HomeMy WebLinkAbout01-07-15 (2) 1,5fl561i01,fl5
REV-1500
V— 5/" 0EX02-iOTI)��jfi�
•L jj,,��jj,,jj ennstivania OFFICIAL USE ONLY
PA Department of Revenue pe Y County Code Year File Number
Bureau of Individual Taxes """�FNfY"
INHERITANCE TAX RETURN }�,�( 7... .._.. . .
Ha risb rg,PA 1 RESIDENT DECEDENT c 1 ! _ }-
Harrisburg,PA z 128-D6D1
ENTER DECEDENT INFORMATION BELOW
Death MMDDYYYY Date of Birth MMDDYYYY
Social Security Number Date of Q _... ,. _ ... _
10/08/2014 08/31/1940
Decedent's Last Name Suffix Decedent's First Name MI
Reilly .: Ann M
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's last Name Suffix 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
C$D I.Original Return 2.Supplemental Return C0 3. Remainder Return(Date of Death
Pdor to 12-13-82)
C) 4.Limited Estate C=:) 4a.Future Interest Compromise(date of C=:) S. Federal Estate Tax Return Required
death after 12-12-82)
C) 6.Decedent Died Testate 7.Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
CCa 9.Litigation Proceeds Received C ) 10. Spousal Poverty Credit(Date of Death C= 11. Election to Tax under Sec.9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
Peter J. Russo (717) 591-1755 C,
M
REGISTER tNILLS USZ-ONLY Q
Ca C:)
r,r1 Cr>
.. _ .... M I
First Line of Address
t,t i s"i
5006 E.Trindle Road '. C>
Second Line of Address „j '*1
Suite 203
_ AT{FILED r
City or Post Office State ZIP Code C)
. . . . _. .. >_ - 61 "r7
Mechanicsburg PA ,17050
Correspondent's e-mail address;prusso@pjrlaw.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 ail information of which preparer has any knowledge.
SIGNATURE S SCTES,UNSIt( E,FO IUNG RETURN DATE
ADDRESS
!`► '*'�l e a F t t` r\S f jwl
SiGNATU P THEIR THAN REPRESENTDATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 15056101,05 15056101105
J 1505610205
REV-1500 EX(FI)
Decedent's Social Security Number_
Decedent's Name: Ann McKay Reilly i
RECAPITULATION
1. Real Estate(Schedule A). ....................... ..................... 1. ; 167,000.00
2. Stocks and Bonds(Schedule B) ....................................... 2.
I
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ..... 3. ;
J
4. Mortgages and Notes Receivable(Schedule D)........................... 4.
i
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. 35,121.91
i
6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6.
__...__--_-_.________. _...__..._.__,
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property ----------
(Schedule G) O Separate Billing Requested........ 7. ' 0.00
L^_.__._..____.___.._._.._.__.._._ _.__._.J
8. Total Gross Assets(total Lines 1 through 7). ....... ..................... 8. 202,121.91
9. Funeral Expenses and Administrative Costs(Schedule H)........ ........... 9. 14,541.65
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............... 10. { 866.01
1.1. Total Deductions(total Lines 9 and 10)................................. 11. ! 15 407.66
12. Net Value of Estate(Line 8 minus Line 11).............................. 12. 186,714.25
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J) ........................ 13.
14. Net Value Subject to Tax(Line 12 minus Line 13) ... ............... ... ... 14. 186,714.25
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 -
15
__...__
16. Amount of Line 14 taxable
at lineal rate X.0 45 186,714.25 16. �- 8,402.14
17. Amount of Line 14 taxable --- '- _._......_._.......... 1..._...___. ......___ ........_.._.___..___.__..._....___._.
at sibling rate X.12 17•
1.
18. Amount of Line 14 taxable
at collateral rate X.15 18•
19. TAX DUE ................... ............................... ....... 19. 8,402.14
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT p
Side 2
1505610205 1505610205 J
r
REV-1500 EX(FI) Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
Ann McKay Reilly
STREETADDIRESS
16 Sharon Road
CITY STATE ZIP
Enola PA 17025
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 8,402.14
2. Credits/Payments
A.Prior Payments
B.Discount 420.10
Total Credits A+B (2) 420.10
3. Interest
(3)
4. If Line 2 is greater than Line I +Line 3,enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2,Line 20 to request a refund. (4)
5. If Line I+Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. 7,982.04
Make check payable to: REGISTER OF WILLS,AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred...................................................._........................_...... ❑ 0
b. retain the right to designate who shall use the property transferred or its income ............................................ ❑ N
c. retain a reversionary interest............................_.................................................................._...................._ ❑ N
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?...........................................................................................................
❑
3. Did decedent own an"in trust for or payable-upon-death bank account or security at his or her death?.............. ❑ N
4. Did decedent own an individual retirement account,annuity or other non-probate property,which
contains a beneficiary designation? ........................................................................................................................ 0 ❑
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1,1994,and before Jan.1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is 3 percent[72 P.S.§9116(a)(1.1)(i)].
For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S.§9116(a)(11)(5)].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 f72 P.S.§9116(a)(1.2)).
* The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)).
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S. §9116(a)(1.3)].A sibling is defined,
under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
REV-1502 EX+(12-12)
pennsylvania SCHEDULE A
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN REAL ESTATE
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Ann M. Reilly 2014-00976
All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property
would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts.
Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F.
Attach a copy of the settlement sheet if the property has been sold.
ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE
NUMBER OF DEATH
DESCRIPTION
I 16 Sharon Road,Enola,PA 17025 167,000.00
t
TOTAL(Also enter on line 1, Recapitulation.) $ 167,000.00
If more space is needed,use additional sheets of paper of the same size.
Cumberland County Tax Assessment Cumberland County Board of Assessment Appeals
One Courthouse Square Room 107 Lloyd W. Bucher
Carlisle; PA 17013 Albert Peterlin
(717) 240-6350 Allen Shank
Stephen D. Tiley, Assistant Solicitor
Hours: 8:00am to 4:30pm Bonnie M. Mahoney, Chief Assessor
Parcel Identifier:
09-14-0835-030.
REILLY, ANN M
16 SHARON ROAD MAILING DATE: JULY 26, 2011
ENOLA PA 17025 APPEAL DEADLINE: AUGUST 25, 2011
BOARD OF ASSESSMENT APPEALS DECISION NOTICE - THIS IS NOT A TAX BILL
This is a notice of a change to the assessed valuation or status of- this property.
REASON FOR CHANGE: 04 - APPEAL BOARD DECISION (ACCEPTED REVIEWERS CHANGE)
, The Board of Assessment Appeals has issued this decision regarding your tax assessment
appeal. You may appeal this decision to .the Court of Common Pleas by filing the
appropriate paperwork with the Prothonotary's office in accordance with local rules of
court.
FUTURE TAX BILLING BASIS EFFECTIVE: 01/01/2012 for County/Munic
07/01/2012 for School
OLD NEW
ASSESSMENT 177,900 167,000
TAX STATUS Taxable Taxable PROPERTY DESCRIPTION
C&G STATUS
Homestead Approved Munic. : 09 EAST PENNSBORO TWP
School: 5 EAST PENNSBORO SD
MARKET-BASED ASSESSMENT Control Number: 09002634
OLD NEW
Land 48,000 48,000
Improvements 129,900 119,000
TOTAL 177, 900 167,000
Property Location:
11-00% of Market Value at 2010 Base Year Rates. 16 SHARON ROAD
PENN HEIGHTS
CLEAN AND GREEN (C&G) ASSESSMENT LOT 35 PB 6 PG 28
Unit/.Lot ID: L-0035
OLD NEW Land Size: .29 acres
Land N/A N/A
Improvements N/A N/A
TOTAL N/A N/A Property Type: R
Residential(Under 10 Acres)
[Land value based on rates provided by the State.
CHANGE OF TAX BASIS - NET CHANGE Cumberland County Commissioners
Gary Eichelberger
COUNTY/MUNIC SCHOOL Rick Rovegno
Land 0 0 Barbara Cross
Improvements -10,900 -10, 900
TOTAL -10,900 -10, 900
Dennis Marion, Chief Clerk
Effects Future Billing Cycles Only
[notc_a11L) ORIGINAL
n.,• euluvw aoxoow;eagrnents Ganged for Phot.o.Recording
c" MDLAND 00'0,;4'rY- PA,
V E-
'89. FEB 24 PH Z 42
e l ure�
MADE THE owe day o 7-� in the year
of our Lord one thousand nine hundred EIGHTY-NINE (1989)
BETWEEN ROBERT J. PUSTI and MAUREEN S. PUSTI, his wife, of East Pennsboro
Township, Cumberland County, Pennsylvania, parties of the first
per,
GRANTORS
AND
EUGENE E. REILLY and ANN M. REILLY, his wife, par-ties of the
second part,
GRANTEES
of the second part, WITNESSETH, that the said part ies of the first part,for and in consider-
ation of the sum of -7----------SEVENTY TWO THOUSAND SIX HUNDRED AND 00/100----------
------------------ -------------------
0/100----------
------------------ -------------------($72,600.00)------------------------ Dollars,
lawful money of the United States of America unto Grantors well and truly
paid by the said part ies of the second part, at and before the sealing and delivery of these
presents, the receipt whereof is hereby acknowledged, have granted,
bargained,sold,aliened, enfcoffed,released, conveyed and confirmed, and by these presents
grant, bargain, sell, alien, enfeoff, release, convey and confirm unto the said part ies of the
second part, their heirs,and assigns,
ALL THAT certain piece or parcel of land situate in the Township of East Pennsboro,
Cumberland County, Pennsylvania, to wit: '
BEGINNING at a point on the north side of Sharon Road, 40 feet wide, as shown
on the hereinafter mentioned Plan of Lots at the dividing line between Lots Nos.
34 and 35 on said Plan, said point being 700 feet treasured eastwardly from Carol
Lane; thence North 3 degrees 4 minutes West along said dividing line 180 feet to
land now or lateof Bretz; thence South 85 degrees 25 minutes East along said Bretz
land and on a line parallel with Sharon Road, 70 feet to Lot No. 36 on said Plan;
thence South 3 degrees 4 minutes East along said Lot No. 36, 180 feet to the
north side of Sharon Road; thence along the north side of Sharon Road, North 85
degrees 25 minutes West 70 feet to Lot No. 34, the place of BEGINNING.
BEING Lot No. 35 in Plan of Lots known as Penn Heights, said Plan being recorded in
the Cumberland County Recorder's Office in Plan Book 6, Page 28.
HAVING thereon erected a dwelling known as 16 Sharon Road.
BEING the same premises which James L. Hileman and Melinda K. Hileman, his wife,
by their deed dated June 16, 1988, and recorded June 17, 1988, in the Office of the
Recorder of Deeds In and for Cumberland County in Deed Book K, Volume 33, Page 161,
granted and conveyed unto Robert J. Pusti and Maureen S.-PUsti, his wife.
A",
cumb.Co.,Pa.
School Dist.Curnb.Co.,Pa. .12k Real Estate Transfer Tax
o Real Estate Transfer Tax X.2-j-k Y, 3 -C 2 ' 0
-
,2- ;,.,f-�� -3 C-3 Date Amt.'-.�
Date Amt.- 4:-11-
Cumb.Co.Dist Col.Aot Dumb.Co.Dist.Col.Agt-
800K G33 PAcfi
TOGETHER with all an singular, the said property, improvements, ways, waters, coater
cow-ses, rights, liberties, privileges, hereditaments and appurtenances whatsoever thereunto be-
longing, or in anywise appertaining, and the reversions and remainders, rents, issues and profits
thereof,.and all the estate,right, title,interest,property, claim and demand whatsoever,of the said
part les of the first part, in law, equity or otherwise howsoever, of, in and to the same and
every part thereof.
TO-HAVE AND TO HOLD the said
hereditaments and premises hereby granted or mentioned,and-intended so to be,with the apprtrte-
nances,unto the said part ies of the second part, they heirs and assigns,to
and-for the only proper use and behoof of the said part ies of the second part, their
heirs and assigns forever.
AND the said grantors hereby covenant and agree that they will warra-at
GENERALLY the property hereby conveyed.
IN WITNESS WHEREOF, the said part ies of the first part have to these presents
set their hands and seal S. Dated the day and'y� 'rsta v rxtten. .
f
`;iipted,�eatcl and Rlcliberel
=-- -.... ............................. SE
in flit rc n nE .BERT J. PIJSTI -)._^"y
...... �V
J
...................... SEAL
f / .......................: MAUREEN .S... PtFSTI ��..
.__-_.,........:..................,.._........,-.._...............................f SEAL
.........................
State ofP nsyl ani }l
Countyf
'On e % day of ' 151 89 , before me,
the undersigned officer, personally appeared Robert J. Pusti and Maureen S. Pusti,
his wife
known to me (or satisfactorily proven) to be the persons whose name s are subscribed-to the
within instrument,and acknowledged that they executed same for the pzlnoses tlirizpyn
contained.
In witness whereof, i hereunto set my ha- and official e
�-', .....
...
....
..N07ARI L SEAL .... T:;.�..__
LINDA L. MCBETH, Notary Public
Camp H44•1--Beroug4r••Cumberland-•Cuurt2y f':
My Commis Title ap � e
,,.I.
State of
SSS.
County] of
On this, the day of 19 before me;
the undersigned officer, personally appeared
known tome (or satisfactorily proven) to be the person whose,name sabseribed to the.
within instrument,and acknowledged that executed same for the puilmses therein
contained.
In witness whereof,1 hereunto set my hand and official seat.
9$A��
....................................................................................... L
.......................................................................................
Title, of Off+cr-r.
do hereby certify that the. precise residence road complete list office address
of the within named grantee is /� �,'h c,4. `��i r� �t t�.. � PQ '/ 7 6 a_'
ttt CC
.4ttornt:7/for.... .................................
ao09�,�33 r g4;1.6
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/ -----•-----•-
�o Bvp spy uo QQQ O0Q21
------------- --
ss j VIrll'VAYASNTN d`, O I 2NIONNOO
ib
REV-i5o8 EX+(08-12)
pennsytvania SCHEDULE
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS &MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Ann M. Reilly 2014-00976
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. 1999 Buick 3,700.00
2. Members 1st Savings Account 5.80
3, Members 1st Investment Savings Account 18,339.96
4. Members 1st Checking Account 3,371.77
5. Susquehanna Bank 2,908.75
6, Jewlery 517.63
7. Coins 1,173.00
8. Clothing 400.00
9. Furntiure 4,705.00
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
TOTAL(Also enter on Line 5, Recapitulation) $ 35,121.91
If more space is needed, use additional sheets of paper of the same size.
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MEMBERS 11t
FEDERAL CREDIT UNION
REGULAR SAVINGS ACCOUNT:
Account Number/Suffix 361448-00
Date Account Established 07/08/2009
Principal Balance at Date of Death $5.80
Accrued Interest to Date of Death $0.00
Total Principal and Accrued Interest $5.80
Name of Joint Owner None
INVESTMENT SAVINGS ACCOUNT:
Account Number/Suffix 361448-05
Date Account Established 03/24/2011
Principal Balance at Date of Death $18,339.61
Accrued Interest to Date of Death $0.35
Total Principal and Accrued Interest $18,339.96
Name of Joint Owner None
CHECKING ACCOUNT:
Account Number/Suffix 361448-11
Date Account Established 02/24/2011
Principal Balance at Date of Death $3,371.73
Accrued Interest to Date of Death $0.04
Total Principal and Accrued Interest $3,371.77
Name of Jdint Owner None
MEMBERS 1sT FEDERAL CREDIT UNION
Tessa L Klugh
Lending Insurance Support Specialist
October 24, 2014
Estate of: ANN M REILLY
Date of Death: 10/08/2014
Social Security Number:
5000 Louise Drive P.O. Box 40 Mechanicsburg,Pennsylvania 17055 (800) 283-2328 www.memberslst.org
Susquehanna
November 3,2014 Susgquehanna Bancshares,Inc.
26 North Cedar Street
P.O. Box 1000
Lititz,PA 17543-7000
Tel 1.800.311.3182
PETER J RUSSO Fax 717.625.4478
ATTORNEYS AT LAW
5006 EAST TRINDLE ROAD, SUITE 203
MECHANICSBURG PA 17050
RE: Ann M Reilly Estate
DOD: October 8,2014
SS#:
Tracking# 390984
To Whom It May Concern:
In response to your letter of October 14, 2014,here is the above customer account information
as of October 8, 2014.
Account#1 Account#2 Account#3
• Account Title: Ann M Reilly
• Account Type/# Checking 10005387401
• Date Opened/Maturity 7/24/2008
• Interest Rate: 0.05%
• Account Balance*: $2,908.75
• Accrued Interest: $0.09
• YTD Interest: $0.93
*Account balance does not include accrued interest.
® There is no safe deposit box in the name of the decedent.
❑ There is a safe deposit box# 0 in the name of the decedent located at the branch name.
If I can be of further assistance, please feel free to call.
Dawn M Berrier
Susquehanna Bank
Deposit Research Department Lead
1-717-625-6546
DMBlkmc
4
- PRECIOUS METALS:DEALER TRANSACT':
Alf-,dealers In precious metals in 'CurnberlandCourity most acciil =`
comleting this form. Bylaw, the dealer is,.requfre�,# o.;maintain this record.for a period of one (1).year,
and-to forward a -copy of this record to.th -Cumberland County District Attomey's•Office, Criminal.
Investigation Division to'fax number 7.17-240-7-763, by the:01Qse of business of the-next working-day after
the day of the transaction. Each.item purchased must be retained in unaltered condition for five (6)full •
working days-afterthe report has been filed. If seller is a minor(under 98 years of age), written acrthority
by parent or guardian:must be attached to andmaintained:with,this record.
I: 'LICENSEE.INFORMATION r,,+
'- •' - --1 --.._...__NAME �J !2:.� �� �� a -�,F - ��L _.� _ . ._. -- _
ADDRESS: 11M' MMM AM 3' J1JL
LICENSE� L f .
II. TRANSAC71ON INFORMATION
DATE$'TIME OF TRANSACTION:
SELLER_ S NAME <7e-F F 4�
� ),(qF��
SELLERS ADDRESS: '� Lo �• fig 1I A=/63
(C%r1Staf MP)
SELLER'S PERSONAL DATA--M'
ATA G � . '1:5__11a6 13
.(Sex (Race) (Age) (Date of Bim)
Di `S LICEN§E-*-2 j)k5
(Number) • (State) (Phofn Yes No)
OTHER IDENTIFICATION(Necessary if no driver's r[cense) .
-- 9. Type:
2 Type: Number.
Quantify Description of Pnedous ldentifying.Marks. Appro�amate Mefaft Jewefs,Stones or Gross Dearer
Metals or Ge�ms/ Mono Etc Composition Glass Cdmp Weiht Price
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Reilly Inventory
Ann M Reilly Estate - Inventory -
I' Clothing $ 480,00
2' Patio Furniture 100.00
3. Porch Furniture 75,00 �
4' Master Bedroom,
o' Bed 100.08
b' Night tables (2) 20.80
C. [hairs (2) 10.00
d, Desks /2\ 80.80
' e' Dressers (2) 150.00 '
f' TV 60.00
g' Lamps /3l I5.00
h, TV stand 10.00
i' Cedar chest 40'80
-' /\rmoir 85.08
' k' Phones, (2) _18.00_ 580.00
S' Guest Room
a' Bed 100.00
b. Dressers (2) 90.00
c' Side table _10-00_ 200.08
6' Bathroom miscellaneous 45^00
7' Dining Room - Table/6 chairs 680^80
8' Living Room '
a. [ouch 175.08
b. Recliner 75.00
c, Tables /4\ 40.80
' d. Rocking [hair 25.88
e. Stereo w/s1and 40.00
`
f' Radio .15,00
Q, China Hutch 500.00
M, Area Rugs 15.00
i. TV w/stand 65.00
'. Vacumn clebner (2) _75.00_ 1025'08
9' Pictures/paintings - all 75'00
18' Curtains/drapery - all 15'00
11. 'Kitchen
a. Utensils 15.08
Page 1
'
'
. .
Reilly Inventory
b' Microwave 58.00
c' Toaster Oven 5.00
d' Cutlery sets (2) 40.00
e' Wicker baskets /81 20'80
f. Glassware 15,00
g' Plates 68.00
h' Pots/pans 70.00
i' [0ffeemaker 10'00
-. Step stool _10.00_ 295.80
12' Laundry Room
a*. TV trays 25.00
b' Washer/dryer 300.00 .
c' Cleaning supplies _10.00_ 335'00
13' Family Room
a. Dehumidf«er 10.80
b. Bookshelf 48.08
c^ Folding Tables 15.08
d' Candle holders (2) 10.00
e. [ouch (2) 175'00
f, [hairs (2) 15'00
g' Round table 28.00
h. Stereos (2) 70.00
i' Box fon 5'00
-. TV w/stand 45'80
k. Table _15'00_ 420'00
14' Basement
a' Chairs (3) 15.00
b. Xmas decorations 75.00
(
` c. Shelf Unit 50.80
d. Floor htrs 40.80
e. Step Ladder 28.08
f' Refrigerator I80.00
g. Humidifner _I5-00_ 315'00
'
lS. Vasds (3) Lamps (8) 100'00
16' Garage
a. Elect Cords 20'00
b. Shovels 10'00 `
c. Ladder (2) 35'00
d. Toolbox 80'00
e. Lawn equip 55'00
f. Charcoal Grill 60.00
g. Gas can /31 10.00
h. Wet Vac 50.00
Page 2
Reilly Inventory
i. Camp chairs 20.00
j. Fishing rods 30.00
k. Step stool 5.00 375.00
17. Riding Lawn Mower 150.00
TOTAL INVENTORY VALUE $5105.00
t
Page 3
1
REV-1510 EX+(08-09)
pennsylvania SCHEDULE G
DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND
INHERRESIDENT
DE EDENTAX TURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Ann M. Reilly 2014-0096
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
ITEM DESCRIPTION OF PROPERTY
INCLUDE THE NAME OF THE TRANSFEREE,THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER.ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
I. Delware Life-23883332
4,311.93 100 0.00
2 EquiTrust-EQ0001075096F 116,231.83 100
TOTAL(Also enter on Line 7, Recapitulation) $ 0.00
If more space is needed, use additional sheets of paper of the same size.
EM
Q _E L iii W A.R E P.O.Box 9133
Wellesley Hills,MA 02481-9133
Tel: 800-752-7216
Fax: 781-304-5383
November 12,..2014
Law Offices of Peter J. Russo PC
Attorneys At Law
5006 E. Trindle Rd. Suite 203
Mechanicsburg, PA 17050
Re: Contract Value:
Contract number: KA13055928-1
Owner(s): Reilly, Ann M.
Our reference number: 23883332
Dear Ms. Bullen:
Thank you for writing to us about this Delaware Life annuity.
The contract value you requested is below:
Value below is provided as of October 8, 2014
Contract value $4311.93
If you have any questions, please call our Customer Service Center at 800-752-7216.
Sincerely,
Life Claims Center of Excellence- Annuities
Delaware Life Insurance Company is authorized to transact business in all states except New York,as well as in the District of
Columbia,Puerto Rico,and the U.S.Virgin Islands. Delaware Life Insurance Company of New York is authorized to transact
business in New York and Rhode Island. Both companies are members of the Delaware Life group of companies. Each company
is responsible for its own financial condition and contractual obligations.
Fill E uiTrList
Life Insurance Company
October 24, 2014
Law Offices of Peter J Russo P.C.
Attn: Tara E Bullen, Legal Secretary
5006 East Trindle Road Suite 203
Mechanicsburg PA 17050
Owner: Ann M Reilly, Deceased
Contract Number: EQ0001075096F
Ms Bullen,
This letter is being sent to you per the authorization of Robert H McIver, who is the Executor
for the Estate of Ann M Reilly. You have requested we forward the value of Mrs Reilly's
EquiTrust Life Insurance Annuity contract as of October 8, 2014, which was her date of death.
The value of contract EQ0001075096F as of October 8, 2014 was $116,231.83.
This contract is solely owned by Mrs Ann M Reilly, Deceased and is the only contract owned
by Mrs Reilly at EquiTrust.
Sincerely,
1
John Cavins
Sr Customer Service Representative
Annuity Services
EquiTrust Life Insurance Company•PO Box 14500•Des Moines, Iowa 50306-3500•866/598-3692
R@V-1511 E;+ (08-13)
QA, � ,
pennsytvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Ann M. Reilly 2014-00976
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
Lodging-Funeral 979.82
2 Food-Funeral 306.37
3. Musselman Funeral Home and Creamfion Services 3,823.18
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions: 3,500.00
Name(s)of Personal Representative(s) Robert McIver
Street Address
City State ZIP
Year(s) Commission Paid:
Z. Attorney Fees: Law Offices of Peter J.Russo(estimate) 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
Relationship of Claimant to Decedent
4. Probate Fees: 932.28
5. Accountant Fees:
6. Tax Return Preparer Fees:
7.
TOTAL(Also enter on Line 9, Recapitulation) $ 14,541.65
If more space is needed,use additional sheets of paper of the same size.
DISCOVER. Discover More Card
Account number ending in 6188
Open Date:Sep 27,2014-Close Date:Oct 26,2014
Page 3 of 6
CONTACT US
R Web Mobile Phone Inquiry Mail Payments
Access your 0 Manage your 1-800-DISCOVER Discover Discover
account securely account anytime, (1-800-347-2683) PO Box 30943 PO Box 6103
at Discover.com anywhere at TDD 1-800-347-7449 Salt Lake City Carol Stream
m.Discover.com UT 84130 IL 60197-6103 J
Transactions
Trans.Date Post Date
Payments and Credits Oct 12 Oct 12 PAYMENT-THANK YOU $ -337.00
Restaurants Oct 10 Oct 10 HOSS'S-ENOLA ENOLA PA $ DOO
Oct 13 Oct 13 PROGRESS GRILL,INC HARRISBURG PA
Gasoline Oct 13 Oct 13 TURKEY HILL#280 ENOLA PA S 46.01
Travel/Entertainment Oct 22 Oct 22 MET OPERA 212-799-3100 NY $ 805.00
010526615
Services Oct 9 Oct 9 LAW OFFICES OF PETER J MECHANICSBURGPA $ 25E
Fees TOTAL FEES FOR THIS PERIOD $ 0.00
Interest Charged TOTAL INTEREST FOR THIS PERIOD $ 0.00
2014 Totals Year-to-Date
TOTAL FEES CHARGED IN 2014 $ 0.00
TOTAL INTEREST CHARGED IN'2014 $ 33.93
Interest Charge Calculation
Your Annual Percentage Rate(APR)is the annual interest rate on your account.
Current Billing Period:30 days
ANNUAL PERCENTAGE RATE BALANCE SUBJECT TO
TYPE OF BALANCE (APR) INTEREST RATE INTEREST CHARGE
Purchases 12.99% V $0.00 $0.00
Cash Advances 23.99% V $0.00 $0.00
V=Variable Rate
Information For You
For more information about how interest charges are calculated see your Cardmember Agreement or go to www.discover.com/interestcharges
NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION
MOV
DISC �IER` Discovero More® Card
Account number ending in 9311
Open Date:Oct 3,2014-Close Date: Nov 2,2014
Page 3 of 6
CONTACT US0 _
Web Mobile Phone Inquiry Mail Payments
Access your Manage your 1-800-DISCOVER ® Discover ® Discover
account securely account anytime, (1-800-347-2683) PO Box 30943 PO Box 6103
at Discover.com anywhere at TDD 1-800-347-7449 Salt Lake City Carol Stream
m.Discover.com UT 84130 IL 60197-6103
Transactions
Trans.Date Post Date
Payments and Credits Oct 13 Oct 14 QUALITY INN RIVERVIEW ENOLA PA $ -298.94
000836
Oct 19 Oct 19 PAYMENT-THANK YOU -73.42
Merchandise Oct 7 Oct 7 AMAZON MKTPLACE PMTS AMZN.COM/BILLWA $ V 78.85
Q8TFYXDR2ES -
Oct 11 Oct 11 GAN*DEM CHRONICLE-C 800-790-9565 NY
o- � 29.09
00.18650172ODC2886861
Nov 1 Nov I AMAZON SERVICES-KINDLE 866-321-8851 WA ��Jy 14.82-
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Travel/Entertainment Oct 10 Oct 10 QUALITY INN RIVERVIEW ENOLA PA _D �"► ? $ is �., 142.9
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Oct 11 Oct 11 QUALITY INN RIVERVIEW ENOLA PA K 248.52
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Oct 11 Oct 11 QUALITY INN RIVERVIEW ENOLA PA
01167R ff__
�ct Oct 12 Oct 12 QUALITY INN RIVERVIEW ENOLA PA YJ 138.54
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–tea` I Oct 13 Oct 13 QUALITY INN RIVERVIEW ENOLA PA � `r'' 285.84 ✓
It 1 0131OR
Oct 13 Oct 13 QUALITY INN RIVERVIEW ENOLA PA 298.94 --
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Services Oct 16 Oct 16 ENVIRONMENT AMERICA BOSTON MA $ 25.00
Oct 23 Oct 23 ACTBLUE'DONATETODEMS 617-517-7600 MA 10.00
ACTBLUE'DONATETODEMS
Fees TOTAL FEES FOR THIS PERIOD $ 0.00
Interest Charged TOTAL INTEREST FOR THIS PERIOD $ 0.00
2014 Totals Year-to-Date
TOTAL FEES CHARGED IN 2014 $ 0.00
TOTAL INTEREST CHARGED IN 2014 0.00
Interest Charge Calculation
Your Annual Percentage Rate(APR)is the annual interest rate on your account.
Current Billing Period:31 days
ANNUAL PERCENTAGE RATE BALANCE SUBJECT TO
TYPE OF BALANCE (APR) INTEREST RATE INTEREST CHARGE
Purchases 18.24% V $0.00 $0.00
NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION
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RECEIPT FOR PAYMENT
LISA M. GRAYSON, ESQ. Receipt Date: 10/14/2014
Cumberland County - Register Of Wills Receipt Time: 09 .42 :22
One Courthouse Square Receipt No. : 1079411
Carlisle, PA 17613
REILLY ANN *M
Estate File No. : 2014-00976
Paid By Remarks : PETER J RUSSO PC
DMB
------------------------ Receipt Distribution ----------------- -------
Fee/Tax Description Payment Amount Payee Name
PETITION LTRS TEST 510 . 00 CUMBERLAND COUNTY GENERAL FUN
WILL 15 . 00 CUMBERLAND COUNTY GENERAL FUN
SHORT CERTIFICATE 50 . 00 CUMBERLAND COUNTY GENERAL FUN
INVENTORY 15 . 00 CUMBERLAND COUNTY GENERAL FUN
INH TAX RETURN 15 . 00 CUMBERLAND COUNTY GENERAL FUN
JCS FEE 35 . 50 BUREAU OF RECEIPTS & CNTR M.D
AUTOMATION FEE 5 . 00 CUMBERLAND COUNTY GENERAL FUN
----------------
Check# 006147 $645 . 50
Total Received. . . . . . . . . $645 . 50
e � PETER J.RUSSO,ESQUIRE AD NUMBER PAGE NO.
_____—____�_-------._....._....____.---_
www.cumbertink.com 5006 EAST TRINDLE ROAD 435530 1-of1
SUITE 203 ----_---- ------SA--LESP-.�_..^SO
ERN—
MECHANICSBURG,PA 17050-4327 BILL DATE
CARIE siirEnuBURG PERPYCOMMY 717-591-1755 11/28/14 heckb
START DATE STOP DATE
.___._.._.._.....----...._._..__.__.__
11/14/14 11128114
_ AD NUMBER �( `AD DESCRIPTION CLASS LINES
435530 EXECUTOR'S NOTICE LETTERS OF ADMIN_ _-- 10 PUBLIC NOTICES— 38 ' 2 cols
Publication Insertions Rate Net Amount Gross Amount
3 THE SENTINEL-LEGAL 3 LGL $201.78
TOTAL AD CHARGE $201.78
3 MOBILE SITE MOB2 $3.00
3 PROOF OF PUBLICATION 01 PRF $7.00
1
i Purchase Order Est.A. Reilly PAY THIS AMOUNT $211.78 $254.14'
*AFTER 12/23114
LeeEnterprises no longer accepts credit card payments senf via e-mail.
Emails containing credit card numbers will be blocked. Please use the coupon
below to send credit card payment to our lockbox. THE SENTINEL
You may also send the coupon to a secure fax at 319-291-4014, THE
c/o LEE NEWSPAPERS
? Thank you for advertising with The Sentinel! Deadline for PO BOX 540
j in-column legal ads is 4:00 p.m. two business days prior to WATERLOO IA 50704-0540
II date Of insertion. For questions,call{717}240-7130.
j
}
Return this portion with your payment Legal
' �_ Check# Credit Card Ad Number 435530
1 THE SENTINEL - - --
c/o LEE NEWSPAPERS [ X � g .... ................1.2_____
..�
j vw j,� t '- Billing Date 11128114
PO BOX 540
WATERLOO IA 50704-0540 Acct#:
� Amount Due'$ 211,78
Ev,Date:LJ__1moan,
Name on credit card f$
1 Enclosed _�
S
Signature _...-.__..._.__...............-------.._............__.:. ---.._._.__._._...
Please make checks payable to: THE SENTINEL
t
000189 THE SENTINEL
UVE PETER J.RUSSO,ESQUIRE clo LEE NEWSPAPERS
5006 EAST TRINDLE ROAD PO BOX 742548
SUITE 203 CINCINNATI OH 45274-2548 F
MECHANICSBURG,PA 170504327 1, ,r�[�e�irrrE�rr�r�er�rr�e�r�t�se�rr� r:�te�erl�rr�rlrr�l�
21540200000004355300000000000000002541400000211782
i
Musselman Funeral Home and Cremation Services
Brian C. Musselman F.D., Supervisor
Clifford D. Forester Sr. F.D. General Manager
Ryan C. Pellman Funeral Director
Amy J. Keefer Funeral Intern
Phone#717-763-7440 "Honored To Serve" Fax#717-730-9798
Dr.Robert H.McIver
240 Killarney Drive
Rochester,NY 14616
Dear Robert,
Thank you for selecting our funeral home to provide services for your family during your time of bereavement. I hope that you found
our services,so far,to be of the highest standards that we always try to achieve. The following is a summary of the service charges as
previously explained and provided in written form on the services for:
ANN MCKAY REILLY
$Inc.
Total Funeral Service Selected
Use of Facilities&Staff for Memorial Service at Funeral Home $Inc.
Transfer of Remains to Funeral Home $Inc.
Acknowledgement Cards $Inc.
Register Book $Inc.
Memorial Folders $Inc.
SPECIAL SERVICES
Cremation Package D $3475
TOTAL SPECIAL CHARGES $3,475.00
CASH ADVANCES
Certified Copies of Death Certificate $60.00
Newspaper Notice Harrisburg Patriot $ 168.19
Flowers-Um Spray $ 119.99
CASH ADVANCE TOTAL $348.18
TOTAL OF SERVICES $3,823.18
BALANCE DUE $3,823.18
If there are any questions or concerns that remain unanswered,please call me.
Sincerely,
302 Wt"MeJ flue .
�e"��Oe , R, l 70 (3
REV-1512 EX+(12-12)
` pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Ann M. Reilly 2014-00976
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. Comcast 306.72
2 American Water 196.38
3 PPL 221.34
4 East Pennsboro Township 141.57
5
6
7
8
9
10-
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
TOTAL(Also enter on Line 10, Recapitulation) $ 866.01
If more space is needed,insert additional sheets of the same size.
po Icast Account Number 09547190810-01-5
Billing Date 10/14/14
Total Amount Due $150.36
Payment Due by 11/07/14
Page 1 of 3
Contact us: www.comcast.com :,z"' 1-888-931-1379
AKIN IZEILLY ���:�.�i���_s°`if"t�.�o��t`��{�s�i��;i{i�ssi
Previous Balance 150.30
For service at: Payment- 09/29/14-thank you -150.30
16 SHARON RD
ENOLA PA 17025-1823 New Charges -see below 150.36
Total Amount Due $.150,36
News from Comcast Payment Due by 11/07/14
Questions? Call 1-800-XFINITY(1-800-934-6489)
- - -
�y-
`
-
Thank you for your prompt payment. l �'i XFINITY Bundled Services 109.99
p,
Ifou have an American Express Card, use it to enroll in �� Additional XFINITY TV Services 19,90
Y p �,,=.
AutoPay.You can also enroll in Comcast's Ecobill process o
today to say goodbye to checks,stamps,envelopes,and even Additional XFINITY Internet Services 0.00
your paper bill. Learn how at www.comcast.com/myaccount. 6y) Additional XFINITY Voice Services 8.00
Hearing/Speech Impaired Call 711
Other Charges:& Credits 5.18
Taxes, Surcharges & Fees 7.29
Total New Charges $150.36
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Detach and enclose this coupon with your payment. Please write your account number on your check or money order.Do not send cash.
=;' Account Number 09547 190810-01-5
dco cast
Payment Due by 11/07/14
PO BOX 985
TOLEDO OH 43697-0985 Total Amount Due $150.36
AV 01 010450 95686B 39 A**5DGT Amount Enclosed $
III,I„�IIIII,III,I,VIIItill IILII'111II,I1IIII'lll'IIIIIII,IIII,I Make checks payable to Comcast
ANN REILLY
16 SHARON RD
ENOLA PA 17025-1823 III'�I�II�"II�'II"IIIII��IIII�I'I'I'1�1'I!1'IIII�I'I'I�I,�I�I11
COl'ICAST CABLE
P 0 BOX 3005
SOUTHEASTERN PA 19398-3005
09547 190810 01 5 8 015036
PENNSYLVANIA . 00010242100352092110000000000009450019
'W-AvtERICAN WATER - 1024-210035209211
PO Box 371412,Pittsburgh,Pa.15250.7412 December 8, 2014
For Service To:16 SHARON RD B - $94.50
Check this box for address changes and •, . - 9 e. $95.92 after 12/8/14
note new address on back.
Amount Enclosed
ANN M. REILLY
c/o EXECUTOR-ROBERT MCIVER PENNSYLVANIA AMERICAN WATER
240 KILLARNEY DR PO BOX 371412
ROCHESTER, NY 14616-2431 PITTSBURGH, PA. 15250-7412
IIIIIIIIIIIIIIIIIII IIII IIIIIIIIIIIII0111 IIIII�IIII01111111111111111111111111111111111111111111111111111111111111111110111111111111110111111
......................................................Please tear along the dotted line and return this portion withyour payment:
..................... --
BILLING PERIOD AND METER READINGS BILLING SUMMARY
• Billing date:November 14,2014 For Service To: 16 SHARON RD
• Due Date:December 8,2014 For Account 1024-210035209211
• Billing period:Oct 14 to Nov 13(31 Days) Prior Balance
• Next reading on or about:Dec 11,2014 Balance from last bill 38.49
• Customer Type:Residential Payments as of Nov5.Thank you! -38.49
• Meter Reading Measurement: Balance Forward 0.00
1 unit=100 gallons of water . Current Water Service
• Billing Measurement: 100 gallons(CGL) . Water Service Charge 15.00
Meter No. N091723004 • Water Usage Charge($1.02140000 x 20.00) 20.43
Size of meter 5/8° • Total Water Service Related Charges 35.43
Current Read 383 (Actual) Other Charges
Previous Read 363 (Actual) Water Late Payment Charge 0.58
Total water used this 20 units Total Other Charges 0.58
billing period 1 (2,000gallons) Adjustments
Total Water Use Comparison(in 100 gallons) .Return Payment Fee 20.00
Return Payment 38.49
• Current billing period 2014: 20.00 CGL . Total Adjustments 58.49
• Same billing period 2013: 11.00 CGL TOTAL CURRENT-CHARGES 94.50
Billed Use Graph(100 gallons)
25 TOTAL AMOUNT DUE y $94.50
zo a.d
1s Pay your bill online:www.water.paymybill.com f
Q) Pay by phone:24-hours a day,every day at 1-866.271-5522 Va�/�
10 f Pay in person:Residential customers may obtain a listing of
5 payment locations by visiting www.amwater.com/myh2o
IN I Iwo ® Pay by mail:Remit your payment to the address shown above
2 N D 1 F M A M 1 1 A S 0 N 2
0 o e a e a p a u u u e c o 0
3 v c n b r r y n I g p t v g
Important messages from Pennsylvania American Water
• Have you recently changed your primary phone number?If you have,please update your account information online using My H2O Online
at www.amwater.com%myh2o or call us at the number below so that we can update our records.
• Approximately 4.44 percent,or$4.20,of state taxes are included in your current bill.
• Any portion of the water charges which is not paid as of 12/08/2014 will be subject to a 1.50%penalty.
• Save time.Save money.Sign up for paperless billing and pay your bill online!It's a convenient,secure and environmentally friendly way to
receive and pay your bill.To get started,log on to www.amwater.com/myh2o:
Questions about this bill?Call our 24-Hour Customer Service Center: 1-800-565-7292 www.pennsylvaniaamwater.com
630000492447
n a L'.- d b U-4 v a c- u n-• .. a x-a u—.--u
' 1024-210035209211
PO Box 371412,Pittsburgh,Pa.15250-7412 . November 5, 2014
For Service To:16 SHARON RD $38.49
® Check this box for address changes and a• v o $39.07 after 11/5/14
note new address on back.
Amount Enclosed
Paid elecfronlcally Tharikyou,
1111111°Itrnalnlr'il'III'it'IL.1111'lllL..11n.11aa.11a.11,
003089 1 AV 0.37E 0309010030891003162 14 01 ACS7Cw 002
Ilaa 1111 Il I ll I � I i 11191nlilllllal as III II l I
ANN M. REILLY PENNSYLVANIA AMERICAN WATER
16 SHARON RD PO BOX 371412
ENOLA, PA 17025-1823 PITTSBURGH, PA. 15250-7412
IIIQI II II III II II IIII Illll�lll illi 11111 I I Ili ll�l l 11 l l it l 111 l 11�l 111 1111 I!III I III VIII I I I ID!I li!II VIII IIIIIIII!I III!I III Ill l lilll 1111 I II VIII III IIII
Please tear along dotted line and.return this Portion with your_payment:....._............................................._........................................-...._.__............_............
BILLING PERIOD AND METER READINGS BILLING SUMMARY
Billing date:October 14,2014 For Service To: 16 SHARON RD
• Due Date:November 5,2014 For Account 1024-210035209211
• Billing period:Sep 13 to Oct 13(31 Days) Prior Balance
Next reading on or about:Nov 13,2014 • Balance from last bill 35.43
Customer Type: Residential Payments as of Oct7.Thank you! -35.43
• Meter Reading Measurement: Balance Forward 0.00
1 unit=100 gallons of water
• Billing Measurement: 100 gallons(CGL) Current Water Service
Water Service Charge 15.00
Meter No. N091723004 Water Usage Charge($1.02140000 x 23.00) 23.49
Size of meter 5/8" Total Water Service Related Charges 38.49
Current Read 363(Actual) TOTAL CURRENT CHARGES 38.49
Previous Read 340(Actual) )
Total water used this 23 units TOTAL AMOUNT DUE $38.49
billing period (2,300 gallons)
Total Water Use Comparison(in 100 gallons) (! Pay your bill online:www.water.paymybill.com
• Current billing period 2014: 23.00 CGL 0) Pay by phone:24-hours a day;every day at 1-866-271-5522
• Same billing period 2013: 11.00 CGL Pay in person:Residential customers may obtain a listing of
payment locations by visiting www.amwater.com/myh2o
Billed Use Graph(100 gallons) ?_I
25 Pay by mail:Remit your payment to the address shown above
20 In
15 J
10 } 5
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5
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2 0 N D J F M A M J 1 A S 0 2
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Important messages from Pennsylvania American Water
• Have you recently changed your primary phone number?If you have, please update your account information online using My H2O Online
at www.amwater.corn/myh2o or call us at the number below so that we can update our records.
Approximately 4.44 percent,or$ 1.71,of state taxes are included in your current bill.
Any portion of the water charges which is not paid as of 11/05/2014 will be subject to a 1.50%penalty.
Questions about this bill?Call our 24-Hour Customer Service Center:1-800-565-7292 www.pennsylvaniaamwater.com
602500832459
0030901003162ACS7CW ETM1C001 2 (ACS7CW 0030900107200)
.PPL Electric Utilities
827 Hausman Road `,•.:�:.'.'
Allentown, PA 18104-9392
Tel. 800.342.5775 Fax 484.634.3484 "`-
www.pplelectric.com P
ANN REILLY
16 SHARON RD
ENOLA, PA 17025
October 22, 2014
Bill Account Number: 45370-72007
Dear Ann Reilly:
We removed your account from our Automatic Bill Payment(ABP)Plan on 10/22/2014 either by
your request or because of an issue with your participation on this plan.
Because of this removal,your current balance due WILL NOT be automatically withdrawn from
your bank account. You will now need to make payments through an online account,which you
can create at www.pplelectric.com, or by mail to the following address:
PPL Electric Utilities
Cash Processing Center- GENN1
Two N 9th Street (,�`� C��
Allentown, PA 18101 (e,C-l l c
If you cannot pay$115.51 by 11/07/2014,please call us at 1-800-342-5775,Monday through
Friday,between 8 a.m. and 5 p.m. to make other arrangements.
Sincerely,
PPL Electric Utilities
Remove from EFT
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REV-1513 EX+(01-10)
pennsytvania SCHEDULEJ
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Estate of James E. Kauffman 21-14-0503
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS[Include outright spousal distributions and transfers under
Sec.9116(a)(1.2).]
1. Sharon A.Reilly Step-Daughter $5000
2. Cherie L.Hayclon Daughter 25%
3. Leslie A.Charles Daughter 35%
4. Jeffrey E.Thomas Son 35%
5. Jessica J.Charles Granddaughter 5%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $
If more space is needed,use additional sheets of paper of the same size.