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Home My WebLink About10-17-14 J 1505610105 REV-1500 EX�°2_'1,«, �� PA Department of Revenue pennsylvania OFFICIAL USE ONLY Bureau of Individual Taxes �""p'„`"T �"`"`""` Coun Code Year File Number PO BOX28o6o1 � INHERITANCE TAX RETURN y j ; Harrisburg,PA i�lz8-o6oi RESIDENT DECEDENT �/ / � ' �(p � ENTER DECEDENT INFORMATION BELOW -- Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY __.._..... .. ._......... , _..._ 158-30-2824 06/02/2014 06/08/1939 ; ; _...... _ ......__.. .. ............ MI ecedent s Last Name Suffix Decedent s First Name _. _.... _.._ __. . _... _.._.......... 'Beams Barbara � _ _. ; __.... _...... _ , _ _. ....... _....... ___.. Applicable)Enter Surviving Spouse's Information Below Spouse s Last Name Su�x S ouse s First Name _ __.. _.... _......... . . _.... . _......_ , _ _�....___ . _.� __.__._ ___._... Spouse's Social Security Number " ' THIS RETURN MUST BE FILED IN DUPLICATE WITH THE _�. _ . REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW G� 1. Original Return O 2.Supplemental Retum O 3. Remainder Return(Date of Death Prior to 12-13-82) O 4. Limited Estate p 4a.Future Interest Compromise(date of p 5. Federal Estate Tax Retum Required death after 12-12-82) � 6. Decedent Died Testate O 7.Decedent Maintained a Living Trust 8. Totai Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) O 9. Litigation Proceeds Received O 10.Spousal Poverty Credit(Date of Death O 11. Election to Tax under Sec.9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT—THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED�g Name Daytime Telephon�Vumber � _._.. o � �'' rrn __.. __ Michael Cherewka (717)232-47(� .:� c� ��; c� _._... �. ,, � �., � _.. _ __ _._ _ . _._ _. _ ,. ___ , , _._ — � :-�� REGISTER OF V�I�LL9-tJSE�Y { C-j ' „� ' I'�'1 ," ;� ; '; C:=.7 First Line of Address ,, �,.� � ...__ . __... .. .. .. _........ .. .__... . _ ._..._..._. __........ _.__.... __.. 624 North Front Street ; =3 � -,:� - : --_ _.._ _.._. _...._ ' t--� _ c a _.. ._. ...._...... _... r C Second Line of Address V n� __._� _ �......... _...._. � . C.) O � _.. _C 'rl �. City or Post Office State ZIP Code DATE FILED _....._ _.... __. _ _ . __. . , Wormleysburg PA ' 17043 __._..... _... _ _..... _ , _.. CorrespondenYs e-maii address:mcherewka@cherewkalaw.com Under penalties of perjury,I declare that I have examined this retum,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true;xorrect and complet .,Declaration of preparer other than the personal representative is based on all infortnation of which preparer has any knowledge. SIG RE OF PER SIBLE FOR FILING RETURN �'I� f �" �� . ,�� DAT�� AbDRESS 'J SI '� OF EPAR E HAN REPRESENTATIVE DATE � � �� G��.�� ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 � 1505610105 1505610105 J � � 1505610205 � REV-1500 EX(FI) DecedenPs Social Securiry Number �ecedent's Name: RECAPITULATION L Real Estate(Schedule A). ..................... ....................... 1. ; 0.00 : 2. Stocksand Bonds(Schedule B) ....................................... 2. ; 0.00 : 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ..... 3. ; 0.00 : 4. Mortgages and Notes Receivable(Schedule D)........................... 4. ; 0.00 ; 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. : 760.20 : 6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6. ' 513.01 ; __ __ _..... 7. Inter-Vivos Transfers&Misceilaneous Non-Probate Property (Schedule G) O Separate Biiling Requested........ 7. 0.00 8. Total Gross Assets(total Lines 1 through 7)......... .................... e. ; 1,273.21 ; 9. Funeral Expenses and Administrative Costs(Schedule H)................... 9. : 2,299.08 ; 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............... 10. :' 9,956.73 ; 11. Total Deductions(total Lines 9 and 10)................. ................ 11. : 12,255.81 ; 12. Net Value of Estate(Line 8 minus Line 11) .............. ................ 12. : -10,982.60 i 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which . : _ ......, .. ....� .. . an election to tax has not been made(Schedule J) ........................ 13. 0.00 14. Net Value Subject to Tax(Line 12 minus Line 13) ............... ......... 14. : 0.00 ' TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 _. ______.. __ __.... . _ ...__. ; (a)(1.2)X.0_ 15. -.. .....v...,,,. _ . _ .._:............ ..... . .......... . . ... ._......,. ,. : 16. Amount of Line 14 taxable at lineal rate X.0_ 16. : .......:. . ..... . .. ...... . . ... .....,,�,.,..... _...:.. . .. 17. Amount of Line 14 taxable at sibling rate X.12 17. ...,...�.. ... .,.. . .... . ___ . ; 18. Amount of Line 14 taxable ; at coilateral rate X.15 18. 19. TAX DUE ..................................... 0.00 ; ..... ............... 19.: __.._. ; 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 L 1505610205 15�5610205 � REV-i5o8 EX+(o8-i2) � pennsylvania SCHEDULE E DEPARTMENTOFREVENUE CASH, BANK DEPOSITS & MISC. INHERITANCE TAX REfURN pERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Barbara J. Beams 21-14-0560 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Fumiture,Household Goods 480.00 2. Aetna Premiums Refund 134.40 3. PA Tax Refund _ 145.80 TOTAL(Also enter on Line 5, Recapitulation) $ 760.20: If more space is needed,use additional sheets of paper of the same size. . _.. . -, . . ...� . , - . ._ .�- . . . .._.. -.. . ... . . . _ . . . - � . . ---- ----------..--- -.--- ---� �,`` , .. : : � A��A►��►L. _ - � � A� � ��.� � � � . ��-(� .S� `31 s-r S'�, �' N i u-= . ��g�E„ - A� , .. - . . � - —I . � p� _ ��i� . � - - v�l.�J� �c l�d � � c-' s� o,� - � _ . — C � - �,ao - ? c� L>i-tilP T' �L� S�T D . . . • i�1� I�oFz� � SD � - . _� ,y c� � ,c� � � _ _ .�. .p ov.3- 7`Iz y '`N �,�d u 1/o,zo � - � . _ . - x",Ls�-T -::TUP TT2U�i� . D,i� ;. . _ , _, . _ , ; . a��a . . t3 5�d'� S T �dS .. _ s�" s�9 i� h'o�.�Ho ,� - - � Ela� Ga X�5 : � - ��,c� T � �}-AA P�415 �-- �� . _ , ., U U —�- - -; t � - . . �1 , ':� t ''.' �.' .:�-. ' '..: .:'.... .:...� ...::.�.:... ' . . .. - � * I . '.. : -- '. . � . -: . . : � . .. �:: �.- _ .. . �..: .::� .. ._ .. .: '... . . ..: e. ..a .. .. '._.. . . . ' ...�': .: .. . . . _ ._"„�:: ..:-... ' .. :..,:: � ..:. � .... '.:'-:::'':'. I .., .,. ... . ._..:. . ...�.'... ;.. . . . — . i ! . • � � . " . �, � .. :;'��' i� � _ REV-15o9 EX+(o1-io) � pennsylvania SCHEDULE F DEPARTMENTOFREVENUE �OINTLY—OWNED PROPERTY INHERITANCE TAX REfURN � RESIDENT DECEDENT ' ESTATE OF: FILE NUMBER: Barbara J. Beams 21-14-0560 If an asset became jointly owned within one year of the decedenYs date of death,it must be reported on Schedule G. SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A. Kimberly Slaughter 920 S. 18th St. Friend ', Camp Hill, PA 17011 8. _ _ _ _ _ _ _ _ _ _ _ C. : : _ JOINTLY OWNED PROPERTY: LETTER DATE DESCRIPIION OF PROPERIY %OF DATE OF DEAIIi IfEM FOR JOINT MADE INCLUDE NAME OF FlNANCIAL INSRMfON AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT'S VALUE OF NUMBER TENAM' ]OINT IDENTIFYING NUMBER,ATTACH DEED FOR JOINTLY HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. Santander Checking Act.No.2811141251 1,026.01 50 513.01 ' TOTAL(Also enter on Line 6, Recapitulation) $ 513.01 If more space is needed, use additional sheets of paper of the same size. � � � ' � ` •• 1 1 � 1. 1 � KIMBERLY O SLAUGHTER Account k 7680348316 BARBARA BEAMS Balances �E�TIF31Ii� a:- �:��- '� .� r �� —= _...�__-'- Deposits/Credits +$0.04 Average Daity Balance $1,48331� ��- — _ j� ----= -- - - — - - --- - _- — Interest � _ �_ k�� - -�� _ -- Earned this Period $0.04 Paid LastYear $0.00 �_—_._�w:;-��_ � �stiSS��LE'��=Q..472� .� �� — .s��— � *The mterest earned and the mterest paid may differ dependmg on when interest is credited to your account. Account Activity Date Description Additions Subtractions Balance 05-02 Beginning Balance $1,483.30 .. . _— ,,.__ -- -: _;�t�t�- _-= -�C��--: _. . .: . :. �.. ' _ _ - — .��;�-- - _ -- - ''�..-z _ 06-01 Ending Balan�e $1,48334 a page 2 of 4 � 7680348376 , ; . .. � � � �. � � KIMBERLY O SLAUGHTER Account H 2811141251 BARBARA BEAMS Balances ! _- �� REV-1511 EX+(03-13) � pennsylvania SCHEDULE H DEPARTMENTOFREVENUE FUNERAL EXPENSES AND � INHERITANCETAXRENRN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Barbara J. Beams 21-14-0560 DecedenYs debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERALEXPENSES: 1, _ _ B, ADMINISTRATIVE COSTS: 1. Personal Representative Commissions ' S00.00 Name(s)of Personal Representative(s) Kimberly Slaughter ' Street Address 920 S. 31 st Street �;ty Camp Hill State PA ZIp 17011 Year(s)Commission Paid: 1 Z� Attorney Fees: 1,500.00 3. Family Exemption: (If decedent's address is not the same as claimanYs,attach explanation.) ' ' Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate fees: 118.50 ' 5• Accountant Fees; 6. Tax Return Preparer Fees: �� Legal Advertising-The Sentinel 105.58 a. Legal Advertising-Cumberland County Law Journal 75.00 _ _ _ __. _ _ _ _ __ . _ __ _ _ _ _ __ _ _ _ _ TOTAL(Also enter on Line 9, Recapitulation) $ 2,299.�8 If more space is needed,use additional sheets of paper of the same size. �J��D coG�'�- �� I :� �+ • .,� . ��ssoc►P�`°� CUMBERLAND LAW JOURNAL 32 SOUTH BEDFORD STREET CARLISLE, PA 17013 Tele: (717)249-3166 Fax:(717)249-2663 August 29, 2014 Cumberland Law Journal is published every Friday by the Cumberiand County BarAssociation 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: Kimberly O. Slaughter RE: Barbara J. Beams Estate Legal advertisements must be received by Friday Noon. All legal advertising must be paid in advance. Make all checks payable to: Cumberland Law Journal. ------------------------------------------------------------------ ------------------------------------------------------------------ Advertisement inserted on following dates: August 15, August 22, and August 29, 2014 Advertising Cost $ 75.00 Proof of Publication $ 0.00 Second Proof Request $ 0.00 - Payment received $ 75.00 Total Amount Due $ 0.00 Becky H. Morgenthal, Executive Director PROOF OF PUBLICATION OF NOTICE IN CUMBERLAND LAW JOURNAL (Under Act No. 587, approved May 16, 1929), P, L.1784 COMMONWEALTH OF PENNSYLVA1vIA : . ss. COUNTY OF CUMBERLAND . Lisa Marie Coyne,Esquire,Editor of the Cumberland Law Journal, of the County and State aforesaid,being duly sworn, according to law, deposes and says that the Cumberland Law Jotunal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid, was established January 2, 1952, and designated by the local courts as the official legal periodical for the publication of all legal notices, and has, since January 2, 1952,been regularly issued weekly in the said County, and that the printed notice or publication attached hereto is exactly the same as was printed in the regular editions and issues of the said Cumberland Law Journal on the following dates, viz; Au�ust 15,Au�ust 22 and August 29 2014 ,. Affiant further deposes that he is authorized to verify this statement by the Cumberland Law Journal, a legal periodical of general circulation, and that he is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statements as to time,place and character of publication are true. .� ,� ,�,--_ �---__ ;' � Lisa Marie Coyne, ditor SWO�'N TO AND SUBSCRIBED before me this 29 day of August, 2014 _ CI Beams,Barbara J.,dec'd. NOt�l'y Late of Mechanicsburg,Upper Al- ' � len Township. Executrix:Kiunberly O.Slaughter, i 920 South 31st Street,Camp Hill, PA 17011. Attomey:None. COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL DEBOFAH A COLIINS Nolary Public CARLISLE BORO.,CUMBERLAND CNTY My Commission Explres Apr 28,2018 The Sexxti�a�.el KIM SLAUGHTER AD NUMBER PAGE NO. www.cumberlink.com 920S.31STSTREET � 433065 1 of1 /) D ��"' e, CAMP HILL,PA 77011 BILL DATE SALESPERSON ��t� - 717-418-4356 cr.cus�e swFPewnusc PERRYCOU�liY 08/28/14 wolfc START DATE STOP DATE 08/14/14 08/28/14 AD NUMBER AD DESCRIPTION CLASS LINES 433065 ESTATE NOTICE ESTATE OF BARBARA J. 10 PUBLIC NOTICES 18 * 2 cols Publication Insertions Rate Net Amount Gross Amount 3 THE SENTINEL-LEGAL 3 LGL $95.58 TOTAL AD CHARGE $95.58 3 MOBILE SITE MOB2 $3.00 3 PROOF OF PUBLICATION 01 PRF $7.00 PREVIOUSLY PAID ($105.58) Purchase Order Est. B.J. Beams $0.00 $0.00 Lee Enterprises no longer accepts credit card payments sent via e-mail. Emails containing credit card numbers will be blocked. Please use the coupon below to send credit card payment to our lockbox. THE SENTINEL You may also send the coupon to a secure fax at 319-291-4014. c/o LEE NEWSPAPERS Thank you for advertising with The Sentineli Deadline for PO BOX 540 in-column legal ads is 4;00 p.m.two business days prior to �NATERLOO IA 50704-0540 date of insertion. For questions, call (717)240-7130. Return this portlon wi(h your payment Legal THE SENTINEL ❑ Check# _ �Credit Card Ad Number 433065 c/o LEE NEWSPAPERS ❑ � ❑ v�isn' ❑ �,, ❑ ^�"�l' PO BOX 540 '-"i �� w� �..°�� Billing Date OS/28/14 WATERLOO IA 50704-0540 Acct#: Amount Due $ .00 E�.Date:m m i_ , Amopnt : $ Name on credit card F�C�p$ed. Signature —_ Please make checks payable to: THE SENTINEL ,�:: aooios THE SENTINEL r KIM SLAUGHTER c/o LEE NEW5PAPERS 920 S.31 ST STREET PO BOX 742548 CAMP HILL, PA 17011 CINCINNATI OH 45274-2548 I�I��I�I�I��I�If��l�l��l��l�l�l�l��l��lf��l��l„ll��l�l��ll 2154020�0�000433065�0000000��00�OOODOODO��ODOD�008 PROOF OF PUBLICATION State of Pennsylvania,County of Cumberland Cathy Clark,Advertising Director;of The Sentinel,of the County and State aforesaid, being duly swoin,deposes and says that THE SENTINEL,a newspaper of general cuculation in the Borough of Carlisle,Counfy and State aforesaid,was established December 13��,1881,since which date THE SENTINEL has been regularly issued in said County,and that the printed notice or publication attached hereto is exactly the same as was printed and published in the regular editions and issues of Au�ust 14,2014 and August 21 2014 and Au�ust 28 2014 COPY OF NOTICE OF PUBLICATION ' �- �� i Affiant further de oses that he she is not ESTATE NO ICE ' ��'r��y� , P � > ,��tf��a� interested in the subject matter of the i EStATEofBARBpRAJ BEAMB IateofMech�rllcsbuf9 Upper/S�I n i�r �t �- To�ynship PA deceased Lette�s of tesi�mony on the estateabav��p��, �- aforesaid notice or advertisement,and that Barbara J Beams. daceased�having beeng�anted!o lhe unders�g��79""N�� persons hawqg claims ar demar�ds against lhe estete p(the�saidrtlB,'� "pf� " _� all allegations in the foregoing statement as are requasted to make known the sar�e;and all parsong mde4led to��e �� decedentto make-paymeniwithout dela`y lo Kimbady p Slaughlef `� y ,� i t0 tilTle�place and character of publication ExecuUfx 920 Soulh 31st Street Camp:Hill PA 1Zq11 � .. ,- ;.f '��'�,�_ a• true. � Sworn to and subscribed before me this - I� (�(X.L1 (',� , a n��'1') .Y �V�. -��Q.� �. � Nota Public ' My commission expi�es: . COMh9fJfVW�r3L_ T►1�F PENNSYLVANIA geG`tany MNFIoIGySnlotary pui�lic Cariisie I3oro,Cumberiand County My Camn�lsslon Expires Scpc,26,2015 • MEMBER,pENNSYLVANIA qSSOCIATION OF NOTARIES REV-1512 EX+(12-12) � pennsylvania SCHEDULE I DEPARTMENTOFREVENUE DEBTS OF DECEDENT, INHERITANCETAXRETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF PILE NUMBER Barbara J. Beams 21-14-0560 Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1• Motorist Insurance Group Act.#AAM470664 23.75 2. Chase CC Act.#4266 8413 4689 0047 5,143.36 3. Sears Citi Master Card Act.#5121 0720 0244 5890 634.09 4. Patient First 152.25 5. Ashley Cleaning 50.00 6. Comcast Final Bill 67.93 7. West Shore EMS Call#1409700A 1,042.26 8. PPL Act.#64590-89042 5��22 9. Capital One CC Act. Ending in 4757 2,265.87 _ _ _ _ _ _ _ _ __ TOTAL(Also enter on Line 10, Recapitulation) $' 9,956.73 If more space is needed,insert additional sheets of the same size. � The Motorists Insurance. � � � 'Grou ;You know us. MOTORISTS INSURANCE COMPANIES Includes:Molarlsls Muluel Insuro�e company�MICO Insutance Campany 471 E BROAD 5T COLUMBU3 oH 43215-3861 ACCOUNT NUMBER: AAAM470664 ACCOUNT FDR: BARBARA BEAMS MAIL TO BARBARA BEAMS 1069 ALLENDALE RD MAILING DATE: O6/26/14 MECHANICSBURG PA 17�55 4466 AMOUNT DUE: 23.75 AGENT 7676 CAPITOL AREA AGENCY 220 E MAIN ST SHIREMNSTOWN PA 17011 6314 AGENT PHONE: (717)737-334Q Our records indicate an unpaid balance is due on your account. Please give this your prompt attention and pay the amount due within 14 days of receipt of this notice. Paymeni of this outstanding premium balance does not reinstate coverage provided by your cancelled policy. To clear your account, please forward the amount due and the lower portion of this letter in the enclosed envelope. THE MOTORISTS INSURANCE GROUP f � � i I PB-121 (1-99) - -- --- — - -- --- - - -- -- -- — -- — — -- -- - - — — — --- — --- - -- ----- - - -- - — - - -- - - — -- - --DETACH AND RETURN THIS PORTION WITH YOUR PAYMENT IN ENCLOSED ENVELOPE— NOTICE OF AMOUNT DUE ACCOUNT NUMBER: AAAM470664 BARBARA BEAMS 1069 ALLENDALE RD AMOUNT DUE: 23.75 MECHANICSBURG PA 17055 4466 AMOUNT PAID: Please wrile your account number on your check or money o�der and make payable to: THE MOTORISTS INSURANCE GROUP PO BOX 182155 COLUMBUS OH 43218-2155 AGENT: CAPITOL AREA AGENCY 7676 ?676AAAM470664D000�237500D00237507151,4 � The Motorists insurance MOTORI5T5 INSURANCE COMPANIES � � 'Group,You know us� 471 E BROAD ST Includes:Motnrfsls Mulual Insurance Compeny 6 MICO Insunnce Companp COLUMBUS OH 43215-3861 ACCOUNT NUMBER: AAAM470664 ACCOUNT FOR: BARBARA BEAMS MAIL TU BARBARA BEAMS 1069 ALLENDALE RD MAILING DATE: 08/27/14 MECHANICSBURG PA 17055 4466 AMOUNT PAST DUE: 23.75 AGENT 7676 CAPITOL AREA AGENCY 220 E MAIN ST SHIREMNSTOWN PA 17011 6314 AGENT PHONE; (717)737-3340 • COLLECTION AUTHORIZATION NOTICE Authorization has been obtained from our Collection Review committee to pursue collection of this debt. We are committed to whatever effort is necessary and proper to effect collection. We strongly encourage you to send payment in full today. You may eliminate further collection effort by contacting your Account Correspondent immediately at (800) 348-9690. THE MOTORISTS INSURANCE GROUP cc: Agency PB-123(6-11) - - -- - - ----- - --- - - -- ---- -- -- - -- - --- --- - - ---- - - -- -- - - -- ---- -- -- - ---- - -- -DETACH AND RETURN THIS PORTION WITH YOUR PAYMENT IN ENCLOSED ENVELOPE-- NOTICE OF AMOUNT DUE ACCOUNT NUMBER: AAAM470664 BARBARA BEAMS 1069 ALLENDALE RD AMOUNT DUE: 23.75 MECHANICSBURG PA 17055 4466 AMOUNT PAID: To pay by�redlt card(Dlscover/MastercardNisa),please aall 1 (800)611-9926 Please write yaur accouni number on your chesk or money arder and make payable to: THE MOTORISTS INSURANCE GROUP PO BOX 182155 COLUMBUS OH 43218-2155 AGENT: 7676 7676AAAM47�66400�002375000002375077,514 �� 4266841346890Q4700�4860pD�514336DD0000008 � P.O.BOX 15123 WILMINGTON, DE �'��?��u€-�� Payment Due Date: 07/19/1�; 19650.5123 �E�°"�Y�a��i`��3�� New Balance: , � 143.3s `�''��"""�''�''��'� Min}mum Pa ment � �^,rsP�>u;n Fal t,�n�. Y $486.00' . � .�.� w,E._ �. .-..,.. _ �,m:�:-qi';._.,.3... :. .�:'e ..:�a;�i _k a�,�x....:. "� Account number:4266 8413 4689,0047 �� . Amount Enclosed 55s38 BEX Z i7a14 D Make your check payable to: Chase Card Services BARBARAJBEAMS 1069ALLENDALERDAPTA ��'�III'll'I'I'«I'�"�I�II�I'��I�III'�"�'I�ICIIII�IIII��,II" MECHANICSBURG PA 17055-4466 CARDMEMBER SERVICE PO BOX 15153 WILMINGTON DE 19886-5153 li�ll�li��ll�ll��l��li�lll�ili��il��1��ii��i� �: 5000 L60 28�: 20 3 1 346890047 iii' CHASE�i Manage your account onllne: - Customer Servfce: Mobfle: Visit chase.com ��"�" �— www.chase.com/freedom `_� 1-800-524-3880 on your mobile browser ACCOUNT SUMMARY ; PAYMENT fNFORMATION . ; ------------�_,.`------__-- ___.._�......._�..__._��. ._..___�__�W:.::._.__._____�.__.y__.__�__._.v__.� Account Number: 4266 8413 4689 0047 New Balance $5,143.36 Previous Balance �027 28 Payment Due Date 07/19/14 Payment,Credits $0.00 Minimum Payment Due $486.00 Purchases $0.00 Late Payment Warning: If we do not recelve your minimum paymont Cash Advances $0.00 by the date listed above,you may have to pay a late fee of up to$35.00 Balance Transters and your APR's wili be subject to increase to a meximum Penalty APR $0.00 of 29,99%. Fees Charged +$35.00 Minfmum Payment Warning: If you make only the minimum paymont Interest Charged +$81.08 each period,you will pay more in interest and It wilf take you longer to New Balance ��36 pay off your balance. For example: Opening/Closing Date OS/22/14-06/22/14 Credit Limit $16,700 If you make no You will pay off the And you will end up additional charges using balance shown on paying an estimated Available Credit $0 this card and each this statement In total of.,. Cash Access Line $3,340 month you pay... about.. Available for C3�h $0 Only the minimum 1&years $11,520 Past Due Amount $319.00 payment Balance over the Credit Limit �•�o if you would like information about credit counsoling services,call 1-666-797-2885. CHASE FREEDOM: ULTIMATE REWARDS�SUMMARY Previous points balance ^ 5,599 �`M"'�–`--�`—'----_____. +1%(1 Pt)/$1 earned on all purchases p +Bonus points from Ultimate Rewards Mall p =Points currently unavailable for redemption 5,599 ACCOUNT ACTIVITY Dat�of _' ----_�_�_.___.—_---- -------._..__:�,_._._ `_..r_____._.> Transaction Merchant Name or Transaction Description $Amount FEES CHARGED 06/19 LATE FEE 35.00 TOTAL FEES FOR THIS PERIOD $35.00 INTEREST CHARGED Account Statement Sand Notice ot Bllling Errore end Cuetomer Service Inqulrles to; {��ri �, � � � �'iustomerService' SEARSCREDITCARDS �`°"� �, '��- 52d1'S(:Brd.COm • PO Box 6282,Sloux Falls,SD 67117-6282 ��, � �� sears �L,�,�,� ��_. � Account tnquiries: ��r -��;;}��x= MasterCard � 1-800-669-8488 Account Number: 5121 0720 0244 5890 Summar of Account Activi Pa menf Informafion Previous Balance $586.27 New Balance $634.09 _ _.._. .... . ._.... _ Payments _ ._ _. _... _ . . _. . . . .. _ . --- _._ __ . , ._. ... _.. _ -$0.00 _. Minimum Payment Due $174.24 Other Credits -$0,00 - - - � -- � - � - - - - - � Payment Due Date September 25,2014 .. _ Purch.ases � +$0.00 __ _ Cash Advances +$0.00 Late Payment Warning: If we do not receive your minlmum payment by the - -- --- ... _._... Fees Charged... +$35.00 date Iisted abova,you may have to pay a late fee up to$35. - - ...... _ _. _. Interest Char ed + 12.82 Minlmum Payment Warning: If you make only the minlmum payment each New Balance $634.09 period,you will psy more In interest and It wlll take you longer to pay off your baiance,For example Past Due Amount $119,42 __ If you lnake no additional;; You wUl pay'off the : And you will, Credit Llmit $2,001.00 �harges us�ng[his card balanoe shown on thls end uq payin an -- - - ;and each moMh you pay.. statement fn about . egtlmated tote9of., Availabie Credit $1,366.00 -• - • - � Onl the minlmum a ment 2 ears Cash.Advance.Limit $50,00 y P Y Y $783 _ . _ _ _...-- . ...... AVaIIable CaSII LIYTtIt $50,00 If you would Ilke Inlormailoh about credR counseling servlces,call 1-877-337-8188. __ . . ...._ . _.... Amount Oyer Credit Limit . .$0,00 _ _. .. ... __ . Statement Closing Date OS/29/2014 - -- _.. - _ _.. _. Next Statement Closing.Date _ � _09/28/2014. _ cn Days in Billing Cycle 31 � � 0 0 � TRAIVSACTIONS Trans Date Descrfption Amount ' FEES .. _,-. . .__... . _... .._..___ ..._...:. ....._.. ......._.. _. .. . ......,._...... ......._ .. . ... _._. --- - ...___._. . _ - _..._. 08/25 LATE FEE $ 35.00 .. .._ , . . . . . _. ._ __ .. __. . . ..__.. .. ......_ .. ._....... .... .. .. ...... ...._. .__._. ... .._.__... . ... ....._. TOTAL PEES FOR THlS PEHIOD $ 35.00 INTEREST CHARGED .. . . . .... _. _................. .. _ ........._.... ..._.. _ . __. .,. ......:...... . _ :.._.. . __. _....._ .._..:. ....._..._. .. ._.: 08/29 (NTEREST CHARGE ON PURCHASES $ j2.g2 _.. _ . . . . .. __ _.... -. . .......... .:. . ._._ . .... .. . .. .. ... ... - - ... ....�_... . 12.82 TOTAL INTEREST FOR THIS PERIOD Avoid having your account closed! We have a number of solutions to help you throuqh the financial difficulty you may be experfencing,but we must hear from you. » Call us today at t-866-518-9057. For the hearinq impaired, call our TDD line at 1-800-926-5818. We're available to you 7 days a week.Monday-Thursday:6:30 a.m.to 11:00 p.m.CT • Friday:6:30 a.m.to 9:00 p,m.CT • Saturday and Sunday:8:00 a.m.to 5:00 p.m.CT PLEASE SEE IMPORTANT INFORMATION oN PAQES 2 AND 4, Page 1 of 4 This Account Is Issued by Citibank,N.A. _______________y_ Please detach and relurn lower porilon wlth Your payment to insurepro�er credll_ Retaln upperporllon for your records_ y ------------------------- ------- -- ------ -------------------• ��p Your Account Number is 6121 0720 0244 5890 II IIII Illlll I�III IIIIIII)(IIIIIIIIII I I I u Payment Due Date September 2b,2014 Po eox s2es New Balance $634.09 SIOUX FALLS,SD 57117•6286 Past Due Amountt $119.42 Minimum Payment Due $174.24 Statement Enclosed " ' Amount.Enclosed �; ; , . :.. . ,. .. ...::.. ■ ,. ., tPast Due Amount ia lnoluded In Ihe Minlmum Paymenl Due, BT00472138 1 AV 0.381 VR052672 TMN 001584 2373 Please print address changes on the reverse side. Make Checks Payable to� �1��1��1�1'i'I�II��II�III��I'�"'�II�III�I�II��I�I'I'��'��'I��' SEARS CREDIT CARDS BARBARA J BEAMS PO BOX 183082 920 S 31 ST ST COLUMBUS,OH 43218-3082 CAMP HILL,PA 17011-5808 I�III�I�"III�'II�II'III�I""�I'il�'III�I'IIIIII'II'I"IIII"�II � �2100 OD17424 00634�9 00�2500 �51,2y0720D2445890 191D WEST SHORE EMS -ALS y��• DlSCOVER MasierC-ard' 205 GRANDVIEW AVE STE 211 CAMP HILL, PA 17011-1708 ON REVERSESIDE WEST SHORE EMS Phone##: (800) 367-0512 Federal Tax ID: 23-2463002 OHOLY SPIR17'HFAI.TH SYS[FAf PATIENT NAME: BARBARA BEAMS INSURANCE: HIGHMARK REJ HUMANA GOLD CHOICE-P� RJ CALL NUMBER: ,140970OA DA7E OF CALL: 06/01/2014 FROM: 1069A ALLENDALE RD To: HARRISBURG HOSPITAL I i ACCOUNT SUMMARY BARBARA BEAMS � 920 South 31st STREET TOTAL CHARGES: 1042.26 CAMP HILL, PA 17011-5808 PAYMENTS/ADJUSTMENTS: 0.00 PLEASE PAY THIS AMOUNT: 1042.26 _ DETA CH ALONG PERFORATION AND RETURN STUB WITH PAYMENT DESCRIPTION OF CHARGE QUANTITY UNIT PRICE AMOUNT ALS EMERGENCY LEVEL 1 A0999 1.0 967.62 967.62 ANGIOCATH (14-24) A0394 1.0 7.08 7.08 EKG ELECTRODES(1) A0398 14,0 1.84 25.76 EXTENSION SET 8"NEEDLELESS A0394 1.0 6.44 6.44 GAUZE PADS A0382 1.0 0.20 0.20 INF CONTROL GLOVES(PR) A0382 1.0 1.00 1.00 NITROGLYCERIN SPRAY 0.4MG A0999 2.0 15.60 31.20 OP SITE A0394 1.0 1.92 1.92 SALINE PREFILLED SYRINGE A0394 1.0 1.04 1.04 Total Charges 1042.26 DESCRIPTION OF PAYMENT RECEIPT PAYMENT DATE AMOUNT Denied by Insurance-ADVANTRA 06/24/2014 0.00 Total Credits 0.00 � PLEASE PAY TNtS AMOUfVT-INWOICE DUE UPON RECEIP7 � $1042.26 RETUFiN�D�HECK F��-$31.00 PATIENT NAME: BEAMS, BARBARA CALL NUMBER: �4097OOA AMOUNT PAID: 07/28/2014 IIViP�B�TANT IViESSAGES: THIS ACCOUNT IS PAST DUE! Send your payment now or contact our office to make payment arrangements. WEST SH�RE EMS -ALS 205 GRANDVIEW AVE STE 219 CAMP H1LL, PA 17011-1708 '�°� Questlons?Please Vlslt us online at Finai Bill Page 1 "�``4�•" O contact us 6y Jul 22, � pplelectrlc.com ��, roo- 1-800-DIAL-PPL ` • " • '. • " • a ' , (1-800-342-5775) 64590-89042 Jul 22,2014 $577,22 Pr�.�t�e.��utnniaB M-F;8am to 5pm Your Electric Usage Profile Billillg Summaiy (Billing detafls on back) Service to; Bal�nce as of Jul 1,2014 $490.00 BARBARA BEAMS Charges: 1069 ALIENDALE RD APT A Total PPL Electric Utllltles Charges $87,22 MECHANICSBURG, PA 17055 Meter:15498656 Total Charges $577,22 Amount.Due ByJul 22,2014 • _ -$577.22 Thls sectlon helps you understand your year-to-year Account Balance $577.22 i electric use by month, Meter readings are actual unless I otherwlse noted, PPL Electrlc Utilitles' price to compare for your rate Is$0,09036 per kWh, � Thls changes the 1st of Mar,Jun,Sept,and Dec, Vfslt papowerswitch.com 2o1a 2014 or www.oca.state.pa.us for supplier offers. L ;5 Your Message Center _ � eo • Budget Settlement Summary after 12 months; ,� We bllled you $1,566,22 - � as Including thls bill,you used $1,566.22 v °' 30 o'n � ¢ 15 • We have added$0,00 to thfs blll to settle your Budget � � Bllling Plan, � J F M A M J 1 A S 0 N D o Months • N1�th paperless bllling,you can recelve and pay your PPL Electric Utllltles bllls onllne.The process Is free, r � , qulck,convenient and secure,To learn more or sign up, - vlslt pplelectric.com. o �. � •� e. � Jun 2014 Z 3 2 77F Jun2013 30 212 7 78F — _ _ a� e� • e Payment Methods = Jun 28 Actual 8440 ✓� Online at; �By phone; 1-800-342-5775 Jun 26 Actual 8437 V pPlelectrlc.com or call BIIIMatrix(servlce fee applies) = at 1-800-672-2413 to pay using Visa, — 2 Days kWh Bliled 3 MasterCard,Dlscover or deblt card, _ • , ,. , „ . 6 By Mall; Correspondence should be sent to; — Jul 2013-Jun 2014 11862 � 989 � Z North 9th Street Customer Services CPC-GENN1 827 Hausman Road '— Allentown,PA 18101-1175 Allentown, PA 18104-9392 =' � Other Important information on the back of this bfll � ; Return this stub in the envelope provided w(th a check payable to PPL Electric Utilltles, N � � F� � s`g�' ry4p�� Y � ' • • � � I'PLEleciticUtllltlee M1`` Y 64590-89042 Jul 22, 2014 $577,22 Amount Enclosed; AV 01 005869 406218 28 B**5DGT I�II�'I��I��II�I�I�'lll'I'�IIII'llll�'I"'lll��ll�'��f"�') �❑�b�� •� � BARBARA BEAMS PPL ELECTRIC UTILITIES 920 S 31ST 5T 2 NORTH 9TH STREET CPC-GENN1 CAMP HILL,PA 17011-5808 ALLENTOWN, PA 18101-1175 �IIII�I��I��11'��'�'�'��III'��I��I'�I'I�il'I�'I'�I�I 1 130D�05772230000577222 6459089042 � V PO BOX 2724 COLUMBUS OH 43216-2724 __ August 28, 2014 Consumer Name: BARBARA BEAMS 855-725-5752 CBCS Account#: 24-17450432 Total Due for 1 accounts; $ 577.22 : ; : ;, Service , Client Naitie, Clien� �acount# • i Prineipa7, �nterest Fees . BaX�nce . ,.;: .- Date ' -.� .:i. , ;.t %: PP&L ELECTRIC UTILITIES #6459089042 07/O1/14 577.22 0,00 0.00 577.22 Your past due account(s) for Ehe amount shown above were placed with our office for payment. Unless you notify this office within 30 days after receiving this notice that you dispute the validity of this debt or any portion thereof, this office will assume this debt is valid. If you notify this office in writing within 30 days from receiving this notice that you dispute the validity of this debt or any portion of it, this office will obtain verification of the debt or obtain a copy of a judgment and mail you a copy of such judgment or verification. If you request of this office in writing within 30 days after receiving this nofice this office will provide you with the name and address of the original creditor, if different from the current creditor. Please send payment using the coupon below, online at www.cbcspavments.com with the access code to log in of: 9.15648203.516 or by calling us at: 855-725-5752. When you provide a check as payment, you authorize CBCS either to use information from your check to make a one- time electronic fund transfer from your account or to process the payment as a check transaction.When we use information from your check to make an electronic fund transfer, funds may be withdrawn from your account as soon as the same day we receive your payment, and you will not receive your check back from your financial institution. This communication from a debt collector is an attempt to collect a debt, and any information obtained will be used for that purpose. �ONCBCS242511 SEE REVERSE SIDE FOR IMPORTANT INFORMATION "'DETACH LOWER PORTION AND RETURN WITH PAYMENT`*" '�:i� qBCSA¢COUNTNU�WBER .,�ALANCE .. . :.. , .:....:. ._.:..�..,......:.....: . _ ...:.., .. _. ..._... . . .....,... '�"'�." C24 17450432 $577,22 PO Box 1022 Wixom MI 48393-1022 AMOUNT � CHANGE SERVICE REQUESTED PAID See reverse side to pay by credlt card� August 28,2014 CBCS PO BOX 2724 COLUMBUS OH 43216-2724 17450432-2511 368755736 �Il�iil�ili�i,illill��uui��i�ili��li�l�l�i��lului�ii��i�� - BARBARA BEAMS 920 S 31 st St Camp Hill PA 17011-5808 24D1745043200057722 Page 2 of 2 l �w:: May.18-Jun,17,2014 31 Days in Billing CydeJ Customer Service 1-800-903-3637 � C�i�7%�"d� www.capitalone.com Credit Limit; $3,200,00 Visa Platinum Acrnunt endiny in 4751 Availa6le Credit; $934.13 N NEW BALANC£ !V7[h11MUP�1 P!#YIVICr63' ��TC Cash Advance Credit LimiL• b3,2oo.00 ~ $2,265,87 �R67.04 1��I14,�D1q AvailableCreditforCashAdvances; �934.13 Prevtous 6alance Payments and Credits Fees and Interest Charged Transadions New Balance o ( r _ p � 52,168,Z3 .) — I 50.00 -{- ( E97.64 . ) } ( $0.00 � . E2,265,87 J W l / W m w � (TRANSACTIONS CONTINUED � N � TOTALS YEAR TO DATE Total Fees This Year $200.59 Total Interest This Year $212.20 V You were assessed a past due fee because your minimum payment was not received by Ihe due date,To avoid this fee in Ihe future,we recommend that you allow at least 7 � business days for your minimum payment to reach Capital Dne, 'n m N � N r P -- - ._.. _:_..._.-- ---- --- --�----.__..__.._ _ - - � , ,, . �... — ,. _�.�:� ,_.:. .,. ._. . �Debit �Teller , Automatic . Automatic , Online Online or �: Card Withdrawaf Deposit Payment Bill Pay PhoneTransfer ' �NUCOOE�R WITHORAWAIE-I � C EDITIT) G(/ � v `� I'�- DATE TRAMSACTION DESCPIPTIOM FEE S � 1��/ �� o�-he�n�- � 5 l5`a� � S ��a a 3"� f . �„ 7 1 � �� . ; ia ,� �., i IF � � ;F. Y I ��-C �%`� � J// ��v . � _ � I�� .i��ti�� iv I� � ( a7 � r1 C'.�,�c�-5�' tn7 �� 9 ';:� �� r � ��`� � a �n�,l[�n.,��e r v-�56 en n e �� 7s �5 � �;1 � � �� G-� 6 I � �� /3v i�,Y� � �'��,,�x l5� �t 5 D � � D / ;�l ' (, �PoSr}- � 1�-1 S � �� I � , C , i - �-- - --- - -- -- - -- � -- — - .__ . .. -- -- --- - - --- , I I�v � �c�:t�n bet(.e�.c w ��s� 7 5 6v � � 5 � I . S�en�;.� L�e-e G�-►,�4-, �,�' : , , � I��,�Js�� 13�� ; � �� . (,I �� . �i . ,. . . . . . I� . , .. �j . � � ._ _ ._ _�y^,_ _ ; L�ST ��'ILL A�D TESTA'��1E�T OF BARBARA.BEAMS :; I, BARBARt� BEAI�IS, of l��echanicsburg, Cumberland Co�u�ty, Peiulsyl�tania, being of so�uid and.disposuig inuid,meinoiy and understanding, do hereby m�ke,pttblish and declare tlus as and for my Last Will and Testament,hereby revolcing and makuig void any a�ld all wiils by me at any time heretofore nlade. 1. I direct that all my debts and funeral eYpenses be paid as soon as practical after my deatl�by my Execut�•iY hereinafter named. -�� I duect that all taaes that may be assessed as a cousequence of my death shall be paid , from my residuaiy estate as pai�t of the eYpenses of the adminislration of my estat.e. `1 -�� 2. All the rest,residue anci remainder of iny estate, real,�ersonal and inixed, and , �;:ji�_re�o��er rh� san:e ma..� bP �ituate, I =�i�e. cle��i�P Zn� }��;u.a;li tu :rr�,. SL�'.UGt-ITER v �� In the event KINI SLAUGHTER should predecease me, I give all the rest,residue and ,� ''� remaii�der of my estate,real,personal and mixed, aaid wheresoever tlie sauie may be situate,to ,: '�� .� BECKY RATHFON. 3. I aui not uiunindfiil of my children,KENNETH BEAMS,MARK BEAMS, 7AMIE TYSON and BRADY LEE CORNMAN. It is my express ulteiltion that none of iny children sha�-e as beneficiaries in this iny Last Will and Testament. 4. I hereby nominate,constitute aiid appoint KIIvI SLAUGHT�R as E�ect�.ti-ix under this my Last Will and Testail�ent. Ii�the event she sliould predecease nie, fail to qualify or cease to act in sucli capacit��, I nomil��te. constittite and ilp�.lQlllt B�.CK�' RATHFnN a�Fxe��tra��. nf t�� my Last Will and Testan�ent. LAW OFFICE6 - SNELBAKER I fui-ther d'u•ect that no person seiving as Eaecuhix hereunder shall be required to post & BRENNEMAN bond to sectue tlle faithfiil pei�formance of her duties in the Co�runonwealth of Pemisylvaiva or in �� •''1'',JI,,:� ji , . .'''."+r _ � ��n,•�other jw•isd.ictioii. , , ' .� , '� ; E} I� V��TI�ESS�S�EREO�',I ha�c�.t�er�iiw�tc��e:t�,�t�,{ �iau� �ui�i.s��.�l to tlzis ii;��La�t�ai.l].an� j. 1 � ; � Testainent wiltten on Tv�To (2)�ages this 7t�'da��of October,?013. , � �'i{ '�.;��a` v r' !'- � t•��`!Yl.:,�)_ ' �SE�� Bai•bara Beams i Sigiled, sealed,published and declared by BARt3ARA BEAMS,the Testatrix above nail�ed, as and for her L�st Will and Testament, iu oiu presence, who, in her presence, at her request, and in the presence of each other,have hereunto subscribed our ilames as attestuig witnesses. (I` �- �..._.�' (SEAL) '�:�3.�G��c�.,��_� �C� ,�-�a(6:.(..!_��T. - � (SEAL) -2- LAW OFFICES SNELBAKER & BRENNEMAN I I i',i.;' �;',�'°�,,:!. ' '•.i., • 'i '::.�:�rt;T.: _ �:�:�.. - i�'..s - CON�1v10NWEALTH OF PENNSYLV�NIA} . SS. COUNTY OF CUMBERLAND ) � We,BARBARA BEAMS, KEITH O. BRENNEMA.N, ESQLTIRE aud SANDRA.I�. SHOWEF�S,the Testatr�and the wihlesses,respectively,whose names are signed to the attached or foregoing instiument, being first duly s�t�orn, do hereby declare to the ttndersigned audiority that the Testatri� signed and e�ecuted the instrument as her Last Will and Testament aild that she had signed willingly, and that she etecuted it as her free and voluutaiy act for the ptu�oses therein eYpressed, and that each of the witnesses,in the presence aud hearing of the Testatrix, signed the Will as witness and that to the best of lus or her ltnowledge the TestatriY was at tl�at tiine eighteen years of age or older, of sound mind and uilder no constraint or undue inlluence, --��C�,;�z.:;�ri='�:�_ ��-'--r-..,%'h:-+'� .' Testati7Y , �-' --, j�� L-- -__ �Vicness' .,�� 't(��1u,_ � C_ ��`�-t.�..t;?�--� Witness Subscribed, sworn to and acicnowledged before me by BARBARA B�Al��S,Testatri�, and subscribed and sworn to before me by I�EITH O. BRENNEMAN,ESQUIRE and SANDRA.K, SHOWERS, witziesses,this 7t�'day of October, 2013. � „ /.?.'�.-,_ /1�--�, -;/ /,•` , jl�� _ --- �� 'r �� ,, � � - IVOtal')' 11�11C � �nw or•r-�c�e SNELBAKER � CON3P�oni�vr-�,�_rr�;;t:,��r;�r-,I!;j f.°i',�t1�.fA & PloWrial Seal o.�.-.�..�...... ,- .,�.��__�_I