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HomeMy WebLinkAbout09-29-14 ESTATE OF : IN THE COURT OF COMMON PLEAS DOROTHY J. WARD : CUMBERLAND COUNTY, PENNSYLVANIA : ORPHANS' COURT DIVISION . N0. 21-14-0468 AMENDED PETITION UNDER SECTION 3102 OF THE PROBATE, ESTATES AND FIDUCIARIES CODE FOR SETTLEMENT OF SMALL ESTATE � TO THE HONORABLE JUDGES OF SAID COURT: c � -`= � � � � til7 ,� O r';7 i7 ��� G.� � Sherry Jean Ward, your Petitioner, files this Petition for Settlement`'.b�'�a.`Sma�Estat�« under the provisions of Section 3102 of the Probate, Estates and Fiduciaries Gade°a�tti in�pport�y thereof avers that: ` ' `� --�, ; -,i r _� ' _.�,.j .� _. � ...:� C'� C..� i_. �'C� (1) Your Petitioner, Sherry Jean Ward is a competent adult residing at 909 Boulevai�, ..°,� Westfield,NJ 07090, and is the daughter of the above decedent. � (2) Dorothy J. Ward, a widow, died on February 25, 2014 at the age of 87 years, but priar thereto lived and was domiciled at 1 Longsdorf Way, Carlisle, Cumberland County, Pennsylvania. A copy of decedent's Death Certificate is attached hereto as Exhibit "A." (3) Dorothy J. Ward died with a Will. No Letters have been issued. A copy of decedent's Last Will and Testament dated, March 17, 1989, is attached hereto as Exhibit "B." (4) Dorothy J. Ward did not own any real estate, and had no other personal property of any value when she died other than the following: Metro Bank account with a balance of$7,922.66 as of February 25, 2014, and a Wells Fargo Irrevocable Burial Reserve account with an approximate balance of $7,561.02. Copies of Metro Bank and Wells Fargo statements are attached hereto as Exhibit "C." (5) Husband, James F. Ward, predeceased Decedent on March 22, 1994. (6) The sole heirs and relationship to the decedent are as follows: Sherry Jean Ward, Daughter Mallory Ann Ward, Daughter Jamie Ward Lieberman, Daughter Gretchen Ward Carvella, Daughter ." , Each daughter has a `/4 beneficial interest in the estate; no daughter has receivied or retained any property of the decedent; none of them are minors, incompetent or deceased. (6) No person or persons are entitled to the family exemption. (7) Decedent's debts and obligations to unpaid claimants include a DPW Claim, medical, and nursing home expenses. True and correct copies of the statements outlining the admitted DPW Claim, medical, and nursing home expenses are attached hereto and incorporated hererin as Exhibit"D." (8) Any unpaid beneficiary, heir or claimant that has not joined in this petition has been provided notice of the intention to present the petition as required by rule. (9) No disbursements have been made prior to the filing of this Petition. (10) Attorney fees in the amount of$1,200.00 will be charged to the estate. (11) Travel expenses in the amount of$546.20 will be reimbursed to the Petitioner. (12) The debts of the Decedent exceed the assets of the estate. Therefore, no inheritance taxes are believed to be due and no certificate from the Register is attached. WHEREFORE, your Petitioner respectfully requests that an Order be made authorizing Sherry Jean Ward to act as Fiduciary for the Estate of Dorothy J. Ward and close the accounts with Metro Bank and Wells Fargo with the proceeds made payable to the Estate of Dorothy J. Ward pursuant to Section 3102 of the Probate, Estates and Fiduciaries Code. . By ._..... �—l5 '�'Y Matthew '. McKnight, Esquire Supre e ourt LD. No. 93010 IRW McKNIGHT, P.C. 60 West Pomfret Street Carlisle, PA 17013 (7l7) 249-2353 STATE OF NEW JERSEY : COUNTY OF . � Sherry Jean Ward being duly sworn according to law, deposes and says that the facts contained in the foregoing Petition are true an correct to the best of her knowledge, information and belief. (SEAL) e Jean Ward Sworn and subscribed before me this 1 5 day o��sN..�G , 2014. o ary Public HILARY S.GEIER tJotary Public,State of New York No.4781 S 00 Qualified in Nassau County Commission Expires December 31,20�� ESTATE OF : IN THE COURT OF COMMON PLEAS DOROTHY J.WARD : CUMBERLAND COUNTY,PENNSYLVA1vIA : ORPHANS' COURT DIVISION . N0.21-14-0468 CONSENT OF GRETCHEN CARVELLA TO AMENDED PETITION FOR 5ETTLEMENT OF 5MALL ESTATE I, Gretchen Carvella,child of Dorothy J.Ward,Deceased, and beneficiary named in the will dated March 17, 1989,do hereby consent to and join in the foregoing petition for settlement of a small estate,and also waive the requirement of written notice of the intention to present the petition. Date: �f� By (�!�RM-��-i- C�tM� �u, i� �� � GRETCHEN CARVELLA � r STATE OF �`')'� � � : �� ���� :SS: COUNTY OF C'IIM�w . On this, the � �'" `day of � �� , 2014, before me, the undersigned officer, personally appeared GRE CHEN CARVELLA, known to me or satisfactorily proven to be the person whose name is subscribed to the within instrument and acknowledged that she executed the same for the purposes therein contained. COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL Mdrea L.�ngard,Notary Public East Pennsboro Twp.,Cumbertand Cwnty NOtary Pub1iC My Commission Expirea May 11,2016 MEMBER,PENN YIYANIA ASSOCIATION OF NOTARIES ESTATE OF : IN THE COURT OF COMMON PLEAS DOROTHY J. WARD : CUMBERLAND COUNTY, PENNSYLVANIA : ORPHANS' COURT DIVISION . N0. 21-14-0468 CONSENT OF MALLORY ANN WARD TO AMENDED PETITION FOR SETTLEMENT OF SMALL ESTATE I, Mallory Ann Ward, child of Dorothy J. Ward, Deceased, and beneficiary named in the will dated March 17, 1989, do hereby consent to and join in the foregoing petition for settlement of a small estate, and also waive the requirement of written notice of the intention to present the petition. Date: 9//�/ By- � MA LORY WARD , STATE OF G�N ,I��I�Q . :ss: � � � -3� - 8a�3 COUNTYOF �Z��-��� . On this, the � day of �� �'/� E,�°, , 2014, before me, the undersigned officer, personally appeared ALLORY ANN WARD, known to me or satisfactorily proven to be the person whose name is subscribed to the within instrument and acknowledged that she executed the same for the purposes therein contained. . otary Public co�o►�n�rti oF a�Nwsv�vEw� �+s�couRr i�-�-os DAYIO BARIW4.DiST.JUDGE 11-1-06 SWOYERSVILLE BOROl1GH, WZERNE COUNN MY COMMlSSION EXPIRES DEC.31,2017 ESTATE OF : IN THE COURT OF COMMON PLEAS DOROTHY J. WARD : CUMBERLAND COUNTY, PENNSYLVANIA : ORPHANS' COURT DIVISION . N0. 21-14-0468 CONSENT OF JAMIE LIEBERMAN TO AMENDED PETITION FOR SETTLEMENT OF SMALL ESTATE I, Jamie Lieberman, child of Dorothy J. Ward, Deceased, and beneficiary named in the will dated March 17, 1989, do hereby consent to and join in the foregoing petition for settlement of a small estate, 211� ?1S(? �Na�ve the re���:lT?Inant (?f s�,'rlit:?7 n�titiQ !�f thA i;i�??2t.0:2 t� rTiSP:1t��7e petition. Date: B /�--�UU� � a�/�y Y JAMIE LIEBERMAN STA TE OF . :SS: COUNTY OF . On this, the ���- day of , 2014, before me, the undersigned officer, personally appeared JA IE LIEBERMAN, known to me or satisfactorily proven to be the person whose name is subscribed to the within instrument and acknowledged that she executed the same for the purposes therein contained. MARK A.MERRlYAN � ' NOTARY PUBL.iC,Ste�tr�f lVeN Yd'k Na OtM�081739 Notary Public t�ualified in Nen Yoric�� C.WTtmldBlOf1�%�1'�Bi r �-��s�2o1S REC�IV�tp SEP � � 2014 �RWfp►&r�ic�VtGh� lAW OP�� H705.112REV.t/05 WARNING: IT IS ILLEGAL TO ALTER THIS COPY OR ��EFOarHis � TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH. CEH�iFIG7cT��s o0) :;,: C�MNWNW�ILTH OF PENAI�XLY1tNIA : ` ` D�PARTIN�N�:Q�HEALTH VITAL,RE.CQk�[75 LQCQi,;RECI�TRAR'S CERTIFIC�1lTlOhl �F aEATH. ' ���,�g�,,,tr+oF���� � r c � � Ca: .. A cE�-r �o T 6 4 6'9�' S:4 ��,�,� ,�� � -� � i �. � :,; �: � : ,:; �� �,. . 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WARD I, DOROTHY J. WARD, of the Borough of Kingston, County of Luzerne and Commonwealth of Pennsylvania hereby make and publish this to be my Last Will and Testatment revoking all former Wills heretofore made by me. ITEM 1: I direct that all my just debts and funeral expenses be paid as soon as convenient after my death. ITEM 2: I give, devise and bequeath all of my property, real and personal, to my beloved husband, JAMES F. WARD. ITEM 3: Should my husband, JAMES F. WARD, predecease me, then in that event, I give, devise and bequeath all of my property, real and personal, to my children, SHERRY JEAN WARD, MALLORY ANN WARD, JAMIE WARD and GRETCHEN WARD, share and share alike. ITEM 4: I nominate, constitute and appoint my husband, JAMES F. WARD, Executor of this my Last Will and Testament. Should my husband, JAMES F. WARD, be unable to serve in that capacity for any reason whatsoever, then in that event, I appoint my daughter, SHERRY JEAN WARD, Executrix in his stead. No bond shall be required cf my Executor in this or any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this � day of ���, 1989. (SEAL) Dorothy J a Signed, sealed, published and declared by the Testatrix above named, as and for her Last Will and Testament, in the presence of us, who have hereunto, at her request, subs�ribad our names in her presence, and in the presence of each other, as witnesses hereto. , �.,A,N��)P_ �� residing at ��uT�-..�. �Ct. —P�--�--_ �o,,.,�.,�,�. �w residing at����1 G� � . _ ��o Metro Bank E 3801 Paxton Street Harrisburg PA 17111-1418 �� - �� BA N K myme obank�om >02627 3972088 001 D9214� DOROTHY J WARD 113 E WOODLAND DR MECHANICSBURG PA 17055 We're here T days a week,24 hours a day at 1-888-937-0004. �� 50 PLUS CHECKING 2840249953 �� �g �q � p yp}�� � ?r'...v �. �.����.��8S�i� �ry.�'!�`�'""�'.4�-��*Yl'��,"r3a.���'S'��"4�i7�^ s t�`�ty��'�z'4 �tS��,z ��� 1'2°;�� �t��d S � aF�F Y� .i�*�y�f 5'���Y��,`.��t=:�: �� 7 c r s � .3 3,. u�'� z 'F��":. ! v � :�r o&� r �v�} Mi s t 2, T+ t � �o�� A z �y� �� � �' ''� � 4 V S �i �P�(��,�r.>�i+ v-a Z�rn . �.{` i� z x� s,x..>�l� -P t :c�, �' � i: @ 'i�"�, .k sv ���.� Q�p . +t.,"4.. 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Check Transactions Number Date Amount Number Date Amount Number Date Amount `���.�. , s�. , ��s����,�3178 02/19 59,732 56 �_ ~���k��:�:`� ��.�...vz;,;+�� .,.x��'�a���:_. �:�� ;:; is s�4..N�., � �� �s-"�:: r�.-' P � {��:�. 181 02119�}ry$7,100.00 ��r�,�. . .;'��'�����: . . � �� � � items denoted with an"E"are electronic entries and will not have a check image. Items denoted with an""'indicate processed checks out of sequence. Interest Summary �ro }��yy� > L�d- -. ) wY-l' �� � s Z� cd �� �4 t �.k t'��.v ��2'� -�i�4.�T'ss p.��N . �`y� �,1�y��� '�i- .Jv �2;<y. � '� h(S �t�e� '� 5 Y e�ya.tl . � � ;.^."�'S, �`�e` � � �c FQ �.�. 'TY !i�pR��r '..' �y ��*'�yp n, z 4 ..y., "� f s �t^{ 1t �' Ak f -.�' g ��p.1 {t •K:g"�,E,�tit . �`� ^:� `{` zy� �- t�i .C�lt��{�yy+�'��tI�1������R�!�{���� �-� �r �;�� ����.y�stwt4 �. k sn.i� f 1f `'�fu #`(� ����+�fR�^ SYM..,�X� s .r��t�a fi' '� 8� ��lt+���'� 11J� 1I� @I'1� y t �c r c r� ✓ -;b s i ,h'}" x t t�"ti r v t a u; y� �C ��+��} y �,p �'".� r� +. ?.- �t+ s z�`2 ����� z ti?`�s -.F^ i . �y '�i. �, � �P'�Y �( � .. t 1 tym X i t+ ] � T � �C' 1't �p4� � �q �' l..k � S+ � Y�'"�,� '1,1 A+t� .s, ..� ''' 1�' S� �� s' 1�. �"'�+. ��..3� +yrm4s��$3�'x °� -� ��..i;y c '`�L..�a��t h��'���"'� � �`� t ������������a����=.�+t�����P�����4����.,. ` � � � � _� �l a =f���s���� �s ' -.,.. �. �y ;(� '`an�'t S°�.ni t�� �"�p� x'S�'M .jl� ,.:i kYXt� .� i'ay F'�„�' €, ��,�� ,4a3 �' 4 t �*o�`S,n�'��` '�' ;�� t z '� „``1.�+ �h�" y ��}&�'' � '�k �u��'T� �'.§���vi�....-i4��.�_t,e°�`'G�'`��..x.�r4r- e i�s�,.. 5`?cr�_.._=.e.s�_.r<_�'c:�i''??��....�:s�z:..,�.,. ��.:.�'..��.;:?is..4,r`.r�.s�^,'�.� ..�ac�.e�,..�a.,�t .. _.� .��. .�...... ...,Ga...a ..�.� . .,e�_ .�...<.,. .a,�-r..,,. . 28 Cycle PegB 1 Of 6 q�14n arn�nn� , W�IIs Fargo� Preferred Rate Savings Account n�mber:7 01 07 201 307 95 � April 14,2012-May 14,2012 L Page 1 of 3 � OCRPIIDTRW 001186 ��'��I�I���I'��'��I"�'��'��II�11��1�����������11�'��1111�11'�'I' QueSt'to#�S? �' DOROTHY WARD Availob/e by phone 24 hours a day,7 duys a week: IRREVOCABLE BURIAL RESERVE 1-800-TO-WELLS (1-800-869-3557) - -- -�3�R�.,,��T A�E �-�8A^-�7�48�3 _ - - — - - - -- __ KINGSTON PA 187044612 En espaiiol: 1-877-727-2932 �a 1-800-288-2288(6 am to 7 pm PT,M-F) Online:welisfargo.com _ Wriie: Wells Fsrgo Bank,N.A.f345) P.O.Box 6995 Portland,OR 97228-6995 0 � � v � v � � _ � You and Wells Farqo ° Thank you for being a Weils Fargo customer.We appreciate your business and understand that you are entrusting us with your banking � needs.Let us assist you in finding the right accounts and services to help you reach your financial goals.Please visit us online at Z wellsfargo.com,call us at the number at the top of your statement,or visit any Wells Fargo store-we'd love to hear from you! � z z z z Activity summary Account number: 1010120130195 Z z Heginninghalancean.4lt4 $z,56D.53 DOROTHY WARD � Deposits/Additions p,33 IRREVOCABLE BURIAL RESERVE Z Withdrawals/Subtractions -0.00 Pennsylvaniaaccounttermsandconditionsapply z 0 Ending balance cn 51i4 $7,5fii.02 For Direct Deposit and Automatic Payments use o Rauting Number(RTN):031000503 N w A � O O A� N fD interest summary Interest paid this statement $0.33 m or Av�'i'age tdlEeteil ba6anee 57,56Q.63 � N Annual percenWge yield earned 0.05% � Interest earned this statement period $0.33 lnterest paid this year $lS8 � � . . , � pennsylwania ' 'DEPARTMENT Q'F PUBLTC WEL.FARE c!y: r;.�(�,,_,_., .....�.! - �9��i6r.K�7�� April 21, 2014 ��R � 4 ���!; IRWIN & MCKNIGHT PC ��,+���,,�;����j��{��� MATTHEW A MCKNIGHT ESQUIRE ���,����_,�.r� W POMFRET PROFESSIONAL BLDG 60 W POMFRET ST � CARLISLE PA 17013-3222 Re: Dorothy Ward CIS #: 720347798 SSN: ###-##-0716 Date of Death: 02/25/2014 ESTATE RECOVERY STATEMENT OF CLAIM Dear Attorney McKnight: Under State and Federal law, the Department of Public Welfare (the Department) is � required to �recover."medical assistance (MA) r.eimbursement from the p.�obate estates of deceased individuals who were over age 55 when such. assistance was received. 42 U.S.C. §1396p(b)(1). 62 P.S. § 1412. This.letter sets forth the amount of the Department's claim against the estate of the above referenced individual and explains the obligations of executors, administrators, and persons receiving estate property. Although the amount in the estate may be considerably less than that which is owed to the Department, our claim is against the estate, no one else. Statemen# of Claim Amount The Department maintains a claim in the amount of $13,413.20 against the above-mentioned estate. This claim is for repayment of MA granted on behalf of the decedent. Enclosed is the Department's itemized statement of claim. A portion of this medical expense, namely $13,413.20, was incurred during the last six months of the decedent's life; therefore, it is a Class 3 claim pu"rsuant to Section 3392 of the Decedents, Estates, and Fiduciaries Code, 20 Pa. C.S.A: 3392(3). The balance of the claim, namely .00, is to be entered as a prio'rity.Class 5.i claim against the e'state. You should refer:fo Secti.on 3392 for a�riiore.complete`explanation of the priorify rules. If a lawsuit is filed for injuries sustained by the decedent prior to death, then the Department may also have a lien against the personal injury action. A statement of claim for that injury-related lien must be requested separately. Bureau of Program Integrity � Division of Third Party Liability � Recovery Section PO Box 8486 � Harrisburg, Pennsylvania 17305-8486 _ _ . , . _ S IA1 tMtN 1 UF' At+(:VUN 1 �� OMNICARE KING OF PRUSSIA 6990B SNOWDRIFT RD PAGE: 1 of 1 ALLENTOWN,PA 18106 • ACCOUNT NO: 9009-42 Y•e �. � RETURN SERVICE REQUESTED 342s5 INVOICE NO: STATEMENT r DX NO: KOPDX INVOICE DATE: 02/28/14 �oen2 0,0, phone: 877-670-6323 FACILITY: 9009 CUMBERLAND CROSSING PATIENT NO: 42 You may also view/pay your bills at: PATIENT NAME: WARD,DOROTHY https://myomniview.omnicare.com AMOUNT DUE: 68.00 TAX: 0.00 I'��'��I"I�h���1�6���I�IIJl6�hhll���l�����h�ll'��I�'ll�l' DOROTHY WARD GRETCHEN CARVELLA DUEDATE: O3/25/2014 113 WOODLAND DRIVE MECHANICSBURG, PA 17055-3373 AMOUNTDUE: 68.00 34285*TOK09RK1T007538 40 K0921 QE:1.1 KEEP 40F�PORTION FOR YOUR RECORDS-RETURN BOYTOM STUB WITH PAYMENT IIIV���I�I���InI�I��II�N�I��I�IIpI�qN WARD, DOROTHY 9009 CUMBERLAND CRO$SING . • �� 9U09-42 02/28/14 DATE: : RX:NO,.. TRANS .: DESCRIPTION PNY$ICIAN ;NDC NO.;:' QUANT . AMOUNT � TYPE 3 3 J 3 b Messages Finance Cherges may be assessed at a MONTHLY PERIQD RATE OF 1.50%(ANNUAL RATE OF 18.00%)based upon an unpaid balance outstanding 30 days or more. PREVIOUS BALANCE CHARGES FINANCE CHARGE TOTAL CHARGES PAYMENTS & CREDITS AMOUNT DUE 68.00 0.00 0.00 68.00 0.00 68.00 � 34285*TOK09RK1T007538 10 INSURE PROPER CREDIT,DETAC6�9 AND RETUR(d THIS PORTION IN THE ENCLOSED ENVELOPE. sso23ac ❑PIe8S2 CheCk If ebOV2 8ddf@SS IS If1COff6Ct efld I�dICat2 Chflnge on�BVBfSe SId2. IF PAYING BY MASTERCARD,DISCOVER,VISA OR AMERICAN EXPRESS,FILL OUT BELOW. CHECK CARD USING FOR PAYMENT ACCOUNT NO: 9009-42 •• � �� �� � � INVOICE NO: STATEMENT MASTERCARD DISCOVER � VISA AMERICANEXPRESS DX NO: KOPDX CARD NUMBER INVOICE DATE: 02/28/14 FACILITY: 9009 CUMBERLAND CROSSING SIGNATURE EXP.DATE PATIENT NO: 42 PATIENT NAME: WARD,DOROTHY � �� . : • AMOUNT DUE: 68.00 II����I����I�I���IIi��l��l�'�111����"I�'��'�'I'll�llll���l�li�l� OMNICARE KING OF PRUSSIA AMOUNT ENCLOSED$ P.O. BOX 740391 CINCINNATI, OH 45274-0391 0�00�09009-4270STATEMENT3�OOKOPDX900000680�8 STATEMENT Page: 1 of � 'L� I A KO N Invoice# Account# Date LUTHERAN SOCIAL MIN[STR[ES 344659 630CCNC 02/28/2014 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 3/23/2014 $54.00 Resident Name Gretchen Carvella 113 Woodlanc�Dri�ce --- --- -- -Ward�Dorothy-J-- -- Mechanicsburg, PA 17055 _ _ _ Please make cHeck payabte to Diakon Lutheran Social Ministries Dorothy J Ward Cumberland Crossings Retirement Community 02/'1812014 Gretchen Carvella Date Descripfion Units Net Balance rom rou Char es Credits 1/31/2014 Balance Forward $9,732.56 2/18/2014 Payment Received Ck#178 .00 -9,732.56 1/01/2014 1/31/2014 Resident Liability(Jan) .00 29.0 2/01/2014 02/28/2014 Resident Liability(Feb) .00 -503.5 2/10/2014 02/24/2014 Resident Liability(Feb) .00 503.5 2/24/2014� 02/24l2014 Phone-Basic Service Phone Basic Service 1.00 Month 23.5 2/24/2014 02/24/2014 Sales Tax Sales Tax � 1.00 Each 1.4 TOTAL BALANCE DUE $sa.00 PLEASE RETURN TOP PORTION WITH YOUR PAYMENT,RETAIN BOTTOM PORTION FOR YOUR RECORDS ti_,..��.� n . .�,�..,,.�,. .. _ ���._...;�.����.��_.._..»�.. i/ISA � � ,.��„�.�..��..,,,� ' FOR DETAILS , ' . �� �� � . � ' ; .� T n Orchop�d��Inscicuce 03/11/2014 04/Ol/2014 011 of Pennsylvania - 3399 Trindle Road ' � " '� Camp Hill,PA 17011 316944 For Billing Questions please cail(717)761-5530 option 3 Monday-Friday(8:00 to 4:30) • �� - � •� • ADDRESS SERVICE REQUESTED 1 1 ORTHOPEDIC INSTITUTE OF PENNSYLVANIA N 1��1�"'�I��'�'�'1����I�'I��'I"���1'1'���I�������'�'��II�I��"1' 3399 TRINDLE RD FL 1 N DOROTHY J WARD CAMP HILL PA 17011-4407 N 1 LONGSDORF WAY ��III��I�II�III�""�'���II��'I'I'III'I"I"I�'��II'I'III'�I�I�II --���,ISL-�n i�ni�-�62-3 -- _ ❑ Please check box if above address is incorrect or insurance � PLEASE DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT information has changed,and indicate change(s)on reverse side. Page 1..Qf 1 .. . ___ �. �- • . . . ` • • 01/15/14 X-RAY SPINE LUMBOSACRAL A 95.00 03/05/14 MEDICARE Payment 27.28 03/05/14 Contract Adjust Adj . -60.20 03/05/14 Contract Adjust Adj . -0.56 ,��'6 9;6 ? ; s .;�` ,, � x Y �T}�f �'k� �'� � ����`;i ����h� . �F{� � '� "l¢��} L�T N `) :'4 't'��i "�' 4YR�, w' ] �ar� � ��. � �y � ��p��� �'X��"� �'8.1 ,�3�`.r �"T';�3 ' : . .. . . .. .._ .. _ �r�. ,g �'� .��-�° ' �-i �� �h ��: � r,' �a }; 1.?.t�. . ..,.���t::�.. Messages: � � .. . - Please Pay T Amount � .. . .- . - . . .•. . � �- �• - 04%01/2014 For Billing Questions call(717)761-5530 option 3 oaee�ast Paid 00/00/00 Monday through Friday(8:00 to 4:30) DOROTHY J WARD 'Payment must be received by Payment Due Date See back of statement for FREQUENTLY Amount Last Paid $0.00 ASKED BILLING QUESTIONS&ANSWERS pccount Number 316944 and information on our Injury Clinic. �. �!�G'�C2� I�/� ��"l"`C'G%l:����G�s eJ�l.�'/. � � 420 Wyoming Avenue,Kingston,PA 18704 Richard W. Snowdon Funeral Director/Supervisor Sherry Jean Ward 3/24/2014 909 Boulevard Funeral Services for: Westfield,NJ 07090 Dorothy J.Ward 2/25/2014 Direct Cremation $2,525.00 Our charge for this service includes: Professional services ofFuneral Director and Staff.Transfer to funeral hame, Consultation with family or representative of deceased,Securing and recording vital statistics, Procurring necessary authorizations,obtaining&filing of death certificate,Coordinafion with clergy,cemetery,crematory or other third parties, Obtain personal fam�ily history&placement of obituary notices,Preparation&care of deceased in manner requested,Sheltering and Identificaton prior to cremation, Transfer to crematory by van and return of cremains to funeral home for presentation to family,Utility vehicle to tran�port certificates,permits or misceltaneous trips in Wyoming Valley,24 hour availability of personnel,Ovefiead, insurance and inventory expenses. Removal to Ewing Funeral Home in Carlisle(Included in Direct Cremation) �ncluded Transporta�ion from Carlisle to Kingston $360.00 Cremation Container $150.00 Urn: Maus Metal Granite Finish Solid Aluminum Urn $160.00 Urn Vault: Styrene w/Green Felt Lining(Cemetery Requirement) $95.00 Funeral Director&Staff for Cemetery Services 8 Supervision $375.00 (without prior use of facility) Total Page 1 $3,665.00 �_ Page 2 Cash Advances 8 Accommodations Items Sunlight Crematory Charge $260.00 Cumberland County Coroner's O�ce Cremation Permit $30.00 St. Mary's Cemetery Opening Charge (Saturday) $940.00 Marker Inscription: Dorothy $260.00 1926-2014 Rev. John Hartman-Honorarium $200.00 Certified Copies of Death certificate: 5@$6 each $30.00 10 free veteran copies ordered Obituaries: Times Leader $152.00 Citizen's Voice $55.00 Total Funeral Expense $5,592.00 Cumberland County Deceased Veteran's Widow's Death Benefit -$100.00 Balance Due $5,492.00 Please remit payment to: Harold C. Snowdon Home for Funerals, Inc. 420 Wyoming Avenue Kingston, PA 18704 Thank you for your confidence in the Snowdon Family � , • ' -1 -� � �._. H,,,.,..�,�..�.,,�-��.,�,�,� ..,..�:.,.,t.,.�.:.�...�..,,�,:.am,o.�s `< '�', �, � d � $ ;' �� • ' -*. � � C� � m W m 9D � � *� 3 `D � � $ °1��. cu � � � � � 177 � � � c� n � r� � -� � � n � � � �, � � � � 'm'� ,� � c � � ,t' v� �- n� 'C v' � � � � 3 � 3 .1 .� , � N � N � � �t► �D � e� � � � w m �' � � '�,i . � �'o !'r'I o�' � � � Q p) < � � F �' c�i m � o .i � i� 611 � � C� � m ' � ' �;`� o , � � � o � � � � . � �+� C �, 3 a� v�' cn � cn � O �G < � �,;, N p� ai -1 D � < � I � � � � m "t � � � � � � � � � ° � � ai � v �y � a n� � N � N � �7t N � O Q- N I� N 6 � O � � � � Qj ?� � � � Z Wc W j '�° � � � Q p I N (� N � �. O � � fD � � '+ � � c° � N � � (�p � � � � � � `.� � � n � � N d N n � . 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AccountActivity 3/27/14, 12:33 PM ��l ���Wr �r CH3�5�� ���'���� ' _ _ . • CREDIT CARD (...4740) Trans Date Post Date Tvae Descriotion Amount � ,.'-,1 i ' _._ 03/22/2014 03/24/2014 Sale GROTTO $188.34 i � , HARVEYS LAKE,RA 186180000 US In-Qerson transaction ' ,..............,� ..._ ..._...,. � j�--�--�-rT�: . � � � �i,. . � � . � � �,��R r'F._. . . ; ���-. i:_ �_he - _... _ .., : `.=.Y?C� -�:__�-- : �£��- ***RESTAURANT�*� i3 EMILY H ' 1 492/1 Chk 1177 Gst 1- � Mar22'14 06:07PM � l GLS PINOT NOIR @ 6.25 12.50 1 GLS MERLOT 6.25 ? GLS REISLING @ 7.99 15.98 � BLUE MOON 23oz @ 5,50 11 ,00 1 YNG LAGER 16oz 2,75 ! CLUB SODA 2.19 '? K JR PIZZA @ 3.95 7.90 2 rx B�1L'UN @ 0.99 1.98 1 JR MEATHEAD 6.99 1 JR PIZZA 5.99 rx ANCHOVIE 0.99 rx P1USH 0.99 rx BLACK OLIUE 0,99 1 JR MARGA 6.9Q 1 JR BIANCO 6.99 1 REG PIZZA 9.99 1/2 BLACK OLIVE 1.25 4 TOSS SALAD @ 3.99 15.96 1 CHIX PHILLY 7.95 0 RINGS $ 1.79 2 LING CLAM SCE C� 9.99 19.98 ' Food 98.92 Bar 48.48 Tax . • Total 1 5 3 . 3 h[tps: /!� °"'nr/�� Page 1 of 1 Y�� - - - � ���:3 �