HomeMy WebLinkAbout01-20-15 (3) � 1505610140
REV-1500 �` �°,_,°,
PA Department of Revenue OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
Po Box 2eoso� INHERITANCE TAX RETURN 2 1 1 3 0 ? 0 0
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
0 6 0 4 2 0 1 3 1 0 3 1 1 9 3 8
DecedenYs Last Name Suffix DecedenYs First Name MI
S W A R T Z M A R Y L
(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 Ai�PRO��CIATe�VF►L5 BELOW
� 1.Original Retum � 2.Supplemental Return � 3.Remainder Return(date of death
pr�cr to 12-13-32j
� 4.Limited Estate � 4a.Future Interest Compromise(date of � 5.Federal Estate Tax Return Required
deatn afEer 12-1�-62j
QX 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)
Q 9.Litigdtion Praceeas Received U i 0.Spousai rov�rty�redit(daie of deatn � �i 1.Eieciion to iax under Sec.91 i 3��j
between 12-31-91 and 1-1-95) (Attach Sch.O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD�DIRECTED�O:
Name �aytime Tel�ion�e Numbe� � �
M A T T H E W A . M c K N I G H T 7 1 7 ��4 9 � 3 '-� '�;
r� -� c� r,� .�
�:�
REGIST R G� I�.j1.S U NLIl' i �,'.�
,.� ��
...... . , .. ..J
First line of address ' `=�� c�r � ' ,-�
:� �.�,� _r�
I R W I N 8 M c K N I G H T , P • C • ., ' :.�,� rv ��== '
�_.{ r—
Second line of address rv �
.�m �
6 0 W E S T P 0 M F R E T S T R E E T
Cl;y 0:P�st Office StB:@ Z:P Code DATE FILED
' C A R L I S L E P A 1 7 0 1 3
CorrespondenYs e-mail address:
Under penalties of pery'ury,I deciare that I have examined this retum,including accompanying schedules and statements,and to the best of my knowledge and belief,
it�s true,��� ct snd ccmFiate.�e 'araUor ; reparar�,her�han u�e perscnai�2pre�enta5va is�asa�cn ali irforrnatic��f.vhict�p�zpare�Fsa�a�y k��awic-dge.
SIGNA P N R NSI FI I RE URN ATE/�
ADD ESS
1191 No MIDDLETOh RD CARLISLE PA 170y3
SIGNAT RE PARER OTHER THAN REPRESENTATIVE � E _
�
ADGP.E3S
60 W• OMFRET STREET CARLISLE PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1 �
� 150561014U 1505610140 �'�
� 150561��44
REV-1500 EX DecedenYs Social Security Number
�ecedent�s Name: M A R Y L• S W A R T Z
RECAPITULATION
�. R�al Estate(Schedul�a� ....... ........ . ............ .... .. . . ... . . . . �. 8 4 4 5 0 � . 0 0
2. Stocks and Bonds(Schedule B) .. ........ . ......... ....... .. . ... . . ... Z• •
3. Closely Held Cerpo►atien,Partnershi�or Sole-Proprietorship(Sch�dule C) _.._ . 3, •
4. MoRgages and Notes Receivable(Schedule D) .. .......... .. ... .. . . . .. .. 4. •
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)., .... . 5. 2 5 6 4 2 . 2 4
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested .. . . .. . 6. 1 1 7 5 � 0 . 0 0
7. Inter-`Jivos Transfers�Misceilaneous No�-Probate Property
(Schedule G) � Separate Billing Requested .. . ... . 7. .
8. Total Gross Assets(total Lines 1 through 7) ... .. .......... ...... . .. ... 8. 9 8 7 6 4 2 . 2 4
9. Funeral Expenses and Administrative Costs(Schedule H) .. . .. ... .. . . .. ... . 9• $ 5 4 9 1 . 4 9
10. Debts of Decedent,Mort a e Liabilities,and Liens Schedule I �o. 2 1 2 2 7 5 . 9 4
9 9 ( ) ... . .... . ... .
;i. T�tal Dedua.icns(tctal L�nes 9 and 1C) .... .......... . .... .. .... . . .... i 1. � 6 7 ? �a � . 4 3
12. Net Value of Estate(Line 8 minus Line 11) ............... .... .... . .. . . 12. 7 1 9 8 7 4 . 8 1
13. Charitabl�and Govemmentsl Bsaue�ts/Sec 9113 Trusts for whi�h
an electio�to tax has not been made(Schedule J) .... .. .... .. . . .. . ... .. i3. .
14. Net Value Subject to Tax(Line 72 minus Line 13) ...................... 14. 7 1 9 8 7 4 . 8 1
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116
(a)(1.2)X.0_ 0 . 0 D 15. � . 0 0
16. Amount of Line 14 taxable
at lineal rate X.045 7 1 9 8 7 4 . 8 1 �s. 3 2 3 9 4 . 3 7
17. Amount of Line 14 taxable
at sibling rate X.12 � . � � 17. � . � �
18. Amount of Line 14 taxable
at collateral rate X.15 � • � � 18. � . 0 �
19. TAX DUE ... .. .. ...... ...... . ........ ....... . .. .. .. .. . . ... . .. .. 19. 3 2 3 9 4 . 3 7
2u. riL�I�i THE GVaL iF YOIi AitE R�QiIE�TiNG A ftcFiJPiD GF AN t7VErcri�`riYSEFIT �
Side 2
� 1505610240 150561024C J
REV-1500 EX Page 3 File Number
Decedent's Complete Address: 2� 13 0700
DECEDENTS NAME
MARY L. SWARTZ
STREET ADDRESS
22 RIDGEWAY DRIVE
CIN STATE ZIP
CARLISLE PA 17015
Tax Payments and Credits:
1• (ax Due(Fage 2,Lin�1�) (i j 32,394.37
2. �red�tslPa;�me�ts
A,Prior Payments 20,000.00
B.Discount 1,000.00
Total Gredits(A+g 1 �2� 21,000.00
3. Interest
i3)
4, If Line 2 is greater than Line 1+Line 3,enter the difference.This is the OVERPAYMENT.
Fill in oval on Page 2,Line 20 to request a refund. (4) 0.00
5. If�ine i+Line 3 is G�eater iiisn Lir�e 2,er�ar the�if�2ren;;�.This is the T/�X CUE. (5) 1'!,394.3 i
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: ...................................................................... ❑ X❑
b. retain the right to designate who shall use the property transferred or its income; ............................... ❑ X❑
c. retain a reversionary interest;or ....................... ........................................................................ ❑ X❑
d. receive the promise for life of either payments,benefits or care? ....................................................... ❑ 0
2. If death occurred after December 12,1982,did decedent transfer property within Qne 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 death? ......... ❑ �
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 tau rate imposed on the net value of transfers to or for the use of the surviving spouse is
3 percent[72 P.S.§9116(a)(1.1)(i)].
For dates of death on or after Jan.1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and
��in�a�ax return are s�ill aapiieable zve��i�ihe suevi�iny spaus�is th�only be�eficiai y.
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(1.2)[72 P.S.§9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the 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 ai least one parent in common with the decedent,whether by blood or adoption.
REV-1502 EX+(12-12)
pennsylvania SGH�DULE /4
DEPARTMENT OF REVENUE
REAL ESTATE
!NHERITANCE TAX RETURP!
RESIDEM DECEDENT
ESTATE OF: FILE NUMBER:
MARY L. SWARTZ 21 13 0700
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 seil,both having reasonable knowledge of the relevant facts.
Real property that is jointiy�owned with right of survivorship must be disclosed on Schedule F.
Attach a copy o!the settlement sheet i�the property has been sold.
ITEM Include a copy of the deed showing decedenYs interest if owned as tenant in common. VALUE AT DATE
NUMBtR ( OF DEATH
DESCRIPTION
1. 23 RIDGEWAY DRIVE, CARLISLE, PENNSYLVANIA 146,100.00
TAX ASSESSMENT
2. 22 RIDGEWAY DRIVE, GARLISLE, PENNSYLVANIA 193,300.00
TAX ASSESSMENT
3. 1137 PHEASANT DRIVE NORTH LOT 59, CARLISLE, PENNSYLVANIA 89,000.00
APPRAISAL A�TACHED
4. 1406 BRADLEY DRIVE K-212, CARLISLE, PENNSYLVANIA 55,000.00
APPRAISAL ATTACHED
5. 1402 BRADLEY DRIVE A-113, CARLISLE, PENNSYLVANIA 75,000.00
�1PPRAiSAL RTTACHED
6. 1414 BRADLEY DRIVE G-114, CARLISLE, PENNSYLVANIA 75,000.00
�APPR�ISAL ATTACNED
7. 1402 BRADLEY DRIVE A-112, CARLISLE, PENNSYLVANIA 55,000.00
APPRAISAL ATTACHED
8. 3461 SPRING ROAD, CARLISLE, PENNSYLVANIA 156,100.00
i AX ASSE�SMENT
I
TOTAL(Also enter on Line 1,Recapitulation.) $ 844 500.00
If more s�ace is needed,use additional sheels of paoer of the same sizs,
REV-1508 EX+(OB-12)
pennsylvania SCHEDULE E
DEPARTMENTOFREVENUE CASH, BANK DEPOSITS � MISC.
INHERITANCE TAX RETURN
RESIDENT DECEDENT PERSONAL PROPERTY
ESTATE OF: FILE NUMBER:
MARY L. SWARTZ 21 13 0700
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. ORRSTOWN BANK-CHECKING ACCOUNT#108006222 13,100.24
2. ORRSTOWN BANK-CHECKING ACCOUNT#108006223 4,971.52
3. ORRSTOWN BA�lK-CHE�KlNG ACGOUNT#143Q00100 6,655.48
4. PERSONAL PROPERTY-APPRAISAL ATTACHED 915.00
TOTAL(Also enter on Line 5,Recapitulation) $ 25 642.24
If more space is needed,use additional sheets of paoer of the same size.
REV-150y EX+(01-1U) I
pennsylvania SCHEDULE F
DEPARTMENT OF REVENUE � �OINTLY-OWNED PROPERTY
IPJHERIT,4NCE TAX RETUP.N
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
MARY L. SWARTZ 21 13 0700
If an asset was made joinUy 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. PARTNERSHIP INTEREST JOHN AND AMY BITNER DAUGHTER/SIL
680 CRANES GAP ROAD
C�,RLISLE �A 17G13
B.
c.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
I7EM FQR JOIM? h"JiDE IP:CLUC�NA"dE Q�FINANCIAL INSTlTJTIQN AN,^.BANK,1CCv^UNT,N:lM9ER OR SIMI:P.R ,n.A?E OF'JEAT4 DECEL'ENT'G `JALUE�€
NUMBER TENANT JOINT IDENTIFYING NUMBER.ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. 1/2 INTEREST(OWN BLDG NOT BUSINESS) 235,000.00 50. 117,500.00
425 N. fALTIMORE AVENUE
MT. HOLLY SPRINGS, PA
TAX ASSESSMENT
I
I
I
TOTAL(Also enter on Line 6,Recapitulation) S 117 50�J.00
If more soace is needed,use additional sheets of paper of the same size.
REV-1511 EX+(10-09)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCETAXRETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
MARY L. SWARTZ 21 13 0700
Decedent's debts must be reported on Schedule I.
ITEM
PvUMBER DESCRIPTIdfv Aiv10UNT
A. F�IIVcRAL EXPENSES.
1. HOFFMAN-ROTH FUNERAL HOME 11,119.10
2. BHUGHMAN M�MORIAL WORK�, INC. 219.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s)
Street Address
��Y State ZIP
Year(s)Commission Paid:
2, ,4ttomey Fees: IRWIN &McKNIGHT, P.C. 30,000.00
3. Family Exemption:(If decedenYs address is not the same as claimanYs,attach explanation.)
Claimant
SUeet Address
��Y State ZIP
Relationship of Claimant to Decedent
4• ProbateFees: REGISTER OF WILLS 543.50
5 AccountantFees: WAGNER'S TAX SERVICE 140.00
2013 INCOME TAX RETURN
6. TaxRetumPreparerFees: PATRICIAA. ROSENDALE, CPA 500.00
FiNAL FIDiJ�IARi�TAX RETIiRN
7. CUMBERLAND LAW JOURNAL-ESTATE NOTICE 75.00
8. CO�CPuRA i iOiV BiIi�EAi1 -PARTiVEr�SrIIP 125.�G
9. HOME PARAMOUNT-PEST CONTROL 450.00
10. LEBO'S PLUMBING &AIR CONDITIONING-REPAIRS 240.00
11. KAREN STUM -REIMBURSEMENT OF REPAIRS TO REAL ESTATE 2,743.71
12. THE SENTINEL-ESTATE NOTICE 189.54
13. DIVERSIFIED APPRAISALS-APPRAISALS ON REAL ESTATE 1,875.00
14. KUNTZ�RYWALL- �RYV!lALL I?EPAIF?S 68�.OQ
15. NATHAN CHRONISTER-PLUMBING 574.50
16. CONSERVATION CONCEPTS, INC. -WEATHERIZE 523.51
17. HINSON'S APPLIANCE REPAIR-SERVICE CALL AND LABOR 68.90
18. F'ENCILS ThEE SERVICE-LAWN CA�tE/TREE fRIIVIING 650.OU
TOTAL(Also enter on Line 9,Recapitulation) I $ 55 491 49
If more space is needed,use additional sheets of paper of the same size.
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
MA�Y L. S'J�IARTZ 21 13 0%00
DecedenYs Name Page 1 File Number
Schedule H-Funeral Expenses 8 Administrative Costs-B7.
ITEM
NUMBER DF_SCRIPTION AM�UNT
19. MAHONEY'S PLUMBING-REPAIRS 922.50
20. LEBO'S PLUMBING-SERVICE 240.00
2�. Afifl'BIT�lEr�- RElMB�;RSENIEPlT 2�t�.�7
22. CRUM'S FLOORING&REPAIRS 1,748.63
23. DOTTIE WETTSTEIN-REIMBURSEMENTS 772.63
24. S.A. DAVIS ELECTRICAL-REPAIRS 55.00
25. YARA JONES-REIMBURSEMENT OF SECURITY DEPOSIT 800.00
� I
SUBTOTAL SCHEDULE H-B7 4,769.73
REV-1512 EX+(12-12)
pennsyivania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT�
I�JHERITANCE?AXRETURN MORTGACE LIABIl.IT!ES�LlEN�
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
MAR�f L. SWF,RTZ 21 13 0700
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. ORRSO N BANK-HOME EQUITY LINE OF CREDIT#230955 116,404.72
2. ORRSTOWN BAR�K-LOAN ACCOUNT#26433909005 33;510.91
3. PHEASANT RUN CONDOMINIUM ASSOC. FEES-CONDO FEES ON FOUR(4) UNITS 8,904.00
4. AT&T-TELEPHONE 158.24
5. CARLISLE RECIONAL MEDIC,4L CENTER-MEDICAL 107.2E
6. CEN�URYLINK-TELEPHONE 81.66
7. CARRY•_Gl11GTU1�ITE, L��-MED!CA.L 415.74
8. DI,�lCCl� LUTHER�N SQCIAL MIrJISTlRES-�lURSINr 1,62�.00
9. FGREST FARiC HEAL i H CENT�Fc-�IURSiIvG 750.0�
14. GUI�IBERLAND GOODWII_L FIRE RESCUE-AMBULANCE 268.35
11. MET-ED-ELECTRIC 352.77
12. NORTH MIDDLETON AUTHORITY-WATER/SEWER 1,288.59
13. KEMPER PREFERRED/MILLER INSURANCE- HOMEOWNERS INSURANCE I 3,313.08
14. LAWALL AT HERSHEY, INC. -MEDICAL 271.88
15. CONSERVATION CONCEPTS, INC. -WEATHERIZE 92.22
TQTAL(Also snter on Line 10,Rpca�itulation) 5 212 275.94
If more space is needed,insert additionai sheets of the same size.
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
MARY L.SWARTZ 21 13 0700
DecedenYs Name Page 2 File Number
Schedule 1-Debts of Decedent,Mortgage Liabilities,&Liens
ITEM —
NUMBER DESCRIPTION AMOUNT
1E. CMNI�SR�KING OF PRUSSIA-MEL'iCAL �21.18
17. Pr�L-CLECI RIC 723.16
18. ROTECH HEALTHCARE, INC. -MEDICAL 137.43
19. SOUTH MIDDLETON TOWNSHIP-WATER/SEWER 769.59
20. TORREY PlNES BA,NK-CR€DIT CARD �8Q.00
21. UGI UTILITIES-UTILITY 691.29
22. MSHMC PHYSICANS-MEDICAL 29.30
23. ERIE INSURANCE-HOMEOWNERS INSURANCE 368.00
24. FRANK ROBERTO, TAX COi.LECTOR-REAL ESTATE�AXES 599.95
25. JENNIFER L.VARNER, TAX COLLECTOR-REAL ESTATE TAXES 3,760.25
26. MELANIE�TRIrKLAND, TAX�OL�ECTCaR-R�AL FSTATE TAXES F,024.17
27. ROBERT C. CAIRNS, TAX COLLECTOR-REAL ESTATE TAXES 2,938.26
28. ROBifv I�. ��LLENi3ERGER, �AX�.OLLECTGR-ri�i�L ESTF�TE Ti�CES �,541.8 i
29. ORRSOTWN BANK-HOME EQUITY LINE OF CREDIT#230955-LOAN PAYMENTS 18,388.86
30. ORRSTO`,�IN RANK-LJP.N�C�CJRT#26�33909005-LJA"� ?A�MENTS 4,754.27
SUBTOTAL SCHEDULE I 44,667.52
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
MHRY L.SWI�RTZ 2'i 13 0700
Decedent's Name Page 3 File Number
Schedule I-Debts of Decedent,Mortgage Liabilities,i�Liens
ITEM
NUMBER DESCRIPTION AMOUNT
31. AQVRNCED DISPOSRL-TRASH 63.00
SUBTOTAL SCHEDULE I 63.00
GRAND TOTAL SCHEDULE I $ 212,275.94
REV-1513 EX+(01-70)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
MARY L. SWARTZ 21 13 0700
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 disfibutions and transfers under
sec.9115!a)(1.2).]
1. KAREN L. STUM �ine�l 239,9�8.27
1191 N. MIDDLETON RD 1/3 REMAINDER
CARLISLt, PA 17013
2. DOTTIE L.WETTSTEIN Lineal 239,958.27
1123 ROCKLEDGE DRIVE 1/3 REMAINDER
CARLISLE, PA 17015
3. AiAY S. BITNER Lineal 239,958.27
680 CRANES GAP ROAD 1/3 REMAINDER
CARLISLE, PA 17013
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
II. NON-TAXABIE�ISTRIBUTIONS:
A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
5'O�AL i�P PAt2T I1-EN i�R i O i A�NGN-I AXFiBLE�iSTRiBliTiOiJS ON LiIvE 1;i OF Fi��-950G COVEI�SHEET. $
If more space is needed,use additional sheets of paper of the same size.
, ' . = L A S T W I L L 1� N D , T E S T A M E N T < <
' O F
' MARY L. S WART Z
I, I�,RY L. SWARTZ, a resident of Carlisle, South Middleton
Township, Cumberland County, Pennsylvania, being of sound and
disposing mind, memory and understanding, do make, publish, and
declare this to b� my Last Will and Testament, hereby revoking and
making all previous Wills and Cocticils heretofore made by me.
FIRST
I order and direct my personal representative hereinafter
named to pay all of my just debts, funeral expenses and expenses
involved or connected with the administration of my estate as
soon after my death as is reasonably possible. However, my
personal representative need not accelerate and pay those
unmatured obligations which, in his, her or its opinion, it miqht
be proper and more advantageous to retain or renew and pay as
they become due and payable. If I do not own a burial plot or a
grave marker at the time of my death, I authorize my personal
representative, in his, her or its sole discretion, to purchase a
burial plot and to erect a suitable grave marker at my grave,
and to expend sums from my estate for this purpose.
�ECQ�ND
I give, devise and bequest the rest, residue and remainder
of my estate, together with all insurance proceeds thereon of
whatever nature and wheresoever situate in equal shares Lo my
r.:
� � �
children, Karen L. Stum, Dottie L. Wettstein and Am� �. Bi�er�
� � � ac�
Carlisle, Cumberland County, Pennsylvania, per stir��.� z �' `�
�
» � rv -Y; rn
a � � y ,�; s:'
� N � � �
a � a � rp -��
,� o , �3 �
� � �, =.� t�
1 ' x.' � r- n�
—� r—
� �' Cn �
�
' . • LAST fnTILL AND TESTAMENT OF MARY, L. SyJARTZ • �
' It is further my desire that my personal representative, after
r consultation with any heir or heirs of mine who survive me, and in
his, her or its own discretion, choose such articles from my
tangible personal property (exclusive of cash, stock certificates,
bonds, and all other tangible evidences of intangible personal
property) as he, she or it believes will be useful to such heir or
r�eirs or desiLable far nim or her or th�m t� have, eith�r from a
sentimental point of view or otherwise, and to deliver such
articles to such heir or heirs or among su�h heirs in equal or
unequal shares as determined by the further exercise of his, her or
its discretion, provided no other heir objects to the distribution.
All tangible personal property not so distributed is to be sold,
either publicly or privately, by my personal representative, adding
Liie proceeds of such sale or saies to my residuary estate and to be
disposed of in equal shares among my survivinq heirs after payment
of my estate debts, taking into account the tangible personal
property otherwise provided to them.
THIRD
I grant my personal representative the following powers in
addition to and not in limitation of such powers as my personal
representati��e shall hold by law:
(a) To retain all property received including the stock of
and corporate fiduciary acting hereunder, provided such
pro�erty �emains proc�uc�ive.
(b) To join in any corporation, partnership,
recapitalization, merger, reorganization or voting
2
�LAST WILL AND TESTAMENT OF MARY L. SWARTZ
r (h) To compromise claims without court approval including,
but not limited to, any controversies with the United
States of America or the Commonwealth of Pennsylvania
concerning estate and inheritance taxes on any
interests that- may �ass �?nder this Tny Last Will and
Testament.
(i) To �istribLte in �ash or in kind upon any division or
distribution of my estate.
(j ) To undertake any and all acts deemed necessary and
proper by my personal representative for the proper,
advantageous and prompt management of the settlement of
my estate.
(k) In general, to exercise all powers in the management of
my estate which any individual could exercise in the
management of similar property owned in his own right,
upon such terms and conditions as to him, her or it may
seem best and to execute and deliver all instruments
and to do all acts which he, she or it deems necessary
or proper to carry out the purposes of this, my Last
Will and Testament.
FOURTH
No interest of any beneficiary of my estate, either in
income or in principal, shall be subject to anticipation or
pledge, assignment, sale or transfer in any manner to charge or
encumber his interest either in income or principal, nor shall
the interest of any beneficiary be iiable or subject ir� any
4
. • • LAST WILL AND TESTAMENT OF MARY �L. SfaTARTZ ' •
�manner while in the possession of my personal representative for
��
the liability of such beneficiary.
FIFTH
I nominate, constitute and appoint my Daughter, Raren L. Stum,
of Carlisle, Cumberland County, Pennsylvania, as Executrix of this
my Last Will and Testament. If Karen L. Stu*n is Lna�le or unwilling
to serve as Executrix of this my Last Will and Testament, then I
nominate, cons�itute and appoint my daughter, Do#tie L. Wettstein,
of Carlisle, Cumberland County, Pennsylvania, as Executrix of this
my Last Will and Testament. If Dottie L. Wettstein is unable or
unwilling to serve as Executrix of this my Last Will and Testament,
then I nominate, constitute and appoint my daughter, Amy S. Bitner,
of Carlisle, Cumberland County, Pennsylvania, as Executrix of this
my Last Will and Testament. I direct that my personal representative
�hall not bA required to g,_vA or post bend for the f��_thful
performance of his, her or its duties in this or any other
jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand to this my
Last Will and Testament this 29th day of March, 2012.
WIT ESS:
-�----�� � �-
MAR L. WARTZ
✓ ' (�
5
, , . . .
'LAST WILL AND TESTAMENT OF MARY L. SWARTZ
r�
AFFIDAVIT
COMMONTnTEALTH OF PENNSYLVANIA .
SS.
COUNTY OF �-�..rn.�e.-�-t����. .
WE. F.n�\L. �G.�.�ecs and DPA�'C'He-Z U S/f0�6 , the
witnesses whose names are attached to the foregoing document,
being duly qualified according to law, do depose and say that we
were present and saw Testatrix sign and execute the instrument as
her Last Wi11 and Testament; the she signed willingly and the she
executed it as her free and voluntary act for the purposes therein
ex�resse�; that 2ach sub�cri�ing •,aitr.e�s ir. the hearir_g and s�qht
of the testatrix signed the Last Will and Testament as witnesses
and that to the best of our knowledge the testatrix was at the
time 18 or nore years of age, of sound mind and un��r no
constraint or undue influence.
�----� . s+-
�. L/ �
Sworn or affirmed and subscribed before me by �G7!!9 � �`N1�/E�S
and �q�� 6 S,/�Tj() this c�-� day of ��1� , 2012.
�., �
COMMONVIf .LTH OF PENNSYLVA,Pi4�+ � �'
Notarla!Seal � f;;
JenniferL.Ege�Nota�Y Public Notar
Cedisle Boro,Cumbedand.r+o��Y l
My Commiss!an[xplres Ju�y 28,��',,;?,
i,:,:,u;ucr,('�f1115y�vdfna ASSOC18uJfl Of 1aUtdfid5
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OD A A �' t0 CT Of.
:,
n
�
�
_�
,
,
SUMMARY APPRAISAL REPORT
� 1137 PHEASANT DRIVE NORTH
CARLISLE, PENNSYLVA1vIA
,
, P�ErAiZE�i FGR
THE ESTATE OF MARY L. SWARTZ
,
,
, �
,
BY
� LARRY E. FOOTE
DIVERSIFIED APPRAISAL SERVICES
35 EAST HIGH STREET, SUITE 101
� CARLISLE, PENNSYLVANIA
17013-3052
;
(717)249-2758
;
;
;
�
�
�
�t
� Diversified Appraisal Services
l
Real Estate Appraisers and Consultants 35 East High Street
� Carlisle,PA 17013-3052
(717)249-2758
� FAX(717J 258-4701
� March 13,2014
,
. TO: The estate of Ma�y L. Swartz
' FM: Lany E. Foote
RE: Summary Appraisal Report
' rcesidential Property
� l 1�7 Pheasant Drive North
Carlisle,Pennsylvania
� At your request, I have appraised the captioned property. The appraisal report,which
follows this letter, is submitted in support of my opinion of Market Value of the Leased Fee
Interest i�tr.�property, as of June 4,20:3.
I hereby certify that,to the best of my knowledge and belief,the data,facts,and
. opinions set forth therein, are accurate, subject to the Statement of Assumptions and Limiting
' Conditions that is also made a part of the report,and that the indicated Market Value of the
subject property, as of June 4,2013 is:
' EIGHTY-NINE THOUSAND DOLLARS
, $$9,000
' This apprai�al has bee�made in cor.fornity v��ith the stan�ards of prafessionz.l practice
of the National Association of Realtors Appraisal Section. I appreciate your having considered
�
me for this assignment and trust that you find the report entirely satisfactory.
Respectfully submitted,
.��
Larry E. Foote
Pa. Certified General Appraiser
GA-000014-L
2
-i
�
� SUMMARY OF IMPORTANT FACTS AND CONCLUSIONS
_�
� LOCATION: 1137 Pheasant Drive North, Carlisle,Pennsylvania
,
�
TAX PARCEL NLJMBER: 29-17-1583-061
, IMPROVEMENTS: Two-story attached single-family dweiling.
' PROPERTY RIGHTS: Leased fee interest.
,
OWNERSHIP HISTORY: The subject property is owned by Mary L. Swartz. No
' sale of the property has taken place during the past three
, years.
� SCOPE OF THE ASSIGNMENT: �'he scope of the assignment included an analysis of the
, subje�t's area, an inspection of the subject property, an
estimation of the property's highest and best use,
' consideration of ail three approaches to vaiue, and the
, application of those relevant to the valuation of the
subj�ct.
CLIENT: The estate of Mary L. Swartz.
INTENDED USER: The estate of Mary L. 3wartz and others.
. OBJECTIVE: To estimate the market value of the subject property as
unencumbered.
. USE OF THE APPRAISAL: Use by the client in an estate settlement.
' EFFECTIVE DATE: June 4,2013.
INSPECTION DATE: March 12,2014.
• HIGHEST AND BEST USE: Continued use as a single-family residence.
� COST APPROACH: N.A.
;
�
SALES APPROACH: $89,000
� INCOiVIE APPROACH: $33,OG0
�INAL VALLTL CCl�ICLUS?ON: �89,00�
� 3
_�
,
� THE VALUATION PROCESS
_�
' The valuation process is defined in The Appraisal of Real Estate as published by the
� Appraisal Institute, as"a systematic set of procedures an appraiser follows to provide answers
to a client's questions about real property value."
� It consists of a series of steps that are appropriate to a specific and particulaz appraisal
, assignment that begins with a client engaging a real estate appraiser to develop an opinion of
value for a specific�roperty as of a giv�n effective date and ends when the appraiser
" communicates and reports the final conclusions and opinions to the client.
Definition of the Appraisal Problem:
� The first step in the appraisal process includes the presentation of the following:
1. Identification of the client,the intended use,and the intended users of the appraisal
report.
� 2. The purpose of the appraisal, including a definition of the value being reported.
3. I�etermination nf the�ff_e�tive date of tfie appraisal report.
4. Extraordinary assumptions that are applicable to the appraisal assigrunent.
� 5. Hypothetical conciitions that are applicable to the appraisal assignment.
,
, Scope o�V+TorK:
Scope of work is defined in the Uniform Standards of Professional Practice as being
"the type and extent of reseazch and analyses in an assignment." This includes the degree and
extent of research and the data that is deemed as necessary t�develop a credible opinic,n of
value for the property being appraised.
, Data Collection and Analysis:
The appraiser must gather and analyze market area data, subject proper�y data, and
' compazable property data that is relative and relevant to the appraisal assignment.
Development and AppGcation of Traditional Approaches to Value:
The appraiser must consider which of the three traditional approaches to value are
� applicable,relevant,and necessary for developing a credible opinion of value for the subject
property. These three traditional approaches to value include the Cost Approach, Sales
' Comparison Approach, and Income Capitalization Approach. When two or more of these
� approaches to value are developed,the appraiser must determine the amount of emphasis and
consideration to be given to each of those approaches to value, since one or more may have
' greater significance in the appraisal of a specific property.
Reconciliation of Value Indications and Final Opinion of Value:
The final step in the valuation process is the reconciliation of the value indications
- developed by the appraiser. Reconciliation is the analysis af aliernative coiiciusions to arrive at
a final value estimate. Reconciliation is required because different value indications result
from the use of multipl� a�proaches ta value and w�ithir� the a�plicatior. o�a sir.gle arproach.
� The final value estimate is not derived simply by applying technical and quantitative
� 4
�
,
� procedures, rather, it involves the exercise of judgment, and the value conclusion reached must
� be consistent with market thinking.
,
,
,
,
�
- 5
_�
-,
� APPRAISAL CERTIFICATION
,
,
I hereby certify that upon application for valuation by:
THE ESTATE OF MARY L. SWARTZ
,
i�'�e undersign�d�ersana�ly;ns�e.,ted the f�llr,wir��descri'�ed pr��erty:
, All that certain piece or parcel of land, with the imnrovements thereon erected, situate
in North Middleton Township, Cumberland County, Pennsylvania, bounded and described as
follows:
Beginning at a point on the eastern right-of-way line of Pheasant Drive North at the
dividing line of Lots Nos. 59 and 60 as shown on the Final Subdivision Plan of�Pheasant Run
, Estates, Phase II and Phase III;thence by aforesaid eastern�ight-of-way line,North 06 degrees
49 minutes 39 seconds East 18.00 feet to a point on the southem line of Lot No. 58;thence by
� aforesaid line, Soutn 83 degrees 1�minutes�1 seconds Easi i40.�G fee�to a poin�on the
western line of Lot No. 55;thence by aforesaid line, South 06 degrees 49 minutes 39 seconds
:'Ves� :8.00�e��to a p�ir.t an*he nor�w�:e:n li�„e of Lo�I�T�. ��J;�.henee hy afo:esaad line,?�iort.h g3
� degrees 10 minutes 21 seconds West 140.00 feet to a point,being the place of beginning.
To the best of my knowledge and belief the statements contained in tr�is r�port s.re true
and correct, and that neither the employment to make this appraisal nor the compensation is
contingent upon the value reported, and that in my opinion the Market Va1ue as of June 4,2013
is:
EIGHTY-NINE THOUSAND DOLLARS
, $89,000
The property was appraised as a whole, subject to the contingent and limiting conditions
outlined herein.
,�!���
, Larry E. Foote
Pa. Certified General Appraiser
GA-000014-L
6
__
_�
_�
,
SUMMARY APPRAISAL REPORT
K212, 1406 BRADLEY DRIVE
' CARLISLE, PENNSYLVANIA
PREPARED FJP�
� THE ESTATE OF MARY L. SWARTZ
� BY
LARRY E. FOOTE
DIVERSIFIED APPRAISAL SERVICES
35 EAST HIGH STREET, SUITE 101
, CARLISLE, PENNSYLVANIA
. 17013-3052
(717)249-2758
,
�
� Diversified Appraisal Services
� Real Estate Appraisers and Consulfants 35 East High Street
. Carlisle,PA 17013-3052
(717J 249-2758
FAX(717)258-4701
� March 13, 2014
. TO: The estate of Mary L. Swartz
FM: Larry E. Foote
RE: Summary Appraisal Report
' Residential C;ondominium
. �212, 1406 Rradley Drive
Carlisle,Pennsylvania
- At your request, I have appraised the captioned property. The appraisal report,which
follows this letter,is submitted in support of my opinion of Market Value of the Leased Fee
Iiiterzst ir�tr�E property, as of Ja��e 4, 2013.
, I hereby certify that,to the best of my knowledge and belief,the data,facts, and
opinions set forth therein, are accurate, subject to the Statement of Assumptions and Limiting
' Conditions that is also made a part of the report, and that the indicated Market Value of the
, subject property,as of June 4, 2013 is:
� FIFTY-FIVE THOUSAND DOLLARS
$55,000
' This appraisal has'oeen made in confornity with the standards of prafessional practice
, of the National Association of Realtors Appraisal Section. I appreciate your having considered
me for this assignment and trust that you find the report entirely satisfactory.
Respectfully submitted,
, ,� SO' -��
' Larry E. Foote
, Pa. Certified General Appraiser
GA-000014-L
. 2
-i
�
� SUMMARY OF IMPORTANT FACTS AND CONCLUSIONS
�
� LOCATION: K212, 1406 Bradley Drive, Carlisle, Pennsylvania
,
TAX PARCEL NUMBER: Part of 29-17-1583-15B
, IMPROVEMENTS: Second floor condominium unit.
" PROPERTY RIGHTS: Leased fee interest.
OWNERSHIP HISTORY: The subject property is owned by Mary L. Swartz. No
sales of the property have taken place during the past
� three years.
� SCOPE OF THE ASSIGNMENT: The scope of the assignment included an analysis of the
subject's area, an ins�ectiQn of the subject property, an
estimation of the property's highest and best use,
consideration of all three approaches to value, and the
application of those relevant to the valuation of the
, subject.
CLIENT: � The esta.te of Mary L. Swartz.
INTENDED USER: The estate of Mary L. Swartz and others.
_ OBJECTIVE: To estimate the market value of the subject property as
unencumbered.
. USE OF THE APPRAISAL: Use by the client in an estate settlement.
EFFECTIVE DATE: June 4,2013.
INSPECTION DATE: March 12, 2014.
� HIGHEST AND BEST USE: Continued use as a single-family residence.
COST APPROACH: N.A.
SALES APPROACH: $55,000
- INCOME AFPROACH: $69,000
FINAL VALliE CON�LUSIGN: $SS,OOG
� 3
,
THE VALUATION PROCESS
� The valuation process is defined in The Appraisal of Real Estate as published by the
� Appraisal Institute,as"a systematic set of procedures an appraiser follows to provide answers
to a client's questions about real property value."
' It consists of a series of steps that are appropriate to a specific and particular appraisal
, assignment that begins with a client engaging a real estate appraiser to develop an opinion of
value for a speci�c property as of a given effective date and ends winen the appraiser
' communicates and reports the fmal conclusions and opinions to the client.
Definition of the Appraisal Problem:
The first step in the appraisal process includes the presentation of the following:
1. Identification of the client,the intended use, and the intended users of the appraisal
report.
2. The purpose of the appraisal, including a definition of the value being reported.
, ?. Det�:minati�n of the effective date Qf the appraisal report.
4. Extraordinary assumptions that are applicable to the appraisal assignment.
� 5. Hypothetical conditions that aze applicable to the appraisal assignment.
; Scupe of�%dur�c:
Scope of work is defined in the Uniform Standards of Professional Practice as being
"the type and extent of research and analyses in an assignment." This includes the degree and
, extent of reseazch and the data that is deemed as necessary to deveiop a credible opinion of
value for the property being appraised.
; Data Collection and Analysis:
The appraiser must gather and analyze maxkec azea data, subject property data, and
comparable property data that is relative and relevant to the appraisal assignment.
Development and Application of Traditional Approaches to Value:
The appraiser must consider which of the three traditional approaches to value are
, applicable,relevant,and necessary for developing a credible opinion of value for the subject
property. These three traditional approaches to value include the Cost Approach, Sales
' Comparison Approach, and Income Capitalization Approach. When two or more of these
- approaches to value are developed,the appraiser must determine the amount of emphasis and
consideration to be given to each of those approaches to value, since one or more may have
greater significance in the appraisal of a specific property.
Reconciliation of Value Indications and Final Opinion of Value:
The final step in the valuation process is the reconciliation of the value indications
� developed by the appraiser. Reconciliation is the analysis of alternative conclusions to arrive at
a final value estimate. Reconciliation is required because different value indications result
from the use �f mul�iple approuch�s to value ar�d wiihin the applica�ion of a singie approach.
� The final value estimate is not derived simply by applying technical and quantitative
4
- procedures, rather, it involves the exercise of judgment, and the value conclusion reached must
, be consistent with market thinking.
,
,
,
5
_,
,
APPRAISAL CERTIFICATION
,
,
I hereby certify that upon application for valuation by:
- THE ESTATE OF MARY L. SWARTZ
� the undersigned p�rsa�ially ir�s�,�ct�d u'�e follo�virig describad prapErty:
All that certain condominium �nit in the property known,nam�d and identified as
Pheasant Run Condominiums, situate in North Middleton Township,Cumberland County,
Pennsylvania,being known as Unit K-212, 1406 Bradley Drive, Carlisle, Pennsylvania.
To the best of my knowledge and belief the statements contained in this report are true
' and correct, and that neither the employment to make this appraisal nor the compensation is
contingent upon the value ren4rt�d: and that in my opinion thP M�rket Value as of June 4, 2Q13
is:
FIFTY-FIVE THOUSAND DOLLARS
. $SS,QO�
The property was appraised as a whole, subject to the contingent and limiting conditions
outlined herein.
. �
Larry E. Foote
Pa. Certified General Appraiser
GA-000014-L
6
-,
-,
�
,
SUMMARY APPI3AISAL REPORT
A113, 1402 BRADLEY DRIVE
CARLISLE, PENNSYLVANIA
, P�PAF'.ED FOR
THE ESTATE OF MARY L. SW�RTZ
BY
, LARRY E. FOOTE
' DIVERSIFIED APPRAISAL SERVICES
35 EAST HIGH STREET, SUITE 101
, CARLISLE, PENNSYLVANA
17013-3052
(717) 249-2758
�
� Diversified Appraisal Services
Real Estate Appraisers and Consultants 35 East High Street
. Carlisle,PA 17013-3052
(717)249-2758
FAX(717)258-4701
� March 13,�014
T�: The estate of Mazy L. Swartz
FM: Larry E. Foote
RE: Summary Appraisal Report
Residential Condominium
A:13. 1402 Bradlev Drive
Carlisle,Pennsylvania
� At your request, I have appraised the captioned property. 'The appraisal report,which
follows this letter, is submitted in support of my opinion of Market Va1ue of the Leased Fee
Iate:est�n the property, as cf June 4,�0?3.
, I hereby certify that,to the best of my knowledge and belief,the data,facts,and
opinions set forth therein, aze accurate, subject to the Statement of Assumptions and Limiting
� Conditions that is also made a part of the report, and that the indicated Market Value of the
subject property,as of June 4, 2013 is:
' SEVENTY-FIVE THOUSAND DOLLARS
$75,000
' This appraisai nas been mad�in conformity with the sta.ndards of professional_practice
of the National Association of Realtors Appraisal Section. I appreciate your having considered
me for this assignment and trust that you find the report entirely satisfactory.
Respectfully submitted,
. .����'�-�/
' Larry E. Foote
Pa. Certified General Appraiser
GA-000014-L
2
i
,
SUMMARY OF IMPORTANT FACTS AND CONCLUSIONS
�
LOCATION: A113, 1402 Bradley Drive, Carlisle,Pennsylvania
,
TAX PARCEL NUMBER: 29-17-1583-015B-U1_13-A
IMPROV�MENTS: First floor condominium unit.
PROPERTY RIGHTS: Leased fee interest.
OWNERSHI� HISTORY: The subject property is own�d by Mary L. Swartz. No
sales of the property have taken place during the past
, three years.
' SCOPE OF THE ASSIGNMENT: The scope of the assignment included an analysis of the
subject'� are�, ar� inspection of the subject property, an
estimation of the property's highest and best use,
� consideration of all three approaches to value, and the
application of those relevant to the valuation of the
, subject.
� CLIENT: Th�estate of Mary L. Swartz.
INTENDED USER: The estate of Mary L. Swartz and others.
, OBJECTNE: To estimate the market value of the subject property as
unencumbered.
USE OF THE APPRAISAL: Use by the client in an estate settlement.
� EFFECTIVE DATE: � June 4, 2013.
INSPECTION DATE: March 12, 2014.
� HIGHEST AND BEST USE: Continued use as a single-family resid�nce.
CQST APPROACH: N.A.
SALES APPROACH: $75,000
INCOME AFPROACH: $74,000
t�IrdAL VALUE CONCLUSIQN: $75,00�
3
�
,
� THE VALUATION PROCESS
,
The valuation process is defined in The Appraisal of Real Estate as published by the
� Appraisal Institute, as"a systematic set of procedures an appraiser follows to provide answers
to a client's questions about real property value."
It consists of a series of steps that are appropriate to a specific and particulax appraisal
assignment that begins with a client engaging a real estate appraiser to develop an opinion of
value foi°a specitic properry as of a given effec�i�z date an�t ends when t�ie appraiser
" communicates and reports the final conclusions and opinions to the client.
,
Definition of the Appraisal Pro�ilem:
' The first step in the appraisal process includes the presentation of the following:
1. Identification of the client,the intended use, and the intended users of the appraisal
report.
� 2. The purpose of the appraisal, including a definition of the vaiue being reported.
3. Deter��ination of�h�effective date cf the appraisal report.
4. Extraordinary assumptions that are applicable to the appraisal assignment.
� 5. Hypothetical conditions that are applicable to the appraisal assigninent.
, S�o�e�f W6rk:
Scope of work is defined in the Uniform Standards of Professional Practice as being
"the type and extent of research and analyses in an assignment." This includes the degree and
extent of reseazch and the data that is deemed as necessary to cievelop a credible opinion of
value for the property being appraised.
, Data Collection and Analysis:
The appraiser must gather and analyze market area data,subject property data,and
' comparable property data that is relative and relevant to the appraisal assignment.
Development and Application of Traditional Approaches to Value:
The appraiser must consider which of the three traditional approaches to value are
applicable,relevant, and ne��ssary f�r developing a credible opinion of value for the subject
property. These three traditional approaches to value include the Cost Approach, Sales
Comparison Approach, and Income Capitalization Approach. When two or more of these
approaches to value are developed,the appraiser must determine the amount of emphasis and
consideration to be given to each of those approaches to value,since one or more may have
gr�ater significance in the appraisal of a specific property.
Reconciliation of Value Indications and Final Opinion of Vatue:
The final step in the valuation process is the reconciliation of the value indications
developed by the appraiser. Reconciliation is the analysis of alternative concl�asi�ns to arri��e at
a final value estimate. Reconciliation is required because different value indications result
fram the use �f multiple approaches t� value ar_d within the application of a single approach.
The final value estimate is not derived simply by applying technical and quantitative
4
i
Iprocedures, rather, it involves the exercise of judgment, and the value conclusion reached must
be consistent with market thinking.
I
I
�
I
I
I
I
,.
I
I
�
�
I
5
_i
�
� .
,
i
,
� SUMMARY APPRAISA,L REPORT
, G114, 1414 BRADLEY DRIVE
' CARLISLE, PENNSYLVANIA
,
Pt��'.PaF.ED r C�F.
, THE ESTATE OF MARY L. SWARTZ
,
' BY
LARRY E. FOOTE
� DIVERSIFIED APPRAISAL SERVICES
35 EAST HIGH STREET, SUITE 101
CARLISLE, PENNSYLVANIA
� 17013-3052
;
(717)249-2758
;
�
,
Diversified Ap�raisal Services
Real Estate Appraisers and Consultants 35 East High Streef
, Carlisle,PA 17013-3052
(717)249-2758
, FAX(717)258-4701
� March 13, 2014
,
, TQ�: The estate of Mary L. Swartz
' FM: Larry E. Foote
RE: Summary Appraisal Report
�esidential Condorriinium
. Cal 14, 1414 Br�dley Drive
Carlisle,Pennsylvania
. At your request, I have appraised the captioned property. The appraisal report,wiuch
follows this letter, is submitted in support of my opinion of Market Value of the Leased Fee
rnieresi ir_tiie property,as�f June 4,2Q 13.
I hereby certify that,to the best of my knowledge and belief,the data,facts,and
opinions set forth therein, are accurate, subject to the Statement of Assumptions and Limiting
� Conditions that is a.lso made a part of the report,and that the indicated Market Value of the
, subject property,as of June 4, 2013 is:
� SEVENTY-FIVE THOUSAND DOLLARS
$75,000
• This appraisal has been made in conformity with ihe standards of professional practice
of the National Association of Realtors Appraisal Section. I appreciate your having considered
me for this assignment and trust that you find the report entirely satisfactory.
Respectfully submitted,
,�S��r�-('/
� Larry E. Foote
Pa. Certified General Appraiser
Gt�-000014-L
2
�
�
. SUMMARY OF IMPORTANT FACTS AND CONCLUSIONS
�
� LOCATION: G114, 1414 Bradley Drive, Carlisle, Pennsylvania
' TAX PARCEL NUMBER: 29-17-1583-15B-U114-G
IMPROV�MENTS: rirst floor condominium unit.
PROPERTY RIGHTS: Leased fee interest.
OWNERSHIP HISTORY: The subject property is owned by Mary I�, Swartz. No
sales of the property have taken place during the past
, three years.
' SCOPE OF THE ASSIGNMENT: The scope of the assignment included an analysis of the
, subject's araa, an inspection of the subject property, an
estimation of the property's highest and best use,
' consideration of alI three approaches to vaiue, and the
application of those relevant to the valuation of the
subj��t.
CLIENT: The estate of Mary L. Swartz.
� INTENDED USER: The estate of Mary L. Swartz and others.
OBJECTIVE: To estimate the market value of the subject property as
� unencumbered.
USE OF THE APPRAISAL: Use by the client in an estate settlement.
� EFFECTIVE DATE: June 4, 2013.
INSPECTION DATE: March 12, 2014.
HIGHFST �ND BEST USE: Continued use as a single-family residence.
CnST A.pPROACH: N..A.
SALES APPROACH: $75,000
iNCOME APPROACH: $64,000
Ft�?VAL VALU� CONCLUSIGN: $75,0(�0
3
�
,
. THE VALUATION PROCESS
_�
, The valuation process is defined in The Appraisal of Real Estate as published by the
Appraisal Institute,as"a systematic set of procedures an appraiser follows to provide answers
� to a client's questi�ns about real property valu�."
- It consists of a series of steps that are appropriate to a specific and particular appraisal
assignment that begins with a client engaging a real estate appraiser to develop an opinion of
vaiue for a specific property as of a given eftective 4ate a.�-�d en�s when the a�praiser
� communicates and reports the final conclusions and opinions to the client.
Def nrtion of the A�praisal Problem:
The first step in the appraisal process includes the presentation of the following:
1. Identification of the client,the intended use,and the intended users of the appraisal
report.
� 2. The purpose of the appraisal, including a definition of the value being reported.
3. Determination of the effective dats cf the appraisa, re�ort.
4. Extraordinary assumptions that are applicable to the appraisal assignment.
� 5. Hypothetical conditions that are applicable to the appraisal assignment.
. Sc6��of Wark:
" Scope of work is defined in the Uniform Standards of Professional Practice as being
"the typ�and extent of research and analyses in an assignment." This includes the degree and
extent of research and the data that is deemed as necessary to develop a credible opinion of
' value for the property being appraised.
Data Collection and Analysis:
� The appraiser must gather and analyze market area data,subject property data, a.nd
comparable property data that is relative and relevant to the appraisal assignment.
Development and Application of Traditional Approaches to Value:
� The appraiser must consider which of the three traditional approaches to value are
app!icable,releyant, and necessary for c�eveloping a credible opinion of value for the subject
property. These three traditional approaches to value include the Cost Approach, Sales
Comparison Approach, and Income Capitalization Approach. When two or more of these
; approaches to value are developed,the appraiser must determine the amount of emphasis and
consideration to be given to each of those approaches to value, since one or more may have
greater significance in the appraisal of a specific property.
Reconciliation of Value Indications and Final Opinion of Value:
The final step in the valuation process is the reconciliation of the value indications
, developed by the appraiser. Recon�iliation is th� analysis of alternative conclus:ons to arri•✓e at
a final value estimate. Reconciliation is required because different value indications result
from th� use of multiple approaches *o value a.nd within the applic�tion of a singi_e approach.
The final value estimate is not derived sir:iply by applying technical and quantitative
4
._�
: procedures, rather, it involves the exercise of judgment, and the value conclusion reached must
-,
be consistent with market thinking.
,
,
,
�
5
�
. APPRAISAL CERTIFICATION
�
,
I hereby certify that upon application for valuation by:
- THE ESTATE OF MARY L. SWARTZ
' the undcrs:gn�d persor�al�y inspected*�.iie fol�owir�g describ�d pr�p�rt;�:
All��hat certai�n condorn�nium unit in t�'�e property known,named and identified as
Pheasant Run Condominiums, situate in North Middleton Township,Cumberland County,
Pennsylvania,being known as Unit G-114, 1414 Bradley Drive, Carlisle,�'ennsylvania.
,
To the best of my knowledge and belief the statements contained in this report are true
" and correct, and that neither the employment to make this appraisal nor the compensation is
ccntingent upor�th�value reported, and that in r�y opinior_th�Market Value as of June 4, 2013
is:
, SEVENTY-FIVE THOUSAND DOLLARS
$75,OG0
• The property was appraised as a whole, subject to the contingent and limiting conditions
outli�ned hereir..
, ��
Larry E.Foote
' Pa. Certified General Appraiser
GA-000014-L
6
�
�
,
SUMMARY APPRAISAL REPORT
A112, 1402 BRADLEY DRIVE
' CARLISLE, PENNSYL�ANiA
PRFPA�D FOR
THE ESTATE OF MARY L. SWARTZ
� BY
LARRY E. FOOTE
' DIVERSIFIED APPRAISAL SERVICES
35 EAST HIGH STREET, SUITE 101
, CARLISLE, PENNSYLVANIA •
' 17013-3052
(717) 249-2758
�
� Diversified Appraisal Services
� Real Estate Appraisers and Consultanfs 35 Easf High Street
. Carlisle,PA 17013-3052
(717)249-2758
� FAX(717)258-4701
� March 13,2014
. TO: The estate of Mary L. Swartz
' FM: Larry E. Foote
RE: Summary Appraisal Report
Residential C�ndomin:u�-n
. A 112, 1402 Bradley Drive
Carlisle,Pennsylvania
i
� At your request, I have appraised the captioned property. The appraisal report,which
follows this letter, is submitted in support of my opinion of Market Value of the Leased Fee
Ir,t�rest in the pro��r�y, as cf Ju�-�e 4, 2013.
. I hereby certify that,to the best of my knowledge and belief,the data,facts, and
opinions set forth therein, are accurate, subject to the Statement of Assumptions and Limiting
� Conditions that is also made a part of the report, and that the indicated Market Value of the
. subject property,as of June 4, 2013 is:
� FIFTY-FIVE THOUSAND DOLLARS
, $55,000
` This appraisal has been made in conformi�y with tY��e standards of professional practice
. of the National Association of Realtors Appraisal Section. I appreciate your having considered
me for this assignment and trust that you find the report entirely satisfactory.
Respectfully submitted,
. �.�
' Larry E. Foote
Pa. Certified General Appraiser
GA-000014-L
� 2
SUMMARY OF IMPORTANT FACTS AND CONCLUSIONS
LOCATION: A112, 1402 Bradley Drive, Carlisle, Pennsylvania
TAX PARCEL NUMBER: 29-17-1583-015B-U112-A
INiFR�VEMENTS: First�loor condominium unit.
PROPERTY RIGHTS: Leased fee interest.
OWNERSHIP HISTORY: The subject property is owned by Mary L. Swartz. No
sales of the property have taken place during the past
three years.
SCOPE OF TrIE ASSIiiNMENT: The scope of tne assignment inciuded an analysis of the
subject's area, an inspection of the subject property, an
estimation of the property's highest and best use,
c�nsideration of all three approaches to value, �a tn�
application of those relevant to the valuation of the
subiect.
CLIENT: The estate of Mary L. Swartz.
INTENDED USER: The estate of Mary L. Swartz and others.
OBJECTIVE: To estimate the market value of the subject property as
unencumbered.
USE OF THE APPRAISAL: Use by the client in an estate settlement.
EFFECTIVE DATE: June 4, 2013.
INSPECTION DATE: ivlarch I2, 2014.
HIGHEST AND BEST USE: Continued use as a single-family residence.
COST APPROACH: N.A.
SALES APPROACH: $55,000
INCOME APPROACH: $72,000
F_TNAT VAI,UE CONCLUSION: $55,000
3
THE VALUATION PROCESS
The valuation process is defined in The Appraisal of Real Estate as published by the
Appraisal Institute, as "a systematic set of procedures an appraiser follows to provide answers
to a client's questions about real property value."
It consists of a series of steps that are appropriate to a specific and particular appraisal
, assignmen�that begins with a client engaging a real estate appraiser io develop an opinion of
va:ue fcr a specific prope:ty as of a gi✓en eff�ctive date a.r�d ends vvY���n the appraiser
communicates and reports the final conclusions and opinions to the client.
Definition of the Appraisal Problem:
The first step in the appraisal process includes the presentation of the following:
1. Identification of the client,the intended use, and the intended users of the appraisal
report.
2. The purpose of tne appraisal, including a ciefinition of the value being reported.
3. Determination of the effective date of the appraisal report.
4. Extraordinary assumptions that are applicable to the appraisal assignment.
5. ��ypothetical coiiditions S:hat are appiicabl�to the appraisal ass�gnmeni.
Scope of WQrk:
Scope of work is defined in the Uniform Standards of Professional Practice as being
"the type and extent of research and analyses in an assignment." This includes the degree and
extent of research and the data that is deemed as neeessary to develop a credible opiruon of
value for the property being appraised.
Data Collection and Analysis:
The appraiser must gather and analyze market area data, subject property data, and
comparable property data that is relative and relevant to the appraisal assignment.
Development and Application of Traditional Approaches to Vatue:
The appraiser must consider which of the three traditional approaches to value are
, applicable, relevant, and necessary for developing a credible opinion of value for the subject
property. These three traditional approaches to value include the Cost Approach, Sales
Comparison Approach, and Income Capitalization Approach. When two or more of these
approaches to value are developed,the appraiser must determine the amount of emphasis and
consideration to be given to each of those approaches to value, since one or more may have
greater significance in the appraisal of a specific property.
Reconciliation of Value Indications and Final Opinion of Value:
The final step in the valuation process is the reconciliation of the value indications
developed by the appraise:. Reconciliation:s the analysis of alternative conclusions to arrive at
a final value estimate. Reconciliation is required because different value indications result
from the use of mult�ple approaches tc� value and within th� application of a single approach.
� The final value estimate is not derived simply by applying technical and quantitative
4
procedures, rather, it involves the exercise of judgment, and the value conclusion reached must
be consistent with market thinking.
- 5
APPRAISAL CERTIFICATION
I hereby certify that upon application for valuation by:
THE ESTATE UF MARY L. SWARTZ
the�andersigned personally ins�ected the follov��ing desyribe�property:
All that certain condominium unit in the property known, named and identified as
Pheasant Run Condominiums, situate in North Middleton Township, Cumberland County,
Pennsylvania,being known as Unit A-112, 1402 Bradley Drive, Carlisle, Pennsylvania.
To the best of my knowledge and belief the statements contained in this report are true
and correct, and that neither ine employment io make this appraisal nor the con�pensation is
contingent upon the value reported, and that in my opinion the Market Value as of June 4, 2013
is:
. FIFTY-FIVE THOUSAND DOLLARS
�55,000
The property was appraised as a whole, subject to the contingent and limiting conditions
outlined herein.
,� {���
Larry E. Foote
Pa. Certified General Appraiser
GA-000014-L
6
Property Mapper
Cumberland County, PA
�
�
� PERRY COUNTY �'-p
y
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Copyright 2011 Esri. All rights reserved. Thu Jan 15 2015 04:02:53 PM.
3461 SPRING ROAD
PIN: 21-12-2958-016
Deedbook: 00252-04387
Owner: SWARTZ, RICHARD H & MARY L
Land Use Code: 101
Property Type: R
Acreage: 1.34
Square Feet: 1440
Taxable Status: T
Clean &Green Status:
Land Assessed Value $: 66300
Building Assessed Value $: 89800
Total Assessed Value $: 156100
Sale Price $: 110000
Sale Date: Thu]ul 25 2002 08:00:00 PM
Year Built: 1930
Municipality: MIDDLESEX TOWNSHIP
Height in Stories: 2
Type of Dwelling: DEiACH
Primary Exterior: Aluminum
Basement Percentage: 100
Air Canditioning: NO
Total Rooms: 6
Bedrooms: 3
Full Bath: 1
Half Bath: 1
� O�sTowN
B�
A Traditivn of Excellence
Ju�e 26,2U 13
Law Offices Irwin&McKnight, P. C.
West Pomfret Professional Building
60�Vest Pomfret St
Carlisle,PA 17013
Fax: 249-6354
Re: Estate of Mary L 5wartz
Social Security Number 265-54-3625
Date of Deafih 6/04/2013
IT IS HEREBY CERTIFIED THAT THE ABOVE NAMED DECEDENT HAD THE
FOLLOWING ACCOUNTS WITH ORRSTOWN BANK:
CHECKINGACCDUNT
Account No.- 108006222
Account Type- Free Checking
Date Opened- 03/13/2002
Joint Account(name/date)- No
Balance- $13,100.24
Accrued Interest- $0.00
CHECKINGACCOUNT
Account No.- 108006223
Account Type- 50+Interest Checking
Date Opened- 03/13/2002
Joint Account(name/date)- No
Balance- $4971.21
Accrued Interest- $031
CHECKING ACCOUNT
Account No.- 143000100
Account Type- Money Market
Da�e Open�d- 07/02i2002
Joint Account(name/dafe)- No
Balance- $6,655.41
Accru�3 Interest- $OA7
2695 Philadelphia Avenue • Chambersburg, PA ll�01
LOANACCOUNT
Account No.- 230955
Account Type- Home Equity Line
Date Opened- 04/O1/2009
J�int Aeco�t(name/date)- YES /Richard H Swartz-Primary/Mary Swartz—co-maker
B�an�z- $1 i 6,404.i2
LOANACCOUNT
Account No.- 26433909005
Account Type- CL Semi/Fix W/Floor
Date Opened- 10/15/2010
Joint Account(name/date)- YES /Richard H Swartz-Primary/Mary Swartz—co-maker
Balance- $33,510.91
Best Regards,
� � �y��°
Lisa R. Kline
Deposit Processing Clerk
Kevin M.Wickard
140 Pleasant Hall Road
Carlisle,PA 17013
(71'�241-5341
April 1, 2013
Estate of Mary Swartz
22 Ridgeway Drive
Carlisle PA 17015
I,the undersigned appraiser,have personally inspected the articles listed on the attached summary. To
the best of my lrnowledge, the values stated are true and correct as of July 27, 2013. I have found most
items to be in good cond.itian and have taken into account both physical dnd functiozal depreciation in
arriving at conclusion of value.
I further certify that I have no personal interest in the property and that neither my employment nor
compensation is cantingent upon the valuation of this property.
In my�pinion the�air market va�ue of the items cointained in the estate of Ma�-y Swar[z as of July 27,
2013 is $915.00
Respectfully submitted,
,�u,,,; �.,,.�,�J�,,! �a 9- �3 �,
.�..� I ,o��. � ;-;��, �
Kevin M. Wickard P
Living Room
sofa and chair 100.00
rocker 50.00
3 pc. Table set 25.00
misc. In living room 25.00
Office
storage cabinet 25.00
desk 25.00
picture 10.00
file c3binet 10.0�J
misc. In office 10.00
Dining Room
table, chairs,hutch 500.00
chair 10.00
sofa 50.00
misc. In dining room 25.00
Basement
��. 25.00
Kitchen
��. 25.00
Total $ 915.00
Property Mapper
Cumberland County, PA
0
�
PERRY COJNTY G.p
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�opyright 2011 Esri. All rights reserved. Mon Dec 15 2014 11:06:52 AM.
321 N BALTIMORE AVENUE
�IN: 23-31-2187-016
�eedbook: 00162-00556
�wner: SWART2, RICHARD H&MARY L
�nd Use Code: 303
�roperty Type: C2
acreage: 0.41 �
3quare Feet:
faxable Status: T
�lean&Green Status:
_and Assessed Value $: 61400
3uilding Assessed Value $: 173600
fota!Assess�d Va!ue $: 235000
iale Price $: 1
�ale Date: Thu Dec 4 1986 07:00:00 PM
fear Built:
Nunicipality: MT HOLLY SPRINGS BORO
ieight in Stories:
fype of Dwelling:
�rimary Exterior:
3asement Per�centage:
�ir Conditioning:
fotal Rooms:
3edrooms:
'ull Bath:
ialf Bath:
_ _ _
_ __ ._ _
. �
219 North HanoverStreet
Carlisle,Pennsylvania 17013
/� 717.243.4511
�� toll free 1.866.451.4511
�
fax 717.243.3723
www.hoffmanroth.com
FUNERAL HOME & CREMATORY, INC. into@hoftmanrotn.com
July 4, 2013
Dottie L. Wettstein
1123 Rockledge Drive
Carlisle, P�S 17015
Statement of Funeral Expenses for: Mary Lucille Swartz
Date of Death: June 4, 2013 Account Id: 16909-147
PACKAGE:
Traditional Funeral Service
TRADITIONAL FUNERAL SERVICE PACKAGE � 4,850.OQ
Sub Total: $ 4,850.00
MERCHANDISE:
Caskst: C�ristian II $ 3,OEOAO
Outer Container: Monticello $ 1,620.00
Sub Total: $ 4,680.00
TOTAL FUNERAL HOME CHARGES: $ 9,530.00
CASH ADVANCES:
Waggoners United Methodist Church Cemetery $ 700.00
18 Certified Death Certificates at$6.00 each $ 108.00
Newspaper Notice-Sentinel $ 402.60
Clergy $ 100.00
Flowers � $ 212.00
Hairdresser $ 40.00
Additianal Flowers $ 26.50
Sub Total: $ 1,589.10
Total Funeral Expense: $ 11,119.10
Payments Made:
I
Balanc�: $ .19.10
SERVING OUR COMMUNITY SINCE 1 907
J�3�����.� -
Z��c��� �"i��
41 South Bedford Street Carlisle,Pa 17013 Phone:717-243-5480 Faz: 7�7 243-5687
E-Mail:carlisle@baug6manmemorials.com
This form ma be sent b e-mai! faxed or mailed
- Work Urder# C j�1.—�3�
(
� Death D�te Inscriptaom Order -
Name af Deceased: 1'�'1/C���,/ L �"'i,V��� -
(
Date of Birth(futl dace ptease): (`�� ,3/ l 'r'f,3� � '
Date of Death(full aaze p�ease); ��11/�a Y _a��3
List other aames on memorial; �`�-
Tyae of Burisi• �Traditional Burial �Cremation
Styie of Meaxoria�• T
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Inscriotion• ❑ Year Onlv
❑ Abbreviated Full Date � F�Date Snelled Out
Faner�!Services Provided b ;
Cemetery Information �
Name o€�emete�y: �L`�/lv�J
City: C'/�((J �C'� State: ��
Section: Lot: Grave No.:
Description of Location in Cemetery: �'
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�„^� D � ; F� CONORIdiVS ON THE$ACK OF iNE�U$TCJNF6R�S-CC11�1�'IN'JIADlFlQN TO THE JOB SPECIFICATION
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�.■ CustomerService' OMED POTC�IREDiTrSERVCEStomerServicelnqulriesto:
� The Home Depot V� myhomedepotaccount.com ao eox�soa2e,st.�o��s,Mo sa»s
s ` Consumer Credit Card ;�u� � Account Inquiries:
�-800-6��-0232 Account Number: 6035 3202 4499 9874
Summar of Account Activit Pa ment Informafion
Previous Balance $0.00 New Balance
--- - -- __ .__� --- _
Payments _,_ -- -- ----_. ._,_
-- —__ _____.___ - - _$21 12
_ _$0,00 Mmimum Pa ment Due
-- --
__._
Other Credits - � - Y---- 21 12
_ ---
_-$0_00 Payment Due Date �
___ _._
Purchases __ _ _.__ ___ �--
_ ,.��,F A,pril5,_2014
+$21.12 2
� La±e Payment Warning: If we do not receive your minimuin payment by the
— --- --- �„,�,
F�es Chargeci - -- "
-_ __.
__._ _ . ___ +$0.00
--- --- _..___._, date Iisted above,you may have to pay a late fee up to$35.
Interest Charged --
f$0.00 Minimum Payment Warning: If you make only the minimum payment each
New Balance $21,�2 period,S�ou will aay mcre in interest ard it wili take you longer io pay off your
Past Due Amount $0.00 balance.For example:
Jf you makeno additional You wilFpay off the And you will
charges using this card balancs sho•;vn on this end u a in an
Credit Limit and each month you pay... statement in about... estima sd t tagof...
- _ . ___ ___ $2,501.00
Available Credtt � _ -- _ - _._.__
._ .
---- ---
_ $2,479 00 Only the minimurri payment 1 month $21
Statement Closin Date � ����
- -- ---- �-.g ____ __. _ ___ 03/09/2014 �f you would ifke iniormation about credtt counseling services,call 1-877-337-8187.
Next Statement Closin Date � , - -�
-.__..__.__--�---9--- __.._ 04/08/2014
Da s in Billin C cle ----_____.._--___._..
- --31--
�
� A minimum payment of$21.12 is due to avoid a late fee.To avoid OVERFLOWING Get Paperless Statements
J interest cnarges,pay$21.12 by Aprii 5,2014. �FILE�ABINETS? and more at
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� myhomedepotaccount.com
Piease see the enclosed privacy notice for important information.
If you call us,you may he�r our new interactivs voice raspo��se ur�it. itie hope you find it quick and easy to get the information and service you need.
TRANSACTIONS
Trana Date DescNption
_.__....._ _ ...._._�_._�_---- — -::.- � t
—---__-----.-_ __.____. Amount
n2/10 THE HOME DEFOT�,nRiISLc PH "-�-`�Q
. _ /w___.'j..�-._" _ ___
__---_ ____$ 21.12
HARDWARE 1�J ��--- ___..__ .._.---
FEES �i
_ : .__, .. ...._.: .
..._. ... , .
TOTAL FEES FOR THIS PERIOD � `' ""�
� _...._.. ..:._.. .>:..,..
,/� / � .._.:.,...$ . _... 0.00 ,..
� v
NASSLE-FREE SHOPPING
The Home Depot Consumer Credit Card makes shopping easier. �
Forgot your card?With your vatid ID,we'll look up your account info at checkout. ��; '��, ,
Forgot your receipt?Enjoy free look-up of card purchases made wi t hin 9 0 days, h'` ��
PLEASE SEE IMPORTANT INFORMATION ON PAGES 2 AND 4. PBge 7 Of 6
This Account is Issued by Citibank,N.A. '
___ _____ _� _ Please detach and return lower portlon with yourpayment to insureproper credit. Retaln upper portion for your records. �Y
, ��-- ------------ --- -----------
- - ----- --------
{�' - ------ --------------------- �
� � -------
[� This one-of-a-4dnd trimmer includes a rotating shaft for easy edging,
adjustable cut width and a 3-year warranty
[� Plus,the 18-volt Lithium-ion battery works with all RYOBI ONE+tools
� �`°`` Get ours toda
�,� . o � Y Y-exciusively ,
� at The Home Depot�.
.: . -
. . � . .-. •
�� �2014 Homer TLC,Inc.Ail rights reserved, � �
444
'� Page 3 of 6
� ��J`� I���
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S RlIV'l1V��lI/�LLIAMSo �
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CARLISLE`Sto�e 5949
, 823 f �HIGH ST ' �
CARLISLE R�. ` i7013 261'0
Fax((11 r,�n��t3� �355 ,- _
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www.sher��in-4uilliams.com
SALE _ _ 12:03pm .-�
Tran # 6476 1 09/24l14 • ' .� .
E01/10501 10
BRENT PO# 7681U2483526 ��g�h'� ����$�� . . +���'A��� ���'
"���# ����,1� ",Spring Rd.
Capents: 035777015148. � '�' } �y,�' PA 1�7013
. �'� �' � � " S £��R����R'ri
078435�8154 ' ��aon8;7'��'��� 3���;1 ��x 717-24�•6�4�35
073251009133 - `�n�� � �
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GLEIM PAINTING*DOUG. - c w SORD P O. P O E '
Acccu;�t Y,XXX 2348 9 ��.�- �� "�. • �' �"� �
Job 1 GLETM PAINTI•NG*DOUG NAME
B;tl ro: . '� 1�,�'y► L�: t
GLE1M �AINT�N6�DOUu�• ` ' �'" ' — P�YC��G� .,
ADDRESS
103 CLARINDON PL : ����'` � • � ��. ��i,; �'�
CRRLISLE, PA 17013 1209 / �� � �
(717)258-5203 _ ��/!t'f � ,r�,��f
" O BY � C C.O.D. CHARGE ON ACCL MDSE.RETD. PAID OUT
65U2-00660 GALLON A27W1815 , f.. �r`��,�
EMINENCE CEIL WH „ , . ,
. ..
*Sale Price 1.00 C� 23.99 23.99 , _. .. .. . _ _ . ,, _
145-2440 DCHK-04 EACH �"'�^•ti
9X12 .4MIL UROP � „� �� ���� J'
1.00 � ,-' 2,09 2.09 �-
DisCoul�i �X15.00) -0.31 `
1fi3-6133 00286-2400 EACH -"
5PK BLUE"rtRAY'°`L'INERS � '�
;`1 00:-.�,� . fi:19 6.19 ��,;
�Discount�'(X15:00) -0.93 �
�' �,
181-0027 104500250-2`1`/2"".`
2:5�� PRUVAL'A/S
1.00 @ 10,49 10.49
Discount (x15.00) -1.57 �� � � ���� P �
SUBTOTAL 39.95
6.00OX SALES TAX:1-391701300 2.41 ..`
CASH TENDERED -60,00 �r `
', ���,
CHANGE DUE 17•64 , � �E�
TOTAL $42.36 � � ����
- F�
... . . . . _�� T�
RECEIVED 9Y�.. �---" TOTAL
Si'ORE HUURS ,,�7� '�
SUNDAY 10:00=AM',= 6:00 PM � RRODUCT 810T pq c�alms Antl:refum�d;�oed.mushbe ac�ompanied by this bill.
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�.ISLE, PA 17Q13 (71n 259-7'1� `
- SALE -
�t n„ S�iLES'i: S1710RR1 7�0179 ;Rlq�: 913�6Q A1-07-14
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,���� �' INUOICE 711A6 Sf18T0tAL: Q.00
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� SpLESi: S1710RR1 710479 iRANS�: 5137760 Oi-07-S4
,�,� �� ����., ^, n �
ur"`-� � l�Y tI1499 lFiR1914LY 37�.49
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r INVOICE ll?47 SUBTDTAL: 370•49
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IIflIOICE 7714T SI�TBTAI: 374.49
SUBTOTAL: 374.49
TpX: 22.47
BALANGE DUE: 396.96
t�t: 396.�
TOTAL DISCOUNF_ '�9=�1
NYLOYE'S CARD IAHI�R; #890GDGOi'§8'tT50
i _ _ _ ,
�'� � �A��LY�����
my family. my family dollar.
� N o STORE,#08446 1706 Spring Rd.
F���LY41`���"�, �� � Carl i sl e,PA, 717-243-9245
i c°�'o ! fY1 �
my family. my fa y dollar. Q � BLEACH CONCENTRATED REG 1210Z
STORE #0844�Spring Rd. 13?251037672 2.90 T
Carlisle,P , 717-243-9245 �, BLEACH CONCENTRATED REG 1210Z
R E T U R N O R EX C H A NG E ; ' 3LEACH3CONCENTRATEq REG 1210Z 2'90 T
ORIGINAL STORE 8446 , � 32251037672 2.90 T
ORIGINAL REGISTER 2 I � 9EAVY DUTY ALUMINUM FOIL 425�
ORIG TXN NUMBER: 216� � 12251049484 2.50 T
ORIG TXN DATE: 07-�,�2-2013 ch TINTED SPKAY BOTi4.E-140Z 1,00 T
cUST PHnNE NUMBER (717)2q3-1R52 0 '2251054815
RETURN REASON DI[� NOT WANT � � SOAP BDVWSH PMGRNi MNG 1�rL OZ 2PK
0-13 IBD PNL INSUL 40X84 CHOC B4 ' 4182280994 5.00 T
032251011559 a 11.50-T � EAVY DUTY BATTERY AA 4PK
2251058868 1.00 T
SUBTOTAL $11.50- � ONEY BUNS 1.770Z 6CT
TAX1 � '4300041020 1.79
A M T D U E T O C U S T O M ER 6� � ' ULTRA HAND RENEWAL LAV 2G FL OZ
N 7000846208 3.00 T
M A S T ER C A R D �12'19 ' G ' 'A�E ACT PACS W XTRA LEMON 16CT
####�##�####2551 12'i9 i 7000806417 3.75 T
RETIJRN �ARTV PEANUT 12 OZ
SWIPED �32251024979 3.00
APPROVED i � PARTY PEANUT 12 OZ
�� AUTH# 0^v6145 �� J32251024979 3.00
SEQUENCE N0: 576384 M PEANUT CHOCOLATE 12.6 OZ
�5 INVOICE #: 5763 040000�21245 3.25
- • -- - -- - ; C�TT 1000 BAT�i TISSUE 20RL 2J96SF
� : � � � 054000150296 15.00
32 ���� � ' 05400015U296H TISSUE 20RL 2096S15.00
� ` � , , D NAPKINS PRINT 4GOCT
( �' 40Q300172092 3.00 T
� � .�(LEENEX ULTRA FACIAL 170 CT
I 1 036000123074 _ 2.00 T
F� �L�`������L�� ! Q � SPARKLE FkPER TUWtL 6RL 228.SSF
my f ily, my family dollar. 030400216466 p4.50 T
�7 STOR q08446 1706 Spring Rd. ! vi REGULAR PRICE 5.00
1 Car isle,PA, 717-243-9245 � FAB LO SPRING STAIN FIGHTER 32LD 50FL OZ
� � 885967373134 p2.50 T
is _ � � ��;E:l� �1�2!'�7 t:yiF� �.�k��:;q-;��.��:;;.-- � � ; � REGULAR PRICE 3.00
' FAB LO SPRING STAIN FIGHTER 32LD 50FL OZ
ORIGINAL STORE 8446 � � ' � ; 885967373134 p2..50 T
���3 � ORIGINAL REGISTER 2 � I S REGULAR PRICE 3.00
��`�� - TXN NUMBER: 851 ; Q � , WEDISH FISH SOFT CHEWY RED 14
�; ORIG TXN DATE,; 07-06-2013 � � y �. ! 070462500103 3.00
� � CUST PHONE NUMBER (717>243-1852 f � � � '� IBD PNL INSUL 40X84 IGE B5
RETURN REASON QAMAGED � ¢ � 032251011566 11.50'T
IBD PNL INSUL 40X84 BEIGE B5 � W � � IBD PNL INSUL 40X84 B GE 65
� �; � 032251011566 11.50-T Q N � � 032251045431 � ���� � 1.50
--��;� REG U L A R S A L E ` � : � � I IBD PNL iNSUL 4ox84 BEirE B5
� ' W � I 032251045431 11.5J
�== ; IBD PNL INSUL 40X84 BEIGE B5 E � � � IBD PNL INSUL 40X84 BEIGE 65
--=-._____ 0322510q5q31 11.50 T � � � � 032251011566 1.50 T
`1 ; IBD PNL INSUL 40X84 BEIGE B5 - . SUBTOTAL $129.49
032251045q31 11.50 T � ' � w �
IBD PNL INSUL 40X8q BEiGE B� 3 �- z � � ; TAX1 $5:13
0322510q5431 1 1.5 0 T � W � � � � T O T A L 134.62
IBD PNL INSUL 40X84 CHOC 64 ¢. f ( V I S A 134.62
"'--� '� 032251011559 c� 1�_T � ` °� � #####ii######9105
� �� SUBTOTAL ���"� $34.50 � � ' � � SWIPEDSE
��=..,� TAX1 $2.07 � � � � APPROVED
' T O T A L $36.57 � A�nHF�680^193 ns51F7
i MASTERCARD $36.57
� ############2551
PURCHASE
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KANSAS CIT1� h10 64999 Zone-5 $2,32 � CRRLISLE, PA 17013 (717) 258-7700
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CAP,LISIE. PA 17013 (717) 158-7700 � � CHkL1SlE. VR 17Ui3 (717) 258-77'�0
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340 E. Louther St., Suite 1
Carlisle, PA 17013
(717) 243-8314
luann@wagnerstax.com
April 12, 2014
Mary L. Swartz
c/o Karen Stum 1191 N. Middleton Rd
Carlisle, PA 17013
Statement of Charges for Services Rendered:
Per Form Charges:
See forms listed below-Federal 150.00
See forms listed below-Pennsylvania 35.00
Suntotal bQfore discount $ 185.00
Discount -45.00
Total fee $ 140.00
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Diversi aed A�t�raisal Services INVOICE
Real Estate Appraisers and Consultants Number 0313145
3 5 East High StrePt _
Suite 101 r�'i= , �����,�
Carlisle, Pennsylvania 17013-3052 DATE: March 13, 2014
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Tel: 717.249.2758 , : : :� '
Fax: 717.255.4701
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TO: The estate of Mary L. Swartz AMOLJNT: $1,875.00
FOR: Residential Appraisal Reports
1137 Fheasant Drive North, Carlisle
Unit A112, 1402 Bradley Drive, Carlisle
Unit A113, 1402 Bradley Drive, Carlisle
Unit G114, 1414 Bradley Drive, Carlisle
Unit K212, 1406 Bradley Drive, Carlisle
Thank You,
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Larry E. Foote
Certified General Appraise�
GA-000014-L
TERMS: Due upon receipt
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PA HIC#PA011819 ��
375 Sandy Hollow Church Road �
New Bloomfiei A 17068 Invoice
Bill To:
Mark and Dottie Wettstein Invoice#: 00002005
1123 R�ckledge Dri��e
Carlisle, PA 17013-9125 Date: 5/9/2014
Page: 1
DATE DESCRIPTlON AMOUNT
10/25/2013 Professional cleaning�f VVeather Master Awning cover. $482.75
Charges for Removal of Awning Covers for Cleaning is billed separately.
Labor 2nd tr�ve�are bilied at$5�per te�hnician per hour.(Minimum billing 1 hour)
10/28/2013 I Received and Processed Deposit via Personal Check#767, Thank You!
10/30/2013 Removal of Stationary Awning Complete. $72.50
NOTE:You will be billed for the Balance of the Clean�ng charges and the SQring
2014 Seasonal Services at the completion of the reinstallation.
5/2/2014 2014 Spring Seasonal Service-Installation of Awning Complete. $90.00
5/9/2014 Please remit balance due or phone with credit card authorization. Thank You!
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Saies Tax: $38.72
We appreciate your business.
Total Amount: $683.97
Amount Apolied: $255.86
Balarce Lue: $428.11
Terms: C.O.D.
Conservation Goncepts, Inc.
PA HIC#PA011819
375 Sandy Hollow Church Road
New Bloomfield, P. 7068 Invoice
800-755-2405
BiH To:
Mark and Dottie Wettstein
1123 Rockledge Drive I^voice#: C0002396
Carlisle, PA 17013-9125 Date: 11/7/2014
Page: 1
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I DATE I DESCRIPTION i AMOUiVT
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10/8/2014 2014 Fall 5easonal Service
Removal of Awning(s)
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� We appreciate your business.
� Total Amount: � $95.40
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❑CONTqACT
DESCRIPTION UF WORK /]�j ///�� �
��... O�O� /�{� �� I�S ❑ EMRA .
O /-�CG-t.
OUANT. DESCRIPTION OF MATERIAL USED PRICE AMOUNT �
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� ��S.Sa�c. ,S' s' .
HOURS - U180R AMOUNT �
T�TA�
MECHANICS � ��� MATERIALS
HELPERS � UIBON �S ��
%� � � �, �
1 hereby acknowledge th2 satisfactory TOTAL LABOR TAX
complehon ol the above describetl work. �
SIGNATURE DATE COMPLETED TOTAL �� l
sales•servlce•lnsrauatlon
- ResideMi.il and Commerdal I n vo i ce
�� leboshvac.com
' � � r � Date Invoice#
�AIR C�NDITtON1NG, INC. U
_ i 6/21/2013 17082
62 Chestnut Ade. Phane 717-243-8345
Carlisle Pa 17013 Fax 717-243-7655
Bill To
Karen Stum
1191 North Middleton Rd.
Carlisle,PA 17013
P.O.No. Terms
d{Y Description Rate Amount
Customer reported poor cooling at 1406 Bradley Drive(Mary
Swartz K212)
Lebo's found that indoor coil was e�remely dirty.Coil was cleaned
with Nu-Czlgon foaming evaporatcr cleane:ar.d water. Cai:was
brushed to assist with debris removal. Condensate line was flushed
and cleaned.Charge was accurate. It is recommended that an air
filter be used and changed frequently.
Materiais,Nu-Calgon coil cleaner 15.00 I5.00
2 Labor,Kris 112.50 225.00
Contractor#PA010816
-Thank You,We appreciate your busir.ess!
Total $240.00
1.5%Interest will be applied after 30 days
717-243-8345
� C r u m's [� Estimate
. �
� Flooring & Repairs ���oice
65 Pipeline Road � Nevwille, PA 17241
(717) 776-4343 HIC# PA030187
Job Name or No. Date f``
Name �
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Checks payable to: Total Materials
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SHERWlAI—W/LLIAMS,
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CARLISLE Store-5949 ; � � u, ° `� ��
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823 E HIGH ST ������'�� � ., ,� �
CARLISLE PA 17013 2610 LONE'S NOME CENTERS. INC. `°�
(717)243-2400 850 EASi NI9N STREET �n
Fax (717) 243-4355 CAALIS�E. PA 17013 t717) 259-7700 •�
www.sherwin-williams.com
— SALE —
SALE 7;pgam SALESII; 51710LF1 705736 iRANSi: 2171127 11-11-13 �
Trar � 3E98-9 11/11/13 �
EO��lO�+01 �Q 427.204 KB lOIN SS DYL TPfi KkIFE( 8.88 r � '' �
DONALD PO# PHEASANT RUN CONDO •18324 4-INX4-IN YALL PATCH (494 3.7e �
Order � OE009267295949 12157 USfi 16-LB L/tl 90-MIN DRY 8.33 r ' �
DARF�WER*STEPHEN I 460606 2-1/16INX250Fi DRYhIALL J 3.32 pW�a �'
Account XXXX-3717-5 �
Job 1 DARHOWER*STEPHEN ' Suerora�: 2a.s� `^
e;i� ro: j'
TA%: 1.46 �
DAAHOhIEfl*STEPHEN INUOICE 02106 TOTAL: 25.77 O �
PO BO%1311 CASH : 26.00 � � .-
Mi HOLLY SPGS, PA 17065 0021 CHANGE: 0.23 �
(717)462-2521
STORE: 1710 iERMINaL: 02 11/11/13 07:09:00
6503-63369 5 GAL B20pIB351 - -- ----- ----------- _ _ •
6�( MpTTE EW � t,�
*Sale Price 5.00 � 29.19 145.95 �,, � %T�
DiscoGnt ;$) -3E.70 a
Calor. SY6119 I�ITIGIE YHITE � �' �'(
J �� C
CCE►color cast oz 32 64 12B � � .-
B1 Bleck - 5 - - � °C1 '�
A2 Meroon - 1 - 1 € �g� �� �
Y3 Deen Gold - 48 1 1 I� &� ,,
Sher-Color Farnule
Wuents: Pricin9 Accownodatian
180-6678 106678160 18 IN
16" MINI FRAME
1,00 @ 3.79 3.79 •
Discount (X15.00) -0.57
SUBTOTAL 112,47
6.00OX SALES TSX:1-391701300 6.75
CdSH TENDERED -120.� ;� — — - — --J � — _ `, � — .
, _ _ __— � -
CHANGE DUE 0.78 ' _ — —
TOTAL 5119.7I .� ��£ � /�
STORE HOl1RS
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LOWE'S NOME CENTERS, L!C
d50 EHSi NI�a'N SrREET
�8RLI.SLE, PA 1?Q13 (717) ?58-7?00
— SAL� —
3AlESq; Si710ND1 194�110.8 TRANSN: 497696G o6-2e-i4
ihd�ili f.SN 43%72 NI.INp UIN WHi `t9.9'r
SU6TOTAL: 29�4�
TAR: 1.80
i�VOTCE 04'294 fOTAL: •
VISA: 31.77
�JT3R:�XK�1i%XXXX1(XQ408 Rh10UN1:31.7t BUTHCD:3�1a019
54{IFEn HEFID:976973171004 Q6/'l8liq 15:36:13
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STORE: 1710 1'ERMINAL: 04 05/28/14 13:36:26
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'er_`�/``�� �
The UPS Store - #6300
?755 W. Trindle Rd.
��rlisle, PA 17Q15
�717) 145-0026
. 11/19/13 12;31 PM
We are the one stnp for all your
shippirtg, postal antl business n�eds,
We offer ali� the serv�c�s you need
to eep .your b�as i riess goilg,
�` i �
IIIIIIi�II IlIIIIIIII IIIIII� I I iilIIIII Iflillllllllililll
� 001 001045 (001) TO $ 23.74
Ground Res'idential
Tracking# �1Z8709YE0350569792
002 OJ1045 (��1) TO $ 4i,69
• Ground Residential
� Tracki�g# 1ZB709YEt73i7P38318
� 003 001045 (001) Tp � 36 31
Ground Resldential
Tracking# 1Z8709YE0317240163
004 001045 (001) TO � 4?,05
� Ground Residential
Tracking# 1Z8709YE0350575347
U05 001045 (QO1) TO $ ',9,53
Ground Residential
Tracking# 1Z87Q9YE0317245711
006 001045 (001) TO $ 14.56
Ground Residential
Tracking# 1Z8709YE03505BOB95
007 OtOQ64 (002) T1 $ 4.51
15x12x10 bo
008 031042 (016 ****S�*�� TO $ 3.7�
15x12x10 fl Pac S S
� 009 500162 (009} *���g*��* T; $ 2,11
15x12x10 ma.t std
J10 �10064 (OO;C) T1 $ 4,�1
15x12x10 h�ox
• 011 031041 (01�1 ���*S*��� TO $ 6.00
15x12x10 f� � Pac SF
012 500163 (005, ����5��** T1 $ 3;92
15x12x10 mat�frag
Oi3 010152 {pp2) T1 $ 7.25
. 20 x 20 x 12 bax
014 020509 (009) ����5���* T1 $ 10,00 ,
20x20x12 Mat Cust '
015 030508 (016) ����5���� TO $ 4,00
20x20x12 Serv Frag
,� Subl'otal $ 229.03
SALES TAX (T1) $ 1 .94
Total $ 230.97
VISA $ 230.97
ACCOIiVi NUh1BER * ����*���:�; �qg
Appr Code: (S) Saie -
JOB INVOICE
�, S. A. Davis Electrical - 3 2 g 2
� 122 Garrison Lane
Carlisle, PA 17013
` CUSTOMERSORDERNO. DATEQRD ED
� 717-243-6185 L � j
� PA 0346429 OR�ER TAKEN BY DA E PR ISED � A.M.
C ❑ P.M.
PHONE
BILL TO
J� �� MECHANIC
ADDRESS
---- � HELPER
CITY �
��� JOB NAME AND LOCATION ❑ onv wOaK
, [] CONTRACT
DESCRIPTION OF WORK � EXTRA
� , � 1
��. QUANT. DE3CRIP770H OF MATERIAL USED PRICE AMOUNT
, � e � � �-
' i C' ,� Z o�� �
+��C�J�C� P� C��t'�v /
� c�-�r+�
Net:30 Days: A finance charge oE 1�%per monffi
will be charged on all accounts over 30 days.
HOURS LABOR AMOUNT TOTAL
MECHANICS @ MATERIALS
TOTAL
HELPERS @ LABOR
I hereby acknowledge the satisfactory TOTAL LABOR TAX
completion of?he above described work.
SIGNATURE DATE COMPLETED TOTAL �� �v
RICHARD H. SWARTZ Page: 1 of 3
22 RIDGEWAY DR Bitt Cycle Date: 06/14/13-07/13/13
���� CARLISLE, PA 17015-7613 Account: 464013073694
Visit us ontine at: www.att.com
Wir�tess Staterr�ent
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Previous Balance 5109.14
. .
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Payment - 06y29 S102.85CR
AdjuStments 50.00 With myAT&T,managing your account is easy.
' Log in to check your monthly usage,review your
Past Due - Pte�se Pay !mme�tiately $E,29 hill and mor�.
New Ch�t'g�5�' �49_�d � Visitatt.com/myattortextDOWNLOAD �
_ to 8758 to get the free app.
TOtd� /41110U11t �U@ $55.3C� OrnineaccountregistraUonreq�0loractivation.L'anpatibledevicereq'd.Dataandmessaging
rates may apply for download and app usage.
!�ew Cha:ges D;�e in Fu(t 5y Aug �8, 2C13
_ � _.------- --- .__—_----- -- -- ----_---
�� �� �' � � �� ���� �: ,.�� �� ..:
- - � � _ ( A �Account GFiarg�s � � � � �
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Other Charges and Credits
Service Pa e Total ___ ___ ----
One-Time Charges
A Account Charges 1 $5.58 Date Descr�tion
1. 07/13 Late Payment Charge 5.00
� Wireless 543.52 '
Surcharges and OtherFees
717 385-3904 543.52 : 1 2. State Gross Receipts Surcharge 0.26
Total New Cha[ges $49.10 Government Fees and Taxes
3. PA State Sales Tax 0.32
Total Other Charges & Credits 5.58
Totat Account Charges 5.58
r_ ,..__.. __.,_.-----.___. _ _..--------- _ __---_,_—___�_..
(�� 717 385-3904 l
RICHARD H.SWARTZ J
Nation 450 with Rotlover- Inctudes 450 Anytime Minutes
with Rollover, Nationwide Long Distance & Roaming, Unlimited
Mobi(e to Mobite catling to/from other AT&T Mobiles, 5,000
How to Contact U5: Night (9pm-6am) & Vb'eekend h1inutes, Call Farward Feature,
For questions about your account: 1 800'331-0500 ' Calter ID, Call Wait, Conference Call Feature, Mobite
or 611 from your cell phone Purchases & Downloads Detail, Basic Voice Mail Feature,
For Deaf/Hard of hearing TTY: 1 866 241-6567 (Additional Minutes 50.45 each).
Vis6t us entine at�v�v�v.att.com
� For Important Information about you►' bill, please International Roaming- Expanded - Includes international
see the News You Can Use section (Page 2).
•
RICHARD H. SWARTZ Page: 1 of 3
22 RIDGEWAY DR Bill Cycte Date: 05/14/13-06/13/13
���� CARLISLE, PA 17015-76� Account: 464013073694
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$102:85'
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A��us���P►��S ' s000: _ � place to find
������ �� � � � � �' � � � �� �� � • • • ;� your new tablet.
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Add a tablet today!
New Charges, ���� � � a$g4�7�; ����,__ Call 855.More4you
_ _ __-Y�:__...���':=.. (855.667.3496)
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New Charges.Due ir, �ult by : : �Jul Q8,:201«3�;
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Se;vice Pa e , ` Tota[,. . _ _____ ____---- ------
- One-Time Charges
� Account Char es �� � � 1 � , � � Date Description
� � 9 � ,�$5 58����. � � 1. 06/13 Late Payment Charge 5.00
� Wireless � � 548 99 ' �� ��archarges and Other Fees
717 385-3904 548.99 1 2. State Gross Receipts Surcharge 0.26
Total New Gharges�� $54:57���� 3overnment Fees and Taxes
3. PA State Sales Tax 0.32
Total Other Charges & Credits 5.58
Total Account Charges 5.58
�._ �.__.. ..__.._,_ _ ,___. _ ___.. __---_--_...`___._._..�..______._T.
' � � 717 385-3904 ' �
_.__ RICHARD H.SWARTZ >
Nation 450 with Rollover- Includes 450 Anytime Minutes
with Rollover, Nationwide Long Distance & Roaming, Unlimited
M�bi(e to Mobile calling to/from other AT&T Mobiles, 5,000
How tfi COntaCY Us Night j9pm-6am) & Weekend Minutes, Call Forward Feature,
For questions about your account: 1 800 331-0500 Caller ID, Call Wait, Conference Call Feature, Mobile
or 611 from your cell phone Purchases & Downloads Detail, Basic Voice Mail Feature,
For Deaf/Hard of hearing TTY: 1 866 241-6567 (Additional Minutes S0.45 e�ch).
Visit us ontine at www.att.com
-� For !mpor�ant Informatien about your bill, pl2ase �nternational Roaming - Expanded - Includes international
���; see the News You Can Use section (Page 2).
�. -
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MEDfCAL CENTER
� � • �� � � � I -
� ' ' �• �
Patient Name Mary L Swartz
ACcount Numbe� 1350464 a Onllne at www.carlislermc.com
Date of Service May 23,2013 (available 24/7)
Service Type Outpatient � BY Phone-717-960-1680
Insurance Name Humana Gold Choice Replc
Name of Insured Mary L Swartz
Policy Number �By credit card-complete section below and return
H544S5532
Amount Due From You $16.62 �By check-return section below with check
� • • • • . . Q
• � . . � . .
Am�unt due from you is$16.62 as of 06/30/2013 for The charges listed below do not reflect the discount that
Outpatient performed on May23,2013. you and your insurance company received.
Total Charges Lab 157.06
$157.06 TOTAL CHARGES $157.06
Discount�/Adjustments Given -$140.44
Insurance Payments Received $0.00
Amount You Paid $0.00
Arnount Due Fram fou $16.62
8
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__... . . _._.__.__ _.
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.NEDICAL CENTEit
. � •• �• � Q � �. •
Patient Name Mary L Swartz . .
ACcount Number 1347419 a Online at www.carlislermc.com
Date of Service May 14,2013 (available 24/7)
Service Type Outpatient � BY phone-717-960-1680
Insurance Name Humana Gold Choice Replc
Name of Insured Mary L Swartr �By credit card-complete section below and retum
Policy Number H54465532
Amount Due From You $25.32 �By check-retum section below with check
O � � Q • •
Rmount due from you is$25.32 as of 07/21/2013 for The charges listed below do not reflect the discount that
Outpatient perFormed on May 14,2013. you and your insurance company received.
Lab 261.77
Total Charges $261.77 TOTAL CHARGES $261.77
Discounts/Adjustments Given -$236.45
Insurance Payments Received $0.00
Amount You Paid $0.00
Amount Due From You $25.32
�
�
�
� ' •• • �P�ti611U1$A�.�111 3269-HMASTMT-1772500-146871432&P;7633732-1-315;33496101-1;1
As of today,we have not received payment in full on your account.lmmediate
payme�t is required,please contact ourbusiness office today.
__.._._.�..---------___--- ___...
Reorder.TSSSokwareCorpaation 443-321-560a�7s-oa .___...._.. _. ...... ... ._... . .... ...,. _. . .. . _... ... ._.._ ........ � .�... _.. __._..
0
_ REGIONSA�L.
---- „�.�,�<.,� , �v�:�
� • ' •' �
• ' o• •
Patient Name Mary L Swartz
AcCount Number 1335363 � Online at www.carlislermc.com
Date of Service April 05,2013 (available 24/7)
Service Type Outpatient � BY phone-717-960-1680
Insurance Name Humana Gold Choice Repic
Name of Insured Mary L Swartz
Policy Number �By check-retum section below with check
Amount Due From You H�65532
� $25.32
• • • . . Q
• ' � • • • . .
fvno�nt due from you is$25.32 as of 02/09/2014 for The charges listed below do not reflect the discount that
Outpatient pertormed on April 05,2013. you and your insurance company received.
Total Charges Lab 261.77
$261.77 TOTAL CHARGES $261.77
Discounts/Adjustm2nts Given -$211.63
Insurance Payments Received _$24 82
Amount You Paid $0.00
Art�ount Due From You $25.32
�
s
RE ONAL
MEGICAL CENTEn
O � �� ` � O • •' �
Patient Name Mary L Swartz a Online at www.carlislermc.com
Account Number 1336386 (available 24/7)
Date of Service April 10,2013
Service Type Outpatient � BY phone-717-960-1680
Insurance Name Humana Gold Choice Replc
Name of Insured Mary L Swartz �By credit card-complete section below and retum
Policy Number H54465532
Amount Due From You $40.00 �By check-return section below with check
� • • O • •
Amount due from you is$40.00 as of 05/26/2013 for The charges listed below do not reflect the disCount that
Outpatient pertormed on April 10,2013. you and your insurance company received.
Supplies 29.55
Total Charges $389.95 Respiratory 360.40
Discounts/Adjustments Given -$329.70 TOTAL CHARGES E389.95
Insurance Payments Received -$20.25
Amount You Paid $0.00
Amount Due From You $40.00
S
S
N
D � ' •' • ������ 3269-HMASTMT-1705490-1428118583-P;7433730-1-317;33333798-1;1
The amount shown on this statement is outstanding at this time.Your prompt �
paymenf will be greatly appreciated.
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DARRYL GUISTWITE,DO (717)609-2639
56 ASHTON STREET `
CARLISLE,PA 1 70 1 5-69 1 4
Mary L.Swart� 10951 C8/i2/13 1 McD
C/O Karen Stubb
1191 N Middleton Road
Carlisle,PA 17013
CPT4
04/12/!3 99308 Nursinb Home Est.Patient Leve!2 DG 1 80.00 �9•�2
Patient:Swartz,Mary L- 10951
Servicing Provider: L7arryl K Guistwite DO
OS/20/2013 Humana Claims Center 46.03 14.25
04/17/13 99309 Nursing H�me Est.Patient I,evel 3 nG 1 105.�0 25•g�
Patient: Swartz,Mary L- 10951
Servicing Provider:Darryl K Guistwite DO
OS/29/2013 Humana Claims Center 60.36 18.77
04/19/13 99309 Nursing Home Est.Patient Level 3 DG 1 105.00 25•8�
Patient:Swartz,Mary L- 10951
Servicing Provider: Darryl K Guistwite DO
OS/29/2013 Humana Claims Center 60.36 18.77
04/22/13 99308 Nursing Home Est.Patient Level 2 DG 1 80.00 �9•�2
Patient: Swartz,Mary L- 10951
Servicing Provider:Darryl K Guistwite DO
07/17/2013 Humana Claims Center 45.11 15.17
04/24/13 99309 Nursing Home Est.Patient Level 3 DG 1 105.00 25•g�
Patient: Swartz,Mary L- 10951
Servicing Provider:Darryi K Guistwite DO
06/24/2013 Humana Claims Center 6036 18.77
04/26/l3 99309 Nursing Home Est.Patient Level 3 DG 1 105.00 ��•25
Patient: Swartz,Mary L- 10951
Servicing Provider:Darryl K Guistwite DO
06/25/2013 Medicare 67.60 20.15
OS/06/13 99308 Nursing Home Est.Patient Level 2 DG 1 80.00 13.15
***X** Continue On Next Page ***�`**
Darryl Gu�stwite DO•56 Ashton Street•CARLISLE,PA 17015-5914 �'3
r q
DARRYL GUISTWITE,DO (717)609-2639
56 ASHTON STREET �
CARLISLE,PA 17015-6914
�ary L.Swartz 1�951 08/12/13 2 MED
C/O Karen Stubb
1191 N Middleton Road
Carlisle,PA 17013
CPT4
Patieht:Swartz,l:�ar,�L- 1OG51
Servicing Provider:Darryl K Guistwite DO
06/27/2013 Medicare 51.55 15.30
OS/13/13 99308 Nursing Home Est.Patient Level 2 DG 1 80.00 13.15
Pat�ent:Swartz,Ma.ry L- 10951
Servicing Provider:Darryl K Guistwite DO
07/02/2013 Medicare 51.55 15.30
U5/i7/13 99308 Nursing Home E:st.I�atient i,evei 2 DG i $0.�0 13.15
Patient: Swartz,Mary L- 10951
Servicing Provider:Darryl K Guistwite DO
07/10/2013 Medicare 51.55 15.30
05/24/13 99309 Nursing Home Est.Patient Leve13 DG 1 105.00
17.25
Patient: Swartz,Mary L- 10951
Servicing Provider:Darryl K Guistwite DO
07/17/2013 Medicare 67.60 20.15
OS/28/13 99308 Nursing Home Est.Patient Level 2 DG 1 80.00
13.15
Patient: Swartz,Mary L- 10951
Servicing Provider:Darryl K Guistwite DO
07/]7/2013 Medicare 51.55 15.30
OS/29/13 99308 Nursing Home Est.Patient Level 2 DG 1 80.00
13.15
Patient: Swartz,Mary L- 10951
Se:vicing Provider:Darryl K Guisrivite DO
08/OS/2013 Medicare 51.55 15.30
06/04/13 99316 N�irsina Facility Discharge Lvl 2 DG 1
I 10.00 19.97
Patient: Swartz,Mary L- 10951
****** Continue On Next Page ***�`**
Darr}�I Guistwite DO•56 Ashton Street•CARL[SLE,PA 17015-6914
64
z ,
DARRYL GUISTWITE,DO (717)609-2639
56 ASHTON STREET •
CARLISLE,PA 17015-6914
P�tary L.Swartz 1�951 08/12/13 3 MLD
C/O Karen Stubb
1191 N Middleton Road
Carlisle,PA 17013
CPT4
Servicing Provider:Darryl K_Guistwite'J�J
07/17/2013 Medicare 78.27 11.76
237.27
Mary L.Swartz
10951
237.27
Darryl Guistwite DO•56 Ashton Street•CARLISLE,PA 17015-6914 65
DA1tRY�TWITE,DO (717)609-2639
56 ASHTON STREET
CARLISLE,PA 17015-6914
pu,ount Number Billile Date P� Offce Use O��v
Mary L.Swaztz
10951 OS/15/13 1 ��U
C/U Karen Stubb
1191 N Middleton Road
Carlisle,PA 17013
CPT4 Descrintion Prov. Units Mesa• haz a Ins•Paid Adiustrnent Patiert Paid Balance�Due �j
S�rvice Date 185.00 R �48.22 t
03/25/13 99306 Nursing Home New Patient Level 3 DG 1 � ��. �,�'
Patient:�wartz,:vlary=-- 1 Q951 ���
Servicing Provider:Darryl K Guistwite DO 112.52 24.26
04/29/2013 Humana Claims Center 48.2� ��
04/02/13 99306 Nursing Home New Patient Leve13 DG 1 185.00
Patient:Swartz,Mary L- 10951
Servicing Proender:Danyl K Gui�twit�DO 112.52 24.26
OS/14/2013 Humana Claims Center 19.72 ��
04/03/13 99308 Nursing Home Est.Patient Leve12 DG 1
80.00
Patient:Swartz,Mary L- 10951
Servicing Provider:Darryl K Guistwite DO 46.03 14.25
OS/14%2013 Humana Claims Center 19.72 �
04/05/13 99308 Nursing Home Est.Patient Leve12 �DG 1
sa.00
Patient:Swartz,Mary L-10951
Servicing Provider:Darryl K Guistwite DO 46.03 14.25
OS/14/2013 Humana C(aims Center 105.00 25'g� ,�
04/08/13 99309 Nursing Home Est.Patient Level 3 DG 1
Patient:Swartz,Mary L- 10951 ___ .
_
_._ ____..
__.._ __
__._.._ _____ ._
Servicing Provider.Darryl K Guistwite DO 60.36 18•��
OS/14/2013 Humana Claims Center g0.00 �9'�Z d
04/i0/13 99308 Nursing Horrie Est.PaL n�095112 DG 1
Patient:Swartz,Mary
Servicing Provider:Darryl K Guistwite DO 46.03 14.25
OS/14/2013 Humana Claims Center
Please Pay--> 181.47
Comments:
Please pay within 30 days...thank you Mary L.Swartz
423.49 181.47 Scheduled Amount
10951 1,110.00 NeW�� pmt Current Due Past Due Finance Charge
Acwunt Nunber New Charaes NeW paY'�'�°� /BiIling Fee
Since Last Bill Sinee Last Bill Since Iast Bill
Darryl Guistwite DO•56 Ashton Street•CARLISLE,PA 17015-6914
70
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Forest Park Health Center Resident: Swartz, Mary (23545)
700 Walnut Bottom Road Location: -
Carlisle, PA 17013-3699 Statement Date: 5/1/2013
(888) 880-7090
Effective � Units Unit Amount Amount
Date Description
BALANCE FORWARD $150.00
4/19/2013 Payment-#5259 ($150.00)
12/31/2012 Humana Private Pay Copay for December 2012 dates of � $750.00 $750.00
service
BALANCE DUE $750.00
__.... .
PAYMENT IS DUE ON RECEIPT
QUESTIONS REGARDING BILL?
PLEASE CALL 888-880-7090/NICOLE M. EXT 807
N icole.mocik,@guardianeldercare.net
WE ACCEPT
VISA/MASTERCARD/DISCOVER/AMERICAN EXPRESS
(SEE BACK OF BIL,L)
PAST DUE: This balance is a Humana copay for Dec 2012 dates of service. Payment of this balance is now due
in full.
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t2/12l2013 9:28:06 AM CPhillip North Middleton Authorlty `�C..J�� Page
Account Profile
Account 06000758 � RICHARD SWARTZ
C�� � Biiling Address pw�.
RICHARD SWARTL RICHARD SWARTZ RICHARD SWARTZ
1402 BRADLEY DR 112 22 RIDGEWAY DR 22 RIDGEWAY DR
CARLISLE
7172496562
CARLISLE PA 1 709 5761 3 CARLtSLE PA 170157613
! ransact�°ns
Date Due�Date Check Group Type Batch Cons Am t B�Iansse.
12/02/2013 12@12013 Monthy AdjustrneM �ENi3t20374�308 U ,{ 4.16 ;��87 23
Penalt� `�- �
11/�1/2013 11/30/�013 Monthry BiU BiIN3Q9Q3082844 2 � 83.07 83.07
/13/2013 9/132013 NbMhly Paymerrt REC20130916110927 $3.07 O.pp
09l012Q73 9/302013 Mornhty Biit �i111307151is257 0 83.07 83.07
07/152013 7/15/2013 Monthly Paymerrt REC20130716110106 -83.07 0.00
07/01/2013 7/3012U13 iUfonthly Bill Bi11130430151425 0 83.07 83.07
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. NORTH MIDDLETON AUTHORITY
240 CLEARWATER DRIVE
� CARLISLE,PA 17013
(71�243-8269
DATE: 10/02/2013
gICHARD SWARTZ
22 RIDGEWAY DR
CARLISLE,PA 170157613
SE1tVICE TERMINATIOleT NOTICE
LANDLORD RATEPAYEK NOTIFICATION
Account No.: 06000737
Metered Address: 1406 BRADLEY DR 212
Past Due Amount: $ 151.77
Fee if property is posted: $ 5.00
Turn-On Fee if service is terminated: $30.00 �
Please be advised that unless your water and/or se ee�ll be termina�dis paid in full
the service at the metered address referenced abov
As required by State Law,Act No. 1978-297, `Disi a��ation proceed ngs.aAtthat
Premises, ` we will notify your tenant(s)of schedu
time vye w�ll also inform them of their rights as specified by law.
Under this act, you are required to provide us with the name and addres�e o���Count
tenant(s)within seven(7) days of receipt of this notice,unless you pay
due or make satisfactory payment arrangements. I A�IL pENA�LTY OF NOT MORE
THIS REQtJIREMENT,IT COULD RESULT IN
THAN $500 EACH DAY THIS INFORMATION IS WITHHELD.
If you wish to discuss this matter f�u�ther,you may ounh Fr day�8f 00 a.m. to 4 30 p m.
number liste d a bove or v i s i t o u r o ff i c e M o n d a y t h r g
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PREF� E�
. �� h:�� . , � � , ��� �������f��
MILLER NS ASSOC INC '� � � �
19 BROOKIM�OD AVE STE 102 UNITRIN AUTO AND HOME
CARLISLE,PA 17015 INSURANCE COMPANY
Agency Phone 717.243.a400 12926 Gran Bay Pkwy W-Jacksonville, FL 32258
�` ; � � `.��1 £��
y� �� ,,,z � ��
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0000129 01SP0.660 'SNGLP 873017073 CO2-P00129-� 02 DF 03$688 FffectivP: 12-23-2013
������I1��1'���III�II��11�11���1�������111�1�1'I��'I��I'��I�I�'�I EXpiratiOn: 12-23-2014
Producer Code 12:01 a.m.standard time at the
MARY L SWARTZ 29-3065 described location.
� 22 RIDGEWAY DR
CARUSLE, PA 17013
b011182013
RENEWAL CERTIFICATE- DWELLING FIRE POLICY
This certficate continues ynur policy in forr.e fo�the po�icy period showm.It will bereme effective�nly ff the required premium is paid before!he
effective date of the Policy Period stated.The required premium will be billed separately under the Kemper Billing System.
Please attach this certificate to your policy
.. , .... „„ ., r �:� �`� y v"°z��" `�� ' ''� ��? ,� ., �� � �' � k
�� �� "�` , • � ���"!., r� '�s�q`� �';.kv,�.,�`�s � ��,�n,�a,t:��'�i .�.�.��.1t'�' .�r.�,.. �h ��`� .��"�s� �`�'"..��� .
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:. �..w... .. ... ..::. . .^.:?'.:h..
i he bescribed Location covered by this policy is located at the address below:
23 RIDGEWAY DR, CARLISLE, PA 17015
This insurance applies to the t5escribed Location, Coverage for which a Limit of Liability is shown and
Perils Insured Against for wh�ch a Premium is stated �� , �
. a�- � 4. :: � � L i� 2 � *. ��.rs° P �� � � `�� �E � ZS X�'��,�r���
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���;'� ��� �,'�..S.n '�.,. i�
* A. Dwelling $ 190,500 $ 4�0.00
* B. Other Structures-Blanket Basis $ 19,050 Included
C. Personal Property
* D. Fair Rental Value-Basic Limit $ 19,050 Included
* E. Additional Living Expense(Up to 25%/month) Included Included
Combined with Basic Coverage D
EXTENDED COVERAGE Included
VANDALISM AND MALICIOUS MISCHIEF Included
PERSONAL LIABILITY: each occurrence • $ 500,000 $ 65.00
MEDICAL PAYMENTS TO OTHERS: each person � 1,000 Included
Total Premium for Endorsements $ 18.00._..
Total Policy Premium $ �83.00
For information about additional costs to you related to this policy, please read endorsement BC0001 ___,.. J
Payment Expected From Insured
� a �� � ���' �` � ��; ���
�x � ,� ' -'�`� �:�+ :. � a '�� ay� fi �.. � �� �, '�'���"��.��'°��
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"� ��;��� _....- ., r�..,�.�
Policy�T $� 500
�n,��� �. ����.� �+��.� 1^u°' �P. '�Y"L�` �=X�:�¢.� :�. s �j." ,` ; ,�.��.,�''� °�S'..�x a1��� .i.Y�•�'� �'�f.����.
��� ��s ����s°1�.� < "��'`¢i�'� - h�x�€,. �a::"ad. ��.<��",'�,�„t'.,4..
:r z•:x, ... :. ,....
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Construction Frams Not more thar 5U0 ft from hydrant Pdiles from Dept 1
Occupied 1 Family Yr Construction 1994
County Cumberland State PA
Fire Dist Carlisle Owner Occupied No
Prot Class 4 Terr.16 Seasonal No Structure Type Townhouse
� �
�
* Indicates a change was made to your policy �l�� �
CONTINUED ON REVERSE . � ��
293065
K E M P E R PREMIUM BILL
PREFERRED for Personal Package Policy
Unitrin Auto and Home.lnsurance Company
MILLER INS ASSOC INC ,/� ��s� Policy Period:03-16-2014 to 03-16-2015
198ROOKWOODAVESr�ivbz Quarterly Pay Plan
CARUSLE PA 17015
► Policy Number: PZ 029764
Visk www.eKemper.com for customer information and
online payments.For payments call us at 877-Ai88-7488•
0000161 MB "AUTO T2 0 552817015781322 -COS-13
I�������II������I�I�I�I�'I�I�III�II�11���������"���I�II�II�I��1� BiAing ID:6A6A3A7P
MARY L SWARTZ Agent and Telephone Number
22 R I DGEWAY DR MILLER�NS ASSOC INC
CARLISLE PA 17015 717-243-4400
Statement as of 02-06-2014
Save a treel Sign upur�bills from one convee nt,seeu'Place w6eneyou sigrn up for free eB ling
you can also pay Yc
at yoyr bank's website or ffi MyCheckFree.eom�.
BILUNG INFORMATION
Previous Balance $25s.75 ► Minimum Due 280.75 ,
-$259.75 � To Pay In Full
Payment-Thank You ► Due Date 'F6-2014
Policy Effective 03-16-2014 $1,099.00
A$6.00 biNing charge is;ncluded in the
Minimum Due.If you pay this biil in full,
New Balance
$1,099.00 there is no billing charge.
INSURED PROPERTY
2�RincFwav nR — -
�CEMPER
PREF�'RRED PREMIUM BILL
for Personal Fire Policy
MILLER INS ASSOC INC Unitrin Auto and Home Insurance Company
19 BROOKWOOD AVE STE 102 Policy Period: 12-23-2013 to 12-23-2014
CARLISLE PA 17Q15 Monthly Pay Plan
► Policy Number DF 038688
vo,eeo oi � Visit kemperpreferred.com for customer information and
0001879 0,naao.+oz••nuro T806W317015761322 1 online payments.For payments call us at B77.488.7488.
��hlll��li�llli��lu��h�u�u�,ip�i�nll��lh��l�li�r�u�hh
MARY L SWARTZ Billing ID:OA6A5A3P
22 RIDGEWAY DR p ent and Telephone Number
CARLISLE PA 17015-7613 MILLER INS ASSOC INC
717-243-4400
SYatemer►�as of D1-02-2014
Save a treel Sign up toclay for paperiess bi0ing and palicy docs at kemperpreferrea.com.Md,
you can also pay Your bitls from�n+e con�renieM,secure Plare�hsn you sign up for free eBiliing
at�ou:bahk's website or at,MyCheckPree.com�.
BILLING INFORMkTION ► Minimum Que
�qag.pp i► To Pay in Full �T
previous Balance 01- 2014'
Paymer�-Thatdc You $4 6.25 ► Due Date
'Billing Cha� �'.�
Wew Balance $448.75
1NSt1RED P�aFERTY'
23 RIDGEWAY DR
CARUSLE PA 17015 `
'"See Reverse For knpaf��t InEormation Ineludirg
our Electronlc Check Conversion Procedu�" _
� KEMPER
PREFE�,R'RED PREMIUM BILL
for Personal Fire Policy
MILLER INS ASSOC INC Unitrin Auto and Home Insurance Compa�y
19 BROOKWOOD AVE STE 102 Policy Period: 12-23-2014 to 12-23-2015
CARLISLE PA 17015 Monthly Pay Plan
► Policy Number DF 038688
ru,+:d o� � Visit kemperpreferred.com for customer information a�d
0001427 oi Meo.<u••�uio I61�62'll 1Y1�15�912523 � online payments.For payments call us at 877.488.7468.
I�������1��I�I�1���II���'I�'�II����111��1�11�����1111����1111��I�
MARY L SWARTZ Billing ID:OA6A5A3P
C!O DOTTIE WETTSTEW �
1123 ROCKLEDGE DR Agent and Telephone Number
CARLISLE PA 17015-9125 MILLER INS ASSOC INC
717-243-4400
' Statemerrt as of t i-18 2074
Save a tr�et Sign up today#ar paperless�iliing awd policy tlacs at kemperpreS�rred com.And,
you can also pay your bills from one;canuenieitt,secure place when you sign up far free eBillin9
at your bank's webstte ar at MyCheckFree.com�.
BILLING INFORMATION �` Minimum Due' $48.33
Policy EffecUve/42-23-2014 ' $508.00 �' 'to Pay in Full �.�0
New Balance -
�� ► Due D�ta 12-�3'-2014
a as.00 aiu�y����uaea�Rma
Minlmum Due.If ya►pay this 6ii1 in fuil.
there is no biAing chaige
`INSURED PROPERTY
`23 RIDGEWAY RR
CARLISLE PA 17U15 _ , ._._. : -
KEMPER
PREFERRED PREMIUM BIL
for Personal Package Policy
MiLLER iNS ASSOC INC Unitrin Auto and Home Insurance Company
19 BROOKWOOD AVE STE 102 Policy Period: 03-16-2013 to 03-16-2014
CARLISLE PA 17015
QuaRerly Pay Plan
► Policy Number PZ 029764
roa3ez o, � Visit kemperpreferred.com for customer information and
OOO�i378 Ol M80.402••nuro T90623717015-761322 1 online payments.For payments call us at 877.488.7488.
dihh�rhr���i��u�iu�Pi41�r��r��I�lidIlP���uP������
MARY L SWARTZ Billing ID:6A6A3A7P
22 RIDGEWAY DR pgent and Telephone Number
CARLISLE PA 17015-7613 ry��LLER INS ASSOC INC
717-243-4400
Statement as of 11-26-2Q1�
Save a treel Sign up today for paperless bilfing and poficy docs at�cempffrpr'fetr�d.C°m.��d"
you can also pay your bilis from one conrenient�secure P�ace when you sign up for free eBitlin9
at your bank's websiie or at MyCheckFree•com�9.
5
► Minimum Due 32gg 75
BILLING WFORMATION �1,25 R jo Pay�n Full
Previous Balance � 3
-$331.75 ► Due Dale
payment-Thank You �.7�
P��t-fiank You $6.00
•Biliing Charge �g.75
New Balance
INSUR€D PROP�RTY
22 RIDGEWAY DR
CARLtSLE PA 17013 `
2002 CADILtAC DEVILLE
KEM PE R
PREFERRED PREMIUM BILL
for Personal Fire Policy
MILLER INS SSOC INC Unitrin Auto and Home Insurance Company
19 BROOKVVOOD AVE STE 102 Policy Period: 07-11-2013 to 07-11-2014
CARLISLE PA 17015 Two Pay Plan
�ozasb o, � Policy Number DX 051109
OOOZ$S�i O7 MB0.405••nuro T20611417015761322 1 Visit kemperpreferred.com for customer information and
�IIII�'��'����'�'���'��'��'�'��I�I"'ll��"I��1'I�'I��'���I��I��' � online payments.For payments call us at 877.488.7488.
MARY L SWARTZ Billing ID:OA8A4A6P
22 RIDGEWAY DR
CARLISLE PA 17015-7613 Agent and Telephone Number
MILLER INS ASSOC INC
717-243-4400
Statemeett as of 06-06-2013 ;
3ave a treet Sign up today for paperle$s billing;and policy docs at kemperpreferred.com'.And,
you can also pay your bilis from one convcnierrt,secur�e place when you sign op for free eBitiing
at your bank s website or at MyCheckFree,com�.
BILLING INFdRMaTION ► Minimum Due $247:50
Palicy Eifective 07-11-2013 $483.p0 ►ITo Pay in Full
Niew Baiance g4g3 up ► Due Daie -11-2�13
A SB.00 billing charge is inelutled in ttie
Min�num Due.If you pey tl�is Dili in full;
U�ere is na binirg ct�ge. '
INSURED PROPERTY
1137 PHEASANT RUN DR NORTH
CARLISLE PA 17013
' ""See Reverse For hnportaM Infotma�ion Including
our Electronic Check Corrve►sion Procedures""
KEMPE� _ _--
PREFERR NOTICE OF CANCELLATION �
M,uFRiNsassocrNt Insurance Provided B =
1g BROOKWOODAVE STE f02 UNITRIN AUTO AND HOME _
CARLISLE PA??015 INSURANCE COMPANY —
qgency Phone(717)243-44�� 12926 Gran Bay Pkwy W-Jacksonville,FL 32258 �
' Policy,Number Date of Mailing �
Named Insured and Mailing'Address pZ 029 764 06-28-2013 -
�
o��. ..n � oo� o��.. o. _
MARY L SWARTZ ProducerCode �
29-3065 -
22 RIDGEWIIY DR -
CARLISLE PA 17��5 AgenUCustomerlD __
SWARRI1 �
_ __.__ _
_ _ .__ _.
� y lic number on your check and make it
Return this portion with your pay
ment in the enclosed envelo Please print o���n� or call us at • $•
payable to Kemper Preferred.Visit kemperpreferred.com to make online pay 331•75
Minimum Due + . 5
Cancellation Remittance Tp pay In Full -2013
Policy Numbe►: PZ�Z9 764 Due Date
Agent Number: 29-3065 �
qgent Name: MILLER INS ASSOC INC Amount Paid
Insured:
MARY L SWARTZ
�d�rlf•Il�h�idur�l!��IPll�a��liriui°0d�ld�lidhlld
KEMPER PREFERRED
BOX 70839
Charlotte NC 28272-0839
263637�297640 ��33175 OL�89125 0010U�DOD�OOO�OUOUO�UODD000
__. __ �.._.. � vr 1i11J
� ___� �� .,.-����LLti�roN ur 1NSURANCE. READ IT CAREFULLY.
EMPER
EFERRED
PREMIUM BILL
MILLER INS ASSOC INc for Personal Fire Poliey
19 BROOKWOOD AVE STE 102 Unitrin Auto and Home Insurance Company
CARLISLE PA 17015 Policy Period: 07-11-2014 to 07-11-2015
Two Pay Plan
Po4173 0, ► Policy Number DX 051109
0004�69 Ol M80.432••AUTO T7 U6254 17015-761322 � 7� " Visit kemperpreferred.com for customer information and
1'��'����'ll�'������'1�I1"�����III'���II""II'�I�'�'I�'���'���' � online payments.For payments call us at 877.488.7488.
MARY L SWARTZ
22 RIDGEWAY�R Biiling ID:OA8A4A6P
CARLISLE PA 17015-7613
Agent and Telephone Number
MILLER INS ASSOC INC
717-243-4400
' Statement as of t�-19-2014 'r
3ave a treel Sign up torlay far paperles$biiling and policy docs ai kemperpreferred.com.Antl,.
you can atso pay your bills from�ne can�nenient,secure place whan you sign up far fres eBilling
at your bank's website or at MyC1�kFree.carr�.
BI�.LINCi INFORMqT10N ► Minimum Due $260.5Q
�0�B�� $515.00' ► To Pay in Full �
Payment-Thank Yau -�2S0.5Q ► Dae DatE 05 1 t-2015
'Billing Charge; �.�
Wgx►Balance $2u0.50
INSURED PROPERTY
" -�--- � � � � � -- � 1.14ZDLIFACAIATDIW I1G:�.A�l1G'ru� . �
KE �iP� R
PREFERRED
PREMIUM BILL
MILLE'�INS AssoC iNc for Personal Package Policy
19 BROOKWOOD AVE STE 102 Unitrin Auto and Home Insurance Company
CARLISLE PA 17015 Policy�eriod: 03-16-2013 to 03-16-2014
QuarteAy Pay Plan
rosu�3 0, ► Policy Number PZ 029764
OOOSO�$Ol M80.405••nuro �106704 17015761322 � Visit kemperpreferred.com for customer information and
�IIII�'��'����'�'���'��'��'�'��I�I"'ll��"I��1'I�'I��'���I��1��' � online payments.For payments call us at 877.488.7488.
MARY L SWARTZ
22 RIDGEWAY DR Billing ID:6A6A3A7P
CARLISLE PA 17015-7613
Agent and Telephone Number
MILLER INS ASSOC INC
717-243-4400
SYatemant as af 05 23-20t3
Save a treel3ign up today for paperless billing and policy docs at kemperpreferred,com.:And,
you can als�paY�ous bil!s fmm one cor�ne2nt,sec�re Fiace yviaen you'sign up,f�r free eBiiiing
at yoar bank's website or at MyCheckFree.comQsl.
BILLING INFORMATiON ►Minimum Due $305.75
Previous Bala�e ` $1,125.00 ►To Pay in Full ;865.25'
�aymeM-Thank You �285J5 ►�Due Date 06-9 - 013
`Billing Charge $6.00
"LaEe Charge '$20.00 `
New Balance 3865.25 -
INSURED PROPERTY
�2 R1DGflNAY DR ' ,
CARLISLE PA 17013'
2002 CAQILLAC DE1/ILLE
»�v e�___�__� _ .: _
KEMPER
PREFERRED PREMIUM BiLL
� ��� for Personal Fire Policy
MILLER,d�NS ASSOC INC Unitrin Auto and Home Insurance Company
19 BR�OKVVOOD AVE STE 102 Policy Period: 07-11-2014 to 07-11-2015
CARLISLE PA 17015 Two Pay Plan
ros,se m ► Policy Number DX 051109
0005753 0,�eo.,oa••nuro T21611477015-761322 1 Visit kemperpreferred.com for customer information and
II�1��I'�I�'�����1�11�111������1�1��'�'I'��'���I���'I�'�i�l"II�� � online payments.For payments call us at 877.488.7488.
MARY L SWARTZ Biliing ID:OABA4A6P
22 RIDGEWAY DR
CARLISLE PA 17015-7613 Agent and Telephone Numbe�
iUIILLER INS ASSOC INC
717-243-4400
SYatemet�as af OB-08-2E314 ;
8ave a tree!8ig►T up';#�slay for paperfess billing and pplic�r docs at kemperpreierrect.com.Md;
yau;can alsa Pay Your biils from one co��nt,sec�lr�pface when you sig�up for fr�ee esilling
at your bank's website or at MyChe�IcFr�e.com�.
BILLING INFORMATIQN ► Miniltlum Due„ �0,5 '
Policy Effective Q7-112014 5509.00 ► Ta Pay in Fulf �.00'
�iCw B�ance ' �9 0G i Due Oate ' 0'1 t-2Qf4
11 S6.OQ M'I�ng cherge is ixluded in 1he
Minimum Doe.if ycU pa�r M�iss biM in tuN,
ihere is tw biUing cl�ge.
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KEl� PEI�
PREFERRED O PREMIUM BILL
for Personal Package Policy
MILLER INS ASSOC INC U�itrin Auto and Home Insurance Company
19 BROOKWOOD AVE STE 102 Policy Period: 03-16-2014 to 03-16-2015
CARLISLE PA 17015 Quarterly Pay Plan
P01426 0, � Policy Number PZ 029764
0001425 0,n,eo.nsz••nuro T60617117015-761322 1 Visit kemperpreferred.com for customer information and
���I'�I�"�"�'��1�����1��'I�I�"�I'1�1'�I�'I�I���I���'llll�l'I�� online payments.For payments call us at 877.488.7488.
MARY L SWARTZ Billing ID:6A6A3A7P
22 RIDGEWAY DR
CARLISLE PA 17015-7613 Agent and Telephone Number
MILL�f2 INS ASSOC INC
717-243-4400
Statemeni as of OS-26 2014 -
Save a tteet Sign-up totlay for paperiess billing a�d"policy docs at kemperpreferred.com,And, '.
yau can aiso pay Your:bilis fram one conu�nieM,secure place when yau sign up fcsr free eBil(ing
at your bar.lc's websi±e ar at MyCheckF[ee.c9m�9.
BILLING INFORMATION ► Minimum Due $�80.75
Previous Balance I $83U.25 ►';To Pay in Full ' �555.50}
Payment-Thank You -$2841.75 ' ► Due Date ' 4
"Billing Charge $6.00 —
New Balance $555.50
If�SURED PROPERTY
22 RtDGEWAY DR
CARLISlE PA 1�013
2002 CADILLAC DEVILLE '
"See Reverse Far Important Informatla►Mcluding;
our Ekctronic Gheck Carversan Procedures"`
KEMPER
PREFERRED PREMIUM BILL
for Personal Fire Policy
MILLER INS SOC INC Unitrin Auto and Home Insurance Company
19 BROOKWOOD AVE STE 102 Policy Period: 07-11-2013 to 07-11-2014
CARLISLE PA 17015 Two Pay Plan
eosboo o, ► Policy Number DX 051109
0005595 0,n,ao.,oz••nuro T30625517075-767322 7 Visit kemperpreferred.com for customer information and
"�����'I�II'I���'�I�'I�I'���'���'���I�'I�"II���'�"1��'��I��I�� � online payments.For payments call us at 877.488.7488.
MARY L SWARTZ
22 RiDGEWAY DR Billing ID:OA8A4A6?
CARLISLE PA 17015-7613 Agent and Telephone Number
MILLER INS ASSOC INC
717-243-4400
' sr�teme�r�s of�2-2a2ot�
Save a tr�ee}Sign up today for paperless bitling and policy da:s at kemperptef$r�ed,com.Aoa, .
yQu can a1so,:paX your bilts from ane co�venient,secure piace when you sign up for free eBitling
at yaur banks website or at MyCheckfree com�.
BILLING INFaRMATlON ►Minimum Que $247.50'
Previaus Balance $489.00` ► To Pay irt Fuif S24T.5�
PaYment-Tf�ank-You $24i.50 !�Uue Date
: oi-�f�a��
�a�irr�cr�r� g�.�
New Bafance $247 50
�_-�---._�.�.
: iNSURED PROPERT1f ----_ �
KEMPER
PREFERRED„ PREMIUM BILL
� for Personal Package Policy
MILLER INS ASSOC INC Unitrin Auto and Home Insurance Company
19 BROOKWOOD AVE STE 102 Policy Period: 03-16-2014 to 03-18-2015
CARLISLE PA 17015 Quarterly Pay Plan
ra+ro3 0, ► Policy Number PZ 029764
0004699 oi nao.aos�•nuro TO 7 6104 77015-767322 1 Visit kemperpreferred.com for customer information and
��'ll����'I���'I'���II�'��'�I�����'�1����I'I'�I"II�I"I�'I�I���� � online payments.For payments call us at 877.488.7488.
MARY L SWARTZ Billin ID:6A6A3A7P
22 RIDCEWAY DR 9
CARLISLE PA 17015-7613 Agent a�d Teiephone Number
MILLER INS ASSOC INC
cs
717-243-4400
S�aieme�a!`as of a5 23-2014
SaMe�tree!Sign up taday for paperless billing and poticy docs at kemperprefieRedcom,;And,
yau can atso pay your biits from ane coFnrenients secure;ptace when yo�r sig�up for fres e�ii!ing
at your'6a�k's wrebsite or at MyCheckFreetcom�,
BILLING INFORMATION �Minimum�ue ' �gp.�g
Previous Baiance ; $1,1Q5,00 ►To Pay in Futl .�5
PaXment-Thank You $284.75 ►Due Eiate
*Billing Gharge ` $6.00 ' 06-16 2014:
New Balance �p� ;
INSURED PROPERTY
22 RIDGEIIIFAY DR
CARLtSLE PA'17013
2002 CADILtflC QEUILCE
. . . . . '"SeeReverseFor:rrmrtaritlnkv..,.f��.,..r...a..a:..�.. �����.
Conservation Concepts, Inc.
PA HIC#PA011819 �
375 Sandy Hollow Church Road
New Bloomfield, PA 17068 Invoice
�
Bill To: �
Ylary Swariz Invoice#: 00001879
22 Ridgeway Drive
Carlisle, PA 17015 Date: 6/21/2013
Page: 1
DATE DESCRIPTION AMOUNT
1/2/2013 2013 Spring Seasonal Service- Reinstaliation of Weathermaster Cover.
Labor and Trave!hours billed on actual hours!.ised for sen�ice based or.the
current$58 per hour per technician. (One hour minimum) ,
4/9/2J13 Reinstallation of WeatherMaster Awni!?g. R$7.0�
6/21/2013 Please remit balance due or phone with Credit Card Authorization. Thank you.
�
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I �
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� Sales Tax: $5.22
� Delayed Billing —
Total Amount: $92.22
Amount Applied: $0.00
� Balance Due: $92.2
Terms: C.Q.D.
LAWALL AT HERSHEY, INC.
� 500 UNIVERSITY DR -EC182
HERSHEY, PA 17033-2360
(717) 531-5882
Invoice # 310016
Date 08-07-13
Bill To: Provided To:
NIARY "L SWARI'Z MARY L S4ur�RTZ
22 RIDGEWAY DRIVE 22 RIDGEWAY DRIVE
CARLISLE PA 17015 CARLISLE PA 17015
3RV FROM QTY HCFC DESCRIPTION FEE TOTAL
02-12-13 2 L1932 LT RT AFO RIG ANT TIB PREFAB TCF= 992 . 10 1984 .20
02-12-13 2 L2820 LT RT SOFT INTERFACE BELOW KNEE SE lOFi.24 212 .48
2196. 68
Referred by Dr. MOKSHA RANASINGHE MD
Diagnosis Code : 781.2
NonAllowed . 418 . 64
Amount Due - (Patient) . 271.88
Last Payment Received
Type . Primary Ins
Date Received : 06-12-13
Amount . 1066. 82
NOTE
BALANCE IS YOUR CO-INSURANCE.
PLEASE REMIT PAYMENT.
THANK YOU
FOF, BILLING INQUIRES PLEASE CALL 1-800-735-4627
PLEASE REMIT PAYMENTS TO 8028 FRANKFORD AVENUE PHILADELPHIA, PA. 19136
�
STATEMENT OF ACCOUNT
� OMNICARE KING OF PRUSSIA
6990B SNOWDRIFT RD
ALLENTOWN,PA 18106 PAGE:1 of 1
� ACCOUNT NO: 9009-199
RETUR RVICE REQUESTED 34Z85 INVOICE NO: PH1042946
DX NO: KOPDX
INVOICE DATE: 07/31/13
000�s�o,o� phone:877-670-6323 FACILITY: 9009 CUMBERLAND CROSSING
PATIENT NO: 199
You may also view/pay your bills at: PATIENT NAME: SWARTZ,MARY
https://myomniview.omnicare.com AMOUNT DUE: 395.37
Illu� u i� 6dd unll LL�IIILlliul Id T�: 0.00
li hihluiih di i li Illi
MARY SWARTZ
C!O KAREN STUM DUEDATE: O8/25/2013
1191N.MIDDLETON RaAD
CARLISLE,PA 17013-8720 AMOUNTDUE: 395.��
34285*TUN109SA53007933
� 3UMOA4PX2:1.1
KEEP TOP PORTION FORYOUR RECORDS-RETURN BOTTOM STUB WITH PAYMENT �������"���������
SWARTZ,MARY 9009 CUMBERLAND CROSSING
. � „
9009-199 07/31/13
DATE RX N0. TRANS DESCRIPTION PHYSICIAN NDC N0. GUANT AMOUNT TYPE
Medicare D Plan: HUMANA/CARE PWS MEDICARE
07/01/13 34104 LOCK PAYMENT - THANK YOU - Lockbox 20730701081505 -25.87
000289073
g OS/72/73 R2155367 CHARGE VITAMIN A &D OINTMENT Claim is not related to GUISTUITE 00168-0035-04 173.4 631 OTC
gHospice diaono�is and is therefore non-covered
0
'a
$
Messa3es �
Finance Charges may be assessed at a MONTHLY PERIOD RATE OF
1.50%(ANNUAL RATE OF 18.00%)based upon an unpald balance
outstanding 30 days or more.
PREVIOUS BALANCE CHARGES FINANCE CHARGE TOTAL CHARGES PAYMENTS & CREDITS AMOUNT DUE
474.87 6.31 0.00 421.18 -25.81 395.37
-�t ----__ -- _
1�� STATEMENT OF ACCOUNT
J OMNICARE KING OF PRUSSIA
6990B SNOWDRIFT RD
ALLENTOWN,PA 18106 PAGE:1 of 1
� ACCOUNT NO: 9009-199
RETURN SERVICE REQUESTED 34285 INVOICE NO: PH989268
DX NO: KOPDX
INVOICE DATE: 04/30/13
aoaas�o,o, phone:877-670-6323 FACILITY: 9009 CUMBERLAND CROSSING
PATIENT NO: 199
You may also view/pay your bills at: PATIENT NAME: SWARTZ,MARY
https://myomniview.omnicare.com AMOUNT DUE: 25.81
�uuid�I�PdI��I�uiIdll�Pulli���III�I�11m�m�Pu��PI� T�� o.00
MARY SWARTZ
C/O KAREN STUM DUE DATE: OS/2S/2013
1191N.MIDDLETON ROAD
CARLISLE,PA 17013-8720 AMOUNTDUE: 25.81
34285*TS209SRPQ007844
3S209ZYNk1:1,1
KEEP TOP PORTION FOR YOUR RECORDS-RETURN BOTTOM STUB WITH PAYMENT ��������������,.��
SWARTZ,MARY 9009 CUMBER�,4ND CROSSING
. � „
9009-199 04/30/13
DATE RX N0. TRANS DESCRIPTION PHYSICIAN NDC N0. GUANT AMOUNT TYPE
Medicare D Plan: HUMANA/CARE PLUS MEDICARE
04/24/73 R2752602 CHARGE SIMVASTATIN F/C 20MG TABLET (COP ) GUISTNITE 76714-0683-03 7 6.00 RX
04/24/13 R27526021 CHARGE LEVOTHYROXINE SODIUM 0.075MG GUtSTWtTE 00378-1805-07 7 6.00 RR
g 04/25/73 R2762804 CHARGE CEPACOL SORE THROAT MAX N GUISTWtTE 63824-0730-16 16 4.82 OTC
� 15MG-2.6MG L02ENGE Claim
Hospice diagnosis and is,�y r�>��y�
v ^
� 04/29/13 R2152602 CHARGE THERA-M 9MG-400MCG TABLET C 'nnt r , nrcruirc nnenc_ci.n�_e� -, .. .,.. ___
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contact us by Nov 22. `� pp�electric.com Page 1
Pp�••' 1'800-DIAL-PPL
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"�`�"""`""'"1O" ' -F:Sam to 5pm 81630-78115 Nov 22 2013 s,`t �r ""
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Your Electric Usage Profile
Billing Summary (Billing detaiis on back)
Serv�ce to: Balance as of Nov 1,2013
MARY SWARTZ $0.�
1137 PHEASANT DR N Charges:
CARLISLE,PA 17013 Total PPL Electric Utilities Charges $24 48
Meter:58044543 Total Charges
Your next meter reading is on or about Dec 3,2013. � $24 48
, ���'�S��'0�;2"�'r Z,fli3,,';. `+t,.6;y" " t �� "; � ,
This section helps you understand your electric use by Account Balance '� ''°"` �� "` ���•�'
month. Meter readings are act�al unless othenvise $24.48
noted. PPL Electric Utilities'price to compare for your rate is$0.08777 per kWh.
This graph shows the averag?number of kWh you used This changes the lst of Mar,Jun,Sept,and Dec.Visit pape�rerswitch.com
each day. You used 74 kWh in 29 days,or an average of ��N""�W'O�•state.pa.us for supplier offers.
2 kWh a day.
The average daily temperature for your area last month Your 1Aessage Center
— was 56F. • Your balance on this biil reflects$29.76 transferred
�2oi3 from account 6083077147 to this account.
e • Go Paperless,and receive a FREE LED at
3 5 pplelectric.com/gopaperless
� 4 • Information about appliance energy use and tips on
o saving energy are available through the Energy Library
3 on our Web site,pplelectric.com/e-power
m z • Before digging around your home or property,you
Q 1 should always cali the state's One Call notification
system to locate any undergreund utility lines. You ca�
° do this by simply dialing 811,which will connect you to
� F M A M � i n s o N p the One Call system. Be safe and call 811 before you
dig.
Months
�
wov i Actual 57197 Pa ment Methods
Oct 3 Actual 57123 ✓� Onlme at
29 Days kWh Bilied V Pp�electric.com �ey Phone:1-80p-342_5775
._ 74 or call BiIlMatrix(service fee applies) �
ai 1-800-572_2qi3 to pay using Visa,
MasterCard,Discover or debit card.
� By Mail: Correspondence should be sent to:
2 North 9th Street Customer Services
CPC-GEWN3 827 Hausman Road
Allentown,PA 18101-1175 Allentown,Pq 18104-9392 =
�---- Other important information on the back of this bill� .
827 Hausman Road lJlentowe pqCg��I9�
Te1.800.342.5775(800.DIALPPL)Fax 484:634.3484 ••
PP��tr�c:.�m ppl•�.
AT O1 003478 221 48 13 A••3DGT ��OC41C��aes '�
IPhhrv����qli� Iq��IP��ul�luhrq��pu���ii��u��ii
MARY SWAR
22 RIDGEWAY DR October 08,2013
CARLISLE PA 17015-7613
�
Bill Account No:81630.78115 '
Dear C�stomer,
During an automated review of closed accounts,our System found an account in yow name at: =
Service Address: 1402 BRADLEY DR APT A 112 �
CARLISLE PA 17013 S
Balance: $29.76 �
This balauce has been transferred to your current account. If you do not agree with these
findings or,would like to request payment terms,please call us at 1-800-358-5623. =
Sincerely, =
PPL Electric Utilities =
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Current Billing Information Page 1 of 1
05/16/13
✓ f
Insured Name: Company: CP02
Patient Name: MARY SWARTZ Account#: 0094-0103622
FACS#: 17103487
Serv���te I�e�iPf�+P�! .:.. ,>a.. ., .. .�:, .. .�.� .'; . ��its,, �tllet# ,';:; ;�ilo�t :' l�si�raiir�ResP. � Patf�nt Fiesp . .Patte�t�. F..�lent�alanae ;
04l18/13 RAD W BACKUP NIPPV-Rental 1 770.60 277.15 220.82 56.33 0.00 56.33
04/18/13 HUMIDIFIER HEATED-Purohase 1 400.00 130.01 103.59 26.42 0.00 26.42
04/18l13 HEADGEAR PAP-Purchase 1 49.69 15.43 12.29 3.14 0.00 3.14
04/18/13 TUBING PAP-Purchase 1 49.22 17.03 13.57 3.46 0.00 3.46
04/18/13 FILTER NON DISP PAP-Purchase 1 18.40 5.63 4.49 1.14 0.00 1.14
04/18/13 WATER CHAMBER REPLAC-Purchase 1 25.00 8.41 6.70 1.71 0.00 1.71
04i18i13 NASAL APPLICA7iJ PAP-Purchase 1 147.0� 50.76 40.44 10.32 0.00 10.32
04/18/13 CUSHION PAP REPLACE-Purchase 1 52.00 17.50 13.94 3.56 0.00 3.56
04/01/13 MISC ADJUSTMENTS-Purchase 0 0.00 O.OU 0.00 0.00 24.91 -24.91
PATIENT'S TOTAL BALANCE NOW 81.17
,. ,
•Ali Amo�nts are D ays.
:"'� ...:: . �aaal,nll�d�.�'`. .. .... ..: .... . .:: . ....�; :'. � ..�.�`.` z ��.�:: � ` rz
..Y .,'
* You are r�ponsible for notifying us of any change in insurance mverage or discontinued use of equipment or service. � /�/
* Faiiure to provide accurate insurance informarion rriay res�it in you beir�g billEd�ir�ct�y for products or services provided. � . ��
* Charges due include deductible and co-insurance amounts aocording to the rules of your insurance plan.
Fo�questions rega�ding your bi//-mnbct the PalrentAcct�unts Depa�iment at 866-418-2772 /,�
�� �C,Y
When returning CPAP/BIPAP supplies,please ship to: �Ort YouR iNFo�nOt�
•Payments and Chargas received after the last day of the p vio month may not be
Sleep Central,104 Max Hurt Dr.,Murray,KY 42071 reflected
' � ` ' '�'h�s�e��a�f��r s b wc metlf ai� i m�tt��i����'a�rider�n�.nai: . sl�an±cfiar �r+�1nr�ud��._ , .
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025060101N0400
�^ rou are responsi�ie ror notirymg us or any cnange in insurance coverage or discontinuea use or eqwpment or senrice. I
* Failure to provide accurate insurance information may result in you being billed directly for products or services provided.
* Charges due include deductible and co-insurance amounts according to the rules of your insurance plan.
Fo�questions rega�ding your bi//-contad the PatientAccounts Departinent at 866-418-2771
When rctumi�g C?AP/BIPAP supp[9es,ple�se ship te: FOR YouR iNFow�u►rioN
Sleep Central,104 Max Hurt Dr.,Murray,KY 42071 •Payments and Charges received after the last day of the previous month may not be
reflected
,..�: ?c .�ir..'�.�, .�i..s ,.�..,,r,. .,..�. . .�l.T.��iS"[.�� .a ,•_:�.!'� v""'; �������z-R'{/Yl �.���_'f!����R*�'^Q'�� ����J�iRtY �1��.� �i . :i��'�
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***Understanding your statement***
QNewly designed payment coupon now located at the top of the statement. Be sure to include any address or insurance changes on the reverse side.
QThis section contains important account identification information. The Account#and/or FACS#may be necessary if contacting the Patient Accounts
Department or using on-line payment system.
QBilling Information Detail has been expanded to include information about Insurance Payments,Patient Responsibility,Patient Payments and Patient Balance.
026330202T0000
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KEEP THIS PORTION OF THE BILL FOR YOUR RECORDS �
South Middleton Township Municipal Authority 345 Lear Lane, P.O. Box 8, Boiling Springs, PA 17007 (717) 258-6476
SERVICEADDRESS 22 RIDGEWAY DRIVE accT No. 01611750
METER ID# 039177�7
METER DATE METER#1 METER#2 METER#3 METER#4 METER READING KEY
READING
CURRENT A=ACTUAL
6/16/2014 540 A 0 0 0
E=ESTIMATED
PREVIOUS 3/14/2014 539 A 0 0 0
TOTAL GALLONS USED 'I,OOO
SERVICE tiNITS t'aALLONS CURFEFiT pAST DUE CREDIT TOTt1L
TYPE BILLED BILLED CHARGES DUE SERVICE PERIOD
WATER 1 1,�00 2$.56
28.56 FROM 04/01/2014
f SEWFR
1 106.66 -13.52 93.'14
FIRE ro 06/30/2014
SURCHARGE
� �' 8/01/2014 -.. �. �3�.22 PAY NET BY pLEASE SE�ADDITIONAL
� DUE DATE
IMPORTANT INFORMAT�ON
ALL PAST DUE AMOUNTS DUE IMMEDIATELY UPON RECEIPT 121.70 ON THE BACK OF THIS BILL
'""""""""'•"'IMPORTANT NOTICE""'•"•*"••••'•••
As previously notfied,the SMTMA sewer treatment plant is undergoing a major construction project. Heavy equipment is moving throughout the facility
and the roadway is in disrepair. At times,the road is closed due to excavation or equipment and materials that block the way. We are asking that you DO
NOT come to our office to make payments for your water and sewer bills. Please either mail the payment in the envelope provided with your bill or take
advantage of our AutoPay service. The application for AutoPay is on the back of the bill stub. If you are unable to pay by mail or use AutoPay and must
pay in perso^,ple2se ccme to the facility on FRIDAYS CNLY. The majcrity af the ccnstrurtion crews do not:vork cn Fridays and access is less restri�ed.
We are making this request for the safety af you,our customer. We thank you for following this direction during this lengthy construction period.
— --------- --- --------- ---- --- ---- __._ - ----- -__ __ _
KEEP THIS PORTION OF THE BILL FOR YOUR RECORDS
South Middleton Township Municipal Authority 345 Lear Lane, P.O. Box 8, Boiling Springs, PA 17007 (717) 258-6476
SERVICEADDRESS 22 RIDGEWAY DRIVE accT No. 01611750
METER ID# 03917717
METER DATE METER#1 METER#2 METER#3 METER#4 METER READING KEY
READING
CURRENT 9/15/2014 540 A Q 0 O A=ACTUAL
--- -- — — --- — — E=ESTIMATED
PREVIOUS 6/16/2014 540 A 0 0 0
TOTAL GALLONS USED
SERVICE UNITS GALLONS CURRENT TOTAL SERVICE PERIOD
TYPE BILLED BILLED CHARGES PAST DUE CREDIT DUE
VJATER � 28.56 28.56 FROM 07/01/2014
SEWER � 106.66 106.66
FIRE To 09/30/2014
SURCHARGE
� �� 1/03/2014 � , � � �. 148.74 PAY NET BY pLEASE SEE ADDITIONAL
DUE DATE
IMPORTANT INFORMATION
ALL PAST DUE AMOUNTS DUE IMMEDIATELY UPON RECEIPT 135.22 ON THE BACK OF THIS BILL
""""""""'SPECIAL NOTICE"""""""""""•*
SMTMA IS DIRECTING THAT CUSTOMERS DO NOT COME TO THE ADMINISTRATION OFFICE TO PAY BILIS IN PERSON.
THE SMTMA SEWAGE TREATMENT PLANT IS UNDER AN UPGRADE/EXPANSION PROJECT. THE GROUNDS AROUND THE PLANT,WHICH
INCLUDE THE ADMINISTRATION OFFIGE,ARE AN ACTIvE CONSTRUCTION SITE. HEAW E�UIPMENT�S MOVING DURING ALL PARTS OF THE
WORK DAY. THE ENTRANCE LANE AND DRIVEWAYS AT OUR LOCATION ARE BEING DUG UP AND REPOSITIONED. THE ROADWAY IS
OFTEN BLOCKED/CLOSED DURING THE DAY FOR EXCAVATION. THE PROJECT IS EXPECTED TO CONTINUE FOR THE NEXT 12 MONTHS.
DURING THIS TIME,PLEASE MAIL YOUR PAYMENTS IN THE ENCLOSED RETURN ENVELOPE INCLUDED WITH YOUR BILL OR TAKE
ADVANTAGE OF OUR AUTO-PAY OFTION WHIGii ViiILL DRAFT THE PAYMENT FRGM YOUR CFieCKING OR 3AVINGS ACCOUNT ON THE DUE
DATE OF THE BILL. THANK YOU FOR YOUR COOPERATION IN THIS MATTER.
KEEP THIS PORiION OF THE BILL FUR YUUH HECUHUS
South Middleton Township Municipal Authority 345 Lear Lane, P.O. Box 8, Boiling Springs, PA 17007 (717) 258-6476
SERVICE ADDRESS 2 RIDGEWAY DRiVE accT No. 01611750
METERID 03917717
METER DATE METER#1 METER#2 METER#3 METER#4 METER READING KEY
READING
A=ACTUAL
CURRENT 12/18/2013 539 A � Q Q
E=ESTIMATED
PREVIOUS 09/16/2013 539 A 0 0 0
TOTAL GALLONS USED
SERVICE UNITS GALLONS CURRENT pqST DUE CREDIT TC.`TAL
TYPE BILLED BILLED CHARGES DUE SERVICE PERIOD
WATER
1 28.56 2g.56 FROM 10/01/2013
SEWER
1 92.75 92.75 ro
FIRE 12/31/2013
SURCHARGE
� �. PAY NET BY
02/04/2014 • '.� �� ?$3.44 DUE DQTE PLEASE SEE ADDITIONAL
IMPORTANT INFORMATION
ALL PAST DUE AMOUNTS DUE IMMEDIATELY UPON RECEIPT 121.31 ON THE BACK OF THIS BILL
"""""""""""NOTICE OF SEWER RATE INCREASE"""'••""""`••"•
A SEWER RATE INCREASE OF 15%WAS APPROVED BY THE SOUTH MIDDLETON TOWNSHIP MUNICIPAL AUTHORITY BOARD ON DECEMBER
9,2013. THE INCREASE WILL TAKE EFFECT FOR ALL SEWER SERVICES ON JANUARY 1,2014. THE INCREASED RATES WILI APPEAR ON
THE 1ST QUARTER BILL WHICH WILL BE MAILED AT THE BEGINNING OF APRIL 2014. THIS INCREASE IS NECESSARY TO FUND THE
MANDATED UPGRADE OF SOUTH MIDDLETON TOWNSHIP MUNICIPAL AUTHORITI^S SEWER TREATMENT PLANT TO COMPLY WITH THE
CHE3A?EAKc SAY INITIATlVE FOR NUTRIEIvT R�MOVAL OF ALL{,NASTE:NATER SOURCES THF:T DI�CFiARGE!NTO THE BAY. THE
RESIDENTIAL QUARTERLY SEWER RATE WILL INCREASE FROM$92.75 PER QUARTER TO$106.66 PER QUARTER. COMMERCIAL AND
INDUSTRIAL SEWER RATE INFORMATION IS AVAILABLE UPON REQUEST.
---------- -------_
KEEP THIS PORTION OF THE BILL FOR YOUR RECORDS
South Middleton Township Municipal Authority 345 Lear Lane, P.O. Box 8, Boiling Springs, PA 17007 (717) 258-6476
SERVICE ADDRESS 22 RIDGEWAY DRIVE accT No. 01611750
METERI # 03917717
METER ATE METER#1 METER#2 METER#3 METER#4 METER READING KEY
READING
A=ACTUAL
CURRENT 03/14/2014 539 A 0 0 0
E=ESTIMATED
PREVIOUS 12/18/2013 539 A 0 0 0
TOTAL GALLONS USED
SERVICE UNITS GALLOIdS CURRENT ppST DUE CREDIT TOTAL
TYPE BILLED BILLED CHARGES DUE SERVICE PERIOD
WATER
SEWER � 28.56 28.�g FROM 01/01/2014
FIRE � 106.66 106.66 To
03/31/2014
SURCHARGE
� �. PAY NET BY
05/02/2014 ' '.� �� 148.74 DUE DATE PLEASE SEE ADDITIONAL
IMPORTANT INFORMATION
ALL PAST DUE AMOUNTS DUE IMMEDIATELY UPON RECEIPT 135.22 �N THE BACK QF TH!S B!LL
`»'*„"'2013 ANNUAL WATER QUALITY REPORT-CONSUMER CONFIDENCE REPORT"""""`
THE SMTMA 2013 ANNUAL WATER QUALITY REPORT/CONSUMER CONFIDENC�REPORT IS NOW AVAILABLE ON-LINE AT report.smtme.ne!
OR YOU MAY VISIT OUR WEBSITE AT www.smtma.org. THIS REPORT CONTAINS IMPORTANT INFORMATION ABOUT THE SOURCE AND
QUALITY OF YOUR DRINKING WATER. PLEASE CALL(717)258-6476 EXT.0 IF YOU WOULD LIKE A PAPER COPY OF THE REPORT MAILED TO
YOUR HOME.
LA SMTMA 2013 INFORME ANUAL DE LA CALIDAD DE AGUA POTABLE/C�NSUMER INFORME CONFIANZA SE ENCUENTRA AHORA
DISPONIBLE EN LINEA EN report.smtma.net O SITIO WEB EN www.smtma.org. ESTE iNFORME CONTIENE INFORMACION IMPORTANTE
ACERCA DEL ORIGEN Y LA CALiDAD DE SU AGUA POTABLE. POR FAVOR LLAMC AL(7i 7)25ts-6476 x 0 SI DESEA UNA COPiA EN PAPEL DEL
INFORME ENVIADO POR CORREO A SU CASA.
KEEP THIS PORTION OF THE BILL FOR YOUR RECORDS
South Middleton Township Municipal Authority 345 Lear Lane, P.O. Box 8, Boiling Springs, PA 17007 (717) 258-6476
SERVICE ADDRESS 22 RIDGEWAY DRIVE ���� accr.No. 01611750
METER ID# 03917717
METER E METER#1 METER'#2 METER#3 METER#4 METER READING KEY
READING
CURRENT 06/14/2013 538 i4 � 0 O A=ACTUAL
E=ESTIMATED
PREVIOUS 03/14/2013 537 A � Q �
TOTAL GALLONS USED �,OOO
SERViCE UYITS GALLONS CIiRR'cNT pqST DUE CREDIT TaT/�L
TYPE BILLED BILLED CHARGES DUE SERVICE PERIOD
WATER 1 1,000 28.56 2$•56 FROM 04/01/2013
SEWER � 92.75 �2.75 ---
FIRE ro 06/30/2013
SURCHARGE
� �' 08/02/2013 , .�� �, �3�.� PAY NET BY pLEASE SEE ADDITIONAL
DUE DATE
IMPORTANT INFORMATION
ALL PAST DUE AMOUNTS DUE IMMEDIATELY UPON RECEIPT 121.31 ON THE BACK OF THIS BILL
'"""""""""`ANNUAL WATER QUALITY REPORT(CONSUMER CONFIDENCE REPORT-CCR)"""'•""'•`
The 2012 Annual Water Quality RepoR for the Public Water System is now available on-line at:http://goo.gUgL4oX or you may visit our web site at:
www.smtma.org. If you would prefer to have a paper copy mailed to your home,please call 717-258-6476 Ext.0,Monday through Friday,8:00 am to 4:00
pm. Thank You.
""""""'""""""""""CUSTOMER ADVISORY""'•"«"""••""""'**
The South Middleton Township Municipal Authority Waste Water 7reatment Plant re-canstruction project has begun.'•""WE ARE ADVISING
CUSTOMERS THAT PAYMENT IN PERSON AT OUR ADMINISTRATION OFFICE IS BEING STRONLY DISCOURGAGED."'"'The area in and around
?he grounde ard facil�ties is an a�ive ca�st:u�ti�r.area. La:gc-he2v�,�eqcipmer'.u�ili be ir:use and the r�ad and parki�g!.t may bs blo:.lced and/or be ir.
disrepair for the duration of the project which will last approximately 24 months. We are asking that you mail your payments in with the retum envelope
provided with your bill or you may sign up for our Auto Debit payment option. IF YOU MUST PAY YOUR BILL IN PERSON,PLEASE USE EXTREME
CAUTION WHEN ENTERING AND EXITING THE AREA. If you have any questions,please contact our office and we will try to assist you. THANK YOU
FOR YOUR COOPERATION IN THIS MATfER.
-------- ---- ---- -- — - ---- ---_- - -- - --- - -- ----- -._.
KEEP THIS PORTION OF THE BILL FOR YOUR RECORDS
South Middleton Township Municipal Authority 345 Lear Lane, P.O. Box 8, Boiling Springs, PA 17007 (717) 258-6476
SERVICEADDRESS 22 RIDGEWAY DRIVE Accr.No. 01611750
TER ID# 03917717
METER DATE METER#1 METER#2 METER#3 METER#4 �1ETER READING KEY
READING
A=ACTUAL
CURRENT 09/16/2013 539 A � Q Q
E=ESTIMATED
PREVIOUS 06/14/2013 538 A 0 0 0
TOTAL GAILONS USED �,OOO
SERVICE UNITS GALLONS CURRENT ppST DUE CREDIT TOTAL SERVICE PERIOD
TYPE BILLED BILLED CHARGES DUE
WATER
1 1,006 28.56 �8.56 FROBA 07/01/2013
SEWER
1 92.75 92.75 ro
FIRE 09/30/2013
SURCHARGE
� �. PAY NET BY
11/04/2013 ' ' ' �� 133.44 DUE DATE PLEASE SEE ADDITIONAL
IMPORTANT INFORMATION
ALL PAST DUE AMOUNTS DUE IMMEDIATELY UPON RECEIPT 121.31 ON THE BACK OF THlS BILL
HYDRANT FLUSHING—SMTMA staff will be flushing fire hydrants throughout the township on Wednesdays and Thursdays. Hydrant flushing is done to
clear the water mains of naturelly occurring sediment that collects in the lines to ensure proper fundion of the hydrant system. If flushing is being done in
your area,you may experience di�colored water and/or releases ef air from your faucet�. Th?s is only temporary ar+d will_Mear after a few minutes ef
running water through you lines. We will attempt to send an autamated telephone message several days prior to flushing in your area. If a current phone
number is not listed above,please contact our office during regular business hours to update your infortnation. PLEASE NOTE THAT FLUSHING LINES
CP.USES NO&AFETY OR H�AL?H RELP.TED"SSUES.
""«,.""""""""""""CUSTOMER ADVISORY'""'*'."*""""""`•••*'•
The South Middleton Twp.Mun.Auth.Waste Water Treatment Plant re-construction project is now underway. ""WE ARE ADVISING CUSTOMERS
iHAT�AYMENT IN PERSON AT vUR ADMINISTF2A7iON OFFICE IS STRONGLY DISCOURAGED."' The area in and around our oTfice is an active I
canstrudion zone,and construdion may limit access to our facility for the next 72 to 78 months. Large heavy equipment is in use and the road and
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� Past Biil Iniormation-UGI Utility ,� � �„,}tu„�r���,y «tis,� , ,
_� The account balance on your last bill was................. $64.46 0�'�����5'������ � +
- B15 3EdYICf Thankyo�foryourpaymentof...................................... -38.48 ,,,..,,< ,��.�u�,�.�� {1„�,.at�k_�;4
Billing Summary for Senrice to: Late Charge ........................................................................ 0.33 213772298023
MARv L SWaR7t ESr Yo�r balance as of 12/23/2014(due now)................��'�'
22 RIDGEWAY DR
CARUSLE PA 17015
Rate Classification: Current Biii Intormation-UGI Utility
Residen6ai Heafing CusYon�er Charge............................................................... 8.55
9illing Peri�d: Commadity Charge(39 CCF at$0.63205j ............... 24.65
11/17/2014 fo 12/18/2014(31 days) t�istributiun Charges(First 39 GCF at$0.33410) .... 13.03
Remote Device Read PA 5tate Tax Surcharge.............:..................................... -0.24
Que9tions? Total C�rrent Charges-UGI Ut�lity................................-�T�'$
Call 800-276-2722 or write to UGI at UGI9Uti Bty charges owed this bill .......................... 26.00 $5Z.83
PO BOX 13009 ....................................................
�eading.PA 196�2-3009 Total Amaunt Due,Please Pay by D�e Date(D1/13/2015)..................................... s 52.33
'Yoar c�rrenf UGI charges inclade
State taxes totaling abouf$1.48.
�leter Information-Next Read Date January 21,2015
3.10 Averago CCF Per Day ��;r Number Provious Reading Present Reading CCF Used
2•7° t�13E�3 4Q5�(remote) 4QS3(remotet 39
2.48
Z.17 Messages from U61
1.86 'Yoer c�r�ent prir.e ta�ompare is$0.61095/CCF.
1.55 ■Yottr fotal annual usage is 300 CCF. Yoar average monthly usage is 25 CCF.
124
p,93 •Yoer ann�al budget year began with Febr�ary 2014.
0.62 To date yo�have been billed $358.00 N
To date yuu have used $311.00 �
0.31 ;
N
D.00 •Help prevent pipeline damage,accidents and service disruptions.Call 811 before yau dig. �
0 J F M A M J J A S 0 N D `Like os on Facebook at www.facebaok.com/ugiutilities for ways to save energy,holiday
2013 Months 2014 enterfaining tips and exclusive affers.
■Tis the season when no family sfiould be cold.To donate to Operation Share,visit
, www.ugiopera6onshare.org.Or,if you need assistance,visit the website or�all ,�
LasE This 1-600-UGI-WARM.
Average Year Year
•Save time.Save the planet 5ign up fo view and pay your UGI bills online at www.ugi.cam.
'CCFfday 1•82 �•Zs �f yoe pay at a payment agent please take yo�r entire bill. Make check payable to UGI.
'Oaily temperat�re 35°F 37°F Keep this part for your records. Important i�ormation is on the back of this bill.
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Past Bill Information-U61 Utility
�H �The accaunt balance on your last bill was.__.._........ $25.00 �
— e.s sr�r�e� Thank u for ur a ���`
— Y� Yo P Y�Tient of_........................_...._.._ -25.31
eiiling Summary fir Service to: ��Charge....__...._......__..___.._...._..____...._.._.......... 0.37 213772298023
MqRy C gyypF�En Vour balance as of 10/22/2013...._.........._.
..........._.._-��d
22 PoDGEWAY DR
CARLISLE PA 17015
Rafe Classifleation: Current Bill InTormation-UGI USlity
Residential Heating Custnmer Charge.......__......_..__..........__...._....__..._.... 8.55
Biiling PeNod: Commodity Charge(5 CCF at$0.68800)........_........ 3.44
09/18/2013 to 70/17/2013(29 days) Distribution Charges(First 5 CCF at$0.33400)._.... 1.67
Remote Oevice Read PA Sfaffi Tax Surcharge.............__...._............_..__....__ -0.06
Questio�s? Total Current Charges-UGI Utility...._...._..__,.,,,._;,__'--�fi$
Call 800-276-2722 w mite to U�I at Budget&Iling Amount...__...._..........___..................__.. 25.00
PO BOX 13009 U61 Utility charges ovred fhis bfll____.............._.__..__..__...._..__.._. S 25.00
Readin ,PA 1g612-3009 -••."...."....""_...
9 Total Mrount Due,Plwse Pay by Due Date(11/12/2018) _ ........ t 25.pp
"Your current UGI charges indude -�"""""""""""�"'
State taxes totaling about$0.44.
Average CCF Per Day ��r InPormation-Next Read Date Navember 18,2019
2't0 Meter Number Previous Reading Present Reading �p� '
1'89 1113643 3703 remote
�sg 1 ) 3708(remote) 5
1.47 Meu�qes irom UGI ` _
1.26 ■Your current price to compare is$0.68919/CCF,
1.05
0.84 'Yeur tapl annual usage�s 248�F. Ycar 2verage ronth;y usage��20 C�F.
0.63 ■Your annual budget year hegan with February 2013.
p,qp To date you have been billed $267.00
�21 To date yau have used g�gq�� _
0.00 •Help prevant pipeiine damage,accidents and service disruptions.Call 811 6efore you dig. _
D N D J F M A M J J A S 0 •Save time.Save the planet Sign up to view and pay your t1Gl 6ills online at www.ugi.cam.
20i2 Mor.;hs 2013
Lsst This
A��9B Year Year -
_
�
.�
.� � Past Bfll Information-UGI Utflity
-- ewa sErvitE � �
The account balance on your last bill was....,,._........
Biiling Summa1y tor Service to: PaY�'�ents.................. $0.00
MARY L SWARTZ E5T .........�..................................................�..__�O.,,eO= 213772298023
22 RIDGEWAY DR Your balance as of 08/22/2013..................................
CARLISLE PA 17015 •• u uu
IRate Classification. I
; Residential Heating Gurrent Bill Information-UGI Utility
� BIlling Peried: Customer Charge................................._.................._
U7/19/2013 to 08/19/2013(31 days) D stri6ution Charges{First 6 CCF a8$0 3350 �����"'" E.5� ,
Remoie De�rce R 4.12
�d �A State Tax Surcharge Q�...•... 2.J1 '
� Questiona? .............................. .. -0.06 '
Total Current Charges-UGI lltilify,,,,,,,,,,,,,,,,;;;;;;;;;;;;;;;;----�-i�
i Call B00-276-2722 or write to UGI at Budget Billing Amount..............
! PO�X 13009 U61 Utility charges owed the$ti�jj 25.00
......... ,
j Reading.PA 19612-3009 ................................
Total Amount Due,Please Pay 6y Due Dak(pg/1y201�)..... ................ s 25.00
�"Your current UG!charges include . s 25.00
..... ..................
te taxes totaling about$0.47. ��""
2.1 G Average CCF Per Day ��r Intormation-Next Read C�ate Septsr�ber 19,2015
189 Meter Number Prerioua Roading Preaent Reading CCF Uaed
1113643 3690 remote
1.68 ( ) 3696(remofe) 6
1.47 Measagea from U61
�'26 •Your current price to compare is$O.6B919/CCF.
?.05
0.84 'Your total annual usage is 254 CCF. Your average monthly usage is 21 CCF.
0.63 i
0.42 ■shanged yuur Budget B Iling mount t$25 ndp��Sea�p if you ha e any Su st onse �
0.21 q
0.00 •Your annual budget year began with February 2013. '
To date you have been 6ifled g.
To date you have used $217.00 gi
ASQNDJ FMAMJJA $155.50
2012 Months 2013 ■Hel �
p prevent pipeline damage,accidents and service disruptions.Call 811 before you dig.
'Save time.Save the ptanet Sign up to view and pay yaur UGf bills online at wwyv.ugp,com.
Last This
Average Year Year
CCF/day 0.24 0.19 e '
Daily temperature 76°F 71�F If you payat a payment agent please take your entire bill. Make c6eck paya6le to UGI.
" � - K�P�his part for your records. Important lntormation is on the back ot this bill.
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�� Erie° Insurance insured Copy
�\ Exchange Mail Date: 01/28/2014
Member • Erie Insurance Group
100 Erie Ins.PI. • Erie,PA 16530
,/' Premium Invoice
�,,'"
Named Insured
MARY L SWARTZ Policyholder: MARY l, SWARTZ
22 RIDGEWAY DRIVE Policy Number: Q381880079
CARLIS�E PA 17015-7613
�.�,�: Policy Type: Ultrasure for Landlord
Poiicy Period: 02/18/Z014 - 02/18/2015
56320798
AA7638 Previous Minimum Due: $0.00
Payment: $0.00
Net Adjustments: $0.00
Past Due Amount: $0.00
Current Installment: $122.64
ERIE Agent Biiling Fees Due: $0.00
Agent tvumber ;aA7638 To pay in full: $36f3.0�
GREGORY A GARRITY Minimum Due: $122.64
2621 SPRING RD �ue Date: 02/18/2014
CARLISLE, PA 17013-8712
(717) 243-3467 Thank you for choosing Erie Insurance for your
ii�suranee na�ds!
Want to pay this bill online? Go to�nnrnN.erieinsurance.com, Pay My Bill and make a convenient, secure online payment.
Other bill paying options are also available on our Web site. Contact your Agent with questions or coverage changes.
Fees will be added for any returned payments and included on future invoices.
Keep top portion for your records/Return bottom portion with your payment
Detach here PC0004
Detach here
PC0004
Page 3 of 3
FRANK R BERTO,T��o��E�TOR TAXPAYER'S COPY
Z7o N o STONEHOUSE r�0:,� KEEP THIS PORTION FOR YOUR RECORDS
CARLIS E,PA 17015
TEMP-RETURN SERVICE REQUESTED
***** REMINDER NOTICE *****
� . � • . . :
�I�I��I����II�I����I��11��1�1�'�i�'��I��III�'I'I"������I�I��I��I
001076""*"'*""`*'*"AUTO**5-DIGIT 1T013
�WARTZ,F:ICHAP.E2 H�R":ARY L i IIiIII IIIII IIIII IIIII IIIII IIIII IIII�IIIII IIII I�II
22 RIDGEWAY DR#22
CARLISLE PA 17015-7613
To review the assessment data for this property, go to:
www.courthouseonline.com>AssessmentOffice>Cumberland>PropertyRecords.
Then enter control# 21001864 and password
...........................................................................................................................................................................................................................................................................................................
- ***** REMINDER NOTICE *****
� , � . . . •- � � • ► � ��
Payable To: FRANK ROBERTO,TAX COLLECTOR Office Hours: MAR-OCT TUES 4-7;THURS 10-1
270 N OLD STON�HOUSE RC�R� NOV-FEB BY APPOINTMENT ONLY
CARLISLE,PA 17015 EXTRA HRS APRIL 17&24 AND
AUGUST 21�28 Bill No: • 2640
PHONE(717)960-0716 Bill Date: 03l01/2013
Control No: 21001564
MAP NO: 21-12-2958-016.
Desc: 3461 SPRING ROAD Assessed Value: Land:66,300 Im rovement:89,800 Total:156,100
Discount Face ena
LOTS 3&4
Acres 1.34 Deed 0025204387 Count RE 2.131 $326,00 S5 3 5
' County Lib 0.143 $21.87 $22.32 $24.55
Munic.R!E 1.22 $186.63 $190.44 209.48
$1.00 FEE FOR ADDITIONAL RECEIPTS
Tax Payer: .
SWARTZ,RICHARD H 8�MARY L TAX AMOUNT DUE
22 RIDGEWAY DR#22 $534.50 $545.41 $699.95
CARLISLE PA 17015-7613 If Date Of Pa ent is on 3/1113 thr 0/ 3 5/1113 thru 6/30N3 / 3 o a r
.. •..• �. • •
...............................................................................................................................................................................................................................................................................................:............
***** REMINDER NOTICE **'�** �
Cumberland County Pennsylvania
� , � . . . �- . .� s � � �� •
TAX COLLECTOR COPY-RETURN WITH PAYMENT FOR PROPER CREDIT Bill No: 2640
SWARTZ,RICHARD H 8 MARY L 3461 SPRING ROAD Bill Date: 03/01/2013
22 RIDGEWAY DR#22 LOTS 3 8�4 Control No:21001864
CARLISLE PA 17015-7613 Acres 1.34 Deed 0025204387 MAP NO:21-12-2958-016.
Payable To: Assessed Value: Land:66,300 Im rovement:89,800 Total:156 100
FI�ANK ROBERTO,TAX COLLECTOR Discount Face Penalty
270 N OLD STONEHOUSE ROAD
CARLlSLE,'AA 17015 Count RE 2.131 326.00 .
Count Lib 0.143 21.87
PHONE(717)960-0716
I IIIIII IIIII II�II�IIII I'III II'll I�III IIIII II�I III)
TAX AMOUNT DUE $534.50 $545.41 $599.95 I
5 2512 2624
JENNIFER VARNER TAX COLLECTOR PRE30RTID
PO BOX 4O FIRST CLAS3 MAIL
BOILING SPRINGS PA 170070040 U.S. P03TAG8 PAID �
PERMIT NO 303
Temp-Return S ice Requested EHSNSBD1tG PA 15931 �
SCHOOL EAL ESTATE TAX STATEMENT ENCLOSED �
*******�****AUTOi'*SCH 5-DIGIT 17007 25121 AV 0.381
o��
SWARTZ RICHARD H&MARY L ��'
22 RIDG�WAY DR ���
CARLISLE PA 17015-7613 r���
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�I�I����Iltl�II���I���III�I� 2014 State e�ofAR alEst te Taxes Bi IlDate: 7/01/20?4
Con!rol Nc:040-�J06065
VABLE Assesaed Land I
mprovement Mineral Total
JENNIFER VARNER TAX COLLECTOR values 4s,400 144,900 0 193,300
PO B�X 40 xomeatead Exclusion 13,259-
BOILING SPRINGS PA 17007 0040 SOUTH MIDDLETON S.D. Discoun: Fsce Renal
Rates .00915490 .00915490 2 9c 10+k
sc: ASSESS.NO-40003507 SCHOOL R/8 1,734.25 1,769.64 1,946.60
MAP NO: 40-24-Q749-06Q. x�mesteaa creait iai.se-
22 RIDGEWAY DRIVE -- !' �'
ACRES .180 DEED 255 /2307 TAX AMOUNT DUE-----> $1,615.29 $1,648.26 $1,813.09
GREENFIELD xf Paid oa or After �/oi/aaia 9/oi/aoia 11/Ol/2014
LOT 25 PH II PB 65 PG 14 if Pa.�.d oa cr sefore e/3i/aoia io/ai/ao±a 12 31/2014
RESIDENTIAL 1 FAMILY IF TAXES ARE IN ESCROW FORWARD
TO MORTGAGE CO
x SWARTZ RICHARD H&MARY L IF NOT PAID BY 12/31/2014 THIS BILL WILL BE RETURNED TO TAX
YEH 22 RIDG�WAY DR CLAIM BUREAU FOR COLLECTION
CARLISLE PA 17015-7613
NOTICE OF PROPERTY TAX RELIEF
Your enclosed tax bill includes a tax reduction for your homestead and/or farmstead
FICE TUE-WED-THU 9:30 AM-3:00 PM property. As an eligible homestead and/or farmstead property owner,you have received
�uRs: 520 PARK DRIVE(TOWNSHIP BLDG) tax reUef through a homestead and/or farmstead exclusion which has been provided
PHONE:717-258-0127 under the Pennsylvania Taxpayer Relief Act,a law passed by the Pennsylvania General
JVARNER@SMIDDLETON.COM Assembly designed to reduce your property taxes.
/ / $
Taz Collector Signature Date Paid Amount Paid
If paying.in installment�use the coupons b�low to�ubrinit p�yments.lf paying in full use ONLYtt�e 1ST coupon belov�to s�bm�t payment.
I
U(YEAR ZO14 DATE 7/OlI2O14 BILL# 5926 I TAXYEAR ZO14 DATE 7�01�2014 BILI# 5926 � TAXYEAR ZO14 DATE 7��1�2�14 BILL# 5926
1YABLE TO � PAYABLE TO PAYABLE TO
:NNIFER VARNER TAX COLLECTOR JENNIFER VARNER TAX COLLECTOR JENNIFER VARNER TAX COLLECTOR
�BOX 40 PO BOX 40 PO BOX 40
�Il!NG SPRINGS PA 17007 0040 BOILING SPRINGS PA 17007 0040 BOILING SPRINGS PA 17007 0040
�NTRGL# CONTROL# CO.'�ITROi#
t0 006065 040 006065 040 006065
� �A.� MAP#
)-24-0748-060. 40-24-0748-060. 40-24-0748-060.
:HOOL SCHOOL SCHOOL
�UTH MIDDLETON S.D. SOUTH MIDDLETON S.D. SOUTH MIDDLETON S.D.
�X PAYER TAX PAYER � TAX PAYER
VVARTZ,RICHARD H&MARY L SWARTZ,RICHARD H&MARY L SWARTZ,RICHARD H&MARY L
PLEASE RETURN COUPON PLEASE RETURN COUPON ' PLEASE RETURN COUPON
ST WITH FIRST OR FULL PAYMENT ZND WITH SECOND PAYMENT ' 3RD WITH THIRD PAYMENT
$549.42 ON OR BEFORE 8/31/2014 $549.42 ON OR BEFORE 9/30/2014 � $549.42 ON OR BEFORE 10/31/2014
S7ALLMENiSCANNO7STARTAFTER 8/31/2014 $604.36 AFTER 10/31/20i4 $604.37 A�TER 10/31/2014
��
1LL PAYMENT AMOUNT PAY BY
DISCOUNT $1,615.29 B/31 2014
FACE $1,648.26 10 31 2014
PENALTY $1,813.09 12/31 2014
5 2512 2623
JENNIFER VARNER TAX COLLECTOR PRESORTBD
PO BOX 4O FIRST CLASS MAIL
BOILING SPRINGS PA 17007 0040 II.S. POSTAGE PAID �
PERMIT NO 303 �
Tem etum Service Requested EBENSBORG PA 15931 �
S HOOL REAL ESTATE TAX STATEMENT ENCLOSED �
**"'"`*******AUTO**SCH 5-DIGIT 17007 25121 AV 0.381 0�
22 RIDG�WAYHDRD H&MARY L ��
CARLISLE PA 17015-7613 r°u�
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II�II�I�OIIIIIII��I��II��fI� 2014 State e� fAYERCOPY BiIINo: 5925
Co��trol iJo:04G-006064
t o Real Estate Taxes Bill Date: 7/01/2014
'YABLE Aesesaed Land Improvement Mineral Total
JENNIFER VARNER TAX COLLECTOR valuee 43,100 103,000 0 146,100
PO BOX 40 SOUTH MIDDLETON S.D. Dlscount Face Penal
BOILING SPRINGS PA 17007 0040 Rates .00915490 .00915490 2+k 10+t
3CHOOL R E 1,310.78 1,337.53 1,471.2B
:sc: ASSESS.NO-40003499
nnAP►vo: ao-24-o�ae-o52. TAX AMOUNT DUE-----> $1,310.78 $1,337.53 $1,471.28
23 RIDGEWAY DRIVE
ACRES .150 DEED 2010N 1538 If Paid On or Af ter �/oi/aola 9/oi/aoia ii/oi/aoia
If Paid On or Hefore 9/31/aai4 1o/31/zoi4 ia/31/2014
GREENFIELD IF TAXES ARE IN ESCROW FORWARD
LOT 17 F'H II PB 65 PG 14 TO MOF3TG/!GE CO
RESIDENTIAL 1 FAMILY IF NOT PAID BY 1?J31l2014 THIS BILL WILL BE RETURNED TO TAX
, CLAIM BUREAU FOR COLLECTION
X SWARTZ RICHARD H&MARY L
.YER 22 RIDG�WAY DR
CARLISLE PA 1 701 5-761 3
FICE TUE-WED-THU 9:30 AM-3:00 PM
was: 520 PARK DRIVE(TOWNSHIP BLDG)
PHON E:717-258-0127 �
JVARN ER@SMI DD LETON.COM
—1� $
Tax Collector Signature Date Paid Amount Paid
_ _ If.paying in installments use,the cAuponsb�l�w ta.�ub�i4_payments.If.pa�ying in fu0 use ON�Ytt}e'I�T c.oupon belcw tr�subnit payment_
� I
JCYEAR ZO14 DATE �/OI/ZO14 BILL# 5925 ! TAXYEAR ZO14 DATE ��01�2�14 BILL# 5925 ; TAXYEAR ZO14 DATE ���1/2�14 BILL# $925
1YABLE TO ' PAYABLE TO �
PAYABLETO
:NNIFER VARNER TAX COLLECTOR JENNIFER VARNER TAX COLLECTOR , JENNIFER VARNER TAX COLLECTOR
�BOX 40 PO BOX 40 PO BOX 40
�ILING SPRINGS PA 17007 0040 BOILING SPRINGS PA 17007 0040 ' BOILING SPRINGS PA 17007 0040
�NTRt7L# �OM'ROL# ; CONTRbL#
10 006064 040 006064 � 040 006064
9� MAP#
)-24-0748-052. 40-24-0748-052. 40 24-0748-052.
'HOOL ' SCHOOL ; gCHOOL
JUTH MIDDLETON S.D. ' SOUTH MIDDLETON S.D. � SOUTH MIDDLETON S.D.
1X PAYER TAX PAYER � TAX PAYER
NARTZ,RICHARD H&MARY L SWARTZ,RICHARD H&MARY L � SWARTZ,RICHARD H&MARY L
PLEASE RETURN COUPON PLEASE RETURN COUPON � PLEASE RETURN COUPON
ST WITH FIRST OR FULL PAYMENT ZND WITH SECOND PAYMENT ; 3RD WITH THIRD PAYMENT
$445.84 ON OR BEFORE 8/31/2014 $445.84 ON OR BEFORE 9/30/2014 $445.85 ON OR BEFORE 10/31/2014
1LLMEN7SCANNOTSTARTAF7ER 8/31/2014 $490.42 AFTER 10/31/2014 �
$490.44 AFTER 10/31/2014
OR �
'AYMENT AMOUNT PAY BY �
OUNT $1,310.76 8/31/2014 '
' 1,337.53 10 31 2014 '
lTY 1,471.28 12 31 2014 �
_ .__.._
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Bills nowdue and payable To: 2014-2015 CARLISLE AREA SCHOOL DISTRICT REAL ESTATE BILL
MELANIE STRICKLAND
2053 SPRING RD 2%Discount Face 10%Penalty
CARIISLE PA 17013 Tax Type(s) Mills Jul 01-Aug 31 Sep 01-Oct 31 Nov 01-Dec 31
� �1���D I N F U L l� 12.9333 $685.70 $699.69 $769.66
Office Hours: See Reverse Side A 1 � 2014
Fhone: 717-254-1291 NUG
TAX CQl.�.ECTOR TOTAL ; ' '$685J0 , $699:69`: : 5769:66
.�. _ ,..,
. ,,<.
SWART�, RICI-�IARD i-� & IbiARY L Bill# 0040?i arcel 2s-��-��ss-ots6-���t2-A
22 RIDGEWAY DRIV� Issued 7/1/2014 �a�d use �o�
CARLISLE, PA 17015 Location 1402 BRADLEY DRIVE A-112
Beginning Assessment $54,100
HOME OWNER COPY Homestead Reduction go
Farmstead Reduction $p
N�tAssessmern $54,100
N�N����I����9u_Iu���I���I�II��I�I���Ig���II���� IF PAYING INSTALLMENTS, START WITH C;OUPON#] AT THE BOTTOM
Bius nowdue and payab�e Ta: 2014-2G15 CARLISL� AREA SC:HOO'L DISTFiICT I�EAL �STATE BILL .
MELANIE STRICKLAND
2053 SPRlNG RD No Discount Facs 10%Penal:y
CARLISLE PA 17013 Tax Type(s) Mills Before Oct 31 After Oct 31
3 School 12.9333 $233.23 $256.55
�ftice iiours: See Reverse Side
Phone: 717-254-1291
Ir�tallmen4 3(Disc�rd if p�id irn Full) TOTAL � �`'$293.23% �25s:55 -
,_ , . _ . . ,,.
SWARTZ, RICHARD H & MARY L Bi11# 004071 Parce� 29-17-1583-075B-U1112-A
22 RIDGEWAY DRIVE Issued 7/1/2014 �a�d use �o�
CARLISLE, PA 17015 Location 1402 BRADLEY DRIVE A-112
Beginning Assessment $54,100
� IMPORTANT! Homestead Reduction gp
Farmstead Reduction $p
READ INSTRUCTIONS ON BACK Net Assessment $54,100
II�IIIVIINI��NI��IU�INI�IINII��I�II�M�IV���III�NIII�I��I�InUIVII
TEAR HERE
- - - - - - - - - - - - -__ ___ - - -- - -- - -
Bi�is nowdue and payab�e To: 2�14-2015(:ARLISLE AREA S�HOOL DISTRICT REAL ESTATE BILL
MELANIE STRICKLAND
2053 SPRING RD No Discount Face 10%Penalty
CARLISLE PA 17013 Tax Type(s) Milis Before Sep 30 After Sep 30
2 School 12.9333 $233.23 $256.55
Office Hours: See Reverse Side
Phone: 717-254-1291
Instaliment 2 Discard if aid in Full ��� TorAE" '� �` '� �
� P � � . . : ,: '. $233.23.�_ -.. ._� ;$256;55�,
SWARTZ, RICHARD H & MARY L Bill# 004071 Parce� 29-17-1583-0158-U1112-A
22 R!I)GEWAY QRIVE Issued 7/1/2014 �and use �o�
CARLISLE, PA 17015 Location 1402 BRADLEY DRIVE A-112
Beginning Assessment $54,100
Homestead Reduction $0
IMPORTANT! �armstead Reduction $p
READ INSTRUCTIONS ON BACK Net Assessment $54,100
II'�II II�IIIIII iy�11811i111 IIi�Ni��li i�diill liid I�I��I�I�II INlli u1N�II u�l NII Nil6i II
_ _ _ TEAR NERE
- -.�.:. �,- _- - - - - - - - - - - - - - - - - - - -
... .._... ..._ .—
22 RIDGEINAY DRIVE issued?/1�2o?a `-��---- — — — — — — — — — — — — - ,
Location 7402 BRADLEY DRIVE A-112
r'A!]I ICI � PA?7(115 '
Bills nowdue and payab�e To: 2014-2015 CARLISLE AREA SCHOOL DISTRICT REAL ESTATE BILL
MELANIE STRICKLAND
2053 SPRING RD 2%Discount Face 10%Penalty
CARLISLE PA 17 Tax Type(s) Mills Jul 01-Aug 31 Sep 01-Oct 31 Nov 01-Dec 31
Scl��'D I� 12.9333 $981.02 $1,001.04
�d $1,101.14
Office Hours: See Reverse Side AU� 1 1 2014
Phone: 717-254-1291 STRICKIA►d�
T�C� �TOTAt $981:02 $1,00104 •
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Y
_ �1,i01 i4. �
,.. _, .r _ �. ,, >._:. . , ,
�WARTZ, RICHARD Fi & Mi-^�RY L Bill!t 0040 Parca! 29-1?-1583 0158-U4514-G
22 RIDGEWAY DRIVE Issued 7/1/2014 Land Use �o�
CARLISLE, PA 17015 Locatlon 1414 BRADLEY DRIVE G-114
Beginning Assessment $77,400
HOME OWNER COPY Homestead Reduc?ion g�
Farmstead Reduction $p
Net A;sessment $77,400
II�1�I�RIlp�qR1�19N1.pI�N�I�NIip���I�qIII�I�IIIIII�n���NII�II IF PAYING INSTALLMENTS, START WITH COUPON#1 AT THE BOTTOM
Bi��s nowd�e and payab!e To: 2p14-2015 CARLISLE AFiEA SCHO�L DISTRICT REAL ESTATE BILL
MELANiE STRICKLAND
2053 SPRING RD No Qiscount Face 10%Penalty
CARLISLE PA 17013 Tax Type(s) Mills Before Oct 31 After Oct 31
� School 12.9333 $333.68
$367.05
O�ice Hours: See Reverse Side
Phone: 717-254-1291
Insiailm�nt 3(Disca�d i�p�id in Fuli) TOTAt.' ;-:$�� ; �s�.� ;;
SWARTZ, RICHARD H & MARY L Bill# 004074 Parcei 29-17-1583-0156-U4114-G
22 RIDGEWAY DRIVE Issued 7/1/2014 �a�d use �o�
CARLISLE, PA 17015 Location 1414 BRADLEY DRIVE G-114
Beginning Assessment $77,400
� IMPORTANT! Homestead Reduction gp
Farmstead Reduction $p
READ INSTRUCTIONS ON BACK Net Assessment g77,400
II�I I�WIII I�hN�Ip Ilql�I I�I��I��d I���II�I alll�II q�aN�INI il
---- -- TEAR HERE
- - - - - - - - - - - - - - - - - - - -_- - - =- - _ - -- - - -
Bills nowdue and payab�e To: 2014-2V15 CARLI�LE AREA SCHOOL DISTRICT REAL ESTATE BILL
MELANIE STRICKLAND
2053 SPRING RD No Discount Face 10°/a Penal
CARLISLE PA 17013 Tax Type(s) Mills Before Sep 30 After Sep 0
2 School 12.9333 $333.68 $367.05
Office Hours: See Reverse Side
Phone: 717-254-1291
Installment 2(Discard if paid in Full) �- ���= To'ra� �� " � �� ��68 �� � ��
�3sros
. . �.,. . .�, . � . � ,.
SWARTZ, RICHARD H & MARY L Bill# 004074 Parcel 29-17-1583-0158-U4114-G
22 RID�E�JVAY DRIVE Issued Z/1/2Q14 �and use to�
CARLISLE, PA 17015 Location 1414 BRADLEY DRIVE G-114
Beginning Assessment $77,400
Homestead Reduction $p
IMPORTANT! Farmstead Raduction gp
READ INSTRUCTIONS ON BACK Net Assessment $77,aoo
niN Ilii IIIIII uW Ild I�IN�iil luh I�li I�Ilii�Ilnl�lii NIIh la Illli I�IR�IN'�iil li�Vf�II�li
TEAR HERE
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Bills nowdue and payable To: 2014-2015 CARLISLE AREA SCHOOL DISTRICT REAL ESTATE BILL
MELANIE STRICKLAND 2%Discount Face 10%Penalty
2053 SPRING RD Tax Type(s) Mills Jul 01-Aug 31 Sep 01-Oct 31 Nov 01-Dec 31
CARLISLE PA 17013 ��
School �` ` 12.9333 $1,572.92 $1,605.02 $1,765.
`w` V
Office Hours: See Reverse Side �P�� `1 , ��1�
Phone: 717-254-1291 v�j � .
cj. �Q TOTAL $1,6'2 92 $1,605 02 $1,755.52.
G-�Jw^�`'���'VA�C� � `.� � �_ , � ��->
My '��C�C y Bill# 004075 Parcei 29 17-1583-061.
SWARTZ, RICHARD H & MARY L Issued 7/1;2G14 �and use �ot
22 RIDGEWHY DRfVE Location 1137 PHEASANT DRIVE NORTH
CARLISLE, PA 17015 Beginning Assessment $�2a,�0o
Hornestead Reduction $�
HOME OWNER COPY Farmstead Reduction $o
Net Assessment $124,100
I���IINNIlN�N��NlII�IlIII��IININN�NlI�II _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ IF PAYING INSTALLMENTS, START WITH COUPON#1 AT THE BOTTOM_
Bills nowdue and payable To: 2014-2015 CARLISLE AREA SCHOOL DISTRICT REAL ESTATE BILL
MELANIE STRICKLAND ya Discount �ace 10%Penalty
2053 SPRING RD Tax Type(s)
Mills Before Oct 31 After Oct 31
CARLISLE PA 17013 —�— $535.00 $588.50
School 12.9333
3
Office Hours: See Reverse Side
Phone: 717-254-1291
Installment 3(Discard if paid i�i Full) � TOTA�� � ��S��5oo": � ��'$� ����
Bill# 004075 Parcel 29-17-1583-061.
SWARTZ, RICHARD H & MARY L Issued 7/1/2014 LLoca on 1�137 PHEASANT DRIVE NORTH
22 RIDGEWAY DRIVE
CARLISLE, PA 17015 Beginning Assessment $�24,�00
Homestead Reduction $�
IMPORTANT! Farmstead Reduction $0
READ INSTRUCTIONS ON BACK
Net Assessment $124,100
IIQI�I�NIINNINNNA�U�I��IIVIIUII�IqI�II�q�bu TEAR HERE
Bills nowdue and payable To 2014-2015 CARLISLE AREA SCHOOL DISTRICT REAL ESTATE BILL
MELANIE STRICKLAND No Discount Face 10%Penalty
2053 SPRING RD Tax Type(s)
Mills Before Sep 30 After Sep 30
CARLISLE PA 17013 $535.01 $588.51
School 12.9333
�
Office Hours: See Reverse Side
Phone: 717-254-1291 �.�1 ".
Instaiimerjt 2(Discard if paid in Full)
�TOTAL ' �� 5535:01 � S5.
Bill# 004075 Parcel 29-17-1583-061.
SWARTZ, RICHARD H & MARY L i_an�±use �m
fssuetl 7/1i2014 Location 1737 PHEASANT DRIVE NORTH
22 RIDGEWAY DRIVE
CARLISLE, PA 17015 Beginning Assessment $�2a,t0o
Homestead Reduction $�
IWIPORTAN�' Farmsteaa Reduction $�
NetAssessment $124,100
READ INSTRUCTIONS ON BACK
II�IIIIIN�INIbBN81�IIIIIiII�NIIIIIiIIAdINIIi�IINIINIII� TEAR HERE
ai��s nowdue and payab�e To: 2014-2015 GARLISLE AREA SCHOOL DISTRICT REAL ESTATE BILL
MELANIE STRICKLAND
2053 SPRING RD 2%Discount Face 10%Penalty
CARLISLE PA 17013 Tax Type(s) Mills Jul 01-Aug 31 Sep 01-Oct 31 Nov 01-Dec 31
� School 12.9333 $647.67 $660.89 $726.98
PAID IN FU L
Office Hours: See Reverse Side � � �0��
Phone: 717-254-1291 AUCj
MELANIEASTRlC D.To�a� ' ,.'�sa7s�:< Ssso.es'" ` ` $�zs.ss -
TAX COI.I_ECTOR -_ .:� ,. < ,� . .�� �� � . , ;
SWARTZ, RICHARD H & MARY L Biil# 004073 Parcet 29-17-1583-015B-U2212-K
22 RIDGEWAY DRIVE Issued 7/1/201� Land Use �o�
CARLISL�, PA 17015 Location 1406 BRADLEY DRIVE K-212
Beginning Assessment $51,100
Homestead Reduction $0
HOME OWNER COPY Farmstead Reduction $o
Net Assessment $51,100
���ll�up�nlNlN��ull��NlIIp�Iiplq`I����I���I��l��„,��I�yw� IF PAYING INSTALLMENTS, START WITH COUPON#1 AT THE BOTTOM
- -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Bi��s nowdue and payab�e To: 2014-2015 CARLISLE AREA SCHOOL DISTRICT REAL ESTATE BILL
MELANIE STRICKLAND
2053 SPRING RD No Discount Face 10%Penalty
CARLISLE PA 17013 Tax Type(s) Mills Before Oct 31 After Oct 31
3 Scnool 12.9333 $22029 $242.32
)ffice Hours: See Reverse Side
'hone: 717-254-1291
lnstallment 3 �Discarci if paid in Full) �' TQTa�;�� $22o:2s��� � ; � �:�$242.32�'��
SWARTZ, RICHARD H & MARY L . . BiII# 004073 Parce� 29-17-1583-015B-U2212-K
22 RIDGEWAY DRIVE Issued 7/1/2014 �and use to�
CARLISLE, PA 17015 �ocation 1406 BRADLEY DRIVE K-212
Beginning Assessment $51,100
Homestead Reduction $0
� IMPORTANT! Farmstead Reduction $o
READ INSTRUCTIONS ON BACK Net Assessment $S�,t00
I�I�I���A�I�I����II��I��II�IQ�IIII�II��I�I�IIIIIUII�I�IINI TEAR HERE
�s nowdue and payable To: 2014-2015 CARLISLE AREA SCHOOL DISTRICT REAL ESTATE BILL
NELANIE STRICKLAND
'053 SPRING RD Tax Type(s) Mills No Discount BefoFe Sep 30 After Sep 30
;ARLISLE PA 17013
2 School 12.9333 $220.30 $242.33
i�e Hdurs: See Reverse Side
>ne: 717-254-1291
Installment 2(Discard if paid in Full) TOTA[ g22o 30 "� �, �`$242.33-
SWARTZ, RICHARD H & MARY L Bili# 004073 Parce� 29-17-1583-015B-U2212-K
22 RIDGEWAY DRIVE Issued 7/1/2014 �and:;se to�
CARLISLE, PA 17015 Location 1406 BRADLEY DRIVE K-212
Beginning Assessment $51,100
Homestead Reduction $0
I!1l�PORTANT! Farmstead Reduction $o
READ INSTRUCTIONS ON BACK Net Assessment $51,100
INI�!Iln�ll��l!!Iplllllllil&uIIIIIII��BIII��INIII��I�I�IIIIINIIIIIWIPIIIIII�I -
TEAR HERE
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�� b� 2013-2014 CARLISLE AREA SCHOOL DISTRICT REAL ESTATE TAX BILL
Bills now due and payable To: Tax Type
Millage 2%Discount Face 10%Penalty
Robin K.Sollenberger,Tax Collector 12.6056 $1,533.07 $1,564.36 $1,720.80
5 Hill Drive School
Carlisle,PA 17013
Office Hours: See Reverse Side
Phone: 717-249-0747
TOTAL $1,533.07 $1,564.36 $1,720.80
7/1-S/31 9/1-10/31 11/1 -12/31
1 B�II# 004135 ?arcel 29-17-?583-061.
Owner: , 9 L Issue Date 7h/2013 Land Use 101
SWARTZ, RICHARD H &MARY L 1� 1� �V� Location 1137 PHEASANT DRIVE NORTH LOT 5
22 RIDGEWAIr DRIVE �� BeginningAssessment $t2a,too
CARLISLE, PA 17015 2Q�3
III I
IIIIII �C� 1� �B�RGERHOME OWNER COPY
ROg?A�CpLL�CTOR
IF PAYING INSTALLMENTS,START WITH COUPON#1 AT THE BOTTOM
/'m�{� � 2013-2014 CARLISLE A�tEA SCHOOL DISTF�i�Ti REAL ESTATE TE1X�ILL
Bilis now due and payable To: Tax Type
Millage 2%Discount Face i 0%Penalty
Robin K.Sollenberger,Tax Collector Scfiool 12.6056 $668.32 $681.96 $750.16
5 Hill Drive
Carlisle,PA 17013
Office Hours: See Reverse Side
Phone: 717-249-0747
1'OTAL $668.32 $687.96 $f50.16
7/1-8/31 9/1 -10/31 11/1 -12/31
���� Bill# 004131 Parcel 29-17-1583-015B-U1112-A
Ow11e�: Land Use 1�7
SWARTZ, RiCHARD H &MA�,D � Issue Date 7/1/2013 Location 1402 BRADLEY DRIVE A-112
22 RIDGEWAY DRIVE �Q�`3 BeginningAssessment $5a,too
CARLISLE, PA 17015 �C� 1�
����������
iN K s���E'���RGER HOME OWNER COPY
�p8�AX GpL
IF PAYING INSTALLMENTS,START WITH COUPON#1 AT THE BOTTOM
�G���r�',�'`�' p`�
2013-2014 CARLISLE AREA SCHOOL DISTRICT REAL ESa ATE TAXo61 Penalty
Bills now due and payable To: Tax Type
Millage 2%Discount
Robin K.Sollenberger,Tax Collector c�hool 12.�056 $631.27
$644.15 $708.57
5 Hill f�rive -
Carlisle,PA 17013 �•
Office Hours: 71�_24g 0747 ide
Phone:
TOTAL $631.27 $644.15 $708.5
7/1-8131 9/1-10/31 11/1-12131
V"�� Bill# 004133 Paro�l 2°-17-1583-015B-U2212-K
Owner: ���,�� Land Use ���
Issue Date 7/1/2013 Location 1406 BRADLEY DRIVE K-212
SWARTZ, RICHARD H &MP� geginningAssessment ��,too
CARLDISLEWPA 1�01v5 0�,� �� �01� �,�it
��y�,'��B oR HOME OWNER COPY
II I I II I'II �pY''�P�,f'�`�
IF PAYING INSTALLMENTS,START WITH COUPON#1 AT THE a0'tT'
i�--.3"3� -- 8'�'7 l
� - ���� ���
,.�;' ���^ �d��ed L�is�l
�,,: 0003322163
1
Feb-28-14 �
� � ,i ' ��i 32117 �
0 �
� II
RICFlARD H SWAIRTZ
22 RIDGEWAY DR
�ARLISLE,�A 17015-7613 � '� � � 63.00
:u. $
� ����I'i " �e
i� ,.;. _...__�
��;:
��n'�
Balance forward: $63.00
Payments: $0.00
Adjustrnents: $0.00
Invoices: � $0.00
(a001)
RICHARD H SWARTZ
22 RIDGEWAY DR, CARLISLE PA
Serv#001 RESID TRASH 0.26 YD I
28-Feb Minimum Tag Purchase . 12.00 - $63.00
E O1Mar14-28Feb15
i Site Total $63.00
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t� - �' �.,�,��'. �.sti
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Please cut at dotted line and return the bottom portion with vour oavment ��
f'LEASE REMITTO: ���
----'ZNVOICENO.--�O'o33�i63-----------"----------- dvanced Disposal-LC
•-------------------------------
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Feb-2s-s4 � . � arol Stream, IL 6�71y7-6484
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