HomeMy WebLinkAbout06-12-15 (3) � i .. � ■ s .. �
J ��;�� pennsyivania
1505618403
� C�EFAFTh1E1lT_�F FEVEI0.�X(03-14)
REV-1500 �F��CIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
Po Box.2aoso� INHERITANCE TAX RETURN
Harrisburg,PA 17128-0601 RESIDENT DECEDENT z 1 15 0 0 3 3
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
12 19 2014 04 16 1922
DecedenYs Last Name Suffix DecedenYs First Name MI
RUPERT BEATRICE B
(If Applicable)Enter Survivi�g Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Mame MI
THIS RETURN MUST BE FILED IN DUPLICATE WITFY 7HE
REGISTER OF WILLS
FILL IN APPROPRIATE aVALS BELOW
� 1. Original Return ❑ 2. Supplemental Return ❑ 3. Remainder Return(date of death
prior to 12-13-82)
� q, Agricultural Exemption(date of ❑ 5. Future Interest Compromise(date of ❑ g. Federal Estate Tax Return Required
death on or after 7-1-2012) death after 12-12-82)
� �• Decedent Died Testate ❑ 8. Decedent Maintained a Living Trust 1 9. Total Number of Safe Deposit Boxes
(Attach copy of will) (Attach copy of trust.)
❑ 10. Litigation Proceeds Received ❑ ��� Non-Probate Transferee Return ❑ 12. Deferral/Election of Spousal Trusis
(Schedule F and G Assets Only)
❑ 13. Business Assets ❑ 14. Spouse is Sole Beneficiary
(No trust involved)
CORP,ESPONDEM-THIS SECTION MUST BE COMPLETm.ALL CORRESPONDENCE AND CONFlDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
GERALD J BRINSER ?17 838 6348
First Line of Address
6 E MAIN STREET
Second Line of Address
PO BOX 323
City or Post Office State ZIP Code
PALMYRA PA 17078
CorrespondenYs email address: 9jbrin@aol.com
REGISTER OF WILLS USE ONLY
REGISTER OF WILLS USE ONLY �'-�
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pATE FILED MMDDYYYY � �-r' '"'� rn
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Side 1 �-
I I��I'I III�IIIII III'I'II I III'I II�'I I�III'I�I)"III IIII I'II
� 1505618403 1505618403 J
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� 1505618411 f '
REV-1500 EX
DecedenYs Social Security Number
oe�ede�rSName: RUPERT, BEATRICE B.
RECAPITULATION
1. Reai Estate(Schedule A)........................................................................................... 1.
2. Stocks and Bonds(Schedule B)................................................................................. 2.
3. Ciosely Held Corporation, Partnership or Sole-Proprietorship(Schedule C).............. 3•
4. Mortgages and Notes Receivable(Schedule D)......................................................... 4• 7 6 , 10 2 • 2 6
5. Cash,Bank Deposits and Misceilaneous Personal Property(Schedule E)................ 5. 5 1 , 6 0 3 • 7 5
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested.............. 6.
7. Inter-Vivo�Transfers&Miscellaneous Non-Probate Property
(Schedule G) ❑ Separate Billing Requested.............. 7. 6 2 9 , 8 0 8 • 0 0
8. Total Gross Assets(total Lines 1 through 7)............................................................ 8. 7 5 7 , 51 4 - 01
9. Funerai Expenses and Administrative Costs(Schedule H)........................................ g. 6 , 8 8 9 • 8 9
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)................................ 10. 5 , 10 1 • 3 4
11. Total Deductions(total Lines 9 and 10)................................................................... 11. 1 1 , 9 9 1 • 2 3
12. Net Value of Estate(Line 8 minus Line 11).............................................................. 12. 7 4 5 , 5 2 2 • 7 8
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J).................................................... 13.
14. Net Value Subject to Tax(Line 12 minus Line 13)................................................... 14. 7 4 5 , 5 2 2 • 7 8
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICASLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116
(a)(1.2)X .00 15.
16. Amount of Line 14 taxable
at lineal�ate X .045 7 4 5 , 5 2 2 • 7 8 ts. 3 3 , 5 4 8 • 5 3
17. Amount of Line 14 taxable
at sibling rate X.12 17.
18. Amount of Line 14 taxable
at collaterai rate X .15 18
19. TAXDUE.................................................................... ............................................ 19. 33 , 548 - 53
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT �
Under penaities of perjury,I declare I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true,correct and complete.Declaration of preparer other than the person responsible for filing the return is based on all information of which preparer has
any knowledge.
SIGNAT OF PERSON RESPONSIBLE�yFO`R�FILI G RETURN Nancy R. Marter oArE
��2�-Y\..tiv��'" �� �� 0�-rv1_/�� �
ADORESS
5142 Erbs Bridge Road, Mechanicsburg, PA 17055
SIGNATURE OF PREPARER�THER REPRESFit�T VE Gerald J Brinser DAT
G �
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ADDRESS grinser,Wagner&Zimmerm n
6 E. Main Street, Palmyra, PA 17078
I I'�II II"I IIIII I'III I II'IIIII II'll I'III'IIII IIIII II' IIII Side 2
� 1505618411 1505618411 J
I 11116. II IIIIII. I
REV-1500 EX Page 3 File Number 21 - 15 - 0033
Deced�ent's Complete Address:
DECEDENT'S NAME
Rupert, Beatrice B.
STREET ADDRESS
898 Oak Oval
CITY STATE ZIP
Mechanicsburg PA 17055
Tax Payments and Credits:
1. Tax Due(Page 2,�ine 19) (1) 33,548.53
2. Credits/Payments
A. Prior Payments 31,500.00
B. Discount 1,657.89
Tota�Credits(A +g? (2) 33,157.89
3. Interest �3� 0.0 0
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4}
Check box on Page 2,Line 20 to request a refund
5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 3 9 0.6 4
Make Check Payable to: REGISTER OF WILLS, AGENT.
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. �...w.... , v.�. �
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X"IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred:.................................................................................... x
b. retain the right to designate who shall use the property transferred or its ii�come:......................................... x
c. retain a reversionary interest;or........................................................................... ......................................... x
d. receive the promise for life of either payments,benefits or care?...................... ........................................... x
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving
adequate consideration?............................................................................................... ........................................ ❑ x❑
3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?............... � Q
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.
`� � � n c .::.�S� ,�.�.�.�� �_.s��,:�::,_�. ��A.uc,e. ..._.�.��. ..�..b..s�-�?�.���::���,...a��a.e�e.,�...� t:.?. ?`�`�� �.���. ��`"�...::a � ._>.:.,�;�.+.��i�� �,". �,�..,����K.s.:�
:.. ...�. .� t..�....�.�.>,...
For dates of death on or after July 1, 1994 and before Jan.1,1995,the tax rate imposed on the nek value of transfers to or for the use of the surviving spouse
is 3 percent[72 P.S.§9116(a)(1.1)(i)].
For dates of death on or after January 1,1995,the tax rate imposed on the net value of transfers to or far the use of the surviving spouse is 0 percent
f72 P.S.§9116(a)(1.1)(ii)�. The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disciosure of assetsand
fiiling a tax return are stdi 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 21 years of age or younger at death to or for the use of a natural parent,an
adoptive parent,or a step-parent of the child is 0 percent[72 P.S.§9116(a)(1.2)].
•The tax rate imposed on the net value of transfers to or for the use of the decedent's lineai beneficiaries is 4.5 percent,except as noted in [72 P.S.§9116(a)(1)].
•The tax rate imposed on the net value of transfers to or for the use of the decedenYs siblings is 1�percent[72 P.S.§9116(a)(1.3)). A sibling is defined
under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
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. �♦� pennsylvania
��+ DEPARTMENTOFREVENUE SCHEDULE D
INHERITANCETAXRETURN MORTGAGES & NOTES RECEIVABLE
RESIDENT DECEDENT
ESTATE OF RU @It, B@atClCe B. FILE NUMBER
p 21 - 15 -0033
All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE OF
NUMBER DESCRIPTION DEATH
1 Joseph P. and Nancy R. Marter- Note Payable 76,102.26
TOTAL(Also enter on Line 4,Recapitulation) 76,102.26
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�;: pennsylvania SCHEDULE E
DEPARTMENTOFREVENUE CASH BANK DEPOSITS AND MISC.
INHERITANCE TAX RETURN r
RESIDENTDECEDENT PERSONAL PROPERTY
FILE NUMBER
ESTATE OF Rupert, Beatrice B. 21 - 15 -0033
Include the proceeds of litigation and the date the proceeds were received by the estate.All property jointiy-owned with the right of
survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE OF
NUMBER DESCRIPTION DEATH
1 PNC Bank-Checking Account#5140227154 25,375.50
(Includes accrued inter�st of$.07)
2 PNC Bank-Savings Account#5004883907 25,492.11
(Includes accrued interest of$0.51)
3 Face Value of Cash in Safe Deposit Box 500.00
4 1 oz. Silver 16.09
5 Blue Cross- Refund 220.05
TOTAL(Also enter on Line 5, Recapitulation) 51,603.75
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REV-1510 EX+(08-09)
M;, pennsylvar�ia (
� DEPARTMENTOFREVENUE -SCHEDULE G
INHERITANCETAXRETURN INTER-VIVOS TRANSFERS 8�
RES�DENTDECEDENT MISC. NON-PROBATE PROPERTY
ESTATE OF Rupert, Beatrice B. FILE NUMBER
21 - 15-0033
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH ?�0�'�F EXCLUSION
Include the name of the transferee,their relationship to decedent VAWE OF ASSET DE�.D'S TAXABLE VALUE
NUMBER INTcREST PFAPPLICABLE)
and the date of transfer. Attach a copy of the deed for real estate.
1 PNC Investments- IRA Account No. 005-799408,with 22s,290.99 1 QO% 226,290.99
daughter, Nancy R. Marter, named as beneficiary.
2 PNC Investments- Individual Account No. 3s�,115.27 10(7% 391,115.27
005-715522,titled "TOD"to daughter, Nancy R.
Marter.
3 MetLife-Total Control Account#4047185079,with �2,40�.74 1Q0% 12,401.74
daughter, Nancy R. Marter, and grandchildren,Joanne
Marter and Frank Marter, named as beneficiaries.
TOTAL(Also enter on line 7, Recapitulation) 629,808.00
ii u � e� �
REV-1517 EX+(08-13)
.� pennsylvania ���H
�� DEPARTMENT OF REVENUE FUNER�►L D�ENSES AND
INHERITANCE TAX RETURN AMAIw"C�w���
RESIDENT DECEDENT /1LJ11111YIJ 1 IV1
FILE NUMBER
ESTATE OF Rupert, Beatrice B.
21 - 15-0033
DecedenYs debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
FUNERAL EXPENSES:
A. 1 Wegman's, Ashcombe Farm &Greenhouse, Giant, etc. - Funeral Luncheon Food & 979.66
Supplies
2 Carlisle Camera Shop-Funeral Memorial DVD 281.86
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zip
Year(s)Commission Paid
2. Attorney's Fees grinser,Wagner&Zimmerman--Gerald J. Brinser 2,000.00
3. Famiiy Exemption: (If decedenYs address is not the same as claimanYs,attach explanation)
Claimant
Street Address
City State Zip
Relationship of Ciaimant to Decedent
4. Probate Fees Register of Wilis (Ltrs. Pd. $60.00 = $10,001 -$25,000} 165.50
5. AccountanYs Fees
6. Tax Return Preparer's Fees Boreman & Babb 180.00
7. Other Administrative Costs
� Register of Wilis-Additional Cost of Letters 200.00
See attached 3,082.87
TOTAL(Also enter on line 9, Recapitulation) 6,889.89
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REV-1511 E7C+�08•13�
.� pennsylvania �uleH ,�
� DEPARTMENT OF REVENUE I
INHERITANCE TAX RETURN FU�E�J�SQS� I
RESiDENT DECEDENT A�dminish�ative Cos1s cor�finued 1
ESTATE OF Rupert, Beatrice B. FILE NUMBER
21 - 15-0033
2 The Sentinel - Legal Advertising 126.82
3 Cumberland Law Journal - Legal Advertising 75.00
4 Postmaster-Certified Mail Re: Safe Deposit Box Inventory 6.49
5 U. S. Treasury-2014 Income Tax 2,508.00
6 PA Department of Revenue-2014 Income Tax 240.00
� PP & L- Electric 126.56
Page 2 of Schedule H
i i ; i � s . �
.� ; pennsylvania SCHEDULE I
�� DEPARTMENTOFREVENUE DEBTS OF DECEDENT MORTGAGE
INHERITANCE TAX RETURN �
RES�DENTDECEDENT LIABILITIES & LIENS
FILE NUMBER
ESTATE OF Rupert, Beatrice B. 21 - 15-0033
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION AMOUNT
1 Messiah Lifeways @ Messiah Village 3,496.03
2 PNC-VISA Balance 1,149.52
3 Messiah Lifeways- Emergency Call System 33.00
4 Capital Blue Cross 220.05
5 PP & L- Electric 84.06
6 Verizon - Phone 44.08
7 Alert Pharmacy 74.60
TOTAL(Aiso enter on Line 10, Recapitulation) 5,101.34
ii �. � i�� . �
REV-1513 EX+(Ot-10)
:,�; pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BEN EFICIARI ES
RESIDENT DECEDENT
ESTATE OF I FILE NUMBER
Rupert, Beatrice B.
21 - 15-0033
RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$)
RECEIVING PROPERTY DoNotListTrustee(s�
I� TAXABLE DISTRIBUTIONS[include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2)]
1 Nancy R. Marter Daughter Personalty; Sched. 637,254.96
5142 Erbs Bridge Road G, Items 1 &2; 1/3 of
Mechanicsburg, PA 17050-2432 Sched. G, Item 3;
Residue
2 Joanne Breeden Marter Grandchild 1/3 Sched. G, Item 3; 54,133.91
143 Thames Street �50,000 Specific
Brooklyn, NY 11237-1720 Bequest
3 Frank Joseph Marter Grandchild 1/3 Sched. G, Item 3; 54,133.91
38 Stephen Road,Apt E1 �50,000 Specific
Camp Hill, PA 17011-1190 Bequest
Enter doliar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate.
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00
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BEATRICE B. I�UPERT - . � �t
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I, BEA'TRI�E �. RUPERT, currently of Llpper Allen Township;:;Cumb�,lan�= ��-,
Cc�unty, Pennsyh�ania, d�clare this to be my Last Will and Testg�men�, her�by re�s�kin� �
any a.nd all prior Wills and C�dicils made by me. � '�'
I. I direct that aIl my just debts and funeral expenses be �aid. from the assexs of my
estate as soon as practicable after rr�y demise.
II. I direct that all estate and inheritance taxes that niay be assessed in consequence
6f my death, shall be paid out of the principal of my gen�ral e�tate to the same eff�ect as if
said tatces were expenses uf administration and all pro��rt�� in�ludable in my taxabl�
esta�e whether or not passing under this Vi-'ill shall l�e free and cle�ar thereof.
III. I bequeath unto rny daughter, Nancy Rupert i4'Ixxrter, a�l tangible personal
prc►perty uThich I c,wr� at my death.
�V. I bequeath the sum of Fifty Thousand ($50,0�0.00) Doliars unto my
granddaughter, Joanne Breeden Marter. If she predeceases rne �.his i�equ�st shall lapse and
pass as part of rrzy residuary estate below.
�'. I bequeath the sum of Fif�- Thousand ($Sn,040A0) Doliars unto my grandson,
Frank Joseph Marter. If he p�-ecieceas�s rr�e this be�uest shatl ta�se and pass as part of my
resi�uary estate below.
IV. All the rest, residue and remainder of my estate, af whatev�r a�dti�re and ��herever
situate, inclutiing praperty over which I hold a pawer of appc��niment, I d�vise and
bequeath unto my daughter, Naacy Rupert Marter. ar her issue per stirpes.
VII. I appoint my daughter, Nancy Rupert Marter, Executrix �f this my Will. In the
even� that she fails to qualify or ceases to act as Exe�utrix, I appoin# my son-in-law,
Jc�se�h T. Marter, Executor of this my Will.
VIII, I direct that na bond be required of my fiduciaxies for the faithful performance of
th�ir uties in any jurisdictian.
-1-
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IN WITI�ESS WHEREOF, I, BEA�I'RICIE B. RUPERT, herewith set my hand to
this my Last Will, typewritten on two (2} sheets of paper i�cluding the attestation clause
and signatur4s of witnesses, this /,S�i day of �v�,� , 2008.
..���,'' EAL,)
ATRICE �3. RZ.7�'ERT
�igned by BEATRICE B. RI.�PERT, by her decla.z�ed �� b� her Will in aur
pr�sence, who have �ereuz�ko subscribed our names as witnesses ir� her presence and �t
her re est, this 1,5'* day of �uL�, , 2008.
__..��
_ ..�.-t..-�� residing at d,,.
residing at� ,�-�� ���_
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COMt��10�`JVVF{,a1.T�i O� PE?��NSYI,d'ANIA :
C�[�iti�l-�Y (�F 1.�;B,�NON :
S,UF:, BI;A.TRICE B. Rt1PERT. GE',RA1,I) J. BRII�SER �t�d �jG2z�r ��
'+ �.
'��.e�„t . the testatrix and the witnesses, respectivel��. «�h�se r�arnes are signed to the
�ttach?d or foregain� instrument, being tirst du(� affirmed, do hereby declare to the
ur�c�ersi�ned authorit�r that the testatrix signed and �x�cuted the instrument as her L,ast
'vVill an�l tha� si�e signed w�illingly (or ,��iilin�i�- dire�:ted arlothbr t�� sign for her), and tllat
she execute� it �� her free and volui�tary act f��r the purposLs lher,�n ex.pressed. anei that
eac�� Q�� �he ��v�itnesses, in the presence an� hearing of the t�sta.trix, signed the Will as
���itr�esse:� and that ta the best ot� our kno��ledt�e the testatrix was at tl�at time eighteen
vears of a�e ��r older, of s�und mind and ur�der no eonstraint.c��� u�Zcl�ie influenee.
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Vv' "I�NES.'
Subscrii�ed, sti���rn c�r aftinned and acknozti�ledged before rne by BEA"[RICE B.
RIJP�.RT. the testatri�, GERAI.D 1. BR1I�TSER and f'�G��G;`f ..�'�� �� t`�y S •
��itness�s, this l�c��y of ���l�t,�--- ' ?OOR. ,
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Ct7MMONWEAL'i H qF F'ENNSYLVANIA
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�NENDY L CRt�W�;+�C� N�tary Public
�almy�a 6oro. E.ai!anon County
Mv��om+^issipr�]:pires Sep?ember it7.2009
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Amortization Schedule Calculatar Page 2 of 6
Date Interest Principal Balance
Aug,2014 5178.76 $322.44 $77,399.44
Sep,2014 5178.02 $323.18 $77,076.26
Oct.2014 S177.28 $323.92 $76,752.34
Nov,2014 S176.53 $324.67 $76,427.87
Dec,2014 S175.78 $325.41 $76,102.26 �
2014 $2,158.31 $3,856.05 $76,102.26 °�,. �� � � �
�
Jan,2015 $175.04 $326.16 $75,776.10
Feb.2015 5174.29 $326.91 $75,449.19
Mar.2015 5173.53 $327.66 $75,121.52
Apr,2015 5172.78 $328.42 $74,793.11
May,2015 5172.02 $329.17 $74,463.93
Jun,2015 5171.27 $329.93 $74,134.01
Jul,2015 5170.51 $330.69 $73,803.32
Aug;2015 5169.75 $331_45 $73,471.87
Sep;2015 5168.99 $332.21 $73,139.66
Oct,2015 a168.22 $332.98 $72,806.68
Nov.2015 $167.46 $333.74 $72,472.94
Dec.2015 5166.69 $334.51 $72,138.43
2015 $2,05d.53 $3,963.83 $72,138.43
Jan,2016 S165.92 $335.28 $71,803.15
Feb,2016 $165.15 $336.65 �71,467.10
Mar,2016 5164.37 $336.82 $71,13d.28
Apr,2016 5163.60 $337.60 $70,792.68
May,2016 $162.82 $338.37 $70,454.31
Jun,2016 S162.04 $339.15 $70,115.16
Jul,2016 $161.26 $339.93 $69,775.23
Aug,2016 5160.48 $340.71 $69,434.51
Sep,2016 $159.70 $341.50 $69,093.02
Oct.2016 5158.91 $342.28 $68,750.73
Nov,2016 S158.13 $343.07 $68,407.66
Dec,2016 S157.34 $343.86 $68,063.81
2016 $1,939.73 $4,074.63 $68,063.81
Jan,2017 5156.55 $344.65 $67,719.16
Feb.2017 �155.75 $345.44 $67,373.71
Mar,2017 $154.96 $346.24 $67,027.48
Apr,2017 5154.16 $347.03 $66,680.44
May,2017 $153.37 $347.83 $66,332.61
Jun,2017 5152.57 $348.63 $65,983.98
Jul,2017 $151.76 $349.43 $65,634.55
Aug,2017 5150.96 $350.24 $65,284.31
Sep,2017 5150.15 $351.04 $64,933.27
Oc#,2017 5149.35 $351.85 $64,581.42
Nov.2017 5148.54 $352.66 $64,228.76
Dec,2017 5147.73 $353.47 $63,87529
2017 $1,825.84 $4,188.52 $63,875.29
Jan.2Q18 5146.91 $354.28 $63,521.00
http://www.amortization-calc.com/ 2/24/2015
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Feb, 6. 2015 2: 22PM PNC BANK 412-705-0057 No, 3381 P, 1
'� ���
February 6, 2015
Gerald J Brinser, Esq.
Brinser, Wagner &Zimmerman
6 E Main St, 2"d Fl
Palm�ra,PA 17078
.RE: Narne: Beatrice B Rupert
SSN: 181-12-3179
T�Ob; 12-19,2014
Dear Mr, Brinser:
Yn response to your raquest�or Date of Death(DOD) balances for the custoz�r�er noted above, our
records show the follo�ving: ,
Checkiug A.ccount
Account# 5140227154 Established: 07-21-1986
SEATRICE B ItC)'PETtT
D0Y7 balance: $ 25,375.43 +0.07 accxued interest
7nterest�ai�d 01-01-2014 thru 12-�9-2014 $ 0.00 YTD
Savings Account
Account# 5004883907 Established: 09-01-2006
BEATRICE B RUPERT �
DOD bslance: $ 25,491.60+ 0.51 accrued intexest
Interest paid 01-01-2014 thru 12-19-2014 $ 0.00 YTD
� /
In�vestment Account ,�r� �
The decedent maintained 7nvestment Account# 00000000000005715522 & 00000000000005799408
. For further information, you may call the Brokerage Deparcment at 1.-800-762�6111.
�leasc nore that this office pt'ovides date of death balances for deposit accounts (IEiAs, CDs,Checking and
Savings). We do not process any financ�al transactions or provide�tatements. Tf you need assistance with
an�of�hese items,please call 1-8$8�PNC-BANrC(1-588-762-2265) or stop by your loca]PNC Bank branch
off�ice.
Sincerely,
National Financial Ser�vices Center
PNC Bank,I�,A, Zv�exnber FDIC
page 1 of 2
, . . . . .
Feb. 6, 2015 2: 22PM PNC BANK 412-705-0051 No. 3381 P, 2
Thts message is intended for the use of the individual or entity to whi�lz it is addressed and may
contain information that is privrleged, conftdential and exemptfrom d�sclosure u�der applicable law.
If the r�eader of this message is �rot che intended rectpient or the enzplc�yee or agenF responsible for
dedivering this message to the intended recipzent, you are he�eby r�otifi.ed that any dissernination,
dist��rbution or copyrng of this commurircatio�rs is strictly prohtbited. If you have received this
communication in er�or,please »otify me tmmediately by reply or by telephone at 800�762-1775 and
tmrnediately destroy this faxed document.
Page 2 of 2
. !., • page 1 of 1
1 m ' 3m ����'�� YTD ' 't AfI From 'Aug 28,2014 To Feb 24,2015
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16 Silver.$16.69
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http://integration.nfusionsolutions.biz/client/jmbullion/module/largehistoricalchart/silver-c... 2/24/201�
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Jan. 27. 2015 3 : 43PM PNC Bank No. 1306 P, 2
�PNC
1NVESTMENTS
NemOer FIN RA an0 SICG
...... . ........ . . ...... ... , . .._... .
. . """ . .. ,.._. .... . . ..... . .
January Z6,2015 �
..... . . .... - --. - �
Donna Pollock _. .
�Q�p�,pollock(cilpnc.com I
...-- - -
_ ...._ . .
..
....�_. . ..._.. I
.
RE: 006-716522/BEATRICE RUPERT,(INDIVIDUAL TOD) � I
_ . . _ ...... .. .... �
Dear Qonna . . . . - . .. �
•- - - - -- . I
_. _.... ._... .....
The value ol lhe abov_e-reFerenced account on December 191h,2014.is as toilows: i
,',;,, SYmb > ..,.. .
oil . ,.r;: AcGrued
Amount . Deacrl tlori� Gusl DOD Prlce DOb Value ,;`.inferest
600 BANK NEW YOFiK MELLON CORv BK $ 41.08 $ 24 6A8.00
......__ ••- .,.,., _— — ..�.�.,.__
183 CHEVRON CORP NEW CVX $ 110.73 $ 20,263,59
97 CITIGHOUP INC COM NEW C S 54,12 $ 5,z49.64
1356 EXXONMOBILCORP XOM $ 91.63 124,250.Z8
5051.127 FED�RATED STRATEGIC VALUE DIVIDEND Cl A SVAAX $ 5.97 $ 30,155.23
600 FIRSTEN�ftGY CORP FE 35.81 $ 23 286,00
,.,._ ___ ,,. ..z�,..--.- -- .,.... ...._
642 JPMORGAN CkASE&CO JPM S 61.85 $ 39,714.12
0.03 PNC BANK DEPOSIT SWEEP PROGRAM QPNCQ $ 1.00 $ p.03
1A00 vvl CORP�� W PPL $- 35,96 $�_�--50�372.00 ---- ,
900 PUBLIC SERVICE ENTERPRISE GROUP INC PEG $ 42.35 $ 38,115.00
_ 55 TRAVELERS C05 INC COM,� _ TRV _, � �106.06 $ 5,333.30
532 WELLS FARGO&CO NEW WFC $ 54.94 $ 29,228.08
_ _ $ 391,115,27 �. - •
,
Grand 7otai Market Vafue+Accrued Interest � $ 391,�15.27
! . . � ,
�Note:DOD price is based ofi the ciosing price on lhe day the Cllent has passed away,if lhis Is a noll-bUsiness day the price wili be
taken from the previous business day's closin�prlce, j
I .... � � � i
If you haee any quesllons, please contacl our Estale Resolution besk at 800-622-7086. �
. I _.__I. .._. . i I
3incerey, � ; �
_.., --- !--.. ... . I .._.... . . � _
Ank�t Palel I � � ,
PNC Investrnenls,LLC, . ._ .. . . .
Eslale Resolulion Desk
I7he summaries,prlces,quotes andlor statistics contalned hereln have been obtalnad from sources believed to be rellabie but'
�are not necessarily colmplete and cannoE be gual'anteed.They are provided for Informational purposes only.Past
!pe(formance does not guarantee future tesulCs.
PNC Inveelments LlC
Member of The PNC Financial Services O�oup
2 East Main Slreet Mechanicsburg Pennsylvania 17055
www.pnr.com
� '��"Y��'k Importantlnrestorinfartnallon:SecarRies end brokerage services are prnvided by PNC Investmenis LLC,member FINRq and SIPC.
,NoBankGua�aucc pnnuilies and ol�or insurance products are olferea Oy PNC Insurance 5ervicoa,LLC,a licensed insurance agency.
1IVI.t..II.1EIIIII 1
Jan, 28. 2015 1 : 12PM PNC Bank No, 1311 P, 2
�PI�IC
Y 1NVESTIVIENTS
N�mn..PINRq an0 S1PC
.
IJanuary 27th.,.,2015 . . _ - �
Donna Polbck . .. . . . . . _ . -• �
�Donna.polbcK(dtonc com i
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: _... ..._, .._... _. _ �
.
RE: 005-799408/Beatrice Rupert-1Rq_ ;
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�Dc�ar oonna:
i _.._ . ...._.. ..._. ..._ -- -----� _. _: _.._. '
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'7he vslue of Ihe abo�are►erenced accoUnt on December 18th,2014 Is as Follovrs:
C;. , , , . • Sytriboll �;I, �r : > ,J�ctryed.
nt � Descrl tlon Cusl OD Pt1ca` `oob Value ):�'�ln e t:`>
294.861 AMEWCAN EUROPACIFIC GROVJiH CLASS F1 AEGFX �' 7,81 13 619.20
&26.399 AMERfCAN GROWTH FUND OF AMERICA CLASS F1 GFAFX 270 $ 35 415,34
188.2A2 AR7ISAN MID CAP VALUE ART 24.78 $ 4 664.64
10 309,840 FE��RATEp pRIME CASH 08LIGATIONS Cl.SS QPRXQ 1.00 $ 90 309.84
1 346.256�IDELITY ADVISOR FL f�ATE HIGN INC Cl T FFRTX $9.60 12 924.06
99.204 HAaDING LOEVNER EMERG MRK75 PORTADV _ HLEIvD( _rr �21 4�032.91
7 291.729 JANUS FLEXIBLE BOND CLASS I JFLEX $10.54 76 854.02
337•A6�MAINSTAY EPOCH GL08AL EqUIlY YLD 1 EPSYX $19,5$ 8 587.52
�'19.574 MqINSTAY ICAP SELECT 6p7Y FO CL A ,__�_,ICSRX,_,,,,_, $46•0,1, 33 107.60
366.1qg PIMCO UNCONSTRAINED eD INSTL CLASS PFIUX 71.20 4 324,86 �
?A4.287 ROYCE 10o FUND SERVICE C�ASS ,_ . _ RYOFDC _�8.60 $ 2�100,87
_��,.��.� .��MID CAP�}Z�WTH . F�----- ._ 2 449-67
._ $��,,,,,,,,,,,,,,,,M._ 4 515.30 .
TRREX 4 950.87
1 AO D E � 70 5z3-29 �
� $226 280.99
arand Total Market Valua*Accrued Intarest 226 2flo.g8
.... . _ . _.. .._.. _ . � .. ;. ' I '
�
�Note:DOD prlce is bssed off Ihe closine price on the day tl�e clienl has passed away,ff thls ls a non-buslne�.s day Ihe price w111 be faken from the .
preNous buslness day'a closin�..price.
. J... .. ... . .. ) _ � -- � ... �l
If,you ha�any,questions, please conlact our Eslate ResoluBon Desk a(800-622-7086.
_ I ��
Si icerely, ! � I
i � I I
�(Tk'!f�t'BY i I I II '
PNC lntiestmenls.ILC.
I Eslate Resolubon Desk � � ' � "
i . . _ . . . . . .
. .. . _.. - -- . - _.. ..._ ._. .......
'The summarlas,prices,quotes and/or 9tatlstics contained hereln have 6een obtalned from saurces believed to be rellable but are not
I�hecessarly complete end cannot be guaranlead.They are provlded for informatlonal purposes ony.PasE pertormance doas not
.�ueranlee(ulure r�sulls.
I � i
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PNC Inveslments LLC
Member of The PNC Financinl Sarvices Graup
2 Easr Main Strest Mechanicsburg Pennsylvania 17055
wv✓w.pnc.corn
� '������"'U"` ImDortaMlnvestorinfarmalion;Securities antl brokerage scrvires are provided by PNC Inves�menls LLC,memher FINRA and SIPC.
•�o HNikGunnuucc pnnuilies and ol�erinsursn�e producls are oflered py PNC Insurance Servicas L,LC,a lieensed insurance agency.
i i G. � a4� �
Metl.�fe'
Nte���te
Total Control Account
PO Box 6300
Scranton.PA 13�0�-6300
500-635-7=83
February 5, 2015
Brinser, Wagner & Zimmennan � ;�-�
Attn: Gerald J. Brinser � ' . '�� ';�' ���` ��M
6 East Nlain Street
PO Bo� 323 '� ', � - ���--��,'� , � '�
Palmyra, PA 17078 ' `�� � -
Re: Total Control Account# 404718�079
Nletropolitan Life Insurance Company •
Accountholder: Beatrice Rupert
Yotu Client: Nancv Marter ExecutriY of the Estate of Beatrice fZi.i}�crt
Dear Attoiney Brinser:
This is in response to your cor-respondence, dated January 21, 201� re�aa-dina the above
referenced Total Control AccoLint.
The latest desianation of beneticiary contained in Beatrice Rtg�ert'� reccrrds, datec� Api�il 25.
?00� names your client ancl two other individuals as the Co-Priuiar�� Beneficiaries to receive the
Total Control Accotmt balance. Since MetLife is the Total Control �Account administrator, our
obli�ation is to the la�v�ful Beneticiaries.
Due to contidentiality reasons�ve are unable to release any information �-eQardin�the Total
Control Account to the Estate of Beatriee Rupert un ess our otfice receiu�es written authorization
tioin the bene iciaries before releasing this iiiformation. The atlth<ariza(ion should state that the
beneficiaries consent to MetLife's release of inforination reQardin�.� the i��ientity of the
beneficiaries and/or amoLint of Total Control Account to the rec��iester. ti�e will also require a
copy of the death certiticate for Beahice Rupert along with the autl-doriz�:itioil from the
beneficiaries. The death certiticate will allow us to validate the infori��ation in our records so
that �ve can provide you �vith the accurate date of de�th balaiice.
If you have any qliestioi7s or reqliire filrther assistance, please call our TCA Custoiner Service
department at 800-638-7283 Nlondav through Friday. 8:OOam throir�h f�:00pm ET.
Sincerelv.
TCA Administration Services
Note�.Nlztropolitan Life Insttr�nce Compv���(_�ILIC)provides administrnti��r szn�ice;for Tot.�l Conu��l.-Ac�.:uunts'establi,hcd in cunnec[ii�n�cidi
polici�s i;sued M'NILIC or bY�zi���in i�f��ILIC'i insurance compan}�aFliliates-
tca.00�2.rev.06
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RECEIPT FOR PAYMENT
-------------------
------------------
LISA M. GRAYSON, ESQ. Rec:eipt Date : 1/12/2015
Cumberland County - Register Of Wills Rerea.�7t Time : 09 :56:23
One Courthouse S quare Rer.ei.pt No. : 1080130
Carlisle, PA 17613
RUPERT BEATRICE B
Estate File No . : 2015-00033
Paid By Remarks : BRINSER WAGNER ET AL
HMW
--------- -- ------ -------
Receipt Distribution --- - -- - -------------------
Fee/Tax Description Payment Amount Payee Name
PETITION LTRS TEST 60 . 00 CLTMBERLANI:) COUNTY GENERAL FUN
WILL 15 . 00 CUMBERLAI�TI) COUNTY GENERAL FUN
SHORT CERTIFICATE 20 . 00 CUMBERLAI'�L) COUNTY GENERAL FUN
JCS FEE 35 . 50 BUREAU OF RECEIPTS & CNTR M.D
AUTOMATION FEE 5 . 00 CUMBERLANL) COUNTY GENERAL FUN
INVENTORY 15 . 00 CUMBERLAI�TI:) COUNTY GENERAL FUN
INH TAX RETURN 15 . 00 CUMBERI�AND COUNTY GENERAL FUN
--- ---- ---------
Check# 4997 $165 . 50
Total Received. . . . . . . . . $165 . 50
iiu .. � �av �
�e�Senti�iel ZIMMERMAN BRINSER,WAGNER& AD NUMBER PAGE NO.
www.cumberlink.com 6E.MAINSTREET,2NDFL. 437058 1 of1
����� � P.O.BOX 323 BILL DATE SALESPERSON
..._.�� PALMYRA,PA 17078 02/12l15 eb c1
,-p.RitStE i IPI'FN:>EU:.o PERP,t!—'n;tii`' 7�7'H.38'G�H ...___ ___._. __.._ .__.. ____y_ ._.....
START DATE STOP DATE
. .. 01/29/15. 02/12/15 .
AD NUMBER AD DESCRIPTION CIASS LINES
437058 NOTICE NOTICE IS HEREBY GIVEN THAT 10 PUBLIC NOTICES 22 * 2 cols
Publication Insertions Rate Net Amount Gross Amount
3 THE SENTINEL-LEGAL 3 LGL $116.82
TOTAL AD CHARGE $116.82
3 MOBILE SITE M062 $3.00
3 PROOF OF PUBLICATION 01PRF $7.00
I �(" !�--� ?lc,�''
�� � �� 5c-
�:�
PurchaseOrder Est. Eatrice B Ruper PAY THIS AMOUNT $126.8� $152.18*
r�
' *AFTER 03/09/15
Lee Enterprises no longer accepts credit card payments sent via e-mail.
Emaiis containing credit card numbers will be biocked. Please use the coupon
below to send credit card payment to our lockbox. THE SENTINEL
You may also send the coupon to a secure fax at 319-291-4014. c/o LEE NEWSPAPERS
Thank you for advertising with The Sentinel! Deadline for PO BOX 540
in-column legal ads is 4:00 p.m. two business days prior to WATERLOO IA 50704-0540
date of insertion. For questions, call (717)240-7130.
1 r1.�' � '�
� Notar ublic
Y
My commission expires:
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vJ�����D co���
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�'�SOC�P���
CUMBERLAND LAW JOURNAL
32 SOUTH BEDFORD STREET
CARLISLE, PA 17013
Tele: (7'17)249-3166 Fax:(717)249-2663
February 13, 2015
Cumberland Law Journal is published every Friday by the Cumberland County
Bar Association and is designated by the Court of Common Pleas as the official IPgal
publication for Cumberland County and the legal newspaper for publication of legal
notices.
TO: Gerald J. Brinser, Esquire
RE: Beatrice B. Rupert 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 the following dates:
January 30, February 6, and February 13, 2015
Advertising Cost $ 75.00
Proof of Publication $ 0.00
Second Proof Request $ 0.00
Payment received $ 0 .00
Total Amount Due $ 75.00
� ��
_ „
________- � k� ..
^� ` �;�
Payment received by . 'N " ; �-��
,� � �-
ii � � ■� �
PROOF OF PUBLICATION OF NO'I'ICF.
IN CUMBERLAND LAW JOURNAL
(Under Act No. 587, approved May 16, 1929), P. L.1784
COMMONWEALTH OF PENNSYLVANIA :
. ss.
COUNTY OF CUMBERLAND .
Lisa Marie Coyne,Esquire, Editor of the Cumberland Law Journal, of the County and
State aforesaid, being duly swom, according to law, deposes and says t11at the Cumberland Law
Journal, a legal periodical published in the Borough of Carlisle in the C:ounty and State aforesaid,
was established January 2, 1952, and designated by the local courts as the official legal
periodical for the publication of all legal notices, and has, since Januat-y 2, 1952, been regularly
issued weekly in the said County, and that the printed notice or publication attached hereto is
exactly the same as was printed in the regular editions and issues of the said Cumberland Law
Journal on the following dates,
viz:
January 30 February 6, and February 13, 2015 _______
Affiant further deposes that he is authorized to verify this staternent by the Cumberland
Law Journal, a legal periodical of general circulation, and that he is not interested in the subject
matter of the aforesaid notice or advertisement, and that all allegations in the foregoing
statements as to time, place and character of publication are true.
_._
.`� � ' ;
� �� �.. .
a
�,� � �,� � ---
, �W
� a Lisa Marie Cayne,�Editor
\�,
SWORN TO AND SlJ�3SCRIBED before me this
13 day of February_2O15
1 ',f% � ''�` �' :L r�=.,�,�'
��— -� ---.
Notary �,,
Rupert,Beatrice B.,dec'd.
Late of Upper Allen Township.
Executrix:Nancy R. Marter, 5142
Erbs Bridge Road,Mecharucsburg, COMMOf'�!lN�11?1 H Of PENNS'lLL�Ai�iA
,�:�:.::
PA 17050. NOTAf'tIAL SEAL
Attorney:GeraldJ.Brinser,Esquire. ��aqi�l�hi A C'?LLI�lS
Notary Pu�,lic
CARUSLf BORO.,CUMBERLAND CNTY
My Commissfon Expires Apr 28,2018
.. . _. . .,_. _. . . . ., �. .� _ . � i . � a� �
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£ �r �. �f�, �� � �. �;,� ge . ,
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7 �i`�" �
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� Cettified Fee � ?`�.�°..:" � i,.:;
P � P°'`�ar'< 'ICE OF BOX INVENTOIiY
� Retum Recei t Fee 7:; ''lere -
7 (EndoramenlRaquired) ����'� ' '
] �
] �estricted Delivery Fee ;, ;��, s
/Endorsement Required) � -��'-
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7 7otal Pastage&Fees � .�.s� -��� _-� —-� �
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' Sentr� .- �� :, r-� -� inventory will be condt�icted for the following:
� "" J
f� �..�9 � � �� """'_
� SPreet Apf No� � �.
� o�PO Bo No �. r � ;
� C�ty State,ZIP+4 -- --- �- -� �� �.�------�-- % B. Rupert
�� <::a'''. ,,'-f . (�., � -- -i.� f.:=..��
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________ �" e
Issue Postage: �6•49
— �ing Inventory:
Total : $6.49
Paid by: �ttOlrie Nanc R Marter
Personal Check $6•49 y y �
.O. Box 323 5142 Erbs Bridge Road
�@ For tracking or inquiries ga to
usPs.com or �a>> i-soo-222-isii. 8 Mechan icsburg, PA 17050
Order stamps at usps.com/shop or call (717)7Ci3-1203
i-800-Stamp24. Go to usps.com/clicknship
to print shipping labels with postage. For
other information cal l 1-800-ASK-USPS. try: 7anuary 22, 2015 @ 11:00 ain
����������������������������������������
����������������������������������������
This Notice is being supplied to:
PA Dept of Revenue PNC Bank
Safe Deposit Box Unit 939 Oak Oval
P.O. Box 280601 Mechanicsbw-g, PA 17055
Harrisburg, PA 17128-0601
; --� -- - ,.--1 r _ __
. . . • . . �•
, ' • ____
■ Complete items 1,2,and 3.Also complete n ture
item 4 if Restricted Delivery is desired. {� '
■ Print your name and address on the reverse \ � ❑Address
so that we can return the card to you. . Received by(Printed Name) cfi.,qate q�€ppi�Vgy
■ Attach this card to the back of the mailpiece, j�jW i LU i:�
or on the front if space permits. -- - ------ - --
D. Is delivery address different from item 1? ❑Yes
1. Article Addressed to: If YES,enter delivery address below: ❑No
PA DEPT OF REVENUE
SAFE DEpOSIT UNIT
PO BOX 280601
HARRISBURG PA 17128-0601 =- -- -- - - -
3. Service Type
�Certified Mail� ❑Priority Mail Express"'
❑Registered ❑Return Receipt for Merchandise
❑Insured Mail ❑Gollect on Delivery
4. Restricted Delivery?(Extra Fee) p Yes
2. ArticleNumber 7�y� ���� pppp 1950 4732
(liansfer from service labeQ
__ ___
: PS Form 3811,July 2013 Domestic Return Receipt
� i r.. � �aai �
DATE DESCRIPTION ` RATE Days/ CHARGES CREDITS BALANCE
Unrts
Balance Forward 33.00
12/22/14 PAYMENT RECEIVED -THANK YOU!!! 33.0� 0.00
*** Residential Living �**
12/01/14 Emergency Cali System 12/01-12/31 33.00 1.U0 33.00 33. 0
12/11/14 Transportation Assistant 22.00 1.75 : 38.50 �: . _�
.��p�lu
;�.V�L
,�
Please make sure to allow adequate time for your payment to be received in our office by Page 1
1/31/15.Any payments received after the due date will be considered late and will not be
reflected on your next statement.
ID# CURRENT OVER 30 OVER 60 OVER 9D OVER 120 TOTAL AMOUNT DUE
20507 71.50 0.00 0.00 O.Op 0.00 $"� � -::
NAME BEATRiCE B. RUPERT N/A PB-0'
Please make check payable to Messiah Lifeways Community Support Services.
A 1%finance charge may be assessed on accounts for which payment has not been received by the due date.
i have any questions or concerns about your bill, please address them directly to Fiscal Services at(717)790-8220. Thank
ii � iav �
��
� �` 1v� �SSIAH �
m� i . .. .._. �._, Form PB-01
:r.
�
a�t ��������� ���d����
100 MT ALLEN DR.,MECHANICSBURG,PA i7o55 RESIDENT# UNIT STMT. DATE
20507 898 11/30/2014
RESIDENT S
BEATRICE B. RUPERT BEATRICE '�. RUPERT
898 OAK OVAL
MECHANICSBURG, PA 17055 TOTALAMC�UNT DUE $1 404.00
DA�E ��E 12/31/2014
� • • ' � • . • � •• - • • . • • � . • � 1 � � � '•
_.
DATE DESCRIPTION RATE Daysl CHARGES CREDITS BALANCE
Units_
Balance Forward 1,403.Q0
1v2a�4 PAYMENT RECEIVED -THANK YOU!+� � 1,403.00 0.00
*** Residential Living ***
10/24��4 WINDOW CLEANING 3.0012.00 36.00 36.00
71/01/14 MNTHLY CHG CLEARFIELD 11I01-11130 1.348.Oi} '1.00 1,348.00 1,384:00
11/03/14 BARBER/BEAUTY SHOP 20.00 1.0�9 20.00 1,404.00
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Please make sure to aliow adequate time for your payment to be received in our office by Page 1
12/31/14. Any payments received after the due date will be consid�red late and will not be
reflected on your next statement.
RESIDENT# CURRENT OVER 30 OVER 60 OVER 90 OVER 120 TOTAL AMOUNT DUE
28507 1,368.00 36.00 0.00 0.00 8.00 $1,404.00
�ESIDENT NAME BEATRICE B. RUPERT N°A PB��
�lease make check payable to Messiah Lifeways at Messiah Village.
,1%finance charge may be assessed on accounts for which payment has not been received by the due date.
If you have any questions or concerns about your bill,please address them directly to Fiscal Services at 790-8220.
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IV� ESSIAH - . � �`_ ` � _ � _ .:_ r_
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� Form PB-01
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100 MT.ALLEN DR.,MECHANICSBURG,Pa 1�055 RESIDENT# ; UNIT STMT. DATE
20507 898 01/31/2015
RESIDENT(S)
NANCY MARTER BEATRICE B. RUPERT
5142 ERBS BRIDGE ROAD
MECHANICSBURG, PA 17050 TOTALAMOUNT DUE $1 292.00
DATE QUE 02/28/2015
DETACH AND RETURN THiS PORTION WITH YOUR REMITTANCE $
--- ------------------------- --_�-------------------- -- ------------ --- ------------ ------ ------------------ AMOUNTREMITfED.
- -- ------- - ------ -
DATE DESCRIPTION RATE Daysl �HARGES CREDITS BALANCE
Units
BaCance Forward 1,348.00
ov31�15 PAYMENT RECENED -THANK YOU 1,404.00 -56.00
*** Residential Living ***
01/01/15 MNTHLY CHG CLEARFIELD 01/01-01/31 1,348.00 1.00 1,348.00 1,292.00
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Page 1
RESIDENT# CURRENT OVER 30 OVER 60 OVER 90 OVER 120 70TALAMOUNT DUE
20507 1,292.00 4.00 0.00 O.00 0.00 $1,292.00
RESIDENT NAME BEATRICE B. RUPERT N%A PB-0'
Please make check payable to Messiah Lifeways at Messiah Viltage.
A 1%finance charge may be assessed on accounts for which payment has not been received by the due date.
if you have any questions or concerns about your bill, please address them directly to Fiscal Services at 790-8220.