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Home My WebLink About05-15-15 J 15�5619134 extoa.ialtcp REV-1500 OFFICIAL USE ONLY BureauoflntlividualTaxes CountyCo�e Year FileNumber ao eoX 28o6oi INHERITANCE TAX RETURN 2 � � 4 1 0 1 2 Harrsbu PAi�i28-o601 RESIDENTDECEDENT ENTER OECEDENT INFORMATION BELOW Social Secunry Number Date of Death mm0ovrvv Date of Bitlh Mmoovvrr 1 1 0 0 9 2 0 1 4 0 4 1 9 1 9 2 4 �ecedenfs Last Name SuHix Decetlenfs First Name MI R o u p a s M a r y R (If Applicable)Enler Surviving Spouse's Intortnatlon Below Spouse's Las�Name Sutfx Spouse's Fl�st Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW � 1.O�iginal Return � 2. Supplemental Re[um � 3. Remainder ReNm(date of tlea�� Pnorto 12-13-82) � 4.AgriculWre Exemp�ion � 5. PoNre Interesl Compmmise(Oa�e ot � 6. Fetleral Esta�e Taz ReWm Required (GateotdeatM1onoratler]42014) deathaFlerl2-12-82) � ]. Decetlent Died Testate � 8. �ecetlent Maintainetl a Living Tmst _ 9.Total Number of Safe Deposi�Boxes (AtlachcopYo(wIIL) (Attac�wPYa(Imst) � 10. Litigalion ProceeEs Receivetl � 11.Non-Probate Transferee ReWrn � 12. Deferrel/Election of Spousal Tmsis (Schetlule F antl G Assets only) ❑ 13.Business Assets ❑ 14.Spouse is Sole Benefciary (No imst involvetl) CORRESPONDENT�THIS SECTION MUST BE COMPLETE�.pLL CORRESPONUENCE AND CONFIOENTIAL TH%INFORMATION SMOULO BE DIRECTEO T0: Name Oaytime Telephone Number The r e s a L . Sha de Wi x 71 7 652 8455 First Line of Atltlress Wi x , We n g e r & We i d n e r Semnd Line of Aaaress 4 7 0 5 D u k e S t r e e t Ciry or Post OKce State ZIP Code H a r r i s b u r g P A 1 7 1 0 9 Corresponaent's e-maii aadress: tIsW2000 801 com � REGISTEROFWILLSUSEONLT ' � REGISTEROFWILLSVSEONLY � li i ' OATE FILE�MM�DYYVY � n "' '� m �..— _—�. I .i ...l c o .� , � I_____. I I :s P � -.., � I -- -. . . . - .._ -- .� � ;-� cn � DATEFlLEDSTRM� _ . . __. . s . . —P - �il 3 '"� Ci � f(l PLEASE USE ORIGINAL FORM ONLY . 'V � � " � Side 7 � � III�IIIIIIIIIIIIII'IIIIIIIIIIIIIII'll'IIIIIIIIIIIIIIIIIII�II � � � 1505619134 1505619134 J 1505619234 REV4500 EX(Fl) DecedenYs Social5ecuri�y Number o�ae�rs�,ame Marv R. Rouqas RECAPITULATION 1. Real Estate(Schetlule A) . . .. . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. • 2. Stocks antl Bonds(Schetlule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. . 3. Closely Heltl Corporetion, Partnership o�Sole-Pmprie�orship(Sc�etlule C) . . . . . 3. • 4. Martgages an0 Notes Receivable(Schetlule D) . . . .. . . . . . . . . . . . . . . . . . . . . . 4. . s. Casn,eank Deposits ana Miscellaneous Pereonal Property(Scnedule E). . . . . . . 5. 5 3 3 , 5 $ 6. Jointly Ownetl Propetly(Schedule F) ❑ Separate Billing Requested . . . .. . . 6. � � 4 $ 6 5 , g � ]. Inter-Vivos Transhrs&Miscellaneous N -Probate Pmperty (Schetlule G) �] separete Biilinq Requestetl . . . . . . . z 8 4 1 6 8 , 9 5 a. Tor�i cross nssen pocai�mes i mm�yn�� . . . . . . . . . . . . . . _ . . e. 1 9 9 5 6 8 , 5 0 9. Funeral Expenses and Atlminisirative Cosis(Schetlule H) . . . . . . . . . . . . . . . . . . 9. 9 7 � 8 . 2 8 10. Debts of DeceEent,Morigage Liabilities,and Liens(ScheGule I) . . . . . . . . . . . . . 10. 4 6 . 3 3 i t 7otal DeaucGons(total�ines s ana to) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i t 9 7 6 4 . 6 1 �z. Ne�veweoresrare0.meamm�su�e �i) . . . . . . _ _ . _ _ . . . . . . . _ _ . . �z. 1 8 9 8 0 3 . 8 9 13. Chari�ableanEGovemmenlalBequests/Sec9113Tms�sforwhich an election ro tax has not been made(Schetlule J) . . . . . . . . . . . . . . . . . . . . . . 13. . 14. Net Value Subject to Tax(Lina 12 minus Line 13) . . . tq, � 8 9 a Q 3 . $ 9 TA%CALCUUTION-SEE INSTRUGTIONS FOR APPLICABLE RATES 15. Amount o(Line 14 taxable a�Ihe spousal tax rale,or transfers unde�Sec. 9116 (a)(12)%0 _ � . � � t5. 0 . � � 16. Amount of Line 14 taxable auineai�ate x.oas 1 8 9 8 0 3 . 8 9 is 8 5 4 1 . 1 8 17. AmountofLineldtaxable at sibling rate %.12 � O . O � 1]. Q , � � 18. Amount of Line i4 ta�ble atcollateralra[eX.15 � . � Q �g. Q . Q � 79. TAXDUE . . . . . .. .. . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . 19. 8 rJ 4 � . � 8 20. FILL IN THE OVAL IF YOU ARE RE�UESTING A REFUND OF AN OVERPAYMENT � UnEei penaNes ol pe�ury,I Oeclare I�ave eeamineJ Nis reWm,IncWEinq accompanying schetlules and s�akments.antl ro��e besl of my knowletl9e antl belief. i�Is Uue,cortect anE complele.Decla2tion IN preparer oUer iM1an t�e person resDonsi0le br flling��e re�om Is bautl on all'mformation of w�lc�pie0arer M1as any knavletlge. SIGNATURE OF PERSON RESPONSIBI FOR FILING RETORNn � o � � N ��-DNT[`� Y�VI/ Q/I.U^� � �h�� ^ _ �, I J 'Efzss �ouSeV� . Ca�� ; I �/�' , I o IL - (�FSL SIGNATURE P PREP E�THER T�VINI PE�SON RE$$F�NSI LE Fpq[��FlLING THE RETORN pAT � . �,81�-4-0LC! /J�/'Ad[ "'1✓' �I � Cl�l �a.0/S nooRessy.� OS' �..��Ce 5 ec`(" � ri`sb �:...c Pf� 11 /� IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII itle2 L 1505619234 1505619234 J REV-1500 EX (FI) Gage 3 Flle Numbe� DecedenYs Complete Address: zt ia �aiz DECEDENTSNAME Mary R. Roupas . _ _ _ _. . _ _. . . _ __.__ . .. _—_. . _- STREETA��RESS 412 Sprin House Road. _. .. . . .. _ . .— _. _ .. - __.. CITV I� STATE ZIP Camp Hill PA 17011 Tax Payments and Credits: �. Tm�Due(Page 2,Line 19) (1) 8,541.18 2. CreDils/Payments A,PriorPayments _ _ 8,000.00 B.Diswunl . . ._ 4z].OS (See InsWctions.) lotal Credlts(A t B) (2) 8,421.05 3. Interest (3) 4. If Line 2 is greater Ihan Line 1 �Line 3,enter�he diHerence.This is the OVERPAYMENT. Fill in oval on Page 2,Line PO W requeet a retund. (4) 0.00 5. IfLinei «�ine3isgreater�hanLine2,enlerlhediHerence.Thisis�heTAXDUE. (5) 120.13 Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1, Oiddecedenlmakeatransferen0: Yes No a. retainiheuseorincomeofthepmpetlytransferred ..... ._._.... .."' .-- ❑ ❑ b. retainthenghirodesignatewhoshallusetheDropertytransfertedoritsincome ..... x c. re�ainareversionaryinterest _......... �� x _........._. ......... ...... d. receivethepmmiseforlrfeo(eitherDaymenis,benetitsorcare� ._ .. ....... ...... ..._. ❑ � 2. IfOea�hocarredafter�ec. 12,1982,ditldeceden�transferpmpetlywi�hinoneyearofdeath ❑ ❑ without receiving a0e9uate consideration? ._............. ............... _._......... ..... 3. Diddecedentavnan'inWsifoforDaya0le-upondeathbankacwuntorseantyathisorherdealM ._._ ❑ ❑X 4. Oid tleceden�own an individual relirement account annuity orothernon-pm6ate propetly,which o�ntainsabeneficia7desi9na�ion?........ ............ .............._. ............_. ........... ❑X ❑ IF THE ANSWER TO ANV OF THE ABOVE QUESTIONS IS VES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Por dates of tleath on or aBer July 1,1994,antl before Jan. 1, 1995,ihe t�ra[e imposed on[he net value o�tmnsfers ro or br the use oi ihe surviving spouse is 3 percent[72 P.S.§9116(a)(1.1)(i)1. For da[es of death on or aRer Jan. 1, 1995,Ihe tax rate imposed on Ihe net value of transfers�o or for the use of the surviving spouse is 0 percent �72 P.S.§9116(a)(1.1)(ii)�.The staWte dces not exempt a irans�erto a surviving spouse imm tac,antl ihe staNtory requirements for tlisclosure of assets antl filing a tax return are still applicable even if ihe suniving spouse is ihe onty benefciary. For dates of death on or afler July 1,2000: • The tax rate imposetl on ihe net value of iransfers from a deceased child 21 years of age or younger at tleath to or for the use of a naNral parent,an adoptive parent or a step-parenl of ihe child is 0 percenl[72 P.S.§9116(a)(12)]. • The tax ra[e imposed on the net value of transfers�o ortor tl�e use ot the decetlenTs lineal beneficiaries is 4.5 percent,except as no�etl in �72 P.S.49116(a�(1)I. • The ta�c rate imposed on the net value of Uansfers to or for the use of ihe decedenfs 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. ae¢isoe ex.�oa-iz) pennsylvania SCHEDULE E oeanarmexroFaeveH�e CASH� BANK DEPOSITS & MISC. INHERItANCETA%REIDRN aEsioENroECEOEHr PERSONAL PROPERTY ESTATE OF: FILE NUMBER: Marv R. Roupas 21 14 1012 Inclutle Me procee0s of litiga[ion antl the tlate ihe proceeds were received by the estate. All property foin[ly owneE wiN right of survivorship must be disclosetl on Schetlule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Safeco Insurance 164.09 Refund (See Schedule E, Exhibit 1) American Water Enterprise Refund 2. (See Schedule E, Exhibit 2) 24.54 United Health Care Insurance 3. Refund 208.00 (See Schedule E, Exhibit 3) 4. United Health Care Insurance 4170 Refund (See Schedule E, Exhibit 4) PA Media Group Newspaper Subscription Refund 5. (See Schedule E, Exhibit 5) 9525 TOTAL(Alsoen�eronLineS,RecapiWla�ion) E 533.58 If more space is neetled.use atltlitional sheets af paper of the same size. � 3c� ac� 2ot � ��p� st �d �-c �ec-� �,��r�,ti,.e� �d ch�e�, .{� �,� �� 23 5 q 9 q e 3 f � I � �-, 0 � ��,, �-�' - � _ - i 1i�'G �. s� �„ �n,.sd � , �o�i .� r:.,. . ��. ✓`",�'- `�f � �fiT'��3 �ft� , l"-'.`- raE�� :.� �� .,.- ` . Alabcct9MuwlComP 9 CA ON4G1203].:: � �.30/22/]4�.. . ��''�'�.. ��..�.'r�".''~�... �,.�_��, _.�".-��^s. -w��:�` �i, .n c� ;��°� ',Y'�i." � PA6E 1 OF 1 ♦[[WNT MIImER: ]1116II6004 P1YEE: MRRY R ROUP(S PAYEE �NORE55: � . 412 SPRING HWSE ¢0 CRMP HILL PA 1]O11d452 � XEMRKS: } n..� x�.�.�.a: � Me r mlly r�c�SvW a paye�n4 on yaur policy. l}u policy Mos previaualy cencalatl m�tl �qalns cmro�1W. If yau M1ew aro eu�slions� please eon2ac! khe i�MepentlenS Safeeo a9Nt lia4etl en ye�� peliey. 5"v�cercly� Firenci�l S��vices � TOTRL pq11M: 4164.09 Schedule E, Exhibit 1 f.ARWI111 V nFTACH CHFCN RFF(IRF 11FP(ICTNl:.RFT>IN CTCTFE/FAR F/l�vni IO oc�nonc American Water Enterprise � � . � � . . — To: � MARY ROUPAS �. TEMPSL00004934 - . ��Number. . � 006099]4 . . . . . Date: . . l i/W/2019 �_�e Imoice Number Date . Despiption . � �� Amount � �-- � � �� iscount Paid Amount 49,489 � � 10/28/2019 21003fi9256R . . �.. . ....324.54 $0.00 ;29.54 r��u�,d C�e � os�(ed (�- �l/eo, yvl � _ . 1 q/P Phone: (866)430-0819 ', TOTALS: EZ4.59 . ;0.00 $29.5q Schedule E, Exhibit 2 UnitedHealthcare Insurance Company — PO Box 105133 --� = Atlanta, GA 30304 = DATE: 11/192014 — MEMBERSg�#: 016410799-1 � CHECK NUMBER: 377575 = CHECK AMOUNT: 5208.00 � 323MRP�R1la1W1Mi8&01 � ESTATE OF MARY R ROUPAS 412 SPRINGHOUSE RD � � � � - - - � CAMP HILL PA 17011 THIS REFUND IS FOR MONTHI.Y PREMIUM PAYMENTS AFTER HEALTH PLAN CO VERAGE HAS ENDED. FOR QUESTIONS, PLEASE CALL CUSTOMER SERVICE AT 1-800-523-5800. IF YOU HAVE pNY QLJESTIONS,PLEASE CALL TOLL FREE 1-800-523-5800. � z08 .�0 d��e� `I � 2�(� �•ISupplemental and Personal Health Plansm�,rcat�UmmdHralthfare �� Immana Compeny . , . . , . PlsawdltuhcMxkvidc u�d�P9RnPromP ,� � .-. . ::- _ - '_� aga o Schedule E, Exhibit 3 Page 1 of 1 Unitea Heal[hCare Svs Inc �� 90-GO PO Box 29180 Hot Springs AR 71913 CHECK �ATE 11-25-2014 � CHECK NUMBER 02977232 I IN17010E�- YOUCEIEfi �' �; � - N�� GROSS��.AMOUN7 qISGOUNT ��. NETAMOUDI7 NIIMHER DATE 0000000000000000004926639 � 11-24-14 21991994 41J0 .00 � 41.70� MEMBER A 000052622-1 YOUR ACCOUNT WAS PREVIOUSLV TERMINATE�. THIS R EFI1N� REPRESENTS FUNOS RELEIVE� AFTER VOUR TERMINATION DATE.IF YOU HNVE QUESTIONS, PLEASE CFLL 1-888-867-5575(TTY 71]). GPS I�EFlDOH ��' TOTAL USD 41J0 .00 41.70 SINGLEPAY � �( �--� �'�� 3 rDee . wr�F w,.,,�, �„ �,n,v w.,,,,�„�,�, ,,,��.,,�,_,��..,�,n�,�„h., . Schedule E, Exhibit 4 �� PA Media Group PO BOX 1038 W Imington DE 19899-1038 � 000� aao a000�ai oaam000 ooi m�oozee ir.s:o 0 MARYROUPAS 412 SPRING HOUSE RD CAMP HILL, PA 17011-1452 Page 1 of 7 � InvoiceNo. InvoiceDa[e VoucherlD GmssAmount DiscountTaken PaidAmount OOG066995.207d-01-24 11242014 OW35388 9525 000 9525 Newspaper Subscnba Refuntl SUBSCRIBER REFUND �" q5� 25 P��s�� Sa�_ �„� For informalion on how�o recelve your payments hster or questioris regarEing l�is payment,please wll(Bfi6)211-2820 CHECKNUMBER DATE VENDORNO. NAME TOTA�AMOUNT 6500006962 17J012014 9999999999 MARVROlIPAS E9525 Schedule E, Exhibit 5 aev-�soe ex.�oi-io� pennsylvania SCHEDULE F oePna�rnENroFaeve�vue �OINTLY-OWNEDPROPERTY INHERIiANLETA%RHURN RESI�ENT�ECEDENT ESTATE Of: FILE NUMBER: Marv R Roupas 21 14 1012 H an asaM was made jaintly ovmeC vAthin one year of the decedenfs tlate of death,it must be reporled an Schetlule G. SURVNING JOINT TENANT(S)NFME(S) A�DRESS RELATIONSHIP TO DECE�ENT n. Mary Ann Mace 412 Spring House Road, Camp Hill, PA 17011 Daughter B. C JOINTLYAWNED PROPERTY: LEiTER DATE DESCFIPtIONOFPROPERiV YoOF I]AiEOFOEAiH REM FORJOINT MF�E INCLO�ENNMEOFFINANqALINSili0TI0NAN�BANKACCOUMNUMBEROF51MIlAR �ATEOFDEAiH �ECE�ENi'S VAWEOF NUM6ER TENANi JOINT IDENTIhINGNUMBER. AiiACH�EE�FORJ01NiLVHELDRFALESiAi6 VNWEOFHSSEt WTERESi �ECEOEM'SIMERESi t. n. 12/3191 Citizens Bank, One Citizens Drive, Riverside, RI 02915 11,634.87 50. 5.817.44 Checking Account#6100767817 (See Schedule F, Exhibit 1) Citizens Bank, One Citizens Drive, Riverside, RI 02915 2. A. 12/3/91 SavingsAccount#61401643262 0.05 50. 0.03 (See Schedule F, Ezhibit 2) 3. A. 2122/94 Real Estate: 412 Spring House Rd., Camp Hill, PA 17011 218,097.00 50. 109,048.50 Appraised value$220,300 x .99 CLR Cumbedand Co. _ $218.097.00 (See Schedule F, Exhibit 3) George Q Roupas predeceased Mary R. Roupas TOTAL(AlsoenteronLlne6,RecapAulation) S ��qg65-97 Ii rtrore space¢neetleQ use aCGi6onal shee6 0l paper oiNe same size. a� Citizens Bank ° Account Number 6100767817 Account Title MARY R ROUPAS / MARY ANN MACE Date Opened 12/3/1991 Account Type Checldng Princi al Balance as of DOD $11634.82 Interes[from Iast Posti�g to DOD $ .OS Account Balance as of DOD $11634.87 Y1'D Interest to DOD $ .53 Schedule F, Exhibit 1 �� Citizens Bank � Account Number 6140164362 Account Title MARY R ROUPAS / MARY ANN MACE Date Opened 12/3/1991 AccountType Savings Princi al Balance as of DOD $ .OS Interest from Last Posting to DOD $ .00 Accoun[Balance as of DOD $ .OS Y1'D Interest to DOD $ .65 Schedule F, Exhibit 2 PAYABLETO: BILL#:8725 � RETURN THIS PORTION WITX A PAYMENT FOR SECONO INSTALLMENT BILL#:8725 Micliael Langan,Taa Collector ROUPAS,GEORGE C 8 MARY R 230 5.SpoNng Hill Roatl �-OFFICE HOURS Mechanicsburg,PA 1]050 BILL�AiE: PfOPerty Lowtion _:, l/112014 �0-204848-012 . .., ?urya.o�nu>,emne� �n�o�..T�.a m�rs.-s�m wa aovm 4125PRINGHOUSEROAD ' ^°°F^�6a^aF^.'oni,-semma:wpm PINEBROOK ��°°� �T'��am�R. s �ocnopm `�'c ,sa -� ��.,rys.xois ROUPAS,GEORGE C 8 MARV R �OT 39 BLK M PL 10 PB 19 PG 8 " �a��or sow+�*em i��eao'i�oaremce�. 412 SPRING HOUSE RD r pnone:]n-]3]�ne22 CAMPHILL.PAI7�N-0652 }n ,'i:� �� Please Indlrate: 0 SECON�INSTALLMENT 0 SEGOND IHSTALLMENT WITH PENALtt NO DISCOUNT If paitl on or before 9130/14 $634.35 H If paid aRer 9/30/14 $69]le PAYABLE TO: BILL#:a725 RETURN THIS PORTION WITH A PAYMENT FOR FINAL INSTALLMENT BILL#: 8725 ROUPAS,GEDRGE C 8 MARV R MichaelLangan,TazColleqor � _ ��OFFICEHOURS 230 S.SpoNng Hill Roatl Property LowHon MechanicsDurg,PA 7]O50 ' BILL DATE: 10-241848-012 '� �-�.�'�'�"^101�^Noveniha` '!It/2014 ,"uon.ru�.arwrs.-eamwa�.wa� 412SPRINGHOUSEROAD -r�eorn.arzsemFe.ioni,-samioa-.w� PWEBROOK "�� -�m�T�:.nm�n.-s�maaopm ':�.Gua o.mmre.iz,so�a-�ziwzry s,mis ROUPAS,GEORGE C 8 MARV R LOT 39 BLK M PL t0 PB 19 PG 8.,,,, ��ew^'^^^a^�n^��^�^��. 412 SPRING HOUSE RD ' ¢ '-Iplione:]n-139rezz CAMP HILL,PA 170114452 Please InGicafe: -d,,,,,,,,,.... �u:�.,ya.,..:, 0 FINALINSTALLMENT O FINALINSTALLMEMWRHPENFLtt NO DISCOUNT Ifpaitlonorbe(oret0l31/ib $634.34 H IfpaiCafler10131/14 g6g7,�y PAVABLE TO: BILL x.8]25 Michael Langaq Taz Coileclor Hours:See Reverse MUNIQPALT':Mampden Twp. BILL NO:B]YS 2305.SpoNngHillRoatl Phone:]t]-03]A822 PROPERLV:6125PRINGHOUSEROFO BILL�AiE:1I120t4 Me[hani�'sbmg,PA 1]050 MqP CODE:10.20.18dB-012 ROl1PAS,GEORGE C d MARV R NOTICH OF PROPERTY TAX RELIEF � Your<nciosed tax bill ivcludcs a taz reAucrion for yow M1ommnd andlor faxmsteed nSS[ssMEM f39.800 5180,500 512t1.3� property. As an eligible homesteed enNor f steed pmpmy owna, you M1ave _�..�, ' �f'' '+y5,{� y - civM �vc rclid WougM1 a homesrzd anElor faRnscwd exclus�ov which is R;�;x„�. -y:.� -t- pmvided imdcr We Pcovsylvavia Tupaytt Relief Act, a law pessed by Ne q�r�pi,�� B.B98 8.898 R � PemrylvaniaGrnerelAvsemblydesignedtoreduceYowO�nY��. FULLscNooLa�EiAX 835C.14 81.606.09 81.9G023 THIS TAX IS UUE AND PAYABLE.YOU ARE HEf�� F�❑�E D - - __ ��-a� ° ��j� ��- TO MAKE PAYMENT THEREOf�Q�(.� '{' F U I - ,:;«iU:-� .f.':' ROlIPAS,GEORGE C 8 MARY R 4t2 SPRING HOUSE R� CAMPHILL,PA1]011-1452 JUL i 4 2(114 TAXAMOLINTDUE S1.B6a.9B 51, 3.oa 52,a33.36 if Paitl On or 8efore 114 1]/i5n4 � Hampden Twp. NO CHECKS ACCEPTED AFTER DECEMBER 15, 2014 Tax Collecwr E634.35 863C_35 5634.31 OnmMoreB/3L16 OnorEelare9/'fW1a Onor�eloreID(JVtd Schedule F, Exhibit 3 , 53� i - S �S '94 ;c:; : _ Fil E [� SPECIAL WARRANTY DEED TfIIS INDENTURE, MADE Tf� � day of m the year of our L.ord One Thousand Nine Hundred and Ninety-fou�4). BETWEEN GEORGE C. ROUPAS and MARY R. ROUPAS, husband and wife, and MARY ANN MACE, G�mberland County, Pennsytvania, GRANTORS, pazties of the First Part 3 ;`: � GEORGE C. ROUPAS and MARY R. ROUPAS, husband and wife, with respect to their undivided one-half iuterest, and Mary Ann Mace, single woman, as joint tenants with the right of survivorship as their individual one- half interesis and not as tenants in common, GRANTEES, parhies of the Second Part WITNESSETH, that the said parties of the first parf, for and in consideration of the sum of ONE ($1.00) DOLI.AR, in hand paid, lawful money of the United States of America, well aad truly paid by the said party of the second part to the said parties of the first part, at and before the sealing and delivery of these presents, the receipt whereof is hereby acknowledged, have granted, bazgained,sold, aliened, enfeoffed,released, conveyed, and confirmed and by tLese preunts do grant, bazgain, sell, alien, enfeoff, release, convey, and confirm unto the said pariy of the second part, Lis he'us and assigns, ALL THAT CERTAIN piece or pazcel of land, situate in the Towuship of Hampden,County of Cumberland and Commonwealth ef Pe�rfi�+wia,aoze gzrticaiaziy ocunued znti dexr,'oed as follows, to wit BEGINNING at a point on the easterly side of Spring House Road which point is in a northerly direction by its vazious courses from the southeastem comer of Orr's Bridge Road and Spring House Road at the dividing line between Lots Nos. 39 and 40, Blcek M; of the herein- after mentioned Plan; thence by the easterly side of Spring House Road, North 16 degrees 25 minutes West, 100 feet to a point at the dividing line beriveen Lots Nos. 38 and 39, Block "M" of the Plan; thence by said dividing line, North 73 degrees 35 minutes East 105 feet :�o-: fOt ra�F 902 I to a point at the dividing line between I.ou Nos. 11 and 39, Blcek"M" _ _. of the Plan; thence by the said dividing line and ihe line of Lot No. 10, Block"M", South 16 degrees 25 minutes East 100 feet to a point at ihe dividing line between Lou Nos. 30 and 40, Blcek M, of tLe Plan; thence by said dividing line, South 73 degrees 35 minutes West, 105 fet to a point on the easterly side of Spring House Road, the place of BEGINNING. BEING all of Lot 39, Block "M", Plan 10, Pine Brook, which Plan is recorded in the C�mbetland County Recorder's Office in Plan Book 19.�Page.AS� .. HAVING THEREON ERECTED a dwelling known and numbered as 412 Spring House Road, Camp Hill, pennsylvania. UNDER AND SUBJECT, nevertheless, to conditions, resriictions, easements and righis-of-way of record. BEING the same premises which ROBERT S.TRAIN and SANDRA J. TRAIN, husband and wife, by Deed dated April 9, 1991 and recorded in Record Book J-35, Page 24 granted and conveyed unto � � GEORGE C. ROUPAS and MARY R. ROUPAS, husband and wife, and MARY ANN MACE, GRAN1'OS herein. TH75 LS A TRANSFER FRC1�1 HUSH�.ND AND WINE AND IB�U(3i1'ER 'I1� HUSHAND ATID WIF'E AND IY1[JQ1TII2 AND IS EY.FNIPT F'fd�M RFAL ESTATE TRANSFII2 TP.X. IN R'ITNESS WHEREOF, the said parties of the first part have herwnto set their hands and seals the day and year first above written. SIGNED, SEALED and DELIVERED in the esence of: G/� C� --��i-cr i 1 R'itness GEORGE C. ROUPAS � �c� ��n,e� � .�r�s✓lSEAI,1 Wifiess MA Y ROUPAS�— �s,�+'.c � /vuv� a/h,[, ` SEAL Witness MARY MACE 9QOr i� P�GE ,4�3 COMMONWEALTH OF PENNSYI.VANIA . : SS: COUNTY OF DAUPHIN ; On Uils, the ��day of 'U 1994, before me, a Notary Public, the undersigned of5cer, persouall appeazed GEORGE C. ROUPAS and MARY R ROUPAS, his wife, known ro me (or satisfacton7y � prwen) to be the persoas whose names aze subscnbed to the within . instrument, and aclmowledged that they executed the same for the purpose �� therein contained. � IN WITNESS WHEREOF, I ereuptp my hand and official sea�l. �,,,,,,, f �il I �� - , t . r,�;�� My commission expires:�� . � ��": LivAFrtl<e�Cur,Nn_rvPWfc ;� �. Hartw�^.C=_�^hinC2'_�ry _p�' . NfyCa'nr.ti�'�6�r=cE.y.t4.1986 � ?�� N.:��: w c. y.,a-kal.:�no;P:?anes "-'6� •JS�r��' �� y,��,�. i: COMMONR'EALTH OF PENNSYLVANIA , : SS: COUNTY OF DAUPHIN , On this, the 1�� day of 1' lX�`l 1994, before me, a Notary Public, the undersigned officer, personally a eared MARY ANN MACE known to me (or satisfactorily prwen)to be the persons whose names are subscnbed to the within instrument, and acknowledged that they executed the same for the puipose therein contained.- IN WITNESS WHEREOF, ere t et i y hand and of5cial seal. r ',�gRB _"" � rra��s=a� My commission expires:_�.p f�� ¢:�. L53A F�e h er I .. n rubfiC � O ria^u �s C � rrY 2' " .a r My G�mri�ia 'Y 4,19E5 =b ,� . 4� IM . ?enr�sY� '� .sa:,�on af- ��?res - y � o�q�L� • ��J�.. M.� ��Si,' - .� /7'Jg�, �� 30CS ";oj, P„GE �0� CERTIFICATE OF RESIDENCE I hereby certify that [l�e Precise Residence of the , � Y � Z ,t„� Grantee, in tl�e within Deed, is �a�.,,, c , A �me� for antee. COMMONWEALTH OF PENNSYLVANIA } � COUNTY OF`��'� }SS: - } � RECORDED In the Office for Recording of Deeds, Mortgages, etc. in and for the Counly of Cumberland, in Record Book�, Page�. C,�� i61 SS My Hand and Seal of OfSce, this�� day of 1994. �i��.r'�` �� :� "� ' �c, '� � L��-C.UI �1 v. _ `�:�,y iC:: ♦ i . +7k�A-,''� �` r .x' ' . . �,�e`��n�.;`b w . �„ , 4�a _ 90GK ,'�Oj. PAGE 9�5 REV-0510 EX�(OB-09) pennsylvania SCHEDULE G oeraArme�v�oFRevexue INTER•VIVOSTRANSFERSAND irvHEa�rancEraer�ruer� MISC. NON-PROBATE PROPERTY REsmErvroECEOEHr ESTATE OF FILE NUMBER Mary R. Roupas 21 14 1012 This uhetlule mus[be mmple[etl an0 filcH if Ne answer to any of Questions 1 Nmugh 4 on page Nree o(Ihe REV4500 is yes. �ESCRIPTION OF PROPERTV ITEM wcwoErnErvuaEoir�*Au+sv[Ae[,rHeiAA[unorvsmProo[ceo[ertnrvo DATEOFDEATH %OF�EC�'S E%CWSION TAXABLE NUMBER rnEonhoFinar�srEa.nnncNacowoi*x[oeEoroaqcuEs*pi[. VALUEOFASSET IMEREST VAUIE t. Citizen Investment Services, P.O. Box 42025, Providence, RI 35,407.32 100.00 35,407.32 IRA- Beneficiary: MaryAnnMace, Daughter (See Schedule G, Exhibit 1) Security Benefit, One Security Benefit PI., Topeka, KS 66636 Annuity- Beneficiary�. Mary Ann Mace. Daughter 2. (SeeScheduleG, Exhibit2) 48,761.63100.00 48,761.63 TOTAL (AlsoenteronLine7 Recapitulation) E 84168.95 If mo2 space is nCEtl¢�,use atltliiional sAee�s of paper o�Ne same siee. Jan. 2 2015 10:28AM , No. 511D P. 2 �; , . _ ;..� , �. �_ ��' �a. ' ' � � F Y F . � tE ^'�. +F"L: � Y _. � . . � 4; � � � t{ j � �� '••�' a�'e r}� ��.c . S � . . a.- ° - t 'L#y.: �zt�: _ - � Pr T r ' . --. ' -I. ...�_'� - . �IDy�L�1011�6V � � �i... . , . . �/OTf1ldL�II . - � �. _'. AIX'.OIIDI�I.7C-lXi�091 - '<C '' . oF •�Q�09l10 4 . . ' 3 °-'v.-.' .: ?.� i:C,�.... . . _ . . .� RE:AccountNlmbcL7C067091 � � � Deer T�sa�Ws �We ee wri�g wtth rog�d m yomreceotrryoest far the above reErenceA accomt Please e�md om condolmcesmlhefimilyofMazyARn�. � We ue pnvi�g a nmmery ofMes.Roupes'scwu��the�ble belaw az ofth dase ofbusmcss on �ao�rzoia. Nomberaf¢Wm SharcRitt ValaeofAccoun[ PR2S17C � � 678.075 E11.44 57757.18 PII'AX 1063941 . � 51095 T11650.14 QCCOQ(mmeYmadet) �. 16.000.00 51.00 TI6,000.00 ToOil . __ � . � Si5.40732 �i:.- _-.:sa�-tt�i�: Shcu7d�R��e�oonf,`��'p4ase[allod'¢`(.1t�to`��frSevice7ksk�azl-800-7A5-2049. Weert avmlahCC '� 8':3Qa�a'm 5:00 pm We wll be heppyto essis[you -. .3i*i,.., .n 'a9r; ...- a�-r�- . _ .. _ Simc¢ety. �� _ _�_. ..:— . ,- .. _ . . ,v,c; siSLrr..:� �. . ... �. ,�. - . MaivmStack� . � � CCOBme&ie�Aca�tSpecietist . . � �_ � . � . . . �or-. . , .. . 013-072804-COSC � - Q�: 'Tg+:f t�c�ha 1 y.tGy:: . ��..: taer` - .. �: I . � . '$9h�C"VIIk'S.ei�FnJ.,t,Y ��.n.�� . _ _ . � � � Schedule G, Exhibit 1 v�,._.�� . .x . ��- SEGURITYBENEFITm //`` One Secutlty 9enefi�Placa�Topeka,KS 665360001 800988.2461-SecutltyBeoefit.wm December 19, 2014 THERESA L SHADE W IX W IX,W ENGER 8 W EIDNER 4705 DUKE ST HARRISBURG PA 1 71 0 93 04 7 Re: Contract Number: 7003106481, MARY R. ROUPAS (Deceased) Dear Ms. Shade Wix: We are in receipt of your request for information regarding the referenced annuiry contract. We are pleased to have this opportunity to serve you. This is a Non-Qual�ed Annuity conVact established on October 5, 2006. The account value on the date of dea[h, October 9, 2014, was$ 48,761.63. The Cost Basis (after-[ax) amoun[was $24,615.92. If we may assist you with other questions, please contact our National Service Center at(800) 888-2461. Our Customer Cen[er associates are available from 7:00 am -6:00 pm Central Standard Time. Sincerely, Client Service Specialist IV Service Operations Security Benefit A3051 A GOGGENHEIM PARTNERS COMPANY ,� Schedule G, Exhibit 2 aEv-isn ex.(aaia> pennsylvania SCHEDULE H oeauerrnEr�roraeveuue FUNERALEXPENSESAND wHewrancerAxaEruRrv ADMINISTRATIVECOSTS aEsioEr�roECEOErvr ESTATE OF FILE NUMBER Mary R Rouvas 21 14 1072 oeceeam.aee�m�si n�reaon�a o�xnea�ie�. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERALEXPENSES'. 1. Preneed Associates, 1551 Kenneth Road, York, PA 17408 7,804.00 (See Schedule H, Exhibit 1) B. ADMINISTRATIVECOSTS: WAIVED 1. PersonalRepresentativeCommissions: Name(s)otversanaiRepresenqUve(s) StreetAedress Ciry Sta�e ZIP VeaQs)Gommission PaiE�. p, nnomeyFees�. Theresa L Shade Wix, Esq., Wix, Wenger&Weidner 1,300.00 3, FamilyExemptiortpiEeceGenYsatldressisnotNesameasdaimanfs.adachexDlanation) Claimanl StreetAtlEress Ciry State ZIP ReWibnshiD oi Qaiman�to DeceOent 4. Proba�eFeas�. Cumberland County Register of Wills 315.50 5. AccouManiFees'. 6. TaxRelumPrepaarFees'. Z The Sentinel, P.O. Box 742548, Cincinnati, OH 45D4 2��8 Est2[e Advertising (See Schedule H, Exhibit 2) 8. Cumberland Counry Law Journal, 32 S. Bedford St., Cadisle, PA 17013 75.00 Estate Advertising (See Schedule H, Exhibit 3) 12.00 g. Wix, Wenger&Weidner, 4705 Duke Street, Harrisburg, PA 17109 Photocopying TOTAL(AlsoenteronLinefl.RecapiWlation) S g7�828 It more space is neetle0,use aJtlitional shee6 oi paper of ihe same size. >,Hamcom..«u�mm, ano�erv�meeroiP�mna:ansi 917 jF<. ,/7(,' $ECURIiI'AGflEEMENT FOR 9pRIAL MEXCHANDISE ANOIOP CflEMFTION MEpCHTNDISE AND/OP ESTABLISHMENT OF qN IqqEVOCABLE TFUST FOR OTHEq E%FENSE FUN�ING TryISAGREEMEM In maEe IM a CaY b OGf..�l� 44 ��=0y and�Mren you,Oe Buyet � K�.r.� ann Nh [f m `il-+ <r r n� Hc.,u 2d- "n -'II )1 :a i j w�„ dw.m mcm. enOm.MeSelbr,PrmxOhsmtialea.Nc..1S51KenneNRoa].Yoh.PRP1pB. pMe>P�]fi]-0551nu� fv]1>-061-9919 —� q6PFENEM OF ontliliov�e na 1➢m w �ntl prvvWe BUNI anUlv�Lmmetlon M :vtt+u�a�in.�`�mdec:e�eeio.,�em.in�o o,o.a.�.00�me a:,m a<N n,ee��an�erv.om.,e �� ,ei. n�.�e�e.oa�nary��m«�ee eem.a�a o�m.,...,..n�,ee�.ce enni>novisiorvs,e.orHe�A xPEH°se Furiow�� I Y Fm tFe purpox ot��ie Secunry qq�eemm�aM uNesi 5 d Nem¢IItleE Celox,Le.uma,kttp¢ake jexelry,elu.�ave Eeen Eellvert0 o�� m,m m�em n��w�:n.n m .x�: � o:.aea .�m n .e�e:m., � . ...e., ee .�eio o�.mee�.nnn.,:�m�,o i.a,v.,o e v.;:ae:�a�_�w�,n.n e.rr.,,�a�nm.� m, ort�aa me�em. ��m��:�m , i:ssrom..�e�.�same�.wmm..�...n�me.a��:�mn.m.,n.nn�e�inbeeo�q„po„m.m,m � of au[�Le¢i9nee. Cempnemm[a�nio� �_..asusee�orme,nwcna�dize5eieonon �MRqTIONOFAMOUNTiINqNCED: �. �u:C -�J �1 LiOiAL GSN SPIF PRILE 5 �u��'I : wmemeemwan edniomninmtiw� m(m � -..;I, J '�i� 3.00WNGAYMEM $ - �'�" ❑aa�ooycrem�fzm 50tliScin""° �`"^°• • ' '° ¢'vaiaevinrasnorovmecxt aMo� euau�se�ernoxs . ._sm is '� Ua.W ;,amourvrwrvnrvreonminusz� 5 :'�..'- . 1�;; :..�.,��..bwmo.a�.....S�i we�. J•r'��f 1;�\ FEOEftALTRUTHJNLENOINGDI5CLO5URE5 �eesnm l xo�� -�`"" '�^""� pNNUAL FINANCE � PERCENTAGE CHARGE � w.�vum.�eam..m.��cm�o..m—, 'R�`AmE en m .mmzi .. ..lre si�w,ce $e AMOIINT TOTALOF TOTALSALE � FINANCED PAYMENTS -'PRICE uumvmp rk�ma�an m�m�� imsi�i �. w �me. mn=r�ka: eaaxnnoxsE�Ec oxsMre.e�•�io'sVnemmNs� / ra"�:nea / ��m�m�" . .... m � n••• mk.�naJa.n ;�� u^N� / ^o., . wm r . ��._ . , NEEPSAKESEIFCTIONS. .SUMOUIE 6m� nw weme � �_. Ma� am.m�,—�. w. n'°��mPm�"�ae�re'amm�iAr�.��w��^�.npmm: ' W� � a3 IvnTBa�k ' nmei�_�p m�mw_�p s_ua '� u.m.�_�am.me..�o_zm 6pYEF'S21LHii0CHNCEL I n arc YOqiNEBVYER MPYCANCELtXRmPN5PRI0NPiPM'TIME � iRIOR i0 MI�NI4Ni OF iXE iXIRO BIISMESS pPV ARER TNE {�xr[vz�rtu_w[� OAiEOFiX15NPN5PRION6YHIN0il%INGUSTHESELLER FiXER IN WRIiING.BY iEIFGRPM�F 9V LEIIER GOftMARKE� �. '° '^' AqT tATER iNAN SOCX TXIRO 9LISME55 ORV OR ORALLY �. a�^�" PROVIOED MPt SpCN ORAI fANCELLAiION 6 WNFIRME� IN '�. WARIttGWRXINSVCNiHREE9LSME55DFYi. '� F"�"` - '. �,1 � I IWEI 1NE 90YER6 XEREBY PGREF iNNT M COM OERP90N I OTXEREXGENSEFIIN�XG SUEWhlS E7"�GC OF iNELO0D5 AHO/OR SERVCES LO BE OELVERE� THPi �. BVTERI51 INOIVOIIFLtV AND JOINRY IS IFREI HEREBY yeem�ran�ne.w.awmis.wenepre�np pBIILRIEo i0 C ALL GMOIINiS O PND SHOVL� . ...�. PV WIN4 BUVERI9 OEFPIILT IN iXE ALREEMENi WIiX SFLLER, M ' GSXS�LEPPICEOFREMSSEIFRE�............57K��'��r' ACCOROPNCEWRHiHFiERM50FiHECOMRPR9EiWEEN � eVYERl9PNDSELLER,9WERI5IMEREBYALREE51i0�FYPLI ' LESSAnyPppllu�leCnEM1___..._.,_......., f �OLLECTOXCOPS,REASONABLEA40RNEVGEESFN�COURi "- � COSiS OCON COMMENCEMFNi OR NITI N OF P Ceamb. COLLERION EFFORtt OR lE WL GFDCEEOINGSp* TOTALCRSHSRLEPRICE ...__. _..S I�[�� °�""�'nmanee�[ampownpvymxne�een'r+ee - BUM�mQuesisl�e�MelollorvMgp¢rsonls)s�oulEMnoAfiMOINic —�mm� cmMGqfm�umiw� wMonNn SecunNn9reemem. X•� w,••• OYew On.u� m ❑ou�o.« Dom..ne��0�„• -. Schedule H, Exhibit 1 The Sentinel �X WENGER 8 WEIDNER AD NUMBER PAGE NO. www. mba��_�k.�om 508N.SECONDSTREET 435671 'lof7 _ � �. G P.O.BOX845 � BILL.DATE SALESPERSON ��v HARRISBURG,PA 17708-0845 -- - ��,�� p�,c�M 717-652-8455 11/30/14 heckb �START DATE STOP DATE ii/i5H4 '11/29/74 PDNUMBER PDOESCRIPTION C1P55 LMES _— _ 435671 �� NOTICE LETTERS OF ADMINISTRATION O �10 PUBLIC NOTICES 3b ` 2 cols Publieation Insertions Rate NNAmount GrossAmount 3THESENrINEL-LEG41 3 LGL 9201]8 TOTAL A�CHARGE $201.]8 3 PROOF OF PUBLICATION 01 PRF $1.00 3MOBILESITE MOB2 $3.00 PurchaseQder Es1.M.R.Roupas PAV THIS AMOUNT $211.78 $254.14` •AFTER 12/25/14 Lee Enlerprises no longer accepls credit card payments sent via e-mail. ��- —� � Emails containing credi�card numbers will be blocked. Please use lhe coupon below to send credil card payment to our lockbox. THE SENTINEL Vou may also sentl lhe coupon to a secure fax a1319-291-4014. �/a LEE NEWSPAPERS Thank you for advertising with The Sentinel! Deadline for PO BOX 540 _ . . in-column legal ads is 4:00 p.m.hvo business days prior to W�+TERLOO IA 50704-0540 date of insertioa For questions, call Q17) 240-7130. Schedule H, Exhibit 2 �q��qND Y� V W . . � � CUMBERLANDLAWJOURNAL 32SOUTH BEDFORD STREET CARLISLE, PA 17013 Tele: (777)248-31fi8 Fu:(71'n 249-2883 December 5, 2014 Cumberland Law Journal is published every Friday by the Cumberland County Bar Association and is designated by the Court of Common Pleas as the o�cial legal publication for Cumberland County and the legal newspaper for publication of legal notices. TO: Theresa L. Shade Wix, Esquire RE: Mary Rutledge Roupas Estate Legal advertisements must be received by Friday Noon. All legal advertising must be paid in advance. Make all checks payable to: Cumberland Law Journal. Advertisement inserted on following dates: November 21, November 28, and December 5, 2014 Advertising Cost $ 75.00 Proof of Publication $ 0.00 Second Proof Request $ 0.00 Payment received $ 75.00 ------------- Total Amount Due $ 0.00 Becky H. Morgenthal, Executive Director Schedule H, Exhibit 3 REV.1512 E%�(H-02) pennsylvania SCHEDULE I oEaAa.iaeH.oraeveuue DEBTS OF DECEDENT, wheairANCErnxREruRN MORTGAGE LIABILITIES & LIENS aEsioEHroECEOENr ESTATE OF FILE NUMBER Mary R Roupas 21 14 1012 Reportdebtn incurtetl bythe decedenl priorto Ueath Nat remained unpaid af the tlate of death,including unreimbursed medical e:penses. ITEM VA W E AT DATE NUMBER DESCRIPTION OF�EATH 7. AAA Financial Services, P.O. Box 982235 45.98 Decedent prescriptions (See Schedule I, Ezhibit 1) ATBT Final Bill 2. (See Schedule I, Ezhibit 2) 0.35 707AL(Also en�er an Line 10,RecapiNlatlon) 5 46.33 If more space is neetled,insetl atlditional sheets o(the same size. 0 � � ��'. � momm� m � o �v .. o �x vo ~ � U a P ¢ = � 'o Z �� g a.-. _^ a F X °' m = = � � • < � SOi X � c : U O 0o z a a� o `� : � o a M i ¢�-r'; � avxic�i ci �" .a ti _ 'JC . ��°o 3 ¢� m`� Nm¢ ¢ ¢ �¢vmPim~� LL � -Q� : � _ �.^.m wai�iMi� m � � �� c oN � �v �u..a�a.. a a o � � o`wan ••o cmiononon . .. x- a _ .. � � � . �yp `_ . o¢ � �owiow� k � nmm — F-F- w^ NUz^¢^z.. m x¢¢¢c� z � _ Z a£Z - �v�i¢v`�i¢h¢ £ � W j �c � � (n..�� ^ .. �. m � _ « � . � � � WorldPoints �M� �� f w -��" �1 �� I � MARYPOUPAS /� �� Mcount Number'.3]4639016213]a9 � 1 V� ��/� I�` . I , % Septemher 21�Ocmber 21,2014 �V�V U . �Acwq�rt Inrormetian: � . . www.aaanetacrese.mm MeilGllin[inauiriesm: New6alanceTotal . . . ..:....... ...._...... ...,......._...545.96 PreviousBalance... ..._.._..........89].50 AAAFinancial5ervlces Curren[PaymentDue ,......._.... ._....._.. ...__._.525.00 Paymen6antlONerGretlits................-9].50 P.O.8ox 982235 � Pu¢hases and AtllusUnents_............:...45.98 ElYaso.17(999982:35 TotalMinimumPaYmenlDue....._........................... . . ._.:...f25.00 FeesCM1er6etl._......._....._................_......._....O.OD MeilPeYmenbm: PaYmeiitDueDate .......:. .........._.. . .........11/18/14 InterestCha�6etl..... . . �......._.__.0.00 AAA17nancialServices . ... .: . ._... _._ . ... Y.Q Box 15019 Late P�yment Wem�n6 R we tlo not recerve your Total M nimum Paymen[by�� New 9aiance Total ..... 545.98 WilrstingloM1 DE]9886 5019 �e tlale lisred atiore,you mey have tu pay a la@ fee of up�o$36.00 antl� � 41momerServlw: � yWrAPRsmaybeincrease0uptoNePenalqAPRo(29.99%. TotalCretli[Gne....._..................A20.100.00 LH88.6853683 iMa�Minimum Peyment Weming:lfyou make onty.Ne Totel Minimum Total CreditAvailable_._.........._..520.054.�2 � Payment each pe�iotl,you will pay more in interesl antl i[will take you longer. Cas�Cretli[Llne..._................_.....E6,030.00 (L6003463I48TIY) Wpayofiyou�balance. Porexample: � PorvonofCre0ltAvailable . .. � � (orGas� _..,.,. ....46�W000 StatementClosingDate ....l0/22/14 Days in B Iling Gycle _..32 � Only�he Total � 2 momhs � � �� S47 48 Mlnimum Payment � If you would like informaUon about cretlit counseling services,call 18fifi30P5238. � � � Schedule I, Exhibit 1 . .,__ u......e � � Fehrarice Accvun! Your AT&T Statement f��4� b'� I( Au st 5 - November 4, 2014 � �� g" �� u.. .k,p�. IS�U�, 'li� 8t8ct cs-F�{� c�c�-�� Oz. ABWNWFM 1 •09030506066o16N B Custome�ID: 717 763-7420 0506068 �u��ui��u,n,��ui��u��u�i�i�n,��ui��ui�u�i� Pagelof2 GEORGECROUPAS 412 SPRING HOUSE RD Customer Service: 7 800 22T-0300 CnMP HILL PA n011-7452 TeXt Phone(TTY): � 1 800 855-2880 IntemetAtltlress: �� www.att.com/customerservice �[(; Erztra! Extra! Pm�ious balarice . �� Need to a o q y .. ._....._......................................................_......41.9] P Y Y ur 6ill uickl 7 Dial Pa eM receivetl Au 19- Thank 1.8002882747 and use ATBT's ym g you..........................................A1 9� automated system to make your life ATBTOneRate�Ilca115.............................................02...............027 easierl . Surcher9es aiW oNer fees._.............._._.._.................P 2...............O.W GovemmentfeesanE�a¢es..................__...................V2...............0.02 0 � Beneftnews TOWI amount tlue SO.J6� �� Sign up for AT&T Online Billing and you Wre tlue Novcneer fe,2074 vronY get another paper billl To sign up just visit w.wv.att.com/customerservice. This statement indutles charges from the last three months. � Never Mail Another Chxk to Pay Your ATBT Bill. For the ultimate convenience, enroll in ATBT Automatic Bill Payment(ABP)and have your Poture payments automatically deducletl from your checking account. To enroll, check the box and sign on the line on the 6ack of the remittance coupon, and return with your payment. Or sign up for online billing to review antl pay your bill each month by logging onto your AT&T Online Billing account atwv✓a.att.com/remitdoc �= Extra! Extra! � Neetl to pay your bill quickly9 By using ATBT's Free automated system, you can make your bill paying easied Just dial 1.8002862747 and pay your bill[odayl Dial 1 800.CALL.ATT for Collect calls 1.BOO.CALLATT for Collect calis is one Flat rate, 24 hours a day, every tlay. �ial down the center 1.BOO.GA-L-L-A-T-T(1.800225.5288). � Schedule I, Exhibit 2 . �....«....e..��., ti,.,.�.�.�,.:�.; , RW-0513 E%��01-00� pennsylvania SCHEDULE J oevavin+eurov AevEr�ue gENEFICIARIES INHERITANCE iM RENRN RESI�ENi�ECEDENi ESTATE OF: FILE NUMBER: Ma R. Rou as 21 14 1012 RELATIONSHIPTODECEDENT AMOUNTORSHARE NUMBER NAME AND A�DRESS OF PERSON(S)RECEIVING PROPERTV Do Not ListTrustee�s) OF ESTATE � TAXABLE�ISTRIBUTIONS pndu�eauvqhtspausaldisNbutionsandtranslersunJer Sec.91 i6(a111.1�.] 1. MaryAnnMace Lineal 1o4� 412 Spring House Road, Camp Hill, PA 17011 ENTER DOLLAR AMOUNTS FOR DISTRIBl1TI0N5 SHOWN ABOVE ON LINE515 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. ❑. NON-TAXABLE DISTRIBUTIONS: A,SPOUSAL DISTRIBUTIONS UNOER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN�. 1. 8,CHARITABLE HND GOVERNMENTAL OISTRIBUTIONS'. 1. TOTAL OF PART II-ENTER TOTAL NON-TA%ABLE DISTRIBUTIONS ON LWE 730F REV-1500 COVER SHEET. S If more space is neetled,use additional sheets of paper of ihe same sire. OF MARY RUTLEDGE ROUPAS I, MARY RUTLEDGE ROUPAS,of York Counry, Pennsylvania,being of sound vund, memory and understanding, do hereby make, publish and declare the following to be my Last Will and Testament, hereby revoking any and all Wills and Codicils heremfore made by me. � 1. I declare that I am a widow. I have one child now living whose name is Mary Ann Mace, and all refecences herein to "My Child" or "My Daughter" are references to her. 2. It is my intention by this Wil] to dispose of all of the property which I may own at my demise. 3. I direct and authorize that all of my just debts and burial eayenses be paid as soon as coovenient after my death, said obligations to be paid out of my estate by my Exewtrix hereinafter named. 4. All estate, inheritauce, succession or other taxes, imposed or payable by reasou of my death, and interest and penalties thereon, with respect to all property comprisine my gross estate for death tax purposes, whether or not such property comprising my gross estate for death tax purposes passes under this Will, shall be paid out of and be bome by my residuary esta[e. 5. Al] the rest, residue and remainder of the property which I may o�vn at the time of my death, real and pe�sonal, aud wheresoever situate, I hereby give, devise and bequeath [o my daughtec Mary Ann Mace. In the event that my daughter, Mary Ann Mace, should predeceue me or fail to survive me by thirty (30) days, I hereby give, devise and bequeath the rest, residue and remainder of my estate to my nieces and nephews, Eleaoor Demetriades, Chris Roupas, Diane Newberger and Gus H. Roupas, to be di�ided equally, share and share alike. 6. If any bene5ciary under this Will in any manner, directly or indirectly, contests or attacks this Will or any of its provisions, any shaze or interest in my esiate given to that contesting bene6ciary under this Will is rewked and shall be disposed of in the same manner provided Lerein, as if that contesting bene5ciary had predeceased me without issue. Z If any provision of this Will or of any Codicil hereto is held m be inoperative, invalid or illegal, it is my intention that all the remaining provisions thereof shall convnue to be fully operative and effective so far as is possible a¢d ceasonable. 8. I heceby nominate, constitute and appoint my daughter, Mary Ann Mace. of Cumberland Counry, Pennsylvauia, as the Executrix of this, my Last Wil] and Testament, and direct t6at no bond or other sureTy is required of her in this or any ot6er jurisdiction for her performance of this office. 9. In the event that my daughter, Mary Ann Mace, is unable or unwilling to act as Executrix during the administiation of my estate, I then appoint my nephew, Gus H. Roupas, of York County, Pennrylvania, in her stead and direct that no bond or other sureTy be required of him in this or any other jurisdiction for ktis performance of this office. 10. In the eveut that any bene5ciary under this, my Last Wil] and Testament, is a minor at the [ime of my death, 1 then appoint the Guardiau of said minor child u Trustee of said minor beneficiarv's share of my estate, unless otheiwise provided in this Last Will and Testament. I heieby furthec direct that my said Executrix and any Tmstee appointed, shall have ' full power, at their discretion, to do aoy aud all things necessaly for the complete administration of my estate, including the power to sell, at public or private sale witho�t Order of Court, any rea] or personal property belonging to my estate, and to compound, compromise or othenvise ro settle or adjust any aud all claims, charges, debts and demands whatsoevec agaiust or in favor of my estate as fully as I could do if I were living. 2 IN WITNESS WHEREOF, I have hereunto set my hand and sea] this �/ �dav of February, 1997, to this, my Last Will and Testament, consisting of three (3) pages plus a witness and I�otary pages. � //'[/�A/- K// 0A'PO, YL.�i � MARY R E GE R PA � 3 SIGNED, SEALED, PUBLISHED AND DECLARED by MARY RUTLEDGE ROUPAS, the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, who, in her presence and in the presence of each other, at her request, 6ave subscribed our names as wi[nesses hereto. of 32 South Beaver Street York, PA 7401 of 32 South Beaver Street York, PA 7401 COMMONWEALTH OF PENNSYLVANIA : SS CO[JiVTY OF YORK . We, MARY RUTLEDGE ROUPAS, Irene �'. Sartalis and �aRoTrF� LlJAD[7/{ the Testatrix and witnesses respecrively,whose names are si¢ned to tbe attached instrument. being first duly af5rmed, do hereby declare to the undersigned authoriTy that the Testatrix signed and executed the instrument as her Last Will and Testament, and that she sigued willingly, and that she executed it as her free and voluntary act for the purposes therein expiessed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness, and that to the best of our knowledge, the Testatrix was at that time eighteen (18) years of age or oldei, of sound mind, and �nder no control or undue influence. �7�, _ �/Y-Ldti�..C�� . �SAR R E GE R PAS ESS WI E 4 COMMONWF.ALTH OF PENNSYLVANIA : : SS COUNTY OF YORK On ttvs -�?�+ day of Febmary, 1997, before me, the undersigned, personally appeared MARY RUTI.EDGE ROUPAS,Dorothy Livadi[is and Irene N. SartaGs,who are known to me or satisfactori]y proven to be the persons whose names are subscribed to the within Last WID and Testament, and acknowledged tha[ they executed the same for the purposes Werein contained. ��n,.� � � �l 1 11�{- NO PUB C r�men�sea� ryy�cy L Yost.Notary PubtK York YoM Co�nry {,�y�rtni,sbn Expires May 29.20W pp�yyry�qA4otl�lOn W NNmlec 5