HomeMy WebLinkAbout01-0168
PETITION FOR PROBATE and GRANT OF LETTERS
Estate of '~i(f/'vi. i3~ L",/4Lj{E/~ No. ~/-()I-/ ~f
also known as To:
Register of Wills for the
, Deceased. County of Cumberland in the
Social Security No. (}.;.,~, - 1(:. - ST-;.-J (;, Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who islare 18 years of age or o\der an the executo(;...
in the last will of the above decedent, dated<<:-//-> , '-i ,
and codicil(s) dated I
(state relevant circllmstances, e.g. renunciation, death of executor, etc.)
hU<
County, Pennsylvania, with
/fI/ ;::
I
Dec~dent, the~. 77
at tF 7/~/I t / '-'-A-tl/r
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
~fter execution of t~ill offered for probate; was not the victim of a killing and was never adjudicated
mcompetent: I~ .
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows: ~ //
,
years of age, died
f6::1 tJ
,
,,&./'L'V! ,
$
$ / :lV;. C?;r
$
$
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters Testamentary
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
theron.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA I s~
COUNTY OF Cumberlar.d J ~
/ r;, .-.;;? (.) 9 - 9
The petitioner(s) above-named swear(s) or 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 represen-
tative(s) of the above decedent petitioner(s) will well and truly administ~r the estate according to law.
Sworn to or affirmed and SUbscribed~~~~
before me this 12th _ day of i:/ / ~/
,/ - rua 7 " .;/ . ~ 2001, / /
, 1<- ~tU;(! ;"
MARY , LEWI / Register '7
REGI~ R OF WILLS !
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~o. 21-2001-168
Estate of
Irene B. Walker
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW February 13th 1~2001, in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated February 4th.1980
described therein be admitted to probate and filed of record as the last will of
Irene B.Walker
and Letters Testamentary
are hereby granted to James B. Walker
~..-..,
~1liU;f (]d();~1~U'~~
.../;/ Register of W111s MARY C. LEWIS ~q..L
/ REGIS1~R OF WILLS ~
FEES
Probate, Letters, Etc. ......... $ 235.00
Short Certificates( 6) . . . . . . . . .. $~~
Renunciation ................ $
x-Pages (3) $ 9.00
JCP TOTAL _ $ 5.00
Filed f~PW9~ .l3:t.ll,.200.l.. $. .267...o.Q.
ATTORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
MAILED LETTERS AND ORDER 'TO EXECU'IOR
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WARNING: !t is illegal to duplIcate this copy by photostat or photograph
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21-2001-168
t'llO~ : 4.3 Rev 2187
COMMONWEALTH OF PENNSVLVANIA . OEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
T't'PE:PRINl
IN
PERMAkEN r
BLACK INK
NAME Of DECeDeNT <f-f(SI Ml()dle, LlSl}
Irene B. Walker
STAlf Fll..f ~MBER
~~~~===~~ :Ex.E~mal~r:o~~UR: NUMBfe, _
BIRTHPLACE ic.ly ar.a PLACE Of' DEATH iCtoeck OPfy (lne -- -;.ee ,nSlru(.;I.o.rs on Q(t\el ,ode)
Stale Of ..- crelC}fl COlJflUYI HOSPtTAl: --
Ludlow, Massachuset Opal..".O ER/Outpauenl 0
7 k
FACIUT't' NAME (II nolln!:.:N'l.Jll00 gll/e sl'eel ana numbefl
~ D[ATH ,Mcm"..{la"''<'A1
5626t-eoruary ~, "UU
.,
77
UNDER 1 VEAR
Montta Oa.,...
UNOERlOAY-
~:=otyj []
AGE llast Bl(tt'laav.
y,.
....,.,.. l 101"'0'"
~,
COUNTY OF llEAfH
Cumberland
RACE . Am.oc~ Indi.n, a&..ck, WhiI.. eu;
lSpeci)j
White
.,
DECEDENT'S USUAL OCCUPIJ!ON
(~V::~<<~m~;
KIND OF BUSINESS/INDUSTRV
WAS DECEDENT EVER IN
US AAMED FOR515?
Ve.D No~
12
SURIIIVING SPOuSE
111""'..~~1'\OIt'I\Q1
. 11..
',b.
DECEDE'1a~~tG A9fEThSW\veCiyfT""'" SlallI. ZopCO<leI ~~~~NT'S
Mechanicsburg, Pennsylvania 1705 ~~r':.c~"""
on OIt'ler SiOe)
17.. Stale
~
~
o
o
~
z
Cumberland
Did
_edonI
live.,.
-ip? 17dO ::0:'=-':::::0/
lolOTHER'SNAME,F..I.M"'''Ie,M"""",Sumame) Ida M. Baron
".
INFORMANT'S ~m^~~fJW1:h~;i~~17025
2Gb
PUlCE OF DISPOSITION. NO/TlfI 0' C.....r.IY. CremolOty
OfOlllot'W~lIjng Green Memorial Park
-
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FAI'HER'S NAME (F..., M"""e last)
'lb. Couoty
<..../borO
11.
INFORMANT'S NAMe (T YpelP"n,)
2Ol6,
METHOO OF OlSPOSIT~
O IIonaI LT CrOtnOI_ 0
~ 0IIl0t (Spoocoly
. 2'..
SlGkAT
lOCATION, CityfTown, Sta... LOP Code
Camp Hill, Pennsylvania 17011
ltc.
LICENSE NUlolBER FD-012662-L
Ub,
I of my knowledge. dea.h occurred ~'lhe lime. dale and piau slaled
Ie and Tldel
21d.
NA...E 'lND ADDRESS OF FACilITY
Myers Funeral Home, Inc 37 East Main Street Mechanicsburg, Pa 17055
22c.
LICENSE NUMBER
DATE PAONOUNfED DE",:> (MonIO. Day. Yea,)
2'. S-: -SO .... 2~. 0,;:( (01/0 I
27. PART t; Emerrn. diseases, iO'UfieS Of rompIK:atO'lS which caused the dftalh Do nol en'.' Ihe mode 0' dying. StK:h as cardiac 01 respu310ry iU8Sl, Shock or heart fallul.
llSl only one cause on each tiRe
DIJE SIGNED
1_. DaY,_1
23b, 23<;
WAS CASE REFERRED TO ME:DICAl EXAMINERiCORONER?
Yel 0 No~
DUE TO (OA AS A CONSl:OUENCE Of}
2e,
I Approximate
i='=;
I
16 /?1 c
PART .1: Other 1IgfurlC...... condiIiona contllbutintj 1O death. but
_ """'/II''V in /he lIIldotly>ng ~ _ '" PART I
\.(~
dA.: if. j,6.t C L-I);
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WERE AUlOPSY FINDINGS
AIIAlUlBlE PRIOA TO
COMPlETION 01' CAUSE
OF DEAI'H1
MJlNNER OF DEATH
DATE OF INJURV
(Mof1", Day, Year)
I
:
~~--~---I----
L
TIME OF INJURV
INJURV IJ WORK?
DESCRIBE HON INJURV OCCURRED
N.it.lulal
g
[]
[l
PendIng InveshgallOll
(]
[]
rJ ~CE OFIN.IIJFIY''Aiho-;;;., "'':,'':;'01, ta"''''Y, offic.
bulklirlljl, etc _ ISpoc,1v)
30..
v.. 0 NoD
Ve.O
NoH
Suo<Klo
1.4, JOe.
3001,
lOCilTlON /SIJ_ C'lVlTown SIaIO)
COulo no. btt de18nnlflad
180. 21b.
CERllFlEA lCt'1llCk oni.,. one)
"CEATWYING PHYSICIAN lPhy'Sl<<:.an C.~t.tyI"'J c.au5.e 01 deatfl ""h~f' .lliolllel IJflySJe,dn hdS P(Uf)ounced dCdfrl J,nu COfnpieloo tlt.>tn ;'131
To U- t:J.e., 01 my know'-d9., d.ath occurred d\MI1o th. c.'ae(s).OO m..nn., a. ala.ed. .
19
301,
SIGNATURE M TITLE OF CERTIFIER
E1' 31b 'Df~ C C~ t0~ /7
liCENSE NU"',6 ER . ,. -~~" DATE SiG~EO 1M""., Doy, Yo.1)
1-] 31e. fl1 J,., /11" .7.,./ ~ _J~.,2 . -,,0 - ;~"'~ ,
L NAME AND ADORESS'6f: PERSON WHO COlolPlHEO CAUSE OF DEATH
(lie'" 27)Typeor Pnnl 7<'''':,,-.i A C,.-v( c~-, .1'0
2/7(; ,..; vA'^- /?:J
/1'1..<_4, _I,J~.'^, /1'1, )f), -'
31
DATE flLEO (MQnlh Day y'ealj
. PRONOUNCING AND CER1IFYING PHYSICIAN WhVs.l:Ldfl t1fJUl .)1:)I\UlHI(:I()(1lk'dlh dlld LelMYlfltj 10 C.;iU$U or OedU,\
To .h. ~. 0' my knowtadge, dea'h occurred at Uwl dme. d.te, i1nd place. and due '0 th. cau~.(.J and manner... s..,red
'IIEDICAl EXAIIINERJCORONER
On the b..i. of examination and/or investigation. In my opinion, dellto occurred at the lime, dale, and place. and due to the cause(s) and
manner .. stal~
3h
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df=-
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]0 kbtu illY It)) 2COI
STONE, SAJER
& STEWART
Attorneys at Law
310 Bridge Street
New Cumberland, Pa.
17070
.-
...
LAST WILL AND TESTAMENT
OF
IRENE B. WALKER
I, IRENE B. WALKER, of the Borough of New Cumberland, County of
Cumberland and Commonwealth of Pennsylvania, declare this to be my last will
and revoke any will previously made by me.
I T EM I:
I devise and bequeath all of my estate, of every nature and
wherever situate, to my husband, ROBERT F. WALKER, if he survives me by thirty
i days.
ITEM II:
Should my husband, ROBERT F. WALKER, fail to survive me by
thirty days, I make the following disposition of my estate:
A. Should either of my sons, JOHN R. WALKER or DAVID A. WALKER,
be living in my homestead real estate at 744 Carol Street, New Cumberland,
Pennsylvania, at the time of my death, I direct that either or both of my said
sons shall be allowed to continue to live in said real estate for a period of
one year from the date of my death. During the one year from the date of my
death, I direct that the cost of all insurance, real estate taxes, heating and
maintenance of the aforesaid homestead real estate be paid from the residue of
my estate as an expense of administration. At the expiration of one year from
the date of my death, I direct that my homestead real estate be sold and that
Page 1 of 4 pages
..,
STONE, SAJER
& STEWART
Attorneys at Law
310 Bridge Street
New Cumberland, Pa.
17070
...
~
c-'
... .
ITEN VII:
I direct that my Executor or Guardian, or their successors
shall not be required to give bond for the faithful performance of their duties
in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
!-/{'
day of
1980.
i
i
_ .__.__.. __,_.' .'.L'-____'::=_'--_,-4--_C~;~-_(_____l~.EAL 1.1
IRENE B. WALKER I
I
1
I
SIGNED, SEALED, PUBLISHED and DECLARED, by IRENE B. WALKER, the I
Testatrix above named, as and for her Last Will and Testament, and in the
presence of us, who, at her request, in her presence and in the presence of
each other, have subscribed our names as witnesses.
!
----.-.- ~,---, .--.- I
Address " 1
7 j _ / /] '\ f'._ r' i
f'~\L'_-~~~U~l,~L--L--1r-----~~
Address ,r-";
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COMMONWEALTH OF PENNSYLVANIA
:S5:
COUNTY OF CUMBERLAND
I, IRENE B. WALKER, Testatrix whose name is signed to the attached or
foregoing instrument, having been duly qualified according to law, do hereby
acknowledge that I signed and executed this instrument as my last will; that I
Page 3 of 4 pages
..".
/fI-
signed it willingly and that I signed it as my free and voluntary act for the
purposes therein contained.
_~_____~_~~_.Jl/~' ~-"_____~~~:J'--L___~ __-._~__.~!:~,~~,~~~. ~~~-
IRENE B. WALKER
Sworn or affirmed to and acknowledged before me by IRENE B. WALKER,
II
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il
II COMMONWEALTH OF PENNSYLVANIA
11 : S5:
Ii COUNTY OF CUMBERLAND
:! we'~~s_~.=~~_~t~~ and~<:2~_1~~
II
!ithe witnesses whose names are signed to the attached or foregoing instrument,
il
I
Ilbeing duly qualified according to law, do depose and say that we were present
Ii
II
rand saw testatrix sign and execute the instrument as her last will; that testa-
Itrix signed willingly and that she executed it as her free and voluntary act
I
'I
~for the purposes therein expressed; that each of us in the hearing and sight of
this ~~__._ day of ~~ 1980.
3~~~~~.
NOMRr~~;~ ~1l'it\ huWy Pi.Mk
"II''! ','....,:' h',i, ."'~t>':~mt..J' m
..,~ ...." '"n":V {lIf~",I":1O . ~
:1 the testatrix
.!
'j
II the testatrix signed the will as witnesses; that to the best of our knowledge
Ii
II the testatrix was at the time eighteen or more years of age, of sound mind and
'\
STONE, SAJER
& STEWART
iiunder no constraint or undue influence.
Ii
II
II
~ M~._--
\1 Sworn or affirmed to and sUbscri~l to before me by -.~"~1I.:l cllJ
Ii . .'ST5l V~~ and_ C~~~ ~I&..l.- -' witnesses thi s_~...
(day of .",~~():)." , 1980.
!i ~
II
I
jl
II
Ii
<:: -: -,:~~,~~{'__ ~:~__~2~~--~~~;j;~~:~:- /-~:=="
Attorneys at Law
310 Bridge Street
New Cumberland, Pa.
17070
-, \ ~~' r\
_, ' I \ ~
----~:r:--.; .\..;~ ~.".~..~_L_ .~~--- ~
~~t.flry .' PUR~~~\-'_.J~ 'h"i~~
'11\. f>.p;~t,: fl~::
fik.,. ',~...t;.~:;" .,~ -........;; *,",,'j"l
Page 4 of 4 pages
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CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
~-:7~~ 13. w}fa:~
f2t3- ~,:J/r?/
Date of Death:
Will No. ~~{/I'-c:)(~g
Admin. No. -7</ -C..?/.- (.J/L78
To the Register:
I certify that notice of (beneficial interest) 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 ~ ~ ~l:J / :
Name
Address
J3J/S/( 61R-6d~ /lIT (1~<~ S;fl#/ I#-
~ ~9pc4
/N ~-I/76ll>tiJ !l11;(;IIAAJ/C!~3t1/f; I?t. /?~
j)m~;o Ii !/)1I1/(6'~ 8 l3qC-/t(}LI!T NYlrJ L~I!~i/;L~ Ii /~)I/
/
t 1Mt..7P tJ~---{-6if;(!tIJ2J~) YPJ ~vi5 r1i~ff 6iotA; 1ft /7,10(~
Notice has now been given to all persons entitled theretO:der Role 5.6(a) except ;J j
~
\k-P'Xt I. . !tltl~
t~IIAJ 1? /t#q~
Date:
illm/ OZ3 iXOt)/
! I
~~t?k
~tre /
Name ~~~ ?3.{/J~
Address lip ~A-)17 {}p,e-
i;Uot1 .4 /7;J~
Telephone(7/~--2~_ /7b~
Capacity: ~;;sonal Representative
_Counsel for personal representative
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
JAMES B WALKER
169 LEE ANN COURT
ENOLA, PA 17025
-------- fold
ESTATE INFORMATION: SSN: 026-16-5626
FILE NUMBER: 2 1 - 200 1 - 0 1 68
DECEDENT NAME: WALKER IRENE B
DATE OF PAYMENT: 10/26/2001
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 02/09/2001
NO. CD 000443
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $8,083.00
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$8,083.00
REMARKS: JAMES B WALKER
CHECK# 1010
SEAL
INITIALS: AC
RECEIVED BY:
MARY C. LEWIS
REGISTER OF WILLS
REGISTER OF WILLS
\//:'-aCJj'- 5'
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
Recel
R'3~,; .-
of
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
12-17-2001
WALKER
02-09-2001
21 01-0168
CUMBERLAND
101
.01 Ole 27
mo :11
JAMES B WALKER
169 LEE ANN CT
ENOLA (;it:IJA 17025
CUlnbe:,,;i
'*
REY-1547 EX AFP 1l2-DDl
IRENE
B
Amount Remitted
Ph
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 ~
iff,,: iS4j-EX--AFP--fi"2':o0 Y-NcificE--oF--fNHEiiiTAN-cE-YAx-A-PPR]risEifENT-,--AL1-OWANCE-oi----------- - -- - --
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF WALKER IRENE B FILE NO. 21 01-0168 ACN 101 DATE 12-17-2001
TAX RETURN WAS: (X) ACCEPTED AS FILED
CHANGED
NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of 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
179,617.00 X 045 = 8,083.00
.00 X 12 = .00
.00 X 15 = .00
(9)= 8,083.00
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)
.00
.00
.00
.00
197.013.00
.00
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
nO)
9,782.00
7.614.00
(1)
(2)
(3)
(14)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
197,013.00
17.39~ nn
179,617.00
.00
179,617.00
.
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
10-26-2001 CDOO0443 .00 8,083.00
TOTAL TAX CREDIT 8,083.00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
. 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.)
J
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STATUS REPORT UNDER RULE 6.12
Name of Decedent: :;:fiI:A,!;, 13. /J;;LJ{6~
Date of Death: FefJ. ~ .;?ti/l
Will No. -:J tJO/- i)O //7/3 Admin. No.
0l/-0/-0/68
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 ~" No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes No
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest? Yes No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to ~h)p report.
Date: /hf3 . 1#4:
I Sig~ e
V ddM B~ .~
Name (Please type or print)
/ 6 f L-t-~ /f;tJ;tJ f!ol/;a- -6J11II/1-
Address
(1/7) '73;2-- /1/P8
Te 1. No.
~ersonal Representative
Capacity:
Counsel for personal
representative
(MAH:rmf/AM3)
,
.
REV-1500 EX + (6-00) QFF1C1AL USE ONLY
COMMONWEALTH OF PENNSYLVANIA REV-1500
DEPARTMENT OF REVENUE
DEPT. 280601 INHERITANCE TAX RETURN FilE NUMBER
HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 21-01-0168
COUNTY CODE YEAR NUM8ER
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
WALKER, IRENE B. 026-16-5626
DECE- DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE
DENT
02-09-2001 10-06-1923 WITH THE REGISTER OF WILLS
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
3. Remainder Return
CHECK ~ ' 0",,'. ''''" ~' '"".....".., 8 (data of death prior to 12-13-82)
APPRO- 4. Umited Estate 4a. Future IntereST Compromise S, Federal Estate Tax Return Required
(daleolduthafter12-12-82)
PRIATE 6. DeClldent Died Testate 1. Oeca(lentMalnlalned a living Trust 8. Total Number of Safe Deposit Boxes
(Attach capy of Will) (Attach a copy ot Trust)
BLOCKS 9. Litigation Proceeds Received 10. Spousal Poverty Credit (date 01 death between 011. Elec;tlonto taxunderSec.3113(A)
12-31-91 and 1-1-SS) (Attach Seh 0)
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE 8< CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
COR- JAMES B. WALKER
RE. FIRM NAME (If Applicable) 169 LEE ANN COURT
SPON
DENT ENOLA, PA 17025
TELEPHONE NUMBER
610-823-1438
OFFICIAL USE ONLY
1. Real Estate (Schedule A) (1)
2. StocKS and Bonds (Schedule B) (2) .
3, Closely Held Corporation, P;lrlnership ~r Sole-Proprietorship (3)
4. Mortga1J8s &. Notes Receivable (Schedule 0) (4) . !
5. Cash, Bank Deposits & Miscellaneous Personal
Property (Schedule E) (5) 197,013.
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested (6)
RECA-
PITULA- 7. Inter-Vivos Transfers & Miscellaneous
TION Non-Probate Property (Schedule G or L) (7)
8. Total Gross Assets (total Lines 1-7) (B) 197,013 .
9. Funeral Expenses & Administrative Costs \Sched\,lle H\(9) 9,782.
10. Debts of Decedent, Mortgage liabilities, & liens (Schedule I) (10) 7,614.
11. Total Deductions (total Lines 9 & 10) (11) 17,396.
12. Net Value of Estate (line 8 minus Line 11) (12) 179,617.
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax (13)
has not been made (Schedule J)
14. Net Value Subject to TaX (Line 12 minus Line 13) (14) 179,617.
SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES
15. AmoLJntof Line 14 taxa,ble at the spoLJsal tax
rate, 01 transters LJncler Sec. 9116{a)(1.2] X .0 (15)
TA;( 16. AmoLJntofLine 14 taxable at lineal rate 179,617. X .0 .045(16) 8,083.
COMPU- 17. AmOllntof Line 14 taxable at sibling rate o . x.12 (17)
TATlON 1B. AmoLJntof Line 14 taxable at collateral rate x.15 (1B) o .
19. Tax Due (19) 8,083.
20. 0 !CHECKHEREIFYOUAAE REQUESTING A REFUND OF AH OVERPAYMENT I
>>BE SURE TO ANSWER ALL QUESTIONS ON PAGE 2AND RECHECK MATH<<
o PA15001
NTF 29755
EL
r
.
PA REV-1500 EX (6-00)
Decedent's Complete Address:
Page 2
STREET ADDRESS
713 ALLEGHENY BUILDING
MESSIAH VILLAGE 100 MT ALLEN ROAD
CITY I STATE I ZIP
MECHANICSBURG PA 17055
Tax Payments and Credits:
1. Tax Due (Page 1 Une 1.9)
2. Credits; Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
8,083.
Total Credits (A + 8 + C) (2)
3. Interest/Penalty jf applicable
O. Interest
E. Penalty
4.
TotallnteresUPenalty (0 + E)
If Una 2 is greater than Una 1 + Una 3, enter the d"ifference. This is Ihe OVERPAYMENT.
Check box on Page 1 LIne 20 to request a refund
II Une 1 ... Line 3 is greater Ihan Une 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the lax dUe.
B. Enter the total at line 5 ... 5A. This is the BALANCE DUE.
Make Check Payable 10: REGISTER OF WILLS, AGENT
(4)
(5)
(SA)
(58)
8,083.
(3)
5.
8,083.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and;
a, retain Ihe Llse or income ot the property transferred;
b. rAr.<lin l.he right to designate 'Nho sh:l!) u:::c the property transferred ()( il'" il\~(jme;
c. rel3in 3. reversionary interest; or.
d. receive the promise for life of either payments, b.enelits or care?
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
wtthout 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 perjury, I declare that I 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 of preparer other than the personal representative is based on information of
which re has an knowled
SIGNATUR F PERSO LE FOR ILlNG RETURN
DATE
Yes
~
I'
8
8
No
~
~
iXI
I!ii
o
I!ii
(717)
DATE 16 I
/J..4- JODI
17109
RD SUITE 126
HBG, PA 17109
dates deathonor and 1995, tax rate on transfers to the use of the sur\ll\lingspouse
[72 P.S. i 9116 (aJ{1.1)(i}J.
For datesof death on or after January 1, 1995. the tax rate is imposed on the n!!t value of transfers to orlor the US!! 01 th!!SurVI\lingspouseis 0% [72 P.S., 9116(a)(1.1)(ii)).
The statute (/rlF~!; not exemnt a transfer to a surviving spouse from tax, and th~ statutory req~iremer.ts lor discl05ure of assets and filing a tax return are still applicable even
if
tl1esllrvlVlngspouse'ls the "nly beneficiary.
FordatesofdeathonorafterJuly1.2000:
The tax rate imposed on the net value of trar\slers lrom 11. deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent,
or a stepparent 01 the child is 0% (72 P.S. '9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the wse of the decedent's lineal oeneiic\ariesis 4.5%, except as noted in 7:2.P.S. 99116(1.2) [72 P,S,'9116(a)(1)].
Tne tax rate Imposed on the net value of transfers to or forthe use of the decedent's siblings is 12% [72 P.S..!i 9116(a)(1.3)J. A sibling is defined, under Section 9102, asan individual
who has at least one parent in common with the decedent, whether by blood oradoption.
o PA15002
NTF 29756
REV-1508 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
J:RENE B. WALKER
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
21-01-0168
Include proceeds of litigation & date proceeds Wen! rl!lceived by the Il$tate. AU prop. lolntty-owned with right 01 survivorship must be disclosed on Sch. F.
ITEM VALUE AT
NO. DESCRIPTION DATE OF DEATH
1. SSJ:AH VJ:LLAGE REFUND 39,974.
2. 000 FEDERAL TAX REBATE 300.
3. $100 US SAVJ:NGS BONDS 1,850.
4. MEERS FIRST FEDERAL CREDIT UNION 9,196.
CCOUNT 160335-00
5. MEERS FRIST FEDERAL CREDIT UNION 26.
CCOUNT 160335-05
6. NC BANK 2,329.
CCOUNT 51-4006-6565
7. NC BANK 143,234.
CCOUNT 51-3005-8377
8. FEDERAL TAX REFUND 104.
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
197,013.
o PA15081 NTF 33305
REV-1511EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
IRENE B. WALKER
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21-01-0168
Debts at decedent must be reported on Schedule l.
ITEM
NO.
DESCRIPTION
AMOUNT
A. FUNERAL EXPENSES:
,. MYERS FUNERAL HOME
ROLLING GREEN CEMETARY
GRAVE MARKER
5,320.
760.
2,055.
8. ADMINISTRATIVE COSTS:
,.
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)JEJN No. of Personal Aepresentative(s)
Street Address
City StaIB
Zip
Year(s) Commission PaId:
2.
3.
Attorney Fees
Family Exemption: (If decedent's address is not the same as claimant's, attach 8xplanallon)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
175.
4.
Probate Fees
267.
5.
Accountant's Fees
1,000.
6. Tax Return Prepare(s Fees
7. THE SENTINEL
THE PATRIOT NEWS
68.
137.
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
9,782.
o PA15111
NTF3330e
RT.
REV-1512 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
IRENE B. WALKER
Include unreimbursed medical expenses.
ITEM
NO,
1.
SSIAH VILLAGE
2.
IGHBORHOOD CARE
3 .
FINAL BILL
4.
5. XRAY IMAGING
6. ILMORE EYE ASSOCIATES
7 . PL JANUARY
8. RIZON - JANUARY
9 .
PL FINAL BILL
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
21-01-0168
DESCRIPTION
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
o PA15121 NTF 33309
AMOUNT
6,631.
540.
21.
14.
34.
148.
15.
22.
168.
21.
7,614.
'C'T
REV-1513 EX> (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
ESTATE OF IRENE B WALKER
NUMBER
I
2.
3 .
4
II
o PA15131
,.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and
transfers under Sec. 9116 (a) (1.2)J
JAMES B. WALKER
169 LEE ANN COURT
ENOLA, PA 17025
JOHN R. WALKER
151 STATE ROAD
MECHANICSBURG, PA 17055
JEFFREY L. WALKER
3455 STREET ROAD APT CLARK 14
BENSALEM, PA 19030
DAVID A. WALKER
1770 MARCO DRIVE
CAMARILLO, CA 93010
FILE NUMBER
21-01-01.68
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
SON
SON
SON
SON
AMOUNT OR SHARE
OF ESTATE
25.Ch
25.%
25. i6
25.%
I
ENTER DOLLAR AMTS. FOR DISTRIBS. SHOWN ABOVE ON LINES 15 THROUGH 18. AS APPROPRIATE. ON REV-1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
,.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
,.
TOTAL OF PART II -- ENTER TOTAL NON-TAXABLE DISTRIBS. ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
NTF :33293
",T.
r. . ". This is ro certify thar the. i}:lform:-r\on he~e given is cottecrly copied fro,:, 'an original cerrificlte of death dqly filed. with me as
;'. I:ocll. ~g1Srrar. The ong<nal cemficate wIll be forwarded to the Srare VIral Records Office for permanent filing.
~~,,"
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for ,his certificate, $2.00
No.
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COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEAlTH' 'IITAL AE.CQROS
CERTIFICATE OF DEATH
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Register of Wills of CUMBERLAND County, Pennsylvi
Certificate of Grant of Letters
No. 2001-00168 PA No. 21-01-0168
ESTATE OF WALKER IRENE B
l LJI.::>'l', r lrt::i'l', MlUULJ:;)
Late of
UPPER ALLEN TOWNSHIP
I,.;UMJ:jJ:;rtLJl.NU I,.;UUN'l'Y,
Deceased
Social Security No. 026-16-5626
day of February
WHEREAS, on
dated February
was admitted to
the 13th
4th 1980
probate as the last will of WALKER IRENE B
(LJI.::iT, rlH::iT, MlUULJ:;)
late of UPPER ALLEN TOWNSHIP
2021. an
ins1:rum
CUMBERLAND County, who died on the
9th day of February 2001 'and,
WHEREAS, ,a true copy of the will as probated is dnnexed hereto.
I
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 JAMES B WALKER
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 13th day of February 2001.
7e~~~d
H 1S e 1: 11 ~
**NOTE** ALL NAMES ABOVE APPEAR (T,II!':'!'. FTR!':'!'. MTrmT F'
STATE OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SHORT CERTIFICATr
I,
MARY C. LEWIS
Register for the Probate of Wills and Granting
Letters of Administration &c. in and for said
County of CUMBERLAND do hereby certify that on
the 13th day of February A.D.,
Two Thousand and One.
Letters
TESTAMENTARY
estate of WALKER IRENE B
ILA~~, tlK~~, M1UUL~)
in common form were granted by the Register of
said County, on the
, late of UPPER ALLEN TOWNSHIP
in said county, deceased, to
JAMES B WALKER
(LA~~, tlK~~, M1UUL~)
and that 'same has not since been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of said office at CARLISLE, PENNSYLVANIA, this 13th day of February
A.D., Two Thousand and One.
File No. 2001-00168
PA File No. 21-01-0168
Date of Death 2/09/2001 Register
S.S. * 026-16-5626
NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL
21-2001-168
LAST WILL AND TESTAMENT
OF
IRENE B. WALKER
I, IRENE B. WALKER, of the Borough of New Cumberland, County of
Cumberland and Commonwealth of Penusylvania, declare this to be my last will
and revoke any will previously made by me.
ITEM 1:
I devise and bequeath all of my estate, of every nature and
wherever situate, to my husband, ROBERT F. WALKER, if he survives me by thirty
days.
ITEM n:
Should mY.nhusband, ROBERT F. WALKER, fail to survive ,me b1'
~ ,
thirty days, I make the following disposition of my estate:
A. Should either of my sons, JOHN R. WALKER or DAVID A. WALKER,
be living in my homestead real estate at 744 Carol Street, New Cumberland,
Pennsylvania, at the time of my death, I direct that either or both of my said
sons shall be allowed to continue to live in said real estate for a period of
one year from the date of my death: During the one year from the date of my
death, I direct that the cost of all insurance, real estate taxes, heating and
maintenance of the aforesaid homestead real estate be paid from the residue of
my estate as an expense of administration. At the expiration of one year from
STONE, SAJER
.. STEWAR-r
the date of my death, 1 direct that my homestead real estate be sold and that
Attorneys at Law
310 BrIdge Street
New Cumberland. Pa.
17070
Page 1 of 4 pages
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the proceeds thereof be added to and treated as part of the residue of my
estate.
B. I devise and bequeath the residue of my estate, of every
nature and wherever situate, to my issue, per stirpes, living on the thirty-
first day following my death.
ITEM III:
In the event that any of my property should pass, either
under this will or otherwise, to a minor child of mine, I appoint my son, JOHN
R. WALKER, Guardian of any such property with respect to which I am authorized
to appoint a Guardian and have not otherwise specifically done so. Such
guardian shall have the power to use principal, as well as income, from time to
time, for the minor's support and education or to make payment for these purpose
"without further rF?:8ponsi.biliny', to the mi.nor.
I
ITEM IV:
I direct that all taxes that may be assessed in consequence
of my death, of whatever nature and by whatever jurisdiction imposed, shall be
paid from my residuary estate as a pare of the expense of the administration of
my estate.
ITEM V:
Should my husband, ROBERT F. WALKER, predecease me, I
apoint my son, JOHN R. WALKER, Guardian of the persons of my minor children.
ITEM VI:
I appoint my husband, ROBERT F. WALKER, Executor of this
my last will. Should my husband, ROBERT F. WALKER, fail to qualify or cease to
STONE, SAJER
& STEWART
act as Executor, I appoint my son, JAMES B. WALKER, Executor of this my last
Attorneys at Law
310 Bridge Street
New Cumberland, Pa.
17070
will.
~
Page 2 of 4 pages
STONE, SAJER
a. STEWART
Attorneys at Law
310 Bridge Street
-lew Cumberland, Pa.
17070
ITEM VII:
I direct that my Executor or Guardian, or their successors
shall not oe required to give bond for the faithful performance of their duties
in any jurisdiction.
1.-'-,/ tit"
IN WITNESS WHEREOF, I have hereunto set my hand and seal this.
"
day OL",?~
,
C'1.<<. ", '<<-I-, 1980 .
d
r:
I
/--)
/~/d'
V- ,,) U /'"
'IRENE B. WALKER
(SEAL)
\.,:-
SIGNED, SEALED, PUBLISHED and DECLARED, by IRENE B. WALKER, the
Testatrix above named, as and for her Last Will and Testament, and in the
presence of us, who, at her request, in her presence and in the presence' of
each other, have subscribed our names as witnesses.
h-/ /;V~;~I
/l'L.uv-- (~CL-,
-- "
Address
r-
COMMONWEALTH OF PENNSYLVANIA
:SS:
COUNTY OF CUMBERLAND
I, IRENE B. WALKER, Testatrix whose name is signed to the attached or
foregoing instrument, having been duly qualified according to law, do hereby
acknowledge that I signed and executed this instrument as my last will; that I
Page 3 of 4 pages
signed it willingly and that I signed it as my free and voluntary act for the
purposes therein contained.
n _-, .
-1'! /. C'1~.j
.. I/.. .
-\.:-1 MfJ' /..~, ~, AJ c ,('..fA)
IRENE B. WALKER
Sworn or affirmed to and acknowledged before me by IRENE B_ WALKER,
the testatrix this ~~
day of
_~...\.)'.. ~~ 1980.
NO~f.b
My Commission Expires
:''!W Curnbo!riolnd.!>>A
. NolJIy PIHIC.
28. 1m
ClIm-'" ~
~ ,\~~.
COMMONWEALTH OF PENNSYLVANIA
:55:
COUNTY OF CUMBERLAND
We~,.,Ln~~\' ~~~;\'and \.9~,,"~V\ \~ ~\
the witnesses whose names are signed to the attached or foregoing instrument,
being duly qualified according to law, do depose and say that we were present
d';:.d saw testatrix sign and execute the inst:rmnent as her last will; that testa-
I
trix signed willingly and that ~he executed it as her free and volunt3ry 3Ct
for the purposes therein ~~pressed; that each of us in the hearing and sight of
the testatrix signed the will as witnesses; that to the best of our knowledge
l
the testatrix was at the time eighteen or more years of age, of sound mind and
under no constraint or undue influence.
..
~;;;:
STONE. SAJER
10. STEWART
Attorneys at Law
310 Bridge Street
New Cumberland, Pa.
17070
Sworn or affirmed to. and :ubscribed to before me bYY \'\-~ w
"S\:-;))C\;S and C~~)\~..9 '\.~ ~~ l~ ,witnesses this ~ ~
day of ~ ~.> \':))l.l)).~ 19.80.
- ~Jl ~ ,. oj r.
~fitf? l~ _., tary Public
My CommisliOfl Expires !t J:~. 1982
rl... Wnberiand. PA C"",borion4 COCllllY
ESTATE OF IRENE B. WALKER
FILE NO. 21-01-0168
INHERITANCE TAX RETURN - SCHEDULE E
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May 21, 2001
James Walker
960 Sterling Court
Euula, P A 17C25
Continuing Care Retirement Services-Founded 1896
Enclosed please fmd a refund check in the amount of539,974.00. TIlls is the amount of the
refund due to your mother's estate from the apartment at 713 Allegheny Building, Messiah
Villa.ge in which she resided.
DETACH AND AETA'N THISSTATE:MEJ>lT
rHE ATTACHED CHECK IS IN PA.YMENT
OF ITEMS DESCRI8EDAOOVE.
If you have any questions regarding the refund. please call me at (717)790-8220.
VENDOR NO.
VENDOR NAME
CHECK NO
60253
Dear Mr. Walker:
Sincerely,
Jr:. ~ ~
Steven C. Moles
Assistant Director of Fiscal Services
<.-(
MESSIAH VILLAGE
100 MT ALLEN OR, PO B.QX ZQ\~
MECHANICS8URG, PA 17055.;:015
INVQICe DATE
OSf.!I/200l
007409
ESTATE OF IRENE WALKER
mSCOUNT
AMOUNT PAID COMMENTS
J9.974.00
REFUND APT nn
.l,'l'I.llo1::1ml'l:I;;:l;.
1N.1l01tE A.MOUlloT
OS/I8/2oo1
OSlaOl
J9.974.00
39,974-00
....._.. .' . ...1
fl~~!VA~~k'if13';;~~%!
. ',. .." i_~.."x.;'';.'''' -,~~
MESSIAH VILLAGE..Refund Schedule for Irene B. Walker at 713 Allegheny
Acquisition
Fee:
$63,200.00
I
Percent Amount
Month R~
e
2 Mar-97 98.50% $62,252.00
3 ADr-97 97.75% $61,778.00
4 Mav-97 97.00% $61,304.00
5 Jun 97 98.25% $60.830.00
6 Jul 97 95.50% $60.356.00
7 Auo-97 94.75% $59,862.00
8 Seo-97 94.00% $59,408.00
9 OeH17 93.25% $58,934.00
10 Nov 97 92.50% $58.460.00
11 Dec-97 91.75% $57,986.00
12 Jan-98 91.00% 557,512.00
13 Feb-9Il 90.25% $57,038.00
14 Mar-98 89.50% $56,564.00
15 r-98 88.75% $56.090.00
16 Ma 98 88.00% 555.616.00
17 Jun 98 87.25% $55,142.00
18 Jut 98 86.50% $54.666.00
19 ALia-98 85.75% $54,194.00
20 Se -98 85.00% $53,720.00
21 Oct-98 84.25% $53.246.00
22 Nov 98 83.50% $52,772.00
23 Dec-98 82.75% $52,298.00
24 Jan 99 82.00% $51 .824.00
25 Feb 99 81.25% 551,350.00
26 Mar-99 80.50% $50.876.00
27 Ar.r-99 79.75% $50,402.00
28 Mav-99 79.00% $49.928.00
29 Jun-99 78.25% $49,454,00
30 Jul-99 77 .50% $46,980.00
31 Aue-GO 76.75% 548,506.00
~2 SeD' 89 70.UO'1.. $48,U:32.00
33 Oct-99 75.25% 447.558.00
34 NOIl-99 74.50% '547.084.00
35 Dee 99 73.75% 546.610.00
36 Jan-2Q00 73.00% 546,136.00
37 Feb-2OOQ 72.25% 545,662.00
38 Mar-2oo0 71.50% 545,188.00
39 Apr-2oo0 70.75% $44,714.00
40 Ma -2000 70.00% 544,240.00
41 Jun aooo 69.25% $43,766.00
42 Jut 2000 68.50% 543,292.00
43 Au 2000 67.75% $42.818.00
44 Sep 2000 67.00% $42.344.00
45 Oct-2QOO 66.25% $41,870.00
46 NOli 2000 65.50% $41,396.00
47 Dee 2000 64.75% $40,922.00
48 Jan-2001 64.00% $40.448.00
49 Feb 2001 63.25% $39,974.00
50 Mar 2001 62.50% $39,500.00
-._...~"..
.~'"
Month Occupied:
Feb-97
Percent Amount
Month Refunded ~
r- 1.
52 Mav-2oo1 61.00% $36,552.00
53 Jun-2oo1 60.25% $36,078.00
54 Jut-2oo1 59.50% 537,604.00
55 Aug-2oo1 58.75% 537,130.00
56 Seo-2oo1 58.00% 538,656.00
57 001-2001 57.25% $36,182.00
56 Nov-2oo1 56.50% 535,708.00
59 Dee 2001 55.75% 535.234.00
60 Jan 2002 55.00% 534.780.00
61 Feb 2002 54.25% 534.286.00
62 Mar 2002 53.50% 533.812.00
63 "Or 2002 52.75% 533.338.00
64 Mav-2002 52.00% 532,864.00
65 JUn-2002 51.25% 532.390.00
66 Jul-2002 50.50% 531,916.00
67 Au -2002 49.75% 531,442.00
68 Sea. 2002 49.00% 530,966.00
69 Oct-2002 48.25% 530,494.00
70 NOlI 2002 47.50% 530.020.00
7-; Dee 2002 46.75% $29,546.00
72 Jan -2003 46.00% 529.072.00
73 Feb-2003 45.25% 528.598.00
74 Mar-2003 44.50% 528,124.00
75 r-2oo3 43.75% 527.650.00
76 Ma -2003 43.00% $27,176.00
77 Jun -2003 42.25% 526.702.00
78 Jul-2003 41.50% $26,228.00
79 Au -2003 40.75"10 525.754.00
80 5e 2003 40.00% 525,280.00
8,1 Oet-2003 39.25% 524.806.00
, tic NOli 2000 38.50% 524-,332..00
80 Dee - 2003 37.75% $23,858.00
84 Jan -2004 37.00% 523,384.00
85 Feb-2004 36.25% $22.910.00
86 Mar-2oo4 35.50% 522,436.00
87 Apr 2004 34.75% 521.962.00
88 May-2004 34.00% $21,488.00
89 Jun-2oo4 33.25% $21,014.00
90 Jul-2004 32.50% $20.540.00
91 AUQ-2oo4 31.75% 520,066.00
92 Sep-2oo4 31.00% $19,592.00
93 Oet-::.ul4 30.25% $19,118.00
94 NOli 2004 29.50% $18.644.00
95 Dee 2004 28.75% $18.170.00
96 Jan 2005 28.00% $17,696.00
97 Feb-2005 27.25% $17.222.00
98 Mar-2oo5 26.50% S16,748.oo
99 r-2oo5 25.75% S16.274.00
100 Mall- 200S 25.00% $15.800.00
",c.J
.~......-)
..-.,.,.-.-.)
}~'~i:;-:d
..1
[ it IRS
Department of tile Treasury
Internal Revenue Service
NctIce 1Z75 (June 2001)
Catalog NUmber 319808
www.lrs~gov
.J
Notice of Status and Amount of lmmediate Tax Relief
:""'"
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~(...':;:.~.
,....';,-;tJ
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Dear Taxpayer:
We are pleased to inform you that the United States Congress passed and President
George W. Bush signed into law the Economic Growth and Tax Relief Reconciliation Act
of 2001, which provides long-term tax relief for all Americans who pay income taxes.
The new tax law provides immediate tax relief In 2001 and long-term tax relief for the
years to come. I ,
I
As part of the immediate tax relief, you will be receiving a check in the amount of
$300.00
during the week of 08/06/2001.
Your amount is based on information you submitted on your 2000 federal tax return and
is just the first installment of the long-term tax relief provided by the new law. The amount
of the check could be reduced by any outstanding federal debt you owe, such as past
due child support or federal or state income taxes. You need to take no additional steps.
Your check will be mailed to you. You will not be required to report the amount as taxable
income on your federal tax return.
On the reverse side of this letter is information on how your check amount was
calculated. If you need additional information, please visit the IRS web site at
www.irs.gov or call 1-800-829-4477. Please keep a copy of this notice with your tax
records.
LREIl! 724680 cueS17354-1C128517402
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--------------------------------~--~-----------------------------------------------~----------------------------c-----------------------------~
Department ot_lIelJsuIf
Int8rnaI "-ServIcor
. PhiladelphlaService. Center
. 11603 ROOllElVelt BlVd.
Philadelphia,. PA 19161
Official Business
Penalty lor Private Use, $300
ENCLOSED IS AN IMPORTANT
MESSAGE FROM THE IRS
ON THE STATUS AND AMOUNT OF
IMMEDIATE TAX REUEF.
DO NOT THROW AWAY!
PRESORTED
FIRST-cLASs MAlL.
Pootago and Fees PaId
IntemaI Revenue ServIce
Permn No. _
1392-253-08 ************** AUTOCR ** 8-099
RE0172468D CU0517354-1C120517402
IRENE 8 WALKER
fjj) IRS
[RENE WALKER
c/o James B Walker
960 Sterling Court
ENOLA, PA 17025
NotIce 1275 (Juno 2001)
Catatog Number 319808
NOT!CE OF STATUS ANqAMOUNT OF IMMEDIATE TAX RELIEF
I
If your filing status on
your retum is:
Then:
"
"
Thfr'amount 01 your check will be the lesser' of:
$300,
5%:01' your taxable ,income' "or
- your income, tax Iiabilityt .
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1Taxable income is \)(1 Form 1040, line 39; Form 1040A, line 25; Form 1040EZ, line 6; or the Telefile Tax Record, line K.
2rncome tax liability 1-. determined on Farm 1040, line 51; Form 1040A, line 33; Form 1040EZ, line 10; or the Telefile Tax Record,
line K.
NOTE: Please be aware that the government is required to adjust these checks if you owe past due Federal or state income tax,
other Federal debt$. or past due child support.
@ PrInted on recycled PBpet'
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Send lnqull'" 10:
5000 t.&ul.. Drive
PO Box 40
M~h.nlcaburg. PA 17055
www.members1st.org
Member's
Statement
of Account
AccOunt Num"" F""" TO Pogo
160335 01-01-01 03-31-01 1 0/ 1
MemberslST
FEDERAL CREDIT UNION
Main Switchboard: (717) 697.1161 or (800) 28:).2328
Ca11-24: (717) 697.4372 or (800) 28:).4372
TOO: (717) 697.5312 or (800) 283-2328 axt. 5312
T.I.Sranch: (717) 795-6049 or (BOO) 237.72BB
JOIN US FOR OUR ANNUAL MEETING
ON SATURDAY, APRIL 21ST AT 8:30
A.M. THE MEETING WILL BE HELD AT
THE NAVAL INVENTORY CONTROL
POINT OFFICER'S CLUB IN
MECHANICSBURG. CALL (717)795-
5128 OR (800) 283-2328, EXT.5128
FOR RESERVATIONS.
1",111",111"",1,1,1,1",1,1,11",11",1,,1,11,,11,"",111
IRENE B WALKER
C/O JAMES B WALKER
960 STERLING COURT
ENOLA PA 17025
10975
TRANS.'. EfF...
OATE O"TE'
TRANSACTION DESCRIPTION
,
AMOUNT
BALANCE
SUFFIX:OO SAVINGS
021401 TFR FROM SHARES 160335-05
021401 SHARE WITHDRAWAL
26.35
9196.22 9222.57
-9222.57 .00
Y-T-D DIVIDENDS: .00
TRUTH IN SAVINGS INFORMATION
ANNUAL PERCENTAGE YIELD
/ 2.90%
SUFFIX:05 INVESTMENT
012601 SHARE WITHDRAWAL
01310,1 DIVIDEND
1("\.,"'0'1 cHARc DI'''Dc'ln
IV I- ,... (I....' '- "I, '-,...
0214dl TFR TO SHARES
SAVINGS
----------------
14141.68
9141.68
9184.93
9196.22
.00
-5000.00
43.25
. II. 291
-9i96.ZZi
1
,
, I
Y-T-D DIVIDENDS: 54.54 I
TRUTH IN SAVINGS INFORMATION
ANNUAL PERCENTAGE Y I ELO /. 0% I
ANNUAL PERCENTAGE YIELD EARNED / 3.83% I
-------~:~-~::~-----------------------------------------------------------[---
* IRA YTD * OTHER YTD * TOTAL YTD * TOT L YTD * TOT L YTD
DIVIDENDS DIVIDENDS DIVIDENDS WITH OLOING FOR EITURES
1603"'0-00
1:
.00
54.54
54.54
.00
.00
Premium Plan Accourit Statement
~"C Bank
0. PNCHA1\K
Primary account number. 51-4006-6565
Page 1 of 2
Fa. th. p..;od 01/1212001 to 02108/2001
~
,
Number of enclosur~: 6
IRENE B WALKER
713 MESSIAH VLG
PO BOX 2015
MECHANICSBURG PA 17055-2015
1! For 24--hour customer service or
current rates: Call 1-888-PNC-BANK
r8J Write to: Customer Service
PO Box 609
Pitt.burgh PA 15230-9738
~ Visit us at wvvw.pncbank.com
~
~
TOO terminal: 1-800-531-1648
For he:lfin; impaired clients onlv
Take a Bite Out of Taxes-Consult a PNC Brokerage Corp
Investment Consultant Today.
Get a [ree, no I..lbli$11iun consultatioll. p~c Broker;l.ge Curp OCfl'fS J. \\ide r:\nge of non-bank investment prollucfS and senices,
$\t<h as non-FDiC insuretl swcks, bOl1ds, mutual Cunds, unit inveSfmetH trusts, ar1\l olhl..~r products \\-'hieh Il1:\Y be able ro help you
incrca:il..~ your income, reduce raxl'S, prepare Cor college, l..lr pt:m fur rr~irelnl'lIt. P~C Broker;tge hwestlnem Con.sultams c.'1n be
rt"~lrl1t"d Illrollgh \llll" Cu.slOlller St"lTict" Ct'lller at 1.800-76'1-lllll, our web:;ite;H www.pncbrokcrage.com or;'l( any P~C Bank
hr:1llch onic<.a.
Premium Plan
Interest Checking AeeOLll'!t Summary
ACI!ounr number: 51-.1006-6565 AccOl.nt lmk <JlJ numbec 0026165626
Irene 8 W~lkeT
\,-\\;0.:10
Deposits .Jnd
o\hef Jddlllons
li,26-!. 16
Checks and olher
deductions
\395.75
EndiJ;\g
balance
Please see the Activity Detail section for
additional information.
Balance Summary
Beginning
bala\'\ca
2,:1:2.8.01
Average monti'll,!
balance
Charges
and (ees
~,S5-L-lG
.00
Transaction Summary
Checks paid/
withdrawals
Sank card/PQS Ac.c.ount Informalion
transac;tions a:>sls!ance calls
Teller
tr<lnSc.ctlons
ti
o
o
Total AiM
transacti<:H'Is
PNC Bank MAC
ATM transactions
Other MAC A TM
transactions
Olher A TM
transactions
I)
o
o
o
Annual Percentage
Yield EOITned (A?YE)
0.25%
Number of days
in interest period
Average collected
balance for APYE
In1erest Earned
thIS perioQ
As of 02.108, a total of $1.98 in interest was
earned thIS year.
Interest Summary
'23
2.0'29.-\6
.39
"ctivity Detail
Deposits and Other Additions
)~/08
Amount Description
,),000.00 Deposit ReferC':lKe ~'o. 024-163976
1,~63. 77 Din,,,:ct Deposit - Civil Ser\'"
'US Tre:lsury 31::? F 1355-l-ij W CSF
.j9 Interest P:\nllent
There were 3 Dl?posits and Other Additions
totaling $6.264_16.
)ate
)1/26
)2/01
Account number: 51-4006-6565 - continued
---
0PNCBANC
For tho poriod. 01/1212001 tc> 0210812001'
IRENE B WALKER
Primary account number: 51-4006-6565
Page 2 of 2
Premiwn Plan Account Statement
!t For 24--hour customer service:
Call: 1-888-PNC-BANK
Checks
Check Date Re1erence
number Amount paid number
3~O5 :!O.()() 'JI/lil anU,JA..j.'j
3:!.O71: 10.00 Olil il 0220i"-H-lii
3213 1: 2l.32 ()l/:!.~ 1)2111927,~
Check
number
3216
3217
321il
Date Reference
Amount paid number
;12.1)] 01/25 O'21~339o
:!o.OO O:!/OS f1Zj'27i5~2
5.2.11.30 01/31 0231i,353
. Gap in check sequence
There were 6 checks listed totaling
$5,395.75.
Daily Balance Detail
Date
01/12
01/18
Balance
1,.H.)O.~)O
1,430.50
Date
<H/':!2
01/25
Balance
1,409.13
1,:3:!6.55
Date
0\/26
01/31
Balance
6,326.55
I,OHi5
Date
02/01
02/08
Balance
2,':H8.5':!
:1,:328.91
Premium Plan Accouht Statement
PNe Bank
0. PNCBAN<
For the p.riod 01/05/2001 to 03/05/2001
o
o
IRENE B WALKER
960 STERLING CT
ENOLA PA 17025-2664
Primary account number: 51-3005-8377
Page 1 of 2
Number of enclosures: 0
,'t
'!t For 24-hour customer service or
current rates: Call1-888-PNC-BANK
181 Write to: Customer Service
PO Box 609
Pillsburgh PA 15230-9738
a Visit us at www.pncbank.com
~ roo terminal: 1-800-531-1648
For he:u'lo~ impaIred clicnu. only
Our annual Priv~cy Policy sr:ltement is enclosed. Pleo.se review it to find out how we use your financial
and personal information to help you reach your gO<lls.
Premium Plan
Money Market Direct Account Summary
Account number. 51-3005-8377 AccourH1Unk i!) number. 0026165626
Irene B Walker
.,
Balance Summary
Please see the Activity Detail section for
additional information.
Beginning
balance
1-!:!,t)i17,.t5
Deposits and
aUI'8f 3aU\\lOnS
950.~3
Checks and other
deducllons
5,tlOO.OO
':"verage monthly
balance
1-13,070.27
Ending
balance
138,6.17.63
Ci1M'1'eS
.Jnd fees
"
.00
Transaction Summary
Checks paidl
WIthdrawals
Bank card/POS Account Information
transactions assIstance calls
o
o
Total ATM
transactions
PNC Bank MAC
ATM transactions
Other MAC ATM
transactions
o
o
o
As or 03/05. a total of $1.502.28 in interest
was earned this year.
Interest Summary
Annual Percentage
Yield Earned (APYE)
Number of days
in interest period
Average collected
balance for APYE
4.117.
60
142.330.37
Activity Detail
Deposits and Other Additions
Date
02/05
03/05
Amount
536.62
-113.61
Description
Interest Payment
Interest Payment
Teller
transactIons
Other A TM
transactions
Interest Earned
this penod
950.23
o
There were 2 Deposits and Other Additions
totaling $950.23.
Date
Description
There was 1 Other Deduction totaling
$5,000.00.
Other Deductions
Amount
03/05
5,000.00 \Vithdl~Wa1 Reference No. 0'1.2334123
.
Premium Plan AccOlmt Statement
Account nwnber: 51-3005-8377. continued
Daily Balance Detail
0. PNCBAN<
For the period 01/0512001 to 03105/2001
IRENE B WALKER
Primary account number: 51-3005-8377
Page Z of Z
1t For 24-hour customer service:
Call: '.BBS-PNC.BANK
Cate
01/05
Balance
1-!2,G97..15
Date
02/05
Balance
143,234.07
Dale
03/05
Balance
138,647.68
When you look for ways to try to save money, you probably think about shopping for bargains at the grocery store or at a
department store. How abou< sa,ing money on your annual t.1X bill? Why pay Uncle Sam right away? Invest in a "",.deferred
variable or fixed annuity, and control when you pay taxes on your earnings. Learn more about investing in annuities by
contacting a PNC Brokerage Corp Investment Consultant to set up a free no-obligation consultation. PNC Brokerage Investment
Consultants can be reached through our Customer Service Center at 1-800-762-6111, its web-site at www.pncbrokerage.com or
any PNC Bank branch office.
ESTATE OF IRENE B. WALKER
FILE NO. 21-01-0168
iNHERITANCE TAX RETURN - SCHEDULE H
~~~~~~~;'J!,:;~t';::~~1t;'~~.2:;';:~ ,,;
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Myers Funeral Home, Inc.
37 East Main Street
Mechanicsburg, Pa. 17055
Boyd L Myers Jr., Supervisor
(717) 166-3421
A STANDARD OF EXCELLENCE SINCE 1910
February 25. 2001
Mr. James B. Walker
960 Sterling Court
Encla, Pa. 17025
Dear Mr. Walker.
Yau have the right to pay the entire amount due at any time to avoid future interest charges.
Services for: Irene 8. Walker
BALANCE
Payment Received
$5,320,00
02/2501
BALANCE AFTER PAYMENT
Interest Added
Late Charge Added
NEW BALANCE
PAYMENT AMOUNT DUE
DATE PAYMENT DUE
MONTHS REMAINING
S5,320,00
$5.320.00
Mar 9. 2001
1
Credits Granted S1,J65.Q PacKage. PnCll Oi~cou{\t
Interest at the rate of 1 % per month ( 12 % per annum) will tJe added 10 balance after 30 days.
(A I..tllpayrtlenlfee 01 S20.00w,lIbe a33essedif not pa'l;Ibytheduedate)
IRENE B. WALKER
113 MESSIAH VILLAGE
POBOX 2015
MECHANICS BURG, PA 17055-2015
DITE _~ /.3 10/
I I
r
,..;./u./c-
PAYTQ THE IV] 'I J II
ORDER Of . If.Qf7~\ U;hQl"~ \J6'Yl'L<-
~"--<' +L r.1 n-und filhK -t,) 1,-"'1'1" ",f
i )...If- '1vL,
d
PNCJBANK.
040 .
Premium
Plan
PNC Bank. >i.A.
Central PA
mR
.:03 l. 3 l. 27381: 3227
~"""lANO 1991
Il^~J-1
"f'--R'Y'
~ {e~
/ >>/.sthIJ/
3227
60-1273/:313101
I $ =:? l, ~ C~}
--')-'/.
c~ :::' ,3"~~;~';; ".",n
h, DOLL.\RS ffi ~.",...".."
. Myers Funeral Horne, Inc.
37 East Main Street
Mechanicsburg, Pa. 17055
Boyd L. Myers Jr., Supervisor
(717) 766-3421
STATEMENT OF FUNERAL GOODS AND SERVICES SELECTED
Char~es are only for those items that you' selected or that are reguired. If we are re~ired by law or by a cemetery or crematory to use any items we wit
explam in writing b~low. if YO,:! selected, a funeral that ~ay requlre embalrningl sue as a fu~eral with viewing, you may have to pay for embalming. Yo
do not h.ave to pa~ tor em~almm~you did not approve If you selected arrangements such as direct cremation or immediate burial. If we charge you for a
embalmmg, we will explam why clow.
For Services of Irene B. Walker Date Of Death February 9. 200 I Date of Contract February 10.2001
Charge to James B. Walker 960 Sterling Court Enolo. Po. 17025
Name AdC1ress L..Jty ::'!ate Zip
A. CHARGE FOR SERVICES SELECTED: C. SPECIAL CHARGES
1. PROFESSIONAL SERVICES Forwarding Remains to other Funeral Home S
Services of Funeral Director and Staff S 1695.00 Receiving Remains fonn other Funeral Home S
Embalming S 895.00 Immediate Bur1ai S
Casketing, dressing, cosmetology S 195.00 Direct Cremation S
Other Preparation of body S 95.00 S
Hairdresser / Barber S SUB-TOTAL OF SPECIAL CHARGES CS
Autopsy Remains S D. CASH ADV ANCED
$ Opening Grove/Crypt S
SUB-TOTAL PROFESSIONAL SERVICES 2.330.00
Al S Newspaper Locol S Incl
2. USE OF FACiLiTIES AND SERVICES Newspaper S
F or visitation J wake service S 425.00 Clergy / Moss Offering S 75.00
For funeral ceremony S 450.00 Certitied Copies of Death Certificate 10 S 20.00
For memorial $ervice S Family Flowers S
Equipment & services for graves ide $erv~ S 295.00 S
S S
SUB-TOTAL FACILITIES AND EQUIPMENT :\2 S t.170.1J1J S
J. AUTOMOTIVE EQUIPMENT S
V chide to mmsfer remains to Funeral Home $ 350.IJO SUB-TOTAL OF CASH ADY ANCED 0$ 95.00
I-kurse (Casb:t C.><lch) S 29\.00 We .:hargeyou'or our sl.:rviccs in Dbtaining the following:
------~------------~- --
[-'lower c.~~,' [-'\oml Distribution ~ !nd >JONE
------ ---- - -~_.
F.lInilyell. S Inl.;l --._-------'--- _.- .--
-- u_'___ ---.------- ._---. . . -
.-.-----.--- --'i9500 SUMMARY OF CHARGES
L..:au Car I C\~rgy Car S
UtilityClr S TOTAL ABOVE ITEMS (A.B.C.D) S 6.685.00
Out of town transportation S Sales Ta., (if .-Ippi (it) % S 0.00
--
S
SUB-TOTAL AUTOMOTIVE EQUIPMENT AJ S 340.00 TOT AL OF ALL SECTIONS $ 6,685.00
TOTAL SERVICES, FACILITIES, AUTOMOBILE A$ ~,890.00 LESS: Payment \tlnde S
B. CHARGES FOR MERCHANDISE SELECTED LESS: Credits Pending S
Casket Livingston 50\2333 S 1575.00 LESS: Credits granted Package Pr1ce Discount S \,365.00
Other R~cept:lcle S BALANCE DUE by Mar 12. 2001 S 5,320.00
Outer Burial Container S .-\ bte charge of U% per month on the outstanding balance (annual rate of 13%) I
Acknowledgment Cards S IDe! will be added to the baJal1ce. ,
Re:gister Book S lncl
Memorial Folders S lncl REASON FOR REQUIRED SERVICES OR :HERCHANDISE
Prayer Cards S Reason for embalming family viewing
T ~mporary Grave ylarkers S Cemetery requires outer burial contain~r
Burial Clothing S 125.00
Other Clothing S DISCLAIMER OF WARRANTIES
Our funeral 'nome makes no representations or warranties regarding caskets
Cremation urn $ or outer burial containers. The only warranties, expressed or implied, grante
$ in connection with goods sold with the funeral service are the express writte
$ warranties, if any, extended by the manufacturer thereof. No ather warrantie
including the implied warranties af merchantability or fitness for particula
TOTAL MERCHANDISE SELECTED BS \.700.00 purpose are extended by the seller.
I agree that I have examined the items of goods and services selected above and found them to be correct and according to the arrangements I hav
requested. I acknowledge receipt of a copy of th~s Statement of Funeral GoodS and Services Selected. I rep~esent that I have sl.lffic\ent.f~ntis a'lla\\able f
ffayment of the cash price for the 500dS and servIces selected. I also agree to make payment of $ 5320.00 WIthIn 30 days. I agree to be JOintly and several
iable with anyone else who signs elow. A LATE CH~RGE of 1.5% per month (18%ler annum) Will be applied to the unpaid balance beglnnm~.30 days afte
the date of this contract. I wlll also pay the Funeral DIrector all reasonable costs pal by the Funeral Director to collect amounts \ owe u,nder t IS agreemen .
Those costs ma~ Include .attorney fees and court costs, Any items requested after the date of thIS agreement will be conSidered part of thiS agreement and w I
be reflected on t e final btll.
(Seal) . February 10. 200 I
Purchaser Contract Date
(Seal)
PurcnllSer Boyd L. l'vtyers Jr. Licensed Funeral Director
@Vtye;za~o:::::~' :::::';:~j~U /9/0
STATEMENT OF FUNERAL GOODS AND SERVICES SELECTED
Ch:l'1lo ~rt only for lhO!t jU~m.' rh~l )"m.l lclt'ClCd or Ih~1 ~rt' rcquircd. rf \\'(' lrt' rrquircd by law llr by ~ n"mt'lt"T) Of w:malory III U~t' ~ny itt'm~, 'Nt' will
cllpl'-In inwtttil\&hclow.
If rou sclfeted a funt'r~llh:l1 mal' require t'mbalmjn~. luch a~ a (un('Tal with viewinA. you may h2vc: 10 pa)' {or t'mhalmin~. You do Olll 112\'('10 pay (or embalminl!
you did om approl'c jr~lC'd amn~cnl' ~ ;IS:I direct tt' lion u~m('di}le burial. If we ~h2n~cIJ fllr I.'mlr.llmlnll. we will t'xpPf" w~ below
for lbe Scnlcc 01 /V'C A& ~r- _ D:atc of Death Z - - Jot'll
~ r7 1/ I.' 1/' '1'.." 5T7'r<-U....c- "___T-
Charge to, ./AMe:...5' / ) f)~-rN(.{hL If..... l/1./A(/ <-...9~ J . 7' z..S-
Name ,\,J<.lre~~ \.ily r.:- ~........(...~'bIC , I I ~
A. CUARGE FOR SERVICES SELECTED,
I PROFF.5SrONAL SERVICES
Sefl"iCC5 of Funtr~1 [JirtCl()(/~!~(f
Emtnlmin~
Ot!u~r prcj11n.tinn (\ft\m.l~
Olher dnlhin~
,~
,~
Crem~tjon IIrn
m~niption)
BOYD L. MYERS, JR.. Sup~rvisor
~'T E. MAIN 5T1lEET
Ml!arANICSBURO.I'ENNSYLVANrA 170.'13
(117)766-;1421
OTHER
,~L
SUB-TOTAL Of PROFESSIONAL SERVICE-r., ,
2" FII.(.ltlT1El AND Sf,RV1CES
lJS(0(f1cilitiolndservictsror
vie....in!tlVlsimJonIWlke)
list of f~eiUrits ~ndltrvi(eS
(urrllnt"r,lt.crt"mnnr
U~(\{h,cititits1.rnl5(\"Ii<:CS{\\1
,'<ltmOrill Serviet
lJ.lt" <lftquipmtnl ]nu len'jCtS
fllr ~r~vtsidt" ltrl'jet
Other use IJfbei!ili"
AIJ~
,-.;r,.L
TOTAL MERCUANOlSE sEi"KTED
c. SPECIAl. CHARGES:
FlJr....udinll<lfrtmliillltJ
,~
{Funer.lllltln1cl
Re(cjvinIlO/ (emlins frr>m
'-
IFuner~1 !InRlc)
Imm('di~le BlIrill
Direcl ere-mllilln
~
II ;c....L.
SUB.TOTAL OF SPECIAL ClIARGES
D, (ASII,\DVANCED
Ofll'rTin~ (;rll'c
Cemeltr)' Equiflme-nl
I.'H ~n<l Dccd
~cw'flaflcr "'''lkn_l,uol
:-lew'fI~per NOIi(t.l_l)lo."I.!"wn
rell.r~lOne ,,< Tdt'llfJm'
\irlHC
Unl1rl.U:bs Olrt'rln~
1',llh",uen
Cnl,lkd CUrlt" or l)lr Pt':lIb
Crrllfit.Jle
,~(,
SUB-TOTAL Of FAC1liTIESIF.QUlPMF.NT
.\. l\lJTml0Tl\'F. EQllIPMEi'lT
Vchicle: m \f1.nM'l:f {Cm~iM III fU'I\tn\ \\mne L
1,,1(11 J~
llt~r~e ICl,krl (UJl'h)
tuol
l.irT1ulI~int
1.001
Flmih' nr
I.nol
Fh,wn t'~l 0"11 nnr~\ ,1;'rn.ilillll
l.uIJl
I.l;J<llUlder~nr
!.ool (At/...-
CH for pJllhe~rrr~
I.nol
Out uf lo\\"n Ir;n~flmlJllon
'-=--
! r,,,,,-{....
'-=-
'-=--
SUB.TOTAL OF I~UTOMOTIVE EQUIPMENT
TOTH Of PROFESSiONAL SERVlCES,
FACILITIES AND AUTOMOTIVE
EQUIPMENT
/""tr"'f~J
,~
~ -===-
'=-
!',,!i\"t ~"(.~m
rlm,.n"
VIUI! Srnlll' !.bJr~('
,~
,~
SUB.TOTAl Of ADVANCl:5
,\,~ J-LL \l;'e chu~e 1"" {or our \rr,.ic~s in "bl~inll1!l:
(!pt(if)'((Isb ,ull'n"r~' thaI nrrj.lJarkrr/_IIp)
AA.1y'I.I(::'-
,\S~~
'-
'-
'-
BI/700 'iL
:i
(" S--==-
/'
,=..''1
:2:..';-, '1
J.'J:v"-c...
'-=-
'-=-
1-
17...:5:.<:='
,-=-
s~!2
I
!~'-~
,~
I
,
,
,
,
,
[)! Q5'6'<1>
SUMMARY Of (HARGES
A Profe~.lioll,1 Sefl"ice.l, r" ilirle~ ]nd
Etjuiflmcnt.-.Hld'\II\<lm\\li\,t
Equipmelll
8,\lerchJndisr
( Spe(i~\ Char~es
o (Jsh '\d\"Jnl'~~
TOTAL Of ,\l.l SECTIONS
PAID AT TIME OF OR PRIOR TO
ARRANGEMENTS
RABNCE DUE
B. C!lARGE fOil MERCllANDISE SELECTED,. __1 ~
(~~kel .. ., . . J L.;2t..J ,
lDescriplion) L'/l/"Ve, Tn,v
f1.4k'
OrherRtccpllC!e
IDtscriplion)
OilIer huti,l (Onr~inrr
(D(scriptionj
Ackno\\'leu~em(nl ordl
Rq.:islerhook(l)
~lemmy fllWtt5
PrJI'erords
Temporlry !:r~\'c mlrker
llllrlllclOlhlng .;1t..-1a
'~
' L
,
,
. '-
t!,...p73s~~
S~S-:~
~~_&
,
, Jr..~
,~c~'"
_0 -
s----,--. .'"'
$.522.1.' ~-
eu [h(" flurch~se
uirtment i.~ rxrbined helow
,'''' ~
<;~
.hJler)
/.-
~~,)""
~ .' <1,lcen.lru IUr!erll Diret"!urj
y .LLOW_C~"o""
J ~gret thlll h~I.( ulm.incd [he items of !:ond~ ~nd .Ierl"i(el selected ahovr Inu found Ihem 10 be COrfCt"!l<W J((\1IuillFo 10 \\le,tnn~el1'V:nl! I h~v( reQuc5red. I acknow!ed!:c
1(((\t\1 ~.f,'1 (1lT'" OllhlS St~lement of flloer.l (;oml.\ Jn~ SeTvlGl"i'dec[ed, ,I lepre~m I J l1:Ive \Uffirlr.nr funds Jnillhle fnr fl~l"mentllf Ihe osh price for Ihe ~oods
~.ntlltr\ll(l Irlectt.u. I also J~rcc 10 m.,~paymenlllf-t:z,. J...::...L within < 0.. (bn l,l~rrr 1Il IIr i"inl1r lnd .lcI.erJIII" Ii.hle wilh Jnl"llnr else Wh.'.'
signs IJelo"- A lIre chH!:e of per mnnl!l lmo~nllng ro pCT I'ear WIll he l!"plirrJ III the m\)l1.itllllbl\(C I>e~nninll 31---- (121'1
from rhe dl.tc of. 1,ltlll~ICe~m, ~ :"'1\\ a\~n p~l' 10 lhe funcr.tl DlreClor ~n rrls.onable COSlS p~ld by Ihe FIlr1cr]1 JlireclOr 10 lollecr JmOUnll J owe under lhis ]!:Teemenr
Thol.C' l.om m~l melude, mornejS kt~, court com lnu <Hhcr CIlm. ,10)" lddlllOnll scn.!Cel Dr merchJndlSC ordered or re4oc~led .fter the u~le of Ih;~ l~rcemenl wili
lit" consluercd pm of rhls J~reemenr Jnu rhe eosl thereof Will hc refleclcd on lhe fin~1 blillJr mtcmen!
='
lSeJ
chJlcr)
W!IITF..rUn<f"IDloo:<,,,,
IRENE B. WALKER
713 MESSIAH VILLAGE
POBOX 2015 .., ) ( ) 60-1273/313 10'
MECHANICSBURG. PA 17055.2015 D.IT[ 0'- d...1.LI Q!
PAYTO THE C\ U(} - C7'~/'~ ,1 n . \' ,
ORDEROF /' 0Uh<..QA...- D C/} V ~h.J I $ IO~7 cc!
01'1 /'iI /1 .1 (/:J!f5~"- 7'<,--" A ~ ",-~ 1 -J.':'."',::::'::'........
~~~!. _. ~~f!:.Ju",-, ::.ooL~l.!Jo..."..ft""
PNClBANK. .
PNC B.... N.A. 040 ~ Prenuum J
:p;;t2~~, ~~~;,Y~-
1:0:1~:1~27:181: :1225 1I'5~l.,op II' ,1'00 ~
~HAIO\,ANO '!PI?
3225
3226
GC-i27::l/313101
:,.)
..
,I' 0 O..oo-l:lil:s.,.som~ .
RECEIPT FOR PAYMENT
-------------------
-------------------
Cumberland County - Register Of Wills
Hanover and High Streee
Carlisle, PA 17013
Receipt Date
Receipt Time
Receipt No.
2/13/200..
09:34:5';
102461'
WALKER IRENE B
File Number 2001-00168
Remarks WALKER JAMES B
SK
------------------------ Distribution Of Receipt -----------------------
Transaction Description Payment Amount Payee Name '
PETITION FOR PROBA
SHORT CERTIFICATE
EXTRA PAGES
JCP FEE
235.00
18.00
9.00
5.00
CUMBERLAND COUNTY GENERAL--
CUMBERLAND COUNTY GENERAL I
CUMBERLAND COUNTY GENERAL I
BUREAU OF RECEIPTS & CNTR I'
CheckiF 4076
Total Received.........
$267.00
$267.00
JAMES D. BOGAR
Attorney at Law
One West Main street
Shiremanstown, PA 17011
Telephone (717) 737-8761
S TAT E MEN T
June 12, 2001
James B. Walker
960 Sterling Court
Enola PA 17025
In Reference To:
JDB FN 3364-1
Estate of Irene B. Walker
06/07/01 Office consultation with client re various
matters involving the administration of the
Estate of Irene B. Walker
For professional services rendered
;previous balance
2/1/00 Payment - thank you
Total payments and adjustments
BALANCE DUE
PNCJBAN~ _
PNC B-.nk, N..A.
,>:,'(Ceuuw.l PA' wo
';:'~':S,~::;
+;;~jJ.' .-
PAYTO-rnf :"",,,:. ': c'"
O"OEAOF"'" ,A ~I c S
- ~~.- .,- .,
,----..,----- ~.' ---"
-. . -- .---
"--._-_..-.
Amount
175.00
$175.00
$390.00
($390.00)
($390.00)
$175.00
/ OM .'
I $U 7 :z.~.
., . ,-' . --.. . . _ .. , . , ._ _ _~ms1'3
'__ ., ,. ,,'. _..' :Jux;J,O ~/
, K. b~'GA){" Hi,;n~a+~,
VE: /1 40 DOLLARS ff1r:;;:.::::o'
=osSl5'J'O'l^f!'1'
FOA Con"u W,,-hOA F-ee..
':0 '11'1117 'lB':
SOD \ \ 701 \ SII'
1.-
,1'000001. 7 500tll
H & R BLOCK PREMIUM
4811 Jonestown Road
Harrisburg P A 17112
Tel: (717) 657-0316 Fax: (717) 540-6006
October 24, 2001
ESTATE OF IRENE B. WALKER
JAMES. B WALKER, EXECUTOR
169 LEE ANN COURT
ENOLA, PA 17025
For Professional Services Rendered:
FOR THE PREPARATION OF PA REV 1500, 20011041, 2001 PA41 AND FINAL 1040
OF IRENE B. WALKER
\
j
Total Fee.............................. $
Received on Account ........... $
Amount Due ......................... $
1,000.00
0.00
1,000.00
~A~CE ADDRESS I BILL TO
ENTlNEL - LEGAL JAMES B WALKER
P.O. BOX 130, CARLISLE, PA 17013
AD NUMBER I ClASS SALESPERSO^ BILLING DATE LINES
209921 10 PUBLIC NOTICES 28 10/10/01 19
AD DESCRIPTION START DATE STOP DATE
EXECUTOR NOTICE LETTERS TESTAMENTAR 09/26/01 10/10/01
PUBLICATION INSERTIONS RATE NET AMOUNT GROSS AMOUNT
3 THE SENTINEL - LEGAL 3 LGL 61. 56
TOTAL AD CHARGE 61.56
3 2001 PROOF OF PUBLICATION OlPRF 6.35
PREVIOUSLY PAID -67.91
c:.J\JCjod1
DAYS RUN C; I~ t Ie; / :j
)0
PURCHASE ORDER ( r PAY THIS AMOUNT .00 .00*
Irene B Walker
RETAIN THIS PORTION FOR YOUR RECORDS.
. AFTER 11/09/01
MESSAGE:
Thank you for advertising with The Sentinel.
Deadlines for in-column legal advertisements: Monday is Friday at
11 a.m.; Tuesday is Friday at 4 p.m.; Wednesday is Monday at 12 Noon;
Thursday is Tuesday at 12 Noon; Friday is Wednesday at 12 Noon; Sunday
is Thursday at 12 Noon.
If you have any questions regarding your Legal bill please call
Dauris Henry at 243-2611, ext. 202 or Sherry Clifford ext 201.
Fax your leg~ls LO 243-3754, aLLE~tion Sherry Clifford
You can also EMAIL your legal to:: classad@epix.net. Please include
a cover letter and the ad as an attachment.
DETACH AND RETURN THIS PORTION WITH YOUR PAYMENT
THE SENTINEL - LEGAL Irene B Walker
POBOX 130 CARLISLE PA 17013
AD NUMBER CLASSO START DATE STOP DATE
209921 PUBLIC NOTICES 09/26/01 10/10/01
AD DESCRIPTION BILLING DATE TELEPHONE NUMBER
EXECUTOR NOTICE LETTERS TESTAMENTAR 10/10/01 717-732-1768
GROSS AMOUNT OF
.00
DUE AFTER 11/09/01
TOTAL AMOUNT DUE
.00
ENTER AMOUNT ENCLOSED
JAMES B WALKER
169 LEE ANN COURT
ENOLA, PA
I",III",III"",J,I,I,I"I,I,I
17025
~---------~--~~~nnnnnnnnnnnnnnnnnnnnnnnnnnnnnn~
PROOF OF PUBLICATION
State of Pennsylvania,
County of Cumberland.
Lori Saylor, Classified Advertising Manager of THE SENTINEL,
of the County and State aforesaid, being duly sworn, deposes and says that THE SENTINEL, a newspaper of
general circulation in the Borough of Carlisle, County and State aforesaid, was established December 13th,
1881, since which date THE SENTINEL has been regularly issued in said County, and that the printed notice
or publication attached hereto is exactly the same as was printed and published in the regular editions and
issues of THE SENTINEL on the following dates, viz
Copy of Notice of Publication
September 26, October 3 and 10, 2001
EXECUTOR NOTICE
Letters Testamentary on
the Estate of IRENE B.
WALKER late of Upper
Allen Township late of
Cumberland County,
Pennsylvania, deceased,
have been granted to
the und8(slgned.
All p<!r!!(lr"''lltrl..,w!n!llh9m~
salves to. be indebted to'
said Estate will make
payment Immediately,
and lhose having claIms
wHl present them for
settlement.
James B. Walker
169 Lee Ann Court
Enela, PA 17025
Affiant further deposes that he is not interested in
the subject matter of the aforesaid notice or
advertisement, and that all allegations in the
foregoing statement as to time, place and character
of PUbu<a~ trd {?
~ { a(2~d (rL-
October 10, 2001
Sworn to and subscribed before me this
day of October , 2001.
dfiuvJWv;
10th
~o
Notary Public
My commission expires:
NOTARIAL SEAL
SHIRLEY O. DURNIN, Notary Public
Carlisle Bore.. Cumberland County
M Commission Expires Au . 9, 2003
CU~..SSIFIEO G
I\.OVE"RTISltl
INVOICe. ,," (71n "",,138
. ,,,,,"
_'!.regarding ttlisIn
0"
BILLING DATE
10/11/01 J
-
~ ~t--Nrtn5
0-"(717)255-6121
To Place your ad Call Clas$\"..... 55-6417
T~ll.lSh99\ Req\lMot call (717) 2
I'A.
17n<;
STGi> DATE TIMES
\ ~O/09tOl IG L 1.001N
~;:;I{f BOX CHARGE
Iff":' AFFIDAVIT CHARGE
I/}/t? BOL.O I'Rl:f\'
It'll ATTENTION G8TER
SIZE
\ \$
AD AMOUNT
132.48
\
.le NO. CLASS START DATE
REfefl€:8 B \
'M. 30S 09/25/01
n:.S25'l1.
01
thl
Sl.Il
Cit~
185.
WAU..::R
'C...,
J~ "'-~ ANN C1URT
1.69 \
,=->lu\.
1.50
3.00
DEBIT MEMO
CREDIT MEMO
their,
9th da
notice \ ..,.-
publican
,
CILbl.:-ldoiT
DISCOUNTS
ADVANCE PAYMENT
..
~~
~~
ACCOUNT NAME
\ J,\"~S '3. ...ALI<E.~
~\$
13 6. 98
\
J
statement
adopted Sl.
the office ft
Volume 14;,
\ J\J.~ U?J~ q::CE!?T
TERMS -
O~"AG LINE
\ ~3T A~:: J1= 'HLK ::R
PUBLIC/.
COP.
.,...........v..;........~.......:................,..........,...........................,.
Sworn to and suo$cr:~od bt;fOiB [Ile ThiS 15ttr day ot8ctober 2r:b01 A.D.
"I j/
NOIanalSeal 1/ /' /.. /. _
TenyL Russell NOlaryPUbtIQJ ;9'./ (....-1.::~ I r-< -., /___-f:
Harrlsburg. Dauphin County , ~ .~ -----
My Commission Expires June 6. 2002 NOTARY PUBLIC
Member, PennSYlVania ASSOCiation 01 Notaries
My commission expires June 6, 2002
U!GAL NOTICE
Estate of "ene B. Wolkef. OeceaHd.
Loft c.f the TcwnshlD of UPDer AII~. CumOer.
laM COl-mtv. PA. E
Lett.rs Tes~'Cry on the al)ove s-
tete hOW I)Hn granted ta the underslGlOed.
wno request 011 penons having claims or ci6-
monds ovalnst tlV "tate of tM deud..,t to
mo..e knOWn l'tw some and 011 person IndeotllKl
10"'" dltCedent to make paym.,,' without de-
laY to. JQn\6S B. Walker. Executor, 169 Lite
Ann Court. Enota. PA 17025.
JAMES B. WALKER
169 LEE ANN COURT
ENOLA, PA. 17025
Statement of Advertising Costs
To THE PATRIOT-NEWS CO.. Dr.
For publishing the notice or pUblication attached
hereto on the above stated dates $
Probating same Notary Fee(s) $
~~ $
135.48
1.50
136.98
Publisher's Receipt for Advertising Cost
The Patriot News Co., publisher of The Patriot-News and The Sunday Patriot-News, newspapers of general
circulation, hereby acknowledge receipt of the aforesaid notice and publication costs and certifies that the same have
Jeen duly paid.
By....................................................................
--~_.--_.-
EST ATE 0 F IRENE B. WALKER
FILE NO. 21-01-0168
INHERITANCE TAX RETURN - S([HEDULE I
MESSIAH VILLAGE STATEMENT
100 Mt. Allen Drive
P.O. Box 2015
Mechanicsburg, PA 170552015
(7l7) 697-4666
Resident: IRENE B WALKER
Resident Number Date
000029704 0212812001
Page Amount Due
1 1,649.00
Discharge Dale 02109/2001
B
I JIM WALKER
L 960 STERLING COURT
L ENOLA. PA 17025
T
o
Date
Descriotion
Charaes
Credits
Total
Beginning Balance
MONTHLY CHARGE TIOGA
BARBER/BEAUTY SHOP
ROOM & BOARD - SEMI-PVT
8 DAYS AT 150.00 PER DAY
A.L. TRANSPORTATION
Dr Kilmore
PAYMENT RECEIVED - THANK YOU!
420.00
11.00
1,200.00
4.982.05
5,402.05
5,413.05
6,613.05
02/0112001
02/0112001
02/0112001
0210712001
18.00
6.631.05
02/2812001
-4,982.05
1.649.00
3224
CIfiENE e. '!MLKER~
713 ME.SSIA~
POBOX 2015 .
MECHANICSI3UAG, PA 17055-2015
1):\11
'1 /~ I / (1)
<.>~ I '" ~/ '-' I
60-1273/313101
". / I t? /J $ 4--0 X ~ '.' ~
g-~J?RWFE ,J!' / ilL 'Vjt..-ULtl " /.7<
4/1 /I-f:i7(}-I.UtLd ~iC.un r:Lu. z-L:!;l-q; -I-u'7J (I ~": DOLLIRS [!J ;:'::::.~'::':'
PNCJBANK. Premium' ~/
PNC B..... N-A., 040 ,Plan .iJ ^ L ~!
CencnlPA ._'-~. /~~/~a., - ..
rDR()()(},iJ;;;,!:'f71J1-!-- ) L.,t,' 1 ,q.A,m c; .
.:0 H ~-l. 27:1a;: :1221, II' 51.1,0lJ-l:5!;5 II' ,"0 ~~~'~
--,~
3230
IRENE e, WALKER
713 MESSIAH VILLAGE
POBOX 2.015
MECHANICS8URG, PA 17055-2015
PAY TO THE~'Vuz.J ,/LA-:
ORDER OF
Current
1 * ,
PNCJBANK. Premium . ~
PNCB.....N.A. 040 Plan, :f& ~~,.c
Central PA ,., I/. rft/""
~;~~'~~l.:~~;~~:l2:lOi II.S~I,~r:5~-- -:;;- t!O~_'!
.~'"' 0.00 0.00 1.649.00
U.OO
3 , 0
6Q...1273/313101
IMIL
I $ J ~ LJ_'i. ,)<'
1.649.00
1
1%F1N
.
~ NeighborCarE
DATE; Cr#;.S-fJ ~
RE; 77 If' (t IKer-
Dear Guarantor.:};hAl Wt( I K e r
Neighbo<care .
600 Alleodale Road
Ki"9 01 Prussi<!. PA 19406
tel 610 962 5995
fax 610 9621083
NeighbolCare is a supplier of durable medical equipment and supplies. It is always our pleasure
to provide services to r~de~ in nursfg facilities. According to our records, your secondary
insurance {fa Pm. (. /(1 / <; () .,q 11 has issued or will be issuing payment
to you or the subscriber, As a result, we ~e requesting that you forward to NeighbolCare
payment in the amount of$ 7)lj() I j" which is due on your coi~surance balance for;
INVOICE # DATE OF SERVICE AMOTJNT PAID DATE PAID
~.
Lf5~flJ~ / -/- :/00 / /:;5: ~-7 S-c29-o /
LjJ2jf)7_ cl- /- 2..00 / 07.65 YdY-o/
Y)151'3 I!) - :J c.;- ;)0 (!II L;9, r; d. S-cJ9-6/
-L '-"'...... ~ ~
Lj r :J 50 if / j(-/-.2b-H;- / if'!. 03 S-/)9-d/
Lj e:;) ')() 5 / 2,-) - ::<'tfr:)-d'- /Lf-5 ;sJ 5'- iJ9-{) J
sf J ,! ~
Thank you in advance for remitting your payment willi' n da s of ipt of this letter. For
r<:~r.convenience, w.e, h~ve ~~~~~,sed : return envelope., ~y:o~~h,a~e. ,;,:y e~:~~~' j~; pI,
/ QO 2.
PNCJBANlK.
PNCBank,S.A.
CeDtnl PA 040
1lIl-1273i313
11s ..100/
,
6~YD~~'J'FE filE I G)"'\ f'.. 0 i<. CARE I $ 5 LJ.o~13
'1-G.~ 91''''''('\'' ~A- ~lt4/ wu.l 11,00 DOLLARS m"",,,::::'
" _~ "WEOF ~~~; ~;;~~
'l-Zz 0)(, +'5'),'5"03 'f';=s:- i~ "f?
FOR 1J.-<:l. $'~i '/'" 1 <:7\4- fLL-
':011112718': SOD 1 1 70 2 1 SIl' ."00000 SI,O 18...
~ ~\
(\~ % \A< t"\..
f/~cPT
.
.,
BlueCross.
BlueShiehL
Explanation of Benefits
THIS IS NOT A BILL
Federal Employee Program
01158,004310
,.
7
PENNSYLVAHIA BLUE SHIELD
PO BOX 890037 CAHP HILL PA 17089-0037
IRENE B WALKER
744 CAROL ST
NEW CUMBERLND PA
17070
MEDICAL QUESTIONS CALL 1-S00-779-69QS.
DENTAL QUESTIONS CALL 1-S00-7Q6-S6S7.
TTY QUESTIONS CALL 1-S00-3QS-3SQS
CLAII1 NUI1BER:
DATE RECEIVED:
DATE PROCESSED:
DATE PAID:
PATIENT NAI1E:
ID NUI1BER:
01645610399
OS/24/2001
OS/27/2001
OS/29/2001
IRENE WALKER
R00359692
CHECK NUI18ER:
51654074
SUI1I1ARY Df STANDARD OPTION BENEFITS ON THIS CLAII1
BENEFIT CHECK ENCLOSED
PROVIDER NAI1E: ASCO HEALTHCARE INC
DATES Of SERVICE: 01/01/2001 - 01/31/2001
TYPE Of ISUBI1ITTED INEGOTIATED 1 NONCOVERED 1 EXP 1 ALLOWABLE 1 DEDUCT 1 COINS OTHER 1 WHAT WE 1 WHAT YOU
SERVICE ICHARCES I SAVINGS I CHARGES 1 . I CHARGES I COPAY COVERAGE 1 owe 1 owe
RX DRUGS 1 416.241 127.711 13101 288.531 230.821 57.711 57.71
1 1 1 13031 1 1 1
DI1E RENT I 114.501 5.841 13101 108.661 86.931 21. 731 21. 73
1 1 1 13031 1 1 1
RX DRUGS 1 355.261 24.491 13101 330.771 264.021 60.151 66.15
I 1 , 1 13031 1 1 1
TOTALS '$880.00 158. .4 727.':'0 58Z.3? $145 . 5~ $145.59
. EXPLANATION OF CODES/REI1ARKS
310--YOU ARE ENROLLED
BENEFITS FIRST.
AfTER I1EDICARE'S
IN I1EDICARE,
we HAve PAID
PAYHEHT. NO
WHICH IS PRII1ARY. THIS I1EANS HEDICARE PROVIDES
100% OF THE ALLOWABLE CHARGES ON THIS CLAIM
DEDUCTIBLE OR COINSURANCE APPLIES.
303--YOUR HEALTH CARE PROVIDER HAS AGREED TO ACCEPT ASSIGNI1ENT OF I1EDICARE
BENEFITS. THIS I1EANS YOU ARE NOT RESPONSIBLE FOR THE DIfFERENCE BETWEEN THE
I1EDICARE - APPROVED AI1DUNT AND THE ACTUAL CHARGE.
YOUR RESPONSIBILITY TO THE PROVIDERIS) IS $145.59. WE PAID
THE PROVIDER CAN COLLECT $145.59 FROM YOU FOR THESE SERVICES.
$145.59.
~*................................................................................
THE SERVICE BENEFIT PLAN OFFERS HEALTH CARE INFORI1ATIDN SERVICES 24 HOURS A
DAY, 7 DAYS A WEEK. CALL BLue HEALTH CONNECTION, TOLL-FREE AT 1-888-BLUE-432
(1-888-258-3432). WITH BLUE HEALTH CONNECTION, YOU HAVE ACCESS TO REGISTERED
NURSES WHO CAN HELP YOU ASSESS YOUR SYMPTOI1S. USING BLUE HEALTH CONNECTION
I1AY SAVE YOU TIllE AND UNNECESSARY OUT-OF-POCKET EXPENSES. YOU CAN ALSO
ACCESS OTHER HEALTH RESOURCES ONLINE AT Www.FEPBLUE.ORG
WHAT YOU OWE SUI1I1ARY Of OUT-Of-POCKET EXPENSES FOR 2001
1 CALENDAR YEAR CATASTROPHIC PROTECTION
CALENDAR YR DEDUCTIBLE $ 1 DEDUCTIBLE PPO NON-PPO
PER ADI1ISSIDN DEDUCTIBLE $ 1
COINSURANCE $ 1
COPAYI1ENT $ IWHAT YOU HAVE PAID
NON-COVERED CHARGES $ I INDIVIDUAL $106 $106
PRECERTIFICATION PENALTY $ 1 fAI1ILY
IANNUAL I1AXII1UI1
TOTAL: $ 1 INDIVIOUAL $3~OOO $5}000
I fAI1ILY
An'll resubmission of eligible expenses on this claim must be received no later than December 31 of the calendar year following the
.,
BlueCross.
BlueShiehL
Explanation of Benefits
THIS IS NOT A BILL
01158,004315
,.
8
Federal Employee Program
PENNSYLVANIA BLUE SHIELD
PO 80X 890037 CAMP HILL PA 17089-0037
IRENE B WALKER
744 CAROL ST
NEW CUMBERLNDPA
17070
MEDICAL QUESTIONS CALL '-800-779-69~5,
DENTAL QUESTIONS CALL '-800-7~6-5687,
TTY QUESTIONS CALL '-800-3~5-38~8
CLAIN NU~ER:
DATE RECEIVED:
DATE PROCESSED:
DATE PAID:
PATIENT NANE:
10 NUNBER:
01645610400
OS/24/2001
OS/27/2001
OS/29/2001
IRENE WALKER
R00359692
CHECK NUHBER:
51654075
SUHHARY OF STANDARD OPTION BENEFITS ON THIS CLAIH
BENEFIT CHECK ENCLOSEO
PROVIDER NAHE: ASCO HEALTHCARE INC
OATES OF SERVICE: 02/01/2001 - 02/09/2001
TYPE OF ISUBHITTED INEGOTIATEO INONCOVEREOIEXPI ALLOWABLE I DEDUCT 1 COINS OTHER 1 WHAT WE I WHAT YOU
SERVICE I CHARGES I SAVINGS I CHARGES I . I CHARGES I COPAY COVERAGE 1 OWE I owe
RX DRUGS I 120.561 36.991 1310 I 83.571 66.861 16.711 16.71
I I I 13031 1 1 I
OHE RENT I 114.501 5.841 1310 I 108.661 86.931 21.731 21. 73
I I I 13031 I I I
RX ORUGS I 103.141 7.111 1310 I 96.031 76.821 19.211 19.21
I , I 1 13031 , I 1 1
TOTALS ;338.20 49.94 288.26 230.61 $57.65 $57.65
~ EXPLANATION OF CODES/REMARKS
310--YOU ARE ENROLLEO
8ENEFITS FIRST.
AFTER HEDICARE'S
IN ~EDICARE, WHICH IS PRIMARY. THIS MEANS ~EDICARE PROVIDES
WE HAve PAID 100% OF THE ALLOWABLE CHARGES ON THIS CLAIH
PAYHENT. NO OEOUCTIBLE OR COINSURANCE APPLIES.
303--YOUR HEALTH CARE PROVIOER HAS AGREEO TO ACCEPT ASSIGNNENT OF NEDICARE
BENEFITS. THIS NEANS YOU ARE NOT RESPONSIBLE FOR THE OIFFERENCE BETWEEN THE
MEDICARE - APPROVED AHOUNT AND THE ACTUAL CHARGE.
YOUR RESPONSIBILITY TO THE PROVIDER(S) IS $57.65. WE PAID
THE PROVIDER CAN COLLECT $57.65 FROM YOU FOR THESE SERVICES.
$57.65.
*.....**..***************..........***.*******************************************
THE SERVICE BENEFIT PLAN OFFERS HEALTH CARE INFORNATION SERVICES 24 HOURS A
DAY, 7 DAYS A WEEK. CALL BLUE HEALTH CONNECTION, TOLL-FREE AT 1-888-BLUE-432
(1-B88-25B-3432). WITH BLUE HEALTH CONNECTION, YOU HAVE ACCESS TO REGISTERED
NURSES WHO CAN HELP YOU ASSESS YOUR SYNPTOHS. USING BLUE HEALTH CONNECTION
NAY SAVE YOU TINE AND UNNECESSARY OUT-OF-POCKET EXPENSES. YOU CAN ALSO
ACCESS OTHER HEALTH RESOURCES ONLINE AT WWW.FEPBLUE.ORG
WHAT YOU OWE SUHHARY OF OUT-Of-POCKET EXPENSES FOR 2001
I CALENDAR YEAR CATASTROPHIC PROTECTION
CALENDAR YR DEDUCTIBLE $ I DEDUCTIBLE PPO NON- PPO
PER ADHISSION DEDUCTIBLE $ 1
COINSURANCE $ I
COPAYNENT $ IWHAT YOU HAVE PAID
NON-COVERED CHARGES $ 1 INDIVIDUAL $106 $106
PRECERTIFICATION PENALTY $ I FAHILY
IANNUAL HAXIl1Utt
TOTAL: $ I INOIVIDUAL $3,000 $5,000
I fAMILY
Any resubmission of eligible expenses on this claim must be received no later than December 31 of the calendar year following the
.,
BlueCross.
BlueShiehL
EXplanation of Benefits
THIS IS NOT A BILL
01158,004313
4
4
Federal Employee Program
PENNSYLVANIA BLUE SHIELD
PO BOX a,0037 CAHP HILL PA 170a,-0037
IRENE B WALKER
744 CAROL ST
NEW CUMBERLND PA
17070
KEDICAL QUESTIONS CALL '-SOO-779-69QS,
DENTAL QUESTIONS CALL '-800-7Q6-S687,
TTY QUESTIONS CALL '-800-3QS-38QS
CLAIH NUI1BER:
DATE RECEIVED:
DATE PROCESSEO:
DATE PAID:
PATIENT NAHE:
ID NUHBER:
01&4510105"
0512412001
. OS/27/2001
0512"2001
IRENE WALKER
R0055'&'2
CHECK NUHBER:
510541)71
SUHHARY OF STANDARD OPTION 8ENEFITS ON THIS CLAIH
8ENEFIT CHECK ENCLOSED
PROVIDER NAHE: ASCO HEALTHCARE IHC
DATES OF SERVICE: 10/25/2000 - 10/31/2000
OHE RENT
ISUBHITTED 'NEGOTIATED INONCOVEREDIEXPI
I CHARGES I SAVINGS I CHARGES I.. 1
I '4.1&1 28.a'l 15101
I I 1 15031
I 114.sol 5.641 13101
1 I I 15051
I aO.22\ 5.S51 15101
I I I 15051
TOTALS
$288.88
40. i6
ALLOWA8LE I DEDUCT I COINS I OTHER I WHAT WE I WHAT YOU
CHARGES , COPAY I COVERAGE I OWE 1 OWE
.S.271 I 52.221 13.051 13.05
I I I I
10a...1 I 6..'5\ 21. 731 21. 75
I I I I
74.&lJI I. 5'.7sl 14.'41 14.94
I I I I
a~~, Q~ l~!!.';I!! 1:4';'. 7Z s~., .72
I
TYPE OF
SERVICE
RX DRUGS
RX DRUGS
. EXPlANATIOH OF coDeS/REMARKS
310-~YOU ARE ENROllED
8ENEFITS fIRST.
AFTER HEDICARE'S
IN MEDICARE, WHICH IS PRIMARy. THIS MEANS HEDICARE PROVIDES
we HAVE PAID 100Y. OF THE ALLOWABLE CHARGES ON THIS CLAIH
PAVMENT. NO OEDUCTI8lE OR COINSURANCE APPLIES.
303-~YOUR HEALTH CARE PROVIDER HAS AGREED TO ACCEPT ASSIGNMENT Of MEDICARE
8ENEfITS. THIS HEANS YOU ARE NOT RESPONSI8LE fOR THE DIffERENCE BETWEEN THE
HEDICARE - APPROVED AHOUNT AND THE ACTUAL CHARGE.
YOUR RESPONSI8ILITY TO THE PROVIDERISJ IS $4'.72. WE PAID
THE PROVIDER CAN COLLECT $4'.72 FROH YOU FOR THESE sERVICES.
$4'.72.
....~*.***.**.***.***.************************************************************
THE SERVICE 8ENEfIT PLAN OffERS HEALTH CARE INFoRHATION SERVICES 24 HOURS A
DAY, 7 DAYS A WEEK. CALL 8LUE HEALTH CONNECTION, TOLL-fREE AT 1-888-8LUE-452
(1-888-258-5452). WITH 8LUE HEALTH CONNECTION, YOU HAVE ACCESS TO REGISTERED
NURSES WHO CAN HELP YOU ASSESS YOUR SYHPTOHS. USING BLUE HEALTH CONNECTION
HAY SAVE YOU TIME AND UNNECESSARY OUT-OF-POCKET EXPENSES. YOU CAN ALSO
ACCESS OTHER HEALTH RESOURCES ONLINE AT WWW.FEPBLUE.ORG
WHAT YOU OWE SUMHARY Of OUT-Of-POCKET EXPENSES FOR 2000
.. I CALENDAR YEAR CATASTROPHIC PROTECTION
CALENDAR YR DEDUCTI8LE $ 1 DEDUCTI8LE PPO NON-PPO
PER ADHISSION DEDUCTIBLE $ I
COINSURANCE $ ,
COPAYHENT $ IWHAT YOU HAVE PAID
NON-COVERED CHARGES $ I INDIVIDUAL $545 $545
PRECERTIFICATION PENALTY $ I fAHILY
!ANNUAL HAKIHUM
TOTAL: $ I INDIVIDUAL $2,000 $3.750
I FAHILY
~n\l rp,!';.uhmission of eligible expenses on this claim must be received no later than December 31 of the calendar year following the
.. ,--- .....:_..._.......;.,.I.,.t..r ......".,,,,., ",,,,I'l,,,,,A/95
-------~ __"",',:0,.,;
.,
BlueCross.
BlueShielcL
Explanation of Benefits
THIS IS NOT A BILL
Federal Employee Program
011O~, 00431~
4
S
PENNSVLVANIA 8LUE SHIELD
PO BOX 8'0037 CAHP HILL PA 1708'-0037
IREHE B WALKER
744 CAROL 5T
HEW CUMBERLHD PA
17373
MEDICAL QUESTIONS CALL 1-aOO-779-69~5,
DENTAL QUESTIONS CALL 1-aOO-7~6-5687,
TTY QUESTIONS CALL 1-aOO-3~5-38~8
CUIH NUIfllER:
DATE RECEIVED:
DATE PROCESSED:
DATE PAID:
PATIENT NAHE:
ID NUlIIlER:
0164Si>103'7
OS12412001
OS127/2001
OS/2'12001
IRENE WALKER
R003S'6'2
CHECK NU"BER:
Sli>54072
SUKtlARV Of STANDARD OPTION BENEfITS ON THIS CLAIH
BENEfIT CHECK ENCLOSED
PROVIOER NAI1E: ASCO HEALTHCARE IHC
DATES Of SERVICE: 11/01/2000 - 11/30/2000
TVPE Of ISUBI1ITTED INEGOTIATED INONCOVEREDIEXP\ ALLOWABLE I DEDUCT I COINS OTHER I WHAT WE I WHAT YOU
SERVICE I CHARGES I SAVINGS ICHARGES I . 1 CHARGES I COPAY CovERAGE I OWE I OWE
RX DRUGS I 403.041 123.61,1 13101 27'.3al 223.sol 5S.88' 55.a8
1 1 I 13031 I I I
DI1E RENT I 114.501 5.a41 1310 I 10a.661 a6.'31 21.731 21. 73
I , I 13031 I I 1
RX DRUGS I 343.aol 23.701 13101 320.101 256.0al . 64.021 64.02
I I 1 13031 I I !
TOTALS $8bl.34 153.20 708.14 51,0.51 $141. 03 .hl.03
. EXPLANATION OF CODeS/REMARKS
310--VOU ARE ENROLLED IN "EDICARE, WHICH IS PRI"ARV. THIS "EANS "EDICARE PROVIDES
aENEfITS fIRST. WE HAVE PAID 100Y. Of THE ALLOWABLE CHARGES ON THIS CLAI"
AfTER "EDICARE'S PAVHENT. NO DEDUCTIBLE OR COINSURANCE APPLIES.
303--VOUR HEALTH CARE PROVIOER HAS AGREED TO ACCEPT ASSIGNI1ENT Of "EDICARE.
BENEfITS. THIS HEANS YOU ARE NOT RESPONSIBLE FOR THE DIfFERENCE 8ETWEEN THE
HEDICARE - APPROVED AHOUNT AND THE ACTUAL CHARGE.
YOUR RESPONSIBllITV TO THE PROVIOER(Sl IS .141..3. wE PAlO
THE PROVIDER CAN COLLECT $141.63 fROH YOU FOR THESE SERVICES.
$141. 63.
..................................................................................
THE SERVICE 8ENEfIT PLAN OFFERS HEALTH CARE INfOR"ATION SERVICES 24 HOURS A
OAt, 1 DAYS A WEEK. CALL BLUE HEALTH CONNECTION, TOll-FREE AT !-888-BLUE-432
(1-8aa-25a-3432). wITH BLUE HEALTH CONNECTION, YOU HAVE ACCESS TO REGISTERED
NURSES WHO CAN HELP YOU ASSESS YOUR SVI1PTOI1S. USING BLUE HEALTH CONNECTION
I1AV SAVE YOU TIHE AND UNNECESSARV OUT-Of-POCKET EXPENSES. YOU CAN ALSO
ACCESS OTHER HEALTH RESOURCES ONLINE AT www.fEPBlUE.oRG
WHAT YOU OlfE SUI1I1ARV Of OUT-Of-POCKET EXPENSES FOR 2000
I CALENDAR VEAR CATASTROPHIC PROTECTION
CALENDAR VR DEDUCTIBLE $ I DEDUCTIBLE PPO NON-PPO
PER ADHISSION OEDUCTIBLE $ 1
COINSURANCE $ I
COPAVI1ENT $ IlfHAT YOU HAVE PAID
NOH-COVERED CHARGES . I INDIVIDUAL $343 $343
PRECERTIFICATION PENAlTV $ 1 fAI1ILV
IANNUAl HAXlHUI1
TOTAL: $ 1 INDIVIDUAL $2,000 $3,750
I fAHIlV
"'_" ___...._:__,__ _4 _"_,,,,,_ _......~_~__ __ ....:~ ~J_:_ _.__~ L_ _~__'.__.J__
...-l
~
ve"7on
Page 2 of 11
717 766-0179-926 45Y
..:.:'''".,-.,..----.:
. ... ....c..
..~. ,<. , .
.,::".,'~'" -.;!i':',
February 19. 2001
.-_.. .
-- -, ~ ,- .
-f "
~. ".
.
-,.'. .
This information is required by the Public Utility Commission. "Basic"
service includes the line charge, local calling and TOUCH TONE service
(if applicable). "Non-Basic" service includes optional services, other
than TOUCH TONE, such as Maintenance agreement for inside wire and
Guardian and does not include toll services,
.,.-.."
..~;-.;,,-...~
'h.'"
'r:
,.,,- ".,
,
BASIC
Past Due
Balances
$.00
Current
Charges
$15.47
Totals
;;'.'!",
$15.47 rJ'
$6.00 U\-YI
NON-BASIC $.00 $.00*" ~ o~t
TOTALS $.00 $21.47 ($21.47) 1 \1
The following pages provide additional billing details.~ ~\~ C
* (Includes Verizon and other service provide~(~~.
TOLL
$.00
$6.00*
IRENE B, WALKER
713 MESSIAH VILLAGE
POBOX 2015
MECHANICSBURG, PA 17055.2015
~-'::"'::>I=. '-~:1J.'r~'''''11-'' I
l ~'83'-:):::;;::'/!75
3229
[)\IT
3/3
/1 "
I___'f
60~ 1273/313 101
---ri , ~ "\~i
PNCJBA:~lK
PNC Bank, :"I.A. 040"
Central PA
l/ Z l....l. ~\ 'SY',
U ,.~
- l".J-,j-,L~_'Jz.ct
$ , I <-L-',
;; I /
I';\y ro TH I:
()IU)FI~ ()F
'+-7/
, I':J ..:...' r)()I,L~~:~': ill :::~.~:;o~";::'.'"
Premium
Plan
.')
/1
.~;~~
":~OOO 2 ~I,U
IDR) 17 71", ~J nc) 91.'--
1:0 ~ ~ ~ ~ 2 7 ~al: ~ 229
u...,-J
I":' '
".~L"ND 1'l'l'
MESSIAH VILLAGE
. .
STATEMENT
100 Mt. Allen Drive
P.O. Box 2015
Mechanicsburg, PA 170552015
(717) 697-4666
Resident Number Date
000029704 02/28/2001
Page Amount Due
1 1.649.00
Resident: IRENE B WALKER
Discharge Dale 0210912001
B
I JIM WALKER
L 960 STERLING COURT
L ENOLA. PA 17025
T
o
02/28/2001
MONTHLY CHARGE TIOGA
BARBER/BEAUTY SHOP
ROOM & BOARD - SEMI-PVT
8 DAYS AT 150.00 PER DAY
A.L. TRANSPORTATION
Dr Kilmore
PAYMENT RECEIVED - THANK YOU!
Charqes Credits Total
4.982.05
420.00 5,402.05
11.00 5,413.05
1.200.00 6,613.05
18.00 6.631.05
-4,982.05 1.649.00
Date Description
Beginning Balance
02/01/2001
02101/2001
02/01/2001
02/07/2001
IRENE B. WALKER
713 MESSIAH VillAGE
POBOX 2015 P 0552015 '),I 11 .~~ II :. i () I
MECHANICSBURG, A 17 - I I
S'irJ?RTb~E~.'Yt.C-J~: C- 'lLQf-- a .L/ I $ / ~ '/-'1. c],'
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PNCJBAN1l\.
PNC Bonk, N.A. 040
CentJal PA
3230
6Q..1273/313101
Premium
Plan
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Past
Due
31-60 Days
61-90 Days
91-120 Days
Over 120
T alai Due
IRENE B WALKER
0.00
0.00
0.00
1.649.00
1%FIN
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For:
IRENE B WAUCER
713 AlUOHENY APTS 1FL
MECHANICSBO PA 17055
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QDestiODS about
this bill? Please
contact us by Mar 7
at 1-800-342-5775
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or write to:
Cuatomc-r SC'rncc:
827 H:ausman Rd.
Allentown. PA
18104-9392
www.pplweb.com
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Summary Page
Balance a.s of Feb 14, 2001 S 0.00
Ch",~s:
TotnrpPL U11UTIES Charges S 13.67
Total Charg.. S 13.67
Ip ..In.._..-,,.._,,, ,.-~to '.--M -1'100I"""""'-"'''-''~''''lJ:6~1
,.ay-.........I:W~tJ.-,O,1.A r::.LlWalI: 3r,.,~. "'~:"';'~,'/"~:";~~-,ri'''),;~,-,''''';.' :.
Account Balance S 13.67
C l 3 3 J-?J
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Electric
Use
This grJph.shows
your e1eclnc use
over Ihe last 13
months.
Typ" 0'
Meter Reading!:
Actual -
E.slimalea D
Cuslomer D
6
KWH. Avenge Per Day
Meter Reading Information
'"
Feb 14 ^,,"Iual
Jan 16 A,,"lual
29 Da s 1 e
24786
24704
~
5
,
2001
32F
J
Average' Feb
Tcmpet:1ture
KWH Per Day
Yeurty Use:
Mar 1999. reb 2000
:-'1:lr 2000. Fcb 2001
2000
25F
,
3
,
Totlll
Use
l546
1367
AVer3l:'
Mouthl'
12/
ll.
o
,I. ~
FMAMJ 1 ^SONDJ F
2000 MOlllhS 2001
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For your conv~nienc~. you C:ln now [av your bill using vour Visa.
MasterCard. Dlscov~r. or i\meric:lJ1 c;<press Cud. CJll'BiIlMalrix at
1-800-b7:::.<24LJ. BiIIMalrix will charge your credit card:t setvu,;e fee for
making thiS payment. .
Take showers instead of baths 10 save energy J.nd water. It t:lkes about 30
~aJ1ons of water 10 fill an :lverage bathtub. A 5-millutc shower uses about
_0 gallons. Low tlow shower heads can cut your hot water use in half.
Save postage :.llld late charges - sign up for Automated Bill Payment.
Never again worry about an appliance breakdown. C:l111-877-789~7139 (0
register tor our new PPL ^pplianc~C~e program. Sl~p worrying and enjoy
the same conVClllence J.nd pe.:tce ot mllld as our ['!rowm~ fanlllv of PPL
~pplianceC:\re customcrs. Call today - and relaX. Visifwww:pplweb.coOl
tor ruore ddJ.ll:'i.
IRENE B. WALKER
713 MESSIAH VILLAGE
POBOX 2015
MECHANICSBUAG. PA 17055-2015
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713 MESSIAH VILLAGE
POBOX 2015
MECHANICSBUAG. PA 17055-2015
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IRENE B. WALKER
713 MESSIAH VILLAGE
POBOX 2015
MECHANICSBURG, PA 17055-2015
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IRENE B. WALKER
713 MESSIAH VILLAGE
POBOX 2015
MECHANICS BURG, PA 17055-2015
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713 MESSIAH VILLAG~ .. ,
? 0 BOX 2015
MECHANICSBURG,?A 17055-2015
D40
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Plan
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For:
IRENE B WALKER
713 ALLEGHENY APTS IFL
MECHANICSBG 'PA 170SS
Final Bill
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PPL Utilities
Customer Service
827 Hausman Rd.
AlIenlown, PA
18104-9392
1.800.J~2-5775
www.pplweb.com
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Page 3
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91900-75005
Sc:wnerr
"a::wruin
T olal from Last Bill
$13.67
Billing Details
Amount You Still Owe as or Feb 28, 2001
$ 13.67
Current Charges
Chm:ges I'or - PPL UTILITIES
Residential Rate: RS for Feb 14. Feb 28
Distribution Charge:
Customer Char.J;e
45 KWH at L79600000~ per KWH
Transmission CharJi.e:
45 KWH at 0.37700000~ per KWH
Transition Charge:
45 KWH at 1.88700000~ per KWH
Generation Char~e:
Capa<.:itv and 'Enero;y_
'15 KWH at 4,84'600000~ per KWH
PA Tax Adjustment Surcharge at-0,73000000%
Total PPL U'I1LlTIES Charges
3,02
0,81
0,17
0.85
2.18
-0,05
$ 6.98
IPa)lThl~Am()tmtNo'Later/IUan,Mar 21,2001
Account Balance
$20;~51
$ 20,65
General
Information
I I
Generation pricc~ and L:h<lr~es arc set bv the electric generation sllppl ier
you have cho::ien. 'llle pubric Utilitv Commis::;iol1 re~lates distribution
prices ~1.f1(~ servi~es. 'rhe Fe~cral Ellergy Regulatory-c.:ol1llllission regulate::;
transmiSSIon pf1C~S and services.
I'PL uses about $2.04 of this bill to Ray stale taxes. In addition, about
$0,90 of this bill pays the PA Gross Receipts T'Lx.
The Transition Charge includes an Intangible Transition Charge (ITC) and
the applicable gross receipts tax which tOllether amount to $OX;7. The ITC
is a per usage cnarge approved bv the PuBlic Utility Commission which
PPL collects as agent lor PPL Transition Bond Company LLC and which
that company uses to service debt incurred to recover a portion of PPL1s
stranded costs. The,$ross receipts tax, which is collected for the
Commonwealth of ,'ennsy!yal11a, is equal to 4,4% of the ITC
fc-: VGU:- CG~,;,~!!i~nc~. you can now g,av vour bill usiuf! vOllr Visa.
MasterCard. Discover or American t.ipress Card, CalrBillMatlix at
1-800-672-2413. BiUNlatrix will charge your credit card a service fee for
making this payment.
We app'rec:ate the opportunity to have served you, Because you haye paid
your bIlls within 30 days Oyer the past yoar, you have established an
excellent payment record with Pennsylvania 'Power & Light Company,
Clean the coils on the back or bottom of your refrigerator every 3 months,
Dust covered coils waste energy.
Never again worry about an appliance breakdown, Call 1-877-789-7139 to
register tor our new PPL AppIianceCare program. Stop worrying and enjoy
the same convenience and peace of mind as our growincr family of PPL
~pplianceCare customers. CaJl today. and relax, visifwww.pplweb.com
tor Illore detaIls,