The URL can be used to link to this page

Home My WebLink About01-0064 /b-';;O";:' - 9 G REV-1500 EX + (6-00) - ~, OFFICIAL USE ONLY COMMONWEALTH OF PENNSYLVANIA REV-1500 DEPARTMENT OF REVENUE DEPT. 280601 INHERITANCE TAX RETURN FILE NUMBER HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 21 2001 0064 COUNTY CODE YEAR NUMBER DECEDENTS NAME (LAST. FIRST. AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Orris, Carolyn W. 184-24-5294 DECE- DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE DENT 01/07/01 01/09/1932 WITH THE REGISTER OF WILl.S (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 3. Remainder Return CHECK ~' Original Return ~' Supplemental Return B (date of death prior to 12-13-82) APPRO- 4. Limited Estate 4a. Future Interest Compromise 5. Federal Estate Tax Return Required (dale of death after 12-12-82) PRIATE 6. Decedent Died Testate 7. Decedent Maintained a Living Trust 01 8. Total Number of Safe Deposit Boxes (Attach copy of Wifl) tttach a copy of Trust) BLOCKS 9. Litigation Proceeds Received 10. pousal Poverty Credit (date of death between 0 11. Election to lax under Sec. 9113(A) 12-31-91 and H-95) (Attach SchD) ni"~MQ!l't'~~i4\Iilp;AUi~!I~~i!:!QW!~AiiTAXll!!@i!M^TI!ijjij$~l!iilj!lj@ijptQi NAME COMPLETE MAILING ADDRESS eOR- Mark E. Halbnmer , re 1013 Murrma Road, Suite 100 RE- FIRM NAME (If Applicable) IBroyne , PA 17043 SPON DENT Gates & Associates, P.C. TELEPHONE NUMBER 717-731-9600 52,271.92 OFFICIAL USE ONLY 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 6,008.72 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) None 4. Mortgages & Notes Receivable (Schedule D) (4) None 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 95,030.74 6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested (6) 3,063.07 RECA- PITULA- 7. Inter-Vivos Transfers & Miscellaneous TION Non-Probate Property (Schedule G or L) (7) 95,924.66 8. Tolal Gross Assets (total Lines 1-7) (8) 252,299.11 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 37,433.28 10. Debts of Decedent, Mortgage Liabilities, & liens (Schedule I) (10) 641.24 11. Tolal Deductions (total Lines 9 & 10) (11) 38,074.52 12. Net Value of Estate (Line 8 minus Line 11) (12) 214,224.59 13. Charitable and GovemmentalBequestslSec 9113 Trusts for which an election to tax (13) None has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 214,224.59 SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X.O (15) 16. Amount of Une 141axable allineal rate 214,224.59 X.O 45 (16) 9,640.11 TAX 0.00 - 0.00 COMPU- 17. Amount of Line 141axable al sibling rate x.12 (17) TATION 18. Amount of Line 14 taxable at collateral rate 0.00 X .15 (18) 0.00 19. Tax Due (19) 9,640.11 20. ~ 1~!lmlll!@ij~~uti~W!i~m'I~A89\ii!IiIfA_f#1 "'))))""""''''''''''''''''''''''''.'''''')''',!i'"Uil!'i$Q!\!iimOIiN$Wliill\~p;qQa!!mIQ!!$',Qlil:!!iI\i!l!ii'~''ANQ'!\l!PHa;;KMii:rM~''''''.'''' o PA15001 NTF 29755 Copyright 2000 GreatlandlNelco LP - Forms Software Only Estate of : Carolyn W. Orris SUl\fIIARY OF ALlJJCATICNS 'IO BENEFICIARIES Taxable at lineal rate Randy R. Orris In Trust for Jeffrey S. Orris, 191,177.22 23,047.37 214,224.59 21-2001-0064 PA REV-1500 EX (6-00) Page 2 Decedent's ComDlete Address: STREET ADDRESS 8 South Second Street CITY ] STATE I ZIP Wonnl PA 17043 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 13,800.00 726.32 Total Credits (A + B + C) (2) 3. Interest'Penalty n applicable D. Interest E. Penalty TotallnterestlPenalty (D + E) (3) 4. If Une 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAVMENT. Check box on Page 1 Une 20 10 raqueala refund (4) 5. If Line 1 + Line 3 is greater than Line 2. enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 9,640.11 14,526.32 0.00 4,886.21 ~t~~~k!~!~~f~~~3cc3!i!aa~~~fI8~~~'!~21!a'!!;~1;1!+A~k~~~~~~ik+~~t~2k~/ 1. Did decedent make a transfer and: 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; or. . . .. .. .. . . . . . . . . . . . .. . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . d. receive the promise for life of either payments, benefits or care? .............................. 2. If death occurred after December 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. Under penalties of ~r~ury, I declare that r have examined this return including accompanying schedules and statements, and to the best of my knowledge and belief, It is true, correct and complete. Declaration 01 preparer other than the personal representative is based on information of which re rer has an knowled e. SIGNATURE OF P SON RESP N LE F lUNG RETURN DATE - '-i- Yes No ~ I ~ ~ E9 D (0) ADDRE 1013 Mt.mma Road, Suite 100, lan:Jyne, PA 17043 [72 P.S. 8 9116(a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate is imposed on the net value of transfers to or for the use of the surviving spouse is 0% (72 P_S. 1119116 (a) (1 .1) (ii)] The statute dOflS not Alt:Amnt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to Of for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 19116(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%, except as noted in 72.P.S. Ii 9116(1.2) [72 P.S. %9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 19116(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. o PA15002 NTF 29756 Copyright 2000 GreatlandlNelco LP . Fonns Software Only Estate of : Carolyn W. Orris 21-2001-0064 The following person(s) are signing the return as representative(s) of the estate: Randy R. Orris 998 Goven1Or's Bay Drive Redwocd city, CA 94065 Estate of : Carolyn W. Orris 21-2001-0064 The follOlling persan(s) are signing the retum as representative(s) of the estate: Randy R. Orris 998 Goven1.or's Bay Drive Redwocd City, CA 94065 REV-1502 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Carolyn W. Ol:ris SCHEDULE A REAL ESTATE FILE NUMBER 21-2001-0064 All real property owned solely or as a tenant In common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seiter, neither being compelled to buy or selt, both having reasonable knowledge of the relevant facts. Real property which Is Jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH 1 Two-story, single-family dwelling located at 8 South Second Street, Bora.1gh of Wonnleysburg, County of CUmberland, Callralwealth of Pennsylvania being Tax Parcel No. 47-20-1858-075; transferred to decedent by Kenneth C. and Helen C. Hilbish, husband and wife, on March 29, 1979, by deed recorded in the Office of the Recorder of Deeds of CUmberland County at Deed Book 1-28, Page 602. Valuation per sales price. (See attached Settlement Statement.) 52,000.00 2 Reimbursement at settlement of items paid in advance by seller. (see attached Settlement Statement) 271.92 7 CPA21 NTF 10904 Copyright Forms Software Only, 1997 Nelco, Inc. TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets 01 the same size) 52,271. 92 REV-1503 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Carolyn W. Orris All property Jointly-owned with right 01 survivorship must be disclosed on Schedule F. SCHEDULE B STOCKS & BONDS FILE NUMBER 21-2001-0064 ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH 1 460 shares of Waypoint Bank (f/k/a Harris Savings Bank) CCIlIIOl1. stock; elate of death average $10.90625 per share. 2 ALL EUIDS WERE REDEEMED IN J1\NOARY 2001, '!HE M:NIH OF JE:E)EI'iII" S DEA.1H. SEE: A'I'mCHED "INVENIORY 2" REDEMPI'ICN DErAIL OF ALL EUIDS . 5,016.88 0.00 3 5 Series EE: u.S. Savings Bands; $50.00 face value 125.00 4 interest accrued to elate of death 117.52 5 2 Series EE: u.S. Savings Bands; $100.00 face value 100.00 6 interest accrued to elate of death 94.52 7 1 Series EE: u.S. Savings Band; $1,000.00 face value 500.00 8 interest accrued to elate of death 54.80 7 CPA31 NTF 10905 Copyright Forms Software Only, 1997 Nelco, Inc. TOTAL (Also enter on tine 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 6,008.72 REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Carolyn W. Orris SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONALPROPERTV FILE NUMBER 21-2001-0064 Include proceeds of litigation & dale proceeds were received by the estate. All Droo. IOlnUv-owned wtth rlaht of survivorship must be disclosed on Sch. F. ITEM VALUE AT NO. DESCRIPTION DATE OF DEATH 1 F\1ltan Bank l'Ibney Market Savings Acct. No. 9900-66803 (see attached) 10,349.86 2 interest accrued to date of death 2.98 3 F\1ltan Bank Checking Acct. No. 1068-51180 (see attached) 12,676.47 4 F\1ltan Bank certificate of Deposit No. 022-0120868 (see attached) 10,150.00 5 interest a=ued to date of death 513.71 6 F\1ltan Bank certificate of Deposit No. 022-0128003 (see attached) 15,000.00 7 interest accrued to date of death 53.76 8 waypoint Bank certificate of Deposit No. 1060286156 (see attached) 35,022.61 9 interest accrued to date of death 34.60 10 Proceeds fran auction of miscellaneous persrna1 prcperty (see attached :inventory) 2,356.75 11 1998 Chevrolet Cavalier IS sedan (see attached) 8,870.00 TOTAL (Also enter on line 5. Recapliulation) $ (If more space is needed, insert additional sheets of the same size) 95,030.74 7 CPA81 NTF 10908 Copyright Forms Software Only, '997 Nelco, Inc. REV.1509 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Carolyn W. Ol:Tis If an asset was made joint within one year of the decedenfs dale of death, R must be reported on Schedule G. SCHEDULE F JOINTL V-OWNED PROPERTY FILE NUMBER 21-2001-0064 SURVIVING JOINT TENANT(S) NAME A Rarrly R. Ol:Tis ADDRESS 998 Govemor's Bay Drive Red\o.u:xi City, CA 94065 RELATIONSHIP TO DECEDENT Ben JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOfI MADE Include name of financial institution and bank DATE OF DEATH DECO'S VALUE OF JOINT account number or similar identifying number. NO. TENANT JOINT Attach deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1 A varies 100 Series BE u.s. Savings 2,500.00 50.00% 1,250.00 Bands ; $50.00 face value. All bonds were redeared in January 2001, the m::nth of decedent's death. See attached "Inventory 1" redarpticn detail of all bonds. 2 A varies interest accrued to date of 3,626.14 50.00% 1,813.07 death TOTAL (Also enter on line 6, Recapitulation) $ 3,063.07 7 CPA91 NTF 10909 (If more space is needed. insert additional sheets of the same size) Copyright Forms Software Only, 1997 NefCo, Inc. REV-1510 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Carolyn W. OJ:ris SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 21-2001-0064 ThiS schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY %OF EXCLUSION ITEM INCLUDE NAME OF THE TRANSFEREE, THEIR DATE OF DEATH DECO'S (IF TAXABLE VALUE RELATIONSHIP TO DECO & DATE OF TRANSFER. NO. ATTACH COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST APPLICABLE) 1 State Ehployees' Retirarent System; 92,946.21 100.00% 2,946.21 0.00 Pension account, death benefit payable to decedent's san, Randy R. OJ:ris. (See attached PSERS letter dated March 22, 2001.) Date of death account benefit was $92,946.21. Under Title 71 Pa.C.S.A. Section 5953 (a), the entire death benefit of the decedent's SERB account is exerrpt fran taxation. 2 Pennsylvania State El:rployees Credit 9,457.33 Union; Checking Account (see attached) 3 interest accrued to date of death 4.82 4 Pennsylvania State El:rployees Credit 12,802.03 Union; Individual Retirarent Account (see attached) 5 interest accrued to date of death 14.27 6 Pennsylvania State El:rployees Credit 5,728.35 Union; Certificate of Deposit (see attached) 7 interest accrued to date of death 5.73 8 Pennsylvania State Ehployees Credit 11,293.93 Union; Certificate of Deposit (see attached) 9 interest accrued to date of death 9.52 10 Pennsylvania State Ehployees Credit 20,000.00 Union; Certificate of Deposit (see attached) 'Ibtal fran continuation oaae (s) 36,608.68 TOTAL (Also enter on line 7. Recapitulation) $ 95,924.66 7 CPA01 NTF 10910 (If more space is needed, insert additional sheets of the same size) Copyright Fonns Software Only, 1997 Nelco, Inc. Estate of : Carolyn W. OrTis salElXJLE G Page 2 21-2001-0064 Inter-vivos Transfers and Nan-I?rcbate Prcperty Item No. Descripticn 11 interest accrued to date of death 12 Pennsylvania State Enployees Credit Unicn; Certificate of Deposit (see attached) 13 interest accrued to date of death 14 Pennsylvania State Enployees Credit Unicn; Certificate of Deposit (see attached) 15 interest accrued to date of death 16 fulton Bank; Individual Retirarent Acco.mt; Acct. No. 022-400353 (see attached) 17 interest accrued to date of death 18 fultcn Bank; Individual Retirarent Acco.mt; Acct. No. 022-2000345 (see attached) 19 interest accrued to date of death 20 fultcn Bank; Individual Retirarent Acco.mt; Acct. No. 350-1902107 (see attached) 21 interest accroed to date of death 22 fultcn Bank; Individual Retirarent Acco.mt; Acct. No. 390-1463236 (see attached) 23 interest accrued to date of death % Of rate of Death Deed I s Value of Asset Interest Exclusion Taxable Value 16.87 12,803.37 10.90 3,495.30 3.49 7,210.30 7.15 7,621.99 9.24 2,686.30 3.00 2,737.88 2.89 'IDrAL. (Carry forward to main schedule) . . . . . . 36,608.68 REV-1511EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Carolyn W. Orris SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-2001-0064 Debts of decedent must be ITEM NO. A. FUNERAL EXPENSES: on Schedule I. DESCRIPTION AMOUNT See Schedule attached 'Ibtal fran continuation page (s) 8,012.49 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Randy R. Orris Social Security Number(s)/EIN No. of Personal Representatlve(s) Street Address 998 Governor's Bay Drive City Redwood City Slate 7,500.00 CA Zip 94065 Year(s) Commission Paid: 2001 2. 3. Attorney Fees NaIre: Gates & Associates, P. C. 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 7,500.00 0.00 4. Probate Fees 279.00 5. Accountant's Fees 0.00 6. Tax Return Preparer's Fees 0.00 See Schedule attached 'Ibtal fran continuation page (s) 14,141. 79 TOTAL (Also enter on line 9. Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 37,433.28 7 CPA11 NTF 10911 Copyright Forms Software Only, 1997 Nelco, Inc. Estate of : Carolyn W. Orris SCEEOOLE H, PARI' A -- F\meral Expenses Item No. Description 1 M.1sselrran Funeral Hare - funeral services (see attached) 2 Blue Ridge JVk:m:>rial Gardens - Wrial expense (see attached) 3 Preacher - rrarorial service (see attached) 4 Hertz - car rental (see attached) 5 Perkins Restaurant & Bakery - post-funeral dinner (see attached) TOrAL. (Carry fo:rward to main schedule) . . . . . . Page 2 21-2001-0064 Arramt 6,932.50 875.00 100.00 88.71 16.28 8,012.49 Estate of : Carolyn W. Orris SCliEOOLE H, PART B -- 1\dministrative Costs Item No. Description 7 Ct.nnberland legal JOl.Inlal - publication of estate notice (see attached) 8 Patriot-News Co. - publication of estate notice (see attached) 9 United States Postal Service - postage (see attached) 10 United States Postal Service - certified mail (see attached) 11 NotaJ:y Public - stock certificate (see attached) 12 Notary Public - Deed (see attached) 13 lVCI Vbrldcan - long distance phone charges in=ed during administration of estate (see attached) 14 JVCI Vbrldcan - long distance phone charges in=ed during administration (see attached) 15 Sclmltz International - transport of vehicle (see attached) 16 MailBoxes, Etc. - shipping of personal items (see attached) 17 Bob's Tire & Auto Service - packing boxes (see attached) 18 Mark Heckmm - residential real estate appraisal (see attached) 19 Bricker's Auction - ccnmission on auction proceeds (see attached) 20 Closing costs for sale of real estate (see attached Settlarent Statarent) 21 American Water - water (see attached) 'IOrnL. (Carry forward to rrain schedule) Page 2 21-2001-0064 Anount 75.00 200.22 28.25 5.26 10.00 10.00 44.61 12.50 898.00 260.00 54.88 275.00 786.75 6,449.69 10.86 9, 121. 02 Estate of : Carolyn w. Orris SCHElXlLE H, PARI' B -- Administrative Costs Item No. Description 22 West Shore Oil Co. - fuel for heating of decedent's residence for period fran date of death to sale of real estate (see attached) 23 Verizan - phone service (see attached) 24 AT&T - pha1e service (see attached) 25 PP&L - utility (see attached) 26 United Airlines - travel fran California to Pennsylvania; attended funeral/exeuctor appointment (arrcunt sha.oin is one-half of $2,955.00 fees.) (see attached) 27 Harrisburg Maxriott - hotel aCU-iluulatians for 01/06/2001 - 01/19/2001 (see attached) 28 Hertz - rental car for period 01/06/2001 - 01/19/2001 (see attached) 29 Texa= - gas for rental car (see attached) 30 8un=o - gas for rental car (see attached) 31 Exxon Express - gas for rental car (see attached) 32 G:ingeIDread Man Riverside - weals during period 01/06/2001 - 01/19/2001 (see attached) 'IOTI\.L. (Carry forward to main schedule) . . . . . . Page 3 21-2001-0064 1\m::Junt 393.39 18.59 7.32 91. 84 1,477.50 2,492.88 384.00 17.66 4.36 14.85 118.38 5,020.77 REV-1S12 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Carolyn W. Orris Include unreimbursed medical expenses. ITEM NO. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS FILE NUMBER 21-2001-0064 DESCRIPTION AMOUNT 6.00 14.38 45.93 185.92 104.00 29.01 16.77 6.18 52.80 78.15 15.90 86.20 1 AT&T - phone service (see attached) 2 Verizon - phone service (see attached) 3 PP&L - electric service (see attached) 4 West Shore Oil Co. - fuel for heating of decedent's residence (see attached) 5 Borough of Wo:rrnleysburg - Sewage/Refuse (see attached) 6 Ccm:::a.st - cable (see attached) 7 Amarican Water - water (see attached) 8 HealthSa.lth Rehabilitation of Mechanicsburg - rredical bill (see attached) 9 HealthSa.lth Rehabilitation of Mechanicsburg - final rredical bill (see attached) 10 West Shore Ehergency Medical Service - stretcher transport (see attached) 11 Holy Spirit Hospital - hospital bill (see attached) 12 Decedent's 2000 Federal/Pennsylvania incare tax liability (see attached) 7 CPA12 NTF 10912 TOTAL (Also enter on line 10, Recap~ulation) $ (If more space is needed, insert additional sheets of the same size) 641. 24 Copyright Forms Software Only. 1997 Nelco, Inc. REV-1513 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER Carolvn W. Orris 21 2001-0064 RELATIONSHIP TO DECEDENT AMOUNT OR No. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) SHARE OF ESTATE I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1 Randy R. Orris San 191,177.22 998 Goven1Or's Bay Drive Redwood City, CA 94065 2 In Trust for Jeffrey S. Orris, Grandson 23,189.49 c/o Randy R. Orris, Trustee 998 Goven1Or's Bay Drive Redwood City, CA 94065 ENTER DOLLAR AMTS. FOR DISTRIBS. SHOWN ABOVE ON LINES 15 THROUGH 17 AS APPROPRIATE ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE None B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS None TOTAL OF PART 11-- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00 Copyright Forms Software Only, 1997 Nelc:o, Inc. (If more space is needed, insert additional sheets of the same size) 7 CPA13 NTF 10913 ;i:,,~ ,"" d'\'" This is [0 cerriEv that the information here given is correedv copied from an original certificate of death dul)' filed with me JS Local Regisrrar.' The original cerr' "e wiU'-be torwarded t~ the State Vital Rec Office for permanent fIling, WARNING: It is illegal to duplicate this copy by photostat or photograph. No. ~""";~ 11'lltl~\~" OF pl:;;~.-=- t".~"" ""'-- ~\~... _.-_-,__.' UA'\ is;. "" " <:;;:" !~~. ' '\~l ~ '- -', I_~ ~~: ."," ,Ibf ~*" ',~.'r";:*f \* ':"~;--" ~i ~~ .. - c...'t:--"\;;/ --i-9h~ ",-""" ~...~ : RIEHl ~\ J>,l "",,,11 /) (.:.:,,"&-'V ~v) . L Loal .~r'--" ~.YYZJ~ ,-!~~~.,~}:c..,~ ~~-.. ~ ,/ RegisTrar l' Fee for this certificate. $2.00 P 7174204 \'-':0,' () Q 00'1\ ~~ln Darc 14JR'v,2J87 COMMONWEALTH OF PENNSYLVANIA. QEN.RTMENT OF HEALTH. 'IITAL RECORDS CERTIFICATE OF DEATH U R'YEAR - .." SE)< emale !TATl"F'UNUI,II!IER SOCIAl. SECUf'llTY NUMeEI\ .. AGt(~....a;nnoavl ..184 -24 -5294 OAJEOFClEATH,McnUl.Day. 'NIl an.7,2001 NAME OF DECEOENT(F~.., M~, lUj OECEOENT'S USUAL OCC\JM1lON . (G,.._OI....:lf'koarw""'~ of '.._, etl ccmpurei"~~ r state government ~ "', 11b. OECEOENT'S UAlUHO AODAES8 (SIr"', Cof'tIbon. sc-. ZopCoo.l B S. Second Street Wormleysburg,PA17043 OECEOEHT"S ACTUAL AESIOENCE ,...- ~-- Pennsylvania WAflfTAl swus. M&mIQ "--........,. w......... wid~""'" ... l1c.O""'.......lIvellln SURYIVINGSPO\JSE tW_gr.,...-._, ORE OF 8IRTH 1/dorlIrI. aav. '"""I 8lATHP1.ACf:rC"V-a sw.~ktr.."CWNrOjI. elfenstein,PA , F,t,C1LrlY w..ME1Wf'IClI_, 0-_""''''-' Pt.AC&:OFOEAJH(C/>IClI."..,_ ..~""ad...-_l - ",,**,,0 E~O "",0 ~- - (SlloOCd'>ll~ 68 Y.... an.9,1932 .. crrv. eoAO. TWPOFOEAl'H .. COUNTY OF OEIU"H Cumberland Co. Lower Allen Twp. ealthSouth Renova center M. ~ KIND OF 8US1NESS/lNOUSTRY If.. Slew .. - .... CumberlaD3 Co. -....1 1U,~-=-~OfWorrnleysburg MOntER'S NAMEtf....~. M.....Sur.-t ,J>label V. Kramer Il"IF~AHT'SMAlw.GA~(Slc<MI.~,~.Lpl?<M1 ,~8 Governor s Bay Dr. ,Reowood City, CA94065 JI'l.ACEOFDlSPOSlTIOH."'-ol~Cr~ LOCATION.CitylTown.Sllt...~c- -r:7'e'ilidge Mem. Gardens Lower Paxton ~!) i'A 1c, 214. NAMEAHOAODAESS.OIFFH:1I.Jt'( 0'1 . selman Funeral Home, 324 Il.Imel. m.. ,raro,.-e,PA . LICENse NUU8EJ'l ORE SlGMED .~""'l ,...,. ,,,. car I Wary R. Orris ... CASE "",,, ... .- ......- :_andclllllll , , , nuE1OtOFlASA CONSEOlJENCE 00: OlJE TO (OR AS A CONSEOUENCE 0Fl: MAHNEA Of OIlATH ........ 4"' -- 0 -"- 0 0 CouId""'bot~ 0 OAf!: OFWJUFlY IW""..,n....1 n....OFIN./VIlY INJURY I$WOAK1 DESCRIBE HOW IHJlJRY OCCUFllli:D. \W 0 ~O ... ... PUlCE OF..uRY .Al'-'-. """. _,I~ orb --- ,.,. 'MEDICAL EJ(.lI,UNEAlCORONER ant"-l:I....ot.K_tlon.ncl!DrI.w..tlg.llon, In "'l'op'n,on,d"lhocc:unfillltf'teUtne,det., .ndplaC., .nddu..Uleceu..,.j'nd "'...n".'''''_h'''' 3U. REGISTFWl'S SlGNAl'URE AND NU~8ER I~/~/""I 2M. 2... CUlTIFIER le"*,,, 0I'fY (lI'W\ .CEftTIF'l'INCIII'HYSIClAN(Ptl",-,C..lIIyot>gcauUlo/dHl/\_~~_MlP'~...._cornplllletl"_131 ,....beMlIf....,~,....U1occ:""""""Ia_CltUM(.I.n<l...._..__.,'_.... 'PtIONOUNdHGAHO CQlTIFYJNQ I'liY'ICI"N~PIlvsc.an I)OI!'ll)l'on""ncJV}<IUlI\_~1l)-=-'" OI-ilhl TotIW_'"'....,~,_tl'IOCC:...'".I__.OIU..n<lplH.,.ndCl...Ia....CMIMf.'_.........,.....IIIl.< ,. P: Z,;;o / LAST WILL AND TESTAMENT OF CAROL YN W. ORRIS . , WHEREAS, on dated March the 16th 28th 2000 . -. Register of Wills of CUMBERLAND County, Pennsylvani Certificate of Grant of Letters No. 2001-00064 PA No. 21-01-0064 ESTATE OF ORRIS CAROLYN W (Ll\::i'!' , r J.X::i'!' , 1!'lJ.UUl..t;) a/k/a Late of ORRIS CAROLYN MARIE WORMLEYSBURG BOROUGH ~UMH~KLA~U CUUft~y, Deceased Social Security No. 184-24-5294 day of January 2001 an instrumen was admitted to probate as the last will of ORRIS CAROLYN W (l..A::i'J.', rJ.x::i'J.', J.VlJ.UUl..t;) a/k/a ORRIS CAROLYN MARIE late of WORMLEYSBURG BOROUGH 7th day of January 2001 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, MARY C. LEWIS , Register of Wills in and for the County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to RANDY R ORRIS , CUMBERLAND County, who died on the who has duly qualified as Executor(rix) and has agreed to administer the estate according to law, all of which fully appears of record in my Office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYLVANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my Office the 16th day of January 2001. '-nIl}"" \ e. ~.;o <)" .pS.~t-t~ xeg1.s~er or 1. s \ **NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE) LAST WILL AND TESTAMENT OF CAROLYN W. ORRIS I, CAROLYN W. ORRIS, of the Borough of Wormleysburg, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I: I direct that my Executor hereinafter named shall pay all my just debts and funeral expenses as soon as conveniently may be done after my decease. ITEM II: I devise and bequeath all the rest, residue and remain- der of my estate, of every nature and wherever situate, as follows: A. 80% thereof to my son, RANDY R. ORRIS. B. 20% thereof to the Trustee hereinafter named IN TRUST, to hold, manage, invest and reinvest the share so received, and the accumulation of income thereon, and to use and apply so much of the income or principal as the Trustee deems advisable in his sole and absolute discretion for the support and education of my grandson, JEFFREY S. ORRIS. When my grandson, JEFFREY S. ORRIS, reaches the age of twenty-five (25) years, the Trustee shall distribute the balance and the then remaining principal and any accumulated income thereon to my grandson, JEFFREY S. ORRIS. Should my grandson, JEFFREY S. ORRIS, Page 1 of 4 die before receiving the balance of the trust principal, the trust " } shall terminate and be distributed to my son, RANDY R. ORRIS. ITEM III: The interests of the beneficiaries hereunder shall ne: " l be subject to anticipation or to voluntary or involuntary alienation, ITEM IV: I appoint my son, RANDY R. ORRIS, Trustee of any trust created under this my Last Will and Testament. ITEM V: I appoint my son, RANDY R. ORRIS, Executor of this my last will. ITEM VI: No fiduciary acting hereunder shall be required to pos: bond or enter security for the faithful performance of his duties in any jurisdiction. IN WITNESS WHEREOF, I, CAROLYN W. ORRIS, have hereunto set my > -, hand and seal this d-~) day of ~{c\"" , 2000. l. CCL~) w. Lit. ~ , C OLYN W. ORRIS SIGNED, SEALED, PUBLISHED and DECLARED by CAROLYN W. ORRIS, the Testatrix above named, as and for her Last Will and Testament. and in J 1 .1 i I Page 2 of 4 ~-;'..'/;~.-<.. '.;.,' '-<:':,'l-,.....".~~W~...:oa..h~'-"~' --,,,,~>, )-"~. '" 'i'~7":!o.~..~,~ .' ~ ~...~- ",'4~'''--'~.,o;"tI'' . -""~-'..';''''''~H "',. --~,....,~;,'lf~' l:::::;W~~'i;1~!t'~~i~i/~~i\-'.>:;: :.. ,,:;. ,': :::~'}~~.'.,,:, -' ,'- .,~::;{:.~:.~". . ' - ::;;']~~~:;:~,:.:," ,:.')j:?}: ------,-------_.- ~---- the presence of us, who at her request, in her presence and in the each other, have subscribed our names as witnesses. r~ .~ /\,,, o.lc"'We~./) C- Address ~.<:: )J::i "~ ~. -~ Yi>r$ 'if. <ofo A'(j_ w t s 't"'u)~ ddress , COMMONWEALTH OF PENNSYLVANIA: SS: COUNTY OF CUMBERLAND I, CAROLYN W. ORRIS, the Testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified accord:~~ , to law do hereby acknowledge that I signed and executed this instru- ment as my last will; that I signed it willingly and that I signed ic >, as my free and voluntary act for the purposes therein contained. i. tf\~~~'G:R' W, [:irru, OLYN W. ORRIS , , } Sworn to or affirmed to and acknowledged before me by CAROLYN W. ORRIS, the Testatrix, this '""C '-J day of ih4-< / (,.... , 2000. ~z2(~k ;/ ~A' Notary Public ;~ .~t ~:. -\ ,.,;; '1 ,;:. ; NOTARIAL SEAL PATRlCHIA L YOTER, Nolary ~Ic New Cumberland BolO. Cmtberlanll Co. My CommIs3lon ~Ires Nov. 18. 2m! ~~ Page 3 of 4 ..~ ".'" i~:~t't:..:,' >....~;:~~~~~ ~:c;'::"': 'f~~'i' '~;1<i;:-::';~; '.',' :::'~:; ::." '. ';":' ," '. ,", ",': '~~r~'.o:<, , "'::':~,~~' COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND ~ We, ~)'" ~. ~~ and ~yt<>Q. Lur k e", ,. " '.:: ., ;? the witnesses whose names are signed to the attached or foregoing ;1 instrument, being duly qualified according to law, depose and say tha: we were present and saw Testatrix sign and execute the instrument as her last will; that Testatrix signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; i that each of us in the hearing and sight of the Testatrix signed the " will as witnesses; that to the best of our knowledge, the Testatrix was at that time eighteen or more years of age, of sound mind and under no constraint or undue influ'n~CVJ- tness .y ., i -~ )(~~. ';;},n~-~ Wit~ss U , l Sworn to or affirmed to and acknowledged before me by ~).""~~f< and N:J. 'I e 'I< . 041. ( ~ dct;k ~ ~'L Notary Public j/Jrh~)' , 2000. .-,..:1 witnesses, this Lv day of Page 4 of 4 NOTARIAL SEAL PATIIICHIA L Y01El, Nolary FWJc New cumberland Bora. ClJnbefland Co. My Commls3lon Explr8s Nov. 16. 200Z ~~~~i}~~f..~(:~, ":':~ ~,[ \' ~.~:- ~~": .:: , : <,~ :-" ~ ~ ~/~)",:; ~ ~~, '. \:.') "~~'J:. ~:'~ >. ' . ". ':.,'->~~~~~i' > '.. .~.) '.~;:~~~:::~ PA REV-1500 SCHEDULE A REAL ESTATE .,. L S. DEPARnIE';T OF HOl:SING AND URB,wDEVELOPMENT SETTLE~IE';T STATEMENT .. I . I"~ -.:FIlA ,. 14. .--VA ,. r'.f"dlN...bor: I IIAR12S-132 ; I. MIrq:...I.... C_s... . COSY. INS. n'PE OF LOAN f'MH.... T.A. of Harrisburg, LLP 4775 LinglesIown Road Harrisburg, PCMsylvania J 71 J2 717.671-6715 (ax; 717-671-6718 1. X CO:-'Y L'/I;/.o.,;s 7 Loan Numbft C YOTE. Thtilo"" lSfu;'-;uhed-;o ii"" FOUQ s;a;;,;~nl oiiini;'/T~aiii:i. "A;"Ow,u po/liio (lI/lI b.v iir"e swi,.me;,t agl'm are shoK'n. /tems murJ,.~'d . 'p.o ,",I "~~I! PEIt!..!'!:..~lde fh'!. C'~o.t:~L_~ Dn s/lo..:" !!.~~~a.!.P!Irpos,.s and tlrr not ~,!~/uti,.~ in !h_~ tOlols. p. Borr~~~r: _,~~~_H_~~andTanY!M-~.:'_~"lan. . E. Seller. Carol}'n W. Orris! Estate - Eastern -Mortgage Services.' F. Lender: 3895 Adler Place ~el~!e~~~ f!~~lvani~!!OI7 __. 8 S. 2nd SUecl Wonnleysburg, Cumberland COuaty. Pennsylvania 17043 G. PropcC'ty: Wormleysburg Borough lot PART 63, Genellll Plan of'Wannleysburg. Book Orphans Ct Docket 8, Page 13 Cumberland County, Pennsvlvania H. Settlement Agem;- "r:A~ dfH!irisbu,:g: UP -- - ---.----. . Plac~ of Settlement: __ _4]i~_ L~SI~~,?~~l1 Road.H~'~.,J'ennsY~ia _11U~_ Da~p'hi~ C2~n()' L S~ftlement Date: . ~an:h 1~.l.qO.L__ _ _ ___ mmt and fo lhe best..... knowledge and belief. il is a 'me and acCUl"3le statemenl of all recerrllS and ttanSacllon. I filnherceJlitdW 1 have m:el\led a copy ofHUD.1 Sell1cment Stat<:mc7I\. 1111:<-/(, W fo!t Carolyn W ~niS, Estate ; Ie. Summary or Seller's Transaction ~. .h_.._---+__~_.~~ lOO. Gron Amount Due From Borrower: 400. Gras. Amount Due To Seller: 101. C';nmcrSalesPri~c- "---~-==--=--=-~.5~i.~I._.~~~s!f~.f!.i~..::~'. 102. _ ~isori!f Pi.~' ____ ___ . 1 402.. Pcrson_al.~~ .. ._ 103. S~~!~~~91arseslo8orro~cr1!!neI400) ___ ~!_~3._____. m.._'~___ _ ..~. _~..._ Adjustlll!~~ for ~'ems Paid h S.!!!!!~ Advan~ _. _ _._ Adju~~~.~!~J~~~.~a~d ~y.~eller in Ad\-.ance: 106. ~~t)~ To"-nTa~~.;_ ___. _....__._. _._~._.L.~:.~iD'/1:~~T~~.u.. _. _.. 10: COUnty. Parish Taxes ~~ar 14. 2001 thru Dee: 31, 13116D' 407 County I Parish Taxes Mat 14,2001 thN [)e{; 31. 200t ~.__ ~.._. _ _.___.._,.__.___~_":'...l!l!..~_u_________. ~'._ . lOS Assessmenls\far 14. 200lthru Jun 30. 2001 _ UClS2; 408. Assessments Mar 14. 200llhru Jun 30. '2001 109 S-ew~ .\lar 14,1001 thru !o.tar.J1,-i6Ol------.. -"nCi; 40<}, SCwCfM'ar 14,"2001 lhru Mar 31.2001 110 Tr.uh \far 14. 200llhru ~la"'jl:iOOf~' .,,----- - -- r.~410. Trash Mar -14,2001 thru Mar 31. 2001 120. Gr~ss Am~untDut-.from- 8orr~~~i~ _~.~~-=~~.~ :. 4iO.-(;miAmou~t Due to s;i,;]:: - -.- . - . __ .~.____..~__. L... 200. Am~El!!~ ~id ~r.!lr in Behalf ~(I!o~l!!"..!r-=--___ ~OO. .~~u~!i~!~ in Am<<!!l!! Q~e to St:ller: 201. Deposi~_Eaf!'es1M~!1~,___.- _ _.___SDUG1..lQ.I.:_.~~_~i~t~!~~~c:li~!ls)._ 202, Principill Amoun1_ ~J~ew he...!!"_ _ __. _ _ _ ~ 4~.48IJ!I.l5D~,_ Senlem~~ c;:barses1o Seller (Line 1400) 203. E,isllnILo&n(tJ _ .._ ...__ _, __ l'O!..~!!!!nILoart(~'_.~._ 2,," _._ .__ _. __~+{;;lM~'!~f(~[!.I!![M~s"~!!' 20$. _ _ __ u_ _____ _u __ ' SO,: l!tC!.trof~Mont.ll~to 2tl6. ._.. ____..__'___.__... ---r106. Purch~Mon~lofoI'!8!!B!!~._ _ Adjustments {or Items U'!.Paid by Seller:. Adjustments for Items Unpaid by Seller: 210. CftY-T~~~J~;-=:_.' ----.:~~~~:.==_=_=___=r5i"O~~.f!!i!Townfaxcs.-..~~~_... .-~_..... 211. Count)..' Pari~U~~. _,___~_ _~__ _~!!. Cou_,!!y!_ParishT~~_ 212. ."'-ssessmCl"lts : 512. Assessments 213. ~lo~fnsSost~~~~li~-~~'-- .. _ _ I,5JI"':.}J3. CJ~n.~bySell~_u ___. . I Total Reductions in Amount Due 220, Totat Paid bv I for Borrower: 51,40lIl 520. SeJl _. ..___.__u~___ _ .~~=_=-:--=:___..~==t=-=~_t:~~~=..~~~-.~.._ 300. Cash al Settlement from I to Borrower: 11600. Cuh at Settlement to I from Seller: .. 30 I. G-ross ~~~~uiil~dUE ~I?m~~rrowcr {line 120~ 54.951.~ _ ~1. Gross Amount due to SeUer tITn~.420i- ~02. L(.'S~ Am~unt P~id ~. for ~QrT~~ .1!!n~. ~~Qt . 51.40Yi; ~ ~~ ~~.E~~ ~~~'!!'II ~~c ~cllCr (line 520) I S3,555.6i 603. Cash To Seller: _._____.____..u.. . ~L__..~ _ _~__.. ._~__ J. Summa..,.' of Borrower's Transactfon 303. Cssh From Borrower: &rro\\ct": Seller: B,~rT\)v.cr: '1{ r/1N!1/)7/LA- Seller: Th~ I1l"D-1 S~rrlemerH SUlemerll which I have prepared is a true and accu~nl Oflhis IransaClion. l have caused or ....III...~,,<.. .1-_ ,,__ ,....L.L__. S2.UOO.UO 130.60 120.5! DAO 7.4fl 52,271.92 4,I}411 69 I.SOU.OO 6,449.69 51.271.92 6,449.69 545,822.23 SerdC'1Tler1t D3fe:~far,h 14.2001 L Senlem;nt-d.Iiift--' 7(iO~ Total-Sales/- Broker's Commission: Band on Price 552,000.00 @ 7.00% . $3,640.00 Dh'islon of Commission IS follo~"'S 701, 1:8~5:00to RE"~AX Realt\' Associalcs _,of i~~9t~!~~~~~ ~~!~sjonllS'----"--- -:'03. Commission Paid at Scnlement 7~. p'~_~~~& S~j~ef~;o ~~~~~~_A~"!!I ~ -_' 10.5: ~rocessiC\'!I: Ftc 10 R.E.'~~; E:~l~f~cssioM" ____..___ ,06. 9,ecd ~~}<:! Galcs .& Associatcs (POC SOJJO) 800. Items Pa\'8bJ~ in Connection ,.,ith LoaD: SOl. lo'an ~S;;no;-f;clo-!asi~M~~g!~jimccs_=~_--- --- ~02.l~!n_p~ 10 ~~ M_~~gageSC!:l:'i~ ___._ _ ._ _ - ,- S03. :~pp~j~l E~_~~_~~ ~I"!gagc_ ~~____... .-'----- - ,- SO.-&, Credir Rt'P.Q..'!...!O_~ Mo!:!S~.s~ SCTVic:t5 ------ 805. Lende(~ !!!.~on Fee ," __ __ _~____'__- _.... -_ - .-- . ~96. ~\1oT1ga!e Insunn~ 1p'pli~~~.fee __ _______ --- SQ",:-\ss~.!i~f~___. _ ________________ ._- S08. Applicari~!, f~_ ~.~~~.E!!g~~ Scmccs (POC S3~~:~) 809, Real ES!a1~ r.~ ~~j~f~~ ~!!~~ M~ S~~~ ~IO.p~~~~!:~_~o_~t~~!'!&!I~__ ..___.___. 311. Comminnent F<< !~ ~~ ~~g!se Sc..~__._ _ __ 312._f~t."f!!.E:q:J['essFce to Easlt1'!!}l12'!B~S~~~_ u ,__. __h___ 900. !~!.~s ~eQuired ~ Len~~>~~ ~.~'~~J~~___ _ ..______. -- 901. lnl=,~!fto.!" ~far !~.2OQ.~~~pr ~.~\lO1 @~~~. '-~ ." . 902. ~tort2Uc Insurance Premium 90J~ HU,1l'd !n~nn~~ PrCniiu~~~~~e InsuiWe(.,oC1J6.~C.=~-:==_~_ ~_ Flood Insurance Premium 100_0. ~.~~!!"~ -!!~~Q~!!~'~it~ -Lt~~~: ------ -- - ~~_ ==',' --~, - 10~!.Jl~~!~~~.!.!!?~'!~,@ ItJ~~______ _______ 1002. ~1ongas~ ln~ta!!~_ Lm~n.tM @~~2J.L~month __ ___._. _._m 1003. City Pro~'!!L."C~____.___ IOO-t Count)' Propcrt>. Taxes I ~~hs @J.!,~ pa-month ____.____ 1005_ Annual AssessmtTlU , moochs @ JJ.6J IlC!'monrh 1099. .~!S~~te ^~~'!!!!!8,A_djl!sz.!T1~.. ___ _. ______ _'_'_ _ _ .-- ~ lQ.O: T!~!e_~~!..rg~!~__,,__ II ql. Scntem~~?i. C~~ F~__n_. _. 1102. Abs1::l'3ct or Tille Search 110). iitJe'Exam{narion---'- 1104_ Title'nsuranc-eBindC:i: -- - -------------- t ~~~.p_~~ment !..repat3oO!!..._ __ u_ __ I !06. SoW): f~. to T.A...:!l(H~~urg.l.lP .._________. 1107. Anomer Foes (trl:ctudes abo'o'c item l"lumbers: 1108. Tidc'h~$l:n3l1cc to TA.ofHarrlsburc.LLP (includes above iran numbctc:II01~ll04 1109. LauttiJiC-;;\rerasc _ _~~~OO_OO_ IUskPranium -.-'.-TOo--'--- 1110. Ou-n~!. Coverage 52.000.00 Ri$Jr ~!!!.'!L. _ :'=-s40:1~__. !~lt, ~!'c!~~~u._IOO.300,8..~ .I~ T,~:~[~~LLP .------ f 1112.qo!iEg~~~~!:-ctter_~<<!..!:~__TI~~1~Cmtpanr.___~__... ----- .~-= --- .:- 1113. 2001 Cou!,~.T~~J!...~!~fu!~ .__ _._._ ____ --"-- - II !~_ ~o~~ Wamuuy .!.D~~____ _ 1200_ GO~'~!!Imrn! Rtcordfnl.n~ TnllsfuCbula: -- --~- _-__ . . --.--- -. 1 1201. Recordi~sf~: ~. _ 25.50 MI)(t8~S~__ _ .J1.5(L ~cL~.. .--6.00-: I~Q~.9tt.coun1y1a)tJswn.E!:___~__ 520.00 M~I!.-__~~____ --_._,. I 1203. Stale lax'~~pJl: ~~ _.. gLOO~.!!'s..e.. _~.oo :;fu: _.---=-~-~.~--- I 1300. A~dlri~!,,!1 ~~!!!!!!!!!!.~ Ch!-rg!!~_____. .____.,. - ---___ 1301.Su(\'~ _ i I3Q2. Pest In~~n~~PCrln-P~' _ .____ ____. -,..--.--, --t- I .- r- -I -'I - ------T. ! '-' -j. -t.- -I , .. + -- -." - I '-"r'-" I , 1400. Total S.nl.m.nt Charg.. (En'" O.II"I~n J and 110. 502, S...lon K) """"..dnn.." m:Y"'K.;"~- E7;;:"M.H"lun'~ - - - _J. Seilerinlllals' 11'9 Carolyn. W. Orris, Esl.lte fHcNumbcr: HARI2;-J32 TA K12()109 Paid from Borrower-'s Funds at Settlement I. 75.00 . 494.00 . -494.00 _I. ,. 17_00 . 350_00 . 250.00 . 3000 _ -m.1i - , i_ -'.22.66 32.11 . jjS6' 269.04 ,18.7\ .J2.00" 540.75 150.00 . -- ')5.00 . 77.00. - 520.00. J5.oo 51,683.53 Paid from Seller's Funds at ~ttI~m~nt J.640.00 250.<10 12.00 162.69 J65.00 520.00 54,949_69 PA REV-1500 SCHEDULE B .STOCKS and BONDS cPOM RRNDY ORRIS RND KRREN FOLEY PHONE NJ. 650 631 5619 MAR. 272001 10:19AM P6 Waypoint Financial Corp. / Harris Financial. Inc. Registrar and Transfer Company F\'N~uently Asked Questions About Letters of Transmittal 1. H7'<t1 i.~ a .tetter of Transmittal? ^ L..tl:er of Transmittal is a form generally used for an exchange of stock andlor a cash payment. --._2. ...Y>'l1,v-didJ.1'e<:ei,'e it? On October 17. 2000, Waypoint Financi.~J Corp. completed its stock offering, Harris Financial, MHC completed its mutual to stock conversion, and Harri., Financial, Inc. completed its acquisilion by me York Financial Corp. As a former stockholder of Harris Financial, Inc., you are now entitled to reed 0.7667 shares of Waypoint Financial Corp. for each share of Harris Financial, Inc. that you previously owne. au have been sent this form to complete and return along with your certificate(s) to effect the exchange of stock you hold. If you already hold shares in "street name," the exchange has already been made. and your next brokerage statement will show that you now hold shares of Waypoint Financial Corp. common stock. 3. Suppose I decide not to fill it out and return it with my certificates. What happens? No dividends or other distributions declared by Waypoint Financial Corp., will be paid to the holders of record after October 17, 2000. until such holders submit lheir Harris Financial. Inc. certiticates in exchange for certificates representing shares of Way point Financial Corp. Once such certificates are submitted, any unpaid dividends will be paid without interest. _.._~, If I S(!M..i" my co:li.fkPtes..I have no...p.mot I OJIIl1J!d.these.s/ilcks.Jf.something happe~the" what? We recommend you make copies De your celtiticate(s) and comple fTransmittaL We also recom- mend sending them registered mail, retum receipt requested, a insured ~ % of the market value. lease deliver the certitlcate(s) and conlp(eted Letter of Transmittal to e 0 owing address: Registrar and Transfer Company 10 Commerce Drive Cranford, NJ 07016 Attn: Exchange Department Historical Quotes 1lA;HoOlFINANCEW Page 1 of 1 ~(5J Finance Home - Yahoo! - HelD Find your next job here. UEOorCareers ~~i~tr.::~~ve _~.,__liii ;'t!i"~='l'<~"t~ i~~t~~~I~~~~,\!L More Info: ~ I Cllilrll ~ I Profile I Research I ~ I Insider Historical Quotes Nasdaq:WYPT Month Day Year Start Date: /;r<:r:...iti I05J I~!:i End Date: 1J"~!':~ 1~!3 I~!:J It Daily C Week1y C Monthly C Dividends Date Open High Low Close Volume Adj. Close* 8-Jan-0 1 10.8594 11 10.75 10.875 60,700 10.7951 5-Jan-0 1 11.0625 11.0625 10.8125 10.8125 220,700 10.733 .Wb 4(;b O ?1' I, . J / Wq37~ Download Spreadsheet Format 01 ,,r- b(1) t\ u0 rD. VI W..,.::: * adjusted for dividends andsplits.pleasesee FAO. Qllestions or Comments? Copyright @2001 Yahoo! All Rights Reserved. See our Jmpol'(twtI2isc]qimerslJ11dLegqlJrzform1llion. Historical chart data and daily updates provided by Commodity Svstems. Inc. rCS]). Data and information is provided for informational purposes only, and is not intended for trading purposes. Neither Yahoo nor any of its data or content providers (such as CSI) shall be liable for any errors or delays in the content, or for any actions taken in reliance thereon. http://chart.yahoo.com/t?a=O 1&b=05 &c=O 1 &d=O 1 &e=08&f=O 1 &g=d&s=wypt&y=O&z=hars 3/26/200 I FROM RRNDY ORRIS RND KRREN FOLEY PHONE NO. : 650 631 5619 FEB. 022001 11: 15RM P3 ,,,.d..lIlpti.on Dat..:~ Inventory 2 InventOrySll~ Number l:nventory Redemption of Sonds vaJ.\lEt Value Intarest 1\ceru.Z1.1 n...,nds Frp-~Januf.\::Y 1990 Issue Dates: \.T~nuary 1.990 and Later 'ISQUe. Oates: rn~ntory Totals 6 $391.88 $391.88 $191.88 2 ----.J5~U!! $599.96 _!t.?4.96 * B $991. 84 $991. 84 $266.84 0 $0.00 $0.00 $0.00 a $991.84 $991. 84 $266.84 CllrrFllnt IncO'mlit Sonds .~~?-~~~~~ ~ Froce~ds from S9ries EE & I Savings Bonds with issue date~ beginning January 1990 may be ~ligible for special t~x exemption when used for post-secondary education. For further ~nforma:tion, concerninq. the ben-efi ts and restrictions t!tat" appJ._y....~ . pJe61s'e contact the Internal Revenue ~p.rv{(:~. - . 1 These bonds are not eligible for payment within 6 months of their issue date. 2 These bonds have reached final maturity ~nd will earn no additional interest. They can be exchanged for SH Bonds wi~hin a year of their final maturity date. 3 These bonds have r€ached final maturity and will ~arn no additional interest. They are not eligible for exchange for Series HH Bonds since they have been held over a year past their final maturity date, '1S0t-..\t)S \ N l\)f~. ('(\ ~ O~ LI\Q.DlCtN OR\<.\ <;; OR.. R~'/fmCi~t ORRIS , ldtCftUi?vi ) 2 FROM RANDY ORRIS AND KAREN FOLEY PHONE NO. : 650 631 5619 FEB. 022001 11:16AM P4 Inventory 2 Accrual Bonds R"delllption Dat''000 XS9uta Y.i.o~d Ne.x.t. I'i.nal $eE;~~~ D8nom~ Se~iQs Pat<> V8..lue rnterlilst 1'0 Oat.. Accrual Mat=:i.ty $50 EE 3/1989 ~ $49.34 $24.34 6.00% 3/2001 3/2019 $50 F.E 3/1969 $49.34 $24.34 6.00% 3/2001 3(2019 $50 EE 5(1969'" $49.34 $24.34 6.00% 5/2001 5/2019 $50 EE 5/1989 ~ $49.34 $24.34 6.00% 5(2001 5/2019 $130 EE 7/1969 $98.68 $46.68 6.00% 7/2001 7/2019 $50 EE 1/1991-j $45.16 $20.16 6.00'0 7/2001 1/2021 . $100 EE 10/1969/ $95.84 $45.64 6.00% 4/2001 10/2019 $1,000 EE 8/1998 $554.80 $54.80 4.35% 212001 8/2028 . , '" Not eligible for payment (purchase price) 2 = Matured {el<<:hangeable fOr HH) 3" Matured (not elCChangeable) . = Possibly eligible for U.S. Savings Bond EducatiOn Benefit Program. See footnotes on Inventory Summary page. 1 PA REV-1500 SCHEDULE E CASH, BANK DEPOSITS & MISCELLANEOUS PERSONAL PROPERTY Fulton ncmk PO. BOX 4887 . LANCASTER. PA 17604 People dedicated to your success. ~ (717)291-2589 WWW.FULTONBANK.COM 1-800-FULTON-4 February 27, 2001 i"-, Traci L. Sepkovic Gates & Associates 1013 Mumma Rd_ Suite 100 Lemoyne, PA 17043 r ',.....r . _.::'::~'C ~.. "'~ . -, -'. ','i Dear Ms. Sepkovic: RE: Carolyn W. Oms, deceased January 7, 2001 '~<. -, In response to your recent inquiry concerning the accounts maintained in the name of the decedent, please be advised that the fonowing accounts were open at the date of death: Visa #4301731500187412, open 3/82, limit $6,500, balance $ -0-, last paid 11/00, joint with R. K. Oms. Checking #1068-51180, open 4/3/68, balance $12,676.47, joint with. Raymond K. Oms, Jr. Money Market Savings #9900-66803, open 11/17/83, balance $10,349.86 and accrued interest $2.98; paying 1.5%, joint with Raymond K. Oms, Jr. The decedent also had a safe deposit box at our West Shore branch, box #6, joint with Raymond K. Oms, Jr. Please see reverse for CDIIRA information. If you hav" any further questions, please do not hesitate to contact mc_ '.r", I . "17 %/:_ ""'11"") . Very truly yours, s,':.- '.'':_ ___'~I Q ~ ,~,- "Bi < ':1{~"~1 / w l' J~.~ :l~ <>.~~:.~I:C:/~~; , J""~~) ('. ~ luf-t;V \ I '/', ' I., /1/. hristine Putt Smith . <'..;", . 1/... Credit Confirmation Processor ~ ";'. """, ".-" "I.~.~...:,..~ " .... ./\~~ ~'\" . >. r I' -" Estate afCarolyn W. Orris dad 1/7/2001 page -2- ACC CD# BALANCE INT RATE OPEN ROLL OVER MA TURITY 022-0120868 10,150.00 513.71 6.53 4/6/00 nla 10/6/01 *in her name only 022-0128003 15,000.00 53.76 6.53 4/18/00 nla 10/18/01 * in her name only 022-1400353 7,210.30 7.15 5.17 3/14/00 nla 9/11/01 "her IRA 022-2000345 7,621.99 9.24 5.71 9/12/89 3/1 liOO 9/lliOl "her IRA 350-1902107 2,686.30 3.00 5.83 3/21/96 3/2l/00 3/21/01 * her l~" 390-1463236 2,737.88 2.89 5.5 31l4/00 nla 912l!01 "her IRA VI WaY~ct~'1t LOOK FOR us. WE'LL GET YOU THERE. FEBRUARY 26,2001 GA TES & ASSOCIATES 1013 MUMMA RD LEMOYNE PA 17043 The information which you requested on the CAROL YN W ORRIS DECEASED (Social Security Number 184-24-5294) is as follows. Account Number(s) 1060286156 Class of Account CERTIFICATE Date Opened 031396 Principal Balance 35022.61 Accrued Interest 34.60 Balance at Date of Death 35057.21 Account Ownership !TO Name of Joint Owner, if any RA YMOND ORRIS Date Ownership Was Established 031396 Additional Information Requested S7;lYI I Yatht ~r=tYfM'YI J- Sati.cr Services Pep. P.O. Box 17/. HARRISBURG. PENNSYLVANIA 17105-17/1 Toll Free I-B66-WAYPOINT (1-866-929-7646) . www.waypointbank.com ~, BRICKERS AUCTION Complete Auction Service Auction - Wednesday Evenings t:J )< I!! 5 766-5785 Chuck Bricker, Auctioneer TOTAL SALE ~ 3.7~, ?.J- COMM. ? f tl 7 S- CLEAR. J 6- ? /) I Ii SDU /-5/-0\ m 3:J\1d NOu:>n\1 5 03>OIClfl o9S!99LL!L LO:9! !00%0/o0 , ') .~ ~ " Xii ~~ ~.!:..o,;;..J ~.::l!ti 1:oI~ . ~-._-r: , 1't0 ;.*'-;-1 rf& '~~:=.1l ~.';.7a r:f~"j t:E~ ,ff It~ t~l ,~ri 'F1~ t;(~ ~W~ ",j~~ I '4..'\~ f.\::~\i (h:-:1;] f~?, ~~'-~ ~.'.' ~(:' ~:(i!i ~~' ':"', ~'... of "".... of..... "" om." """',,,.. P.__"" : BRAOL<:y'l ",'AlLORY ~:;"I!~ "'T".h~\allO"t..-..laIoolUN~.l"'""",*"r''''''..dIo.....",..lI-....wluI",""", -'-, - "" f!.~,:"..'. DlIhe saki vehiClt>. SecM'larv o( Tt:l~rtlllioD . t4( · _ut.1r.:.~ :,.["~~7r.1W'::Q::!..I~;:"1i~~M\~fY.::'~~ 0; 1{Y ! If II co-purcnaser olher than your spouse IS hsteo..;.-,<J '.1\)\1 wan!'~ UllelO .m"- SUBSCRIBED AND SWORN , be ~Slecl as 'JOint Tenants WIth Righi at Survrwrshrp' (On death of one I"',{r... TO BEFOAE ME. ~y '" owner. lit18 goes to suMving owner.' CHECK HERE O. OtherwiSe, the tilla . w~1 be issued as "Tenants in Common" (On demt\ 01 one owner, in1erest of deceasea owner goes 10 hislher heirs or eSlalel. ~':i; .t:; i;",' ~~'~~i; :.,;:" :>H,',',' ~i~li !::<:;'" ~~:;;,! lmI'lii~~~~~&~~.&~,8l;.n:,~Il~~\1~~~!~;1~~4;~;:~~1;")',";:';;~~~t~i ~! ':ERTlFICATE OF TITLE ~ 0.' 000741099000145-Q01 1G1JF52TXW7172147 I I I GVWR I' CHEVROlET MAKE OF VEHIClE I 1'1"15 511,5831,1302 VEHICLE IDENTIFICATION NUMBER YENO TfllENUMBEA BODY TYPE oup2j SEAT CAP 3/14/00 DATE OF ISSUE oooH~~!~OI PRlORtm...Esr....TE 1 I EP..~~e: 5/ o OooM. STATUS I I ~ 1127/98 DATE PA TITLED ., GCWR ''"lm.E":eMNos - UNt.ACaI WEIGHT '_..eaIlli --~f Pen" ~...... - ._.- Sw "'" ' , -<'i- "'" - _ , ?,. c.P .<Dfj",'n,"~rol Tr4n"''''''''U1tiO''. ".;,. OOOMETER5fAfUS o ~ ACTUAL MlaGE , .. UILEAGE EllCEEOS THE MECHAAllCAl.. LIMITS .', 2~NOTTJoIEAI:t\J.OJ..MIl.U.GE 3~NOTTliEACTtJ.I.lMILEAGE.QOOMETER TAMI'ERINI:],VERIFlED 4 .. EXEMPT I'I'lOM ODOMETER DiSClOSURE PA 17043 TTTtEBRANDS "..ANTIQUEVEI-IICLE C.Cl..ASSJCVEHICl.E o s COLLECt"oSlE VSl~ " .. OUT OF COUNTRY G ;0 ORIGJNAU.Y MFGD. FDA NON-U,S. OISTRIBlJTION Ol"Il.GP.ICl.J..'l\lN.lVEl-llCU; L.LOGGM\'EHICLE P'OI$iWASAPOUCEVEHICLE R:RECONSIJlUCTED 5.. 51l\EfTROO T . RECOI'BlEll TIfEFT VEHIClE V.. VEHICl.ECONTAINSREISSUEDVIN W..FlOOD\'&!IClE )l ..ISWAS.lTAXI FIRST LIEN FAVOR OF; SECOND UEN FAV(lft OF' OATE ~ Jf._dli"'hold<<is~sttdul)Ql1sa1i$l>lctv:m<lflt\cli""l~.1h8fuR liIIrIholdwmllSlforwaldltl/lTolletolh,Sure;tuolMolorV,IlicIeIWllhIhe lIppfOIIl'leMlDrmandlee. AUTHORtZED REPRESENTATIVE SECOND UEN REl!ASED DATE eY AUntORIZED FiEPAESE'.fATIVe CAROLYN W ORRIS 8 S 2ND ST WORMLEYSBURG PA 17043 SlGNATlJAE01"Pl':ASOtlAOMlNISTEAINQOAni 1 ST UEN 011 TE; .... IF NO LIEN. CHECK 0 <=> ~ W <=> <..0 .j:::,. <..0 U"l 1ST UENHOUlER IsnlER I i CITY , ! FINANCIAL INSTITUT10N NUlrdIlER I .P STATE i 2NO lIEN OATE: ~ IF NO UEN. CHECK n..~n.___""'C"""""'T;"","',__ _.._"'..........-__o_..,..c_..."""'_ : 2ND UENHOl.OER , STREET SIQNATUIIEOf' APf'UCA"r 011 AUTHOAIZED $IGNEA I CITY STATE ZIP FiNANCIAL lNSTllUTlON NUMSER SK;IU.TIJl'EO'FCO.A~lCJoNllTlTlEOF.UTf'KlIIIZEDSIGNEA o FROM : RANDY ORRIS AND KAREN FOLEY Kelley Olue nuok '!sed Car Vwues fi!>I):oQ ~., ."" ..'.- -. . . Kelley Blue Book 'nu, ~l{\,. , - ~~~: kbb.cofn - cui ding tlJe cat ouver ~<<~TP\ - . Used Car Valull!:S . N"'" Car Prlo1l9 ; Motorc:ydt!S : Buy a_c.. Buy a U'""" Car . Sell YOUT 0>. , Financing ln5uranoe 1..'l'fT'O" Chf!'ek WTllrmnti(!.-; C;,r Ri':views ('.aT rrevif!ws f')t'd~0t1 Gui()e Aboutkbb Home' lqf2. PHONE NO. : 650 631 561 9 FEE. 02 2001 11 :f8RM P7 http://WW\ com/kblk.i.dlllkw.kc:.ur1kbb:J'sOll'02&:;1&27U:.4:CJ {;,,-: :t FOR. 'Fl\\<2.. N\~'(X\ A\{ f.R.A 6-Et) T~~~[ -:D.l ~p..L\.lE ; 'lAL \l [ .J- RflR I L VAUjl; ~2:t~. r,;':, j"Z /31 0 I 0 I 0 I 0 10m Cllckonthe__1D1IisKII1Is_ 81ue Book Trade-In Report PennsytvBnia'February 2.2001 1998 Chevrolet Cavalier LS Sedan 4D Engine: 4-CyL 2.4 Uter Trans: Automatic DriVe: Front Wheel Drive Mileage: 6,400 Ways to Buv a b/!>.{!d Car Find a Certified Used Vehit;;l./l Wavs To Buv a New Car List Your Car For Sale Online Finaneino Ouote Insurance Quot~ Warranty Ouote Parts & AccessorIes Pavment Calculator Equipment Air Conditioning Power Steering Tilt Wheel Cruise Control AM/FM Stereo Cassette Dual Air Bags A6S (4-Wheel) Consumer Rated Condition: Excellent "Excellent" condition means that the vehicle looks great, is in excellent mechanical condition and needs no reconditioning. It should pass a smog inspection, The engine compartment should be clean, with no fluid leaks. The paint is glossy and the body and Interior are free of any wear or visible defects. There is no rust. The tires are the proper size and match and are new or nearly new. A clean title hlstorv is assumed. This is an exceptional vehicle. ~de-In V8~ ~:2~ Trade-in value represents what you might expect to receive from ~ this consumer owned vehicle. Keep In mind that the dealer must then absorb the cost of making the vehicle ready for sale, advertising, sales commissions, arranging financing and insurance and standing behind the vehicle for any mechanical or safety problems. COQyrlght Cl 2001 bv KelI4Y 61U4 !look co., All Rights Reserved, Jan-Feb 2001 Edition. The infonTl8tton In I:t1ls re!:'ort was printed from the Kelley Blue Book Web site (www.kbb.com) and i5 i.....""...AaA ~....... "".ro!'.......1Io1 II..,., ...,. ~Iletvo,....... ......10.1 ....... ......~ ...uo ""_ c:"IA ..... "-_....;....~ .,.. "'.........h.&.. 212101 9:51 AM FRot1 : RANDY ORR I 5 AND KAREN FOLEY Kr.t(cy Blue Book lJ.~cd Car Values PHONE NO. 650631 5619 FEB. 022001 11:18RM P8 hrtp:J/wwv :omlkh/ki.dlllkw.kc.ur?k bb:486456&..T&277&4:CI r ;?."! -oJ:.~':";~" :;z -;. .....v.ltooo. -~ ,",~.. ',~,", ~~ ""*"1~~'" Used Ca,.. \1'\";1'.'5 ~:ew Car rridng MotClteydes Ruy it Np.w Car Buy a Usci:.d Car Sen You.- Car f1nancing Insurance Lemon Check Warr8nde.s CiiU" Reviews car Previews Decision Guide : AIlotJt kbb Home lof2 Kelley Blue Book.. KO:';'J:;om - !~.:'W''d;.1g ;he C..:if bl;ye~ Ty ~....;. ~ r&.~ot' www. j .com !Got , cnd< on the irnIlge IIbcMt to vleit 1h1s 8dverIfser j!{m!:mi~~l~E~~~~i! Pennsylvania, February 2, 2001 i ~~.. ----:--~----- 1998 Chevrolet ClIvalier LS Sedan 40 Engine: 4-Cyl. 2.4 Uter Trans: Automatic Drive: Front Wheel Drive Mileage: 6,400 Ways tQ Buy a Used Car Find a Certified Used Vehicle Ways To Buy a New Car list Your Car for Sale Online Finane/no Quote Insurance Quote Warranty Ollote Parts 8< Acces5Qries Payment Calculator Equipment Air Conditioning Power Steering Tilt Wheel Cruise Control AM/fM Stereo Cassette Dual Air Bags ABS (4-Wheel) Gtail va,u0 Suggested retail represents the price a dealership might ask r this make and model vehicle. This represents a fully reconditioned vehlde in excellent conditIon with a clean title hlstolX. This retail price is not a trade-in or private-party value, but rather assumes that a dealer has absorbed the cost of maJdng the vehicle ready for sale, reconditioning, advertising, sales commissions, arranging for financing and Insurance and standing behind the vehicle for any mechanical or safety problems. Many late model vehicles at this price have passed an inspection program or carry a warranty. Actual dealer selling price may vary from this price. Copyright Q 2001 by Kelley Blue Book Co., All Rights Re..."'ed. Jan-Feb 2001 Edition. The Information tn thiS report was prtnted tram the Kelley Blue Sook WQb site (www.kbb.com) and Is intended fOr the personal use of the custOmer only and may not be SOld or transmitted to ~nothC!r party. Wf! Zlssume no responsibility for errors or omissions. ~ -- -,---------'~--------.-..-+ ~- .- . "-,. ",' .-. . ::~:;, ..... " .., '_ ::';_.::c..' - ,-:< , 212/019,S4 ^M PA REV-1500 SCHEDULE F JOINTL Y OWNED PROPERTY FROM RRNDY ORRIS RND KRREN FOLEY PHONE NO. : 650 631 S6 '" FEB. 02 2001 11:21RM P12 Redemption Date: 1(2001 Inventory 1.r~ Inventory summa1~~ Number of' Bonds I.n'Ventory 'Value RcIdclmpt.ion VaJ.ue Interest 1\c:cJ:'Ual Bonds Pr,@.-January 19~O Issu8 Datgs: Janu~ry 19~O ~nd Late~ Issua DaeG4~ 100 o _.~ $6,126.14 $0.00 ~-ii6~14 $6,126.14 $0.00 $6,126.1"4 $3,626.14 $0.00 . $3,626. IT $0.00 $3,626.14 o $0.00 $0.00 100~126.~~ $6,126.14 C'l.t~rent IJlcC'me Bonds Invputory Tottt~s ~~~ * prr::ceed.5 fro'", St?ries SF.. & I Savings Bonds with issue dates beginning Januar.y 1990 may be eligiblG! for special ta.x exemption when used for post-secondary educatior:::. For further information concerning the benefits and ~estrictions that apply, please contact the Internal Revenue Service. 1 These bonds are not eligible for payment within 6 mo~ths of ~heir issue date. 2 Th~3e bonds have reached final maturity and ~ill earn no additional intArest. They can be exchanged for HH Bond~ within a year of their final maturity date. 3 These bonds have reached final maturity and will earn no additional int~re$t. Th~y are not eligible tor exchan9~ for Series UK Bonds since they have be~n held over a year past thgir final maturity date. ~ NA;M.E'- Of" ~(Z.OLa N OC2-<G1.5 oe Rb.~ \J '{ ()~JGL$ FROM RANDY ORRIS AND KAREN FOLEY PI-lJ€ NO. : 650 631 5E"g FEB. 02 2001 11: 22RM P::O Inventory 1 Accrual Bonds ~.c;ad9W\pti.on Data: 1/2001 Issue Y;i.eld Next Final $Qrial Num.be<: -E~ Se~ Ds:t.e value J:nterast To Date Accrual. Haturi t:y $50 Eli: 3/1983' $77.90 652.90 6.60% 3/2001 3/2013 650 EE 411983{ $77.90 $52.90 6.60% 4/2001 4/2013 $50 EE 5/:9831 $75.82 650.82 6.4n 5/2001 5/2013 $50 EE 5/1983~ $75.82 $50.82 6.4U 5/2001 5/2013 $50 EE 6/1983 I $75.82 $50.82 6.44% 6/2001 6/2013 $50 1414 7/1983 $75. e 2 $50.82 6.44% 7/2001 7/2013 650 EE 6/1983,1 $75.82 $50.82 6.44% 6/2001 6/2013 $SO EE 6/1983{ $73.82 $48.82 6.47% 2/2001 8/2013 $50 EE 8/1983~ $73.62 $48.82 6.47% 2/2001 8/2013 $50 EE 9/1983 $73.82 $48.82 6.47% 3/2001 9/2013 $50 EE 1011983 f $73.82 $48.82 6.47% 4/2001 10/2013 550 EE 10/1983 I $73.82 S48.82 6.Q7% 4/2001 10/2013 $50 EE 1111983 $72.60 547.60 6.37% 5/2001 11/2013 $50 EE 11/1983 ~ $72.60 $47.60 6.3H 512001 11/2013 $50 EE 12/1983 I $72.60 $47.60 6.37% 6/2001 12/2013 S50 EE 12/1983.J $72.60 S4 7.60 6.37% 6/2001 12/20J.3 S50 EE 111984; $72.60 $47.60 6..37% 7/2001 1/2014 650 EE 2/1984 j $70.70 $45.70 6.40~ 2/2001 2/2014 650 EE 2/1984 $70.70 545.70 6.40% 2/2001 2/2014 S50 EE 3/1984 f $70.70 $45.70 6.40% 3/2001 3/2014 S50 EE 4/19841 $10.10 S45.70 6.40% 4/2001 4/2014 $50 EE 411984, $70.10 $45.70 6.40% 4/2001 4/2014 S50 EE 5/1984 j $69.36 $44.36 6.28" 5/2001 5/2014 650 EE 5/1984 $69.36 $44.36 6.28% 5/200l 5/2014 $50 EE 6/1984~ $69.36 $44.36 6.28% 6/2001 6/2014 S50 EE 7/1984 $69.36 $44.36 6.28% 7/2001 712014 $50 EE 7/1984~ $69.36 $44.36 6.28% 7/2001 1/2014 S50 EE 5/1985 $64.94 $39.94 6.25~ 5/2001 5/2015 $50 EE 6/1985l $64.94 $39.94 6.25% 6/2001 6/2015 $50 EE 6/1985 $64. 94 $.'39.94 6.25% 6/2001 6/2015 $50 EE 5/1985~ $64. 94 $39.94 6.25% 5/2001 5/2015 S50 EE 7/1985 'I $6( . 94 $39.91 6.25% 712001 7/2015 $50 EE 12/1985 $63.66 $38.66 6.33% 6/2001 12/2015 $50 EE 8/1985, 663.66 $38.66 6.33% 212001 812015 $50 EE 8/1985 I $63.66 $38.66 6.33% 2/2001 8/201.5 $50 EE 9/1985 663.66 538.66 6.33% 3/2001 9/201.5 650 EE 1O/J.985~ $63.66 $38.66 6.33% 4/2001 10/2015 S50 EE 10/1985 ( S63.66 $38.66 6.33% 4/2001 10/2015 S50 EE 10/1985 $63.66 538.66 6.33% 4/2001 10/2015 $50 EE 11/19851 s63.66 $38.66 6.33% 51200!. 11/2015 $50 EE 2/1986 j $62.42 537.42 6.41% 2/2001 2/2016 S50 EE 111986 563.66 $38.66 6.33% 7/2001 1/2016 S50 EE 12/J 9851 $63.66 $38.66 6.33% 6/Z001 12/2015 S50 EE 211986; $62.42 $37.42 6.41% 212001 Z/2016 S50 EE 5/1986 $62.42 $37.42 6.41% 5/2001 512016 550 EE 5/1986~ $62.42 537.42 6.41% 5/2001 5/2016 550 EE 3/1986 ( 562.42 $37.42 6.41% 3/2001 3/2016 ~I?~ ~$50 BE 4/1986 $62.42 $37.42 6.41% 4/2001 4/2016 $50 EE ?"5/1986:) $62.42 $37.42 6.41% 5/2001 5/2016 S50 EE 6/1986 ~ $62.42 S37.42 6.41% 6/2001 6/2016 $50 EE 7/1986 " $62.42 537.42 6.41% 7/2001 7/2016 650 EE 7/19861 662.42 $37.42 6.41% 7/2001 7/2016 1 = Not eligible for payment (purchase price) 2 = Matured (elChangeable for HH) a = Matured (not eJ<Changeable) . = Possibly eligible for U.S. Savings Bond Educafion Benerrt Program. See footnotes on Inventory Summary page. 1 FROM RANDY ORRIS AND KAREN Fa.EY PHJNE NO. : 650 631 5f.1-g FEB. 02 2001 11:23AM Pl~ Inventol)' 1 Accrual Bonds (continued) R'Rde1l\ption D'!lte: 1/2001 resue Y:i..ld Nest F;.naJ. Serial NUll\ber Denom. Series ~!-.. Value Interest ro Date Accrual Matu..-il:y $SO EE 8/1986~ $61.20 $36.20 6.50% 2/2001 812016 $SO EE: 9/1986 $ 61. 20 $36.20 6.50% 3/2001 9/2016 $50 EE 9/1986 ~ $61. 20 $36.20 6.50% 3/2001 9/2016 $50 EE 10/1986 S61. 20 $36.20 6.50% 4/2001 10/2016 $50 EE 11/1986 ~ $55.44 $30.44 5.77% 5/2001 11/2016 $50 EE 10/1986,/ $61.20 $36.20 6.50% 4/2001 10/2016 $50 EE 11/1986 $55.44 $30.44 5.77% 5/2001 11/2016 S50 SE 1Z11986f S55.44 $30.44 5.77% 6/2001 12/2016 $50 EE 1/1967" $55.44 $30.44 5.77% 7/2001 112017 $50 EE 3/1987,/ $53.96 S28.96 5.78% 3/2001 3n017 $50 EE 1/1987; $55.44 $30.44 5.77% 7/2001 1/2017 $50 EE 2/1987 $53.96 $28.96 5.78% 2/2001 212017 $50 EE 4/1987 ~ $53.96 $28.96 5.78" 4/2001 4/2017 $50 tE 411987/ $53.96 $28.96 5.78% 4/2001 4/2017 $50 BE 5/1987 $53.94 $28.94 5.78% 5/2001 5/2017 $50 BE 311987f $53.96 $28.96 5.78% 3/2001 3/2017 $50 EE 8/1987 .; $52.88 $27.88 5.85% 212001 8/2017 550 EE 7/1987 ~ $53.94 $28.94 5.78% 7/2001 7/2017 850 EE 6/1987./ 853.94 828.94 5.78% 6/2001 6/2017 $50 EE 6/1987 I $53.94 $28.94 5.78% 6/2001 6/2017 $50 EE 9/1987 $52.88 $27.88 5.85% 3/2001 9/2017 $50 BE 10/19871 $52.88 827.88 5.85% 412001 10/2017 $50 EE 8/1987,( $52.88 $27.88 5.85% 2/2001 8/2017 $50 EE 9/1987 ~ $52.88 $27.88 5.85% 3/2001 9/2017 $50 EE 1011987 $52.88 $27.88 5.85% 4/2001 10/2017 $50 EE 12/1987 ) $52.88 $27.88 5.85% 6/2001 12/2017 $50 EE 12/1987 $52.88 $27.88 5.85% 6/2001 12/2017 $50 EE 11/1987./ $52.88 $27.88 5.85% 512001 11/2017 $50 EE 1/1988 ~ $52.88 $27.88 5.85% 112001 1/2018 $50 EE 2/1988 $51.84 $26.84 5.n% 2/2001 2/2018 $50 tE 2/1988 } $51.84 $26.84 5.92% UlOOl 2/2018 $50 EE 3/1988 $51. 8 4 $26.84 5.92% 312001 3/2018 $50 EE 3/1988 ~ $51.84 $26.84 5.92% 312001 3/2018 $50 EE 4/1988 $51. 84 826.84 5.92% 4/2001 412018 $50 EE 5/1988~ $51. 84 826.84 5.92% 5/2001 512018 $50 EE 5/1988,f $51. 84 $26.84 5.92% 5/2001 5/2018 S50 EE 7/1988 I $51.84 $26.84 5.92% 7/2001 7/7.018 $50 EE 8/1988 $50.82 $25.82 6.00% 2/2001 812018 $50 EE 7/19881 851. 84 $26.64 5.92% 7/2001 7/2018 $50 EE 6/1988.J 851. 84 $26.84 5.92% 612001 612018 $50 EE 8/1988 $50.82 $25.62 6.00% 212001 8/2018 $50 EE 9/1988 ~ $50.82 $25.82 6.00% 312001 9/2018 $50 EE 9/1988 $50.82 $25.82 6.00% 3/2001 9/2018 $50 EE 10/1988 ~ $50.82 $25.82 6.00% 4/2001 10/2018 $50 EE 1/1989 $50.82 $25.82 6.00% 1/2001 1/2019 $50 EF. 11/1988 ~ 850.82 $25.82 6.00% 5/2001 11/2018 $50 EE 11/1988 " $50.82 $25.82 6.00i 512001 11/2018 $50 EE 1211988 $50.82 $25.62 6.00% 6/2001 12/2018 1 .. Nol eligible for payment (purchase price) 2'= Matured (e><<:hangllllbfe for HH) 3" Matured (not elCllllangeable) . = PO$$ibly eligible for U.S. Savings Bond EducatIOn Benefit progrem. See foolnotes on Inventory Summary page. 2 PA REV-1500 SCHEDULE G INTER-VIVOS TRANSFERS and MISCELLANEOUS NON-PROBATE PROPERTY FRO~l : RAtjDY ORR 1 5 AND KRREN FOLEY PHONE NO. : 650 631 561 g MAR. 272001 10: 19AM P5 COMMONWEALTH OF PENNSY1.VANIA STATE EMPLOYEES' RETfREMEI-lT SYSTEM 30 NORTH THIRD STREET - P.O. BOX 1147 HARRISBURG, PENNSYLYANIA 171De- 1147 TOLLFREE: 1-l1~33-$4$1 WWW.sers..surt8.pl.US March 22, 2001 R7d')J)'Y .R OaRIS 998 GOVERNORS BAY DR FEDl100[) CITY. CA 94065 n,,: CAROLYN W ORRIS SSN: 184-24-5294 Dear Beneficiary: We are writing to you regarding the above named account. The enclosed forms must be completed by you, according to the printed instructions. before we can proceed with the processing of this account for payment. Please note: The Retirement Code does not proVide for the payment of interest on the principal sum of a death benefit. If you are a spouse, please read the enclosed Information pertaining to the recent Change in the Federal tax law. Also, please complete the EJection form and the Trustee to Trustee Transfer (if applicable) and return to the system as soon as possible, If you are not a spouse, please complete the Withholding Election form along with the required forms and return to this system as soon as possible. To aid you in making an option selection, the following information is provided. Death Benefit Payable to you: Taxable Portion: Non Taxable Portion: If you have any questions or need assistance, please contact the field office nearest you at 1-800-633-5461 . Sincerely, ~4q" )n. n., ~ Unda M. Miller, Director Benefits Determination Division Enclosures BENes 111111/11111111111111111111 1111111111 11111111111111111111 11111 11111111 PSE(~ PENNSYlVANIA STATE EMPLOYEES CREDIT UNION ", , )~~ '<,,:",\ , ',,", ) " " February 20, 2001 Account # 0184245294 /"" ('c~ , \-." / '-:;'7r "', ';~,/.,!- -'"Ii TRACl L. SEPKOVIC C/O GA TES & ASSOCIATES PC 1013 MUMMA RD SUITE 100 LEMOYNE, PA 17043 Dear MS, SEPKOVIC: The following is the status of CAROL YN W, ORRIS's account with PSECU as of the date of death, Date Established Date of Death Date of Birth 03212000 REMOVED JOINT DUE TO DEATH AT SAME TIME CHANGED TO TENTATIVE TRUST IN TRUST FOR RANDY R ORRIS 12011989 01072001 01091932 Joint Owner's Name Sharers) Regular Shares (S I) Moneyhandler Shares (S4) Share 50 60 Month IRA Certificate-2 Share 55 12 Month Certificate-7 Share 60 6 Month Certificate Share 6\ 6 Month Certificate Share 62 6 Month Certificate Share 63 12 Month Certificate Balance $ 9,457,33 0.00 \2,802.03 5,728.35 11,293.93 20,000.00 12,803.3 7 3,495.30 Accrued Dividend $ 4,82 0.00 14.27 5.73 9.52 16.87 10.90 3.49 The decedent had no loans with us. The dividend earned from January 1,2001 until date of death was $65,60, We do not have safe deposit boxes for our members. If you have any questions, please call 234- 8484 in Harrisburg or our toll-free number, (800) 237-7328. At the menu prompt, enter 6 and then extension 2227. Sincerely, ') ~L:4f Meacie Fairfa~~ Member Service Representative Finance Support Unit Main Address: 1 Credit Union Place, Harrisburg, PA 17110-2990' (717) 234-8484' (800) 237-7328 Mailing Address: P,O, Box 67013, Harrisburg, PA 17106-7013' (717) 777-2100 (TOO)' (800) 472-1967ITOD) www.psecu.com Savings federally insured up to S1 00,000 by the National Credit Union Administration. Fulton BdIlk P.O. BOX 4887 . LANCASTER. PA 17604 People dedicated to your success. ~ (717)291-2589 WWWFULTONBANK.COM ) -800-FULTON-4 February 27, 2001 ^. Traci L. Sepkovic Gates & Associates 1013 Mumma Rd. Suite 100 Lemoyne, P A 17043 I- " --'::~-~:(~, , Dear Ms. Sepkovic: RE: Carolyn W. Orris, deceased January 7,2001 " In response to your recent inquiry concerning the accounts maintained in the name of the decedent, please be advised that the following accounts were open at the date of death: Visa #4301731500187412, open 3/82, limit $6,500, balance $ -0-, last paid 11100, joint with R. K. Orris. Checking #1068-51180, open 4/3/68, balance $12,676.47, joint with. Raymond K. Orris, Jr. Money Market Savings #9900-66803, open 11/17/83, balance $10,349.86 and accrued interest $2.98; paying 1.5%, joint with Raymond K. Orris, Jr. The decedent also had a safe deposit box at our West Shore branch, box #6, joint with Raymond K. Orris, Jr. Please see reverse for CDIIRA information. If you haw any further questions, please do not hesitate to contact mc. IS~ " . ., '/}t '- .r. ';;c-. o/': '- 1.; ",--;. ,<.q,. "!~7"',' '''//~/^ J ,.,' -r' "''', . :.. ~'i- (,~. -:)" .,..... l ?_,';:,. ", .; ')'i/' '~'/~ .' P /) ~ " /"/: '- ,.... . / '/1r ""') , "-':li ,,,:,, ~./ ." j,.. '''''- ....,., - . '~_' fl' .-1 . o..:r.( " -..:'.... "j".. -:'~\'r /' .1' Very truly yours, 0~\'ufl/V~ Christine Putt Smith Credit Confirmation Processor Estate of Carolyn W. Orris dod 1/7/2001 page -2- ACC CD# BALANCE INT RATE OPEN ROLL OVER MATURITY 022-0120868 10,150.00 513.71 6.53 4/6/00 n1a 10/6/01 *in her name only 022-0128003 15,000.00 53.76 6.53 4/18/00 n1a 10/18/01 *in her name only 022-1400353 7,210.30 7.15 5.17 3/14/00 n1a 9/11/01 'her IRA 022-2000345 7,621.99 9.24 5.71 9/12/89 3/l1i 00 9/l1i0 1 'her IRA 350-1902107 2,686.30 3.00 5.83 3/21/96 3/21/00 3/21/01 'her IRA 390-1463236 2,737.88 2.89 5.5 3/14/00 n1a 9/21/01 'her IRA PA REV-1500 SCHEDULE H FUNERAL EXPENSES and ADMINISTRATIVE COSTS FROl1 g >- :!! ~':'~.1 ~ r~ ", : ~ ~ '" <> '" ~ ~ ~ = RRljDY ORR I S RND KRREN FOLEY PHONE NO. 650 631 5619 FEB. 132001 11:11RM P14 ~",;;.,~", FRrJrl RANDY ORRIS RND KRREN FOLEY PHONE NO. : 650 631 5619 <s.l\I-...-e' Receiptoa.e ;:"'4,--=:::d/ No. . 046294 /') .<"-- FROM l;;1:~::" L/$!;Z5~: 8!:~.~. .' !d~ / ~ w. FEB. 132001 11: 15RM P:~ mOM ACCT. PArD DlJE TO s: ~; ~ (') '" (3 '" => c. 30 , ..; -i III . [TiO ., ., ". .' .:.i:~ o~ ~, 11> Do ., ; -~ ::J ::J 1'1 "',; .'.'~ C"lm 1/1 iii ". , " , ":;: DZ 'Q 'tl n ""<';~' "-i (', 0 ~ ':j m~ '" ., ID " ". ". ., _"t,', , 0 $:, .",;'........: ;JJ \' < < -! i,:;:,,;~~ -I 1l> 1l> ., :3 :I; ::J ::J 1l> ,":,-;-.',,:~ 1TI .... " " .....;:,;,..,~"; t:' (I) ~ :3 :3 Ul ,~;O;;:; .... - ~." /."ii' t") lJ) r--.... - - 0 if D 1Tl ID ID .., ". ~ r- :0 1l> !l> ". III < 2L. 00 00 D .... ,...<J ID ID lJ) (") lJ) m t' .... ~~ lJ) H ^-. " :,. -i trl ",' J> ~.<J z z r-{, C1 0 ~ m -t . n .- 0 ffl ;JJ m 0 ~ ttl . -< ~ C ~ z =l ~ '" 0 ... ... ~ 0 ~ . . . (J] ~~;: --! (J] -l (') C 0 :Il CD 0 ~ m --! ~ 0 0 (J! UI ... r- =i j;! r- ~ C " " ". Z C~ 0 ly.... a- I'" (lo -I . . . 0 ... 0 ... 0 0 ... C e.l! 0 U1 - 0 .;~ m ,~ ',"" ;i~ 10.,;.01 < (ii' '" '" g '" '" ;;; c. 000 ~ ~ "m :j ..; .(J] ~(') m Iii ...:!! z 2 'V -; -; -l ~ "tJ 03- 6 :)>0 ^ ;JJ2 m ^ ....0 z m c" ~ 0 3_ c UJF :p :&:2 I l>m r-cn :I; :Q t~ r-cn 0 m 0:::' r Z :&:Z -< 0 <- < C lJl 1> r' :Il '1) ~ .... n :>;I m H Z -I -l fTi :I; :ll 0 Iij .... -t 1> r- CUMBERLAND LAW JOURNAL 2 LIBERTY AVENUE CARLISLE, PA 17013 FEBRUARY 23,2001 Cumberland Law Journal is published every Friday by the Cumband County Bar Association and is designated by the Court of Common Pleas as the official legal publication for Cumberland County and the legal newspaper for publication oflegal notices. TO: Mark E. Halbruner, ESQUIRE RE: Carolyn W. Orris aka Carolyn Marie Orris, 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: February 9,16, 23, 2001 Advertising Cost $ 75.00 $ 0.00 $ 0.00 $ 75.00 ------------- $ 0.00 Proof ofPublicalioll Second Proof Request Payment received Total Amount Due Payment received February 6.2001 by Beckv H. Morgenthal/Executive Director \ ' .' ~. t~~~ :OGlCS ~ ,~ \~%~ '~ Q'~ ~ \ {it,. " \ \"' -f:~:,;'';;:'~ ~ '}~c'r~" Q )" ....'.!'.,~ .,,:,~i~Z'\\' , ~~}~ \ ~ . ~ '.0 iIii' ~ ~ . ,'.x ... ... ~ -.l 'P ('\ 0 \:: ... ":3l " -g, ~ ~~, '" ... Q ~ '" '" - cr. so ..:IE ~ ~ :c ~ o "0', ~ ~. ~, \ , g e '"I. ~. % o (') &;, :J: ::E rn ~ ~ \~ %" ~ ~ "~ \ .$~ ~~ l:l ~ 'jJ "" "" ~ ~ ..... .0'" ')... :n ~ <r %8\ ~ ~8~ m " .. ., !\ 1ft \~ IN \- 'rI+ \ i 1 8 ~ . N ~ N 8> ~ \ 1\\ ;:; ;;; \, 0' n .. ~.,,,.. .., ~ : I ~ ~ ~. ~ a ~ ~ -s N .. j; fID N o g<;s=n b lJ" '"' ~CD .0 ~ l\'i " ~~ ' .M :-. ~. . O . '" . )- ..... .. ..... o .. Gl r lJ" - ., ." ~ 1ft .. g6;~\ \'< ~ '\ ~~C'l \\ ti ~%~ \ i6 '<;~ ifiC on ~ ' ~(/) t. P: ~"ll" \' .... ~~- o 0004~U; (T %?(/) '\ *' ~o 1\, "l m~ '" <P- c:> g~ . o ",', . (/)' -~ \ . , \\ ~, . . . . . . . . . . . . . . \ I-" o ~, , 03/28/01 07:46 FAX 650 506 7120 . . ~~"";'''''''>;''''~'~'''''''''';';'i''';\:;~';'j;!,;i;1.,,,'~'*';tM~::t'J,i..i~r ORACLE 02/12/2001 6ELMONT PO aELMOHT, C.1Hornh 9~0029998 (650)591-9588 \ 02:33,57 PM \ = Product o"edptton _ Sa"s Receipt 5.10 Unit Qty PrlCo rtn.l Price MESA AZ 85201 Express $12.25 M.n PO-AnO sorlo1 Huobor ET209579517Us Nextdoy Noon INoro.' Dell .ery Issue PVl' $12.25 ME5^ ^Z 85201 Express Mot 1 PO-^OO sortol Numbor ET209579525US Noxtdoy Hoon INoro.\ Oel'verY $16.00 IssuO PVI, $16.00 Tot.,: P.ld by' Cosh $28.25 ~ C~ >>\1'*' IOp0300857678 Clerk: 05 _____ Th&n~ you fer ~our bus~ness ----- B\i'l..Tt. - X_\lC.-vf.E ~004 : ~~;:~:~~~~~~<~~""+:~f~;:::~~~~;;i;~i:~:?c>:~:~i~~ \ {,t'f\l\\UrJ ~ V_Vir" I \:>.N tllflb I . r"~ul'\L'> ell ~lt. ~Utl"''il- It A,-e if~ I I , :z I ? I I -..::I I I ~=j ~.-~-'_. &S I 0 0 ~ ~' ;]J U> 03L28/01 0;:51 FAX 650 506 ;120 2- ", ~'I\r~': :' G.~ ~ALTJWASH INT'l A~ It N i hi '''I.~~Il, , 590~91J5U1 H"~~)1 t\P\1.\S ; nnJU. I f.ll U'(. 4D67 fi: '~Iltl' !1t,U lWJRt.: lCill\\. 12111110[; 10:2B ;~llj;.J~t 0111'3/Ut 11;35 1.~ll!'::; !:-l- 154<1? (AH: 13153 '\ 'illtS 1~~I\ilN' ~289 "''\... PLAN INJUlJT, lHUS IlHUS.., "';.~~* 1:1.5, F ",,- '" 1 "ITI~ 857.99 857.99 , EX ,iiJlJ;5 \~3U 14,30 5 'v nrs 3~.32 171.60 ,l.^ .. 1043.09 StJ~lU r ~l 1)( 1l.'j\llll. l.jo~ 1f}~3.89 1'26.U5 ,VIU )'t.ID!lV AM)( . l'It Ii I LARll X2n~JI46B2XlQ( Bik110 .. . '11.'JO'~ Th'!lnk for rellut~ ~~~ l!ert; ::~:,;:::1-.~*~;'i::;.k1-~; 000 O~ () 0 ~O ~ l; mZ C') 'J: :o~ '" -,- ~ ~ ;: r) i I I I i I I I i I I ;>,) ". .~ I I I I ORACLE 11 ( f I [ I I Ii!IDD9 "'('011!tl. f ''''''<1.:1*1.1 (" \mr'1ll1 (' ~ltl1lt,' nUsl&mbza.'f-~TOVWIlJJ.UCBIVE. .. A 8TATEMSNT WIIoL xor _IIAZLED 'UNI.F..eS RqlUE8TZD FoR YOUR C01'MlN1EllC&. D811 THB z-z MAIL 1lI'lVBLOPE .. . III .... e 19 It: 4- ",Q ~ ~ ill ~ . "- :'is ~ g I!dl ~ 0\ .. .... . ~ 0 ... g? "':0 0 .... ~ ~ '" "''''il!i- ~ .:\S 0..... ~( eq ~~ ~ "'... ~ I ~ : s ~ '" !Ii "'0 - '" 0 .... Iol~ 2;0 ~ (.) ~ ~ ~<n -'" "0 , u :l == G' ~ (II "'~ III 0- - ISl M (II I- g: <0 !/.... .~ ~ I1l 0'" ~~ ~ ~ ~I I~I I ~ 0 ",I') ~ O~_; . :z: zltl II! :i '" Sfll'- :=' 2" ~ <3 .. - ~ ti! ~ ~ II liD hi 15 I') , z !z[;; >- r- S I" ., c "'... 0 :'i, i ~; ~g 0 "10 ; I ~ I " 0.. ~ ... U ~s "' Q ~ 0 . - r= III ... 0: 0: a 0: Q >- C[ CDC[ o .0) 0:>- .J ot- .... 2"'''' olil a: os Ii! ILl (II ...Jo :>QN w~ 00 I :3",l!)on ILz 3.0 3 co QIlI _ w<t .. _ 4 / .~ ~ T~UCI< NUMBER - -. -- - - 5 [)RI~,IEI'l NUMBE!'? ------ '-12 SALES NUMBE!'? --- 11434 ALLONS START ------ .0 GALLONS FINISH --- 126.3 PRICE/GAllON -- ~.35~~ PRODUCT COST - - 17(;). 5l FUEL OIL - . NO TAX SALE$ - ..-:::~. ~' TOTAL COST -../ ;170.51---' 10 DAY PAY OSC --~---.J, CD W ... 8 z a: :3. t:i i' C:-l ~" a::~ III ;;..~; ","' ~:,..' ~ -'.'....., ".;"~~"'::'''':' _~":"'!1.,",",W...1<>,~H"i:n.:::w > m OJ > '" ill . <:.;\i'~i ;:1t'~\~~ i I. ~ RRNDY ORR r 5 RND ICRREN FOLEY I I I I I I I I I I )-; .'Ii ~." ., .~ .'2 (:] ~ ~ ~ FROM ~~::i;:;*"~..~~~~.~::::.::,.~,,~,~:~:~.:..:~~~~;~:-::~~~.::'::,~~\.~;;'. PHONE i'IJ. : 650 631 561'3 " ~ ~ ' THJ!t rs TJD!lbaLY mvou;z 'tou WILL RECZrYE. Cl- A $TATEMmtT WDJ.,1fvr 1I~ MAIJ,ED 1lN1.Z&& Rltgm:1S'I'XD POR 'yOUR coJ'fVEltJENCE. 'USE TJI]t E;-Z )tAlL 'BNVEWPE I~ w If) :; u f1J - Z oM ;j :s ~ ~ ;;; a: w ~ Q ..!; g:~ ~~ "'''' o:~ ~ ........ ." ~ loT'! (.) 8 JI Z ~ ..... .,.... il!.& 2 ~ '/ : ~:;: o !e o E" ti ;z =~~@ WJ g 0 ~H rry ~"O ~" cc GJ~'fIl.ea.. rr~""~~~tl ~ :b." Si; ~ ~ :;ft-- ~...~;;lOi O-M ~(I)i!gl ~~i~~ril ~ ~ Q j x w "' u >- 2: '" "' w ~ -' "' "' '" "' - "' "' '< :2 }J Q ffi \:..I ,- _ i!! o .....t iB N J) Q n h! ~ ~ ~ II ~il ~ ~ ~-~.. 00 · ~ i ~ i ~g i (I) I"!II? ... ex: 011;;1 ex: 0 a: :i~ Co ~ (Jl(!l W(!l :ll Q 0:: .J a:: :;:: Q:l as Q::l w o :z III ZC1l ~ ~ DUI -i om >-0>- u> ,. a: Will ij llJuJ <r ex: Ul.J Ul.JM w J: :&-4' a W mo:: <Ui! [Jl ex: 19 a: 0 ot-- c -.... (fJ uJ ... 0- o l.J z a:: :;J ~ w '" i C. ~ ~ ~ f. I .J..F TPlUCK NUMBER O~I"'E~ NliMBER SALES NUMBER GALLONS $TAIH GALLONS FINISH Pl'lICE/GALLON P'RODUCT coST FUEL oIL. N() TA~ SALE$ TOTAL COST 2:22.138 1.0 DAY PAY DSC - - - - ;). 't::l _______ 3 _______ 1 .- - - - 1.099 ______ .0 --- :1.5';'.2 1..'i000 222.88 .~~~ \ .:., ....-,- .i"'. FEB. 13 21211211 11: 10RM F::, l; Ii! ~ ~ ~ \ i ! ..' .. tW'i"/,*,~fi~rf~if4."""':::" ,';"". I i I , I I \ \ I i '. I I , ;. I ! -' 03 '28/01 07:56 FA.l: 650 506 7120 ~;~t~:~t~:i::!-;:::~::~:~ ;::;;;;;:(::~~;::(::~ ;::~-:::~~:,"'~~1+';:;% ~:;\: > 8' p t7 r; Cl c:J it A I I ORACLE / ,I / I IR.!-I,~, ;3 i7A~ R,21'~ ;~"~" --....: .....: .~..}.~ -, :,,: .~..:;<~:~~~,~1 v " .'.:" :'.~: <_:-:l.j../f.:){. RE'C'EI'PT 00 ~g '" $ , 1 I ! I f :'l' ~ :- ~ 8 O'ifi c ffl!j ~ '" m o m ,< IY ~ '" o :!; m 000 ~~"Q g 02, rn en !B~""'~. ..~ --\- '~. :B g z o . o o r- s;- :n (J) 00 f'..J ., .- ii. ~' ej/--l , /--I :,'" /g!013 , ',-...:.,'.':'., .... , '.' ,.'. . :~~~~~~f~~~~~~i~:+ii~:~W~:i~~~!?#~~;~~~~~.\~.~:~;~~.~~:~~;:.;;:~i:::':~:::;i:;;;; , ! I , I II 03/28/01 07:57 FAX 650 506 7120 ORACLE 1i!J014 fA ==' Poetq S $3.00 ~~,. $0.00 t... .", . 0101 . c:;f ~5 "J $0.00:0 \ In ' .' ~,"'. ("" RetumAeellllptF" 41.50. t:C ].' (' . l ..' ru (EXCej:ltfOfGlIl1ad.) n "J'A'" ~ (Endo~em9T11 Required) $ '.......(~tt6,TtlJOl ru ..... $,.2b " " . TotalPo,tfIg. fIi/fIf}-- 1b be comPtet~ trY J.I'"""p",'CI'''Iy. "'-^.,,~ ~_ ._____ N-,,~\~it'l'R._+_-l'-'=~ ----- -- - -- ---PO fklll' NO. St;~t.Ap' No or ..v..eK.~_:g~'~-~-------------- Cliyl~~~",- N":S ()/OIL -3S1'2.... III o *.~:~~:;!~;;~;:~~~":~~~~~~:~::i;;,,:~.~,~+:::;~~;!;~:J~~~f;{:~~M;;~~.~:;~~~tw~::~~ : ru :T InSUJa/'lO"F.- R~.~~ (E~orsemef'\ p.eQu.: speell1l-lf,ndlLng :> :> ..~~~~~t?~f:';8:}~~~(~~:~~:~';~1~;~.~ File No. 8ssecon File Number: Bssecon ......... INVOICE ......... Mr. Randy Orris 99B Goveno~s Bay Drive Redwood City, CA 94065 Borrower: Invoice # : Order Date : Reference/Case # : PO Number: Orris Estate B S. Second Street Wormleysburg, PA 17043 Terms: Single Family Appraisal (Paid in Full) Invoice Total State Sales Tax @ Deposit Deposit Amount Due Please Make Check Payable To: MARK HECKMAN REAL ESTATE APPRAISERS 1309 Bridge Street, New Cumberiand PA 17070 Fed. 1.0. #: 23-2350976 This firm is a sole proprietorship. Thank you for using our services. 01/29/2001 $ $ 275.00 $ $ ($ ($ 275.00 0.00 275.00 ) ) $ 0.00 ~, BRlCKERS AUCTION Complete Auction Service Auction - Wednesday Evenings t:J ;< f! 15 766.5785 Chuck Bricker. Auctioneer TOTAL SALE ",2 35> 6, /..5- COMM. /' f &, 7.5- CLEAR. J 6- ? LJ I ~ SOL"" /-51-0\ I TO 39\1d NOU:Jn\l 5 d3>f:JI"ff Z9ST99LLTL LZ:9T TOOZ/ZO/ZO .,. t:. S. OEPART'1E~T OF HOUSl~C AND URBAN DEVELOPMENT SETTLE~IEST STATEMENT TYPE or LOAN .. I ~) IfHA. , I . -.J . !4.. VA S. J',F.a.NWIlblr ! IIARI25-JJ2 .1. """"...Ift! Cue !Ilo. 'FMHA. ). x CO~V. UN/1';S c sorE t"hu.form ISfumi;hi" ioii~'r .roua SiiiiiMrnro/ac,u"aiseulemi';lciitt. Amounrs paitiia-OIId b.y i;iei;;lieme~t agent are shoK'''. flems mar~'l'd 'PO,,",) h-er.t! PEJd outside d1':. ('p~i!!r:._~ sllo~:1I !!.e~~ f~ ~....!!!!E!!..'!tl'~rposn _ are 1101 !nc:/uduJ in the tOlals. !,.8o,,!~~~r: _.~~_I!~~andTanY~M.ff~an ". 'n E. Seller: Carol)'" W. Orris. Estate - Eastem- Mortgage SerVices' F. Lender: 3&95 Adler Place !kt~!~~~m. ~~l!fl~yJvani~~Q!1..___ 8 S. 2nd Street Wormleysburg, Cumberland County, Pennsylvania 17043 G. Property: WonnJeysburg Borough Lot PART 63. General Plan ofWonnleysburg. Book Orphans Ct. Docket 8, Page 23 Cumberland COUnt)', Pennsyl\'ania _ H. Senlement Agem:- TA-, ofHan{sburg, liP -- . - _n__. ~ Place of Senlemenr: ~7iS Linglestown Road, Harrisburg, Pennsylvania _17112 Dauphin County !._Senle-ment Date: ---l1mh f~,~j~_____ .----.- -~- ._'m_ -. - J. Summary o( Borr01\"tr'i Transacdon ; Ie. S.lftmary of Seller's Transaction . -. ------J---- - 100. Gross Amount Due From Borrower: 400. Gross. A_nt Due To Seller. 101. ~,?~~c!~alesPric~ -.--.----.--- 52,000.00; 401~ Conn-actSllcS'Prlce' --- 102. _~~,!!IP.!.~. _ _~~'~.-=--~-:_~.~~_~ --. r-402:: -perso~~i:~-- ,_~:: 103 S~nl~~~f:'hargestoBo~.llineI400) ~,6~3J~~,~J._____. .._____. _ _ ..._ ,._'. Adju5trl1~~~ for !tems Paid ~~' ~.!!!!!'l~ Advln~ _ _ ,__ AdJu~,tme~!~.':'l~~!I!~.fa~d ~)'_Seller in Advance: 106. City TownTa.'<.es. __. ___. ______,___.. _"_______..:.....~~_~i!I/~~_T~!S._.,,. _. '.. 10':' Counry' Parish -taxes \1.31" 14, 200llhru Dee 31, 130.60 '407 Counry I Plrisb Taxes Mar 14, 2001 lhru Dee 3 I, 1001 , . 2001 lOS Asse,smenls \1ar-14, 200llbru lun 30. 2001 -- -i2iliI40i."ASsCSsm_MIr'I~(i601-ihnijun 30, -2001 109 Sew'er-~fa-r 14, 2001 [hm .\j-;.31.-i6OT------uo ----li:<iOfio9.Sewer MIr i4",'200llhruMar 31,2001 110 Trash \tar l~. 200! _lh!u ~t~-jl:i~f-~' ----~~..~: ~-_. 71O:4!~:...J"!!~ Mar-I., 2001 thru~!l.r !!,~OOJ ,_ 120. GrC!.5S .:\~~~)Unt 'Due (rom Borr~~'~_r:~ ,___ ~~.9~~.~ ~ 420. 9_r055 AII!I"I~t Due to Seller: T.A. of Harrisburg, LLP 4775 Lingleslown Road Harrisburg, PeMsyl\'ania 17 I 12 711.671-6715 (ax.: 717.671-671& ,CONV INS. , 200. Amounts Paid bv or in Beha,f oiiioiTowe~r:-- --- ~ - ~ 500. Reductio. in Amount Due to Seller: 201 DcpOsi!_-E~iStM!?!1e~' ___- ---~~_==--5QQ~~r-SOI,:_:k~~~it.l~T.~~~i~sj__ 201. Principal AmounI of~ew u.n_ _ _ ~ 4~,400.~.r SO~'. Senlem~~argcs to Seller (Line 1400) 203. Eltistins Loan(IJ"~ >-'.-=-...~~=-- . _, .! 'O~. _ t;~~,nl ~~,. . _ ,_ 204. . _.__HQ'!.:..J!l}'.2..ffC1LFi!!!M~~I~.~l..o 205. .____ _,. _____ ,SO': ~!tl?fTof~cLMo"I..8~to. _ 2Q6. _ ,. _ . ___ ._~'_ _______ .___.LL~~~~1"'~S!8!.!~ _ __ _ . _ Adjustments (or Items UftJ!lid by Seller: . __ _ AdJustmenasfar Itl!R1S Unpaid by 'Seller: 210 dty - T~~I~~-=:_ - - ..- ~.~~_-=,-_=~~~_~__ _-~-IsiQ~~~i.!iFf~-faxcS _~~'-.. -', - - .. 21t. Count). , P~~hT~~_ ~___ _n __~___ __._. _-iJl1:.. Co~~~(~i~_cs_ 211. Assessments : 512. Asscssmera 213 9o~ing~ost!~~'Elf~--- _._~. t,5~:~~)l3. qClsinB~bySell~___ .__.. 220. TOlal Paid by I (or Borrower: 51,400..1520. ~~:~~tdKtlons In Amount Dur .__.._f-----'!--- -----..-... ..... JOO'- 'CaSh- at ~nier;:i;~ifro'm Tie -Borro;;r:--- - j 600. Cash at Sddement to ifrom 8eller:--' 3Dl Gross~~~~l;n~~~~ frl?m-~ofl't*.cr (Iin~ 12qL 54.955~~ . ~Ol. Gross AI~u_ due 10 Seller (iin~-~20i- ~Dl. L...'S~ ..o\ml?unr P~id ~)' for ~QrTD\!~ 1!!nC?_~~Ql . 51,400.00; ~ _L_~ ~~~CIions ~!f)Q.~~l ~ue ~eller (line 520) i $3,555.45 i 603. Casb To Seller: _L 303. Cash From Borrower: BOlTO\\t'r. Seller. 1 ha\t' carefully re\'ie~ed the HCD.I Scalemenl dlSbu~(mcnts made on my aceounl r by in I 7lolllNymbft 52,000.00 130.6Q 120.52 13.40 7.4(/ 52.271.92 4,9~9.69 1,500.00 6,449.69 52.271.92 6,449.69 545,822.23 cnt and to the best of., know~gezndbclit(,itis auueandaccuralesJatemenlofaJI reccipt~ and tT3nsaclion. I funhcr ceni(y1lW I have received a ClIp)' ofHUD.! Selllcmenl Stalement. 1~U:~..# Seller. 8.1lTOwer: -1;f fi{1 r!1 /1/ !LA- fO!J The HLD-I Sc:nk-men[ St.1lement which I have prepared is a UUe and accunlleKICounl oflhis tranuaiM!.. I have":::luseU or will cause lhe funds hi he dl,bur.cl.lm a.:.:,:.nhl'lccwnhlhlsst3te..ent. 1\.1 ,~d Senlemenl D3re:\farch 14.2001 \ --I' .-1. ------l. - -! ,. I ! --- f . ---- . I --0.00-' ---- I \ I --.---....... t- 1400. T..al 5.rtl.m.nt Charg.. (En'or .011"" !03JD J a. 110' 502, 5..,,1.0 K) : BoITO....erlnutal'i ~Y8rlK.H~:~- 1i{C/ T';"M.Heckma~ - - - __L_ Sellerlnluals: 119 CarnlynW.Olris,EstalC File Number: HAR 125-]]2 TA K12fJlO') Paid from Borrower's Funds a' SeUlement 75.00. 494.00 . 494.00 I [- 77.00 350.00 . 250.00 . 30.00 213.12 , -I . 22.66 32.11 i3.56. 269.04 -18.71 L i i , I I j2.0-0. i.. Senlemeii,-dlarga ---' 700:-,.."""OiaISa"iti""i Broker's Commjssion: Based on Price 552,000.00 @ 7.00% - $3,640.00 Diyision or Commission as follol\''S 70t. I:S~5:OOto R.E.~t:\x Realtv Associates ioi T79fgo cO' RE:\tAXReal~S1Oi1iiS- --.-- .. -"Or.- C';mmission-Paidat sCitiemcnt- 7OJ. P~~~~i St!"~:i~iF~io RW~'~.~~_A.~!~ ~ . 10;: ~~essins.!ee!o REI:\f~~ ~!:!I~~Jc:ssio!~L_. __._ _..__ 706. peed ~~!~ Q~les & ~sociatcs (~OC so.~_. 800. Items Pa\'able in Connettion l\'ith Loan: 801.loan~g~i!i~Ftclo!UiCf!M~J.!ga;~Evices_='~--- - ~02. l~'!'1~QiscauT!!. ~_~~ M~gage~ _.-___ 803. :~EP~i~1 E~.-.!~.~~~ ~~SBge_~~_____.. .________ so.s. Credi[ R~_1!..~~_Eastem ~!!g~g~ Secviccs ____. ___"_ ._._ ~OS.lend~~1!:!..~ion~____ _.__~_._.____ h._ ._____ ~~6- ~\Io"gage Insurance ~p'pli~~~_Fec __ ______ ____ S~~'.:~~~~f~__ _,_ . _ _. _....________._____ ___ 80S_ A,pp!icario!,> f~__ ~_East.E!'!.M2!,!gl!~ Services (poe S~~~.:!~O) 809_ Real Es!at~ T_~ ~~~~f~ ~~~~ ~~!S~S~i~~ ~IO. q~umenlJ:!gl.f~_!o_E~[~~!!i!I~__. ____.. .__. 8 II. Commirmcru Fee !~ ~~ P1o.!!l,!g~~____ _ __. _ __ 312:F~I."'!!.E:tpressFec 10 Easl~~~I1,!gl!g~Sc:rviccs_. .~. 900. H!f!1.!1le:quired h~~~~_!~ ~ r~~_iDAdvance;___. _ ..... _.. 901. !nt~~~!!.o.!fl \tar l~_~Q.Q~ ~~~pr I, ~OOI ,@ q:~~~ ~~y 902: ~~o!,,!!S~ (nsu~c:.~~~ _ _.__~__ _. ___. ...._.____ _. 903. Hazard Jns~~~~ Prcmiu~ t..o_~e lns~(JlOC l~!-Q9L_ __._ .__.__. 904. Flood Insurance Premium ~~..o_O. )~~~!"'~-P_~po~~t~.~1t~ Le~~~~: .------ -~- - _~_ ~=.~- ._ l09!.!i~~!~~~.~.!!lo.r:!~~.@ .11~n~~L___ ___._n.~_ 1002. ~1ongag:~tn~l'8Ece. L_ml:?'!.~~ @~3~:!L~month__ 1003. City P!O~. T~~ __.~__.'__ IOO.t County Propect>. Taxes 1 .!1:!~hs @..~~J'!!:month ___. __ 1005. Annual Asscssments 8 month$- @ Jl61 P".' month . 1099. .~ggr~!leA~~nrin&_A.dj~st.!".!!!!..___ _._._.._____._. _.____~. i. ~ ~QO: _T~t~eJ~~!!...rg~~=____.__________ ___.___ __________._ 1101. Sertlem!Jl!~!.C~~!!!8F~_____ ______. 1102. Abstract or Tille Search 1103. Tidc-E~~{~~rio~~.--: 11M. Tille Insurance Binder- '1 !~~.p_~i.~iFeparario~___=____ _~-_~=~_._. 1106. SoraJ').' f~. to T.~ ~fH'~!i.~burs. LLP _._________ _ u""_ 1107. AlIomey Fees (includes above item numbers: 1 tOS. Title'lnsurancetOl-A.ofHarrisburg, LtP (includes above item numbers: I 101.1104 1109. Lender;ico~CRSe 49,400.00 RiskPranium ---.---(f.oo-'--_._~-- 1110. Ch\Tt~!~o\'erage --=-=-~600.oo- -Risk~~~:_. ~'s40.J.~_~. I! I J. ~!!t!~~~~.IOO.300,8..~ _r~ T.~,_~~~~.____.___ 1112. <;:lo~!!!g ~eQic~!:-ent!...!l!.T~._TJt!~ln.~I'IDCeCompany ____..., \113.2001 Counry_Taxes 10 OennisP.Freisrak ____ 1114_ HomeWarTantY-toAHS------ - ----. 1200. GQ~~!"!'~!.RHord~niind-Tr.nsftrCbal"Res: _ __ 1201. Recording fees: Oec:d 25.S0 MottgBge S!.SO ~e!~_. qQ~. ~~tt.CounrY-taxlswn.2_S:__.~~~. 520.00 MDJ1R!SC-- ~_ -~~~ 1203. Slate IU'~~P': ~_ _-' gO.OO .M.~sase.. .~,OO. 12~. t205. .----" 1300. A4diti~~~1 ~ritlemen~-Cb!..rg!!~~_===~~~.. _.__.__ 130r.Survey __.__ 13~2.PesrJn~~nj~Pcnn-P~' _. .____ _.__. 540.75 150.00 is.oo. 77.00 . ,~O.OO' 35.00 $2,683.53 Paid rrom Seller's Funds a' Settlement 3.64U.00 250.00 12.00 162.69 365,00 520.00 $4,949.69 _____03/28/01 07:52 FAX 650 506 7120 '. -, ',.,' ::::'::':;::::~~:~:;:~;;:~~~\~~:~:':;:~:;:~ ORACLE G!l010 ...,~~-".... -'- '--li- f.l.._,..,~'t"'~'''f''''''t.:i.,,,.' 11-.-, Ir- .!;:/, .:~:~~.< (:;...~~~~:: Ei~..'J,~l~-.h.~""i#i"::<....;l;...r,, ~," f',-,'~~.;' r1 c,.,- ~i t.-, .. ..... ';'~ ,. '" ~ 'oJ: ".I':~'\l:' f4r'1l"f. [. -~ 4t!..-Jt "~:,. };;.'2tA"-ii, ....,'I~tJV. . r'At;'-f"'?~~l"'~i '...~#:r,:'-.3,~1 _ .:' :"."It~ -~. ~_.;._: 1lI;'(,f>..- "$'i~'IJ.-' .,:. :,':";f,'t '~,',t'.t":~.~ ~Ji'\;.~;:~l~/_,::: ~'rs.!; $16 77 'ip.;~ :>:.';if.I.';f '".ro.t" . ~i>:<' 1~ITJjWW"f -16 .77 {I! OQ'l'~!"~"'I' .00;,' i;~' .~;t.~;~~~::" ,H."-!:l.1:-:,'iI.'''''':~"i-'''' 11.-~_~J.'1. 9. 7S . :'::~Nf~~(ii;J"~~ f'~;'~4 . .04 ::t:}.''1~! - 'k.',: l."",," ":"~ff.~29~f;5 ~A:r: 9 : ~~ -19.. . ", .' . ;:r'tJ.\ ~'~itl-x \/:// 'b.J~.~OO'.i:;; & ;:;j: !.'/:./?l :.. /~~C~; ." ;r,>~~ '\\Yrtl~j{,;'i#~t;1 1.00 1.00 $10,861 " :0.- ,\1 l ~)~ ,y~t'~r " ',/~;\\/' .~~:i .'.t;;". ". .:",' ~ .". '.. . '.' <..,.... .... "~..~,,..:....., ...... ..:..I.;.;.....!. :~,....-.',..../..~;...~..,-,~.:.....'.,;.~.';,f...~,. _':"'~'. .'. . t. ~ , ~'I ~ , .,: -' p ,,' -, ':',: ;'.::;~.-~,~.:;.,'/~'~...~~.).:,.......'..;'.- "; Water.Us~ilI:OIlfP~~9Jl." :;\,. e,...: . I '..Mo","I, u..~j~.~uriilr.~ll.IIO".. . I .,. , .) .' I '.1;~f*~~~?t;i;i, I~ f i ril;'dt;~;~(:'~E.~S'.?;'iil.r:llWXf:l,~ijlf;i.<i;:. :' ,'.: . y~ r:!.:~~;:',,~~,';:'~~~Xb~{' ;:; '. ,',,~~{t;.i~~~r >.~. . ~. ;. 6~ .; ,;;~z;~."~~', "-:':f.~i' .",', ~n'" t. . ,:1 ;;::~ ~>l'L': Messages to you from pennsvtvllnl. . American . Any jJoriion of /hIs water biJ willch rs not paid as of 311!101 will be subjecllo a 1.50% ponally. . A VOID COSTl. Y SERVICE LINE REPAIRS... To /eam how yriu can plDl8ct yourself against unexpected and cosily service line repairs, call (800) 565.7292, and ask aboullhe Water Llna Protactlon Program. Your peace of mind ;s worth It . Effecllve January I, 2001. "e State Tax Adjustment Surchlllf/9 (STAS) was Increased /rom -0.44% 10 -0.43%. . Pennsylvenla-Amerlcan Holrter Company Is a proud recipient of /ha 2000 Governor's Awam for Environmental ~~nM. \ . E/fecUve January 1, 2001. the DislribuUon System Improvement Charf18 (DSIC) has Increased 1rom 1,01 % 10 1.49%. This charge funds ropIacement of water rmlTfbution fat:Hllles, . Save lime and money by SIfPIlng up for Pannsy/vilnla.AmmIr:an Water Company's BulomeUc paymant service. Your bfl/ will ba paid dIreCtly tom your checking Dr savings acmunt at your bank, credit union or savings and loan. For more If1formatton, contact PA WO's customer service center f{sIrKJ at the bottom of th;s b/JI. QuesUons? Ca" 1-800-717-7292 Weekdays-8;15 am 10 6;30 pm Saturday-8;15 am 102:00 pm Emergencie.; 717-774-2420" PAWC, 852 We.ley Dr.. Mechanlcsburg, Pa 17055-4436 Inlemet: www.pawc.com AIM ,n, @-= FROM RANDY ORRIS AND KAREN FOLEY :5eU'i?~ r:eC:"1pt 14 151 221947 TEXACO RT 11~15 L>'t1u'IHE PA InvOice OnTE TINE R...th # # 9281376 (j1/.llV200D 92: 17 PN 98502345 AMERICAN EXPRESS RCCOUNT NUMBER XXY~ XXXXXX 02914 ORRIS/RR Selr Serve Credit PUMP PRODUCT PRICE 08 UNL 1. 399 i~'~'~:~:~;;~:~~(.~~::::,~~.( GRLLONS 12,620 TOTl'lL $17.66 ~~~.. G,,?,l... '\\ ~ "';;1 1...., '.':r.l :=: '::: 0:.,", . .:t::: r.'O';. ,:~j ~~ !~:; ~ ;:.-:; -.. !-. .-... n.-:r.--..... , %'B.....a:::!;\ ~.;=.......-~ ffi~:~~;~ ,~..-.p,..'..' .. ,"\.., I:"'.' ;',_ __.,J I~I" l.o..\ L,.( L-W ,.....,..... ~~, :c::: ::= "lI::: ..- ~.:,) ,;,::;. ;;.:.r .'~_ "...J .r- w- ':10;:-'''' .."J:> ;'-- :;~ ':'..1 ''''" 1i (~ ,....- q)'~~ ,-- ....... ..~. ~.' ~~ :.':.~ PHONE NO. 650 631 5619 f';:i~:'~ S T1:,:"?" ? AU70 :;1) :~':.'~.~.~~:. .]iY-:k:.::'TO!.:.lf-! ?O!:';C. H';::\~.~ :~~S:URi:~~ PM 1712t~3 '?"i 7-'~,~-::;-8981 ~>:": ~~-!: ~~.3 S~-!. -:-.~ ~~~"':-7 .:"};:';.j?3 445:~ ?~~?~? . ~~' ..~:W, ',:: ;1:~~: ~~.~ ~, 1 .-", (!""'..' iT) ~\ .:: .~~ l~'~: i:;:-t:~ ~ ,'~"",- ' ~ ~J'~'; :.~~';:"i~~.t:'.:'!~:;~ " :I~.{_~~ ~:=: 32:....~ +":'d~7 ,hrK.g~ 'C;(c.C:fB";:;C;';';'''EE:' ~;?7 iF ';:'7'; :+:-:(<~ 'I?;E~:, ~.\! II!: P.1~I~r 1'; f!-:f ~~'-',:;:::":';>::'; ;.s~:~"! ~:iO,~ m ?Er.j:i.f.N ;'':;- :~-~ :~::C~;:~ :;8' ~r. So( r~ tf~'':'j~:i:C':;:-=''TI'!:'::r:JZ:'~\'~ .<:'~J;:':\' , . "~7. -""/ - .'--- /1 // l~/?tr~ ' '-Ih:. I~ ~_L> --- . " ..,. :';';".,~~SH"~ii ~.l!~ ::wx!~USi0~ ":r.f, . .. . .....~,. ' ' :7~ r',. i"'~, cr- C'" , , r...... r.,_ 'l""I'I'-! ...... :~..I ':_'~ (.:0"''- -'.~ ,~ ~"_l .~es.' ..::.;,. =a. ~fj ...., -.I 1.."l.."'I .g:: ._' ;".~ c.~~ ....... .-. l"'A~~1 '~r:x1"".1 ':\, '00 "r ~~S~ ~: ;;: &1 f.::~ ~ ,'~ ,:-::;; ,';0;: ~}'!!4:. JI"I::\:, 1- ,- :Z:O :::H... ;::;l:Zl J:........: .,..... ... :oc::~ ,..- ...... '.,....:. 01 r-i 01".- i "'" i ci i I _. i I {'t i I I 1 I I I .01; '" " " .>- .... H .. :::l .... ,... <t: r~ r- ~i:: 0 -I FEB. 132001 11:13RM P:~ -SUNoeo CARDMATIC- SU.l1QCO Best ~dE and More 17'41 '07 <::::"0i/11/110 At1X Card Sale 114/02 I #xx,oO,Xloo{xx2B14 INVOICE # 15536-2 APPROVAL # 545893 I PUNP # 137 2.963 G @S 1.439 Unl Reg dk 4.26 TOTAL (::, ~4.;~) &i-<':. - - S0! EISENHOWER HARRISBURG PA 17111 n',ank You. Plea5e Cone A$ain J , ,', ,. -, , ~~*:~~!~1.-::~:':~f.:i;::;::::~:~~;::::0:::;:'i::;:':~;i:~:;~'~~;~~~~::.:~:~ ,';,:<; ~,!.J c:S ~- ~.-'l = ~ " 7- ~;::.:: .:,)..,., I;:':'';;';';': l:...,':.i:) "j;;: '1-".. I.w ~ _.~!~ I %!:i:ic' I a~~ t\ i '~'t:=""bJ' , :~~ j r-'~~ ~ '=' ~..... ,,,,::; I'..~~~--"" :=~J ~ J:..') ---' r 1-- ,;:..-:> ~._~. '" ~~::'..1 0.." ~21...;! I I ~ ~ .;E:::'i:!fu<::::::"-'::::"'l ~'C'l'= :'- (...~ L.o.i Jf \..L' l.~ tEr.::;;':& . ~~;~ ~:ll..., ':.1':: : :~~_ ~e~ I "", t::j ~ ~):~.~? 0= OQ::; :L. L,.~.'-~: ,~.- " ~ ".". ~:~~~. !~:;:i-~;4f. FROI'1 RANDY ORRIS AND KAREN FOLEY p.n.~ (I~'F.X leXm<XXKXXXX2tJ1.4 p.~ O'tRIS CreJit S...1.. ~RF.DIT *488689 66 1.2:1.8:33 REG '.1.985 d14 ~ 89 ~ ra{~' (;l'--S :!~:~::.:.;:,~;;!!~A::+:~~~~~'1}~~;f:~ _I --. !;a.-' " ,H. "'~',_.. S r.::;:\ ~til ')'" :=.:i ~'l'1,'1 ~"""l;l Cl i/)~~;:5; ~.. roO) 'llf.~' ~.' '--I ~.., -~.. ""::::::1 ~ 1 ,~::.x= ~=- ho: a~t.~1 /- ~gl"'\i c: II J:7 '~.o--! - (,-:. .=., -,:,r~ ~;:3",":,> ~- <= I ''f.J'' .. ~" rnrTJ ~ r"'"!t""";l.-.: ~~ I, ~~::r.~ '"'=~- r;>""~ 8 S C., -l ;::~ ;~:i :;;J: ~l =-. t_. r."~ "'>'I~:::J ,.~ C,..,- ..... E;:::"'~ "'" \ r..,~:> ::1::' ':,,~ :"l.,"l --,~ ~~., 1\' ~:::c.F: :.=: ~~ ,"', 1:::... ~'"';l %~ !\\'~\:~ft .;.-';, ,J -:':'I""I~:: 2l i ~~-1 "" " ~ p, [~ :':ltl i ~~.\ '-g o PHONE NO. 650 631 5619 HARRiSJ:llllli INll AlIlPrnl IlCNlAl HEf1FfJ' 693262764 RltIil'I C!1I\I. COMPWItl) Rv, 6949 I<('N I<D , HA~'.8WG INn AlfRlRT RaHAL. 01l1UIOI 18,43 F-l'lWN, 01111/01 16,03 "llES IN, 10710 ~JT, 16632 "'LI:.IJHlVEN, /8 I"'l!o..~ "IAN INIOIIT, Inn I~ID \.J" ..... CI.S, I T'~""j{(,..~ I OAVS n.!!!l 12.:ll SlllTOfAL 72 G'l l:t"'A.l:SSlliN h::t. 1d.()JV~HV t,:.1U IX 8.000l: ON 60.29 G4~ PA S\~}.'At!I" ~ ><<:1 Olt .71 FAIO RV. AHX 'FeDIT CAHO I, XX2n431~~ Thlln~. 'jOU fot' ren~~ Hertz -i ,..., .-' -i ~, r " "- (,'J:t' '.. :t.l c::t. :D 1110 -" -Ie::: C 0% 1-, -1-1 --I ::CO.. -<: r .. .. ;fl' ;;J.~ I I I ::a::.:=t:'_ n'1l.'"",:. ~ .....""'-~ :O~':o,)s;! .:::;~::~:rr.:;' :::::i~~g: e:; ;:t.~;.~;;;;:: I ~.... '_~ .....-..1 _ :::;;~=:;'t~ ""w -:;0 I t3 1:..:' ~ "" ~, 0-. MD 39 .45 l- I i . ~~~:~~~:1;f~ f .. t , , I --::j- ,,=r 8 r- c.:.l .' ;~ 1."" -..2 t ~, ,~, ::.::, :::.;.r ~. ,.' ....' .., Vl 1:>J : '" ., ';'. " ."~' rv1 .- ton ;'-J ~ ...) q. ,-. l" ,",' ~ -. '" ~\.<: ~ ~ ...:; , ,., " lIJ ~i .'~ ,. ~ t,jj ,- ~.. ~M ,:;.!': -, '" C f:.~ ,~ .., - ~Y': ~ :7; ~ ,-- .- " &; ." ~ ,,,, ,.., 0 .... , ,~' <:-.J .,- .::r; :;:, ,... ,~ .., "' "" t.:';, ;r .- L .. ~. "" '" , , '" r.:i' .~ ~, ~ ~ ~~1 ~ ~.1: .. .~'.' (l) .. '" '" ,-., ....-: u. .-." 'J" e," .'.J;; ~ .& - '" ...1 ::;: , ~"',: .:0::: '" .u ., .. ,.- '" .~~ ,'.. 0':\., .' L 0' ~~o<:' -- > .. '" ., ~i '"~ t:: ,y ~ , ':." e 0> ''-' ':';., ~, ..:::. ':. :.9. ., ;~: L ~ "' ,""; '.,J ." ~ .. ". '. ~ .. ~ '" ~ ::.:: "IT: '" ~ r., " .' ~:' <. 0' L.;:;I "-' ~ .'&. 1."-.: ~. "' ~ --.. q ." = 'u ~ ~ ..- c. c, . .' " ,"'. -.' ~ " ,':":) ~ - ~ 0:_' ::.,~ .. .-.~ ;;: 0 Q ~. ,~ ~. ." f; 0.' ~ ':' ,,, .,"~ ~ -ij<; I ('-, i C" :"c.c- .~...l. 'c' --J I c. ~~ (JJ r0 ('.:1 . , !)~ I)'. ."",j ...J :::=(..;'\.~ c= -..II;."C. -I r.) '.0 :c: -~I .....-.... --I~::v ~~~ ........ , .,.."" _~::S,..., ~;:ZT.'~ r", .r~:;tlO ~... ,- ,'., 1"""'':''';\ >~ '0::;: ;,:'?;' .-<- ~= ::;';:t">.:J '" "" 1:llI;f1o.... ,....~ Yr,:I' \!I;>'.'" ..c,,-'._I .-, ~ ~. ~" ." ." =:r~ FROM : RRNDY ORRI~ AND KAREN FOLEY PHONE /'D. 650 631 5619 FEB. 02 2001 12: 16RM P'" , ',J I";U ..JJUU p.1- I~ I~ SCHULTZ INTERNATIONAL ~lbfifPJ1JlnmJ@ @1i(f]@2 t. , L.~. jo h-"ik i ~.._' , 'ro }".(:)-- ~If, Page 1cf % :J CORPt'!A4TE OMSION CA . 936 hltTftou: ANmr.. Herman 'ueft & C& 10254 . 1-aOO-I--'RONt"O :J CO~POPAn: OMSION IN' 9905 EJlIr...1tt. Hi;NItI<< . Ill. ~'3lZ . 1-!O"....~1J$1I :J CORPOAATf OMSION IX. 1104 H.lndu_Ad.' DoIlu.IX 75101. '.'O~77.nxAS tmiGnal'TolI Ft~ 1-800.637.8764 'II 1-1011-33400931 -"';':. '-:,"i':'-=--,'.:7.:; t.~>- :: 'fl@ @{ljJ1J WtfJD{IfJ{j[/J 1fj@@@{jf]{jJa I - 1(.- 0 I 1~ Date Car AY2Uable: :r::vv......,,~Difl:n? loday'a Dale: ~ 0 Across America DI'iveaway ~ ~ ';;f~F5~~.; - . ( . ! 0 ~R~~~lt~!i~g~*R!~~~ Across Am.erlcaIrucking 0000, R:,"riC"'>..:Jc.E- ~h7"'i..:j:.a-s.,", (!.~/fICI5 ~f.Lt. ~ T"'" __ ~.,!*,,"..' ,....- OVERSEAS j~"~ ~~~-r~~~ ....~..'..._"''''W'O,I,;':''.,.. ~~ -.;1;', .............. .... 'JT-~~ "tl'n.I_.n.looepp/nk..IIY.....UOlif'IlII...._~In....paldl\lllUll-.c. '. ".~ - ." 8 ....., t\-\E.'1IWlf; - tl\\lf\L\~ :g~ ...,.t'"-i'"s~h l -.: <\ ~Q 11 .....",..- ceel (<,:>.-' CRR., 1~ G 3\-.S(.I~ ~~ \l..o""u.t~ ... ..~ 3'1 -0 ~. U -\*\04,8 - l'Mur-. CJl:JDrQ cosr. DEPOsIT: BAl.ANCE: r=~: IIAlAHCE' s s s 1 !0 '" , , con I ~"r":.Ot) D8'OStl! S , '1~.O(\ BAl.AHCE: I "') oo,c>o CDtt I D8'DSre S _E: $ s S J c '" ~D u IWIILfIl ~ ; S ^tD 0 ; ~ 3Co 5. ~~o\rtU.:.<;. !>l...t hut vehicle lemeed Wllldy III go. = wtmwmonllll!1I a~"sable III hl~e ell>lnl DllnICllon dewtclIIln . I'l/lldeS III "'Quimf fa lint I Ml '""" 01 OU _l*k-IIP (IlIIveIWIY amy)1 Speti>llns11l1C1lcns; <: I_ID IIld Il/IIIorizt!l1llspDlIIllOll rlfY"'fell II A11~ an _..llIe ,,1M> 101m. . M.i1deposllla;'ltCA OrN OlX (SttMewtsmml Notr: PAYMENt' c_C........,naIb1...dlor_lIIlustlll.S10llG_I..tIlI..1IUil1llfr. tl-odII....._~,.,..__..._t . ....lpI(JlII...,.'..lP,....,. __...,..........111.........,. ~....CIs/I.~CIlteO, orll_Onle" ;0-$818-' ~D*_ I ..~ 7."a " 0 =- lJepO",--J $ I Sl1N4 I SC!<Ul.Tl 'Hlt~"AnOll~ T!WlSPGlll'$ _CllS _ WIlll Ulmtll StA,IU'l\IGIlTS UlIlmI m DMSlOH ACCfLElljL1iIl 01'.." CQIU'OIlAnon IIC Z5l:lS~ :;"<<-G.....,...,'u'r-t. 01.,................. ......_1...... Sf"'" X JAN 16 2001 18'09 3113 798 3300 PAGE. 131 ~ I ,;.' ) a: ~.:Y!"" ~ ":. '0: 0, C1 \Z ,it 'a. - .:z: o ..,t.-, ~' a: ,.: '0.; \ i I iU, ~ ~i li ~~~'~;':.::.:f{, ,:::>:'.:<:'.i. . ...~TT.n ,00<: n '63'; 6'% ,~9 0S9 : 'eN ~d },3<OJ N3ClCi>l (JNCl 51 <Jdl AaN~<J : WO<JJ FROM RANDY ORRIS AND KAREN FOLEY PHONE t-O. '; A~i;;~ti;;t~::>t2 ,. .~<~. .,' <tn . 7i;;fe\~~~f'''' j;,'.......t3Cfusli.Feli is:'::',', , .;,~q'!8oo.J4ls775;,;';>:' ':~;:;.~':::'::Ol:";~t:;o; ;:;:',:'. ',.'.' .:i:'~~~:-' -;:, :<;ustQ'mct-''s~rvi~e 827 !'f3~~.'iI'~d, .",.", ~:;';~'j~~~li1!:;';0;'i;'!z; -":.,:':!,:\;1:-':.:;'-':. EI."'..'" .,.....'........' edv~c . Use '. I ': .:':~::::~~ :~_",<', '; This grapn;s~~ws your e::lecrnc:use over the last 13 Dl0Dtbs. Tvpes of Mekr Readillgs, AelU.1 _ Esthu:ucd tm Cu::::romer o " , -..\'..:J/..- pp....fji~: . -- .....',.. 650 631 5619 FEB. 132001 11:14AM PIS ''age 1 "lIll'" ,UM.l",," 02560-71002 Account Balance 30 KWH. Average Pcr O:l y .. '."'aillib".or:writi... . $0.00 $ 43.67 $ 43.67 ~~\\J 1t\ Meter Readina Information . er J.n 25 Dec23 3 . Actual AClu.. KWH HJlled .;~~~:i:~::;~~#;1 15022 14585 --u7 2001 2W 13 Ave-t'age- Montbly 627 436 Olber importanl information on bacl, -+ .. ________________~...._________.__..___ .....______~.._________n__..__.._.._. ...._.._________________.._.___...__......._.______________..____e______. 2S 20 IS 10 5 () JFMAMJJASONDJ 2000 Months 2001 Average -Jan 'fcJnperature KWH Per 0:> y Yearly Use: l'Ob 1999. Jan 2000 Fcb 2000 - Jan 2001 2000 32F 28 Totlll Use 7523 5226 03/28/0~~5 FAX 650 506 7120 -------- ~~:?8W:t~*1~:.:.:~i\. ',.' ,:.,' . El~~tti'~':':i::j:~~1)~~1:' . Use""" .".,.,ji:::, '.\,':.;\'(~':'.\ ' .,";.'r\'~,:;;',: ',_,- ',.',"'1""'."__' ~~i~~~ri~h~:~":. '~~:(?)' over tbe:last'J3'" mouths. Typ.. of Meter Readings. Actual _ Estimated _ Customer CJ ORACLE " , "II' ''",..1, ~,:......~.;,., ppl :::: :-.- ....... " ~ Ii!1012 Page I .~;i:T(:: ':f;i::( '-mc~t,~;::;" 02560-71002 ,';~;!;i1ii'~",;"." 1". 1?\~fJ~~;';; Summary Page Balance a, of Feb 23, 2001 $ o.on Ch4rjLe5' TotafPPL UTILITIES Cb4rges $ 30.59 Total Charges $ 30.59 _IIJIIWJj:~_,~..ifIJ Account Balance $ 30.59 ;t.:1A~r~#:~ 24 KWH - Average Per Day Meter Reading Illformati..u ~r '" 20 Feb 23 Actual 15292 ;"on 25 Actual 15022 16 " Da'- e -----nn 12 Average. Feb 2000 2001 Tem~crature 31F 33F KWiPerDay t9 9 8 Yearly Us.. Total A ve_ra~e 4 Use Moutb r Mar 1999 - Feb 2000 7448 62 0 Mar 2000 . Feb 2001 4356 405 FMAMJJASONDIF 2000 Months 2001 Other important information on bac!, -+ ~~ n__ .. ____~ ___ ~____ _ ~__ _ __.'..__ __ _ ~_ . _ u __ .__~_ _ __~ _ ___~__._~__ ~_~ _ _ ._.~.. .__~__~____ .____~ _____~__ ______~_ ~ __..__ ._. ._~___. __ . __. __ ___. 03/28/01 Q1~58 FAX 650 506 7120 :i:ft(~,;'.r;':F;';~:~:::!~:::~;::~W~!:': .....$:. coillli\jJ,us . . ...\J,,~OO.J ., :'::". bf,::~~'tti~~~\f,i~~r~~J11': '.l. . C!ist\>irl.. er Stl.lJ.. ~.' e: , ~2'fI.~$m~n'I'\\I~' A1loprown;l!X:,' t~l 04-9392..' ;., "',ii';,;, WwW,ppl\vo>b;<&Di", ,J::"; ~i,U;: ", I:' .. Electri~i':" Use this giaph llhci;"'. your.electric use OYer the last 13 Dlontbs. Typa of Mfter Readings: Actual - Estimated - Customer CJ ORACLE .' , . ~'f I '''",\.''::l~~~ ~ ppl J~~~ " N Summary Page Balance as of Mar 14, 2001 Olar~.: TotafPPL lJ1lLlTIES Qqe. Total Charges Ij!J 015 Page 1 :O:!,-1gkj;.i\li;i; , ,_t:;:'::,:1F:~~: 02560-71002 :~r.:~~ff~\::~ . ~~9!:":i~:;:; $0.00 $ 17.58 $ 17.58 Account Balance ~'"C.~t't:{~"'f"~""~""""";.N\"..,,*J~""';'/"^' ~ ;:..::: T;;"~"%'.~'~~f: ~.PiH~.,..r.w.r'+M.:;,,~ ?:A~,*~.l;.~;<'4*}'?f~le';t:=";lo:~.J:{W .:.;<;),~:<lJ li!;f:~~'f.\~.~!"l ~~L~;"I:~.~ l'l:~~JS~~J \:.;~J'~ ~" ~;,~ .>~>\: t!i:1)~ ~<~~i;'~~~*@:~~' ~~Vk~<-~ , ...x...... ....",,_ 1 -=-u- _ ",,_ __~_..,-......__..^'l~_ )~_'c _ ._.....'"_.... ~.~,.......~,.._"....:.:.-;,<..:;:;~~~=.~ $ 17.58 24 KWH - Average Per Day Met.... He.dlnt: Infonnation '~ er ".' Mar 14 Aotual 15448 .... 20 "'" Feb 23 A"lual 15292 ';.: 16 I e --rn; Avenge - Mar 2000 ZOO 1 12 Telnnetature 47F 35F KW Per Day 16 8 8 Yearly Use: Total A ver8~e 4 Us. Montb ; .. Apr 1999 - Mal 2000 7259 60 0 Apr 2000. Mal 2001 4544 379 I I MAMJJASONDJFM 2000 Months 2001 Olher importanl information on hack ~ ___w_~__~______~_~~______~________~___~____~_~.___~__~________.____~__~~_~___~_..~_____._______~_,.___~___.~_~___________w______~_w__ FROM RANDY ORRIS AND KAREN FOLEY PHONE NO. vel 'IU'~ ~ Summary, of vour account 650 631 5619 FEB. 02 2001 12:23PM - January 10, 2001 Charges from last month Amount of your last bill.............. $13.43 ~ount you paid through Jan 12....... -13.43 Amount you sti I r owe.............................. $.00 Charges for this month Our charges.......................... $14.38 Call 1 800-660-7111 if you have a question MeI WorldCom charges................. .4.21 Call 1 800-660-7111 if you have a question Total for this month.....Due Date Feb 6 .......... $18.59 $18.59 Total amount due A late payment charge of 1.25% may apply to any balance carried forward to next month's bill. Cont i nued ._.' .....,. .-......-.----------- ,_..--.'--------...-.-. , -- 03/28/01 07:47 FAX 650 506 7120 ORACLE ~005 Your AT&T C'~'1tement January 6-I'cbl"\Jary 5. 2001 ~~A-n.T ,eWNCJFM ,0916017548301 e_ 0 52060AB10.27aB~5eA74973 11./.../"11I,,,,".,,1.1,,,1.1..1.11I....1.1.1.1..1..1.11...1 CAROL YN W ORRIS 996 GOVERNORS SAY DR . REDWOOD CITY CA 94065.2205 Customer # 711763-9835 Page 1 013 Customer Service: 1 801! 222-0300 Text Phone (TTY): 1 ooe 833-3232 ;~rih\'l1f.U~Y:;df~;olf.~rgc~t'~'..)~'.,: i, Prevloun balance. ...... ..., ...:.__..."... ...... ".. ........ ............. ...... .....,.6.00 raymanl received .Jan:31 - Thank you".....................,,,..,... -6.00 AT& r direct dialed calls ............................................................6.11 Olh9r c.harMs ~I)d credUs ....:.................,........................""....:0.60 . , ...J.llxaa and sHt(jh"'gel&'-.'''''."."''''..c......"........:.7.....,,..:..~..:;::.:;......o:or ;'rbIAI emount due $7.32 , . bote dlle Februory 19,2001 ~ N'O ' '. , -- "~1r\\& ~ ;'" ~ 6~~ , !, ',;."" "":'"",,,,;:.'-,", ":/'::J;;;ij.{:;f::'.;:';' . ~~~~I~~.~ij~:"l'lilt~ . 03/28/01 08:02 FAX 650 506 7120 ~'~:':::i;:~~:~r.~;:::.:::~;~.J;?~:~t::i~:1,:f ORACLE ,__~"~,~"""""",,,_, _ ._.~___~. ." _ _~.c.. __. _ _ - . . 1i!J017 AccDunt Numhr 650 631-5619 730 N 3159 State.nent Date, Mar 2, 2001 Page 4 Mel WorhlColn Accoullt Number 7H099435 Queslion. .boa<< your Mel World COin ~iIl1 800-444-3333 Oltlin. Account Manager from Me, WClrldCom: www.mcl.comlservlce y; Mer WORlDCOM (nvoice Date: 02/21/01 Current Charges (See Service Summary) ...................... fij;;:[~1:0#Wf:.~~~:6j~?;~Ej~:'J~i~~~tt~i~@~ij~:1;i$:<<tjj~1~ii~~i:r~j~~~&1~t[~~m~:i~~1.~1ti~ti~ii~ttm}i~i!}@~!? ServIce Summary Long Distance.............................................. t.~:ii~J:\:ij4:f:f,.~1t~hif;;~~:!~:;~ii~ti~j~tt:iHjfMi!:~it~~~tt~1i[~&i~ii~~:~!i~ti;ijt~:itt:~t~&!j~~~~&@mj}i:;Mif{ :mg Taxes and Surcharges Federal Excise Tax. .'......... .............................. f~-~!.:.t:;s~iWf~~{!jt:H~~~:tl~ijj~~~:~ij:~~~:g}:~1~~~itt~itt~~:i~i~i;~~~!&~J~~i:~:&*~~i~~i;~~~;i0.:~~M:i~:.w~l!@~if Please remember to pa~ your bill on t;me.each .onth. Failure to pay your Her WorldCom- charge5 could r~$ult in the 1055 of access to Mer WorldCom's 9reat products. It could also lead to the involvement of a collection agency. Your local telephone service will not be affected by failure to pay the3e charg~s. All telecommunications carriers are required to contribute to the Federal Unjver~al Service Fund~ Her WorldCom~ collects tts contribution to the fund in a Federal Universal Service Fee CFUSF'~ This fee, assessed on your stete-fa-state and international charges, will change to 9.97: on Febru4r~ I. ZOOl. l..ang Distance Call. from 650.631.5619: Date. an 2. an2 3. an 4. an 5. an 9 6. 8n30 7. a 0 8. an30 9. an 10. an 11. an 12. an 13. an 14. an 68.81 2.34 iNimUm;;mNHd$ ;,:,:,;':"':'~;'-' 82.81 B.20 ~*-iM}i"...' "u .....:.;.:,..;.;.: .........::.:':.:.:.:?\:::;;: 2.01 ..;2.7...... ..<\)"4....... ~\ / /.",~- / ,,\ f:t<.' 'I' .. R.tu Minutes Arr~T1 Irect a : Irect ay reet II reet a .5 rect a 2 6 - rect a .2 rect ,y 2 Ireet a reet a Ifect a 0 reet . r. . 'fect . reet a S.G Roven. of Face Plge lor Type .lId lI.fe Jllfonllafiol1. continues . 6 6860 BC35 lA 6506316619 730 940650000 RTEN 9240 03/Z8jO!~54 FAX 650 506 1120 ORACLE R'iii'PIU -- _:II lV"" ~Ol1 Mel WarldCam Aocaunt: 1 M073062 Telephone Number: 518518-3809 Customer Servlee: g www.mel.com/servlc8 Statement Date: 01121101 -t-::. . Page40f4 Mel WORLDCOM . 1 800444-1004 MC!-WorldCom Card.... (contln.uedl ~ C;tQ'3for5185183809: Date TIme PI;J;..Q.9 NI~mber Rate Jan 13 12:S9p Harrtsburg. P^ 717730-6701 24Hr _Galled from, Laurel. Mll 301 725~791 Jan 16 '2~59p Tempe, AI 480394...0991 24Hr Called frqm HarrlsburQ. PA 117564-5511 Jan 18 6;S6p Sflcrsblmnt. CA 650506-8141 24Hr Calledtrom Harrl b PA 717564-6526 Total Mel WorldCom Card.M Calls Taxes and Surcharges long Distance Service Federal Excise Tax ............................................................. Federal. Stale & local Surcharges .................................... Slate & laca' Taxe. -Out of Slate ................................... Stale & local Surcharges - Out at Slate ......".................. Federal Unwersal Service Fee ...,'......................m.'........... Payphone Access Fee ...........................................,........... Total Taxes and Surcharges ~f;-:;~~~~~:~: :;.~;::::E.~;~' Key to Rate Codes: 24 Hr = Call Priced at 24-+1our Rate .. = Call Made from Payphane For Your Infonnatlon ... Take a look at any enclosed special value o"e($ just for Mel WorIdComSI.l clIstomers. Mln 2 Amount 2.75 .. 2.00 2.00 $93.90 $93.90 $3.11 $.03 $5.57 $.46 $7.45 $1.90 $18.52 !'Iease contact OUf Customer Service depar1ment as listed at the tap ctycur Ittvolce or wrtte 10 Mel WorldCom, PO Box 4600. Iowa ctty ,IA 52244-4600 If you have any questions regarding your Mel WorldComlilM charges. Mel Wor1dCori1 'Nill work to resolve all questions YOIJ may have. If you are not satisfied with the resolutfon ot QuestIons regarding your charges. you may register a complaint wnh the California Public Utnltlos Commission (Cpuq at 505 Van Ness Avenue. San Francisco. CA 94102 or by cal"ng1-a00--&49-7570. Vouean also contact the Consumer Intormatton Bureau. 44512th Street. SW. Washington, DC 20554 oreall 1-1188-225-5322. f") c U sv} ';;:/~0 . .:,. -,. . ... -. ::~~~;!"1~~.:~~r::\~:t 03/28/01 08:03 FAX 650 506 7120 ORACLE Account Number 650 631-5619 730 N 3159 Statement Date Mar 2, 2001 Mel WorfdCQIR Account Number 7H099435 Questions .bout YOllI MCl WorillCotn hitlt 800-444-3333 Ollli,.e AccoulIt Malla".r from Met WOlldCom: www.mci.com/service -y..;; Mel WORlDCOM long DIstance (continued) Calls from 650.631-5619: O.te Tim. T 0+ n.te. a 1 02 feet a 2. . Ir. a 3. J-eb 2 6 Irect a 4. . Irect ay 5. . -4 2 Irect Dav 6. feb 5 7 255-/6 Direct Oa 7. e i57~2 !reet ay 8. . 03 IfSct Oa 9. . reet ay 10. Feb 6 Ireet . lI. . ,reet a 12. . .ree ay 13. Feu 7 Direct Day 14. . 8 Direct Dav 15. . tree ay 16. . Ireet ay 17. . .ree ay 18. . Ir. ay 19. . Ifect Dav 20. . 9 r. a 21. . 9 Iree ay 22. . rec .y 23. . 9 Irect a 24. 0 9 reel a 25. . "Be a ::~~f~ ~::~~~i;:Hi!~~:~~~:t~4:t 26. 0' reet a 27. I'eb Ireet 0 28. . ro 0 29. . roct ay 30. mi~ g:~:"~ Da~ 31. 32. rect g:v 33. Feb14 DIrect Day 34. ~:m ~m~;:: l~~!~:~~~ ~lh1H:~ g!;:~:. Oay 35. Day 36. 120pm rect aaL 37. Feb14 4:49pm ell ZAijE I NJ 90i>400~~2-r-;-Olr.cl Day 38. I'i1iU ""T:rJr fL I ziWETFI:r-llllll400-2824 Olr.ct ~:~ 39. F.~~4 ~~; m l~;~!~U~~ i~~ ~=~:!~~ riii:E 40.1'. ~ 1: am aa 41. I'061l 3:29pm Day 42. Febt7 10:02am ATKIHr~r-a036~r-[lir.ct Night 43. 1'ODl7 10;55810 PURTl.ANDOH ~1l3 "R9=ll10~rr.ct Night 44. Feb19 2:42pm JAt:SA A-r-480321l-~223 Direct Day 45. Feb20 1:26pm HEIlNlmN VA 103 464-8824 Direct Day Total Calls from 650-631-5619: ~018 Pogo 5 Minutes .3 .9 3 ~ 1 \ :~g 1- .6 .30 5 :~ .6 <. ~ .:.~ 1: P!f- 7 2.10 1~ ~ 1 .30 1 .30 1 .30 ~ I :;g I 1 .25 4 1.00 2 .60- 3 .90 62.61 t#1:~:t:?~~~D':ipl:~!;.,i~:~:(ff~:Wb1r~w/t~%1;;<#%~tt.l/{@:i~!_lt!{:/:~i:iNi~ii.WIt{WYW1~1:~:\Jetu~u~ !;mrr!!7r1}: .:.:.:.:.:-:- .:.: ::~:~:..:2:~;~1,:! Other Fe.. ~;:ii~i~~t.&i~';:f:i~~;::,t:m~~t ::r~t:ii::!\~:r~f;tY~i;,;ij:~:~~~:b~ii~t:1~m~:~~:;:>:::::~:i~:&:ili:;~~;tKt:~0?;~~m~~t:;~pr~rt i .;-:.:.:. ...........'....."..'.. : :~:~:::~.(::::/}>: + s.. R.v...... af face Paye far TVp. Ind A.,. lItIom,atioll. 6 6860 BC1S 1A 6&06316619 730 94065DOOO RTEN' "4. 6,.20 ..::6.;20 r/ I continues Continued of<. MCIWORLDCOM.. Page to of 11 717 763-9835-459 GOY ;[i~~;~~%~~~~~~,~7t~s '.; ,t'i:5*f:~:~~.;~;,';;'!~~~~~~t:!WJ.,:;\~t;;!;tii~f:'\~~i\t::~:"';~'T~{~') ~.:~f"~o~r'f aC6~":',~f.&t;:"':'C:'h_arQ<e;s.','<':': 'i::,~.'..~:.'.~,}~.....,~.::'.~.:~:'.~:'.'::,,':.'.;~,.:.::,:'_,: ,:~~E:~',;,~",':,"'~,~",:.~.'.t.'.','.:f,f.~.~'.;:.:;';....:;..:\:r:~.;':'...: ",~':i': ""<.' ~",.~.',.';.'.'..'r,:.':..~~.,~:'~.:,:.>:< . "(.' . t)~r)::~~:.i:;~:~~:::~~~::~h.t~~,~~~~i~ ;~':, -. .-, .- . , . '. l " . _. t' " :.. . -, .- '. .' . No. 'Oate Time Call type Pla.:eNumb@r Minutes Call ing card calls 1 Oee: 13 4:31PM Cost T Day To PHILA PA 215-923-0977 Fr MECI1AHC. PA 717-697-7706 10 Subtotal for .calling card calls 3,67 A $3,67 T=Taxand or surcharge rate applied: A=14.00% Surcharge ... . . . . , . . . . , . . . . , . , . . . . . , . . . . . . . . . . . . . . . , . , . . . . Federal tax.",.......""....,...,.......,:........,..,.. State tax........."..................................,... . .18 . .12 +,24 Total MeI WorldCom toll charges $4.21 Continued 03/28/01 07:48 FAX 650 506 7120 ORACLE ~007 HARRISllUR~arnott 46SO Undle Road, Harritburg, I'ftlnsylvanfa 17111 (71n 564-5511 For Future Reservations at the Harrisburg Marriott Call, 1-800-343-59112 1010 FOLEY/KAREN ROOM NAME NSCK TYFE 16 164.00 01/19/01 RI'I1E DEPART 01/06/01 ARRIVE PASSPORT: AXXXXXXXXXXXXI008 09:26 11ME 15:15 TIME GUEST FOLIO 2903 ACCT# 998 QOVENOR'S BAY DR REOIWOO CITY CA 94065 PAYMENT CHARGES 164.00 9.84 3.28 .75 28.33 .75 32.37 164.00 9.84 3.28 164.00 9.84 3.28 .75 .75 28.66 164.00 9.84 3.28" Rcor.,., ClEflK O~TE I 01/06 ROOM 01(06 RII.TX 01/06 CNTY TAX Vl/07 LOCAL 01/07 ASHLEYS 01/07 LOCAL 01/07 RM SERV 01(07 ROOM 01/07 RM.TX 01/07 CNTY TAX 01(08 ROOM 01(08 RM,TX 01/08 CNTY TAX 01/09 LOCAL 01/09 LOCAL 01/09 RM SERV 01/09 ROOM 01/09 RM.TX 01/09 CNTY TAX 01(10 LOCAL 01110 ROOM 01110 RM.TX 01/10 CNTY TAX 01111 RMSERV 01/11 LNG 01 ST 01(11 LNG Ot To, 01/11 LNG 01/11 RO~lM 01/11jlM:'il 01/1r:c'R1" 01/1,2., ..' o 1/1:ZFC:~ o. o v,.~ ~,,.j,,lIt;1;Ji'~~;Tl'll . , o lrI-r~OI:rA'L...'t"~";'if!2 ""', 01/12 LOCAL 1293-LOC 01/12 ROOM 1010, 1 01/12 RM.TX 1010, 1 01/12 CNTY TAX 1010, 1 01/13 LOCAL 1394~lOC .,-" /0402 /oIR#: 736170176 I 1 HARRISBUR~mott. CREDITS BAlANCE vue ~-- '0~~ I' I.".:.:.~,..~: """"'-'~._' .',,-,,:,,-.:...: " ;;;;l;;1~ ~J~H~:.. ...i',!.Jt~tm! ~C~:~~_ 4650 Undle Road Harrisburg, ~vania 17111 (717) 564-551 t This llllltamlln' is you, o"'y receipt You hav......, 10 p~ 111 e.." Of' by awo'led ~r&on.r ch8'Ck: or 10 allltlorlol:. us 10 ..".~. your cndlt card for..II amounts chlllTgld to you, Tile amOUFlI rhoWn In" c,..dim cDlumn ~Ih all)' cntdIl card Mltry In tnlt fefltP.nce co/umn above wlfl be charged 101M c""all card numbllr nl forth lboY1I. {The cr.atl ~ complny .....111 bill In .". ulwi mannw.} II lor any relSon the crfilll clrd comP4~ Joel flOI make ~~~u';1n':::~i r=:' ZnO:::::I;: ::1Ty~ ~~:~t~~' r5~ ~~o':IT,:~~~IA"l~e 1"81~:~ :r~te~.:~u~ ;=~~u.~~ plul lI'lerell,onableco,lolCollecdon, lnoIudlng.-orney,.... SiqflalureX ~6~:>~~~_ l=".. 0.........'...1;".... AI 4"v M.,....iott Hnf.lr"n 1-ftOfl-1.1l\.Q'lIJ(\ "",IT1;MrnINT CON 'lECYCLEtI"""ER. ~ 03/28/0t 07:49 FAX 650 506 7120 'lARR'SBUR~rnott. 1010 ROOr.1 NSCK TirE IG FOLEY/KAREN NAME 998 GOVENOR'S BAY OR REDWOOD CITY CA P.""" 94065 cl.Et IK r.ODm::ss ~~~~E-I--.-----nEFERENGE I 01/13 nOON 1010, 1 01/13 R~.TX 1010, 1 01/13 CNTY TAX 1010, 1 01/14 LOCAL 1806-LOC 01/14 ROOM 1010, 1 01/14 RM.TX 1010, 1 01/14 CNTY TAX 1010/ 1 01/15 LOCAL 2074-LOC 01115 LOCAL 2359-LOC 01/15 LOCAL 2440-LOC 01/15 LOCAL 2493-LOC 01115 MOVIE MOVIE 01/15 ROOM 1010, 1 01/15 RM.TX 1010, 1 01/15 CNTY TAX 1010, 1 01/16 LOCAL 3107-LOC 01/16 LOCAL 3135-LOC 01/16 LOCAL 3202-LOC 01/16 RM SERV 34981010 01/16 LOCAL 3474-LOC 01/16 LOCAL 3485-LOC 01/16 LOCAL 3497-LOC 01/16 LOCAL 3648-LOC 01/16 LOCAL 3775-LOC 01/16 ROOM 1010, 1 . 01/16 RM. TX "",.._ ,10).o:;",.b;,i. 01/16 CNTY,~' ";p..,,,WO "'c"""~' 01/17 LOGA ' ~~li11'~:I' g ~ ~ H':kgr\,,~-I{J:'!",<2i' 01/17,:RI!1;.'i~ 01 Ir~RTli: 01,Z,Ll%,b~~-,mh"i"':":. : . o rT1il"'~1lCl\t;i<"'t''''''-'v'U9''' 01/18 ROOM 1010, 1 01/18 RM.TX 1010, 1 01/18 CNTY TAX 1010, 1 01/19 LOCAL 7235-LOC 01/19 CCARO-AX HARRISBUR~mott. ORACLE 4650 llndle Road, ".rriIburg. PertnsylvanG 17111 (71,") 56".551' 1'01' Future Reservations at the Harrisburg Marriott Call: '-800-343-5982 164.00 01/19/01 RATE DEPART 01/06/01 ARRIVE PASSPORT: AXXXXXXXXXXXX1008 GUEST FOLIO 2903 ACCT# 09:26 nME 15: 15 nME ,,"VMENT 10402 MR#: 736170176 CREDITS BALANCE DUE CHARGES 164.00 9.84 3.28 .75 164.00 9.84 3.28 .75 .75 .75 .75 9.53 164.00 9.84 3.28 .75 .75 .75 15.13."" I I'~~-..-. ), M$j~llI~JI ; i1'i'll:Vi H! ..j ,,-,.-r:;, ::J; r,.-~:~j' l~ : I~ 1._. .'1',1..:',.1~111 .J".. J~iJ~r.'t . (Ii ~,,! I i'/; .. ......',. :,;,,";,E,-~-...,~, ";:......,,:.z,.i'.~~.__~:.:..j!J.....41,., f,,('" "- , , "l'1('1"1.'l"'n!. ,,', -~"'....!..~.."_ t-."~:~",t," ~l' ~,,': ~,::I,r -. ~i')" I ""I" .I<..;;ill,.....,...~n~-J,j:,i ,i,,' "~M ;;"1 JiJ . ,. !J1_b.T'l'~,";V U,..'}t i::.~; ~ ~_' I .f;:;,j~.r:~r..:- M". . :'!"~~!;;~~~" ~ ,-tr.t ,",0"'" ~\\" ,,,..~, .,'-_ .,._ ,I ..:~"'!.1~.t;i_~~"_~'" r 1. >10 ~?..~'~~::f;F~-~. :~!.~ ~~$.eiiix~;;;, !m.:5;:~: 2492.88 .00 4650 Undle Road Harrisburg, Pfttnsylwnia 17111 (717) 5(,4.5511 This 'lalemlll'lt It 'fOUl: only ","\pt. \'OU.......... to ~ Wl ~..sn ~ l:J't ..~ ~onM ch<<:k ~ \0 aulhmIz. lilt to thargtl your e,..J,I cen:llcr II! amounts en_rged 10 yoo_ 1hll amount .now..ln". credta ~umn ~ 8f1Y' endIt eIIrd _V'( 1IIlt1. r.lerenc& c:olllltln aboVe "'" M . hargl'd to 1tIt1 crl!i:lil CArd number 'Ill forth ebove. (The ~ eam companY wUl bfll In the II" ".annllr.) II lor any ,..eon 11111 c'.a11 cetd company e:)H not makfc payn'lenl on 'his account. )'0loI wilt O\W UII lUdtalftOUnl. 1f)'1:l11 a,. dfnIcI blllR, ,n" .wnl po1ymlll'llllMt made wllhln 25 day, .It., cl'ItoI '(.out. you Will owe us Intllrollsllr(lm the ch~-o\ll dat. 'l)I\"" .....,.ki SfIIQUM .,.... rat. 0( '.5""", moMl'I\__Ht4u.Al. RATE 1tl%). or 1I1e maximum IIllo_d by I.w, plutlt1erlt8/10n9b111 cO"lofllollectlon,'ncl.......alll;rmey'".. 31gnlltllrll X THlSfTl:W'IlINT.IOIollll!CVClrD".pt;,,@ 6,2955 Aev.7/OO For Reservationf AI AI1Y Marriott Halel Call1-800-22S-9290 ~008 I i- f....,.,.,.."',..., " .,..........;".:<: .':. .-"".":' ~ I .~. ~. I. LC"n<,:\,~"" ~ I , J / FRO~l : RRNDY ORR I 5 RND f " ".."... .. N FOLEY PHONE NO. : 650 631 56 ,,,... "'1.1. Ni:~ IN UUl:I.Ul FEB. 02 2001 12: 22PM P12 ~J;:~qOS J.... ~~; ,:! , ~ '. 'I<~ r- , {'~t~::.:.;! J\ (I,., ;~" i~,"';:J I' "..,' 'f URGENT ITINERARY AND Rf . Q-~t~"<\?$ . \ S~ Jt&6 '\'l, ~ =OR: nA!I~Y ORRIS Ff1:t (5SIJ l 0,31 55\9 THIS DOCUMENT IS FGR ~J::i:E::;C::UC: Q Y~\lr nirline ticket IS ~l~l,,~t;'onk;, ~t~;~d 11' '.- n As WUll all alrUne UcKeh, Yl;:~r ei~;:t:'~njc t,~~ . 6ring tile CREDIT CARP u$ed k r ;~rchas( . Please nole that ~II Seal A9signmomts are": 20 minutes prior to departure (30 minuter . If YOiJr travel plana change call UNITED P ,. 7'hrmh you for choo$ing United Airl... ( .m aCle i " ~ Check.m '!lease if unclaimed Hail) ; at '-800'241-6522 ~u.J...C- '\1L~~ ,.{' \ -\.[ v \ e.,-rt'<' '\1.- RESERVATION NUMQ~R:c:;i;~~~~'=:> PARTY OF 11) TICKE7 NO. CP.P.:S/P.ANDV MR 01621618614BS MILEAGE PLUS NO. Q0332 273 96S ~ := ;',~: ~ r ' " DoC BB F~ARR :3,0025 P.,CEIPT iJ8C ~~ ~~. .. ~"~",~GE .,.:.'~ :j'~ 19.00 O~~ DOCC~.'~~~ ~ F~~=. r<efoILS:H1Rt: ~ASlS ;'011 ~~I. UR 5FO 018.60 1346.98 "502731.16 u:p , , .~ . e < ... ;"u lJA ,. ....c'_ ,!ORD X~ ~G .['J .~ ':';,~l'J :.:'6fC'.~'~\,trt "'.;\" :f =.2U ~FGRC3EU13CR~3 IIINERARv UN ITED 162 ~P MILES 1846 EOUIP: 747 SEATS' 2E NONSTOP - UNITED FIPST/C DEPRRT: 'JED 13 DEe 11:35P SRN FRAN ARRIVE, THU 14 DEe S:24A CHl:AGDI SAGGAGE ALLO~ANCE: 2PC SNACK M,. NON-SNakING FLIGHT UN ~ IE D 44 "'''STOP DEPRRT: THU I' DEe 6,1'A CHICAGO, ARRIVE: THU 14 DEe 9:59A 6ALTl MO oAGGAGE ALLOWANCE: 2PC SNACI( 3<>< . \\ I~Ol UNITED ~ Jiij NONSTOP DEPART: rHU ~ ~P 2Al T 1 MOl ARRIVE: rHU 28 DEe 2'~F OI~CP.GO, BAGGAGE ALLOWANCE: CPC ~ ~f'l,",'> ,,,, \, G:. TED ~ ~Th" 1'.~<) t NONSTOP DE ;>RT: THU 26 ~[( ~ CH ;cRGDI AA ; VE: THU 28 D~C ~ SAN FRR~ L SA GAGE AllOUANCE: 2PC "o~~ D 1 NNtR IPST/CONFIRMED fau IP , StATS: 621 MP MIlES OC10 I B NON-SMDKINe cllr~T MP MILES 621 RST/CONqPM, tOU: SEA'." 757 2C NaN-SMC~INC FLIGHT ST/C~.~;r:' >;~ i!' MP MILES 1846 '. ~ 7 ~]~-SMDKING <lIG~T WUNITE J ~RLINES FROM RANDY ORR I 5 AND " , FOLEY PHONE NO. 6513 631 56' FEB. 132 2001 12:23PM P13 :;:-~~~i:~:~.,;,,:~:~~_~:.~~k~;f:~:~~~:;~~:{~~/:~,;~t~:::.:;=~.~~';::;.~~:~1~::;:~~::-~.;;':~;~::."~:~'~:'::~~: o-!-~ \ P&'kINs RF.SifIUR CR'J,OI?F: #:J/a & BRkERI' '1." lJ~ HILL, PI' ~..::' <XJBSI " . rBi ~~...,,~----~- PRr;,.. ~ I CHk ----.. "" <t ---. JRNto'o 4950 --_ _~~2 ___~""'''! -- JfjN:II)'O_. OSED-.~_4.00 -L r: 49PIrJ "'__...-. --- .tbOD PA REV-1500 SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES and LIENS FROM ~h~'~<:~:~~+~:!':-:~;:::):~:';:f'!:~~( RANDY ORR1S AND f N FOLEY PHONE NO. 6513 631 56' Your A_&T Statement December 6-January 5, 2001 'BWNCJFM '09160175483018# o 117135~ Tl0.267ee23A7~M-':lOGt HI' IJIIIIII'lIlIlIIllIlultllJ I I I un "" AROL YN W ORRIS 8S2NDS WORMLEYSBURG PA 17043.1310 1.~tll111nar",'dt' (:harges. Previous balance ....................................................................38.30 paymenl received Dee 26 . Thank you ............................. -38.30 AT&T direcl dialed oall.............................................................0.36 Oth~r duuges and credits ........................................................5.14 lax..s and surcharge. ...................,..........................................0.50 .. T ota' amount due Dale due $6.00 January 30, 2001 FEB. 132 2001 12: 16RM P4 OAT&T Cuslomer # 7.17 763-9835 Page 1 013 .. Cuslomer Service: 1 800222-0300 Texl Phone (TTY): 1 800 833-3232 4Y-' Extra! Extra! Take your best swing at www.att.CQm/grandprize and win a \rip to the 2002 A T& T Pebble Beach Nalional Pro-Am! Or win othe:r prize$\ Continued... ~~,o ., Continues on back JjjJ .' ~~~;~;;;:';;'~.~~~;f.~~:r;..~:~;~:~~~?~;~%~~. . .. .. ~.. ver~' !1 Detail of this month's c:harcz@s ----page 5 of 11 7 763-9835-459 GOY January 10, 2001 BASIC CHARGES These monthly charges are for your service from Jan 10 to Feb 9 Local calling with 25$ allowance ........................................... Dial Tone Line -Residence -Touchtone ................ You wi II receive this I ist of your services every 3 months. Please keep this list for your records. Federal line cost charge................................. Local Number Portability Surcharge..................... Federal Universal Service Fund Surcharge........ . ... ....~ Additional credits and charges Adjustment due to change in rate C'H \ 10 From Jan 2, 2001 to the date of this bill \,,1'1 Federal Universal Service Fund Surcharge.;.......... ~ verllolJ Page 7 of 11 717 763-9835-459 60Y January 10, 2001 $.00 +5.28 +4.35 -.23 + .43 +.02 Continued Total Verizon basic charges ~ Please check the Customer Guide -- Local Call ing pages of your telephone directory for discount information. Total for our charges $14.38 Payment arrangements or payment information? In Pa. call toll free 1 800-464-0820; out of Pa. call 1 800-464-0820. All othel' calls or questions, in Pa. ea" toll free 1 800-660- 7111; out of Pa. ea" 1 800-660-2215. (Included on this portion of your bill is approximately $ .77 for Pa. taxes on utilities.) FROM RANDY QRRIS AND , N FOLEY 1..'~+~.;F~fi'itie;"" ~T;::" " .. .~. .. '." :~:3{:'.:" "-:.; ":...., - , "':JH;~;.{:: ~ '{' E~::i~~if~~~:~ -': .. -_:':'.:.~ ./~~~" , , ' ::,l"," .,;:; (lii~~ll:'~ri~I"~:Jii~~!~~f'J:~/.:~;~i; -;;::,:;tii i~: '~"_ ,::.; ", _, [O:3Se';':':':',,~~~~'~;.:~:',:,:;:"_ ",'tQlll~~1 \Is Qr1it#J6""": .:.' ,';':.~~::'-~~~,~~i~t;':;,i~:'7:~~:i;~J~..~:t," :.:' "<)r""Tit~'()i,;'<':-,,:,.__ ",- .. Gust(jrqer.,Se,.-vi~':'" ":$.!7J-j'''''''rii1I.iil,<l. An~1l1~",iJ;PA,c' , 18tQ+<J392">,,, '. ",~,pp)W~)<#>Il\' , , Ele,ctrlc Use ;:,~~;~~:~:'~~~;;;~O:~'~~':::~~:~~;;:~:; . Tllis grdph $hows your cle,ctric use liVe< 'he IUIH nlotUbs. TYI.es of Meter R.adlug.. AemaJ _ F...<c;timated r;o."t;::~f Customer CJ PHONE W. I II" "';'\1::':;':;- pp .iT:.: . ". '. ~ 650 631 5E FEB. 02 2001 12: 17PM PE P"cc 1 C'; .. Ywr.BUl. I. NUI"I\I,ltir Summary Page B.lla,",. a.~ of Dc. 26, 2000 Charges: Tot.rrPL UTIl111F.S Charges To"" Charges 30 KWH. Av"mg. Per Day Ol560.71 002 seW}IC' ri' $0.00 $ 45,93 S 45,93 ~~\\) Md.. Readinlllafonaatioo . Dee 23 At'lu.1 No. 21 A('lual :! ,. 14585 14118 -'67 2000 31F 15 2S ... .... . ., .- J . I . 1T -., 1111 II I I I Avenge - De. T~!1!PeraUlW KWH Per Day Yearly U.., Jan 1'999 - Dee 1999 141\ lOOO - Dee .!OOO 1999 401' ~2 Total n,e- 769\ 5573 AnMl~eo MOllthlj 64 464 20 15 10 5 o DJ I'M^MJ J ASOND 1999 Mou.hs ::!OOO . OIIJer iDlporlanl jnror'malio" 0" back -+ _~____________~___'_ ._.______~______h___.____._____.. ...____. .._n___________ "__n__ _. _h_________.,. . __________. __. ._____ ____._. '~_______" FROM RANDY ORR I 5 AND f I \ J I ~ d .~ ~ - .~ S ... ~ i,.,. . ~ :';:', ,- - ~*~i;;;'~:~:('~,~:;~-r.~:::;?;~;: i ~ .!If i l! ~ ~. j , I ~~~~~i::i;.j:f.j-i-:~i::::~:\:*,;:=~-:~;~~:::~ :.~ -!~;*~;i~::1!~~;~ ~{i.+.:~;:~.}.;;:-'.:. I , i , i , FELEY PHONE NO. 650 631 56' t'~r)~~.: .) .. "j ,;. "~i~ ) .. Tm, IS TlllRnn.T ll"VOK:S 'l'OU WILL R.&aJVZ. s= ^ STATEME1fT WILL 1'I'OT II'B Ml\I1.BD VNLEU BQt1Z8TED FO.R YOUR CONVBNlENCS. VSS THE E-Z MAIL ~~. w l! "' ~ ~ w ~ .,...., >- !zl ;c!;: dS:.- :l :5 ;;! ;l\ ..::0 ., ",0 V ~~ i . ..:1: ... <9 9 '9", , << .S; ::i ~ w ~ '. . n C J> . .-;11> ~ ,.. " . " ::! Z! fl :1] 0 w -:ll w $ Ul~ 8h ;c =1 .. M O'l:1 NY tJl", 0- tnz ~ ~~ ~) ~ Or: .. ,;- " I "''' o i- ,.. m.7 B ~ .e-o .i! ~! I!l m !!J Ii w >- Q N <; ~ ! ! Isl <9 0 ~ If) :l ~ " 0 de w " U ell ::> '-' " r~ G ... ~ ~! 15 ~. z .. !i 0 0 a ;;; ~g i w z ~ >- !j 8 " III Ul .... a. o (J Ii ~ ~ c ,.: ; !I.l i ; II 0- I- Z "'bit!) 1Ill!l tt: Cl rr CI:: ;:J Z~;:J c~ L:i OZr:ll ~1Il CI:: ~~~ m5~J s;:! Cl::1Il.J ;s:<t=> i~a: GlUl~ llltt:Sj: SE: o 0,....0... lrCll3 Q;l3"'~ LL"" _ - . L I I ,Z ~.. _"I". , ;,10." . ~ ., TfilUCK NUMBE~. =-=:::-43 DRIVE~ NUM6E~ ___ 1043~ ~r-4LES NUMBE~ ~ -= ~ '5 SlTl"lRT - - - - - - .....' I.:II:'lLLor~$ FlNI:;:H --- 132.8 Gp~I~EO /GALL8N- - ,- 1.~~0~l~ P~ODUCT c 5T -- 1~~.,~ F1JEL 011_ -r;:<> - ~ NO t~~ACRE:oS! = =~~3~ ::~...- ~0 DAY PAY D~C ~. ... > @ c :::l ;; ~ ~ ~ @ ... ;;: !# "" -< : ..~.,~,-,"_, .~'.~" ..;:-4>;-':,..:. : . FEB. 02 2001 12: 18PM P7 FRon RANDY ORRIS AND ,N FOLEY BOROUGH OF WORMLEYSBURG I 20 MAAKETSTREET. WORMLEYSBURq, FA 17043 PHONE; (717),76,3,"4,483, PLEASE FORWARD, ADDRESS CORRECTION REOUESTED , " r 1_'"-'"'" I r'.::::l I .::0.~t~~' ',', , , I , , , I I I , I , PHONE /-,0. 650 631 5f 8 S SECORD SHEET' l::;~"TION WOR!lEYSBURG, PI 17043 SEWAGE REFUSE , " . ;?~(~~!;;:;.ii;~;!:,.~:::::~~~;.~;~~~.:~~;;:~\*~~1-*:;*{~~*.~~i~~;~~1:~;~::;:~~~j:;:;~ PREVIOUS 6AlJ,NCE. PA,YMEN':'!i PAST 0\11:. PENAlry INTEREST OrHE.n CHARGES. . 0l/01101 SEWAGE 61." 67.01 RHUSE 37.00 17 ,00 c..ol'r t\)L- E\ilIT& FEB. 02 213131 12: 19PM P8 r "I' "'" ''',''1 I A I c i I , .:,:}~::"~~~~@~ FROM RANDY ORRIS AND ", ,-' T D",,;,,'~6h'~ ". ~~,:.,e;'" .. ,,:.~,:,:', ',If.',. ':; . FnPdI_r :N FOLEY PHONE i'lJ. 650 631 Sf FEB. 02 2001 12:20PM Pl~ c......nt Fe.. &0 Total Chug.. T"".. ~ $0,00 $2'7.48 $Ua ~ THANKYOU FOR PAYING youn BILL ON TIME. Your promp~ attenti4A ia appNdlltl:d. A $2.00 1at. cbar8'f "Win be IlPplitd oD1y...hr.n. II pfL)'meD.t i. fOflCh.l!d 5 d~ pm your Pa1lDtu:lt Oue Date. Pot YOUT _~me:ue. ~ ~ow acc.pt ",,culll.k' aDd o.utcmatic trlOl:l.tMy endit eard P8,fID.n.ts. direct del:i.t (ZipCheck) and.MAC for PO]1Utlts. Balance nt BUIiDg ,: t BahmcCf 11119 12104 Pre'"ousDIlIa..ucrc...... ... " .._...,.... ,_. .... .... .......... ..29.01 1tayment-'l'h.o.nk You.. ...... . '" . ... . , . . .. .... ..... .. ..' .... . .29.01 CR B~atBUlizaD.ta.. ....... ............ ......... '" .., .... ..00 C_Ckartlo<< 12/20.1119 Servic= 8tudard.. .., ___.......... ... ..........."... -.. ..... .... ..16.72 Sae:ic.... .... ...... ................". ..... ......., .._......8.78 $ TaealCarreut Claa-IM. .... ....... .................... .... ..... !1.48 TIIz.- amd "PSl! 12120..1/19 12120..1119 I,"" ", .! '! j '! rcCRegu1atoryFC1I:I........ .... .___ ........" ...... ....... ...0.04 Fr~biHill'-........... .._.. .... .... ............... ..... ..lA9 TotalF.... 'J'_e... _............... ........................_....... oS Tobtl.AJ:aOUDtDa.. by Vo&lOl..... ....... ............. ... _._.... ...0. Eff~v,Jlln. 1.2001. WTVE. ChllJUlel 51 will wadded to your 19lb1e lll:lnp. ~\~ . ::ZOJL\llD1'BrWQRMU:!1mtJSQ.PA SfOCl CUIDlPAOUI FROM RANDY ORRIS ANT '"'''11,1'11,1",,,,,, ,..,.uvu. 18'1 FCLEY t.JJUI~~~__.. PHONE NO. : 659 631 Sf -.....:;1....---...-. FEB. 02 2001 12:21PM Pi: Fors~rViceTo~ndOrris -PrlorJll!UC,1 .'.-". . ~:e~~:I~I~:::r;:::::o;~:". .... ...., ,'.'. '. ;;i;;~';it.~1~~t:j'~:f BiII;l1gperio~~~~M~~ijW~~~~~;/~'.::.,~c;h{ .}~P,i~~~/~;:;~ Billing Date: Ja~:1r;200,l ': .... . 'W"hlrVo/Jln;;: 7.oOJb'f.':''i: Billing .Period: ,Dee 1"'~Jan1~'(3? JiaYS) ,'IJ'CjiaJ W1ii.,'~~~~~':!1i)/i01 . :.,. Next readmg oitllboill:,~.14.2001'..' . ;.'.... .' . .'iirtin., -.h....."". ;;t~~;IMrI:1 Prespnt-l\'=tua", ',"', ;,..-311909....,,,.:. , ..~~~.o'..:O'~<'.~'...l.'.'f<. ,"' -.{..;:' , '6:::':~\i'~?1!'i;;f(~0~ ."~ifi~i -$2.44 .00 -2.<&4 '.'. '.' ~., ,;;. : ., . . Water ,u~:ii~~I~~\i;~[~~-~il:i:"..~r~~:'.. 4 . MoritlilV!'I!lst"'!lWld"'d gaI1Ons. , .,..", ~::~J.<'-"~' ',,!' " ~ .,~. ~:':~ . :.. . ~ . . _' .,':.}~~;:.~~f~,~ _ ~:"~!:/'~ ":" ....".".""i'..,.~,.v,.,p..._. ". - '1/'" - '. if\:: \" . ". ~~::{;:~. ,(,. :Vt" , '.':' : ::~~~. ::'.'~.~~,.~..~.;,(~' .:' :;':tJ.,r ~> . . .. : ,.. .','~: .., ......- '.., ~i::"f;:/~:':::~~:!1:: . 8 <,01 J-::"'F~,:1,j.tlAt~~~!;tI4j;;~~~:~''-'$; .~(fc'ij:i;r6-' .',: ..1'.:8.:.t>,~:~,;:a~~';~rf'1I:;'':':.'''''~ "'~"o.i~,. .......;~)?:'.;I':;;t~:~~i;0~';.'.~.....'::~.':;.... . J':'j' .,.;f R<' ,,~':~ 1. ,', ',,' -,'.' ". : <'~ :('~. ' <~'~)I~~~'f!r · . ;'..i~. ... ...... . ~ . ".:' " ':.,' : ~~~~+~~~:!' ~g~~~u~mP~~WMm-~M~n . Any portion ollhi$ wale bill which IS not paid as of 2I1VO f wffl be "'*feet 10 a f .50% penalty. . A VOID CDS1/. Y SERVICE LINE REPAIRS... To leam how you can pftllect yoU1$l1/r against unexpectec! and oosNy SfJMea 11M mpalrs, call (8f1O) 565-7292. and askaboul Ute WalrlJne Pto_ Program. Your pear:;e or mind is wot1h It. . Efft!!ctflle January I, 2001 VIe Slate TIlK Adjustmenl Sutr:harge (STASI w.ul1lcreaHdlhlm -0.44% to -0.43%. . PAWC ret:eived the Govrmo1'sAward for Envi"'n~11I1 Excellence tJrlts Water Tl'ealmelll Residual Program. As a "'sllll of /he program, tesittuaJ {tom the wa".. I11ratmellt proDe$S Island eppt/ed _ _ as /C>psoil or a /C>pscll blend. For mo", information. contact PA WC's customer service center fisted on the bottom of thl. bill. . . Effective January I, 2001. .... Disfribulion Sysl8m f/'l'fll'OV&mellt Chalflfl IDSIC} haslncreaHd {tom 1.01% to 1.49%. This charr1e funds replacement 01 water dlstrl_ f4t:Illlles. . On any gl_ day, you mll1l1nd Pennsylvsnla.Amerfcan Water Q,mpany meter readers wa/l<lng from doo, to door in yollr communIty reading meters. The... dedicated employees walk _al miles elJch day In all types of weather la complete /heir jobs. A$ such, they wanted 10 extsnd dJe/; appreciallon to f/IOse cus/C>mers wIlo etear II patl> to the meter reading devices durIn(J the Winter when (hem Is snoWfall on tho ground.. Your efforts do not go unnoticed by ou' staff. and ....thank yolllor making a dllfervnce. QUGstions? Call 1-800-717-7292 Weekday.oS: 1 5 am to 6 :30 pm Saturday-8:15 am to 2:00pm emergencies: 717-774-2420 PAWC. 852 Wesley Dr.. Mechanicsburg. Pa. 17055-4436 Internet: www.pawc.com ~ -= .... "... -" ..., "M H '0 dd'" ~ ~ ~\ 0 '<J ~~% ~ ;Jo't'J . .'1 ~ t;\t;; :r-' t'lt'lH ~ ., " ~ .. ~ l" t-< " \;5 ~ ..... g rfj ~ -g - ~ ..... >U If> 0 rfj l~ ~ (f1 g ~ "" ~ \]j ~ ~ 'lJ lP ~ - <:: l'l ~ 0 t- 0 ~ t I-' .{{l <f><f> <f> <J> <J> .{{l <J> " ~ " " <To '" " g .. ,.., ,.., 0 " 0:> 0:> 0 ..., " " 03/25/01 07:47 F~ 650 50~ 7120 ORACLE .. .. " .. .. . " .. .. .. . .. . , , . .. <'l .. " .. .. .. .. .. .. .. .. " .~:'::~f:'... III ..... ~ ..., o ~0:>0 0(f1~ \N~~ rfjU ;l" t-' -.J o ... '" .....0 'g,~ ~@ .....~ o S <P () ~ /i =?\ ""7/ ~Gl ~ -0'- :<\'" ~r;\ ~~ ~ :r~ 01 00 tilt.< OZ" 8tG ~h \11 ." \" \~ ,~ \A ,~ -1 "J7 ..., ..... g o -1j III ,.... r; ~ G'l "l \?, ~ % o ,.... (f1 ~ G'l \'~.~ \ \ FPOl1 RRHDY ORR I S AND' 'H FOLEY PHONE NO. 650 631 5f FEB. 022001 12:17PM P5 PJ\l'IENT NJlJ-m: 1'7\.TJENT !'11J!1BEF: CAROLYN ORRIS 396593 BILLING FOR, C) ~ ,') \ Cl \ '\ ~S\ c5r~ ~~~~ ~/O~ /.& 1/~ l"lF,r' 00 Hr:ALTHSOUTE REHABILITATION O~ MECHANCISBURG RENOVA CENTER BILL, TO, CI\ROLY1'l ORRIS {1 S 2"" ST WORMLEYSBURG FA 17043 - - DESCRIPTION AMOUNT TELEVISION $ 30.00 DATE: DECEMBER '00 . TAX ON TELEVISION $ 1. 80 LAlJNDRY $ DATE: HAIRDRESSER/COMMENTS: 12/S-WASH/CUT/DRY, $10; $ 21.00 12/12-WASH/SET,$11 BARBER/COMMENTS: $ PAST DUE AMOUNT DATE: $ DATE $ PREVIOUS PAYMENTS RECEIVED -$ TOTAL ( PLEASE PAY THIS AMOUNT) $ 52.80 - .. . - - -..- -. . - ~ ., ,'. :~:.~A*.f ,i~,' ;~ ;:: ~ " (' of a ., a. ~t ~ ~ ~ i? (:5 " I <:::: -j o i! r- 3(") mO oS:: -s:: Om ~~ mCl> c" ;u 3-< T11~ om .. nm f!gJ J>~ lJJO lJJm ..... lJJ..... -<tIl J> zz no /Tl-i ("l o ;;; ~ o a! -< -l-lID ".... III .. , :J:J III l/lut.... u-on 00':1" , , JIJ ........, /C) ...p ~~ ~ Q --- ~<; <; -i III , :J !II :J 3;;r;ut - ....." --0 JIJ 1Il" !II"'" 0", JIJ JIJ >,: -~1:~ '.:.' :~,:.~~:~;€ ....,.., },~~t :tj n,O:" 'm';' ^'Yr ~Q~ .~~:~ fl~ ',' ~.: \~ c z =l o ~ D ~ " " ~ (~ c (I) . . . - 0 - 0- ~ (.n 0 <.J\ lJ'-1"J'oo-- -< . . C 00'-'" o 0 ,~q C r1m .~ O-:ll "'- \l Ill:::! ~~ "'0 C-n :z_ ~F j2~ r'" o~ li:Z c.. C ::Il ~ ~ ~ .... :;; ~ ffi -l ~ ;;! " ^ 0 ~ 0 9 c " .. I ~ I. ~ ~,;;~ J) r'fm (j; ~t m z -i m :lJ J: o r -< m " ..... AI .... -i J: C Ig .:. -i ~ FROM RANDY ORRIS AND ON FOLEY PHONE NO. 650 631 Sf FEB. 022001 12:19PM P9 ACt,,,'''''''oer:. 15099849 ..."....m.. ORRIS ,CAROLYN Smlte start: SUlem""Oat., 12/22/00 Pall'eNo. 1 06/04/00 06/13/00 Q\Jf!STl1')l'fS? ~le1llS'1' Ceil; 1-877-254-92:59 Conl;lcc L-=-~ma;:~~~';'l~MA~L;j$u~e; l TOTAl ~AT1eNI' cRI;pi1$ . ....~ ~~~~'~~~;9#t~\i"..~i:f.~~g; ,", 'w .~ '.."" ,,.,,,., '~~_ ~ ~,~ ,C, ~;~'~~:\'~ ~ ;' i;:~~{i.~:~~~~:wr~"te:-v.rtllIS'>HiA{AN'tE ..:"..; l, :'.:~'.:/~r.~~'ff:)~{t~::~(, :" . 06/13/.QII'~'.MED'.,c:(.~dn)SP;"'IP . ....."90. PlE'DI'CARE';.I/P,," 06/ 14/:"Q;OC:;O.THER"l7iATUNT. NON'.,CO "'0, liED I;IlA'BE<:.I)(P. 06/29:60;0/. 'I1EDI.:'P.Yl'!T"'H.OSP' ,II', "'0 I'I&D'Z'CARE.'.IXP:' O';/2!,;I:,OJI,~:;'IIEDICI'MffOSP-'IP "90 "EDICARE'.I/P 06/2!U,O.U:..HED C.tN~'HOSP~.IP "'OHEOICAREI/P ~"~r."":::.:.,::,' "", ". . . . . 'i'3iz3'O.{S";' '.7, "2'7.47,,' '.. 10.50:' . ',5.585.42';" . 7 ,618.33,- 7,627.4.7 ' ;;(~~:~~;~J.'~~:~ ,.~.. ;:;;:;i", :;', ,'\' :~:'~(:';'~\:"~;~~" :.:.:~~;\ :::,. . .. . "",., . , .'" " ~.1 : ;~:Y;~'i;~")~::'\~,~.~;> ~". ,',' . .....: ".",:. .~*,~.::,;~:j;i:{~'~ i; ""-;",. II 1 R HU SI> 1 .000030915 ACCoUNT&ALANce; PAYIIENT IS DUE UPON RECEIPT OF THIS STATEMENT. 119U MEDICARE X/I' .00 886 PEBTF PLEASE DISREGARD THIS STATEMENT IF YOU HAVE PAID. .00 . Until your inaU(3.nce MaJl naid. the PlEASE PA'{ THIS 4.MOUNY r.~t.cel1ts the I)Qlan~ w" estImate you ow.. Any balanc:e unpaid by your insurance Utili b9 due from you... ThanK you. . .. 03/28/01 08:04 FAX 650 5n6 7120 F",m 1 040A Label (See page 20.) Use the IRS labe'. OIhGIWlSe, ple,s6 print or type, Presidential Eleetlon Campaign (Se. paye 21.) Filing status Check only one box. Exemptions If more tha" seven dependents, see page 23. :;.~:~ :~: Income Attach Form(.) W-2 here. Also attach Forml') l099-R II tax wa. withheld. I' you dId not gel a W-2, see page 26. Enclose. but do not attach, any payment. Adjusted gross Income ORACLE 1i!I019 ,,"--.......: ,_..,.. . - ..... ('" ~ . I II I ?..OO I \,). oR1U\ L . o E L H E R E ~1 Co 101 00 (~OOO Sl4. 00 2.11S~ OC (19<1 00 l"\:W~ co ..........,..,;.,:,:0:.,;:::,:.:1-. . . t:r; "fn~~: ;,'",,<::,;-';:':', '~/b~i~: t'iL 29,3(,,8 Do Wi'. c.L ....1<:"". Form 1040A (2000) ___ -!J/_28/01 08: 08 FA:!. 650 006_7120 ORACLIl Ii!I020 Amount you owe Sign here Joint return? See page 21. Keep a copy for your records. I } Tax, ~,IJ -z..ZoO 00 J I f , , [ ;-:;;:~ If you have a qualifying child, attach Schedule EIC. :;~ "~;~'f. ..~. C<> I' Refund e~ 00 Have it directty I ! [ I ) ) I ! I 1 , -'.no. ( ) OiJl>1 Form 1040A(2000) '~1'M~ i I I I ; \ \ ! Paid preparer's use only VIl'd>A(1iI~ Oat. Chock If Hlf-omployod 0 aN \5'/ RA..o ~ O~-'~ t\<. Et.\~11J-It. 01= (j>J!J:)Ly.,j W. 03/2B101 OB:12 FAX 650 506 7120 Schedule 1 (Form 1040A) Interest (See page 62 and the instructions rorForm 1040A, line Sa.) :~~jf.~iA Part /I Ordinary dividends (See page 62 and the instructions for Form 1040A, line 9.) ~:~f~~~~.Oft(;; ORACUl 1i!I021 \.,"''(4)0\..."1" .til^",~ 1=\I<.:ro"'- l!.~i::... PS8:~ " ~. . , , ~i 1 10 Cb ~ :~ ~ ?, !i; -." { p' l' 1- ~ i~ if i~ ~ .4 "'~A~ th.(alnOl.llrts....n line 5: Enterilie tOlalli.re ando!1,fo~n\ J04G.,\ .' ... .,1~~l".l'~~\f_l,lt$~;9;...:::?~:~:-~:::: :.~,:i,-': ',".'. .:. .": ' ,',:-,~:::, --}A~.,4~~~'~',~~;';"::<:~,,:''- ,~.I~,~, i,S: ':_~~ Act'~..it~.~ l~A In~,",cti....~ '., .~.~ i2)lt~. '~1lFOnn 1040Aj 2000 l.sO 00 PA-40 - 2000 (09-00) PennsylYllnla Income To: Relllm PA DtpIrtment of R9'IInUI, Harrisburg, PIl 17129-0006 OFFICIAL USE ONLY PLEASE PRINT IN BLACK INK. ENTER ONE LETTER OR NUMBER IN EACH BOX. ALL IN OVALS COMPLETELV. Your Social Secm1ty Number Spouse', Social Security tbnbar c::::J ExltiMlon. See i1S1tructions. , '. 03/28/01 08:15 FAX 650 50ti-I120 ORACLE D.(C..~~D -'J -I 0000110015 20 8(,.$ \ 8"\,.2::;1.;.._\ 2.. 'l. A." 2..1.0 ~ ~L~i 'N~me u' '-"DRRIS -:\'<.B ...1 .~YOU' Arst Name ;~;:\( p,. '1\'i\O I-l {) :.,~r:Spouse's First Name :.: k.. 1\ R 0 L V N ,~( ij l '. _..r :S~Dl!S~.'~ Last Name. Only If different from Las1 Name above MI t<\ MI :;. :-; '1 ;.: :~ ~ -:':.SI :";':lj :~ .~ ;;: {3-ri ~.s.: ~ f!. .~<3 i~ f r1 ~.:;,., og@ w , .v_.........., Arslline o~ addr~ss .-P.O. Box; APanm6r.tNu~ Suite; RR No. -11 applicable "\"\ e. ll~i ~O\l (~t-IO Its. i:)Q.. SfCOnd line of address. Street Address City or Post Office Slale ZIP COd. R~D\.lO ScI1<>oI COde (. f\; .~ A '0(, s.., .01:> <:"'\\"1 DaytIme T.lephon. NumbOf '" 2. \'1'0 0 o-'l o o ..... .... o o o o 'CoSo 0 ?~ \"j (.,Jl ame school dO on 2/31 . ~whe'" you Ilvedon 12/31/00. Col'lO.BaLI'INl> R K. ORR.I$, l..'. ORi.I5. IgJ022 2.(2.9..100 I/lio/ '\nO,-! I) .ROL'ij-N A......dod Return. FBI In thl. oval W = you are amending your 2000 PA return. = Floc.1 VHr FJlor.. FiB In this oval. FY beginning ~ -feD & ending ~~_ Rnld8l1cy Status. Fdlll only one oval. tI!!> A Resident c:) N Nonresident = P Part-Veer Resident from ~-100 to ~-100. Type FIler. Allin only one ove!. = S Single ., J Married, Filing JoinBy CJ M Married. Filing ~epa.rately c.::> f Final Rutum. In'1k:llIe reason.: r.ll.ll.o<,'i-'l ./1/z.oo' - D Deceased. Datn 01 death ~.18-'oo .... (U.'lMllQ Identlfloatlon'Lahel Change. <:::::) AllIn this oval if ttle label you received with this booJdet is not completely correct. or 'f you did not file a 1999 PA tax ,"etOO1. Do nol make corrections on the label- DISCARD IT. MunIclpeI\Iy wher8) 'OIl Ived 00 1 1100. WO~u:~S au~" 1)0 n\)\ US~ u;rl:S j nlpr wI10!t' dull,ns .". ~io\<.~ .~ "liS!' ,.,,. 'I /la. Gross Compen!atlon, from FA Schedule W-2S. or your Formes) W-2. or other statBmentst. . . . . . .' 1a. ......... lb. ~b. Unrelmbursed Emolovee Business Exoenses. from PA Schedule UEJ. . , . . . . . . . . . . . ~.: ."'t ",', ~c. Net Compensation. SUbtract Una 1b from Une 1a.J..... ... ,............................ 1c. . '~"",, 2. Interest Income. Complete end enclose PA Schedule A. II over $2.'500.1 . . . . . . . . . . . . . . . . _ . . .. 2. '" I 01 () 0 i'''''l'' . \ ~ D () 0 ~. Dividend Income. Gomplete and enclose PA Schedule H. If over $2,500.1 .. . . . . . . . . . . . . . . . . . . 3. 4. Ne11ncome or Loss from the Operalfon of a Business, ProfessIon, or Farm. . . . . . . . . . . . .. 2S 4. l~' '~, ~,' , S. Net Gain or Loss from the Ssle, Exchange, or Dlsposfffon of Proporty. .... , . . , . . . . . . . .. a 5. ';'::!n' 6. Net Income or Loss from Rents, Royalties. Patents, or Copyrights. . . .. . . . . . , . . . . . , . . ,. 2\ 8. 7, Eslate or Trust Income. Complete and enclose PA Sctl9dule J. ..,............,........,.. 7. "y,'-' , 8. Gambling and Lottery WInnings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Total PA l}Ixabfe n:ome. Add onIv Iha POSilive II'kXln19 amcurts from Unes 10. 2. 3, 4. 5, 6. 7. and 8.1 00 NOT A.DO any losses reponed on Unes 4, 5. or 6. . .. .. ... . . .. .. " . . . .. . . . _ . .. .' . 8. 9. (,2.$100 ',"" 10. Contributions To Your Medica' Savings Account. See the Instructions. .............".... 10. ~2. PA lax Liability. MultIply LIne 11 by 2.8"0 CU.~tI}. Also enter on un. 13, Side 2.! .. _. ...... 12. SIde 1 .(.", Z.s ;.1 0 b "li" \\i~ 2.0 ., "," 11. Adjusted PA Taxable Income. SubtractUne 10rrom Une9........................,..... 11, L EC O"f.'JCl.l;" USF; (l."l:.' 0000110015 Fe OOIJOU0015 ....J 03/28/01 08:16 FAX 650 5n~ 7120 ORACLE 1ilI023 -1 r~~;'ec~~;~'~l:~'''.'''''' 000Q0220012 . I '1.JlVo" "." 7 l() illl~g11r_ Is;,- 1/ /'>.(}1l - . iL..t~...~, ,. 1.';;lt,;~JYourN."": "'f""-lW6 f\..U'-Il'S I!L!'A Tax Liability. Entar vour tax lIablUtv from line 1Z on Slda 1l.. .... .. .. . . .. , .. . .. .. . .. .. 13. OfFICIAL use. ONLY 15. Credit from your 1999 PA Income Tax Return. 15. "4 rofttl PA Tax WltnnelCl from PA Schedule W-2S or YOUf Fonnf!U W-? or other sfJltemen.. ...... 14. 16.2000 Estlmaled Installment Payments................... ............................ 16. 11. 2000 Extension Payment. ....................................................... 17. 18. Nonresident Tax Withheld on yOur PASch8dule(S) NRK-l.... .........._..."............ 18. 19. Total Estimated P.ymentsendCredltll.Add Unes1S. 16. 17,MdlS; . ............... 19. I. I ~' ~ ~I': Tax Forglvene.. CredlL COmplete L1n.a 20a, 2Ob, 21, and 22. Rood klItRJctIons. 20b 0 dents Part a Ii 2 PA Schad I SP If j 20a. Filing Status: C) Unmarried or c:::> Married C:=1I o.ce.sed apen I , nit , U 8 ,h,.. Sopa,.ted."""-' ""]''"'>'rrITI ' ~ g,1. Tolal Eliolbilitv Income from Part C. Une 11. PA Schedule SPJ . .. . C j~ t .t~~ - , ru .... o o I\J ru o o o o ,.-,. ...."'.,.,..... ~~...~~,_ _, l< pC[r - 'Tl~r~ ~orQJvene6S (;redit from ..art D. Line 16, PA ~cneaul8 SPJ ........................... 22- t-~~~ ;';-'.f.-:.~-a 23. Total C'ad" tor Taxes Paid to Other States Of Countries. Encloae your PA Schedule G or RK-1. . . , 23- . . ! ~ . t' '1 lJ.>"/~l;%,\.?<i 't+"'~~ 24. PA Employment Incenttve Payments Credit. E~loseyour PA Schec*a W, AK-1 or NRK.1. ...... 24. J. ,I . ~.r'" . . ,1.. ~., ""'" 25. PA Jobs CreaUon Tax Credit. from enclosed certlflcate or PA Sch8dlje RK-1 or NRK-1. ...... ... 25. J ) ~~. ;. :a4 ~ lll'J] ::....,g!ilt,"'\n. 28. PA Waste nra RacyoIlng InveslmantTax Cre<i~ from ondosod C8llI1icaIatf "" _0 RK.1 or NRK-l. ... 26. :; ~ " ~., :Ii< , . I 27. PA Research and Development Tax Credit, from erdOS8d certlRcate or PASchedu!e RK-1 or NRK-1. .... n. ~ I 128. TOTAL PAYMENTS illiG CREDITS. Add Unas 14. 19. snd 22 tmJuah. 27J,........ . .,.. . . '" Zll. l ( 129. TAX DUE. It Une 13 Is more tnsn line 28 . ~G enterlnetjJf1erenr.A hlmtJ......., ,...., ...,...... Zll. \ h' \ 5"" . - -'-~ij". r. ~~E~:'A~~ENT. ~ L:no 26 ~s more than ~no 1~ ant~uo dlffel1lllC8 horeJ .............".. 30. , . , ( , . .~.. e 0 AU Line 3 thro gh 37 must qual lne 3 .... ,....,..,';Al [J1. Refund Amount of Une 30 vou want as a check maUetj to vow. . . . . . . . . . . . Refund 31. r.>! ..... ~ll!!I ~~,I~fu1~. ;iit)~ " , . 32. Credit -. Amount of Un9 30 you want as a credit 10 your 2001 e&limated fax accountl ..... . . . . . r3. ~~~=~,I~~ ~..~~.O.LJ~~ ~~ ~~e. ~:.v~~.~~~t.t~.~~~~t~.~.~~ .~~I~.~~...~~~~I~~~f.,."". 134. ~:~:~:;~~I~~:.~~r.~~.y~~.~~f.t~.~~~.~.t~~.~~I~~~~.~~~~~~~'............. ~ ~~~~,~~ ~~. ~~.o.u~~ ~ ~~e. ~ ~~.~~t. t~. ~~~~t~.: .t:~ ~~.~ ~.~~~~~~~ ~~~t~ . . . . . . 33. [t" ~~.i.J.i~,~'"i~-"ii....,!,',J ! ~\ I 'I I \ ._"-~ 34.. " ~ (;~J j '.~ . ;. - !')J ,~l~li'\.m-;iim;.,;.:;;.~,:..;.,'f.~~:"~!.. -~ ;;-~1 35. ~':j' ~Jf.Jt'~~"; "'''l 36. ~ ,i' ;~l ,!I. :j ,1 t~ . '! tt.....,,;.. 't"""'._....J;'..""_~_7:.,:,J;,..I!".~.,~\,' .'- ..,- ~fP.fJ...'.,'"IlA"'...;r.~ff.~I~~ ;......<11....~... ~....: 37.:J (~ '. .; X .~ .~ ~~ : ;~ l~, ., -J..",~\..,,')l.,.....j.'-IJ-t...., ___1 .:~: G6. Uonanon ... Amount or un. 3U you Viani to aonat. 10 l1le l\.oreatVletII8l11 Memorial Inc. I ~=;~:~ ;=(~~ ~~ ~~n.~;~ .~~.~~~t. t~.~~~~t~.~ .~~ .~~~~~~. ~~I~~ ~~~~. . . . . . . _ . Under pename. of perjury, I (we, decla,. Ihal I (we), have elUlnMned Ihl. retum, ~dlng .11 accompanying achedul. end I'llltemenll, anella lhe bes' of mv (our) belief the ant true, correct. and com let.. You' sc.:;.v, Of}Jl.I..S -1 .'J(>OUSQ' .grtal\Jf4l.lttltll'\glok'My: . A. ClI\.L~ Prep.rer or COmpany Name, other 1han I8xpayer(s) F'rllp.", r~O;::B~ Name /'i!~Q prllll102..l2:" ~ SIgn..!' 0.'.: SpOURI',Oc.upatlQn: L 0000220012 Oal.: Your Occo.JPlll.IDn: PLEASE 00 HOT CAlL ASOtlT VOUR AEflHJ UNTIL 8 W Ski" 0000220012 -.J 03/28/01 08:18 FAX 650 506 7120 ORACLE ~024 .-.J WAGE STA1. .ENT SUMMARY l"A Schedule W.2S (09100) PA DE ~R11/le:NT OP R Name~s) as shown on your PA tax return: 0001210012 2000 OFFICIAl. USE ONLY 5"""' 50curily Number: "structlona. Instead submitting your orm s -2. or PhotocoPieS. you may write necessary onnatfon . Keep your origmal Fonn(s) W-2. Important Your PA compensation may be different from your f94;leral wages. celJtlon. If you believe thai . PA amount on your Form W-2 Is Incorrect. you mU1Jt submit your accual Form W~2 with a written explanation from your emptoyer. You must submit oIher slste..-nts lor amounts you are reporting as cornpensa1\on on your PA tax return Informatton From Each Form W-2 Number of Form(s) W.2 I I If you need more space. ycu may phoIocopy tis lCheduIe or pre~ 'fOUr o\Vl1 schedLdaln thls fennat. (a) (bJ (q InClude tn. total on UM 1. d) ,_ ..ololnl on Uno " 000 not includo local Employer IdentlftcaUon Numb9\" F1Ideral wages horn PA taxable COJ.,pe.wIol. PA taX wIIIlheld i:1oome Iax_ f~' box 1 110m box 17 from bo> 18 n colJnn (d). 1. $ I $ $ "Do not i1ttJde 1lIx 2. ;'11!1 $ $ $ _loanolhar 3. $ $ $ _at "'""'Y In 4. ;.,~ir $ $ $ COUnn (d). 5. I $ $ $ CautIon. Th> 6. $ $ $ ~ 7. o' $ $ $ resoMlSlhori\t1t '" nlq<i19 your Total $ $ actual Fonn(.) W-2. Interest and Dividend Income 2000 PA Schedule A & 8 (09'()o) PA DEPARTMeNT OF F'EVENUIi Namepq as shown on your PA taxretum: W Social Security Number. \<. I(.r...Ol\J.D k . . O~'$ 2'2..C - l,Q ... 9 G,S It you need more space, you may photocopy these sch ules or preQ8111 yOUr own schedules in thfs format. Cautlaft. Federal and PA rules 10r taxable Interest and dMciend Income are dfffer'ent. RNd the Instruction.. FlUngtt~.1f either your PA Interat Income or dMd]nd Income Is $2,500 or less, you do not need to submIt a 'Schedule. rf either.your interest Income or diVIdend Income Is more than $2.500, you must suhmlt a sd1edule. Filing options: nJ 1. You can 8ubmlt a copy at your federaJ schedufe, or you can just enter 'JfU f8derallntarast tIcome andIor dMdend Income. The Department can verify the r-lIII amounts you reported on your Federal Income Tax return. C 2. Olhel'Wf8e, list the name 01 each paver and lI\e amount of PA interest anddlvtdend lncom8 you received In 2000. ~ PA Schedule A - PA Tanbr. In"'" Income ru FUfng 0 tlon 1. EntertheamounUrom UfFed8ralScheduleB 1 orSd1edulet foI'm-1G4OA). "'" . C Filing option 2. PA Taxable Interest Income. Read the 'n.tructlons. CJ CJ t. $ ~:!- Wl\'l ~O\.v, 'Q,(>.,.>(... $ 'Z. \ 'i>S co r\J~~ ap.O\l..'f!.. $ QI,. OC> DC\:.C-l:l $ ~I"'\''S. ll. . $ $ $ $ $ $ $ 2.. Total PA Tax." Int9f9l,t Income. Add 'tie amounts above and enter an Une 2 of your PA taX retUrn. 2. $ ~It>i .00 PA Schedule 8 . PATaxable DlYldend Inco.. F1Ung option 1. Enler the amount rrom your Federal Schedule B (Form 1040) or ScheciJIe [ (Fcxm 104M). Filing option 2. PA TSl(8ble Dividend Income Read the tnstrucdon8. .0$ ISo.OO 1$ $ $ $ $ $ $ $ $ $ 2. Tolal PA T<<xable Dividend Income. Add the amounts above and enter 0" Une 3 of your PA tax return. 2. $ "TSO .0(:) Important, Capital gain dlatribuUons aAl dMdand Income tot PA puqIDHII..wn though you rapott them on SchlldUl. D fa fftderal purpoMfl. L [J001210012 0001210012 -.J -. .. Register of Wills Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate. of Carolyn W. Orris No. ~ I -0 J -to '-I also known as, Carolyn Marie Orris I Deceased Social Security No. 184-24-5294 Randy R. Orris,. Petitione.'s), who is/are 18 years Dt lIOe 01 oIdet'. applyCi") tOr: (COMPLETE" A" OR "8" BELOW:) & A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut.2!.- named in the Last Will of the Decedent. dated March 28, 2000 and codicil(s) dated N/ A . State relevant cifl:umst8Ilces. e.g.. renunciBtion. death of executD'. etc, Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incompetent: r:I B. Grant of Letters of Administration (c.t.a.. d.b.n.c.t.a.: pendente lite; durante absentia; durante minoritBte) Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence Decedent was. domiciled at death in Cumberland CO\lnty, Pennsylvania, with his/her last family or principal residence at 8 South Second Street, Wormleysburg, Boro ofWormleysburg, Cumberland County, PA 17043 (list stl"t. number a,d municipality) Decedent, then 68 years of age, died. January 7 , 2021, at HealthSouth Renova Center, Lower Allen ILocBtioo) TownshIp, P A Decedent at death owned property with estimated values as follows: (If domiciled in PAl All personal property ......... ',' . . . . . . . . . . . . . . . . . . . $ 150,000.00 (If not domiciled in PAl Personal property in Pennsylvania. . . . . . . . . . . . . . . . . . . . . . $ (If not domiciled in PAl Personal property in County. . . . . . . . . . . . . . . . . . . . . . . . . . $ Value of real estate in Pennsylvania ............................................... $ 1 45,000.00 Real Estata situatadT :;.:oli~';'~:. 8. South. Secon<f Street; W ormleysburg; CUiribeiIaild Counfi,. P 6nnsJ~~~~ .~?04 j Wherefore, Petitioner(s} respectfully request(s) the probate of the last Will and Codicil(s} presented with this Petition and the grant of letters in the appropriate form to the undersigned: Typed or printed name and residence Randy R. Orris 998 Governors Bay Drive, Redwood City, CA 94065 RW-7 J~-~C)d--9 ...11 ... Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true and correct to the best of,the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to and affirmed and subscribed W,O~/~ an y . rns, ecutor ( before me this 12th __ day of · January 2001 . r- ~ C. ~J-U. a,-,-PB AJdn"~. I. I. \ Estate of Carolyn W'. On-is DECREE OF REGiSTER Deceased No. 21-01-64 Carolyn Marie Orris also known as Date of Death: January 7, 2001 Social Security No: 184-24-5294 AND NOW, ~ANAURY 16 , 20~, in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DeCREED that Letters ~ Testamentary 0 of Administration (c.t...; d.b.n,ro,t.; pendente lite; dUlente ab~lia; c1u18l\1t!' minoriU'tel are hereby granted to' Randy R. Orris - in the above estate and that the instrument(s), if any, dated March 28, 2000 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters. . . . . . . . . . . . . . . . . .. . . . .. . . . Short Certificate(s)...~O... Renunciation................. . Affidavit ( )................. Extra Pages ( )..... . . .. .. . Cod i ci I. . . . . . . . . . . . . .. . . . . . . . . . . . JCP Fee........................ Inventory & Tax Forms... o th e r . . . . . . . . . . . . . . . . . . . . . . . . . . . . TOTAL............:.. . RW-7a $ 235.00 ~ C,., ~~o ~J!B.\lp~t, Register of Will! \ $ 30.00 $ $ $ 9.00 $ $ 5.00 $ $ Attorney: Mark E. Halbruner, Esquire 1.0. No: 66737 Address: Gates & Associates, P .C. 1013 Mumma Road, Suite 100, Lemoyne, PA 17043 Telephone: 717-731-9600 DATE FILED: Jan. 16,2001 $ 279.00 ['h is is to certify that the information here given is correctly copied fron? an original certificate of death dul)~ fLIed with me as L\)cd Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filmg. WARNING: It is illegal to duplicate this copy by photostat or photograph. 21-01-64 P 7174185 f ", 111,'111/"'''''/',,,,, \\l'~ t.....\1~ OF P~i;",-_ l'~'\.!>-- ~l;I(~J ~ ~l~~' ." "~\. * 5::)B' . ~~ s~ Jtl'... \?~ ~~! '. . ";;;I!:~ ~ ~f!{'A. !i:~ ~*\~..;.,~.. fJ*~ \4~'c" . l~l '\.~.~ . .' /~\" --;.-;}?fMrNf~{~~,\ll "';"'~"~'~/JI/JIIIJII' ", a~/ ~~ ~q.~ <... ~ a..t.~~'l"'P!-~ ?_ <>7 Local Registrar d Fee for this certificate, $2.00 No. JAN 0 Q 2001 Date .143 Rev. 2187 COMMONWEALTH OF PENNSYLVANIA · OEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH STATE FILE NUMeeA SOCIAL SECURITY NUMBER 3.184 -24 -5294 DATE OF DEATH iMOIlIt1. Day. '.." an.7,2001 BIRTHPlACE (City aAd SIaIe !Y F!Yeogn Counlry, 68 VIS. elfenstein,PA ERIOulpatielll 0 ~)D . Cumber land Co. ... DECEDENT'S USUAL OCCUPATION (Giveluocfo/ work~dur ~ of ..... do u r canpU~ pr r state goverrunent 11.. 11b. DECEDENT'S MAIlING ADDRESS (Street. Cllyfbom. Stale. Zip Code) 8 S. Second Street Wormleysburg,PA17043 lDwer Allen Twp. ealthSouth Renova Center Ie. ... KIND OF BUSINESS/INDUSTRY RACE. American Indian, Sleek. WhIte. etc. (Speedy) white 10. COUNTY OF OERH DECEDENTS ACTUAL RESIDENCe (See IflSlrUCbOn& on other SIde) WAS oeceDENT e"ER I DECEDENT'S EDUCATION U.S. ARMED FORCE S onl h com v.. 0 No err~~ry (1~) 12. 13. 17.. State Pennsylvania MARITAL SWUS. Merried Nevef Married. Widowed. wid~pecrtyl 14. l1c.O YR. decedent lived In SURVIVING SPOUSE (II WII.. gNe maoden name) CUmberland Co. Did decedenI '"'- in e towl1lhip? NIp. 17b. 17d.~within~~ofWormleysburg city/bGro. Carl Wary R. Orris MOTHER'S NAME (First. Middle. MlIIden Surname) 1l.1abe1 V. Kramer INF~T'S MAlUHO ~ss (Street. City/i)wn. Slate. Zip ~~ ~~ti Governor 5 Bay Dr. ,RedwOod City, CA94065 PlACE OF DlSP08lTlON . Narne 01 Cemetery, Cr8mUlty LOCATION. CICyIlbwn, Stete. ZIp Code or Other PIece' 1 :2 lue Ridge Mem. Gardens lDwer Paxton ~. }PA a1e:. 21d. NAME AND AOORESSOF ~IUTY " sselman Funeral Home, 324 H.mrellwe. ,I.a'rq1rE,PA LICENSE NUMBER ORE SIGNED (Month. Day. .,.,,) ~ it.... 23a-c only when .~ ~. not evail8ble at time of death to ~ c:ertJfy eeuee of dNtt'I. _ __ 24-28 rnUlII be c:ornpIeted by :--..-.on who pl'OIlOUrlCa death. ~ - 27. MAT I: Enter the diH_. injuries 0 LiaC only one ca.... on ellCll 21. I Apptoximat. : interwl betwMn I oneet and dnIh I I I Sequentidy Iiet c:onditiona if eny,lMdIng to iIMledIaIe QIMe. Enter UNDERLYINQ CAUlII! (~0I1fltUfY theI iMl8fed ~ resul/JnO en deelhl lAST \ b. c. d. DUE TO (OA AS A CONSEQuENCE Of): DUE TO (OA AS A CONSEQUENCE Of): WAS AN AUTOPSY WERE AUTOPSY FINDINGS MANNER OF DEATH PERFORMED? AUlUl.A8l.E PRIOR TO ~ COMPLETION OF CAUse 0 OF DEATH? Naturel Homic:ide Pending InveatlQiltion 0 ~ D No 0 CoYId not be delenntned 0 DATE OF INJURV (,,",com. Day. Year) TIME OF INJURV INJURV Ia WORK? DESCRIBe HOW INJURY OCCURRED. V.. 0 NoD Ii ~ ~~ "PAONOUNClNG AND CERTIfYING PHYSlCJAN (PhYSlCllIn bo/tI p<onouoclng oeoilh and Cef'I.ly.ng 10 cause 01 aealh) To the beet of "', knowledge, deeth occurred ., the time, d.... and piKe. and due 10 the c.uH(.) end menner e. ...ted.. . . . . . . . . . . . . . . . . . . . . . . . . o :aIL 21b. CERTII'IER (Clleclt only one) "CERTII'YING PHYSICIAN (PhVSIC&an C/lftllylOg cause 01 Oealh wilen anoll1e< phYSlCoarl Ilas p<llnOIJnced Oeath ana completed Item 23) To the bMI of "', knowledge, dea. occurred due 10 the caUM(.) end menner.. ""ed. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.. 3 . PLACE Of INJURV - AI home. !arm. str..t. factory. olllca building. .Ie. (Spec.ly\ 308. "UEDlCAl. EXAUINER/CORONER On the bael. of ellemln.llon .nd/or InveatlgeUon, in my opinion, d..th occurred at the lime, d.te, and place, end due to the e.uM(a) end manner.. ..eted.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31e. REGISTRAR'S SIGNATURE AND NUMBER o I~/~/~I 34. p. 2c;o / Register of Wills Cumbe.rland' County, Pennsylvania INVENTORY Estate of Carolyn W. Orris No. 21-2001-0064 also known as ,Date of Death January 7, 2001 , Deceased Social Security No. 184-24-5294 Randy R. Orris Personal RepresentativeCs) of the above Estate, deceased, verify that the items appearing in the following inventory include ail of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. 1.0. No.: 66737 Address: Gates & Associates, P.C., 1013 Mumma Road. Suite 100, Lemoyne. P A 17043 Telephone: 717-731-9600 P SOnal[r.sO~~ Randy R. Orris Name of Attorney: Mark E. Halbruner, Esquire Dated G, -4. LOO\ Description Value 1. Real estate located at 8 South Second Street, Wormleysburg, Cumberland County, Pennsylvania. 2. 460 shares of Waypoint Bank common stock; date of death average $10.90625 per share. $ 52,271 .92 3. U.S. Savings Bonds 4. Fulton Bank Money Market Savings Acct. No. 9900-66803 5. Fulton Bank Checking Acct. No. 1068-51180 6. Fulton Bank Certificate of Deposit No. 022-0120868 7. Fulton Bank Certificate of Deposit No. 022-0128003 8. Waypoint Bank Certificate of Deposit NO.1 060289156 5,016.88 991.84 9. Net proceeds from auction of miscellaneous personal property (Gross proceeds were $2,356.75 less $786.75 auctioneer fees) 10. 1998 Chevrolet Cavalier LS Sedan 10,352.84 12,676.47 10,663.71 15,053.76 35,057.21 1,570.00* 8,870.00 Total: $152,524.63 (Attach Additional Sheets if necessary) NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may. at the election of the personal representative, include the value of each item. but such figures should not be extended into the total of the Inventory. RW-8 ~0-dChl'- 9 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE *' BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG I PA 17128-0601 RANDY R ORRIS 998 GOVERNORS BAY DR REDWOOD CITY CA 94065-0000 INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN REV-IU" EX AFP el2-00) 10-22-2001 ORRIS 01-07-2001 21 01-0064 CUMBERLAND 184-24-5294 01131985 CAROLYN W Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1604 EX AFP (12-00) -- INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __ DATE 10-22-2001 ESTATE OF ORRIS CAROLYN W DATE OF DEATH 01-07-2001 COUNTY CUMBERLAND FILE NO. 21 01-0064 ADJUSTMENT BASED ON: S.S/D.C. NO. 184-24-5294 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 01131985 FINANCIAL INSTITUTION: ALLFIRST BANK ACCOUNT NO. 0023519789 TYPE OF ACCOUNT: () SAVINGS (X) CHECKING () TRUST () TIME CERTIFICATE DATE ESTABLISHED 06-28-1988 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 1,052.49 0.166 175.42 .00 175.42 .45 7.89 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) INTEREST IS CHARGED THROUGH 11-06-2001 TOTAL TAX CREDIT .00 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 7.89 'EVERSE SIDE OF THIS FORM INTEREST AND PEN. .06 TOTAL DUE 7 9~ f PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 'OTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), 1AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) . \ .. REV-1470 EX (6-88) . INHERITANCE TAX EXPLANA TION OF CHANGES COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG PA 17128-0601 DECEDENT'S NAME CAROLYN W ORRIS FILE NUMBER CLAUDIA MAFFEI ACN 2101-0064 01131985 REVIEWED BY ITEM SCHEDULE NO. EXPLANA liON OF CHANGES Changed tax rate from 15 percent to 4.5 percent since a son is a lineal beneficiary. ROW Page 1 \/h-aora.- 5' BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REY-l'07 EX AFP (12-00> KAREN L FOLEY 998 GOVERNORS BAY DR REDWOOD CITY; CA 94065 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 09-17-2001 ORRIS 01-07-2001 21 01-0064 CUMBERLAND 01131986 CAROLYN W Allount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forti with your tax pay.ent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REY=ii.lfj-i3f-AFP--ri"2-:iiifr------...-iNHERITANcE--fAx-STAfEME-tif-OF-AC-Couiff--.-..--------------------- ESTATE OF ORRIS CAROLYN W FILE NO. 21 01-0064 ACN 01131986 DATE 09-17-2001 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 07-23-2001 P R I NCI PAL TAX DUE: ........................................................................................................................................................................................................................... 26.31 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 08-10-2001 CDOOO152 .00 26.31 TOTAL TAX CREDIT 26.31 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 IE IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIrw (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) " 1~-~v-9 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT * REV-In7 EX AFP (12-00> MARK E HAL BRUNER ESQ GATES & ASSOCIATES 1013 MUMMA RD STE 100 < LEMOYNE PA 17043 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 08-06-2001 ORRIS 01-07-2001 21 01-0064 CUMBERLAND 101 CAROLYN W Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-v:i6'ifj-Ex--AFP--(i2-:ol)r------...--iNifERi'~fANcE--TAX--STATEME-N'T-Or=-ACCOUNT--...--------------------- ESTATE OF ORRIS CAROLYN W FILE NO. 21 01-0064 ACN 101 DATE 08-06-2001 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 07-16-2001 PR I NC I PAL TAX DUE: ........................................................................................................................................................................................................................... 9,640.11 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 04-06-2001 AA478247 482.01 13,800.00 07-20-2001 REFUND .00 4,641.90- TOTAL TAX CREDIT 9,640.11 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) \, / b-c{)o~-..9 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX MARK E HAL BRUNER ESQ GATES & ASSOCIATES 1013 MUMMA RD STE 100 LEMOYNE PA 17~4~-7558 DATE ESTATE OF DATE OF DEATH FILE NUMBER iCOUNTY ACN 07-23-2001 ORRIS 01-07-2001 21 01-0064 CUMBERLAND 101 * REV-1547 EX AFP (12-00) CAROLYN w Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-V=is4j-E:X-AFP--(i2-':O())--NO'~fiCE:--OF-.rtiHE:ifiTAiicE-TAjc-APPRAiSE:MENT~--Aii-oWAiicE-OR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF ORRIS CAROLYN W FILE NO. 21 01-0064 ACN 101 DATE 07-23-2001 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. 10. 11. 12. 13. 14. (9) (10) 37,433.28 52,271.92 6,008.72 .00 .00 95,030.74 3,063.07 95,924.66 (8) Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) Debts/Mortgage Liabilities/Liens (Schedule I) Total Deductions Net Value of Tax Return Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) Net Value of Estate Subject to Tax NOTE: I~ an assessment was issued previously, lines 14, IS and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: .00 X 00 = .00 214,224.59 X 045 = 9,640.11 .00 X 12 = .00 .00 X 15 = .00 (19)= 9,640.11 641.24 (11) (12) (13) (14) NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 252,299.11 38.074 52 214,224.59 .00 214,224.59 PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 04-06-2001 AA478247 482.01 13,800.00 TOTAL TAX CREDIT 14,282.01 BALANCE OF TAX DUE 4,641.90CR INTEREST AND PEN. .00 TOTAL DUE 4,641.90CR * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A ".CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) )h"/;;0-/~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG I PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE v '* NOTICE OF INHERITANCE TAX APPRAISEKENT~ ALLOWANCE OR DISALLOWANCE OF DEDUCTION~, AND ASSESSKENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REY-1548 EX AFP <12-00) RANDY R ORRIS 998 GOVERNORS BAY DR REDWOOD CITY CA 94065 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 07-23-2001 ORRIS 01-07-2001 21 01-0064 CUMBERLAND 184-24-5294 01131985 Allount Remitted CAROLYN W MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ Rifv=is~8-E3f-AFii-(i2-:oo1------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 07-23-2001 ESTATE OF ORRIS CAROLYN W DATE OF DEATH 01-07-2001 COUNTY CUMBERLAND FILE NO. 21 01-0064 TAX RETURN WAS: S.S/D.C. NO. 184-24-5294 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 01131985 FINANCIAL INSTITUTION: ALLFIRST BANK ACCOUNT NO. 0023519789 TYPE OF ACCOUNT: () SAVINGS (Xl CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 06-28-1988 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 1,052.49 0.166 175.42 .00 175.42 .15 26.31 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) PAYMENT MUST BE MADE BY 10-08-2001*. TOTAL TAX CREDIT .00 BALANCE OF TAX DUE 26.31 INTEREST AND PEN. .00 TOTAL DUE 26.31 * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. * ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A --CREDIT-- ( CRl, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) /6 '-ld6~ c,,/' BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE (;/ *' NOTICE OF INHERITANCE TAX APPRAISEKENTL ALLOWANCE OR DISALLOWANCE OF DEDUCTION~, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-1548 EX AFP <12-00) KAREN L FOLEY 998 GOVERNORS BAY DR REDWOOD CITY CA 94065 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 07-23-2001 ORRIS 01-07-2001 21 01-0064 CUMBERLAND 184-24-5294 01131986 CAROLYN W Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-v:isir8-E3f-A~J>>-(i1f:oo)------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 07-23-2001 ESTATE OF ORRIS CAROLYN W DATE OF DEATH 01-07-2001 COUNTY CUMBERLAND FILE NO. 21 01-0064 TAX RETURN WAS: S.S/D.C. NO. 184-24-5294 ex) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 01131986 FINANCIAL INSTITUTION: ALLFIRST BANK ACCOUNT NO. 0023519789 TYPE OF ACCOUNT: () SAVINGS ()O CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 06-28-1988 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 1,052.49 0.166 175.42 .00 175.42 .15 26.31 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) PAYMENT MUST BE MADE BY 10-08-2001*. TOTAL TAX CREDIT .00 BALANCE OF TAX DUE 26.31 INTEREST AND PEN. .00 TOTAL DUE 26.31 * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. * ( IF TOTAL DUE IS lESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A ..CREDIT.. ( CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE Of THIS fORM FOR INSTRUCTIONS. ) .. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE 'BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 *' ~- INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. 21 01-0064 ACN 01131986 DATE 07-10-2001 REY-154S EX AFP C09-00> EST. OF CAROLYN W ORRIS S.S. NO. 184-24-5294 DATE OF DEATH 01-07-2001 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS lXJ CHECKING o TRUST o CERTIF . KAREN L FOLEY 998 GOVERNORS BAY DR REDWOOD CITY CA 94065 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 ALLFIRST BANK has provided the Depart.ent with the infor.ation listed below which has been used in calculating the potential tax due. 'Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this infor.ationis incorrect, please obtain written correction fro. the financial institution, attach a copy to this for. and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Co..onwealth of Pennsylvania. Questions .ay be answered by calling (,717) 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0023519789 Date 06-28-1988 Established PART [!] 1,052.49 16.667 175.42 .15 26.31 TAXPAYER RESPONSE :1~~~~lilIL.I~~~1~i1~lj_I~1~iIL~111l1_~11ml: .'.:.:;:.:::F!~~:.:' ~%11;"."'."'."';m~A~:':;~;' ...............-.....-.-.............-...-...".......-...-.........-.......................-.........-.-.......-.-.-................................................... ..-........ ........ ...-.........-.-.. -.-.................-."...".................-...-.................-.-.".-.....-.............-.-...................-.-.......-.-...-...-.-.-.-.-...............-........ .........-. ........ ..-.........-.............. .-.-.-...-...........-.-.-.-...-...........-.-.-.....-.............-.............. ......-.-.-.......-.....-.....-...-.................-.-...........-.......-................ ..-........ -....... ...........-.......-.....-. Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x To insure proper credit to your account, two (2) copies of this notice .ust acco.pany your pay.ent to the Register of Wills. Make check payable to: "Register of Wills, Agent". x. NOTE: If tax pay~nts are .ade within three (3) .onths of the decedent.s date of death, you .ay deduct a 5Z discount of the tax due. Any inheritance tax due will beco.e delinquent nine (9) .onths after the date of death. Tax [CHECK ] ONE BLOCK ONLY A. The above infor.ation and tax due is correct. 1. You .ay choose to re.it pay.ent to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you .ay check box "A" and return this notice to the Register of Wills and an official assess.ent will be issued by the PA Depart.ent of Revenue. B. [J The above asset has been or will be reported and tax paid with the PennsYlvania Inheritance Tax return to be filed by the decedent.s representative. c. [] The above infor.ation is incorrect and/or debts and deductions were paid by you. You .ust co.plete PART ~ and/or PART ~ below. PART [!] DATE PAID DEBTS AND DEDUCTIONS CLAIMED If you indicate a different tax rate, please state your relationship to decedent: PART ~ TAX RETURN - COMPUTATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax s. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OF I 2 3 4 S 6 7 8 x TAX ON ~OINT/TRUST ACCOUNTS x PAYEE DESCRIPTION AMOUNT PAID I TOTAL (Enter on Line S of Tax Computation) I $ that the facts I have reported above are true, correct and and belief. HOME (CoSO ) ~3 \ - ~ ~ ~q WORK ( b{O ) ~oCa - g l "\ TELEPHONE NUMBER Dk. COMMONWEALTH OF PENNSVLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 '* ) 0 ---c1{~ -c; INFORMATfNODN NOTICE FILE NO. 21 01-0064 TAXPAYER RESPONSE ACN 01131985 DATE 07-10-2001 REY-1545 EX AFP (09-00) EST. OF CAROLYN W ORRIS S.S. NO. 184-24-5294 D~TE OF DEATH 01-07-2001 COUNTY CUMBERLAND TYPE OF ACCOUNT D SAVINGS [X] CHECKING D TRUST D CERTIF . -, , i _ RANDY R ORRIS 998 GOVERNORS BAY DR REDWOOD CITY CA 94065 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 ALLFIRST BANK has provided the Depart.ent with the inforaation listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this infor.ationis incorrect, please obtain written correction fro. the financial institution, attach a copy to this for. and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Co..onwealth of Pennsylvania. Questions .ay be answered by calling (717) 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0023519789 Date 06-28-1988 Established PART [!] A. [ CHECK ] ONE BLOCK B. ONLY c. Account Balance Percent Taxable Amount SUbject to Tax Rate Potential Tax Due To insure proper credit to your account, two (2) copies of this notice .ust acco.pany your pay.ent to the Register of Wills. Make check payable to: "Register of Wills, Agent". x x- NOTE: If tax payaents are .ade within three (3) .onths of the decedent.s date of death, you .ay deduct a 57. discount of the tax due. Any inheritance tax due will beco.e delinquent nine (9) .onths after the date of death. Tax '-'~';';~m~.lmM~i1l1l.lt~.mm -.............................-.....-...-...................................-...-......... ...........-.........-...-...-.................-.-...-.-.........-...................-...- -...-.....................................-.-.....-.....................-................... [] The above information and tax due is correct. 1. You .ay choose to re.it pay.ent to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you .ay check box "An and return this notice to the Register of Wills and an official assess.ent will be issued by the PA Department of Revenue. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent"s representative. ~The above infor.ation is incorrect and/or debts and deductions were paid by you. You .ust coaplete PART ~ and/or PART ~ below. x ON JOINT/TRUST ~ - 2..8 - \'l ti:) ; CS2.,4 ~ t~.Cr.~( \lS .~2. o \ l~ .~'- to C\~ t-8~ DEBTS AND DEDUCTIONS CLAIMED ACCOUNTS If you indicate a different tax rate, please state your relationship to decedent: PART ~ TAX RETURN - COMPUTATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax s. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due TAX OF 1 2 3 4 5 6 7 8 x PART ~ DATE PAID PAVEE DESCRIPTION AMOUNT PAID I TOTAL (Enter on Line 5 of Tax Computation) I $ o perjury, I declare that the facts I have reported above are true, correct and my knowledge and belief. HOME (~ ~ 0 ) (,~ \ --S<:'11 WORK (~!() )G.J/-~'\,\ TELEPHONE NUMBER DATE COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 REV-1162 EX( 11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT RANDY R ORRIS 998 GOVERNORS BAY DR REDWOOD CITY, CA 94065 -------- fold ESTATE INFORMATION: SSN: 184-24-5294 FILE NUMBER: 21-2001- 0064 DECEDENT NAME: ORRIS CAROLYN W DATE OF PAYMENT: 08/14/2001 POSTMARK DATE: 08/10/2001 COUNTY: CUMBERLAND DATE OF DEATH: 01/07/2001 NO. CD 000152 ACN ASSESSMENT CONTROL NUMBER AMOUNT 01131986 I $26.31 I I I I I I I I TOTAL AMOUNT PAID: $26.31 REMARKS: RANDY R ORRIS CHECK#1080 SEAL INITIALS: CW RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX( 11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT RANDY R ORRIS 998 GOVERNORS SAY DR REDWOOD CITY, CA 94065 -------- fold ESTATE INFORMATION: SSN: 184-24-5294 FILE NUMBER: 21-2001- 0064 DECEDENT NAME: ORRIS CAROLYN W DATE OF PAYMENT: 08/15/2001 POSTMARK DATE: 08/10/2001 COUNTY: CUMBERLAND DATE OF DEATH: 01/07/2001 NO. CD 000159 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $7.89 I I I I I I I I TOTAL AMOUNT PAID: $7.89 REMARKS: RANDY R ORRIS CHECK# 1081 SEAL INITIALS: SK RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS RtolsTER OF witts . .,/ . \ l v '---- PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE FORM 6.12 YEARLY UNTIL COMPLETION. STATUS REPORT UNDER RULE 6.12 Name of Decedent: Date of Death: Carolyn W. Orris atk/a Carolyn Marie Orris January 7,2001 21-01-0064 Will No.: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: Nt A 3. If the answer to No.1 is yes, state the following: A. Did the personal representative file a final account with the court? No B. The separate Orphans' Court No. (if any) for the personal representative's account is: None C. Did the personal representative state an account informally to the parties in interest? Yes D. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphans' Court and may be attached to this report. Date: December 18, 2002 f11~!:~a Mark E. Halbruner, Esquire PA J.D. # 66737 GATES, HALBRUNER & HATCH, P.C. 1013 Mumma Road, Suite 100 Lemoyne, PA 17043 (717) 731-9600 Capacity: Counsel for Personal Representative . Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 . Date: 12/06/2002 RANDY R ORRIS 998 GOVERNORS BAY DR REDWOOD CITY, CA 94065 RE: Estate of ORRIS CAROLYN W File Number: 2001-00064 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 1/07/2003 Your prompt 'attention to this matter will be appreciated. Thank You. Sincerely, MARY C. LEWIS REGISTER OF WILLS cc: v File Counsel Judge ~ ~ CERTIFICATION OF NOTICE UNDER RULE 5.6la) Name of Decedent: Carolyn W. Orris a/k/a Carolyn Marie Orris Date of Death: January 7, 2001 File No.: 21-01-0064 To the Register: I certify that notice of estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on January 30, 2001. Name Address Randy R. Orris 998 Governor's Bay Drive Redwood City, CA 94065 Jeffrey S. Orris 1440 East Broadway Road #211 7 Tempe, AZ 85282 Notice has now been given to all persons entitled thereto under Rule 5.6(a). '/111M/( ~.. Mark E. Ha bruner, Esquue Counsel for Personal Representative Gates & Associates, P.C. 1013 Mumma Road, Suite 1~ Lemoyne, P A 17043 ,'- (717) 731-9600 Dated: January 30, 2001 .-'" ~ IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION TillS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE ANY MONEY OR PROPERTY FROM TillS ESTATE OR OTHERWISE. Whether you will receive any money or property will be detennined wholly or partly by the decedent's Will. If the decedent died without a Will, whether you will receive any money or property will be determined by the intestacy laws of Pennsylvania. BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, PENNSYL VANIA In Re: Estate of Carolyn W. Orris, a/k/a Carolyn Marie Orris, deceased. No. 21-01-0064 TO: Randy R. Orris 998 Governor's Bay Drive Redwood City, CA 94065 Jeffrey S. Orris 1440 East Broadway Road #2117 Tempe, AZ 85282 Please take notice of the death of decedent and the grant of letters to the personal representative(s) named below. The Decedent, Carolyn W. Orris alkla Carolyn Marie Orris, died on the 7th day of January, 2001, at Cumberland County, Pennsylvania. The Decedent died testate (with a Will). The personal representative of the Decedent is: Randy R. Orris 998 Governors Bay Drive Redwood City, CA 94065 (650) 631-5619 If the Decedent died testate, the Will has been filed with the Office of the Register of Wills of Cumberland County, located at 1 Courthouse Square, Carlisle, PA 17013-3387; Phone No.: 717-240-6345. A copy of the Will or Petition may be obtained by contacting the Register of Wills and paying the charges for duplication. Mark E. Halbruner, Es ire ._~' Counsel for Personal Representative Gates & Associates, P. c. 1013 Mumma Road, Suite 100 Lemoyne, PA 17043 (71 7) 731-9600 Dated: January '3cJ 2001 '-"U1'1-"~.;'~'t._.: <D ~~ ~ >< <C I- W I- <c<C -I- zen <cW >0 -Iz ><C en zW zO wZ c..<C I- a: w :I: z <{ z <{ ~ en >- w (f)UJX ;; ~=>~ co UJZ..J 0 ~~~ ~ 0~5! ;::.: ILL> <{ ~OC 0... <{1-2: (j WZu.'-CC ~~O~=> OlI~~~ ~~~b:~ OUJ:)UJ<{ UOa:lOI >< w C\J (0 >- w c:r: I'- ~ N CO r-- ~ <{ <( o z l- n. - w o w a: ...J c:( - o - LL LL o ....:....'>-<.....:.= .'.. 1'2 C; ~ 9 z i"...' ::> OJ 0 :2 n <( $ ~ aJ-la: z:2~W ()(/)~(D <((/)z:2 Wo::> ~()z <( :E o [[ LL C W > [j (,) w [[ L ., .~..'t!.....'"C..'7-.....,."":'.-:"'..., . <-i o .,~-.; g .,...., w ~_. ,...., LG ::l [; tn .J liJ .-.:- '"," ~...;. Oi' rJ: o a: u (-, 01 U) (! - {'j 0 if.: (> u..l ....-t.-l ~3 CD LJ ~~- icr I!) c:''t;''f~~:,~ - I . __ ,'-'",..;. ,'_,.,....~~_,..~::J.".. ~:,..,.~~ '~;;~~'!~~..;_.....--.....'....."c-~.'-__.,.. _~'_~ "_'-_'''"','' .,-_~~.., "'.-'....,'.... _,. ,~.. w a: w ::I: Cl <5 u.. () () ~_s:. {.J) o c\ ~J) C0 ,,,,,..., tft Cl <( 0... ~ Z ::> o :2 <( -l <( ~ o ~ w a: w ::I: Cl <5 u.. ~ ~ ....J (:, fU U.... .' '!: nJ i i=' <1" (f) (1) CC ---t ~ Z LD ,. ~'-. 0 ..0 :3 -I 1" Z t r--- .3' -> ~ Z ~.Q I- , (f) --' 0 0 <{O ~ (J i~ """"' .t.. .-. ..J ^" 0 Q Z ~ '...1 -i~ \_/ <( <! 0 g -........ 0.....". E UJ' ~..s UJ' w co ..-! 0,'" ~O :J 0,..; LL....... I- ~rd 00 LL <{ i::U LL <( 0 ~ 0 I- Z UJ UJ I- Z UJ W ~ I- (f) => l- ff) ...J <{ <{ 0 0 <{ W u::: Z 0 0... U 0 '\ \ <~ ,. ~....: UJ ~.J ~,j -;>>- ",--.. cr~ · f,U i-, (fJ ,,~ >-ry 0 (D (r td fa <;": iJ: > '- W () w a: 00 -I -I S LL o a: w I- 00 (9 W a: t:'J t, , ...o.J i-~ <I r '. _J o J~ ..;.; (J') (I ~ [', OJ tJ1 CU L.L1 }- <r # U .'J.: L) OW ''-. U CJ -l (/) <( ~ w a: (/) <( :2 w a: ~~ " -, ~. '::) '-I ~ ,:" ( , ' _, L' - \ tI) ,,: \ _~ \ . . . 1 o ' , ~. ! \ '-"... # / i i.... ,l$. a:. '6 ~Cv 6- ~ ,Jt \-W ~ ~ CA c9 ~ o i ~ \JJ ./\ Gl- C:;;J- c5 u ,JJ v1 ? o :I ~ J 01 v1 0 --- -) u ~ .-"'" Y..,-/ ~c5 \/) ...9 ;~ p~ r6 f.:) ~ ~ F '6/ t:,J ~ if' '2 D -!.i&~ ~ /3 W ,.p 0 Oo'~ rV~o = - - - - .. - - - - - ... - - - ... = - (1".' \:~ \') (1) -.Ii-.. ,.:' .,..1 () r'., .,.4 \ l. ~---// -- , \ '1 , , I I ; \ \ ., ,~\\\ . ~'>, " /\ (/1 \ -.. (.) l \J i ,I . 1(1 " ,,,__,' i j v^ _9 D ....c:r:-" de) ~ A' >-U ~ -- ~ ~ JU t ~f> ~ Dt. '?> "6i'-.:fJ ~ D~~ oifSct o JJ -::? ,:,0 .:::c ~ ':) ~ 0 .j U ,- 00 -- o , -- ~:2 ~ rS d- D- t> 1 ~~~ \_ V4 :J '0 ~ ~ ~ju .-- .~ ~ " ~ 'J .~ ~ - ... - - - - - - - - - ... - - ... fa) .,... .rl in .i.. il) .,..1 () r'" .,... -~- _/-- BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280&01 HARRISBURG PA 17128-0&01 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ;-';,'-('''If''"\f"'\ :'!::,)jtED ~mJUT ANCE TAX .stC:S~tT~T~:~~NT OF ACCOUNT '-:".,., ',,':"-1.,,' * REV-l&07 EX AFP (03-05) RANDY R ORRIS 998 GOVERNORS BAY DR REDWOOD CITY CA 94065 2007 JUH 29 PH ,: 22 CLERK OF C&;~N~[~ggR~A DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 06-18-2007 ORRIS 01-07-2001 21 01-0064 CUMBERLAND 01131985 CAROLYN W Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR RECORDS of- --------------------------------------------------------------------------- REV-1607 EX AFP (03-05) *** INHERITANCE TAX STATEMENT OF ACCOUNT *** ESTATE OF ORRIS CAROLYN W FILE NO. 21 01-0064 ACN 01131985 DATE 06-18-2007 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 10-19-2001 PRINCIPAL TAX DUE: 7.89 PAYMENTS (TAX CREDITS): INT AT REV PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) EREST IS CHARGED THROUGH 07-03-2007 TOTAL TAX CREDIT .00 THE RATES APPLICABLE AS OUTLINED ON THE ERSE SIDE OF THIS FORM.* BALANCE OF TAX DUE 7.89 INTEREST AND PEN. 2.62 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE 10.51 II SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRl, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. l q