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03-18-15
� R�V-'1500 ��'��_„' � �sos��a�a� �y,ti` OFFiCiAL USE ONLY PA Department of Revenue pennsylvania colir,ry coae Ye�r file Number Bu�eau of Individual Taxes �EF^R7ti,E�,*oF�E:-E�,�� Po eox2aoso� INHERITANCE TAX RETURN 21 13 0 0 7 61 Harrisburg,PA 17128-0601 RESIDEIU3 DECEDENT ENTER DEGEDENT INFQRMATION BELOW Social Securily Number Date of Death Date of Birth 06 12 2Q13 03 14 1936 Qecedent's Last Name Suffix DecedenYs First Name M� URANI LtJRETTA M {If Applicable)Enter Surviving Spouse's lnformation Below Spouse's Last Name Suffix 5pouse's First Name M� Spouse's Social Security Number TH1S RETURN MUST BE FILED IN DUPl.1CATE W1TH THE REGISTER tJF V1ll��S FIL�IN APPROPRIATE OVALS BELOW � t Original Retum ❑ 2. Supplemental Return � 3,Reniainder Retum(Oate of Death Prtorto 12-13-82) [� 4_ Limited Estete � qg,Future interest Compromise (� 5. Fedarai Estate Tax Return Required (daie of death aiier 12-12-82) � g oececen�o�ed resaate � 7 Deced=_nt Mainfained a Living Trust 8, Total Number o`Safe Deposit Boxes (At:ach Copy of yVilt) IAftar,�Copy of Trusi) � 9. Litigation Proceeds Received � 10.Spo�sai Poverty Credit(Date of Death � 1�.Election to tax under Sec.9113(A) between 12-31-91 and 1-1-95) (Attach Schedule O) GORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIdENTIAL TAX INFO#2MATION SHbULD BE DIRECTED T0: Name paytime Telephone Number MICHAEL C GI4RDAN0 717 745 4160 REGISTER OF WILLS USE ONLY , �, `. '?3 First Line of Address � '-r-� ' �"� � �,.� G i ::-> 221 W MAIN STREET �-' � � s � --� - , _�� . , . -,7 -:::., , .. : , ,,..,, , � Second�ine of Address !�' CC.7 DATE FILEB-�+ City or Post Office State ZIP Code - _; MECHANICSBURG PA 17055 �---� . ' ' , ,; ., , , �- .:; ' � `�; CorrespondenYse-mai�adaress: mgiordano@giordanolaw.com "'"" �nder penalties of perjury,I declare that!have examined ihis return,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true,correct and complete.Deciaratian ofi preparer other than the personal representative is based on ail informaiion of which preparer has any knowledge. SIGNATUftE OF PERSON RESFONSiBLE F�R FI�ING RETURN DATE �� �,�,� Lori Kania �//(�//J AooR� ' 29 Lee Ann Ct , Enola, PA 17U25 SIGNA� P PREPARcR OTHER TNAN REPR S N7ATIVE. D�,TE �����.�'�"'� �,' �����''� Michael C Giardano �/ / 7/Z(/ � AOORESS Michael C.Giordano,Attarney $� Counselor at Law 221 W. Main Street, Mschanicsburg, PA 17055 Side 1 � 'I 5(?561 U 143 1�U5614143 � � �� � 150561U243 REV-1540 EX DecedenYs 5ocial Security Number oe�e��nts Na��e: L1 R A N I� L O R E T T A M. ��...._.__._..................... .. RECAPITULATiON 1. Reai Estate(Schedule A).......................................................................................... 1. 37 , soa . 00 2. Stocks and Borzds(Schedule B)......................,........................................................ 2. 3. Ciosely Heid Corporation,Partnership or Sale-Proprietorship(Schedule C).......... 3. 4. MorTgages 8 Notes Receivabie{Schedule D).......................................................... 4. 5 Cash,Bank DEposits&Misceilaneous Personai Property{Schedule E}................ 5. 1 , 51 8 . 6 4 6. Jointly Otivned Property(Scheduie F) ❑ Separate Biliing Requasted............. 6. 1 8 , �7 7 0 . 9 0 7. Inter-Vivos Transfers&Miscellaneous NotrProbate Property (Schedule G) 0 Separate 8illing Requested............. 7. 8. Total Gross Assets(total�ines 1 through 7)..,......_............................................... g. 5 7 , 0$ 9 . 5 4 ----._............_..._....._--_......_...-_ ----_____ 9. Funeral Expenses and Administrative Costs(Schedule H}..................................... 9. 3 1 , 6 6 5 . 7 0 10. Qebts of Decedent,Nortgage Liabilities and Liens(Schedule I)............................. 10. 5 , 5 7 5 . 5 1 11. Totat Deductions(total Lines 9 and 10).................................................................. 11. �7 , 2 4 1 . 2 1 12. �ei Value of Estate(Line 8 minus Line 11)............................................................. 12. 1 � , $4 8 . 3 3 13. Gharitaale and Governmentei 8equestsiSec 9113 Trusts fior which an electior�to tax has not been made(Schedule J)................................................. 13. 14. Net Vaiue Subject to Tax(Line 12 minus line 13)................................................. 14. 1 9 , $4 8 . 3 3 --------.._...---..._.......-._.._-- TAX COMPUTATION-SEE INSTRUCTiONS FQR APPtICABLE RATES 15. Amaunt of Line 14 taxable at the spousal tax raie,or transfers under Sec.9116 (a}{1.2)X.00 ��� 16. Amount of Line 14 taxable at�inea�rate X oa5 19 , 8 4 8 . 3 3 �s. 8 9 3 . 1? 17. Amount of Line 14 taxa�ie at sibiing rate X .12 ��• 18. Amount of Line 14 taxable at collaterai rate X .15 �$• 19. TAX DUE.:................................................................................................................. 19. � g 3 . 1 7 20. FILL IN TNE OVAL IF YOU ARE REQUESTING A REFUND QF AN(7VERPAYMENT, � Side 2 � '1505610243 1505E10243 � REV-1500 EX Page 3 Fite Number 21 - 13 - 00761 Decedent's Complete Address. DECEDENT'S NAME Urani, Laratta M. __......__ ---...._.__. _........._ __— _..__.._ STREET AQDRES5 1100 Grandan V1/ay, Ste. 514 _.. _...._--- _..�........ _..__....._._ ___,.. _._.........__.... ��-�, STATC Mechanicsburg PA 17U50 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) __... 893.17 2. Credits/Paymen?s A• Prior Payments 9,004.40 B. Discaunt ----..._..._.....__ Tota1 C�edits(A +B) t2) 1,004.40 3. interest (3j 0.0� � � 4. If line 2 is greater than Line 1 +Line 3,enter the difference. This is the �VERPAYMEN7. (4) 1 1 1.23 Check box on Page 2,Line 2D to request a re#und 5. if Line 1 +�ine 3 is greater than Line 2,enter the differencs. This is the TAX DUE �5� Make Check Payable to: REGiSTER OF WILLS, AGENT. ��� ���,,f � �* : �, �' � . ��',�` � � ��. .��.���� :�„e..,.�u�...���,.,. � �,,� .,.,.�,._ . ,,,,_..,��,�.._.w,._ ,�,ar,a,v�..... _., ..��M, �,_..,��� . ,.,,�,.�.. _ ,�.�..�.,��'��' .A„�,N,.�d.�_.�, P�EASE ANSWER THE FOLLOWING QUESTIONS SY PLACING AN "X" 1N THE APPROPRIATE BLOCKS 1. Did decadent make a transfer and: Yes No ,-. j— a. retai�the use or income o#the property transferred................................................................................... i �; b. retain the right to designate who shaii use the properiy transferred or its income:.................................... :� � c. retain a reversionary interest;or.................................................................................................................. � � d. receive fhe promise for iife of either payments,benefits or care?.............................................................. � ,��x 2. Ifi death occurred after Dec. 12, 1982, did decedent transfer property wi#hin one year of death without receiving adequate consideration?...........................................................................-- -.._...................._.......... ; ' � 3. Did decedent own an"in trust far" or payable upon death bank account or security at his or her death?......... ' � � 4. Did decedent own an individuai retirement account,annuity,or other non-probate property which containsa beneficiary designation?...................................................................................................................... �i � IF THE ANSWER TO ANY OF THE ABOVE QllEST1ONS IS YES,YOU MUST COMPLETE SCHEDU�E G AND FiLE IT AS PART OF THE RETURN. , : , p , � a ���re�-:���ea,�,.. �a....,e� ..n�,,=_�.,_.. �: � � . .a....���w ..e.x.. , �"Pcu�.,,x�s-s'�`l'm�.,,,,,�y.a .u..,.....n . ,....,��+�' ......,.,, ,s.�o.<. .,_. ...�.x.aa�. �.ua� ,`�6H4I�a 3r+�wu.�, a�.�wbk.... For dates of death on or after July 1, 1994 and before Jan. 1,1995,the tax rate imposed on the net vaiue of iransfers tfl or for the use of the surviving spouse is 3 percent[?2 P.S.§9116(a)(1.1)(i)]. For dates oi death on or after January 1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a){1.1)(ii}], The statute does not exempt a transfer ta a surviving spouse from tax,and the statutory rsquirements for disclosure o# assets and filing a#ax return are stiii applicable even i#the surviving spouse is the oniy beneficiary. For dates of death on or aftar.luly 1,2000:. �The tax rate imposed on the net vai�3e 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 chiid is 0 percen#[72 P.S.§9116(a)(1.2)]. •The tax rate imposed on the net value o#transfers to or for the use of the decedenfs lineal beneficiaries is 4.5 percent,except as noted in [72 P.S.§9116{a){1)j. •The tax rate imposed on the net value of transfers to or for the�se of the decedent's siblings is 12 percent[72 P.S.§9116(a){1.3). A sibling is defined under Section 9102,as an individua!who has at least one parent in common with the decedent,wfiether by bloo�or adoption. ����� ;; pennsylvania � DEPARTMENTOFREVENUE SCHEDULE A INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT FILE NUMBER ESTATE OF Urani, Loretta M. 21 - 13 -00761 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 wilfing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. Attach a copy of the settlement sheet if the property has been sold. Include a copy of the deed showing decedenYs interest if owned as tenant in common. ITEM DESCRIPTION VALUE AT DATE OF NUMBER DEATH Property located at 445 S. Liberty Street, Blairsville, PA 37,500.00 TOTAL(Also enter on Line 1, Recapitulation) 37,500.00 �►� pennsylvania SCHEDULE E �� DEPARTMENTOFREVENUE CASH BANK DEPOSITS AND MISC. INHERITANCE TAX RETURN � RESIOENT DECEDENT PERSONAL PROPERTY FILE NUMBER ESTATE OF Urani, Loretta M. 21 - 13 -00761 Include the proceeds of litigation and the date the proceeds were received by the estate.All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM DESCRIPTION VALUE AT DATE OF NUMBER DEATH 1 First Commonwealth Bank Account# ...9182 593.64 2 Automobile Dodge Neon 2003 (poor condition) 600.00 3 Household Furnishings (yard sale proceeds) 325.00 TOTAL(Also enter on Line 5, Recapitulation) 1,518.64 REV-1509 EX+(01-10) ����j,.�� pennsyivania SCHEDULE F �t DEPARTMENT OF REVENUE INHERITANCE TAX RETURN JOINTLY-OWNED PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Urani, Loretta M. 21 - 13-00761 if an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT Lori Urani Kania 29 Lee Ann Ct. Daughter A Enola, PA 17025 Linda Maria Urani McCracken 1000 Reef Circle Daughter B Placentia, CA 92870 JOINTLY OWNED PROPERTY: ITEM LETTER DATE C�F�SCRtPTIO�C�F PRO�ERTY %OF DATE OF DEATH FOR JOINT MADE Include name o inanaal ins i u ion an bank account numbe DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT or similar identifying number.Attach deed forjointly-held real VALUE OF ASSET INTEREST DECEDENT'S INTEREST estate. 1 A, B 06/30/1992 S&T Savings Account �a,198.28 33.33% 4,732.29 2 A, B 06/30/1992 S&T Checking Account 2,619.40 33.33% 873.05 3 A, B 01/26/2002 Marion Center Bank Account �,165.29 33.33% 388.39 4 A, B 10/01/1987 PNC Stock--484 shares @ $71.335 per share 34,526.14 33.33% 11,507.56 5 A, B Centric Bank Account �,708�99 33.33°/a 569.61 TOTAL(Also enter on line 6, Recapitulation) 18,070.90 REV-1511 EX+(10-09) �; ,; pennsylvania ���H ���.� DEPARTMENT OF REVENUE FUNERAL�.SES AND ����������� INHERITANCE TAX RETURN /�11A/p1�11G�T�AT7�/C/'+�1Q'�` RESIDENT DECEDENT /`�1LAIIIII�Ih7 1 IV"\1 1 V G\+W FILE NUMBER ESTATE OF Urani, Loretta M. 21 - 13 -00761 Decedent's debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER FUNERAL EXPENSES: A. 1 Skirpan Funeral Home 6,993.00 2 Lafayette Memorial Park, including Name plate and D.O.D. plate 3,221.50 3 Gary's Floral 535.00 4 Pastor Honorarium 30.00 5 Olive Garden- Funeral Luncheon/Repast 224.57 B. ADMINISTRATIVE COSTS: �, Personal Representative's Commissions Name of Personal Representative(s) Lori Kania 2,958.23 StreetAddress 29 Lee Ann Ct, city Enola state PA zip 17025 Year(s)Commission Paid 2014 2. Attorney's Fees Michael C. Giordano 900.00 3, Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Cumberland County Fees: including Letters, 6 short certificates, filing 263.50 5. AccountanYs Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs a Publication of Estate in Cumberland Law Journal 75.00 See attached 16,464.90 TOTAL(Also enter on line 9, Recapitulation) 31,665.70 Schedule H Funeral F�enses& COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN Adminisfiative Costs cor�tinued RESIDENT DECEDENT FILE NUMBER ESTATE OF Urani, Loretta M. 21 - 13-00761 9 Publication of Estate in Patriot News 123.38 �o Penelec Electric Utility for decedent's residence 221.05 �� Blairsville Municipai Authority-Water/sewer/trash for decedent's residence 303.16 �2 People's Natural Gas for decedent's residence 774.61 13 American Modern Select Insurance Co. (property insurance on decedent's residence) 747.00 �a Capital self storage (for decedent's personal property pending distribution or donation) 1,976.08 15 Lawn care and snow removal from decedent's residence 400.00 �s Vital records-copies of death certificates 27.00 �� Property taxes-school and county--for decedent's residence (2013/2014) 2,207.87 �$ Bank fees on Estate account 15.00 19 Cumberland Valley Motors-- Expenses to decedenYs auto in anticipation of sale 716.06 20 Cleaning Supplies to clean decedent's house 89.98 21 Rick Neese-- hauling and cleanout services 600.00 22 Stationary supplies and postage 166.00 23 Net settlement charges for sale of decedent's residence including seller assistance to 6,462.44 buyer and adjustments 24 Transportation costs for executor to administer estate property 508.32 z5 Faulkner podge for decedent's auto 482•97 26 Allstate Insurance for decedent's home and auto 311.26 27 Title fee and vehicle registration for decedenYs auto 32.50 Page 2 of Schedule H Schedule H Funeral E�er�ses& COMMONWEALTH OF PENNSYLVANIA ,q,�in'�shative Cos1s c�or�tinued INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF Urani, Loretta M. 21 - 13-00761 28 Hampton Inn for personal representative while administering estate property 300.22 Page 3 of Schedule H �.,,� pennsylvania SCHEDULE I � DEPARTMENTOFREVENUE DEBTS OF DECEDENT, MORTGAGE INHERITANCE TAX RETURN RESIDENTDECEDENT LIABILITIES & LIENS FILE NUMBER ESTATE OF Urani, Loretta M. 21 - 13-00761 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM DESCRIPTION AMOUNT NUMBER 1 Millenium Pharmacy Systems 331.93 2 Genesis Rehab Services 210.00 3 Omnicare Pharmacy Services of Eastern PA 30.73 4 Verizon bill 120.66 5 Joyce Plumbing & Heating 180.00 6 Veterinarian Bilis for decedent's pet 143.00 7 Milton Hershey Medical Center 150.00 8 Sarah Todd Memorial Home 1,474.98 9 Emeritus Rent June 2013-- reimbursed to Lori 1,500.00 10 Special Event Emergency Medical Services--ambulance 60.00 11 Pet care--supplies 33.45 12 Central Medical Equipment-- hospital bed 21.76 13 Select Medical/Bureau of Account Management 1,000.00 14 Per capita taxes Indiana Cty 30.50 15 Discover Card ...7816 223.94 TOTAL(Also enter on Line 10, Recapitulation) 5,575.51 SCHEDULEI DEBTS OF DECEDENT, MORTGAGE COMMONWEALTHOFPENNSYLVANIA LIABILITIES & LIENS INHERITANCE TAX RETURN RESIDENT DECEDENT co nti n u ed FILE NUMBER ESTATE OF Urani, Loretta M. 21 - 13-00761 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM DESCRIPTION AMOUNT NUMBER 16 West Shore EMS - BLS 64.56 Page 2 of Schedule I c e ue . , s .. �" N�Ma����,,,. OMB Approval No.2502•0265 0 'e`�I���I"�= A. Settlement Statement (HUD-1) I�I�II�4 e k3'�H ue�F�� 8. Type of Loan 1.OX fHA 2.Q RHS 3.�Conv.Unins. 6. File Number. �7. Loan Number: 8. Mortgage Insurance Case Number. 4 Q VA 5.Q Conv.lns. IOR2014-044 2014040442 442-3970605-703 C. Note: 7his lorm is lumished!o give you a sfateme�t ol acWa!setNemen(costs. Amounts paid to and by the setttemenl agenf are shown. Rems marketl"(p.o.c.)"we�e paid ou�side the closing;fhey are shown here for in/amationa/purposes and are not includetl in the rota/s. D. Name andAddress of Borrowec E. Name andAddress of Sellec F. Name andAtldress of Lender Barry Breedlove Jr. Estate ot�ore�ta M Urani 445 S�iberty Stteet Piaza Home Mortgage Inc. Blairsville,PA 15717 500 Edgewater Or#566 Waketield,MA01880 G. Property location; H. SettlementAgent: I. Settlement Date: 445 South Liberty Street Clear to Close SetUemani,LLC Blairsville.PA 15it7 707 Grant Street,Suite 2400 July 18,2014 Indiana County,Pennsylvania Pittsburgh,PR 15219 Ph (412)258-3600 Place of Setuement: American Dream Mortgage 16a Philadelphia Street,Indiana.PA 15701 J. Summary of Borrower's transactioo K. Summary of Seller's transaction 160. Gross Amount Due from Borrower 400. Gross Amouni Due to Seliec 101. Conttact sales rica 37.500.00 401. Cootract sales price 37,500.00 102. Personai r ert ' 402 Personal ro ert 103. Seftlemenl Char es to 8orrower(Line 140D '� 3,638.97 403. 104 ' 404. 105 405 Ad'ustments for items aid b Seller in advance Ad'ustments for items aid b Selier in advance 706. Count lBorou h Taz 07118/14 to 01/Ot/15 '� 283.4"0 0.06. Count/Borou h Tax 07/18/14 to 01101I15 283.46 107. Count Taxes to '' 407. Count Taxes to 108 School Taxes to ' 40B. School Taxes to t0�. 409. 110. �� 410. 11 L '� 411. ' 712. ' 41 Z. ', 120. Gross Amount Due trom Borrower i A1,422.43 420.Gross Amount Due to Seller 37.783.46 200. Amounts Paitl b or in Behaii of Borrower 500. Reductions in Amount Due 5eller: 201. De sit or earnest mona I 500.00 501. Excess de osit see inslructions I 202. Princi al amouN ot new loan(s 36.920.00 502. Settiement char es ro Seller Line 1400) '�� 4,353.80 203. Exislir loan(s)taken sub�ect to 503. Existin loan s taken sub'ect to 244. I 504. Payoff First Mortgage � 205. 5�5. Pa oH Second Mort a e ypg. 506. De .retained $500.00� ( 500.00 207. 507. InheritancelEstate T�Escrow i 870.00 '' 208. 508. 209. SelierAssist 6J 2250.00 509. SellerAssist(6% 2250.00 Ad'ustments for items un aid b Seiler Ad'ustments for items un aid b Seiler 210. Count/Borou h Tax to 510.Count 18orou h Tax to 21�. Count Taxes to 51�. Couni Tazes to 212. School Taxes Q7f01/14 to 071�8/14 � 45.13 512.School Taxes 07/01fi4 to 07758/14 ' 45.13 213. 513. 27q, 514. 21 S. 515. 21 fl 516. 217 517. 218. ' S18. ! 219. '�.. 5'19. 220. Total Paid tr lfor Bortower 39.615.13 520.Total Reduction Amount Due Seller � 8,019.93 300. Cash at SetUement from/to Borrower 600. Cash at settlement tolfrom Saller 301. Gross amount due irom Borrower Ifne 120 I 41,422.43 601. Gross amounl due to Seller line 420 37,783.46 302 Less amount paid by/fo�Bwrower Qlno 220) I( 39.515.131 502. Less reductions due Seller(line 520) �'�f 8.018.93 J03. Cash X�From � To Bortower � 1,607.30 603. Cash O To � From Seller '��. 29,764.53 •aa��a o�s�ae oi aaa���,e nv oo�:ows�te;,saue�rs�.ia�ee��u,o�m��a.oa�nm Tne PUGi�c ReFo�oi�g 6u�tlen fo�mI5 Cullxcoon o�inlo�mauon�s es6rnatad a��5 minutes per rssponse br collecvng.reviewinq,antl�epo�Cn9lna tlnW.Tnia apency may nol coliec[m�s iNo:maCon,ana you are not�e4ui'e0 N Comp�ete C��s brm,,:nleas it asO�aYs a a�renay�aii�i GM118 Control n�mOtc Nc cenf.tlen0alily�s assuieC,VN�is Disclosu:e ie m8ndatory.This�e desiqned W Vrov�':tle Ne VarUes to u RESRi:ovate d a ansaroon wiN inroemaoan aunng the asmemem vracess Page i of 3 HUD-t (0 R2074-044,PF D/0 R2014-Q44/32) . � l.Settlement Char es 700.Total Real Estate Broker Fees 5 3,50Q.00 Paid From Paid From Division a/commission(line 7fA)as foUo�vs: Borrowefs Seller's 7 �, � Funds at Funtls at 702. to Settieinent Settiement 703.Commission aid at settlemeM 3 000.00 704. De osit ReCd 8 Listin A an[ fo Jo Realt 5500.00 POC 705. 800.Items Pa able in Connection with Loan BOt.Our ori inaGon char e $ 1,000.00 from GFE#t 002.Your credit or charge(points)for the speci6c interest rate chosen $ -845.48 (from GFE#2) 803.Your ad usted ori ination char es from GFE#A 154.52 804. raisai tee to AMC Settlement irom GFE#3 P.O.C.5500.00(B}' 805.Credit Re ort to from GFE*3 � 806.Taxservice to fromGFE�3 � d07.Flood cerUfication to (rom GFE#3 ' ��� 8p8. from GFE i73 � 809, fromGFE#3 � ' 810. (rom GFE#3 611 ((rom GFE#3) 900.Items Re uired b Lender to Be Paid in Advance SOt.Dail interest char es irom 07N8/74 to 08l01154 i4 $4.5390DO/da from GFE#t0 63.55 902.Mor; a e insurance remium for 12 months to HUD trom GFE t13 63327 903.Homeowner's insurance for 1.0 ears lo State Farm trom GFE#11 P.O.C.5846.00 B` � � �� 904. irom GF E#11 905. (from GFE#11) tODO.Reserves De osited with Lender 7001.Initial deposilfor your escrow accou�t (from GFE tt9) 248.31 � 1002.Nomeowner's insurance 6.000 months @ S 70.50 per monlh $ 423.6U ����� ' 1003.Mort a e insurance D.00 months $ 40.41 er monlh $ 7004.Pro ert taxes 5 471.26 Count/Borou h Tax 6.000 monlhs $ 51.63 er month � �� Schooi Tazes 2.000 months 80.7A er month � 1005. 7006. months $ er monih 5 � � � � 10D7. months $ er monlh $ � 1008. 5 1009.A QreaateAdjustment $ -645.95 1700.TIUe Charges 11D1. Tille services and lender's title insurance from GFE#4 1,050.92 7102. Setllement ar closin fee 1103. Owner's title insurance to Old Re ublic National Title Insurence Com an from GPE tt5 6.50 7104. Lender's litie insurance to Old Re ublic National Title Insurance Com an 695.50 � 1105. Lender's title olic limit S 36820.00 � � 1706. Owner'stitie lic limit 5 37500.00 � � 1107. A enFs rtion of the total title insurance remium to Clear to Close Set�lemenl LLC $ 59670 � 1108. Undenvriter's rtion ot the total litle insurancs remium to Old Re ublic National Title Insurance Cc $ 105.30 . � ��� 1109. Taz Cerlifications to C�ear to Close Settlement LLC S 8��� 1110. Deed Pre aration to Clear to Close Settlement LLC $ �25_00 N71. Courier Fees to Clear to Close Settlement LLC S »�9� 1112. $ 1113. $ 1200.Government Recording and Transfer Charges 1201.GovernmeM recordin char es to Indiana Count Recorder o(Deeds hom GFE#7 138.00 1202.Deed S 62.00 Mort a e$ 76.D0 Releasas Olher$ � 1203 Transfer taxes to Indiana Count Recotder of Deeds irom GPE�8 375.00 � 1204.Cit fCount ta�lstam s Oeed S 375.09 Mor a e$ � �8��`� 1205.State tarJstamps Deed� 375.00 Mort a e$ 187.SD 12Cfi. 1207. 1300.Additionai SetHement Charges 1301.Re uired services thal u can sho for �t�om GFE!!6 1302 2014 Count lBcrcu h Taxes to Joan Baker 5 ��49 1303. Duplicate Tar Bill Fee to Joan Baker $ 5.00 130G. Current WatertSewage/Trash Biil to Blairsville Municipal Authoriry $ �9�4� 1305. Final WatedSewagelfrash Bill estima�e to 6lairsville Municipal Authority 5 SO.pO 1306.2014/2015 School Taxes to Joan Baker S `.�68.90 1400.Total Settlement Charges(entar on lines 103,Section J and 502,Section K) 3,638.97 4,353.80 'Pa�tl oub�0e o'closiAp bp bo�rowerlB},seil0t{Sj,�er:da�Il1,or m�rtl-pary�T) Certified to be a true copy. Page 2 of 3 HUD-1 (OR2014-044.PF D70 R2014-044/32) � Comparison of Good Faith Estimate(GFE)and HUD-1 Charges Good Faith Estimate HUD•1 Charges That Cannoi increase HUD-1 Line Numbe� Ouroriginationchargo #8D1 �,000.00 1,000.00 Your credit or charge(points)(or the specific rale chosen #802 -845.48 -&45.48 Your adjusted originalicn charges #803 154.52 154.52 Transfertaxes #1203 375.00 375.00 Charges That in Total Cannot increase More than 10% Good Faith Estimate HUD-1 Govemment recatling charges #1201 158.00 138.00 Appraisal fee #804 535.00 500.00 Mortgagelnsurance Premium # 902 633.27 633.27 Title services and lender's title insu!ance #1101 1,143.50 1,050.92 Owner's title insurance to Oid Republic Nalional Tdle Insurance #1103 25.00 6.50 Total 2,494.77 2,328.69 Increase between GFE and HUD-1 Charges $ -166.08 or -6.66° Charges That Can Change Good Paith Estimate HUD-1 Initial daposil for your escrow account �1001 1,755.37 248.31 Oaily irterest charges #901 S 4539000/tlay 72.62 63.55 Homeowner's insurance #903 600.00 846.00 Loan Terms Your initial loan amount is $36,820.P� Your loan term is 30.00 years Your initial interest rate is 4.5000°h Yoor initial montbly amowrt owed for principal,interest aad S 226.97 includes any moAgage insurence is � Principal O Intarest � Mortgage insurance Can your interest rate rise9 Q No � Yes,il can rise to a maximum of %. The first change will be on snd can change again every_months after . Every change date,your fnterest rete can increase or decrease by °10.. Over the life of the�oan,ycur interes�rate is guaranieed to never be lower than %or higher than %. Even if you make payments on time,can your loan balance rise? QX No � Yes,it can rise to a maximum of$ Even if you make paymonts on time,can your montbty QX No � Yes,ihe first increase can be on and the monthly amount owed for pnncipal,interest,and mortgage insurance rise? amount owed can rise to$ The msximum it can ever rise to is$ Does yourloan have a prepayment penalty? �X No � Yes,your maximum prepaymen;penalty is 5 Does your loa�hava a hailoon paymenYt QX No � Yes.you have a balloon payment of$ due in_years on Toial monthly amount owad including escrow account payments ❑ You do not have a monfhly escrow payment fa items,such as property laxes and homeowner's insurance. You must pay ihese items direcUy yourself. QX You have an additional mo�thty escrow payment of$202.87 that results in a iotal inifial monthly amount owed ot 5429.8A. This includes principal,interest,any mortgaga insurence and any items checked below: OX Properry taxes �X Homeowner's insurance � Fioodinsurance QX Schooltaxes � QX Townshiptazes Note: If you have any questions about the SetUement Charges and Loan Terms Gsted on this form,please contacl your lender. Page 3 of 3 HUD-t HUD-1 Attachment� Borrawer(s):Barry Breedlove Jc Selle�(s): Estate of Loretta M Urani 445 S Liberty Street Biairsville,PA 15717 Lender:Plaza Home Mortgage Inc. Settiement Agent:Clear to Ciose Settlement,LLC (412}258-3800 Place of Settiement:American Dream Mortgage 164 Philadelphia Street,indiana,PA 15701 Settlement Date:July 18,2Q14 Property Location:445 South�iberty Street Blairsville,PA 15717 indiana County,Pennsylvania Adjusted Origination Gharge Details BORROWER Origination Charge Origination Fee 1,OOD.00 to American Dream Mortgage Inc. Total $ 1,000.00 Origination CrediUCharge(pointsi for the specific interest rate chosen CrediUCharge -845.48 to Plaza Home Mortgage Inc. Total $ -845.48 Adjusted Qrigination Charges $ 154.52 Reserves Deposited with Lender BORROWER Homeowner's Insurance 423.00 6.OD0 at 70.50 per month 309.78 CountylBorough Tax 6.000 at 51.63 per month 161.48 School Taxes 2.D00 at 80.74 per month Aggregate Adjustment -645.95 Total S 248.31 Title Services and Lender's Title Insurance Details BORROWER SELLER Settlement Fee 200.00 to Clear to Close Settlement,LLC Other Title insura�ce CPl 75.00 to Old Republic National Title Insurance Gompany E-DoclReview Fee 50.00 to Clear to Close Settlement,LLC Courier Fee 21.42 to Glear to Close Settlement,LLC Incoming Wire Fee 9.00 to Ciear to Ciose Settlement,LLC Lender's title insurance 695.50 to Old Republic National Title Insurance Company Totai $ 1,OS0.92 $ 0.00 WARNING: It is a crime to knawingly make false stateme�ts to the U�ited Statas on this or any similar fortn. Pe�aliies upon conviction can include a fine and imprisonment. For details see: Title 18 U.S.Code Section 1001 and Section 1010. (0 R2014-044.PF D/O R2014-044/32) HUD-1 Attachment- Continued Owner's Title Insurance BORROWER SE�LER Owner's Policy Premium 6.50 to Oid Repubiic National Title insurance Company Totai $ fi.50 $ 0.00 Lender's Title Insurance BORROWER SELLER 'fees also shown above in Titie Services and Lender's Tifle Insurance Details Le�der's Policy Premium 545.50 to Old Republic National Ttie insurance Company Lender's Endorsement Charges 150.00 Endorsement Endorsement Charge PAEndorsement 10Q,300,900 150.00 7otai $ 695.5Q $ 0.00 I have carefuily reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief,it is a true and accurate statement of all receipts and disbursements made on my account or by me in this transaction. I further certify that I have received a copy of the HUD-1 Settlement Statement. Estate of Loretta M Urani Barry Breediove Jr. BY: Lori Kania Executrix To the best of my knowledge,the HUD-1 Settlement Statement which I have prepared is a true and accurate account of the funds which were received and have been or will be disbursed by the undersigned as part of the settlement of this transaction. / / ����,, ,/.���"�~" ,,"� Clear to Close Settiement,�LC Settiement Agent WARNING: It is a cAme to knowingiy make faise statements to the United States on this or any similar form. Penalties upon conviction can include a fine and imprisonment. For details see: Title 18 U.S.Code Section 1001 and Section 1010, (OR20�4-044.PF D/O R2014-044/32) c e ue I�! � '!(�� � ��� � � ���� 07 O1 20$3 t 07 31�2013 �: � � � � �=irs: t o;r�r;��nu�eal�h �ank 201]71201 b91821 102 �� �°^L��' 10000001581871 004 O1 A Indiana, �A 1570�-G��a Rddress Service Requested Customer 5ervice Information #BWNMCMC ` • O O O • • e 0 • 9 b O • • • i • P • ♦ • � a 0 i • O ♦ ♦ ! e 00006633 MFCBN153860 01 OOO�Q0000 i'ersonal Servite: 1-800-71 1-BANK i2265) LORETTA M URANI Monday -Friday 7:00 a.m. - 10:00 p.m. 29 LEE ANN CT Saturday - Sunday $:00 a.m. - 8:00 p.m, ENOLA PA 17025-194$ Aufoma#ed Service: 24 hours,7 days Main Office: First Commonwealth, PO Box 400, lndiana, PA 15741-Q400 Visit Us at www.fcbanking.tom far FREE Online Banking and-Bii[ Payment. �Visit Us Qn Facebook:firs#Commonwealth Bank Surnmarv of Bank Accounts Actaunt Type Accovnt# Ending Balance Amerlcan Dream Reward ***�`**91$2 $0.�0 Total Assets $���� News Fflr You ��.���. N a.� �� � ' �'i�� �c� �c��� ��� ��s�� ����d �����. � Everybody's Doing lt! Join the more than l OQ,000 FCB customers who enjoy the many banking conveniences of online banking. Check ` , ` � �'.�` �� laraEe�,.- b�i!!�,vieu�-tran�actior�s-ar��d-�aor�:-Enroll--_tod�y q#_�___ .___.�_ . _._. ______. {�Y� - fcbankingoniine.cam. Accaunt Summa #or American Dream Reward��'**'��"9182 Accau�#Holder: LORETTA M URANI Seginning 8alance $543.67 Average Collected Balance �210.65 (+) Deposits and Credits $0.00 Average Daily Balance �210.b5 (-}Withdrawqis and Dehits �593.67 Avg Collected �v carning Interest $43�.3� Ending Balarrce $0.00 Annual Percentage Yield Earned 0,00% Total Service Charges for Period $0.00 Interest Earned this Period �4.OQ Days in Period 31 Interest Paid Year to Date �d•3� Miscellaneons Debits and Credits Date Descripfiion Deposifs W9thdrawals Balonce Ju1 Ol Beginning Balance $543.b7 Ju112 Wifihdrawal -$593.b7 �0.00 Jul 31 Tnding Balance �0.00 News For Yau �.�,,�,�� . - - � ���" e eStatements are a secure way to receive your manfhly account updates. You'll simply be notified via email that your slatement is ready to be viewed through your online banking account. .,��' `� Switch to secure paperless stat�ments today at fchar�kingoniina.corn. o s a a o s o 0 0 o a e a s a a a a a a 4 a o e o o e K • o o • O !+ �""'T�9.+��•.. . � � . � i O INSPECTION: Be certain that fhe satety inspection (required) and emissions inspect+on(if applicable) stickers are valid_ If not,the vehicle must be ins�ected within 10 days of purchase. Forms that are needsd to cornplete the transactions listed in this fact sheet are available from authorized PennDOT agen#s or may be downloaded from PennDOT's Driver and Vehicle Services websi#e at wvsrww.d mv.stafe.pa.us. BUYER'S ACKNOINLEQGEMENT At the time of sale,the seiler shauld get a receip#fram the buyer that acknowiedges the receipt of the transferred title and deli�ery of the vehicie_ �+or your convenience, an example of a typical receipt is illustrated belo�v. BUYEF�'�s A�K1�i�'.;i�dLECt�E`,�EhlT C�F DELI' R' �1F�J'�H[CL� TCTL.� :e;�icte `.t4f:e_ ���.��c:: '�e�r t.�s�� �-'-��j :c.�filurn�e>= �� 1�� Z,`! U q t'( �l�'� � S7 � i,h3 L2 �i� � `;'��tiel� I��n�rc;:t ��P-?u�be� , :- l�- L. , 5 � i �,c3l5 P,t�$t, - 1('.,[�� � � � J �... , , . t ._'�"� �'�.., r � -- _Ye 4�1 rj �3 t - � { � �i;�G_P.r.>t � �`�--,_� `�l � °�� , �-,t . '�Vr�y :�k:�7.; �.d��r::c:i^t�_f�ic.� �:�,h'r,i� ,�ra^vrl,���s a�v�1 ka r�-r�, a,^.�J ���;�.�r,o:�r�� .�e�,:c:���~L'fIJGC a�,��Y�. t•s�:ee oF�='.'_- ^;eeY ah;s rt�.:_:_�avid�nc_c��'e and�,_,�.=s'�t t;7e vt�:c:�:,.-bu_:—. G��Z,��ii � �{J�, Please Nota: Authorized agents are under contract to PennDOT and ma�y R S�ge sesep��nanen#m,ogor�ve`hrcie} fee;thBSQ are in addition to any Penn�OT sfatutary fees for femporary, registration plates and cards or ofher related products and services offeredfees�you�aret encouraged to con+tact�h,eV�ry� fees are m8rket driven, 8nd vary by a9errt- To corrrpare service(detivery) authorized agents in pour area for the applicable service{delivery)fees charged. , , . _ � a- `� , �Yo� : . � � _.: , � : ,� �or�'Qu1 :� •- Buszness � : � .� : � ,_. ��re Revulw e:lrounu Y��u. �, OEPOS(TS MAY NOT BE AVAILABLE FOR IMMEDIATE WIT3iDRAWAI..BANK SYMBOI.TRANSAGTION NUMBER AND AMOUNT OF DEPOSIT AflE SHOWN ABOVE. c e ue ..... Resort Piaza f}ffice cu;iric Ju�r,��r: iO3UQU22d4 ���,�r;: Preierred Sauings LOi2ETTA M URANI OR L1NQA MAF2tA U}2AN1 OR LORI M UFtANi ,Page 9 ttf 2 29�.EE ANt�CT StatemeRt from: ENOI.A PA 17025-1948 May 1 ta June 30,2013 Enctosures 0 ACGOUNT SUMItAAt2Y tN'fEFiEST{71SGlOSUR� Grevinus Sta2ament Balanca 5 74 19923 Annual PemerVaga Yiew{APY}Earned d.35; Cn_posita siul Otner Adtlaions + 13 35 interesb3earfng Oays 61 VJilh[lvawa�aix.'Othe�Subiract#�ns - 13.OQc1:Hl Average Balance for APv S 1D,641.34 Ending Balenco on Juno 30.2073 5 7,21 i.o3 In;or�st Paid this Siatement $ 13.36 tow 8aklnte S 1.2�1.63 Inlerest P7o3 YTD S 4e.S3 Averagc Leager Baiance 5 1,2tt53 DAILY ACTIVITY ON Y4UR ACCOUNT NUMBEFt:1030U02244 � �.. ��Subtractions Additions Batance � �y' 05-01 Previaus Statement Baiarce 14,198. � Ofi-14 #Elec Transfier W1D $ 12,QQQ.QO - $ 2,198-28 ra ncc ooaooso+aoaonrE:u�-�v-�a 77t�E:'12:21:49 Q6-18 #Elec Tranafer W/D $ 1,Ofl0.00 - $ 1,198.28 IO RCC�30�90�4Q6DATE:t75-18-t3 TiME 17_3D_1 i 08-28 #inferest Credit $ 13.35 $ 1,211.63 06-3Q Ending Tozais $ '13,400.Q0 - $ 13.35 $ 1,211.a3 WITHDRAWALS date Amounf Oate Amount 06-1Q Elec transfer w!d 12,QOO.dd 06-18 Elec transfer w/d 1,000.00 QEPOSITS Uate Amourrt Date Amoanf 06-28 Interest credit 13.35 t 7oz5 MEh�tEER FC}IC _ $ �� �� � �.��� = -,- .- FO F`ax I'v!7 �'�' �n����.tina.PA i>i64 Resort Piaza Office _.��o:in� r=��mber: 0300901406 �.yr�: Preferred Checking LORETTA M URANI OR LINDA MARIA URANI OR LORI M URAN( P�9��°f� 29 LEE ANN GT Statement from: ENOLA PA 17025-1948 May 17 to June 14,2013 Enclosures 0 ACCOUNT SUMMARY PREFERRED DESIT CAR�REWARDS Previous Statemen;Balan�e $ 2,72°�10 Rewards this s[atemenC $ 0.00 Oeposits and Other Additions + �2.Ul0AU Checks Paid and O�her Sub:ractions - 180.00 Ending Balance or June ta,2C�73 S �-�.sis ao Just say credit and eam cash back every time Low 6alance $ 2,564.AD you use your S&T Preferred Debit Card. Average!edger Balaece 5 3.�Q4.9Z C7_ _vPN� _,..:G . _ _R�� �� v .ac2� _.... [ II=i7? [_[� ._ �:5: ' OF OGR �k:.�'I v. ���'zB�E C '�: Qn L ' K i.. .. u �IG?`: J .�.�.^: i hi.=. .. :T.�u.. .z.. ,-.�, I� � .. ..�_,.._..,� F'�. 1)a� UI1ri1L.i5! L,�..'t?� �[ �;:P;Yi ����t_.. DAILY ACTIVITY ON YOUR ACCOUNT NUMBER:0300901406 Subtracfions Additions Balance 05-17 Previous Statement Balance S 2,729.40 05-24 #Preauthorizecl Credit $ 35.00 S 2,764.40 TYCO EL'eCTRORICS PAYROL_TY 130524 06-03 #Preauthorized Debit � 180.00 - $ 2,584.40 FREEDOPA9lUE FREEDOf.1EFT L '136603 � A��,O`� Y 06-07 #Preauthorized Credik $ 35.00 � 2,619.40 " U���}� TYCO EI_ECTRONICS PAYROIL TY k�'^l�'��4" 13Q667 06-14 #Elec Transfer Credit $ 12,0�0.00 5 14,619.40 PR ACC 01030002244DATE:06-14-13 TIR9E:12:21:39 06-14 Ending Totais � 180.00 - $ 12,D70.00 S 14,619.40 17025 MEMBER FDIC • 1 .. r �� ��. �. �` �a��� ` . —' `� a $1 t I i �� ' PG&ax 14J Ind:i'�ana.FA IS10I LORET7A M URANI QR ::_.v�ur,._ ,:,::::�-: �3Q0901406 r_.rc.<.: preferred Checking Page 2 of 2 WITHDRAWALS Dafe Amount Date Amouni 06-03 Preauthorized debit 18Q.00 QEP�SITS Date Amount Dafe Amount 05-24 Preauthorized credit 35.00 0E-14 Elec transfer credit 12,000.00 06-07 Preauthorized credit 35.�0 OVERDRAFT/RETURN ITEM FEES Total for Total fhis period year-to-date Total Overdraft Fees $0.00 $0.00 Totai Returned Item Fees 50.00 $0.00 MEMBER FDfC ,. �G%iYt�i 1.,,�1�.L.iv"ft'i+y' USt.C.G4ir:✓1��.. l "� t��. 70�:: C i.71t�T F�7�I?.'r� i��' s . ;� `��) �3�� f 3�! " I'. , . �t�� C�, �'' � . � ,� . � , ,� ?.>d�a;:,., P . 1�'(31 rJ�a�-,�- a,t.�. r.�;;�c�L:s�i Ii f�irr<a� vn� 1.�U� �,— ,� � ,�z,•;1�.n_:.ru�.�cc��terli=+r>i,.�.7i:, �..�'z�.1'�� !;!E".1u�^��.t�!.0 `�e:� t�i�1�'v3"St �`:�.,'. r.)1" I.iTt.r�C.t'iiRi �I.:OC':'13:�Oi1�P.Ci�GCOI7C1�ri:.i::;i.: LORET='A M LTR.r'�?�tI OR LINDA I�iARIt? U_�I MCCP,R.C�EN OP. LORI M iJ�NI 2 9 �.�E Alv�d CT ENOL,.z PA 1'J�2 5 BliYING, BUIi.,D1NG, �R REi�'iODELING? i�iariar_ Center �ar_k_ has great LOG7 rates for vour grand plansl Stog by any of cur 8 locaticns roi: mare details . rRIMA�Y P.CCT: 20?2Q81�0 S'1'�^ENENT ?ERIQD: 06�04/2013 - 07/0^-_/2013 ________________________________--------------------------------- P?2EFER�ED fiCC``_' (Iv��7} 20^-_2081Z0 (`�E�R-TJ-�A"_'E INT�REST: 1.20) 3 ��/Ol 02 -- �EP�SITS PND M�SC��I:fiI�TE�US TRfi�?vSAC'1IONS -- INT P��.D 1��0i�'} � p� p��p.. �.I�?i`NAL P��l2CENTAGE YIELD EI�.IC�nD FOP 31 D1?YS IS .1Q = IDITER�ST ��.RIvED DTTKING �CYCLE PERIOD 0.10 � � � CU�RE�:T IN^EtcES 1 R.ATE . l 0 0 0 � -- CHECKS -- ��..,.. _v tJl�::`�r.�it. . . . . ..�'.i°ll.t J11'1'._. .Jri1� __---iV UlYlt3�_"C, ,._. . . .:.lvlUU_G'1'. . .llFl l�_ iv"t,i�iFs�,i��;��. . :�. .�si�iCiui3T. . .Lt�l� � -- BAL�i�CE sNFOR'✓�h`T1��I -- DA''E. . . . . . . . . .�t���.NCE D'A_TE. . . . . . . . . .BAI�?��CE D�TE. . . . . BA�NCE 06/03 1, 165.29 07/04 1, 165 .39 A'v�P.ACE �A1�1VCE FOR THI S S 1 r'�TEi�lENT CYCLE: $1, 15 5.2 9 SU?�:MZa.RY: , PREVIOl7S `I'O`�'�L TOT�li S�RVICE E•n�Ii3G ACCOtJI�T . , . . .NiTM3E?. . . . . . .B:`_L-Tz.'�IC�'. . . . . . . . .DEB.LTS. . . . . . . . .�RE•DiTS. . . . .CI-:hRGE. . .BALA�ICE. . ��� 20-"-208110 ',155.29 . Qp _ ,10 . 00 1, i65 .39 , ENV# CE8BDR2ZBBDC6TK_BBBBB f'� PNCIIQVBSI'MENTS.LLC � �� `�.r 1900 F.AS"I'tiIN7'H S"I�I2IiE'J' B7-YB13-:6-I "_L,�`,,�°,°"��`�' 11VVEST1UIElVTS icoiosoz Member FINRA and SIPC LORE7TA M URANI LINDA MARIA URANI � LORI M URANI 29 lEE ANN CT ENOLA PA 17025 STATEMENT FOR THE PERI00 APRIL 1,20i3 TO MAY 31,2013 LORETTA M URANI&LINDA M URAN!-Joint WROS Account Number:� ,�.,,m.� �a._-.,.�.� ,«.�,. �.�,,,.��.,�,�,N.........cs.-. .�,�.��.�..x.�.._�.....��..,....,.�.,.,�,z_.,,. ....:.,.... YOI�R INVFSTMFNT ��������Foe qucstions aboutyossc acwunu. TOTAL VALUE UF YOUR PORTFOLIO $�4�&73.76 REPRFSENTAPIVE Nation:il: 8�5 762 4683 PNC INVfSTMENTS CLN'I'BR RI2ii:}.'US FOR YOUR INFORMATION �� �����"���u�� CHANGE W VALUE OF YOUR�PORTFOLIO ������� $chcusands Srokcragc and insu ance produccs arr:Noc FDIC I��sured,Nor 13an1:Guacan�ecd and:�1ay 40.000 Lose Valim.Secueicies and brokr,cagr.srm<es az�e providai by PNG L�ves�cmenis LLC,meruber PI\RA and SIPC.Mnuicie.s aneL oeher insuruice producu are otlerrd by CNC in.s�iirarn-e 30.000 Scrvices,LLC a licensed insuranee agrncy. 20.000 10.000 . 0.000 12/10 03/t1 O6/71 09111 12l11 03/12 O6l12 09/12 12/12 03/13 CURREN C6.+u�ge In VnJ��OF]'nur Po�le'o inl���ariar can Gc f und ne Mu�r�rirour F'oonmro nt r{x rnd n j rh'u r.urnn<nt. PNC Investments,LLC - ���ne��ricd w(ch Nauom,L P;n:md�.�l Se�,•ices LLC,Memb��r ntti[:.Srnc, P�9i MK _CF,6BDk2`LZ}SBDCS37li_EI3[iHI320130531 Statement for tha Period Aprii 1,2013 to May 31,2013 � ��� LORETTA M URANI 8 LINDA M URANI-Joint WRO.�. Account Number.+��k 1N�ST1VfE�NTS Member FINRA and SIPC Account Overview .w,�,.�„m,,.�. ��a.a� .,�,.o.. ., .. . .r _ ,mPa�iaa',.� .... m}c�ta-to-I�a�e ACCO _.,��., ..�. .,�..�...� .._,_,,,,. _..,...., CHANGE IN ACCOUNT VALUE r��rr � UNT f�LLOCATION BEGINNING VALUE $32.186.00 g28,22�.04 Additions and Withdrawals ($212.96) {$408.56) Income $212.96 5408.56 Taxes,Fees and F�cpenses $0.00 �0.00 Change in Investment Value $2,48?.76 �6,451.72 ENDING VALUE(AS OF OSi3i/?3) S3A,673.76 S3A,673.76 R f �o MuulL . .f uunrom,fnr n,o,r n f;�m.arvrn or,C:ba,=gr e,r[.:';r:m:en.r t�uLa Equity 100.0'/. IF1CG(4it.• • ,.••��� ,.,., �.•,�,� •.�.��.�,� �•� � ����>�» � � .����..•�•� •�.,,•�.�� Parer,�l P�norPer'ina' C'ir»nnl Pn'ia:l TAXABLE G�rrerrti'c,io.� }ear-to-Dare Equity 100.0°6 g32,186.00 $34,673.76 Taxabia 6ividends $212.96 5406.56 TOTAI. , . ��� 100.0% $32,186.00 S34,67376 TOTAL TAXABLE 5212.96 5406 50 TOTALINCOME $212.96 $406,56 'A��o�mrAl/oe�rionrGo�,-�ri�rr�.mvagrrhurea�lal:rrrl:rrrr<p�rsre,::r�rom�rar.�[ar�or�nr�aiiu. Acco�uuAG"ncanm:frreq:r�:ic.�,f'e�in_emc«r.dorfx.ranyorteaump=ad��munm(,f�izf aul.+nar Tasnldenrcav�vri��r.trn�iredua,edarrinfem:a:im.,e:aiLzGle;nPr/Z;ardrnn:rrixr.aanm,�ri<�.nr 6r�rrofibortrore��;.NF.Shernm�ra;r:im�riam:'anrmdr��lw+ucmain»u�ruai_frertdarr , p.r� r�u d`. (}. n � ne -.�.a��f �n o.�aza n fi.r. .. � lr'�:,i�.�ir! . o:t:aJG �runmr<r.'G! r �� r.a j.d� d�::���grTr�1f L. �T!'Il� r'o a a.rhn rgr �ay cri Fa�va rG.9-L�ie.rcl hN ir ma:�ed i�r��zGn nry rfm,i«b,}.r,r yrar, be im.ludrl r.�../_.qH.: �sl...cario..!!,v rh,nr n:ey r� f/c.� � ur�..x(pn.fetu�dkcrsrro. Cnr:nd.• ym�r brok�idealrr nn��ro n,cd�i�:�:n�rrnnorrr�rrn�ba,. MESSAGES AND ALERTS� � � � � � ��� �� �"� y� U�ccu have a plan(or mdremend Call I'-.��C I��vc>[ma;n�s cudav and we r�i l�elp you get one. .: PNC Investmenis�LLC ;icco,m��u,;ed��i:l:Na�!on.al I�Ir.�c.d.J.Scr��i�es 1.1.C.IVt:mb<r •.:r;. . � kk^�.�,��, N�Sti.StPC .a-iN r,i i�inr%;z[:t3Ucrs'r�;_tita �s�_.o�:;a93i � r:�q;. :. Jt Y��n:; .::.Iti01C!.✓J :�:C•.:J��Gr;�i StAtement for the Period April t,2013 to Mey 31,2013 � ��� LORETTA M URANI&LINDR M UftANI-Joint WROS Accouni Number:� ���STMElVTS Member FINRA and SIPC Holdings NFS-provitletl cost basis,realized gain(loss)antl holdir.g per�iod inlormation may not rnflecl all adius�me�ts necessary for tax purposes. Please re/er lo Faotnoles ar:d Cozl Basis Inlormafion at the end ot ihls stalemenl for more intormation. EQT.TITIES-100.00%ofTotalA couuc Valu ,,,,�„„„ ,,,� ,,,,,,,,;;,�„,,,�,,.�r�.�«. � .�.L,,.� ,.�...���,�..__ .. 5 mhol/Cuzip Price or Current Estlmatea Tolal UnreallzeC Y� Cost Basis Gain(Loss} Description Accounl Type Quantity o5(J1/13 Market Value qnnual lncome —_.__—__..... Equity ' PNC FINL SVCS GROUP PNC 4Ec c71.64 S3k.G73.76 �S5t.E4 =stiinateeYield 2.AF.�45 CASH "uividend Op;ion�asn Capital Gaia Option�ash Total.F.quicies 534.673.76 E851.84 Total Securities $3A,G73.76 SA51.84 TOTAL PORTFOLIO VAI,L7E 53�,673.76 S85t.na � PNC lnvestmonts,LLC n�cuunc�a�,ird.�i�h N�,doo-.,l Pl�,:�n�:b�d Sr„dces I,1.C.Mcnilxr Nl'jL,SIP<: Ad!ti CEB1dDI2ZZ91�DC6TK_Lii3BiiB2o!30537 P°� Statement for the Period April 1,2013 to May 31,2013 �� LORE7TA M URANI&LINDA M URANI-Joint WROS Account Number.� � >��CT�ET�TS Member FINRA and SIPC .f�CtlVltY ADDITIONS AND V�ITHDItAWAI,S>CHECKING ACTMTY � ,� , �e.-s �,.,,� . .. ,, ..�� . �,._ , �_� ._ e .. .�.. ..... , .-�_.. f. u.a:� ,. .,,�,:_, �....,� � � �..,,, ><. �„ , . � __.. _ .. . ..,.�� _, , Expense �ate Cneck Number Payee Detaii Code Amount Cos.3asis Gain fLoss; —___—_ _—__ ..—_"'__ �...._...__ .......___ �............._--_"'____ et,«k��,�n���Ty oslton3 cHECK issu�o�rt;ir�r iisas�zsa Is2�2.ss1 Tot.d Checicing.1ctivity IS212.961 'CO"CAL ADD1T[ONS AND'WITHDRAWALS (S'L12.961 ACTTb1T'Y>INCOME>T'AX�BLL LNCOA�IE .� ... � � ,._ _ _ ,. .. �.. �� .. ,�. ., � ..,� �_ .. . _�. _x ,�.,. .� .� . _ „ . .� ..� .� .. � F. .... �.�_.. .. . � � � __ _ _ _. Set�lement .W:couM Date Tyce TransactVon DescriDtion A_�_ Quardity Amount Ta�:able Dividends OS/05/13 �NCC�11F 61VIOEND[tEC�NFC PNCFINLSUCSfRpUp 5212.9E _ _...._._. ..............-- ..._.__._. ...__--.._ .____—..__�—_..--------__ ._._.._._...__.. "Potal 7a�cable Dividends 5212.96 --...---- ._...__....___ .._... __ __....._ _.......___---....._..__........__ _ ......___ .... _. ?otal Ta�:able Inwme 5272.96 TOTAI.INCOMI: SZ�2.96 ;� PNC Invesiments:LLC ` -a�ue. '^.4,�drni 1 .,:x:;.J C.:.;cesLLC:.41�n:'ae� ?ztw�r \,til� �.IPi: MV CIIebDR7Zll6l�Cli11:_iiuflll�.2Gi30�3i Y'"�'s �'s9' a Nf,aK�.oiNtT.y,:2��9 0�a`.,�[i-'OoOno£tm_fX.lsJn ao . ? ZORETTA M Uk�Vi Date 6/28/13 Page 1 of 3 L_NDA NLARIA URANI MCCRACKEN Account Nurrioer @XYXXX@833o LORI URANI K.ANIA Enclosures 9 110 Q GRANDODI [�TAY #514 MECH_ANICSBURG PA 1"7050 JOIN US AT F,NY CENTRIC SANK FTNANCIAL CENTER FOR A CUSTOMER P.PPREC-ATION DAY AND SUMMER PTCNIC FROP�I 11AM-2PM ON J"(JNE 28�2013 (RAIN DATE: u'ULY 12TH) . ENJOY GRE?1T CONVERSATION, COMPLIMED1TFiRY FOOD-INCLUDING AOT DOGS ?�ID ICE CREl-�M - .AND ENTER A GRAND PRIZE DRAWIiVG! WE'f2E LOOKING FORWARD TO SEEING YOL'! ---- CHECKING ACCOUNTS ---- NEW BILL Pr'lY S�RVICE TO SU=T ALL OF YOUR NEEDS PLEASE CP_LL 657-7727 OR VISIT WGIW.CENTRICBANK.COM Golden Affinity Checking Number af Enclosures 9 Account Num:oer �XXXXX�y8336 Statemer_t Dates 6/C1/13 thru 6/30/13 Previous Stmt Balance 4,492.43 Days ir: the statemer_t period 3G 5 Deposits,iCredits 5,237.50 Average Ledger 3, 095 19 Checks/Debits 6,516.98 Average Collected 3, 095 Service Charge _00 Interest Earned .63 Interest Paid .63 Annual Percer_tage Yie�d Ea�ned 0.250 Current Stmt Baiance 3,213 .58 2013 Ir_terest Paid 7.26 ------------------------------------------------------------------------------- �ctivity in Date Order Date Description Amourt Balance 6/03 CHECK # 344 164.13- 4,328.30 6j03 CHECK r"r 339 10.00- 4,318.30 0/03 CHECK # 345 10.00- 4,308.30 6/04 CHECK # 3�7 116.6C- 4, 191.70 6/05 E-PAYMENT DISCOVER 44.C3- 4, 147.67 2510020270 06/OS/13 ID #-1781 TRl�CE �-091000Q15873C92 6/05 E-PAYMENT D:SCOVER 35.00- 4, 112 .67 3510020270 06/C5/13 ID #-1781 TRACE #-C9100001�07139C 6/05 PP_YMENTS JERlZON F1N_ANCIA 6C.73- 4, 051.94 91/95154C1 Q6/05/13 CHECK#-346 TRACE #-G21000025583970 6/07 ONLINE FMT BK OF AMER V:/MC 1,OOC.00- 3, 051.94 95000COCCC 06/07/13 LOPET^_A M tiRANT_ Date 6/28/13 Pag2 2 of 3 L=NDA P�RI� L'RAN: MCCP.ACKEN �ccount Numb2r �XXXXX�&336 LOR- UR�'Vi f:AN�A Enclosures ° 110 0 GR.IINDON WAY �514 MECfLANICSBURG PFi 17050 Go�den Affinity Checking �XXXXX�»8336 (Contir:ued) Activitv in Date Orde= Date � Descr_ptior_ Amour_t Balance ID #-CKr27G903571POS TRACE #-1211412�5147556 0/10 DDA R_EGULAR DEPOS=T 1,50G.00 4,551.54 oJ1G DBT CRD 1C:02 05/OS/13 �465371 26.60- 4,525.34 HESS 38424 HARRISBURG PA Card +� 315? 6/10 DBT CRD G2:55 05/08/13 Q40330fi 12.50- 4, 512.84 THE PATRIOT-NE6�]S E'L PA 717-255-815C PA Ca_d #� 3154 '0/11 CHECK #i 348 4,109.85- 402.99 5/12 XXSOC SEC SSA TP,EAS 31Q 1,306 .00 1,708.99 90317360�2 O&/12/13 ID ? TRACE #-031736046987198 &,/13 DDA REGULAR DEPOS=T �19.00 2,127.y9 bjl3 DBT CRD 10:03 06/13/13 3700001 36.74- 2,091.25 GtiLF OIL �2C46357 NUMMELSTOWv PA Card # 3154 6/14 DBT CRD C9:51 06/14/13 8001005 153 .00- 1,948.25 AVIA.N F.ND F�LINE HOSPI Camp Hi''w�'.� PA Ca_d # 315� 5/17 DBT CRD Q6:C6 05/17/13 984�988 52.41- 1, 895.84 SHEETZ C00043C° EBENSBliRG P� CaY'd �r 315� 5/18 CHECh_ # 349 311.26- 1,584 .58 5�`19 DDA REGULA.R DEPOS:T 2,000.40 3,584.5� 6%20 DBT CRD C1:5� C5/�0/13 00058?6 33 .�5- 3,551.13 GIASIT o263 ENOLA PA Card # 3154 6;`21 DBT CRD 1C:18 Co'j21/13 3700G54 61.11- 3,49C .Q2 GUL_ O?L 92C�6355 uARLISLE PA Card � 3154 . , LORETTA �4 URANI Date 6/28/13 Page 3 of 3 LINDA M.�RIA UF.F�T= P�[CCR�ICI�.EN Account Numaer �vXXXXX@8336 LORI URAi�II KANIA Enclosures 9 110 0 GR��IDON WAY #514 MECHANICSBURG PR 17050 Golden Affirity Checking @XXXXX�8336 (Continued) Activity ir_ Date O=deY Date Description Amount Balance 6/24 CRED'=T 02:24 06;22/13 0403815 12 .50 3, 5G2 .52 THE PATRIOT-NEu]S EZ PA 717-255-8150 P� CGrd # 3154 6/24 DBT CRD 07:12 06/24/13 400CC23 224 .57- 3,277.95 THE OLTVE GAP.DOG0444o1 UNIONTOWIV PA Card t 3154 5J24 DBT CRD 10:28 06/22/13 18QOC10 65.00- 3,212.95 LA_�AYETTE MEMORiAL 617 215-82628G0 PA Card r 3154 6/30 INTEREST PAID 30 D�YS .63 3, 213 .58 ------------------------------------------------------------------------------ Checks in Serial Numi�er Order Date Check No. .Amour_t Date Check No. Amount 6/03 339 10.00 6/04 3�7* 116.60 6/03 344* 164 .13 6/11 3�8 4, 109.85 6/03 345 10.00 6/18 3�9 311.26 *Irdicates Skip in Check Number ------------------------------------------------------------------------------- Daily Balar_ce Inforrration Date Ba��ance Date Balance Date Balance 6/G1 4,492 .�'3 ----����3� 6/19 3�58� .58 6/C3 4,308.30 6/12 1,708.99 / ,q 6/20 3,551.13 6{04 ^, 191.70 T�I' , 1.25 J�fj��/,� 6/21 3,490.02 6;C5 4, Q51.94 6{14 1, 948.25 '/",.`.,. "� 6/24 3,212.95 6/07 3,051.94 6/17 1, 895.84 6/30 3,213 .58 6/1C 4,512.84 6/18 1, 584.5�5 ------------------------------------------------------------------------------ Interest Rate Summary 5/31 .25°s c e ue � t :,,, �, �;iii <:��.13 P:':'. . ... ... ._ �i'lit;�lELtJ. ........ . ....... ......... ... .... . .... .... . . .. .. .. ...... .... ..... .. . . .... �JG'i O� � ...._. . ...... 1 c r� /�j', f,�r:tn a Ct��.:�:� Gc 1 . �,..� . --- r+o-6Xsaa3 . � � f�, .r. t,^/ �7� `"� �-� . �. kCL4stN[ j � � t ! -LPwC. �> a�s:_i 3/ � ' �. M.:tWEf � ..1 C.-.'l,f, f �. � �—���t' D/.7C�, Y--- . ��. t . �.�.. iYl�f?iNC 'T1s_C�i�t� f1�L11�_�`.� f"�C•i*i.-'�- �'+' j,� /'+ '�j• (j� '. ' riR71i:R[ti—.s�--.�7..�.-.._ '_.7.^`'�'.�_._ ��a � . . 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S�. ,(�Gr,�10� ,S�.�tz��e�s � � ��1 G'G�N l'C� -�-� �i�bU���y��- THE F'S'"%.TE 0: LORETTA M UR�1V= Date 8,/30/13 Fage 1 of 1 �5 LEE ANN CT Account Numb2r CXXXXX��2548 ENOLA PP Z7025 EncloNures � --- CHECKING ACCOUNTS ---- NETrt BT_LL FAY SERVICE TO SUIT ALL 0� YOUP. T7EEDS PLEASE CALL 657-7727 OR V-SIT WWW.CENTRICBAIVK.COM Business Cn=cicing Number cf Enc_osures 4 Account Number c�XXXXXQ25=18 Statem2nt Dates fi/20/13 thru 8/31/13 Previous Stmt B�_ance .00 Days in the statem2r_t period 12 1 DepcsitsjCredits 582.14 Average Ledger 956 3 Checks/Debits 74.52 Average Collected 956 S2rvice Cha�ge .00 Snterest Paid .00 Current Stmt Balar.ce 907.62 -----------------------------------------------------——-----——-----—----- Activi�y ir_ Date O;der Date Descriptior Amount Balance 8/20 DDA KEGULAR DEPOSIT 982.14 982.14 8/27 CHECK # 101 17.41- 954.73 8/28 CHECK # 102 50.25- 914.48 8;29 CH�CK # 103 6.&6- 9C7.62 -------------------------------------------------------------—------------ Chec:s ir 9eria? Nu;nper Order Date Ch2ck No. Amount Date Check No. Amount 8j27 1Ci 1'/.=1 8/29 103 6.86 8/28 1C2 50.25 *Ir_dicates Ski� in Check Number ------------------------------------------------------------------------------ Daily Ba�'_ance Ir.formation Date Balance Date Salanc2 8/20 982.14 fi/28 914.48 8/27 �So4.73 S/29 907.62 _... _ _ ._.......___ . THE ESTATE OF LORETTa M liRANI Date 2%28f14 Faqe 2 of 2 29 LEE ANN CT Accour_c Nucrber ���YXXXX���2548 ENOL� PA 17025 E^.closures 2 Busir_ess C�ecking ��XX�XX:�25_8 (Cor_tir_ued} --------------—------------------------------------------------------------ Daily 3alar_ce _rfo=matior_ Date Ba=anc� D�t� Bulance Date Balance 2/O1 3,798.12 2/1G 3,539.92 2/27 3,360.82 2,/G4 3,%14.92 2/2�� 3,386.44 THE ESTATE 0� LORETTA yt URAN� Date 8/30/13 Page 1 0= 1 29 LEE ANN ��T Account Number �XXXXXC2548 E�70LA PA 17025 Er_clasures 4 --— CHECKING ACCOIJNTS ---- �]EW BT_LL PAY SERVICE TO StiiT ALL OF YOUP NEEDS PLEASE C?�LL 557-7727 OP, VTS�T WulF7.CENTRICBAI�IK.COt�1 Business Chec;�ing D7umber of Enclosures 4 Account Nurrine� CYXXXXn2548 Statement Dates 8/20/13 thru 8/31/13 Previous Stmt Ba�ar_ce .00 Days in the statement period 12 1 DepositsjCredits 982.1� Average Ledger 956 3 C}iecks/Debits 74.52 Average Collected 956 Service Charge .00 Interest Paid .00 Currer_t Stm� Baianc� 907.62 ------------------------------------------------------------------------------ Activi�y in Date Order Date Desc�iption Amour_t Balance 8/20 DDA P,E�3ULAR DEPOSIT 982.1� 982.14 8/27 CHECK # 101 1`/.41- 964 .73 8/28 CHECK # 102 50.25- 914 .48 8/29 CHEC�C � 103 6.86- 9C7.62 ------------------------------------------------------------------------------- Chec;�s in Se�ia�. Numi�er Order Da�e Check No. Amount Date Check No. Amount B/27 101 17.41 S/29 103 6 .86 8/2� 102 5C.25 *Indicates Skip in Check Numner ------------------------------------------------------------------------------- Dai�y Balar_ce =r�fo_matior. Date Ba,�ance Date Balance 8/20 982.14 8/28 914.48 SJ27 964.73 8/29 9C7.62 THE ESTATE Or LORETTA M tiRAN� Date 9/30/13 Page 1 of 2 29 LEE �iI CT Pccount Numb2r �XXXXXQ2548 EtiOLA PA 17025 Enclosures 7 Now Available - Centric Bank Mopiie Banx�.r:g Verify transactions and balances, pay biils, transfer funds, and check account aierts - wherever �nd wheneve� it 's most convenient for you! Downlcad our f_ee app on the App Store or Google Play. ---- CHECKING ACCOUAJTS ---- NEW BILL PAY SERVICE TO StiIT ALL OF YOUR NEEDS PLEASE Ct`�LL 657-"/727 OR �J_Si1' 'v7WF7.CENTRT_CBANK.COM Business Checking Numi�er of Enclosures 7 Account Numi�er @XXXXXCu2548 Statement Dates 9/Ol/13 thru 9/30/13 Previous S�mt Salance 90�.62 Days in the statement period 30 DepositsJCredits .00 Average Ledger 442 7 Checks/Debits 786.02. Average Collected 442 Service Charge .Oo Irterest Paid •Q� Current Stm� Balar_ce 121.60 ------------------------------------------------------------------------------ Activity in Date Order Da�e Descriptior: Amount Balance 9/03 CHECK +r 10 331.96- 575.66 5i10 CHECK � 1Q01 116.50- 459.06 9f19 CHECK �' 105 46.42- 412.64 9/23 CHECK # 105 13 .17- 399.�7 9/24 CHECK �`+ 107 3�.10- 365.37 9/24 CHECK # 106 33 .77- 331.60 9/26 CHEC:� # 1002 210.00- 121.6C ------------------------------------------------------------------------------- Checks in Serial Number Order DGte Ch�ck No. Amourc D�te Check Nc. Amount 9/03 10 331.9b 9/2? 108 33 ."77 9/19 105* 46.42 9j1C 1C01* 116.60 9/23 1G'o 13 .17 9/26 1CO2 210.00 9/24 10'7 34.10 *Indicates Skip ir_ Check Numoe= THE EST�TE Qr LORETTA M URl�i` Date 9/30/13 PagE 2 of 2 29 LEE ANi�T CT ACCOunt Nu�tiper GXXXXX+w2548 BNOLA PA 17025 Er_Closures 7 Business Checkir_g ��XXxXX�2548 (Continued) ------------------------------------------------------------—----------------- Daily Ba_ar_ce �nformatio;� Date Balance Date Balance Date Salance 9/O1 907.62 9/19 =12,64 9�'25 121.60 9/C3 575.60 9/23 3°9.4't 9/10 459.C'o 9/24 331.6C T�E EST�TE OF LORETTA M URAN= Date 10/31/13 Page 2 of 2 29 LEE �NN CT Account Number @XXXXX@2548 EN�L� PA i7025 Enc�osures 7 Business Ch2cking ��XXXXX�2548 (Continued) Dai�.y Ba=ance Informatio. Date Baiar_ce Date Ba?ance Date Balance 10/O1 121.00 1C;16 543 .93 10/29 5CC.18 10/07 691.25 10/21 553 .93 10/Ofi 57� .'06 1C/22 528.93 One ent_y per electronic banicing service er_rollment, with the exception of Mobi�e and Text Banking where only one entry will be given fcr both services. Fo= afficial drati�irg ru�es, ir_cludirg eligibi�ity and how to enter, contact your loca� financial center. THE ESTATE Or LORETTA M UF.hNI Date 10/31/13 Page 1 of 2 29 LEE ANN CT ACCount Numoe: ��XXX_XX�254$ ENOLA PA 17025 Enclosures 7 Ma�e your holidays merrier & b�1QhtEr! En=o-�1 in 21eCLYGr�ic barkir_g services - e-sta�ements, online banking & nill p�r�, mobi�e � tex� banking - fo= char_ces to win a Windows Su=face 2 Tablet! ---- CNEC�?NG ACCOL'NTS ---- NEW B�LL PAY SERVICE TO SUIT ALL Or' YOUR NEEDS PLEASE CALL 657-7727 OR VIS?T G7Wir1.C�:NTR�CBANK.COM Business Checking Numi�er of Enclosures 7 Accour_t Number CXXXXX�2548 Statement Dates 10/Ol/13 triru 1C/31/13 Previous Stmt Ba�.ance 121.60 Days in the statement period 31 2 Depasits;Credi�s 579.66 Ave}�nge Ledge� 467 5 Checks/Debits 201.08 Average Collected 467 Service Cha�ge .CC Inte�est Paid .0� Current Stmt Ba'�ance 500.18 --------------------------------------------------------------—--------------- ACtivity in Date Ord2r Date Desc=iption Amour.t Baianc2 10/07 DDA REGULAR DEP05IT 569.66 691.26 10/G8 CHECK # 1003 116.6G- 574.66 10/16 CHECK #�' 1C05 30.73- 543 .93 1Q/21 DDA REGLLE�R DEPGSIT lO.OG 553 .93 10/22 CHECK # 100�s 25.00- 528 .93 1C/29 CHECIC # 1007 23.65- SC5 .28 10/29 CHECK # 1000 5.1C- SC0.18 --------------------------—--------------------------------------------------- Checks ir_ Serial Nurr�ner Ord�r Date Check No. Amount Date Check DIo. Amount 10/�S 1CO3 116.60 1Cj29 1G07 23 .65 10/16 1005* 30.73 10;2.2 1008 25.Q0 10/29 100'0 5.10 *=ndicates Skip in Check Number ------------------——-------------------------------------------------------- THE ESTATE OF LO{ETTA M UR�VT Date 11/29/13 Page 1 of 2 29 LEE ANN CT Account Number c�XXXXX«2548 ENOLA PA 17C25 Enclosures 5 Make yaur holidays merrier & brighter! Enroll in electronic banking services - e-statements, online bar.1ing & ��ill pGy, mobile & text bn�?kir_g - =o= chances to win a u;indows Surface 2 Tablet! ---- CHECKTNG ACCOUNTS ---- NEW BILL PAY SERViCE TO SUIT ALL OF YOUR NEEDS PLEASE CALL 6�'1-7727 OP. VISIT WWW.CETITRICBANK.COM Business Checking Number of Enclosures 5 Accour_'t Num.ber ���XXXXX,-x�2548 Statemer.t Dates 11/O1/13 thru 11/30/13 Previous Stmt Balance 500.18 Days in the statement period 3C 1 Deposits/Credits 1, 142.91 Averag2 Ledger 1, 022 6 Checxs/Debits 954.70 Average Collected 1, G22 Service Charge •fl� 'r.terest Paid ��� Current Stmt Ba�ar_ce 688.39 ----------------------------------------------------------------------------- Activity in Date Order Date Desc�iptior_ Amount Balarce 11/O1 DDA REGL'LAR DEPQSIi' 1, 142 .91 1, 643 .09 11/Ol EFT TRANS AMERICAN MdDFRN 391.00- 1,252.09 131G715597 11/G1/13 TD # TRACE #-04200dQ1Q096191 11fD4 ST_GONrILE Capital Self Sto 83 .20- 1,168_89 904C213841 11/04/13 =L? tt TRACE #-111924684182739 11J05 CHECK # 1C09 18.50- 1, 150.39 11/13 CHECK # 1010 116 .60- 1,033 .79 11/25 CHECK # 1012 318.40- 715.39 =1J26 CHECK # 1G13 27.00- 688.39 -------------------------------------------------------------- Checks in Serial Alumbe= O.�der Amount Da�e Check No. Amount Date Check No. 116.60 11/05 1009 18.50 11/13 1010 *�ndicates Skip in Check Numb2r THE ESTA'i'E OF LORETTA M URANI D.ate 11/29/13 Page 2 of 2 29 LEE �NN CT Account Numi�er �?XXXXX^2548 ENOLA P:a 17025 Enclosu=es 5 Busir_ess Checking :�XXXXXQ2548 (Cor_tir.ued) Checks in Seria"_ Num'oer Orde- Date Cneck No. Amount Dat2 Check No. Amount 11/25 1012* 318.40 11;26 1013 27.00 *=ndicGtes Skip in Check Number ----------------------------------------------------------------------------- Daily Balance �nformatior_ Date Balar_ce Date Salance Date BG'_ance 11/O1 1,252.C9 11/05 1,150.39 11/25 715.39 11j04 1,158.89 11/13 1, C33 .79 11/25 683.39 Or_e entr_y �e� e'_ect?-onic bar_king service er.�ollmer:t, with the exception of Mobi�e ard Text Banking whe_e on"'�y one entry wi-= be given for poth services. For officia� drawing rules, inc:uding eligibility ar_d how to er.ter, contact your loca? fir_ancia� center. THE ESTATE OF LORETTA M URANI Date 12/31/13 Page 1 of 2 29 LEE F,,.NN CT Accourt Numb�r wXXXXX�254fi E�OL� PA 17025 Enclosures 8 P�a�e your holidays merrier & brighte�! Enroll. in electranic bar_kir:g services - e-s'tatements, onli�2 ban�ing & bill pay, mabile & text banking - for chances to tivin d T�11riC10�riS Su_iace 2 Tablet! ---- CHECKING ACCOUNTS ---- NEGI BILL PAY SERV=CE TO SUIT ALL OF YOUR NEEDS PLEASE CALL 657-7727 OR VISTT WWW.CENTR�CBANI{.CdM Business Checking Num�er of Enciosures S Account Numoer �XXXXX<?2548 Statement Dates 12/Ol/13 i.hru 12/31/13 Previous SLfi,t Balance 688.39 Days in the statement period 31 1 Deposits/Credits 1,000.00 Average Ledger 1,336 8 Chec;csjDepits 585.77 Ave��age Co�_ected 1,336 Service Cnarge .00 Interest Paid .00 Curr2r_t Stmt Balance 1, 1Q�.52 ------------------------------------------------------------------------------- Activity in Date Order Date Description Amount Balance 12/02 DDA REGUI.IAR DEPOSIT 1, 000.00 1,688.39 12/03 S:GONFILE Capita�. Seif Sto 83 .20- 1,605.19 90002138�'1 12/03/13 ID # TRACE r�-111924b85483748 12/03 CHECK :i 1015 116.6C- 1,�88.59 12/04 CHECK u 1011 18.5G- 1,G70.09 12/10 CHECK � 1014 100.00- 1,370.09 12/24 CHECK �= 1018 118.78- 1,251.31 12/27 CHECK # 1017 30.19- 1,221.12 12/27 CHECK # 1C19 18.5G- 1,202 .62 12/30 CHECK # 1016 100.CQ- 1,102.62 ------------------------------------------------------------------------------- Checks in Serial Num�e� O�de= Date Check No. Amount Date Check No. P_maunt 12/C4 1011 18.50 12/03 1015 116.60 la/lo ioia* ioo.00 ia/3o loi6 loo.oc *Indicates Skip in Check Numi�er THE ESTATE 0� LORETTA A� IIFc�_ Date 12/31/13 Page 2 of 2 29 LEE A.nT�T CT �CC011r_t NLmbQr �aXXXXX«25�8 ENOLA PA 17025 Enclosures 8 Eusir_ess Checking �XYXXX@2548 (Continued) Checks in Serial rlumi�er Order DGte Creck T3o. Amount D�.te Check No. Ilmourt 12/27 1017 30.19 12/27 1019 18.5C 12/24 1018 11fi.78 *Indicates Skip in Cneck Nun�er ------------------------------------------------------------------------------ Dai_y Balar.ce Information Date Ba_ance Date Ba��nce Date Balance 12/C1 688.39 12j04 1,470.09 12j27 1,202.62 12/02 1,68$.39 12/10 1,370.G9 12j3Q 1, 102.62 12/03 1,488.5° 12j"24 1,251.31 Or_e er_try per electranic i�anking service enro�lmert, with the exceptior. of Mabile and Tex� Banking where orly one entry F=ill be given for both services. For official d�awing ru"�.es, including eligibility and how to er_ter, contact your local financia_ center. THE ESTATE OF LORETTA N1 UR�NI Daze 1/31/l� Page 1 of 2 29 LEE ANN CT Account Num�er �XXXXX�2548 EN4LA PA 17025 Er_closures 4 Save time and money by znro�_ing in our conver_ient ar_d secure electronic banking services-mobile and text bankirg, or_1ir_e bankir_g, bill pay, and e-statements! For m.ore information, please �-isit your loc�l financial czr.ter or u�:+�i.centricbanic.com —-- CHECKING ACCOL�IVTS ---- NEW BILL PAY SERVICE TO SUIT ALL OF YOUFt NEEDS PLEASE CALL 657-7727 OP. VISIT WWW.CENTRICBANK.COM Business Checking Number of Er_�closures 4 Account Num�er ��XXXXXQ2548 Statement Dates 1/Ol/14 thru 1/31/14 Previous Stmt Balance 1,1O2 .E2 Days ir_ the statement pet�iod 31 1 Deposits/Credits 2, 923 .93 Avzrage Ledger 2,�94 4 Checks/Debits 228.a3 Average Collected 2,79� Service Charge -�� Interest Paid •o� Currer_c Stmt BGlar.ce 3,798.12 --------------------------------------------------------------------------- Activity in Date Orde� Date Descrip�ion Amount Balance 1/03 SIGONFILE Capital Self Sta 83.20- 1, 019.42 900C213$41 01�03f14 ID tt TRACE #-11192�686827659 1/13 DDA F.EGIILAR DEPOSIT 2, 923 .93 3, 9�3.35 1/24 CHECK # 1021 22.94- 3,920.41 1/27 CHECK # 102G 18.50- 3, 901.91 1/28 CHECK # 1022 1Q3 .79- 3,798.12 --------------------------—------------------------------------ Chec:{s in Serial ��umi7er Orde�~ Date Check i�7o. Amour_t Date Check No. Amount 1/27 1C2C 18.50 1/28 1022 103 .79 1/24 102]. 22.94 *Indicates Skip ir_ CY-,eck Number ----—------------------------------------------------------ THE ESTATE OF LORETTt� P�1 Lr2FiIV3 Dnte 1/`31�1� Pdge 2 �f 2 2S LEE ANi�7 CT Account Numi�er GXXYXX�p,2548 EPdO�� PA 17025 Enclosures 4 Business Chec'.{ing ��XXXXX�-2548 (Cor.tinued) DGi"_y Bal�nce Irformatior_ Date Balance Date Balance Da�e Balance 1/Ol 1,1Q2.62 1/13 3, 943 .35 1/27 3, 901.91 1/03 1,C19.42 1/24 3,920.41 1/28 3,798.12 THE ESTATE OF LORETTA NI URAN� Date 2/28/14 Fage 1 of 2 29 LEE ANN CT Account Numi�er ��XXXXX@2548 ENOLA PF 17C2S F.nclosures 2 Save time an� mo�ey by er_rallir_g in our ccnvenier_t ar_d secure electronic bG^�kirg services-m.obi=e ar_d text banking, online bar_]4ir_g, bi=1 pay, and e-statements! ror n.are ir.formation, p�ease visit your loca� finar_ciai cer.ter or www.centricbGnk.com. ---- CHECKING ACCOL7IvTS ---- NEW BILL PAY SERVICE TO Sli=T ALL OF YOUR NEEDS PLE�SE CALL 657-772"J OR VIS_'P WW�ra.CEN`I'RTCBAiUK.COM Busir_ess Checking Numner of Enclosures 2 Account Numoer GXXXXX@2548 Statement Dates 2/01/14 thru 2/28/14 Previous Stmt Balance 3,798.12 Days in the statement period 28 Deposits;Credits .00 Average Ledger 3, '009 4 Checks/De'�its �37.30 Average Collected 3,609 Se:vice Charge .00 �r_terest Paid .00 Current Strrit Balanc2 3, 360.82 ----------------------------------------------------------------------- t�ctivity ir. Date Order Date Descriptior. �mount Balarce 2/Oa S_GONrILE Capital Self Sto 83 .20- 3,714 .92 900O213841 02/04/14 ID # TRACE #-111924688325882 2/19 CHECK # 1024 175.00- 3, 539.92 2/20 CHECK # 1023 153 .4$- 3, 386.44 2l2� C?-HECK FYMT Pene"_ec 25.62- 3, 360.fi2 093�196821 02/27/1� CHECK#-1025 TRACE �-021000022643033 --------------------------—----------------------------------- Checks in Seria� Numbe� O�der Date Check No. Amount D�.te Check No. Amount 2�2� 1p23 153 .48 2/19 102� 175.00 *Indicates Skip in Check Numbez THE ESTATE OF LORETT� M UR_ANI Date 2/28/14 Page 2 of 2 29 LEE ANN CT Account Number @XXXXX�25�8 ENOLA PA 17025 Enclosu�es 2 Bus�ress Check_ing :_tiXXzXX�w25�8 (Contir_ued) ------------------------------------------------------------------------------- Daily Balance �nfarmation Date BGlance Date Balar:ce Date Ba-'_ance 2/Ol 3,798.12 2/19 3,539.92 2/27 3,360.82 2/04 3,714 .92 2/20 3,386.44 THE ESTATE Q_� LORETTA M UR�NI Date 3/31/14 Page 1 of 2 29 LEE � CT Account Numi�er GXXXXXcw2558 ErdOLA PA 17025 Enclosures � Save time ancl mor.ey py en=olling in our cor_<renient and secure el2ctror_ic barking services-mobile and text banking, onli�e ban:ing, bill pay, ard e-statements! 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ID # TRACE #-111924689667538 3/10 CHECK # 1027 1,588.34- 1,670.78 3/14 DDA REGUL��R D�POSIT 500.00 2, 170.78 3/18 CHECiI r�r 1029 975.00- 1, 195.78 ------------------------------------------------------------------------------- Checks in Serial Number Order Date Check No. Amount Date Check No. Amount 3/03 1026 18.50 3/18 1029* 975.00 3/10 1C27 1,588.3� *Zndicates Skip in Chpc'.�c Number -------------------------------------------------�-----------------—------ ThE ESTATE Or LORETTA M URANI Date 3/31/14 Page 2 of 2 29 LEE ANN CT P_ccount Numb2r GXXXXX«2548 ENOLA PA 17025 E�c�osures 4 Busir_ess Checz�_r_g �XXXXX�?2543 (Cor_tinu2d) Daily Ba--arce Ir:formation Date Balance Date BGiance Date Balance 3/Ol 3,35�.82 3/Q4 3,259.12 3/14 2, 170.78 3j03 3,342.32 3/1Q 1,67C.78 3/18 1, 195.78 THE ESTATE OF LORETTA M URANI Date 4/30/14 Page 1 of 2 29 LEE ANN CT Accour.t Number CXXXXXr2548 EDJOLA PA 17C25 Er_closures 3 Save time and money by enrolling in our conver.ient and secure electronic par:king services-moAile and tex_t bankir.g, online bankir.g, bill pay, and e-statements! 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NEEDS FLEASE CALL 657-7727 GR VISIT Ti7WW.CENTRICBANK.COM Business Checkir.g Number of Er:Closux'2s 1 Account Nurnber �XXkXX��254II Statement Dates 6/Cl/l� thYu b/30/1� Previous Stmt Ba�ar_ce 237.37 Days in the sta�emer_t period 30 1 Deposits/Credits 905.48 Average Ledger 168 2 Checks/D2bits 115.15 Averaye Collected 168 Service Cha=ge •�� Interest Paid .00 Cur�ert Stmt Ba1ar_ce 1, 02'7.70 ------------------------------------------------------------------------------ Activi�y ir. Dat2 Order Date Description �?mount Ba�ance o'j03 SIGONFILE Capita� 5elf S�o 95.32- 152.05 9000213841 G6/03/14 ID # TRACE #-11192a684181385 0/12 CHECK PYMT Penelec 29.83- 122.22 C934196821 C6/12/14 CHECK_#-1038 T12�>CE #-0210QQG20376155 6/30 DDA REGUI,�P. DEPOSIT 9U5.48 1, 027.70 ------------------------------------------------------------------------------ Dai�y BalGnce Ir.formatior. Date Balar.ce Date Ba�ar_ce o'/Ol 237 .37 6/12 122.22 a'/03 152_05 6/30 1,027.70 THE ESTATE OF LORETTA M URAN� Date 7/31/14 Page 1 of 2 29 LEE ANN CT Account Number CXXXXX�2548 ENO�A PA 17C25 Enclosures 5 Available on the App Store and Google Play, the Centric Bar_k Mobile Ban1ing app makes anytime a good time to do you-r pan'.�ing! Pay bills, transfcr funds, view your accounts, a�d deposit checxs--directly from your smartphone. 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Amount Date Check No. Ameunt 8/`_8 10L5 '_I.Bt� $/25 1.046 50Q,44 *Indicates Sk�p ;n ChIIck �tiurnber ------------------------------------------------------------------------------- ��ily Balaizce Tnforma�ion � T�ate i�alance �7a�e Balance DatP Balanre �101 31,��?.61 8j�:t5 3�?, 94U.iS 8JL5 j0,437.3; 8/04 3?,G62.29 &/18 s0, 337.35 8/27 30,436.08 1�vailable c�n the �1pp Store and Gcagle F3.ay, rY��e Centric Bank Mobile Bankin;• a�� makes anytime a gao� time ta t3c �raur. �ankin�! �ay bills, trans�er. f::�ds, ��•iew vour accounts, �r�� c�e�sit checks--d�.rectly fro�n ycur amartpl�one_ Fox rncre iniormation ��si: ene of our Fina�cial Cen�:�rs car cu� we�site �r C�ntr'uBank.com TF3z�' �,�~IA'�r'E OF L•JRE2'T� M URPNI 29 S:�E AN�1 �T Date »'��iA, ?A 37625 Accountt�dli4 PaSe 1 of 2 Enclosuresmber �XXXXX�?2548 � t,xca t ing �Te4us! Text Messace Alerts are Internet Bankin n�w available. 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Gattii�a cx:��.M ��:e �/�a/�o �� aue �/�.�;�� F�cx� d�e a/aa/oo F�zv ctue o/o�/�o F�P c�ue o/oc�/flo �cP due Q/c�o/oa �.az�s c��e �/�o,�oo � Weight; 11 Lbs 5 Oz an �/l3/1.3 i Peri ormea an: 6/l3 J 13 By: L T sTER�r D�IM �XANI-P.�GUL�R. 1. 0 9 8 . 0 G Dis1�: BHI Fortnu.la Ni�x lo� 1. 4 45 . fl0 R�C�s�IMEI�D XRAYS IF LiMP�NG CC�r�TTlliftTES. ALS� RECOMMEIti?D RECHE�K �iPPQ.�T�I".�"ME�dT. Subtt�t�l : '143 . OQ Tr�tal : 143 . QO ***** Pavrt�exit s ****� VISA/M.C.+: 3�3 . OQ Tota� PaVment: 1�3 . t}0 Balance Due As o� ��'etifi.otls Balar�c�: .�0 6/13/�.3 >7»»»>}» : . �0 ��aflt�! ..A!�!i? r E�ItaE NG�s �.���i H�R'�'�i}ALE bFt i�# Cf�i�ti' IiYLL PA 1?011 ii:RK,tiiRt ?,D.; ii55 ?-�N?�ItTAL H��LTH EX�'t'IS-PREVENTATZVE MEI7ICII�7E? ! ! ! r ! ?,�RGN�H� !"t : 3il"sBdt?la 2� HOL7�2 A��C3ZNTMENT CANCELL.�TI01�1 F�EQUZRED T{� AG h�t�S7E�c�ARD �*,�����k#��3154 Sf�LE �ATCN� 8�:�1� 3�-�U: #�435145 t°p1E� vUN i3� 19 ilPg� i;d:a, �113'3�:�3�'i13 �a-r�� �j��.e� LLaI i3R�N? 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I unc��r penaltie�s of�e�juz�y, d�claLe. t�at I�l�a�v�c rea� the fore�oing, ��r�d tlie iacts �lle�ed �re �r�.i�, to t11e E�est�o�mtr l:��o�nrled�e anc� t�elief. ; �-t, l:xecut�d tl7is_��:1 da�� c�f r%= i-� F�.e '� ?�}_...__._ ,.z ;� f� � �- �. Angel Bra��n Pl�or�e;-� 717-21�-3005 Bureau af x�ccc�unt �az�a�enzent Claimatzt �i�ro�F��n�ol����cl�.inc.cam State of�'e�1ns��lvania, C�u�ltv of Cu1�3b�rla�ld ; [N �4vIT:vESS ���HERE.C>F, I Iza��U set z���� ha��d and z�ot�a.rial s�al tllis .�`�:l � uay oi (;}� !;, �. ;� �a 1 �' « _..�„ � i i�Toia�-y I'ublic -� � � I i i `-�' ' � i_ COt�fitUICNV'J�r�L`CN C�t=P�i�li�iS,,,,,, YLVAI�IIA \�Iy Gain�ni.,ioii I�xT�ires.� ( � , r i � .a _ ���-A��A�s��� ' t , ,-���Ti��R�.SCHi�v�:�R,t��t�ry i'�ibi� � �ot+vert�llen i�vp„Ca�bsilandCt�un@y E�1y Cammissian��Sir�s Novem�er i9,241i6 �,„,�.�-.n��m,�.,-x�..�<�..� ; -, ti- ;_ � � �� �.. ,a . u ... , ��;��_R,a.�.��e.,� w_ ue.�_ ,`,'�,., ,. ,_� , , .r�,w H, a ,r � t . _ �. .a... �.. .. . _.,..�.�� _._ �.,� � �� _ �. .�.� __ ��e,. . .... ._ ��__ ..,... . � � x � ���, � Discover More Card �° `� '�` Accounl number endin n i$10 9+ Open Daie: .lur b,2013-Close Date:Jvl 5,2�13 Ccrdmember Since 1989 Page 1 cf 4 ACCOU�IT SUlv�hltAR�Y PAYNIENT I�IF�'JR�/iAT1C�N Previous Balance $223.94 N@1N Bp`pnC�-' ��2�.9� , ___�._...--_�__ ___-----_.___ ; Paymenfis and Credits – ��.00 t4'�inimum Payment Due" $70.00 Purchases � �d��� Payment Due Date August 4,20i 3 8alance Transfers T �a.00 ' Indudes past due amount of: $35A0 Cash Advances ''" $0.00 Fees Charged } �`�•�� late Fayment lNarning: If we co noi receivE your minimum payment by fhe Ir:teres�Chorged { S0.00 c�ate listed c�bove,}�ou may hav�#o pay a late fee o�up to�35.00 ond your d purchase and balance fransfer APRs for new transartions may be increased up to New Balcnce �223�`� • fhe?encl'ry APR o#28.2d%varieble. See Interest Cnarge Colcule,ion section foilowing the Minimum Payment Warning: Ir'you make enly the minimum payment eoch Transadions section for deFcail�d RPR informo#icn period,you will pay more in in�=rest and it Fvil{�al:e you longer te poy off your _. ___-__..___�.._ ._--------- - ....._�.._ _._.... Credif Line S11 000 ba�ance.For example: — Credit Line Auailoble $0 l�you�s��e nci add�tEonal c�ac�es, �'lou S�ill��ay crs 1}�` And;You v�il�end up = usinr�thas�ard and ea h-niorl�r `� �tarce ahown�on E}rs i�.aqing on estimafec3leta( J — Cash Advance Credit Line �5,500 �-�,,,,, , _<tntzment m,a6ouP.� of..il � Cash Advance Credit Line Available �a0 Onl fhe minimum �o��ment 6�months 5224 �� _ � — You m�y bs able fo avoid interest on Purchases. Ir you vaould like iniormation about credit counselir�g services,call 1-$00-347-1 i 2i. i See reverse for details. — (\�YVt'���� — Contact Us Discover.com Ccsshback BonusOO Anniversary Morth = 1-840-3�7-2083 October — Opening 3alance S �7.73 " Please see Riofiice a# C�csr� es New Cashbacl.�onus This Pericd - � �.�0 � � � Cashbac�C �c�r�us �a�e�nce —�___ -� .----__-57..00 � R�c�eeme_d This Period _ �' � _ �_.� � #fl �OUY (g'S'�@PE'Sf �CStf:S �2C�5Oft ]� :.! _ ��,� i �� To learn more, log in af DiscovEr.com — � ��F �� � ���,Z i 4,�pii�d --}° = ywta.�c�. �Ke. _ _._ _ _. ,.. N,ake Cnack payabEe io D�sm�-er. (�p�'►��;SEE REVER5E SlDE FOR(tdtPORTANT II�IFORMATIOt�i Pieose�oid on the perfo;a;icn��:ow,aeta�h a��d retum wifih your paymeni. pCi�tTtB(i�`��OU�YOii ::i �R �£3tf�}tl�(�i� '�.�L2)/�3}���7QTk� - rltcount number ending in � ------ 78�16 Fleose do�not Eoli3,�c1i��or staple. � �Discotier:com �-�Q�3��-��$� � Minin�um Paymert Due �7�•�� _____....._._._....._..____.__ New Balance 5223.9q �11iii�����������f�����I�I�IIi���ilil��El�l�il��llil��i�ll�l����� ----�----_-------------�------_____ 00005&322 Ol Ab' G.357 TG 07 SDSi(L�03 292 Payment Due Dafe August 4,2013 ----_.....__-----.._..------____�.._�_.___._...._----- LORETTA URANI }•��`+�'� —� }�'�=� Amounf enclosed � ��� , �z� j 1100 GRANDON\rJkY STE 514 � MECHANICSBURG P,4 170�d-4195 PO BOX 7 i 08� CH�RLOTTE NC 28272-1084 Phona nnd Intemet p�ymerls must be re�eiv�d hy�PM EI to he credited as of ihe sor.�e day. I�l��'l1��1�1,�f i�ll�l�1��1�����1������11����111���(���11�Itll�u Address,e•mait or telsphone changed?Note chonoe=_on reverse side. �dC1001,b8645��49C�?73$7a0���94Q0099990007DOn ����� V1/EST SNC3�2� E4�iS - B�� ���� �fl5�RAN�V��W I�t�E SUtTE 2'1'1 � . � ���:�� ,�������� CA�1tlP HIL.L, P�,"��1�1'I-'17�08 c,�r��v��s�s��� Phc�ne #; (8�0} 3�7-0�12 Fed�ral T�x IQ: 23-2463�t12 ;,,: � ... - P�,TIEPdT�dA�:�t�: L4RETiA UF2Af�ll �i�SUR�3�tC�. }-IlG�iMARK-FREEDCZM BLU lSAL lSAL ��L�.r;v�,G����: 23850�VV raa-�-�c��-cr��t: �2���t2o�� ,„���s: SAR�,A i O��D t��E(v�ORlA�HOME ;t�: C4F2LiSLE REGIQi�A� NiED(CAL CTR �� �,C:v�'�����' .�`,a'�l�,l��3�.�`t �� LQRETi'A[3RAi�1 135.73 C1�7 L{}Et� KA�2tA �'t�1"�.L CH�i�?G�S; 29 L��ANN C�T' S��a�`��t��liul�,i3JUST�t�h�TS: 71.�7 ENOLA, PA 17{l25 �'�-��s=�'��"��'������!����: $4.56 L'i:T,-t't,�^��f.`�.}`;vG Fs�h'r�Cfti'�e7{'Jfi7r1�'klc^l-�'�Tt9f�t*l5i7JF�4`Jlil-1?�r11':'i?cltl�` ,_,_, L}ES,��.R3Pi1C}��!C3�G}-ftlFiv� �UAi':i'1i"Y � �33.43T P;�t�L" { ,"iT���l+£�!'T' �� ,ka � 4t1he�Icnair C�21�+7ay Trans�ri A013{l �l.� 5�.�€�� � �9.45 Tr�ns�Qrt Van tvfi�leage ��2t�9 2.3 3.7�t 8.60 Nlhselchair C�ne Way Trans�or•. nCl'130 1.�' S9:45 59.45 � Transpert�fan �riii�ac�e �Cl2�9 2.2 3.74 8.23 � � P � � ! i � I � � � � Tota! Charges 135.73 # _ _ � E�E�CREPTfGi"y'Clr�A'f����" ' t�i.r.r.GEI:�'3 t P',�Yh9Et�IT€3d?�i C � ��,Fttf3tJ3�3T Medicare Assignment Adjustrnent ��1��1���� �.6� � Payment-h�tedicare H��D i5743759 C311J12C13 64.54 - � _ _ M � _ ! � t �� � � Total Gredits 7i.17 .,. _ � . ,_ � �64,56 �:��i��a-�r����: URa�v�. �.c����r�'A t��� c��.L r�{�x,���R. 238�0911V ���jc�uc�-r:�;s�: � � D3f2'!!2fl13 This is the amQun#clue�fter vour lnsurance Carrrer`s payment. WE�T SH(3RE EiViS -B1.S 2U5 GF2ANC71!#EV�!AV�SL3lTE 21�# CAMP NlLL, PA'17011-1708