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Home My WebLink About04-02-15 .I!IIII III IIIIIII 1 � � pennsytvania 15 0 5 6],41�5 oePnArmeNroraevervue EX(03-14)(FI) REV-1500 OFFICIAL USE ONLY Bureau of Individual Taxes County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN �/j n Harrisburg, PA 17128-0601 RESIpENT DECEDENT (�� ,/1 ' �d�p ENTER DECEDENT INFORMATION BELOW Social Security Number pate of Death MMDDYYYY Date of Birth MMDDYYYY ' 162- 05271928 ' DecedenYs Last Name Suffix DecedenYs First Name MI _ . .. __. _ _. . __ , Sennett Jr. Harry ; R ` . _. __ _. __ (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW � 1.Originai Return p 2. Supplemental Return p 3. Remainder Return(date of death prior to 12-13-82) " p 4.Agriculture Exemption(date of � 5. Future Interest Compromise(date of � 6. Federal Estate Tax Return Required death on or after 7-1-2012) death after 12-12-82) � 7. Decedent Died Testate p 8. Decedent Maintained a Living Trust _ 9. Totai Number of Safe Deposit Boxes (Attach copy of will.) (Attach copy of trust.) p 10. Litigation Proceeds Received p 11. Non-Probate Transferee Return p 12. Deferral/Election of Spousal Trusts (Schedule F and G Assets Only) O 13. Business Assets O 14. Spouse is Sole Beneficiary (No trust involved) CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number __ _ _.__ ':Nathan C. Wolf, Esquire i (717) 241-4436 First Line of Address Wolf&Wolf _ _ _. Second Line ofAddress ;10 West High Street —_._. _- -- __ _. ___ _ � City or Post Office State ZIP Code , . _ _ _ _ Carlisle ' PA ' 17013 ' Correspondent°s ema�i aaaress: nathancwolf@embarqmail.com REGISTER OF WILLS US�NLY � �' rn � REGISTER OF WILLS USE ON�Y �; Q � 1?ATE FILED MNIDUYY1fY ,` '� 3"► � � G7 � �� L: »,�. �� * t-' � `I"t1 � `". ;�^ N � C7 ,,. � �� c� p DA'��FkCff AM� � � '� ;.� � � i" fTl ^-i � PLEASE USE ORIGINAL FORM ONLY '" N � � Side 1 � i iiiiii iiiii iiiii iiiii iiiii iii�iiii�iiiii iiiii iiiii iiii iiii � 15�56 4 05 1505614105 \� �, . � � 15056142Q5 REV-1500 EX(FI) Decedent's Social Security Number DecedenYs Name: Harry R. Sennett, Jr. ': ' RECAPITULATION 1. Real Estate(Schedule A). . . .. .. . . . . . . .. . .. . . .. . . . . . . . .. . .. .. . . . . .. .. . 1. ' Z6,250.00 2. Stocks and Bonds(Schedule B) . .. . . .. . . . . ... . . .. .. . . . .. .. . . . .. . .. . . . . 2. ' 3. Closely Heid Corporation, Partnership or Sole-Proprietorship(Schedule C) . . . . . 3. ' 4. Mortgages and Notes Receivable(Schedule D) . .. .. ... .. .. .. .. . .. .. .. . . . . 4. 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E). .. .. . . 5. 6,998.57 ', 6. Jointly Owned Property(Schedule F) O Separate Billing Requested . . . . . . . 6. ' _. _. __ __ _ _ 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property ' (Schedule G) O Separate Billing Requested... .. .. . 7. ' 8. Total Gross Assets(total Lines 1 through 7). . .. . . . ... .. . .. .. . . . . .. .. .. .. 8. 33,248.57 ' 9. Funeral Expenses and Administrative Costs(Schedule H). . . . .. . .. .. . . . . . . . . 9. ' 24,797.14 ' 10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule I).. . .. . . .. . . .. . . 10. 12,201.42 11. Total Deductions(total Lines 9 and 10). . .. .. . . . .. .. . .. . . .. . . ... . . .. .. . . 11. 36,998.56 ' 12. Net Value of Estate(Line 8 minus Line 11) . .. .. ... .. . .. .. . . .. .. . . . . . .. . . 12. -3,749.99 ' 13. Charitable and Governmental Bequests/Sec.9113 Trusts for which an election to tax has not been made(Schedule J) . . . . . . . .. .. .. .. .. . . . . . . . 13. ' 14. Net Value Subject to Tax(Line 12 minus Line 13) . .. . .. . .. .. .. .. .. .. .. .. . 14. ' -3,749.99 ' TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec. 9116 _ _ (a)(1.2)X.0_ 15. �_ _ . . __ __ , .�, � r _ ev -- -� � 16. Amount of Line 14 taxable at lineal rate X.0 45 -3,749.99 ! 16. _. ��. .. m_N .._._..____ _� w� �a.n., ..n; � e v v_ ._.. __� �__ _ _._ 17. Amount of Line 14 taxabie at sibling rate X.12 17. 18. Amount of Line 14 taxabie �� "-" � �- _- _� .. �m � m �. , _e��. n .,�_�,A �e.� �. �.. ._ - at collateral rate X.15 18. ' 19. TAX DUE . . ... .. . . .. . . . . .. . .. .. . .. . . .. .. .. .. . .. . . .. . . . .. .. .. . . . . . . 19. 0.00 ' 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Under penalties of perjury, I declare I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true, correct a omple e. Decl�ration of pr par r other than the person responsible for filing the return Vs based on all information of which preparer has any knowledge. �L �� - � - �� SIGNATURE OF PE ON RE ONSIBIE FOR FILI RETURN DATE � \ ^4/ ��'f9 G� ADDRESS ~ , jf_ / _l.�/S SIGNATURE OF PREPARE R T N RESPONSIBLE FOR FILING THE RETURN DATE �� a`" / ,r'+ �/� � , ,,,.�!1 /� �� c 1� ,�A�^�� ADDRESS i iiiiii iiiii iiiii i i i ii iii�iiiii iiii�iiiii iiiii iiii iiii Side 2 � 6 420 15056142D5 � REV-1500 EX (FI) Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME Harry R. Sennett, Jr. STREET ADDRESS 151 South Side Drive CITY ------- ------ � STATE iZIP ----------- Newville PA i 17241 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 0.00 2. CreditslPayments A.Prior Payments __._ B.Discount (See instructions.) Total Cretlits(A+B) (2) 3. Interest (3) 4. If Line 2 is greater than Line t +Line 3,enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2,Line 20 to request a refund. (4) 5. If Line 1 +line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred .......................................................................................... ❑ � b. retain the right to designate who shall use the property transferred or its income ............................................ ❑ � c. retain a reversionary interest .............................................................................................................................. ❑ � d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ � 2. If death occurred after Dec. 12, 1982,did decedent transfer property within one year of death without receiving adequate consideration?.............................................................................................................. ❑ � 3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?.............. ❑ � 4. Did decedent own an individual retirement account,annuity or other non-probate property,which contains a beneficiary designation? ........................................................................................................................ ❑ � IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. ,��; � � ;�� _� � � � �. �� , .,�� ti„' G'� For dates of death on or after July 1, 1994,and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent[72 P.S.§9116(a)(1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets antl filing a tax return are still appiicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a step-parent of the chiid 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 decedent's lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedenYs siblings is 12 percent[72 P.S. §9116(a)(1.3)].A sibling is defined, under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption. �Ev-t�oz�x+ (12-r�',: � r` � pennsylvania SCHEDULE A ' DEPARTMENTOFREVENUE REAL ESTATE INHERITANCE TAX RETURN RESIDENT OECEDENT ESTATE OF: FILE NUMBER: Harry R. Sennett, Jr. 21-13-0326 All real property owned solety or as a tenant in common must be reported at fair market value.Falr market value is defined as the price at which property would be exchanged between a willing buyer antl a willing seller,neither being compelled to buy or sell, 6oth having reasonable knowledge of khe relevant facts. Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Indude a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER Of DEATH DESCRIPTION 1� 151 South Side Drive, Newville,PA 17241 26,250.00 See attached valuation information TOTAL (Also enter on Line i, Recapitulation.) $ 26,250.00 If more space is needetl,use additional sheets of paper of the same size. REV-i5o8 EX+(o8-ia) ; � , pennsylvania SCNEDIJLE E - DEPARTMENTOFREVENUE CASH, BANK DEPOSITS & MISC. � INHERITANCE TAX RETUftN pERS�NAL PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Harry R. Sennett, Jr. 21-13-0326 Include the proceeds of litigation and the date the proceeds were received by the estate. Ail property jointly owned with right of survivorship must be disclosed an 5chedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION _ OF DEATH �, M&T Bank,Checking Account 5,526.16 2. M&T Bank,Savings Account 2Q0.01 3. AmeriGas Propane,LP Refund 153.40 4. Personal Property per appraisal 1,119.00 TOTAL(Also enter on Line 5, Recapitulation) $ 6,998.57 If more space is needed, use additional sheets of paper of the same size. ._.. .__.. REV-1511 EX+ (08-13) �? pennsylvania SCH E DU LE H DEPARTMENTOFREVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Harry R. Sennett, Jr. 21-13-0326 Decedent's debts must be reported on Schedule I, ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1' Hoffman-Roth Funeral Home&Crematory, Inc. 9,926.14 B. ADMINISTRATIVE COSTS; 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address __ City State___.__ZIP Year(s)Commission Paid: —_ 2,500.00 2. Attorney Fees: 3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation.) Claimant — Street Address __—_._ City State ZIP Relationship of Claimant to Decedent _ 4. Probate Fees 183.50 5. Accountant Fees: 6. Tax Return Preparer Fees: �• Cumberland Law Journal-Legal Advertising 75.00 `' s. The Sentinel-Legal Advertising 168.30 s. Sovereign Bank-Estate Checks 29.2� t o. Register of Wills-Inheritance tax retum 15.00 i�. Kevin Wickard-personal property appraisal 50.00 �2. Additional expenses-see attachment 11,850.00 TOTAL(Also enter on Line 9, Recapitulation) $ 24,797.14 If more space is needed,use additional sheets of paper of the same size. SCH�DUL� �-I FUN�RAL EXPENS�S AND ADMINISTRA'TIV`� COST$ ESTATE OF FILE NUMBER Harry R. Sennett,Jr. 21-13-00326 CONTINUATION PAGE OF ADMINISTRATIVE COSTS 1. Jeromy L. Steigleman (Cost of repairs to home for sale) $ 8,450.00 2. Installation cost for furnace $ 1,400.00 3. Reserve for Outstanding,Ex�enses $ 2 000 00 Total $ 11,850.00 REV-1512 EX+(12-12) � pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Harry R. Sennett, Jr. 21-13-0326 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• Pennsylvania Department of Public Welfare 4,457.32 2. Guradian LTC Pharmacy 60.25 3. Spring Road Family Practice, Inc. 13.76 4. Carlisle Physician Services 66.69 5. Hospitalists of Central Pennsylvania 134.09 6. Carlisle Digestive Disease Associates 33.94 7. Quantum Imaging&Therapeutic Associates 13.24 8. Carlisle Regional Medication Center 923.31 9. Hartzell Eye Specialists 58.71 10. PPL Electric Utilities 64.23 11. CenturyLink 53.13 12. Kuhn Communications, Inc. 38.03 13. Reimbursement of Septic Loan to Wilmer Wolf 5,000.00 14 Hoffman-Roth Funeral Home&Crematory, Inc.-Final payment of Funeral Expense for Leona Sennett 1,284.72 Leona Sennett was the spouse of the decedent who died 2I112013,and the balance remained unpaid TOTAL(Also enter on Llne 10, Recapitulation) $ 12,201.42 If more space is needed,insert additional sheets of the same size. REV-1513 EX+ (01-10) �^� �,`pennsylvania SCHEDULE ] BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Harry R. Sennett, Jr 21-13-0326 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXRBLE DISTRIBUTIONS[Include outright spousal distributions and transfers under Sec.9116(a) (1.2),] 1. Judy L.Wolf,825 Torway Road, Gardners, PA 17324 Daughter 20% of Residue 2. Donna Shoff,2 Irish Road,Newville,PA 17241-9514 Daughter 20% af Residue 3. Ruth Kitner, 1121 Centerville Road, Newville,PA 17241-9554 Daughter 20% of Residue 4. Robert Sennett,291 Frost Roatl,Gardners, PA 17324 Son 2q% of Residue 5. Susan Foster, 16637 West 147th Street, Olathe,KA 66062 Daughter 20% of Residue ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: L B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: L TOTAL OF PART II — ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ If more space is needed,use additional sheets of paper of the same size. LAST WILL AND TESTAMENT OF HARRY R. SENNETT, JR. I, Harry R. Sennett, Jr. , of Penn Township, Cumberland County, Pennsylvania, declare this to be my last Will and Testament and revoke all Wills and Codicils previously made by me . ITEM I : I direct that my legally enforceable debts, funeral expenses, and the expenses of the administration of my estate, shall be paid from my residuary estate as soon as practicable after my decease, as a part of the expense of the administration c� �-=-A � �_..� %� rn of my estate . � Q �'' �� W _,�� `7 � � � fpi —�'' � �� 1 a �.� ITEM II: I devise and bequeath all of my esta��ek,�� e��y"� tl � '' r'� cr� ,.:s 1��. C� �;� nature and wherever situate unto my wife, Leona E �enn��t,._� c - �,. __ ._,� �� : ...� <:-, -_1 �, < ,, ., provided she shall survive me by thirty (30) days � : :. . . � �;� ::. ti�.� ITEM III: Should my said wife, Leona E . Sennet,�, predece��e�y me or die on or before the thirtieth day following my death, I bequeath all of my firearms and related shells and equipment unto my son, Robert C. Sennett, provided he shall survive me by thirty ;3 0? days . ITEM IV: Should my said wife, Leone E. Sennett, predecease me or die on or before the thirtieth day following my death, I bequeath all of my said wife' s jewelry and doll collection, including all related paraphernalia, in equal shares unto my daughters, Judy L. Wolf , Ruth A. Kitner, Susan K. Foster, and Donna J. Shoff, who shall survive me by thirty (30) days . �'��c.�IZ�C�'r� � ��ti��LL�/� � r ITEM V: Should my said wife, Leona E. Sennett, predecease and should my son, Robert C. Sennett, survive me, I devise and bequeath a life estate in my real property at 151 Southside Drive, Newville (Penn Township) , Cumberland County, Pennsylvania, and all policies of insurance thereon, and all of my tangible personal property on the premises, not specifically bequeathed, unto my said son, Robert C. Sennett, without liability for waste . Upon the death of my said son or at such prior time as he shall cease to use the premises as a primary residence for himself, the life estate shall terminate and the remainder interest in my said real property and tangible personal property shall vest in equal shares in such of my children as shall be living on the date of my death, as hereinafter provided. Should my said son be temporarily placed in a rehabilitation hospital or long term care facility with any reasonable expectation that he may recover sufficiently to return home, the life estate shall not be terminated by his temporary absence but shall terminate only upon certification from his medical care providers that his condition is permanent and will not reasonably improve to allow him to return to the home . So long as my said son uses the premises at his primary residence, he shall pay all costs of maint�nance thereof, including insurance, all repairs, utilities, taxes and assessments . Further, I direct that no person other than my said son, or any one of my four daughters, who may find herself without a residence at which to reside, shall be the only -a- � , , �?��,,n-c�,,�`�.s� �,��.2 � � inhabitants of the premises . Should any other person become a resident of the premises, without the unanimous consent of my other remainder beneficiaries aforesaid, the life estate shall terminate . I direct that my said son shall not be required to give bond as a life tenant under this Item V of my Will . ITEM VI : Should my said wife, Leona E. Sennett, predecease I devise all of my real property at 151 Southside Drive, Newville (Penn Township) , Cumberland County, Pennsylvania, in equal shares unto my five children, Judy L. Wolf, Ruth A. Kitner, Susan K. Foster, Donna J. Shoff, and Robert C. Sennett, subject to the life estate for my son, Robert C. Sennett, created in Item V hereof . Should any of my said children predecease me, his or her share of this devise shall lapse and such share shall be added to the shares of my children who shall survive me. ITEM VII: Should my wife, Leona E. Sennett, predecease me or die on or before the thirtieth day following my death, I devise and bequeath the rest, residue and remainder of my Estate of every nature and wherever situate in equal shares unto my five (5) children, Judy L. Wolf, Ruth A. Kitner, Susan K. Foster, Donna J . Shoff, and Robert C. Sennett . Provided, however, that should any of my said children predecease me or die on or before the thirtieth day following my death, his or her share of my Estate shall lapse and such share (s) shall be added to the share of my said children who shall survive me by thi.rty (30) days . ITEM VIII: All Federal, State and other death taxes payable because of my death, with respect to the property forming my -3- ,%�?�z�vz-� ��.�•�yn,Z�J'� gross Estate for tax purposes, whether passing under this will or otherwise, including any interest or penalty imposed in connection with such taxes, such be considered a part of the expense of the administration of my Estate and shall be paid out of the principal of my Residuary Estate without apportionment or right of reimbursement . ITEM IX: I appoint my wife, Leona E . Sennett, Executor of this my last Will and Testament . Should my said wife fail to qualify or cease to act as Executor, I appoint my daughter, Judy L. Wolf . Should my said wife and my said daughter fail to qualify or cease to act as Executor, I appoint my daughter, Ruth A. Kitner, Executor of this my last Will and Testament . ITEM X: I direct that my personal representatives, as well as their successors, shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal, this � day of February, 2007 . � ,.�J 1� [S EAL] Ha y R. Sennett, Jr. -4- The preceding instrument, consisting of four (4) typewritten pages, each identified by the signature of the Testator, was on the date thereof, signed, published and declared by Harry R. Sennett, Jr. , the Testator therein named, as and for his last Will, in the presence of us, who, at his request, in his presence and in the presence of each other, have subscribed our names as witnesses hereto. * �,,� 3�-� c'�..: � ��, � �_� j r i' \J' � ;�.�� i i,,; � .�2 �%%..�P�C�'ln.-z �' r;;'i�2-�z -5- COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND We, Harry R. Sennett, Jr. , Dale F. Shughart, Jr . , and Leona E . Sennett, the Testator and the witnesses, respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his last Will and that he had signed willingly, and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as witness and that to the best of his/her knowledge the Testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence . � ��7 � ��m�� tator :C-�..�,_...... � �j - , ' � f' �' ' � � �..l."` 1 ��i 7 ... YY Z l. . rJ�-E3`'• �i C.<:�^J � /� i.�._��Cr'/�.�C� ��.¢1-t?�'vL.2z--�'� W3tness Subscribed, sworn to and acknowledged before me by Harry R. Sennett, Jr. , the Testator, Dale F . Shughart, Jr. , and Lecna E. Sennett, witnesses, this /�/"— day of February, 2007 . � y� , �� Notary blic :�� ,�._.a.� �;,�,��.�:�.,�.�� J�'i7'A�tL4L SFAL 90NNIE L CaYLE.NOTARY PUBLIC BORO OF CARlISLE,CUAABERLAND CO.PA MY tOMNiISSiON IXPlI�ES OCT08ER 17,Z010 -6- � � ;.;_. �� \ � -_ ,.�: s � d„�,�� " _�w ps�.. .� ,.- ra _.�, ; R .. 1 s y .;; .,�:� ,_.. ' � ��„i.�' � _ _ �� ,;, ��. � . � � �� `�� 't�:�� i'' �� Pricing your property correctly is crucial. You want to sell your property in a timely manner at the highest price possible. Current market conditions determine the value. ,. �« . Pricing too high or too low can cost you time and money. Realistic pricing will achieve a maximum sale price in a reasonable amount of time. Analysis of�1�ee comparable proper�ies sugges�s a 2is� price range of.• �2�,o00 �o �z9,sc�� , � � Larry Yorlets,CSP,SRES,ABR,GRI,CRS,MCSP,CDPE,CIAS,ASP O�ce:717-591-5555 F�ct.7759 O�ce Fax:717-591-7273 � � E-mail:larry.yorlets@comcast.nct Voicemail:717-591-7759 � Mobile:717-574-3597 � Each Office Independently Ch�vned and Operated. t01-CT—Warrenty Deed—ShoK Form—Act 190�Double Sheet . Henry Hall, Inc., InAfana, Pa. , . • • �� ',�S�X�•.t.4...,.` � � ORQED O�FIr.. _ nF TNE �t� � � JS CUM r.R�� G '!, , '. �a. MADE THE �`��"G' day oj ��- '�9 JUH I5 i��c�ye�{j of our Lord ane thousand nine hundred eighty-nine (1989) BETWEEN TONY M. SENNETT and SHERRY L. SENNETT, his wife, of_ Penn Township, Cumberland County, Pennsylvania, party of the first part, herein called the Gr¢ntor S and HARRY R. SENNETT, JR. and LEONA E. SENNETT, his wife, oF of Penn Township, Cumberland County, Pennsylvania, Grantee s: WITNESSETH, that in consideration of Twenty-seven Thousand Five Hundred ($2 7,5 0 0.0 0) Dollars, in hand paid,the receipt whereof is hereby¢cknowledged, the said gr¢ntars do hereb� grant and convey to the said grantees , as tenants by the entireties, their heirs and assigns: ALL that certain tract of land with the improvements thereon erected situate in Penn Township, Cumberland County, Pennsylvania, bounded and described as follows: BEGINNING at a spike in the center of Township Road No. 349 on the dividing line between Lots Nos. 15 and 16 on the hereinafter mentioned Plan of Lots; thence by said dividing line, South 00° 10' East 200 feet to an iron pin; thence North 84� 26' 20" West 100 feet to an iron pin; thence by the dividing line between Lot Nos. 14 and 15 on said Plan of Lots, North 00° 10' west 200 feet to a spike in the center of Township Road No. 349 aforesaid; thence by the center of said Road, 5outh 84° 26' 20" East 100 feet to the Place of BEGINNING. BEING Lot No. 15 on the Subdivision Plan of Lots of Thomas E. Meals, as recorded in the Office of the Recorder of Deeds for Cumberland County in Plan Book 30, Page 27. BEING improved with a permanent mobile home. BEING the same premises which David Gerald Shively and Susan Marie Shively, his wife, by deed dated April 17, 1984, and recorded in the Office of the Recorder of Deeds, aforesaid, in Deed Book "Q", Vol. 30, Page 380, granted and conveyed to Tony M. Sennett, one of the Grantors herein. �' � )tv"irl�,7i+q'NF�,L�i'r� `5r ��V1 d �-"Ir,?�1�1� �' Q �-,. 74�AR i�A*�� p�" �f ��l,t�- _ o�Noshipat � ��7 .� _ -. r._�,__.._�_� Cumb.Co..Pa. Q �h ,,i,n�� 1-96 Rsel Estats 1Fanafer Tiuc �-., ��i�s ,I�,i �Db �� t c� rJ �,�,a. �:�. .��. „�...___ . . . � .. G�6 _�s �um.,1.��.Z�'-v __ -8��> �,�a�- � Cumb.Co.Dist.Cot.Apt.� �; ; `� c�J�.r ;� School Oist.Cum�i:Co.,Pa. 1!6 Raei&tec.lFesKfer'ti�c BOUK 33 PAGE 916 a.o.b"�S �9Amc�s��`,_`� � ,_(`'�'��. N �c� c�me.co.n�c co�.aqc � And the said grantors hereby covenant and agree thut �he property hereby conveyed. will warrant specially IN WITNESS WHEREOF, saicl grantor s 3uc vehereunto set their hand S and seals the dcLy and year first above written. ,�--� �--/��------------ ------------ ------ . s�aen ------ ' _ �'1_t_ - �igneD>�ealeb anb�eliberea To M. sennett �---�� /� in tile �regence nt s�eL - -------------------------------------------------- ---------� ' J ��,y,�„' � ��-�'- - ---�.---�"�-i�,-------- �� ------�✓- ------------ -`�---------------------- ------ ----- - Sherry Sennett �� A� , ---- SEAL ' ---"-"----G.-'---�------!'�'�-�----------------__ -'------"-'----"-------------'--'--'-'----------------_... 5tate of Pennsylvania �ss. County of Cumberland � �y of J��` 19gg , before me, On this, the j U the undersigned o�'ieer, personally ¢PPeared Tony M. Sennett ai�c? Sh�rry L. 5ennett, his wife, .�,ioii�'ax ,�;��o�G (or satisfactorily proven) to be the person s ex°cutedns2me f orrthe purpo e P th�ein :-'``,�.'"thin ans��nt,and acknowledged th.at they ^ �'cvn,tainec�' ��''-- a_ :. � nd and o�ci.al ea�l� '�` � • .rnr yy��'l�SS WHEREOF, I hereunto set my � � � � � �.�a_v,.` .---� ." �'' __ sseL � r' `� ------- -------- . , ... ------------------- � �+'C7 „en!b4fF. '�`a ' '___._ ------------------------------ ' .. ,T'�'�/ ` >�3 >��:� l,�"; ' NOTARIAI SEAL , �-------------------- ~ MICHAEL P RUNOLE.NOTARY PUBIIC --•--------_-----------------------------------T2tle of O ff�eer. CARLISLE BOPO,CUMBERLANO COUNTY MY COMMISSION EXPIRES DECEMBEH 20,1aS0 State of �ss, County of �y of , 19 , before me, pn this, the the undersigned oJfccer, personally appeared subscribed to the kn,mun to me (or saCisfactorily proven) to be the person executed same for the purposes therein urithin instrument,a.^id aelcno'u�ledged tha.t contained. IN WITNESS WHER,EOF, I hereunto set my hand and of.�ieial sea. r` ------------------------------------------------------ -- s�ai. - ---- - ---------------------------------------------Titte of O.�cer. I do hereby certif y that the precise residence and co�ple��t��e�address �1� ��,��' �� o f the within named grantee is /S I 5 au�-1,� 5��-t � � �� i9 89 r , �V�.�L��`�� ------------------------------------------------------- r� Attorney for -----Grantees-----�------------------------ �oo�� 33 PncE 91 � � � Q � � \ � �; � � � ' � I COMMONWE LTH OF PENNSYLVANIA Caunty �f _�--==�--------------------------------------------- ss. RECORDED on this ----------/-`�----- �y °f ---- ------------------------------------ A. D. 19__v/, in the Recorder's o,�ce of tlae said Co nty,in Deed Book � voa. ------��---3---------, Page __�l�-'---•--•-----� Given under my hand and the sead of the sa' o�dc te above written. " ' � �`��Recorder. ----•----- --- - --�-------------•--�_--------- � �� Q M�zs� 499 Mitchell Road,Millsboro,DE 19966 Adjustment Services Phone 888-502-4349 F a�c (302)934-2955 March 29,2013 Nathan C. Wolf Attorney 10 W. High Street Carlisle, PA 17013 Re: Estate of Harrv R. Sennetr,ir. Social Security: 162-22-7397 Date of Death: March 09, 2013 Dear Sir or Madam: Per your inquiry on March 26,2013,please be advised that at the time of death,the above-named decedent had on deposit with this bank the following: 1. Type ofAccount CheckingAccount Account Number 571490 Ownership(Names o� Judy Wolf(POA) Harry R Sennett,Jr. Leona E.Sennett Opening Date 04/18/1980 Balance on Date of Death $S,526.16 Accrued Interest � $ .00 _____ ___ _ Total $5,526.16 2. TypeofAccount SavingsAccount Account Number 25004920104607 Ownership(Names o� Judy Wolf(POA) Harry R.Sennett,Jr. Leona E.Sennett Opening Date 11/17/1994 Balance on Date of Death $200.00 Accrued Interest $ .01 _ __ _ __ Total $200.01 DEPOSIT TICKET [1_/� 'cnsn►' � -� HARRY R SENNETT JR.ESTATE osi2s so-�2ssi2sis _= OLF II JUDY L W � I 5 �� 10 W HIGH ST. I CARLISLE,PA 17013 ► I I�� I�,}� TOTAL FROM II ; DATE I � OTHEFi SIDE► o DEPOSITS MAY NOT AVAILA LE FOR IMMEDIATE WITHDRAWAL �, SUB TOTAL �.: ' �.� `(�� I, SIGN HEflE FOR CASH RECEIVED(IF RE�UIRED)k � �. � LESS CASH � � �� i` FECEIVED i� SovereignBank,N.a. � � � .�•� � PART OF THE SANTANDER GROUP �: 56 L755 205�: 2 �073 2 29 29��' y � ; � �� M . @ ��rc�� R �T ��. 7 � �� yg`F 5�� . �' ��+°� ,� � � ! � �,w � � � t � �X Y ��,:.q�'3 �'' £ h 4�e' f1�"��,, . 1 � � �, , �, � � � � � �� t �� j � �� p �� .�� r - � � �' b � � �� $ - � �� . ..g i��, . �� i�. 4 '�.+ � '�.� � � "�'�',j v � M ,�`"'�'�'ti`�+� e � ��`�4�€�%� % n%��' � �§� �'��i#�� '-`�'l��' i�* �a) 3�a��;�: I ��,�i'�� n �, �� °�' t'�` � � `�-�� t �45 � ��m ��-��'w �� ' �} �,�- � 7�� -� t� �' E �-� �'�'�S �n �i �'�" � �. f� i� �t i � $ S 1 � � ._se� r .�. �� ' a�` �`��:. 'gw�a �?-,yt� ��t , � $ �. * �, � �*r:a��-; � 5 s �f i a��.��4''� :� � ��. �'i �t �, ��` , �� g� r �` i'�� 3 ��`�w� �i- �?�,"_ , '� �. �s� ��rr .� ��sd��:: ,� � t ��,� �'am � �� ,: I �,� � .a- �{. . � *�' � �;m�� cs'�jM1*�#�S ��i� a ' � �� , � � � �n -�� d li. ,'�'w,-'�,.��a��;�c%� �'u��'-.�z � 's� `� "�¢.�-.��s,.,!��-.��z :.�'.��.�t� �„��f��:'��:.. �a.�°;�.a�,�H^.'� _��, , � ;t .�.,.,�., . , . ra�.-h 1�=,s � . . iw � � •�• • � � ��- / I I'. NI � . _�. _ ��`� al��` `� � I'I II �� I �'' � - - tnr�� , � �� ;\ — �__ "� �� a��,� �,� '�/;�� \ II� I��u JF, � �,�. I�I � ,i — = _- �/s j A� �� a \��i ��I ��4 i x � - - — ��d �� u./ � V�� Z�� . i s r I:pi �i� � 1 � � - � /�� / ��/�h�j ��.�� :;f� .. ��, E �� o h liq� I I �.., uy �i� �/ ��/�� ./�� \�t_3\� ��*� � ��; � iN n I y � \�� y � _�� , � �� ;� r� 9, �� i—=��2�F�� — � �� p� A7%�i' � ' 1 K +I� 1' �'n�p� �p'j �r� � � � �S .��// ✓ � � �> �� . I� : ' � ,�. 1 Inll��„J��u� ,r,. j� s�� _ . �,�_ ��'=43'� Y' A�� ,� �//�' ' � � ,�� 4 I �� \ /��. ✓ � w �� \;� r��% �� ,�. .�� I,� I le � �a% � �c / ¢°��j� / ��` �� \� :�� I%�� „ � i � i. ��v��aa��w*� q II�1�� i��j��,� � �� ik - I �1��,�( / \��i :ei%(< �w �.� .�,. , e,s,,�„ _ - -. ��i ��I�h� �I � I ��:II I ��11!I�i i '-��!� �o%;��. �� , _ - ��r�(�I��I��Ii, ,��iN� �,� � ��I�� h� �.„ ,��,�� '� ..�� s�.�' a --_ ��- - \ \��E�.�III�� `��,�'"i �� ,.� Q� I ,IIII�I�.� I �/� ��jy '.�ol � �—� - � a �II��I � .r�,� - __ _ �. _ u.3 � - ��\�%i�l�Illi� /��...�� II ��II :�u�iu��ll ni i. / e/ ��/�i%d �I��Ij�ll�� \`s' ii b ��'ii i�l� J ig,� !e �� d' ' �� i ��F �b'�_�- � ' � �i l / � i � .�.� i /�/ � i �� i �� '�- � � `�� ,y�� .�',. �� i�� l i! � u� �� C ir � �� I i��I � iiiii � � o � �I��`�"_>_„�,,.,�. � i ;._�._H..2w---��e "��` �, �'�z;' �s. � ;df��ri�, ��jIIIII_�JI�.eI�:.��I I+ :. _ _ lo ��_��,..�� //�� i'0033 207567ii' �:04330 L60 L�: 094��077 2��' �; Kevin M.Wickard 140 Pleasant Hall Road Carlisle, PA 17013 (717) 241-5341 April 1, 2013 Estate of Harry Sennett 151 South Side Drive Newville, PA 17241 I, the undersigned appraiser, have personally inspected the articles Iisted on the attached summary. To the best of my knowledge, the values stated are true and correct as of April 1, 2013. I have found most items to be in good condition and have taken into account both physical and functional 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 contingent upon the valuation of this property. In my opinion the fair market value of the items contained in the estate of Harry Sennett as ofApril 1, 2013 is $1,119.00 Respectfully submitted, ��,�.�� ,�h ,�c.�.,�,�.�u>l� i�_ 1 __ l � Kevin M. Wickard �G;�� y� � __, �� C =� ' � :� SHED #1 --- ___ __ - ___ _--- -- -�------ � �Honda CB 360 motorcycle as is 100.00 �Yard machine by m&d 6 speed 275.00 Car ramps 5.00 Saws, drills, small bench grinder 15.00 18" hedge trunmer 10.00 Electric cords 10.00 7 tool boxes w/fishing gear 7$8.00 40.00 Fertilizer spreader 5.00 ---- --- -- - - Fishing rods 20.00 Christmas items 10.00 - --- - - ---__ _ --- _ ____ ____ - -- -- - - Chuck stove 10.00 Chain saws -as is 2.00 Drills, tin snips, vice, etc. 10.00 Hardware and wrenches-nuts/bolts 10.00 - _---- __ - -- - --- - - - - _ -- ----- - -------- -- L--- - , ___ __ __ ____-- -�- -- � METAL SHED#2 _----- (2) air conditioners 2x$5 00 10.00 Aladdin heater 5 00 Patio furniture 10.00 Ornaments 5.00 ---- - -- - -- --------- _ ------ -- -_--- Misc. tools in shed#2 5.00 Fishing rods 10.00 Wheel barrow 5.00 --- _-- -__ -_ _ -- - -- - -_ _ __ - -----1--_ �- ---- _ __ __----- -- Closed in PORCH --- - -- -- - __----- - - - �hutch 25.00 Folding table 5.00 �------ - --- - - _- -- - --- Bread cabinet 10.00 Lights 10.00 -- -- - __ __- - - - ----, Doll collection 5.00 Book shelves 2.00 -- �---- - -- - -- -_-- - ---J KITCHEN _ _ -- - - �. �-- , I White kitchen cabinet 25.00 Table and cha�rs 25.00 � -- --- --- -- -- --- __-- -- - - - -- ------- - -� Refrigerator 100.00 Kitchen appliances and contents 10.00 LIVING ROOM r 20.00 Monitor 10.00 � I Glider rocker - - - --- - -_ _ __- -- ----- ----- -- _. _. -_.- � Sofa and chair 20.00 Pictures and nicknacks 5.00 L_ _ __�___ _ ___-- - - - --- - - -� TOYS AND TOY CARS __- -- ----- --------- � __ --- , APPROX. 30 TRUCKS AND CARS � 30S$5.00= $150.00 150.00 � ' � ---- i__________ I �- -------- -- -- __ SEDROOM#1 �-.._ -- - -- _ ----- __ _- - -- � �Deer Mounts 2$5.00 10.00 Hess trucks -all for 25.00 - - - _ ___ _ _ - --- -- __-- -- -- - 8 gun-gun cabinet �5.00 Misc. in bedroom#1 5.00 BEDROOM#2 BEDROOM #3 No value-items took water �0 �No value-clothing &linens l 0 J Misc. Washer$50.00 Total Value: $1,119.00 Dryer $10.00 ' �-' 219 Norfh Hanover Street Carlisle,Pennsylvania 17013 717.243.4511 r .- ..;r ��''�',; ,�- � .� toll free 1.866.451.4511 �.� � � �� €:�, fax 717.243.3723 ��' � -,�' �'�,�"�'�-��,,_"�`,_��n:=: !��t www.hoffmanroth.com � ;'' FUNERAL HOME � CREMATORY, INC. info@hoffmanroth.com August 7, 2013 Ruth Kitner Nathan Wolf, Esq. 1121 Centerville Road RE: Harry Sennett, Jr Estate, 10 West High Street Newville, PA 17241 Carliste, PA 17013 Statement of Funeral Expenses for: Harry R. Sennett, Jr. Date of Death: March 9, 2013 Account Id: 16836-078 PACKAGE: Traditional Funeral Service TRADITIONAL FUNERAL SERVICE PACKAGE $ 4,850.00 Sub Total: $ 4,850.00 MERCHANDISE: Casket: Atlantic $ 2,340.00 Outer Container: Monticello $ 1,620.00 Sub Total: $ 3,960.00 TOTAL FUNERAL HOME CHARGES: $ 8,810.00 CASH ADVANCES: South Fairview First Church Of God $ 600.00 6 Certified Death Certificates at$ 6.00 each $ 36.00 Newspaper Notice- Sentinel $ 221.14 Clergy $ 100.00 Flowers $ 159.00 Sub Total: $ 1,116.14 Total Funeral Expense: $ 9,926.14 Total Payments Made: $ 10,053.74 Payments Made: Harr� R Sennett. Jr.// Check 51138850 Apr 1, 2013 6,000.00 Int Waived Aug 7, 2013 127.60 Estate Of Harry/Attorney Wolf Check 176 Aug 7, 2013 3,926.14 Accrued Late Fees: $ 127.60 Balance: $ 0.00 SERVING OUR COMMUNITY SIN ��. E 1 9O7 RECEIPT_FOR_PAYMENT �,�_� ` �r�d'�(j,_�� I� I`-v' �`-�.` ` �� GLENDA FARNER STRASBAUGH Receipt Date : 3/19/2013 Cumberland County - Register Of Wills Receipt Time : 11 : 54 : 15 One Courthouse Sc(uare Receipt No . : 1073491 Carlisle, PA 17613 SENNETT HARRY R JR Estate File No . : 2013-00326 Paid By Remarks : WOLF & WOLF DMB --------------------- --- Receipt Distribution - - - - ------- -- ------- ---- Fee/Tax Description Payment Amount Payee Name PETITION LTRS TEST 60 . 00 CUMBERLAND COUNTY GENERAL FUN WILL 15 . 00 CUMBERLAND COUNTY GENERAL FUN SHORT CERTIFICATE 50 . 00 CUMBERLAND COUNTY GENERAL FUN INVENTORY 15 . 00 CUMBERLAND COUNTY GENERAL FUN INH TAX RETURN 15 . 00 CUMBERLAND COUNTY GENERAL FUN JCS FEE 23 . 50 BUREAU OF RECEIPTS & CNTR M.D AUTOMATION FEE 5 . 00 CUMBERLAND COUNTY GENERAL FUN - ------- -------- Check# 3765 $183 . 50 Total Received. . . . . . . . . $183 . 50 ��p coG��- ,��, , �R�9SSOC�P�� CUMBERLAND LAW JOURNAL 32 SOUTH BEDFORD STREET CARLISLE, PA 17013 Tele: (717)249-3166 Fax:(717)249-2663 May 17, 2013 Cumberland Law Journal is published every Friday by the Cumberland County F�ar Associ�tion and is desi�nated by the Court of Common Pleas as the official legal __ ,. ._ �_ .. __, ., '>lication of legal 60-7269/2313 1 02 DATE lV �� _ � PAY TO CU-PY(�2 E Y'�Q F�Jc-F �-C(CU �O U f�Q I I �7��!c Ttk((yy ORDF.R OF n �/ � .:�=��^�" �✓"7�1.V`C D 7� /'DU OLLARS LJ o,��zo�fl.��. < SovereignBank,NA. PART OF THE SANTANDER GROUP MEMo tf�veyi2_�.�n�,�'�:,f�t __ __ _o�� _ L X � c � legal advertising . . -- ��------------ �. Z 3 L 3 7 2 6 9 L�. 2 10 7 3 2 2 9 2 9�� L 0 2 d Law Journal. Advertisement inserted on the following dates: May 3, May 10, and May 17, 2013 Advertising Cost $ 75.00 Proof of Publication $ 0.00 Second Proof Request $ 0.00 Payment received $ 0 .00 Total Amount Due $ 75.00 Payment received by Th+� Sentinel WOLF&WOLF ATTORNEYS AD NUMBER PAGE NO.. www.cumberlink.com 10WESTHIGHSTREET 420480 10f•1 CARLISLE,PA 17013 BILL DATE SALESRERSON �d��" 717-241-4436 05/15113 wolfc c:+aus.E s�ur��:r�:,r•,uee� F��;a'ccaur�?v START DATE STOP I�ATE 05/01/13 - 05115/'13 AD NUMBER AD DESCRIPTION CLASS LINES 420480 EXECUTOR'S NOTICE LETTERS TESTAMEN 10 PUBLIC NOTICES 30 * 2 cols Publication Insertions Rate Net Amount Gross Amount 3 THE SENTINEL-LEGAL 3 LGL $159.30 TOTAL AD CHARGE $159.30 3 MOBILE SITE MOB2 $2.00 3 PROOF OF PUBLICATION 01PRF $7.00 60-7269/2313 1 01 DATE � �� PAY TO � ! ��h�! I `�' IlV U � g THE ORDER OF , � }�� -- �.�}-- � �p, ��,��F.��., � : / )/�Q fn��Q.��r�i-Y`^'I ��M' a� nD DOLLARS LJ o.u��,o�A.�k � v 7�� i l i'- v , m Sovereign Bank,N.A. PART OF THE SANTANDER GROUP � '/�� t/g �i MEMo/J4 ,"D• �a�T O O ---( �,{(�,��— c—� "`�r-1 - -------- � $168.30 $201.96* �: 2 3 � 3 7 2 6 9 L�: 2 L 0 7 3 2 2 9 2 9 ii'0 L 0 L *AFTER 06/09/13 THE SENTINEL . Thank you for advertising with The Sentinel! Deadline for c/o LEE NEWSPAPERS in-column legal ads is 4:00 p.m. finro business days prior to PO BOX 540 date of insertion. For questions,call (717)240-7130. WATERLOO IA 50704-0540 Return this portlon wlth your payment Legal [] Check# ❑Credit Card Ad Number 420480 THE SENTINEL c!o LEE NEWSPAPERS. � � � �� Billing Date 05l15/13 PO BOX 540 Amount Due $ 168.3Q WATERLOO IA 50704-0540 Acct#: E�.Date:m � Name on credit card � Signature Piease make checks payable to: THE SENTINEL � 000zai THE SENTINEL � WOLF&WOLF ATTORNEYS c/o LEE NEWSPAPERS 10 WEST HIGH STREET PO BOX 742548 CARLISLE, PA 1701.3 CINGINNATI OH 45274-2548 ��u��in��n��n��i��i�u�u��i�n�n��n�i�n�� 215402000000�4204800�OODOOODOOOD0�2019600000168308 � ' Jeromy L. Steigleman 400 Pine Grove Road, Gardners, PA 17324 � (717)486-8081 ' PA035585 May 1, 2013 Estimate for Bill Wolf, Southside Drive Replace front and rear exterior doors $850 Kitchen Replace a11 base cabinets and counter tops $2800 Replace doors on existing upper cabinets $550 Miscellaneous $450 Paneling and trim repair in whole house Repair draws and closet doors in a113 bedrooms Patch bathroom sub floor and lay new linoleum New ceiling and sub floor in bedroom#1 $1100 New ceiling in bedroom#2 $500 ,� ��G�'� �/, `�'�"" � New tin roof on rear addition $800 „ • `' �� s--. ,, ,�i ��-"" ✓ =° G New furnace $1400 � . ' 1'� �� N � � Total Material/Labor $8450 This estimate is good for 30 days and will not exceed the listed amounts unless extra items are added to the project by the home owner. Any estimate exceeding $1000.00 will require half of the total estimate be paid before the job can be started. By signing below I give the contractor the ok to complete the job and will provide him with half of the total estimate to cover materials/labor before the job is started. The remaining balance will be due at the completion of the job. �� Signature of home owner F-...e'',��-'C �* pennsylvania �� DEPARTMENT OF PUBLIC WELFARE May 8, 2013 NATHAN C WOLF 10 WEST HIGH STREET CARLISLE PA 17013-2922 Re: Harry Sennett jr CIS #: 920298173 . SSN: ###-##-7397 Date of Death: 03/09/2013 ESTATE RECOVERY STATEMENT OF CLAIM Dear MR WOLF: Under State and Federal law, the Department of Public Welfare (the Department) is required to recover medical assistance (MA) reimbursement from the probate estates of deceased individuals who were over age 55 when such assistance was received. 42 U.S.C. �1396p(b)(1). 62 P.S. § 1412. This letter sets forth the amount of the Department's claim ' against the estate of the above referenced individual and explains the obligations of executors, administrators, and persons receiving estate property. Although the amount in the estate may be considerably less than that which * is owed to the Department, our claim is against the estate, no one else. Statement of Claim �►mount The Department maintains a claim in the amount of �4,457.32 against the above-mentioned estate. This claim is for repayment of MA granted on behalf of the decedent. Enctosed is the Department's itemized statement of claim. A portion of this medical expense, namety $.00, was incurred during the last six months of the decedent's life; therefore, it is a Class 3 claim pursuant to Section 3392 of the Decedents, Estates, and Fiduciaries Code, 20 Pa. C.S.A. 3392(3). The balance of the claim, namely �4 457.32, is to be entered as a priority Class 5.1 claim against the estate. You should refer to Section 3392 for a more complete explanation of the priority rules. If a lawsuit is filed for injuries sustained by the decedent prior to death, then the Department may also have a lien against the personal injury action. A statement of claim for that injury-related lien must be requested separately. � �� Bureau of Program Integrity � Division of Third Party Liability � Recovery Section PO Box 8486 � Harrisburg, Pennsylvania 17105-8486 � ��P� � :� � � �� .�� Guardian LTC Phartnacy � ��,'�. '��a.'��a��'� . `� .�,��.a�'�� ` �'' `� �� __..�_____.___._.._----..____._______._...-------_..___., (814)503-7400 ' CUSTOMER NO.: 443 123 Brubaker Road PAGE: � ? 8rockway,PA 15624 � ! DATE 1OI2/2013 I United States ' ' REMIT TO AD�RESS: SOLD SENNETT,HARRY ._._.____._..r..�..�.._._____.._._._.__....______.__.._�.....—_..__,.,,.r TO: �51 SOUTHSIDE DRIVE � Guardian LTC Pharmacy NEWVILLE,PA 17241 -'�.. 123 Brubaker Road i ''�. Brockway,PA 15824 � USA i '�`�r i��"��$5�%" ..�� .�� ...��, G w,�'��.w.��'b`°"� i id'�'`��. ".�;,- �t . r"' ��tu :.� t �� p ��s��`�y �-z�^s' � :_��` ,�B '` �"�"�� `` � � i -� . 9 - o es��n r � i p, a "M.11 'tyr�t .� ��I � a`Sek�Ym�w . � ��?�'�"��B�e�BP,�.�w m«��' x dF 2 a � a , ,,.,�a_.",.��'�.�...��?�.� �'�°�.:„ �. �..�,��^n.�r��...��x.��`+��, 2 � �s.,�. ,w.d�..� ,. �.).� ,e .(�o-��E��k�.� �' , ,�,..,._.. , ( � . �IN000000371 � 8131I2011 t IN ; `,,9/30/2011 � 308.19;. iIN000000864 i 9/30I2011 W { i 10/30/2011 � 820.32� 'IN000001425 � 10/3112011 IN � � 11/30/2011 i 7J21 �CN000001335 i 3I3112012 CR =3/31/2012 � -1,075.983. �IIN000007682 ` 5/3112012 IN ��6/30/2012 2.39'E�. i � � �10/3V2012 -2.99� iCN000003559 � 10/31l2012 �� CR ' � I I t � �i ':' j .,'. i i � ; t � , �� , ; i i � � � ' i � � { � a S � � � €� k � I i i j i i t ' 4 � i : � � I 7 � t i � i ' � � i ! C ., E ; � i ( '�� i ' { � �� i � ; : ; � ; � ' ___ _. _�__ .�__. __... �..m_ ., w._._..,.. � , _.._ .. �IN ly�e � il._.„.,^�T y-mP� Appuedae�aat uc UnapplietlCash ACCOUNTOVERDUE.ALLCREDITON Tp}ep 60.25��. ;DB-DebitNote ED-EamedDiscount RF-ReNntl HOLD. �'.CR-CreditNote AD-Adlustment C'��Um�' O.00��:. �ilT-IntereslPayable PI-Prepayment ��A��: . p.��.. r...,,.__._._ _,___..._�.��____..._..._n. ......�._....��__ . 1•30 DAYS O/DUE . 31-60 DAYS O/DUE 61-90 DAYS O/DUE j OVER 90 DAYS 0/DUE ' 0.00 ' 0.00 �� 0.00 1 1,138.62 � � . . . . • . 09/27/13 16505 $ 13.76 ' SPRING ROAD FAMILY PRACTICE, INC. - � � ' � • • ' ' 1921 SPRING ROAD �� ❑��: ❑I�� ❑°�`�y„ $ CARLISLE, PA 17013 ��, AC�(�t'e55 Service Requested CARDNUMBER AUTHORIZATIONCODE �❑�� (last 3 or 4 digits on back �I of card in slgnature line) '�, SIGNATURE EXP.DATE � 03195 II' � '' SPRING ROAD FAMILY PRACTICE, INC. ESTATE OF HARRY R SENNETT JR 1921 SPRING ROAD 825 TORWAY RD CARLISLE, PA 17013 GARDNERS PA 17324-9097 I�Please check box if above address is incorrect or insurance Pl�ase check box if credit card billing address is different than state- ' `—'information has changed,and indicate change(s)on reverse side. �—� ment address and write in address on back. —---------------------------�--------------------------------------------------------------------------------------------,-------------------------------------------------------------------------------------------------------- � RETURN TOP PORTlON•RETAiN I�OWER PORTION Your Account Balance is Seriously Overdue! Make Payment Immediately PLEASE PAY UPON RECEIPT.IF YOU HAVE ANY QUESTIONS REGARDING YOUR STATEMENT PLEASE DO NOT HESITATE TO CONTACT ME AT (717)-243-5444 AND ASK FOR RUTH IN BILLING. Appointment Service Description Charge Payment Adjust Patient 02/26/13 - HARRY - KAUFFMAN, WILLIAM M.D. 13.76 OFFICE VISIT EST LEVEL 3 99213 496 79.00 03/27/13 BS PENNSYLVA Payment 0.00 06/05/13 Medicare Payment 55.04 - 06/05/13 Medicare Payment , 0.84 06/05/13 Accept Assign Ad�. -9.15 06/05/13 Accept.Assign Ad� . -0.21 The 'PLEASE PAY' includes unpaid co-pay or co-ins. Please make payment. i � LASTPAYMENTRECEIVED Current Over30 Over60 Over90 Over120 Patient 00/00/00 0.00 0.00 0.00 0.00 13.76 0.00 _ 13.76 � PLEASE SPRING ROAD FAMILY PRACTICE, INC. MAKE CHECK 1921 SPRING ROAD � PAYABLETO: CARLISLE� PA 17013 -- payment Due Upon Receipt 13.76 Ph:(717)-243-5444 Statement Date: 09/27/13 Acct#:16505 Page 1 of 1 nncnnn�nozn+aaan nnz�os n�n+�nnnnn . . � CHECK CARD USING �"'�' FOR PAYMENT: �I y� � �� DISC£tVEa L_(��i�.�i"s� CARD NUMBER AMOUNT CARLISLE PHYSICIAN SERVICES P.O.BOX 11407 DEPT 2124 $IRMINCTHL�M,AL 35246-2124 SIGNATURE 3 digit VIN# EXP DATE ,. . . . NUMERO DE CUENTA 5/13/13 CPS9544026 33.31 Please send payment to: �� **��**�****�********AUTO**MIXED AADC 350 CARLISLE PHYSICIAN SERVICES HARRY R SENNETT � P.O. BOX 11407 DEPT 2124 825 TORWAY RD � BIRMINGHAM, AL 35246-2124 GARDNERS, PA 17324-9097 I�I�I�II�"��I'll�l'�I�'�'I�I�I��I"�I��'��I�'�"I'�'��'I�i' . • . � ❑Check box if address or insurance information . � is incorrect and indicate change(s)on reverse side. PATIENT NAME: HARRY SENNETT __FACILITY_NAME; CARLI$LE REG19NAL MEDICAL.C.ENTER__ - --- ---- - -- -__ - _ � '• � � • � � O1/17/13 R FRANKLIN EMERGENCY DEPT VISIT - DR 1,082.00 02/15/13 PAYMENT - INSURANCE 45.83 02/15/13 CONTRACTUAL ADJUSTMENT 915.47 03/O1/13 PAYMENT - INSURANCE 87.39 33.31 This is your Emergency Room Physician's bill which is separate from your hospital bill. Your insurance company has processed your claim and the balance is now your responsibihty. YOUR ACCOUNT IS NOW DELINQUENT. PLEASE MAKE PAYMENT IMMEDIATELY. . � ACCOUNT NUMBER CURRENT BALANCE NUMERO DE CUENTA 30 DAYS 60 DAYS&OVER 3 3.31 CPS9544026 0.00 0.00 33.31 • � � * 3rd Attempt * * � � � CORECCION EN LA INFORMAC16N DEL SEGURO: Por favor de proveernos copia de la tar�eta de seguro m�dico. Indique si el seguro Medico es primario o secundario. Pay Online,Electronic Statements,Download Medical Records, OFFICE HOURS: 8AM-8PM MON-THUR,and 8AM-6PM FRI and On-line Account Information all available now with PaymentsMD Patient Portal. Toll Free: 877-358-0145 Go to https://portal.paymentsmd.com/apollomd Para preguntas,por favor llame al: 866-853-3802 Get your medical history today with Patient Health Services Report At www.paymentsmd.com. � 0 a m Fill In Below�'o Pav Bv Credit Card �gP ❑v�s� . Z .� 3: , ❑ MasterCard > HOSPITALISTS OF CENTRAL PENNSYLVANIA m PO BOX 62722 Card Number Exp.Date Security Code =— � BALTIMORE, MD 212642722 � � Card Holder Name Signature = ^ FORWARDING SERVICE REQUESTED Statement Date Pay This Amount Accaunt# � 06/20/13 $134.09 140294600 - I�f< — Payment Due Date Show Amount� @ � _— 07/12/13 Paid Here `p � *y�henp ying by credit card your receipt will be from Global Health Management Services. � I�iillliiilnlliiilil�l�illiliilli�ililiil�i�liilililllii��ll� HOSPITALISTS OF CENTRAL PENNSYLVANIA � **'*'"*"""***ALL FOR AADC 170 — a 13 a 2 o PO BOX 62722 � BALTIMORE, MD 212642722 — SENNETT JR HARRY R � 825 TORWAI�RD — GARDNERS PA 17324-9097 ❑Please check if address or insurance information is incorrect and complete form on back. PLEASE DETACH AND RETURN TOP POR710N WITH YOUR PAYMENT Account #: 140294600— Please Pay: $134.�9 �ue �ate: 07/12/13 Payments Date Description Amount Adjustments BALANCE FORWARD LAST STATEMENT 80.11 03/07/13 99222 INITIAL HOSPITAL CARE/LEVEL 2 295.00 04/10/13 MCCK MEDICARE CHECK -105.85 04/10/13 MCDS MEDICARE DISALLOWANCE -162.69 05/O1/13 BLDN BLUE SHIELD DENIED 0.00 03/08/13 99232 HOSPITAL DAILY VISIT 150.00 04/10/13 MCCK MEDICARE CHECK -54.94 04/10/13 MCDS MEDICARE DISALLOWANCE -81.32 05/O1/13 BLDN BLUE SHIELD DENIED 0.00 03/09/13 99238 HOSPITAL DISCHARGE DAY MGMT 138.00 04/10/13 MCCK MEDICARE CHECK -55.12 04/10/13 MCDS MEDICARE DISALLOWANCE -69.10 05/O1/13 BLDN BLUE SHIELD DENIED 0.00 A Word About Your Account YOUR ACCOUNT BALANCE IS OVERDUE. PLEASE PAY PROMPTLY OR CALL US TO DISCUSS ANY PROBLEMS RELATED TO THIS BALANCE. Total Now Due 13a.09 � Make Checks HOSPITALISTS OF CENTRAL PENNSYLVANIA For Billin Questions Call Payable To: PO BOX 62722 �$�8� 6��-8�22 BALTIMORE, MD 212642722 PAGE 1 OF 1 PD1881-25 Remit payment to: Patient Statement Carlisle Digestive Disease Associates Wednesday, July 03, 2013 241 Alexander Spring Road . , . - i ' � -. . Carlisle, PA 17015-6953 $33.94 (717) 245-2228 Payment Type: []Cash � Check �]Visa ❑ Mastercard �American Express � Discover Harry R Sennett Account# 825 Torway Road Expiration Date / I Gardners, PA 17324 Signature f l Please✓Box if above address intormation is incorrect&indicate changes on reverse side. Date � � Reflects transactions posted through 713/2013 for 491aFt (Detach and remit with payment) �. - �- . . - - Harry R Sennett(50127)/Jonathan J Verrecchio D0/222913 Location:Carlisle Regional Medical Center 03/07/2013 Initial-Moderate Complexity $220.00 1.00 $220.00 $0.00 04/10/2013 Medicare Adjustment from Medicare 8874245 -$87.69 $0.00 04/10/2013 Medicare Payment from Medicare 8874245 -$105.85 $0.00 04/18/2013 Transfer from Insurance -$26.46 $26.46 Patient Responsibility $0.00 $26.46 Harry R Sennett(50127)/Jonathan J Verrecchio D0/222914 Location:Carlisle Regional Medical Center 03/08/2013 Subsequent-Focused Visit $90.00 1.00 $90.00 $0.00 04/10/2013 Medicare Adjustment from Medicare 8874245 -$52.60 $0.00 04/10/2013 Medicare Payment from Medicare 8874245 -$29.92 $0.00 04/18/2013 Transfer from Insurance -$7.48 $7.48 Patient Responsibility $0.00 $7.48 PAST D UE Prompt payment will avoid collection , procedures. ' Mail your check today! � � � r°� g �;� � �,��.;� �+ � �° �� r ��; :�`a . � � �, ` "p B � gg �� pw. � I �i. � .�. � � D 3 ;t . iu �kir- a . E+ � r D t.�3,'B�,G" k S.e� �p �r { M d � �•�• 1 1 .1 . .� � . .i ' f � . . . • • • ' . • $0.00 $0.00 $0.00 .$33.94 $0.00 $0.00 $33.94 $0.00 $33.94 Make check payable to Carlisfe Digestive Disease Payment due by July 24th Carlisle Digestive Disease Associates *241 Alexander Spring Road* Carlisle, PA 17015-6953 * (717) 245-2228 PLEASE RETURN TOP PORTION WITH YOUR PAYMENT.RETAIN BOTTOM PORTIOfJ FOR YOUR RECORDS 900-NCC b0 NOT SEND PAYMENTS TO THIS ADDRESS For billing questions call: (717)932-5955 Dept. 19687 or: (877)932-5955 P O Box 1259 Fax: (717)932-4856 Oaks,PA 19456 Office Hours: 8:00 AM - 4:30 PM IIIIIIIIIIII�IIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Tax ID: 251792806 To pay your bill online and register for eStatements, please visit us at: www.qita.com Final Notice Date: 6l26/2013 Patient Name: HARRY R SENNETT JR Account#: 168388 Personal& Confidential Balance Due: $1.74 '��I��n��i�l�n I��il��ll��1��il��i�l�� 19672-35 o k HARRY SENNETT J ESTATE � � ],51 SOUTHSIDE DR NEWVILLE PA 17241-9536 • � According to our records,your balance of$1.74 is delinquent and remains unpaid to our practice. Please pay the amount in full unmediately using the bottom portion of this letter or call (717)932-5955 or(877)932-5955 to make payment arrangements. To pay your bill online and register for eStatements, please visit us at: www.qita.com If pavment is not received within ten(10)business davs your account mav be placed far collection without further involvement bv Quantum Ima�in�and Therapeutic Associates. Please understa,nd that failure to pay could adversely affect your credit rating. Respond to this fmal notice today. FINAL NOTICE! Pleasc detach and return bottom �ortion with �r�aytnent in the enclosed envelone ............................................................................................................................................................................................................................................... GUARANTOR NAME AND ADDRESS IF PAYIN�BV VISA,MASTERCARD OR DISCOVER,FlLL OUT BELOW H A R R Y S E N N E T T J E S T A T E ❑�i�,� ❑MASTERCARD� ❑DISCOVER� 151 SOUTHSIDE DR �R�� °"•°"� """°""� NEWVILLE PA 17241,-9536 PRINT CAiiDHOLDER NAME MUST INCWDE 3 DIGIT SECURITY CODE FROM BACK OF CARD Final Notice Date: 6/26/2013 Patient Name: HARRY R SENNETT JR Remit To: Account#: 168388 Balance Due: $1.74 Quantum Imaging and Therapeutic Associates P O Box 62165 Baltimore,NID 21264-2165 I��LI��fI��LI�II��I��L�LL��II�II��I�I��IL��IJ�II��I I IIIIIII IIII IIIII IIIII IIIII I�II�I��II IIIII IIIII IIII)IIII IIII 19672-35 Undeliverable Mail Only: �,��,��Ir�� P.O, Box 1954 LLC Southgate, MI 48195-0954 Healthcare Division �� Columbus OH9 43236-1596 Toll Free:800-966-0755 Mon.-Fri 8:00 AM-6:00 PM EST MM1/89010517/105 008 72397808 0006684/0029 I��I��I�I��II��I�I��l��i�ll�l�l�llll��l��ll�ll Date of Service: January 20, 2013 Harry Sennett Estate Jr Balance: $923.31 825 Torway Rd Account Number: 89010517 Gardners, PA 17324-9097 Client Ref Number: 9544026 Date: August 26, 2013 Dear Harry Sennett Estate Jr: We hop e that you read our prior letter to you. Your delinquent,debt remains unpaid and,we intend to continue our coflection activity on behalf of our client. We urge you to give this matter your attention. Please contact our office at the telephone number listed below should you wish to initiate a payment by telephone. Please have this letter available when you cail. We are a debt collector attempting to collect a debt and any information obtained will be used for that purpose. Sincerely, Account Representative 800-966-0755 Allied Interstate LLC Notice: SEE REVERSE SIQE FOR OTNER IMPORTP,f�!i INFOR�v�ATION --------------------------------------------------------------------------------------------Detach and return with payment------------ ----------------------------------------------------------------------------- � Date: August 26, 2013 Client Ref Number: 9544026 Client: CARLISLE REGIONAL MEDICAL CTR Amount Due: $923.31 Amount Remitted: $ Payment and Correspondence Address; M M 1189010517/858 lil��l��i��i�i°��I�illi��i�i�l�l��lini��i�lli��lllil��l�lli�i Allied Interstate LLC Healthcare Division P,O. Box 361596 Columbus, OH 43236-1596 105 -----. o ■ - � � 0 0 wr- �.� p ~ w _ . � `� a o " Zt� z W � N � � m¢ '^ c�o W _ Z `° `^ �n ao J � w � o w� � N G � m ¢ W �� - H W _ � o w � � � !k7 tl] W � � a - H �D � � .-i � v � Q - u] �v Z O : � c� � aaE^�h,1a � � H rl '� . . . . . ~ � N N �l t!! 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O4 H� W. � . � fV' v�i '�C� c W ��,H Vl � � . . . � Q . �� v' lD N E Q x a a7 a U O1 NW Np o M y � � O'A P- �. � . . � . . � . .� � HEi �c� � � o N cn w � p° z o U1 �1 0 I c'',tN_, 2 U D m c� w N �� ,�a � � o ~ �`°° � H W �, H H a o aN a� o �c � o � a Q H N � �� HQ� o � c� �o a o A o � U u1 H rl � � W�*7"� �m �WW � o Z � �? � �n {� O �j v7RL'[� U �� .TzQr�C aci `m Q w ��'+ a >o q~ � t'`�w '�U2 x a @ m n- � O aa a� �" a • o wwoa Woa � roo r'-'aoa ��3 ¢ � � � � � N�� ^� ��u�� lu . � � � � o � U Na 9 m� U .. . � Za a . U�' E � a W O�1 y `�- n�tz rl 3 � m � o 0 N(YiH � �� oFCuIW U� a ' NNroc� �z u ❑ a � � Ey(�� q "� n x r-I Z wO U . � m m .~-i w� W �� U r+ ro N ro QO f"1 V ^�i Z � � � � eNi:�� .� �U . Cn 02288 2316499 002289 002289 00001/00001 920966904 ' � Questions?Please � Visit us online at Page 1 �`,��;.',, °*� `�fr� contact us by Jun 6. pplelectric.com � � , �� . . � � . �:;. 1-800-DIAL-PPL p� � � „ (1-800-342-5775) 14620-78003 Jun 6, 2013 $�4.�� x.��a�s�i�uciii�oe� M-F:82t7t t0 SptT� Yaur Electric Usage Profile Billing Summary (Billing details on back) Service to: Balance as of May 3,2013 $50.07 HARRY R SENNETT JR Charges: 151 SOUTHSIDE DR Total PPL Electric Utilities Charges $14.16 NEWVILLE, PA 17241 Meter:84509019 Totai Charges $64.23 Your next meter reading is on or about Jun 3, 2013. p��gy,#�� ,�p�,3 ��•�� This section helps you understand your year-to-year Account Balance $64.23 electric use by month. Meter readings are actual unless pp�Electric Utilities' price to compare for your rate is$0.07237 per kWh. otherwise noted. This changes the 1st of Mar,Jun,Sept,and Dec.Visit papowerswitch.com �20�2 �20�3 or www.oca.state.pa.us for supplier offers. z4 Your Message Center Y 20 • With paperless billing,you can receive and pay your . 16 PPL Electric Utilities bills online.The process is free, � lz quick,convenient and secure.To learn more or sign up, a visit pplelettrit.com. ; $ • Information about appliance energy use and tips on ` a a 5aving energy are availabfe through the Energy Library � 0 on our Web site, pplelectric.com. ° � � F M A nn i � a s o rv � . Before digging around your home or property,you � nnoncns should always call the state's One Call notification system to locate any underground utility lines. You can � � , . , . do this by simply dialing 811,which will connect you to � � � the�ne Call system. Be safe and call S11 before you dig. May 2013 30 0 0 53F May 2012 30 132 4 53F — = • • . �� • Payment Methods = ` May 2 Actual 50392 � �nline at: O By phone:i-800-342-5775 = Apr 2 Actual 50392 Pp�electric.com or call BiIlMatrix(service fee applies) � at 1-800-672-2413 to pay using Visa, � 30 Days kWh Billed 0 MasterCard, Discover or debit card. _ � �. � � , � � By Mail: Correspondence should be sent to: _ Jun 2012-May 2013 3315 � 27� 2 North 9th Street Customer Services CPC-GENN1 827 Hausman Road Jun 2011- May 2012 2573 214 � Allentown, PA 18101-1175 Allentown, PA 18104-9392 — Other important information on the back of this bill-� � �r�y�a',, `°�g"�"°<;.• � � Return this part in the envetope . , � - •. - � . r - m provided with a cher=k payable � pp� �a�.w " to PPL Electric Utilities. 14620-78043 Jun 6, 2013 $64.23 PPL Electrlt UtElltles Amount Enclosed: AT 01 054187 51727E195 A*"`3DGT ❑�� III � � � � ��II ��1� � II II I ��I111� L I� III �II,� ❑❑L�L� � �t I � � � � � �I �I�� I �� I� � HARRY R SENNETT JR PPL ELECTRIC UTILITIES 151 SOUTHSIDE DR 2 NORTH 9TH STREET CPC-GENN1 NEWVIL�E, PA 17241-9536 ALLENTOWN, PA 18101-1175 ��II�I�I'I�"I�1111'll�l�ll'IL��1��1�1��11'��t��l'lll'I��I'�I� 1 510�00064231L1000064238 1W62078003 ,�;��, �� CenturyLink� P.O. Box 1319 Charlotte, NC 28201-1 31 9 Account Name: HARRY R JR SENNE7T Page: 1 of 3 Account Number: 313600514 Bii► Qate: May 04,2013 Contact Numbers Current Charyes Summary_________ oeta�i Page Product,Services and Billing 1-500-201-4099 Late Fees o.z2 Repair Service Total Current Charges 0•22 1-800-788-3600 Payment or Account Balance 24R 1-800-201-4099 High Speed Internet Tech Support 24/7 1-800-788-3600 Dial-up Internet 24i7 Tech Support 1-888-872-7313 Financial Services/Payment Arrangements 1-888-646-0004 Visit us online www.century�ink.com Previous Balance Payments&Adjs Past Due Current Charges Amount Due Date Due __ 70.43 I ,�.�z ca I 52.99 I o.zz 1 53.13 I May 31,2013 _ Just a iriendly reminder that your account is past due. If you have already made your payment, thank you fior bri�g�n� your account up to date, 6 The Due Date On This Bill Applies to Current Charg�s Only ***PLEASE FOLD,TEAR HERE AND RETURN THIS PORTION WITH YOUR PAYMENT**` FOR CHANGE OF ADORESS OR PAYMENT AUTHORIZATION: F D 041713 �Please check here and complete reverse.Thank You. Account IVumber: 313600514 Amount Due By May 31, 2013 53.13 AV 01 053601 422996189 A�"5D6T CenturyLink HARRY R JR SENNETT P.O. Box 1319 151 SOUTHSIDE DR Charlotte,NC 28201-1319 NEWVILLE,PA 17241-9536 �,�I��It��ll��ll�'�I'll��ll'I��I"1��1"'1'�II��I�� I�I�I'10i1��11�1��1��1��1��11��11��111�'lll'll��lll�� 000�31360�514200000��05291�00��[100CBl305041300�0�053132�00�0�0 1 Account Number �� Due Date KUHN COMMUNICATIONS,INC. P.O. BOX 277 001-000453 0 4/15/13 WALNUT BOTTOM, PA 17266-0277 �'��"" 532-8857 ACCOUtIt SUI'T1117aC)/ _ _ AMOUNT IS DUE IN OUR OFFICE ON Billing Date 4/1/2013 OR BEFORE THE 15TH. IF THIS HARRY SENNETT JR Previous balance $36.03 �otrNT zs rroT PAID A $2 .o0 151 SOUTHSIDE DR (-) Payments $0.00 SERVICE FEE wzLL BE ADDED TO NEWVILLE PA 17241-9536 (-) After Payments $36.03 YOUR ACCOUNT. Current IVlonth Activity Billing Questions Please Call: Date Description of Service Amount 532-8857 �—._��. _ _ 3/18/2013 SERVICE FEE $2.00 Total Current Charges $2.00 _ OFFICE WILL BE OPEN SATURDAY, Total Due $38.03 APRIL 6TH & APRIL 13TH FROM 8AM - NOON *************************** INTERNET&PHONE TECH SUPPORT #1-866-833-4950 www.kuhncom.net VOD WILL BE AVAILABLE MAY 1ST! ! ANNOUNCING AS OF MAY 1ST ----VOD WILL BE AVAILABLE! ! ! ! ***NBC SPORTS NOW IN HD ON CHANNEL 213 ,_ �_...__,.. .� .. . . ...... _.. . __. . Sel'VICe AddY@SS: P�ease detach at the perforation, and enclose this portion with your payment. Thank you! 151 SOUTHSIDE DR Due Date Account No. Previous Bal. Payments Current Charges Amount Due Amt Enclosed NEWVILLE PA 17241-9536 — 4/15/13 001-000453 $36.03 $0.00 A $2.00 $38.03 $ Please indicate ihe amount enclosed,do not send cash! KUHN COMMUNICATIONS,INC. Please make check or money order payable to: P.O. BOX 277 WALNUT BOTTOM, PA 17266-0277 �in��u�n��i��u��n��u��n��n��n��in�� I��III��I��I�6I��6��II6I��Id��Ii��II��LI��I6I6�I KUHN COMr�r.�rICATIONS, INC. HARRY SENNETT JR P.o. sox 277 151 SOUTHSIDE DR WALNUT BOTTOM, PA 17266-0277 NEWVILLE PA 17241 -9536 ��I��II��I I��