HomeMy WebLinkAbout10-10-14 (2) � 1505610143
REV-1500 EX�oz_„> -�;
OFFICIAL USE ONLY
PA Department of Revenue pennsylvania County Code Year File Number
Bureau of Individual Taxes OEVARTMENTOFREVENUE
Po Box.2soso� INHERITANCE TAX RETURN 21 14 00090
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
201 18 8913 O1 18 2014 12 15 1926
Decedent's Last Name Suffix DecedenYs First Name MI
SOLADA WILLIAM E
(If Applicable)Enter Surviving Spouse's Information Betow
Spouse's Last Name Su�x Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
� 1. Original Return � 2. Supplemental Return � 3. Remainder Return(Date of Death
Priorto 12-13-82)
� 4. Limited Estate � 4a. Future�nterest Compromise
(date of death after 12-12-82) ❑ 5. Federal Estate Tax Return Required
� g Decedent Died Testate � Decedent Maintained a Living Trust 1 $. TOtal NUmbOf Of Safe De OSit BOxes
(Attach Copy of Wilp ❑ (Atlach Copy of Trust) P
� 9. Litigation Proceeds Received � 10. Spousal Povert Credit(Date of Death ��,Election to tax under Sec.9113 A
between 1231�31 and 1'-1-95) � (Attach Schedule O) � �
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD B�RECTED T�O�:
Name Daytime TelepF�e Number � ;,,� �
BRUCE J WARSHAWSKY 717 238��/0 � ,�rn �
�:� -� _...� :;;; ��
' _�. •' i �::�
REGISTER OF1�NI�;.~�,S�WSE�Y �Y.�
First Line of Address -, � -� ,'� �=ro�
:=i � _r,i
2320 NORTH SECOND STREE ,, � � �
: =�'., N C`r'1
Second Line of Address - � �
- C� �
. O
City or Post Office DATE FILED
State ZIP Code
HARRISBURG PA
CorrespondenYs e-mail address: bjW@cClaWpc.com
Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNA URE OF PERSON RESPONSIB FOR FILING RETURN DATE
Kath E Putt -/
ADDRESS
504 Lancaster Ave., Enola, PA 17025
SIG TURE OF PREPARER OTHE THAN R PRESENTATIVE DATE
, Bruce J.Warshawsky /� � _/
A R
2320 North Second Street, Harrisburg, PA
Side 1
� 15D561�143 1505610143 � •
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, ,
� 1505610243
REV-1500 EX
Decedent's Social Security Number
Decedenr9r,ema: Solada, William E 201 18 8913
RECAPITULATION
1. Real Estate(Schedule A)....................................................................................... 1. H3,190 . 00
2. Stocks and Bonds(Schedule B)............................................................................. 2.
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C)......... 3.
4. Mortgages&Notes Receivable(Schedule D)........................................................ 4.
5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)............... 5. 121, 7�5 . 8 4
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers&Miscelianeous I�n;Probate Property
(Schedule G) U Separate Billing Requested............ 7,
8. Total Gross Assets(total Lines 1 through 7)........................................................ g. 2 04, 8 95 . 8 4
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 2 5, 121 . 0 9
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................ 10. 3 ,03 9. $8
11. Total Deductions(total Lines 9 and 10)................................................................ 11. 2 8, 16 0 . 6 7
12. Net Value of Estate(Line 8 minus Line 11).......................................................... �2. 17 6� 735 . 17
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)............................................... �4_ 1�]G, 7 3 5 . 17
TAX COMPUTATION-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.00 15. 0 . 0 0
16. Amount of Line 14 taxable 17 6 7
at lineal rate X .045 , 3 5 . 17 �s. 7, 953 . 0 8
17. Amount of Line 14 taxable
at sibling rate X.12 0 . 0 0 17. 0 . 0 0
18. Amount of Line 14 taxable
at collateral rate X.15 0 . 0 0 18. 0 . 0 0
19. TAX DUE................................................................................................................ 19. 7 , 953 . �8
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. �
Side 2
� 1505610243 150561�243 �
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REV-1500 EX Page 3 File Number 21-14-00090
Decedent's Complete Address:
DECEDENT'S NAME
Solada,William E
STREET ADDRESS
507 State St.
CITY STATE ZIP
Enola PA 17025
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 7,953.08
2. Credits/Payments
A. Prior Payments 10,000.00
B. Discount 397.65
Total Credits(A +B) (2) 10,397.65
3. Interest �3�
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. �4) 2,444.57
Check box on Page 2,Line 20 to request a refund
5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. �5�
Make Check Payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred:............................................................................... � �
b. retain the right to designate who shall use the property transferred or its income:.....:............................ ❑ �
c. retain a reversionary interest;or.............................................................................................................. �
d. receive the promise for life of either payments,benefits or care?............................................................ � �
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without ❑ ❑
receiving adequate consideration?.................................................................................................................... x
3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death7....... ❑ �x
4. Did decedent own an individual retirement account,annuity,or other non-probate property which
contains a beneficiary designation?.................................................................................................................. ❑ �
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994 and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving
spouse is 3 percent[72 P.S.§9116(a)(1.1)(i)].
For dates of death on or after January 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S.§9116(a)(1.1)(ii)]. The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of
assets and filing a 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 for the use of the decedenYs lineal beneficiaries is 4.5 percent,except as noted in
[72 P.S.§9116(a)(1)j.
. 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.
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Rev-1502 EX+(01-10)
� SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE 7AX RETURN
RESIDENTDECEDENT
ESTATE OF FILE NUMBER
Solada,William E 21-14-00090
All real property owned solely or as a tenant in common must be reported at fatr market value.Fair market value is defined as the price at which property would be
exchanged belween e willing buyer and a willin seller,�either being compelled to buy or sell,both having reasonable knowledge ot the relevant facts.
Real property that Is polntly-owned w(th Aght of survlvorship must be disclosed on schedule F.
Attach a copy of the setttement sheet Ii the property haa bean sold
Include a copy of the deed ahowing decedenYs Interest it owned aa tenant in common.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Home located at 507 State St., Enola, PA(Sale Price 88500 LESS:Seller assistance of 5310) 83,190.00
TOTAL(Also enter on Line 1, Recapitulation) 83,190.00
(If more space is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule A(Rev.01-10)
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Rev-1508 EX+(11-10) ,
� SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OFPENNSVLVANIA
INHERITANCE TAX RETURN
RESIDENTDECEDENT
ESTATE OF FILE NUMBER
Solada William E 21-14-00090
Include the proceeds of litigation and lhe date the proceeds were received by the estate.
All property jointly-owned with the right of survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Comcast refund 107.75
2 Donegal(home insurance)refund 70.50
3 John Hancock refund 29.33
4 Members 1st Account 114455-00 37,550.65
5 Members 1stAccount 114455-05 71,620.50
6 Members 1stAccount 114455-11 7,459.11
7 2005 Saturn lon Sedan in Good Condition 4,218.00
8 Personal Property 650.00
9 Safety Deposit Box(no items of monetary value) 0.00
TOTAL(Also enter on Line 5, Recapitulation) 121,705.84
(If more space is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule E(Rev. 11-10)
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REV-1151�EX+(�0-09)
SCHEDULE H
COMM W AN,A FUNERAL EXPENSES AND
���'d °���°�'��� ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Solada,William E 21-14-00090
DecedenYs debts must be reported on Schedule I.
' ITEM
DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
See continuation schedule(s)attached 2,836.02
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zio
Year(s)Commission Paid
2. Attornev's Fees Cunningham 8� Chernicoff, P.C. 5,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation)
Claimant
Street Address
City State Zip
Relationshi�of Claimant to Decedent
4. Probate Fees 238.50
5. AccountanYs Fees
6. Tax Return Preparer's Fees 189.00
7. Other Administrative Costs 16,857.57
See continuation schedule(s)attached
TOTAL(Also enter on line 9, Recapitulation) 25,121.09
Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev. 10-09)
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� � SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Solada,William E 21-14-00090
ITEM
NUMBER DESCRIPTION AMOUNT
F�neral Expenses
1 Richardson Funeral Home 2,610.00
2 Richardson Funeral Home 226.02
H-A 2,836.02
Other Adminic+rative Gost�
3 Checks for Estate bank account 20.95
4 Expenses incurred in the maintenance and upkeep of the Real Estate on Schedule A- 263.50
Donegal-Home Insurance(131.75+131.75)
5 Expenses incurred in the maintenance and upkeep of the Real Estate on Schedule A-Sadler- 175.50
repair burner
6 Expenses incurred in the maintenance and upkeep of the Real Estate on Schedule A-E. 138.00
Pennsboro Twp.-Sewer/Trash 2Q
7 Expenses incurred in the maintenance and upkeep of the Real Estate on Schedule A-Verizon 60.69
8 Expenses incurred in the maintenance and upkeep of the Real Estate on Schedule A-PP&L 278.93
(43.28+33.61+30.38+39.01+29.26+29.92+30.31+43.16)
9 Expenses incurred in the maintenance and upkeep of the Real Estate on Schedule A-PA 113.12
American Water(17.04+16.02+16.02+17.04+17.04+27,96)
10 Expenses incurred in the maintenance and upkeep of the Real Estate on Schedule A- 56.63
Comcast
11 Expenses incurred in the maintenance and upkeep of the Real Estate on Schedule A-Sadler 313.80
Oil
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98)
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' � SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Solada,William E 21-14-00090
ITEM
NUMBER DESCRIPTION AMOUNT
12 Expenses incurred in the maintenance and upkeep of the Real Estate on Schedule A-UGI 59.57
(7*8.51)
13 Expenses incurred in the maintenance and upkeep of the Real Estate on Schedule A-John 7,251.00
Kauffman(1879+2600+2772)
14 Expenses incurred in the maintenance and upkeep of the Real Estate on Schedule A-AT&T 23.32
15 Expenses incurred in the maintenance and upkeep of the Real Estate on Schedule A-Real 356.59
Estate Taxes
16 Expenses incurred in the maintenance and upkeep on Real estate in Schedule A-Misc.to 351.82
prepare home for sale(see tape)
17 Law Office Costs 25.00
18 Legal Advertisements(CPBJ-150, CCBA-75) 225.00
19 Net Real Property Taxes paid on Real Estate in Schedule A(1059.37-156.31-989.71 see HUD -86.65
-1)
20 Net Sewer Charges on Real Estate in Schedule A(138-102-see HUD-1) 36.00
21 Personal taxes 9.80
22 Real Estate Broker and transaction fees on Real Estate in Schedule A(5310+195 see HUD-1) 5,505.00
23 Reserve for Costs anticipated 250.00
24 Title fee, Deed Prep,Cert.Fee and Home Warranty on Real Estate in Schedule A(20+150+10 545.00
+365-see HUD-1)
25 Transfer Tax on Real Estate in Schedule A-see HUD-1 885.00
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� � SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Solada,William E 21-14-00090
ITEM
NUMBER DESCRIPTION AMOUNT
H-B7 16,857.57
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Rev-1512 EX+(�2-08)
� � SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES AND LIENS
COMMONWEALTHOFPENNSVLVANIA
INHERITANCE TAX RETURN
RESIDENTDECEDENT
ESTATE OF FILE NUMBER
Solada,William E 21-14-00090
Report debts incuned 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 Checks cleared after death from DecedenYs checking account(2 checks 138+14.10 per 152.10
bank statement)
2 Cunningham &Chernicoff for POA 50.00
3 ICP 19.81
4 Income Tax-2013 to IRS 275.00
5 New Bloomfield EMS 1,100.00
6 West Shore EMS 1,442.67
TOTAL(Also enter on Line 10, Recapitulation) 3,039.58
(If more space is needed,additional pages of the same size)
Copyright(c)2008 form software only The Lackner Group, Inc. Form PA-1500 Schedule I(Rev. 12-08)
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REV-1513 EX+(01-10)
SCHEDULE J
�oMr���,��������ANIA BENEFICIARIES
ESTATE OF FILE NUMBER
Solada,William E 21-14-00090
RELATIONSHIP TO
NUMBER NAME AND ADDRESS OF DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE
PERSON(S)RECEIVING PROPERTY (Words) ($$$)
I TAXABLE DISTRIBUTIONS (include outright spousal
' distributions,and transfers
under Sec.9116 a 1.2
Kathy Putt Daughter Half
504 Lancaster Ave.
Enola, PA 17025
Steven Solada Son Half
2797 Little Dry Run Rd.
Cincinnati,OH 45244
Total
Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 cover sheet as a ro riate.
NON-TAXABLE DISTRIBUTIONS:
II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule J(Rev.01-10)
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, 1AN/22/2�14/��D 01 :09 PM FAX No, P, 002
�� .
�
...—�.,,
LAST WILL AbTD TESTAMENT
aF ,
WILLIAM E. SQLADA i
. �
I, �PILLiAM E. SOLADA o� �ha Horough of West Fairview,
.�
Cumberland County, Pennsylvania, declare this to be my Last W3,11 �
. %
and '�'est�ment� her�bx revoking any will previou�ly made by rne. �
. �
Y � � dir�ct the paym�nt o� all my jugt d�bts �nd ,
funeral expenseg out of my estate �as soon as may be practical. �
after my death. �
i
,
� ';
II - I de�rise and bec�ueath all o� my eetate of what- >�
r�
ever nature and wherever situate unto my wife, �'ranc�� E. 3ola�ta, `�
i
providin,g �he sur�ri�res me by sixty (60) days.
:;
III - Shoul.d my said w�i�� fail to be l�.ving an the ,
si�cty-first (61st} day following my death, then I devise and '`•
bequeath all ,of my es�ate vf �rhatever nature and wherever situate r•
unto my childr�n, �athy E. Futt and Steven W. Salada, in equ�l
shares, the share o� a deceased child to be� paid tv his or her
�.ssue per stirpes . •
;
)IS,GY71b0, IV - I appoint my wife, �rances L. Salada, Executrix af '
1�LT�'F 8r
[ASLA�ND �his, my Last 'Will �nd Testament. Shou�.d my said w�.fe fai� tQ ,
P Market Street �
�y�cw,rA qualify or cease �o act as such, then I appoint my daughter, ,
Kathy �, putt, to act in this capacity. Neither of m� personal ;
represen�a�ives shall be requir�d to post bond in this or any
jurisdic�ion. ' ,
�- �
' � ' Page ].
JAN/22/2�14/W�D 01 :09 PM FAX No, P. 003
. � , �� . .. , ... .. . . . . , , .. . . . .. t,
. , . ,. . ., ,
.. _ . . . . ... �� . .
�rf WITNES9g y�H�REOF, I have hereunto set my hand and seal on
this, the �� � d�y o� , �.994.
� � {SEAL)
Wyl�iam E. Sal.ada
S�.gned, sealed, publ�shed and decla�ed by W�LL=AM 8. 50Lpi�A, _
TeStator ther��n named, on this and one (1) othe� eheet o� paper y
as and tor hi� La�t W3.11 and Testament, in au� pres�nce, who, in ;
his presence. at hi� request, and 3n the presence o� each other,
have her�unto subscribed our name� as a�test�ng witnesge�- .i
't
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' � ' Address ;;
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Name Addres ' ;
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mYS,GU'�p0. ;
SHUFF& �;
1ViAS�.AND
1
l09 Ma=ket street
Camp Hili,pA ' '
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JAN/22/2�14/W�D 01 :09 PM FAX No, P, 004
� � � :�
� 1' . ,
COMMONWEALTH OF PENNSYLVANYA) ,
: SS.
COY3N'TY QF CLTA7;BERLAND)
w�, the ur�dersigned, the testator and th� wi�.nes�es,
re�pectively, whose namas are signed to the �oregoing ins�ru-
mant, being �ixst duly �worn, do hereby declare to the+ under-
si�ned authority that the tes�ator Q�gn�d and exacuted the
instrument as� his Las� Will and Testament and tha� he signed
willingl,X (or willingl�r d3rected ano�her to sign for bi.my , and
that he e�tecuted it �� h�a �ree v�rill and vr�li�ntary act for the
�urposes there�.n expr�ssed, and �hat' each o� the wit�nesses, in
�he p�esence and hea�ing af the testato� s�gned the wi11, aa
witnesses and that to the best of their knowledge the tes�atar
was at that time eighteen years of aqe ar older, af sound mind,
and under no constraint or undue infXuence.
�V w �9
' Teetator
w.
.._:�
� WitnesS
,
• 'Witn gs
S�bscribed, swo�n to and ac�nowledge before me b� the
testatar, and subscr3.b�d and sworn �o fore me b�r both
witnesses, this /,� � day ot , 1994. '
)I5,GU�DO,
�'CJF'F& ,�
[AS�.AND ' t � •
�Merket Suaet „ � �, • .
empx;u,P� ot�ry Ptxbl,ic '
NOTA,RiAL 8�nt
THrIMA S.McCAttS�llv ,��M(;�,X PuDlic
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r��y�:cm,r�i�sion�Zpir��.i��i,j�:- �?S6
,
� _".�_.. OMB Approval No.2502-0265
- =t�- A. Settlement Statement (HUD-1)
.- . ..
1.Q FHA 2.❑RHS 3.Q Conv.Unins. 6.File Number: 7.Loan Number. 8.Mortgage Insurance Case Number:
141504EX 5701754220 446-2138474703
4.Q VA 5.Q Conv.Ins.
C.Note:This form is fumished to give you a statement of acwal settlemen[casts Amounts paid to and hy the settlement agenfs are shown Items marked
'(p.o.c)"were paid outside the closing;fhey are slwHm here for infortnaGonal purposes and are not included in the totals
D.Name&Address of Borrower. E.Name&Address of Seller: F.Name&Address of Lender:
Joshua Gienn,Ashley Sunday The Estate of William E.Solada,by Kathy E.Putt, Fulmn Bank N.A
301 Newbery Road,Middletnwn,PA 17057 Executrix One Penn Square,Iancaster,PA 17602
G.Property Location: H.Settlement Agent I.Settlement Date:07/25I2014
507 State SVeet Capital Nrea AbsUactors,LLP Disbursement Date:07/2512014
Enola,PA 17025 500 N.Progress Ave.,Harrisburg,PA 17109
West Fairview Borough
Phone:717-920-9179 Fax:717-909-3045
Place of Settleme�t TitleExpress
500 N.Progress Ave.,Hartis6urg,PA 17109 Printed 07/2512014 at 3:59 pm
by DB
:.
100. Gross Amount Due trom Bortower 400. Gross Amount Due to Seller
101. Contract sales price 86,500.00 401. Contract sales price 88,500.00
702. Personal ro e 402. Personal ro
1b�: Settlemenl charges to borrower(line 1400) 6,341.91 403.
104. 404.
105. 405.
Ad'ustrnents for ifems aid b seller in advance Ad'ustments for items id b seller in advance
106. Cityftown taxes fo 406. Cityltown taxes to
107. County taxes 07/25l2014 to 12I3112014 156.31 407. County faxes 0712512014 to 12/3112014 �" 156.3t
108. School taxes 07/2512014 in O6I30/2015 989.71 408. School taxes 0725/2014 to Ofi13012015 989.71
1 G9. Sewer JIAIS 07/25l2014 to 09l30I2014 102.00 409. Sewer JIAIS 0712512014 to 0913012014 ' 102.00
1�0. 4?0.
� 411.
112. 412.
120. Gross Amount Due from Borrower 96,089.93 420. Gross Amount Due to Seller ����•02
200. AmouMs Paid b or in Behalf of Borrower 500. Reductions In Amount Due W Seller
201. Deposit or eamest money 1,000.00 501. Excess deposit(see instructions)
202. Prinapal artwunt of new loan(s) 86,896.00 502. Settlement charges to seller(line 1400) 8,132.37
203. Existin loa s faken sub'ect to 503. Existin loa s faken su 'ect to
204. 504. Pa off of first moR a e loan
205. 50.5. Payoff of second mortgage loan
206. 506.
207. Sellers Assitance 5,310.00 507. Sellers Assitance 5,310.00 i
208. 508.
209. 509. '
Ad'ustments for items un aid h seller Adjustments for itcros un 'd b seller
210. Cityftown taxes to 510. Cityltown taxes to
211. Counry taxes to 511. Counry taxes to
212. School taxes to 512. School faxes to
213. 513.
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. 519.
��• Total Paid b/for Bonower 93,206.00 520. ToUI Reduetion Amount Due Seller 13,44237
300. Cash at Settlement fromlW Bortower 600. Cash at SeClement tol(rom Seller
��. Gross amount due from borrower(line 120) 96,089.93 gp�, Gross anwunt due W seller(line 420) 89,748.02
;;;;�,� Less amounts paid by/for bortower(6ne 220) g3,206.00 602. Less reductlau in amount due seller(line 520) 13,442.37
303. Cash QX From ❑ To Bortower �.�•� 603. Cash XQ To ❑ From Seller 76,305.65
u�c�nm.�w.suaW.w.���uaouammdn.ro..wmad.r.wrr.....a:w.a�...r��r.nas�e.��.amwa�wP.unm RESPAmurMLarrJlm�HamWbn ms
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Previous editions are obsolete Page 1 of 4
,.
. 700. Tofal Real Estate Broker Fees S 5,3to.00 Paid From Paid From
Divisionofcommission Iine700 asfdlows: Bol'I'Owel''S Sellef'S
701. $2,655.00 to ReMax Delta Group,inc. Funds at Funds at
7i% $2,655.00 � ExitRealryCapitalArea Settlement Settlement
70�. Commission paid at selUement 5,310A(
704. Transacbon Fee � Exit Realty Capifal Area 150.00
705. Transaction Fee � RelMax Delta Group Inc. 195.IN
800. kems Pa able in Connection wifh Loan
801. Our wiginadon charge (indudes Origination Pant 0.000°k or$0.00) $795.00 (from GFE#1)
802. Your credit or charge(points)for ihe speafic interest rate chosen $-434.48 (from GFE#2)
803. Your adjusted origina6on charges (from GFE A) 360.52
804. Appraisal fee N A raisal Solutions (from GFE N3) 4.50.00
805. Credit repoA to CredStar (from GFE#3) 87•84
806. Tax service to from GFE#3
807. Flood certifica6on to Core ic Flood Services (from GFE q3) 11.50
808. �
�y � (from GFE#3)
810. to (irom�FE#3)
811. Inspection Fee to raisal Solutions (from GFE N3) 100•00
900. Mems R uired b Lender to be Paid in Advance
901. Daily interest charges from from 0TI2512014 m 0810112014 @$8.92771day (from GFE#10) 62.49
902. Mortgage insurance premium for months to Fulton Bank N.A. (from GFE k3) 1,494.54
9�3. Homeowners insurance fa t ears to USAA (from GFE#11) 886.83
gpq. months W from GFE#11
1000.Reserves De sited with Lender
1001. Initial deposit f�your escrow account (fran GFE#9) 388.69
1002.Homeowners insurance 3�nths $ 73.90/monih 5�1.7�
1003.Mortgageinsurance months $ 95.27/month $
1004.Property haxes months $ O.00lmonih S
1005.Countytaxes 6�nths $ 30.321month 5181•92
1006.School ta�ces 2�nths S 90.OBImonth $180.16
iUu7.Aggregate Adjustrnent $-195.09
1100.Title Char es
1101.Title services ard lenders title insurance $ from GFE#4 1,2fi3.50 I a 20.Q
1102 Se�lement or closing fee to $
1103.Owners 6tle insurance-Frst Nnerican TiUe Insurance Canpany $ from GFE#5 »•�
1104.Lenders We insurance-First Mierican TNe Insurance Company 37,053.50
1105.Lenders fitle policy limit$86,896.00 Lenders Policy
1106.Ownefs tifle policy limit$88,500.00 Owners Pdicy
1107.AgenPs portion of the tntal title insurance premium $841.07
W Ca ital Area AbsVactors,LlP
1108. Underwrilers portion of the total tltle insurance premium $223.43
to First American TiUe Insurance Com an
11D9.Deed Preparation Fee to Law Office of Kevin R. ay 150.0
Helm
1200.Govemmeat Recordin and Trensfer Ch es
1201.Govemment recording charges $ (from GFE#7) 190.00
�ZOZ•Deed$77.00 Mort a e$113.00 Release$
1203.Transfer taxes $ (from GFE#8) 885.00
1204.City/County faxlstamps Deed$885.00 Mo a e$ -
1205.State Taxlstamps Deed$885.00 Mo a e$ 885.0
1206. pead$ MoA e$
1207. 3
1300.Additional SettlemeM C es
1301.Required services that you ran shop for (from GFE q6)
1302.Survey � $
1303. to
1304.2014/15 school taxes in West Fairview Borou h Tax Collectnr 1,059:
1305.3rd quarfer sewer charges to West Fairview Borou h 138.f
1306.CeR Fee tn West Fairview Borou h 10.0
1307.Home Warranty tn First American Home Bu ers Protecdon C 3fi5.f
.�i i � . � � 6,341.91 8,132.37
'Paid outside of dosing by(8)arrower,(S)eller,(L�nder,(I)nvestor,Bro(K�r."Credit by lender stawn on page 1."'CredR by seller shown on page 1.
Previous editions are obsolete Page 2 of 4 HUC
Cw°� arison of Gaod faifh Esfimate GF and HUD�7 Char es Good Faifh Estimate HUD�1
� Char es That Cannot Increase HUD�1 Line Number
Ourorigination charge # �� 795.00 795.00
Your credit w charge(poinfs)for the speafic interest rate rhosen # 802 �34.48 -434.48
Your adjusted aigina6on charges # 803 360.52 360.52
Transfertaxes # 1203 885.00 885.00
Char es That in TofaF Cannot Increase Yore Than 10°b Good Faith Estimate HUa1
Govemmentrecording charges # 1201 260.OD 190.00
Appraisalfee #� 450.00 _ 450.00
CreditrepoR #� 40.00 87.84
Fload certfiption #807 11.50 11.50
#gpg 0.00 0.00
#810 0:00 0.00
Inspection Fee #811 125.00 100.00
Mortgage insurence premium #902 1,494.54 1,494.54
2,381.04 2,333.88
� $ �7.16 a -1.9806%
Char es That Can Chan e Good Faifh Estimate HUD�1
Inifial deposit for your escrow account q 1001 1,324.00 388.69
Daily interest charges irom #901 $8.9277/da 187.48 62.49
Homeowners insurance #� 600.� 886.83
Title services and lenders title insurar�e q 1101 1,295.00 1,263.5C
Owners title insurance-Frst American Title Insurance Company # 11�3 100.00 11.00
#
#
Loan Terms
1'uur initial loan amount is $86,896.00
Yau loan term is 30.years
Your iniGal interest rate is 3.7500%
Your inidat monihly artrount owed fa prinapal,interest,and any mor�age $497.70 indudes
insurance is QX Prinapal
XQ Interest
X❑Mortgagelnsurance
Can your interest rate rise? XQ No. ❑Yes,it can rise tn a maximum of %.The first change
will be on I I and can change again every years a8er I I . Every
change date,your interest rate nn increase or decxease by �. Over the life of
the loan,your inlerest rate is guaranieed to never be lower than %or higher
thart %.
Even'rf you make payments on time,ran your loan balance rise? XQ No. ❑Yes,it can rise to a maximum of$ .
Even'rf you make payrt�ents on time,pn your monthly amaunt owed for QX No. ❑Yes,the first increase can be on / / and the monthly
principal,interest and rtwrtgage insurance rise? amount owed can rise to$ .
The maximum it can ever rise to is$ .
Does your loan have a prepayment penalty.� Q No. ❑Yes,your maximum prepayment penalty is$ .
Does your loan have a balloon paymenP? QX No. ❑Yes,you have a balloon payment of$ due in
years on 1 1 .
Total monthly amount owed induding escrow account paymenis ❑You do not have a monthly escrow payment for items,such as property taxes
and homeowners insurance.You must pay tliese iteans directly yourself.
❑X You have an additionai monthly escrow payment of$194.30
that results in a total initiai moNhly amount owed of$692.00.This inrludes
principal,interest,any mortgage insurance and any items checked below:
QX Property taxes �Homeowners insurance
�Flood insurance �X Sdwol taurs
❑ ❑
Note: If you have any questions about the Settlement Charges and Loan Tertns listed on this form,please contad your lender.
Previous editians are obsolete Page 3 of 4 HU[
- HUD CERTIFICATION OF BUYER AND SELLER
I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief,it is a true and accurate statement of all receipts and
disbursements made on my account or by me in this Vansactlon I further certify that I have received a copy of the HUD-1 Sedlement Statement
Joshua GI n
Ashley Sunday
f ��� �-��' ��-�
The Estate of William E. ada,by Kathy E.rutt,ExecuUix
Agent•Kathy E.Putt
Title:Executrix
The HUD�1 Settlement Statement which I have prepared is a We and accuraie account of this Vansacfion I have caused or wil�cause the funds to be
disbursed in accordance with this statement
,��,..c�� 7-75 tl
SEITLEME TAGENT DATE
WARNING:IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM PENALTIES UPC
CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT.FOR DETAILS SEE TITLE 18:U.S.CODE SECTION 1001 AND SECTION 1010.
Previous editions are obsole[e Page 4 of 4 HUL
. . �
Name of Borrower: Name of Seller. File Number.
Joshua Gienn The Estate of William E.Solada,by Kathy E.Putt, 141504EX
Ashley Sunday Executrix
Prepared U7/25I2014 at 3:59 pm
Note:This page displays an itemization of the charges shown on line 1101 of the HUD-1 SetUeme�!Statement.This page
accompanies but is not a part of the HUD-1 Settfement Statement If a discrepancy exists,the information on the HUD-1 Settlement
Statement applies.
1100.Title Charges Total Charge Borrower Seller
��p�,Title services and lenders title insurance �
E-Documents to Ca ital Area Ahstractors,LLP $ 100.00 100.00
Notary Fee Purdiasers ro Ca ital Area Abstractors,LLP $ �.� �.�
Wire Fee to Ca ital Area Abstractors,LLP $ 20.00 20.00
Express Mail-Signed Docs to C ital Area Abstraclnrs,LLP $ 25•00 25•00
Courier Fee to Ca ital Area Abstractors,LLP $ 25.00 25.00
Nofary Fe�Sellers to Ca ital Area Abstractors,LLP $ 10.00 10.0�
Wire Fee�Payoff to Ca ital Area Abstractors,LLP $ 0.�
Tax Cert Fee to Ca ital Area A6stractors,LLP $ 10.00 10Ai
1102.SeWemeM or dosing fee � g 0.00
1104.Lenders title insurance-First American Tit�first American Title Insurance G$ 1,053.50 1,053.50
Tofals: S 1,283.50 0.00 1,2p.50 20.a
Seiler/Lender credits shown on a e 1 POC=Paid Outside Closin CR=Lender Credit
Previous editions are obsolete Page 1 0 1 HUD-
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LEBANON, PA 17446 �Om��.7�,
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- W� SOLADA 15283 0339�24-48-3DG �
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CHECK NO: 0012660816 CHECK DATE: 03/05/14
ACCOUNTNO: 09547-18691801
F�ar WR SOLAD7,► .
ed check represents a refund for account number 09547-1869180�• ia the amouat of
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IF NOT CORRECf.P�-EASE N�T��US PROMP'fLY NO RECBPT DESIRED.
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DONEGAL MUTUAL INSURANCE COMPANY �—
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BILLING INQUIRIES CALL: 1-800-877-0600
08/06/14 CANCELLATION MEMO 0004481 G 0827642 3205
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N SOLODA WILLIAM E HOMEOWNERS
S C/O KATHY PUTT E%EC
V 504 LANCASTER DR
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POLICY EFFECTIVE: 3/16/14 �A --- -- ---- • ---- -- ---- SI ----
TOTAL POLICY PREMIUM; $499.00
ACCOUNT BALANCE 263.50
PRO–RATA CANCELLATION EFFECTIVE 07/25/14 334.00CR
CANCELLATION REQUESTED BY INSURED g�
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� � REFUND DUE $70.5
D N A CHECR WILL BE SENT UNDER SEPARAT .
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T E A RAYMOND A SMITH INS AGY
I R G A DIV OF CHRISTIAN–BARER CO
O E E P 0 BOB 158
N S N CAMP HILL PA 17001-0158 �
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site at wuyw.danegalgroup;cpm
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������'���� t INSURED WILLIAM E SOL.ADA
Eaala ,',.
392 Esst Detun:Ari.v�
8aola PA 17Q23 ` � 11.,}�
Inquiries Call: 717-729-1299 �r�r. .
Aoct XXXX}ODt573 ESTATS OF WILLIA �. �
Elf: 03/06/14 Dat�: 03/06j14 �:
Tls: 1816 Tim�: 11:12am [
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� STATEM ENT OF CHECK5 0 3 7 0 4 9 6 7
Deposit to CHECKIMO 0011 - .
Prwv sa�: �12,646.se �;�,7 CHECK NO. g�0- 503704gb7 --
Amount: 29.33 ->
�ew sa1: 112,676.29 � CHECK DATE 02-27-14
S�g: #809933 �.:
AMOUNTS DEDUCTED '
Check Recsived 29.33: 25.�Q
4.33
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- 29,33 . TOTAL DEDUCTED .00
m' so"x`G"` CHECK AMOUNT 2g.33
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MEMBERS 1st
PBDBRAL CRHDIT(AVION
REGULAR SAVINGS ACCOUNT:
Account Number/Suffix 114455-00
Date Account Established 05/07/1990
Principal Balance at Date of Death $37,548.03 �� l,�
Accrued Interest to Date of Death $2,g2 T-�.
Total Principaf and Accrued interest $37,550.65
Total interest Accrued 1/1/2014-1/18/2014 $2.g2
Name of Joint Owner None
INVESTMENT SAVINGS ACCOUNT:
Account Number/Suffix 114455-05 �
Date Account Established 08/01/2001 �
Principal Balance at Date of Death $71,612.16 1 C
Accrued Interest to Date of Death $8.34
Total Principal and Accrued Interest $71,620.50
Total Interest Accrued 1/1/2014-1/18/2014 $8.34
Name of Joint Owner None
Account NumbeNSuffix 114455-11
Date Account Established 06/01/1994 — ,—/
Principal Balance at Date of Death $7,458.94 (, ��D
Accrued Interest to Date of Death $0.17
Total Principal and Accrued Interest $7,459.11
Total Interest Accrued 1/1/2014-1/18/2014 $0.17
Name of Joint Owner None
VISA CREDIT CARD ACCOUNT
Account Number 4672090000200394
Date Account Established 10/08/1993
Balance at Date of Death $0.00
Joint Cardholder None
SAFE DEPOSIT BOX: YES
Date Established 12/01/2004
Branch Location Enola (392 East Penn Drive, Enola, PA 17025)
Name of Leasee William E Solada
MEMBERS 1ST FEDERAL CREDIT UNION
Tessa L Klugh
Lending Insurance Support Specialist
February 4, 2014
Estate of:WILLIAM E SOLADA
Date of Death: 01/18/2014
Sociai Security Number: 201-18-8913
5000 Louise Drive • P.O. Box 40 • Mechanicsburg,Pennsylvania 17055 • (800) 283-2328 • wwwmemberslst.org
Kelley Blue Book http://www.kbb.com/saturn/ion/2005-saturn-ion/1-sedan-4d/?conditi...
,
,-
�� � � Ketley Blue Book The Trusted Resource`
�
S`'F�A-FEr-FA:R �-F +�3�� Findthe-lowe�t.rat�,,:
tt - .t� ,�""'T"11'"'""'-. � EVEN;IF IT'�NOT WITkI U�t ` .;
_ �� _ I
� _ ;:-.::� :. , .�.� �.._� . ; : '�. ,. , , . .; ,.' .
�+��* � � �
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� . _ .
AdvatlsemeM Why adsi
2005 Saturn lon SetlTo Private Party
Pricing Report � �Qod
� � F�ir Conditioe Vary Good '
S�/�@:1 Sedan 4D Condifion $4�218 Condition
Mileage:5i,sza $3,768 $4,318
Ex�.u.rt
i# ' l!�' ...�� ' Condition
$4.393
_ . ._ .
Vehicle Highlights '� " �'`�
�� ,
Fuel Economy: Max Seating:5
City 21/Hwy 29/Comb 24 MPG
Privata Party Values valid tor your ares throuyh 4/SO/2014
Doors:4 Engine:4-Cyl,2.2 Liter
Drivetrain:FWD Transmission:Automatic
EPA Class:Sub Compact Cars Body Style:Sedan
Country of Origin:Unfted States Country of Assembly:United States
_.... _ ._ ._ . . ... __.._ _ ___... _ _ __ _ __ . _. _ ._ _
_ . _ _... _._ _
Your Configured Options
Our pre-selected opdons,based on typlpl equlpment for thls car.
✓Optlons that you added whlle conflgudng thls car. '
Englne Steeriny Wheels and Tlres I
4-Cyl,2.2 Llter Power Steering ' Steel Wheels
Transmission T11t Wheel �
i
Automatic Entertalnment and Instrumentatlon
Drivetraln AM/FM Stereo
FWD Safety and Security
' Dual Alr Bags !
_,. .... _ _ __._....._ _
_ _ __
_ _ _ __ _ _ _._ ... __ _____.
Glossary of Terms
Tip:
Kelley Blue Book�Trade-In Value-Thls Is the amount you pn expect lo recelve when you trade In
your car to a dealer.Thls value Is determined based on the style,condltlon,mlleage and opdons �t's erucial to know your ear's
inaicated, true condition when you sell it,
7rode-In Range-The Trade-In Range Is Kelley Blue eook's estlmate of what you wn reasonably expect so that you ean priee it
to recelve thls week based an the style,mndltlon,mlleage and opdons of your vehlcle when you bade It appropriately.Consider having
In to a dealer.However,every dealer Is dlfferent and values are not guaranteed. yOUf PY1@ChdC11C JIV2 y0U df1
objective report.
Kelley Blue Book�Prlvate Party Value-Thls Is the stardng polnt For negodatlon of a used-car sale
between a prlvate buyer and seller,ThIs Is an"as Is"value that does not Include any warrantles.The flnal
prlce depends on the cars actual condltlon and local market factors.
Prlvate Party Range-The Prlvate Party Range Is Kelley Blue Baok's estlmate of what you can
reasonably expect to recelve thls week for a vehlcle wlth stated mlleage In the selecbed condltlon and
conflgured wlth your selected opHons,excluding taxes,dtle and fees when selling to a prlvate party.
Excellent CondiHon-3%of all cars we value.ThIs car looks new and Is In excellent mechanlpl
condltlon.It has never had palnt or bodywork and has an Interlor and body free of wear and vlslble
1 of 2 4/4/2014 12:30 PM
Kelley Blue Book http://www,kbb.com/saturn/ion/2005-saturn-ion/1-sedan-4d/?conditi...
.
defects.The ar is rust-free and does not need recondltloning.Its clean engine compartment Is ftee of
fluld leaks.It also has a clean tlNe hlstory,has complete and veriflable service records and will pass
safery and smog Inspecdon.
Very Good Condldon-2346 of all cars we value.This car has minor wear or vlsible defects on the body
and Interior but Is in excellent mechanical condltlon,requiring only minlmal recondidoning.It has Iittle to
no palnt and bodywork and Is Free of rust.Its clean engine mmpartment Is free of fluid leaks.The tires
match and have 75%or more of tread.It also has a clean tlNe history,witfi most servlce records
avallade,and will pass safety and smog inspection.
Gaod Conditlon-54%oP all rars we value,This car is free of ma)or mechanical problems but may need
some recondltloning.Its palnt and bodywork may requlre minor touch-ups,wltfi repairable msmedc
defects,and Its englne compartment may have minor leaks.There are minor body scretches or dings and
minor Interior blemishes,but no rust.The tlres match and have 504fi or more of tread.It also has a clean
tltle history,with wme servlce records avallable,and wlll pass safety and smag Inspection.
Falr Condidon•18%of all cars we value.Thls car has some mechaniwl or wsmedc defects and needs
servidng,but Is stlll In safe running condiUon and has a clean tltle hlstory.The palnt,body and/or InteHor
may�eed professional serWdng.The tlres may need replacing and there may be some repalrable rust
damage.
_ _ ._ ._ _... _ _.__.....__. _ _.. _
__ __ __.
m 1995-2014 Kelley Blue Book Co.',Inc.All rlgMs reserved,
m 2014 KNley Blue Book Co.,fnc.AlI Nphtr reserved.�/4/201�-4/10/201�Edl[lon Ior PennsylvanN 17025.The speUllc InPorma[lon requlred[o determine[he vslue Ior thls paKlcufar vehlcle was
supplled Oy[Ae pason peneratlnp thls rcport.Vehlcle va/uaGons arc opinlons an0 may vary/rom vehkla to veh/cle.Actua/valuatlons wll/vary based upon market cond/dons,spec/flcatlons,vehk/e
contlltlon or ather partltular clrcums[ancer pertlnent to[hla particular vehlcle or tha transactlon or the partles to the transactlon.Thlr report Is In[ended/or[he Indlvldual use o/the person
genaratlnp thls«poK only and sha//not be sald or transmlf[M to ano[Aer party.Kelley Blue Baok sssumes no rssponslblllty Por e�rors or omisslons.(v.74091)
2 of 2 4/4/2014 12:30 PM
Bruce Warshawsky
From: Erica Taylor <appraisals@classicedgeauction.com>
Sent: Tuesday, March 25, 2014 10:01 AM �
To: putter011@verizon.net
Cc: Bruce Warshawsky; 'Kerry'
Subject: RE: RE:Appraisal Appointment: 3/24 @ 2pm (Estate of William Solada, Enola)
Bruce:
I met with Kathy Putt in Enola yesterday. I just wanted to follow-up with y and let you know what we discussed. The
overall value of the personal property remaining in the home is betwee $500-$80 1 did not complete an appraisal
while I was there, but I did take photos of everything. I think it would be reasonable to donate all of the items in the
home to a charitable group. If the items were sold at auction, our commission would be 35%and there just isn't enough
personal property there to make that the best option.
I also spoke with Rob Derfler from Pine Grove (I think you have worked with him on some other estate clean-outs
through our office). He does not have any pick-ups scheduled in this area and was not able to make a special trip to
Enola because the total value at auction was less than$1,500. We discussed taking a few of the antique items to Kerry
Pae Auction Center, but again,there's just not quite enough dollar value for that to be the best option.
If you would like me to complete an appraisal report, I can do that from the photos that I took. It would be a 1-2 hour
appraisal to complete ($75-$150 estimate). I didn't want to complete the appraisal and bill the estate if you really
didn't need one in this case. Please discuss with Kathy and let me know if you require an appraisal or anything
additional from me.
Thank you,
Erica Taylor
Kerry Pae Auctioneers
From:Bruce Warshawsky [mailto:bjwCa�cclawpc.com]
Sent: Wednesday, ]anuary 29, 2014 10:04 AM
To:Erica Taylor
Cc:Kathy Putt(putter011C�verizon.net); Bruce Warshawsky
Subject: New Assignment
Erica:
Hope you are well--new assignment, for the Estate of William Solada--house in Enola, Executrix is Kathy Putt,
copied on this email. I will leave it to the 2 of you to coordinate logistics. Thanks!
Bruce J. Warshawsky, Esq.
Cunningham &Chernicoff, P.C.
1
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AFE DEP�SIT BOX INVENTORY Pa9� � of_�
INSTRUCTIONS
(!) Cash:Reporttatalonly. '
(2) Stocks:Ust In detail every oommon or prefemsd certiticata,warrent or other rigi�ts found in box.SUocks are to be designated by
name of oompany,certificate number,date of oertlficafe,name in which stodc is registered,and number of shares and Gass of stock.
(3) Ob[igatEons of U.3.Govemment Number of items,date of Issue,face value,names in wt�ich registered and type of ownership,
I.e.,joinUy held,payable on death,ata.
(4} Bonds:Designa�by name,amount,serial number,or other designation.(Bearer Sonds)
(v� Bank and Savinga and Loan Passbooks:5tate nsme of deposRor,number of book,laat date appearing ln book,name of bank
and braneh,and balance.
{6) Jewelry,Coins,Stampo,ManuscrEpts,etc:Llst and describe as fitfly as pass�ble.
('� peeds,MortgaQes,Current Insuranca Policies or other evidences oE Indebtedness:List and describe as fuiy as possible.
(8) AII other contents.
{9) Retum completed form to: DEPARTMENT OF REVENUE
INHERRANCE TAX DIYSSION
DEPT.280801
FWRRISBURG,PA 17128-0601
�� lTEM DESCRIPTION '
NO. '
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1 CERTTiFY UNDER PENALTY OF PERJURY 7HAT THE ABOVE RECORD IS PER50N RECEMNG COPY UF
CORREET AND COMPLETE TO THE BES OF MY KN0INLEDGE AND BELJEF. SAFE DEP051T BQX INVEIITORY:
51t3NATURE � � SIGNATURE � �
PRINTNAM� K� � �'4 ,� ` PRINTNAME/,�N��KAP R RIATEBpp(r' _OW'
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PRINT7ITLE DATE CHECK ROPRfATEB
Lq�c""'la(trix) ❑Admin�strator(trIx)
�xeC u�-�,�x- �� 1�1�� o��a��a ❑��,t�.«e�.d���
NOTE:Attach addltlonal 8'!i x 11'sheet{s)if necessary or use duplicates of thfs page of form.
The Depertrnent Is autliorfzed by law,42 U.S.C.§905(cx2)(C)n,b require discbsiae of Sadal Sewrlty numt�ers in connecSon u�th admEnistering state tax laws.The De�rfi�ent uses the
5odal Seauilyy number b idenf�r tl�e decedent end p�sor�representaGv�of the estate.The Car�manwestth mey also use fhe Infama8on in sxchange of ta�c fnformatiart agreemenfs
wdh Federal and laxd ta�dn sulhaities.The state{aw hibffs the Cottunonweaflh's somef irom disdosm confidenCral tax ir�fortna�on e fa of6cial
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Charges ue only for thoso items t6at you sdected or that u�nqnlred.If we ate required bp law or by a temetet�ot��r���,,.r�„r� �,�`��
cxploln in wdting below. r
I�you Seltcted�,fi�necal thu maq tequire anb�lming,such aa a funenl with viewing�You may hape co pap for embalming.Yau ctaE�e�e rto pa�g f��� �
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Memor�lt s�rvtet :� t,,,,,�„�,_,,,;; {I�,rar�[Hvme) �.r,...� �"�`""
Ust of`a�'p�icet and servtce� I�td�Bn�fai. ;
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3UB-TOT�OF�CIA�C�iAkGr89 .......... C: ����'�` ��.
—�—, D!CASg ADVANCS�
, .... .. ... i;.,:�._ Openin8 Gtave .................. i
S[J$-TOTA�OF 1�AC111�'I�9BQUIPMBNT........... A2: �emetay EqaipmenF.............. t
3.AUTOMOTIYE EQUIPMEAtT Lot�nd I)eM.................... i
VeWcle to a�aNshr remains tq Funaa!Home. N��P�Norices—Loca1 .,,,,,,,, : :
......... �,.,,,�,��,r��. Newspaper NoHc�►s—Out-of-town.. i
Loc�t...`............... ._�.�. Telephone&Talegnrna .... .. i�
Heuse(C�sket Coach) • ,�� . :
�itrtousina � �ec$Ylll�Offex�tg ;��.�s ��
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�'�p[�JC �` i� `�
Plo a•car or flonl disposition...... :� �oiiar l�sctn� .................. i�_
Local........................... i Vault Suvia Charge.............. t
Lead eadclergy cu ^s .
Local:. ..... . . .......... f j
Cu for p�rtrs ;
Local..... . ....... i �
Oat of[owR a�aspottation . ... i :___^__
�.-...„ f f_,—.,—
' � SU&�'QTAL OF ADVANCES....................... Ik �
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SUH-TOTAL OP AUTU1liOT�HQ�PMBNT........ A3 i We charge qou for our sa�vices ln obt�lning:
TOTA,I.01+�HUFLSSION�L S��►Y�R; (SP�.�J'�asb advances tbat nre mark�up)
FACILY�S h1�D'KUT�II�QTIVS, :
EQ[IIPMEIV'i' .........�A f
SUMMABY OF CAARGE9
�.CHARG�F�H 1l�CHANDISB SELEC1�Dt �,. A. Pmfessioa�i Savices, Facllidea and
,
' C�sket ..... .....: ......:.... #`�"�'� Equipment,and Automodve �
(L�escrl tioa ' � '` ��
P � Equlpmenr...................... t � U1�
,.-- .,.. B. Mecchandise..................... i �� �
Othor Recepr�cle ................. 3 C. S(�ecial Chuges .................. �_� ��
(Descdpdon) D. Cash Advances................... i
TOTAI,OF ALL SECTION3................ ..... f
_ Outes butiat contaittet.::..,..,»;;.... ;.�� ��^ FAID T _ ''. . , ,
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�ac�ar�o� �J uyr.era� �o»ze, �nc. N��O��
' �i�79s.00e�
� SUPERVi90$�R�Y
STATEMENT OF FUNERAL C,pOD3 AND SERYICES SELECTED
U Chugn mie only for thoae items thu�ou uleaed�that ue requ4ed.I[ae a[e required by�w dr b�a ameuey a ae�mtoq w we any Item�,we wW
�phin in wtlHas below.
IEyon selaredafuuenithumsl re4uineaobalmioB.�nchasafnnaalw(t6 vk+vtn6.Y��1hi�e w pa�[oremLaimins.Youdo aat havewpay forembalmiod
yoa did not approrc it7roa xkc lted un°8emen�sncA u a direct a immedhte 6uti�1.If we chuged fot em�lmios,we wW esphto whT below.
ror the see.ier or �'•••• /�.�F.c�+=.� ,s�i����+ nue ur neur /-/9� .�oirt
c:harge co, ,•S�/� ,���_�i3 z1 L��,c:G ��JA ��sd�.c. �.� �74'.2 i`'�,
� City Sptc
A.CBABGS FOE 98HV[CB8 SBLBCY'EDe Other cia[hl� .
1.PEOPESSIONAL SERV[CL�4 s
Secvias of Fw�l DittctodStlif....i i
Fm�imio6......................i Ctemuion om...................i
other piep�ndon of 6od� (Daalptiou)
OI'HER t
............................... t �� i
SUB TOTAL OF PROFBSSIONAI.9BRVIC89.........Al� i
2.FACILI77ES AND SSRVICBS TOTAL�A1VD1�9SLBCf�1..................B!
Use of[uWda md xrvias for _G SPHQAL CHABGBSr
viewlog Mdtatioo/Watce)........_f Fo�B��for to
Ux of hdtltla md tavlca : s •
(Fnoenl Home) -
For fi�aml cvem��............ i�Z"� Rece[viog�rem�iro hom
- -- --- �-----F7se-ef-hcfl(tia and-serrlees[ot -- - -. .
_ - _.. _
__. _ _ -- ----t-- -
Manorhl Ser►itt ...............i (Fnneral Home)
Ux of eqWpmeot aad xevien immedi�te Buti�l.................i
fa'�av�savia..............i D1rca Crnu�don.......... .�i
.....
�[bQ46[��7O�f�Ci �''���'�/YL(�r...':S1i '�,1':�_f��s�
SOB-7'07'AL OF SPBCIAL C8ABG89....'.�........�:�6l��Q����
D.C6SH ADVANC�
•.............................. t OpmNig Gnve ..................t
SUB-?OiAL OF FACR.IIY@91EQUIP6�N'['...........A2! ��Y F9�P�E•-•....-......i
3.AvfOMOrnB EQUIP1NEtV1' tot�nd Dad....................i //
Yehide to LL'�nsfG[em�tro to Fmrnl HomO,, G� Newap�per NoHc�-�Loal.........t�O.,� �0�-- �Z �.1,�r-y
�.,�j N�wa�NaNcat-Out-0f-town....i
Local........................... f'�y5z— Telephoae R Telegnmf ...........i
He�ne(Galoet Coac6) •
� �.........................:�ea G4 p� a�-��
�............................: �«�,��..............:
� P�uhcuaa......................i ��, /�y
I.aol...........................t Cerd6cd Cop�of the Death, C�Ye. � �'/!VI/l%
T�f� Cerd6cm..................••••i
'.` Locol...........................t Po)la Escott._............-••...f
flOwer tu or tloial dispositlou Flaweli........................i
loal...........................f VaultSanice Ch�e..............i
Lnd adclag�ar s
Loa�........................... s �
Gr for p�bnrm f
; Local...........................t j
Out of[own cnaspomdon.........f :
: i
' j SOB-TOTAL OF ADVANCBS....................... D i.�t�. a�.
SOH-TOtAL O!A(frOM011Y8 EQOBl�V7....__.. A3 t We cdarge you for aor senloe�ia abhinM�
'FOTAL OP PEOFESSIONAL SB�VIC84, f�.fy ca�a�reu a,e�Pl
FACQl'17ES dPm AtTPOM011YB
` F.(jIFIPMF1'17'-•.................................A t
' _ _. SQAL�ABY OF�A@GE4
�(�pH�FpB�t�CH8PID1�SEI�f.7FD,,�f,J-� A.Prok�ioml Savka.Fzdlido and
f�aka-.:....................•--f�=�rF E9aipmen[,nnd Ama�otive ?� .0�7
�� Equlpment......................s,0i�,��
B.Machandiae.....................i
X7s�Haequack.................f C.SpecvlChargw.....:_...........S
' ��� D.Gs6 Advances...................f,� t;�'�-.
TOT6L OF ALL SECTiONS........................i
(�b�s�oo@uisa............. PAID AT 11A18 OF OH PSIOt TO
�3 ARHAPiGE1�N7S................................t.
: r BALANCB DOe. �
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ee�oupt QEs wPg af i1gS5�.*�f P:����Sriaaed.[reptrseat t6u I have mBicknt fund��nilabk fot p�ment�the ps6 pdoe[or t!x good�
�ndasniaar�tecisd.���eR�s��ffi� a�it5io daps.(�g[a m be joiaty md aeaaall�li�ltwith.�ayo�dK who
si�r�tq�v A k+it t.tucse e�E�.-.�'�i�qgto per yeu�vlll be�ppikd to tLt mp�W halaeoe h� d�s
Lrqm tbe�tep,�t�iFa(�eameet 3�a�5o;�,r#>#guF�t��fi�osombk coau p�id br�he Fwm{D&euor to afkct�momu t owe�mder�hb agreemmt.
n3flse ass m�i�de�fs�f,�rr�E e��$�era�.ea��t urrtaa or maduna+x ocdaea or reqnened�fter t6e auo or dds�wut
be w�Ga�e}�att��fas agir,�mt s�tt�e ms thaipof�I3 be RSomed aa dx ftmi b1U m satemenc
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NEWI Order Branch
sSLQP119E
Order Search
Order Conffrmatlon
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L • The order has been submilted.You may pr(nt this screen for your racords then either place another order for thie axount,a�ees another account or ExH.
Order Conbna
CorMrmetlon s: 8 0 2 0 4 9 4 4 5 0 �
Routlny0: 23198224 ���
Accamt�k 21Z�
Estlm�bd Orda Tofal• 320
Ord�rDab: 08/07H4
Ibm 1: Produet Duenptlon AMiqus Checks-Oupl
�'"pK^� ESTATE OF WILLIAM E SOUIDA
KATHY E PUTT EXECUTRIX
PH.717-732-4377
504lANCASTER AVENUE
ENOLA,PA 17025
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ShlPpnp MMho� $��p91hre1y-14 DBy�
Shippin0 Add�as: ESTATE OF WILLIAM E SOLADA
504 LANCA3TER AVENUE
ENOLA,PA 17025
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Privacy Sscurtty and Rellablitty Tsrms and Condldona
All desigm slmwnt are s��d ta dtmqe a@hwt notke.
A8 trademaAn ara tlla property of thelf r�s wzr.as-�20t4 Det�me Ertefprlse Operatlotn,Lle All Rlphts Reserved
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6/7/2Q14
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RECEIPT FOR PAYMENT
LISA M. GRAYSON, ESQ. Receipt Date : 1/28/2014
Cumberland County - Register Of Wills Receipt Time: 11 :23 :57
One Courthouse S quare Receipt No. : 1076858
Carlisle, PA 17613
�
SOLADA WILLIAM E
Estate File No. : 2014-00090
Paid By Remarks : KATHY PUTT
DMB
------------------------ Receipt Distribution ------------------------
Fee/Tax Description Payment Amount Payee Name
PETITION LTRS TEST 135 . 00 CUMBERLAND COUNTY GENERAL FUN
WILL 15 . 00 CUMBERLAND COUNTY GENERAL FUN
SHORT CERTIFICATE 30 . 00 CUMBERLAND COUNTY GENERAL FUN
INVENTORY 15 . 00 CUMBERLAND COUNTY GENERAL FUN
INH TAX RETURN 15 . 00 CUMBERLAND COUNTY GENERAL FUN
JCS FEE 23 . 50 BUREAU OF RECEIPTS & CNTR M.D
AUTOMATION FEE 5 . 00 CUMBERLAND COUNTY GENERAL FUN
----------------
Check## 1915 $238 . 50
Total Received. . . . . . . . . $238 . 50
--� ' Department of the Treasury
: � B�� �� � Infiemal Revenua Service
732 WERTZVILLE RD
ENOLA, PA
Fice: 37026 (717)732-0766
�fessional: #726879 MARY LOU SWARTZ �j �
'tent: WILLIAM SOLAQA f; �'r ���
K Preparation 189.00
` Total 1�.� - �.
> Check #507 Tendered 1 . � ` .
Change Due o.oo �:Deiach Coupt�n Below
' Employee No. 835717 F B�fore Mailing ,
Thank You for choosing HB�R Blodc
for your tax services.
���/2U14 12:22:45 PM 5744332
�ke your check payable to the 'IInited Statea Tressury' .
Iri�lud� in the chack's memo saction '2013 80RM 1040A' aaad your SSN.
INTBRNAL REVEN�B 3$RVICE
P. O. BOR 37008 �
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LE MItRS INBUMNCE COMPANY+PENINSULA INPEMNRY CbMPANY ��(/� �„�
THE PENM�h IN8URANCE CpMP/W1j•SOUT�ipiM INSURANCE COMPANM OF VI�if31NFA ��
P.O.8DX304•MlWIEITA,RA 1754T-0.90Q•1-80D-977-OBOQ•www.dorre9�9�P•�
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DON�GAL MUTUAL INSURANCE COMPANY �
BILLING INQUIRIES CALLs 1-800-877-0600
05/19/14 PREMIUM INVOICE 0004481 G 0827642 3205
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SSOLODA WILLIAM E � � OMEOWNERS D
U 507 STATE RD � �t—?'
R WEST FAIRVIEW PA 17025-3035
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TOTAL PREMIUM 513.00
AMOUNT RECEIVED/CREDITED 131.75
ACCOUNT BALANCE 381.25
* AMOUNT DUE 06/16/14 131.75
NEBT INSTALLMENT DUE 09/16/14 131.75
' CURRENT INSTALLMENT INCLUDES $7.00 SERVICE CHARGE. . -' �
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� �; c� � AMOUNT DUE $131.75
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SOLODA WILLIAM E RAYMOND A SMITH INS AGY
507 STATE RD A DIV OF CHRISTIAN—BARER CO
WEST FAIR�FIEW PA 17025-3035 P 0 B�% 158
CAMP HILL PA 17001
I�nIIL��Iih��uhl�ldn�ll�llu�nll��hl�lh��h��l6ull 0004481
TELEPHONE:
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Dear Policy�tolder:
The aftached amended Declaration has been issued to reflect the recent changes made to your
Mameowrt$rs Insurance Policy.
' FaEr���r wonvenience,we hav�presented on the payment stub below the minimum amount
dt�� a��l_ ihe amount to pay the policy balance in full including any premlum for this
���e�t R[ease re�rtew the stat�ment of account shown on the endorsement attached.
it�rer�b�afanyfunher service or if you have any questions concerning your policy,please do
��t h�����conf�ac#yotu agentfor assistance. �
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Date Invoice#
� . 07/14/2014 13861
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06/16/2014 Equipment: Burner
Equipment-Description: HW, COIL
Labor
Replace ignition transformer 8 oil
bumer nozzle
100.00
1 10000volt Ignition Transformer(a�69.50
1 1.10 80 A Oii Burner Noale Q 6.00 69.50
6.00
SUB-TOTAL PARTS: 75.50
INVOICE SUB-TOTAL: 175.50
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5adler Clit C,ompany 1�78 ` iN1�QtCE TO7Al.
175,50
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18.0%A��UAL PERCENTAGE R�4TE. F'AY Ti,ifS ANlOUiVT►
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1-01-2014 PREVIOUS BALANCE
Enola,PA 17025-2796 1-23-2014 138.00
: ,y� 717-732-0711 PAYMENT -138.00
o� Offfce hours:8:00 am-4:00 pm M-F 6�0-2014 SEWER SERVICE
TRASH SERVICE 91.50
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WEST FAIRVIEW �PA 17025
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t� 7;1i'�,rt � t% x>r:. ' SF�jf ��, fsi eMReceivedJan23 -$30.69
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Adjuatme�Ms and CredMa �__ ----� - — $30.69
Betore You Move.. Overdus Balance_Plees�Psy Now -- --- -- -- �0.08
Call 1-888-418-96g1 and we'll help set up your
Imemet,N and Pho�for your neW a�re�You can
be uP ard n�nning in no time!DON'T WAIP.And be New Ch�ges
siva to ask if FlOS Is availeWe In yaur area Service L1meM AcUvity - - _---- - -. --- -- -- -- ---
avai�abi��tyvadea ---- .--- — ---___. a.00
Ta�ms,Govemmerdel Sur�harges and Fees -. ---- --�---- $30.00
iNaValueOurCustomers TotalNawCharyas —_ — - — ---. __ ,_._--- --- -
We apgteciate ycnQ 6usiness&waM to deqver ffie vary 530.00
4est eqtertainmeM to yoa Cau us at Total Amount Due—Please pay Now �p,gg
1--88�638-2214 to tind out abaut the new waya
Ve�izon can save you money.We enjoy being yo� Yaur aaount has 6�an dixonn�ad.Mr othor charpes or aadita wiU appear
pruvider,a�ul we would Iike 10 keep you with us longer �Yow ne�d b�l.Ovardw balances aa subjed to colt�ctlon adlon.
bY�P�►�4 your Verizon expedence.
Revlew Your Services
Did you krmw you co�dd be eligible for savlrge with
Ve�izon aervlces?Call us a11-888-287-8599 today�
Verizon�epreseMat�es are sland(�g by to heip review w s �
your accowt _ _ ' � ' 1
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Enter yoiu ten digit number 717-732-0166.Use 551 ff asked tor �
idemi(Ma11w►code.Cuslomera with disabiliiies call 1-800-974-6006 TTY.omer
Piease rewm remit slip wifh paymeM.
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��� �:" 1-80Q-DIA�-PPL ' � . - r. - � � -
^►'�; (1-80Q342-5T75) 46760-73004 Feb�13,2014
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Your EIeC1�ic Usage Proftle 6iiling Summary (eiuing details on back�
Seivice#v: Balance as of Jan 23,ZQ14 �0.0p
W1WAM ESOLADA . Charges:
507 STA7E RD Total RPL Electrlc Utilities Charges $20.03
W�ST fAIRVifW.PA 17Q75 _ :.
M�et�3
Total Public Power LlC Charges $23.25
�'�si�t���s'���tiir�g i�,�r��r�tit Feb 21,ZOi4. Total Charges $43.28
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; ���, ��4 PPL Electric Utilities'prlce to compare for your rate is$0.08754 per kWh.
k, �° This changes the lst af Mar,Jun,Sep#,and Dec.Visit papowerswitch.com
� " or www.oca.state.pa.us for suppller offers. ��
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1 ; PPL Electrlc Ufiltties k�i!s onpne.The process ts free,
� ' � � quick,conveNent and secure.To learn more or sign up,
¢ S vtsit pplelectric.com.
Q • Information about appliance energy use and tips on �
saving energy are available throu h the Energy Library �
� F an A M � � a s o N D Ott OU�W@b 5iL'e,ppielectric.comf e-power €1
M0"� • Before dtgging around your horne or property,you
�. , , should always cail the state's One Call nottfic�tion
� = system to locate any underground utility iine5. You can
• �. • ; �, r. • � do this by simpiy dtaling 811,which wiil connect you to
,��pl�; the One Caii system. Be safe and caA 831 before you a✓ �� .
33 179 5 30F, d(g, � ��
,la��013 83 385 12 34F . . �I ��
•- • `- • � P'ayment Methods �� =
Jan 22 Actual 49315 ,/�, pnline at: By phone:i-800-341�-5775 —
Dec 20 Actual 49136 U PP�electric.com �or cail BiIIMa�trl�c(service fee applies) =
� at 1-$Oa672-2413 to pay using Visa, =
33 Days kWh Billed 179 . MasterCard,Dlscaver or deblt cat�d. �
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• . .. . . . � • .: � By MatL- Correspondence should be serrt to: �
F�b 2013-Jan 2014 � 4380 365 2 North+9th Street Customer Services �
CPGGENNI <SZ7 Hausman Road -_-
Feb 2012-Jan 2013 5227 436 Allentown,PA 18101-1175 Allentown,PA 181049392 �
Uther important information on the back af this bill�
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�;;�„�,, : M-F:Sam to 5pm
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Balance as of feb 24,2014 ���
�� Charges:
����` 7otal PPL Electric Utilities Charges $18•�
�� ���� Total Public Power LLC Charges _$�•�
�'� � $33.61
����5;p�€�€ahout Mar 21,2014. T�ai Charges
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�� �4 ` ppL Eiectric Utilities'price to compare for your rate is$0.08754 per kWh.
��f,� �� ���� This changes the ist of Mar,Jun,Sept„and Dec.Vistt paRoM►erswitch•com
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����iuw�w.; _ M��*�to 5pm
Your�t��Usage Praf���� ���i��g Summary: ' (Bllling detalls on back)
Service tr�� : ���ce as cf Mar 24,20i4 $p.GO
W I LLIANI��� �����:
507 S7A'f'�� -. ; �'�PPL Electrlc Utllitle5 Charges $1i.52
WEST�A{1���.���7025 ' ,��(public Power LLC C�arges $12.86
Meter:��
Your nex!��C"�"�v�g is on or ati�t,��2.;2014. ���$� $30.38
This sect�a+� ' '�t�understand �"�:�rear ��$Yapr�:�,��� � $�C?.�$
, ��ectric u��-� _ �. Meter read�r���sal uniess �������Ce $30.38
� �therwis�ti�,, . .
��� �Zp�4 ������Utllities'prlce ta��ampare for your rate ls$0,08754 per kWh,
k 1'���g�s the 1st of Mar,lu�,�ept,and Dec.Vislt p8power�witch.com
, ; . 30 �,:' c'��tr�t�.state.pa.us for supplter offers.
� ; Z5 � �� ���
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� �' � 4 J� � ��at��n about appII��Ge e�ergy use and tlps on �
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a ���w,r�ys call the s#ate��Q�Call notlflcation �
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{ . ' S233 ' �� � � _ �:�I8101-1175 ���s2rwn,PA 18104-9392 �
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�:" 1-800-DIAL-PPL
: � • t : t • � � .
°�°`- (1-800-342-5775)
�.�uu�ree. ��~ M-F:8am to 5pm 46760-73004. May 15,2014 �- $39,�1
Your Eleatric Usage Proflie Billin� Summ�ry (Billin� detaiis on back)
Service to: Balance as of Apr 24,2�i4 $p.pp
WlLtIAM E SOLADA Charges:
507 STATE RD Tota)PPL Electrlc Utlllties Charges $19.40
WEST FA(RVIEW,PA 17025 Total Public Power LLC Charges $19.61
Meter:42783p93
Your next meter reading is on or about May 22,2014. Total Charges $39.01
'This section heips you understand your year-tayear m�y��ue�Y May�5,�p1�4 . '�3�.O1
electric use by month. Meter readings are actual unless Account Balance $39.01
otherwise noted.
2013 �1014 PPL Electric Utilltles'price to compare for your rate Is$0.08754 per kWh,
Thls changes the 1st of Mar,Jun,Sept,and Dec.Visit papowerswitch.com
30 or www.oca.state.pa.us for suppller offers.
t u
3 zo ' Your Message Center
a �s : � With paperless bllling,you can recelve and pay y-our �
� • PPL Electric Ut(Iltles bllis onllne.The process is frec�
�a ` � � quick,convenierrt and secure.To learn more or sign up,
a �;1; visit pplelectric.com.
o ' ' • Informatlon about appilance energy use and tlps on
` � F M a nn � � n s o N D saving energy are avallable throu�h the Energy library �
o n o u r W e b s l te,p p ie l e c tr ic.com e-power
Months • Before digging around your home or property,you �
� , , � , should always call the state's One Call notiflcatlon
system to locate any underground utllity iines. You can �
' '� ' ' � do thls by simply dlaling 811,which will connect you to t�
Apr 2014 33 l51 5 47F the One Call system. Be safe and call 811 before you ,VI
dig. � ` �
Apr 2013 32 345 r1 47F � \'1� �
' `� "` "' Payment Methods �� �
Apr 23 Actual 49684 � OnJl�e at: �By phone:i-8�-342-5775 �
Mar 21 Attuai 49533 pp�e ectrfc.com or call BIIIMatrix service fee applles) �
33 Days kWh Bllled 151 �1-�-672-241�to pay using Visa, �
MasterCard, Dlscover or deblt card. �
- ; �• • • . . � By Matl: Correspondence should be sent to: �
t�iay 201.3-Apr 2a�4 ; 37�54 . 313 2 North 9th Street Customer Servlces
CPC-GENN1 827 Hausman Road �
AAay 2012-Apr 2�13 ` 5271 439 Ailentown, PA 18101-1175 Allentown,PA 18104-9392 �
Other impoKant information on the back of this biil-� �
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� ��,, contact us by Jun 13. pplelectric.com ��
�� �._ 1-800-DIAL-PPL � : ' � " - •` - • � .
°�;�;; (1-800-342-5775) � �,� 'V\ 46760-73004 Jun 13,2014 ` ��9��6
Pw,r��uuuu., M-F:8am to 5pm � �;,�
Your Electric Usage Proflle Billing Summary (Bllling details on back)
Service to: Balance as of May 23,2034 SD•�
WILLIAM E 50LADA Charges:
507 STATE RD Total pPL Electric Utilities Charges $17,44
WEST FAIRVIEW, PA 17025 Total Public Power CLC Charges $11,82
Meter:42783093
You�next meter reading Is on or about Jun 23,2014. Total Charges $29•26
Thls settlon helps you understand your year-tayear �������X�'������' $�s.26
electrlc use by morrth. Meter readings are actual unless Account Balance $29•26
otherwise noted.
2013 �2014 PPL ElectNc Utlllties'prlce to compare for your rate Is$0.08754 per kWh.
Thls changes the ist of Mar,Jun,Sept,and Dec.Vlsit papowenwttch.com
30 or www.oca.state.pa.us for supplle�offers.
� o � Your AAessage Center
�' • Wlth paperless bllling,you can recelve and pay your
� � ; PPL Electric Utllities bllis onllne.the process is free,
�o : quick,convenlent and secure.To learn more or sign up,
4 ? visit pplelectric.com. ^
� � • Informatlon about appliance energy u5e and tips on
: � � � � a� � j A s o N � saving energy are avallable throu h fhe Energy Lfbrary �
on our Web site,pplelectric.comf e-power
M01� • Before digging around your home or property,you
should always cali the sta#e's One Call notification
' ' - ` � system to locate any underground utility iines. You can
, .►. • t do this by simply dfaling 811,which will connect you to
, ��I'��'� Z� ,�° �1 ` 3 58F tl�8 One Cali sy�tem. Be safe and call 811 before you
����� . � , '>3�tt1 :; 10 58F =
;. - �
y . - . • Payment I�Aethods —
�: �r� �s,tual 49775 Onjine a�t: �By phone:i-800-342-5775 �
� ,�� Acfiial 496$4 � PP��e���'�m or call BIIIMatrlx�service fee applles) �
at i-800�672-Z41 to pay using Vlsa,
•�„ '�� : icli�hBitled 91 MasterCard,Discover or debit card. �
�;, _ , � @y Mail: Correspondence should be sent to: �
2 Worth 9th Street Customer Services �
� ����F���6314 ` 3545 295 �p�..�ENNi 827 Hausman Road �
�;��'„i��y�ni3 = 3Zg� q41 Altentown,PA 18101-1175 Allentown,PA 18104-9392 �
Other important information on the back of.this blll�
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��� �°- 1-800-DIAL-PPL "
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°°'•: (1-800-342-5775)
°•,� 46760-73004 Jul 15,20Z4 ; �Z9.92�
��.�Qu�,�. M-F:8am to Spm
Your Electric Usage Profile Bflling Summary {Bllling detalls on back)
Servtte to: Balance as of Jun 24,2014 $D.00
WILLIAM E SOLADA Charges:
507 STATE RD total PPL Electric Utllities Charges $17.58
WEST FAIRVIEW,PA 17025 Total Publlc Power LLC Charges $12.34
Meter:42783093
Your next meter reading is on or about Jul 23,2014. Total Charges $2g.g2
Thls section helps you under5tand your year-to-year ; ��unt Du�gyJul 15,�Q1� '' �7.�;9�
electrlc use by mon#h. Meter readings are actual unless Account Balance $2g,g2
otherwise noted.
2o�s �2014 PPL Elect�lc Util�tles'prlce to compare for your rate Is$0.09036 per kWh,
This changes ths ist of Mar,Jun,Sept,and Dec.Vislt papowerswitch.com
3o ar www.oca.state.pa.us for suppller offers.
� o Your Message Center
� y� � • Wlth�aperless bll{ing,you can recelve and pay your �
PPL E ectric Utlllties bflls online.7he process is free,
�o ' qulck,convenlent and secure.To learn more or sign up,
�� 5 vlsit pplelectric.com.
o • Information about appllance energy use and tlps on �
� F nn a M � � a s o N D saving energy are available throu h the Energy Library
� on our Web slte,pplelectric.com�e-power �
Months • Before dlgging around your home or property,you �
should always call the state's One Call notiflcation
' " : : system to locate any underground utillty ilnes. You can �
� * s • • do thls by simpiy dlaling 811,which will connect you to 1 �`�
Jun 2014 �32 9 5 3 6 9 F the One Call system. Be safe and call 811 before you '
dig. � �
Jun 2013 30 S06 17 68F �
Payment Methods �
: •• .� �• —
Jun 23 Actual 49870 ✓� Online at: �By phone:i-B00-342-5775 �
May 22 Actuai 49775 U pp�electric.com or cal)BIIIMatrfx(service fee appIles) �
at i-800-672-2413 to pay using Visa, �
';';�Z Days kWh Bllled 95 � MasterC�rd,Discover or deblt card. �
�
- � . . . . � � , By Mall: Correspondence should be sent to: =
� 2 North 9th Street Customer Services
Jut ZD33-Jun 2014 3134 261 a
CPGGENNI 827 Nausman Road
!ul��12-Jun 2013 5278 440 Alientown,PA 18101-1175 Altentown, PA 18104-9392 �
�
Other important(ntormation on the back of this btll�
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pp�'°��`"`°��:: l�J contact us b Au 14.
m�- i-800-DIAL-PPL g Pp�electriC.com � e .. • , . . :
��•: �
.,� (1-800-342-5775) 46760-73004 Aug 14,2014 ; $3�.3'1
w�.�,�unuue. M-F:8am to 5pm
Your Electrlc Usage Profile Bllling Summary (Btlling details on back)
Service to: Balance a�of Jul Z4,Z034 $0.00
WILLIAM E SOLADA Charges:
507 STATE RD Total PpL Electrlc Utllltles Charges $17.71
WEST FAIRVIEW, PA 17025 Tatal Public Power LLC Charges $12,60
Meter:42783093
Your next meter reading Is on or about Aug 21,2014. Total Charges $30.31
fils sectlon heips you understand your year-tayear i1'1ou�►t�iu��Iy;A�t�14,3014 ` $3�1.31
electrk use by month. Meter readings are actual unless Account Balance $30.31
otheruvise noted.
20�3 �2p�4 PPL Etectric Utllltles'price to compare for your rate Is$0.09036 per kWh,
Thls changes the 1st of Mar,Jun,Sept,and Dec.vislt papowerswitch.wm
30 or www.orA.ztete.pa.us for 5uppller offers.
� � •
Y 20 Your Message Center
� � � • With apertess bfillng,you can recelve and pay your " �
� � PPL EPectrlc Utllitles hills onllne.The process Is free,
io qulck,convenlent and secure.To learn more or sign up,
� 5 vislt pplelectric.com.
o • Informatlon about appllance energy use and tlps o� �
� F M A nn � � A s o N o saving energy are avallabie throu h the Energy Llbrary �
on our Web site,pplelectric.comf e-power
nn°ntns • Before dlgging around your home or property,you \�
,, �, , , � , should always call the state's One Call notiflcatlon ��
� = system ta locate any underground utlllty Ilnes. You can �
� �• � y ` ; �� - o do this by simply dialing 811,which wlll connect you to
` Jui 20�.4 30 97 3 76F the One Call system. Be safe and call 811 before you �
dig, �
Ju12013 32 817 Z6 78F _ �
: .. .. , .,
payment Methods �
Jul 23 Actual 49967 � On�ine at: �By phone:i-800-342-5775 �
Jun 23 Actual 49870 Pp electric.com or call BIIIMatrix�servlce fee applles) �
at i-8Q0-672-Z4i to pay using Visa, �
30 Days kWh Bllled 97 MasterCard,Dlscover or deblt card. �
• + ,. . , . , By Mail: Correspondence should be sent to: �
Aug 2013-Jul 2014 2414 . 201 � Z North 9th Street Customer Services
CPC-6ENN1 827 Hausman Road �
Aug 2012-Jul 2013 5247 437 Altentown, PA 18101-1175 Allentown,PA 18104-9392 �
�
Other Important information on the back of thls btll�
��
�
�
, � � �
,v,:� �
��
,�. < ,
•�•4�: ' � Questtons7 Please � Visit us online at Final Bill Page 1
•y�m„aro•':
�+: contact us by Aug 20. pplelectric.com
n 1-800-DIAL-PPL ` ' " r • i. - ` ' '` -
1''� °�;; (1-800-342-5775j 46760-73004 Aug 20,2014 '$�L3.1�
o uu��. M-F:8am to 5pm
Electrlc Usage Profile Billing 9ummary (Blllin� detalls on back�
to: Balance ae ot Jul 30,2034 $30.3i
JI E SOLADA Charges:
�TE RD Total Publlc Power LLC Cliarges $7,92
AIRVIEW, PA 17025 Total PPL Electric Utilitles Charges $4.93
42783093
TotalCharges $43,i6
tlon helps you understand your year-to-year �Durit Dtte.�iy Aug 20,1►�14 $43.i&
use by month. Meter readings are actual unless Account Balance $43.16
Ise noted,
�2013 �20�4 PPL Electric Utllltie5'prlce to compare for your rate is$0.09036 per kWh.
This changes the 1st of Mar,Jun,Sept,and Dec.Vlsit.papowerswitch.com
� or www.oca.state.pa.us for suppller offers.
Your Message Center
� Informatlon about appllance energy use and tips on
saving energy are avali�ble through the Energy Llbrary
� on our Web site,pplelectrtc.com/e-power
• Before digging around your home or property,you �
, should always call the state's One Call notlflcatlon ,��Q �
� F M A nn � � a. s o N � sYstem to focate any underground utlllty Ilnes. You can� - �( �
do this by slmply dialing 8ii,which witl connect you to �
Months the One Call system. Be safe and call 811 before you pd ��n��I�
dlg' f �I
'• ' ` - ` = • We appreclate the opportunity to have served you.
. •� s. - o Because you have pald your bills within 30 days over
)14 . 6 61 10 74F the past year,you have established an excellent
payment record with PPL Electric Utiilties.
D13 29 484 17 71F � � �
�
�• �� �• � �• � � Payment Methods =
!29 Actual 50028 0nj f e at: By phone:l-800-342-5775 �
:23 Actual 49967 � ��ie�ettric.com �or cali BIIIMatrlx service fee appIles) �
at 1-8 0 0-6 7 2-7 4 3�to pay us ing V isa, —�
�ays kWh Bllled 61 MasterCard,Dlscover or debit card. �
, ,. . . , _ ,, � BY Mall: Correspondence should be sent to: �
G13-Jul 2014 1993 ; i66 2 Narth 9th Street Customer Services
CPGGENNI 827 Hausman Road =
.�12-Jul 2013 5057 421 Aller�town,PA 18101-1175 Allentown,PA 18104-9392 �
Other Important(nformat(on on the back of thls bill�
, � �
� �
�
.;�
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,;,•
RIOD AND METE�t READINGS BILLINQ SUMMARI�
jte:February 13,2014 For Service To:507 STATE ST
e:March 7,203,4 For Account 1024210034609139 yll a� r
ariod:Jar114 to Feb 11(29 Days) prior Balance P� /�'�
ding on or about Mar 11,2014 • Balance from Iast biu t�'
:r Type:Residential PaymeMs as pf Jan23.Thank youl 14.24 �
:ading Measuremen� � 14 24
100 gallons of water Balance Forward 0.00
easurement:l0�gallons(CGL) au►►eM Water servt�e
• Water Senrice Charge 15,00
No. � N045387485 • Wate�Usage�harge($1.02140000 x 2.00) 2_pq
meter 5/8" • Total Water Servlce Related Charges 17.04
t Read 2,979(Actual) TOTAL CURRENT CHARGES 17.04
is Read 2,977(Actual) .
�ater used th�s 2 units TOTAL ANlOU111T DUE �
erlod (200 gailons) �1�7.��
Jse Comparison(in 100 gatlons) Pay your blll online:www.vyater.paymyblll.com
�illing period 2014: 2.00 CGL m Pay by phone:24hours a day,every day at 1-866-271-5522
ting period 2013: 12.00 CGL f Pay in person:Residentiaf customers may obtain a listing of
aph(100 gallons) peYment locations by visiting www,amwater.com/myh2a .
� Pay by mall:Remit your paymerrt to the address shown above
i,
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��
a M J J A S O N D J F 2
p a u u u e c o e a e 0 .
� Y n. I. g p t v c n b 1
4
Ir�portant messages from Pennsylvanla American Water
�rpximately 4.44 percent,or$0.76,of state taxes are included In your current blll.
r;,portion of the water charges which is not paid as of 03/07/2014 wlli be subject to a i50%penalty.
�tions about this bill?Call our 24Hour Customer Service Center:l-800-565-7282 www.pennsylvaniaamwater.com
:=�:�;b1/026562ACRAODETM1C004 94 (ACRppp pF58610101C00) 623750180523
�
BILLING RERIOD APID METER READI.NGS BILUN4 SUMMARY
• Billing date:March 13,2014 For ServlCe To:507 STATE ST
• Due Date:Aprti 4,2014 For Accou�nt 1U24210034609139
• Billing period:Feb 12 to Mar 11(28 Days) Prlor Balance
• Next reading on or abou�Apr 09,.2014 � Balance from Iast bill 17.04
• Customer Type:Residential • Paymerits as of Feb24.Thank youl -17.04
• Meter Reading Measuremerrt: Balance Fonivard 0.00 -
1 unit=100 gallons of water
• Billing Measuremen�100 gallons(C6L) Current water Service .
• Water Servtce Charge 15.00
Meter No. NU45387485 • Water Usage Charge($1.02140000 x 1.00) . 1.p2
Sire of ineter 5�g■ • Total Water Servics Reiated Charges �� 16.02
{:urrent Read 2,980(Actual TOTAL CURRENT CHARGES 16.02
P�evlous Read 2.979(Actuaq
T�a�'"�er"$ed t��s 1 units TOTAL AMOUNT DUE � $16.02
6itiing riod (100 gallons)
Totat Wster Use Comparison(in 100 gatlons) Pay your btll onllne:www.water.paymybiH.com I
•' Gurrent biliing period 2014: 1.00 CGL m Pay by phone:24hours a day,every day at 1-866-271-5522
• Sarrse��itling period 2013: 11.00 CGL f Pay In person:Residential customers may obtain a listing of
Bllted lJse:�aph{1Q0 gaUons) paymentlocations by visiting www.amwater.com/myh2o
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� Important messages from Pennsylvania American Water
• �'��tt�a3Pt'sR�ANT WATER QUALITY INFQRMATION:
��'c�.ar cr�€��aa�UVater Quality Report can be vlewed electronically at www.amwater.com/ccr/mechanicsburg.pdf.If you p�efer a paper copy to
���'tty y��u.please contact our Customer$ervice Center at 800-565-7292..
*�pwsrx;�:�t;��y 4.44 percent,or$0.71,of state taxes are lncluded in your current hilL
�:4�y��ar�sf zhe water charges which is not paid as of 04/04/2014 wi1!be subject to a 150%penaity.
* Ss�,���r�r pa�r�e.ss billing!It's a convenient and environmentally friendly way to receive your water and/or wastewater bill.Users must
�.r��"s�rz��n�.scr ge:started,visit www.amwater.com/myh2o.Go to Account Detail and click on the green Paperless Bllling button.Follow the
��aS.����.s:��z aF��i yo�'re enrolled!
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Q�3es�iot�a6ottt this bill?Call our 24Hour Customer Service Center.l-800-565-7292 www.pennsylvaniaamwater.com
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iILLING PERIODAND METER�l�DlNGS BILLING SUMMARY .
Billing date:Apr�l 15;2014 " For Service To:507 STATE ST
Due Date:May 7,20i4 For Account 1024210034609139 �
Billing period:Mar 12 to Apr 10(30 Days) p�o�����
Next reading on or about May 09,2014 • Balance from last bill
Customer Type:ResidenUal i6.o2
• Paymenfs as of Mai21.Thank youl 16 02
Meter Reading Measuremen� Balance Forward '
1 unit=100 gallons of water 0.00
Billing Measuremen�100 gallons(CGL) �ReM water Serv�ce
• Water Service Charge 15:00
Meter No. N045387485 • Water Usage Charge(aL02140000 x.1.00) 1.02
Slze of ineter 5 g• • Total Water Servlce Rela#ed Cha►ges 16:Oa
Current Regd 2,981(Actual TOTAL CURREIYT CHARGES 16.02
Previous Read. 2,980(Actual)
Tota�water used.th�s 1 units TOTAL AfVl�UNT DUE � $16.02
bllling perlod (100 �Ilons).
rtal Water Use Comparison(in 100 gallons) �YYo�blli onllne:www.water.paymybill.com
Current billing period 2014: 1.00 CGL m Pay by phone:24hours a day,every day at 1-866=271-5522
Same billing period 2013: 12.00 CGL f Pay in person:Residential oustomers may obtain a fisting of
Iiled Use Graph(100 gallons) Payment locations by visi�ing www.amwater.com/myh2o
15 � Pay by mail:Remit your paymerrt to the address Shown above
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�P°�t messages from Pennsytvania American Water
• ***IMPORTANT WATER QUALITY IfUFQRA9iqT�ON;
•Your annual Water Quality Repork can be vieraed e►ecprfln�ca�i�at w�r.�r��#����r/mechanicsburg.pdf.If you prefer a paper copy to .
be sent to you,please co�act our¢ustomer Senrice Ceriter at 8pa-565-72g2,
•Approximately 4.44 percent,or$0.7i,of state taxes are ir�duded in your cunent bitl.
�Any portion of the water charges which is not patd as af 05/p7/2014�rilt be subject to a 150%penalty.
• Sign up for paperless billingl!t's a icoi�venierrt arid errr:ronir.er�tsi►�friendty way#o rece�ve your water and/or wastewater bill. Users rrwst
: enroll online.To get started,visit www.amwater.corn�/myt�2a,�O�o�1r��p��and click on the green Paperless Biliing.button.Follow the
steps,.press submit and you're enroUedi
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` Questions about this btli?Call our 24Hour Custora���Secr�v�ice Center.i-800-565-7292 www.pennsylvaniaamwafer.com .
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BILLING PERIOD qND METER READINGS BtLLING SUMMARY
• Billing date:May 12,2014 For Service To:507 STA7E ST
• Due Date:lune 3,201�4 For Accoant 1024210034609139
• . Billing period:Apr 11 to May 09(29 Days) Prior Balanca
• Next reading on or about:Jun 10,2014 • Balance ftom last bill 16,02 .
• Customer Type:Residential • Payments as of Apr28.Thank you! -16.02 '
• Meter Reading Measuremerrt: Balance Forwat'd 0.00
1 unit=100 galions of water
• Bliling Measurement:100 gallons(CGL) Curre�Water servlce
• Water Service Charge , 15:00
Meter No. N045387485 • Water Usege Charge($L0214o000 x 2.00) 2,p4
Size of ineter 5 g• • Totai Watar Senrice Related Chargea 17,04
Current Read 2,983(Actual) TOTAL CURRENT CHARGES 17.04
Previous Read 2,981(Actuaq
Tot��water�sed th�s 2�nits . TQTAL ANlOUNT DUE ♦ $17.04
biUing perlod (200 gaAons).
Tofal Water Use Compar[son(�n 100 gallons) Pay your blll oN(ne:www.water.paymybill.com
• Cucrent biiBng periai 2014: 2.00 CGL m Pay by phone:24hours a day,every day at 1-866-271-5522
• Sar��billing period 2013: 13.00 CGL � Pay ln person:Residential customers may obtain a listing of
������:������� payment locations by visiting www,amwater.com/myh2o
�� �I Pay by mail:Remit your payment to the address shown above
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Impol�tant messages from Pennsylvania American Water
• Approximately 4.44 perceM,or$0.76,of state taxes are included in your cur�ent bilL 1,
•Any portion of the water charges which is not pajd as of 06/03/2014 will be subject to a 150%penalty. � ���
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B19.LING PERIOD AND METER READIN(3.S BILLING SUMMARY
• Billing date:lune 11.2014 For.Service To;507 STATE ST
• Due Date:July 3,2014 For Account 1024210034609139
• Billing period:May 10 to Jun.10(32 Days). pdor Ba�ance
� Next reading on or abouL-Jui 10,2014 • Balance from last bill ' 17.04 .
• Customer Type:Residential • Payments as of May21:Thank you! =17.04
� Meter Reading Measurement Balance Forward 0.00
1 unit=100 gailons of water
• Bilifng Measuremen�100 gallons(CGL) cunent Water servtce
• Water Service Charge 15.00
Meter No. N045387485 • Water Usage Charge(SL02140000 x 2.00) 2.04
Slie o}meter 5 g" • Total Water Service Related Charges 1T.04
curre�Reaa 2,985 Actual TOTAL CURRENT CHARGES 1�,p4
Previous Read 2.983(Actual)
Tota�water usea th�s 2 un�ts TOTAL AMOUNT DUE � $17.04
bllling period (200 allons)
Total Water Use Comparison(in 100 gallons) Pay your bill online:www.water.paymybill.com
• Currerrt billing period 2014: 2.00 CGL m Pay by phone:24hours a dey,every day at 1-866-271-5522
• Same billing period 2013: 14.00 CGL f Pay in person:Residential.customers may obtain a listing of
Bllled Use(iraph(100 gallons) payment locations by visiti�g www.amwater.com/myh2o
� � Pay by mall:Remit your payment to the addr�ss shown above
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Importarrt messages from Pennsylvanla American Water
•Approximately 4.44 percerrt,or$0.76,of state taxes are inqiuded in your currerrt bill.
�Any portion of the water charges which is not paid as of 07/03/2014 wiil be subject to a L5096 penalty.
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Qu�tions about this 6i11?Call our 24Hour Custorr�er Service Center.l-800-565-729Z www.pennsyivaniaamwater.com
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� Billing date:July 29,2014 For Service To:507 STATE ST
� Due Date:August 20,20i4 For Account 1024210034609139
• Billing pedod:Jul 10 to Jul 27(18 Days) Prlor Balance
• Customer Type:Residential • Baiance from last bill 16.02
• Meter Reading Measurement: TOTAL PAST AMOUNT-DUE IMMEDIATELY
1 unit=100 gallons of water 16.02
•. Billing Measurement 100 gallons(CGL) �r►eM H►ater Service
• Water Servlce Charge 8.88
Meter No. N045387485 • Water Usage Charge(31.02140U00 x 3.00) 3.06
Slze of ineter 5�g■ • Total Water Smrvlce Related Char�es 1i.94
Current Read 2,389(Actuai) TOTAL CURRENT CHARGES . �9,�,
Prevlous Read 2,986(Actual
Total water used this 3�n►ts TOTAL AIVIOUNT DUE $27.96
bttling period (300 Ilons)
Tatai Water Use Comparison(in 100 gallons) Pay your blil onNne:www.water.paymybill.com
• Current bilUng period 2014: 3.00 CGL m Pay by phone:24hours a day,every day at 1-866-271-5522
• Same billing period 2013: 11:00 CGL � . Pay in peraon:Residerrtial customers may obtain a listing of
Bllled Uae Oraph{100 gatlons) payment locations by vistUng www.amwater.com/myh2o
15 — � Pay by malls R�mit your paymerit to the address shown above
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Important messages irom Pennsylvanla American Water '
•Attention Pet Owners:At Pennsylvania Ameriqn Water,we care deeply about our employees'safety.From Ume to time,ouc fteld staff must �
access your property to read the water meter or perform service work.When we do,we ask that you keep your pets inside in a separate room
or on a leash at safe distance from the meter for the duration of the service visit Keepingyour pets secure for this brtef amount of time goes
a long way to prever�t bites.EVen the most gerrtte,well-mannered pets can become protective and aggressive around people R doesn't know.
Thanks for helping to keep our employees safe.
• Have you recently changed your primary phone numbei't If you have,please update your account information online using My H20 Online
at www.amwater.com/myh2o or call us at the number below so that we can update our records.
* ***Flnal Bili*** This is your flnal bill for service.lt has been our pleasure to serve you.
�� �The due tiate pertains to current charges oniy.Any past due balance should be paid immedia#ely.
•�PA���tely 4.44 percent,or$0.53,of state taxes are included In your currerrt bill.
•My portion ofthe water charges which is not paid as of 08/20/2014 will be subjectto a 1.50%penalty.
Questions about thts bill?Cali our 24Hour Customer Service Center:l-S00-56r7292 www.pennsylvaniaamwater.com
ODU08110GOOBBACRWDPETM1COOtt24 (ACRWDP 000p810101800) 881250534777
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Bi r�Date 01/14/14
Unpaid Balance $100.01-Due Now
New Ch�gps �43.38-Due 02/07J14
Total ArrtiouM Dus $56.63
Contact us: � www.comc�st.cam 1-888-931-1379 Pa9e 1 af 3
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BIIIIn��ummary Tor gsrvica to; The accou�6alance on your last bill was._��___. S�s1' 22163245T209
wILLIAM E 50LADA Thank you for your payment af_...�.....,,_______,
507 STATE sT Your balat�ce as of Ot/31/2014__.�_______.,,,r_,,,�
: ENOLA PR 17025
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12/30/20i3 to 01/2B/2014(29 days) Cus�n�Charge _ _ 8.55
R�n u t e O e v ice R�d PA Sfiab Tax Sureha�9e.__________�..�.. _. 0.04 .
Tofal�t+rnent Ch ty�,,,,_______r,""'°�"-�j�
QuseHons? ar9ea-tl6t tltili �8.51
CaU 8Q0-2T6-2722 or wriba b UGI at Ua Utillty�arges owed this WN�_�
PO�fC 13009 Ta�al Amouat Dua.Plaaae Pay by Due Dafe(02/21l2014),...._�� s�8.51
Readiag,PA 19612 3009 .
*Your cimeot UGl c6arges indude
Stafie ia�ms fioialing about S 0.27.
MaEsr L�fnrmation-Next Read Date February 28.2U14
MNerReadtqp I�ormaHan MaEerllumbsr Previana Reading Present Readinp CCF Ueed
1204686 295(remote) 295(remote) 0
' Meaeages from Uq
'Yaur current pdoa tin eompa�e is S 0.62045/CCF.
■Your tiotai annual usage is 3 CCF. Your average ma�thly usage is 0 CCF.
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507 STATE ST Your balance as of 03/04/2014________..�_,,.,,�
ENOLA PA 17025
Rats qa�an•
Reai�ifial Genaal�
BilUng P�iud; Currsnt BIII IMormatfon-UGI IHIIUy
01l28t20�1�tn 02/27/2014(30 daya) Custrnrier Charge.._._ -- - , 8.55
Remol�Ds�itce Read PA State Tax 5urcharpe.�___.�__.._______�__„_� rp_pq
Total Currant d�a ^'�-�
QaestlonsT rgea=UGI UtiGty --Y-;""�3��
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Reading.PA 99G1�-3009
Your curieot UGl chargas include ---...�
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M°b°r B�In�I�s��afl Al�r Nam6� � Prevlous Roadinp Presa�Readiag CCF Ueed
1204686 295{reniota) 295(r�note) p
Adaas�as�ram�#
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r� s�s see riea ThB a��{���ce on your last ill Vvas....._----- s 8.51
Bflllng Samtna tar iervica to: 'ihank you f�your payme�►t af..._.......__...._____..—
607�5TA7E S�T�� Yuur balance as oF 04l02l2014�.._---------.��a
ENOLA PA 17025
Rate ClaasiticaUon•
Residen6at General� p���t Btll lefirrmatioa-11G1 Utility
Btlling Perlod: Cusfiomer Charpe.M --________.._.._____._..... 8.55
02/2712014 tn 03/28/2014(29 days) PA 5tata Tax Surt�ar9e_--..- , --------- 0.04
Remote Dennce Read Total Current Chargea-U61 Ufiuty...._�...._--r--�� =g,g1
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'your cur�ent UGt cha[g��nclude
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i204686 295(remote) 295(remols)
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Bflli�1g SummaN tor Servica to: Thank you for your payment of_...._...-..._r_....�...... 8.51
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ENOLA PA 17025
Rate Claasf6cation:
Residential Ganaral ���B�p���ation-Ud Utilfty
8111iq Psriod: CustomerCharge.�_..__....__......_....--------_-»---. 8.55
03/28l2014 fo 04/29/2014(32 days� P���T���a�e,�„M.. ._..�...__.... 0.04
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Mefer tleadiag I�ormatlon Metsr Number Prsvious Rsading Present Ksad(np
1204686 295(remobe� 295(remotef �
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■Your totat annnal usage ia 2 CCF. Your avarage manthly usage is 0 CCF.
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wiw�w e souo� Thank u� urpa !"�r last ilt waa____,___ S 8.51 221632457209
5��T�TE ST Your balance asof Di%p3 2014�...,.,...,_.,_„_,,,,,,_„__---.�
9YOLp PA 17025
RBte�18sai1icaflOn:
Resideafiai General
�un,g r�ad: Conent�11 Irtformatioa-UI�Utili�
04/29/2Dt4 b 05/29/2014(3U days) �sbmer Charge._.,_,.___„_",,,,_,_,�,�
Remo6�lieaice Read . PA State Tau Surcharge._.__..,......... ......__---- 8.55
Qaesfioas? Total Currenf Chargea-U61 Utii'ty """"_"""_..���
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PO BOl(�3009 �9a�lhis 6i11__._.,..,_____,___,.,,_ ;8.51
�eading.P�196�2-3009 TO��onnt Oue,Plaase pay by Due pa�(08/y�014),�____....�
'Yaurcurreett�l --w.-..___... 58.51
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n9 about S 0.27.
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1204686 � P��Readie� CCF Used
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innu.�E SOLAD Thank you for ynurpayment of_..�......___..__.,_..�....,__g,gz
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900LA PA i7025
Raie ClassiflcaUoa:
Residen6al General
BtUln�PeriOd: Cunssnt Bill IMormafioa-Ud Utlllt�► .
05/29/2014 to 06/27/2014(29 days) �s���arge.___�.�r_r____.,,._....__„__r_r_, 8.55
Remata Device Read PA Siate Ta�t Surcharge_�. __��____..,......,_. 0.04
QaestiaosT Tolal E�rrent Charges-UGI Uti6_ty _.._....__.......�.—�£�
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PO�U(i3009 Total Amount Due,Plea�e Pay Iry Dae Date(OT/29/2Q1�..,,__.,,,w____..___ �8.40
Readiag.PA 196t2-3009
'Your ourtent OGI chatges includs �
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Mater Readin�IMor�aatlon MeEer Numbe� Previous Readla� Pro�ent Reading CCF Used,
' _ ` 1204666 295(retnote) 285(remote) 0
' AAesaay�fiaw Uq
•Your surtent prica b compare ia S 0.66159/CCF.
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■Help Eueveot pipeliae damage,accidents and service disruptiona Call 811 beior�s you dig.
! ■Give bacic to the heroea in our community durinp our Summer of Heraes S1Neepstakes,going on untit Juty 31.Like our Facebook page to �
� donate S1 to Keystone Wounded Warriors.www facefmok.com/ugiuiilities �
; ■S'ave 509i ar mare on yaur heafing bills when ynu awitch b natural gas.lfiait www ugi.comlcalculaUor for a persomalized savinpa es6mate.
■Are you or aayone you know planning to build a new home?�sit www.findnbuild.cnm for valeable 6pa a frse mob� pp.
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WIWI[M E 50LAOA Thank you f�yourpayment of�----__..______��
507 STATESi Your balance as of 08/01/2014___,.�..._,...___
ENOU PA 17025
Rafie Clas�iflCelf�:
ttasidential feneral
�Iliny pertod: Curreat Bill loformatiaa-UW Ufilitr
06/27/2014 to O7/28/2014(31 days) �s���►9e--......-...._...�.-...._...__....r..,.__...,_ 8.55
Final Rad PA State Tax 5u�harge____...�.,_______�.___...... 0.04
q���� Total Current Charpea-U61 U61i�y -g�'
Ca11800 276-2T22 or write tn UGI at U��liiy charp�mred lhis bill_......____.,_�___________„_„---_,,,,,,_____ �8.51
PO BOX 13009 Talal A�oent Due�Pleaae Pay by pae Da�e(OB/Y'll2014)_.._..__....,.�...._ �8.51
Readirtg,PA 19612-3009
'Yoer curtent UGI chargea include �
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INesaagea finm UGI ;
` �Yaur current price b compare ia S 0.66159/CCF.
�Your total anaual usage is 1 CCF. Your avarape monthly usage is 0 CCF.
'Thank you iar your buainess. You have mainiain�i an�a�ellent payment hiabry with UGI. This bill may be uaed as a credit referencs ior
obtaining futura utility servia.
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4/21/2014
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504 LancasterAverwe Jdm Kaufiman Carpentq►I
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MR WM E SOLADA
507 STATE sT Customer Service: 1 800 222-0300
���P�17� Text Phone(TTY): 1800 855-2880 -
Internet Address;
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To�ala��rtdue 523.3s Sign up for AT8�T Online Billing and you
won't get another paper billl To sign up
Data duo March 11,2014 just visit www.att.com/cuStomBrseNice.
This sEa#ement includes charges from the last three months.
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and$ig�ott the fine:a�n the badc of the remittarrce coupon.and
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DEBBIE LUPOLp,TREASURER TAXPAYER�S COPY
98 S ENOLA DRNE;ROOM 101
ENOLA,Pq 17025 KEEP THIS PORTION FOR YOUR RECORD
TEMP-RETURN SERVICE REQUESTED
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043599"""�~"*��AUTO"5-DIGIT 17025
SOLADA,yU�LL1AM E 8 FRANCES E �� 1�f,��
ENOL4APA 17025-3035 �j1� ���� �����������������������������������H����
To review the assessment data for this property, go to:
www.courthouseonline.com>AssessmentOffice>Cumberfand>PropertyRecords.
Then eMer control# 45000085 and password ��yyy��E
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Payabie To: DEBBIE LUPOLD,TREASURER •• Office Hours:, MON THRU`THURS 9AMrtPM ••••
98 S ENOLA ORNE;ROOM 101 CLOSED FR18 HOLIDAYS
ENOLA,PA 17025 �
PHONE(717)901-9392 Bill No: 6528
Bill Date: 3/1/14
�p N�- 45-16-1050-007. Control No: 45000088
�� SO7 STATE ROAD Assessed Value: Land:20,000 im rovement:87,400 Total:107,400
LAND LESS THAN 1 ACRE Discount Face ena
Acres 0.1 Deed 0024L00690 Coun RE 2.195 $231.03
County Lib 0.143 $15.08 $15.36
$16.90
j � Munic.R/E 1.05 $110.Si 112.77 124.05
;
,St.C�FEE FOR ADDITIONAL RECEIPTS
Tau Fa.er.
�A,WIWAM E 8 FRANCES E
50T STRTE ST TAX AMOUNT DUE a33g,5g $363.87 $400.28
EMDZA PA 17025�035 If Date Of Pa nt is on 5/1/14 th�u B/30/14
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2.98 UISCOUNT ERCH -0.15 73 ��d� U�L�� 'RD. ,
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3410 PNE HDAL 240 2 1/4 X 1 I/ 20.a9 ENtl !RA "^�?�(�� ��'�
21.99 DI5COUNT EpCH -1.16 . - �'�'�.;1 732,-36�� ,�:.� � � , ,
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SUBiOTAL• 26.55 �` � �''`'� .-�. �
TAX: 1�59 SALE , �P�M'��,�"� �� , `, .9 c�16d11
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- Pref�rr'��t,Cu��nme`y��`"�!� . ° ' ` � �5.80
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064080696 ` SHOWER�LINER T ' , 463 N ENOLA�RT5 11 15
680.302�3.' ' $2:2g ENOLA�, Pq 17025 -
WIND01� PANEL� T $19:98.: :;
2;0; $9 99;,ea ., , . � (.717)732-3673.
� SUSTOTAL $ , .�� I
T = PA TAX 6 0000� on .:$22 27 1.3Q L ** WELCOME TO YOUR **
' V' TOTAL'. ' � � �* KMART STORE Q123 �t+� �
� CASH PAYMENT $25.00 ''' ;, � � ,
CHANGE DUE $0.10 CASHIERt ALEXIS `�
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GIPTCAR� wlnnersl DEBIT APPROVAL 4628q3
RMOUNT DEBIT FROM CARD �qg,qZ
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TELL US ABOUT YOUR UISIT WITHIN 72 HOURS � � w = "
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ON QUR NE,I�,SHORTER: SU�VEY: , ,. �' ' ' '
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One $1,500 TG'F G i ftCard� naf'1 dna 1 sweepstakes ,, N fd�,X, F T I;; T 4 Q 7;
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S1x $25 instant TGT GiftCard winners/stete RECEIPT# �091�3 �050t�19 005 .'91q$g."''
EN UN PLAZO DE 72 �HORAS •
�; CUENTENOS SOBRE SU VISITA USANDO . 05/01/1 q' 11;5.1 AM. 9123: 05, 9,14$ �065
NU�STRl4'NUEUA Y CORTA' ENCWEST�F � '�
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� Tenga i�-opohtuhidad merisuai de�'ganar: **�**********�****�,***�***�*****�*****
Una tar,�eta TGT �i ftCaFd,de $i„500,en un
• sorteo nacional Y SYY MBR SAVINGS THiS TRIP: :�,15
Seis genadorAs po1^,estadd al lnstante'de:' OTHER SRVINGS,: gq, �g
_ una ta��,eta TGi C�1ftCard de,$25 *�.****�**********�*****�***�**********
� , .;: , 18+� TO.�ENTER�,:: : � - �
� TARGET TEAM AND FAMILY NOT ELIGIBLE.� You are' a BASE ;�Member.:.',.
FOR COMPLETE RULES' SEE GUEST SERVICE
� OR WWW.INFOkMTARGET.COM Current Polnts Balance; 568
� � �. ;, ��, , . Base Points Earned: 268
Bonus Points Earned: 0
Polnts ExPiriny, 03/31/Z015 ; 7 ;
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iRANSN:, 9180084 03-��,,, �c,�f,i�"
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' 14`,27 p ' ' CN SWEATSHIR N � �11.88
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45663 ZINsSER 1-QT'BIN PRIMER � GROCERY3: `
' �Z'e� 05508Q576 , DQVE, � � FI�� 3,50 y
OUNi EACH, -0,67 ' � 055080669 WONf�A- FN 1.00 '
614aVAl 1-QA! I��T�FLT bLT WHF� . 2�:06- 05508Q7,46�.; RUSS�L. � F�V , �3�.98
24':27 NT EACH ` � 2.� g1:99 ea �
107204 LCC SYSiEN US�,ONLY ` ' � � 05508074�t RUSSEL ' � '' FN $3.98
! ,� 0.OQ N 2.0 $1;99 ea,
' 055080749 RUSSEL," FN $3.19
' SU8i0TAl: � ! 055080750 RUSSEL FN $3.19
71:74 � � 055080799; STARBURST• . FN $4.00
� TA1f; 4,3Q 4:0 �1.�.00 ea
INVOICE Q909�, iOiAL �. ` '' '', , ' , `
` 7 HEALTH-BEAUTY-COSI�TICS
" LCCs. 094030491 CHAPSTICK 6 N $3.99
TOTAL. QIgCOUNT-'
. �LCC:1(XXXgXXXXXJ(X3317 AMOUNi.16.04 RUiHCD:QOQA97� , �
SdIIPED REFID:180084211309 03/25714 16;q1;yq , . --� 06 031349 WIN[y'ON�{PaNEL T $4.99
Regula'r Price $9.99
. ' '� `�y 068031349 WINDf�ti�'�pANEL T $4.99
��. � Regular Pr1ce $9.99 �p
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Si01�: �219 , TERMINA�;, 09. 03/25/i�iG�41.41t��,,. , "�I' 24004096� EGG., DYE. T. $2.50
�' OF ITEM9 PURGF�ASEG�„ ;
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1 I � EXCI,UDES FEES, SERVYCE5 AND SPECtAL ORDER IiEM9 f 0�3031277 .. GLOW TATTOOS,..
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.��„ � T = PA TAX 6.0000� on $16:48 $0.99
iHANK VOU,FO� SHOPPINB LOWE'S ' TOTAL $68.06
� SE€.REIJERS�SID�FOR`�R�TURN�POLICY . �a ,.;; ' e *3028 DEBIT TOTAL PAYMENT $68.06
, , SrORE MpNAGE�' J�M„OUNKEL6E�AEp � '� ? • '
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��� �E HAUE rNE LOVESi PAICES, QUARANiE�O► '` � '� ' ' ���� � ���� ' �� ' �
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� MECHANICSBURO, PA 17050 ., �71� 6��� i MONTFILY . � , PLUS d
+ � R ` ' S1500 Instant
- _ RETURN 18536 " � GIlTCARD winnarsf �
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ORIQ. STORE: 2223' D8TE:032514 INV: 9091 ,ON.OUR NE�I SHORfER SUR.1(EY':`, . .
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i SUBTOtAI; 1.54- ' Usel^� : 7 ��2
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TOTAL RETURN: 7 16. For`a mon hly� chanae �o;w1n: �
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LCC:RXXKXXXXX%X1t3317 A�OUNT:27.16.
Six $25 lristant;TGT Gt�tCa��''�innersistate
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I N V O I C E
1500 Paxton Street
J OU R NAL Harrisburg, PA 17104 3/19/2014
M U LT I M E D I A T.717-236-4300
F.717-236-6803 ORDER#: 94883
www.journalmultimedia.com TERMS: Net 30 Days
-------------- INVOICE TO------------ -------------- ADVERTISER
------------
Cunningham &Chernicoff, P.C. Cunningham &Chernicoff, P.C.
Accounts Payable
P. O. Box 60457
Harrisburg, PA 17106
INVOICING:Advertiser
DESCRIPTION OF CHARGES COST � CREDIT � BAI_ANCE
PUBLICATION: CLASSIFIED/CENTRAL PENN BUS.JRNL
COVER DATE: 3/14/2014 THEME: CLASSIFIED AD/CENTRAL PENN BUSINESS JOUR
RATE CARD: � Q
DESCRIPTION OF AD: Q
Legnl listing: Estate of William E.Solada
REP(S):
MARK SUNDAY
SIZE: LEGAL LISTING, PAGE: 150.00
COLOR: B&W 0.00
SPACE SUB-TOTAL: 150.0
" BALANCE DUE: 150.00
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CUMBERLAND LAW JOURNAL
32 SOUTH BEDFORD STREET
CARLI3LE, PA 17013
Teie: ����2ae-a�ee Fax:����2ae-2sea
March 14, 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: Bruce J. Warshawsk , Es uire l 7� U
Y q �
RE: William E. Solada 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 the following dates:
February 28, March 7, and March 14, 2014
Advertising Cost $ 75.00
Proof of Publication $ 0.00
Second Proof Request $ 0.00
Payment received $ 0 .00
Total Amount Due $ 75.00
Payment received by
DEBBIE LUPOLD,�►s��R � ��� TAXPAYER'S COPY
� I RTI N FOR YOUR RECORDS
88 S ENOLA DRNE;ROOM 10l KEEP TH S PO O
ENOLA,PA 17025
TEMP-RETURN SERVICE REQUESTED
EAST PENNSBORO T1NP
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WILLIAM E SOLADA
ENOLAPA17025�035 3i`�`! ` IIIII�II�I�IIIHII��III�III�pI�I�IIIIpIIN
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Offlce Hours: MON THRU THURS 9AM-4PM Bill No: 11763
Payable To: DEBBIE LUPOLD,TREASURER OVER 70 ONLY PAY HALF OF B�LL 8�����8� 3N/14
98 S ENOLA ORNE;ROOM 101 BIRTHDATE, / / Control No:08-016437
ENOLA,PA 17025 � --
SIGNATURE
PHONE(717�901-8392
�� ��������I'�III'I Discount Face Penalty
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F�#.�2€3��(DR ADDCROMAL RECEIPTS EAST PENNSBORO TWP $9.80 510.00 $11.00
Ta�tPa�er:
�F,gpippp TAX AMOUNT DUE Ss.so S1o.00 517.00
�p;��p�,� If Date of Payment Is on 3H/14 thru 4/30/14 5H/14 thru 6/30H4 7/1H4 or Late
Ei1�A PA'i70Z33035
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5000 Louise Drive
P.O.Box 40
Mechanicsburg PA 17055-0040
a (800)237-7288
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P��,���a� www.memberslst.org
WILLIAM E SOLADA
507 STATE ST
ENOLA PA 17025
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CHECKING 7,307.01
SAVINGS 109,180.18
CERTIFICATES 0.00
LOANS � � ,
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Date Date Description Deposits Withdrawals Balance
01/OS 01/OS Check 002697 Tracer 0000239912 363.12 6,387.36
01/09 01/09 Deposit by Check 1,331.72 7,719.08
01/09 01/09 Withdrawal ACH LIBERTY MUTUAL 92.83 7,626.25
TYPE: PAYMENT ID:9267721101 CO: LIBERTY MUTUAL
01/09 01/09 Check 002699 Tracer 0000311595 16.49 7,609.76
01/09 01/09 Check 002698 Tracer 0000313471 42.30 7,567,46
01/14 01/14 Check 002700 Tracer 0000349439 8.51 7,558.95
01/17 01/17 Clieck 002791 Tracer 0000270385 100.01 7,458.94
0 /24 01/27 Check 002794 Tracer 0000281096 14.24 7,444.?0
�� 01/24 01/27 Check 002792 Tracer 0000258648 138.00 7,306.70
1/31 01/31 Deposit Dividend 0.050% 0.31 7,307.01
Annual Percentage Yield Earned 0.050%from 01/01/14 through
01/31/14
ENDING BALANCE: $7,307.01
Check# Date Amount Check# Date Amount Check# Date Amount
2697 01/OS 363.12 2698 01/09 42.30 2699 01/09 16.49
. 2700 01/14 8.51 2791* 01/17 100.01 2792 01/27 138.00
-` 2794" ' 01/27. , 14:24 , .
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*Indicates check out of sequence 7 Checks Cleared for 682.67 �
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CUNNINGHAM& CHERNICOFF, P.C.
2320 N. 2nd Street,P.O. Box 60457
� � Harrisburg, PA 17106-0457
�
Ph:(717)238-6570 Fax:(717)238-4809
William Solada Jan 03, 2014
507 State Street
Enola,PA 17025
File#: 610813
Attention: Inv #: 81220
Power of Attorney
DATE DESCRIPTION HOURS AMOUNT LAWYER
Ju1-29-13 T/C w/Kathy Putt; Prepare Power of Attorney 0.40 100.00 BJW
Ju1-31-13 Prepare Power of Attorney 0.30 75.00 BJW
Sep-03-13 Email w/Kathy Putt 0.10 25.00 BJW
Oct-02-13 Email w/client 0.10 25.00 BJW
Jan-03-14 Courtesy Discount -175.00 BJW
Totals $50.00
SAGES E!C— p�NEL�"�►;T�gEt,tAYY .
. .
� .,,_._,�._�,�.._______...
_____..
____ .
" • " - i - � i . -_ -
*** PLEAS� PAY IIPON RECEIPT. FOR B�I.I,ING , • • -
*�* AM ANIt 4 Pl� (�17ESTTONS ` •' - ' '
A1�iD CHOO5E $IT,T,ING, �L 774-1366 BETWEEN l:0 �**
't** I.�TE FL�E gDDEl)`_TO BAI�NCBS OVER 60 DAYSFOLD�DE 3/1/10 THERE WILL $E A *�*
���Y�E*�*�k�?�e*�F�k��k*�E��EaEir k�Jt�ir�k�k*�ir��F�r�k*****�fr****�t*x-**�*�fr**�k**�k�*�tr*****�F�Ar******�+k�lr
' Insuranc� Char es '�**
Ina Pap/�:d a � Pending to Prv: 7715,Oq �*
� ga�.nst. Ins :pending 4989.87-2747.94 -22.81
�11/13 1 17 F HOSPITAE, SIIBSEQIIEIdT
`18 j]..3 CAltB. 99233 425.4 135.00
�18/13 MEDICARE R�1 Pa ent
Obf14 MEDTCARE RAILRq� Papmeu� 0.00
Accept Assign Adj. 77.64
-37.SS 19.81
/
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a.00.: _�.0p
�TTERNIS.TS OF CENTRAL PA
�08 LOWT$ER. STREET . ,, i� u
LEMOYNI�:,: PA 17Q43 , . �
Payment Due IIpon Rec 19.81*
�'AT� I-WILI.IAM E SOLADA PRV,� 17-SWEENEF Ph:�717)-774-1366
, ALAN ,T., M.D. Acct#: 73fi35
Date: OTl03/],4
Page 1 of 1
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T�Xpa�1"4 Ad111d
Social securily numb�r
sor�nA �PILLYAM �. 2os��.a-8s��
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Spow�'�soet�l�ourity nienber
Tax Re m Informatlon - Tax Ye r Endin Decomber 31 2 13 ole Doliars Onl
� Adjuated pross Incom.(FOm�f 1040,Iine 38:Fortn 104QA,iinp Z4;FOnh 1040EZ.Ilne 4) . 1 �2 3 4 2 3.
Z Totol ta�c(Form 1040,Me 81;Form 1040A,Iino�;Form 1040EZ,Iine 1 d) . , , 2 1 3 4 3.
a Fpdered inoametaxwfthhskJ(Form 104p,pne82;�orm 1040A,I(no39;Fbnn 1040EZ,Iine 7) . � . . . . . . 3 1 0 68
4 Refund{Forrn 1040,Ilns T4a;Forrn 9040A,Iine 430;Fprm 1p4pFZ,�(ne 11a;Form 1040-Sg,F+��{�,��ne 9 3e) , r . 4
A Amount u owa Farm 1 Qqp,Iine 78;Form 1 Iina a$;Fofit�1040Q.Itne 12 , � �
Ta a er D�claration and Si ha#ure qutharizatlfln Be aure ou et and kee a co ot our rstum 5�
UnderpenoitiesofpQrJuy,�dedetethatlhaveexaminqdaCppyoimyelectronicindividuallnoometexretumandaccom anyinge�sheduleaandatat�ment�
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�n P'art I�lbove aro the ornounts Aqm my �� �,�qp�� I� lnt
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Autharized IR5 e�81e Pro (den of Indiv u 1lnoome Tax Retums.
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Do Not�Submit This Form to the �Rg Unlese Requested To Da SQ
�A �Gr Papervvork Reduction Act Notice,saa yqurtdx return Pnstrvctions. Form$$79 (2019)
�8T9�D�,�3013�J�..,�A��.� ^AA A LIfl�T�..,.FD8879D�1Y1.0
MAR/07/2014/FRI 04;57 PM FAX No, P, 004
n$c$ms$a
F°� DepertmentoftheTroa�ury-IntprnplReybnue3ervlce � '
1040A V.s. Individual Income Tax Return c��> ZQ'�."� IR8Us�Only-Donotwrit�or�tapl��ntn��ep�.,
OMB No,1645-0074
�ILLIAM E $OI,ADA -�D�CEASLD 1/18/2014 Yaurtpaimissourl6ynumber
� Rl►THY PUTT 201�18-991�
50�4 LANCASTER 1�iV$ SP���s���sewrNynumber
EiNOI,A� P11 �,7 p 2 S ` Meke auro thm SBN(a)abovs
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far�lan oournry nam� FonlOn provinal�tNyoount Fonl n aat.l aa + �Q����y�W�S3 to o to tnl�fund.CN�ck9n9
Y 0 P d a box h�low wll� �np�your tuc or
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one box. � n hqrp.►
hero,� n widow�r with de +lndent ohild eae instructlons
�x�mptlons Ba Yourseli. If someona can claim you as a dependent, do not ch�ck ew�as
box 6a. � e:on eb� 1
b S ltSe No.of ehlldr�n
c Dependenb: 4 oneawno:
It mare than�Ix (�)�ePendent'e eocial (3)D�psnd�nYe �a...o:�� •Ilv�dwlth
d•p•ndena,e�� (1)Fl�at neme Laetneme �curity numbqr �eltlitionahip to yau o►�iia i�+i a°r:du y°�
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r�orm�a�w 2 8a Taxable Int� ach ule B if uir� 8a 381.
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11a IRA 114 1'axable amount
��You did not distributibns. 11a seetnstrucdons. 11 b
�.�.w.z,:.• 12A PenslonS 8C1d 12b Taxable amount
Instructlon�.
ann uitles. 12� see fnatructlona. 12b 2 0 8 4 d.
13 Unemploym�nt compensatlon
and Alaska Permanent Fund dividends. 13
74a Social s�cu�lty b Ta ount
benefits. 14a 1 69. ae stru nA. 14b 2 236.
1S Add llnes 7 throu h 74 far ri h 1 Is our 1 In o e ► 16 23 423.
Adjusted
g�Qss 16 Educator expense� (see instructions�;,,, 1�
income 17 1RA deduction see instr�l�tlons , �7
18_ S#ud�nt loan interest deduction (see instructions) 1�
19 Tuition and fees. Attach Form $917, 19
20 Add I(nes 18 thrau h 19. Theae are our to y��ient� ZO
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21 Subtract Ilne 20 from line 95. '1'hls Is vour adlusted qross �ncome f 21 23.423_
K9A For Dlscloaure,Prlvacy A�t,and Pap�ryyp�peduction Act Notics,sea aoparato fr�struetlqna, Form 1040A(2013)
�040�1(ZQ13 ,
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� MAR/07/2014/FRI 04;58 PM FAX No, P. 005
Form 10�40,4(2013 yQZyL=� � gOLADA � �
T� G�ed�b, 22 ount�r ��� 41-1B—B 13 �+ge2
payments �3� Chedt YauwmrobombetorsJanuary2,1949, � 23 923
�, 811nd Toi��boxe�
9tandArd gp�swp�bombeforo.lanuaryZ,1848, Bltnd ah�oked ► 23� 1
Ddd�ation b If you ara marrled flling spparatey and your spouae fiemFzes
tor- deductbna ero
•PeOpiswho Z4 Entor nda ► 23b
oheakany ' 7 600.
boxonlin» 2� a24 IIns24 ���� �
23Aor23b Ze ns.MutN I 3 b thenumberonll eQd, , 15
prwho�n n $ubtrecttlne28fromllns23.itline281�n�proth�pne28,anflt-p,., 28 3 900 .
be claim�l�
�t dependent, le la ur co
80°���• 28 T in an altsm � � 1 923.
•All others: 29 m atlo 2 1 3 4 .
Sinplaor, ��ib n rttca
Morri�d�llhp � Craditfor�yelderlyor disltbled. h
seperate y, �s
$8,100
Mertiad fllinp �� (on
jQual �n 3� Rotl aevin o n tlonacred�. orm8880. 32
W�dOw e�, 3� C t crodft. 8812 N
$12,2 3� d Ilnes29 �
Head oi �•Th� total
household, � SubtraCEN�e34Tromlinp?,�, Ifline341�mor�thanlfne28,.n��-�,Thlsis �
lali
Federolin �W�hho a�W 2an 1 343.
37 2013�timated tox payrll ount 1 � $•
�1you have a II�I frqm 2D72 rotum
a quaifgrinp
Child,�ttach �+ dl
SoheduleElC. b N lecamb tton.
3� ditlonalchil credR, 881
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41 es38 3T and40. our
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Thia la h ount u d,
Dirqo� 43e tafline42 nt 42
depoett? •KFO�B ched check ►
Seeinetruc�tpn� � b �uBnp
and flp In numba� ,�
43b,43c, ► d Account
and 43d or number
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ur
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y0U oWe �ee�nstruction
a Eat(ma�ed teus ena e..tn.tn,e��,,,. i" '� 2 7 5.
'1'h��d �arl�/ L10 you wanttp olloW anotherA•�n to d(aouse this return w({h t}�e IR3 pa�Inetruotlon� X
destgne� �B�9n�'aneme � Yea. Comp��bthefollowinp, No
� g BLOClr F'honeno. PeroonallDn
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� knowl�tlpo entl belii{,tn�y u�tru�,eerr �a t a�l au�� ul��eAd sta��m�����tl to th�bxi of mY
he�e ofpr�pusr(ath�rtnantn�taxpayr)t■p onolllnfor n ���#m �^����aafv�tl0unflp�h�ta�ty�r.Q�q�ratlon
Jointroturn9 YoursignaWrb iohth• rNNuanyknowi�dp�.
Sao In��u�(o�s. � occupatton Daytimephone numbe�
�po�py �'or Yn Oal �D t ! ETIRED
��your Spouae'aslgnpture,lisjointrotur muat u�'aprx;upAtlon •� e • e �soaon
teoorda. Or Irif A --DO rio 1 �t�•n�w4t�i�i�'es'��r�s�S°
P�id Prfnt/h'P•p►'op�r�aname Proparor'asipnaturo pata
MARY LpU SiPARTZ Ch�� � �N
preparer �3 6 a014 seH-4mpbyed
u$6 dnly !rm'aname► H R,�Tp R BLOCiC ]i00429349
Ftrm'aaddrgs ►E�TOLA PA 7025 �"'sFl� 2 -�265030
Phon n 717 732- 766
. Form 1 aapq(2a13)
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+,� � � � .�, ; ` New Bloomfield, PA 17068
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�r Federal ID#25-1899661
._
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Statian: 717.582.2144 Office: 717.582.7471
Proudly provld�ngAL&and BLS Senrices Ng�S(ii�Hotrnail,com . www.N8FD8.com
in Perry Coutthf . .
7o W'hom It 1Ltiay Can�ern.
�r�cbsed yau will find your bills. These were sent to Medicare and they processed them saying that the
base rate a�d the mileage should have been bilied together as one charge. Since they were billed
.separately they would no#pay the mileage.
. �, •
They ar�saying you are only responsible for the base rate totalin 770.00 but the mileage was$330.00
���af bi�t�od�ogether tha#would have been your responsibility also so that should still be your
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PATIENT NAME WILLIAM SOLADA �NSURANCE pq�METTO GBA REJ
NATIONAL ELEVATORS INS NONE
CALL NUMBER: 1401127A DATE OF CALL• 01 N 7/2014
FROM: STONEBRIDGE NURSING HOME
\�`� T�' HOLY SPIRIT HOSPITAL
�\ ACCOUN7 SUMMAR'�(
WILLIAM SOLADA
507 STATE ST TOTAL CHARQES:
ENOLA,PA 1 T025 �� PATMENTS✓AD.lUSTMENT3:
PLEASE PAY THIS AMOUNT. 1442.67
�, > ..:.,-_.-----.------------- -DLRACHALON�PERIroRATIONANDRETt1RNSTUBVYITHPAYMENT
. ' ��tCW b�GNARC���'.� , t11�A1�Y`:`. Uf�'1`I�RIC�, _ : AAIIQUNT ! __-
20GTT TUBING A0394 1.0 14.72 14.72
ALS EMERGENCY LEVEL 2 A0999 1.0 1043.55 1043.55
ANGIOCATH(1424) A0394 1.0 6.72 6.72
CARDIZEM 25MG VIAL A0384 1.0 2.40 2.40
EKG ELECTROD�S(1) A0398 4.0 0.80 3.20
EZ 10 45mm NEEDLE A0394 1.0 345.00 345.00 '
GAUZE PADS A0382 2.0 0.20 0.40
GLUCOSE BLOOD A0394 1.0 7.08 � 7.08
LIDOCA[NE 900MG A0394 1.0 6.48 8.48
NEEDL�S(�LL} A0999 3.0 0.76 2•28
NSS t?.9°1�.i(IQpcc Bag A0394 1.0 3.48 � 3.48
SAUNE PREFlLLm SYRINGE A0394 2.0 2.56 5•�2
�idN O�PAYMENT REGEfPT . PAIFMF�!'�'RA'F� AMdUNT
������d�`�3'�G��`4i°J`��li�3i➢"s�t�i°tP�xs;.�!�l���d�'ilh�i�,�i:+�Bva�' �- ` .
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�������`�������"���"�: �1���r.�i��rr�i�ar�c�unt w�s DEAIlED by yaur insurance
car�`�r;Tt�e balance is yQut���i���y-�tfe�a�remf#
Pay;�en��o our offic�
iI'►iEST 5�34RI�'E�iS-PEt�EiY CDUNtY 205 GRANDVIEW AVE STE 211 CAMP H!!L,PA 17017-1708
_ �,
,
REV•1513 EX+(01-10)
SCHEDULE J
�oMr���,��o����ANIA BENEFICIARIES
ESTATE OF FILE NUMBER
Solada,William E 21-14-00090
RELATIONSHIP TO
NAME AND ADDRESS OF SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT M/ords) ($$$)
I TAXABLE DISTRIBUTIONS [include outright spousal
' distributions,and transfers
under Sec.9116 a 1.2
Kathy Putt Daughter Half
504 Lancaster Ave.
Enola, PA 17025
Steven Solada Son Half
2797 Little Dry Run Rd.
Cincinnati,OH 45244
Total
Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 cover sheet as a ro riate.
NON-TAXABLE DISTRIBUTIONS:
II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule J(Rev.01-10)
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