive, (2005). BETWEEN t RAJINDER N. CHADHA and SANTOSHCHANDHA, his wife, and SANJAYBHASIN a single man, of the Borough of Camp Hill, Cumberland County, Pennsylvania hereinafter referred to as the GRANTORS and JOSE hL TMO a single mare of Camp Hill, Cumberland county, Pennsylvania hereinafter referred to as the GRANTEE Wknessseth, That in consideration of ONE HUNDRED THIRTY SEVEN THOUSAND DOLLARS ($137,000.00), in hand paid the receipt whereof is hereby acknowledged, the said grantors do hereby grant and convey to the said grantee,his heirs and assigns, ALL THAT CERTAIN lot of land situate in the Township of East Pennsboro, County of Cumberland and State of Pennsylvania, bounded and described as fotlows. BEGINNING at a point on the westerly line of Erford Road (west) which point is one hundred ten (110)feet south of the southwesterly comer of Stephen Road and Erford Road (west)and at the dividing line between Lots 8 and 9, Block C, on the herdn*er mentioned Plan of Lots: thence along the westerly line of Erford Road (west) South thirty (30) degrees East, eighty(80)feet to a point at the dividing line between Lots Nos. 9 and 10, Block C on said Plan; thence along said dividing line South sixty(60)degrees West one hundred forty-one and twenty- six hundredths (141.26)feet to a point at dividing line between Lots 6 and 9, Block C on said Pl n; thence along said dividing line North, eighteen(18)degrees thirty-two (32)minutes West, fifteen and four hundredths(15.04)feet to a point at dividing tine between Lots 7 and 9, Block C on said Plan; thence along said dividing line North six (6) degrees twenty-seven (27) minutes East eighty-one and thirteen hundredths (81.13)feet to a point at dividing line between Lots 8 and 9, Block C aforesaid thence along same North sixty (60) degrees East ninety and seven hundredths(90.07)fleet to a point, the place of BEGINNING. 1. $iJlJX ,272 PArF,16 i BRING Lot No. 9,Block C in Plan No. 2 of Ridley Park, which Mme is recorded in Plan Book 12, Page 50. HAVRVG THEREON ERECTER a dwelling house known as 507 Erford Road Camp Rill; Pennsylvania BEING TIM SAME PREMISES which Rajider N. Chadha and Saniosh Clwndha his wife,arid Sanjay Bhasin by Deed dated December 15, 1995 and recorded December 22, 1995 in the Office of the Recorder of Deeds in acrd for Cwnberiand County, Pennsylvania in Book 132, Page 115.1, granted and conveyed unto Rajinder N. Chadha and Santosh Chandha his wife and Sanjay Bhasin, Grantors herein. UNDER AND SUBJECT, nevertheless, to restrictions, conditions and easements as contained in prior instruments of record AND THE said Grantors eovenan t that they will foreverVveially wmrant aad'defetrd the lands and premises, he edUmnents and appurteaonces hereby conveyed IN WITNESS WIIERSOF, the said Grantors have hereunto set their hand and seal or if corporation, it has caused these presents to be signed by its proper corporate officers and its corporate seal to be a fed hereto, the day and year fast written above. In de presence of Sig"A Seated and Detiwered fFALj Rfiness: I Rajinder N.VChadha Q-s:k t S A"�S 4 CJ-4 dL.n.. {sru} Ktness: I Santosh Chadha ttne� • Sanjay Bhasin Y 2 WK 272 fact;642 r Conemonweahh of p0masYbania. County of CunebOf=d SS On this, the 'day of 2005 , before undersigned officer,personally ap ed R ' me a Notary Public the wife and Sar{jay Bhasin, brown to me ed r.Chaa%a and Santosh Chadha husband and is subscribed to the within ' ly proven) to be the person(s) whose name instrument and acknowledged that they executed the same for the Purpose therein contained IN WPI%VESS WH o set my hand and officml seal. COMMONW AIrH OF PENNSriVANIA N ARWI SEAL {SF OANIEL NL NAHTNUW, Notary Public NQTAff Br1C N LI ar CumberWld Bom.,Cumberland Co. My Conu,a ion FtOm: iM'Commbeeui Expkee Jen.41.2009 CERTIFICATE OF RESIDRNCE N 1 her certify tl precise! a of the grantees herein is as follows, 3Ja�oa�.c�-Hip�� 1 l �'12eG'i�?ii rGimute fSEt O ComatonweaM Of PeRmly1mania. County of : SS RECORDED in the We for Recording of Deeds, etc., m and for said County, in Deed Book Volume Page_ WITNESS my Hand and O cmj this this 1 Certify to be recor gff' -- i of 2005. to Cumberland County lJjPA�� (SFncj *7ecorder of Deeds 3 ............ r fJU Yc „� TI i tC JryS T ' n r N � 1 ^�W�ii ggY Omm,bop]�W .QD d. WC+CIIWfJ6�[+�CTO r O U TxjoCenterStSWD/deeds?reaLeWCLN . .. .- „_..,; = =t J S Parcel No. 09-14-0834-208 UKG FRZLt, a 00UtJY-PA '02 MRR 25 HV T� W ANTY DEED � ZS� THIS DEED made the 22”'day of March, 2002. Lt 1 BETWEEN BHASKER C. DESAI and PRAVINA B. DESAI, Trustees under the Pravina B. Desai Living Trust dated May 21, 1997 and any amendments thereto, Parties of the First Part, GRANTORS, -AND- JOSE M. TREJO,JR,adult individual,Party ofthe Second Part, GRANTEE, WITNESSETH, That the said GRANTORS for and inconsideration of the sum of s- One Thousand and 00/100 ($31,000.00) Dollars and other good and valuable considerations-7paid by the said GRANTEE to the said GRANTORS, at and before the signing and delivery of these presents, the receipt of which is hereby acknowledged, have granted, bargained, sold, and conveyed, and by these presents do grant, bargain, sell, and convey unto the said GRANTEE and GRANTEE'S heirs, successors and assigns the premises described as follows: ALL THOSE TWO CERTAIN pieces or parcels of land situate in East Pennsboro Township, Cumberland County, Pennsylvania being more particularly bounded and described as follows,to wit: TRACT NO. 1: BEGINNING at a point 150 feet west of the western line of Center Street along the northern line of Lots Nos. 9 and 10 on the hereinafter mentioned Plan of Lots; thence westwardly along the northern line of Lots Nos. 9 and 10, 405.9 feet to a point in the eastern line of a 33 feet wide lane; thence northwardly along the eastern line of said land 70 feet to a point; thence eastwardly along the southern line of Lots Nos. 6 and 5, 406.4 feet to a point 150 feet west of the western line of Center Street; thence southwardly along the western line of property now or formerly of Maurice E. Baker and Esther Baker, husband and wife, 70.1 feet to a point, the place of BEGINNING. BEING part of Lot No. 7 and all of Lot No. 8 on the Plan of Lots known as West Enola Acres, said Plan being recorded at Cumberland County Plan Book 3,Page 22. TRACT NO.2: BEGINNING at a point in Center Street, said Center Street being located in the above-mentioned section of East Pennsboro known as West Enola, said point being further located 361.7 feet south of the intersection of the southern line of the School property of East Pennsboro Township with the intersection of Center Street; thence South 75 degrees 51 minutes West along lands now or formerly of Robert L. Egan, formerly of Herbert Kruger, 260.40 feet to a stake; thence continuing along the line of the property now or formerly of said Robert L. Egan, South 73 degrees 17 minutes West, 299.61 feet to an iron pin in the line of a 33 feet wide unnamed lane; thence North 14 degrees 23 minutes West, 65 feet to a point in line of land aforesaid; thence North 74 degrees 59 minutes East, 559.42 feet to a point on the western line of said Center Street; thence South 14 degrees 45 minutes East, 60 feet to an iron pin on the line of said Center Street,the place of BEGINNING. BEING THE SAME PREMISES WHICH Bhasker C. Desai and Pravina B. Desai,husband and wife, by their Deed dated May 21, 1997 and recorded May 30, 1997 in the Office of the Recorder of Deeds of Cumberland County, Pennsylvania at Deed Book 158, Page 545,transferred i and conveyed unto Bhasker C. Desai and Pravina B. Desai, Trustees, or their successors in nest, under the Pravina B. Desai Living Trust dated May 21, 1997, and any amendments thereto, GRANTORS herein. UNDER AND SUBJECT TO all restrictions, easements, covenants, conditions and agreements of record. TOGETBER with all buildings, improvements, woods, ways, rights, liberties, privileges, hereditamems and appurtenances, to the same belonging, or in any way appertaining, and any revisions, remainders, rents, issues and profits thereof, and of every part and parcel thereof, including any interests specifically set forth herein; if any. And also, all the estate, right, title, interest, property, possession, claim and demand whatsoever, both in law and equity, of the GRANTORS of, in and to the same. TO HAVE AND TO HOLD the said premises, and the appurtenances, hereby granted to GRANTEE and GRANTEE'S heirs, successors and assigns,to and for the only proper use, benefit and behoof of the said GRANTEE and GRANTEE'S heirs, successors and assigns forever, under and subject to the conditions set forth herein,if any. AND the said GRANTORS hereby covenant and agree that GRANTORS will specially warrant the property hereby conveyed- IN WITNESS WHEREOF, the said GRANTORS have hereunto set their hands and seals the day and year first above written. SIGNED, SEALED and DELIVERED IN THE PRESENCE OF WITNESS PRAVINA B.DESAI LIVIN TRUST By: AVA'_L' 4-I Bhasker C-Desai,Trustee�,jJ By. Pi-V7 rs! Gt a Pravina B.Desai,Trustee COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF DAUPHIN On the 22nd day of March, 2002, before me, a Notary Public in and for said County and State, the undersigned officer, personally appeared BHASKER C. DESAI and PRAVINA B. DESAI, Trustees under the Pravina B. Desai Living Trust dated May 21, 1997, known to me (or satisfactorily proven) to be,the persons whose name is subscribed to the within instrument, and acknowledged that they executed the same for the purposes therein contained,and desired the same might be recorded as such. IN WITNESS WHEREOF,I hereunto set my hand and official seal. r 11A Notary Public NOTARIAL SEAL Steve C.Nicholas,Notary public Township of susw&o na,County Of DaLom My Commission Ocpires Sept 25,2003 CERTIFICATE OF RESIDENCE I hereby certify that the precise address of the Grantee herein is: 58 Greenmont Drive Enola,PA 17025�-2643 AttorneyJAgautfor Grantee Recorded in the Office for the Recording of Deeds in and for Cumberland County, Pennsylvania in Record Book ,Page WITNESS my Hand and Seal of Office,this day of 2002. Recorder of Deeds DERT P, Z 1 G,L P, 017 D E_'DS i". :__AND 0 OU T Y- 3 D E 0 17 Hal 01 THIS DEED Tax Parcel No. 10-15-1281-028 Made the day of in the year of our Lord two thousand three (2003) Between ALAN S. MEMINGER and GILDA T. MEMINGER, husband and wife, parties of the first part ("Grantors") AND JOSE M. TREJO and MONICA A. TREJO, husband and wife, parties of (� I i the second part ( Sirantees") Witnesseth, that the said Grantors, for and in consideration of the sum of Four Hundred Thirty-Five Thousand and 001100 ($435,000,.00) Dollars lawful money o f t he United States unto Grantors well and truly paid by the, Grantees, the receipt of whic is hereby acknowledged, do hereby grant, bargain, sell,lalien, enfeoff, release, convey and confirm unto the said Grantees, Grantees' heirs and assigns, ALL THAT CERTAIN tract or parcel of land being situ�te in Township of Hampden, County of Cumberland, and Commonwealth of Pennsylvania, more particularly bounded and described as follows, to wit: BEGINNING at a point on the southern line Or the cul de-sac of General Knipe Circle, a 50 foot wide street, said point also being the northeastern corner of Lot No. 40; thence along the southern line of said cul-de-sac along a cu to the left having a radius of 66.00 feet and an arc length of 100.69 feet, said arc cure subtended by a chord of South 84 degrees 04 minutes 32 seconds East, a distance of 90.92 feet to a point, said point also being the northwestern corner of Lot No. 42; thence along the western line of said lot South 38 degrees 27 minutes 05 seconds Eas't a distance of 243.39 feet to concrete monument, said monument a!s-- being the northwestern -corner of lands nt, or formerly of Garie and Leslir K. Shields; thence along the western line of said Ian(s South 17 degrees 58 minutes 45 seconds West a distance of 206.96 feet to a conc ete monument; thence continuing along said lands South 06 degrees 03 minutes 43 seconds West a distance of 62.91 feet to a concrete monument, said monument also being on the northern right-of-way line of Smith Drive T-600, a 60 foot wide street; thence along said right-of-way line South 68 degrees 55 minutes 15 seconds West distance of 36.00 feet to a concrete monument; thence continuing along said right- way line along a curve to the right having a radius of 734.93 feet and an arc length f 100.00 feet, said arc being subtended by a chord of South 72 degrees 49 minutes 98 seconds West a distance of 99.92 feet to a concrete monument, said monument al lo being the southeastern corner of lands now or formerly of John W. and Alice K. Smith; thence along the eastern line of said lands North 17 degrees 10 minutes 50 second X_rbv, 260 West a distance of 427.32 feet to a concrete monument, said monument also bein the southern corner of Lot No. 40; thence along the southeastern line of said lot North 1 degrees 42 minutes 00 seconds East a distance of 124.89 feet to a point, the plac of BEGINNING. CONTAINING 99,927.37 square feet or 2.2940 acres. SAID Lot is subject to a 70 foot wide wetlands easement crossing in the southern p rt of the lot, as being shown in greater detail on the Final Subdivision Plan Sheet 3 or 8 of Phase III of the Signal Hill Residential Development dated May 23, 1996, as prepa d by Melham Associates, P.C. BEING Lot 41 on the Final Subdivision Plan of Signal Hill Residential Development Tract 1, Phase 111, dated May 23, 1996, fist revised June 24, 1996 prepared by Mel am Associates, P.C. and recorded in Plan Book 74, Page 68. , i HAVING thereon erected a residential dwelling known and numbered as 5538 Gen ral Knipe Circle, Mechanicsburg, Pennsylva is 17050. l BEING the same premises which Susquehanna Enterprises, Inc., a Pennsylvania corporation, and Signal Hill Development, a joint venture comprised of Susquehan a Enterprises, Inc. and The Homestead Group, Inc., a Pennsylvania corporation, by Ceed dated July 8, 1997, recorded J K 0 1997 in Cumberland County Deed Book 1616, Page 454, granted and conveyed unto Alan S. Meminger and Giida T, Meminger, husband and wife, Grantors hlerein. UNDER AND SUBJECT to all restrictions, reservations, easements, covenants, conditions and rights-of-way of record. Together with all and singular the hereditaments and appurtenances thereunto belonging or in anywise appertaining and the reversions and remainders, rents, iss es and profits thereof and all the estate, right, t lle, interest, property, claim and dpma d whatsoever of the.Grantors, in law, equity or otherwise; of, in and to the same land every part thereof. To Have and to Hold the above-described premises with the appurtenances unto t e Grantees, Grantees' heirs and assigns, forever. And the said Grantors hereby covenant and agree that they will warrant specially t e property hereby conveyed. '606 260 FAGA , In Witness Whereof, the Grantors have hereunto set their hands and seals the da and year first above written. WITNESS: C__A- tn emi gar eminger C ommonwealth of Pennsylvania County of Dauphin SS.; 1 On this, the day of Qcote " 2003, before me, a Notary Public, t e undersigned officer, personally appeared Alan S. Meminger and Gilda T. Meminge , known to me (or satisfactorily proven) to be the persons whose names are subscrib d to the within deed and acknowledged that they executed the same for the purpose therein contained. In Witness Whereof, I hereunto set my hand and official seal. Notary Public My Commission Expires: (SEAL) O!_.<p S" NOTARIAL SEA:Notajy \��yl CHRISTINA L.NICHOLAS, PublicSusquehanna Twp. DaupntyMy.Corofifssion Expires Ju2005 Q VVuu.. ,5y1 BOOK 260 PAGE4M I Hereby Certify that the precise residence of the Grantees is 5538 General Knipe Circle, Mechanicsburg, Pennsylvania 17050 Attorney for Grantees Commonwealth of Pennsylvania SS.: County of Cumberland Recorded on this _ day of 2003, in the Cumberland County Recorder of Deeds Office in Record/Deed Book_, Volume _, Page I Cert,fy tiq X13 yW?&R had+ and the seal of the said Office the date above written. Ire Cu iberiand Co,upnty PA 6 Cumberland County Recorder of Deeds 'recorder of Z--ds F:\drg\5665-Meminger,Alan S.&Gilda 7V 2533-Sale of 5538 General Knipe Circle,Mechanicsburg\Documents\Deed.doc 9/29/03 4:47 PM 4v :y _ - i 'i i:: 12 a :� :, BOOK 260 PASE4W " 4 75 e {N-? $ RO ERT DEOLER ECGitCc{; t r DEEDS Uniform Parcel Identifier hR?EIRLAIiO COUNTY-r:. 09-13-0997-007 �� fl AM 9 00 SPECIAL WARRANTY DEED COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND THIS INDENTURE, is made this 30 day of April,2004,between Daniel S. Liddick,Jr.,an adult individual(the "Grantor"),of Cumberland County,Pennsylvania,and Jose Trejo,an adult individual (the"Grantee"), of Cumberland County,Pennsylvania. and MONICA TREJO WITNESSETH,that the Grantor,for and in consideration of the sum of One Hundred and Eighty-five Thousand Dollars($185,000.00),to him in hand paid by the Grantee at and before the ensealing and delivery hereof,the receipt whereof is hereby acknowledged,has granted,conveyed, bargained, sold, aliened,released,and confirmed,and by these presents hereby grants,conveys, bargains,sells, aliens,releases,and confirms unto the Grantee and his successors and assigns, ALL THAT CERTAIN tract or parcel of land situated at and known as 75 Pine Hill Road,Enola, East Pennsboro Township,Cumberland County,Commonwealth of Pennsylvania,more particularly bounded and described in Exhibit"A" attached hereto and by this reference made a part hereof. BEING THE SAME PREMISES which Daniel S.Liddick,Jr.,Trustee of the Liddick Family Trust,by Deed dated November 27,2002,and recorded on or about November 27,2002,in the Office of the Recorder of Deeds in and for Cumberland County,Pennsylvania in Deed Book 254,Page 3692, conveyed unto Daniel S.Liddick,Jr.,the Grantor herein. UNDER AND SUBJECT,to the extent the same are valid and binding,all easements, restrictions,subdivision plans,covenants,rights and reservations of record,if any. On December 3,2002,Daniel S.Liddick,Jr.,filed his voluntary petition for relief under Chapter 13 of the United States Bankruptcy Code. His bankruptcy case is docketed to Case No.1-02-06585- MDF in the United States Bankruptcy Court for the Middle District of Pennsylvania. The conveyance of the property herein described,free and clear of all liens,claims and encumbrances,pursuant to Section 363 of the U.S.Bankruptcy Code,and subject only as stated herein,was authorized,ordered and directed by that certain Order dated April 28,2004,and issued by the United States Bankruptcy Court for the Middle District of Pennsylvania,a certified copy of which is recorded along herewith. TOGETHER with all and singular the rights,liberties,privileges,hereditaments,and appurtenances whatsoever thereunto belonging,or in any wise appertaining,and the reversions and remainders,rents, issues, and profits thereof, and also, all the estate,right, title, interest,property,claim, and demand whatsoever,of him,the said Grantor,in law,or equity,or otherwise howsoever,of,in,to, or out of the same. TO HAVE AND TO HOLD the premises hereby granted,or mentioned,or intended so to be, with the appurtenances,unto the said Grantee,his successors and assigns,to the only proper use and behoof of the said Grantee,his successors and assigns,forever. �OOk 2W PAGF4M AND the Grantor,by these presents,hereby covenants,promises,and agrees that he will SPECIALLY warrant the property hereby conveyed. IN WITNESS WHEREOF,the said Grantor has executed this Deed on the day and year first above written Signed,sealed and delivered in the presence of E Lorthine A.Goforth,Power oflAttorney For Daniel S.Liddick,Jr. I hereby certify that the aad�dress o e within-named Grantee is �c r " / 7114 5— 'j Y it-t.., AUo;ney for Grantee COMMONWEAL'T'H OF PENNSYLVANIA F�,�,,,p SS. COUN'T'Y OF �` l Wtn On this,the 3 O` day of April,2004,before me,a Notary Public,the undersigned officer, personally appeared Lorraine A Goforth,Power o€Attorney for Daniel S.Liddick,Jr.,known to me(or satisfactorily proven)to be the person whose name is subscribed to the within instrument,and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF,I hereunto set my hand and official sea]. �NMm P No Public;PW*11W lea 2 . t I EXHIBIT "A" E II BEGINNING at a point in the eenter of Pine Hill Road at comer of lands now or formerly of Ralph Kincr;thence along said lands of Kincr South 88 degrees 41 minutes 19 seconds West,655.49 feet to a stake in line ofiands now or formerly of Charles Lender;thence along said lands of Lender South 3 degrees 15 minutes 40 seconds Wes;2 t692 fat to a cherry tree;thence along the same South 45 degrees 56 minutes-East,539.85 feet to a poplar tree in line of lands now or formerly of Harvey G.Wilt-,thence along said land of Wilt South 82 degrees 54minutes 39 seconds East, 137,02 feet to a stake;thence by the same South 82 degrees 56 minutes East, 135.27 feet to a point in line of lands now or formerly of Paul Liddick;thence along said land North 13 degrees 19 minutes West, 141,93 feet to an iron pipe;thence along the same North 83 degrees 17 minutes East,a distance of 103.45 feet to an iron pipe in line of land now or formerly of D.S.Liddiek,Sr.;thence along said land now or formerly of Uddick,Sr. North 82 degrees 59 minutes East 70.41 feet to a point in the center of the Pine Hill Road;thence along the center line of Pine Hill Road North 8 degrees 23 minutes West 167.36 feet to a point;thence continuing along said center line North 16 degrees 34 minutes 8 seconds West 132.20 feet to a point; thence continuing along said center line of Pine Hill Road North 27 degrees 26 minutes 23 seconds West 101.08 feet to a point;thence continuing along said center tine North 12 degrees 16 minutes 30 seconds` West 102.11 feet to a point,the place of BEGINNING. .". ertiry this to be recorded in Cumberland County PA Recorder of Deeds +J CGGS' \ShX�X�++A iC tY QSA—!� r r'q z b ca m a a �m _ a Btl01tCf mu+�+�wwr.r.r cn uvo s. Ln ppLRib Cad Cn OOOK/t Ln cao OOOC?4op+oO4c? T F. ER ZOOS JUN 28 RM 8 19THIS DEED Tax Parcel No. C)C1- Made the ),;4t day of December, in the year of our Lord two thousand one (2001) Between ALAN S. MEMINGER, an adult individual, party of the.first part ("Grantor") AND JOSE M. TREJO, JR. and MONICA A. TREJO, husband and wife, parties of the second part ("Grantees") WiLuesseth, that the said Grantor, for and in consideration of the sum of One Hundred Nineteen Thousand Five Hundred and 00/100 ($119,500.00) Dollars lawful money of the United States unto Grantor well and truly paid by the Grantees, the receipt of which is hereby acknowledged, does hereby grant, bargain, sell, alien, enfeoff, release, convey and confirm unto the said Grantees, Grantees' heirs and assigns, Parcel 1 ALL THAT CERTAIN piece or parcel of land situate in East Pennsboro Township, Cumberland County, Pennsylvania and being more fully described as follows: BEGINNING at a point on the northern right-of-way line of Belle Vista Drive at the dividing line between Lot No. 2 and Lot NO. 3, herein described; thence by said dividing line the following three (3) courses and distances: 1. North thirty-one (31) degrees eight minutes (8) minutes twenty-three (23)seconds West a distance of thirty and zero hundredths (30.00) feet to a point; 2. North Eighty-one (81) degrees forty (40) minutes sixteen (16) seconds West a distance of two hundred six and eight-five hundredths (206.85) feet to a point; 3. North twenty-nine (29) degrees fifty-four (54) minutes twenty-two (22) seconds West a distance of two hundred forty and fifty-six hundredths (240.56) feet to a point on line of lands now or formerly of John and Bonita Wright: Thence by said lands of Wright North sixty (60) degrees five (05) minutes thirty-eight (38) seconds East a distance of one hundred fifteen and thirteen hundredths (1115.13) feet to a paint on the dividing line between Lot No. 4 and Lot No. 3; thence by said dividing line the following three (3) courses and distances: 1. South twenty-nine (29) degrees fifty-four (54) minutes twenty-two (22) seconds East a distance of two hundred fifty-three and fifty-three hundredths (253.53) feet to a point; 2. South eighty-two (82) degrees twenty-six (26) minutes thirty-three (33) seconds East a distance of one hundred eighty-five and sixty hundredths(185,60) feet to a point; 3. South thirty-one (31) degrees eight (08) minutes twenty-three (23) seconds East a distance of thirty and zero hundredths (30.00) feet to a point on the northern right-of-way line of Belle Vista Drive Thence by said right-of-way line South fifty-eight (58) degrees fifty-one (51) minutes thirty-seven (37) seconds West a distance of one hundred and zero hundredths (100.00) feet to a point, the Place of BEGINNING. Being Lot No, 3 of a preliminary/final subdivision plan recorded in Cumberland County Recorder of Deeds Office in Plan Book 65, Page 123-A and containing 43,560 square feet. BEING A PORTION OF THE SAME PREMISES WHICH Alan S. Meminger and Judy C. Meminger, by their Deed dated December 28, 1992 and recorded December 29, 1992 in the Office of the Recorder of Deeds of Cumberland County, Pennsylvania at Deed Book B, Volume 36, Page 369, transferred and conveyed unto Alan S. Meminger. Parcel 2 ALL THAT CERTAIN piece or parcel of land situate in East Pennsboro Township, Cumberland County, Pennsylvania and being more fully described as follows: BEGINNING at a point on the southern line of lands now or formerly of John and Bonita Wright at the northwest corner of Lot 3 (Meminger Subdivision); thence extending through said lands of Wright North twenty-nine (29) degrees fifty-four (54) minutes twenty-two (22) seconds West a distance of one hundred and seventeen hundredths (100.17) feet to a point on the northern line of Wright lands; thence along said line North sixty-three (63)degrees fifty-two (52) minutes forty-seven (47) seconds East a distance of one hundred fifteen and thirty-eight hundredths (115.38) feet to a point; thence continuing through lands of Wright South twenty-nine (29) degrees fifty- four (54) minutes twenty-two (22) seconds East a distance of ninety-two and fifty-six hundredths (92.56) feet to a point, the northeast corner of Lot 3 (Meminger Subdivision); thence along the northern line of said Lot 3 South sixty (60) degrees five (05) minutes thirty-eight (38) seconds West a distance of one hundred fifteen and thirteen hundredths (115.13) feet to a point, the place of BEGINNING. CONTAINING 0.25 acres. BEING Lot No. W3 of a Subdivision and Lot Add On Plan for MemingedWright recorded in Cumberland County Recorder of Deeds Office on May 23, 2000 in Plan Book 81, Page 8. BEING together with Lot 3 (incorrectly referred to in the prior deed as Lot 2), Plan Book 65, Page 123, known and numbered as 596 Belle Vista Drive. BEING A PORTICN OF THE SAME PREKISES WBIC$ John A. Wright and Bonita M_ Wright. by their Deed dated June 29, 2000 and recorded July U, 2000 at Cumberland County, Pennsylvania Deed Book 225, Page 46, transferred and conveyed unto Alan S. Hemi.nger. Gilda T Meminger joins in this deed only for the purposes of conveying any interest she has in the premises, and not for purposes of warranting title. Together with all and singular the hereditaments and appurtenances thereunto belonging or in anywise appertaining and the reversions and remainders, rents, issues and profits thereof and all the estate, right, title, interest, property, claim and demand whatsoever of the Grantor, in law, equity or otherwise, of, in and to the same and every part thereof. To Have and to Hold the above-described premises with the appurtenances unto the Grantees, Grantees' heirs and assigns, forever. And the said Grantor hereby covenants and agrees that he will warrant specially the property hereby conveyed. 112 Witness Whereof, the Grantor has hereunto set his hand and seal the day and year first above written. WITNESS: ` CU Alan S. Me t ink r Gilda T. Meminger Commonwealth of Pennsylvania SS.: County of Dauphin On this, theJ,'54 day of b 4 C Eti-65A , 2001, before me, a Notary Public, the undersigned officer, personally appeared Alan S. Meminger and Gilda T. Meminger, known to me (or satisfactorily proven) to be the persons whose names are subscribed to the within deed and acknowledged that they executed the same for the purposes therein contained. In Witness Whereof, I hereunto set my hand and official seal. Su u e h NOTARIAL SEAL r i 1,I CHRISTINA L.NICHOLAS:Notary Public Notary Public M CommissonTEz IresJ�ne20,2005 My Commission Expires: (SEAL) IHereby Certify that the precise residence of the Grantees is �4 G24f.,fn,vN� Il2w F4 I '7U)S t � �VUC c Qe4k-1 *fforrtey for Grantees Commonwealth ofPennsylvania : SS.: County of Cumberland Recorded on this — day of 2001, in the Cumberland County Recorder of Deeds Office in Record/Deed Book_, Volume _, Page Given under my hand and the seal of the said Office the date above written. Cumberland County Recorder of Deeds F:\drg\5665-Meminger,Alan S.&Gilda 114470-Summerdale PropertyZocuments\Sale of Lot M-3 to Trejo\Deed from Meminger to Trejo.doc 12/14/01 REV-1504 E%+(g-12) pennsylvania SCHEDULE C DEPARTMENT OF REVENUE CLOSELY-HELD CORPORATION, INHERITANCE TAX RETURN RESIDENT DECEDENT PARTNERSHIP OR SOLE-PROPRIETORSHIP ESTATE OF TREJO, JOSE MERCED a/k/a Jose M. Trejo, Jr. FILE NUMBER Schedule C-1 or C-2(including all supporting information) must be attached for each closely-held corporation/partnership2interest 0850 decedent, other than a sole-proprietorship.See instructions for the supporting information to be submitted for sole-proprietorships. ITEM NUMBER NUMBER DESCRIPTION VALUE AT DATE r. Trejo Enterprises, Inc. OF DEATH 2 El Rodeo of Carlisle Pike,Inc. 113,207.00 3 El Rodeo of Hanover, Inc. 65,398.00 4 6417 Carlisle Pike, Inc. 14,700.00 5 El Gran Rodeo, Inc. 28,000.00 6 El Rodeo, Inc. 35,349.00 7 Mi Mariachi, Inc. 29,213.00 g Mi Rodeo,Inc. 52,500.00 9 Mi Hacienda, Inc. 17,640.00 10 Mi Guadalajara, Inc. 57,750.00 11 Arellano Corporaiton 93,765.00 12 El Rodeo of Swatara, Inc. 10,265.00 13 Degollado,Inc. 73,544.00 14 Abeulos,Inc. 186,725.00 15 2818 East Market Enterprises, Inc. 48,222.00 16 Trejo,LLC 69,127.00 17 Casa Fiesta Mexican Bar&Grill,Inc. 73,500.00 18 Arellano,Trejo Bravo&Arellano 28,000.00 19 Arellano,Trejo&Bravo 32,978.00 20 Arellano,Bravo,Trejo 8 Trejo 21,427.00 2,573.00 The Estate claims a minority percentage discount to be applied to the valuation of Decedent's minority equity position in the above entities which are outline on Schedules C-1 and C-2. The inability of Decedent to sell his interests reduced the value of his minority equity position against the total enterprise value of each entity. TOTAL(Also enter on line 3, Recapitulation) $ 1,053,883.00 (If more space is needed,insert additional sheets of the same size) Trejo Jose Schedule C-1 attachments stalest SCHEDULE CA CLOSELY-HELD CORPORATE STOCK INFORMATION REPORT ESTATE OF: TREJO,JOSE MERCED aWa Jose M.Trejo,Jr FILE NUMBER 2113-0850 MASTER LIST OF ATTACHMENTS FOR ALL CORPORATIONS ITEM A- Detailed calculations used in the valuation of decedent's stock. Attached hereto ITEM B. Complete copies of US Form 1120 for the years: 2009, 2010, 2011, 2012 and 2013 Attached to individual GIs ITEM C. Real Estate Owned by the Corporation Deeds and fair market value information attached to individual C-1 s ITEM D. Principal stockholders, number of shares held and relationship to decedent Attached hereto ITEM E. Officers, salaries, bonuses and benefits received Attached hereto ITEM F. Statement of dividends paid each year Attached hereto ITEM G. Other information No attachments REV-1508 EX+(08-1z) Pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE C o NTTUnN PERSONAL PROPERTY - ESTATE OF: TREJO, JOSE MERCED a/k/a Jose M. Trejo, Jr. FILE NUMBER: Include the proceeds of litigation and the date the proceeds were received by the estate. 2113-0850 All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE 1. Wells Fargo Acct#xxxxxx5437 DE DEATH 2. Ameritrade Acct#XXx-xx8945 16,592.22 3. Metro Bank Acct#xxxxx6886 2,037.58 101.00 TOTAL(Also enter on Line 5, Recapitulation) $ 18,730.80 If more space is needed,use additional sheets of paper of the same size. Camplete Advantage' Checking Account number:x$437 n June 1,2013-June 30,2013 M Page 1 of 7 DODPIIDTAK 0:1267 Plrlhgllllllyugl"nlprruynl',IrrldrPUhrllpwlyd n JOSE M TREJO Questions? 5538 GENERAL KNIPE DR Available by phone 24 hours a day,7 days a week: MECHANICSBURG PA 17050-1676 1-800-TO-WELLS (1-800-869-3557) 1T1:' 1-800-877-4833 En esponol: 1-877-727-2932 0 1-800-288-2288(6 am to 7pm PT,M-F) Online: wellsfargo.com Write., Wells Fargo Bank,N.A.(345) P.O.Box 6995 Portland,OR 97228-6995 0 0 0 You and Wells Fargo 0 a Thank you for being a Wells Fargo customer.We a Account options >,Your understand that you are entrusting us with your banking needs.Let us assist you convenientserviceswith youroccount. Goto ° A check mark in the box indicates you have these in finding the right accounts and services to hel y 9 m pyou reach our financial oafs. weflsfargo.com or call the numberabove ifyou have V Please visit us online at w�ellsfargo.com,call us at the number at the to f z statement,or visit any Wells Fargo store-we'd love to hear from you! z po your questions orifyou would like to oddnewservices. Z Online Banking ❑✓ Direct Deposit z Online Bill Pa f-� z Y Ell Auto Transfer/Payment z z Online Statements Overdraft Protection z z Mobile Bankin z 9 Debit Card z My Spending Report O z Overdraft Service � o Activity summary ; Beginning balance on 6/1 Account number: 2504095437 Deposits/Additions $20,501.35 JOSE TREJO 23,607.41 ° Wi[hdrawals/Sub[ractions 27.576 Pennsylvania account terms ondconditiansapp/y a Ending balance on 6130 - .54 For Direct Deposit and Automatic Payments use $16,592,22 Routing Number(RTN): 037000503 l 0 Overdraft Protection m This account is not currently covered by Overdraft Protection. If you would like more information regarding Overdraft Protection and eligibility requirements Please call the number listed on your statement or visit your wells Fargo store. f Account number:~S437 IN June 1,2013-June 30,2013 ■ Page 2 of 7 • Interest summary Interest Paid this statement Average collected balance $0.14 Annual percentage yield earned $17,143.09 Interest earned this statement Period 0.01% Interest paid this year $0.14 $0.66 Transaction history Check Date Number Desorption 6/3 Deport Made In A 3ranch/Store Deposits/ Withdrawals/ Additions Ending daily Check Crd Purchase 05/31 Turkey #280 Eno'!- Pq '" Subtractions ._..„4737o2xxxxxx5648 763151470 768377?,MCC--5542 7,32000 balance _._ ....,_,. 58.55 _..,.......-........ Cheer Crd Purcnase'OS/31 V✓affle House 1452 Hemsburg pq 473702xxxxxx5648 003751521 0197 2?McC=5812 Check Crd Purchase 05/31 A.1'"q I 2461 --�- ............. 6/3 47 3702xxxxxx5648003150583818937?M 5866772-7753 CA ..... . ......3.63 Check Crd Purchase 05/37 qII Pro West Meehan csburg Pp 473702xxxxxx5648 163151620405527> 6/3 .... ..._. McC=55338.47 Check Crd Purchase 05/31 Red Lobster U50000 Mechanicsburg - _ PA ck_70d xxxxxx5648 383151715973007? Check Crd Purchase 05/37 Turkey-'ll;;280 En la Pq _473702 ._ xxxxxx5648283151800307250> _ � POS Purchase-06%01 Mach ID000000 Tar 5C=5542 Mechanchase get T2202 Target T2 ” .....9Pa 564800463152684912888? POS Purchase-06/07 Mach ID 000000 Dicks Cloth-5Hampden 276 70 "'�"�� "'"'"-""'--•-- 0/3 Tbwnura aje 00000000544080274?11. _._... .......... dcC=5655 .... 589.21 '__........... ................. 005 Purchase 06/07 M ch ID 000000 Giant 6263 Enola FA 5648 6/3 -- 00583753066086689?McC 5417 POS Purchase 06/02 Mach ID 000000 Best Buy1478 86.15 Mecham<sbur a --" ' ._ gP 564800000000457218133?McC-5732 POS Purchase-06/03 Mach"ID 000000 The Home D=5732 317 ..' Harrisburg, 56gg "' ..w,.._ 4 00000000as906o8v> Check Crd Purchase 06/03 Sweet Frog 200087 Mechancsburg Pq 74.80 °'- 20 372.75 -- (.heck rd P_ur56482831550474744647 Check Crd Purchase 06104 AI"q -- McC=5814 - P pple Runes S 866-772-7753 CA. 20.354.68 - 473702xxxxxx5648 083154849204530? 6/6 v Check Crd Purchase 06/Oa Outback 3921 Meehan[s burg p,q 473702xxxxxx5648 083 7 55748 71 ? .. 20,344.36 Check Crd Purchase 06/05 TheRestaurant Sto Camp Hill PA 47 86 ............._ xxxxx5648.1631567755768667 POS PU"re 06/06 Mach ID 0000007hecHomoe Depot4720" ` 5.49 6/6 cna nics sbur urge``648 C0 83757710y Cash eV✓ithdrawal in Branch/Store 350'?agcC-S 0 -." t22.7c .. ._.._..,,.,w_-_.. ----- Mechanicsburg pq 56gg 6416 Carlisle Pike -""""" Check Crd Purchase 06/ 5M .......... 4 37 xx Orter Health Syst 479-6369291gp _` .. .. 7 350.00 _....,.... ..._.. x648 283756726409215> 18,818.26 Check Crd Purchase 06/06 McDonald's F5050 Ha9nsburg PA 3 49'7.00 ... ........ 47n702xX ....... 6/7 xxxx5648 163757667268928? POS Purchase-06/07 Mach ID 000000 G a t 60054 8.55 Mechanicsbur -"" 9Pa 5648 005837585367733457 -- Check Crd xx 648 06/07 Best Buy 0007 MechaM csbu g1Pq 9.7 5 303 55 473702xxxxxxc a-s ' -6/0---546475755? - "37799 Check Grd'Purchase 0 Tg1 Fridays 11469 Mechanicsburc PA" ` L'G� } 6/70 4neck xxxxx5648083157569669815?McC- ........ ...... Check Crd Purchase 06/06 Bed Bath&'Beyond Mechanicsburg pA 42.16' 473702 xxxxxx5648003157697674135?McC 5779 6/10 ...... . . heck Crd Purchase 06%07q I"A 75.59 ''-'-'"---- P pple Runes S 866-712-7753 CA 473702...... 5648 00375847 8599277?McC- .."... .................. ............. ..._......... 5735 ....... 4.1.2....... .................. ....................... Account number:111RAM9437 a June ],2013-June 30,2013 • Page 3 of 7 • Transaction history (continued) Check Dote Number Description 6/70 POS Purchase-06/07 Deposits/ Withdraw,/,/ Mach ID 000000 Giant 6263 Enola PA 5648 Additions Subtractions Ending doily ,...._....._ ._. .,,.._...._�._._,.,_.�--..»...._ balance 6/70 0383759060004083?McC=5417 POS Purchase-O6/O8 Mach ID 000000 Turkey Hill Mini 2060 68.06 Enola PA 5648 00303159691926237 y _ 6/10 ....-.�....__.�._..__...__--,_-. POS Purchase 06/08 Mach ID 00000 Turkey Hill Mini 2060 "-'"`""""""""----------- 6/70-" - EnoIa PA5648003831596953597027 ...-."... .. . __._"...,,.,.__.,._..,__......"............. M[C 5547 PA 5 Purchase 06%08 Mach ID 000000 Exxonmobil PO5 Greencas 11.59 PA 564800000000656620550?McC-5541 6/70 ......... .... VA 5 Purchase 06%09 Mach ID 000000 Wal Mart Per Roanoke V.5648 00000000454655790 ............ MCC 5477 -�� Deposit Made In A Branch/Store._. 49.41 . .. ....... 15,376,99 Check CrdPurchase06/10 TurkeyHdl X280 EnolaPq 7396928 - .._..... 473702-x- ............. ....... ..... 6/11 .... xxx5648 003 7 6 7 698572373> -"` ., McC-5542 ` Check Crd Purchase 06/70 Hoyt Harrisburg j4 Harrisburg PA.......... 7408 - osp"xxzxxx5648 1637620811373977 6/71 ........___--_. ....-. POS Purchase 06%11'Mach ID 000000 Ro s Sto$es 20.00 - 6/7- -- 5648 00000000554893863> 5 1 "'"""""'^---------.. McC=5370 _. . POS Purchase O6/71 Mach ID ,-- Clark 5 736 533 Park m 9.99 - -' Lancaster Pq 564800383162821035707> w" �_-_- _ M[C=5667 POS Purchase 06%77 Mach ID 000000 Forever 2l lnc Lancaster -- 11999 p PA 5648 .._._...._,.,......__..�_.._._ c 6/17 " .......003837628264325157 '--- - m McC=5627 05 Purchase 186 06/11?Mach ID 000000 H M Lancaster PA 5648'-` ^'^^•°-- 6/71 - - 00583762834577865?McC 5317 - " POS Purchase O6/11 Mach ID 000000 A F 145 769.35 "°- x 648 00000000656336790 7 048 Lancaster PA McC=5691 -�" 703 79 Check Crd Purchase 06/71 Redbox"Dvd Rental 866-733-2693 7L" v 473702 ............._._._ `: 6/11 " ,- xxx56482831621645790227McC 7841 -" ---- z 6/12 --- Withdrawal Made In A Branch/Store� „.,•_>„,,,,,,,,,,„"_ ,-._." 7.63 Check Crd Purchase 06/77A I• z p App le l tunes 5866-7i2-7753 CA- .__ 473702xxxxxx56481631623873526597 3000.00 "` -" Z . .......-. 25,752.44 Check Crd Purchase 06/77 GnnabonLanca tes pAS 585 Z 473702xxxxxx5648283162846597337?McC_ -- _ _ "�`� - 6/12�-' Trmiry High Sch Facts 0 000 000 1 1 782a53Jose M Trejo-- 3.39 1.6/73 ......... z Recur Debit Crd Pmt06/77 qutopay/Dish Ntwk 800-894 9737 CO 473702-----x5 ....._.. - .. ........... 497875 '.-" 7 648083762385576914?McC=4899 20,764.45 z .......... 118.71 '- o Check Crd Purchase O6/71 Conner Apicella OR iMechanicsburg PA 473702-x- `-'- - x-'5648 763762572631252?McC_80Z7 "" --- 6/73�.-- ...__ "" .. 192.00.... .._.. . Check Crd Purchase 06/11 Conner Apicella OR Nlechamcsburg _-_°A 473J02..8,.._.-_.„82831 6/73 x'xxxx5648283762572998870?McC= Check Crd Purchase 06/11 York Buff'e[York 0438"'8021 202.00 '_ `^'^-• m 473702xxxxxx564 8 003 7 62.717415763?McC 5812 - 6/13 ..,. . o ...... 9i 56._ e<k Crd Purchase Al 06 qunbe Annes Pg244 473702 Lancaster PA 2888' A 6/13 ......... xxxxxz5648283162845079138?McC 5874 --_ - � ...._... 957...... __ _ Check Crd Purchase 06/72 Turkey Hill 4280 Enola PA 473702 . ................. xdx urc648083763365420566?McC- 6/73 .. -._._. ...-...... o Check Crd Purchase 06/72McDonald's F14097 Lorton VA 7857 v ---x5048 163 163497834987?h1cC-- -_-- - 6/73..._."._... -. ._.. Check Crd Purchase 06%72 Mcponald's F3502 Emporia VA 1705 - - 12>7Z xxxxxx5648 0031635904945527McC 5814 6/73 -_,.__.. ...__ . .. ... . . . ,..- _,..._ 73.68 ._.. . .. Check Crd Purchase 06/72 McDonald'SF 27810 Pt VVentwotth PCs xxxxxx564g 2831637995525617McC 5814 ....._ 767._....,. -._............._..... Ha Purchase 06/72 Mach ID 000000 Shell Service Station Hawthorne FL 564800463764068746646?McC 5541 ....... ._ 456 ....,..._...-.. POS Purchase 06/72 Mach ID 000000 Shell Service Station ' „Hawthorne FL 564800463764064207864?McC=5542 6/73 ....... ..... 73 74 POS Purchase 06/73 Mach ID 000000 Walgreens 10470 Robsev St Petersbur fl 564800463164568246787 7 ..... McC- 23 77 ......... POS Purchase 06/13 Mach ID 000000 Pub6x Supe rMar 535 T' -----------_.,_.._._- _._...28..88 6/td `" --.__.Venice FL 564800303164707202889> ------ - McC=5471 13L31 Cneck Crd Purchase 06/72 Exxonmobil 4752 Emporia VA 19800.38 473702x.... _5648383163595772 789?McC= ,..�....._..._. - ".._"« 5542 83.73 Account number:ANOMS437 0 June 1,2013-June 30,2013 • Page 4 of 7 • Transaction history (continued) Check Dare Number Description Deposits/ Withdrawals/ 6/74 Check Crd Purchase 06/12 Wilco 930 0000 5[George SC Additions Ending daily Subtractions balance _..._•",,, 473702xxxxxx5648 7631637472946147MCC=5542 73.79 6/77 ""° •-- 19,642.86 Check Crd Purchase 06/12 Taco Bell 026018 St George SC 473702xxxxxx56482831637S7686148"+ McC-5814 heck Crd Purchase 06/73 Exxonim 9740 Saint petersE FL 473702xxxxxx5648 3831645373248127 McC=5542 39.69 .. ............. 6/77 - Preensb hose-O6/75 Mach ID000000 Target T1078Target T7 Greensboro NC 5648 00383766597096007?McC= 6/77 ...... ,....106.97 ........... �� .,. 5477 Check Crd Purchase 06/15 McDonaltl s Fi 0607 Greensboro NC 473702xxxxxx5648 283166608314889?McC=5874 6/17 .......... .....980 ......... POS Purchase-06/76 M ch ID 000000 Exxonmob7l POS Greensho ............... NC 5648 00000000442220332?Mc C-5542 ._....._ .. .....17.68 ..._...... 6/77 P05 Purchase-06/16 Mach ID 000000 Wal Mart 5299 Clermont FL 5648000000006557792797McC 5477 'ry � .,... 34574 _- `. _ffie._.._...,,,,_, ._- 79,176.80 Check Crd Purchase 06/16 Sleep'Inn 336 9371272 NC.,.,.._. 473702xxxxxx56482837666715478587MCC=3637 -� —" 8344 19033.36 Q3702 rchase 6nr v estgate Tickets Orlando FL' �702xxxxxx5648 08316855487008P _ 7,788.00 '-- - MCC=7017 -- CheckCrd Purchase 06/17 Westgate Ticke[s 7 Kissimmee FL ................. ,.,,. 473702muxx5648 283 7 6811162475 7?McC=7071 256 00 .............. .... 6/79 POS Purchase 06/79 Mach fD 000000 King 5 Supermar .......... Kissimmee FL 5648 00000000551918669> McC=5417 84.96 - '76,904.40 Check Crd Purchase 06/78 Fry Cart Lake 473702xxxxxx5648 003 7 69667 734207?McC=5874 u 6/20 ...... ..,.,, ... .. Check Crd Purchase 06/19 Apl"Apple Runes S 866 772-7753-CA 473702xxxxxx5648 003710189483724 7 _.�.__ 6/20 ....... _..... .._ Mc C-5735 .. ..2.28 Check -..._.., 6127 ......_._...... .....,.... Check Crd Purchase O6/78 Dpc Disney Lckets Lake Buena VI FL 200,00 ,....-.,.._ ........76673.40 473702xxxxxx5648 163169604018694 7 -"�� McC 7996 795.96 ��"-"" "'•` 627 POS Purchase 06'%27 Mach I1 000000 0318 Qf 5g U5 7000 U Orlando FL 5648005831727702073457 .... 244.95 .'.... McC-5691 16 232 49 Check Crd Purchase 831 East Train Station Lake Buena VI FL ...._... 47 3702xxxxxx5648.0831775253667027McC=5947 ..... ...38.24 ........ ........ 6/24 Check Crtl Purchase 06/20 Auntie Graviry s Lake Buena VI FL ................. 473702xxxxxx5648 763177591895260?McC= 4.79 6/24 ....-..... 5814 ........ ........ Check Crd Purchase 06/20 Aunte Gravity s Lake Buena VI FL ""- 473702xxxxxx56480031 715976347207 ... ...._ ..23.97 .._. .... ......_ o McC 5874 Check Crd Purchase 06/20 Turkey Leg Wagon Lake Buena VI FL -.��-""' 473702xxxxxx5648 763177689096049> "- ""'" - McC 5814 57.23 6/24 . ...,.._".. ....-... a Check Crd Purchase 06/20 Aloha Isle Lake Buena VI FL Check xxxxxx564828320L 3695771 ?McC=581a -�"- 62a.... 15.95 ..._.__.....,".._..._.. Check Crd Purchase 06/20 Lunching Pad Lake Buena VI FL 473702xxxxxx5648 003177 782491150 7McC= _ 6/24 � ....... ......_... 28.39 ........... ......... Check Crd Purchase 06/21 Labamba VerandORO Orlando FL ..._. ..,__. 473702xxxxxxS648 003 7 725547 59455?McC=5814 .,... . ... 20.22 ........ ... oi24 ....... neck Cro Purc�ase 0612 Us's z bu ks o 2c brlan-to pl ............... 473702xxxxxx5648 2837 72655829054> 6/24 -• -- MCC 5814 � 36.42 Check Crd Purchase 06/27 Termrnat 01300rlando FL 473702xxxxxx5648 1 17273 947882 7 6/24..._. .. 38.24 ... . ........._. - -�-- McC 5947 .- Check Crd Purchase 06%27 Outback 1059 Kissimmee FL 473702xxxxxx5648083172047276456 7 """'- "°°•---------•--.- McC-5812 731.77 , Check Crd Purchase 0622 P r"kin g 0140 Orlando FL 473702xxxxxz5648 7637734%86341577 McC 7523 ...... 16.00 .........._............-... 6/24 Check Crd Purchase 06/228utterbeer Caro0900ilando FL 473702xzxxxx56482831735576495487MCC 5814 53 75 624 Check Crd Purchase 06/22 Grkus McGurku0090 Orlando FL _ 473702xxxxxx56482831 73616746570> McC 5874 37-68 '"` -- Check Crd purchase 06%22 Grkus McGurku0090 Orlando FL- "-`-"` 654 473702xxxxxx5648 003 7 73631829252?McC=5814 Check Crd Purchase 06%221oa Gnnabon 0090 Orfz;d l .......... 4 73702xxxxxx56480031736890195407 w4.25 ..._....... ._-................-McC=5814 Account number:iNNM5437 r June 1,2013-June 30,2013 ■ Page 5 of 7 Transaction history (continued) Check Deposits/ Withdrawals/ Ending daily Date Number Description Additions Subtractions balance 6124 Check Crd Purchase 06/22 Shell Oil 57542548 Kissimmee FL Si.82 473702xxxxxx5648 383174105002642?MCC=5542 624 Check Crd Purchase 06723 Marathon Petro1294 Sanford FL 329 _ 473702xxxxxx5648 163174346152489?MCC=5541 -._ 1333,... ..1333_. -_,.._...0 ... _.,.. ...w..nm. Hall 624 - �POS Purchase-06!23 Mach in OD0000 Exxonmobil POS HaUfax 64.23 NC 5648 00000000551946849?MCC=5542 _ _ _ ... 3333. . ., .._ ...-. 3131. ... ... .. P 3311 .._. .. . ............. 6/24 POS Purchase-06123 Mach ID 000000 Wai Mart 5u er � � � � � � � �� -67946 MechaniCSbur4pa 5648 00000000744489060?MCC-5411 .. .. ... he; . .. 3313_ . .. .............._ .. _ ......_..... 6124 Check Crd Purchase 06!24 Redbox*Dvd Rental 866-733-26931L ��-�� 27.98 74,931.96 473702xxx 6648083175118649510?McC=7841 -3333 ;rch _ ._........ ._..._......_ 3-77 - . ..........._ 3333.. 6!25 Check Crd Purchase 0624 ApI*Apple lkunes 5866.7}2-7]53 CA -� - - 129 473702xxxxxx5 648003175091592769?McC=5735 . .... .............._.,...»,......_.........r.._.T._.__..__.._.._«_,._.r�_.....�._.�.._._...-_....�........ ._,...,�.-e.1333_.. _w,.._ ._...,.,,.,...,..,.5,00 6 5 773 Check 5,000.p0 9,930.67 3313.. . ... ........... . ................ ............. 3333-._...... .__..... ._....... 3333...1333. . ............. ..........._... _..........__. .._..._,.. fi126 ,Deposit Madeln ABranch/$tore 800000 3333. 1333 ... -..._..._.,. ..__...__. _ ...,.........__.. .. .,.,,,.........._ ........._._,._,.. _....... ........_'_......._,...-.......M 6126 POS purchase-06125 Mach l�DOOt>DD Target T2202 Target T2 73995 .Mechanusburgpa 564800583177052527812?McC 5417 . 1333. 3333 .. . - 3333 ... . _ ............. ....,_..... , ._..._,..._. .._.,_.._ ^`',..Chase-6526,.a.,h ID 000000 H PA Lancaster PA 5648 131.00 a brzb �, 00303177698091124.McC-5311 v 3333 ... ,_...... ..... ... .........- . Park .. .. ._............ ............. 6126 POS Purchase-0626 Mach(D 006000 Journeys 7463 Park Ci 121.97 -= Lancaster PA 564800303177716313535?McC 5661 _ o 3333 _. _0 se- . 626 POS Purchase-66126 Mach ID 000004 Forever 211nc Camp Hill 766.40 X PA 5648003837777903172$3?McC=5621 6 0 .__,_,._....._..............._.,_,,.w...._.._.-....m 3133.-,,.. t2b P175 Purchase 06/26 Mach ID 000000 Hco 30484 Lovter Allen PA�. 1930 ,�, 5648 00000000349839452?McC=5691 ._._....... 33,33 ._....._ . ,,. .,. 3567 Capital - 64.99 z Camp Hill PA 5648 00303177796843121 ?McC 5661 z .. ._..._..__.__ -' 3131_ ,-06 Mach 333.3sha .. 333.3..... ....,_..........., -.. 6/26 P05 Purchase-06/26 Mach ID 000000 Ntarshalis Marshalis 166.44 z Mechanicsburgpa 564800303177827136661?McC 5651 _ z 3333 b a ... .. . ._. 3331. . . ........_. ................ _.,. 3333 _3.112_ POS Purchase-06/26 Mach ID�D00000 Dicks Clothing HamFden 79054 �� 16,930.72 Z Towns 564$00000000854297783?McC=5655 _ .. .. 3333 . ._ .. .. ____. ....._... .___....__... ._ -3333. . . ........ 627 Check Crd Purchase 06!26 McDonaid`s F5l)50 Harrisburg PA 72.51 Z 473702xmx 5648083177618180267?McC-5874 z 6/27 -� � �- - - Check Crd Purchase 06/26 The Restaurant Sto Camp Hill PA 76.29 16,841.26 z 473702xxxxxx5648163177762451549?McC=5046 d _ 3333«..................,. ...._.__,..,._...,.,_..... _ - 3113... .__, ._._.__. , ..,.. .,....,.....«.3333.»,,.,,._._.._.._,_...,,,,, .mm......,.,._ _ ..,._.._._.._....,..._...,„_ °w 6/28 Check Crd Purchase 06/26 EI Puebiito Mexico Lancaster PA 194 6, 0 473702xxxxxx5648083177647578324?McC 5499 ... ......3333. ,.. .... .,.,. ._....._. _ ......,_ ._ .-......._, ... -.. , n° 6!2$ Check Crd Purchase 06126 Apple Store dR304 Lancaster PA 705.90 w� 473702xxxxxx5648 083177723147110 7McC=5732 a, ._.......__._ 3333. 6128 Check Crd Purchase 06!27 Famous Famrgiia Washington OC 4626 473702xxxaxx 476 5648 163178342406 ?McC=5812 3333. .. 3333. . _ .._.._ _ 3333 ......_ - .. 3333 w ... 3333 _ .............. ..._._ 6128 Check{rd PurCh2se 06!27 Turkey Hill#280 Enola PA 7755 473702xxxRax5648 083178245647277?MCC=5542 0 __er _,.,. 1111_ 6%28 -'� Interest Payment � �� 014m '�� - 76592.22 ° 3333.. ........... ... _._..... 3333 3333 _..__.__. ..._....... .-........ ......,..-. ......_... ..3331.. ............. .......... Ending balance on 6130 16,592.22 Totals $23,607.41 $22,516.54 The Ending Daily Balance does notreftectany pending withdrawals orholds on deposited funds thatmay have been outstanding on your account when your transactions posted-/f you had insufficient ovotloble funds when a transaction posted,fees may have been assessed. Summary of checks written(checks listed are also displayed in the preceding Transaction history) Number Date Amount Number Date Amount 713 6/25 5,000.00 716' 6120 200.00 *Gap incheck sequence. Accountnurnber:% 5437 0 June ),2013-June 30,2013 • Page 6 of 7 Summary Of Overdraft and Returned Item fee(s) ------ t6tai_6�e�dTaft 0 e.j� Total this statementperiod F T TarOlYeCNO-cratIt otal Returned Item Fees ___S0.00 t reflects assed r twve-nie since fiat fullstor, Ww D TCFCU Account number:380IM437 ■ June 1,2013-June 30,2013 ■ Page 7 of 7 • Worksheet to balance your account General statement policies for Wells Fargo Bank Follow the steps below to reconcile your statement balance with your It To dispute or report inaccuracies in information we have furnished to a account register balance. Be sure thatyour register shows any interest Consumer Reporting Agency aboutyour accounts. You have the right to paid into your account and any service charges,automatic payments or dispute the accuracy of information that Wells Fargo Bank,N.A.has ATM transactions withdrawn from your account during this statement furnished to a consumer reporting agency by writing to us at Wells Fargo period. Servicing,P.O.Box 14415,Des Moines,fA 50306-3415. Please describe the Enter the ending balance on this statement 5 f specific Information that is inaccurate or in dispute and the basis for the dispute along with supporting documentation. Ifyou believe the © List outstanding deposits and other information furnished is the result of identity theft,please provide us with credits to your account that do not appear on an identity theft report. tothe right, . Enter the total in the column M In case of errors or questions about your electronic transfers, to the right. telephone us at the number printed on the front of this statement or write Description _Amount us at Wells Fargo Bank,P.O.Box 6995,Portland,OR 97228-6995 as soon as ----- ---- you can,if you think your statement or receipt is wrong or if you need more information about a transfer on the statement or receipt. We must hear from you no later than 60 days after we sent you the FIRST statement on which the error or problem appeared. t.Tell us your name and account number(if any). 1 2.Describe the error or the transfer you are unsure about,and explain as Total $ } $ cleady as you can why you believe It is an error or why you need more G information. ° 0 Add 3.Tell us the dollar amount of the suspected error. �A and to calculate the subtotal. 5 o We will investigate your complaint and will correct any error promptly. If n 0 List outstanding checks,withdrawals,and we take more than 10 business days to do this,we will credit your account a other debits to your account that do not appear for the amount you think is in error,so that you will have the use of the on this statement. Enter the total in the column money during the time it takes us to complete our investigation. 23 to the right. In case of errors or questions about your Direct Deposit Advance" z service z Numbed, Description i Amount zz I— If you think your bill i5 wrong,or if you need more information about a z transaction on your bill,write us at Wells Fargo Bank P.O.Box 6995, z Portland,OR 97228-6995 as soon as possible.We must hear from you no z later than 60 days after we sent you the first bill on which the error or z problem appeared.You can telephone us,but doing so will not preserve z your rights. z in your letter,give us the following information: o 1.Your name and account number ° 2.The dollar amount of the suspected error 3.Describe the error and explain,if you can,why you believe there is an N error.If you need more information,describe the item you are unsure about. You do not have to pay any amount in question while we are investigating, f but you are still obligated to pay the parts of your bill that are not in °m question.While we investigate your question,we cannot report you as ° delinquent or take any action to Collett the amount you question. rn II Total 0 Subtract[0]from,,C]to calculate the I� adjusted ending balance. This amount should be the same as the current balance shown in your register. = $ ( alorow¢ns mega sank N.i Nlryhts reserved. WLSRO359801 Member FDIC.uxeav 0 Q m � a'o o m m p 0 _ a a s 3 n �o, > -�o�_o 3 v 7 a a c o m o co o o 0 m 030`00 oG -� `" 'n o y m g m 3 5.?XZrnm n. 3 s = a v 3 mmNO10 a0 � y y N �mPo�>� a am a w N m °p A -i > m O M N z N O IL o O y N N � C W � Ni i i i $w0 N 0 W W p O) O , i � v0 p O y O N O w A XC W 1 O N is O n1 N O O m 0 3N�� N n m c h n=>w d m xogm m zm F nm;um mm cn .. in 0 m>AO �_ Cry- •••° N 0 '• ozm> 3 rD a jmm CD N n o C? -050 O i z W N 0 o o Z3 0 -oz m O W ' O N v a N > co O O W � w O i0 CD 1 z H O. o a <» c `.. 69 m 0 3 G 1D C ti g 'n C C O In cxommr = ._ ' o > > _a w m Cm--4> Z �. 3 i GT y Q a c o _i3 O-im r_mp 'a° m a0 m e ° fD m ram�0az � m w f a v O, d vmoDmm fD 3 - y m D rmN Z*...im >�°m a � 0 m m W-I p > N . o CL >c0 em -4� C0 D>p Dpo A O N A D rO 0 O p m T O r O D r m O _ p O O wl � O � O O O N a 0 °m 0 0 p 0 °—' coo room ° p o 0 w o A O , � s D_ w m 3 O L l N = O 0 3 v m CA w CD s n 3 p Q N CD 00 O m W w O Ow y n _ m o 0 n 1D Oa S y m � m am > w m A a n m o o p n -q 3 m° < C C m m m 0 EA 3 � m D W my wM n� c O 3 d �' � o - V7 VI LT to A ay N i m y N 0 m 0 y o w o m d s OA p m; p D m m a 0 2 - 0 O N w p 3 v, Ea o m 3 o O m 0 Z x< w 3! a C � O T CO 0 m -4 a m =m C m o 0000 m <o OC N OOO O,m� N ca Oe� 00oom .N., v3 0 < m m - ai 3 m y 6 0 0 0 m ` m m 0 m q _ %m ban 3 -3 A " - N)6 .N. c w v n A mo m -° n ,C m m' n x 3a (ry c a o o o oO 0 0 0 0 � � o c m D m ° w m 0 { � m m � O O OOD � lOJI N � NOO 0 0 O O A O p - N a c d opp iO C o op m ro m 3 m �D G d fD C7 W m Z V fop d N C O_ m H w N ,01 N m e 3 !Q _� _O W O �• an d 2 m ro 0 O N c zG m n 2 w W W w wtQ n N W m _ m o � om o3 Dm W 3 m � .Z70 m d � = O" O m d o m D 3 < fo o= •mom x X m 0 O za 'a m p ➢ a° O O m � a ( w N m O O N CL m 9 ry W w 3 D0 < 0- 0 O� 3 05 m m m M d O O. 00 Q = O. S < < < N d � d D .a m 3 0 0 o L1 0-m °- •• u - m Z7 3 c m m O 4J f'n n 3 nCO 3 c _ A a m c 'c Mo o O o o 0 :0 _ T o m 0 m. y TA '° a m-a fwp mmoo m v O o O T OmoO -n ZCO w mop m a n n O X n >° ° O O Z Om m o F m 3 o OT Oo d m 3 m aw �o n a Zomo �o O mi SAWN 00 'o ZOO =4 c ro n m - 0 O 3 CO W an d o a m W n 00 a n a? ^ m c o v c to a •00 3 c c tl1 yj = M W n � O •c° m' m m 3 � _n •'-o m ~ 0 N d S W S m 0 0 O d Z, cc x c � a ry O c 2 , , o d m m S a m m 6 D O. J0C ry N (Q O O ro m m d n O X01 - 3mm `� d X G d ^ d d x 00 x m N D c 0 G O 3 m 2 ITI m `c N d c m •c° Ds a b am o _ ° O N 3 fmp m N 0 -0 ➢Oi m d M = 0 0 ~ N K O o ➢ X C 9 0 d v a � o c O CL > > �° f °' w 69 D �. ,Q• 3 o fp m o m o 0 0 o c p S N m o N r2 0 N N N O O o < 3 O m y O m 3 D X 3 � N 'Z w d fD 0 (O O � j ➢1 N W OI O) A N N fop REV-1510 EX+ (08-09) pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND RESIDENT EDENTTURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF TREJO, JOSE MERCED a/k/a Jose M. Trejo, Jr. FILE NUMBER This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV is yes ITEM DESCRIPTION OF PROPERTY NUMBER isfers;DE mE NWE Of THE TRANSF F,TIFM REUTONSNm TO DECEDEAND DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE F TIE DEED ny REq a,,,M. VALUE OF ASSET INTEREST (tEgaRUCaaiE) VALUE 1• Effective 1,2013, Decedent transferred various percentages of his interests orporations listed on Schedule C-1 and the Partnerships listed on e C-2 to his wife,Monica A. Trejo,for the consideration of$100.Th are outlined on the attachment to Schedule G. TOTAL(Also enter on Line 7, Recapitulation) $ 0.00 If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+ (08-13) , pennSylvania SCHEDULE H '' DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE DE EDENT RN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF TREJO, JOSE MERCED a/k/a Jose M. Trejo, Jr. FILE NUMBER 21 13-0850 ITEM Decedent's debts must be reported on schedule I. NUMBER DESCRIPTION A. FUNERAL EXPENSES: AMOUNT 1, Funeral 2. Thank you cards and postage 15,000.00 35.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) street Address City -s— --------_....._ State_ZIP Year(s)Commission Paid: Z. Attorney Fees: 11,500.00 3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation.) 3,500.00 Claimant Monica A. Trejo Street Address 5538 General Knipe Circle city Mechanicsburg state PA ZIP 17050 Relationship of Claimant to Decedent Spouse 4. Probate Fees: 418.50 5. Accountant Fees: 6. Tax Return Preparer Fees: 7. Advertising Fees-Cumberland Law Journal&The Sentinel B. Postage,copies, Notary-Nicholas Law Offices, PC 285.78 50.00 TOTAL (Also enter on Line 9, Recapitulation) $ 30,789.28 If more space is needed, use additional sheets of paper of the same size. REV-1512 EX+(12-12) pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, 1NHERrrANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER TREJO, JOSE MERGED a1k/a Jose M. Trejo, Jr. 21 13-0850 Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unraimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1' Mortgages A.Cowen Loan Servicing,LLC-Loan##xxxxxx1092- 99,624.49 on 507 Erford Road,Camp Hill,PA 17011 -owned soley in decedent's name B.PNC Bank-Loan#xxxxxxxxxxx3910-Balance of$172,080.77 86,040.38 on 5538 General Knipe Circle,Mechanicsburg,PA 17050-owned as Tenants by the Entireties C.Bank of America-Loan#xxxxx0982-Balance of$118,865.95 59,432.98 on 75 Pine Hill Road,Enola,PA 17025-owned as Tenants by the Entireties 2. 2013 Real Estate Taxes A.507 Erford Road,Camp Hill,PA 17011-owned soley in decedent's name 1,635.16 B, Center St.,Enola,PA 17025-owned soley in decedent's name 952.14 C.5538 General Knipe Cir,Mechanicsburg PA 17050-owned as Tenants by the Entireties-$5,511.36 2,755.68 D.75 Pine Hill Road,Enola,PA 17025-owned as Tenants by the Entireties-$2,792.25 1,396.13 E.596 Belle Vista Drive,Enola,PA 17025-owned as Tenants by the Entireties-$3,060.38 1,530.19 F.4703 Duke Street,Harrisburg,PA 17109-owned as Tenants by the Entireties-$1,24724 62162 G. 125 Earl Avenue,Harrisburg,PA 17109-owned as Tenants by the Entireties-$2,569.88 1,284.94 3. Sewer/Trash on 507 Erford Road,Camp Hill,PA 17011 -owned soley in decedent's name 2,895.65 4. PNC Bank Loan#xxxxx1426-Personal loan to decedent,Monica A.Trejo,Vidal 0.Bravo and Carmen Bravo-Balance of$577,800.54.Decedent's proportionate share is 25% 144,450.14 5. DCM Services-Chase Bank USA,NA Acct#xxxxxxxxxxxx7567 1,489.78 6. SVA School of Visual Arts#1012519-Tuition for son(Victor Trejo) 25,323.00 7. FACTS Management Company-2013.14 Trinity High School Tuition for daughter(Vanessa Trejo) 6,575.00 8. Apicella Lorei Orthodontics#081310 orthodontia services for daughter(Joanna Trejo) 2,496.00 9. Apicelia Lorei Orthodontics#081315 orthodontia services for daughter(Vanessa Trejo) 2,63100 10. Verizon#7175851650-Open account 900.00 NOTE:Estate denies liability for claim filed by Maria Franco for$31,000 vs.the Estate TOTAL(Also enter on Line 10,Recapitulation) $ 442,036.28 If more space is needed,insert additional sheets of the same size. -. ..-- Qewen fawn Servicing,LLC �AccOUn!Statement I Account Number: 4MOM052 Account Statement Date: 00!1712013 g °E° Property Address: 507 Erford Road NMLS 1862 Camp Hill PA 17011 YC PeN CUSTOMER CARE CENTER 1400.7`1612916 GURR Page 1 Your tali may Da mearded forMe coaching and development a mrasswistes. Special-Notices . CLAIM YOUR$40 CASH BACK FOR GAS TODAY! See the special offer for U-S.homeowners for$40 back on 2FP 02466/0054391OD49670029 2ACQDJ5 your gas purchases and a free review of the home service JOSE M TREJO plan that can save you thousands.Please reply before: 5888 GENERAL KNIPE DRIVE 10131113! MECHANICSBURG,PA 17050 - Reduce your financial burden when your home is impacted by a disaster or you involuntarily lose your job.Let First Protector pay your mortgage for you. Visit www.OcwenFirstProtector.egm or gill-877479.3947, 8am-8pm E.T.for more information. DetOlsoflcomlung Current principal fWance: kmouROue- 99,624.49 Cunnt Amount Due: Interest Rate: .+ 8.95000% Principal: 114.64 Nod Payment Due Date: 07OWD13 k>lEmst 743.03 _ Current Escrow Balance: 1,376.65 E&onvc 263.41 intermt Pad Yeal'-TO-0 ale: 4,476.11 Current Amount Due by 07101113: 1,061.08 Tares Paid Yearv7o-Date: 451.84 Assessed Fee-Evense Outstanding Beginning Principal Balance: 100,313.61 Late Charges: 42.88 Prii RaduPIMS Year-To-Date: 689.12 PrewReNmed CheCk Fee: 4000 Beginning Escrow Balance: $17-00 Torn FeewExpense Outstandnna: 82.88 Escrow DepaRts/Adjustments Year-To-Daw 1211.69 Total Amount vile: 1,143.96 Escrow Disbursements Adjustrnenis Year-TO-Date: 451.84, Recently Assessed Amaorrts: Map=3 Later Charges_ _ _---- 42.86 TINS i5 the pm+caz!4alanrx onry 90t h2 amsa,zrequtreC to paYywrv:wuMinfllti. 'Recent Account Activity _ Date Description It Printipal Interest Escrow Optional fate Citarges FinatOtha' Suarense Totdi 06!10!13 Payment Reversal i 1129& 744.72- 200.79-. 1,058.46 06l12I13 Payment 112.95 744.72 203-41 I 1,oG1.08 0&112713 Payment + 113.791 743.88 19$.17 1 1,055.84 (FmPSrY+3rtM.'ages _. wemay retortninformiaten cotyour coattm cmtt Fair Cr,tat¢payments,t go to ,RO.ss.errone.aetavto myour acewnt mayce refl«#w in your Wean report.To obtain intartnation'aboutyour ngMS undei the Fate Credo Reporting Act go tD wWwits eovlcred R. U you arecurrendy in!anknOt yor if yw hayseed forbarkn+pi%since Inaireng Shis ban,please read the bankruptcy information Provided on the back of this statement. p}aazerpta;Platyour mmNtWpaymerttarnauMhaschanged to 81,060.91 eRecUve OW12D13.Fuftflar detail regarding the meson for this cFRngswM be included in 3separate,letter.. ,�J ;t FO{DAND PLEASE DETACH Me RETURN aorioM PORTION Wmf PAYMENT WTHE ENCLOSE)ENVELGPEWtiH ADDRESS V*8E . FOLD AND DETACH HERE PLEAea M HOTSENO CORRESP NDENCE Wm:YOUR PAYMENT-MAYS WRRC YOUR ACCOUNT NW41BER Q YWR CHECK. DETACH HERE .b&]➢WO96%KAWSYiiET.911CCpZ:: 011288309995 00000000000000000000000042888 000000706531092 50 001143960 IPaynrent Goupon Account Number Jose M Trejo (�L chertc iorenenge of�ntomaUOn 0706531092 F l entl xere�wrse sitln otmupon. O C W E N AMOK DUE S -1 143.96 K Received attar071712013 add Lace Chergeoh $;__..._ 42.88 T0relAmw.nt Duewfth Late Chagle: $�_- s.a'a� r'tk4ikll""I➢fFkffft''fI'fiP'n•tt^vhi•'f1i1r4Pthfl' Not tfY—ieen+beurt[L any Aidikona Principal: $ .__, j 00WEN ettess funds us 5rst te 4mrec M PO BOX 6440 wtapM;ng ,Madue nnc rrten Adddtii al Escrow. $rte CAROL STREAM IL 60197.6440 a44aionai pnncipa. Late Charges: $! Other-tP,eeaesrearn S[_.-....._„1 Total Erxased: $ —- - - - - - - - - PNOBANK, NATIONAL ASSOCIATION 00479304 m Box 535238 00001 For Incluirlas Please Call P1TrSWM MH, PA IS -5230 1-888-762-1099 S.I.N. 22-1146430 JOSE M TREJO JR 40 5538 GENERAL KNIPE DR MECHANICSBURG PA 17050 2013 t xxx-xx-5473 THIS STATEMENT IS A FORM 1098 OMB NO.15454901,OR A FORM 1098-E OMB NO. I545.1576, OR 1092-A OMB NO. 154""T OR 1099.8 OMB NO,1545.0715 OR 1099-C OMB NO. 1545-1424, OR 1039-DIY OMB NO.1545-0110 OR 10994NT OMB No. 1545-0112 OR 1099.MtSC OMB No. 1545-0115 OR 1029-OID OMB NO. 1545-0117 U.S.INFORMATION RETURN 2013 - 1098, MORTGAGE INTEREST STATEMENT ACCOUNT NUMBER INSTALLMENT low wAmmommomm"3 9 10 Box I MORTGAGE INTEREST* 6,482.28 TOTAL BOX I INTEREST 6,482.28 OUP, VOCAMATXM AND 13 SEM FURNMED TO THE RKEp1FALAEYEkDE BERYICBIFYDO ARE MKMERITOMEA RETURN.A NEOUGENcE PENALTY ORCINERSAVETION MAYBE AMPOSM ON YOU WTHF M M"MINES THAT AM MEAPAYMENT CFTAX RESIA.TBSECAUeEYOU OYERSTATEO XCECUCTR)W CR 1310 PUT REPORT CORRECT AMOUNT& -FORM IMCAUTPOW.THE AMOUNTSHOWN MAY NOT BE rALY DW=V"BY YOM UUMSASEDCH THE LCANAMC)UNTAMTHE COST AND VALUEOrTHEEECUROPRCEEM WAY Appoll ALSO,YoomAv ONLYCEDUCT WEEREWTOTHE EXTENT rrWASINCURRED BY YOU,ACTINL.y PAID NYYOU,AM NOT RENWASMIED BY -FORM 1099-OV.TWBMAY NOT BETHS CORRECT FK]URE TOREPORT ON YOUR OCOW TAX RETURN, PLEASE REFER TOTHE MYRUCTMES OMTHE SACK OF THMUTATEMENT. COPY W-CA lVe,a il'$% 4C�j44 ( REV-1504 E%+(g-12) pennsylvania SCHEDULE C DEPARTMENT OF REVENUE CLOSELY-HELD CORPORATION, INHERITANCE TAX RETURN RESIDENT DECEDENT PARTNERSHIP OR SOLE-PROPRIETORSHIP ESTATE OF TREJO, JOSE MERCED a/k/a Jose M. Trejo, Jr. FILE NUMBER Schedule C-1 or C-2(including all supporting information) must be attached for each closely-held corporation/partnership2interest 0850 decedent, other than a sole-proprietorship.See instructions for the supporting information to be submitted for sole-proprietorships. ITEM NUMBER NUMBER DESCRIPTION VALUE AT DATE r. Trejo Enterprises, Inc. OF DEATH 2 El Rodeo of Carlisle Pike,Inc. 113,207.00 3 El Rodeo of Hanover, Inc. 65,398.00 4 6417 Carlisle Pike, Inc. 14,700.00 5 El Gran Rodeo, Inc. 28,000.00 6 El Rodeo, Inc. 35,349.00 7 Mi Mariachi, Inc. 29,213.00 g Mi Rodeo,Inc. 52,500.00 9 Mi Hacienda, Inc. 17,640.00 10 Mi Guadalajara, Inc. 57,750.00 11 Arellano Corporaiton 93,765.00 12 El Rodeo of Swatara, Inc. 10,265.00 13 Degollado,Inc. 73,544.00 14 Abeulos,Inc. 186,725.00 15 2818 East Market Enterprises, Inc. 48,222.00 16 Trejo,LLC 69,127.00 17 Casa Fiesta Mexican Bar&Grill,Inc. 73,500.00 18 Arellano,Trejo Bravo&Arellano 28,000.00 19 Arellano,Trejo&Bravo 32,978.00 20 Arellano,Bravo,Trejo 8 Trejo 21,427.00 2,573.00 The Estate claims a minority percentage discount to be applied to the valuation of Decedent's minority equity position in the above entities which are outline on Schedules C-1 and C-2. The inability of Decedent to sell his interests reduced the value of his minority equity position against the total enterprise value of each entity. TOTAL(Also enter on line 3, Recapitulation) $ 1,053,883.00 (If more space is needed,insert additional sheets of the same size) Trejo Jose Schedule C-1 attachments stalest SCHEDULE CA CLOSELY-HELD CORPORATE STOCK INFORMATION REPORT ESTATE OF: TREJO,JOSE MERCED aWa Jose M.Trejo,Jr FILE NUMBER 2113-0850 MASTER LIST OF ATTACHMENTS FOR ALL CORPORATIONS ITEM A- Detailed calculations used in the valuation of decedent's stock. Attached hereto ITEM B. Complete copies of US Form 1120 for the years: 2009, 2010, 2011, 2012 and 2013 Attached to individual GIs ITEM C. Real Estate Owned by the Corporation Deeds and fair market value information attached to individual C-1 s ITEM D. Principal stockholders, number of shares held and relationship to decedent Attached hereto ITEM E. Officers, salaries, bonuses and benefits received Attached hereto ITEM F. Statement of dividends paid each year Attached hereto ITEM G. Other information No attachments REV-1508 EX+(08-1z) Pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE C o NTTUnN PERSONAL PROPERTY - ESTATE OF: TREJO, JOSE MERCED a/k/a Jose M. Trejo, Jr. FILE NUMBER: Include the proceeds of litigation and the date the proceeds were received by the estate. 2113-0850 All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE 1. Wells Fargo Acct#xxxxxx5437 DE DEATH 2. Ameritrade Acct#XXx-xx8945 16,592.22 3. Metro Bank Acct#xxxxx6886 2,037.58 101.00 TOTAL(Also enter on Line 5, Recapitulation) $ 18,730.80 If more space is needed,use additional sheets of paper of the same size. Camplete Advantage' Checking Account number:x$437 n June 1,2013-June 30,2013 M Page 1 of 7 DODPIIDTAK 0:1267 Plrlhgllllllyugl"nlprruynl',IrrldrPUhrllpwlyd n JOSE M TREJO Questions? 5538 GENERAL KNIPE DR Available by phone 24 hours a day,7 days a week: MECHANICSBURG PA 17050-1676 1-800-TO-WELLS (1-800-869-3557) 1T1:' 1-800-877-4833 En esponol: 1-877-727-2932 0 1-800-288-2288(6 am to 7pm PT,M-F) Online: wellsfargo.com Write., Wells Fargo Bank,N.A.(345) P.O.Box 6995 Portland,OR 97228-6995 0 0 0 You and Wells Fargo 0 a Thank you for being a Wells Fargo customer.We a Account options >,Your understand that you are entrusting us with your banking needs.Let us assist you convenientserviceswith youroccount. Goto ° A check mark in the box indicates you have these in finding the right accounts and services to hel y 9 m pyou reach our financial oafs. weflsfargo.com or call the numberabove ifyou have V Please visit us online at w�ellsfargo.com,call us at the number at the to f z statement,or visit any Wells Fargo store-we'd love to hear from you! z po your questions orifyou would like to oddnewservices. Z Online Banking ❑✓ Direct Deposit z Online Bill Pa f-� z Y Ell Auto Transfer/Payment z z Online Statements Overdraft Protection z z Mobile Bankin z 9 Debit Card z My Spending Report O z Overdraft Service � o Activity summary ; Beginning balance on 6/1 Account number: 2504095437 Deposits/Additions $20,501.35 JOSE TREJO 23,607.41 ° Wi[hdrawals/Sub[ractions 27.576 Pennsylvania account terms ondconditiansapp/y a Ending balance on 6130 - .54 For Direct Deposit and Automatic Payments use $16,592,22 Routing Number(RTN): 037000503 l 0 Overdraft Protection m This account is not currently covered by Overdraft Protection. If you would like more information regarding Overdraft Protection and eligibility requirements Please call the number listed on your statement or visit your wells Fargo store. f Account number:~S437 IN June 1,2013-June 30,2013 ■ Page 2 of 7 • Interest summary Interest Paid this statement Average collected balance $0.14 Annual percentage yield earned $17,143.09 Interest earned this statement Period 0.01% Interest paid this year $0.14 $0.66 Transaction history Check Date Number Desorption 6/3 Deport Made In A 3ranch/Store Deposits/ Withdrawals/ Additions Ending daily Check Crd Purchase 05/31 Turkey #280 Eno'!- Pq '" Subtractions ._..„4737o2xxxxxx5648 763151470 768377?,MCC--5542 7,32000 balance _._ ....,_,. 58.55 _..,.......-........ Cheer Crd Purcnase'OS/31 V✓affle House 1452 Hemsburg pq 473702xxxxxx5648 003751521 0197 2?McC=5812 Check Crd Purchase 05/31 A.1'"q I 2461 --�- ............. 6/3 47 3702xxxxxx5648003150583818937?M 5866772-7753 CA ..... . ......3.63 Check Crd Purchase 05/37 qII Pro West Meehan csburg Pp 473702xxxxxx5648 163151620405527> 6/3 .... ..._. McC=55338.47 Check Crd Purchase 05/31 Red Lobster U50000 Mechanicsburg - _ PA ck_70d xxxxxx5648 383151715973007? Check Crd Purchase 05/37 Turkey-'ll;;280 En la Pq _473702 ._ xxxxxx5648283151800307250> _ � POS Purchase-06%01 Mach ID000000 Tar 5C=5542 Mechanchase get T2202 Target T2 ” .....9Pa 564800463152684912888? POS Purchase-06/07 Mach ID 000000 Dicks Cloth-5Hampden 276 70 "'�"�� "'"'"-""'--•-- 0/3 Tbwnura aje 00000000544080274?11. _._... .......... dcC=5655 .... 589.21 '__........... ................. 005 Purchase 06/07 M ch ID 000000 Giant 6263 Enola FA 5648 6/3 -- 00583753066086689?McC 5417 POS Purchase 06/02 Mach ID 000000 Best Buy1478 86.15 Mecham<sbur a --" ' ._ gP 564800000000457218133?McC-5732 POS Purchase-06/03 Mach"ID 000000 The Home D=5732 317 ..' Harrisburg, 56gg "' ..w,.._ 4 00000000as906o8v> Check Crd Purchase 06/03 Sweet Frog 200087 Mechancsburg Pq 74.80 °'- 20 372.75 -- (.heck rd P_ur56482831550474744647 Check Crd Purchase 06104 AI"q -- McC=5814 - P pple Runes S 866-772-7753 CA. 20.354.68 - 473702xxxxxx5648 083154849204530? 6/6 v Check Crd Purchase 06/Oa Outback 3921 Meehan[s burg p,q 473702xxxxxx5648 083 7 55748 71 ? .. 20,344.36 Check Crd Purchase 06/05 TheRestaurant Sto Camp Hill PA 47 86 ............._ xxxxx5648.1631567755768667 POS PU"re 06/06 Mach ID 0000007hecHomoe Depot4720" ` 5.49 6/6 cna nics sbur urge``648 C0 83757710y Cash eV✓ithdrawal in Branch/Store 350'?agcC-S 0 -." t22.7c .. ._.._..,,.,w_-_.. ----- Mechanicsburg pq 56gg 6416 Carlisle Pike -""""" Check Crd Purchase 06/ 5M .......... 4 37 xx Orter Health Syst 479-6369291gp _` .. .. 7 350.00 _....,.... ..._.. x648 283756726409215> 18,818.26 Check Crd Purchase 06/06 McDonald's F5050 Ha9nsburg PA 3 49'7.00 ... ........ 47n702xX ....... 6/7 xxxx5648 163757667268928? POS Purchase-06/07 Mach ID 000000 G a t 60054 8.55 Mechanicsbur -"" 9Pa 5648 005837585367733457 -- Check Crd xx 648 06/07 Best Buy 0007 MechaM csbu g1Pq 9.7 5 303 55 473702xxxxxxc a-s ' -6/0---546475755? - "37799 Check Grd'Purchase 0 Tg1 Fridays 11469 Mechanicsburc PA" ` L'G� } 6/70 4neck xxxxx5648083157569669815?McC- ........ ...... Check Crd Purchase 06/06 Bed Bath&'Beyond Mechanicsburg pA 42.16' 473702 xxxxxx5648003157697674135?McC 5779 6/10 ...... . . heck Crd Purchase 06%07q I"A 75.59 ''-'-'"---- P pple Runes S 866-712-7753 CA 473702...... 5648 00375847 8599277?McC- .."... .................. ............. ..._......... 5735 ....... 4.1.2....... .................. ....................... Account number:111RAM9437 a June ],2013-June 30,2013 • Page 3 of 7 • Transaction history (continued) Check Dote Number Description 6/70 POS Purchase-06/07 Deposits/ Withdraw,/,/ Mach ID 000000 Giant 6263 Enola PA 5648 Additions Subtractions Ending doily ,...._....._ ._. .,,.._...._�._._,.,_.�--..»...._ balance 6/70 0383759060004083?McC=5417 POS Purchase-O6/O8 Mach ID 000000 Turkey Hill Mini 2060 68.06 Enola PA 5648 00303159691926237 y _ 6/10 ....-.�....__.�._..__...__--,_-. POS Purchase 06/08 Mach ID 00000 Turkey Hill Mini 2060 "-'"`""""""""----------- 6/70-" - EnoIa PA5648003831596953597027 ...-."... .. . __._"...,,.,.__.,._..,__......"............. M[C 5547 PA 5 Purchase 06%08 Mach ID 000000 Exxonmobil PO5 Greencas 11.59 PA 564800000000656620550?McC-5541 6/70 ......... .... VA 5 Purchase 06%09 Mach ID 000000 Wal Mart Per Roanoke V.5648 00000000454655790 ............ MCC 5477 -�� Deposit Made In A Branch/Store._. 49.41 . .. ....... 15,376,99 Check CrdPurchase06/10 TurkeyHdl X280 EnolaPq 7396928 - .._..... 473702-x- ............. ....... ..... 6/11 .... xxx5648 003 7 6 7 698572373> -"` ., McC-5542 ` Check Crd Purchase 06/70 Hoyt Harrisburg j4 Harrisburg PA.......... 7408 - osp"xxzxxx5648 1637620811373977 6/71 ........___--_. ....-. POS Purchase 06%11'Mach ID 000000 Ro s Sto$es 20.00 - 6/7- -- 5648 00000000554893863> 5 1 "'"""""'^---------.. McC=5370 _. . POS Purchase O6/71 Mach ID ,-- Clark 5 736 533 Park m 9.99 - -' Lancaster Pq 564800383162821035707> w" �_-_- _ M[C=5667 POS Purchase 06%77 Mach ID 000000 Forever 2l lnc Lancaster -- 11999 p PA 5648 .._._...._,.,......__..�_.._._ c 6/17 " .......003837628264325157 '--- - m McC=5627 05 Purchase 186 06/11?Mach ID 000000 H M Lancaster PA 5648'-` ^'^^•°-- 6/71 - - 00583762834577865?McC 5317 - " POS Purchase O6/11 Mach ID 000000 A F 145 769.35 "°- x 648 00000000656336790 7 048 Lancaster PA McC=5691 -�" 703 79 Check Crd Purchase 06/71 Redbox"Dvd Rental 866-733-2693 7L" v 473702 ............._._._ `: 6/11 " ,- xxx56482831621645790227McC 7841 -" ---- z 6/12 --- Withdrawal Made In A Branch/Store� „.,•_>„,,,,,,,,,,„"_ ,-._." 7.63 Check Crd Purchase 06/77A I• z p App le l tunes 5866-7i2-7753 CA- .__ 473702xxxxxx56481631623873526597 3000.00 "` -" Z . .......-. 25,752.44 Check Crd Purchase 06/77 GnnabonLanca tes pAS 585 Z 473702xxxxxx5648283162846597337?McC_ -- _ _ "�`� - 6/12�-' Trmiry High Sch Facts 0 000 000 1 1 782a53Jose M Trejo-- 3.39 1.6/73 ......... z Recur Debit Crd Pmt06/77 qutopay/Dish Ntwk 800-894 9737 CO 473702-----x5 ....._.. - .. ........... 497875 '.-" 7 648083762385576914?McC=4899 20,764.45 z .......... 118.71 '- o Check Crd Purchase O6/71 Conner Apicella OR iMechanicsburg PA 473702-x- `-'- - x-'5648 763762572631252?McC_80Z7 "" --- 6/73�.-- ...__ "" .. 192.00.... .._.. . Check Crd Purchase 06/11 Conner Apicella OR Nlechamcsburg _-_°A 473J02..8,.._.-_.„82831 6/73 x'xxxx5648283762572998870?McC= Check Crd Purchase 06/11 York Buff'e[York 0438"'8021 202.00 '_ `^'^-• m 473702xxxxxx564 8 003 7 62.717415763?McC 5812 - 6/13 ..,. . o ...... 9i 56._ e<k Crd Purchase Al 06 qunbe Annes Pg244 473702 Lancaster PA 2888' A 6/13 ......... xxxxxz5648283162845079138?McC 5874 --_ - � ...._... 957...... __ _ Check Crd Purchase 06/72 Turkey Hill 4280 Enola PA 473702 . ................. xdx urc648083763365420566?McC- 6/73 .. -._._. ...-...... o Check Crd Purchase 06/72McDonald's F14097 Lorton VA 7857 v ---x5048 163 163497834987?h1cC-- -_-- - 6/73..._."._... -. ._.. Check Crd Purchase 06%72 Mcponald's F3502 Emporia VA 1705 - - 12>7Z xxxxxx5648 0031635904945527McC 5814 6/73 -_,.__.. ...__ . .. ... . . . ,..- _,..._ 73.68 ._.. . .. Check Crd Purchase 06/72 McDonald'SF 27810 Pt VVentwotth PCs xxxxxx564g 2831637995525617McC 5814 ....._ 767._....,. -._............._..... Ha Purchase 06/72 Mach ID 000000 Shell Service Station Hawthorne FL 564800463764068746646?McC 5541 ....... ._ 456 ....,..._...-.. POS Purchase 06/72 Mach ID 000000 Shell Service Station ' „Hawthorne FL 564800463764064207864?McC=5542 6/73 ....... ..... 73 74 POS Purchase 06/73 Mach ID 000000 Walgreens 10470 Robsev St Petersbur fl 564800463164568246787 7 ..... McC- 23 77 ......... POS Purchase 06/13 Mach ID 000000 Pub6x Supe rMar 535 T' -----------_.,_.._._- _._...28..88 6/td `" --.__.Venice FL 564800303164707202889> ------ - McC=5471 13L31 Cneck Crd Purchase 06/72 Exxonmobil 4752 Emporia VA 19800.38 473702x.... _5648383163595772 789?McC= ,..�....._..._. - ".._"« 5542 83.73 Account number:ANOMS437 0 June 1,2013-June 30,2013 • Page 4 of 7 • Transaction history (continued) Check Dare Number Description Deposits/ Withdrawals/ 6/74 Check Crd Purchase 06/12 Wilco 930 0000 5[George SC Additions Ending daily Subtractions balance _..._•",,, 473702xxxxxx5648 7631637472946147MCC=5542 73.79 6/77 ""° •-- 19,642.86 Check Crd Purchase 06/12 Taco Bell 026018 St George SC 473702xxxxxx56482831637S7686148"+ McC-5814 heck Crd Purchase 06/73 Exxonim 9740 Saint petersE FL 473702xxxxxx5648 3831645373248127 McC=5542 39.69 .. ............. 6/77 - Preensb hose-O6/75 Mach ID000000 Target T1078Target T7 Greensboro NC 5648 00383766597096007?McC= 6/77 ...... ,....106.97 ........... �� .,. 5477 Check Crd Purchase 06/15 McDonaltl s Fi 0607 Greensboro NC 473702xxxxxx5648 283166608314889?McC=5874 6/17 .......... .....980 ......... POS Purchase-06/76 M ch ID 000000 Exxonmob7l POS Greensho ............... NC 5648 00000000442220332?Mc C-5542 ._....._ .. .....17.68 ..._...... 6/77 P05 Purchase-06/16 Mach ID 000000 Wal Mart 5299 Clermont FL 5648000000006557792797McC 5477 'ry � .,... 34574 _- `. _ffie._.._...,,,,_, ._- 79,176.80 Check Crd Purchase 06/16 Sleep'Inn 336 9371272 NC.,.,.._. 473702xxxxxx56482837666715478587MCC=3637 -� —" 8344 19033.36 Q3702 rchase 6nr v estgate Tickets Orlando FL' �702xxxxxx5648 08316855487008P _ 7,788.00 '-- - MCC=7017 -- CheckCrd Purchase 06/17 Westgate Ticke[s 7 Kissimmee FL ................. ,.,,. 473702muxx5648 283 7 6811162475 7?McC=7071 256 00 .............. .... 6/79 POS Purchase 06/79 Mach fD 000000 King 5 Supermar .......... Kissimmee FL 5648 00000000551918669> McC=5417 84.96 - '76,904.40 Check Crd Purchase 06/78 Fry Cart Lake 473702xxxxxx5648 003 7 69667 734207?McC=5874 u 6/20 ...... ..,.,, ... .. Check Crd Purchase 06/19 Apl"Apple Runes S 866 772-7753-CA 473702xxxxxx5648 003710189483724 7 _.�.__ 6/20 ....... _..... .._ Mc C-5735 .. ..2.28 Check -..._.., 6127 ......_._...... .....,.... Check Crd Purchase O6/78 Dpc Disney Lckets Lake Buena VI FL 200,00 ,....-.,.._ ........76673.40 473702xxxxxx5648 163169604018694 7 -"�� McC 7996 795.96 ��"-"" "'•` 627 POS Purchase 06'%27 Mach I1 000000 0318 Qf 5g U5 7000 U Orlando FL 5648005831727702073457 .... 244.95 .'.... McC-5691 16 232 49 Check Crd Purchase 831 East Train Station Lake Buena VI FL ...._... 47 3702xxxxxx5648.0831775253667027McC=5947 ..... ...38.24 ........ ........ 6/24 Check Crtl Purchase 06/20 Auntie Graviry s Lake Buena VI FL ................. 473702xxxxxx5648 763177591895260?McC= 4.79 6/24 ....-..... 5814 ........ ........ Check Crd Purchase 06/20 Aunte Gravity s Lake Buena VI FL ""- 473702xxxxxx56480031 715976347207 ... ...._ ..23.97 .._. .... ......_ o McC 5874 Check Crd Purchase 06/20 Turkey Leg Wagon Lake Buena VI FL -.��-""' 473702xxxxxx5648 763177689096049> "- ""'" - McC 5814 57.23 6/24 . ...,.._".. ....-... a Check Crd Purchase 06/20 Aloha Isle Lake Buena VI FL Check xxxxxx564828320L 3695771 ?McC=581a -�"- 62a.... 15.95 ..._.__.....,".._..._.. Check Crd Purchase 06/20 Lunching Pad Lake Buena VI FL 473702xxxxxx5648 003177 782491150 7McC= _ 6/24 � ....... ......_... 28.39 ........... ......... Check Crd Purchase 06/21 Labamba VerandORO Orlando FL ..._. ..,__. 473702xxxxxxS648 003 7 725547 59455?McC=5814 .,... . ... 20.22 ........ ... oi24 ....... neck Cro Purc�ase 0612 Us's z bu ks o 2c brlan-to pl ............... 473702xxxxxx5648 2837 72655829054> 6/24 -• -- MCC 5814 � 36.42 Check Crd Purchase 06/27 Termrnat 01300rlando FL 473702xxxxxx5648 1 17273 947882 7 6/24..._. .. 38.24 ... . ........._. - -�-- McC 5947 .- Check Crd Purchase 06%27 Outback 1059 Kissimmee FL 473702xxxxxx5648083172047276456 7 """'- "°°•---------•--.- McC-5812 731.77 , Check Crd Purchase 0622 P r"kin g 0140 Orlando FL 473702xxxxxz5648 7637734%86341577 McC 7523 ...... 16.00 .........._............-... 6/24 Check Crd Purchase 06/228utterbeer Caro0900ilando FL 473702xzxxxx56482831735576495487MCC 5814 53 75 624 Check Crd Purchase 06/22 Grkus McGurku0090 Orlando FL _ 473702xxxxxx56482831 73616746570> McC 5874 37-68 '"` -- Check Crd purchase 06%22 Grkus McGurku0090 Orlando FL- "-`-"` 654 473702xxxxxx5648 003 7 73631829252?McC=5814 Check Crd Purchase 06%221oa Gnnabon 0090 Orfz;d l .......... 4 73702xxxxxx56480031736890195407 w4.25 ..._....... ._-................-McC=5814 Account number:iNNM5437 r June 1,2013-June 30,2013 ■ Page 5 of 7 Transaction history (continued) Check Deposits/ Withdrawals/ Ending daily Date Number Description Additions Subtractions balance 6124 Check Crd Purchase 06/22 Shell Oil 57542548 Kissimmee FL Si.82 473702xxxxxx5648 383174105002642?MCC=5542 624 Check Crd Purchase 06723 Marathon Petro1294 Sanford FL 329 _ 473702xxxxxx5648 163174346152489?MCC=5541 -._ 1333,... ..1333_. -_,.._...0 ... _.,.. ...w..nm. Hall 624 - �POS Purchase-06!23 Mach in OD0000 Exxonmobil POS HaUfax 64.23 NC 5648 00000000551946849?MCC=5542 _ _ _ ... 3333. . ., .._ ...-. 3131. ... ... .. P 3311 .._. .. . ............. 6/24 POS Purchase-06123 Mach ID 000000 Wai Mart 5u er � � � � � � � �� -67946 MechaniCSbur4pa 5648 00000000744489060?MCC-5411 .. .. ... he; . .. 3313_ . .. .............._ .. _ ......_..... 6124 Check Crd Purchase 06!24 Redbox*Dvd Rental 866-733-26931L ��-�� 27.98 74,931.96 473702xxx 6648083175118649510?McC=7841 -3333 ;rch _ ._........ ._..._......_ 3-77 - . ..........._ 3333.. 6!25 Check Crd Purchase 0624 ApI*Apple lkunes 5866.7}2-7]53 CA -� - - 129 473702xxxxxx5 648003175091592769?McC=5735 . .... .............._.,...»,......_.........r.._.T._.__..__.._.._«_,._.r�_.....�._.�.._._...-_....�........ ._,...,�.-e.1333_.. _w,.._ ._...,.,,.,...,..,.5,00 6 5 773 Check 5,000.p0 9,930.67 3313.. . ... ........... . ................ ............. 3333-._...... .__..... ._....... 3333...1333. . ............. ..........._... _..........__. .._..._,.. fi126 ,Deposit Madeln ABranch/$tore 800000 3333. 1333 ... -..._..._.,. ..__...__. _ ...,.........__.. .. .,.,,,.........._ ........._._,._,.. _....... ........_'_......._,...-.......M 6126 POS purchase-06125 Mach l�DOOt>DD Target T2202 Target T2 73995 .Mechanusburgpa 564800583177052527812?McC 5417 . 1333. 3333 .. . - 3333 ... . _ ............. ....,_..... , ._..._,..._. .._.,_.._ ^`',..Chase-6526,.a.,h ID 000000 H PA Lancaster PA 5648 131.00 a brzb �, 00303177698091124.McC-5311 v 3333 ... ,_...... ..... ... .........- . Park .. .. ._............ ............. 6126 POS Purchase-0626 Mach(D 006000 Journeys 7463 Park Ci 121.97 -= Lancaster PA 564800303177716313535?McC 5661 _ o 3333 _. _0 se- . 626 POS Purchase-66126 Mach ID 000004 Forever 211nc Camp Hill 766.40 X PA 5648003837777903172$3?McC=5621 6 0 .__,_,._....._..............._.,_,,.w...._.._.-....m 3133.-,,.. t2b P175 Purchase 06/26 Mach ID 000000 Hco 30484 Lovter Allen PA�. 1930 ,�, 5648 00000000349839452?McC=5691 ._._....... 33,33 ._....._ . ,,. .,. 3567 Capital - 64.99 z Camp Hill PA 5648 00303177796843121 ?McC 5661 z .. ._..._..__.__ -' 3131_ ,-06 Mach 333.3sha .. 333.3..... ....,_..........., -.. 6/26 P05 Purchase-06/26 Mach ID 000000 Ntarshalis Marshalis 166.44 z Mechanicsburgpa 564800303177827136661?McC 5651 _ z 3333 b a ... .. . ._. 3331. . . ........_. ................ _.,. 3333 _3.112_ POS Purchase-06/26 Mach ID�D00000 Dicks Clothing HamFden 79054 �� 16,930.72 Z Towns 564$00000000854297783?McC=5655 _ .. .. 3333 . ._ .. .. ____. ....._... .___....__... ._ -3333. . . ........ 627 Check Crd Purchase 06!26 McDonaid`s F5l)50 Harrisburg PA 72.51 Z 473702xmx 5648083177618180267?McC-5874 z 6/27 -� � �- - - Check Crd Purchase 06/26 The Restaurant Sto Camp Hill PA 76.29 16,841.26 z 473702xxxxxx5648163177762451549?McC=5046 d _ 3333«..................,. ...._.__,..,._...,.,_..... _ - 3113... .__, ._._.__. , ..,.. .,....,.....«.3333.»,,.,,._._.._.._,_...,,,,, .mm......,.,._ _ ..,._.._._.._....,..._...,„_ °w 6/28 Check Crd Purchase 06/26 EI Puebiito Mexico Lancaster PA 194 6, 0 473702xxxxxx5648083177647578324?McC 5499 ... ......3333. ,.. .... .,.,. ._....._. _ ......,_ ._ .-......._, ... -.. , n° 6!2$ Check Crd Purchase 06126 Apple Store dR304 Lancaster PA 705.90 w� 473702xxxxxx5648 083177723147110 7McC=5732 a, ._.......__._ 3333. 6128 Check Crd Purchase 06!27 Famous Famrgiia Washington OC 4626 473702xxxaxx 476 5648 163178342406 ?McC=5812 3333. .. 3333. . _ .._.._ _ 3333 ......_ - .. 3333 w ... 3333 _ .............. ..._._ 6128 Check{rd PurCh2se 06!27 Turkey Hill#280 Enola PA 7755 473702xxxRax5648 083178245647277?MCC=5542 0 __er _,.,. 1111_ 6%28 -'� Interest Payment � �� 014m '�� - 76592.22 ° 3333.. ........... ... _._..... 3333 3333 _..__.__. ..._....... .-........ ......,..-. ......_... ..3331.. ............. .......... Ending balance on 6130 16,592.22 Totals $23,607.41 $22,516.54 The Ending Daily Balance does notreftectany pending withdrawals orholds on deposited funds thatmay have been outstanding on your account when your transactions posted-/f you had insufficient ovotloble funds when a transaction posted,fees may have been assessed. Summary of checks written(checks listed are also displayed in the preceding Transaction history) Number Date Amount Number Date Amount 713 6/25 5,000.00 716' 6120 200.00 *Gap incheck sequence. Accountnurnber:% 5437 0 June ),2013-June 30,2013 • Page 6 of 7 Summary Of Overdraft and Returned Item fee(s) ------ t6tai_6�e�dTaft 0 e.j� Total this statementperiod F T TarOlYeCNO-cratIt otal Returned Item Fees ___S0.00 t reflects assed r twve-nie since fiat fullstor, Ww D TCFCU Account number:380IM437 ■ June 1,2013-June 30,2013 ■ Page 7 of 7 • Worksheet to balance your account General statement policies for Wells Fargo Bank Follow the steps below to reconcile your statement balance with your It To dispute or report inaccuracies in information we have furnished to a account register balance. Be sure thatyour register shows any interest Consumer Reporting Agency aboutyour accounts. You have the right to paid into your account and any service charges,automatic payments or dispute the accuracy of information that Wells Fargo Bank,N.A.has ATM transactions withdrawn from your account during this statement furnished to a consumer reporting agency by writing to us at Wells Fargo period. Servicing,P.O.Box 14415,Des Moines,fA 50306-3415. Please describe the Enter the ending balance on this statement 5 f specific Information that is inaccurate or in dispute and the basis for the dispute along with supporting documentation. Ifyou believe the © List outstanding deposits and other information furnished is the result of identity theft,please provide us with credits to your account that do not appear on an identity theft report. tothe right, . Enter the total in the column M In case of errors or questions about your electronic transfers, to the right. telephone us at the number printed on the front of this statement or write Description _Amount us at Wells Fargo Bank,P.O.Box 6995,Portland,OR 97228-6995 as soon as ----- ---- you can,if you think your statement or receipt is wrong or if you need more information about a transfer on the statement or receipt. We must hear from you no later than 60 days after we sent you the FIRST statement on which the error or problem appeared. t.Tell us your name and account number(if any). 1 2.Describe the error or the transfer you are unsure about,and explain as Total $ } $ cleady as you can why you believe It is an error or why you need more G information. ° 0 Add 3.Tell us the dollar amount of the suspected error. �A and to calculate the subtotal. 5 o We will investigate your complaint and will correct any error promptly. If n 0 List outstanding checks,withdrawals,and we take more than 10 business days to do this,we will credit your account a other debits to your account that do not appear for the amount you think is in error,so that you will have the use of the on this statement. Enter the total in the column money during the time it takes us to complete our investigation. 23 to the right. In case of errors or questions about your Direct Deposit Advance" z service z Numbed, Description i Amount zz I— If you think your bill i5 wrong,or if you need more information about a z transaction on your bill,write us at Wells Fargo Bank P.O.Box 6995, z Portland,OR 97228-6995 as soon as possible.We must hear from you no z later than 60 days after we sent you the first bill on which the error or z problem appeared.You can telephone us,but doing so will not preserve z your rights. z in your letter,give us the following information: o 1.Your name and account number ° 2.The dollar amount of the suspected error 3.Describe the error and explain,if you can,why you believe there is an N error.If you need more information,describe the item you are unsure about. You do not have to pay any amount in question while we are investigating, f but you are still obligated to pay the parts of your bill that are not in °m question.While we investigate your question,we cannot report you as ° delinquent or take any action to Collett the amount you question. rn II Total 0 Subtract[0]from,,C]to calculate the I� adjusted ending balance. This amount should be the same as the current balance shown in your register. = $ ( alorow¢ns mega sank N.i Nlryhts reserved. 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S < < < N d � d D .a m 3 0 0 o L1 0-m °- •• u - m Z7 3 c m m O 4J f'n n 3 nCO 3 c _ A a m c 'c Mo o O o o 0 :0 _ T o m 0 m. y TA '° a m-a fwp mmoo m v O o O T OmoO -n ZCO w mop m a n n O X n >° ° O O Z Om m o F m 3 o OT Oo d m 3 m aw �o n a Zomo �o O mi SAWN 00 'o ZOO =4 c ro n m - 0 O 3 CO W an d o a m W n 00 a n a? ^ m c o v c to a •00 3 c c tl1 yj = M W n � O •c° m' m m 3 � _n •'-o m ~ 0 N d S W S m 0 0 O d Z, cc x c � a ry O c 2 , , o d m m S a m m 6 D O. J0C ry N (Q O O ro m m d n O X01 - 3mm `� d X G d ^ d d x 00 x m N D c 0 G O 3 m 2 ITI m `c N d c m •c° Ds a b am o _ ° O N 3 fmp m N 0 -0 ➢Oi m d M = 0 0 ~ N K O o ➢ X C 9 0 d v a � o c O CL > > �° f °' w 69 D �. ,Q• 3 o fp m o m o 0 0 o c p S N m o N r2 0 N N N O O o < 3 O m y O m 3 D X 3 � N 'Z w d fD 0 (O O � j ➢1 N W OI O) A N N fop REV-1510 EX+ (08-09) pennsylvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND RESIDENT EDENTTURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF TREJO, JOSE MERCED a/k/a Jose M. Trejo, Jr. FILE NUMBER This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV is yes ITEM DESCRIPTION OF PROPERTY NUMBER isfers;DE mE NWE Of THE TRANSF F,TIFM REUTONSNm TO DECEDEAND DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE F TIE DEED ny REq a,,,M. VALUE OF ASSET INTEREST (tEgaRUCaaiE) VALUE 1• Effective 1,2013, Decedent transferred various percentages of his interests orporations listed on Schedule C-1 and the Partnerships listed on e C-2 to his wife,Monica A. Trejo,for the consideration of$100.Th are outlined on the attachment to Schedule G. TOTAL(Also enter on Line 7, Recapitulation) $ 0.00 If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+ (08-13) , pennSylvania SCHEDULE H '' DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE DE EDENT RN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF TREJO, JOSE MERCED a/k/a Jose M. Trejo, Jr. FILE NUMBER 21 13-0850 ITEM Decedent's debts must be reported on schedule I. NUMBER DESCRIPTION A. FUNERAL EXPENSES: AMOUNT 1, Funeral 2. Thank you cards and postage 15,000.00 35.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) street Address City -s— --------_....._ State_ZIP Year(s)Commission Paid: Z. Attorney Fees: 11,500.00 3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation.) 3,500.00 Claimant Monica A. Trejo Street Address 5538 General Knipe Circle city Mechanicsburg state PA ZIP 17050 Relationship of Claimant to Decedent Spouse 4. Probate Fees: 418.50 5. Accountant Fees: 6. Tax Return Preparer Fees: 7. Advertising Fees-Cumberland Law Journal&The Sentinel B. Postage,copies, Notary-Nicholas Law Offices, PC 285.78 50.00 TOTAL (Also enter on Line 9, Recapitulation) $ 30,789.28 If more space is needed, use additional sheets of paper of the same size. REV-1512 EX+(12-12) pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, 1NHERrrANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER TREJO, JOSE MERGED a1k/a Jose M. Trejo, Jr. 21 13-0850 Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unraimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1' Mortgages A.Cowen Loan Servicing,LLC-Loan##xxxxxx1092- 99,624.49 on 507 Erford Road,Camp Hill,PA 17011 -owned soley in decedent's name B.PNC Bank-Loan#xxxxxxxxxxx3910-Balance of$172,080.77 86,040.38 on 5538 General Knipe Circle,Mechanicsburg,PA 17050-owned as Tenants by the Entireties C.Bank of America-Loan#xxxxx0982-Balance of$118,865.95 59,432.98 on 75 Pine Hill Road,Enola,PA 17025-owned as Tenants by the Entireties 2. 2013 Real Estate Taxes A.507 Erford Road,Camp Hill,PA 17011-owned soley in decedent's name 1,635.16 B, Center St.,Enola,PA 17025-owned soley in decedent's name 952.14 C.5538 General Knipe Cir,Mechanicsburg PA 17050-owned as Tenants by the Entireties-$5,511.36 2,755.68 D.75 Pine Hill Road,Enola,PA 17025-owned as Tenants by the Entireties-$2,792.25 1,396.13 E.596 Belle Vista Drive,Enola,PA 17025-owned as Tenants by the Entireties-$3,060.38 1,530.19 F.4703 Duke Street,Harrisburg,PA 17109-owned as Tenants by the Entireties-$1,24724 62162 G. 125 Earl Avenue,Harrisburg,PA 17109-owned as Tenants by the Entireties-$2,569.88 1,284.94 3. Sewer/Trash on 507 Erford Road,Camp Hill,PA 17011 -owned soley in decedent's name 2,895.65 4. PNC Bank Loan#xxxxx1426-Personal loan to decedent,Monica A.Trejo,Vidal 0.Bravo and Carmen Bravo-Balance of$577,800.54.Decedent's proportionate share is 25% 144,450.14 5. DCM Services-Chase Bank USA,NA Acct#xxxxxxxxxxxx7567 1,489.78 6. SVA School of Visual Arts#1012519-Tuition for son(Victor Trejo) 25,323.00 7. FACTS Management Company-2013.14 Trinity High School Tuition for daughter(Vanessa Trejo) 6,575.00 8. Apicella Lorei Orthodontics#081310 orthodontia services for daughter(Joanna Trejo) 2,496.00 9. Apicelia Lorei Orthodontics#081315 orthodontia services for daughter(Vanessa Trejo) 2,63100 10. Verizon#7175851650-Open account 900.00 NOTE:Estate denies liability for claim filed by Maria Franco for$31,000 vs.the Estate TOTAL(Also enter on Line 10,Recapitulation) $ 442,036.28 If more space is needed,insert additional sheets of the same size. -. ..-- Qewen fawn Servicing,LLC �AccOUn!Statement I Account Number: 4MOM052 Account Statement Date: 00!1712013 g °E° Property Address: 507 Erford Road NMLS 1862 Camp Hill PA 17011 YC PeN CUSTOMER CARE CENTER 1400.7`1612916 GURR Page 1 Your tali may Da mearded forMe coaching and development a mrasswistes. Special-Notices . CLAIM YOUR$40 CASH BACK FOR GAS TODAY! See the special offer for U-S.homeowners for$40 back on 2FP 02466/0054391OD49670029 2ACQDJ5 your gas purchases and a free review of the home service JOSE M TREJO plan that can save you thousands.Please reply before: 5888 GENERAL KNIPE DRIVE 10131113! MECHANICSBURG,PA 17050 - Reduce your financial burden when your home is impacted by a disaster or you involuntarily lose your job.Let First Protector pay your mortgage for you. Visit www.OcwenFirstProtector.egm or gill-877479.3947, 8am-8pm E.T.for more information. DetOlsoflcomlung Current principal fWance: kmouROue- 99,624.49 Cunnt Amount Due: Interest Rate: .+ 8.95000% Principal: 114.64 Nod Payment Due Date: 07OWD13 k>lEmst 743.03 _ Current Escrow Balance: 1,376.65 E&onvc 263.41 intermt Pad Yeal'-TO-0 ale: 4,476.11 Current Amount Due by 07101113: 1,061.08 Tares Paid Yearv7o-Date: 451.84 Assessed Fee-Evense Outstanding Beginning Principal Balance: 100,313.61 Late Charges: 42.88 Prii RaduPIMS Year-To-Date: 689.12 PrewReNmed CheCk Fee: 4000 Beginning Escrow Balance: $17-00 Torn FeewExpense Outstandnna: 82.88 Escrow DepaRts/Adjustments Year-To-Daw 1211.69 Total Amount vile: 1,143.96 Escrow Disbursements Adjustrnenis Year-TO-Date: 451.84, Recently Assessed Amaorrts: Map=3 Later Charges_ _ _---- 42.86 TINS i5 the pm+caz!4alanrx onry 90t h2 amsa,zrequtreC to paYywrv:wuMinfllti. 'Recent Account Activity _ Date Description It Printipal Interest Escrow Optional fate Citarges FinatOtha' Suarense Totdi 06!10!13 Payment Reversal i 1129& 744.72- 200.79-. 1,058.46 06l12I13 Payment 112.95 744.72 203-41 I 1,oG1.08 0&112713 Payment + 113.791 743.88 19$.17 1 1,055.84 (FmPSrY+3rtM.'ages _. wemay retortninformiaten cotyour coattm cmtt Fair Cr,tat¢payments,t go to ,RO.ss.errone.aetavto myour acewnt mayce refl«#w in your Wean report.To obtain intartnation'aboutyour ngMS undei the Fate Credo Reporting Act go tD wWwits eovlcred R. U you arecurrendy in!anknOt yor if yw hayseed forbarkn+pi%since Inaireng Shis ban,please read the bankruptcy information Provided on the back of this statement. p}aazerpta;Platyour mmNtWpaymerttarnauMhaschanged to 81,060.91 eRecUve OW12D13.Fuftflar detail regarding the meson for this cFRngswM be included in 3separate,letter.. ,�J ;t FO{DAND PLEASE DETACH Me RETURN aorioM PORTION Wmf PAYMENT WTHE ENCLOSE)ENVELGPEWtiH ADDRESS V*8E . FOLD AND DETACH HERE PLEAea M HOTSENO CORRESP NDENCE Wm:YOUR PAYMENT-MAYS WRRC YOUR ACCOUNT NW41BER Q YWR CHECK. DETACH HERE .b&]➢WO96%KAWSYiiET.911CCpZ:: 011288309995 00000000000000000000000042888 000000706531092 50 001143960 IPaynrent Goupon Account Number Jose M Trejo (�L chertc iorenenge of�ntomaUOn 0706531092 F l entl xere�wrse sitln otmupon. O C W E N AMOK DUE S -1 143.96 K Received attar071712013 add Lace Chergeoh $;__..._ 42.88 T0relAmw.nt Duewfth Late Chagle: $�_- s.a'a� r'tk4ikll""I➢fFkffft''fI'fiP'n•tt^vhi•'f1i1r4Pthfl' Not tfY—ieen+beurt[L any Aidikona Principal: $ .__, j 00WEN ettess funds us 5rst te 4mrec M PO BOX 6440 wtapM;ng ,Madue nnc rrten Adddtii al Escrow. $rte CAROL STREAM IL 60197.6440 a44aionai pnncipa. Late Charges: $! Other-tP,eeaesrearn S[_.-....._„1 Total Erxased: $ —- - - - - - - - - PNOBANK, NATIONAL ASSOCIATION 00479304 m Box 535238 00001 For Incluirlas Please Call P1TrSWM MH, PA IS -5230 1-888-762-1099 S.I.N. 22-1146430 JOSE M TREJO JR 40 5538 GENERAL KNIPE DR MECHANICSBURG PA 17050 2013 t xxx-xx-5473 THIS STATEMENT IS A FORM 1098 OMB NO.15454901,OR A FORM 1098-E OMB NO. I545.1576, OR 1092-A OMB NO. 154""T OR 1099.8 OMB NO,1545.0715 OR 1099-C OMB NO. 1545-1424, OR 1039-DIY OMB NO.1545-0110 OR 10994NT OMB No. 1545-0112 OR 1099.MtSC OMB No. 1545-0115 OR 1029-OID OMB NO. 1545-0117 U.S.INFORMATION RETURN 2013 - 1098, MORTGAGE INTEREST STATEMENT ACCOUNT NUMBER INSTALLMENT low wAmmommomm"3 9 10 Box I MORTGAGE INTEREST* 6,482.28 TOTAL BOX I INTEREST 6,482.28 OUP, VOCAMATXM AND 13 SEM FURNMED TO THE RKEp1FALAEYEkDE BERYICBIFYDO ARE MKMERITOMEA RETURN.A NEOUGENcE PENALTY ORCINERSAVETION MAYBE AMPOSM ON YOU WTHF M M"MINES THAT AM MEAPAYMENT CFTAX RESIA.TBSECAUeEYOU OYERSTATEO XCECUCTR)W CR 1310 PUT REPORT CORRECT AMOUNT& -FORM IMCAUTPOW.THE AMOUNTSHOWN MAY NOT BE rALY DW=V"BY YOM UUMSASEDCH THE LCANAMC)UNTAMTHE COST AND VALUEOrTHEEECUROPRCEEM WAY Appoll ALSO,YoomAv ONLYCEDUCT WEEREWTOTHE EXTENT rrWASINCURRED BY YOU,ACTINL.y PAID NYYOU,AM NOT RENWASMIED BY -FORM 1099-OV.TWBMAY NOT BETHS CORRECT FK]URE TOREPORT ON YOUR OCOW TAX RETURN, PLEASE REFER TOTHE MYRUCTMES OMTHE SACK OF THMUTATEMENT. COPY W-CA lVe,a il'$% 4C�j44 ( REV-1504 EX.(9-I2) SCHEDULE C pennsylvania DEPARTMENT OF REVENUE CLOSELY-HELD CORPORATION, INHERTfANCE TAX RETURN PARTNERSHIP OR RESIDENT DECEDENT SOLE-PROPRIETORSHIP ESTATE OF FILE NUMBER TREJO, JOSE MERCED a/k/a Jose M. Trejo, Jr. 21 13-0850 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 NUMBER VALUE AT DATE NUMBER DESCRIPTION OF DEATH t, Trejo Enterprises,Inc. 113,207.00 2 El Rodeo of Carlisle Pike, Inc. 65,398.00 3 El Rodeo of Hanover, Inc. 14,700.00 4 6417 Carlisle Pike, Inc. 28,000.00 5 El Gran Rodeo, Inc. 35,349.00 6 El Rodeo, Inc. 29,213.00 7 Mi Mariachi, Inc. 52,500.00 8 Mi Rodeo,Inc. 17,640.00 9 Mi Hacienda, Inc. 57,750.00 10 Mi Guadalajara,Inc. 93,765.00 11 Arellano Corporaiton 10,265.00 12 El Rodeo of Swatara, Inc. 73,544.00 13 Degollado,Inc. 186,725.00 14 Abeulos, Inc. 48,222.00 15 2818 East Market Enterprises, Inc. 69,127.00 16 Trejo,LLC 73,500.00 17 Casa Fiesta Mexican Bar&Grill,Inc. 28,000.00 18 Arellano,Trejo Bravo&Arellano 32,978.00 19 Arellano,Trejo&Bravo 21,427.00 20 Arellano,Bravo,Trejo&Trejo 2,573.00 The Estate claims a minority percentage discount to be applied to the valuation of Decedent's minority equity position in the above entities which are outline on Schedules C-1 and C-2. The inability of Decedent to sell his interests reduced the value of his minority equity position against the total enterprise value of each entity. TOTAL (Also enter on line 3, Recapitulation) $ 1,053,883.00 (If more space is needed,insert additional sheets of the same size) Trejo Jose Schedule C-I attachments scofest SCHEDULE C-1 CLOSELY-HELD CORPORATE STOCK INFORMATION REPORT ESTATE OF: FILE NUMBER TREJO,JOSE MERCED a/k/a Jose M. Trejo,Jr 2113-0850 MASTER LIST OF ATTACHMENTS FOR ALL CORPORATIONS ITEM A. Detailed calculations used in the valuation of decedent's stock. Attached hereto ITEM B. Complete copies of US Form 1120 for the years: 2009,2010, 2011, 2012 and 2013 Attached to individual C-Is ITEM C. Real Estate Owned by the Corporation Deeds and fair market value information attached to individual C-I Is ITEM D. Principal stockholders, number of shares held and relationship to decedent Attached hereto ITEM E. Officers, salaries, bonuses and benefits received Attached hereto ITEM F. Statement of dividends paid each year Attached hereto ITEM G. Other information No attachments REV-Iso8 EX+(o8-tz) pennsylvania SCHEDULE E DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RE4DENr DECEDENT ESTATE OF: FILE NUMBER: TREJO, JOSE MERCED a/k/a Jose M. Trejo, Jr. 21 13-0850 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. Wells Fargo Acct#xxxxxx5437 16,592.22 2. Ameritrade Acct#xxx-xx8945 2,037.58 3, Metro Bank Acct#xxxxx6886 101.00 TOTAL(Also enter on Line 5, Recapitulation) $ 18,730.80 If more space is needed, use additional sheets of paper of the same size. Complete Advantage° Checking Account number:301IM437 ; June 1,2013-June 30,2013 ■ Page 1 of 7 DCDP11DTAK 01!257 I . Id 1 1 1 1 III Irrll n1L lulu r II r Ihlr Questions? III 11111 I III m IdI Illhll 11 JOSE M TREJO Available by phone24 hours a day,7 days a week: 5538 GENERAL KNIPE DR 1-800-TO-WELLS (1-800-869-3557) MECHANIC5BURG PA 17050-1676 TTY: 1-800-877-4833 En espahol: 1-877-727-2932 0 1-80O-288-2288(6 am to7 pm PT,M-F) Online: wellsfargo.com Write: Wells Fargo Bank,NA.(345) P.O.Box 6995 Portland,OR 97228-6995 0 n v 0 You and Wells Fargo Account options el Thank you for being a Wells Fargo customer.We appreciate your business and Acheck morkln the box indicares you have these understand that you are entrusting us with your banking needs.Let us assist you convenient services with youroccount. Go to z in finding the right accounts and services to helpyou reach your financial goals. wefisfargo.comor call the number above ifyouhove z Please visit us online at wellsfargo.corn,callus at the number at the top of your questions or ifyou would like to oddrtewservices. z statement,or visit any Wells Fargo stare-we'd Love to hear from you! Z Online Banking Q Direct Deposit [� s z Online Bill Pay C Auto Transfer/Payment(] Online Statements z E] Overdraft Protection z Mobile Banking Debitcard z z My Spending Report Overdraft Service Q 4 c> 0 Activity summary Account number: 2504095437 Beginning balance on 6/1 $20,501.35 JOSE M TREJO Deposits/Additions 23,60741 Pennsytv¢nr¢¢ccaunt rerr»s andconditfoas apply u Withdrawafst5ubtractions - 27,516.54 For Direct Deposit and Automatic Payments use o Ending balance on 6/3o $16,592.22 flouting Number(RTN): 031000503 v N m a> .Overdraft Protection This account is not currently covered by Overdraft Protection. If you would like more information regarding Overdraft Protection and eligibility requirements please call the number listed on your statement or visit your Wells Fargo store. Account nurnber:ANNW5437 ■ June 1,2013-June 30,2013 ■ Page 2 of 7 Interest summary Interest paid this statement $0.14 Average collected balance $17,143.09 Annual percentage yield earned 0.01% Interest earned this statement period $0.14 Interest paid this year $0.66 Transaction history Check Date Number Description Deposits/ Withdraevols/ Ending daily 6/3 _ ,Deposit Made In A Branch/Store Additions Subtractions balance 6/3 - _ 7,320.00 Check Crd Purchase 05%31 Turkey Hill W280 Enola PA'�� "'" 473702xxxxxx5648163151470 768377?McC 5542 ......... 58.55 .._..,......._..... o° _.......... _ Check Crd Purcnase 05/31 Waffle House 7452 Harrisburg PA -"" �- -`" 24 61..._.»..... .._..._..._, 6/3 ............ . .473702xxxxxx5648003151527701912 7MCC 5612 Check CrC Purchase 05/37 Apl`Apple Itunes 5 866-712-7753 CA _- 473702xxxxxx5648003150583818937?MCC 5735 363 6/3 ........ .... .. Check Crd Purchase 05/31 All Pro West Mechanicsburg PA ............... 6/3. . ......... 473702xxxxxx56 040 48 763751625527?McC 5533 847 Check Crd PUrchase 05731 Red Lobster U50000 Mechanicsburg ....._... ..._..... ......_.._. PA 473702xxxxzx5648383751715913007 7McC 5812 53.34 Check Crd Purchase05%31�Turkey Hill k280 Enola PA..._..... - 3702xxxxxx5648283751800307250?McC 5542 6/3 47POS°urchase-O6%Oi Mach ID 000000 Target T2202 Targe[72 Mechanicsburg pa 5648 004631526849.72888?McC-5417 -POS Purchase-06/07 Mach lb b0000b Dicks clothing Hampden -- °""`` .........589.27........,...... ................. 6/3 TOwnspa 564800000000544080274 MCC=5655 ....__.. ...... POS Purchase-06/01 Mach ID 000000 Giant 6263 Enola PA �- - 00583753066086689?McC=5477 86.75 6/3 POS Purchase-06102 Mach ID 000000 Best Buy 1478 317.99 echanicsburgea 5648 0000000045 7 218 7 33?MCC=5732 6/3 - ._._.. .._ . _ _. _ POS Purchase 06/03 Mach ID 000000 The Home Depot � "-"�� ".. ' 14.80 __ ,-..,. Harrisburg PA 564800000000859060827?MCC 5200 20,372.75 ..._... Check Crd purchase 06/03 Sweet Frog 200081 Mechanicsburg PA ', 473702xxxxxx5648283155047474464 McC=5874 7807 20,354.68 = 6/5 -...... .. N Check Crd Purchase 06/04 Apl"Apple Itunes 5 866 772-7753 CA" - -'""' 473702xxxxxx5648083154849204530?MCC=5735 1032 20,344.36 6/6 .... ._ ...... Check Crd Purchase 06/04 Outback 3927 Mechanicsburg PA - .,,....473702xxxxxx5648 083155748710327 7MCC=5872 47 86 676 Check Crd Purchase 06/05 The Restaurant Sto Camp Hill PA 4 3702xxxxxx5648163156 775576866 7McC=5046 549 POS Purchase 06/06 Mach ID 000000 The Home Depot 4720 PAernari sburgpa 61 8 00 83157710y 13601 NcC 5400 7>27s- C h rawal m Branch/Store 6476 Carlisle Pike "'-'""" ""°""'-""°-w Mechanicsburg urg Pq 5648 tg g7 8.26 Check Crd Purchase 06105 Mortar Health Syst479-6369291 AR 6/7 3,497 473702xxxxxx5648283156726409275?McC=8099 Check Crd Purchase 06/06 McDonald's(5050 Harrisburg PA ............ 473702xxxxxx5648 163757667268928?McC=5874 8.55 6/7 POSPUrchase 06/07 Mach ID 000000 G12nt 6005 '" '- ---- 916 Mechanicsburgpa56480058't B'u 667 We' ?McC 5411 75303.55 6'/10 Check Crd Pur 648 06/07 Best Buy 0001 Mechanicsburg PA " --` -- -,_ 473702xxx;4x5648613160546475755>MCC 5732 6%70 473702xxxxxx5 .,� Check �riaaysTi�64 C 5812anicsburg°A - _'" ---- Check Crd Purchase 06/06 Bed 6/70 ....... ........... ..,........... y Mechanicsburg PA .473702xxxxxx5648 0037 57697674135>MCC=5719 15.89 6/10 ..... ..... .... Check Crd Purchase 06/07 Apl"Apple Itunes 5 866-712-7753 CA ' 473702xxxxxx5648 003158418599277?McC=5735 Account number:wAONW5437 0 June 1,2013-June 30,2013 ■ Page 3 of 7 • Transaction history (continued) Check Date Number Description Deposits/ Withdrawals/ Ending daily 6/10 POS Purchase-06/07 Mach ID 000000 Giant 6263 Enola PA 5648 Additions Subtractions balance 00383759060004083?McC=5411 68.06 b/10 POS Purchase-06/08 Mach ID 000000 Turkey Hill Mini 2060 Enola PA 5648 00303159697926231?McC=5542 47.97 6/70 POS Purchase-06/08 Mach ID 000000 Turkey Hill Mini 2060 ........ EnoIa PA 564800383159695359102>MCC=5547 11'59 6/10 ...._. POS Purchase 06/08 Mach ID 000000 Exxonmobil POS Greencas PA 5648 00000000656620550? 5.35 ""' - ��- McC 5541 6/70 POS Purchase 0609 Mach ID 000000 Wal Mart Super Roanoke VA 564800000000454655/90?McC 5477 4947 75,3j6.99 6/71 Depos[MadelnA Branch/Store� �'�__.. 13 969 28...... ........1.6/11 Check Crd Purchase 06/70 Turkey Hill;<280 Enola PA ..... ,,,.,..,, 473702xxxxxx5648003161698572373 7McG=5542 74 08 __..... ....._ 6/77 _.c Check Crd Purchase 06/10 Hoyt Harrisburg 14 Harrisburg PA 2000 ....... ....... ...- ....,.__ - .. _ xxxxxx5648 1631620817373977McC-7832 6/71 POS Purchase-06/71 Mach ID 000000 Ross Stores t0 York PA- 5648 00000000554893863>MCC=5370 9.99 POS 17 ,__...,._.- Lancaster PA 5648 00383/6282 7 035707>MCC 5661 17999 _ 6/ POS Purchase 06/11 Mach ID 000000 Forever 27 Inc Lancaster"-`_��-�'-'-'"""""""'- '-- --- -- _ PA 564800383162826432572?McC 5627 8960 0 ,..... . urchase-06)71 Mach iD 000000 H M Lancaster POS P PA 5648- ............. 169.35 s ....... .._..,.,,.,,,. 0058316283457TS65?MCC-5311 0 6/77 _.. _ POS Purchase O6/7-7 Mach ID 000000 A F 76448 Lancaster PA _-�� - .' .-..�.' ... ......... N -__ 564800000000656336790?McC=5691 103.79 ..." Check Crd Purchase 06/11 Redbox'Dvd Renta1 866-73 3-2693 1E _..._..... Z 473702xxxxxx5648283762164579022?MCC-7841 7.63 z ,.,_ _ Withdrawal Made In A Branch/Store '" -' -°"-'-" -• .... ......... ..._. ._...-.. 2 6/72 ""' 30.0000 Check Crd Purchase 06/17 Apl"Apple Runes S 866 772 7753 CA .............5 752.44 z 5.85 Z 473702zxxxzx5648163162381352659?McC-573 z 6/12._ ....___......., .. ,,.. __.. .. Check Crd Purchase 06/71 Gnnabon Lancaster PA 473702xxxxxx5648283162846591337?MCC 5814 6/12 "-.° ,.._ ..".._,_-.. . --_"__"_ Z Trinity High Sch Farts 000000011782453 Jose M Trelo ''-- -- ......_ ................ 49)87 .. 6/73 Recurbebit Crd Pmto6/11 AUtopay/Dish Ntwk 800-894-9737 C0 ?G 76445 77877 ...-_.. _.. ,...,__.,.. 47 702xxxxxs.56480831623855789747MtC 4899 °o 6/13 ...Ev ...._...... Check Crd Purchase 06/17 Conner Apicella OR Mechanicsburg °A 473702xxxxxx5648163162572631252?McC=8021 192.00 0 6/13 ""`___..._ _._.,._.n,'"...-_., . Check Crd Purchase 06/17 Conner Apicella OR Mechanicsburg'-'_-' PA473702xxxxxx%482831625 729988707 202.00 ° McC=8027 "--Check _.- 473702xxxxxx5648003162 717415763?McC=5812 97.56 n 6/13 ....,._.. _ Check Crtl Purchase 06/11 Auntie Annes PA244 Lancaster PA��-�� -��_"-"' ... ............. .......... m 6/13...... ...... 473702xxxxxx5648283162845079738?McC 5814 937 � Check Crd Purchase 06/72 Turkey Hill k280 Enola PA � ° 78.51 -" 02xxxxzx5648083163365420566?McC 5542 m 6/13 -__. . . . . a Check Crd Purchase 06/12 McDonald's F14097 Lorton .....,,,- 473702xxxxxx5648,7637 o34978349877iLicC 5814 - Check Crd Purchase 06/12 McDonald s F3502 Emporia VA- -"" ... . 6/73-- --'____ 473702xxxxxx5648003163590494552>MCC 5874 73'.68 .. ._._...,,_ Check Crd Purchase 06/72 McDonald s F278i 0 Pt Wentworth GA 767 _..._-_-_._._,_........._.. 473702xxxxxx5648283763799552567?MCC=5814 6/73 ...... ...... POS Purchase 06/72 Mach ID 000000 Shell Service Station �� -"-..... - -.............--•-- _ Hawthorne FL564800463764068746646? 4.56 Kw chase POs Purchase-06/12 Mach ID 000000 Shell Service Station ........_ ..__ - �........ Hawthorne FL 5648 00463164064201864?MCC-5542 73.74 6/73 P05 Purchase 06/13 Mach ID 000600 Walgreens 70470 Roosev St Petersb�fl 5648 00463164568246781?McC 5912 23'71 6/73 " __..., .... __..._....-., POS Purchase_-06/13 Mach ID 000000 Pubhx Super Mar 535 T' "-"-"'""""""-'•-'---------"------•--,."" .. Venice FL 564800303164707202889?McC 5417 131.31 79,800.36 6/74":_._,. ........_,._.-. hec„.._ Check Crd Purchase 06/72 Exxonmobil 4752 Emporia VA'� " " -'-_.'_".`-. _"„„ ......._83.73 ........ 473702xxxxxx5648 383163595172789?McC=5542 ..... ...._....._ ......_.............. ._._..__... ...........,...... .... .................. .......,.... Account number: 5437 s June 1,2013-June 30,2013 ■ Page 4 of 7 Transaction history (continued) Check Deposits/ Withdrawals/ Ending daily Date Number Description Additions Subtractions balance 6/14 Check Crd Purchase 06/12 Wilco 930 0000 St George SC 73.79 19,642.86 473702xxxxxx5648 163163747294614 7MCC=5542 6/17 Check Crd Purchase 06/12 Taco Bell A026018 St George SC ""�`-""`"-""""'-"12_j8�`-"'°' "----•°°°` 473702xxxxxx5648283163757686146 7MCC 5874 ..._,.__.,...., ,,.._.. . ..._......._. ,".... ..__ 6/17 Check Crd Purchase 06/13 .... 3969,........._... ,............. 473702xxxxxx564838316453 7324812?MCC=5542 6/17 POs Purchase-06/15 Mach ID 000000 Target T1078 Target Tl "'" _ - .........706.97 ....... Greensboro NC 5646 00383166591096007 7McC 5411 6/77 ........._... ... . .. Check Crd Purchase 06/7S�NICDOnald's F70607 Greensboro NC -- 9.80 473702xxxxxx5648283166608314889?McC=5874 POS Purchase--06/76 Mach ID 000000 Exxonmobil POs Greensbo ""` 68 NC 5648000000004422203327McC 5542 6/17 POS Purchase-06/76 Mach 10'000000 WaI Mart 52 9CIe � "-"'---°- 9 rmont 34574 79,716.80 FL 5648 00000000655719279.McC=5471 Check Crd Purchase 06/16 Sleep 1-nn-3-3-6--9-3-112,-7-2 NC_mm 8344 19,033 36 473702xxxxxx>648 283166611547858 7MK=3631 ChzckC„rurChase v6i i7'v'Jes.gaYe pickets I Orlando FL 788 00 473702xxxxxx5648 083168554870082?McC=7017 .. .. .........,. Check Crd Purchase 06/77 Westgate Tickets 7 Kissimmee FL '--- �� 25600 _.,..,_ _.473702xxxxxx5648 283168111624751 '+McC=7017 111.6/19 POS Purchase-06/19 Mach ID 000000 Kings Supermar 84.96 16.904.40 Kissimmee FL 564800000000557918669?McC 5411 _ - 28 473702xxxxxxS648 003169667 734207?MCC-5814 6120 2 28 473702xxxxxx5648 003170789483724 7MCC=0735 I 6/20 ....._. 776 -Check ......... ...... ........... ....... ._.... ... 6/21 Check Crd Purchase 06%18 Dpc Disney Tickets Lake Buena VI FL "`"" """""""' --`°"_'-"— --'------- 795.9fi 473702xxxxxx5648 163169604018694?McC=7996 6/21 "-m P05 Purchase-06/27 Mach ID0000000318 of 5g U51000v.-� - - 244.95 16,232.49 Orlando FL 5648 00583172770207345?.McC=5697 6/24 Check Crd Purchase 06/20 East Train StatiohLake Buena VI FL 473702xxxxxx5648 0831715253667027 3814 _,-............ McC=5947 6/24 Check Crd Purchase 66120 Auntie GraViry s Lake Buena VI FL "' -- a.79 473702xxxxxx5648 16377159789526E 7MCC=5874 Check Crd Purchase 06/20 Auntie Gravity's Lake Buena VI FL ` " 23.91 0 473702xxxxxx5648 0037 71591634720?McC=5874 6/24_,...._.. ...__. .... _._,_ _.._.... ...._ ......_ 473702xxxxxx5648 163177689096G497McC=5874 51 23 6/24 Check Crd Purchase 06/20 Aloha Isle Lake-Buena VI FL ' °"""' --�----- ---------- 473702xxxxxx5648283171733695117 ?MCC=5814 15 95 6/24 Check Crd Purchase 06720 Lunching Pad Lake Buena VI FL - ..473702xzxxxx5648 0031 71782491 7 50 7MCC=5874 6/24 ...... ......... Check Crd Purchase 06/27 Labamba Verand01200rlando FL �� '- ............... 473702xxxxxx5648 003172554159455 7MCC=5874 2012 or2v �i,eck Cro Purchase,"06/2 Us,Sta u As o 20 Or!ando Ft 473702xxxxxx5648 2837 72655829054?McC=581436.x2 ChWk ermn at 01300rlando F 473702xxx56481631727399478827MCC=5947 3824 6/24 Check Crd Purchase 06/21 Outback 1059 Kissimmee FL � �� "" "�`""""""`_"""'" 473702xxxxxx5648 083172047216456 7McC=5812 7 31 77 6/24 ... ...._........ .. Check Crd Purchase 06/22 P��rking 07400rlando FL 473702xxxxxx5 6481631734786341577McC-7523 7600 " ' ..... Check CrdP 5648283/7 55764954 ?McC=00rlando FL 5375 - ¢ 473702xxxxxx5648 283173557649548 7McC=5814 6/24 Check Crd Purchase 06/22 Cirkus Mcmurku6090 Orlando FL-- _ " 3166 473702xxxxxx5648283173676 7465707MCC=5814 Check Crd Purchase 06/22 Cirkus MCGurku00900rlando FL 38 91 473702xxxxxx5648 003173631829252?McC=5874 6/24 Check Crd Purchase 06/22 Ice Cinnabon 00900rlando FL 473702xxxxxa5648 003173689019540?MCC=5814 Account number:4MMIM5437 a June 1,2013-June 30,2013 ■ Page 5 of 7 Transaction history (continued) Check Date Number Description Deposits/ Withdrawals/ Ending daily 6/24 Check Crd 17in!06/22 Shell Oil 57542548 Kissimmee FL Additions Subtractions balance 473702xxxxxx564838_„,3174105002642?MCC=5542 51.82 ..,. Check Crd Purchase 06/23 Marathon Petro1299 Sanford FL "-'- -.... 473702xxxxxxS648 1631743461529897MCC=5547 329 6/24 P05 Purchase 06/23 Mach ID 000000 Exxonrnobtl POS Halifax'--'°.._,_._,.' NC 5648 00000000557 946849 7McC-5042 64.23 6724 POS Purchase-0623 Mach ID 000000 WaI Mart Super '-- MecCSburgpa,5648 00000000744489060?MCC-5411 619 46 hani 6/24 Check Crd Purchase 06/24 Redbox*Dvd Rental 866-733-2693 IL ........... ..._....... ...... 473702xxxxxx5648 083 7 75 7 186495 7 0>McC=7841 27.98 14,931.96 ........ 6 Check Cr.d Purchase 06/24. Apt"Apple Runes 5866-772-7753 CA -- - - ............. 473702xxxxxx5648 0037 75091592769?McC=5735 1'29 6/25 .__ ,._.__.__,_-_.`.... 773 Check 6/26 De os¢Made lnA Branch/Store 500000 993067 .°,...f... ...-.. 800000 ...... 6/26 POS Purchase 005'Mach ib 600000 Tirgei T2202 Target T2 Me[hamcsburgpa 564800583177052527872 7McC 5411 0,'26 S? chas -06.!26 ?ach ID OOOOOOH^dLanca..ter PP.5648 003037776980911247McC=5311 - POSPurchase-0626 Mach ID 000000 Journeys 7463 Park Ci __. � Lancaster PA 5648 0030317777 6313535 7 12 L97 ��------ McC=5667 _ 6/26 POS Purchase-06/26 Mach ID 000000 Forever�1 Inc Camp Hill � PA564800383177790311283?McC 5621 766.40 -- 6/26 __.-,.__..„._..-_°._..___._.._.._, T, POS Purchase 0626 Mach ID 000000 Hm 30484 Lower Allen PA"°-'"�-'-'"° - ° 56480000000U3498394527MCC=5697 ro .. ....,_... .,.-.."_..._ m POs'Purchase-0626 Mach ID-000000 FOOtLocke3567 z Camp Hill PA 564800303177796843127 7McC=5.661 Z 6/26 ._.... .. .. POS Purchase 06/26 Mach ID 000000 Marshalls Marshalls Z .. ..._....... Mechanicsb .166.40 urypa 5648003037J782 7136667 ?McC 5657 z POS Purchase 6/26 ...... .. . 06/25 Mach ID 000000 Dick Z s Clothing Hampden z z Townspa 564800000000854297783 7McC-5655 790.54 ��76930.12 Z 6/27 Check ad Purchase 06/26 McDonald's F5050 Harrisburg PA..._ z _ 72.57 ..'.. z 473702 xxzxxx5648083177618180267?McC 5814 z 0/27 Check Crd Purchase 06/26 The Restaurant Sto Camp Hill Pq'��'- `--'°""'"-' ' 473702xxxxxxS648 7631777624515497McC 5046 7629' 16.841.26 z 6/28 °..___.°_ .,.... ... _ Check Crd Purchase 06/26 EI Pueblito Mexica Lancaster PA � ° 473702xxxxxx564808317 76475783247MCC=5499 Check Crd Purchase 06/26 Apple Store 7R304 Lancaster PA - ° .......... .... ...... ............. 473702xxxxxx5648 0837 77723747710?MCC-5732 .... 105.90 ......... ° 628 ....... .. ._.. n Check Crd Purchase 06/27 Famous famigha Washington DC ................. ....46.26 ............ . ...... 473J02xxxxxx5648 1637783424064767MCC 5812 6/28... .. _ - m Check Crd Purchase 06/27 TurkeyHill%280 Enola Pq N 473702xxxxxx5648 083778245647277>McC 5542 77.56 Interest Payment- "'-'-"- ___ -'- Ending balance on 6130 6 59222 0 Totals 16,592.22 m $23,607.41 $27,516.54 The Ending Doily Balance does notreflecr any pending withdrawals or holds on deposited funds thatmay have607.outstanding on your account when your _. bansoctionsposted. lfyou hadinsuFf-cientovoiloble funds when a transaction posted,fees may hove been assessed. Summary of checks written(checks listed are also displayed in the preceding Transaction history) Number Date Amount Number Date Amount 713 6/25 5,000.00 716- 6/20 200.00 *Gap in check sequence. Ac_ount nutnber: 5437 ! June 1,2013-June 30,2013 ■ Page 6 of 7 Summary of Overdraft and Returned Item fee(s) Total this statementpenod Totalyeartodatei Total Overdraft Fees --- --- -- __ .. .. $0001__ Total Returned Item Fees - '-- — --- --- - $7000 t Yearvto-date total reflects fees assessed orreversed since first full statementpenod ofcurrent calendar year. 50 00 M 00 ; 0 r r ;. Account number:1NNIM437 S June 1,2013-June 30,2013 ■ Page 7 of 7 Worksheet to balance your account General statement policies for Wells Fargo Bank Follow the steps below to reconcile your statement balance with your a To dispute or report inaccuracies in information wehave furnished to a account register balance. Be sure that your register shows any interest Consumer Reporting Agency about your accounts. You have the right to paid into your account and any service charges,automatic payments or dispute the accuracy of information that Wells Fargo Bank,N.A.has ATM transactions withdrawn from your account during this statement furnished to a consumer reporting agency by writing to us at Wells Fargo period. Servicing,P.O.Box 14415,Des Moines,IA 50306-3415 Please describe the 0 Enter therending balance on this statement. ,s,-_`� - specific information that is inaccurate or in dispute and the basis for the dispute along with supporting documentation. If you believe the © List outstanding deposits and other information furnished is the result of identity theft,please provide us with credits to your account that do not appear on an identity theft repom this statement. Enter the total in the column U in case of errors or questions about your electronic transfers, to the right. telephone us at the number printed on the front of this statement or write Description Amount us at Wells Fargo Bank,P.O.Box 6995,Portland,OR 97229-6995 as soon as you can,if you think your statement or receipt is wrong or if you need more information about a transfer on the statement or receipt. We must hear ---` from you no later than 60 days after we sent you the FIRST statement on which the error or problem appeared, 1.Tell us your name and account number(if any). I 2.Describe the error or the transfer you are unsure about,and explain as + $ clearly as you can why you believe it is an error or why you need more information. Q Add �ry 3.Tell us the dollar amount of the suspected error- We and J to calculate the subtotal. = o We will investigate your complaint and will correct any error promptly. if s © List outstanding checks,withdrawals,and we take more than 10 business days to do this,we will credit your account o other debits to your account that do not appear for the amount you think is in error,so that you will have the use of the on this statement. Enter the total in the column money during the time it takes us to complete our investigation. to the right. M In case of errors or questions about your Direct Deposit Advances z service z Number unt z If you think your bill is wrong,or if you need more information about a z transaction on your bill,write us at Wells Fargo Bank,P.O.Box 6995, z Portland,OR 97228-6995 as soon as possible.We must hear from you no z --1-----f later 60 days after we sent you first on which the error or z 1( problem lem appeared.You can telephone ne us,but doing so will no[preserve Z your rights. z z In your letter,give us the following information: $ A 1.Your name and account number °o 2.The dollar amount of the suspected error 3-Describe the error and explain,if you can,why you believe there is an error.If you need more information,describe the item you are unsure about. You do not have to pay any amount in question while we are investigating, but you are still obligated to pay the parts of your bill that are not in m question.While we investigate your question,we cannot report you as ° N delinquent or take any action to collect the amount you question. � I t_ I Total s 0 Subtract[1]) from©to calculate the adjusted ending balance. 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N d O O rJ° a3 o co m c :0 <° 03 m ma �°-oo m mODo O .y.. D sm 0a dg n ^ D � DS -i -�iO [n �^ D n m c m T 3 S N = c 0 c c n O n m W N C-A 1 w w o c o o Comm. 3 n o > - mO o p c 3 � D m (O w O ae ojm ins 3 Ono A C N O n? O m J O c o 0 C O N (D a m O C L : 3 G N a h d N J n 0 O x N y ti 3 d o m co 3 N S -I O O O 01. �. C L Z n d N n o m m m O. x to N N d 0 N C S A d T J y N _ O X x y 0 0 C O 3 �. N z O X J CL y o m O W moo. o c m c x O O N O N J m X 0 n 0 y N m X J 0 J a v a � c O C ° J J ' c N O O O N O D' o, 3 o N .a. m m O O O O C O S N O y N m N d n N N. O .. J a 3 0 y m x c �c 3 M a N N N N N N Co T a {O O O O O N in m W A N N [00 1 F 4 REV-1510 EX+(08-09) pennsylvania SCHEDULE G �7 DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERRANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER TREJO, JOSE MERCED a/k/a Jose M. Trejo, Jr. 21 13-0850 This schedule must be completed and fled if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. DESCRIPTION OF PROPERTY ITEM MauDE THE NWE OF E TRANSFEREE,VEER REUTNMSHIP TO DCCEDErt AND DATE OF DEATH % DECD'S EXCLUSION TAXABLE NUMBER THE DAIS OFinaxsrsc ATrA ACOPY OF IRE DEW FOR READS AIE. VALUE OF ASSET INTEREST (IF�UCAHtE) VALUE 1. Effective January 1,2013,Decedent transferred various percentages of his interests in the Corporations listed on Schedule C-1 and the Partnerships listed on Schedule C-2 to his wife, Monica A.Trejo,for the consideration of $1.00.Those transfers are outlined on the attachment to Schedule G. TOTAL(Also enter on Line 7, Recapitulation) $ 0.00 If more space is needed,use additional sheets of paper of the same size. REV-1511 Ex+(08-13) -JrA"W--. pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND RESIDENT DECEDENT ADMINISTRATIVE ADMINISTRATIVE COSTS ' RESIDENT DECEDENT ESTATE OF FILE NUMBER TREJO, JOSE MERCED a/k/a Jose M. Trejo, Jr. 21 13-0850 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' Funeral 15,000.00 z. Thank you cards and postage 35.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City_ State ZIP _ Year(s)Commission Paid: z Attomey Fees: 11,500.00 3. Family Exemption: (If decedent's address is not the same as clalmant's,attach explanation.) 3,500.00 Claimant Monica A. Trelo Street Address 5538 General Knipe Circle city Mechanicsburg state PA zip 17050 Relationship of Claimant to Decedent Spouse 4. Probate Fees: 418.50 5. Accountant Fees: 6. Tax Return Preparer Fees: /• Advertising Fees-Cumberland Law Journal&The Sentinel 285.78 8. Postage,copies, Notary-Nicholas Law Offices, PC 50.00 TOTAL(Also enter on Line 9, Recapitulation) $ 30,789.28 If more space is needed,use additional sheets of paper of the same size. REV-1512 EX+(12-12) pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RHIDENT DECEDENT ESTATE OF FILE NUMBER TREJO, JOSE MERCED a/k/a Jose M. Trejo, Jr. 21 13-0850 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 OF DEATH 1. Mortgages A. Ocwen Loan Servicing,LLC-Loan#xxxxxx1092- 99,624.49 on 507 Erford Road,Camp Hill,PA 17011 -owned soley in decedent's name B.PNC Bank-Loan#xxxxxxxxxxx3910-Balance of$172,080.77 86,040.38 on 5538 General Knipe Circle,Mechanicsburg,PA 17050-owned as Tenants by the Entireties C. Bank of America-Loan#xxxxxO982-Balance of$118,865.95 59,432.98 on 75 Pine Hill Road,Enola,PA 17025-awned as Tenants by the Entireties 2. 2013 Real Estate Taxes A.507 Erford Road, Camp Hill, PA 17011 -owned soley in decedent's name 1,635.16 B.Center St.,Enola,PA 17025-owned soley in decedent's name 952.14 C.5538 General Knipe Cir, Mechanicsburg PA 17050-owned as Tenants by the Entireties-$5,511.36 2,755.68 D.75 Pine Hill Road,Enola,PA 17025-owned as Tenants by the Entireties-$2,792.25 1,396.13 E.596 Belle Vista Drive,Enola,PA 17025-owned as Tenants by the Entireties-$3,060.38 1,530.19 F.4703 Duke Street,Harrisburg,PA 17109-owned as Tenants by the Entireties-$1,247.24 623.62 G. 125 Earl Avenue,Harrisburg,PA 17109-owned as Tenants by the Entireties-$2,569.88 1,284.94 3. Sewer/Trash on 507 Erford Road,Camp Hill,PA 17011 -owned soley in decedent's name 2,895.65 4. PNC Bank Loan#xxxxx1426-Personal loan to decedent,Monica A.Trejo,Vidal 0. Bravo and Carmen Bravo-Balance of$577,800.54.Decedent's proportionate share is 25% 144,450.14 5. DCM Services-Chase Bank USA, NA Acct#xxxxxxxxxxxx7567 1,489.78 6. SVA School of Visual Arts#1012519-Tuition for son(Victor Trejo) 25,323.00 7. FACTS Management Company-2013.14 Trinity High School Tuition for daughter(Vanessa Trejo) 6,575.00 8. Apicella Lorei Orthodontics#081310 orthodontia services for daughter(Joanna Trejo) 2,496.00 9. Apicella Lorei Orthodontics#081315 orthodontia services for daughter(Vanessa Trejo) 2,631.00 10. Verizon#7175851650-Open account 900.00 NOTE:Estate denies liability for claim filed by Maria Franco for$31,000 vs.the Estate TOTAL(Also enter an Line 10, Recapitulation) $ 442,036.28 If more space is needed,insert additional sheets of the same size. -_--- -� OLwen Loan Servicing,uc Account Statement www.ocwen.cam Account Number: X092 j Account Statement Date: 06/1712013 .e W € N ......- Property Address: .. 507 Erford Road NMLS E:1652 Camp Hill PA 17011 $$ NL Permit Nn M48 '-V CUSTOMER CARE CENTER I$00-7 6 2936 CURR Page l Your call M. ,be re Co ad for the Douching and develrunn.d Df our associates. _ �Special.Notices I"'lilllllll"1111'III'11111"'11'llil'll'llli'1"'ll"'ll'II'I CLAIM YOUR$40 CASH BACK FOR GAS TODAY! See the special offer for U.S.homeowners for$40 back on 2FP 02465/006439/0049670029 2 ACQDJ5 your gas purchases and a free review of the home service JOSE M TREJO plan that can save you thousands.Please reply before: 5836 GENERAL IW IPE DRIVE 10/31/13! MECHANICSBURG,PA 17050 Reduce your financial burden when your home is impacted by a disaster or you involuntarily lose your job.Let First Protector pay your mortgage for you. Visit www.OcwenFirstProtector.com or calll-877479-3947, 8am-8pm E.T.for more information. Acccuotl4tgrm0'o1n1-- -;, .. ....:I Details,Of Amour Ack . C rrmt Principal Balance: 99,6ZC49 CumentAmount Due: Interest Rate: 8.95000% Principal: 114.-14 Need Payment Due Date: 07101/2013 Interest 74103 Curtest Escrow Balance: 1,376.85 Escow. 203.41 Interest Paid Yeer-TO-Date: 4,476.11 Current Amount Due by 07/01113: 1,061.08 Tares Paid Year-To-Date: 451.64 Assessed Fees/Expense Outstanding: Beginning Principal Balance: 100,313.61 Late Charges: 42.88 Principal Reducfians Year-To-Date: 689.12 Prev-Retumed Check Fee: 40.00 Beginning Escrav Balance: 617.00 Total Fees/Expense Outstanding: 82.88 Escrow Depostts/Adjustrents Year-To-Datc 1,211.69 Total Amount Due: 1,143.96 Escrow DisbursementsfAdjustments Year-To-Date: 451.84 Recenty Assessed Amounts: May-2013 Late Charges_ 42.88 'this is ire,principal balance only,rat the amount required N pay your account in full. Recent Account Activity Date Desafption Principal Intereaf Escrow Optional Late Charges F.fOmer Suspense Total 05110/13 Payment Reversal 11295- 744.72- 200.79- 1,058.46- 0611?J13 Payment 112.95 744.72 203.41 1,061.08 06112113 Payment 113.79 743.88 198.17 1,055.84 we may report iMoarriad aboutyouacewmmcretYf Fair Cr.Latepaymen ts,missedwwfto.ta.tcadrt tltlautts on your account may De reFlactetl in your credtt report To obtain information about your rights antler the Fair Ctetlh Reporting Act go to vwAV.ttD.gwlcretlit. If you are currm0y in banlouptuy or 9you have filed for banlauptry since obtaining this loan,Please read the bankruptcy infarmatlon provided on the back of this statement Please note that your monthly payment amount has changed to$1,060.91 effeCrie 06101=13.Further detail regardng the _. reason for this change will be included in aseparate letter., FOLD AND PLEASE DETACH AND RETJRN eOTr0.N PORTON An"PAYM,EM'WiHE ENCLOSED ENVELOPE WITH ADDRESS v13eLE. FOLD AND DETACH HERE PLEASE DO NOTSEND CORRESPONDENCE WITH YOVR FAYMENr-ALWAYS Weirs YOURAC000Nr NOMaER ON YOUR CXEM DETACH HERE OOM]4➢Oe48]/,rgW55:{FMISAM.: 011288309995 00000000000000000000000042888 000000706531092 50 001143960 Payment Coupon —, Account Number Jose M Trejo Check for change of info:madln 0706531092 © and see rererseaide ofmupon. O C w E N AMOUNT DUE S iT143.9&] N Received after 071172013 add later Charge of: $ 4288 Total Amount Due wain Late charge: $ --i.1s�3aea r'Iddlgr...plpu111.aI,ip19P11",11,�'rlgll'glhl'ih None:ttyounoan is current any Additional Principal $ J OCWEN esessfunds irarstbeappliedt0 _ PC BOX 6440 eutstendinpamaunbdueandtnen Additional Escnovn $0 CAROL STREAM IL 60197-6440 ademanal Pnnapa. Late Charges: $ J Total Enclosed: 6 f { PNCBANKF NATIONAL ASSOCIATION 00478304 PO BOX 535230 00001 PZTTSBURSB, PA 15253-5230 For Irqulriee Please Call 3 E.I.N. 22-1146430 1-888-762-1099 i 039304 JOSE M TREJO JR 40 5538 GENERAL KNIPE DR MECHANICSBURG PA 17050 �le'r��eai - " 2013 XXX-XX-5473 THIS STATEMENT IS A FORM 1098 OMB NO.15450901,OR A FORM €098-E OMB NO. 1545-1578, OR 1099/1 OMB NO. 1545-0877 OR 1099.8 OMB NO.1545-0715 OR 1099-C OMB NO. 1545-1424, OR 1099-DIV OMB NO.1545-0110 OR 109"NT OMB NO. 1545-0112 OR 1099•MISC OMB NO. 1545-0115 OR 1099.010 OMB NO. 1545-0117 U.S.INFORMATION RETURN 2013 - 1098, MORTGAGE INTEREST STATEMENT ACCOUNT NUMBER INSTALLMENT 3910 BOX 1 MORTGAGE INTEREST* 6,482.28 TOTAL BOX 1 INTEREST 6,482.28 } THISIRORMATMOa1PONrANTTAI INFORMTION AND IS BERM MRNONWW THE BRERNAt AEYENUESERWCEIFYOU ARE REOU DTOFILEA RETURN,A FENALTYOROINER SANCOON NAY BE YeH08ED ON YW 9FTHE WA DETERMNESTHAT AN UNDEAPAYMEM OFTA%REBIfLTB BKAUBEYW OYEASTATED ADEDUUODN OR DID NOT R®ORr CORRECT A11011N18. •FCRNTOPSCAUTIMTHEA/,MINITSHOWN MAY NOT BE FULLY DEDUCTMERY YOU,IJMRBBASED ON THE LOANAMOIM AND THE COST AND YALUEOP THE SECURED PROPFUD MAYAPPLY.ALSO,YOUMAY ONLY DEDUCTINIERESf TO THE WrEM R WAS INCURRED BY YOU,ACfUALLYPAID BYYOU,ANDNOT REBWIW9E0 BY ANOTHER PERSON. FORM 100401..THOS MAY NOT BE THE CORRECT FKIURE TOREPORT ON YOUR SCONE TAX RETURN. PLEASE REFER TOTHE WTRUCTIOHS ONTHE BACK OFTHEI STATEMENT. COPY BFOp PAYER,RECS+ffUfi,BdilgtlFR,OR OFBTOq Ive'a%II,IGf IA9FMF1 G9Y'10lBAIAIbOl11Nf0 PEYRI�W �rlt� c�la ,r � Elul-LC Zo� 3 s See<icio at Clien"n � Fecha del estado de cuenta 05["13 I1de4 stet veu� CA 9d062 5170 ✓ Z Wonero de Cuenta 4W0982 _ Domicilio de la Propieded Home Loans 76 Pine Hill Road gas cripciun del prestam0 ara vivienda Saldo de capital $ll9,245.95 0065222 et As aml—AUTO ,e e 1m 11�1372 � Saldo de depbsito an garantia MSR I2 AG 1000-1-2—M24318 IN PEW JOSE&MONICATREJO ,} Mee anicsb Knipe 17 7 — MacllanicsEOrgPA1705C-7676 �(t rl i�lll1l�tllHlh�t�l�l 111tq llJl�t�t{'2Pilkllllhl{1{l�Pllu PARA SERVIC{O AL CLIENTE:1.800.669.660; . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Elija sus ofertas de reembolso de dinero en efectivo. BankAmeriDeals(&se to pace facil. En linen o en su dispositivo m6vil,consulte las ofertas que BankAmeriDeals tiene pars usted.Elija las ofertas,realise las compras y el reembolso de dinero an efectivo pasara a Ia cuenta de cheques o de ahorros de Bank of America° que usted seleccione. Obtenga rods informacion en www.bankofamerica.com/deals o toque el icon de,Deals(Ofertas)en la aplicacibn do Banca WIWI. Bank of Amerca,NA.Miembro de FDIC.Q Ofrecondo igaaldad de oporwoidades en prestamos hipotecarias 92013 Rank of America Corporation.El CrBdi-x y 1-a garanua estan sulei os a aprobaci6n.Se aplican terminus y ccndiciones.Esto no consoo,ye un compromiso de preatamo.Los pragramas,tasas,terminas y condiciones estaan sujetos a modificacibn sin previo aviso. 06 del 1013 M24318 ARBC5M �Resumea de pages ycantidadas adeadadas (' _Y_ f�y� Page actual adeudadu e107101/Zp13 al a61a6f20Y3 � � Pago de capraly/ointareses — 5997.46 I Cantidad de Pago de dep6sito an garanv 546 a 8.30 t7 Pago con veacudsento el 871011413 51,465.76 77 Registro del proximo Pago 07 106/2013 $1,465.76 Cargo p or Pago atrasador de 549.87 si el pago se recib a despues da107/16/2013 Si el pago se recibe despues del 07 116/2013 S1,515.63 ,{.j 1+ —Z C45-,q Ei'pa go adeudado"no incluye^dngOn pago avasado,cargos per pago atrasado pendientes ni Cqq` 11 [.t1 cargos adeudados. 1 J"u\ Y"rl � p f . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NOVEOADES IMPORTANTES Registrese Para Alertas de Cuenta Con los sarvicios be PayPtan de Bank of America,N.A.,IUsted no necesita reoibir los estados de cuenta monsuales impresos mas! Usted puede conseguir algo que puede resultar be mayor valor—Alertas de Cuenta. Estes correos electronicos In pueden ayuciarenvariasmaneras. Eilos: • Confirman CUandO su pago se aplica • Le mantienen-al-dia con informacion importante sobre su cuenta Per eso,jvisite wvwa.bankofamerica.com desde una computadora personal e inscribase para recibirAlertas de Cuenta hey mism0! 2de4 Detalles del prestamo para vivienda Tipo y plazo del prestamo Pr6mmas fechas a recorder Tipo de prestamo 30 Yr Conventional con PMI °Fecha de giro del proximo pago 07/06/2013 Plazo contactual restante 20 afi os,11 meses 'Los giros de pago no se realizaran si su pr6stamo se encuentra an Tasa de interes 6.250% estado de morosidad. Gastos relacionados con la propiedad A excepci6n de Jos conceptos marcados con un asiedsco(*1,somas responsables del pago de Jos siguienres conceptos,qua se incluyen an su cuenta de dep6sito an garantia.El pago de los conceptos marcados con an asterisco(*)as responsabilidaddel propietario de la vivienda. Mori de p6liza/ Pr6xima fecha Cantidad Descripci6n Beneficiario ldenvficaci6n fiscal Frecuencia de vancimlento qua ence Seguro de Propietario Ohio Casualty Group DOD 11230972 Anual 04/30/2014 5670.00 Pago mensual de PMI 21280200 Mensual 06/0712013 5727.50 Impuestos de Escuela East Pennsboro Twp/Asd Tax Col 09-13-0997-007 Anual 08/01/2013 $2,792.25 Imp.de la ciudad East Pennsboro Township Treasu 09-13-0997-007 Anual 04/01/2014 $857.14 Si usted tiene una cuenta de dep6sito an genenda,no envfe par correo su facture de impuastos actual.Trabaiaremos con su Recaudador de impuestos pare pagarlos impuastos an forma puntual.Si usted recibi6 una facture Provisoria,Morose,Complementare,Corregida o Ajustada,escriba su mimero de cuenta an la facture y enviele a nombre de:BAC Tax Services Corporation,Attn:Tax Dept CA6-973-113-01, PO Box 10211,Van Nuys,CA 91410-0211. Actividadreciente del prestamo pare vivienda --__ .— CaPfal .._ _. _- adicional Depbsio Fecha Descripcidn _ _Capital_ Inieresas oa9ado -_EaranSa _ _- Total 06/062013 Varies transacciones $100.00 $100.00 06106/2013 Pagode Junio $3 73.83 $623.63 $468.30 $1,46575 05/15)2013 PagodelPMl -$121.50 -$121.50 —Saldo final $119,24595 52,75373 "NOT/L o Artl050al w mbleveme vo stl igval a lativ4dad r,ecmia Pea maY>a Prbtrn>Pea obrmc inlmmvcbn saEre Iv mnmf�dn.PmrS u01�noon.xb'['nm de ivramraabv aR,ma6[adn dlspmiWe rtl 24 hover Ilene a 1ffiI,6855833. -_ Para comunicarse con nosotros Tanga an Clients Lo Siguiente: Nuevo Due lio Postal Para enviar on pago por Forma de un dia pare afro* En lines v -bankofamerice-eom SoliciNdes'cscrites Calncadas(0WR)(seg6 n as definen an la Bank of America,NA. Secci6n6 de Is ley RESPA y an Is Se.C16n 3500.21 del Retail Payment Services,DE5-023-0304,Christiana 111, Per 1.800.669.6607(English) Reglzmento Xj 900 Samoset Drive telefono 1.600.256.'u"u25(Espanoi) PO Sox942019 Newark,DE19713-6002 TDD 1.800.300.6407 Simi Valley,CA93094-2019 "Acepta Gnicamente correspondenc iade un dia pare con. Monday-Friday7a.m.-7om.Local Time Pam envier on pago porcorrell En este domicile no se aceptan Pago$an persona. Las llamadas pueden ser escuchadaso Bank of America,NA. Asumos Relacionados eon Segal grabadas Para Dare ndzar un asrvicio de PD Box 15222 Insurance Dept,PC Box9fi1291 g Feuded. Wilmington,OE 1988fi-5222 Foriwanh,TX76 7 61-0291 Per Consultas Generale$(Except.Sclicrtudes 1 ospagostzmu8n puedenrealizarse poi-Telefono,En Linea oan Como Escritas Calificadas,o CW`R) cualquier Sucursel de BankofAmence. Bank of America,NA. PC 6.x5170 Simi Valley,CA93062-5170 Bank of America,NA Member FDIC.Equal Housing Lender.0 2013 Bank of America C.rp.rad.n.Trademarks are the property of Bank of America"Toranon.All rights reserved. County of Dauphin I Information for Property 35-052-142-000-0000, Tax ... Page 1 of 1 4� DAUPHIN COUNTY N E \ N S" Y L VA N I A � 11 ' I want To... Information for Property_35-052-142-000-0000, Tax Year 2013, _ Dauphin County Property Information Website Dauphin County GIS Tax Year Property ID Images(Sew) Interactive Maps 12013 35-052-142-000-0000 "�•'_ Dauphin County - Assessors Page Township Property Use , Dauphin County Tax LOWER PAXTON TWP R01-1 STORY RESIDENCE Claims Page Neighborhood Site Address Dauphin County 35042-HUNTFIELD SUBDIVISION 4703 DUKE ST Treasurers Page Owner Name and Address[Show Details] Mailing Name and Address TREJO,JOSE TREIO,JOSE 4659 JONESTOWN RD 4659 JONESTOWN RD HARRISBURG,PA 17109 HARRISBURG,PA 17109 Payments I'd Like To... Billing Pd. Tax Billed Discount/Pen. Total Billed Total Paid Balance Due Date Paid Start a New Search Annual Billing $465.52 ($9.31) $456.21 $4S6.21 $0.00 03/14/2013 View: Note:Payment amounts may only reflect the Dauphin County amounts Assessment Info. Billing&Collection Tax Amounts CAMA Information Fund(Tax) Description Rate Type Millage/Tax Rate Flat Tax Amount Delinquent Taxes Annual Billing Name Information Central Dauphin School District Millage 14.317300 $781.72 Map/GIS County Library Millage 0.350000 $19.11 print: County Real Estate Millage 6.876000 $375.43 Current Page Fire Protection Millage 0.322000 $17.58 Parcel Report MUN: LOWER PAXTON TWP Millage 0.937000 $51.16 Account Options: Municipal Library Millage 0.041000 $2.24 Login Total $1,247.24 Wedge version 3.0-BETA CaPyrlght C 2009-2014,OEVNET,Inc All rl9M1rs rnervcd. `""t @��'N County of Dauphin,Department of I Sword street,FMnolo, Copy^9h[®2002-2014,Dauphin County.All RighUD 0.NET I 3 Sou[I:Semnd 5[reeq flRh Fla HIPAA PMa[y Notil I Prrvary Policy I PA 5[att Weblike Harrisburg,PA 17108-129 WeDmaste,$dauphirl cars ad Dauphin Cbunry I County Phone Numbel Employees Onl loll http://www.dauphinpropertyinfo.org/view/RE/350521420000000/2013 9/3/2014 County of Dauphin I Information for Property 35-053-118-000-0000, Tax ... Page 1 of I DAUPHIN COUNTY A.= I want TO... Information for_Proper_ty_ 35 ,053-118 0.00-0000_, Tax Year _20.13 Dauphin County property Information Website Dauphin County GIS Tax Year Property ID Images(See All) Interactive Maps 35-053-116-000-0000 Dauphin County Assessors Page Township Property Use Dauphin County Tax LOWER PAXTON TWP R01-1 STORY RESIDENCE Claims Page Neighborhood Site Address Dauphin County 35043-RUTHERFORD/LOCUST LN./NYES RD. 125 EARL AVE Treasurers Page Owner Name and Address(Show Details) Mailing Name and Address TRE70,30SE M 3R TREI O,IOSE M JR .. 4659]ONESTOWN RD 4659]ONESTOWN RD HARRISBURG, PA 17109 HARRISBURG,PA 17109 Payments I'd Like To... Billing Pd. Tax Billed Discount/Pen. Total Billed Total Paid Balance Due Date Paid Start a New Search Annual Billing $959.18 ($19.18) $940.00 $940.00 $0.00 03/14/2013 View: Note:Payment amounts may only reflect the Dauphin County amounts Assessment Info. Billing&Collection Tax Amounts CAMA Information Fund(Tax) Description Rate Type Millage/Tax Rate Flat Tax Amount Delinquent Taxes Annual Billing Name Information Central Dauphin School District Millage 14.317300 $1,610.70 Map/GIS Cnunty Library Millage 0.350000 $39.38 Print: County Real Estate Millage 6.876000 $773.55 Current Page Fire Protection Millage 0.322000 $36.23 Parcel Report MUN: LOWER PAXTON TWP Millage 0.937000 $105.41 Account Options: Municipal Library Millage 0.041000 $4.61 Log In Total $2,569.88 wedge version 3.0-BETA Copyright m 2009-2014,DE NET,Inc.All rights reserved. ��j ^• .+'�y county of Dauphin,DepaNnent of Information Technolog copyright B 2002-2014,Dauphin county.All Mon.aeserved. ®I,n�,e 2 South second Street,Fifth Floc .up.Privacy Notice l Pr ary Pote,I PA state websife HarrNburg,PA 17108-129 wedmaster @dauphoc.org Contact Dauphin county I County Phone Numbn Employees ON loading http://www.dauphinpropertyinfo.org/view/RE/350531180000000/2013 9/3/2014 7-01-2013 ;PREVIOUS BALANCE 2943.85 87-2013 7025 ��70- -0 LATE CHARGE 9.15 8-07-2013 LATE CHARGE 4.65 7-19-2013 PAYMENT -200.00 12-31-2013 ' SEWER SERVICE i 91.50 12-31-2013 TRASH SERVICE 46.60 TREJOJM001 11-08-2013 2895.65 : T16 PI 006420 • AUTO**S-DIGIT 17050 2909.4S : JOSE M.TREJO hT 6538 GENERAL KNIPE DR MECHANICSBURG PA 17050-1676 507 ERFORD ROAD CAMP HILL PA 17011 Easi 7-01-2013 PREVIOUS BALANCE 2943.85 8-07-2013 LATE CHARGE 9.15 8-07-2013 LATE CHARGE 4.65 8:00 a - 7-19-2013 PAYMENT -200.00 :12-31-2013 SEWER SERVICE 91.50 lip .M 12-31-2013 TRASH SERVICE 46.50 TREJOJM00l 1111111111111111 IN 11111 lill ill III IIIII IIIIII III 111 : 11-08-2013 2895.65 '507 ERFORD ROAD CAMP HILL PA 17011 2909.45 PNC 340777 Commercial Loan Statement �117iSBUR6H PA 15230-7777 Page 1 of 1 Direct any questions regarding your Interest Paid statement to the above address. Portfolio Obligation Obligor Year to Date 010 X1426 IM9544 8,081.23 VIDAL BRAVO, CARMEN BRAVO, JOSE M Maturity Billed Due TREJO JR AND MONICA A T REJO Date Date Date Total Amount Due 39 VICTORIA WAY 03/07/22 05/24/13 06/07/13 6,007.10 CAMP HILL PA 17011-1728 Payment must be made in the amount indicated in the"Total Amount Due'section above to avoid additional interest and/or delinquency charges. I Summary Interest Due Debits and Credits Interest Due Interest Due Fees Due 1,527.04 1,527.04 1,618.81 1,618.81 0.00 Previous Principal Current Total Total Late Principal Due Debits and Credits Principal Due Principal Due Charges Due 4,529.84 4,529.84 4,388.29 4,388.29 0.00 city Detail Tran Description Interest Rate Fee Amount Principal Amount Principal Balance Days Interest /13 Balance Fomx d 3.200300 592,330.38 1,527,04 /13 Ach Inc Pa7mt 3.200300 592,330.38 1,527.04 /13 Ach Prin Paymt 3.200300 4,529.84- 587,800.54 /13 Prbue/indexClia 587,800.54 /13 Int.Accrual 3.198200 587,800.0-4 15 783.30 /13 Int.Accrual 3.198200 �� 587,800.54 16 835.51 {A i 90a,py dc"M services 7601 PENN AVE S, SUITE A600 MINNEAPOLIS, MINNEsoTA 55423-5004 TELEPHONE 612-243-8620 Hours (CT): 7:00 am - 7:00 pm M - TH FAx 877-326-8784 7:00 am - 5:00 pm F TOLL-FREE 877-326-6766 April 24, 2014 Re: Estate of: JOSE TREJO Our Client: Chase Bank USA N.A. Account No Unpaid Balance Reference No ************7567 $1489.78 9489316 Dear Sir or Madam: This letter confirms an unpaid balance of$1489.78 on the above listed account regarding the Estate of JOSE TREJO. W are not holding you personally responsible for the balance. We are seeking payment from the assets of the decedent's estate. If you need to make payment arrangements or to make payment over the phone, call us toll free at 1-877-326-6766. Cordially, DCM Services, LLC This company is a debt collector. we are attempting to collect a debt and any information obtained will be used for tha purpose. Calls may be monitored or recorded for quality assurance purposes. NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION -Side 1 of 2- —Detach Lower Portion and Return with Payment" DCM SERVICES, LLC 7601 PENN AVE S, SUITE A600 Reference #: 9489316 Client ID: IPMC11 s MINNEAPOLIS, MN 55423-5004 Unpaid Balance: $1489.78 ADDRESS SERVICE REQUESTED Checks Payable to: DCM Services LLC Amount Enclosed: $ April 24, 2014 lllhhllhlllp,I'I,gill,l.lllllill„I,nu„llllhwp,luel 1651]-226 The Estate of JOSE TREJO DCM Vices/Chase 4i'�9E Attn:STEVE C NICHOLAS PO Boox x 1473 t�ddasc 2215 FOREST HILLS DR Minneapolis MN 55440-1473 HARRISBURG PA 17112-1699 9489316 7567 16517-7101- IEVOiCE DATE Disregzrtl I +o ce r;..Ymeirl.rrradd ater tlz;e Slow 06/06/13 Welcome to the Fall 2013 semester at SVA. This is a preliminary billing statement. Please review Gast due data EOaTE eecd w,ts caasacln uaeie ;IS OUE rvmnt the enclosed corres ondence. View and pa East cue tare suaersedes pzV�^ent cescline ezte p y yOUr statement online at www.sva-edu/paybil 13/FA-TERM SEMESTER COURSE SCHEDULE O3DM-CIM DEPT CAT.# CRED DEPT CAT.# CRED Victor R. Trejo HLD 2977*R 3 .0 5536 General Knipe Drive CFD 4010*A 3.0 Mechanicsburg, PA 17050 CFD 4940*A 6.0 HPD 2931*R 3 .0 CFD 3431*A 3 .0 TOTAL CREDITS: 18.0 13/SP PREVIOUS TERM BALANCE 3,495. 00 09/03/13 Film Dept. Fee 1,340. 00 09/03/13 Health Insurance Fee 925.00 09/03/13 Film Tuition Fee 19,363.00 4, 368.00 08/01/13 DUE 4,365.00 09/01/13 4, 365. 00 10/01/13 4,365. 00 11/01/13 4,365.00 12/01/13 escua't IeE $25,323 .00 I $0.00 $17,460. 00 $7, 863 . 00 �ay'rnants me '.c oe/Cur s o- s st .-. '+ :.c , " o."lake chack or to 'e d 'c,s 's ,, NOT SEND b SP '1i allt. 0 e e e Ca USd l 5 'J ''J PE"Ielta,Or e ,'�:-Zaaa iedsa,,ems. 2 ,u!, I y ee.E C B PS JE,ta C "un.';d ate 0li:e di ___ ..,c...;. s e..as!...Street,Ne•, o..,,°J, JOCSG. Victor R. Trejo 1012519 06/06/13 08/01/13 $7, 863 . 00 FACTS Management Company P O Box 82527 Lincoln NE 68501 RETURN SERVICE REQUESTED >00079 3291091 001 092122 Mr.Jose Trejo 5538 General Knipe Mechanicsburg, Pennsylvania 17050 Trinity High School Customer#: 529824187 2013.2014 School Year Agreement#: 102318950 Online Access: https:/ionline.factsmgt.com/register Pegistrat:on Code: L224N94 Jose Trejo: 05115/2013 Thank you for using FACTS Management Company to make your payment for Trinity High School.The person responsible for payment on this agreement is Mr.Jose Trejo. The total balance due to Trinity High School is$6,425.00. Details about your balance are located at the end of this notice. Your schedule of payments is listed below. FACTS will send you an invoice approximately 20 days prior to the due date of each payment. Due Date Amount 06/15/2013 - $1,63625 09/15/2013 $1,606.25 121115/2013 $1,606.25 03/15/2014 $1,60625 Fee Information: The$30.00 nonrefundable enrollment fee is included in your 06/1512013 invoice. A$30.00 FACTS returned payment fee will be assessed for each returned payment. Any balance remaining unpaid after the due date shall incur a late fee of$40.00 per month. Customer Service and Online Access: This confirmation notification is based on the terms of your original agreement. Go to FACTS to view and manage your information online.Access information is included at the top of this notice. If you have any questions, please contact FACTS Customer Service at(866)441-4637. If you have questions regarding the terms of your payment plan, please contact Trinity High School-Carol Mullen at 717-761-1116. Thank you, FACTS Management Company Balance Details Name Description Amount' Vanessa Trejo Tuition $6,575.00 Vanessa Trejo Tuition-Payment at Institution-non refundable deposit $-150.fl0 on tuition 00079 3291091 000080 000158 00001/00001 Date APICELLA .1-Lom 7/3/13 mber 400 E. Main Street Account Nu Mechanicsburg, PA 17055 081310 (717) 697-8222 Amount Due Now $192.00 Jose Trejo Amount Enclosed 5538 General Knipe Circle Mechanicsburg, PA 17050 Please return top portion with payment Patient Account Summary Patient Name Amount Due Now Unbilled Contracts Remaining Balance Joanna Trejo $192.00 $2,304.00 $2,496.06. , Date Description Patient Amount Balance Forward $0.00 5/15/13 Contract Charge Trejo,Joanna $192.00 6/12/13 Visa Payment by Trejo, Jose Trejo,Joanna ($192.00) 6/15/13 Contract Charge Trejo,Joanna $192.00 Retain for your records Current Due Over 30 Over 60 Over 90 Amount Due Now Amount Enclosed $192.00 $0.00 $0.00 $0.00 $192.00 (�� T('��'! Date � lPiL- EL.LA -..,LokEi 7/3/13 Account Number 400 E. Main Street Mechanicsburg, PA 17055 081315 (717) 697-8222 Amount Due Now $202.00 Jose Trejo Amount Enclosed 5538 General Knipe Circle Mechanicsburg, PA 17050 Please return top portion with payment Patient Account Summary Patient Name Amount Due Now Unbilled Contracts Remaining Balance Vanessa Trejo $202.00 $2,429.00 $2,631.00 Date Description Patient Amount Balance Forward $0.00 5/15/13 Contract Charge Trejo, Vanessa $202.00 6/12/13 Visa Payment by Trejo,Jose Trejo, Vanessa ($202.00) 6/15/13 Contract Charge Trejo, Vanessa $202.00 Retain for your records Current Due Over 30 Over 60 Over 90 Amount Due Now Amount Enclosed $202.00 $0.00 $0.00 $0.00 $202.00 REV-1513 EX+(01-10) �9pennsytvania SCHEDULE J DEPARTMENTOF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT �j ESTATE OF: - FILE NUMBER: TREJO, Jose Merced a/k/a Jose M. Trejo, Jr. 21 13-0850 _ RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE �I TAXABLE DISTRIBUTIONS(Include outright spousal distributions and transfers under Sec. 9116(a)(1.2).1 1. SEE ATTACHED SCHEDULE 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. i 6. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ONLINE 13 OF REV-150G COVER SHEET. $ If more space is needed,use additional sheets of paper of the same size. Trejo Jose Schedule 1 Attachment son/est SCHEDULE J (Cont.) BENEFICIARIES ESTATE OF: FILE NUMBER TREJO,JOSE MERCED a/k/a Jose M.Trejo,Jr 2113-0850 No. Name and Address of Relationship Amount or Person Receiving Property to Decedent Share of Estate I. TAXABLE DISTRIBUTIONS 1. Monica A. Trejo Spouse The first$30,000.00 5538 General Knipe Circle plus one-half of the balance Mechanicsburg, PA 17050 of the intestate estate 2. Victor Ricardo Trejo Son 20% of one-half of the 5538 General Knipe Circle balance of the intestate estate Mechanicsburg, PA 17050 3. Jose Ernesto Trejo Son 20% of one-half of the 5538 General Knipe Circle balance of the intestate estate Mechanicsburg, PA 17050 4. Vanessa Monica Trejo Daughter 20% of one-half of the 5538 General Knipe Circle balance of the intestate estate Mechanicsburg, PA 17050 5. Joanna Arasally Trejo Daughter 20% of one-half of the 5538 General Knipe Circle balance of the intestate estate Mechanicsburg, PA 17050 6. Veronica Briana Trejo Daughter 20% of one-half of the 5538 General Knipe Circle balance of the intestate estate Mechanicsburg, PA 17050 It. NON-TAXABLE DISTRIBUTIONS A. Spousal Distributions under §9113 for which an election to tax is not taken: B. Charitable and Governmental Distributions .taus«117-M 5'...ice his RECORDER'S USE ONLY REALTY TRANSFER TAX Beak N.mb.r COM ONWEALTSIOFPENNSTD'ANIA STATEMENT OF VALUE DEPARTMENT OF REVENUE P.S.Nv.b.r BUREAU OF INDIVIDUAL TAXES DEFT.760603 I D.I.R....ded NAFRISSURG,FA 17173.0603 See Reverse for Instructions Complete each section and file in duplicate wi!h Recorder of Deeds when (1) the full raluelcansideratian is net set fenh in the deed,(2)when the deed is without considerelion, or by gip., or(3) a tax exemption is claimed. A Statement of Value is not required if the transfer is wholly exempt From lox based on: (1) family (eleticnship or l2) public utility easement. If mere space is needed, aaech additional sheer(s). Nerve Telephone Nurnh:: Area Cad. (7)7 1 Zr34 A 18;? $Ir<•;y r't's1C �r WeV8 r`v`y�}'� S'�e �1Gr5ya:e � Zip Code W �S PA 17)0 s Ore d Acceptance ci Document Grcntorl:}lleaer(s} Gremee(s)fless<e(s) • Yl�iri _r_ TY Sue<: --`— Ssrec Address arc c 5�1;`c�; � 155y��'` Cveenrnom i)ye cy �'�1tchCjnlC b22 P)_0W Y'y"1 (U%. PA 170zs Zip (:ad, Street Addreu % Cry,Tc-nshq, mvgh �5G c(_fP1)P \I G l��ivy l-. nsbovc Ti, P. Ceur•` \W 1� IScnoal 0•st s Y L ♦ e V ITax For:et N_ <��CV I— q — CV C LJM`�1 c�-� �C7`� L Aevel es uderafien 2.Other Con 3.Total Cemi alien � ,5oca CX� 1+ '(ion e = t F 5U0 oc� d.Covey Assessed Valve 5.Cammon le.el Ratia Fecor 6.Fair M Ae.Value g1ZrJO - iX 111 = X576 .50 I la. Amount of Esempfon Claimed Ili Percentege of Interest Conveyed O loo 2. Check Appropriate Box Below for Exemption Claimed ❑ Will or intestate succession _ .(Nam•d D...d.-Q (Enos F4 NamS..1 ❑ Transfer to Indus!riol D"elopment Agency. .• ❑ Transfer to agent or Wow party. (Attach copy of egencylstrew party agreement). ❑ Transfer between principal and agent. (Mach copy of agency/strew trust agreement). Tax Acid prior deed S ❑ Transfers to the Canmonwea6h, the United States, and Inslrumentali:ies by gift, dedicolion; condemna'ien ar in lieu of condemnation. (Anech copy of resolution). ❑ Transfer from mortgagor to a holder of a mortgage in default. Mortgage Book Number , page Number ❑ Correcti" deed (Attach copy of the prior deed). ❑ Slelvlory corporate consolidation,merger or &ision. (Attach copy of articles). ' ® Other (Please explain exemption claimed,if other than listed eboee.) 'rho- delay In f�Cn_(c`la)a ;s ; eve �0 i mw Under Penchi's of law,I d.cicre shot I have examine?this Statement,including accompanying inform a:ioe,and to the best of my know!rdg• and b<6ef, it is true, correct and complele. Dat. $.ynctvr. of C<rt.spon 1 r Rapen 'bl. Pa rt� I W z?-05 INST#: 20070611096 Recorded: 03/21/2007 at 12:01 :53 PM 5 PAGES JAMES M. ZUGAY, RECORDER OF DEEDS, DAUPHIN COUNTY,PA. RECORDED BY DEPUTY CLERK: TBUCKLEW Tmjo 125 Earl Avddadskin Tax Parcel No. 35-053-118 SPECIAL WARRANTY DEED THIS DEED made the I'1 day of March,2007. BETWEEN ELIJIO ARELLANO,a married man,Party of the First Part,GRANTOR, -AND- JOSE M. TREJO, JR. and MONICA A. TREJO, husband and wife, Parties of the Second Part,hereinafter jointly referred to as GRANTEE, WITNESSETH, That the said GRANTOR for and in consideration of the sum of One Hundred Fifty Thousand and 001100 ($150,000.00) Dollars and other good and valuable considerations paid by the said GRANTEE to the said GRANTOR, at and before the signing and delivery of these presents, the receipt of which is hereby acknowledged,has granted,bargained, sold, and conveyed, and by these presents does grant, bargain, sell, and convey unto the said GRANTEE and GRANTEE'S heirs,successors and assigns the premises described as follows: ALL THAT CERTAIN tract or parcel of land situate in Lower Paxton Township, Dauphin County, Pennsylvania, being a portion of Lots Nos. 1, 2 and 3 on that certain Plan of Lots laid out by Byron F. Shoesley, known as Park Place and recorded in Dauphin County Plan Book G at Page 40, as more particularly bounded and described in accordance with a survey and plan thereof made by D.P.Raffensperger,Registered Surveyor,dated June 1, 1966, as follows,to wit: BEGINNING at a point on the eastern line of Earl Avenue,which point is fifty(50) feet north of the northeast comer of Earl Avenue and Queen Avenue; thence North four (4) degrees fifteen (15) minutes West along the eastern line of Earl Avenue, a distance of fifty-five(55) feet to a point on the southern side of a 15 feet wide alley; thence North sixty-four(64)degrees time (9) minutes East along said alley, a distance of one hundred seven and fifty-five one-hundredths (107.55) feet to a point at the dividing line between Lots Nos. 2 and 3 on the aforementioned Plan; thence South four(4) degrees fifteen(15)minutes East along said dividing line, a distance of forty-five and seven one-hundredths (45.07) feet to a point; thence at right angles to said last mentioned line North eighty-five (85) degrees forty-five (45) minutes East, a distance of fifty (50) feet to the dividing line between Lots Nos. 3 and 4 on said Plan; thence South four (4) degrees fifteen(15)minutes East along the dividing line between Lots Nos. 3 and 4,a distance of forty-eight and nine-tenths (48.9) feet to a point; thence at right angles to said last mentioned line, South eighty-five (85) degrees forty-five(45)minutes West, a distance of one hundred fifty (150)feet to a point on the eastern side of Earl Avenue,the place of BEGINNING. INSTRUMENT #: 20070011096 PAGE 2 OF 5 HAVING THEREON ERECTED a single brick dwelling house known as 125 Earl Avenue,Harrisburg,Pennsylvania 17109. BEING THE SAME PREMISES WHICH Brian W. Olson and Lori F. Olson, husband and wife, by their Deed dated May 30, 2002 and recorded June 5, 2002 in the Office of the Recorder of Deeds of Dauphin County, Pennsylvania in Record Book 4408 at Page 161, transferred and conveyed unto Elijio Arellano,GRANTOR herein. Elijio Arellano is the brother of Monica A. Trejo, one of the Grantees herein. Therefore,this transfer is exempt from PA Realty Transfer Taxes. TOGETHER with all buildings, improvements, woods, ways, rights, liberties, privileges, hereditaments and appurtenances, to the same belonging, or in any way appertaining, and any revisions, remainders, rents, issues and profits thereof, and of every part and parcel thereof, including any interests specifically set forth herein, if any. And also, all the estate, right, title, interest, property, possession, claim and demand whatsoever, both in law and equity, of the GRANTOR of,in and to the same. TO HAVE AND TO HOLD the said premises, and the appurtenances, hereby granted to GRANTEE and GRANTEE'S heirs, successors and assigns, to and for the only proper use, benefit and behoof of the said GRANTEE and GRANTEE'S heirs, successors and assigns forever,under and subject to conditions of record. AND the said GRANTOR hereby covenants and agrees that GRANTOR will specially warrant the property hereby conveyed. INSTRUMENT #: 20070011096 PAGE 3 OF 5 IN WITNESS WHEREOF, the.said GRANTOR has hereunto set his hand and seal the day and year first above written. SIGNED, SEALED and DELIVERED IN THE PRESENCE OF WITNESS E ARELLANO INSTRUMENT #_ 20070011096 PAGE 9 OF 5 COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF DAUPHIN On the I" day of March, 2007, before me, a Notary Public in and for said County and State, the undersigned officer, personally appeared ELIHO ARELLANO, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained, and desired the same might be recorded as such. IN WITNESS WHEREOF,I hereunto set my hand and official seal. C."- � �- Notary Public OPPOWWWRALTH OF PCNMY VANA NOTARIAL SEAL CHRISTINA L.NICHOLAS,Notary PLft LarvPagatFwp..Oa�hinCounry . Caotrtt�xt hae620,20U4 rr#:taxrxrrtr+k*+t,x**+*x«r.wr a�,e r txw,r a x�t�a+*xw,t,t«r�wv�*ew r kw.r a*,t*��a*a x�*+e+�w•matxfiut CERTIFICATE OF RESIDENCE I hereby certify that the precise address of the Grantee herein is: 5538 General Knipe Circle Mechanicsburg,PA 17050-1676 CI - c� .° Att rrn /Agent for Grantee FOR RECORDING PURPOSES ONLY NO TITLE CERTIFICATION James M.Zugay, Esq. LocaSon Recorder of Deeds Dauphin County Courthouse (717) 780-6560 Room 102 �.---, „.� j-• Front&Market Streets Candace E. Meck Harrisburg, PA 17101 First Deputy Recorder of Deeds Harrisburg, Pennsylvania CERTIFIED END PAGE INSTRUMENT #: 20070011096 RECORD DATE: 3/2101007 12:01:53 PM RECORDED BY: TBUCKLEVV DOC TYPE: DEED AGENT: NICHOLAS LAW OFFICE DIRECT NAME: ARELLANO, ELIJIO INDIRECT NAME: TREJO, JOSE M.JR. RECORDING FEES- State: $0.50 RECORDING FEES- Courrty: $13.00 ACT 8 OF 1998: $5.00 LOWER PAXTON TVVP CENTRAL DAUPHIN AOPC: $10.00 AFFORDABLE HOUSING: $13.00 I Certify This Document To Be Recorded In Dauphin County,Pennsylvania. James M. Zugay,Recorder of Deeds THIS IS A CERTIFICATION PAGE PLEASE DO NOT DETACH THIS PAGE IS NOW PART OF THIS LEGAL DOCUMENT MADE THE &I day of q in the year one thousand nine hundred ninety-M(19 ( f?✓"✓ BETWEEN ROY JAMES BOWERMAN and JULIA BARBARA BOWERMAN,his wife, of Harrisburg, Pennsylvania, Grantors, AND JOSE TREJO and MONICA A.TREJO, his wife,of Enola, Pca_'Psylvaaia, °n Grantees, N.0 OCR a �o x WITNE33ETH, that in consideration of FORTY-SEVEN THOUSAND------------------------ �----==--- - '-------------------------'---------.------------($47,000.00)-------------------------------------------Dollars, in hand paid,the receipt whereof is hereby acknowledged,the said grantors do hereby grant and convey to the said grantees,their heirs and assigns, ALL THAT CERTAIN lot of land situate in Lower Paxton Township, Dauphin County, Pennsylvania, being parts of Lot Nos.416 and 417 on the Plan of Farmlyn Garden Plots,which Plan is recorded in the Recorder's Office of Dauphin County, Pennsylvania,in Plan Book'G', Pago 31,and which lot is bounded and described as follows,to wit: BEGINNING at the southeast comer of Duke Street and a 20 foot wide alley as shown on Plan; thence eastwardly along said Duke Street, 50 feet,more or less, to a point;thence southwardly, 120 feet to an alley; thence westwardly along said alley, 50 feet to the 20 foot wide alley herein mentioned; thence northwardly along said alley, 120 feet to a point,the place of BEGINNING. HAVING THEREON ERECTED a one story frame and masonry dwelling numbered 4703 Duke Street,Harrisburg,Pennsylvania. UNDER AND SUBJECT to all those conditions, restrictions and reservations specifically set forth on the Plan of Lots herein mentioned. Further, this land is conveyed on condition that its use remain residential only. BEING THE SAME PREMISES which Carl L. Beck and Josephine Beck,his wife, by their Deed dated and recorded May 20, 1955 in the Office of the Recorder of Deeds in and for Dauphin County in Deed Book Q,Volume 39, Page 397, granted and conveyed unto Roy James Bowerman and Julia Barbara Bowerman, his wife, Grantors herein. R3309Pi3 376 • And the said grantors do hereby Warrant Specially the property hereby conveyed. IN WITNESS WHEREOF, said grantors have hereunto set their hands and seals the day and year first above written, n Slpvil,9uh0 mb XtHlitn! /y - 44:� ROY ES BOWERMA�uf-rt/ In @e Drarnn at N L1A BARBARA BOWERMAN STATE OF ,�// COUNTY Op e U/r1)xrjA'-IC�C,. On this,the #-A day of 1q91-11 ' 1999, before me, the undersigned officer, personally appeared ROY JAMES BOWERMAN&JULIA BARBARA BOWERMAN, his wife, known to me(or satisfactorily proven)to be the persons whose names are subscribed to the within instrument,and acknowledged that they executed same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal 1 • EAL) No Pub NdaW and 1!-Z, l SnU LOCOltttl W.�gxnp ACgr�1y ?lnllA.A!o^..i J!o.NcIaN PUat MY Covmlaefo0 Fi�ires Nov.5.2001 I.N..•.'!I;:I'.il'1\.!...(:I_.O MCcoi7 Liy Coaim{slun Ex01ros Nay.S,2V0 STATE OF COUNTY OF On this, the day of , 199_, before me,the undersigned officer,personally appeared {mown to me(or satisfactorily proven)to be the person whose name subscribed to the within instrument, and acknowledged that executed same for the purposes therein contained. IN WITNESS WHEREOF,I hereunto set my hand and official seal (SEAL) Notary Public BX3989PG 377 CIRTIFICAT&OF RESIDENCY I do hereby certify that the precise residence and complete post office address of the wi in grantees is: 1-1763 L1_' f 77 LX 14 � '�—///J AtwrneytAgent to 1 hereby CERTIFY that this document is Uwl M 21,111 t recorded in the Recorda's Offioe of om M Dauphin County, Pennsylvania. 11 WBAKM tw Mr all `PPUltfllrgtLllryi it it NFNWMM lip 4.9 110 ``Opp C. r� 4�i 1 15 19w 1111 0.9 119 r� •.•.�uJc..'� 1 T 6F91YIf HIM 1111 IL11 '•,7 1 Q am PM LM 1.M IN 4.11 LM .. '� M IELTI IM WS t 65.10 MMMM QL11 .<, . ~� Mahiy:.r.: IS LM RAM76 . , e MOD i`„ M ®IILL 9N111 4e 4.6 MIL.. 1ILM 411 COMMONWEALTH OF PENNSYLVANIA: SS County of RECORDED on this day of A. D. 19_ in the Recorder's office of the said County,in Deed Book , Vol, Page Given under my hand and the seal of the said office, the date above written. Recorder 0,0389 '6 378 Trejo?24SWD/deeds/read.cst/CLN UPI No. /,of SPECIAL WARRANTY DEED THIS DEED made the _day of March,2002 BETWEEN R.C.R. REALTY COMPANY, a Pennsylvania General Partnership consisting of Jack Chabot and J. Patrick Ross ,,,,General Partners, Party of the First part, GRANTOR, -AND - JOSE M. TREJO, JR. and MONICA A. TREJO, husband and wife, as Tenants by the Entireties as to an undivided one-half (1/2) interest; and JESUS R. ARELLAN6 as to the remaining one-half(1/2) undivided interest; as Tenants in Common as to the whole part, Parties of the Second Part, GRANTEES, WITNFSSETH, That the said GRANTOR for and in consideration of the sum of Two Hundred Forty-Seven Thousand Five Hundred and 00/100 ($247,500.00) Dollars and other good and valuable considerations paid by the said GRANTEE to the said GRANTOR, at and before the signing and delivery of these presents, the receipt of which is hereby acknowledged, has granted, bargained, sold, and conveyed, and by these presents does grant, bargain, sell, and convey unto the said GRANTEE and GRANTEE'S heirs, successors and assigns the premises described as follows: ALL THAT CERTAIN tract of land situate in the 14"' Ward of the-Cityof-York, County of York and Commonwealth of Pennsylvania, described according to a survey made by Stewart Whittier & Associates and shown on a Subdivision Plan dated October 9, 1978, Drawing No, L- 7832, recorded at York County Plan Book BB, Page 79, as follows: BEGINNING at a point on the southerly right-of-way line of PennDOT L.R. 66041 (US Route 30) at a comer of lands now or formerly of Rodney N. Stuver et Lm; thence by the same South 09 degrees 05 minutes 42 seconds East 287.48 feet to a point at lands now or formerly of Fireside Terrace Subdivision; thence by the same South 81 degrees 05 minutes 50 seconds West 129.41 feet to a point at lands now or formerly of Herbert N. Stuver and designated as Lot j on said plan-, thence by the same North 09 degrees 05 minutes 42 seconds West 264.46 feet to a point on the southerly right-of-way line of PermDOT L.R. 66041 (US Route 30); thence along the southerly right-of-way line of said road the following two (2)courses and distances: 1)North 72 degrees 57 minutes 30 seconds East 45.16 feet; and 2) along a curve to the right whose radius is 1185.00 feet, subtending a central angle of 04 degrees 06 minutes 08 seconds an arc distance of 84.84 feet to the point and place of BEGINNING. BEING designated as Lot 2 on the aforementioned Plan and CONTAINING 0.81 acres, more or less. YORK COUNTY ASSESSMENT OFFICE 01 MAR6 _ Hui' GaCE 4 � u 250 BEING THE SAME PREMISES WHICH York County Industrial Development Authority, by its Deed dated June 15, 1987 and recorded June 19, 1987 in the Office of the Recorder of Deeds of York County, Pennsylvania at Deed Book 95-Z Page 895, transferred and conveyed unto R.C.R. Realty Company, a Pennsylvania General Partnership. ALSO BEING THE SAME PREMISES WHICH R.C.R. Realty Company by Land Contract dated June 22, 1994 and recorded July 22, 1994 in the Office of the Recorder of Deeds of York County, Pennsylvania at Record Book 940, Page 599, sold, transferred and conveyed unto Jose Trejo, Jesus Arellano and Elijio Arellano. TOGETHER with all buildings, improvements, woods, ways, rights, liberties, privileges, hereditaments and appurtenances, to the same belonging, or in any way appertaining, and any revisions, remainders, rents, issues and profits thereof, and of every part and parcel thereof, including any interests specifically set forth herein, if any. And also, all the estate, right, title, interest, property, possession, claim and demand whatsoever, both in law and equity, of the GRANTOR of, in and to the same. TO HAVE AND TO HOLD the said premises, and the appurtenances, hereby granted to GRANTEE and GRANTEE'S heirs, successors and assigns, to and for the only proper use, benefit and behoof of the said GRANTEE and GRANTEE'S heirs, successors and assigns forever, under and subject to the conditions set forth herein, if any. AND the said GRANTOR hereby covenants and agrees that GRANTOR will specially warrant the property hereby conveyed. IN WITNESS WHEREOF, the said GRANTOR has hereunto set their hand and seal the day and year first above written. SIGNED, SEALED and DELIVERED IN THE PRESENCE OF WITNESS R.C.R. REALTY COMPANY, a Pennsylvania Partnership Y: ..i i ! 250 " IN WI7Nf,S5 WHEREOF, rtle undersigned intending o be le bound h their hands and scats this 7 day of sue' g legally $''` hereunto se, �nm Witness: R.C.R. Realty Company ql _k cltab t --- 1. Pat Res -------- aaasaxasaaaa axaaaa State of Win 4r..0 On eh ig .L. d."of - ��. ,200?,before me, the andersigned offieer,personally appeared Jack Chabot individually and as a generai partner on behalf of R.C.R. Realty company,. who bcing duly sworn ac—rdi^.g a jaw states that the foreae:n Affidavit is true and correct p C ..g......_ N WITNESS WHEREOF,)hereunder set my hand and Official Seal. Scott * D Erisslon.0 C8a6Jr. , '*MYComc ; e XV E , ` June 13.2003 '�— tay?Db1i State of County of :ss On mis day of ,2 002,before roe,the undersigned office..-,personally appeared J. Pat Ross, individually and as a geitetai partner an behalf of R.C.P.. Rea;: Company, who being duly sworn according to law states that the k4going A.fdavit is true and correct. 1PS tY.17NESS WHEREOF,1 hereunder set my hand'an\al Seal. NotafyPublic duW,.. i Rt,t 1484 250 State of SS. County of On the day of 2002, before me, a Notary Public in and for said County and State, re undersigned officer, personally appeared known to me (or satisfactorily proven) to be the person whose name is subscriX to the within instrument, and acknowledged that he executed the same for the purposes therein contained, and desired the same might be recorded as such. IN WITNE"WHEREOF, I hereunto set my hand and official seal. ' Notary Public \ State of ;. SS. County of On the day of. 2002, before me, a Notary Public in and for said County and State, the undersigned officer,personally appeared v known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he executed.,,,,, the same for the purposes therein contained, and desired the same might be recorded as such. . IN WITNESS WHEREOF, I hereunto set my hand and official seal. Notary,,Public ;; tD Ell;i". :ri 145 . 2504 ALL THAT CERTAIN tract of land situate in the 14 s Ward of the City of York, County of York and Commonwealth of Pennsylvania, described according to a survey made by Stewart Whittier & Associates and shown on a Subdivision Plan dated October 9, 1978, Drawing No. L-7832, recorded at York County Plan Book BB, Page 79, as follows: BEGINNING at a point on the southerly right-of-way line of PennDOT L.R. 66041 (US Route 30) at a comer of lands now or formerly of Rodney N. Stover et ux; thence by the same South 09 degrees 05 minutes 42 seconds East 287.48 feet to a point at lands now or formerly of Fireside Terrace Subdivision; thence by the same South 81 degrees 05 minutes 50 seconds West 129.41 feet to a point at lands now or formerly of Herbert N. Stover and designated as Lot 3 on said plan; thence by the same North 09 degrees 05 minutes 42 seconds West 264.46 feet to a point on the southerly right-of-way line of PennDOT L.R. 66041 (US Route 30); thence along the southerly right-of-way line of said road the following two (2) courses and distances: 1) North 72 degrees 57 minutes 30 seconds East 45.16 feet; and 2) along a curve to the right whose radius is 1185.00 feet, subtending a central angle of 04 degrees 06 minutes 08 seconds an arc distance of 84.84 feet to the point and place of BEGINNING. BEING designated as Lot 2 on the aforementioned Plan and CONTAINING 0.81 acres, more or less. BEING THE SAME PREMISES WHICH York County Industrial Development Authority, by its Deed dated June 15, 1987 and recorded June 19, 1987 in the Office of the Recorder of Deeds of York County, Pennsylvania at Deed Book 95-Z-895, transferred and conveyed unto RCR Realty Company, a Pennsylvania General Partnership. ALSO BEING THE SAME PREMISES WHICH RCR Realty Company, by Land Contract dated June 22, 1994 and recorded July 22, 1994 at Record Book 940, Page 599, sold, transferred and conveyed unto Jose Trejo, Jesus Arellano and Elijio Arellano. - - n Exhibit"A" ?�?so:der of Bc-eda X484 20 CERTIFICATE OF RESIDENCE I hereby certify that the precise address of the Grantee herein is: 724 Loucks Road York, PA 17404-1703 Attei%ey/Agent for Grantee Recorded in the Office for the Recording of Deeds in and for York County, Pennsylvania in Record Book , Page WITNESS my Hand and Seal of Office, this day of 2002. Recorder of Deeds TA- TmjoS W D/d=&red-eWCLN Parcel No. 38-19-1608-011k SPECIAL WARRANTY DEED THIS DEED made the 27°day of January, 1999. - co C-0 BETWEEN CHAD HAZ AM,Parry of the First Part, GRANTOR, 7. G -AND - JOSE TREJO and MONICA TREJO,husband and wife,as tenants by the emir Nes a5 to an undivided thirty (30%) percent interest; and JESUS B. ARELLANO, as to the rannaincsna: severity(70%)percent interest; as Tenants in Common,Parties of the Second Part, GRANcTBES3: C.n WITNESSETH, That the said GRANTOR for and in consideration of the sum of Three Hundred Eighty Thousand and 00/100 ($380,000.00) Dollars and other good and valuable considerations paid by the said GRANTEES to the said GRANTOR, at and before the signing and delivery of these presents, the receipt of which is hereby acknowledged, has granted, bargained, sold, and conveyed, and by these presents does grant, bargain, sell, and convey unto the said GRANTEES and GRANTEES' heirs, successors and assigns the premises described as follows: ALL THAT CERTAIN tract or parcel of land together with the improvements thereon located in the Township of Silver Spring, County of Cumberland and Commonwealth of Pennsylvania,more particularly bounded and described as follows: BEGINNING at an existing iron pin in Silver Spring Township, Cumberland County, Pennsylvania, said point being on the south right-of-way of US Highway 11 (Carlisle Pike - LR 34 - 100 feet wide) and also being the northeast comer of Lot No. 1 on the hereinafter mentioned Plan; thence along said right-of-way 89 degrees 04 minutes 12 seconds East, a distance of 117.73 feet to an iron pin; thence along lands'now or formerly of Patricia M. Cascardo the following two courses and distances: (1) South 01 degree 00 minutes 00 seconds East, a distance of 178.54 feet to an iron pin (set); and (2) South 89 degrees 00 minutes 00 seconds West, a distance of 117.73 feet to an existing iron pin; thence along Lot No. 1 on the hereinafter mentioned Plan, North 01 degree 00 minutes 00 seconds West, a distance of 178.68 feet to a point, the point of BEGINNING. CONTAINING 21,028 square feet, more or less. BEING Lot No. 2 on the Limited Final Plan for Chad Hazam Subdivision recorded in the Office of the Recorder of Deeds of Cumberland County,Pennsylvania, in Plan Book 58, Page 7. BEING PART OF THE SAME PREMISES WHICH Winters-Boland, Inc., by its deed dated July 26, 1988, and recorded in the Office of the Recorder of Deeds of Cumberland County, > >: - 269 Pennsylvania, in Deed Book K-32, Page 765, transferred and conveyed unto Chad Hazam and Larry A. Wohler t/a N-Vest Properties, a Pennsylvania general partnership. ALSO BEING PART OF THE SAME PREMISES WHICH Winters-Boland, Inc., by its deed dated July 26. 1988, and recorded July 28, 1988, in Cumberland County Deed Book 33-M. Page 153, transferred and conveyed unto Chad Hazam and Larry A. Wohler, t/a N-Vest Properties, a general partnership; and ALSO BEING PART OF THE SAME PREMISES WHICH subsequently Larry A. Wohler, by his deed dated December 18, 1991, and recorded August 9, 1996, in the Office of the Recorder of Deeds of Cumberland County, Pennsylvania, in Deed Book 143, Page 1158, transferred and conveyed his undivided one-half interest unto Chad Hazam, vesting sole title in Chad Hazam, GRANTOR herein. TOGETHER with all buildings, improvements, woods, ways, rights, liberties, privileges, hereditaments and appurtenances, to the same belonging, or in any way appertaining, and any revisions, remainders, rents, issues and profits thereof, and of every part and parcel thereof, including any interests specifically set forth herein, if any. And also, all the estate, right, title, interest, property, possession, claim and demand whatsoever, both in law and equity, of the GRANTOR of, in and to the same. TO HAVE AND TO HOLD the said premises, and the appurtenances, hereby granted to GRANTEES and GRANTEES' heirs, successors and assigns, to and for the only proper use, benefit and behoof of the said GRANTEES and GRANTEES' heirs, successors and assigns forever, under and subject to the conditions set forth herein, if any. AND the said GRANTOR hereby covenants and agrees that GRANTOR will specially warrant the property hereby conveyed. IN WITNESS WHEREOF, the said GRANTOR has hereunto set his hand and seal the day and year first above written. SIGNED, SEALED and DELIVERED IN THE PRESENCE OF WITNESS CHAD HAZAM COMMONWEALTH OF PENiNSYLVANI.A COUNTY OF DAUPHIN SS. On the 27`" day of January, 1999. before me, a Notary Public in and for said County and State, the undersigned officer, personally appeared CHAD HAZAM. known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. and desired the same might be recorded as such. IN WITNESS WHEREOF, I hereunto set my hand and official seal. My Commission Expires: Notary Public NOTARIAL SEAL STEVE GNICHOLAS,Notary Public City o`Harrisburg, Dauphin County P,dy .orrm:r=i.�r res_Sept 25, 19s CERTIFICATE OF RESIDENCE I hereby certify that the precise address of the Grantees herein is: 6417 Carlisle Pike Mechanicsburg. PA 17055 Att�Agent for Grantees aFax a;.$�'e**j:Y['F ie MJkfi MX*z�YC R,i.%M#zac?zMM>F x.' $Mk�k ak>ia,F4##r,.,ka[akEx%k•f a[:k#*i[*arc a'.:tM#T%k#*�, atX*=F%k$3ae>;c ak** Recorded in the Office for the Recording of Deeds in and for Cumberland County; Pennsylvania in Record Book Page WITNESS my Hand and Seal of Office, this day of 1999. Recorder of Deeds