HomeMy WebLinkAbout08-28-14 � 15�56101�1 '
REV-1500 Ex�°'.'°, v�
OFFICIAL USE ONLY
PA Department of Revenue pennsytvania Coun Code Year File Number
Bureau of IndividuaL Taxes `���,��`�"�"jNHERITANCE TAX lZETURN ry
PO BOX z8o6oi �( �� ^
Harrisburq,PA i�i28-0601 RESIDENT DECEDENT � I�
ENTER DECEDENT INFORMATION BELOW
Sociai Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
04/02/2014 03/24/1932
DecedenYs Last Name S�ffix Decedent's First Name MI
Trace Robert w
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Su�x Spouse's First Name M�
Spouse's Social Security Number �
THIS RETURN h1US i BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
� �.Original Return p 2. Supplemental Return p 3. Remainder Return(date of death
priorto 12-73-82)
p 4.Limited Estate p 4a.,Future Interest Compromise(date of p 5. Federal Estate Tax Return Required
death after 12-12-82)
C� 6. Decedent Died Testate O 7.becedent Maintained a Living Trust 0 8. Total Numbar of Safe Deposit Boxes
(Attach Copy of Wiil) (Attach Copy of Trust)
O 9,litigation Proceeds Received O 10.Spousal Poverty Credit(date of death O 11. Election to tax under Sec.9113(A)
between 12-31-91 and 1-1-95) (Attach Sch.O)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
Mark W.Allshouse, Esq. (717) 582-4006
�
° �
REGISTCI�O�WILLS US'C�NLY� �1�
47 �
First line of address �'T'1 � n G�� �,� �
4833 Spring Road � � � � � �
Second line of address , �mP; ` �`+ � �
;-, �j _� 3 � �
, r�
City or Post Office State ZIP Code ` E FILED ~ �^- �
--�
Sher.mans Dale NA 1%09U x'' � � .-�� '
CorcespondenYs e-maii address: mark@christianlavwersolutions.com
Under penalties of pery'ury,I declare that I have examined this return,including accompanying schedu�es and statements,and to the best of my knowledge and belief,
it is true,correc[and complete.Declaration of preparer other than the persona!representative is based on all informatlon of which preparer has any knowledge.
SI T RE O ERSON RESPONSIBLE FOR FILING RETURN DATE
� - �' O�I Lt��JCOiy
A RESS
102 Meals Drive rlisle, PA 17015 �
SIGNAT E P P R OTH H E SENTATIVE . y� ��
GJ
ADDR S
48 Spring Road, Shermans D e, PA 17090
P�EASE USE ORIGINAL FORM ONLY
Side 1
� 15056101�1 15�5610101 J
� 15�56101�5
REV-1500 EX DecedenYs Social Security Nurnber
� Decedent�s Name: Robert W.Trace
RECAPITULATION
1. Real Estate(Schedule A). . ... . . . ... .. . ... ...... ... .. ... ... .. ....... .. 1. 0.00
2. Stocks and Bonds(Schedule B) . ... ... .. .. ... . .. ... ... .. . . .. . ... . . .... 2.
0.00
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) . .. . . 3. 0.00
4. Mort a es and Notes Receivable Schedule D 4. 0.00
9 9 � ) .. . .. . . . . . . .. ... . .. .... . .. .
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E).... .. . 5. 58,390.68
6. Jointly Owned Property(Schedule F) O Separate Billing Requested .. . .. . . 6. 0.00
7. Inter-Vivos Transfers&Misce�laneous Non-Probate Property
(Schedule G) O Separate Billing Requested... .. ... 7. �.00
8. Totai Gross Assets(total Lines 1 through 7}.... ..... ... .. .. . ... .. . ... ... 8. 58,390.68
9. Funeral Expenses and Administrative Costs{Schedule H)... .. ... ... .. ... .. . .9. 6,475.83
10. Debts of Decedent, Mortgage Liabilities,and Liens(Schedule I) . .. . .. ... . . .. 10. 2,25$•�8
11. Total Deductions(total Lines 9 and 10).. .. . . ...... . ... ... . .. ....... .... 11. 8,734.61
12. Net Value of Estate(Line 8 minus Line 11) . ...... .. . ... .... .. ... ... ..... . 12. 49,656.07
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J} .... .. . ..... .... ..... .. . 13. 1,500.00
14. Net Value Sub'ect to Tax Line 12 minus Line 13 14. 48,156.07
1 � ) .. .. .. . .. ... .. .. . . .. .. ..
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116
(a)(12)X.0_ 0.00 15. 0.00
16. Amount of Line 14 taxable
at lineal rate X.0_ 0.00 �g, 0.00
17. Amount of Line 14 taxable
at sibling rate X.12 0.00 17 0.0�
18. Amount of Line 14 taxable 48,156.07 �g 7,223.41
at collateral rate X.15
19. TAX DUE .. .. ...... . . . ... . .. .. .. . . .. ... ... .. .. . ... .. ... . .. . . . . ... . 19. 7,223.41
20. FILL IN THE OVAL IF YOU ARE REQUESTlNG A REFUND OF AN OVERPAYMENT O
Side 2
� 15�5610105 1505610105 J
REV-1500 EX Page 3 F11e Number
Decedent's Complete Address:
DECEDENTS NAME
Robert W. Trace
-- _..... _ _ — ---- --------- _....-- ----- --
STREETADDRESS
219 East Locust Street
CITY - -- ^-- -- — - STATEPA Z�P17055 —
Mechanicsburg
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 7,223.41
2. CreditslPayments
A.Prior Payments 4,300.00
_._..._................_...._.._._........_......------._.._.._.._._...--
B.Discount 226.30
—...-------------------------- 4,526.30
Total Credits(A+B) (2}
3. Interest
�3� 2,697.11
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. •
Fill in ovai on Page 2,Line 20 to request a refund. (4) 0.00
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 2,697.11
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 transferretl:.......................................................................................... ❑ X❑
b. retain the right to designate who shall use the property transferred or its income:............................................ ❑ x❑
c. retain a reversionary interest;or.......................................................................................................................... ❑ 0
d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ 0
2. If death occurred after Dec.12,1982,did decedent transfer property within one year of death
without receiving adequate consideration?.............................................................................................................. ❑ �
3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?.............. ❑ �
4. Did decedent own an individual retiremert account,annuity or other non-probate property,which
containsa beneficiary designation? ........................................................................................................................ ❑ �
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994,and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is
3 percent[72 P.S.§9116(a)(1.1)(i)].
For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S. §9116 (a) (1.1) (ii)].The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000:
. The tax rate imposed on the net value of transfers from a deceased chiid 21 years of age or younger at death to or for the use of a natural parent, an
adoptive parent or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)].
. The tax rate imposed on the net value of transfers to or for the use of the decedenYs lineal beneficiaries is 4.5 percent, except as noted in
72 P.S.§9116(1.2)(72 P.S.§9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedenYs siblings is 12 percent[72 P.S.§9116(a)(1.3)].A sibling is defined, under
Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
REV-1508 EX+(6-98) Y
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CAS�, BANK DEPOSITS� Ot MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Robert W. Trace 21-14-0390
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. Members 1st Federal Credit Union savings account no.265990-00 25.31
2. Members 1st Federal Credit Union certificate of deposit no.265990-42 12,689.72
3. Members 1st Federal Credit Union certificate of deposit no.265990-43 12,216.05
4. Citizens Bank checking account no.6100701433 14,002.83
5. Prudential Insurance Company life insurance policy no.25389431 13,59921
6. Prudential Insurance Company life insurance policy no.21453738 1,620.21
7. Discover credit card cash rewards 103.28
8. Social security direct deposit 870.00
9. Discover card identity theft fee refund 1.79
10. Cumberland County Volunteer Firemen's Association death benefit 50.00
11. Central Penn Auto Club(AAA)refund 47.25
12. Diakon Lutheran Social Ministries refund 122.07
13. Public School Employees'Retirement System earned retirement 2g.78
14. UGI refund 28.50
15. Donegal Insurance Company homeowner's insurance refund 70.00
16. Camera Corner-photo equipment and cameras 60.00
17. Stephen Ott-sale of miscellaneous personal property 57.00
18. Gold Mine and G&C Gold-sale of coins 74.00
19. Cheryl Shughart-sale of vehicle 2,500.00
20. Strock Enterprises-sale of television set 75.00
21. Cash 148.68
TOTAL(Also enter on line 5, Recapitulation) a 58,390.68
(If more space is needed,insert additional sheets of the same sizej
REV-1511 EX+ ;10-0°j
�� ` pennsylvania SCHEDULE H
' DEPARTMENT OFREVENUE F U N E RAL EXPE N SES AN D
INHERITANCETAX RETURN AD M I N ISTRATIVE COSTS
RESIDENT DECEDENT �
ESTATE OF FILE NUMBER
Robert W. Trace 21-14-0390
Decedent's debts must be reported on Schedule I,
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERALEXPENSES:
1' Hollinger Funeral Home-entire amount prepaid
B. ADMINISTRATIVE COSTS;
1. Personal Representative Commissions: 2,919.00
Name(s)of Personal Representative(s) StBVen E. TraCe, EXeCUtOt'
street address 102 Meals Drive
city Carlise state PA ZIP 17015
Year(s)Commission Paid: 2014
2,500.00
2. Attorney fees:
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation.)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees: 333.50
5. Accountant Fees:
6. Tax Return Preparer Fees:
�• Cumberland Law Journal-estate advertising fee 75.00
s. Journal Multimedia-estate advertising fee 194.00
s. US Postal Service-cost to mail donation to Castan EDA Museum of Ethnic Costumes 13.38
�o. Deluxe checks-checks tor estate checking account 15.95
��. Eric Hollinger,Landlord-decedent's last month's rent 425.00
TOTAL(Also enter on Line 9, Recapitulation) $ 6,475.83
If more space is�eeded,use additional sheets of paper of the same size.
�Fv-rsiz Ex+ ��2-oa)
�� , pennsylvania SCHEDULE I �
���� DEPARTMENT OF REVENUE �DEBTS OF DECEDENT�
INHERITAN�E TAX RETURN M�ORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Robert W. Trace 21-14-0390
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• Masland Associaties,Inc.medical bill 31.54
2. Hospitalists of Centrai Pennsylvania medical bill 14.19
3. Express Scripts prescription biil 13.00
4. Diakon Lutheran Social MinistrieslCumberland Crossings medical bill 122.��
5. Diakon Lutheran Social Ministries/Cum�erland Crossings medical bill 1,557.07
6. Trust Ambulance,Inc.ambulance bill 132.00
7. Trust Ambulance,Inc.ambulance bill 35.00
8. United Water utility bill 29.53
9. Discover credit card bill 77.90
10. UGI utility bills 72.36
11. Verizon telephone bill 137.45
12. PPL Electric Utilities electric utility bills 36.67
TOTAL(Also enter on Line 10, Recapitulation) $ 2�258.�8
If more space is needed,insert additional sheets of the same size.
REV-1513 EX+(01-10)
�. pennsylvania SCHEDULE ]
��� DEPARTMENT OFREVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Robert W. Trace 21-14-0390
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(5)RECEIVING PROPERTY Do Not List Trustee(s) Of ESTATE
I TAXABLE DISTRIBUTIONS[Include outright spousai distributions and transfers under
Sec.9116(a)(1.2).]
1. Kenneth L.Shover,24 Cedarhurst Lane,Camp Hill,PA 17011 nephew 1/13-residue
2. Barbara A.Houser,3432 Bedford Drive,Camp Hill,PA 17011 niece 1/13-residue
3, Steven E.Trace, 102 Meals Drive,Carlisle,PA 17015 nephew 1/13-residue
4. Ronald D.Trace,304 N Arch Street Mechanicsburg,PA 17055 nephew 1/13-residue
5. Jeffrey L.Trace 39 E Locust Street Mechanicsburg,PA 17055 nephew 1/13-residue
6. Pamela K.Kehler 269 Penn Street Highspire,PA 17034 niece 1/13-residue
7. Diane M.Howard 16 Nittany Drive Mechanicsburg,PA 17055 niece 1/13-residue
8. Lois M.Newman 1223 Mill Creek Road Hampstead,NC 28443-2810 niece 1/13-residue
9. Cheryl L.Shughart 1012 Baish Road Mechanicsburg,PA 17055 ' niece 1/13-residue
SEE ATTACHED CONTINUATION
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B, CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
Washington Fire Company 1,000.00
2. Mechanicsburg Museum Association 500.00
TOTAL OF PART II— ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ 1,500.00
If more space is needed,use additionai sheets of paper of the same size.
Schedule J Continuation
Estate of Robert W. Trace
No. Name of heir Address Relationship Amount/Share
10 Nevin E. Shughart 102 Mill Drive, I�illsburg, PA 17019 nephew 1/13-residue
11 Jeffrey W. Shughart 78 Horsekiller Road, Shippensburg, PA 17257 nephew 1/13-residue
12 Elaine K. Shughart 148 Simmons Road, Mechanicsburg, PA 17055 niece 1/13-residue
13 Beth Ann Bear 401 First Street, Carlisle, PA 17013 niece 1/13-residue
LAST WILL AND TESTAMENT
OF
ROBERT W. TRACE
I, Robert W. Trace, of Cumberland County, Pennsylvania, being of sound and disposing
mind, memory and understanding, da hereby make, publish and declare this as and for my Last
Will and Testament, hereby revoking all other Wills and Codicils heretofore made by me.
FIRST
I direct the payment of my j�,�st debts and expenses of my last illness and funeral from my
estate as soon after my deatti as conveniently may be done.
I direct that my remains be buriec� in my U.S. Air Force uniform at Fort Indiantown Gap
National Cemetery, Annville, Pennsylvania, with a funeral with the appropriate military honors.
It is my desire that on the night of my viewing, a memorial service be conducted by the
Cumberland County Voluntary Firef ghters Association and that Hollinger Funeral Home of Mt.
Holly Springs, Pennsylvania handle rny burial arrangements.
SECOND
I hereby make the following specific bequests:
� (A) I give the sum of Onc 1'housand Dollars ($1,000)to the Washington Fire
� Company of Mechanicsburg, Pennsylvania,to its building fund.
� (B) I give the sum of Five Hundred Dollars ($500) to the Mechanicsburg Museum
Assoeiation of Mechanicsburg, Pennsylvania.
(C) I give unto the Washington Fire Company of Mechanicsburg, Pennsylvania, all
of my tire company mugs, banquet menus, convention ribbons, pins, books, pictures and all
other fire company memorabilia.
(D) I give ur.to Ronald 7`race all of my Penn State mugs,jackets, caps and other
Penn State memorabilia.
THIRD
I give, devise and bequeath a:l the rest, residue and remainder of my estate in equal
shares to my nieces and nephews, Kenneth L. Shover, Barbara A. Houser, Steven E. Trace,
Ronald D. Trace,Jeffrey L. Trace, Pamela K. Kehler, Diane M. Howard, Lois M. Newman,
Cheryl L. Shughart,Nevin E. Shughart,Jeffrey W. Shughart, Elaine K. Sheaffer and Beth
Ann Bear. In the event any niece or nephew predeceases me, the deceased niece or nephew's
share shall pass in equal shares to my surviving nieces and nephews.
FOURTH
I direct that each devisee and legatee pay the federal, state and other death taxes
attributable to his or her distributive share.
I understand that my life insurance, annuities, IRAs, in-trust-for bank accounts and any
other assets on which I may designate a beneficiary will pass to the beneficiaries that I have
named and will not be controlled by the provisions of this Will.
I also understand that any assets I own jointly with another with rights of survivorship or
�
presumed rights of survivorship (whether the joint ownership was created before or after this
J
" Will)will pass to the surviving joint owner and will not be controlled by the provisions of this
� Will.
FIFTH
In addition to the powers conferred by law, I authorize any personal representative acting
under this instrument, in his or her absolute discretion:
(A) To retain in the form received, or to sell either at public or private sale any
real or personal property;
(B) To exercise any options to subscribe for stocks, bonds, or other
investments;
2
(C) To join in any plan of lease, mortgage, consolidation, exchange,
reorganization or foreclosure of any corporation in which my estate or any trust may hold
stocks, bonds or other securi�ies;
(D) To sell, transfer, convey, mortgage, pledge, lease or exchange any
property, real or personal, which at any time may form part of my estate, for the payment
of debts or taxes, or for any purpose of administration or distribution, for such prices and
upon such terms as my pers���lal representative, in his or her sole discretion, may deem
wise, and to execute and deli�,�er�eeds of conveyance or transfer thereof;
(E) To make settlements and compromises on such terms as my personal
representative in his or her sole discretion may deem wise without the necessity of
obtaining any court approval thereof;
(F) To make distribution h�reunder either in cash or kind, as my personal
representative in his or her discretion may deem wise.
SIX'TH
� I do hereb nominate, constitute and appoint my nephew, Steven E. Trace to act as
Y
.
� Executor of this my Last Will and Testament. Provided, however, that if he is unwilling or
� unable to act as Executor, I direct the duties of Executrix to be performed by my niece, Cheryl
Shughart.
SEVENTH
I direct that no personal reprtsentative, guardian,trustee or other fiduciary appointed
under this instrument shall be required to give bond for the faithful performance of their duties in
any jurisdiction.
�
� ��. �,��--� ��.-�.�.,�,�;,�.�� .� w_ � �,,.�,��-..�- :�
IN WITNESS WHEREOF, I, R�bert W. Trace, have hereunto set my hand and seal to
this my Last Will and Testament, cc,nsisting of five (5) typewritten pages, the first three (3) of
which bear my signature in the margin fcr identification, this��day of March, 2014.
�1�.� � �---_
, /�-�,'--C�
Robert W. Trace, Testator
Signed, sealed, published and declared by the above-named Robert W. Trace, Testator, as
and for his Last Will and Testament in the presence of us, who have hereunto subscribed our
names at his request as witnesses thereto, in the presence of said Testator and of each other.
�_._-
t�� �--:� + � 1�c ADDRESS � � �'� �'`rc�o,�.�
�r�����,,�f�•�7rss-°s°
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��„�,�,-� � �!l.l��. ADDRESS �i� � ,I��
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� ��.��r.�c� ��f��.��' /`�Df�l
COMMONWEALTH OF PENNSYLVANIA :
COUNTY OF CUMBERLAND :
We, Robert W. Trace, ��ru�r��� /��, /!'�t�"�U and
%�'�J�c/"�i �2;', �J/;S'�jC�'�S'� , the Testator and witnesses, respectively whose
names are signed to the foregoing or attached instrument, being first duly sworn, do hereby
declare to the undersigned authority that the Testator signed and executed the instrument as his
Last Will and Testament and that he signed willingly and that he executed as his free and
voluntary act for the purposes therei:n expressed, and that each of the witnesses, in the presence
and hearing of the Testator signed the Will as witnesses and that to the best of their knowledge
the Testator was at the time eighteer� (18) or more years of age, of sound mind and under no
constraint or undue influence.
'��'� � � � �'��c.
Robert W. Trace, Testator
---�f �'�- �' ��
�
u, ,`�c /� l r e,Witness
�;� „�a � �.
-�!�� �
. :��,.�. ,Witness
4
.��- ���n��� .�.,� ,.�,....�.�,�� �. �.� b,. ,� �. �_.�
� ,� ���.� �rm;�. d.
Subscribed, sworn to and acknowledged before me by Robert W. Trace,the Testator, and
subscribed to and sworn or affirmed to before me by ` ��i�i'`/' ` �', ���"'�.� and
/1��'/1�i l�:� �✓1vf��1'��" _, witnesses, this ��'''' day of `�'`a�c�G•,�-� ,
2014.
,. ,
' N` ary Public
COMMONWEALTH OF PENNSYLVANIA
NOTARIAL SEAL
SalIie Ailshouse,Notary Public
Cazroll Twp,Perry County
My commission ex ires March 29,2016
5
St
�
MEMBERS 1St
FEDERAL CREDTT UNION
REGULAR SAVINGS ACCOUNT:
Account Number/Suffix 265990-00
Date Account Established 06/08/2005
Principal Balance at Date of Death $25.31
Accrued Interest to Date of Death $0.00
Total Principal and Accrued Interest $25.31
Name of Joint Owner None
CERTIFICATE OF DEPOSIT:
Account Number/Suffix 265990-42*
Date Account Established 11/04/2013
Principal Balance at Date of Death $12,689.29
Accrued interest to Date of Death $0.43
Total Principal and Accrued interest $12,689.72
Name of Joint Owner None
`Rollover from CD 265990-41 opened 04/06/2012.
CERTIFICATE OF DEPOSIT:
Account Number/Suffix 265990-43
Date Account Established 12/20/2012
Principal Balance at Date of Death $12,215.72
Accrued Interest to Date of Death $0.33
Total Principal and Accrued Interest $12,216.05
Name of Joint Owner None
MEMBERS 1ST FEDERAL CREDIT UNION
�
Tessa L Klugh
Lending Insurance Support Specialist
May 7, 2014
Estate of: ROBERT W TRACE
Date of Death: 04/02/2014
Social Security Number: 182-22-7847
5000 Louise Drive • P.O.Box 40 • Mechanicsburg,Pennsylvania 17055 • (800) 283-2328 • wwwmemberslst.org
� � �
Account Number 6100701433
Account Title Robert W Trace
Date Opened 12/8/1972
Account Type Checking
Princi al Balance as of DOD $14002.83
Interest from Last Posting to DOD $ .00
Account Balance as of DOD $14002.83
YTD Interest to DOD $ .00
�-----
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EST]�TE OF 4208E12T W TRACE
Activity Period:
RecentActivity Since Apr 12,2014 � .
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Recent Account Activity Totals
Last Statement Balance $77.90 I C I ' /� (� � ��,
Recent Payments and Credits- $79.69 ` � J� O V l. I
Recent Transactions +$0.00
Current Balance =$-1.79
Next Statement Closing Date �May 12
Please allow 1-3 days for payments to app�ar on your account.
About Your Last Statement View Statement
Last Statement Posted Apr 12, 2014
Last Statement Balance 77.90
Minimum Payment Due $ 0.00
Payment Due Date May 7, 2014
[.,ate and Minimum Pavment Warnin�s
No payments are scheduled.
Pending Transactions ��
Hide Pending Transactions
You have no new pending transactions.
Trans. Date.Post Date DescriAtion Amount Cate�ory
OS/02/14 OS/02/14 �PAYMENT - THANK YOU $-77.90 Payments and Credits
��04/18/14 03/25/14 �IDENTITY THEFT FEE REFLJND - MONTHLY$-1.79 Payments and Credits
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68587 ESTATE OF ROBERT TRACE 48906 Q6/12/14
INVOICENUMBER 'INVOICE.DATE INVOICE,pESCRIPTION GR4SSAMOUNT `DISCOUNT' NETAMOUNT
289499 06/04/14 REFUND 122 . 07 0. 00 122 .07
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DIAKON L UTH�'1?AN SOCIAL MINISTRIES`
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Date S/29/14
R08ERT W TRACE CO STEVE TRACE 102 MEALS DR CARLISLE PA 17015
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LE MARS INSURANCE COMPANY•PENMSULA INDEMNITY COMPANY
IE PENINSULA INSURANCE COMPANY•SOUTNERN INSUFANCE COMPANY OF VIRGINIA
P.O.BOX 300•MARIETTA,PA 77547-0300• 1-800-H7Y•0600•www.tlonogalgroup.cnm
DONEGAL MUTUAL INSURANCE COMPANY
BILLING INQUIRIES CALL: 1-800-877-0600
05/09/14 CANCELLATION MEMO 0005681 G 5Q01891 1205
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PRO—RATA CANCELLATI�N EFFECTIVE 05/05/J.4 70.00CR
CANCELLATION REQUESTED BY TNSURED
A REFUND DUE $70.00
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� T A GUNN—MOWERY LLC
T E G P 0 B�X 900
I R E CAMP HILL PA 17001-0900
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Gold Mine and G&C GOLD �
57 West Main Street, Mechanicsburg, PA 17055
' (717) 76�-1697 .
(717) 448-5692 �
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In Consideration of� %�"� value received,I da hereby sell and assign all �
prope�ies listed on this bili of sale to Gold Mine i G&C Gold,and warrant that I have lawfui ;
autho�ty to dispose oi same and am at least 18 years of age. I fu rther warrant theright that a
' i shail defend my right and title to dispose of said property, ;
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CHERYL LYNN SHUGHART ����� 216 4
PH.717-697-2885
1012 BAISH RD. � _ �p_ i�
� MECHANICSBURG,PA 17055 onrE
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STROCK ENTERPRISES INC. sia 49 4 2 3 2
PH.717.697.2824
TL9 WILLIAMS GROVE RD. �r� �_� Z _ 2v��
MECFiANICSBURG,PA 17055 __
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RECEIPT FOR PAYMENT
LISA M. GRAYSON, ESQ. Receipt Date : 4/23/2014
Cumberland County - Register Of Wills Receipt Time : 09 : 09 : 02
One Courthouse S quare Receipt No. : 1077755
Carlisle, PA 17613
TRACE ROBERT W
Estate File No. : 2014-00390
Paid By Remarks : CHRISTIAN LAWYER SOLUTIONS LLC
DB1
------------------------ Receipt Distribution ------------------------
Fee/Tax Description Payment Amount Payee Name
PETITION LTRS TEST 210 . 00 CUMBERLAND COUNTY GENERAL FUN
WILL 15 . 00 CUMBERLAND COUNTY GENERAL FUN
JCS FEE 23 . 50 BUREAU OF RECEIPTS & CNTR M.D
SHORT CERTIFICATE 50 . 00 CUMBERLAND COUNTY GENERAL FUN
AUTOMATION FEE 5 . 00 CUMBERLAND COUNTY GENERAL FUN
INVENTORY 15 . 00 CUMBERLAND COUNTY GENERAL FUN
INH TAX RETURN 15 . 00 CUMBERLAND COUNTY GENERAL FUN
----------------
Check# 3310 $333 . 50
Total Received. . . . . . . . . $333 . 50
�J`����D c�G�'1.
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CUMBERLAND LAW JOURNAL
32 SOUTH BEDFORD STREET
CARUSLE, PA 17013
Tele: (7'17)249-3166 Fax:(71'�249-2663
May 23, 2014 �
Cumberland Law Journal is published every Friday by the Cumberland County
Bar Association and is designated by the Court of Common Pleas as the official legal
publication for Cumberland County and the legal newspaper for publication of legal
notices.
TO: Mark W. Allshouse, Esquire
RE: Robert W. Trace Estate
Legal advertisements must be received by Friday Noon. All legal advertising
must be paid in advance. Make all checks payable to: Cumberland Law Journal.
Advertisement inserted on following dates:
May 9, May 16, and May 23, 2014
Advertising Cost $ 75.00
Proof of Publication $ 0.00
Second Proof Request $ 0.00
Payment received $ 75.00
Total Amount Due $ 0.00
Becky H. Morgenthal, Executive Director
I N V O I C E
1500 Paxton Street
J OU R NAL Harrisburg, PA 17104 5/23/2014
T.717-236-4300
M U LT I M E D I A F.717-236-6803 ORDER#: 95733
www.journalmultimedia.com TERMS: Net 30 Days
-------------- INVOICE TO ------------ -------------- ADVERTISER------------
Christian Lawyer Solutions, LLC Christian Lawyer Solutions, LLC
Accounts Payable
4833 Spring Road
Shermans Dale, PA 17090
INVOICING:Advertiser
DESCRIPTION OF CHARGES COST = CREDIT = BALANCE
PUBLICATION: CLASSIFIED/CENTRAL PENN BUS.JRNL
COVER DATE: 5l16/2014 THEME: CLASSIFIED AD/CENTRAL PENN BUSINESS JOUR
RATE CARD:
DESCRIPTION OF AD:
Legal listing: Estate of Robert W.Trace
REP(S):
MARK SUNDAY
SIZE: LEGAL LISTING, PAG�: 194.00
COLOR: B&W 0.00
SPACE SUB-TOTAL: 194.00
* BALANCE DUE: 194.00
BUILING SPRINGS PO
BOILING SPRINGS, Pennsylvania
. 170079998
4134870007 -0099
04/19�2014 t7171258-6668 09:°i4:56 AM
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--- Sales Receipt — —
Product Sale Unit Final
Uescri�tiar� Qty Price Price
0@ TUCSON AZ 85718-2229 Zone-8 $13.38
Standard Post
3 lb. 7.50 oz.
Expected Delivery: Sat 04/26/14
USPS Tracking #:
9114901230801614552701
Issue PVI: $13 38
Total : $13.38
Paid by:
Cash $20.00
Change Due: -$6.62
�� For tr•acking or• inquiries yo ta
USPS.com or call 1-800-222-1811.
Order� stamps at usps.corn/shop ar call
1-800-Stamp24. Go to usps.com/clicknship
ta pr�int ship��irig labels with postage. For
other information call 1-800-ASK-USPS.
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a box online at usps.com/poboxes.
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Order Contents
Conflrmation#: 6 0 1 7 9 7 0 3 5 1
Routlnyli: 23138224
AccouM#: 2185555444
EsUmated Order 7ota1: $15.95
Ordar Date: 04/23/14
kem 1: DescHpuon Antique 50 Intro Checks-Dupl
Imprint: ROBERT W TRACE ESTATE
102 MEALS DRIVE
I CARUSLE,PA 17013
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Shipp�ny Method: Standard Delivery-14 Days
Shlpping Addreaa: ROBERT W TRACE ESTATE
102 MEALS DRIVE
CARLISLE,PA 17013
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Privacy Security and Reliability Tarms and Conditions
All desi9ns shown are subject to change wlthout nonce.
AII trademarks are the uroperty of their respeccive owners.rc2U1a Deluxe Enterprise ODerafions,[nc.All Ri9hts keserved
Build Versian:9.1..22 .
4/23/2014
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102 MEALS DRIVE �/�� ,�/jf '
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IF PAYING BY MASTERCARO,DISCOVER OR VISA,Fill OUT BELOW.
CHECK CARD U81NG FOR PAYMENT
��TER O�OVER �❑
CAR�NUMBER EXP.DATE •ID CODE
MASLAND ASSOCIATES INC
220 WILSON STREET SUITE 109 w.r.�or,cnao SIGNATURE
CARLISLE, PA 17013
STATEMENT QATE PAY THIS AMOUNT ACCOUNT NUMBER
06/11/14 $31.54 1740
Please Pay Promptly,Thank You.249-1929 'LASTTHRfEAIGtTSONBACKpFCREDRCARD SHOW AMOUNT
PAGE 1 /1 PAID HERE $
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� QSS0611A SCH 5-DIGIT 17007
7000001666 00.0006.0201 1534/1 t'���'�'�I'���'I���'�'�I'��'��I�����'f�'1'I�����I���II�������f'��
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ROBERT W TRACE MASLAND ASSOCIATES INC
�'� 1 LONGSDORF WAY 220 WILSON STREET SUITE 109
CARLISLE PA 17015-7623 CARLISLE PA 17013-3697
� Pleese eheck box H address Is IncorreM or insurazke
information has ehangod,and Indlcato chonge(s)on revarae aide.
_ .. . � .
PLEASE DETACH AND RETURN TOP POR110N WITH YOUR PAYMENT STATE M E NT ��DENTIFlCATION CODE:L4STTHREE DIGITS ON BACK OF MC,DISCOVER.AND VISA
DATE DESCRIPTIpN pF SERVICE AMOUNT INS.BAL PAT.BAL LINE ITEM BAL
02/16/14 ENCOUNTER 855984 FOR ROBERT WITH NEIDERER D0,PHILIP A �
02/16/14 99495-Hospitai D/C Face To Face Within 14 Calendar $197.00 $31.54
Days
03l10/14 Medicare Payment -$123.64
03/10/14 Medicare Adjustment _$41,82
05/30/14 WPS Tricare For Life Payment(4 (Non Covered $0.00
Service))
ENCOUNTER TOTAL $31.54 $O.Op $31.54 $31.54
Balance is your responsibility.Piease notify us af insurance changes promptly.Thank you.
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CURRENT 30-60 DAYS 60-90 DAYS 80-120 DAYS OYER 120 QAYS TOTAL ACCOUNT BALANCE '+' • '"� "° .J !
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$31.54 �o.00 $o.00 $o.00 $o.00 $31.54 �� °t�54:'�� `� i
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MASLAND ASSOCIATES INC • 220 WILSON STREET 5l'[TE 109 • CARLiSLE,PA 17013 �
� �tll in elow To Pav By Credit Ca�d
❑ ViSa
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> H4SPITALIST5 OF CENTRAL FENN5YLVANIA
; PO BOX 62722 Card Number
=^' Q BALTIMORE, MD 212642722 �Xp,pate Security�ode
N
— M Card Holder Name Signsture
° FORWARDING SERVICE REQUESTED StatementDate PayThisAmaunt Account#
= Q5/22/14 $14.19 140321134 - �
=� Payment Due Date Show Amc�unt� �
=•' 06t12114 Paid Here
'_"' � "I '�� " I � " II' I �I �I '��� ptying by credit card your recelpf wiil be from Globa! Health Manegement Services.
�" ��� ��� ������ � � ��� �"� �� �� �� ���" � � �� HOSPITALISTS OF CENTRAL PENNSYLVANIA
**'""""*`"***ALL FOR AADC 170 011529
— PO BOX 62722
� TRACE,ROBEFIT W BALTIMQRE, MD 212642722
= �`P MEALS DR
CAR(.ISLE PA 17015-3186
❑Please check if address or Insurance Iniormation
Is incortect and comp(ete form on aack. PLEASE dETACH AND RETURN TOP PORTION WITH YOUR PAYMENT
_
_
Account #: 14U321134— Piease Pay: �14.19 ou� �at�: 0�/12/14
Date Qescri tian Payments
p Amount Adjustments
BA�ANCE FORWARD LAST STATEMENT Q.��
03/14/14 99232 HOSPITAL DAI�Y VISIT 150.00
04/11/14 MCCK MEDICARE CHECK -55.63
04/11/14 MCDS MEDTCARE pISALLOWANCE -$0.18
A Ward About Your Account
BALANCE DUE IS YOUR RESPONSIBILI`fY AND SHOULD BE PAIO
IN FULL WITHIN 15 DAYS.
Tatal Now Due 14.ls �
Make Cheoks HOSPITQLISTS OF CENTRAL PENNSYLVANIA For Billin Questions Cai!
Payabie To: PO BOX 62722 (888� 610-$�22
BALTIMORE, MD 212642722
Nuica: as PAGE 1 �F 1
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Payment Due
Return the Payment Slip below to us with your payment. �•—
Keep the top portion for your records. � E X P R E S S 5 C R I P T S°
-.o•
Invoice number: 59-024607625 express-scripts.comltricare
a
Plan member. ROBERT TRACE �- First-time visitors please register.Have your member
Group number: PD1-DODA ID#and a recent prescription number handy.
As of: 03/3112014 877,363.1303
�-_.`� '� � 24/7 access to pharmacists who are ready to help you
\ � with your medications.
Total amount due (upon receip : $ 13.00
- _ _ _
____ __ ----------
• ONLY USE the BLUE envelope for your payment.
• Do not send prescriptions or correspondence in the blue envelope. It will cause delay.
� Send your correspondence in writing to: Express Scripts,PO Box 52150,PHOENIX AZ 85072-9643
• Future orders may be held if you have an unpaid balance.
• This order was processed before you requested automatic debit or credit card payment.Call 877_363.1303 to pay____.__
;C Cut this slip at the dotted line and return with your payment in the BLUE envelope.
Kober�Trace Cumberland Crossings Retirement�ommunity 03/31i2014
Steven Trace
Date Description Units Net Balance
rom rou Char es Credits
2/28/2014 Balance Forward $0.00
�3/19/2014 3/31/2014 Personal Laundry .42 Month 23.0
�3/19/2014 3/19/2014 Transportation per Mile 7.00 Mile 21.0
�3/21/2014 3/21/2014 Transportation per Mile 12.00 Mile 36.0
3/24/2014 3/24/2014 Transportation per Mile 7.00 Mile 21.0
3l26/2014 3/26/2014 Transportation per Mile 7.00 Mile 21.0
/''^..
TOTAL BALANCE DUE ' $�ZZ.o�
i'LEAS���:TU:iN 7CiP°URFiOiV'A/ITW.YpUF�f'.4YPv1E'r1!?,Rv1'AIN C90T7QM PUF�?IOiJ F'OI�:YOUR R�CORCJS
STATEMENT Pa9e: � of �
� I 1�KC� N Invoice# Account# Date
LUTI-IGFAN 5C)CIAL MINIS�I'R1E5 375976 9337CCNC 05/05/2014
Cumberland Crossings Retirement Community
1 Longsdorf Way
Carlisle, PA 17015-7623 Due Date Amount Due Amount Paid
Facility#(717)245-9941
Business Office#(717)240-6040 5/23/2014 $1,557.07
Steven Trace Resident Name
102 Meals Dr. Trace, Robert
Carlisle, PA 17015
_. . _._ .... .
Pi�ase make check payable to Diakon Lutheran Social Ministries
Robert Trace Cumberland Crossings Retirement Community 05/05/2014
Steven Trace
D te Description Units Net Balance
r m �ou Cha es re its
03/31/2014 Balance Farward 122.07
13/28/2014 03/31J2014 Semi Private 4.00 Day 1,148.0
)4/01/2014 4/01/2014 Semi Private 1.00 Day 2g7.p
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�`"� �v�:�..�` L� �{���f�
��lj'$k(�t!)P4T h'+�c j�� rr n�r�......._ __
F`��.r'i'I� r�!' ��� c
�I�'�fi,"x�:����IzPru�rcfti �l��i°���C.r�i�Y'
TOTAL. BALANCE DUE � ��,557.0T
°I.�AS�:RETi_lfiiV 7t��?(�3i1'IQ�4 N/i1"k^I YOi1R?:�,YF1�N7.id`5?I.ItJ(�!`.t._Ofv9 f'C)FI't'ti)i3 i p�`i��Cin rP_;;;IFiC?C,
Trust Ambulance Inc
1131 PRIMROSE AVE
CAMP HILL,PA 170116924
(717)737-2600
Patient name: TRACE,ROBERT Run Number: 14-1927
Date of call: 3/6/2014
Time of call: 11:00
Caller: Whlte,BeCky
From: ManorCare Carlisle
ROBERT TRACE To: 3842 LONDONDERRY SQUARE
219 E.LOCUST STREET 2ND FLOOR
MECHANICSBURG,PA 17055
Payment
Description Payer Check# Quantity Unit Price Date Amount
Wheelchair Base Rate � $45.00 $45.00
WheelchairMileage 4� $2.00 $82.00
Wheelchair Base Rate � $45.00 $45.00
WheelchairMileage 41 $2.00 $82.00
Contractual Allow-Contract Manor Care Carlisle 03/07/2014 $122.00
PLEASE PAY THIS AMOUNT $132.00
--—-------- -------
----------------- - ---------------------
- -------------
DETACH ALONG LINE AND RETURN STUB WITH YOUR PAYMENT.THANK YOU.
Patient name: TRACE,ROBERT Run Number: 14-1927 AMOUNT �
ENCLOSED:
Current date: 3/21/2014
Due on: 04/10/2014
REMITTO: TrustAmbulance Inc Admin use ONLY
1131 PRIMROSE AVE Check Date:
CAMP HILL,PA 170ll6924 PT Facilty
Check#:
This is your first notice.These charges are not covered by your Insurance. If you need to pay with a credit card or have questions,please
contact our office.Failure to correspond or pay will result in getting sent to collections.
Trust Ambulance �nc
1131 PRIMROSE AVE
CAMP HILL,PA 170116924
(717)737-2600
Patient name: TRACE,ROBERT Run Number: 14-1942
Date of call: 3/6/2014
Time of ca1L• 14:00
Caller: White,Becky
From: ManorCare Carlisle
ROBERT TRACE To: 220 WILSON STREET
219 E.LOCUST STREET 2ND FLOOR
MECHANICSBURG,PA 17055
Payment
Description Payer Check# Quantity Unit Price Date Amount
Wheelchair Base Rate � $45.00 $45.00
Wheelchair Mileage 2 $2.00 $4.00
Contractual Allow-Contract Manor Caze Carlisle 03/07/2014 $14.00
PLEASE PAY THIS AMOUNT $35.00
---- --- --- - --- -- -- ---- ---- --- --- --
DETACH ALONG LINE AND RENRN STUB WITH YOUR PAYMENT.THANK YOU.
Patient name: TRACE,ROBERT Run Number: 14-1942 AMOUNT S
ENCLOSED:
Current date: 3/21/2014
Due on: 04/10/2014
REMITTO: TrustAmbulance Inc Admin use ONLY
1131 PRIMROSE AVE Check Date:
CAMP HILL,PA 170116924 PT Facilty
Check#:
This is your first notice.These charges are not covered by your Insurance. If you need to pay with a credit card or have questions,please
contact our office.Failure to correspond or pay will result in getting sent to collections.
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USAGE HISTORY 8111111g Dat�; OS/07/14
Usage in Thousands of Gallons Account Number: 00�03698962552
r . �.— __ _.— _.� ... _._ � _. _..
_�_
� _......_.__._ _
3 .. - ,-- ..-� Previous Balance $11.59
Payments Through 05/07/14 $0.00
Z _ Balance Forward- pAST pUE $11.59
Current Charges Due Q5/27/Z014 $17.94
, -. __ � . � � __. �. ira�`�r,:�aMc�rn�'�'��� �m �����
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0 0 o u n o 0 0 0 0 ,o 0 o FINAI Blll
JOn feD Moe Ap� Moy •
Past Due 8a/orrce may be subject to Jate charges,colleciion and/or
Next meter reading date:on or about 06/06/2014 *PAY BY 06/02/2014 TO AVQID A 1 5%IATE PAYMENT CHARGE
SEHVICE To: RGBERT'fRACE SERVkCE AODRESS: 21�9 E lOCUST ST MECHANIC58URG PA
M��er��Juml��r��� _ -S°e�"vice � Doys oY ; hJ��er Reodst�g �� � `' � �
.� � � � �'S :�,u�h��.0'�'s,,, �� . � �, £ '� x : ��
x . �i�OFh ,,.;a.�s.,�`tf. ' �1"y1t�12� :�CEI?IOl1S' P}esenf ��15Q9E 3 ��1'�Eq,��!+L �"a d�ditY �� ��� ��
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050335964 04/07/1k 05/06/14 Z9 0525 � 0526 � ^ 1 �MGI M
EpUfVA�ENT TO i,000 GALLONS TUAI W07
SERVICE CHARGES $11.00 STATE TAX AD]USTMENT SURCHARGE $O.d3 CR
WATER CHARGES $5.91 WATER IATE PENAITY CHARGE $0.17
DISTRIBUTION$YSTEM IMPROVEMEN $0.89 TOTAL CUR{2ENT CHARGES $17.94
SEE REVERSE SIDE FOR IMPORTANT ACCOUNT INfORMATiQN
� �.. �. ° l!`�"�RTA'�IT�l���ACES., �° y ��„, � ' ��
Your consumption is based on.an actual readin gm�ro ement Charger(D51C)increased from 4.79/o to � � y Y � �'^/�'j p<A : �';
Effectiue April 1, 2014 the Diskribution System I � ° 5.29%.ThisPcharge funds the
re�placement of water d�stnbut�on fac�t�t�es in PennsylUama.
Effective April 10,2014 the State Tax Adjustment surcharge derreased from 0.12�/o ta(0.22%)
i u o o ae +++wa PIEASE DETACFf HERE AND RETURN 7HE BGTTOM PORTION WITH Y�R PAYi�tENT,IN THE REiURN rNVEIOPE PROVIpf,D.. ppp
...... .... . . . ....... .....,.... ......... .-•----.,..._. .... _... . oos
. � � UNITED WATER Account Number: 00203698962552
Cu tomer Seruice Cenier
81�9 Adams Drive Balance Fonuard - ppST DU�' $11.59
Hummeistaan,PA 17036
7emp-Return 5eroice Requested Current Charges Due OS/27/2014 $17.94
SERVICE AppRESS: 219 E lOCUST 5T ��,;�������'��,�. z� �g� �»xs� � �"�g"��° ;
MECHANICSBURG PA ~�?!?°se'mp'�e�?°.�,°.�f�l't�'�T�V}C�,F��1,'CIfAi�lf.'�A�µ��,���,,,„':, _�.
❑ Piease check this box if you have made any
Payment Amount Enclased $_,��,�._,�, �
changes to the information on the reverse side.
001913 I�Ilill�hi��������i��n�uh"il�hlrp��h����h��i�,��ihll��
'����I�II'IIII��II���'li"IIII"IIIII'��III"IIIIIIIII'I�I'�I�III UNITEp WATER PENNSYIVANiA
*"*AUTO*'MIXED AADC 2801913 T9:14 19131 MB 0.435 PAYMENT CENTER
ROBERT TRACE Pb B�X 371804
.�_> 102 MEAlS DR PIT7SBURGH PA 15250-7804
CARLISIE PA 17Q15-3186
002036989625520000�0029530�OODQOOS
��SC� VER Discover More Card
Account number ending in 6670
Open Date:Mar 13,2014-Close Date:Apr 12,2014
Cardmember Since 1986
. Page 1 of 6
ACCOUNT SUMMARY PAYMENT INFORMATION =��.
, PreviousBolonce $1,202.27 New Balance $77.9� .�
1; Payments and Credits — $��2�2•2� Minimum Payment Due �–�°"�$35.00
°; Purchases + $77.90 payment Due Date May 7,2014
Balance Transfers + $0.00
Cash Advances + $0.00 Lafe Payment Warning: if we do not receive your minimum payment by the
Fees Charged + $0.00 date listed above,you may have to pay a late fee of up to$35.00 and your
Interest Charged + $0.00 purchase and balance transfer APRs for new transactions may be increased up to
the Penally APR of 16.24/o variable.
New Balance $�7�9�
See Interest Charge Calculation section following the REWARDS
Transactions section for detailed APR information
Credit Line $15,000 Cashbuck BonusOO Anniversary Month
June
— Credit Line Available $14,422
Opening Balance $ 102.52
— Cash Advance Credit Line $7,500 New Cashback Bonus This Period
— Cash Advance Credit Line Available $7,500 Everywhere Else + $ 0.77
— Redeemed This Period —$ 0.00
= You may be able to avoid interest on Purchases. CQSMI7CICIC BOtIUS BC1IClt1C@ � �03.29
— See reverse for details.
— To learn more,log in at Discover.com
= eoo es°"a" �I�O
_ �ao
670 /'1 � ^
� V L
- min 300 Your FICO�Credit Score on 4/b/14.
Fico•c.odnn�.w More at Discover.com/FICO
;a�rtv�T��cE
'L 1
'19�LOCUS7 ST
�1ECHANi�SBURG PA 17055
tate Ciassificatiop: Cu�rent Bill Infarmati�n-UGI Utilify
;esidentia!Heating Customer Charge.... .............. 8.55
............................................
liliing Period: Commodity Char�e� 19 CCF at$0.62000) .............. 11.7�
°.3I24l2014 to 04123t2014(30 days) ��strib�tion Charges (First 19 CCF at$0.33421} ,,, �,3�
Rernote Device Etead PA Stafe 7ax St�rcharge .................................................. -Q.13
tuastians? PA S�les T�x...................................................................... 1.60
'q BOX�30p9 722 flr write to�1G! at UGI Ut lity h rg�seawed th sfbr#1 ........................... 28.1
................ .................................... �2s.�5
... ..... ,
�eading.PA 19612�3009 Tata1 Amount Due,Rlease Pay by Due Date(05l19f2094) ..................................... S 28.95
'our carrent lJGI charges inciude
�tate taxes tota�ing about$2.45.
Meter infnrm�tioh -ldext Read D�te May 23, 2014
7$Q Average CCF Per Day Me#er Number Previous Reading Present Reacling CCF Ussd
7.�2 117�522 8Q46{remotey 8�65 (remote� 19
6.24
5.46 Messages fram ll�i
4.68 °Yuut current price to Gampare is$ 0.62045/CCF.
3.�a ■Your total usage is 494 CCF. Your average monthE�r usage is 123 CCF.
3.12
�_gQ 'We can rrtake your energy costs easier�n yaur budget with ot�r 12 mnnth Budget Billing
� �� ptan. Your monthty payment woulci be apprrntima�ety�56,Q0. For mas�e infarmation �
about�is pfisn cal! UGI. �
�.78 �
�
�.pp •Nelp pre+�ent pipeline damage, accidents an�service�isruptions.Ca�! 811 �sfore you dig. °°
d M J J A S 0 N D J � M A "Save time.Save the planet,Sign np ta view anrf pay your UGt bilfs online at www.ugi.com.
2013 Mo�ths 2�14
Last This �,
veragB Year Year �
C����� Q'�3 ff you pay at.a payment agent plsase tak�yaur entire t�ilf. Make check a abte ta UGt.
�i(y temperatura 48°F A Y
Keep this part far your records. Impartar�t intorm�tian is �� the k,a�� rt1'this bill,
l�GI t�tilit[es.�nc. Cus#am�r Number Pl�ase pay by the due d�te
� PO 8ox 15523 219725�21 Q5�7 to auaid the late charge.
Wilmirrgtan.DE 19886-55�3 Flease return this portion
_.._ sas sFa�icF with your paymen�.
� ,`Q�3�����
.. . ,,, ,..-. .: ...
�.: May i�, 2014
AV 01 �02251 495428 14 A**5I}Gl"
�e���l����III1��tl�'1�1'I��II.}`fl�sllei�I�`�:I�1���1"'�i�11�1s��1� : � � • !
RC)`BERT � TRACE � $ 28.15
CO STEVE TRACE . , � ���, � ,. ',
, ' ' . ,. _ .`r ..'
ID2 MEALS DR ' � ', �.�
CARLISCE PA i70I5-3lS�i � 28.50 `� ,
1llOLf11 YV I�Vivt.
:t1 STEVE TR�iCE
�L 1
!19 E i.0011ST ST
AEGFlANfC56liRG PA 17055
tate Classification: Curre�t Bill Intarmation-UGt Utility
tesfdential Heating C�stomer Charg� ...................._.......................................... 3.42
3ifiing Psriad. Commodity Charge� 12 CCF at$0.62167} ................. 7.46
)4/23/2Q 4 4 to 05/05/2014{12 days) Oistribufion Charges ............................................... ......... 4.Q 1
PA State T�c 5urcharge..................................................... -O.U7
Final Read PA S�les Tax. 0.89
puesfions? ........................................................................
:alE 8�a-2�6-2722 or write to iJGI at UG�U�t`�iity charges�owed thislb�,li............................... .��
aq BQX 13Q09 .... .............................................. $d3.86
teading,PA 19612-34Q9 Tutal Amaunt Due,Piease Pay by Clue date(f�'i128f2014) ....................................... S 43.86
�our current UGt Charges include
3tate taxes tatalEng abo�t$ 1.37.
,�..�.._ Meter lteading lnfnrmation
�verage GCF Per tlay
7.80 .�_.._._..... ^__._�_._ Meter Nurnber Previoux Reading P'res�nt Reading CCF Used
���2 11705�2. 8065 {rem�#e) 8f!?7 (final) 12
6.24
5.46 Messag�s fnarn UGi
4.g� •Your curren�prics ko com�rare is $0.62U45 lCCF.
�'�Q ■Yattr tot�! usage is 494 CCF. Your average mon#hly usage€s 123 CCF.
3.12
2.34 •He�p prewent pipeline damage,accidents�nd servics disruptions.CaN 811 hefore yau dig.
1.56 `:
0.78 �
�
�
0.00 �
MJJAStINDJ FPAAM
2�13' Months 2Q14 �
�ast This •
�verage Year Year �
`�F���y �"�� Ifi you pa�at a payment agent piease take your entirs bill. Make check payable to UG1.
3�i(y tsmparate�re 54°F Kes this
_ _.__.� _,. p part for your secords. Irnportant informatidn is an the b�ack of this biii.
.:�,
���:� UG�U�E�itlBS, Inc. eustomer Number �'�ease pay hy the due date
� P�Box 15523 �1'�7����1�I�� to avaid the late cbarge.
Wilmington,QE 19886-5523 Please return this pQrtinn
_:��°- a.�s s��v�cE with your paymen#.
FtH. ' �u��'�t�,
, ...,., .. . ....�,,. . ...,., .
AB t71 DOp'�30 13824 B 4 A
May 28, 2014
�
1 ► � I �I � � �1 r��l 1� � � � 1) 1{11r1 : � i��� < • � "
� ri l I �f � ��I I�lI i E ! tl�r� r : it : i El aa
RQBERT W TF�AC� ` � 43.8�i
C a aT�1XE TRA CE ,;'�'�#��,'.�t��'��E" � `: �,
. . . . � � �� � �: �� � .'��; ��..-. .`.:�� r , �.. ,,�
�.02 MEALS Df� .. .,...,,y .
C�RL ISLE PA 17Q 15--3I$6 $ 44.41
� .. . ,��.�,���,-�;�.-�,�,:� ��.�..-,�.� . �.�. -�-�� .
Account Number Amount Due
79 9000 !�8749013145j05 . 5137.45
. _
ver�n
Account Information
�t#�i�el'I���t�tyv$t��r� ;:`. stacemene nate: ai�9na
;:::.,..;.,.....:.:-..-;;::-...>.............:.....:>:....:..::::::.. ....::.....:::.::::::...:.:-::..
>::::>;:::s:::;;:::::;>::>?:::::::,:,r:.. ': s.... ...:... .
.:;:.::�:::.:.:.:..:..... :.
,�:°;•:.3�1�::::�1`::.���C:;i:;>:::;::,s::::::::::.::::> ROBERT W TRACE
:::...:.:....... ......:.....,�i .:...:..::.;.,.,:;:::.:;......
i�'Aa�i�t.�N6/�::::��:>;°:::::;:''.;;:�:::'>`::;°;- Phone• - 97- 54
_.......,...,..
;.:::::.::.:..:::.:...:::.:
....::::...::.:::..:.:..
....::::::::....::.:..:.:............... .....�,...:.:_,:....,,,,.... . 17 6 90
;;;:;:.:::.:...�:.:;,:: ..
,:::......::.: ..
;:?::�!�1�'�'::;::.,::�i�';:�1�$'s?::::::;::;':,'':>;::c
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^:::�i�':.`#Of{i.�1l�f�;�0�'�:�q:i'�?;i:ii;,ii;:i:�::i;i;;;:
;:'5:;.::.�:�::�:.::::�.
..:�::�+.e:r.;.,,,:.;:;.;.:,:;�,.�.,.::�;.;r:-.:..:;::::��•.:.
Account Summa
ry
- _ �
Pre ious Balance 117.37
,.-...,............................................................,............ $
— Payment Received Apr 8 –$117.37
------- V������ — Balana Forward . 5.00
Get More,Save More
Call 1-888-303-724410 ensure you're getling the New Charges
besl Verizon services at a great value–from Phone,
Internet and N to money–saving bundles, Currem Activiiy $125.87
inlerrrational plans and fun add–ons.Together we'll Taxes,Governmental Surcharges and Fees $10.43
find ways to save you even more. Verizon Surcharges and Other Charges&Credits $1.15
MOVING?Call 1-866—VZMOVES Total New Charges Due by May 13,2014 S737A5
Cail Verizon before you move to set up your Internei,
N and phone tor your new home.Plus,ask aboul our Total Amount Due s137.45
great new money–saving bundles.Don't wait.Call
ahead!1-866–VZMOVES(1-866-896-6837). ��ralurn Verizon–owned oquiprt�nt immodiatNy to prevent charges of up
Service availability varies. to 5850 Per unit Find out more in Need–to–Know at the end of tl�is bill.
Questions about your bill or service?
View your bills in detail at verizon.com or cail 1-800–VERIZON(1-800-837-4966).
When asked for your accouM nu�ber,please er�er 8749013145.Cus[omers with
disabilities call 1-800-974-6006 T1Y.
' ��'t ' Questions?Please vlsit us oniine at ����0 �ii! p�g��,
�s�r����
�R�t�.
*;�... contact us by May 28. pplelectric.com � � � � +
n� '~ 1-800-DIAL-PPL � `
�"' °:=�` (1-800-342-5775)
88310-67048 May 28, 2Q14 $12.52
���r��un�m�. ,\ M-F:8am to 5pm
Your Electric Usa eg profile _ __ Bil�ing Summary (Bitiing detaiis on back)
Service to: Balance as of May 7,2014 $O.QO
ROBERT WM 7RACE ' Charges:
219 E LOCU57 ST, 15T Fl Totai PPL E►ectric Ut(lities Charges $10.8�
MECHANICSBURG, PA 17055 Total Dominion Energy Solutions Charges $1.79
Meter:54462444
Totai Charges � $12.62
this section helps you understand your electric use by �Amount Due By May z8,2014 $12.62�
month. Meter readings are actual unless otherwise Account Balance $1z,g2
noted.
t'h(s graph shows the average number of kWh you used pRL Electric Utii(ties'prlce to campare far your rate is$0.08754 per kWh.
each day. You used 22 kWh in z1 days,or an average of This changes the 1st of Mar,lun,Sept, and Dec.Visit papowerswitch.com
1 kWh a day. or www.oca.state.pa.us for supplier offers,
The average daily temperature for your area last month Your Message Genter
�t�s 52F.
. 2Q�4 • With paperless billing,you can receive and pay your
PPL Eiectric Utii�ties biils onfine.The process is free,
� 20 � •---- �� E visit ppleleCt�ic.COm d secure.To learn more or sign up,
i 16 -------- -� • Informatfon about appliance energy use and tips on '
� 1Z ___ savfng energy are avallabie throu h the Energy�ibrary �
G
- �- -� � ""� on our Web site,ppleiectric.com;�e-power 8
� $ --.._.............�..._.._ _.__.._....�........ . Befare digging around your home or prapertY,You
z 4 _ _�_._ shauid always call the state's t�ne Caii notification
Q �1 i system to locate any underground utility lines. You can
------- ------------- -- do this by slmpiy dialing 811,which will connect you to
� F M A M � i a s a rv a the Cne Cali system. Be safe and call 811 befare you
Months dig,
•r r• ,� �
.�..�
May � Actual a79zz Payment Methods �
Apr 15 Actual ---' V� �4y9Q0 .,/� � Y phone:i-8�0-342-5775 —..
C7nline at: g �
21 Days kWh Billed 27 v pPlelectric.com or call BiIlMatrlx(servfce fee appliesJ �
at 1-80Q-672-2413 to pay uSing Visa, .r
MasterCa�d, Discover or debit card. —
�
� By Mafl: Correspqndence should be sent to; �
2 North 9th Street Customer Services
CPC-GENN1 827 Nausman Road ,:
Allentown, PA 18101-1175 Allentown, PA 18104-9392 "==
Other important information an the back of this biil -3
' '��a�y;�, � Retum this part in the envelope � , �
�`*{IF;4�y+�. �
p�f »' prpvided with a check payable • � � �. ! , • � �
��..
aL������� �. to PPL Eiectric Utilities. 8$3 1 0-6 7 Q 4$ May 2 8, 2 0 1 4 $1 2.6 2
Amount Enciosed;
AV 01 007081 139096 29 D*;5DGT
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�
ROBERT WM TRACE PPL ELECTRIC UTILITIES
C/0 STEVEN TRACE
102 MEA�S DR 2 NORTM 9TH STREET CPC-GENN1
CARLISLE,PA 17015-3186 AILENT�WN, PA 18101-1175
II���ili��n�il�il��i�iilii��lifill���I��li�il��Nll�lli�iluini
7, 6700�OD12627�Od�D12629 8831067D48
,tf.4tYif1i11tulmize�ees.�x�isi�f�ec�t�ttstt�ti[anete��ur€waeer�s=�a�tu�:�e[[ai�yyss�a���rasn��crnxiu�srr���Ee��sn��rerar:..ss...ser.;..s�s.a.aa �r:..a..s....��s.x..ss......�..:...�..,.�..........m -.«
` ''' ' � Questions?Please Visit us online at . Page 1
k1:♦ / :
�*Y`}�R�:�'' O contact us by May 2. pplelectriacom
��f ��-- 1-800-DIAL.PPL � ' � •
"` ^� (1-800-342-5775)
� 88310-67048 AUto P�y
���i�n.+a+,�nuue� M-F:8am to Spm
Your Electric Usage Profile Billing Summary (Billing details on back)
Service to: Balance as of Apr 16,2014 $0.00
ROBERT WM TRACE Charges:
219 E LOCUST ST, iST FL Total PPL Electric Utilities Charges $17.20
MECHANICSBURG, PA 17055 Total Dominion Energy Solutions Charges $6.85
Meter: 54462444
Your next meter reading is on or about May 15,2014. Total Charges $24.05
This section helps you understand your electric use by ��omatio Bill�ayment on May 7,�014 ,
_
month. Meter readings are actual unless otherwise Account Balance $24.05
noted.
This graph shows the average number of kWh you used PPL Electric Utilities' price to compare for your rate is$0.08754 .
each day. You used 84 kWh in 32 days,or an average of This changes the ist of Mar,Jun,Sept,and Dec.Visit papowerswitch.com
2 kWh a day. or www.oca.state.pa.us for supplier offers.
The average daily temperature for your area last month your Mes s age Center
was 45F. -
�2o1a • With paperless billing, you can receive and pay your
_.___________. PPL Electric Utilities bills online.The process is free,
24 quick, convenient and secure.To learn more or sign up,
3 zo --------- visit pplelectriacom.
=- 16 ---------- -- • Information about appliance energy use and tips on
� saving energy are available through the Energy Library
° 12 ---- —�--"--- on our Web site,pplelectriacom/e-power
m 8 --"---- • Before digging around your home or property,you
Q 4 _ ____.___,____ should always call the state's One Call notification
system to locate any underground utility lines. You can
� -- ---- do this by simply dialing 811,which will connect you to
� F M A nn > > a s o N o . the One Call system. Be safe and call 811 before you
Months dig.
' �� � .
Apr 15_ _Actual _ 47900 Payment Methods
Mar 14 Actual 47816 Online at: �By phone: 1-800-342-5775
`� pplelectric.com or call BiIlMatrix (service fee applies)
32 Days kWh eilled 84 at 1-800-672-2413 to pay using Visa,
MasterCard, Discover or debit card.
� By Mail: Correspondence should be sent to:
2 North 9th Street Customer Services
CPC-GENN1 827 Hausman Road
Allentown, PA 18101-1175 Allentown, PA 18104-9392
Other important information on the back of this bill�
L�Ft15 T�,q�
LAWYER � �
S��UT1��S 4833 Spring Road • Shermans Dale, PA 17090 •p. 717.582.4006 • f. 717.582.7476
e. mark@christianlawyersolutions.com • i. christianlawyersolutions.com
August 26, 2014
Register of Wills
Cumberland County Courthouse
1 Courthouse Square, Suite 102
Carlisle, PA 17013
Re: Estate of Robert W. Trace
No. 21-14-0390
Dear Sir/Madam:
Enclosed please find the original and two copies of the Inheritance Tax Return in the
above-referenced Estate along with a check to pay the tax. Will you kindly return to my office a
time-stamped copy of the Return and a receipt for the payment. I have enclosed a self-
addressed postage prepaid envelape.
Thank you for your assistance in this matter. Certainly do not hesitate to contact me
should you have any questions.
�
Very truly yours, � � �
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ark W. Allshouse � c�„ � aO � v
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Enclosure -�, -� � � �
cc: Steven E. Trace, Executor �' � � ,.�!`,�